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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. 1298 Mal- Practice RVUs 2 Global CPT 1 / HCPCS Mod Status Description RVUs 2 RVUs 2 RVUs 2 RVUs 2 RVUs 2 74182 TC A Mri abdomen w/dye 0.00 16.53 15.79 NA NA 0.52 XXX 74182 26 A Mri abdomen w/dye 1.73 0.66 0.64 0.66 0.64 0.08 XXX 74183 A Mri abdomen w/o & w/dye 2.26 18.74 20.51 NA NA 1.02 XXX 74183 TC A Mri abdomen w/o & w/dye 0.00 17.88 19.68 NA NA 0.92 XXX 74183 26 A Mri abdomen w/o & w/dye 2.26 0.86 0.83 0.86 0.83 0.10 XXX 74185 R Mri angio, abdom w orw/o dye 1.80 14.91 14.17 NA NA 0.67 XXX 74185 TC R Mri angio, abdom w orw/o dye 0.00 14.22 13.50 NA NA 0.59 XXX 74185 26 R Mri angio, abdom w orw/o dye 1.80 0.69 0.67 0.69 0.67 0.08 XXX 74190 C X-ray exam of peritoneum 0.00 0.00 0.00 NA NA 0.00 XXX 74190 TC C X-ray exam of peritoneum 0.00 0.00 0.00 NA NA 0.00 XXX 74190 26 A X-ray exam of peritoneum 0.48 0.19 0.18 0.19 0.18 0.02 XXX 74210 A Contrst x-ray exam of throat 0.36 1.76 1.66 NA NA 0.08 XXX 74210 TC A Contrst x-ray exam of throat 0.00 1.62 1.52 NA NA 0.06 XXX 74210 26 A Contrst x-ray exam of throat 0.36 0.14 0.14 0.14 0.14 0.02 XXX 74220 A Contrast x-ray, esophagus 0.46 1.99 1.84 NA NA 0.08 XXX 74220 TC A Contrast x-ray, esophagus 0.00 1.82 1.67 NA NA 0.06 XXX 74220 26 A Contrast x-ray, esophagus 0.46 0.17 0.17 0.17 0.17 0.02 XXX 74230 A Cine/vid x-ray, throat/esoph 0.53 1.94 1.83 NA NA 0.09 XXX 74230 TC A Cine/vid x-ray, throat/esoph 0.00 1.73 1.63 NA NA 0.07 XXX 74230 26 A Cine/vid x-ray, throat/esoph 0.53 0.21 0.20 0.21 0.20 0.02 XXX 74235 C Remove esophagus obstruction 0.00 0.00 0.00 NA NA 0.00 XXX 74235 TC C Remove esophagus obstruction 0.00 0.00 0.00 NA NA 0.00 XXX 74235 26 A Remove esophagus obstruction 1.19 0.51 0.48 0.51 0.48 0.05 XXX 74240 A X-ray exam, upper gi tract 0.69 2.30 2.15 NA NA 0.11 XXX 74240 TC A X-ray exam, upper gi tract 0.00 2.03 1.89 NA NA 0.08 XXX 74240 26 A X-ray exam, upper gi tract 0.69 0.27 0.26 0.27 0.26 0.03 XXX 74241 A X-ray exam, upper gi tract 0.69 2.55 2.34 NA NA 0.11 XXX 74241 TC A X-ray exam, upper gi tract 0.00 2.29 2.09 NA NA 0.08 XXX 74241 26 A X-ray exam, upper gi tract 0.69 0.26 0.25 0.26 0.25 0.03 XXX 74245 A X-ray exam, upper gi tract 0.91 3.93 3.63 NA NA 0.17 XXX 74245 TC A X-ray exam, upper gi tract 0.00 3.58 3.29 NA NA 0.13 XXX 74245 26 A X-ray exam, upper gi tract 0.91 0.35 0.34 0.35 0.34 0.04 XXX 74246 A Contrst x-ray uppr gi tract 0.69 2.78 2.56 NA NA 0.13 XXX 74246 TC A Contrst x-ray uppr gi tract 0.00 2.51 2.30 NA NA 0.10 XXX 74246 26 A Contrst x-ray uppr gi tract 0.69 0.27 0.26 0.27 0.26 0.03 XXX 74247 A Contrst x-ray uppr gi tract 0.69 3.20 2.88 NA NA 0.14 XXX 74247 TC A Contrst x-ray uppr gi tract 0.00 2.93 2.62 NA NA 0.11 XXX 74247 26 A Contrst x-ray uppr gi tract 0.69 0.27 0.26 0.27 0.26 0.03 XXX 74249 A Contrst x-ray uppr gi tract 0.91 4.31 3.96 NA NA 0.18 XXX 74249 TC A Contrst x-ray uppr gi tract 0.00 3.96 3.62 NA NA 0.14 XXX 74249 26 A Contrst x-ray uppr gi tract 0.91 0.35 0.34 0.35 0.34 0.04 XXX 74250 A X-ray exam of small bowel 0.47 2.46 2.21 NA NA 0.09 XXX 74250 TC A X-ray exam of small bowel 0.00 2.28 2.04 NA NA 0.07 XXX 74250 26 A X-ray exam of small bowel 0.47 0.18 0.17 0.18 0.17 0.02 XXX 74251 A X-ray exam of small bowel 0.69 9.90 7.82 NA NA 0.10 XXX 74251 TC A X-ray exam of small bowel 0.00 9.63 7.56 NA NA 0.07 XXX 74251 26 A X-ray exam of small bowel 0.69 0.27 0.26 0.27 0.26 0.03 XXX 74260 A X-ray exam of small bowel 0.50 8.21 6.58 NA NA 0.10 XXX

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. 1299 Mal- Practice RVUs 2 Global CPT 1 / HCPCS Mod Status Description RVUs 2 RVUs 2 RVUs 2 RVUs 2 RVUs 2 74260 TC A X-ray exam of small bowel 0.00 8.02 6.40 NA NA 0.08 XXX 74260 26 A X-ray exam of small bowel 0.50 0.19 0.18 0.19 0.18 0.02 XXX 74270 A Contrast x-ray exam of colon 0.69 3.56 3.15 NA NA 0.14 XXX 74270 TC A Contrast x-ray exam of colon 0.00 3.29 2.89 NA NA 0.11 XXX 74270 26 A Contrast x-ray exam of colon 0.69 0.27 0.26 0.27 0.26 0.03 XXX 74280 A Contrast x-ray exam of colon 0.99 4.92 4.34 NA NA 0.17 XXX 74280 TC A Contrast x-ray exam of colon 0.00 4.54 3.97 NA NA 0.13 XXX 74280 26 A Contrast x-ray exam of colon 0.99 0.38 0.37 0.38 0.37 0.04 XXX 74283 A Contrast x-ray exam of colon 2.02 3.53 3.45 NA NA 0.23 XXX 74283 TC A Contrast x-ray exam of colon 0.00 2.76 2.71 NA NA 0.14 XXX 74283 26 A Contrast x-ray exam of colon 2.02 0.77 0.74 0.77 0.74 0.09 XXX 74290 A Contrast x-ray, gallbladder 0.32 1.57 1.39 NA NA 0.06 XXX 74290 TC A Contrast x-ray, gallbladder 0.00 1.45 1.27 NA NA 0.05 XXX 74290 26 A Contrast x-ray, gallbladder 0.32 0.12 0.12 0.12 0.12 0.01 XXX 74291 A Contrast x-rays, gallbladder 0.20 1.57 1.29 NA NA 0.03 XXX 74291 TC A Contrast x-rays, gallbladder 0.00 1.49 1.22 NA NA 0.02 XXX 74291 26 A Contrast x-rays, gallbladder 0.20 0.08 0.07 0.08 0.07 0.01 XXX 74300 C X-ray bile ducts/pancreas 0.00 0.00 0.00 NA NA 0.00 XXX 74300 TC C X-ray bile ducts/pancreas 0.00 0.00 0.00 NA NA 0.00 XXX 74300 26 A X-ray bile ducts/pancreas 0.36 0.14 0.13 0.14 0.13 0.02 XXX 74301 C X-rays at surgery add-on 0.00 0.00 0.00 NA NA 0.00 ZZZ 74301 TC C X-rays at surgery add-on 0.00 0.00 0.00 NA NA 0.00 ZZZ 74301 26 A X-rays at surgery add-on 0.21 0.08 0.08 0.08 0.08 0.01 ZZZ 74305 C X-ray bile ducts/pancreas 0.00 0.00 0.00 NA NA 0.00 XXX 74305 TC C X-ray bile ducts/pancreas 0.00 0.00 0.00 NA NA 0.00 XXX 74305 26 A X-ray bile ducts/pancreas 0.42 0.17 0.16 0.17 0.16 0.02 XXX 74320 A Contrast x-ray of bile ducts 0.54 2.13 2.44 NA NA 0.19 XXX 74320 TC A Contrast x-ray of bile ducts 0.00 1.91 2.23 NA NA 0.17 XXX 74320 26 A Contrast x-ray of bile ducts 0.54 0.22 0.21 0.22 0.21 0.02 XXX 74327 A X-ray bile stone removal 0.70 2.98 2.74 NA NA 0.14 XXX 74327 TC A X-ray bile stone removal 0.00 2.70 2.47 NA NA 0.11 XXX 74327 26 A X-ray bile stone removal 0.70 0.28 0.27 0.28 0.27 0.03 XXX 74328 C X-ray bile duct endoscopy 0.00 0.00 0.00 NA NA 0.00 XXX 74328 TC C X-ray bile duct endoscopy 0.00 0.00 0.00 NA NA 0.00 XXX 74328 26 A X-ray bile duct endoscopy 0.70 0.28 0.27 0.28 0.27 0.03 XXX 74329 C X-ray for pancreas endoscopy 0.00 0.00 0.00 NA NA 0.00 XXX 74329 TC C X-ray for pancreas endoscopy 0.00 0.00 0.00 NA NA 0.00 XXX 74329 26 A X-ray for pancreas endoscopy 0.70 0.28 0.27 0.28 0.27 0.03 XXX 74330 C X-ray bile/panc endoscopy 0.00 0.00 0.00 NA NA 0.00 XXX 74330 TC C X-ray bile/panc endoscopy 0.00 0.00 0.00 NA NA 0.00 XXX 74330 26 A X-ray bile/panc endoscopy 0.90 0.36 0.34 0.36 0.34 0.04 XXX 74340 C X-ray guide for GI tube 0.00 0.00 0.00 NA NA 0.00 XXX 74340 TC C X-ray guide for GI tube 0.00 0.00 0.00 NA NA 0.00 XXX 74340 26 A X-ray guide for GI tube 0.54 0.21 0.20 0.21 0.20 0.02 XXX 74355 C X-ray guide, intestinal tube 0.00 0.00 0.00 NA NA 0.00 XXX 74355 TC C X-ray guide, intestinal tube 0.00 0.00 0.00 NA NA 0.00 XXX 74355 26 A X-ray guide, intestinal tube 0.76 0.31 0.29 0.31 0.29 0.03 XXX 74360 C X-ray guide, GI dilation 0.00 0.00 0.00 NA NA 0.00 XXX

<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 />

1298<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 />

74182 TC A Mri abdomen w/dye 0.00 16.53 15.79 NA NA 0.52 XXX<br />

74182 26 A Mri abdomen w/dye 1.73 0.66 0.64 0.66 0.64 0.08 XXX<br />

74183 A Mri abdomen w/o & w/dye 2.26 18.74 20.51 NA NA 1.02 XXX<br />

74183 TC A Mri abdomen w/o & w/dye 0.00 17.88 19.68 NA NA 0.92 XXX<br />

74183 26 A Mri abdomen w/o & w/dye 2.26 0.86 0.83 0.86 0.83 0.10 XXX<br />

74185 R Mri angio, abdom w orw/o dye 1.80 14.91 14.17 NA NA 0.67 XXX<br />

74185 TC R Mri angio, abdom w orw/o dye 0.00 14.22 13.50 NA NA 0.59 XXX<br />

74185 26 R Mri angio, abdom w orw/o dye 1.80 0.69 0.67 0.69 0.67 0.08 XXX<br />

74190 C X-ray exam of peritoneum 0.00 0.00 0.00 NA NA 0.00 XXX<br />

74190 TC C X-ray exam of peritoneum 0.00 0.00 0.00 NA NA 0.00 XXX<br />

74190 26 A X-ray exam of peritoneum 0.48 0.19 0.18 0.19 0.18 0.02 XXX<br />

74210 A Contrst x-ray exam of throat 0.36 1.76 1.66 NA NA 0.08 XXX<br />

74210 TC A Contrst x-ray exam of throat 0.00 1.62 1.52 NA NA 0.06 XXX<br />

74210 26 A Contrst x-ray exam of throat 0.36 0.14 0.14 0.14 0.14 0.02 XXX<br />

74220 A Contrast x-ray, esophagus 0.46 1.99 1.84 NA NA 0.08 XXX<br />

74220 TC A Contrast x-ray, esophagus 0.00 1.82 1.67 NA NA 0.06 XXX<br />

74220 26 A Contrast x-ray, esophagus 0.46 0.17 0.17 0.17 0.17 0.02 XXX<br />

74230 A Cine/vid x-ray, throat/esoph 0.53 1.94 1.83 NA NA 0.09 XXX<br />

74230 TC A Cine/vid x-ray, throat/esoph 0.00 1.73 1.63 NA NA 0.07 XXX<br />

74230 26 A Cine/vid x-ray, throat/esoph 0.53 0.21 0.20 0.21 0.20 0.02 XXX<br />

74235 C Remove esophagus obstruction 0.00 0.00 0.00 NA NA 0.00 XXX<br />

74235 TC C Remove esophagus obstruction 0.00 0.00 0.00 NA NA 0.00 XXX<br />

74235 26 A Remove esophagus obstruction 1.19 0.51 0.48 0.51 0.48 0.05 XXX<br />

74240 A X-ray exam, upper gi tract 0.69 2.30 2.15 NA NA 0.11 XXX<br />

74240 TC A X-ray exam, upper gi tract 0.00 2.03 1.89 NA NA 0.08 XXX<br />

74240 26 A X-ray exam, upper gi tract 0.69 0.27 0.26 0.27 0.26 0.03 XXX<br />

74241 A X-ray exam, upper gi tract 0.69 2.55 2.34 NA NA 0.11 XXX<br />

74241 TC A X-ray exam, upper gi tract 0.00 2.29 2.09 NA NA 0.08 XXX<br />

74241 26 A X-ray exam, upper gi tract 0.69 0.26 0.25 0.26 0.25 0.03 XXX<br />

74245 A X-ray exam, upper gi tract 0.91 3.93 3.63 NA NA 0.17 XXX<br />

74245 TC A X-ray exam, upper gi tract 0.00 3.58 3.29 NA NA 0.13 XXX<br />

74245 26 A X-ray exam, upper gi tract 0.91 0.35 0.34 0.35 0.34 0.04 XXX<br />

74246 A Contrst x-ray uppr gi tract 0.69 2.78 2.56 NA NA 0.13 XXX<br />

74246 TC A Contrst x-ray uppr gi tract 0.00 2.51 2.30 NA NA 0.10 XXX<br />

74246 26 A Contrst x-ray uppr gi tract 0.69 0.27 0.26 0.27 0.26 0.03 XXX<br />

74247 A Contrst x-ray uppr gi tract 0.69 3.20 2.88 NA NA 0.14 XXX<br />

74247 TC A Contrst x-ray uppr gi tract 0.00 2.93 2.62 NA NA 0.11 XXX<br />

74247 26 A Contrst x-ray uppr gi tract 0.69 0.27 0.26 0.27 0.26 0.03 XXX<br />

74249 A Contrst x-ray uppr gi tract 0.91 4.31 3.96 NA NA 0.18 XXX<br />

74249 TC A Contrst x-ray uppr gi tract 0.00 3.96 3.62 NA NA 0.14 XXX<br />

74249 26 A Contrst x-ray uppr gi tract 0.91 0.35 0.34 0.35 0.34 0.04 XXX<br />

74250 A X-ray exam of small bowel 0.47 2.46 2.21 NA NA 0.09 XXX<br />

74250 TC A X-ray exam of small bowel 0.00 2.28 2.04 NA NA 0.07 XXX<br />

74250 26 A X-ray exam of small bowel 0.47 0.18 0.17 0.18 0.17 0.02 XXX<br />

74251 A X-ray exam of small bowel 0.69 9.90 7.82 NA NA 0.10 XXX<br />

74251 TC A X-ray exam of small bowel 0.00 9.63 7.56 NA NA 0.07 XXX<br />

74251 26 A X-ray exam of small bowel 0.69 0.27 0.26 0.27 0.26 0.03 XXX<br />

74260 A X-ray exam of small bowel 0.50 8.21 6.58 NA NA 0.10 XXX

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