EMPIRE MEDICARE SERVICES
AREA 99 NEW JERSEY
2005 FEE SCHEDULE

 

# PROCEDURE
CODE		 MOD PAR
FEE		 NONPAR
FEE		 LIMITING
CHARGE
# 10021 76.37 72.55 83.43
10021 144.40 137.18 157.76
# 10022 70.56 67.03 77.08
10022 160.14 152.13 174.95
# 10040 81.92 77.82 89.49
10040 91.22 86.66 99.66
# 10060 89.66 85.18 97.96
10060 101.49 96.42 110.88
# 10061 167.20 158.84 182.67
10061 180.72 171.68 197.43
# 10080 96.90 92.06 105.87
10080 180.99 171.94 197.73
# 10081 168.79 160.35 184.40
10081 277.39 263.52 303.05
10120 144.02 136.82 157.34
# 10120 93.31 88.64 101.94
10121 265.73 252.44 290.31
# 10121 192.63 183.00 210.45
10140 141.87 134.78 155.00
# 10140 121.59 115.51 132.84
10160 119.89 113.90 130.99
# 10160 97.91 93.01 106.96
10180 226.43 215.11 247.38
# 10180 184.17 174.96 201.20
11000 50.65 48.12 55.34
# 11000 35.43 33.66 38.71
11001 22.60 21.47 24.69
# 11001 17.53 16.65 19.15
11004 594.29 564.58 649.27
11005 810.19 769.68 885.13
11006 747.23 709.87 816.35
11008 304.16 288.95 332.29
11010 476.93 453.08 521.04
# 11010 297.34 282.47 324.84
11011 564.57 536.34 616.79
# 11011 318.64 302.71 348.12
11012 822.32 781.20 898.38
# 11012 473.29 449.63 517.07
11040 43.82 41.63 47.87
# 11040 30.72 29.18 33.56
11041 63.77 60.58 69.67
# 11041 49.83 47.34 54.44
11042 89.75 85.26 98.05
# 11042 67.36 63.99 73.59
11043 246.96 234.61 269.80
# 11043 213.58 202.90 233.34
11044 322.93 306.78 352.80
# 11044 293.35 278.68 320.48
11055 42.39 40.27 46.31
# 11055 25.91 24.61 28.30
# 11056 36.25 34.44 39.61
11056 53.57 50.89 58.52
11057 65.97 62.67 72.07
# 11057 47.38 45.01 51.76
11100 86.10 81.80 94.07
# 11100 48.91 46.46 53.43
11101 30.78 29.24 33.63
# 11101 24.86 23.62 27.16
11200 76.02 72.22 83.05
# 11200 64.19 60.98 70.13
11201 18.88 17.94 20.63
# 11201 17.19 16.33 18.78
# 11300 30.00 28.50 32.78
11300 62.96 59.81 68.78
# 11301 51.27 48.71 56.02
11301 82.12 78.01 89.71
# 11302 62.51 59.38 68.29
11302 98.00 93.10 107.07
# 11303 73.24 69.58 80.02
11303 118.03 112.13 128.95
# 11305 40.30 38.29 44.03
11305 64.80 61.56 70.79
# 11306 59.57 56.59 65.08
11306 88.30 83.89 96.47
# 11307 68.41 64.99 74.74
11307 102.22 97.11 111.68
# 11308 85.08 80.83 92.95
11308 121.42 115.35 132.65
# 11310 44.03 41.83 48.10
11310 77.41 73.54 84.57
# 11311 64.14 60.93 70.07
11311 95.41 90.64 104.24
# 11312 72.57 68.94 79.28
11312 109.33 103.86 119.44
# 11313 97.72 92.83 106.75
11313 143.35 136.18 156.61
# 11400 73.14 69.48 79.90
11400 120.04 114.04 131.15
# 11401 95.08 90.33 103.88
11401 138.60 131.67 151.42
# 11402 109.72 104.23 119.86
11402 157.89 150.00 172.50
# 11403 132.32 125.70 144.56
11403 177.54 168.66 193.96
# 11404 147.78 140.39 161.45
11404 202.71 192.57 221.46
# 11406 189.88 180.39 207.45
11406 249.46 236.99 272.54
# 11420 81.46 77.39 89.00
11420 116.53 110.70 127.31


# These amounts apply when service is performed in a facility setting.

Limiting charge applies to unassigned claims by non-participating providers.

All Current Procedural Terminology (CPT) codes and descriptors are copyrighted
by the American Medical Association.