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 23585 04 N M Y 449.50 23600 04 N M 194.20 23605 04 N M 277.50 23615 04 N M Y 545.25 23616 04 N M Y 975.25 23620 04 N I 111.00 23625 04 N M 163.70 23630 04 N M Y 524.40 23650 04 N M 178.90 23655 04 N M 255.20 23660 04 N M Y 419.00 23665 04 N M 206.70 23670 04 N M Y 842.10 23675 04 N M 299.70 23680 04 N M Y 599.35 23700 04 N M 194.20 23800 04 N M Y 839.35 23802 04 N M Y 839.35 23900 04 N M Y 1198.70 23920 04 N M Y 1048.85 23921 04 N M Y 224.70 Wednesday, April 01, 2009 Page 56 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 23929 04 Y M Y 23930 04 N M 179.70 17.00 23931 04 N I 141.30 17.00 23935 04 N M Y 240.00 24000 04 N M Y 299.70 24006 04 N M Y 380.15 24065 04 N I 113.60 17.00 24066 04 N M Y 264.25 17.00 24075 04 N M 149.80 24076 04 N M Y 224.70 24077 04 Y M Y Y 24100 04 N M Y 299.70 24101 04 N M Y 480.00 24102 04 N M Y 524.40 24105 04 N M 380.15 24110 04 N M Y 527.20 24115 04 N M Y 749.20 24116 04 N M Y 749.20 24120 04 N M Y 449.50 24125 04 N M Y 749.20 24126 04 N M Y 749.20 Wednesday, April 01, 2009 Page 57 of 458
- Page 13 and 14: Hcpcs Note ProgCov Eff Date HP NDC
- Page 15 and 16: Hcpcs Note ProgCov Eff Date HP NDC
- Page 17 and 18: Hcpcs Note ProgCov Eff Date HP NDC
- Page 19 and 20: Hcpcs Note ProgCov Eff Date HP NDC
- Page 21 and 22: Hcpcs Note ProgCov Eff Date HP NDC
- Page 23 and 24: Hcpcs Note ProgCov Eff Date HP NDC
- Page 25 and 26: Hcpcs Note ProgCov Eff Date HP NDC
- Page 27 and 28: Hcpcs Note ProgCov Eff Date HP NDC
- Page 29 and 30: Hcpcs Note ProgCov Eff Date HP NDC
- Page 31 and 32: Hcpcs Note ProgCov Eff Date HP NDC
- Page 33 and 34: Hcpcs Note ProgCov Eff Date HP NDC
- Page 35 and 36: Hcpcs Note ProgCov Eff Date HP NDC
- Page 37 and 38: Hcpcs Note ProgCov Eff Date HP NDC
- Page 39 and 40: Hcpcs Note ProgCov Eff Date HP NDC
- Page 41 and 42: Hcpcs Note ProgCov Eff Date HP NDC
- Page 43 and 44: Hcpcs Note ProgCov Eff Date HP NDC
- Page 45 and 46: Hcpcs Note ProgCov Eff Date HP NDC
- Page 47 and 48: Hcpcs Note ProgCov Eff Date HP NDC
- Page 49 and 50: Hcpcs Note ProgCov Eff Date HP NDC
- Page 51 and 52: Hcpcs Note ProgCov Eff Date HP NDC
- Page 53 and 54: Hcpcs Note ProgCov Eff Date HP NDC
- Page 55 and 56: Hcpcs Note ProgCov Eff Date HP NDC
- Page 57 and 58: Hcpcs Note ProgCov Eff Date HP NDC
- Page 59 and 60: Hcpcs Note ProgCov Eff Date HP NDC
- Page 61 and 62: Hcpcs Note ProgCov Eff Date HP NDC
- Page 63: Hcpcs Note ProgCov Eff Date HP NDC
- Page 67 and 68: Hcpcs Note ProgCov Eff Date HP NDC
- Page 69 and 70: Hcpcs Note ProgCov Eff Date HP NDC
- Page 71 and 72: Hcpcs Note ProgCov Eff Date HP NDC
- Page 73 and 74: Hcpcs Note ProgCov Eff Date HP NDC
- Page 75 and 76: Hcpcs Note ProgCov Eff Date HP NDC
- Page 77 and 78: Hcpcs Note ProgCov Eff Date HP NDC
- Page 79 and 80: Hcpcs Note ProgCov Eff Date HP NDC
- Page 81 and 82: Hcpcs Note ProgCov Eff Date HP NDC
- Page 83 and 84: Hcpcs Note ProgCov Eff Date HP NDC
- Page 85 and 86: Hcpcs Note ProgCov Eff Date HP NDC
- Page 87 and 88: Hcpcs Note ProgCov Eff Date HP NDC
- Page 89 and 90: Hcpcs Note ProgCov Eff Date HP NDC
- Page 91 and 92: Hcpcs Note ProgCov Eff Date HP NDC
- Page 93 and 94: Hcpcs Note ProgCov Eff Date HP NDC
- Page 95 and 96: Hcpcs Note ProgCov Eff Date HP NDC
- Page 97 and 98: Hcpcs Note ProgCov Eff Date HP NDC
- Page 99 and 100: Hcpcs Note ProgCov Eff Date HP NDC
- Page 101 and 102: Hcpcs Note ProgCov Eff Date HP NDC
- Page 103 and 104: Hcpcs Note ProgCov Eff Date HP NDC
- Page 105 and 106: Hcpcs Note ProgCov Eff Date HP NDC
- Page 107 and 108: Hcpcs Note ProgCov Eff Date HP NDC
- Page 109 and 110: Hcpcs Note ProgCov Eff Date HP NDC
- Page 111 and 112: Hcpcs Note ProgCov Eff Date HP NDC
- Page 113 and 114: 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 />
23585 <strong>04</strong> N M Y 449.50<br />
23600 <strong>04</strong> N M 194.20<br />
23605 <strong>04</strong> N M 277.50<br />
23615 <strong>04</strong> N M Y 545.25<br />
23616 <strong>04</strong> N M Y 975.25<br />
23620 <strong>04</strong> N I 111.00<br />
23625 <strong>04</strong> N M 163.70<br />
23630 <strong>04</strong> N M Y 524.40<br />
23650 <strong>04</strong> N M 178.90<br />
23655 <strong>04</strong> N M 255.20<br />
23660 <strong>04</strong> N M Y 419.00<br />
23665 <strong>04</strong> N M 206.70<br />
23670 <strong>04</strong> N M Y 842.10<br />
23675 <strong>04</strong> N M 299.70<br />
23680 <strong>04</strong> N M Y 599.35<br />
23700 <strong>04</strong> N M 194.20<br />
23800 <strong>04</strong> N M Y 839.35<br />
23802 <strong>04</strong> N M Y 839.35<br />
23900 <strong>04</strong> N M Y 1198.70<br />
23920 <strong>04</strong> N M Y 1<strong>04</strong>8.85<br />
23921 <strong>04</strong> N M Y 224.70<br />
Wednesday, April <strong>01</strong>, 20<strong>09</strong> Page 56 <strong>of</strong> 458
Change language