Medicaid Fee Schedule without Mods 200801
Medicaid Fee Schedule without Mods 200801
Medicaid Fee Schedule without Mods 200801
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
PROC-CODE DESC MAC BEG END<br />
52647<br />
NON-CONTACT LASER COAGULATION OF PROSTATE, INCLUDING<br />
CONTROL OF POSTOPERATIVE BL $554.10 20060701 99999999<br />
52648<br />
CONTACT LASER VAPORIZATION WITH OR WITHOUT<br />
TRANSURETHRAL RESECTION OF PROSTATE, $620.08 20060701 99999999<br />
52649<br />
LASER ENUCLEATION OF THE PROSTATE WITH MORCELLATION,<br />
INCLUDING CONTROL OF POSTOP $541.97 <strong>200801</strong>01 99999999<br />
52700 TRANSURETHRAL DRAINAGE OF PROSTATIC ABSCESS $330.54 20060701 99999999<br />
53000<br />
URETHROTOMY OR URETHROSTOMY, EXTERNAL (SEPARATE<br />
PROCEDURE) $127.75 20060701 99999999<br />
53010<br />
URETHROTOMY OR URETHROSTOMY, EXTERNAL (SEPARATE<br />
PROCEDURE) $218.38 20060701 99999999<br />
53020 MEATOTOMY, CUTTING OF MEATUS (SEPARATE PROCEDURE) $72.72 20060701 99999999<br />
53025 MEATOTOMY, CUTTING OF MEATUS (SEPARATE PROCEDURE) $51.13 20060701 99999999<br />
53040 DRAINAGE OF DEEP PERIURETHRAL ABSCESS $350.40 20060701 99999999<br />
53060 DRAINAGE OF SKENE'S GLAND ABSCESS OR CYST $118.00 20060701 99999999<br />
53080 DRAINAGE OF PERINEAL URINARY EXTRAVASATION $368.83 20060701 99999999<br />
53085 DRAINAGE OF PERINEAL URINARY EXTRAVASATION $538.45 20060701 99999999<br />
53200 BIOPSY OF URETHRA $104.35 20060701 99999999<br />
53210 URETHRECTOMY, TOTAL, INCLUDING CYSTOSTOMY $574.43 20060701 99999999<br />
53215 URETHRECTOMY, TOTAL, INCLUDING CYSTOSTOMY $727.62 20060701 99999999<br />
53220 EXCISION OR FULGURATION OF CARCINOMA OF URETHRA $350.72 20060701 99999999<br />
53230 EXCISION OF URETHRAL DIVERTICULUM (SEPARATE PROCEDURE) $488.48 20060701 99999999<br />
53235 EXCISION OF URETHRAL DIVERTICULUM (SEPARATE PROCEDURE) $458.13 20060701 99999999<br />
53240 MARSUPIALIZATION OF URETHRAL DIVERTICULUM, MALE OR FEMALE $324.96 20060701 99999999<br />
53250 EXCISION OF BULBOURETHRAL GLAND (COWPER'S GLAND) $297.68 20060701 99999999<br />
53260 EXCISION OR FULGURATION $134.32 20060701 99999999<br />
53265 EXCISION OR FULGURATION $150.80 20060701 99999999<br />
53270 EXCISION OR FULGURATION $127.74 20060701 99999999<br />
53275 EXCISION OR FULGURATION $211.80 20060701 99999999<br />
53400 URETHROPLASTY $591.90 20060701 99999999<br />
53405 URETHROPLASTY $695.66 20060701 99999999<br />
53410<br />
URETHROPLASTY, ONE-STAGE RECONSTRUCTION OF MALE<br />
ANTERIOR $729.91 20060701 99999999<br />
53415 URETHROPLASTY, TRANSPUBIC OR PERINEAL, ONE STAGE, FOR $877.08 20060701 99999999<br />
53420<br />
URETHROPLASTY, TWO-STAGE RECONSTRUCTION OR REPAIR OF<br />
PROSTATIC $697.18 20060701 99999999<br />
53425<br />
URETHROPLASTY, TWO-STAGE RECONSTRUCTION OR REPAIR OF<br />
PROSTATIC $731.84 20060701 99999999<br />
53430 URETHROPLASTY, RECONSTRUCTION OF FEMALE URETHRA $705.64 20060701 99999999<br />
53431<br />
URETHROPLASTY WITH TUBULARIZATION OF POSTERIOR URETHRA<br />
AND/OR LOWER BLADDER FOR $776.62 20060701 99999999<br />
53440<br />
OPERATION FOR CORRECTION OF MALE URINARY INCONTINENCE,<br />
WITH OR $684.87 20060701 99999999<br />
53442 REMOVAL OF PERINEAL PROSTHESIS INTRODUCED FOR CONTINENCE $416.54 20060701 99999999<br />
53443<br />
URETHROPLASTY WITH TUBULARIZATION OF POSTERIOR URETHRA<br />
AND/OR $868.46 19990701 99999999<br />
53444 INSERTION OF TANDEM CUFF (DUAL CUFF) $560.48 20060701 99999999<br />
53445<br />
OPERATION FOR CORRECTION OF URINARY INCONTINENCE WITH<br />
PLACEMENT $774.74 20060701 99999999<br />
53446<br />
REMOVAL OF INFLATABLE URETHRAL/BLADDER NECK SPHINCTER,<br />
INCLUDING PUMP, RESERVOIR $526.92 20060701 99999999<br />
53447<br />
REMOVAL, REPAIR OR REPLACEMENT OF INFLATABLE SPHINCTER<br />
INCLUDING $633.87 20060701 99999999<br />
53448<br />
REMOVAL AND REPLACEMENT OF INFLATABLE URETHRAL/BLADDER<br />
NECK SPHINCTER INCLUDING $938.99 20060701 99999999<br />
Hawaii <strong>Medicaid</strong> <strong>Fee</strong> <strong>Schedule</strong> <strong>without</strong> <strong>Mods</strong> 01/2008 191