2006 Fee Schedule Empire Medicare Services, New Jersey Area 01

EMPIRE	MEDICARE SERVICES
AREA 01	NEW JERSEY
2006 FEE SCHEDULE

#	PROCEDURE CODE	MOD	PAR FEE	NONPAR FEE	LIMITING CHARGE
	ANES		19.05	18.10	20.81
	G0008		21.52	21.52	N/A
	G0009		21.52	21.52	N/A
	G0010		21.52	21.52	N/A
#	G0101		26.64	25.31	29.11
	G0101		42.82	40.68	46.78
#	G0102		9.96	9.46	10.88
	G0102		25.22	23.96	27.55
#	G0104		64.56	61.33	70.53
	G0104		146.86	139.52	160.45
#	G0105	53	64.56	61.33	70.53
#	G0105		226.98	215.63	247.97
	G0105	53	146.86	139.52	160.45
	G0105		443.82	421.63	484.87
	G0106	26	55.96	53.16	61.13
	G0106	TC	108.36	102.94	118.38
	G0106		164.32	156.10	179.52
	G0108		38.74	36.80	42.32
	G0109		22.56	21.43	24.64
#	G0117		27.20	25.84	29.72
	G0117		51.70	49.12	56.49
#	G0118		9.96	9.46	10.88
	G0118		31.69	30.11	34.63
	G0120	26	55.96	53.16	61.13
	G0120	TC	108.36	102.94	118.38
	G0120		164.32	156.10	179.52
#	G0121	53	64.56	61.33	70.53
#	G0121		226.98	215.63	247.97
	G0121	53	146.86	139.52	160.45
	G0121		443.82	421.63	484.87
	G0124		24.51	23.28	26.77
#	G0127		10.42	9.90	11.39
	G0127		18.74	17.80	20.47
	G0128		4.96	4.71	5.42
	G0130	26	12.43	11.81	13.58
	G0130	TC	38.83	36.89	42.42
	G0130		51.26	48.70	56.01
	G0141		24.51	23.28	26.77
#	G0166		4.56	4.33	4.98
	G0166		168.70	160.27	184.31
#	G0168		29.32	27.85	32.03
	G0168		108.85	103.41	118.92
	G0179		66.40	63.08	72.54
	G0180		86.23	81.92	94.21
	G0181		140.37	133.35	153.35
	G0182		148.70	141.27	162.46
#	G0186		961.76	913.67	1,050.72
	G0186		1,026.26	974.95	1,121.19
	G0202	26	39.81	37.82	43.49
	G0202	TC	120.48	114.46	131.63
	G0202		160.29	152.28	175.12
	G0204	26	49.30	46.84	53.87
	G0204	TC	118.63	112.70	129.61
	G0204		167.93	159.53	183.46
	G0206	26	39.81	37.82	43.49
	G0206	TC	96.07	91.27	104.96
	G0206		135.88	129.09	148.45
	G0237		22.47	21.35	24.55
	G0238		23.39	22.22	25.55
	G0239		16.00	15.20	17.48
#	G0245		51.09	48.54	55.82
	G0245		73.28	69.62	80.06
#	G0246		26.18	24.87	28.60
	G0246		43.75	41.56	47.79
#	G0247		30.49	28.97	33.32
	G0247		44.83	42.59	48.98
	G0248		306.91	291.56	335.29
	G0249		183.92	174.72	200.93
	G0250		10.36	9.84	11.32
#	G0268		36.29	34.48	39.65
	G0268		54.32	51.60	59.34
	G0270		22.1	21.00	24.15
	G0271		8.69	8.26	9.50
	G0275		15.02	14.27	16.41
	G0278		15.02	14.27	16.41
	G0281		12.67	12.04	13.85
	G0283		12.67	12.04	13.85
	G0288		498.58	473.65	544.7
	G0289		105.92	100.62	115.71
	G0308		922.08	875.98	1,007.38
	G0309		767.88	729.49	838.91
	G0310		614.28	583.57	671.11
	G0311		621.36	590.29	678.83
	G0312		517.57	491.69	565.44
	G0313		413.97	393.27	452.26
	G0314		546.77	519.43	597.34
	G0315		455.29	432.53	497.41
	G0316		363.99	345.79	397.66
	G0317		343.05	325.90	374.79
	G0318		285.67	271.39	312.10
	G0319		228.29	216.88	249.41
	G0320		767.88	729.49	838.91
	G0321		517.57	491.69	565.44
	G0322		455.29	432.53	497.41
	G0323		285.67	271.39	312.10
	G0324		25.50	24.23	27.86
	G0325		15.14	14.38	16.54
	G0326		17.21	16.35	18.80
	G0327		9.68	9.20	10.58
#	G0329		3.70	3.52	4.05

# 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.