EMPIRE MEDICARE SERVICES
AREA 01 NEW JERSEY
2006 FEE SCHEDULE

 

# PROCEDURE
CODE		 MOD PAR
FEE		 NONPAR
FEE		 LIMITING
CHARGE
# 28308 408.12 387.71 445.87
28308 503.83 478.64 550.44
28309 955.34 907.57 1,043.71
# 28310 407.73 387.34 445.44
28310 509.44 483.97 556.57
# 28312 373.56 354.88 408.11
28312 457.25 434.39 499.55
# 28313 451.17 428.61 492.90
28313 471.98 448.38 515.64
# 28315 372.12 353.51 406.54
28315 444.25 422.04 485.35
28320 731.57 694.99 799.24
# 28322 674.42 640.70 736.81
28322 806.19 765.88 880.76
# 28340 506.94 481.59 553.83
28340 609.12 578.66 665.46
# 28341 596.90 567.06 652.12
28341 695.38 660.61 759.70
# 28344 357.51 339.63 390.57
28344 455.53 432.75 497.66
# 28345 483.31 459.14 528.01
28345 553.58 525.90 604.79
28360 1,104.54 1,049.31 1,206.71
# 28400 240.99 228.94 263.28
28400 267.81 254.42 292.58
# 28405 423.82 402.63 463.02
28405 433.53 411.85 473.63
28406 608.39 577.97 664.67
28415 1,353.46 1,285.79 1,478.66
28420 1,368.38 1,299.96 1,494.95
# 28430 214.05 203.35 233.85
28430 252.43 239.81 275.78
# 28435 329.59 313.11 360.08
28435 336.06 319.26 367.15
28436 492.49 467.87 538.05
28445 1,231.98 1,170.38 1,345.94
# 28450 201.17 191.11 219.78
28450 230.76 219.22 252.10
28455 298.71 283.77 326.34
28456 316.02 300.22 345.25
28465 613.90 583.21 670.69
# 28470 204.13 193.92 223.01
28470 235.57 223.79 257.36
# 28475 284.19 269.98 310.48
28475 289.73 275.24 316.53
28476 385.75 366.46 421.43
28485 511.59 486.01 558.91
# 28490 124.69 118.46 136.23
28490 142.26 135.15 155.42
# 28495 166.43 158.11 181.83
28495 171.52 162.94 187.38
# 28496 254.65 241.92 278.21
28496 489.06 464.61 534.30
# 28505 353.79 336.10 386.52
28505 548.44 521.02 599.17
28510 119.61 113.63 130.67
28515 153.02 145.37 167.18
# 28525 310.23 294.72 338.93
28525 499.33 474.36 545.51
28530 114.24 108.53 124.81
# 28531 202.47 192.35 221.20
28531 443.35 421.18 484.36
28540 202.81 192.67 221.57
28545 220.53 209.50 240.93
# 28546 350.45 332.93 382.87
28546 467.89 444.50 511.18
# 28555 553.63 525.95 604.84
28555 749.66 712.18 819.01
# 28570 183.23 174.07 200.18
28570 187.39 178.02 204.72
28575 325.82 309.53 355.96
28576 385.50 366.23 421.16
# 28585 636.53 604.70 695.41
28585 705.42 670.15 770.67
# 28600 210.11 199.60 229.54
28600 216.12 205.31 236.11
28605 268.12 254.71 292.92
28606 443.61 421.43 484.64
28615 731.73 695.14 799.41
# 28630 121.77 115.68 133.03
28630 148.13 140.72 161.83
# 28635 156.91 149.06 171.42
28635 180.03 171.03 196.68
# 28636 248.52 236.09 271.50
28636 306.31 290.99 334.64
# 28645 341.47 324.40 373.06
28645 419.15 398.19 457.92
# 28660 90.64 86.11 99.03
28660 112.37 106.75 122.76
28665 152.69 145.06 166.82
# 28666 242.26 230.15 264.67
28666 395.30 375.54 431.87
# 28675 289.02 274.57 315.76
28675 464.71 441.47 507.69
28705 1,442.72 1,370.58 1,576.17
28715 1,056.28 1,003.47 1,153.99
28725 915.19 869.43 999.84
28730 886.31 841.99 968.29
28735 858.67 815.74 938.10
28737 755.65 717.87 825.55


# 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.