Medicaid Fee Schedule without Mods 200801

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PROC-CODE DESC MAC BEG END 45380 COLONOSCOPY, FIBEROPTIC, BEYOND SPLENIC FLEXURE $208.40 20060701 99999999 45381 COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITH DIRECTED SUBMUCOSAL INJ $166.15 20060701 99999999 45382 COLONOSCOPY, FIBEROPTIC, BEYOND SPLENIC FLEXURE $290.16 20060701 99999999 45383 COLONOSCOPY, FIBEROPTIC, BEYOND SPLENIC FLEXURE $296.73 20060701 99999999 45384 COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITH REMOVAL OF TUMOR(S), PO $244.59 20060701 99999999 45385 COLONOSCOPY, FIBEROPTIC, BEYOND SPLENIC FLEXURE $276.36 20060701 99999999 45386 COLNSPY FIBRPTC BEYND SPLNC; W/RETRGRDE LAVAGE $180.35 20060701 99999999 45387 COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITH TRANSENDOSCOPIC STENT P $236.04 20060701 99999999 45391 COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITH ENDOSCOPIC ULTRASOUND $208.29 20060701 99999999 45392 COLONOSCOPY, FLEXIBLE, PROXIMAL TO SPLENIC FLEXURE; WITH TRANSENDOSCOPIC $263.46 20060701 99999999 45395 LAPAROSCOPY, SURGICAL; PROCTECTOMY, COMPLETE, COMBINED ABDOMINOPERINEAL, WITH CO $1,235.31 20060701 99999999 45397 LAPAROSCOPY, SURGICAL; PROCTECTOMY, COMBINED ABDOMINOPERINEAL PULL-THROUGH PROCE $1,341.80 20060701 99999999 45400 LAPAROSCOPY, SURGICAL; PROCTOPEXY (FOR PROLAPSE) $721.42 20060701 99999999 45402 LAPAROSCOPY, SURGICAL; PROCTOPEXY (FOR PROLAPSE), WITH SIGMOID RESECTION $975.84 20060701 99999999 45500 PROCTOPLASTY $373.88 20060701 99999999 45505 PROCTOPLASTY $328.78 20060701 99999999 45520 PERIRECTAL INJECTION OF SCLEROSING SOLUTION FOR PROLAPSE $24.08 20060701 99999999 45540 PROCTOPEXY FOR PROLAPSE $644.79 20060701 99999999 45541 PROCTOPEXY FOR PROLAPSE $570.98 20060701 99999999 45550 PROCTOPEXY COMBINED WITH SIGMOID RESECTION, ABDOMINAL APPROACH $857.06 20060701 99999999 45560 REPAIR OF RECTOCELE (SEPARATE PROCEDURE) $393.09 20060701 99999999 45562 EXPLORATION, REPAIR, AND PRESACRAL DRAINAGE FOR RECTAL INJURY; $582.24 20060701 99999999 45563 EXPLORATION, REPAIR, AND PRESACRAL DRAINAGE FOR RECTAL INJURY; WITH COLOSTOMY $899.35 20060701 99999999 45800 CLOSURE OF RECTOVESICAL FISTULA $668.58 20060701 99999999 45805 CLOSURE OF RECTOVESICAL FISTULA $813.06 20060701 99999999 45820 CLOSURE OF RECTOURETHRAL FISTULA $676.37 20060701 99999999 45825 CLOSURE OF RECTOURETHRAL FISTULA $788.49 20060701 99999999 45900 REDUCTION OF PROCIDENTIA (SEPARATE PROCEDURE) UNDER $103.00 20060701 99999999 45905 DILATION OF ANAL SPHINCTER (SEPARATE PROCEDURE) UNDER $93.59 20060701 99999999 45910 DILATION OF RECTAL STRICTURE (SEPARATE PROCEDURE) $111.38 20060701 99999999 45915 REMOVAL OF FECAL IMPACTION OR FOREIGN BODY (SEPARATE $130.27 20060701 99999999 45990 ANORECTAL EXAM, SURGICAL, REQUIRING ANESTHESIA (GENERAL, SPINAL, OR EPIDURAL), D $71.48 20060701 99999999 46020 PLACEMENT OF SETON $170.66 20060701 99999999 46030 REMOVAL OF ANAL SETON, OTHER MARKER $59.39 20060701 99999999 46040 INCISION AND DRAINAGE OF ISCHIORECTAL AND/OR PERIRECTAL ABSCESS $218.22 20060701 99999999 46045 INCISION AND DRAINAGE OF INTRAMURAL, INTRAMUSCULAR OR $197.76 20060701 99999999 46050 INCISION AND DRAINAGE, PERIANAL ABSCESS, SUPERFICIAL $58.09 20060701 99999999 46060 INCISION AND DRAINAGE OF ISCHIORECTAL OR INTRAMURAL $310.30 20060701 99999999 46070 INCISION, ANAL SEPTUM (INFANT) $141.96 20060701 99999999 46080 SPHINCTEROTOMY, ANAL, DIVISION OF SPHINCTER $132.61 20060701 99999999 46083 INCISION OF THROMBOSED HEMORRHOID, EXTERNAL $66.73 20060701 99999999 46200 FISSURECTOMY, WITH OR WITHOUT SPHINCTEROTOMY $189.59 20060701 99999999 46210 CRYPTECTOMY $133.09 20060701 99999999 46211 CRYPTECTOMY $196.66 20060701 99999999 46220 PAPILLECTOMY OR EXCISION OF SINGLE TAG, ANUS $64.46 20060701 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 176
PROC-CODE DESC MAC BEG END 46221 HEMORRHOIDECTOMY, BY SIMPLE LIGATURE (EG, RUBBER BAND) $95.01 20060701 99999999 46230 EXCISION OF EXTERNAL HEMORRHOID TAGS AND/OR MULTIPLE PAPILLAE $106.34 20060701 99999999 46250 HEMORRHOIDECTOMY, EXTERNAL, COMPLETE $222.24 20060701 99999999 46255 HEMORRHOIDECTOMY INTERNAL AND EXTERNAL, SIMPLE $282.52 20060701 99999999 46257 HEMORRHOIDECTOMY INTERNAL AND EXTERNAL, SIMPLE $322.65 20060701 99999999 46258 HEMORRHOIDECTOMY INTERNAL AND EXTERNAL, SIMPLE $345.83 20060701 99999999 46260 HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, COMPLEX $382.85 20060701 99999999 46261 HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, COMPLEX $419.16 20060701 99999999 46262 HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, COMPLEX $438.67 20060701 99999999 46270 FISTULECTOMY $177.65 20060701 99999999 46275 FISTULECTOMY $258.47 20060701 99999999 46280 FISTULECTOMY $331.72 20060701 99999999 46285 FISTULECTOMY $195.26 20060701 99999999 46288 CLOSURE OF ANAL FISTULA WITH RECTAL ADVANCEMENT FLAP $330.49 20060701 99999999 46320 ENUCLEATION OR EXCISION OF EXTERNAL THROMBOTIC HEMORRHOID $74.51 20060701 99999999 46500 INJECTION OF SCLEROSING SOLUTION, HEMORRHOIDS $68.75 20060701 99999999 46505 CHEMODENERVATION OF INTERNAL ANAL SPHINCTER $131.05 20060701 99999999 46600 ANOSCOPY $20.92 20060701 99999999 46604 ANOSCOPY $48.15 20060701 99999999 46606 ANOSCOPY $31.12 20060701 99999999 46608 ANOSCOPY $68.88 20060701 99999999 46610 ANOSCOPY $59.64 20060701 99999999 46611 ANOSCOPY; WITH REMOVAL OF SINGLE TUMOR, POLYP, OR OTHER LESION BY SNARE TECHNIQU $69.42 20060701 99999999 46612 ANOSCOPY $103.70 20060701 99999999 46614 ANOSCOPY $81.48 20060701 99999999 46615 ANOSCOPY; WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) NOT AMENABLE T $104.98 20060701 99999999 46700 ANOPLASTY, PLASTIC OPERATION FOR STRICTURE $374.95 20060701 99999999 46705 ANOPLASTY, PLASTIC OPERATION FOR STRICTURE $333.61 20060701 99999999 46706 REPAIR OF ANAL FISTULA WITH FIBRIN GLUE $103.78 20060701 99999999 46710 REPAIR OF ILEOANAL POUCH FISTULA/SINUS (EG, PERINEAL OR VAGINAL), POUCH ADVANCEM $653.77 20060701 99999999 46712 REPAIR OF ILEOANAL POUCH FISTULA/SINUS (EG, PERINEAL OR VAGINAL), POUCH ADVANCEM $1,363.74 20060701 99999999 46715 REPAIR OF CONGENITAL ANOVAGINAL FISTULA (''CUT-BACK'' TYPE $344.51 20060701 99999999 46716 PERINEAL TRANSPLANT OF ANOVAGINAL FISTULA $574.51 20060701 99999999 46730 CONSTRUCTION OF ANUS FOR CONGENITAL ABSENCE $980.40 20060701 99999999 46735 CONSTRUCTION OF ANUS FOR CONGENITAL ABSENCE $1,157.70 20060701 99999999 46740 CONSTRUCTION OF ANUS FOR CONGENITAL ABSENCE, WITH REPAIR OF $1,063.47 20060701 99999999 46742 REPAIR OF HIGH IMPERFORATE ANUS WITH RECTOURETHRAL OR RECTOVAGINAL FISTULA; COMB $1,422.06 20060701 99999999 46744 REPAIR OF CLOACAL ANOMALY BY ANORECTOVAGINOPLASTY AND URETHROPLASTY, SACROPERINE $1,851.74 20060701 99999999 46746 REPAIR OF CLOACAL ANOMALY BY ANORECTOVAGINOPLASTY AND URETHROPLASTY, COMBINED AB $2,104.97 20060701 99999999 46748 REPAIR OF CLOACAL ANOMALY BY ANORECTOVAGINOPLASTY AND URETHROPLASTY, COMBINED AB $2,124.89 20060701 99999999 46750 SPHINCTEROPLASTY, ANAL, FOR INCONTINENCE OR PROLAPSE $406.48 20060701 99999999 46751 SPHINCTEROPLASTY, ANAL, FOR INCONTINENCE OR PROLAPSE $402.14 20060701 99999999 46753 GRAFT (THIERSCH OPERATION) FOR RECTAL INCONTINENCE AND/OR $325.94 20060701 99999999 46754 REMOVAL OF THIERSCH WIRE OR SUTURE, ANAL CANAL $95.92 20060701 99999999 46760 SPHINCTEROPLASTY, ANAL, FOR INCONTINENCE, ADULT $537.59 20060701 99999999 46761 SPHINCTEROPLASTY ANAL FOR INCONTINENCE ADULT LEVATOR MUSCLE $516.01 20060701 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 177
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