EMPIRE MEDICARE SERVICES
AREA 01 NEW JERSEY
2006 FEE SCHEDULE

 

# PROCEDURE
CODE		 MOD PAR
FEE		 NONPAR
FEE		 LIMITING
CHARGE
30110 220.78 209.74 241.20
30115 456.37 433.55 498.58
# 30117 350.82 333.28 383.27
30117 745.67 708.39 814.65
30118 843.17 801.01 921.16
# 30120 508.41 482.99 555.44
30120 531.07 504.52 580.20
30124 300.89 285.85 328.73
30125 695.51 660.73 759.84
30130 405.93 385.63 443.47
30140 437.15 415.29 477.58
30150 910.80 865.26 995.05
30160 889.61 845.13 971.90
# 30200 67.70 64.32 73.97
30200 108.39 102.97 118.42
# 30210 107.19 101.83 117.10
30210 144.18 136.97 157.52
# 30220 136.91 130.06 149.57
30220 262.21 249.10 286.47
# 30300 133.42 126.75 145.76
30300 259.18 246.22 283.15
30310 228.28 216.87 249.40
30320 521.63 495.55 569.88
30400 1,150.12 1,092.61 1,256.50
30410 1,423.65 1,352.47 1,555.34
30420 1,520.13 1,444.12 1,660.74
30430 1,059.61 1,006.63 1,157.62
30435 1,411.12 1,340.56 1,541.64
30450 1,833.71 1,742.02 2,003.32
30460 897.89 853.00 980.95
30462 1,815.33 1,724.56 1,983.24
30465 1,059.82 1,006.83 1,157.85
30520 553.96 526.26 605.20
30540 765.03 726.78 835.80
30545 1,069.75 1,016.26 1,168.70
# 30560 153.15 145.49 167.31
30560 275.21 261.45 300.67
# 30580 569.28 540.82 621.94
30580 660.83 627.79 721.96
# 30600 499.35 474.38 545.54
30600 615.40 584.63 672.32
30620 669.63 636.15 731.57
30630 676.07 642.27 738.61
# 30801 136.26 129.45 148.87
30801 238.44 226.52 260.50
# 30802 196.87 187.03 215.08
30802 300.90 285.86 328.74
# 30901 67.37 64.00 73.60
30901 115.45 109.68 126.13
# 30903 89.66 85.18 97.96
30903 192.30 182.69 210.09
# 30905 120.40 114.38 131.54
30905 248.00 235.60 270.94
# 30906 161.09 153.04 176.00
30906 285.93 271.63 312.37
30915 619.91 588.91 677.25
30920 839.35 797.38 916.99
30930 129.85 123.36 141.86
# 31000 114.16 108.45 124.72
31000 181.20 172.14 197.96
31002 232.38 220.76 253.87
# 31020 369.00 350.55 403.13
31020 523.88 497.69 572.34
# 31030 567.94 539.54 620.47
31030 792.18 752.57 865.46
31032 619.99 588.99 677.34
31040 864.79 821.55 944.78
31050 523.89 497.70 572.36
31051 689.44 654.97 753.22
31070 460.32 437.30 502.90
31075 845.78 803.49 924.01
31080 1,129.85 1,073.36 1,234.36
31081 1,250.27 1,187.76 1,365.92
31084 1,210.79 1,150.25 1,322.79
31085 1,279.27 1,215.31 1,397.61
31086 1,170.13 1,111.62 1,278.36
31087 1,158.72 1,100.78 1,265.90
31090 998.47 948.55 1,090.83
31200 636.78 604.94 695.68
31201 790.80 751.26 863.95
31205 985.14 935.88 1,076.26
31225 1,654.68 1,571.95 1,807.74
31230 1,841.64 1,749.56 2,011.99
# 31231 88.11 83.70 96.26
31231 204.16 193.95 223.04
# 31233 163.21 155.05 178.31
31233 294.06 279.36 321.26
# 31235 194.96 185.21 212.99
31235 342.92 325.77 374.64
# 31237 217.19 206.33 237.28
31237 370.69 352.16 404.98
# 31238 237.76 225.87 259.75
31238 383.40 364.23 418.86
31239 742.10 705.00 810.75
31240 193.95 184.25 211.89
31254 334.87 318.13 365.85
31255 496.07 471.27 541.96
31256 242.10 230.00 264.50
31267 391.38 371.81 427.58
31276 625.55 594.27 683.41


# 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.