Medicaid Fee Schedule without Mods 200801

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PROC-CODE DESC MAC BEG END 61517 IMPLANTATION OF BRAIN INTRACAVITARY CHEMOTHERAPY AGENT (LIST SEPARATELY IN ADDIT $54.88 20060701 99999999 61518 CRANIECTOMY FOR EXCISION OF BRAIN TUMOR, INFRATENTORIAL OR POSTERIOR $2,016.50 20060701 99999999 61519 CRANIECTOMY FOR EXCISION OF BRAIN TUMOR, INFRATENTORIAL OR POSTERIOR $2,195.03 20060701 99999999 61520 CRANIECTOMY FOR EXCISION OF BRAIN TUMOR, INFRATENTORIAL OR POSTERIOR $2,756.59 20060701 99999999 61521 CRANIECTOMY FOR EXCISION OF BRAIN TUMOR, INFRATENTORIAL OR POSTERIOR $2,333.05 20060701 99999999 61522 CRANIECTOMY, INFRATENTORIAL OR POSTERIOR FOSSA $1,532.92 20060701 99999999 61524 CRANIECTOMY, INFRATENTORIAL OR POSTERIOR FOSSA $1,592.78 20060701 99999999 61526 CRANIECTOMY, BONE FLAP CRANIOTOMY, TRANSTEMPORAL (MASTOID) $2,593.02 20060701 99999999 61530 CRANIECTOMY, BONE FLAP CRANIOTOMY, TRANSTEMPORAL (MASTOID) $2,308.04 20060701 99999999 61531 SUBDURAL IMPLANTATION OF STRIP ELECTRODES THROUGH ONE OR MORE BURR OR TREPHINE H $863.69 20060701 99999999 61533 CRANIECTOMY, TREPHINATION, BONE FLAP CRANIOTOMY $1,093.90 20060701 99999999 61534 CRANIECTOMY, TREPHINATION, BONE FLAP CRANIOTOMY $962.32 20060701 99999999 61535 CRANIECTOMY, TREPHINATION, BONE FLAP CRANIOTOMY $609.65 20060701 99999999 61536 CRANIECTOMY, TREPHINATION, BONE FLAP CRANIOTOMY $1,812.38 20060701 99999999 61537 CRANIOTOMY WITH ELEVATION OF BONE FLAP; FOR LOBECTOMY, TEMPORAL LOBE, WITHOUT EL $1,250.16 20060701 99999999 61538 CRANIECTOMY, TREPHINATION, BONE FLAP CRANIOTOMY $1,585.42 20060701 99999999 61539 CRANIECTOMY, TREPHINATION, BONE FLAP CRANIOTOMY $1,690.60 20060701 99999999 61540 CRANIOTOMY WITH ELEVATION OF BONE FLAP; FOR LOBECTOMY, OTHER THAN TEMPORAL LOBE, $1,508.86 20060701 99999999 61541 CRANIECTOMY, TREPHINATION, BONE FLAP CRANIOTOMY $1,501.39 20060701 99999999 61542 CRANIECTOMY, TREPHINATION, BONE FLAP CRANIOTOMY $1,606.25 20060701 99999999 61543 CRANIECTOMY, TREPHINATION, BONE FLAP CRANIOTOMY $1,462.13 20060701 99999999 61544 CRANIECTOMY, TREPHINATION, BONE FLAP CRANIOTOMY $1,461.91 20060701 99999999 61545 CRANIECTOMY TREPHINATION BONE FLAP CRANIECTOMY EXCISION OF $2,198.30 20060701 99999999 61546 CRANIOTOMY FOR HYPOPHYSECTOMY OR EXCISION OF PITUITARY $1,722.43 20060701 99999999 61548 HYPOPHYSECTOMY OR EXCISION OF PITUITARY TUMOR, TRANSNASAL OR $1,265.82 20060701 99999999 61550 CRANIECTOMY FOR CRANIOSTENOSIS $733.77 20060701 99999999 61552 CRANIECTOMY FOR CRANIOSTENOSIS $932.30 20060701 99999999 61556 CRANIOTOMY FOR CRANIOSYNOSTOSIS; FRONTAL OR PARIETAL BONE FLAP $1,118.05 20060701 99999999 61557 CRANIOTOMY FOR CRANIOSYNOSTOSIS; BIFRONTAL BONE FLAP $1,146.79 20060701 99999999 61558 EXTENSIVE CRANIECTOMY FOR MULTIPLE CRANIAL SUTURE CRANIOSYNOSTOSIS (EG, CLOVERLE $1,321.95 20060701 99999999 61559 EXTENSIVE CRANIECTOMY FOR MULTIPLE CRANIAL SUTURE CRANIOSYNOSTOSIS (EG, CLOVERLE $1,713.64 20060701 99999999 61563 EXCISION, INTRA- AND EXTRACRANIAL, BENIGN TUMOR OF CRANIAL BONE (EG, FIBROUS DYS $1,383.83 20060701 99999999 61564 EXCISION, INTRA- AND EXTRACRANIAL, BENIGN TUMOR OF CRANIAL BONE (EG, FIBROUS DYS $1,645.74 20060701 99999999 61566 CRANIOTOMY WITH ELEVATION OF BONE FLAP; FOR SELECTIVE AMYGDALOHIPPOCAMPECTOMY $1,500.94 20060701 99999999 61567 CRANIOTOMY WITH ELEVATION OF BONE FLAP; FOR MULTIPLE SUBPIAL TRANSECTIONS, WITH $1,721.93 20060701 99999999 61570 CRANIECTOMY OR CRANIOTOMY $1,252.79 20060701 99999999 61571 CRANIECTOMY OR CRANIOTOMY $1,359.27 20060701 99999999 61575 TRANSORAL APPROACH TO SKULL BASE BRAIN STEM OR UPPER SPINAL $1,921.86 20060701 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 206
PROC-CODE DESC MAC BEG END 61576 TRANSORAL APPROACH TO SKULL BASE BRAIN STEM OR UPPER SPINAL $2,529.28 20060701 99999999 61580 CRANIOFACIAL APPROACH TO ANTERIOR CRANIAL FOSSA; EXTRADURAL, INCLUDING LATERAL R $1,523.03 20060701 99999999 61581 CRANIOFACIAL APPROACH TO ANTERIOR CRANIAL FOSSA; EXTRADURAL, INCLUDING LATERAL R $1,711.58 20060701 99999999 61582 CRANIOFACIAL APPROACH TO ANTERIOR CRANIAL FOSSA; EXTRADURAL, INCLUDING UNILATERA $1,624.98 20060701 99999999 61583 CRANIOFACIAL APPROACH TO ANTERIOR CRANIAL FOSSA; INTRADURAL, INCLUDING UNILATERA $1,888.31 20060701 99999999 61584 ORBITOCRANIAL APPROACH TO ANTERIOR CRANIAL FOSSA, EXTRADURAL, INCLUDING SUPRAORB $1,797.65 20060701 99999999 61585 ORBITOCRANIAL APPROACH TO ANTERIOR CRANIAL FOSSA, EXTRADURAL, INCLUDING SUPRAORB $1,996.07 20060701 99999999 61586 BICORONAL, TRANSZYGOMATIC AND/OR LEFORT I OSTEOTOMY APPROACHTO ANTERIOR CRANIAL $1,344.89 20060701 99999999 61590 INFRATEMPORAL PRE-AURICULAR APPROACH TO MIDDLE CRANIAL FOSSA (PARAPHARYNGEAL SPA $2,105.65 20060701 99999999 61591 INFRATEMPORAL POST-AURICULAR APPROACH TO MIDDLE CRANIAL FOSSA (INTERNAL AUDITORY $2,227.64 20060701 99999999 61592 ORBITOCRANIAL ZYGOMATIC APPROACH TO MIDDLE CRANIAL FOSSA (CAVERNOUS SINUS AND CA $2,062.58 20060701 99999999 61595 TRANSTEMPORAL APPROACH TO POSTERIOR CRANIAL FOSSA, JUGULAR FORAMEN OR MIDLINE SK $1,503.46 20060701 99999999 61596 TRANSCOCHLEAR APPROACH TO POSTERIOR CRANIAL FOSSA, JUGULAR FORAMEN OR MIDLINE SK $1,805.30 20060701 99999999 61597 TRANSCONDYLAR (FAR LATERAL) APPROACH TO POSTERIOR CRANIAL FOSSA, JUGULAR FORAMEN $1,939.46 20060701 99999999 61598 TRANSPETROSAL APPROACH TO POSTERIOR CRANIAL FOSSA, CLIVUS OR FORAMEN MAGNUM, INC $1,714.92 20060701 99999999 61600 RESECTION OR EXCISION OF NEOPLASTIC, VASCULAR OR INFECTIOUS LESION OF BASE OF AN $1,302.50 20060701 99999999 61601 RESECTION OR EXCISION OF NEOPLASTIC, VASCULAR OR INFECTIOUS LESION OF BASE OF AN $1,448.08 20060701 99999999 61605 RESECTION OR EXCISION OF NEOPLASTIC, VASCULAR OR INFECTIOUS LESION OF INFRATEMPO $1,470.31 20060701 99999999 61606 RESECTION OR EXCISION OF NEOPLASTIC, VASCULAR OR INFECTIOUS LESION OF INFRATEMPO $2,020.58 20060701 99999999 61607 RESECTION OR EXCISION OF NEOPLASTIC, VASCULAR OR INFECTIOUS LESION OF PARASELLAR $1,881.84 20060701 99999999 61608 RESECTION OR EXCISION OF NEOPLASTIC, VASCULAR OR INFECTIOUS LESION OF PARASELLAR $2,196.32 20060701 99999999 61609 TRANSECTION OR LIGATION, CAROTID ARTERY IN CAVERNOUS SINUS; WITHOUT REPAIR $505.41 20060701 99999999 61610 TRANSECTION OR LIGATION, CAROTID ARTERY IN CAVERNOUS SINUS; WITH REPAIR BY ANAST $1,495.50 20060701 99999999 61611 TRANSECTION OR LIGATION, CAROTID ARTERY IN PETROUS CANAL; WITHOUT REPAIR $368.91 20060701 99999999 61612 TRANSECTION OR LIGATION, CAROTID ARTERY IN PETROUS CANAL; WITH REPAIR BY ANASTOM $1,411.33 20060701 99999999 61613 OBLITERATION OF CAROTID ANEURYSM, ARTERIOVENOUS MALFORMATION, OR CAROTID-CAVERNO $2,143.09 20060701 99999999 61615 RESECTION OR EXCISION OF NEOPLASTIC, VASCULAR OR INFECTIOUS LESION OF BASE OF PO $1,642.86 20060701 99999999 61616 RESECTION OR EXCISION OF NEOPLASTIC, VASCULAR OR INFECTIOUS LESION OF BASE OF PO $2,250.28 20060701 99999999 61618 SECONDARY REPAIR OF DURA FOR CSF LEAK, ANTERIOR, MIDDLE OR POSTERIOR CRANIAL FOS $884.60 20060701 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 207
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Medicaid Fee Schedule without Mods 200801

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