EMPIRE MEDICARE SERVICES
AREA 99 NEW JERSEY
2006 FEE SCHEDULE

 

# PROCEDURE
CODE		 MOD PAR
FEE		 NONPAR
FEE		 LIMITING
CHARGE
28122 614.38 583.66 671.21
# 28124 367.07 348.72 401.03
28124 423.89 402.70 463.11
# 28126 282.56 268.43 308.69
28126 334.29 317.58 365.22
28130 652.03 619.43 712.34
# 28140 508.94 483.49 556.01
28140 613.69 583.01 670.46
# 28150 320.33 304.31 349.96
28150 386.07 366.77 421.79
# 28153 275.68 261.90 301.19
28153 344.80 327.56 376.69
# 28160 307.14 291.78 335.55
28160 359.31 341.34 392.54
28171 658.80 625.86 719.74
# 28173 609.68 579.20 666.08
28173 711.46 675.89 777.27
# 28175 422.99 401.84 462.12
28175 508.23 482.82 555.24
# 28190 148.35 140.93 162.07
28190 229.77 218.28 251.02
# 28192 360.29 342.28 393.62
28192 438.32 416.40 478.86
# 28193 419.67 398.69 458.49
28193 491.34 466.77 536.79
# 28200 354.89 337.15 387.72
28200 420.20 399.19 459.07
# 28202 494.36 469.64 540.09
28202 610.13 579.62 666.56
# 28208 334.09 317.39 365.00
28208 398.13 378.22 434.95
# 28210 451.37 428.80 493.12
28210 544.67 517.44 595.06
# 28220 345.14 327.88 377.06
28220 398.15 378.24 434.98
# 28222 422.33 401.21 461.39
28222 469.83 446.34 513.29
# 28225 284.64 270.41 310.97
28225 343.16 326.00 374.90
# 28226 359.08 341.13 392.30
28226 403.60 383.42 440.93
# 28230 343.54 326.36 375.31
28230 385.95 366.65 421.65
# 28232 290.62 276.09 317.50
28232 341.93 324.83 373.55
# 28234 291.52 276.94 318.48
28234 347.50 330.13 379.65
# 28238 553.73 526.04 604.95
28238 652.11 619.50 712.43
# 28240 341.33 324.26 372.90
28240 390.10 370.60 426.19
# 28250 439.41 417.44 480.06
28250 503.02 477.87 549.55
# 28260 568.31 539.89 620.87
28260 625.14 593.88 682.96
# 28261 831.18 789.62 908.06
28261 886.73 842.39 968.75
# 28262 1,184.36 1,125.14 1,293.91
28262 1,296.74 1,231.90 1,416.69
# 28264 774.67 735.94 846.33
28264 793.76 754.07 867.18
# 28270 369.22 350.76 403.37
28270 418.41 397.49 457.11
# 28272 288.05 273.65 314.70
28272 344.46 327.24 376.33
# 28280 422.08 400.98 461.13
28280 497.14 472.28 543.12
# 28285 348.25 330.84 380.47
28285 409.31 388.84 447.17
# 28286 339.11 322.15 370.47
28286 404.42 384.20 441.83
# 28288 418.30 397.39 457.00
28288 463.25 440.09 506.10
# 28289 560.60 532.57 612.46
28289 654.75 622.01 715.31
# 28290 454.15 431.44 496.16
28290 519.46 493.49 567.51
# 28292 546.79 519.45 597.37
28292 628.64 597.21 686.79
# 28293 662.48 629.36 723.76
28293 859.67 816.69 939.19
# 28294 578.31 549.39 631.80
28294 694.08 659.38 758.29
# 28296 636.62 604.79 695.51
28296 752.81 715.17 822.45
# 28297 677.03 643.18 739.66
28297 791.53 751.95 864.74
# 28298 564.63 536.40 616.86
28298 658.77 625.83 719.70
# 28299 725.76 689.47 792.89
28299 840.68 798.65 918.45
28300 732.45 695.83 800.20
28302 722.06 685.96 788.85
# 28304 652.35 619.73 712.69
28304 746.07 708.77 815.09
28305 746.90 709.56 815.99
# 28306 439.47 417.50 480.13
28306 552.70 525.07 603.83
# 28307 507.76 482.37 554.73
28307 751.60 714.02 821.12


# 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.