Medicaid Fee Schedule without Mods 200801

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PROC-CODE DESC MAC BEG END 31643 BRONCHOSCOPY; WITH PLACEMENT OF CATHETER(S) FOR INTRACAVITARY RADIOELEMENT APPLI $177.88 20060701 99999999 31645 BRONCHOSCOPY $169.64 20060701 99999999 31646 BRONCHOSCOPY $138.51 20060701 99999999 31656 BRONCHOSCOPY $109.20 20060701 99999999 31700 CATHETERIZATION, TRANSGLOTTIC (SEPARATE PROCEDURE) $66.58 20030401 99999999 31708 INSTILLATION OF CONTRAST MATERIAL FOR LARYNGOGRAPHY $58.26 19990701 99999999 31710 CATHETERIZATION FOR BRONCHOGRAPHY, WITH OR WITHOUT INSTILLATION $56.98 19990701 99999999 31715 TRANSTRACHEAL INJECTION FOR BRONCHOGRAPHY $43.00 20060701 99999999 31717 CATHETERIZATION WITH BRONCHIAL BRUSH BIOPSY $80.55 20060701 99999999 31720 CATHETER ASPIRATION (SEPARATE PROCEDURE) $47.17 20060701 99999999 31725 CATHETER ASPIRATION (SEPARATE PROCEDURE) $87.57 20060701 99999999 31730 TRANSTRACHEAL (PERCUTANEOUS) INTRODUCTION OF NEEDLE WIRE DILATOR/ STENT OR INDWE $136.14 20060701 99999999 31750 TRACHEOPLASTY $760.80 20060701 99999999 31755 TRACHEOPLASTY $1,008.25 20060701 99999999 31760 TRACHEOPLASTY $1,046.30 20060701 99999999 31766 CARINAL RECONSTRUCTION $1,469.78 20060701 99999999 31770 BRONCHOPLASTY $1,164.52 20060701 99999999 31775 BRONCHOPLASTY $1,266.99 20060701 99999999 31780 EXCISION TRACHEAL STENOSIS AND ANASTOMOSIS $1,020.72 20060701 99999999 31781 EXCISION TRACHEAL STENOSIS AND ANASTOMOSIS $1,240.35 20060701 99999999 31785 EXCISION OF TRACHEAL TUMOR OR CARCINOMA $843.72 20060701 99999999 31786 EXCISION OF TRACHEAL TUMOR OR CARCINOMA $1,193.33 20060701 99999999 31800 SUTURE OF EXTERNAL TRACHEAL WOUND OR INJURY $418.12 20060701 99999999 31805 SUTURE OF EXTERNAL TRACHEAL WOUND OR INJURY $758.25 20060701 99999999 31820 SURGICAL CLOSURE TRACHEOSTOMY OR FISTULA $300.69 20060701 99999999 31825 SURGICAL CLOSURE TRACHEOSTOMY OR FISTULA $430.82 20060701 99999999 31830 REVISION OF TRACHEOSTOMY SCAR $301.77 20060701 99999999 32000 THORACENTESIS, PUNCTURE OF PLEURAL CAVITY FOR ASPIRATION, $57.25 20030401 99999999 32001 TOTAL LUNG LAVAGE (UNILATERAL) $245.30 19990701 99999999 32002 THORACENTESIS W/INSERTION OF TUBE W/WO WATER SEAL(SEP PROC) $93.44 19990701 99999999 32005 CHEMICAL PLEURODESIS (EG, FOR RECURRENT OR PERSISTENT $92.71 19990701 99999999 32019 INSERTION OF INDWELLING TUNNELED PLEURAL CATHETER WITH CUFF $173.40 20050101 99999999 32020 TUBE THORACOSTOMY WITH OR WITHOUT WATER SEAL (EG, PNEUMOTHORAX, $180.76 19990701 99999999 32035 THORACOSTOMY $533.31 20060701 99999999 32036 THORACOSTOMY $588.97 20060701 99999999 32095 THORACOTOMY LIMITED, FOR BIOPSY OF LUNG OR PLEURA $554.58 20060701 99999999 32100 THORACOTOMY, MAJOR $727.19 20060701 99999999 32110 THORACOTOMY, MAJOR $855.13 20060701 99999999 32120 THORACOTOMY, MAJOR $698.40 20060701 99999999 32124 THORACOTOMY, MAJOR $739.32 20060701 99999999 32140 THORACOTOMY, MAJOR $832.24 20060701 99999999 32141 THORACOTOMY, MAJOR $819.06 20060701 99999999 32150 THORACOTOMY, MAJOR $789.52 20060701 99999999 32151 THORACOTOMY, MAJOR $792.66 20060701 99999999 32160 THORACOTOMY, MAJOR $544.77 20060701 99999999 32200 PNEUMONOSTOMY, WITH OPEN DRAINAGE OF ABSCESS OR CYST $720.30 20060701 99999999 32201 PNEUMONOSTOMY; WITH PERCUTANEOUS DRAINAGE OF ABSCESS OR CYST $210.24 20060701 99999999 32215 PLEURAL SCARIFICATION FOR REPEAT PNEUMOTHORAX $662.49 20060701 99999999 32220 DECORTICATION, PULMONARY, (SEPARATE PROCEDURE) $1,082.94 20060701 99999999 32225 DECORTICATION, PULMONARY, (SEPARATE PROCEDURE) $819.89 20060701 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 142
PROC-CODE DESC MAC BEG END 32310 PLEURECTOMY $789.60 20060701 99999999 32320 DECORTICATION AND PARIETAL PLEURECTOMY $1,151.20 20060701 99999999 32400 BIOPSY, PLEURA $81.43 20060701 99999999 32402 BIOPSY, PLEURA $522.86 20060701 99999999 32405 BIOPSY, LUNG OR MEDIASTINUM, PERCUTANEOUS NEEDLE $97.07 20060701 99999999 32420 PNEUMONOCENTESIS, PUNCTURE OF LUNG FOR ASPIRATION $95.42 20060701 99999999 32421 THORACENTESIS, PUNCTURE OF PLEURAL CAVITY FOR ASPIRATION, INITIAL OR SUBSEQUENT $39.92 20080101 99999999 32422 THORACENTESIS WITH INSERTION OF TUBE, INCLUDES WATER SEAL (EG, FOR PNEUMOTHORAX) $65.65 20080101 99999999 32440 PNEUMONECTOMY, TOTAL $1,183.81 20060701 99999999 32442 REMOVAL OF LUNG, TOTAL PNEUMONECTOMY; WITH RESECTION OF SEGMENT OF TRACHEA FOLLO $1,335.44 20060701 99999999 32445 PNEUMONECTOMY, EXTRAPLEURAL $1,342.20 20060701 99999999 32480 LOBECTOMY, TOTAL OR SEGMENTAL $1,046.59 20060701 99999999 32482 REMOVAL OF LUNG, OTHER THAN TOTAL PNEUMONECTOMY; TWO LOBES (BILOBECTOMY) $1,104.21 20060701 99999999 32484 REMOVAL OF LUNG, OTHER THAN TOTAL PNEUMONECTOMY; SINGLE SEGMENT (SEGMENTECTOMY) $1,139.00 20060701 99999999 32486 REMOVAL OF LUNG, OTHER THAN TOTAL PNEUMONECTOMY; WITH CIRCUMFERENTIAL RESECTION $1,264.00 20060701 99999999 32488 REMOVAL OF LUNG, OTHER THAN TOTAL PNEUMONECTOMY; ALL REMAINING LUNG FOLLOWING PR $1,339.81 20060701 99999999 32491 EXCISION-PLICATION OF EMPHYSEMATOUS LUNG(S) (BULLOUS OR NON -BULLOUS FOR LUNG VO $1,143.50 20060701 99999999 32500 WEDGE RESECTION OF LUNG, SINGLE OR MULTIPLE $874.18 20060701 99999999 32501 RESECTION AND REPAIR OF PORTION OF BRONCHUS (BRONCHOPLASTY) WHEN PERFORMED AT TI $239.01 20060701 99999999 32503 RESECTION OF APICAL LUNG TUMOR (EG, PANCOAST TUMOR), INCLUDING CHEST WALL RESECT $1,277.16 20060701 99999999 32504 RESECTION OF APICAL LUNG TUMOR (EG, PANCOAST TUMOR), INCLUDING CHEST WALL RESECT $1,458.81 20060701 99999999 32520 RESECTION OF LUNG $1,248.92 19990701 99999999 32522 RESECTION OF LUNG $1,353.45 19990701 99999999 32525 RESECTION OF LUNG $1,455.42 19990701 99999999 32540 EXTRAPLEURAL ENUCLEATION OF EMPYEMA (EMPYEMECTOMY) $844.83 20060701 99999999 32550 INSERTION OF INDWELLING TUNNELED PLEURAL CATHETER WITH CUFF $112.08 20080101 99999999 32551 TUBE THORACOSTOMY, INCLUDES WATER SEAL (EG, FOR ABSCESS, HEMOTHORAX, EMPYEMA), W $92.62 20080101 99999999 32560 CHEMICAL PLEURODESIS (EG, FOR RECURRENT OR PERSISTENT PNEUMOTHORAX) $57.74 20080101 99999999 32601 THORACOSCOPY, DIAGNOSTIC (SEPARATE PROCEDURE); LUNGS AND PLEURAL SPACE, WITHOUT $292.36 20060701 99999999 32602 THORACOSCOPY, DIAGNOSTIC (SEPARATE PROCEDURE); LUNGS AND PLEURAL SPACE, WITH BIO $316.68 20060701 99999999 32603 THORACOSCOPY, DIAGNOSTIC (SEPARATE PROCEDURE); PERICARDIAL SAC, WITHOUT BIOPSY $371.66 20060701 99999999 32604 THORACOSCOPY, DIAGNOSTIC (SEPARATE PROCEDURE); PERICARDIAL SAC, WITH BIOPSY $420.39 20060701 99999999 32605 THORACOSCOPY, DIAGNOSTIC (SEPARATE PROCEDURE); MEDIASTINAL SPACE, WITHOUT BIOPSY $351.15 20060701 99999999 32606 THORACOSCOPY, DIAGNOSTIC (SEPARATE PROCEDURE); MEDIASTINAL SPACE, WITH BIOPSY $404.02 20060701 99999999 32650 THORACOSCOPY, SURGICAL; WITH PLEURODESIS, ANY METHOD $618.26 20060701 99999999 32651 THORACOSCOPY, SURGICAL; WITH PARTIAL PULMONARY DECORTICATION $754.11 20060701 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 143
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