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 54348 04 N M Y 958.60 54352 04 Y M Y Y 54360 04 N M Y Y 690.78 54380 04 N M Y 386.30 54385 04 N M Y 446.00 54390 04 N M Y 600.70 54400 09 Y M 54401 09 Y M 54405 09 Y M 54406 09 Y M 54408 09 Y M 54410 09 Y M 54411 09 Y M 54415 09 Y M 54416 09 Y M 54417 09 Y M 54420 04 N M Y 409.20 54430 04 N M Y 409.20 54435 04 N M 405.10 54440 04 N M Y 224.70 54450 04 N I 37.45 Wednesday, April 01, 2009 Page 214 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 54500 04 N I 68.20 17.00 54505 04 N I 113.60 17.00 54512 04 N M 356.05 54520 04 N M Y 351.00 54522 04 N M 404.20 54530 04 N M Y 958.60 54535 04 N M Y 958.60 54550 04 N M Y 359.30 54560 04 N M Y 480.00 54600 04 N M Y 359.30 54620 04 N M Y 299.70 54640 04 N M Y 504.90 54650 04 N M Y 480.00 54660 09 Y M 54670 04 Y M 54680 04 Y M Y 54690 04 N M Y 351.00 54692 04 N M Y 504.90 54699 04 Y M Y 54700 04 N I 128.30 17.00 54800 04 N I 119.25 Wednesday, April 01, 2009 Page 215 of 458
- 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
- Page 201 and 202: Hcpcs Note ProgCov Eff Date HP NDC
- Page 203 and 204: Hcpcs Note ProgCov Eff Date HP NDC
- Page 205 and 206: Hcpcs Note ProgCov Eff Date HP NDC
- Page 207 and 208: Hcpcs Note ProgCov Eff Date HP NDC
- Page 209 and 210: Hcpcs Note ProgCov Eff Date HP NDC
- Page 211 and 212: Hcpcs Note ProgCov Eff Date HP NDC
- Page 213 and 214: Hcpcs Note ProgCov Eff Date HP NDC
- Page 215 and 216: Hcpcs Note ProgCov Eff Date HP NDC
- Page 217 and 218: Hcpcs Note ProgCov Eff Date HP NDC
- Page 219 and 220: Hcpcs Note ProgCov Eff Date HP NDC
- Page 221: Hcpcs Note ProgCov Eff Date HP NDC
- Page 225 and 226: Hcpcs Note ProgCov Eff Date HP NDC
- Page 227 and 228: Hcpcs Note ProgCov Eff Date HP NDC
- Page 229 and 230: Hcpcs Note ProgCov Eff Date HP NDC
- Page 231 and 232: Hcpcs Note ProgCov Eff Date HP NDC
- Page 233 and 234: Hcpcs Note ProgCov Eff Date HP NDC
- Page 235 and 236: Hcpcs Note ProgCov Eff Date HP NDC
- Page 237 and 238: Hcpcs Note ProgCov Eff Date HP NDC
- Page 239 and 240: Hcpcs Note ProgCov Eff Date HP NDC
- Page 241 and 242: Hcpcs Note ProgCov Eff Date HP NDC
- Page 243 and 244: Hcpcs Note ProgCov Eff Date HP NDC
- Page 245 and 246: Hcpcs Note ProgCov Eff Date HP NDC
- Page 247 and 248: Hcpcs Note ProgCov Eff Date HP NDC
- Page 249 and 250: Hcpcs Note ProgCov Eff Date HP NDC
- Page 251 and 252: Hcpcs Note ProgCov Eff Date HP NDC
- Page 253 and 254: Hcpcs Note ProgCov Eff Date HP NDC
- Page 255 and 256: Hcpcs Note ProgCov Eff Date HP NDC
- Page 257 and 258: Hcpcs Note ProgCov Eff Date HP NDC
- Page 259 and 260: Hcpcs Note ProgCov Eff Date HP NDC
- Page 261 and 262: Hcpcs Note ProgCov Eff Date HP NDC
- Page 263 and 264: Hcpcs Note ProgCov Eff Date HP NDC
- Page 265 and 266: Hcpcs Note ProgCov Eff Date HP NDC
- Page 267 and 268: Hcpcs Note ProgCov Eff Date HP NDC
- Page 269 and 270: Hcpcs Note ProgCov Eff Date HP NDC
- Page 271 and 272: 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 />
54348 <strong>04</strong> N M Y 958.60<br />
54352 <strong>04</strong> Y M Y Y<br />
54360 <strong>04</strong> N M Y Y 690.78<br />
54380 <strong>04</strong> N M Y 386.30<br />
54385 <strong>04</strong> N M Y 446.00<br />
54390 <strong>04</strong> N M Y 600.70<br />
54400 <strong>09</strong> Y M<br />
544<strong>01</strong> <strong>09</strong> Y M<br />
54405 <strong>09</strong> Y M<br />
54406 <strong>09</strong> Y M<br />
54408 <strong>09</strong> Y M<br />
54410 <strong>09</strong> Y M<br />
54411 <strong>09</strong> Y M<br />
54415 <strong>09</strong> Y M<br />
54416 <strong>09</strong> Y M<br />
54417 <strong>09</strong> Y M<br />
54420 <strong>04</strong> N M Y 4<strong>09</strong>.20<br />
54430 <strong>04</strong> N M Y 4<strong>09</strong>.20<br />
54435 <strong>04</strong> N M 405.10<br />
54440 <strong>04</strong> N M Y 224.70<br />
54450 <strong>04</strong> N I 37.45<br />
Wednesday, April <strong>01</strong>, 20<strong>09</strong> Page 214 <strong>of</strong> 458
Change language