Medicaid Fee PROC-CD MOD Description Schedule 10021 FINE NEEDLE ASPIRATION; WITHOUT IMAGING GUIDANCE $65.06 10022 FINE NEEDLE ASPIRATION; WITH IMAGING GUIDANCE $66.30 10040 ACNE SURGERY (EG, MARSUPIALIZATION, OPENING OR REMOVAL OF $47.83 10040 32 ACNE SURGERY (EG, MARSUPIALIZATION, OPENING OR REMOVAL OF $62.24 10060 INCISION AND DRAINAGE OF ABSCESS (EG, CARBUNCLE, SUPPURATIVE $52.42 10060 32 INCISION AND DRAINAGE OF ABSCESS (EG, CARBUNCLE, SUPPURATIVE $59.93 10061 INCISION AND DRAINAGE OF ABSCESS (EG, CARBUNCLE, SUPPURATIVE $97.47 10061 32 INCISION AND DRAINAGE OF ABSCESS (EG, CARBUNCLE, SUPPURATIVE $108.08 10080 32 INCISION AND DRAINAGE OF PILONIDAL CYST $107.30 10080 INCISION AND DRAINAGE OF PILONIDAL CYST $56.78 10081 32 INCISION AND DRAINAGE OF PILONIDAL CYST $163.42 10081 INCISION AND DRAINAGE OF PILONIDAL CYST $103.48 10120 32 INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES $85.13 10120 INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES $54.57 10121 32 INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES $156.40 10121 INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES $112.70 10140 32 INCISION AND DRAINAGE OF HEMATOMA $83.39 10140 INCISION AND DRAINAGE OF HEMATOMA $71.01 10160 PUNCTURE ASPIRATION OF ABSCESS, HEMATOMA, BULLA, OR CYST $57.25 10160 32 PUNCTURE ASPIRATION OF ABSCESS, HEMATOMA, BULLA, OR CYST $70.39 10180 32 INCISION AND DRAINAGE, COMPLEX, POSTOPERATIVE WOUND INFECTION $133.32 10180 INCISION AND DRAINAGE, COMPLEX, POSTOPERATIVE WOUND INFECTION $108.05 11000 32 DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN $31.76 11000 DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN $23.96 11001 DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN $12.45 11001 32 DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN $17.44 DEBRIDEMENT OF SKIN, SUBCUTANEOUS TISSUE, MUSCLE AND FASCIA 11004 FOR NECROTIZING $415.20 DEBRIDEMENT OF SKIN, SUBCUTANEOUS TISSUE, MUSCLE AND FASCIA 11005 FOR NECROTIZING $566.13 DEBRIDEMENT OF SKIN, SUBCUTANEOUS TISSUE, MUSCLE AND FASCIA 11006 FOR NECROTIZING $520.32 REMOVAL OF PROSTHETIC MATERIAL OR MESH, ABDOMINAL WALL FOR 11008 NECROTIZING SOFT $211.51 DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL 11010 32 ASSOCIATEDWITH OPEN FRACTURE $281.81 DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL 11010 ASSOCIATEDWITH OPEN FRACTURE $219.04 DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL ASSOC 11011 32 WITHOPEN FX(S)/DISLOCATI $333.00 DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL ASSOC 11011 WITHOPEN FX(S)/DISLOCATI $262.37 DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL ASSOC 11012 32 WITHOPEN FRACTURE(S)/DIS $484.78 DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL ASSOC 11012 WITHOPEN FRACTURE(S)/DIS $373.19 11040 32 DEBRIDEMENT $27.63 11040 DEBRIDEMENT $20.46 11041 DEBRIDEMENT $33.06 11041 32 DEBRIDEMENT $42.11 11042 32 DEBRIDEMENT $56.05 11042 DEBRIDEMENT $44.20 11043 32 DEBRIDEMENT $145.85 11043 DEBRIDEMENT $125.89 11044 DEBRIDEMENT $172.73 11044 32 DEBRIDEMENT $190.42 Medicaid Fee Schedule 200711 Draft 1 Medicaid Fee PROC-CD MOD Description Schedule PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR 11055 32 CALLUS); SINGLE L $24.88 PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR 11055 CALLUS); SINGLE L $15.03 PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR 11056 32 CALLUS); TWO TO F $31.38 PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR 11056 CALLUS); TWO TO F $21.02 PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR 11057 32 CALLUS); MORE THA $38.57 PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR 11057 CALLUS); MORE THA $27.45 11100 32 BIOPSY OF SKIN, SUBCUTANEOUS TISSUE AND/OR MUCOUS MEMBRANE $54.75 11100 BIOPSY OF SKIN, SUBCUTANEOUS TISSUE AND/OR MUCOUS MEMBRANE $32.61 11101 BIOPSY OF SKIN, SUBCUTANEOUS TISSUE AND/OR MUCOUS MEMBRANE $16.91 11101 32 BIOPSY OF SKIN, SUBCUTANEOUS TISSUE AND/OR MUCOUS MEMBRANE $26.88 11200 EXCISION (INCLUDING SIMPLE CLOSURE OR LIGATURE STRANGULATION), $37.52 11200 32 EXCISION (INCLUDING SIMPLE CLOSURE OR LIGATURE STRANGULATION), $44.96 11201 EXCISION (INCLUDING SIMPLE CLOSURE OR LIGATURE STRANGULATION), $11.56 11201 32 EXCISION (INCLUDING SIMPLE CLOSURE OR LIGATURE STRANGULATION), $17.49 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, TRUNK, 11300 32 ARMS OR LEGS; LESIO $38.81 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, TRUNK, 11300 ARMS OR LEGS; LESIO $22.28 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, TRUNK, 11301 32 ARMS OR LEGS; LESIO $52.06 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, TRUNK, 11301 ARMS OR LEGS; LESIO $35.53 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, TRUNK, 11302 32 ARMS OR LEGS; LESIO $62.88 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, TRUNK, 11302 ARMS OR LEGS; LESIO $44.16 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, TRUNK, 11303 32 ARMS OR LEGS; LESIO $77.80 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, TRUNK, 11303 ARMS OR LEGS; LESIO $54.40 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, SCALP, 11305 32 NECK, HANDS, FEET, $39.84 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, SCALP, 11305 NECK, HANDS, FEET, $27.37 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, SCALP, 11306 32 NECK, HANDS, FEET, $55.68 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, SCALP, 11306 NECK, HANDS, FEET, $40.09 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, SCALP, 11307 32 NECK, HANDS, FEET, $65.24 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, SCALP, 11307 NECK, HANDS, FEET, $47.15 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, SCALP, 11308 32 NECK, HANDS, FEET, $81.58 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, SCALP, 11308 NECK, HANDS, FEET, $60.37 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, FACE, EARS, 11310 32 EYELIDS, NOSE, $49.21 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, FACE, EARS, 11310 EYELIDS, NOSE, $31.44 Medicaid Fee Schedule 200711 Draft 2 Medicaid Fee PROC-CD MOD Description Schedule SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, FACE, EARS, 11311 32 EYELIDS, NOSE, $62.25 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, FACE, EARS, 11311 EYELIDS, NOSE, $44.16 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, FACE, EARS, 11312 32 EYELIDS, NOSE, $71.81 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, FACE, EARS, 11312 EYELIDS, NOSE, $51.54 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, FACE, EARS, 11313 32 EYELIDS, NOSE, $93.59 SHAVING OF EPIDERMAL OR DERMAL LESION, SINGLE LESION, FACE, EARS, 11313 EYELIDS, NOSE, $69.27 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED 11400 ELSEWHERE), $42.74 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED 11400 32 ELSEWHERE), $71.86 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED 11401 ELSEWHERE), $56.58 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED 11401 32 ELSEWHERE), $85.90 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED 11402 ELSEWHERE), $67.58 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED 11402 32 ELSEWHERE), $99.08 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED 11403 ELSEWHERE), $81.11 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED 11403 32 ELSEWHERE), $116.04 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED 11404 ELSEWHERE), $92.35 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED 11404 32 ELSEWHERE), $130.08 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED 11406 32 ELSEWHERE), $159.67 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED 11406 ELSEWHERE), $132.54 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED 11420 ELSEWHERE), $47.53 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED 11420 32 ELSEWHERE), $69.19 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED 11421 ELSEWHERE), $64.22 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED 11421 32 ELSEWHERE), $90.73 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED 11422 ELSEWHERE), $73.76 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED 11422 32 ELSEWHERE), $103.59 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED 11423 ELSEWHERE), $91.62 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED 11423 32 ELSEWHERE), $126.55 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED 11424 ELSEWHERE), $107.64 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED 11424 32 ELSEWHERE), $142.88 Medicaid Fee Schedule 200711 Draft 3 Medicaid Fee PROC-CD MOD Description Schedule EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED 11426 32 ELSEWHERE), $194.19 EXCISION, BENIGN LESION, EXCEPT SKIN TAG (UNLESS LISTED 11426 ELSEWHERE), $167.69 11440 EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE), FACE, $58.77 11440 32 EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE), FACE, $83.10 11441 EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE), FACE, $73.83 11441 32 EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE), FACE, $100.32 11442 EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE), FACE, $81.88 11442 32 EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE), FACE, $113.28 11443 EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE), FACE, $106.21 11443 32 EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE), FACE, $143.63 11444 EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE), FACE, $138.99 11444 32 EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE), FACE, $177.35 11446 EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE), FACE, $180.43 11446 32 EXCISION, OTHER BENIGN LESION (UNLESS