Table 1 Cost inputs used in diagnostic and therapeutic procedures
Procedure code | Description | 2013 Medicare reimbursement |
|---|---|---|
CPT 99203 | E & M new patient – 30 minutes (nonfacility [NF]) | $108.19 |
CPT 73560 | Xray knee one or two views | $32.32 |
CPT 73721 | MRI knee - Global | $405.21 |
CPT 73721-25 | MRI knee - Professional | $66.69 |
CPT 73221 | MRI shoulder - Global | $405.21 |
CPT 73221-26 | MRI shoulder – Professional | $66.69 |
CPT 29805 | Diagnostic shoulder arthroscopy (NF) | $479.38 |
CPT 29827 | Rotator cuff repair | $1,086.35 |
CPT 29870 | Diagnostic knee arthroscopy (NF) | $603.23 |
CPT 29877 | Chondroplasty (Facility) - if a TP or a FN crossover (FN CO) | $632.49 |
CPT 29881 | Meniscectomy (Facility) – if a FP | $551.51 |
CPT 01440 | General anesthesia (45 minutes) – for hospital outpatient procedure - knee | $131.55 |
CPT 01630 | General anesthesia (90 minutes) for hospital outpatient procedure – rotator cuff repair | $243.32 |
APC 0041 | Outpatient knee arthroscopy | $2,111.62 |
APC 0042 | Outpatient shoulder arthroscopy | $3,880.22 |
CPT 99213 | E & M existing patient – 30 minutes Non-facility (NF) | $72.81 |
CPT 97110 | Therapeutic procedures, 15Â minutes each, physical therapy | $31.98 |
CPT 20610 | Arthrocentesis – major joint | $65.56 |