EMPIRE MEDICARE SERVICES
AREA 01 NEW JERSEY
2006 FEE SCHEDULE

 

# PROCEDURE
CODE
MOD PAR
FEE
NONPAR
FEE
LIMITING
CHARGE

#

15115

776.49

737.67

848.32

15115

863.42

820.25

943.29

#

15116

164.19

155.98

179.38

15116

185.46

176.19

202.62

#

15120

797.15

757.29

870.88

15120

933.54

886.86

1,019.89

#

15121

205.86

195.57

224.91

15121

328.85

312.41

359.27

#

15130

610.49

579.97

666.97

15130

773.70

735.02

845.27

#

15131

97.48

92.61

106.50

15131

117.36

111.49

128.21

#

15135

843.17

801.01

921.16

15135

924.08

877.88

1,009.56

#

15136

98.50

93.58

107.62

15136

108.67

103.24

118.73

#

15150

671.50

637.93

733.62

15150

764.90

726.66

835.66

#

15151

129.82

123.33

141.83

15151

151.08

143.53

165.06

#

15152

162.15

154.04

177.15

15152

185.27

176.01

202.41

#

15155

722.30

686.19

789.12

15155

762.06

723.96

832.55

#

15156

180.87

171.83

197.60

15156

195.66

185.88

213.76

#

15157

197.08

187.23

215.31

15157

216.97

206.12

237.04

#

15170

330.34

313.82

360.89

15170

398.30

378.39

435.15

#

15171

97.82

92.93

106.87

15171

100.59

95.56

109.89

#

15175

496.31

471.49

542.21

15175

562.42

534.30

614.45

#

15176

154.70

146.97

169.02

15176

160.25

152.24

175.08

#

15200

645.28

613.02

704.97

15200

793.70

754.02

867.12

#

15201

88.60

84.17

96.80

15201

178.76

169.82

195.29

#

15220

655.90

623.11

716.58

15220

771.95

733.35

843.35

#

15221

79.51

75.53

86.86

15221

161.34

153.27

176.26

#

15240

764.48

726.26

835.20

15240

868.97

825.52

949.35

#

15241

125.13

118.87

136.70

15241

196.33

186.51

214.49

#

15260

825.62

784.34

901.99

15260

901.45

856.38

984.84

#

15261

161.89

153.80

176.87

15261

221.99

210.89

242.52

#

15300

281.62

267.54

307.67

15300

326.46

310.14

356.66

#

15301

63.75

60.56

69.64

15301

66.99

63.64

73.19

#

15320

327.27

310.91

357.55

15320

377.67

358.79

412.61

#

15321

95.17

90.41

103.97

15321

99.79

94.80

109.02

#

15330

281.15

267.09

307.15

15330

326.00

309.70

356.16

#

15331

63.75

60.56

69.64

15331

66.53

63.20

72.68

#

15335

313.99

298.29

343.03

15335

361.61

343.53

395.06

#

15336

91.07

86.52

99.50

15336

96.61

91.78

105.55

#

15340

291.88

277.29

318.88

15340

349.68

332.20

382.03

#

15341

31.51

29.93

34.42

15341

50.46

47.94

55.13

#

15360

313.89

298.20

342.93

15360

378.16

359.25

413.14

#

15361

72.54

68.91

79.25

15361

78.09

74.19

85.32

#

15365

331.31

314.74

361.95

15365

394.19

374.48

430.65

#

15366

91.22

86.66

99.66

15366

96.77

91.93

105.72

15400

363.18

345.02

396.77

#

15401

65.60

62.32

71.67

15401

133.10

126.45

145.42

#

15420

375.30

356.54

410.02

15420

421.07

400.02

460.02

#

15421

96.55

91.72

105.48

15421

128.92

122.47

140.84

#

15430

561.42

533.35

613.35

15430

574.83

546.09

628.00

#

15570

731.76

695.17

799.45

15570

942.13

895.02

1,029.27

#

15572

714.67

678.94

780.78

15572

855.69

812.91

934.85

#

15574

801.09

761.04

875.20

15574

935.17

888.41

1,021.67

#

15576

699.13

664.17

763.80

15576

832.29

790.68

909.28

#

15600

228.48

217.06

249.62

15600

438.85

416.91

479.45

#

15610

268.52

255.09

293.35


# 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.