Medicaid Fee Schedule without Mods 200801
Medicaid Fee Schedule without Mods 200801
Medicaid Fee Schedule without Mods 200801
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PROC-CODE DESC MAC BEG END<br />
27640 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR $732.60 20060701 99999999<br />
27641 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR $602.73 20060701 99999999<br />
27645 RESECTION FOR TUMOR, RADICAL $844.88 20060701 99999999<br />
27646 RESECTION FOR TUMOR, RADICAL $789.95 20060701 99999999<br />
27647 RESECTION FOR TUMOR, RADICAL $673.88 20060701 99999999<br />
27648 INJECTION PROCEDURE FOR ANKLE ARTHROGRAPHY $39.92 20060701 99999999<br />
27650<br />
REPAIR, PRIMARY, OPEN OR PERCUTANEOUS, RUPTURED ACHILLES<br />
TENDON $563.24 20060701 99999999<br />
27652<br />
REPAIR, PRIMARY, OPEN OR PERCUTANEOUS, RUPTURED ACHILLES<br />
TENDON $606.10 20060701 99999999<br />
27654 REPAIR, SECONDARY, RUPTURED ACHILLES TENDON, $609.96 20060701 99999999<br />
27656 REPAIR, FASCIAL DEFECT OF LEG $281.61 20060701 99999999<br />
27658 REPAIR OR SUTURE OF FLEXOR TENDON OF LEG $329.70 20060701 99999999<br />
27659 REPAIR OR SUTURE OF FLEXOR TENDON OF LEG $422.47 20060701 99999999<br />
27664 REPAIR OR SUTURE OF EXTENSOR TENDON OF LEG $307.34 20060701 99999999<br />
27665 REPAIR OR SUTURE OF EXTENSOR TENDON OF LEG $365.90 20060701 99999999<br />
27675 REPAIR FOR DISLOCATING PERONEAL TENDONS $425.80 20060701 99999999<br />
27676 REPAIR FOR DISLOCATING PERONEAL TENDONS $494.61 20060701 99999999<br />
27680 TENOLYSIS, INCLUDING TIBIA, FIBULA AND ANKLE FLEXOR $339.55 20060701 99999999<br />
27681 TENOLYSIS, INCLUDING TIBIA, FIBULA AND ANKLE FLEXOR $411.71 20060701 99999999<br />
27685 LENGTHENING OR SHORTENING OF TENDON, LEG OR ANKLE $365.66 20060701 99999999<br />
27686 LENGTHENING OR SHORTENING OF TENDON, LEG OR ANKLE $459.37 20060701 99999999<br />
27687 GASTROCNEMIUS RECESSION (EG, STRAYER PROCEDURE) $383.46 20060701 99999999<br />
27690 TRANSFER OR TRANSPLANT OF SINGLE TENDON (WITH MUSCLE $489.33 20060701 99999999<br />
27691 TRANSFER OR TRANSPLANT OF SINGLE TENDON (WITH MUSCLE $575.65 20060701 99999999<br />
27692 TRANSFER OR TRANSPLANT OF SINGLE TENDON (WITH MUSCLE $102.31 20060701 99999999<br />
27695 SUTURE, PRIMARY, TORN, RUPTURED OR SEVERED LIGAMENT, $430.99 20060701 99999999<br />
27696 SUTURE, PRIMARY, TORN, RUPTURED OR SEVERED LIGAMENT, $492.11 20060701 99999999<br />
27698 SUTURE, SECONDARY REPAIR, TORN, RUPTURED OR SEVERED $573.94 20060701 99999999<br />
27700 ARTHROPLASTY, ANKLE $542.19 20060701 99999999<br />
27702 ARTHROPLASTY, ANKLE $830.46 20060701 99999999<br />
27703 ARTHROPLASTY, ANKLE $862.38 20060701 99999999<br />
27704 REMOVAL OF ANKLE IMPLANT $443.11 20060701 99999999<br />
27705 OSTEOTOMY $640.92 20060701 99999999<br />
27707 OSTEOTOMY $318.71 20060701 99999999<br />
27709 OSTEOTOMY $628.29 20060701 99999999<br />
27712 OSTEOTOMY $791.47 20060701 99999999<br />
27715 OSTEOPLASTY, TIBIA AND FIBULA, LENGTHENING $831.90 20060701 99999999<br />
27720 REPAIR OF NONUNION OR MALUNION, TIBIA $897.06 20060701 99999999<br />
27722 REPAIR OF NONUNION OR MALUNION, TIBIA $697.86 20060701 99999999<br />
27724 REPAIR OF NONUNION OR MALUNION, TIBIA $911.50 20060701 99999999<br />
27725 REPAIR OF NONUNION OR MALUNION, TIBIA $844.40 20060701 99999999<br />
27726<br />
REPAIR OF FIBULA NONUNION AND/OR MALUNION WITH INTERNAL<br />
FIXATION $455.21 <strong>200801</strong>01 99999999<br />
27727 REPAIR OF CONGENITAL PSEUDARTHROSIS, TIBIA $756.14 20060701 99999999<br />
27730 EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING $408.16 20060701 99999999<br />
27732 EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING $341.04 20060701 99999999<br />
27734 EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING $497.01 20060701 99999999<br />
27740 EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING, $544.44 20060701 99999999<br />
27742 EPIPHYSEAL ARREST BY EPIPHYSIODESIS OR STAPLING, $591.57 20060701 99999999<br />
27745 PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING OR WIRING) $610.87 20060701 99999999<br />
27750 TREATMENT OF CLOSED TIBIAL SHAFT FRACTURE $205.49 20060701 99999999<br />
27752 TREATMENT OF CLOSED TIBIAL SHAFT FRACTURE $341.45 20060701 99999999<br />
27756 OPEN TREATMENT OF CLOSED OR OPEN TIBIAL SHAFT $464.49 20060701 99999999<br />
27758 OPEN TREATMENT OF CLOSED OR OPEN TIBIAL SHAFT $726.16 20060701 99999999<br />
27759<br />
OPEN TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT<br />
FIBULAR FRACTURE) BY IN $819.11 20060701 99999999<br />
Hawaii <strong>Medicaid</strong> <strong>Fee</strong> <strong>Schedule</strong> <strong>without</strong> <strong>Mods</strong> 01/2008 130