EMPIRE MEDICARE SERVICES
AREA 01 NEW JERSEY
2006 FEE SCHEDULE

 

# PROCEDURE
CODE		 MOD PAR
FEE		 NONPAR
FEE		 LIMITING
CHARGE
# 21085 721.69 685.61 788.45
21085 791.50 751.93 864.72
# 21086 2,035.50 1,933.73 2,223.79
21086 2,235.24 2,123.48 2,442.00
# 21087 2,014.45 1,913.73 2,200.79
21087 2,204.01 2,093.81 2,407.88
# 21100 400.96 380.91 438.05
21100 715.82 680.03 782.03
# 21110 622.50 591.38 680.09
21110 678.44 644.52 741.20
# 21116 49.95 47.45 54.57
21116 235.35 223.58 257.12
# 21120 566.62 538.29 619.03
21120 709.95 674.45 775.62
# 21121 701.60 666.52 766.50
21121 790.37 750.85 863.48
21122 780.14 741.13 852.30
21123 999.01 949.06 1,091.42
# 21125 839.74 797.75 917.41
21125 3,014.64 2,863.91 3,293.50
# 21127 939.42 892.45 1,026.32
21127 2,485.51 2,361.23 2,715.41
21137 800.33 760.31 874.36
21138 994.13 944.42 1,086.08
21139 1,141.25 1,084.19 1,246.82
21141 1,444.14 1,371.93 1,577.72
21142 1,435.34 1,363.57 1,568.11
21143 1,508.55 1,433.12 1,648.09
21145 1,547.54 1,470.16 1,690.68
21146 1,653.75 1,571.06 1,806.72
21147 1,637.21 1,555.35 1,788.65
21150 1,881.65 1,787.57 2,055.71
21151 2,282.24 2,168.13 2,493.35
21154 2,385.35 2,266.08 2,605.99
21155 2,731.92 2,595.32 2,984.62
21159 3,346.69 3,179.36 3,656.26
21160 3,285.29 3,121.03 3,589.18
21172 1,881.54 1,787.46 2,055.58
21175 2,330.90 2,214.36 2,546.51
21179 1,649.32 1,566.85 1,801.88
21180 1,849.67 1,757.19 2,020.77
21181 791.06 751.51 864.24
21182 2,278.24 2,164.33 2,488.98
21183 2,544.45 2,417.23 2,779.81
21184 2,758.20 2,620.29 3,013.33
21188 1,836.43 1,744.61 2,006.30
21193 1,355.39 1,287.62 1,480.76
21194 1,506.36 1,431.04 1,645.70
21195 1,437.57 1,365.69 1,570.54
21196 1,561.07 1,483.02 1,705.47
21198 1,209.08 1,148.63 1,320.92
21199 1,114.57 1,058.84 1,217.67
21206 1,199.39 1,139.42 1,310.33
# 21208 893.89 849.20 976.58
21208 1,484.77 1,410.53 1,622.11
# 21209 676.27 642.46 738.83
21209 802.95 762.80 877.22
# 21210 891.00 846.45 973.42
21210 1,610.41 1,529.89 1,759.37
# 21215 921.59 875.51 1,006.84
21215 2,429.31 2,307.84 2,654.02
21230 851.25 808.69 929.99
# 21235 588.83 559.39 643.30
21235 747.87 710.48 817.05
21240 1,203.66 1,143.48 1,315.00
21242 1,117.62 1,061.74 1,221.00
21243 1,760.41 1,672.39 1,923.25
21244 1,081.65 1,027.57 1,181.71
# 21245 975.41 926.64 1,065.64
21245 1,186.24 1,126.93 1,295.97
21246 968.32 919.90 1,057.89
21247 1,815.00 1,724.25 1,982.89
# 21248 952.65 905.02 1,040.77
21248 1,079.33 1,025.36 1,179.16
# 21249 1,381.29 1,312.23 1,509.06
21249 1,568.08 1,489.68 1,713.13
21255 1,505.04 1,429.79 1,644.26
21256 1,251.54 1,188.96 1,367.30
21260 1,289.15 1,224.69 1,408.39
21261 2,510.22 2,384.71 2,742.42
21263 2,119.00 2,013.05 2,315.01
21267 1,736.13 1,649.32 1,896.72
21268 2,051.71 1,949.12 2,241.49
# 21270 772.05 733.45 843.47
21270 975.95 927.15 1,066.22
21275 875.64 831.86 956.64
21280 531.50 504.93 580.67
21282 356.71 338.87 389.70
21295 184.68 175.45 201.77
21296 410.02 389.52 447.95
# 21300 45.68 43.40 49.91
21300 143.24 136.08 156.49
# 21310 32.03 30.43 34.99
21310 130.98 124.43 143.09
# 21315 153.09 145.44 167.26
21315 261.74 248.65 285.95
# 21320 155.71 147.92 170.11
21320 262.06 248.96 286.30
21325 561.66 533.58 613.62
21330 685.83 651.54 749.27


# 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.