EMPIRE MEDICARE SERVICES
AREA 99 NEW JERSEY
2006 FEE SCHEDULE

 

# PROCEDURE
CODE		 MOD PAR
FEE		 NONPAR
FEE		 LIMITING
CHARGE
94350 26 14.04 13.34 15.34
94350 TC 30.31 28.79 33.11
94350 44.35 42.13 48.45
94360 26 14.04 13.34 15.34
94360 TC 28.50 27.08 31.14
94360 42.54 40.41 46.47
94370 26 14.04 13.34 15.34
94370 TC 27.88 26.49 30.46
94370 41.92 39.82 45.79
94375 26 16.44 15.62 17.96
94375 TC 22.37 21.25 24.44
94375 38.80 36.86 42.39
94400 26 22.01 20.91 24.05
94400 TC 32.75 31.11 35.78
94400 54.75 52.01 59.81
94450 26 21.64 20.56 23.64
94450 TC 31.69 30.11 34.63
94450 53.33 50.66 58.26
94452 26 16.81 15.97 18.37
94452 TC 40.18 38.17 43.90
94452 56.98 54.13 62.25
94453 26 21.64 20.56 23.64
94453 TC 59.68 56.70 65.21
94453 81.32 77.25 88.84
94620 26 34.89 33.15 38.12
94620 TC 101.22 96.16 110.58
94620 136.11 129.30 148.70
94621 26 77.00 73.15 84.12
94621 TC 78.75 74.81 86.03
94621 155.75 147.96 170.15
94640 13.46 12.79 14.71
94642 34.88 33.14 38.11
# 94656 64.01 60.81 69.93
94656 99.63 94.65 108.85
# 94657 44.88 42.64 49.04
94657 75.84 72.05 82.86
# 94660 41.27 39.21 45.09
94660 59.08 56.13 64.55
94662 40.90 38.86 44.69
94664 14.62 13.89 15.97
94667 23.90 22.71 26.12
94668 19.82 18.83 21.65
94680 26 14.04 13.34 15.34
94680 TC 78.12 74.21 85.34
94680 92.16 87.55 100.68
94681 26 10.82 10.28 11.82
94681 TC 109.17 103.71 119.27
94681 119.99 113.99 131.09
94690 26 3.98 3.78 4.35
94690 TC 85.44 81.17 93.35
94690 89.43 84.96 97.70
94720 26 14.04 13.34 15.34
94720 TC 41.23 39.17 45.05
94720 55.27 52.51 60.39
94725 26 14.04 13.34 15.34
94725 TC 124.86 118.62 136.41
94725 138.90 131.96 151.75
94750 26 12.43 11.81 13.58
94750 TC 55.33 52.56 60.44
94750 67.76 64.37 74.03
94760 2.43 2.31 2.66
94761 5.18 4.92 5.66
94762 23.62 22.44 25.81
94770 26 7.99 7.59 8.73
94770 TC 32.69 31.06 35.72
94770 40.68 38.65 44.45
94772 26 111.35 105.78 121.65
94772 TC 181.76 172.67 198.57
94772 293.11 278.45 320.22
95004 4.61 4.38 5.04
# 95010 8.84 8.40 9.66
95010 19.87 18.88 21.71
# 95015 8.84 8.40 9.66
95015 12.23 11.62 13.36
95024 6.73 6.39 7.35
95027 6.73 6.39 7.35
95028 10.12 9.61 11.05
95044 8.85 8.41 9.67
95052 10.97 10.42 11.98
95056 7.58 7.20 8.28
95060 15.58 14.80 17.02
95065 8.85 8.41 9.67
95070 97.85 92.96 106.90
95071 124.99 118.74 136.55
# 95075 54.77 52.03 59.83
95075 73.43 69.76 80.22
95078 11.34 10.77 12.39
95115 17.28 16.42 18.88
95117 21.94 20.84 23.97
# 95144 3.59 3.41 3.92
95144 10.80 10.26 11.80
# 95145 3.59 3.41 3.92
95145 16.31 15.49 17.81
# 95146 4.01 3.81 4.38
95146 21.40 20.33 23.38
# 95147 3.59 3.41 3.92
95147 20.55 19.52 22.45
# 95148 4.01 3.81 4.38
95148 27.34 25.97 29.87
# 95149 4.01 3.81 4.38


# 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.