EMPIRE MEDICARE SERVICES
AREA 99 NEW JERSEY
2005 FEE SCHEDULE

 

# PROCEDURE
CODE		 MOD PAR
FEE		 NONPAR
FEE		 LIMITING
CHARGE
# 38220 66.59 63.26 72.75
38220 201.81 191.72 220.48
# 38221 83.84 79.65 91.60
38221 222.43 211.31 243.01
38230 331.25 314.69 361.89
38240 135.89 129.10 148.47
38241 137.05 130.20 149.73
38242 103.78 98.59 113.38
38300 268.68 255.25 293.54
# 38300 173.61 164.93 189.67
38305 454.14 431.43 496.14
38308 442.23 420.12 483.14
38380 562.01 533.91 614.00
38381 863.11 819.95 942.94
38382 688.46 654.04 752.15
# 38500 252.43 239.81 275.78
38500 320.46 304.44 350.11
38505 134.70 127.97 147.17
# 38505 81.04 76.99 88.54
38510 513.44 487.77 560.94
# 38510 426.40 405.08 465.84
38520 463.59 440.41 506.47
38525 406.45 386.13 444.05
38530 538.98 512.03 588.83
38542 443.81 421.62 484.86
38550 468.60 445.17 511.95
38555 980.45 931.43 1,071.14
38562 699.50 664.53 764.21
38564 694.51 659.78 758.75
38570 572.20 543.59 625.13
38571 856.67 813.84 935.92
38572 1,019.01 968.06 1,113.27
38700 614.40 583.68 671.23
38720 974.75 926.01 1,064.91
38724 1,033.76 982.07 1,129.38
38740 650.06 617.56 710.19
38745 833.09 791.44 910.16
38746 285.44 271.17 311.85
38747 285.40 271.13 311.80
38760 828.21 786.80 904.82
38765 1,245.83 1,183.54 1,361.07
38770 813.19 772.53 888.41
38780 1,066.02 1,012.72 1,164.63
38790 366.02 347.72 399.88
# 38790 87.56 83.18 95.66
38792 41.22 39.16 45.03
38794 331.54 314.96 362.20
39000 466.94 443.59 510.13
39010 842.30 800.19 920.22
39200 922.58 876.45 1,007.92
39220 1,166.04 1,107.74 1,273.90
39400 454.31 431.59 496.33
39501 853.42 810.75 932.36
39502 1,020.98 969.93 1,115.42
39503 5,535.27 5,258.51 6,047.29
39520 1,052.19 999.58 1,149.52
39530 982.22 933.11 1,073.08
39531 1,036.50 984.68 1,132.38
39540 849.54 807.06 928.12
39541 913.08 867.43 997.54
39545 909.50 864.03 993.63
39560 792.88 753.24 866.23
39561 1,167.17 1,108.81 1,275.13
40490 118.99 113.04 130.00
# 40490 75.89 72.10 82.92
40500 473.17 449.51 516.94
# 40500 365.00 346.75 398.76
40510 481.15 457.09 525.65
# 40510 371.28 352.72 405.63
# 40520 375.81 357.02 410.57
40520 520.74 494.70 568.91
40525 593.59 563.91 648.50
40527 705.15 669.89 770.37
# 40530 425.43 404.16 464.78
40530 561.92 533.82 613.89
# 40650 295.55 280.77 322.89
40650 443.45 421.28 484.47
# 40652 365.31 347.04 399.10
40652 512.36 486.74 559.75
# 40654 438.53 416.60 479.09
40654 593.61 563.93 648.52
40700 919.66 873.68 1,004.73
40701 1,160.75 1,102.71 1,268.12
40702 905.52 860.24 989.28
40720 1,014.76 964.02 1,108.62
40761 1,081.54 1,027.46 1,181.58
# 40800 125.15 118.89 136.72
40800 175.44 166.67 191.67
# 40801 226.54 215.21 247.49
40801 280.63 266.60 306.59
# 40804 130.91 124.36 143.01
40804 195.99 186.19 214.12
# 40805 235.78 223.99 257.59
40805 306.35 291.03 334.68
# 40806 34.77 33.03 37.98
40806 90.97 86.42 99.38
# 40808 103.92 98.72 113.53
40808 153.36 145.69 167.54
# 40810 126.37 120.05 138.06
40810 177.92 169.02 194.37


# 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.