EMPIRE MEDICARE SERVICES
AREA 01 NEW JERSEY
2006 FEE SCHEDULE

 

# PROCEDURE
CODE		 MOD PAR
FEE		 NONPAR
FEE		 LIMITING
CHARGE
78278 TC 234.85 223.11 256.58
78278 291.27 276.71 318.22
78282 26 21.98 20.88 24.01
78282 TC 148.69 141.26 162.45
78282 172.20 163.59 188.13
78290 26 39.01 37.06 42.62
78290 TC 147.38 140.01 161.01
78290 186.38 177.06 203.62
78291 26 50.63 48.10 55.32
78291 TC 147.84 140.45 161.52
78291 198.47 188.55 216.83
78300 26 35.67 33.89 38.97
78300 TC 120.29 114.28 131.42
78300 155.96 148.16 170.38
78305 26 47.70 45.32 52.12
78305 TC 176.69 167.86 193.04
78305 224.39 213.17 245.15
78306 26 49.37 46.90 53.94
78306 TC 206.00 195.70 225.06
78306 255.36 242.59 278.98
78315 26 58.09 55.19 63.47
78315 TC 230.68 219.15 252.02
78315 288.78 274.34 315.49
78320 26 59.82 56.83 65.35
78320 TC 285.60 271.32 312.02
78320 345.42 328.15 377.37
78350 26 12.43 11.81 13.58
78350 TC 36.52 34.69 39.89
78350 48.95 46.50 53.48
78414 26 26.18 24.87 28.60
78414 TC 86.61 82.28 94.62
78414 114.68 108.95 125.29
78428 26 45.79 43.50 50.03
78428 TC 109.28 103.82 119.39
78428 155.07 147.32 169.42
78445 26 28.24 26.83 30.85
78445 TC 90.52 85.99 98.89
78445 118.76 112.82 129.74
78456 26 57.29 54.43 62.59
78456 TC 195.17 185.41 213.22
78456 252.46 239.84 275.82
78457 26 44.00 41.80 48.07
78457 TC 128.61 122.18 140.51
78457 172.61 163.98 188.58
78458 26 52.36 49.74 57.20
78458 TC 194.07 184.37 212.03
78458 246.43 234.11 269.23
78459 26 88.34 83.92 96.51
78459 TC 2,016.70 1,915.87 2,203.25
78459 2,107.29 2,001.93 2,302.22
78460 26 49.37 46.90 53.94
78460 TC 114.37 108.65 124.95
78460 163.74 155.55 178.88
78461 26 71.04 67.49 77.61
78461 TC 227.91 216.51 248.99
78461 298.95 284.00 326.60
78464 26 62.75 59.61 68.55
78464 TC 341.45 324.38 373.04
78464 404.20 383.99 441.59
78465 26 84.43 80.21 92.24
78465 TC 569.36 540.89 622.02
78465 653.78 621.09 714.25
78466 26 39.87 37.88 43.56
78466 TC 126.76 120.42 138.48
78466 166.63 158.30 182.05
78468 26 45.67 43.39 49.90
78468 TC 176.69 167.86 193.04
78468 222.35 211.23 242.91
78469 26 52.33 49.71 57.17
78469 TC 252.60 239.97 275.97
78469 304.92 289.67 333.12
78472 26 56.49 53.67 61.72
78472 TC 266.74 253.40 291.41
78472 323.23 307.07 353.13
78473 26 84.73 80.49 92.56
78473 TC 398.31 378.39 435.15
78473 483.05 458.90 527.74
78478 26 36.23 34.42 39.58
78478 TC 75.81 72.02 82.82
78478 112.04 106.44 122.41
78480 26 35.77 33.98 39.08
78480 TC 75.81 72.02 82.82
78480 111.58 106.00 121.90
78481 26 57.04 54.19 62.32
78481 TC 252.60 239.97 275.97
78481 309.64 294.16 338.28
78483 26 85.75 81.46 93.68
78483 TC 379.91 360.91 415.05
78483 465.66 442.38 508.74
78491 26 89.63 85.15 97.92
78491 TC 937.44 890.57 1,024.16
78491 1,026.78 975.44 1,121.76
78492 26 111.77 106.18 122.11
78492 TC 1,570.69 1,492.16 1,715.98
78492 1,682.10 1,598.00 1,837.70
78494 26 68.98 65.53 75.36
78494 TC 338.87 321.93 370.22
78494 407.84 387.45 445.57
78496 26 29.11 27.65 31.80
78496 TC 338.87 321.93 370.22


# 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.