EMPIRE MEDICARE SERVICES
AREA 01 NEW JERSEY
2006 FEE SCHEDULE

 

# PROCEDURE
CODE		 MOD PAR
FEE		 NONPAR
FEE		 LIMITING
CHARGE
52351 349.08 331.63 381.37
52352 409.57 389.09 447.45
52353 472.41 448.79 516.11
52354 436.98 415.13 477.40
52355 522.11 496.00 570.40
52400 585.72 556.43 639.89
52402 304.65 289.42 332.83
52450 495.99 471.19 541.87
52500 543.04 515.89 593.27
52510 430.99 409.44 470.86
52601 763.52 725.34 834.14
52606 511.19 485.63 558.47
52612 513.13 487.47 560.59
52614 446.44 424.12 487.74
52620 420.20 399.19 459.07
52630 457.45 434.58 499.77
52640 419.68 398.70 458.51
# 52647 651.41 618.84 711.67
52647 3,869.83 3,676.34 4,227.79
# 52648 699.73 664.74 764.45
52648 3,906.12 3,710.81 4,267.43
52700 437.44 415.57 477.91
53000 168.52 160.09 184.10
53010 289.40 274.93 316.17
# 53020 106.74 101.40 116.61
53020 214.93 204.18 234.81
# 53025 71.84 68.25 78.49
53025 221.18 210.12 241.64
53040 431.85 410.26 471.80
# 53060 179.12 170.16 195.68
53060 212.41 201.79 232.06
53080 547.00 519.65 597.60
53085 787.97 748.57 860.86
# 53200 156.53 148.70 171.01
53200 172.25 163.64 188.19
53210 806.49 766.17 881.10
53215 971.45 922.88 1,061.31
53220 470.33 446.81 513.83
53230 628.86 597.42 687.03
53235 659.33 626.36 720.31
53240 440.60 418.57 481.36
53250 406.41 386.09 444.00
# 53260 194.36 184.64 212.34
53260 232.73 221.09 254.25
# 53265 199.60 189.62 218.06
53265 259.71 246.72 283.73
# 53270 206.16 195.85 225.23
53270 237.14 225.28 259.07
53275 297.52 282.64 325.04
53400 826.61 785.28 903.07
53405 913.01 867.36 997.46
53410 1,028.02 976.62 1,123.11
53415 1,167.40 1,109.03 1,275.38
53420 890.42 845.90 972.79
53425 1,000.61 950.58 1,093.17
53430 1,020.87 969.83 1,115.30
53431 1,221.41 1,160.34 1,334.39
53440 857.65 814.77 936.99
53442 745.32 708.05 814.26
53444 843.46 801.29 921.48
53445 927.72 881.33 1,013.53
53446 677.73 643.84 740.42
53447 872.87 829.23 953.61
53448 1,321.48 1,255.41 1,443.72
53449 632.29 600.68 690.78
53450 414.22 393.51 452.54
53460 474.59 450.86 518.49
53500 809.53 769.05 884.41
53502 512.87 487.23 560.31
53505 504.37 479.15 551.02
53510 670.89 637.35 732.95
53515 846.22 803.91 924.50
53520 577.25 548.39 630.65
# 53600 71.72 68.13 78.35
53600 104.54 99.31 114.21
# 53601 58.98 56.03 64.43
53601 100.59 95.56 109.89
53605 73.60 69.92 80.41
# 53620 96.29 91.48 105.20
53620 161.48 153.41 176.42
# 53621 80.47 76.45 87.92
53621 153.99 146.29 168.23
# 53660 44.64 42.41 48.77
53660 90.88 86.34 99.29
# 53661 44.12 41.91 48.20
53661 90.82 86.28 99.22
53665 44.24 42.03 48.33
# 53850 585.84 556.55 640.03
53850 4,764.55 4,526.32 5,205.27
# 53852 624.06 592.86 681.79
53852 4,537.85 4,310.96 4,957.60
# 53853 355.58 337.80 388.47
53853 2,789.38 2,649.91 3,047.40
# 54000 108.80 103.36 118.86
54000 200.81 190.77 219.39
# 54001 144.66 137.43 158.04
54001 240.83 228.79 263.11
54015 345.28 328.02 377.22
# 54050 100.29 95.28 109.57
54050 129.42 122.95 141.39


# 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.