Upstate Medicare Division -
2007 Fee Schedule - Revised 7-13-07

Codes: 60000 - 60999 | 61000 - 61999 | 62000 - 62999 | 63000 - 63999 | 64000 - 64999 |
  65000 - 65999 | 66000 - 66999 | 67000 - 67999 | 68000 - 68999 | 69000 - 69999 |

# These amounts apply when service is performed in a facility setting.
C The payment for the technical component is capped at the OPPS amount.
  Limiting charge applies to unassigned claims by non-participating providers.
  All Current Procedural Terminology (CPT) codes and descriptors are copyrighted 2006 by the American Medical Association.

60000 - 60999

NOTE PROCEDURE MOD PAR AMOUNT NON-PAR AMOUNT LIMITING CHARGE
  60000   132.34 125.72 144.58
# 60000   123.63 117.45 135.07
  60001   87.68 83.30 95.80
# 60001   45.88 43.59 50.13
  60100   102.60 97.47 112.09
# 60100   73.34 69.67 80.12
  60200   565.16 536.90 617.44
  60210   602.36 572.24 658.08
  60212   865.02 821.77 945.04
  60220   659.66 626.68 720.68
  60225   792.72 753.08 866.04
  60240   850.16 807.65 928.80
  60252   1,141.01 1,083.96 1,246.55
  60254   1,490.41 1,415.89 1,628.27
  60260   955.57 907.79 1,043.96
  60270   1,196.25 1,136.44 1,306.91
  60271   925.69 879.41 1,011.32
  60280   377.56 358.68 412.48
  60281   508.11 482.70 555.11
  60500   871.38 827.81 951.98
  60502   1,098.35 1,043.43 1,199.94
  60505   1,213.64 1,152.96 1,325.90
  60512   217.18 206.32 237.27
  60520   914.14 868.43 998.69
  60521   1,043.75 991.56 1,140.29
  60522   1,258.41 1,195.49 1,374.81
  60540   923.57 877.39 1,009.00
  60545   1,062.53 1,009.40 1,160.81
  60600   1,270.02 1,206.52 1,387.50
  60605   1,575.50 1,496.73 1,721.24
  60650   1,040.81 988.77 1,137.09

61000 - 61999

NOTE PROCEDURE MOD PAR AMOUNT NON-PAR AMOUNT LIMITING CHARGE
  61000   92.62 87.99 101.19
  61001   93.13 88.47 101.74
  61020   108.88 103.44 118.96
  61026   115.39 109.62 126.06
  61050   97.16 92.30 106.15
  61055   123.63 117.45 135.07
  61070   71.18 67.62 77.76
  61105   363.08 344.93 396.67
  61107   285.26 271.00 311.65
  61108   719.73 683.74 786.30
  61120   592.64 563.01 647.46
  61140   1,036.52 984.69 1,132.39
  61150   1,115.57 1,059.79 1,218.76
  61151   811.99 771.39 887.10
  61154   1,025.42 974.15 1,120.27
  61156   1,042.82 990.68 1,139.28
  61210   331.87 315.28 362.57
  61215   380.69 361.66 415.91
  61250   704.28 669.07 769.43
  61253   793.44 753.77 866.84
  61304   1,383.30 1,314.14 1,511.26
  61305   1,658.62 1,575.69 1,812.04
  61312   1,713.61 1,627.93 1,872.12
  61313   1,638.62 1,556.69 1,790.19
  61314   1,502.97 1,427.82 1,641.99
  61315   1,742.75 1,655.61 1,903.95
  61316   76.41 72.59 83.48
  61320   1,609.85 1,529.36 1,758.76
  61321   1,763.82 1,675.63 1,926.97
  61322   1,920.44 1,824.42 2,098.08
  61323   1,963.89 1,865.70 2,145.56
  61330   1,380.11 1,311.10 1,507.77
  61332   1,619.47 1,538.50 1,769.28
  61333   1,618.23 1,537.32 1,767.92
  61334   1,067.27 1,013.91 1,166.00
  61340   1,195.43 1,135.66 1,306.01
  61343   1,856.05 1,763.25 2,027.74
  61345   1,706.16 1,620.85 1,863.98
  61440   1,641.86 1,559.77 1,793.74
  61450   1,571.53 1,492.95 1,716.89
  61458   1,693.69 1,609.01 1,850.36
  61460   1,741.18 1,654.12 1,902.24
  61470   1,564.72 1,486.48 1,709.45
  61480   1,592.43 1,512.81 1,739.73
  61490   1,599.80 1,519.81 1,747.78
  61500   1,128.71 1,072.27 1,233.11
  61501   958.79 910.85 1,047.48
  61510   1,816.44 1,725.62 1,984.46
  61512   2,168.12 2,059.71 2,368.67
  61514   1,593.98 1,514.28 1,741.42
  61516   1,560.59 1,482.56 1,704.94
  61517   77.07 73.22 84.20
  61518   2,328.24 2,211.83 2,543.60
  61519   2,519.26 2,393.30 2,752.30
  61520   3,241.56 3,079.48 3,541.40
  61521   2,712.66 2,577.03 2,963.58
  61522   1,828.88 1,737.44 1,998.06
  61524   1,743.77 1,656.58 1,905.07
  61526   2,978.70 2,829.77 3,254.24
  61530   2,520.08 2,394.08 2,753.19
  61531   979.25 930.29 1,069.83
  61533   1,262.29 1,199.18 1,379.06
  61534   1,349.45 1,281.98 1,474.28
  61535   793.49 753.82 866.89
  61536   2,193.96 2,084.26 2,396.90
  61537   1,954.21 1,856.50 2,134.98
  61538   2,082.66 1,978.53 2,275.31
  61539   1,974.95 1,876.20 2,157.63
  61540   1,867.84 1,774.45 2,040.62
  61541   1,782.33 1,693.21 1,947.19
  61542   1,937.40 1,840.53 2,116.61
  61543   1,825.68 1,734.40 1,994.56
  61544   1,568.21 1,489.80 1,713.27
  61545   2,674.37 2,540.65 2,921.75
  61546   1,932.91 1,836.26 2,111.70
  61548   1,314.42 1,248.70 1,436.01
  61550   781.34 742.27 853.61
  61552   1,013.31 962.64 1,107.04
  61556   1,345.15 1,277.89 1,469.57
  61557   1,412.59 1,341.96 1,543.25
  61558   1,374.11 1,305.40 1,501.21
  61559   2,040.85 1,938.81 2,229.63
  61563   1,621.73 1,540.64 1,771.74
  61564   2,021.92 1,920.82 2,208.94
  61566   1,888.42 1,794.00 2,063.10
  61567   2,109.51 2,004.03 2,304.63
  61570   1,536.35 1,459.53 1,678.46
  61571   1,665.22 1,581.96 1,819.25
  61575   2,027.96 1,926.56 2,215.54
  61576   3,155.15 2,997.39 3,447.00
  61580   2,106.90 2,001.56 2,301.79
  61581   2,256.25 2,143.44 2,464.96
  61582   2,352.77 2,235.13 2,570.40
  61583   2,425.05 2,303.80 2,649.37
  61584   2,353.66 2,235.98 2,571.38
  61585   2,535.84 2,409.05 2,770.41
  61586   1,840.65 1,748.62 2,010.91
  61590   2,684.29 2,550.08 2,932.59
  61591   2,722.38 2,586.26 2,974.20
  61592   2,654.41 2,521.69 2,899.94
  61595   1,998.95 1,899.00 2,183.85
  61596   2,227.95 2,116.55 2,434.03
  61597   2,413.39 2,292.72 2,636.63
  61598   2,177.34 2,068.47 2,378.74
  61600   1,791.27 1,701.71 1,956.97
  61601   1,957.17 1,859.31 2,138.21
  61605   1,906.16 1,810.85 2,082.48
  61606   2,527.29 2,400.93 2,761.07
  61607   2,368.85 2,250.41 2,587.97
  61608   2,749.09 2,611.64 3,003.39
  61609   561.38 533.31 613.31
  61610   1,646.47 1,564.15 1,798.77
  61611   424.78 403.54 464.07
  61612   1,478.11 1,404.20 1,614.83
  61613   2,673.60 2,539.92 2,920.91
  61615   2,098.12 1,993.21 2,292.19
  61616   2,779.61 2,640.63 3,036.72
  61618   1,089.02 1,034.57 1,189.76
  61619   1,266.96 1,203.61 1,384.15
  61623   499.77 474.78 546.00
  61624   970.15 921.64 1,059.89
  61626   783.78 744.59 856.28
  61680   1,909.25 1,813.79 2,085.86
  61682   3,642.69 3,460.56 3,979.64
  61684   2,430.32 2,308.80 2,655.12
  61686   3,891.54 3,696.96 4,251.50
  61690   1,814.91 1,724.16 1,982.78
  61692   3,129.88 2,973.39 3,419.40
  61697   3,465.85 3,292.56 3,786.44
  61698   3,654.58 3,471.85 3,992.63
  61700   2,986.64 2,837.31 3,262.91
  61702   3,240.20 3,078.19 3,539.92
  61703   1,108.74 1,053.30 1,211.30
  61705   2,176.67 2,067.84 2,378.02
  61708   1,834.64 1,742.91 2,004.35
  61710   1,644.50 1,562.28 1,796.62
  61711   2,218.09 2,107.19 2,423.27
  61720   999.94 949.94 1,092.43
  61735   1,243.68 1,181.50 1,358.73
  61750   1,165.86 1,107.57 1,273.71
  61751   1,133.71 1,077.02 1,238.57
  61760   1,227.70 1,166.32 1,341.27
  61770   1,284.22 1,220.01 1,403.01
  61790   685.93 651.63 749.37
  61791   907.53 862.15 991.47
  61793   1,068.48 1,015.06 1,167.32
  61795   222.26 211.15 242.82
  61850   782.76 743.62 855.16
  61860   1,294.34 1,229.62 1,414.06
  61863   1,255.36 1,192.59 1,371.48
  61864   364.69 346.46 398.43
  61867   1,875.87 1,782.08 2,049.39
  61868   537.46 510.59 587.18
  61870   981.18 932.12 1,071.94
  61875   902.19 857.08 985.64
  61880   443.63 421.45 484.67
  61885   495.13 470.37 540.93
  61886   624.08 592.88 681.81
  61888   338.40 321.48 369.70

62000 - 62999

NOTE PROCEDURE MOD PAR AMOUNT NON-PAR AMOUNT LIMITING CHARGE
  62000   705.42 670.15 770.67
  62005   1,008.77 958.33 1,102.08
  62010   1,266.82 1,203.48 1,384.00
  62100   1,358.73 1,290.79 1,484.41
  62115   1,340.65 1,273.62 1,464.66
  62116   1,469.11 1,395.65 1,605.00
  62117   1,609.16 1,528.70 1,758.01
  62120   1,528.52 1,452.09 1,669.90
  62121   1,413.99 1,343.29 1,544.78
  62140   873.50 829.83 954.30
  62141   957.44 909.57 1,046.01
  62142   719.48 683.51 786.04
  62143   851.41 808.84 930.17
  62145   1,169.72 1,111.23 1,277.91
  62146   1,008.79 958.35 1,102.10
  62147   1,198.82 1,138.88 1,309.71
  62148   109.59 104.11 119.73
  62160   171.91 163.31 187.81
  62161   1,273.10 1,209.45 1,390.87
  62162   1,568.56 1,490.13 1,713.65
  62163   1,012.31 961.69 1,105.94
  62164   1,656.05 1,573.25 1,809.24
  62165   1,314.50 1,248.78 1,436.10
  62180   1,317.48 1,251.61 1,439.35
  62190   734.74 698.00 802.70
  62192   801.01 760.96 875.10
  62194   313.00 297.35 341.95
  62200   1,149.01 1,091.56 1,255.29
  62201   973.66 924.98 1,063.73
  62220   844.14 801.93 922.22
  62223   851.10 808.55 929.83
  62225   398.50 378.58 435.37
  62230   688.68 654.25 752.39
  62252   84.67 80.44 92.51
  62252 TC 42.30 40.19 46.22
  62252 26 42.38 40.26 46.30
  62256   466.54 443.21 509.69
  62258   933.47 886.80 1,019.82
  62263   639.29 607.33 698.43
# 62263   337.33 320.46 368.53
  62264   408.41 387.99 446.19
# 62264   205.71 195.42 224.73
  62268   529.25 502.79 578.21
# 62268   241.92 229.82 264.29
  62269   621.52 590.44 679.01
# 62269   245.73 233.44 268.46
  62270   146.85 139.51 160.44
# 62270   67.79 64.40 74.06
  62272   171.25 162.69 187.09
# 62272   74.08 70.38 80.94
  62273   161.75 153.66 176.71
# 62273   100.11 95.10 109.37
  62280   315.06 299.31 344.21
# 62280   132.91 126.26 145.20
  62281   275.08 261.33 300.53
# 62281   126.37 120.05 138.06
  62282   336.38 319.56 367.49
# 62282   117.31 111.44 128.16
  62284   216.86 206.02 236.92
# 62284   79.29 75.33 86.63
  62287   497.85 472.96 543.90
  62290   332.07 315.47 362.79
# 62290   153.75 146.06 167.97
  62291   296.36 281.54 323.77
# 62291   146.95 139.60 160.54
  62292   476.75 452.91 520.85
  62294   661.08 628.03 722.23
  62310   219.71 208.72 240.03
# 62310   90.15 85.64 98.49
# 62311   75.15 71.39 82.10
  62311   206.45 196.13 225.55
  62318   249.65 237.17 272.75
# 62318   93.63 88.95 102.29
  62319   221.43 210.36 241.91
# 62319   86.64 82.31 94.66
  62350   439.05 417.10 479.67
  62351   704.06 668.86 769.19
  62355   356.92 339.07 389.93
  62360   233.98 222.28 255.62
  62361   382.15 363.04 417.50
  62362   477.68 453.80 521.87
  62365   372.80 354.16 407.28
  62367   36.56 34.73 39.94
# 62367   20.54 19.51 22.44
  62368   50.24 47.73 54.89
# 62368   32.83 31.19 35.87

63000 - 63999

NOTE PROCEDURE MOD PAR AMOUNT NON-PAR AMOUNT LIMITING CHARGE
  63001   1,027.78 976.39 1,122.85
  63003   1,039.33 987.36 1,135.46
  63005   985.56 936.28 1,076.72
  63011   920.16 874.15 1,005.27
  63012   1,009.13 958.67 1,102.47
  63015   1,241.64 1,179.56 1,356.49
  63016   1,275.49 1,211.72 1,393.48
  63017   1,040.64 988.61 1,136.90
  63020   981.75 932.66 1,072.56
  63030   816.17 775.36 891.66
  63035   179.43 170.46 196.03
  63040   1,204.04 1,143.84 1,315.42
  63042   1,132.00 1,075.40 1,236.71
  63043   241.51 229.43 263.84
  63044   228.22 216.81 249.33
  63045   1,070.41 1,016.89 1,169.42
  63046   1,026.28 974.97 1,121.22
  63047   941.56 894.48 1,028.65
  63048   191.44 181.87 209.15
  63050   1,250.63 1,188.10 1,366.32
  63051   1,437.57 1,365.69 1,570.54
  63055   1,384.05 1,314.85 1,512.08
  63056   1,289.39 1,224.92 1,408.66
  63057   295.69 280.91 323.05
  63064   1,528.48 1,452.06 1,669.87
  63066   182.79 173.65 199.70
  63075   1,193.85 1,134.16 1,304.28
  63076   229.02 217.57 250.21
  63077   1,308.30 1,242.89 1,429.32
  63078   182.09 172.99 198.94
  63081   1,519.83 1,443.84 1,660.42
  63082   247.09 234.74 269.95
  63085   1,638.64 1,556.71 1,790.22
  63086   175.55 166.77 191.79
  63087   2,087.26 1,982.90 2,280.34
  63088   239.17 227.21 261.29
  63090   1,698.13 1,613.22 1,855.20
  63091   163.64 155.46 178.78
  63101   1,955.13 1,857.37 2,135.98
  63102   1,952.70 1,855.07 2,133.33
  63103   263.04 249.89 287.37
  63170   1,296.98 1,232.13 1,416.95
  63172   1,160.89 1,102.85 1,268.28
  63173   1,420.55 1,349.52 1,551.95
  63180   1,177.78 1,118.89 1,286.72
  63182   1,256.39 1,193.57 1,372.61
  63185   928.36 881.94 1,014.23
  63190   1,075.21 1,021.45 1,174.67
  63191   1,169.47 1,111.00 1,277.65
  63194   1,214.84 1,154.10 1,327.22
  63195   1,253.24 1,190.58 1,369.17
  63196   1,475.01 1,401.26 1,611.45
  63197   1,389.19 1,319.73 1,517.69
  63198   1,475.06 1,401.31 1,611.51
  63199   1,576.57 1,497.74 1,722.40
  63200   1,250.71 1,188.17 1,366.40
  63250   2,425.68 2,304.40 2,650.06
  63251   2,558.53 2,430.60 2,795.19
  63252   2,554.24 2,426.53 2,790.51
  63265   1,394.08 1,324.38 1,523.04
  63266