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 60260 04 N M Y Y 718.70 60270 04 N M Y Y 839.35 60271 04 N M Y Y 749.20 60280 04 N M Y Y 718.70 60281 04 N M Y 718.70 60300 04 1/1/2008 N I 27.75 27.05 60500 04 N M Y Y 839.35 60502 04 N M Y Y 839.35 60505 04 N M Y Y 839.35 60512 04 N M Y Y 135.00 60520 04 N M Y Y 749.20 60521 04 N M Y Y 839.35 60522 04 N M Y Y 1198.70 60540 04 N M Y Y 839.35 60545 04 N M Y Y 958.60 60600 04 N M Y Y 839.35 60605 04 N M Y Y 839.35 60650 04 N M Y 839.35 60659 04 Y M Y 60699 04 Y M Y 61000 04 N I 112.40 Wednesday, April 01, 2009 Page 232 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 61020 04 N I 112.40 61026 04 N M 62.15 61050 04 N I 112.40 61055 04 N M 157.50 61070 04 N I 112.40 61105 04 N M Y Y 359.30 61107 04 N M Y 359.30 61108 04 N M Y 599.35 61120 04 N M Y Y 359.30 61140 04 N M Y Y 510.30 61150 04 N M Y Y 958.60 61151 04 N I Y Y 330.80 61154 04 N M Y Y 599.35 61156 04 N M Y Y 599.35 61210 04 N M Y Y 449.50 61215 04 N M Y 449.50 61250 04 N M Y Y 449.50 61253 04 N M Y Y 449.50 61304 04 N M Y Y 749.20 61305 04 N M Y Y 886.90 61312 04 N M Y Y 861.50 Wednesday, April 01, 2009 Page 233 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 />
60260 <strong>04</strong> N M Y Y 718.70<br />
60270 <strong>04</strong> N M Y Y 839.35<br />
60271 <strong>04</strong> N M Y Y 749.20<br />
60280 <strong>04</strong> N M Y Y 718.70<br />
60281 <strong>04</strong> N M Y 718.70<br />
60300 <strong>04</strong> 1/1/2008 N I 27.75 27.05<br />
60500 <strong>04</strong> N M Y Y 839.35<br />
60502 <strong>04</strong> N M Y Y 839.35<br />
60505 <strong>04</strong> N M Y Y 839.35<br />
60512 <strong>04</strong> N M Y Y 135.00<br />
60520 <strong>04</strong> N M Y Y 749.20<br />
60521 <strong>04</strong> N M Y Y 839.35<br />
60522 <strong>04</strong> N M Y Y 1198.70<br />
60540 <strong>04</strong> N M Y Y 839.35<br />
60545 <strong>04</strong> N M Y Y 958.60<br />
60600 <strong>04</strong> N M Y Y 839.35<br />
60605 <strong>04</strong> N M Y Y 839.35<br />
60650 <strong>04</strong> N M Y 839.35<br />
60659 <strong>04</strong> Y M Y<br />
60699 <strong>04</strong> Y M Y<br />
61000 <strong>04</strong> N I 112.40<br />
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