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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. 1306 Mal- Practice RVUs 2 Global CPT 1 / HCPCS Mod Status Description RVUs 2 RVUs 2 RVUs 2 RVUs 2 RVUs 2 75960 TC A Transcath iv stent rs&i 0.00 2.30 5.47 NA NA 0.77 XXX 75960 26 A Transcath iv stent rs&i 0.82 0.33 0.32 0.33 0.32 0.05 XXX 75961 A Retrieval, broken catheter 4.24 4.77 6.57 NA NA 0.73 XXX 75961 TC A Retrieval, broken catheter 0.00 3.11 4.98 NA NA 0.55 XXX 75961 26 A Retrieval, broken catheter 4.24 1.66 1.59 1.66 1.59 0.18 XXX 75962 A Repair arterial blockage 0.54 3.38 6.54 NA NA 0.86 XXX 75962 TC A Repair arterial blockage 0.00 3.18 6.34 NA NA 0.83 XXX 75962 26 A Repair arterial blockage 0.54 0.20 0.20 0.20 0.20 0.03 XXX 75964 A Repair artery blockage, each 0.36 2.28 3.85 NA NA 0.46 ZZZ 75964 TC A Repair artery blockage, each 0.00 2.15 3.72 NA NA 0.43 ZZZ 75964 26 A Repair artery blockage, each 0.36 0.13 0.13 0.13 0.13 0.03 ZZZ 75966 A Repair arterial blockage 1.31 4.01 7.08 NA NA 0.89 XXX 75966 TC A Repair arterial blockage 0.00 3.43 6.53 NA NA 0.83 XXX 75966 26 A Repair arterial blockage 1.31 0.58 0.55 0.58 0.55 0.06 XXX 75968 A Repair artery blockage, each 0.36 2.31 3.87 NA NA 0.45 ZZZ 75968 TC A Repair artery blockage, each 0.00 2.15 3.72 NA NA 0.43 ZZZ 75968 26 A Repair artery blockage, each 0.36 0.16 0.15 0.16 0.15 0.02 ZZZ 75970 C Vascular biopsy 0.00 0.00 0.00 NA NA 0.00 XXX 75970 TC C Vascular biopsy 0.00 0.00 0.00 NA NA 0.00 XXX 75970 26 A Vascular biopsy 0.83 0.34 0.32 0.34 0.32 0.04 XXX 75978 A Repair venous blockage 0.54 3.22 6.42 NA NA 0.85 XXX 75978 TC A Repair venous blockage 0.00 3.03 6.23 NA NA 0.83 XXX 75978 26 A Repair venous blockage 0.54 0.19 0.19 0.19 0.19 0.02 XXX 75980 C Contrast xray exam bile duct 0.00 0.00 0.00 NA NA 0.00 XXX 75980 TC C Contrast xray exam bile duct 0.00 0.00 0.00 NA NA 0.00 XXX 75980 26 A Contrast xray exam bile duct 1.44 0.58 0.55 0.58 0.55 0.06 XXX 75982 C Contrast xray exam bile duct 0.00 0.00 0.00 NA NA 0.00 XXX 75982 TC C Contrast xray exam bile duct 0.00 0.00 0.00 NA NA 0.00 XXX 75982 26 A Contrast xray exam bile duct 1.44 0.58 0.55 0.58 0.55 0.06 XXX 75984 A Xray control catheter change 0.72 2.32 2.30 NA NA 0.14 XXX 75984 TC A Xray control catheter change 0.00 2.03 2.02 NA NA 0.11 XXX 75984 26 A Xray control catheter change 0.72 0.29 0.28 0.29 0.28 0.03 XXX 75989 A Abscess drainage under x-ray 1.19 2.27 2.59 NA NA 0.22 XXX 75989 TC A Abscess drainage under x-ray 0.00 1.80 2.14 NA NA 0.17 XXX 75989 26 A Abscess drainage under x-ray 1.19 0.47 0.45 0.47 0.45 0.05 XXX 75992 C Atherectomy, x-ray exam 0.00 0.00 0.00 NA NA 0.00 XXX 75992 TC C Atherectomy, x-ray exam 0.00 0.00 0.00 NA NA 0.00 XXX 75992 26 A Atherectomy, x-ray exam 0.54 0.23 0.22 0.23 0.22 0.03 XXX 75993 C Atherectomy, x-ray exam 0.00 0.00 0.00 NA NA 0.00 ZZZ 75993 TC C Atherectomy, x-ray exam 0.00 0.00 0.00 NA NA 0.00 ZZZ 75993 26 A Atherectomy, x-ray exam 0.36 0.14 0.14 0.14 0.14 0.02 ZZZ 75994 C Atherectomy, x-ray exam 0.00 0.00 0.00 NA NA 0.00 XXX 75994 TC C Atherectomy, x-ray exam 0.00 0.00 0.00 NA NA 0.00 XXX 75994 26 A Atherectomy, x-ray exam 1.31 0.33 0.36 0.33 0.36 0.07 XXX 75995 C Atherectomy, x-ray exam 0.00 0.00 0.00 NA NA 0.00 XXX 75995 TC C Atherectomy, x-ray exam 0.00 0.00 0.00 NA NA 0.00 XXX 75995 26 A Atherectomy, x-ray exam 1.31 0.49 0.48 0.49 0.48 0.05 XXX 75996 C Atherectomy, x-ray exam 0.00 0.00 0.00 NA NA 0.00 ZZZ

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. 1307 Mal- Practice RVUs 2 Global CPT 1 / HCPCS Mod Status Description RVUs 2 RVUs 2 RVUs 2 RVUs 2 RVUs 2 75996 TC C Atherectomy, x-ray exam 0.00 0.00 0.00 NA NA 0.00 ZZZ 75996 26 A Atherectomy, x-ray exam 0.36 0.13 0.13 0.13 0.13 0.02 ZZZ 76000 A Fluoroscope examination 0.17 2.72 2.39 NA NA 0.08 XXX 76000 TC A Fluoroscope examination 0.00 2.66 2.33 NA NA 0.07 XXX 76000 26 A Fluoroscope examination 0.17 0.06 0.06 0.06 0.06 0.01 XXX 76001 C Fluoroscope exam, extensive 0.00 0.00 0.00 NA NA 0.00 XXX 76001 TC C Fluoroscope exam, extensive 0.00 0.00 0.00 NA NA 0.00 XXX 76001 26 A Fluoroscope exam, extensive 0.67 0.26 0.25 0.26 0.25 0.05 XXX 76010 A X-ray, nose to rectum 0.18 0.54 0.56 NA NA 0.03 XXX 76010 TC A X-ray, nose to rectum 0.00 0.47 0.49 NA NA 0.02 XXX 76010 26 A X-ray, nose to rectum 0.18 0.07 0.07 0.07 0.07 0.01 XXX 76080 A X-ray exam of fistula 0.54 1.10 1.14 NA NA 0.08 XXX 76080 TC A X-ray exam of fistula 0.00 0.89 0.93 NA NA 0.06 XXX 76080 26 A X-ray exam of fistula 0.54 0.21 0.21 0.21 0.21 0.02 XXX 76098 A X-ray exam, breast specimen 0.16 0.32 0.36 NA NA 0.03 XXX 76098 TC A X-ray exam, breast specimen 0.00 0.26 0.30 NA NA 0.02 XXX 76098 26 A X-ray exam, breast specimen 0.16 0.06 0.06 0.06 0.06 0.01 XXX 76100 A X-ray exam of body section 0.58 3.53 3.01 NA NA 0.10 XXX 76100 TC A X-ray exam of body section 0.00 3.31 2.80 NA NA 0.07 XXX 76100 26 A X-ray exam of body section 0.58 0.22 0.21 0.22 0.21 0.03 XXX 76101 A Complex body section x-ray 0.58 5.32 4.41 NA NA 0.11 XXX 76101 TC A Complex body section x-ray 0.00 5.12 4.21 NA NA 0.08 XXX 76101 26 A Complex body section x-ray 0.58 0.20 0.20 0.20 0.20 0.03 XXX 76102 A Complex body section x-rays 0.58 7.50 6.12 NA NA 0.14 XXX 76102 TC A Complex body section x-rays 0.00 7.31 5.93 NA NA 0.11 XXX 76102 26 A Complex body section x-rays 0.58 0.19 0.19 0.19 0.19 0.03 XXX 76120 A Cine/video x-rays 0.38 1.75 1.62 NA NA 0.08 XXX 76120 TC A Cine/video x-rays 0.00 1.63 1.49 NA NA 0.06 XXX 76120 26 A Cine/video x-rays 0.38 0.12 0.13 0.12 0.13 0.02 XXX 76125 C Cine/video x-rays add-on 0.00 0.00 0.00 NA NA 0.00 ZZZ 76125 TC C Cine/video x-rays add-on 0.00 0.00 0.00 NA NA 0.00 ZZZ 76125 26 A Cine/video x-rays add-on 0.27 0.13 0.12 0.13 0.12 0.01 ZZZ 76140 I X-ray consultation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76150 A X-ray exam, dry process 0.00 0.51 0.49 NA NA 0.02 XXX 76350 C Special x-ray contrast study 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76376 A 3d render w/o postprocess 0.20 1.39 1.92 NA NA 0.10 XXX 76376 TC A 3d render w/o postprocess 0.00 1.31 1.84 NA NA 0.08 XXX 76376 26 A 3d render w/o postprocess 0.20 0.08 0.08 0.08 0.08 0.02 XXX 76377 A 3d rendering w/postprocess 0.79 1.40 1.98 NA NA 0.39 XXX 76377 TC A 3d rendering w/postprocess 0.00 1.10 1.69 NA NA 0.31 XXX 76377 26 A 3d rendering w/postprocess 0.79 0.30 0.29 0.30 0.29 0.08 XXX 76380 A CAT scan follow-up study 0.98 4.68 4.48 NA NA 0.22 XXX 76380 TC A CAT scan follow-up study 0.00 4.31 4.12 NA NA 0.18 XXX 76380 26 A CAT scan follow-up study 0.98 0.37 0.36 0.37 0.36 0.04 XXX 76390 N Mr spectroscopy 1.40 10.47 10.74 NA NA 0.66 XXX 76390 TC N Mr spectroscopy 0.00 10.00 10.27 NA NA 0.59 XXX 76390 26 N Mr spectroscopy 1.40 0.47 0.47 0.47 0.47 0.07 XXX 76496 C Fluoroscopic procedure 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 />

1306<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 />

75960 TC A Transcath iv stent rs&i 0.00 2.30 5.47 NA NA 0.77 XXX<br />

75960 26 A Transcath iv stent rs&i 0.82 0.33 0.32 0.33 0.32 0.05 XXX<br />

75961 A Retrieval, broken catheter 4.24 4.77 6.57 NA NA 0.73 XXX<br />

75961 TC A Retrieval, broken catheter 0.00 3.11 4.98 NA NA 0.55 XXX<br />

75961 26 A Retrieval, broken catheter 4.24 1.66 1.59 1.66 1.59 0.18 XXX<br />

75962 A Repair arterial blockage 0.54 3.38 6.54 NA NA 0.86 XXX<br />

75962 TC A Repair arterial blockage 0.00 3.18 6.34 NA NA 0.83 XXX<br />

75962 26 A Repair arterial blockage 0.54 0.20 0.20 0.20 0.20 0.03 XXX<br />

75964 A Repair artery blockage, each 0.36 2.28 3.85 NA NA 0.46 ZZZ<br />

75964 TC A Repair artery blockage, each 0.00 2.15 3.72 NA NA 0.43 ZZZ<br />

75964 26 A Repair artery blockage, each 0.36 0.13 0.13 0.13 0.13 0.03 ZZZ<br />

75966 A Repair arterial blockage 1.31 4.01 7.08 NA NA 0.89 XXX<br />

75966 TC A Repair arterial blockage 0.00 3.43 6.53 NA NA 0.83 XXX<br />

75966 26 A Repair arterial blockage 1.31 0.58 0.55 0.58 0.55 0.06 XXX<br />

75968 A Repair artery blockage, each 0.36 2.31 3.87 NA NA 0.45 ZZZ<br />

75968 TC A Repair artery blockage, each 0.00 2.15 3.72 NA NA 0.43 ZZZ<br />

75968 26 A Repair artery blockage, each 0.36 0.16 0.15 0.16 0.15 0.02 ZZZ<br />

75970 C Vascular biopsy 0.00 0.00 0.00 NA NA 0.00 XXX<br />

75970 TC C Vascular biopsy 0.00 0.00 0.00 NA NA 0.00 XXX<br />

75970 26 A Vascular biopsy 0.83 0.34 0.32 0.34 0.32 0.04 XXX<br />

75978 A Repair venous blockage 0.54 3.22 6.42 NA NA 0.85 XXX<br />

75978 TC A Repair venous blockage 0.00 3.03 6.23 NA NA 0.83 XXX<br />

75978 26 A Repair venous blockage 0.54 0.19 0.19 0.19 0.19 0.02 XXX<br />

75980 C Contrast xray exam bile duct 0.00 0.00 0.00 NA NA 0.00 XXX<br />

75980 TC C Contrast xray exam bile duct 0.00 0.00 0.00 NA NA 0.00 XXX<br />

75980 26 A Contrast xray exam bile duct 1.44 0.58 0.55 0.58 0.55 0.06 XXX<br />

75982 C Contrast xray exam bile duct 0.00 0.00 0.00 NA NA 0.00 XXX<br />

75982 TC C Contrast xray exam bile duct 0.00 0.00 0.00 NA NA 0.00 XXX<br />

75982 26 A Contrast xray exam bile duct 1.44 0.58 0.55 0.58 0.55 0.06 XXX<br />

75984 A Xray control catheter change 0.72 2.32 2.30 NA NA 0.14 XXX<br />

75984 TC A Xray control catheter change 0.00 2.03 2.02 NA NA 0.11 XXX<br />

75984 26 A Xray control catheter change 0.72 0.29 0.28 0.29 0.28 0.03 XXX<br />

75989 A Abscess drainage under x-ray 1.19 2.27 2.59 NA NA 0.22 XXX<br />

75989 TC A Abscess drainage under x-ray 0.00 1.80 2.14 NA NA 0.17 XXX<br />

75989 26 A Abscess drainage under x-ray 1.19 0.47 0.45 0.47 0.45 0.05 XXX<br />

75992 C Atherectomy, x-ray exam 0.00 0.00 0.00 NA NA 0.00 XXX<br />

75992 TC C Atherectomy, x-ray exam 0.00 0.00 0.00 NA NA 0.00 XXX<br />

75992 26 A Atherectomy, x-ray exam 0.54 0.23 0.22 0.23 0.22 0.03 XXX<br />

75993 C Atherectomy, x-ray exam 0.00 0.00 0.00 NA NA 0.00 ZZZ<br />

75993 TC C Atherectomy, x-ray exam 0.00 0.00 0.00 NA NA 0.00 ZZZ<br />

75993 26 A Atherectomy, x-ray exam 0.36 0.14 0.14 0.14 0.14 0.02 ZZZ<br />

75994 C Atherectomy, x-ray exam 0.00 0.00 0.00 NA NA 0.00 XXX<br />

75994 TC C Atherectomy, x-ray exam 0.00 0.00 0.00 NA NA 0.00 XXX<br />

75994 26 A Atherectomy, x-ray exam 1.31 0.33 0.36 0.33 0.36 0.07 XXX<br />

75995 C Atherectomy, x-ray exam 0.00 0.00 0.00 NA NA 0.00 XXX<br />

75995 TC C Atherectomy, x-ray exam 0.00 0.00 0.00 NA NA 0.00 XXX<br />

75995 26 A Atherectomy, x-ray exam 1.31 0.49 0.48 0.49 0.48 0.05 XXX<br />

75996 C Atherectomy, x-ray exam 0.00 0.00 0.00 NA NA 0.00 ZZZ

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