table 12: cy 2018 work rvus for new, revised and ... · table 12: cy 2018 work rvus for new,...

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CMS-1676-F 413 TABLE 12: CY 2018 Work RVUs for New, Revised and Potentially Misvalued Codes HCPCS Code Long Descriptor CY 2017 Work RVU Proposed CY 2018 Work RVU Final CY 2018 Work RVU CMS Work Time Refinement 00731 Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified NEW 0.00 0.00 No 00732 Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; endoscopic retrograde cholangiopancreatography (ERCP) NEW 0.00 0.00 No 00811 Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; not otherwise specified NEW 0.00 0.00 No 00812 Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy NEW 0.00 0.00 No 00813 Anesthesia for combined upper and lower gastrointestinal endoscopic procedures, endoscope introduced both proximal to and distal to the duodenum NEW 0.00 0.00 No 10040 Acne surgery (eg, marsupialization, opening or removal of multiple milia, comedones, cysts, pustules) 1.21 0.91 0.91 No 15730 Midface flap (ie, zygomaticofacial flap) with preservation of vascular pedicle(s) NEW 13.50 13.50 No 15733 Muscle, myocutaneous, or fasciocutaneous flap; head and neck with named vascular pedicle (ie, buccinators, genioglossus, temporalis, masseter, sternocleidomastoid, levator scapulae) NEW 15.68 15.68 No 15734 Muscle, myocutaneous, or fasciocutaneous flap; trunk 19.86 23.00 23.00 No 15736 Muscle, myocutaneous, or fasciocutaneous flap; upper extremity 17.04 17.04 17.04 No 15738 Muscle, myocutaneous, or fasciocutaneous flap; lower extremity 19.04 19.04 19.04 No 19294 Preparation of tumor cavity with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with partial mastectomy NEW 3.00 3.00 No 19303 Mastectomy, simple, complete 15.85 15.00 15.00 No 20939 Bone marrow aspiration for bone grafting, spine surgery only, through separate skin or fascial incision NEW 1.16 1.16 No 29445 Application of rigid total contact leg cast 1.78 1.78 1.78 No 29580 Strapping; Unna boot 0.55 0.55 0.55 No 29581 Application of multi-layer compression system; leg (below knee), including ankle and foot 0.25 0.60 0.60 No 30140 Submucous resection inferior turbinate, partial or complete, any method 3.57 3.00 3.00 No 30901 Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method 1.10 1.10 1.10 No

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Page 1: TABLE 12: CY 2018 Work RVUs for New, Revised and ... · TABLE 12: CY 2018 Work RVUs for New, Revised and Potentially Misvalued Codes HCPCS Code Long Descriptor CY 2017 Work RVU Proposed

CMS-1676-F 413

TABLE 12: CY 2018 Work RVUs for New, Revised and Potentially Misvalued Codes

HCPCS

Code Long Descriptor

CY 2017

Work

RVU

Proposed

CY 2018

Work

RVU

Final

CY

2018

Work

RVU

CMS Work

Time

Refinement

00731

Anesthesia for upper gastrointestinal

endoscopic procedures, endoscope introduced

proximal to duodenum; not otherwise specified

NEW 0.00 0.00 No

00732

Anesthesia for upper gastrointestinal

endoscopic procedures, endoscope introduced

proximal to duodenum; endoscopic retrograde

cholangiopancreatography (ERCP)

NEW 0.00 0.00 No

00811

Anesthesia for lower intestinal endoscopic

procedures, endoscope introduced distal to

duodenum; not otherwise specified

NEW 0.00 0.00 No

00812

Anesthesia for lower intestinal endoscopic

procedures, endoscope introduced distal to

duodenum; screening colonoscopy

NEW 0.00 0.00 No

00813

Anesthesia for combined upper and lower

gastrointestinal endoscopic procedures,

endoscope introduced both proximal to and

distal to the duodenum

NEW 0.00 0.00 No

10040

Acne surgery (eg, marsupialization, opening or

removal of multiple milia, comedones, cysts,

pustules)

1.21 0.91 0.91 No

15730 Midface flap (ie, zygomaticofacial flap) with

preservation of vascular pedicle(s) NEW 13.50 13.50 No

15733

Muscle, myocutaneous, or fasciocutaneous flap;

head and neck with named vascular pedicle (ie,

buccinators, genioglossus, temporalis, masseter,

sternocleidomastoid, levator scapulae)

NEW 15.68 15.68 No

15734 Muscle, myocutaneous, or fasciocutaneous flap;

trunk 19.86 23.00 23.00 No

15736 Muscle, myocutaneous, or fasciocutaneous flap;

upper extremity 17.04 17.04 17.04 No

15738 Muscle, myocutaneous, or fasciocutaneous flap;

lower extremity 19.04 19.04 19.04 No

19294

Preparation of tumor cavity with placement of a

radiation therapy applicator for intraoperative

radiation therapy (IORT) concurrent with

partial mastectomy

NEW 3.00 3.00 No

19303 Mastectomy, simple, complete 15.85 15.00 15.00 No

20939

Bone marrow aspiration for bone grafting,

spine surgery only, through separate skin or

fascial incision

NEW 1.16 1.16 No

29445 Application of rigid total contact leg cast 1.78 1.78 1.78 No

29580 Strapping; Unna boot 0.55 0.55 0.55 No

29581 Application of multi-layer compression system;

leg (below knee), including ankle and foot 0.25 0.60 0.60 No

30140 Submucous resection inferior turbinate, partial

or complete, any method 3.57 3.00 3.00 No

30901 Control nasal hemorrhage, anterior, simple

(limited cautery and/or packing) any method 1.10 1.10 1.10 No

Page 2: TABLE 12: CY 2018 Work RVUs for New, Revised and ... · TABLE 12: CY 2018 Work RVUs for New, Revised and Potentially Misvalued Codes HCPCS Code Long Descriptor CY 2017 Work RVU Proposed

CMS-1676-F 414

HCPCS

Code Long Descriptor

CY 2017

Work

RVU

Proposed

CY 2018

Work

RVU

Final

CY

2018

Work

RVU

CMS Work

Time

Refinement

30903 Control nasal hemorrhage, anterior, complex

(extensive cautery and/or packing) any method 1.54 1.54 1.54 No

30905

Control nasal hemorrhage, posterior, with

posterior nasal packs and/or cautery, any

method; initial

1.97 1.97 1.97 No

30906

Control nasal hemorrhage, posterior, with

posterior nasal packs and/or cautery, any

method; subsequent

2.45 2.45 2.45 No

31241 Nasal/sinus endoscopy, surgical; with ligation

of sphenopalatine artery NEW 8.00 8.00 No

31253

Nasal/sinus endoscopy, surgical with

ethmoidectomy; total (anterior and posterior),

including frontal sinus exploration, with

removal of tissue from frontal sinus, when

performed

NEW 9.00 9.00 No

31254 Nasal/sinus endoscopy, surgical with

ethmoidectomy; partial (anterior) 4.64 4.27 4.27 No

31255 Nasal/sinus endoscopy, surgical with

ethmoidectomy; total (anterior and posterior) 6.95 5.75 5.75 No

31256 Nasal/sinus endoscopy, surgical, with maxillary

antrostomy 3.29 3.11 3.11 No

31257

Nasal/sinus endoscopy, surgical with

ethmoidectomy; total (anterior and posterior),

including sphenoidotomy

NEW 8.00 8.00 No

31259

Nasal/sinus endoscopy, surgical with

ethmoidectomy; total (anterior and posterior),

including sphenoidotomy, with removal of

tissue from the sphenoid sinus

NEW 8.48 8.48 No

31267

Nasal/sinus endoscopy, surgical, with maxillary

antrostomy; with removal of tissue from

maxillary sinus

5.45 4.68 4.68 No

31276

Nasal/sinus endoscopy, surgical, with frontal

sinus exploration, including removal of tissue

from frontal sinus, when performed

8.84 6.75 6.75 No

31287 Nasal/sinus endoscopy, surgical, with

sphenoidotomy 3.91 3.50 3.50 No

31288

Nasal/sinus endoscopy, surgical, with

sphenoidotomy; with removal of tissue from the

sphenoid sinus

4.57 4.10 4.10 No

31295

Nasal/sinus endoscopy, surgical; with dilation

of maxillary sinus ostium (eg, balloon dilation),

transnasal or canine fossa

2.70 2.70 2.70 No

31296 Nasal/sinus endoscopy, surgical; with dilation

of frontal sinus ostium (eg, balloon dilation) 3.29 3.10 3.10 No

31297 Nasal/sinus endoscopy, surgical; with dilation

of sphenoid sinus ostium (eg, balloon dilation) 2.64 2.44 2.44 No

31298

Nasal/sinus endoscopy, surgical; with dilation

of frontal and sphenoid sinus ostia (eg, balloon

dilation)

NEW 4.50 4.50 No

31600 Tracheostomy, planned (separate procedure) 7.17 5.56 5.56 No

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CMS-1676-F 415

HCPCS

Code Long Descriptor

CY 2017

Work

RVU

Proposed

CY 2018

Work

RVU

Final

CY

2018

Work

RVU

CMS Work

Time

Refinement

31601 Tracheostomy, planned (separate procedure);

younger than 2 years 4.44 8.00 8.00 No

31603 Tracheostomy, emergency procedure;

transtracheal 4.14 6.00 6.00 No

31605 Tracheostomy, emergency procedure;

cricothyroid membrane 3.57 6.45 6.45 No

31610 Tracheostomy, fenestration procedure with skin

flaps 9.38 12.00 12.00 No

31645

Bronchoscopy, rigid or flexible, including

fluoroscopic guidance, when performed with

therapeutic aspiration of tracheobronchial tree,

initial

2.91 2.88 2.88 No

31646

Bronchoscopy, rigid or flexible, including

fluoroscopic guidance, when performed with

therapeutic aspiration of tracheobronchial tree,

subsequent, same hospital stay

2.47 2.78 2.78 No

32994

Ablation therapy for reduction or eradication of

1 or more pulmonary tumor(s) including pleura

or chest wall when involved by tumor

extension, percutaneous, including imaging

guidance when performed, unilateral;

cryoablation

NEW 9.03 9.03 No

32998

Ablation therapy for reduction or eradication of

1 or more pulmonary tumor(s) including pleura

or chest wall when involved by tumor

extension, percutaneous, including imaging

guidance when performed, unilateral;

radiofrequency

5.68 9.03 9.03 No

33927

Implantation of a total replacement heart

system (artificial heart) with recipient

cardiectomy

NEW 49.00 49.00 No

33928

Removal of a total replacement heart system

(artificial heart) for heart transplantation NEW C C No

33929

Removal and replacement of total replacement

heart system (artificial heart) NEW C C No

34701

Endovascular repair of infrarenal aorta by

deployment of an aorto-aortic tube endograft

including pre-procedure sizing and device

selection, all nonselective catheterization(s), all

associated radiological supervision and

interpretation, all endograft extension(s) placed

in the aorta from the level of the renal arteries

to the aortic bifurcation, and all

angioplasty/stenting performed from the level

of the renal arteries to the aortic bifurcation; for

other than rupture (eg, for aneurysm,

pseudoaneurysm, dissection, penetrating ulcer)

NEW 23.71 23.71 No

34702

Endovascular repair of infrarenal aorta by

deployment of an aorto-aortic tube endograft

including pre-procedure sizing and device

NEW 36.00 36.00 No

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CMS-1676-F 416

HCPCS

Code Long Descriptor

CY 2017

Work

RVU

Proposed

CY 2018

Work

RVU

Final

CY

2018

Work

RVU

CMS Work

Time

Refinement

selection, all nonselective catheterization(s), all

associated radiological supervision and

interpretation, all endograft extension(s) placed

in the aorta from the level of the renal arteries

to the aortic bifurcation, and all

angioplasty/stenting performed from the level

of the renal arteries to the aortic bifurcation; for

rupture including temporary aortic and/or iliac

balloon occlusion when performed (eg, for

aneurysm, pseudoaneurysm, dissection,

penetrating ulcer, traumatic disruption)

34703

Endovascular repair of infrarenal aorta and/or

iliac artery(ies) by deployment of an aorto-

uniiliac endograft including pre-procedure

sizing and device selection, all nonselective

catheterization(s), all associated radiological

supervision and interpretation, all endograft

extension(s) placed in the aorta from the level

of the renal arteries to the iliac bifurcation, and

all angioplasty/stenting performed from the

level of the renal arteries to the iliac

bifurcation; for other than rupture (eg, for

aneurysm, pseudoaneurysm, dissection,

penetrating ulcer)

NEW 26.52 26.52 No

34704

Endovascular repair of infrarenal aorta and/or

iliac artery(ies) by deployment of an aorto-

uniiliac endograft including pre-procedure

sizing and device selection, all nonselective

catheterization(s), all associated radiological

supervision and interpretation, all endograft

extension(s) placed in the aorta from the level

of the renal arteries to the iliac bifurcation, and

all angioplasty/stenting performed from the

level of the renal arteries to the iliac

bifurcation; for rupture including temporary

aortic and/or iliac balloon occlusion when

performed (eg, for aneurysm, pseudoaneurysm,

dissection, penetrating ulcer, traumatic

disruption)

NEW 45.00 45.00 No

34705

Endovascular repair of infrarenal aorta and/or

iliac artery(ies) by deployment of an aorto-

biiliac endograft including pre-procedure sizing

and device selection, all nonselective

catheterization(s), all associated radiological

supervision and interpretation, all endograft

extension(s) placed in the aorta from the level

of the renal arteries to the iliac bifurcation, and

all angioplasty/stenting performed from the

level of the renal arteries to the iliac

bifurcation; for other than rupture (eg, for

aneurysm, pseudoaneurysm, dissection,

NEW 29.58 29.58 No

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CMS-1676-F 417

HCPCS

Code Long Descriptor

CY 2017

Work

RVU

Proposed

CY 2018

Work

RVU

Final

CY

2018

Work

RVU

CMS Work

Time

Refinement

penetrating ulcer)

34706

Endovascular repair of infrarenal aorta and/or

iliac artery(ies) by deployment of an aorto-

biiliac endograft including pre-procedure sizing

and device selection, all nonselective

catheterization(s), all associated radiological

supervision and interpretation, all endograft

extension(s) placed in the aorta from the level

of the renal arteries to the iliac bifurcation, and

all angioplasty/stenting performed from the

level of the renal arteries to the iliac

bifurcation; for rupture including temporary

aortic and/or iliac balloon occlusion when

performed (eg, for aneurysm, pseudoaneurysm,

dissection, penetrating ulcer, traumatic

disruption)

NEW 45.00 45.00 No

34707

Endovascular repair of iliac artery by

deployment of an ilio-iliac tube endograft

including pre-procedure sizing and device

selection, all nonselective catheterization(s), all

associated radiological supervision and

interpretation, and all endograft extension(s)

proximally to the aortic bifurcation and distally

to the iliac bifurcation, and treatment zone

angioplasty/stenting when performed,

unilateral; for other than rupture (eg, for

aneurysm, pseudoaneurysm, dissection,

arteriovenous malformation)

NEW 22.28 22.28 No

34708

Endovascular repair of iliac artery by

deployment of an ilio-iliac tube endograft

including pre-procedure sizing and device

selection, all nonselective catheterization(s), all

associated radiological supervision and

interpretation, and all endograft extension(s)

proximally to the aortic bifurcation and distally

to the iliac bifurcation, and treatment zone

angioplasty/stenting when performed,

unilateral; for rupture including temporary

aortic and/or iliac balloon occlusion when

performed (eg, for aneurysm, pseudoaneurysm,

dissection, arteriovenous malformation,

traumatic disruption)

NEW 36.50 36.50 No

34709

Placement of extension prosthesis(es) distal to

the common iliac artery(ies) or proximal to the

renal artery(ies) for endovascular repair of

infrarenal abdominal aortic or iliac aneurysm,

false aneurysm, dissection, penetrating ulcer,

including pre-procedure sizing and device

selection, all nonselective catheterization(s), all

associated radiological supervision and

interpretation, and treatment zone

NEW 6.50 6.50 No

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CMS-1676-F 418

HCPCS

Code Long Descriptor

CY 2017

Work

RVU

Proposed

CY 2018

Work

RVU

Final

CY

2018

Work

RVU

CMS Work

Time

Refinement

angioplasty/stenting when performed, per

vessel treated

34710

Delayed placement of distal or proximal

extension prosthesis for endovascular repair of

infrarenal abdominal aortic or iliac aneurysm,

false aneurysm, dissection, endoleak, or

endograft migration, including pre-procedure

sizing and device selection, all nonselective

catheterization(s), all associated radiological

supervision and interpretation, and treatment

zone angioplasty/stenting when performed;

initial vessel treated

NEW 15.00 15.00 No

34711

Delayed placement of distal or proximal

extension prosthesis for endovascular repair of

infrarenal abdominal aortic or iliac aneurysm,

false aneurysm, dissection, endoleak, or

endograft migration, including pre-procedure

sizing and device selection, all nonselective

catheterization(s), all associated radiological

supervision and interpretation, and treatment

zone angioplasty/stenting when performed;

each additional vessel treated

NEW 6.00 6.00 No

34712

Transcatheter delivery of enhanced fixation

device(s) to the endograft (eg, anchor, screw,

tack) and all associated radiological supervision

and interpretation

NEW 12.00 12.00 No

34713

Percutaneous access and closure of femoral

artery for delivery of endograft through a large

sheath (12 French or larger), including

ultrasound guidance, when performed,

unilateral

NEW 2.50 2.50 No

34714

Open femoral artery exposure with creation of

conduit for delivery of endovascular prosthesis

or for establishment of cardiopulmonary

bypass, by groin incision, unilateral

NEW 5.25 5.25 No

34715

Open axillary/subclavian artery exposure for

delivery of endovascular prosthesis by

infraclavicular or supraclavicular incision,

unilateral

NEW 6.00 6.00 No

34716

Open axillary/subclavian artery exposure with

creation of conduit for delivery of endovascular

prosthesis or for establishment of

cardiopulmonary bypass, by infraclavicular or

supraclavicular incision, unilateral

NEW 7.19 7.19 No

34812

Open femoral artery exposure for delivery of

endovascular prosthesis by groin incision,

unilateral

6.74 4.13 4.13 No

34820

Open iliac artery exposure for delivery of

endovascular prosthesis or iliac occlusion by

abdominal or retroperitoneal incision, unilateral

9.74 7.00 7.00 No

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CMS-1676-F 419

HCPCS

Code Long Descriptor

CY 2017

Work

RVU

Proposed

CY 2018

Work

RVU

Final

CY

2018

Work

RVU

CMS Work

Time

Refinement

34833

Open iliac artery exposure with creation of

conduit for delivery of endovascular prosthesis

or for establishment of cardiopulmonary

bypass, by abdominal or retroperitoneal

incision, unilateral

11.98 8.16 8.16 No

34834 Open brachial artery exposure for delivery of

endovascular prosthesis unilateral 5.34 2.65 2.65 No

36215

Selective catheter placement, arterial system;

each first order thoracic or brachiocephalic

branch, within a vascular family

4.67 4.17 4.17 No

36216

Selective catheter placement, arterial system;

initial second order thoracic or brachiocephalic

branch, within a vascular family

5.27 5.27 5.27 No

36217

Selective catheter placement, arterial system;

initial third order or more selective thoracic or

brachiocephalic branch, within a vascular

family

6.29 6.29 6.29 No

36218

Selective catheter placement, arterial system;

additional second order, third order, and

beyond, thoracic or brachiocephalic branch,

within a vascular family

1.01 1.01 1.01 No

36465

Injection of non-compounded foam sclerosant

with ultrasound compression maneuvers to

guide dispersion of the injectate, inclusive of all

imaging guidance and monitoring; single

incompetent extremity truncal vein (eg, great

saphenous vein, accessory saphenous vein)

NEW 2.35 2.35 No

36466

Injection of non-compounded foam sclerosant

with ultrasound compression maneuvers to

guide dispersion of the injectate, inclusive of all

imaging guidance and monitoring; multiple

incompetent truncal veins (eg, great saphenous

vein, accessory saphenous vein), same leg

NEW 3.00 3.00 No

36470 Injection of sclerosant; single incompetent vein

(other than telangiectasia) 1.10 0.75 0.75 No

36471 Injection of sclerosant; multiple incompetent

veins (other than telangiectasia), same leg 1.65 1.50 1.50 No

36482

Endovenous ablation therapy of incompetent

vein, extremity, by transcatheter delivery of a

chemical adhesive (eg, cyanoacrylate) remote

from the access site, inclusive of all imaging

guidance and monitoring, percutaneous; first

vein treated

NEW 3.50 3.50 No

36483

Endovenous ablation therapy of incompetent

vein, extremity, by transcatheter delivery of a

chemical adhesive (eg, cyanoacrylate) remote

from the access site, inclusive of all imaging

guidance and monitoring, percutaneous;

subsequent vein(s) treated in a single extremity,

each through separate access sites

NEW 1.75 1.75 No

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CMS-1676-F 420

HCPCS

Code Long Descriptor

CY 2017

Work

RVU

Proposed

CY 2018

Work

RVU

Final

CY

2018

Work

RVU

CMS Work

Time

Refinement

36511 Therapeutic apheresis; for white blood cells 1.74 2.00 2.00 No

36512 Therapeutic apheresis; for red blood cells 1.74 2.00 2.00 No

36513 Therapeutic apheresis; for platelets 1.74 2.00 2.00 No

36514 Therapeutic apheresis; for plasma pheresis 1.74 1.81 1.81 No

36516

Therapeutic apheresis; with extracorporeal

selective adsorption or selective filtration and

plasma reinfusion

1.22 1.56 1.56 No

36522 Photopheresis, extracorporeal 1.67 1.75 1.75 No

36555

Insertion of non-tunneled centrally inserted

central venous catheter; younger than 5 years of

age

2.43 1.93 1.93 No

36556 Insertion of non-tunneled centrally inserted

central venous catheter; age 5 years or older 2.50 1.75 1.75 No

36569

Insertion of peripherally inserted central venous

catheter (PICC), without subcutaneous port or

pump; age 5 years or older

1.82 1.70 1.70 No

36620

Arterial catheterization or cannulation for

sampling, monitoring or transfusion (separate

procedure); percutaneous

1.15 1.00 1.00 No

36901

Introduction of needle(s) and/or catheter(s),

dialysis circuit, with diagnostic angiography of

the dialysis circuit, including all direct

puncture(s) and catheter placement(s),

injection(s) of contrast, all necessary imaging

from the arterial anastomosis and adjacent

artery through entire venous outflow including

the inferior or superior vena cava, fluoroscopic

guidance, radiological supervision and

interpretation and image documentation and

report;

2.82 - 3.36 No

36902

Introduction of needle(s) and/or catheter(s),

dialysis circuit, with diagnostic angiography of

the dialysis circuit, including all direct

puncture(s) and catheter placement(s),

injection(s) of contrast, all necessary imaging

from the arterial anastomosis and adjacent

artery through entire venous outflow including

the inferior or superior vena cava, fluoroscopic

guidance, radiological supervision and

interpretation and image documentation and

report; with transluminal balloon angioplasty,

peripheral dialysis segment, including all

imaging and radiological supervision and

interpretation necessary to perform the

angioplasty

4.24 - 4.83 No

36903

Introduction of needle(s) and/or catheter(s),

dialysis circuit, with diagnostic angiography of

the dialysis circuit, including all direct

puncture(s) and catheter placement(s),

injection(s) of contrast, all necessary imaging

5.85 - 6.39 No

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CMS-1676-F 421

HCPCS

Code Long Descriptor

CY 2017

Work

RVU

Proposed

CY 2018

Work

RVU

Final

CY

2018

Work

RVU

CMS Work

Time

Refinement

from the arterial anastomosis and adjacent

artery through entire venous outflow including

the inferior or superior vena cava, fluoroscopic

guidance, radiological supervision and

interpretation and image documentation and

report; with transcatheter placement of

intravascular stent(s), peripheral dialysis

segment, including all imaging and radiological

supervision and interpretation necessary to

perform the stenting, and all angioplasty within

the peripheral dialysis segment

36904

Percutaneous transluminal mechanical

thrombectomy and/or infusion for

thrombolysis, dialysis circuit, any method,

including all imaging and radiological

supervision and interpretation, diagnostic

angiography, fluoroscopic guidance, catheter

placement(s), and intraprocedural

pharmacological thrombolytic injection(s);

6.73 - 7.50 No

36905

Percutaneous transluminal mechanical

thrombectomy and/or infusion for

thrombolysis, dialysis circuit, any method,

including all imaging and radiological

supervision and interpretation, diagnostic

angiography, fluoroscopic guidance, catheter

placement(s), and intraprocedural

pharmacological thrombolytic injection(s); with

transluminal balloon angioplasty, peripheral

dialysis segment, including all imaging and

radiological supervision and interpretation

necessary to perform the angioplasty

8.46 - 9.00 No

36906

Percutaneous transluminal mechanical

thrombectomy and/or infusion for

thrombolysis, dialysis circuit, any method,

including all imaging and radiological

supervision and interpretation, diagnostic

angiography, fluoroscopic guidance, catheter

placement(s), and intraprocedural

pharmacological thrombolytic injection(s); with

transcatheter placement of intravascular

stent(s), peripheral dialysis segment, including

all imaging and radiological supervision and

interpretation necessary to perform the stenting,

and all angioplasty within the peripheral

dialysis circuit

9.88 - 10.42 No

36907

Transluminal balloon angioplasty, central

dialysis segment, performed through dialysis

circuit, including all imaging and radiological

supervision and interpretation required to

perform the angioplasty

2.48 - 3.00 No

36908 Transcatheter placement of intravascular 3.73 - 4.25 No

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CMS-1676-F 422

HCPCS

Code Long Descriptor

CY 2017

Work

RVU

Proposed

CY 2018

Work

RVU

Final

CY

2018

Work

RVU

CMS Work

Time

Refinement

stent(s), central dialysis segment, performed

through dialysis circuit, including all imaging

radiological supervision and interpretation

required to perform the stenting, and all

angioplasty in the central dialysis segment

36909

Dialysis circuit permanent vascular

embolization or occlusion (including main

circuit or any accessory veins), endovascular,

including all imaging and radiological

supervision and interpretation necessary to

complete the intervention

3.48 - 4.12 No

38220 Diagnostic bone marrow; aspiration(s) 1.08 1.20 1.20 No

38221 Diagnostic bone marrow; biopsy(ies) 1.37 1.28 1.28 No

38222 Diagnostic bone marrow; biopsy(ies) and

aspiration(s) NEW 1.44 1.44 No

38573

Laparoscopy, surgical; with bilateral total

pelvic lymphadenectomy and peri-aortic lymph

node sampling peritoneal washings, peritoneal

biopsy(s), omentectomy, and diaphragmatic

washings, including biopsy(s) when performed

NEW 20.00 20.00 No

43107

Total or near total esophagectomy, without

thoracotomy; with pharyngogastrostomy or

cervical esophagogastrostomy, with or without

pyloroplasty (transhiatal)

44.18 52.05 52.05 No

43112

Total or near total esophagectomy, with

thoracotomy; with pharyngogastrostomy or

cervical esophagogastrostomy, with or without

pyloroplasty (ie, McKeown esophagectomy, or

tri-incisional esophagectomy)

47.48 62.00 62.00 No

43117

Partial esophagectomy, distal two-thirds, with

thoracotomy and separate abdominal incision,

with or without proximal gastrectomy; with

thoracic esophagogastrostomy, with or without

pyloroplasty (Ivor Lewis)

43.65 57.50 57.50 No

43286

Esophagectomy, total or near total, with

laparoscopic mobilization of the abdominal and

mediastinal esophagus and proximal

gastrectomy, with laparoscopic pyloric drainage

procedure if performed, with open cervical

pharyngogastrostomy or esophagogastrostomy

(ie, laparoscopic transhiatal esophagectomy)

NEW 55.00 55.00 No

43287

Esophagectomy, distal two-thirds, with

laparoscopic mobilization of the abdominal and

lower mediastinal esophagus and proximal

gastrectomy, with laparoscopic pyloric drainage

procedure if performed, with separate

thoracoscopic mobilization of the middle and

upper mediastinal esophagus and thoracic

esophagogastrostomy (ie, laparoscopic

thoracoscopic esophagectomy, Ivor Lewis

NEW 63.00 63.00 No

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HCPCS

Code Long Descriptor

CY 2017

Work

RVU

Proposed

CY 2018

Work

RVU

Final

CY

2018

Work

RVU

CMS Work

Time

Refinement

esophagectomy)

43288

Esophagectomy, total or near total, with

thoracoscopic mobilization of the upper,

middle, and lower mediastinal esophagus, with

separate laparoscopic proximal gastrectomy,

with laparoscopic pyloric drainage procedure if

performed, with open cervical

pharyngogastrostomy or esophagogastrostomy

(ie, thoracoscopic, laparoscopic and cervical

incision esophagectomy, McKeown

esophagectomy, tri-incisional esophagectomy)

NEW 66.42 66.42 No

51798

Measurement of post-voiding residual urine

and/or bladder capacity by ultrasound, non-

imaging

0.00 0.00 0.00 No

52601

Transurethral electrosurgical resection of

prostate, including control of postoperative

bleeding, complete (vasectomy, meatotomy,

cystourethroscopy, urethral calibration and/or

dilation, and internal urethrotomy are included)

15.26 13.16 13.16 No

55874

Transperineal placement of biodegradable

material, peri-prostatic, single or multiple

injection(s), including image guidance, when

performed

NEW 3.03 3.03 No

57240

Anterior colporrhaphy, repair of cystocele with

or without repair of urethrocele, including

cystourethroscopy, when performed

11.50 10.08 10.08 No

57250 Posterior colporrhaphy, repair of rectocele with

or without perineorrhaphy 11.50 10.08 10.08 No

57260 Combined anteroposterior colporrhaphy,

including cystourethroscopy, when performed 14.44 13.25 13.25 No

57265

Combined anteroposterior colporrhaphy,

including cystourethroscopy, when performed;

with enterocele repair

15.94 15.00 15.00 No

58575

Laparoscopy, surgical, total hysterectomy; with

or without salpingo-oophorectomy, unilateral or

bilateral, with resection of malignancy (tumor

debulking), with omentectomy

NEW 32.60 32.60 No

64418 Injection, anesthetic agent; suprascapular nerve 1.32 1.10 1.10 No

64553 Percutaneous implantation of neurostimulator

electrode array; cranial nerve 2.36 6.13 6.13 No

64555

Percutaneous implantation of neurostimulator

electrode array; peripheral nerve (excludes

sacral nerve)

2.32 5.76 5.76 No

64910 Nerve repair; with synthetic conduit or vein

allograft (eg, nerve tube), each nerve 11.39 10.52 10.52 No

64911 Nerve repair; with autogenous vein graft

(includes harvest of vein graft), each nerve 14.39 14.00 14.00 No

64912 Nerve repair; with nerve allograft, each nerve,

first strand (cable) NEW 12.00 12.00 No

64913 Nerve repair; with nerve allograft, each NEW 3.00 3.00 No

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HCPCS

Code Long Descriptor

CY 2017

Work

RVU

Proposed

CY 2018

Work

RVU

Final

CY

2018

Work

RVU

CMS Work

Time

Refinement

additional strand

67820 Correction of trichiasis; epilation, by forceps

only 0.71 0.32 0.32 No

70490 Computed tomography, soft tissue neck;

without contrast material 1.28 1.28 1.28 No

70491 Computed tomography, soft tissue neck; with

contrast material(s) 1.38 1.38 1.38 No

70492

Computed tomography, soft tissue neck;

without contrast material followed by contrast

material(s) and further sections

1.45 1.62 1.62 No

70544 Magnetic resonance angiography, head; without

contrast material(s) 1.20 1.20 1.20 No

70545 Magnetic resonance angiography, head; with

contrast material(s) 1.20 1.20 1.20 No

70546

Magnetic resonance angiography, head; without

contrast material(s), followed by contrast

material(s) and further sequences

1.80 1.48 1.48 No

70547 Magnetic resonance angiography, neck; without

contrast material(s) 1.20 1.20 1.20 No

70548 Magnetic resonance angiography, neck; with

contrast material(s) 1.20 1.50 1.50 No

70549

Magnetic resonance angiography, neck; without

contrast material(s), followed by contrast

material(s) and further sequences

1.80 1.80 1.80 No

71045 Radiologic examination, chest; single view NEW 0.18 0.18 No

71046 Radiologic examination, chest; 2 views NEW 0.22 0.22 No

71047 Radiologic examination, chest; 3 views NEW 0.27 0.27 No

71048 Radiologic examination, chest; 4 or more views NEW 0.31 0.31 No

71100 Radiologic examination, ribs, unilateral; 2

views 0.22 0.22 0.22 No

71101

Radiologic examination, ribs, unilateral;

including posteroanterior chest, minimum of 3

views

0.27 0.27 0.27 No

71110 Radiologic examination, ribs, bilateral; 3 views 0.27 0.29 0.29 No

71111

Radiologic examination, ribs, bilateral;

including posteroanterior chest, minimum of 4

views

0.32 0.32 0.32 No

71250 Computed tomography, thorax; without

contrast material 1.02 1.16 1.16 No

71260 Computed tomography, thorax; with contrast

material(s) 1.24 1.24 1.24 No

71270

Computed tomography, thorax; without

contrast material, followed by contrast

material(s) and further sections

1.38 1.38 1.38 No

72195 Magnetic resonance (eg, proton) imaging,

pelvis; without contrast material(s) 1.46 1.46 1.46 No

72196 Magnetic resonance (eg, proton) imaging,

pelvis; with contrast material(s) 1.73 1.73 1.73 No

72197 Magnetic resonance (eg, proton) imaging,

pelvis; without contrast material(s), followed by 2.26 2.20 2.20 No

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CMS-1676-F 425

HCPCS

Code Long Descriptor

CY 2017

Work

RVU

Proposed

CY 2018

Work

RVU

Final

CY

2018

Work

RVU

CMS Work

Time

Refinement

contrast material(s) and further sequences

73100 Radiologic examination, wrist; 2 views 0.16 0.16 0.16 No

73110 Radiologic examination, wrist; complete,

minimum of 3 views 0.17 0.17 0.17 No

73120 Radiologic examination, hand; 2 views 0.16 0.16 0.16 No

73130 Radiologic examination, hand; minimum of 3

views 0.17 0.17 0.17 No

73140 Radiologic examination, finger(s), minimum of

2 views 0.13 0.13 0.13 No

73718

Magnetic resonance (eg, proton) imaging, lower

extremity other than joint; without contrast

material(s)

1.35 1.35 1.35 No

73719

Magnetic resonance (eg, proton) imaging, lower

extremity other than joint; with contrast

material(s)

1.62 1.62 1.62 No

73720

Magnetic resonance (eg, proton) imaging, lower

extremity other than joint; without contrast

material(s), followed by contrast material(s)

and further sequences

2.15 2.15 2.15 No

74022

Radiologic examination, abdomen; complete

acute abdomen series, including supine, erect,

and/or decubitus views, single view chest

0.32 0.32 0.32 No

74018 Radiologic examination, abdomen; 1 view NEW 0.18 0.18 No

74019 Radiologic examination, abdomen; 2 views NEW 0.23 0.23 No

74021 Radiologic examination, abdomen; 3 or more

views NEW 0.27 0.27 No

74181 Magnetic resonance (eg, proton) imaging,

abdomen; without contrast material(s) 1.46 1.46 1.46 No

74182 Magnetic resonance (eg, proton) imaging,

abdomen; with contrast material(s) 1.73 1.73 1.73 No

74183

Magnetic resonance (eg, proton) imaging,

abdomen; without contrast material(s),

followed by with contrast material(s) and

further sequences

2.26 2.20 2.20 No

75635

Computed tomographic angiography,

abdominal aorta and bilateral iliofemoral lower

extremity runoff, with contrast material(s),

including noncontrast images, if performed, and

image postprocessing

2.40 2.40 2.40 No

75710 Angiography, extremity, unilateral, radiological

supervision and interpretation 1.14 1.75 1.75 No

75716 Angiography, extremity, bilateral, radiological

supervision and interpretation 1.31 1.97 1.97 No

76510

Ophthalmic ultrasound, diagnostic; B-scan and

quantitative A-scan performed during the same

patient encounter

1.55 0.70 0.70 No

76511 Ophthalmic ultrasound, diagnostic; quantitative

A-scan only 0.94 0.64 0.64 No

76512 Ophthalmic ultrasound, diagnostic; B-scan

(with or without superimposed non-quantitative 0.94 0.56 0.56 No

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CMS-1676-F 426

HCPCS

Code Long Descriptor

CY 2017

Work

RVU

Proposed

CY 2018

Work

RVU

Final

CY

2018

Work

RVU

CMS Work

Time

Refinement

A-scan)

76516 Ophthalmic biometry by ultrasound

echography, A-scan 0.54 0.40 0.40 No

76519

Ophthalmic biometry by ultrasound

echography, A-scan; with intraocular lens

power calculation

0.54 0.54 0.54 No

76881 Ultrasound, extremity, nonvascular, real-time

with image documentation; complete 0.63 0.63 0.63 No

76882

Ultrasound, extremity, nonvascular, real-time

with image documentation; limited, anatomic

specific

0.49 0.49 0.49 No

77261 Therapeutic radiology treatment planning;

simple 1.39 1.30 1.30 No

77262 Therapeutic radiology treatment planning;

intermediate 2.11 2.00 2.00 No

77263 Therapeutic radiology treatment planning;

complex 3.14 3.14 3.14 No

78300 Bone and/or joint imaging; limited area 0.62 0.62 0.62 No

78305 Bone and/or joint imaging; multiple areas 0.83 0.83 0.83 No

78306 Bone and/or joint imaging; whole body 0.86 0.86 0.86 No

88184

Flow cytometry, cell surface, cytoplasmic, or

nuclear marker, technical component only; first

marker

0.00 - 0.00 No

88185

Flow cytometry, cell surface, cytoplasmic, or

nuclear marker, technical component only; each

additional marker

0.00 - 0.00 No

88333

Pathology consultation during surgery;

cytologic examination (eg, touch prep, squash

prep), initial site

1.20 1.20 1.20 No

88334

Pathology consultation during surgery;

cytologic examination (eg, touch prep, squash

prep), each additional site

0.73 0.73 0.73 No

88360

Morphometric analysis, tumor

immunohistochemistry (eg, Her-2/neu, estrogen

receptor/progesterone receptor), quantitative or

semiquantitative, per specimen, each single

antibody stain procedure; manual

1.10 0.85 0.85 No

88361

Morphometric analysis, tumor

immunohistochemistry (eg, Her-2/neu, estrogen

receptor/progesterone receptor), quantitative or

semiquantitative, per specimen, each single

antibody stain procedure; using computer-

assisted technology

1.18 0.95 0.95 No

92136

Ophthalmic biometry by partial coherence

interferometry with intraocular lens power

calculation

0.54 0.54 0.54 No

93279

Programming device evaluation (in person)

with iterative adjustment of the implantable

device to test the function of the device and

select optimal permanent programmed values

0.65 0.65 0.65 No

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CMS-1676-F 427

HCPCS

Code Long Descriptor

CY 2017

Work

RVU

Proposed

CY 2018

Work

RVU

Final

CY

2018

Work

RVU

CMS Work

Time

Refinement

with analysis, review and report by a physician

or other qualified health care professional;

single lead pacemaker system

93280

Programming device evaluation (in person)

with iterative adjustment of the implantable

device to test the function of the device and

select optimal permanent programmed values

with analysis, review and report by a physician

or other qualified health care professional; dual

lead pacemaker system

0.77 0.77 0.77 No

93281

Programming device evaluation (in person)

with iterative adjustment of the implantable

device to test the function of the device and

select optimal permanent programmed values

with analysis, review and report by a physician

or other qualified health care professional;

multiple lead pacemaker system

0.90 0.85 0.85 No

93282

Programming device evaluation (in person)

with iterative adjustment of the implantable

device to test the function of the device and

select optimal permanent programmed values

with analysis, review and report by a physician

or other qualified health care professional;

single lead transvenous implantable

defibrillator system

0.85 0.85 0.85 No

93283

Programming device evaluation (in person)

with iterative adjustment of the implantable

device to test the function of the device and

select optimal permanent programmed values

with analysis, review and report by a physician

or other qualified health care professional; dual

lead transvenous implantable defibrillator

system

1.15 1.15 1.15 No

93284

Programming device evaluation (in person)

with iterative adjustment of the implantable

device to test the function of the device and

select optimal permanent programmed values

with analysis, review and report by a physician

or other qualified health care professional;

multiple lead transvenous implantable

defibrillator system

1.25 1.25 1.25 No

93285

Programming device evaluation (in person)

with iterative adjustment of the implantable

device to test the function of the device and

select optimal permanent programmed values

with analysis, review and report by a physician

or other qualified health care professional;

implantable loop recorder system

0.52 0.52 0.52 No

93286 Peri-procedural device evaluation (in person)

and programming of device system parameters 0.30 0.30 0.30 No

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HCPCS

Code Long Descriptor

CY 2017

Work

RVU

Proposed

CY 2018

Work

RVU

Final

CY

2018

Work

RVU

CMS Work

Time

Refinement

before or after a surgery, procedure, or test with

analysis, review and report by a physician or

other qualified health care professional; single,

dual, or multiple lead pacemaker system

93287

Peri-procedural device evaluation (in person)

and programming of device system parameters

before or after a surgery, procedure, or test with

analysis, review and report by a physician or

other qualified health care professional; single,

dual, or multiple lead implantable defibrillator

system

0.45 0.45 0.45 No

93288

Interrogation device evaluation (in person) with

analysis, review and report by a physician or

other qualified health care professional,

includes connection, recording and

disconnection per patient encounter; single,

dual, or multiple lead pacemaker system

0.43 0.43 0.43 No

93289

Interrogation device evaluation (in person) with

analysis, review and report by a physician or

other qualified health care professional,

includes connection, recording and

disconnection per patient encounter; single,

dual, or multiple lead transvenous implantable

defibrillator system, including analysis of heart

rhythm derived data elements

0.92 0.75 0.75 No

93290

Interrogation device evaluation (in person) with

analysis, review and report by a physician or

other qualified health care professional,

includes connection, recording and

disconnection per patient encounter;

implantable cardiovascular monitor system,

including analysis of 1 or more recorded

physiologic cardiovascular data elements from

all internal and external sensors

0.43 0.43 0.43 No

93291

Interrogation device evaluation (in person) with

analysis, review and report by a physician or

other qualified health care professional,

includes connection, recording and

disconnection per patient encounter;

implantable loop recorder system, including

heart rhythm derived data analysis

0.43 0.37 0.37 No

93292

Interrogation device evaluation (in person) with

analysis, review and report by a physician or

other qualified health care professional,

includes connection, recording and

disconnection per patient encounter; wearable

defibrillator system

0.43 0.43 0.43 No

93293

Transtelephonic rhythm strip pacemaker

evaluation(s) single, dual, or multiple lead

pacemaker system, includes recording with and

0.32 0.31 0.31 No

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CMS-1676-F 429

HCPCS

Code Long Descriptor

CY 2017

Work

RVU

Proposed

CY 2018

Work

RVU

Final

CY

2018

Work

RVU

CMS Work

Time

Refinement

without magnet application with analysis,

review and report(s) by a physician or other

qualified health care professional, up to 90 days

93294

Interrogation device evaluation(s) (remote), up

to 90 days; single, dual, or multiple lead

pacemaker system with interim analysis,

review(s) and report(s) by a physician or other

qualified health care professional

0.65 0.60 0.60 No

93295

Interrogation device evaluation(s) (remote), up

to 90 days; single, dual, or multiple lead

implantable defibrillator system with interim

analysis, review(s) and report(s) by a physician

or other qualified health care professional

1.29 0.74 0.74 No

93296

Interrogation device evaluation(s) (remote), up

to 90 days; single, dual, or multiple lead

pacemaker system or implantable defibrillator

system, remote data acquisition(s), receipt of

transmissions and technician review, technical

support and distribution of results

0.00 0.00 0.00 No

93297

Interrogation device evaluation(s), (remote) up

to 30 days; implantable cardiovascular monitor

system, including analysis of 1 or more

recorded physiologic cardiovascular data

elements from all internal and external sensors,

analysis, review(s) and report(s) by a physician

or other qualified health care professional

0.52 0.52 0.52 No

93298

Interrogation device evaluation(s), (remote) up

to 30 days; implantable loop recorder system,

including analysis of recorded heart rhythm

data, analysis, review(s) and report(s) by a

physician or other qualified health care

professional

0.52 0.52 0.52 No

93299

Interrogation device evaluation(s), (remote) up

to 30 days; implantable cardiovascular monitor

system or implantable loop recorder system,

remote data acquisition(s), receipt of

transmissions and technician review, technical

support and distribution of results

0.00 0.00 0.00 No

93306

Echocardiography, transthoracic, real-time with

image documentation (2D), includes M-mode

recording, when performed, complete, with

spectral Doppler echocardiography, and with

color flow Doppler echocardiography

1.30 1.50 1.50 No

93307

Echocardiography, transthoracic, real-time with

image documentation (2D), includes M-mode

recording, when performed, complete, without

spectral or color Doppler echocardiography

0.92 0.92 0.92 No

93308

Echocardiography, transthoracic, real-time with

image documentation (2D), includes M-mode

recording, when performed, follow-up or

0.53 0.53 0.53 No

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CMS-1676-F 430

HCPCS

Code Long Descriptor

CY 2017

Work

RVU

Proposed

CY 2018

Work

RVU

Final

CY

2018

Work

RVU

CMS Work

Time

Refinement

limited study

93350

Echocardiography, transthoracic, real-time with

image documentation (2D), includes M-mode

recording, when performed, during rest and

cardiovascular stress test using treadmill,

bicycle exercise and/or pharmacologically

induced stress, with interpretation and report;

1.46 1.46 1.46 No

93351

Echocardiography, transthoracic, real-time with

image documentation (2D), includes M-mode

recording, when performed, during rest and

cardiovascular stress test using treadmill,

bicycle exercise and/or pharmacologically

induced stress, with interpretation and report;

including performance of continuous

electrocardiographic monitoring, with

supervision by a physician or other qualified

health care professional

1.75 1.75 1.75 No

93503

Insertion and placement of flow directed

catheter (eg, Swan-Ganz) for monitoring

purposes

2.91 2.00 2.00 No

93613 Intracardiac electrophysiologic 3-dimensional

mapping 6.99 5.23 5.23 No

93668 Peripheral arterial disease (PAD) rehabilitation,

per session N 0.00 0.00 No

93792

Patient/caregiver training for initiation of home

INR monitoring under the direction of a

physician or other qualified health care

professional, including face-to-face, use and

care of the INR monitor, obtaining blood

sample, instructions for reporting home INR

test results, and documentation of

patient's/caregiver’s ability to perform testing

and report results

NEW 0.00 0.00 No

93793

Anticoagulant management for a patient taking

warfarin, must include review and

interpretation of a new home, office, or lab

International Normalized Ratio (INR) test

result, patient instructions, dosage adjustment

(as needed), and scheduling of additional test(s)

when performed

NEW 0.18 0.18 No

94617 Exercise test for bronchospasm, including pre-

and post-spirometry and pulse oximetry NEW 0.70 0.70 No

94618

Pulmonary stress testing (eg, 6-minute walk

test), including measurement of heart rate,

oximetry, and oxygen titration, when performed

NEW 0.48 0.48 No

94621

Cardiopulmonary exercise testing, including

measurements of minute ventilation, CO2

production, O2 uptake, and

electrocardiographic recordings

1.42 1.42 1.42 No

95004 Percutaneous tests (scratch, puncture, prick) 0.01 0.01 0.01 No

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HCPCS

Code Long Descriptor

CY 2017

Work

RVU

Proposed

CY 2018

Work

RVU

Final

CY

2018

Work

RVU

CMS Work

Time

Refinement

with allergenic extracts, immediate type

reaction, including test interpretation and

report, specify number of tests

95250

Ambulatory continuous glucose monitoring of

interstitial tissue fluid via a subcutaneous

sensor for a minimum of 72 hours; sensor

placement, hook-up, calibration of monitor,

patient training, removal of sensor, and printout

of recording

0.00 0.00 0.00 No

95251

Ambulatory continuous glucose monitoring of

interstitial tissue fluid via a subcutaneous

sensor for a minimum of 72 hours;

interpretation and report

0.85 0.70 0.70 No

95930

Visual evoked potential (VEP) testing central

nervous system except glaucoma, checkerboard

or flash, with interpretation and report

0.35 0.35 0.35 No

96160

Administration of patient-focused health risk

assessment instrument (eg, health hazard

appraisal) with scoring and documentation, per

standardized instrument

0.00 0.00 0.00 No

96161

Administration of caregiver-focused health risk

assessment instrument (eg, depression

inventory) for the benefit of the patient, with

scoring and documentation, per standardized

instrument

0.00 0.00 0.00 No

96360 Intravenous infusion, hydration; initial, 31

minutes to 1 hour 0.17 0.17 0.17 No

96361 Intravenous infusion, hydration; each additional

hour 0.09 0.09 0.09 No

96372

Therapeutic, prophylactic, or diagnostic

injection (specify substance or drug);

subcutaneous or intramuscular

0.17 0.17 0.17 No

96374

Therapeutic, prophylactic, or diagnostic

injection (specify substance or drug);

intravenous push, single or initial

substance/drug

0.18 0.18 0.18 No

96375

Therapeutic, prophylactic, or diagnostic

injection (specify substance or drug); each

additional sequential intravenous push of a new

substance/drug

0.10 0.10 0.10 No

96377

Application of on-body injector (includes

cannula insertion) for timed subcutaneous

injection

0.00 0.17 0.17 No

96401 Chemotherapy administration, subcutaneous or

intramuscular; non-hormonal anti-neoplastic 0.21 0.21 0.21 No

96402 Chemotherapy administration, subcutaneous or

intramuscular; hormonal anti-neoplastic 0.19 0.19 0.19 No

96409 Chemotherapy administration; intravenous,

push technique, single or initial substance/drug 0.24 0.24 0.24 No

96411 Chemotherapy administration; intravenous, 0.20 0.20 0.20 No

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HCPCS

Code Long Descriptor

CY 2017

Work

RVU

Proposed

CY 2018

Work

RVU

Final

CY

2018

Work

RVU

CMS Work

Time

Refinement

push technique, each additional substance/drug

96573

Photodynamic therapy by external application

of light to destroy premalignant lesions of the

skin and adjacent mucosa with application and

illumination/activation of photosensitizing

drug(s), per day

NEW 0.48 0.48 No

96574

Debridement of premalignant hyperkeratotic

lesion(s) (ie, targeted curettage, abrasion)

followed with photodynamic therapy by

external application of light to destroy

premalignant lesions of the skin and adjacent

mucosa with application and

illumination/activation of photosensitizing

drug(s), per day

NEW 1.01 1.01 No

96910

Photochemotherapy; tar and ultraviolet B

(Goeckerman treatment) or petrolatum and

ultraviolet B

0.00 0.00 0.00 No

97012 Application of a modality to 1 or more areas;

traction, mechanical 0.25 0.25 0.25 No

97014 Application of a modality to 1 or more areas;

electrical stimulation (unattended) 0.18 0.18 0.18 No

97016 Application of a modality to 1 or more areas;

vasopneumatic devices 0.18 0.18 0.18 No

97018 Application of a modality to 1 or more areas;

paraffin bath 0.06 0.06 0.06 No

97022 Application of a modality to 1 or more areas;

whirlpool 0.17 0.17 0.17 No

97032 Application of a modality to 1 or more areas;

electrical stimulation (manual), each 15 minutes 0.25 0.25 0.25 No

97033 Application of a modality to 1 or more areas;

iontophoresis, each 15 minutes 0.26 0.26 0.26 No

97034 Application of a modality to 1 or more areas;

contrast baths, each 15 minutes 0.21 0.21 0.21 No

97035 Application of a modality to 1 or more areas;

ultrasound, each 15 minutes 0.21 0.21 0.21 No

97110

Therapeutic procedure, 1 or more areas, each 15

minutes; therapeutic exercises to develop

strength and endurance, range of motion and

flexibility

0.45 0.45 0.45 No

97112

Therapeutic procedure, 1 or more areas, each 15

minutes; neuromuscular reeducation of

movement, balance, coordination, kinesthetic

sense, posture, and/or proprioception for sitting

and/or standing activities

0.45 0.50 0.50 No

97113

Therapeutic procedure, 1 or more areas, each 15

minutes; aquatic therapy with therapeutic

exercises

0.44 0.48 0.48 No

97116 Therapeutic procedure, 1 or more areas, each 15

minutes; gait training (includes stair climbing) 0.40 0.45 0.45 No

97127 Therapeutic interventions that focus on NEW I I Yes

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CY 2018

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CY

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CMS Work

Time

Refinement

cognitive function (eg, attention, memory,

reasoning, executive function, problem solving,

and/or pragmatic functioning) and

compensatory strategies to manage the

performance of an activity (eg, managing time

or schedules, initiating, organizing and

sequencing tasks, direct (one-on-one) patient

contact (do not report 97X11 in conjunction

with 0364T, 0365T, 0368T, 0369T) (report

97X11 only once per day)

97140

Manual therapy techniques (eg, mobilization/

manipulation, manual lymphatic drainage,

manual traction), 1 or more regions, each 15

minutes

0.43 0.43 0.43 No

97530

Therapeutic activities, direct (one-on-one)

patient contact (use of dynamic activities to

improve functional performance), each 15

minutes

0.44 0.44 0.44 No

97533

Sensory integrative techniques to enhance

sensory processing and promote adaptive

responses to environmental demands, direct

(one-on-one) patient contact, each 15 minutes

0.44 0.48 0.48 No

97535

Self-care/home management training (eg,

activities of daily living (ADL) and

compensatory training, meal preparation, safety

procedures, and instructions in use of assistive

technology devices/adaptive equipment) direct

one-on-one contact, each 15 minutes

0.45 0.45 0.45 No

97537

Community/work reintegration training (eg,

shopping, transportation, money management,

avocational activities and/or work

environment/modification analysis, work task

analysis, use of assistive technology

device/adaptive equipment), direct one-on-one

contact, each 15 minutes

0.45 0.48 0.48 No

97542 Wheelchair management (eg, assessment,

fitting, training), each 15 minutes 0.45 0.48 0.48 No

97760

Orthotic(s) management and training (including

assessment and fitting when not otherwise

reported), upper extremity(ies), lower

extremity(ies) and/or trunk, initial orthotic(s)

encounter, each 15 minutes

0.45 0.50 0.50 No

97761

Prosthetic(s) training, upper and/or lower

extremity(ies), initial prosthetic(s) encounter,

each 15 minutes

0.45 0.50 0.50 No

97763

Orthotic(s)/prosthetic(s) management and/or

training, upper extremity(ies), lower

extremity(ies), and/or trunk, subsequent

orthotic(s)/prosthetic(s) encounter, each 15

minutes

NEW 0.48 0.48 No

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Code Long Descriptor

CY 2017

Work

RVU

Proposed

CY 2018

Work

RVU

Final

CY

2018

Work

RVU

CMS Work

Time

Refinement

99091

Collection and interpretation of physiologic

data (eg, ECG, blood pressure, glucose

monitoring) digitally stored and/or transmitted

by the patient and/or caregiver to the physician

or other qualified health care professional,

qualified by education, training,

licensure/regulation (when applicable) requiring

a minimum of 30 minutes of time

B - 1.10 No

99483

Assessment of and care planning for a patient

with cognitive impairment, requiring an

independent historian, in the office or other

outpatient, home or domiciliary or rest home,

with all of the following required

elements:Cognition-focused evaluation

including a pertinent history and

examination;Medical decision making of

moderate or high complexity;Functional

assessment (eg, Basic and Instrumental

Activities of Daily Living), including decision-

making capacity;Use of standardized

instruments for staging of dementia (eg,

Functional Assessment Staging Test [FAST],

Clinical Dementia Rating [CDR]);Medication

reconciliation and review for high-risk

medications;Evaluation for neuropsychiatric

and behavioral symptoms, including

depression, including use of standardized

screening instrument(s);Evaluation of safety

(eg, home), including motor vehicle

operation;Identification of caregiver(s),

caregiver knowledge, caregiver needs, social

supports, and the willingness of caregiver to

take on caregiving tasks;Development,

updating or revision, or review of an Advance

Care Plan;Creation of a written care plan,

including initial plans to address any

neuropsychiatric symptoms, neuro-cognitive

symptoms, functional limitations, and referral

to community resources as needed (eg,

rehabilitation services, adult day programs,

support groups) shared with the patient and/or

caregiver with initial education and

support.Typically, 50 minutes are spent face-to-

face with the patient and/or family or caregiver.

NEW 3.44 3.44 No

99484

Care management services for behavioral health

conditions, at least 20 minutes of clinical staff

time, directed by a physician or other qualified

health care professional, per calendar month,

with the following required elements:Initial

assessment or follow-up monitoring, including

the use of applicable validated rating

NEW 0.61 0.61 No

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CY 2017

Work

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Proposed

CY 2018

Work

RVU

Final

CY

2018

Work

RVU

CMS Work

Time

Refinement

scales;Behavioral health care planning in

relation to behavioral/psychiatric health

problems, including revision for patients who

are not progressing or whose status

changes;Facilitating and coordinating treatment

such as psychotherapy, pharmacotherapy,

counseling and/or psychiatric consultation;

andContinuity of care with a designated

member of the care team

99492

Initial psychiatric collaborative care

management, first 70 minutes in the first

calendar month of behavioral health care

manager activities, in consultation with a

psychiatric consultant, and directed by the

treating physician or other qualified health care

professional, with the following required

elements:outreach to and engagement in

treatment of a patient directed by the treating

physician or other qualified health care

professional; initial assessment of the patient,

including administration of validated rating

scales, with the development of an

individualized treatment plan; review by the

psychiatric consultant with modifications of the

plan if recommended; entering patient in a

registry and tracking patient follow-up and

progress using the registry, with appropriate

documentation, and participation in weekly

caseload consultation with the psychiatric

consultant; andprovision of brief interventions

using evidence-based techniques such as

behavioral activation, motivational

interviewing, and other focused treatment

strategies.

NEW 1.70 1.70 No

99493

Subsequent psychiatric collaborative care

management, first 60 minutes in a subsequent

month of behavioral health care manager

activities, in consultation with a psychiatric

consultant, and directed by the treating

physician or other qualified health care

professional, with the following required

elements:tracking patient follow-up and

progress using the registry, with appropriate

documentation; participation in weekly

caseload consultation with the psychiatric

consultant; ongoing collaboration with and

coordination of the patient's mental health care

with the treating physician or other qualified

health care professional and any other treating

mental health providers; additional review of

progress and recommendations for changes in

NEW 1.53 1.53 No

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CY 2017

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CY 2018

Work

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Final

CY

2018

Work

RVU

CMS Work

Time

Refinement

treatment, as indicated, including medications,

based on recommendations provided by the

psychiatric consultant;provision of brief

interventions using evidence-based techniques

such as behavioral activation, motivational

interviewing, and other focused treatment

strategies;monitoring of patient outcomes using

validated rating scales; and relapse prevention

planning with patients as they achieve

remission of symptoms and/or other treatment

goals and are prepared for discharge from

active treatment.

99494

Initial or subsequent psychiatric collaborative

care management, each additional 30 minutes in

a calendar month of behavioral health care

manager activities, in consultation with a

psychiatric consultant, and directed by the

treating physician or other qualified health care

professional

NEW 0.82 0.82 No

G0283

Electrical stimulation (unattended), to one or

more areas for indication(s) other than wound

care, as part of a therapy plan of care

0.18 0.18 0.18 No

G0513 Prolonged preventive service(s), initial 30

minutes NEW 1.17 1.17 No

G0514 Prolonged preventive service(s), first 30

minutes NEW 1.17 1.17 No

G0515

Development of cognitive skills to improve

attention, memory, or problem solving

(includes compensatory training), direct one-

on-one patient contact, each 15 minutes

NEW 0.44 0.44 No

G0516 Insertion, non- biodegradable drug delivery

implants, 4 or more NEW 1.82 1.82 No

G0517 Removal, non- biodegradable drug deliver

implants, 4 or more NEW 2.10 2.10 No

G0518 Removal with reinsertion, non-biodegradable

drug delivery implants, 4 or more NEW 3.55 3.55 No