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Reimbursement Rate Changes for Some Procedure
Codes to Be Effective November 1, 2015, and January 1,
2016, for Texas Medicaid
Information posted December 30, 2015
Note: This article applies only to claims submitted to TMHP for processing. Refer to the
Medicaid managed care organizations (MCOs) for information about MCO benefits,
limitations, prior authorization, reimbursement, and MCO specific claim processing
procedures.
Effective for dates of services on or after November 1, 2015, and January 1, 2016,
reimbursement rate changes and updates for some procedure codes were presented at
a public rate hearing on November 12, 2015.
The following topics were covered at the rate hearing:
Effective for dates of service on November 1, 2015 through December 31, 2015
Medical Policy Review:
o
Pathology and Laboratory Services – Drug Testing and Therapeutic Drug Assays
G0434
Note: Procedure code G0434 became a benefit of Texas Medicaid for dates of
service from November 1, 2015 through December 31, 2015 and will be
discontinued on January 1, 2016 due to 2016 Healthcare Common Procedure
Coding System (HCPCS) implementation.
Effective for dates of service November 1, 2015
Special Review:
o
Clinical Diagnostic Laboratory Services - Oncotype DX
Effective for dates of service on or after January 1, 2016
1. Calendar Fee Review topics:
o
Access to Care
o
“B" Codes (Enteral supplies)
o
Family Planning Other than LARCs
o
Hospital Outpatient Imaging (Q0035)
o
Long Acting Reversible Contraceptives (LARCs)
o
Musculoskeletal System Surgery
o
“Q” Codes (Physician, DME, and Physician-administered drug codes)
o
“R” Codes (Transportation of portable x-ray equipment to home or nursing home,
per trip)
o
Radiopharmaceuticals
o
Respiratory System Surgery
o
“T” Codes (Registered nurse services, sign language or oral interpretive services,
screening for specified programs, and environmental lead investigation)
2. Medical Policy Review:
o
Diagnostic and Therapeutic Breast Procedures
o
Pathology and Laboratory Services – Microbiology
o
Magnetoencephalography
o
Vision Nonsurgical Services
Providers may refer to the HHSC rate analysis web page at:
www.hhsc.state.tx.us/rad/rate-packets.shtml
Note: Most of the changes to Medicaid rates in the topics, Family Planning and LARCs,
will also be made to rates in Healthy Texas Women services. Providers can refer to the
Online Fee Schedule (OFL) for procedure codes that may be reimbursed as Expanded
Primary Health Care and DSHS Family Planning Program services.
For more information, call the TMHP Contact Center at 1-800-925-9126.
CLINICAL DIAGNOSTIC LABORATORY SERVICES (G0434)
TOS *
Procedure
Code
Age
Range
5
G0434
0-999
Typed of Service: 5 = Laboratory
Clinical
Laboratory
Current Fee
Clinical
Laboratory
Medicaid Fee
Effective
11/1/2015
Not a Benefit
$12.71
Sole
Community
Current Fee
Sole Community
Medicaid Fee
Effective
11/1/2015
DSHS Lab
Current Fee
DSHS Lab
Medicaid
Fee
Effective
11/1//2015
Not a Benefit
$13.13
Not a Benefit
$15.13
Clinical Diagnostic Laboratory Services Oncotype DX
100% of Texas Fee for Non-DSHS
Typed of
Medicare Fee Labs 100% of CMS
Service Procedure
effective
(60%) to Load in
(TOS)*
Code
11/1/2015
Phoenix
5
81519
$2,619.05
*Typed of Service (TOS): 5 = Laboratory
$2,619.05
Fee for Sole
Community Labs
103.3% of CMS
(62%)
$2,706.35
Reduction @ 84%
Reduction @ 86.8%
of Texas Medicaid Texas Medicaid Fee (Sole
Fee Effective
Community) Effective
11/1/2015
11/1/15
$2,200.00
$2,273.33
Access to Care
TOS*
Procedure
Code
2
2
2
2
2
2
2
2
2
2
4
I
T
4
I
T
67005
67010
67311
67312
67314
67316
67318
67320
67331
67332
93303
93303
93303
93307
93307
93307
J
E0635
J
J
L
J
J
J
J
J
J
J
J
E0635
E0990
E0990
E1002
E1003
E1004
E1006
E1007
E1008
E1010
E1014
J
L
J
L
J
L
J
L
J
J
J
J
J
L
J
L
J
Modifier
Age
Range
NonCurrent
Facility
(N)/Facili Medicaid
RVU
ty (F)
Current
Medicaid
Conversion
Factor
Current
Medicaid
Fee
Current
Percent
Reduction
$680.58
$669.39
$666.02
$715.09
$731.77
$802.04
$672.51
$319.66
$316.41
$343.47
$174.30
$54.90
$119.40
$100.80
$39.00
$61.80
Manually
Priced
Manually
Priced
0%
0%
0%
2%
0%
2%
2%
2%
2%
2%
0%
0%
0%
0%
0%
0%
Current
Adjusted
Medicaid
Fee
0-20
0-20
0-20
0-20
0-20
0-999
0-999
0-999
0-999
0-999
0-20
0-20
0-20
0-20
0-20
0-20
F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
F
N/F
F
F
N/F
F
TG
0-20
N
TG
21-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
N
N
N
N
N
N
N
N
N
N
N
$130.44
$13.04
$3,661.00
$4,282.40
$4,748.30
$6,295.60
$7,861.02
$7,881.83
$1,595.33
$319.87
8%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$680.58
$669.39
$666.02
$700.79
$731.77
$786.00
$659.06
$313.27
$310.08
$336.60
$174.30
$54.90
$119.40
$100.80
$39.00
$61.80
Manually
Priced
Manually
Priced
$130.44
$13.04
$3,661.00
$4,282.40
$4,748.30
$6,295.60
$7,861.02
$7,881.83
$1,595.33
$319.87
E1231
0-999
N
$2,968.35
0%
$2,968.35
E1231
E1232
E1232
E1233
E1233
E1234
E1234
E1235
E1236
E2205
E2206
E2207
E2207
E2209
E2209
E2210
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
$296.83
$2,189.65
$218.96
$2,268.82
$226.88
$1,975.17
$197.53
$2,825.15
$3,103.09
$33.45
$41.65
$42.25
$4.23
$104.51
$10.47
$6.39
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$296.83
$2,189.65
$218.96
$2,268.82
$226.88
$1,975.17
$197.53
$2,825.15
$3,103.09
$33.45
$41.65
$42.25
$4.23
$104.51
$10.47
$6.39
5.81
1.83
3.98
3.36
1.30
2.06
$30.0000
$30.0000
$30.0000
$30.0000
$30.0000
$30.0000
8%
Adjusted
Medicaid Percent
Reduction Medicaid Fee
Fee
Effective
Effective Effective
1/1/2016
1/1/2016
1/1/2016
$680.58
$669.39
$666.02
$715.09
$731.77
$802.04
$672.51
$319.66
$316.41
$343.47
$100.80
$39.00
$61.80
$100.80
$39.00
$61.80
Manually
Priced
Manually
Priced
$124.59
$12.46
$3,661.00
$4,282.40
$4,748.30
$6,295.60
$7,861.02
$7,881.83
$1,595.33
$319.87
Manually
Priced
Manually
Priced
$2,189.65
$218.97
$2,268.82
$226.88
$1,975.17
$197.52
$2,680.34
$2,364.57
$33.45
$41.65
$42.25
$4.23
$104.51
$10.45
$6.39
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
$680.58
$669.39
$666.02
$715.09
$731.77
$802.04
$672.51
$319.66
$316.41
$343.47
$174.30
$54.90
$119.40
$100.80
$39.00
$61.80
0.00%
Manually Priced
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
Manually Priced
0.00%
Manually Priced
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
Manually Priced
$124.59
$12.46
$3,661.00
$4,282.40
$4,748.30
$6,295.60
$7,861.02
$7,881.83
$1,595.33
$319.87
$2,189.65
$218.97
$2,268.82
$226.88
$1,975.17
$197.52
$2,680.34
$2,364.57
$33.45
$41.65
$42.25
$4.23
$104.51
$10.45
$6.39
Access to Care
Current
Medicaid
Conversion
Factor
Current
Medicaid
Fee
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
TOS*
Procedure
Code
J
E2216
0-999
N
$28.51
0%
$28.51
J
J
J
J
J
J
E2217
E2227
E2228
E2310
E2311
E2371
0-999
0-999
0-999
0-999
0-999
0-999
N
N
N
N
N
N
0%
0%
0%
0%
0%
0%
J
9
9
9
J
9
E2619
L8680
L8686
L8614
L8614
V2623
0-999
0-999
0-999
0-999
0-999
0-999
N
N/F
N/F
F
N
N/F
$32.07
$1,530.22
$913.04
$1,141.22
$2,136.07
$181.39
Manually
Priced
$32.07
$1,530.22
$913.04
$1,141.22
$2,136.07
$181.39
Manually
Priced
$4,646.94
$15,756.30
$23,380.00
$23,380.00
$888.60
Modifier
TG
TG
Age
Range
NonCurrent
Facility
(N)/Facili Medicaid
RVU
ty (F)
$4,646.94
$15,756.30
$23,380.00
$23,380.00
$888.60
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid Percent
Reduction Medicaid Fee
Fee
Effective
Effective Effective
1/1/2016
1/1/2016
1/1/2016
Manually
Priced
Manually
Priced
$1,530.22
$913.04
$1,141.22
$2,136.07
$167.31
Manually
Priced
$4,646.94
$15,756.30
$23,380.00
$23,380.00
$1,141.18
0.00%
Manually Priced
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
Manually Priced
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
Manually Priced
$1,530.22
$913.04
$1,141.22
$2,136.07
$167.31
$4,646.94
$15,756.30
$23,380.00
$23,380.00
$1,141.18
*Type of Service (TOS): 2 = Surgery, 4 = Radiology, 9 = Other Medical Items or Services, I = Professional Component, J = DME Purchase - New, L = DME Rental - Monthly,
T = Technical Component
**Modifier: TG = Complex / high tech level of care
Enteral Supplies ("B" codes)
TOS*
Procedure Modifier*
Code
*
NonFacility
Current
Age
(N)/
Medicaid
Range Facility (F)
Fee
9
9
9
9
9
9
9
9
9
9
B4034
B4035
B4036
B4081
B4082
B4083
B4087
B4088
B4100
B4103
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
N
N
N
N
N
N
N
N
N
N
9
9
9
9
9
9
9
9
9
9
9
9
9
9
9
9
9
B4104
B4149
B4150
B4152
B4153
B4154
B4155
B4157
B4158
B4159
B4160
B4161
B4162
B4164
B4168
B4172
B4176
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
$6.11
$11.65
$8.00
$21.61
$16.07
$2.47
$35.67
$35.67
$0.65
$2.94
Manually
Reviewed
$1.57
$1.11
$0.98
$4.45
$2.93
$5.62
$6.26
$1.18
$1.15
$1.11
$2.93
$8.82
$19.10
$27.85
$28.06
$53.89
Current Medicaid
Current
Adjusted
Fee
Percent Medicaid Effective
Reduction
Fee
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$6.11
$11.65
$8.00
$21.61
$16.07
$2.47
$35.67
$35.67
$0.65
$2.94
Manually
Reviewed
$1.57
$1.11
$0.98
$4.45
$2.93
$5.62
$6.26
$1.18
$1.15
$1.11
$2.93
$8.82
$19.10
$27.85
$28.06
$53.89
$6.11
$11.65
$8.00
$21.61
$16.07
$2.47
$35.67
$35.67
$0.72
$3.23
Manually
Reviewed
$1.57
$1.05
$0.93
$4.23
$2.78
$6.18
$5.95
$1.30
$1.27
$1.11
$2.93
$8.82
$19.10
$27.85
$28.06
$53.89
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid Fee
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$6.11
$11.65
$8.00
$21.61
$16.07
$2.47
$35.67
$35.67
$0.72
$3.23
Manually
Reviewed
$1.57
$1.05
$0.93
$4.23
$2.78
$6.18
$5.95
$1.30
$1.27
$1.11
$2.93
$8.82
$19.10
$27.85
$28.06
$53.89
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Enteral Supplies ("B" codes)
TOS*
Procedure Modifier*
Code
*
NonFacility
Current
Age
(N)/
Medicaid
Range Facility (F)
Fee
9
9
9
9
9
9
9
9
9
9
9
9
9
9
J
L
J
L
J
L
J
L
B4178
B4180
B4185
B4189
B4193
B4197
B4199
B4216
B4220
B4222
B4224
B5000
B5100
B5200
B9000
B9000
B9002
B9002
B9004
B9004
B9006
B9006
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
F
N
F
N
F
N
F
9
9
9
9
9
B9998
B9998
B9998
B9998
B9998
0-999
0-999
0-999
0-999
0-999
N
N
N
N
N
U1
U2
U3
U4
$64.69
$27.42
$12.63
$199.85
$258.24
$314.40
$359.25
$8.68
$9.00
$11.10
$28.11
$13.37
$5.22
$2.76
$1,225.78
$112.63
$1,225.78
$118.71
$2,836.83
$449.08
$2,836.83
$449.08
Manually
Reviewed
$7.04
$138.00
$23.00
$32.20
Current Medicaid
Current
Adjusted
Fee
Percent Medicaid Effective
Reduction
Fee
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$64.69
$27.42
$12.63
$199.85
$258.24
$314.40
$359.25
$8.68
$9.00
$11.10
$28.11
$13.37
$5.22
$2.76
$1,225.78
$112.63
$1,225.78
$118.71
$2,836.83
$449.08
$2,836.83
$449.08
Manually
Reviewed
$7.04
$138.00
$23.00
$32.20
$64.69
$27.42
$12.63
$199.85
$258.24
$314.40
$359.25
$8.68
$9.00
$11.10
$28.11
$13.37
$5.22
$3.04
$1,225.78
$122.58
$1,225.78
$122.58
$2,836.83
$449.08
$2,836.83
$449.08
Manually
Reviewed
$6.34
$138.00
$20.70
$28.98
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid Fee
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$64.69
$27.42
$12.63
$199.85
$258.24
$314.40
$359.25
$8.68
$9.00
$11.10
$28.11
$13.37
$5.22
$3.04
$1,225.78
$122.58
$1,225.78
$122.58
$2,836.83
$449.08
$2,836.83
$449.08
Manually
Reviewed
$6.34
$138.00
$20.70
$28.98
0%
0%
0%
0%
0%
Enteral Supplies ("B" codes)
TOS*
Procedure Modifier*
Code
*
9
B9998
9
B9999
U5
NonFacility
Current
Age
(N)/
Medicaid
Range Facility (F)
Fee
0-999
N
0-999
N
$2.76
Manually
Reviewed
Current Medicaid
Current
Adjusted
Fee
Percent Medicaid Effective
Reduction
Fee
1/1/2016
0%
$2.76
Manually
Reviewed
$2.76
Manually
Reviewed
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid Fee
Effective
1/1/2016
0%
$2.76
Manually
Reviewed
*Type of Service (TOS): 9 = Other Medical Items or Services, J = Other Medical Items or Services, L = DME - Rental
**Modifier: U1 =Disposable g. tube adapter set, each - 4 per month, U2 =Mic - key g tube - 2 per rolling year, U3 = Mic - key
extension set - 4 per month, U4 = mic / flexiflow gastrostomy tube, U5 = Mic extension set - 4 per month
Family Planning Excluding LARCS
TOS*
7
7
2
2
2
2
Procedure
Code
Modifier
00851
00851
11981
11981
11981
11981
Age
Range
21-999
21-999
0-20
21-999
0-20
21-999
2
11981
0-20
2
11981
21-999
2
11981
0-20
2
2
2
11981
11982
11982
21-999
0-20
21-999
2
11982
0-20
2
11982
21-999
2
11982
0-20
2
2
2
11982
11983
11983
21-999
0-20
21-999
2
11983
0-20
2
11983
21-999
2
11983
0-20
2
2
2
11983
36410
36410
21-999
0-20
21-999
2
36410
3-20
2
2
36410
36410
21-999
0-20
NonProvider Type
Facility (PT) /Provider
(N)/Facilit
Specialty
Current
y (F)
(PS)**
Medicaid RVU
3,4,5,19,20,21,
22
N/F
6.00
71
F
6.00
71
N
3.87
71
N
3.87
71
F
2.33
71
F
2.33
3,10,19,20,21,2
2,33
3.87
N
3,10,19,20,21,2
2,33
N
3.87
3,10,19,20,21,2
2,33
2.33
F
3,10,19,20,21,2
2,33
F
2.33
71
N
4.38
71
N
4.38
3,10,19,20,21,2
2,33
4.38
N
3,10,19,20,21,2
2,33
N
4.38
3,10,19,20,21,2
2,33
F
2.79
3,10,19,20,21,2
2,33
F
2.79
71
N
6.10
71
N
6.10
3,10,19,20,21,2
2,33
N
6.10
3,10,19,20,21,2
2,33
N
6.10
3,10,19,20,21,2
2,33
F
4.85
3,10,19,20,21,2
2,33
F
4.85
71
N
0.48
71
N
0.48
N
N
F
2
2
2
2
2
36410
57170
57170
57170
57170
21-999
0-20
0-20
21-55
21-55
F
N
F
N
F
2
57170
0-20
N
2
57170
0-20
F
2
57170
21-999
N
2
2
2
57170
58340
58340
21-999
0-20
21-999
F
N
N
2
58340
0-20
N
2
58340
0-20
F
2
58340
21-999
N
2
2
2
58340
58555
58555
21-999
0-20
21-999
F
N
N
2
58555
0-20
N
2
58555
0-20
F
10,19,20,21,22
3,10,19,20,21,2
2
3,10,19,20,21,2
2
3,10,19,20,21,2
2
71
71
71
71
3,10,19,20,21,2
2,33,46
3,10,19,20,21,2
2,33,46
3,10,19,20,21,2
2,33,46
3,10,19,20,21,2
2,33,46
71
71
3,10,19,20,21,2
2
3,10,19,20,21,2
2
3,10,19,20,21,2
2
3,10,19,20,21,2
2
71
71
3,10,19,20,21,2
2,33
3,10,19,20,21,2
2,33
0.48
0.48
0.28
Current
Medicaid
Conversion
Factor
Current
Medicaid
Fee
Current
Percent
Reduction
Current
Adjusted
Medicaid Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
$19.5800
$19.5800
$28.0672
$26.7305
$28.0672
$26.7305
$117.48
$117.48
$108.62
$103.45
$65.40
$62.28
2%
7%
5%
5%
5%
5%
$115.13
$109.26
$103.19
$98.28
$62.13
$59.17
6.00
6.00
4.01
4.01
2.39
2.39
$19.5800
$19.5800
$28.0672
$26.7305
$28.0672
$26.7305
$117.48
$117.48
$112.55
$107.19
$67.08
$63.89
2.00%
2.00%
0.00%
0.00%
0.00%
0.00%
$115.13
$115.13
$112.55
$107.19
$67.08
$63.89
$28.0672
$108.62
0%
$108.62
4.01
$28.0672
$112.55
0.00%
$112.55
$26.7305
$103.45
0%
$103.45
4.01
$26.7305
$107.19
0.00%
$107.19
$28.0672
$65.40
0%
$65.40
2.39
$28.0672
$67.08
0.00%
$67.08
$26.7305
$28.0672
$26.7305
$62.28
$122.93
$117.08
0%
5%
5%
$62.28
$116.78
$111.23
2.39
4.54
4.54
$26.7305
$28.0672
$26.7305
$63.89
$127.43
$121.36
0.00%
0.00%
0.00%
$63.89
$127.43
$121.36
$28.0672
$122.93
0%
$122.93
4.54
$28.0672
$127.43
0.00%
$127.43
$26.7305
$117.08
0%
$117.08
4.54
$26.7305
$121.36
0.00%
$121.36
$28.0672
$78.31
0%
$78.31
2.89
$28.0672
$81.11
0.00%
$81.11
$26.7305
$28.0672
$26.7305
$74.58
$171.21
$163.06
0%
5%
5%
$74.58
$162.65
$154.91
2.89
6.32
6.32
$26.7305
$28.0672
$26.7305
$77.25
$177.38
$168.94
0.00%
0.00%
0.00%
$77.25
$177.38
$168.94
$28.0672
$171.21
0%
$171.21
6.32
$28.0672
$177.38
0.00%
$177.38
$26.7305
$163.06
0%
$163.06
6.32
$26.7305
$168.94
0.00%
$168.94
$28.0672
$136.13
0%
$136.13
5.00
$28.0672
$140.34
0.00%
$140.34
$26.7305
$28.0672
$26.7305
$129.64
$13.47
$12.83
0%
5%
5%
$129.64
$12.80
$12.19
5.00
0.48
0.48
$26.7305
$28.0672
$26.7305
$133.65
$13.47
$12.83
0.00%
0.00%
0.00%
$133.65
$13.47
$12.83
$28.0672
$13.47
0%
$13.47
0.48
$26.7305
$12.83
0.00%
$12.83
$12.83
0%
$12.83
0.48
$26.7305
$12.83
0.00%
$12.83
$7.86
0%
$7.86
0.27
$28.0672
$7.58
0.00%
$7.58
$7.48
$46.40
$37.33
$44.18
$35.55
0.27
1.72
1.38
1.72
1.38
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$7.22
$48.28
$38.73
$45.98
$36.89
0.00%
0.00%
0.00%
0.00%
0.00%
$7.22
$48.28
$38.73
$45.98
$36.89
$48.28
0.00%
$48.28
$38.73
$26.7305
$28.0672
Percent
Adjusted
Medicaid Fee Reduction Medicaid Fee
Effective
Effective
Effective
1/1/2016
1/1/2016
1/1/2016
0.28
1.74
1.40
1.74
1.40
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$7.48
$48.84
$39.29
$46.51
$37.42
0%
5%
5%
5%
5%
1.74
$28.0672
$48.84
0%
$48.84
1.72
$28.0672
$39.29
0%
$39.29
1.38
$28.0672
$38.73
0.00%
$46.51
1.72
$26.7305
$45.98
0.00%
$45.98
1.40
$28.0672
1.74
$26.7305
$46.51
0%
1.40
3.32
3.32
$26.7305
$28.0672
$26.7305
$37.42
$93.18
$88.75
0%
5%
5%
$37.42
$88.52
$84.31
1.38
3.36
3.36
$26.7305
$28.0672
$26.7305
$36.89
$94.31
$89.81
0.00%
0.00%
0.00%
$36.89
$94.31
$89.81
3.32
$28.0672
$93.18
0%
$93.18
3.36
$28.0672
$94.31
0.00%
$94.31
1.66
$28.0672
$46.59
0%
$46.59
1.66
$28.0672
$46.59
0.00%
$46.59
3.32
$26.7305
$88.75
0%
$88.75
3.36
$26.7305
$89.81
0.00%
$89.81
1.66
8.63
8.63
$26.7305
$28.0672
$26.7305
$44.37
$242.22
$230.68
0%
5%
5%
$44.37
$230.11
$219.15
1.66
8.59
8.59
$26.7305
$28.0672
$26.7305
$44.37
$241.10
$229.61
0.00%
0.00%
0.00%
$44.37
$241.10
$229.61
8.63
$28.0672
$242.22
0%
$242.22
8.59
$28.0672
$241.10
0.00%
$241.10
5.53
$28.0672
$155.21
0%
$155.21
5.41
$28.0672
$151.84
0.00%
$151.84
Family Planning Excluding LARCS
TOS*
Procedure
Code
Modifier
Age
Range
2
58555
21-999
2
2
2
8
2
2
2
2
2
2
8
2
2
8
8
2
2
58555
58661
58661
58661
58670
58670
58671
58671
58700
58700
58700
58720
58720
58720
58720
64435
64435
21-999
0-20
21-999
21-999
21-999
21-999
21-999
21-999
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
2
64435
0-20
2
64435
0-20
2
64435
21-999
2
4
4
64435
74000
74000
21-999
0-20
21-999
4
74000
0-20
4
74000
21-999
I
I
74000
74000
0-20
21-999
T
74000
0-20
T
4
4
74000
74010
74010
21-999
0-20
21-999
4
74010
0-20
4
74010
21-999
I
74010
0-20
I
74010
21-999
T
74010
0-20
T
4
4
74010
74740
74740
21-999
0-20
21-999
4
74740
0-20
4
I
I
I
I
T
T
74740
74740
74740
74740
74740
74740
74740
21-999
0-20
21-999
0-20
21-999
0-20
21-999
T
74740
0-20
T
74740
21-999
NonProvider Type
Facility (PT) /Provider
(N)/Facilit
Specialty
Current
y (F)
(PS)**
Medicaid RVU
3,10,19,20,21,2
2,33
N
8.63
3,10,19,20,21,2
2,33
F
5.53
3,19,20,21,22
F
18.71
3,19,20,21,22
F
18.71
3,19,20,21,22
F
2.99
71
F
10.58
3,19,20,21,22
F
10.58
71
F
10.59
3,19,20,21,22
F
10.59
3,19,20,21,22
F
22.45
3,19,20,21,22
F
22.45
3,19,20,21,22
F
3.59
3,19,20,21,22
F
21.04
3,19,20,21,22
F
21.04
3,19,20,21,22
F
3.37
3,19,20,21,22
F
3.37
N
71
3.85
N
71
3.85
3,4,5,19,20,21,
22
N
3.85
3,4,5,19,20,21,
22
F
2.44
3,4,5,19,20,21,
22
N
3.85
3,4,5,19,20,21,
22
F
2.44
71
N/F
0.70
71
N/F
0.70
3,10,19,20,21,2
2,43,75
0.70
N/F
3,10,19,20,21,2
2,43,75
N/F
0.70
3,10,19,20,21,2
2
N/F
0.26
3,10,19,20,21,2
2
N/F
0.26
3,10,19,20,21,2
2,43,75
0.44
N/F
3,10,19,20,21,2
2,43,75
N/F
0.44
N
71
1.11
N
71
1.11
3,10,19,20,21,2
2,43,75
N/F
1.11
3,10,19,20,21,2
2,43,75
N/F
1.11
3,10,19,20,21,2
2
N/F
0.33
3,10,19,20,21,2
2
0.33
N/F
3,10,19,20,21,2
N/F
2,43,75
0.78
3,10,19,20,21,2
N/F
2,43,75
0.78
N
71
2.20
N
71
2.20
3,19,20,21,22,7
N/F
5
2.20
3,19,20,21,22,7
N/F
5
2.20
N
71
1.67
N
71
1.67
3,19,20,21,22
N/F
0.53
3,19,20,21,22
N/F
0.53
71
N
1.67
71
N
1.67
3,19,20,21,22,7
5
1.67
N/F
3,19,20,21,22,7
5
N/F
1.67
Current
Medicaid
Conversion
Factor
Current
Medicaid
Fee
Current
Percent
Reduction
Current
Adjusted
Medicaid Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
$26.7305
$230.68
0%
$230.68
8.59
$26.7305
$229.61
0.00%
$229.61
$26.7305
$28.0672
$26.7305
$26.7305
$26.7305
$26.7305
$26.7305
$26.7305
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$147.82
$525.14
$500.13
$79.92
$282.81
$282.81
$283.08
$283.08
$630.11
$600.10
$95.96
$590.53
$562.41
$94.59
$90.08
$108.06
$102.91
0%
0%
0%
0%
0%
0%
5%
0%
0%
0%
0%
0%
0%
0%
0%
5%
5%
$147.82
$525.14
$500.13
$79.92
$282.81
$282.81
$268.93
$283.08
$630.11
$600.10
$95.96
$590.53
$562.41
$94.59
$90.08
$102.66
$97.76
5.41
18.50
18.50
$26.7305
$28.0672
$26.7305
10.35
10.35
10.33
10.33
22.31
22.31
$26.7305
$26.7305
$26.7305
$26.7305
$28.0672
$26.7305
21.00
21.00
$28.0672
$26.7305
3.85
3.85
$28.0672
$26.7305
$144.61
$519.24
$494.51
$79.12
$276.66
$276.66
$276.13
$276.13
$626.18
$596.36
$95.42
$589.41
$561.34
$94.31
$89.81
$108.06
$102.91
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
$144.61
$519.24
$494.51
$79.12
$276.66
$276.66
$276.13
$276.13
$626.18
$596.36
$95.42
$589.41
$561.34
$94.31
$89.81
$108.06
$102.91
$108.06
Percent
Adjusted
Medicaid Fee Reduction Medicaid Fee
Effective
Effective
Effective
1/1/2016
1/1/2016
1/1/2016
$28.0672
$108.06
0%
$108.06
3.85
$28.0672
$108.06
0.00%
$28.0672
$68.48
0%
$68.48
2.40
$28.0672
$67.36
0.00%
$67.36
$26.7305
$102.91
0%
$102.91
3.85
$26.7305
$102.91
0.00%
$102.91
$26.7305
$28.0672
$26.7305
$65.22
$19.65
$18.71
0%
5%
5%
$65.22
$18.67
$17.77
2.40
0.66
0.66
$26.7305
$28.0672
$26.7305
$64.15
$18.52
$17.64
0.00%
0.00%
0.00%
$64.15
$18.52
$17.64
$28.0672
$19.65
0%
$19.65
0.66
$28.0672
$18.52
0.00%
$18.52
$26.7305
$18.71
0%
$18.71
0.66
$26.7305
$17.64
0.00%
$17.64
$7.30
0%
$7.30
0.26
$28.0672
$7.30
0.00%
$7.30
$7.30
0%
$7.30
0.26
$26.7305
$6.95
0.00%
$6.95
$28.0672
$12.35
0%
$12.35
0.40
$28.0672
$11.23
0.00%
$11.23
$26.7305
$28.0672
$26.7305
$11.76
$31.15
$29.67
0%
5%
5%
$11.76
$29.59
$28.19
0.40
0.98
0.98
$26.7305
$28.0672
$26.7305
$10.69
$27.51
$26.20
0.00%
0.00%
0.00%
$10.69
$27.51
$26.20
$28.0672
$31.15
0%
$31.15
0.98
$28.0672
$27.51
0.00%
$27.51
$26.7305
$29.67
0%
$29.67
0.98
$26.7305
$26.20
0.00%
$26.20
$28.0672
$9.26
0%
$9.26
0.33
$28.0672
$9.26
0.00%
$9.26
$26.7305
$8.82
0%
$8.82
0.33
$26.7305
$8.82
0.00%
$8.82
$28.0672
$21.89
0%
$21.89
0.65
$28.0672
$18.24
0.00%
$18.24
$26.7305
$28.0672
$26.7305
$20.85
$61.75
$58.81
0%
5%
5%
$20.85
$58.66
$55.87
0.65
2.11
2.11
$26.7305
$28.0672
$26.7305
$17.37
$59.22
$56.40
0.00%
0.00%
0.00%
$17.37
$59.22
$56.40
$28.0672
$61.75
0%
$61.75
2.11
$28.0672
$59.22
0.00%
$59.22
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$58.81
$46.87
$44.64
$14.88
$14.17
$46.87
$44.64
0%
5%
5%
0%
0%
5%
5%
$58.81
$44.53
$42.41
$14.88
$14.17
$44.53
$42.41
2.11
0.55
0.55
0.55
0.55
1.56
1.56
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$56.40
$15.44
$14.70
$15.44
$14.70
$43.78
$41.70
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
$56.40
$15.44
$14.70
$15.44
$14.70
$43.78
$41.70
$28.0672
$46.87
0%
$46.87
1.56
$28.0672
$43.78
0.00%
$43.78
$26.7305
$44.64
0%
$44.64
1.56
$26.7305
$41.70
0.00%
$41.70
$28.0672
$28.0672
Family Planning Excluding LARCS
TOS*
Procedure
Code
Modifier
Age
Range
4
4
76830
76830
0-20
21-999
4
76830
0-20
4
I
I
76830
76830
76830
21-999
0-20
21-999
I
76830
0-20
I
T
T
76830
76830
76830
21-999
0-20
21-999
T
76830
0-20
T
4
4
76830
76856
76856
21-999
0-20
21-999
4
76856
0-20
4
I
I
I
I
T
T
76856
76856
76856
76856
76856
76856
76856
21-999
0-20
21-999
0-20
21-999
0-20
21-999
T
76856
0-20
T
4
4
76856
76857
76857
21-999
0-20
21-999
4
76857
0-20
4
I
I
I
I
T
T
76857
76857
76857
76857
76857
76857
76857
21-999
0-20
21-999
0-20
21-999
0-20
21-999
T
76857
0-20
T
4
76857
76881
21-999
0-20
4
76881
I
76881
0-20
I
76881
21-999
T
76881
0-20
T
76881
21-999
4
76882
0-20
4
76882
21-999
I
76882
0-20
I
76882
21-999
21-999
NonProvider Type
Facility (PT) /Provider
(N)/Facilit
Specialty
Current
y (F)
(PS)**
Medicaid RVU
71
N
3.57
71
N
3.57
3,10,19,20,21,2
2,33,43,72,73,7
5,79
N
3.57
3,10,19,20,21,2
2,33,43,72,73,7
5,79
N
3.57
71
N
0.98
71
N
0.98
3,10,19,20,21,2
2,33,75
0.98
N/F
3,10,19,20,21,2
2,33,75
0.98
N/F
71
N
2.59
71
N
2.59
3,10,19,20,21,2
2,33,43,75
N
2.59
3,10,19,20,21,2
2,33,43,75
N
2.59
71
N
3.51
71
N
3.51
3,19,20,21,22,7
5
3.51
N
3,19,20,21,22,7
5
N
3.51
71
N
0.97
71
N
0.97
3,19,20,21,22
N/F
0.97
3,19,20,21,22
N/F
0.97
71
N
2.54
71
N
2.54
3,19,20,21,22,7
5
N
2.54
3,19,20,21,22,7
5
N
2.54
71
N
1.52
71
N
1.52
3,19,20,21,22,7
5
N
1.52
3,19,20,21,22,7
5
1.52
N
71
N
0.54
71
N
0.54
3,19,20,21,22
N/F
0.54
3,19,20,21,22
N/F
0.54
71
N
0.98
71
N
0.98
3,19,20,21,22,7
5
N
0.98
3,19,20,21,22,7
5
0.98
N
3,19,20,21,22,3
2,75,95
N
3.35
3,19,20,21,22,3
2,75,95
3.35
N
3,19,20,21,22,3
2,95
N/F
0.90
3,19,20,21,22,3
2,95
N/F
0.90
3,19,20,21,22,3
2,75,95
N
2.45
3,19,20,21,22,3
2,75,95
2.45
N
3,19,20,21,22,3
2,75,95
N
1.01
3,19,20,21,22,3
2,75,95
N
1.01
3,19,20,21,22,3
2,95
N/F
0.70
3,19,20,21,22,3
2,95
0.70
N/F
$100.20
$95.43
Current
Percent
Reduction
5%
5%
Current
Adjusted
Medicaid Fee
$95.19
$90.66
Medicaid
RVU
Effective
1/1/2016
3.46
3.46
Medicaid
Conversion
Factor
Effective
1/1/2016
$28.0672
$26.7305
$28.0672
$100.20
0%
$100.20
3.46
$28.0672
$97.11
0.00%
$97.11
$26.7305
$28.0672
$26.7305
$95.43
$27.51
$26.20
0%
5%
5%
$95.43
$26.13
$24.89
3.46
1.00
1.00
$26.7305
$28.0672
$26.7305
$92.49
$28.07
$26.73
0.00%
0.00%
0.00%
$92.49
$28.07
$26.73
$28.0672
$27.51
0%
$27.51
1.00
$28.0672
$28.07
0.00%
$28.07
$26.7305
$28.0672
$26.7305
$26.20
$72.69
$69.23
0%
5%
5%
$26.20
$69.06
$65.77
1.00
2.46
2.46
$26.7305
$28.0672
$26.7305
$26.73
$69.05
$65.76
0.00%
0.00%
0.00%
$26.73
$69.05
$65.76
$28.0672
$72.69
0%
$72.69
2.46
$28.0672
$69.05
0.00%
$69.05
$26.7305
$28.0672
$26.7305
$69.23
$98.52
$93.82
0%
5%
5%
$69.23
$93.59
$89.13
2.46
3.10
3.10
$26.7305
$28.0672
$26.7305
$65.76
$87.01
$82.86
0.00%
0.00%
0.00%
$65.76
$87.01
$82.86
$28.0672
$98.52
0%
$98.52
3.10
$28.0672
$87.01
0.00%
$87.01
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$93.82
$27.23
$25.93
$27.23
$25.93
$71.29
$67.90
0%
5%
5%
0%
0%
5%
5%
$93.82
$25.87
$24.63
$27.23
$25.93
$67.73
$64.51
3.10
0.97
0.97
0.97
0.97
2.13
2.13
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$82.86
$27.23
$25.93
$27.23
$25.93
$59.78
$56.94
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
$82.86
$27.23
$25.93
$27.23
$25.93
$59.78
$56.94
$28.0672
$71.29
0%
$71.29
2.13
$28.0672
$59.78
0.00%
$59.78
$26.7305
$28.0672
$26.7305
$67.90
$42.66
$40.63
0%
5%
5%
$67.90
$40.53
$38.60
2.13
1.33
1.33
$26.7305
$28.0672
$26.7305
$56.94
$37.33
$35.55
0.00%
0.00%
0.00%
$56.94
$37.33
$35.55
$28.0672
$42.66
0%
$42.66
1.33
$28.0672
$37.33
0.00%
$37.33
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$40.63
$15.16
$14.43
$15.16
$14.43
$27.51
$26.20
0%
5%
5%
0%
0%
0%
0%
$40.63
$14.40
$13.71
$15.16
$14.43
$27.51
$26.20
1.33
0.69
0.69
0.69
0.69
0.64
0.64
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$35.55
$19.37
$18.44
$19.37
$18.44
$17.96
$17.11
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
$35.55
$19.37
$18.44
$19.37
$18.44
$17.96
$17.11
$28.0672
$27.51
0%
$27.51
0.64
$28.0672
$17.96
0.00%
$17.96
$26.20
0%
$26.20
0.64
$26.7305
$17.11
0.00%
$17.11
$94.03
0%
$94.03
3.29
$28.0672
$92.34
0.00%
$92.34
$26.7305
$89.55
0%
$89.55
3.29
$26.7305
$87.94
0.00%
$87.94
$28.0672
$25.26
0%
$25.26
0.90
$28.0672
$25.26
0.00%
$25.26
$26.7305
$24.06
0%
$24.06
0.90
$26.7305
$24.06
0.00%
$24.06
$28.0672
$68.76
0%
$68.76
2.39
$28.0672
$67.08
0.00%
$67.08
$26.7305
$65.49
0%
$65.49
2.39
$26.7305
$63.89
0.00%
$63.89
$28.0672
$28.35
0%
$28.35
1.02
$28.0672
$28.63
0.00%
$28.63
$26.7305
$27.00
0%
$27.00
1.02
$26.7305
$27.27
0.00%
$27.27
$28.0672
$19.65
0%
$19.65
0.70
$28.0672
$19.65
0.00%
$19.65
$26.7305
$18.71
0%
$18.71
0.70
$26.7305
$18.71
0.00%
$18.71
Current
Medicaid
Conversion
Factor
Current
Medicaid
Fee
$28.0672
$26.7305
$26.7305
$28.0672
Percent
Adjusted
Medicaid Fee Reduction Medicaid Fee
Effective
Effective
Effective
1/1/2016
1/1/2016
1/1/2016
0.00%
$97.11
$97.11
0.00%
$92.49
$92.49
Family Planning Excluding LARCS
Current
Medicaid
Conversion
Factor
Current
Medicaid
Fee
Current
Percent
Reduction
Current
Adjusted
Medicaid Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
$28.0672
$8.70
0%
$8.70
0.32
$28.0672
$8.98
0.00%
$8.98
$26.7305
$28.0672
$26.7305
$8.29
$19.93
$18.98
0%
5%
5%
$8.29
$18.93
$18.03
0.32
0.71
0.71
$26.7305
$28.0672
$26.7305
$8.55
$19.93
$18.98
0.00%
0.00%
0.00%
$8.55
$19.93
$18.98
$28.0672
$19.93
0%
$19.93
0.71
$28.0672
$19.93
0.00%
$19.93
$26.7305
$18.98
$9.30
0%
5%
$18.98
$8.84
0.71
$26.7305
$18.98
$9.30
0.00%
0.00%
$18.98
$9.30
$5.60
$5.60
$50.84
0%
5%
0%
0%
$9.30
$5.32
$5.60
$50.84
$9.30
$5.60
$5.60
$50.84
0.00%
0.00%
0.00%
0.00%
$9.30
$5.60
$5.60
$50.84
$50.84
$34.11
0%
0%
$50.84
$34.11
$50.84
$34.11
0.00%
0.00%
$50.84
$34.11
$34.11
$0.54
0%
0%
$34.11
$0.54
$34.11
$0.54
0.00%
0.00%
$34.11
$0.54
$0.54
$2.83
0%
0%
$0.54
$2.83
$0.54
$2.83
0.00%
0.00%
$0.54
$2.83
$2.83
$12.26
0%
0%
$2.83
$12.26
$2.83
$12.26
0.00%
0.00%
$2.83
$12.26
$12.26
$14.00
$14.00
$12.91
$12.30
0%
0%
0%
5%
5%
$12.26
$14.00
$14.00
$12.26
$11.69
$12.26
$14.00
$14.00
$12.91
$12.30
0.00%
0.00%
0.00%
0.00%
0.00%
$12.26
$14.00
$14.00
$12.91
$12.30
$12.91
0%
$12.91
$12.91
0.00%
$12.91
$12.30
$10.11
0%
0%
$12.30
$10.11
$12.30
$10.29
0.00%
0.00%
$12.30
$10.29
N
0%
$10.11
0-999
$10.11
$10.29
N
0%
$93.53
0-999
$93.53
$113.32
N
0%
$93.53
0-999
$93.53
$113.32
N
0%
$37.48
0-999
$37.48
$37.48
N
0%
$37.48
0-999
$37.48
$37.48
0%
$19.42
0-999
N/F
$19.42
$19.42
0%
$19.42
0-999
N/F
$19.42
$19.42
*Type of Service (TOS): 1 = Medical Services, 2 = Surgery, 4 = Radiology, 7 = Anesthesia, 8 = Assistant Surgery, 9 = Other/Durable Medical Equipment, I = Professional Component, T = Technical Component
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
$10.29
$113.32
$113.32
$37.48
$37.48
$19.42
$19.42
TOS*
Procedure
Code
Modifier
Age
Range
NonProvider Type
Facility (PT) /Provider
(N)/Facilit
Specialty
Current
y (F)
(PS)**
Medicaid RVU
3,19,20,21,22,3
2,75,95
N
0.31
3,19,20,21,22,3
2,75,95
N
0.31
71
N/F
0.71
71
N/F
0.71
3,10,19,20,21,2
2,27,32,33,95,9
6
N
0.71
3,10,19,20,21,2
2,27,32,33,95,9
6
N
0.71
71
N
3,10,19,20,21,2
2,28,32,33,43,7
2,93,95
N
71
F
43,72,73
F
71
N/F
T
76882
0-20
T
1
1
76882
96372
96372
21-999
0-20
21-999
1
96372
0-20
1
1
96372
99000
21-999
0-999
1
1
1
9
99000
99001
99001
A4261
0-999
0-999
0-999
0-999
9
9
A4261
A4266
0-999
0-999
N/F
N/F
9
1
A4266
A4267
0-999
0-999
N/F
N/F
1
1
A4267
A4268
0-999
0-999
N/F
N/F
1
1
A4268
A4269
0-999
0-999
N/F
N/F
1
1
1
1
1
A4269
A9150
A9150
H1010
H1010
0-999
0-999
0-999
0-20
21-999
N/F
N
N
1
H1010
0-20
N
1
1
H1010
J1000
21-999
0-999
N
N
1
1
1
1
1
1
1
J1000
J7303
J7303
J7304
J7304
S4993
S4993
FP
FP
N
N
3,10,19,20,21,2
2,33,46,78,79
71
3,10,19,20,21,2
2,33,46,78,79
71
3,10,19,20,21,2
2,33,46
71
3,10,19,20,21,2
2,33,46
71
3,10,19,20,21,2
2,33,46
71
46
71
71
3,10,19,20,21,2
2,33
3,10,19,20,21,2
2,33
71
3,10,19,20,21,2
2,33
71
46
71
46
71
46
Percent
Adjusted
Medicaid Fee Reduction Medicaid Fee
Effective
Effective
Effective
1/1/2016
1/1/2016
1/1/2016
$9.30
Modifier: FP = Service provided as part of family planning program
Provider Type / Provider Specialty: 3 = County Indigent Health Care Program, 4 = Certified Registered Nurse Anesthetist (CRNA) 5 = Certified Registered Nurse Anesthetist (CRNA) Group, 10 = Physician Assistant / Nurse Practitioner / Clinical Nurse
Specialist, 19 = Physician (D.O.), 20 = Physician (M.D.), 21 = Physician Group (D.O. only), 22 = Physician Group (M.D. only), 27 = Dentist (D.D.S., D.M.D.) 28 = Optometrist, 32 = Podiatrist, 33 = Certified Nurse Midwife / Registered Nurse / Licensed
Midwife, 43 = Radiation Treatment Centers, 46 = Federally Qualified Health Centers (FQHC), 71 = Family Planning Clinic, 72 = Nephrology (Hemodialysis, Renal Dialysis), 73 = Renal Dialysis Facility, 75 = Portable X-ray Supplier, Radiological Lab,
Physiological lab, 78 = Rural Health Clinic - Freestanding / Independent, 79 = Rural Health Clinic - Hospital Based, 93 = Optometric Group, 95 = Podiatry Group, 96= Dentistry Group
Hospital Outpatient Radiology
TOS*
Procedure
Code
4
Q0035
Age Range
Current Medicaid
Fee
Current
Adjusted
Medicaid Fee
Non-Rural
Hospital
Medicaid Fee
Effective
1/1/2016
0-999
$178.42
$178.42
$178.42
*Type of Service (TOS): 4 = Radiology Services
Non-Rural
Hospital
Medicaid Fee
Effective
1/1/2016
Rural Hospital
Medicaid Fee
Effective 1/1/2016
Adjusted Medicaid Fee
Effective 1/1/2016
$178.42
$193.42
$193.42
Long-Acting Reversible Contraceptives (LARCS)
TOS*
2
Procedure Modifier Modifier
Code
1**
2**
11976
Age
Range
10-55
Adjusted
Medicaid
Fee
Effective
1/1/2016
$108.26
0.00%
$108.26
$103.65
$318.28
$309.31
$103.65
$318.28
$309.31
0.00%
0.00%
0.00%
$103.65
$318.28
$309.31
0%
0%
0%
$303.12
$293.86
$279.87
$303.12
$293.86
$279.87
0.00%
0.00%
0.00%
$303.12
$293.86
$279.87
$293.86
0%
$293.86
$293.86
0.00%
$293.86
$279.87
$55.06
$55.06
0%
0%
0%
$279.87
$55.06
$55.06
$279.87
$55.57
$55.06
0.00%
0.00%
0.00%
$279.87
$55.57
$55.06
Current
Medicaid
Fee
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
71
3.80
$27.2760
$103.65
0%
$103.65
3.80
11.34
11.34
$27.2760
$28.0672
$27.2760
$103.65
$318.28
$309.31
0%
0%
0%
11.34
10.47
10.47
$26.7305
$28.0672
$26.7305
$303.12
$293.86
$279.87
10.47
$28.0672
10.47
2.06
2.06
$26.7305
$26.7305
$26.7305
N
11976
55250
55250
10-55
0-20
21-999
N/F
N
N
2
2
2
55250
55450
55450
21-999
0-20
21-999
N/F
N
N
2
55450
0-20
N/F
2
55450
2
2
58300
58300
21-999
0-20
21-999
N/F
N
N
2
58300
0-20
F
2
2
2
58300
58301
58301
21-999
0-20
21-999
F
N
N
2
58301
0-20
N/F
2
2
58301
58565
21-999
21-999
N/F
N
3,10,19,20,
21,22,33,46
71
71
3,19,20,21,
22
71
71
3,19,20,21,
22
3,19,20,21,
22
71
71
3,10,19,20,
21,22,33
3,10,19,20,
21,22,33
71
71
3,10,19,20,
21,22,33
3,10,19,20,
21,22,33
71
3,10,19,20,
21,22
3,10,19,20,
21,22
3,19, 20,
21,22,46
3,19,20,21,
22
3,19,20,21,
22
3,19,20,21,
22
3,19,20,21,
22
71
3,10,19,20,
21,22
71
3,10,19,20,
21,22,33
71
2
58565
21-999
N
2
58565
21-999
F
2
58600
21-999
F
2
58605
21-55
F
2
58611
21-55
F
8
58611
21-55
F
2
9
58615
A4264
21-55
21-999
F
N
9
1
A4264
J1050
21-999
0-999
N/F
N/F
1
1
J1050
J7300
U1
0-999
0-999
N/F
1
J7300
U8
0-999
N/F
1
J7300
0-999
N
1
J7300
U8
0-999
N
1
J7300
FP
0-999
N
1
1
J7300
J7301
FP
0-999
0-999
N
N
71
3,10,19,20,
21,22,33,46
,60,61,62,7
8,79
3,10,19,20,
21,22,33,46
,60,61,62,7
8,79
3,10,19,20,
21,22,33,46
,60,61,62,7
8,79
3,10,19,20,
21,22,33,46
,60,61,62,7
8,79
71
1
J7301
U8
0-999
N
71
U8
Percent
Reduction
Effective
1/1/2016
Current
Medicaid
Conversion
Factor
2
2
2
U1
Medicaid
Fee
Effective
1/1/2016
Provider
Type (PT)
NonFacility /Provider Current
(N)/Facilit Specialty Medicaid
RVU
(PS)***
y (F)
N/F
Medicaid
Medicaid Conversio
n Factor
RVU
Effective Effective
1/1/2016
1/1/2016
4.05
1.98
$26.73
$28.07
2.06
$28.0672
$57.82
0%
$57.82
$57.82
0.00%
$57.82
2.06
2.87
2.87
$26.7305
$26.7305
$26.7305
$55.06
$76.72
$76.72
0%
0%
0%
$55.06
$76.72
$76.72
$55.06
$76.72
$76.72
0.00%
0.00%
0.00%
$55.06
$76.72
$76.72
2.87
$28.0672
$80.55
0%
$80.55
$80.55
0.00%
$80.55
2.87
57.73
$26.7305
$26.7305
$76.72
$1,543.15
0%
0%
$76.72
$1,543.15
$76.72
$1,543.15
0.00%
0.00%
$76.72
$1,543.15
57.73
$26.7305
$1,543.15
0%
$1,543.15
$1,543.15
0.00%
$1,543.15
13.02
$26.7305
$348.03
0%
$348.03
$348.03
0.00%
$348.03
10.95
$26.7305
$292.70
0%
$292.70
$292.70
0.00%
$292.70
9.88
$26.7305
$264.10
0%
$264.10
$264.10
0.00%
$264.10
2.31
$26.7305
$61.75
0%
$61.75
$61.75
0.00%
$61.75
0.37
$26.7305
$9.89
0%
$9.89
$9.88
0.00%
$9.88
7.32
$26.7305
$195.67
$1,560.00
0%
0%
$195.67
$1,560.00
$195.67
$1,560.00
0.00%
0.00%
$195.67
$1,560.00
$1,560.00
$64.98
0%
0%
$1,560.00
$64.98
$1,560.00
$64.98
0.00%
0.00%
$1,560.00
$64.98
$64.98
$609.96
Not a
Benefit
0%
0%
$64.98
$753.78
0.00%
0.00%
$753.78
0%
$64.98
$609.96
Not a
Benefit
$376.89
0.00%
$376.89
$609.96
0%
$609.96
$753.78
0.00%
$753.78
Not a
Benefit
0%
Not a
Benefit
$376.89
0.00%
$376.89
$609.96
0%
$609.96
$753.78
0.00%
$753.78
$376.89
$663.32
0.00%
0.00%
$376.89
$663.32
$530.66
0.00%
$530.66
Not a
Benefit
$698.44
Not a
Benefit
0%
0%
0%
Not a
Benefit
$698.44
Not a
Benefit
$64.98
Long-Acting Reversible Contraceptives (LARCS)
TOS*
Procedure Modifier Modifier
Code
1**
2**
1
J7301
0-999
$698.44
0%
$698.44
U8
0-999
N/F
71
J7302
U1
0-999
N/F
71
J7302
U1
0-999
N/F
71
N
3,10,19,20,
21,22,33,46
$717.11
N
3,10,19,20,
21,22,33,46
Not a
Benefit
N
3,10,19,20,
21,22,33,46
Not a
Benefit
0-999
0-999
N
N
3,10,19,20,
21,22,33,46
71
Not a
Benefit
0-999
N
71
$672.61
Not a
Benefit
N
3,10,19,20,
21,22,33,46
$672.61
N
3,10,19,20,
21,22,33,46
Not a
Benefit
J7302
1
1
U8
J7302
J7302
J7302
0-999
U8
J7302
J7307
U1
1
J7307
U8
J7307
J7307
0-999
U1
1
1
1
Current
Adjusted
Medicaid
Fee
$717.11
Not a
Benefit
Not a
Benefit
Not a
Benefit
1
1
Current
Percent
Reduction
N/F
U8
1
3,10,19,20,
21,22,33,46
Current
Medicaid
Fee
0-999
0-999
J7301
J7302
1
N
Current
Medicaid
Conversion
Factor
3,10,19,20,
21,22,33,46
71
1
1
1
Age
Range
Provider
Type (PT)
NonFacility /Provider Current
(N)/Facilit Specialty Medicaid
RVU
(PS)***
y (F)
0-999
U8
0-999
U8
0-999
N
Not a
Benefit
Medicaid
Medicaid Conversio
n Factor
RVU
Effective Effective
1/1/2016
1/1/2016
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$663.32
0.00%
$663.32
$530.66
$826.72
0.00%
0.00%
$530.66
$826.72
$413.36
0.00%
$413.36
$671.25
0.00%
$671.25
$125.00
0.00%
$125.00
0%
Not a
Benefit
$717.11
Not a
Benefit
Not a
Benefit
Not a
Benefit
0%
$717.11
$826.72
0.00%
$826.72
0%
Not a
Benefit
$413.36
0.00%
$413.36
0%
Not a
Benefit
$671.25
0.00%
$671.25
$335.63
$786.95
0.00%
0.00%
$335.63
$786.95
$629.56
0.00%
$629.56
0%
0%
0%
0%
0%
Not a
Benefit
$672.61
Not a
Benefit
0%
$672.61
$786.95
0.00%
$786.95
0%
Not a
Benefit
$629.56
0.00%
$629.56
0%
0%
*Type of Service (TOS): 1 = Medical Services, 2 = Surgery, 8 = Assistant Surgery, 9 = Other Medical Items or Services
**Modifier:
FP = Service provided as part of family planning program, U1 = Either 1) for J1010, reimbursed for services rendered to female clients as medically appropriate for the purpose of contraception (150 mg dose, quantity of 1
must be billed); or 2) for J7302, Liletta instead of Mirena, U8 = Modifiers Indicating 340b Discounts on Rebatable Clinician-Administered Drugs
***Provider Type (PT) /Provider Specialty (PS)
3 = County Indigent Health Care Program, 10 = Physician Assistant / Nurse Practitioner / Clinical Nurse Specialist, 19 = Physician (D.O.), 20 = Physician (M.D.), 21 = Physician Group (D.O. only), 22 = Physician Group (M.D.
only), 33 = Certified Nurse Midwife / Registered Nurse / Licensed Midwife, 46 = Federally Qualified Health Centers (FQHC), 60 = Hospital - Long Term, Limited, Or Specialized Care, 61 = Hospital - Private Full Care, 62 =
Hospital - Private, O/P Service/Emergency Care Only, 71 = Family Planning Clinic, 78 = Rural Health Clinic -
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
20005
20005
20005
20005
20100
20100
20100
20100
20101
20101
20101
20101
20102
20102
20102
20102
20103
20103
20103
20103
20150
20150
20150
20150
20200
20200
20200
20200
20205
20205
20205
20205
20206
20206
20206
20206
20220
20220
20220
20220
20225
20225
20225
20225
20240
20240
20245
20245
20250
20250
20251
20251
20251
20251
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
N
F
N
F
N/F
N/F
F
F
N
F
N
F
N
F
N
F
N
F
N
F
N/F
N/F
F
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N/F
N/F
F
F
F
F
F
F
F
F
8.74
6.68
8.74
6.68
17.31
17.31
2.77
2.77
12.67
5.91
12.67
5.91
13.83
7.27
13.83
7.27
16.43
9.98
16.43
9.98
26.10
26.10
4.18
4.18
5.82
2.72
5.82
2.72
8.10
4.42
8.10
4.42
6.61
1.71
6.61
1.71
4.74
2.09
4.74
2.09
14.82
3.18
14.82
3.18
6.28
6.28
17.75
17.75
11.06
11.06
12.04
12.04
1.93
1.93
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$245.31
$187.49
$233.62
$178.56
$485.84
$462.70
$77.75
$74.04
$355.61
$165.88
$338.68
$157.98
$388.17
$204.05
$369.68
$194.33
$461.14
$280.11
$439.18
$266.77
$732.55
$697.67
$117.32
$111.73
$163.35
$76.34
$155.57
$72.71
$227.34
$124.06
$216.52
$118.15
$185.52
$47.99
$176.69
$45.71
$133.04
$58.66
$126.70
$55.87
$415.96
$89.25
$396.15
$85.00
$176.26
$167.87
$498.19
$474.47
$310.42
$295.64
$337.93
$321.84
$54.17
$51.59
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$245.31
$187.49
$233.62
$178.56
$485.84
$462.70
$77.75
$74.04
$355.61
$165.88
$338.68
$157.98
$388.17
$204.05
$369.68
$194.33
$461.14
$280.11
$439.18
$266.77
$732.55
$697.67
$117.32
$111.73
$163.35
$76.34
$155.57
$72.71
$227.34
$124.06
$216.52
$118.15
$185.52
$47.99
$176.69
$45.71
$133.04
$58.66
$126.70
$55.87
$415.96
$89.25
$396.15
$85.00
$176.26
$167.87
$498.19
$474.47
$310.42
$295.64
$337.93
$321.84
$54.17
$51.59
8.76
6.69
8.76
6.69
17.56
17.56
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
12.87
6.04
12.87
6.04
13.97
7.36
13.97
7.36
16.57
9.98
16.57
9.98
26.08
26.08
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
5.91
2.76
5.91
2.76
8.24
4.51
8.24
4.51
6.71
1.71
6.71
1.71
4.79
2.10
4.79
2.10
14.94
3.16
14.94
3.16
6.23
6.23
17.70
17.70
11.35
11.35
12.14
12.14
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$245.87
$187.77
$234.16
$178.83
$492.86
$469.39
$78.86
$75.10
$361.22
$169.53
$344.02
$161.45
$392.10
$206.57
$373.43
$196.74
$465.07
$280.11
$442.92
$266.77
$731.99
$697.13
$117.12
$111.54
$165.88
$77.47
$157.98
$73.78
$231.27
$126.58
$220.26
$120.55
$188.33
$47.99
$179.36
$45.71
$134.44
$58.94
$128.04
$56.13
$419.32
$88.69
$399.35
$84.47
$174.86
$166.53
$496.79
$473.13
$318.56
$303.39
$340.74
$324.51
$54.52
$51.92
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$245.87
$187.77
$234.16
$178.83
$492.86
$469.39
$78.86
$75.10
$361.22
$169.53
$344.02
$161.45
$392.10
$206.57
$373.43
$196.74
$465.07
$280.11
$442.92
$266.77
$731.99
$697.13
$117.12
$111.54
$165.88
$77.47
$157.98
$73.78
$231.27
$126.58
$220.26
$120.55
$188.33
$47.99
$179.36
$45.71
$134.44
$58.94
$128.04
$56.13
$419.32
$88.69
$399.35
$84.47
$174.86
$166.53
$496.79
$473.13
$318.56
$303.39
$340.74
$324.51
$54.52
$51.92
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
20500
20500
20500
20500
20501
20501
20501
20501
20520
20520
20520
20520
20525
20525
20525
20525
20526
20526
20526
20526
20527
20527
20527
20527
20550
20550
20550
20550
20551
20551
20551
20551
20552
20552
20552
20552
20553
20553
20553
20553
20600
20600
20600
20600
20604
20604
20604
20604
20605
20605
20605
20605
20606
20606
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
2.96
2.41
2.96
2.41
3.31
1.10
3.31
1.10
5.75
4.18
5.75
4.18
13.51
7.09
13.51
7.09
2.15
1.62
2.15
1.62
2.34
1.86
2.34
1.86
1.65
1.19
1.65
1.19
1.71
1.22
1.71
1.22
1.56
1.09
1.56
1.09
1.80
1.23
1.80
1.23
1.35
1.02
1.35
1.02
2.02
1.29
2.02
1.29
1.41
1.07
1.41
1.07
2.22
1.46
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$83.08
$67.64
$79.12
$64.42
$92.90
$30.87
$88.48
$29.40
$161.39
$117.32
$153.70
$111.73
$379.19
$199.00
$361.13
$189.52
$60.34
$45.47
$57.47
$43.30
$65.68
$52.20
$62.55
$49.72
$46.31
$33.40
$44.11
$31.81
$47.99
$34.24
$45.71
$32.61
$43.78
$30.59
$41.70
$29.14
$50.52
$34.52
$48.11
$32.88
$37.89
$28.63
$36.09
$27.27
$56.70
$36.21
$54.00
$34.48
$39.57
$30.03
$37.69
$28.60
$62.31
$40.98
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$83.08
$67.64
$79.12
$64.42
$92.90
$30.87
$88.48
$29.40
$161.39
$117.32
$153.70
$111.73
$379.19
$199.00
$361.13
$189.52
$60.34
$45.47
$57.47
$43.30
$65.68
$52.20
$62.55
$49.72
$46.31
$33.40
$44.11
$31.81
$47.99
$34.24
$45.71
$32.61
$43.78
$30.59
$41.70
$29.14
$50.52
$34.52
$48.11
$32.88
$37.89
$28.63
$36.09
$27.27
$56.70
$36.21
$54.00
$34.48
$39.57
$30.03
$37.69
$28.60
$62.31
$40.98
2.98
2.44
2.98
2.44
3.36
1.10
3.36
1.10
5.79
4.21
5.79
4.21
13.70
7.18
13.70
7.18
2.20
1.66
2.20
1.66
2.40
1.91
2.40
1.91
1.68
1.20
1.68
1.20
1.72
1.23
1.72
1.23
1.56
1.08
1.56
1.08
1.81
1.23
1.81
1.23
1.35
1.02
1.35
1.02
2.05
1.32
2.05
1.32
1.41
1.06
1.41
1.06
2.27
1.51
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$83.64
$68.48
$79.66
$65.22
$94.31
$30.87
$89.81
$29.40
$162.51
$118.16
$154.77
$112.54
$384.52
$201.52
$366.21
$191.92
$61.75
$46.59
$58.81
$44.37
$67.36
$53.61
$64.15
$51.06
$47.15
$33.68
$44.91
$32.08
$48.28
$34.52
$45.98
$32.88
$43.78
$30.31
$41.70
$28.87
$50.80
$34.52
$48.38
$32.88
$37.89
$28.63
$36.09
$27.27
$57.54
$37.05
$54.80
$35.28
$39.57
$29.75
$37.69
$28.33
$63.71
$42.38
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$83.64
$68.48
$79.66
$65.22
$94.31
$30.87
$89.81
$29.40
$162.51
$118.16
$154.77
$112.54
$384.52
$201.52
$366.21
$191.92
$61.75
$46.59
$58.81
$44.37
$67.36
$53.61
$64.15
$51.06
$47.15
$33.68
$44.91
$32.08
$48.28
$34.52
$45.98
$32.88
$43.78
$30.31
$41.70
$28.87
$50.80
$34.52
$48.38
$32.88
$37.89
$28.63
$36.09
$27.27
$57.54
$37.05
$54.80
$35.28
$39.57
$29.75
$37.69
$28.33
$63.71
$42.38
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
8
8
2
2
2
2
2
2
20606
20606
20610
20610
20610
20610
20611
20611
20611
20611
20612
20612
20612
20612
20615
20615
20615
20615
20650
20650
20650
20650
20660
20660
20661
20661
20662
20662
20663
20663
20664
20664
20665
20665
20665
20665
20670
20670
20670
20670
20680
20680
20680
20680
20680
20680
20680
20680
20690
20690
20692
20692
20693
20693
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N/F
N/F
N/F
N/F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N/F
N/F
N/F
N/F
N/F
N/F
2.22
1.46
1.70
1.32
1.70
1.32
2.55
1.72
2.55
1.72
1.70
1.19
1.70
1.19
6.88
4.65
6.88
4.65
5.78
4.41
5.78
4.41
6.93
6.93
14.33
14.33
12.49
12.49
12.83
12.83
24.68
24.68
2.97
2.57
2.97
2.57
10.67
4.20
10.67
4.20
17.55
12.15
17.55
12.15
2.81
1.94
2.81
1.94
16.92
16.92
31.96
31.96
12.83
12.83
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$59.34
$39.03
$47.71
$37.05
$45.44
$35.28
$71.57
$48.28
$68.16
$45.98
$47.71
$33.40
$45.44
$31.81
$193.10
$130.51
$183.91
$124.30
$162.23
$123.78
$154.50
$117.88
$194.51
$185.24
$402.20
$383.05
$350.56
$333.86
$360.10
$342.95
$692.70
$659.71
$83.36
$72.13
$79.39
$68.70
$299.48
$117.88
$285.21
$112.27
$492.58
$341.02
$469.12
$324.78
$78.87
$54.45
$75.11
$51.86
$474.90
$452.28
$897.03
$854.31
$360.10
$342.95
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$59.34
$39.03
$47.71
$37.05
$45.44
$35.28
$71.57
$48.28
$68.16
$45.98
$47.71
$33.40
$45.44
$31.81
$193.10
$130.51
$183.91
$124.30
$162.23
$123.78
$154.50
$117.88
$194.51
$185.24
$402.20
$383.05
$350.56
$333.86
$360.10
$342.95
$692.70
$659.71
$83.36
$72.13
$79.39
$68.70
$299.48
$117.88
$285.21
$112.27
$492.58
$341.02
$469.12
$324.78
$78.87
$54.45
$75.11
$51.86
$474.90
$452.28
$897.03
$854.31
$360.10
$342.95
2.27
1.51
1.71
1.32
1.71
1.32
2.62
1.78
2.62
1.78
1.73
1.20
1.73
1.20
7.03
4.74
7.03
4.74
5.87
4.48
5.87
4.48
7.19
7.19
14.64
14.64
13.34
13.34
11.30
11.30
25.55
25.55
2.98
2.57
2.98
2.57
10.82
4.24
10.82
4.24
17.66
12.17
17.66
12.17
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
17.14
17.14
32.19
32.19
12.87
12.87
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$60.68
$40.36
$47.99
$37.05
$45.71
$35.28
$73.54
$49.96
$70.03
$47.58
$48.56
$33.68
$46.24
$32.08
$197.31
$133.04
$187.92
$126.70
$164.75
$125.74
$156.91
$119.75
$201.80
$192.19
$410.90
$391.33
$374.42
$356.58
$317.16
$302.05
$717.12
$682.96
$83.64
$72.13
$79.66
$68.70
$303.69
$119.00
$289.22
$113.34
$495.67
$341.58
$472.06
$325.31
$79.31
$54.65
$75.53
$52.05
$481.07
$458.16
$903.48
$860.45
$361.22
$344.02
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$60.68
$40.36
$47.99
$37.05
$45.71
$35.28
$73.54
$49.96
$70.03
$47.58
$48.56
$33.68
$46.24
$32.08
$197.31
$133.04
$187.92
$126.70
$164.75
$125.74
$156.91
$119.75
$201.80
$192.19
$410.90
$391.33
$374.42
$356.58
$317.16
$302.05
$717.12
$682.96
$83.64
$72.13
$79.66
$68.70
$303.69
$119.00
$289.22
$113.34
$495.67
$341.58
$472.06
$325.31
$79.31
$54.65
$75.53
$52.05
$481.07
$458.16
$903.48
$860.45
$361.22
$344.02
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
8
8
2
2
20694
20694
20694
20694
20696
20696
20696
20696
20697
20697
20697
20697
20802
20802
20802
20802
20805
20805
20805
20805
20808
20808
20808
20808
20816
20816
20816
20816
20822
20822
20822
20822
20824
20824
20824
20824
20827
20827
20827
20827
20838
20838
20838
20838
20900
20900
20900
20900
20902
20902
20902
20902
20910
20910
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
N
F
N
F
N/F
N/F
F
F
N/F
N/F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
N/F
N/F
F
F
N/F
N/F
12.02
9.63
12.02
9.63
32.28
32.28
5.16
5.16
51.93
51.93
8.31
8.31
66.35
66.35
10.62
10.62
87.57
87.57
14.01
14.01
113.61
113.61
18.18
18.18
56.88
56.88
9.10
9.10
52.20
52.20
8.35
8.35
61.18
61.18
9.79
9.79
52.09
52.09
8.33
8.33
74.59
74.59
11.93
11.93
11.88
5.49
11.88
5.49
8.22
8.22
1.32
1.32
11.74
11.74
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$337.37
$270.29
$321.30
$257.41
$906.01
$862.86
$144.83
$137.93
$1,457.53
$1,388.11
$233.24
$222.13
$1,862.26
$1,773.57
$298.07
$283.88
$2,457.84
$2,340.79
$393.22
$374.49
$3,188.71
$3,036.85
$510.26
$485.96
$1,596.46
$1,520.43
$255.41
$243.25
$1,465.11
$1,395.33
$234.36
$223.20
$1,717.15
$1,635.37
$274.78
$261.69
$1,462.02
$1,392.39
$233.80
$222.67
$2,093.53
$1,993.83
$334.84
$318.89
$333.44
$154.09
$317.56
$146.75
$230.71
$219.72
$37.05
$35.28
$329.51
$313.82
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$337.37
$270.29
$321.30
$257.41
$906.01
$862.86
$144.83
$137.93
$1,457.53
$1,388.11
$233.24
$222.13
$1,862.26
$1,773.57
$298.07
$283.88
$2,457.84
$2,340.79
$393.22
$374.49
$3,188.71
$3,036.85
$510.26
$485.96
$1,596.46
$1,520.43
$255.41
$243.25
$1,465.11
$1,395.33
$234.36
$223.20
$1,717.15
$1,635.37
$274.78
$261.69
$1,462.02
$1,392.39
$233.80
$222.67
$2,093.53
$1,993.83
$334.84
$318.89
$333.44
$154.09
$317.56
$146.75
$230.71
$219.72
$37.05
$35.28
$329.51
$313.82
12.15
9.70
12.15
9.70
34.86
34.86
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
59.98
59.98
$28.0672
$26.7305
79.80
79.80
$28.0672
$26.7305
94.60
94.60
$28.0672
$26.7305
114.53
114.53
$28.0672
$26.7305
60.50
60.50
$28.0672
$26.7305
51.72
51.72
$28.0672
$26.7305
58.59
58.59
$28.0672
$26.7305
53.16
53.16
$28.0672
$26.7305
62.20
62.20
$28.0672
$26.7305
11.98
5.49
11.98
5.49
8.28
8.28
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
13.11
13.11
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$341.02
$272.25
$324.78
$259.29
$978.42
$931.83
$156.55
$149.09
$1,683.47
$1,603.30
$269.36
$256.53
$2,239.76
$2,133.09
$358.36
$341.29
$2,655.16
$2,528.71
$424.83
$404.59
$3,214.54
$3,061.44
$514.33
$489.83
$1,698.07
$1,617.20
$271.69
$258.75
$1,451.64
$1,382.50
$232.26
$221.20
$1,644.46
$1,566.14
$263.11
$250.58
$1,492.05
$1,420.99
$238.73
$227.36
$1,745.78
$1,662.64
$279.32
$266.02
$336.25
$154.09
$320.23
$146.75
$232.40
$221.33
$37.18
$35.41
$367.96
$350.44
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$341.02
$272.25
$324.78
$259.29
$978.42
$931.83
$156.55
$149.09
$1,683.47
$1,603.30
$269.36
$256.53
$2,239.76
$2,133.09
$358.36
$341.29
$2,655.16
$2,528.71
$424.83
$404.59
$3,214.54
$3,061.44
$514.33
$489.83
$1,698.07
$1,617.20
$271.69
$258.75
$1,451.64
$1,382.50
$232.26
$221.20
$1,644.46
$1,566.14
$263.11
$250.58
$1,492.05
$1,420.99
$238.73
$227.36
$1,745.78
$1,662.64
$279.32
$266.02
$336.25
$154.09
$320.23
$146.75
$232.40
$221.33
$37.18
$35.41
$367.96
$350.44
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
20912
20912
20920
20920
20922
20922
20922
20922
20924
20924
20924
20924
20926
20926
20931
20931
20937
20937
20937
20937
20938
20938
20938
20938
20950
20950
20950
20950
20955
20955
20955
20955
20956
20956
20956
20956
20957
20957
20957
20957
20962
20962
20962
20962
20969
20969
20969
20969
20970
20970
20970
20970
20972
20972
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
N/F
N/F
N/F
N/F
N
F
N
F
F
F
F
F
N/F
N/F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
N/F
N/F
F
F
N/F
N/F
F
F
N/F
N/F
F
F
N/F
N/F
F
F
N/F
N/F
F
F
N/F
N/F
F
F
N/F
N/F
13.81
13.81
11.31
11.31
17.43
14.28
17.43
14.28
14.39
14.39
2.30
2.30
12.53
12.53
3.23
3.23
4.82
4.82
0.77
0.77
5.28
5.28
0.84
0.84
7.06
2.60
7.06
2.60
72.26
72.26
11.56
11.56
75.82
75.82
12.13
12.13
65.63
65.63
10.50
10.50
62.90
62.90
10.06
10.06
80.10
80.10
12.82
12.82
82.04
82.04
13.13
13.13
63.11
63.11
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$387.61
$369.15
$317.44
$302.32
$489.21
$400.80
$465.91
$381.71
$403.89
$384.65
$64.55
$61.48
$351.68
$334.93
$90.66
$86.34
$135.28
$128.84
$21.61
$20.58
$148.19
$141.14
$23.58
$22.45
$198.15
$72.97
$188.72
$69.50
$2,028.14
$1,931.55
$324.46
$309.00
$2,128.06
$2,026.71
$340.46
$324.24
$1,842.05
$1,754.32
$294.71
$280.67
$1,765.43
$1,681.35
$282.36
$268.91
$2,248.18
$2,141.11
$359.82
$342.69
$2,302.63
$2,192.97
$368.52
$350.97
$1,771.32
$1,686.96
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$387.61
$369.15
$317.44
$302.32
$489.21
$400.80
$465.91
$381.71
$403.89
$384.65
$64.55
$61.48
$351.68
$334.93
$90.66
$86.34
$135.28
$128.84
$21.61
$20.58
$148.19
$141.14
$23.58
$22.45
$198.15
$72.97
$188.72
$69.50
$2,028.14
$1,931.55
$324.46
$309.00
$2,128.06
$2,026.71
$340.46
$324.24
$1,842.05
$1,754.32
$294.71
$280.67
$1,765.43
$1,681.35
$282.36
$268.91
$2,248.18
$2,141.11
$359.82
$342.69
$2,302.63
$2,192.97
$368.52
$350.97
$1,771.32
$1,686.96
13.75
13.75
11.31
11.31
17.31
14.34
17.31
14.34
14.60
14.60
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
12.35
12.35
3.31
3.31
4.91
4.91
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
5.44
5.44
$28.0672
$26.7305
7.02
2.61
7.02
2.61
72.71
72.71
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
76.74
76.74
$28.0672
$26.7305
60.69
60.69
$28.0672
$26.7305
58.38
58.38
$28.0672
$26.7305
79.50
79.50
$28.0672
$26.7305
83.02
83.02
$28.0672
$26.7305
66.11
66.11
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$385.92
$367.54
$317.44
$302.32
$485.84
$402.48
$462.70
$383.32
$409.78
$390.27
$65.56
$62.44
$346.63
$330.12
$92.90
$88.48
$137.81
$131.25
$22.05
$21.00
$152.69
$145.41
$24.43
$23.27
$197.03
$73.26
$187.65
$69.77
$2,040.77
$1,943.57
$326.52
$310.97
$2,153.88
$2,051.30
$344.62
$328.21
$1,703.40
$1,622.27
$272.54
$259.56
$1,638.56
$1,560.53
$262.17
$249.68
$2,231.34
$2,125.07
$357.01
$340.01
$2,330.14
$2,219.17
$372.82
$355.07
$1,855.52
$1,767.15
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$385.92
$367.54
$317.44
$302.32
$485.84
$402.48
$462.70
$383.32
$409.78
$390.27
$65.56
$62.44
$346.63
$330.12
$92.90
$88.48
$137.81
$131.25
$22.05
$21.00
$152.69
$145.41
$24.43
$23.27
$197.03
$73.26
$187.65
$69.77
$2,040.77
$1,943.57
$326.52
$310.97
$2,153.88
$2,051.30
$344.62
$328.21
$1,703.40
$1,622.27
$272.54
$259.56
$1,638.56
$1,560.53
$262.17
$249.68
$2,231.34
$2,125.07
$357.01
$340.01
$2,330.14
$2,219.17
$372.82
$355.07
$1,855.52
$1,767.15
Musculoskeletal System Surgery
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
TOS*
Procedure
Code
Age
Range
8
8
2
2
8
8
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
20972
20972
20973
20973
20973
20973
20974
20974
20974
20974
20975
20975
20975
20975
20979
20979
20979
20979
20982
20982
20982
20982
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
F
F
N/F
N/F
F
F
N
F
N
F
F
F
F
F
N
F
N
F
N
F
N
F
2
20999
0-999
N/F
8
2
2
2
2
2
2
8
8
8
8
2
2
8
8
2
2
2
2
8
8
8
8
2
2
8
8
2
2
2
20999
21010
21010
21011
21011
21011
21011
21011
21011
21011
21011
21012
21012
21012
21012
21013
21013
21013
21013
21013
21013
21013
21013
21014
21014
21014
21014
21015
21015
21016
0-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
N/F
N/F
N/F
N
F
N
F
N
F
N
F
N/F
N/F
N/F
N/F
N
F
N
F
N
F
N
F
N/F
N/F
N/F
N/F
F
F
F
10.10
10.10
80.77
80.77
12.92
12.92
2.13
1.41
2.13
1.41
5.05
5.05
0.81
0.81
1.50
0.94
1.50
0.94
103.83
10.93
103.83
10.93
21.41
21.41
9.74
7.29
9.74
7.29
1.56
1.17
1.56
1.17
9.53
9.53
1.52
1.52
14.55
11.32
14.55
11.32
2.33
1.81
2.33
1.81
14.74
14.74
2.36
2.36
20.35
20.35
29.67
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$283.48
$269.98
$2,266.99
$2,159.02
$362.63
$345.36
$59.78
$39.57
$56.94
$37.69
$141.74
$134.99
$22.73
$21.65
$42.10
$26.38
$40.10
$25.13
$2,914.22
$306.77
$2,775.43
$292.16
Manually
Priced
Manually
Priced
$600.92
$572.30
$273.37
$204.61
$260.36
$194.87
$43.78
$32.84
$41.70
$31.27
$267.48
$254.74
$42.66
$40.63
$408.38
$317.72
$388.93
$302.59
$65.40
$50.80
$62.28
$48.38
$413.71
$394.01
$66.24
$63.08
$571.17
$543.97
$832.75
Current
Percent
Reduction
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
2%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Current
Adjusted
Medicaid
Fee
$283.48
$269.98
$2,266.99
$2,159.02
$362.63
$345.36
$59.78
$39.57
$56.94
$37.69
$141.74
$134.99
$22.73
$21.65
$42.10
$26.38
$40.10
$25.13
$2,914.22
$306.77
$2,775.43
$292.16
Manually
Priced
Manually
Priced
$600.92
$572.30
$273.37
$204.61
$260.36
$194.87
$43.78
$32.84
$41.70
$31.27
$267.48
$254.74
$42.66
$40.63
$408.38
$317.72
$388.93
$302.59
$65.40
$50.80
$62.28
$48.38
$413.71
$394.01
$66.24
$63.08
$571.17
$543.97
$832.75
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
72.90
72.90
$28.0672
$26.7305
2.19
1.45
2.19
1.45
5.19
5.19
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
1.47
0.92
1.47
0.92
106.17
11.01
106.17
11.01
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
21.93
21.93
9.93
7.42
9.93
7.42
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
9.70
9.70
$28.0672
$26.7305
14.81
11.51
14.81
11.51
$28.0672
$28.0672
$26.7305
$26.7305
14.94
14.94
$28.0672
$26.7305
20.30
20.30
29.39
$28.0672
$26.7305
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
$296.88
$282.74
$2,046.10
$1,948.65
$327.38
$311.78
$61.47
$40.70
$58.54
$38.76
$145.67
$138.73
$23.31
$22.20
$41.26
$25.82
$39.29
$24.59
$2,979.89
$309.02
$2,837.98
$294.30
Manually
Priced
Manually
Priced
$615.51
$586.20
$278.71
$208.26
$265.43
$198.34
$44.59
$33.32
$42.47
$31.73
$272.25
$259.29
$43.56
$41.49
$415.68
$323.05
$395.88
$307.67
$66.51
$51.69
$63.34
$49.23
$419.32
$399.35
$67.09
$63.90
$569.76
$542.63
$824.90
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
2%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$296.88
$282.74
$2,046.10
$1,948.65
$327.38
$311.78
$61.47
$40.70
$58.54
$38.76
$145.67
$138.73
$23.31
$22.20
$41.26
$25.82
$39.29
$24.59
$2,979.89
$309.02
$2,837.98
$294.30
Manually
Priced
Manually
Priced
$615.51
$586.20
$278.71
$208.26
$265.43
$198.34
$44.59
$33.32
$42.47
$31.73
$272.25
$259.29
$43.56
$41.49
$415.68
$323.05
$395.88
$307.67
$66.51
$51.69
$63.34
$49.23
$419.32
$399.35
$67.09
$63.90
$569.76
$542.63
$824.90
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
21016
21016
21016
21025
21025
21025
21025
21026
21026
21026
21026
21029
21029
21029
21029
21030
21030
21030
21030
21031
21031
21031
21031
21032
21032
21032
21032
21034
21034
21034
21034
21034
21034
21040
21040
21040
21040
21044
21044
21044
21044
21045
21045
21045
21045
21046
21046
21046
21046
21047
21047
21047
21047
21048
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
F
F
N
F
N
F
N/F
N/F
F
F
F
F
F
F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
29.67
4.75
4.75
25.52
21.59
25.52
21.59
17.66
14.32
17.66
14.32
22.29
18.66
22.29
18.66
14.90
12.05
14.90
12.05
11.22
8.42
11.22
8.42
11.42
8.34
11.42
8.34
37.76
33.35
37.76
33.35
5.34
5.34
15.01
12.07
15.01
12.07
25.33
25.33
4.05
4.05
35.22
35.22
5.64
5.64
31.90
31.90
5.10
5.10
37.51
37.51
6.00
6.00
32.77
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$793.09
$133.32
$126.97
$716.27
$605.97
$682.16
$577.11
$495.67
$401.92
$472.06
$382.78
$625.62
$523.73
$595.82
$498.79
$418.20
$338.21
$398.28
$322.10
$314.91
$236.33
$299.92
$225.07
$320.53
$234.08
$305.26
$222.93
$1,059.82
$936.04
$1,009.34
$891.46
$149.88
$142.74
$421.29
$338.77
$401.22
$322.64
$710.94
$677.08
$113.67
$108.26
$988.53
$941.45
$158.30
$150.76
$895.34
$852.70
$143.14
$136.33
$1,052.80
$1,002.66
$168.40
$160.38
$919.76
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$793.09
$133.32
$126.97
$716.27
$605.97
$682.16
$577.11
$495.67
$401.92
$472.06
$382.78
$625.62
$523.73
$595.82
$498.79
$418.20
$338.21
$398.28
$322.10
$314.91
$236.33
$299.92
$225.07
$320.53
$234.08
$305.26
$222.93
$1,059.82
$936.04
$1,009.34
$891.46
$149.88
$142.74
$421.29
$338.77
$401.22
$322.64
$710.94
$677.08
$113.67
$108.26
$988.53
$941.45
$158.30
$150.76
$895.34
$852.70
$143.14
$136.33
$1,052.80
$1,002.66
$168.40
$160.38
$919.76
29.39
$26.7305
25.76
21.80
25.76
21.80
17.83
14.45
17.83
14.45
21.96
18.34
21.96
18.34
14.97
12.09
14.97
12.09
11.40
8.55
11.40
8.55
11.56
8.46
11.56
8.46
38.09
33.60
38.09
33.60
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
15.11
12.14
15.11
12.14
25.41
25.41
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
35.41
35.41
$28.0672
$26.7305
32.44
32.44
$28.0672
$26.7305
38.26
38.26
$28.0672
$26.7305
33.31
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$785.61
$131.98
$125.70
$723.01
$611.86
$688.58
$582.72
$500.44
$405.57
$476.60
$386.26
$616.36
$514.75
$587.00
$490.24
$420.17
$339.33
$400.16
$323.17
$319.97
$239.97
$304.73
$228.55
$324.46
$237.45
$309.00
$226.14
$1,069.08
$943.06
$1,018.16
$898.14
$162.91
$143.70
$424.10
$340.74
$403.90
$324.51
$713.19
$679.22
$114.11
$108.68
$993.86
$946.53
$159.02
$151.44
$910.50
$867.14
$145.68
$138.74
$1,073.85
$1,022.71
$171.82
$163.63
$934.92
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$785.61
$131.98
$125.70
$723.01
$611.86
$688.58
$582.72
$500.44
$405.57
$476.60
$386.26
$616.36
$514.75
$587.00
$490.24
$420.17
$339.33
$400.16
$323.17
$319.97
$239.97
$304.73
$228.55
$324.46
$237.45
$309.00
$226.14
$1,069.08
$943.06
$1,018.16
$898.14
$162.91
$143.70
$424.10
$340.74
$403.90
$324.51
$713.19
$679.22
$114.11
$108.68
$993.86
$946.53
$159.02
$151.44
$910.50
$867.14
$145.68
$138.74
$1,073.85
$1,022.71
$171.82
$163.63
$934.92
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
21048
21048
21048
21049
21049
21049
21049
21050
21050
21050
21050
21060
21060
21060
21060
21070
21070
21073
21073
21073
21073
21076
21076
21077
21077
21079
21079
21079
21079
21080
21080
21080
21080
21081
21081
21081
21081
21082
21082
21083
21083
21084
21084
21084
21084
21085
21085
21085
21085
21086
21086
21086
21086
21087
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
0-20
0-20
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
0-20
0-20
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
N/F
F
F
N/F
N/F
F
F
N/F
N/F
F
F
N/F
N/F
F
F
N/F
N/F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
32.77
5.24
5.24
34.97
34.97
5.60
5.60
24.81
24.81
3.97
3.97
23.80
23.80
3.81
3.81
17.62
17.62
11.18
7.40
11.18
7.40
28.57
23.97
71.77
60.63
48.18
40.00
48.18
40.00
54.16
44.65
54.16
44.65
50.04
41.05
50.04
41.05
47.48
38.68
44.20
34.87
51.57
41.49
51.57
41.49
23.86
18.41
23.86
18.41
53.46
44.72
53.46
44.72
53.46
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$28.0672
$28.0672
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$28.0672
$28.0672
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$875.96
$147.07
$140.07
$981.51
$934.77
$157.18
$149.69
$696.35
$663.18
$111.43
$106.12
$668.00
$636.19
$106.94
$101.84
$494.54
$470.99
$313.79
$207.70
$298.85
$197.81
$801.88
$672.77
$2,014.38
$1,701.71
$1,352.28
$1,122.69
$1,287.88
$1,069.22
$1,520.12
$1,253.20
$1,447.72
$1,193.52
$1,404.48
$1,152.16
$1,337.59
$1,097.29
$1,332.63
$1,085.64
$1,240.57
$978.70
$1,447.43
$1,164.51
$1,378.49
$1,109.05
$669.68
$516.72
$637.79
$492.11
$1,500.47
$1,255.17
$1,429.01
$1,195.39
$1,500.47
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$875.96
$147.07
$140.07
$981.51
$934.77
$157.18
$149.69
$696.35
$663.18
$111.43
$106.12
$668.00
$636.19
$106.94
$101.84
$494.54
$470.99
$313.79
$207.70
$298.85
$197.81
$801.88
$672.77
$2,014.38
$1,701.71
$1,352.28
$1,122.69
$1,287.88
$1,069.22
$1,520.12
$1,253.20
$1,447.72
$1,193.52
$1,404.48
$1,152.16
$1,337.59
$1,097.29
$1,332.63
$1,085.64
$1,240.57
$978.70
$1,447.43
$1,164.51
$1,378.49
$1,109.05
$669.68
$516.72
$637.79
$492.11
$1,500.47
$1,255.17
$1,429.01
$1,195.39
$1,500.47
33.31
$26.7305
35.00
35.00
$28.0672
$26.7305
24.29
24.29
$28.0672
$26.7305
23.45
23.45
$28.0672
$26.7305
17.81
17.81
11.38
7.35
11.38
7.35
29.09
24.43
73.03
61.64
49.11
40.81
49.11
40.81
54.97
45.28
54.97
45.28
50.87
41.80
50.87
41.80
48.21
39.33
45.93
36.52
52.55
42.25
52.55
42.25
22.08
16.57
22.08
16.57
54.27
45.45
54.27
45.45
54.27
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$28.0672
$28.0672
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$28.0672
$28.0672
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$890.39
$149.59
$142.46
$982.35
$935.57
$157.18
$149.69
$681.75
$649.28
$109.08
$103.88
$658.18
$626.83
$105.31
$100.29
$499.88
$476.07
$319.40
$206.29
$304.19
$196.47
$816.47
$685.68
$2,049.75
$1,730.06
$1,378.38
$1,145.42
$1,312.73
$1,090.87
$1,542.85
$1,270.88
$1,469.38
$1,210.36
$1,427.78
$1,173.21
$1,359.78
$1,117.33
$1,353.12
$1,103.88
$1,289.13
$1,025.01
$1,474.93
$1,185.84
$1,404.69
$1,129.36
$619.72
$465.07
$590.21
$442.92
$1,523.21
$1,275.65
$1,450.66
$1,214.90
$1,523.21
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$890.39
$149.59
$142.46
$982.35
$935.57
$157.18
$149.69
$681.75
$649.28
$109.08
$103.88
$658.18
$626.83
$105.31
$100.29
$499.88
$476.07
$319.40
$206.29
$304.19
$196.47
$816.47
$685.68
$2,049.75
$1,730.06
$1,378.38
$1,145.42
$1,312.73
$1,090.87
$1,542.85
$1,270.88
$1,469.38
$1,210.36
$1,427.78
$1,173.21
$1,359.78
$1,117.33
$1,353.12
$1,103.88
$1,289.13
$1,025.01
$1,474.93
$1,185.84
$1,404.69
$1,129.36
$619.72
$465.07
$590.21
$442.92
$1,523.21
$1,275.65
$1,450.66
$1,214.90
$1,523.21
Musculoskeletal System Surgery
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
2
2
21087
21087
21087
21088
21088
21088
21088
0-20
21-999
21-999
0-20
0-20
21-999
21-999
F
N
F
N
F
N
F
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
21089
21100
21100
21110
21110
21116
21116
21116
21116
21120
21120
21120
21120
21120
21120
21121
21121
21121
21121
21121
21121
21122
21122
21122
21122
21123
21123
21123
21123
21125
21125
21125
21125
21125
21125
21127
21127
21127
21127
21127
21127
21137
21137
21137
21137
21138
0-999
0-20
0-20
0-20
0-20
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
N/F
N
F
N
F
N
F
N
F
N
F
N
F
F
F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
F
F
N
F
N
F
F
F
F
F
F
F
F
44.72
53.46
44.72
$28.0672
$26.7305
$26.7305
20.20
10.88
22.96
19.27
4.05
1.23
4.05
1.23
18.99
15.17
18.99
15.17
2.43
2.43
21.80
18.14
21.80
18.14
2.90
2.90
19.82
19.82
3.17
3.17
25.07
25.07
4.01
4.01
87.18
23.18
87.18
23.18
3.71
3.71
120.88
24.81
120.88
24.81
3.97
3.97
21.72
21.72
3.48
3.48
26.19
$28.0672
$28.0672
$28.0672
$28.0672
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$1,255.17
$1,429.01
$1,195.39
$1,500.47
$1,255.17
$1,429.01
$1,195.39
Manually
Priced
$566.96
$305.37
$644.42
$540.85
$113.67
$34.52
$108.26
$32.88
$533.00
$425.78
$507.61
$405.50
$68.20
$64.96
$611.86
$509.14
$582.72
$484.89
$81.39
$77.52
$556.29
$529.80
$88.97
$84.74
$703.64
$670.13
$112.55
$107.19
$2,446.90
$650.60
$2,330.36
$619.61
$104.13
$99.17
$3,392.76
$696.35
$3,231.18
$663.18
$111.43
$106.12
$609.62
$580.59
$97.67
$93.02
$735.08
Current
Percent
Reduction
0%
0%
0%
0%
0%
0%
0%
2%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
$1,255.17
$1,429.01
$1,195.39
$1,500.47
$1,255.17
$1,429.01
$1,195.39
Manually
Priced
$566.96
$305.37
$644.42
$540.85
$113.67
$34.52
$108.26
$32.88
$533.00
$425.78
$507.61
$405.50
$68.20
$64.96
$611.86
$509.14
$582.72
$484.89
$81.39
$77.52
$556.29
$529.80
$88.97
$84.74
$703.64
$670.13
$112.55
$107.19
$2,446.90
$650.60
$2,330.36
$619.61
$104.13
$99.17
$3,392.76
$696.35
$3,231.18
$663.18
$111.43
$106.12
$609.62
$580.59
$97.67
$93.02
$735.08
45.45
54.27
45.45
$28.0672
$26.7305
$26.7305
33.16
15.07
23.35
19.55
4.23
1.28
4.23
1.28
17.24
13.80
17.24
13.80
$28.0672
$28.0672
$28.0672
$28.0672
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
23.07
19.25
23.07
19.25
$28.0672
$28.0672
$26.7305
$26.7305
18.42
18.42
$28.0672
$26.7305
22.22
22.22
$28.0672
$26.7305
89.96
21.16
89.96
21.16
$28.0672
$28.0672
$26.7305
$26.7305
124.47
25.58
124.47
25.58
$28.0672
$28.0672
$26.7305
$26.7305
19.94
19.94
$28.0672
$26.7305
25.30
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
$1,275.65
$1,450.66
$1,214.90
$1,523.21
$1,275.65
$1,450.66
$1,214.90
Manually
Priced
$930.71
$422.97
$655.37
$548.71
$118.72
$35.93
$113.07
$34.22
$483.88
$387.33
$460.83
$368.88
$73.73
$59.02
$647.51
$540.29
$616.67
$514.56
$86.45
$82.33
$517.00
$492.38
$82.72
$78.78
$623.65
$593.95
$99.78
$95.03
$2,524.93
$593.90
$2,404.68
$565.62
$95.02
$90.50
$3,493.52
$717.96
$3,327.15
$683.77
$114.87
$109.40
$559.66
$533.01
$89.55
$85.28
$710.10
0%
0%
0%
0%
0%
0%
0%
2%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$1,275.65
$1,450.66
$1,214.90
$1,523.21
$1,275.65
$1,450.66
$1,214.90
Manually
Priced
$930.71
$422.97
$655.37
$548.71
$118.72
$35.93
$113.07
$34.22
$483.88
$387.33
$460.83
$368.88
$73.73
$59.02
$647.51
$540.29
$616.67
$514.56
$86.45
$82.33
$517.00
$492.38
$82.72
$78.78
$623.65
$593.95
$99.78
$95.03
$2,524.93
$593.90
$2,404.68
$565.62
$95.02
$90.50
$3,493.52
$717.96
$3,327.15
$683.77
$114.87
$109.40
$559.66
$533.01
$89.55
$85.28
$710.10
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
21138
21138
21138
21139
21139
21139
21139
21141
21141
21141
21141
21142
21142
21142
21142
21143
21143
21143
21143
21145
21145
21145
21145
21146
21146
21146
21146
21147
21147
21147
21147
21150
21150
21150
21150
21151
21151
21151
21151
21154
21154
21154
21154
21155
21155
21155
21155
21159
21159
21159
21159
21160
21160
21160
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
26.19
4.19
4.19
30.74
30.74
4.92
4.92
39.36
39.36
6.30
6.30
40.49
40.49
6.48
6.48
41.04
41.04
6.57
6.57
43.38
43.38
6.94
6.94
50.07
50.07
8.01
8.01
43.47
43.47
6.96
6.96
51.72
51.72
8.28
8.28
58.52
58.52
9.36
9.36
63.72
63.72
10.20
10.20
64.43
64.43
10.31
10.31
71.69
71.69
11.47
11.47
75.22
75.22
12.04
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$700.07
$117.60
$112.00
$862.79
$821.70
$138.09
$131.51
$1,104.72
$1,052.11
$176.82
$168.40
$1,136.44
$1,082.32
$181.88
$173.21
$1,151.88
$1,097.02
$184.40
$175.62
$1,217.56
$1,159.57
$194.79
$185.51
$1,405.32
$1,338.40
$224.82
$214.11
$1,220.08
$1,161.97
$195.35
$186.04
$1,451.64
$1,382.50
$232.40
$221.33
$1,642.49
$1,564.27
$262.71
$250.20
$1,788.44
$1,703.27
$286.29
$272.65
$1,808.37
$1,722.25
$289.37
$275.59
$2,012.14
$1,916.31
$321.93
$306.60
$2,111.21
$2,010.67
$337.93
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$700.07
$117.60
$112.00
$862.79
$821.70
$138.09
$131.51
$1,104.72
$1,052.11
$176.82
$168.40
$1,136.44
$1,082.32
$181.88
$173.21
$1,151.88
$1,097.02
$184.40
$175.62
$1,217.56
$1,159.57
$194.79
$185.51
$1,405.32
$1,338.40
$224.82
$214.11
$1,220.08
$1,161.97
$195.35
$186.04
$1,451.64
$1,382.50
$232.40
$221.33
$1,642.49
$1,564.27
$262.71
$250.20
$1,788.44
$1,703.27
$286.29
$272.65
$1,808.37
$1,722.25
$289.37
$275.59
$2,012.14
$1,916.31
$321.93
$306.60
$2,111.21
$2,010.67
$337.93
25.30
$26.7305
32.35
32.35
$28.0672
$26.7305
38.98
38.98
$28.0672
$26.7305
41.69
41.69
$28.0672
$26.7305
42.06
42.06
$28.0672
$26.7305
47.24
47.24
$28.0672
$26.7305
49.20
49.20
$28.0672
$26.7305
52.00
52.00
$28.0672
$26.7305
48.48
48.48
$28.0672
$26.7305
59.29
59.29
$28.0672
$26.7305
63.78
63.78
$28.0672
$26.7305
67.82
67.82
$28.0672
$26.7305
69.37
69.37
$28.0672
$26.7305
75.27
75.27
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$676.28
$113.62
$108.20
$907.97
$864.73
$145.28
$138.36
$1,094.06
$1,041.95
$175.05
$166.71
$1,170.12
$1,114.39
$187.22
$178.30
$1,180.51
$1,124.28
$188.88
$179.88
$1,325.89
$1,262.75
$212.14
$202.04
$1,380.91
$1,315.14
$220.95
$210.42
$1,459.49
$1,389.99
$233.52
$222.40
$1,360.70
$1,295.89
$217.71
$207.34
$1,664.10
$1,584.85
$266.26
$253.58
$1,790.13
$1,704.87
$286.42
$272.78
$1,903.52
$1,812.86
$304.56
$290.06
$1,947.02
$1,854.29
$311.52
$296.69
$2,112.62
$2,012.00
$338.02
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$676.28
$113.62
$108.20
$907.97
$864.73
$145.28
$138.36
$1,094.06
$1,041.95
$175.05
$166.71
$1,170.12
$1,114.39
$187.22
$178.30
$1,180.51
$1,124.28
$188.88
$179.88
$1,325.89
$1,262.75
$212.14
$202.04
$1,380.91
$1,315.14
$220.95
$210.42
$1,459.49
$1,389.99
$233.52
$222.40
$1,360.70
$1,295.89
$217.71
$207.34
$1,664.10
$1,584.85
$266.26
$253.58
$1,790.13
$1,704.87
$286.42
$272.78
$1,903.52
$1,812.86
$304.56
$290.06
$1,947.02
$1,854.29
$311.52
$296.69
$2,112.62
$2,012.00
$338.02
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
21160
21172
21172
21172
21172
21175
21175
21175
21175
21179
21179
21179
21179
21180
21180
21180
21180
21181
21181
21181
21181
21182
21182
21182
21182
21183
21183
21183
21183
21184
21184
21184
21184
21188
21188
21188
21188
21193
21193
21193
21193
21194
21194
21194
21194
21195
21195
21195
21195
21196
21196
21196
21196
21198
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
12.04
53.78
53.78
8.60
8.60
61.45
61.45
9.83
9.83
44.74
44.74
7.16
7.16
44.08
44.08
7.05
7.05
20.72
20.72
3.32
3.32
55.15
55.15
8.82
8.82
68.53
68.53
10.96
10.96
63.70
63.70
10.19
10.19
45.12
45.12
7.22
7.22
37.29
37.29
5.97
5.97
39.25
39.25
6.28
6.28
38.32
38.32
6.13
6.13
42.49
42.49
6.80
6.80
33.40
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$321.84
$1,509.45
$1,437.57
$241.38
$229.88
$1,724.73
$1,642.59
$275.90
$262.76
$1,255.73
$1,195.92
$200.96
$191.39
$1,237.20
$1,178.28
$197.87
$188.45
$581.55
$553.86
$93.18
$88.75
$1,547.91
$1,474.19
$247.55
$235.76
$1,923.45
$1,831.84
$307.62
$292.97
$1,787.88
$1,702.73
$286.00
$272.38
$1,266.39
$1,206.08
$202.65
$192.99
$1,046.63
$996.78
$167.56
$159.58
$1,101.64
$1,049.17
$176.26
$167.87
$1,075.54
$1,024.31
$172.05
$163.86
$1,192.58
$1,135.78
$190.86
$181.77
$937.44
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$321.84
$1,509.45
$1,437.57
$241.38
$229.88
$1,724.73
$1,642.59
$275.90
$262.76
$1,255.73
$1,195.92
$200.96
$191.39
$1,237.20
$1,178.28
$197.87
$188.45
$581.55
$553.86
$93.18
$88.75
$1,547.91
$1,474.19
$247.55
$235.76
$1,923.45
$1,831.84
$307.62
$292.97
$1,787.88
$1,702.73
$286.00
$272.38
$1,266.39
$1,206.08
$202.65
$192.99
$1,046.63
$996.78
$167.56
$159.58
$1,101.64
$1,049.17
$176.26
$167.87
$1,075.54
$1,024.31
$172.05
$163.86
$1,192.58
$1,135.78
$190.86
$181.77
$937.44
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
50.90
50.90
$28.0672
$26.7305
66.81
66.81
$28.0672
$26.7305
37.67
37.67
$28.0672
$26.7305
44.10
44.10
$28.0672
$26.7305
21.25
21.25
$28.0672
$26.7305
55.19
55.19
$28.0672
$26.7305
64.13
64.13
$28.0672
$26.7305
69.36
69.36
$28.0672
$26.7305
45.09
45.09
$28.0672
$26.7305
34.26
34.26
$28.0672
$26.7305
43.24
43.24
$28.0672
$26.7305
38.70
38.70
$28.0672
$26.7305
42.66
42.66
$28.0672
$26.7305
33.60
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$321.92
$1,428.62
$1,360.58
$228.58
$217.69
$1,875.17
$1,785.86
$300.03
$285.74
$1,057.29
$1,006.94
$169.17
$161.11
$1,237.76
$1,178.82
$198.04
$188.61
$596.43
$568.02
$95.43
$90.88
$1,549.03
$1,475.26
$247.84
$236.04
$1,799.95
$1,714.23
$287.99
$274.28
$1,946.74
$1,854.03
$311.48
$296.64
$1,265.55
$1,205.28
$202.49
$192.84
$961.58
$915.79
$153.85
$146.53
$1,213.63
$1,155.83
$194.18
$184.93
$1,086.20
$1,034.47
$173.79
$165.52
$1,197.35
$1,140.32
$191.58
$182.45
$943.06
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$321.92
$1,428.62
$1,360.58
$228.58
$217.69
$1,875.17
$1,785.86
$300.03
$285.74
$1,057.29
$1,006.94
$169.17
$161.11
$1,237.76
$1,178.82
$198.04
$188.61
$596.43
$568.02
$95.43
$90.88
$1,549.03
$1,475.26
$247.84
$236.04
$1,799.95
$1,714.23
$287.99
$274.28
$1,946.74
$1,854.03
$311.48
$296.64
$1,265.55
$1,205.28
$202.49
$192.84
$961.58
$915.79
$153.85
$146.53
$1,213.63
$1,155.83
$194.18
$184.93
$1,086.20
$1,034.47
$173.79
$165.52
$1,197.35
$1,140.32
$191.58
$182.45
$943.06
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
21198
21198
21198
21199
21199
21199
21199
21206
21206
21206
21206
21208
21208
21209
21209
21209
21209
21210
21210
21210
21210
21210
21210
21215
21215
21215
21215
21230
21230
21235
21235
21240
21240
21240
21240
21242
21242
21242
21242
21243
21243
21243
21243
21244
21244
21244
21244
21245
21245
21245
21245
21246
21246
21246
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
F
F
N
F
N
F
F
F
F
F
N/F
N/F
F
F
N/F
N/F
F
F
N/F
N/F
F
F
F
F
F
F
F
F
F
F
F
F
F
33.40
5.34
5.34
30.20
30.20
4.83
4.83
34.58
34.58
5.53
5.53
24.71
24.71
18.28
18.28
2.92
2.92
65.55
24.70
65.55
24.70
3.95
3.95
117.96
26.49
117.96
26.49
21.17
21.17
16.28
16.28
31.69
31.69
5.07
5.07
29.06
29.06
4.65
4.65
48.14
48.14
7.70
7.70
30.73
30.73
4.92
4.92
25.50
25.50
4.08
4.08
23.61
23.61
3.78
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$892.80
$149.88
$142.74
$847.63
$807.26
$135.56
$129.11
$970.56
$924.34
$155.21
$147.82
$693.54
$660.51
$513.07
$488.63
$81.96
$78.05
$1,839.80
$693.26
$1,752.18
$660.24
$110.87
$105.59
$3,310.81
$743.50
$3,153.13
$708.09
$594.18
$565.88
$456.93
$435.17
$889.45
$847.09
$142.30
$135.52
$815.63
$776.79
$130.51
$124.30
$1,351.16
$1,286.81
$216.12
$205.82
$862.51
$821.43
$138.09
$131.51
$715.71
$681.63
$114.51
$109.06
$662.67
$631.11
$106.09
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$892.80
$149.88
$142.74
$847.63
$807.26
$135.56
$129.11
$970.56
$924.34
$155.21
$147.82
$693.54
$660.51
$513.07
$488.63
$81.96
$78.05
$1,839.80
$693.26
$1,752.18
$660.24
$110.87
$105.59
$3,310.81
$743.50
$3,153.13
$708.09
$594.18
$565.88
$456.93
$435.17
$889.45
$847.09
$142.30
$135.52
$815.63
$776.79
$130.51
$124.30
$1,351.16
$1,286.81
$216.12
$205.82
$862.51
$821.43
$138.09
$131.51
$715.71
$681.63
$114.51
$109.06
$662.67
$631.11
$106.09
33.60
$26.7305
28.97
28.97
$28.0672
$26.7305
35.73
35.73
$28.0672
$26.7305
24.40
24.40
17.76
17.76
$28.0672
$26.7305
$28.0672
$26.7305
66.10
25.20
66.10
25.20
$28.0672
$28.0672
$26.7305
$26.7305
118.03
26.15
118.03
26.15
21.93
21.93
16.30
16.30
32.44
32.44
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
29.72
29.72
$28.0672
$26.7305
49.26
49.26
$28.0672
$26.7305
30.80
30.80
$28.0672
$26.7305
25.46
25.46
$28.0672
$26.7305
25.94
25.94
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$898.14
$150.89
$143.70
$813.11
$774.38
$130.10
$123.90
$1,002.84
$955.08
$160.45
$152.81
$684.84
$652.22
$498.47
$474.73
$79.76
$75.96
$1,855.24
$707.29
$1,766.89
$673.61
$113.17
$107.78
$3,312.77
$733.96
$3,155.00
$699.00
$615.51
$586.20
$457.50
$435.71
$910.50
$867.14
$145.68
$138.74
$834.16
$794.43
$133.47
$127.11
$1,382.59
$1,316.74
$221.21
$210.68
$864.47
$823.30
$138.32
$131.73
$714.59
$680.56
$114.33
$108.89
$728.06
$693.39
$116.49
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$898.14
$150.89
$143.70
$813.11
$774.38
$130.10
$123.90
$1,002.84
$955.08
$160.45
$152.81
$684.84
$652.22
$498.47
$474.73
$79.76
$75.96
$1,855.24
$707.29
$1,766.89
$673.61
$113.17
$107.78
$3,312.77
$733.96
$3,155.00
$699.00
$615.51
$586.20
$457.50
$435.71
$910.50
$867.14
$145.68
$138.74
$834.16
$794.43
$133.47
$127.11
$1,382.59
$1,316.74
$221.21
$210.68
$864.47
$823.30
$138.32
$131.73
$714.59
$680.56
$114.33
$108.89
$728.06
$693.39
$116.49
Musculoskeletal System Surgery
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
TOS*
Procedure
Code
Age
Range
8
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
21246
21247
21247
21247
21247
21255
21255
21256
21256
21256
21256
21260
21260
21260
21260
21261
21261
21261
21261
21263
21263
21263
21263
21267
21267
21267
21267
21268
21268
21268
21268
21270
21270
21270
21270
21275
21275
21275
21275
21280
21280
21282
21282
21295
21295
21296
21296
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N/F
N/F
N/F
N/F
F
F
F
F
2
21299
0-999
N/F
8
2
2
2
2
21299
21310
21310
21310
21310
0-999
0-20
0-20
21-999
21-999
F
N
F
N
F
3.78
45.57
45.57
7.29
7.29
39.79
39.79
35.31
35.31
5.65
5.65
38.42
38.42
6.15
6.15
62.46
62.46
9.99
9.99
53.89
53.89
8.62
8.62
47.65
47.65
7.62
7.62
51.44
51.44
8.23
8.23
21.02
21.02
3.36
3.36
24.21
24.21
3.87
3.87
16.87
16.87
11.09
11.09
5.85
5.85
13.24
13.24
3.71
0.80
3.71
0.80
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$101.04
$1,279.02
$1,218.11
$204.61
$194.87
$1,116.79
$1,063.61
$991.05
$943.85
$158.58
$151.03
$1,078.34
$1,026.99
$172.61
$164.39
$1,753.08
$1,669.59
$280.39
$267.04
$1,512.54
$1,440.51
$241.94
$230.42
$1,337.40
$1,273.71
$213.87
$203.69
$1,443.78
$1,375.02
$230.99
$219.99
$589.97
$561.88
$94.31
$89.81
$679.51
$647.15
$108.62
$103.45
$473.49
$450.94
$311.27
$296.44
$164.19
$156.37
$371.61
$353.91
Manually
Priced
Manually
Priced
$104.13
$22.45
$99.17
$21.38
Current
Percent
Reduction
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
2%
0%
0%
0%
0%
Current
Adjusted
Medicaid
Fee
$101.04
$1,279.02
$1,218.11
$204.61
$194.87
$1,116.79
$1,063.61
$991.05
$943.85
$158.58
$151.03
$1,078.34
$1,026.99
$172.61
$164.39
$1,753.08
$1,669.59
$280.39
$267.04
$1,512.54
$1,440.51
$241.94
$230.42
$1,337.40
$1,273.71
$213.87
$203.69
$1,443.78
$1,375.02
$230.99
$219.99
$589.97
$561.88
$94.31
$89.81
$679.51
$647.15
$108.62
$103.45
$473.49
$450.94
$311.27
$296.44
$164.19
$156.37
$371.61
$353.91
Manually
Priced
Manually
Priced
$104.13
$22.45
$99.17
$21.38
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
43.97
43.97
$28.0672
$26.7305
37.96
37.96
34.32
34.32
$28.0672
$26.7305
$28.0672
$26.7305
32.95
32.95
$28.0672
$26.7305
58.47
58.47
$28.0672
$26.7305
54.04
54.04
$28.0672
$26.7305
45.23
45.23
$28.0672
$26.7305
53.14
53.14
$28.0672
$26.7305
20.77
20.77
$28.0672
$26.7305
24.04
24.04
$28.0672
$26.7305
16.24
16.24
10.84
10.84
5.41
5.41
12.06
12.06
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
3.75
0.77
3.75
0.77
$28.0672
$28.0672
$26.7305
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
$110.94
$1,234.11
$1,175.34
$197.46
$188.05
$1,065.43
$1,014.69
$963.27
$917.39
$154.12
$146.78
$924.81
$880.77
$147.97
$140.92
$1,641.09
$1,562.93
$262.57
$250.07
$1,516.75
$1,444.52
$242.68
$231.12
$1,269.48
$1,209.02
$203.12
$193.44
$1,491.49
$1,420.46
$238.64
$227.27
$582.96
$555.19
$93.27
$88.83
$674.74
$642.60
$107.96
$102.82
$455.81
$434.10
$304.25
$289.76
$151.84
$144.61
$338.49
$322.37
Manually
Priced
Manually
Priced
$105.25
$21.61
$100.24
$20.58
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
2%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$110.94
$1,234.11
$1,175.34
$197.46
$188.05
$1,065.43
$1,014.69
$963.27
$917.39
$154.12
$146.78
$924.81
$880.77
$147.97
$140.92
$1,641.09
$1,562.93
$262.57
$250.07
$1,516.75
$1,444.52
$242.68
$231.12
$1,269.48
$1,209.02
$203.12
$193.44
$1,491.49
$1,420.46
$238.64
$227.27
$582.96
$555.19
$93.27
$88.83
$674.74
$642.60
$107.96
$102.82
$455.81
$434.10
$304.25
$289.76
$151.84
$144.61
$338.49
$322.37
Manually
Priced
Manually
Priced
$105.25
$21.61
$100.24
$20.58
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
8
8
21315
21315
21315
21315
21320
21320
21320
21320
21325
21325
21330
21330
21335
21335
21336
21336
21337
21337
21337
21337
21338
21338
21339
21339
21340
21340
21340
21340
21343
21343
21343
21343
21344
21344
21344
21344
21345
21345
21346
21346
21347
21347
21347
21347
21348
21348
21348
21348
21355
21355
21356
21356
21356
21356
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
N
F
N
F
N
F
N
F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N
F
N
F
N/F
N/F
N/F
N/F
N/F
N/F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
7.92
4.37
7.92
4.37
7.33
3.88
7.33
3.88
13.45
13.45
16.07
16.07
20.90
20.90
18.47
18.47
11.56
8.48
11.56
8.48
20.55
20.55
22.18
22.18
21.54
21.54
3.45
3.45
34.95
34.95
5.59
5.59
44.68
44.68
7.15
7.15
17.88
17.88
26.07
26.07
31.66
31.66
5.07
5.07
33.88
33.88
5.42
5.42
9.23
9.23
10.82
10.82
2.28
1.73
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$222.29
$122.65
$211.71
$116.81
$205.73
$108.90
$195.93
$103.71
$377.50
$359.53
$451.04
$429.56
$586.60
$558.67
$518.40
$493.71
$324.46
$238.01
$309.00
$226.67
$576.78
$549.31
$622.53
$592.88
$604.57
$575.77
$96.83
$92.22
$980.95
$934.23
$156.90
$149.42
$1,254.04
$1,194.32
$200.68
$191.12
$501.84
$477.94
$731.71
$696.86
$888.61
$846.29
$142.30
$135.52
$950.92
$905.63
$152.12
$144.88
$259.06
$246.72
$303.69
$289.22
$63.99
$48.56
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$222.29
$122.65
$211.71
$116.81
$205.73
$108.90
$195.93
$103.71
$377.50
$359.53
$451.04
$429.56
$586.60
$558.67
$518.40
$493.71
$324.46
$238.01
$309.00
$226.67
$576.78
$549.31
$622.53
$592.88
$604.57
$575.77
$96.83
$92.22
$980.95
$934.23
$156.90
$149.42
$1,254.04
$1,194.32
$200.68
$191.12
$501.84
$477.94
$731.71
$696.86
$888.61
$846.29
$142.30
$135.52
$950.92
$905.63
$152.12
$144.88
$259.06
$246.72
$303.69
$289.22
$63.99
$48.56
7.97
4.39
7.97
4.39
7.34
3.90
7.34
3.90
13.70
13.70
16.46
16.46
20.85
20.85
18.51
18.51
11.63
8.50
11.63
8.50
21.60
21.60
24.48
24.48
22.95
22.95
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
34.94
34.94
$28.0672
$26.7305
40.06
40.06
$28.0672
$26.7305
18.07
18.07
26.00
26.00
32.72
32.72
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
34.73
34.73
$28.0672
$26.7305
10.31
10.31
10.89
10.89
$28.0672
$26.7305
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$223.70
$123.22
$213.04
$117.35
$206.01
$109.46
$196.20
$104.25
$384.52
$366.21
$461.99
$439.98
$585.20
$557.33
$519.52
$494.78
$326.42
$238.57
$310.88
$227.21
$606.25
$577.38
$687.09
$654.36
$644.14
$613.46
$103.06
$98.15
$980.67
$933.96
$156.91
$149.43
$1,124.37
$1,070.82
$179.90
$171.33
$507.17
$483.02
$729.75
$694.99
$918.36
$874.62
$146.94
$139.94
$974.77
$928.35
$155.96
$148.54
$289.37
$275.59
$305.65
$291.10
$64.71
$48.90
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$223.70
$123.22
$213.04
$117.35
$206.01
$109.46
$196.20
$104.25
$384.52
$366.21
$461.99
$439.98
$585.20
$557.33
$519.52
$494.78
$326.42
$238.57
$310.88
$227.21
$606.25
$577.38
$687.09
$654.36
$644.14
$613.46
$103.06
$98.15
$980.67
$933.96
$156.91
$149.43
$1,124.37
$1,070.82
$179.90
$171.33
$507.17
$483.02
$729.75
$694.99
$918.36
$874.62
$146.94
$139.94
$974.77
$928.35
$155.96
$148.54
$289.37
$275.59
$305.65
$291.10
$64.71
$48.90
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
21356
21356
21360
21360
21360
21360
21365
21365
21365
21365
21366
21366
21366
21366
21385
21385
21385
21385
21386
21386
21387
21387
21390
21390
21390
21390
21395
21395
21395
21395
21400
21400
21400
21400
21401
21401
21401
21401
21406
21406
21407
21407
21407
21407
21408
21408
21408
21408
21421
21421
21421
21421
21422
21422
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
N
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
N/F
N/F
N/F
N/F
F
F
N/F
N/F
F
F
N
F
N
F
N/F
N/F
2.28
1.73
15.34
15.34
2.45
2.45
32.16
32.16
5.15
5.15
34.20
34.20
5.47
5.47
19.62
19.62
3.14
3.14
20.13
20.13
21.11
21.11
23.21
23.21
3.71
3.71
28.26
28.26
4.52
4.52
5.49
4.46
5.49
4.46
14.07
8.88
14.07
8.88
14.74
14.74
18.85
18.85
3.02
3.02
26.07
26.07
4.17
4.17
21.93
18.59
21.93
18.59
19.15
19.15
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$60.95
$46.24
$430.55
$410.05
$68.76
$65.49
$902.64
$859.65
$144.55
$137.66
$959.90
$914.18
$153.53
$146.22
$550.68
$524.45
$88.13
$83.93
$564.99
$538.08
$592.50
$564.28
$651.44
$620.41
$104.13
$99.17
$793.18
$755.40
$126.86
$120.82
$154.09
$125.18
$146.75
$119.22
$394.91
$249.24
$376.10
$237.37
$413.71
$394.01
$529.07
$503.87
$84.76
$80.73
$731.71
$696.86
$117.04
$111.47
$615.51
$521.77
$586.20
$496.92
$537.49
$511.89
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$60.95
$46.24
$430.55
$410.05
$68.76
$65.49
$902.64
$859.65
$144.55
$137.66
$959.90
$914.18
$153.53
$146.22
$550.68
$524.45
$88.13
$83.93
$564.99
$538.08
$592.50
$564.28
$651.44
$620.41
$104.13
$99.17
$793.18
$755.40
$126.86
$120.82
$154.09
$125.18
$146.75
$119.22
$394.91
$249.24
$376.10
$237.37
$413.71
$394.01
$529.07
$503.87
$84.76
$80.73
$731.71
$696.86
$117.04
$111.47
$615.51
$521.77
$586.20
$496.92
$537.49
$511.89
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
15.47
15.47
$28.0672
$26.7305
32.02
32.02
$28.0672
$26.7305
33.39
33.39
$28.0672
$26.7305
19.61
19.61
$28.0672
$26.7305
20.00
20.00
20.47
20.47
22.77
22.77
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
28.98
28.98
$28.0672
$26.7305
5.55
4.52
5.55
4.52
14.11
8.82
14.11
8.82
16.44
16.44
18.51
18.51
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
25.84
25.84
$28.0672
$26.7305
24.22
20.05
24.22
20.05
19.44
19.44
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$61.63
$46.58
$434.20
$413.52
$69.47
$66.16
$898.71
$855.91
$143.79
$136.95
$937.16
$892.53
$149.95
$142.80
$550.40
$524.19
$88.06
$83.87
$561.34
$534.61
$574.54
$547.17
$639.09
$608.65
$102.25
$97.38
$813.39
$774.65
$130.14
$123.94
$155.77
$126.86
$148.35
$120.82
$396.03
$247.55
$377.17
$235.76
$461.42
$439.45
$519.52
$494.78
$83.12
$79.16
$725.26
$690.72
$116.04
$110.52
$679.79
$562.75
$647.41
$535.95
$545.63
$519.64
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$61.63
$46.58
$434.20
$413.52
$69.47
$66.16
$898.71
$855.91
$143.79
$136.95
$937.16
$892.53
$149.95
$142.80
$550.40
$524.19
$88.06
$83.87
$561.34
$534.61
$574.54
$547.17
$639.09
$608.65
$102.25
$97.38
$813.39
$774.65
$130.14
$123.94
$155.77
$126.86
$148.35
$120.82
$396.03
$247.55
$377.17
$235.76
$461.42
$439.45
$519.52
$494.78
$83.12
$79.16
$725.26
$690.72
$116.04
$110.52
$679.79
$562.75
$647.41
$535.95
$545.63
$519.64
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
21422
21422
21423
21423
21423
21423
21431
21431
21431
21431
21432
21432
21432
21432
21433
21433
21433
21433
21435
21435
21435
21435
21436
21436
21436
21436
21440
21440
21440
21440
21445
21445
21445
21445
21450
21450
21450
21450
21451
21451
21451
21451
21452
21452
21452
21452
21453
21453
21453
21453
21454
21454
21461
21461
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N/F
N/F
N
F
3.06
3.06
23.82
23.82
3.81
3.81
20.74
20.74
3.32
3.32
18.90
18.90
3.02
3.02
50.54
50.54
8.09
8.09
36.34
36.34
5.81
5.81
59.28
59.28
9.48
9.48
16.71
13.61
16.71
13.61
22.08
17.99
22.08
17.99
17.50
14.08
17.50
14.08
21.88
18.39
21.88
18.39
17.91
10.58
17.91
10.58
26.23
22.51
26.23
22.51
16.86
16.86
61.64
27.15
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$85.89
$81.80
$668.56
$636.72
$106.94
$101.84
$582.11
$554.39
$93.18
$88.75
$530.47
$505.21
$84.76
$80.73
$1,418.52
$1,350.96
$227.06
$216.25
$1,019.96
$971.39
$163.07
$155.30
$1,663.82
$1,584.58
$266.08
$253.41
$469.00
$381.99
$446.67
$363.80
$619.72
$504.93
$590.21
$480.88
$491.18
$395.19
$467.78
$376.37
$614.11
$516.16
$584.86
$491.57
$502.68
$296.95
$478.74
$282.81
$736.20
$631.79
$701.14
$601.70
$473.21
$450.68
$1,730.06
$762.02
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$85.89
$81.80
$668.56
$636.72
$106.94
$101.84
$582.11
$554.39
$93.18
$88.75
$530.47
$505.21
$84.76
$80.73
$1,418.52
$1,350.96
$227.06
$216.25
$1,019.96
$971.39
$163.07
$155.30
$1,663.82
$1,584.58
$266.08
$253.41
$469.00
$381.99
$446.67
$363.80
$619.72
$504.93
$590.21
$480.88
$491.18
$395.19
$467.78
$376.37
$614.11
$516.16
$584.86
$491.57
$502.68
$296.95
$478.74
$282.81
$736.20
$631.79
$701.14
$601.70
$473.21
$450.68
$1,730.06
$762.02
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
22.79
22.79
$28.0672
$26.7305
22.68
22.68
$28.0672
$26.7305
18.45
18.45
$28.0672
$26.7305
50.06
50.06
$28.0672
$26.7305
36.34
36.34
$28.0672
$26.7305
58.75
58.75
$28.0672
$26.7305
16.66
13.52
16.66
13.52
22.34
18.19
22.34
18.19
18.03
14.41
18.03
14.41
23.74
19.56
23.74
19.56
16.57
9.80
16.57
9.80
26.46
22.68
26.46
22.68
16.58
16.58
61.48
27.14
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$87.30
$83.14
$639.65
$609.19
$102.34
$97.47
$636.56
$606.25
$101.85
$97.00
$517.84
$493.18
$82.85
$78.91
$1,405.04
$1,338.13
$224.81
$214.10
$1,019.96
$971.39
$163.19
$155.42
$1,648.95
$1,570.42
$263.83
$251.27
$467.60
$379.47
$445.33
$361.40
$627.02
$510.54
$597.16
$486.23
$506.05
$404.45
$481.95
$385.19
$666.32
$548.99
$634.58
$522.85
$465.07
$275.06
$442.92
$261.96
$742.66
$636.56
$707.29
$606.25
$465.35
$443.19
$1,725.57
$761.74
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$87.30
$83.14
$639.65
$609.19
$102.34
$97.47
$636.56
$606.25
$101.85
$97.00
$517.84
$493.18
$82.85
$78.91
$1,405.04
$1,338.13
$224.81
$214.10
$1,019.96
$971.39
$163.19
$155.42
$1,648.95
$1,570.42
$263.83
$251.27
$467.60
$379.47
$445.33
$361.40
$627.02
$510.54
$597.16
$486.23
$506.05
$404.45
$481.95
$385.19
$666.32
$548.99
$634.58
$522.85
$465.07
$275.06
$442.92
$261.96
$742.66
$636.56
$707.29
$606.25
$465.35
$443.19
$1,725.57
$761.74
Musculoskeletal System Surgery
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
TOS*
Procedure
Code
Age
Range
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
21461
21461
21461
21461
21462
21462
21462
21462
21462
21462
21465
21465
21465
21465
21470
21470
21470
21470
21480
21480
21480
21480
21485
21485
21485
21485
21490
21490
21490
21490
21495
21495
21497
21497
21497
21497
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
N
F
F
F
N
F
N
F
F
F
N/F
N/F
F
F
N/F
N/F
F
F
N
F
N
F
N
F
N
F
N/F
N/F
F
F
N/F
N/F
N
F
N
F
2
21499
0-999
N/F
8
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
21499
21501
21501
21501
21501
21502
21502
21502
21502
21510
21510
21550
21550
21550
21550
21552
0-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
N/F
N
F
N
F
F
F
F
F
F
F
N
F
N
F
N/F
61.64
27.15
4.34
4.34
64.90
29.95
64.90
29.95
4.79
4.79
28.27
28.27
4.52
4.52
35.02
35.02
5.60
5.60
2.85
0.92
2.85
0.92
20.13
16.85
20.13
16.85
26.89
26.89
4.30
4.30
20.34
20.34
21.15
17.61
21.15
17.61
12.90
9.19
12.90
9.19
15.18
15.18
2.43
2.43
12.72
12.72
7.44
4.51
7.44
4.51
12.64
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$1,647.67
$725.73
$121.81
$116.01
$1,821.56
$840.61
$1,734.81
$800.58
$134.44
$128.04
$793.46
$755.67
$126.86
$120.82
$982.91
$936.10
$157.18
$149.69
$79.99
$25.82
$76.18
$24.59
$564.99
$472.93
$538.08
$450.41
$754.73
$718.78
$120.69
$114.94
$570.89
$543.70
$593.62
$494.26
$565.35
$470.72
Manually
Priced
Manually
Priced
$362.07
$257.94
$344.82
$245.65
$426.06
$405.77
$68.20
$64.96
$357.01
$340.01
$208.82
$126.58
$198.87
$120.55
$354.77
Current
Percent
Reduction
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
2%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
$1,647.67
$725.73
$121.81
$116.01
$1,821.56
$840.61
$1,734.81
$800.58
$134.44
$128.04
$793.46
$755.67
$126.86
$120.82
$982.91
$936.10
$157.18
$149.69
$79.99
$25.82
$76.18
$24.59
$564.99
$472.93
$538.08
$450.41
$754.73
$718.78
$120.69
$114.94
$570.89
$543.70
$593.62
$494.26
$565.35
$470.72
Manually
Priced
Manually
Priced
$362.07
$257.94
$344.82
$245.65
$426.06
$405.77
$68.20
$64.96
$357.01
$340.01
$208.82
$126.58
$198.87
$120.55
$354.77
61.48
27.14
$26.7305
$26.7305
65.39
30.24
65.39
30.24
$28.0672
$28.0672
$26.7305
$26.7305
26.96
26.96
$28.0672
$26.7305
34.90
34.90
$28.0672
$26.7305
2.82
0.92
2.82
0.92
20.36
17.02
20.36
17.02
26.61
26.61
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
18.37
18.37
21.27
17.66
21.27
17.66
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
12.95
9.21
12.95
9.21
14.65
14.65
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
12.69
12.69
7.49
4.54
7.49
4.54
12.85
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
$1,643.39
$725.47
$121.88
$116.08
$1,835.31
$848.75
$1,747.91
$808.33
$135.80
$129.33
$756.69
$720.65
$121.07
$115.30
$979.55
$932.89
$156.73
$149.26
$79.15
$25.82
$75.38
$24.59
$571.45
$477.70
$544.23
$454.95
$746.87
$711.30
$119.50
$113.81
$515.59
$491.04
$596.99
$495.67
$568.56
$472.06
Manually
Priced
Manually
Priced
$363.47
$258.50
$346.16
$246.19
$411.18
$391.60
$65.79
$62.66
$356.17
$339.21
$210.22
$127.43
$200.21
$121.36
$360.66
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
2%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$1,643.39
$725.47
$121.88
$116.08
$1,835.31
$848.75
$1,747.91
$808.33
$135.80
$129.33
$756.69
$720.65
$121.07
$115.30
$979.55
$932.89
$156.73
$149.26
$79.15
$25.82
$75.38
$24.59
$571.45
$477.70
$544.23
$454.95
$746.87
$711.30
$119.50
$113.81
$515.59
$491.04
$596.99
$495.67
$568.56
$472.06
Manually
Priced
Manually
Priced
$363.47
$258.50
$346.16
$246.19
$411.18
$391.60
$65.79
$62.66
$356.17
$339.21
$210.22
$127.43
$200.21
$121.36
$360.66
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
21552
21552
21552
21554
21554
21554
21554
21555
21555
21555
21555
21556
21556
21557
21557
21557
21557
21558
21558
21558
21558
21600
21600
21600
21600
21610
21610
21610
21610
21615
21615
21615
21615
21616
21616
21616
21616
21620
21620
21620
21620
21627
21627
21627
21627
21630
21630
21630
21630
21632
21632
21632
21632
21685
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N
F
N
F
N/F
N/F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N/F
12.64
2.02
2.02
20.76
20.76
3.32
3.32
11.75
8.73
11.75
8.73
15.22
15.22
27.49
27.49
4.40
4.40
38.51
38.51
6.16
6.16
16.06
16.06
2.57
2.57
34.16
34.16
5.47
5.47
18.16
18.16
2.91
2.91
24.42
24.42
3.91
3.91
14.57
14.57
2.33
2.33
15.54
15.54
2.49
2.49
34.92
34.92
5.59
5.59
34.92
34.92
5.59
5.59
28.80
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$337.87
$56.70
$54.00
$582.68
$554.93
$93.18
$88.75
$329.79
$245.03
$314.08
$233.36
$427.18
$406.84
$771.57
$734.82
$123.50
$117.61
$1,080.87
$1,029.39
$172.89
$164.66
$450.76
$429.29
$72.13
$68.70
$958.78
$913.11
$153.53
$146.22
$509.70
$485.43
$81.68
$77.79
$685.40
$652.76
$109.74
$104.52
$408.94
$389.46
$65.40
$62.28
$436.16
$415.39
$69.89
$66.56
$980.11
$933.43
$156.90
$149.42
$980.11
$933.43
$156.90
$149.42
$808.34
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$337.87
$56.70
$54.00
$582.68
$554.93
$93.18
$88.75
$329.79
$245.03
$314.08
$233.36
$427.18
$406.84
$771.57
$734.82
$123.50
$117.61
$1,080.87
$1,029.39
$172.89
$164.66
$450.76
$429.29
$72.13
$68.70
$958.78
$913.11
$153.53
$146.22
$509.70
$485.43
$81.68
$77.79
$685.40
$652.76
$109.74
$104.52
$408.94
$389.46
$65.40
$62.28
$436.16
$415.39
$69.89
$66.56
$980.11
$933.43
$156.90
$149.42
$980.11
$933.43
$156.90
$149.42
$808.34
12.85
$26.7305
21.08
21.08
$28.0672
$26.7305
11.88
8.79
11.88
8.79
15.25
15.25
27.62
27.62
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
38.77
38.77
$28.0672
$26.7305
16.06
16.06
$28.0672
$26.7305
35.47
35.47
$28.0672
$26.7305
18.06
18.06
$28.0672
$26.7305
21.14
21.14
$28.0672
$26.7305
14.55
14.55
$28.0672
$26.7305
15.64
15.64
$28.0672
$26.7305
34.66
34.66
$28.0672
$26.7305
34.80
34.80
$28.0672
$26.7305
28.65
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$343.49
$57.71
$54.96
$591.66
$563.48
$94.67
$90.16
$333.44
$246.71
$317.56
$234.96
$428.02
$407.64
$775.22
$738.30
$124.04
$118.13
$1,088.17
$1,036.34
$174.11
$165.81
$450.76
$429.29
$72.12
$68.69
$995.54
$948.13
$159.29
$151.70
$506.89
$482.75
$81.10
$77.24
$593.34
$565.08
$94.93
$90.41
$408.38
$388.93
$65.34
$62.23
$438.97
$418.07
$70.24
$66.89
$972.81
$926.48
$155.65
$148.24
$976.74
$930.22
$156.28
$148.84
$804.13
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$343.49
$57.71
$54.96
$591.66
$563.48
$94.67
$90.16
$333.44
$246.71
$317.56
$234.96
$428.02
$407.64
$775.22
$738.30
$124.04
$118.13
$1,088.17
$1,036.34
$174.11
$165.81
$450.76
$429.29
$72.12
$68.69
$995.54
$948.13
$159.29
$151.70
$506.89
$482.75
$81.10
$77.24
$593.34
$565.08
$94.93
$90.41
$408.38
$388.93
$65.34
$62.23
$438.97
$418.07
$70.24
$66.89
$972.81
$926.48
$155.65
$148.24
$976.74
$930.22
$156.28
$148.84
$804.13
Musculoskeletal System Surgery
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
TOS*
Procedure
Code
Age
Range
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
8
8
21685
21685
21685
21700
21700
21700
21700
21705
21705
21705
21705
21720
21720
21720
21720
21725
21725
21725
21725
21740
21740
21740
21740
21742
21742
21742
21742
21743
21743
21743
21743
21750
21750
21750
21750
21805
21805
21820
21820
21825
21825
21825
21825
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
N/F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
28.80
4.61
4.61
10.67
10.67
1.71
1.71
15.95
15.95
2.55
2.55
13.84
13.84
2.21
2.21
13.45
13.45
2.15
2.15
29.25
29.25
4.68
4.68
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
19.81
19.81
3.17
3.17
7.81
7.81
4.15
4.15
15.70
15.70
2.51
2.51
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
2
2
2
2
2
2
2
2
2
2
21899
21920
21920
21920
21920
21925
21925
21930
21930
21930
0-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
F
N
F
N
F
F
F
N
F
N
7.31
4.62
7.31
4.62
10.05
10.05
13.34
10.37
13.34
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$769.84
$129.39
$123.23
$299.48
$285.21
$47.99
$45.71
$447.67
$426.35
$71.57
$68.16
$388.45
$369.95
$62.03
$59.07
$377.50
$359.53
$60.34
$57.47
$820.97
$781.87
$131.35
$125.10
$820.97
$781.87
$131.35
$125.10
$820.97
$781.87
$131.35
$125.10
$556.01
$529.53
$88.97
$84.74
$219.20
$208.77
$116.48
$110.93
$440.66
$419.67
$70.45
$67.09
Manually
Priced
$205.17
$129.67
$195.40
$123.49
$282.08
$268.64
$374.42
$291.06
$356.58
Current
Percent
Reduction
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
$769.84
$129.39
$123.23
$299.48
$285.21
$47.99
$45.71
$447.67
$426.35
$71.57
$68.16
$388.45
$369.95
$62.03
$59.07
$377.50
$359.53
$60.34
$57.47
$820.97
$781.87
$131.35
$125.10
$820.97
$781.87
$131.35
$125.10
$820.97
$781.87
$131.35
$125.10
$556.01
$529.53
$88.97
$84.74
$219.20
$208.77
$116.48
$110.93
$440.66
$419.67
$70.45
$67.09
Manually
Priced
$205.17
$129.67
$195.40
$123.49
$282.08
$268.64
$374.42
$291.06
$356.58
28.65
$26.7305
10.63
10.63
$28.0672
$26.7305
15.85
15.85
$28.0672
$26.7305
13.83
13.83
$28.0672
$26.7305
15.57
15.57
$28.0672
$26.7305
29.85
29.85
$28.0672
$26.7305
19.79
19.79
$28.0672
$26.7305
7.81
7.81
4.17
4.17
15.60
15.60
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
7.30
4.59
7.30
4.59
10.21
10.21
13.50
10.46
13.50
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
$765.83
$128.66
$122.53
$298.35
$284.15
$47.74
$45.46
$444.87
$423.68
$71.18
$67.79
$388.17
$369.68
$62.11
$59.15
$437.01
$416.19
$69.92
$66.59
$837.81
$797.91
$134.05
$127.67
$837.81
$797.91
$134.05
$127.67
$837.81
$797.91
$134.05
$127.67
$555.45
$529.00
$88.87
$84.64
$219.20
$208.77
$117.04
$111.47
$437.85
$417.00
$70.06
$66.72
Manually
Priced
$204.89
$128.83
$195.13
$122.69
$286.57
$272.92
$378.91
$293.58
$360.86
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$765.83
$128.66
$122.53
$298.35
$284.15
$47.74
$45.46
$444.87
$423.68
$71.18
$67.79
$388.17
$369.68
$62.11
$59.15
$437.01
$416.19
$69.92
$66.59
$837.81
$797.91
$134.05
$127.67
$837.81
$797.91
$134.05
$127.67
$837.81
$797.91
$134.05
$127.67
$555.45
$529.00
$88.87
$84.64
$219.20
$208.77
$117.04
$111.47
$437.85
$417.00
$70.06
$66.72
Manually
Priced
$204.89
$128.83
$195.13
$122.69
$286.57
$272.92
$378.91
$293.58
$360.86
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
21930
21931
21931
21931
21931
21932
21932
21932
21932
21933
21933
21933
21933
21935
21935
21936
21936
21936
21936
22010
22010
22015
22015
22100
22100
22100
22100
22101
22101
22101
22101
22102
22102
22102
22102
22103
22103
22103
22103
22110
22110
22110
22110
22112
22112
22112
22112
22114
22114
22114
22114
22116
22116
22116
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
10.37
13.34
13.34
2.13
2.13
18.77
18.77
3.00
3.00
20.91
20.91
3.35
3.35
29.30
29.30
40.26
40.26
6.44
6.44
27.10
27.10
25.65
25.65
24.98
24.98
4.00
4.00
25.40
25.40
4.06
4.06
23.34
23.34
3.73
3.73
4.09
4.09
0.65
0.65
30.97
30.97
4.96
4.96
30.58
30.58
4.89
4.89
28.41
28.41
4.55
4.55
4.02
4.02
0.64
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$277.20
$374.42
$356.58
$59.78
$56.94
$526.82
$501.73
$84.20
$80.19
$586.89
$558.93
$94.03
$89.55
$822.37
$783.20
$1,129.99
$1,076.17
$180.75
$172.14
$760.62
$724.40
$719.92
$685.64
$701.12
$667.73
$112.27
$106.92
$712.91
$678.95
$113.95
$108.53
$655.09
$623.89
$104.69
$99.70
$114.79
$109.33
$18.24
$17.37
$869.24
$827.84
$139.21
$132.58
$858.29
$817.42
$137.25
$130.71
$797.39
$759.41
$127.71
$121.62
$112.83
$107.46
$17.96
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$277.20
$374.42
$356.58
$59.78
$56.94
$526.82
$501.73
$84.20
$80.19
$586.89
$558.93
$94.03
$89.55
$822.37
$783.20
$1,129.99
$1,076.17
$180.75
$172.14
$760.62
$724.40
$719.92
$685.64
$701.12
$667.73
$112.27
$106.92
$712.91
$678.95
$113.95
$108.53
$655.09
$623.89
$104.69
$99.70
$114.79
$109.33
$18.24
$17.37
$869.24
$827.84
$139.21
$132.58
$858.29
$817.42
$137.25
$130.71
$797.39
$759.41
$127.71
$121.62
$112.83
$107.46
$17.96
10.46
13.52
13.52
$26.7305
$28.0672
$26.7305
19.04
19.04
$28.0672
$26.7305
21.29
21.29
$28.0672
$26.7305
29.54
29.54
40.72
40.72
$28.0672
$26.7305
$28.0672
$26.7305
27.59
27.59
26.20
26.20
27.20
27.20
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
23.79
23.79
$28.0672
$26.7305
23.04
23.04
$28.0672
$26.7305
4.10
4.10
$28.0672
$26.7305
30.42
30.42
$28.0672
$26.7305
33.02
33.02
$28.0672
$26.7305
28.75
28.75
$28.0672
$26.7305
4.14
4.14
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$279.60
$379.47
$361.40
$60.72
$57.82
$534.40
$508.95
$85.50
$81.43
$597.55
$569.09
$95.61
$91.05
$829.11
$789.62
$1,142.90
$1,088.47
$182.86
$174.16
$774.37
$737.49
$735.36
$700.34
$763.43
$727.07
$122.15
$116.33
$667.72
$635.92
$106.84
$101.75
$646.67
$615.87
$103.47
$98.54
$115.08
$109.60
$18.41
$17.54
$853.80
$813.14
$136.61
$130.10
$926.78
$882.64
$148.28
$141.22
$806.93
$768.50
$129.11
$122.96
$116.20
$110.66
$18.59
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$279.60
$379.47
$361.40
$60.72
$57.82
$534.40
$508.95
$85.50
$81.43
$597.55
$569.09
$95.61
$91.05
$829.11
$789.62
$1,142.90
$1,088.47
$182.86
$174.16
$774.37
$737.49
$735.36
$700.34
$763.43
$727.07
$122.15
$116.33
$667.72
$635.92
$106.84
$101.75
$646.67
$615.87
$103.47
$98.54
$115.08
$109.60
$18.41
$17.54
$853.80
$813.14
$136.61
$130.10
$926.78
$882.64
$148.28
$141.22
$806.93
$768.50
$129.11
$122.96
$116.20
$110.66
$18.59
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
22116
22206
22206
22206
22206
22207
22207
22207
22207
22208
22208
22208
22208
22210
22210
22210
22210
22212
22212
22212
22212
22214
22214
22214
22214
22216
22216
22216
22216
22220
22220
22220
22220
22222
22222
22222
22222
22224
22224
22224
22224
22226
22226
22226
22226
22305
22305
22305
22305
22310
22310
22310
22310
22315
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
N
0.64
67.56
67.56
10.81
10.81
68.54
68.54
10.97
10.97
16.90
16.90
2.70
2.70
50.63
50.63
8.10
8.10
42.09
42.09
6.73
6.73
42.40
42.40
6.78
6.78
10.45
10.45
1.67
1.67
46.23
46.23
7.40
7.40
44.70
44.70
7.15
7.15
45.43
45.43
7.27
7.27
10.49
10.49
1.68
1.68
5.42
4.92
5.42
4.92
8.73
8.05
8.73
8.05
25.12
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$17.11
$1,896.22
$1,805.91
$303.41
$288.96
$1,923.73
$1,832.11
$307.90
$293.23
$474.34
$451.75
$75.78
$72.17
$1,421.04
$1,353.37
$227.34
$216.52
$1,181.35
$1,125.09
$188.89
$179.90
$1,190.05
$1,133.37
$190.30
$181.23
$293.30
$279.33
$46.87
$44.64
$1,297.55
$1,235.75
$207.70
$197.81
$1,254.60
$1,194.85
$200.68
$191.12
$1,275.09
$1,214.37
$204.05
$194.33
$294.42
$280.40
$47.15
$44.91
$152.12
$138.09
$144.88
$131.51
$245.03
$225.94
$233.36
$215.18
$705.05
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$17.11
$1,896.22
$1,805.91
$303.41
$288.96
$1,923.73
$1,832.11
$307.90
$293.23
$474.34
$451.75
$75.78
$72.17
$1,421.04
$1,353.37
$227.34
$216.52
$1,181.35
$1,125.09
$188.89
$179.90
$1,190.05
$1,133.37
$190.30
$181.23
$293.30
$279.33
$46.87
$44.64
$1,297.55
$1,235.75
$207.70
$197.81
$1,254.60
$1,194.85
$200.68
$191.12
$1,275.09
$1,214.37
$204.05
$194.33
$294.42
$280.40
$47.15
$44.91
$152.12
$138.09
$144.88
$131.51
$245.03
$225.94
$233.36
$215.18
$705.05
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
71.30
71.30
$28.0672
$26.7305
69.78
69.78
$28.0672
$26.7305
16.75
16.75
$28.0672
$26.7305
52.17
52.17
$28.0672
$26.7305
43.20
43.20
$28.0672
$26.7305
43.15
43.15
$28.0672
$26.7305
10.65
10.65
$28.0672
$26.7305
46.43
46.43
$28.0672
$26.7305
45.26
45.26
$28.0672
$26.7305
45.89
45.89
$28.0672
$26.7305
10.59
10.59
$28.0672
$26.7305
5.47
4.96
5.47
4.96
8.82
8.13
8.82
8.13
25.56
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$17.71
$2,001.19
$1,905.88
$320.19
$304.94
$1,958.53
$1,865.25
$313.36
$298.44
$470.13
$447.74
$75.22
$71.64
$1,464.27
$1,394.53
$234.28
$223.12
$1,212.50
$1,154.76
$194.00
$184.76
$1,211.10
$1,153.42
$193.78
$184.55
$298.92
$284.68
$47.83
$45.55
$1,303.16
$1,241.10
$208.51
$198.58
$1,270.32
$1,209.82
$203.25
$193.57
$1,288.00
$1,226.66
$206.08
$196.27
$297.23
$283.08
$47.56
$45.29
$153.53
$139.21
$146.22
$132.58
$247.55
$228.19
$235.76
$217.32
$717.40
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$17.71
$2,001.19
$1,905.88
$320.19
$304.94
$1,958.53
$1,865.25
$313.36
$298.44
$470.13
$447.74
$75.22
$71.64
$1,464.27
$1,394.53
$234.28
$223.12
$1,212.50
$1,154.76
$194.00
$184.76
$1,211.10
$1,153.42
$193.78
$184.55
$298.92
$284.68
$47.83
$45.55
$1,303.16
$1,241.10
$208.51
$198.58
$1,270.32
$1,209.82
$203.25
$193.57
$1,288.00
$1,226.66
$206.08
$196.27
$297.23
$283.08
$47.56
$45.29
$153.53
$139.21
$146.22
$132.58
$247.55
$228.19
$235.76
$217.32
$717.40
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
22315
22315
22315
22318
22318
22318
22318
22319
22319
22319
22319
22325
22325
22325
22325
22326
22326
22326
22326
22327
22327
22327
22327
22328
22328
22328
22328
22505
22505
22510
22510
22510
22510
22511
22511
22511
22511
22512
22512
22512
22512
22513
22513
22513
22513
22514
22514
22514
22514
22515
22515
22515
22515
22526
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
N
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
F
22.06
25.12
22.06
46.64
46.64
7.46
7.46
52.06
52.06
8.33
8.33
41.18
41.18
6.59
6.59
42.50
42.50
6.80
6.80
42.49
42.49
6.80
6.80
8.12
8.12
1.30
1.30
3.50
3.50
48.96
12.71
48.96
12.71
48.50
11.91
48.50
11.91
27.11
5.79
27.11
5.79
206.55
14.50
206.55
14.50
205.78
13.55
205.78
13.55
124.87
6.05
124.87
6.05
9.79
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$619.16
$671.47
$589.67
$1,309.05
$1,246.71
$209.38
$199.41
$1,461.18
$1,391.59
$233.80
$222.67
$1,155.81
$1,100.76
$184.96
$176.15
$1,192.86
$1,136.05
$190.86
$181.77
$1,192.58
$1,135.78
$190.86
$181.77
$227.91
$217.05
$36.49
$34.75
$98.24
$93.56
$1,374.17
$356.73
$1,308.73
$339.74
$1,361.26
$334.28
$1,296.43
$318.36
$760.90
$162.51
$724.66
$154.77
$5,797.28
$406.97
$5,521.18
$387.59
$5,775.67
$380.31
$5,500.60
$362.20
$3,504.75
$169.81
$3,337.84
$161.72
$274.78
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$619.16
$671.47
$589.67
$1,309.05
$1,246.71
$209.38
$199.41
$1,461.18
$1,391.59
$233.80
$222.67
$1,155.81
$1,100.76
$184.96
$176.15
$1,192.86
$1,136.05
$190.86
$181.77
$1,192.58
$1,135.78
$190.86
$181.77
$227.91
$217.05
$36.49
$34.75
$98.24
$93.56
$1,374.17
$356.73
$1,308.73
$339.74
$1,361.26
$334.28
$1,296.43
$318.36
$760.90
$162.51
$724.66
$154.77
$5,797.28
$406.97
$5,521.18
$387.59
$5,775.67
$380.31
$5,500.60
$362.20
$3,504.75
$169.81
$3,337.84
$161.72
$274.78
22.37
25.56
22.37
48.08
48.08
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
54.13
54.13
$28.0672
$26.7305
41.71
41.71
$28.0672
$26.7305
43.74
43.74
$28.0672
$26.7305
43.88
43.88
$28.0672
$26.7305
8.33
8.33
$28.0672
$26.7305
3.83
3.83
50.11
13.12
50.11
13.12
49.65
12.32
49.65
12.32
27.87
6.12
27.87
6.12
208.61
15.67
208.61
15.67
207.51
14.60
207.51
14.60
125.90
6.61
125.90
6.61
9.69
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$627.86
$683.23
$597.96
$1,349.47
$1,285.20
$215.92
$205.63
$1,519.28
$1,446.92
$243.08
$231.51
$1,170.68
$1,114.93
$187.31
$178.39
$1,227.66
$1,169.19
$196.43
$187.07
$1,231.59
$1,172.93
$197.05
$187.67
$233.80
$222.67
$37.41
$35.63
$107.50
$102.38
$1,406.45
$368.24
$1,339.47
$350.70
$1,393.54
$345.79
$1,327.17
$329.32
$782.23
$171.77
$744.98
$163.59
$5,855.10
$439.81
$5,576.25
$418.87
$5,824.22
$409.78
$5,546.85
$390.27
$3,533.66
$185.52
$3,365.37
$176.69
$271.97
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$627.86
$683.23
$597.96
$1,349.47
$1,285.20
$215.92
$205.63
$1,519.28
$1,446.92
$243.08
$231.51
$1,170.68
$1,114.93
$187.31
$178.39
$1,227.66
$1,169.19
$196.43
$187.07
$1,231.59
$1,172.93
$197.05
$187.67
$233.80
$222.67
$37.41
$35.63
$107.50
$102.38
$1,406.45
$368.24
$1,339.47
$350.70
$1,393.54
$345.79
$1,327.17
$329.32
$782.23
$171.77
$744.98
$163.59
$5,855.10
$439.81
$5,576.25
$418.87
$5,824.22
$409.78
$5,546.85
$390.27
$3,533.66
$185.52
$3,365.37
$176.69
$271.97
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
22526
22527
22527
22532
22532
22532
22532
22533
22533
22533
22533
22534
22534
22534
22534
22548
22548
22548
22548
22551
22551
22551
22551
22552
22552
22552
22552
22554
22554
22554
22554
22556
22556
22556
22556
22558
22558
22558
22558
22585
22585
22585
22585
22586
22586
22586
22586
22590
22590
22590
22590
22595
22595
22595
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
9.79
4.42
4.42
51.24
51.24
8.20
8.20
47.99
47.99
7.68
7.68
10.42
10.42
1.67
1.67
55.93
55.93
8.95
8.95
49.09
49.09
7.85
7.85
11.33
11.33
1.81
1.81
36.35
36.35
5.82
5.82
47.76
47.76
7.64
7.64
44.13
44.13
7.06
7.06
9.63
9.63
1.54
1.54
53.76
53.76
8.60
8.60
45.13
45.13
7.22
7.22
42.97
42.97
6.88
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$261.69
$124.06
$118.15
$1,438.16
$1,369.67
$230.15
$219.19
$1,346.94
$1,282.80
$215.56
$205.29
$292.46
$278.53
$46.87
$44.64
$1,569.80
$1,495.04
$251.20
$239.24
$1,377.82
$1,312.20
$220.33
$209.83
$318.00
$302.86
$50.80
$48.38
$1,020.24
$971.65
$163.35
$155.57
$1,340.49
$1,276.65
$214.43
$204.22
$1,238.61
$1,179.62
$198.15
$188.72
$270.29
$257.41
$43.22
$41.16
$1,508.89
$1,437.03
$241.38
$229.88
$1,266.67
$1,206.35
$202.65
$192.99
$1,206.05
$1,148.61
$193.10
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$261.69
$124.06
$118.15
$1,438.16
$1,369.67
$230.15
$219.19
$1,346.94
$1,282.80
$215.56
$205.29
$292.46
$278.53
$46.87
$44.64
$1,569.80
$1,495.04
$251.20
$239.24
$1,377.82
$1,312.20
$220.33
$209.83
$318.00
$302.86
$50.80
$48.38
$1,020.24
$971.65
$163.35
$155.57
$1,340.49
$1,276.65
$214.43
$204.22
$1,238.61
$1,179.62
$198.15
$188.72
$270.29
$257.41
$43.22
$41.16
$1,508.89
$1,437.03
$241.38
$229.88
$1,266.67
$1,206.35
$202.65
$192.99
$1,206.05
$1,148.61
$193.10
9.69
4.40
4.40
51.88
51.88
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
47.94
47.94
$28.0672
$26.7305
10.55
10.55
$28.0672
$26.7305
58.16
58.16
$28.0672
$26.7305
50.22
50.22
$28.0672
$26.7305
11.77
11.77
$28.0672
$26.7305
36.72
36.72
$28.0672
$26.7305
48.86
48.86
$28.0672
$26.7305
44.86
44.86
$28.0672
$26.7305
9.67
9.67
$28.0672
$26.7305
59.10
59.10
$28.0672
$26.7305
46.26
46.26
$28.0672
$26.7305
44.23
44.23
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$259.02
$123.50
$117.61
$1,456.13
$1,386.78
$232.98
$221.88
$1,345.54
$1,281.46
$215.29
$205.03
$296.11
$282.01
$47.38
$45.12
$1,632.39
$1,554.65
$261.18
$248.74
$1,409.53
$1,342.41
$225.52
$214.79
$330.35
$314.62
$52.86
$50.34
$1,030.63
$981.54
$164.90
$157.05
$1,371.36
$1,306.05
$219.42
$208.97
$1,259.09
$1,199.13
$201.45
$191.86
$271.41
$258.48
$43.43
$41.36
$1,658.77
$1,579.77
$265.40
$252.76
$1,298.39
$1,236.55
$207.74
$197.85
$1,241.41
$1,182.29
$198.63
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$259.02
$123.50
$117.61
$1,456.13
$1,386.78
$232.98
$221.88
$1,345.54
$1,281.46
$215.29
$205.03
$296.11
$282.01
$47.38
$45.12
$1,632.39
$1,554.65
$261.18
$248.74
$1,409.53
$1,342.41
$225.52
$214.79
$330.35
$314.62
$52.86
$50.34
$1,030.63
$981.54
$164.90
$157.05
$1,371.36
$1,306.05
$219.42
$208.97
$1,259.09
$1,199.13
$201.45
$191.86
$271.41
$258.48
$43.43
$41.36
$1,658.77
$1,579.77
$265.40
$252.76
$1,298.39
$1,236.55
$207.74
$197.85
$1,241.41
$1,182.29
$198.63
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
22595
22600
22600
22600
22600
22610
22610
22610
22610
22612
22612
22612
22612
22614
22614
22614
22614
22630
22630
22630
22630
22632
22632
22632
22632
22633
22633
22633
22633
22634
22634
22634
22634
22800
22800
22800
22800
22802
22802
22802
22802
22804
22804
22804
22804
22808
22808
22808
22808
22810
22810
22810
22810
22812
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
6.88
36.84
36.84
5.89
5.89
36.06
36.06
5.77
5.77
45.68
45.68
7.31
7.31
11.25
11.25
1.80
1.80
44.37
44.37
7.10
7.10
9.17
9.17
1.47
1.47
52.86
52.86
8.46
8.46
14.27
14.27
2.28
2.28
38.89
38.89
6.22
6.22
60.13
60.13
9.62
9.62
69.20
69.20
11.07
11.07
52.28
52.28
8.36
8.36
58.56
58.56
9.37
9.37
64.34
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$183.91
$1,034.00
$984.75
$165.32
$157.44
$1,012.10
$963.90
$161.95
$154.23
$1,282.11
$1,221.05
$205.17
$195.40
$315.76
$300.72
$50.52
$48.11
$1,245.34
$1,186.03
$199.28
$189.79
$257.38
$245.12
$41.26
$39.29
$1,483.63
$1,412.97
$237.45
$226.14
$400.52
$381.44
$63.99
$60.95
$1,091.53
$1,039.55
$174.58
$166.26
$1,687.68
$1,607.30
$270.01
$257.15
$1,942.25
$1,849.75
$310.70
$295.91
$1,467.35
$1,397.47
$234.64
$223.47
$1,643.62
$1,565.34
$262.99
$250.46
$1,805.84
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$183.91
$1,034.00
$984.75
$165.32
$157.44
$1,012.10
$963.90
$161.95
$154.23
$1,282.11
$1,221.05
$205.17
$195.40
$315.76
$300.72
$50.52
$48.11
$1,245.34
$1,186.03
$199.28
$189.79
$257.38
$245.12
$41.26
$39.29
$1,483.63
$1,412.97
$237.45
$226.14
$400.52
$381.44
$63.99
$60.95
$1,091.53
$1,039.55
$174.58
$166.26
$1,687.68
$1,607.30
$270.01
$257.15
$1,942.25
$1,849.75
$310.70
$295.91
$1,467.35
$1,397.47
$234.64
$223.47
$1,643.62
$1,565.34
$262.99
$250.46
$1,805.84
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
37.73
37.73
$28.0672
$26.7305
36.88
36.88
$28.0672
$26.7305
46.30
46.30
$28.0672
$26.7305
11.54
11.54
$28.0672
$26.7305
45.90
45.90
$28.0672
$26.7305
9.46
9.46
$28.0672
$26.7305
54.19
54.19
$28.0672
$26.7305
14.60
14.60
$28.0672
$26.7305
39.35
39.35
$28.0672
$26.7305
61.10
61.10
$28.0672
$26.7305
70.83
70.83
$28.0672
$26.7305
53.89
53.89
$28.0672
$26.7305
58.91
58.91
$28.0672
$26.7305
64.19
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$189.17
$1,058.98
$1,008.54
$169.44
$161.37
$1,035.12
$985.82
$165.62
$157.73
$1,299.51
$1,237.62
$207.92
$198.02
$323.90
$308.47
$51.82
$49.36
$1,288.28
$1,226.93
$206.12
$196.31
$265.52
$252.87
$42.48
$40.46
$1,520.96
$1,448.53
$243.35
$231.76
$409.78
$390.27
$65.56
$62.44
$1,104.44
$1,051.85
$176.71
$168.30
$1,714.91
$1,633.23
$274.39
$261.32
$1,988.00
$1,893.32
$318.08
$302.93
$1,512.54
$1,440.51
$242.01
$230.48
$1,653.44
$1,574.69
$264.55
$251.95
$1,801.63
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$189.17
$1,058.98
$1,008.54
$169.44
$161.37
$1,035.12
$985.82
$165.62
$157.73
$1,299.51
$1,237.62
$207.92
$198.02
$323.90
$308.47
$51.82
$49.36
$1,288.28
$1,226.93
$206.12
$196.31
$265.52
$252.87
$42.48
$40.46
$1,520.96
$1,448.53
$243.35
$231.76
$409.78
$390.27
$65.56
$62.44
$1,104.44
$1,051.85
$176.71
$168.30
$1,714.91
$1,633.23
$274.39
$261.32
$1,988.00
$1,893.32
$318.08
$302.93
$1,512.54
$1,440.51
$242.01
$230.48
$1,653.44
$1,574.69
$264.55
$251.95
$1,801.63
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
22812
22812
22812
22818
22818
22818
22818
22819
22819
22819
22819
22830
22830
22830
22830
22840
22840
22840
22840
22842
22842
22842
22842
22843
22843
22843
22843
22844
22844
22844
22844
22845
22845
22845
22845
22846
22846
22846
22846
22847
22847
22847
22847
22848
22848
22848
22848
22849
22849
22849
22849
22850
22850
22850
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
64.34
10.29
10.29
62.30
62.30
9.97
9.97
78.31
78.31
12.53
12.53
23.23
23.23
3.72
3.72
21.94
21.94
3.51
3.51
21.96
21.96
3.51
3.51
23.36
23.36
3.74
3.74
28.12
28.12
4.50
4.50
21.18
21.18
3.39
3.39
21.98
21.98
3.52
3.52
25.27
25.27
4.04
4.04
10.29
10.29
1.65
1.65
37.30
37.30
5.97
5.97
20.69
20.69
3.31
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$1,719.84
$288.81
$275.06
$1,748.59
$1,665.31
$279.83
$266.50
$2,197.94
$2,093.27
$351.68
$334.93
$652.00
$620.95
$104.41
$99.44
$615.79
$586.47
$98.52
$93.82
$616.36
$587.00
$98.52
$93.82
$655.65
$624.42
$104.97
$99.97
$789.25
$751.66
$126.30
$120.29
$594.46
$566.15
$95.15
$90.62
$616.92
$587.54
$98.80
$94.09
$709.26
$675.48
$113.39
$107.99
$288.81
$275.06
$46.31
$44.11
$1,046.91
$997.05
$167.56
$159.58
$580.71
$553.05
$92.90
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$1,719.84
$288.81
$275.06
$1,748.59
$1,665.31
$279.83
$266.50
$2,197.94
$2,093.27
$351.68
$334.93
$652.00
$620.95
$104.41
$99.44
$615.79
$586.47
$98.52
$93.82
$616.36
$587.00
$98.52
$93.82
$655.65
$624.42
$104.97
$99.97
$789.25
$751.66
$126.30
$120.29
$594.46
$566.15
$95.15
$90.62
$616.92
$587.54
$98.80
$94.09
$709.26
$675.48
$113.39
$107.99
$288.81
$275.06
$46.31
$44.11
$1,046.91
$997.05
$167.56
$159.58
$580.71
$553.05
$92.90
64.19
$26.7305
63.07
63.07
$28.0672
$26.7305
81.52
81.52
$28.0672
$26.7305
23.65
23.65
$28.0672
$26.7305
22.37
22.37
$28.0672
$26.7305
22.43
22.43
$28.0672
$26.7305
24.00
24.00
$28.0672
$26.7305
28.94
28.94
$28.0672
$26.7305
21.56
21.56
$28.0672
$26.7305
22.38
22.38
$28.0672
$26.7305
23.36
23.36
$28.0672
$26.7305
10.56
10.56
$28.0672
$26.7305
37.99
37.99
$28.0672
$26.7305
21.07
21.07
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$1,715.83
$288.26
$274.53
$1,770.20
$1,685.89
$283.23
$269.74
$2,288.04
$2,179.07
$366.09
$348.65
$663.79
$632.18
$106.21
$101.15
$627.86
$597.96
$100.46
$95.67
$629.55
$599.57
$100.73
$95.93
$673.61
$641.53
$107.78
$102.64
$812.26
$773.58
$129.96
$123.77
$605.13
$576.31
$96.82
$92.21
$628.14
$598.23
$100.50
$95.72
$655.65
$624.42
$104.90
$99.91
$296.39
$282.27
$47.42
$45.16
$1,066.27
$1,015.49
$170.60
$162.48
$591.38
$563.21
$94.62
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$1,715.83
$288.26
$274.53
$1,770.20
$1,685.89
$283.23
$269.74
$2,288.04
$2,179.07
$366.09
$348.65
$663.79
$632.18
$106.21
$101.15
$627.86
$597.96
$100.46
$95.67
$629.55
$599.57
$100.73
$95.93
$673.61
$641.53
$107.78
$102.64
$812.26
$773.58
$129.96
$123.77
$605.13
$576.31
$96.82
$92.21
$628.14
$598.23
$100.50
$95.72
$655.65
$624.42
$104.90
$99.91
$296.39
$282.27
$47.42
$45.16
$1,066.27
$1,015.49
$170.60
$162.48
$591.38
$563.21
$94.62
Musculoskeletal System Surgery
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
TOS*
Procedure
Code
Age
Range
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
22850
22851
22851
22851
22851
22852
22852
22852
22852
22855
22855
22855
22855
22865
22865
22865
22865
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
2
22899
0-999
F
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
22899
22900
22900
22900
22900
22901
22901
22901
22901
22902
22902
22902
22902
22903
22903
22903
22903
22904
22904
22904
22904
22905
22905
22905
22905
0-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
F
F
F
F
F
F
F
F
F
F
F
F
F
N/F
N/F
N/F
N/F
F
F
F
F
F
F
F
F
15.99
15.99
2.56
2.56
18.80
18.80
3.01
3.01
9.19
9.19
1.47
1.47
12.29
12.29
1.97
1.97
29.85
29.85
4.78
4.78
38.03
38.03
6.08
6.08
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
2
2
2
8
8
2
2
8
8
22999
23000
23000
23000
23000
23020
23020
23020
23020
0-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
F
F
F
F
F
F
F
F
F
10.53
10.53
1.68
1.68
19.64
19.64
3.14
3.14
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
3.31
11.75
11.75
1.88
1.88
19.78
19.78
3.16
3.16
32.02
32.02
5.12
5.12
58.75
58.75
9.40
9.40
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$88.48
$329.79
$314.08
$52.77
$50.25
$555.17
$528.73
$88.69
$84.47
$898.71
$855.91
$143.70
$136.86
$1,648.95
$1,570.42
$263.83
$251.27
Manually
Priced
Manually
Priced
$448.79
$427.42
$71.85
$68.43
$527.66
$502.53
$84.48
$80.46
$257.94
$245.65
$41.26
$39.29
$344.95
$328.52
$55.29
$52.66
$837.81
$797.91
$134.16
$127.77
$1,067.40
$1,016.56
$170.65
$162.52
Manually
Priced
$295.55
$281.47
$47.15
$44.91
$551.24
$524.99
$88.13
$83.93
Current
Percent
Reduction
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
2%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
0%
0%
0%
0%
0%
0%
0%
0%
Current
Adjusted
Medicaid
Fee
$88.48
$329.79
$314.08
$52.77
$50.25
$555.17
$528.73
$88.69
$84.47
$898.71
$855.91
$143.70
$136.86
$1,648.95
$1,570.42
$263.83
$251.27
Manually
Priced
Manually
Priced
$448.79
$427.42
$71.85
$68.43
$527.66
$502.53
$84.48
$80.46
$257.94
$245.65
$41.26
$39.29
$344.95
$328.52
$55.29
$52.66
$837.81
$797.91
$134.16
$127.77
$1,067.40
$1,016.56
$170.65
$162.52
Manually
Priced
$295.55
$281.47
$47.15
$44.91
$551.24
$524.99
$88.13
$83.93
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
11.98
11.98
$28.0672
$26.7305
20.19
20.19
$28.0672
$26.7305
32.36
32.36
$28.0672
$26.7305
59.49
59.49
$28.0672
$26.7305
16.23
16.23
$28.0672
$26.7305
19.15
19.15
$28.0672
$26.7305
9.50
9.50
$28.0672
$26.7305
12.64
12.64
$28.0672
$26.7305
30.34
30.34
$28.0672
$26.7305
38.31
38.31
$28.0672
$26.7305
10.71
10.71
$28.0672
$26.7305
19.83
19.83
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
$90.11
$336.25
$320.23
$53.80
$51.24
$566.68
$539.69
$90.67
$86.35
$908.25
$865.00
$145.32
$138.40
$1,669.72
$1,590.20
$267.16
$254.43
Manually
Priced
Manually
Priced
$455.53
$433.84
$72.88
$69.41
$537.49
$511.89
$86.00
$81.90
$266.64
$253.94
$42.66
$40.63
$354.77
$337.87
$56.76
$54.06
$851.56
$811.00
$136.25
$129.76
$1,075.25
$1,024.05
$172.04
$163.85
Manually
Priced
$300.60
$286.28
$48.10
$45.80
$556.57
$530.07
$89.05
$84.81
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
2%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
0%
0%
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$90.11
$336.25
$320.23
$53.80
$51.24
$566.68
$539.69
$90.67
$86.35
$908.25
$865.00
$145.32
$138.40
$1,669.72
$1,590.20
$267.16
$254.43
Manually
Priced
Manually
Priced
$455.53
$433.84
$72.88
$69.41
$537.49
$511.89
$86.00
$81.90
$266.64
$253.94
$42.66
$40.63
$354.77
$337.87
$56.76
$54.06
$851.56
$811.00
$136.25
$129.76
$1,075.25
$1,024.05
$172.04
$163.85
Manually
Priced
$300.60
$286.28
$48.10
$45.80
$556.57
$530.07
$89.05
$84.81
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
23030
23030
23030
23030
23031
23031
23031
23031
23035
23035
23035
23035
23040
23040
23040
23040
23044
23044
23065
23065
23065
23065
23066
23066
23066
23066
23071
23071
23071
23071
23073
23073
23073
23073
23075
23075
23075
23075
23076
23076
23077
23077
23077
23077
23078
23078
23078
23078
23100
23100
23100
23100
23101
23101
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
N
F
N
F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
12.43
7.27
12.43
7.27
11.96
6.24
11.96
6.24
19.48
19.48
3.12
3.12
20.48
20.48
3.28
3.28
16.15
16.15
6.11
4.77
6.11
4.77
15.64
10.10
15.64
10.10
11.89
11.89
1.90
1.90
19.67
19.67
3.15
3.15
13.19
9.26
13.19
9.26
15.32
15.32
32.64
32.64
5.22
5.22
41.21
41.21
6.59
6.59
14.21
14.21
2.27
2.27
12.95
12.95
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$348.88
$204.05
$332.26
$194.33
$335.68
$175.14
$319.70
$166.80
$546.75
$520.71
$87.57
$83.40
$574.82
$547.44
$92.06
$87.68
$453.29
$431.70
$171.49
$133.88
$163.32
$127.50
$438.97
$283.48
$418.07
$269.98
$333.72
$317.83
$53.33
$50.79
$552.08
$525.79
$88.41
$84.20
$370.21
$259.90
$352.58
$247.52
$429.99
$409.51
$916.11
$872.48
$146.51
$139.53
$1,156.65
$1,101.56
$184.96
$176.15
$398.83
$379.84
$63.71
$60.68
$363.47
$346.16
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$348.88
$204.05
$332.26
$194.33
$335.68
$175.14
$319.70
$166.80
$546.75
$520.71
$87.57
$83.40
$574.82
$547.44
$92.06
$87.68
$453.29
$431.70
$171.49
$133.88
$163.32
$127.50
$438.97
$283.48
$418.07
$269.98
$333.72
$317.83
$53.33
$50.79
$552.08
$525.79
$88.41
$84.20
$370.21
$259.90
$352.58
$247.52
$429.99
$409.51
$916.11
$872.48
$146.51
$139.53
$1,156.65
$1,101.56
$184.96
$176.15
$398.83
$379.84
$63.71
$60.68
$363.47
$346.16
12.62
7.36
12.62
7.36
12.21
6.33
12.21
6.33
19.59
19.59
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
20.70
20.70
$28.0672
$26.7305
16.46
16.46
6.16
4.79
6.16
4.79
15.91
10.25
15.91
10.25
12.05
12.05
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
19.96
19.96
$28.0672
$26.7305
13.38
9.37
13.38
9.37
15.50
15.50
32.85
32.85
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
41.22
41.22
$28.0672
$26.7305
14.39
14.39
$28.0672
$26.7305
12.91
12.91
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$354.21
$206.57
$337.34
$196.74
$342.70
$177.67
$326.38
$169.20
$549.84
$523.65
$87.97
$83.78
$580.99
$553.32
$92.96
$88.53
$461.99
$439.98
$172.89
$134.44
$164.66
$128.04
$446.55
$287.69
$425.28
$273.99
$338.21
$322.10
$54.11
$51.54
$560.22
$533.54
$89.64
$85.37
$375.54
$262.99
$357.65
$250.46
$435.04
$414.32
$922.01
$878.10
$147.52
$140.50
$1,156.93
$1,101.83
$185.11
$176.29
$403.89
$384.65
$64.62
$61.54
$362.35
$345.09
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$354.21
$206.57
$337.34
$196.74
$342.70
$177.67
$326.38
$169.20
$549.84
$523.65
$87.97
$83.78
$580.99
$553.32
$92.96
$88.53
$461.99
$439.98
$172.89
$134.44
$164.66
$128.04
$446.55
$287.69
$425.28
$273.99
$338.21
$322.10
$54.11
$51.54
$560.22
$533.54
$89.64
$85.37
$375.54
$262.99
$357.65
$250.46
$435.04
$414.32
$922.01
$878.10
$147.52
$140.50
$1,156.93
$1,101.83
$185.11
$176.29
$403.89
$384.65
$64.62
$61.54
$362.35
$345.09
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
2
2
23105
23105
23105
23105
23106
23106
23107
23107
23107
23107
23120
23120
23120
23120
23125
23125
23125
23125
23130
23130
23140
23140
23145
23145
23145
23145
23146
23146
23150
23150
23150
23150
23155
23155
23155
23155
23156
23156
23156
23156
23170
23170
23172
23172
23172
23172
23174
23174
23174
23174
23180
23180
23182
23182
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
18.17
18.17
2.91
2.91
14.09
14.09
18.84
18.84
3.01
3.01
16.66
16.66
2.67
2.67
20.16
20.16
3.23
3.23
17.31
17.31
15.06
15.06
19.77
19.77
3.16
3.16
17.64
17.64
18.78
18.78
3.00
3.00
22.57
22.57
3.61
3.61
19.28
19.28
3.08
3.08
15.92
15.92
16.11
16.11
2.58
2.58
21.55
21.55
3.45
3.45
18.96
18.96
18.81
18.81
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$509.98
$485.69
$81.68
$77.79
$395.47
$376.63
$528.79
$503.60
$84.48
$80.46
$467.60
$445.33
$74.94
$71.37
$565.83
$538.89
$90.66
$86.34
$485.84
$462.70
$422.69
$402.56
$554.89
$528.46
$88.69
$84.47
$495.11
$471.53
$527.10
$502.00
$84.20
$80.19
$633.48
$603.31
$101.32
$96.50
$541.14
$515.36
$86.45
$82.33
$446.83
$425.55
$452.16
$430.63
$72.41
$68.96
$604.85
$576.04
$96.83
$92.22
$532.15
$506.81
$527.94
$502.80
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$509.98
$485.69
$81.68
$77.79
$395.47
$376.63
$528.79
$503.60
$84.48
$80.46
$467.60
$445.33
$74.94
$71.37
$565.83
$538.89
$90.66
$86.34
$485.84
$462.70
$422.69
$402.56
$554.89
$528.46
$88.69
$84.47
$495.11
$471.53
$527.10
$502.00
$84.20
$80.19
$633.48
$603.31
$101.32
$96.50
$541.14
$515.36
$86.45
$82.33
$446.83
$425.55
$452.16
$430.63
$72.41
$68.96
$604.85
$576.04
$96.83
$92.22
$532.15
$506.81
$527.94
$502.80
18.32
18.32
$28.0672
$26.7305
14.28
14.28
18.97
18.97
$28.0672
$26.7305
$28.0672
$26.7305
16.80
16.80
$28.0672
$26.7305
20.44
20.44
$28.0672
$26.7305
17.55
17.55
15.18
15.18
20.04
20.04
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
17.89
17.89
19.07
19.07
$28.0672
$26.7305
$28.0672
$26.7305
22.87
22.87
$28.0672
$26.7305
19.54
19.54
$28.0672
$26.7305
16.13
16.13
16.29
16.29
$28.0672
$26.7305
$28.0672
$26.7305
21.84
21.84
$28.0672
$26.7305
19.22
19.22
18.97
18.97
$28.0672
$26.7305
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$514.19
$489.70
$82.27
$78.35
$400.80
$381.71
$532.43
$507.08
$85.19
$81.13
$471.53
$449.07
$75.44
$71.85
$573.69
$546.37
$91.79
$87.42
$492.58
$469.12
$426.06
$405.77
$562.47
$535.68
$90.00
$85.71
$502.12
$478.21
$535.24
$509.75
$85.64
$81.56
$641.90
$611.33
$102.70
$97.81
$548.43
$522.31
$87.75
$83.57
$452.72
$431.16
$457.21
$435.44
$73.15
$69.67
$612.99
$583.79
$98.08
$93.41
$539.45
$513.76
$532.43
$507.08
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$514.19
$489.70
$82.27
$78.35
$400.80
$381.71
$532.43
$507.08
$85.19
$81.13
$471.53
$449.07
$75.44
$71.85
$573.69
$546.37
$91.79
$87.42
$492.58
$469.12
$426.06
$405.77
$562.47
$535.68
$90.00
$85.71
$502.12
$478.21
$535.24
$509.75
$85.64
$81.56
$641.90
$611.33
$102.70
$97.81
$548.43
$522.31
$87.75
$83.57
$452.72
$431.16
$457.21
$435.44
$73.15
$69.67
$612.99
$583.79
$98.08
$93.41
$539.45
$513.76
$532.43
$507.08
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
23182
23182
23184
23184
23184
23184
23190
23190
23190
23190
23195
23195
23195
23195
23200
23200
23200
23200
23210
23210
23210
23210
23220
23220
23220
23220
23330
23330
23330
23330
23333
23333
23334
23334
23335
23335
23350
23350
23350
23350
23395
23395
23395
23395
23397
23397
23397
23397
23400
23400
23400
23400
23405
23405
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
N/F
N/F
N/F
N/F
N/F
N/F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
3.01
3.01
20.91
20.91
3.35
3.35
16.22
16.22
2.60
2.60
21.49
21.49
3.44
3.44
43.33
43.33
6.93
6.93
50.96
50.96
8.15
8.15
55.90
55.90
8.94
8.94
6.80
4.30
6.80
4.30
13.01
13.01
30.71
30.71
36.62
36.62
3.66
1.48
3.66
1.48
36.74
36.74
5.88
5.88
32.57
32.57
5.21
5.21
27.68
27.68
4.43
4.43
17.93
17.93
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$84.48
$80.46
$586.89
$558.93
$94.03
$89.55
$455.25
$433.57
$72.97
$69.50
$603.16
$574.44
$96.55
$91.95
$1,216.15
$1,158.23
$194.51
$185.24
$1,430.30
$1,362.19
$228.75
$217.85
$1,568.96
$1,494.23
$250.92
$238.97
$190.86
$120.69
$181.77
$114.94
$365.15
$347.76
$861.94
$820.89
$1,027.82
$978.87
$102.73
$41.54
$97.83
$39.56
$1,031.19
$982.08
$165.04
$157.18
$914.15
$870.61
$146.23
$139.27
$776.90
$739.90
$124.34
$118.42
$503.24
$479.28
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$84.48
$80.46
$586.89
$558.93
$94.03
$89.55
$455.25
$433.57
$72.97
$69.50
$603.16
$574.44
$96.55
$91.95
$1,216.15
$1,158.23
$194.51
$185.24
$1,430.30
$1,362.19
$228.75
$217.85
$1,568.96
$1,494.23
$250.92
$238.97
$190.86
$120.69
$181.77
$114.94
$365.15
$347.76
$861.94
$820.89
$1,027.82
$978.87
$102.73
$41.54
$97.83
$39.56
$1,031.19
$982.08
$165.04
$157.18
$914.15
$870.61
$146.23
$139.27
$776.90
$739.90
$124.34
$118.42
$503.24
$479.28
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
21.16
21.16
$28.0672
$26.7305
16.45
16.45
$28.0672
$26.7305
21.78
21.78
$28.0672
$26.7305
43.87
43.87
$28.0672
$26.7305
51.57
51.57
$28.0672
$26.7305
56.53
56.53
$28.0672
$26.7305
6.88
4.40
6.88
4.40
13.08
13.08
30.88
30.88
36.78
36.78
3.73
1.48
3.73
1.48
37.00
37.00
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
32.98
32.98
$28.0672
$26.7305
28.01
28.01
$28.0672
$26.7305
17.97
17.97
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$85.19
$81.13
$593.90
$565.62
$95.02
$90.50
$461.71
$439.72
$73.87
$70.36
$611.30
$582.19
$97.81
$93.15
$1,231.31
$1,172.67
$197.01
$187.63
$1,447.43
$1,378.49
$231.59
$220.56
$1,586.64
$1,511.08
$253.86
$241.77
$193.10
$123.50
$183.91
$117.61
$367.12
$349.63
$866.72
$825.44
$1,032.31
$983.15
$104.69
$41.54
$99.70
$39.56
$1,038.49
$989.03
$166.16
$158.24
$925.66
$881.57
$148.11
$141.05
$786.16
$748.72
$125.79
$119.80
$504.37
$480.35
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$85.19
$81.13
$593.90
$565.62
$95.02
$90.50
$461.71
$439.72
$73.87
$70.36
$611.30
$582.19
$97.81
$93.15
$1,231.31
$1,172.67
$197.01
$187.63
$1,447.43
$1,378.49
$231.59
$220.56
$1,586.64
$1,511.08
$253.86
$241.77
$193.10
$123.50
$183.91
$117.61
$367.12
$349.63
$866.72
$825.44
$1,032.31
$983.15
$104.69
$41.54
$99.70
$39.56
$1,038.49
$989.03
$166.16
$158.24
$925.66
$881.57
$148.11
$141.05
$786.16
$748.72
$125.79
$119.80
$504.37
$480.35
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
23405
23405
23406
23406
23406
23406
23410
23410
23410
23410
23412
23412
23412
23412
23415
23415
23420
23420
23420
23420
23430
23430
23430
23430
23440
23440
23440
23440
23450
23450
23450
23450
23455
23455
23455
23455
23460
23460
23460
23460
23462
23462
23462
23462
23465
23465
23465
23465
23466
23466
23466
23466
23470
23470
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
2.87
2.87
22.01
22.01
3.52
3.52
23.43
23.43
3.75
3.75
24.33
24.33
3.89
3.89
19.82
19.82
27.65
27.65
4.42
4.42
21.33
21.33
3.41
3.41
21.57
21.57
3.45
3.45
27.04
27.04
4.33
4.33
28.63
28.63
4.58
4.58
31.09
31.09
4.97
4.97
30.61
30.61
4.90
4.90
31.89
31.89
5.10
5.10
32.02
32.02
5.12
5.12
34.50
34.50
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$80.55
$76.72
$617.76
$588.34
$98.80
$94.09
$657.61
$626.30
$105.25
$100.24
$682.87
$650.35
$109.18
$103.98
$556.29
$529.80
$776.06
$739.10
$124.06
$118.15
$598.67
$570.16
$95.71
$91.15
$605.41
$576.58
$96.83
$92.22
$758.94
$722.79
$121.53
$115.74
$803.56
$765.29
$128.55
$122.43
$872.61
$831.05
$139.49
$132.85
$859.14
$818.22
$137.53
$130.98
$895.06
$852.44
$143.14
$136.33
$898.71
$855.91
$143.70
$136.86
$968.32
$922.20
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$80.55
$76.72
$617.76
$588.34
$98.80
$94.09
$657.61
$626.30
$105.25
$100.24
$682.87
$650.35
$109.18
$103.98
$556.29
$529.80
$776.06
$739.10
$124.06
$118.15
$598.67
$570.16
$95.71
$91.15
$605.41
$576.58
$96.83
$92.22
$758.94
$722.79
$121.53
$115.74
$803.56
$765.29
$128.55
$122.43
$872.61
$831.05
$139.49
$132.85
$859.14
$818.22
$137.53
$130.98
$895.06
$852.44
$143.14
$136.33
$898.71
$855.91
$143.70
$136.86
$968.32
$922.20
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
22.18
22.18
$28.0672
$26.7305
23.67
23.67
$28.0672
$26.7305
24.53
24.53
$28.0672
$26.7305
20.09
20.09
27.89
27.89
$28.0672
$26.7305
$28.0672
$26.7305
21.49
21.49
$28.0672
$26.7305
21.76
21.76
$28.0672
$26.7305
27.38
27.38
$28.0672
$26.7305
28.86
28.86
$28.0672
$26.7305
31.47
31.47
$28.0672
$26.7305
30.74
30.74
$28.0672
$26.7305
32.36
32.36
$28.0672
$26.7305
32.39
32.39
$28.0672
$26.7305
34.70
34.70
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$80.70
$76.86
$622.53
$592.88
$99.60
$94.86
$664.35
$632.71
$106.30
$101.23
$688.49
$655.70
$110.16
$104.91
$563.87
$537.02
$782.79
$745.51
$125.25
$119.28
$603.16
$574.44
$96.51
$91.91
$610.74
$581.66
$97.72
$93.07
$768.48
$731.88
$122.96
$117.10
$810.02
$771.44
$129.60
$123.43
$883.27
$841.21
$141.32
$134.59
$862.79
$821.70
$138.05
$131.47
$908.25
$865.00
$145.32
$138.40
$909.10
$865.80
$145.46
$138.53
$973.93
$927.55
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$80.70
$76.86
$622.53
$592.88
$99.60
$94.86
$664.35
$632.71
$106.30
$101.23
$688.49
$655.70
$110.16
$104.91
$563.87
$537.02
$782.79
$745.51
$125.25
$119.28
$603.16
$574.44
$96.51
$91.91
$610.74
$581.66
$97.72
$93.07
$768.48
$731.88
$122.96
$117.10
$810.02
$771.44
$129.60
$123.43
$883.27
$841.21
$141.32
$134.59
$862.79
$821.70
$138.05
$131.47
$908.25
$865.00
$145.32
$138.40
$909.10
$865.80
$145.46
$138.53
$973.93
$927.55
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
8
8
2
2
23470
23470
23472
23472
23472
23472
23473
23473
23473
23473
23474
23474
23474
23474
23480
23480
23485
23485
23485
23485
23490
23490
23490
23490
23491
23491
23491
23491
23500
23500
23500
23500
23505
23505
23505
23505
23515
23515
23515
23515
23520
23520
23520
23520
23525
23525
23525
23525
23530
23530
23530
23530
23532
23532
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
F
F
F
F
N
F
N
F
N
F
N
F
F
F
F
F
F
F
5.52
5.52
41.85
41.85
6.70
6.70
46.67
46.67
7.47
7.47
50.45
50.45
8.07
8.07
23.37
23.37
27.27
27.27
4.36
4.36
24.57
24.57
3.93
3.93
28.92
28.92
4.63
4.63
6.19
6.29
6.19
6.29
9.98
9.44
9.98
9.44
20.56
20.56
3.29
3.29
6.51
6.61
6.51
6.61
10.83
10.03
10.83
10.03
16.27
16.27
2.60
2.60
17.73
17.73
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$154.93
$147.55
$1,174.61
$1,118.67
$188.05
$179.09
$1,309.90
$1,247.51
$209.66
$199.68
$1,415.99
$1,348.55
$226.50
$215.72
$655.93
$624.69
$765.39
$728.94
$122.37
$116.54
$689.61
$656.77
$110.30
$105.05
$811.70
$773.05
$129.95
$123.76
$173.74
$176.54
$165.46
$168.13
$280.11
$264.95
$266.77
$252.34
$577.06
$549.58
$92.34
$87.94
$182.72
$185.52
$174.02
$176.69
$303.97
$281.51
$289.49
$268.11
$456.65
$434.91
$72.97
$69.50
$497.63
$473.93
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$154.93
$147.55
$1,174.61
$1,118.67
$188.05
$179.09
$1,309.90
$1,247.51
$209.66
$199.68
$1,415.99
$1,348.55
$226.50
$215.72
$655.93
$624.69
$765.39
$728.94
$122.37
$116.54
$689.61
$656.77
$110.30
$105.05
$811.70
$773.05
$129.95
$123.76
$173.74
$176.54
$165.46
$168.13
$280.11
$264.95
$266.77
$252.34
$577.06
$549.58
$92.34
$87.94
$182.72
$185.52
$174.02
$176.69
$303.97
$281.51
$289.49
$268.11
$456.65
$434.91
$72.97
$69.50
$497.63
$473.93
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
42.05
42.05
$28.0672
$26.7305
46.97
46.97
$28.0672
$26.7305
50.80
50.80
$28.0672
$26.7305
23.68
23.68
27.49
27.49
$28.0672
$26.7305
$28.0672
$26.7305
24.87
24.87
$28.0672
$26.7305
29.21
29.21
$28.0672
$26.7305
6.20
6.30
6.20
6.30
10.07
9.50
10.07
9.50
20.71
20.71
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
6.61
6.70
6.61
6.70
11.01
10.19
11.01
10.19
16.49
16.49
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
17.97
17.97
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$155.83
$148.41
$1,180.23
$1,124.02
$188.84
$179.84
$1,318.32
$1,255.53
$210.93
$200.88
$1,425.81
$1,357.91
$228.13
$217.27
$664.63
$632.98
$771.57
$734.82
$123.45
$117.57
$698.03
$664.79
$111.68
$106.37
$819.84
$780.80
$131.17
$124.93
$174.02
$176.82
$165.73
$168.40
$282.64
$266.64
$269.18
$253.94
$581.27
$553.59
$93.00
$88.57
$185.52
$188.05
$176.69
$179.09
$309.02
$286.00
$294.30
$272.38
$462.83
$440.79
$74.05
$70.53
$504.37
$480.35
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$155.83
$148.41
$1,180.23
$1,124.02
$188.84
$179.84
$1,318.32
$1,255.53
$210.93
$200.88
$1,425.81
$1,357.91
$228.13
$217.27
$664.63
$632.98
$771.57
$734.82
$123.45
$117.57
$698.03
$664.79
$111.68
$106.37
$819.84
$780.80
$131.17
$124.93
$174.02
$176.82
$165.73
$168.40
$282.64
$266.64
$269.18
$253.94
$581.27
$553.59
$93.00
$88.57
$185.52
$188.05
$176.69
$179.09
$309.02
$286.00
$294.30
$272.38
$462.83
$440.79
$74.05
$70.53
$504.37
$480.35
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
8
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
23532
23532
23540
23540
23540
23540
23545
23545
23545
23545
23550
23550
23550
23550
23552
23552
23552
23552
23570
23570
23570
23570
23575
23575
23575
23575
23585
23585
23585
23585
23600
23600
23600
23600
23605
23605
23605
23605
23615
23615
23615
23615
23616
23616
23616
23616
23620
23620
23620
23620
23625
23625
23625
23625
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
N
F
N
F
N
F
N
F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
F
F
F
F
N
F
N
F
N
F
N
F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
2.84
2.84
6.34
6.44
6.34
6.44
9.63
8.77
9.63
8.77
16.30
16.30
2.61
2.61
18.66
18.66
2.99
2.99
6.54
6.74
6.54
6.74
11.30
10.61
11.30
10.61
28.01
28.01
4.48
4.48
9.22
8.71
9.22
8.71
13.15
12.07
13.15
12.07
25.26
25.26
4.04
4.04
35.51
35.51
5.68
5.68
7.61
7.25
7.61
7.25
10.75
10.03
10.75
10.03
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$79.71
$75.91
$177.95
$180.75
$169.47
$172.14
$270.29
$246.15
$257.41
$234.43
$457.50
$435.71
$73.26
$69.77
$523.73
$498.79
$83.92
$79.92
$183.56
$189.17
$174.82
$180.16
$317.16
$297.79
$302.05
$283.61
$786.16
$748.72
$125.74
$119.75
$258.78
$244.47
$246.46
$232.82
$369.08
$338.77
$351.51
$322.64
$708.98
$675.21
$113.39
$107.99
$996.67
$949.20
$159.42
$151.83
$213.59
$203.49
$203.42
$193.80
$301.72
$281.51
$287.35
$268.11
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$79.71
$75.91
$177.95
$180.75
$169.47
$172.14
$270.29
$246.15
$257.41
$234.43
$457.50
$435.71
$73.26
$69.77
$523.73
$498.79
$83.92
$79.92
$183.56
$189.17
$174.82
$180.16
$317.16
$297.79
$302.05
$283.61
$786.16
$748.72
$125.74
$119.75
$258.78
$244.47
$246.46
$232.82
$369.08
$338.77
$351.51
$322.64
$708.98
$675.21
$113.39
$107.99
$996.67
$949.20
$159.42
$151.83
$213.59
$203.49
$203.42
$193.80
$301.72
$281.51
$287.35
$268.11
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
6.41
6.51
6.41
6.51
9.70
8.81
9.70
8.81
16.29
16.29
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
18.76
18.76
$28.0672
$26.7305
6.61
6.81
6.61
6.81
11.47
10.75
11.47
10.75
28.23
28.23
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
9.28
8.74
9.28
8.74
13.25
12.14
13.25
12.14
25.46
25.46
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
35.81
35.81
$28.0672
$26.7305
7.69
7.32
7.69
7.32
10.86
10.12
10.86
10.12
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$80.70
$76.86
$179.91
$182.72
$171.34
$174.02
$272.25
$247.27
$259.29
$235.50
$457.21
$435.44
$73.15
$69.67
$526.54
$501.46
$84.25
$80.23
$185.52
$191.14
$176.69
$182.03
$321.93
$301.72
$306.60
$287.35
$792.34
$754.60
$126.77
$120.74
$260.46
$245.31
$248.06
$233.62
$371.89
$340.74
$354.18
$324.51
$714.59
$680.56
$114.33
$108.89
$1,005.09
$957.22
$160.81
$153.16
$215.84
$205.45
$205.56
$195.67
$304.81
$284.04
$290.29
$270.51
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$80.70
$76.86
$179.91
$182.72
$171.34
$174.02
$272.25
$247.27
$259.29
$235.50
$457.21
$435.44
$73.15
$69.67
$526.54
$501.46
$84.25
$80.23
$185.52
$191.14
$176.69
$182.03
$321.93
$301.72
$306.60
$287.35
$792.34
$754.60
$126.77
$120.74
$260.46
$245.31
$248.06
$233.62
$371.89
$340.74
$354.18
$324.51
$714.59
$680.56
$114.33
$108.89
$1,005.09
$957.22
$160.81
$153.16
$215.84
$205.45
$205.56
$195.67
$304.81
$284.04
$290.29
$270.51
Musculoskeletal System Surgery
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
TOS*
Procedure
Code
Age
Range
2
2
8
8
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
8
8
2
2
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
23630
23630
23630
23630
23650
23650
23650
23650
23655
23655
23660
23660
23660
23660
23665
23665
23665
23665
23670
23670
23670
23670
23675
23675
23680
23680
23680
23680
23700
23700
23800
23800
23800
23800
23802
23802
23802
23802
23900
23900
23900
23900
23920
23920
23920
23920
23921
23921
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
F
F
F
F
N
F
N
F
F
F
F
F
F
F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
2
23929
0-999
F
8
2
2
2
23929
23930
23930
23930
0-999
0-20
0-20
21-999
F
N
F
N
22.32
22.32
3.57
3.57
8.87
8.16
8.87
8.16
11.32
11.32
16.61
16.61
2.66
2.66
12.05
11.24
12.05
11.24
25.05
25.05
4.01
4.01
14.20
14.20
26.51
26.51
4.24
4.24
5.56
5.56
29.27
29.27
4.68
4.68
36.62
36.62
5.86
5.86
39.66
39.66
6.35
6.35
32.15
32.15
5.14
5.14
13.50
13.50
9.93
6.12
9.93
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$626.46
$596.62
$100.20
$95.43
$248.96
$229.03
$237.10
$218.12
$317.72
$302.59
$466.20
$443.99
$74.66
$71.10
$338.21
$315.48
$322.10
$300.45
$703.08
$669.60
$112.55
$107.19
$398.55
$379.57
$744.06
$708.63
$119.00
$113.34
$156.05
$148.62
$821.53
$782.40
$131.35
$125.10
$1,027.82
$978.87
$164.47
$156.64
$1,113.15
$1,060.13
$178.23
$169.74
$902.36
$859.39
$144.27
$137.39
$378.91
$360.86
Manually
Priced
Manually
Priced
$278.71
$171.77
$265.43
Current
Percent
Reduction
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
2%
0%
0%
0%
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
$626.46
$596.62
$100.20
$95.43
$248.96
$229.03
$237.10
$218.12
$317.72
$302.59
$466.20
$443.99
$74.66
$71.10
$338.21
$315.48
$322.10
$300.45
$703.08
$669.60
$112.55
$107.19
$398.55
$379.57
$744.06
$708.63
$119.00
$113.34
$156.05
$148.62
$821.53
$782.40
$131.35
$125.10
$1,027.82
$978.87
$164.47
$156.64
$1,113.15
$1,060.13
$178.23
$169.74
$902.36
$859.39
$144.27
$137.39
$378.91
$360.86
Manually
Priced
Manually
Priced
$278.71
$171.77
$265.43
22.48
22.48
$28.0672
$26.7305
8.92
8.18
8.92
8.18
11.49
11.49
16.66
16.66
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
12.12
11.29
12.12
11.29
25.28
25.28
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
14.41
14.41
26.78
26.78
$28.0672
$26.7305
$28.0672
$26.7305
5.66
5.66
29.61
29.61
$28.0672
$26.7305
$28.0672
$26.7305
37.11
37.11
$28.0672
$26.7305
40.15
40.15
$28.0672
$26.7305
32.56
32.56
$28.0672
$26.7305
13.19
13.19
$28.0672
$26.7305
10.02
6.19
10.02
$28.0672
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
$630.95
$600.90
$100.95
$96.14
$250.36
$229.59
$238.44
$218.66
$322.49
$307.13
$467.60
$445.33
$74.82
$71.25
$340.17
$316.88
$323.97
$301.79
$709.54
$675.75
$113.53
$108.12
$404.45
$385.19
$751.64
$715.84
$120.26
$114.53
$158.86
$151.29
$831.07
$791.49
$132.97
$126.64
$1,041.57
$991.97
$166.65
$158.72
$1,126.90
$1,073.23
$180.30
$171.72
$913.87
$870.35
$146.22
$139.26
$370.21
$352.58
Manually
Priced
Manually
Priced
$281.23
$173.74
$267.84
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
2%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$630.95
$600.90
$100.95
$96.14
$250.36
$229.59
$238.44
$218.66
$322.49
$307.13
$467.60
$445.33
$74.82
$71.25
$340.17
$316.88
$323.97
$301.79
$709.54
$675.75
$113.53
$108.12
$404.45
$385.19
$751.64
$715.84
$120.26
$114.53
$158.86
$151.29
$831.07
$791.49
$132.97
$126.64
$1,041.57
$991.97
$166.65
$158.72
$1,126.90
$1,073.23
$180.30
$171.72
$913.87
$870.35
$146.22
$139.26
$370.21
$352.58
Manually
Priced
Manually
Priced
$281.23
$173.74
$267.84
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
23930
23931
23931
23931
23931
23935
23935
24000
24000
24006
24006
24006
24006
24065
24065
24065
24065
24066
24066
24066
24066
24071
24071
24071
24071
24073
24073
24073
24073
24075
24075
24075
24075
24076
24076
24077
24077
24079
24079
24079
24079
24100
24100
24100
24100
24101
24101
24101
24101
24102
24102
24102
24102
24105
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
N
F
N
F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
6.12
8.13
4.56
8.13
4.56
14.47
14.47
13.56
13.56
20.26
20.26
3.24
3.24
7.21
4.77
7.21
4.77
17.39
11.70
17.39
11.70
11.53
11.53
1.84
1.84
19.65
19.65
3.14
3.14
13.79
9.35
13.79
9.35
15.44
15.44
29.57
29.57
37.87
37.87
6.06
6.06
11.86
11.86
1.90
1.90
14.19
14.19
2.27
2.27
17.52
17.52
2.80
2.80
9.90
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$163.59
$228.19
$127.99
$217.32
$121.89
$406.13
$386.79
$380.59
$362.47
$568.64
$541.56
$90.94
$86.61
$202.36
$133.88
$192.73
$127.50
$488.09
$328.39
$464.84
$312.75
$323.61
$308.20
$51.64
$49.18
$551.52
$525.25
$88.13
$83.93
$387.05
$262.43
$368.61
$249.93
$433.36
$412.72
$829.95
$790.42
$1,062.90
$1,012.28
$170.09
$161.99
$332.88
$317.02
$53.33
$50.79
$398.27
$379.31
$63.71
$60.68
$491.74
$468.32
$78.59
$74.85
$277.87
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$163.59
$228.19
$127.99
$217.32
$121.89
$406.13
$386.79
$380.59
$362.47
$568.64
$541.56
$90.94
$86.61
$202.36
$133.88
$192.73
$127.50
$488.09
$328.39
$464.84
$312.75
$323.61
$308.20
$51.64
$49.18
$551.52
$525.25
$88.13
$83.93
$387.05
$262.43
$368.61
$249.93
$433.36
$412.72
$829.95
$790.42
$1,062.90
$1,012.28
$170.09
$161.99
$332.88
$317.02
$53.33
$50.79
$398.27
$379.31
$63.71
$60.68
$491.74
$468.32
$78.59
$74.85
$277.87
6.19
8.17
4.59
8.17
4.59
14.52
14.52
13.71
13.71
20.45
20.45
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
7.28
4.81
7.28
4.81
17.87
11.95
17.87
11.95
11.65
11.65
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
19.99
19.99
$28.0672
$26.7305
13.99
9.44
13.99
9.44
15.56
15.56
29.76
29.76
38.21
38.21
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
12.00
12.00
$28.0672
$26.7305
14.35
14.35
$28.0672
$26.7305
17.66
17.66
$28.0672
$26.7305
10.04
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$165.46
$229.31
$128.83
$218.39
$122.69
$407.54
$388.13
$384.80
$366.48
$573.97
$546.64
$91.84
$87.46
$204.33
$135.00
$194.60
$128.57
$501.56
$335.40
$477.67
$319.43
$326.98
$311.41
$52.32
$49.83
$561.06
$534.34
$89.77
$85.49
$392.66
$264.95
$373.96
$252.34
$436.73
$415.93
$835.28
$795.50
$1,072.45
$1,021.37
$171.59
$163.42
$336.81
$320.77
$53.89
$51.32
$402.76
$383.58
$64.44
$61.37
$495.67
$472.06
$79.31
$75.53
$281.79
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$165.46
$229.31
$128.83
$218.39
$122.69
$407.54
$388.13
$384.80
$366.48
$573.97
$546.64
$91.84
$87.46
$204.33
$135.00
$194.60
$128.57
$501.56
$335.40
$477.67
$319.43
$326.98
$311.41
$52.32
$49.83
$561.06
$534.34
$89.77
$85.49
$392.66
$264.95
$373.96
$252.34
$436.73
$415.93
$835.28
$795.50
$1,072.45
$1,021.37
$171.59
$163.42
$336.81
$320.77
$53.89
$51.32
$402.76
$383.58
$64.44
$61.37
$495.67
$472.06
$79.31
$75.53
$281.79
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
24105
24110
24110
24115
24115
24115
24115
24116
24116
24116
24116
24120
24120
24125
24125
24125
24125
24126
24126
24126
24126
24130
24130
24134
24134
24134
24134
24136
24136
24138
24138
24138
24138
24140
24140
24140
24140
24145
24145
24147
24147
24149
24149
24149
24149
24150
24150
24150
24150
24152
24152
24152
24152
24155
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
9.90
16.70
16.70
20.98
20.98
3.36
3.36
24.55
24.55
3.93
3.93
15.02
15.02
17.62
17.62
2.82
2.82
18.45
18.45
2.95
2.95
14.41
14.41
21.25
21.25
3.40
3.40
18.11
18.11
19.15
19.15
3.06
3.06
19.89
19.89
3.18
3.18
16.82
16.82
17.67
17.67
33.43
33.43
5.35
5.35
44.50
44.50
7.12
7.12
39.32
39.32
6.29
6.29
24.32
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$264.63
$468.72
$446.40
$588.85
$560.81
$94.31
$89.81
$689.05
$656.23
$110.30
$105.05
$421.57
$401.49
$494.54
$470.99
$79.15
$75.38
$517.84
$493.18
$82.80
$78.85
$404.45
$385.19
$596.43
$568.02
$95.43
$90.88
$508.30
$484.09
$537.49
$511.89
$85.89
$81.80
$558.26
$531.67
$89.25
$85.00
$472.09
$449.61
$495.95
$472.33
$938.29
$893.60
$150.16
$143.01
$1,248.99
$1,189.51
$199.84
$190.32
$1,103.60
$1,051.04
$176.54
$168.13
$682.59
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$264.63
$468.72
$446.40
$588.85
$560.81
$94.31
$89.81
$689.05
$656.23
$110.30
$105.05
$421.57
$401.49
$494.54
$470.99
$79.15
$75.38
$517.84
$493.18
$82.80
$78.85
$404.45
$385.19
$596.43
$568.02
$95.43
$90.88
$508.30
$484.09
$537.49
$511.89
$85.89
$81.80
$558.26
$531.67
$89.25
$85.00
$472.09
$449.61
$495.95
$472.33
$938.29
$893.60
$150.16
$143.01
$1,248.99
$1,189.51
$199.84
$190.32
$1,103.60
$1,051.04
$176.54
$168.13
$682.59
10.04
16.91
16.91
21.26
21.26
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
24.87
24.87
$28.0672
$26.7305
15.13
15.13
17.87
17.87
$28.0672
$26.7305
$28.0672
$26.7305
18.68
18.68
$28.0672
$26.7305
14.55
14.55
21.55
21.55
$28.0672
$26.7305
$28.0672
$26.7305
16.65
16.65
19.43
19.43
$28.0672
$26.7305
$28.0672
$26.7305
20.24
20.24
$28.0672
$26.7305
17.04
17.04
17.91
17.91
33.74
33.74
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
45.04
45.04
$28.0672
$26.7305
39.10
39.10
$28.0672
$26.7305
24.61
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$268.37
$474.62
$452.01
$596.71
$568.29
$95.47
$90.93
$698.03
$664.79
$111.68
$106.37
$424.66
$404.43
$501.56
$477.67
$80.25
$76.43
$524.30
$499.33
$83.89
$79.89
$408.38
$388.93
$604.85
$576.04
$96.78
$92.17
$467.32
$445.06
$545.35
$519.37
$87.26
$83.10
$568.08
$541.03
$90.89
$86.56
$478.27
$455.49
$502.68
$478.74
$946.99
$901.89
$151.52
$144.30
$1,264.15
$1,203.94
$202.26
$192.63
$1,097.43
$1,045.16
$175.59
$167.23
$690.73
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$268.37
$474.62
$452.01
$596.71
$568.29
$95.47
$90.93
$698.03
$664.79
$111.68
$106.37
$424.66
$404.43
$501.56
$477.67
$80.25
$76.43
$524.30
$499.33
$83.89
$79.89
$408.38
$388.93
$604.85
$576.04
$96.78
$92.17
$467.32
$445.06
$545.35
$519.37
$87.26
$83.10
$568.08
$541.03
$90.89
$86.56
$478.27
$455.49
$502.68
$478.74
$946.99
$901.89
$151.52
$144.30
$1,264.15
$1,203.94
$202.26
$192.63
$1,097.43
$1,045.16
$175.59
$167.23
$690.73
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
24155
24155
24155
24160
24160
24164
24164
24200
24200
24200
24200
24201
24201
24201
24201
24220
24220
24220
24220
24300
24300
24301
24301
24301
24301
24305
24305
24310
24310
24320
24320
24320
24320
24330
24330
24330
24330
24331
24331
24331
24331
24332
24332
24340
24340
24340
24340
24341
24341
24341
24341
24342
24342
24342
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
24.32
3.89
3.89
35.99
35.99
20.76
20.76
5.80
3.96
5.80
3.96
15.81
10.48
15.81
10.48
4.50
1.97
4.50
1.97
11.67
11.67
21.44
21.44
3.43
3.43
16.38
16.38
13.52
13.52
22.23
22.23
3.56
3.56
20.41
20.41
3.27
3.27
22.39
22.39
3.58
3.58
17.40
17.40
17.50
17.50
2.80
2.80
21.27
21.27
3.40
3.40
22.14
22.14
3.54
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$650.09
$109.18
$103.98
$1,010.14
$962.03
$582.68
$554.93
$162.79
$111.15
$155.04
$105.85
$443.74
$294.14
$422.61
$280.14
$126.30
$55.29
$120.29
$52.66
$327.54
$311.94
$601.76
$573.10
$96.27
$91.69
$459.74
$437.85
$379.47
$361.40
$623.93
$594.22
$99.92
$95.16
$572.85
$545.57
$91.78
$87.41
$628.42
$598.50
$100.48
$95.70
$488.37
$465.11
$491.18
$467.78
$78.59
$74.85
$596.99
$568.56
$95.43
$90.88
$621.41
$591.81
$99.36
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$650.09
$109.18
$103.98
$1,010.14
$962.03
$582.68
$554.93
$162.79
$111.15
$155.04
$105.85
$443.74
$294.14
$422.61
$280.14
$126.30
$55.29
$120.29
$52.66
$327.54
$311.94
$601.76
$573.10
$96.27
$91.69
$459.74
$437.85
$379.47
$361.40
$623.93
$594.22
$99.92
$95.16
$572.85
$545.57
$91.78
$87.41
$628.42
$598.50
$100.48
$95.70
$488.37
$465.11
$491.18
$467.78
$78.59
$74.85
$596.99
$568.56
$95.43
$90.88
$621.41
$591.81
$99.36
24.61
$26.7305
36.31
36.31
20.94
20.94
5.91
4.03
5.91
4.03
15.95
10.53
15.95
10.53
4.57
1.99
4.57
1.99
11.95
11.95
21.42
21.42
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
16.49
16.49
13.55
13.55
22.52
22.52
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
20.69
20.69
$28.0672
$26.7305
22.67
22.67
$28.0672
$26.7305
17.63
17.63
17.58
17.58
$28.0672
$26.7305
$28.0672
$26.7305
21.43
21.43
$28.0672
$26.7305
22.31
22.31
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$657.84
$110.52
$105.25
$1,019.12
$970.58
$587.73
$559.74
$165.88
$113.11
$157.98
$107.72
$447.67
$295.55
$426.35
$281.47
$128.27
$55.85
$122.16
$53.19
$335.40
$319.43
$601.20
$572.57
$96.19
$91.61
$462.83
$440.79
$380.31
$362.20
$632.07
$601.97
$101.13
$96.32
$580.71
$553.05
$92.91
$88.49
$636.28
$605.98
$101.80
$96.96
$494.82
$471.26
$493.42
$469.92
$78.95
$75.19
$601.48
$572.83
$96.24
$91.65
$626.18
$596.36
$100.19
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$657.84
$110.52
$105.25
$1,019.12
$970.58
$587.73
$559.74
$165.88
$113.11
$157.98
$107.72
$447.67
$295.55
$426.35
$281.47
$128.27
$55.85
$122.16
$53.19
$335.40
$319.43
$601.20
$572.57
$96.19
$91.61
$462.83
$440.79
$380.31
$362.20
$632.07
$601.97
$101.13
$96.32
$580.71
$553.05
$92.91
$88.49
$636.28
$605.98
$101.80
$96.96
$494.82
$471.26
$493.42
$469.92
$78.95
$75.19
$601.48
$572.83
$96.24
$91.65
$626.18
$596.36
$100.19
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
24342
24343
24343
24343
24343
24344
24344
24344
24344
24345
24345
24345
24345
24346
24346
24346
24346
24357
24357
24358
24358
24359
24359
24360
24360
24360
24360
24361
24361
24361
24361
24362
24362
24362
24362
24363
24363
24363
24363
24365
24365
24365
24365
24366
24366
24366
24366
24370
24370
24370
24370
24371
24371
24371
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
3.54
20.06
20.06
3.21
3.21
31.30
31.30
5.01
5.01
19.95
19.95
3.19
3.19
31.30
31.30
5.01
5.01
12.51
12.51
14.86
14.86
18.78
18.78
25.60
25.60
4.10
4.10
28.69
28.69
4.59
4.59
30.25
30.25
4.84
4.84
41.69
41.69
6.67
6.67
18.17
18.17
2.91
2.91
19.39
19.39
3.10
3.10
44.13
44.13
7.06
7.06
50.97
50.97
8.16
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$94.63
$563.03
$536.21
$90.10
$85.80
$878.50
$836.66
$140.62
$133.92
$559.94
$533.27
$89.53
$85.27
$878.50
$836.66
$140.62
$133.92
$351.12
$334.40
$417.08
$397.22
$527.10
$502.00
$718.52
$684.30
$115.08
$109.60
$805.25
$766.90
$128.83
$122.69
$849.03
$808.60
$135.85
$129.38
$1,170.12
$1,114.39
$187.21
$178.29
$509.98
$485.69
$81.68
$77.79
$544.22
$518.30
$87.01
$82.86
$1,238.61
$1,179.62
$198.15
$188.72
$1,430.59
$1,362.45
$229.03
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$94.63
$563.03
$536.21
$90.10
$85.80
$878.50
$836.66
$140.62
$133.92
$559.94
$533.27
$89.53
$85.27
$878.50
$836.66
$140.62
$133.92
$351.12
$334.40
$417.08
$397.22
$527.10
$502.00
$718.52
$684.30
$115.08
$109.60
$805.25
$766.90
$128.83
$122.69
$849.03
$808.60
$135.85
$129.38
$1,170.12
$1,114.39
$187.21
$178.29
$509.98
$485.69
$81.68
$77.79
$544.22
$518.30
$87.01
$82.86
$1,238.61
$1,179.62
$198.15
$188.72
$1,430.59
$1,362.45
$229.03
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
20.28
20.28
$28.0672
$26.7305
31.69
31.69
$28.0672
$26.7305
20.39
20.39
$28.0672
$26.7305
31.69
31.69
$28.0672
$26.7305
12.38
12.38
14.99
14.99
18.90
18.90
25.95
25.95
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
29.03
29.03
$28.0672
$26.7305
30.59
30.59
$28.0672
$26.7305
41.98
41.98
$28.0672
$26.7305
18.41
18.41
$28.0672
$26.7305
19.57
19.57
$28.0672
$26.7305
44.78
44.78
$28.0672
$26.7305
51.89
51.89
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$95.42
$569.20
$542.09
$91.07
$86.73
$889.45
$847.09
$142.31
$135.53
$572.29
$545.03
$91.57
$87.20
$889.45
$847.09
$142.31
$135.53
$347.47
$330.92
$420.73
$400.69
$530.47
$505.21
$728.34
$693.66
$116.53
$110.99
$814.79
$775.99
$130.37
$124.16
$858.58
$817.69
$137.37
$130.83
$1,178.26
$1,122.15
$188.52
$179.54
$516.72
$492.11
$82.68
$78.74
$549.28
$523.12
$87.88
$83.70
$1,256.85
$1,196.99
$201.10
$191.52
$1,456.41
$1,387.05
$233.03
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$95.42
$569.20
$542.09
$91.07
$86.73
$889.45
$847.09
$142.31
$135.53
$572.29
$545.03
$91.57
$87.20
$889.45
$847.09
$142.31
$135.53
$347.47
$330.92
$420.73
$400.69
$530.47
$505.21
$728.34
$693.66
$116.53
$110.99
$814.79
$775.99
$130.37
$124.16
$858.58
$817.69
$137.37
$130.83
$1,178.26
$1,122.15
$188.52
$179.54
$516.72
$492.11
$82.68
$78.74
$549.28
$523.12
$87.88
$83.70
$1,256.85
$1,196.99
$201.10
$191.52
$1,456.41
$1,387.05
$233.03
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
24371
24400
24400
24400
24400
24410
24410
24410
24410
24420
24420
24420
24420
24430
24430
24430
24430
24435
24435
24435
24435
24470
24470
24470
24470
24495
24495
24498
24498
24498
24498
24500
24500
24500
24500
24505
24505
24505
24505
24515
24515
24515
24515
24516
24516
24516
24516
24530
24530
24530
24530
24535
24535
24535
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
8.16
23.31
23.31
3.73
3.73
30.14
30.14
4.82
4.82
28.30
28.30
4.53
4.53
30.22
30.22
4.84
4.84
30.77
30.77
4.92
4.92
16.69
16.69
2.67
2.67
18.48
18.48
24.74
24.74
3.96
3.96
10.09
9.20
10.09
9.20
14.12
12.80
14.12
12.80
24.99
24.99
4.00
4.00
24.55
24.55
3.93
3.93
10.72
9.72
10.72
9.72
17.44
16.14
17.44
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$218.12
$654.25
$623.09
$104.69
$99.70
$845.95
$805.66
$135.28
$128.84
$794.30
$756.47
$127.14
$121.09
$848.19
$807.80
$135.85
$129.38
$863.63
$822.50
$138.09
$131.51
$468.44
$446.13
$74.94
$71.37
$518.68
$493.98
$694.38
$661.31
$111.15
$105.85
$283.20
$258.22
$269.71
$245.92
$396.31
$359.26
$377.43
$342.15
$701.40
$668.00
$112.27
$106.92
$689.05
$656.23
$110.30
$105.05
$300.88
$272.81
$286.55
$259.82
$489.49
$453.00
$466.18
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$218.12
$654.25
$623.09
$104.69
$99.70
$845.95
$805.66
$135.28
$128.84
$794.30
$756.47
$127.14
$121.09
$848.19
$807.80
$135.85
$129.38
$863.63
$822.50
$138.09
$131.51
$468.44
$446.13
$74.94
$71.37
$518.68
$493.98
$694.38
$661.31
$111.15
$105.85
$283.20
$258.22
$269.71
$245.92
$396.31
$359.26
$377.43
$342.15
$701.40
$668.00
$112.27
$106.92
$689.05
$656.23
$110.30
$105.05
$300.88
$272.81
$286.55
$259.82
$489.49
$453.00
$466.18
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
23.55
23.55
$28.0672
$26.7305
30.51
30.51
$28.0672
$26.7305
28.63
28.63
$28.0672
$26.7305
30.45
30.45
$28.0672
$26.7305
31.03
31.03
$28.0672
$26.7305
19.33
19.33
$28.0672
$26.7305
15.45
15.45
25.03
25.03
$28.0672
$26.7305
$28.0672
$26.7305
10.22
9.30
10.22
9.30
14.27
12.92
14.27
12.92
25.21
25.21
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
24.77
24.77
$28.0672
$26.7305
10.83
9.81
10.83
9.81
17.54
16.20
17.54
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$221.93
$660.98
$629.50
$105.76
$100.72
$856.33
$815.55
$137.01
$130.49
$803.56
$765.29
$128.57
$122.45
$854.65
$813.94
$136.74
$130.23
$870.93
$829.45
$139.35
$132.71
$542.54
$516.70
$86.81
$82.67
$433.64
$412.99
$702.52
$669.06
$112.40
$107.05
$286.85
$261.02
$273.19
$248.59
$400.52
$362.63
$381.44
$345.36
$707.57
$673.88
$113.21
$107.82
$695.22
$662.11
$111.24
$105.94
$303.97
$275.34
$289.49
$262.23
$492.30
$454.69
$468.85
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$221.93
$660.98
$629.50
$105.76
$100.72
$856.33
$815.55
$137.01
$130.49
$803.56
$765.29
$128.57
$122.45
$854.65
$813.94
$136.74
$130.23
$870.93
$829.45
$139.35
$132.71
$542.54
$516.70
$86.81
$82.67
$433.64
$412.99
$702.52
$669.06
$112.40
$107.05
$286.85
$261.02
$273.19
$248.59
$400.52
$362.63
$381.44
$345.36
$707.57
$673.88
$113.21
$107.82
$695.22
$662.11
$111.24
$105.94
$303.97
$275.34
$289.49
$262.23
$492.30
$454.69
$468.85
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
24535
24538
24538
24545
24545
24545
24545
24546
24546
24546
24546
24560
24560
24560
24560
24565
24565
24565
24565
24566
24566
24575
24575
24575
24575
24576
24576
24576
24576
24577
24577
24577
24577
24579
24579
24579
24579
24582
24582
24586
24586
24586
24586
24587
24587
24587
24587
24600
24600
24600
24600
24605
24605
24615
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
F
F
F
16.14
21.12
21.12
26.54
26.54
4.25
4.25
29.71
29.71
4.75
4.75
9.08
8.16
9.08
8.16
15.06
13.84
15.06
13.84
20.38
20.38
20.91
20.91
3.35
3.35
9.57
8.63
9.57
8.63
15.51
14.23
15.51
14.23
23.80
23.80
3.81
3.81
22.96
22.96
30.98
30.98
4.96
4.96
30.90
30.90
4.94
4.94
10.34
9.50
10.34
9.50
13.31
13.31
20.25
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$431.43
$592.78
$564.55
$744.90
$709.43
$119.29
$113.60
$833.88
$794.16
$133.32
$126.97
$254.85
$229.03
$242.71
$218.12
$422.69
$388.45
$402.56
$369.95
$572.01
$544.77
$586.89
$558.93
$94.03
$89.55
$268.60
$242.22
$255.81
$230.68
$435.32
$399.40
$414.59
$380.38
$668.00
$636.19
$106.94
$101.84
$644.42
$613.73
$869.52
$828.11
$139.21
$132.58
$867.28
$825.97
$138.65
$132.05
$290.21
$266.64
$276.39
$253.94
$373.57
$355.78
$568.36
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$431.43
$592.78
$564.55
$744.90
$709.43
$119.29
$113.60
$833.88
$794.16
$133.32
$126.97
$254.85
$229.03
$242.71
$218.12
$422.69
$388.45
$402.56
$369.95
$572.01
$544.77
$586.89
$558.93
$94.03
$89.55
$268.60
$242.22
$255.81
$230.68
$435.32
$399.40
$414.59
$380.38
$668.00
$636.19
$106.94
$101.84
$644.42
$613.73
$869.52
$828.11
$139.21
$132.58
$867.28
$825.97
$138.65
$132.05
$290.21
$266.64
$276.39
$253.94
$373.57
$355.78
$568.36
16.20
21.41
21.41
26.77
26.77
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
29.92
29.92
$28.0672
$26.7305
9.11
8.15
9.11
8.15
15.27
14.02
15.27
14.02
20.64
20.64
21.11
21.11
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
9.70
8.71
9.70
8.71
15.74
14.43
15.74
14.43
24.03
24.03
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
23.25
23.25
31.22
31.22
$28.0672
$26.7305
$28.0672
$26.7305
31.41
31.41
$28.0672
$26.7305
10.37
9.49
10.37
9.49
13.48
13.48
20.41
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$433.03
$600.92
$572.30
$751.36
$715.58
$120.22
$114.49
$839.77
$799.78
$134.36
$127.96
$255.69
$228.75
$243.51
$217.85
$428.59
$393.50
$408.17
$374.76
$579.31
$551.72
$592.50
$564.28
$94.80
$90.28
$272.25
$244.47
$259.29
$232.82
$441.78
$405.01
$420.74
$385.72
$674.45
$642.33
$107.91
$102.77
$652.56
$621.48
$876.26
$834.53
$140.20
$133.52
$881.59
$839.61
$141.05
$134.34
$291.06
$266.36
$277.20
$253.67
$378.35
$360.33
$572.85
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$433.03
$600.92
$572.30
$751.36
$715.58
$120.22
$114.49
$839.77
$799.78
$134.36
$127.96
$255.69
$228.75
$243.51
$217.85
$428.59
$393.50
$408.17
$374.76
$579.31
$551.72
$592.50
$564.28
$94.80
$90.28
$272.25
$244.47
$259.29
$232.82
$441.78
$405.01
$420.74
$385.72
$674.45
$642.33
$107.91
$102.77
$652.56
$621.48
$876.26
$834.53
$140.20
$133.52
$881.59
$839.61
$141.05
$134.34
$291.06
$266.36
$277.20
$253.67
$378.35
$360.33
$572.85
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
8
8
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
24615
24615
24615
24620
24620
24635
24635
24635
24635
24640
24640
24650
24650
24650
24650
24655
24655
24655
24655
24665
24665
24665
24665
24666
24666
24666
24666
24670
24670
24670
24670
24675
24675
24675
24675
24685
24685
24685
24685
24800
24800
24800
24800
24802
24802
24802
24802
24900
24900
24900
24900
24920
24920
24920
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
N/F
N/F
F
F
F
F
N
F
N
F
N
F
N
F
N
F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
20.25
3.24
3.24
15.73
15.73
19.16
19.16
3.07
3.07
3.94
2.69
7.38
6.79
7.38
6.79
12.40
11.32
12.40
11.32
18.53
18.53
2.96
2.96
20.86
20.86
3.34
3.34
8.21
7.43
8.21
7.43
12.86
11.75
12.86
11.75
18.62
18.62
2.98
2.98
23.61
23.61
3.78
3.78
28.55
28.55
4.57
4.57
20.93
20.93
3.35
3.35
20.84
20.84
3.33
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$541.29
$90.94
$86.61
$441.50
$420.47
$537.77
$512.16
$86.17
$82.06
$110.58
$75.50
$207.14
$190.58
$197.27
$181.50
$348.03
$317.72
$331.46
$302.59
$520.09
$495.32
$83.08
$79.12
$585.48
$557.60
$93.74
$89.28
$230.43
$208.54
$219.46
$198.61
$360.94
$329.79
$343.75
$314.08
$522.61
$497.72
$83.64
$79.66
$662.67
$631.11
$106.09
$101.04
$801.32
$763.16
$128.27
$122.16
$587.45
$559.47
$94.03
$89.55
$584.92
$557.06
$93.46
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$541.29
$90.94
$86.61
$441.50
$420.47
$537.77
$512.16
$86.17
$82.06
$110.58
$75.50
$207.14
$190.58
$197.27
$181.50
$348.03
$317.72
$331.46
$302.59
$520.09
$495.32
$83.08
$79.12
$585.48
$557.60
$93.74
$89.28
$230.43
$208.54
$219.46
$198.61
$360.94
$329.79
$343.75
$314.08
$522.61
$497.72
$83.64
$79.66
$662.67
$631.11
$106.09
$101.04
$801.32
$763.16
$128.27
$122.16
$587.45
$559.47
$94.03
$89.55
$584.92
$557.06
$93.46
20.41
$26.7305
15.62
15.62
19.33
19.33
$28.0672
$26.7305
$28.0672
$26.7305
3.98
2.70
7.43
6.82
7.43
6.82
12.39
11.28
12.39
11.28
18.72
18.72
$28.0672
$28.0672
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
21.08
21.08
$28.0672
$26.7305
8.29
7.47
8.29
7.47
13.01
11.88
13.01
11.88
18.79
18.79
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
23.90
23.90
$28.0672
$26.7305
28.89
28.89
$28.0672
$26.7305
20.83
20.83
$28.0672
$26.7305
21.12
21.12
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$545.57
$91.66
$87.29
$438.41
$417.53
$542.54
$516.70
$86.81
$82.67
$111.71
$75.78
$208.54
$191.42
$198.61
$182.30
$347.75
$316.60
$331.19
$301.52
$525.42
$500.39
$84.07
$80.06
$591.66
$563.48
$94.67
$90.16
$232.68
$209.66
$221.60
$199.68
$365.15
$333.44
$347.76
$317.56
$527.38
$502.27
$84.38
$80.36
$670.81
$638.86
$107.33
$102.22
$810.86
$772.24
$129.74
$123.56
$584.64
$556.80
$93.54
$89.09
$592.78
$564.55
$94.84
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$545.57
$91.66
$87.29
$438.41
$417.53
$542.54
$516.70
$86.81
$82.67
$111.71
$75.78
$208.54
$191.42
$198.61
$182.30
$347.75
$316.60
$331.19
$301.52
$525.42
$500.39
$84.07
$80.06
$591.66
$563.48
$94.67
$90.16
$232.68
$209.66
$221.60
$199.68
$365.15
$333.44
$347.76
$317.56
$527.38
$502.27
$84.38
$80.36
$670.81
$638.86
$107.33
$102.22
$810.86
$772.24
$129.74
$123.56
$584.64
$556.80
$93.54
$89.09
$592.78
$564.55
$94.84
Musculoskeletal System Surgery
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
TOS*
Procedure
Code
Age
Range
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
24920
24925
24925
24925
24925
24930
24930
24930
24930
24931
24931
24931
24931
24935
24935
24940
24940
24940
24940
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
24999
25000
25000
25001
25001
25020
25020
25023
25023
25024
25024
25025
25025
25028
25028
25031
25031
25035
25035
25040
25040
25065
25065
25065
25065
25066
25066
25071
25071
25071
25071
25073
25073
25073
0-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
F
F
F
F
F
F
F
F
F
F
F
F
F
N/F
N/F
N/F
N/F
F
F
F
F
N
F
N
F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
3.33
16.07
16.07
2.57
2.57
22.04
22.04
3.53
3.53
22.08
22.08
3.53
3.53
29.81
29.81
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
9.48
9.48
9.69
9.69
16.21
16.21
31.35
31.35
22.10
22.10
34.62
34.62
14.77
14.77
10.31
10.31
16.49
16.49
15.95
15.95
7.12
4.65
7.12
4.65
10.11
10.11
12.07
12.07
1.93
1.93
15.07
15.07
2.41
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$89.01
$451.04
$429.56
$72.13
$68.70
$618.60
$589.14
$99.08
$94.36
$619.72
$590.21
$99.08
$94.36
$836.68
$796.84
$836.68
$796.84
$133.88
$127.50
Manually
Priced
$266.08
$253.41
$271.97
$259.02
$454.97
$433.30
$879.91
$838.00
$620.29
$590.74
$971.69
$925.41
$414.55
$394.81
$289.37
$275.59
$462.83
$440.79
$447.67
$426.35
$199.84
$130.51
$190.32
$124.30
$283.76
$270.25
$338.77
$322.64
$54.17
$51.59
$422.97
$402.83
$67.64
Current
Percent
Reduction
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Current
Adjusted
Medicaid
Fee
$89.01
$451.04
$429.56
$72.13
$68.70
$618.60
$589.14
$99.08
$94.36
$619.72
$590.21
$99.08
$94.36
$836.68
$796.84
$836.68
$796.84
$133.88
$127.50
Manually
Priced
$266.08
$253.41
$271.97
$259.02
$454.97
$433.30
$879.91
$838.00
$620.29
$590.74
$971.69
$925.41
$414.55
$394.81
$289.37
$275.59
$462.83
$440.79
$447.67
$426.35
$199.84
$130.51
$190.32
$124.30
$283.76
$270.25
$338.77
$322.64
$54.17
$51.59
$422.97
$402.83
$67.64
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
14.67
14.67
$28.0672
$26.7305
22.34
22.34
$28.0672
$26.7305
22.12
22.12
$28.0672
$26.7305
26.07
26.07
$28.0672
$26.7305
9.61
9.61
9.83
9.83
16.40
16.40
31.57
31.57
22.35
22.35
35.43
35.43
14.98
14.98
10.45
10.45
16.70
16.70
16.12
16.12
7.24
4.70
7.24
4.70
10.30
10.30
12.21
12.21
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
15.28
15.28
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
$90.33
$411.75
$392.14
$65.88
$62.74
$627.02
$597.16
$100.32
$95.55
$620.85
$591.28
$99.34
$94.60
$731.71
$696.86
$731.71
$696.86
$117.07
$111.50
Manually
Priced
$269.73
$256.88
$275.90
$262.76
$460.30
$438.38
$886.08
$843.88
$627.30
$597.43
$994.42
$947.06
$420.45
$400.42
$293.30
$279.33
$468.72
$446.40
$452.44
$430.90
$203.21
$131.92
$193.53
$125.63
$289.09
$275.32
$342.70
$326.38
$54.83
$52.22
$428.87
$408.44
$68.62
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$90.33
$411.75
$392.14
$65.88
$62.74
$627.02
$597.16
$100.32
$95.55
$620.85
$591.28
$99.34
$94.60
$731.71
$696.86
$731.71
$696.86
$117.07
$111.50
Manually
Priced
$269.73
$256.88
$275.90
$262.76
$460.30
$438.38
$886.08
$843.88
$627.30
$597.43
$994.42
$947.06
$420.45
$400.42
$293.30
$279.33
$468.72
$446.40
$452.44
$430.90
$203.21
$131.92
$193.53
$125.63
$289.09
$275.32
$342.70
$326.38
$54.83
$52.22
$428.87
$408.44
$68.62
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
8
8
2
25073
25075
25075
25075
25075
25076
25076
25077
25077
25078
25078
25078
25078
25085
25085
25085
25085
25100
25100
25101
25101
25105
25105
25107
25107
25107
25107
25109
25109
25110
25110
25111
25111
25112
25112
25115
25115
25116
25116
25118
25118
25119
25119
25119
25119
25120
25120
25125
25125
25126
25126
25126
25126
25130
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
N/F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N/F
N/F
N/F
N/F
N/F
N/F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
2.41
13.47
8.98
13.47
8.98
14.68
14.68
25.20
25.20
33.37
33.37
5.34
5.34
12.77
12.77
2.04
2.04
9.80
9.80
11.44
11.44
13.69
13.69
17.46
17.46
2.79
2.79
15.27
15.27
9.63
9.63
9.05
9.05
10.95
10.95
21.53
21.53
17.00
17.00
10.77
10.77
14.11
14.11
2.26
2.26
14.11
14.11
16.83
16.83
16.95
16.95
2.71
2.71
12.68
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$64.42
$378.07
$252.04
$360.06
$240.04
$412.03
$392.40
$707.29
$673.61
$936.60
$892.00
$149.88
$142.74
$358.42
$341.35
$57.26
$54.53
$275.06
$261.96
$321.09
$305.80
$384.24
$365.94
$490.05
$466.71
$78.31
$74.58
$428.59
$408.17
$270.29
$257.41
$254.01
$241.91
$307.34
$292.70
$604.29
$575.51
$477.14
$454.42
$302.28
$287.89
$396.03
$377.17
$63.43
$60.41
$396.03
$377.17
$472.37
$449.87
$475.74
$453.08
$76.06
$72.44
$355.89
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$64.42
$378.07
$252.04
$360.06
$240.04
$412.03
$392.40
$707.29
$673.61
$936.60
$892.00
$149.88
$142.74
$358.42
$341.35
$57.26
$54.53
$275.06
$261.96
$321.09
$305.80
$384.24
$365.94
$490.05
$466.71
$78.31
$74.58
$428.59
$408.17
$270.29
$257.41
$254.01
$241.91
$307.34
$292.70
$604.29
$575.51
$477.14
$454.42
$302.28
$287.89
$396.03
$377.17
$63.43
$60.41
$396.03
$377.17
$472.37
$449.87
$475.74
$453.08
$76.06
$72.44
$355.89
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
13.61
9.04
13.61
9.04
14.80
14.80
25.47
25.47
33.52
33.52
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
12.95
12.95
$28.0672
$26.7305
9.92
9.92
11.55
11.55
13.76
13.76
17.68
17.68
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
15.38
15.38
9.75
9.75
9.15
9.15
11.01
11.01
21.72
21.72
17.14
17.14
10.88
10.88
14.30
14.30
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
14.23
14.23
17.21
17.21
17.18
17.18
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
12.74
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$65.35
$381.99
$253.73
$363.80
$241.64
$415.39
$395.61
$714.87
$680.83
$940.81
$896.01
$150.53
$143.36
$363.47
$346.16
$58.16
$55.39
$278.43
$265.17
$324.18
$308.74
$386.20
$367.81
$496.23
$472.60
$79.40
$75.62
$431.67
$411.12
$273.66
$260.62
$256.81
$244.58
$309.02
$294.30
$609.62
$580.59
$481.07
$458.16
$305.37
$290.83
$401.36
$382.25
$64.22
$61.16
$399.40
$380.38
$483.04
$460.03
$482.19
$459.23
$77.15
$73.48
$357.58
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$65.35
$381.99
$253.73
$363.80
$241.64
$415.39
$395.61
$714.87
$680.83
$940.81
$896.01
$150.53
$143.36
$363.47
$346.16
$58.16
$55.39
$278.43
$265.17
$324.18
$308.74
$386.20
$367.81
$496.23
$472.60
$79.40
$75.62
$431.67
$411.12
$273.66
$260.62
$256.81
$244.58
$309.02
$294.30
$609.62
$580.59
$481.07
$458.16
$305.37
$290.83
$401.36
$382.25
$64.22
$61.16
$399.40
$380.38
$483.04
$460.03
$482.19
$459.23
$77.15
$73.48
$357.58
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
8
25130
25135
25135
25135
25135
25136
25136
25136
25136
25145
25145
25145
25145
25150
25150
25151
25151
25151
25151
25170
25170
25170
25170
25210
25210
25215
25215
25215
25215
25230
25230
25240
25240
25246
25246
25246
25246
25248
25248
25250
25250
25250
25250
25251
25251
25251
25251
25259
25259
25260
25260
25263
25263
25263
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
12.68
15.83
15.83
2.53
2.53
13.99
13.99
2.24
2.24
14.66
14.66
2.35
2.35
16.02
16.02
16.59
16.59
2.65
2.65
42.25
42.25
6.76
6.76
13.82
13.82
17.47
17.47
2.80
2.80
12.16
12.16
12.11
12.11
4.57
2.15
4.57
2.15
11.76
11.76
15.13
15.13
2.42
2.42
20.46
20.46
3.27
3.27
11.74
11.74
17.91
17.91
17.75
17.75
2.84
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$338.94
$444.30
$423.14
$71.01
$67.63
$392.66
$373.96
$62.87
$59.88
$411.47
$391.87
$65.96
$62.82
$449.64
$428.22
$465.63
$443.46
$74.38
$70.84
$1,185.84
$1,129.36
$189.73
$180.70
$387.89
$369.42
$490.33
$466.98
$78.59
$74.85
$341.30
$325.04
$339.89
$323.71
$128.27
$60.34
$122.16
$57.47
$330.07
$314.35
$424.66
$404.43
$67.92
$64.69
$574.25
$546.91
$91.78
$87.41
$329.51
$313.82
$502.68
$478.74
$498.19
$474.47
$79.71
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$338.94
$444.30
$423.14
$71.01
$67.63
$392.66
$373.96
$62.87
$59.88
$411.47
$391.87
$65.96
$62.82
$449.64
$428.22
$465.63
$443.46
$74.38
$70.84
$1,185.84
$1,129.36
$189.73
$180.70
$387.89
$369.42
$490.33
$466.98
$78.59
$74.85
$341.30
$325.04
$339.89
$323.71
$128.27
$60.34
$122.16
$57.47
$330.07
$314.35
$424.66
$404.43
$67.92
$64.69
$574.25
$546.91
$91.78
$87.41
$329.51
$313.82
$502.68
$478.74
$498.19
$474.47
$79.71
12.74
16.05
16.05
$26.7305
$28.0672
$26.7305
14.17
14.17
$28.0672
$26.7305
14.85
14.85
$28.0672
$26.7305
16.31
16.31
16.88
16.88
$28.0672
$26.7305
$28.0672
$26.7305
42.78
42.78
$28.0672
$26.7305
13.92
13.92
17.69
17.69
$28.0672
$26.7305
$28.0672
$26.7305
12.38
12.38
12.21
12.21
4.62
2.18
4.62
2.18
11.87
11.87
15.24
15.24
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
20.32
20.32
$28.0672
$26.7305
11.90
11.90
18.05
18.05
18.03
18.03
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$340.55
$450.48
$429.02
$72.08
$68.64
$397.71
$378.77
$63.63
$60.60
$416.80
$396.95
$66.69
$63.51
$457.78
$435.97
$473.77
$451.21
$75.80
$72.19
$1,200.71
$1,143.53
$192.11
$182.96
$390.70
$372.09
$496.51
$472.86
$79.44
$75.66
$347.47
$330.92
$342.70
$326.38
$129.67
$61.19
$123.49
$58.27
$333.16
$317.29
$427.74
$407.37
$68.44
$65.18
$570.33
$543.16
$91.25
$86.91
$334.00
$318.09
$506.61
$482.49
$506.05
$481.95
$80.97
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$340.55
$450.48
$429.02
$72.08
$68.64
$397.71
$378.77
$63.63
$60.60
$416.80
$396.95
$66.69
$63.51
$457.78
$435.97
$473.77
$451.21
$75.80
$72.19
$1,200.71
$1,143.53
$192.11
$182.96
$390.70
$372.09
$496.51
$472.86
$79.44
$75.66
$347.47
$330.92
$342.70
$326.38
$129.67
$61.19
$123.49
$58.27
$333.16
$317.29
$427.74
$407.37
$68.44
$65.18
$570.33
$543.16
$91.25
$86.91
$334.00
$318.09
$506.61
$482.49
$506.05
$481.95
$80.97
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
25263
25265
25265
25265
25265
25270
25270
25272
25272
25274
25274
25275
25275
25280
25280
25290
25290
25295
25295
25300
25300
25300
25300
25301
25301
25301
25301
25310
25310
25310
25310
25312
25312
25312
25312
25315
25315
25315
25315
25316
25316
25316
25316
25320
25320
25320
25320
25332
25332
25332
25332
25335
25335
25335
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
2.84
21.26
21.26
3.40
3.40
13.95
13.95
15.70
15.70
19.05
19.05
19.11
19.11
15.95
15.95
12.36
12.36
14.81
14.81
19.49
19.49
3.12
3.12
18.24
18.24
2.92
2.92
17.53
17.53
2.80
2.80
20.35
20.35
3.26
3.26
21.92
21.92
3.51
3.51
25.13
25.13
4.02
4.02
27.96
27.96
4.47
4.47
24.00
24.00
3.84
3.84
25.24
25.24
4.04
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$75.91
$596.71
$568.29
$95.43
$90.88
$391.54
$372.89
$440.66
$419.67
$534.68
$509.22
$536.36
$510.82
$447.67
$426.35
$346.91
$330.39
$415.68
$395.88
$547.03
$520.98
$87.57
$83.40
$511.95
$487.56
$81.96
$78.05
$492.02
$468.59
$78.59
$74.85
$571.17
$543.97
$91.50
$87.14
$615.23
$585.93
$98.52
$93.82
$705.33
$671.74
$112.83
$107.46
$784.76
$747.38
$125.46
$119.49
$673.61
$641.53
$107.78
$102.65
$708.42
$674.68
$113.39
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$75.91
$596.71
$568.29
$95.43
$90.88
$391.54
$372.89
$440.66
$419.67
$534.68
$509.22
$536.36
$510.82
$447.67
$426.35
$346.91
$330.39
$415.68
$395.88
$547.03
$520.98
$87.57
$83.40
$511.95
$487.56
$81.96
$78.05
$492.02
$468.59
$78.59
$74.85
$571.17
$543.97
$91.50
$87.14
$615.23
$585.93
$98.52
$93.82
$705.33
$671.74
$112.83
$107.46
$784.76
$747.38
$125.46
$119.49
$673.61
$641.53
$107.78
$102.65
$708.42
$674.68
$113.39
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
21.57
21.57
$28.0672
$26.7305
14.00
14.00
15.94
15.94
19.31
19.31
19.21
19.21
16.09
16.09
12.47
12.47
14.95
14.95
19.71
19.71
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
18.42
18.42
$28.0672
$26.7305
17.73
17.73
$28.0672
$26.7305
20.59
20.59
$28.0672
$26.7305
22.23
22.23
$28.0672
$26.7305
26.33
26.33
$28.0672
$26.7305
28.27
28.27
$28.0672
$26.7305
24.08
24.08
$28.0672
$26.7305
27.18
27.18
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$77.11
$605.41
$576.58
$96.87
$92.25
$392.94
$374.23
$447.39
$426.08
$541.98
$516.17
$539.17
$513.49
$451.60
$430.09
$350.00
$333.33
$419.60
$399.62
$553.20
$526.86
$88.51
$84.30
$517.00
$492.38
$82.72
$78.78
$497.63
$473.93
$79.62
$75.83
$577.90
$550.38
$92.46
$88.06
$623.93
$594.22
$99.83
$95.08
$739.01
$703.81
$118.24
$112.61
$793.46
$755.67
$126.95
$120.91
$675.86
$643.67
$108.14
$102.99
$762.87
$726.53
$122.06
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$77.11
$605.41
$576.58
$96.87
$92.25
$392.94
$374.23
$447.39
$426.08
$541.98
$516.17
$539.17
$513.49
$451.60
$430.09
$350.00
$333.33
$419.60
$399.62
$553.20
$526.86
$88.51
$84.30
$517.00
$492.38
$82.72
$78.78
$497.63
$473.93
$79.62
$75.83
$577.90
$550.38
$92.46
$88.06
$623.93
$594.22
$99.83
$95.08
$739.01
$703.81
$118.24
$112.61
$793.46
$755.67
$126.95
$120.91
$675.86
$643.67
$108.14
$102.99
$762.87
$726.53
$122.06
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
25335
25337
25337
25350
25350
25350
25350
25355
25355
25355
25355
25360
25360
25360
25360
25365
25365
25365
25365
25370
25370
25370
25370
25375
25375
25375
25375
25390
25390
25390
25390
25391
25391
25391
25391
25392
25392
25392
25392
25393
25393
25393
25393
25394
25394
25394
25394
25400
25400
25400
25400
25405
25405
25405
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
4.04
25.14
25.14
19.13
19.13
3.06
3.06
21.79
21.79
3.49
3.49
18.62
18.62
2.98
2.98
26.05
26.05
4.17
4.17
28.66
28.66
4.59
4.59
25.49
25.49
4.08
4.08
21.82
21.82
3.49
3.49
28.39
28.39
4.54
4.54
28.90
28.90
4.62
4.62
32.24
32.24
5.16
5.16
22.31
22.31
3.57
3.57
22.82
22.82
3.65
3.65
29.50
29.50
4.72
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$107.99
$705.61
$672.00
$536.93
$511.35
$85.89
$81.80
$611.58
$582.46
$97.95
$93.29
$522.61
$497.72
$83.64
$79.66
$731.15
$696.33
$117.04
$111.47
$804.41
$766.10
$128.83
$122.69
$715.43
$681.36
$114.51
$109.06
$612.43
$583.26
$97.95
$93.29
$796.83
$758.88
$127.43
$121.36
$811.14
$772.51
$129.67
$123.49
$904.89
$861.79
$144.83
$137.93
$626.18
$596.36
$100.20
$95.43
$640.49
$609.99
$102.45
$97.57
$827.98
$788.55
$132.48
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$107.99
$705.61
$672.00
$536.93
$511.35
$85.89
$81.80
$611.58
$582.46
$97.95
$93.29
$522.61
$497.72
$83.64
$79.66
$731.15
$696.33
$117.04
$111.47
$804.41
$766.10
$128.83
$122.69
$715.43
$681.36
$114.51
$109.06
$612.43
$583.26
$97.95
$93.29
$796.83
$758.88
$127.43
$121.36
$811.14
$772.51
$129.67
$123.49
$904.89
$861.79
$144.83
$137.93
$626.18
$596.36
$100.20
$95.43
$640.49
$609.99
$102.45
$97.57
$827.98
$788.55
$132.48
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
25.45
25.45
19.32
19.32
$28.0672
$26.7305
$28.0672
$26.7305
22.08
22.08
$28.0672
$26.7305
18.77
18.77
$28.0672
$26.7305
26.36
26.36
$28.0672
$26.7305
29.00
29.00
$28.0672
$26.7305
27.46
27.46
$28.0672
$26.7305
22.06
22.06
$28.0672
$26.7305
28.72
28.72
$28.0672
$26.7305
28.95
28.95
$28.0672
$26.7305
32.34
32.34
$28.0672
$26.7305
22.90
22.90
$28.0672
$26.7305
23.05
23.05
$28.0672
$26.7305
29.73
29.73
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$116.24
$714.31
$680.29
$542.26
$516.43
$86.76
$82.63
$619.72
$590.21
$99.16
$94.43
$526.82
$501.73
$84.29
$80.28
$739.85
$704.62
$118.38
$112.74
$813.95
$775.18
$130.23
$124.03
$770.73
$734.02
$123.32
$117.44
$619.16
$589.67
$99.07
$94.35
$806.09
$767.70
$128.97
$122.83
$812.55
$773.85
$130.01
$123.82
$907.69
$864.46
$145.23
$138.31
$642.74
$612.13
$102.84
$97.94
$646.95
$616.14
$103.51
$98.58
$834.44
$794.70
$133.51
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$116.24
$714.31
$680.29
$542.26
$516.43
$86.76
$82.63
$619.72
$590.21
$99.16
$94.43
$526.82
$501.73
$84.29
$80.28
$739.85
$704.62
$118.38
$112.74
$813.95
$775.18
$130.23
$124.03
$770.73
$734.02
$123.32
$117.44
$619.16
$589.67
$99.07
$94.35
$806.09
$767.70
$128.97
$122.83
$812.55
$773.85
$130.01
$123.82
$907.69
$864.46
$145.23
$138.31
$642.74
$612.13
$102.84
$97.94
$646.95
$616.14
$103.51
$98.58
$834.44
$794.70
$133.51
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
25405
25415
25415
25415
25415
25420
25420
25420
25420
25425
25425
25425
25425
25426
25426
25426
25426
25430
25430
25431
25431
25431
25431
25440
25440
25440
25440
25441
25441
25441
25441
25442
25442
25442
25442
25443
25443
25443
25443
25444
25444
25444
25444
25445
25445
25446
25446
25446
25446
25447
25447
25447
25447
25449
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
4.72
27.55
27.55
4.41
4.41
33.31
33.31
5.33
5.33
27.42
27.42
4.39
4.39
32.04
32.04
5.13
5.13
20.11
20.11
22.45
22.45
3.59
3.59
21.82
21.82
3.49
3.49
26.15
26.15
4.18
4.18
22.36
22.36
3.58
3.58
22.21
22.21
3.55
3.55
22.12
22.12
3.54
3.54
20.45
20.45
33.32
33.32
5.33
5.33
23.48
23.48
3.76
3.76
29.62
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$126.17
$773.25
$736.43
$123.78
$117.88
$934.92
$890.39
$149.60
$142.47
$769.60
$732.95
$123.22
$117.35
$899.27
$856.45
$143.98
$137.13
$564.43
$537.55
$630.11
$600.10
$100.76
$95.96
$612.43
$583.26
$97.95
$93.29
$733.96
$699.00
$117.32
$111.73
$627.58
$597.69
$100.48
$95.70
$623.37
$593.68
$99.64
$94.89
$620.85
$591.28
$99.36
$94.63
$573.97
$546.64
$935.20
$890.66
$149.60
$142.47
$659.02
$627.63
$105.53
$100.51
$831.35
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$126.17
$773.25
$736.43
$123.78
$117.88
$934.92
$890.39
$149.60
$142.47
$769.60
$732.95
$123.22
$117.35
$899.27
$856.45
$143.98
$137.13
$564.43
$537.55
$630.11
$600.10
$100.76
$95.96
$612.43
$583.26
$97.95
$93.29
$733.96
$699.00
$117.32
$111.73
$627.58
$597.69
$100.48
$95.70
$623.37
$593.68
$99.64
$94.89
$620.85
$591.28
$99.36
$94.63
$573.97
$546.64
$935.20
$890.66
$149.60
$142.47
$659.02
$627.63
$105.53
$100.51
$831.35
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
27.90
27.90
$28.0672
$26.7305
33.72
33.72
$28.0672
$26.7305
27.75
27.75
$28.0672
$26.7305
32.44
32.44
$28.0672
$26.7305
21.07
21.07
22.44
22.44
$28.0672
$26.7305
$28.0672
$26.7305
22.03
22.03
$28.0672
$26.7305
26.70
26.70
$28.0672
$26.7305
22.83
22.83
$28.0672
$26.7305
22.51
22.51
$28.0672
$26.7305
23.79
23.79
$28.0672
$26.7305
20.70
20.70
33.60
33.60
$28.0672
$26.7305
$28.0672
$26.7305
23.71
23.71
$28.0672
$26.7305
29.56
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$127.15
$783.07
$745.78
$125.29
$119.32
$946.43
$901.35
$151.43
$144.22
$778.86
$741.77
$124.62
$118.68
$910.50
$867.14
$145.68
$138.74
$591.38
$563.21
$629.83
$599.83
$100.77
$95.97
$618.32
$588.87
$98.93
$94.22
$749.39
$713.70
$119.90
$114.19
$640.77
$610.26
$102.52
$97.64
$631.79
$601.70
$101.09
$96.27
$667.72
$635.92
$106.84
$101.75
$580.99
$553.32
$943.06
$898.14
$150.89
$143.70
$665.47
$633.78
$106.48
$101.40
$829.67
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$127.15
$783.07
$745.78
$125.29
$119.32
$946.43
$901.35
$151.43
$144.22
$778.86
$741.77
$124.62
$118.68
$910.50
$867.14
$145.68
$138.74
$591.38
$563.21
$629.83
$599.83
$100.77
$95.97
$618.32
$588.87
$98.93
$94.22
$749.39
$713.70
$119.90
$114.19
$640.77
$610.26
$102.52
$97.64
$631.79
$601.70
$101.09
$96.27
$667.72
$635.92
$106.84
$101.75
$580.99
$553.32
$943.06
$898.14
$150.89
$143.70
$665.47
$633.78
$106.48
$101.40
$829.67
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
8
8
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
8
25449
25449
25449
25450
25450
25455
25455
25490
25490
25490
25490
25491
25491
25491
25491
25492
25492
25492
25492
25500
25500
25500
25500
25505
25505
25505
25505
25515
25515
25515
25515
25520
25520
25520
25520
25525
25525
25525
25525
25526
25526
25526
25526
25530
25530
25530
25530
25535
25535
25535
25535
25545
25545
25545
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
F
F
F
F
N
F
N
F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
F
F
F
29.62
4.74
4.74
17.48
17.48
19.43
19.43
19.80
19.80
3.17
3.17
21.02
21.02
3.36
3.36
25.72
25.72
4.12
4.12
7.68
7.07
7.68
7.07
14.20
13.03
14.20
13.03
19.03
19.03
3.04
3.04
16.04
15.23
16.04
15.23
22.35
22.35
3.58
3.58
27.18
27.18
4.35
4.35
7.38
6.69
7.38
6.69
13.82
12.82
13.82
12.82
17.70
17.70
2.83
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$791.76
$133.04
$126.70
$490.61
$467.25
$545.35
$519.37
$555.73
$529.26
$88.97
$84.74
$589.97
$561.88
$94.31
$89.81
$721.89
$687.51
$115.64
$110.13
$215.56
$198.44
$205.29
$188.98
$398.55
$365.72
$379.57
$348.30
$534.12
$508.68
$85.32
$81.26
$450.20
$427.46
$428.76
$407.11
$627.30
$597.43
$100.48
$95.70
$762.87
$726.53
$122.09
$116.28
$207.14
$187.77
$197.27
$178.83
$387.89
$359.82
$369.42
$342.69
$496.79
$473.13
$79.43
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$791.76
$133.04
$126.70
$490.61
$467.25
$545.35
$519.37
$555.73
$529.26
$88.97
$84.74
$589.97
$561.88
$94.31
$89.81
$721.89
$687.51
$115.64
$110.13
$215.56
$198.44
$205.29
$188.98
$398.55
$365.72
$379.57
$348.30
$534.12
$508.68
$85.32
$81.26
$450.20
$427.46
$428.76
$407.11
$627.30
$597.43
$100.48
$95.70
$762.87
$726.53
$122.09
$116.28
$207.14
$187.77
$197.27
$178.83
$387.89
$359.82
$369.42
$342.69
$496.79
$473.13
$79.43
29.56
$26.7305
14.29
14.29
16.93
16.93
19.09
19.09
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
21.32
21.32
$28.0672
$26.7305
26.05
26.05
$28.0672
$26.7305
7.75
7.11
7.75
7.11
14.32
13.13
14.32
13.13
19.25
19.25
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
16.27
15.44
16.27
15.44
22.56
22.56
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
27.56
27.56
$28.0672
$26.7305
7.46
6.74
7.46
6.74
13.99
12.95
13.99
12.95
17.89
17.89
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$790.15
$132.75
$126.42
$401.08
$381.98
$475.18
$452.55
$535.80
$510.29
$85.73
$81.65
$598.39
$569.89
$95.74
$91.18
$731.15
$696.33
$116.98
$111.41
$217.52
$199.56
$207.16
$190.05
$401.92
$368.52
$382.78
$350.97
$540.29
$514.56
$86.45
$82.33
$456.65
$433.36
$434.91
$412.72
$633.20
$603.04
$101.31
$96.49
$773.53
$736.69
$123.76
$117.87
$209.38
$189.17
$199.41
$180.16
$392.66
$363.47
$373.96
$346.16
$502.12
$478.21
$80.34
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$790.15
$132.75
$126.42
$401.08
$381.98
$475.18
$452.55
$535.80
$510.29
$85.73
$81.65
$598.39
$569.89
$95.74
$91.18
$731.15
$696.33
$116.98
$111.41
$217.52
$199.56
$207.16
$190.05
$401.92
$368.52
$382.78
$350.97
$540.29
$514.56
$86.45
$82.33
$456.65
$433.36
$434.91
$412.72
$633.20
$603.04
$101.31
$96.49
$773.53
$736.69
$123.76
$117.87
$209.38
$189.17
$199.41
$180.16
$392.66
$363.47
$373.96
$346.16
$502.12
$478.21
$80.34
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
25545
25560
25560
25560
25560
25565
25565
25565
25565
25574
25574
25574
25574
25575
25575
25575
25575
25600
25600
25600
25600
25605
25605
25605
25605
25606
25606
25607
25607
25608
25608
25609
25609
25622
25622
25622
25622
25624
25624
25624
25624
25628
25628
25628
25628
25630
25630
25630
25630
25635
25635
25635
25635
25645
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
N
F
N
F
N
F
N
F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
F
F
F
F
N
F
N
F
N
F
N
F
F
2.83
7.87
7.12
7.87
7.12
14.70
13.34
14.70
13.34
19.14
19.14
3.06
3.06
25.64
25.64
4.10
4.10
9.25
8.76
9.25
8.76
15.53
14.63
15.53
14.63
18.80
18.80
20.89
20.89
23.43
23.43
29.80
29.80
8.58
7.84
8.58
7.84
13.43
12.25
13.43
12.25
20.46
20.46
3.27
3.27
8.62
7.93
8.62
7.93
12.56
11.19
12.56
11.19
16.16
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$75.65
$220.89
$199.84
$210.37
$190.32
$412.59
$374.42
$392.94
$356.58
$537.21
$511.62
$85.89
$81.80
$719.64
$685.37
$115.08
$109.60
$259.62
$245.87
$247.26
$234.16
$435.88
$410.62
$415.12
$391.07
$527.66
$502.53
$586.32
$558.40
$657.61
$626.30
$836.40
$796.57
$240.82
$220.05
$229.35
$209.57
$376.94
$343.82
$358.99
$327.45
$574.25
$546.91
$91.78
$87.41
$241.94
$222.57
$230.42
$211.97
$352.52
$314.07
$335.74
$299.11
$453.57
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$75.65
$220.89
$199.84
$210.37
$190.32
$412.59
$374.42
$392.94
$356.58
$537.21
$511.62
$85.89
$81.80
$719.64
$685.37
$115.08
$109.60
$259.62
$245.87
$247.26
$234.16
$435.88
$410.62
$415.12
$391.07
$527.66
$502.53
$586.32
$558.40
$657.61
$626.30
$836.40
$796.57
$240.82
$220.05
$229.35
$209.57
$376.94
$343.82
$358.99
$327.45
$574.25
$546.91
$91.78
$87.41
$241.94
$222.57
$230.42
$211.97
$352.52
$314.07
$335.74
$299.11
$453.57
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
7.89
7.13
7.89
7.13
14.83
13.44
14.83
13.44
19.37
19.37
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
25.88
25.88
$28.0672
$26.7305
9.33
8.82
9.33
8.82
15.58
14.65
15.58
14.65
19.05
19.05
21.08
21.08
23.66
23.66
30.07
30.07
8.63
7.86
8.63
7.86
13.69
12.47
13.69
12.47
20.66
20.66
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
8.68
7.97
8.68
7.97
12.74
11.35
12.74
11.35
16.39
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$76.51
$221.45
$200.12
$210.90
$190.59
$416.24
$377.22
$396.41
$359.26
$543.66
$517.77
$86.99
$82.84
$726.38
$691.79
$116.22
$110.69
$261.87
$247.55
$249.40
$235.76
$437.29
$411.18
$416.46
$391.60
$534.68
$509.22
$591.66
$563.48
$664.07
$632.44
$843.98
$803.79
$242.22
$220.61
$230.68
$210.10
$384.24
$350.00
$365.94
$333.33
$579.87
$552.25
$92.78
$88.36
$243.62
$223.70
$232.02
$213.04
$357.58
$318.56
$340.55
$303.39
$460.02
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$76.51
$221.45
$200.12
$210.90
$190.59
$416.24
$377.22
$396.41
$359.26
$543.66
$517.77
$86.99
$82.84
$726.38
$691.79
$116.22
$110.69
$261.87
$247.55
$249.40
$235.76
$437.29
$411.18
$416.46
$391.60
$534.68
$509.22
$591.66
$563.48
$664.07
$632.44
$843.98
$803.79
$242.22
$220.61
$230.68
$210.10
$384.24
$350.00
$365.94
$333.33
$579.87
$552.25
$92.78
$88.36
$243.62
$223.70
$232.02
$213.04
$357.58
$318.56
$340.55
$303.39
$460.02
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
8
8
2
2
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
25645
25645
25645
25650
25650
25650
25650
25651
25651
25652
25652
25660
25660
25670
25670
25670
25670
25671
25671
25675
25675
25675
25675
25676
25676
25676
25676
25680
25680
25685
25685
25685
25685
25690
25690
25695
25695
25695
25695
25800
25800
25800
25800
25805
25805
25805
25805
25810
25810
25810
25810
25820
25820
25820
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
N
F
N
F
F
F
F
F
N/F
N/F
F
F
F
F
F
F
N
F
N
F
F
F
F
F
N/F
N/F
F
F
F
F
N/F
N/F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
16.16
2.59
2.59
9.07
8.53
9.07
8.53
13.75
13.75
17.67
17.67
11.47
11.47
17.21
17.21
2.75
2.75
15.02
15.02
12.35
11.30
12.35
11.30
17.85
17.85
2.86
2.86
13.41
13.41
20.90
20.90
3.34
3.34
13.62
13.62
17.99
17.99
2.88
2.88
20.79
20.79
3.33
3.33
24.03
24.03
3.84
3.84
24.66
24.66
3.95
3.95
17.42
17.42
2.79
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$431.96
$72.69
$69.23
$254.57
$239.41
$242.45
$228.01
$385.92
$367.54
$495.95
$472.33
$321.93
$306.60
$483.04
$460.03
$77.18
$73.51
$421.57
$401.49
$346.63
$317.16
$330.12
$302.05
$501.00
$477.14
$80.27
$76.45
$376.38
$358.46
$586.60
$558.67
$93.74
$89.28
$382.28
$364.07
$504.93
$480.88
$80.83
$76.98
$583.52
$555.73
$93.46
$89.01
$674.45
$642.33
$107.78
$102.65
$692.14
$659.17
$110.87
$105.59
$488.93
$465.65
$78.31
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$431.96
$72.69
$69.23
$254.57
$239.41
$242.45
$228.01
$385.92
$367.54
$495.95
$472.33
$321.93
$306.60
$483.04
$460.03
$77.18
$73.51
$421.57
$401.49
$346.63
$317.16
$330.12
$302.05
$501.00
$477.14
$80.27
$76.45
$376.38
$358.46
$586.60
$558.67
$93.74
$89.28
$382.28
$364.07
$504.93
$480.88
$80.83
$76.98
$583.52
$555.73
$93.46
$89.01
$674.45
$642.33
$107.78
$102.65
$692.14
$659.17
$110.87
$105.59
$488.93
$465.65
$78.31
16.39
$26.7305
9.08
8.52
9.08
8.52
13.85
13.85
17.90
17.90
11.69
11.69
17.34
17.34
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
15.22
15.22
12.45
11.35
12.45
11.35
18.08
18.08
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
13.37
13.37
21.21
21.21
$28.0672
$26.7305
$28.0672
$26.7305
13.80
13.80
18.23
18.23
$28.0672
$26.7305
$28.0672
$26.7305
20.98
20.98
$28.0672
$26.7305
24.34
24.34
$28.0672
$26.7305
24.86
24.86
$28.0672
$26.7305
17.60
17.60
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$438.11
$73.60
$70.10
$254.85
$239.13
$242.71
$227.74
$388.73
$370.22
$502.40
$478.48
$328.11
$312.48
$486.69
$463.51
$77.87
$74.16
$427.18
$406.84
$349.44
$318.56
$332.79
$303.39
$507.45
$483.29
$81.19
$77.33
$375.26
$357.39
$595.31
$566.95
$95.25
$90.71
$387.33
$368.88
$511.67
$487.30
$81.87
$77.97
$588.85
$560.81
$94.22
$89.73
$683.16
$650.62
$109.31
$104.10
$697.75
$664.52
$111.64
$106.32
$493.98
$470.46
$79.04
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$438.11
$73.60
$70.10
$254.85
$239.13
$242.71
$227.74
$388.73
$370.22
$502.40
$478.48
$328.11
$312.48
$486.69
$463.51
$77.87
$74.16
$427.18
$406.84
$349.44
$318.56
$332.79
$303.39
$507.45
$483.29
$81.19
$77.33
$375.26
$357.39
$595.31
$566.95
$95.25
$90.71
$387.33
$368.88
$511.67
$487.30
$81.87
$77.97
$588.85
$560.81
$94.22
$89.73
$683.16
$650.62
$109.31
$104.10
$697.75
$664.52
$111.64
$106.32
$493.98
$470.46
$79.04
Musculoskeletal System Surgery
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
TOS*
Procedure
Code
Age
Range
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
25820
25825
25825
25825
25825
25830
25830
25830
25830
25900
25900
25905
25905
25905
25905
25907
25907
25907
25907
25909
25909
25909
25909
25915
25915
25915
25915
25920
25920
25922
25922
25922
25922
25924
25924
25924
25924
25927
25927
25929
25929
25929
25929
25931
25931
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
2.79
21.48
21.48
3.44
3.44
26.95
26.95
4.31
4.31
20.13
20.13
18.08
18.08
2.89
2.89
17.40
17.40
2.78
2.78
19.48
19.48
3.12
3.12
29.72
29.72
4.76
4.76
19.78
19.78
14.03
14.03
2.24
2.24
17.44
17.44
2.79
2.79
22.98
22.98
16.94
16.94
2.71
2.71
19.06
19.06
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
2
2
2
2
2
2
2
2
25999
26010
26010
26010
26010
26011
26011
26011
0-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
F
N
F
N
F
N
F
N
7.41
3.92
7.41
3.92
10.92
5.24
10.92
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$74.58
$602.88
$574.17
$96.55
$91.95
$756.41
$720.39
$120.97
$115.21
$564.99
$538.08
$507.45
$483.29
$81.11
$77.25
$488.37
$465.11
$78.03
$74.31
$546.75
$520.71
$87.57
$83.40
$834.16
$794.43
$133.60
$127.24
$555.17
$528.73
$393.78
$375.03
$62.87
$59.88
$489.49
$466.18
$78.31
$74.58
$644.98
$614.27
$475.46
$452.81
$76.06
$72.44
$534.96
$509.48
Manually
Priced
$207.98
$110.02
$198.07
$104.78
$306.49
$147.07
$291.90
Current
Percent
Reduction
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
0%
0%
0%
0%
0%
0%
0%
Current
Adjusted
Medicaid
Fee
$74.58
$602.88
$574.17
$96.55
$91.95
$756.41
$720.39
$120.97
$115.21
$564.99
$538.08
$507.45
$483.29
$81.11
$77.25
$488.37
$465.11
$78.03
$74.31
$546.75
$520.71
$87.57
$83.40
$834.16
$794.43
$133.60
$127.24
$555.17
$528.73
$393.78
$375.03
$62.87
$59.88
$489.49
$466.18
$78.31
$74.58
$644.98
$614.27
$475.46
$452.81
$76.06
$72.44
$534.96
$509.48
Manually
Priced
$207.98
$110.02
$198.07
$104.78
$306.49
$147.07
$291.90
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
21.66
21.66
$28.0672
$26.7305
27.35
27.35
$28.0672
$26.7305
20.25
20.25
20.21
20.21
$28.0672
$26.7305
$28.0672
$26.7305
17.64
17.64
$28.0672
$26.7305
19.74
19.74
$28.0672
$26.7305
27.98
27.98
$28.0672
$26.7305
20.05
20.05
17.58
17.58
$28.0672
$26.7305
$28.0672
$26.7305
19.57
19.57
$28.0672
$26.7305
23.28
23.28
15.71
15.71
$28.0672
$26.7305
$28.0672
$26.7305
21.36
21.36
$28.0672
$26.7305
7.49
3.93
7.49
3.93
11.07
5.30
11.07
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
$75.27
$607.94
$578.98
$97.27
$92.64
$767.64
$731.08
$122.82
$116.97
$568.36
$541.29
$567.24
$540.22
$90.76
$86.44
$495.11
$471.53
$79.22
$75.44
$554.05
$527.66
$88.65
$84.43
$785.32
$747.92
$125.65
$119.67
$562.75
$535.95
$493.42
$469.92
$78.95
$75.19
$549.28
$523.12
$87.88
$83.70
$653.40
$622.29
$440.94
$419.94
$70.55
$67.19
$599.52
$570.96
Manually
Priced
$210.22
$110.30
$200.21
$105.05
$310.70
$148.76
$295.91
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
0%
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$75.27
$607.94
$578.98
$97.27
$92.64
$767.64
$731.08
$122.82
$116.97
$568.36
$541.29
$567.24
$540.22
$90.76
$86.44
$495.11
$471.53
$79.22
$75.44
$554.05
$527.66
$88.65
$84.43
$785.32
$747.92
$125.65
$119.67
$562.75
$535.95
$493.42
$469.92
$78.95
$75.19
$549.28
$523.12
$87.88
$83.70
$653.40
$622.29
$440.94
$419.94
$70.55
$67.19
$599.52
$570.96
Manually
Priced
$210.22
$110.30
$200.21
$105.05
$310.70
$148.76
$295.91
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
8
26011
26020
26020
26025
26025
26030
26030
26034
26034
26035
26035
26037
26037
26040
26040
26045
26045
26055
26055
26055
26055
26060
26060
26070
26070
26075
26075
26080
26080
26100
26100
26105
26105
26110
26110
26111
26111
26111
26111
26113
26113
26113
26113
26115
26115
26115
26115
26116
26116
26117
26117
26118
26118
26118
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
N/F
N/F
N/F
N/F
N/F
N/F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N
F
N
F
F
F
F
F
F
F
F
5.24
12.26
12.26
11.91
11.91
13.98
13.98
15.17
15.17
24.62
24.62
16.12
16.12
8.76
8.76
13.27
13.27
15.63
8.75
15.63
8.75
7.49
7.49
8.89
8.89
9.32
9.32
11.03
11.03
9.47
9.47
9.45
9.45
9.07
9.07
11.82
11.82
1.89
1.89
15.55
15.55
2.49
2.49
14.14
9.41
14.14
9.41
14.92
14.92
21.21
21.21
30.03
30.03
4.80
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$140.07
$344.10
$327.72
$334.28
$318.36
$392.38
$373.69
$425.78
$405.50
$691.01
$658.10
$452.44
$430.90
$245.87
$234.16
$372.45
$354.71
$438.69
$245.59
$417.80
$233.89
$210.22
$200.21
$249.52
$237.63
$261.59
$249.13
$309.58
$294.84
$265.80
$253.14
$265.24
$252.60
$254.57
$242.45
$331.75
$315.95
$53.05
$50.52
$436.44
$415.66
$69.89
$66.56
$396.87
$264.11
$377.97
$251.53
$418.76
$398.82
$595.31
$566.95
$842.86
$802.72
$134.72
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$140.07
$344.10
$327.72
$334.28
$318.36
$392.38
$373.69
$425.78
$405.50
$691.01
$658.10
$452.44
$430.90
$245.87
$234.16
$372.45
$354.71
$438.69
$245.59
$417.80
$233.89
$210.22
$200.21
$249.52
$237.63
$261.59
$249.13
$309.58
$294.84
$265.80
$253.14
$265.24
$252.60
$254.57
$242.45
$331.75
$315.95
$53.05
$50.52
$436.44
$415.66
$69.89
$66.56
$396.87
$264.11
$377.97
$251.53
$418.76
$398.82
$595.31
$566.95
$842.86
$802.72
$134.72
5.30
12.40
12.40
12.09
12.09
14.07
14.07
15.42
15.42
24.68
24.68
16.17
16.17
8.88
8.88
13.40
13.40
15.86
8.85
15.86
8.85
7.49
7.49
9.03
9.03
9.53
9.53
11.13
11.13
9.61
9.61
9.67
9.67
9.17
9.17
11.98
11.98
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
15.68
15.68
$28.0672
$26.7305
14.35
9.51
14.35
9.51
15.08
15.08
21.37
21.37
30.35
30.35
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$141.67
$348.03
$331.46
$339.33
$323.17
$394.91
$376.10
$432.80
$412.18
$692.70
$659.71
$453.85
$432.23
$249.24
$237.37
$376.10
$358.19
$445.15
$248.39
$423.95
$236.56
$210.22
$200.21
$253.45
$241.38
$267.48
$254.74
$312.39
$297.51
$269.73
$256.88
$271.41
$258.48
$257.38
$245.12
$336.25
$320.23
$53.80
$51.24
$440.09
$419.13
$70.41
$67.06
$402.76
$266.92
$383.58
$254.21
$423.25
$403.10
$599.80
$571.23
$851.84
$811.27
$136.29
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$141.67
$348.03
$331.46
$339.33
$323.17
$394.91
$376.10
$432.80
$412.18
$692.70
$659.71
$453.85
$432.23
$249.24
$237.37
$376.10
$358.19
$445.15
$248.39
$423.95
$236.56
$210.22
$200.21
$253.45
$241.38
$267.48
$254.74
$312.39
$297.51
$269.73
$256.88
$271.41
$258.48
$257.38
$245.12
$336.25
$320.23
$53.80
$51.24
$440.09
$419.13
$70.41
$67.06
$402.76
$266.92
$383.58
$254.21
$423.25
$403.10
$599.80
$571.23
$851.84
$811.27
$136.29
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
26118
26121
26121
26123
26123
26125
26125
26130
26130
26135
26135
26140
26140
26145
26145
26160
26160
26160
26160
26170
26170
26180
26180
26185
26185
26185
26185
26200
26200
26205
26205
26210
26210
26215
26215
26230
26230
26235
26235
26236
26236
26250
26250
26260
26260
26260
26260
26262
26262
26262
26262
26320
26320
26340
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
4.80
16.92
16.92
23.62
23.62
7.84
7.84
13.06
13.06
15.60
15.60
14.27
14.27
14.48
14.48
16.07
9.41
16.07
9.41
11.49
11.49
12.52
12.52
15.62
15.62
2.50
2.50
12.75
12.75
17.10
17.10
12.49
12.49
15.99
15.99
14.14
14.14
13.96
13.96
12.48
12.48
31.15
31.15
23.26
23.26
3.72
3.72
18.16
18.16
2.91
2.91
9.78
9.78
9.40
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$128.31
$474.90
$452.28
$662.95
$631.37
$220.05
$209.57
$366.56
$349.10
$437.85
$417.00
$400.52
$381.44
$406.41
$387.06
$451.04
$264.11
$429.56
$251.53
$322.49
$307.13
$351.40
$334.67
$438.41
$417.53
$70.17
$66.83
$357.86
$340.81
$479.95
$457.09
$350.56
$333.86
$448.79
$427.42
$396.87
$377.97
$391.82
$373.16
$350.28
$333.60
$874.29
$832.66
$652.84
$621.75
$104.41
$99.44
$509.70
$485.43
$81.68
$77.79
$274.50
$261.42
$263.83
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$128.31
$474.90
$452.28
$662.95
$631.37
$220.05
$209.57
$366.56
$349.10
$437.85
$417.00
$400.52
$381.44
$406.41
$387.06
$451.04
$264.11
$429.56
$251.53
$322.49
$307.13
$351.40
$334.67
$438.41
$417.53
$70.17
$66.83
$357.86
$340.81
$479.95
$457.09
$350.56
$333.86
$448.79
$427.42
$396.87
$377.97
$391.82
$373.16
$350.28
$333.60
$874.29
$832.66
$652.84
$621.75
$104.41
$99.44
$509.70
$485.43
$81.68
$77.79
$274.50
$261.42
$263.83
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
17.10
17.10
23.86
23.86
7.91
7.91
13.28
13.28
15.69
15.69
14.40
14.40
14.65
14.65
16.31
9.52
16.31
9.52
11.60
11.60
12.66
12.66
15.49
15.49
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
12.82
12.82
17.32
17.32
12.62
12.62
16.19
16.19
14.27
14.27
14.10
14.10
12.58
12.58
30.89
30.89
23.17
23.17
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
18.25
18.25
$28.0672
$26.7305
9.89
9.89
9.49
$28.0672
$26.7305
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$129.80
$479.95
$457.09
$669.68
$637.79
$222.01
$211.44
$372.73
$354.98
$440.37
$419.40
$404.17
$384.92
$411.18
$391.60
$457.78
$267.20
$435.97
$254.47
$325.58
$310.07
$355.33
$338.41
$434.76
$414.06
$69.56
$66.25
$359.82
$342.69
$486.12
$462.97
$354.21
$337.34
$454.41
$432.77
$400.52
$381.44
$395.75
$376.90
$353.09
$336.27
$867.00
$825.71
$650.32
$619.35
$104.05
$99.10
$512.23
$487.83
$81.96
$78.05
$277.58
$264.36
$266.36
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$129.80
$479.95
$457.09
$669.68
$637.79
$222.01
$211.44
$372.73
$354.98
$440.37
$419.40
$404.17
$384.92
$411.18
$391.60
$457.78
$267.20
$435.97
$254.47
$325.58
$310.07
$355.33
$338.41
$434.76
$414.06
$69.56
$66.25
$359.82
$342.69
$486.12
$462.97
$354.21
$337.34
$454.41
$432.77
$400.52
$381.44
$395.75
$376.90
$353.09
$336.27
$867.00
$825.71
$650.32
$619.35
$104.05
$99.10
$512.23
$487.83
$81.96
$78.05
$277.58
$264.36
$266.36
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
26340
26341
26341
26341
26341
26350
26350
26352
26352
26352
26352
26356
26356
26357
26357
26357
26357
26358
26358
26358
26358
26370
26370
26372
26372
26372
26372
26373
26373
26373
26373
26390
26390
26390
26390
26392
26392
26392
26392
26410
26410
26412
26412
26415
26415
26416
26416
26418
26418
26420
26420
26420
26420
26426
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
9.40
2.75
2.09
2.75
2.09
19.78
19.78
22.82
22.82
3.65
3.65
30.56
30.56
24.34
24.34
3.89
3.89
25.69
25.69
4.11
4.11
21.15
21.15
24.76
24.76
3.96
3.96
23.74
23.74
3.80
3.80
23.44
23.44
3.75
3.75
27.28
27.28
4.36
4.36
15.70
15.70
18.94
18.94
22.28
22.28
21.30
21.30
16.05
16.05
19.83
19.83
3.17
3.17
14.19
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$251.27
$77.18
$58.66
$73.51
$55.87
$555.17
$528.73
$640.49
$609.99
$102.45
$97.57
$857.73
$816.88
$683.16
$650.62
$109.18
$103.98
$721.05
$686.71
$115.36
$109.86
$593.62
$565.35
$694.94
$661.85
$111.15
$105.85
$666.32
$634.58
$106.66
$101.58
$657.90
$626.56
$105.25
$100.24
$765.67
$729.21
$122.37
$116.54
$440.66
$419.67
$531.59
$506.28
$625.34
$595.56
$597.83
$569.36
$450.48
$429.02
$556.57
$530.07
$88.97
$84.74
$398.27
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$251.27
$77.18
$58.66
$73.51
$55.87
$555.17
$528.73
$640.49
$609.99
$102.45
$97.57
$857.73
$816.88
$683.16
$650.62
$109.18
$103.98
$721.05
$686.71
$115.36
$109.86
$593.62
$565.35
$694.94
$661.85
$111.15
$105.85
$666.32
$634.58
$106.66
$101.58
$657.90
$626.56
$105.25
$100.24
$765.67
$729.21
$122.37
$116.54
$440.66
$419.67
$531.59
$506.28
$625.34
$595.56
$597.83
$569.36
$450.48
$429.02
$556.57
$530.07
$88.97
$84.74
$398.27
9.49
2.82
2.15
2.82
2.15
20.02
20.02
22.89
22.89
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
30.89
30.89
24.69
24.69
$28.0672
$26.7305
$28.0672
$26.7305
25.35
25.35
$28.0672
$26.7305
21.37
21.37
25.10
25.10
$28.0672
$26.7305
$28.0672
$26.7305
23.39
23.39
$28.0672
$26.7305
23.75
23.75
$28.0672
$26.7305
27.65
27.65
$28.0672
$26.7305
15.86
15.86
19.58
19.58
19.25
19.25
25.15
25.15
16.22
16.22
19.91
19.91
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
14.32
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$253.67
$79.15
$60.34
$75.38
$57.47
$561.91
$535.14
$642.46
$611.86
$102.79
$97.90
$867.00
$825.71
$692.98
$659.98
$110.88
$105.60
$711.50
$677.62
$113.84
$108.42
$599.80
$571.23
$704.49
$670.94
$112.72
$107.35
$656.49
$625.23
$105.04
$100.04
$666.60
$634.85
$106.66
$101.58
$776.06
$739.10
$124.17
$118.26
$445.15
$423.95
$549.56
$523.38
$540.29
$514.56
$705.89
$672.27
$455.25
$433.57
$558.82
$532.20
$89.41
$85.15
$401.92
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$253.67
$79.15
$60.34
$75.38
$57.47
$561.91
$535.14
$642.46
$611.86
$102.79
$97.90
$867.00
$825.71
$692.98
$659.98
$110.88
$105.60
$711.50
$677.62
$113.84
$108.42
$599.80
$571.23
$704.49
$670.94
$112.72
$107.35
$656.49
$625.23
$105.04
$100.04
$666.60
$634.85
$106.66
$101.58
$776.06
$739.10
$124.17
$118.26
$445.15
$423.95
$549.56
$523.38
$540.29
$514.56
$705.89
$672.27
$455.25
$433.57
$558.82
$532.20
$89.41
$85.15
$401.92
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
26426
26428
26428
26432
26432
26433
26433
26434
26434
26434
26434
26437
26437
26440
26440
26442
26442
26445
26445
26449
26449
26450
26450
26455
26455
26460
26460
26471
26471
26474
26474
26474
26474
26476
26476
26477
26477
26478
26478
26479
26479
26479
26479
26480
26480
26483
26483
26483
26483
26485
26485
26485
26485
26489
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
N/F
N/F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
14.19
21.16
21.16
13.84
13.84
14.76
14.76
18.08
18.08
2.89
2.89
17.29
17.29
17.16
17.16
26.91
26.91
15.98
15.98
19.63
19.63
11.33
11.33
11.24
11.24
10.97
10.97
17.12
17.12
16.76
16.76
2.68
2.68
16.27
16.27
16.22
16.22
17.31
17.31
17.25
17.25
2.76
2.76
20.95
20.95
23.53
23.53
3.76
3.76
22.43
22.43
3.59
3.59
26.02
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$379.31
$593.90
$565.62
$388.45
$369.95
$414.27
$394.54
$507.45
$483.29
$81.11
$77.25
$485.28
$462.17
$481.63
$458.70
$755.29
$719.32
$448.51
$427.15
$550.96
$524.72
$318.00
$302.86
$315.48
$300.45
$307.90
$293.23
$480.51
$457.63
$470.41
$448.00
$75.22
$71.64
$456.65
$434.91
$455.25
$433.57
$485.84
$462.70
$484.16
$461.10
$77.47
$73.78
$588.01
$560.00
$660.42
$628.97
$105.53
$100.51
$629.55
$599.57
$100.76
$95.96
$730.31
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$379.31
$593.90
$565.62
$388.45
$369.95
$414.27
$394.54
$507.45
$483.29
$81.11
$77.25
$485.28
$462.17
$481.63
$458.70
$755.29
$719.32
$448.51
$427.15
$550.96
$524.72
$318.00
$302.86
$315.48
$300.45
$307.90
$293.23
$480.51
$457.63
$470.41
$448.00
$75.22
$71.64
$456.65
$434.91
$455.25
$433.57
$485.84
$462.70
$484.16
$461.10
$77.47
$73.78
$588.01
$560.00
$660.42
$628.97
$105.53
$100.51
$629.55
$599.57
$100.76
$95.96
$730.31
14.32
20.81
20.81
14.06
14.06
14.93
14.93
18.31
18.31
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
17.53
17.53
17.39
17.39
27.19
27.19
16.15
16.15
19.88
19.88
11.44
11.44
11.37
11.37
11.03
11.03
17.24
17.24
17.00
17.00
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
16.51
16.51
16.19
16.19
17.36
17.36
17.19
17.19
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
21.10
21.10
23.70
23.70
$28.0672
$26.7305
$28.0672
$26.7305
22.70
22.70
$28.0672
$26.7305
26.55
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$382.78
$584.08
$556.26
$394.62
$375.83
$419.04
$399.09
$513.91
$489.44
$82.23
$78.31
$492.02
$468.59
$488.09
$464.84
$763.15
$726.80
$453.29
$431.70
$557.98
$531.40
$321.09
$305.80
$319.12
$303.93
$309.58
$294.84
$483.88
$460.83
$477.14
$454.42
$76.34
$72.71
$463.39
$441.32
$454.41
$432.77
$487.25
$464.04
$482.48
$459.50
$77.20
$73.52
$592.22
$564.01
$665.19
$633.51
$106.43
$101.36
$637.13
$606.78
$101.94
$97.08
$745.18
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$382.78
$584.08
$556.26
$394.62
$375.83
$419.04
$399.09
$513.91
$489.44
$82.23
$78.31
$492.02
$468.59
$488.09
$464.84
$763.15
$726.80
$453.29
$431.70
$557.98
$531.40
$321.09
$305.80
$319.12
$303.93
$309.58
$294.84
$483.88
$460.83
$477.14
$454.42
$76.34
$72.71
$463.39
$441.32
$454.41
$432.77
$487.25
$464.04
$482.48
$459.50
$77.20
$73.52
$592.22
$564.01
$665.19
$633.51
$106.43
$101.36
$637.13
$606.78
$101.94
$97.08
$745.18
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
8
8
2
26489
26490
26490
26492
26492
26492
26492
26494
26494
26494
26494
26496
26496
26497
26497
26497
26497
26498
26498
26498
26498
26499
26499
26499
26499
26500
26500
26502
26502
26502
26502
26508
26508
26510
26510
26516
26516
26517
26517
26517
26517
26518
26518
26518
26518
26520
26520
26525
26525
26530
26530
26530
26530
26531
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
26.02
22.17
22.17
24.65
24.65
3.94
3.94
22.37
22.37
3.58
3.58
23.48
23.48
24.25
24.25
3.88
3.88
32.13
32.13
5.14
5.14
23.25
23.25
3.72
3.72
17.37
17.37
19.72
19.72
3.16
3.16
17.82
17.82
16.64
16.64
19.51
19.51
23.11
23.11
3.70
3.70
23.34
23.34
3.73
3.73
18.07
18.07
18.05
18.05
15.20
15.20
2.43
2.43
17.65
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$695.53
$622.25
$592.62
$691.86
$658.91
$110.58
$105.32
$627.86
$597.96
$100.48
$95.70
$659.02
$627.63
$680.63
$648.21
$108.90
$103.71
$901.80
$858.85
$144.27
$137.39
$652.56
$621.48
$104.41
$99.44
$487.53
$464.31
$553.49
$527.13
$88.69
$84.47
$500.16
$476.34
$467.04
$444.80
$547.59
$521.51
$648.63
$617.74
$103.85
$98.90
$655.09
$623.89
$104.69
$99.70
$507.17
$483.02
$506.61
$482.49
$426.62
$406.30
$68.20
$64.96
$495.39
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$695.53
$622.25
$592.62
$691.86
$658.91
$110.58
$105.32
$627.86
$597.96
$100.48
$95.70
$659.02
$627.63
$680.63
$648.21
$108.90
$103.71
$901.80
$858.85
$144.27
$137.39
$652.56
$621.48
$104.41
$99.44
$487.53
$464.31
$553.49
$527.13
$88.69
$84.47
$500.16
$476.34
$467.04
$444.80
$547.59
$521.51
$648.63
$617.74
$103.85
$98.90
$655.09
$623.89
$104.69
$99.70
$507.17
$483.02
$506.61
$482.49
$426.62
$406.30
$68.20
$64.96
$495.39
26.55
22.58
22.58
25.05
25.05
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
21.99
21.99
$28.0672
$26.7305
24.06
24.06
24.57
24.57
$28.0672
$26.7305
$28.0672
$26.7305
32.75
32.75
$28.0672
$26.7305
23.01
23.01
$28.0672
$26.7305
17.52
17.52
20.11
20.11
$28.0672
$26.7305
$28.0672
$26.7305
17.78
17.78
16.69
16.69
19.66
19.66
23.42
23.42
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
23.20
23.20
$28.0672
$26.7305
18.28
18.28
18.29
18.29
15.37
15.37
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
17.84
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$709.69
$633.76
$603.57
$703.08
$669.60
$112.49
$107.14
$617.20
$587.80
$98.75
$94.05
$675.30
$643.14
$689.61
$656.77
$110.34
$105.08
$919.20
$875.42
$147.07
$140.07
$645.83
$615.07
$103.33
$98.41
$491.74
$468.32
$564.43
$537.55
$90.31
$86.01
$499.03
$475.27
$468.44
$446.13
$551.80
$525.52
$657.33
$626.03
$105.17
$100.16
$651.16
$620.15
$104.19
$99.22
$513.07
$488.63
$513.35
$488.90
$431.39
$410.85
$69.02
$65.74
$500.72
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$709.69
$633.76
$603.57
$703.08
$669.60
$112.49
$107.14
$617.20
$587.80
$98.75
$94.05
$675.30
$643.14
$689.61
$656.77
$110.34
$105.08
$919.20
$875.42
$147.07
$140.07
$645.83
$615.07
$103.33
$98.41
$491.74
$468.32
$564.43
$537.55
$90.31
$86.01
$499.03
$475.27
$468.44
$446.13
$551.80
$525.52
$657.33
$626.03
$105.17
$100.16
$651.16
$620.15
$104.19
$99.22
$513.07
$488.63
$513.35
$488.90
$431.39
$410.85
$69.02
$65.74
$500.72
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
8
8
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
26531
26531
26531
26535
26535
26536
26536
26540
26540
26541
26541
26541
26541
26542
26542
26545
26545
26546
26546
26546
26546
26548
26548
26550
26550
26550
26550
26551
26551
26551
26551
26553
26553
26553
26553
26554
26554
26554
26554
26555
26555
26555
26555
26556
26556
26556
26556
26560
26560
26560
26560
26561
26561
26561
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
17.65
2.82
2.82
11.85
11.85
19.83
19.83
18.33
18.33
22.31
22.31
3.57
3.57
18.99
18.99
19.30
19.30
27.70
27.70
4.43
4.43
21.30
21.30
46.37
46.37
7.42
7.42
83.96
83.96
13.43
13.43
87.26
87.26
13.96
13.96
90.84
90.84
14.53
14.53
38.71
38.71
6.19
6.19
77.91
77.91
12.47
12.47
15.95
15.95
2.55
2.55
26.54
26.54
4.25
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$471.79
$79.15
$75.38
$332.60
$316.76
$556.57
$530.07
$514.47
$489.97
$626.18
$596.36
$100.20
$95.43
$533.00
$507.61
$541.70
$515.90
$777.46
$740.43
$124.34
$118.42
$597.83
$569.36
$1,301.48
$1,239.49
$208.26
$198.34
$2,356.52
$2,244.29
$376.94
$358.99
$2,449.14
$2,332.50
$391.82
$373.16
$2,549.62
$2,428.20
$407.82
$388.39
$1,086.48
$1,034.74
$173.74
$165.46
$2,186.72
$2,082.57
$350.00
$333.33
$447.67
$426.35
$71.57
$68.16
$744.90
$709.43
$119.29
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$471.79
$79.15
$75.38
$332.60
$316.76
$556.57
$530.07
$514.47
$489.97
$626.18
$596.36
$100.20
$95.43
$533.00
$507.61
$541.70
$515.90
$777.46
$740.43
$124.34
$118.42
$597.83
$569.36
$1,301.48
$1,239.49
$208.26
$198.34
$2,356.52
$2,244.29
$376.94
$358.99
$2,449.14
$2,332.50
$391.82
$373.16
$2,549.62
$2,428.20
$407.82
$388.39
$1,086.48
$1,034.74
$173.74
$165.46
$2,186.72
$2,082.57
$350.00
$333.33
$447.67
$426.35
$71.57
$68.16
$744.90
$709.43
$119.29
17.84
$26.7305
12.03
12.03
19.99
19.99
18.46
18.46
22.58
22.58
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
19.11
19.11
20.04
20.04
28.10
28.10
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
21.38
21.38
47.01
47.01
$28.0672
$26.7305
$28.0672
$26.7305
94.85
94.85
$28.0672
$26.7305
77.67
77.67
$28.0672
$26.7305
90.88
90.88
$28.0672
$26.7305
39.11
39.11
$28.0672
$26.7305
81.14
81.14
$28.0672
$26.7305
16.70
16.70
$28.0672
$26.7305
26.26
26.26
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$476.87
$80.12
$76.30
$337.65
$321.57
$561.06
$534.34
$518.12
$493.45
$633.76
$603.57
$101.40
$96.57
$536.36
$510.82
$562.47
$535.68
$788.69
$751.13
$126.19
$120.18
$600.08
$571.50
$1,319.44
$1,256.60
$211.11
$201.06
$2,662.17
$2,535.39
$425.95
$405.66
$2,179.98
$2,076.16
$348.80
$332.19
$2,550.75
$2,429.27
$408.12
$388.68
$1,097.71
$1,045.43
$175.63
$167.27
$2,277.37
$2,168.91
$364.38
$347.03
$468.72
$446.40
$75.00
$71.42
$737.04
$701.94
$117.93
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$476.87
$80.12
$76.30
$337.65
$321.57
$561.06
$534.34
$518.12
$493.45
$633.76
$603.57
$101.40
$96.57
$536.36
$510.82
$562.47
$535.68
$788.69
$751.13
$126.19
$120.18
$600.08
$571.50
$1,319.44
$1,256.60
$211.11
$201.06
$2,662.17
$2,535.39
$425.95
$405.66
$2,179.98
$2,076.16
$348.80
$332.19
$2,550.75
$2,429.27
$408.12
$388.68
$1,097.71
$1,045.43
$175.63
$167.27
$2,277.37
$2,168.91
$364.38
$347.03
$468.72
$446.40
$75.00
$71.42
$737.04
$701.94
$117.93
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
26561
26562
26562
26562
26562
26565
26565
26565
26565
26567
26567
26568
26568
26568
26568
26580
26580
26580
26580
26587
26587
26587
26587
26590
26590
26590
26590
26591
26591
26593
26593
26596
26596
26596
26596
26600
26600
26600
26600
26605
26605
26605
26605
26607
26607
26608
26608
26615
26615
26641
26641
26641
26641
26645
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
F
F
F
F
F
F
N
F
N
F
N
4.25
35.97
35.97
5.76
5.76
19.01
19.01
3.04
3.04
18.98
18.98
25.19
25.19
4.03
4.03
43.02
43.02
6.88
6.88
26.77
26.77
4.28
4.28
39.72
39.72
6.36
6.36
12.11
12.11
16.61
16.61
21.49
21.49
3.44
3.44
8.30
7.83
8.30
7.83
9.07
8.28
9.07
8.28
12.91
12.91
13.50
13.50
16.30
16.30
10.49
9.63
10.49
9.63
12.04
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$113.60
$1,009.58
$961.50
$161.67
$153.97
$533.56
$508.15
$85.32
$81.26
$532.72
$507.34
$707.01
$673.34
$113.11
$107.72
$1,207.45
$1,149.95
$193.10
$183.91
$751.36
$715.58
$120.13
$114.41
$1,114.83
$1,061.74
$178.51
$170.01
$339.89
$323.71
$466.20
$443.99
$603.16
$574.44
$96.55
$91.95
$232.96
$219.77
$221.86
$209.30
$254.57
$232.40
$242.45
$221.33
$362.35
$345.09
$378.91
$360.86
$457.50
$435.71
$294.42
$270.29
$280.40
$257.41
$337.93
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$113.60
$1,009.58
$961.50
$161.67
$153.97
$533.56
$508.15
$85.32
$81.26
$532.72
$507.34
$707.01
$673.34
$113.11
$107.72
$1,207.45
$1,149.95
$193.10
$183.91
$751.36
$715.58
$120.13
$114.41
$1,114.83
$1,061.74
$178.51
$170.01
$339.89
$323.71
$466.20
$443.99
$603.16
$574.44
$96.55
$91.95
$232.96
$219.77
$221.86
$209.30
$254.57
$232.40
$242.45
$221.33
$362.35
$345.09
$378.91
$360.86
$457.50
$435.71
$294.42
$270.29
$280.40
$257.41
$337.93
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
37.66
37.66
$28.0672
$26.7305
19.20
19.20
$28.0672
$26.7305
19.10
19.10
25.54
25.54
$28.0672
$26.7305
$28.0672
$26.7305
43.19
43.19
$28.0672
$26.7305
27.52
27.52
$28.0672
$26.7305
40.21
40.21
$28.0672
$26.7305
12.18
12.18
16.86
16.86
21.28
21.28
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
8.35
7.86
8.35
7.86
9.16
8.34
9.16
8.34
13.11
13.11
13.60
13.60
16.50
16.50
10.74
9.78
10.74
9.78
12.24
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$112.31
$1,057.01
$1,006.67
$169.12
$161.07
$538.89
$513.23
$86.22
$82.12
$536.08
$510.55
$716.84
$682.70
$114.69
$109.23
$1,212.22
$1,154.49
$193.96
$184.72
$772.41
$735.62
$123.59
$117.70
$1,128.58
$1,074.83
$180.57
$171.97
$341.86
$325.58
$473.21
$450.68
$597.27
$568.83
$95.56
$91.01
$234.36
$220.61
$223.20
$210.10
$257.10
$234.08
$244.85
$222.93
$367.96
$350.44
$381.71
$363.53
$463.11
$441.05
$301.44
$274.50
$287.09
$261.42
$343.54
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$112.31
$1,057.01
$1,006.67
$169.12
$161.07
$538.89
$513.23
$86.22
$82.12
$536.08
$510.55
$716.84
$682.70
$114.69
$109.23
$1,212.22
$1,154.49
$193.96
$184.72
$772.41
$735.62
$123.59
$117.70
$1,128.58
$1,074.83
$180.57
$171.97
$341.86
$325.58
$473.21
$450.68
$597.27
$568.83
$95.56
$91.01
$234.36
$220.61
$223.20
$210.10
$257.10
$234.08
$244.85
$222.93
$367.96
$350.44
$381.71
$363.53
$463.11
$441.05
$301.44
$274.50
$287.09
$261.42
$343.54
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
26645
26645
26645
26650
26650
26665
26665
26670
26670
26670
26670
26675
26675
26676
26676
26685
26685
26686
26686
26686
26686
26700
26700
26700
26700
26705
26705
26706
26706
26715
26715
26720
26720
26720
26720
26725
26725
26725
26725
26727
26727
26735
26735
26740
26740
26740
26740
26742
26742
26742
26742
26746
26746
26750
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
N
F
F
F
F
F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
F
F
F
F
N
F
N
F
N
F
N
F
F
F
N
11.07
12.04
11.07
13.51
13.51
17.84
17.84
9.58
8.73
9.58
8.73
11.81
11.81
14.16
14.16
16.45
16.45
17.71
17.71
2.83
2.83
9.22
8.66
9.22
8.66
10.72
10.72
12.45
12.45
16.26
16.26
5.61
5.22
5.61
5.22
9.51
8.61
9.51
8.61
13.26
13.26
16.91
16.91
6.45
6.06
6.45
6.06
10.40
9.47
10.40
9.47
21.03
21.03
5.22
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$310.70
$321.84
$295.91
$379.19
$361.13
$500.72
$476.87
$268.88
$245.03
$256.08
$233.36
$331.47
$315.69
$397.43
$378.50
$461.71
$439.72
$497.07
$473.40
$79.43
$75.65
$258.78
$243.06
$246.46
$231.49
$300.88
$286.55
$349.44
$332.79
$456.37
$434.64
$157.46
$146.51
$149.96
$139.53
$266.92
$241.66
$254.21
$230.15
$372.17
$354.45
$474.62
$452.01
$181.03
$170.09
$172.41
$161.99
$291.90
$265.80
$278.00
$253.14
$590.25
$562.14
$146.51
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$310.70
$321.84
$295.91
$379.19
$361.13
$500.72
$476.87
$268.88
$245.03
$256.08
$233.36
$331.47
$315.69
$397.43
$378.50
$461.71
$439.72
$497.07
$473.40
$79.43
$75.65
$258.78
$243.06
$246.46
$231.49
$300.88
$286.55
$349.44
$332.79
$456.37
$434.64
$157.46
$146.51
$149.96
$139.53
$266.92
$241.66
$254.21
$230.15
$372.17
$354.45
$474.62
$452.01
$181.03
$170.09
$172.41
$161.99
$291.90
$265.80
$278.00
$253.14
$590.25
$562.14
$146.51
11.24
12.24
11.24
13.69
13.69
18.03
18.03
9.58
8.71
9.58
8.71
11.97
11.97
14.30
14.30
16.51
16.51
17.94
17.94
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
9.14
8.57
9.14
8.57
10.90
10.90
12.44
12.44
16.36
16.36
5.62
5.23
5.62
5.23
9.58
8.64
9.58
8.64
13.40
13.40
17.08
17.08
6.51
6.11
6.51
6.11
10.42
9.45
10.42
9.45
21.23
21.23
5.22
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$315.48
$327.18
$300.45
$384.24
$365.94
$506.05
$481.95
$268.88
$244.47
$256.08
$232.82
$335.96
$319.96
$401.36
$382.25
$463.39
$441.32
$503.53
$479.55
$80.56
$76.73
$256.53
$240.54
$244.32
$229.08
$305.93
$291.36
$349.16
$332.53
$459.18
$437.31
$157.74
$146.79
$150.23
$139.80
$268.88
$242.50
$256.08
$230.95
$376.10
$358.19
$479.39
$456.56
$182.72
$171.49
$174.02
$163.32
$292.46
$265.24
$278.53
$252.60
$595.87
$567.49
$146.51
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$315.48
$327.18
$300.45
$384.24
$365.94
$506.05
$481.95
$268.88
$244.47
$256.08
$232.82
$335.96
$319.96
$401.36
$382.25
$463.39
$441.32
$503.53
$479.55
$80.56
$76.73
$256.53
$240.54
$244.32
$229.08
$305.93
$291.36
$349.16
$332.53
$459.18
$437.31
$157.74
$146.79
$150.23
$139.80
$268.88
$242.50
$256.08
$230.95
$376.10
$358.19
$479.39
$456.56
$182.72
$171.49
$174.02
$163.32
$292.46
$265.24
$278.53
$252.60
$595.87
$567.49
$146.51
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
2
2
2
2
8
26750
26750
26750
26755
26755
26755
26755
26756
26756
26765
26765
26770
26770
26770
26770
26775
26775
26775
26775
26776
26776
26785
26785
26820
26820
26820
26820
26841
26841
26842
26842
26842
26842
26843
26843
26843
26843
26844
26844
26844
26844
26850
26850
26852
26852
26852
26852
26860
26860
26861
26861
26862
26862
26862
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
N
F
N
F
N
F
F
F
F
F
N
F
N
F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
5.23
5.22
5.23
8.89
7.76
8.89
7.76
11.79
11.79
14.21
14.21
7.82
7.26
7.82
7.26
10.76
9.76
10.76
9.76
12.50
12.50
15.49
15.49
22.04
22.04
3.53
3.53
20.33
20.33
22.03
22.03
3.52
3.52
20.65
20.65
3.30
3.30
22.85
22.85
3.66
3.66
19.28
19.28
22.15
22.15
3.54
3.54
15.63
15.63
2.97
2.97
20.17
20.17
3.23
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$146.79
$139.53
$139.80
$249.52
$217.80
$237.63
$207.43
$330.91
$315.15
$398.83
$379.84
$219.49
$203.77
$209.03
$194.06
$302.00
$273.94
$287.62
$260.89
$350.84
$334.13
$434.76
$414.06
$618.60
$589.14
$99.08
$94.36
$570.61
$543.43
$618.32
$588.87
$98.80
$94.09
$579.59
$551.98
$92.62
$88.21
$641.34
$610.79
$102.73
$97.83
$541.14
$515.36
$621.69
$592.08
$99.36
$94.63
$438.69
$417.80
$83.36
$79.39
$566.12
$539.15
$90.66
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$146.79
$139.53
$139.80
$249.52
$217.80
$237.63
$207.43
$330.91
$315.15
$398.83
$379.84
$219.49
$203.77
$209.03
$194.06
$302.00
$273.94
$287.62
$260.89
$350.84
$334.13
$434.76
$414.06
$618.60
$589.14
$99.08
$94.36
$570.61
$543.43
$618.32
$588.87
$98.80
$94.09
$579.59
$551.98
$92.62
$88.21
$641.34
$610.79
$102.73
$97.83
$541.14
$515.36
$621.69
$592.08
$99.36
$94.63
$438.69
$417.80
$83.36
$79.39
$566.12
$539.15
$90.66
5.23
5.22
5.23
8.92
7.75
8.92
7.75
11.89
11.89
14.32
14.32
7.81
7.23
7.81
7.23
10.90
9.87
10.90
9.87
12.64
12.64
15.63
15.63
22.33
22.33
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
20.44
20.44
22.13
22.13
$28.0672
$26.7305
$28.0672
$26.7305
20.92
20.92
$28.0672
$26.7305
22.74
22.74
$28.0672
$26.7305
19.44
19.44
22.38
22.38
$28.0672
$26.7305
$28.0672
$26.7305
15.86
15.86
2.99
2.99
20.42
20.42
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$146.79
$139.53
$139.80
$250.36
$217.52
$238.44
$207.16
$333.72
$317.83
$401.92
$382.78
$219.20
$202.93
$208.77
$193.26
$305.93
$277.02
$291.36
$263.83
$354.77
$337.87
$438.69
$417.80
$626.74
$596.89
$100.28
$95.50
$573.69
$546.37
$621.13
$591.55
$99.38
$94.65
$587.17
$559.20
$93.95
$89.47
$638.25
$607.85
$102.12
$97.26
$545.63
$519.64
$628.14
$598.23
$100.50
$95.72
$445.15
$423.95
$83.92
$79.92
$573.13
$545.84
$91.70
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$146.79
$139.53
$139.80
$250.36
$217.52
$238.44
$207.16
$333.72
$317.83
$401.92
$382.78
$219.20
$202.93
$208.77
$193.26
$305.93
$277.02
$291.36
$263.83
$354.77
$337.87
$438.69
$417.80
$626.74
$596.89
$100.28
$95.50
$573.69
$546.37
$621.13
$591.55
$99.38
$94.65
$587.17
$559.20
$93.95
$89.47
$638.25
$607.85
$102.12
$97.26
$545.63
$519.64
$628.14
$598.23
$100.50
$95.72
$445.15
$423.95
$83.92
$79.92
$573.13
$545.84
$91.70
Musculoskeletal System Surgery
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
TOS*
Procedure
Code
Age
Range
8
2
2
8
8
2
2
2
2
2
2
26862
26863
26863
26863
26863
26910
26910
26951
26951
26952
26952
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
F
F
F
F
F
F
F
F
F
F
F
3.23
6.57
6.57
1.05
1.05
20.06
20.06
18.22
18.22
18.03
18.03
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
26989
26990
26990
26991
26991
26992
26992
27000
27000
27001
27001
27001
27001
27003
27003
27003
27003
27005
27005
27005
27005
27006
27006
27006
27006
27025
27025
27027
27027
27030
27030
27030
27030
27033
27033
27033
27033
27035
27035
27035
27035
27036
0-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
F
N/F
N/F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N/F
N/F
F
F
F
F
F
F
F
F
F
F
F
F
F
17.70
17.70
14.89
14.89
27.46
27.46
11.97
11.97
15.41
15.41
2.47
2.47
16.93
16.93
2.71
2.71
20.71
20.71
3.31
3.31
20.96
20.96
3.35
3.35
26.16
26.16
24.18
24.18
26.18
26.18
4.19
4.19
27.81
27.81
4.45
4.45
33.60
33.60
5.38
5.38
28.87
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$86.34
$184.40
$175.62
$29.47
$28.07
$563.03
$536.21
$511.38
$487.03
$506.05
$481.95
Manually
Priced
$496.79
$473.13
$417.92
$398.02
$770.73
$734.02
$335.96
$319.96
$432.52
$411.92
$69.33
$66.02
$475.18
$452.55
$76.06
$72.44
$581.27
$553.59
$92.90
$88.48
$588.29
$560.27
$94.03
$89.55
$734.24
$699.27
$678.66
$646.34
$734.80
$699.80
$117.60
$112.00
$780.55
$743.38
$124.90
$118.95
$943.06
$898.14
$151.00
$143.81
$810.30
Current
Percent
Reduction
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Current
Adjusted
Medicaid
Fee
$86.34
$184.40
$175.62
$29.47
$28.07
$563.03
$536.21
$511.38
$487.03
$506.05
$481.95
Manually
Priced
$496.79
$473.13
$417.92
$398.02
$770.73
$734.02
$335.96
$319.96
$432.52
$411.92
$69.33
$66.02
$475.18
$452.55
$76.06
$72.44
$581.27
$553.59
$92.90
$88.48
$588.29
$560.27
$94.03
$89.55
$734.24
$699.27
$678.66
$646.34
$734.80
$699.80
$117.60
$112.00
$780.55
$743.38
$124.90
$118.95
$943.06
$898.14
$151.00
$143.81
$810.30
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
6.61
6.61
$28.0672
$26.7305
20.20
20.20
18.38
18.38
18.14
18.14
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
17.99
17.99
14.95
14.95
27.51
27.51
11.94
11.94
15.52
15.52
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
17.16
17.16
$28.0672
$26.7305
20.87
20.87
$28.0672
$26.7305
21.17
21.17
$28.0672
$26.7305
26.21
26.21
25.56
25.56
27.02
27.02
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
28.00
28.00
$28.0672
$26.7305
30.83
30.83
$28.0672
$26.7305
29.15
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
$87.33
$185.52
$176.69
$29.68
$28.27
$566.96
$539.96
$515.88
$491.31
$509.14
$484.89
Manually
Priced
$504.93
$480.88
$419.60
$399.62
$772.13
$735.36
$335.12
$319.16
$435.60
$414.86
$69.70
$66.38
$481.63
$458.70
$77.06
$73.39
$585.76
$557.87
$93.72
$89.26
$594.18
$565.88
$95.07
$90.54
$735.64
$700.61
$717.40
$683.23
$758.38
$722.26
$121.34
$115.56
$785.88
$748.45
$125.74
$119.75
$865.31
$824.10
$138.45
$131.86
$818.16
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$87.33
$185.52
$176.69
$29.68
$28.27
$566.96
$539.96
$515.88
$491.31
$509.14
$484.89
Manually
Priced
$504.93
$480.88
$419.60
$399.62
$772.13
$735.36
$335.12
$319.16
$435.60
$414.86
$69.70
$66.38
$481.63
$458.70
$77.06
$73.39
$585.76
$557.87
$93.72
$89.26
$594.18
$565.88
$95.07
$90.54
$735.64
$700.61
$717.40
$683.23
$758.38
$722.26
$121.34
$115.56
$785.88
$748.45
$125.74
$119.75
$865.31
$824.10
$138.45
$131.86
$818.16
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
8
8
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
8
8
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
27036
27036
27036
27040
27040
27040
27040
27041
27041
27043
27043
27045
27045
27045
27045
27047
27047
27047
27047
27048
27048
27049
27049
27050
27050
27052
27052
27054
27054
27054
27054
27057
27057
27059
27059
27059
27059
27060
27060
27062
27062
27065
27065
27065
27065
27066
27066
27066
27066
27067
27067
27067
27067
27070
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
N
F
N
F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
F
F
N/F
N/F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
28.87
4.62
4.62
9.75
5.74
9.75
5.74
19.63
19.63
13.30
13.30
21.32
21.32
3.41
3.41
13.21
10.32
13.21
10.32
17.35
17.35
38.99
38.99
11.39
11.39
16.43
16.43
19.53
19.53
3.12
3.12
27.14
27.14
51.62
51.62
8.26
8.26
13.21
13.21
12.95
12.95
14.59
14.59
2.33
2.33
23.17
23.17
3.71
3.71
29.49
29.49
4.72
4.72
24.26
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$771.71
$129.67
$123.49
$273.66
$161.11
$260.62
$153.43
$550.96
$524.72
$373.29
$355.52
$598.39
$569.89
$95.71
$91.15
$370.77
$289.65
$353.11
$275.86
$486.97
$463.77
$1,094.34
$1,042.22
$319.69
$304.46
$461.14
$439.18
$548.15
$522.05
$87.57
$83.40
$761.74
$725.47
$1,448.83
$1,379.83
$231.84
$220.79
$370.77
$353.11
$363.47
$346.16
$409.50
$390.00
$65.40
$62.28
$650.32
$619.35
$104.13
$99.17
$827.70
$788.28
$132.48
$126.17
$680.91
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$771.71
$129.67
$123.49
$273.66
$161.11
$260.62
$153.43
$550.96
$524.72
$373.29
$355.52
$598.39
$569.89
$95.71
$91.15
$370.77
$289.65
$353.11
$275.86
$486.97
$463.77
$1,094.34
$1,042.22
$319.69
$304.46
$461.14
$439.18
$548.15
$522.05
$87.57
$83.40
$761.74
$725.47
$1,448.83
$1,379.83
$231.84
$220.79
$370.77
$353.11
$363.47
$346.16
$409.50
$390.00
$65.40
$62.28
$650.32
$619.35
$104.13
$99.17
$827.70
$788.28
$132.48
$126.17
$680.91
29.15
$26.7305
9.83
5.75
9.83
5.75
19.76
19.76
13.51
13.51
21.58
21.58
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
13.44
10.45
13.44
10.45
17.54
17.54
38.58
38.58
11.54
11.54
16.68
16.68
19.68
19.68
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
29.29
29.29
52.56
52.56
$28.0672
$26.7305
$28.0672
$26.7305
13.37
13.37
13.13
13.13
14.89
14.89
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
23.41
23.41
$28.0672
$26.7305
29.86
29.86
$28.0672
$26.7305
24.41
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$779.19
$130.91
$124.67
$275.90
$161.39
$262.76
$153.70
$554.61
$528.19
$379.19
$361.13
$605.69
$576.84
$96.91
$92.29
$377.22
$293.30
$359.26
$279.33
$492.30
$468.85
$1,082.83
$1,031.26
$323.90
$308.47
$468.16
$445.86
$552.36
$526.06
$88.38
$84.17
$822.09
$782.94
$1,475.21
$1,404.96
$236.03
$224.79
$375.26
$357.39
$368.52
$350.97
$417.92
$398.02
$66.87
$63.68
$657.05
$625.76
$105.13
$100.12
$838.09
$798.17
$134.09
$127.71
$685.12
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$779.19
$130.91
$124.67
$275.90
$161.39
$262.76
$153.70
$554.61
$528.19
$379.19
$361.13
$605.69
$576.84
$96.91
$92.29
$377.22
$293.30
$359.26
$279.33
$492.30
$468.85
$1,082.83
$1,031.26
$323.90
$308.47
$468.16
$445.86
$552.36
$526.06
$88.38
$84.17
$822.09
$782.94
$1,475.21
$1,404.96
$236.03
$224.79
$375.26
$357.39
$368.52
$350.97
$417.92
$398.02
$66.87
$63.68
$657.05
$625.76
$105.13
$100.12
$838.09
$798.17
$134.09
$127.71
$685.12
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
27070
27070
27070
27071
27071
27071
27071
27075
27075
27075
27075
27076
27076
27076
27076
27077
27077
27077
27077
27078
27078
27078
27078
27080
27080
27080
27080
27086
27086
27086
27086
27087
27087
27087
27087
27090
27090
27090
27090
27091
27091
27091
27091
27093
27093
27093
27093
27095
27095
27096
27096
27096
27096
27097
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
N/F
N/F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
F
F
N
F
N
F
F
24.26
3.88
3.88
26.15
26.15
4.18
4.18
60.15
60.15
9.62
9.62
72.33
72.33
11.57
11.57
81.32
81.32
13.01
13.01
59.30
59.30
9.49
9.49
14.56
14.56
2.33
2.33
8.23
4.70
8.23
4.70
17.89
17.89
2.86
2.86
23.63
23.63
3.78
3.78
45.83
45.83
7.33
7.33
5.26
2.02
5.26
2.02
2.36
2.36
4.61
2.43
4.61
2.43
19.40
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$648.48
$108.90
$103.71
$733.96
$699.00
$117.32
$111.73
$1,688.24
$1,607.84
$270.01
$257.15
$2,030.10
$1,933.42
$324.74
$309.27
$2,282.42
$2,173.72
$365.15
$347.76
$1,664.38
$1,585.12
$266.36
$253.67
$408.66
$389.20
$65.40
$62.28
$230.99
$131.92
$219.99
$125.63
$502.12
$478.21
$80.27
$76.45
$663.23
$631.64
$106.09
$101.04
$1,286.32
$1,225.06
$205.73
$195.93
$147.63
$56.70
$140.60
$54.00
$66.24
$63.08
$129.39
$68.20
$123.23
$64.96
$544.50
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$648.48
$108.90
$103.71
$733.96
$699.00
$117.32
$111.73
$1,688.24
$1,607.84
$270.01
$257.15
$2,030.10
$1,933.42
$324.74
$309.27
$2,282.42
$2,173.72
$365.15
$347.76
$1,664.38
$1,585.12
$266.36
$253.67
$408.66
$389.20
$65.40
$62.28
$230.99
$131.92
$219.99
$125.63
$502.12
$478.21
$80.27
$76.45
$663.23
$631.64
$106.09
$101.04
$1,286.32
$1,225.06
$205.73
$195.93
$147.63
$56.70
$140.60
$54.00
$66.24
$63.08
$129.39
$68.20
$123.23
$64.96
$544.50
24.41
$26.7305
26.31
26.31
$28.0672
$26.7305
60.89
60.89
$28.0672
$26.7305
73.74
73.74
$28.0672
$26.7305
82.32
82.32
$28.0672
$26.7305
60.05
60.05
$28.0672
$26.7305
14.78
14.78
$28.0672
$26.7305
8.43
4.84
8.43
4.84
17.98
17.98
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
23.80
23.80
$28.0672
$26.7305
46.14
46.14
$28.0672
$26.7305
5.33
2.03
5.33
2.03
2.39
2.39
4.56
2.42
4.56
2.42
19.65
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$652.49
$109.62
$104.40
$738.45
$703.28
$118.15
$112.52
$1,709.01
$1,627.62
$273.44
$260.42
$2,069.68
$1,971.11
$331.15
$315.38
$2,310.49
$2,200.45
$369.68
$352.07
$1,685.44
$1,605.17
$269.67
$256.83
$414.83
$395.08
$66.37
$63.21
$236.61
$135.85
$225.34
$129.38
$504.65
$480.61
$80.74
$76.90
$668.00
$636.19
$106.88
$101.79
$1,295.02
$1,233.35
$207.20
$197.34
$149.60
$56.98
$142.47
$54.26
$67.08
$63.89
$127.99
$67.92
$121.89
$64.69
$551.52
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$652.49
$109.62
$104.40
$738.45
$703.28
$118.15
$112.52
$1,709.01
$1,627.62
$273.44
$260.42
$2,069.68
$1,971.11
$331.15
$315.38
$2,310.49
$2,200.45
$369.68
$352.07
$1,685.44
$1,605.17
$269.67
$256.83
$414.83
$395.08
$66.37
$63.21
$236.61
$135.85
$225.34
$129.38
$504.65
$480.61
$80.74
$76.90
$668.00
$636.19
$106.88
$101.79
$1,295.02
$1,233.35
$207.20
$197.34
$149.60
$56.98
$142.47
$54.26
$67.08
$63.89
$127.99
$67.92
$121.89
$64.69
$551.52
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
27097
27097
27097
27098
27098
27098
27098
27100
27100
27100
27100
27105
27105
27105
27105
27110
27110
27110
27110
27111
27111
27111
27111
27120
27120
27120
27120
27122
27122
27122
27122
27125
27125
27125
27125
27130
27130
27130
27130
27132
27132
27132
27132
27134
27134
27134
27134
27137
27137
27137
27137
27138
27138
27138
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
19.40
3.10
3.10
19.74
19.74
3.16
3.16
23.32
23.32
3.73
3.73
24.66
24.66
3.95
3.95
27.61
27.61
4.42
4.42
25.60
25.60
4.10
4.10
37.13
37.13
5.94
5.94
31.42
31.42
5.03
5.03
32.43
32.43
5.19
5.19
38.94
38.94
6.23
6.23
48.11
48.11
7.70
7.70
55.08
55.08
8.81
8.81
42.28
42.28
6.76
6.76
43.96
43.96
7.03
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$518.57
$87.01
$82.86
$554.05
$527.66
$88.69
$84.47
$654.53
$623.36
$104.69
$99.70
$692.14
$659.17
$110.87
$105.59
$774.94
$738.03
$124.06
$118.15
$718.52
$684.30
$115.08
$109.60
$1,042.14
$992.50
$166.72
$158.78
$881.87
$839.87
$141.18
$134.45
$910.22
$866.87
$145.67
$138.73
$1,092.94
$1,040.89
$174.86
$166.53
$1,350.31
$1,286.00
$216.12
$205.82
$1,545.94
$1,472.32
$247.27
$235.50
$1,186.68
$1,130.17
$189.73
$180.70
$1,233.83
$1,175.07
$197.31
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$518.57
$87.01
$82.86
$554.05
$527.66
$88.69
$84.47
$654.53
$623.36
$104.69
$99.70
$692.14
$659.17
$110.87
$105.59
$774.94
$738.03
$124.06
$118.15
$718.52
$684.30
$115.08
$109.60
$1,042.14
$992.50
$166.72
$158.78
$881.87
$839.87
$141.18
$134.45
$910.22
$866.87
$145.67
$138.73
$1,092.94
$1,040.89
$174.86
$166.53
$1,350.31
$1,286.00
$216.12
$205.82
$1,545.94
$1,472.32
$247.27
$235.50
$1,186.68
$1,130.17
$189.73
$180.70
$1,233.83
$1,175.07
$197.31
19.65
$26.7305
20.01
20.01
$28.0672
$26.7305
23.80
23.80
$28.0672
$26.7305
24.98
24.98
$28.0672
$26.7305
27.94
27.94
$28.0672
$26.7305
25.95
25.95
$28.0672
$26.7305
37.60
37.60
$28.0672
$26.7305
31.67
31.67
$28.0672
$26.7305
32.72
32.72
$28.0672
$26.7305
39.18
39.18
$28.0672
$26.7305
48.40
48.40
$28.0672
$26.7305
55.39
55.39
$28.0672
$26.7305
42.57
42.57
$28.0672
$26.7305
44.22
44.22
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$525.25
$88.24
$84.04
$561.62
$534.88
$89.86
$85.58
$668.00
$636.19
$106.88
$101.79
$701.12
$667.73
$112.18
$106.84
$784.20
$746.85
$125.47
$119.50
$728.34
$693.66
$116.53
$110.99
$1,055.33
$1,005.07
$168.85
$160.81
$888.89
$846.55
$142.22
$135.45
$918.36
$874.62
$146.94
$139.94
$1,099.67
$1,047.30
$175.95
$167.57
$1,358.45
$1,293.76
$217.35
$207.00
$1,554.64
$1,480.60
$248.74
$236.90
$1,194.82
$1,137.92
$191.17
$182.07
$1,241.13
$1,182.02
$198.58
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$525.25
$88.24
$84.04
$561.62
$534.88
$89.86
$85.58
$668.00
$636.19
$106.88
$101.79
$701.12
$667.73
$112.18
$106.84
$784.20
$746.85
$125.47
$119.50
$728.34
$693.66
$116.53
$110.99
$1,055.33
$1,005.07
$168.85
$160.81
$888.89
$846.55
$142.22
$135.45
$918.36
$874.62
$146.94
$139.94
$1,099.67
$1,047.30
$175.95
$167.57
$1,358.45
$1,293.76
$217.35
$207.00
$1,554.64
$1,480.60
$248.74
$236.90
$1,194.82
$1,137.92
$191.17
$182.07
$1,241.13
$1,182.02
$198.58
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
27138
27140
27140
27140
27140
27146
27146
27146
27146
27147
27147
27147
27147
27151
27151
27151
27151
27156
27156
27156
27156
27158
27158
27158
27158
27161
27161
27161
27161
27165
27165
27165
27165
27170
27170
27170
27170
27175
27175
27176
27176
27176
27176
27177
27177
27177
27177
27178
27178
27178
27178
27179
27179
27179
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
7.03
25.50
25.50
4.08
4.08
36.72
36.72
5.88
5.88
42.02
42.02
6.72
6.72
45.51
45.51
7.28
7.28
49.07
49.07
7.85
7.85
40.07
40.07
6.41
6.41
34.79
34.79
5.57
5.57
39.43
39.43
6.31
6.31
33.67
33.67
5.39
5.39
16.83
16.83
26.18
26.18
4.19
4.19
31.78
31.78
5.08
5.08
26.18
26.18
4.19
4.19
27.83
27.83
4.45
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$187.92
$715.71
$681.63
$114.51
$109.06
$1,030.63
$981.54
$165.04
$157.18
$1,179.38
$1,123.22
$188.61
$179.63
$1,277.34
$1,216.51
$204.33
$194.60
$1,377.26
$1,311.67
$220.33
$209.83
$1,124.65
$1,071.09
$179.91
$171.34
$976.46
$929.95
$156.33
$148.89
$1,106.69
$1,053.98
$177.10
$168.67
$945.02
$900.02
$151.28
$144.08
$472.37
$449.87
$734.80
$699.80
$117.60
$112.00
$891.98
$849.50
$142.58
$135.79
$734.80
$699.80
$117.60
$112.00
$781.11
$743.91
$124.90
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$187.92
$715.71
$681.63
$114.51
$109.06
$1,030.63
$981.54
$165.04
$157.18
$1,179.38
$1,123.22
$188.61
$179.63
$1,277.34
$1,216.51
$204.33
$194.60
$1,377.26
$1,311.67
$220.33
$209.83
$1,124.65
$1,071.09
$179.91
$171.34
$976.46
$929.95
$156.33
$148.89
$1,106.69
$1,053.98
$177.10
$168.67
$945.02
$900.02
$151.28
$144.08
$472.37
$449.87
$734.80
$699.80
$117.60
$112.00
$891.98
$849.50
$142.58
$135.79
$734.80
$699.80
$117.60
$112.00
$781.11
$743.91
$124.90
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
25.88
25.88
$28.0672
$26.7305
37.05
37.05
$28.0672
$26.7305
42.56
42.56
$28.0672
$26.7305
46.07
46.07
$28.0672
$26.7305
49.68
49.68
$28.0672
$26.7305
40.58
40.58
$28.0672
$26.7305
35.10
35.10
$28.0672
$26.7305
39.59
39.59
$28.0672
$26.7305
34.01
34.01
$28.0672
$26.7305
19.25
19.25
26.49
26.49
$28.0672
$26.7305
$28.0672
$26.7305
32.18
32.18
$28.0672
$26.7305
26.49
26.49
$28.0672
$26.7305
28.18
28.18
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$189.12
$726.38
$691.79
$116.22
$110.69
$1,039.89
$990.37
$166.38
$158.46
$1,194.54
$1,137.65
$191.13
$182.02
$1,293.06
$1,231.47
$206.89
$197.04
$1,394.38
$1,327.97
$223.10
$212.48
$1,138.97
$1,084.72
$182.24
$173.56
$985.16
$938.24
$157.63
$150.12
$1,111.18
$1,058.26
$177.79
$169.32
$954.57
$909.10
$152.73
$145.46
$540.29
$514.56
$743.50
$708.09
$118.96
$113.29
$903.20
$860.19
$144.51
$137.63
$743.50
$708.09
$118.96
$113.29
$790.93
$753.27
$126.55
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$189.12
$726.38
$691.79
$116.22
$110.69
$1,039.89
$990.37
$166.38
$158.46
$1,194.54
$1,137.65
$191.13
$182.02
$1,293.06
$1,231.47
$206.89
$197.04
$1,394.38
$1,327.97
$223.10
$212.48
$1,138.97
$1,084.72
$182.24
$173.56
$985.16
$938.24
$157.63
$150.12
$1,111.18
$1,058.26
$177.79
$169.32
$954.57
$909.10
$152.73
$145.46
$540.29
$514.56
$743.50
$708.09
$118.96
$113.29
$903.20
$860.19
$144.51
$137.63
$743.50
$708.09
$118.96
$113.29
$790.93
$753.27
$126.55
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
2
2
8
8
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
27179
27181
27181
27181
27181
27185
27185
27187
27187
27187
27187
27193
27193
27193
27193
27194
27194
27200
27200
27200
27200
27202
27202
27202
27202
27215
27215
27216
27216
27217
27217
27218
27218
27220
27220
27220
27220
27222
27222
27226
27226
27226
27226
27227
27227
27227
27227
27228
27228
27228
27228
27230
27230
27232
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
N/F
N/F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
4.45
29.13
29.13
4.66
4.66
16.78
16.78
28.35
28.35
4.54
4.54
13.40
13.58
13.40
13.58
19.98
19.98
5.10
5.31
5.10
5.31
15.18
15.18
2.43
2.43
17.19
17.19
25.51
25.51
23.94
23.94
33.06
33.06
15.09
14.96
15.09
14.96
27.83
27.83
30.29
30.29
4.85
4.85
47.60
47.60
7.62
7.62
54.23
54.23
8.68
8.68
13.40
13.40
21.74
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$118.95
$817.60
$778.66
$130.79
$124.56
$470.97
$448.54
$795.71
$757.81
$127.43
$121.36
$376.10
$381.15
$358.19
$363.00
$560.78
$534.08
$143.14
$149.04
$136.33
$141.94
$426.06
$405.77
$68.20
$64.96
$482.48
$459.50
$715.99
$681.90
$671.93
$639.93
$927.90
$883.71
$423.53
$419.89
$403.36
$399.89
$781.11
$743.91
$850.16
$809.67
$136.13
$129.64
$1,336.00
$1,272.37
$213.87
$203.69
$1,522.08
$1,449.60
$243.62
$232.02
$376.10
$358.19
$610.18
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$118.95
$817.60
$778.66
$130.79
$124.56
$470.97
$448.54
$795.71
$757.81
$127.43
$121.36
$376.10
$381.15
$358.19
$363.00
$560.78
$534.08
$143.14
$149.04
$136.33
$141.94
$426.06
$405.77
$68.20
$64.96
$482.48
$459.50
$715.99
$681.90
$671.93
$639.93
$927.90
$883.71
$423.53
$419.89
$403.36
$399.89
$781.11
$743.91
$850.16
$809.67
$136.13
$129.64
$1,336.00
$1,272.37
$213.87
$203.69
$1,522.08
$1,449.60
$243.62
$232.02
$376.10
$358.19
$610.18
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
32.45
32.45
$28.0672
$26.7305
16.81
16.81
28.60
28.60
$28.0672
$26.7305
$28.0672
$26.7305
13.51
13.69
13.51
13.69
20.52
20.52
5.16
5.38
5.16
5.38
15.35
15.35
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
17.22
17.22
25.54
25.54
23.97
23.97
33.06
33.06
15.23
15.09
15.23
15.09
28.20
28.20
30.55
30.55
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
47.99
47.99
$28.0672
$26.7305
54.72
54.72
$28.0672
$26.7305
13.51
13.51
21.74
$28.0672
$26.7305
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$120.52
$910.78
$867.40
$145.72
$138.78
$471.81
$449.34
$802.72
$764.49
$128.44
$122.32
$379.19
$384.24
$361.13
$365.94
$575.94
$548.51
$144.83
$151.00
$137.93
$143.81
$430.83
$410.31
$68.93
$65.65
$483.32
$460.30
$716.84
$682.70
$672.77
$640.73
$927.90
$883.71
$427.46
$423.53
$407.11
$403.36
$791.50
$753.80
$857.45
$816.62
$137.19
$130.66
$1,346.94
$1,282.80
$215.51
$205.25
$1,535.84
$1,462.69
$245.73
$234.03
$379.19
$361.13
$610.18
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$120.52
$910.78
$867.40
$145.72
$138.78
$471.81
$449.34
$802.72
$764.49
$128.44
$122.32
$379.19
$384.24
$361.13
$365.94
$575.94
$548.51
$144.83
$151.00
$137.93
$143.81
$430.83
$410.31
$68.93
$65.65
$483.32
$460.30
$716.84
$682.70
$672.77
$640.73
$927.90
$883.71
$427.46
$423.53
$407.11
$403.36
$791.50
$753.80
$857.45
$816.62
$137.19
$130.66
$1,346.94
$1,282.80
$215.51
$205.25
$1,535.84
$1,462.69
$245.73
$234.03
$379.19
$361.13
$610.18
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
8
8
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
8
8
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
27232
27235
27235
27236
27236
27236
27236
27238
27238
27240
27240
27244
27244
27244
27244
27245
27245
27245
27245
27246
27246
27246
27246
27248
27248
27248
27248
27250
27250
27252
27252
27253
27253
27253
27253
27254
27254
27254
27254
27256
27256
27256
27256
27257
27257
27258
27258
27258
27258
27259
27259
27259
27259
27265
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
F
F
F
F
N/F
N/F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
N/F
21.74
25.96
25.96
34.26
34.26
5.48
5.48
13.07
13.07
27.30
27.30
35.22
35.22
5.64
5.64
35.23
35.23
5.64
5.64
10.92
10.98
10.92
10.98
21.25
21.25
3.40
3.40
5.26
5.26
21.67
21.67
26.92
26.92
4.31
4.31
36.24
36.24
5.80
5.80
8.54
6.74
8.54
6.74
10.30
10.30
31.69
31.69
5.07
5.07
44.37
44.37
7.10
7.10
11.38
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$581.12
$728.62
$693.92
$961.58
$915.79
$153.81
$146.48
$366.84
$349.37
$766.23
$729.74
$988.53
$941.45
$158.30
$150.76
$988.81
$941.72
$158.30
$150.76
$306.49
$308.18
$291.90
$293.50
$596.43
$568.02
$95.43
$90.88
$147.63
$140.60
$608.22
$579.25
$755.57
$719.59
$120.97
$115.21
$1,017.16
$968.71
$162.79
$155.04
$239.69
$189.17
$228.28
$180.16
$289.09
$275.32
$889.45
$847.09
$142.30
$135.52
$1,245.34
$1,186.03
$199.28
$189.79
$319.40
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$581.12
$728.62
$693.92
$961.58
$915.79
$153.81
$146.48
$366.84
$349.37
$766.23
$729.74
$988.53
$941.45
$158.30
$150.76
$988.81
$941.72
$158.30
$150.76
$306.49
$308.18
$291.90
$293.50
$596.43
$568.02
$95.43
$90.88
$147.63
$140.60
$608.22
$579.25
$755.57
$719.59
$120.97
$115.21
$1,017.16
$968.71
$162.79
$155.04
$239.69
$189.17
$228.28
$180.16
$289.09
$275.32
$889.45
$847.09
$142.30
$135.52
$1,245.34
$1,186.03
$199.28
$189.79
$319.40
21.74
26.24
26.24
34.54
34.54
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
13.21
13.21
27.60
27.60
35.56
35.56
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
35.55
35.55
$28.0672
$26.7305
11.05
11.09
11.05
11.09
21.44
21.44
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
5.23
5.23
21.91
21.91
27.13
27.13
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
36.77
36.77
$28.0672
$26.7305
8.65
6.78
8.65
6.78
9.85
9.85
32.07
32.07
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
44.95
44.95
$28.0672
$26.7305
11.38
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$581.12
$736.48
$701.41
$969.44
$923.27
$155.11
$147.72
$370.77
$353.11
$774.65
$737.76
$998.07
$950.54
$159.69
$152.09
$997.79
$950.27
$159.65
$152.04
$310.14
$311.27
$295.37
$296.44
$601.76
$573.10
$96.28
$91.70
$146.79
$139.80
$614.95
$585.67
$761.46
$725.20
$121.83
$116.03
$1,032.03
$982.88
$165.12
$157.26
$242.78
$190.30
$231.22
$181.23
$276.46
$263.30
$900.12
$857.25
$144.02
$137.16
$1,261.62
$1,201.54
$201.86
$192.25
$319.40
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$581.12
$736.48
$701.41
$969.44
$923.27
$155.11
$147.72
$370.77
$353.11
$774.65
$737.76
$998.07
$950.54
$159.69
$152.09
$997.79
$950.27
$159.65
$152.04
$310.14
$311.27
$295.37
$296.44
$601.76
$573.10
$96.28
$91.70
$146.79
$139.80
$614.95
$585.67
$761.46
$725.20
$121.83
$116.03
$1,032.03
$982.88
$165.12
$157.26
$242.78
$190.30
$231.22
$181.23
$276.46
$263.30
$900.12
$857.25
$144.02
$137.16
$1,261.62
$1,201.54
$201.86
$192.25
$319.40
Musculoskeletal System Surgery
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
27265
27266
27266
27267
27267
27267
27267
27268
27268
27268
27268
27269
27269
27269
27269
27275
27275
27280
27280
27280
27280
27282
27282
27282
27282
27284
27284
27284
27284
27286
27286
27286
27286
27290
27290
27290
27290
27295
27295
27295
27295
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
N/F
F
F
N/F
N/F
F
F
N/F
N/F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
2
27299
0-999
F
8
27299
0-20
F
8
2
2
2
2
8
8
2
2
27299
27301
27301
27303
27303
27303
27303
27305
27305
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
F
F
F
F
F
F
F
F
F
11.38
16.54
16.54
12.44
12.44
1.99
1.99
15.30
15.30
2.45
2.45
35.62
35.62
5.70
5.70
5.16
5.16
29.74
29.74
4.76
4.76
24.33
24.33
3.89
3.89
46.34
46.34
7.41
7.41
47.29
47.29
7.57
7.57
46.46
46.46
7.43
7.43
36.21
36.21
5.79
5.79
14.09
14.09
18.19
18.19
2.91
2.91
13.77
13.77
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$304.19
$464.23
$442.12
$349.16
$332.53
$55.85
$53.19
$429.43
$408.98
$68.76
$65.49
$999.75
$952.14
$159.98
$152.36
$144.83
$137.93
$834.72
$794.97
$133.60
$127.24
$682.87
$650.35
$109.18
$103.98
$1,300.63
$1,238.69
$207.98
$198.07
$1,327.30
$1,264.09
$212.47
$202.35
$1,304.00
$1,241.90
$208.54
$198.61
$1,016.31
$967.91
$162.51
$154.77
Manually
Priced
Manually
Priced
Manually
Priced
$395.47
$376.63
$510.54
$486.23
$81.68
$77.79
$386.49
$368.08
Current
Percent
Reduction
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
2%
2%
0%
0%
0%
0%
0%
0%
0%
0%
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
$304.19
$464.23
$442.12
$349.16
$332.53
$55.85
$53.19
$429.43
$408.98
$68.76
$65.49
$999.75
$952.14
$159.98
$152.36
$144.83
$137.93
$834.72
$794.97
$133.60
$127.24
$682.87
$650.35
$109.18
$103.98
$1,300.63
$1,238.69
$207.98
$198.07
$1,327.30
$1,264.09
$212.47
$202.35
$1,304.00
$1,241.90
$208.54
$198.61
$1,016.31
$967.91
$162.51
$154.77
Manually
Priced
Manually
Priced
Manually
Priced
$395.47
$376.63
$510.54
$486.23
$81.68
$77.79
$386.49
$368.08
11.38
16.74
16.74
12.43
12.43
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
15.51
15.51
$28.0672
$26.7305
35.95
35.95
$28.0672
$26.7305
5.25
5.25
31.15
31.15
$28.0672
$26.7305
$28.0672
$26.7305
21.50
21.50
$28.0672
$26.7305
44.18
44.18
$28.0672
$26.7305
47.87
47.87
$28.0672
$26.7305
47.03
47.03
$28.0672
$26.7305
36.34
36.34
$28.0672
$26.7305
14.24
14.24
18.32
18.32
$28.0672
$26.7305
$28.0672
$26.7305
13.83
13.83
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
$304.19
$469.84
$447.47
$348.88
$332.26
$55.82
$53.16
$435.32
$414.59
$69.65
$66.33
$1,009.02
$960.96
$161.44
$153.75
$147.35
$140.34
$874.29
$832.66
$139.89
$133.23
$603.44
$574.71
$96.55
$91.95
$1,240.01
$1,180.95
$198.40
$188.95
$1,343.58
$1,279.59
$214.97
$204.73
$1,320.00
$1,257.14
$211.20
$201.14
$1,019.96
$971.39
$163.19
$155.42
Manually
Priced
Manually
Priced
Manually
Priced
$399.68
$380.64
$514.19
$489.70
$82.27
$78.35
$388.17
$369.68
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
2%
2%
0%
0%
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$304.19
$469.84
$447.47
$348.88
$332.26
$55.82
$53.16
$435.32
$414.59
$69.65
$66.33
$1,009.02
$960.96
$161.44
$153.75
$147.35
$140.34
$874.29
$832.66
$139.89
$133.23
$603.44
$574.71
$96.55
$91.95
$1,240.01
$1,180.95
$198.40
$188.95
$1,343.58
$1,279.59
$214.97
$204.73
$1,320.00
$1,257.14
$211.20
$201.14
$1,019.96
$971.39
$163.19
$155.42
Manually
Priced
Manually
Priced
Manually
Priced
$399.68
$380.64
$514.19
$489.70
$82.27
$78.35
$388.17
$369.68
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
8
2
2
8
8
2
2
2
2
8
8
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
27305
27305
27306
27306
27306
27306
27307
27307
27310
27310
27310
27310
27323
27323
27323
27323
27324
27324
27325
27325
27325
27325
27326
27326
27327
27327
27327
27327
27328
27328
27329
27329
27329
27329
27330
27330
27331
27331
27331
27331
27332
27332
27332
27332
27333
27333
27333
27333
27334
27334
27334
27334
27335
27335
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
N/F
N/F
F
F
F
F
F
F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
2.20
2.20
10.52
10.52
1.68
1.68
13.63
13.63
20.84
20.84
3.33
3.33
7.65
5.07
7.65
5.07
11.23
11.23
15.83
15.83
2.53
2.53
14.58
14.58
12.96
8.91
12.96
8.91
17.62
17.62
29.65
29.65
4.74
4.74
11.86
11.86
13.53
13.53
2.16
2.16
18.22
18.22
2.92
2.92
16.64
16.64
2.66
2.66
19.49
19.49
3.12
3.12
21.79
21.79
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$61.75
$58.81
$295.27
$281.20
$47.15
$44.91
$382.56
$364.34
$584.92
$557.06
$93.46
$89.01
$214.71
$142.30
$204.49
$135.52
$315.19
$300.18
$444.30
$423.14
$71.01
$67.63
$409.22
$389.73
$363.75
$250.08
$346.43
$238.17
$494.54
$470.99
$832.19
$792.56
$133.04
$126.70
$332.88
$317.02
$379.75
$361.66
$60.63
$57.74
$511.38
$487.03
$81.96
$78.05
$467.04
$444.80
$74.66
$71.10
$547.03
$520.98
$87.57
$83.40
$611.58
$582.46
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$61.75
$58.81
$295.27
$281.20
$47.15
$44.91
$382.56
$364.34
$584.92
$557.06
$93.46
$89.01
$214.71
$142.30
$204.49
$135.52
$315.19
$300.18
$444.30
$423.14
$71.01
$67.63
$409.22
$389.73
$363.75
$250.08
$346.43
$238.17
$494.54
$470.99
$832.19
$792.56
$133.04
$126.70
$332.88
$317.02
$379.75
$361.66
$60.63
$57.74
$511.38
$487.03
$81.96
$78.05
$467.04
$444.80
$74.66
$71.10
$547.03
$520.98
$87.57
$83.40
$611.58
$582.46
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
10.31
10.31
$28.0672
$26.7305
13.80
13.80
21.04
21.04
$28.0672
$26.7305
$28.0672
$26.7305
7.68
5.09
7.68
5.09
11.39
11.39
14.66
14.66
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
14.77
14.77
13.12
9.00
13.12
9.00
17.88
17.88
29.83
29.83
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
11.93
11.93
13.67
13.67
$28.0672
$26.7305
$28.0672
$26.7305
18.51
18.51
$28.0672
$26.7305
16.86
16.86
$28.0672
$26.7305
19.68
19.68
$28.0672
$26.7305
21.98
21.98
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$62.11
$59.15
$289.37
$275.59
$46.30
$44.09
$387.33
$368.88
$590.53
$562.41
$94.48
$89.99
$215.56
$142.86
$205.29
$136.06
$319.69
$304.46
$411.47
$391.87
$65.84
$62.70
$414.55
$394.81
$368.24
$252.60
$350.70
$240.57
$501.84
$477.94
$837.24
$797.37
$133.96
$127.58
$334.84
$318.89
$383.68
$365.41
$61.39
$58.47
$519.52
$494.78
$83.12
$79.16
$473.21
$450.68
$75.71
$72.11
$552.36
$526.06
$88.38
$84.17
$616.92
$587.54
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$62.11
$59.15
$289.37
$275.59
$46.30
$44.09
$387.33
$368.88
$590.53
$562.41
$94.48
$89.99
$215.56
$142.86
$205.29
$136.06
$319.69
$304.46
$411.47
$391.87
$65.84
$62.70
$414.55
$394.81
$368.24
$252.60
$350.70
$240.57
$501.84
$477.94
$837.24
$797.37
$133.96
$127.58
$334.84
$318.89
$383.68
$365.41
$61.39
$58.47
$519.52
$494.78
$83.12
$79.16
$473.21
$450.68
$75.71
$72.11
$552.36
$526.06
$88.38
$84.17
$616.92
$587.54
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
27335
27335
27337
27337
27337
27337
27339
27339
27339
27339
27340
27340
27345
27345
27345
27345
27347
27347
27347
27347
27350
27350
27350
27350
27355
27355
27355
27355
27356
27356
27356
27356
27357
27357
27357
27357
27358
27358
27358
27358
27360
27360
27360
27360
27364
27364
27364
27364
27365
27365
27365
27365
27370
27370
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
3.49
3.49
11.87
11.87
1.90
1.90
21.35
21.35
3.42
3.42
10.54
10.54
13.67
13.67
2.19
2.19
15.04
15.04
2.41
2.41
18.61
18.61
2.98
2.98
17.17
17.17
2.75
2.75
21.02
21.02
3.36
3.36
23.19
23.19
3.71
3.71
7.99
7.99
1.28
1.28
24.29
24.29
3.89
3.89
44.70
44.70
7.15
7.15
59.31
59.31
9.49
9.49
4.53
1.49
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$97.95
$93.29
$333.16
$317.29
$53.33
$50.79
$599.23
$570.70
$95.99
$91.42
$295.83
$281.74
$383.68
$365.41
$61.47
$58.54
$422.13
$402.03
$67.64
$64.42
$522.33
$497.45
$83.64
$79.66
$481.91
$458.96
$77.18
$73.51
$589.97
$561.88
$94.31
$89.81
$650.88
$619.88
$104.13
$99.17
$224.26
$213.58
$35.93
$34.22
$681.75
$649.28
$109.18
$103.98
$1,254.60
$1,194.85
$200.68
$191.12
$1,664.67
$1,585.39
$266.36
$253.67
$127.14
$41.82
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$97.95
$93.29
$333.16
$317.29
$53.33
$50.79
$599.23
$570.70
$95.99
$91.42
$295.83
$281.74
$383.68
$365.41
$61.47
$58.54
$422.13
$402.03
$67.64
$64.42
$522.33
$497.45
$83.64
$79.66
$481.91
$458.96
$77.18
$73.51
$589.97
$561.88
$94.31
$89.81
$650.88
$619.88
$104.13
$99.17
$224.26
$213.58
$35.93
$34.22
$681.75
$649.28
$109.18
$103.98
$1,254.60
$1,194.85
$200.68
$191.12
$1,664.67
$1,585.39
$266.36
$253.67
$127.14
$41.82
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
12.01
12.01
$28.0672
$26.7305
21.70
21.70
$28.0672
$26.7305
10.66
10.66
13.82
13.82
$28.0672
$26.7305
$28.0672
$26.7305
15.20
15.20
$28.0672
$26.7305
18.73
18.73
$28.0672
$26.7305
17.36
17.36
$28.0672
$26.7305
21.28
21.28
$28.0672
$26.7305
23.42
23.42
$28.0672
$26.7305
8.11
8.11
$28.0672
$26.7305
24.50
24.50
$28.0672
$26.7305
45.19
45.19
$28.0672
$26.7305
59.76
59.76
$28.0672
$26.7305
4.40
1.46
$28.0672
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$98.71
$94.01
$337.09
$321.03
$53.93
$51.36
$609.06
$580.05
$97.45
$92.81
$299.20
$284.95
$387.89
$369.42
$62.06
$59.11
$426.62
$406.30
$68.26
$65.01
$525.70
$500.66
$84.11
$80.11
$487.25
$464.04
$77.96
$74.25
$597.27
$568.83
$95.56
$91.01
$657.33
$626.03
$105.17
$100.16
$227.62
$216.78
$36.42
$34.68
$687.65
$654.90
$110.02
$104.78
$1,268.36
$1,207.95
$202.94
$193.27
$1,677.30
$1,597.41
$268.37
$255.59
$123.50
$40.98
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$98.71
$94.01
$337.09
$321.03
$53.93
$51.36
$609.06
$580.05
$97.45
$92.81
$299.20
$284.95
$387.89
$369.42
$62.06
$59.11
$426.62
$406.30
$68.26
$65.01
$525.70
$500.66
$84.11
$80.11
$487.25
$464.04
$77.96
$74.25
$597.27
$568.83
$95.56
$91.01
$657.33
$626.03
$105.17
$100.16
$227.62
$216.78
$36.42
$34.68
$687.65
$654.90
$110.02
$104.78
$1,268.36
$1,207.95
$202.94
$193.27
$1,677.30
$1,597.41
$268.37
$255.59
$123.50
$40.98
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
27370
27370
27372
27372
27380
27380
27380
27380
27381
27381
27381
27381
27385
27385
27385
27385
27386
27386
27386
27386
27390
27390
27390
27390
27391
27391
27392
27392
27392
27392
27393
27393
27393
27393
27394
27394
27394
27394
27395
27395
27395
27395
27396
27396
27396
27396
27397
27397
27397
27397
27400
27400
27400
27400
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
N
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
4.53
1.49
11.52
11.52
16.92
16.92
2.71
2.71
22.79
22.79
3.65
3.65
16.36
16.36
2.62
2.62
23.67
23.67
3.79
3.79
12.72
12.72
2.04
2.04
16.39
16.39
20.25
20.25
3.24
3.24
14.48
14.48
2.32
2.32
18.56
18.56
2.97
2.97
25.01
25.01
4.00
4.00
17.51
17.51
2.80
2.80
26.09
26.09
4.17
4.17
19.75
19.75
3.16
3.16
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$121.09
$39.83
$323.33
$307.94
$474.90
$452.28
$76.06
$72.44
$639.65
$609.19
$102.45
$97.57
$459.18
$437.31
$73.54
$70.03
$664.35
$632.71
$106.37
$101.31
$357.01
$340.01
$57.26
$54.53
$460.02
$438.11
$568.36
$541.29
$90.94
$86.61
$406.41
$387.06
$65.12
$62.01
$520.93
$496.12
$83.36
$79.39
$701.96
$668.53
$112.27
$106.92
$491.46
$468.05
$78.59
$74.85
$732.27
$697.40
$117.04
$111.47
$554.33
$527.93
$88.69
$84.47
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$121.09
$39.83
$323.33
$307.94
$474.90
$452.28
$76.06
$72.44
$639.65
$609.19
$102.45
$97.57
$459.18
$437.31
$73.54
$70.03
$664.35
$632.71
$106.37
$101.31
$357.01
$340.01
$57.26
$54.53
$460.02
$438.11
$568.36
$541.29
$90.94
$86.61
$406.41
$387.06
$65.12
$62.01
$520.93
$496.12
$83.36
$79.39
$701.96
$668.53
$112.27
$106.92
$491.46
$468.05
$78.59
$74.85
$732.27
$697.40
$117.04
$111.47
$554.33
$527.93
$88.69
$84.47
4.40
1.46
11.62
11.62
17.06
17.06
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
22.89
22.89
$28.0672
$26.7305
16.50
16.50
$28.0672
$26.7305
23.83
23.83
$28.0672
$26.7305
12.89
12.89
$28.0672
$26.7305
16.61
16.61
20.53
20.53
$28.0672
$26.7305
$28.0672
$26.7305
14.67
14.67
$28.0672
$26.7305
18.72
18.72
$28.0672
$26.7305
25.33
25.33
$28.0672
$26.7305
17.73
17.73
$28.0672
$26.7305
26.43
26.43
$28.0672
$26.7305
20.03
20.03
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$117.61
$39.03
$326.14
$310.61
$478.83
$456.02
$76.61
$72.96
$642.46
$611.86
$102.79
$97.90
$463.11
$441.05
$74.10
$70.57
$668.84
$636.99
$107.01
$101.92
$361.79
$344.56
$57.89
$55.13
$466.20
$443.99
$576.22
$548.78
$92.20
$87.80
$411.75
$392.14
$65.88
$62.74
$525.42
$500.39
$84.07
$80.06
$710.94
$677.08
$113.75
$108.33
$497.63
$473.93
$79.62
$75.83
$741.82
$706.49
$118.69
$113.04
$562.19
$535.41
$89.95
$85.67
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$117.61
$39.03
$326.14
$310.61
$478.83
$456.02
$76.61
$72.96
$642.46
$611.86
$102.79
$97.90
$463.11
$441.05
$74.10
$70.57
$668.84
$636.99
$107.01
$101.92
$361.79
$344.56
$57.89
$55.13
$466.20
$443.99
$576.22
$548.78
$92.20
$87.80
$411.75
$392.14
$65.88
$62.74
$525.42
$500.39
$84.07
$80.06
$710.94
$677.08
$113.75
$108.33
$497.63
$473.93
$79.62
$75.83
$741.82
$706.49
$118.69
$113.04
$562.19
$535.41
$89.95
$85.67
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
27403
27403
27403
27403
27405
27405
27405
27405
27407
27407
27407
27407
27409
27409
27409
27409
27412
27412
27412
27412
27415
27415
27415
27415
27416
27416
27418
27418
27418
27418
27420
27420
27420
27420
27422
27422
27422
27422
27424
27424
27424
27424
27425
27425
27427
27427
27427
27427
27428
27428
27428
27428
27429
27429
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
18.24
18.24
2.92
2.92
19.28
19.28
3.08
3.08
22.55
22.55
3.61
3.61
27.51
27.51
4.40
4.40
47.31
47.31
7.57
7.57
39.26
39.26
6.28
6.28
27.97
27.97
23.70
23.70
3.79
3.79
20.95
20.95
3.35
3.35
21.20
21.20
3.39
3.39
21.27
21.27
3.40
3.40
12.70
12.70
20.38
20.38
3.26
3.26
31.77
31.77
5.08
5.08
35.73
35.73
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$511.95
$487.56
$81.96
$78.05
$541.14
$515.36
$86.45
$82.33
$632.92
$602.77
$101.32
$96.50
$772.13
$735.36
$123.50
$117.61
$1,327.86
$1,264.62
$212.47
$202.35
$1,101.92
$1,049.44
$176.26
$167.87
$785.04
$747.65
$665.19
$633.51
$106.37
$101.31
$588.01
$560.00
$94.03
$89.55
$595.02
$566.69
$95.15
$90.62
$596.99
$568.56
$95.43
$90.88
$356.45
$339.48
$572.01
$544.77
$91.50
$87.14
$891.69
$849.23
$142.58
$135.79
$1,002.84
$955.08
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$511.95
$487.56
$81.96
$78.05
$541.14
$515.36
$86.45
$82.33
$632.92
$602.77
$101.32
$96.50
$772.13
$735.36
$123.50
$117.61
$1,327.86
$1,264.62
$212.47
$202.35
$1,101.92
$1,049.44
$176.26
$167.87
$785.04
$747.65
$665.19
$633.51
$106.37
$101.31
$588.01
$560.00
$94.03
$89.55
$595.02
$566.69
$95.15
$90.62
$596.99
$568.56
$95.43
$90.88
$356.45
$339.48
$572.01
$544.77
$91.50
$87.14
$891.69
$849.23
$142.58
$135.79
$1,002.84
$955.08
18.44
18.44
$28.0672
$26.7305
19.47
19.47
$28.0672
$26.7305
22.84
22.84
$28.0672
$26.7305
27.84
27.84
$28.0672
$26.7305
47.85
47.85
$28.0672
$26.7305
39.76
39.76
$28.0672
$26.7305
28.30
28.30
23.81
23.81
$28.0672
$26.7305
$28.0672
$26.7305
21.29
21.29
$28.0672
$26.7305
21.38
21.38
$28.0672
$26.7305
21.57
21.57
$28.0672
$26.7305
12.88
12.88
20.55
20.55
$28.0672
$26.7305
$28.0672
$26.7305
32.16
32.16
$28.0672
$26.7305
36.13
36.13
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$517.56
$492.91
$82.81
$78.87
$546.47
$520.44
$87.44
$83.27
$641.05
$610.52
$102.57
$97.68
$781.39
$744.18
$125.02
$119.07
$1,343.02
$1,279.05
$214.88
$204.65
$1,115.95
$1,062.80
$178.55
$170.05
$794.30
$756.47
$668.28
$636.45
$106.92
$101.83
$597.55
$569.09
$95.61
$91.05
$600.08
$571.50
$96.01
$91.44
$605.41
$576.58
$96.87
$92.25
$361.51
$344.29
$576.78
$549.31
$92.28
$87.89
$902.64
$859.65
$144.42
$137.54
$1,014.07
$965.77
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$517.56
$492.91
$82.81
$78.87
$546.47
$520.44
$87.44
$83.27
$641.05
$610.52
$102.57
$97.68
$781.39
$744.18
$125.02
$119.07
$1,343.02
$1,279.05
$214.88
$204.65
$1,115.95
$1,062.80
$178.55
$170.05
$794.30
$756.47
$668.28
$636.45
$106.92
$101.83
$597.55
$569.09
$95.61
$91.05
$600.08
$571.50
$96.01
$91.44
$605.41
$576.58
$96.87
$92.25
$361.51
$344.29
$576.78
$549.31
$92.28
$87.89
$902.64
$859.65
$144.42
$137.54
$1,014.07
$965.77
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
27429
27429
27430
27430
27430
27430
27435
27435
27435
27435
27437
27437
27438
27438
27438
27438
27440
27440
27440
27440
27441
27441
27441
27441
27442
27442
27442
27442
27443
27443
27443
27443
27445
27445
27445
27445
27446
27446
27446
27446
27447
27447
27447
27447
27448
27448
27448
27448
27450
27450
27450
27450
27454
27454
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
5.72
5.72
21.12
21.12
3.38
3.38
23.09
23.09
3.69
3.69
18.79
18.79
24.05
24.05
3.85
3.85
22.71
22.71
3.63
3.63
23.47
23.47
3.76
3.76
24.85
24.85
3.98
3.98
23.26
23.26
3.72
3.72
35.86
35.86
5.74
5.74
33.28
33.28
5.32
5.32
38.92
38.92
6.23
6.23
23.05
23.05
3.69
3.69
28.94
28.94
4.63
4.63
37.12
37.12
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$160.54
$152.90
$592.78
$564.55
$94.87
$90.35
$648.07
$617.21
$103.57
$98.64
$527.38
$502.27
$675.02
$642.87
$108.06
$102.91
$637.41
$607.05
$101.88
$97.03
$658.74
$627.36
$105.53
$100.51
$697.47
$664.25
$111.71
$106.39
$652.84
$621.75
$104.41
$99.44
$1,006.49
$958.56
$161.11
$153.43
$934.08
$889.59
$149.32
$142.21
$1,092.38
$1,040.35
$174.86
$166.53
$646.95
$616.14
$103.57
$98.64
$812.26
$773.58
$129.95
$123.76
$1,041.85
$992.24
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$160.54
$152.90
$592.78
$564.55
$94.87
$90.35
$648.07
$617.21
$103.57
$98.64
$527.38
$502.27
$675.02
$642.87
$108.06
$102.91
$637.41
$607.05
$101.88
$97.03
$658.74
$627.36
$105.53
$100.51
$697.47
$664.25
$111.71
$106.39
$652.84
$621.75
$104.41
$99.44
$1,006.49
$958.56
$161.11
$153.43
$934.08
$889.59
$149.32
$142.21
$1,092.38
$1,040.35
$174.86
$166.53
$646.95
$616.14
$103.57
$98.64
$812.26
$773.58
$129.95
$123.76
$1,041.85
$992.24
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
21.20
21.20
$28.0672
$26.7305
23.19
23.19
$28.0672
$26.7305
19.05
19.05
24.21
24.21
$28.0672
$26.7305
$28.0672
$26.7305
23.01
23.01
$28.0672
$26.7305
23.78
23.78
$28.0672
$26.7305
25.05
25.05
$28.0672
$26.7305
23.55
23.55
$28.0672
$26.7305
36.16
36.16
$28.0672
$26.7305
33.48
33.48
$28.0672
$26.7305
39.17
39.17
$28.0672
$26.7305
22.03
22.03
$28.0672
$26.7305
29.09
29.09
$28.0672
$26.7305
37.59
37.59
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$162.25
$154.52
$595.02
$566.69
$95.20
$90.67
$650.88
$619.88
$104.14
$99.18
$534.68
$509.22
$679.51
$647.15
$108.72
$103.54
$645.83
$615.07
$103.33
$98.41
$667.44
$635.65
$106.79
$101.70
$703.08
$669.60
$112.49
$107.14
$660.98
$629.50
$105.76
$100.72
$1,014.91
$966.57
$162.39
$154.65
$939.69
$894.94
$150.35
$143.19
$1,099.39
$1,047.03
$175.90
$167.52
$618.32
$588.87
$98.93
$94.22
$816.47
$777.59
$130.64
$124.41
$1,055.05
$1,004.80
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$162.25
$154.52
$595.02
$566.69
$95.20
$90.67
$650.88
$619.88
$104.14
$99.18
$534.68
$509.22
$679.51
$647.15
$108.72
$103.54
$645.83
$615.07
$103.33
$98.41
$667.44
$635.65
$106.79
$101.70
$703.08
$669.60
$112.49
$107.14
$660.98
$629.50
$105.76
$100.72
$1,014.91
$966.57
$162.39
$154.65
$939.69
$894.94
$150.35
$143.19
$1,099.39
$1,047.03
$175.90
$167.52
$618.32
$588.87
$98.93
$94.22
$816.47
$777.59
$130.64
$124.41
$1,055.05
$1,004.80
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
27454
27454
27455
27455
27455
27455
27457
27457
27457
27457
27465
27465
27465
27465
27466
27466
27466
27466
27468
27468
27468
27468
27470
27470
27470
27470
27472
27472
27472
27472
27475
27475
27477
27477
27479
27479
27479
27479
27485
27485
27486
27486
27486
27486
27487
27487
27487
27487
27488
27488
27488
27488
27495
27495
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
5.94
5.94
26.86
26.86
4.30
4.30
27.33
27.33
4.37
4.37
35.82
35.82
5.73
5.73
33.68
33.68
5.39
5.39
34.43
34.43
5.51
5.51
33.66
33.66
5.39
5.39
36.18
36.18
5.79
5.79
18.83
18.83
20.85
20.85
24.65
24.65
3.94
3.94
19.09
19.09
40.37
40.37
6.46
6.46
50.52
50.52
8.08
8.08
34.41
34.41
5.51
5.51
32.26
32.26
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$166.72
$158.78
$753.88
$717.98
$120.69
$114.94
$767.08
$730.54
$122.65
$116.81
$1,005.37
$957.49
$160.83
$153.17
$945.30
$900.28
$151.28
$144.08
$966.35
$920.33
$154.65
$147.29
$944.74
$899.75
$151.28
$144.08
$1,015.47
$967.11
$162.51
$154.77
$528.51
$503.34
$585.20
$557.33
$691.86
$658.91
$110.58
$105.32
$535.80
$510.29
$1,133.07
$1,079.11
$181.31
$172.68
$1,417.95
$1,350.42
$226.78
$215.98
$965.79
$919.80
$154.65
$147.29
$905.45
$862.33
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$166.72
$158.78
$753.88
$717.98
$120.69
$114.94
$767.08
$730.54
$122.65
$116.81
$1,005.37
$957.49
$160.83
$153.17
$945.30
$900.28
$151.28
$144.08
$966.35
$920.33
$154.65
$147.29
$944.74
$899.75
$151.28
$144.08
$1,015.47
$967.11
$162.51
$154.77
$528.51
$503.34
$585.20
$557.33
$691.86
$658.91
$110.58
$105.32
$535.80
$510.29
$1,133.07
$1,079.11
$181.31
$172.68
$1,417.95
$1,350.42
$226.78
$215.98
$965.79
$919.80
$154.65
$147.29
$905.45
$862.33
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
27.20
27.20
$28.0672
$26.7305
27.72
27.72
$28.0672
$26.7305
36.09
36.09
$28.0672
$26.7305
34.23
34.23
$28.0672
$26.7305
38.84
38.84
$28.0672
$26.7305
33.92
33.92
$28.0672
$26.7305
36.51
36.51
$28.0672
$26.7305
19.07
19.07
21.14
21.14
26.58
26.58
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
19.33
19.33
40.61
40.61
$28.0672
$26.7305
$28.0672
$26.7305
50.78
50.78
$28.0672
$26.7305
34.66
34.66
$28.0672
$26.7305
32.54
32.54
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$168.81
$160.77
$763.43
$727.07
$122.15
$116.33
$778.02
$740.97
$124.48
$118.56
$1,012.95
$964.70
$162.07
$154.35
$960.74
$914.99
$153.72
$146.40
$1,090.13
$1,038.21
$174.42
$166.11
$952.04
$906.70
$152.33
$145.07
$1,024.73
$975.93
$163.96
$156.15
$535.24
$509.75
$593.34
$565.08
$746.03
$710.50
$119.36
$113.68
$542.54
$516.70
$1,139.81
$1,085.53
$182.37
$173.68
$1,425.25
$1,357.37
$228.04
$217.18
$972.81
$926.48
$155.65
$148.24
$913.31
$869.81
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$168.81
$160.77
$763.43
$727.07
$122.15
$116.33
$778.02
$740.97
$124.48
$118.56
$1,012.95
$964.70
$162.07
$154.35
$960.74
$914.99
$153.72
$146.40
$1,090.13
$1,038.21
$174.42
$166.11
$952.04
$906.70
$152.33
$145.07
$1,024.73
$975.93
$163.96
$156.15
$535.24
$509.75
$593.34
$565.08
$746.03
$710.50
$119.36
$113.68
$542.54
$516.70
$1,139.81
$1,085.53
$182.37
$173.68
$1,425.25
$1,357.37
$228.04
$217.18
$972.81
$926.48
$155.65
$148.24
$913.31
$869.81
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
8
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
27495
27495
27496
27496
27497
27497
27498
27498
27498
27498
27499
27499
27499
27499
27500
27500
27501
27501
27502
27502
27503
27503
27506
27506
27506
27506
27507
27507
27507
27507
27508
27508
27508
27508
27509
27509
27510
27510
27511
27511
27511
27511
27513
27513
27513
27513
27514
27514
27514
27514
27516
27516
27516
27516
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N/F
N/F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
F
F
N/F
N/F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
5.16
5.16
15.43
15.43
16.56
16.56
18.61
18.61
2.98
2.98
19.92
19.92
3.19
3.19
13.62
13.62
14.18
14.18
22.01
22.01
22.89
22.89
38.30
38.30
6.13
6.13
27.86
27.86
4.46
4.46
14.94
14.08
14.94
14.08
18.33
18.33
19.55
19.55
28.57
28.57
4.57
4.57
35.57
35.57
5.69
5.69
27.68
27.68
4.43
4.43
14.38
13.52
14.38
13.52
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$144.83
$137.93
$433.08
$412.45
$464.79
$442.66
$522.33
$497.45
$83.64
$79.66
$559.10
$532.47
$89.53
$85.27
$382.28
$364.07
$397.99
$379.04
$617.76
$588.34
$642.46
$611.86
$1,074.97
$1,023.78
$172.05
$163.86
$781.95
$744.71
$125.18
$119.22
$419.32
$395.19
$399.35
$376.37
$514.47
$489.97
$548.71
$522.58
$801.88
$763.69
$128.27
$122.16
$998.35
$950.80
$159.70
$152.10
$776.90
$739.90
$124.34
$118.42
$403.61
$379.47
$384.38
$361.40
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$144.83
$137.93
$433.08
$412.45
$464.79
$442.66
$522.33
$497.45
$83.64
$79.66
$559.10
$532.47
$89.53
$85.27
$382.28
$364.07
$397.99
$379.04
$617.76
$588.34
$642.46
$611.86
$1,074.97
$1,023.78
$172.05
$163.86
$781.95
$744.71
$125.18
$119.22
$419.32
$395.19
$399.35
$376.37
$514.47
$489.97
$548.71
$522.58
$801.88
$763.69
$128.27
$122.16
$998.35
$950.80
$159.70
$152.10
$776.90
$739.90
$124.34
$118.42
$403.61
$379.47
$384.38
$361.40
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
15.66
15.66
17.01
17.01
18.87
18.87
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
20.19
20.19
$28.0672
$26.7305
13.82
13.82
14.32
14.32
22.05
22.05
23.10
23.10
38.63
38.63
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
28.06
28.06
$28.0672
$26.7305
15.05
14.16
15.05
14.16
18.50
18.50
19.68
19.68
28.79
28.79
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
35.86
35.86
$28.0672
$26.7305
27.92
27.92
$28.0672
$26.7305
14.60
13.71
14.60
13.71
$28.0672
$28.0672
$26.7305
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$146.13
$139.17
$439.53
$418.60
$477.42
$454.69
$529.63
$504.40
$84.74
$80.70
$566.68
$539.69
$90.67
$86.35
$387.89
$369.42
$401.92
$382.78
$618.88
$589.41
$648.35
$617.47
$1,084.24
$1,032.60
$173.48
$165.22
$787.57
$750.06
$126.01
$120.01
$422.41
$397.43
$402.29
$378.50
$519.24
$494.51
$552.36
$526.06
$808.05
$769.57
$129.29
$123.13
$1,006.49
$958.56
$161.04
$153.37
$783.64
$746.32
$125.38
$119.41
$409.78
$384.80
$390.27
$366.48
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$146.13
$139.17
$439.53
$418.60
$477.42
$454.69
$529.63
$504.40
$84.74
$80.70
$566.68
$539.69
$90.67
$86.35
$387.89
$369.42
$401.92
$382.78
$618.88
$589.41
$648.35
$617.47
$1,084.24
$1,032.60
$173.48
$165.22
$787.57
$750.06
$126.01
$120.01
$422.41
$397.43
$402.29
$378.50
$519.24
$494.51
$552.36
$526.06
$808.05
$769.57
$129.29
$123.13
$1,006.49
$958.56
$161.04
$153.37
$783.64
$746.32
$125.38
$119.41
$409.78
$384.80
$390.27
$366.48
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
8
8
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
27517
27517
27519
27519
27519
27519
27520
27520
27520
27520
27524
27524
27524
27524
27530
27530
27530
27530
27532
27532
27532
27532
27535
27535
27535
27535
27536
27536
27536
27536
27538
27538
27538
27538
27540
27540
27540
27540
27550
27550
27550
27550
27552
27552
27556
27556
27556
27556
27557
27557
27557
27557
27558
27558
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
N/F
N/F
F
F
F
F
N
F
N
F
F
F
F
F
N
F
N
F
N
F
N
F
F
F
F
F
F
F
F
F
N
F
N
F
F
F
F
F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
F
F
19.49
19.49
25.45
25.45
4.07
4.07
9.14
8.36
9.14
8.36
21.46
21.46
3.43
3.43
8.53
7.93
8.53
7.93
17.47
16.42
17.47
16.42
25.68
25.68
4.11
4.11
34.08
34.08
5.45
5.45
13.42
12.58
13.42
12.58
23.20
23.20
3.71
3.71
14.37
13.37
14.37
13.37
17.81
17.81
24.95
24.95
3.99
3.99
29.95
29.95
4.79
4.79
34.15
34.15
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$547.03
$520.98
$714.31
$680.29
$114.23
$108.79
$256.53
$234.64
$244.32
$223.47
$602.32
$573.64
$96.27
$91.69
$239.41
$222.57
$228.01
$211.97
$490.33
$460.86
$466.98
$438.91
$720.77
$686.44
$115.36
$109.86
$956.53
$910.98
$152.97
$145.68
$376.66
$353.09
$358.72
$336.27
$651.16
$620.15
$104.13
$99.17
$403.33
$375.26
$384.12
$357.39
$499.88
$476.07
$700.28
$666.93
$111.99
$106.65
$840.61
$800.58
$134.44
$128.04
$958.49
$912.85
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$547.03
$520.98
$714.31
$680.29
$114.23
$108.79
$256.53
$234.64
$244.32
$223.47
$602.32
$573.64
$96.27
$91.69
$239.41
$222.57
$228.01
$211.97
$490.33
$460.86
$466.98
$438.91
$720.77
$686.44
$115.36
$109.86
$956.53
$910.98
$152.97
$145.68
$376.66
$353.09
$358.72
$336.27
$651.16
$620.15
$104.13
$99.17
$403.33
$375.26
$384.12
$357.39
$499.88
$476.07
$700.28
$666.93
$111.99
$106.65
$840.61
$800.58
$134.44
$128.04
$958.49
$912.85
19.77
19.77
25.78
25.78
$28.0672
$26.7305
$28.0672
$26.7305
9.22
8.41
9.22
8.41
21.70
21.70
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
8.62
7.99
8.62
7.99
17.73
16.65
17.73
16.65
25.89
25.89
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
34.36
34.36
$28.0672
$26.7305
13.58
12.72
13.58
12.72
23.38
23.38
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
14.41
13.37
14.41
13.37
17.99
17.99
25.33
25.33
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
30.30
30.30
$28.0672
$26.7305
34.58
34.58
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$554.89
$528.46
$723.57
$689.11
$115.77
$110.26
$258.78
$236.05
$246.46
$224.80
$609.06
$580.05
$97.45
$92.81
$241.94
$224.26
$230.42
$213.58
$497.63
$467.32
$473.93
$445.06
$726.66
$692.05
$116.27
$110.73
$964.39
$918.46
$154.30
$146.95
$381.15
$357.01
$363.00
$340.01
$656.21
$624.96
$104.99
$99.99
$404.45
$375.26
$385.19
$357.39
$504.93
$480.88
$710.94
$677.08
$113.75
$108.33
$850.44
$809.93
$136.07
$129.59
$970.56
$924.34
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$554.89
$528.46
$723.57
$689.11
$115.77
$110.26
$258.78
$236.05
$246.46
$224.80
$609.06
$580.05
$97.45
$92.81
$241.94
$224.26
$230.42
$213.58
$497.63
$467.32
$473.93
$445.06
$726.66
$692.05
$116.27
$110.73
$964.39
$918.46
$154.30
$146.95
$381.15
$357.01
$363.00
$340.01
$656.21
$624.96
$104.99
$99.99
$404.45
$375.26
$385.19
$357.39
$504.93
$480.88
$710.94
$677.08
$113.75
$108.33
$850.44
$809.93
$136.07
$129.59
$970.56
$924.34
Musculoskeletal System Surgery
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
TOS*
Procedure
Code
Age
Range
8
8
2
2
2
2
2
2
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
8
8
27558
27558
27560
27560
27560
27560
27562
27562
27566
27566
27566
27566
27570
27570
27580
27580
27580
27580
27590
27590
27590
27590
27591
27591
27591
27591
27592
27592
27592
27592
27594
27594
27596
27596
27598
27598
27598
27598
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
F
F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
2
27599
0-999
F
8
2
2
2
2
2
2
8
8
2
2
2
2
2
27599
27600
27600
27601
27601
27602
27602
27602
27602
27603
27603
27603
27603
27604
0-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
F
F
F
F
F
F
F
F
F
N
F
N
F
F
5.46
5.46
10.23
9.48
10.23
9.48
13.72
13.72
25.45
25.45
4.07
4.07
4.28
4.28
41.09
41.09
6.57
6.57
23.32
23.32
3.73
3.73
27.72
27.72
4.44
4.44
19.72
19.72
3.16
3.16
14.67
14.67
20.95
20.95
21.00
21.00
3.36
3.36
11.88
11.88
12.64
12.64
14.37
14.37
2.30
2.30
14.97
11.09
14.97
11.09
9.48
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$153.25
$145.95
$287.13
$266.08
$273.45
$253.41
$385.08
$366.74
$714.31
$680.29
$114.23
$108.79
$120.13
$114.41
$1,153.28
$1,098.36
$184.40
$175.62
$654.53
$623.36
$104.69
$99.70
$778.02
$740.97
$124.62
$118.68
$553.49
$527.13
$88.69
$84.47
$411.75
$392.14
$588.01
$560.00
$589.41
$561.34
$94.31
$89.81
Manually
Priced
Manually
Priced
$333.44
$317.56
$354.77
$337.87
$403.33
$384.12
$64.55
$61.48
$420.17
$311.27
$400.16
$296.44
$266.08
Current
Percent
Reduction
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
2%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Current
Adjusted
Medicaid
Fee
$153.25
$145.95
$287.13
$266.08
$273.45
$253.41
$385.08
$366.74
$714.31
$680.29
$114.23
$108.79
$120.13
$114.41
$1,153.28
$1,098.36
$184.40
$175.62
$654.53
$623.36
$104.69
$99.70
$778.02
$740.97
$124.62
$118.68
$553.49
$527.13
$88.69
$84.47
$411.75
$392.14
$588.01
$560.00
$589.41
$561.34
$94.31
$89.81
Manually
Priced
Manually
Priced
$333.44
$317.56
$354.77
$337.87
$403.33
$384.12
$64.55
$61.48
$420.17
$311.27
$400.16
$296.44
$266.08
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
10.27
9.47
10.27
9.47
13.91
13.91
25.78
25.78
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
4.35
4.35
41.41
41.41
$28.0672
$26.7305
$28.0672
$26.7305
23.42
23.42
$28.0672
$26.7305
27.90
27.90
$28.0672
$26.7305
19.90
19.90
$28.0672
$26.7305
14.66
14.66
20.92
20.92
20.88
20.88
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
11.96
11.96
12.90
12.90
14.25
14.25
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
15.16
11.16
15.16
11.16
9.87
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
$155.29
$147.89
$288.25
$265.80
$274.52
$253.14
$390.41
$371.82
$723.57
$689.11
$115.77
$110.26
$122.09
$116.28
$1,162.26
$1,106.91
$185.96
$177.11
$657.33
$626.03
$105.17
$100.16
$783.07
$745.78
$125.29
$119.32
$558.54
$531.94
$89.37
$85.11
$411.47
$391.87
$587.17
$559.20
$586.04
$558.13
$93.77
$89.30
Manually
Priced
Manually
Priced
$335.68
$319.70
$362.07
$344.82
$399.96
$380.91
$63.99
$60.95
$425.50
$313.23
$405.23
$298.31
$277.02
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
2%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$155.29
$147.89
$288.25
$265.80
$274.52
$253.14
$390.41
$371.82
$723.57
$689.11
$115.77
$110.26
$122.09
$116.28
$1,162.26
$1,106.91
$185.96
$177.11
$657.33
$626.03
$105.17
$100.16
$783.07
$745.78
$125.29
$119.32
$558.54
$531.94
$89.37
$85.11
$411.47
$391.87
$587.17
$559.20
$586.04
$558.13
$93.77
$89.30
Manually
Priced
Manually
Priced
$335.68
$319.70
$362.07
$344.82
$399.96
$380.91
$63.99
$60.95
$425.50
$313.23
$405.23
$298.31
$277.02
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
8
8
2
27604
27605
27605
27605
27605
27606
27606
27607
27607
27610
27610
27612
27612
27612
27612
27613
27613
27613
27613
27614
27614
27614
27614
27615
27615
27616
27616
27618
27618
27618
27618
27619
27619
27620
27620
27620
27620
27625
27625
27625
27625
27626
27626
27626
27626
27630
27630
27630
27630
27632
27632
27632
27632
27634
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
F
F
F
F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
N/F
N/F
N/F
N/F
N/F
9.48
9.68
5.31
9.68
5.31
8.17
8.17
17.45
17.45
18.69
18.69
16.14
16.14
2.58
2.58
7.14
4.65
7.14
4.65
16.45
11.63
16.45
11.63
29.26
29.26
36.20
36.20
12.64
8.70
12.64
8.70
13.48
13.48
12.99
12.99
2.08
2.08
16.57
16.57
2.65
2.65
17.90
17.90
2.86
2.86
15.99
10.51
15.99
10.51
11.77
11.77
1.88
1.88
19.47
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$253.41
$271.69
$149.04
$258.75
$141.94
$229.31
$218.39
$489.77
$466.45
$524.58
$499.59
$453.00
$431.43
$72.41
$68.96
$200.40
$130.51
$190.86
$124.30
$461.71
$326.42
$439.72
$310.88
$821.25
$782.13
$1,016.03
$967.64
$354.77
$244.18
$337.87
$232.56
$378.35
$360.33
$364.59
$347.23
$58.38
$55.60
$465.07
$442.92
$74.38
$70.84
$502.40
$478.48
$80.27
$76.45
$448.79
$294.99
$427.42
$280.94
$330.35
$314.62
$52.77
$50.25
$546.47
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$253.41
$271.69
$149.04
$258.75
$141.94
$229.31
$218.39
$489.77
$466.45
$524.58
$499.59
$453.00
$431.43
$72.41
$68.96
$200.40
$130.51
$190.86
$124.30
$461.71
$326.42
$439.72
$310.88
$821.25
$782.13
$1,016.03
$967.64
$354.77
$244.18
$337.87
$232.56
$378.35
$360.33
$364.59
$347.23
$58.38
$55.60
$465.07
$442.92
$74.38
$70.84
$502.40
$478.48
$80.27
$76.45
$448.79
$294.99
$427.42
$280.94
$330.35
$314.62
$52.77
$50.25
$546.47
9.87
9.72
5.30
9.72
5.30
8.22
8.22
17.59
17.59
18.77
18.77
16.25
16.25
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
7.14
4.65
7.14
4.65
16.39
11.54
16.39
11.54
29.40
29.40
36.58
36.58
12.88
8.83
12.88
8.83
13.59
13.59
13.19
13.19
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
16.80
16.80
$28.0672
$26.7305
17.75
17.75
$28.0672
$26.7305
16.06
10.49
16.06
10.49
11.92
11.92
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
19.74
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$263.83
$272.81
$148.76
$259.82
$141.67
$230.71
$219.72
$493.70
$470.19
$526.82
$501.73
$456.09
$434.37
$72.97
$69.50
$200.40
$130.51
$190.86
$124.30
$460.02
$323.90
$438.11
$308.47
$825.18
$785.88
$1,026.70
$977.80
$361.51
$247.83
$344.29
$236.03
$381.43
$363.27
$370.21
$352.58
$59.23
$56.41
$471.53
$449.07
$75.44
$71.85
$498.19
$474.47
$79.71
$75.92
$450.76
$294.42
$429.29
$280.40
$334.56
$318.63
$53.53
$50.98
$554.05
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$263.83
$272.81
$148.76
$259.82
$141.67
$230.71
$219.72
$493.70
$470.19
$526.82
$501.73
$456.09
$434.37
$72.97
$69.50
$200.40
$130.51
$190.86
$124.30
$460.02
$323.90
$438.11
$308.47
$825.18
$785.88
$1,026.70
$977.80
$361.51
$247.83
$344.29
$236.03
$381.43
$363.27
$370.21
$352.58
$59.23
$56.41
$471.53
$449.07
$75.44
$71.85
$498.19
$474.47
$79.71
$75.92
$450.76
$294.42
$429.29
$280.40
$334.56
$318.63
$53.53
$50.98
$554.05
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
27634
27634
27634
27635
27635
27637
27637
27637
27637
27638
27638
27638
27638
27640
27640
27641
27641
27645
27645
27645
27645
27646
27646
27646
27646
27647
27647
27647
27647
27648
27648
27648
27648
27650
27650
27650
27650
27652
27652
27654
27654
27654
27654
27656
27656
27656
27656
27658
27658
27658
27658
27659
27659
27659
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
N/F
N/F
N/F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
19.47
3.12
3.12
16.84
16.84
21.48
21.48
3.44
3.44
22.01
22.01
3.52
3.52
23.83
23.83
19.14
19.14
50.96
50.96
8.15
8.15
44.17
44.17
7.07
7.07
29.95
29.95
4.79
4.79
4.60
1.50
4.60
1.50
18.97
18.97
3.04
3.04
19.73
19.73
20.27
20.27
3.24
3.24
11.23
11.23
1.80
1.80
10.69
10.69
1.71
1.71
13.93
13.93
2.23
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$520.44
$87.57
$83.40
$472.65
$450.14
$602.88
$574.17
$96.55
$91.95
$617.76
$588.34
$98.80
$94.09
$668.84
$636.99
$537.21
$511.62
$1,430.30
$1,362.19
$228.75
$217.85
$1,239.73
$1,180.69
$198.44
$188.98
$840.61
$800.58
$134.44
$128.04
$129.11
$42.10
$122.96
$40.10
$532.43
$507.08
$85.32
$81.26
$553.77
$527.39
$568.92
$541.83
$90.94
$86.61
$315.19
$300.18
$50.52
$48.11
$300.04
$285.75
$47.99
$45.71
$390.98
$372.36
$62.59
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$520.44
$87.57
$83.40
$472.65
$450.14
$602.88
$574.17
$96.55
$91.95
$617.76
$588.34
$98.80
$94.09
$668.84
$636.99
$537.21
$511.62
$1,430.30
$1,362.19
$228.75
$217.85
$1,239.73
$1,180.69
$198.44
$188.98
$840.61
$800.58
$134.44
$128.04
$129.11
$42.10
$122.96
$40.10
$532.43
$507.08
$85.32
$81.26
$553.77
$527.39
$568.92
$541.83
$90.94
$86.61
$315.19
$300.18
$50.52
$48.11
$300.04
$285.75
$47.99
$45.71
$390.98
$372.36
$62.59
19.74
$26.7305
16.92
16.92
22.03
22.03
$28.0672
$26.7305
$28.0672
$26.7305
22.40
22.40
$28.0672
$26.7305
24.12
24.12
19.26
19.26
51.57
51.57
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
44.73
44.73
$28.0672
$26.7305
29.51
29.51
$28.0672
$26.7305
4.62
1.50
4.62
1.50
18.96
18.96
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
19.76
19.76
20.36
20.36
$28.0672
$26.7305
$28.0672
$26.7305
11.40
11.40
$28.0672
$26.7305
10.75
10.75
$28.0672
$26.7305
13.79
13.79
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$527.66
$88.65
$84.43
$474.90
$452.28
$618.32
$588.87
$98.93
$94.22
$628.71
$598.76
$100.59
$95.80
$676.98
$644.74
$540.57
$514.83
$1,447.43
$1,378.49
$231.59
$220.56
$1,255.45
$1,195.66
$200.87
$191.31
$828.26
$788.82
$132.52
$126.21
$129.67
$42.10
$123.49
$40.10
$532.15
$506.81
$85.14
$81.09
$554.61
$528.19
$571.45
$544.23
$91.43
$87.08
$319.97
$304.73
$51.20
$48.76
$301.72
$287.35
$48.28
$45.98
$387.05
$368.61
$61.93
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$527.66
$88.65
$84.43
$474.90
$452.28
$618.32
$588.87
$98.93
$94.22
$628.71
$598.76
$100.59
$95.80
$676.98
$644.74
$540.57
$514.83
$1,447.43
$1,378.49
$231.59
$220.56
$1,255.45
$1,195.66
$200.87
$191.31
$828.26
$788.82
$132.52
$126.21
$129.67
$42.10
$123.49
$40.10
$532.15
$506.81
$85.14
$81.09
$554.61
$528.19
$571.45
$544.23
$91.43
$87.08
$319.97
$304.73
$51.20
$48.76
$301.72
$287.35
$48.28
$45.98
$387.05
$368.61
$61.93
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
8
8
2
2
8
8
2
27659
27664
27664
27665
27665
27665
27665
27675
27675
27675
27675
27676
27676
27676
27676
27680
27680
27681
27681
27685
27685
27685
27685
27686
27686
27687
27687
27687
27687
27690
27690
27690
27690
27691
27691
27691
27691
27692
27692
27692
27692
27695
27695
27696
27696
27698
27698
27698
27698
27700
27700
27700
27700
27702
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
2.23
10.32
10.32
11.84
11.84
1.89
1.89
13.90
13.90
2.22
2.22
17.58
17.58
2.81
2.81
12.25
12.25
15.53
15.53
13.33
13.33
2.13
2.13
15.79
15.79
13.01
13.01
2.08
2.08
18.08
18.08
2.89
2.89
21.54
21.54
3.45
3.45
3.05
3.05
0.49
0.49
13.71
13.71
16.06
16.06
18.37
18.37
2.94
2.94
16.98
16.98
2.72
2.72
27.82
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$59.61
$289.65
$275.86
$332.32
$316.49
$53.05
$50.52
$390.13
$371.55
$62.31
$59.34
$493.42
$469.92
$78.87
$75.11
$343.82
$327.45
$435.88
$415.12
$374.14
$356.32
$59.78
$56.94
$443.18
$422.07
$365.15
$347.76
$58.38
$55.60
$507.45
$483.29
$81.11
$77.25
$604.57
$575.77
$96.83
$92.22
$85.60
$81.53
$13.75
$13.10
$384.80
$366.48
$450.76
$429.29
$515.59
$491.04
$82.52
$78.59
$476.58
$453.88
$76.34
$72.71
$780.83
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$59.61
$289.65
$275.86
$332.32
$316.49
$53.05
$50.52
$390.13
$371.55
$62.31
$59.34
$493.42
$469.92
$78.87
$75.11
$343.82
$327.45
$435.88
$415.12
$374.14
$356.32
$59.78
$56.94
$443.18
$422.07
$365.15
$347.76
$58.38
$55.60
$507.45
$483.29
$81.11
$77.25
$604.57
$575.77
$96.83
$92.22
$85.60
$81.53
$13.75
$13.10
$384.80
$366.48
$450.76
$429.29
$515.59
$491.04
$82.52
$78.59
$476.58
$453.88
$76.34
$72.71
$780.83
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
10.45
10.45
11.76
11.76
$28.0672
$26.7305
$28.0672
$26.7305
13.86
13.86
$28.0672
$26.7305
17.04
17.04
$28.0672
$26.7305
12.39
12.39
15.75
15.75
13.31
13.31
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
16.22
16.22
13.10
13.10
$28.0672
$26.7305
$28.0672
$26.7305
18.09
18.09
$28.0672
$26.7305
21.61
21.61
$28.0672
$26.7305
3.01
3.01
$28.0672
$26.7305
13.70
13.70
15.84
15.84
18.39
18.39
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
16.76
16.76
$28.0672
$26.7305
27.98
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$58.98
$293.30
$279.33
$330.07
$314.35
$52.81
$50.30
$389.01
$370.48
$62.24
$59.28
$478.27
$455.49
$76.52
$72.88
$347.75
$331.19
$442.06
$421.01
$373.57
$355.78
$59.77
$56.92
$455.25
$433.57
$367.68
$350.17
$58.83
$56.03
$507.74
$483.55
$81.24
$77.37
$606.53
$577.65
$97.04
$92.42
$84.48
$80.46
$13.52
$12.87
$384.52
$366.21
$444.58
$423.41
$516.16
$491.57
$82.59
$78.65
$470.41
$448.00
$75.27
$71.68
$785.32
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$58.98
$293.30
$279.33
$330.07
$314.35
$52.81
$50.30
$389.01
$370.48
$62.24
$59.28
$478.27
$455.49
$76.52
$72.88
$347.75
$331.19
$442.06
$421.01
$373.57
$355.78
$59.77
$56.92
$455.25
$433.57
$367.68
$350.17
$58.83
$56.03
$507.74
$483.55
$81.24
$77.37
$606.53
$577.65
$97.04
$92.42
$84.48
$80.46
$13.52
$12.87
$384.52
$366.21
$444.58
$423.41
$516.16
$491.57
$82.59
$78.65
$470.41
$448.00
$75.27
$71.68
$785.32
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
2
2
2
27702
27702
27702
27703
27703
27703
27703
27704
27704
27705
27705
27705
27705
27707
27707
27709
27709
27709
27709
27712
27712
27712
27712
27715
27715
27715
27715
27720
27720
27720
27720
27722
27722
27722
27722
27724
27724
27724
27724
27725
27725
27725
27725
27726
27726
27727
27727
27727
27727
27730
27730
27732
27732
27734
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
27.82
4.45
4.45
32.11
32.11
5.14
5.14
16.48
16.48
21.69
21.69
3.47
3.47
11.51
11.51
33.45
33.45
5.35
5.35
31.55
31.55
5.05
5.05
30.57
30.57
4.89
4.89
25.03
25.03
4.00
4.00
25.36
25.36
4.06
4.06
36.35
36.35
5.82
5.82
34.83
34.83
5.57
5.57
27.75
27.75
26.31
26.31
4.21
4.21
16.66
16.66
10.90
10.90
17.60
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$743.64
$124.90
$118.95
$901.24
$858.32
$144.27
$137.39
$462.55
$440.52
$608.78
$579.78
$97.39
$92.75
$323.05
$307.67
$938.85
$894.14
$150.16
$143.01
$885.52
$843.35
$141.74
$134.99
$858.01
$817.15
$137.25
$130.71
$702.52
$669.06
$112.27
$106.92
$711.78
$677.89
$113.95
$108.53
$1,020.24
$971.65
$163.35
$155.57
$977.58
$931.02
$156.33
$148.89
$778.86
$741.77
$738.45
$703.28
$118.16
$112.54
$467.60
$445.33
$305.93
$291.36
$493.98
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$743.64
$124.90
$118.95
$901.24
$858.32
$144.27
$137.39
$462.55
$440.52
$608.78
$579.78
$97.39
$92.75
$323.05
$307.67
$938.85
$894.14
$150.16
$143.01
$885.52
$843.35
$141.74
$134.99
$858.01
$817.15
$137.25
$130.71
$702.52
$669.06
$112.27
$106.92
$711.78
$677.89
$113.95
$108.53
$1,020.24
$971.65
$163.35
$155.57
$977.58
$931.02
$156.33
$148.89
$778.86
$741.77
$738.45
$703.28
$118.16
$112.54
$467.60
$445.33
$305.93
$291.36
$493.98
27.98
$26.7305
32.08
32.08
$28.0672
$26.7305
16.59
16.59
21.65
21.65
$28.0672
$26.7305
$28.0672
$26.7305
11.58
11.58
33.87
33.87
$28.0672
$26.7305
$28.0672
$26.7305
31.94
31.94
$28.0672
$26.7305
30.33
30.33
$28.0672
$26.7305
25.23
25.23
$28.0672
$26.7305
25.70
25.70
$28.0672
$26.7305
36.59
36.59
$28.0672
$26.7305
35.27
35.27
$28.0672
$26.7305
27.88
27.88
24.55
24.55
$28.0672
$26.7305
$28.0672
$26.7305
16.88
16.88
12.86
12.86
18.90
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$747.92
$125.65
$119.67
$900.40
$857.51
$144.06
$137.20
$465.63
$443.46
$607.65
$578.72
$97.22
$92.60
$325.02
$309.54
$950.64
$905.36
$152.10
$144.86
$896.47
$853.77
$143.44
$136.60
$851.28
$810.74
$136.20
$129.72
$708.14
$674.41
$113.30
$107.91
$721.33
$686.97
$115.41
$109.92
$1,026.98
$978.07
$164.32
$156.49
$989.93
$942.78
$158.39
$150.84
$782.51
$745.25
$689.05
$656.23
$110.25
$105.00
$473.77
$451.21
$360.94
$343.75
$530.47
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$747.92
$125.65
$119.67
$900.40
$857.51
$144.06
$137.20
$465.63
$443.46
$607.65
$578.72
$97.22
$92.60
$325.02
$309.54
$950.64
$905.36
$152.10
$144.86
$896.47
$853.77
$143.44
$136.60
$851.28
$810.74
$136.20
$129.72
$708.14
$674.41
$113.30
$107.91
$721.33
$686.97
$115.41
$109.92
$1,026.98
$978.07
$164.32
$156.49
$989.93
$942.78
$158.39
$150.84
$782.51
$745.25
$689.05
$656.23
$110.25
$105.00
$473.77
$451.21
$360.94
$343.75
$530.47
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
27734
27740
27740
27740
27740
27742
27742
27742
27742
27745
27745
27745
27745
27750
27750
27750
27750
27752
27752
27752
27752
27756
27756
27756
27756
27758
27758
27758
27758
27759
27759
27759
27759
27760
27760
27760
27760
27762
27762
27762
27762
27766
27766
27767
27767
27767
27767
27768
27768
27769
27769
27780
27780
27780
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
F
F
N
F
N
F
N/F
N/F
F
F
N
F
N
17.60
17.70
17.70
2.83
2.83
19.48
19.48
3.12
3.12
21.61
21.61
3.46
3.46
9.80
9.02
9.80
9.02
15.25
14.10
15.25
14.10
16.37
16.37
2.62
2.62
25.45
25.45
4.07
4.07
28.56
28.56
4.57
4.57
9.47
8.67
9.47
8.67
13.57
12.43
13.57
12.43
17.38
17.38
8.01
8.06
8.01
8.06
12.49
12.49
20.83
20.83
8.67
7.91
8.67
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$470.46
$496.79
$473.13
$79.43
$75.65
$546.75
$520.71
$87.57
$83.40
$606.53
$577.65
$97.11
$92.49
$275.06
$253.17
$261.96
$241.11
$428.02
$395.75
$407.64
$376.90
$459.46
$437.58
$73.54
$70.03
$714.31
$680.29
$114.23
$108.79
$801.60
$763.42
$128.27
$122.16
$265.80
$243.34
$253.14
$231.75
$380.87
$348.88
$362.73
$332.26
$487.81
$464.58
$224.82
$226.22
$214.11
$215.45
$350.56
$333.86
$584.64
$556.80
$243.34
$222.01
$231.75
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$470.46
$496.79
$473.13
$79.43
$75.65
$546.75
$520.71
$87.57
$83.40
$606.53
$577.65
$97.11
$92.49
$275.06
$253.17
$261.96
$241.11
$428.02
$395.75
$407.64
$376.90
$459.46
$437.58
$73.54
$70.03
$714.31
$680.29
$114.23
$108.79
$801.60
$763.42
$128.27
$122.16
$265.80
$243.34
$253.14
$231.75
$380.87
$348.88
$362.73
$332.26
$487.81
$464.58
$224.82
$226.22
$214.11
$215.45
$350.56
$333.86
$584.64
$556.80
$243.34
$222.01
$231.75
18.90
20.43
20.43
$26.7305
$28.0672
$26.7305
22.44
22.44
$28.0672
$26.7305
21.87
21.87
$28.0672
$26.7305
9.90
9.09
9.90
9.09
15.39
14.21
15.39
14.21
16.61
16.61
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
25.70
25.70
$28.0672
$26.7305
28.80
28.80
$28.0672
$26.7305
9.51
8.67
9.51
8.67
13.55
12.35
13.55
12.35
17.63
17.63
8.04
8.08
8.04
8.08
12.66
12.66
20.91
20.91
8.72
7.92
8.72
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$505.21
$573.41
$546.10
$91.75
$87.38
$629.83
$599.83
$100.77
$95.97
$613.83
$584.60
$98.21
$93.54
$277.87
$255.13
$264.63
$242.98
$431.95
$398.83
$411.38
$379.84
$466.20
$443.99
$74.59
$71.04
$721.33
$686.97
$115.41
$109.92
$808.34
$769.84
$129.33
$123.17
$266.92
$243.34
$254.21
$231.75
$380.31
$346.63
$362.20
$330.12
$494.82
$471.26
$225.66
$226.78
$214.91
$215.98
$355.33
$338.41
$586.89
$558.93
$244.75
$222.29
$233.09
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$505.21
$573.41
$546.10
$91.75
$87.38
$629.83
$599.83
$100.77
$95.97
$613.83
$584.60
$98.21
$93.54
$277.87
$255.13
$264.63
$242.98
$431.95
$398.83
$411.38
$379.84
$466.20
$443.99
$74.59
$71.04
$721.33
$686.97
$115.41
$109.92
$808.34
$769.84
$129.33
$123.17
$266.92
$243.34
$254.21
$231.75
$380.31
$346.63
$362.20
$330.12
$494.82
$471.26
$225.66
$226.78
$214.91
$215.98
$355.33
$338.41
$586.89
$558.93
$244.75
$222.29
$233.09
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
27780
27781
27781
27781
27781
27784
27784
27786
27786
27786
27786
27788
27788
27788
27788
27792
27792
27808
27808
27808
27808
27810
27810
27810
27810
27814
27814
27814
27814
27816
27816
27816
27816
27818
27818
27818
27818
27822
27822
27822
27822
27823
27823
27823
27823
27824
27824
27824
27824
27825
27825
27825
27825
27826
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
N
F
N
F
F
F
N
F
N
F
N
F
N
F
F
F
N
F
N
F
N
F
N
F
F
F
F
F
N
F
N
F
N
F
N
F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
F
7.91
11.86
11.02
11.86
11.02
20.48
20.48
8.97
8.13
8.97
8.13
11.94
10.93
11.94
10.93
18.66
18.66
9.48
8.54
9.48
8.54
13.31
12.11
13.31
12.11
22.08
22.08
3.53
3.53
9.03
8.12
9.03
8.12
13.78
12.40
13.78
12.40
24.06
24.06
3.85
3.85
27.32
27.32
4.37
4.37
8.90
8.66
8.90
8.66
15.49
14.08
15.49
14.08
23.95
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$211.44
$332.88
$309.30
$317.02
$294.57
$574.82
$547.44
$251.76
$228.19
$239.77
$217.32
$335.12
$306.77
$319.16
$292.16
$523.73
$498.79
$266.08
$239.69
$253.41
$228.28
$373.57
$339.89
$355.78
$323.71
$619.72
$590.21
$99.08
$94.36
$253.45
$227.91
$241.38
$217.05
$386.77
$348.03
$368.35
$331.46
$675.30
$643.14
$108.06
$102.91
$766.80
$730.28
$122.65
$116.81
$249.80
$243.06
$237.90
$231.49
$434.76
$395.19
$414.06
$376.37
$672.21
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$211.44
$332.88
$309.30
$317.02
$294.57
$574.82
$547.44
$251.76
$228.19
$239.77
$217.32
$335.12
$306.77
$319.16
$292.16
$523.73
$498.79
$266.08
$239.69
$253.41
$228.28
$373.57
$339.89
$355.78
$323.71
$619.72
$590.21
$99.08
$94.36
$253.45
$227.91
$241.38
$217.05
$386.77
$348.03
$368.35
$331.46
$675.30
$643.14
$108.06
$102.91
$766.80
$730.28
$122.65
$116.81
$249.80
$243.06
$237.90
$231.49
$434.76
$395.19
$414.06
$376.37
$672.21
7.92
12.11
11.23
12.11
11.23
20.66
20.66
9.03
8.16
9.03
8.16
12.03
11.00
12.03
11.00
18.83
18.83
9.53
8.57
9.53
8.57
13.37
12.14
13.37
12.14
22.26
22.26
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
9.16
8.21
9.16
8.21
13.82
12.40
13.82
12.40
24.19
24.19
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
27.56
27.56
$28.0672
$26.7305
8.92
8.66
8.92
8.66
15.64
14.20
15.64
14.20
23.96
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$211.71
$339.89
$315.19
$323.71
$300.18
$579.87
$552.25
$253.45
$229.03
$241.38
$218.12
$337.65
$308.74
$321.57
$294.04
$528.51
$503.34
$267.48
$240.54
$254.74
$229.08
$375.26
$340.74
$357.39
$324.51
$624.78
$595.02
$99.96
$95.20
$257.10
$230.43
$244.85
$219.46
$387.89
$348.03
$369.42
$331.46
$678.95
$646.61
$108.63
$103.46
$773.53
$736.69
$123.76
$117.87
$250.36
$243.06
$238.44
$231.49
$438.97
$398.55
$418.07
$379.57
$672.49
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$211.71
$339.89
$315.19
$323.71
$300.18
$579.87
$552.25
$253.45
$229.03
$241.38
$218.12
$337.65
$308.74
$321.57
$294.04
$528.51
$503.34
$267.48
$240.54
$254.74
$229.08
$375.26
$340.74
$357.39
$324.51
$624.78
$595.02
$99.96
$95.20
$257.10
$230.43
$244.85
$219.46
$387.89
$348.03
$369.42
$331.46
$678.95
$646.61
$108.63
$103.46
$773.53
$736.69
$123.76
$117.87
$250.36
$243.06
$238.44
$231.49
$438.97
$398.55
$418.07
$379.57
$672.49
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
8
8
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
27826
27826
27826
27827
27827
27827
27827
27828
27828
27828
27828
27829
27829
27829
27829
27830
27830
27831
27831
27832
27832
27832
27832
27840
27840
27842
27842
27846
27846
27846
27846
27848
27848
27848
27848
27860
27860
27870
27870
27870
27870
27871
27871
27871
27871
27880
27880
27880
27880
27881
27881
27881
27881
27882
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N/F
N/F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
23.95
3.83
3.83
30.98
30.98
4.96
4.96
37.09
37.09
5.93
5.93
19.57
19.57
3.13
3.13
10.03
10.03
11.32
11.32
21.52
21.52
3.44
3.44
10.55
10.55
14.08
14.08
20.92
20.92
3.35
3.35
23.34
23.34
3.73
3.73
5.07
5.07
29.66
29.66
4.75
4.75
19.67
19.67
3.15
3.15
26.60
26.60
4.26
4.26
25.35
25.35
4.06
4.06
17.49
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$640.20
$107.50
$102.38
$869.52
$828.11
$139.21
$132.58
$1,041.01
$991.43
$166.44
$158.51
$549.28
$523.12
$87.85
$83.67
$281.51
$268.11
$317.72
$302.59
$604.01
$575.24
$96.55
$91.95
$296.11
$282.01
$395.19
$376.37
$587.17
$559.20
$94.03
$89.55
$655.09
$623.89
$104.69
$99.70
$142.30
$135.52
$832.47
$792.83
$133.32
$126.97
$552.08
$525.79
$88.41
$84.20
$746.59
$711.03
$119.57
$113.87
$711.50
$677.62
$113.95
$108.53
$490.90
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$640.20
$107.50
$102.38
$869.52
$828.11
$139.21
$132.58
$1,041.01
$991.43
$166.44
$158.51
$549.28
$523.12
$87.85
$83.67
$281.51
$268.11
$317.72
$302.59
$604.01
$575.24
$96.55
$91.95
$296.11
$282.01
$395.19
$376.37
$587.17
$559.20
$94.03
$89.55
$655.09
$623.89
$104.69
$99.70
$142.30
$135.52
$832.47
$792.83
$133.32
$126.97
$552.08
$525.79
$88.41
$84.20
$746.59
$711.03
$119.57
$113.87
$711.50
$677.62
$113.95
$108.53
$490.90
23.96
$26.7305
31.17
31.17
$28.0672
$26.7305
37.36
37.36
$28.0672
$26.7305
19.70
19.70
$28.0672
$26.7305
10.03
10.03
11.49
11.49
21.81
21.81
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
10.51
10.51
14.28
14.28
21.12
21.12
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
23.47
23.47
$28.0672
$26.7305
4.99
4.99
29.76
29.76
$28.0672
$26.7305
$28.0672
$26.7305
19.73
19.73
$28.0672
$26.7305
26.82
26.82
$28.0672
$26.7305
25.16
25.16
$28.0672
$26.7305
17.51
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$640.46
$107.60
$102.47
$874.85
$833.19
$139.98
$133.31
$1,048.59
$998.65
$167.77
$159.78
$552.92
$526.59
$88.47
$84.25
$281.51
$268.11
$322.49
$307.13
$612.15
$582.99
$97.94
$93.28
$294.99
$280.94
$400.80
$381.71
$592.78
$564.55
$94.84
$90.33
$658.74
$627.36
$105.40
$100.38
$140.06
$133.39
$835.28
$795.50
$133.64
$127.28
$553.77
$527.39
$88.60
$84.38
$752.76
$716.91
$120.44
$114.71
$706.17
$672.54
$112.99
$107.61
$491.46
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$640.46
$107.60
$102.47
$874.85
$833.19
$139.98
$133.31
$1,048.59
$998.65
$167.77
$159.78
$552.92
$526.59
$88.47
$84.25
$281.51
$268.11
$322.49
$307.13
$612.15
$582.99
$97.94
$93.28
$294.99
$280.94
$400.80
$381.71
$592.78
$564.55
$94.84
$90.33
$658.74
$627.36
$105.40
$100.38
$140.06
$133.39
$835.28
$795.50
$133.64
$127.28
$553.77
$527.39
$88.60
$84.38
$752.76
$716.91
$120.44
$114.71
$706.17
$672.54
$112.99
$107.61
$491.46
Musculoskeletal System Surgery
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
8
8
27882
27884
27884
27886
27886
27888
27888
27888
27888
27889
27889
27892
27892
27893
27893
27894
27894
27894
27894
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
17.49
16.63
16.63
19.03
19.03
19.38
19.38
3.10
3.10
19.15
19.15
15.89
15.89
17.45
17.45
24.57
24.57
3.93
3.93
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
27899
28001
28001
28001
28001
28002
28002
28002
28002
28003
28003
28003
28003
28005
28005
28008
28008
28008
28008
28010
28010
28010
28010
28011
28011
28011
28011
28020
28020
28022
28022
28024
28024
28035
0-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
F
N
F
N
F
N
F
N
F
N
F
N
F
N/F
N/F
N
F
N
F
N
F
N
F
N
F
N
F
F
F
F
F
F
F
N
7.89
4.85
7.89
4.85
12.77
9.24
12.77
9.24
20.42
16.40
20.42
16.40
16.68
16.68
12.36
8.40
12.36
8.40
6.66
6.01
6.66
6.01
9.29
8.32
9.29
8.32
10.37
10.37
9.31
9.31
8.71
8.71
15.20
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$467.52
$466.76
$444.53
$534.12
$508.68
$543.94
$518.04
$87.01
$82.86
$537.49
$511.89
$445.99
$424.75
$489.77
$466.45
$689.61
$656.77
$110.30
$105.05
Manually
Priced
$221.45
$136.13
$210.90
$129.64
$358.42
$259.34
$341.35
$246.99
$573.13
$460.30
$545.84
$438.38
$468.16
$445.86
$346.91
$235.76
$330.39
$224.54
$186.93
$168.68
$178.03
$160.65
$260.74
$233.52
$248.33
$222.40
$291.06
$277.20
$261.31
$248.86
$244.47
$232.82
$426.62
Current
Percent
Reduction
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
$467.52
$466.76
$444.53
$534.12
$508.68
$543.94
$518.04
$87.01
$82.86
$537.49
$511.89
$445.99
$424.75
$489.77
$466.45
$689.61
$656.77
$110.30
$105.05
Manually
Priced
$221.45
$136.13
$210.90
$129.64
$358.42
$259.34
$341.35
$246.99
$573.13
$460.30
$545.84
$438.38
$468.16
$445.86
$346.91
$235.76
$330.39
$224.54
$186.93
$168.68
$178.03
$160.65
$260.74
$233.52
$248.33
$222.40
$291.06
$277.20
$261.31
$248.86
$244.47
$232.82
$426.62
17.51
16.78
16.78
19.20
19.20
19.92
19.92
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
18.87
18.87
15.78
15.78
17.56
17.56
24.94
24.94
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
8.07
4.96
8.07
4.96
12.72
9.15
12.72
9.15
20.37
16.28
20.37
16.28
16.68
16.68
12.49
8.45
12.49
8.45
6.67
6.02
6.67
6.02
9.28
8.28
9.28
8.28
10.49
10.49
9.37
9.37
8.80
8.80
15.24
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
$468.05
$470.97
$448.54
$538.89
$513.23
$559.10
$532.47
$89.46
$85.20
$529.63
$504.40
$442.90
$421.81
$492.86
$469.39
$700.00
$666.66
$112.00
$106.67
Manually
Priced
$226.50
$139.21
$215.72
$132.58
$357.01
$256.81
$340.01
$244.58
$571.73
$456.93
$544.50
$435.17
$468.16
$445.86
$350.56
$237.17
$333.86
$225.87
$187.21
$168.96
$178.29
$160.92
$260.46
$232.40
$248.06
$221.33
$294.42
$280.40
$262.99
$250.46
$246.99
$235.23
$427.74
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$468.05
$470.97
$448.54
$538.89
$513.23
$559.10
$532.47
$89.46
$85.20
$529.63
$504.40
$442.90
$421.81
$492.86
$469.39
$700.00
$666.66
$112.00
$106.67
Manually
Priced
$226.50
$139.21
$215.72
$132.58
$357.01
$256.81
$340.01
$244.58
$571.73
$456.93
$544.50
$435.17
$468.16
$445.86
$350.56
$237.17
$333.86
$225.87
$187.21
$168.96
$178.29
$160.92
$260.46
$232.40
$248.06
$221.33
$294.42
$280.40
$262.99
$250.46
$246.99
$235.23
$427.74
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
2
2
8
8
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
28035
28035
28035
28039
28039
28039
28039
28039
28039
28039
28039
28041
28041
28043
28043
28043
28043
28045
28045
28045
28045
28046
28046
28047
28047
28047
28047
28050
28050
28052
28052
28054
28054
28055
28055
28060
28060
28060
28060
28062
28062
28062
28062
28070
28070
28070
28070
28072
28072
28072
28072
28080
28080
28080
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
N
F
N
F
N
F
N
F
N
F
N/F
N/F
N
F
N
F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
F
F
N/F
N/F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
10.26
15.20
10.26
14.66
10.05
14.66
10.05
2.35
1.61
2.35
1.61
13.19
13.19
11.42
7.51
11.42
7.51
14.23
10.01
14.23
10.01
21.13
21.13
29.48
29.48
4.72
4.72
8.08
8.08
8.07
8.07
6.75
6.75
10.82
10.82
14.81
10.20
14.81
10.20
16.79
11.68
16.79
11.68
15.23
10.15
15.23
10.15
14.57
9.57
14.57
9.57
14.96
10.47
14.96
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$287.97
$406.30
$274.25
$411.47
$282.08
$391.87
$268.64
$65.96
$45.19
$62.82
$43.04
$370.21
$352.58
$320.53
$210.78
$305.26
$200.75
$399.40
$280.95
$380.38
$267.57
$593.06
$564.82
$827.42
$788.02
$132.48
$126.17
$226.78
$215.98
$226.50
$215.72
$189.45
$180.43
$303.69
$289.22
$415.68
$286.29
$395.88
$272.65
$471.25
$327.82
$448.81
$312.21
$427.46
$284.88
$407.11
$271.31
$408.94
$268.60
$389.46
$255.81
$419.89
$293.86
$399.89
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$287.97
$406.30
$274.25
$411.47
$282.08
$391.87
$268.64
$65.96
$45.19
$62.82
$43.04
$370.21
$352.58
$320.53
$210.78
$305.26
$200.75
$399.40
$280.95
$380.38
$267.57
$593.06
$564.82
$827.42
$788.02
$132.48
$126.17
$226.78
$215.98
$226.50
$215.72
$189.45
$180.43
$303.69
$289.22
$415.68
$286.29
$395.88
$272.65
$471.25
$327.82
$448.81
$312.21
$427.46
$284.88
$407.11
$271.31
$408.94
$268.60
$389.46
$255.81
$419.89
$293.86
$399.89
10.23
15.24
10.23
14.68
10.07
14.68
10.07
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
13.19
13.19
11.53
7.54
11.53
7.54
14.27
9.97
14.27
9.97
21.04
21.04
31.03
31.03
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
8.89
8.89
8.00
8.00
6.79
6.79
10.89
10.89
14.94
10.23
14.94
10.23
16.82
11.65
16.82
11.65
15.27
10.16
15.27
10.16
14.90
9.69
14.90
9.69
15.21
10.59
15.21
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$287.13
$407.37
$273.45
$412.03
$282.64
$392.40
$269.18
$65.92
$45.22
$62.78
$43.07
$370.21
$352.58
$323.61
$211.63
$308.20
$201.55
$400.52
$279.83
$381.44
$266.50
$590.53
$562.41
$870.93
$829.45
$139.35
$132.71
$249.52
$237.63
$224.54
$213.84
$190.58
$181.50
$305.65
$291.10
$419.32
$287.13
$399.35
$273.45
$472.09
$326.98
$449.61
$311.41
$428.59
$285.16
$408.17
$271.58
$418.20
$271.97
$398.28
$259.02
$426.90
$297.23
$406.57
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$287.13
$407.37
$273.45
$412.03
$282.64
$392.40
$269.18
$65.92
$45.22
$62.78
$43.07
$370.21
$352.58
$323.61
$211.63
$308.20
$201.55
$400.52
$279.83
$381.44
$266.50
$590.53
$562.41
$870.93
$829.45
$139.35
$132.71
$249.52
$237.63
$224.54
$213.84
$190.58
$181.50
$305.65
$291.10
$419.32
$287.13
$399.35
$273.45
$472.09
$326.98
$449.61
$311.41
$428.59
$285.16
$408.17
$271.58
$418.20
$271.97
$398.28
$259.02
$426.90
$297.23
$406.57
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
28080
28086
28086
28086
28086
28086
28086
28088
28088
28088
28088
28090
28090
28090
28090
28092
28092
28092
28092
28100
28100
28100
28100
28102
28102
28102
28102
28103
28103
28103
28103
28104
28104
28104
28104
28106
28106
28106
28106
28107
28107
28107
28107
28107
28107
28108
28108
28108
28108
28110
28110
28110
28110
28111
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
N
F
N
F
F
F
N
F
N
F
N
F
N
F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
F
F
N
F
N
F
N
F
N
F
N
10.47
15.63
10.33
15.63
10.33
1.65
1.65
13.35
8.41
13.35
8.41
13.47
8.83
13.47
8.83
12.10
7.70
12.10
7.70
11.76
11.76
1.88
1.88
16.34
16.34
2.61
2.61
11.24
11.24
1.80
1.80
10.04
10.04
1.61
1.61
12.79
12.79
2.05
2.05
15.71
10.49
15.71
10.49
1.68
1.68
12.64
8.27
12.64
8.27
13.24
8.27
13.24
8.27
14.24
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$279.87
$438.69
$289.93
$417.80
$276.13
$46.31
$44.11
$374.70
$236.05
$356.85
$224.80
$378.07
$247.83
$360.06
$236.03
$339.61
$216.12
$323.44
$205.82
$330.07
$314.35
$52.77
$50.25
$458.62
$436.78
$73.26
$69.77
$315.48
$300.45
$50.52
$48.11
$281.79
$268.37
$45.19
$43.04
$358.98
$341.88
$57.54
$54.80
$440.94
$294.42
$419.94
$280.40
$47.15
$44.91
$354.77
$232.12
$337.87
$221.06
$371.61
$232.12
$353.91
$221.06
$399.68
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$279.87
$438.69
$289.93
$417.80
$276.13
$46.31
$44.11
$374.70
$236.05
$356.85
$224.80
$378.07
$247.83
$360.06
$236.03
$339.61
$216.12
$323.44
$205.82
$330.07
$314.35
$52.77
$50.25
$458.62
$436.78
$73.26
$69.77
$315.48
$300.45
$50.52
$48.11
$281.79
$268.37
$45.19
$43.04
$358.98
$341.88
$57.54
$54.80
$440.94
$294.42
$419.94
$280.40
$47.15
$44.91
$354.77
$232.12
$337.87
$221.06
$371.61
$232.12
$353.91
$221.06
$399.68
10.59
15.94
10.46
15.94
10.46
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
12.66
7.89
12.66
7.89
13.62
8.87
13.62
8.87
12.22
7.72
12.22
7.72
11.95
11.95
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
17.48
17.48
$28.0672
$26.7305
11.25
11.25
$28.0672
$26.7305
10.25
10.25
$28.0672
$26.7305
12.32
12.32
$28.0672
$26.7305
14.91
10.03
14.91
10.03
$28.0672
$28.0672
$26.7305
$26.7305
12.81
8.33
12.81
8.33
13.41
8.33
13.41
8.33
14.32
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$283.08
$447.39
$293.58
$426.08
$279.60
$46.97
$44.74
$355.33
$221.45
$338.41
$210.90
$382.28
$248.96
$364.07
$237.10
$342.98
$216.68
$326.65
$206.36
$335.40
$319.43
$53.66
$51.11
$490.61
$467.25
$78.50
$74.76
$315.76
$300.72
$50.52
$48.12
$287.69
$273.99
$46.03
$43.84
$345.79
$329.32
$55.33
$52.69
$418.48
$281.51
$398.55
$268.11
$45.04
$42.90
$359.54
$233.80
$342.42
$222.67
$376.38
$233.80
$358.46
$222.67
$401.92
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$283.08
$447.39
$293.58
$426.08
$279.60
$46.97
$44.74
$355.33
$221.45
$338.41
$210.90
$382.28
$248.96
$364.07
$237.10
$342.98
$216.68
$326.65
$206.36
$335.40
$319.43
$53.66
$51.11
$490.61
$467.25
$78.50
$74.76
$315.76
$300.72
$50.52
$48.12
$287.69
$273.99
$46.03
$43.84
$345.79
$329.32
$55.33
$52.69
$418.48
$281.51
$398.55
$268.11
$45.04
$42.90
$359.54
$233.80
$342.42
$222.67
$376.38
$233.80
$358.46
$222.67
$401.92
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
8
8
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
8
28111
28111
28111
28112
28112
28112
28112
28113
28113
28113
28113
28114
28114
28114
28114
28114
28114
28114
28114
28116
28116
28116
28116
28118
28118
28118
28118
28118
28118
28119
28119
28119
28119
28120
28120
28120
28120
28122
28122
28122
28122
28122
28122
28124
28124
28124
28124
28126
28126
28126
28126
28130
28130
28130
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
F
F
N
F
N
F
N
F
N
F
N
F
N
F
F
F
N
F
N
F
N
F
N
F
N/F
N/F
F
9.42
14.24
9.42
14.03
8.99
14.03
8.99
16.98
12.21
16.98
12.21
30.76
24.00
30.76
24.00
4.92
3.84
4.92
3.84
21.33
16.17
21.33
16.17
16.86
11.75
16.86
11.75
1.88
1.88
15.06
10.35
15.06
10.35
19.46
14.31
19.46
14.31
17.16
12.63
17.16
12.63
2.02
2.02
13.65
9.45
13.65
9.45
11.37
7.14
11.37
7.14
19.03
19.03
3.04
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$264.39
$380.64
$251.80
$393.78
$252.32
$375.03
$240.31
$476.58
$342.70
$453.88
$326.38
$863.35
$673.61
$822.23
$641.53
$138.09
$107.78
$131.51
$102.65
$598.67
$453.85
$570.16
$432.23
$473.21
$329.79
$450.68
$314.08
$52.77
$50.25
$422.69
$290.50
$402.56
$276.66
$546.19
$401.64
$520.18
$382.51
$481.63
$354.49
$458.70
$337.61
$56.70
$54.00
$383.12
$265.24
$364.87
$252.60
$319.12
$200.40
$303.93
$190.86
$534.12
$508.68
$85.32
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$264.39
$380.64
$251.80
$393.78
$252.32
$375.03
$240.31
$476.58
$342.70
$453.88
$326.38
$863.35
$673.61
$822.23
$641.53
$138.09
$107.78
$131.51
$102.65
$598.67
$453.85
$570.16
$432.23
$473.21
$329.79
$450.68
$314.08
$52.77
$50.25
$422.69
$290.50
$402.56
$276.66
$546.19
$401.64
$520.18
$382.51
$481.63
$354.49
$458.70
$337.61
$56.70
$54.00
$383.12
$265.24
$364.87
$252.60
$319.12
$200.40
$303.93
$190.86
$534.12
$508.68
$85.32
9.42
14.32
9.42
14.20
9.03
14.20
9.03
17.18
12.30
17.18
12.30
31.21
24.26
31.21
24.26
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
21.80
16.41
21.80
16.41
17.15
11.89
17.15
11.89
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
15.18
10.37
15.18
10.37
19.55
14.33
19.55
14.33
17.30
12.67
17.30
12.67
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
13.77
9.48
13.77
9.48
11.43
7.14
11.43
7.14
17.56
17.56
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$264.39
$382.78
$251.80
$398.55
$253.45
$379.57
$241.38
$482.19
$345.23
$459.23
$328.79
$875.98
$680.91
$834.26
$648.48
$140.16
$108.95
$133.48
$103.76
$611.86
$460.58
$582.72
$438.65
$481.35
$333.72
$458.43
$317.83
$53.40
$50.85
$426.06
$291.06
$405.77
$277.20
$548.71
$402.20
$522.58
$383.05
$485.56
$355.61
$462.44
$338.68
$56.90
$54.19
$386.49
$266.08
$368.08
$253.41
$320.81
$200.40
$305.53
$190.86
$492.86
$469.39
$78.86
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$264.39
$382.78
$251.80
$398.55
$253.45
$379.57
$241.38
$482.19
$345.23
$459.23
$328.79
$875.98
$680.91
$834.26
$648.48
$140.16
$108.95
$133.48
$103.76
$611.86
$460.58
$582.72
$438.65
$481.35
$333.72
$458.43
$317.83
$53.40
$50.85
$426.06
$291.06
$405.77
$277.20
$548.71
$402.20
$522.58
$383.05
$485.56
$355.61
$462.44
$338.68
$56.90
$54.19
$386.49
$266.08
$368.08
$253.41
$320.81
$200.40
$305.53
$190.86
$492.86
$469.39
$78.86
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
8
8
2
2
2
28130
28140
28140
28140
28140
28150
28150
28150
28150
28153
28153
28153
28153
28160
28160
28160
28160
28171
28171
28171
28171
28173
28173
28175
28175
28190
28190
28190
28190
28192
28192
28192
28192
28193
28193
28193
28193
28200
28200
28202
28202
28202
28202
28208
28208
28208
28208
28210
28210
28210
28210
28220
28220
28220
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
N
F
N
F
F
F
F
F
F
F
N
F
N
F
F
F
F
F
N
F
N
3.04
17.23
12.70
17.23
12.70
12.25
8.06
12.25
8.06
11.83
7.59
11.83
7.59
12.04
7.72
12.04
7.72
24.42
24.42
3.91
3.91
22.20
22.20
14.02
14.02
7.33
3.84
7.33
3.84
13.51
9.02
13.51
9.02
15.28
10.63
15.28
10.63
9.12
9.12
12.22
12.22
1.96
1.96
13.56
8.92
13.56
8.92
11.57
11.57
1.85
1.85
12.82
8.61
12.82
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$81.26
$483.60
$356.45
$460.57
$339.48
$343.82
$226.22
$327.45
$215.45
$332.03
$213.03
$316.22
$202.88
$337.93
$216.68
$321.84
$206.36
$685.40
$652.76
$109.74
$104.52
$623.09
$593.42
$393.50
$374.76
$205.73
$107.78
$195.93
$102.65
$379.19
$253.17
$361.13
$241.11
$428.87
$298.35
$408.44
$284.15
$255.97
$243.78
$342.98
$326.65
$55.01
$52.39
$380.59
$250.36
$362.47
$238.44
$324.74
$309.27
$51.92
$49.45
$359.82
$241.66
$342.69
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$81.26
$483.60
$356.45
$460.57
$339.48
$343.82
$226.22
$327.45
$215.45
$332.03
$213.03
$316.22
$202.88
$337.93
$216.68
$321.84
$206.36
$685.40
$652.76
$109.74
$104.52
$623.09
$593.42
$393.50
$374.76
$205.73
$107.78
$195.93
$102.65
$379.19
$253.17
$361.13
$241.11
$428.87
$298.35
$408.44
$284.15
$255.97
$243.78
$342.98
$326.65
$55.01
$52.39
$380.59
$250.36
$362.47
$238.44
$324.74
$309.27
$51.92
$49.45
$359.82
$241.66
$342.69
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
17.20
12.64
17.20
12.64
12.36
8.10
12.36
8.10
11.92
7.60
11.92
7.60
12.20
7.78
12.20
7.78
24.43
24.43
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
21.94
21.94
14.09
14.09
7.40
3.85
7.40
3.85
13.57
9.02
13.57
9.02
15.41
10.65
15.41
10.65
9.22
9.22
12.18
12.18
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
13.73
8.98
13.73
8.98
11.85
11.85
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
13.04
8.69
13.04
$28.0672
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$75.10
$482.76
$354.77
$459.76
$337.87
$346.91
$227.34
$330.39
$216.52
$334.56
$213.31
$318.63
$203.15
$342.42
$218.36
$326.11
$207.96
$685.68
$653.03
$109.71
$104.48
$615.79
$586.47
$395.47
$376.63
$207.70
$108.06
$197.81
$102.91
$380.87
$253.17
$362.73
$241.11
$432.52
$298.92
$411.92
$284.68
$258.78
$246.46
$341.86
$325.58
$54.70
$52.09
$385.36
$252.04
$367.01
$240.04
$332.60
$316.76
$53.22
$50.68
$366.00
$243.90
$348.57
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$75.10
$482.76
$354.77
$459.76
$337.87
$346.91
$227.34
$330.39
$216.52
$334.56
$213.31
$318.63
$203.15
$342.42
$218.36
$326.11
$207.96
$685.68
$653.03
$109.71
$104.48
$615.79
$586.47
$395.47
$376.63
$207.70
$108.06
$197.81
$102.91
$380.87
$253.17
$362.73
$241.11
$432.52
$298.92
$411.92
$284.68
$258.78
$246.46
$341.86
$325.58
$54.70
$52.09
$385.36
$252.04
$367.01
$240.04
$332.60
$316.76
$53.22
$50.68
$366.00
$243.90
$348.57
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
28220
28222
28222
28222
28222
28225
28225
28226
28226
28226
28226
28230
28230
28230
28230
28232
28232
28232
28232
28234
28234
28234
28234
28238
28238
28238
28238
28240
28240
28240
28240
28250
28250
28250
28250
28260
28260
28260
28260
28261
28261
28261
28261
28262
28262
28262
28262
28264
28264
28264
28264
28270
28270
28270
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
N
F
N
F
F
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
F
F
F
F
N
F
N
F
F
F
F
F
F
F
F
F
N
F
N
F
F
F
F
F
F
F
F
F
N
F
N
8.61
14.58
10.05
14.58
10.05
7.40
7.40
16.84
10.63
16.84
10.63
12.50
8.13
12.50
8.13
11.13
6.99
11.13
6.99
11.68
7.54
11.68
7.54
14.02
14.02
2.24
2.24
12.60
8.30
12.60
8.30
11.57
11.57
1.85
1.85
14.62
14.62
2.34
2.34
27.71
21.95
27.71
21.95
33.49
33.49
5.36
5.36
20.68
20.68
3.31
3.31
14.08
9.57
14.08
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$230.15
$409.22
$282.08
$389.73
$268.64
$207.70
$197.81
$472.65
$298.35
$450.14
$284.15
$350.84
$228.19
$334.13
$217.32
$312.39
$196.19
$297.51
$186.85
$327.82
$211.63
$312.21
$201.55
$393.50
$374.76
$62.87
$59.88
$353.65
$232.96
$336.80
$221.86
$324.74
$309.27
$51.92
$49.45
$410.34
$390.80
$65.68
$62.55
$777.74
$616.08
$740.70
$586.73
$939.97
$895.20
$150.44
$143.28
$580.43
$552.79
$92.90
$88.48
$395.19
$268.60
$376.37
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$230.15
$409.22
$282.08
$389.73
$268.64
$207.70
$197.81
$472.65
$298.35
$450.14
$284.15
$350.84
$228.19
$334.13
$217.32
$312.39
$196.19
$297.51
$186.85
$327.82
$211.63
$312.21
$201.55
$393.50
$374.76
$62.87
$59.88
$353.65
$232.96
$336.80
$221.86
$324.74
$309.27
$51.92
$49.45
$410.34
$390.80
$65.68
$62.55
$777.74
$616.08
$740.70
$586.73
$939.97
$895.20
$150.44
$143.28
$580.43
$552.79
$92.90
$88.48
$395.19
$268.60
$376.37
8.69
14.53
9.97
14.53
9.97
7.42
7.42
12.73
8.41
12.73
8.41
12.64
8.19
12.64
8.19
11.20
7.00
11.20
7.00
11.85
7.60
11.85
7.60
14.14
14.14
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
12.75
8.34
12.75
8.34
11.66
11.66
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
14.72
14.72
$28.0672
$26.7305
28.83
22.73
28.83
22.73
34.22
34.22
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
18.56
18.56
$28.0672
$26.7305
14.23
9.60
14.23
$28.0672
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$232.29
$407.82
$279.83
$388.39
$266.50
$208.26
$198.34
$357.30
$236.05
$340.28
$224.80
$354.77
$229.87
$337.87
$218.92
$314.35
$196.47
$299.38
$187.11
$332.60
$213.31
$316.76
$203.15
$396.87
$377.97
$63.50
$60.48
$357.86
$234.08
$340.81
$222.93
$327.26
$311.68
$52.36
$49.87
$413.15
$393.47
$66.10
$62.96
$809.18
$637.97
$770.64
$607.58
$960.46
$914.72
$153.67
$146.36
$520.93
$496.12
$83.35
$79.38
$399.40
$269.45
$380.38
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$232.29
$407.82
$279.83
$388.39
$266.50
$208.26
$198.34
$357.30
$236.05
$340.28
$224.80
$354.77
$229.87
$337.87
$218.92
$314.35
$196.47
$299.38
$187.11
$332.60
$213.31
$316.76
$203.15
$396.87
$377.97
$63.50
$60.48
$357.86
$234.08
$340.81
$222.93
$327.26
$311.68
$52.36
$49.87
$413.15
$393.47
$66.10
$62.96
$809.18
$637.97
$770.64
$607.58
$960.46
$914.72
$153.67
$146.36
$520.93
$496.12
$83.35
$79.38
$399.40
$269.45
$380.38
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
8
8
2
2
2
2
8
8
2
2
2
2
8
8
2
2
2
2
8
28270
28272
28272
28272
28272
28280
28280
28280
28280
28285
28285
28285
28285
28286
28286
28286
28286
28288
28288
28288
28288
28289
28289
28289
28289
28289
28289
28290
28290
28290
28290
28292
28292
28292
28292
28292
28292
28293
28293
28293
28293
28293
28293
28294
28294
28294
28294
28294
28294
28296
28296
28296
28296
28296
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
F
F
N
F
N
F
N
F
N
F
F
F
N
F
N
F
F
F
N
F
N
F
F
F
N
F
N
F
F
9.57
11.28
7.28
11.28
7.28
14.94
10.10
14.94
10.10
15.28
10.79
15.28
10.79
13.00
8.61
13.00
8.61
17.33
12.31
17.33
12.31
21.07
15.73
21.07
15.73
2.52
2.52
16.78
11.29
16.78
11.29
22.63
17.25
22.63
17.25
2.76
2.76
29.95
20.38
29.95
20.38
3.26
3.26
21.50
15.34
21.50
15.34
2.45
2.45
20.43
14.93
20.43
14.93
2.39
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$255.81
$316.60
$204.33
$301.52
$194.60
$419.32
$283.48
$399.35
$269.98
$428.87
$302.85
$408.44
$288.42
$364.87
$241.66
$347.50
$230.15
$486.40
$345.51
$463.24
$329.05
$591.38
$441.50
$563.21
$420.47
$70.73
$67.36
$470.97
$316.88
$448.54
$301.79
$635.16
$484.16
$604.91
$461.10
$77.47
$73.78
$840.61
$572.01
$800.58
$544.77
$91.50
$87.14
$603.44
$430.55
$574.71
$410.05
$68.76
$65.49
$573.41
$419.04
$546.10
$399.09
$67.08
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$255.81
$316.60
$204.33
$301.52
$194.60
$419.32
$283.48
$399.35
$269.98
$428.87
$302.85
$408.44
$288.42
$364.87
$241.66
$347.50
$230.15
$486.40
$345.51
$463.24
$329.05
$591.38
$441.50
$563.21
$420.47
$70.73
$67.36
$470.97
$316.88
$448.54
$301.79
$635.16
$484.16
$604.91
$461.10
$77.47
$73.78
$840.61
$572.01
$800.58
$544.77
$91.50
$87.14
$603.44
$430.55
$574.71
$410.05
$68.76
$65.49
$573.41
$419.04
$546.10
$399.09
$67.08
9.60
11.42
7.34
11.42
7.34
14.86
9.99
14.86
9.99
15.45
10.85
15.45
10.85
12.99
8.57
12.99
8.57
17.42
12.33
17.42
12.33
21.19
15.77
21.19
15.77
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
17.11
11.44
17.11
11.44
22.81
17.33
22.81
17.33
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
30.14
20.40
30.14
20.40
$28.0672
$28.0672
$26.7305
$26.7305
22.08
15.52
22.08
15.52
$28.0672
$28.0672
$26.7305
$26.7305
20.60
15.01
20.60
15.01
$28.0672
$28.0672
$26.7305
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$256.61
$320.53
$206.01
$305.26
$196.20
$417.08
$280.39
$397.22
$267.04
$433.64
$304.53
$412.99
$290.03
$364.59
$240.54
$347.23
$229.08
$488.93
$346.07
$465.65
$329.59
$594.74
$442.62
$566.42
$421.54
$70.82
$67.45
$480.23
$321.09
$457.36
$305.80
$640.21
$486.40
$609.72
$463.24
$77.82
$74.12
$845.95
$572.57
$805.66
$545.30
$91.61
$87.25
$619.72
$435.60
$590.21
$414.86
$69.70
$66.38
$578.18
$421.29
$550.65
$401.22
$67.41
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$256.61
$320.53
$206.01
$305.26
$196.20
$417.08
$280.39
$397.22
$267.04
$433.64
$304.53
$412.99
$290.03
$364.59
$240.54
$347.23
$229.08
$488.93
$346.07
$465.65
$329.59
$594.74
$442.62
$566.42
$421.54
$70.82
$67.45
$480.23
$321.09
$457.36
$305.80
$640.21
$486.40
$609.72
$463.24
$77.82
$74.12
$845.95
$572.57
$805.66
$545.30
$91.61
$87.25
$619.72
$435.60
$590.21
$414.86
$69.70
$66.38
$578.18
$421.29
$550.65
$401.22
$67.41
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
2
2
2
2
8
8
2
2
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
2
2
2
2
2
2
8
8
2
28296
28297
28297
28297
28297
28297
28297
28298
28298
28298
28298
28298
28298
28299
28299
28299
28299
28299
28299
28300
28300
28300
28300
28302
28302
28302
28302
28304
28304
28304
28304
28304
28304
28305
28305
28305
28305
28306
28306
28306
28306
28306
28306
28307
28307
28307
28307
28308
28308
28308
28308
28308
28308
28309
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
N
F
N
F
F
F
N
F
N
F
F
F
N
F
N
F
F
F
N/F
N/F
F
F
N/F
N/F
F
F
N
F
N
F
F
F
N/F
N/F
F
F
N
F
N
F
F
F
N
F
N
F
N
F
N
F
F
F
N/F
2.39
23.36
16.78
23.36
16.78
2.68
2.68
20.69
14.50
20.69
14.50
2.32
2.32
25.59
19.36
25.59
19.36
3.10
3.10
18.79
18.79
3.01
3.01
20.37
20.37
3.26
3.26
23.27
17.12
23.27
17.12
2.74
2.74
18.29
18.29
2.93
2.93
17.63
11.62
17.63
11.62
1.86
1.86
20.02
13.33
20.02
13.33
16.11
10.75
16.11
10.75
1.72
1.72
25.68
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$63.89
$655.65
$470.97
$624.42
$448.54
$75.22
$71.64
$580.71
$406.97
$553.05
$387.59
$65.12
$62.01
$718.24
$543.38
$684.03
$517.50
$87.01
$82.86
$527.38
$502.27
$84.48
$80.46
$571.73
$544.50
$91.50
$87.14
$653.12
$480.51
$622.02
$457.63
$76.90
$73.24
$513.35
$488.90
$82.24
$78.32
$494.82
$326.14
$471.26
$310.61
$52.20
$49.72
$561.91
$374.14
$535.14
$356.32
$452.16
$301.72
$430.63
$287.35
$48.28
$45.98
$720.77
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$63.89
$655.65
$470.97
$624.42
$448.54
$75.22
$71.64
$580.71
$406.97
$553.05
$387.59
$65.12
$62.01
$718.24
$543.38
$684.03
$517.50
$87.01
$82.86
$527.38
$502.27
$84.48
$80.46
$571.73
$544.50
$91.50
$87.14
$653.12
$480.51
$622.02
$457.63
$76.90
$73.24
$513.35
$488.90
$82.24
$78.32
$494.82
$326.14
$471.26
$310.61
$52.20
$49.72
$561.91
$374.14
$535.14
$356.32
$452.16
$301.72
$430.63
$287.35
$48.28
$45.98
$720.77
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
23.43
16.75
23.43
16.75
$28.0672
$28.0672
$26.7305
$26.7305
20.79
14.53
20.79
14.53
$28.0672
$28.0672
$26.7305
$26.7305
25.94
19.54
25.94
19.54
$28.0672
$28.0672
$26.7305
$26.7305
18.83
18.83
$28.0672
$26.7305
20.64
20.64
$28.0672
$26.7305
23.96
17.54
23.96
17.54
$28.0672
$28.0672
$26.7305
$26.7305
18.78
18.78
$28.0672
$26.7305
17.75
11.63
17.75
11.63
$28.0672
$28.0672
$26.7305
$26.7305
20.53
13.60
20.53
13.60
16.32
10.82
16.32
10.82
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
26.28
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$64.20
$657.61
$470.13
$626.30
$447.74
$75.22
$71.64
$583.52
$407.82
$555.73
$388.39
$65.25
$62.14
$728.06
$548.43
$693.39
$522.31
$87.75
$83.57
$528.51
$503.34
$84.56
$80.53
$579.31
$551.72
$92.69
$88.28
$672.49
$492.30
$640.46
$468.85
$78.77
$75.02
$527.10
$502.00
$84.34
$80.32
$498.19
$326.42
$474.47
$310.88
$52.23
$49.74
$576.22
$381.71
$548.78
$363.53
$458.06
$303.69
$436.24
$289.22
$48.59
$46.28
$737.61
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$64.20
$657.61
$470.13
$626.30
$447.74
$75.22
$71.64
$583.52
$407.82
$555.73
$388.39
$65.25
$62.14
$728.06
$548.43
$693.39
$522.31
$87.75
$83.57
$528.51
$503.34
$84.56
$80.53
$579.31
$551.72
$92.69
$88.28
$672.49
$492.30
$640.46
$468.85
$78.77
$75.02
$527.10
$502.00
$84.34
$80.32
$498.19
$326.42
$474.47
$310.88
$52.23
$49.74
$576.22
$381.71
$548.78
$363.53
$458.06
$303.69
$436.24
$289.22
$48.59
$46.28
$737.61
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
28309
28310
28310
28310
28310
28312
28312
28312
28312
28313
28313
28313
28313
28315
28315
28315
28315
28320
28320
28320
28320
28322
28322
28322
28322
28322
28322
28340
28340
28340
28340
28341
28341
28341
28341
28344
28344
28344
28344
28345
28345
28345
28345
28360
28360
28360
28360
28400
28400
28400
28400
28405
28405
28405
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
N/F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N/F
N/F
F
F
N
F
N
F
F
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
F
F
F
F
N
F
N
F
N
F
N
25.68
15.52
10.18
15.52
10.18
14.65
9.18
14.65
9.18
15.25
10.35
15.25
10.35
13.75
9.29
13.75
9.29
17.75
17.75
2.84
2.84
22.73
16.66
22.73
16.66
2.67
2.67
16.61
11.87
16.61
11.87
19.29
14.15
19.29
14.15
12.42
8.22
12.42
8.22
14.98
10.46
14.98
10.46
25.48
25.48
4.08
4.08
7.09
6.49
7.09
6.49
11.07
10.07
11.07
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$686.44
$435.60
$285.72
$414.86
$272.12
$411.18
$257.66
$391.60
$245.39
$428.02
$290.50
$407.64
$276.66
$385.92
$260.74
$367.54
$248.33
$498.19
$474.47
$79.71
$75.91
$637.97
$467.60
$607.58
$445.33
$74.94
$71.37
$466.20
$333.16
$443.99
$317.29
$541.42
$397.15
$515.63
$378.24
$348.59
$230.71
$331.99
$219.72
$420.45
$293.58
$400.42
$279.60
$715.15
$681.09
$114.51
$109.06
$199.00
$182.16
$189.52
$173.48
$310.70
$282.64
$295.91
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$686.44
$435.60
$285.72
$414.86
$272.12
$411.18
$257.66
$391.60
$245.39
$428.02
$290.50
$407.64
$276.66
$385.92
$260.74
$367.54
$248.33
$498.19
$474.47
$79.71
$75.91
$637.97
$467.60
$607.58
$445.33
$74.94
$71.37
$466.20
$333.16
$443.99
$317.29
$541.42
$397.15
$515.63
$378.24
$348.59
$230.71
$331.99
$219.72
$420.45
$293.58
$400.42
$279.60
$715.15
$681.09
$114.51
$109.06
$199.00
$182.16
$189.52
$173.48
$310.70
$282.64
$295.91
26.28
15.84
10.31
15.84
10.31
14.98
9.32
14.98
9.32
15.31
10.33
15.31
10.33
13.96
9.38
13.96
9.38
17.50
17.50
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
22.82
16.67
22.82
16.67
$28.0672
$28.0672
$26.7305
$26.7305
16.72
11.88
16.72
11.88
19.39
14.16
19.39
14.16
16.01
10.39
16.01
10.39
15.10
10.49
15.10
10.49
23.56
23.56
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
7.12
6.51
7.12
6.51
11.41
10.36
11.41
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$702.48
$444.58
$289.37
$423.41
$275.59
$420.45
$261.59
$400.42
$249.13
$429.71
$289.93
$409.24
$276.13
$391.82
$263.27
$373.16
$250.73
$491.18
$467.78
$78.59
$74.84
$640.49
$467.88
$609.99
$445.60
$74.86
$71.30
$469.28
$333.44
$446.93
$317.56
$544.22
$397.43
$518.30
$378.50
$449.36
$291.62
$427.96
$277.73
$423.81
$294.42
$403.63
$280.40
$661.26
$629.77
$105.80
$100.76
$199.84
$182.72
$190.32
$174.02
$320.25
$290.78
$305.00
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$702.48
$444.58
$289.37
$423.41
$275.59
$420.45
$261.59
$400.42
$249.13
$429.71
$289.93
$409.24
$276.13
$391.82
$263.27
$373.16
$250.73
$491.18
$467.78
$78.59
$74.84
$640.49
$467.88
$609.99
$445.60
$74.86
$71.30
$469.28
$333.44
$446.93
$317.56
$544.22
$397.43
$518.30
$378.50
$449.36
$291.62
$427.96
$277.73
$423.81
$294.42
$403.63
$280.40
$661.26
$629.77
$105.80
$100.76
$199.84
$182.72
$190.32
$174.02
$320.25
$290.78
$305.00
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
28405
28406
28406
28415
28415
28415
28415
28420
28420
28420
28420
28430
28430
28430
28430
28435
28435
28435
28435
28436
28436
28445
28445
28445
28445
28446
28446
28446
28446
28450
28450
28450
28450
28455
28455
28455
28455
28456
28456
28465
28465
28470
28470
28470
28470
28475
28475
28475
28475
28476
28476
28485
28485
28490
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
N/F
N/F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
N/F
N/F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
N/F
N/F
F
F
N
F
N
F
N
F
N
F
N/F
N/F
F
F
N
10.07
15.10
15.10
31.78
31.78
5.08
5.08
35.80
35.80
5.73
5.73
6.70
5.96
6.70
5.96
9.29
8.32
9.29
8.32
12.77
12.77
30.39
30.39
4.86
4.86
34.98
34.98
5.60
5.60
6.16
5.49
6.16
5.49
8.51
7.65
8.51
7.65
9.04
9.04
17.91
17.91
6.28
5.87
6.28
5.87
7.29
6.48
7.29
6.48
9.96
9.96
15.02
15.02
4.13
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$269.18
$423.81
$403.63
$891.98
$849.50
$142.58
$135.79
$1,004.81
$956.95
$160.83
$153.17
$188.05
$167.28
$179.09
$159.31
$260.74
$233.52
$248.33
$222.40
$358.42
$341.35
$852.96
$812.34
$136.41
$129.91
$981.79
$935.03
$157.18
$149.69
$172.89
$154.09
$164.66
$146.75
$238.85
$214.71
$227.48
$204.49
$253.73
$241.64
$502.68
$478.74
$176.26
$164.75
$167.87
$156.91
$204.61
$181.88
$194.87
$173.21
$279.55
$266.24
$421.57
$401.49
$115.92
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$269.18
$423.81
$403.63
$891.98
$849.50
$142.58
$135.79
$1,004.81
$956.95
$160.83
$153.17
$188.05
$167.28
$179.09
$159.31
$260.74
$233.52
$248.33
$222.40
$358.42
$341.35
$852.96
$812.34
$136.41
$129.91
$981.79
$935.03
$157.18
$149.69
$172.89
$154.09
$164.66
$146.75
$238.85
$214.71
$227.48
$204.49
$253.73
$241.64
$502.68
$478.74
$176.26
$164.75
$167.87
$156.91
$204.61
$181.88
$194.87
$173.21
$279.55
$266.24
$421.57
$401.49
$115.92
10.36
15.16
15.16
31.91
31.91
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
36.25
36.25
$28.0672
$26.7305
6.79
6.03
6.79
6.03
9.28
8.32
9.28
8.32
12.93
12.93
30.81
30.81
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
35.40
35.40
$28.0672
$26.7305
6.18
5.51
6.18
5.51
8.27
7.43
8.27
7.43
9.18
9.18
17.77
17.77
6.28
5.86
6.28
5.86
7.35
6.53
7.35
6.53
10.09
10.09
15.15
15.15
4.18
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$276.93
$425.50
$405.23
$895.62
$852.97
$143.30
$136.48
$1,017.44
$968.98
$162.79
$155.04
$190.58
$169.25
$181.50
$161.18
$260.46
$233.52
$248.06
$222.40
$362.91
$345.63
$864.75
$823.57
$138.36
$131.77
$993.58
$946.26
$158.97
$151.40
$173.46
$154.65
$165.19
$147.29
$232.12
$208.54
$221.06
$198.61
$257.66
$245.39
$498.75
$475.00
$176.26
$164.47
$167.87
$156.64
$206.29
$183.28
$196.47
$174.55
$283.20
$269.71
$425.22
$404.97
$117.32
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$276.93
$425.50
$405.23
$895.62
$852.97
$143.30
$136.48
$1,017.44
$968.98
$162.79
$155.04
$190.58
$169.25
$181.50
$161.18
$260.46
$233.52
$248.06
$222.40
$362.91
$345.63
$864.75
$823.57
$138.36
$131.77
$993.58
$946.26
$158.97
$151.40
$173.46
$154.65
$165.19
$147.29
$232.12
$208.54
$221.06
$198.61
$257.66
$245.39
$498.75
$475.00
$176.26
$164.47
$167.87
$156.64
$206.29
$183.28
$196.47
$174.55
$283.20
$269.71
$425.22
$404.97
$117.32
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
28490
28490
28490
28495
28495
28495
28495
28496
28496
28496
28496
28505
28505
28505
28505
28510
28510
28510
28510
28515
28515
28515
28515
28525
28525
28530
28530
28530
28530
28531
28531
28540
28540
28540
28540
28545
28545
28545
28545
28546
28546
28546
28546
28555
28555
28555
28555
28570
28570
28570
28570
28575
28575
28575
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
F
F
N
F
N
F
F
F
N
F
N
F
N
F
N
F
N
F
N
F
F
F
F
F
N
F
N
F
N
F
N
3.55
4.13
3.55
5.04
4.25
5.04
4.25
12.45
6.64
12.45
6.64
18.96
14.22
18.96
14.22
3.51
3.41
3.51
3.41
4.57
4.04
4.57
4.04
11.49
11.49
3.26
2.90
3.26
2.90
5.51
5.51
5.82
5.25
5.82
5.25
8.37
7.43
8.37
7.43
16.39
9.63
16.39
9.63
18.92
18.92
3.03
3.03
6.15
5.19
6.15
5.19
10.33
9.35
10.33
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$99.64
$110.40
$94.89
$141.46
$119.29
$134.72
$113.60
$349.44
$186.37
$332.79
$177.49
$532.15
$399.12
$506.81
$380.11
$98.52
$95.71
$93.82
$91.15
$128.27
$113.39
$122.16
$107.99
$322.49
$307.13
$91.50
$81.39
$87.14
$77.52
$154.65
$147.29
$163.35
$147.35
$155.57
$140.34
$234.92
$208.54
$223.73
$198.61
$460.02
$270.29
$438.11
$257.41
$531.03
$505.74
$85.04
$80.99
$172.61
$145.67
$164.39
$138.73
$289.93
$262.43
$276.13
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$99.64
$110.40
$94.89
$141.46
$119.29
$134.72
$113.60
$349.44
$186.37
$332.79
$177.49
$532.15
$399.12
$506.81
$380.11
$98.52
$95.71
$93.82
$91.15
$128.27
$113.39
$122.16
$107.99
$322.49
$307.13
$91.50
$81.39
$87.14
$77.52
$154.65
$147.29
$163.35
$147.35
$155.57
$140.34
$234.92
$208.54
$223.73
$198.61
$460.02
$270.29
$438.11
$257.41
$531.03
$505.74
$85.04
$80.99
$172.61
$145.67
$164.39
$138.73
$289.93
$262.43
$276.13
3.60
4.18
3.60
5.16
4.35
5.16
4.35
12.78
6.85
12.78
6.85
19.50
14.55
19.50
14.55
3.56
3.47
3.56
3.47
4.67
4.12
4.67
4.12
11.31
11.31
3.31
2.94
3.31
2.94
5.24
5.24
5.52
4.99
5.52
4.99
8.50
7.52
8.50
7.52
16.67
9.77
16.67
9.77
19.32
19.32
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
4.91
4.24
4.91
4.24
10.42
9.42
10.42
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$101.04
$111.73
$96.23
$144.83
$122.09
$137.93
$116.28
$358.70
$192.26
$341.62
$183.10
$547.31
$408.38
$521.24
$388.93
$99.92
$97.39
$95.16
$92.75
$131.07
$115.64
$124.83
$110.13
$317.44
$302.32
$92.90
$82.52
$88.48
$78.59
$147.07
$140.07
$154.93
$140.06
$147.55
$133.39
$238.57
$211.07
$227.21
$201.01
$467.88
$274.22
$445.60
$261.16
$542.26
$516.43
$86.76
$82.63
$137.81
$119.00
$131.25
$113.34
$292.46
$264.39
$278.53
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$101.04
$111.73
$96.23
$144.83
$122.09
$137.93
$116.28
$358.70
$192.26
$341.62
$183.10
$547.31
$408.38
$521.24
$388.93
$99.92
$97.39
$95.16
$92.75
$131.07
$115.64
$124.83
$110.13
$317.44
$302.32
$92.90
$82.52
$88.48
$78.59
$147.07
$140.07
$154.93
$140.06
$147.55
$133.39
$238.57
$211.07
$227.21
$201.01
$467.88
$274.22
$445.60
$261.16
$542.26
$516.43
$86.76
$82.63
$137.81
$119.00
$131.25
$113.34
$292.46
$264.39
$278.53
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
28575
28576
28576
28585
28585
28585
28585
28600
28600
28600
28600
28605
28605
28605
28605
28606
28606
28615
28615
28615
28615
28630
28630
28630
28630
28635
28635
28635
28635
28636
28636
28636
28636
28645
28645
28645
28645
28660
28660
28660
28660
28665
28665
28665
28665
28666
28666
28675
28675
28675
28675
28705
28705
28705
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
N/F
N/F
F
F
F
F
N
F
N
F
N
F
N
F
N/F
N/F
F
F
F
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N/F
N/F
N
F
N
F
F
F
F
9.35
11.24
11.24
19.58
19.58
3.13
3.13
6.26
5.39
6.26
5.39
9.26
8.35
9.26
8.35
11.40
11.40
22.60
22.60
3.62
3.62
4.48
3.14
4.48
3.14
5.00
3.79
5.00
3.79
7.41
4.97
7.41
4.97
18.78
13.87
18.78
13.87
3.31
2.55
3.31
2.55
4.39
3.76
4.39
3.76
5.43
5.43
16.23
11.51
16.23
11.51
36.44
36.44
5.83
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$249.93
$315.48
$300.45
$549.56
$523.38
$87.85
$83.67
$175.70
$151.28
$167.33
$144.08
$259.90
$234.36
$247.52
$223.20
$319.97
$304.73
$634.32
$604.11
$101.60
$96.76
$125.74
$88.13
$119.75
$83.93
$140.34
$106.37
$133.65
$101.31
$207.98
$139.49
$198.07
$132.85
$527.10
$389.29
$502.00
$370.75
$92.90
$71.57
$88.48
$68.16
$123.22
$105.53
$117.35
$100.51
$152.40
$145.15
$455.53
$323.05
$433.84
$307.67
$1,022.77
$974.06
$163.63
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$249.93
$315.48
$300.45
$549.56
$523.38
$87.85
$83.67
$175.70
$151.28
$167.33
$144.08
$259.90
$234.36
$247.52
$223.20
$319.97
$304.73
$634.32
$604.11
$101.60
$96.76
$125.74
$88.13
$119.75
$83.93
$140.34
$106.37
$133.65
$101.31
$207.98
$139.49
$198.07
$132.85
$527.10
$389.29
$502.00
$370.75
$92.90
$71.57
$88.48
$68.16
$123.22
$105.53
$117.35
$100.51
$152.40
$145.15
$455.53
$323.05
$433.84
$307.67
$1,022.77
$974.06
$163.63
9.42
11.40
11.40
19.27
19.27
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
6.22
5.37
6.22
5.37
9.41
8.46
9.41
8.46
11.33
11.33
22.71
22.71
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
4.49
3.14
4.49
3.14
4.93
3.72
4.93
3.72
10.10
6.47
10.10
6.47
18.91
13.93
18.91
13.93
3.35
2.55
3.35
2.55
4.45
3.79
4.45
3.79
5.53
5.53
17.07
11.98
17.07
11.98
36.28
36.28
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$251.80
$319.97
$304.73
$540.85
$515.10
$86.54
$82.42
$174.58
$150.72
$166.26
$143.54
$264.11
$237.45
$251.53
$226.14
$318.00
$302.86
$637.41
$607.05
$101.99
$97.13
$126.02
$88.13
$120.02
$83.93
$138.37
$104.41
$131.78
$99.44
$283.48
$181.59
$269.98
$172.95
$530.75
$390.98
$505.47
$372.36
$94.03
$71.57
$89.55
$68.16
$124.90
$106.37
$118.95
$101.31
$155.21
$147.82
$479.11
$336.25
$456.29
$320.23
$1,018.28
$969.78
$162.92
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$251.80
$319.97
$304.73
$540.85
$515.10
$86.54
$82.42
$174.58
$150.72
$166.26
$143.54
$264.11
$237.45
$251.53
$226.14
$318.00
$302.86
$637.41
$607.05
$101.99
$97.13
$126.02
$88.13
$120.02
$83.93
$138.37
$104.41
$131.78
$99.44
$283.48
$181.59
$269.98
$172.95
$530.75
$390.98
$505.47
$372.36
$94.03
$71.57
$89.55
$68.16
$124.90
$106.37
$118.95
$101.31
$155.21
$147.82
$479.11
$336.25
$456.29
$320.23
$1,018.28
$969.78
$162.92
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
28705
28715
28715
28715
28715
28725
28725
28725
28725
28730
28730
28730
28730
28735
28735
28735
28735
28737
28737
28737
28737
28740
28740
28740
28740
28750
28750
28750
28750
28755
28755
28755
28755
28760
28760
28760
28760
28760
28760
28800
28800
28800
28800
28805
28805
28810
28810
28820
28820
28820
28820
28825
28825
28825
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
N
F
N
F
F
F
F
F
F
F
F
F
N/F
N/F
N
F
N
F
N
F
N
5.83
26.82
26.82
4.29
4.29
22.15
22.15
3.54
3.54
21.08
21.08
3.37
3.37
22.45
22.45
3.59
3.59
19.80
19.80
3.17
3.17
18.01
18.01
2.88
2.88
23.41
17.05
23.41
17.05
14.59
9.48
14.59
9.48
22.43
16.45
22.43
16.45
2.63
2.63
15.69
15.69
2.51
2.51
21.45
21.45
12.55
12.55
16.33
11.47
16.33
11.47
15.57
10.74
15.57
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$155.84
$752.76
$716.91
$120.41
$114.67
$621.69
$592.08
$99.36
$94.63
$591.66
$563.48
$94.59
$90.08
$630.11
$600.10
$100.76
$95.96
$555.73
$529.26
$88.97
$84.74
$505.49
$481.42
$80.83
$76.98
$657.05
$478.55
$625.76
$455.76
$409.50
$266.08
$390.00
$253.41
$629.55
$461.71
$599.57
$439.72
$73.82
$70.30
$440.37
$419.40
$70.45
$67.09
$602.04
$573.37
$352.24
$335.47
$458.34
$321.93
$436.51
$306.60
$437.01
$301.44
$416.19
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$155.84
$752.76
$716.91
$120.41
$114.67
$621.69
$592.08
$99.36
$94.63
$591.66
$563.48
$94.59
$90.08
$630.11
$600.10
$100.76
$95.96
$555.73
$529.26
$88.97
$84.74
$505.49
$481.42
$80.83
$76.98
$657.05
$478.55
$625.76
$455.76
$409.50
$266.08
$390.00
$253.41
$629.55
$461.71
$599.57
$439.72
$73.82
$70.30
$440.37
$419.40
$70.45
$67.09
$602.04
$573.37
$352.24
$335.47
$458.34
$321.93
$436.51
$306.60
$437.01
$301.44
$416.19
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
27.08
27.08
$28.0672
$26.7305
22.42
22.42
$28.0672
$26.7305
21.07
21.07
$28.0672
$26.7305
22.53
22.53
$28.0672
$26.7305
19.95
19.95
$28.0672
$26.7305
17.96
17.96
$28.0672
$26.7305
23.57
17.08
23.57
17.08
14.68
9.49
14.68
9.49
22.86
16.67
22.86
16.67
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
15.73
15.73
$28.0672
$26.7305
21.19
21.19
12.49
12.49
16.37
11.44
16.37
11.44
15.63
10.72
15.63
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$155.16
$760.06
$723.86
$121.61
$115.82
$629.27
$599.30
$100.68
$95.89
$591.38
$563.21
$94.62
$90.11
$632.35
$602.24
$101.18
$96.36
$559.94
$533.27
$89.59
$85.32
$504.09
$480.08
$80.65
$76.81
$661.54
$479.39
$630.04
$456.56
$412.03
$266.36
$392.40
$253.67
$641.62
$467.88
$611.06
$445.60
$74.86
$71.30
$441.50
$420.47
$70.64
$67.28
$594.74
$566.42
$350.56
$333.86
$459.46
$321.09
$437.58
$305.80
$438.69
$300.88
$417.80
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$155.16
$760.06
$723.86
$121.61
$115.82
$629.27
$599.30
$100.68
$95.89
$591.38
$563.21
$94.62
$90.11
$632.35
$602.24
$101.18
$96.36
$559.94
$533.27
$89.59
$85.32
$504.09
$480.08
$80.65
$76.81
$661.54
$479.39
$630.04
$456.56
$412.03
$266.36
$392.40
$253.67
$641.62
$467.88
$611.06
$445.60
$74.86
$71.30
$441.50
$420.47
$70.64
$67.28
$594.74
$566.42
$350.56
$333.86
$459.46
$321.09
$437.58
$305.80
$438.69
$300.88
$417.80
Musculoskeletal System Surgery
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
TOS*
Procedure
Code
Age
Range
2
28825
21-999
F
10.74
$26.7305
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
28899
29000
29000
29000
29000
29010
29010
29010
29010
29015
29015
29015
29015
29035
29035
29035
29035
29040
29040
29040
29040
29044
29044
29044
29044
29046
29046
29046
29046
29049
29049
29049
29049
29055
29055
29055
29055
29058
29058
29065
29065
29065
29065
29075
29075
29075
29075
29085
29085
29085
29085
29086
0-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
N
F
N
F
N
$287.09
Manually
Priced
4.78
4.78
0.76
0.76
4.30
4.30
0.69
0.69
5.00
5.00
0.80
0.80
3.88
3.88
0.62
0.62
5.33
5.33
0.85
0.85
4.57
4.57
0.73
0.73
4.99
4.99
0.80
0.80
2.80
2.00
2.80
2.00
3.94
3.94
0.63
0.63
2.68
2.68
2.73
1.95
2.73
1.95
2.46
1.78
2.46
1.78
2.69
1.92
2.69
1.92
2.23
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$134.16
$127.77
$21.33
$20.32
$120.69
$114.94
$19.37
$18.44
$140.34
$133.65
$22.45
$21.38
$108.90
$103.71
$17.40
$16.57
$149.60
$142.47
$23.86
$22.72
$128.27
$122.16
$20.49
$19.51
$140.06
$133.39
$22.45
$21.38
$78.59
$56.13
$74.85
$53.46
$110.58
$105.32
$17.68
$16.84
$75.22
$71.64
$76.62
$54.73
$72.97
$52.12
$69.05
$49.96
$65.76
$47.58
$75.50
$53.89
$71.91
$51.32
$62.59
Current
Percent
Reduction
0%
2%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
$287.09
Manually
Priced
$134.16
$127.77
$21.33
$20.32
$120.69
$114.94
$19.37
$18.44
$140.34
$133.65
$22.45
$21.38
$108.90
$103.71
$17.40
$16.57
$149.60
$142.47
$23.86
$22.72
$128.27
$122.16
$20.49
$19.51
$140.06
$133.39
$22.45
$21.38
$78.59
$56.13
$74.85
$53.46
$110.58
$105.32
$17.68
$16.84
$75.22
$71.64
$76.62
$54.73
$72.97
$52.12
$69.05
$49.96
$65.76
$47.58
$75.50
$53.89
$71.91
$51.32
$62.59
10.72
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
$26.7305
$286.55
Manually
Priced
0%
5.40
5.40
$28.0672
$26.7305
4.06
4.06
$28.0672
$26.7305
5.07
5.07
$28.0672
$26.7305
3.84
3.84
$28.0672
$26.7305
4.05
4.05
$28.0672
$26.7305
4.50
4.50
$28.0672
$26.7305
4.40
4.40
$28.0672
$26.7305
2.10
1.64
2.10
1.64
4.01
4.01
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
2.75
2.75
2.76
1.97
2.76
1.97
2.49
1.80
2.49
1.80
2.74
1.95
2.74
1.95
2.21
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$151.56
$144.34
$24.25
$23.09
$113.95
$108.53
$18.23
$17.36
$142.30
$135.52
$22.77
$21.68
$107.78
$102.65
$17.24
$16.42
$113.67
$108.26
$18.19
$17.32
$126.30
$120.29
$20.21
$19.25
$123.50
$117.61
$19.76
$18.82
$58.94
$46.03
$56.13
$43.84
$112.55
$107.19
$18.01
$17.15
$77.18
$73.51
$77.47
$55.29
$73.78
$52.66
$69.89
$50.52
$66.56
$48.11
$76.90
$54.73
$73.24
$52.12
$62.03
2%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$286.55
Manually
Priced
$151.56
$144.34
$24.25
$23.09
$113.95
$108.53
$18.23
$17.36
$142.30
$135.52
$22.77
$21.68
$107.78
$102.65
$17.24
$16.42
$113.67
$108.26
$18.19
$17.32
$126.30
$120.29
$20.21
$19.25
$123.50
$117.61
$19.76
$18.82
$58.94
$46.03
$56.13
$43.84
$112.55
$107.19
$18.01
$17.15
$77.18
$73.51
$77.47
$55.29
$73.78
$52.66
$69.89
$50.52
$66.56
$48.11
$76.90
$54.73
$73.24
$52.12
$62.03
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
29086
29086
29086
29105
29105
29105
29105
29125
29125
29125
29125
29126
29126
29126
29126
29130
29130
29130
29130
29131
29131
29131
29131
29200
29200
29200
29200
29240
29240
29240
29240
29260
29260
29260
29260
29280
29280
29280
29280
29305
29305
29305
29305
29325
29325
29325
29325
29345
29345
29345
29345
29355
29355
29355
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
1.46
2.23
1.46
2.49
1.70
2.49
1.70
1.83
1.13
1.83
1.13
2.17
1.39
2.17
1.39
1.17
0.82
1.17
0.82
1.46
0.95
1.46
0.95
1.49
1.13
1.49
1.13
1.61
1.24
1.61
1.24
1.44
1.05
1.44
1.05
1.42
1.02
1.42
1.02
4.53
4.53
0.72
0.72
5.09
5.09
0.81
0.81
3.88
2.90
3.88
2.90
4.04
3.08
4.04
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$40.98
$59.61
$39.03
$69.89
$47.71
$66.56
$45.44
$51.36
$31.72
$48.92
$30.21
$60.91
$39.01
$58.01
$37.16
$32.84
$23.02
$31.27
$21.92
$40.98
$26.66
$39.03
$25.39
$41.82
$31.72
$39.83
$30.21
$45.19
$34.80
$43.04
$33.15
$40.42
$29.47
$38.49
$28.07
$39.86
$28.63
$37.96
$27.27
$127.14
$121.09
$20.21
$19.25
$142.86
$136.06
$22.73
$21.65
$108.90
$81.39
$103.71
$77.52
$113.39
$86.45
$107.99
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$40.98
$59.61
$39.03
$69.89
$47.71
$66.56
$45.44
$51.36
$31.72
$48.92
$30.21
$60.91
$39.01
$58.01
$37.16
$32.84
$23.02
$31.27
$21.92
$40.98
$26.66
$39.03
$25.39
$41.82
$31.72
$39.83
$30.21
$45.19
$34.80
$43.04
$33.15
$40.42
$29.47
$38.49
$28.07
$39.86
$28.63
$37.96
$27.27
$127.14
$121.09
$20.21
$19.25
$142.86
$136.06
$22.73
$21.65
$108.90
$81.39
$103.71
$77.52
$113.39
$86.45
$107.99
1.44
2.21
1.44
2.53
1.72
2.53
1.72
1.83
1.12
1.83
1.12
2.21
1.40
2.21
1.40
1.16
0.81
1.16
0.81
1.46
0.95
1.46
0.95
0.85
0.52
0.85
0.52
0.82
0.53
0.82
0.53
0.82
0.55
0.82
0.55
0.83
0.56
0.83
0.56
4.62
4.62
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
5.18
5.18
$28.0672
$26.7305
3.92
2.92
3.92
2.92
4.04
3.07
4.04
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$40.42
$59.07
$38.49
$71.01
$48.28
$67.63
$45.98
$51.36
$31.44
$48.92
$29.94
$62.03
$39.29
$59.07
$37.42
$32.56
$22.73
$31.01
$21.65
$40.98
$26.66
$39.03
$25.39
$23.86
$14.59
$22.72
$13.90
$23.02
$14.88
$21.92
$14.17
$23.02
$15.44
$21.92
$14.70
$23.30
$15.72
$22.19
$14.97
$129.67
$123.49
$20.75
$19.76
$145.39
$138.46
$23.26
$22.15
$110.02
$81.96
$104.78
$78.05
$113.39
$86.17
$107.99
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$40.42
$59.07
$38.49
$71.01
$48.28
$67.63
$45.98
$51.36
$31.44
$48.92
$29.94
$62.03
$39.29
$59.07
$37.42
$32.56
$22.73
$31.01
$21.65
$40.98
$26.66
$39.03
$25.39
$23.86
$14.59
$22.72
$13.90
$23.02
$14.88
$21.92
$14.17
$23.02
$15.44
$21.92
$14.70
$23.30
$15.72
$22.19
$14.97
$129.67
$123.49
$20.75
$19.76
$145.39
$138.46
$23.26
$22.15
$110.02
$81.96
$104.78
$78.05
$113.39
$86.17
$107.99
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
29355
29358
29358
29358
29358
29365
29365
29365
29365
29405
29405
29405
29405
29425
29425
29425
29425
29435
29435
29435
29435
29440
29440
29440
29440
29445
29445
29445
29445
29450
29450
29505
29505
29505
29505
29515
29515
29515
29515
29520
29520
29520
29520
29530
29530
29530
29530
29540
29540
29540
29540
29550
29550
29550
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
3.08
4.56
2.98
4.56
2.98
3.50
2.52
3.50
2.52
2.32
1.71
2.32
1.71
2.23
1.62
2.23
1.62
3.28
2.37
3.28
2.37
1.28
0.87
1.28
0.87
3.87
3.02
3.87
3.02
4.05
3.21
2.36
1.43
2.36
1.43
2.04
1.43
2.04
1.43
1.35
0.99
1.35
0.99
1.43
1.05
1.43
1.05
1.05
0.74
1.05
0.74
0.88
0.55
0.88
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$82.33
$127.99
$83.64
$121.89
$79.66
$98.24
$70.73
$93.56
$67.36
$65.12
$47.99
$62.01
$45.71
$62.59
$45.47
$59.61
$43.30
$92.06
$66.52
$87.68
$63.35
$35.93
$24.42
$34.22
$23.26
$108.62
$84.76
$103.45
$80.73
$113.67
$90.10
$66.24
$40.14
$63.08
$38.22
$57.26
$40.14
$54.53
$38.22
$37.89
$27.79
$36.09
$26.46
$40.14
$29.47
$38.22
$28.07
$29.47
$20.77
$28.07
$19.78
$24.70
$15.44
$23.52
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$82.33
$127.99
$83.64
$121.89
$79.66
$98.24
$70.73
$93.56
$67.36
$65.12
$47.99
$62.01
$45.71
$62.59
$45.47
$59.61
$43.30
$92.06
$66.52
$87.68
$63.35
$35.93
$24.42
$34.22
$23.26
$108.62
$84.76
$103.45
$80.73
$113.67
$90.10
$66.24
$40.14
$63.08
$38.22
$57.26
$40.14
$54.53
$38.22
$37.89
$27.79
$36.09
$26.46
$40.14
$29.47
$38.22
$28.07
$29.47
$20.77
$28.07
$19.78
$24.70
$15.44
$23.52
3.07
4.62
3.01
4.62
3.01
3.52
2.52
3.52
2.52
2.34
1.73
2.34
1.73
2.24
1.63
2.24
1.63
3.39
2.41
3.39
2.41
1.25
0.83
1.25
0.83
3.89
3.02
3.89
3.02
4.12
3.24
2.38
1.43
2.38
1.43
2.05
1.42
2.05
1.42
0.88
0.53
0.88
0.53
0.80
0.52
0.80
0.52
0.73
0.51
0.73
0.51
0.54
0.33
0.54
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$82.06
$129.67
$84.48
$123.49
$80.46
$98.80
$70.73
$94.09
$67.36
$65.68
$48.56
$62.55
$46.24
$62.87
$45.75
$59.88
$43.57
$95.15
$67.64
$90.62
$64.42
$35.08
$23.30
$33.41
$22.19
$109.18
$84.76
$103.98
$80.73
$115.64
$90.94
$66.80
$40.14
$63.62
$38.22
$57.54
$39.86
$54.80
$37.96
$24.70
$14.88
$23.52
$14.17
$22.45
$14.59
$21.38
$13.90
$20.49
$14.31
$19.51
$13.63
$15.16
$9.26
$14.43
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$82.06
$129.67
$84.48
$123.49
$80.46
$98.80
$70.73
$94.09
$67.36
$65.68
$48.56
$62.55
$46.24
$62.87
$45.75
$59.88
$43.57
$95.15
$67.64
$90.62
$64.42
$35.08
$23.30
$33.41
$22.19
$109.18
$84.76
$103.98
$80.73
$115.64
$90.94
$66.80
$40.14
$63.62
$38.22
$57.54
$39.86
$54.80
$37.96
$24.70
$14.88
$23.52
$14.17
$22.45
$14.59
$21.38
$13.90
$20.49
$14.31
$19.51
$13.63
$15.16
$9.26
$14.43
Musculoskeletal System Surgery
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
TOS*
Procedure
Code
Age
Range
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
29550
29580
29580
29580
29580
29581
29581
29581
29581
29582
29582
29582
29582
29583
29583
29583
29583
29584
29584
29584
29584
29700
29700
29700
29700
29705
29705
29705
29705
29710
29710
29710
29710
29720
29720
29720
29720
29730
29730
29730
29730
29740
29740
29740
29740
29750
29750
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
0.55
1.49
1.02
1.49
1.02
1.74
0.36
1.74
0.36
1.98
0.45
1.98
0.45
1.23
0.32
1.23
0.32
1.98
0.45
1.98
0.45
1.76
0.97
1.76
0.97
1.89
1.34
1.89
1.34
3.30
2.33
3.30
2.33
2.39
1.25
2.39
1.25
1.84
1.29
1.84
1.29
2.78
1.97
2.78
1.97
2.45
1.90
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
2
2
2
2
2
8
29799
29800
29800
29804
29804
29804
0-999
0-20
21-999
0-20
21-999
0-20
N/F
N/F
N/F
N/F
N/F
F
14.86
14.86
18.73
18.73
3.00
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$14.70
$41.82
$28.63
$39.83
$27.27
$48.84
$10.10
$46.51
$9.62
$55.57
$12.63
$52.93
$12.03
$34.52
$8.98
$32.88
$8.55
$55.57
$12.63
$52.93
$12.03
$49.40
$27.23
$47.05
$25.93
$53.05
$37.61
$50.52
$35.82
$92.62
$65.40
$88.21
$62.28
$67.08
$35.08
$63.89
$33.41
$51.64
$36.21
$49.18
$34.48
$78.03
$55.29
$74.31
$52.66
$68.76
$53.33
Manually
Priced
$417.08
$397.22
$525.70
$500.66
$84.20
Current
Percent
Reduction
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
0%
0%
0%
0%
0%
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
$14.70
$41.82
$28.63
$39.83
$27.27
$48.84
$10.10
$46.51
$9.62
$55.57
$12.63
$52.93
$12.03
$34.52
$8.98
$32.88
$8.55
$55.57
$12.63
$52.93
$12.03
$49.40
$27.23
$47.05
$25.93
$53.05
$37.61
$50.52
$35.82
$92.62
$65.40
$88.21
$62.28
$67.08
$35.08
$63.89
$33.41
$51.64
$36.21
$49.18
$34.48
$78.03
$55.29
$74.31
$52.66
$68.76
$53.33
Manually
Priced
$417.08
$397.22
$525.70
$500.66
$84.20
0.33
1.49
1.01
1.49
1.01
1.77
0.38
1.77
0.38
2.01
0.47
2.01
0.47
1.26
0.34
1.26
0.34
2.01
0.47
2.01
0.47
1.75
0.96
1.75
0.96
1.93
1.37
1.93
1.37
3.57
2.44
3.57
2.44
2.45
1.29
2.45
1.29
1.83
1.28
1.83
1.28
2.86
2.04
2.86
2.04
2.74
2.11
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
14.92
14.92
18.49
18.49
$28.0672
$26.7305
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
$8.82
$41.82
$28.35
$39.83
$27.00
$49.68
$10.67
$47.31
$10.16
$56.42
$13.19
$53.73
$12.56
$35.36
$9.54
$33.68
$9.09
$56.42
$13.19
$53.73
$12.56
$49.12
$26.94
$46.78
$25.66
$54.17
$38.45
$51.59
$36.62
$100.20
$68.48
$95.43
$65.22
$68.76
$36.21
$65.49
$34.48
$51.36
$35.93
$48.92
$34.22
$80.27
$57.26
$76.45
$54.53
$76.90
$59.22
Manually
Priced
$418.76
$398.82
$518.96
$494.25
$83.03
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
0%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$8.82
$41.82
$28.35
$39.83
$27.00
$49.68
$10.67
$47.31
$10.16
$56.42
$13.19
$53.73
$12.56
$35.36
$9.54
$33.68
$9.09
$56.42
$13.19
$53.73
$12.56
$49.12
$26.94
$46.78
$25.66
$54.17
$38.45
$51.59
$36.62
$100.20
$68.48
$95.43
$65.22
$68.76
$36.21
$65.49
$34.48
$51.36
$35.93
$48.92
$34.22
$80.27
$57.26
$76.45
$54.53
$76.90
$59.22
Manually
Priced
$418.76
$398.82
$518.96
$494.25
$83.03
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
8
29804
29805
29805
29806
29806
29807
29807
29819
29819
29820
29820
29820
29820
29821
29821
29821
29821
29822
29822
29822
29822
29823
29823
29823
29823
29824
29824
29824
29824
29825
29825
29825
29825
29826
29826
29826
29826
29827
29827
29827
29827
29828
29828
29828
29828
29830
29830
29834
29834
29834
29834
29835
29835
29835
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
3.00
13.44
13.44
30.33
30.33
29.55
29.55
16.71
16.71
15.42
15.42
2.47
2.47
16.86
16.86
2.70
2.70
16.40
16.40
2.62
2.62
17.90
17.90
2.86
2.86
19.33
19.33
3.09
3.09
16.72
16.72
2.68
2.68
5.07
5.07
0.81
0.81
30.74
30.74
4.92
4.92
26.43
26.43
4.23
4.23
12.97
12.97
13.99
13.99
2.24
2.24
14.44
14.44
2.31
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$80.19
$377.22
$359.26
$851.28
$810.74
$829.39
$789.89
$469.00
$446.67
$432.80
$412.18
$69.33
$66.02
$473.21
$450.68
$75.78
$72.17
$460.30
$438.38
$73.54
$70.03
$502.40
$478.48
$80.27
$76.45
$542.54
$516.70
$86.73
$82.60
$469.28
$446.93
$75.22
$71.64
$142.30
$135.52
$22.73
$21.65
$862.79
$821.70
$138.09
$131.51
$741.82
$706.49
$118.72
$113.07
$364.03
$346.69
$392.66
$373.96
$62.87
$59.88
$405.29
$385.99
$64.84
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$80.19
$377.22
$359.26
$851.28
$810.74
$829.39
$789.89
$469.00
$446.67
$432.80
$412.18
$69.33
$66.02
$473.21
$450.68
$75.78
$72.17
$460.30
$438.38
$73.54
$70.03
$502.40
$478.48
$80.27
$76.45
$542.54
$516.70
$86.73
$82.60
$469.28
$446.93
$75.22
$71.64
$142.30
$135.52
$22.73
$21.65
$862.79
$821.70
$138.09
$131.51
$741.82
$706.49
$118.72
$113.07
$364.03
$346.69
$392.66
$373.96
$62.87
$59.88
$405.29
$385.99
$64.84
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
13.60
13.60
30.63
30.63
29.91
29.91
16.91
16.91
15.37
15.37
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
16.76
16.76
$28.0672
$26.7305
16.28
16.28
$28.0672
$26.7305
17.74
17.74
$28.0672
$26.7305
19.15
19.15
$28.0672
$26.7305
16.60
16.60
$28.0672
$26.7305
5.10
5.10
$28.0672
$26.7305
30.33
30.33
$28.0672
$26.7305
26.14
26.14
$28.0672
$26.7305
13.16
13.16
13.94
13.94
$28.0672
$26.7305
$28.0672
$26.7305
14.50
14.50
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$79.08
$381.71
$363.53
$859.70
$818.76
$839.49
$799.51
$474.62
$452.01
$431.39
$410.85
$69.02
$65.74
$470.41
$448.00
$75.27
$71.68
$456.93
$435.17
$73.11
$69.63
$497.91
$474.20
$79.67
$75.87
$537.49
$511.89
$86.00
$81.90
$465.92
$443.73
$74.55
$71.00
$143.14
$136.33
$22.90
$21.81
$851.28
$810.74
$136.20
$129.72
$733.68
$698.74
$117.39
$111.80
$369.36
$351.77
$391.26
$372.62
$62.60
$59.62
$406.97
$387.59
$65.12
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$79.08
$381.71
$363.53
$859.70
$818.76
$839.49
$799.51
$474.62
$452.01
$431.39
$410.85
$69.02
$65.74
$470.41
$448.00
$75.27
$71.68
$456.93
$435.17
$73.11
$69.63
$497.91
$474.20
$79.67
$75.87
$537.49
$511.89
$86.00
$81.90
$465.92
$443.73
$74.55
$71.00
$143.14
$136.33
$22.90
$21.81
$851.28
$810.74
$136.20
$129.72
$733.68
$698.74
$117.39
$111.80
$369.36
$351.77
$391.26
$372.62
$62.60
$59.62
$406.97
$387.59
$65.12
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
29835
29836
29836
29836
29836
29837
29837
29837
29837
29838
29838
29840
29840
29843
29843
29843
29843
29844
29844
29844
29844
29845
29845
29845
29845
29846
29846
29847
29847
29847
29847
29848
29848
29850
29850
29851
29851
29851
29851
29855
29855
29855
29855
29856
29856
29856
29856
29860
29860
29860
29860
29861
29861
29861
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
2.31
16.47
16.47
2.64
2.64
15.08
15.08
2.41
2.41
16.78
16.78
12.87
12.87
13.77
13.77
2.20
2.20
14.18
14.18
2.27
2.27
16.47
16.47
2.64
2.64
14.82
14.82
15.52
15.52
2.48
2.48
14.50
14.50
17.77
17.77
26.61
26.61
4.26
4.26
22.48
22.48
3.60
3.60
28.47
28.47
4.56
4.56
19.02
19.02
3.04
3.04
20.73
20.73
3.32
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$61.75
$462.27
$440.25
$74.10
$70.57
$423.25
$403.10
$67.64
$64.42
$470.97
$448.54
$361.22
$344.02
$386.49
$368.08
$61.75
$58.81
$397.99
$379.04
$63.71
$60.68
$462.27
$440.25
$74.10
$70.57
$415.96
$396.15
$435.60
$414.86
$69.61
$66.29
$406.97
$387.59
$498.75
$475.00
$746.87
$711.30
$119.57
$113.87
$630.95
$600.90
$101.04
$96.23
$799.07
$761.02
$127.99
$121.89
$533.84
$508.41
$85.32
$81.26
$581.83
$554.12
$93.18
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$61.75
$462.27
$440.25
$74.10
$70.57
$423.25
$403.10
$67.64
$64.42
$470.97
$448.54
$361.22
$344.02
$386.49
$368.08
$61.75
$58.81
$397.99
$379.04
$63.71
$60.68
$462.27
$440.25
$74.10
$70.57
$415.96
$396.15
$435.60
$414.86
$69.61
$66.29
$406.97
$387.59
$498.75
$475.00
$746.87
$711.30
$119.57
$113.87
$630.95
$600.90
$101.04
$96.23
$799.07
$761.02
$127.99
$121.89
$533.84
$508.41
$85.32
$81.26
$581.83
$554.12
$93.18
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
16.64
16.64
$28.0672
$26.7305
15.06
15.06
$28.0672
$26.7305
16.85
16.85
13.03
13.03
13.95
13.95
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
14.17
14.17
$28.0672
$26.7305
16.52
16.52
$28.0672
$26.7305
14.91
14.91
15.68
15.68
$28.0672
$26.7305
$28.0672
$26.7305
14.65
14.65
18.01
18.01
26.95
26.95
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
22.64
22.64
$28.0672
$26.7305
28.81
28.81
$28.0672
$26.7305
19.26
19.26
$28.0672
$26.7305
20.60
20.60
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$62.01
$467.04
$444.80
$74.73
$71.17
$422.69
$402.56
$67.63
$64.41
$472.93
$450.41
$365.72
$348.30
$391.54
$372.89
$62.65
$59.66
$397.71
$378.77
$63.63
$60.60
$463.67
$441.59
$74.19
$70.65
$418.48
$398.55
$440.09
$419.13
$70.41
$67.06
$411.18
$391.60
$505.49
$481.42
$756.41
$720.39
$121.03
$115.26
$635.44
$605.18
$101.67
$96.83
$808.62
$770.11
$129.38
$123.22
$540.57
$514.83
$86.49
$82.37
$578.18
$550.65
$92.51
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$62.01
$467.04
$444.80
$74.73
$71.17
$422.69
$402.56
$67.63
$64.41
$472.93
$450.41
$365.72
$348.30
$391.54
$372.89
$62.65
$59.66
$397.71
$378.77
$63.63
$60.60
$463.67
$441.59
$74.19
$70.65
$418.48
$398.55
$440.09
$419.13
$70.41
$67.06
$411.18
$391.60
$505.49
$481.42
$756.41
$720.39
$121.03
$115.26
$635.44
$605.18
$101.67
$96.83
$808.62
$770.11
$129.38
$123.22
$540.57
$514.83
$86.49
$82.37
$578.18
$550.65
$92.51
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
29861
29862
29862
29862
29862
29863
29863
29863
29863
29866
29866
29867
29867
29868
29868
29870
29870
29871
29871
29873
29873
29874
29874
29875
29875
29876
29876
29877
29877
29879
29879
29880
29880
29881
29881
29882
29882
29883
29883
29884
29884
29884
29884
29885
29885
29885
29885
29886
29886
29887
29887
29887
29887
29888
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
3.32
23.33
23.33
3.73
3.73
23.40
23.40
3.74
3.74
29.96
29.96
36.53
36.53
47.90
47.90
11.76
11.76
14.66
14.66
14.94
14.94
15.35
15.35
14.13
14.13
18.75
18.75
17.79
17.79
18.95
18.95
16.09
16.09
15.47
15.47
20.00
20.00
24.09
24.09
17.71
17.71
2.83
2.83
21.46
21.46
3.43
3.43
18.14
18.14
21.37
21.37
3.42
3.42
28.29
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$88.75
$654.81
$623.62
$104.69
$99.70
$656.77
$625.49
$104.97
$99.97
$840.89
$800.85
$1,025.29
$976.47
$1,344.42
$1,280.39
$330.07
$314.35
$411.47
$391.87
$419.32
$399.35
$430.83
$410.31
$396.59
$377.70
$526.26
$501.20
$499.32
$475.54
$531.87
$506.54
$451.60
$430.09
$434.20
$413.52
$561.34
$534.61
$676.14
$643.94
$497.07
$473.40
$79.43
$75.65
$602.32
$573.64
$96.27
$91.69
$509.14
$484.89
$599.80
$571.23
$95.99
$91.42
$794.02
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$88.75
$654.81
$623.62
$104.69
$99.70
$656.77
$625.49
$104.97
$99.97
$840.89
$800.85
$1,025.29
$976.47
$1,344.42
$1,280.39
$330.07
$314.35
$411.47
$391.87
$419.32
$399.35
$430.83
$410.31
$396.59
$377.70
$526.26
$501.20
$499.32
$475.54
$531.87
$506.54
$451.60
$430.09
$434.20
$413.52
$561.34
$534.61
$676.14
$643.94
$497.07
$473.40
$79.43
$75.65
$602.32
$573.64
$96.27
$91.69
$509.14
$484.89
$599.80
$571.23
$95.99
$91.42
$794.02
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
23.19
23.19
$28.0672
$26.7305
23.13
23.13
$28.0672
$26.7305
30.34
30.34
37.01
37.01
48.49
48.49
11.88
11.88
14.82
14.82
15.11
15.11
15.49
15.49
14.27
14.27
18.99
18.99
17.93
17.93
19.11
19.11
16.21
16.21
15.59
15.59
20.21
20.21
24.34
24.34
17.67
17.67
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
21.74
21.74
$28.0672
$26.7305
18.39
18.39
21.52
21.52
$28.0672
$26.7305
$28.0672
$26.7305
28.41
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$88.10
$650.88
$619.88
$104.14
$99.18
$649.19
$618.28
$103.87
$98.92
$851.56
$811.00
$1,038.77
$989.30
$1,360.98
$1,296.16
$333.44
$317.56
$415.96
$396.15
$424.10
$403.90
$434.76
$414.06
$400.52
$381.44
$533.00
$507.61
$503.24
$479.28
$536.36
$510.82
$454.97
$433.30
$437.57
$416.73
$567.24
$540.22
$683.16
$650.62
$495.95
$472.33
$79.35
$75.57
$610.18
$581.12
$97.63
$92.98
$516.16
$491.57
$604.01
$575.24
$96.64
$92.04
$797.39
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$88.10
$650.88
$619.88
$104.14
$99.18
$649.19
$618.28
$103.87
$98.92
$851.56
$811.00
$1,038.77
$989.30
$1,360.98
$1,296.16
$333.44
$317.56
$415.96
$396.15
$424.10
$403.90
$434.76
$414.06
$400.52
$381.44
$533.00
$507.61
$503.24
$479.28
$536.36
$510.82
$454.97
$433.30
$437.57
$416.73
$567.24
$540.22
$683.16
$650.62
$495.95
$472.33
$79.35
$75.57
$610.18
$581.12
$97.63
$92.98
$516.16
$491.57
$604.01
$575.24
$96.64
$92.04
$797.39
Musculoskeletal System Surgery
TOS*
Procedure
Code
Age
Range
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
29888
29888
29888
29889
29889
29889
29889
29891
29891
29891
29891
29892
29892
29892
29892
29893
29893
29893
29893
29894
29894
29894
29894
29895
29895
29895
29895
29897
29897
29897
29897
29898
29898
29898
29898
29899
29899
29899
29899
29900
29900
29901
29901
29902
29902
29904
29904
29904
29904
29905
29905
29905
29905
29906
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
28.29
4.53
4.53
34.93
34.93
5.59
5.59
19.66
19.66
3.15
3.15
17.80
17.80
2.85
2.85
17.45
12.22
17.45
12.22
14.56
14.56
2.33
2.33
13.60
13.60
2.18
2.18
14.65
14.65
2.34
2.34
16.20
16.20
2.59
2.59
29.66
29.66
4.75
4.75
13.37
13.37
15.16
15.16
17.34
17.34
18.18
18.18
2.91
2.91
19.67
19.67
3.15
3.15
20.71
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$756.21
$127.14
$121.09
$980.39
$933.70
$156.90
$149.42
$551.80
$525.52
$88.41
$84.20
$499.60
$475.80
$79.99
$76.18
$489.77
$342.98
$466.45
$326.65
$408.66
$389.20
$65.40
$62.28
$381.71
$363.53
$61.19
$58.27
$411.18
$391.60
$65.68
$62.55
$454.69
$433.03
$72.69
$69.23
$832.47
$792.83
$133.32
$126.97
$375.26
$357.39
$425.50
$405.23
$486.69
$463.51
$510.26
$485.96
$81.68
$77.79
$552.08
$525.79
$88.41
$84.20
$581.27
Current
Percent
Reduction
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$756.21
$127.14
$121.09
$980.39
$933.70
$156.90
$149.42
$551.80
$525.52
$88.41
$84.20
$499.60
$475.80
$79.99
$76.18
$489.77
$342.98
$466.45
$326.65
$408.66
$389.20
$65.40
$62.28
$381.71
$363.53
$61.19
$58.27
$411.18
$391.60
$65.68
$62.55
$454.69
$433.03
$72.69
$69.23
$832.47
$792.83
$133.32
$126.97
$375.26
$357.39
$425.50
$405.23
$486.69
$463.51
$510.26
$485.96
$81.68
$77.79
$552.08
$525.79
$88.41
$84.20
$581.27
28.41
$26.7305
35.38
35.38
$28.0672
$26.7305
19.59
19.59
$28.0672
$26.7305
18.00
18.00
$28.0672
$26.7305
17.64
12.31
17.64
12.31
14.45
14.45
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
13.93
13.93
$28.0672
$26.7305
14.62
14.62
$28.0672
$26.7305
16.32
16.32
$28.0672
$26.7305
30.16
30.16
$28.0672
$26.7305
12.01
12.01
15.08
15.08
13.94
13.94
18.44
18.44
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
18.70
18.70
$28.0672
$26.7305
20.40
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid
Fee
Effective
1/1/2016
$759.41
$127.58
$121.51
$993.02
$945.73
$158.88
$151.32
$549.84
$523.65
$87.97
$83.78
$505.21
$481.15
$80.83
$76.98
$495.11
$345.51
$471.53
$329.05
$405.57
$386.26
$64.89
$61.80
$390.98
$372.36
$62.56
$59.58
$410.34
$390.80
$65.65
$62.53
$458.06
$436.24
$73.29
$69.80
$846.51
$806.19
$135.44
$128.99
$337.09
$321.03
$423.25
$403.10
$391.26
$372.62
$517.56
$492.91
$82.81
$78.87
$524.86
$499.86
$83.98
$79.98
$572.57
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$759.41
$127.58
$121.51
$993.02
$945.73
$158.88
$151.32
$549.84
$523.65
$87.97
$83.78
$505.21
$481.15
$80.83
$76.98
$495.11
$345.51
$471.53
$329.05
$405.57
$386.26
$64.89
$61.80
$390.98
$372.36
$62.56
$59.58
$410.34
$390.80
$65.65
$62.53
$458.06
$436.24
$73.29
$69.80
$846.51
$806.19
$135.44
$128.99
$337.09
$321.03
$423.25
$403.10
$391.26
$372.62
$517.56
$492.91
$82.81
$78.87
$524.86
$499.86
$83.98
$79.98
$572.57
Musculoskeletal System Surgery
NonFacility
Current
(N)/
Current
Medicaid
Current
Facility Medicaid Conversion Medicaid
(F)
RVU
Factor
Fee
TOS*
Procedure
Code
Age
Range
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
29906
29906
29906
29907
29907
29907
29907
29914
29914
29914
29914
29915
29915
29915
29915
29916
29916
29916
29916
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
2
29999
0-999
N/F
20.71
3.31
3.31
25.01
25.01
4.00
4.00
28.91
28.91
4.63
4.63
29.50
29.50
4.72
4.72
29.51
29.51
4.72
4.72
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
*Type of Service (TOS): 2 = Surgery, 8 = Assistant Surgery
$553.59
$92.90
$88.48
$701.96
$668.53
$112.27
$106.92
$811.42
$772.78
$129.95
$123.76
$827.98
$788.55
$132.48
$126.17
$828.26
$788.82
$132.48
$126.17
Manually
Priced
Current
Percent
Reduction
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
$553.59
$92.90
$88.48
$701.96
$668.53
$112.27
$106.92
$811.42
$772.78
$129.95
$123.76
$827.98
$788.55
$132.48
$126.17
$828.26
$788.82
$132.48
$126.17
Manually
Priced
20.40
$26.7305
25.32
25.32
$28.0672
$26.7305
28.55
28.55
$28.0672
$26.7305
29.08
29.08
$28.0672
$26.7305
29.16
29.16
$28.0672
$26.7305
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
$545.30
$91.61
$87.25
$710.66
$676.82
$113.71
$108.29
$801.32
$763.16
$128.21
$122.11
$816.19
$777.32
$130.59
$124.37
$818.44
$779.46
$130.95
$124.71
Manually
Priced
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$545.30
$91.61
$87.25
$710.66
$676.82
$113.71
$108.29
$801.32
$763.16
$128.21
$122.11
$816.19
$777.32
$130.59
$124.37
$818.44
$779.46
$130.95
$124.71
Manually
Priced
Q Codes (Physician, DME, and Physician-Administered Drug Codes)
TOS*
Procedure
Code
Age
Range
Non-Facility
(N)/ Facility
(F)
4
I
I
T
1
1
1
1
J
J
J
J
J
J
J
J
J
J
J
J
J
J
J
J
J
J
J
J
J
J
J
J
J
9
Q0035
Q0035
Q0035
Q0035
Q3014
Q3014
Q3014
Q3014
Q0480
Q0481
Q0482
Q0483
Q0484
Q0485
Q0486
Q0487
Q0488
Q0489
Q0490
Q0491
Q0492
Q0493
Q0494
Q0495
Q0496
Q0497
Q0498
Q0499
Q0500
Q0501
Q0502
Q0503
Q0504
Q0506
0-20
0-20
0-20
0-20
0-20
21-999
0-20
21-999
0-20
0-20
0-20
0-20
0-20
0-20
0-20
0-20
0-20
0-20
0-20
0-20
0-20
0-20
0-20
0-20
0-20
0-20
0-20
0-20
0-20
0-20
0-20
0-20
0-20
0-999
N/F
N
F
N
N/F
N/F
N/F
N/F
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
9
Q0507
0-999
F
J
Q0507
0-999
N
9
Q0508
0-999
F
J
1
Q0508
Q2004
0-999
0-999
N
N/F
Current
Medicaid
RVU
Current
Medicaid
Conversion
Factor
0.63
0.26
0.23
0.37
$28.067
$28.067
$28.067
$28.067
Current
Medicaid
Fee
$17.68
$7.30
$6.46
$10.38
$23.94
$23.94
$23.94
$23.94
$84,703.77
$13,665.98
$4,280.43
$17,633.48
$3,424.36
$330.63
$275.16
$321.04
$12,300.00
$15,287.29
$661.27
$1,039.55
$83.77
$238.45
$201.77
$3,928.45
$1,409.96
$440.26
$483.06
$156.96
$28.72
$480.31
$611.47
$1,223.00
$645.32
$803.28
Manually
Priced
Manually
Priced
Manually
Priced
Manually
Priced
$35.70
Current Percent
Reduction
0%
0%
0%
0%
0%
0%
0%
0%
8%
8%
8%
2%
2%
2%
2%
2%
2%
8%
2%
2%
2%
2%
2%
8%
8%
8%
2%
2%
8%
8%
2%
2%
2%
2%
2%
2%
2%
2%
0%
Current
Adjusted
Medicaid
Fee
Medicaid
RVU
Effective
1/1/2016
Medicaid
Conversion
Factor
Effective
1/1/2016
$17.68
$7.30
$6.46
$10.38
$23.94
$23.94
$23.94
$23.94
$77,927.47
$12,572.70
$3,938.00
$17,280.81
$3,355.87
$324.02
$269.66
$314.62
$12,054.00
$14,064.31
$648.04
$1,018.76
$82.09
$233.68
$197.73
$3,614.17
$1,297.16
$405.04
$473.40
$153.82
$26.42
$441.89
$599.24
$1,198.54
$632.41
$787.21
Manually
Priced
Manually
Priced
Manually
Priced
Manually
Priced
$35.70
0.59
0.25
0.25
0.34
$28.0672
$28.0672
$28.0672
$28.0672
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
$16.56
$7.02
$7.02
$9.54
$19.49
$18.56
$19.49
$18.56
$77,927.47
$12,572.70
$3,938.00
$17,280.81
$3,355.87
$324.02
$269.66
$314.62
$12,054.00
$14,064.31
$648.04
$1,018.76
$82.09
$233.68
$197.73
$3,614.17
$1,297.16
$405.04
$473.40
$153.82
$26.42
$441.89
$599.24
$1,198.54
$632.41
$787.21
Manually
Priced
Manually
Priced
Manually
Priced
Manually
Priced
$35.70
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
*Type of Service (TOS): 1 = Surgery, 4 = Radiology, 9 = Other Medical Items or Services, I = Professional Component, J = DME Purchase - New, T = Technical Component
Adjusted
Medicaid
Fee
Effective
1/1/2016
$16.56
$7.02
$7.02
$9.54
$19.49
$18.56
$19.49
$18.56
$77,927.47
$12,572.70
$3,938.00
$17,280.81
$3,355.87
$324.02
$269.66
$314.62
$12,054.00
$14,064.31
$648.04
$1,018.76
$82.09
$233.68
$197.73
$3,614.17
$1,297.16
$405.04
$473.40
$153.82
$26.42
$441.89
$599.24
$1,198.54
$632.41
$787.21
Manually
Priced
Manually
Priced
Manually
Priced
Manually
Priced
$35.70
R Codes (Transportation of portable x-ray equipment to home or nursing home, per trip)
TOS*
4
4
4
4
4
4
Procedure
Code
Modifier**
R0070
R0075
R0075
R0075
R0075
R0075
UN
UP
UQ
UR
US
Non-Facility Current
(N)/ Facility Medicaid
Age
Fee
(F)
Range
0-999
0-999
0-999
0-999
0-999
0-999
N/F
N/F
N/F
N/F
N/F
N/F
$179.72
$89.87
$59.91
$44.93
$35.95
$29.96
Current Medicaid
Fee
Current Adjusted
Medicaid Effective
Percent
1/1/2016
Fee
Reduction
0%
0%
0%
0%
0%
0%
$179.72
$89.87
$59.91
$44.93
$35.95
$29.96
$131.02
$65.51
$43.67
$32.76
$26.20
$21.84
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid Fee
Effective
1/1/2016
0%
0%
0%
0%
0%
0%
$131.02
$65.51
$43.67
$32.76
$26.20
$21.84
*Type of Service (TOS): 4 = Radiology
**Modifier: UN = Two Patients Served, UP = Three Patients Served, UQ = Four Patients Served, UR = Five Patients Served, US =
Six or more Patients Served
Radiopharmaceuticals
TOS*
Procedure
Code
Age
Range
NonFacility
(N)/
Facility
(F)
9
9
9
9
9
9
9
9
9
A9500
A9502
A9503
A9504
A9505
A9507
A9508
A9510
A9542
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
0-999
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
9
9
9
9
9
9
A9543
A9544
A9545
A9563
A9564
A9600
0-999
0-20
0-999
0-999
0-999
0-999
N/F
F
N/F
N/F
N/F
N/F
Current
Medicaid
Fee
Current
Percent
Reduction
$106.71
$119.29
$16.58
$372.77
$25.26
$3,193.12
$394.73
$42.84
$1,785.00
Manually
Priced
$2,513.51
$22,438.96
$45.64
$155.70
$1,316.64
Manually
Priced
$238.68
$2,688.41
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0-999
N/F
0%
9
A9699
0-999
N/F
0%
9
A9700
0-20
F
0%
1
G3001
*Type of Service (TOS): 1 = Surgery, 9 = Other Medical Items or Services
Current
Adjusted
Medicaid
Medicaid Fee Effective
Fee
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted
Medicaid Fee
Effective
1/1/2016
$106.71
$106.71
$119.29
$99.41
$16.58
$21.87
$372.77
$372.77
$25.26
$25.26
$3,193.12
$3,634.48
$394.73
$200.74
$42.84
$44.76
$1,785.00
$1,785.00
Manually
Priced
Manually Priced
$2,513.51
$2,513.51
$22,438.96
$22,438.96
$45.64
$45.64
$155.70
$155.70
$1,316.64
$1,316.64
Manually
Priced
Manually Priced
$238.68
$238.68
$2,688.41
$2,688.41
0%
0%
0%
0%
0%
0%
0%
0%
0%
$106.71
$99.41
$21.87
$372.77
$25.26
$3,634.48
$200.74
$44.76
$1,785.00
0%
0%
0%
0%
0%
0%
Manually Priced
$2,513.51
$22,438.96
$45.64
$155.70
$1,316.64
0%
0%
0%
Manually Priced
$238.68
$2,688.41
Respiratory System Surgery
TOS*
Procedure
Code
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
30000
30000
30000
30000
30020
30020
30020
30020
30100
30100
30100
30100
30110
30110
30110
30110
30115
30115
30117
30117
30117
30117
30118
30118
30120
30120
30120
30120
30124
30124
30125
30125
30130
30130
30140
30140
30150
30150
30160
30160
30160
30160
30200
30200
30200
30200
30210
30210
30210
30210
30220
30220
30300
30300
30300
30300
30310
30310
NonAge
Facility (N)/
Range Facility (F)
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
F
F
N
F
N
F
F
F
N
F
N
F
N/F
N/F
N/F
N/F
F
F
F
F
N/F
N/F
N/F
N/F
F
F
N
F
N
F
N
F
N
F
F
F
N
F
N
F
N/F
N/F
Current
Medicaid
RVU
Current
Medicaid
Conversion
Factor
Current
Medicaid
Fee
7.15
3.59
7.15
3.59
7.26
3.60
7.26
3.60
4.39
2.08
4.39
2.08
7.13
3.93
7.13
3.93
13.08
13.08
27.45
10.29
27.45
10.29
22.92
22.92
15.76
13.21
15.76
13.21
8.66
8.66
18.34
18.34
11.57
11.57
13.51
13.51
23.09
23.09
23.24
23.24
3.72
3.72
3.54
1.80
3.54
1.80
4.63
3.02
4.63
3.02
3.79
3.79
7.25
3.90
7.25
3.90
6.29
6.29
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$200.68
$100.76
$191.12
$95.96
$203.77
$101.04
$194.06
$96.23
$123.22
$58.38
$117.35
$55.60
$200.12
$110.30
$190.59
$105.05
$367.12
$349.63
$770.44
$288.81
$733.75
$275.06
$643.30
$612.66
$442.34
$370.77
$421.27
$353.11
$243.06
$231.49
$514.75
$490.24
$324.74
$309.27
$379.19
$361.13
$648.07
$617.21
$652.28
$621.22
$104.41
$99.44
$99.36
$50.52
$94.63
$48.11
$129.95
$84.76
$123.76
$80.73
$106.37
$101.31
$203.49
$109.46
$193.80
$104.25
$176.54
$168.13
Current
Current
Percent
Adjusted
Reduction Medicaid Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$200.68
$100.76
$191.12
$95.96
$203.77
$101.04
$194.06
$96.23
$123.22
$58.38
$117.35
$55.60
$200.12
$110.30
$190.59
$105.05
$367.12
$349.63
$770.44
$288.81
$733.75
$275.06
$643.30
$612.66
$442.34
$370.77
$421.27
$353.11
$243.06
$231.49
$514.75
$490.24
$324.74
$309.27
$379.19
$361.13
$648.07
$617.21
$652.28
$621.22
$104.41
$99.44
$99.36
$50.52
$94.63
$48.11
$129.95
$84.76
$123.76
$80.73
$106.37
$101.31
$203.49
$109.46
$193.80
$104.25
$176.54
$168.13
Medicaid
RVU
Effective
1/1/2016
Medicaid
Percent
Conversion
Medicaid
Reduction
Factor Effective Fee Effective Effective
1/1/2016
1/1/2016
1/1/2016
6.56
3.39
6.56
3.39
6.64
3.42
6.64
3.42
4.04
1.99
4.04
1.99
6.58
3.75
6.58
3.75
12.33
12.33
24.99
9.72
24.99
9.72
21.88
21.88
14.79
12.47
14.79
12.47
8.13
8.13
17.34
17.34
10.86
10.86
12.56
12.56
21.94
21.94
22.07
22.07
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
3.24
1.71
3.24
1.71
4.29
2.85
4.29
2.85
3.58
3.58
6.57
3.61
6.57
3.61
5.85
5.85
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$184.12
$95.15
$175.35
$90.62
$186.37
$95.99
$177.49
$91.42
$113.39
$55.85
$107.99
$53.19
$184.68
$105.25
$175.89
$100.24
$346.07
$329.59
$701.40
$272.81
$668.00
$259.82
$614.11
$584.86
$415.11
$350.00
$395.34
$333.33
$228.19
$217.32
$486.69
$463.51
$304.81
$290.29
$352.52
$335.74
$615.79
$586.47
$619.44
$589.94
$99.11
$94.39
$90.94
$47.99
$86.61
$45.71
$120.41
$79.99
$114.67
$76.18
$100.48
$95.70
$184.40
$101.32
$175.62
$96.50
$164.19
$156.37
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$184.12
$95.15
$175.35
$90.62
$186.37
$95.99
$177.49
$91.42
$113.39
$55.85
$107.99
$53.19
$184.68
$105.25
$175.89
$100.24
$346.07
$329.59
$701.40
$272.81
$668.00
$259.82
$614.11
$584.86
$415.11
$350.00
$395.34
$333.33
$228.19
$217.32
$486.69
$463.51
$304.81
$290.29
$352.52
$335.74
$615.79
$586.47
$619.44
$589.94
$99.11
$94.39
$90.94
$47.99
$86.61
$45.71
$120.41
$79.99
$114.67
$76.18
$100.48
$95.70
$184.40
$101.32
$175.62
$96.50
$164.19
$156.37
Respiratory System Surgery
TOS*
Procedure
Code
2
2
2
2
2
2
8
8
2
2
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
30320
30320
30400
30400
30410
30410
30410
30410
30420
30420
30430
30430
30430
30430
30435
30435
30450
30450
30450
30450
30460
30460
30460
30460
30462
30462
30462
30462
30465
30465
30520
30520
30540
30540
30540
30540
30545
30545
30545
30545
30560
30560
30560
30560
30580
30580
30580
30580
30600
30600
30600
30600
30620
30620
30630
30630
30801
30801
NonAge
Facility (N)/
Range Facility (F)
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
0-20
F
F
N/F
N/F
N/F
N/F
F
F
N/F
N/F
N/F
N/F
F
F
N/F
N/F
N/F
N/F
F
F
N/F
N/F
F
F
N/F
N/F
F
F
F
F
N/F
N/F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
N
F
N
F
N/F
N/F
N/F
N/F
N
F
Current
Medicaid
RVU
Current
Medicaid
Conversion
Factor
Current
Medicaid
Fee
13.72
13.72
30.58
30.58
35.70
35.70
5.71
5.71
41.27
41.27
26.88
26.88
4.30
4.30
33.62
33.62
44.90
44.90
7.18
7.18
24.48
24.48
3.92
3.92
43.13
43.13
6.90
6.90
29.55
29.55
18.91
18.91
20.77
20.77
3.32
3.32
25.33
25.33
4.05
4.05
8.42
4.21
8.42
4.21
19.37
14.99
19.37
14.99
17.35
12.79
17.35
12.79
19.12
19.12
18.94
18.94
7.14
4.23
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$385.08
$366.74
$858.29
$817.42
$1,002.00
$954.28
$160.26
$152.63
$1,158.33
$1,103.17
$754.45
$718.52
$120.69
$114.94
$943.62
$898.68
$1,260.22
$1,200.20
$201.52
$191.92
$687.09
$654.36
$110.02
$104.78
$1,210.54
$1,152.89
$193.66
$184.44
$829.39
$789.89
$530.75
$505.47
$582.96
$555.19
$93.18
$88.75
$710.94
$677.08
$113.67
$108.26
$236.33
$118.16
$225.07
$112.54
$543.66
$420.73
$517.77
$400.69
$486.97
$358.98
$463.77
$341.88
$536.64
$511.09
$531.59
$506.28
$200.40
$118.72
Current
Current
Percent
Adjusted
Reduction Medicaid Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$385.08
$366.74
$858.29
$817.42
$1,002.00
$954.28
$160.26
$152.63
$1,158.33
$1,103.17
$754.45
$718.52
$120.69
$114.94
$943.62
$898.68
$1,260.22
$1,200.20
$201.52
$191.92
$687.09
$654.36
$110.02
$104.78
$1,210.54
$1,152.89
$193.66
$184.44
$829.39
$789.89
$530.75
$505.47
$582.96
$555.19
$93.18
$88.75
$710.94
$677.08
$113.67
$108.26
$236.33
$118.16
$225.07
$112.54
$543.66
$420.73
$517.77
$400.69
$486.97
$358.98
$463.77
$341.88
$536.64
$511.09
$531.59
$506.28
$200.40
$118.72
Medicaid
RVU
Effective
1/1/2016
Medicaid
Percent
Conversion
Medicaid
Reduction
Factor Effective Fee Effective Effective
1/1/2016
1/1/2016
1/1/2016
12.90
12.90
28.68
28.68
33.67
33.67
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
39.18
39.18
24.68
24.68
$28.0672
$26.7305
$28.0672
$26.7305
35.56
35.56
42.67
42.67
$28.0672
$26.7305
$28.0672
$26.7305
23.22
23.22
$28.0672
$26.7305
40.40
40.40
$28.0672
$26.7305
27.99
27.99
17.78
17.78
19.61
19.61
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
24.38
24.38
$28.0672
$26.7305
7.66
3.93
7.66
3.93
18.71
14.68
18.71
14.68
16.29
12.23
16.29
12.23
17.80
17.80
17.86
17.86
6.52
3.91
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$362.07
$344.82
$804.97
$766.63
$945.02
$900.02
$151.20
$144.00
$1,099.67
$1,047.30
$692.70
$659.71
$110.83
$105.55
$998.07
$950.54
$1,197.63
$1,140.59
$191.62
$182.49
$651.72
$620.68
$104.28
$99.31
$1,133.91
$1,079.91
$181.43
$172.79
$785.60
$748.19
$499.03
$475.27
$550.40
$524.19
$88.06
$83.87
$684.28
$651.69
$109.48
$104.27
$214.99
$110.30
$204.76
$105.05
$525.14
$412.03
$500.13
$392.40
$457.21
$343.26
$435.44
$326.91
$499.60
$475.80
$501.28
$477.41
$183.00
$109.74
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$362.07
$344.82
$804.97
$766.63
$945.02
$900.02
$151.20
$144.00
$1,099.67
$1,047.30
$692.70
$659.71
$110.83
$105.55
$998.07
$950.54
$1,197.63
$1,140.59
$191.62
$182.49
$651.72
$620.68
$104.28
$99.31
$1,133.91
$1,079.91
$181.43
$172.79
$785.60
$748.19
$499.03
$475.27
$550.40
$524.19
$88.06
$83.87
$684.28
$651.69
$109.48
$104.27
$214.99
$110.30
$204.76
$105.05
$525.14
$412.03
$500.13
$392.40
$457.21
$343.26
$435.44
$326.91
$499.60
$475.80
$501.28
$477.41
$183.00
$109.74
Respiratory System Surgery
TOS*
Procedure
Code
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
30801
30801
30802
30802
30802
30802
30901
30901
30901
30901
30903
30903
30903
30903
30905
30905
30905
30905
30906
30906
30906
30906
30915
30915
30920
30920
30930
30930
NonAge
Facility (N)/
Range Facility (F)
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
F
F
F
F
N/F
N/F
2
30999
0-999
N/F
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
30999
31000
31000
31000
31000
31002
31002
31020
31020
31020
31020
31030
31030
31032
31032
31040
31040
31050
31050
31051
31051
31070
31070
31075
31075
31080
31080
31081
0-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
N/F
N
F
N
F
N/F
N/F
N
F
N
F
F
F
F
F
N/F
N/F
F
F
F
F
F
F
F
F
F
F
F
Current
Medicaid
RVU
Current
Medicaid
Conversion
Factor
7.14
4.23
8.94
5.78
8.94
5.78
2.89
1.66
2.89
1.66
6.36
2.35
6.36
2.35
7.91
2.97
7.91
2.97
8.64
3.86
8.64
3.86
17.35
17.35
25.07
25.07
3.77
3.77
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
5.60
3.16
5.60
3.16
6.11
6.11
14.90
10.96
14.90
10.96
15.77
15.77
17.24
17.24
22.79
22.79
14.63
14.63
19.48
19.48
13.37
13.37
23.51
23.51
30.97
30.97
45.24
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
Current
Medicaid
Fee
$190.86
$113.07
$250.92
$162.23
$238.97
$154.50
$81.11
$46.59
$77.25
$44.37
$178.51
$65.96
$170.01
$62.82
$222.01
$83.36
$211.44
$79.39
$242.50
$108.34
$230.95
$103.18
$486.97
$463.77
$703.64
$670.13
$105.81
$100.77
Manually
Priced
Manually
Priced
$157.18
$88.69
$149.69
$84.47
$171.49
$163.32
$418.20
$307.62
$398.28
$292.97
$442.62
$421.54
$483.88
$460.83
$639.65
$609.19
$410.62
$391.07
$546.75
$520.71
$375.26
$357.39
$659.86
$628.43
$869.24
$827.84
$1,269.76
Current
Current
Percent
Adjusted
Reduction Medicaid Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$190.86
$113.07
$250.92
$162.23
$238.97
$154.50
$81.11
$46.59
$77.25
$44.37
$178.51
$65.96
$170.01
$62.82
$222.01
$83.36
$211.44
$79.39
$242.50
$108.34
$230.95
$103.18
$486.97
$463.77
$703.64
$670.13
$105.81
$100.77
2%
Manually Priced
2%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Manually Priced
$157.18
$88.69
$149.69
$84.47
$171.49
$163.32
$418.20
$307.62
$398.28
$292.97
$442.62
$421.54
$483.88
$460.83
$639.65
$609.19
$410.62
$391.07
$546.75
$520.71
$375.26
$357.39
$659.86
$628.43
$869.24
$827.84
$1,269.76
Medicaid
RVU
Effective
1/1/2016
6.52
3.91
8.29
5.45
8.29
5.45
2.72
1.63
2.72
1.63
5.87
2.28
5.87
2.28
7.34
2.88
7.34
2.88
8.00
3.77
8.00
3.77
16.44
16.44
23.83
23.83
3.52
3.52
5.24
3.04
5.24
3.04
5.51
5.51
13.89
10.30
13.89
10.30
15.15
15.15
16.40
16.40
21.93
21.93
13.82
13.82
18.39
18.39
12.51
12.51
22.26
22.26
29.38
29.38
43.63
Medicaid
Percent
Conversion
Medicaid
Reduction
Factor Effective Fee Effective Effective
1/1/2016
1/1/2016
1/1/2016
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$174.28
$104.52
$232.68
$152.97
$221.60
$145.68
$76.34
$45.75
$72.71
$43.57
$164.75
$63.99
$156.91
$60.95
$206.01
$80.83
$196.20
$76.98
$224.54
$105.81
$213.84
$100.77
$461.42
$439.45
$668.84
$636.99
$98.80
$94.09
Manually
Priced
Manually
Priced
$147.07
$85.32
$140.07
$81.26
$154.65
$147.29
$389.85
$289.09
$371.29
$275.32
$425.22
$404.97
$460.30
$438.38
$615.51
$586.20
$387.89
$369.42
$516.16
$491.57
$351.12
$334.40
$624.78
$595.02
$824.61
$785.34
$1,224.57
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
2%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$174.28
$104.52
$232.68
$152.97
$221.60
$145.68
$76.34
$45.75
$72.71
$43.57
$164.75
$63.99
$156.91
$60.95
$206.01
$80.83
$196.20
$76.98
$224.54
$105.81
$213.84
$100.77
$461.42
$439.45
$668.84
$636.99
$98.80
$94.09
Manually
Priced
Manually
Priced
$147.07
$85.32
$140.07
$81.26
$154.65
$147.29
$389.85
$289.09
$371.29
$275.32
$425.22
$404.97
$460.30
$438.38
$615.51
$586.20
$387.89
$369.42
$516.16
$491.57
$351.12
$334.40
$624.78
$595.02
$824.61
$785.34
$1,224.57
Respiratory System Surgery
TOS*
Procedure
Code
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
31081
31081
31081
31084
31084
31084
31084
31085
31085
31086
31086
31087
31087
31090
31090
31200
31200
31201
31201
31205
31205
31225
31225
31225
31225
31230
31230
31230
31230
31231
31231
31231
31231
31233
31233
31233
31233
31235
31235
31235
31235
31237
31237
31237
31237
31238
31238
31238
31238
31239
31239
31240
31240
31254
31254
31255
31255
31256
NonAge
Facility (N)/
Range Facility (F)
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N/F
N/F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
F
F
F
F
F
F
F
F
F
Current
Medicaid
RVU
Current
Medicaid
Conversion
Factor
Current
Medicaid
Fee
45.24
7.24
7.24
34.57
34.57
5.53
5.53
47.96
47.96
33.62
33.62
32.32
32.32
30.93
30.93
17.41
17.41
22.43
22.43
27.32
27.32
55.84
55.84
8.93
8.93
61.80
61.80
9.89
9.89
6.43
1.91
6.43
1.91
8.11
4.08
8.11
4.08
9.18
4.80
9.18
4.80
9.88
5.38
9.88
5.38
10.10
5.83
10.10
5.83
20.71
20.71
4.79
4.79
8.09
8.09
11.83
11.83
5.87
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$1,209.29
$203.21
$193.53
$970.28
$924.07
$155.21
$147.82
$1,346.10
$1,281.99
$943.62
$898.68
$907.13
$863.93
$868.12
$826.77
$488.65
$465.38
$629.55
$599.57
$766.80
$730.28
$1,567.27
$1,492.63
$250.64
$238.70
$1,734.55
$1,651.94
$277.58
$264.36
$180.47
$53.61
$171.88
$51.06
$227.62
$114.51
$216.78
$109.06
$257.66
$134.72
$245.39
$128.31
$277.30
$151.00
$264.10
$143.81
$283.48
$163.63
$269.98
$155.84
$581.27
$553.59
$134.44
$128.04
$227.06
$216.25
$332.03
$316.22
$164.75
Current
Current
Percent
Adjusted
Reduction Medicaid Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$1,209.29
$203.21
$193.53
$970.28
$924.07
$155.21
$147.82
$1,346.10
$1,281.99
$943.62
$898.68
$907.13
$863.93
$868.12
$826.77
$488.65
$465.38
$629.55
$599.57
$766.80
$730.28
$1,567.27
$1,492.63
$250.64
$238.70
$1,734.55
$1,651.94
$277.58
$264.36
$180.47
$53.61
$171.88
$51.06
$227.62
$114.51
$216.78
$109.06
$257.66
$134.72
$245.39
$128.31
$277.30
$151.00
$264.10
$143.81
$283.48
$163.63
$269.98
$155.84
$581.27
$553.59
$134.44
$128.04
$227.06
$216.25
$332.03
$316.22
$164.75
Medicaid
RVU
Effective
1/1/2016
Medicaid
Percent
Conversion
Medicaid
Reduction
Factor Effective Fee Effective Effective
1/1/2016
1/1/2016
1/1/2016
43.63
$26.7305
32.87
32.87
$28.0672
$26.7305
41.98
41.98
31.96
31.96
30.86
30.86
29.17
29.17
16.18
16.18
21.11
21.11
25.46
25.46
53.65
53.65
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
59.37
59.37
$28.0672
$26.7305
5.97
1.88
5.97
1.88
7.49
3.94
7.49
3.94
8.53
4.66
8.53
4.66
7.37
4.64
7.37
4.64
7.36
4.87
7.36
4.87
17.56
17.56
4.63
4.63
7.87
7.87
11.53
11.53
5.71
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$1,166.25
$195.93
$186.60
$922.57
$878.63
$147.61
$140.58
$1,178.26
$1,122.15
$897.03
$854.31
$866.15
$824.90
$818.72
$779.73
$454.13
$432.50
$592.50
$564.28
$714.59
$680.56
$1,505.81
$1,434.09
$240.93
$229.45
$1,666.35
$1,586.99
$266.62
$253.92
$167.56
$52.77
$159.58
$50.25
$210.22
$110.58
$200.21
$105.32
$239.41
$130.79
$228.01
$124.56
$206.86
$130.23
$197.00
$124.03
$206.57
$136.69
$196.74
$130.18
$492.86
$469.39
$129.95
$123.76
$220.89
$210.37
$323.61
$308.20
$160.26
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$1,166.25
$195.93
$186.60
$922.57
$878.63
$147.61
$140.58
$1,178.26
$1,122.15
$897.03
$854.31
$866.15
$824.90
$818.72
$779.73
$454.13
$432.50
$592.50
$564.28
$714.59
$680.56
$1,505.81
$1,434.09
$240.93
$229.45
$1,666.35
$1,586.99
$266.62
$253.92
$167.56
$52.77
$159.58
$50.25
$210.22
$110.58
$200.21
$105.32
$239.41
$130.79
$228.01
$124.56
$206.86
$130.23
$197.00
$124.03
$206.57
$136.69
$196.74
$130.18
$492.86
$469.39
$129.95
$123.76
$220.89
$210.37
$323.61
$308.20
$160.26
Respiratory System Surgery
NonAge
Facility (N)/
Range Facility (F)
Current
Medicaid
RVU
Current
Medicaid
Conversion
Factor
Current
Medicaid
Fee
TOS*
Procedure
Code
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
31256
31267
31267
31276
31276
31287
31287
31288
31288
31290
31290
31291
31291
31292
31292
31293
31293
31294
31294
31295
31295
31295
31295
31296
31296
31296
31296
31297
31297
31297
31297
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
N
F
N
F
5.87
9.39
9.39
14.92
14.92
6.89
6.89
7.98
7.98
34.35
34.35
36.52
36.52
29.67
29.67
32.20
32.20
36.83
36.83
65.54
4.98
65.54
4.98
66.53
5.95
66.53
5.95
65.64
4.90
65.64
4.90
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
2
2
2
8
8
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
31299
31300
31300
31300
31300
31320
31320
31360
31360
31360
31360
31365
31365
31365
31365
31367
31367
31367
31367
31368
31368
31368
31368
31370
31370
31370
31370
0-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
$156.91
$263.55
$251.00
$418.76
$398.82
$193.38
$184.17
$223.98
$213.31
$964.11
$918.19
$1,025.01
$976.20
$832.75
$793.09
$903.76
$860.72
$1,033.71
$984.48
$1,839.52
$139.77
$1,751.92
$133.12
$1,867.31
$167.00
$1,778.38
$159.05
$1,842.33
$137.53
$1,754.59
$130.98
Manually
Priced
37.82
37.82
6.05
6.05
20.08
20.08
62.08
62.08
9.93
9.93
76.72
76.72
12.28
12.28
66.02
66.02
10.56
10.56
73.04
73.04
11.69
11.69
62.10
62.10
9.94
9.94
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$1,061.50
$1,010.95
$169.81
$161.72
$563.59
$536.75
$1,742.41
$1,659.43
$278.71
$265.43
$2,153.32
$2,050.76
$344.67
$328.25
$1,853.00
$1,764.75
$296.39
$282.27
$2,050.03
$1,952.40
$328.11
$312.48
$1,742.97
$1,659.96
$278.99
$265.70
Current
Current
Percent
Adjusted
Reduction Medicaid Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$156.91
$263.55
$251.00
$418.76
$398.82
$193.38
$184.17
$223.98
$213.31
$964.11
$918.19
$1,025.01
$976.20
$832.75
$793.09
$903.76
$860.72
$1,033.71
$984.48
$1,839.52
$139.77
$1,751.92
$133.12
$1,867.31
$167.00
$1,778.38
$159.05
$1,842.33
$137.53
$1,754.59
$130.98
2%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Manually Priced
$1,061.50
$1,010.95
$169.81
$161.72
$563.59
$536.75
$1,742.41
$1,659.43
$278.71
$265.43
$2,153.32
$2,050.76
$344.67
$328.25
$1,853.00
$1,764.75
$296.39
$282.27
$2,050.03
$1,952.40
$328.11
$312.48
$1,742.97
$1,659.96
$278.99
$265.70
Medicaid
RVU
Effective
1/1/2016
Medicaid
Percent
Conversion
Medicaid
Reduction
Factor Effective Fee Effective Effective
1/1/2016
1/1/2016
1/1/2016
5.71
9.16
9.16
14.53
14.53
6.69
6.69
7.76
7.76
33.33
33.33
35.54
35.54
28.69
28.69
31.13
31.13
35.64
35.64
58.37
4.82
58.37
4.82
59.19
5.75
59.19
5.75
58.12
4.71
58.12
4.71
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$152.63
$257.10
$244.85
$407.82
$388.39
$187.77
$178.83
$217.80
$207.43
$935.48
$890.93
$997.51
$950.00
$805.25
$766.90
$873.73
$832.12
$1,000.32
$952.68
$1,638.28
$135.28
$1,560.26
$128.84
$1,661.30
$161.39
$1,582.18
$153.70
$1,631.27
$132.20
$1,553.58
$125.90
Manually
Priced
36.16
36.16
$28.0672
$26.7305
18.73
18.73
59.60
59.60
$28.0672
$26.7305
$28.0672
$26.7305
73.77
73.77
$28.0672
$26.7305
63.14
63.14
$28.0672
$26.7305
70.00
70.00
$28.0672
$26.7305
59.33
59.33
$28.0672
$26.7305
$1,014.91
$966.57
$162.39
$154.65
$525.70
$500.66
$1,672.81
$1,593.14
$267.65
$254.90
$2,070.52
$1,971.91
$331.28
$315.51
$1,772.16
$1,687.76
$283.55
$270.04
$1,964.70
$1,871.14
$314.35
$299.38
$1,665.23
$1,585.92
$266.44
$253.75
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$152.63
$257.10
$244.85
$407.82
$388.39
$187.77
$178.83
$217.80
$207.43
$935.48
$890.93
$997.51
$950.00
$805.25
$766.90
$873.73
$832.12
$1,000.32
$952.68
$1,638.28
$135.28
$1,560.26
$128.84
$1,661.30
$161.39
$1,582.18
$153.70
$1,631.27
$132.20
$1,553.58
$125.90
Manually
Priced
$1,014.91
$966.57
$162.39
$154.65
$525.70
$500.66
$1,672.81
$1,593.14
$267.65
$254.90
$2,070.52
$1,971.91
$331.28
$315.51
$1,772.16
$1,687.76
$283.55
$270.04
$1,964.70
$1,871.14
$314.35
$299.38
$1,665.23
$1,585.92
$266.44
$253.75
Respiratory System Surgery
TOS*
Procedure
Code
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
31375
31375
31375
31375
31380
31380
31380
31380
31382
31382
31382
31382
31390
31390
31390
31390
31395
31395
31395
31395
31400
31400
31400
31400
31420
31420
31500
31500
31502
31502
31505
31505
31505
31505
31510
31510
31510
31510
31511
31511
31511
31511
31512
31512
31512
31512
31513
31513
31515
31515
31515
31515
31520
31525
31525
31525
31525
31526
NonAge
Facility (N)/
Range Facility (F)
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
0-20
21-999
21-999
0-20
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N/F
N/F
N/F
N/F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N/F
N/F
N
F
N
F
N/F
N
F
N
F
N/F
Current
Medicaid
RVU
Current
Medicaid
Conversion
Factor
58.97
58.97
9.44
9.44
58.16
58.16
9.31
9.31
63.75
63.75
10.20
10.20
85.34
85.34
13.65
13.65
89.70
89.70
14.35
14.35
30.07
30.07
4.81
4.81
25.01
25.01
3.23
3.23
1.03
1.03
2.56
1.49
2.56
1.49
6.48
3.63
6.48
3.63
6.55
3.87
6.55
3.87
6.34
3.90
6.34
3.90
3.95
3.95
6.38
3.31
6.38
3.31
4.70
7.65
4.76
7.65
4.76
4.71
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
Current
Medicaid
Fee
$1,655.12
$1,576.30
$264.95
$252.34
$1,632.39
$1,554.65
$261.31
$248.86
$1,789.28
$1,704.07
$286.29
$272.65
$2,395.25
$2,281.18
$383.12
$364.87
$2,517.63
$2,397.73
$402.76
$383.58
$843.98
$803.79
$135.00
$128.57
$701.96
$668.53
$90.66
$86.34
$28.91
$27.53
$71.85
$41.82
$68.43
$39.83
$181.88
$101.88
$173.21
$97.03
$183.84
$108.62
$175.08
$103.45
$177.95
$109.46
$169.47
$104.25
$110.87
$105.59
$179.07
$92.90
$170.54
$88.48
$131.92
$214.71
$133.60
$204.49
$127.24
$132.20
Current
Current
Percent
Adjusted
Reduction Medicaid Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$1,655.12
$1,576.30
$264.95
$252.34
$1,632.39
$1,554.65
$261.31
$248.86
$1,789.28
$1,704.07
$286.29
$272.65
$2,395.25
$2,281.18
$383.12
$364.87
$2,517.63
$2,397.73
$402.76
$383.58
$843.98
$803.79
$135.00
$128.57
$701.96
$668.53
$90.66
$86.34
$28.91
$27.53
$71.85
$41.82
$68.43
$39.83
$181.88
$101.88
$173.21
$97.03
$183.84
$108.62
$175.08
$103.45
$177.95
$109.46
$169.47
$104.25
$110.87
$105.59
$179.07
$92.90
$170.54
$88.48
$131.92
$214.71
$133.60
$204.49
$127.24
$132.20
Medicaid
RVU
Effective
1/1/2016
Medicaid
Percent
Conversion
Medicaid
Reduction
Factor Effective Fee Effective Effective
1/1/2016
1/1/2016
1/1/2016
56.33
56.33
$28.0672
$26.7305
55.51
55.51
$28.0672
$26.7305
60.89
60.89
$28.0672
$26.7305
81.78
81.78
$28.0672
$26.7305
86.07
86.07
$28.0672
$26.7305
28.57
28.57
$28.0672
$26.7305
23.88
23.88
3.17
3.17
1.00
1.00
2.36
1.40
2.36
1.40
6.06
3.54
6.06
3.54
6.04
3.74
6.04
3.74
5.92
3.77
5.92
3.77
3.83
3.83
5.92
3.21
5.92
3.21
4.54
7.23
4.63
7.23
4.63
4.55
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$1,581.03
$1,505.73
$252.96
$240.92
$1,558.01
$1,483.81
$249.28
$237.41
$1,709.01
$1,627.62
$273.44
$260.42
$2,295.34
$2,186.02
$367.25
$349.76
$2,415.74
$2,300.69
$386.52
$368.11
$801.88
$763.69
$128.30
$122.19
$670.24
$638.32
$88.97
$84.74
$28.07
$26.73
$66.24
$39.29
$63.08
$37.42
$170.09
$99.36
$161.99
$94.63
$169.53
$104.97
$161.45
$99.97
$166.16
$105.81
$158.24
$100.77
$107.50
$102.38
$166.16
$90.10
$158.24
$85.80
$127.43
$202.93
$129.95
$193.26
$123.76
$127.71
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$1,581.03
$1,505.73
$252.96
$240.92
$1,558.01
$1,483.81
$249.28
$237.41
$1,709.01
$1,627.62
$273.44
$260.42
$2,295.34
$2,186.02
$367.25
$349.76
$2,415.74
$2,300.69
$386.52
$368.11
$801.88
$763.69
$128.30
$122.19
$670.24
$638.32
$88.97
$84.74
$28.07
$26.73
$66.24
$39.29
$63.08
$37.42
$170.09
$99.36
$161.99
$94.63
$169.53
$104.97
$161.45
$99.97
$166.16
$105.81
$158.24
$100.77
$107.50
$102.38
$166.16
$90.10
$158.24
$85.80
$127.43
$202.93
$129.95
$193.26
$123.76
$127.71
Respiratory System Surgery
TOS*
Procedure
Code
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
31526
31527
31527
31528
31528
31529
31529
31530
31530
31531
31531
31535
31535
31536
31536
31540
31540
31541
31541
31545
31545
31546
31546
31560
31560
31561
31561
31570
31570
31570
31570
31571
31571
31575
31575
31575
31575
31576
31576
31576
31576
31577
31577
31577
31577
31578
31578
31578
31578
31579
31579
31579
31579
31580
31580
31580
31580
31582
NonAge
Facility (N)/
Range Facility (F)
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
N/F
N/F
N/F
N/F
N/F
N/F
N/F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
F
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
F
F
F
F
F
Current
Medicaid
RVU
Current
Medicaid
Conversion
Factor
Current
Medicaid
Fee
4.71
5.84
5.84
4.33
4.33
4.84
4.84
5.88
5.88
6.33
6.33
5.67
5.67
6.30
6.30
7.23
7.23
7.89
7.89
10.82
10.82
16.41
16.41
9.34
9.34
10.21
10.21
10.32
6.85
10.32
6.85
7.44
7.44
3.47
2.28
3.47
2.28
6.84
3.68
6.84
3.68
7.44
4.47
7.44
4.47
8.54
5.14
8.54
5.14
6.41
4.22
6.41
4.22
36.79
36.79
5.89
5.89
56.99
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$125.90
$163.91
$156.11
$121.53
$115.74
$135.85
$129.38
$165.04
$157.18
$177.67
$169.20
$159.14
$151.56
$176.82
$168.40
$202.93
$193.26
$221.45
$210.90
$303.69
$289.22
$460.58
$438.65
$262.15
$249.66
$286.57
$272.92
$289.65
$192.26
$275.86
$183.10
$208.82
$198.87
$97.39
$63.99
$92.75
$60.95
$191.98
$103.29
$182.84
$98.37
$208.82
$125.46
$198.87
$119.49
$239.69
$144.27
$228.28
$137.39
$179.91
$118.44
$171.34
$112.80
$1,032.59
$983.42
$165.32
$157.44
$1,599.55
Current
Current
Percent
Adjusted
Reduction Medicaid Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$125.90
$163.91
$156.11
$121.53
$115.74
$135.85
$129.38
$165.04
$157.18
$177.67
$169.20
$159.14
$151.56
$176.82
$168.40
$202.93
$193.26
$221.45
$210.90
$303.69
$289.22
$460.58
$438.65
$262.15
$249.66
$286.57
$272.92
$289.65
$192.26
$275.86
$183.10
$208.82
$198.87
$97.39
$63.99
$92.75
$60.95
$191.98
$103.29
$182.84
$98.37
$208.82
$125.46
$198.87
$119.49
$239.69
$144.27
$228.28
$137.39
$179.91
$118.44
$171.34
$112.80
$1,032.59
$983.42
$165.32
$157.44
$1,599.55
Medicaid
RVU
Effective
1/1/2016
Medicaid
Percent
Conversion
Medicaid
Reduction
Factor Effective Fee Effective Effective
1/1/2016
1/1/2016
1/1/2016
4.55
5.68
5.68
4.19
4.19
4.70
4.70
5.70
5.70
6.17
6.17
5.51
5.51
6.12
6.12
7.03
7.03
7.68
7.68
10.51
10.51
15.99
15.99
9.11
9.11
9.96
9.96
9.73
6.68
9.73
6.68
7.26
7.26
3.27
2.21
3.27
2.21
6.39
3.58
6.39
3.58
6.92
4.35
6.92
4.35
7.95
4.97
7.95
4.97
6.02
4.08
6.02
4.08
34.97
34.97
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
54.31
$28.0672
$121.62
$159.42
$151.83
$117.60
$112.00
$131.92
$125.63
$159.98
$152.36
$173.17
$164.93
$154.65
$147.29
$171.77
$163.59
$197.31
$187.92
$215.56
$205.29
$294.99
$280.94
$448.79
$427.42
$255.69
$243.51
$279.55
$266.24
$273.09
$187.49
$260.09
$178.56
$203.77
$194.06
$91.78
$62.03
$87.41
$59.07
$179.35
$100.48
$170.81
$95.70
$194.23
$122.09
$184.98
$116.28
$223.13
$139.49
$212.51
$132.85
$168.96
$114.51
$160.92
$109.06
$981.51
$934.77
$157.04
$149.56
$1,524.33
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$121.62
$159.42
$151.83
$117.60
$112.00
$131.92
$125.63
$159.98
$152.36
$173.17
$164.93
$154.65
$147.29
$171.77
$163.59
$197.31
$187.92
$215.56
$205.29
$294.99
$280.94
$448.79
$427.42
$255.69
$243.51
$279.55
$266.24
$273.09
$187.49
$260.09
$178.56
$203.77
$194.06
$91.78
$62.03
$87.41
$59.07
$179.35
$100.48
$170.81
$95.70
$194.23
$122.09
$184.98
$116.28
$223.13
$139.49
$212.51
$132.85
$168.96
$114.51
$160.92
$109.06
$981.51
$934.77
$157.04
$149.56
$1,524.33
Respiratory System Surgery
NonAge
Facility (N)/
Range Facility (F)
TOS*
Procedure
Code
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
31582
31584
31584
31584
31584
31587
31587
31587
31587
31588
31588
31588
31588
31590
31590
31590
31590
31595
31595
31595
31595
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
2
31599
0-999
F
8
2
2
2
8
2
2
2
2
2
2
2
2
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
31599
31600
31600
31601
31601
31603
31603
31605
31605
31610
31610
31611
31611
31611
31611
31612
31612
31613
31613
31614
31614
31615
31615
31615
31615
31620
31620
31620
31620
31622
31622
31622
31622
31623
31623
0-999
0-20
21-999
0-20
0-20
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
F
N/F
N/F
F
F
N/F
N/F
N/F
N/F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
Current
Medicaid
RVU
Current
Medicaid
Conversion
Factor
56.99
45.18
45.18
7.23
7.23
29.87
29.87
4.78
4.78
34.30
34.30
5.49
5.49
27.14
27.14
4.34
4.34
23.05
23.05
3.69
3.69
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
11.75
11.75
7.70
1.23
6.60
6.60
5.42
5.42
21.53
21.53
16.38
16.38
2.62
2.62
1.42
1.42
13.86
13.86
22.98
22.98
5.51
3.83
5.51
3.83
8.67
2.00
8.67
2.00
9.60
4.36
9.60
4.36
10.16
4.37
$28.0672
$26.7305
$28.0672
$28.0672
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
Current
Medicaid
Fee
$1,523.37
$1,268.08
$1,207.68
$202.93
$193.26
$838.37
$798.44
$134.16
$127.77
$962.70
$916.86
$154.09
$146.75
$761.74
$725.47
$121.81
$116.01
$646.95
$616.14
$103.57
$98.64
Manually
Priced
Manually
Priced
$329.79
$314.08
$216.12
$34.52
$185.24
$176.42
$152.12
$144.88
$604.29
$575.51
$459.74
$437.85
$73.54
$70.03
$39.86
$37.96
$389.01
$370.48
$644.98
$614.27
$154.65
$107.50
$147.29
$102.38
$243.34
$56.13
$231.75
$53.46
$269.45
$122.37
$256.61
$116.54
$285.16
$122.65
Current
Current
Percent
Adjusted
Reduction Medicaid Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$1,523.37
$1,268.08
$1,207.68
$202.93
$193.26
$838.37
$798.44
$134.16
$127.77
$962.70
$916.86
$154.09
$146.75
$761.74
$725.47
$121.81
$116.01
$646.95
$616.14
$103.57
$98.64
2%
Manually Priced
2%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Manually Priced
$329.79
$314.08
$216.12
$34.52
$185.24
$176.42
$152.12
$144.88
$604.29
$575.51
$459.74
$437.85
$73.54
$70.03
$39.86
$37.96
$389.01
$370.48
$644.98
$614.27
$154.65
$107.50
$147.29
$102.38
$243.34
$56.13
$231.75
$53.46
$269.45
$122.37
$256.61
$116.54
$285.16
$122.65
Medicaid
RVU
Effective
1/1/2016
Medicaid
Percent
Conversion
Medicaid
Reduction
Factor Effective Fee Effective Effective
1/1/2016
1/1/2016
1/1/2016
54.31
43.29
43.29
$26.7305
$28.0672
$26.7305
28.74
28.74
$28.0672
$26.7305
32.66
32.66
$28.0672
$26.7305
25.45
25.45
$28.0672
$26.7305
21.88
21.88
$28.0672
$26.7305
11.49
11.49
7.91
$28.0672
$26.7305
$28.0672
6.46
6.46
5.32
5.32
20.53
20.53
15.47
15.47
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
1.46
1.46
13.01
13.01
21.69
21.69
5.20
3.71
5.20
3.71
8.20
1.96
8.20
1.96
8.92
4.20
8.92
4.20
9.43
4.23
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$1,451.73
$1,215.03
$1,157.16
$194.40
$185.15
$806.65
$768.23
$129.06
$122.92
$916.67
$873.02
$146.67
$139.68
$714.31
$680.29
$114.29
$108.85
$614.11
$584.86
$98.26
$93.58
Manually
Priced
Manually
Priced
$322.49
$307.13
$222.01
$35.52
$181.31
$172.68
$149.32
$142.21
$576.22
$548.78
$434.20
$413.52
$69.47
$66.16
$40.98
$39.03
$365.15
$347.76
$608.78
$579.78
$145.95
$104.13
$139.00
$99.17
$230.15
$55.01
$219.19
$52.39
$250.36
$117.88
$238.44
$112.27
$264.67
$118.72
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
2%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$1,451.73
$1,215.03
$1,157.16
$194.40
$185.15
$806.65
$768.23
$129.06
$122.92
$916.67
$873.02
$146.67
$139.68
$714.31
$680.29
$114.29
$108.85
$614.11
$584.86
$98.26
$93.58
Manually
Priced
Manually
Priced
$322.49
$307.13
$222.01
$35.52
$181.31
$172.68
$149.32
$142.21
$576.22
$548.78
$434.20
$413.52
$69.47
$66.16
$40.98
$39.03
$365.15
$347.76
$608.78
$579.78
$145.95
$104.13
$139.00
$99.17
$230.15
$55.01
$219.19
$52.39
$250.36
$117.88
$238.44
$112.27
$264.67
$118.72
Respiratory System Surgery
TOS*
Procedure
Code
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
31623
31623
31624
31624
31624
31624
31625
31625
31625
31625
31626
31626
31626
31626
31627
31627
31627
31627
31628
31628
31628
31628
31629
31629
31629
31629
31630
31630
31631
31631
31632
31632
31632
31632
31633
31633
31633
31633
31634
31634
31634
31634
31635
31635
31635
31635
31636
31636
31637
31637
31638
31638
31640
31640
31641
31641
31643
31643
NonAge
Facility (N)/
Range Facility (F)
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N/F
N/F
N/F
N/F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N/F
N/F
F
F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
Current
Medicaid
RVU
Current
Medicaid
Conversion
Factor
Current
Medicaid
Fee
10.16
4.37
9.56
4.40
9.56
4.40
10.23
5.07
10.23
5.07
13.65
6.12
13.65
6.12
41.36
2.81
41.36
2.81
11.53
5.64
11.53
5.64
18.63
6.07
18.63
6.07
5.98
5.98
6.81
6.81
2.15
1.45
2.15
1.45
2.64
1.87
2.64
1.87
60.60
5.95
60.60
5.95
10.57
5.60
10.57
5.60
6.62
6.62
2.19
2.19
7.57
7.57
7.65
7.65
7.67
7.67
5.24
5.24
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$271.58
$116.81
$268.32
$123.50
$255.54
$117.61
$287.13
$142.30
$273.45
$135.52
$383.12
$171.77
$364.87
$163.59
$1,160.86
$78.87
$1,105.57
$75.11
$323.61
$158.30
$308.20
$150.76
$522.89
$170.37
$497.99
$162.25
$167.84
$159.85
$191.14
$182.03
$60.34
$40.70
$57.47
$38.76
$74.10
$52.49
$70.57
$49.99
$1,700.87
$167.00
$1,619.87
$159.05
$296.67
$157.18
$282.54
$149.69
$185.80
$176.96
$61.47
$58.54
$212.47
$202.35
$214.71
$204.49
$215.28
$205.02
$147.07
$140.07
Current
Current
Percent
Adjusted
Reduction Medicaid Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$271.58
$116.81
$268.32
$123.50
$255.54
$117.61
$287.13
$142.30
$273.45
$135.52
$383.12
$171.77
$364.87
$163.59
$1,160.86
$78.87
$1,105.57
$75.11
$323.61
$158.30
$308.20
$150.76
$522.89
$170.37
$497.99
$162.25
$167.84
$159.85
$191.14
$182.03
$60.34
$40.70
$57.47
$38.76
$74.10
$52.49
$70.57
$49.99
$1,700.87
$167.00
$1,619.87
$159.05
$296.67
$157.18
$282.54
$149.69
$185.80
$176.96
$61.47
$58.54
$212.47
$202.35
$214.71
$204.49
$215.28
$205.02
$147.07
$140.07
Medicaid
RVU
Effective
1/1/2016
9.43
4.23
8.93
4.27
8.93
4.27
9.49
4.92
9.49
4.92
12.76
6.14
12.76
6.14
40.13
2.81
40.13
2.81
10.60
5.48
10.60
5.48
16.78
5.91
16.78
5.91
5.79
5.79
6.70
6.70
2.03
1.41
2.03
1.41
2.51
1.83
2.51
1.83
53.50
5.99
53.50
5.99
9.97
5.45
9.97
5.45
6.41
6.41
2.14
2.14
7.34
7.34
7.36
7.36
7.44
7.44
5.10
5.10
Medicaid
Percent
Conversion
Medicaid
Reduction
Factor Effective Fee Effective Effective
1/1/2016
1/1/2016
1/1/2016
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$252.07
$113.07
$250.64
$119.85
$238.70
$114.14
$266.36
$138.09
$253.67
$131.51
$358.14
$172.33
$341.08
$164.13
$1,126.34
$78.87
$1,072.69
$75.11
$297.51
$153.81
$283.34
$146.48
$470.97
$165.88
$448.54
$157.98
$162.51
$154.77
$188.05
$179.09
$56.98
$39.57
$54.26
$37.69
$70.45
$51.36
$67.09
$48.92
$1,501.60
$168.12
$1,430.08
$160.12
$279.83
$152.97
$266.50
$145.68
$179.91
$171.34
$60.06
$57.20
$206.01
$196.20
$206.57
$196.74
$208.82
$198.87
$143.14
$136.33
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$252.07
$113.07
$250.64
$119.85
$238.70
$114.14
$266.36
$138.09
$253.67
$131.51
$358.14
$172.33
$341.08
$164.13
$1,126.34
$78.87
$1,072.69
$75.11
$297.51
$153.81
$283.34
$146.48
$470.97
$165.88
$448.54
$157.98
$162.51
$154.77
$188.05
$179.09
$56.98
$39.57
$54.26
$37.69
$70.45
$51.36
$67.09
$48.92
$1,501.60
$168.12
$1,430.08
$160.12
$279.83
$152.97
$266.50
$145.68
$179.91
$171.34
$60.06
$57.20
$206.01
$196.20
$206.57
$196.74
$208.82
$198.87
$143.14
$136.33
Respiratory System Surgery
TOS*
Procedure
Code
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
31645
31645
31645
31645
31646
31646
31646
31646
31647
31647
31648
31648
31649
31649
31651
31651
31660
31661
31717
31717
31717
31717
31720
31720
31725
31725
31730
31730
31730
31730
31750
31750
31750
31750
31755
31755
31755
31755
31760
31760
31760
31760
31766
31766
31766
31766
31770
31770
31770
31770
31775
31775
31775
31775
31780
31780
31780
31780
NonAge
Facility (N)/
Range Facility (F)
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
N
F
N
F
N
F
N
F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N/F
N
F
N
F
N/F
N/F
N/F
N/F
N
F
N
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
Current
Medicaid
RVU
Current
Medicaid
Conversion
Factor
Current
Medicaid
Fee
9.73
4.80
9.73
4.80
8.82
4.18
8.82
4.18
6.64
6.64
6.94
6.94
2.18
2.18
2.31
2.31
6.66
7.03
8.12
3.25
8.12
3.25
1.47
1.47
2.72
2.72
38.00
4.33
38.00
4.33
41.66
41.66
6.67
6.67
52.44
52.44
8.39
8.39
40.98
40.98
6.56
6.56
53.00
53.00
8.48
8.48
39.72
39.72
6.36
6.36
40.81
40.81
6.53
6.53
35.23
35.23
5.64
5.64
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$273.09
$134.72
$260.09
$128.31
$247.55
$117.32
$235.76
$111.73
$186.37
$177.49
$194.79
$185.51
$61.19
$58.27
$64.84
$61.75
$178.03
$187.92
$227.91
$91.22
$217.05
$86.87
$41.26
$39.29
$76.34
$72.71
$1,066.55
$121.53
$1,015.76
$115.74
$1,169.28
$1,113.59
$187.21
$178.29
$1,471.84
$1,401.75
$235.48
$224.27
$1,150.19
$1,095.42
$184.12
$175.35
$1,487.56
$1,416.72
$238.01
$226.67
$1,114.83
$1,061.74
$178.51
$170.01
$1,145.42
$1,090.87
$183.28
$174.55
$988.81
$941.72
$158.30
$150.76
Current
Current
Percent
Adjusted
Reduction Medicaid Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$273.09
$134.72
$260.09
$128.31
$247.55
$117.32
$235.76
$111.73
$186.37
$177.49
$194.79
$185.51
$61.19
$58.27
$64.84
$61.75
$178.03
$187.92
$227.91
$91.22
$217.05
$86.87
$41.26
$39.29
$76.34
$72.71
$1,066.55
$121.53
$1,015.76
$115.74
$1,169.28
$1,113.59
$187.21
$178.29
$1,471.84
$1,401.75
$235.48
$224.27
$1,150.19
$1,095.42
$184.12
$175.35
$1,487.56
$1,416.72
$238.01
$226.67
$1,114.83
$1,061.74
$178.51
$170.01
$1,145.42
$1,090.87
$183.28
$174.55
$988.81
$941.72
$158.30
$150.76
Medicaid
RVU
Effective
1/1/2016
Medicaid
Percent
Conversion
Medicaid
Reduction
Factor Effective Fee Effective Effective
1/1/2016
1/1/2016
1/1/2016
9.22
4.66
9.22
4.66
8.29
4.04
8.29
4.04
6.44
6.44
5.86
5.86
1.96
1.96
2.14
2.14
6.02
6.30
7.44
3.12
7.44
3.12
1.47
1.47
2.57
2.57
34.89
4.30
34.89
4.30
39.47
39.47
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
49.30
49.30
$28.0672
$26.7305
40.00
40.00
$28.0672
$26.7305
48.91
48.91
$28.0672
$26.7305
38.88
38.88
$28.0672
$26.7305
35.60
35.60
$28.0672
$26.7305
34.22
34.22
$28.0672
$26.7305
$258.78
$130.79
$246.46
$124.56
$232.68
$113.39
$221.60
$107.99
$180.75
$172.14
$164.47
$156.64
$55.01
$52.39
$60.06
$57.20
$160.92
$168.40
$208.82
$87.57
$198.87
$83.40
$41.26
$39.29
$72.13
$68.70
$979.26
$120.69
$932.63
$114.94
$1,107.81
$1,055.05
$177.25
$168.81
$1,383.71
$1,317.81
$221.39
$210.85
$1,122.69
$1,069.22
$179.63
$171.08
$1,372.77
$1,307.39
$219.64
$209.18
$1,091.25
$1,039.28
$174.60
$166.28
$999.19
$951.61
$159.87
$152.26
$960.46
$914.72
$153.67
$146.36
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$258.78
$130.79
$246.46
$124.56
$232.68
$113.39
$221.60
$107.99
$180.75
$172.14
$164.47
$156.64
$55.01
$52.39
$60.06
$57.20
$160.92
$168.40
$208.82
$87.57
$198.87
$83.40
$41.26
$39.29
$72.13
$68.70
$979.26
$120.69
$932.63
$114.94
$1,107.81
$1,055.05
$177.25
$168.81
$1,383.71
$1,317.81
$221.39
$210.85
$1,122.69
$1,069.22
$179.63
$171.08
$1,372.77
$1,307.39
$219.64
$209.18
$1,091.25
$1,039.28
$174.60
$166.28
$999.19
$951.61
$159.87
$152.26
$960.46
$914.72
$153.67
$146.36
Respiratory System Surgery
NonAge
Facility (N)/
Range Facility (F)
Current
Medicaid
RVU
Current
Medicaid
Conversion
Factor
Current
Medicaid
Fee
TOS*
Procedure
Code
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
8
8
2
2
2
2
2
2
2
2
31781
31781
31781
31781
31785
31785
31785
31785
31786
31786
31786
31786
31800
31800
31805
31805
31805
31805
31820
31820
31825
31825
31830
31830
31830
31830
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
45.67
45.67
7.31
7.31
32.12
32.12
5.14
5.14
43.03
43.03
6.88
6.88
22.05
22.05
24.44
24.44
3.91
3.91
9.91
9.91
14.42
14.42
13.60
10.38
13.60
10.38
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
31899
32035
32035
32035
32035
32036
32036
32036
32036
32096
32096
32096
32096
32097
32097
32097
32097
32098
32098
32098
32098
32100
32100
32100
32100
32110
32110
32110
32110
32120
32120
32120
0-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
$1,281.83
$1,220.78
$205.17
$195.40
$901.52
$858.58
$144.27
$137.39
$1,207.73
$1,150.21
$193.10
$183.91
$618.88
$589.41
$685.96
$653.29
$109.74
$104.52
$278.15
$264.90
$404.73
$385.45
$381.71
$291.34
$363.53
$277.46
Manually
Priced
21.74
21.74
3.48
3.48
23.40
23.40
3.74
3.74
24.27
24.27
3.88
3.88
24.27
24.27
3.88
3.88
23.53
23.53
3.76
3.76
24.48
24.48
3.92
3.92
43.81
43.81
7.01
7.01
26.18
26.18
4.19
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$610.18
$581.12
$97.67
$93.02
$656.77
$625.49
$104.97
$99.97
$681.19
$648.75
$108.90
$103.71
$681.19
$648.75
$108.90
$103.71
$660.42
$628.97
$105.53
$100.51
$687.09
$654.36
$110.02
$104.78
$1,229.62
$1,171.06
$196.75
$187.38
$734.80
$699.80
$117.60
Current
Current
Percent
Adjusted
Reduction Medicaid Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$1,281.83
$1,220.78
$205.17
$195.40
$901.52
$858.58
$144.27
$137.39
$1,207.73
$1,150.21
$193.10
$183.91
$618.88
$589.41
$685.96
$653.29
$109.74
$104.52
$278.15
$264.90
$404.73
$385.45
$381.71
$291.34
$363.53
$277.46
2%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Manually Priced
$610.18
$581.12
$97.67
$93.02
$656.77
$625.49
$104.97
$99.97
$681.19
$648.75
$108.90
$103.71
$681.19
$648.75
$108.90
$103.71
$660.42
$628.97
$105.53
$100.51
$687.09
$654.36
$110.02
$104.78
$1,229.62
$1,171.06
$196.75
$187.38
$734.80
$699.80
$117.60
Medicaid
RVU
Effective
1/1/2016
Medicaid
Percent
Conversion
Medicaid
Reduction
Factor Effective Fee Effective Effective
1/1/2016
1/1/2016
1/1/2016
40.42
40.42
$28.0672
$26.7305
30.95
30.95
$28.0672
$26.7305
45.84
45.84
$28.0672
$26.7305
20.41
20.41
23.75
23.75
$28.0672
$26.7305
$28.0672
$26.7305
9.40
9.40
13.80
13.80
12.68
9.84
12.68
9.84
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
21.02
21.02
$28.0672
$26.7305
22.56
22.56
$28.0672
$26.7305
23.37
23.37
$28.0672
$26.7305
23.37
23.37
$28.0672
$26.7305
22.15
22.15
$28.0672
$26.7305
23.49
23.49
$28.0672
$26.7305
42.45
42.45
$28.0672
$26.7305
25.23
25.23
$28.0672
$26.7305
$1,134.48
$1,080.45
$181.52
$172.87
$868.68
$827.31
$138.99
$132.37
$1,286.60
$1,225.33
$205.86
$196.05
$572.85
$545.57
$666.60
$634.85
$106.66
$101.58
$263.83
$251.27
$387.33
$368.88
$355.89
$276.18
$338.94
$263.03
Manually
Priced
$589.97
$561.88
$94.40
$89.90
$633.20
$603.04
$101.31
$96.49
$655.93
$624.69
$104.95
$99.95
$655.93
$624.69
$104.95
$99.95
$621.69
$592.08
$99.47
$94.73
$659.30
$627.90
$105.49
$100.46
$1,191.45
$1,134.71
$190.63
$181.55
$708.14
$674.41
$113.30
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$1,134.48
$1,080.45
$181.52
$172.87
$868.68
$827.31
$138.99
$132.37
$1,286.60
$1,225.33
$205.86
$196.05
$572.85
$545.57
$666.60
$634.85
$106.66
$101.58
$263.83
$251.27
$387.33
$368.88
$355.89
$276.18
$338.94
$263.03
Manually
Priced
$589.97
$561.88
$94.40
$89.90
$633.20
$603.04
$101.31
$96.49
$655.93
$624.69
$104.95
$99.95
$655.93
$624.69
$104.95
$99.95
$621.69
$592.08
$99.47
$94.73
$659.30
$627.90
$105.49
$100.46
$1,191.45
$1,134.71
$190.63
$181.55
$708.14
$674.41
$113.30
Respiratory System Surgery
TOS*
Procedure
Code
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
2
2
2
32120
32124
32124
32124
32124
32140
32140
32140
32140
32141
32141
32141
32141
32150
32150
32150
32150
32151
32151
32151
32151
32160
32160
32160
32160
32200
32200
32200
32200
32215
32215
32215
32215
32220
32220
32220
32220
32225
32225
32225
32225
32310
32310
32310
32310
32320
32320
32320
32320
32400
32400
32400
32400
32405
32405
32405
32405
32440
NonAge
Facility (N)/
Range Facility (F)
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
F
Current
Medicaid
RVU
Current
Medicaid
Conversion
Factor
Current
Medicaid
Fee
4.19
27.89
27.89
4.46
4.46
29.71
29.71
4.75
4.75
45.60
45.60
7.30
7.30
30.10
30.10
4.82
4.82
30.16
30.16
4.83
4.83
23.67
23.67
3.79
3.79
33.95
33.95
5.43
5.43
24.05
24.05
3.85
3.85
47.66
47.66
7.63
7.63
29.85
29.85
4.78
4.78
27.51
27.51
4.40
4.40
47.90
47.90
7.66
7.66
4.47
2.55
4.47
2.55
13.59
3.03
13.59
3.03
46.83
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$112.00
$782.79
$745.51
$125.18
$119.22
$833.88
$794.16
$133.32
$126.97
$1,279.86
$1,218.91
$204.89
$195.13
$844.82
$804.59
$135.28
$128.84
$846.51
$806.19
$135.56
$129.11
$664.35
$632.71
$106.37
$101.31
$952.88
$907.50
$152.40
$145.15
$675.02
$642.87
$108.06
$102.91
$1,337.68
$1,273.98
$214.15
$203.95
$837.81
$797.91
$134.16
$127.77
$772.13
$735.36
$123.50
$117.61
$1,344.42
$1,280.39
$214.99
$204.76
$125.46
$71.57
$119.49
$68.16
$381.43
$85.04
$363.27
$80.99
$1,314.39
Current
Current
Percent
Adjusted
Reduction Medicaid Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$112.00
$782.79
$745.51
$125.18
$119.22
$833.88
$794.16
$133.32
$126.97
$1,279.86
$1,218.91
$204.89
$195.13
$844.82
$804.59
$135.28
$128.84
$846.51
$806.19
$135.56
$129.11
$664.35
$632.71
$106.37
$101.31
$952.88
$907.50
$152.40
$145.15
$675.02
$642.87
$108.06
$102.91
$1,337.68
$1,273.98
$214.15
$203.95
$837.81
$797.91
$134.16
$127.77
$772.13
$735.36
$123.50
$117.61
$1,344.42
$1,280.39
$214.99
$204.76
$125.46
$71.57
$119.49
$68.16
$381.43
$85.04
$363.27
$80.99
$1,314.39
Medicaid
RVU
Effective
1/1/2016
Medicaid
Percent
Conversion
Medicaid
Reduction
Factor Effective Fee Effective Effective
1/1/2016
1/1/2016
1/1/2016
26.93
26.93
$28.0672
$26.7305
28.96
28.96
$28.0672
$26.7305
44.27
44.27
$28.0672
$26.7305
29.22
29.22
$28.0672
$26.7305
29.38
29.38
$28.0672
$26.7305
22.86
22.86
$28.0672
$26.7305
33.26
33.26
$28.0672
$26.7305
23.25
23.25
$28.0672
$26.7305
45.96
45.96
$28.0672
$26.7305
28.82
28.82
$28.0672
$26.7305
26.20
26.20
$28.0672
$26.7305
46.40
46.40
$28.0672
$26.7305
4.34
2.54
4.34
2.54
12.80
3.02
12.80
3.02
45.43
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$107.91
$755.85
$719.85
$120.94
$115.18
$812.83
$774.12
$130.05
$123.86
$1,242.53
$1,183.36
$198.80
$189.34
$820.12
$781.07
$131.22
$124.97
$824.61
$785.34
$131.94
$125.65
$641.62
$611.06
$102.66
$97.77
$933.52
$889.06
$149.36
$142.25
$652.56
$621.48
$104.41
$99.44
$1,289.97
$1,228.53
$206.40
$196.56
$808.90
$770.37
$129.42
$123.26
$735.36
$700.34
$117.66
$112.05
$1,302.32
$1,240.30
$208.37
$198.45
$121.81
$71.29
$116.01
$67.90
$359.26
$84.76
$342.15
$80.73
$1,275.09
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$107.91
$755.85
$719.85
$120.94
$115.18
$812.83
$774.12
$130.05
$123.86
$1,242.53
$1,183.36
$198.80
$189.34
$820.12
$781.07
$131.22
$124.97
$824.61
$785.34
$131.94
$125.65
$641.62
$611.06
$102.66
$97.77
$933.52
$889.06
$149.36
$142.25
$652.56
$621.48
$104.41
$99.44
$1,289.97
$1,228.53
$206.40
$196.56
$808.90
$770.37
$129.42
$123.26
$735.36
$700.34
$117.66
$112.05
$1,302.32
$1,240.30
$208.37
$198.45
$121.81
$71.29
$116.01
$67.90
$359.26
$84.76
$342.15
$80.73
$1,275.09
Respiratory System Surgery
TOS*
Procedure
Code
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
32440
32440
32440
32442
32442
32442
32442
32445
32445
32445
32445
32480
32480
32480
32480
32482
32482
32482
32482
32484
32484
32484
32484
32486
32486
32486
32486
32488
32488
32488
32488
32491
32491
32491
32491
32501
32501
32501
32501
32503
32503
32503
32503
32504
32504
32504
32504
32505
32505
32505
32505
32506
32506
32506
32506
32507
32507
32507
NonAge
Facility (N)/
Range Facility (F)
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
Current
Medicaid
RVU
Current
Medicaid
Conversion
Factor
46.83
7.49
7.49
91.19
91.19
14.59
14.59
105.34
105.34
16.85
16.85
44.30
44.30
7.09
7.09
47.42
47.42
7.59
7.59
42.96
42.96
6.87
6.87
70.15
70.15
11.22
11.22
71.14
71.14
11.38
11.38
44.01
44.01
7.04
7.04
7.27
7.27
1.16
1.16
54.08
54.08
8.65
8.65
61.07
61.07
9.77
9.77
28.71
28.71
4.59
4.59
4.93
4.93
0.79
0.79
4.93
4.93
0.79
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
Current
Medicaid
Fee
$1,251.79
$210.22
$200.21
$2,559.45
$2,437.55
$409.50
$390.00
$2,956.60
$2,815.79
$472.93
$450.41
$1,243.38
$1,184.16
$199.00
$189.52
$1,330.95
$1,267.56
$213.03
$202.88
$1,205.77
$1,148.34
$192.82
$183.64
$1,968.91
$1,875.14
$314.91
$299.92
$1,996.70
$1,901.61
$319.40
$304.19
$1,235.24
$1,176.41
$197.59
$188.18
$204.05
$194.33
$32.56
$31.01
$1,517.87
$1,445.59
$242.78
$231.22
$1,714.06
$1,632.43
$274.22
$261.16
$805.81
$767.43
$128.83
$122.69
$138.37
$131.78
$22.17
$21.12
$138.37
$131.78
$22.17
Current
Current
Percent
Adjusted
Reduction Medicaid Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$1,251.79
$210.22
$200.21
$2,559.45
$2,437.55
$409.50
$390.00
$2,956.60
$2,815.79
$472.93
$450.41
$1,243.38
$1,184.16
$199.00
$189.52
$1,330.95
$1,267.56
$213.03
$202.88
$1,205.77
$1,148.34
$192.82
$183.64
$1,968.91
$1,875.14
$314.91
$299.92
$1,996.70
$1,901.61
$319.40
$304.19
$1,235.24
$1,176.41
$197.59
$188.18
$204.05
$194.33
$32.56
$31.01
$1,517.87
$1,445.59
$242.78
$231.22
$1,714.06
$1,632.43
$274.22
$261.16
$805.81
$767.43
$128.83
$122.69
$138.37
$131.78
$22.17
$21.12
$138.37
$131.78
$22.17
Medicaid
RVU
Effective
1/1/2016
Medicaid
Percent
Conversion
Medicaid
Reduction
Factor Effective Fee Effective Effective
1/1/2016
1/1/2016
1/1/2016
45.43
$26.7305
$1,214.37
$204.01
$194.30
89.58
89.58
$28.0672
$26.7305
103.29
103.29
$28.0672
$26.7305
42.92
42.92
$28.0672
$26.7305
46.03
46.03
$28.0672
$26.7305
41.78
41.78
$28.0672
$26.7305
68.44
68.44
$28.0672
$26.7305
70.26
70.26
$28.0672
$26.7305
42.96
42.96
$28.0672
$26.7305
7.14
7.14
$28.0672
$26.7305
52.66
52.66
$28.0672
$26.7305
60.42
60.42
$28.0672
$26.7305
27.07
27.07
$28.0672
$26.7305
4.58
4.58
$28.0672
$26.7305
4.57
4.57
$28.0672
$26.7305
$2,514.26
$2,394.52
$402.28
$383.12
$2,899.06
$2,760.99
$463.85
$441.76
$1,204.64
$1,147.27
$192.74
$183.56
$1,291.93
$1,230.40
$206.71
$196.86
$1,172.65
$1,116.80
$187.62
$178.69
$1,920.92
$1,829.44
$307.35
$292.71
$1,972.00
$1,878.08
$315.52
$300.49
$1,205.77
$1,148.34
$192.92
$183.73
$200.40
$190.86
$32.06
$30.54
$1,478.02
$1,407.63
$236.48
$225.22
$1,695.82
$1,615.06
$271.33
$258.41
$759.78
$723.59
$121.56
$115.77
$128.55
$122.43
$20.57
$19.59
$128.27
$122.16
$20.52
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$1,214.37
$204.01
$194.30
$2,514.26
$2,394.52
$402.28
$383.12
$2,899.06
$2,760.99
$463.85
$441.76
$1,204.64
$1,147.27
$192.74
$183.56
$1,291.93
$1,230.40
$206.71
$196.86
$1,172.65
$1,116.80
$187.62
$178.69
$1,920.92
$1,829.44
$307.35
$292.71
$1,972.00
$1,878.08
$315.52
$300.49
$1,205.77
$1,148.34
$192.92
$183.73
$200.40
$190.86
$32.06
$30.54
$1,478.02
$1,407.63
$236.48
$225.22
$1,695.82
$1,615.06
$271.33
$258.41
$759.78
$723.59
$121.56
$115.77
$128.55
$122.43
$20.57
$19.59
$128.27
$122.16
$20.52
Respiratory System Surgery
TOS*
Procedure
Code
8
2
2
8
8
2
2
2
2
2
2
2
2
2
2
8
8
8
8
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
8
8
8
8
2
2
2
2
8
8
8
8
2
2
2
2
2
32507
32540
32540
32540
32540
32550
32550
32551
32551
32552
32552
32553
32553
32553
32553
32553
32553
32553
32553
32554
32554
32554
32554
32555
32555
32555
32555
32556
32556
32556
32556
32557
32557
32557
32557
32560
32560
32561
32561
32561
32561
32561
32561
32561
32561
32562
32562
32562
32562
32562
32562
32562
32562
32601
32601
32604
32604
32606
NonAge
Facility (N)/
Range Facility (F)
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
0-20
21-999
21-999
0-20
21-999
0-20
21-999
0-20
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
F
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
F
F
F
F
F
Current
Medicaid
RVU
Current
Medicaid
Conversion
Factor
Current
Medicaid
Fee
0.79
51.61
51.61
8.26
8.26
6.63
6.63
5.23
5.23
4.99
4.99
17.59
6.19
17.59
6.19
2.81
0.99
2.81
0.99
16.65
2.64
16.65
2.64
19.20
3.30
19.20
3.30
17.55
3.62
17.55
3.62
28.49
4.88
28.49
4.88
2.33
2.33
2.84
2.10
2.84
2.10
0.45
0.34
0.45
0.34
2.57
1.88
2.57
1.88
0.41
0.30
0.41
0.30
9.24
9.24
14.34
14.34
13.81
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$21.12
$1,448.55
$1,379.56
$231.84
$220.79
$186.09
$177.22
$146.79
$139.80
$140.06
$133.39
$493.70
$173.74
$470.19
$165.46
$78.87
$27.79
$75.11
$26.46
$467.32
$74.10
$445.06
$70.57
$538.89
$92.62
$513.23
$88.21
$492.58
$101.60
$469.12
$96.76
$799.63
$136.97
$761.55
$130.44
$65.40
$62.28
$79.71
$58.94
$75.91
$56.13
$12.63
$9.54
$12.03
$9.09
$72.13
$52.77
$68.70
$50.25
$11.51
$8.42
$10.96
$8.02
$259.34
$246.99
$402.48
$383.32
$387.61
Current
Current
Percent
Adjusted
Reduction Medicaid Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$21.12
$1,448.55
$1,379.56
$231.84
$220.79
$186.09
$177.22
$146.79
$139.80
$140.06
$133.39
$493.70
$173.74
$470.19
$165.46
$78.87
$27.79
$75.11
$26.46
$467.32
$74.10
$445.06
$70.57
$538.89
$92.62
$513.23
$88.21
$492.58
$101.60
$469.12
$96.76
$799.63
$136.97
$761.55
$130.44
$65.40
$62.28
$79.71
$58.94
$75.91
$56.13
$12.63
$9.54
$12.03
$9.09
$72.13
$52.77
$68.70
$50.25
$11.51
$8.42
$10.96
$8.02
$259.34
$246.99
$402.48
$383.32
$387.61
Medicaid
RVU
Effective
1/1/2016
Medicaid
Percent
Conversion
Medicaid
Reduction
Factor Effective Fee Effective Effective
1/1/2016
1/1/2016
1/1/2016
50.35
50.35
$28.0672
$26.7305
6.47
6.47
4.93
4.93
4.63
4.63
16.84
5.64
16.84
5.64
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
5.71
2.58
5.71
2.58
8.21
3.27
8.21
3.27
15.76
3.57
15.76
3.57
14.52
4.47
14.52
4.47
2.27
2.27
2.66
1.99
2.66
1.99
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
2.41
1.80
2.41
1.80
$28.0672
$28.0672
$26.7305
$26.7305
8.96
8.96
14.08
14.08
13.42
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$19.55
$1,413.18
$1,345.88
$226.11
$215.34
$181.59
$172.95
$138.37
$131.78
$129.95
$123.76
$472.65
$158.30
$450.14
$150.76
$75.62
$25.33
$72.02
$24.12
$160.26
$72.41
$152.63
$68.96
$230.43
$91.78
$219.46
$87.41
$442.34
$100.20
$421.27
$95.43
$407.54
$125.46
$388.13
$119.49
$63.71
$60.68
$74.66
$55.85
$71.10
$53.19
$11.95
$8.94
$11.38
$8.51
$67.64
$50.52
$64.42
$48.11
$10.82
$8.08
$10.31
$7.70
$251.48
$239.51
$395.19
$376.37
$376.66
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$19.55
$1,413.18
$1,345.88
$226.11
$215.34
$181.59
$172.95
$138.37
$131.78
$129.95
$123.76
$472.65
$158.30
$450.14
$150.76
$75.62
$25.33
$72.02
$24.12
$160.26
$72.41
$152.63
$68.96
$230.43
$91.78
$219.46
$87.41
$442.34
$100.20
$421.27
$95.43
$407.54
$125.46
$388.13
$119.49
$63.71
$60.68
$74.66
$55.85
$71.10
$53.19
$11.95
$8.94
$11.38
$8.51
$67.64
$50.52
$64.42
$48.11
$10.82
$8.08
$10.31
$7.70
$251.48
$239.51
$395.19
$376.37
$376.66
Respiratory System Surgery
TOS*
Procedure
Code
2
2
2
2
2
2
2
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
32606
32607
32607
32608
32608
32609
32609
32650
32650
32650
32650
32651
32651
32651
32651
32652
32652
32652
32652
32653
32653
32653
32653
32654
32654
32654
32654
32655
32655
32655
32655
32656
32656
32656
32656
32658
32658
32658
32658
32659
32659
32659
32659
32661
32661
32661
32661
32662
32662
32662
32662
32663
32663
32663
32663
32664
32664
32664
NonAge
Facility (N)/
Range Facility (F)
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
Current
Medicaid
RVU
Current
Medicaid
Conversion
Factor
Current
Medicaid
Fee
13.81
9.58
9.58
11.79
11.79
8.12
8.12
20.03
20.03
3.20
3.20
32.78
32.78
5.24
5.24
49.64
49.64
7.94
7.94
31.60
31.60
5.06
5.06
35.25
35.25
5.64
5.64
28.72
28.72
4.60
4.60
23.92
23.92
3.83
3.83
21.41
21.41
3.43
3.43
21.86
21.86
3.50
3.50
23.93
23.93
3.83
3.83
26.69
26.69
4.27
4.27
41.86
41.86
6.70
6.70
25.41
25.41
4.07
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$369.15
$268.88
$256.08
$330.91
$315.15
$227.91
$217.05
$562.19
$535.41
$89.82
$85.54
$920.04
$876.23
$147.07
$140.07
$1,393.26
$1,326.90
$222.85
$212.24
$886.92
$844.68
$142.02
$135.26
$989.37
$942.25
$158.30
$150.76
$806.09
$767.70
$129.11
$122.96
$671.37
$639.39
$107.50
$102.38
$600.92
$572.30
$96.27
$91.69
$613.55
$584.33
$98.24
$93.56
$671.65
$639.66
$107.50
$102.38
$749.11
$713.44
$119.85
$114.14
$1,174.89
$1,118.94
$188.05
$179.09
$713.19
$679.22
$114.23
Current
Current
Percent
Adjusted
Reduction Medicaid Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$369.15
$268.88
$256.08
$330.91
$315.15
$227.91
$217.05
$562.19
$535.41
$89.82
$85.54
$920.04
$876.23
$147.07
$140.07
$1,393.26
$1,326.90
$222.85
$212.24
$886.92
$844.68
$142.02
$135.26
$989.37
$942.25
$158.30
$150.76
$806.09
$767.70
$129.11
$122.96
$671.37
$639.39
$107.50
$102.38
$600.92
$572.30
$96.27
$91.69
$613.55
$584.33
$98.24
$93.56
$671.65
$639.66
$107.50
$102.38
$749.11
$713.44
$119.85
$114.14
$1,174.89
$1,118.94
$188.05
$179.09
$713.19
$679.22
$114.23
Medicaid
RVU
Effective
1/1/2016
Medicaid
Percent
Conversion
Medicaid
Reduction
Factor Effective Fee Effective Effective
1/1/2016
1/1/2016
1/1/2016
13.42
8.98
8.98
11.02
11.02
7.54
7.54
19.30
19.30
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
31.86
31.86
$28.0672
$26.7305
48.27
48.27
$28.0672
$26.7305
30.75
30.75
$28.0672
$26.7305
33.21
33.21
$28.0672
$26.7305
27.74
27.74
$28.0672
$26.7305
23.31
23.31
$28.0672
$26.7305
20.82
20.82
$28.0672
$26.7305
21.27
21.27
$28.0672
$26.7305
23.29
23.29
$28.0672
$26.7305
25.97
25.97
$28.0672
$26.7305
40.72
40.72
$28.0672
$26.7305
24.74
24.74
$28.0672
$26.7305
$358.72
$252.04
$240.04
$309.30
$294.57
$211.63
$201.55
$541.70
$515.90
$86.67
$82.54
$894.22
$851.63
$143.08
$136.26
$1,354.80
$1,290.28
$216.77
$206.44
$863.07
$821.96
$138.09
$131.51
$932.11
$887.72
$149.14
$142.04
$778.58
$741.50
$124.57
$118.64
$654.25
$623.09
$104.68
$99.69
$584.36
$556.53
$93.50
$89.04
$596.99
$568.56
$95.52
$90.97
$653.69
$622.55
$104.59
$99.61
$728.91
$694.19
$116.63
$111.07
$1,142.90
$1,088.47
$182.86
$174.16
$694.38
$661.31
$111.10
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$358.72
$252.04
$240.04
$309.30
$294.57
$211.63
$201.55
$541.70
$515.90
$86.67
$82.54
$894.22
$851.63
$143.08
$136.26
$1,354.80
$1,290.28
$216.77
$206.44
$863.07
$821.96
$138.09
$131.51
$932.11
$887.72
$149.14
$142.04
$778.58
$741.50
$124.57
$118.64
$654.25
$623.09
$104.68
$99.69
$584.36
$556.53
$93.50
$89.04
$596.99
$568.56
$95.52
$90.97
$653.69
$622.55
$104.59
$99.61
$728.91
$694.19
$116.63
$111.07
$1,142.90
$1,088.47
$182.86
$174.16
$694.38
$661.31
$111.10
Respiratory System Surgery
TOS*
Procedure
Code
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
32664
32665
32665
32665
32665
32666
32666
32666
32666
32667
32667
32667
32667
32668
32668
32668
32668
32669
32669
32669
32669
32670
32670
32670
32670
32671
32671
32671
32671
32672
32672
32672
32672
32673
32673
32673
32673
32674
32674
32674
32674
32800
32800
32800
32800
32810
32810
32810
32810
32815
32815
32815
32815
32820
32820
32820
32820
32851
NonAge
Facility (N)/
Range Facility (F)
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
Current
Medicaid
RVU
Current
Medicaid
Conversion
Factor
4.07
36.40
36.40
5.82
5.82
26.73
26.73
4.28
4.28
4.93
4.93
0.79
0.79
4.95
4.95
0.79
0.79
40.19
40.19
6.43
6.43
47.92
47.92
7.67
7.67
53.11
53.11
8.50
8.50
45.46
45.46
7.27
7.27
35.81
35.81
5.73
5.73
6.42
6.42
1.03
1.03
28.27
28.27
4.52
4.52
27.03
27.03
4.32
4.32
83.87
83.87
13.42
13.42
42.19
42.19
6.75
6.75
98.00
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
Current
Medicaid
Fee
$108.79
$1,021.65
$972.99
$163.35
$155.57
$750.24
$714.51
$120.13
$114.41
$138.37
$131.78
$22.17
$21.12
$138.93
$132.32
$22.17
$21.12
$1,128.02
$1,074.30
$180.47
$171.88
$1,344.98
$1,280.93
$215.28
$205.02
$1,490.65
$1,419.66
$238.57
$227.21
$1,275.93
$1,215.17
$204.05
$194.33
$1,005.09
$957.22
$160.83
$153.17
$180.19
$171.61
$28.91
$27.53
$793.46
$755.67
$126.86
$120.82
$758.66
$722.53
$121.25
$115.48
$2,354.00
$2,241.89
$376.66
$358.72
$1,184.16
$1,127.76
$189.45
$180.43
$2,750.59
Current
Current
Percent
Adjusted
Reduction Medicaid Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$108.79
$1,021.65
$972.99
$163.35
$155.57
$750.24
$714.51
$120.13
$114.41
$138.37
$131.78
$22.17
$21.12
$138.93
$132.32
$22.17
$21.12
$1,128.02
$1,074.30
$180.47
$171.88
$1,344.98
$1,280.93
$215.28
$205.02
$1,490.65
$1,419.66
$238.57
$227.21
$1,275.93
$1,215.17
$204.05
$194.33
$1,005.09
$957.22
$160.83
$153.17
$180.19
$171.61
$28.91
$27.53
$793.46
$755.67
$126.86
$120.82
$758.66
$722.53
$121.25
$115.48
$2,354.00
$2,241.89
$376.66
$358.72
$1,184.16
$1,127.76
$189.45
$180.43
$2,750.59
Medicaid
RVU
Effective
1/1/2016
Medicaid
Percent
Conversion
Medicaid
Reduction
Factor Effective Fee Effective Effective
1/1/2016
1/1/2016
1/1/2016
36.02
36.02
$28.0672
$26.7305
25.30
25.30
$28.0672
$26.7305
4.59
4.59
$28.0672
$26.7305
4.58
4.58
$28.0672
$26.7305
39.10
39.10
$28.0672
$26.7305
46.66
46.66
$28.0672
$26.7305
51.97
51.97
$28.0672
$26.7305
44.21
44.21
$28.0672
$26.7305
35.41
35.41
$28.0672
$26.7305
6.30
6.30
$28.0672
$26.7305
27.73
27.73
$28.0672
$26.7305
26.31
26.31
$28.0672
$26.7305
81.53
81.53
$28.0672
$26.7305
40.77
40.77
$28.0672
$26.7305
95.83
$28.0672
$105.81
$1,010.98
$962.83
$161.76
$154.05
$710.10
$676.28
$113.62
$108.20
$128.83
$122.69
$20.61
$19.63
$128.55
$122.43
$20.57
$19.59
$1,097.43
$1,045.16
$175.59
$167.23
$1,309.62
$1,247.25
$209.54
$199.56
$1,458.65
$1,389.18
$233.38
$222.27
$1,240.85
$1,181.76
$198.54
$189.08
$993.86
$946.53
$159.02
$151.44
$176.82
$168.40
$28.29
$26.94
$778.30
$741.24
$124.53
$118.60
$738.45
$703.28
$118.15
$112.52
$2,288.32
$2,179.34
$366.13
$348.69
$1,144.30
$1,089.80
$183.09
$174.37
$2,689.68
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$105.81
$1,010.98
$962.83
$161.76
$154.05
$710.10
$676.28
$113.62
$108.20
$128.83
$122.69
$20.61
$19.63
$128.55
$122.43
$20.57
$19.59
$1,097.43
$1,045.16
$175.59
$167.23
$1,309.62
$1,247.25
$209.54
$199.56
$1,458.65
$1,389.18
$233.38
$222.27
$1,240.85
$1,181.76
$198.54
$189.08
$993.86
$946.53
$159.02
$151.44
$176.82
$168.40
$28.29
$26.94
$778.30
$741.24
$124.53
$118.60
$738.45
$703.28
$118.15
$112.52
$2,288.32
$2,179.34
$366.13
$348.69
$1,144.30
$1,089.80
$183.09
$174.37
$2,689.68
Respiratory System Surgery
NonAge
Facility (N)/
Range Facility (F)
TOS*
Procedure
Code
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
8
8
2
2
2
2
2
2
32851
32851
32851
32852
32852
32852
32852
32853
32853
32853
32853
32854
32854
32854
32854
32855
32855
32855
32855
32856
32856
32856
32856
32900
32900
32900
32900
32905
32905
32905
32905
32906
32906
32906
32906
32940
32940
32940
32940
32960
32960
32960
32960
32997
32997
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
21-999
0-20
0-20
21-999
21-999
0-20
21-999
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
N
F
N
F
F
F
2
32999
0-999
F
Current
Medicaid
RVU
Current
Medicaid
Conversion
Factor
98.00
15.68
15.68
107.05
107.05
17.13
17.13
136.93
136.93
21.91
21.91
145.53
145.53
23.28
23.28
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
41.58
41.58
6.65
6.65
39.93
39.93
6.39
6.39
49.27
49.27
7.88
7.88
36.93
36.93
5.91
5.91
4.55
3.07
4.55
3.07
10.53
10.53
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$26.7305
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
*Type of Service (TOS): 2 = Surgery, 8 = Assistant Surgery
Current
Medicaid
Fee
$2,619.59
$440.09
$419.13
$3,004.59
$2,861.50
$480.79
$457.89
$3,843.24
$3,660.21
$614.95
$585.67
$4,084.62
$3,890.09
$653.40
$622.29
$258.75
$246.43
$41.40
$39.43
$361.32
$344.12
$57.81
$55.06
$1,167.03
$1,111.45
$186.65
$177.76
$1,120.72
$1,067.35
$179.35
$170.81
$1,382.87
$1,317.01
$221.17
$210.64
$1,036.52
$987.16
$165.88
$157.98
$127.71
$86.17
$121.62
$82.06
$295.55
$281.47
Manually
Priced
Current
Current
Percent
Adjusted
Reduction Medicaid Fee
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
$2,619.59
$440.09
$419.13
$3,004.59
$2,861.50
$480.79
$457.89
$3,843.24
$3,660.21
$614.95
$585.67
$4,084.62
$3,890.09
$653.40
$622.29
$258.75
$246.43
$41.40
$39.43
$361.32
$344.12
$57.81
$55.06
$1,167.03
$1,111.45
$186.65
$177.76
$1,120.72
$1,067.35
$179.35
$170.81
$1,382.87
$1,317.01
$221.17
$210.64
$1,036.52
$987.16
$165.88
$157.98
$127.71
$86.17
$121.62
$82.06
$295.55
$281.47
2%
Manually Priced
Medicaid
RVU
Effective
1/1/2016
Medicaid
Percent
Conversion
Medicaid
Reduction
Factor Effective Fee Effective Effective
1/1/2016
1/1/2016
1/1/2016
95.83
$26.7305
105.04
105.04
$28.0672
$26.7305
133.96
133.96
$28.0672
$26.7305
142.19
142.19
$28.0672
$26.7305
41.46
41.46
$28.0672
$26.7305
39.03
39.03
$28.0672
$26.7305
48.21
48.21
$28.0672
$26.7305
36.07
36.07
$28.0672
$26.7305
3.61
2.64
3.61
2.64
9.87
9.87
$28.0672
$28.0672
$26.7305
$26.7305
$28.0672
$26.7305
$2,561.58
$430.35
$409.85
$2,948.18
$2,807.77
$471.71
$449.24
$3,759.88
$3,580.82
$601.58
$572.93
$3,990.88
$3,800.81
$638.54
$608.13
$260.38
$247.98
$41.66
$39.68
$363.60
$346.28
$58.18
$55.41
$1,163.67
$1,108.25
$186.19
$177.32
$1,095.46
$1,043.29
$175.27
$166.93
$1,353.12
$1,288.68
$216.50
$206.19
$1,012.38
$964.17
$161.98
$154.27
$101.32
$74.10
$96.50
$70.57
$277.02
$263.83
Manually
Priced
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
0%
2%
Adjusted
Medicaid
Fee
Effective
1/1/2016
$2,561.58
$430.35
$409.85
$2,948.18
$2,807.77
$471.71
$449.24
$3,759.88
$3,580.82
$601.58
$572.93
$3,990.88
$3,800.81
$638.54
$608.13
$260.38
$247.98
$41.66
$39.68
$363.60
$346.28
$58.18
$55.41
$1,163.67
$1,108.25
$186.19
$177.32
$1,095.46
$1,043.29
$175.27
$166.93
$1,353.12
$1,288.68
$216.50
$206.19
$1,012.38
$964.17
$161.98
$154.27
$101.32
$74.10
$96.50
$70.57
$277.02
$263.83
Manually
Priced
T Codes (Registered nurse services, sign language or oral interpretive services, screening for specified
programs, and environmental lead investigation)
TOS*
D
D
1
1
D
D
S
Procedure Modifier
Code
**
T1002
T1003
T1013
T1013
T1023
T1023
T1029
U1
UA
Age
Range
NonFacility
(N)/
Facility
(F)
Current
Medicaid
Fee
0-999
0-999
0-999
0-999
0-20
21-999
0-999
N
N
N
N
N
N
N
$11.05
$8.09
$76.05
$19.01
$88.75
$80.05
$335.91
Current
Adjusted
Current
Medicaid
Percent
Fee
Reduction
5%
5%
0%
0%
5%
5%
0%
$10.50
$7.69
$76.05
$19.01
$84.31
$76.05
$335.91
Medicaid
Fee
Effective
1/1/2016
Percent
Reduction
Effective
1/1/2016
Adjusted Medicaid
Fee Effective
1/1/2016
$11.05
$8.09
$76.05
$19.01
$88.75
$80.05
$335.91
5%
5%
0%
0%
5%
5%
0%
$10.50
$7.69
$76.05
$19.01
$84.31
$76.05
$335.91
*Type of Service (TOS): 1 = Medical Services, D = Tuberculosis Clinic: S = Texas Health Steps Medical Service
**Modifier: U1 = First hour of service - limited once per day, per provider, UA = Each additional 15 minutes of service - Limited to 28
per day
Diagnostic and Therapeutic Breast Procedures
TOS* Procedure Code
Age Range
Current Medicaid Fee
NA
19000
0-999
F
NA
F
11920
0-999
NA
F
11921
0-999
NA
F
19300
0-999
*Type of Service (TOS): F = Ambulatory Surgical Center
Medicaid Group
Number
Medicaid Fee Effective
1/1/2016
NA
NA
NA
8
$65.23
$86.50
$98.85
$872.41
Pathology and Laboratory Services - Microbiology
TOS*
Procedure Code
5
5
87905
G0103
Fee for Sole
Community Labs
Reduction @ 86.8%
Fee for Non-DSHS Labs 103.3% of CMS Reduction @ 84% of Texas Medicaid Fee (Sole
100% of Texas 1/1/16 100% of CMS (60%) to (62%) to Load in Texas Medicaid Fee
Community) Effective
Medicare Fee
Load in Phoenix
Phoenix
Effective 1/1/16
1/1/16
$16.63
Not a benefit
*Type of Service (TOS): 5 = Laboratory
$16.63
Not a benefit
$17.18
Not a benefit
$13.97
Not a benefit
$14.43
Not a benefit
Magnetoencephalography
Provider
Type (PT)/
Non-Facility Provider
(N)/ Facility Specialty
(F)
(PS)
TOS*
Procedure
Code
Age
Range
4
4
4
4
4
4
95965
95965
95966
95966
95967
95967
0-20
21-999
0-20
21-999
0-20
21-999
F
F
F
F
F
F
4
95965
0-999
F
4
95966
0-999
F
4
95967
0-999
F
4
95965
0-999
F
4
95966
0-999
F
4
95967
0-999
F
Current
Medicaid Fee
Current
Adjusted
Medicaid Fee
Not a Benefit
Not a Benefit
Not a Benefit
Not a Benefit
Not a Benefit
Not a Benefit
Not a Benefit
Not a Benefit
Not a Benefit
Not a Benefit
Not a Benefit
Not a Benefit
60,61,62
Not a Benefit
60,61,62
Not a Benefit
60,61,62
Rural
Hospital
Rural
Hospital
Rural
Hospital
Medicaid Fee
Effective
1/1/2016
Percent
Reduction
0%
0%
0%
0%
0%
0%
Adjusted
Medicaid Fee
Effective
1/1/2016
Not a Benefit
$1,886.28
$1,886.28
$1,094.24
$1,094.24
$925.88
$925.88
$2,357.85
0%
$1,886.28
$1,886.28
$1,094.24
$1,094.24
$925.88
$925.88
$2,357.85
Not a Benefit
$1,367.80
0%
$1,367.80
Not a Benefit
Not a Benefit
$1,157.35
0%
$1,157.35
Not a Benefit
Not a Benefit
$2,389.85
0%
$2,389.85
Not a Benefit
Not a Benefit
$1,399.80
0%
$1,399.80
Not a Benefit
Not a Benefit
$1,189.35
0%
$1,189.35
*Type of Service (TOS): 4 = Radiology
Provider Type: 60 = Hospital - long term, limited or specialized care, 61 = Hospital - private full care, 62 = Hospital - private,
outpatient service/emergency care only
Vision Services Nonsurgical
TOS*
Procedure
Code
Age
Range
NonFacility
(N)/
Facility
(F)
1
92025
0-20
N
Current
Medicaid
Fee
Percent
Reduction
Current
Adjusted
Medicaid
Fee
$28.0672
$30.03
0.00%
$30.03
$26.7305
Current
Medicaid
Current
Medicaid Conversion
Factor
RVU
1.07
Medicaid
RVU
Effective
1/1/16
Medicaid
Conversion
Factor
Effective
1/1/16
Medicaid
Fee
Effective
1/1/16
Percent
Reduction
Adjusted
Medicaid
Fee
Effective
1/1/16
1.07
$28.0672
$30.03
0.00%
$30.03
I
92025
0-20
F
Not a Benefit
0.00%
Not a Benefit
0.57
$28.0672
$16.00
0.00%
$16.00
T
1
92025
92025
0-20
21-999
N
N
Not a Benefit
$28.60
0.00%
0.00%
Not a Benefit
$28.60
0.50
1.07
$28.0672
$26.7305
$14.03
$28.60
0.00%
0.00%
$14.03
$28.60
I
92025
21-999
F
Not a Benefit
0.00%
Not a Benefit
0.57
$26.7305
$15.24
0.00%
$15.24
T
1
92025
92065
21-999
0-20
N
N
Not a Benefit
$42.38
0.00%
0.00%
Not a Benefit
$42.38
0.50
1.51
$26.7305
$28.0672
$13.37
$42.38
0.00%
0.00%
$13.37
$42.38
I
92065
0-20
F
Not a Benefit
0.00%
Not a Benefit
0.51
$28.0672
$14.31
0.00%
$14.31
T
1
92065
92065
0-20
21-999
N
N
Not a Benefit
$40.36
0.00%
0.00%
Not a Benefit
$40.36
1.00
1.51
$28.0672
$26.7305
$28.07
$40.36
0.00%
0.00%
$28.07
$40.36
I
92065
21-999
F
Not a Benefit
0.00%
Not a Benefit
0.51
$26.7305
$13.63
0.00%
$13.63
T
1
92065
92081
21-999
0-20
N
N
$28.0672
Not a Benefit
$26.94
0.00%
0.00%
Not a Benefit
$26.94
1.00
0.96
$26.7305
$28.0672
$26.73
$26.94
0.00%
0.00%
$26.73
$26.94
1.07
1.51
1.51
0.96
$28.0672
$26.7305
I
92081
0-20
F
Not a Benefit
0.00%
Not a Benefit
0.46
$28.0672
$12.91
0.00%
$12.91
T
1
92081
92081
0-20
21-999
N
N
$26.7305
Not a Benefit
$25.66
0.00%
0.00%
Not a Benefit
$25.66
0.50
0.96
$28.0672
$26.7305
$14.03
$25.66
0.00%
0.00%
$14.03
$25.66
0.96
I
92081
21-999
F
Not a Benefit
0.00%
Not a Benefit
0.46
$26.7305
$12.30
0.00%
$12.30
T
1
92081
92082
21-999
0-20
N
N
$28.0672
Not a Benefit
$37.89
0.00%
0.00%
Not a Benefit
$37.89
0.50
1.35
$26.7305
$28.0672
$13.37
$37.89
0.00%
0.00%
$13.37
$37.89
$26.7305
1.35
I
92082
0-20
F
Not a Benefit
0.00%
Not a Benefit
0.61
$28.0672
$17.12
0.00%
$17.12
T
1
92082
92082
0-20
21-999
N
N
Not a Benefit
$36.09
0.00%
0.00%
Not a Benefit
$36.09
0.74
1.35
$28.0672
$26.7305
$20.77
$36.09
0.00%
0.00%
$20.77
$36.09
I
92082
21-999
F
Not a Benefit
0.00%
Not a Benefit
0.61
$26.7305
$16.31
0.00%
$16.31
T
1
92082
92083
21-999
0-20
N
N
Not a Benefit
$50.80
0.00%
0.00%
Not a Benefit
$50.80
0.74
1.81
$26.7305
$28.0672
$19.78
$50.80
0.00%
0.00%
$19.78
$50.80
I
92083
0-20
F
Not a Benefit
0.00%
Not a Benefit
0.79
$28.0672
$22.17
0.00%
$22.17
T
1
92083
92083
0-20
21-999
N
N
Not a Benefit
$48.38
0.00%
0.00%
Not a Benefit
$48.38
1.02
1.81
$28.0672
$26.7305
$28.63
$48.38
0.00%
0.00%
$28.63
$48.38
I
92083
21-999
F
Not a Benefit
0.00%
Not a Benefit
0.79
$26.7305
$21.12
0.00%
$21.12
T
1
92083
92136
21-999
0-20
N
N
$28.0672
Not a Benefit
$71.29
0.00%
0.00%
Not a Benefit
$71.29
1.02
2.54
$26.7305
$28.0672
$27.27
$71.29
0.00%
0.00%
$27.27
$71.29
$26.7305
1.35
1.81
1.81
2.54
$28.0672
$26.7305
I
92136
0-20
F
Not a Benefit
0.00%
Not a Benefit
0.88
$28.0672
$24.70
0.00%
$24.70
T
1
92136
92136
0-20
21-999
N
N
Not a Benefit
$67.90
0.00%
0.00%
Not a Benefit
$67.90
1.66
2.54
$28.0672
$26.7305
$46.59
$67.90
0.00%
0.00%
$46.59
$67.90
2.54
I
92136
21-999
F
Not a Benefit
0.00%
Not a Benefit
0.88
$26.7305
$23.52
0.00%
$23.52
T
92136
21-999
N
Not a Benefit
0.00%
Not a Benefit
1.66
$26.7305
$44.37
0.00%
$44.37
Vision Services Nonsurgical
TOS*
Procedure
Code
Age
Range
NonFacility
(N)/
Facility
(F)
1
92140
0-20
N
1.77
1
92140
0-20
F
1
92140
21-999
1
1
92140
92235
I
Medicaid
RVU
Effective
1/1/16
Medicaid
Conversion
Factor
Effective
1/1/16
Medicaid
Fee
Effective
1/1/16
0.00%
0.00%
Not a
Benefit
Not a
Benefit
Not a
Benefit
Not a
Benefit
$86.73
Adjusted
Medicaid
Fee
Effective
1/1/16
Current
Medicaid
Fee
Percent
Reduction
Current
Adjusted
Medicaid
Fee
$28.0672
$49.68
0.00%
$49.68
0.75
$28.0672
$21.05
0.00%
$21.05
N
1.77
$26.7305
$47.31
0.00%
$47.31
21-999
0-20
F
N
0.75
3.09
$26.7305
$28.0672
$20.05
$86.73
0.00%
0.00%
$20.05
$86.73
3.09
$28.0672
Not a
Benefit
Not a
Benefit
Not a
Benefit
Not a
Benefit
$86.73
92235
0-20
F
Not a Benefit
0.00%
Not a Benefit
1.33
$28.0672
$37.33
0.00%
$37.33
T
1
92235
92235
0-20
21-999
N
N
Not a Benefit
$82.60
0.00%
0.00%
Not a Benefit
$82.60
1.76
3.09
$28.0672
$26.7305
$49.40
$82.60
0.00%
0.00%
$49.40
$82.60
I
92235
21-999
F
Not a Benefit
0.00%
Not a Benefit
1.33
$26.7305
$35.55
0.00%
$35.55
T
1
92235
92240
21-999
0-20
N
N
$28.0672
Not a Benefit
$201.24
0.00%
0.00%
Not a Benefit
$201.24
1.76
7.17
$26.7305
$28.0672
$47.05
$201.24
0.00%
0.00%
$47.05
$201.24
Current
Medicaid
Current
Medicaid Conversion
Factor
RVU
3.09
7.17
$26.7305
Percent
Reduction
0.00%
0.00%
0.00%
I
92240
0-20
F
Not a Benefit
0.00%
Not a Benefit
1.80
$28.0672
$50.52
0.00%
$50.52
T
1
92240
92240
0-20
21-999
N
N
$26.7305
Not a Benefit
$191.66
0.00%
0.00%
Not a Benefit
$191.66
5.37
7.17
$28.0672
$26.7305
$150.72
$191.66
0.00%
0.00%
$150.72
$191.66
$28.0672
7.17
I
92240
21-999
F
Not a Benefit
0.00%
Not a Benefit
1.80
$26.7305
$48.11
0.00%
$48.11
T
1
92240
92250
21-999
0-20
N
N
Not a Benefit
$62.31
0.00%
0.00%
Not a Benefit
$62.31
5.37
2.22
$26.7305
$28.0672
$143.54
$62.31
0.00%
0.00%
$143.54
$62.31
I
92250
0-20
F
Not a Benefit
0.00%
Not a Benefit
0.68
$28.0672
$19.09
0.00%
$19.09
T
1
92250
92250
0-20
21-999
N
N
Not a Benefit
$59.34
0.00%
0.00%
Not a Benefit
$59.34
1.54
2.22
$28.0672
$26.7305
$43.22
$59.34
0.00%
0.00%
$43.22
$59.34
I
92250
21-999
F
Not a Benefit
0.00%
Not a Benefit
0.68
$26.7305
$18.18
0.00%
$18.18
T
1
92250
92265
21-999
0-20
N
N
Not a Benefit
$67.92
0.00%
0.00%
Not a Benefit
$67.92
1.54
2.42
$26.7305
$28.0672
$41.16
$67.92
0.00%
0.00%
$41.16
$67.92
I
92265
0-20
F
Not a Benefit
0.00%
Not a Benefit
1.32
$28.0672
$37.05
0.00%
$37.05
T
1
92265
92265
0-20
21-999
N
N
$26.7305
Not a Benefit
$64.69
0.00%
0.00%
Not a Benefit
$64.69
1.10
2.42
$28.0672
$26.7305
$30.87
$64.69
0.00%
0.00%
$30.87
$64.69
2.22
2.22
2.42
2.42
$26.7305
$28.0672
I
92265
21-999
F
Not a Benefit
0.00%
Not a Benefit
1.32
$26.7305
$35.28
0.00%
$35.28
T
1
92265
92270
21-999
0-20
N
N
$28.0672
Not a Benefit
$72.69
0.00%
0.00%
Not a Benefit
$72.69
1.10
2.59
$26.7305
$28.0672
$29.40
$72.69
0.00%
0.00%
$29.40
$72.69
2.59
I
92270
0-20
F
Not a Benefit
0.00%
Not a Benefit
1.17
$28.0672
$32.84
0.00%
$32.84
T
1
92270
92270
0-20
21-999
N
N
$26.7305
Not a Benefit
$69.23
0.00%
0.00%
Not a Benefit
$69.23
1.42
2.59
$28.0672
$26.7305
$39.86
$69.23
0.00%
0.00%
$39.86
$69.23
$28.0672
2.59
I
92270
21-999
F
Not a Benefit
0.00%
Not a Benefit
1.17
$26.7305
$31.27
0.00%
$31.27
T
1
92270
92275
21-999
0-20
N
N
Not a Benefit
$115.92
0.00%
0.00%
Not a Benefit
$115.92
1.42
4.13
$26.7305
$28.0672
$37.96
$115.92
0.00%
0.00%
$37.96
$115.92
I
92275
0-20
F
Not a Benefit
0.00%
Not a Benefit
1.51
$28.0672
$42.38
0.00%
$42.38
4.13
Vision Services Nonsurgical
TOS*
Procedure
Code
Age
Range
NonFacility
(N)/
Facility
(F)
T
1
92275
92275
0-20
21-999
N
N
Current
Medicaid
Fee
Percent
Reduction
Current
Adjusted
Medicaid
Fee
$26.7305
Not a Benefit
$110.40
0.00%
0.00%
Not a Benefit
$110.40
Current
Medicaid
Current
Medicaid Conversion
Factor
RVU
4.13
Medicaid
RVU
Effective
1/1/16
Medicaid
Conversion
Factor
Effective
1/1/16
Medicaid
Fee
Effective
1/1/16
Percent
Reduction
Adjusted
Medicaid
Fee
Effective
1/1/16
2.62
4.13
$28.0672
$26.7305
$73.54
$110.40
0.00%
0.00%
$73.54
$110.40
I
92275
21-999
F
Not a Benefit
0.00%
Not a Benefit
1.51
$26.7305
$40.36
0.00%
$40.36
T
1
92275
92285
21-999
0-20
N
N
$28.0672
Not a Benefit
$16.28
0.00%
0.00%
Not a Benefit
$16.28
2.62
0.58
$26.7305
$28.0672
$70.03
$16.28
0.00%
0.00%
$70.03
$16.28
0.58
I
92285
0-20
F
Not a Benefit
0.00%
Not a Benefit
0.09
$28.0672
$2.53
0.00%
$2.53
T
1
92285
92285
0-20
21-999
N
N
$26.7305
Not a Benefit
$15.50
0.00%
0.00%
Not a Benefit
$15.50
0.49
0.58
$28.0672
$26.7305
$13.75
$15.50
0.00%
0.00%
$13.75
$15.50
$28.0672
0.58
I
92285
21-999
F
Not a Benefit
0.00%
Not a Benefit
0.09
$26.7305
$2.41
0.00%
$2.41
T
1
92285
92286
21-999
0-20
N
N
Not a Benefit
$30.31
0.00%
0.00%
Not a Benefit
$30.31
0.49
1.08
$26.7305
$28.0672
$13.10
$30.31
0.00%
0.00%
$13.10
$30.31
I
92286
0-20
F
Not a Benefit
0.00%
Not a Benefit
0.63
$28.0672
$17.68
0.00%
$17.68
T
1
92286
92286
0-20
21-999
N
N
Not a Benefit
$28.87
0.00%
0.00%
Not a Benefit
$28.87
0.45
1.08
$28.0672
$26.7305
$12.63
$28.87
0.00%
0.00%
$12.63
$28.87
I
92286
21-999
F
Not a Benefit
0.00%
Not a Benefit
0.63
$26.7305
$16.84
0.00%
$16.84
T
1
92286
92287
21-999
0-20
N
N
Not a Benefit
$108.90
0.00%
0.00%
Not a Benefit
$108.90
0.45
3.88
$26.7305
$28.0672
$12.03
$108.90
0.00%
0.00%
$12.03
$108.90
I
92287
0-20
F
Not a Benefit
0.00%
Not a Benefit
1.32
$28.0672
$37.05
0.00%
$37.05
T
1
92287
92287
0-20
21-999
N
N
Not a Benefit
$103.71
0.00%
0.00%
Not a Benefit
$103.71
2.56
3.88
$28.0672
$26.7305
$71.85
$103.71
0.00%
0.00%
$71.85
$103.71
1.08
1.08
3.88
3.88
$26.7305
$28.0672
$26.7305
I
92287
21-999
F
Not a Benefit
0.00%
Not a Benefit
1.32
$26.7305
$35.28
0.00%
$35.28
T
92287
21-999
N
Not a Benefit
0.00%
Not a Benefit
2.56
$26.7305
$68.43
Not a
Benefit
Not a
Benefit
0.00%
$68.43
Not a
Benefit
Not a
Benefit
E
92326
0-20
N/F
0.99
$28.0672
$27.79
0.00%
$27.79
E
92326
21-999
N/F
0.99
$26.7305
$26.46
0.00%
$26.46
1
92326
0-20
N/F
Not a Benefit
0.00%
Not a Benefit
0.99
$28.0672
$27.79
0.00%
$27.79
1
92326
21-999
N/F
Not a Benefit
0.00%
Not a Benefit
0.99
$26.7305
$26.46
0.00%
$26.46
*Type of Service (TOS): 1 = Medical Services, E = Eyeglasses/Vision Services, I = Professional Component, T = Technical Component
0.00%
0.00%