Medicaid Fee Schedule without Mods 200801

More documents

Recommendations

Info

PROC-CODE DESC MAC BEG END 51575 CYSTECTOMY, COMPLETE $1,459.21 20060701 99999999 51580 CYSTECTOMY, COMPLETE, WITH URETEROSIGMOIDOSTOMY OR $1,433.19 20060701 99999999 51585 CYSTECTOMY, COMPLETE, WITH URETEROSIGMOIDOSTOMY OR $1,658.56 20060701 99999999 51590 CYSTECTOMY, COMPLETE, WITH URETEROILEAL CONDUIT OR SIGMOID $1,558.35 20060701 99999999 51595 CYSTECTOMY, COMPLETE, WITH URETEROILEAL CONDUIT OR SIGMOID $1,861.32 20060701 99999999 51596 CYSTECTOMY COMPL W/CONTINENT DIVERSION INCL BOWEL ANASTOMOSI $1,963.82 20060701 99999999 51597 PELVIC EXENTERATION, COMPLETE, FOR VESICAL, PROSTATIC OR $1,863.15 20060701 99999999 51600 INJECTION PROCEDURE FOR CYSTOGRAPHY OR VOIDING URETHROCYSTOGRAPHY $32.89 20060701 99999999 51605 INJECTION PROCEDURE AND PLACEMENT OF CHAIN FOR CONTRAST AND/OR $26.01 20060701 99999999 51610 INJECTION PROCEDURE FOR RETROGRADE URETHROCYSTOGRAPHY $40.43 20060701 99999999 51700 BLADDER IRRIGATION, SIMPLE, LAVAGE AND/OR INSTILLATION $30.96 20060701 99999999 51701 INSERTION OF NON-INDWELLING BLADDER CATHETER (EG, STRAIGHT CATHETERIZATION FOR R $19.82 20060701 99999999 51702 INSERTION OF TEMPORARY INDWELLING BLADDER CATHETER; SIMPLE (EG, FOLEY) $21.90 20060701 99999999 51703 INSERTION OF TEMPORARY INDWELLING BLADDER CATHETER; COMPLICATED (EG, ALTERED ANA $58.37 20060701 99999999 51705 CHANGE OF CYSTOSTOMY TUBE $49.55 20060701 99999999 51710 CHANGE OF CYSTOSTOMY TUBE $66.41 20060701 99999999 51715 ENDOSCOPIC INJECTION OF IMPLANT MATERIAL INTO THE SUBMUCOSAL TISSUES OF THE URET $168.80 20060701 99999999 51720 BLADDER INSTILLATION OF ANTICARCINOGENIC AGENT (INCLUDING $68.68 20060701 99999999 51725 SIMPLE CYSTOMETROGRAM (CMG) (EG, SPINAL MANOMETER) $178.89 20060701 99999999 51726 COMPLEX CYSTOMETROGRAM (EG, CALIBRATED ELECTRONIC EQUIPMENT) $232.33 20060701 99999999 51736 SIMPLE UROFLOWMETRY (UFR) (EG, STOP-WATCH FLOW RATE, MECHANICAL $30.09 20060701 99999999 51741 COMPLEX UROFLOWMETRY (EG, CALIBRATED ELECTRONIC EQUIPMENT) $51.59 20060701 99999999 51772 URETHRAL PRESSURE PROFILE STUDIES (UPP) (URETHRAL CLOSURE $181.65 20060701 99999999 51784 ELECTROMYOGRAPHY STUDIES (EMG) OF ANAL OR URETHRAL SPHINCTER, OTHER THAN NEEDLE, $138.67 20060701 99999999 51785 ELECTROMYOGRAPHY STUDIES (EMG) OF ANAL OR URETHRAL $150.11 20060701 99999999 51792 STIMULUS EVOKED RESPONSE (EG, MEASUREMENT OF BULBOCAVERNOSUS $180.61 20060701 99999999 51795 VOIDING PRESSURE STUDIES (VP) $223.63 20060701 99999999 51797 VOIDING PRESSURE STUDIES (VP) $186.18 20060701 99999999 51798 MEASUREMENT OF POST-VOIDING RESIDUAL URINE AND/OR BLADDER CAPACITY BY ULTRASOUND $15.83 20060701 99999999 51800 CYSTOPLASTY OR CYSTOURETHROPLASTY, PLASTIC OPERATION ON $825.34 20060701 99999999 51820 CYSTOURETHROPLASTY WITH UNILATERAL OR BILATERAL $780.81 20060701 99999999 51840 ANTERIOR VESICOURETHROPEXY, OR URETHROPEXY $551.43 20060701 99999999 51841 ANTERIOR VESICOURETHROPEXY, OR URETHROPEXY $668.26 20060701 99999999 51845 ABDOMINO-VAGINAL VESICAL NECK SUSPENSION, WITH OR WITHOUT $546.20 20060701 99999999 51860 CYSTORRHAPHY, SUTURE OF BLADDER WOUND, INJURY OR RUPTURE $581.94 20060701 99999999 51865 CYSTORRHAPHY, SUTURE OF BLADDER WOUND, INJURY OR RUPTURE $735.21 20060701 99999999 51880 CLOSURE OF CYSTOSTOMY (SEPARATE PROCEDURE) $377.65 20060701 99999999 51900 CLOSURE OF VESICOVAGINAL FISTULA, ABDOMINAL APPROACH $675.48 20060701 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 188
PROC-CODE DESC MAC BEG END 51920 CLOSURE OF VESICOUTERINE FISTULA $561.93 20060701 99999999 51925 CLOSURE OF VESICOUTERINE FISTULA $744.32 20060701 99999999 51940 CLOSURE OF BLADDER EXSTROPHY $1,282.67 20060701 99999999 51960 ENTEROCYSTOPLASTY, INCLUDING BOWEL ANASTOMOSIS $1,188.89 20060701 99999999 51980 CUTANEOUS VESICOSTOMY $548.63 20060701 99999999 51990 LAPAROSCOPY, SURGICAL; URETHRAL SUSPENSION FOR STRESS INCONTINENCE $535.99 20060701 99999999 51992 LAPAROSCOPY, SURGICAL; SLING OPERATION FOR STRESS INCONTINENCE (EG, FASCIA OR SY $582.01 20060701 99999999 52000 CYSTOURETHROSCOPY (SEPARATE PROCEDURE) $77.48 20060701 99999999 52001 CYSTOURETHROSCOPY WITH IRRIGATION AND EVACUATION OF CLOTS $178.65 20060701 99999999 52005 CYSTOURETHROSCOPY, $115.52 20060701 99999999 52007 CYSTOURETHROSCOPY, $147.35 20060701 99999999 52010 CYSTOURETHROSCOPY, $115.85 20060701 99999999 52204 CYSTOURETHROSCOPY, WITH BIOPSY $118.32 20060701 99999999 52214 CYSTOURETHROSCOPY, WITH FULGURATION (INCLUDING CRYOSURGERY OR $169.94 20060701 99999999 52224 CYSTOURETHROSCOPY, WITH FULGURATION (INCLUDING CRYOSURGERY OR $152.94 20060701 99999999 52234 CYSTOURETHROSCOPY, WITH FULGURATION (INCLUDING CRYOSURGERY OR $243.61 20060701 99999999 52235 CYSTOURETHROSCOPY, WITH FULGURATION (INCLUDING CRYOSURGERY OR $286.51 20060701 99999999 52240 CYSTOURETHROSCOPY, WITH FULGURATION (INCLUDING CRYOSURGERY OR $507.87 20060701 99999999 52250 CYSTOURETHROSCOPY WITH INSERTION OF RADIOACTIVE SUBSTANCE, $196.97 20060701 99999999 52260 CYSTOURETHROSCOPY, WITH DILATION OF BLADDER FOR INTERSTITIAL $165.11 20060701 99999999 52265 CYSTOURETHROSCOPY, WITH DILATION OF BLADDER FOR INTERSTITIAL $108.76 20060701 99999999 52270 CYSTOURETHROSCOPY, WITH INTERNAL URETHROTOMY $170.16 20060701 99999999 52275 CYSTOURETHROSCOPY, WITH INTERNAL URETHROTOMY $213.08 20060701 99999999 52276 CYSTOURETHROSCOPY WITH DIRECT VISION INTERNAL URETHROTOMY $242.69 20060701 99999999 52277 CYSTOURETHROSCOPY, WITH RESECTION OF EXTERNAL SPHINCTER $285.52 20060701 99999999 52281 CYSTOURETHROSCOPY, WITH CALIBRATION AND/OR DILATION OF URETHRAL $112.00 20060701 99999999 52282 CYSTOURETHROSCOPY, WITH INSERTION OF URETHRAL STENT $288.76 20060701 99999999 52283 CYSTOURETHROSCOPY, WITH STEROID INJECTION INTO STRICTURE $148.90 20060701 99999999 52285 CYSTOURETHROSCOPY FOR TREATMENT OF THE FEMALE URETHRAL $144.23 20060701 99999999 52290 CYSTOURETHROSCOPY $191.23 20060701 99999999 52300 CYSTOURETHROSCOPY $234.19 20060701 99999999 52301 CYSTOURETHROSCOPY; WITH URETERAL MEATOTOMY, UNILATERAL/BILATERAL WITH RESECTION $241.41 20060701 99999999 52305 CYSTOURETHROSCOPY $234.82 20060701 99999999 52310 CYSTOURETHROSCOPY, WITH REMOVAL OF FOREIGN BODY, CALCULUS, $143.45 20060701 99999999 52315 CYSTOURETHROSCOPY, WITH REMOVAL OF FOREIGN BODY, CALCULUS, $240.98 20060701 99999999 52317 LITHOLAPAXY: CRUSHING OR FRAGMENTATION OF CALCULUS BY ANY $326.69 20060701 99999999 52318 LITHOLAPAXY;CRUSHING OR FRAGMENTATION OF CALCULUS;OVER 2.5CM $436.67 20060701 99999999 52320 CYSTOURETHROSCOPY (INCLUDING URETERAL CATHETERIZATION) $237.10 20060701 99999999 52325 CYSTOURETHROSCOPY (INCLUDING URETERAL CATHETERIZATION) $318.07 20060701 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 189
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:
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 115 and 116:
Page 117 and 118:
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:
Page 127 and 128:
PROC-CODE DESC MAC BEG END 27310 AR
Page 129 and 130:
PROC-CODE DESC MAC BEG END 27513 OP
Page 131 and 132:
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 137 and 138: PROC-CODE DESC MAC BEG END 29848 AR
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 145 and 146: PROC-CODE DESC MAC BEG END 33130 RE
Page 153 and 154: PROC-CODE DESC MAC BEG END 35102 DI
Page 155 and 156: PROC-CODE DESC MAC BEG END TRANSLUM
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 165 and 166: PROC-CODE DESC MAC BEG END 41114 EX
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 181 and 182: PROC-CODE DESC MAC BEG END 48511 EX
Page 187: PROC-CODE DESC MAC BEG END 50940 DE
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 203 and 204: PROC-CODE DESC MAC BEG END 59070 TR
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 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 233 and 234: PROC-CODE DESC MAC BEG END 75822 VE
Page 237 and 238: PROC-CODE DESC MAC BEG END 76938 UL
Page 239 and 240:
PROC-CODE DESC MAC BEG END 77401 RA
Page 241 and 242:
PROC-CODE DESC MAC BEG END 78261 GA
Page 243 and 244:
PROC-CODE DESC MAC BEG END 79000 RA
Page 245 and 246:
PROC-CODE DESC MAC BEG END 82000 AC
Page 247 and 248:
PROC-CODE DESC MAC BEG END 82533 CO
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:
PROC-CODE DESC MAC BEG END 87471 IN
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:
PROC-CODE DESC MAC BEG END 96000 CO
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

Create successful ePaper yourself

Delete template?

Save as template?