Medicaid Fee Schedule without Mods 200801

More documents

Recommendations

Info

PROC-CODE DESC MAC BEG END 35304 THROMBOENDARTERECTOMY, INCLUDING PATCH GRAFT, IF PERFORMED; TIBIOPERONEAL TRUNK $894.39 20070101 99999999 35305 THROMBOENDARTERECTOMY, INCLUDING PATCH GRAFT, IF PERFORMED; TIBIAL OR PERONEAL A $859.88 20070101 99999999 35306 THROMBOENDARTERECTOMY, INCLUDING PATCH GRAFT, IF PERFORMED; EACH ADDITIONAL TIBI $320.07 20070101 99999999 35311 THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT $1,281.64 20060701 99999999 35321 THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT $663.86 20060701 99999999 35331 THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT $1,090.09 20060701 99999999 35341 THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT $1,211.54 20060701 99999999 35351 THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT $989.98 20060701 99999999 35355 THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT $857.11 20060701 99999999 35361 THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT $1,186.34 20060701 99999999 35363 THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT $1,284.85 20060701 99999999 35371 THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT $647.88 20060701 99999999 35372 THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT $693.01 20060701 99999999 35381 THROMBOENDARTERECTOMY, WITH OR WITHOUT PATCH GRAFT $817.68 19990701 99999999 35390 REOPERATION, CAROTID, THROMBOENDARTERECTOMY, MORE THAN ONE MONTH AFTER ORIGINAL $141.70 20060701 99999999 35400 ANGIOSCOPY (NON-CORONARY VESSELS OR GRAFTS) DURING THERAPEUTIC INTERVENTION (LIS $142.16 20060701 99999999 35450 TRANSLUMINAL ANGIOPLASTY, INTRAOPERATIVE (SEPARATE PROCEDURE) $551.33 20060701 99999999 35452 TRANSLUMINAL ANGIOPLASTY, INTRAOPERATIVE (SEPARATE PROCEDURE) $328.35 20060701 99999999 35454 TRANSLUMINAL ANGIOPLASTY, INTRAOPERATIVE (SEPARATE PROCEDURE) $334.88 20060701 99999999 35456 TRANSLUMINAL ANGIOPLASTY, INTRAOPERATIVE (SEPARATE PROCEDURE) $406.43 20060701 99999999 35458 TRANSLUMINAL ANGIOPLASTY, INTRAOPERATIVE (SEPARATE PROCEDURE) $516.66 20060701 99999999 35459 TRANSLUMINAL ANGIOPLASTY, OPEN; TIBIOPERONEAL TRUNK AND BRANCHES $473.36 20060701 99999999 35460 TRANSLUMINAL ANGIOPLASTY, OPEN; VENOUS $271.37 20060701 99999999 35470 TRANSLUMINAL ANGIOPLASTY, PERCUTANEOUS; TIBIOPERONEAL TRUNK AND BRANCHES $460.89 20060701 99999999 35471 TRANSLUMINAL ANGIOPLASTY, PERCUTANEOUS; RENAL OR VISCERAL ARTERY $537.85 20060701 99999999 35472 TRANSLUMINAL ANGIOPLASTY, PERCUTANEOUS; AORTIC $303.22 20060701 99999999 35473 TRANSLUMINAL ANGIOPLASTY, PERCUTANEOUS; ILIAC $322.34 20060701 99999999 35474 TRANSLUMINAL ANGIOPLASTY, PERCUTANEOUS; FEMORAL- POPLITEAL $391.90 20060701 99999999 35475 TRANSLUMINAL ANGIOPLASTY, PERCUTANEOUS; BRACHIOCEPHALIC $488.29 20060701 99999999 35476 TRANSLUMINAL ANGIOPLASTY, PERCUTANEOUS; VENOUS $255.57 20060701 99999999 35480 TRANSLUMINAL PERIPHERAL ATHERECTOMY, OPEN; RENAL OR OTHER VISCERAL ARTERY $601.35 20060701 99999999 35481 TRANSLUMINAL PERIPHERAL ATHERECTOMY, OPEN; AORTIC $357.89 20060701 99999999 35482 TRANSLUMINAL PERIPHERAL ATHERECTOMY, OPEN; ILIAC $371.40 20060701 99999999 35483 TRANSLUMINAL PERIPHERAL ATHERECTOMY, OPEN; FEMORAL- POPLITEAL $447.95 20060701 99999999 35484 TRANSLUMINAL PERIPHERAL ATHERECTOMY, OPEN; BRACHIOCEPHALIC $547.08 20060701 99999999 35485 TRANSLUMINAL PERIPHERAL ATHERECTOMY, OPEN; TIBIOPERONEAL TRUNK AND BRANCHES $421.74 20060701 99999999 35490 TRANSLUMINAL PERIPHERAL ATHERECTOMY, PERCUTANEOUS; RENAL OR OTHER VISCERAL ARTER $592.78 20060701 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 154
PROC-CODE DESC MAC BEG END TRANSLUMINAL PERIPHERAL ATHERECTOMY, PERCUTANEOUS; 35491 AORTIC $341.52 20060701 99999999 35492 TRANSLUMINAL PERIPHERAL ATHERECTOMY, PERCUTANEOUS; ILIAC $363.09 20060701 99999999 35493 TRANSLUMINAL PERIPHERAL ATHERECTOMY, PERCUTANEOUS; FEMORAL-POPLITEAL $448.99 20060701 99999999 35494 TRANSLUMINAL PERIPHERAL ATHERECTOMY, PERCUTANEOUS; BRACHIOCEPHALIC $517.39 20060701 99999999 35495 TRANSLUMINAL PERIPHERAL ATHERECTOMY, PERCUTANEOUS; TIBIOPERONEAL TRUNK AND BRANC $426.15 20060701 99999999 35500 HARVEST OF UPPER EXTREMITY VEIN, ONE SEGMENT, FOR LOWER EXTREMITY BYPASS PROCEDU $247.21 20060701 99999999 35501 BYPASS GRAFT, WITH VEIN $1,004.08 20060701 99999999 35506 BYPASS GRAFT, WITH VEIN $1,052.45 20060701 99999999 35507 BYPASS GRAFT, WITH VEIN $1,027.69 19990701 99999999 35508 BYPASS GRAFT, WITH VEIN $1,003.10 20060701 99999999 35509 BYPASS GRAFT, WITH VEIN $982.25 20060701 99999999 35510 BYPASS GRAFT, WITH VEIN; CAROTID-BRACHIAL $820.97 20060701 99999999 35511 BYPASS GRAFT, WITH VEIN $795.90 20060701 99999999 35512 BYPASS GRAFT, WITH VEIN; SUBCLAVIAN-BRACHIAL $952.34 20060701 99999999 35515 BYPASS GRAFT, WITH VEIN $877.60 20060701 99999999 35516 BYPASS GRAFT, WITH VEIN $846.75 20060701 99999999 35518 BYPASS GRAFT, WITH VEIN $845.20 20060701 99999999 35521 BYPASS GRAFT, WITH VEIN $896.83 20060701 99999999 35522 BYPASS GRAFT, WITH VEIN; AXILLARY-BRACHIAL $924.60 20060701 99999999 35523 BYPASS GRAFT, WITH VEIN; BRACHIAL-ULNAR OR -RADIAL $378.03 20080101 99999999 35525 BYPASS GRAFT, WITH VEIN; BRACHIAL-BRACHIAL $882.43 20060701 99999999 35526 BYPASS GRAFT, WITH VEIN $1,066.15 20060701 99999999 35531 BYPASS GRAFT, WITH VEIN $1,286.53 20060701 99999999 35533 BYPASS GRAFT, WITH VEIN $1,102.79 20060701 99999999 35536 BYPASS GRAFT, WITH VEIN $1,207.67 20060701 99999999 35537 BYPASS GRAFT, WITH VEIN; AORTOILIAC $1,510.87 20070101 99999999 35538 BYPASS GRAFT, WITH VEIN; AORTOBI-ILIAC $1,687.18 20070101 99999999 35539 BYPASS GRAFT, WITH VEIN; AORTOFEMORAL $1,585.78 20070101 99999999 35540 BYPASS GRAFT, WITH VEIN; AORTOBIFEMORAL $1,766.72 20070101 99999999 35541 BYPASS GRAFT, WITH VEIN $1,276.73 19990701 99999999 35546 BYPASS GRAFT, WITH VEIN $1,291.19 19990701 99999999 35548 BYPASS GRAFT, WITH VEIN $1,121.57 20060701 99999999 35549 BYPASS GRAFT, WITH VEIN $1,218.06 20060701 99999999 35551 BYPASS GRAFT, WITH VEIN $1,295.70 20060701 99999999 35556 BYPASS GRAFT, WITH VEIN $1,114.89 20060701 99999999 35558 BYPASS GRAFT, WITH VEIN $785.97 20060701 99999999 35560 BYPASS GRAFT, WITH VEIN $1,213.63 20060701 99999999 35563 BYPASS GRAFT, WITH VEIN $882.48 20060701 99999999 35565 BYPASS GRAFT, WITH VEIN $846.00 20060701 99999999 35566 BYPASS GRAFT, WITH VEIN $1,380.82 20060701 99999999 35571 BYPASS GRAFT, WITH VEIN $1,038.64 20060701 99999999 35572 HARVEST OF FEMOROPOPLITEAL VEIN, ONE SEGMENT, FOR VASCULAR RECONSTRUCTION PROCED $270.51 20060701 99999999 35582 IN-SITU VEIN BYPASS $1,383.71 19990701 99999999 35583 IN-SITU VEIN BYPASS $1,181.10 20060701 99999999 35585 IN-SITU VEIN BYPASS $1,455.32 20060701 99999999 35587 IN-SITU VEIN BYPASS $1,097.42 20060701 99999999 35600 HARVEST OF UPPER EXTREMITY ARTERY, ONE SEGMENT, FOR CORONARY ARTERY BYPASS PROCE $199.67 20060701 99999999 35601 BYPASS GRAFT, WITH OTHER THAN VEIN $961.32 20060701 99999999 35606 BYPASS GRAFT, WITH OTHER THAN VEIN $985.94 20060701 99999999 35612 BYPASS GRAFT, WITH OTHER THAN VEIN $867.84 20060701 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 155
Page 1 and 2:
PROC-CODE DESC MAC BEG END A0130 NO
Page 3 and 4:
PROC-CODE DESC MAC BEG END A4355 3-
Page 5 and 6:
PROC-CODE DESC MAC BEG END A4431 OS
Page 7 and 8:
PROC-CODE DESC MAC BEG END A5093 OS
Page 9 and 10:
PROC-CODE DESC MAC BEG END A6231 GA
Page 11 and 12:
PROC-CODE DESC MAC BEG END A6452 HI
Page 13 and 14:
PROC-CODE DESC MAC BEG END A7504 FI
Page 15 and 16:
PROC-CODE DESC MAC BEG END ENTERAL
Page 17 and 18:
PROC-CODE DESC MAC BEG END D4210 GI
Page 19 and 20:
PROC-CODE DESC MAC BEG END D7911 SU
Page 21 and 22:
PROC-CODE DESC MAC BEG END E0248 TR
Page 23 and 24:
PROC-CODE DESC MAC BEG END E0580 NE
Page 25 and 26:
PROC-CODE DESC MAC BEG END E0911 TR
Page 27 and 28:
PROC-CODE DESC MAC BEG END E1085 HE
Page 29 and 30:
PROC-CODE DESC MAC BEG END E1638 HE
Page 31 and 32:
PROC-CODE DESC MAC BEG END E2324 PO
Page 33 and 34:
PROC-CODE DESC MAC BEG END E2605 PO
Page 35 and 36:
PROC-CODE DESC MAC BEG END G0091 IN
Page 37 and 38:
PROC-CODE DESC MAC BEG END G0206 DI
Page 39 and 40:
PROC-CODE DESC MAC BEG END K0032 SE
Page 41 and 42:
PROC-CODE DESC MAC BEG END K0130 FO
Page 43 and 44:
PROC-CODE DESC MAC BEG END K0240 HY
Page 45 and 46:
PROC-CODE DESC MAC BEG END K0529 ST
Page 47 and 48:
PROC-CODE DESC MAC BEG END K0822 PO
Page 49 and 50:
PROC-CODE DESC MAC BEG END L0350 TL
Page 51 and 52:
PROC-CODE DESC MAC BEG END L0633 LU
Page 53 and 54:
PROC-CODE DESC MAC BEG END L1685 HO
Page 55 and 56:
PROC-CODE DESC MAC BEG END L2106 AF
Page 57 and 58:
PROC-CODE DESC MAC BEG END L2670 AD
Page 59 and 60:
PROC-CODE DESC MAC BEG END L3420 FU
Page 61 and 62:
PROC-CODE DESC MAC BEG END L3906 WH
Page 63 and 64:
PROC-CODE DESC MAC BEG END L4110 RE
Page 65 and 66:
PROC-CODE DESC MAC BEG END L5622 AD
Page 67 and 68:
PROC-CODE DESC MAC BEG END L5701 AL
Page 69 and 70:
PROC-CODE DESC MAC BEG END L5981 AL
Page 71 and 72:
PROC-CODE DESC MAC BEG END L6646 UP
Page 73 and 74:
PROC-CODE DESC MAC BEG END L6915 HA
Page 75 and 76:
PROC-CODE DESC MAC BEG END L8170 EL
Page 77 and 78:
PROC-CODE DESC MAC BEG END M0728 EX
Page 79 and 80:
PROC-CODE DESC MAC BEG END Q4047 CA
Page 81 and 82:
PROC-CODE DESC MAC BEG END V2522 CO
Page 83 and 84:
PROC-CODE DESC MAC BEG END W9801 QU
Page 85 and 86:
PROC-CODE DESC MAC BEG END 00530 AN
Page 87 and 88:
Page 89 and 90:
Page 91 and 92:
Page 93 and 94:
Page 95 and 96:
PROC-CODE DESC MAC BEG END 11443 EX
Page 97 and 98:
PROC-CODE DESC MAC BEG END 12056 LA
Page 99 and 100:
PROC-CODE DESC MAC BEG END 15341 TI
Page 101 and 102:
PROC-CODE DESC MAC BEG END 15934 EX
Page 103 and 104: PROC-CODE DESC MAC BEG END 19110 NI
Page 105 and 106: PROC-CODE DESC MAC BEG END 20612 AS
Page 107 and 108: PROC-CODE DESC MAC BEG END 21100 AP
Page 109 and 110: PROC-CODE DESC MAC BEG END 21310 TR
Page 111 and 112: PROC-CODE DESC MAC BEG END 21920 BI
Page 113 and 114: PROC-CODE DESC MAC BEG END 22844 PO
Page 119 and 120: PROC-CODE DESC MAC BEG END 25316 FL
Page 121 and 122: PROC-CODE DESC MAC BEG END 26010 DR
Page 123 and 124: PROC-CODE DESC MAC BEG END 26530 AR
Page 125 and 126: PROC-CODE DESC MAC BEG END 27067 EX
Page 129 and 130: PROC-CODE DESC MAC BEG END 27513 OP
Page 133 and 134: PROC-CODE DESC MAC BEG END 28200 RE
Page 135 and 136: PROC-CODE DESC MAC BEG END 28636 PE
Page 139 and 140: PROC-CODE DESC MAC BEG END 30801 CA
Page 141 and 142: PROC-CODE DESC MAC BEG END 31560 LA
Page 143 and 144: PROC-CODE DESC MAC BEG END 32310 PL
Page 153: PROC-CODE DESC MAC BEG END 35102 DI
Page 159 and 160: PROC-CODE DESC MAC BEG END 36555 IN
Page 161 and 162: PROC-CODE DESC MAC BEG END 37188 PE
Page 167 and 168: PROC-CODE DESC MAC BEG END 42836 AD
Page 169 and 170: PROC-CODE DESC MAC BEG END 43260 EN
Page 175 and 176: PROC-CODE DESC MAC BEG END 45114 PR
Page 177 and 178: PROC-CODE DESC MAC BEG END 46221 HE
Page 185 and 186: PROC-CODE DESC MAC BEG END 50393 IN
Page 187 and 188: PROC-CODE DESC MAC BEG END 50940 DE
Page 189 and 190: PROC-CODE DESC MAC BEG END 51920 CL
Page 191 and 192: PROC-CODE DESC MAC BEG END 52647 NO
Page 193 and 194: PROC-CODE DESC MAC BEG END 54162 LY
Page 195 and 196: PROC-CODE DESC MAC BEG END 55110 SC
Page 197 and 198: PROC-CODE DESC MAC BEG END 56353 HY
Page 199 and 200: PROC-CODE DESC MAC BEG END 57310 CL
Page 205 and 206:
PROC-CODE DESC MAC BEG END 61026 VE
Page 207 and 208:
PROC-CODE DESC MAC BEG END 61576 TR
Page 209 and 210:
PROC-CODE DESC MAC BEG END 61865 CR
Page 211 and 212:
PROC-CODE DESC MAC BEG END 62360 IM
Page 213 and 214:
PROC-CODE DESC MAC BEG END 63270 LA
Page 215 and 216:
PROC-CODE DESC MAC BEG END 64479 IN
Page 217 and 218:
PROC-CODE DESC MAC BEG END 64837 SU
Page 219 and 220:
PROC-CODE DESC MAC BEG END 65870 SE
Page 221 and 222:
PROC-CODE DESC MAC BEG END 67225 DE
Page 223 and 224:
PROC-CODE DESC MAC BEG END 68320 CO
Page 225 and 226:
PROC-CODE DESC MAC BEG END 69643 TY
Page 227 and 228:
PROC-CODE DESC MAC BEG END 70542 MA
Page 229 and 230:
PROC-CODE DESC MAC BEG END 72200 RA
Page 231 and 232:
Page 233 and 234:
PROC-CODE DESC MAC BEG END 75822 VE
Page 235 and 236:
Page 237 and 238:
PROC-CODE DESC MAC BEG END 76938 UL
Page 239 and 240:
Page 241 and 242:
PROC-CODE DESC MAC BEG END 78261 GA
Page 243 and 244:
Page 245 and 246:
PROC-CODE DESC MAC BEG END 82000 AC
Page 247 and 248:
Page 249 and 250:
PROC-CODE DESC MAC BEG END 83015 HE
Page 251 and 252:
PROC-CODE DESC MAC BEG END 83903 MO
Page 253 and 254:
PROC-CODE DESC MAC BEG END 84425 TH
Page 255 and 256:
PROC-CODE DESC MAC BEG END 85370 FI
Page 257 and 258:
PROC-CODE DESC MAC BEG END 86343 LE
Page 259 and 260:
Page 261 and 262:
PROC-CODE DESC MAC BEG END 87206 SM
Page 263 and 264:
Page 265 and 266:
Page 267 and 268:
PROC-CODE DESC MAC BEG END 88184 FL
Page 269 and 270:
PROC-CODE DESC MAC BEG END 89140 GA
Page 271 and 272:
PROC-CODE DESC MAC BEG END 90734 ME
Page 273 and 274:
PROC-CODE DESC MAC BEG END 90847 FA
Page 275 and 276:
PROC-CODE DESC MAC BEG END 92250 OP
Page 277 and 278:
PROC-CODE DESC MAC BEG END 92602 DI
Page 279 and 280:
PROC-CODE DESC MAC BEG END 93237 EL
Page 281 and 282:
Page 283 and 284:
PROC-CODE DESC MAC BEG END 94016 PA
Page 285 and 286:
PROC-CODE DESC MAC BEG END 95811 PO
Page 287 and 288:
Page 289 and 290:
PROC-CODE DESC MAC BEG END 97022 PH
Page 291 and 292:
PROC-CODE DESC MAC BEG END 99214 OF
Page 293 and 294:
PROC-CODE DESC MAC BEG END 99307 SU
Page 295:
PROC-CODE DESC MAC BEG END 99440 NE
show all

Medicaid Fee Schedule without Mods 200801

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?