CPT Codes and Fees

TABLE OF CONTENTS

CPT Codes and Fees,
Effective January 1, 2015

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, 2015

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