Part B Fee Schedules

Fee Schedule 35013-35601

CPT/HCPC Code	Medicare Location	Global Surgery Indicator	Multiple Surgery Indicator	Prevailing Charge Amount	Fee Schedule Amount	Site of Service Amount
35013	004	90	2	X	4,079.38	X
35013	001	90	2	X	4,241.63	X
35013	003	90	2	X	4,096.48	X
35013	002	90	2	X	4,213.30	X
35021	002	90	2	X	4,348.21	X
35021	003	90	2	X	4,043.44	X
35021	001	90	2	X	4,421.89	X
35021	004	90	2	X	3,995.06	X
35022	004	90	2	X	4,003.06	X
35022	003	90	2	X	4,049.07	X
35022	002	90	2	X	4,330.14	X
35022	001	90	2	X	4,398.46	X
35045	001	90	2	X	2,861.39	X
35045	004	90	2	X	2,553.42	X
35045	002	90	2	X	2,807.30	X
35045	003	90	2	X	2,641.24	X
35081	002	90	2	X	5,626.19	X
35081	003	90	2	X	5,158.54	X
35081	001	90	2	X	5,620.36	X
35081	004	90	2	X	5,370.84	X
35082	004	90	2	X	6,242.42	X
35082	002	90	2	X	6,688.79	X
35082	003	90	2	X	6,302.40	X
35082	001	90	2	X	6,809.47	X
35091	003	90	2	X	5,665.17	X
35091	002	90	2	X	6,162.97	X
35091	004	90	2	X	5,653.91	X
35091	001	90	2	X	6,367.73	X
35092	003	90	2	X	8,894.02	X
35092	002	90	2	X	9,107.59	X
35092	004	90	2	X	8,859.90	X
35092	001	90	2	X	9,159.57	X
35102	001	90	2	X	6,113.02	X
35102	003	90	2	X	5,646.76	X
35102	002	90	2	X	5,611.69	X
35102	004	90	2	X	5,665.64	X
35103	004	90	2	X	6,936.69	X
35103	001	90	2	X	7,591.34	X
35103	002	90	2	X	7,495.16	X
35103	003	90	2	X	6,992.80	X
35111	002	90	2	X	4,007.79	X
35111	003	90	2	X	3,792.77	X
35111	004	90	2	X	3,747.71	X
35111	001	90	2	X	4,198.62	X
35112	002	90	2	X	3,362.16	X
35112	003	90	2	X	3,145.49	X
35112	004	90	2	X	3,110.58	X
35112	001	90	2	X	3,414.69	X
35121	003	90	2	X	5,348.25	X
35121	002	90	2	X	5,607.49	X
35121	004	90	2	X	5,221.33	X
35121	001	90	2	X	5,577.15	X
35122	004	90	2	X	5,590.53	X
35122	003	90	2	X	6,183.08	X
35122	002	90	2	X	6,192.35	X
35122	001	90	2	X	6,333.26	X
35131	001	90	2	X	4,546.17	X
35131	004	90	2	X	4,413.02	X
35131	003	90	2	X	4,429.76	X
35131	002	90	2	X	4,623.84	X
35132	003	90	2	X	4,752.57	X
35132	002	90	2	X	5,080.22	X
35132	001	90	2	X	5,156.84	X
35132	004	90	2	X	4,713.46	X
35141	002	90	2	X	3,976.86	X
35141	003	90	2	X	3,754.37	X
35141	004	90	2	X	3,701.05	X
35141	001	90	2	X	4,046.54	X
35142	003	90	2	X	4,122.58	X
35142	002	90	2	X	4,245.97	X
35142	004	90	2	X	4,104.96	X
35142	001	90	2	X	4,320.04	X
35151	003	90	2	X	4,025.47	X
35151	002	90	2	X	4,233.43	X
35151	004	90	2	X	4,009.52	X
35151	001	90	2	X	4,312.18	X
35152	004	90	2	X	2,761.45	X
35152	003	90	2	X	2,792.47	X
35152	002	90	2	X	4,356.88	X
35152	001	90	2	X	3,030.40	X
35180	004	90	2	X	2,175.39	X
35180	001	90	2	X	3,298.89	X
35180	003	90	2	X	2,199.94	X
35180	002	90	2	X	3,283.69	X
35182	001	90	2	X	3,198.06	X
35182	004	90	2	X	2,934.15	X
35182	002	90	2	X	3,621.37	X
35182	003	90	2	X	2,968.19	X
35184	003	90	2	X	2,345.40	X
35184	002	90	2	X	3,452.09	X
35184	004	90	2	X	3,175.83	X
35184	001	90	2	X	3,470.69	X
35188	001	90	2	X	3,383.65	X
35188	004	90	2	X	2,360.17	X
35188	003	90	2	X	2,386.79	X
35188	002	90	2	X	3,367.27	X
35189	004	90	2	X	3,628.85	X
35189	001	90	2	X	3,481.28	X
35189	003	90	2	X	3,206.87	X
35189	002	90	2	X	3,736.74	X
35190	003	90	2	X	3,457.79	X
35190	002	90	2	X	3,529.80	X
35190	004	90	2	X	3,441.91	X
35190	001	90	2	X	3,455.21	X
35201	002	90	2	X	2,450.68	X
35201	003	90	2	X	2,177.16	X
35201	004	90	2	X	2,151.10	X
35201	001	90	2	X	2,529.39	X
35206	001	90	2	X	2,377.37	X
35206	004	90	2	X	2,124.81	X
35206	003	90	2	X	2,150.61	X
35206	002	90	2	X	2,333.08	X
35207	004	90	2	X	2,240.05	X
35207	002	90	2	X	3,247.76	X
35207	003	90	2	X	3,319.08	X
35207	001	90	2	X	3,414.53	X
35211	003	90	2	X	3,777.82	X
35211	002	90	2	X	4,037.70	X
35211	001	90	2	X	4,795.89	X
35211	004	90	2	X	3,735.08	X
35216	004	90	2	X	3,091.59	X
35216	001	90	2	X	3,388.35	X
35216	002	90	2	X	4,353.87	X
35216	003	90	2	X	3,126.71	X
35221	001	90	2	X	3,233.03	X
35221	004	90	2	X	2,933.72	X
35221	003	90	2	X	2,967.52	X
35221	002	90	2	X	3,181.12	X
35226	001	90	2	X	2,614.00	X
35226	002	90	2	X	3,246.32	X
35226	003	90	2	X	2,121.66	X
35226	004	90	2	X	2,096.00	X
35231	004	90	2	X	2,915.52	X
35231	003	90	2	X	3,582.04	X
35231	002	90	2	X	3,791.78	X
35231	001	90	2	X	3,918.55	X
35236	002	90	2	X	2,715.73	X
35236	003	90	2	X	2,555.49	X
35236	001	90	2	X	2,795.27	X
35236	004	90	2	X	2,463.57	X
35241	002	90	2	X	4,160.61	X
35241	003	90	2	X	3,897.04	X
35241	004	90	2	X	3,853.20	X
35241	001	90	2	X	4,224.63	X
35246	002	90	2	X	4,135.72	X
35246	003	90	2	X	3,881.23	X
35246	001	90	2	X	4,197.24	X
35246	004	90	2	X	3,834.42	X
35251	001	90	2	X	3,127.02	X
35251	004	90	2	X	2,856.51	X
35251	003	90	2	X	2,888.78	X
35251	002	90	2	X	3,080.39	X
35256	004	90	2	X	2,563.39	X
35256	002	90	2	X	2,812.99	X
35256	003	90	2	X	2,616.32	X
35256	001	90	2	X	2,824.37	X
35261	004	90	2	X	2,695.14	X
35261	001	90	2	X	3,273.97	X
35261	002	90	2	X	2,964.67	X
35261	003	90	2	X	3,359.39	X
35266	004	90	2	X	2,370.85	X
35266	002	90	2	X	2,611.28	X
35266	003	90	2	X	2,399.72	X
35266	001	90	2	X	2,662.66	X
35271	001	90	2	X	4,002.76	X
35271	004	90	2	X	3,646.71	X
35271	003	90	2	X	3,687.91	X
35271	002	90	2	X	3,941.25	X
35276	002	90	2	X	3,749.38	X
35276	003	90	2	X	3,163.78	X
35276	001	90	2	X	3,438.21	X
35276	004	90	2	X	3,128.46	X
35281	002	90	2	X	4,032.40	X
35281	003	90	2	X	3,894.28	X
35281	001	90	2	X	4,107.17	X
35281	004	90	2	X	3,679.27	X
35286	001	90	2	X	2,827.48	X
35286	004	90	2	X	2,555.30	X
35286	003	90	2	X	2,593.58	X
35286	002	90	2	X	2,798.93	X
35301	001	90	2	X	3,893.35	X
35301	004	90	2	X	3,589.16	X
35301	003	90	2	X	3,594.15	X
35301	002	90	2	X	3,813.73	X
35302	001	90	2	X	2,171.05	X
35302	004	90	2	X	1,921.94	X
35302	003	90	2	X	1,921.94	X
35302	002	90	2	X	1,921.94	X
35303	004	90	2	X	2,112.07	X
35303	002	90	2	X	2,112.07	X
35303	003	90	2	X	2,112.07	X
35303	001	90	2	X	2,383.73	X
35304	001	90	2	X	2,480.24	X
35304	003	90	2	X	2,197.71	X
35304	002	90	2	X	2,197.71	X
35304	004	90	2	X	2,197.71	X
35305	001	90	2	X	2,383.73	X
35305	004	90	2	X	2,112.07	X
35305	002	90	2	X	2,112.07	X
35305	003	90	2	X	2,112.07	X
35306	002	ZZZ	0	X	792.98	X
35306	003	ZZZ	0	X	792.98	X
35306	001	ZZZ	0	X	892.90	X
35306	004	ZZZ	0	X	792.98	X
35311	004	90	2	X	5,078.84	X
35311	002	90	2	X	5,031.50	X
35311	003	90	2	X	4,887.22	X
35311	001	90	2	X	5,657.52	X
35321	004	90	2	X	2,749.23	X
35321	001	90	2	X	3,078.89	X
35321	003	90	2	X	2,782.41	X
35321	002	90	2	X	3,021.05	X
35331	001	90	2	X	4,327.61	X
35331	003	90	2	X	4,567.83	X
35331	002	90	2	X	4,746.76	X
35331	004	90	2	X	3,949.68	X
35341	004	90	2	X	4,604.77	X
35341	001	90	2	X	5,079.04	X
35341	003	90	2	X	4,657.63	X
35341	002	90	2	X	4,996.69	X
35351	004	90	2	X	4,189.96	X
35351	001	90	2	X	4,486.49	X
35351	003	90	2	X	4,145.28	X
35351	002	90	2	X	4,410.61	X
35355	001	90	2	X	4,364.12	X
35355	003	90	2	X	4,218.87	X
35355	002	90	2	X	4,335.75	X
35355	004	90	2	X	4,201.54	X
35361	001	90	2	X	5,191.10	X
35361	002	90	2	X	5,102.67	X
35361	003	90	2	X	5,252.54	X
35361	004	90	2	X	4,683.56	X
35363	004	90	2	X	5,185.29	X
35363	003	90	2	X	5,247.04	X
35363	002	90	2	X	5,660.13	X
35363	001	90	2	X	5,760.15	X
35371	001	90	2	X	3,527.50	X
35371	004	90	2	X	3,185.86	X
35371	003	90	2	X	3,242.06	X
35371	002	90	2	X	3,479.91	X
35372	001	90	2	X	3,548.00	X
35372	004	90	2	X	3,236.50	X
35372	002	90	2	X	3,496.23	X
35372	003	90	2	X	3,266.40	X
35390	001	ZZZ	0	X	596.76	X
35390	003	ZZZ	0	X	550.46	X
35390	002	ZZZ	0	X	587.74	X
35390	004	ZZZ	0	X	544.43	X
35400	002	ZZZ	0	X	491.31	X
35400	003	ZZZ	0	X	491.31	X
35400	004	ZZZ	0	X	491.31	X
35400	001	ZZZ	0	X	551.89	X
35500		ZZZ	0	X	*	X
35501	002	90	2	X	4,613.77	X
35501	003	90	2	X	4,278.68	X
35501	004	90	2	X	4,227.64	X
35501	001	90	2	X	4,694.92	X
35506	004	90	2	X	4,224.59	X
35506	001	90	2	X	4,933.83	X
35506	003	90	2	X	4,275.40	X
35506	002	90	2	X	4,879.69	X
35508	001	90	2	X	4,437.24	X
35508	002	90	2	X	4,359.30	X
35508	003	90	2	X	4,037.30	X
35508	004	90	2	X	3,989.27	X
35509	002	90	2	X	4,465.14	X
35509	003	90	2	X	4,115.99	X
35509	001	90	2	X	4,549.79	X
35509	004	90	2	X	4,067.14	X
35510	002	90	2	X	2,762.01	X
35510	003	90	2	X	2,762.01	X
35510	004	90	2	X	2,762.01	X
35510	001	90	2	X	3,043.06	X
35511	001	90	2	X	3,142.25	X
35511	004	90	2	X	2,865.00	X
35511	002	90	2	X	3,354.51	X
35511	003	90	2	X	3,339.20	X
35512	001	90	2	X	2,986.56	X
35512	004	90	2	X	2,708.70	X
35512	002	90	2	X	2,708.70	X
35512	003	90	2	X	2,708.70	X
35515	002	90	2	X	3,398.13	X
35515	003	90	2	X	3,187.22	X
35515	004	90	2	X	3,151.13	X
35515	001	90	2	X	3,449.26	X
35516	002	90	2	X	4,043.42	X
35516	003	90	2	X	3,726.57	X
35516	004	90	2	X	3,682.09	X
35516	001	90	2	X	4,120.13	X
35518	003	90	2	X	3,631.65	X
35518	001	90	2	X	4,013.65	X
35518	002	90	2	X	3,939.17	X
35518	004	90	2	X	3,749.64	X
35521	001	90	2	X	5,139.31	X
35521	004	90	2	X	5,002.64	X
35521	002	90	2	X	5,113.97	X
35521	003	90	2	X	4,893.04	X
35522	003	90	2	X	2,629.14	X
35522	002	90	2	X	2,629.14	X
35522	001	90	2	X	2,902.18	X
35522	004	90	2	X	2,629.14	X
35523	003	90	2	X	2,229.81	X
35523	002	90	2	X	2,229.81	X
35523	004	90	2	X	2,229.81	X
35523	001	90	2	X	2,459.89	X
35525	001	90	2	X	2,773.97	X
35525	003	90	2	X	2,508.22	X
35525	002	90	2	X	2,508.22	X
35525	004	90	2	X	2,508.22	X
35526	004	90	2	X	3,516.57	X
35526	001	90	2	X	3,862.82	X
35526	003	90	2	X	3,557.05	X
35526	002	90	2	X	3,803.05	X
35531	002	90	2	X	5,558.61	X
35531	003	90	2	X	5,425.88	X
35531	004	90	2	X	4,986.08	X
35531	001	90	2	X	5,622.96	X
35533	003	90	2	X	5,896.35	X
35533	002	90	2	X	6,061.46	X
35533	004	90	2	X	4,592.74	X
35533	001	90	2	X	6,101.50	X
35535	004	90	2	X	3,629.89	X
35535	001	90	2	X	4,000.99	X
35535	003	90	2	X	3,629.89	X
35535	002	90	2	X	3,629.89	X
35536	004	90	2	X	4,862.29	X
35536	002	90	2	X	5,240.50	X
35536	003	90	2	X	4,920.13	X
35536	001	90	2	X	5,404.08	X
35537	004	90	2	X	3,715.73	X
35537	001	90	2	X	4,188.56	X
35537	003	90	2	X	3,715.73	X
35537	002	90	2	X	3,715.73	X
35538	003	90	2	X	4,151.52	X
35538	002	90	2	X	4,151.52	X
35538	004	90	2	X	4,151.52	X
35538	001	90	2	X	4,677.68	X
35539	002	90	2	X	3,901.91	X
35539	003	90	2	X	3,901.91	X
35539	001	90	2	X	4,397.06	X
35539	004	90	2	X	3,901.91	X
35540	002	90	2	X	4,349.85	X
35540	003	90	2	X	4,349.85	X
35540	001	90	2	X	4,901.10	X
35540	004	90	2	X	4,349.85	X
35556	002	90	2	X	4,449.49	X
35556	003	90	2	X	4,472.12	X
35556	001	90	2	X	4,659.20	X
35556	004	90	2	X	4,454.39	X
35558	003	90	2	X	3,718.83	X
35558	002	90	2	X	4,022.27	X
35558	004	90	2	X	3,828.18	X
35558	001	90	2	X	4,020.72	X
35560	001	90	2	X	6,832.38	X
35560	003	90	2	X	6,637.90	X
35560	002	90	2	X	6,790.83	X
35560	004	90	2	X	6,614.03	X
35563	003	90	2	X	2,496.24	X
35563	002	90	2	X	4,011.29	X
35563	004	90	2	X	2,468.47	X
35563	001	90	2	X	2,706.72	X
35565	003	90	2	X	4,046.10	X
35565	002	90	2	X	4,239.76	X
35565	004	90	2	X	4,076.17	X
35565	001	90	2	X	4,314.26	X
35566	001	90	2	X	5,993.82	X
35566	004	90	2	X	5,626.82	X
35566	002	90	2	X	5,373.58	X
35566	003	90	2	X	5,276.30	X
35570	002	90	2	X	2,799.51	X
35570	003	90	2	X	2,799.51	X
35570	004	90	2	X	2,799.51	X
35570	001	90	2	X	3,086.44	X
35571	004	90	2	X	6,193.20	X
35571	002	90	2	X	6,369.30	X
35571	003	90	2	X	6,209.60	X
35571	001	90	2	X	6,404.89	X
35572	002	ZZZ	0	X	785.12	X
35572	003	ZZZ	0	X	785.12	X
35572	004	ZZZ	0	X	785.12	X
35572	001	ZZZ	0	X	871.10	X
35583	001	90	2	X	4,674.88	X
35583	004	90	2	X	4,526.32	X
35583	003	90	2	X	4,580.59	X
35583	002	90	2	X	4,585.95	X
35585	004	90	2	X	5,635.57	X
35585	003	90	2	X	5,344.07	X
35585	002	90	2	X	5,268.43	X
35585	001	90	2	X	6,070.62	X
35587	004	90	2	X	6,320.60	X
35587	001	90	2	X	6,539.92	X
35587	002	90	2	X	6,440.86	X
35587	003	90	2	X	6,329.90	X
35600	004	ZZZ	0	X	633.46	X
35600	001	ZZZ	0	X	705.76	X
35600	002	ZZZ	0	X	633.46	X
35600	003	ZZZ	0	X	633.46	X
35601	001	90	2	X	4,388.32	X
35601	004	90	2	X	3,944.04	X
35601	003	90	2	X	3,992.24	X
35601	002	90	2	X	4,311.10	X

Fee Schedule 35013-35601

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