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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. 1254 Mal- Practice RVUs 2 Global CPT 1 / HCPCS Mod Status Description RVUs 2 RVUs 2 RVUs 2 RVUs 2 RVUs 2 52204 A Cystoscopy w/biopsy(s) 2.59 8.23 9.82 1.46 1.32 0.17 000 52214 A Cystoscopy and treatment 3.70 15.55 12.58 1.95 2.36 0.26 000 52224 A Cystoscopy and treatment 3.14 14.74 20.22 1.71 1.57 0.22 000 52234 A Cystoscopy and treatment 4.62 NA NA 2.42 2.24 0.33 000 52235 A Cystoscopy and treatment 5.44 NA NA 2.82 2.60 0.39 000 52240 A Cystoscopy and treatment 9.71 NA NA 4.67 4.34 0.69 000 52250 A Cystoscopy and radiotracer 4.49 NA NA 2.44 2.25 0.32 000 52260 A Cystoscopy and treatment 3.91 NA NA 2.05 1.90 0.28 000 52265 A Cystoscopy and treatment 2.94 7.38 8.89 1.53 1.43 0.22 000 52270 A Cystoscopy & revise urethra 3.36 7.00 8.03 1.85 1.70 0.24 000 52275 A Cystoscopy & revise urethra 4.69 9.30 10.89 2.43 2.24 0.33 000 52276 A Cystoscopy and treatment 4.99 NA NA 2.61 2.41 0.35 000 52277 A Cystoscopy and treatment 6.16 NA NA 3.08 2.87 0.44 000 52281 A Cystoscopy and treatment 2.80 5.28 5.75 1.63 1.49 0.20 000 52282 A Cystoscopy, implant stent 6.39 NA NA 3.16 2.93 0.45 000 52283 A Cystoscopy and treatment 3.73 4.15 4.10 1.99 1.84 0.26 000 52285 A Cystoscopy and treatment 3.60 4.37 4.29 1.94 1.79 0.26 000 52290 A Cystoscopy and treatment 4.58 NA NA 2.42 2.23 0.32 000 52300 A Cystoscopy and treatment 5.30 NA NA 2.70 2.51 0.38 000 52301 A Cystoscopy and treatment 5.50 NA NA 2.89 2.67 0.46 000 52305 A Cystoscopy and treatment 5.30 NA NA 2.66 2.46 0.38 000 52310 A Cystoscopy and treatment 2.81 4.04 4.21 1.52 1.40 0.20 000 52315 A Cystoscopy and treatment 5.20 6.70 7.21 2.64 2.45 0.37 000 52317 A Remove bladder stone 6.71 16.97 20.02 3.22 2.99 0.48 000 52318 A Remove bladder stone 9.18 NA NA 4.35 4.04 0.65 000 52320 A Cystoscopy and treatment 4.69 NA NA 2.36 2.18 0.33 000 52325 A Cystoscopy, stone removal 6.15 NA NA 3.00 2.78 0.44 000 52327 A Cystoscopy, inject material 5.18 2.21 9.64 2.21 2.12 0.37 000 52330 A Cystoscopy and treatment 5.03 9.32 16.74 2.50 2.32 0.36 000 52332 A Cystoscopy and treatment 2.83 12.26 10.65 1.64 1.50 0.21 000 52334 A Create passage to kidney 4.82 NA NA 2.51 2.32 0.35 000 52341 A Cysto w/ureter stricture tx 5.35 NA NA 2.93 2.75 0.43 000 52342 A Cysto w/up stricture tx 5.85 NA NA 3.15 2.96 0.46 000 52343 A Cysto w/renal stricture tx 6.55 NA NA 3.46 3.25 0.51 000 52344 A Cysto/uretero, stricture tx 7.05 NA NA 3.83 3.58 0.55 000 52345 A Cysto/uretero w/up stricture 7.55 NA NA 4.06 3.79 0.58 000 52346 A Cystouretero w/renal strict 8.58 NA NA 4.51 4.22 0.65 000 52351 A Cystouretero & or pyeloscope 5.85 NA NA 3.15 2.90 0.41 000 52352 A Cystouretero w/stone remove 6.87 NA NA 3.69 3.40 0.49 000 52353 A Cystouretero w/lithotripsy 7.96 NA NA 4.16 3.85 0.57 000 52354 A Cystouretero w/biopsy 7.33 NA NA 3.89 3.59 0.52 000 52355 A Cystouretero w/excise tumor 8.81 NA NA 4.54 4.20 0.63 000 52400 A Cystouretero w/congen repr 8.66 NA NA 5.00 4.69 0.68 090 52402 A Cystourethro cut ejacul duct 5.27 NA NA 2.35 2.19 0.40 000 52450 A Incision of prostate 7.63 NA NA 5.68 5.19 0.54 090 52500 A Revision of bladder neck 7.99 NA NA 5.85 5.38 0.60 090 52601 A Prostatectomy (TURP) 15.13 NA NA 8.91 7.63 0.87 090 52630 A Remove prostate regrowth 7.65 NA NA 5.02 4.52 0.51 090

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. 1255 Mal- Practice RVUs 2 Global CPT 1 / HCPCS Mod Status Description RVUs 2 RVUs 2 RVUs 2 RVUs 2 RVUs 2 52640 A Relieve bladder contracture 4.73 NA NA 3.68 3.51 0.47 090 52647 A Laser surgery of prostate 11.15 41.48 49.72 7.23 6.57 0.73 090 52648 A Laser surgery of prostate 12.00 42.02 50.13 7.58 6.90 0.79 090 52649 A Prostate laser enucleation 17.16 NA NA 9.87 9.87 1.11 090 52700 A Drainage of prostate abscess 7.39 NA NA 4.94 4.51 0.48 090 53000 A Incision of urethra 2.30 NA NA 1.85 1.78 0.16 010 53010 A Incision of urethra 4.35 NA NA 3.96 3.70 0.24 090 53020 A Incision of urethra 1.77 NA NA 1.00 0.92 0.13 000 53025 A Incision of urethra 1.13 NA NA 0.68 0.64 0.08 000 53040 A Drainage of urethra abscess 6.49 NA NA 4.52 4.26 0.45 090 53060 A Drainage of urethra abscess 2.65 2.00 2.03 1.50 1.47 0.28 010 53080 A Drainage of urinary leakage 6.82 NA NA 4.79 5.09 0.52 090 53085 A Drainage of urinary leakage 11.05 NA NA 5.07 5.67 0.92 090 53200 A Biopsy of urethra 2.59 1.76 1.66 1.37 1.27 0.20 000 53210 A Removal of urethra 13.59 NA NA 8.07 7.53 0.89 090 53215 A Removal of urethra 16.72 NA NA 9.66 8.92 1.10 090 53220 A Treatment of urethra lesion 7.53 NA NA 5.19 4.83 0.49 090 53230 A Removal of urethra lesion 10.31 NA NA 6.55 6.11 0.73 090 53235 A Removal of urethra lesion 10.86 NA NA 7.21 6.65 0.72 090 53240 A Surgery for urethra pouch 6.98 NA NA 5.16 4.76 0.52 090 53250 A Removal of urethra gland 6.42 NA NA 4.85 4.47 0.49 090 53260 A Treatment of urethra lesion 3.00 2.47 2.42 1.88 1.77 0.25 010 53265 A Treatment of urethra lesion 3.14 2.96 2.91 2.04 1.89 0.24 010 53270 A Removal of urethra gland 3.11 2.43 2.38 1.85 1.77 0.30 010 53275 A Repair of urethra defect 4.54 NA NA 2.90 2.74 0.32 010 53400 A Revise urethra, stage 1 13.98 NA NA 8.57 7.95 0.98 090 53405 A Revise urethra, stage 2 15.51 NA NA 9.37 8.63 1.10 090 53410 A Reconstruction of urethra 17.53 NA NA 10.22 9.45 1.16 090 53415 A Reconstruction of urethra 20.55 NA NA 11.58 10.54 1.37 090 53420 A Reconstruct urethra, stage 1 15.04 NA NA 7.29 7.05 0.96 090 53425 A Reconstruct urethra, stage 2 16.94 NA NA 9.73 9.04 1.13 090 53430 A Reconstruction of urethra 17.30 NA NA 9.10 8.59 1.15 090 53431 A Reconstruct urethra/bladder 21.03 NA NA 11.61 10.74 1.41 090 53440 A Male sling procedure 15.34 NA NA 9.70 8.79 0.96 090 53442 A Remove/revise male sling 13.29 NA NA 8.80 7.98 0.82 090 53444 A Insert tandem cuff 14.06 NA NA 8.48 7.84 0.94 090 53445 A Insert uro/ves nck sphincter 15.21 NA NA 9.63 9.01 0.99 090 53446 A Remove uro sphincter 10.89 NA NA 7.33 6.82 0.72 090 53447 A Remove/replace ur sphincter 14.15 NA NA 8.80 8.22 0.95 090 53448 A Remov/replc ur sphinctr comp 23.26 NA NA 13.05 12.08 1.50 090 53449 A Repair uro sphincter 10.43 NA NA 6.95 6.41 0.68 090 53450 A Revision of urethra 6.67 NA NA 4.95 4.55 0.43 090 53460 A Revision of urethra 7.65 NA NA 5.34 4.94 0.50 090 53500 A Urethrlys, transvag w/ scope 12.87 NA NA 7.64 7.30 0.90 090 53502 A Repair of urethra injury 8.16 NA NA 5.45 5.09 0.62 090 53505 A Repair of urethra injury 8.16 NA NA 5.65 5.21 0.54 090 53510 A Repair of urethra injury 10.83 NA NA 6.99 6.54 0.74 090 53515 A Repair of urethra injury 14.09 NA NA 8.31 7.73 1.05 090

<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 />

1255<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 />

52640 A Relieve bladder contracture 4.73 NA NA 3.68 3.51 0.47 090<br />

52647 A Laser surgery of prostate 11.15 41.48 49.72 7.23 6.57 0.73 090<br />

52648 A Laser surgery of prostate 12.00 42.02 50.13 7.58 6.90 0.79 090<br />

52649 A Prostate laser enucleation 17.16 NA NA 9.87 9.87 1.11 090<br />

52700 A Drainage of prostate abscess 7.39 NA NA 4.94 4.51 0.48 090<br />

53000 A Incision of urethra 2.30 NA NA 1.85 1.78 0.16 010<br />

53010 A Incision of urethra 4.35 NA NA 3.96 3.70 0.24 090<br />

53020 A Incision of urethra 1.77 NA NA 1.00 0.92 0.13 000<br />

53025 A Incision of urethra 1.13 NA NA 0.68 0.64 0.08 000<br />

53040 A Drainage of urethra abscess 6.49 NA NA 4.52 4.26 0.45 090<br />

53060 A Drainage of urethra abscess 2.65 2.00 2.03 1.50 1.47 0.28 010<br />

53080 A Drainage of urinary leakage 6.82 NA NA 4.79 5.09 0.52 090<br />

53085 A Drainage of urinary leakage 11.05 NA NA 5.07 5.67 0.92 090<br />

53200 A Biopsy of urethra 2.59 1.76 1.66 1.37 1.27 0.20 000<br />

53210 A Removal of urethra 13.59 NA NA 8.07 7.53 0.89 090<br />

53215 A Removal of urethra 16.72 NA NA 9.66 8.92 1.10 090<br />

53220 A Treatment of urethra lesion 7.53 NA NA 5.19 4.83 0.49 090<br />

53230 A Removal of urethra lesion 10.31 NA NA 6.55 6.11 0.73 090<br />

53235 A Removal of urethra lesion 10.86 NA NA 7.21 6.65 0.72 090<br />

53240 A Surgery for urethra pouch 6.98 NA NA 5.16 4.76 0.52 090<br />

53250 A Removal of urethra gland 6.42 NA NA 4.85 4.47 0.49 090<br />

53260 A Treatment of urethra lesion 3.00 2.47 2.42 1.88 1.77 0.25 010<br />

53265 A Treatment of urethra lesion 3.14 2.96 2.91 2.04 1.89 0.24 010<br />

53270 A Removal of urethra gland 3.11 2.43 2.38 1.85 1.77 0.30 010<br />

53275 A Repair of urethra defect 4.54 NA NA 2.90 2.74 0.32 010<br />

53400 A Revise urethra, stage 1 13.98 NA NA 8.57 7.95 0.98 090<br />

53405 A Revise urethra, stage 2 15.51 NA NA 9.37 8.63 1.10 090<br />

53410 A Reconstruction of urethra 17.53 NA NA 10.22 9.45 1.16 090<br />

53415 A Reconstruction of urethra 20.55 NA NA 11.58 10.54 1.37 090<br />

53420 A Reconstruct urethra, stage 1 15.04 NA NA 7.29 7.05 0.96 090<br />

53425 A Reconstruct urethra, stage 2 16.94 NA NA 9.73 9.04 1.13 090<br />

53430 A Reconstruction of urethra 17.30 NA NA 9.10 8.59 1.15 090<br />

53431 A Reconstruct urethra/bladder 21.03 NA NA 11.61 10.74 1.41 090<br />

53440 A Male sling procedure 15.34 NA NA 9.70 8.79 0.96 090<br />

53442 A Remove/revise male sling 13.29 NA NA 8.80 7.98 0.82 090<br />

53444 A Insert tandem cuff 14.06 NA NA 8.48 7.84 0.94 090<br />

53445 A Insert uro/ves nck sphincter 15.21 NA NA 9.63 9.01 0.99 090<br />

53446 A Remove uro sphincter 10.89 NA NA 7.33 6.82 0.72 090<br />

53447 A Remove/replace ur sphincter 14.15 NA NA 8.80 8.22 0.95 090<br />

53448 A Remov/replc ur sphinctr comp 23.26 NA NA 13.05 12.08 1.50 090<br />

53449 A Repair uro sphincter 10.43 NA NA 6.95 6.41 0.68 090<br />

53450 A Revision of urethra 6.67 NA NA 4.95 4.55 0.43 090<br />

53460 A Revision of urethra 7.65 NA NA 5.34 4.94 0.50 090<br />

53500 A Urethrlys, transvag w/ scope 12.87 NA NA 7.64 7.30 0.90 090<br />

53502 A Repair of urethra injury 8.16 NA NA 5.45 5.09 0.62 090<br />

53505 A Repair of urethra injury 8.16 NA NA 5.65 5.21 0.54 090<br />

53510 A Repair of urethra injury 10.83 NA NA 6.99 6.54 0.74 090<br />

53515 A Repair of urethra injury 14.09 NA NA 8.31 7.73 1.05 090

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