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 82190 A 04 10/1/2008 N N 7.31 7.31 14.62 82205 A 04 10/1/2008 N N 4.43 4.43 8.86 82232 A 04 10/1/2008 N N 3.96 3.96 7.92 82239 B 04 10/1/2008 N N 8.38 8.38 16.76 82240 B 04 10/1/2008 N N 6.38 6.38 12.76 82247 A 04 10/1/2008 N N 2.33 2.33 4.66 82248 A 04 10/1/2008 N N 2.33 2.33 4.66 82252 A 04 10/1/2008 N N 1.31 1.31 2.62 82261 B 04 10/1/2008 N N 8.25 8.25 16.50 82270 A 04 10/1/2008 N N 1.24 1.24 2.48 82271 A 04 10/1/2008 N N 1.02 1.02 2.04 82272 A 04 10/1/2008 N N 1.02 1.02 2.04 82274 A 04 10/1/2008 N N 5.00 5.00 10.00 82286 A 04 10/1/2008 N N 2.01 2.01 4.02 82300 A 04 10/1/2008 N N 3.34 3.34 6.68 82306 B 04 10/1/2008 N N 4.43 4.43 8.86 82307 04 10/1/2008 N N 8.85 8.85 17.70 82308 A 04 10/1/2008 N N 3.15 3.15 6.30 82310 A 04 10/1/2008 N N 2.33 2.33 4.66 82330 A 04 10/1/2008 N N 6.68 6.68 13.36 82331 A 04 10/1/2008 N N 2.08 2.08 4.16 Wednesday, April 01, 2009 Page 314 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 82340 A 04 10/1/2008 N N 2.70 2.70 5.40 82355 A 04 10/1/2008 N N 2.33 2.33 4.66 82360 A 04 10/1/2008 N N 4.54 4.54 9.08 82365 A 04 10/1/2008 N N 2.33 2.33 4.66 82370 A 04 10/1/2008 N N 2.33 2.33 4.66 82373 A 04 10/1/2008 N N 2.81 2.81 5.62 82374 A 04 10/1/2008 N N 2.40 2.40 4.80 82375 A 04 10/1/2008 N N 2.33 2.33 4.66 82376 A 04 10/1/2008 N N 2.33 2.33 4.66 82378 B 04 10/1/2008 N N 6.71 6.71 13.42 82379 A 04 10/1/2008 N N 5.81 5.81 11.62 82380 A 04 10/1/2008 N N 2.33 2.33 4.66 82382 B 04 10/1/2008 N N 7.58 7.58 15.16 82383 B 04 10/1/2008 N N 7.58 7.58 15.16 82384 B 04 10/1/2008 N N 7.58 7.58 15.16 82387 B 04 10/1/2008 N N 5.74 5.74 11.48 82390 B 04 10/1/2008 N N 4.43 4.43 8.86 82397 A 04 10/1/2008 N N 6.92 6.92 13.84 82415 A 04 10/1/2008 N N 4.43 4.43 8.86 82435 A 04 10/1/2008 N N 2.25 2.25 4.50 82436 A 04 10/1/2008 N N 2.33 2.33 4.66 Wednesday, April 01, 2009 Page 315 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 />
82190 A <strong>04</strong> 10/1/2008 N N 7.31 7.31 14.62<br />
82205 A <strong>04</strong> 10/1/2008 N N 4.43 4.43 8.86<br />
82232 A <strong>04</strong> 10/1/2008 N N 3.96 3.96 7.92<br />
82239 B <strong>04</strong> 10/1/2008 N N 8.38 8.38 16.76<br />
82240 B <strong>04</strong> 10/1/2008 N N 6.38 6.38 12.76<br />
82247 A <strong>04</strong> 10/1/2008 N N 2.33 2.33 4.66<br />
82248 A <strong>04</strong> 10/1/2008 N N 2.33 2.33 4.66<br />
82252 A <strong>04</strong> 10/1/2008 N N 1.31 1.31 2.62<br />
82261 B <strong>04</strong> 10/1/2008 N N 8.25 8.25 16.50<br />
82270 A <strong>04</strong> 10/1/2008 N N 1.24 1.24 2.48<br />
82271 A <strong>04</strong> 10/1/2008 N N 1.02 1.02 2.<strong>04</strong><br />
82272 A <strong>04</strong> 10/1/2008 N N 1.02 1.02 2.<strong>04</strong><br />
82274 A <strong>04</strong> 10/1/2008 N N 5.00 5.00 10.00<br />
82286 A <strong>04</strong> 10/1/2008 N N 2.<strong>01</strong> 2.<strong>01</strong> 4.02<br />
82300 A <strong>04</strong> 10/1/2008 N N 3.34 3.34 6.68<br />
82306 B <strong>04</strong> 10/1/2008 N N 4.43 4.43 8.86<br />
82307 <strong>04</strong> 10/1/2008 N N 8.85 8.85 17.70<br />
82308 A <strong>04</strong> 10/1/2008 N N 3.15 3.15 6.30<br />
82310 A <strong>04</strong> 10/1/2008 N N 2.33 2.33 4.66<br />
82330 A <strong>04</strong> 10/1/2008 N N 6.68 6.68 13.36<br />
82331 A <strong>04</strong> 10/1/2008 N N 2.08 2.08 4.16<br />
Wednesday, April <strong>01</strong>, 20<strong>09</strong> Page 314 <strong>of</strong> 458
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