Medicaid Fee Schedule without Mods 200801

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PROC-CODE DESC MAC BEG END 93531 COMBINED RIGHT HEART CATHETERIZATION AND RETROGRADE LEFT HEART CATHETERIZATION, $1,980.57 20060701 99999999 93532 COMBINED RIGHT HEART CATHETERIZATION AND TRANSSEPTAL LEFT HEART CATHETERIZATION $2,024.52 19990701 99999999 93533 COMBINED RIGHT HEART CATHETERIZATION AND TRANSSEPTAL LEFT HEART CATHETERIZATION $1,829.82 19990701 99999999 93536 PERCUTANEOUS INSERTION OF INTRA-AORTIC BALLOON CATHETER $262.13 19990701 99999999 93539 INJECTION PROCEDURE DURING CARDIAC CATHETERIZATION; FOR SELECTIVE OPACIFICATION $21.59 20060701 99999999 93540 INJECTION PROCEDURE DURING CARDIAC CATHETERIZATION; FOR SELECTIVE OPACIFICATION $23.11 20060701 99999999 93541 INJECTION PROCEDURE DURING CARDIAC CATHETERIZATION $15.36 20060701 99999999 93542 INJECTION PROCEDURE DURING CARDIAC CATHETERIZATION $15.36 20060701 99999999 93543 INJECTION PROCEDURE DURING CARDIAC CATHETERIZATION $15.90 20060701 99999999 93544 INJECTION PROCEDURE DURING CARDIAC CATHETERIZATION $13.61 20060701 99999999 93545 INJECTION PROCEDURE DURING CARDIAC CATHETERIZATION $21.59 20060701 99999999 93555 IMAGING SUPERVISION, INTERPRETATION AND REPORT FOR INJECTION PROCEDURE(S) DURING $237.06 20060701 99999999 93556 IMAGING SUPERVISION, INTERPRETATION AND REPORT FOR INJECTION PROCEDURE(S) DURING $358.37 20060701 99999999 93561 INDICATOR DILUTION STUDIES SUCH AS DYE OR THERMAL DILUTION, $43.92 20060701 99999999 93562 INDICATOR DILUTION STUDIES SUCH AS DYE OR THERMAL DILUTION, $19.25 20060701 99999999 93571 INTRAVASCULAR DOPPLER VELOCITY AND/OR PRESSURE DERIVED CORONARY FLOW RESERVE MEA $219.12 20060701 99999999 93572 INTRAVASCULAR DOPPLER VELOCITY AND/OR PRESSURE DERIVED CORONARY FLOW RESERVE MEA $170.28 19990701 99999999 93580 PERCUTANEOUS TRANSCATHETER CLOSURE OF CONGENITAL INTERATRIAL COMMUNICATION (IE, $719.01 20060701 99999999 93581 PERCUTANEOUS TRANSCATHETER CLOSURE OF A CONGENITAL VENTRICULAR SEPTAL DEFECT WIT $963.22 20060701 99999999 93600 BUNDLE OF HIS RECORDING $124.21 20060701 99999999 93602 INTRA-ATRIAL RECORDING $139.08 20060701 99999999 93603 RIGHT VENTRICULAR RECORDING $165.09 20060701 99999999 93607 LEFT VENTRICULAR RECORDING $197.20 19990701 99999999 93609 INTRAVENTRICULAR MAPPING OF TACHYCARDIA SITE W/ CATH MULT SI $380.28 20060701 99999999 93610 INTRA-ATRIAL PACING $186.21 20060701 99999999 93612 INTRAVENTRICULAR PACING $195.76 20060701 99999999 93613 INTRACARDIAC ELECTROPHYSIOLOGIC 3-DIMENSIONAL MAPPING (LIST SEPARATELY IN ADDITI $238.63 20060701 99999999 93615 RHYTHM ECG; ESOPHGL LEAD $49.26 20060701 99999999 93616 ESOPHAGEAL RECORDING OF ATRIAL ELECTROGRAM WITH OR WITHOUT $80.70 19990701 99999999 93618 INDUCTION OF ARRHYTHMIA BY ELECTRICAL PACING $353.96 20060701 99999999 93619 COMPREHENSIVE ELECTROPHYSIOLOGIC EVALUATION WITH RIGHT ATRIAL PACING AND RECORDI $637.92 20060701 99999999 93620 COMPREHENSIVE ELECTROPHYSIOLOGIC EVALUATION WITH RIGHT ATRIA $900.80 19990701 99999999 93624 ELECTROPHYSIOLOGIC FOLLOW-UP STUDY TO TEST EFFECTIVENESS $278.41 20060701 99999999 93631 LFT VENTRICULAR ENDO RESECT,W/WO CRYOABL,W/MAP $565.96 19990701 99999999 93640 ELECTROPHYSIOLOGIC EVALUATION OF CARDIOVERTER- DEFIBRILLATOR $421.81 20060701 99999999 93641 ELECTROPHYSIOLOGIC EVALUATION OF CARDIOVERTER- DEFIBRILLATOR LEADS (INCLUDES DEFI $547.26 20060701 99999999 93642 ELECTROPHYSIOLOGIC EVALUATION OF CARDIOVERTER- DEFIBRILLATOR (INCLUDES DEFIBRILLA $491.76 20060701 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 280
PROC-CODE DESC MAC BEG END 93650 INTRACARDIAC CATHETER ABLATION OF ARRHYTHMOGENIC FOCUS OR TR $550.26 20060701 99999999 93651 INTRACARDIAC CATHETER ABLATION OF ARRHYTHMOGENIC FOCUS; FOR TREATMENT OF SUPRAVE $848.33 20060701 99999999 93652 INTRACARDIAC CATHETER ABLATION OF ARRHYTHMOGENIC FOCUS; FOR TREATMENT OF VENTRIC $896.93 20060701 99999999 93660 AUTONOMIC NERVOUS SYSTEM EVALUATION OF CARDIOVASCULAR FUNCTION WITH TILT TABLE E $120.87 20060701 99999999 93701 BIOIMPEDANCE, THORACIC, ELECTRICAL $29.00 20060701 99999999 93720 PLETHYSMOGRAPHY, TOTAL BODY $33.11 20060701 99999999 93721 PLETHYSMOGRAPHY, TOTAL BODY $23.71 20060701 99999999 93722 PLETHYSMOGRAPHY, TOTAL BODY $8.75 20060701 99999999 93724 ELECTRONIC ANALYSIS OF ANTITACHYCARDIA PACEMAKER SYSTEM (INCLUDES ELECTROCARDIOG $344.84 20060701 99999999 93727 PLTHYSMGRPHY, RGNL; INTER & REPORT ONLY $20.74 20060701 99999999 93731 ELECTRONIC ANALYSIS OF DUAL-CHAMBER INTERNAL PACEMAKER SYSTEM $37.42 20060701 99999999 93732 ELECTRONIC ANALYSIS OF DUAL-CHAMBER INTERNAL PACEMAKER SYSTEM $55.03 20060701 99999999 93733 ELECTRONIC ANALYSIS OF DUAL-CHAMBER INTERNAL PACEMAKER SYSTEM $33.42 20060701 99999999 93734 ELECTRONIC ANALYSIS OF SINGLE-CHAMBER INTERNAL PACEMAKER SYSTEM $29.77 20060701 99999999 93735 ELECTRONIC ANALYSIS OF SINGLE-CHAMBER INTERNAL PACEMAKER SYS $47.48 20060701 99999999 93736 ELECTRONIC ANALYSIS OF SINGLE-CHAMBER INTERNAL PACEMAKER SYSTEM $29.47 20060701 99999999 93737 ELECTRONIC ANALYSIS OF CARDIOVERTER/DEFIBRILLATOR; WITHOUT REPROGRAMMING $36.24 19990701 99999999 93738 ELECTRONIC ANALYSIS OF CARDIOVERTER/DEFIBRILLATOR; WITH REPROGRAMMING $54.72 19990701 99999999 93741 ELECTRONIC ANALYSIS OF PACING CARDIOVERTER-DEFIBRILLATOR (INCLUDES INTERROGATION $54.89 20060701 99999999 93742 ELECTRONIC ANALYSIS OF PACING CARDIOVERTER-DEFIBRILLATOR (INCLUDES INTERROGATION $69.11 20060701 99999999 93743 ELECTRONIC ANALYSIS OF PACING CARDIOVERTER-DEFIBRILLATOR (INCLUDES INTERROGATION $62.08 20060701 99999999 93744 ELECTRONIC ANALYSIS OF PACING CARDIOVERTER-DEFIBRILLATOR (INCLUDES INTERROGATION $77.71 20060701 99999999 93770 DETERMINATION OF VENOUS PRESSURE $40.26 19990701 99999999 93784 AMBULATORY BLOOD PRESSURE MONITORING, UTILIZING A SYSTEM $48.38 20060701 99999999 93786 AMBULATORY BLOOD PRESSURE MONITORING, UTILIZING A SYSTEM $23.17 20060701 99999999 93788 AMBULATORY BLOOD PRESSURE MONITORING, UTILIZING A SYSTEM $13.07 20060701 99999999 93790 AMBULATORY BLOOD PRESSURE MONITORING, UTILIZING A SYSTEM $12.15 20060701 99999999 93797 PHYSICIAN SERVICES FOR OUTPATIENT CARDIAC REHABILITATION $9.96 20060701 99999999 93798 PHYSICIAN SERVICES FOR O/P CARDIAC REHAB. W/ECG MONITORING $15.38 20060701 99999999 93875 NON-INVASIVE PHYSIOLOGIC STUDIES OF EXTRACRANIAL ARTERIES, BILATERAL, (EG, PERIO $66.32 20060701 99999999 93880 DUPLEX SCAN OF EXTRACRANIAL ARTERIES; COMPLETE BILATERAL STUDY $161.52 20060701 99999999 93882 DUPLEX SCAN OF EXTRACRANIAL ARTERIES; FOLLOW-UP OR LIMITED STUDY $102.54 20060701 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 281
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