EMPIRE MEDICARE SERVICES
AREA 01 NEW JERSEY
2006 FEE SCHEDULE

 

# PROCEDURE
CODE		 MOD PAR
FEE		 NONPAR
FEE		 LIMITING
CHARGE
94260 33.87 32.18 37.01
94350 26 14.49 13.77 15.84
94350 TC 32.91 31.26 35.95
94350 47.41 45.04 51.80
94360 26 14.49 13.77 15.84
94360 TC 30.88 29.34 33.74
94360 45.37 43.10 49.57
94370 26 14.49 13.77 15.84
94370 TC 30.33 28.81 33.13
94370 44.82 42.58 48.97
94375 26 16.96 16.11 18.53
94375 TC 24.32 23.10 26.57
94375 41.28 39.22 45.10
94400 26 22.69 21.56 24.79
94400 TC 35.50 33.73 38.79
94400 58.19 55.28 63.57
94450 26 22.32 21.20 24.38
94450 TC 34.49 32.77 37.69
94450 56.81 53.97 62.07
94452 26 17.33 16.46 18.93
94452 TC 43.74 41.55 47.78
94452 61.06 58.01 66.71
94453 26 22.32 21.20 24.38
94453 TC 65.00 61.75 71.01
94453 87.33 82.96 95.40
94620 26 36.01 34.21 39.34
94620 TC 110.03 104.53 120.21
94620 146.04 138.74 159.55
94621 26 79.49 75.52 86.85
94621 TC 85.52 81.24 93.43
94621 165.01 156.76 180.27
94640 14.61 13.88 15.96
94642 34.88 33.14 38.11
# 94656 65.92 62.62 72.01
94656 104.76 99.52 114.45
# 94657 46.31 43.99 50.59
94657 80.06 76.06 87.47
# 94660 42.58 40.45 46.52
94660 62.00 58.90 67.74
94662 42.21 40.10 46.12
94664 15.81 15.02 17.27
94667 25.89 24.60 28.29
94668 21.54 20.46 23.53
94680 26 14.49 13.77 15.84
94680 TC 84.97 80.72 92.83
94680 99.47 94.50 108.68
94681 26 11.16 10.60 12.19
94681 TC 118.63 112.70 129.61
94681 129.79 123.30 141.80
94690 26 4.10 3.90 4.49
94690 TC 93.02 88.37 101.63
94690 97.12 92.26 106.10
94720 26 14.49 13.77 15.84
94720 TC 44.75 42.51 48.89
94720 59.24 56.28 64.72
94725 26 14.49 13.77 15.84
94725 TC 135.73 128.94 148.28
94725 150.22 142.71 164.12
94750 26 12.83 12.19 14.02
94750 TC 60.19 57.18 65.76
94750 73.02 69.37 79.78
94760 2.59 2.46 2.83
94761 5.45 5.18 5.96
94762 25.42 24.15 27.77
94770 26 8.23 7.82 8.99
94770 TC 35.41 33.64 38.69
94770 43.64 41.46 47.68
94772 26 111.35 105.78 121.65
94772 TC 181.76 172.67 198.57
94772 293.11 278.45 320.22
95004 4.99 4.74 5.45
# 95010 9.16 8.70 10.01
95010 21.18 20.12 23.14
# 95015 9.16 8.70 10.01
95015 12.86 12.22 14.05
95024 7.30 6.94 7.98
95027 7.30 6.94 7.98
95028 11.00 10.45 12.02
95044 9.62 9.14 10.51
95052 11.93 11.33 13.03
95056 8.23 7.82 8.99
95060 16.92 16.07 18.48
95065 9.62 9.14 10.51
95070 106.62 101.29 116.48
95071 136.21 129.40 148.81
# 95075 56.77 53.93 62.02
95075 77.11 73.25 84.24
95078 12.30 11.69 13.44
95115 18.77 17.83 20.50
95117 23.85 22.66 26.06
# 95144 3.70 3.52 4.05
95144 11.56 10.98 12.63
# 95145 3.70 3.52 4.05
95145 17.57 16.69 19.19
# 95146 4.16 3.95 4.54
95146 23.12 21.96 25.25
# 95147 3.70 3.52 4.05
95147 22.19 21.08 24.24
# 95148 4.16 3.95 4.54
95148 29.59 28.11 32.33


# 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.