EMPIRE MEDICARE SERVICES
AREA 99 NEW JERSEY
2006 FEE SCHEDULE

 

# PROCEDURE
CODE		 MOD PAR
FEE		 NONPAR
FEE		 LIMITING
CHARGE
78725 TC 79.97 75.97 87.37
78725 101.24 96.18 110.61
78730 26 20.06 19.06 21.92
78730 TC 64.86 61.62 70.86
78730 84.92 80.67 92.77
78740 26 31.69 30.11 34.63
78740 TC 94.75 90.01 103.51
78740 126.45 120.13 138.15
78760 26 36.52 34.69 39.89
78760 TC 119.24 113.28 130.27
78760 155.76 147.97 170.17
78761 26 39.35 37.38 42.99
78761 TC 142.40 135.28 155.57
78761 181.74 172.65 198.55
78800 26 36.89 35.05 40.31
78800 TC 151.25 143.69 165.24
78800 188.14 178.73 205.54
78801 26 44.52 42.29 48.63
78801 TC 187.50 178.13 204.85
78801 232.02 220.42 253.48
78802 26 47.77 45.38 52.19
78802 TC 246.42 234.10 269.22
78802 294.19 279.48 321.40
78803 26 61.04 57.99 66.69
78803 TC 291.52 276.94 318.48
78803 352.56 334.93 385.17
78804 26 59.46 56.49 64.96
78804 TC 481.36 457.29 525.88
78804 540.82 513.78 590.85
78805 26 40.56 38.53 44.31
78805 TC 151.25 143.69 165.24
78805 191.81 182.22 209.55
78806 26 47.77 45.38 52.19
78806 TC 286.43 272.11 312.93
78806 334.20 317.49 365.11
78807 26 61.10 58.05 66.76
78807 TC 291.52 276.94 318.48
78807 352.62 334.99 385.24
78811 26 87.40 83.03 95.48
78811 TC 2,149.22 2,041.76 2,348.02
78811 2,236.13 2,124.32 2,442.97
78812 26 108.33 102.91 118.35
78812 TC 2,128.41 2,021.99 2,325.29
78812 2,236.13 2,124.32 2,442.97
78813 26 112.37 106.75 122.76
78813 TC 2,372.85 2,254.21 2,592.34
78813 2,484.59 2,360.36 2,714.41
78814 26 123.25 117.09 134.65
78814 TC 2,438.19 2,316.28 2,663.72
78814 2,560.74 2,432.70 2,797.61
78815 26 136.12 129.31 148.71
78815 TC 2,767.56 2,629.18 3,023.56
78815 2,902.91 2,757.76 3,171.42
78816 26 139.34 132.37 152.23
78816 TC 3,283.37 3,119.20 3,587.08
78816 3,421.92 3,250.82 3,738.44
79005 26 99.54 94.56 108.74
79005 TC 116.69 110.86 127.49
79005 216.24 205.43 236.24
79101 26 108.84 103.40 118.91
79101 TC 116.69 110.86 127.49
79101 225.53 214.25 246.39
79200 26 111.24 105.68 121.53
79200 TC 116.69 110.86 127.49
79200 227.93 216.53 249.01
79300 26 91.79 87.20 100.28
79300 TC 123.26 117.10 134.67
79300 218.02 207.12 238.19
79403 26 130.37 123.85 142.43
79403 TC 186.67 177.34 203.94
79403 317.03 301.18 346.36
79440 26 112.14 106.53 122.51
79440 TC 116.69 110.86 127.49
79440 228.84 217.40 250.01
79445 26 134.06 127.36 146.46
# 80500 21.78 20.69 23.79
80500 23.90 22.71 26.12
80502 76.95 73.10 84.07
83020 26 21.35 20.28 23.32
83912 26 20.08 19.08 21.94
84165 26 20.93 19.88 22.86
84166 26 20.93 19.88 22.86
84181 26 20.93 19.88 22.86
84182 26 22.15 21.04 24.20
85060 26.16 24.85 28.58
# 85097 56.02 53.22 61.20
85097 120.05 114.05 131.16
85390 26 20.51 19.48 22.40
85396 22.89 21.75 25.01
85576 26 21.78 20.69 23.79
86077 54.80 52.06 59.87
# 86078 55.22 52.46 60.33
86078 57.77 54.88 63.11
# 86079 55.65 52.87 60.80
86079 57.34 54.47 62.64
86255 26 21.35 20.28 23.32
86256 26 21.35 20.28 23.32
86320 26 21.35 20.28 23.32
86325 26 20.51 19.48 22.40
86327 26 24.97 23.72 27.28


# 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.