Practitioner Fee Schedule (pdf)- Updated 04/01/09 - State of Illinois
Practitioner Fee Schedule (pdf)- Updated 04/01/09 - State of Illinois Practitioner Fee Schedule (pdf)- Updated 04/01/09 - State of Illinois
Hcpcs Note ProgCov Eff Date HP NDC Ind SurgInd M1 (26) M2 (TC) Assist Surg Co-Surg Unitprice MaxQty StateMax Surg Child Adult 27780 04 N M 152.60 27781 04 N M 217.80 27784 04 N M Y 416.20 27786 04 N M 152.60 27788 04 N M 222.00 27792 04 N M Y 299.70 27808 04 N M 208.05 27810 04 N M 305.15 27814 04 N M Y 610.45 27816 04 N M 224.70 27818 04 N M 369.05 27822 04 N M Y 599.35 27823 04 N M Y 599.35 27824 04 N M Y 232.20 27825 04 N M Y 286.20 27826 04 N M Y 515.70 27827 04 N M Y 638.00 27828 04 N M Y 696.90 27829 04 N M Y 412.00 27830 04 N M 153.75 27831 04 N M 224.70 Wednesday, April 01, 2009 Page 94 of 458
Hcpcs Note ProgCov Eff Date HP NDC Ind SurgInd M1 (26) M2 (TC) Assist Surg Co-Surg Unitprice MaxQty StateMax Surg Child Adult 27832 04 N M Y 599.35 27840 04 N M 138.20 27842 04 N M 208.05 27846 04 N M Y 378.70 27848 04 N M Y 481.90 27860 04 N I 77.10 27870 04 N M Y 659.00 27871 04 N M Y 659.00 27880 04 N M Y 613.20 27881 04 N M Y 674.20 27882 04 N M Y 588.20 27884 04 N M Y 252.65 27886 04 N M Y 374.55 27888 04 N M Y 599.35 27889 04 N M Y 374.55 27892 04 N M Y 220.40 27893 04 N M Y 212.80 27894 04 N M Y 293.20 27899 04 Y M Y 28001 04 N M 136.05 17.00 28002 04 N M Y 143.95 Wednesday, April 01, 2009 Page 95 of 458
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Hcpcs Note ProgCov Eff Date HP NDC Ind SurgInd M1 (26) M2 (TC) Assist Surg Co-Surg Unitprice MaxQty <strong>State</strong>Max Surg Child Adult<br />
27780 <strong>04</strong> N M 152.60<br />
27781 <strong>04</strong> N M 217.80<br />
27784 <strong>04</strong> N M Y 416.20<br />
27786 <strong>04</strong> N M 152.60<br />
27788 <strong>04</strong> N M 222.00<br />
27792 <strong>04</strong> N M Y 299.70<br />
27808 <strong>04</strong> N M 208.05<br />
27810 <strong>04</strong> N M 305.15<br />
27814 <strong>04</strong> N M Y 610.45<br />
27816 <strong>04</strong> N M 224.70<br />
27818 <strong>04</strong> N M 369.05<br />
27822 <strong>04</strong> N M Y 599.35<br />
27823 <strong>04</strong> N M Y 599.35<br />
27824 <strong>04</strong> N M Y 232.20<br />
27825 <strong>04</strong> N M Y 286.20<br />
27826 <strong>04</strong> N M Y 515.70<br />
27827 <strong>04</strong> N M Y 638.00<br />
27828 <strong>04</strong> N M Y 696.90<br />
27829 <strong>04</strong> N M Y 412.00<br />
27830 <strong>04</strong> N M 153.75<br />
27831 <strong>04</strong> N M 224.70<br />
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