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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. 1242 Mal- Practice RVUs 2 Global CPT 1 / HCPCS Mod Status Description RVUs 2 RVUs 2 RVUs 2 RVUs 2 RVUs 2 45307 A Proctosigmoidoscopy fb 1.70 3.07 3.06 0.69 0.64 0.11 000 45308 A Proctosigmoidoscopy removal 1.40 3.29 2.97 0.64 0.59 0.09 000 45309 A Proctosigmoidoscopy removal 1.50 3.50 3.34 0.71 0.74 0.22 000 45315 A Proctosigmoidoscopy removal 1.80 3.67 3.47 0.86 0.81 0.15 000 45317 A Proctosigmoidoscopy bleed 2.00 3.29 3.09 0.78 0.75 0.15 000 45320 A Proctosigmoidoscopy ablate 1.78 3.47 3.34 0.87 0.83 0.16 000 45321 A Proctosigmoidoscopy volvul 1.75 NA NA 0.86 0.79 0.13 000 45327 A Proctosigmoidoscopy w/stent 2.00 NA NA 1.04 0.96 0.16 000 45330 A Diagnostic sigmoidoscopy 0.96 2.48 2.43 0.63 0.60 0.08 000 45331 A Sigmoidoscopy and biopsy 1.15 3.19 3.17 0.81 0.75 0.09 000 45332 A Sigmoidoscopy w/fb removal 1.79 5.39 5.30 1.02 0.97 0.16 000 45333 A Sigmoidoscopy & polypectomy 1.79 5.50 5.35 1.01 0.96 0.15 000 45334 A Sigmoidoscopy for bleeding 2.73 NA NA 1.56 1.46 0.20 000 45335 A Sigmoidoscopy w/submuc inj 1.46 5.13 4.66 0.90 0.85 0.11 000 45337 A Sigmoidoscopy & decompress 2.36 NA NA 1.27 1.20 0.21 000 45338 A Sigmoidoscopy w/tumr remove 2.34 5.73 5.61 1.31 1.24 0.19 000 45339 A Sigmoidoscopy w/ablate tumr 3.14 5.58 5.06 1.69 1.59 0.26 000 45340 A Sig w/balloon dilation 1.89 10.00 9.06 1.07 1.01 0.15 000 45341 A Sigmoidoscopy w/ultrasound 2.60 NA NA 1.51 1.40 0.19 000 45342 A Sigmoidoscopy w/us guide bx 4.05 NA NA 2.23 2.06 0.30 000 45345 A Sigmoidoscopy w/stent 2.92 NA NA 1.62 1.51 0.23 000 45355 A Surgical colonoscopy 3.51 NA NA 1.56 1.52 0.36 000 45378 A Diagnostic colonoscopy 3.69 6.25 6.24 1.88 1.78 0.30 000 45378 53 A Diagnostic colonoscopy 0.96 2.48 2.43 0.63 0.60 0.08 000 45379 A Colonoscopy w/fb removal 4.68 7.98 7.92 2.27 2.16 0.39 000 45380 A Colonoscopy and biopsy 4.43 7.58 7.50 2.31 2.17 0.35 000 45381 A Colonoscopy, submucous inj 4.19 7.53 7.45 2.22 2.08 0.30 000 45382 A Colonoscopy/control bleeding 5.68 10.09 10.08 2.98 2.78 0.41 000 45383 A Lesion removal colonoscopy 5.86 8.38 8.29 2.72 2.60 0.48 000 45384 A Lesion remove colonoscopy 4.69 7.04 7.00 2.25 2.15 0.38 000 45385 A Lesion removal colonoscopy 5.30 8.22 8.13 2.69 2.53 0.42 000 45386 A Colonoscopy dilate stricture 4.57 11.98 12.11 2.25 2.14 0.39 000 45387 A Colonoscopy w/stent 5.90 NA NA 3.04 2.87 0.48 000 45391 A Colonoscopy w/endoscope us 5.09 NA NA 2.64 2.48 0.42 000 45392 A Colonoscopy w/endoscopic fnb 6.54 NA NA 3.31 3.11 0.42 000 45395 A Lap, removal of rectum 32.79 NA NA 13.53 13.60 3.63 090 45397 A Lap, remove rectum w/pouch 36.29 NA NA 14.03 14.12 3.67 090 45400 A Laparoscopic proc 19.31 NA NA 7.37 7.50 2.03 090 45402 A Lap proctopexy w/sig resect 26.38 NA NA 9.18 9.40 2.82 090 45499 C Laparoscope proc, rectum 0.00 0.00 0.00 0.00 0.00 0.00 YYY 45500 A Repair of rectum 7.64 NA NA 4.51 4.27 0.75 090 45505 A Repair of rectum 8.20 NA NA 5.15 4.84 0.86 090 45520 A Treatment of rectal prolapse 0.55 2.81 2.52 0.39 0.38 0.05 000 45540 A Correct rectal prolapse 18.02 NA NA 6.69 6.73 1.85 090 45541 A Correct rectal prolapse 14.72 NA NA 6.78 6.59 1.55 090 45550 A Repair rectum/remove sigmoid 24.67 NA NA 9.32 9.32 2.62 090 45560 A Repair of rectocele 11.42 NA NA 5.67 5.52 1.13 090 45562 A Exploration/repair of rectum 17.82 NA NA 8.40 8.07 1.84 090

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. 1243 Mal- Practice RVUs 2 Global CPT 1 / HCPCS Mod Status Description RVUs 2 RVUs 2 RVUs 2 RVUs 2 RVUs 2 45563 A Exploration/repair of rectum 26.22 NA NA 11.08 10.97 3.11 090 45800 A Repair rect/bladder fistula 20.18 NA NA 9.54 9.03 1.86 090 45805 A Repair fistula w/colostomy 23.19 NA NA 9.94 9.85 2.03 090 45820 A Repair rectourethral fistula 20.24 NA NA 9.35 8.94 1.58 090 45825 A Repair fistula w/colostomy 24.01 NA NA 11.15 10.84 2.32 090 45900 A Reduction of rectal prolapse 2.96 NA NA 1.68 1.64 0.30 010 45905 A Dilation of anal sphincter 2.32 NA NA 1.62 1.58 0.27 010 45910 A Dilation of rectal narrowing 2.82 NA NA 1.86 1.81 0.30 010 45915 A Remove rectal obstruction 3.16 4.15 4.20 2.03 2.05 0.30 010 45990 A Surg dx exam, anorectal 1.80 NA NA 0.76 0.77 0.17 000 45999 C Rectum surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 46020 A Placement of seton 2.94 3.16 2.96 2.30 2.20 0.31 010 46030 A Removal of rectal marker 1.24 1.87 1.74 0.82 0.79 0.14 010 46040 A Incision of rectal abscess 5.26 6.49 6.25 4.00 3.91 0.62 090 46045 A Incision of rectal abscess 5.79 NA NA 3.98 3.71 0.54 090 46050 A Incision of anal abscess 1.21 3.12 2.98 0.98 0.94 0.14 010 46060 A Incision of rectal abscess 6.24 NA NA 4.47 4.17 0.67 090 46070 A Incision of anal septum 2.74 NA NA 2.80 2.57 0.36 090 46080 A Incision of anal sphincter 2.50 3.05 2.88 1.16 1.15 0.30 010 46083 A Incise external hemorrhoid 1.42 2.45 2.71 1.02 1.07 0.15 010 46200 A Removal of anal fissure 3.48 6.20 5.63 3.71 3.51 0.39 090 46210 A Removal of anal crypt 2.73 5.84 5.67 3.34 3.17 0.31 090 46211 A Removal of anal crypts 4.31 7.53 7.01 4.50 4.26 0.48 090 46220 A Removal of anal tag 1.58 2.99 2.82 1.11 1.08 0.17 010 46221 A Ligation of hemorrhoid(s) 2.31 3.69 3.44 2.00 1.94 0.23 010 46230 A Removal of anal tags 2.59 3.49 3.39 1.36 1.35 0.30 010 46250 A Hemorrhoidectomy 4.17 5.95 5.80 2.88 2.82 0.48 090 46255 A Hemorrhoidectomy 4.88 6.31 6.21 3.11 3.05 0.58 090 46257 A Remove hemorrhoids & fissure 5.68 NA NA 3.86 3.62 0.64 090 46258 A Remove hemorrhoids & fistula 6.28 NA NA 4.10 3.90 0.68 090 46260 A Hemorrhoidectomy 6.65 NA NA 4.12 3.89 0.76 090 46261 A Remove hemorrhoids & fissure 7.63 NA NA 4.38 4.19 0.79 090 46262 A Remove hemorrhoids & fistula 7.80 NA NA 4.79 4.54 0.83 090 46270 A Removal of anal fistula 4.81 6.32 6.00 3.92 3.66 0.46 090 46275 A Removal of anal fistula 5.31 6.58 6.11 3.99 3.75 0.52 090 46280 A Removal of anal fistula 6.28 NA NA 4.31 4.05 0.66 090 46285 A Removal of anal fistula 5.31 6.50 5.83 3.98 3.68 0.44 090 46288 A Repair anal fistula 7.68 NA NA 4.79 4.52 0.79 090 46320 A Removal of hemorrhoid clot 1.62 2.39 2.33 0.90 0.89 0.18 010 46500 A Injection into hemorrhoid(s) 1.64 3.57 3.21 1.26 1.24 0.16 010 46505 A Chemodenervation anal musc 3.13 3.29 3.23 2.31 2.23 0.14 010 46600 A Diagnostic anoscopy 0.55 1.36 1.41 0.39 0.37 0.05 000 46604 A Anoscopy and dilation 1.03 12.03 11.33 0.52 0.54 0.12 000 46606 A Anoscopy and biopsy 1.20 3.85 3.84 0.60 0.56 0.09 000 46608 A Anoscopy, remove for body 1.30 3.66 3.86 0.58 0.60 0.16 000 46610 A Anoscopy, remove lesion 1.28 3.75 3.83 0.61 0.61 0.15 000 46611 A Anoscopy 1.30 2.45 2.68 0.58 0.63 0.19 000 46612 A Anoscopy, remove lesions 1.50 4.33 4.56 0.67 0.75 0.28 000

<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 />

1243<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 />

45563 A Exploration/repair of rectum 26.22 NA NA 11.08 10.97 3.11 090<br />

45800 A Repair rect/bladder fistula 20.18 NA NA 9.54 9.03 1.86 090<br />

45805 A Repair fistula w/colostomy 23.19 NA NA 9.94 9.85 2.03 090<br />

45820 A Repair rectourethral fistula 20.24 NA NA 9.35 8.94 1.58 090<br />

45825 A Repair fistula w/colostomy 24.01 NA NA 11.15 10.84 2.32 090<br />

45900 A Reduction of rectal prolapse 2.96 NA NA 1.68 1.64 0.30 010<br />

45905 A Dilation of anal sphincter 2.32 NA NA 1.62 1.58 0.27 010<br />

45910 A Dilation of rectal narrowing 2.82 NA NA 1.86 1.81 0.30 010<br />

45915 A Remove rectal obstruction 3.16 4.15 4.20 2.03 2.05 0.30 010<br />

45990 A Surg dx exam, anorectal 1.80 NA NA 0.76 0.77 0.17 000<br />

45999 C Rectum surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY<br />

46020 A Placement of seton 2.94 3.16 2.96 2.30 2.20 0.31 010<br />

46030 A Removal of rectal marker 1.24 1.87 1.74 0.82 0.79 0.14 010<br />

46040 A Incision of rectal abscess 5.26 6.49 6.25 4.00 3.91 0.62 090<br />

46045 A Incision of rectal abscess 5.79 NA NA 3.98 3.71 0.54 090<br />

46050 A Incision of anal abscess 1.21 3.12 2.98 0.98 0.94 0.14 010<br />

46060 A Incision of rectal abscess 6.24 NA NA 4.47 4.17 0.67 090<br />

46070 A Incision of anal septum 2.74 NA NA 2.80 2.57 0.36 090<br />

46080 A Incision of anal sphincter 2.50 3.05 2.88 1.16 1.15 0.30 010<br />

46083 A Incise external hemorrhoid 1.42 2.45 2.71 1.02 1.07 0.15 010<br />

46200 A Removal of anal fissure 3.48 6.20 5.63 3.71 3.51 0.39 090<br />

46210 A Removal of anal crypt 2.73 5.84 5.67 3.34 3.17 0.31 090<br />

46211 A Removal of anal crypts 4.31 7.53 7.01 4.50 4.26 0.48 090<br />

46220 A Removal of anal tag 1.58 2.99 2.82 1.11 1.08 0.17 010<br />

46221 A Ligation of hemorrhoid(s) 2.31 3.69 3.44 2.00 1.94 0.23 010<br />

46230 A Removal of anal tags 2.59 3.49 3.39 1.36 1.35 0.30 010<br />

46250 A Hemorrhoidectomy 4.17 5.95 5.80 2.88 2.82 0.48 090<br />

46255 A Hemorrhoidectomy 4.88 6.31 6.21 3.11 3.05 0.58 090<br />

46257 A Remove hemorrhoids & fissure 5.68 NA NA 3.86 3.62 0.64 090<br />

46258 A Remove hemorrhoids & fistula 6.28 NA NA 4.10 3.90 0.68 090<br />

46260 A Hemorrhoidectomy 6.65 NA NA 4.12 3.89 0.76 090<br />

46261 A Remove hemorrhoids & fissure 7.63 NA NA 4.38 4.19 0.79 090<br />

46262 A Remove hemorrhoids & fistula 7.80 NA NA 4.79 4.54 0.83 090<br />

46270 A Removal of anal fistula 4.81 6.32 6.00 3.92 3.66 0.46 090<br />

46275 A Removal of anal fistula 5.31 6.58 6.11 3.99 3.75 0.52 090<br />

46280 A Removal of anal fistula 6.28 NA NA 4.31 4.05 0.66 090<br />

46285 A Removal of anal fistula 5.31 6.50 5.83 3.98 3.68 0.44 090<br />

46288 A Repair anal fistula 7.68 NA NA 4.79 4.52 0.79 090<br />

46320 A Removal of hemorrhoid clot 1.62 2.39 2.33 0.90 0.89 0.18 010<br />

46500 A Injection into hemorrhoid(s) 1.64 3.57 3.21 1.26 1.24 0.16 010<br />

46505 A Chemodenervation anal musc 3.13 3.29 3.23 2.31 2.23 0.14 010<br />

46600 A Diagnostic anoscopy 0.55 1.36 1.41 0.39 0.37 0.05 000<br />

46604 A Anoscopy and dilation 1.03 12.03 11.33 0.52 0.54 0.12 000<br />

46606 A Anoscopy and biopsy 1.20 3.85 3.84 0.60 0.56 0.09 000<br />

46608 A Anoscopy, remove for body 1.30 3.66 3.86 0.58 0.60 0.16 000<br />

46610 A Anoscopy, remove lesion 1.28 3.75 3.83 0.61 0.61 0.15 000<br />

46611 A Anoscopy 1.30 2.45 2.68 0.58 0.63 0.19 000<br />

46612 A Anoscopy, remove lesions 1.50 4.33 4.56 0.67 0.75 0.28 000

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