Medicaid Fee Schedule without Mods 200801

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PROC-CODE DESC MAC BEG END 01480 ANESTHESIA FOR OPEN PROCEDURES ON BONES OF LOWER LEG, ANKLE, AND FOOT; NOT OTHER $22.80 19990701 99999999 01482 ANESTHESIA FOR OPEN PROCEDURES ON BONES OF LOWER LEG, ANKLE, AND FOOT; RADICAL R $22.80 19990701 99999999 01484 ANESTHESIA FOR OPEN PROCEDURES ON BONES OF LOWER LEG, ANKLE, AND FOOT; OSTEOTOMY $22.80 19990701 99999999 01486 ANESTHESIA FOR OPEN PROCEDURES ON BONES OF LOWER LEG, ANKLE, AND FOOT; TOTAL ANK $22.80 19990701 99999999 01490 ANESTHESIA FOR LOWER LEG CAST APPLICATION, REMOVAL, OR REPAIR $22.80 19990701 99999999 01500 ANESTHESIA FOR PROCEDURES ON ARTERIES OF LOWER LEG, INCLUDING BYPASS GRAFT; NOT $22.80 19990701 99999999 01502 ANESTHESIA FOR PROCEDURES ON ARTERIES OF LOWER LEG, INCLUDING BYPASS GRAFT; EMBO $22.80 19990701 99999999 01520 SPACE MAINTAINER,REMOVABLE,UNILATERAL $22.80 19990701 99999999 01522 ANESTHESIA FOR PROCEDURES ON VEINS OF LOWER LEG; VENOUS THROMBECTOMY, DIRECT OR $22.80 19990701 99999999 01600 ANESTHESIA FOR ALL PROCEDURES ON INTEGUMENTARY SYSTEM OF SHOULDER AND AXILLA $22.80 19990701 99999999 01610 ANESTHESIA FOR ALL PROCEDURES ON NERVES, MUSCLES, TENDONS, FASCIA, AND BURSAE OF $22.80 19990701 99999999 01620 ANESTHESIA FOR ALL CLOSED PROCEDURES ON HUMERAL HEAD AND NECK, STERNOCLAVICULAR $22.80 19990701 99999999 01622 ANESTHESIA FOR ARTHROSCOPIC PROCEDURES OF SHOULDER JOINT $22.80 19990701 99999999 01630 ANESTHESIA FOR OPEN PROCEDURES ON HUMERAL HEAD AND NECK, STERNOCLAVICULAR JOINT, $22.80 19990701 99999999 01632 ANESTHESIA FOR OPEN PROCEDURES ON HUMERAL HEAD AND NECK, STERNOCLAVICULAR JOINT, $22.80 19990701 99999999 01634 ANESTHESIA FOR OPEN PROCEDURES ON HUMERAL HEAD AND NECK, STERNOCLAVICULAR JOINT, $22.80 19990701 99999999 01636 ANESTHESIA FOR OPEN PROCEDURES ON HUMERAL HEAD AND NECK, STERNOCLAVICULAR JOINT, $22.80 19990701 99999999 01638 ANESTHESIA FOR OPEN PROCEDURES ON HUMERAL HEAD AND NECK, STERNOCLAVICULAR JOINT, $22.80 19990701 99999999 01650 ANESTHESIA FOR PROCEDURES ON ARTERIES OF SHOULDER AND AXILLA; NOT OTHERWISE SPEC $22.80 19990701 99999999 01652 ANESTHESIA FOR PROCEDURES ON ARTERIES OF SHOULDER AND AXILLA; AXILLARY-BRACHIAL $22.80 19990701 99999999 01654 ANESTHESIA FOR PROCEDURES ON ARTERIES OF SHOULDER AND AXILLA; BYPASS GRAFT $22.80 19990701 99999999 01656 ANESTHESIA FOR PROCEDURES ON ARTERIES OF SHOULDER AND AXILLA; AXILLARY-FEMORAL B $22.80 19990701 99999999 01670 ANESTHESIA FOR ALL PROCEDURES ON VEINS OF SHOULDER AND AXILLA $22.80 19990701 99999999 01680 ANESTHESIA FOR SHOULDER CAST APPLICATION, REMOVAL OR REPAIR; NOT OTHERWISE SPECI $22.80 19990701 99999999 01682 ANESTHESIA FOR SHOULDER CAST APPLICATION, REMOVAL OR REPAIR; SHOULDER SPICA $22.80 19990701 99999999 01700 ANESTHESIA FOR ALL PROCEDURES ON INTEGUMENTARY SYSTEM OF UPPER ARM AND ELBOW $22.80 19990701 99999999 01710 ANESTHESIA FOR PROCEDURES ON NERVES, MUSCLES, TENDONS, FASCIA, AND BURSAE OF UPP $22.80 19990701 99999999 01712 ANESTHESIA FOR PROCEDURES ON NERVES, MUSCLES, TENDONS, FASCIA, AND BURSAE OF UPP $22.80 19990701 99999999 01714 ANESTHESIA FOR PROCEDURES ON NERVES, MUSCLES, TENDONS, FASCIA, AND BURSAE OF UPP $22.80 19990701 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 90
PROC-CODE DESC MAC BEG END 01716 ANESTHESIA FOR PROCEDURES ON NERVES, MUSCLES, TENDONS, FASCIA, AND BURSAE OF UPP $22.80 19990701 99999999 01730 ANESTHESIA FOR ALL CLOSED PROCEDURES ON HUMERUS AND ELBOW $22.80 19990701 99999999 01732 ANESTHESIA FOR ARTHROSCOPIC PROCEDURES OF ELBOW JOINT $22.80 19990701 99999999 01740 ANESTHESIA FOR OPEN PROCEDURES ON HUMERUS AND ELBOW; NOT OTHERWISE SPECIFIED $22.80 19990701 99999999 01742 ANESTHESIA FOR OPEN PROCEDURES ON HUMERUS AND ELBOW; OSTEOTOMY OF HUMERUS $22.80 19990701 99999999 01744 ANESTHESIA FOR OPEN PROCEDURES ON HUMERUS AND ELBOW; REPAIR OF NONUNION OR MALUN $22.80 19990701 99999999 01756 ANESTHESIA FOR OPEN PROCEDURES ON HUMERUS AND ELBOW; RADICAL PROCEDURES $22.80 19990701 99999999 01758 ANESTHESIA FOR OPEN PROCEDURES ON HUMERUS AND ELBOW; EXCISION OF CYST OR TUMOR O $22.80 19990701 99999999 01760 ANESTHESIA FOR OPEN PROCEDURES ON HUMERUS AND ELBOW; TOTAL ELBOW REPLACEMENT $22.80 19990701 99999999 01770 ANESTHESIA FOR PROCEDURES ON ARTERIES OF UPPER ARM AND ELBOW; NOT OTHERWISE SPEC $22.80 19990701 99999999 01772 ANESTHESIA FOR PROCEDURES ON ARTERIES OF UPPER ARM AND ELBOW; EMBOLECTOMY $22.80 19990701 99999999 01780 ANESTHESIA FOR PROCEDURES ON VEINS OF UPPER ARM AND ELBOW; NOT OTHERWISE SPECIFI $22.80 19990701 99999999 01782 ANESTHESIA FOR PROCEDURES ON VEINS OF UPPER ARM AND ELBOW; PHLEBORRHAPHY $22.80 19990701 99999999 01784 ANESTHESIA FOR REPAIR OF ARTERIO-VENOUS (A-V) FISTULA, CONGENITAL OR ACQUIRED $22.80 19990701 99999999 01800 ANESTHESIA FOR ALL PROCEDURES ON INTEGUMENTARY SYSTEM OF FOREARM, WRIST, AND HAN $22.80 19990701 99999999 01810 ANESTHESIA FOR ALL PROCEDURES ON NERVES, MUSCLES, TENDONS, FASCIA, AND BURSAE OF $22.80 19990701 99999999 01820 ANESTHESIA FOR ALL CLOSED PROCEDURES ON RADIUS, ULNA, WRIST, OR HAND BONES $22.80 19990701 99999999 01829 ANESTHESIA FOR DIAGNOSTIC ARTHROSCOPIC PROCEDURES ON THE WRIST $22.80 20030401 99999999 01830 ANESTHESIA FOR OPEN PROCEDURES ON RADIUS, ULNA, WRIST, OR HAND BONES; NOT OTHERW $22.80 19990701 99999999 01832 ANESTHESIA FOR OPEN PROCEDURES ON RADIUS, ULNA, WRIST, OR HAND BONES; TOTAL WRIS $22.80 19990701 99999999 01840 ANESTHESIA FOR PROCEDURES ON ARTERIES OF FOREARM, WRIST, AND HAND; NOT OTHERWISE $22.80 19990701 99999999 01842 ANESTHESIA FOR PROCEDURES ON ARTERIES OF FOREARM, WRIST, AND HAND; EMBOLECTOMY $22.80 19990701 99999999 01844 ANESTHESIA FOR VASCULAR SHUNT, OR SHUNT REVISION, ANY TYPE (EG, DIALYSIS) $22.80 19990701 99999999 01850 ANESTHESIA FOR PROCEDURES ON VEINS OF FOREARM, WRIST, AND HAND; NOT OTHERWISE SP $22.80 19990701 99999999 01852 ANESTHESIA FOR PROCEDURES ON VEINS OF FOREARM, WRIST, AND HAND; PHLEBORRHAPHY $22.80 19990701 99999999 01860 ANESTHESIA FOR FOREARM, WRIST, OR HAND CAST APPLICATION, REMOVAL, OR REPAIR $22.80 19990701 99999999 01900 ANESTHESIA FOR INJECTION PROCEDURE FOR HYSTEROSALPINGOGRAPHY $22.80 19990701 99999999 01902 ANESTHESIA FOR BURR HOLE(S) FOR VENTRICULOGRAPHY $22.80 19990701 99999999 01904 ANESTHESIA FOR INJECTION PROCEDURE FOR PNEUMOENCEPHALOGRAPHY $22.80 19990701 99999999 01905 ANESTHESIA FOR MYELOGRAPHY, DISKOGRAPHY, VERTEBROPLASTY $22.80 20020101 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 91
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Medicaid Fee Schedule without Mods 200801

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