2018 Workers' Compensation Part B Fee Schedule

44146-45331

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CPT/HCPC Code Modifier Medicare Location Global Surgery Indicator Multiple Surgery Indicator Prevailing Charge Amount Fee Schedule Amount Site of Service Amount
Implied Decimal 2 (in dollars)
44146   1 90 2 0 358432 0
44146   2 90 2 0 345193 0
44146   3 90 2 0 333833 0
44146   4 90 2 0 324650 0
44147   1 90 2 0 317946 0
44147   2 90 2 0 306051 0
44147   3 90 2 0 289254 0
44147   4 90 2 0 285468 0
44150   1 90 2 0 339068 0
44150   2 90 2 0 322151 0
44150   3 90 2 0 299387 0
44150   4 90 2 0 295975 0
44151   1 90 2 0 314919 0
44151   2 90 2 0 262820 0
44151   3 90 2 0 246069 0
44151   4 90 2 0 243357 0
44155   1 90 2 0 382614 0
44155   2 90 2 0 373254 0
44155   3 90 2 0 357269 0
44155   4 90 2 0 355455 0
44156   1 90 2 0 302416 0
44156   2 90 2 0 345373 0
44156   3 90 2 0 278817 0
44156   4 90 2 0 275752 0
44157   1 90 2 0 294827 0
44157   2 90 2 0 261798 0
44157   3 90 2 0 261798 0
44157   4 90 2 0 261798 0
44158   1 90 2 0 302442 0
44158   2 90 2 0 268577 0
44158   3 90 2 0 268577 0
44158   4 90 2 0 268577 0
44160   1 90 2 0 282363 0
44160   2 90 2 0 275938 0
44160   3 90 2 0 242324 0
44160   4 90 2 0 233130 0
44180   1 90 2 0 135633 0
44180   2 90 2 0 121201 0
44180   3 90 2 0 121201 0
44180   4 90 2 0 121201 0
44186   1 90 2 0 95536 0
44186   2 90 2 0 85060 0
44186   3 90 2 0 85060 0
44186   4 90 2 0 85060 0
44187   1 90 2 0 157711 0
44187   2 90 2 0 140497 0
44187   3 90 2 0 140497 0
44187   4 90 2 0 140497 0
44188   1 90 2 0 173096 0
44188   2 90 2 0 154159 0
44188   3 90 2 0 154159 0
44188   4 90 2 0 154159 0
44202   1 90 2 0 267144 0
44202   2 90 2 0 239807 0
44202   3 90 2 0 239807 0
44202   4 90 2 0 239807 0
44203   1 ZZZ 0 0 43945 0
44203   2 ZZZ 0 0 39511 0
44203   3 ZZZ 0 0 39511 0
44203   4 ZZZ 0 0 39511 0
44204   1 90 2 0 251334 0
44204   2 90 2 0 227718 0
44204   3 90 2 0 227718 0
44204   4 90 2 0 227718 0
44205   1 90 2 0 222397 0
44205   2 90 2 0 201714 0
44205   3 90 2 0 201714 0
44205   4 90 2 0 201714 0
44206   1 90 2 0 269732 0
44206   2 90 2 0 244242 0
44206   3 90 2 0 244242 0
44206   4 90 2 0 244242 0
44207   1 90 2 0 295026 0
44207   2 90 2 0 267468 0
44207   3 90 2 0 267468 0
44207   4 90 2 0 267468 0
44208   1 90 2 0 318791 0
44208   2 90 2 0 289242 0
44208   3 90 2 0 289242 0
44208   4 90 2 0 289242 0
44210   1 YYY 2 0 282593 0
44210   2 YYY 2 0 255849 0
44210   3 YYY 2 0 255849 0
44210   4 YYY 2 0 255849 0
44211   1 90 2 0 350356 0
44211   2 90 2 0 317988 0
44211   3 90 2 0 317988 0
44211   4 90 2 0 317988 0
44212   1 90 2 0 327664 0
44212   2 90 2 0 296996 0
44212   3 90 2 0 296996 0
44212   4 90 2 0 296996 0
44213   1 ZZZ 0 0 31007 0
44213   2 ZZZ 0 0 27870 0
44213   3 ZZZ 0 0 27870 0
44213   4 ZZZ 0 0 27870 0
44227   1 90 2 0 243838 0
44227   2 90 2 0 218358 0
44227   3 90 2 0 218358 0
44227   4 90 2 0 218358 0
44238     90 2 0 0 0
44300   1 90 2 0 145063 0
44300   2 90 2 0 142602 0
44300   3 90 2 0 135510 0
44300   4 90 2 0 135958 0
44310   1 90 2 0 181731 0
44310   2 90 2 0 175608 0
44310   3 90 2 0 169317 0
44310   4 90 2 0 172206 0
44312   1 90 2 0 83057 0
44312   2 90 2 0 82630 0
44312   3 90 2 0 71840 0
44312   4 90 2 0 80509 0
44314   1 90 2 0 150089 0
44314   2 90 2 0 144861 0
44314   3 90 2 0 137100 0
44314   4 90 2 0 139360 0
44316   1 90 2 0 215110 0
44316   2 90 2 0 212048 0
44316   3 90 2 0 199385 0
44316   4 90 2 0 200500 0
44320   1 90 2 0 182775 0
44320   2 90 2 0 171401 0
44320   3 90 2 0 165268 0
44320   4 90 2 0 165904 0
44322   1 90 2 0 188247 0
44322   2 90 2 0 184988 0
44322   3 90 2 0 171570 0
44322   4 90 2 0 169588 0
44340   1 90 2 0 75996 0
44340   2 90 2 0 75680 0
44340   3 90 2 0 71394 0
44340   4 90 2 0 73927 0
44345   1 90 2 0 139243 0
44345   2 90 2 0 137256 0
44345   3 90 2 0 153795 0
44345   4 90 2 0 127690 0
44346   1 90 2 0 165001 0
44346   2 90 2 0 162573 0
44346   3 90 2 0 155140 0
44346   4 90 2 0 139381 0
44360   1 0 2 0 56537 0
44360   2 0 2 0 58628 0
44360   3 0 2 0 52442 0
44360   4 0 2 0 51772 0
44361   1 0 3 0 71184 0
44361   2 0 3 0 69546 0
44361   3 0 3 0 69162 0
44361   4 0 3 0 59352 0
44363   1 0 3 0 59131 0
44363   2 0 3 0 58333 0
44363   3 0 3 0 55026 0
44363   4 0 3 0 54379 0
44364   1 0 3 0 78917 0
44364   2 0 3 0 77615 0
44364   3 0 3 0 72210 0
44364   4 0 3 0 71328 0
44365   1 0 3 0 78053 0
44365   2 0 3 0 76755 0
44365   3 0 3 0 71373 0
44365   4 0 3 0 70497 0
44366   1 0 3 0 91222 0
44366   2 0 3 0 90003 0
44366   3 0 3 0 84927 0
44366   4 0 3 0 83846 0
44369   1 0 3 0 98986 0
44369   2 0 3 0 97633 0
44369   3 0 3 0 91990 0
44369   4 0 3 0 90806 0
44370   1 0 3 0 44542 0
44370   2 0 3 0 40732 0
44370   3 0 3 0 40732 0
44370   4 0 3 0 40732 0
44372   1 0 3 0 93664 0
44372   2 0 3 0 96161 0
44372   3 0 3 0 93706 0
44372   4 0 3 0 85312 0
44373   1 0 3 0 78316 0
44373   2 0 3 0 90094 0
44373   3 0 3 0 72374 0
44373   4 0 3 0 87682 0
44376   1 0 2 0 75744 0
44376   2 0 2 0 74891 0
44376   3 0 2 0 71337 0
44376   4 0 2 0 70483 0
44377   1 0 3 0 80139 0
44377   2 0 3 0 79227 0
44377   3 0 3 0 75450 0
44377   4 0 3 0 74545 0
44378   1 0 3 0 104510 0
44378   2 0 3 0 103328 0
44378   3 0 3 0 98406 0
44378   4 0 3 0 97229 0
44379   1 0 3 0 72760 0
44379   2 0 3 0 66455 0
44379   3 0 3 0 66455 0
44379   4 0 3 0 66455 0
44380   1 0 2 0 55103 0
44380   2 0 2 0 52670 0
44380   3 0 2 0 51602 0
44380   4 0 2 0 41125 0
44381     0 3 0 0 0
44382   1 0 2 0 56969 0
44382   2 0 2 0 59795 0
44382   3 0 2 0 37572 0
44382   4 0 2 0 56901 0
44384     0 3 0 0 0
44385   1 0 2 0 56641 0
44385   2 0 2 0 53963 0
44385   3 0 2 0 61067 0
44385   4 0 2 0 38879 0
44386   1 0 2 0 62829 0
44386   2 0 2 0 30387 0
44386   3 0 2 0 28792 0
44386   4 0 2 0 28449 0
44388   1 0 2 0 71115 0
44388   2 0 2 0 67798 0
44388   3 0 2 0 70465 0
44388   4 0 2 0 72622 0
44389   1 0 3 0 75985 0
44389   2 0 3 0 75623 0
44389   3 0 3 0 72739 0
44389   4 0 3 0 74060 0
44390   1 0 3 0 54491 0
44390   2 0 3 0 61619 0
44390   3 0 3 0 50956 0
44390   4 0 3 0 50358 0
44391   1 0 3 0 82355 0
44391   2 0 3 0 83574 0
44391   3 0 3 0 76147 0
44391   4 0 3 0 75190 0
44392   1 0 3 0 108093 0
44392   2 0 3 0 104001 0
44392   3 0 3 0 103907 0
44392   4 0 3 0 101216 0
44394   1 0 3 0 108093 0
44394   2 0 3 0 104001 0
44394   3 0 3 0 103907 0
44394   4 0 3 0 101216 0
44401     0 3 0 0 0
44402     0 3 0 0 0
44403     0 3 0 0 0
44404     0 3 0 0 0
44405     0 3 0 0 0
44406     0 3 0 0 0
44407     0 3 0 0 0
44408     0 3 0 0 0
44500   1 0 0 0 5176 0
44500   2 0 0 0 5114 0
44500   3 0 0 0 4866 0
44500   4 0 0 0 4804 0
44602   1 90 2 0 179131 0
44602   2 90 2 0 178408 0
44602   3 90 2 0 160246 0
44602   4 90 2 0 160063 0
44603   1 90 2 0 211695 0
44603   2 90 2 0 208228 0
44603   3 90 2 0 193975 0
44603   4 90 2 0 191789 0
44604   1 90 2 0 191582 0
44604   2 90 2 0 190406 0
44604   3 90 2 0 172650 0
44604   4 90 2 0 172098 0
44605   1 90 2 0 223003 0
44605   2 90 2 0 219409 0
44605   3 90 2 0 204604 0
44605   4 90 2 0 196400 0
44615   1 90 2 0 164356 0
44615   2 90 2 0 161853 0
44615   3 90 2 0 151547 0
44615   4 90 2 0 149904 0
44620   1 90 2 0 148465 0
44620   2 90 2 0 146162 0
44620   3 90 2 0 136680 0
44620   4 90 2 0 136896 0
44625   1 90 2 0 194010 0
44625   2 90 2 0 170160 0
44625   3 90 2 0 170160 0
44625   4 90 2 0 170160 0
44626   1 90 2 0 277710 0
44626   2 90 2 0 247819 0
44626   3 90 2 0 247819 0
44626   4 90 2 0 247819 0
44640   1 90 2 0 177263 0
44640   2 90 2 0 173582 0
44640   3 90 2 0 165016 0
44640   4 90 2 0 167769 0
44650   1 90 2 0 197341 0
44650   2 90 2 0 194491 0
44650   3 90 2 0 182768 0
44650   4 90 2 0 180753 0
44660   1 90 2 0 197357 0
44660   2 90 2 0 194666 0
44660   3 90 2 0 183570 0
44660   4 90 2 0 181473 0
44661   1 90 2 0 252658 0
44661   2 90 2 0 246646 0
44661   3 90 2 0 233113 0
44661   4 90 2 0 232039 0
44680   1 90 2 0 237733 0
44680   2 90 2 0 233216 0
44680   3 90 2 0 196045 0
44680   4 90 2 0 224451 0
44700   1 90 2 0 219023 0
44700   2 90 2 0 191140 0
44700   3 90 2 0 191140 0
44700   4 90 2 0 191140 0
44701   1 90 2 0 29268 0
44701   2 90 2 0 26656 0
44701   3 90 2 0 26656 0
44701   4 90 2 0 26656 0
44705     XXX 9 0 0 0
44715     XXX 2 0 0 0
44720   1 XXX 2 0 45919 0
44720   2 XXX 2 0 42086 0
44720   3 XXX 2 0 42086 0
44720   4 XXX 2 0 42086 0
44721   1 XXX 2 0 68105 0
44721   2 XXX 2 0 61128 0
44721   3 XXX 2 0 61128 0
44721   4 XXX 2 0 61128 0
44799     YYY 2 0 0 0
44800   1 90 2 0 151617 0
44800   2 90 2 0 146034 0
44800   3 90 2 0 141793 0
44800   4 90 2 0 143768 0
44820   1 90 2 0 160307 0
44820   2 90 2 0 150748 0
44820   3 90 2 0 155537 0
44820   4 90 2 0 143512 0
44850   1 90 2 0 135726 0
44850   2 90 2 0 165255 0
44850   3 90 2 0 124783 0
44850   4 90 2 0 123388 0
44899     YYY 2 0 0 0
44900   1 90 2 0 106568 0
44900   2 90 2 0 95338 0
44900   3 90 2 0 95338 0
44900   4 90 2 0 95338 0
44950   1 90 2 0 110313 0
44950   2 90 2 0 107035 0
44950   3 90 2 0 100397 0
44950   4 90 2 0 97655 0
44955   1 ZZZ 0 0 67646 0
44955   2 ZZZ 0 0 67759 0
44955   3 ZZZ 0 0 38056 0
44955   4 ZZZ 0 0 68410 0
44960   1 90 2 0 145933 0
44960   2 90 2 0 146343 0
44960   3 90 2 0 136951 0
44960   4 90 2 0 135426 0
44970   1 90 2 0 105196 0
44970   2 90 2 0 94437 0
44970   3 90 2 0 94437 0
44970   4 90 2 0 94437 0
44979     YYY 2 0 0 0
45000   1 90 2 0 52777 0
45000   2 90 2 0 52056 0
45000   3 90 2 0 49661 0
45000   4 90 2 0 49130 0
45005   1 10 2 0 31662 0
45005   2 10 2 0 29704 0
45005   3 10 2 0 29899 0
45005   4 10 2 0 30596 0
45020   1 90 2 0 63532 0
45020   2 90 2 0 61777 0
45020   3 90 2 0 59334 0
45020   4 90 2 0 60080 0
45100   1 90 2 0 55727 0
45100   2 90 2 0 54427 0
45100   3 90 2 0 52831 0
45100   4 90 2 0 53143 0
45108   1 90 2 0 65649 0
45108   2 90 2 0 64649 0
45108   3 90 2 0 60530 0
45108   4 90 2 0 59851 0
45110   1 90 2 0 373780 0
45110   2 90 2 0 359842 0
45110   3 90 2 0 334879 0
45110   4 90 2 0 329417 0
45111   1 90 2 0 275795 0
45111   2 90 2 0 263230 0
45111   3 90 2 0 256947 0
45111   4 90 2 0 262134 0
45112   1 90 2 0 382660 0
45112   2 90 2 0 376574 0
45112   3 90 2 0 351526 0
45112   4 90 2 0 336280 0
45113   1 90 2 0 382660 0
45113   2 90 2 0 376574 0
45113   3 90 2 0 351526 0
45113   4 90 2 0 336280 0
45114   1 90 2 0 373483 0
45114   2 90 2 0 345829 0
45114   3 90 2 0 321658 0
45114   4 90 2 0 318454 0
45116   1 90 2 0 282954 0
45116   2 90 2 0 278642 0
45116   3 90 2 0 260910 0
45116   4 90 2 0 258041 0
45119   1 90 2 0 351389 0
45119   2 90 2 0 310688 0
45119   3 90 2 0 310688 0
45119   4 90 2 0 310688 0
45120   1 90 2 0 377183 0
45120   2 90 2 0 370962 0
45120   3 90 2 0 345330 0
45120   4 90 2 0 341433 0
45121   1 90 2 0 352219 0
45121   2 90 2 0 344797 0
45121   3 90 2 0 328872 0
45121   4 90 2 0 303214 0
45123   1 90 2 0 275795 0
45123   2 90 2 0 263230 0
45123   3 90 2 0 256947 0
45123   4 90 2 0 262134 0
45126   1 90 2 0 412394 410379
45126   2 90 2 0 369398 367678
45126   3 90 2 0 369398 367678
45126   4 90 2 0 369398 367678
45130   1 90 2 0 224316 0
45130   2 90 2 0 227042 0
45130   3 90 2 0 224920 0
45130   4 90 2 0 189828 0
45135   1 90 2 0 310240 0
45135   2 90 2 0 304473 0
45135   3 90 2 0 280676 0
45135   4 90 2 0 277397 0
45136   1 90 2 0 284170 0
45136   2 90 2 0 256343 0
45136   3 90 2 0 256343 0
45136   4 90 2 0 256343 0
45150   1 90 2 0 81325 0
45150   2 90 2 0 100740 0
45150   3 90 2 0 112368 0
45150   4 90 2 0 74223 0
45160   1 90 2 0 176151 0
45160   2 90 2 0 174495 0
45160   3 90 2 0 147174 0
45160   4 90 2 0 166574 0
45171   1 90 2 0 86714 0
45171   2 90 2 0 77116 0
45171   3 90 2 0 77116 0
45171   4 90 2 0 77116 0
45172   1 90 2 0 119010 0
45172   2 90 2 0 106301 0
45172   3 90 2 0 106301 0
45172   4 90 2 0 106301 0
45190   1 90 2 0 122063 0
45190   2 90 2 0 120276 0
45190   3 90 2 0 112359 0
45190   4 90 2 0 111099 0
45300   1 0 2 0 11525 9179
45300   2 0 2 0 11364 9049
45300   3 0 2 0 10651 8489
45300   4 0 2 0 11297 8990
45303   1 0 3 0 11914 8859
45303   2 0 3 0 11697 8682
45303   3 0 3 0 11427 8341
45303   4 0 3 0 10676 7875
45305   1 0 3 0 20652 0
45305   2 0 3 0 20545 0
45305   3 0 3 0 19971 0
45305   4 0 3 0 20806 0
45307   1 0 3 0 33786 0
45307   2 0 3 0 35347 0
45307   3 0 3 0 36044 0
45307   4 0 3 0 35777 0
45308   1 0 3 0 33453 0
45308   2 0 3 0 31607 0
45308   3 0 3 0 31328 0
45308   4 0 3 0 27133 0
45309   1 0 3 0 33453 0
45309   2 0 3 0 31607 0
45309   3 0 3 0 31328 0
45309   4 0 3 0 27133 0
45315   1 0 3 0 34903 0
45315   2 0 3 0 32732 0
45315   3 0 3 0 31384 0
45315   4 0 3 0 26994 0
45317   1 0 3 0 40852 0
45317   2 0 3 0 40094 0
45317   3 0 3 0 39884 0
45317   4 0 3 0 39725 0
45320   1 0 3 0 56110 0
45320   2 0 3 0 53277 0
45320   3 0 3 0 54674 0
45320   4 0 3 0 54474 0
45321   1 0 3 0 45022 0
45321   2 0 3 0 44803 0
45321   3 0 3 0 43913 0
45321   4 0 3 0 43767 0
45327   1 0 3 0 17594 0
45327   2 0 3 0 15834 0
45327   3 0 3 0 15834 0
45327   4 0 3 0 15834 0
45330   1 0 2 0 18744 13890
45330   2 0 2 0 18475 13679
45330   3 0 2 0 21280 15601
45330   4 0 2 0 17118 12668
45331   1 0 3 0 34168 0
45331   2 0 3 0 34051 0
45331   3 0 3 0 33370 0
45331   4 0 3 0 32338 0