EMPIRE MEDICARE SERVICES
AREA 01 NEW JERSEY
2006 FEE SCHEDULE

 

# PROCEDURE
CODE		 MOD PAR
FEE		 NONPAR
FEE		 LIMITING
CHARGE
# 54055 88.85 84.41 97.07
54055 124.46 118.24 135.98
# 54056 104.18 98.97 113.82
54056 130.07 123.57 142.11
# 54057 91.41 86.84 99.87
54057 155.68 147.90 170.09
# 54060 131.19 124.63 143.32
54060 225.97 214.67 246.87
# 54065 158.69 150.76 173.37
54065 223.89 212.70 244.61
# 54100 117.78 111.89 128.67
54100 209.79 199.30 229.20
# 54105 238.85 226.91 260.95
54105 347.50 330.13 379.65
54110 651.99 619.39 712.30
54111 845.93 803.63 924.17
54112 990.90 941.36 1,082.56
# 54115 422.02 400.92 461.06
54115 464.55 441.32 507.52
54120 640.81 608.77 700.09
54125 846.73 804.39 925.05
54130 1,241.03 1,178.98 1,355.83
54135 1,595.40 1,515.63 1,742.97
# 54150 110.84 105.30 121.10
54150 280.06 266.06 305.97
54152 155.11 147.35 169.45
# 54160 156.84 149.00 171.35
54160 298.32 283.40 325.91
54161 211.72 201.13 231.30
# 54162 194.61 184.88 212.61
54162 343.49 326.32 375.27
54163 220.96 209.91 241.40
54164 191.95 182.35 209.70
# 54200 90.30 85.79 98.66
54200 128.67 122.24 140.58
54205 555.05 527.30 606.40
# 54220 147.22 139.86 160.84
54220 281.30 267.24 307.33
# 54230 86.17 81.86 94.14
54230 106.98 101.63 116.87
# 54231 127.92 121.52 139.75
54231 151.04 143.49 165.01
# 54235 77.48 73.61 84.65
54235 95.05 90.30 103.85
54240 26 76.46 72.64 83.54
54240 TC 29.95 28.45 32.72
54240 106.42 101.10 116.27
54250 26 127.74 121.35 139.55
54250 TC 9.98 9.48 10.90
54250 137.72 130.83 150.45
54300 702.61 667.48 767.60
54304 825.57 784.29 901.93
54308 780.53 741.50 852.73
54312 912.66 867.03 997.08
54316 1,085.85 1,031.56 1,186.29
54318 769.69 731.21 840.89
54322 853.91 811.21 932.89
54324 1,063.69 1,010.51 1,162.09
54326 1,030.60 979.07 1,125.93
54328 998.50 948.58 1,090.87
54332 1,086.11 1,031.80 1,186.57
54336 1,360.12 1,292.11 1,485.93
54340 613.11 582.45 669.82
54344 1,053.89 1,001.20 1,151.38
54348 1,118.32 1,062.40 1,221.76
54352 1,590.79 1,511.25 1,737.94
54360 787.77 748.38 860.64
54380 868.03 824.63 948.32
54385 1,030.34 978.82 1,125.64
54390 1,358.04 1,290.14 1,483.66
54400 584.78 555.54 638.87
54401 703.69 668.51 768.79
54405 846.89 804.55 925.23
54406 767.12 728.76 838.07
54408 808.99 768.54 883.82
54410 967.78 919.39 1,057.30
54411 1,008.35 957.93 1,101.62
54415 543.96 516.76 594.27
54416 712.17 676.56 778.04
54417 890.76 846.22 973.15
54420 744.95 707.70 813.86
54430 668.98 635.53 730.86
54435 428.21 406.80 467.82
54440 996.45 946.63 1,088.62
# 54450 68.20 64.79 74.51
54450 91.78 87.19 100.27
# 54500 82.10 78.00 89.70
54500 84.42 80.20 92.23
54505 237.06 225.21 258.99
54512 559.28 531.32 611.02
54520 356.73 338.89 389.72
54522 638.49 606.57 697.56
54530 563.99 535.79 616.16
54535 778.39 739.47 850.39
54550 509.45 483.98 556.58
54560 717.22 681.36 783.56
54600 463.61 440.43 506.49
54620 322.52 306.39 352.35
54640 472.04 448.44 515.71
54650 751.20 713.64 820.69
54660 359.42 341.45 392.67


# 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.