EMPIRE MEDICARE SERVICES
AREA 99 NEW JERSEY
2005 FEE SCHEDULE

 

# PROCEDURE
CODE		 MOD PAR
FEE		 NONPAR
FEE		 LIMITING
CHARGE
# 40812 202.43 192.31 221.16
40812 258.21 245.30 282.10
# 40814 313.38 297.71 342.37
40814 357.74 339.85 390.83
# 40816 327.84 311.45 358.17
40816 377.28 358.42 412.18
# 40818 270.12 256.61 295.10
40818 320.83 304.79 350.51
# 40819 235.15 223.39 256.90
40819 276.98 263.13 302.60
# 40820 157.42 149.55 171.98
40820 220.38 209.36 240.76
# 40830 164.42 156.20 179.63
40830 233.30 221.64 254.89
# 40831 236.16 224.35 258.00
40831 304.19 288.98 332.33
# 40840 675.60 641.82 738.09
40840 794.34 754.62 867.81
# 40842 668.68 635.25 730.54
40842 807.28 766.92 881.96
# 40843 855.19 812.43 934.29
40843 1,030.12 978.61 1,125.40
# 40844 1,188.91 1,129.46 1,298.88
40844 1,366.39 1,298.07 1,492.78
# 40845 1,359.88 1,291.89 1,485.67
40845 1,522.57 1,446.44 1,663.41
# 41000 115.05 109.30 125.70
41000 153.08 145.43 167.24
# 41005 126.57 120.24 138.28
41005 194.61 184.88 212.61
# 41006 274.06 260.36 299.41
41006 342.52 325.39 374.20
41007 350.34 332.82 382.74
# 41007 260.75 247.71 284.87
41008 345.16 327.90 377.09
# 41008 282.63 268.50 308.78
41009 367.53 349.15 401.52
# 41009 308.37 292.95 336.89
41010 189.08 179.63 206.57
# 41010 112.18 106.57 122.56
41015 400.23 380.22 437.25
# 41015 346.98 329.63 379.07
41016 415.63 394.85 454.08
# 41016 356.90 339.06 389.92
41017 416.85 396.01 455.41
# 41017 360.65 342.62 394.01
41018 483.21 459.05 527.91
# 41018 417.29 396.43 455.89
# 41100 129.53 123.05 141.51
41100 171.79 163.20 187.68
# 41105 116.32 110.50 127.08
41105 157.73 149.84 172.32
# 41108 92.66 88.03 101.23
41108 132.38 125.76 144.62
# 41110 133.38 126.71 145.72
41110 190.00 180.50 207.58
# 41112 253.94 241.24 277.43
41112 306.76 291.42 335.13
# 41113 284.41 270.19 310.72
41113 338.07 321.17 369.35
41114 666.58 633.25 728.24
41115 213.97 203.27 233.76
# 41115 153.13 145.47 167.29
41116 288.09 273.69 314.74
# 41116 222.60 211.47 243.19
41120 1,060.74 1,007.70 1,158.86
41130 1,156.87 1,099.03 1,263.88
41135 1,959.20 1,861.24 2,140.43
41140 2,209.16 2,098.70 2,413.51
41145 2,563.87 2,435.68 2,801.03
41150 2,021.67 1,920.59 2,208.68
41153 2,065.25 1,961.99 2,256.29
41155 2,308.46 2,193.04 2,522.00
41250 197.78 187.89 216.07
# 41250 131.86 125.27 144.06
41251 235.41 223.64 257.19
# 41251 162.73 154.59 177.78
41252 291.68 277.10 318.67
# 41252 222.38 211.26 242.95
41500 471.14 447.58 514.72
41510 476.35 452.53 520.41
41520 312.36 296.74 341.25
# 41520 270.11 256.60 295.09
41800 159.80 151.81 174.58
# 41800 104.45 99.23 114.11
41805 166.30 157.99 181.69
# 41805 146.86 139.52 160.45
41806 270.16 256.65 295.15
# 41806 246.92 234.57 269.76
41822 266.50 253.18 291.16
# 41822 181.14 172.08 197.89
41823 381.47 362.40 416.76
# 41823 315.97 300.17 345.20
# 41825 151.62 144.04 165.65
41825 186.27 176.96 203.50
# 41826 190.49 180.97 208.12
41826 204.44 194.22 223.35
# 41827 301.44 286.37 329.33
41827 379.62 360.64 414.74
# 41828 262.62 249.49 286.91


# 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.