Medicaid Fee Schedule without Mods 200801

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PROC-CODE DESC MAC BEG END 36597 REPOSITIONING OF PREVIOUSLY PLACED CENTRAL VENOUS CATHETER UNDER FLUOROSCOPIC GU $44.70 20060701 99999999 36598 CONTRAST INJECTION(S) FOR RADIOLOGIC EVALUATION OF EXISTING CENTRAL VENOUS ACCES $93.80 20060701 99999999 36600 ARTERIAL PUNCTURE, WITHDRAWAL OF BLOOD FOR DIAGNOSIS $15.16 20060701 99999999 36620 ARTERIAL CATHETERIZATION OR CANNULATION FOR $47.24 20060701 99999999 36625 ARTERIAL CATHETERIZATION OR CANNULATION FOR $82.56 20060701 99999999 36640 ARTERIAL CATHETERIZATION FOR PROLONGED INFUSION THERAPY $111.18 20060701 99999999 36660 CATHETERIZATION, UMBILICAL ARTERY, NEWBORN, FOR DIAGNOSIS OR $53.88 20060701 99999999 36680 PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION $61.78 20060701 99999999 36800 INSERTION OF CANNULA FOR HEMODIALYSIS, OTHER PURPOSE $131.27 20060701 99999999 36810 INSERTION OF CANNULA FOR HEMODIALYSIS, OTHER PURPOSE $222.78 20060701 99999999 36815 INSERTION OF CANNULA FOR HEMODIALYSIS, OTHER PURPOSE $153.06 20060701 99999999 36818 ARTERIOVENOUS ANASTOMOSIS, OPEN; BY UPPER ARM CEPHALIC VEIN TRANSPOSITION $539.64 20060701 99999999 36819 ARTERIOVENOUS ANASTOMOSIS, OPEN; BY BASILIC VEIN TRANSPOSITION $614.70 20060701 99999999 36820 INSERTION OF CANNULA FOR HEMODIALYSIS, OTHER PURPOSE $589.23 20060701 99999999 36821 ARTERIOVENOUS ANASTOMOSIS, DIRECT, ANY SITE $556.23 20060701 99999999 36822 INSERTION OF CANNULA(S) FOR PROLONGED EXTRACORPOREAL CIRCULATION $413.24 20060701 99999999 36823 INSERTION OF ARTERIAL AND VENOUS CANNULA(S) FOR ISOLATED EXTRACORPOREAL CIRCULAT $904.49 20060701 99999999 36825 CREATION OF ARTERIOVENOUS FISTULA $560.04 20060701 99999999 36830 CREATION OF ARTERIOVENOUS FISTULA $718.23 20060701 99999999 36831 THROMBECTOMY, ARTERIOVENOUS FISTULA WITHOUT REVISION, AUTOGENOUS OR NONAUTOGENOU $417.83 20060701 99999999 36832 REVIS OF ARTERIOVENOUS FISTULA W/WO THROMBECTOMY AUTOGENOUS $611.77 20060701 99999999 36833 REVISION, ARTERIOVENOUS FISTULA; WITH THROMBECTOMY, AUTOGENOUS OR NONAUTOGENOUS $642.67 20060701 99999999 36834 PLASTIC REPAIR OF ARTERIOVENOUS ANEURYSM (SEPARATE PROCEDURE) $483.96 20060701 99999999 36835 INSERTION OF THOMAS SHUNT $344.20 20060701 99999999 36838 DISTAL REVASCULARIZATION AND INTERVAL LIGATION (DRIL), UPPER EXTREMITY HEMODIALY $902.28 20060701 99999999 36860 CANNULA DECLOTTING $109.31 20060701 99999999 36861 CANNULA DECLOTTING $142.93 20060701 99999999 36870 THROMBECTOMY, PERCUTANEOUS, ARTERIOVENOUS FISTULA, AUTOGENOUS OR NONAUTOGENOUS G $295.12 20060701 99999999 37140 ANASTOMOSIS $1,059.21 20060701 99999999 37145 ANASTOMOSIS $1,108.27 20060701 99999999 37160 ANASTOMOSIS $1,072.45 20060701 99999999 37180 ANASTOMOSIS $1,119.18 20060701 99999999 37181 ANASTOMOSIS $1,217.26 20060701 99999999 37182 INSERTION OF TRANSVENOUS INTRAHEPATIC PORTOSYSTEMIC SHUNT(S) (TIPS) (INCLUDES VE $671.45 20060701 99999999 37183 REVISION OF TRANSVENOUS INTRAHEPATIC PORTOSYSTEMIC SHUNT(S) (TIPS) (INCLUDES VEN $313.63 20060701 99999999 37184 PRIMARY PERCUTANEOUS TRANSLUMINAL MECHANICAL THROMBECTOMY, NONCORONARY, ARTERIAL $326.07 20060701 99999999 37185 PRIMARY PERCUTANEOUS TRANSLUMINAL MECHANICAL THROMBECTOMY, NONCORONARY, ARTERIAL $118.97 20060701 99999999 37186 SECONDARY PERCUTANEOUS TRANSLUMINAL THROMBECTOMY (EG, NONPRIMARY MECHANICAL, SNA $178.40 20060701 99999999 37187 PERCUTANEOUS TRANSLUMINAL MECHANICAL THROMBECTOMY, VEIN(S), INCLUDING INTRAPROCE $303.32 20060701 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 160
PROC-CODE DESC MAC BEG END 37188 PERCUTANEOUS TRANSLUMINAL MECHANICAL THROMBECTOMY, VEIN(S), INCLUDING INTRAPROCE $219.50 20060701 99999999 37195 THROMBOLYSIS, CEREBRAL, BY INTRAVENOUS INFUSION $265.85 19990701 99999999 37200 TRANSCATHETER BIOPSY $173.66 20060701 99999999 37201 TRANSCATHETER THERAPY, INFUSION FOR THROMBOLYSIS OTHER THAN CORONARY $263.51 20060701 99999999 37202 TRANSCATHETER THERAPY, INFUSION OTHER THAN FOR THROMBOLYSIS, ANY TYPE (EG, SPASM $288.12 20060701 99999999 37203 TRANSCATHETER RETRIEVAL, PERCUTANEOUS, OF INTRAVASCULAR FOREIGN BODY (EG, FRACTU $236.55 20060701 99999999 37204 TRANSCATHETER OCCLUSION OR EMBOLIZATION (EG, FOR TUMOR DESTRUCTION, TO ACHIEVE H $930.12 20060701 99999999 37205 TRANSCATHETER PLACEMENT OF AN INTRAVASCULAR STENT(S), (NON-CORONARY VESSEL), PER $373.52 20060701 99999999 37206 TRANSCATHETER PLACEMENT OF AN INTRAVASCULAR STENT(S), (NON-CORONARY VESSEL), PER $182.20 20060701 99999999 37207 TRANSCATHETER PLACEMENT OF AN INTRAVASCULAR STENT(S), (NON-CORONARY VESSEL), OPE $388.19 20060701 99999999 37208 TRANSCATHETER PLACEMENT OF AN INTRAVASCULAR STENT(S), (NON-CORONARY VESSEL), OPE $188.96 20060701 99999999 37209 EXCHANGE OF A PREVIOUSLY PLACED ARTERIAL CATHETER DURING THROMBOLYTIC THERAPY $97.11 20060701 99999999 37210 UTERINE FIBROID EMBOLIZATION (UFE, EMBOLIZATION OF THE UTERINE ARTERIES TO TREAT $359.02 20070101 99999999 37215 TRANSCATHETER PLACEMENT OF INTRAVASCULAR STENT(S), CERVICAL CAROTID ARTERY, $812.13 20060701 99999999 37216 TRANSCATHETER PLACEMENT OF INTRAVASCULAR STENT(S), CERVICAL CAROTID ARTERY, $782.55 20060701 99999999 37250 INTRASVASCULAR ULTRASOUND (NON-CORONARY VESSEL) DURING THERAPEUTIC INTERVENTION $94.03 20060701 99999999 37251 INTRASVASCULAR ULTRASOUND (NON-CORONARY VESSEL) DURING THERAPEUTIC INT EACH ADDL $71.82 20060701 99999999 37500 PHLEBORRHAPHY, SUTURE OF MAJOR VEIN, WOUND OR INJURY $452.48 20060701 99999999 37565 LIGATION OF INTERNAL JUGULAR VEIN $414.85 20060701 99999999 37600 LIGATION $450.28 20060701 99999999 37605 LIGATION $509.97 20060701 99999999 37606 LIGATION $361.85 20060701 99999999 37607 LIGATION OR BANDING OF ANGIOACCESS ARTERIOVENOUS FISTULA $288.88 20060701 99999999 37609 LIGATION OR BIOPSY, TEMPORAL ARTERY $137.46 20060701 99999999 37615 LIGATION, MAJOR ARTERY (EG, POST-TRAUMATIC, RUPTURE) $319.71 20060701 99999999 37616 LIGATION, MAJOR ARTERY (EG, POST-TRAUMATIC, RUPTURE) $756.33 20060701 99999999 37617 LIGATION, MAJOR ARTERY (EG, POST-TRAUMATIC, RUPTURE) $789.88 20060701 99999999 37618 LIGATION, MAJOR ARTERY (EG, POST-TRAUMATIC, RUPTURE) $280.01 20060701 99999999 37620 INTERRUPTION, PARTIAL OR COMPLETE, OF INFERIOR VENA CAVA BY $523.85 20060701 99999999 37650 INTERRUPTION, PARTIAL OR COMPLETE, OF FEMORAL VEIN, BY LIGATURE, $314.87 20060701 99999999 37660 INTERRUPTION, PARTIAL OR COMPLETE, OF COMMON ILIAC VEIN BY $753.71 20060701 99999999 37700 LIGATION AND DIVISION OF LONG SAPHENOUS VEIN AT SAPHENOFEMORAL $217.28 20060701 99999999 37718 LIGATION, DIVISION, AND STRIPPING, SHORT SAPHENOUS VEIN $289.39 20060701 99999999 37720 LIGATION AND DIVISION AND COMPLETE STRIPPING OF LONG OR SHORT $308.58 19990701 99999999 37722 LIGATION, DIVISION, AND STRIPPING, LONG (GREATER) SAPHENOUS VEINS FROM SAPHENOFE $340.04 20060701 99999999 37730 LIGATION AND DIVISION AND COMPLETE STRIPPING OF LONG AND SHORT $401.95 19990701 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 161
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