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Practitioner Fee Schedule (pdf)- Updated 04/01/09 - State of Illinois

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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 />

82340 A <strong>04</strong> 10/1/2008 N N 2.70 2.70 5.40<br />

82355 A <strong>04</strong> 10/1/2008 N N 2.33 2.33 4.66<br />

82360 A <strong>04</strong> 10/1/2008 N N 4.54 4.54 9.08<br />

82365 A <strong>04</strong> 10/1/2008 N N 2.33 2.33 4.66<br />

82370 A <strong>04</strong> 10/1/2008 N N 2.33 2.33 4.66<br />

82373 A <strong>04</strong> 10/1/2008 N N 2.81 2.81 5.62<br />

82374 A <strong>04</strong> 10/1/2008 N N 2.40 2.40 4.80<br />

82375 A <strong>04</strong> 10/1/2008 N N 2.33 2.33 4.66<br />

82376 A <strong>04</strong> 10/1/2008 N N 2.33 2.33 4.66<br />

82378 B <strong>04</strong> 10/1/2008 N N 6.71 6.71 13.42<br />

82379 A <strong>04</strong> 10/1/2008 N N 5.81 5.81 11.62<br />

82380 A <strong>04</strong> 10/1/2008 N N 2.33 2.33 4.66<br />

82382 B <strong>04</strong> 10/1/2008 N N 7.58 7.58 15.16<br />

82383 B <strong>04</strong> 10/1/2008 N N 7.58 7.58 15.16<br />

82384 B <strong>04</strong> 10/1/2008 N N 7.58 7.58 15.16<br />

82387 B <strong>04</strong> 10/1/2008 N N 5.74 5.74 11.48<br />

82390 B <strong>04</strong> 10/1/2008 N N 4.43 4.43 8.86<br />

82397 A <strong>04</strong> 10/1/2008 N N 6.92 6.92 13.84<br />

82415 A <strong>04</strong> 10/1/2008 N N 4.43 4.43 8.86<br />

82435 A <strong>04</strong> 10/1/2008 N N 2.25 2.25 4.50<br />

82436 A <strong>04</strong> 10/1/2008 N N 2.33 2.33 4.66<br />

Wednesday, April <strong>01</strong>, 20<strong>09</strong> Page 315 <strong>of</strong> 458

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