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Department of Veterans' Affairs Fee Schedules for Medical Services

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Item Nos. Patients LMO <strong>Fee</strong><br />

96 1 $98.30<br />

2 $82.20<br />

3 $76.85<br />

4 $74.20<br />

5 $72.60<br />

6 $71.50<br />

7+ $67.60<br />

Item Nos. Patients LMO <strong>Fee</strong><br />

2147 1 $135.95<br />

2 $121.60<br />

3 $116.80<br />

4 $114.40<br />

5 $112.95<br />

6 $112.00<br />

7+ $109.40<br />

Item Nos. Patients LMO <strong>Fee</strong><br />

2506,<br />

2522,<br />

2553<br />

1 $108.10<br />

2 $93.75<br />

3 $89.00<br />

4 $86.55<br />

5 $85.10<br />

6 $84.15<br />

7+ $81.55<br />

2122 1 $54.15<br />

2 $39.75<br />

3 $35.00<br />

2179 1 $158.90<br />

2 $133.00<br />

3 $124.45<br />

2509,<br />

2526,<br />

2559<br />

1 $145.55<br />

2 $131.20<br />

3 $126.40<br />

4 $32.55<br />

4 $120.15<br />

4 $124.00<br />

5 $31.15<br />

5 $117.55<br />

5 $122.55<br />

6 $30.15<br />

6 $115.85<br />

6 $121.60<br />

7+ $27.55<br />

7+ $110.90<br />

7+ $119.00<br />

2125 1 $77.05<br />

2 $51.20<br />

3 $42.65<br />

4 $38.30<br />

5 $35.75<br />

6 $34.00<br />

7+ $29.05<br />

2199 1 $186.45<br />

2 $172.05<br />

3 $167.30<br />

4 $164.90<br />

5 $163.45<br />

6 $162.45<br />

7+ $159.85<br />

2610 1 $38.55<br />

2 $28.50<br />

3 $25.15<br />

4 $23.45<br />

5 $22.45<br />

6 $21.75<br />

7+ $19.25<br />

2137 1 $54.15<br />

2 $39.75<br />

3 $35.00<br />

4 $32.55<br />

5 $31.15<br />

6 $30.15<br />

7+ $27.55<br />

2220 1 $209.40<br />

2 $183.50<br />

3 $174.95<br />

4 $170.65<br />

5 $168.05<br />

6 $166.30<br />

7+ $161.35<br />

2613 1 $58.65<br />

2 $49.75<br />

3 $46.75<br />

4 $45.30<br />

5 $44.40<br />

6 $43.85<br />

7+ $41.65<br />

2138 1 $106.95<br />

2 $81.10<br />

3 $72.55<br />

2503,<br />

2518,<br />

2547<br />

1 $69.70<br />

2 $55.35<br />

3 $50.55<br />

2616 1 83.95<br />

2 75.05<br />

3 72.05<br />

4 $68.20<br />

4 $48.15<br />

4 70.60<br />

5 $65.65<br />

5 $46.70<br />

5 69.70<br />

6 $63.90<br />

6 $45.75<br />

6 69.15<br />

7+ $58.95<br />

7+ $43.15<br />

7+ 66.95<br />

8 1 NOVEMBER 2011 – 31 OCTOBER 2012

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