2020 National Physician Fee Schedule Relative Value File January Release CPT codes and descriptions only are copyright 2018 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. Dental codes (D codes) are copyright 2019/20 American Dental Association. All Rights Reserved. RELEASED 11/08/2019 NON-FACILITY HCPCS MOD DESCRIPTION TOTAL MULTIPLIER TOTAL 1000F Tobacco use assessed 0.00 $70.00 $0.00 10004 Fna bx w/o img gdn ea addl 1.48 $70.00 $103.60 10005 Fna bx w/us gdn 1st les 3.67 $70.00 $256.90 10006 Fna bx w/us gdn ea addl 1.70 $70.00 $119.00 10007 Fna bx w/fluor gdn 1st les 8.43 $70.00 $590.10 10008 Fna bx w/fluor gdn ea addl 4.79 $70.00 $335.30 10009 Fna bx w/ct gdn 1st les 13.32 $70.00 $932.40 10010 Fna bx w/ct gdn ea addl 8.02 $70.00 $561.40 10011 Fna bx w/mr gdn 1st les 0.00 $70.00 $0.00 10012 Fna bx w/mr gdn ea addl 0.00 $70.00 $0.00 1002F Assess anginal symptom/level 0.00 $70.00 $0.00 10021 Fna bx w/o img gdn 1st les 2.80 $70.00 $196.00 1003F Level of activity assess 0.00 $70.00 $0.00 10030 Guide cathet fluid drainage 17.53 $70.00 $1,227.10 10035 Perq dev soft tiss 1st imag 12.84 $70.00 $898.80 10036 Perq dev soft tiss add imag 10.92 $70.00 $764.40 1004F Clin symp vol ovrld assess 0.00 $70.00 $0.00 10040 Acne surgery 3.11 $70.00 $217.70 1005F Asthma symptoms evaluate 0.00 $70.00 $0.00 1006F Osteoarthritis assess 0.00 $70.00 $0.00 10060 Drainage of skin abscess 3.44 $70.00 $240.80 10061 Drainage of skin abscess 5.97 $70.00 $417.90 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 5.99 $70.00 $419.30 10081 Drainage of pilonidal cyst 8.67 $70.00 $606.90 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 4.31 $70.00 $301.70 10121 Remove foreign body 7.76 $70.00 $543.20 10140 Drainage of hematoma/fluid 4.85 $70.00 $339.50 1015F Copd symptoms assess 0.00 $70.00 $0.00 10160 Puncture drainage of lesion 3.71 $70.00 $259.70 1018F Assess dyspnea not present 0.00 $70.00 $0.00 10180 Complex drainage wound 7.30 $70.00 $511.00 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 1.61 $70.00 $112.70 11001 Debride infected skin add-on 0.67 $70.00 $46.90 11004 Debride genitalia & perineum 16.68 $70.00 $1,167.60 11005 Debride abdom wall 22.72 $70.00 $1,590.40 11006 Debride genit/per/abdom wall 20.49 $70.00 $1,434.30 11008 Remove mesh from abd wall 7.99 $70.00 $559.30 1101F Pt falls assess-docd le1/yr 0.00 $70.00 $0.00 11010 Debride skin at fx site 13.56 $70.00 $949.20 11011 Debride skin musc at fx site 15.10 $70.00 $1,057.00 11012 Deb skin bone at fx site 19.34 $70.00 $1,353.80 11042 Deb subq tissue 20 sq cm/< 3.57 $70.00 $249.90 11043 Deb musc/fascia 20 sq cm/< 6.64 $70.00 $464.80 11044 Deb bone 20 sq cm/< 8.96 $70.00 $627.20 11045 Deb subq tissue add-on 1.19 $70.00 $83.30 11046 Deb musc/fascia add-on 2.12 $70.00 $148.40 11047 Deb bone add-on 3.53 $70.00 $247.10 11055 Trim skin lesion 1.78 $70.00 $124.60 11056 Trim skin lesions 2 to 4 2.10 $70.00 $147.00 11057 Trim skin lesions over 4 2.31 $70.00 $161.70 1110F Pt lft inpt fac w/in 60 days 0.00 $70.00 $0.00 11102 Tangntl bx skin single les 2.84 $70.00 $198.80 11103 Tangntl bx skin ea sep/addl 1.51 $70.00 $105.70 11104 Punch bx skin single lesion 3.57 $70.00 $249.90 11105 Punch bx skin ea sep/addl 1.72 $70.00 $120.40 11106 Incal bx skn single les 4.32 $70.00 $302.40 11107 Incal bx skn ea sep/addl 2.04 $70.00 $142.80 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 2.52 $70.00 $176.40 11201 Remove skin tags add-on 0.53 $70.00 $37.10 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/< 2.84 $70.00 $198.80 11301 Shave skin lesion 0.6-1.0 cm 3.45 $70.00 $241.50 11302 Shave skin lesion 1.1-2.0 cm 3.99 $70.00 $279.30 11303 Shave skin lesion >2.0 cm 4.39 $70.00 $307.30 11305 Shave skin lesion 0.5 cm/< 2.99 $70.00 $209.30 11306 Shave skin lesion 0.6-1.0 cm 3.50 $70.00 $245.00 11307 Shave skin lesion 1.1-2.0 cm 4.09 $70.00 $286.30 11308 Shave skin lesion >2.0 cm 4.37 $70.00 $305.90 11310 Shave skin lesion 0.5 cm/< 3.29 $70.00 $230.30 11311 Shave skin lesion 0.6-1.0 cm 3.90 $70.00 $273.00 11312 Shave skin lesion 1.1-2.0 cm 4.51 $70.00 $315.70 11313 Shave skin lesion >2.0 cm 5.27 $70.00 $368.90 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< 3.57 $70.00 $249.90 11401 Exc tr-ext b9+marg 0.6-1 cm 4.35 $70.00 $304.50 11402 Exc tr-ext b9+marg 1.1-2 cm 4.83 $70.00 $338.10 11403 Exc tr-ext b9+marg 2.1-3cm 5.58 $70.00 $390.60 11404 Exc tr-ext b9+marg 3.1-4 cm 6.34 $70.00 $443.80 11406 Exc tr-ext b9+marg >4.0 cm 9.07 $70.00 $634.90 11420 Exc h-f-nk-sp b9+marg 0.5/< 3.60 $70.00 $252.00 11421 Exc h-f-nk-sp b9+marg 0.6-1 4.54 $70.00 $317.80 11422 Exc h-f-nk-sp b9+marg 1.1-2 5.11 $70.00 $357.70 11423 Exc h-f-nk-sp b9+marg 2.1-3 5.81 $70.00 $406.70 11424 Exc h-f-nk-sp b9+marg 3.1-4 6.71 $70.00 $469.70 11426 Exc h-f-nk-sp b9+marg >4 cm 9.63 $70.00 $674.10 11440 Exc face-mm b9+marg 0.5 cm/< 3.97 $70.00 $277.90 11441 Exc face-mm b9+marg 0.6-1 cm 4.88 $70.00 $341.60 11442 Exc face-mm b9+marg 1.1-2 cm 5.43 $70.00 $380.10 11443 Exc face-mm b9+marg 2.1-3 cm 6.45 $70.00 $451.50 11444 Exc face-mm b9+marg 3.1-4 cm 8.09 $70.00 $566.30 11446 Exc face-mm b9+marg >4 cm 11.14 $70.00 $779.80 11450 Removal sweat gland lesion 11.67 $70.00 $816.90 11451 Removal sweat gland lesion 14.54 $70.00 $1,017.80 11462 Removal sweat gland lesion 11.36 $70.00 $795.20 11463 Removal sweat gland lesion 14.79 $70.00 $1,035.30 11470 Removal sweat gland lesion 12.38 $70.00 $866.60 11471 Removal sweat gland lesion 15.08 $70.00 $1,055.60 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/< 5.61 $70.00 $392.70 11601 Exc tr-ext mal+marg 0.6-1 cm 6.52 $70.00 $456.40 11602 Exc tr-ext mal+marg 1.1-2 cm 7.02 $70.00 $491.40 11603 Exc tr-ext mal+marg 2.1-3 cm 8.00 $70.00 $560.00 11604 Exc tr-ext mal+marg 3.1-4 cm 8.93 $70.00 $625.10 11606 Exc tr-ext mal+marg >4 cm 12.81 $70.00 $896.70 11620 Exc h-f-nk-sp mal+marg 0.5/< 5.64 $70.00 $394.80 11621 Exc s/n/h/f/g mal+mrg 0.6-1 6.55 $70.00 $458.50 11622 Exc s/n/h/f/g mal+mrg 1.1-2 7.25 $70.00 $507.50 11623 Exc s/n/h/f/g mal+mrg 2.1-3 8.52 $70.00 $596.40 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 11.66 $70.00 $816.20 11640 Exc f/e/e/n/l mal+mrg 0.5cm< 5.77 $70.00 $403.90 11641 Exc f/e/e/n/l mal+mrg 0.6-1 6.78 $70.00 $474.60 11642 Exc f/e/e/n/l mal+mrg 1.1-2 7.69 $70.00 $538.30 11643 Exc f/e/e/n/l mal+mrg 2.1-3 9.06 $70.00 $634.20 11644 Exc f/e/e/n/l mal+mrg 3.1-4 11.18 $70.00 $782.60 11646 Exc f/e/e/n/l mal+mrg >4 cm 14.57 $70.00 $1,019.90 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 0.93 $70.00 $65.10 11721 Debride nail 6 or more 1.29 $70.00 $90.30 11730 Removal of nail plate 3.14 $70.00 $219.80 11732 Remove nail plate add-on 0.95 $70.00 $66.50 11740 Drain blood from under nail 1.52 $70.00 $106.40 1175F Function stat assessed rvwd 0.00 $70.00 $0.00 11750 Removal of nail bed 4.45 $70.00 $311.50 11755 Biopsy nail unit 3.47 $70.00 $242.90 11760 Repair of nail bed 5.55 $70.00 $388.50 11762 Reconstruction of nail bed 8.44 $70.00 $590.80 11765 Excision of nail fold toe 4.80 $70.00 $336.00