EMPIRE MEDICARE SERVICES
AREA 99 NEW JERSEY
2005 FEE SCHEDULE

 

# PROCEDURE
CODE		 MOD PAR
FEE		 NONPAR
FEE		 LIMITING
CHARGE
23101 478.57 454.64 522.84
23105 675.22 641.46 737.68
23106 510.23 484.72 557.43
23107 704.52 669.29 769.68
23120 596.35 566.53 651.51
23125 746.36 709.04 815.40
23130 644.89 612.65 704.55
23140 529.05 502.60 577.99
23145 725.82 689.53 792.96
23146 657.25 624.39 718.05
23150 671.79 638.20 733.93
23155 823.20 782.04 899.35
23156 707.19 671.83 772.60
23170 562.04 533.94 614.03
23172 573.12 544.46 626.13
23174 786.35 747.03 859.08
23180 767.49 729.12 838.49
23182 729.18 692.72 796.63
23184 819.91 778.91 895.75
23190 587.72 558.33 642.08
23195 773.35 734.68 844.88
23200 907.60 862.22 991.55
23210 942.12 895.01 1,029.26
23220 1,117.68 1,061.80 1,221.07
23221 1,302.29 1,237.18 1,422.76
23222 1,748.55 1,661.12 1,910.29
# 23330 160.56 152.53 175.41
23330 236.62 224.79 258.51
23331 622.00 590.90 679.54
23332 921.90 875.81 1,007.18
23350 187.68 178.30 205.05
# 23350 55.42 52.65 60.55
23395 1,307.04 1,241.69 1,427.94
23397 1,210.67 1,150.14 1,322.66
23400 1,040.04 988.04 1,136.25
23405 673.00 639.35 735.25
23406 842.37 800.25 920.29
23410 963.03 914.88 1,052.11
23412 1,023.03 971.88 1,117.66
23415 791.36 751.79 864.56
23420 1,063.15 1,009.99 1,161.49
23430 796.40 756.58 870.07
23440 825.72 784.43 902.09
23450 1,025.56 974.28 1,120.42
23455 1,094.90 1,040.16 1,196.18
23460 1,180.10 1,121.10 1,289.27
23462 1,148.94 1,091.49 1,255.21
23465 1,193.86 1,134.17 1,304.30
23466 1,127.20 1,070.84 1,231.47
23470 1,297.47 1,232.60 1,417.49
23472 1,568.53 1,490.10 1,713.62
23480 879.54 835.56 960.89
23485 1,029.22 977.76 1,124.42
23490 885.90 841.61 967.85
23491 1,100.03 1,045.03 1,201.78
# 23500 198.84 188.90 217.24
23500 213.63 202.95 233.39
# 23505 328.50 312.08 358.89
23505 352.59 334.96 385.20
23515 614.14 583.43 670.94
23520 217.03 206.18 237.11
# 23520 212.39 201.77 232.04
23525 349.02 331.57 381.31
# 23525 323.66 307.48 353.60
23530 581.44 552.37 635.23
23532 659.50 626.53 720.51
23540 218.36 207.44 238.56
# 23540 197.23 187.37 215.48
23545 317.19 301.33 346.53
# 23545 282.12 268.01 308.21
23550 598.02 568.12 653.34
23552 694.15 659.44 758.36
23570 227.65 216.27 248.71
# 23570 222.58 211.45 243.17
23575 385.87 366.58 421.57
# 23575 361.78 343.69 395.24
23585 730.64 694.11 798.23
23600 324.26 308.05 354.26
# 23600 282.01 267.91 308.10
23605 480.18 456.17 524.60
# 23605 436.24 414.43 476.59
23615 798.82 758.88 872.71
23616 1,565.27 1,487.01 1,710.06
23620 260.78 247.74 284.90
# 23620 234.16 222.45 255.82
23625 385.51 366.23 421.16
# 23625 357.62 339.74 390.70
23630 614.43 583.71 671.27
# 23650 260.39 247.37 284.48
23650 303.07 287.92 331.11
23655 379.21 360.25 414.29
23660 610.10 579.60 666.54
# 23665 400.00 380.00 437.00
23665 425.77 404.48 465.15
23670 647.79 615.40 707.71
# 23675 518.89 492.95 566.89
23675 561.15 533.09 613.05
23680 799.57 759.59 873.53
23700 206.49 196.17 225.60
23800 1,077.64 1,023.76 1,177.32


# 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.