Years > 2002 > March, 2002 > Friday, March 1, 2002
Next Article Next
Next Previous Article
67 FR 41 pgs. 9556-9579 - Medicare Program; Correction of Certain Calendar Year 2002 Payment Rates Under the Hospital Outpatient Prospective Payment System and the Pro Rata Reduction on Transitional Pass-Through Payments; Correction of Technical and Typographical Errors

Type: RULEVolume: 67Number: 41Pages: 9556 - 9579
Docket number: [CMS-1159-F4]
FR document: [FR Doc. 02-5071 Filed 2-28-02; 8:45 am]
Agency: Health and Human Services Department
Sub Agency: Centers for Medicare Medicaid Services
Official PDF Version:  PDF Version

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare Medicaid Services

42 CFR Parts 413, 419, and 489

[CMS-1159-F4]

RIN 0938-AK54

Medicare Program; Correction of Certain Calendar Year 2002 Payment Rates Under the Hospital Outpatient Prospective Payment System and the Pro Rata Reduction on Transitional Pass-Through Payments; Correction of Technical and Typographical Errors

AGENCY:

Centers for Medicare Medicaid Services (CMS), HHS.

ACTION:

Final rule.

SUMMARY:

This final rule corrects inadvertent technical errors that affect the amounts and factors used to determine the payment rates for services paid under the Medicare hospital outpatient prospective payment system as published in the November 30, 2001 final rule entitled "Changes to the Hospital Outpatient Prospective Payment System for Calendar Year 2002." In addition, this final rule corrects the amount of the uniform reduction to be applied to transitional pass-through payments for CY 2002. This final rule also corrects other technical and typographical errors that appeared in the November 30, 2001 final rule.

EFFECTIVE DATE:

This final rule is effective on April 1, 2002. The effective date for § 419.32(b)(1)(iii), revised at 66 FR 59856, published on November 30, 2001 and § 419.62(d), added at 66 FR 55865, published on November 2, 2001, is April 1, 2002.

FOR FURTHER INFORMATION CONTACT:

Robert Braver, (410) 786-0378.

SUPPLEMENTARY INFORMATION:

Availability of Copies and Electronic Access

Copies: To order copies of the Federal Register containing this document, send your request to: New Orders, Superintendent of Documents, P.O. Box 371954, Pittsburgh, PA 15250-7954. Specify the date of the issue requested and enclose a check or money order payable to the Superintendent of Documents, or enclose your Visa or Master Card number and expiration date. Credit card orders can also be placed by calling the order desk at (202) 512-1800 or by faxing to (202) 512-2250. The cost for each copy is $9. As an alternative, you can view and photocopy the Federal Register document at most libraries designated as Federal Depository Libraries and at many other public and academic libraries throughout the country that receive the Federal Register .

This Federal Register document is also available from the Federal Register online database through GPO Access, a service of the U.S. Government Printing Office. The Web site address is: http://www.access.gpo.gov/nara/index.html.

I. Background

On November 30, 2001, we published a final rule announcing the final ambulatory payment classification (APC) groups, relative weights, and payment rates under the hospital outpatient prospective payment system (OPPS) for calendar year (CY) 2002 (66 FR 59856). As discussed in detail in that final rule, in setting the APC relative weights, we incorporated 75 percent of the estimated transitional pass-through costs for devices eligible for transitional pass-through payments in CY 2002 into the costs of the APC groups associated with the use of the devices (66 FR 59906).

After publication of the November 30, 2001 final rule, we discovered that the final rule reflected several inadvertent technical errors in which we incorrectly associated specific devices approved for transitional pass-through payments with particular procedures. The magnitude of these errors was significant enough to affect not only the estimate of total transitional pass-through payments and the uniform reduction percentage to be applied to transitional pass-through payments in 2002, but also the payment rates for all procedure-related APCs. (Procedure-related APCs are those other than the APCs for pass-through drugs and devices, new technology, and partial hospitalization.) Using rates that reflected these errors would have inappropriately affected payments to hospitals. Thus, we determined that it would be inappropriate to allow the payment rates published on November 30, 2001 to become effective without further changes. In order to ensure that there were no other errors that might also have significant implications for OPPS payments, we decided to undertake an intensive review of the relevant data files. Because of the time needed for this review, we were unable to complete it and recalculate the rates before the previously published effective date of January 1, 2002 announced in the November 30, 2001 final rule. We therefore decided to continue to pay for services covered under the OPPS after January 1, 2002 and until no later than April 1, 2002 under the rates in effect on December 31, 2001. In addition, we decided to make transitional pass-through payments during that period without applying the uniform reduction announced on November 30, 2001.

Therefore, on December 31, 2001, we published a final rule, entitled "Prospective Payment System for Hospital Outpatient Services; Delay in Effective Date of Calendar Year 2002 Payment Rates and the Pro Rata Reduction on Transitional Pass-Through Payments' (66 FR 67494), that announced we would indefinitely delay the effective date for §§ 419.32(b)(1)(iii) and 419.62(d) of the regulations. We also announced that we were delaying until no later than April 1, 2002, the effective date of the updated OPPS payment rates and the uniform reduction of transitional pass-through payments that we published in the preamble and addenda of the November 30, 2001 final rule.

We did not delay the following provisions of the November 30, 2001 final rule:

• Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 coinsurance limit.

• Limitation of copayment amount to inpatient hospital deductible amount.

• Changes in services covered within the scope of OPPS.

• Categories of hospitals subject to, and excluded from, the OPPS.

• Criteria for new technology APCs.

• Provider-based issues.

• Change to the definition of "single-use devices" for transitional pass-through payments.

We have also discovered typographical and other technical errors in the preamble and addenda to the November 30, 2001 final rule. These errors involve the incorrect assignment of status indicators (SIs) to certain Physicians' Current Procedural Terminology (CPT) codes, inconsistencies between the preamble and addenda in the assignment of codes to APC groups, and similar matters. Correction of these typographical and technical errors does not involve any changes in the policies announced in the November 30, 2001 final rule. Corrections to the preamble text are listed below. The appropriate corrections are incorporated into the new addenda A, B, C, and D. The corrected addenda A and D are printed at the end of this rule. Addenda B and C are available on our Web site: http://www.cms.hhs.gov. Tables 2 and 3 below summarize the corrections to the errors in addenda A and B.

II. Correction of Errors

In the FR Doc. 01-29621 published November 30, 2001 (66 FR 59856), we are making the corrections described below.

A. Corrections of Device Cost Assignments to APCs

Since publication of the December 31, 2001 final rule, we have conducted an intensive internal review of device costs associated with specific CPT codes. We have also considered information concerning the use of devices brought to our attention from hospitals, manufacturers, and other such sources. As a result of this review, we determined that we had inadvertently associated device(s) with certain procedures for which no devices are used, incorrectly identified device(s) used with certain other procedures, or failed to associate one or more devices with procedures requiring the use of those devices. The following APCs were affected:

• APC 0084Level I Electrophysiologic Evaluation

• APC 0085Level II Electrophysiologic Evaluation

• APC 0090Insertion/Replacement of Pacemaker/Pulse Generator

• APC 0091Level I Vascular Ligation

• APC 0104Transcatheter Placement of Intracoronary Stents

• APC 0229Transcatheter Placement of Intravascular Shunts

• APC 0237Level III Posterior Segment Eye Procedures

• APC 0241Level IV Repair and Plastic Eye Procedures

• APC 0242Level V Repair and Plastic Eye Procedures

• APC 0246Cataract Procedures with IOL Insert

• APC 0248Laser Retinal Procedures

• APC 0312Radioelement Applications

• APC 0313Brachytherapy

The changes in the assignment of device costs associated with these 13 APCs resulted in a net reduction in the estimate of total transitional pass-through payments for CY 2002.

In addition, the changes in the assignment of device costs associated with these 13 APCs have caused changes to the median costs for these APCs. (Median costs are used to set the relative weights of each APC. The relative weight of each APC is the ratio of its median cost to the median cost of APC 601, Mid-level clinic visit, adjusted by the "scalar" that is discussed below.) We found that the changes in the assignment of device costs and the resulting changes in the median costs of the 13 associated APC groups affected the relative payment weights for all procedure-related APCs as well as the estimate of aggregate CY 2002 payments.

The changes in relative payment weights resulting from revisions in the assignment of device costs associated with the 13 APCs identified above required that we recalculate the "scalar," which is the factor that we use to ensure compliance with section 1833(t)(9)(B) of the Social Security Act (the Act). That section of the Act provides that APC reclassification and recalibration changes (and wage index changes) must be made in a manner so that the estimated aggregate payments under the OPPS for a particular year are neither greater nor less than the estimated aggregate payments would have been without these changes. The corrections, as well as appropriate adjustments made under the authority of section 1833(t)(2)(E) of the Act, have the overall effect of revising the scalar from 0.945, which we announced in the November 30, 2001 final rule (66 FR 59886), to 0.951. This revised scalar has the effect of slightly increasing the relative weights of the procedure-related APCs (except for those for which we revised the device-associated costs).

We are also revising the target that we set for outlier payments in the November 30, 2001 final rule from 2.0 percent to 1.5 percent, and thus we are revising the threshold for outlier payments from 3 times the applicable APC payment for a service to 3.5 times the applicable payment amount for a service. These adjustments ensure that the payment rate for every procedure-related APC is at least equal to and in no case lower than the rate published in the November 30, 2001 final rule (except for those APCs for which we revised the device-associated costs). The conversion factor is reduced by 1.5 percent (rather than 2.0 percent) to reflect the revised outlier target and 0.5 percent for the adjustments described above that are due to changes in relative payment weights resulting from revisions in the assignment of device costs. The overall effect of these adjustments does not change the conversion factor announced in the November 2, 2001 final rule. The conversion factor remains $50.904.

Recalculation of the scalar changes the offset amounts that we published in Table 5 in the November 30, 2001 final rule. Certain APC rates increased as a result of the incorporation of 75 percent of the pass-through costs of devices eligible for pass-through payments. Those amounts were deducted from the pass-through payments for those devices, so that the increases to the APC rates were offset by the simultaneous reduction of the associated pass-through costs, as described in the November 30, 2001 final rule (66 FR 59904-59906). The recalculated offset amounts are listed in Table 1 below, which parallels Table 5 of the November 30, 2001 final rule (66 FR 59907). Column 3 shows the device costs already included in the rates for 25 APCs before we incorporated 75 percent of the pass-through device costs into the rates. The label "NA" in column 3 means that there were no device costs associated with the APC before incorporating 75 percent of pass-through device costs into the rates. In Table 1, the amounts in column 3 have not changed since the November 30, 2001 final rule. In Table 1, the amounts in column 5, which are the sum of columns 3 and 4, have changed to account for the corrections in column 4.

APC Description Device costs (before fold-in) reflected in APC rate Additional device costs folded into APC rate Total offset for device costs
1 2 3 4 5
0032 Insertion of Central Venous/Arterial Catheter $73.79 $279.97 $353.76
0046 Open/Percutaneous Treatment Fracture or Dislocation NA 100.29 100.29
0048 Arthroplasty with Prosthesis NA 514.64 514.64
0057 Bunion Procedures NA 162.89 162.89
0070 Thoracentesis/Lavage Procedures NA 26.47 26.47
0080 Diagnostic Cardiac Catheterization 164.27 134.39 298.66
0081 Non-Coronary Angioplasty or Atherectomy 307.06 362.95 670.01
0082 Coronary Atherectomy 242.95 1,214.06 1,457.01
0083 Coronary Angioplasty 528.64 383.31 911.95
0085 Level II Electrophysiologic Evaluation NA 1,578.03 1,578.03
0086 Ablate Heart Dysrhythm Focus NA 1,320.96 1,320.96
0087 Cardiac Electrophysiologic Recording/Mapping NA 1,980.16 1,980.16
0088 Thrombectomy 162.72 261.14 423.86
0089 Insertion/Replacement of Permanent Pacemaker and Electrodes 3,175.70 3,286.36 6,462.06
0090 Insertion/Replacement of Pacemaker Pulse Generator 2,921.06 2,123.20 5,044.26
0094 Resuscitation and Cardioversion NA 19.34 19.34
0103 Miscellaneous Vascular Procedures NA 207.18 207.18
0104 Transcatheter Placement of Intracoronary Stents 428.16 1,256.31 1,684.47
0106 Insertion/Replacement/Repair of Pacemaker and/or Electrodes 657.59 1,049.13 1,706.72
0107 Insertion of Cardioverter-Defibrillator 6,803.85 11,099.62 17,903.47
0108 Insertion/Replacement/Repair of Cardioverter-Defibrillator Leads 6,940.27 19,607.20 26,547.47
0111 Blood Product Exchange NA 209.72 209.72
0115 Cannula/Access Device Procedures NA 127.26 127.26
0117 Chemotherapy Administration by Infusion Only NA 30.03 30.03
0118 Chemotherapy Administration by Both Infusion and Other Technique NA 28.50 28.50
0119 Implantation of Devices NA 3,348.98 3,348.98
0120 Infusion Therapy Except Chemotherapy NA 35.12 35.12
0121 Level I Tube Changes and Repositioning NA 6.10 6.10
0122 Level II Tube Changes and Repositioning 72.55 214.82 287.37
0124 Revision of Implanted Infusion Pump NA 3,308.76 3,308.76
0144 Diagnostic Anoscopy NA 128.28 128.28
0151 Endoscopic Retrograde Cholangio-Pancreatography (ERCP) 60.92 0.00 60.92
0152 Percutaneous Biliary Endoscopic Procedures 107.61 0.00 107.61
0153 Peritoneal and Abdominal Procedures NA 41.23 41.23
0154 Hernia/Hydrocele Procedures 108.11 378.73 486.84
0161 Level II Cystourethroscopy and other Genitourinary Procedures NA 11.20 11.20
0162 Level III Cystourethroscopy and other Genitourinary Procedures NA 319.68 319.68
0163 Level IV Cystourethroscopy and other Genitourinary Procedures NA 901.51 901.51
0179 Urinary Incontinence Procedures NA 3,400.90 3,400.90
0182 Insertion of Penile Prosthesis 2,238.90 569.11 2,808.14
0202 Level VIII Female Reproductive Proc 505.32 1,233.41 1,738.73
0203 Level V Nerve Injections NA 420.98 420.98
0207 Level IV Nerve Injections NA 63.63 63.63
0222 Implantation of Neurological Device 4,458.57 9,599.99 14,058.56
0223 Implantation of Pain Management Device 421.33 3,330.14 3,751.47
0225 Implantation of Neurostimulator Electrodes 1,182.00 11,941.06 13,123.06
0226 Implantation of Drug Infusion Reservoir NA 3,363.74 3,363.74
0227 Implantation of Drug Infusion Device 3,810.46 2,395.55 6,206.01
0229 Transcatherter Placement of Intravascular Shunts 1,074.41 842.97 1,917.38
0246 Cataract Procedures with IOL Insert 146.82 0.00 146.82
0259 Level VI ENT Procedures 12,407.52 3,836.13 16,243.65
0264 Level II Miscellaneous Radiology Procedures NA 61.59 61.59
0312 Radioelement Applications NA 5,897.22 5,897.22
0313 Brachytherapy NA 998.23 998.23
0685 Level III Needle Biopsy/Aspiration Except Bone Marrow NA 210.75 210.75
0686 Level V Skin Repair NA 465.77 465.77
0687 Revision/Removal of Neurostimulator Electrodes NA 1,444.65 1,444.65
0688 Revision/Removal of Neurostimulator Pulse Generator Receiver NA 6,238.79 6,238.79
0692 Electronic Analysis of Neurostimulator Pulse Generators NA 644.44 644.44

As noted above, the estimates of transitional pass-through payments for devices, and of total pass-through payments for all eligible items, have decreased because of the corrections of device costs associated with specific procedures. After we incorporated 75 percent of the estimated pass-through device costs into the APCs, the remaining estimate of total pass-through payments for CY 2002 is 1.20 billion, which results in a uniform reduction in pass-through payments for 2002 of 63.6 percent.

During the first quarter of CY 2002, payments to hospitals for outpatient services are based on the rates and Healthcare Common Procedure Coding System (HCPCS) codes that were in effect for CY 2001, and a uniform reduction of transitional pass-through payments does not apply. Hospitals have thus received the advantage of much higher pass-through payments during the first quarter of CY 2002 than they would have, had we proceeded with implementation of the revised CY 2002 rates and the requisite uniform reduction for services furnished on or after January 1, 2002.

We are making four revised addenda available. Revised Addendum A and Addendum D are printed at the end of this preamble. Addendum A shows the corrected relative weights and payment rates, as well as the national unadjusted copayment and minimum unadjusted copayment amounts that are effective April 1, 2002. Addendum D incorporates several corrections to the payment status indicator addendum that was published on November 30, 2001.

Revised Addendum B and Addendum C are available on our Web site at http://www.cms.hhs.gov. Addendum B shows payment rates, weights, APC assignment, and payment status by HCPCS code. Addendum C lists the HCPCS codes in each APC group.

On December 31, 2001, we published a final rule that delayed the effective date of the payment rates and the uniform reduction to the transitional pass-through payments under the OPPS announced in the November 30, 2001 final rule until no later than April 1, 2002. We also announced that payment under the OPPS would continue to be made under the payment rates in effect on December 31, 2001, and that we would not apply a uniform reduction to payments for transitional pass-through items. This final rule implements the revised payment rates in Addendum A effective for services furnished on or after April 1, 2002. Also, effective for services furnished on or after April 1, 2002, a uniform reduction of 63.6 percent applies to transitional pass-through payments made under the OPPS. In addition, effective for services furnished on or after April 1, 2002, the threshold for determining outlier payments is when service costs are 3.5 times greater than the applicable APC payment amount. Also, effective for services furnished on or after April 1, 2002, payment will be made for new 2002 HCPCS codes and modifiers that are payable under the OPPS.

B. Correction of Technical and Typographical Errors in the Preamble and the Regulations Text of the November 30, 2001 Final Rule

We are correcting the following typographical and technical errors in the preamble and regulations text of the November 30, 2001 final rule. As we have stated previously, these corrections do not involve any changes in the policies announced in that rule.

1. On page 59863, in column two, the heading "Level I Nerve Injections (to include Trigger Point, Joint, Other Injections, and Lower Complexity Nerve Blocks)" is corrected to read "Level VI Nerve Injections (APC 204) (to include Trigger Point, Joint, Other Injections, and Lower Complexity Nerve Blocks)."

2. On page 59863, in column two, the chart that will be under the revised heading (see item 1 above) "Level VI Nerve Injections (APC 204) (to include Trigger Point, Joint, Other Injections, and Lower Complexity Nerve Blocks)" is revised to read:

Reassigned CPT Code from APC
27096 (1 )
62270 0210
62272 0210
62273 0212
62310-62319 0212
1 Currently packaged.

3. On page 59863, in column two, the heading "Level II Nerve Injections (to include Moderate Complexity Nerve Blocks and Epidurals):" is corrected to read "Level III Nerve Injections (APC 206) (to include Moderate Complexity Nerve Blocks and Epidurals):".

4. On page 59863, in column two and continuing to the top of column three, the heading "Level III Nerve Injections (to include Moderately High Complexity Epidurals, Facet Blocks, and Disk Injections):" is corrected to read "Level IV Nerve Injections (APC 207) (to include Moderately High Complexity Epidurals, Facet Blocks, and Disk Injections):".

5. On page 59863, in column three, the heading "Level IV Nerve Injections (to include High Complexity Lysis of Adhesions, Neurolytic Procedures, Removal of Implantable Pumps and Stimulators):" is corrected to read "Level V Nerve Injections (APC 203) (to include High Complexity Lysis of Adhesions, Neurolytic Procedures, Removal of Implantable Pumps and Stimulators):".

6. On page 59868, in column two, the first and second complete sentences beginning at line five from the top of the page are corrected to read "We would note that payment for IMRT planning includes payment for the following CPT codes: 77300, 77336, 77370, 77280-77295, 77305-77321. The only CPT codes that may be billed in addition to 77301 (IMRT planning) are the CPT codes 77332-77334."

7. On page 59870, in column one, the last sentence is corrected to read "According to our methodology for pricing new technology services, these services will be reassigned to APC 0714, New Technology-Level IX ($1250-$1500), which results in a payment rate of $1,375 with a status indicator of 'S,' indicating that the multiple procedure discount is not applied."

8. On page 59883, in column two, on line 17 from the top of the page, "G0224," is corrected to read "G0244."

9. On page 59883, in column two, beginning at the bottom of the page and continuing to the top of column three, the list of acceptable diagnosis codes for chest pain is corrected to read as follows:

For Chest Pain:

411.1Intermediate coronary syndrome

411.81Coronary occlusion without myocardial infarction

411.0Postmyocardial infarction syndrome

411.89Other acute ischemic heart disease

413.0Angina decubitus

413.1Prinzmetal angina

413.9Other and unspecified angina pectoris

786.05Shortness of breath

786.50Chest pain, unspecified

786.51Precordial pain

786.52Painful respiration

786.59Other chest pain

10. On page 59883, in column three, the list of acceptable diagnosis codes for congestive heart failure is corrected to read as follows:

For Congestive Heart Failure:

391.8Other acute rheumatic heart disease

398.91Rheumatic heart failure (congestive)

402.01Malignant hypertensive heart disease with congestive heart failure

402.11Benign hypertensive heart disease with congestive heart failure

402.91Unspecified hypertensive heart disease with congestive heart failure

404.01Malignant hypertensive heart and renal disease with congestive heart failure

404.03Malignant hypertensive heart and renal disease with congestive heart and renal failure

404.11Benign hypertensive heart and renal disease with congestive heart failure

404.13Benign hypertensive heart and renal disease with congestive heart and renal failure

404.91Unspecified hypertensive heart and renal disease with congestive heart failure

404.93Unspecified hypertensive heart and renal disease with congestive heart and renal failure

428.0Congestive heart failure

428.1Left heart failure

428.9Heart failure, unspecified

11. On page 59883, in column three, the second-to-last sentence is corrected to read "For asthma, a peak expiratory flow rate (PEFR) (CPT code 94010), or pulse oximetry (CPT codes 94760 or 94761)."

12. We are also making revisions to our regulations under 42 CFR Part 419, specifically § 419.32 "Calculation of prospective payment rates for hospital outpatient services," and § 419.62 "Transitional pass-through payments: General rules." At §§ 419.32(b)(1)(iii) and 419.62(d), we are revising our language to specify that the provisions under these sections are applicable to a portion of CY 2002 and not necessarily the entire year for 2002.

C. Correction of Technical and Typographical Errors in Addenda A, B, C, and D

Addenda A, B, and D as published in the November 30, 2001 final rule contain a number of typographical and technical errors that do not involve any changes in the policies announced in that rule. Addenda A and D at the end of this document reflect the corrections of these errors. Corrected addenda B and C are available on our Web site athttp://www.cms.hhs.gov.

1. Corrections to Addendum A

Table 2, Corrections to Addendum A of the November 30, 2001 final rule, shows the APC listings for which corrections are required. It provides the data as published in that final rule and the additions and corrections to these data.

BILLING CODE 4120-01-P

[Federal Register graphic "ER01MR02.000" is not available. Please view the graphic in the PDF version of this document.]

[Federal Register graphic "ER01MR02.001" is not available. Please view the graphic in the PDF version of this document.]

2. Corrections to Addendum B of the November 30, 2001 Final Rule

Table 3, Corrections to Addendum B of the November 30, 2001 final rule shows the APC assignments for which corrections are required. It provides the data as published in that final rule and the additions and corrections to these data.

[Federal Register graphic "ER01MR02.002" is not available. Please view the graphic in the PDF version of this document.]

[Federal Register graphic "ER01MR02.003" is not available. Please view the graphic in the PDF version of this document.]

[Federal Register graphic "ER01MR02.004" is not available. Please view the graphic in the PDF version of this document.]

BILLING CODE 4120-01-C

3. Corrections to Addendum D of the November 30, 2001 Final Rule

On page 60091, there are two corrections to Addendum D as published in the November 30, 2001 final rule.

a. Under the status column for Screening Mammography, "Lower of Charges or National Rate" is revised to read "Physician Fee Schedule."

b. We are adding a status indicator that was inadvertently omitted. In the indicator column we are adding, where it should appear alphabetically, status indicator "D", "Deleted Code" under the service column, and "Codes Are Deleted Effective with the Beginning of the Calendar Year" under the status column.

III. Waiver of Notice of Proposed Rulemaking

We ordinarily publish a notice of proposed rulemaking in the Federal Register and invite public comment on the proposed rule. The notice of proposed rulemaking includes a reference to the legal authority under which the rule is proposed, and the terms and substances of the proposed rule or a description of the subjects and issues involved. This procedure can be waived, however, if an agency finds good cause that a notice-and-comment procedure is impracticable, unnecessary, or contrary to the public interest and incorporates a statement of the finding and its reasons in the rule issued. The rates in this final rule incorporate the correction of errors that were identified in connection with the rates published in the November 30, 2001 final rule.

We find that it is in the general public interest to proceed with implementing the corrected rates without proposed rulemaking and public comment. The delay in implementing the 2002 rates was necessary to correct identified inadvertent technical errors and to allow us to review our data files to ensure that other errors could also be identified and corrected. As a matter of good public policy, we do not believe that the necessary delay in implementing the CY 2002 OPPS rates should result in continued uncertainty among hospitals, beneficiaries, and others regarding CY 2002 payment rates for OPPS services. The public is expecting the corrected OPPS update for CY 2002 to be made effective no later than April 1, 2002. Thus, there is an urgent need, effective for services furnished on or after April 1, 2002, to implement the corrected rate update and new 2002 HCPCS codes for Medicare payments under the OPPS. There is not sufficient time to provide notice of proposed rulemaking without further delaying the effective date of the rates. Therefore, we find that it is contrary to the public interest to continue to delay the effective date of the rates.

IV. Collection of Information Requirements

This document does not impose information collection and record-keeping requirements. Consequently, the Office of Management and Budget need not review it under the authority of the Paperwork Reduction Act of 1995.

V. Regulatory Impact Statement

We have examined the impacts of this rule as required by Executive Order 12866 (September 1993, Regulatory Planning and Review) and the Regulatory Flexibility Act (RFA) (September 19, 1980 Pub. L. 96-354). Executive Order 12866 directs agencies to assess all costs and benefits of available regulatory alternatives and, if regulation is necessary, to select regulatory approaches that maximize net benefits (including potential economic, environmental, public health and safety effects, distributive impacts, and equity). A regulatory impact analysis (RIA) must be prepared for major rules with economically significant effects ($100 million or more annually).

As discussed above in this preamble, this final rule corrects inadvertent technical errors in the November 30, 2001 final rule that implemented the CY 2002 payments for the hospital OPPS. We note that the November 30, 2001 final rule was not a major rule. As we also discussed above in the preamble, this final rule corrects the estimate of the transitional pass-through payments for CY 2002 and the resulting uniform reduction that is required for that year, the median costs for several APCs, the scalar used to adjust the relative payment weights for the effects of recalibration, and device cost assignment to device-related APCs. We also note that on November 2, 2001, we published a final rule that announced the updated conversion factor for payments under the OPPS (66 FR 55857).

The RFA requires agencies to analyze options for regulatory relief of small businesses. For purposes of the RFA, small entities include small businesses, nonprofit organizations, and government agencies. Most hospitals and most other providers and suppliers are small entities, either by nonprofit status or by having revenues between $5 million and $25 million (for details see the Small Business Administration's final rule that set forth size standards for health care industries at 65 FR 69432). Individuals and States are not included in the definition of a small entity.

In addition, section 1102(b) of the Act requires us to prepare a regulatory impact analysis for any final rule that may have a significant impact on the operations of a substantial number of small rural hospitals. Such an analysis must conform to the provisions of section 604 of the RFA. With the exception of hospitals located in certain New England counties, for purposes of section 1102(b) of the Act, we define a small rural hospital as a hospital with not more than 100 beds that is located outside of a Metropolitan Statistical Area (MSA) or New England County Metropolitan Area (NECMA). Section 601(g) of the Social Security Amendments of 1983 (Pub. L. 98-21) designated hospitals in certain New England counties as belonging to the adjacent NECMA. Thus, for purposes of the PPS, we classify these hospitals as urban hospitals. See the November 30, 2001 final rule for the regulatory impact analysis related to the updated CY 2002 hospital OPPS payments.

Section 202 of the Unfunded Mandates Reform Act of 1995 also requires that agencies assess anticipated costs and benefits before issuing any rule that may result in an expenditure in any 1 year by State, local, or tribal governments, in the aggregate, or by the private sector, of $110 million. This final rule will not have a significant economic effect on these governments or the private sector.

Executive Order 13132 establishes certain requirements that an agency must meet when it promulgates a final rule that imposes substantial direct compliance costs on State and local governments, preempts State law, or otherwise has Federalism implications. This final rule will not have a substantial effect on States or local governments.

Because the November 30, 2001 final rule includes the relevant impact analysis for the changes to the hospital OPPS, we are not preparing analyses for either the RFA or section 1102(b) of the Act.

In accordance with the provisions of Executive Order 12866, this regulation was reviewed by the Office of Management and Budget.

List of Subjects 42 CFR Part 419

Hospitals, Medicare, Reporting and recordkeeping requirements.

For the reasons set forth in the preamble, 42 CFR part 419 is corrected by making the following correcting amendments:

PART 419-PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES

1. The authority citation continues to read as follows:

Authority:

Secs. 1102, 1833(t), and 1871 of the Social Security Act (42 U.S.C. 1302, 1395l(t), and 1395hh).

§ 419.32 [Corrected]

2. In § 419.32, paragraph (b)(1)(iii) is corrected by removing the phrase "For calendar year 2002," and adding in its place the phrase "For the portion of calendar year 2002 that is affected by these rules,".

§ 419.62 [Corrected]

In § 419.62, paragraph (d) is corrected by removing the phrase "For CY 2002" and adding in its place "For the portion of CY 2002 affected by these rules,".

(Catalog of Federal Domestic Assistance Program No. 93.773, Medicare-Hospital Insurance; and Program No. 93.774, Medicare-Supplementary Medical Insurance Program)

Dated: February 27, 2002.

Thomas A. Scully,

Administrator, Centers for Medicare Medicaid Services.

Approved: February 27, 2002.Tommy G. Thompson,

Secretary.

APC Group title Status indicator Relative weight Payment rate National unadjusted copayment Minimum unadjusted copayment
0001 Photochemotherapy S 0.43 $21.89 $7.88 $4.38
0002 Fine needle Biopsy/Aspiration T 0.42 $21.38 $11.76 $4.28
0003 Bone Marrow Biopsy/Aspiration T 1.04 $52.94 $27.08 $10.59
0004 Level I Needle Biopsy/ Aspiration Except Bone Marrow T 2.48 $126.24 $32.57 $25.25
0005 Level II Needle Biopsy /Aspiration Except Bone Marrow T 4.05 $206.16 $90.71 $41.23
0006 Level I Incision Drainage T 2.19 $111.48 $33.95 $22.30
0007 Level II Incision Drainage T 6.79 $345.64 $72.03 $69.13
0008 Level III Incision and Drainage T 10.99 $559.43 $113.67 $111.89
0009 Nail Procedures T 0.63 $32.07 $8.34 $6.41
0010 Level I Destruction of Lesion T 0.66 $33.60 $9.86 $6.72
0011 Level II Destruction of Lesion T 1.48 $75.34 $27.88 $15.07
0012 Level I Debridement Destruction T 0.66 $33.60 $9.18 $6.72
0013 Level II Debridement Destruction T 1.37 $69.74 $17.66 $13.95
0015 Level IV Debridement Destruction T 2.08 $105.88 $31.20 $21.18
0016 Level V Debridement Destruction T 3.04 $154.75 $65.00 $30.95
0017 Level VI Debridement Destruction T 9.73 $495.30 $227.84 $99.06
0018 Biopsy of Skin/Puncture of Lesion T 1.06 $53.96 $17.66 $10.79
0019 Level I Excision/ Biopsy T 4.24 $215.83 $78.91 $43.17
0020 Level II Excision/ Biopsy T 8.49 $432.17 $130.53 $86.43
0021 Level IV Excision/ Biopsy T 11.89 $605.25 $236.51 $121.05
0022 Level V Excision/ Biopsy T 13.99 $712.15 $292.94 $142.43
0023 Exploration Penetrating Wound T 2.09 $106.39 $40.37 $21.28
0024 Level I Skin Repair T 2.29 $116.57 $41.97 $23.31
0025 Level II Skin Repair T 3.41 $173.58 $65.57 $34.72
0026 Level III Skin Repair T 12.69 $645.97 $277.92 $129.19
0027 Level IV Skin Repair T 18.12 $922.38 $383.10 $184.48
0028 Level I Breast Surgery T 14.08 $716.73 $303.74 $143.35
0029 Level II Breast Surgery T 23.90 $1,216.61 $632.64 $243.32
0030 Level III Breast Surgery T 34.40 $1,751.10 $763.55 $350.22
0032 Insertion of Central Venous/Arterial Catheter T 12.71 $646.99 $129.40
0033 Partial Hospitalization P 4.17 $212.27 $48.17 $42.45
0035 Placement of Arterial or Central Venous Catheter T 0.13 $6.62 $2.91 $1.32
0041 Level I Arthroscopy T 23.74 $1,208.46 $580.06 $241.69
0042 Level II Arthroscopy T 35.97 $1,831.02 $804.74 $366.20
0043 Closed Treatment Fracture Finger/Toe/Trunk T 4.07 $207.18 $41.44
0044 Closed Treatment Fracture/Dislocation Except Finger/Toe/Trunk T 2.54 $129.30 $38.08 $25.86
0045 Bone/Joint Manipulation Under Anesthesia T 11.74 $597.61 $277.12 $119.52
0046 Open/Percutaneous Treatment Fracture or Dislocation T 27.86 $1,418.19 $535.76 $283.64
0047 Arthroplasty without Prosthesis T 26.51 $1,349.47 $537.03 $269.89
0048 Arthroplasty with Prosthesis T 43.44 $2,211.27 $725.94 $442.25
0049 Level I Musculoskeletal Procedures Except Hand and Foot T 15.93 $810.90 $356.95 $162.18
0050 Level II Musculoskeletal Procedures Except Hand and Foot T 20.75 $1,056.26 $507.15 $211.25
0051 Level III Musculoskeletal Procedures Except Hand and Foot T 28.73 $1,462.47 $675.24 $292.49
0052 Level IV Musculoskeletal Procedures Except Hand and Foot T 36.15 $1,840.18 $930.91 $368.04
0053 Level I Hand Musculoskeletal Procedures T 11.76 $598.63 $253.49 $119.73
0054 Level II Hand Musculoskeletal Procedures T 19.95 $1,015.53 $472.33 $203.11
0055 Level I Foot Musculoskeletal Procedures T 15.52 $790.03 $355.34 $158.01
0056 Level II Foot Musculoskeletal Procedures T 18.95 $964.63 $405.81 $192.93
0057 Bunion Procedures T 24.49 $1,246.64 $496.65 $249.33
0058 Level I Strapping and Cast Application S 1.28 $65.16 $19.27 $13.03
0059 Level II Strapping and Cast Application S 2.23 $113.52 $29.59 $22.70
0060 Manipulation Therapy S 0.23 $11.71 $2.34
0068 CPAP Initiation S 3.04 $154.75 $85.11 $30.95
0069 Thoracoscopy T 23.72 $1,207.44 $591.64 $241.49
0070 Thoracentesis/Lavage Procedures T 4.61 $234.67 $79.60 $46.93
0071 Level I Endoscopy Upper Airway T 1.04 $52.94 $14.22 $10.59
0072 Level II Endoscopy Upper Airway T 1.22 $62.10 $34.16 $12.42
0073 Level III Endoscopy Upper Airway T 3.31 $168.49 $74.14 $33.70
0074 Level IV Endoscopy Upper Airway T 11.39 $579.80 $295.70 $115.96
0075 Level V Endoscopy Upper Airway T 17.52 $891.84 $445.92 $178.37
0076 Endoscopy Lower Airway T 7.61 $387.38 $189.82 $77.48
0077 Level I Pulmonary Treatment S 0.39 $19.85 $10.92 $3.97
0078 Level II Pulmonary Treatment S 0.87 $44.29 $19.04 $8.86
0079 Ventilation Initiation and Management S 0.60 $30.54 $16.80 $6.11
0080 Diagnostic Cardiac Catheterization T 34.93 $1,778.08 $838.92 $355.62
0081 Non-Coronary Angioplasty or Atherectomy T 29.42 $1,497.60 $710.91 $299.52
0082 Coronary Atherectomy T 92.53 $4,710.15 $1,351.74 $942.03
0083 Coronary Angioplasty T 59.84 $3,046.10 $794.30 $609.22
0084 Level I Electrophysiologic Evaluation S 6.90 $351.24 $115.91 $70.25
0085 Level II Electrophysiologic Evaluation T 58.28 $2,966.69 $654.48 $593.34
0086 Ablate Heart Dysrhythm Focus T 73.14 $3,723.12 $1,265.37 $744.62
0087 Cardiac Electrophysiologic Recording/Mapping T 52.77 $2,686.20 $537.24
0088 Thrombectomy T 34.57 $1,759.75 $678.68 $351.95
0089 Insertion/Replacement of Permanent Pacemaker and Electrodes T 150.39 $7,655.45 $2,246.59 $1,531.09
0090 Insertion/Replacement of Pacemaker Pulse Generator T 116.11 $5,910.46 $2,133.88 $1,182.09
0091 Level I Vascular Ligation T 21.15 $1,076.62 $348.23 $215.32
0092 Level II Vascular Ligation T 20.02 $1,019.10 $505.37 $203.82
0093 Vascular Repair/Fistula Construction T 14.24 $724.87 $277.34 $144.97
0094 Resuscitation and Cardioversion S 6.12 $311.53 $105.29 $62.31
0095 Cardiac Rehabilitation S 0.62 $31.56 $16.73 $6.31
0096 Non-Invasive Vascular Studies S 1.72 $87.55 $48.15 $17.51
0097 Cardiac and Ambulatory Blood Pressure Monitoring X 0.85 $43.27 $23.80 $8.65
0098 Injection of Sclerosing Solution T 1.25 $63.63 $20.88 $12.73
0099 Electrocardiograms S 0.36 $18.33 $10.08 $3.67
0100 Stress Tests and Continuous ECG X 1.48 $75.34 $41.44 $15.07
0101 Tilt Table Evaluation S 3.76 $191.40 $105.27 $38.28
0103 Miscellaneous Vascular Procedures T 16.04 $816.50 $295.70 $163.30
0104 Transcatheter Placement of Intracoronary Stents T 96.97 $4,936.16 $987.23
0105 Revision/Removal of Pacemakers, AICD, or Vascular T 14.85 $755.92 $370.40 $151.18
0106 Insertion/Replacement/Repair of Pacemaker and/or Electrodes T 36.85 $1,875.81 $503.07 $375.16
0107 Insertion of Cardioverter-Defibrillator T 381.66 $19,428.02 $4,224.27 $3,885.60
0108 Insertion/Replacement/Repair of Cardioverter-Defibrillator Leads T 576.78 $29,360.41 $5,872.08
0109 Removal of Implanted Devices T 6.30 $320.70 $131.49 $64.14
0110 Transfusion S 5.34 $271.83 $114.17 $54.37
0111 Blood Product Exchange S 21.21 $1,079.67 $300.74 $215.93
0112 Apheresis, Photopheresis, and Plasmapheresis S 36.46 $1,855.96 $612.47 $371.19
0113 Excision Lymphatic System T 15.62 $795.12 $326.55 $159.02
0114 Thyroid/Lymphadenectomy Procedures T 29.46 $1,499.63 $493.78 $299.93
0115 Cannula/Access Device Procedures T 21.47 $1,092.91 $506.74 $218.58
0116 Chemotherapy Administration by Other Technique Except Infusion S 0.91 $46.32 $9.26
0117 Chemotherapy Administration by Infusion Only S 4.03 $205.14 $52.69 $41.03
0118 Chemotherapy Administration by Both Infusion and Other Technique S 4.22 $214.81 $72.03 $42.96
0119 Implantation of Devices T 80.14 $4,079.45 $815.89
0120 Infusion Therapy Except Chemotherapy T 3.10 $157.80 $42.67 $31.56
0121 Level I Tube changes and Repositioning T 2.56 $130.31 $52.53 $26.06
0122 Level II Tube changes and Repositioning T 9.94 $505.99 $114.93 $101.20
0123 Bone Marrow Harvesting and Bone Marrow/Stem Cell Transplant S 8.62 $438.79 $87.76
0124 Revision of Implanted Infusion Pump T 89.58 $4,559.98 $912.00
0125 Refilling of Infusion Pump T 3.01 $153.22 $30.64
0130 Level I Laparoscopy T 26.06 $1,326.56 $659.53 $265.31
0131 Level II Laparoscopy T 37.85 $1,926.72 $1,001.89 $385.34
0132 Level III Laparoscopy T 56.38 $2,869.97 $1,239.22 $573.99
0140 Esophageal Dilation without Endoscopy T 5.68 $289.13 $107.24 $57.83
0141 Upper GI Procedures T 7.25 $369.05 $184.67 $73.81
0142 Small Intestine Endoscopy T 6.98 $355.31 $152.78 $71.06
0143 Lower GI Endoscopy T 7.31 $372.11 $186.06 $74.42
0144 Diagnostic Anoscopy T 4.46 $227.03 $49.32 $45.41
0145 Therapeutic Anoscopy T 10.88 $553.84 $179.39 $110.77
0146 Level I Sigmoidoscopy T 2.75 $139.99 $64.40 $28.00
0147 Level II Sigmoidoscopy T 5.74 $292.19 $137.33 $58.44
0148 Level I Anal/Rectal Procedure T 2.41 $122.68 $43.59 $24.54
0149 Level III Anal/Rectal Procedure T 13.61 $692.80 $293.06 $138.56
0150 Level IV Anal/Rectal Procedure T 18.19 $925.94 $437.12 $185.19
0151 Endoscopic Retrograde Cholangio-Pancreatography (ERCP) T 15.39 $783.41 $245.46 $156.68
0152 Percutaneous Biliary Endoscopic Procedures T 16.23 $826.17 $207.38 $165.23
0153 Peritoneal and Abdominal Procedures T 23.70 $1,206.42 $496.31 $241.28
0154 Hernia/Hydrocele Procedures T 31.58 $1,607.55 $556.98 $321.51
0155 Level II Anal/Rectal Procedure T 5.30 $269.79 $99.82 $53.96
0156 Level II Urinary and Anal Procedures T 2.46 $125.22 $37.57 $25.04
0157 Colorectal Cancer Screening: Barium Enema S 1.99 $101.30 $22.19 $20.26
0158 Colorectal Cancer Screening: Colonoscopy T 6.59 $335.46 $83.87 $67.09
0159 Colorectal Cancer Screening: Flexible Sigmoidoscopy S 2.34 $119.12 $29.78 $23.82
0160 Level I Cystourethroscopy and other Genitourinary Procedures T 5.16 $262.66 $105.06 $52.53
0161 Level II Cystourethroscopy and other Genitourinary Procedures T 13.80 $702.48 $249.36 $140.50
0162 Level III Cystourethroscopy and other Genitourinary Procedures T 25.23 $1,284.31 $427.49 $256.86
0163 Level IV Cystourethroscopy and other Genitourinary Procedures T 40.63 $2,068.23 $792.58 $413.65
0164 Level I Urinary and Anal Procedures T 1.02 $51.92 $15.58 $10.38
0165 Level III Urinary and Anal Procedures T 5.25 $267.25 $91.76 $53.45
0166 Level I Urethral Procedures T 12.27 $624.59 $218.73 $124.92
0167 Level II Urethral Procedures T 22.41 $1,140.76 $555.84 $228.15
0168 Level III Urethral Procedures T 18.53 $943.25 $405.60 $188.65
0169 Lithotripsy T 39.85 $2,028.52 $1,115.69 $405.70
0170 Dialysis for Other Than ESRD Patients S 0.29 $14.76 $3.25 $2.95
0179 Urinary Incontinence Procedures T 140.14 $7,133.69 $3,067.48 $1,426.74
0180 Circumcision T 15.11 $769.16 $304.87 $153.83
0181 Penile Procedures T 22.21 $1,130.58 $621.82 $226.12
0182 Insertion of Penile Prosthesis T 88.04 $4,481.59 $1,492.28 $896.32
0183 Testes/Epididymis Procedures T 18.97 $965.65 $448.94 $193.13
0184 Prostate Biopsy T 4.86 $247.39 $123.70 $49.48
0187 Miscellaneous Placement/Repositioning X 4.24 $215.83 $94.96 $43.17
0188 Level II Female Reproductive Proc T 0.81 $41.23 $11.95 $8.25
0189 Level III Female Reproductive Proc T 1.26 $64.14 $18.60 $12.83
0190 Surgical Hysteroscopy T 17.01 $865.88 $424.28 $173.18
0191 Level I Female Reproductive Proc T 0.23 $11.71 $3.40 $2.34
0192 Level IV Female Reproductive Proc T 2.52 $128.28 $35.33 $25.66
0193 Level V Female Reproductive Proc T 11.23 $571.65 $171.13 $114.33
0194 Level VI Female Reproductive Proc T 15.95 $811.92 $397.84 $162.38
0195 Level VII Female Reproductive Proc T 20.74 $1,055.75 $483.80 $211.15
0196 Dilation and Curettage T 13.56 $690.26 $338.23 $138.05
0197 Infertility Procedures T 2.41 $122.68 $49.55 $24.54
0198 Pregnancy and Neonatal Care Procedures T 1.32 $67.19 $32.92 $13.44
0199 Vaginal Delivery T 5.12 $260.63 $72.98 $52.13
0200 Therapeutic Abortion T 11.41 $580.81 $307.83 $116.16
0201 Spontaneous Abortion T 14.42 $734.04 $329.65 $146.81
0202 Level VIII Female Reproductive Proc T 63.90 $3,252.77 $1,593.85 $650.55
0203 Level V Nerve Injections T 15.88 $808.36 $363.78 $161.67
0204 Level VI Nerve Injections T 2.25 $114.53 $43.52 $22.91
0206 Level III Nerve Injections T 3.62 $184.27 $75.55 $36.85
0207 Level IV Nerve Injections T 5.40 $274.88 $123.69 $54.98
0208 Laminotomies and Laminectomies T 29.29 $1,490.98 $298.20
0209 Extended EEG Studies and Sleep Studies, Level II S 10.60 $539.58 $280.58 $107.92
0212 Level II Nervous System Injections T 3.79 $192.93 $88.78 $38.59
0213 Extended EEG Studies and Sleep Studies, Level I S 2.66 $135.40 $70.41 $27.08
0214 Electroencephalogram S 2.11 $107.41 $53.71 $21.48
0215 Level I Nerve and Muscle Tests S 0.66 $33.60 $17.47 $6.72
0216 Level III Nerve and Muscle Tests S 2.63 $133.88 $60.25 $26.78
0218 Level II Nerve and Muscle Tests S 1.04 $52.94 $23.82 $10.59
0220 Level I Nerve Procedures T 13.68 $696.37 $327.29 $139.27
0221 Level II Nerve Procedures T 21.55 $1,096.98 $463.62 $219.40
0222 Implantation of Neurological Device T 304.29 $15,489.58 $3,097.92
0223 Implantation of Pain Management Device T 75.83 $3,860.05 $772.01
0224 Implantation of Reservoir/Pump/Shunt T 28.65 $1,458.40 $453.41 $291.68
0225 Implantation of Neurostimulator Electrodes T 269.11 $13,698.78 $2,739.76
0226 Implantation of Drug Infusion Reservoir T 76.24 $3,880.92 $776.18
0227 Implantation of Drug Infusion Device T 140.36 $7,144.89 $1,428.98
0228 Creation of Lumbar Subarachnoid Shunt T 54.08 $2,752.89 $696.46 $550.58
0229 Transcatherter Placement of Intravascular Shunts T 76.09 $3,873.29 $996.86 $774.66
0230 Level I Eye Tests Treatments S 0.62 $31.56 $14.52 $6.31
0231 Level III Eye Tests Treatments S 2.05 $104.35 $46.96 $20.87
0232 Level I Anterior Segment Eye Procedures T 3.52 $179.18 $78.84 $35.84
0233 Level II Anterior Segment Eye Procedures T 10.90 $554.85 $266.33 $110.97
0234 Level III Anterior Segment Eye Procedures T 19.20 $977.36 $469.13 $195.47
0235 Level I Posterior Segment Eye Procedures T 5.60 $285.06 $78.91 $57.01
0236 Level II Posterior Segment Eye Procedures T 16.30 $829.74 $165.95
0237 Level III Posterior Segment Eye Procedures T 32.16 $1,637.07 $818.54 $327.41
0238 Level I Repair and Plastic Eye Procedures T 3.02 $153.73 $58.96 $30.75
0239 Level II Repair and Plastic Eye Procedures T 5.84 $297.28 $115.94 $59.46
0240 Level III Repair and Plastic Eye Procedures T 13.91 $708.07 $315.31 $141.61
0241 Level IV Repair and Plastic Eye Procedures T 17.84 $908.13 $384.47 $181.63
0242 Level V Repair and Plastic Eye Procedures T 24.26 $1,234.93 $597.36 $246.99
0243 Strabismus/Muscle Procedures T 17.81 $906.60 $431.39 $181.32
0244 Corneal Transplant T 38.69 $1,969.48 $851.42 $393.90
0245 Level I Cataract Procedures without IOL Insert T 10.50 $534.49 $251.21 $106.90
0246 Cataract Procedures with IOL Insert T 20.73 $1,055.24 $495.96 $211.05
0247 Laser Eye Procedures Except Retinal T 4.05 $206.16 $94.83 $41.23
0248 Laser Retinal Procedures T 4.35 $221.43 $94.05 $44.29
0249 Level II Cataract Procedures without IOL Insert T 21.93 $1,116.32 $524.67 $223.26
0250 Nasal Cauterization/Packing T 2.11 $107.41 $37.59 $21.48
0251 Level I ENT Procedures T 2.44 $124.21 $27.99 $24.84
0252 Level II ENT Procedures T 5.99 $304.91 $114.24 $60.98
0253 Level III ENT Procedures T 12.40 $631.21 $284.00 $126.24
0254 Level IV ENT Procedures T 17.47 $889.29 $272.41 $177.86
0256 Level V ENT Procedures T 26.76 $1,362.19 $623.05 $272.44
0258 Tonsil and Adenoid Procedures T 17.53 $892.35 $437.25 $178.47
0259 Level VI ENT Procedures T 378.75 $19,279.89 $9,447.14 $3,855.98
0260 Level I Plain Film Except Teeth X 0.70 $35.63 $19.60 $7.13
0261 Level II Plain Film Except Teeth Including Bone Density Measurement X 1.22 $62.10 $34.15 $12.42
0262 Plain Film of Teeth X 0.65 $33.09 $10.90 $6.62
0263 Level I Miscellaneous Radiology Procedures X 1.62 $82.46 $44.53 $16.49
0264 Level II Miscellaneous Radiology Procedures X 3.74 $190.38 $104.71 $38.08
0265 Level I Diagnostic Ultrasound Except Vascular S 0.95 $48.36 $26.60 $9.67
0266 Level II Diagnostic Ultrasound Except Vascular S 1.55 $78.90 $43.40 $15.78
0267 Vascular Ultrasound S 2.34 $119.12 $65.52 $23.82
0269 Level I Echocardiogram Except Transesophageal S 3.87 $197.00 $102.44 $39.40
0270 Transesophageal Echocardiogram S 5.34 $271.83 $146.79 $54.37
0271 Mammography S 0.60 $30.54 $16.80 $6.11
0272 Level I Fluoroscopy X 1.38 $70.25 $38.64 $14.05
0274 Myelography S 5.27 $268.26 $128.12 $53.65
0275 Arthrography S 2.61 $132.86 $69.09 $26.57
0276 Level I Digestive Radiology S 1.49 $75.85 $41.72 $15.17
0277 Level II Digestive Radiology S 2.16 $109.95 $60.47 $21.99
0278 Diagnostic Urography S 2.36 $120.13 $66.07 $24.03
0279 Level I Angiography and Venography except Extremity S 7.77 $395.52 $174.57 $79.10
0280 Level II Angiography and Venography except Extremity S 13.63 $693.82 $353.85 $138.76
0281 Venography of Extremity S 4.35 $221.43 $115.16 $44.29
0282 Miscellaneous Computerized Axial Tomography S 1.59 $80.94 $44.51 $16.19
0283 Computerized Axial Tomography with Contrast Material S 4.51 $229.58 $126.27 $45.92
0284 Magnetic Resonance Imaging and Magnetic Resonance Angiography with Contrast Material S 7.18 $365.49 $201.02 $73.10
0285 Positron Emission Tomography (PET) S 18.83 $958.52 $415.21 $191.70
0286 Myocardial Scans S 5.43 $276.41 $152.03 $55.28
0287 Complex Venography S 4.09 $208.20 $114.51 $41.64
0288 CT, Bone Density S 1.18 $60.07 $33.03 $12.01
0289 Needle Localization for Breast Biopsy X 1.63 $82.97 $44.80 $16.59
0290 Standard Non-Imaging Nuclear Medicine S 1.76 $89.59 $49.27 $17.92
0291 Level I Diagnostic Nuclear Medicine Excluding Myocardial Scans S 3.52 $179.18 $90.20 $35.84
0292 Level II Diagnostic Nuclear Medicine Excluding Myocardial Scans S 4.22 $214.81 $118.15 $42.96
0294 Level I Therapeutic Nuclear Medicine S 5.04 $256.56 $141.11 $51.31
0295 Level II Therapeutic Nuclear Medicine S 12.17 $619.50 $340.73 $123.90
0296 Level I Therapeutic Radiologic Procedures S 3.41 $173.58 $95.47 $34.72
0297 Level II Therapeutic Radiologic Procedures S 7.11 $361.93 $172.51 $72.39
0299 Miscellaneous Radiation Treatment S 0.21 $10.69 $5.66 $2.14
0300 Level I Radiation Therapy S 2.08 $105.88 $47.72 $21.18
0301 Level II Radiation Therapy S 5.18 $263.68 $52.74
0302 Level III Radiation Therapy S 11.23 $571.65 $216.55 $114.33
0303 Treatment Device Construction X 3.01 $153.22 $69.28 $30.64
0304 Level I Therapeutic Radiation Treatment Preparation X 1.63 $82.97 $41.52 $16.59
0305 Level II Therapeutic Radiation Treatment Preparation X 3.74 $190.38 $91.38 $38.08
0310 Level III Therapeutic Radiation Treatment Preparation X 14.59 $742.69 $339.05 $148.54
0312 Radioelement Applications S 124.64 $6,344.67 $1,268.93
0313 Brachytherapy S 35.74 $1,819.31 $363.86
0314 Hyperthermic Therapies S 3.92 $199.54 $101.77 $39.91
0320 Electroconvulsive Therapy S 3.90 $198.53 $80.06 $39.71
0321 Biofeedback and Other Training S 0.93 $47.34 $21.78 $9.47
0322 Brief Individual Psychotherapy S 1.16 $59.05 $12.40 $11.81
0323 Extended Individual Psychotherapy S 1.74 $88.57 $21.26 $17.71
0324 Family Psychotherapy S 2.71 $137.95 $27.59
0325 Group Psychotherapy S 1.38 $70.25 $18.27 $14.05
0330 Dental Procedures S 11.04 $561.98 $112.40
0332 Computerized Axial Tomography and Computerized Angiography without Contrast Material S 3.26 $165.95 $91.27 $33.19
0333 Computerized Axial Tomography and Computerized Angio w/o Contrast Material followed by Contrast S 5.25 $267.25 $146.98 $53.45
0335 Magnetic Resonance Imaging, Miscellaneous S 5.41 $275.39 $151.46 $55.08
0336 Magnetic Resonance Imaging and Magnetic Resonance Angiography without Contrast S 6.32 $321.71 $176.94 $64.34
0337 MRI and Magnetic Resonance Angiography without Contrast Material followed by Contrast Material S 8.60 $437.77 $240.77 $87.55
0339 Observation S 6.90 $351.24 $70.25
0340 Minor Ancillary Procedures X 0.85 $43.27 $10.82 $8.65
0341 Skin Tests and Miscellaneous Red Blood Cell Tests X 0.11 $5.60 $3.08 $1.12
0342 Level I Pathology X 0.21 $10.69 $5.88 $2.14
0343 Level II Pathology X 0.39 $19.85 $10.72 $3.97
0344 Level III Pathology X 0.56 $28.51 $15.68 $5.70
0345 Level I Transfusion Laboratory Procedures X 0.27 $13.74 $5.37 $2.75
0346 Level II Transfusion Laboratory Procedures X 0.77 $39.20 $12.03 $7.84
0347 Level III Transfusion Laboratory Procedures X 1.57 $79.92 $20.13 $15.98
0348 Fertility Laboratory Procedures X 0.77 $39.20 $7.84
0352 Level I Injections X 0.41 $20.87 $4.17
0353 Level II Allergy Injections X 0.25 $12.73 $2.92 $2.55
0354 Administration of Influenza/Pneumonia Vaccine K 0.11 $5.60
0355 Level I Immunizations K 0.19 $9.67 $5.05 $1.93
0356 Level II Immunizations K 1.12 $57.01 $11.40
0359 Level II Injections X 1.80 $91.63 $18.33
0360 Level I Alimentary Tests X 1.36 $69.23 $34.62 $13.85
0361 Level II Alimentary Tests X 3.27 $166.46 $83.23 $33.29
0362 Fitting of Vision Aids X 0.87 $44.29 $9.63 $8.86
0363 Otorhinolaryngologic Function Tests X 1.74 $88.57 $32.77 $17.71
0364 Level I Audiometry X 0.58 $29.52 $11.51 $5.90
0365 Level II Audiometry X 1.32 $67.19 $20.16 $13.44
0367 Level I Pulmonary Test X 0.70 $35.63 $17.82 $7.13
0368 Level II Pulmonary Tests X 1.48 $75.34 $38.42 $15.07
0369 Level III Pulmonary Tests X 3.51 $178.67 $58.50 $35.73
0370 Allergy Tests X 0.81 $41.23 $11.81 $8.25
0371 Level I Allergy Injections X 0.70 $35.63 $7.13
0372 Therapeutic Phlebotomy X 0.53 $26.98 $10.09 $5.40
0373 Neuropsychological Testing X 1.01 $51.41 $14.39 $10.28
0374 Monitoring Psychiatric Drugs X 0.89 $45.30 $9.97 $9.06
0600 Low Level Clinic Visits V 0.87 $44.29 $8.86
0601 Mid Level Clinic Visits V 0.95 $48.36 $9.67
0602 High Level Clinic Visits V 1.38 $70.25 $14.05
0610 Low Level Emergency Visits V 1.24 $63.12 $19.57 $12.62
0611 Mid Level Emergency Visits V 2.16 $109.95 $36.47 $21.99
0612 High Level Emergency Visits V 3.51 $178.67 $54.14 $35.73
0620 Critical Care S 8.45 $430.14 $150.55 $86.03
0685 Level III Needle Biopsy/Aspiration Except Bone Marrow T 9.21 $468.83 $206.28 $93.77
0686 Level V Skin Repair T 24.15 $1,229.33 $565.49 $245.87
0687 Revision/Removal of Neurostimulator Electrodes T 42.58 $2,167.49 $997.05 $433.50
0688 Revision/Removal of Neurostimulator Pulse Generator Receiver T 146.12 $7,438.09 $3,644.66 $1,487.62
0689 Electronic Analysis of Cardioverter-defibrillators S 0.43 $21.89 $12.03 $4.38
0690 Electronic Analysis of Pacemakers and other Cardiac Devices S 0.38 $19.34 $10.63 $3.87
0691 Electronic Analysis of Programmable Shunts/Pumps S 3.18 $161.87 $89.02 $32.37
0692 Electronic Analysis of Neurostimulator Pulse Generators S 14.43 $734.54 $403.99 $146.91
0693 Level II Breast Reconstruction T 32.00 $1,628.93 $798.17 $325.79
0694 Level III Excision/Biopsy T 4.01 $204.13 $81.65 $40.83
0695 Level VII Debridement Destruction T 15.87 $807.85 $266.59 $161.57
0697 Level II Echocardiogram Except Transesophageal S 2.09 $106.39 $55.32 $21.28
0698 Level II Eye Tests Treatments S 1.04 $52.94 $20.64 $10.59
0699 Level IV Eye Tests Treatment T 6.49 $330.37 $148.66 $66.07
0701 SR 89 chloride, per mCi G $963.42 $137.92
0702 SM 153 lexidronam, 50 mCi G $1,020.00 $146.02
0704 IN 111 Satumomab pendetide per dose G $1,591.25 $227.80
0705 TC 99M tetrofosmin, per dose G $114.00 $16.32
0706 New Technology-Level I ($0-$50) S $25.00 $5.00
0707 New Technology-Level II ($50-$100) S $75.00 $15.00
0708 New Technology-Level III ($100-$200) S $150.00 $30.00
0709 New Technology-Level IV ($200-$300) S $250.00 $50.00
0710 New Technology-Level V ($300-$500) S $400.00 $80.00
0711 New Technology-Level VI ($500-$750) S $625.00 $125.00
0712 New Technology-Level VII ($750-$1000) S $875.00 $175.00
0713 New Technology-Level VIII ($1000-$1250) S $1,125.00 $225.00
0714 New Technology-Level IX ($1250-$1500) S $1,375.00 $275.00
0715 New Technology-Level X ($1500-$1750) S $1,625.00 $325.00
0716 New Technology-Level XI ($1750-$2000) S $1,875.00 $375.00
0717 New Technology-Level XII ($2000-$2500) S $2,250.00 $450.00
0718 New Technology-Level XIII ($2500-$3000) S $2,750.00 $550.00
0719 New Technology_Level XIV ($3000-$3500) S $3,250.00 $650.00
0720 New Technology-Level XV ($3500-$5000) S $4,250.00 $850.00
0721 New Technology-Level XVI ($5000-$6000) S $5,500.00 $1,100.00
0725 Leucovorin calcium inj, 50 mg G $4.15 $0.38
0726 Dexrazoxane hcl injection, 250 mg G $194.52 $24.98
0727 Etidronate disodium inj 300 mg G $63.65 $9.11
0728 Filgrastim 300 mcg injection G $179.08 $23.00
0730 Pamidronate disodium , 30 mg G $265.87 $38.06
0731 Sargramostim injection 50 mcg G $29.06 $4.16
0732 Mesna injection 200 mg G $36.48 $3.30
0733 Non esrd epoetin alpha inj, 1000 u G $12.26 $1.57
0734 Darepoetin alfa, 1 MCG G $4.74 $0.68
0750 Dolasetron mesylate, 10 mg G $16.45 $2.11
0754 Metoclopramide hcl injection up to 10 mg G $1.17 $0.11
0755 Thiethylperazine maleate inj up to 10 mg G $4.60 $0.66
0762 Dronabinol 2.5mg oral G $3.28 $0.42
0763 Dolasetron mesylate oral, 100 mg G $69.64 $8.94
0764 Granisetron hcl injection 10 mcg G $18.54 $2.65
0765 Granisetron hcl 1 mg oral G $44.69 $6.40
0768 Ondansetron hcl injection 1 mg G $6.09 $0.78
0769 Ondansetron hcl 8mg oral G $26.41 $3.39
0800 Leuprolide acetate, 3.75 mg G $93.47 $12.00
0801 Cyclophosphamide oral 25 mg G $2.03 $0.18
0802 Etoposide oral 50 mg G $52.43 $6.73
0803 Melphalan oral 2 mg G $2.29 $0.33
0807 Aldesleukin/single use vial G $672.60 $96.29
0809 Bcg live intravesical vac G $166.49 $21.38
0810 Goserelin acetate implant 3.6 mg G $446.49 $63.92
0811 Carboplatin injection 50 mg G $114.46 $16.39
0812 Carmus bischl nitro inj 100 mg G $117.84 $16.87
0813 Cisplatin 10 mg injection G $42.18 $3.82
0814 Asparaginase injection 10,000 u G $62.61 $8.96
0815 Cyclophosphamide 100 mg inj G $5.82 $0.75
0816 Cyclophosphamide lyophilized 100 mg G $4.89 $0.63
0817 Cytarabine hcl 100 mg inj G $6.10 $0.55
0818 Dactinomycin 0.5 mg G $13.87 $1.99
0819 Dacarbazine 100 mg inj G $12.68 $1.15
0820 Daunorubicin 10 mg G $76.62 $6.94
0821 Daunorubicin citrate liposom 10 mg G $64.60 $9.25
0822 Diethylstilbestrol injection 250 mg G $14.41 $1.30
0823 Docetaxel, 20 mg G $297.83 $42.64
0824 Etoposide 10 mg inj G $10.45 $0.95
0826 Methotrexate Oral 2.5 mg G $3.45 $0.31
0827 Floxuridine injection 500 mg G $129.56 $16.64
0828 Gemcitabine HCL 200 mg G $106.72 $15.28
0830 Irinotecan injection 20 mg G $134.25 $19.22
0831 Ifosfomide injection 1 gm G $156.64 $22.42
0832 Idarubicin hcl injection 5 mg G $412.21 $59.01
0833 Interferon alfacon-1, 1 mcg G $4.10 $0.59
0834 Interferon alfa-2a inj recombinant 3 million u G $34.86 $4.99
0836 Interferon alfa-2b inj recombinant, 1 million G $11.28 $1.45
0838 Interferon gamma 1-b inj, 3 million u G $285.65 $40.89
0839 Mechlorethamine hcl inj 10 mg G $12.01 $1.72
0840 Melphalan hydrochl 50 mg G $400.74 $57.37
0841 Methotrexate sodium inj 5 mg G $0.45 $0.04
0842 Fludarabine phosphate inj 50 mg G $271.82 $38.91
0843 Pegaspargase, singl dose vial G $1,225.57 $179.74
0844 Pentostatin injection, 10 mg G $1,654.14 $236.80
0847 Doxorubicin hcl 10 mg vl chemo G $37.46 $4.81
0849 Rituximab, 100 mg G $454.55 $65.07
0850 Streptozocin injection, 1 gm G $117.64 $16.84
0851 Thiotepa injection, 15 mg G $116.97 $10.59
0852 Topotecan, 4 mg G $664.19 $95.08
0853 Vinblastine sulfate inj, 1 mg G $4.11 $0.37
0854 Vincristine sulfate 1 mg inj G $30.16 $3.87
0855 Vinorelbine tartrate, 10 mg G $88.83 $12.72
0856 Porfimer sodium, 75 mg G $2,603.66 $372.74
0857 Bleomycin sulfate injection 15 u G $289.37 $37.16
0858 Cladribine, 1mg G $53.39 $4.83
0859 Fluorouracil injection 500 mg G $2.73 $0.25
0860 Plicamycin (mithramycin) inj 2.5 mg G $93.80 $13.43
0861 Leuprolide acetate injection 1 mg G $69.79 $6.32
0862 Mitomycin 5 mg inj G $121.65 $11.01
0863 Paclitaxel injection, 30 mg G $173.50 $22.28
0864 Mitoxantrone hcl, 5 mg G $244.21 $34.96
0865 Interferon alfa-n3 inj, human leukocyte derived, 2 G $7.86 $1.12
0884 Rho d immune globulin inj, 1 dose pkg G $34.11 $4.38
0886 Azathioprine oral 50mg G $1.25 $0.11
0887 Azathioprine parenteral 100 mg G $1.06 $0.10
0888 Cyclosporine oral 100 mg G $5.22 $0.67
0889 Cyclosporin parenteral 250mg G $25.08 $3.22
0890 Lymphocyte immune globulin 250 mg G $269.06 $38.52
0891 Tacrolimus oral per 1 mg G $2.91 $0.42
0900 Alglucerase injection, per 10 u G $37.53 $5.37
0901 Alpha 1 proteinase inhibitor, 10 mg G $2.09 $0.30
0902 Botulinum toxin a, per unit G $4.39 $0.63
0903 Cytomegalovirus imm IV/vial G $638.48 $91.40
0905 Immune globulin 500 mg G $35.63 $3.23
0906 RSV-ivig, 50 mg G $15.51 $1.99
0907 Ganciclovir Sodium 500 mg injection K 0.42 $21.38 $4.28
0908 Tetanus immune globulin inj up to 250 u G $102.60 $13.18
0909 Interferon beta-1a, 33 mcg G $225.22 $32.24
0910 Interferon beta-1b/0.25 mg G $68.40 $9.79
0911 Streptokinase per 250,000 iu K 1.67 $85.01 $17.00
0913 Ganciclovir long act implant 4.5 mg G $4,750.00 $680.00
0916 Injection imiglucerase/unit G $3.75 $0.54
0917 Pharmacologic stressors K 0.35 $17.82 $3.56
0925 Factor viii per iu G $0.87 $0.08
0926 Factor VIII (porcine) per iu G $2.09 $0.30
0927 Factor viii recombinant per iu G $1.12 $0.14
0928 Factor ix complex per iu G $0.48 $0.04
0929 Anti-inhibitor per iu G $1.43 $0.18
0930 Antithrombin iii injection per iu G $1.05 $0.15
0931 Factor IX non-recombinant, per iu G $0.71 $0.09
0932 Factor IX recombinant, per iu G $1.12 $0.16
0949 Plasma, Pooled Multiple Donor, Solvent/Detergent T K 2.80 $142.53 $28.51
0950 Blood (Whole) For Transfusion K 1.98 $100.79 $20.16
0952 Cryoprecipitate K 0.66 $33.60 $6.72
0954 RBC leukocytes reduced K 2.69 $136.93 $27.39
0955 Plasma, Fresh Frozen K 2.14 $108.93 $21.79
0956 Plasma Protein Fraction K 1.20 $61.08 $12.22
0957 Platelet Concentrate K 0.93 $47.34 $9.47
0958 Platelet Rich Plasma K 1.11 $56.50 $11.30
0959 Red Blood Cells K 1.95 $99.26 $19.85
0960 Washed Red Blood Cells K 3.62 $184.27 $36.85
0961 Infusion, Albumin (Human) 5%, 50 ml K 2.08 $105.88 $21.18
0962 Infusion, Albumin (Human) 25%, 50 ml K 1.05 $53.45 $10.69
0963 Albumin (human), 5%, 250 ml K 10.35 $526.86 $105.37
0964 Albumin (human), 25%, 20 ml K 2.08 $105.88 $21.18
0965 Albumin (human), 25%, 50ml K 5.20 $264.70 $52.94
0966 Plasmaprotein fract, 5%, 250ml K 5.95 $302.88 $60.58
0970 New Technology-Level I ($0-$50) T $25.00 $5.00
0971 New Technology-Level II ($50-$100) T $75.00 $15.00
0972 New Technology-Level III ($100-$200) T $150.00 $30.00
0973 New Technology-Level IV ($200-$300) T $250.00 $50.00
0974 New Technology-Level V ($300-$500) T $400.00 $80.00
0975 New Technology-Level VI ($500-$750) T $625.00 $125.00
0976 New Technology-Level VII ($750-$1000) T $875.00 $175.00
0977 New Technology-Level VIII ($1000-$1250) T $1,125.00 $225.00
0978 New Technology-Level IX ($1250-$1500) T $1,375.00 $275.00
0979 New Technology-Level X ($1500-$1750) T $1,625.00 $325.00
0980 New Technology-Level XI ($1750-$2000) T $1,875.00 $375.00
0981 New Technology-Level XII ($2000-$2500) T $2,250.00 $450.00
0982 New Technology-Level XIII ($2500-$3000) T $2,750.00 $550.00
0983 New Technology_Level XIV ($3000@ndash;$3500) T $3,250.00 $650.00
0984 New Technology-Level XV ($3500-$5000) T $4,250.00 $850.00
0985 New Technology-Level XVI ($5000-$6000) T $5,500.00 $1,100.00
1002 Cochlear implant system H
1009 Cryoprecip reduced plasma K 0.82 $41.74 $8.35
1010 Blood, L/R, CMV-neg K 2.74 $139.48 $27.90
1011 Platelets, HLA-m, L/R, unit K 11.27 $573.69 $114.74
1012 Platelet concentrate, L/R, irradiated, unit K 1.83 $93.15 $18.63
1013 Platelet concentrate, L/R, unit K 1.12 $57.01 $11.40
1014 Platelets, aph/pher, L/R, unit K 8.50 $432.68 $86.54
1016 Blood, L/R, froz/deglycerol/washed K 6.80 $346.15 $69.23
1017 Platelets, aph/pher, L/R, CMV-neg, unit K 8.86 $451.01 $90.20
1018 Blood, L/R, irradiated K 2.98 $151.69 $30.34
1019 Platelets, aph/pher, L/R, irradiated, unit K 9.16 $466.28 $93.26
1024 Quinupristin/dalfopristin 500 mg (150/350) G $102.05 $13.11
1045 Iobenguane sulfate I-131 G $495.65 $70.96
1058 TC 99M oxidronate, per vial G $36.74 $5.26
1059 Cultured chondrocytes implnt G $14,250.00 $2,040.00
1064 I-131 cap, each add mCi G $5.86 $0.75
1065 I-131 sol, each add mCi G $15.81 $2.03
1066 IN 111 satumomab pendetide G $1,591.25 $227.80
1079 CO 57/58 0.5 mCi G $253.84 $36.34
1084 Denileukin diftitox, 300 MCG G $999.88 $143.14
1086 Temozolomide, oral 5 mg G $6.05 $0.87
1087 I-123 per 100 uci G $0.65 $0.06
1089 Coo 57, 0.5 Mci G $81.10 $10.41
1091 IN 111 Oxyquinoline, per .5 mCi G $427.50 $61.20
1092 IN 111 Pentetate, per 0.5 mCi G $256.50 $23.22
1094 TC 99M Albumin aggr,1.0 cmCi G $33.09 $4.25
1095 Technetium TC 99M Depreotide G $38.00 $5.44
1096 TC 99M Exametazime, per dose G $445.31 $63.75
1097 TC 99M Mebrofenin, per vial G $51.44 $7.36
1098 TC 99M Pentetate, per vial G $22.43 $2.88
1099 TC 99M Pyrophosphate, per vial G $39.11 $5.60
1122 TC 99M arcitumomab, per vial G $1,235.00 $176.80
1166 Cytarabine liposomal, 10 mg G $371.45 $53.18
1167 Epirubicin hcl, 2 mg G $24.94 $3.57
1178 Busulfan IV, 6 mg G $26.48 $3.79
1188 I-131 cap, per 1-5 mCi G $117.25 $15.06
1200 TC 99M Sodium Glucoheptonate G $22.61 $3.24
1201 TC 99M succimer, per vial G $135.66 $19.42
1202 TC 99M Sulfur Colloid, per dose G $76.00 $9.76
1203 Verteporfin for injection G $1,458.25 $208.76
1205 Technetium Tc 99m disofenin G $79.17 $11.33
1207 Octreotide acetate depot 1mg G $138.08 $19.77
1305 Apligraf G $1,157.81 $165.75
1348 I-131 sol, per 1-6 mCi G $146.57 $18.82
1400 Diphenhydramine hcl 50mg G $0.23 $0.02
1401 Prochlorperazine maleate 5mg G $0.65 $0.06
1402 Promethazine hcl 12.5mg oral G $0.01
1403 Chlorpromazine hcl 10mg oral G $0.27 $0.02
1404 Trimethobenzamide hcl 250mg G $0.38 $0.03
1405 Thiethylperazine maleate10mg G $0.56 $0.08
1406 Perphenazine 4mg oral G $0.62 $0.06
1407 Hydroxyzine pamoate 25mg G $0.28 $0.03
1409 Factor viia recombinant, per 1.2 mg G $1,596.00 $228.48
1600 Technetium TC 99M sestamibi G $121.70 $17.42
1601 Technetium TC 99M medronate G $42.18 $5.42
1602 Technetium TC 99M apcitide G $475.00 $68.00
1603 Thallous chloride TL 201, per mCi G $78.16 $7.08
1604 IN 111 capromab pendetide, per dose G $2,192.13 $313.82
1605 Abciximab injection, 10 mg G $513.02 $73.44
1606 Anistreplase, 30 u G $2,693.80 $385.64
1607 Eptifibatide injection, 5 mg G $11.31 $1.45
1608 Etanercept injection, 25 mg G $141.01 $20.19
1609 Rho(D) immune globulin h, sd, 100 iu G $20.55 $2.64
1611 Hylan G-F 20 injection, 16 mg G $213.87 $27.47
1612 Daclizumab, parenteral, 25 mg G $397.29 $56.88
1613 Trastuzumab, 10 mg G $52.83 $7.56
1614 Valrubicin, 200 mg G $423.22 $60.59
1615 Basiliximab, 20 mg G $1,437.78 $205.83
1616 Histrelin acetate, 10 mgs G $14.16 $2.03
1617 Lepirudin G $131.96 $18.89
1618 Vonwillebrandfactrcmplx, per iu G $0.95 $0.14
1619 Ga 67, per mCi G $25.62 $2.32
1620 Technetium tc99m bicisate G $403.99 $57.83
1621 Xenin xe 133 G $29.93 $2.71
1622 Technetium tc99m mertiatide G $137.75 $19.72
1623 Technetium tc99m glucepatate G $22.61 $3.24
1624 Sodium phosphate p32 G $81.10 $7.78
1625 Indium 111-in pentetreotide G $935.75 $133.96
1626 Technetium tc99m oxidronate G $1.47 $0.21
1627 Technetium tc99mlabeled rbcs G $40.90 $5.85
1628 Chromic phosphate p32 G $150.86 $21.60
1713 Anchor/screw bn/bn,tis/bn H
1714 Cath, trans atherectomy, dir H
1715 Brachytherapy needle H
1716 Brachytx seed, Gold 198 H
1717 Brachytx seed, HDR Ir-192 H
1718 Brachytx seed, Iodine 125 H
1719 Brachytxseed, Non-HDR Ir-192 H
1720 Brachytx seed, Palladium 103 H
1721 AICD, dual chamber H
1722 AICD, single chamber H
1724 Cath, trans atherec,rotation H
1725 Cath, translumin non-laser H
1726 Cath, bal dil, non-vascular H
1727 Cath, bal tis dis, non-vas H
1728 Cath, brachytx seed adm H
1729 Cath, drainage H
1730 Cath, EP, 19 or fewer elect H
1731 Cath, EP, 20 or more elec H
1732 Cath, EP, diag/abl, 3D/vect H
1733 Cath, EP, othr than cool-tip H
1750 Cath, hemodialysis,long-term H
1751 Cath, inf, per/cent/midline H
1752 Cath, hemodialysis,short-term H
1753 Cath, intravas ultrasound H
1754 Catheter, intradiscal H
1755 Catheter, intraspinal H
1756 Cath, pacing, transesoph H
1757 Cath, thrombectomy/embolect H
1758 Cath, ureteral H
1759 Cath, intra echocardiography H
1760 Closure dev, vasc, imp/insert H
1762 Conn tiss, human (inc fascia) H
1763 Conn tiss, non-human H
1764 Event recorder, cardiac H
1765 Adhesion barrier H
1766 Intro/sheath, strble, non-peel H
1767 Generator, neurostim, imp H
1768 Graft, vascular H
1769 Guide wire H
1770 Imaging coil, MR, insertable H
1771 Rep dev, urinary, w/sling H
1772 Infusion pump, programmable H
1773 Retrieval dev, insert H
1775 FDG, per dose (4-40 mCi/ml) G $475.00 $68.00
1776 Joint device (implantable) H
1777 Lead, AICD, endo single coil H
1778 Lead, neurostimulator H
1779 Lead, pmkr, transvenous VDD H
1780 Lens, intraocular H
1781 Mesh (implantable) H
1782 Morcellator H
1784 Ocular dev, intraop, det ret H
1785 Pmkr, dual, rate-resp H
1786 Pmkr, single, rate-resp H
1787 Patient progr, neurostim H
1788 Port, indwelling, imp H
1789 Prosthesis, breast, imp H
1813 Prosthesis, penile, inflatab H
1815 Pros, urinary sph, imp H
1816 Receiver/transmitter, neuro H
1817 Septal defect imp sys H
1874 Stent, coated/cov w/del sys H
1875 Stent, coated/cov w/o del sy H
1876 Stent, non-coa/no-cov w/del H
1877 Stent, non-coat/cov w/o del H
1878 Matrl for vocal cord H
1879 Tissue marker, imp H
1880 Vena cava filter H
1881 Dialysis access system H
1882 AICD, other than sing/dual H
1883 Adapt/ext, pacing/neuro lead H
1885 Cath, translumin angio laser H
1887 Catheter, guiding H
1891 Infusion pump, non-prog, perm H
1892 Intro/sheath, fixed, peel-away H
1893 Intro/sheath, fixed, non-peel H
1894 Intro/sheath, non-laser H
1895 Lead, AICD, endo dual coil H
1896 Lead, AICD, non sing/dual H
1897 Lead, neurostim test kit H
1898 Lead, pmkr, other than trans H
1899 Lead, pmkr/AICD combination H
2615 Sealant, pulmonary, liquid H
2616 Brachytx seed, Yttrium-90 H
2617 Stent, non-cor, tem w/o del H
2618 Probe, cryoablation H
2619 Pmkr, dual, non rate-resp H
2620 Pmkr, single, non rate-resp H
2621 Pmkr, other than sing/dual H
2622 Prosthesis, penile, non-inf H
2625 Stent, non-cor, tem w/del sys H
2626 Infusion pump, non-prog, temp H
2627 Cath, suprapubic/cystoscopic H
2628 Catheter, occlusion H
2629 Intro/sheath, laser H
2630 Cath, EP, cool-tip H
2631 Rep dev, urinary, w/o sling H
7000 Amifostine, 500 mg G $392.06 $56.13
7001 Amphotericin B lipid complex, 50 mg G $109.25 $15.64
7003 Epoprostenol injection 0.5 mg G $12.04 $1.72
7005 Gonadorelin hydroch, 100 mcg G $192.37 $27.54
7007 Milrinone lactate, per 5 ml, inj K 0.44 $22.40 $4.48
7010 Morphine sulfate (preservative free) 10 mg G $1.02 $0.09
7011 Oprelvekin injection, 5 mg G $245.81 $35.19
7014 Fentanyl citrate injection G $1.23 $0.11
7015 Busulfan, oral, 2 mg G $1.91 $0.27
7019 Aprotinin, 10,000 kiu G $2.16 $0.31
7022 Elliot's B solution, per ml G $1.43 $0.20
7023 Bladder calculi irrig sol G $24.70 $3.54
7024 Corticorelin ovine triflutat G $368.03 $52.69
7025 Digoxin immune FAB (ovine) G $551.66 $78.97
7026 Ethanolamine oleate, 100 mg G $39.73 $5.69
7027 Fomepizole, 15 mg G $10.93 $1.56
7028 Fosphenytoin, 50 mg G $5.73 $0.82
7029 Glatiramer acetate, per dose G $30.07 $4.30
7030 Hemin, per 1 mg G $0.99 $0.14
7031 Octreotide acetate injection G $138.08 $19.77
7032 Sermorelin acetate, 0.5 mg G $13.60 $1.95
7033 Somatrem, 5mg G $209.48 $29.99
7034 Somatropin injection G $39.90 $5.12
7035 Teniposide, 50 mg G $222.80 $31.90
7036 Urokinase 250,000 iu inj K 6.44 $327.82 $65.56
7037 Urofollitropin, 75 iu G $73.29 $10.49
7038 Muromonab-CD3, 5 mg G $269.06 $38.52
7039 Pegademase bovine inj 25 I.U G $139.33 $19.95
7040 Pentastarch 10% solution G $15.11 $2.16
7041 Tirofiban hydrochloride 12.5 mg G $436.41 $62.48
7042 Capecitabine, oral, 150 mg G $2.43 $0.35
7043 Infliximab injection 10 mg G $63.24 $9.05
7045 Trimetrexate glucoronate G $118.75 $17.00
7046 Doxorubicin hcl liposome inj 10 mg G $358.95 $51.39
7047 Droperidol/fentanyl inj G $6.67 $0.95
7048 Alteplase recombinant K 0.36 $18.33 $3.67
7049 Filgrastim 480 mcg injection G $285.38 $36.65
7050 Prednisone oral G $0.07 $0.01
7051 Leuprolide acetate implant, 65 mg G $5,399.80 $773.02
7052 Somatrem injection G $41.90 $6.00
7315 Sodium hyaluronate injection, 20mg G $130.63 $18.70
7316 Sodium hyaluronate injection, 5mg G $26.13 $3.74
9000 Na chromate Cr51, per 0.25mCi G $0.52 $0.07
9001 Linezolid inj, 200mg G $24.13 $3.45
9002 Tenecteplase, 50mg/vial G $2,612.50 $374.00
9003 Palivizumab, per 50mg G $664.49 $95.13
9004 Gemtuzumab ozogamicin inj, 5mg G $1,929.69 $276.25
9005 Reteplase injection G $1,306.25 $187.00
9006 Tacrolimus inj G $113.15 $16.20
9007 Baclofen Intrathecal kit-1amp G $79.80 $11.42
9008 Baclofen refill kit_per 500 mcg G $11.69 $1.67
9009 Baclofen refill kit-per 2000 mcg G $49.12 $7.03
9010 Baclofen refill kit-per 4000 mcg G $43.08 $6.17
9011 Caffeine Citrate, inj, G $3.05 $0.44
9012 Arsenic Trioxide G $23.75 $3.40
9013 Co 57 Cobaltous CI G $81.10 $10.41
9015 Mycophenolate mofetil oral 250 mg G $2.40 $0.34
9016 Echocardiography contrast G $118.75 $17.00
9018 Botulinum tox B, per 100 u G $8.79 $1.26
9019 Caspofungin acetate, 5 mg G $34.20 $4.90
9020 Sirolimus tablet, 1 mg G $6.51 $0.93
9100 Iodinated I-131 albumin G $10.34 $1.48
9102 51 na chromate, per 50mCi G $64.84 $9.28
9103 Na iothalamate I-125, per 10 uci G $17.18 $2.46
9104 Anti-thymocycte globulin rabbit G $325.09 $46.54
9105 Hep B imm glob, per 1 ml G $133.00 $17.08
9106 Sirolimus, 1 mg G $6.51 $0.93
9108 Thyrotropin alfa, per 1.1 mg G $531.05 $76.02
9109 Tirofliban hcl, per 6.25 mg G $207.81 $29.75
9110 Alemtuzumab, per ml G $486.88 $69.70
9111 Inj, bivalirudin, per 250mg vial G $397.81 $56.95
9112 Perflutren lipid micro, per 2ml G $148.20 $21.22
9113 Inj pantoprazole sodium, vial G $22.80 $3.26
9114 Nesiritide, per 1.5 mg vial G $433.20 $62.02
9115 Inj, zoledronic acid, per 2 mg G $406.78 $58.23
9200 Orcel, per 36 cm2 G $1,135.25 $162.52
9201 Dermagraft, per 37.5 sq cm G $577.60 $82.69
9217 Leuprolide acetate suspnsion, 7.5 mg G $592.60 $84.84
9500 Platelets, irradiated K 1.69 $86.03 $17.21
9501 Platelets, pheresis K 9.22 $469.33 $93.87
9502 Platelet pheresis irradiated K 10.00 $509.04 $101.81
9503 Fresh frozen plasma, ea unit K 1.57 $79.92 $15.98
9504 RBC deglycerolized K 4.14 $210.74 $42.15
9505 RBC irradiated K 2.45 $124.71 $24.94
9506 Granulocytes, pheresis K 28.14 $1,432.44 $286.49

Indicator Service Status
A Pulmonary Rehabilitation Clinical Trial Not Paid Under Outpatient PPS.
A Durable Medical Equipment, Prosthetics and Orthotics DMEPOS Fee Schedule.
A Physical, Occupational and Speech Therapy Physician Fee Schedule.
A Ambulance Ambulance Fee Schedule.
A EPO for ESRD Patients National Rate.
A Clinical Diagnostic Laboratory Services Laboratory Fee Schedule.
A Physician Services for ESRD Patients Physician Fee Schedule.
A Screening Mammography Physician Fee Schedule.
C Inpatient Procedures Admit Patient; Bill as Inpatient.
D Deleted Code Codes are deleted effective with the beginning of the calendar year.
E Non-Covered Items and Services Not Paid Under Outpatient PPS.
F Acquisition of Corneal Tissue Paid at Reasonable Cost.
G Drug/Biological Pass-Through Additional Payment.
H Device Pass-Through Additional Payment.
K Non Pass-Through Drug/Biological Paid Under Outpatient PPS.
N Incidental Services, packaged into APC Rate Packaged.
P Partial Hospitalization Paid Per Diem APC.
S Significant Procedure, Not Discounted When Multiple Paid Under Outpatient PPS.
T Significant Procedure, Multiple Procedure Reduction Applies Paid Under Outpatient PPS.
V Visit to Clinic or Emergency Department Paid Under Outpatient PPS.
X Ancillary Service Paid Under Outpatient PPS.

[FR Doc. 02-5071 Filed 2-28-02; 8:45 am]

BILLING CODE 4120-01-P