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CMS-1403-FC Physi- cian Work Fully Implemented Non- Facility PE Year 2009 Transitional Non- Facility PE Fully Imple- mented Facility PE Year 2009 Transi- tional Facility PE 1 CPT codes and descriptions only are copyright 2008 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply. 2 If values are reflected for codes not payable by Medicare, please note that these values have been established as a courtesy to the general public and are not used for Medicare payment. 1166 Mal- Practice RVUs 2 Global CPT 1 / HCPCS Mod Status Description RVUs 2 RVUs 2 RVUs 2 RVUs 2 RVUs 2 0098T C Rev artific disc addl 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0099T C Implant corneal ring 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0100T C Prosth retina receive&gen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0101T C Extracorp shockwv tx,hi enrg 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0102T C Extracorp shockwv tx,anesth 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0103T C Holotranscobalamin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0104T C At rest cardio gas rebreathe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0105T C Exerc cardio gas rebreathe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0106T C Touch quant sensory test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0107T C Vibrate quant sensory test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0108T C Cool quant sensory test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0109T C Heat quant sensory test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0110T C Nos quant sensory test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0111T C Rbc membranes fatty acids 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0123T C Scleral fistulization 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0124T C Conjunctival drug placement 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0126T C Chd risk imt study 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0130T C Chron care drug investigatn 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0140T C Exhaled breath condensate ph 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0141T I Perq islet transplant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0142T I Open islet transplant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0143T I Laparoscopic islet transplnt 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0144T C CT heart wo dye; qual calc 0.00 0.00 0.00 NA NA 0.00 XXX 0144T TC C CT heart wo dye; qual calc 0.00 0.00 0.00 NA NA 0.00 XXX 0144T 26 C CT heart wo dye; qual calc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0145T C CT heart w/wo dye funct 0.00 0.00 0.00 NA NA 0.00 XXX 0145T TC C CT heart w/wo dye funct 0.00 0.00 0.00 NA NA 0.00 XXX 0145T 26 C CT heart w/wo dye funct 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0146T C CCTA w/wo dye 0.00 0.00 0.00 NA NA 0.00 XXX 0146T TC C CCTA w/wo dye 0.00 0.00 0.00 NA NA 0.00 XXX 0146T 26 C CCTA w/wo dye 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0147T C CCTA w/wo, quan calcium 0.00 0.00 0.00 NA NA 0.00 XXX 0147T TC C CCTA w/wo, quan calcium 0.00 0.00 0.00 NA NA 0.00 XXX 0147T 26 C CCTA w/wo, quan calcium 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0148T C CCTA w/wo, strxr 0.00 0.00 0.00 NA NA 0.00 XXX 0148T TC C CCTA w/wo, strxr 0.00 0.00 0.00 NA NA 0.00 XXX 0148T 26 C CCTA w/wo, strxr 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0149T C CCTA w/wo, strxr quan calc 0.00 0.00 0.00 NA NA 0.00 XXX 0149T TC C CCTA w/wo, strxr quan calc 0.00 0.00 0.00 NA NA 0.00 XXX 0149T 26 C CCTA w/wo, strxr quan calc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0150T C CCTA w/wo, disease strxr 0.00 0.00 0.00 NA NA 0.00 XXX 0150T TC C CCTA w/wo, disease strxr 0.00 0.00 0.00 NA NA 0.00 XXX 0150T 26 C CCTA w/wo, disease strxr 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0151T C CT heart funct add-on 0.00 0.00 0.00 NA NA 0.00 XXX 0151T TC C CT heart funct add-on 0.00 0.00 0.00 NA NA 0.00 XXX 0151T 26 C CT heart funct add-on 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0155T C Lap impl gast curve electrd 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0156T C Lap remv gast curve electrd 0.00 0.00 0.00 0.00 0.00 0.00 XXX

CMS-1403-FC Physi- cian Work Fully Implemented Non- Facility PE Year 2009 Transitional Non- Facility PE Fully Imple- mented Facility PE Year 2009 Transi- tional Facility PE 1 CPT codes and descriptions only are copyright 2008 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply. 2 If values are reflected for codes not payable by Medicare, please note that these values have been established as a courtesy to the general public and are not used for Medicare payment. 1167 Mal- Practice RVUs 2 Global CPT 1 / HCPCS Mod Status Description RVUs 2 RVUs 2 RVUs 2 RVUs 2 RVUs 2 0157T C Open impl gast curve electrd 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0158T C Open remv gast curve electrd 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0159T C Cad breast mri 0.00 0.00 0.00 NA NA 0.00 ZZZ 0159T TC C Cad breast mri 0.00 0.00 0.00 NA NA 0.00 ZZZ 0159T 26 C Cad breast mri 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 0160T C Tcranial magn stim tx plan 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0161T C Tcranial magn stim tx deliv 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0163T C Lumb artif diskectomy addl 0.00 0.00 0.00 0.00 0.00 0.00 YYY 0164T C Remove lumb artif disc addl 0.00 0.00 0.00 0.00 0.00 0.00 YYY 0165T C Revise lumb artif disc addl 0.00 0.00 0.00 0.00 0.00 0.00 YYY 0166T C Tcath vsd close w/o bypass 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0167T C Tcath vsd close w bypass 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0168T C Rhinophototx light app bilat 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0169T C Place stereo cath brain 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0170T C Anorectal fistula plug rpr 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0171T C Lumbar spine proces distract 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0172T C Lumbar spine process addl 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0173T C Iop monit io pressure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0174T C Cad cxr with interp 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0175T C Cad cxr remote 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0176T C Aqu canal dilat w/o retent 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0177T C Aqu canal dilat w retent 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0178T C 64 lead ecg w i&r 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0179T C 64 lead ecg w tracing 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0180T C 64 lead ecg w i&r only 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0181T C Corneal hysteresis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0182T C Hdr elect brachytherapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0183T C Wound ultrasound 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0184T C Exc rectal tumor endoscopic 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0185T C Comptr probability analysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0186T C Suprachoroidal drug delivery 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0187T C Ophthalmic dx image anterior 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0188T N Videoconf crit care 74 min 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0189T N Videoconf crit care addl 30 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0190T C Place intraoc radiation src 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0191T C Insert ant segment drain int 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0192T C Insert ant segment drain ext 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0193T C Rf bladder neck microremodel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0194T C Procalcitonin (pct) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0195T C Arthrod presac interbody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0196T C Arthrod presac interbody eac 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0197T C Intrafraction track motion 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0198T C Ocular blood flow measure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0528F I Rcmnd flw-up 10 yrs docd 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0529F I Intrvl 3+yrs pts clnscp docd 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0535F I Dyspnea mngmnt plan docd 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0540F I Gluco mngmnt plan docd 0.00 0.00 0.00 0.00 0.00 0.00 XXX 10021 A Fna w/o image 1.27 2.14 2.15 0.40 0.43 0.10 XXX

<strong>CMS</strong>-1403-FC<br />

Physi-<br />

cian<br />

Work<br />

Fully<br />

Implemented<br />

Non-<br />

Facility<br />

PE<br />

Year<br />

2009<br />

Transitional<br />

Non-<br />

Facility<br />

PE<br />

Fully<br />

Imple-<br />

mented<br />

Facility<br />

PE<br />

Year<br />

2009<br />

Transi-<br />

tional<br />

Facility<br />

PE<br />

1 CPT codes and descriptions only are copyright 2008 American Medical Association. All Rights<br />

Reserved. Applicable FARS/DFARS apply.<br />

2 If values are reflected for codes not payable by Medicare, please note that these values have <strong>been</strong><br />

established as a courtesy to the general public and are not used for Medicare<br />

payment.<br />

1167<br />

Mal-<br />

Practice<br />

RVUs 2 Global<br />

CPT 1 /<br />

HCPCS Mod Status Description<br />

RVUs 2<br />

RVUs 2<br />

RVUs 2<br />

RVUs 2<br />

RVUs 2<br />

0157T C Open impl gast curve electrd 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0158T C Open remv gast curve electrd 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0159T C Cad breast mri 0.00 0.00 0.00 NA NA 0.00 ZZZ<br />

0159T TC C Cad breast mri 0.00 0.00 0.00 NA NA 0.00 ZZZ<br />

0159T 26 C Cad breast mri 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ<br />

0160T C Tcranial magn stim tx plan 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0161T C Tcranial magn stim tx deliv 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0163T C Lumb artif diskectomy addl 0.00 0.00 0.00 0.00 0.00 0.00 YYY<br />

0164T C Remove lumb artif disc addl 0.00 0.00 0.00 0.00 0.00 0.00 YYY<br />

0165T C Revise lumb artif disc addl 0.00 0.00 0.00 0.00 0.00 0.00 YYY<br />

0166T C Tcath vsd close w/o bypass 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0167T C Tcath vsd close w bypass 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0168T C Rhinophototx light app bilat 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0169T C Place stereo cath brain 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0170T C Anorectal fistula plug rpr 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0171T C Lumbar spine proces distract 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0172T C Lumbar spine process addl 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0173T C Iop monit io pressure 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0174T C Cad cxr with interp 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0175T C Cad cxr remote 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0176T C Aqu canal dilat w/o retent 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0177T C Aqu canal dilat w retent 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0178T C 64 lead ecg w i&r 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0179T C 64 lead ecg w tracing 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0180T C 64 lead ecg w i&r only 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0181T C Corneal hysteresis 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0182T C Hdr elect brachytherapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0183T C Wound ultrasound 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0184T C Exc rectal tumor endoscopic 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0185T C Comptr probability analysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0186T C Suprachoroidal drug delivery 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0187T C Ophthalmic dx image anterior 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0188T N Videoconf crit care 74 min 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0189T N Videoconf crit care addl 30 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0190T C Place intraoc radiation src 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0191T C Insert ant segment drain int 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0192T C Insert ant segment drain ext 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0193T C Rf bladder neck microremodel 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0194T C Procalcitonin (pct) 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0195T C Arthrod presac interbody 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0196T C Arthrod presac interbody eac 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0197T C Intrafraction track motion 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0198T C Ocular blood flow measure 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0528F I Rcmnd flw-up 10 yrs docd 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0529F I Intrvl 3+yrs pts clnscp docd 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0535F I Dyspnea mngmnt plan docd 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

0540F I Gluco mngmnt plan docd 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

10021 A Fna w/o image 1.27 2.14 2.15 0.40 0.43 0.10 XXX

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