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

Radiology

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 TC (27) PC (26)
70010 $374.52 $243.44 $131.08
70015 $194.73 $126.57 $68.16
70030 $42.06 $25.24 $16.82
70100 $49.53 $29.72 $19.81
70110 $61.74 $37.04 $24.70
70120 $54.96 $32.98 $21.98
70130 $80.73 $48.44 $32.29
70134 $77.34 $46.40 $30.94
70140 $55.64 $33.38 $22.26
70150 $72.60 $43.56 $29.04
70160 $48.18 $28.91 $19.27
70170 $86.16 $56.00 $30.16
70190 $57.66 $34.60 $23.06
70200 $74.64 $44.78 $29.86
70210 $53.61 $32.17 $21.44
70220 $71.91 $43.15 $28.76
70240 $44.10 $26.46 $17.64
70250 $60.39 $36.23 $24.16
70260 $86.85 $52.11 $34.74
70300 $25.77 $15.46 $10.31
70310 $40.71 $24.43 $16.28
70320 $69.21 $41.53 $27.68
70328 $47.49 $28.49 $19.00
70330 $73.95 $44.37 $29.58
70332 $179.12 $116.43 $62.69
70336 $768.71 $614.97 $153.74
70350 $39.36 $23.62 $15.74
70355 $53.61 $32.17 $21.44
70360 $42.06 $25.24 $16.82
70370 $109.92 $65.95 $43.97
70371 $207.60 $124.56 $83.04
70373 $149.94 $97.46 $52.48
70380 $57.00 $34.20 $22.80
70390 $144.51 $93.93 $50.58
70450 $367.05 $256.93 $110.12
70460 $449.82 $328.37 $121.45
70470 $548.88 $411.66 $137.22
70480 $407.76 $285.43 $122.33
70481 $473.58 $345.71 $127.87
70482 $565.85 $424.39 $141.46
70486 $394.20 $275.94 $118.26
70487 $465.44 $339.77 $125.67
70488 $563.13 $422.35 $140.78
70490 $407.76 $285.43 $122.33
70491 $473.58 $345.71 $127.87
70492 $565.85 $424.39 $141.46
70496 $685.33 $506.93 $178.40
70498 $685.33 $506.93 $178.40
70540 $818.93 $655.14 $163.79
70542 $1,059.18 $943.25 $115.93
70543 $1,901.96 $1,746.30 $155.66
70544 $913.77 $793.74 $120.03
70545 $913.77 $793.74 $120.03
70546 $1,744.99 $1,566.71 $178.28
70547 $913.77 $793.74 $120.03
70548 $913.77 $793.74 $120.03
70549 $1,744.99 $1,566.71 $178.28
70551 $818.93 $655.14 $163.79
70552 $983.12 $786.50 $196.62
70553 $1,731.46 $1,385.17 $346.29
70554 $1,108.05 $921.14 $186.91
70555 $223.81    
70557 $282.61    
70558 $312.29    
70559 $313.19    
71010 $45.45 $27.27 $18.18
71015 $52.23 $31.34 $20.89
71020 $58.35 $35.01 $23.34
71021 $70.56 $42.34 $28.22
71022 $73.95 $44.37 $29.58
71023 $84.12 $50.47 $33.65
71030 $77.34 $46.40 $30.94
71034 $130.95 $78.57 $52.38
71035 $48.84 $29.30 $19.54
71100 $55.64 $33.38 $22.26
71101 $67.17 $40.30 $26.87
71110 $73.95 $44.37 $29.58
71111 $84.81 $50.89 $33.92
71120 $58.35 $35.01 $23.34
71130 $63.09 $37.85 $25.24
71250 $467.46 $327.22 $140.24
71260 $545.49 $398.21 $147.28
71270 $665.58 $499.18 $166.40
71275 $746.11 $623.41 $122.70
71550 $830.45 $664.36 $166.09
71551 $1,073.47 $944.89 $128.58
71552 $1,908.79 $1,740.56 $168.23
71555 $844.70 $675.76 $168.94
72010 $105.15 $63.09 $42.06
72020 $40.02 $24.01 $16.01
72040 $57.00 $34.20 $22.80
72050 $83.46 $50.08 $33.38
72052 $103.14 $61.88 $41.26
72069 $50.88 $30.53 $20.35
72070 $60.39 $36.23 $24.16
72072 $65.82 $39.49 $26.33
72074 $75.99 $45.59 $30.40
72080 $61.74 $37.04 $24.70
72090 $67.86 $40.72 $27.14
72100 $61.74 $37.04 $24.70
72110 $84.81 $50.89 $33.92
72114 $106.53 $63.92 $42.61
72120 $75.30 $45.18 $30.12
72125 $467.46 $327.22 $140.24
72126 $543.45 $396.72 $146.73
72127 $655.40 $491.55 $163.85
72128 $467.46 $327.22 $140.24
72129 $543.45 $396.72 $146.73
72130 $655.40 $491.55 $163.85
72131 $467.46 $327.22 $140.24
72132 $543.45 $396.72 $146.73
72133 $655.40 $491.55 $163.85
72141 $830.45 $664.36 $166.09
72142 $995.99 $796.79 $199.20
72146 $905.09 $724.07 $181.02
72147 $995.99 $796.79 $199.20
72148 $893.54 $714.83 $178.71
72149 $983.12 $786.50 $196.62
72156 $1,750.46 $1,400.37 $350.09
72157 $1,750.46 $1,400.37 $350.09
72158 $1,731.46 $1,385.17 $346.29
72159 $914.58 $731.66 $182.92
72170 $47.49 $28.49 $19.00
72190 $61.05 $36.63 $24.42
72191 $721.79 $599.09 $122.70
72192 $460.68 $322.48 $138.20
72193 $523.79 $382.37 $141.42
72194 $628.26 $471.19 $157.07
72195 $897.58 $788.82 $108.76
72196 $830.45 $664.36 $166.09
72197 $1,917.80 $1,748.75 $169.05
72198 $844.02 $675.22 $168.80
72200 $48.18 $28.91 $19.27
72202 $55.64 $33.38 $22.26
72220 $50.88 $30.53 $20.35
72240 $373.83 $242.99 $130.84
72255 $348.74 $226.68 $122.06
72265 $326.34 $212.12 $114.22
72270 $495.29 $321.94 $173.35
72275 $195.35 $146.70 $48.65
72285 $586.88 $381.47 $205.41
72291 $123.83    
72292 $126.89    
72295 $554.99 $360.74 $194.25
73000 $46.82 $28.09 $18.73
73010 $48.18 $28.91 $19.27
73020 $42.75 $25.65 $17.10
73030 $51.57 $30.94 $20.63
73040 $179.12 $116.43 $62.69
73050 $59.70 $35.82 $23.88
73060 $50.88 $30.53 $20.35
73070 $46.14 $27.68 $18.46
73080 $50.88 $30.53 $20.35
73085 $179.12 $116.43 $62.69
73090 $46.82 $28.09 $18.73
73092 $44.79 $26.87 $17.92
73100 $44.79 $26.87 $17.92
73110 $48.84 $29.30 $19.54
73115 $147.24 $95.71 $51.53
73120 $44.79 $26.87 $17.92
73130 $48.84 $29.30 $19.54
73140 $37.98 $22.79 $15.19
73200 $403.70 $282.59 $121.11
73201 $467.46 $341.25 $126.21
73202 $564.50 $423.37 $141.13
73206 $648.09 $525.39 $122.70
73218 $884.02 $786.76 $97.26
73219 $1,059.18 $943.25 $115.93
73220 $818.93 $655.14 $163.79
73221 $768.71 $614.97 $153.74
73222 $1,059.18 $943.25 $115.93
73223 $1,901.96 $1,697.64 $155.66
73225 $835.20 $668.16 $167.04
73500 $44.79 $26.87 $17.92
73510 $54.96 $32.98 $21.98
73520 $65.82 $39.49 $26.33
73525 $179.12 $116.43 $62.69
73530 $59.04 $35.42 $23.62
73540 $54.27 $32.56 $21.71
73550 $50.88 $30.53 $20.35
73560 $47.49 $28.49 $19.00
73562 $52.23 $31.34 $20.89
73564 $59.04 $35.42 $23.62
73565 $45.45 $27.27 $18.18
73580 $211.01 $137.16 $73.85
73590 $47.49 $28.49 $19.00
73592 $44.79 $26.87 $17.92
73600 $44.79 $26.87 $17.92
73610 $48.84 $29.30 $19.54
73615 $179.12 $116.43 $62.69
73620 $44.79 $26.87 $17.92
73630 $48.84 $29.30 $19.54
73650 $43.41 $26.05 $17.36
73660 $37.98 $22.79 $15.19
73700 $403.70 $282.59 $121.11
73701 $467.46 $341.25 $126.21
73702 $564.50 $423.37 $141.13
73706 $648.09 $525.39 $122.70
73718 $884.02 $786.76 $97.26
73719 $1,059.18 $943.25 $115.93
73720 $818.93 $655.14 $163.79
73721 $768.71 $614.97 $153.74
73722 $1,059.18 $943.25 $115.93
73723 $1,901.96 $1,746.30 $155.66
73725 $841.31 $673.05 $168.26
74000 $48.84 $29.30 $19.54
74010 $57.00 $34.20 $22.80
74020 $63.78 $38.27 $25.51
74022 $75.30 $45.18 $30.12
74150 $455.25 $318.67 $136.58
74160 $534.63 $390.28 $144.35
74170 $646.58 $484.93 $161.65
74174 $1,030.04 $829.79 $200.25
74175 $721.79 $599.09 $122.70
74176 $409.70 $247.84 $161.86
74177 $642.63 $472.89 $169.74
74178 $812.79 $625.04 $187.75
74181 $830.45 $664.36 $166.09
74182 $1,073.47 $918.72 $128.58
74183 $1,917.80 $1,748.75 $169.05
74185 $844.02 $675.22 $168.80
74190 $118.74 $77.18 $41.56
74210 $105.84 $63.50 $42.34
74220 $116.01 $69.61 $46.40
74230 $130.26 $78.16 $52.10
74235 $271.38 $176.40 $94.98
74240 $154.68 $92.81 $61.87
74241 $156.72 $94.03 $62.69
74245 $231.36 $138.82 $92.54
74246 $166.23 $99.74 $66.49
74247 $168.27 $100.96 $67.31
74249 $242.22 $145.33 $96.89
74250 $123.48 $74.09 $49.39
74251 $137.73 $82.64 $55.09
74260 $138.42 $83.05 $55.37
74261 $747.19 $540.82 $206.37
74262 $839.31 $612.79 $226.52
74263 BR BR BR
74270 $169.62 $101.77 $67.85
74280 $230.01 $138.01 $92.00
74283 $347.37 $208.42 $138.95
74290 $75.30 $45.18 $30.12
74291 $44.79 $26.87 $17.92
74300 $99.06 $64.39 $34.67
74301 $56.31 $36.60 $19.71
74305 $88.20 $57.33 $30.87
74320 $242.22 $157.44 $84.78
74327 $173.70 $112.90 $60.80
74328 $257.82 $167.58 $90.24
74329 $257.82 $167.58 $90.24
74330 $257.82 $167.58 $90.24
74340 $211.01 $137.16 $73.85
74355 $232.04 $150.83 $81.21
74360 $242.22 $157.44 $84.78
74363 $453.21 $294.59 $158.62
74400 $148.59 $89.15 $59.44
74410 $164.88 $98.93 $65.95
74415 $175.05 $105.03 $70.02
74420 $193.37 $116.02 $77.35
74425 $112.62 $73.20 $39.42
74430 $94.32 $61.31 $33.01
74440 $105.15 $68.35 $36.80
74445 $176.40 $114.66 $61.74
74450 $120.09 $78.06 $42.03
74455 $126.87 $82.47 $44.40
74470 $127.56 $82.91 $44.65
74475 $298.53 $194.04 $104.49
74480 $298.53 $194.04 $104.49
74485 $242.22 $157.44 $84.78
74710 $96.33 $57.80 $38.53
74740 $115.35 $74.98 $40.37
74742 $246.96 $160.52 $86.44
74775 $147.90 $88.74 $59.16
75557 $976.82 $752.82 $224.01
75559 $1,429.11            $1,142.80            $286.32
75561 $1,322.49            $1,074.69            $247.80
75563 $1,641.25            $1,343.89            $297.35
75565 $166.58 $143.06 $23.52
75571 $164.21 $111.66 $52.55
75572 $482.16 $322.32 $159.84
75573 $685.26 $456.44 $228.81
75574 $1059.16 $841.11 $218.05
75600 $808.74 $727.87 $80.87
75605 $870.48 $739.91 $130.57
75625 $870.48 $739.91 $130.57
75630 $918.65 $780.85 $137.80
75635 $791.43 $599.08 $192.35
75658 $886.76 $753.75 $133.01
75705 $970.22 $776.18 $194.04
75710 $870.48 $739.91 $130.57
75716 $886.76 $753.75 $133.01
75726 $870.48 $739.91 $130.57
75731 $870.48 $739.91 $130.57
75733 $886.76 $753.75 $133.01
75736 $870.48 $739.91 $130.57
75741 $886.76 $753.75 $133.01
75743 $920.00 $782.00 $138.00
75746 $870.48 $739.91 $130.57
75756 $870.48 $739.91 $130.57
75774 $796.52 $716.87 $79.65
75791 $558.82 $403.45 $155.37
75801 $405.05 $324.04 $81.01
75803 $438.30 $350.64 $87.66
75805 $446.43 $357.14 $89.29
75807 $479.69 $383.75 $95.94
75809 $90.92 $59.10 $31.82
75810 $870.48 $739.91 $130.57
75820 $124.17 $80.71 $43.46
75822 $189.96 $123.47 $66.49
75825 $870.48 $739.91 $130.57
75827 $870.48 $739.91 $130.57
75831 $870.48 $739.91 $130.57
75833 $903.74 $768.18 $135.56
75840 $870.48 $739.91 $130.57
75842 $903.74 $768.18 $135.56
75860 $870.48 $739.91 $130.57
75870 $870.48 $739.91 $130.57
75872 $870.48 $739.91 $130.57
75880 $124.17 $105.54 $18.63
75885 $898.97 $764.12 $134.85
75887 $898.97 $764.12 $134.85
75889 $870.48 $739.91 $130.57
75891 $870.48 $739.91 $130.57
75893 $814.16 $732.74 $81.42
75894 $1,584.23 $1,425.81 $158.42
75896 $1,393.58 $1,254.22 $139.36
75898 $221.19 $176.95 $44.24
75901 $163.39 $116.86 $46.53
75902 $153.72 $116.86 $36.87
75945 $304.39 $272.99 $31.40
75946 $168.19 $136.79 $31.40
75952 $430.00    
75953 $164.31    
75954 $156.51    
75956 $737.94    
75957 $632.26    
75958 $421.58    
75959 $369.09    
75962 $1,004.15 $903.73 $100.42
75964 $542.10 $487.89 $54.21
75966 $1,076.75 $969.07 $107.68
75968 $542.10 $487.89 $54.21
75970 $778.22 $700.40 $77.82
75978 $1,018.40 $916.56 $101.84
75980 $464.76 $325.33 $139.43
75982 $506.15 $354.30 $151.85
75984 $187.26 $121.72 $65.54
75989 $303.27 $197.13 $106.14
76000 $94.32 $61.31 $33.01
76001 $223.89 $145.53 $78.36
76010 $48.84 $31.75 $17.09
76080 $116.01 $75.41 $40.60
76085 $25.46 $19.58 $5.88
76098 $40.71 $24.43 $16.28
76100 $131.63 $78.98 $52.65
76101 $141.81 $85.09 $56.72
76102 $160.80 $96.48 $64.32
76120 $99.74 $59.84 $39.90
76125 $73.28 $43.97 $29.31
76140 BR BR BR
76376 $258.76 $238.20 $20.60
76377 $330.06 $249.14 $80.93
76380 $305.31 $213.72 $91.59
76390 $866.44 $729.75 $136.69
76490 $293.53 $105.23 $188.30
76496 BR BR BR
76497 BR BR BR
76498 BR BR BR
76499 BR BR BR
76506 $146.55 $80.60 $65.95
76510 $316.38 $153.11 $163.28
76511 $154.02 $84.71 $69.31
76512 $155.37 $85.45 $69.92
76513 $155.37 $85.45 $69.92
76514 $22.89 $4.55 $18.35
76516 $127.56 $70.16 $57.40
76519 $127.56 $70.16 $57.40
76529 $137.73 $75.75 $61.98
76536 $139.77 $76.87 $62.90
76604 $132.30 $72.76 $59.54
76645 $116.01 $63.81 $52.20
76700 $196.76 $108.22 $88.54
76705 $142.47 $78.36 $64.11
76770 $190.65 $104.86 $85.79
76775 $141.81 $78.00 $63.81
76776 $224.85 $157.19 $67.66
76800 $193.37 $106.35 $87.02
76801 $169.23 $74.11 $95.12
76802 $131.85 $51.94 $79.91
76805 $221.85 $122.02 $99.83
76810 $441.69 $242.93 $198.76
76811 $436.02 $251.06 $184.97
76812 $257.66 $84.40 $173.26
76813 $228.71 $125.03 $103.68
76814 $151.02 $64.07 $86.95
76815 $147.90 $81.34 $66.56
76816 $122.13 $67.17 $54.96
76817 $175.62 $103.51 $72.11
76818 $171.66 $94.41 $77.25
76819 $178.22 $114.48 $63.74
76820 $167.95 $116.32 $51.62
76821 $188.29 $116.32 $71.97
76825 $206.94 $113.82 $93.12
76826 $140.45 $77.25 $63.20
76827 $187.26 $102.99 $84.27
76828 $122.79 $67.53 $55.26
76830 $158.76 $87.32 $71.44
76831 $168.34 $99.37 $68.97
76856 $158.76 $87.32 $71.44
76857 $99.74 $54.86 $44.88
76870 $153.33 $84.33 $69.00
76872 $158.76 $87.32 $71.44
76873 $271.62 $144.55 $127.07
76881 $217.31 $162.19 $55.12
76882 $57.19 $18.97 $38.22
76885 $169.62 $99.37 $70.25
76886 $151.33 $92.41 $58.92
76930 $156.72 $86.20 $70.52
76932 $156.72 $86.20 $70.52
76936 $519.03 $285.47 $233.56
76937 $60.76 $29.73 $31.03
76940 $313.21 $116.68 $196.53
76941 $221.19 $121.65 $99.54
76942 $156.72 $86.20 $70.52
76945 $177.09 $97.40 $79.69
76946 $128.91 $70.90 $58.01
76948 $128.91 $70.90 $58.01
76950 $135.02 $74.26 $60.76
76965 $563.49 $340.59 $222.90
76970 $101.76 $55.97 $45.79
76975 $168.27 $92.55 $75.72
76977 $75.68 $55.45 $20.23
76998 $113.01    
76999 BR BR BR
77001 $148.88 $114.25 $34.63
77002 $136.49 $88.20 $48.29
77003 $135.10 $80.67 $54.43
77011 $882.31 $772.30 $110.01
77012 $580.00 $475.08 $104.94
77013 $362.07    
77014 $307.56 $230.06 $77.50
77021 $889.04 $750.99 $138.04
77022 $386.00 $386.00 $0.00
77051 $30.67 $25.13 $5.55
77052 $30.67 $25.13 $5.55
77053 $182.61 $149.69 $32.93
77054 $262.11 $221.19 $40.92
77055 $142.79 $79.52 $63.27
77056 $178.14 $99.84 $78.30
77057 $149.41 $86.14 $63.27
77058 $1,440.31 $1,292.91 $147.39
77059 $1,777.15 $1,629.76 $147.39
77071 $52.90    
77072 $40.75 $24.23 $16.52
77073 $76.11 $51.65 $24.46
77074 $115.64 $74.72 $40.92
77075 $161.60 $111.96 $49.67
77076 $132.73 $69.46 $63.27
77077 $97.83 $69.25 $28.58
77078 $257.84 $235.55 $22.29
77080 $199.18 $179.16 $20.01
77081 $72.46 $51.66 $20.80
77082 $62.58 $46.86 $15.72
77084 $976.10 $830.94 $145.16
77261 $132.30    
77262 $200.82    
77263 $298.53    
77280 $277.50 $194.25 $83.25
77285 $436.94 $305.86 $131.08
77290 $542.78 $379.95 $162.83
77293 $845.31 $647.56 $197.74
77295 $2,124.97 $1,487.48 $637.49
77299 BR BR BR
77300 $140.45 $70.22 $70.23
77301 $2,573.25 $1,804.36 $768.89
77305 $179.79 $98.88 $80.91
77310 $240.86 $120.43 $120.43
77315 $310.07 $139.53 $170.54
77321 $335.16 $217.85 $117.31
77326 $232.04 $127.62 $104.42
77327 $342.63 $188.45 $154.18
77328 $499.35 $249.67 $249.68
77331 $113.31 $22.66 $90.65
77332 $132.99 $66.49 $66.50
77333 $195.39 $97.69 $97.70
77334 $313.46 $172.40 $141.06
77336 $180.48    
77338 $877.59 $457.09 $420.50
77370 $211.68    
77371 $2,077.76    
77372 $1,576.45    
77373 $2,942.06    
77399 BR BR BR
77401 $107.19    
77402 $107.19    
77403 $107.19    
77404 $107.19    
77406 $107.19    
77407 $126.20    
77408 $126.20    
77409 $126.20    
77411 $126.20    
77412 $141.12    
77413 $141.12    
77414 $141.12    
77416 $141.12    
77417 $35.97    
77418 $1,066.14    
77421 $273.17 $234.36 $38.81
77422 $123.03    
77423 $160.62    
77424 BR BR BR
77425 BR BR BR
77427 $305.94    
77431 $172.32    
77432 $837.92    
77435 $1,216.77    
77469 BR BR BR
77470 $872.51 $610.76 $261.75
77499 BR BR BR
77520 BR BR BR
77522 BR BR BR
77523 BR BR BR
77525 BR BR BR
77600 $333.12 $166.56 $166.56
77605 $444.39 $222.19 $222.20
77610 $333.12 $166.56 $166.56
77615 $444.39 $222.19 $222.20
77620 $333.12 $166.56 $166.56
77750 $517.68 $77.65 $440.03
77761 $490.53 $122.63 $367.90
77762 $728.00 $182.00 $546.00
77763 $1,033.31 $206.66 $826.65
77776 $576.02 $115.20 $460.82
77777 $922.04 $230.51 $691.53
77778 $1,306.73 $261.35 $1,045.38
77785 $340.82 $205.27 $135.55
77786 $1019.34 $713.97 $305.37
77787 $1515.02 $1046.33 $468.69
77789 $126.87 $25.37 $101.50
77790 $129.60 $25.92 $103.68
77799 BR BR BR
78012 $151.45 $133.99 $17.46
78013 $382.59 $348.80 $33.79
78014 $442.25 $397.02 $45.24
78015 $220.50 $154.35 $66.15
78016 $289.71 $202.80 $86.91
78018 $419.30 $293.51 $125.79
78020 $53.02