EMPIRE MEDICARE SERVICES
AREA 01 NEW JERSEY
2006 FEE SCHEDULE

 

# PROCEDURE
CODE		 MOD PAR
FEE		 NONPAR
FEE		 LIMITING
CHARGE
78496 367.98 349.58 402.02
78580 26 42.34 40.22 46.25
78580 TC 165.69 157.41 181.02
78580 208.02 197.62 227.26
78584 26 56.43 53.61 61.65
78584 TC 154.68 146.95 168.99
78584 211.11 200.55 230.63
78585 26 62.19 59.08 67.94
78585 TC 272.75 259.11 297.98
78585 334.94 318.19 365.92
78586 26 22.79 21.65 24.90
78586 TC 125.37 119.10 136.97
78586 148.16 140.75 161.86
78587 26 28.24 26.83 30.85
78587 TC 135.08 128.33 147.58
78587 163.33 155.16 178.43
78588 26 62.19 59.08 67.94
78588 TC 155.05 147.30 169.40
78588 217.24 206.38 237.34
78591 26 22.79 21.65 24.90
78591 TC 137.39 130.52 150.10
78591 160.18 152.17 175.00
78593 26 27.78 26.39 30.35
78593 TC 166.61 158.28 182.02
78593 194.39 184.67 212.37
78594 26 30.31 28.79 33.11
78594 TC 239.93 227.93 262.12
78594 270.24 256.73 295.24
78596 26 72.18 68.57 78.86
78596 TC 341.45 324.38 373.04
78596 413.63 392.95 451.89
78600 26 25.31 24.04 27.65
78600 TC 138.78 131.84 151.62
78600 164.10 155.90 179.29
78601 26 29.05 27.60 31.74
78601 TC 164.30 156.09 179.50
78601 193.34 183.67 211.22
78605 26 30.31 28.79 33.11
78605 TC 164.30 156.09 179.50
78605 194.61 184.88 212.61
78606 26 36.48 34.66 39.86
78606 TC 187.14 177.78 204.45
78606 223.61 212.43 244.29
78607 26 71.04 67.49 77.61
78607 TC 316.67 300.84 345.97
78607 387.71 368.32 423.57
78608 26 85.94 81.64 93.89
78608 TC 2,325.61 2,209.33 2,540.73
78608 2,411.29 2,290.73 2,634.34
78609 26 85.94 81.64 93.89
78609 TC 2,325.61 2,209.33 2,540.73
78609 2,411.29 2,290.73 2,634.34
78610 26 17.48 16.61 19.10
78610 TC 76.74 72.90 83.84
78610 94.22 89.51 102.94
78615 26 24.51 23.28 26.77
78615 TC 186.21 176.90 203.44
78615 210.72 200.18 230.21
78630 26 39.01 37.06 42.62
78630 TC 243.44 231.27 265.96
78630 282.45 268.33 308.58
78635 26 35.83 34.04 39.15
78635 TC 123.06 116.91 134.45
78635 158.89 150.95 173.59
78645 26 32.38 30.76 35.37
78645 TC 165.69 157.41 181.02
78645 198.06 188.16 216.38
78647 26 51.89 49.30 56.70
78647 TC 285.60 271.32 312.02
78647 337.50 320.63 368.72
78650 26 35.27 33.51 38.54
78650 TC 223.84 212.65 244.55
78650 259.12 246.16 283.08
78660 26 30.31 28.79 33.11
78660 TC 102.91 97.76 112.42
78660 133.22 126.56 145.54
78700 26 25.72 24.43 28.09
78700 TC 147.38 140.01 161.01
78700 173.09 164.44 189.11
78701 26 27.78 26.39 30.35
78701 TC 171.70 163.12 187.59
78701 199.48 189.51 217.94
78704 26 42.34 40.22 46.25
78704 TC 190.83 181.29 208.48
78704 233.17 221.51 254.74
78707 26 54.76 52.02 59.82
78707 TC 215.61 204.83 235.55
78707 270.38 256.86 295.39
78708 26 69.32 65.85 75.73
78708 TC 215.61 204.83 235.55
78708 284.93 270.68 311.28
78709 26 80.48 76.46 87.93
78709 TC 215.61 204.83 235.55
78709 296.09 281.29 323.48
78710 26 37.74 35.85 41.23
78710 TC 285.60 271.32 312.02
78710 323.35 307.18 353.26
78715 26 17.48 16.61 19.10
78715 TC 76.74 72.90 83.84
78715 94.22 89.51 102.94


# 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.