Medicaid Fee Schedule without Mods 200801

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PROC-CODE DESC MAC BEG END 01906 ANESTHESIA FOR INJECTION PROCEDURE FOR MYELOGRAPHY; LUMBAR $22.80 19990701 99999999 01908 ANESTHESIA FOR INJECTION PROCEDURE FOR MYELOGRAPHY; CERVICAL $22.80 19990701 99999999 01910 ANESTHESIA FOR INJECTION PROCEDURE FOR MYELOGRAPHY; POSTERIOR FOSSA $22.80 19990701 99999999 01912 ANESTHESIA FOR INJECTION PROCEDURE FOR DISKOGRAPHY; LUMBAR $22.80 19990701 99999999 01914 ANESTHESIA FOR INJECTION PROCEDURE FOR DISKOGRAPHY; CERVICAL $22.80 19990701 99999999 01916 ANESTHESIA FOR ARTERIOGRAMS, NEEDLE; CAROTID, OR VERTEBRAL $22.80 19990701 99999999 01918 ANESTHESIA FOR ARTERIOGRAMS, NEEDLE; RETROGRADE, BRACHIAL OR FEMORAL $22.80 19990701 99999999 01920 ANESTHESIA FOR CARDIAC CATHETERIZATION INCLUDING CORONARY ARTERIOGRAPHY AND VENT $22.80 19990701 99999999 01921 ANESTHESIA FOR ANGIOPLASTY $22.80 19990701 99999999 01922 ANESTHESIA FOR NON-INVASIVE IMAGING OR RADIATION THERAPY $22.80 19990701 99999999 01924 ANESTHESIA FOR THERAPEUTIC INTERVENTIONAL RADIOLOGIC PROCEDURES INVOLVING THE AR $22.80 20020101 99999999 01925 ANESTHESIA FOR THERAPEUTIC INTERVENTIONAL RADIOLOGIC PROCEDURES INVOLVING THE AR $22.80 20020101 99999999 01926 ANESTHESIA FOR THERAPEUTIC INTERVENTIONAL RADIOLOGIC PROCEDURES INVOLVING THE AR $22.80 20020101 99999999 01930 ANESTHESIA FOR THERAPEUTIC INTERVENTIONAL RADIOLOGIC PROCEDURES INVOLVING THE VE $22.80 20020101 99999999 01931 ANESTHESIA FOR THERAPEUTIC INTERVENTIONAL RADIOLOGIC PROCEDURES INVOLVING THE VE $22.80 20020101 99999999 01932 ANESTHESIA FOR THERAPEUTIC INTERVENTIONAL RADIOLOGIC PROCEDURES INVOLVING THE VE $22.80 20020101 99999999 01933 ANESTHESIA FOR THERAPEUTIC INTERVENTIONAL RADIOLOGIC PROCEDURES INVOLVING THE VE $22.80 20020101 99999999 01935 ANESTHESIA FOR PERCUTANEOUS IMAGE GUIDED PROCEDURES ON THE SPINE AND SPINAL CORD $22.80 20080101 99999999 01936 ANESTHESIA FOR PERCUTANEOUS IMAGE GUIDED PROCEDURES ON THE SPINE AND SPINAL CORD $22.80 20080101 99999999 01951 ANESTHESIA FOR SECOND AND THIRD DEGREE BURN EXCISION OR DEBRIDEMENT WITH OR WITH $22.80 20010101 99999999 01952 ANESTHESIA FOR SECOND AND THIRD DEGREE BURN EXCISION OR DEBRIDEMENT WITH OR WITH $22.80 20010101 99999999 01953 ANESTHESIA FOR SECOND AND THIRD DEGREE BURN EXCISION OR DEBRIDEMENT WITH OR WITH $22.80 20010101 99999999 01960 ANESTHESIA FOR; VAGINAL DELIVERY ONLY $22.80 20020101 99999999 01961 ANESTHESIA FOR; CESAREAN DELIVERY ONLY $22.80 20020101 99999999 01962 ANESTHESIA FOR; URGENT HYSTERECTOMY FOLLOWING DELIVERY $22.80 20020101 99999999 01963 ANESTHESIA FOR; CESAREAN HYSTERECTOMY WITHOUT ANY LABOR ANALGESIA/ANESTHESIA CAR $22.80 20020101 99999999 01964 ANESTHESIA FOR; ABORTION PROCEDURES $22.80 20020101 99999999 01965 ANESTHESIA FOR INCOMPLETE OR MISSED ABORTION PROCEDURES $22.80 20060101 99999999 01966 ANESTHESIA FOR INDUCED ABORTION PROCEDURES $22.80 20060101 99999999 01968 CESAREAN DELIVERY FOLLOWING NEURAXIAL LABOR ANALGESIA/ANESTHESIA (LIST SEPARATEL $22.80 20020101 99999999 01969 CESAREAN HYSTERECTOMY FOLLOWING NEURAXIAL LABOR ANALGESIA/ ANESTHESIA (LIST SEPA $22.80 20020101 99999999 01990 PHYSIOLOGICAL SUPPORT FOR HARVESTING OF ORGAN(S) FROM BRAIN-DEAD PATIENT $22.80 19990701 99999999 01991 ANESTHESIA FOR DIAGNOSTIC OR THERAPEUTIC NERVE BLOCKS AND INJECTIONS (WHEN BLOCK $22.80 20030401 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 92
PROC-CODE DESC MAC BEG END 01992 ANESTHESIA FOR DIAGNOSTIC OR THERAPEUTIC NERVE BLOCKS AND INJECTIONS (WHEN BLOCK $22.80 20030401 99999999 01995 REGIONAL IV ADMINISTRATION OF LOCAL ANESTHETIC AGENT (UPPER OR LOWER EXTREMITY) $22.80 19990701 99999999 01996 DAILY MANAGEMENT OF EPIDURAL OR SUBARACHNOID DRUG ADMINISTRATION $27.32 19990701 99999999 01999 UNLISTED ANESTHESIA PROCEDURE(S) $22.80 20020101 99999999 10021 FINE NEEDLE ASPIRATION; WITHOUT IMAGING GUIDANCE $65.06 20060701 99999999 10022 FINE NEEDLE ASPIRATION; WITH IMAGING GUIDANCE $66.30 20060701 99999999 10040 ACNE SURGERY (EG, MARSUPIALIZATION, OPENING OR REMOVAL OF $47.83 20060701 99999999 10060 INCISION AND DRAINAGE OF ABSCESS (EG, CARBUNCLE, SUPPURATIVE $52.42 20060701 99999999 10061 INCISION AND DRAINAGE OF ABSCESS (EG, CARBUNCLE, SUPPURATIVE $97.47 20060701 99999999 10080 INCISION AND DRAINAGE OF PILONIDAL CYST $56.78 20060701 99999999 10081 INCISION AND DRAINAGE OF PILONIDAL CYST $103.48 20060701 99999999 10120 INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES $54.57 20060701 99999999 10121 INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES $112.70 20060701 99999999 10140 INCISION AND DRAINAGE OF HEMATOMA $71.01 20060701 99999999 10160 PUNCTURE ASPIRATION OF ABSCESS, HEMATOMA, BULLA, OR CYST $57.25 20060701 99999999 10180 INCISION AND DRAINAGE, COMPLEX, POSTOPERATIVE WOUND INFECTION $108.05 20060701 99999999 11000 DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN $23.96 20060701 99999999 11001 DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN $12.45 20060701 99999999 11004 DEBRIDEMENT OF SKIN, SUBCUTANEOUS TISSUE, MUSCLE AND FASCIA FOR NECROTIZING $415.20 20060701 99999999 11005 DEBRIDEMENT OF SKIN, SUBCUTANEOUS TISSUE, MUSCLE AND FASCIA FOR NECROTIZING $566.13 20060701 99999999 11006 DEBRIDEMENT OF SKIN, SUBCUTANEOUS TISSUE, MUSCLE AND FASCIA FOR NECROTIZING $520.32 20060701 99999999 11008 REMOVAL OF PROSTHETIC MATERIAL OR MESH, ABDOMINAL WALL FOR NECROTIZING SOFT $211.51 20060701 99999999 11010 DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL ASSOCIATEDWITH OPEN FRACTURE $219.04 20060701 99999999 11011 DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL ASSOC WITHOPEN FX(S)/DISLOCATI $262.37 20060701 99999999 11012 DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL ASSOC WITHOPEN FRACTURE(S)/DIS $373.19 20060701 99999999 11040 DEBRIDEMENT $20.46 20060701 99999999 11041 DEBRIDEMENT $33.06 20060701 99999999 11042 DEBRIDEMENT $44.20 20060701 99999999 11043 DEBRIDEMENT $125.89 20060701 99999999 11044 DEBRIDEMENT $172.73 20060701 99999999 11055 PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR CALLUS); SINGLE L $15.03 20060701 99999999 11056 PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR CALLUS); TWO TO F $21.02 20060701 99999999 11057 PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR CALLUS); MORE THA $27.45 20060701 99999999 11100 BIOPSY OF SKIN, SUBCUTANEOUS TISSUE AND/OR MUCOUS MEMBRANE $32.61 20060701 99999999 11101 BIOPSY OF SKIN, SUBCUTANEOUS TISSUE AND/OR MUCOUS MEMBRANE $16.91 20060701 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 93
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Medicaid Fee Schedule without Mods 200801

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