Notice: This CMS-approved document has been submitted - Philips ...

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.
1236
Mal-
Practice
RVUs 2 Global
CPT 1 /
HCPCS Mod Status Description
RVUs 2
RVUs 2
RVUs 2
RVUs 2
RVUs 2
43219 A Esophagus endoscopy 2.80 NA NA 1.59 1.53 0.24 000
43220 A Esoph endoscopy, dilation 2.10 NA NA 1.16 1.11 0.17 000
43226 A Esoph endoscopy, dilation 2.34 NA NA 1.31 1.24 0.19 000
43227 A Esoph endoscopy, repair 3.59 NA NA 1.84 1.74 0.28 000
43228 A Esoph endoscopy, ablation 3.76 NA NA 2.02 1.90 0.34 000
43231 A Esoph endoscopy w/us exam 3.19 NA NA 1.79 1.67 0.23 000
43232 A Esoph endoscopy w/us fn bx 4.47 NA NA 2.34 2.21 0.34 000
43234 A Upper GI endoscopy, exam 2.01 4.84 4.98 1.04 1.00 0.17 000
43235 A Uppr gi endoscopy, diagnosis 2.39 5.15 5.16 1.39 1.30 0.19 000
43236 A Uppr gi scope w/submuc inj 2.92 6.51 6.50 1.69 1.58 0.21 000
43237 A Endoscopic us exam, esoph 3.98 NA NA 2.19 2.05 0.43 000
43238 A Uppr gi endoscopy w/us fn bx 5.02 NA NA 2.70 2.52 0.43 000
43239 A Upper GI endoscopy, biopsy 2.87 5.90 5.87 1.60 1.50 0.22 000
43240 A Esoph endoscope w/drain cyst 6.85 NA NA 3.50 3.28 0.56 000
43241 A Upper GI endoscopy with tube 2.59 NA NA 1.46 1.37 0.21 000
43242 A Uppr gi endoscopy w/us fn bx 7.30 NA NA 3.81 3.55 0.53 000
43243 A Upper gi endoscopy & inject 4.56 NA NA 2.43 2.28 0.33 000
43244 A Upper GI endoscopy/ligation 5.04 NA NA 2.73 2.54 0.37 000
43245 A Uppr gi scope dilate strictr 3.18 NA NA 1.67 1.58 0.26 000
43246 A Place gastrostomy tube 4.32 NA NA 2.18 2.06 0.34 000
43247 A Operative upper GI endoscopy 3.38 NA NA 1.83 1.72 0.27 000
43248 A Uppr gi endoscopy/guide wire 3.15 NA NA 1.82 1.69 0.23 000
43249 A Esoph endoscopy, dilation 2.90 NA NA 1.66 1.55 0.22 000
43250 A Upper GI endoscopy/tumor 3.20 NA NA 1.64 1.56 0.26 000
43251 A Operative upper GI endoscopy 3.69 NA NA 1.98 1.86 0.29 000
43255 A Operative upper GI endoscopy 4.81 NA NA 2.60 2.43 0.35 000
43256 A Uppr gi endoscopy w/stent 4.34 NA NA 2.30 2.16 0.32 000
43257 A Uppr gi scope w/thrml txmnt 5.50 NA NA 2.59 2.50 0.36 000
43258 A Operative upper GI endoscopy 4.54 NA NA 2.44 2.28 0.33 000
43259 A Endoscopic ultrasound exam 5.19 NA NA 2.79 2.60 0.35 000
43260 A Endo cholangiopancreatograph 5.95 NA NA 3.17 2.95 0.43 000
43261 A Endo cholangiopancreatograph 6.26 NA NA 3.32 3.09 0.46 000
43262 A Endo cholangiopancreatograph 7.38 NA NA 3.87 3.60 0.54 000
43263 A Endo cholangiopancreatograph 7.28 NA NA 3.84 3.58 0.54 000
43264 A Endo cholangiopancreatograph 8.89 NA NA 4.61 4.29 0.65 000
43265 A Endo cholangiopancreatograph 10.00 NA NA 5.14 4.79 0.73 000
43267 A Endo cholangiopancreatograph 7.38 NA NA 3.79 3.55 0.54 000
43268 A Endo cholangiopancreatograph 7.38 NA NA 4.01 3.74 0.54 000
43269 A Endo cholangiopancreatograph 8.20 NA NA 4.26 3.97 0.60 000
43271 A Endo cholangiopancreatograph 7.38 NA NA 3.85 3.59 0.54 000
43272 A Endo cholangiopancreatograph 7.38 NA NA 3.82 3.57 0.54 000
43273 A Endoscopic pancreatoscopy 2.24 1.08 1.08 1.08 1.08 0.16 ZZZ
43279 A Lap myotomy, heller 22.00 NA NA 8.07 8.07 2.62 090
43280 A Laparoscopy, fundoplasty 18.00 NA NA 6.94 7.04 2.28 090
43289 C Laparoscope proc, esoph 0.00 0.00 0.00 0.00 0.00 0.00 YYY
43300 A Repair of esophagus 9.21 NA NA 5.60 5.81 1.12 090
43305 A Repair esophagus and fistula 17.98 NA NA 8.68 9.20 1.54 090
43310 A Repair of esophagus 26.18 NA NA 10.59 10.73 3.61 090