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Index:
1) E&M Codes
2) Integumentary System Codes
3) Hemic & Lymphatic Systems Codes
4) Digestive Codes
5) Urinary Codes
6) Female Genital System Codes
7) Radiology Codes
8) Hydration & Chemotherapy Codes
Links:
Medicare Physician Fee Schedule Look-up-
View physician service information, geographic practice cost indices and payment policy.
http://www.cms.gov/apps/physician-fee-schedule/overview.aspx
Note that not all codes with an RVU are payable by Medicare.
2014 SGO Physician Fee Schedule
Evaluation & Management
99366 Medical conference with interdisciplinary team of health care professionals, XXX
face-to-face with patient and/or family, 30 mins or more, participation by
non-physician health care professional 0.82 1.21 1.18
99367 Medical conference with interdisciplinary team of health care professionals, XXX
patient and/or family not present, 30 mins or more; participation by
physician 1.10 1.59 1.59
99368 Medical conference with interdisciplinary team of health care professionals, XXX
patient and/or family not present, 30 mins or more; participation by non-
physician health care professional 0.72 1.04 1.04
Preventive Medicine
99384 Preventive visit, new, 12-17 1.75 3.33 2.52 XXX
99385 Preventive visit, new,18-39 1.90 3.55 2.74 XXX
99386 Preventive visit, new, 40-64 2.00 3.82 2.88 XXX
99387 Init preventive visit, new patient, 65+ years 0.48 1.02 0.69 XXX
99394 Preventive visit, established, 12-17 0.98 1.74 1.41 XXX
99395 Preventive visit, established, 18-39 1.46 2.43 2.11 XXX
99396 Preventive visit, established, 40-64 1.95 3.14 2.82 XXX
99397 Preventive visit, established, 65+ 0.24 0.40 0.35 XXX
99401 Preventive counseling, individual 0.50 0.78 0.73 XXX
99402 Preventive counseling, individual 0.65 0.99 0.94 XXX
99403 Preventive counseling, individual 1.30 1.93 1.88 XXX
99404 Preventive counseling, individual 0.15 0.46 0.22 XXX
99406 Counseling, smoking, <10 minutes 0.25 0.60 0.36 XXX
99407 Counseling, smoking, >10 minutes 0.50 0.77 0.72 XXX
99408 Counseling, alcohol/drugs, <30 minutes 0.65 0.99 0.94 XXX
99409 Counseling, alcohol/drugs, >30 minutes 1.30 1.94 1.89 XXX
99411 Preventive counseling,group 0.15 0.46 0.22 XXX
99412 Preventive counseling, group 0.25 0.61 0.37 XXX
HCPCS Level II Codes
G0101 CA Screening; pelvic/breast exam
0.45 1.08 0.79 XXX
Q0091 Obtaining screening pap smear
0.37 1.27 0.56 XXX
Telephone Calls
99441 Telephone E/M service provided by a physician to an established patient, XXX
parent, or guardian not originating from a related E/M service provided
within the previous 7 days nor leading to an E/M service or procedure within
the next 24 hours or soonest available appointment; 5-10 mins of medical
discussion
0.25 0.39 0.36
99442 Telephone E/M service provided by a physician to an established patient, XXX
parent, or guardian not originating from a related E/M service provided
within the previous 7 days nor leading to an E/M service or procedure within
the next 24 hours or soonest available appointment; 11-20 mins of medical
discussion
0.50 0.76 0.72
99443 Telephone E/M service provided by a physician to an established patient, XXX
parent, or guardian not originating from a related E/M service provided
within the previous 7 days nor leading to an E/M service or procedure within
the next 24 hours or soonest available appointment; 21-30 mins of medical
discussion
0.75 1.11 1.08
On-Line Medical Evaluation
99444 Online E/M provided by a physician to an established patient, guardian, or 0.00 0.00 0.00 XXX
health care provider not originating from a related E/M service provided
within the previous 7 days, using the Internet or similar electronic
communication network
2014 SGO Physician Fee Schedule- Hemic & Lymphatic Systems Page 11 of 26
2014 SGO Physician Fee Schedule
Digestive System
e, with documents
CPT Modifier Description Work Total Medicare RVUs Global ASST CO-
Code RVU Non Facility Period SURGEON SURGEON
-Facility
Ureter
50700 Revision of ureter 16.69 26.78 26.78 090 Yes Maybe
50715 Release of ureter for 090 Yes Maybe
retroperitoneal fibrosis 20.64 35.15 35.15
50722 Release of ureter, ovarian vein 090 Yes Maybe
syndrome 17.95 29.36 29.36
50725 Release/revise ureter for 090 Yes Maybe
retrocaval ureter 20.20 32.47 32.47
Bladder
51040 Incise & drain bladder 4.49 8.30 8.30 090 Yes Maybe
51045 Incise bladder/drain ureter (stent) 090 Yes No
7.81 14.12 14.12
51102 Insert suprapubic catheter 2.70 6.46 4.17 000 No No
51701 Insert bladder catheter (straight 000 No No
cath) 0.50 1.55 0.80
51702 Insert temp bladder cath (Foley) 000 No No
0.50 1.99 0.87
51703 Insert bladder cath, complex 1.47 3.68 2.34 000 No No
51725 Simple cystometrogram 1.51 5.30 5.30 000 Maybe No
51725 TC Simple cystometrogram 0.00 3.11 3.11 000 Maybe No
51725 26 Simple cystometrogram 1.51 2.19 2.19 000 Maybe No
51726 Complex cystometrogram 1.71 7.44 7.44 000 No No
51726 TC Complex cystometrogram 0.00 4.99 4.99 000 No No
51726 26 Complex cystometrogram 1.71 2.45 2.45 000 No No
51727 Cystometrogram with UPP 2.11 8.81 8.81 000 Maybe No
51727 TC Cystometrogram with UPP 0.00 5.74 5.74 000 Maybe No
51727 26 Cystometrogram with UPP 2.11 3.07 3.07 000 Maybe No
51728 Cystometrogram with VP 2.11 8.89 8.89 000 Maybe No
51728 TC Cystometrogram with VP 0.00 5.89 5.89 000 Maybe No
51728 26 Cystometrogram with VP 2.11 3.00 3.00 000 Maybe No
51729 Cystometrogram with VP/UPP 2.51 9.61 9.61 000 Maybe No
51729 TC Cystometrogram with VP/UPP 0.00 5.98 5.98 000 Maybe No
51729 26 Cystometrogram with VP/UPP 2.51 3.63 3.63 000 Maybe No
51736 Urine flow measurement 0.17 0.44 0.44 XXX Maybe No
51736 TC Urine flow measurement 0.00 0.20 0.20 XXX Maybe No
51736 26 Urine flow measurement 0.17 0.24 0.24 XXX Maybe No
51741 Electro-uroflowmetry, first 0.17 0.45 0.45 XXX No No
51741 TC Electro-uroflowmetry, first 0.00 0.21 0.21 XXX No No
51741 26 Electro-uroflowmetry, first 0.17 0.24 0.24 XXX No No
51784 Anal/urinary muscle study 1.53 5.44 5.44 000 No No
51784 TC Anal/urinary muscle study 0.00 3.24 3.24 000 No No
51784 26 Anal/urinary muscle study 1.53 2.20 2.20 000 No No
51785 Anal/urinary muscle study 1.53 7.48 7.48 000 Maybe No
51785 TC Anal/urinary muscle study 0.00 4.95 4.95 000 Maybe No
51785 26 Anal/urinary muscle study 1.53 2.53 2.53 000 Maybe No
51792 Urinary reflex study 1.10 5.98 5.98 000 Maybe No
51792 TC Urinary reflex study 0.00 4.39 4.39 000 Maybe No
51792 26 Urinary reflex study 1.10 1.59 1.59 000 Maybe No
51797 Intraabdominal pressure test 0.80 3.16 3.16 ZZZ Maybe No
51797 TC Intraabdominal pressure test 0.00 2.01 2.01 ZZZ Maybe No
51797 26 Intraabdominal pressure test 0.80 1.15 1.15 ZZZ Maybe No
51840 Attach bladder/urethra 11.36 18.85 18.85 090 Yes Maybe
51841 Attach bladder/urethra 13.68 22.38 22.38 090 Yes Maybe
51845 Repair bladder neck 10.15 16.84 16.84 090 Yes Maybe
51860 Repair of bladder wound 12.60 21.45 21.45 090 Yes Maybe
51865 Repair of bladder wound 15.80 25.74 25.74 090 Yes Maybe
51880 Repair of bladder opening 7.87 13.47 13.47 090 Yes Maybe
51900 Repair bladder/vagina lesion 14.63 24.02 24.02 090 Yes Maybe
51920 Close bladder-uterus fistula 13.41 24.94 24.94 090 Yes Maybe
51925 Hysterectomy/bladder repair 17.53 31.41 31.41 090 Yes Maybe
51990 Laparo urethral suspension 13.36 21.53 21.53 090 Yes Maybe
51992 Laparo sling operation 14.87 24.15 24.15 090 Yes Maybe
52000 Cystoscopy 2.23 5.80 3.63 000 No No
52282 Cystoscopy, implant stent 6.39 9.70 9.70 000 No No
52285 Cystoscopy and treatment 3.60 7.94 5.64 000 No No
Urethra
53660 Dilation of urethra 0.71 2.00 1.20 000 No No
53661 Dilation of urethra 0.72 1.96 1.16 000 No No