Procedure Code |
Procedure Description |
Pricing Indicator |
Rate Type |
Mod1 |
Mod2 |
Mod3 |
Mod4 |
Max Fee |
Max Fee Eff. Date |
Max Fee End Date |
PA |
72010 |
X-RAY EXAM SPINE AP&LAT |
PRXOVR |
DEF |
|
|
|
|
NA |
NA |
NA |
N |
72010 |
X-RAY EXAM SPINE AP&LAT |
MAXFEE |
DEF |
|
|
|
|
NA |
|
|
N |
72040 |
X-RAY EXAM NECK SPINE 2-3 VW |
PRXOVR |
DEF |
|
|
|
|
NA |
NA |
NA |
N |
72040 |
X-RAY EXAM NECK SPINE 2-3 VW |
MAXFEE |
DEF |
|
|
|
|
23.93 |
1/1/2018 |
12/31/2299 |
N |
72040 |
X-RAY EXAM NECK SPINE 2-3 VW |
MAXFEE |
DEF |
26 |
|
|
|
8.38 |
1/1/2018 |
12/31/2299 |
N |
72040 |
X-RAY EXAM NECK SPINE 2-3 VW |
MAXFEE |
DEF |
TC |
|
|
|
15.55 |
1/1/2018 |
12/31/2299 |
N |
72050 |
X-RAY EXAM NECK SPINE 4/5VWS |
PRXOVR |
DEF |
|
|
|
|
NA |
NA |
NA |
N |
72050 |
X-RAY EXAM NECK SPINE 4/5VWS |
MAXFEE |
DEF |
|
|
|
|
35.15 |
1/1/2018 |
12/31/2299 |
N |
72050 |
X-RAY EXAM NECK SPINE 4/5VWS |
MAXFEE |
DEF |
26 |
|
|
|
12.30 |
1/1/2018 |
12/31/2299 |
N |
72050 |
X-RAY EXAM NECK SPINE 4/5VWS |
MAXFEE |
DEF |
TC |
|
|
|
22.85 |
1/1/2018 |
12/31/2299 |
N |
72052 |
X-RAY EXAM NECK SPINE 6/>VWS |
PRXOVR |
DEF |
|
|
|
|
NA |
NA |
NA |
N |
72052 |
X-RAY EXAM NECK SPINE 6/>VWS |
MAXFEE |
DEF |
|
|
|
|
43.03 |
1/1/2018 |
12/31/2299 |
N |
72052 |
X-RAY EXAM NECK SPINE 6/>VWS |
MAXFEE |
DEF |
26 |
|
|
|
15.06 |
1/1/2018 |
12/31/2299 |
N |
72052 |
X-RAY EXAM NECK SPINE 6/>VWS |
MAXFEE |
DEF |
TC |
|
|
|
27.97 |
1/1/2018 |
12/31/2299 |
N |
72070 |
X-RAY EXAM THORAC SPINE 2VWS |
PRXOVR |
DEF |
|
|
|
|
NA |
NA |
NA |
N |
72070 |
X-RAY EXAM THORAC SPINE 2VWS |
MAXFEE |
DEF |
|
|
|
|
25.18 |
1/1/2018 |
12/31/2299 |
N |
72070 |
X-RAY EXAM THORAC SPINE 2VWS |
MAXFEE |
DEF |
26 |
|
|
|
8.81 |
1/1/2018 |
12/31/2299 |
N |
72070 |
X-RAY EXAM THORAC SPINE 2VWS |
MAXFEE |
DEF |
TC |
|
|
|
16.37 |
1/1/2018 |
12/31/2299 |
N |
72074 |
X-RAY EXAM THORAC SPINE4/>VW |
PRXOVR |
DEF |
|
|
|
|
NA |
NA |
NA |
N |
72074 |
X-RAY EXAM THORAC SPINE4/>VW |
MAXFEE |
DEF |
|
|
|
|
32.23 |
1/1/2018 |
12/31/2299 |
N |
72074 |
X-RAY EXAM THORAC SPINE4/>VW |
MAXFEE |
DEF |
26 |
|
|
|
9.67 |
1/1/2018 |
12/31/2299 |
N |
72074 |
X-RAY EXAM THORAC SPINE4/>VW |
MAXFEE |
DEF |
TC |
|
|
|
22.56 |
1/1/2018 |
12/31/2299 |
N |
72080 |
X-RAY EXAM THORACOLMB 2/> VW |
PRXOVR |
DEF |
|
|
|
|
NA |
NA |
NA |
N |
72080 |
X-RAY EXAM THORACOLMB 2/> VW |
MAXFEE |
DEF |
|
|
|
|
25.67 |
1/1/2018 |
12/31/2299 |
N |
72080 |
X-RAY EXAM THORACOLMB 2/> VW |
MAXFEE |
DEF |
26 |
|
|
|
8.98 |
1/1/2018 |
12/31/2299 |
N |
72080 |
X-RAY EXAM THORACOLMB 2/> VW |
MAXFEE |
DEF |
TC |
|
|
|
16.69 |
1/1/2018 |
12/31/2299 |
N |
72100 |
X-RAY EXAM L-S SPINE 2/3 VWS |
PRXOVR |
DEF |
|
|
|
|
NA |
NA |
NA |
N |
72100 |
X-RAY EXAM L-S SPINE 2/3 VWS |
MAXFEE |
DEF |
|
|
|
|
25.67 |
1/1/2018 |
12/31/2299 |
N |
72100 |
X-RAY EXAM L-S SPINE 2/3 VWS |
MAXFEE |
DEF |
26 |
|
|
|
8.98 |
1/1/2018 |
12/31/2299 |
N |
72100 |
X-RAY EXAM L-S SPINE 2/3 VWS |
MAXFEE |
DEF |
TC |
|
|
|
16.69 |
1/1/2018 |
12/31/2299 |
N |
72110 |
X-RAY EXAM L-2 SPINE 4/>VWS |
PRXOVR |
DEF |
|
|
|
|
NA |
NA |
NA |
N |
72110 |
X-RAY EXAM L-2 SPINE 4/>VWS |
MAXFEE |
DEF |
|
|
|
|
35.63 |
1/1/2018 |
12/31/2299 |
N |
72110 |
X-RAY EXAM L-2 SPINE 4/>VWS |
MAXFEE |
DEF |
26 |
|
|
|
12.47 |
1/1/2018 |
12/31/2299 |
N |
72110 |
X-RAY EXAM L-2 SPINE 4/>VWS |
MAXFEE |
DEF |
TC |
|
|
|
23.16 |
1/1/2018 |
12/31/2299 |
N |
72114 |
X-RAY EXAM L-S SPINE BENDING |
PRXOVR |
DEF |
|
|
|
|
NA |
NA |
NA |
N |
72114 |
X-RAY EXAM L-S SPINE BENDING |
MAXFEE |
DEF |
|
|
|
|
44.41 |
1/1/2018 |
12/31/2299 |
N |
72114 |
X-RAY EXAM L-S SPINE BENDING |
MAXFEE |
DEF |
26 |
|
|
|
11.10 |
1/1/2018 |
12/31/2299 |
N |
72114 |
X-RAY EXAM L-S SPINE BENDING |
MAXFEE |
DEF |
TC |
|
|
|
33.31 |
1/1/2018 |
12/31/2299 |
N |
97810 |
ACUPUNCT W/O STIMUL 15 MIN |
PRXOVR |
DEF |
|
|
|
|
NA |
NA |
NA |
S |
97810 |
ACUPUNCT W/O STIMUL 15 MIN |
MAXFEE |
DEF |
|
|
|
|
25 |
1/1/2017 |
12/31/2299 |
S |
97811 |
ACUPUNCT W/O STIMUL ADDL 15M |
PRXOVR |
DEF |
|
|
|
|
NA |
NA |
NA |
S |
97811 |
ACUPUNCT W/O STIMUL ADDL 15M |
MAXFEE |
DEF |
|
|
|
|
17.50 |
1/1/2017 |
12/31/2299 |
S |
97813 |
ACUPUNCT W/STIMUL 15 MIN |
PRXOVR |
DEF |
|
|
|
|
NA |
NA |
NA |
S |
97813 |
ACUPUNCT W/STIMUL 15 MIN |
MAXFEE |
DEF |
|
|
|
|
31.15 |
1/1/2018 |
12/31/2299 |
S |
97814 |
ACUPUNCT W/STIMUL ADDL 15M |
PRXOVR |
DEF |
|
|
|
|
NA |
NA |
NA |
S |
97814 |
ACUPUNCT W/STIMUL ADDL 15M |
MAXFEE |
DEF |
|
|
|
|
23.65 |
1/1/2018 |
12/31/2299 |
S |
98940 |
CHIROPRACT MANJ 1-2 REGIONS |
PRXOVR |
DEF |
|
|
|
|
NA |
NA |
NA |
S |
98940 |
CHIROPRACT MANJ 1-2 REGIONS |
MAXFEE |
FAC |
|
|
|
|
10.83 |
1/1/2014 |
12/31/2299 |
S |
98940 |
CHIROPRACT MANJ 1-2 REGIONS |
MAXFEE |
NFF |
|
|
|
|
15.96 |
1/1/2014 |
12/31/2299 |
S |
98941 |
CHIROPRACT MANJ 3-4 REGIONS |
PRXOVR |
DEF |
|
|
|
|
NA |
NA |
NA |
S |
98941 |
CHIROPRACT MANJ 3-4 REGIONS |
MAXFEE |
FAC |
|
|
|
|
16.04 |
1/1/2014 |
12/31/2299 |
S |
98941 |
CHIROPRACT MANJ 3-4 REGIONS |
MAXFEE |
NFF |
|
|
|
|
21.19 |
1/1/2014 |
12/31/2299 |
S |
98942 |
CHIROPRACTIC MANJ 5 REGIONS |
PRXOVR |
DEF |
|
|
|
|
NA |
NA |
NA |
S |
98942 |
CHIROPRACTIC MANJ 5 REGIONS |
MAXFEE |
FAC |
|
|
|
|
22.74 |
1/1/2014 |
12/31/2299 |
S |
98942 |
CHIROPRACTIC MANJ 5 REGIONS |
MAXFEE |
NFF |
|
|
|
|
27.97 |
1/1/2014 |
12/31/2299 |
S |
99202 |
OFFICE O/P NEW SF 15-29 MIN |
PRXOVR |
DEF |
|
|
|
|
NA |
NA |
NA |
N |
99202 |
OFFICE O/P NEW SF 15-29 MIN |
MAXFEE |
FAC |
|
|
|
|
20.84 |
1/1/2016 |
12/31/2299 |
N |
99202 |
OFFICE O/P NEW SF 15-29 MIN |
MAXFEE |
NFF |
|
|
|
|
38.93 |
1/1/2016 |
12/31/2299 |
N |
99203 |
OFFICE O/P NEW LOW 30-44 MIN |
PRXOVR |
DEF |
|
|
|
|
NA |
NA |
NA |
N |
99203 |
OFFICE O/P NEW LOW 30-44 MIN |
MAXFEE |
FAC |
|
|
|
|
32.94 |
1/1/2016 |
12/31/2299 |
N |
99203 |
OFFICE O/P NEW LOW 30-44 MIN |
MAXFEE |
NFF |
|
|
|
|
57.76 |
1/1/2016 |
12/31/2299 |
N |
99211 |
OFF/OP EST MAY X REQ PHY/QHP |
PRXOVR |
DEF |
|
|
|
|
NA |
NA |
NA |
N |
99211 |
OFF/OP EST MAY X REQ PHY/QHP |
MAXFEE |
FAC |
|
|
|
|
5.55 |
1/1/2016 |
12/31/2299 |
N |
99211 |
OFF/OP EST MAY X REQ PHY/QHP |
MAXFEE |
NFF |
|
|
|
|
14.50 |
1/1/2016 |
12/31/2299 |
N |
99212 |
OFFICE O/P EST SF 10-19 MIN |
PRXOVR |
DEF |
|
|
|
|
NA |
NA |
NA |
N |
99212 |
OFFICE O/P EST SF 10-19 MIN |
MAXFEE |
FAC |
|
|
|
|
12.81 |
1/1/2016 |
12/31/2299 |
N |
99212 |
OFFICE O/P EST SF 10-19 MIN |
MAXFEE |
NFF |
|
|
|
|
26.73 |
1/1/2016 |
12/31/2299 |
N |
99213 |
OFFICE O/P EST LOW 20-29 MIN |
PRXOVR |
DEF |
|
|
|
|
NA |
NA |
NA |
N |
99213 |
OFFICE O/P EST LOW 20-29 MIN |
MAXFEE |
FAC |
|
|
|
|
24.85 |
1/1/2016 |
12/31/2299 |
N |
99213 |
OFFICE O/P EST LOW 20-29 MIN |
MAXFEE |
NFF |
|
|
|
|
43.61 |
1/1/2016 |
12/31/2299 |
N |
T1015 |
CLINIC SERVICE |
PRXOVR |
DEF |
|
|
|
|
NA |
NA |
NA |
N |
T1015 |
CLINIC SERVICE |
UCCENC |
UC8 |
|
|
|
|
NA |
NA |
NA |
N |