EMPIRE MEDICARE SERVICES
AREA 99 NEW JERSEY
2006 FEE SCHEDULE

 

# PROCEDURE
CODE		 MOD PAR
FEE		 NONPAR
FEE		 LIMITING
CHARGE
# 21085 690.55 656.02 754.42
21085 754.58 716.85 824.38
# 21086 1,946.76 1,849.42 2,126.83
21086 2,129.96 2,023.46 2,326.98
# 21087 1,926.62 1,830.29 2,104.83
21087 2,100.49 1,995.47 2,294.79
# 21100 380.38 361.36 415.56
21100 669.17 635.71 731.07
# 21110 587.46 558.09 641.80
21110 638.78 606.84 697.87
# 21116 48.22 45.81 52.68
21116 218.28 207.37 238.48
# 21120 535.08 508.33 584.58
21120 666.54 633.21 728.19
# 21121 667.25 633.89 728.97
21121 748.67 711.24 817.93
21122 742.23 705.12 810.89
21123 951.23 903.67 1,039.22
# 21125 801.79 761.70 875.96
21125 2,796.63 2,656.80 3,055.32
# 21127 896.82 851.98 979.78
21127 2,314.92 2,199.17 2,529.05
21137 765.09 726.84 835.87
21138 950.62 903.09 1,038.55
21139 1,090.51 1,035.98 1,191.38
21141 1,381.47 1,312.40 1,509.26
21142 1,375.44 1,306.67 1,502.67
21143 1,442.51 1,370.38 1,575.94
21145 1,482.87 1,408.73 1,620.04
21146 1,583.16 1,504.00 1,729.60
21147 1,567.09 1,488.74 1,712.05
21150 1,802.98 1,712.83 1,969.75
21151 2,178.06 2,069.16 2,379.53
21154 2,279.26 2,165.30 2,490.10
21155 2,620.66 2,489.63 2,863.07
21159 3,211.02 3,050.47 3,508.04
21160 3,153.48 2,995.81 3,445.18
21172 1,812.97 1,722.32 1,980.67
21175 2,243.79 2,131.60 2,451.34
21179 1,582.45 1,503.33 1,728.83
21180 1,776.35 1,687.53 1,940.66
21181 756.80 718.96 826.80
21182 2,186.60 2,077.27 2,388.86
21183 2,444.44 2,322.22 2,670.55
21184 2,652.29 2,519.68 2,897.63
21188 1,751.26 1,663.70 1,913.26
21193 1,297.08 1,232.23 1,417.06
21194 1,442.31 1,370.19 1,575.72
21195 1,370.91 1,302.36 1,497.71
21196 1,490.09 1,415.59 1,627.93
21198 1,152.28 1,094.67 1,258.87
21199 1,070.50 1,016.98 1,169.53
21206 1,142.88 1,085.74 1,248.60
# 21208 851.30 808.74 930.05
21208 1,393.26 1,323.60 1,522.14
# 21209 641.49 609.42 700.83
21209 757.68 719.80 827.77
# 21210 849.29 806.83 927.85
21210 1,509.15 1,433.69 1,648.74
# 21215 879.54 835.56 960.89
21215 2,262.44 2,149.32 2,471.72
21230 814.29 773.58 889.62
# 21235 560.40 532.38 612.24
21235 706.28 670.97 771.62
21240 1,149.44 1,091.97 1,255.77
21242 1,066.10 1,012.80 1,164.72
21243 1,681.70 1,597.62 1,837.26
21244 1,028.49 977.07 1,123.63
# 21245 930.87 884.33 1,016.98
21245 1,124.24 1,068.03 1,228.23
21246 926.53 880.20 1,012.23
21247 1,735.55 1,648.77 1,896.09
# 21248 910.04 864.54 994.22
21248 1,026.23 974.92 1,121.16
# 21249 1,322.62 1,256.49 1,444.96
21249 1,493.95 1,419.25 1,632.14
21255 1,433.62 1,361.94 1,566.23
21256 1,196.99 1,137.14 1,307.71
21260 1,230.78 1,169.24 1,344.63
21261 2,399.34 2,279.37 2,621.28
21263 2,029.64 1,928.16 2,217.38
21267 1,649.50 1,567.03 1,802.08
21268 1,960.23 1,862.22 2,141.55
# 21270 738.42 701.50 806.73
21270 925.44 879.17 1,011.05
21275 837.95 796.05 915.46
21280 505.34 480.07 552.08
21282 337.55 320.67 368.77
21295 174.09 165.39 190.20
21296 388.78 369.34 424.74
# 21300 44.28 42.07 48.38
21300 133.76 127.07 146.13
# 21310 31.13 29.57 34.01
21310 121.88 115.79 133.16
# 21315 145.00 137.75 158.41
21315 244.66 232.43 267.29
# 21320 148.46 141.04 162.20
21320 246.00 233.70 268.76
21325 526.45 500.13 575.15
21330 645.53 613.25 705.24


# 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.