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 J7648 04 Y Y N J7649 04 Y Y N J7650 04 1/1/2007 Y Y N J7657 04 1/1/2007 Y Y N J7658 04 Y Y N J7659 04 Y Y N J7660 04 1/1/2007 Y Y N J7665 04 N Y N 2.15 J7667 04 1/1/2007 Y Y N J7668 04 Y Y N J7669 04 N Y N 0.54 1 0.54 J7670 04 1/1/2007 Y Y N J7674 04 N Y N 0.47 2 0.94 J7676 04 1/1/2008 Y Y N J7680 04 Y Y N J7681 04 Y Y N J7682 04 N Y N 63.79 1 63.79 J7683 04 Y Y N J7684 04 Y Y N J7685 04 1/1/2007 Y Y N J7699 04 Y Y N Wednesday, April 01, 2009 Page 444 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 J7799 04 Y Y N J8499 04 Y Y N J8501 04 Y Y N J8510 04 Y Y N J8520 04 N Y N 3.91 100 391.00 J8521 04 N Y N 13.07 200 2614.00 J8530 04 N Y N 1.91 60 114.60 J8560 04 N Y N 63.56 4 254.24 J8565 04 N Y N 70.68 1 70.68 J8600 04 N Y N 5.39 3 16.17 J8610 04 N Y N 0.36 12 4.32 J8700 04 N Y N 8.84 50 442.00 J8705 04 1/1/2009 N Y N 82.16 10 821.60 J8999 04 Y Y N J9000 04 N Y N 11.67 20 233.40 J9001 04 N Y N 459.35 10 4593.50 J9010 04 N N N 637.29 3 1911.87 J9015 04 N Y N 891.57 1 891.57 J9017 04 N Y N 39.87 15 598.05 J9020 04 N Y N 65.70 2 131.40 J9025 04 N Y N 4.93 185 912.05 Wednesday, April 01, 2009 Page 445 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 />
J7648 <strong>04</strong> Y Y N<br />
J7649 <strong>04</strong> Y Y N<br />
J7650 <strong>04</strong> 1/1/2007 Y Y N<br />
J7657 <strong>04</strong> 1/1/2007 Y Y N<br />
J7658 <strong>04</strong> Y Y N<br />
J7659 <strong>04</strong> Y Y N<br />
J7660 <strong>04</strong> 1/1/2007 Y Y N<br />
J7665 <strong>04</strong> N Y N 2.15<br />
J7667 <strong>04</strong> 1/1/2007 Y Y N<br />
J7668 <strong>04</strong> Y Y N<br />
J7669 <strong>04</strong> N Y N 0.54 1 0.54<br />
J7670 <strong>04</strong> 1/1/2007 Y Y N<br />
J7674 <strong>04</strong> N Y N 0.47 2 0.94<br />
J7676 <strong>04</strong> 1/1/2008 Y Y N<br />
J7680 <strong>04</strong> Y Y N<br />
J7681 <strong>04</strong> Y Y N<br />
J7682 <strong>04</strong> N Y N 63.79 1 63.79<br />
J7683 <strong>04</strong> Y Y N<br />
J7684 <strong>04</strong> Y Y N<br />
J7685 <strong>04</strong> 1/1/2007 Y Y N<br />
J7699 <strong>04</strong> Y Y N<br />
Wednesday, April <strong>01</strong>, 20<strong>09</strong> Page 444 <strong>of</strong> 458
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