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2017 National Physician Fee Schedule Relative Value File January Release CPT Codes and Descriptions Only Are Copyright 2015 American Medical Association

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2017 National Physician Fee Schedule Relative Value File January Release CPT Codes and Descriptions Only Are Copyright 2015 American Medical Association 2017 National Physician Fee Schedule Relative Value File January Release CPT codes and descriptions only are copyright 2015 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. Dental codes (D codes) are copyright 2016/16 American Dental Association. All Rights Reserved. RELEASED 11/14/2016 NON-FACILITY HCPCS MOD DESCRIPTION TOTAL MULTIPLIER TOTAL 10021 Fna w/o image 3.47 70.00 $242.90 10022 Fna w/image 4.00 70.00 $280.00 1003F Level of activity assess 0.00 70.00 $0.00 10030 Guide cathet fluid drainage 19.80 70.00 $1,386.00 10035 Perq dev soft tiss 1st imag 15.25 70.00 $1,067.50 10036 Perq dev soft tiss add imag 13.19 70.00 $923.30 1004F Clin symp vol ovrld assess 0.00 70.00 $0.00 10040 Acne surgery 2.89 70.00 $202.30 1005F Asthma symptoms evaluate 0.00 70.00 $0.00 1006F Osteoarthritis assess 0.00 70.00 $0.00 10060 Drainage of skin abscess 3.33 70.00 $233.10 10061 Drainage of skin abscess 5.86 70.00 $410.20 1007F Anti-inflm/anlgsc otc assess 0.00 70.00 $0.00 1008F Gi/renal risk assess 0.00 70.00 $0.00 10080 Drainage of pilonidal cyst 5.08 70.00 $355.60 10081 Drainage of pilonidal cyst 7.63 70.00 $534.10 1010F Severity angina by actvty 0.00 70.00 $0.00 1011F Angina present 0.00 70.00 $0.00 1012F Angina absent 0.00 70.00 $0.00 10120 Remove foreign body 4.32 70.00 $302.40 10121 Remove foreign body 7.77 70.00 $543.90 10140 Drainage of hematoma/fluid 4.63 70.00 $324.10 1015F Copd symptoms assess 0.00 70.00 $0.00 10160 Puncture drainage of lesion 3.68 70.00 $257.60 1018F Assess dyspnea not present 0.00 70.00 $0.00 10180 Complex drainage wound 7.00 70.00 $490.00 1019F Assess dyspnea present 0.00 70.00 $0.00 1022F Pneumo imm status assess 0.00 70.00 $0.00 1026F Co-morbid condition assess 0.00 70.00 $0.00 1030F Influenza imm status assess 0.00 70.00 $0.00 1031F Smoking & 2nd hand assessed 0.00 70.00 $0.00 1032F Smoker/exposed 2nd hnd smoke 0.00 70.00 $0.00 1033F Tobacco nonsmoker nor 2ndhnd 0.00 70.00 $0.00 1034F Current tobacco smoker 0.00 70.00 $0.00 1035F Smokeless tobacco user 0.00 70.00 $0.00 1036F Tobacco non-user 0.00 70.00 $0.00 1038F Persistent asthma 0.00 70.00 $0.00 1039F Intermittent asthma 0.00 70.00 $0.00 1040F Dsm-5 info mdd docd 0.00 70.00 $0.00 1050F History of mole changes 0.00 70.00 $0.00 1052F Type location activityassess 0.00 70.00 $0.00 1055F Visual funct status assess 0.00 70.00 $0.00 1060F Doc perm/cont/parox atr fib 0.00 70.00 $0.00 1061F Doc lack perm+cont+parox fib 0.00 70.00 $0.00 1065F Ischm stroke symp lt3 hrsb/4 0.00 70.00 $0.00 1066F Ischm stroke symp ge3 hrsb/4 0.00 70.00 $0.00 1070F Alarm symp assessed-absent 0.00 70.00 $0.00 1071F Alarm symp assessed-1+ prsnt 0.00 70.00 $0.00 1090F Pres/absn urine incon assess 0.00 70.00 $0.00 1091F Urine incon characterized 0.00 70.00 $0.00 1100F Ptfalls assess-docd ge2>/yr 0.00 70.00 $0.00 11000 Debride infected skin 1.54 70.00 $107.80 11001 Debride infected skin add-on 0.61 70.00 $42.70 11004 Debride genitalia & perineum 16.76 70.00 $1,173.20 11005 Debride abdom wall 22.67 70.00 $1,586.90 11006 Debride genit/per/abdom wall 20.41 70.00 $1,428.70 11008 Remove mesh from abd wall 7.97 70.00 $557.90 1101F Pt falls assess-docd le1/yr 0.00 70.00 $0.00 11010 Debride skin at fx site 14.37 70.00 $1,005.90 11011 Debride skin musc at fx site 15.27 70.00 $1,068.90 11012 Deb skin bone at fx site 20.23 70.00 $1,416.10 11042 Deb subq tissue 20 sq cm/< 3.30 70.00 $231.00 11043 Deb musc/fascia 20 sq cm/< 6.48 70.00 $453.60 11044 Deb bone 20 sq cm/< 8.94 70.00 $625.80 11045 Deb subq tissue add-on 1.16 70.00 $81.20 11046 Deb musc/fascia add-on 2.09 70.00 $146.30 11047 Deb bone add-on 3.55 70.00 $248.50 11055 Trim skin lesion 1.35 70.00 $94.50 11056 Trim skin lesions 2 to 4 1.65 70.00 $115.50 11057 Trim skin lesions over 4 1.85 70.00 $129.50 1110F Pt lft inpt fac w/in 60 days 0.00 70.00 $0.00 11100 Biopsy skin lesion 2.93 70.00 $205.10 11101 Biopsy skin add-on 0.93 70.00 $65.10 1111F Dschrg med/current med merge 0.00 70.00 $0.00 1116F Auric/peri pain assessed 0.00 70.00 $0.00 1118F Gerd symps assessed 12 month 0.00 70.00 $0.00 1119F Init eval for condition 0.00 70.00 $0.00 11200 Removal of skin tags <w/15 2.51 70.00 $175.70 11201 Remove skin tags add-on 0.54 70.00 $37.80 1121F Subs eval for condition 0.00 70.00 $0.00 1123F Acp discuss/dscn mkr docd 0.00 70.00 $0.00 1124F Acp discuss-no dscnmkr docd 0.00 70.00 $0.00 1125F Amnt pain noted pain prsnt 0.00 70.00 $0.00 1126F Amnt pain noted none prsnt 0.00 70.00 $0.00 1127F New episode for condition 0.00 70.00 $0.00 1128F Subs episode for condition 0.00 70.00 $0.00 1130F Bk pain & fxn assessed 0.00 70.00 $0.00 11300 Shave skin lesion 0.5 cm/< 2.78 70.00 $194.60 11301 Shave skin lesion 0.6-1.0 cm 3.42 70.00 $239.40 11302 Shave skin lesion 1.1-2.0 cm 4.03 70.00 $282.10 11303 Shave skin lesion >2.0 cm 4.45 70.00 $311.50 11305 Shave skin lesion 0.5 cm/< 2.81 70.00 $196.70 11306 Shave skin lesion 0.6-1.0 cm 3.48 70.00 $243.60 11307 Shave skin lesion 1.1-2.0 cm 4.09 70.00 $286.30 11308 Shave skin lesion >2.0 cm 4.29 70.00 $300.30 11310 Shave skin lesion 0.5 cm/< 3.24 70.00 $226.80 11311 Shave skin lesion 0.6-1.0 cm 3.15 70.00 $220.50 11312 Shave skin lesion 1.1-2.0 cm 4.57 70.00 $319.90 11313 Shave skin lesion >2.0 cm 5.30 70.00 $371.00 1134F Epsd bk pain for 6 wks/< 0.00 70.00 $0.00 1135F Epsd bk pain for >6 wks 0.00 70.00 $0.00 1136F Epsd bk pain for 12 wks/< 0.00 70.00 $0.00 1137F Epsd bk pain for >12 wks 0.00 70.00 $0.00 11400 Exc tr-ext b9+marg 0.5 cm< 3.52 70.00 $246.40 11401 Exc tr-ext b9+marg 0.6-1 cm 4.23 70.00 $296.10 11402 Exc tr-ext b9+marg 1.1-2 cm 4.71 70.00 $329.70 11403 Exc tr-ext b9+marg 2.1-3cm/< 5.45 70.00 $381.50 11404 Exc tr-ext b9+marg 3.1-4 cm 6.19 70.00 $433.30 11406 Exc tr-ext b9+marg >4.0 cm 8.92 70.00 $624.40 11420 Exc h-f-nk-sp b9+marg 0.5/< 3.47 70.00 $242.90 11421 Exc h-f-nk-sp b9+marg 0.6-1 4.44 70.00 $310.80 11422 Exc h-f-nk-sp b9+marg 1.1-2 4.98 70.00 $348.60 11423 Exc h-f-nk-sp b9+marg 2.1-3 5.72 70.00 $400.40 11424 Exc h-f-nk-sp b9+marg 3.1-4 6.64 70.00 $464.80 11426 Exc h-f-nk-sp b9+marg >4 cm 9.49 70.00 $664.30 11440 Exc face-mm b9+marg 0.5 cm/< 3.81 70.00 $266.70 11441 Exc face-mm b9+marg 0.6-1 cm 4.76 70.00 $333.20 11442 Exc face-mm b9+marg 1.1-2 cm 5.33 70.00 $373.10 11443 Exc face-mm b9+marg 2.1-3 cm 6.36 70.00 $445.20 11444 Exc face-mm b9+marg 3.1-4 cm 8.00 70.00 $560.00 11446 Exc face-mm b9+marg >4 cm 11.11 70.00 $777.70 11450 Removal sweat gland lesion 10.84 70.00 $758.80 11451 Removal sweat gland lesion 13.81 70.00 $966.70 11462 Removal sweat gland lesion 10.59 70.00 $741.30 11463 Removal sweat gland lesion 13.99 70.00 $979.30 11470 Removal sweat gland lesion 11.70 70.00 $819.00 11471 Removal sweat gland lesion 14.51 70.00 $1,015.70 1150F Doc pt rsk death w/in 1yr 0.00 70.00 $0.00 1151F Doc no pt rsk death w/in 1yr 0.00 70.00 $0.00 1152F Doc advncd dis comfort 1st 0.00 70.00 $0.00 1153F Doc advncd dis cmfrt not 1st 0.00 70.00 $0.00 1157F Advnc care plan in rcrd 0.00 70.00 $0.00 1158F Advnc care plan tlk docd 0.00 70.00 $0.00 1159F Med list docd in rcrd 0.00 70.00 $0.00 1160F Rvw meds by rx/dr in rcrd 0.00 70.00 $0.00 11600 Exc tr-ext mal+marg 0.5 cm/< 5.46 70.00 $382.20 11601 Exc tr-ext mal+marg 0.6-1 cm 6.50 70.00 $455.00 11602 Exc tr-ext mal+marg 1.1-2 cm 7.05 70.00 $493.50 11603 Exc tr-ext mal+marg 2.1-3 cm 8.06 70.00 $564.20 11604 Exc tr-ext mal+marg 3.1-4 cm 8.96 70.00 $627.20 11606 Exc tr-ext mal+marg >4 cm 12.82 70.00 $897.40 11620 Exc h-f-nk-sp mal+marg 0.5/< 5.51 70.00 $385.70 11621 Exc s/n/h/f/g mal+mrg 0.6-1 6.54 70.00 $457.80 11622 Exc s/n/h/f/g mal+mrg 1.1-2 7.29 70.00 $510.30 11623 Exc s/n/h/f/g mal+mrg 2.1-3 8.55 70.00 $598.50 11624 Exc s/n/h/f/g mal+mrg 3.1-4 9.65 70.00 $675.50 11626 Exc s/n/h/f/g mal+mrg >4 cm 11.61 70.00 $812.70 11640 Exc f/e/e/n/l mal+mrg 0.5cm< 5.69 70.00 $398.30 11641 Exc f/e/e/n/l mal+mrg 0.6-1 6.76 70.00 $473.20 11642 Exc f/e/e/n/l mal+mrg 1.1-2 7.72 70.00 $540.40 11643 Exc f/e/e/n/l mal+mrg 2.1-3 9.10 70.00 $637.00 11644 Exc f/e/e/n/l mal+mrg 3.1-4 11.21 70.00 $784.70 11646 Exc f/e/e/n/l mal+mrg >4 cm 14.66 70.00 $1,026.20 1170F Fxnl status assessed 0.00 70.00 $0.00 11719 Trim nail(s) any number 0.40 70.00 $28.00 11720 Debride nail 1-5 0.91 70.00 $63.70 11721 Debride nail 6 or more 1.27 70.00 $88.90 11730 Removal of nail plate 2.97 70.00 $207.90 11732 Remove nail plate add-on 0.90 70.00 $63.00 11740 Drain blood from under nail 1.40 70.00 $98.00 1175F Function stat assessed rvwd 0.00 70.00 $0.00 11750 Removal of nail bed 4.34 70.00 $303.80 11755 Biopsy nail unit 3.77 70.00 $263.90 11760 Repair of nail bed 5.35 70.00 $374.50 11762 Reconstruction of nail bed 7.90 70.00 $553.00 11765 Excision of nail fold toe 4.74 70.00 $331.80 11770 Remove pilonidal cyst simple 7.87 70.00 $550.90 11771 Remove pilonidal cyst exten 16.30 70.00 $1,141.00 11772 Remove pilonidal cyst compl 19.75 70.00 $1,382.50 1180F Thromboemb risk assessed 0.00 70.00 $0.00 1181F Neuropsychia sympts assessed 0.00 70.00 $0.00 1182F Neuropsychi sympt 1+present 0.00 70.00 $0.00 1183F Neuropsychiatric symp absent 0.00 70.00 $0.00 11900 Inject skin lesions </w 7 1.58 70.00 $110.60 11901 Inject skin lesions >7 1.99 70.00 $139.30 11920 Correct skin color 6.0 cm/< 4.83 70.00 $338.10 11921 Correct skn color 6.1-20.0cm 5.61 70.00 $392.70 11922 Correct skin color ea 20.0cm 1.74 70.00 $121.80 11950 Tx contour defects 1 cc/< 2.21 70.00 $154.70 11951 Tx contour defects 1.1-5.0cc 2.84 70.00 $198.80 11952 Tx contour defects 5.1-10cc 3.54 70.00 $247.80 11954 Tx contour defects >10.0 cc 4.49 70.00 $314.30 11960 Insert tissue expander(s) 27.26 70.00 $1,908.20 11970 Replace tissue expander
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