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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. 1312 Mal- Practice RVUs 2 Global CPT 1 / HCPCS Mod Status Description RVUs 2 RVUs 2 RVUs 2 RVUs 2 RVUs 2 76975 TC C GI endoscopic ultrasound 0.00 0.00 0.00 NA NA 0.00 XXX 76975 26 A GI endoscopic ultrasound 0.81 0.32 0.31 0.32 0.31 0.04 XXX 76977 A Us bone density measure 0.05 0.10 0.29 NA NA 0.06 XXX 76977 TC A Us bone density measure 0.00 0.09 0.27 NA NA 0.05 XXX 76977 26 A Us bone density measure 0.05 0.01 0.02 0.01 0.02 0.01 XXX 76998 C Us guide, intraop 0.00 0.00 0.00 NA NA 0.00 XXX 76998 TC C Us guide, intraop 0.00 0.00 0.00 NA NA 0.00 XXX 76998 26 A Us guide, intraop 1.20 0.38 0.39 0.38 0.39 0.13 XXX 76999 C Echo examination procedure 0.00 0.00 0.00 NA NA 0.00 XXX 76999 TC C Echo examination procedure 0.00 0.00 0.00 NA NA 0.00 XXX 76999 26 C Echo examination procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77001 A Fluoroguide for vein device 0.38 2.70 2.39 NA NA 0.11 ZZZ 77001 TC A Fluoroguide for vein device 0.00 2.56 2.25 NA NA 0.10 ZZZ 77001 26 A Fluoroguide for vein device 0.38 0.14 0.14 0.14 0.14 0.01 ZZZ 77002 A Needle localization by xray 0.54 1.27 1.33 NA NA 0.09 XXX 77002 TC A Needle localization by xray 0.00 1.09 1.15 NA NA 0.07 XXX 77002 26 A Needle localization by xray 0.54 0.18 0.18 0.18 0.18 0.02 XXX 77003 A Fluoroguide for spine inject 0.60 0.76 0.94 NA NA 0.10 XXX 77003 TC A Fluoroguide for spine inject 0.00 0.61 0.79 NA NA 0.07 XXX 77003 26 A Fluoroguide for spine inject 0.60 0.15 0.15 0.15 0.15 0.03 XXX 77011 A Ct scan for localization 1.21 19.78 17.03 NA NA 0.47 XXX 77011 TC A Ct scan for localization 0.00 19.34 16.60 NA NA 0.42 XXX 77011 26 A Ct scan for localization 1.21 0.44 0.43 0.44 0.43 0.05 XXX 77012 A Ct scan for needle biopsy 1.16 2.34 3.93 NA NA 0.47 XXX 77012 TC A Ct scan for needle biopsy 0.00 1.89 3.49 NA NA 0.42 XXX 77012 26 A Ct scan for needle biopsy 1.16 0.45 0.44 0.45 0.44 0.05 XXX 77013 C Ct guide for tissue ablation 0.00 0.00 0.00 NA NA 0.00 XXX 77013 TC C Ct guide for tissue ablation 0.00 0.00 0.00 NA NA 0.00 XXX 77013 26 A Ct guide for tissue ablation 3.99 1.59 1.52 1.59 1.52 0.18 XXX 77014 A Ct scan for therapy guide 0.85 4.35 4.08 NA NA 0.20 XXX 77014 TC A Ct scan for therapy guide 0.00 4.05 3.79 NA NA 0.16 XXX 77014 26 A Ct scan for therapy guide 0.85 0.30 0.29 0.30 0.29 0.04 XXX 77021 A Mr guidance for needle place 1.50 9.77 10.28 NA NA 0.64 XXX 77021 TC A Mr guidance for needle place 0.00 9.20 9.72 NA NA 0.55 XXX 77021 26 A Mr guidance for needle place 1.50 0.57 0.56 0.57 0.56 0.09 XXX 77022 C Mri for tissue ablation 0.00 0.00 0.00 NA NA 0.00 XXX 77022 TC C Mri for tissue ablation 0.00 0.00 0.00 NA NA 0.00 XXX 77022 26 A Mri for tissue ablation 4.24 1.52 1.49 1.52 1.49 0.24 XXX 77031 A Stereotact guide for brst bx 1.59 1.89 3.35 NA NA 0.46 XXX 77031 TC A Stereotact guide for brst bx 0.00 1.31 2.78 NA NA 0.37 XXX 77031 26 A Stereotact guide for brst bx 1.59 0.58 0.57 0.58 0.57 0.09 XXX 77032 A Guidance for needle, breast 0.56 0.85 1.01 NA NA 0.09 XXX 77032 TC A Guidance for needle, breast 0.00 0.63 0.80 NA NA 0.07 XXX 77032 26 A Guidance for needle, breast 0.56 0.22 0.21 0.22 0.21 0.02 XXX 77051 A Computer dx mammogram add-on 0.06 0.20 0.26 NA NA 0.02 ZZZ 77051 TC A Computer dx mammogram add-on 0.00 0.18 0.24 NA NA 0.01 ZZZ 77051 26 A Computer dx mammogram add-on 0.06 0.02 0.02 0.02 0.02 0.01 ZZZ 77052 A Comp screen mammogram add-on 0.06 0.19 0.26 NA NA 0.02 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. 1313 Mal- Practice RVUs 2 Global CPT 1 / HCPCS Mod Status Description RVUs 2 RVUs 2 RVUs 2 RVUs 2 RVUs 2 77052 TC A Comp screen mammogram add-on 0.00 0.17 0.24 NA NA 0.01 ZZZ 77052 26 A Comp screen mammogram add-on 0.06 0.02 0.02 0.02 0.02 0.01 ZZZ 77053 A X-ray of mammary duct 0.36 1.23 1.61 NA NA 0.16 XXX 77053 TC A X-ray of mammary duct 0.00 1.09 1.48 NA NA 0.14 XXX 77053 26 A X-ray of mammary duct 0.36 0.14 0.13 0.14 0.13 0.02 XXX 77054 A X-ray of mammary ducts 0.45 1.66 2.21 NA NA 0.21 XXX 77054 TC A X-ray of mammary ducts 0.00 1.49 2.04 NA NA 0.19 XXX 77054 26 A X-ray of mammary ducts 0.45 0.17 0.17 0.17 0.17 0.02 XXX 77055 A Mammogram, one breast 0.70 1.64 1.56 NA NA 0.09 XXX 77055 TC A Mammogram, one breast 0.00 1.37 1.30 NA NA 0.06 XXX 77055 26 A Mammogram, one breast 0.70 0.27 0.26 0.27 0.26 0.03 XXX 77056 A Mammogram, both breasts 0.87 2.14 2.00 NA NA 0.11 XXX 77056 TC A Mammogram, both breasts 0.00 1.81 1.68 NA NA 0.07 XXX 77056 26 A Mammogram, both breasts 0.87 0.33 0.32 0.33 0.32 0.04 XXX 77057 A Mammogram, screening 0.70 1.45 1.46 NA NA 0.10 XXX 77057 TC A Mammogram, screening 0.00 1.18 1.20 NA NA 0.07 XXX 77057 26 A Mammogram, screening 0.70 0.27 0.26 0.27 0.26 0.03 XXX 77058 A Mri, one breast 1.63 21.45 20.67 NA NA 0.99 XXX 77058 TC A Mri, one breast 0.00 20.83 20.07 NA NA 0.92 XXX 77058 26 A Mri, one breast 1.63 0.62 0.60 0.62 0.60 0.07 XXX 77059 A Mri, both breasts 1.63 21.31 22.15 NA NA 1.31 XXX 77059 TC A Mri, both breasts 0.00 20.69 21.55 NA NA 1.24 XXX 77059 26 A Mri, both breasts 1.63 0.62 0.60 0.62 0.60 0.07 XXX 77071 A X-ray stress view 0.41 0.76 0.62 0.76 0.62 0.06 XXX 77072 A X-rays for bone age 0.19 0.43 0.43 NA NA 0.03 XXX 77072 TC A X-rays for bone age 0.00 0.36 0.36 NA NA 0.02 XXX 77072 26 A X-rays for bone age 0.19 0.07 0.07 0.07 0.07 0.01 XXX 77073 A X-rays, bone length studies 0.27 0.66 0.71 NA NA 0.06 XXX 77073 TC A X-rays, bone length studies 0.00 0.55 0.61 NA NA 0.05 XXX 77073 26 A X-rays, bone length studies 0.27 0.11 0.10 0.11 0.10 0.01 XXX 77074 A X-rays, bone survey, limited 0.45 1.43 1.37 NA NA 0.08 XXX 77074 TC A X-rays, bone survey, limited 0.00 1.26 1.20 NA NA 0.06 XXX 77074 26 A X-rays, bone survey, limited 0.45 0.17 0.17 0.17 0.17 0.02 XXX 77075 A X-rays, bone survey complete 0.54 2.28 2.11 NA NA 0.10 XXX 77075 TC A X-rays, bone survey complete 0.00 2.07 1.91 NA NA 0.08 XXX 77075 26 A X-rays, bone survey complete 0.54 0.21 0.20 0.21 0.20 0.02 XXX 77076 A X-rays, bone survey, infant 0.70 2.05 1.78 NA NA 0.08 XXX 77076 TC A X-rays, bone survey, infant 0.00 1.84 1.56 NA NA 0.05 XXX 77076 26 A X-rays, bone survey, infant 0.70 0.21 0.22 0.21 0.22 0.03 XXX 77077 A Joint survey, single view 0.31 0.65 0.79 NA NA 0.08 XXX 77077 TC A Joint survey, single view 0.00 0.53 0.68 NA NA 0.06 XXX 77077 26 A Joint survey, single view 0.31 0.12 0.11 0.12 0.11 0.02 XXX 77078 A Ct bone density, axial 0.25 4.70 4.30 NA NA 0.17 XXX 77078 TC A Ct bone density, axial 0.00 4.61 4.21 NA NA 0.16 XXX 77078 26 A Ct bone density, axial 0.25 0.09 0.09 0.09 0.09 0.01 XXX 77079 A Ct bone density, peripheral 0.22 0.74 1.31 NA NA 0.06 XXX 77079 TC A Ct bone density, peripheral 0.00 0.68 1.25 NA NA 0.05 XXX 77079 26 A Ct bone density, peripheral 0.22 0.06 0.06 0.06 0.06 0.01 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 />

1312<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 />

76975 TC C GI endoscopic ultrasound 0.00 0.00 0.00 NA NA 0.00 XXX<br />

76975 26 A GI endoscopic ultrasound 0.81 0.32 0.31 0.32 0.31 0.04 XXX<br />

76977 A Us bone density measure 0.05 0.10 0.29 NA NA 0.06 XXX<br />

76977 TC A Us bone density measure 0.00 0.09 0.27 NA NA 0.05 XXX<br />

76977 26 A Us bone density measure 0.05 0.01 0.02 0.01 0.02 0.01 XXX<br />

76998 C Us guide, intraop 0.00 0.00 0.00 NA NA 0.00 XXX<br />

76998 TC C Us guide, intraop 0.00 0.00 0.00 NA NA 0.00 XXX<br />

76998 26 A Us guide, intraop 1.20 0.38 0.39 0.38 0.39 0.13 XXX<br />

76999 C Echo examination procedure 0.00 0.00 0.00 NA NA 0.00 XXX<br />

76999 TC C Echo examination procedure 0.00 0.00 0.00 NA NA 0.00 XXX<br />

76999 26 C Echo examination procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX<br />

77001 A Fluoroguide for vein device 0.38 2.70 2.39 NA NA 0.11 ZZZ<br />

77001 TC A Fluoroguide for vein device 0.00 2.56 2.25 NA NA 0.10 ZZZ<br />

77001 26 A Fluoroguide for vein device 0.38 0.14 0.14 0.14 0.14 0.01 ZZZ<br />

77002 A Needle localization by xray 0.54 1.27 1.33 NA NA 0.09 XXX<br />

77002 TC A Needle localization by xray 0.00 1.09 1.15 NA NA 0.07 XXX<br />

77002 26 A Needle localization by xray 0.54 0.18 0.18 0.18 0.18 0.02 XXX<br />

77003 A Fluoroguide for spine inject 0.60 0.76 0.94 NA NA 0.10 XXX<br />

77003 TC A Fluoroguide for spine inject 0.00 0.61 0.79 NA NA 0.07 XXX<br />

77003 26 A Fluoroguide for spine inject 0.60 0.15 0.15 0.15 0.15 0.03 XXX<br />

77011 A Ct scan for localization 1.21 19.78 17.03 NA NA 0.47 XXX<br />

77011 TC A Ct scan for localization 0.00 19.34 16.60 NA NA 0.42 XXX<br />

77011 26 A Ct scan for localization 1.21 0.44 0.43 0.44 0.43 0.05 XXX<br />

77012 A Ct scan for needle biopsy 1.16 2.34 3.93 NA NA 0.47 XXX<br />

77012 TC A Ct scan for needle biopsy 0.00 1.89 3.49 NA NA 0.42 XXX<br />

77012 26 A Ct scan for needle biopsy 1.16 0.45 0.44 0.45 0.44 0.05 XXX<br />

77013 C Ct guide for tissue ablation 0.00 0.00 0.00 NA NA 0.00 XXX<br />

77013 TC C Ct guide for tissue ablation 0.00 0.00 0.00 NA NA 0.00 XXX<br />

77013 26 A Ct guide for tissue ablation 3.99 1.59 1.52 1.59 1.52 0.18 XXX<br />

77014 A Ct scan for therapy guide 0.85 4.35 4.08 NA NA 0.20 XXX<br />

77014 TC A Ct scan for therapy guide 0.00 4.05 3.79 NA NA 0.16 XXX<br />

77014 26 A Ct scan for therapy guide 0.85 0.30 0.29 0.30 0.29 0.04 XXX<br />

77021 A Mr guidance for needle place 1.50 9.77 10.28 NA NA 0.64 XXX<br />

77021 TC A Mr guidance for needle place 0.00 9.20 9.72 NA NA 0.55 XXX<br />

77021 26 A Mr guidance for needle place 1.50 0.57 0.56 0.57 0.56 0.09 XXX<br />

77022 C Mri for tissue ablation 0.00 0.00 0.00 NA NA 0.00 XXX<br />

77022 TC C Mri for tissue ablation 0.00 0.00 0.00 NA NA 0.00 XXX<br />

77022 26 A Mri for tissue ablation 4.24 1.52 1.49 1.52 1.49 0.24 XXX<br />

77031 A Stereotact guide for brst bx 1.59 1.89 3.35 NA NA 0.46 XXX<br />

77031 TC A Stereotact guide for brst bx 0.00 1.31 2.78 NA NA 0.37 XXX<br />

77031 26 A Stereotact guide for brst bx 1.59 0.58 0.57 0.58 0.57 0.09 XXX<br />

77032 A Guidance for needle, breast 0.56 0.85 1.01 NA NA 0.09 XXX<br />

77032 TC A Guidance for needle, breast 0.00 0.63 0.80 NA NA 0.07 XXX<br />

77032 26 A Guidance for needle, breast 0.56 0.22 0.21 0.22 0.21 0.02 XXX<br />

77051 A Computer dx mammogram add-on 0.06 0.20 0.26 NA NA 0.02 ZZZ<br />

77051 TC A Computer dx mammogram add-on 0.00 0.18 0.24 NA NA 0.01 ZZZ<br />

77051 26 A Computer dx mammogram add-on 0.06 0.02 0.02 0.02 0.02 0.01 ZZZ<br />

77052 A Comp screen mammogram add-on 0.06 0.19 0.26 NA NA 0.02 ZZZ

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