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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.
1364
Mal-
Practice
RVUs 2 Global
CPT 1 /
HCPCS Mod Status Description
RVUs 2
RVUs 2
RVUs 2
RVUs 2
RVUs 2
G0181 A Home health care supervision 1.73 0.82 0.98 NA NA 0.07 XXX
G0182 A Hospice care supervision 1.73 0.83 1.04 NA NA 0.07 XXX
G0186 C Dstry eye lesn,fdr vssl tech 0.00 0.00 0.00 0.00 0.00 0.00 YYY
G0202 A Screeningmammographydigital 0.70 2.80 2.80 NA NA 0.10 XXX
G0202 TC A Screeningmammographydigital 0.00 2.56 2.56 NA NA 0.07 XXX
G0202 26 A Screeningmammographydigital 0.70 0.24 0.24 0.24 0.24 0.03 XXX
G0204 A Diagnosticmammographydigital 0.87 3.40 3.25 NA NA 0.11 XXX
G0204 TC A Diagnosticmammographydigital 0.00 3.10 2.96 NA NA 0.07 XXX
G0204 26 A Diagnosticmammographydigital 0.87 0.30 0.29 0.30 0.29 0.04 XXX
G0206 A Diagnosticmammographydigital 0.70 2.67 2.57 NA NA 0.09 XXX
G0206 TC A Diagnosticmammographydigital 0.00 2.43 2.33 NA NA 0.06 XXX
G0206 26 A Diagnosticmammographydigital 0.70 0.24 0.24 0.24 0.24 0.03 XXX
G0219 N PET img wholbod melano nonco 0.00 0.00 0.00 NA NA 0.00 XXX
G0219 TC N PET img wholbod melano nonco 0.00 0.00 0.00 NA NA 0.00 XXX
G0219 26 N PET img wholbod melano nonco 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G0235 N PET not otherwise specified 0.00 0.00 0.00 NA NA 0.00 XXX
G0235 TC N PET not otherwise specified 0.00 0.00 0.00 NA NA 0.00 XXX
G0235 26 N PET not otherwise specified 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G0237 A Therapeutic procd strg endur 0.00 0.20 0.27 NA NA 0.02 XXX
G0238 A Oth resp proc, indiv 0.00 0.22 0.29 NA NA 0.02 XXX
G0239 A Oth resp proc, group 0.00 0.29 0.30 NA NA 0.02 XXX
G0245 R Initial foot exam pt lops 0.88 0.85 0.83 0.32 0.32 0.04 XXX
G0246 R Followup eval of foot pt lop 0.45 0.55 0.55 0.16 0.16 0.02 XXX
G0247 R Routine footcare pt w lops 0.50 0.66 0.62 0.16 0.17 0.02 ZZZ
G0248 R Demonstrate use home inr mon 0.00 3.26 4.11 NA NA 0.01 XXX
G0249 R Provide INR test mater/equip 0.00 3.33 3.49 NA NA 0.01 XXX
G0250 R MD INR test revie inter mgmt 0.18 0.08 0.08 NA NA 0.01 XXX
G0251 E Linear acc based stero radio 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G0252 N PET imaging initial dx 0.00 0.00 0.00 NA NA 0.00 XXX
G0252 TC N PET imaging initial dx 0.00 0.00 0.00 NA NA 0.00 XXX
G0252 26 N PET imaging initial dx 1.50 0.00 0.60 0.00 0.60 0.04 XXX
G0255 N Current percep threshold tst 0.00 0.00 0.00 NA NA 0.00 XXX
G0255 TC N Current percep threshold tst 0.00 0.00 0.00 NA NA 0.00 XXX
G0255 26 N Current percep threshold tst 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G0257 E Unsched dialysis ESRD pt hos 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G0259 E Inject for sacroiliac joint 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G0260 E Inj for sacroiliac jt anesth 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G0268 A Removal of impacted wax md 0.61 0.67 0.66 0.21 0.22 0.02 000
G0269 B Occlusive device in vein art 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G0270 A MNT subs tx for change dx 0.37 0.18 0.25 0.11 0.20 0.01 XXX
G0271 A Group MNT 2 or more 30 mins 0.25 0.07 0.10 0.07 0.10 0.01 XXX
G0275 A Renal angio, cardiac cath 0.25 NA NA 0.13 0.13 0.01 ZZZ
G0278 A Iliac art angio,cardiac cath 0.25 NA NA 0.14 0.13 0.01 ZZZ
G0281 A Elec stim unattend for press 0.18 0.14 0.13 NA NA 0.01 XXX
G0282 N Elect stim wound care not pd 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G0283 A Elec stim other than wound 0.18 0.14 0.13 NA NA 0.01 XXX
G0288 A Recon, CTA for surg plan 0.00 0.98 3.40 NA NA 0.18 XXX
G0289 A Arthro, loose body + chondro 1.48 NA NA 0.63 0.67 0.26 ZZZ