Frequently Serviced Items - 2006 Region A DMERC Fee Schedule

Inclusion or exclusion of a fee schedule amount for an item or service does not imply any health insurance coverage.

HCPCS		MOD1		MOD2		Ceiling		Floor		CT		DE		MA		ME		NH		NJ		NY		PA		RI		VT
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E0450		RR				954.52		811.34		954.52		954.52		954.52		887.68		954.52		954.52		954.52		954.52		954.52		837.57
E0460		RR				733.57		623.53		733.57		623.53		623.53		623.53		623.53		623.53		623.53		623.53		623.53		623.53
E0461		RR				1002.05		851.74		1002.05		1002.05		1002.05		1002.05		1002.05		1002.05		1002.05		1002.05		1002.05		1002.05
E0463		RR				1406.38		1195.42		1406.38		1406.38		1406.38		1406.38		1406.38		1406.38		1406.38		1406.38		1406.38		1406.38
E0464		RR				1406.38		1195.42		1406.38		1406.38		1406.38		1406.38		1406.38		1406.38		1406.38		1406.38		1406.38		1406.38
E0471		RR				642.17		545.84		642.17		545.84		642.17		642.17		642.17		545.84		642.17		545.84		642.17		642.17
E0472		RR				642.17		545.84		642.17		545.84		642.17		642.17		642.17		545.84		642.17		545.84		642.17		642.17
E0500		RR				109.77		93.30		107.03		103.33		109.77		109.77		109.77		109.77		109.77		104.07		109.77		109.77
E0575		RR				102.78		87.36		102.78		99.13		102.78		102.78		102.78		102.78		102.78		94.65		102.78		102.78
E0935		RR				22.73		19.32		22.73		22.73		22.73		22.73		22.73		22.73		19.32		22.73		19.32		22.73
K0455		RR				264.87		225.14		264.87		225.14		225.14		225.14		225.14		225.14		225.14		225.14		231.27		225.14