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 73092 A 04 N N 7.17 7.18 14.35 73100 A 04 N N 10.75 10.75 21.50 73110 A 04 N N 11.10 11.10 22.20 73115 04 N I 30.10 73120 A 04 N N 8.50 8.50 17.00 73130 A 04 N N 9.15 9.15 18.30 73140 A 04 N N 7.17 7.18 14.35 73200 B 04 N N 31.35 31.35 62.70 73201 B 04 N N 37.95 37.95 75.90 73202 B 04 N N 54.93 54.92 109.85 73206 B 04 N N 115.55 115.55 231.10 73218 B 04 N N 148.30 148.30 296.60 73219 B 04 N N 148.30 148.30 296.60 73220 B 04 N N 148.30 148.30 296.60 73221 B 04 N N 148.30 148.30 296.60 73222 B 04 N N 148.30 148.30 296.60 73223 B 04 N N 223.92 223.92 447.85 73225 B 04 N N 148.30 148.30 296.60 73500 A 04 N N 10.75 10.75 21.50 73510 A 04 N N 14.35 14.35 28.70 73520 A 04 N N 19.60 19.60 39.20 Wednesday, April 01, 2009 Page 282 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 73525 C 04 N I 14.02 38.28 52.30 73530 A 04 N N 24.85 24.85 49.70 73540 A 04 N N 17.00 17.00 34.00 73542 04 N I 120.90 73550 A 04 N N 10.75 10.75 21.50 73560 A 04 N N 9.80 9.80 19.60 73562 A 04 N N 10.10 10.10 20.20 73564 A 04 N N 11.10 11.10 22.20 73565 A 04 N N 16.70 16.70 33.40 73580 04 N I 37.90 73590 A 04 N N 10.75 10.75 21.50 73592 A 04 N N 10.75 10.75 21.50 73600 A 04 N N 10.75 10.75 21.50 73610 A 04 N N 14.35 14.35 28.70 73615 04 N I 26.15 73620 A 04 N N 8.50 8.50 17.00 73630 A 04 N N 10.75 10.75 21.50 73650 A 04 N N 8.50 8.50 17.00 73660 A 04 N N 7.17 7.17 14.35 73700 B 04 N N 31.35 31.35 62.70 73701 B 04 N N 37.95 37.95 75.90 Wednesday, April 01, 2009 Page 283 of 458
- 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
- Page 273 and 274: Hcpcs Note ProgCov Eff Date HP NDC
- Page 275 and 276: Hcpcs Note ProgCov Eff Date HP NDC
- Page 277 and 278: Hcpcs Note ProgCov Eff Date HP NDC
- Page 279 and 280: Hcpcs Note ProgCov Eff Date HP NDC
- Page 281 and 282: Hcpcs Note ProgCov Eff Date HP NDC
- Page 283 and 284: Hcpcs Note ProgCov Eff Date HP NDC
- Page 285 and 286: Hcpcs Note ProgCov Eff Date HP NDC
- Page 287 and 288: Hcpcs Note ProgCov Eff Date HP NDC
- Page 289: Hcpcs Note ProgCov Eff Date HP NDC
- Page 293 and 294: Hcpcs Note ProgCov Eff Date HP NDC
- Page 295 and 296: Hcpcs Note ProgCov Eff Date HP NDC
- Page 297 and 298: Hcpcs Note ProgCov Eff Date HP NDC
- Page 299 and 300: Hcpcs Note ProgCov Eff Date HP NDC
- Page 301 and 302: Hcpcs Note ProgCov Eff Date HP NDC
- Page 303 and 304: Hcpcs Note ProgCov Eff Date HP NDC
- Page 305 and 306: Hcpcs Note ProgCov Eff Date HP NDC
- Page 307 and 308: Hcpcs Note ProgCov Eff Date HP NDC
- Page 309 and 310: Hcpcs Note ProgCov Eff Date HP NDC
- Page 311 and 312: Hcpcs Note ProgCov Eff Date HP NDC
- Page 313 and 314: Hcpcs Note ProgCov Eff Date HP NDC
- Page 315 and 316: Hcpcs Note ProgCov Eff Date HP NDC
- Page 317 and 318: Hcpcs Note ProgCov Eff Date HP NDC
- Page 319 and 320: Hcpcs Note ProgCov Eff Date HP NDC
- Page 321 and 322: Hcpcs Note ProgCov Eff Date HP NDC
- Page 323 and 324: Hcpcs Note ProgCov Eff Date HP NDC
- Page 325 and 326: Hcpcs Note ProgCov Eff Date HP NDC
- Page 327 and 328: Hcpcs Note ProgCov Eff Date HP NDC
- Page 329 and 330: Hcpcs Note ProgCov Eff Date HP NDC
- Page 331 and 332: Hcpcs Note ProgCov Eff Date HP NDC
- Page 333 and 334: Hcpcs Note ProgCov Eff Date HP NDC
- Page 335 and 336: Hcpcs Note ProgCov Eff Date HP NDC
- Page 337 and 338: Hcpcs Note ProgCov Eff Date HP NDC
- Page 339 and 340: 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 />
73525 C <strong>04</strong> N I 14.02 38.28 52.30<br />
73530 A <strong>04</strong> N N 24.85 24.85 49.70<br />
73540 A <strong>04</strong> N N 17.00 17.00 34.00<br />
73542 <strong>04</strong> N I 120.90<br />
73550 A <strong>04</strong> N N 10.75 10.75 21.50<br />
73560 A <strong>04</strong> N N 9.80 9.80 19.60<br />
73562 A <strong>04</strong> N N 10.10 10.10 20.20<br />
73564 A <strong>04</strong> N N 11.10 11.10 22.20<br />
73565 A <strong>04</strong> N N 16.70 16.70 33.40<br />
73580 <strong>04</strong> N I 37.90<br />
73590 A <strong>04</strong> N N 10.75 10.75 21.50<br />
73592 A <strong>04</strong> N N 10.75 10.75 21.50<br />
73600 A <strong>04</strong> N N 10.75 10.75 21.50<br />
73610 A <strong>04</strong> N N 14.35 14.35 28.70<br />
73615 <strong>04</strong> N I 26.15<br />
73620 A <strong>04</strong> N N 8.50 8.50 17.00<br />
73630 A <strong>04</strong> N N 10.75 10.75 21.50<br />
73650 A <strong>04</strong> N N 8.50 8.50 17.00<br />
73660 A <strong>04</strong> N N 7.17 7.17 14.35<br />
73700 B <strong>04</strong> N N 31.35 31.35 62.70<br />
737<strong>01</strong> B <strong>04</strong> N N 37.95 37.95 75.90<br />
Wednesday, April <strong>01</strong>, 20<strong>09</strong> Page 283 <strong>of</strong> 458
Change language