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 35548 04 N M Y 839.35 35549 04 N M Y Y 1,198.70 35551 04 N M Y Y 1,198.70 35556 04 N M Y Y 958.60 35558 04 N M Y Y 1,079.30 35560 04 N M Y 1,198.70 35563 04 N M Y Y 1,198.70 35565 04 N M Y Y 1,198.70 35566 04 N M Y Y 958.60 35570 04 1/1/2009 N M Y Y 958.60 35571 04 N M Y Y 958.60 35572 04 N M Y Y 209.75 35583 04 N M Y Y 958.60 35585 04 N M Y Y 958.60 35587 04 N M Y Y 958.60 35600 04 N M Y Y 192.75 35601 04 N M Y Y 839.35 35606 04 N M Y Y 958.60 35612 04 N M Y Y 958.60 35616 04 N M Y 958.60 35621 04 N M Y Y 1,198.70 Wednesday, April 01, 2009 Page 142 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 35623 04 N M Y Y 1,306.65 35626 04 N M Y 958.60 35631 04 N M Y Y 1,198.70 35632 04 1/1/2009 N M Y Y 1198.70 35633 04 1/1/2009 N M Y Y 1198.70 35634 04 1/1/2009 N M Y Y 1198.70 35636 04 N M Y Y 1,079.30 35637 04 1/1/2007 N M Y 1,198.70 35638 04 1/1/2007 N M Y 1,198.70 35642 04 N M Y 958.60 35645 04 N M Y 958.60 35646 04 N M Y Y 1,198.70 35647 04 N M Y Y 1,053.80 35650 04 N M Y 1,079.30 35651 04 N M Y Y 1,198.70 35654 04 N M Y 1,198.70 35656 04 N M Y Y 958.60 35661 04 N M Y Y 1,079.30 35663 04 N M Y Y 1,198.70 35665 04 N M Y Y 1,198.70 35666 04 N M Y Y 958.60 Wednesday, April 01, 2009 Page 143 of 458
- Page 99 and 100: Hcpcs Note ProgCov Eff Date HP NDC
- Page 101 and 102: Hcpcs Note ProgCov Eff Date HP NDC
- Page 103 and 104: Hcpcs Note ProgCov Eff Date HP NDC
- Page 105 and 106: Hcpcs Note ProgCov Eff Date HP NDC
- Page 107 and 108: Hcpcs Note ProgCov Eff Date HP NDC
- Page 109 and 110: Hcpcs Note ProgCov Eff Date HP NDC
- Page 111 and 112: Hcpcs Note ProgCov Eff Date HP NDC
- Page 113 and 114: Hcpcs Note ProgCov Eff Date HP NDC
- Page 115 and 116: Hcpcs Note ProgCov Eff Date HP NDC
- Page 117 and 118: Hcpcs Note ProgCov Eff Date HP NDC
- Page 119 and 120: Hcpcs Note ProgCov Eff Date HP NDC
- Page 121 and 122: Hcpcs Note ProgCov Eff Date HP NDC
- Page 123 and 124: Hcpcs Note ProgCov Eff Date HP NDC
- Page 125 and 126: Hcpcs Note ProgCov Eff Date HP NDC
- Page 127 and 128: Hcpcs Note ProgCov Eff Date HP NDC
- Page 129 and 130: Hcpcs Note ProgCov Eff Date HP NDC
- Page 131 and 132: Hcpcs Note ProgCov Eff Date HP NDC
- Page 133 and 134: Hcpcs Note ProgCov Eff Date HP NDC
- Page 135 and 136: Hcpcs Note ProgCov Eff Date HP NDC
- Page 137 and 138: Hcpcs Note ProgCov Eff Date HP NDC
- Page 139 and 140: Hcpcs Note ProgCov Eff Date HP NDC
- Page 141 and 142: Hcpcs Note ProgCov Eff Date HP NDC
- Page 143 and 144: Hcpcs Note ProgCov Eff Date HP NDC
- Page 145 and 146: Hcpcs Note ProgCov Eff Date HP NDC
- Page 147 and 148: Hcpcs Note ProgCov Eff Date HP NDC
- Page 149: Hcpcs Note ProgCov Eff Date HP NDC
- Page 153 and 154: Hcpcs Note ProgCov Eff Date HP NDC
- Page 155 and 156: Hcpcs Note ProgCov Eff Date HP NDC
- Page 157 and 158: Hcpcs Note ProgCov Eff Date HP NDC
- Page 159 and 160: Hcpcs Note ProgCov Eff Date HP NDC
- Page 161 and 162: Hcpcs Note ProgCov Eff Date HP NDC
- Page 163 and 164: Hcpcs Note ProgCov Eff Date HP NDC
- Page 165 and 166: Hcpcs Note ProgCov Eff Date HP NDC
- Page 167 and 168: Hcpcs Note ProgCov Eff Date HP NDC
- Page 169 and 170: Hcpcs Note ProgCov Eff Date HP NDC
- Page 171 and 172: Hcpcs Note ProgCov Eff Date HP NDC
- Page 173 and 174: Hcpcs Note ProgCov Eff Date HP NDC
- Page 175 and 176: Hcpcs Note ProgCov Eff Date HP NDC
- Page 177 and 178: Hcpcs Note ProgCov Eff Date HP NDC
- Page 179 and 180: Hcpcs Note ProgCov Eff Date HP NDC
- Page 181 and 182: Hcpcs Note ProgCov Eff Date HP NDC
- Page 183 and 184: Hcpcs Note ProgCov Eff Date HP NDC
- Page 185 and 186: Hcpcs Note ProgCov Eff Date HP NDC
- Page 187 and 188: Hcpcs Note ProgCov Eff Date HP NDC
- Page 189 and 190: Hcpcs Note ProgCov Eff Date HP NDC
- Page 191 and 192: Hcpcs Note ProgCov Eff Date HP NDC
- Page 193 and 194: Hcpcs Note ProgCov Eff Date HP NDC
- Page 195 and 196: Hcpcs Note ProgCov Eff Date HP NDC
- Page 197 and 198: Hcpcs Note ProgCov Eff Date HP NDC
- Page 199 and 200: Hcpcs Note ProgCov Eff Date HP NDC
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 />
35623 <strong>04</strong> N M Y Y 1,306.65<br />
35626 <strong>04</strong> N M Y 958.60<br />
35631 <strong>04</strong> N M Y Y 1,198.70<br />
35632 <strong>04</strong> 1/1/20<strong>09</strong> N M Y Y 1198.70<br />
35633 <strong>04</strong> 1/1/20<strong>09</strong> N M Y Y 1198.70<br />
35634 <strong>04</strong> 1/1/20<strong>09</strong> N M Y Y 1198.70<br />
35636 <strong>04</strong> N M Y Y 1,079.30<br />
35637 <strong>04</strong> 1/1/2007 N M Y 1,198.70<br />
35638 <strong>04</strong> 1/1/2007 N M Y 1,198.70<br />
35642 <strong>04</strong> N M Y 958.60<br />
35645 <strong>04</strong> N M Y 958.60<br />
35646 <strong>04</strong> N M Y Y 1,198.70<br />
35647 <strong>04</strong> N M Y Y 1,053.80<br />
35650 <strong>04</strong> N M Y 1,079.30<br />
35651 <strong>04</strong> N M Y Y 1,198.70<br />
35654 <strong>04</strong> N M Y 1,198.70<br />
35656 <strong>04</strong> N M Y Y 958.60<br />
35661 <strong>04</strong> N M Y Y 1,079.30<br />
35663 <strong>04</strong> N M Y Y 1,198.70<br />
35665 <strong>04</strong> N M Y Y 1,198.70<br />
35666 <strong>04</strong> N M Y Y 958.60<br />
Wednesday, April <strong>01</strong>, 20<strong>09</strong> Page 143 <strong>of</strong> 458
Change language