EMPIRE MEDICARE SERVICES
AREA 01 NEW JERSEY
2006 FEE SCHEDULE

 

# PROCEDURE
CODE		 MOD PAR
FEE		 NONPAR
FEE		 LIMITING
CHARGE
75662 TC 608.38 577.96 664.65
75662 704.43 669.21 769.59
75665 26 76.19 72.38 83.24
75665 TC 608.38 577.96 664.65
75665 684.57 650.34 747.89
75671 26 94.57 89.84 103.32
75671 TC 608.38 577.96 664.65
75671 702.95 667.80 767.97
75676 26 75.45 71.68 82.43
75676 TC 608.38 577.96 664.65
75676 683.83 649.64 747.09
75680 26 94.57 89.84 103.32
75680 TC 608.38 577.96 664.65
75680 702.95 667.80 767.97
75685 26 74.62 70.89 81.52
75685 TC 608.38 577.96 664.65
75685 683.00 648.85 746.18
75705 26 125.95 119.65 137.60
75705 TC 608.38 577.96 664.65
75705 734.33 697.61 802.25
75710 26 66.32 63.00 72.45
75710 TC 608.38 577.96 664.65
75710 674.70 640.97 737.12
75716 26 74.99 71.24 81.93
75716 TC 608.38 577.96 664.65
75716 683.37 649.20 746.58
75722 26 66.05 62.75 72.16
75722 TC 608.38 577.96 664.65
75722 674.42 640.70 736.81
75724 26 87.48 83.11 95.58
75724 TC 608.38 577.96 664.65
75724 695.86 661.07 760.23
75726 26 64.66 61.43 70.64
75726 TC 608.38 577.96 664.65
75726 673.04 639.39 735.30
75731 26 65.03 61.78 71.05
75731 TC 608.38 577.96 664.65
75731 673.41 639.74 735.70
75733 26 75.08 71.33 82.03
75733 TC 608.38 577.96 664.65
75733 683.46 649.29 746.68
75736 26 65.49 62.22 71.55
75736 TC 608.38 577.96 664.65
75736 673.87 640.18 736.21
75741 26 74.62 70.89 81.52
75741 TC 608.38 577.96 664.65
75741 683.00 648.85 746.18
75743 26 94.11 89.40 102.81
75743 TC 608.38 577.96 664.65
75743 702.48 667.36 767.46
75746 26 65.12 61.86 71.14
75746 TC 608.38 577.96 664.65
75746 673.50 639.83 735.80
75756 26 67.99 64.59 74.28
75756 TC 608.38 577.96 664.65
75756 676.37 642.55 738.93
75774 26 20.72 19.68 22.63
75774 TC 608.38 577.96 664.65
75774 629.10 597.65 687.30
75790 26 104.84 99.60 114.54
75790 TC 65.37 62.10 71.42
75790 170.20 161.69 185.94
75801 26 47.91 45.51 52.34
75801 TC 261.75 248.66 285.96
75801 309.66 294.18 338.31
75803 26 66.32 63.00 72.45
75803 TC 261.75 248.66 285.96
75803 328.07 311.67 358.42
75805 26 46.80 44.46 51.13
75805 TC 295.13 280.37 322.43
75805 341.93 324.83 373.55
75807 26 66.32 63.00 72.45
75809 26 26.52 25.19 28.97
75809 TC 37.91 36.01 41.41
75809 64.42 61.20 70.38
75810 26 64.66 61.43 70.64
75810 TC 608.38 577.96 664.65
75810 673.04 639.39 735.30
75820 26 39.81 37.82 43.49
75820 TC 46.14 43.83 50.40
75820 85.94 81.64 93.89
75822 26 60.53 57.50 66.13
75822 TC 71.38 67.81 77.98
75822 131.90 125.31 144.11
75825 26 65.40 62.13 71.45
75825 TC 608.38 577.96 664.65
75825 673.78 640.09 736.10
75827 26 64.66 61.43 70.64
75827 TC 608.38 577.96 664.65
75827 673.04 639.39 735.30
75831 26 65.03 61.78 71.05
75831 TC 608.38 577.96 664.65
75831 673.41 639.74 735.70
75833 26 85.72 81.43 93.64
75833 TC 608.38 577.96 664.65
75833 694.09 659.39 758.30
75840 26 65.86 62.57 71.96
75840 TC 608.38 577.96 664.65
75840 674.24 640.53 736.61
75842 26 84.52 80.29 92.33


# 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.