Medicaid Fee Schedule without Mods 200801

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PROC-CODE DESC MAC BEG END 59841 LEGAL (THERAPEUTIC) ABORTION, BY DILATION $263.62 20060701 99999999 59850 LEGAL (THERAPEUTIC) ABORTION, BY ONE OR MORE INTRA-AMNIOTIC $273.77 20060701 99999999 59851 LEGAL (THERAPEUTIC) ABORTION, BY ONE OR MORE INTRA-AMNIOTIC $284.59 20060701 99999999 59852 LEGAL (THERAPEUTIC) ABORTION, BY ONE OR MORE INTRA-AMNIOTIC $393.30 20060701 99999999 59855 INDUCED ABORTION, BY ONE OR MORE VAGINAL SUPPOSITORIES (EG, PROSTAGLANDIN) WITH $292.02 20060701 99999999 59856 INDUCED ABORTION, BY ONE OR MORE VAGINAL SUPPOSITORIES (EG, PROSTAGLANDIN) WITH $352.77 20060701 99999999 59857 INDUCED ABORTION, BY ONE OR MORE VAGINAL SUPPOSITORIES (EG, PROSTAGLANDIN) WITH $434.41 20060701 99999999 59866 MULTIFETAL PREGNANCY REDUCTION(S) (MPR) $185.70 20060701 99999999 59870 UTERINE EVACUATION & CURETTAGE FOR HYDATIDIFORM MOLE $276.37 20060701 99999999 59871 REMOVAL OF CERCLAGE SUTURE UNDER ANESTHESIA (OTHER THAN LOCAL) $102.03 20060701 99999999 60000 INCISION AND DRAINAGE OF THYROGLOSSAL CYST, INFECTED $86.15 20060701 99999999 60001 ASPIRATION AND/OR INJECTION, THYROID CYST $50.36 20030401 99999999 60100 BIOPSY THYROID, PERCUTANEOUS NEEDLE $50.86 20060701 99999999 60200 EXCISION OF CYST OR ADENOMA OF THYROID, OR TRANSECTION $475.53 20060701 99999999 60210 PARTIAL THYROID LOBECTOMY, UNILATERAL; WITH OR WITHOUT ISTHMUSECTOMY $558.64 20060701 99999999 60212 PARTIAL THYROID LOBECTOMY, UNILATERAL; WITH CONTRALATERAL SUBTOTAL LOBECTOMY, IN $742.08 20060701 99999999 60220 TOTAL THYROID LOBECTOMY, UNILATERAL $545.93 20060701 99999999 60225 TOTAL THYROID LOBECTOMY, UNILATERAL $707.59 20060701 99999999 60240 THYROIDECTOMY, $782.77 20060701 99999999 60252 THYROIDECTOMY, TOTAL OR SUBTOTAL FOR MALIGNANCY $912.70 20060701 99999999 60254 THYROIDECTOMY, TOTAL OR SUBTOTAL FOR MALIGNANCY $1,225.94 20060701 99999999 60260 THYROIDECTOMY, SECONDARY $652.67 20060701 99999999 60270 THYROIDECTOMY, INCLUDING SUBSTERNAL THYROID GLAND, STERNAL $941.96 20060701 99999999 60271 THYROIDECTOMY, INCLUDING SUBSTERNAL THYROID GLAND; CERVICAL APPROACH $776.92 20060701 99999999 60280 EXCISION OF THYROGLOSSAL DUCT CYST OR SINUS $361.02 20060701 99999999 60281 EXCISION OF THYROGLOSSAL DUCT CYST OR SINUS $428.90 20060701 99999999 60300 ASPIRATION AND/OR INJECTION, THYROID CYST $25.85 20080101 99999999 60500 PARATHYROIDECTOMY OR EXPLORATION OF PARATHYROID(S) $784.83 20060701 99999999 60502 PARATHYROIDECTOMY OR EXPLORATION OF PARATHYROID(S) $934.53 20060701 99999999 60505 PARATHYROIDECTOMY OR EXPLORATION OF PARATHYROID(S) $1,037.98 20060701 99999999 60512 PARATHYROID AUTOTRANSPLANTATION $195.50 20060701 99999999 60520 THYMECTOMY, PARTIAL OR TOTAL (SEPARATE PROCEDURE) $902.32 20060701 99999999 60521 THYMECTOMY, PARTIAL OR TOTAL; STERNAL SPLIT OR TRANSTHORACIC APPROACH, WITHOUT R $1,020.68 20060701 99999999 60522 THYMECTOMY, PARTIAL OR TOTAL; STERNAL SPLIT OR TRANSTHORACIC APPROACH, WITH RADI $1,160.17 20060701 99999999 60540 ADRENALECTOMY, PARTIAL OR COMPLETE, OR EXPLORATION OF ADRENAL $810.40 20060701 99999999 60545 ADRENALECTOMY, PARTIAL OR COMPLETE, OR EXPLORATION OF ADRENAL $959.47 20060701 99999999 60600 EXCISION OF CAROTID BODY TUMOR $947.39 20060701 99999999 60605 EXCISION OF CAROTID BODY TUMOR $1,041.27 20060701 99999999 60650 LAPAROSCOPY, SURGICAL, WITH ADRENALECTOMY, PARTIAL OR COMPLETE, OR EXPLORATION O $807.07 20060701 99999999 61000 SUBDURAL TAP THROUGH FONTANELLE, OR SUTURE, INFANT, $87.25 20060701 99999999 61001 SUBDURAL TAP THROUGH FONTANELLE, OR SUTURE, INFANT, $81.76 20060701 99999999 61020 VENTRICULAR PUNCTURE THROUGH PREVIOUS BURR HOLE, $97.60 20060701 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 204
PROC-CODE DESC MAC BEG END 61026 VENTRICULAR PUNCTURE THROUGH PREVIOUS BURR HOLE, $111.31 20060701 99999999 61050 CISTERNAL OR LATERAL CERVICAL PUNCTURE $81.80 20060701 99999999 61055 CISTERNAL OR LATERAL CERVICAL PUNCTURE $108.48 20060701 99999999 61070 PUNCTURE OF SHUNT TUBING OR RESERVOIR FOR ASPIRATION $78.40 20060701 99999999 61105 TWIST DRILL HOLE FOR SUBDURAL OR VENTRICULAR PUNCTURE $312.39 20060701 99999999 61107 TWIST DRILL HOLE FOR SUBDURAL OR VENTRICULAR PUNCTURE $296.10 20060701 99999999 61108 TWIST DRILL HOLE FOR SUBDURAL OR VENTRICULAR PUNCTURE $617.54 20060701 99999999 61120 BURR HOLE(S) FOR VENTRICULAR PUNCTURE (INCLUDING $466.09 20060701 99999999 61140 BURR HOLE(S) OR TREPHINE $888.21 20060701 99999999 61150 BURR HOLE(S) OR TREPHINE $958.79 20060701 99999999 61151 BURR HOLE(S) OR TREPHINE $554.54 20060701 99999999 61154 BURR HOLE(S) WITH EVACUATION AND/OR DRAINAGE OF HEMATOMA, $896.50 20060701 99999999 61156 BURR HOLE(S) $944.90 20060701 99999999 61210 BURR HOLE(S) $338.18 20060701 99999999 61215 INSERTION OF SUBCUTANEOUS RESERVOIR, PUMP OR $308.16 20060701 99999999 61250 BURR HOLE(S) OR TREPHINE, SUPRATENTORIAL, EXPLORATORY, $566.02 20060701 99999999 61253 BURR HOLE(S) OR TREPHINE, INFRATENTORIAL, UNILATERAL $663.72 20060701 99999999 61304 CRANIECTOMY OR CRANIOTOMY, EXPLORATORY $1,288.38 20060701 99999999 61305 CRANIECTOMY OR CRANIOTOMY, EXPLORATORY $1,554.65 20060701 99999999 61312 CRANIECTOMY OR CRANIOTOMY FOR EVACUATION OF HEMATOMA, $1,401.33 20060701 99999999 61313 CRANIECTOMY OR CRANIOTOMY EVACUATION OF HEMATOMA SUPRATENTOR $1,413.68 20060701 99999999 61314 CRANIECTOMY OR OTOMY FOR EVACUATION HEMATOMA INFRATENTORIAL $1,412.58 20060701 99999999 61315 CRANIECTOMY OR OTOMY EVACUATION HEMATOMA INFRATENTORIAL $1,528.49 20060701 99999999 61316 INCISION AND SUBCUTANEOUS PLACEMENT OF CRANIAL BONE GRAFT (LIST SEPARATELY IN AD $63.17 20060701 99999999 61320 CRANIECTOMY OR CRANIOTOMY, DRAINAGE OF INTRACRANIAL $1,346.46 20060701 99999999 61321 CRANIECTOMY OR CRANIOTOMY, DRAINAGE OF INTRACRANIAL $1,466.71 20060701 99999999 61322 CRANIECTOMY OR CRANIOTOMY, DECOMPRESSIVE, WITH OR WITHOUT DURAPLASTY, FOR TREATM $1,302.42 20060701 99999999 61323 CRANIECTOMY OR CRANIOTOMY, DECOMPRESSIVE, WITH OR WITHOUT DURAPLASTY, FOR TREATM $1,347.98 20060701 99999999 61330 DECOMPRESSION OF ORBIT ONLY, TRANSCRANIAL $1,166.58 20060701 99999999 61332 EXPLORATION OF ORBIT (TRANSCRANIAL APPROACH) $1,476.34 20060701 99999999 61333 EXPLORATION OF ORBIT (TRANSCRANIAL APPROACH) $1,426.23 20060701 99999999 61334 EXPLORATION OF ORBIT (TRANSCRANIAL APPROACH) $977.09 20060701 99999999 61340 OTHER CRANIAL DECOMPRESSION (EG, SUBTEMPORAL), $1,010.43 20060701 99999999 61343 CRANIECTOMY SUBOCCIPITAL W/CERVICAL LAMINECTOMY DECOMPRESSIO $1,714.04 20060701 99999999 61345 OTHER CRANIAL DECOMPRESSION, POSTERIOR FOSSA $1,436.19 20060701 99999999 61440 CRANIOTOMY FOR SECTION OF TENTORIUM CEREBELLI (SEPARATE PROCEDURE) $1,348.01 20060701 99999999 61450 CRANIECTOMY, SUBTEMPORAL, FOR SECTION, COMPRESSION, OR $1,382.39 20060701 99999999 61458 CRANIECTOMY, SUBOCCIPITAL $1,559.62 20060701 99999999 61460 CRANIECTOMY, SUBOCCIPITAL $1,552.59 20060701 99999999 61470 CRANIECTOMY, SUBOCCIPITAL $1,251.57 20060701 99999999 61480 CRANIECTOMY, SUBOCCIPITAL $1,312.16 20060701 99999999 61490 CRANIOTOMY FOR LOBOTOMY, INCLUDING CINGULOTOMY $1,224.24 20060701 99999999 61500 CRANIECTOMY $1,053.77 20060701 99999999 61501 CRANIECTOMY $871.64 20060701 99999999 61510 CRANIECTOMY, TREPHINATION, BONE FLAP CRANIOTOMY $1,603.92 20060701 99999999 61512 CRANIECTOMY, TREPHINATION, BONE FLAP CRANIOTOMY $1,900.49 20060701 99999999 61514 CRANIECTOMY, TREPHINATION, BONE FLAP CRANIOTOMY $1,450.68 20060701 99999999 61516 CRANIECTOMY, TREPHINATION, BONE FLAP CRANIOTOMY $1,447.85 20060701 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 205
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