Bernadine Singh
Chief Medical Fee Examiner
N.C. Industrial Commission
E-mail: Bernadine.Singh@ic.nc.gov
|
NOTE 1: To purchase a complete copy of the American Medical Association’s Current Procedural Technology Codes, telephone Ingenix, Inc. at (800) INGENIX (464-3649), option 1, or go to http://www.shopingenix.com/modules/catalog/catalog_category.asp to order a CPT® code book online. NOTE 2: Please report any problems or errors directly to Bernadine.Singh@ic.nc.gov. NOTE 3: This page was last revised on February 20, 2009. |
|
Introduction |
CPT
Codes and Fees /
Commission Assigned Codes |
| Evaluation and Management Section 3 | Physical Medicine Section 10 |
| Anesthesia Section 4 (effective April 1, 2000) | Chiropractic Fee Schedule Section 11 (effective March 1, 2001) |
| Surgery Section 5 | Industrial Rehabilitation Section 12 (effective January 1996) |
| Radiology Section 6 | Dental Fee Schedule Section 13 (effective May 1, 2007) |
| Pathology and Laboratory Section 7 | Hospital and Ambulatory Surgical Center Section 14 (effective July 15, 2002) |
| Medicine Section 8 | Forms Section 16 (effective February 1, 2000) |
| Special Services Section 9 | Durable Medical Equipment/Supply Fee Schedule (effective January 1, 2008) |
| CODE | ALLOWANCE |
| 00120 | $48.00 |
| 00140 | $32.00 |
| 00145 | $82.00 |
| 00150 | $48.00 |
| 00160 | $90.00 |
| 00170 | BR |
| 00180 | BR |
| 00210 | $100.00 |
| 00220 | $19.00 |
| 00230 | $18.00 |
| 00240 | $19.00 |
| 00250 | $75.00 |
| 00260 | $75.00 |
| 00270 | $18.00 |
| 00272 | $33.00 |
| 00273 | $46.00 |
| 00274 | $42.00 |
| 00277 | BR |
| 00290 | $75.00 |
| 00310 | $184.00 |
| 00320 | $25.00 |
| 00321 | $100.00 |
| 00322 | BR |
| 00330 | $100.00 |
| 00340 | $100.00 |
| 00350 | BR |
| 00360 | $248.00 |
| 00362 | $260.00 |
| 00363 | $285.00 |
| 00415 | $26.00 |
| 00416 | BR |
| 00421 | BR |
| 00425 | $30.00 |
| 00431 | BR |
| 00460 | $45.00 |
| 00470 | $52.00 |
| 00472 | BR |
| 00473 | BR |
| 00474 | BR |
| 00475 | BR |
| 00476 | BR |
| 00477 | BR |
| 00478 | BR |
| 00479 | BR |
| 00480 | BR |
| 00481 | BR |
| 00482 | BR |
| 00483 | BR |
| 00484 | BR |
| 00485 | BR |
| 00486 | BR |
| 00502 | $45.00 |
| 00999 | BR |
| 01110 | $53.00 |
| 01120 | $38.00 |
| 01203 | $20.00 |
| 01204 | $20.00 |
| 01206 | $31.00 |
| 01310 | $30.00 |
| 01320 | BR |
| 01330 | $30.00 |
| 01351 | $35.00 |
| 01510 | $250.00 |
| 01515 | $380.00 |
| 01520 | $279.00 |
| 01525 | $197.00 |
| 01550 | $33.00 |
| 01555 | $60.00 |
| 02140 | $90.00 |
| 02150 | $105.00 |
| 02160 | $125.00 |
| 02161 | $175.00 |
| 02330 | $95.00 |
| 02331 | $117.00 |
| 02332 | $160.00 |
| 02335 | $200.00 |
| 02390 | $200.00 |
| 02391 | $95.00 |
| 02392 | $117.00 |
| 02393 | $160.00 |
| 02394 | $200.00 |
| 02410 | BR |
| 02420 | BR |
| 02430 | BR |
| 02510 | $382.00 |
| 02520 | $442.00 |
| 02530 | $492.00 |
| 02542 | BR |
| 02543 | $594.00 |
| 02544 | $612.00 |
| 02610 | $385.00 |
| 02620 | $500.00 |
| 02630 | $650.00 |
| 02642 | BR |
| 02643 | BR |
| 02644 | BR |
| 02650 | BR |
| 02651 | BR |
| 02652 | BR |
| 02662 | BR |
| 02663 | BR |
| 02664 | BR |
| 02710 | $175.00 |
| 02712 | BR |
| 02720 | $504.00 |
| 02721 | $504.00 |
| 02722 | $504.00 |
| 02740 | $800.00 |
| 02750 | $775.00 |
| 02751 | $650.00 |
| 02752 | $750.00 |
| 02780 | BR |
| 02781 | BR |
| 02782 | BR |
| 02783 | BR |
| 02790 | $750.00 |
| 02791 | $650.00 |
| 02792 | $504.00 |
| 02794 | BR |
| 02799 | BR |
| 02910 | $76.00 |
| 02915 | BR |
| 02920 | $76.00 |
| 02930 | $200.00 |
| 02931 | $200.00 |
| 02932 | $200.00 |
| 02933 | $250.00 |
| 02934 | BR |
| 02940 | $76.00 |
| 02950 | $142.00 |
| 02951 | $41.00 |
| 02952 | $247.00 |
| 02953 | $150.50 |
| 02954 | $200.00 |
| 02955 | BR |
| 02957 | BR |
| 02960 | $200.00 |
| 02961 | $600.00 |
| 02962 | $600.00 |
| 02970 | $167.00 |
| 02971 | BR |
| 02975 | BR |
| 02980 | BR |
| 02999 | BR |
| 03110 | $36.00 |
| 03120 | $42.00 |
| 03220 | $121.00 |
| 03221 | $121.00 |
| 03230 | BR |
| 03240 | BR |
| 03310 | $495.00 |
| 03320 | $550.00 |
| 03330 | $680.00 |
| 03331 | BR |
| 03332 | BR |
| 03333 | BR |
| 03346 | $500.00 |
| 03347 | $600.00 |
| 03348 | $700.00 |
| 03351 | $200.00 |
| 03352 | $200.00 |
| 03353 | $500.00 |
| 03410 | $700.00 |
| 03421 | $750.00 |
| 03425 | $800.00 |
| 03426 | BR |
| 03430 | $100.00 |
| 03450 | $210.00 |
| 03460 | BR |
| 03470 | BR |
| 03910 | $126.00 |
| 03920 | $210.00 |
| 03950 | BR |
| 03999 | BR |
| 04210 | $372.00 |
| 04211 | $75.00 |
| 04230 | $1,000.00 |
| 04231 | $798.00 |
| 04240 | $372.00 |
| 04241 | BR |
| 04245 | BR |
| 04249 | $272.00 |
| 04260 | $550.00 |
| 04261 | $350.00 |
| 04263 | BR |
| 04264 | BR |
| 04265 | BR |
| 04266 | BR |
| 04267 | BR |
| 04268 | BR |
| 04270 | BR |
| 04271 | BR |
| 04273 | BR |
| 04274 | BR |
| 04275 | BR |
| 04276 | BR |
| 04320 | BR |
| 04321 | $200.00 |
| 04341 | $150.00 |
| 04342 | $230.00 |
| 04355 | $105.00 |
| 04381 | $48.00 |
| 04910 | $72.00 |
| 04920 | BR |
| 04999 | BR |
| 05110 | $1,000.00 |
| 05120 | $1,000.00 |
| 05130 | $1,100.00 |
| 05140 | $1,100.00 |
| 05211 | $550.00 |
| 05212 | $550.00 |
| 05213 | $1,100.00 |
| 05214 | $1,100.00 |
| 05225 | BR |
| 05226 | BR |
| 05281 | $950.00 |
| No Code | $1,500.00 |
| No Code | $1,500.00 |
| 05410 | $39.00 |
| 05411 | $39.00 |
| 05421 | $39.00 |
| 05422 | $39.00 |
| 05510 | $150.00 |
| 05520 | $124.00 |
| 05610 | $124.00 |
| 05620 | $212.00 |
| 05630 | $210.00 |
| 05640 | $104.00 |
| 05650 | $200.00 |
| 05660 | $232.00 |
| 05670 | BR |
| 05671 | BR |
| 05710 | $350.00 |
| 05711 | $350.00 |
| 05720 | $300.00 |
| 05721 | $300.00 |
| 05730 | $175.00 |
| 05731 | $175.00 |
| 05740 | $175.00 |
| 05741 | $175.00 |
| 05750 | $275.00 |
| 05751 | $275.00 |
| 05760 | $275.00 |
| 05761 | $275.00 |
| 05810 | $450.00 |
| 05811 | $450.00 |
| 05820 | $450.00 |
| 05821 | $450.00 |
| 05850 | $72.00 |
| 05851 | $72.00 |
| 05860 | $1,200.00 |
| 05861 | BR |
| 05862 | $300.00 |
| 05867 | BR |
| 05875 | BR |
| 05899 | BR |
| 05911 | BR |
| 05912 | BR |
| 05913 | $1,455.00 |
| 05914 | $1,698.00 |
| 05915 | $2,183.00 |
| 05916 | $1,455.00 |
| 05919 | $728.00 |
| 05922 | BR |
| 05923 | BR |
| 05924 | BR |
| 05925 | BR |
| 05926 | BR |
| 05927 | BR |
| 05928 | BR |
| 05929 | BR |
| 05931 | $728.00 |
| 05932 | $2,183.00 |
| 05933 | $509.00 |
| 05934 | $1,698.00 |
| 05935 | $1,698.00 |
| 05936 | BR |
| 05937 | BR |
| 05951 | $728.00 |
| 05952 | $1,698.00 |
| 05953 | $2,183.00 |
| 05954 | $2,183.00 |
| 05955 | $2,183.00 |
| 05958 | BR |
| 05959 | BR |
| 05960 | BR |
| 05982 | $1,091.00 |
| 05983 | $1,698.00 |
| 05984 | $1,091.00 |
| 05985 | $1,091.00 |
| 05986 | $72.00 |
| 05987 | BR |
| 05988 | BR |
| 05999 | BR |
| 06010 | $1,350.00 |
| 06012 | $1,988.00 |
| 06040 | BR |
| 06050 | BR |
| 06053 | BR |
| 06054 | BR |
| 06055 | BR |
| 06056 | BR |
| 06057 | BR |
| 06058 | BR |
| 06059 | BR |
| 06060 | BR |
| 06061 | BR |
| 06062 | BR |
| 06063 | BR |
| 06064 | BR |
| 06094 | BR |
| 06065 | BR |
| 06066 | BR |
| 06067 | BR |
| 06068 | BR |
| 06069 | BR |
| 06070 | BR |
| 06071 | BR |
| 06072 | BR |
| 06073 | BR |
| 06074 | BR |
| 06194 | BR |
| 06075 | BR |
| 06076 | BR |
| 06077 | BR |
| 06078 | BR |
| 06079 | BR |
| 06080 | BR |
| 06090 | BR |
| 06091 | $75.00 |
| 06092 | $94.00 |
| 06093 | $138.00 |
| 06095 | BR |
| 06100 | BR |
| 06190 | BR |
| 06199 | BR |
| 06205 | BR |
| 06210 | $750.00 |
| 06211 | $700.00 |
| 06212 | $750.00 |
| 06214 | $672.00 |
| 06240 | $750.00 |
| 06241 | $700.00 |
| 06242 | $700.00 |
| 06245 | BR |
| 06250 | $504.00 |
| 06251 | $504.00 |
| 06252 | $504.00 |
| 06253 | BR |
| 06545 | $324.00 |
| 06548 | BR |
| 06600 | BR |
| 06601 | BR |
| 06602 | BR |
| 06603 | BR |
| 06604 | BR |
| 06605 | BR |
| 06606 | BR |
| 06607 | BR |
| 06624 | BR |
| 06608 | BR |
| 06609 | BR |
| 06610 | BR |
| 06611 | BR |
| 06612 | BR |
| 06613 | BR |
| 06614 | BR |
| 06615 | BR |
| 06634 | BR |
| 06710 | $504.00 |
| 06720 | $504.00 |
| 06721 | $504.00 |
| 06722 | $504.00 |
| 06740 | $504.00 |
| 06750 | $750.00 |
| 06751 | $750.00 |
| 06752 | $750.00 |
| 06780 | $750.00 |
| 06781 | BR |
| 06782 | BR |
| 06783 | BR |
| 06790 | $750.00 |
| 06791 | $700.00 |
| 06792 | $750.00 |
| 06794 | BR |
| 06793 | BR |
| 06920 | BR |
| 06930 | $105.00 |
| 06940 | $145.00 |
| 06950 | $286.00 |
| 06970 | $275.00 |
| 06972 | $200.00 |
| 06973 | $175.00 |
| 06975 | BR |
| 06976 | BR |
| 06977 | BR |
| 06980 | BR |
| 06985 | BR |
| 06999 | BR |
| 07111 | $90.00 |
| 07140 | $110.00 |
| 07210 | $250.00 |
| 07220 | $200.00 |
| 07230 | $300.00 |
| 07240 | $400.00 |
| 07241 | $500.00 |
| 07250 | $75.00 |
| 07260 | $300.00 |
| 07261 | BR |
| 07270 | $400.00 |
| 07272 | BR |
| 07280 | $400.00 |
| 07282 | BR |
| 07283 | BR |
| 07285 | $200.00 |
| 07286 | $200.00 |
| 07287 | BR |
| 07288 | BR |
| 07290 | BR |
| 07291 | $110.00 |
| 07292 | $1,500.00 |
| 07293 | $1,500.00 |
| 07294 | $800.00 |
| 07310 | $100.00 |
| 07311 | BR |
| 07320 | $210.00 |
| 07321 | BR |
| 07340 | BR |
| 07350 | BR |
| 07410 | $150.00 |
| 07411 | BR |
| 07412 | BR |
| 07413 | BR |
| 07414 | BR |
| 07415 | BR |
| 07465 | BR |
| 07440 | BR |
| 07441 | BR |
| 07450 | BR |
| 07451 | $250.00 |
| 07460 | $250.00 |
| 07461 | $250.00 |
| 07471 | BR |
| 07472 | BR |
| 07473 | BR |
| 07485 | BR |
| 07490 | BR |
| 07510 | $101.50 |
| 07511 | BR |
| 07520 | $200.00 |
| 07521 | BR |
| 07530 | $250.00 |
| 07540 | BR |
| 07550 | BR |
| 07560 | BR |
| 07610 | BR |
| 07620 | BR |
| 07630 | BR |
| 07640 | BR |
| 07650 | BR |
| 07660 | BR |
| 07670 | BR |
| 07671 | BR |
| 07680 | BR |
| 07710 | BR |
| 07720 | BR |
| 07730 | BR |
| 07740 | BR |
| 07750 | BR |
| 07760 | BR |
| 07770 | BR |
| 07771 | BR |
| 07780 | BR |
| 07810 | BR |
| 07820 | BR |
| 07830 | BR |
| 07840 | BR |
| 07850 | BR |
| 07852 | BR |
| 07854 | BR |
| 07856 | BR |
| 07858 | BR |
| 07860 | BR |
| 07865 | BR |
| 07870 | BR |
| 07871 | BR |
| 07872 | BR |
| 07873 | BR |
| 07874 | BR |
| 07875 | BR |
| 07876 | BR |
| 07877 | BR |
| 07880 | BR |
| 07899 | BR |
| 07910 | $325.00 |
| 07911 | $524.00 |
| 07912 | BR |
| 07920 | BR |
| 07940 | BR |
| 07941 | BR |
| 07943 | BR |
| 07944 | BR |
| 07945 | BR |
| 07946 | BR |
| 07947 | BR |
| 07948 | BR |
| 07949 | BR |
| 07950 | BR |
| 07951 | $3,000.00 |
| 07953 | BR |
| 07955 | BR |
| 07960 | BR |
| 07963 | BR |
| 07970 | BR |
| 07971 | BR |
| 07972 | BR |
| 07980 | $165.00 |
| 07981 | BR |
| 07982 | BR |
| 07983 | BR |
| 07990 | BR |
| 07991 | BR |
| 07995 | BR |
| 07996 | BR |
| 07997 | BR |
| 07998 |