< Back to the main Clinical Laboratory Fee Schedule page

Upstate Medicare Division -
2008 Clinical Laboratory Fee Schedule – New York – Area 99
- Revised 4-24-08

All Current Procedural Terminology (CPT) codes and descriptors are copyrighted 2007 by the American Medical Association.

Procedure Modifier Fee
ATP02   $7.28
ATP03   $8.93
ATP04   $8.93
ATP05   $8.93
ATP06   $10.96
ATP07   $11.20
ATP08   $11.20
ATP09   $12.13
ATP10   $12.13
ATP11   $12.34
ATP12   $12.62
ATP16   $14.77
ATP18   $14.87
ATP19   $15.45
ATP20   $15.95
ATP21   $16.45
ATP22   $16.95
ATP23   $16.95

HCPCS MODIFIER FEE
G0027   $5.04
G0103   $25.70
G0123   $25.88
G0143   $25.88
G0144   $26.76
G0145   $30.72
G0147   $14.76
G0148   $14.76
G0306   $10.79
G0307   $9.04
G0328   $17.41
G0328 QW $17.41
G0394   $4.54

HCPCS MODIFIER FEE
P2038   $7.02
P3000   $14.76
P9612   $3.00
P9615   $3.00

HCPCS MODIFIER FEE
Q0111   $5.84
Q0112   $5.96
Q0113   $2.21
Q0114   $9.99
Q0115   $13.83

HCPCS MODIFIER FEE
36415   $3.00

HCPCS MODIFIER FEE
78267   $10.98
78268   $94.11

HCPCS MODIFIER FEE
80047   $30.29
80048   $11.20
80051   $8.93
80053   $14.77
80061   $18.72
80061 QW $18.72
80069   $12.13
80074   $66.54
80076   $11.20
80100   $20.32
80101   $19.24
80101 QW $19.24
80102   $18.51
80150   $21.06
80152   $25.01
80154   $25.84
80156   $20.34
80157   $18.52
80158   $25.23
80160   $24.05
80162   $18.55
80164   $18.93
80166   $21.66
80168   $22.83
80170   $22.90
80172   $22.76
80173   $20.34
80174   $24.05
80176   $20.52
80178   $9.24
80178 QW $9.24
80182   $18.93
80184   $16.01
80185   $18.52
80186   $19.23
80188   $23.18
80190   $23.41
80192   $23.41
80194   $20.39
80195   $19.17
80196   $9.92
80197   $19.17
80198   $19.77
80200   $22.52
80201   $16.66
80202   $18.93
80299   $19.13
80400   $45.56
80402   $121.46
80406   $107.96
80408   $175.34
80410   $112.23
80412   $460.50
80414   $72.16
80415   $78.08
80416   $184.38
80417   $61.46
80418   $809.76
80420   $100.64
80422   $64.38
80424   $63.98
80426   $207.40
80428   $93.16
80430   $109.60
80432   $188.73
80434   $141.30
80435   $143.85
80436   $127.36
80438   $70.41
80439   $93.88
80440   $81.24

HCPCS MODIFIER FEE
81000   $4.43
81001   $4.43
81002   $3.57
81003   $3.14
81003 QW $3.14
81005   $2.51
81007   $3.59
81007 QW $3.59
81015   $4.02
81020   $5.15
81025   $8.84
81050   $4.19

HCPCS MODIFIER FEE
82000   $17.31
82003   $28.28
82009   $6.31
82010   $11.42
82010 QW $11.42
82013   $15.61
82016   $19.37
82017   $14.94
82024   $53.97
82030   $36.05
82040   $6.92
82042   $7.23
82043   $7.97
82044   $6.39
82044 QW $6.39
82045   $43.81
82055   $15.10
82055 QW $15.10
82075   $16.84
82085   $13.56
82088   $56.94
82101   $36.54
82103   $18.77
82104   $20.20
82105   $23.15
82106   $23.15
82107   $40.56
82108   $35.60
82120   $5.25
82120 QW $5.25
82127   $19.37
82128   $19.37
82131   $23.57
82135   $23.00
82136   $14.94
82139   $14.94
82140   $20.36
82143   $9.61
82145   $21.72
82150   $9.06
82154   $40.29
82157   $40.90
82160   $34.94
82163   $28.68
82164   $20.39
82172   $19.97
82175   $26.51
82180   $13.81
82190   $7.61
82205   $16.01
82232   $22.61
82239   $8.09
82240   $37.13
82247   $7.02
82248   $7.02
82252   $6.35
82261   $14.94
82270   $4.54
82271   $4.54
82271 QW $4.54
82272   $4.54
82272 QW $4.54
82274   $17.41
82274 QW $17.41
82286   $9.62
82300   $32.33
82306   $40.56
82307   $45.02
82308   $37.41
82310   $7.20
82310 QW $7.20
82330   $19.09
82331   $7.23
82340   $8.43
82355   $16.17
82360   $17.99
82365   $16.26
82370   $17.51
82373   $25.23
82374   $6.83
82375   $14.29
82376   $8.37
82378   $26.51
82379   $14.94
82380   $12.89
82382   $24.02
82383   $27.30
82384   $31.99
82387   $13.66
82390   $13.66
82397   $14.94
82415   $17.70
82435   $6.42
82436   $6.37
82438   $6.37
82441   $8.38
82465   $6.08
82465 QW $6.08
82480   $11.01
82482   $10.74
82485   $28.85
82486   $25.23
82487   $22.30
82488   $29.85
82489   $25.84
82491   $25.23
82492   $25.23
82495   $28.34
82507   $38.85
82520   $21.17
82523   $26.11
82523 QW $26.11
82525   $17.34
82528   $30.43
82530   $23.35
82533   $22.78
82540   $6.48
82541   $25.23
82542   $25.23
82543   $25.23
82544   $25.23
82550   $9.10
82552   $18.71
82553   $10.68
82554   $10.68
82565   $7.16
82565 QW $7.16
82570   $6.11
82570 QW $6.11
82575   $13.20
82585   $11.98
82595   $9.04
82600   $27.11
82607   $20.53
82608   $20.01
82610   $15.86
82615   $9.11
82626   $35.31
82627   $31.07
82633   $43.28
82634   $40.90
82638   $17.11
82646   $28.85
82649   $35.91
82651   $36.07
82652   $53.78
82654   $19.34
82656   $16.01
82657   $25.23
82658   $25.23
82664   $48.00
82666   $30.01
82668   $22.37
82670   $39.04
82671   $45.13
82672   $30.30
82677   $30.73
82679   $32.89
82679 QW $32.89
82690   $24.15
82693   $20.82
82696   $32.95
82705   $6.11
82710   $23.47
82715   $24.05
82725   $18.60
82726   $25.23
82728   $19.03
82731   $40.56
82735   $25.91
82742   $27.66
82746   $18.85
82747   $24.20
82757   $24.24
82759   $30.01
82760   $15.64
82775   $29.43
82776   $11.71
82784   $12.99
82785   $23.01
82787   $5.96
82800   $11.83
82803   $27.04
82805   $39.65
82810   $12.20
82820   $10.76
82926   $7.61
82928   $9.15
82938   $24.72
82941   $24.64
82943   $19.97
82945   $5.48
82946   $21.06
82947   $5.48
82947 QW $5.48
82948   $4.43
82950   $6.11
82950 QW $6.11
82951   $16.12
82951 QW $16.12
82952   $5.48
82952 QW $5.48
82953   $6.11
82955   $13.55
82960   $7.94
82962   $3.27
82963   $30.01
82965   $9.77
82975   $22.13
82977   $10.06
82978   $19.91
82979   $9.62
82980   $25.22
82985   $21.06
82985 QW $21.06

HCPCS MODIFIER FEE
83001   $25.97
83001 QW $25.97
83002   $25.88
83002 QW $25.88
83003   $23.29
83008   $23.45
83009   $94.11
83010   $17.58
83012   $21.70
83013   $94.11
83014   $10.98
83015   $26.31
83018   $30.68
83020   $17.99
83021   $25.23
83026   $3.30
83030   $11.56
83033   $8.33
83036   $13.56
83036 QW $13.56
83037   $13.56
83037 QW $13.56
83045   $6.93
83050   $10.23
83051   $10.21
83055   $6.87
83060   $11.56
83065   $9.62
83068   $11.83
83069   $2.98
83070   $6.64
83071   $9.61
83080   $14.94
83088   $41.26
83090   $23.57
83150   $27.04
83491   $24.47
83497   $18.01
83498   $37.95
83499   $35.22
83500   $31.65
83505   $33.96
83516   $16.01
83518   $11.85
83518 QW $11.85
83519   $18.88
83520   $18.09
83525   $15.98
83527   $18.09
83528   $22.22
83540   $9.05
83550   $12.21
83570   $10.67
83582   $19.80
83586   $17.89
83593   $36.75
83605   $14.92
83605 QW $14.92
83615   $8.44
83625   $17.88
83630   $26.91
83631   $26.91
83632   $28.24
83633   $6.11
83634   $16.10
83655   $16.91
83655 QW $16.91
83661   $30.71
83662   $26.43
83663   $26.43
83664   $26.43
83670   $12.80
83690   $8.97
83695   $18.09
83698   $43.81
83700   $15.73
83701   $34.68
83704   $44.08
83718   $11.44
83718 QW $11.44
83719   $16.26
83721   $12.81
83721 QW $12.81
83727   $24.02
83735   $9.36
83775   $9.11
83785   $34.36
83788   $25.23
83789   $25.23
83805   $24.63
83825   $22.72
83835   $23.67
83840   $22.81
83857   $15.01
83858   $20.71
83864   $27.82
83866   $13.76
83872   $6.50
83873   $24.04
83874   $15.86
83880   $43.81
83880 QW $43.81
83883   $15.86
83885   $27.42
83887   $33.09
83890   $5.60
83891   $5.60
83892   $5.60
83893   $5.60
83894   $5.60
83896   $5.60
83897   $5.60
83898   $23.42
83900   $46.84
83901   $23.42
83902   $19.83
83903   $23.42
83904   $23.42
83905   $23.42
83906   $23.42
83907   $4.92
83908   $23.42
83909   $23.42
83912   $5.60
83913   $4.92
83914   $23.42
83915   $15.58
83916   $27.42
83918   $23.00
83919   $23.00
83921   $23.00
83925   $27.19
83930   $9.24
83935   $9.52
83937   $41.71
83945   $17.99
83950   $40.56
83970   $57.67
83986   $3.12
83986 QW $3.12
83992   $20.54
83993   $26.91

HCPCS MODIFIER FEE
84022   $21.76
84030   $7.69
84035   $5.11
84060   $10.32
84061   $10.39
84066   $13.50
84075   $7.23
84078   $10.20
84080   $20.66
84081   $23.09
84085   $9.42
84087   $9.77
84100   $6.63
84105   $7.16
84106   $5.99
84110   $11.80
84119   $7.78
84120   $20.55
84126   $35.59
84127   $7.78
84132   $6.42
84133   $6.01
84134   $20.38
84135   $26.73
84138   $26.46
84140   $28.89
84143   $31.20
84144   $29.15
84146   $27.08
84150   $34.88
84152   $25.70
84153   $25.70
84154   $25.70
84155   $5.12
84156   $5.12
84157   $5.12
84160   $2.73
84163   $21.03
84165   $15.01
84166   $20.30
84181   $23.80
84182   $25.15
84202   $16.89
84203   $12.03
84206   $24.89
84207   $39.25
84210   $15.17
84220   $13.18
84228   $16.26
84233   $40.56
84234   $40.56
84235   $40.56
84238   $51.09
84244   $30.73
84252   $28.28
84255   $35.67
84260   $43.28
84270   $30.36
84275   $18.77
84285   $32.90
84295   $6.72
84300   $6.79
84302   $6.79
84305   $25.53
84307   $25.53
84311   $9.77
84315   $2.73
84375   $27.39
84376   $6.11
84377   $6.11
84378   $16.10
84379   $16.10
84392   $6.64
84402   $35.57
84403   $36.08
84425   $29.67
84430   $9.23
84432   $11.45
84436   $9.61
84437   $9.04
84439   $12.60
84442   $20.66
84443   $23.47
84443 QW $23.47
84445   $40.56
84446   $19.81
84449   $24.57
84450   $7.22
84450 QW $7.22
84460   $7.40
84460 QW $7.40
84466   $17.84
84478   $8.04
84478 QW $8.04
84479   $8.97
84480   $19.81
84481   $23.67
84482   $8.97
84484   $13.75
84485   $10.49
84488   $10.20
84490   $10.63
84510   $14.53
84512   $10.76
84520   $5.51
84525   $5.25
84540   $5.73
84545   $5.73
84550   $6.27
84560   $6.64
84577   $16.77
84578   $4.54
84580   $9.92
84583   $7.02
84585   $21.66
84586   $26.68
84588   $43.81
84590   $16.20
84591   $16.20
84597   $19.15
84600   $22.45
84620   $15.86
84630   $13.78
84681   $29.07
84702   $21.03
84703   $10.49
84703 QW $10.49
84704   $21.03
84830   $14.02

HCPCS MODIFIER FEE
85002   $6.29
85004   $9.04
85007   $4.81
85008   $3.64
85009   $5.19
85013   $3.31
85014   $3.31
85014 QW $3.31
85018   $3.31
85018 QW $3.31
85025   $10.79
85027   $9.04
85032   $6.01
85041   $4.20
85044   $6.01
85045   $5.59
85046   $7.80
85048   $3.55
85049   $6.25
85055   $37.41
85130   $10.68
85170   $5.05
85175   $6.11
85210   $18.14
85220   $24.66
85230   $25.02
85240   $25.02
85244   $28.53
85245   $32.06
85246   $32.06
85247   $32.06
85250   $26.60
85260   $25.02
85270   $25.02
85280   $27.04
85290   $22.83
85291   $9.23
85292   $26.46
85293   $26.46
85300   $16.55
85301   $15.11
85302   $16.80
85303   $17.81
85305   $16.20
85306 &n