| Jurisdiction A DME MAC | ||||||||||||||||||||
| 3rd Quarter 2006 DMEPOS/PEN Fee Schedule Updates | ||||||||||||||||||||
| Inclusion of a fee schedule amount for an item does not necessarily indicate coverage | ||||||||||||||||||||
| MOD1 | MOD2 | CT | DC | DE | MA | MD | ME | NH | NJ | NY | PA | RI | VT | |||||||
| E0705 | NU | $46.85 | $47.23 | $47.23 | $54.89 | $55.12 | $55.12 | $55.12 | $47.23 | $52.62 | $47.23 | $55.12 | $55.12 | |||||||
| E0705 | RR | $4.77 | $4.77 | $4.77 | $5.61 | $5.61 | $5.61 | $5.61 | $4.77 | $5.39 | $4.77 | $5.61 | $5.61 | |||||||
| E0705 | UE | $34.31 | $35.44 | $35.44 | $40.36 | $40.36 | $40.36 | $40.36 | $35.44 | $40.36 | $35.44 | $40.36 | $40.36 | |||||||
| E0762 | NU | $934.63 | $1,099.56 | $1,099.56 | $934.63 | $1,099.56 | $934.63 | $934.63 | $1,099.56 | $934.63 | $1,099.56 | $934.63 | $934.63 | |||||||
| E0762 | RR | $93.47 | $109.96 | $109.96 | $93.47 | $109.96 | $93.47 | $93.47 | $109.96 | $93.47 | $109.96 | $93.47 | $93.47 | |||||||
| E0762 | UE | $700.95 | $824.65 | $824.65 | $700.95 | $824.65 | $700.95 | $700.95 | $824.65 | $700.95 | $824.65 | $700.95 | $700.95 | |||||||
| E1812 | RR | $85.99 | $85.99 | $85.99 | $85.99 | $85.99 | $85.99 | $85.99 | $85.99 | $85.99 | $85.99 | $85.99 | $85.99 | |||||||
| E2601 | NU | $61.16 | $61.16 | $61.16 | $61.16 | $61.16 | $61.16 | $61.16 | $61.16 | $61.16 | $61.16 | $61.16 | $61.16 | |||||||
| E2601 | RR | $6.13 | $6.13 | $6.13 | $6.13 | $6.13 | $6.13 | $6.13 | $6.13 | $6.13 | $6.13 | $6.13 | $6.13 | |||||||
| E2601 | UE | $45.87 | $45.87 | $45.87 | $45.87 | $45.87 | $45.87 | $45.87 | $45.87 | $45.87 | $45.87 | $45.87 | $45.87 | |||||||
| E2602 | NU | $119.40 | $119.40 | $119.40 | $119.40 | $119.40 | $119.40 | $119.40 | $119.40 | $119.40 | $119.40 | $119.40 | $119.40 | |||||||
| E2602 | RR | $11.94 | $11.94 | $11.94 | $11.94 | $11.94 | $11.94 | $11.94 | $11.94 | $11.94 | $11.94 | $11.94 | $11.94 | |||||||
| E2602 | UE | $89.55 | $89.55 | $89.55 | $89.55 | $89.55 | $89.55 | $89.55 | $89.55 | $89.55 | $89.55 | $89.55 | $89.55 | |||||||
| E2603 | NU | $151.59 | $151.59 | $151.59 | $151.59 | $151.59 | $151.59 | $151.59 | $151.59 | $151.59 | $151.59 | $151.59 | $151.59 | |||||||
| E2603 | RR | $15.17 | $15.17 | $15.17 | $15.17 | $15.17 | $15.17 | $15.17 | $15.17 | $15.17 | $15.17 | $15.17 | $15.17 | |||||||
| E2603 | UE | $113.69 | $113.69 | $113.69 | $113.69 | $113.69 | $113.69 | $113.69 | $113.69 | $113.69 | $113.69 | $113.69 | $113.69 | |||||||
| E2604 | NU | $188.41 | $188.41 | $188.41 | $188.41 | $188.41 | $188.41 | $188.41 | $188.41 | $188.41 | $188.41 | $188.41 | $188.41 | |||||||
| E2604 | RR | $18.83 | $18.83 | $18.83 | $18.83 | $18.83 | $18.83 | $18.83 | $18.83 | $18.83 | $18.83 | $18.83 | $18.83 | |||||||
| E2604 | UE | $141.33 | $141.33 | $141.33 | $141.33 | $141.33 | $141.33 | $141.33 | $141.33 | $141.33 | $141.33 | $141.33 | $141.33 | |||||||
| E2605 | NU | $269.17 | $269.17 | $269.17 | $269.17 | $269.17 | $269.17 | $269.17 | $269.17 | $269.17 | $269.17 | $269.17 | $269.17 | |||||||
| E2605 | RR | $26.93 | $26.93 | $26.93 | $26.93 | $26.93 | $26.93 | $26.93 | $26.93 | $26.93 | $26.93 | $26.93 | $26.93 | |||||||
| E2605 | UE | $201.91 | $201.91 | $201.91 | $201.91 | $201.91 | $201.91 | $201.91 | $201.91 | $201.91 | $201.91 | $201.91 | $201.91 | |||||||
| E2606 | NU | $419.93 | $419.93 | $419.93 | $419.93 | $419.93 | $419.93 | $419.93 | $419.93 | $419.93 | $419.93 | $419.93 | $419.93 | |||||||
| E2606 | RR | $42.01 | $42.01 | $42.01 | $42.01 | $42.01 | $42.01 | $42.01 | $42.01 | $42.01 | $42.01 | $42.01 | $42.01 | |||||||
| E2606 | UE | $314.94 | $314.94 | $314.94 | $314.94 | $314.94 | $314.94 | $314.94 | $314.94 | $314.94 | $314.94 | $314.94 | $314.94 | |||||||
| E2607 | NU | $289.85 | $289.85 | $289.85 | $289.85 | $289.85 | $289.85 | $289.85 | $289.85 | $289.85 | $289.85 | $289.85 | $289.85 | |||||||
| E2607 | RR | $28.99 | $28.99 | $28.99 | $28.99 | $28.99 | $28.99 | $28.99 | $28.99 | $28.99 | $28.99 | $28.99 | $28.99 | |||||||
| E2607 | UE | $217.39 | $217.39 | $217.39 | $217.39 | $217.39 | $217.39 | $217.39 | $217.39 | $217.39 | $217.39 | $217.39 | $217.39 | |||||||
| E2608 | NU | $348.09 | $348.09 | $348.09 | $348.09 | $348.09 | $348.09 | $348.09 | $348.09 | $348.09 | $348.09 | $348.09 | $348.09 | |||||||
| E2608 | RR | $34.80 | $34.80 | $34.80 | $34.80 | $34.80 | $34.80 | $34.80 | $34.80 | $34.80 | $34.80 | $34.80 | $34.80 | |||||||
| E2608 | UE | $261.07 | $261.07 | $261.07 | $261.07 | $261.07 | $261.07 | $261.07 | $261.07 | $261.07 | $261.07 | $261.07 | $261.07 | |||||||
| K0606 | RR | KF | $2,268.20 | $2,268.20 | $2,268.20 | $2,268.20 | $2,268.20 | $2,268.20 | $2,268.20 | $2,268.20 | $2,268.20 | $2,268.20 | $2,268.20 | $2,268.20 | ||||||
| K0606 | RR | $2,452.06 | $2,452.06 | $2,452.06 | $2,452.06 | $2,452.06 | $2,452.06 | $2,452.06 | $2,452.06 | $2,452.06 | $2,452.06 | $2,452.06 | $2,452.06 | |||||||
| K0733 | NU | $30.21 | $30.21 | $30.21 | $30.21 | $30.21 | $30.21 | $30.21 | $30.21 | $30.21 | $30.21 | $30.21 | $30.21 | |||||||
| K0733 | RR | $3.04 | $3.04 | $3.04 | $3.04 | $3.04 | $3.04 | $3.04 | $3.04 | $3.04 | $3.04 | $3.04 | $3.04 | |||||||
| K0733 | UE | $22.67 | $22.67 | $22.67 | $22.67 | $22.67 | $22.67 | $22.67 | $22.67 | $22.67 | $22.67 | $22.67 | $22.67 | |||||||
| K0734 | NU | $331.47 | $331.47 | $331.47 | $331.47 | $331.47 | $331.47 | $331.47 | $331.47 | $331.47 | $331.47 | $331.47 | $331.47 | |||||||
| K0734 | RR | $33.15 | $33.15 | $33.15 | $33.15 | $33.15 | $33.15 | $33.15 | $33.15 | $33.15 | $33.15 | $33.15 | $33.15 | |||||||
| K0734 | UE | $248.60 | $248.60 | $248.60 | $248.60 | $248.60 | $248.60 | $248.60 | $248.60 | $248.60 | $248.60 | $248.60 | $248.60 | |||||||
| K0735 | NU | $421.78 | $421.78 | $421.78 | $421.78 | $421.78 | $421.78 | $421.78 | $421.78 | $421.78 | $421.78 | $421.78 | $421.78 | |||||||
| K0735 | RR | $42.19 | $42.19 | $42.19 | $42.19 | $42.19 | $42.19 | $42.19 | $42.19 | $42.19 | $42.19 | $42.19 | $42.19 | |||||||
| K0735 | UE | $316.33 | $316.33 | $316.33 | $316.33 | $316.33 | $316.33 | $316.33 | $316.33 | $316.33 | $316.33 | $316.33 | $316.33 | |||||||
| K0736 | NU | $334.19 | $334.19 | $334.19 | $334.19 | $334.19 | $334.19 | $334.19 | $334.19 | $334.19 | $334.19 | $334.19 | $334.19 | |||||||
| K0736 | RR | $33.42 | $33.42 | $33.42 | $33.42 | $33.42 | $33.42 | $33.42 | $33.42 | $33.42 | $33.42 | $33.42 | $33.42 | |||||||
| K0736 | UE | $250.66 | $250.66 | $250.66 | $250.66 | $250.66 | $250.66 | $250.66 | $250.66 | $250.66 | $250.66 | $250.66 | $250.66 | |||||||
| K0737 | NU | $423.06 | $423.06 | $423.06 | $423.06 | $423.06 | $423.06 | $423.06 | $423.06 | $423.06 | $423.06 | $423.06 | $423.06 | |||||||
| K0737 | RR | $42.30 | $42.30 | $42.30 | $42.30 | $42.30 | $42.30 | $42.30 | $42.30 | $42.30 | $42.30 | $42.30 | $42.30 | |||||||
| K0737 | UE | $317.29 | $317.29 | $317.29 | $317.29 | $317.29 | $317.29 | $317.29 | $317.29 | $317.29 | $317.29 | $317.29 | $317.29 | |||||||
| L2034 | $1,572.27 | $1,600.98 | $1,600.98 | $1,572.27 | $1,600.98 | $1,572.27 | $1,572.27 | $1,637.95 | $1,637.95 | $1,600.98 | $1,572.27 | $1,572.27 | ||||||||
| L2387 | $166.10 | $145.26 | $145.26 | $166.10 | $145.26 | $166.10 | $166.10 | $124.58 | $124.58 | $145.26 | $166.10 | $166.10 | ||||||||
| L3671 | $644.37 | $644.37 | $644.37 | $644.37 | $644.37 | $644.37 | $644.37 | $644.37 | $644.37 | $644.37 | $644.37 | $644.37 | ||||||||
| L3672 | $801.31 | $801.31 | $801.31 | $801.31 | $801.31 | $801.31 | $801.31 | $801.31 | $801.31 | $801.31 | $801.31 | $801.31 | ||||||||
| L3673 | $873.35 | $873.35 | $873.35 | $873.35 | $873.35 | $873.35 | $873.35 | $873.35 | $873.35 | $873.35 | $873.35 | $873.35 | ||||||||
| L3702 | $206.49 | $206.49 | $206.49 | $206.49 | $206.49 | $206.49 | $206.49 | $206.49 | $206.49 | $206.49 | $206.49 | $206.49 | ||||||||
| L3763 | $916.94 | $916.94 | $916.94 | $916.94 | $916.94 | $916.94 | $916.94 | $916.94 | $916.94 | $916.94 | $916.94 | $916.94 | ||||||||
| L3764 | $970.98 | $970.98 | $970.98 | $970.98 | $970.98 | $970.98 | $970.98 | $970.98 | $970.98 | $970.98 | $970.98 | $970.98 | ||||||||
| L3765 | $916.94 | $916.94 | $916.94 | $916.94 | $916.94 | $916.94 | $916.94 | $916.94 | $916.94 | $916.94 | $916.94 | $916.94 | ||||||||
| L3766 | $970.98 | $970.98 | $970.98 | $970.98 | $970.98 | $970.98 | $970.98 | $970.98 | $970.98 | $970.98 | $970.98 | $970.98 | ||||||||
| L3905 | $709.19 | $709.19 | $709.19 | $709.19 | $709.19 | $709.19 | $709.19 | $709.19 | $709.19 | $709.19 | $709.19 | $709.19 | ||||||||
| L3913 | $193.69 | $193.69 | $193.69 | $193.69 | $193.69 | $193.69 | $193.69 | $193.69 | $193.69 | $193.69 | $193.69 | $193.69 | ||||||||
| L3919 | $193.69 | $193.69 | $193.69 | $193.69 | $193.69 | $193.69 | $193.69 | $193.69 | $193.69 | $193.69 | $193.69 | $193.69 | ||||||||
| L3921 | $229.71 | $229.71 | $229.71 | $229.71 | $229.71 | $229.71 | $229.71 | $229.71 | $229.71 | $229.71 | $229.71 | $229.71 | ||||||||
| L3933 | $152.58 | $152.58 | $152.58 | $152.58 | $152.58 | $152.58 | $152.58 | $152.58 | $152.58 | $152.58 | $152.58 | $152.58 | ||||||||
| L3935 | $157.98 | $157.98 | $157.98 | $157.98 | $157.98 | $157.98 | $157.98 | $157.98 | $157.98 | $157.98 | $157.98 | $157.98 | ||||||||
| L3961 | $1,201.47 | $1,201.47 | $1,201.47 | $1,201.47 | $1,201.47 | $1,201.47 | $1,201.47 | $1,201.47 | $1,201.47 | $1,201.47 | $1,201.47 | $1,201.47 | ||||||||
| L3967 | $1,418.53 | $1,418.53 | $1,418.53 | $1,418.53 | $1,418.53 | $1,418.53 | $1,418.53 | $1,418.53 | $1,418.53 | $1,418.53 | $1,418.53 | $1,418.53 | ||||||||
| L3971 | $1,346.51 | $1,346.51 | $1,346.51 | $1,346.51 | $1,346.51 | $1,346.51 | $1,346.51 | $1,346.51 | $1,346.51 | $1,346.51 | $1,346.51 | $1,346.51 | ||||||||
| L3973 | $1,418.53 | $1,418.53 | $1,418.53 | $1,418.53 | $1,418.53 | $1,418.53 | $1,418.53 | $1,418.53 | $1,418.53 | $1,418.53 | $1,418.53 | $1,418.53 | ||||||||
| L3975 | $1,201.47 | $1,201.47 | $1,201.47 | $1,201.47 | $1,201.47 | $1,201.47 | $1,201.47 | $1,201.47 | $1,201.47 | $1,201.47 | $1,201.47 | $1,201.47 | ||||||||
| L3976 | $1,201.47 | $1,201.47 | $1,201.47 | $1,201.47 | $1,201.47 | $1,201.47 | $1,201.47 | $1,201.47 | $1,201.47 | $1,201.47 | $1,201.47 | $1,201.47 | ||||||||
| L3977 | $1,346.51 | $1,346.51 | $1,346.51 | $1,346.51 | $1,346.51 | $1,346.51 | $1,346.51 | $1,346.51 | $1,346.51 | $1,346.51 | $1,346.51 | $1,346.51 | ||||||||
| L3978 | $1,418.53 | $1,418.53 | $1,418.53 | $1,418.53 | $1,418.53 | $1,418.53 | $1,418.53 | $1,418.53 | $1,418.53 | $1,418.53 | $1,418.53 | $1,418.53 | ||||||||
| L5703 | $1,896.03 | $1,677.61 | $1,677.61 | $1,896.03 | $1,677.61 | $1,896.03 | $1,896.03 | $1,865.45 | $1,865.45 | $1,677.61 | $1,896.03 | $1,896.03 | ||||||||
| L5971 | $217.17 | $176.06 | $176.06 | $217.17 | $176.06 | $217.17 | $217.17 | $162.88 | $162.88 | $176.06 | $217.17 | $217.17 | ||||||||
| L6621 | $1,800.78 | $1,800.78 | $1,800.78 | $1,800.78 | $1,800.78 | $1,800.78 | $1,800.78 | $1,800.78 | $1,800.78 | $1,800.78 | $1,800.78 | $1,800.78 | ||||||||
| L6677 | $233.54 | $233.54 | $233.54 | $233.54 | $233.54 | $233.54 | $233.54 | $233.54 | $233.54 | $233.54 | $233.54 | $233.54 | ||||||||
| L6694 | $632.69 | $563.43 | $563.43 | $632.69 | $563.43 | $632.69 | $632.69 | $535.88 | $535.88 | $563.43 | $632.69 | $632.69 | ||||||||
| L6695 | $527.21 | $469.51 | $469.51 | $527.21 | $469.51 | $527.21 | $527.21 | $446.56 | $446.56 | $469.51 | $527.21 | $527.21 | ||||||||
| L6696 | $1,035.59 | $1,035.59 | $1,035.59 | $1,035.59 | $1,035.59 | $1,035.59 | $1,035.59 | $1,035.59 | $1,035.59 | $1,035.59 | $1,035.59 | $1,035.59 | ||||||||
| L6697 | $1,035.59 | $1,035.59 | $1,035.59 | $1,035.59 | $1,035.59 | $1,035.59 | $1,035.59 | $1,035.59 | $1,035.59 | $1,035.59 | $1,035.59 | $1,035.59 | ||||||||
| L6698 | $398.91 | $398.91 | $398.91 | $398.91 | $398.91 | $398.91 | $398.91 | $398.91 | $398.91 | $398.91 | $398.91 | $398.91 | ||||||||
| L6883 | $1,272.63 | $1,272.63 | $1,272.63 | $1,272.63 | $1,272.63 | $1,272.63 | $1,272.63 | $1,696.84 | $1,696.84 | $1,272.63 | $1,272.63 | $1,272.63 | ||||||||
| L6884 | $1,805.87 | $1,790.40 | $1,790.40 | $1,805.87 | $1,790.40 | $1,805.87 | $1,805.87 | $1,866.03 | $1,866.03 | $1,790.40 | $1,805.87 | $1,805.87 | ||||||||
| L6885 | $2,554.41 | $2,578.78 | $2,578.78 | $2,554.41 | $2,578.78 | $2,554.41 | $2,554.41 | $2,554.41 | $2,554.41 | $2,578.78 | $2,554.41 | $2,554.41 | ||||||||
| L7400 | $241.29 | $241.29 | $241.29 | $241.29 | $241.29 | $241.29 | $241.29 | $241.29 | $241.29 | $241.29 | $241.29 | $241.29 | ||||||||
| L7401 | $270.12 | $270.12 | $270.12 | $270.12 | $270.12 | $270.12 | $270.12 | $270.12 | $270.12 | $270.12 | $270.12 | $270.12 | ||||||||
| L7402 | $291.72 | $291.72 | $291.72 | $291.72 | $291.72 | $291.72 | $291.72 | $291.72 | $291.72 | $291.72 | $291.72 | $291.72 | ||||||||
| L7403 | $289.93 | $289.93 | $289.93 | $289.93 | $289.93 | $289.93 | $289.93 | $289.93 | $289.93 | $289.93 | $289.93 | $289.93 | ||||||||
| L7404 | $437.58 | $437.58 | $437.58 | $437.58 | $437.58 | $437.58 | $437.58 | $437.58 | $437.58 | $437.58 | $437.58 | $437.58 | ||||||||
| L7405 | $572.30 | $572.30 | $572.30 | $572.30 | $572.30 | $572.30 | $572.30 | $572.30 | $572.30 | $572.30 | $572.30 | $572.30 | ||||||||