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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.
1297
Mal-
Practice
RVUs 2 Global
CPT 1 /
HCPCS Mod Status Description
RVUs 2
RVUs 2
RVUs 2
RVUs 2
RVUs 2
73718 TC A Mri lower extremity w/o dye 0.00 13.60 13.03 NA NA 0.39 XXX
73718 26 A Mri lower extremity w/o dye 1.35 0.50 0.49 0.50 0.49 0.06 XXX
73719 A Mri lower extremity w/dye 1.62 15.02 14.79 NA NA 0.54 XXX
73719 TC A Mri lower extremity w/dye 0.00 14.41 14.20 NA NA 0.47 XXX
73719 26 A Mri lower extremity w/dye 1.62 0.61 0.59 0.61 0.59 0.07 XXX
73720 A Mri lwr extremity w/o&w/dye 2.15 18.77 20.52 NA NA 0.94 XXX
73720 TC A Mri lwr extremity w/o&w/dye 0.00 17.95 19.73 NA NA 0.84 XXX
73720 26 A Mri lwr extremity w/o&w/dye 2.15 0.82 0.79 0.82 0.79 0.10 XXX
73721 A Mri jnt of lwr extre w/o dye 1.35 13.69 13.21 NA NA 0.45 XXX
73721 TC A Mri jnt of lwr extre w/o dye 0.00 13.18 12.72 NA NA 0.39 XXX
73721 26 A Mri jnt of lwr extre w/o dye 1.35 0.51 0.49 0.51 0.49 0.06 XXX
73722 A Mri joint of lwr extr w/dye 1.62 14.31 14.26 NA NA 0.54 XXX
73722 TC A Mri joint of lwr extr w/dye 0.00 13.69 13.66 NA NA 0.47 XXX
73722 26 A Mri joint of lwr extr w/dye 1.62 0.62 0.60 0.62 0.60 0.07 XXX
73723 A Mri joint lwr extr w/o&w/dye 2.15 17.35 19.46 NA NA 0.94 XXX
73723 TC A Mri joint lwr extr w/o&w/dye 0.00 16.54 18.67 NA NA 0.84 XXX
73723 26 A Mri joint lwr extr w/o&w/dye 2.15 0.81 0.79 0.81 0.79 0.10 XXX
73725 R Mr ang lwr ext w or w/o dye 1.82 14.98 14.21 NA NA 0.67 XXX
73725 TC R Mr ang lwr ext w or w/o dye 0.00 14.27 13.53 NA NA 0.59 XXX
73725 26 R Mr ang lwr ext w or w/o dye 1.82 0.71 0.68 0.71 0.68 0.08 XXX
74000 A X-ray exam of abdomen 0.18 0.47 0.49 NA NA 0.03 XXX
74000 TC A X-ray exam of abdomen 0.00 0.40 0.43 NA NA 0.02 XXX
74000 26 A X-ray exam of abdomen 0.18 0.07 0.06 0.07 0.06 0.01 XXX
74010 A X-ray exam of abdomen 0.23 0.78 0.75 NA NA 0.05 XXX
74010 TC A X-ray exam of abdomen 0.00 0.70 0.67 NA NA 0.04 XXX
74010 26 A X-ray exam of abdomen 0.23 0.08 0.08 0.08 0.08 0.01 XXX
74020 A X-ray exam of abdomen 0.27 0.80 0.78 NA NA 0.05 XXX
74020 TC A X-ray exam of abdomen 0.00 0.70 0.68 NA NA 0.04 XXX
74020 26 A X-ray exam of abdomen 0.27 0.10 0.10 0.10 0.10 0.01 XXX
74022 A X-ray exam series, abdomen 0.32 0.98 0.95 NA NA 0.06 XXX
74022 TC A X-ray exam series, abdomen 0.00 0.86 0.83 NA NA 0.05 XXX
74022 26 A X-ray exam series, abdomen 0.32 0.12 0.12 0.12 0.12 0.01 XXX
74150 A Ct abdomen w/o dye 1.19 6.02 6.04 NA NA 0.35 XXX
74150 TC A Ct abdomen w/o dye 0.00 5.56 5.60 NA NA 0.30 XXX
74150 26 A Ct abdomen w/o dye 1.19 0.46 0.44 0.46 0.44 0.05 XXX
74160 A Ct abdomen w/dye 1.27 8.73 8.39 NA NA 0.42 XXX
74160 TC A Ct abdomen w/dye 0.00 8.24 7.91 NA NA 0.36 XXX
74160 26 A Ct abdomen w/dye 1.27 0.49 0.48 0.49 0.48 0.06 XXX
74170 A Ct abdomen w/o & w/dye 1.40 12.06 11.30 NA NA 0.49 XXX
74170 TC A Ct abdomen w/o & w/dye 0.00 11.52 10.78 NA NA 0.43 XXX
74170 26 A Ct abdomen w/o & w/dye 1.40 0.54 0.52 0.54 0.52 0.06 XXX
74175 A Ct angio abdom w/o & w/dye 1.90 12.15 12.30 NA NA 0.47 XXX
74175 TC A Ct angio abdom w/o & w/dye 0.00 11.40 11.58 NA NA 0.39 XXX
74175 26 A Ct angio abdom w/o & w/dye 1.90 0.75 0.72 0.75 0.72 0.08 XXX
74181 A Mri abdomen w/o dye 1.46 12.31 12.18 NA NA 0.51 XXX
74181 TC A Mri abdomen w/o dye 0.00 11.75 11.64 NA NA 0.45 XXX
74181 26 A Mri abdomen w/o dye 1.46 0.56 0.54 0.56 0.54 0.06 XXX
74182 A Mri abdomen w/dye 1.73 17.19 16.43 NA NA 0.60 XXX