Part B Fee Schedules

Fee Schedule 61521-62161

CPT/HCPC Code	Medicare Location	Global Surgery Indicator	Multiple Surgery Indicator	Prevailing Charge Amount	Fee Schedule Amount	Site of Service Amount
61521	003	90	2	X	8,174.07	X
61521	002	90	2	X	8,762.17	X
61521	004	90	2	X	8,752.82	X
61521	001	90	2	X	9,099.43	X
61522	004	90	2	X	5,300.47	X
61522	001	90	2	X	5,830.59	X
61522	003	90	2	X	5,361.68	X
61522	002	90	2	X	5,739.06	X
61524	003	90	2	X	6,108.25	X
61524	002	90	2	X	6,593.76	X
61524	004	90	2	X	6,035.63	X
61524	001	90	2	X	6,711.36	X
61526	002	90	2	X	8,788.29	X
61526	003	90	2	X	7,129.26	X
61526	004	90	2	X	7,041.65	X
61526	001	90	2	X	8,840.69	X
61530	001	90	2	X	7,770.79	X
61530	003	90	2	X	7,129.26	X
61530	002	90	2	X	7,646.00	X
61530	004	90	2	X	7,041.65	X
61531	001	90	2	X	4,174.16	X
61531	004	90	2	X	3,843.70	X
61531	003	90	2	X	3,889.48	X
61531	002	90	2	X	4,118.83	X
61533	001	90	2	X	4,980.01	X
61533	003	90	2	X	4,574.03	X
61533	002	90	2	X	4,900.67	X
61533	004	90	2	X	4,521.98	X
61534	001	90	2	X	3,125.81	X
61534	004	90	2	X	2,864.35	X
61534	003	90	2	X	2,893.86	X
61534	002	90	2	X	4,138.00	X
61535	001	90	2	X	2,165.39	X
61535	004	90	2	X	1,975.99	X
61535	003	90	2	X	1,999.17	X
61535	002	90	2	X	2,133.01	X
61536	001	90	2	X	6,287.73	X
61536	004	90	2	X	5,719.32	X
61536	002	90	2	X	6,189.80	X
61536	003	90	2	X	5,785.76	X
61537	001	90	2	X	4,085.02	X
61537	002	90	2	X	3,526.71	X
61537	003	90	2	X	3,526.71	X
61537	004	90	2	X	3,526.71	X
61538	001	90	2	X	7,081.35	X
61538	004	90	2	X	6,392.45	X
61538	003	90	2	X	6,469.83	X
61538	002	90	2	X	6,961.69	X
61539	002	90	2	X	6,379.16	X
61539	003	90	2	X	5,963.16	X
61539	001	90	2	X	6,480.13	X
61539	004	90	2	X	5,894.40	X
61540	001	90	2	X	4,936.85	X
61540	004	90	2	X	4,255.53	X
61540	003	90	2	X	4,255.53	X
61540	002	90	2	X	4,255.53	X
61541	002	90	2	X	5,654.76	X
61541	003	90	2	X	5,280.44	X
61541	001	90	2	X	5,945.89	X
61541	004	90	2	X	5,220.11	X
61543	001	90	2	X	4,558.00	X
61543	004	90	2	X	4,161.07	X
61543	003	90	2	X	4,210.75	X
61543	002	90	2	X	4,490.35	X
61544	004	90	2	X	5,541.59	X
61544	003	90	2	X	5,613.26	X
61544	002	90	2	X	5,948.01	X
61544	001	90	2	X	6,028.35	X
61545	003	90	2	X	6,787.56	X
61545	002	90	2	X	7,266.75	X
61545	001	90	2	X	7,382.97	X
61545	004	90	2	X	6,709.73	X
61546	001	90	2	X	7,296.82	X
61546	004	90	2	X	6,299.48	X
61546	003	90	2	X	7,023.39	X
61546	002	90	2	X	7,221.92	X
61548	003	90	2	X	7,462.52	X
61548	002	90	2	X	7,568.57	X
61548	004	90	2	X	7,198.79	X
61548	001	90	2	X	6,013.56	X
61550	001	90	2	X	3,034.63	X
61550	004	90	2	X	2,798.89	X
61550	002	90	2	X	2,995.44	X
61550	003	90	2	X	2,832.98	X
61552	004	90	2	X	3,672.70	X
61552	002	90	2	X	4,844.56	X
61552	003	90	2	X	3,715.03	X
61552	001	90	2	X	4,044.36	X
61556	001	90	2	X	6,240.04	X
61556	004	90	2	X	6,240.04	X
61556	002	90	2	X	6,240.04	X
61556	003	90	2	X	6,240.04	X
61557	003	90	2	X	9,360.10	X
61557	002	90	2	X	9,360.10	X
61557	004	90	2	X	9,360.10	X
61557	001	90	2	X	9,360.10	X
61558	001	90	2	X	5,556.90	X
61558	004	90	2	X	4,980.86	X
61558	002	90	2	X	5,390.59	X
61558	003	90	2	X	5,047.76	X
61559	004	90	2	X	6,459.18	X
61559	001	90	2	X	7,206.19	X
61559	003	90	2	X	6,545.95	X
61559	002	90	2	X	6,990.46	X
61563	004	90	2	X	9,031.65	X
61563	001	90	2	X	9,031.65	X
61563	002	90	2	X	9,031.65	X
61563	003	90	2	X	9,031.65	X
61564	002	90	2	X	11,494.80	X
61564	003	90	2	X	11,494.80	X
61564	004	90	2	X	11,494.80	X
61564	001	90	2	X	11,494.80	X
61566	002	90	2	X	4,235.82	X
61566	003	90	2	X	4,235.82	X
61566	004	90	2	X	4,235.82	X
61566	001	90	2	X	4,844.60	X
61567	002	90	2	X	4,849.81	X
61567	003	90	2	X	4,849.81	X
61567	001	90	2	X	5,510.67	X
61567	004	90	2	X	4,849.81	X
61570	002	90	2	X	4,743.02	X
61570	003	90	2	X	4,733.67	X
61570	004	90	2	X	4,383.86	X
61570	001	90	2	X	5,056.30	X
61571	004	90	2	X	4,758.75	X
61571	001	90	2	X	5,226.15	X
61571	003	90	2	X	4,814.18	X
61571	002	90	2	X	5,145.80	X
61575	001	90	2	X	7,990.66	X
61575	004	90	2	X	7,243.65	X
61575	002	90	2	X	7,862.42	X
61575	003	90	2	X	7,673.22	X
61576	001	90	2	X	7,440.58	X
61576	004	90	2	X	6,801.07	X
61576	003	90	2	X	6,882.56	X
61576	002	90	2	X	7,331.89	X
61580	004	90	2	X	5,580.64	X
61580	001	90	2	X	6,145.41	X
61580	003	90	2	X	5,644.92	X
61580	002	90	2	X	6,047.66	X
61581	004	90	2	X	6,333.70	X
61581	001	90	2	X	6,974.70	X
61581	002	90	2	X	6,863.79	X
61581	003	90	2	X	6,406.76	X
61582	004	90	2	X	5,749.22	X
61582	001	90	2	X	6,330.73	X
61582	002	90	2	X	6,230.14	X
61582	003	90	2	X	5,815.47	X
61583	004	90	2	X	6,560.64	X
61583	002	90	2	X	7,109.69	X
61583	003	90	2	X	6,636.25	X
61583	001	90	2	X	7,224.62	X
61584	003	90	2	X	6,426.47	X
61584	002	90	2	X	6,885.10	X
61584	001	90	2	X	6,996.45	X
61584	004	90	2	X	6,353.21	X
61585	002	90	2	X	7,702.33	X
61585	003	90	2	X	7,189.26	X
61585	001	90	2	X	7,826.92	X
61585	004	90	2	X	7,107.41	X
61586	001	90	2	X	5,410.08	X
61586	002	90	2	X	4,907.31	X
61586	003	90	2	X	4,775.40	X
61586	004	90	2	X	4,775.40	X
61590	002	90	2	X	8,375.08	X
61590	003	90	2	X	7,817.70	X
61590	004	90	2	X	7,728.69	X
61590	001	90	2	X	8,510.35	X
61591	004	90	2	X	8,106.74	X
61591	001	90	2	X	8,927.25	X
61591	002	90	2	X	8,785.30	X
61591	003	90	2	X	8,200.14	X
61592	004	90	2	X	7,352.60	X
61592	003	90	2	X	7,437.34	X
61592	002	90	2	X	7,967.98	X
61592	001	90	2	X	8,096.81	X
61595	001	90	2	X	5,980.06	X
61595	004	90	2	X	5,430.39	X
61595	002	90	2	X	5,884.94	X
61595	003	90	2	X	5,492.99	X
61596	004	90	2	X	6,599.48	X
61596	002	90	2	X	7,151.83	X
61596	003	90	2	X	6,675.51	X
61596	001	90	2	X	7,267.38	X
61597	002	90	2	X	7,559.42	X
61597	003	90	2	X	7,055.96	X
61597	001	90	2	X	7,681.52	X
61597	004	90	2	X	6,975.50	X
61598	004	90	2	X	6,145.78	X
61598	002	90	2	X	6,660.02	X
61598	003	90	2	X	6,216.58	X
61598	001	90	2	X	6,767.68	X
61600	001	90	2	X	5,189.65	X
61600	002	90	2	X	5,107.13	X
61600	003	90	2	X	4,767.29	X
61600	004	90	2	X	4,713.02	X
61601	001	90	2	X	5,564.82	X
61601	004	90	2	X	5,053.34	X
61601	002	90	2	X	5,476.30	X
61601	003	90	2	X	5,111.55	X
61605	003	90	2	X	5,396.86	X
61605	002	90	2	X	5,781.95	X
61605	001	90	2	X	5,875.43	X
61605	004	90	2	X	5,335.36	X
61606	004	90	2	X	7,145.13	X
61606	001	90	2	X	7,868.00	X
61606	002	90	2	X	7,742.94	X
61606	003	90	2	X	7,227.48	X
61607	001	90	2	X	7,349.30	X
61607	002	90	2	X	7,232.39	X
61607	003	90	2	X	6,750.95	X
61607	004	90	2	X	6,674.05	X
61608	004	90	2	X	7,766.47	X
61608	001	90	2	X	8,552.14	X
61608	003	90	2	X	7,855.96	X
61608	002	90	2	X	8,416.17	X
61611	002	ZZZ	0	X	1,224.78	X
61611	003	ZZZ	0	X	1,143.24	X
61611	001	ZZZ	0	X	1,244.56	X
61611	004	ZZZ	0	X	1,130.25	X
61613	003	90	2	X	7,704.05	X
61613	002	90	2	X	8,253.92	X
61613	004	90	2	X	7,616.27	X
61613	001	90	2	X	8,387.34	X
61615	003	90	2	X	5,931.28	X
61615	002	90	2	X	6,354.38	X
61615	004	90	2	X	5,863.66	X
61615	001	90	2	X	6,457.05	X
61616	003	90	2	X	8,066.86	X
61616	002	90	2	X	8,642.26	X
61616	004	90	2	X	7,974.94	X
61616	001	90	2	X	8,781.93	X
61618	002	90	2	X	3,267.89	X
61618	003	90	2	X	3,050.39	X
61618	004	90	2	X	3,015.62	X
61618	001	90	2	X	3,320.70	X
61619	002	90	2	X	4,085.14	X
61619	003	90	2	X	3,813.25	X
61619	004	90	2	X	3,769.84	X
61619	001	90	2	X	4,151.09	X
61623	003	0	2	X	1,156.22	X
61623	002	0	2	X	1,156.22	X
61623	001	0	2	X	1,266.23	X
61623	004	0	2	X	1,156.22	X
61624	003	0	2	X	3,637.12	X
61624	002	0	2	X	3,854.28	X
61624	001	0	2	X	3,906.87	X
61624	004	0	2	X	3,594.09	X
61626	001	0	2	X	3,221.44	X
61626	004	0	2	X	2,963.73	X
61626	002	0	2	X	3,178.22	X
61626	003	0	2	X	2,999.16	X
61630		XXX	2	X	*	X
61635		XXX	2	X	*	X
61640		0	9	X	*	X
61641		ZZZ	9	X	*	X
61642		ZZZ	9	X	*	X
61645	003	0	0	X	1,217.85	X
61645	002	0	0	X	1,217.85	X
61645	001	0	0	X	1,320.64	X
61645	004	0	0	X	1,217.85	X
61650	001	0	2	X	878.90	X
61650	003	0	2	X	811.72	X
61650	002	0	2	X	811.72	X
61650	004	0	2	X	811.72	X
61651	004	ZZZ	0	X	344.76	X
61651	003	ZZZ	0	X	344.76	X
61651	002	ZZZ	0	X	344.76	X
61651	001	ZZZ	0	X	373.27	X
61680	002	90	2	X	8,216.26	X
61680	003	90	2	X	7,650.94	X
61680	004	90	2	X	7,561.94	X
61680	001	90	2	X	8,353.36	X
61682	003	90	2	X	8,755.41	X
61682	001	90	2	X	9,542.95	X
61682	004	90	2	X	8,653.44	X
61682	002	90	2	X	9,389.34	X
61684	002	90	2	X	8,020.20	X
61684	003	90	2	X	7,568.81	X
61684	004	90	2	X	7,479.39	X
61684	001	90	2	X	8,129.27	X
61686	001	90	2	X	9,828.97	X
61686	004	90	2	X	9,042.79	X
61686	003	90	2	X	9,150.97	X
61686	002	90	2	X	9,696.99	X
61690	002	90	2	X	7,278.85	X
61690	003	90	2	X	6,824.96	X
61690	004	90	2	X	6,744.68	X
61690	001	90	2	X	7,388.72	X
61692	002	90	2	X	7,757.79	X
61692	003	90	2	X	7,320.96	X
61692	004	90	2	X	7,234.45	X
61692	001	90	2	X	7,863.30	X
61697	001	90	2	X	8,408.49	X
61697	003	90	2	X	7,345.03	X
61697	002	90	2	X	7,345.03	X
61697	004	90	2	X	7,345.03	X
61698	001	90	2	X	8,096.28	X
61698	003	90	2	X	7,067.47	X
61698	002	90	2	X	7,067.47	X
61698	004	90	2	X	7,067.47	X
61700	003	90	2	X	7,529.70	X
61700	002	90	2	X	8,088.81	X
61700	001	90	2	X	8,252.16	X
61700	004	90	2	X	7,438.09	X
61702	004	90	2	X	8,463.64	X
61702	001	90	2	X	9,364.79	X
61702	003	90	2	X	8,564.42	X
61702	002	90	2	X	9,208.69	X
61703	004	90	2	X	3,172.64	X
61703	001	90	2	X	3,489.46	X
61703	002	90	2	X	3,434.81	X
61703	003	90	2	X	3,209.45	X
61705	002	90	2	X	7,848.86	X
61705	003	90	2	X	7,446.57	X
61705	001	90	2	X	7,977.24	X
61705	004	90	2	X	7,232.82	X
61708	004	90	2	X	6,304.48	X
61708	002	90	2	X	6,712.60	X
61708	003	90	2	X	6,380.60	X
61708	001	90	2	X	6,818.75	X
61710	002	90	2	X	5,127.25	X
61710	003	90	2	X	4,868.23	X
61710	004	90	2	X	4,812.16	X
61710	001	90	2	X	5,591.20	X
61711	003	90	2	X	7,702.51	X
61711	002	90	2	X	7,609.22	X
61711	004	90	2	X	7,611.88	X
61711	001	90	2	X	7,861.33	X
61720	001	90	2	X	6,253.71	X
61720	003	90	2	X	4,418.41	X
61720	002	90	2	X	6,365.26	X
61720	004	90	2	X	4,363.99	X
61735	001	90	2	X	3,538.44	X
61735	004	90	2	X	3,255.46	X
61735	003	90	2	X	3,294.38	X
61735	002	90	2	X	4,391.13	X
61736	002	0	0	X	1,091.04	X
61736	003	0	0	X	1,091.04	X
61736	001	0	0	X	1,169.70	X
61736	004	0	0	X	1,091.04	X
61737	004	0	0	X	1,299.34	X
61737	001	0	0	X	1,394.11	X
61737	002	0	0	X	1,299.34	X
61737	003	0	0	X	1,299.34	X
61750	001	90	2	X	5,617.32	X
61750	003	90	2	X	5,426.76	X
61750	002	90	2	X	5,580.20	X
61750	004	90	2	X	5,407.25	X
61751	004	90	2	X	5,873.64	X
61751	001	90	2	X	6,087.49	X
61751	002	90	2	X	6,064.96	X
61751	003	90	2	X	5,897.10	X
61760	003	90	2	X	4,349.24	X
61760	002	90	2	X	4,589.78	X
61760	004	90	2	X	4,299.24	X
61760	001	90	2	X	4,647.99	X
61770	004	90	2	X	3,899.89	X
61770	002	90	2	X	4,831.23	X
61770	003	90	2	X	3,947.94	X
61770	001	90	2	X	5,044.98	X
61781	001	ZZZ	0	X	482.48	X
61781	004	ZZZ	0	X	424.83	X
61781	003	ZZZ	0	X	424.83	X
61781	002	ZZZ	0	X	424.83	X
61782	003	ZZZ	0	X	347.50	X
61782	002	ZZZ	0	X	347.50	X
61782	001	ZZZ	0	X	390.51	X
61782	004	ZZZ	0	X	347.50	X
61783	002	ZZZ	0	X	424.83	X
61783	003	ZZZ	0	X	424.83	X
61783	001	ZZZ	0	X	482.48	X
61783	004	ZZZ	0	X	424.83	X
61790	004	90	2	X	4,445.00	X
61790	001	90	2	X	4,601.80	X
61790	003	90	2	X	4,460.67	X
61790	002	90	2	X	4,310.19	X
61791	004	90	2	X	4,170.07	X
61791	002	90	2	X	4,295.84	X
61791	003	90	2	X	2,614.33	X
61791	001	90	2	X	4,322.85	X
61796	004	90	0	X	1,290.15	X
61796	002	90	0	X	1,290.15	X
61796	003	90	0	X	1,290.15	X
61796	001	90	0	X	1,468.75	X
61797	001	ZZZ	0	X	398.40	X
61797	003	ZZZ	0	X	355.02	X
61797	002	ZZZ	0	X	355.02	X
61797	004	ZZZ	0	X	355.02	X
61798	004	90	0	X	1,290.15	X
61798	001	90	0	X	1,468.75	X
61798	003	90	0	X	1,290.15	X
61798	002	90	0	X	1,290.15	X
61799	001	ZZZ	0	X	551.00	X
61799	004	ZZZ	0	X	490.89	X
61799	003	ZZZ	0	X	490.89	X
61799	002	ZZZ	0	X	490.89	X
61800	001	ZZZ	0	X	285.76	X
61800	004	ZZZ	0	X	251.38	X
61800	003	ZZZ	0	X	251.38	X
61800	002	ZZZ	0	X	251.38	X
61850	002	90	2	X	2,987.33	X
61850	003	90	2	X	3,122.72	X
61850	004	90	2	X	3,087.13	X
61850	001	90	2	X	3,399.27	X
61860	004	90	2	X	2,162.42	X
61860	003	90	2	X	2,187.32	X
61860	002	90	2	X	2,343.37	X
61860	001	90	2	X	2,381.27	X
61863	001	90	2	X	2,931.65	X
61863	004	90	2	X	2,537.80	X
61863	003	90	2	X	2,537.80	X
61863	002	90	2	X	2,537.80	X
61864	002	ZZZ	0	X	608.71	X
61864	003	ZZZ	0	X	608.71	X
61864	001	ZZZ	0	X	703.22	X
61864	004	ZZZ	0	X	608.71	X
61867	001	90	2	X	4,360.34	X
61867	003	90	2	X	3,882.75	X
61867	002	90	2	X	3,882.75	X
61867	004	90	2	X	3,882.75	X
61868	001	ZZZ	0	X	1,149.87	X
61868	003	ZZZ	0	X	1,022.09	X
61868	002	ZZZ	0	X	1,022.09	X
61868	004	ZZZ	0	X	1,022.09	X
61880	004	90	2	X	1,151.30	X
61880	003	90	2	X	1,165.15	X
61880	002	90	2	X	1,587.33	X
61880	001	90	2	X	1,259.72	X
61885	001	90	2	X	1,347.89	X
61885	003	90	2	X	479.93	X
61885	002	90	2	X	511.90	X
61885	004	90	2	X	474.25	X
61886	002	90	2	X	1,290.63	X
61886	003	90	2	X	1,290.63	X
61886	001	90	2	X	1,473.64	X
61886	004	90	2	X	1,290.63	X
61888	003	10	2	X	603.64	X
61888	002	10	2	X	646.60	X
61888	001	10	2	X	657.00	X
61888	004	10	2	X	596.80	X
61889	004	90	2	X	1,358.55	X
61889	001	90	2	X	1,463.44	X
61889	003	90	2	X	1,358.55	X
61889	002	90	2	X	1,358.55	X
61891	004	90	2	X	642.35	X
61891	001	90	2	X	695.10	X
61891	003	90	2	X	642.35	X
61891	002	90	2	X	642.35	X
61892	004	90	2	X	885.06	X
61892	002	90	2	X	885.06	X
61892	003	90	2	X	885.06	X
61892	001	90	2	X	958.00	X
62000	002	90	2	X	2,632.55	X
62000	003	90	2	X	1,880.26	X
62000	001	90	2	X	2,017.31	X
62000	004	90	2	X	2,332.20	X
62005	001	90	2	X	3,163.53	X
62005	004	90	2	X	2,879.43	X
62005	003	90	2	X	3,788.89	X
62005	002	90	2	X	3,114.65	X
62010	003	90	2	X	4,273.08	X
62010	002	90	2	X	4,602.88	X
62010	004	90	2	X	4,464.92	X
62010	001	90	2	X	4,682.69	X
62100	004	90	2	X	4,747.12	X
62100	002	90	2	X	5,431.37	X
62100	003	90	2	X	5,271.28	X
62100	001	90	2	X	5,649.66	X
62115	003	90	2	X	9,852.77	X
62115	002	90	2	X	9,852.77	X
62115	004	90	2	X	9,852.77	X
62115	001	90	2	X	9,852.77	X
62117	002	90	2	X	11,494.80	X
62117	003	90	2	X	11,494.80	X
62117	001	90	2	X	11,494.80	X
62117	004	90	2	X	11,494.80	X
62120	002	90	2	X	4,622.26	X
62120	003	90	2	X	4,297.01	X
62120	001	90	2	X	4,701.23	X
62120	004	90	2	X	4,247.19	X
62121	004	90	2	X	4,247.19	X
62121	001	90	2	X	4,701.23	X
62121	003	90	2	X	4,297.01	X
62121	002	90	2	X	4,622.26	X
62140	002	90	2	X	3,323.76	X
62140	003	90	2	X	3,240.75	X
62140	004	90	2	X	3,257.19	X
62140	001	90	2	X	3,431.57	X
62141	003	90	2	X	3,631.59	X
62141	001	90	2	X	4,008.96	X
62141	002	90	2	X	3,781.97	X
62141	004	90	2	X	3,582.16	X
62142	004	90	2	X	2,627.22	X
62142	001	90	2	X	4,246.94	X
62142	003	90	2	X	4,124.54	X
62142	002	90	2	X	4,223.09	X
62143	001	90	2	X	2,603.24	X
62143	004	90	2	X	2,367.44	X
62143	003	90	2	X	2,395.01	X
62143	002	90	2	X	2,562.57	X
62145	002	90	2	X	5,452.73	X
62145	003	90	2	X	3,462.71	X
62145	004	90	2	X	3,422.75	X
62145	001	90	2	X	3,757.93	X
62146	002	90	2	X	3,162.78	X
62146	003	90	2	X	2,952.21	X
62146	004	90	2	X	2,918.54	X
62146	001	90	2	X	3,213.91	X
62147	001	90	2	X	3,855.14	X
62147	004	90	2	X	3,501.10	X
62147	003	90	2	X	3,541.43	X
62147	002	90	2	X	3,793.84	X
62148	004	ZZZ	0	X	250.76	X
62148	002	ZZZ	0	X	250.76	X
62148	001	ZZZ	0	X	289.66	X
62148	003	ZZZ	0	X	250.76	X
62160	003	ZZZ	0	X	362.95	X
62160	002	ZZZ	0	X	362.95	X
62160	004	ZZZ	0	X	362.95	X
62160	001	ZZZ	0	X	413.81	X
62161	002	90	2	X	2,584.21	X
62161	003	90	2	X	2,584.21	X
62161	004	90	2	X	2,584.21	X
62161	001	90	2	X	2,961.84	X

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