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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. 1208 Mal- Practice RVUs 2 Global CPT 1 / HCPCS Mod Status Description RVUs 2 RVUs 2 RVUs 2 RVUs 2 RVUs 2 29580 A Application of paste boot 0.55 0.70 0.69 0.33 0.34 0.07 000 29590 A Application of foot splint 0.76 0.58 0.56 0.26 0.27 0.09 000 29700 A Removal/revision of cast 0.57 0.94 0.93 0.26 0.27 0.08 000 29705 A Removal/revision of cast 0.76 0.78 0.79 0.38 0.38 0.13 000 29710 A Removal/revision of cast 1.34 1.34 1.39 0.61 0.63 0.20 000 29715 A Removal/revision of cast 0.94 1.19 1.18 0.46 0.44 0.09 000 29720 A Repair of body cast 0.68 1.15 1.16 0.36 0.37 0.12 000 29730 A Windowing of cast 0.75 0.74 0.76 0.35 0.35 0.12 000 29740 A Wedging of cast 1.12 1.00 1.04 0.48 0.48 0.18 000 29750 A Wedging of clubfoot cast 1.26 1.10 1.09 0.57 0.57 0.21 000 29799 C Casting/strapping procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 29800 A Jaw arthroscopy/surgery 6.73 NA NA 4.98 5.49 0.99 090 29804 A Jaw arthroscopy/surgery 8.71 NA NA 5.92 6.36 1.38 090 29805 A Shoulder arthroscopy, dx 5.94 NA NA 4.82 5.04 1.02 090 29806 A Shoulder arthroscopy/surgery 14.95 NA NA 9.70 10.09 2.50 090 29807 A Shoulder arthroscopy/surgery 14.48 NA NA 9.53 9.92 2.42 090 29819 A Shoulder arthroscopy/surgery 7.68 NA NA 5.80 6.06 1.32 090 29820 A Shoulder arthroscopy/surgery 7.12 NA NA 5.32 5.56 1.22 090 29821 A Shoulder arthroscopy/surgery 7.78 NA NA 5.80 6.07 1.33 090 29822 A Shoulder arthroscopy/surgery 7.49 NA NA 5.71 5.97 1.28 090 29823 A Shoulder arthroscopy/surgery 8.24 NA NA 6.21 6.48 1.41 090 29824 A Shoulder arthroscopy/surgery 8.82 NA NA 6.70 6.92 1.42 090 29825 A Shoulder arthroscopy/surgery 7.68 NA NA 5.78 6.04 1.32 090 29826 A Shoulder arthroscopy/surgery 9.05 NA NA 6.37 6.67 1.55 090 29827 A Arthroscop rotator cuff repr 15.44 NA NA 9.67 10.16 2.67 090 29828 A Arthroscopy biceps tenodesis 13.00 NA NA 8.46 8.46 2.17 090 29830 A Elbow arthroscopy 5.80 NA NA 4.59 4.79 0.99 090 29834 A Elbow arthroscopy/surgery 6.33 NA NA 4.99 5.21 1.08 090 29835 A Elbow arthroscopy/surgery 6.53 NA NA 5.09 5.30 1.13 090 29836 A Elbow arthroscopy/surgery 7.61 NA NA 5.77 6.04 1.22 090 29837 A Elbow arthroscopy/surgery 6.92 NA NA 5.25 5.48 1.19 090 29838 A Elbow arthroscopy/surgery 7.77 NA NA 5.82 6.11 1.30 090 29840 A Wrist arthroscopy 5.59 NA NA 4.71 4.88 0.84 090 29843 A Wrist arthroscopy/surgery 6.06 NA NA 5.01 5.18 0.92 090 29844 A Wrist arthroscopy/surgery 6.42 NA NA 4.98 5.20 1.04 090 29845 A Wrist arthroscopy/surgery 7.58 NA NA 5.58 5.82 0.99 090 29846 A Wrist arthroscopy/surgery 6.80 NA NA 5.22 5.44 1.07 090 29847 A Wrist arthroscopy/surgery 7.13 NA NA 5.38 5.60 1.08 090 29848 A Wrist endoscopy/surgery 6.24 NA NA 5.37 5.44 0.86 090 29850 A Knee arthroscopy/surgery 8.18 NA NA 5.30 5.24 1.25 090 29851 A Knee arthroscopy/surgery 13.08 NA NA 8.51 8.85 2.35 090 29855 A Tibial arthroscopy/surgery 10.60 NA NA 7.51 7.84 1.85 090 29856 A Tibial arthroscopy/surgery 14.12 NA NA 9.03 9.46 2.40 090 29860 A Hip arthroscopy, dx 8.85 NA NA 6.24 6.44 1.36 090 29861 A Hip arthroscopy/surgery 9.95 NA NA 6.81 6.96 1.59 090 29862 A Hip arthroscopy/surgery 10.97 NA NA 7.82 8.02 1.62 090 29863 A Hip arthroscopy/surgery 10.97 NA NA 7.72 7.94 1.42 090 29866 A Autgrft implnt, knee w/scope 14.48 NA NA 9.65 10.10 2.40 090

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. 1209 Mal- Practice RVUs 2 Global CPT 1 / HCPCS Mod Status Description RVUs 2 RVUs 2 RVUs 2 RVUs 2 RVUs 2 29867 A Allgrft implnt, knee w/scope 18.18 NA NA 11.14 11.69 2.79 090 29868 A Meniscal trnspl, knee w/scpe 24.89 NA NA 13.89 14.65 4.36 090 29870 A Knee arthroscopy, dx 5.11 NA NA 4.28 4.44 0.85 090 29871 A Knee arthroscopy/drainage 6.60 NA NA 5.18 5.36 1.14 090 29873 A Knee arthroscopy/surgery 6.09 NA NA 5.69 5.92 1.04 090 29874 A Knee arthroscopy/surgery 7.10 NA NA 5.28 5.50 1.11 090 29875 A Knee arthroscopy/surgery 6.36 NA NA 4.99 5.22 1.09 090 29876 A Knee arthroscopy/surgery 8.72 NA NA 6.36 6.54 1.37 090 29877 A Knee arthroscopy/surgery 8.15 NA NA 6.13 6.30 1.28 090 29879 A Knee arthroscopy/surgery 8.84 NA NA 6.42 6.61 1.39 090 29880 A Knee arthroscopy/surgery 9.30 NA NA 6.62 6.82 1.47 090 29881 A Knee arthroscopy/surgery 8.56 NA NA 6.30 6.48 1.34 090 29882 A Knee arthroscopy/surgery 9.45 NA NA 6.65 6.81 1.50 090 29883 A Knee arthroscopy/surgery 11.61 NA NA 7.86 8.18 1.93 090 29884 A Knee arthroscopy/surgery 8.13 NA NA 6.11 6.28 1.27 090 29885 A Knee arthroscopy/surgery 10.03 NA NA 7.23 7.43 1.58 090 29886 A Knee arthroscopy/surgery 8.34 NA NA 6.22 6.40 1.30 090 29887 A Knee arthroscopy/surgery 9.98 NA NA 7.18 7.38 1.57 090 29888 A Knee arthroscopy/surgery 14.14 NA NA 8.87 9.23 2.42 090 29889 A Knee arthroscopy/surgery 17.15 NA NA 11.16 11.51 2.79 090 29891 A Ankle arthroscopy/surgery 9.47 NA NA 6.75 6.96 1.39 090 29892 A Ankle arthroscopy/surgery 10.07 NA NA 6.38 6.73 1.41 090 29893 A Scope, plantar fasciotomy 6.08 8.52 7.98 4.54 4.41 0.63 090 29894 A Ankle arthroscopy/surgery 7.26 NA NA 4.83 5.00 1.15 090 29895 A Ankle arthroscopy/surgery 7.04 NA NA 4.58 4.82 1.11 090 29897 A Ankle arthroscopy/surgery 7.23 NA NA 4.94 5.19 1.17 090 29898 A Ankle arthroscopy/surgery 8.38 NA NA 5.28 5.52 1.28 090 29899 A Ankle arthroscopy/surgery 15.21 NA NA 9.41 9.72 2.41 090 29900 A Mcp joint arthroscopy, dx 5.74 NA NA 4.65 4.97 0.94 090 29901 A Mcp joint arthroscopy, surg 6.45 NA NA 4.92 5.27 1.06 090 29902 A Mcp joint arthroscopy, surg 7.02 NA NA 5.16 5.52 1.12 090 29904 A Subtalar arthro w/fb rmvl 8.50 NA NA 6.08 6.08 1.25 090 29905 A Subtalar arthro w/exc 9.00 NA NA 6.71 6.71 1.32 090 29906 A Subtalar arthro w/deb 9.47 NA NA 7.08 7.08 1.39 090 29907 A Subtalar arthro w/fusion 12.00 NA NA 8.15 8.15 1.90 090 29999 C Arthroscopy of joint 0.00 0.00 0.00 0.00 0.00 0.00 YYY 30000 A Drainage of nose lesion 1.45 4.02 4.04 1.38 1.38 0.12 010 30020 A Drainage of nose lesion 1.45 4.04 3.86 1.38 1.40 0.12 010 30100 A Intranasal biopsy 0.94 2.54 2.40 0.76 0.78 0.07 000 30110 A Removal of nose polyp(s) 1.65 3.86 3.71 1.47 1.50 0.14 010 30115 A Removal of nose polyp(s) 4.38 NA NA 5.96 5.93 0.41 090 30117 A Removal of intranasal lesion 3.20 17.78 16.66 4.89 4.83 0.26 090 30118 A Removal of intranasal lesion 9.81 NA NA 8.62 8.78 0.78 090 30120 A Revision of nose 5.31 7.24 7.07 5.28 5.47 0.52 090 30124 A Removal of nose lesion 3.14 NA NA 3.31 3.39 0.25 090 30125 A Removal of nose lesion 7.21 NA NA 7.34 7.61 0.63 090 30130 A Excise inferior turbinate 3.41 NA NA 5.61 5.62 0.31 090 30140 A Resect inferior turbinate 3.48 NA NA 7.03 6.84 0.35 090

<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 />

1209<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 />

29867 A Allgrft implnt, knee w/scope 18.18 NA NA 11.14 11.69 2.79 090<br />

29868 A Meniscal trnspl, knee w/scpe 24.89 NA NA 13.89 14.65 4.36 090<br />

29870 A Knee arthroscopy, dx 5.11 NA NA 4.28 4.44 0.85 090<br />

29871 A Knee arthroscopy/drainage 6.60 NA NA 5.18 5.36 1.14 090<br />

29873 A Knee arthroscopy/surgery 6.09 NA NA 5.69 5.92 1.04 090<br />

29874 A Knee arthroscopy/surgery 7.10 NA NA 5.28 5.50 1.11 090<br />

29875 A Knee arthroscopy/surgery 6.36 NA NA 4.99 5.22 1.09 090<br />

29876 A Knee arthroscopy/surgery 8.72 NA NA 6.36 6.54 1.37 090<br />

29877 A Knee arthroscopy/surgery 8.15 NA NA 6.13 6.30 1.28 090<br />

29879 A Knee arthroscopy/surgery 8.84 NA NA 6.42 6.61 1.39 090<br />

29880 A Knee arthroscopy/surgery 9.30 NA NA 6.62 6.82 1.47 090<br />

29881 A Knee arthroscopy/surgery 8.56 NA NA 6.30 6.48 1.34 090<br />

29882 A Knee arthroscopy/surgery 9.45 NA NA 6.65 6.81 1.50 090<br />

29883 A Knee arthroscopy/surgery 11.61 NA NA 7.86 8.18 1.93 090<br />

29884 A Knee arthroscopy/surgery 8.13 NA NA 6.11 6.28 1.27 090<br />

29885 A Knee arthroscopy/surgery 10.03 NA NA 7.23 7.43 1.58 090<br />

29886 A Knee arthroscopy/surgery 8.34 NA NA 6.22 6.40 1.30 090<br />

29887 A Knee arthroscopy/surgery 9.98 NA NA 7.18 7.38 1.57 090<br />

29888 A Knee arthroscopy/surgery 14.14 NA NA 8.87 9.23 2.42 090<br />

29889 A Knee arthroscopy/surgery 17.15 NA NA 11.16 11.51 2.79 090<br />

29891 A Ankle arthroscopy/surgery 9.47 NA NA 6.75 6.96 1.39 090<br />

29892 A Ankle arthroscopy/surgery 10.07 NA NA 6.38 6.73 1.41 090<br />

29893 A Scope, plantar fasciotomy 6.08 8.52 7.98 4.54 4.41 0.63 090<br />

29894 A Ankle arthroscopy/surgery 7.26 NA NA 4.83 5.00 1.15 090<br />

29895 A Ankle arthroscopy/surgery 7.04 NA NA 4.58 4.82 1.11 090<br />

29897 A Ankle arthroscopy/surgery 7.23 NA NA 4.94 5.19 1.17 090<br />

29898 A Ankle arthroscopy/surgery 8.38 NA NA 5.28 5.52 1.28 090<br />

29899 A Ankle arthroscopy/surgery 15.21 NA NA 9.41 9.72 2.41 090<br />

29900 A Mcp joint arthroscopy, dx 5.74 NA NA 4.65 4.97 0.94 090<br />

29901 A Mcp joint arthroscopy, surg 6.45 NA NA 4.92 5.27 1.06 090<br />

29902 A Mcp joint arthroscopy, surg 7.02 NA NA 5.16 5.52 1.12 090<br />

29904 A Subtalar arthro w/fb rmvl 8.50 NA NA 6.08 6.08 1.25 090<br />

29905 A Subtalar arthro w/exc 9.00 NA NA 6.71 6.71 1.32 090<br />

29906 A Subtalar arthro w/deb 9.47 NA NA 7.08 7.08 1.39 090<br />

29907 A Subtalar arthro w/fusion 12.00 NA NA 8.15 8.15 1.90 090<br />

29999 C Arthroscopy of joint 0.00 0.00 0.00 0.00 0.00 0.00 YYY<br />

30000 A Drainage of nose lesion 1.45 4.02 4.04 1.38 1.38 0.12 010<br />

30020 A Drainage of nose lesion 1.45 4.04 3.86 1.38 1.40 0.12 010<br />

30100 A Intranasal biopsy 0.94 2.54 2.40 0.76 0.78 0.07 000<br />

30110 A Removal of nose polyp(s) 1.65 3.86 3.71 1.47 1.50 0.14 010<br />

30115 A Removal of nose polyp(s) 4.38 NA NA 5.96 5.93 0.41 090<br />

30117 A Removal of intranasal lesion 3.20 17.78 16.66 4.89 4.83 0.26 090<br />

30118 A Removal of intranasal lesion 9.81 NA NA 8.62 8.78 0.78 090<br />

30120 A Revision of nose 5.31 7.24 7.07 5.28 5.47 0.52 090<br />

30124 A Removal of nose lesion 3.14 NA NA 3.31 3.39 0.25 090<br />

30125 A Removal of nose lesion 7.21 NA NA 7.34 7.61 0.63 090<br />

30130 A Excise inferior turbinate 3.41 NA NA 5.61 5.62 0.31 090<br />

30140 A Resect inferior turbinate 3.48 NA NA 7.03 6.84 0.35 090

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