MISSISSIPPI MEDICARE CARRIER - 07302
MEDICARE FEE SCHEDULE EFFECTIVE 01/01/2024
STATEWIDE
******
**A2001**1174.20*1115.49*1282.81
**A2002**344.73*327.49*376.61
**A2004**13.78*13.09*15.05
**A2005**267.80*254.41*292.57
**A2007**84.75*80.51*92.59
**A2008**92.91*88.26*101.50
**A2013**1313.25*1247.59*1434.73
**A2014**61.16*58.10*66.82
**A2015**1236.00*1174.20*1350.33
**A2019**580.92*551.87*634.65
**A2021**1387.93*1318.53*1516.31
**A2022**1339.00*1272.05*1462.86
**A2023**15.45*14.68*16.88
**A2024**2008.50*1908.08*2194.29
**A2025**257.50*244.63*281.32
**G0186**409.10*388.65*446.95
#**G0186**354.08*336.38*386.84
**G0339**2451.51*2328.93*2678.27
**G0340**1843.71*1751.52*2014.25
**G0398**119.76*113.77*130.84
**G0398*TC*82.76*78.62*90.41
**G0398*26*37.00*35.15*40.42
**G0399**84.70*80.47*92.54
**G0399*TC*43.90*41.71*47.97
**G0399*26*41.08*39.03*44.88
**G0400**86.86*82.52*94.90
**G0400*TC*48.72*46.28*53.22
**G0400*26*38.14*36.23*41.66
**G0460**688.44*654.02*752.12
#**G0460**112.43*106.81*122.83
**G0465**688.44*654.02*752.12
#**G0465**112.43*106.81*122.83
**G0498**126.19*119.88*137.86
**G6017**70.06*66.56*76.54
**0042T**202.97*192.82*221.74
**0054T**211.24*200.68*230.78
**0055T**211.24*200.68*230.78
**0071T**528.02*501.62*576.86
**0072T**528.02*501.62*576.86
**0075T**898.24*853.33*981.33
**0075T*TC*898.24*853.33*981.33
**0075T*26*898.24*853.33*981.33
**0095T**569.03*540.58*621.67
**0098T**637.39*605.52*696.35
**0100T**1740.94*1653.89*1901.97
**0101T**283.03*268.88*309.21
#**0101T**207.88*197.49*227.11
**0102T**283.03*268.88*309.21
#**0102T**207.88*197.49*227.11
**0106T**28.83*27.39*31.50
**0107T**28.83*27.39*31.50
**0108T**28.83*27.39*31.50
**0109T**28.83*27.39*31.50
**0110T**28.83*27.39*31.50
**0164T**621.63*590.55*679.13
**0165T**636.99*605.14*695.91
**0184T**755.68*717.90*825.59
**0198T**75.27*71.51*82.24
#**0198T**29.89*28.40*32.66
**0200T**1545.89*1468.60*1688.89
#**0200T**375.72*356.93*410.47
**0201T**2318.84*2202.90*2533.34
#**0201T**563.58*535.40*615.71
**0207T**121.71*115.62*132.96
**0208T**32.30*30.69*35.29
**0209T**39.11*37.15*42.72
**0210T**24.65*23.42*26.93
**0211T**38.26*36.35*41.80
**0212T**33.81*32.12*36.94
#**0212T**29.56*28.08*32.29
**0213T**172.67*164.04*188.65
#**0213T**97.52*92.64*106.54
**0214T**88.19*83.78*96.35
#**0214T**55.29*52.53*60.41
**0215T**88.48*84.06*96.67
#**0215T**56.15*53.34*61.34
**0216T**158.23*150.32*172.87
#**0216T**83.64*79.46*91.38
**0217T**82.07*77.97*89.67
#**0217T**47.47*45.10*51.87
**0218T**82.07*77.97*89.67
#**0218T**48.32*45.90*52.79
**0219T**1194.54*1134.81*1305.03
**0220T**1175.10*1116.35*1283.80
**0221T**1452.45*1379.83*1586.80
**0222T**357.68*339.80*390.77
**0232T**688.44*654.02*752.12
#**0232T**112.43*106.81*122.83
**0234T**7331.04*6964.49*8009.16
#**0234T**544.55*517.32*594.92
**0235T**7331.04*6964.49*8009.16
#**0235T**544.55*517.32*594.92
**0236T**7467.78*7094.39*8158.55
#**0236T**631.66*600.08*690.09
**0237T**7467.78*7094.39*8158.55
#**0237T**631.66*600.08*690.09
**0238T**7467.78*7094.39*8158.55
#**0238T**631.66*600.08*690.09
**0266T**825.49*784.22*901.85
**0267T**147.13*139.77*160.74
**0268T**306.24*290.93*334.57
**0269T**780.36*741.34*852.54
**0270T**147.13*139.77*160.74
**0271T**306.24*290.93*334.57
**0272T**49.71*47.22*54.30
**0273T**64.56*61.33*70.53
**0274T**1007.04*956.69*1100.19
**0278T**13.40*12.73*14.64
**0308T**1276.13*1212.32*1394.17
**0329T**75.27*71.51*82.24
#**0329T**29.89*28.40*32.66
**0330T**38.21*36.30*41.75
**0331T**159.73*151.74*174.50
**0332T**272.83*259.19*298.07
**0347T**131.20*124.64*143.34
**0348T**29.01*27.56*31.69
**0349T**30.61*29.08*33.44
**0350T**31.18*29.62*34.06
**0351T**148.19*140.78*161.90
**0352T**40.16*38.15*43.87
**0353T**148.19*140.78*161.90
**0354T**40.16*38.15*43.87
**0358T**22.94*21.79*25.06
**0362T**83.55*79.37*91.28
#**0362T**61.71*58.62*67.41
**0378T**23.27*22.11*25.43
**0394T**217.63*206.75*237.76
**0395T**533.28*506.62*582.61
**0397T**44.05*41.85*48.13
**0398T*26*1746.88*1659.54*1908.47
**0408T**469.08*445.63*512.47
**0409T**323.34*307.17*353.25
**0410T**335.54*318.76*366.57
**0411T**335.54*318.76*366.57
**0412T**209.71*199.22*229.10
**0413T**437.89*416.00*478.40
**0414T**337.09*320.24*368.28
**0415T**281.15*267.09*307.15
**0416T**309.48*294.01*338.11
**0417T**74.98*71.23*81.91
**0418T**49.71*47.22*54.30
**0419T**404.71*384.47*442.14
#**0419T**328.70*312.27*359.11
**0420T**577.70*548.82*631.14
#**0420T**483.82*459.63*528.57
**0421T**1422.97*1351.82*1554.59
#**0421T**643.33*611.16*702.83
**0437T**196.66*186.83*214.85
**0439T**63.51*60.33*69.38
**0440T**220.74*209.70*241.16
#**0440T**110.13*104.62*120.31
**0441T**220.74*209.70*241.16
#**0441T**110.13*104.62*120.31
**0442T**220.74*209.70*241.16
#**0442T**110.13*104.62*120.31
**0449T**691.91*657.31*755.91
**0464T**58.96*56.01*64.41
**0472T**60.12*57.11*65.68
**0473T**49.71*47.22*54.30
**0479T**58.84*55.90*64.29
**0480T**137.97*131.07*150.73
#**0480T**29.42*27.95*32.14
**0483T**1100.59*1045.56*1202.39
**0484T**1427.97*1356.57*1560.06
**0485T**21.30*20.24*23.28
**0485T*TC*7.49*7.12*8.19
**0485T*26*14.06*13.36*15.36
**0486T**42.59*40.46*46.53
**0486T*TC*14.72*13.98*16.08
**0486T*26*27.87*26.48*30.45
**0488T**58.05*55.15*63.42
#**0488T**46.99*44.64*51.34
**0505T**9539.52*9062.54*10421.92
#**0505T**493.15*468.49*538.76
**0507T**20.04*19.04*21.90
**0507T*TC*17.27*16.41*18.87
**0507T*26*2.77*2.63*3.02
**0510T**540.02*513.02*589.97
#**0510T**386.87*367.53*422.66
**0512T**283.03*268.88*309.21
#**0512T**207.88*197.49*227.11
**0513T**84.91*80.66*92.76
#**0513T**62.36*59.24*68.13
**0515T**469.08*445.63*512.47
**0516T**432.80*411.16*472.83
**0517T**306.24*290.93*334.57
**0518T**209.71*199.22*229.10
**0519T**306.94*291.59*335.33
**0520T**432.80*411.16*472.83
**0521T**49.71*47.22*54.30
**0521T*TC*30.60*29.07*33.43
**0521T*26*19.11*18.15*20.87
**0522T**60.12*57.11*65.68
**0522T*TC*31.17*29.61*34.05
**0522T*26*28.95*27.50*31.63
**0523T**135.69*128.91*148.25
**0524T**1412.57*1341.94*1543.23
#**0524T**164.41*156.19*179.62
**0525T**433.08*411.43*473.14
**0526T**335.54*318.76*366.57
**0527T**292.31*277.69*319.34
**0528T**60.12*57.11*65.68
**0528T*TC*31.17*29.61*34.05
**0528T*26*28.95*27.50*31.63
**0529T**49.71*47.22*54.30
**0529T*TC*30.60*29.07*33.43
**0529T*26*19.11*18.15*20.87
**0530T**574.79*546.05*627.96
**0531T**437.89*416.00*478.40
**0532T**306.94*291.59*335.33
**0540T**164.25*156.04*179.45
**0543T**1427.97*1356.57*1560.06
**0544T**1636.73*1554.89*1788.12
**0545T**1636.73*1554.89*1788.12
**0546T**64.62*61.39*70.60
**0552T**5.94*5.64*6.49
**0553T**2122.84*2016.70*2319.21
#**0553T**364.18*345.97*397.87
**0565T**552.35*524.73*603.44
#**0565T**467.55*444.17*510.80
**0566T**89.80*85.31*98.11
#**0566T**54.92*52.17*60.00
**0569T**1636.73*1554.89*1788.12
**0570T**385.12*365.86*420.74
**0571T**507.03*481.68*553.93
**0572T**413.03*392.38*451.24
**0573T**314.22*298.51*343.29
**0574T**365.01*346.76*398.77
**0575T**60.12*57.11*65.68
**0576T**49.71*47.22*54.30
**0577T**176.07*167.27*192.36
**0578T**27.52*26.14*30.06
**0579T**18.12*17.21*19.79
**0580T**193.68*184.00*211.60
**0581T**1944.35*1847.13*2124.20
#**0581T**193.35*183.68*211.23
**0582T**1436.43*1364.61*1569.30
#**0582T**352.76*335.12*385.39
**0583T**1522.66*1446.53*1663.51
#**0583T**120.10*114.10*131.22
**0587T**399.43*379.46*436.38
#**0587T**273.51*259.83*298.80
**0588T**327.37*311.00*357.65
#**0588T**212.51*201.88*232.16
**0589T**44.49*42.27*48.61
#**0589T**36.26*34.45*39.62
**0590T**51.93*49.33*56.73
#**0590T**37.47*35.60*40.94
**0596T**672.69*639.06*734.92
#**0596T**125.28*119.02*136.87
**0597T**672.69*639.06*734.92
#**0597T**125.28*119.02*136.87
**0598T**129.98*123.48*142.00
**0599T**86.85*82.51*94.89
**0600T**3111.04*2955.49*3398.81
#**0600T**679.38*645.41*742.22
**0601T**1334.68*1267.95*1458.14
**0607T**19.36*18.39*21.15
**0608T**1217.40*1156.53*1330.01
**0609T**173.77*165.08*189.84
**0611T**34.54*32.81*37.73
**0614T**336.62*319.79*367.76
**0615T**43.21*41.05*47.21
**0616T**606.34*576.02*662.42
**0617T**675.35*641.58*737.82
**0618T**816.94*776.09*892.50
**0619T**589.79*560.30*644.35
#**0619T**438.43*416.51*478.99
**0620T**1414.22*1343.51*1545.04
**0623T**1600.00*1520.00*1748.00
**0624T**25.00*23.75*27.31
**0625T**1500.00*1425.00*1638.75
**0626T**75.00*71.25*81.94
**0627T**228.45*217.03*249.58
#**0627T**92.31*87.69*100.84
**0628T**68.53*65.10*74.87
#**0628T**27.69*26.31*30.26
**0629T**228.45*217.03*249.58
#**0629T**92.31*87.69*100.84
**0630T**68.53*65.10*74.87
#**0630T**27.69*26.31*30.26
**0631T**71.14*67.58*77.72
**0632T**526.10*499.80*574.77
**0633T**177.23*168.37*193.63
*C*0633T*TC*90.73*86.19*99.12
**0633T*26*55.62*52.84*60.77
**0634T**177.23*168.37*193.63
**0634T*TC*121.61*115.53*132.86
**0634T*26*55.62*52.84*60.77
**0635T**177.23*168.37*193.63
**0635T*TC*121.61*115.53*132.86
**0635T*26*55.62*52.84*60.77
**0636T**177.23*168.37*193.63
**0636T*TC*121.61*115.53*132.86
**0636T*26*55.62*52.84*60.77
**0637T**177.23*168.37*193.63
**0637T*TC*121.61*115.53*132.86
**0637T*26*55.62*52.84*60.77
**0638T**177.23*168.37*193.63
**0638T*TC*121.61*115.53*132.86
**0638T*26*55.62*52.84*60.77
**0639T**71.14*67.58*77.72
**0640T**20.04*19.04*21.90
**0640T*TC*17.37*16.50*18.98
**0640T*26*2.77*2.63*3.02
**0644T**1009.23*958.77*1102.59
#**0644T**222.78*211.64*243.39
**0646T**1636.73*1554.89*1788.12
**0648T**350.51*332.98*382.93
**0648T*TC*235.45*223.68*257.23
**0648T*26*115.06*109.31*125.71
**0650T**53.24*50.58*58.17
**0652T**254.32*241.60*277.84
#**0652T**112.52*106.89*122.92
**0653T**330.85*314.31*361.46
#**0653T**127.22*120.86*138.99
**0654T**130.74*124.20*142.83
**0655T**1422.97*1351.82*1554.59
#**0655T**643.33*611.16*702.83
**0658T**80.80*76.76*88.27
**0659T**2326.21*2209.90*2541.39
#**0659T**401.64*381.56*438.79
**0671T**930.51*883.98*1016.58
**0673T**2950.19*2802.68*3223.08
#**0673T**338.43*321.51*369.74
**0699T**102.36*97.24*111.83
#**0699T**83.64*79.46*91.38
**0707T**329.36*312.89*359.82
#**0707T**250.80*238.26*274.00
**0714T**1221.12*1160.06*1334.07
#**0714T**328.89*312.45*359.32
**0730T**239.47*227.50*261.63
#**0730T**216.45*205.63*236.47
**0738T**66.02*62.72*72.13
**0739T**1422.97*1351.82*1554.59
#**0739T**643.33*611.16*702.83
**0740T**16.96*16.11*18.53
**0741T**40.24*38.23*43.96
**0742T**81.85*77.76*89.42
**0742T*TC*63.77*60.58*69.67
**0742T*26*18.08*17.18*19.76
**0743T**46.77*44.43*51.09
**0744T**818.04*777.14*893.71
**0745T**218.75*207.81*238.98
**0746T**210.65*200.12*230.14
**0747T**845.88*803.59*924.13
**0748T**168.60*160.17*184.20
**0751T**0.01*0.01*0.01
**0752T**0.01*0.01*0.01
**0753T**0.01*0.01*0.01
**0754T**0.01*0.01*0.01
**0755T**0.01*0.01*0.01
**0756T**0.01*0.01*0.01
**0757T**0.01*0.01*0.01
**0758T**0.01*0.01*0.01
**0759T**0.01*0.01*0.01
**0760T**0.01*0.01*0.01
**0761T**0.01*0.01*0.01
**0762T**0.01*0.01*0.01
**0763T**0.01*0.01*0.01
**0764T**3.89*3.70*4.26
**0765T**7.62*7.24*8.33
**0771T**24.68*23.45*26.97
**0772T**24.68*23.45*26.97
**0773T**20.71*19.67*22.62
**0774T**20.71*19.67*22.62
**0777T**325.00*308.75*355.06
#**0777T**25.00*23.75*27.31
**0777T*TC*276.25*262.44*301.81
#**0777T*TC*21.25*20.19*23.22
**0777T*26*48.75*46.31*53.26
#**0777T*26*3.75*3.56*4.09
**0779T**374.57*355.84*409.22
**0779T*TC*350.23*332.72*382.63
**0779T*26*24.34*23.12*26.59
**0780T**20.71*19.67*22.62
**0783T**12.17*11.56*13.29
**0784T**1832.10*1740.50*2001.58
#**0784T**301.18*286.12*329.04
**0785T**216.02*205.22*236.00
#**0785T**132.36*125.74*144.60
**0786T**648.67*616.24*708.68
#**0786T**281.68*267.60*307.74
**0787T**216.02*205.22*236.00
#**0787T**132.36*125.74*144.60
**0788T**17.52*16.64*19.14
#**0788T**16.96*16.11*18.53
**0789T**24.01*22.81*26.23
#**0789T**21.19*20.13*23.15
**0790T**1792.66*1703.03*1958.48
**0791T**8.32*7.90*9.09
**0793T**526.10*499.80*574.77
**0794T**130.35*123.83*142.40
**0795T**649.20*616.74*709.25
**0796T**432.80*411.16*472.83
**0797T**432.80*411.16*472.83
**0798T**688.15*653.74*751.80
**0799T**458.77*435.83*501.20
**0800T**458.77*435.83*501.20
**0801T**891.57*846.99*974.04
**0802T**445.78*423.49*487.01
**0803T**445.78*423.49*487.01
**0804T**70.36*66.84*76.87
**0804T*TC*35.99*34.19*39.32
**0804T*26*34.37*32.65*37.55
**0805T**2548.77*2421.33*2784.53
#**0805T**303.43*288.26*331.50
**0806T**3398.36*3228.44*3712.71
#**0806T**404.58*384.35*442.00
**0807T**37.67*35.79*41.16
**0807T*TC*23.80*22.61*26.00
**0807T*26*13.87*13.18*15.16
**0808T**37.67*35.79*41.16
**0808T*TC*23.80*22.61*26.00
**0808T*26*13.87*13.18*15.16
**0810T**1035.76*983.97*1131.57
**0811T**16.96*16.11*18.53
**0813T**2225.55*2114.27*2431.41
#**0813T**165.97*157.67*181.32
**0814T**411.70*391.12*449.79
#**0814T**313.50*297.83*342.50
**0818T**327.37*311.00*357.65
#**0818T**212.51*201.88*232.16
**0820T**140.67*133.64*153.69
#**0820T**125.64*119.36*137.26
**0821T**140.67*133.64*153.69
#**0821T**125.64*119.36*137.26
**0822T**119.57*113.59*130.63
#**0822T**106.79*101.45*116.67
**0823T**649.20*616.74*709.25
**0824T**688.15*653.74*751.80
**0825T**891.57*846.99*974.04
**0826T**60.12*57.11*65.68
**0826T*TC*31.17*29.61*34.05
**0826T*26*28.95*27.50*31.63
**0827T**0.01*0.01*0.01
**0828T**0.01*0.01*0.01
**0829T**0.01*0.01*0.01
**0830T**0.01*0.01*0.01
**0831T**0.01*0.01*0.01
**0832T**0.01*0.01*0.01
**0833T**0.01*0.01*0.01
**0834T**0.01*0.01*0.01
**0835T**0.01*0.01*0.01
**0836T**0.01*0.01*0.01
**0837T**0.01*0.01*0.01
**0838T**0.01*0.01*0.01
**0839T**0.01*0.01*0.01
**0840T**0.01*0.01*0.01
**0841T**0.01*0.01*0.01
**0842T**0.01*0.01*0.01
**0843T**0.01*0.01*0.01
**0844T**0.01*0.01*0.01
**0845T**0.01*0.01*0.01
**0846T**0.01*0.01*0.01
**0847T**0.01*0.01*0.01
**0848T**0.01*0.01*0.01
**0849T**0.01*0.01*0.01
**0850T**0.01*0.01*0.01
**0851T**0.01*0.01*0.01
**0852T**0.01*0.01*0.01
**0853T**0.01*0.01*0.01
**0854T**0.01*0.01*0.01
**0855T**0.01*0.01*0.01
**0856T**0.01*0.01*0.01
**0859T**20.04*19.04*21.90
**0859T*TC*17.27*16.41*18.87
**0859T*26*2.77*2.63*3.02
**0864T**283.03*268.88*309.21
#**0864T**207.88*197.49*227.11
**10011**373.26*354.60*407.79
#**10011**101.27*96.21*110.64
**10012**207.49*197.12*226.69
#**10012**67.95*64.55*74.23
**15847**321.86*305.77*351.64
**21088**1686.18*1601.87*1842.15
**21742**1066.73*1013.39*1165.40
**21743**1223.19*1162.03*1336.33
**32855**330.90*314.36*361.51
**32856**417.80*396.91*456.45
**33928**3074.58*2920.85*3358.98
**33929**1151.88*1094.29*1258.43
**33933**507.00*481.65*553.90
**33944**406.82*386.48*444.45
**34841**1909.76*1814.27*2086.41
**34842**2135.54*2028.76*2333.07
**34843**2361.32*2243.25*2579.74
**34844**2587.09*2457.74*2826.40
**34845**1909.76*1814.27*2086.41
**34846**2135.54*2028.76*2333.07
**34847**2361.32*2243.25*2579.74
**34848**2587.09*2457.74*2826.40
**43496**1941.81*1844.72*2121.43
**43647**718.12*682.21*784.54
**43648**491.78*467.19*537.27
#**43648**225.44*214.17*246.30
**43881**611.70*581.12*668.29
#**43881**562.42*534.30*614.45
**43882**644.68*612.45*704.32
#**43882**591.62*562.04*646.35
**47143**381.20*362.14*416.46
**47144**452.68*430.05*494.56
**47145**428.81*407.37*468.48
**48551**249.50*237.03*272.58
**50323**190.52*180.99*208.14
**50325**276.55*262.72*302.13
**53451**702.26*667.15*767.22
**53452**351.13*333.57*383.61
**53453**596.75*566.91*651.95
**53454**51.49*48.92*56.26
#**53454**33.06*31.41*36.12
**63043**518.18*492.27*566.11
**63044**474.82*451.08*518.74
**64596**1832.10*1740.50*2001.58
#**64596**301.18*286.12*329.04
**64597**549.63*522.15*600.47
#**64597**90.35*85.83*98.70
**64598**216.02*205.22*236.00
#**64598**132.36*125.74*144.60
**65757**109.24*103.78*119.35
**66983**606.34*576.02*662.42
**66987**709.31*673.84*774.92
**66988**586.84*557.50*641.13
*C*70170**215.80*205.01*235.76
*C*70170*TC*202.19*192.08*220.89
**70555**233.47*221.80*255.07
**70555*TC*122.03*115.93*133.32
*C*70557**596.71*566.87*651.90
*C*70557*TC*455.17*432.41*497.27
*C*70558**307.75*292.36*336.21
*C*70558*TC*151.70*144.12*165.74
*C*70559**298.90*283.96*326.55
*C*70559*TC*151.70*144.12*165.74
*C*74190**475.88*452.09*519.90
*C*74190*TC*455.17*432.41*497.27
**74235**127.97*121.57*139.81
**74235*TC*74.91*71.16*81.83
**74300**72.61*68.98*79.33
**74300*TC*60.27*57.26*65.85
**74301**22.31*21.19*24.37
**74301*TC*13.08*12.43*14.29
**74328**175.06*166.31*191.26
**74328*TC*153.51*145.83*167.70
**74329**122.25*116.14*133.56
**74329*TC*100.42*95.40*109.71
**74330**262.59*249.46*286.88
**74330*TC*237.23*225.37*259.18
**74340**86.58*82.25*94.59
**74340*TC*62.73*59.59*68.53
**74355**86.58*82.25*94.59
**74355*TC*52.60*49.97*57.47
**74360**86.58*82.25*94.59
**74360*TC*61.37*58.30*67.05
**74363**175.06*166.31*191.26
**74363*TC*136.26*129.45*148.87
*C*74445**141.04*133.99*154.09
*C*74445*TC*90.73*86.19*99.12
*C*74450**216.83*205.99*236.89
*C*74450*TC*202.19*192.08*220.89
*C*74470**478.45*454.53*522.71
*C*74470*TC*455.17*432.41*497.27
**74742**233.47*221.80*255.07
**74742*TC*206.16*195.85*225.23
*C*74775**229.83*218.34*251.09
*C*74775*TC*202.19*192.08*220.89
*C*75801**557.77*529.88*609.36
*C*75801*TC*518.41*492.49*566.36
*C*75803**1373.98*1305.28*1501.07
*C*75803*TC*1321.59*1255.51*1443.84
*C*75805**2666.66*2533.33*2913.33
*C*75805*TC*2630.45*2498.93*2873.77
*C*75807**2679.95*2545.95*2927.84
*C*75807*TC*2630.45*2498.93*2873.77
*C*75810**2676.06*2542.26*2923.60
*C*75810*TC*2630.45*2498.93*2873.77
**75894**763.97*725.77*834.64
**75894*TC*698.43*663.51*763.04
*C*75898**2713.86*2578.17*2964.90
*C*75898*TC*2630.45*2498.93*2873.77
**75970**373.86*355.17*408.45
**75970*TC*338.46*321.54*369.77
**76125**34.62*32.89*37.82
**76125*TC*22.28*21.17*24.35
**76390**178.08*169.18*194.56
**76390*TC*129.67*123.19*141.67
**76390*26*48.41*45.99*52.89
**76932**74.34*70.62*81.21
**76932*TC*41.23*39.17*45.05
**76940**141.12*134.06*154.17
**76940*TC*48.07*45.67*52.52
**76941**103.45*98.28*113.02
**76941*TC*43.33*41.16*47.33
**76945**73.53*69.85*80.33
**76945*TC*43.60*41.42*47.63
*C*76975**240.13*228.12*262.34
*C*76975*TC*202.19*192.08*220.89
**76998**175.06*166.31*191.26
**76998*TC*131.89*125.30*144.10
**77013**363.03*344.88*396.61
**77013*TC*191.77*182.18*209.51
**77022**412.14*391.53*450.26
**77022*TC*225.67*214.39*246.55
**77371**533.40*506.73*582.74
**77520**773.98*735.28*845.57
**77522**773.98*735.28*845.57
**77523**888.71*844.27*970.91
**77525**1003.47*953.30*1096.30
*C*78282**354.91*337.16*387.73
*C*78282*TC*340.30*323.29*371.78
**78414**514.99*489.24*562.63
**78414*TC*495.22*470.46*541.03
*C*78429**1365.26*1297.00*1491.55
*C*78429*TC*1290.96*1226.41*1410.37
*C*78430**1361.73*1293.64*1487.69
*C*78430*TC*1290.96*1226.41*1410.37
*C*78431**2031.58*1930.00*2219.50
*C*78431*TC*1949.22*1851.76*2129.52
*C*78432**1690.93*1606.38*1847.34
*C*78432*TC*1602.65*1522.52*1750.90
*C*78433**1785.99*1696.69*1951.19
*C*78433*TC*1689.43*1604.96*1845.70
**78434**599.53*569.55*654.98
**78434*TC*572.38*543.76*625.32
*C*78459**1240.59*1178.56*1355.34
*C*78459*TC*1171.85*1113.26*1280.25
*C*78491**1358.35*1290.43*1483.99
*C*78491*TC*1290.96*1226.41*1410.37
*C*78492**1370.00*1301.50*1496.73
*C*78492*TC*1290.96*1226.41*1410.37
*C*78608**1355.76*1287.97*1481.17
*C*78608*TC*1290.96*1226.41*1410.37
*C*78811**1238.51*1176.58*1353.07
*C*78811*TC*1171.85*1113.26*1280.25
*C*78812**1375.09*1306.34*1502.29
*C*78812*TC*1290.96*1226.41*1410.37
*C*78813**1377.14*1308.28*1504.52
*C*78813*TC*1290.96*1226.41*1410.37
*C*78814**1386.32*1317.00*1514.55
*C*78814*TC*1290.96*1226.41*1410.37
*C*78815**1397.12*1327.26*1526.35
*C*78815*TC*1290.96*1226.41*1410.37
*C*78816**1398.29*1328.38*1527.64
*C*78816*TC*1290.96*1226.41*1410.37
**79300**237.04*225.19*258.97
**79300*TC*176.18*167.37*192.48
**79445**237.04*225.19*258.97
**79445*TC*134.57*127.84*147.02
**86485**15.20*14.44*16.61
**90867**264.41*251.19*288.87
#**90867**125.30*119.04*136.90
**90868**180.68*171.65*197.40
#**90868**99.25*94.29*108.43
**90869**250.40*237.88*273.56
#**90869**146.08*138.78*159.60
**92978**213.79*203.10*233.57
**92978*TC*127.60*121.22*139.40
**92979**131.44*124.87*143.60
**92979*TC*62.96*59.81*68.78
*C*93315**572.82*544.18*625.81
*C*93315*TC*455.17*432.41*497.27
**93317**187.71*178.32*205.07
**93317*TC*106.09*100.79*115.91
*C*93318**549.65*522.17*600.50
*C*93318*TC*455.17*432.41*497.27
**93571**212.95*202.30*232.65
**93571*TC*147.29*139.93*160.92
**93572**129.51*123.03*141.48
**93572*TC*81.72*77.63*89.27
**93600**3557.81*3379.92*3886.91
**93600*TC*3452.62*3279.99*3771.99
**93602**3557.81*3379.92*3886.91
**93602*TC*3454.27*3281.56*3773.79
**93603**3557.81*3379.92*3886.91
**93603*TC*3454.27*3281.56*3773.79
**93609**2134.69*2027.96*2332.15
**93609*TC*1887.83*1793.44*2062.46
**93610**3557.81*3379.92*3886.91
**93610*TC*3411.43*3240.86*3726.99
**93612**3557.81*3379.92*3886.91
**93612*TC*3413.33*3242.66*3729.06
**93615**44.70*42.47*48.84
**93615*TC*11.88*11.29*12.98
**93619**7115.62*6759.84*7773.82
**93619*TC*6766.91*6428.56*7392.84
**93620**7115.62*6759.84*7773.82
**93620*TC*6556.22*6228.41*7162.67
**93621**7115.62*6759.84*7773.82
**93621*TC*7041.26*6689.20*7692.58
**93622**7115.62*6759.84*7773.82
**93622*TC*6962.18*6614.07*7606.18
**93623**2134.69*2027.96*2332.15
**93623*TC*2074.24*1970.53*2266.11
**93624**3557.81*3379.92*3886.91
**93624*TC*3340.18*3173.17*3649.15
**93631**7115.62*6759.84*7773.82
**93631*TC*6756.67*6418.84*7381.67
**93640**1133.95*1077.25*1238.84
**93640*TC*974.10*925.40*1064.21
**93641**1133.95*1077.25*1238.84
**93641*TC*854.69*811.96*933.75
**93662**363.73*345.54*397.37
**93662*TC*298.61*283.68*326.23
**94642**203.81*193.62*222.66
**95700**259.12*246.16*283.08
**95705**103.65*98.47*113.24
**95706**431.17*409.61*471.05
**95707**538.96*512.01*588.81
**95708**155.47*147.70*169.86
**95709**861.30*818.24*940.98
**95710**1076.88*1023.04*1176.50
**95711**129.56*123.08*141.54
**95712**518.23*492.32*566.17
**95713**647.79*615.40*707.71
**95714**207.29*196.93*226.47
**95715**1036.46*984.64*1132.34
**95716**1295.58*1230.80*1415.42
**95965**903.87*858.68*987.48
**95965*TC*529.38*502.91*578.35
**95966**1820.86*1729.82*1989.29
**96020**376.39*357.57*411.21
**96547**644.77*612.53*704.41
#**96547**123.78*117.59*135.23
**96548**322.39*306.27*352.21
#**96548**61.89*58.80*67.62
**97151**47.44*45.07*51.83
#**97151**42.62*40.49*46.56
**97152**40.32*38.30*44.05
#**97152**36.22*34.41*39.57
**97153**32.19*30.58*35.17
#**97153**28.65*27.22*31.30
**97154**4.33*4.11*4.73
#**97154**3.97*3.77*4.34
**97155**32.19*30.58*35.17
#**97155**28.65*27.22*31.30
**97156**34.00*32.30*37.15
#**97156**30.31*28.79*33.11
**97157**9.85*9.36*10.76
#**97157**9.00*8.55*9.83
**97158**5.05*4.80*5.52
#**97158**4.63*4.40*5.06
**98978**40.24*38.23*43.96
# - THESE AMOUNTS APPLY WHEN SERVICE IS PERFORMED IN A FACILITY SETTING.
C - THE PAYMENT FOR THE TECHNICAL COMPONENT IS CAPPED AT THE OPPS AMOUNT.
LC (LIMITING CHARGE) APPLIES TO UNASSIGNED CLAIMS BY NON-PARTICIPATING PROVIDERS.
SOME CODES ARE CARRIER PRICED & SUBJECT TO CHANGE. OUR FEE LOOKUP TOOL HAS CURRENT PRICING.
ALL CURRENT PROCEDURAL TERMINOLOGY (CPT) CODES AND DESCRIPTORS ARE
COPYRIGHTED 2023 BY THE AMERICAN MEDICAL ASSOCIATION.