CPT Codes and Fees


TABLE OF CONTENTS

CPT Codes and Fees,
Effective January 1, 2014

Surgery, Part 1 (10000-29999)
Surgery, Part 2 (30000-49999)
Surgery, Part 3 (50000-69999)
Assistant Surgery Guide
Radiology
Pathology and Laboratory
Evaluation & Management, Medicine, Physical Therapy

Commission Assigned Codes

N.C. Industrial Commission Assigned Codes

Surgery, Part 3

Effective January 1, 2014

ABBREVIATIONS: BR = by report (i.e., report is needed to establish fee), CPT = Current Procedural Terminology, FAC = services were performed in a facility setting, FUD = follow-up days (i.e., number of days in global period), NA = no allowance, OFF = services were performed in physician office setting, PC (26) = professional component, PER AGM = per agreement, SC = special consideration (see Guides or contact Industrial Commission), TBA = to be assigned, TC (27) = technical component, Total = total fee, and Units = requires time or number of units.
 

CPT Code

Total

OFF

FAC

TC (27)

PC (26)

FUD

50010

$1,537.46

 

 

 

 

45

50020

$1,509.01

 

 

 

 

45

50040

$1,438.29

 

 

 

 

45

50045

$1,895.82

 

 

 

 

45

50060

$2,364.69

 

 

 

 

45

50065

$2,621.47

 

 

 

 

45

50070

$2,506.09

 

 

 

 

45

50075

$3,196.79

 

 

 

 

45

50080

$2,042.08

 

 

 

 

45

50081

$2,775.87

 

 

 

 

45

50100

$1,999.83

 

 

 

 

45

50120

$2,029.90

 

 

 

 

45

50125

$2,075.41

 

 

 

 

45

50130

$2,259.06

 

 

 

 

45

50135

$2,744.19

 

 

 

 

90

50200

$357.97

 

 

 

 

0

50205

$1,439.94

 

 

 

 

45

50220

$2,290.74

 

 

 

 

90

50225

$2,770.19

 

 

 

 

90

50230

$3,041.59

 

 

 

 

90

50234

$2,949.78

 

 

 

 

90

50236

$3,208.18

 

 

 

 

90

50240

$2,834.37

 

 

 

 

90

50250

$2,287.82

 

 

 

 

90

50280

$1,994.14

 

 

 

 

90

50290

$1,773.93

 

 

 

 

90

50300

$1,823.49

 

 

 

 

0

50320

$2,970.89

 

 

 

 

90

50323

BR

 

 

 

 

0

50325

BR

 

 

 

 

0

50327

$424.25

 

 

 

 

0

50328

$371.43

 

 

 

 

0

50329

$354.83

 

 

 

 

0

50340

$1,843.00

 

 

 

 

90

50360

$4,080.10

 

 

 

 

90

50365

$4,964.23

 

 

 

 

90

50370

$1,758.48

 

 

 

 

90

50380

$2,104.66

 

 

 

 

90

50382

 

$3,047.81

$580.67

 

 

0

50384

 

$2,942.63

$528.66

 

 

0

50385

 

$2,539.05

$468.63

 

 

0

50386

 

$1,641.70

$354.84

 

 

0

50387

 

$1,473.62

$210.26

 

 

0

50389

 

$1,007.28

$115.55

 

 

0

50390

$338.00

 

 

 

 

0

50391

 

$274.10

$205.50

 

 

0

50392

$545.51

 

 

 

 

0

50393

$678.85

 

 

 

 

0

50394

$89.86

 

 

 

 

0

50395

$580.45

 

 

 

 

0

50396

$178.27

 

 

 

 

0

50398

$156.02

 

 

 

 

0

50400

$2,479.27

 

 

 

 

90

50405

$3,105.78

 

 

 

 

90

50500

$2,415.89

 

 

 

 

90

50520

$2,069.72

 

 

 

 

45

50525

$2,621.47

 

 

 

 

45

50526

$2,368.75

 

 

 

 

90

50540

$2,551.60

 

 

 

 

90

50541

$1,664.27

 

 

 

 

90

50542

$2,119.80

 

 

 

 

90

50543

$2,675.05

 

 

 

 

90

50544

$2,296.12

 

 

 

 

0

50545

$2,600.11

 

 

 

 

90

50546

$2,124.77

 

 

 

 

90

50547

$2,721.10

 

 

 

 

90

50548

$2,498.62

 

 

 

 

90

50549

BR

 

 

 

 

90

50551

$610.28

 

 

 

 

0

50553

$600.51

 

 

 

 

0

50555

$876.80

 

 

 

 

15

50557

$886.56

 

 

 

 

0

50559

$637.90

 

 

 

 

15

50561

$993.00

 

 

 

 

0

50562

$1,124.16

 

 

 

 

90

50570

$863.80

 

 

 

 

0

50572

$1,376.55

 

 

 

 

0

50574

$1,413.12

 

 

 

 

15

50575

$1,868.19

 

 

 

 

0

50576

$1,534.21

 

 

 

 

15

50578

$1,214.04

 

 

 

 

15

50580

$1,210.79

 

 

 

 

0

50590

$1,538.26

 

 

 

 

90

50592

 

$11,282.46

$763.21

 

 

10

50593

 

$8,956.96

$906.28

 

 

10

50600

$1,914.50

 

 

 

 

45

50605

$1,606.53

 

 

 

 

45

50610

$2,080.27

 

 

 

 

45

50620

$2,004.71

 

 

 

 

45

50630

$2,081.09

 

 

 

 

45

50650

$2,222.49

 

 

 

 

90

50660

$2,427.26

 

 

 

 

90

50684

$97.52

 

 

 

 

0

50686

$147.89

 

 

 

 

0

50688

$120.26

 

 

 

 

0

50690

$116.20

 

 

 

 

0

50700

$2,083.53

 

 

 

 

90

50715

$2,268.00

 

 

 

 

45

50722

$2,019.34

 

 

 

 

90

50725

$2,298.05

 

 

 

 

90

50727

$1,010.88

 

 

 

 

45

50728

$1,487.07

 

 

 

 

45

50740

$2,375.26

 

 

 

 

90

50750

$2,509.33

 

 

 

 

90

50760

$2,393.95

 

 

 

 

90

50770

$2,606.85

 

 

 

 

90

50780

$2,416.69

 

 

 

 

90

50782

$2,504.47

 

 

 

 

90

50783

$2,578.40

 

 

 

 

90

50785

$2,709.23

 

 

 

 

90

50800

$2,167.22

 

 

 

 

90

50810

$2,417.51

 

 

 

 

90

50815

$2,981.46

 

 

 

 

90

50820

$3,073.29

 

 

 

 

90

50825

$4,432.77

 

 

 

 

90

50830

$3,931.41

 

 

 

 

90

50840

$2,459.76

 

 

 

 

90

50845

$2,608.48

 

 

 

 

45

50860

$1,948.64

 

 

 

 

90

50900

$1,767.42

 

 

 

 

45

50920

$1,778.79

 

 

 

 

45

50930

$2,352.50

 

 

 

 

45

50940

$1,825.12

 

 

 

 

45

50945

$1,760.56

 

 

 

 

90

50947

$2,801.09

 

 

 

 

90

50948

$2,561.05

 

 

 

 

90

50949

BR

 

 

 

 

90

50951

$589.14

 

 

 

 

0

50953

$620.02

 

 

 

 

0

50955

$728.91

 

 

 

 

15

50957

$728.11

 

 

 

 

15

50959

$606.20

 

 

 

 

15

50961

$679.35

 

 

 

 

0

50970

$962.12

 

 

 

 

0

50972

$662.27

 

 

 

 

0

50974

$1,262.80

 

 

 

 

15

50976

$1,206.73

 

 

 

 

15

50978

$717.54

 

 

 

 

15

50980

$780.93

 

 

 

 

0

51020

$1,006.00

 

 

 

 

45

51030

$825.61

 

 

 

 

45

51040

$767.91

 

 

 

 

45

51045

$859.74

 

 

 

 

45

51050

$1,025.51

 

 

 

 

45

51060

$1,435.88

 

 

 

 

45

51065

$1,181.53

 

 

 

 

45

51080

$828.04

 

 

 

 

45

51100

 

$123.25

$76.18

 

 

0

51101

 

$250.10

$100.20

 

 

0

51102

 

$652.88

$480.52

 

 

0

51500

$1,299.37

 

 

 

 

45

51520

$1,344.05

 

 

 

 

45

51525

$1,831.63

 

 

 

 

45

51530

$1,609.79

 

 

 

 

45

51535

$1,513.07

 

 

 

 

45

51550

$1,960.83

 

 

 

 

45

51555

$2,494.70

 

 

 

 

45

51565

$2,803.50

 

 

 

 

45

51570

$2,957.89

 

 

 

 

45

51575

$3,967.15

 

 

 

 

90

51580

$3,765.62

 

 

 

 

90

51585

$4,477.47

 

 

 

 

90

51590

$4,279.20

 

 

 

 

90

51595

$5,309.59

 

 

 

 

90

51596

$5,552.54

 

 

 

 

90

51597

$5,187.70

 

 

 

 

90

51600

$91.01

 

 

 

 

0

51605

$112.15

 

 

 

 

0

51610

$146.26

 

 

 

 

0

51700

$86.13

 

 

 

 

0

51701

 

$112.89

$52.22

 

 

0

51702

 

$177.10

$57.14

 

 

0

51703

 

$246.85

$153.74

 

 

0

51705

$107.26

 

 

 

 

0

51710

$159.28

 

 

 

 

0

51715

$499.76

 

 

 

 

0

51720

$189.33

 

 

 

 

0

51725

$197.47

 

 

$29.62

$167.85

0

51726

$234.84

 

 

$35.23

$199.61

0

51727

$532.32

 

 

$331.48

$200.84

0

51728

$532.08

 

 

$333.44

$198.65

0

51729

$573.32

 

 

$337.37

$235.94

0

51736

$97.52

 

 

$14.63

$82.89

0

51741

$167.40

 

 

$25.11

$142.29

0

51784

$201.53

 

 

$30.23

$171.30

0

51785

$201.53

 

 

$30.23

$171.30

0

51792

$235.66

 

 

$35.35

$200.31

0

51797

$200.71

 

 

$30.11

$170.60

0

51798

$37.02

 

 

 

 

0

51800

$2,223.30

 

 

 

 

90

51820

$1,903.93

 

 

 

 

90

51840

$1,494.39

 

 

 

 

45

51841

$1,816.98

 

 

 

 

45

51845

$1,542.32

 

 

 

 

45

51860

$1,474.07

 

 

 

 

45

51865

$1,955.13

 

 

 

 

45

51880

$952.38

 

 

 

 

45

51900

$1,827.55

 

 

 

 

45

51920

$1,412.32

 

 

 

 

45

51925

$1,933.19

 

 

 

 

45

51940

$3,445.45

 

 

 

 

45

51960

$3,324.39

 

 

 

 

90

51980

$1,398.49

 

 

 

 

45

51990

$1,361.10

 

 

 

 

90

51992

$1,485.84

 

 

 

 

90

51999

BR

 

 

 

 

0

52000

$261.66

 

 

 

 

0

52001

$253.67

 

 

 

 

15

52005

$356.73

 

 

 

 

0

52007

$455.88

 

 

 

 

15

52010

$385.18

 

 

 

 

0

52204

$370.55

 

 

 

 

15

52214

$508.70

 

 

 

 

0

52224

$471.31

 

 

 

 

0

52234

$728.11

 

 

 

 

15

52235

$971.89

 

 

 

 

15

52240

$1,587.83

 

 

 

 

15

52250

$576.14

 

 

 

 

15

52260

$472.13

 

 

 

 

15

52265

$336.42

 

 

 

 

0

52270

$570.46

 

 

 

 

0

52275

$634.64

 

 

 

 

0

52276

$663.09

 

 

 

 

0

52277

$858.11

 

 

 

 

0

52281

$398.98

 

 

 

 

0

52282

$765.31

 

 

 

 

0

52283

$411.18

 

 

 

 

0

52285

$511.95

 

 

 

 

0

52287

 

$601.60

$328.06

 

 

0

52290

$542.83

 

 

 

 

0

52300

$689.91

 

 

 

 

0

52301

$695.97

 

 

 

 

0

52305

$689.09

 

 

 

 

0

52310

$452.62

 

 

 

 

0

52315

$724.85

 

 

 

 

0

52317

$1,006.83

 

 

 

 

15

52318

$1,332.68

 

 

 

 

15

52320

$745.16

 

 

 

 

0

52325

$1,026.33

 

 

 

 

0

52327

$693.97

 

 

 

 

0

52330

$665.52

 

 

 

 

0

52332

$471.31

 

 

 

 

0

52334

$637.90

 

 

 

 

0

52341

$648.65

 

 

 

 

45

52342

$702.36

 

 

 

 

45

52343

$778.04

 

 

 

 

45

52344

$831.75

 

 

 

 

45

52345

$886.29

 

 

 

 

45

52346

$997.14

 

 

 

 

45

52347

$545.14

 

 

 

 

15

52351

$661.94

 

 

 

 

45

52352

$818.48

 

 

 

 

45

52353

$948.22

 

 

 

 

45

52354

$830.08

 

 

 

 

45

52355

$974.87

 

 

 

 

45

52356

 

$842.17

$842.17

 

 

0

52400

$1,158.79

 

 

 

 

45

52402

$554.18

 

 

 

 

0

52450

$941.01

 

 

 

 

45

52500

$1,190.47

 

 

 

 

90

52601

$1,823.49

 

 

 

 

90

52630

$1,219.73

 

 

 

 

90

52640

$971.89

 

 

 

 

90

52647

$1,500.90

 

 

 

 

45

52648

$1,597.59

 

 

 

 

45

52649

 

 

$1,915.49

 

 

90

52700

$752.48

 

 

 

 

45

53000

$294.17

 

 

 

 

15

53010

$510.32

 

 

 

 

45

53020

$203.16

 

 

 

 

0

53025

$151.14

 

 

 

 

15

53040

$616.76

 

 

 

 

45

53060

$243.78

 

 

 

 

15

53080

$771.99

 

 

 

 

0

53085

$1,284.74

 

 

 

 

15

53200

$289.29

 

 

 

 

15

53210

$1,435.88

 

 

 

 

45

53215

$1,921.01

 

 

 

 

45

53220

$887.37

 

 

 

 

45

53230

$1,325.36

 

 

 

 

45

53235

$1,004.02

 

 

 

 

45

53240

$810.18

 

 

 

 

15

53250

$761.42

 

 

 

 

15

53260

$319.36

 

 

 

 

15

53265

$388.43

 

 

 

 

15

53270

$299.03

 

 

 

 

15

53275

$528.20

 

 

 

 

15

53400

$1,506.58

 

 

 

 

45

53405

$1,887.68

 

 

 

 

45

53410

$1,889.31

 

 

 

 

45

53415

$2,373.64

 

 

 

 

45

53420

$1,886.05

 

 

 

 

45

53425

$1,909.62

 

 

 

 

90

53430

$1,779.61

 

 

 

 

90

53431

$2,045.39

 

 

 

 

90

53440

$1,923.44

 

 

 

 

90

53442

$1,058.82

 

 

 

 

45

53444

$1,466.68

 

 

 

 

45

53445

$2,347.62

 

 

 

 

90

53446

$1,354.37

 

 

 

 

90

53447

$1,682.09

 

 

 

 

45

53448

$2,443.59

 

 

 

 

90

53449

$1,370.87

 

 

 

 

45

53450

$662.27

 

 

 

 

45

53460

$716.72

 

 

 

 

45

53500

$1,423.15

 

 

 

 

90

53502

$954.01

 

 

 

 

45

53505

$967.81

 

 

 

 

45

53510

$1,292.05

 

 

 

 

45

53515

$1,698.35

 

 

 

 

45

53520

$1,101.09

 

 

 

 

45

53600

$121.09

 

 

 

 

0

53601

$99.95

 

 

 

 

0

53605

$136.52

 

 

 

 

0

53620

$164.14

 

 

 

 

0

53621

$135.71

 

 

 

 

0

53660

$78.01

 

 

 

 

0

53661

$76.38

 

 

 

 

0

53665

$87.76

 

 

 

 

0

53850

$1,126.22

 

 

 

 

45

53852

$1,177.08

 

 

 

 

45

53855

 

$1,245.15

$160.80

 

 

0

53860

 

$2,884.25

$459.30

 

 

90

53899

BR

 

 

 

 

0

54000

$166.59

 

 

 

 

0

54001

$234.04

 

 

 

 

0

54015

$471.31

 

 

 

 

15

54050

$122.69

 

 

 

 

0

54055

$140.57

 

 

 

 

0

54056

$134.09

 

 

 

 

0

54057

$219.41

 

 

 

 

0

54060

$238.90

 

 

 

 

15

54065

$377.87

 

 

 

 

15

54100

$199.90

 

 

 

 

15

54105

$350.24

 

 

 

 

15

54110

$1,227.84

 

 

 

 

45

54111

$1,738.17

 

 

 

 

45

54112

$2,032.33

 

 

 

 

45

54115

$771.16

 

 

 

 

45

54120

$1,227.04

 

 

 

 

45

54125

$1,902.31

 

 

 

 

90

54130

$2,619.04

 

 

 

 

90

54135

$3,341.44

 

 

 

 

90

54150

$182.02

 

 

 

 

15

54160

$320.99

 

 

 

 

15

54161

$421.74

 

 

 

 

15

54162

$427.02

 

 

 

 

15

54163

$401.33

 

 

 

 

15

54164

$352.03

 

 

 

 

15

54200

$104.01

 

 

 

 

0

54205

$962.12

 

 

 

 

15

54220

$312.85

 

 

 

 

0

54230

$208.84

 

 

 

 

0

54231

$272.23

 

 

 

 

0

54235

$126.77

 

 

 

 

0

54240

$180.39

 

 

$27.06

$153.33

15

54250

$236.47

 

 

$35.47

$201.00

0

54300

$1,329.42

 

 

 

 

45

54304

$1,626.02

 

 

 

 

45

54308

$1,369.24

 

 

 

 

45

54312

$1,760.11

 

 

 

 

45

54316

$2,134.72

 

 

 

 

45

54318

$1,418.80

 

 

 

 

45

54322

$1,560.20

 

 

 

 

45

54324

$2,066.47

 

 

 

 

45

54326

$1,978.69

 

 

 

 

45

54328

$1,999.83

 

 

 

 

90

54332

$2,237.92

 

 

 

 

90

54336

$2,929.44

 

 

 

 

90

54340

$1,142.52

 

 

 

 

45

54344

$2,464.65

 

 

 

 

90

54348

$2,187.53

 

 

 

 

90

54352

$3,124.48

 

 

 

 

90

54360

$1,440.76

 

 

 

 

45

54380

$1,713.80

 

 

 

 

45

54385

$1,965.69

 

 

 

 

45

54390

$2,708.43

 

 

 

 

45

54400

$1,530.95

 

 

 

 

45

54401

$1,836.49

 

 

 

 

45

54405

$2,328.93

 

 

 

 

45

54406

$1,333.52

 

 

 

 

45

54408

$1,406.24

 

 

 

 

45

54410

$1,667.63

 

 

 

 

45

54411

$1,816.26

 

 

 

 

45

54415

$988.96

 

 

 

 

45

54416

$1,292.49

 

 

 

 

45

54417

$1,598.58

 

 

 

 

45

54420

$1,448.08

 

 

 

 

45

54430

$1,292.05

 

 

 

 

45

54435

$763.85

 

 

 

 

45

54440

$1,114.09

 

 

 

 

45

54450

$140.57

 

 

 

 

15

54500

$137.34

 

 

 

 

0

54505

$413.63

 

 

 

 

15

54512

$1,032.93

 

 

 

 

15

54520

$789.79

 

 

 

 

15

54522

$1,173.79

 

 

 

 

15

54530

$1,200.22

 

 

 

 

45

54535

$1,565.89

 

 

 

 

45

54550

$988.14

 

 

 

 

45

54560

$1,385.49

 

 

 

 

45

54600

$876.80

 

 

 

 

45

54620

$625.70

 

 

 

 

45

54640

$1,124.66

 

 

 

 

45

54650

$1,470.02

 

 

 

 

45

54660

$641.15

 

 

 

 

45

54670

$810.18

 

 

 

 

45

54680

$1,540.72

 

 

 

 

45

54690

$1,323.22

 

 

 

 

90

54692

$1,362.42

 

 

 

 

90

54699

BR

 

 

 

 

90

54700

$336.42

 

 

 

 

15

54800

$335.62

 

 

 

 

0

54830

$672.03

 

 

 

 

15

54840

$768.73

 

 

 

 

45

54860

$872.74

 

 

 

 

45

54861

$1,236.78

 

 

 

 

45

54865 $654.63        

90

55875 $1,437.49        

90

55876   $282.41 $209.69     10

54900

$1,684.54

 

 

 

 

90

54901

$2,311.88

 

 

 

 

90

55000

$143.83

 

 

 

 

0

55040

$784.98

 

 

 

 

45

55041

$1,161.22

 

 

 

 

45

55060

$732.97

 

 

 

 

45

55100

$208.84

 

 

 

 

0

55110

$685.84

 

 

 

 

15

55120

$516.01

 

 

 

 

15

55150

$943.44

 

 

 

 

15

55175

$736.22

 

 

 

 

15

55180

$1,326.19

 

 

 

 

15

55200

$478.62

 

 

 

 

15