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 26863 04 N M Y 119.25 26910 04 N M Y 271.90 26951 04 N M Y 271.90 26952 04 N M Y 259.40 26989 04 Y M Y 26990 04 N I 262.45 17.00 26991 04 N I 215.80 17.00 26992 04 N M Y 418.80 27000 04 N M Y 197.00 27001 04 N M Y 202.20 27003 04 N M Y 299.70 27005 04 N M Y 274.65 27006 04 N M Y 289.20 27025 04 N M Y 374.55 27027 04 1/1/2009 N M Y 367.57 27030 04 N M Y 524.40 27033 04 N M Y 599.35 27035 04 N M Y 599.35 27036 04 Y M Y 27040 04 N I 113.60 17.00 27041 04 N I Y 258.20 17.00 Wednesday, April 01, 2009 Page 78 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 27047 04 N M 224.70 27048 04 N M Y 374.55 27049 04 Y M Y Y 27050 04 N M Y 524.40 27052 04 N M Y 524.40 27054 04 N M Y 749.20 27057 04 1/1/2009 N Y 374.55 27060 04 N M Y 277.50 27062 04 N M Y 374.55 27065 04 N M Y 599.35 27066 04 N M Y 674.20 27067 04 N M Y 749.20 27070 04 N M Y 419.00 27071 04 N M Y 480.00 27075 04 N M Y 599.35 27076 04 N M Y Y 681.10 27077 04 N M Y 723.20 27078 04 N M Y 599.35 27079 04 N M Y 599.35 27080 04 N M Y 359.30 27086 04 N I 107.00 17.00 Wednesday, April 01, 2009 Page 79 of 458
- 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 and 64: Hcpcs Note ProgCov Eff Date HP NDC
- Page 65 and 66: 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: 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
- Page 115 and 116: Hcpcs Note ProgCov Eff Date HP NDC
- Page 117 and 118: Hcpcs Note ProgCov Eff Date HP NDC
- Page 119 and 120: Hcpcs Note ProgCov Eff Date HP NDC
- Page 121 and 122: Hcpcs Note ProgCov Eff Date HP NDC
- Page 123 and 124: Hcpcs Note ProgCov Eff Date HP NDC
- Page 125 and 126: Hcpcs Note ProgCov Eff Date HP NDC
- Page 127 and 128: Hcpcs Note ProgCov Eff Date HP NDC
- Page 129 and 130: Hcpcs Note ProgCov Eff Date HP NDC
- Page 131 and 132: Hcpcs Note ProgCov Eff Date HP NDC
- Page 133 and 134: Hcpcs Note ProgCov Eff Date HP NDC
- Page 135 and 136: 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 />
26863 <strong>04</strong> N M Y 119.25<br />
26910 <strong>04</strong> N M Y 271.90<br />
26951 <strong>04</strong> N M Y 271.90<br />
26952 <strong>04</strong> N M Y 259.40<br />
26989 <strong>04</strong> Y M Y<br />
26990 <strong>04</strong> N I 262.45 17.00<br />
26991 <strong>04</strong> N I 215.80 17.00<br />
26992 <strong>04</strong> N M Y 418.80<br />
27000 <strong>04</strong> N M Y 197.00<br />
270<strong>01</strong> <strong>04</strong> N M Y 202.20<br />
27003 <strong>04</strong> N M Y 299.70<br />
27005 <strong>04</strong> N M Y 274.65<br />
27006 <strong>04</strong> N M Y 289.20<br />
27025 <strong>04</strong> N M Y 374.55<br />
27027 <strong>04</strong> 1/1/20<strong>09</strong> N M Y 367.57<br />
27030 <strong>04</strong> N M Y 524.40<br />
27033 <strong>04</strong> N M Y 599.35<br />
27035 <strong>04</strong> N M Y 599.35<br />
27036 <strong>04</strong> Y M Y<br />
27<strong>04</strong>0 <strong>04</strong> N I 113.60 17.00<br />
27<strong>04</strong>1 <strong>04</strong> N I Y 258.20 17.00<br />
Wednesday, April <strong>01</strong>, 20<strong>09</strong> Page 78 <strong>of</strong> 458
Change language