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 82805 A 04 10/1/2008 N N 5.44 5.44 10.88 82810 A 04 10/1/2008 N N 2.85 2.85 5.70 82820 A 04 10/1/2008 N N 4.89 4.89 9.78 82926 A 04 10/1/2008 N N 2.66 2.66 5.32 82928 A 04 10/1/2008 N N 1.76 1.76 3.52 82938 04 10/1/2008 N N 8.40 8.40 16.80 82941 B 04 10/1/2008 N N 3.96 3.96 7.92 82943 A 04 10/1/2008 N N 3.51 3.51 7.02 82945 A 04 10/1/2008 N N 1.54 1.54 3.08 82946 B 04 10/1/2008 N N 5.25 5.25 10.50 82947 A 04 10/1/2008 N N 1.91 1.91 3.82 82948 A 04 10/1/2008 N N .86 .86 1.72 82950 A 04 10/1/2008 N N 2.33 2.33 4.66 82951 B 04 10/1/2008 N N 6.30 6.30 12.60 82952 A 04 10/1/2008 N N 1.91 1.91 3.82 82953 A 04 10/1/2008 N N 2.33 2.33 4.66 82955 A 04 10/1/2008 N N 4.31 4.31 8.62 82960 A 04 10/1/2008 N N 2.96 2.96 5.92 82962 A 04 10/1/2008 N N .84 .84 1.68 82963 B 04 10/1/2008 N N 6.32 6.32 12.64 82965 A 04 10/1/2008 N N 3.58 3.58 7.16 Wednesday, April 01, 2009 Page 320 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 82975 B 04 10/1/2008 N N 2.70 2.70 5.40 82977 A 04 10/1/2008 N N 2.70 2.70 5.40 82978 A 04 10/1/2008 N N 4.80 4.80 9.60 82979 A 04 10/1/2008 N N 1.76 1.76 3.52 82980 A 04 10/1/2008 N N 3.08 3.08 6.16 82985 B 04 10/1/2008 N N 6.71 6.71 13.42 83001 A 04 10/1/2008 N N 9.09 9.09 18.18 83002 A 04 10/1/2008 N N 4.43 4.43 8.86 83003 A 04 10/1/2008 N N 4.43 4.43 8.86 83008 A 04 10/1/2008 N N 5.63 5.63 11.26 83009 A 04 10/1/2008 N N 21.18 21.18 42.36 83010 A 04 10/1/2008 N N 4.43 4.43 8.86 83012 A 04 10/1/2008 N N 3.34 3.34 6.68 83013 B 04 10/1/2008 N N 4.31 4.31 8.62 83014 B 04 10/1/2008 N N 3.83 3.83 7.66 83015 B 04 10/1/2008 N N 9.23 9.23 18.46 83018 A 04 10/1/2008 N N 2.33 2.33 4.66 83020 B 04 10/1/2008 N N 4.31 4.31 8.62 83021 B 04 10/1/2008 N N 6.09 6.09 12.18 83026 A 04 10/1/2008 N N 1.14 1.14 2.28 83030 A 04 10/1/2008 N N 1.61 1.61 3.22 Wednesday, April 01, 2009 Page 321 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 />
82805 A <strong>04</strong> 10/1/2008 N N 5.44 5.44 10.88<br />
82810 A <strong>04</strong> 10/1/2008 N N 2.85 2.85 5.70<br />
82820 A <strong>04</strong> 10/1/2008 N N 4.89 4.89 9.78<br />
82926 A <strong>04</strong> 10/1/2008 N N 2.66 2.66 5.32<br />
82928 A <strong>04</strong> 10/1/2008 N N 1.76 1.76 3.52<br />
82938 <strong>04</strong> 10/1/2008 N N 8.40 8.40 16.80<br />
82941 B <strong>04</strong> 10/1/2008 N N 3.96 3.96 7.92<br />
82943 A <strong>04</strong> 10/1/2008 N N 3.51 3.51 7.02<br />
82945 A <strong>04</strong> 10/1/2008 N N 1.54 1.54 3.08<br />
82946 B <strong>04</strong> 10/1/2008 N N 5.25 5.25 10.50<br />
82947 A <strong>04</strong> 10/1/2008 N N 1.91 1.91 3.82<br />
82948 A <strong>04</strong> 10/1/2008 N N .86 .86 1.72<br />
82950 A <strong>04</strong> 10/1/2008 N N 2.33 2.33 4.66<br />
82951 B <strong>04</strong> 10/1/2008 N N 6.30 6.30 12.60<br />
82952 A <strong>04</strong> 10/1/2008 N N 1.91 1.91 3.82<br />
82953 A <strong>04</strong> 10/1/2008 N N 2.33 2.33 4.66<br />
82955 A <strong>04</strong> 10/1/2008 N N 4.31 4.31 8.62<br />
82960 A <strong>04</strong> 10/1/2008 N N 2.96 2.96 5.92<br />
82962 A <strong>04</strong> 10/1/2008 N N .84 .84 1.68<br />
82963 B <strong>04</strong> 10/1/2008 N N 6.32 6.32 12.64<br />
82965 A <strong>04</strong> 10/1/2008 N N 3.58 3.58 7.16<br />
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