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CMS-1403-FC CPT 1 / HCPCS Mod Status Description Physi- cian Work RVUs 2 Fully Imple- mented Non- Facility PE 52344 A Cysto/uretero, stricture tx 7.05 NA NA 3.83 3.58 0.55 000 52345 A Cysto/uretero w/up stricture 7.55 NA NA 4.06 3.79 0.58 000 52346 A Cystouretero w/renal strict 8.58 NA NA 4.51 4.22 0.65 000 52400 A Cystouretero w/congen repr 8.66 NA NA 5.00 4.69 0.68 090 52500 A Revision of bladder neck 7.99 NA NA 5.85 5.38 0.60 090 52640 A Relieve bladder contracture 4.73 NA NA 3.68 3.51 0.47 090 53445 A Insert uro/ves nck sphincter 15.21 NA NA 9.63 9.01 0.99 090 54405 A Insert multi-comp penis pros 14.39 NA NA 8.57 7.93 0.95 090 54410 A Remove/replace penis prosth 15.00 NA NA 9.40 8.72 1.10 090 54530 A Removal of testis 8.35 NA NA 5.93 5.52 0.66 090 55706 A Prostate saturation sampling 6.15 NA NA 4.39 4.39 0.39 010 56620 A Partial removal of vulva 7.35 NA NA 4.71 4.74 0.90 090 57287 A Revise/remove sling repair 10.97 NA NA 7.03 6.66 0.90 090 57288 A Repair bladder defect 12.00 NA NA 6.56 6.41 1.12 090 60220 A Partial removal of thyroid 12.29 NA NA 5.89 5.97 1.32 090 60225 A Partial removal of thyroid 14.67 NA NA 7.16 7.24 1.64 090 61796 A Srs, cranial lesion simple 10.79 NA NA 6.85 6.85 2.64 090 61797 A Srs, cran les simple, addl 3.48 1.34 1.34 1.34 1.34 0.72 ZZZ 61798 A Srs, cranial lesion complex 10.79 NA NA 6.85 6.85 2.64 090 61799 A Srs, cran les complex, addl 4.81 1.85 1.85 1.85 1.85 1.00 ZZZ 61800 A Apply srs headframe add-on 2.25 NA NA 1.11 1.11 0.57 ZZZ 61885 A Insrt/redo neurostim 1 array 7.37 NA NA 7.38 6.87 1.59 090 62263 A Epidural lysis mult sessions 6.41 8.72 9.74 2.88 2.96 0.41 010 62267 A Interdiscal perq aspir, dx 3.00 3.38 3.38 1.15 1.15 0.23 000 62350 A Implant spinal canal cath 6.00 NA NA 2.80 3.09 1.02 010 62355 A Remove spinal canal catheter 4.30 NA NA 2.35 2.56 0.71 010 62360 A Insert spine infusion device 4.28 NA NA 2.50 2.55 0.34 010 62361 A Implant spine infusion pump 5.60 NA NA 3.48 3.60 0.80 010 62362 A Implant spine infusion pump 6.05 NA NA 3.11 3.43 1.18 010 62365 A Remove spine infusion device 4.60 NA NA 2.72 2.94 0.86 010 63620 A Srs, spinal lesion 10.79 NA NA 6.85 6.85 2.64 090 63621 A Srs, spinal lesion, addl 4.00 1.54 1.54 1.54 1.54 0.83 ZZZ 63650 A Implant neuroelectrodes 7.15 NA NA 2.71 2.83 0.53 090 63685 A Insrt/redo spine n generator 6.00 NA NA 2.90 3.22 1.05 090 63688 A Revise/remove neuroreceiver 5.25 NA NA 2.88 3.05 0.89 090 64416 A N block cont infuse, b plex 1.81 NA NA 0.22 0.36 0.31 000 64446 A N blk inj, sciatic, cont inf 1.81 NA NA 0.23 0.43 0.20 000 64448 A N block inj fem, cont inf 1.63 NA NA 0.19 0.35 0.18 000 64449 A N block inj, lumbar plexus 1.81 NA NA 0.26 0.44 0.15 000 64455 A N block inj, plantar digit 0.75 0.52 0.52 0.24 0.24 0.09 000 64573 A Implant neuroelectrodes 8.15 NA NA 5.31 5.31 1.60 090 64632 A N block inj, common digit 1.20 0.95 0.95 0.63 0.63 0.05 010 64708 A Revise arm/leg nerve 6.22 NA NA 5.04 5.00 0.96 090 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. RVUs 2 Year 2009 Transitional Non- Facility PE RVUs 2 Fully Imple- mented Facility PE RVUs 2 Year 2009 Transitional Facility PE RVUs 2 1370 Mal- Practice RVUs 2 Global

CMS-1403-FC CPT 1 / HCPCS Mod Status Description Physi- cian Work RVUs 2 Fully Imple- mented Non- Facility PE 64831 A Repair of digit nerve 9.00 NA NA 6.77 6.86 1.41 090 65285 A Repair of eye wound 14.43 NA NA 8.85 8.96 0.64 090 65756 A Corneal trnspl, endothelial 16.60 NA NA 10.14 10.14 0.74 090 65757 C Prep corneal endo allograft 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 66982 A Cataract surgery, complex 14.83 NA NA 9.03 9.26 0.63 090 67225 A Eye photodynamic ther add-on 0.47 0.22 0.23 0.18 0.19 0.02 ZZZ 68810 A Probe nasolacrimal duct 2.09 3.16 3.29 2.04 2.20 0.10 010 69930 A Implant cochlear device 17.60 NA NA 12.24 12.90 1.36 090 77785 26 A Hdr brachytx, 1 channel 1.42 0.49 0.49 0.49 0.49 0.07 XXX 77786 26 A Hdr brachytx, 2-12 channel 3.25 1.12 1.04 1.12 1.04 0.17 XXX 77787 26 A Hdr brachytx over 12 chan 4.89 1.68 1.71 1.68 1.71 0.25 XXX 78808 A Iv inj ra drug dx study 0.18 1.01 1.01 NA NA 0.04 XXX 90951 A Esrd serv, 4 visits p mo,

<strong>CMS</strong>-1403-FC<br />

CPT 1 /<br />

HCPCS Mod Status Description<br />

Physi-<br />

cian<br />

Work<br />

RVUs 2<br />

Fully<br />

Imple-<br />

mented<br />

Non-<br />

Facility<br />

PE<br />

52344 A Cysto/uretero, stricture tx 7.05 NA NA 3.83 3.58 0.55 000<br />

52345 A Cysto/uretero w/up stricture 7.55 NA NA 4.06 3.79 0.58 000<br />

52346 A Cystouretero w/renal strict 8.58 NA NA 4.51 4.22 0.65 000<br />

52400 A Cystouretero w/congen repr 8.66 NA NA 5.00 4.69 0.68 090<br />

52500 A Revision of bladder neck 7.99 NA NA 5.85 5.38 0.60 090<br />

52640 A Relieve bladder contracture 4.73 NA NA 3.68 3.51 0.47 090<br />

53445 A Insert uro/ves nck sphincter 15.21 NA NA 9.63 9.01 0.99 090<br />

54405 A Insert multi-comp penis pros 14.39 NA NA 8.57 7.93 0.95 090<br />

54410 A Remove/replace penis prosth 15.00 NA NA 9.40 8.72 1.10 090<br />

54530 A Removal of testis 8.35 NA NA 5.93 5.52 0.66 090<br />

55706 A Prostate saturation sampling 6.15 NA NA 4.39 4.39 0.39 010<br />

56620 A Partial removal of vulva 7.35 NA NA 4.71 4.74 0.90 090<br />

57287 A Revise/remove sling repair 10.97 NA NA 7.03 6.66 0.90 090<br />

57288 A Repair bladder defect 12.00 NA NA 6.56 6.41 1.12 090<br />

60220 A Partial removal of thyroid 12.29 NA NA 5.89 5.97 1.32 090<br />

60225 A Partial removal of thyroid 14.67 NA NA 7.16 7.24 1.64 090<br />

61796 A Srs, cranial lesion simple 10.79 NA NA 6.85 6.85 2.64 090<br />

61797 A Srs, cran les simple, addl 3.48 1.34 1.34 1.34 1.34 0.72 ZZZ<br />

61798 A Srs, cranial lesion complex 10.79 NA NA 6.85 6.85 2.64 090<br />

61799 A Srs, cran les complex, addl 4.81 1.85 1.85 1.85 1.85 1.00 ZZZ<br />

61800 A Apply srs headframe add-on 2.25 NA NA 1.11 1.11 0.57 ZZZ<br />

61885 A Insrt/redo neurostim 1 array 7.37 NA NA 7.38 6.87 1.59 090<br />

62263 A Epidural lysis mult sessions 6.41 8.72 9.74 2.88 2.96 0.41 010<br />

62267 A Interdiscal perq aspir, dx 3.00 3.38 3.38 1.15 1.15 0.23 000<br />

62350 A Implant spinal canal cath 6.00 NA NA 2.80 3.09 1.02 010<br />

62355 A Remove spinal canal catheter 4.30 NA NA 2.35 2.56 0.71 010<br />

62360 A Insert spine infusion device 4.28 NA NA 2.50 2.55 0.34 010<br />

62361 A Implant spine infusion pump 5.60 NA NA 3.48 3.60 0.80 010<br />

62362 A Implant spine infusion pump 6.05 NA NA 3.11 3.43 1.18 010<br />

62365 A Remove spine infusion device 4.60 NA NA 2.72 2.94 0.86 010<br />

63620 A Srs, spinal lesion 10.79 NA NA 6.85 6.85 2.64 090<br />

63621 A Srs, spinal lesion, addl 4.00 1.54 1.54 1.54 1.54 0.83 ZZZ<br />

63650 A Implant neuroelectrodes 7.15 NA NA 2.71 2.83 0.53 090<br />

63685 A Insrt/redo spine n generator 6.00 NA NA 2.90 3.22 1.05 090<br />

63688 A Revise/remove neuroreceiver 5.25 NA NA 2.88 3.05 0.89 090<br />

64416 A N block cont infuse, b plex 1.81 NA NA 0.22 0.36 0.31 000<br />

64446 A N blk inj, sciatic, cont inf 1.81 NA NA 0.23 0.43 0.20 000<br />

64448 A N block inj fem, cont inf 1.63 NA NA 0.19 0.35 0.18 000<br />

64449 A N block inj, lumbar plexus 1.81 NA NA 0.26 0.44 0.15 000<br />

64455 A N block inj, plantar digit 0.75 0.52 0.52 0.24 0.24 0.09 000<br />

64573 A Implant neuroelectrodes 8.15 NA NA 5.31 5.31 1.60 090<br />

64632 A N block inj, common digit 1.20 0.95 0.95 0.63 0.63 0.05 010<br />

64708 A Revise arm/leg nerve 6.22 NA NA 5.04 5.00 0.96 090<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 />

RVUs 2<br />

Year<br />

2009<br />

Transitional<br />

Non-<br />

Facility<br />

PE<br />

RVUs 2<br />

Fully<br />

Imple-<br />

mented<br />

Facility<br />

PE<br />

RVUs 2<br />

Year<br />

2009<br />

Transitional<br />

Facility<br />

PE<br />

RVUs 2<br />

1370<br />

Mal-<br />

Practice<br />

RVUs 2 Global

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