2018 National Physician Fee Schedule Relative Value File January Release CPT codes and descriptions only are copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. Dental codes (D codes) are copyright 2017/17 American Dental Association. All Rights Reserved. RELEASED 12/18/2017 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 16.04 $70.00 $1,122.80 10035 Perq dev soft tiss 1st imag 14.71 $70.00 $1,029.70 10036 Perq dev soft tiss add imag 12.90 $70.00 $903.00 1004F Clin symp vol ovrld assess 0.00 $70.00 $0.00 10040 Acne surgery 3.13 $70.00 $219.10 1005F Asthma symptoms evaluate 0.00 $70.00 $0.00 1006F Osteoarthritis assess 0.00 $70.00 $0.00 10060 Drainage of skin abscess 3.38 $70.00 $236.60 10061 Drainage of skin abscess 5.87 $70.00 $410.90 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 5.12 $70.00 $358.40 10081 Drainage of pilonidal cyst 7.68 $70.00 $537.60 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 4.38 $70.00 $306.60 10121 Remove foreign body 7.83 $70.00 $548.10 10140 Drainage of hematoma/fluid 4.69 $70.00 $328.30 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 7.06 $70.00 $494.20 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 NON-FACILITY HCPCS MOD DESCRIPTION TOTAL MULTIPLIER TOTAL 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 1.56 $70.00 $109.20 11001 Debride infected skin add-on 0.61 $70.00 $42.70 11004 Debride genitalia & perineum 16.69 $70.00 $1,168.30 11005 Debride abdom wall 22.64 $70.00 $1,584.80 11006 Debride genit/per/abdom wall 20.44 $70.00 $1,430.80 11008 Remove mesh from abd wall 7.96 $70.00 $557.20 1101F Pt falls assess-docd le1/yr 0.00 $70.00 $0.00 11010 Debride skin at fx site 14.43 $70.00 $1,010.10 11011 Debride skin musc at fx site 15.48 $70.00 $1,083.60 11012 Deb skin bone at fx site 20.25 $70.00 $1,417.50 11042 Deb subq tissue 20 sq cm/< 3.35 $70.00 $234.50 11043 Deb musc/fascia 20 sq cm/< 6.53 $70.00 $457.10 11044 Deb bone 20 sq cm/< 8.94 $70.00 $625.80 11045 Deb subq tissue add-on 1.18 $70.00 $82.60 11046 Deb musc/fascia add-on 2.09 $70.00 $146.30 11047 Deb bone add-on 3.54 $70.00 $247.80 11055 Trim skin lesion 1.37 $70.00 $95.90 11056 Trim skin lesions 2 to 4 1.67 $70.00 $116.90 11057 Trim skin lesions over 4 1.89 $70.00 $132.30 1110F Pt lft inpt fac w/in 60 days 0.00 $70.00 $0.00 11100 Biopsy skin lesion 3.00 $70.00 $210.00 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 2.55 $70.00 $178.50 11201 Remove skin tags add-on 0.55 $70.00 $38.50 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 NON-FACILITY HCPCS MOD DESCRIPTION TOTAL MULTIPLIER TOTAL 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/< 2.79 $70.00 $195.30 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/< 2.82 $70.00 $197.40 11306 Shave skin lesion 0.6-1.0 cm 3.48 $70.00 $243.60 11307 Shave skin lesion 1.1-2.0 cm 4.13 $70.00 $289.10 11308 Shave skin lesion >2.0 cm 4.31 $70.00 $301.70 11310 Shave skin lesion 0.5 cm/< 3.25 $70.00 $227.50 11311 Shave skin lesion 0.6-1.0 cm 3.18 $70.00 $222.60 11312 Shave skin lesion 1.1-2.0 cm 4.58 $70.00 $320.60 11313 Shave skin lesion >2.0 cm 5.31 $70.00 $371.70 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< 3.58 $70.00 $250.60 11401 Exc tr-ext b9+marg 0.6-1 cm 4.27 $70.00 $298.90 11402 Exc tr-ext b9+marg 1.1-2 cm 4.76 $70.00 $333.20 11403 Exc tr-ext b9+marg 2.1-3cm 5.50 $70.00 $385.00 11404 Exc tr-ext b9+marg 3.1-4 cm 6.23 $70.00 $436.10 11406 Exc tr-ext b9+marg >4.0 cm 8.99 $70.00 $629.30 11420 Exc h-f-nk-sp b9+marg 0.5/< 3.50 $70.00 $245.00 11421 Exc h-f-nk-sp b9+marg 0.6-1 4.48 $70.00 $313.60 11422 Exc h-f-nk-sp b9+marg 1.1-2 5.04 $70.00 $352.80 11423 Exc h-f-nk-sp b9+marg 2.1-3 5.74 $70.00 $401.80 11424 Exc h-f-nk-sp b9+marg 3.1-4 6.67 $70.00 $466.90 11426 Exc h-f-nk-sp b9+marg >4 cm 9.56 $70.00 $669.20 11440 Exc face-mm b9+marg 0.5 cm/< 3.87 $70.00 $270.90 11441 Exc face-mm b9+marg 0.6-1 cm 4.80 $70.00 $336.00 11442 Exc face-mm b9+marg 1.1-2 cm 5.37 $70.00 $375.90 11443 Exc face-mm b9+marg 2.1-3 cm 6.38 $70.00 $446.60 11444 Exc face-mm b9+marg 3.1-4 cm 8.02 $70.00 $561.40 11446 Exc face-mm b9+marg >4 cm 11.14 $70.00 $779.80 11450 Removal sweat gland lesion 10.98 $70.00 $768.60 11451 Removal sweat gland lesion 13.90 $70.00 $973.00 11462 Removal sweat gland lesion 10.72 $70.00 $750.40 11463 Removal sweat gland lesion 14.05 $70.00 $983.50 11470 Removal sweat gland lesion 11.82 $70.00 $827.40 11471 Removal sweat gland lesion 14.62 $70.00 $1,023.40 NON-FACILITY HCPCS MOD DESCRIPTION TOTAL MULTIPLIER TOTAL 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/< 5.52 $70.00 $386.40 11601 Exc tr-ext mal+marg 0.6-1 cm 6.53 $70.00 $457.10 11602 Exc tr-ext mal+marg 1.1-2 cm 7.08 $70.00 $495.60 11603 Exc tr-ext mal+marg 2.1-3 cm 8.11 $70.00 $567.70 11604 Exc tr-ext mal+marg 3.1-4 cm 8.99 $70.00 $629.30 11606 Exc tr-ext mal+marg >4 cm 12.86 $70.00 $900.20 11620 Exc h-f-nk-sp mal+marg 0.5/< 5.56 $70.00 $389.20 11621 Exc s/n/h/f/g mal+mrg 0.6-1 6.56 $70.00 $459.20 11622 Exc s/n/h/f/g mal+mrg 1.1-2 7.32 $70.00 $512.40 11623 Exc s/n/h/f/g mal+mrg 2.1-3 8.59 $70.00 $601.30 11624 Exc s/n/h/f/g mal+mrg 3.1-4 9.68 $70.00 $677.60 11626 Exc s/n/h/f/g mal+mrg >4 cm 11.63 $70.00 $814.10 11640 Exc f/e/e/n/l mal+mrg 0.5cm< 5.73 $70.00 $401.10 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 7.74 $70.00 $541.80 11643 Exc f/e/e/n/l mal+mrg 2.1-3 9.12 $70.00 $638.40 11644 Exc f/e/e/n/l mal+mrg 3.1-4 11.26 $70.00 $788.20 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 0.41 $70.00 $28.70 11720 Debride nail 1-5 0.94 $70.00 $65.80 11721 Debride nail 6 or more 1.29 $70.00 $90.30 11730 Removal of nail plate 3.01 $70.00 $210.70 11732 Remove nail plate add-on 0.90 $70.00 $63.00 11740 Drain blood from under nail 1.43 $70.00 $100.10 1175F Function stat assessed rvwd 0.00 $70.00 $0.00 11750 Removal of nail bed 4.37 $70.00 $305.90 11755 Biopsy nail unit 3.75 $70.00 $262.50 11760 Repair of nail bed 5.35 $70.00 $374.50 11762 Reconstruction of nail bed 7.97 $70.00 $557.90 11765 Excision of nail fold toe 4.77 $70.00 $333.90 11770 Remove pilonidal cyst simple 7.89 $70.00 $552.30 11771 Remove pilonidal cyst exten 16.49 $70.00 $1,154.30 11772 Remove pilonidal cyst compl 19.86 $70.00 $1,390.20 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 NON-FACILITY HCPCS MOD DESCRIPTION TOTAL MULTIPLIER TOTAL 1183F Neuropsychiatric symp absent 0.00 $70.00 $0.00 11900 Inject skin lesions </w 7 1.60 $70.00 $112.00 11901 Inject skin lesions >7 2.01 $70.00 $140.70 11920 Correct skin color 6.0 cm/< 4.91 $70.00