EMPIRE MEDICARE SERVICES
AREA 99 NEW JERSEY
2005 FEE SCHEDULE

 

# PROCEDURE
CODE		 MOD PAR
FEE		 NONPAR
FEE		 LIMITING
CHARGE
# 15732 1,287.84 1,223.45 1,406.97
15732 1,534.19 1,457.48 1,676.10
# 15734 1,313.65 1,247.97 1,435.17
15734 1,556.20 1,478.39 1,700.15
15736 1,496.09 1,421.29 1,634.48
# 15736 1,199.87 1,139.88 1,310.86
15738 1,557.97 1,480.07 1,702.08
# 15738 1,293.87 1,229.18 1,413.56
15740 854.77 812.03 933.83
# 15740 775.76 736.97 847.52
15750 880.81 836.77 962.29
15756 2,418.15 2,297.24 2,641.83
15757 2,437.71 2,315.82 2,663.19
15758 2,443.19 2,321.03 2,669.18
15760 797.50 757.63 871.27
# 15760 680.88 646.84 743.87
15770 615.10 584.35 672.00
# 15775 229.19 217.73 250.39
15775 353.00 335.35 385.65
# 15776 361.98 343.88 395.46
15776 469.74 446.25 513.19
# 15780 659.14 626.18 720.11
15780 797.32 757.45 871.07
# 15781 429.06 407.61 468.75
15781 494.55 469.82 540.29
# 15782 458.53 435.60 500.94
15782 597.97 568.07 653.28
# 15783 354.99 337.24 387.83
15783 468.66 445.23 512.01
# 15786 140.27 133.26 153.25
15786 226.05 214.75 246.96
# 15787 21.19 20.13 23.15
15787 60.49 57.47 66.09
# 15788 217.00 206.15 237.07
15788 370.39 351.87 404.65
# 15789 403.35 383.18 440.66
15789 542.37 515.25 592.54
15792 377.41 358.54 412.32
# 15792 265.86 252.57 290.46
15793 419.56 398.58 458.37
# 15793 339.27 322.31 370.66
15810 368.52 350.09 402.60
# 15811 442.29 420.18 483.21
15811 472.71 449.07 516.43
15819 707.05 671.70 772.46
# 15820 451.87 429.28 493.67
15820 511.45 485.88 558.76
# 15821 482.06 457.96 526.65
15821 551.36 523.79 602.36
# 15822 377.33 358.46 412.23
15822 433.95 412.25 474.09
# 15823 566.54 538.21 618.94
15823 626.55 595.22 684.50
15831 893.92 849.22 976.60
15832 867.15 823.79 947.36
15833 816.24 775.43 891.74
15834 809.15 768.69 883.99
15835 834.64 792.91 911.85
15836 701.48 666.41 766.37
# 15837 685.52 651.24 748.93
15837 735.38 698.61 803.40
15838 557.74 529.85 609.33
# 15839 681.41 647.34 744.44
15839 784.09 744.89 856.62
15840 990.16 940.65 1,081.75
15841 1,639.86 1,557.87 1,791.55
15842 2,636.42 2,504.60 2,880.29
15845 915.21 869.45 999.87
# 15851 49.08 46.63 53.62
15851 106.97 101.62 116.86
# 15852 51.03 48.48 55.75
15852 114.83 109.09 125.45
# 15860 118.74 112.80 129.72
15860 120.85 114.81 132.03
15920 584.24 555.03 638.28
15922 744.59 707.36 813.46
15931 647.75 615.36 707.66
15933 811.86 771.27 886.96
15934 902.08 856.98 985.53
15935 1,082.93 1,028.78 1,183.10
15936 896.41 851.59 979.33
15937 1,046.56 994.23 1,143.36
15940 674.60 640.87 737.00
15941 907.77 862.38 991.74
15944 872.66 829.03 953.38
15945 970.80 922.26 1,060.60
15946 1,567.22 1,488.86 1,712.19
15950 561.49 533.42 613.43
15951 805.70 765.42 880.23
15952 832.52 790.89 909.52
15953 940.61 893.58 1,027.62
15956 1,143.30 1,086.14 1,249.06
15958 1,154.98 1,097.23 1,261.81
# 16000 48.88 46.44 53.41
16000 74.23 70.52 81.10
# 16010 64.10 60.90 70.04
16010 65.37 62.10 71.42
16015 152.29 144.68 166.38
# 16020 58.87 55.93 64.32
16020 88.87 84.43 97.09


# 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.