Justia Department Of Health And Human Services Centers For Medicare & Medicaid Services Medicare Program; Revisions to Payment Policies, Five-Year Review of Work Relative Value Units, Changes to the Practice Expense Methodology Under the Physician Fee Schedule, and Other Changes to Payment Under Part B; Revisions to the Payment Policies of Ambulance Services Under the Fee Schedule for Ambulance Services; and Ambulance Inflation Factor Update for CY 2007, 69624-70251 [06-9086]

Medicare Program; Revisions to Payment Policies, Five-Year Review of Work Relative Value Units, Changes to the Practice Expense Methodology Under the Physician Fee Schedule, and Other Changes to Payment Under Part B; Revisions to the Payment Policies of Ambulance Services Under the Fee Schedule for Ambulance Services; and Ambulance Inflation Factor Update for CY 2007, 69624-70251 [06-9086]

Download as PDF 69624 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 405, 410, 411, 414, 415, and 424 [CMS–1321–FC and CMS–1317–F] RINs 0938–AO24 and 0938–AO11 Medicare Program; Revisions to Payment Policies, Five-Year Review of Work Relative Value Units, Changes to the Practice Expense Methodology Under the Physician Fee Schedule, and Other Changes to Payment Under Part B; Revisions to the Payment Policies of Ambulance Services Under the Fee Schedule for Ambulance Services; and Ambulance Inflation Factor Update for CY 2007 Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Final rule with comment period. rmajette on PROD1PC67 with RULES2 AGENCY: SUMMARY: This final rule with comment period addresses certain provisions of the Deficit Reduction Act of 2005, as well as making other changes to Medicare Part B payment policy. These changes are intended to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. This final rule with comment period also discusses geographic practice cost indices (GPCI) changes; requests for additions to the list of telehealth services; payment for covered outpatient drugs and biologicals; payment for renal dialysis services; policies related to private contracts and opt-out; policies related to bone mass measurement (BMM) services, independent diagnostic testing facilities (IDTFs), the physician selfreferral prohibition; laboratory billing for the technical component (TC) of physician pathology services; the clinical laboratory fee schedule; certification of advanced practice nurses; health information technology, the health care information transparency initiative; updates the list of certain services subject to the physician self-referral prohibitions, finalizes ASP reporting requirements, and codifies Medicare’s longstanding policy that payment of bad debts associated with services paid under a fee schedule/charge-based system are not allowable. We are also finalizing the calendar year (CY) 2006 interim RVUs and are issuing interim RVUs for new and revised procedure codes for CY 2007. In addition, this rule includes revisions to payment policies under the VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 fee schedule for ambulance services and the ambulance inflation factor update for CY 2007. As required by the statute, we are announcing that the physician fee schedule update for CY 2007 is ¥5.0 percent, the initial estimate for the sustainable growth rate for CY 2007 is 2.0 percent and the CF for CY 2007 is $35.9848. DATES: Effective Date: These regulations are effective on January 1, 2007. Comment Date: Comments will be considered if we receive them at one of the addresses provided below, no later than 5 p.m. on January 2, 2007. ADDRESSES: In commenting, please refer to file code CMS–1321–FC. Because of staff and resource limitations, we cannot accept comments by facsimile (FAX) transmission. You may submit comments in one of three ways (no duplicates, please): 1. Electronically. You may submit electronic comments on specific issues in this regulation to https:// www.cms.hhs.gov/eRulemaking. Click on the link ‘‘Submit electronic comments on CMS regulations with an open comment period.’’ (Attachments should be in Microsoft Word, WordPerfect, or Excel; however, we prefer Microsoft Word.) 2. By mail. You may mail written comments (one original and two copies) to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS–1321–FC, P.O. Box 8014, Baltimore, MD 21244–8014. Please allow sufficient time for mailed comments to be received before the close of the comment period. 3. By express or overnight mail. You may send written comments (one original and two copies) to the following address only: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS–1321–FC, Mail Stop C4–26–05, 7500 Security Boulevard, Baltimore, MD 21244–1850. 4. By hand or courier. If you prefer, you may deliver (by hand or courier) your written comments (one original and two copies) before the close of the comment period to one of the following addresses. If you intend to deliver your comments to the Baltimore address, please call telephone number (410) 786– 7197 in advance to schedule your arrival with one of our staff members. Room 445–G, Hubert H. Humphrey Building, 200 Independence Avenue, SW., Washington, DC 20201; or 7500 Security Boulevard, Baltimore, MD 21244–1850. (Because access to the interior of the HHH Building is not readily available to PO 00000 Frm 00002 Fmt 4701 Sfmt 4700 persons without Federal Government identification, commenters are encouraged to leave their comments in the CMS drop slots located in the main lobby of the building. A stamp-in clock is available for persons wishing to retain a proof of filing by stamping in and retaining an extra copy of the comments being filed.) Comments mailed to the addresses indicated as appropriate for hand or courier delivery may be delayed and received after the comment period. Submission of comments on paperwork requirements. You may submit comments on this document’s paperwork requirements by mailing your comments to the addresses provided at the end of the ‘‘Collection of Information Requirements’’ section in this document. For information on viewing public comments, see the beginning of the SUPPLEMENTARY INFORMATION section. FOR FURTHER INFORMATION CONTACT: Pam West, (410) 786–2302 (for issues related to practice expense). Stephanie Monroe, (410) 786–6864 (for issues related to the geographic practice cost index). Craig Dobyski, (410) 786–4584 (for issues related to list of telehealth services). Roberta Epps, (410) 786–4503 (for issues related to diagnostic imaging services). Bill Larson, (410) 786–4639 (for issues related to coverage of bone mass measurement and addition of ultrasound screening for abdominal aortic aneurysm to the ‘‘Welcome to Medicare’’ benefit). Dorothy Shannon, (410) 786–3396 (for issues related to the outpatient therapy cap). Catherine Jansto, (410) 786–7762 (for issues related to payment for covered outpatient drugs and biologicals). Henry Richter, (410) 786–4562 (for issues related to payments for end-stage renal disease facilities). Fred Grabau, (410) 786–0206 (for issues related to private contracts and opt-out provision). David Walczak, (410) 786–4475 (for issues related to reassignment provisions). August Nemec, (410) 786–0612 (for issues related to independent diagnostic testing facilities). Anita Greenberg, (410) 786–4601 (for issues related to the clinical laboratory fee schedule). James Menas, (410) 786–4507 (for issues related to payment for physician pathology services). Anne Tayloe, (410) 786–4546; or E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations Glenn McGuirk, (410) 786–5723 (for issues related to the ambulance fee schedule. Diane Milstead, (410) 786–3355 or Gaysha Brooks, (410) 786–9649 (for all other issues). SUPPLEMENTARY INFORMATION: Submitting Comments: We welcome comments from the public on the following issues: interim Relative Value Units (RVUs) for selected procedure codes identified in Addendum C and the physician self-referral designated health services (DHS) listed in Tables 18 and 19. You can assist us by referencing the file code CMS–1321–FC and the specific ‘‘issue identifier’’ that precedes the section on which you choose to comment. Inspection of Public Comments: All comments received before the close of the comment period are available for viewing by the public, including any personally identifiable or confidential business information that is included in a comment. We post all comments received before the close of the comment period on the following Web site as soon as possible after they have been received: https://www.cms.hhs.gov/ eRulemaking. Click on the link ‘‘Electronic Comments on CMS Regulations’’ on that Web site to view public comments. Comments received timely will also be available for public inspection as they are received, generally beginning approximately 3 weeks after publication of a document, at the headquarters of the Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, Maryland 21244, Monday through Friday of each week from 8:30 a.m. to 4 p.m. To schedule an appointment to view public comments, phone 1–800–743–3951. This Federal Register document is also available from the Federal Register online database through Government Printing Office Access, a service of the U.S. Government Printing Office. The Web site address is: https:// www.access.gpo.gov/nara/. Information on the physician fee schedule can also be found on the CMS homepage. You can access this data by using the following directions: 1. Go to the following Web site: https:// www.cms.hhs.gov/PhysicianFeeSched/. 2. Select ‘‘PFS Federal Regulation Notices.’’ To assist readers in referencing sections contained in this preamble, we are providing the following table of contents. Some of the issues discussed in this preamble affect the payment policies, but do not require changes to the regulations in the Code of Federal VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 Regulations. Information on the regulation’s impact appears throughout the preamble and is not exclusively in section VI. Table of Contents I. Background A. Development of the Relative Value System B. Components of the Fee Schedule Payment Amounts C. Most Recent Changes to the Fee Schedule II. Provisions of the Final Rule A. Resource-Based Practice Expense Relative Value Units 1. Current Methodology 2. Proposals for Revising the PE Methodology 3. Specific Changes to the Indirect PE Methodology for Calendar Year 2007 4. Additional PE Issues for CY 2007 a. RUC Recommendations for Direct PE Inputs and Other PE Input Issues b. Payment for Splint and Cast Supplies c. Medical Nutrition Therapy Services d. Surgical Pathology Codes e. PE Issues from Rulemaking for CY 2006 f. Other PE Issues for CY 2007 g. Specific PE Concerns Raised by Commenters h. Concerns About Decreases in PE RVUs i. Equipment Utilization and Interest Rate Assumptions j. Further Review of PE Direct Inputs k. Supply and Equipment Items Needing Specialty Input B. Geographic Practice Cost Indices (GPCIs) C. Medicare Telehealth Services D. Miscellaneous Coding Issues 1. Global Period for Remote Afterloading High Intensity Brachytherapy Procedures 2. Assignment of RVUS for Proton Beam Treatment Delivery Services E. Deficit Reduction Act (DRA) 1. Section 5102—Adjustments for Payments to Imaging Services a. Payment for Multiple Imaging Procedures for 2007 b. Reduction in TC for Imaging Services Under the PFS to OPD Payment Amount c. Interaction of the Multiple Imaging Payment Reduction and the OPPS Cap 2. Section 5107—Revisions to Payments for Therapy Services 3. Section 5112—Addition of Ultrasound Screening for Abdominal Aortic Aneurysm (AAA) a. Coverage b. Payment 4. Section 5113—Non-Application of the Part B Deductible for Colorectal Cancer Screening Tests 5. Section 5114—Addition of Diabetes Outpatient Self-Management Training Services (DSMT) and Medical Nutrition Therapy (MNT) for the FQHC Program F. Payment for Covered Outpatient Drugs and Biologicals (ASP Issues) 1. ASP Issues 2. Intravenous Immune Globulin (IVIG) 3. Clotting Factor Furnishing Fee 4. Widely Available Market Prices (WAMP) and Average Manufacturer Price (AMP) Threshold PO 00000 Frm 00003 Fmt 4701 Sfmt 4700 69625 5. Payment for Drugs Furnished During CY 2006 and Subsequent Years in Connection With the Furnishing of Renal Dialysis Services if Separately Billed by Renal Dialysis Facilities 6. Other Issues G. Revisions Related to Payment for Renal Dialysis Services Furnished by End Stage Renal Disease (ESRD) Facilities 1. Growth Update to the Drug Add-on Adjustment to the Composite Rate 2. Update to the Geographic Adjustments to the Composite Rates H. Private Contracts and Opt-Out Provision—Practitioner Definition I. Changes to Reassignment and Physician Self-Referral Rules Relating to Diagnostic Tests J. Supplier Access to Claims Billed on Reassignment K. Coverage of Bone Mass Measurement 1. Provisions of the June 24, 1998 IFC 2. Additional Scientific Evidence 3. Changes to the June 24, 1998 IFC 4. Analysis of and Response to Comments on the June 24, 1998 IFC and the CY 2007 PFS Proposed Rule L. Independent Diagnostic Testing Facility (IDTF) Issues 1. IDTF Changes 2. Performance Standards for IDTFs 3. Supervision 4. Place of Service 5. Analysis of and Response to Public Comments 6. Provisions of the Final Rule M. Independent Laboratory Billing for the TC of Physician Pathology Services to Hospital Patients N. Public Consultation for Medicare Payment for New Outpatient Clinical Diagnostic Laboratory Tests 1. Medicare, Medicaid, and SCHIP Benefits Improvement Protection Act of 2000 (BIPA) 2. Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) 3. Other Laboratory Issues a. Quality b. Blood Glucose Monitoring in SNFs c. Other Lab Issues—Clinical Diagnostic Laboratory Date of Service (DOS) for Stored Specimens O. Criteria for National Certifying Bodies that Certify Advanced Practice Nurses P. Chiropractic Services Demonstration Q. Promoting Effective Use of Health Information Technology (HIT) R. Health Care Information Transparency Initiative S. Bad Debt Payment for Services Associated with Reasonable Charge/Fee Schedules III. Revisions to the Payment Policies of Ambulance Services Under the Fee Schedule for Ambulance Services and the Ambulance Inflation Factor Update for CY 2007 A. History of Medicare Ambulance Services B. Provisions of the Final Regulation C. Analysis of and Responses to Public Comments D. Ambulance Inflation Factor (AIF) for 2007 E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 69626 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations IV. Five-Year Refinement of Relative Value Units Under the Physician Fee Schedule: Responses to Public Comments on the Five-Year Review of Work Relative Value Units A. Scope of Five-Year Review B. Review of Comments (Includes Table entitled ‘‘Work RVU Revisions in Response to the June 29, 2006 proposed notice’’) C. Discussion of Comments by Clinical Area 1. Dermatology and Plastic Surgery 2. Orthopedic Surgery 3. Gynecology, Urology, Pain Medicine, and Neurosurgery 4. Radiology, Pathology, and Other Miscellaneous Services 5. Evaluation and Management Services 6. Cardiothoracic Surgery 7. General, Colorectal and Vascular Surgery 8. Otolaryngology and Ophthalmology 9. HCPAC codes D. Other Issues Under the 5-Year Review 1. Anesthesia Services 2. Discussion of Post-Operative Visits included in the Global Surgical Packages 3. Budget Neutrality 4. Review Process V. Refinement of Relative Value Units for Calendar Year 2007 and Response to Public Comments on Interim Relative Value Units for 2006 A. Summary of Issues Discussed Related to the Adjustment of Relative Value Units B. Process for Establishing Work Relative Value Units for the 2006 Physician Fee Schedule C. Work Relative Value Unit Refinements of Interim Relative Value Units 1. Methodology (Includes table entitled ‘‘2006 Interim Work Relative Value Units for Codes Reviewed Under the Refinement Panel Process’’) 2. Interim 2006 Codes D. Establishment of Interim Work Relative Value Units for New and Revised Physician’s Current Procedural Terminology (CPT) Codes and New Healthcare Common Procedure Coding System Codes (HCPCS) for 2007 (Includes Table titled ‘‘American Medical Association Specialty Relative Value Update Committee and Health Care Professionals Advisory Committee Recommendations and CMS’ Decisions for New and Revised 2007 CPT Codes’’) E. Discussion of Codes for Which There Were No RUC Recommendations or for Which the RUC Recommendations Were Not Accepted F. Additional Pricing Issue G. Establishment of Interim PE RVUs for New and Revised Physician’s Current Procedural Terminology (CPT) Codes and New Healthcare Common Procedure Coding System (HCPCS) Codes for 2007 VI. Physician Self-Referral Prohibition: Annual Update to the List of CPT/ HCPCS Codes A. General B. Nuclear Medicine C. Annual Update to the Code List VII. Physician Fee Schedule Update for CY 2007 A. Physician Fee Schedule Update VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 B. The Percentage Change in the Medicare Economic Index (MEI) C. The Update Adjustment Factor (UAF) VIII. Allowed Expenditures for Physicians’ Services and the Sustainable Growth Rate A. Medicare Sustainable Growth Rate B. Physicians’ Services C. Preliminary Estimate of the SGR for 2007 D. Revised Sustainable Growth Rate for 2006 E. Final Sustainable Growth Rate for 2005 F. Calculation of 2007, 2006, and 2005 Sustainable Growth Rates IX. Anesthesia and Physician Fee Schedule Conversion Factors for CY 2007 A. Physician Fee Schedule Conversion Factor B. Anesthesia Fee Schedule Conversion Factor X. Telehealth Originating Site Facility Fee Payment Amount Update XI. Provisions of the Final Rule XII. Waiver of Proposed Rulemaking and Delay in Effective Date XIII. Collection of Information Requirements XIV. Response to Comments XV. Regulatory Impact Analysis A. RVU Impacts 1. Resource-Based Work and PE RVUs 2. Section 5102 of the DRA Adjustments for Payments for Imaging Services 3. Combined Impacts B. Geographic Practice Cost Indices (GPCI) Payment Localities C. Global Period for Remote Afterloading High Intensity Brachytherapy Procedures D. DRA 5112: Addition of Ultrasound Screening for Abdominal Aortic Aneurysm to ‘‘Welcome to Medicare’’ Benefit E. DRA 5113: Colorectal Screening Exemption from Part B Deductible F. Section 5114: Addition of Diabetes Outpatient Self-management Training Services (DSMT) and Medical Nutrition Therapy (MNT) for the FQHC Program G. Payment for Covered Outpatient Drugs and Biologicals (ASP Issues) H. Provisions Related to Payment for Renal Dialysis Services Furnished by End State Renal Disease (ESRD) Facilities I. Private Contracts and Opt-out Provision J. Supplier Access to Claims Billed on Reassignment K. Coverage of Bone Mass Measurement L. IDTF Changes M. Independent Lab Billing for TC Component of Physician Pathology Services for Hospital Patients N. Public Consultation for Medicare Payment for New Outpatient Clinical Diagnostic Laboratory Tests O. Bad Debt Payment for Services Associated with Reasonable Charge/Fee Schedules P. Revisions to Payment Policies under the Ambulance Fee Schedule and the Ambulance Inflation Factor Update for CY 2007 Q. Alternatives Considered R. Impact on Beneficiaries S. Accounting Statement Addendum A—Explanation and Use of Addendum B. PO 00000 Frm 00004 Fmt 4701 Sfmt 4700 Addendum B—2007 Relative Value Units and Related Information Used in Determining Medicare Payments for 2006. Addendum C—Codes with Interim RVUs Addendum D—2007 Geographic Practice Cost Indices by Medicare Carrier and Locality Addendum E—GAF Addenda Addendum F—Addendum F: CPT/HCPCS Imaging Codes Defined by DRA 5102(b) Addendum G—CY 2007 Wage Index For Urban Areas Based On CBSA Labor Market Areas Addendum H—CY 2007 ESRD Wage Index for Rural Areas Based on CBSA Labor Market Areas Addendum I—RUCA Rurality Level by State and Zip Code Addendum J—Updated List of CPT/HCPCS Codes Used to Describe Certain Designated Health Services Under the Physician Self-Referral Provision In addition, because of the many organizations and terms to which we refer by acronym in this final rule with comment period, we are listing these acronyms and their corresponding terms in alphabetical order below: AAA Abdominal aortic aneurysm AAD American Academy of Dermatology AAFP American Academy of Family Physicians AANS American Association of Neurological Surgeons AAO American Academy of Ophthalmology AAOS American Academy of Orthopaedic Surgeons AATS American Association for Thoracic Surgery ACC American College of Cardiology ACG American College of Gastroenterology ACHPN Advanced Certified Hospice and Palliative Nurse ACOG American College of Obstetrics and Gynecology ACR American College of Radiology ACS American College of Surgeons ADA American Dietetic Association AFROC Association of Freestanding Radiation Oncology Centers AGA American Gastroenterological Association AMA American Medical Association AMP Average manufacturer price APC Ambulatory payment classification ASA American Society of Anesthesiologists ASC Ambulatory surgical center ASCRS American Society of Colon and Rectal Surgeons ASGE American Society of Gastrointestinal Endoscopy ASP Average sales price ASSH American Society for Surgery of the Hand ASTRO American Society for Therapeutic Radiology and Oncology AUA American Urological Association BBA Balanced Budget Act of 1997 (Pub. L. 105–33) BBRA [Medicare, Medicaid and State Child Health Insurance Program] Balanced Budget Refinement Act of 1999 (Pub. L. 106–113) E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations BIPA Medicare, Medicaid, and SCHIP Benefits Improvement Protection Act of 2000 BLS Bureau of Labor Statistics BMD Bone mineral density BMM Bone mass measurement BN Budget neutrality BNF Budget neutrality factor BP Best price CAD Computer-aided detection CAH Critical access hospital CAP Competitive acquisition program CBSA Core-Based Statistical Area CCI Correct Coding Initiative CEO Chief executive officer CF Conversion factor CFO Chief financial officer CFR Code of Federal Regulations CMP Competitive medical plan CMS Centers for Medicare & Medicaid Services CNS Clinical nurse specialist CPI Consumer Price Index CPT (Physicians’) Current Procedural Terminology (4th Edition, 2002, copyrighted by the American Medical Association) CT Computed tomography CTA Computed tomographic angiography CY Calendar year DHS Designated health services DME Durable medical equipment DMEPOS Durable medical equipment, prosthetics, orthotics, and supplies DRA Deficit Reduction Act DSMT Diabetes outpatient self-management training services DXA Dual energy x-ray absorptiometry E/M Evaluation and management EPO Erythopoeitin ESRD End stage renal disease FAX Facsimile FDA Food and Drug Administration (HHS) FQHC Federally qualified health center FR Federal Register GAF Geographic adjustment factor GAO Government Accountability Office GDP Gross domestic product GPO Group purchasing organization GPCI Geographic practice cost index HCPAC Health Care Professional Advisory Committee HCPCS Healthcare Common Procedure Coding System HCRIS Healthcare Cost Report Information System HSA Health Savings Account HHA Home health agency HHS [Department of] Health and Human Services HIT Health information technology HMO Health maintenance organization HOCM High osmolar contrast media HPSA Health Professional Shortage Area HRSA Health Resources Services Administration (HHS) HUD [Department of] Housing and Urban Development ICF Intermediate care facilities IDTF Independent diagnostic testing facility IFC Interim final rule with comment period IPPE Initial preventive physical examination IPPS Inpatient prospective payment system IVIG Intravenous immune globulin IWPUT Intra-service work per unit of time VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 JCAAI Joint Council of Allergy, Asthma, and Immunology LCD Local coverage determination LOCM Low osmolar contrast media LOINC Logical Observation Identifiers Names and Codes MA Medicare Advantage MCP Monthly capitation payment MedPAC Medicare Payment Advisory Commission MEI Medicare Economic Index MLN Medicare Learning Network MMA Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Pub. L. 108–173) MNT Medical nutrition therapy MRA Magnetic resonance angiography MRI Magnetic resonance imaging MSA Metropolitan statistical area MSVP Multi-specialty visit package NCD National coverage determination NCQDIS National Coalition of Quality Diagnostic Imaging Services NDC National drug code NEMA National Electrical Manufacturers Association NHE National health expenditures NOP National Osteoporosis Foundation NP Nurse practitioner NPP Nonphysician practitioners NPWP Nonphysician Work Pool NSQIP National Surgical Quality Improvement Program OBRA Omnibus Budget Reconciliation Act OIG Office of Inspector General OMB Office of Management and Budget OPD Outpatient Department OPPS Outpatient prospective payment system OSCAR Online Survey and Certification and Reporting PA Physician assistant PBM Pharmacy benefit managers PC Professional component PE Practice Expense PE/HR Practice expense per hour PEAC Practice Expense Advisory Committee PERC Practice Expense Review Committee PET Positron emission tomography PFS Physician Fee Schedule PLI Professional liability insurance PPI Producer price index PPO Preferred provider organization PPS Prospective payment system PRA Paperwork Reduction Act PRM Provider Reimbursement Manual PT Physical therapy QCT Quantitative computerized tomography RFA Regulatory Flexibility Act RHC Rural health clinic RIA Regulatory impact analysis RN Registered nurse RUC [AMA’s Specialty Society] Relative (Value) Update Committee RVU Relative value unit SGR Sustainable growth rate SMS [AMA’s] Socioeconomic Monitoring System SNF Skilled nursing facility SNM Society for Nuclear Medicine SPA Single photon absorptiometry STS Society of Thoracic Surgeons SVS Society for Vascular Surgery SXA Single energy x-ray absorptiometry PO 00000 Frm 00005 Fmt 4701 Sfmt 4700 69627 TA Technology Assessment TC Technical Component UAF Update adjustment factor UPIN Unique Physician Identification Number USPSTF United States Preventive Services Task Force VA [Department of] Veteran Affairs WAC Wholesale acquisition cost WAMP Widely available market price WHO World Health Organization I. Background Since January 1, 1992, Medicare has paid for physicians’ services under section 1848 of the Social Security Act (the Act), ‘‘Payment for Physicians’ Services.’’ The Act requires that payments under the physician fee schedule (PFS) be based on national uniform relative value units (RVUs) based on the resources used in furnishing a service. Section 1848(c) of the Act requires that national RVUs be established for physician work, practice expense (PE), and malpractice expense. Before the establishment of the resource-based relative value system, Medicare payment for physicians’ services was based on reasonable charges. A. Development of the Relative Value System 1. Work RVUs The concepts and methodology underlying the PFS were enacted as part of the Omnibus Budget Reconciliation Act (OBRA) of 1989 (Pub. L. 101–239), and OBRA 1990 (Pub. L. 101–508). The final rule, published November 25, 1991 (56 FR 59502), set forth the fee schedule for payment for physicians’ services beginning January 1, 1992. Initially, only the physician work RVUs were resource-based, and the PE and malpractice RVUs were based on average allowable charges. The physician work RVUs established for the implementation of the fee schedule in January 1992 were developed with extensive input from the physician community. A research team at the Harvard School of Public Health developed the original physician work RVUs for most codes in a cooperative agreement with the Department of Health and Human Services (HHS). In constructing the code-specific vignettes for the original physician work RVUs, Harvard worked with panels of experts, both inside and outside the Federal government, and obtained input from numerous physician specialty groups. Section 1848(b)(2)(A) of the Act specifies that the RVUs for radiology services are based on relative value scale we adopted under section E:\FR\FM\01DER2.SGM 01DER2 69628 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 1834(b)(1)(A) of the Act, (the American College of Radiology (ACR) relative value scale), which we integrated into the overall PFS. Section 1848(b)(2)(B) of the Act specifies that the RVUs for anesthesia services are based on RVUs from a uniform relative value guide. We established a separate conversion factor (CF) for anesthesia services, and we continue to utilize time units as a factor in determining payment for these services. As a result, there is a separate payment methodology for anesthesia services. We establish physician work RVUs for new and revised codes based on recommendations received from the American Medical Association’s (AMA) Specialty Society Relative Value Update Committee (RUC). rmajette on PROD1PC67 with RULES2 2. Practice Expense Relative Value Units (PE RVUs) Section 121 of the Social Security Act Amendments of 1994 (Pub. L. 103–432), enacted on October 31, 1994, amended section 1848(c)(2)(C)(ii) of the Act and required us to develop resource-based PE RVUs for each physician’s service beginning in 1998. We were to consider general categories of expenses (such as office rent and wages of personnel, but excluding malpractice expenses) comprising PEs. Section 4505(a) of the Balanced Budget Act of 1997 (BBA) (Pub. L. 105– 33), amended section 1848(c)(2)(C)(ii) of the Act to delay implementation of the resource-based PE RVU system until January 1, 1999. In addition, section 4505(b) of the BBA provided for a 4-year transition period from charge-based PE RVUs to resource-based RVUs. We established the resource-based PE RVUs for each physician’s service in a final rule, published November 2, 1998 (63 FR 58814), effective for services furnished in 1999. Based on the requirement to transition to a resourcebased system for PE over a 4-year period, resource-based PE RVUs did not become fully effective until 2002. This resource-based system was based on two significant sources of actual PE data: The Clinical Practice Expert Panel (CPEP) data and the AMA’s Socioeconomic Monitoring System (SMS) data. The CPEP data were collected from panels of physicians, practice administrators, and nonphysicians (for example, registered nurses) nominated by physician specialty societies and other groups. The CPEP panels identified the direct inputs required for each physician’s service in both the office setting and out-of-office setting. The AMA’s SMS data provided aggregate specialty- VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 specific information on hours worked and PEs. Separate PE RVUs are established for procedures that can be performed in both a nonfacility setting, such as a physician’s office, and a facility setting, such as a hospital outpatient department (OPD). The difference between the facility and nonfacility RVUs reflects the fact that a facility receives separate payment from Medicare for its costs of providing the service, apart from payment under the PFS. The nonfacility RVUs reflect all of the direct and indirect PEs of providing a particular service. Section 212 of the Balanced Budget Refinement Act of 1999 (BBRA) (Pub. L. 106–113) directed the Secretary of Health and Human Services (the Secretary) to establish a process under which we accept and use, to the maximum extent practicable and consistent with sound data practices, data collected or developed by entities and organizations to supplement the data we normally collect in determining the PE component. On May 3, 2000, we published the interim final rule (65 FR 25664) that set forth the criteria for the submission of these supplemental PE survey data. The criteria were modified in response to comments received, and published in the Federal Register (65 FR 65376) as part of a November 1, 2000 final rule. The PFS final rules published in 2001 and 2003, respectively, (66 FR 55246 and 68 FR 63196) extended the period during which we would accept these supplemental data. 3. Resource-Based Malpractice RVUs Section 4505(f) of the BBA amended section 1848(c) of the Act to require us to implement resource-based malpractice RVUs for services furnished on or after 2000. The resource-based malpractice RVUs were implemented in the PFS final rule published November 2, 1999 (64 FR 59380) (hereinafter referred to as the CY 2000 PFS final rule). The malpractice RVUs were based on malpractice insurance premium data collected from commercial and physician-owned insurers from all the States, the District of Columbia, and Puerto Rico. 4. Refinements to the RVUs Section 1848(c)(2)(B)(i) of the Act requires that we review all RVUs no less often than every 5 years. The first 5-year review of the physician work RVUs went into effect in 1997, published on November 22, 1996 (61 FR 59489). The second 5-year review of work RVUs went into effect in 2002, published on November 1, 2001 (66 FR 55246). The PO 00000 Frm 00006 Fmt 4701 Sfmt 4700 third 5-year review is being finalized in this rule for CY 2007. In 1999, the AMA’s RUC established the Practice Expense Advisory Committee (PEAC) for the purpose of refining the direct PE inputs. Through March 2004, the PEAC provided recommendations to CMS for over 7,600 codes (all but a few hundred of the codes currently listed in the AMA’s Current Procedural Terminology (CPT) codes). In the November 15, 2004, PFS final rule (69 FR 66236) (hereinafter referred to as the CY 2005 PFS final rule), we implemented the first 5-year review of the malpractice RVUs (69 FR 66263). 5. Adjustments to RVUS Are Budget Neutral Section 1848(c)(2)(B)(ii)(II) of the Act provides that adjustments in RVUs for a year may not cause total PFS payments to differ by more than $20 million from what they would have been if the adjustments were not made. In accordance with section 1848(c)(2)(B)(ii)(II) of the Act, if adjustments to RVUs cause expenditures to change by more than $20 million, we make adjustments to ensure that expenditures do not increase or decrease by more than $20 million. B. Components of the Fee Schedule Payment Amounts To calculate the payment for every physician service, the components of the fee schedule (physician work, PE, and malpractice RVUs) are adjusted by a geographic practice cost index (GPCI). The GPCIs reflect the relative costs of physician work, PEs, and malpractice insurance in an area compared to the national average costs for each component. Payments are converted to dollar amounts through the application of a CF, which is calculated by the Office of the Actuary and is updated annually for inflation. The general formula for calculating the Medicare fee schedule amount for a given service and fee schedule area can be expressed as: Payment = [(RVU work × GPCI work) + (RVU PE × GPCI PE) + (RVU malpractice × GPCI malpractice)] × CF. However, as discussed in section IV.D of this final rule with comment period, due to the need to meet the budget neutrality (BN) provisions of 1848(c)(2)(B)(ii), we are applying a BN adjustor to the work RVUs in order to calculate payment for a service. Therefore, payment for services will now be calculated as follows: E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations rmajette on PROD1PC67 with RULES2 Payment = [(RVU work × BN adjustor × GPCI work) + (RVU PE × GPCI PE) + (RVU malpractice × GPCI malpractice)] × CF.) C. Most Recent Changes to the Fee Schedule The final rule with comment period that appeared in the Federal Register on November 21, 2005 (70 FR 70116) (hereinafter referred to as the CY 2006 PFS final rule with comment period) addressed Medicare Part B payment policy including the PFS that is applicable for CY 2006; and finalized certain provisions of the interim final rule to implement the Competitive Acquisition Program (CAP) for Part B Drugs. It also revised Medicare Part B payment and related policies regarding: physician work, PE and malpractice RVUs; Medicare telehealth services; multiple diagnostic imaging procedures; covered outpatient drugs and biologicals; supplemental payments to Federally Qualified Health Centers (FQHCs); renal dialysis services; coverage for glaucoma screening services; National Coverage Determination (NCD) timeframes; and physician referrals for nuclear medicine services and supplies to health care entities with which physicians have financial relationships. In addition, the rule finalized the interim RVUs for CY 2005 and issued interim RVUs for new and revised procedure codes for CY 2006. The rule also updated the codes subject to the physician self-referral prohibition and discussed payment policies relating to teaching anesthesia services, therapy caps, private contracts and opt-out, and chiropractic and oncology demonstrations. In accordance with section 1848(d)(1)(E)(i) of the Act, we also announced that the PFS update for CY 2006 would be ¥4.4 percent; the initial estimate for the sustainable growth rate for CY 2006 would be 1.7 percent; and the CF for CY 2006 would be $36.1770. However, subsequent to publication of the CY 2006 PFS final rule with comment period, section 5104 of the Deficit Reduction Act (DRA) of 2005 (Pub. L. 109–171, February 8, 2006), was enacted which amended section 1848(d) of the statute. As a result of this statutory change we maintained the CY 2005 CF of $37.8975 for CY 2006. We also note that the Five-Year Review of Work Relative Value Units Under the Physician Fee Schedule and Proposed Changes to the Practice Expense Methodology proposed notice appeared in the Federal Register on June 29, 2006 (71 FR 37170). In that VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 notice, we proposed revisions to work RVUs affecting payment for physicians’ services. The revisions reflect changes in medical practice, coding changes, and new data on relative value components that affect the relative amount of physician work required to perform each service, as required by the statute. We also proposed revisions to our methodology for calculating PE RVUs, including changes based on supplemental survey data for PE. This revised methodology would be used to establish payment for services beginning January 1, 2007. In this final rule with comment period, we are responding to the comments received on that notice. To the extent that comments received were outside the scope of the proposed notice, they are not addressed in this rule. Work RVU revisions will be fully implemented for services furnished to Medicare beneficiaries on or after January 1, 2007. The changes in PE methodology will be phased-in over a 4year period; although, as we gain experience with the new methodology, we will reexamine this policy beginning next year and propose necessary revisions through future rulemaking. II. Provisions of the Proposed Rule A. Resource-Based Practice Expense (PE) Relative Value Units (RVUs) Practice expense (PE) is the portion of the resources used in furnishing the service that reflects the general categories of physician and practitioner expenses, such as office rent and personnel wages but excluding malpractice expenses, as specified in section 1848(c)(1)(B) of the Act. Section 121 of the Social Security Amendments of 1994 (Pub. L. 103–432), enacted on October 31, 1994, required CMS to develop a methodology for a resource-based system for determining PE RVUs for each physician’s service. Until that time, PEs were based on historical allowed charges. This legislation stated that the revised PE methodology must consider the staff, equipment, and supplies used in the provision of various medical and surgical services in various settings beginning in 1998. The Secretary has interpreted this to mean that Medicare payments for each service would be based on the relative PE resources typically involved with furnishing the service. The initial implementation of resource-based PE RVUs was delayed from January 1, 1998, until January 1, 1999, by section 4505(a) of the BBA. In addition, section 4505(b) of the BBA PO 00000 Frm 00007 Fmt 4701 Sfmt 4700 69629 required that the new payment methodology be phased-in over 4 years, effective for services furnished in CY 1999, and fully effective in CY 2002. The first step toward implementation of the statute was to adjust the PE values for certain services for CY 1998. Section 4505(d) of the BBA required that, in developing the resource-based PE RVUs, the Secretary must: • Use, to the maximum extent possible, generally accepted cost accounting principles that recognize all staff, equipment, supplies, and expenses, not solely those that can be linked to specific procedures. • Develop a refinement method to be used during the transition. • Consider, in the course of notice and comment rulemaking, impact projections that compare new proposed payment amounts to data on actual physician PE. Beginning in CY 1999, we began the 4-year transition to resource-based PE RVUs. In CY 2002, the resource-based PE RVUs were fully transitioned. 1. Current Methodology The following sections discuss the current PE methodology. a. Data Sources There are two primary data sources used to calculate PE. The AMA’s Socioeconomic Monitoring System (SMS) survey data are used to develop the PE per hour (PE/HR) for each specialty. The second source of data used to calculate PE was originally developed by the Clinical Practice Expert Panels (CPEP). The CPEP data include the supplies, equipment and staff times specific to each procedure. The AMA developed the SMS survey in 1981 and discontinued it in 1999. Beginning in 2002, we incorporated the 1999 SMS survey data into our calculation of the PE RVUs, using a 5year average of SMS survey data. (See Revisions to Payment Policies and FiveYear Review of and Adjustments to the Relative Value Units Under the Physician Fee Schedule for CY 2002 final rule, published November 1, 2001 (66 FR 55246) (hereinafter referred to as CY 2002 PFS final rule).) The SMS PE survey data are adjusted to a common year, 1995. The SMS data provide the following six categories of PE costs: • Clinical payroll expenses, which are payroll expenses (including fringe benefits) for nonphysician personnel. • Administrative payroll expenses, which are payroll expenses (including fringe benefits) for nonphysician personnel involved in administrative, secretarial or clerical activities. E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 69630 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations • Office expenses, which include expenses for rent, mortgage interest, depreciation on medical buildings, utilities and telephones. • Medical material and supply expenses, which include expenses for drugs, x-ray films, and disposable medical products. • Medical equipment expenses, which include expenses depreciation, leases, and rent of medical equipment used in the diagnosis or treatment of patients. • All other expenses, which include expenses for legal services, accounting, office management, professional association memberships, and any professional expenses not previously mentioned in this section. In accordance with section 212 of the BBRA, we established a process to supplement the SMS data for a specialty with data collected by entities and organizations other than the AMA (that is, the specialty itself). (See the Criteria for Submitting Supplemental Practice Expense Survey Data interim final rule with comment period, (May 3, 2000, 65 FR 25664).) Originally, the deadline to submit supplementary survey data was through August 1, 2001. In the CY 2002 PFS final rule (66 FR 55246), the deadline was extended through August 1, 2003. To ensure maximum opportunity for specialties to submit supplementary survey data, we extended the deadline to submit surveys until March 1, 2005 in the Revisions to Payment Policies Under the Physician Fee Schedule for CY 2004 final rule, (November 7, 2003; 68 FR 63196) (hereinafter referred to as CY 2004 PFS final rule). The CPEPs consisted of panels of physicians, practice administrators, and nonphysicians (registered nurses (RNs), for example) who were nominated by physician specialty societies and other groups. There were 15 CPEPs consisting of 180 members from more than 61 specialties and subspecialties. Approximately 50 percent of the panelists were physicians. The CPEPs identified specific inputs involved in each physician’s service provided in an office or facility setting. The inputs identified were the quantity and type of nonphysician labor, medical supplies, and medical equipment. In 1999, the AMA’s RUC established the Practice Expense Advisory Committee (PEAC). From 1999 to March 2004, the PEAC, a multi-specialty committee, reviewed the original CPEP inputs and provided us with recommendations for refining these direct PE inputs for existing CPT codes. Through its last meeting in March 2004, the PEAC provided recommendations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 for over 7,600 codes which we have reviewed and accepted. As a result, the current PE inputs differ markedly from those originally recommended by the CPEPs. The PEAC has now been replaced by the Practice Expense Review Committee (PERC), which acts to assist the RUC in recommending PE inputs. b. Allocation of PE to Services To establish PE RVUs for specific services, it is necessary to establish the direct and indirect PE associated with each service. Our current approach allocates aggregate specialty practice costs to specific procedures and, thus, is often referred to as a ‘‘top-down’’ approach. The specialty PEs are derived from the AMA’s SMS survey and supplementary survey data. The PEs for a given specialty are allocated to the services furnished by that specialty on the basis of the direct input data and work RVUs assigned to each CPT code. The specific process is outlined in the June 29, 2006 proposed notice (71 FR 37242). c. Other Methodological Issues: Nonphysician Work Pool (NPWP) As an interim measure, until we could further analyze the effect of the topdown methodology on the Medicare payment for services with no physician work (including the technical components (TCs) of radiation oncology, radiology and other diagnostic tests), we created a separate PE pool for these services. However, any specialty society could request that its services be removed from the nonphysician work pool (NPWP). The specific steps for the NPWP calculation are detailed in the June 29, 2006 proposed notice (71 FR 37243). d. Facility/Non-facility Costs Procedures that can be furnished in a physician’s office, as well as in a hospital, have two PE RVUs: facility and non-facility. The non-facility setting includes physicians’ offices, patients’ homes, freestanding imaging centers, and independent pathology labs. Facility settings include hospitals, ambulatory surgical centers (ASCs), and skilled nursing facilities (SNFs). The methodology for calculating the PE RVU is the same for both facility and nonfacility RVUs, but is applied independently to yield two separate PE RVUs. Because the PEs for services provided in a facility setting are generally included in the payment to the facility (rather than the payment to the physician under the fee schedule), the PE RVUs are generally lower for services provided in the facility setting. PO 00000 Frm 00008 Fmt 4701 Sfmt 4700 2. Proposals for Revising the PE Methodology We have three major goals for our resource-based PE methodology: • To ensure that the PE portion of PFS payments reflect, to the greatest extent possible, the relative resources required for each of the services on the PFS. This could only be accomplished by using the best available data to calculate the PE RVUs. • To develop a payment system for PE that is understandable and at least somewhat intuitive, so that specialties could better predict the impacts of changes in the PE data. • To stabilize the PE portion of PFS payments so that changes in PE RVUs do not produce large fluctuations in the payment for given procedures from year-to-year. In the CY 2006 PFS proposed rule (70 FR 45764), we proposed the following changes to the PE methodology that we believed would help in achieving these three major goals: • Using the PE/HR data from seven specialty-specific supplementary surveys. • Calculating the direct PE using a bottom-up methodology. • Eliminating the NPWP. We also proposed an indirect PE methodology that was to assign to each service the higher of the current indirect PE RVUs or the indirect PE RVUs calculated using the supplementary survey data. In the CY 2006 PFS final rule with comment period (70 FR 70116), we withdrew these proposals primarily because a programming error for the indirect PE RVU calculation had led to the publication of inaccurate proposed PE RVUs. On February 15, 2006, we sponsored a PE Town Hall Meeting and invited the public, including all specialty representatives to attend. At this meeting, we supplied a detailed description of the bottom-up approach to the calculation of resource-based PE RVUs. Three examples were examined in detail that illustrated the impact of the various assumptions that could be used under a bottom-up approach. We specifically requested input from all interested parties on possible changes to our PE methodology, including the move to a bottom-up approach and the various methods of calculating indirect PE. We reviewed the approximately 35 comments that we received in response to our solicitation. Many of the comments were combined efforts from related specialty organizations. Additionally, the AMA RUC also supplied a letter that captured the E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations comments of nearly 30 specialty organizations. The following is a summary of the comments received as a result of the February 15, 2006 PE Town Hall meeting. • Delaying Implementation of Changes to the Current PE Methodology: There were mixed opinions from commenters on whether we should proceed with a proposal to use a bottom-up approach. Some commenters emphasized that the CPEP data has been refined and is now the best available source of data, and asserted that it should be used for the calculation of resource-based PE RVUs. Other comments suggested a delay in changing to a bottom-up approach because of the other issues that are affecting PFS payments this year (such as, the effect of imaging payment provisions in the DRA, the impact of the negative update, and the uncertainty regarding the impact of the 5-Year Review of work RVUs). • Transition to a Bottom-Up Approach: The majority of commenters requested a minimum 1-year transition to a maximum 3-year transition period to fully implement any change to a bottom-up approach. All of the commenters supported a transition period whether or not they supported the implementation of a bottom-up approach. • Use of Supplemental Survey Data: Many commenters stated that, irrespective of what we proposed for CY 2007, the supplemental survey data that has already been accepted should be used. Other commenters believed that the supplemental survey data grossly overstated PEs and should not be utilized in the development of resourcebased PE RVUs. • Multi-Specialty PE Survey: The majority of commenters supported the construction and use of a multispecialty survey to collect PE data. Commenters believed that the supplemental survey data is inflated and that the SMS survey data are outdated. • Review Equipment Utilization Assumptions and Interest Rates: Many commenters supported the review and revision of both the current utilization assumptions and the interest rates associated with high cost equipment. Commenters had mixed reactions as to whether the utilization rates should be higher or lower, and some suggested that we review the possibility of equipment-specific utilization assumptions for the future. Most commenters believed that the current 11 percent interest rate is significantly higher then the actual interest rates and VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 many commenters suggested a rate of approximately prime plus 2 percent. • Proxy Work RVUs for No Physician Work Services: Commenters were divided on the assignment of a proxy work RVU to services that contain no physician work. Some commenters believed that no physician work services are unfairly penalized under any bottom-up approach, while other comments stated that the inclusion of a proxy work RVU would double count the clinical labor associated with the no physician work services. After considering these comments, we made the following proposals for direct PEs in the June 29, 2006 proposed notice (71 FR 37245). a. Use a Bottom-up Method to Calculate the Direct PEs We believe that we have consistently made a good faith effort to ensure fairness in our PE RVU-setting system by using the best data available at any one time. The reason we did not adopt the bottom-up methodology originally proposed in 1997 and instead adopted the top-down methodology finalized in 1998 was because we recognized the concerns among the physician community that the resource input data developed in 1995 by the CPEP were less reliable than the aggregate specialty cost data derived from the SMS process. However, the situation has now changed. The PEAC/PERC/RUC has completed the refinement of the original CPEP data and we believe that the refined PE inputs now, in general, accurately capture the relative direct costs of PFS services. Conversely, although we have now accepted supplementary survey data from 13 specialties, we have not received updated aggregate cost data from most specialties. Thus, we believe that, in the aggregate, the refined direct input data represent more reliably the relative direct cost PE inputs for physicians’ services. Therefore, instead of using the topdown approach to calculate the direct PE RVUs, where the aggregate CPEP/ RUC costs for each specialty are scaled to match the aggregate SMS costs, we proposed to adopt a bottom-up method of determining the relative direct costs for each service. Under this method, the direct costs would be determined by adding the costs of the resources (that is, the clinical staff, equipment and supplies) typically required to provide the service. The costs of the resources, in turn, would be calculated from the refined direct PE inputs in our PE database. We believe that this proposed change, which was welcomed by most PO 00000 Frm 00009 Fmt 4701 Sfmt 4700 69631 commenters in the CY 2006 PFS proposed rule, will lead to greater stability and accuracy in the PE portion of our payment system. Currently, under the top-down methodology, the need to scale the CPEP costs to equal the SMS costs has meant that any changes in the direct PE inputs for one service often leads to unexpected results for other services where the inputs have not been altered. In addition, the current PE RVUs for a procedure do not necessarily change proportionately with changes in the direct inputs, creating possible anomalous values. We believe that our proposed bottom-up methodology would resolve these issues, so that changes in the PE RVUs would be more intuitive and would result in fewer surprises. b. Use the PE/HR Data from the 7 Surveys We Have Previously Accepted and, in addition, Use the PE/HR Data from the Survey Submitted by the National Coalition of Quality Diagnostic Imaging Services (NCQDIS) As explained in the CY 2005 PFS final rule with comment period (69 FR 66242), we received surveys from the American College of Cardiology (ACC), the American College of Radiology (ACR), and the American Society for Therapeutic Radiology and Oncology (ASTRO) by March 1, 2004. The data submitted by the ACC and the ACR met our criteria. However, as requested by the ACC and the ACR, we deferred using their data until issues related to the NPWP could be addressed. (The survey data from ASTRO did not meet the precision criteria established for supplemental surveys; therefore, we did not accept or use it in the calculation of PE RVUs for 2005.) In March 2005, we also received surveys from the Association of Freestanding Radiation Oncology Centers (AFROC), the American Urological Association (AUA), the American Academy of Dermatology (AAD), the Joint Council of Allergy, Asthma, and Immunology (JCAAI), the NCQDIS, and a joint survey from the American Gastroenterological Association (AGA), the American Society of Gastrointestinal Endoscopy (ASGE) and the American College of Gastroenterology (ACG). All the surveys, with the exception of the survey from NCQDIS, met our criteria. Therefore, we proposed in the CY 2006 PFS proposed rule (70 FR 45775) to use the survey data from all the surveys meeting our criteria in the calculation of PE RVUs for 2006; but, as discussed in the CY 2006 PFS final rule with comment period (70 FR 70116) and E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 69632 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations above in this section, this proposal was not finalized. We contracted with the Lewin Group (Lewin) to evaluate whether the supplemental survey data that were submitted met our criteria and to make recommendations to us regarding their suitability for use in calculating PE RVUs. As described in the CY 2006 PFS proposed rule (70 FR 45775), Lewin recommended blending the radiation oncology data from the AFROC survey data with the ASTRO survey data submitted in 2004 to calculate the PE/ HR. According to Lewin, the goal of the AFROC survey was to represent the population of freestanding radiation oncology centers only. To develop an overall average for the radiation oncology PE pool, Lewin recommended we use the AFROC survey for freestanding radiation oncology centers, and the hospital-based subset of last year’s ASTRO survey. We agreed that this blending of the AFROC and ASTRO data was a reasonable way to calculate an average PE/HR that fully reflects the practice of radiation oncology in all settings. Blending the survey data overcame the initial problem that the ASTRO data do not meet the precision criteria as discussed in the CY 2005 PFS final rule (69 FR 66242). In addition, as discussed in the CY 2006 PFS proposed rule (70 FR 45776), blending of the data allowed for a broader base of radiation oncology providers to be represented. Also, as discussed in the CY 2006 PFS proposed rule (70 FR 45764), Lewin indicated that the survey data submitted by the NCQDIS on independent diagnostic testing facilities (IDTFs) did not meet our precision criterion. However, upon further analysis, Lewin agreed with NCQDIS’ determination that the inclusion of one inaccurate record skewed the findings outside the acceptable precision range. Lewin recalculated the precision level at 8.1 percent of the mean PE/HR (weighted by the number of physicians in the practice). Lewin indicated that the level of precision for the total PE/HR satisfies the level of precision requirement, and recommended acceptance of the survey. We proposed to use the PE/HR data from all of these surveys, including the NCQDIS survey, in the calculation of the PE RVUs for 2007. For radiation oncology, we proposed to use the new PE/HR derived from combining the AFROC and ASTRO survey data, as recommended by Lewin. The proposed figures for PE per physician hour were listed in Table 52 in the June 29, 2006 proposed notice (71 FR 37246). Section 303(a)(1)(B) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) (Pub. VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 L. 108–173) added section 1848(c)(2)(I) of the Act to require CMS to use survey data submitted by a specialty group where at least 40 percent of the specialty’s payments for Part B services are attributable to the administration of drugs in 2002 to adjust PE RVUs for drug administration services. The statute applies to surveys that include expenses for the administration of drugs and biologicals, and were received by March 1, 2005 for determining the CY 2006 PE RVUs. Section 303(a)(1)(A)(ii) of the MMA also added section 1848(c)(2)(B)(iv)(II) of the Act to provide an exemption from budget neutrality (BN) in 2005 and 2006 for any additional expenditures resulting from the use of these surveys. In the Changes to Medicare Payment for Drugs and Physician Fee Schedule Payments for CY 2004 interim final rule published January 7, 2004 (69 FR 1084), we stated that the specialties of urology, gynecology, and rheumatology meet this criteria. As described in the CY 2006 PFS final rule with comment period (70 FR 70116), we accepted for the purposes of calculating the 2006 PE RVUs for drug administration services the new survey data from the AUA and exempted from the BN adjustment any impacts of accepting these data for purposes of calculating PE RVUs for drug administration services. (Note: Rheumatology and gynecology did not submit supplemental survey data.) c. Eliminate the NPWP and Calculate the PE RVUs for all Services Using the Same Methodology Primarily because of the lack of representative SMS data or accurate direct cost inputs for specialties such as radiology and radiation oncology, the adoption of the top-down approach necessitated the creation of the NPWP. This separate work pool was created to allocate PE RVUs for TC codes and codes that are not furnished by physicians and, thus, have no work RVUs. In the CY 2000 Physician Fee Schedule; Payment Policies and Relative Value Unit Adjustment final rule, we indicated that ‘‘the purpose of this pool was only to protect the (TC) services from the substantial decreases’’ caused by inaccurate CPEP data and the lack of physician work RVU in the allocation of the indirect costs (64 FR 59406). Unfortunately, the services priced by the NPWP methodology have proven to be especially vulnerable to any change in the work pool’s composition. This has led to significant fluctuations from year-to-year in the PE RVUs calculated for these services. PO 00000 Frm 00010 Fmt 4701 Sfmt 4700 The major specialties comprising the NPWP (radiology, radiation oncology and cardiology) have now submitted supplemental survey data that we have accepted and proposed to use in their PE calculations. (See the discussion on supplementary surveys above in this section.) Now that we have representative aggregate PE data for these specialties, and with the completion of the refinement of the direct cost inputs, the continued necessity and equity of treating these technical services outside the PE methodology applied to other services is questionable. Therefore, we proposed to eliminate the NPWP and to calculate the PE RVUs for the services currently in the work pool by the same methodology used for all other services. This would also allow the use of the refined CPEP/RUC data to price the direct costs of individual services, rather than utilizing the pre1998 charge-based PE RVUs. In addition, the revised methodology would lead to greater stability for the PE RVUs for these services and would lead to more intuitive results than have occurred with the NPWP methodology. d. Modify the Current Indirect PE RVUs Methodology As described previously, the SMS and supplementary survey data are the source for the specialty-specific aggregate indirect costs used in our PE calculations. We then allocate the indirect costs to particular codes on the basis of the direct costs allocated to a code and the work RVUs. In the CY 2006 PFS proposed rule (70 FR 45764), we stated that we had no information that would indicate that the current indirect PE methodology is inaccurate. At that time, we also were not aware of any alternative approaches or data sources that we could use to calculate more appropriately the indirect PE, other than the new supplementary survey data, which we proposed to incorporate into our PE calculations. Therefore, in the CY 2006 PFS proposed rule, we proposed to use the current indirect PEs in our calculation, incorporating the new survey data into the codes furnished by the specialties submitting the surveys (71 FR 45764). We also indicated in that same proposed rule that we would welcome any suggestions that would assist us in further refinement of this indirect PE methodology. For example, we were considering whether we should continue to accept supplementary survey data or whether it would be preferable and feasible to have an SMStype survey of only indirect costs for all specialties, or whether a more formula- E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations based methodology independent of the SMS should be adopted, perhaps using the specialty-specific indirect-to-total cost percentage as a basis of the calculation. For a prior discussion of many of the issues associated with allocating indirect costs, please refer to the CY 2000 Physician Fee Schedule; Payment Policies and Relative Value Unit Adjustment proposed rule (63 FR 30823). 3. Specific Changes to the Indirect PE Methodology for CY 2007 a. Summary of the PE Proposals From the June 29, 2006 Proposed Notice As a result of collaboration with the PFS community and public comments on this issue, in the June 29, 2006 proposed notice, we proposed the following modifications to the indirect PE methodology. rmajette on PROD1PC67 with RULES2 (1) Indirect Percentage Factor: Use of the Specialty-Specific Percentage that Indirect PEs Represent of Total PEs Based on the Survey Data We currently allocate indirect expenses on the sum of the direct expenses and the work RVUs (converted to dollars by multiplying by the CF). We proposed to allocate indirect expenses by applying a specialty-specific indirect percentage factor to the direct expenses to recognize the varying proportion that indirect costs represent of total costs by specialty. This will have the effect of relatively increasing the indirect expense allocation for services that are on average furnished by specialties with higher indirect PE percentages, and relatively decreasing the indirect expense allocation for services that are furnished by specialties with lower indirect PE percentages. For a given service, the specific indirect percentage factor to apply to the direct costs for the purpose of the indirect allocation will be calculated as the weighted average of the ratio of the indirect to direct costs (based on the survey data) for the specialties that furnish the service. For example, if a service is furnished by a single specialty with indirect PEs that were 75 percent of total PEs, the indirect percentage factor to apply to the direct costs for the purposes of the indirect allocation would be (0.75/0.25) = 3.0. (2) Continued Use of the SpecialtySpecific Indirect Scaling Factors As described earlier in this section, we incorporate the indirect PE/HR surveys into the methodology through the use of specialty-specific indirect scaling factors. We would continue to use the specialty-specific indirect scaling factors; however, to apply them in a simpler manner we proposed to VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 create an index. This index would reflect the relationship between each specialty’s indirect scaling factor and the overall indirect scaling factor for the entire PFS. For example, if a specialty had an indirect practice cost index of 2.00, this specialty would have an indirect scaling factor that was twice the overall average indirect scaling factor. If a specialty had an indirect practice cost index of 0.50, this specialty would have an indirect scaling factor that was half the overall average indirect scaling factor. The calculation and application of the indirect practice cost index is described in more detail below in this section. (3) Use of the Clinical Labor Costs in the Indirect Allocation for a Service When the Clinical Labor Costs are Greater than the Physician Work RVU We have received numerous comments that services with little or no physician work RVUs are disadvantaged under our current indirect allocation methodology based on the direct costs and the work RVUs. In response to these comments, when the clinical labor portion of the direct PE RVU is greater than the physician work RVU for a particular service, we proposed to allocate on the direct costs and the clinical labor costs. For example, if a service has no physician work, if the direct PE RVU is 1.10 and if the clinical labor portion of the direct PE RVU is 0.65 RVUs, we would use the 1.10 direct PE RVUs and the 0.65 clinical labor portion of the direct PE RVUs for the indirect PE allocation for that service. As another example, if the physician work RVUs for a service are 0.25, if the direct PE RVU is 1.10 and if the clinical labor portion of the direct PE RVU is 0.65 RVUs, we would use the 1.10 direct PE RVUs and the 0.65 clinical labor RVUs for the indirect allocation for that service. We would not use the 0.25 physician work RVUs for the indirect PE allocation since the 0.65 clinical labor RVUs are greater than the 0.25 physician work RVUs. (4) Use of 2005 Utilization Data in the Indirect PE RVU Calculation Under the current PE methodology, we predominately use the 1997–2000 utilization data in the calculation of the indirect PE RVUs when the service existed during 1997–2000 or the first year of utilization data if the service did not exist during that time period. We used those years of utilization data primarily to increase the year-to-year stability of the PE RVUs. With the changes we proposed to PE RVUs, in particular the elimination of the NPWP, we will increase the year-to-year PO 00000 Frm 00011 Fmt 4701 Sfmt 4700 69633 stability of the PE RVUs. We believe it is now appropriate to use updated utilization data in the calculation of the indirect PEs. We believe the other proposed changes in the PE methodology would help obtain the year-to-year stability we were attempting to achieve by continuing to use the older utilization data. Additionally, the use of more current utilization data would reflect the more current practice patterns. We proposed to use the 2005 utilization data in the calculation of the 2007 indirect PE RVUs. We also sought comments on whether the utilization data should be updated yearly, which would increase the accuracy of the PE calculations, or less often, which would increase the stability of the PE RVUs. (5) Elimination of the Special Methodologies for Services with Technical Components (TCs) and Professional Components (PCs) Under the PFS, when services have TC, PC, and global components that can be billed separately, the payment for the global component equals the sum of the payment for the TC and PCs. Under the current PE methodology, the different mix of specialties that furnish the global, TC and PCs can cause the PE RVUs, otherwise created by the methodology, to fail to add together properly; that is, the global component does not equal the sum of the PC and TCs. The global component might exceed the sum of the TC and PCs or it might be less than the sum of the TC and PCs. We ensure that the TC and PCs add to the global component in one of two ways. For services in the NPWP, we set the PE RVUs for the global component equal to the sum of the PC PE RVU and the TC PE RVU. For services outside the NPWP, we set the PE RVUs for the TC equal to the difference between the global PE RVUs and the PC RVUs. With our proposed change to a bottom-up methodology for the direct PEs, there will be no weighted averaging of the direct cost inputs necessary to create the direct PE RVUs and, therefore, the direct PE RVUs for the PC and TCs would sum to the global component. Under the current methodology, as a result of the process used to ensure the PC and TCs sum to the global, RVUs for a service with a global component can be either more or less than the RVUs that would have been calculated for the service if the PC and TCs did not have to sum to the global. Given the proposed change to bottomup methodology and the elimination of the NPWP, we believe it is E:\FR\FM\01DER2.SGM 01DER2 69634 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations inappropriate to have codes for which the global, and the TC and PCs are assigned RVUs that are either less than or greater than the methodology would otherwise produce, and thus, are paid at a rate that is either less than or greater than the methodology would otherwise specify. (See section II.A.1. of this final rule with comment period for the discussion of the current methodology.) Therefore, we proposed that in the calculation of the indirect percentage factor described earlier in section II.A.3.a.(1), we would use a weighted average of the ratio of indirect to direct costs across all the specialties that furnish the global components, TCs, and PCs; that is, we would apply the same weighted average indirect percentage factor to allocate indirect expenses to the global components, PC, and TCs for a service. We also proposed to utilize a similar weighted averaging approach across all the specialties that furnish the components when calculating the indirect PE scaling factor. Because the direct PE RVUs for the TC and PCs sum to the global under the bottom-up methodology, and we proposed to calculate the indirect percentage factor and the indirect scaling factor so that they do not vary between the TCs, PCs, and global components, our proposed methodology would create TCs and PCs that sum to the global, and no other special methodology would need to be employed. (a) PE RVU Methodology The following is a description of the proposed PE RVU methodology. rmajette on PROD1PC67 with RULES2 (i) Setup File First, we create a setup file for the PE methodology. The setup file contains the direct cost inputs, the utilization for each procedure code at the specialty and facility/nonfacility place of service level, and the specialty-specific survey PE per physician hour data. (ii) Calculate the Direct Cost PE RVUs Sum the costs of each direct input. Step 1: Sum the direct costs of the inputs for each service. The direct costs consist of the costs of the direct inputs for clinical labor, medical supplies, and medical equipment. The clinical labor cost is the sum of the cost of all the staff types associated with the service; it is the product of the time for each staff type and the wage rate for that staff type. The medical supplies cost is the sum of the supplies associated with the service; it is the product of the quantity of each supply and the cost of the supply. The medical equipment cost is the sum of the cost of the equipment associated with the service; it is the VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 product of the number of minutes each piece of equipment is used in the service and the equipment cost per minute. The equipment cost per minute is calculated as described at the end of this section. Apply a BN adjustment to the direct inputs. Step 2: Calculate the current aggregate pool of direct PE costs. To do this, multiply the current aggregate pool of total direct and indirect PE costs (that is, the current aggregate PE RVUs multiplied by the CF) by the average direct PE percentage from the SMS and supplementary specialty survey data. Step 3: Calculate the aggregate pool of direct costs. To do this, for all PFS services, sum the product of the direct costs for each service from Step 1 and the utilization data for that service. Step 4: Using the results of Step 2 and Step 3 calculate a direct PE BN adjustment so that the proposed aggregate direct cost pool does not exceed the current aggregate direct cost pool and apply it to the direct costs from Step 1 for each service. Step 5: Convert the results of Step 4 to an RVU scale for each service. To do this, divide the results of Step 4 by the Medicare PFS CF. (iii) Create the Indirect PE RVUs Create indirect allocators. Step 6: Based on the SMS and supplementary specialty survey data, calculate direct and indirect PE percentages for each physician specialty. Step 7: Calculate direct and indirect PE percentages at the service level by taking a weighted average of the results of Step 6 for the specialties that furnish the service. Note that for services with TC and PCs we are calculating the direct and indirect percentages across the global components, PCs and TCs. That is, the direct and indirect percentages for a given service (for example, echocardiogram) do not vary by the PC, TC and global components. Step 8: Calculate the service level allocators for the indirect PEs based on the percentages calculated in Step 7. The indirect PEs are allocated based on the three components: The direct PE RVU, the clinical PE RVU and the work RVU. (Note that the work RVU used in the calculation included the separate work BN adjustment from the 5-Year Review of the work RVUs discussed in the June 29, 2006 proposed notice. In this final rule, unadjusted work RVUs are used.) For most services the indirect allocator is: indirect percentage * (direct PE RVU/ direct percentage) + work RVU. PO 00000 Frm 00012 Fmt 4701 Sfmt 4700 There are two situations where this formula is modified: • If the service is a global service (that is, a service with global, professional and technical components), then the indirect allocator is: indirect percentage * (direct PERVU/ direct percentage) + clinical PE RVU + work RVU. • If the clinical labor PE RVU exceeds the work RVU (and the service is not a global service), then the indirect allocator is: indirect percentage * (direct PERVU/ direct percentage) + clinical PE RVU. (Note that for global services the indirect allocator is based on both the work RVU and the clinical labor PE RVU. We do this to recognize that, for the professional service, indirect PEs will be allocated using the work RVUs, and for the TC service, indirect PEs will be allocated using the direct PE RVU and the clinical labor PE RVU. This also allows the global component RVUs to equal the sum of the PC and TC RVUs.) For presentation purposes in the examples in the Table 1, the formulas were divided into two parts for each service. The first part does not vary by service and is the indirect percentage * (direct PE RVU/direct percentage). The second part is either the work RVU, clinical PE RVU, or both depending on whether the service is a global service and whether the clinical PE RVU exceeds the work RVU (as described earlier in this step.) Apply a BN adjustment to the indirect allocators. Step 9: Calculate the current aggregate pool of indirect PE RVUs by multiplying the current aggregate pool of PE RVUs by the average indirect PE percentage from the physician specialty survey data. This is similar to the Step 2 calculation for the direct PE RVUs. Step 10: Calculate an aggregate pool of proposed indirect PE RVUs for all PFS services by adding the product of the indirect PE allocators for a service from Step 8 and the utilization data for that service. This is similar to the Step 3 calculation for the direct PE RVUs. Step 11: Using the results of Step 9 and Step 10, calculate an indirect PE adjustment so that the aggregate indirect allocation does not exceed the available aggregate indirect PE RVUs and apply it to indirect allocators calculated in Step 8. This is similar to the Step 4 calculation for the direct PE RVUs. Calculate the Indirect Practice Cost Index. Step 12: Using the results of Step 11, calculate aggregate pools of specialtyspecific adjusted indirect PE allocators E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations rmajette on PROD1PC67 with RULES2 for all PFS services for a specialty by adding the product of the adjusted indirect PE allocator for each service and the utilization data for that service. Step 13: Using the specialty-specific indirect PE/HR data, calculate specialtyspecific aggregate pools of indirect PE for all PFS services for that specialty by adding the product of the indirect PE/ HR for the specialty, the physician time for the service, and the specialty’s utilization for the service. Step 14: Using the results of Step 12 and Step 13, calculate the specialtyspecific indirect PE scaling factors as under the current methodology. Step 15: Using the results of Step 14, calculate an indirect practice cost index at the specialty level by dividing each specialty-specific indirect scaling factor by the average indirect scaling factor for the entire PFS. Step 16: Calculate the indirect practice cost index at the service level to ensure the capture of all indirect costs. Calculate a weighted average of the practice cost index values for the specialties that furnish the service. Note that for services with TC and PCs, we calculate the indirect practice cost index across the global components, PCs and TCs. Under this method, the indirect practice cost index for a given service (for example, echocardiogram) does not vary by the PC, TC and global components. Step 17: Apply the service level indirect practice cost index calculated in Step 16 to the service level adjusted indirect allocators calculated in Step 11 to get the indirect PE RVU. VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 (iv) Calculate the Final PE RVUs. Step 18: Add the direct PE RVUs from Step 6 to the indirect PE RVUs from Step 17. Step 19: Calculate and apply the final PE BN adjustment by comparing the results of Step 18 to the current pool of PE RVUs. This final BN adjustment is primarily required because certain specialties are excluded from the PE RVU calculation for rate-setting purposes, but all specialties are included for purposes of calculating the final BN adjustment. (See ‘‘Specialties excluded from rate-setting calculation’’ below in this section.) (v) Setup File Information • Specialties excluded from ratesetting calculation: For the purposes of calculating the PE RVUs, we exclude certain specialties such as midlevel practitioners paid at a percentage of the PFS, audiology, and low volume specialties from the calculation. This is the same approach used under the current methodology. These specialties are included for the purposes of calculating the BN adjustment. • Crosswalk certain low volume physician specialties: Crosswalk the utilization of certain specialties with relatively low PFS utilization to the associated specialties. This is the same approach used under the current methodology. • Physical therapy utilization: Crosswalk physical therapy utilization to the specialty of physical therapy. This is the same approach used under the current methodology. • Identify professional and technical services not identified under the usual PO 00000 Frm 00013 Fmt 4701 Sfmt 4700 69635 TC and 26 modifier: Flag the services that are PC and TC services, but do not use TC and 26 modifiers (for example, electrocardiograms). This flag associates the PC and TC with the associated global code for use in creating the indirect PE RVU. For example, the professional service code 93010 is associated with the global code 93000. • Payment modifiers: Payment modifiers are accounted for in the creation of the file. For example, services billed with the assistant at surgery modifier are paid 16 percent of the PFS amount for that service; therefore, the utilization file is modified to only account for 16 percent of any service that contains the assistant at surgery modifier. • Work RVUs from the 5-Year Review: The setup file contains the proposed work RVUs from the 5-Year Review published in the June 29, 2006 proposed notice (71 FR 37174). (vi) Equipment Cost Per Minute = The equipment cost per minute is calculated as: (1/(minutes per year * usage)) * price * ((interest rate/(1¥(1/((1 + interest rate) * life of equipment)))) + maintenance) Where: minutes per year = maximum minutes per year if usage were continuous (that is, usage = 1); 150,000 minutes. usage = equipment utilization assumption; 0.5. price = price of the particular piece of equipment. interest rate = 0.11. life of equipment = useful life of the particular piece of equipment. maintenance = factor for maintenance; 0.05. BILLING CODE 4120–01–P E:\FR\FM\01DER2.SGM 01DER2 VerDate Aug<31>2005 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00014 Fmt 4701 Sfmt 4725 E:\FR\FM\01DER2.SGM 01DER2 ER01DE06.002</GPH> rmajette on PROD1PC67 with RULES2 69636 69637 BILLING CODE 4120–01–C VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00015 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 ER01DE06.003</GPH> rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69638 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations rmajette on PROD1PC67 with RULES2 (b) Transition the Resulting Revised PE RVUs Over a 4-Year Period b. Comments and Responses From the June 29, 2006 Proposed Notice As explained in the June 29, 2006 proposed notice, we had concerns that, when combined with a negative update factor for CY 2007 and the changes to the work RVUs under the 5-Year Review, the shifts in some of the PE RVUs resulting from the immediate implementation of our proposals could potentially cause some disruption for medical practices (71 FR 37252). Therefore, we proposed to transition the PE changes over a 4-year period. This would also give ample opportunity for us, as well as the medical specialties and the RUC, to identify any anomalies in the PE data, to make any further appropriate revisions, and to collect additional data as needed prior to the full implementation of the PE changes. During the transition period, the PE RVUs would be calculated on the basis of a blend of RVUs calculated using our methodology described above in this section (weighted by 25 percent during CY 2007, 50 percent during CY 2008, 75 percent during CY 2009, and 100 percent thereinafter), and the current CY 2006 PE RVUs for each existing code. PE RVUs for codes that are new during this period would be calculated using only the methodology, and paid at the fully transitioned rate. We also believe the methodology is less confusing and more intuitive than the current approach. First, the NPWP would be eliminated and all services would be priced using one methodology, eliminating the complicated calculations needed to price NPWP services. Second, any revisions made to the direct inputs for one or more services would now have predictable results. Changes in the direct practice inputs for a service would proportionately change the PE RVUs for that service without significantly affecting the PE RVUs for unrelated services (except, of course, to the extent that a BN adjustment is required to be applied by the statute). The methodology will also create a system that would be significantly more stable from year-to-year than the current approach. Specialties should no longer experience the wide fluctuations in payment for a given service due to an aberrant direct cost scaling factor. Direct PEs should only change for a service if the service is further refined or when prices are updated, while indirect PEs should change only when there are changes in the mix of specialties furnishing the service or if any future new survey data for indirect costs are utilized. The following is a summary of the comments we received on the June 29, 2006 proposed notice (71 FR 37170). VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 (1) Bottom-Up Methodology Comment: The majority of commenters expressed support for the proposed bottom-up approach to calculating resource-based PE RVUs. Many of these commenters stated that the bottom-up approach, which bases the direct portion of the PE RVUs on the actual direct cost inputs, produces more accurate, intuitive, and stable PE RVUs. A few commenters expressed concern about the proposed bottom-up approach. These commenters were not critical of the merits of the proposed bottom-up methodology itself, but were instead critical of the data sources used in the calculation of resource-based PE RVUs. The commenters suggested that the proposal should be delayed until the direct cost data, aggregate specialty cost data, and indirect specialty cost data derived from the aggregate specialty cost data could be verified. Response: We are appreciative of the support for the proposed bottom-up approach to calculating resource-based PE. We also appreciate the comments that expressed concern about our data sources, since we also believe that it is important that we use the best available data to develop the PE RVUs. As discussed in greater detail in subsequent responses, we do believe that the data sources used to calculate the proposed PE RVUs are the best available at this time. This is particularly true of the direct cost input data that forms the basis of the bottom-up methodology, and that has been thoroughly analyzed and discussed by the RUC, PEAC, HCPAC and the PERC and then has been reviewed by us. Therefore, we will implement the bottom-up methodology as proposed. (2) Supplemental Survey Data Comment: Several commenters expressed concern about the significant increase in PE values for specialty groups that submitted supplemental survey data. They stated their belief that the data has created serious inequities in the relativity of PE RVUs across the PFS. The commenters recommended that the supplemental survey data not be used; but, rather, that we wait until a new multi-specialty survey can be completed before using this revised data. One commenter questioned the validity of supplemental survey data, noting that the response rates were fairly low. The commenter also PO 00000 Frm 00016 Fmt 4701 Sfmt 4700 indicated that it was inequitable to accept more recent data from only a few specialties. Another commenter did not agree that individual specialty groups should be allowed to provide survey data. Conversely, several commenters strongly supported our acceptance and use of the supplementary survey data. Response: The BBRA requires us to establish a process for specialty groups to submit supplemental survey data. The statute mandated that we establish criteria for surveys, but required that we accept such data for only two years. However, to give all specialty groups an opportunity to submit data, we twice extended the period for submitting data. Therefore, we accepted data over a 6year period, instead of the 2-year period mandated by the Congress. In addition, our contractor, Lewin, was available to provide assistance to any group interested in submitting a survey by helping to ensure that the proper protocols were met in order to maximize the survey’s chance of meeting our survey criteria. We recognize the limitations of the supplemental survey process. However, we were obligated by statute to establish and use such a process, all specialty groups had an equal opportunity to submit data, and groups that conducted surveys did so at great expense. If the submitted survey data met the criteria we established by notice and comment rulemaking, we were obligated to accept and use the supplemental survey data to the maximum extent practicable and consistent with sound data practices. Additionally, we previously accepted most of the surveys we proposed to use in the CY 2007 PFS proposed rule in either the CY 2005 or the CY 2006 PFS final rules with comment. Although we delayed the use of these surveys for various reasons, as explained fully in the CY 2005 and CY 2006 rules, there is no reason to continue to delay implementation of these surveys. We note that we support the AMA’s efforts to field a multi-specialty survey. However, the earliest this data would be available to incorporate into the PFS would be for CY 2009. We will consider any such data as soon as it becomes available. Comment: The majority of commenters expressed support for the design and use of a multi-specialty practice cost survey. Several commenters further recommended that any multi-specialty practice cost survey adhere to the same standards as the supplemental surveys accepted by CMS. Two commenters were concerned that a multi-specialty practice costs survey would not capture the practice costs E:\FR\FM\01DER2.SGM 01DER2 69639 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations associated with specialties whose practices focus on technical services. Response: We support the design of an AMA-sponsored multi-specialty survey and we understand that over 40 physician and nonphysician specialties have agreed to participate. The AMA has designed this survey tool and the process has been open for comment to all interested parties. We have also offered comments on the survey design to ensure that both the appropriate practice cost data is collected and the highest standards are met in the collection of this data. Comment: A few commenters recommended that we commit to including the costs associated with uncompensated care in the PE RVUs. One commenter suggested that the costs of uncompensated care should be included in the AMA-sponsored multispecialty practice cost survey. Response: Many specialties must deal with the issue of uncompensated care, though we believe that the number of patient care hours spent on uncompensated care is significantly higher for emergency medicine. We currently make an adjustment to the patient care hours for emergency medicine to account for the hours of uncompensated care included in the SMS survey because the calculated PE/ hour should only reflect reimbursable hours. We agree that it would be beneficial if the AMA-sponsored multispecialty survey includes a question on this issue. Comment: ACR expressed concern that we did not fully utilize its supplementary survey data by excluding data on part-time physicians. Response: The precedent for applying average full-time practice hours to all doctors in the practice when analyzing practice hours was set by the AMA’s Socioeconomic Monitoring System (SMS) and was also discussed in the September 23, 2003 Lewin report, ‘‘Recommendations Regarding Supplemental Practice Expense Data Submitted for 2004.’’ As described in this report, independent laboratory organizations were surveyed at the practice level because most independent labs are owned by an organization, not physicians; this is also the case with many free-standing radiology practices. Lewin applied a comparable methodology to the radiology practice level supplemental survey data for its May 26, 2004 recommendation to CMS. The radiology supplemental survey reported that less than 10 percent of radiologists in the practice were parttime doctors. The average of the practice hours for the 2,250 full-time doctors was 38.9 hours and for the 237 part-time doctors 22.2 hours. Using the supplemental survey data results in less than a 5 percent increase in the total practice hours over the number of hours derived from using the SMS methodology. We have determined that the original Lewin calculation is consistent with historical practice hour calculations used in the SMS, and with subsequent recommendations submitted by Lewin to CMS. Comment: Lewin recommended accepting supplemental survey data from ASTRO and AFROC by blending the data in the proportion of 75 percent hospital-based radiation oncology and 25 percent freestanding radiation oncology, resulting in a PE/HR of $161.08. AFROC engaged the services of an independent claims analyst who found that a 62/38 proportion is more appropriate, resulting in a PE/HR of $213. AFROC supplied this information as part of its comments on the proposed notice. Response: Lewin calculated a PE/HR for radiation oncology of $161.08, which is the weighted average based on the percentage of Medicare claims for hospital-based (75 percent) versus freestanding (25 percent) radiation oncologists. In our standard outpatient claims data file for 2003, a radiation oncologist was deemed to be hospitalbased if 50 percent or more of his claims, based on the Unique Physician Identification Number (UPIN), were for services furnished at a hospital-based radiation oncology center. The rationale for weighting the PE/HR by Medicare claims was discussed by Lewin in its ‘‘2005 Recommendations to CMS’’ regarding the American Society for Therapeutic Radiation and Oncology (ASTRO) supplemental survey data. In its comments, AFROC offered two alternative calculations. The first proposed to recount the Medicare claims after removing TC only claims. This method results in a reweighting of hospital-based versus freestanding radiation oncologists of 64 percent hospital based and 36 percent freestanding. The second method used time-weighting to determine the mix of hospital based versus freestanding practitioners. AFROC used physician time data for FY 2004 by radiation oncology CPT code and removed the TCs, resulting in a reweighting of hospital-based versus freestanding proportion of physician time of 62 percent to 38 percent, yielding a combined average PE/HR of $213.07. Lewin reviewed AFROC’s analysis and believes that AFROC presented two reasonable alternatives to weighting hospital-based and freestanding radiation oncologists, with both methods resulting in essentially the same answer. However, Lewin has determined that the time-weighting method is more consistent with the SMS and Lewin analysis of practice hours per physician. Lewin conducted the physician time-weighting analysis using our time and utilization data for FY 2005, resulting in a hospital-based to freestanding weight of 63 percent to 37 percent, respectively. The combined average using this weighting results in a PE/HR for radiation oncologist of $209.19, as shown in Table 2. TABLE 2 ASTRO survey rmajette on PROD1PC67 with RULES2 Hospital-based physicians Number in Sample Percent of Medicare Claims ....... Percent of Physician Time (Facility vs. Non-Facility) ...................... VerDate Aug<31>2005 10:50 Nov 30, 2006 Freestanding practices AFROC survey Weighted average Freestanding practices 67 24.8% 24.8% 63.0% 37.0% ASTRO’s hospital-based and AFROC’s freestanding (by share of Medicare claims) 23 75.2% Combined average 37.0% Jkt 211001 PO 00000 Frm 00017 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 ASTRO’s hospital-based and AFROC’s freestanding (by share of physician time) 69640 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations TABLE 2—Continued ASTRO survey Hospital-based physicians Direct PE per hour: Clinical Payroll Medical Equipment ........... Medical Supplies ............ Indirect PE per hour: Office Expense Clerical Payroll Other Expense Total PE per hour Freestanding practices ASTRO’s hospital-based and AFROC’s freestanding (by share of physician time) $33.46 $153.24 $45.47 $62.98 3.64 80.92 22.81 91.04 25.32 35.99 1.56 31.56 9.00 13.11 4.42 5.84 19.31 12.04 16.92 69.40 39.42 20.17 31.73 18.83 17.73 87.88 59.56 52.43 36.32 23.82 25.73 44.69 29.63 30.06 63.40 346.27 133.55 457.26 161.08 209.19 Comment: With the exception of those comments that requested that we delay the entire revision to the PE methodology, the majority of commenters expressed support for the elimination of the NPWP. Response: The development of the NPWP was necessitated by our lack of accurate aggregate cost data for specialties such as radiology and radiation oncology necessitated the development of the NPWP. The major specialties comprising the NPWP have now submitted supplemental survey data that we have accepted. Now that we have reliable aggregate PE data for these specialties, as well as and refined direct input data at the code level, we will finalize our proposal to eliminate the NPWP. (4) Indirect PE RVUs Methodology rmajette on PROD1PC67 with RULES2 Freestanding practices ASTRO’s hospital-based and AFROC’s freestanding (by share of Medicare claims) $104.80 (3) Nonphysician Workpool Comment: Many commenters recommended that we not use the budget-neutralized work RVUs in the indirect PE allocation, but rather use the unadjusted work RVUs. 10:50 Nov 30, 2006 Weighted average Combined average $9.93 Lewin agrees with AFROC that weighting by hours of patient care is most consistent with our underlying methodology for calculating physician practice hours. Lewin has recommended that the time-weighting methodology for determining the percentage of hospitalbased to freestanding radiation oncologist PE be adopted, which would result in a PE/HR of $213/HR based on 2004 data or $209/HR based on 2005 data. We accept Lewin’s recommendation and will implement a PE/HR of $209 for radiation oncology. VerDate Aug<31>2005 AFROC survey Jkt 211001 Response: As discussed in section III.D.3. of this final rule with comment period , the BN adjustment necessitated by the 5-Year Review of work RVUs will be accomplished through the use of a separate, BN adjustor applied to the work RVUs. However, as recommended by the commenters, we will not use the budget-neutralized work RVUs to calculate indirect PE. Comment: Many commenters disagreed with the use of the physician work RVUs in allocating indirect PE. Some commenters further contended that the intensity portion of physician work has no correlation to indirect PEs. A few commenters contended that physician time would be a more appropriate allocation tool than physician work RVUs. Response: There is no perfect method of allocating indirect expenses down to individual services. We believe the work RVUs are the most constant of the available allocation tools, and this characteristic coincides best with our goal of stability for the PE RVUs. In this final rule with comment, we will continue to use the work RVUs as one of the indirect PE allocators. Comment: Many commenters supported the proposal to use clinical labor costs as an indirect allocator when either the clinical labor RVU exceeds the work RVU or when the service does not contain physician work. Two commenters disagreed with the use of clinical labor costs in allocating indirect PE and stated that this is a ‘‘fudge factor’’ that inappropriately allocates costs to services with very low or no physician work. Response: Because work RVUs reflect the time required to perform the service PO 00000 Frm 00018 Fmt 4701 Sfmt 4700 in addition to the intensity of the physician work involved, services with low or no work RVUs could be valued inappropriately unless we use a proxy for the work RVUs in allocating indirect PE to them. To bring these services onto the same scale as services that do contain physician work, we believe it is appropriate to utilize clinical labor costs as a proxy for physician work in the indirect allocation. We agree with the majority of commenters and will finalize our proposal to use clinical labor costs in allocating indirect PE where the physician work RVU is zero or less than the clinical labor RVU. Comment: Several commenters recommended that the methodology be modified to include clinical labor time in the calculation of specialty-specific aggregate indirect PE pools. Response: We do not agree with the commenters because the PE/HR for each specialty is calculated using physician time as the denominator; clinical staff time is not included in that calculation. It would be inconsistent to then use clinical labor time in the creation of the specialty-specific indirect PE pools. Comment: Many commenters recommend the use of unscaled direct inputs in the allocation of the indirect PE. Response: It would be inconsistent to base the direct PE RVUs on budget neutral scaled direct inputs, and then use unscaled direct inputs that are not budget neutral in creation of the indirect PE RVUs. We also disagree with the commenters’ suggestion that we should use unscaled inputs for the direct PE RVUs. Direct costs represent, on average, approximately one-third of PEs based on the SMS survey data. E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations Therefore, we believe it is appropriate to scale the direct inputs so that approximately one-third of the aggregate PE RVUs are for direct PEs. Comment: Several commenters contended that the approach of basing PE calculations on the weighted average of all specialties performing a service is flawed and should be replaced with an approach that bases the specialtyweighted factors upon specialties that represent 95 percent of the utilization for a CPT code and modifier. A commenter stated that utilizing the service counts associated with lower cost specialties, such as optometry, that would perform only the postoperative portion of a service, as opposed to the full service, inappropriately deflates the total PEs of a service when the practice costs of these specialties are weight averaged. Response: With regards to the general question of including all specialties performing a service in the weightaveraging of the practice costs of the service, this is an issue that has been raised since we first proposed a resource-based PE methodology. We still believe, as we have previously stated, that the inclusion of specialties that perform a very small proportion of a service has no discernible impact on the PE calculation. We agree that it would be inappropriate to assign full service counts to a specialty that only performs the postoperative work of a given surgical procedure. For this reason, we have always adjusted the per specialty utilization for a service using the appropriate payment modifier (modifier -55) before the service is used to weight the practice costs of the various specialties performing a given service. For example, if a specialty performs 100,000 postoperative-only services for a specific procedure (that is, uses modifier -55), those services would be counted based upon the code-specific postoperative percentage multiplied by the 100,000 services. If the postoperative percentage was 10 percent, the specialty performing 100,000 postoperative-only services will be weighted with only 10,000 services. Therefore, we do not believe that any further adjustments are needed. Comment: One commenter recommended that the indirect PE allocation be distributed from the global services to the professional and technical services based upon the share of billings for each service. Response: Although we are unsure of what, exactly, the commenter is suggesting, it is not clear to us how this recommendation could result in an appropriate resource-based PE RVU (for VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 example, if the majority of services furnished were for the PC of a procedure, we believe the commenter is suggesting that it would then be necessary for the PC to have a higher PE RVU then the TC). Therefore, we will retain our current methodology for the allocation of indirect PE for services with TC and PCs, but we welcome further clarification regarding this suggestion. (5) Transition Period Comment: The majority of commenters expressed support for the proposal to transition the PE methodology changes over a 4-year period. One commenter recommended that if the work RVU changes associated with the 5-Year Review are not transitioned, then the PE RVUs should also not be transitioned. Response: We are concerned that, when combined with the negative update adjustment factor (UAF) for CY 2007 and the impact of changes to the work RVUs under the 5-Year Review, the shifts associated with the PE methodology changes could potentially cause some disruption for medical practices. For this reason, we will finalize the proposed 4-year transition to the PE methodology. Comment: One comment supported the use of supplemental survey data, but requested that this supplemental survey data be implemented with no transition, since this data was originally accepted 1–2 years ago. Response: The supplemental survey data is not independently transitioned in the proposed PE methodology. Rather, the RVUs resulting from all the changes to the methodology, which are to some degree interdependent, would be transitioned over 4 years. It would be very difficult to isolate one aspect of our proposed methodology and exempt it from the transition. In addition, we are concerned that such an approach could lead to inequities whereby, for a given specialty, a PE methodology change that has a positive impact would be transitioned over 4 years, while a change with a negative impact would not. For these reasons, we will finalize the 4-year transition as proposed. (6) Other Comments on the PE Methodology Comment: Several commenters requested that one budget neutrality factor (BNF) be applied for PE as opposed to applying a direct adjuster, an indirect adjuster, and a final BN adjustment. Response: The separate adjusters for the direct and indirect pools of RVUs are not pure BN adjustments but are PO 00000 Frm 00019 Fmt 4701 Sfmt 4700 69641 more appropriately viewed as scaling factors. The purpose of the separate direct and indirect adjustments is to scale the pool of direct input RVUs and the pool of indirect RVUs to the direct and indirect RVUs that are available, as determined by the total direct and indirect dollars from the SMS and supplemental surveys. For this reason, the adjustments should be viewed as direct and indirect scaling factors, as opposed to BN adjustments. If we only applied one BN/scaling factor to the final PE RVUs, there would not be the appropriate balance between the direct and indirect PE RVUs and services with more direct RVUs would be paying for those services with less direct RVUs, since the indirect scaler is greater then the direct scaler. Since the direct and indirect RVU pools are scaled and made ‘‘budget neutral’’ in these initial steps, the final BN adjustment is very small. The only reason the final adjustment is needed is because the RVUs associated with specialties that are not used in the rate setting process need to be incorporated back into the system. This introduction of additional RVUs causes a very small adjustment in the final step. For these reasons, we will finalize the proposal to utilize three separate adjustments in the calculation of resource-based PE RVUs. Comment: Several commenters applauded our proposals relating to the PE methodology for being more intuitive and transparent, but requested that we go one step further toward pure transparency by publishing the PE/HR figures and the specialty indirect practice cost indices. Response: We appreciate the support for the intuitive and transparent nature of the revised methodology. Following our original intention of making this methodology resource-based, intuitive, and transparent, we will publish both the PE/HR figures and the indirect practice cost indices on the homepage of the CMS Web site. Comment: A few commenters requested that either their services be ‘‘frozen’’ at the current 2006 PE RVUs or that a floor be placed on the percent reduction associated with any given service due to the revised methodology. Response: We do not believe it would be equitable to maintain current values for certain codes or to place a floor on the percentage reduction associated with a given service in a resource-based system. However, in order to minimize any potential disruptive effects that could be caused by sudden shifts in RVUs, we will be finalizing our proposal to transition to the bottom-up methodology over a 4-year period. This transition period will allow interested E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 69642 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations parties an opportunity to review the data elements associated with their services. For these reasons, we will not institute a floor on the reduction in PE RVUs for a service, nor will we freeze any services at their CY 2006 PE RVUs. Comment: Several commenters have requested that, for purposes of calculating resource-based PE RVUs, certain services should be assigned to specialties with higher PEs then those that are reported in the Medicare claims data. Response: Unless there is evidence that the Medicare claims data is incorrect, or that there is something unique about the services in question, we do not believe it would be appropriate to override our existing utilization data. The Medicare claims data identifies what specialties are furnishing what services and this is an essential component in the development of our resource-based system. If interested specialties contend that persons within their specialty are reporting their specialty designation incorrectly, we urge those specialties to work with their respective organizations to educate their membership about the importance of correct reporting of their specialty designation when billing Medicare. Comment: Several commenters contended that the independent diagnostic testing facility (IDTF) survey data does not reflect the costs of cardiac event monitoring services, because issues such as hours of operation, intense staffing needs and equipment usage are not taken into account. Response: We agree with the commenters that cardiac event monitoring services are unique and are not appropriately represented by the IDTF survey data. For this reason, we will use the PE data associated with cardiology to value these services. Additionally, as discussed in more detail in the section on direct cost inputs (section II.A.4.f. of this final rule with comment period), we are revising the direct inputs for these services to reflect that the PEs are not limited to direct patient encounters. Comment: Some commenters recommended that we review the crosswalk used for both interventional pain management and pain medicine in the CY 2007 PFS proposed rule. The commenters suggested that the appropriate crosswalk for these specialties is the ‘‘all physician’’ PE/HR. Response: We agree with this comment and will crosswalk both interventional pain management and pain medicine to the ‘‘all physician’’ PE/HR. VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 Comment: Several commenters supported the use of revised 2005 utilization data. A few commenters expressed concerns that the use of this revised single year data might cause problems with the stability of the PE RVUs and requested that we delay using this data until the impact on the stability of PE RVUs can be determined. Response: We will finalize our proposal to incorporate the most current Medicare utilization data into the calculation of resource-based PE RVUs. We have always attempted to use the most current data available in ratesetting. Although we understand the concerns conveyed by the few comments that requested a delay in the use of the 2005 utilization data, we do not believe that the use of this data will destabilize the PE RVUs to the extent that a delay would be warranted. Comment: Some commenters contended that we are in violation of the MMA when reducing the PE RVUs of drug administration services by adopting a new methodology. The commenters stated that, because the oncology supplemental survey is not being used for the same purpose as it was when MMA directed us to use the survey, all drug administration services must be exempt from any impact associated with the revised PE methodology. Response: We disagree with this comment. Although the MMA was enacted prior to these changes in our PE methodology, the MMA did not prescribe the use of any particular resource-based PE RVU methodology or constrain our rulemaking authority. The MMA directed us to use the oncology survey data in determining PE RVUs. We have, in fact, used the survey data (in exactly the way the Congress envisioned when it passed MMA) to establish PE RVUs for services furnished during CYs 2004, 2005 and 2006. In addition, under the revised PE methodology, we are utilizing the survey data in the calculation of the indirect PE RVUs. Thus, we do not believe that the use of the survey data within our revised methodology violates the provisions of MMA. Comment: Several commenters contended that the proposed indirect practice costs may not be appropriate for cardiology practices that operate free-standing cardiac catheterization labs. The commenters further stated that the nonfacility technical billings for cardiac catheterization are dominated by IDTFs, but the IDTF supplemental survey data was primarily based on imaging centers. The commenters recommended that the cardiac PO 00000 Frm 00020 Fmt 4701 Sfmt 4700 catheterization services be based solely upon the PE data for cardiology. Response: We agree with these comments. We currently do not have direct cost input data for the nonfacility setting for these services. Until we are able to obtain such data, we will carrierprice the cardiac catheterization codes. We urge interested parties to continue to work with the RUC to develop direct cost inputs for these services in the future. Comment: One commenter recommended that we reinstate the clinical labor costs associated with physicians bringing their own staff to the hospital and contended that not counting these costs is in violation of the statute. Response: We have indicated that we will not pay for clinical staff brought by physicians to the hospital for the following reasons: (1) These costs are already paid to the hospital and would thus be a double payment; (2) we already pay for physician extender staff through the physician work RVUs; and (3) we pay physician assistants (PAs) directly when they serve as assistants at surgery. In response to this decision, the thoracic surgeons contended that hospitals are no longer providing the staff to furnish adequate care. We asked the Office of Inspector General (OIG) to conduct an independent assessment of the staffing arrangements between hospitals and thoracic surgeons. In response to our request, in an April 2002 report, the OIG clearly supported our position to exclude the costs of clinical staff brought to the hospital from the PE calculations. For these reasons we will continue to exclude the clinical labor costs associated with physicians bringing their own staff to the hospital from the calculation of resource-based PE RVUs. Comment: One commenter recommended that the practice costs associated with the handling of pharmaceuticals should be incorporated into the cost categories associated with the calculation of resource-based PE RVUs. Response: The commenter did not offer any recommended inputs or strategies on how to incorporate these costs into the methodology. For this reason we will not incorporate any additional costs related to the handling of pharmaceuticals into the methodology at this time. Comment: One commenter recommended that administrative staff time should be counted as a direct cost. Response: Administrative staff time was included in the original CPEP data as direct PE. However, because of the difficulty in accurately assigning the E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations administrative time to individual procedures, we then converted this expense to an indirect cost. We agree that, in principle, it could be helpful to treat as many of the practice costs as possible as direct, rather than indirect PE, and we would be willing to consider such recommendations if the PERC or RUC would agree to undertake the task of assigning administrative staff times to each code. Comment: One commenter recommended that special resource considerations for screening services should be factored into the calculation of the PE RVUs. Response: We have attempted to account for all resource cost in the calculation of the PE RVUS for all services. Unfortunately, the commenter did not supply any documentation regarding additional resources that the commenter believes should be included for screening services. Therefore, we will not add additional resources as requested at this time. Comment: Many specialty societies expressed concern that the Medicare database currently does not permit the collection of nurse practitioner (NP) specialty-specific data. The commenters contended that this limitation unfairly excludes NPs from participating in certain demonstration projects and other programs. The commenters also state that they are ready to work with us on this and any related issues. Response: It is not clear from the comment exactly what specialty-specific data is at issue. However, we would certainly be willing to work with the commenters to address their concerns. 4. Additional PE Issues for CY 2007 rmajette on PROD1PC67 with RULES2 a. RUC Recommendations for Direct PE Inputs and Other PE Input Issues In the CY 2007 PFS proposed rule (71 FR 48982), we proposed the following concerning direct PE inputs. (i) RUC PE Recommendations The AMA’s Relative Value Update Committee (RUC) established a new subcommittee, the Practice Expense Review Committee (PERC), to assist the RUC in recommending direct PE inputs (clinical staff, supplies, and equipment) for new and existing CPT codes. The RUC reviews and gives final approval for all PERC recommendations. The PERC reviewed the PE inputs for over 2000 existing codes, some of which were unresolved PE issues from the CY 2006 PFS final rule with comment period, at their meetings held in September 2005, February 2006 and April 2006. We reviewed the PERC recommendations that were forwarded VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 by the RUC and proposed to adopt all of them. We have worked with the AMA staff to correct any typographical errors and to ensure that previously PEACaccepted standards are incorporated in the recommendations. The complete PERC recommendations and the revised PE database can be found on our Web site. (See the SUPPLEMENTARY INFORMATION section of this final rule with comment period for directions on accessing our Web site.) Comment: We received comments from many of the specialty societies thanking us for our acceptance of the PERC recommendations. Response: We thank the specialty societies for their positive remarks and we look forward to our continuing relationship with the PERC and the societies. (ii) Standard Supplies and Equipment for 90-Day Global Codes In our proposed rule of August 22, 2006, we proposed to revise the CPEP supply and equipment inputs for those 90-day global procedures for which the RUC had only refined the clinical labor direct PE inputs. We proposed to apply the standard supply and equipment inputs for the facility setting for 90-day global services to these remaining unrefined 90-day global procedure codes. As recommended by the PERC at its April 2006 meeting, for supplies, we proposed to include one minimum supply visit package for each postoperative visit assigned to each code and a postsurgical incision care kit (suture, staple, or both) where appropriate, along with additional items reviewed and recommended by the PERC for certain procedures. For equipment, we proposed to include an exam table and light as the standard equipment, as well as other equipment items recommended by the PERC that were identified by the specialty societies as necessary during the postoperative visit period. However, there are several issues on which we requested input from the PERC or the specialty before we finalized the recommended standards. For example, for many of the 90-day codes in question, the current supply input data contain supplies in far larger quantities than are contained in either the visit package or incision care kit. For other codes, the current data include items that are not contained in the package or kit. In other cases, the PERC recommendations contain additional items in quantities that appear excessive. We plan to work with all the concerned specialties to ensure that the finalized inputs do represent the typical PO 00000 Frm 00021 Fmt 4701 Sfmt 4700 69643 supplies needed to perform each procedure. Because the application of the 90-day global standard supplies and equipment would result in the deletion of some original CPEP inputs, we requested that all the medical specialties examine the direct PE inputs on our Web site and inform us if there are additional items from the original CPEP data that are a necessary part of the postoperative care and if the PERC-recommended PE inputs were listed correctly. Comment: Several commenters expressed concern regarding the accuracy of our PE database for the specialty-specific PERC recommendations and the application of the standard supplies and equipment that we proposed to include in the 90day global codes. One commenter representing urologists noted that several supply items approved by the PERC were missing in the PE database and provided us with specific supply inputs for CPT codes 57310, 57311, 57320, and 57330. Another commenter representing prosthetic urologists recommended that the standard supplies used for infection control or patient comfort be included for each postoperative visit, such as gloves for the physician and clinical staff, table paper, patient drapes and gowns, and also questioned the accuracy of the number of ‘‘multi-specialty visit package’’ (MSVP) associated with their services. They believe that their services entail more postoperative visits than the current number of MSVPs reflected in the PE database. A society representing gynecologic oncologists also recommended that the standard supplies for their procedures should be modified to include additional supplies that are associated with their procedures, such as a pelvic exam kit and a patient drape. Lastly, a medical society representing ophthalmologists urged us to incorporate the PERCrecommended supply and equipment direct inputs for the 90-day global ophthalmologic codes. Response: We thank the urology specialty for reviewing the PE database and providing us with the specific supply items missing from their four CPT codes. These PERC-approved supplies have been added as requested. We have addressed the prosthetic urologists’ concerns regarding the inclusion of supplies for infection control and patient comfort by ensuring that one MSVP was included in the PE database for each postoperative visit for these services. The MSVP contains, among other things, 2 pairs of gloves, table paper, and a patient gown. We also note that the inclusion of a patient E:\FR\FM\01DER2.SGM 01DER2 69644 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations rmajette on PROD1PC67 with RULES2 drape is a standard for the codes identified by the specialty for gynecology and obstetrics. To the extent that prosthetic urologists believe a patient drape is needed in their 90-day global codes, we encourage them to work through the RUC process to correct possible discrepancies. In regard to the request for additional MSVPs for each procedure performed by the urologic prosthetists, we believe the commenter is mistaken, as there is one MSVP for each of the RUC-recommended postoperative visits entered in the PE database. With respect to the comments about the absence of specific supplies in gynecologic oncology procedures, we would note that the 90-day CPT codes identified by the specialty for gynecology and obstetrics all contain these specific items as part of the standard packages, as approved by the RUC and accepted by CMS. We would again suggest that the commenter work through the RUC process to assure that the necessary inputs are included in these services. In response to the request from the society representing ophthalmologists to implement the PERC-recommended supply and equipment changes for ophthalmology services, we have already incorporated these changes into the PE database and they are reflected in the PE RVUs. However, we would note that further equipment adjustments were not made for the ophthalmology CPT codes, as the PERC recommendations did not include any changes to the current equipment or ophthalmology lane assignments. b. Payment for Splint and Cast Supplies In the CY 2000 and CY 2001 PFS final rules (64 FR 59380 and 65 FR 65376, respectively), we removed splint and cast supplies from the PE database for the CPT codes for fracture management and cast/strapping application procedures. Because splint and cast supplies could be separately billed using Healthcare Common Procedure Coding System (HCPCS) codes (Q4001 through Q4051) that were established for payment of these supplies under section 1861(s)(5) of the Act, we did not want to make duplicate payment under the PFS for these items. In the CY 2006 PFS proposed rule (70 FR 45764), we proposed to reinstate payment for all splints and cast supplies through the PE component of the PFS because we believed we may have unintentionally prohibited remuneration for these supplies when they are not used for reduction of a fracture or dislocation (covered under section 1861(s)(5) of the Act), but rather are provided (and covered) as ‘‘incident to’’ a physician’s service under section VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 1861(s)(2)(A) of the Act. This proposal was not finalized; however, in our CY 2006 final rule with comment period (70 FR 70116) we asked the medical specialties and the PERC to determine the typical supplies for splints and casts necessary for each of the fracture management codes and the cast/ strapping application codes because we wanted to make certain that the supply inputs were correct before we proceeded with rulemaking for the CY 2007 PFS. At its February 2006 meeting, the PERC reviewed and approved the supply inputs submitted by the American Academy of Orthopaedic Surgeons (AAOS) for each CPT code for fracture management and cast/strapping application and these were forwarded to us as PERC recommendations. During this interim period we also reassessed the options for payment of materials for splints and casts. We believe that the majority of the splint and cast supplies that are currently paid through the Q-codes are furnished in relationship to cast/ strapping procedures for the management of fractures and dislocations. However, we did not intend for the medically necessary splint and cast supplies used for other reasons (for example, serial casting, wound care, or protection) not to be paid. Because it may be difficult for the contractors to identify the purpose for the cast/strapping application procedure on a claim form, we believe that contractors may have been paying for the splint and cast supply Q-codes when the service is performed for other purposes than treatment of fractures and dislocations. Since these splint and cast supplies can be covered under both sections 1861(s)(5) and 1861(s)(2)(A) of the Act, we proposed to include payment for both statutory benefits using the separate HCPCS Q-codes. This would allow for payment for these medically necessary supplies whether based on sections 1861(s)(5) or 1861(s)(2)(A) of the Act, while ensuring that no duplicate payments are made. Physicians will continue to bill the HCPCS Q-codes, in addition to the cast/ strapping application procedure codes, to be paid for these materials. The following supplies will continue to be paid separately using the HCPCS Q-codes and would not be included in the PE database: • Fiberglass roll. • Cast padding. • Cast shoe. • Stockingnet/stockinette. • Plaster bandage. • Denver splint. • Dome paste bandage. PO 00000 Frm 00022 Fmt 4701 Sfmt 4700 • Cast sole. • Elastoplast roll. • Fiberglass splint. • Ace wrap. • Kerlix. • Webril. • Malleable arch bars and elastics. The splint and cast supplies will not be included in the PEs for the following CPT codes: • 24500 through 24685. • 25500 through 25695. • 26600 through 26785. • 27500 through 27566. • 27750 through 27848. • 28400 through 28675. • 29000 through 29750. We specifically requested input, from medical specialties and contractors on our proposal. Comment: Commenters offered their appreciation and support of our proposal to pay for medically necessary splint and cast supplies using HCPCS Q-codes for both statutory benefits, that is, sections 1861(s)(5) and 1861(s)(2)(A) of the Act. However, one commenter requested that we clarify ‘‘whether this separation applied to the rehabilitation non-physician service codes.’’ In addition, a few commenters noted that the supplies for the Unna-boot have been excluded from payment under the Q-codes, because they are assigned HCPCS A-codes, and asked that we clarify if the Unna-boot supplies will now be included in the Q-codes. One commenter suggested that we omit the cast shoe from the list of supplies that are covered under either benefit. Another commenter asked us to temporarily include the A-HCPCS codes, A–6441 though A–6457, as billable HCPCS codes in conjunction with the strapping and casting CPT procedures codes. Response: We will proceed with our proposal to pay for the splint and cast supplies using the existing HCPCS Qcodes for all medically necessary splints and casts, as appropriate. While we appreciate the comments received, we have questions about and do not understand the request concerning whether this applied to the ‘‘rehabilitation nonphysician service codes.’’ We apologize that our listing of the applicable CPT code ranges in the proposal caused confusion about whether the Unna-boot supplies that currently are identified with HCPCS Acodes would change and be paid using the Q-codes. For clarification purposes, we would like to note that our proposal does not change the existing Q-code descriptors or their pairing with certain CPT codes for payment purposes. For CPT code 29580, (Strapping; Unna boot) physicians and other qualified providers E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations rmajette on PROD1PC67 with RULES2 will continue to use the A-codes designed for the Unna-boot supplies. We appreciate the comments from the commenter asking us to remove the cast shoe from the PE database since shoes are statutorily noncovered items, except for certain diabetic shoes and those that are attached to braces. The cast shoe was erroneously identified as a supply item separately paid using the Q-codes in the listing in our proposed rule. We now realize that the listing in the proposed rule, in reality, merely identifies the supply inputs to be removed from the PE database rather than those that are separately billable. We agree with the commenter, and will remove the cast shoe item from our PE database (27 codes). While we appreciate a commenter’s request to include certain A-codes as separately billable under our proposal, these items were never included in the PE database and it would not be appropriate to include them in the existing Q-codes. c. Medical Nutrition Therapy Services In 2000, the Health Care Professional Advisory Committee (HCPAC) recommended that we assign work RVUs to three new medical nutrition therapy (MNT) CPT codes: 97802, Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes at 0.45 RVUs; 97803, Medical nutrition therapy; reassessment and intervention, individual, face-to-face with the patient, each 15 minutes at 0.37 RVUs; and 97804, Medical nutrition therapy; group (two or more individuals), each 30 minutes at 0.25 RVUs. However, during rulemaking for the CY 2001 PFS final rule, we indicated that MNT was not covered because there was no statutory benefit category that would allow medical nutritionists to bill these services. We also did not accept the HCPAC recommendations for work RVUs for these MNT services because the codes were designed for use only by nonphysicians. The following year, section 105(c) of the Medicare, Medicaid, and State Child Health Insurance Program Benefits Improvement Protection Act of 2000 (BIPA) (Pub. L. 106–554) provided for the coverage of MNT services when furnished by registered dietitians or nutritional professionals at 85 percent of the amount that a physician would be paid for the same services. As a result, we established values for these MNT services for the CY 2002 PFS. In keeping with our earlier decision, we did not assign the HCPAC-recommended work values. However, the associated work value for each code was utilized in the VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 conversion of work to clinical labor time for MNTs as part of the PE component. At that time we received several comments, including one from the American Dietetic Association (ADA), urging us to adopt the work values recommended by the HCPAC. More recently, the ADA has requested us to reconsider our decision not to accept the HCPAC recommended work RVUs. The ADA contends that the payment rate established by section 105(c) of BIPA, 85 percent of the PFS amount that would be paid for the same service if furnished by a physician, is based on the premise that work values are inherent to these MNT services. The ADA believes that without work RVUs, the payment for these services does not reflect 85 percent of what a physician would be paid for performing the same service. Because these MNT codes were created specifically for MNT professionals, the ADA compared the work associated with their services to physician E/M services of CPT codes 99203 and 99213, which have respective work RVUs of 1.34 and 0.67. After reviewing the issues and relevant arguments raised by the ADA, we are persuaded that it would be appropriate to include work RVUs for the MNT services. Consequently, we proposed to establish work RVUs for each code at the level previously recommended by the HCPAC, as follows: • CPT code 97802 = 0.45 RVUs. • CPT code 97803 = 0.37 RVUs. • CPT code 97804 = 0.25 RVUs. Because we proposed to add the work RVUs to these services, the MNT clinical labor time in the direct input database will be removed. Additionally, two HCPCS codes, G0270, MNT subs tx for change dx and G0271, Group MNT 2 or more 30 mins were created to track MNT services following the second referral in the same year and these HCPCS codes correspond to CPT codes 97803 and 97804, respectively. Therefore, we also proposed to add the same work RVUs to these HCPCS codes and to delete the MNT clinical labor inputs from the PE database upon adoption of this policy. We encouraged specialty societies and other professional groups to comment on this proposal. Comment: We received comments from the ADA, several MNT providers, one drug company, the National Kidney Foundation and one Congressional member all supporting our decision to establish work RVUs for the MNT services. Further, several commenters joined the ADA in requesting an increase in the proposed work RVUs. In justification of their request, the ADA PO 00000 Frm 00023 Fmt 4701 Sfmt 4700 69645 and other commenters compared these services to CPT codes 99213 (mid-level E/M service) and 90804 (individual psychotherapy service). These commenters also requested that the total work RVUs for 97802, 97803, and G0270 be equal and the total work RVUs for CPT code 97804 and HCPCS code G0271 also be equal. In addition, the ADA provided specific supplies and equipment to be added to the PE database in order to facilitate correct PE calculations for these codes. Response: We appreciate that the commenters acknowledge and support our decision to establish work RVUs for the 5 MNT services. However, we do not believe it would be appropriate to accommodate the request to increase these work RVUs. We believe that the HCPAC work recommendations best represent the MNT services and encourage the ADA to utilize the established RUC or HCPAC processes to further assess valuation of their services. For this reason, we will maintain the proposed work values for all MNT CPT/ HCPCS codes. However, we have added the supplies and equipment to the PE database as requested. d. Surgical Pathology Codes The College of American Pathologists commented on the equipment times assigned to CPT codes 88304 and 88305 in the basic surgical pathology family of codes. While all six codes in this family have been refined by the PEAC, this refinement occurred at four separate PEAC meetings. CPT codes 88304 and 88305 were refined at the first PEAC meeting in April 1999 before time standards were established for the equipment at subsequent PEAC meetings when the other four CPT codes 88300, 88302, 88307, and 88309 were reviewed. Using our proposed bottomup PE methodology to value these codes, the lack of the equipment time standards for CPT codes 88304 and 88305 create a rank-order anomaly in this family. Consequently, the College of American Pathologists, after reviewing and applying current standards for the equipment times, submitted suggested revised equipment times to us. We proposed to accept these times and the times will be reflected in the PE database on our Web site (See the SUPPLEMENTARY INFORMATION section of this final rule with comment period for directions on accessing our Web site.) Comment: The College of American Pathologists expressed appreciation for these revisions to the equipment time to the surgical pathology CPT codes. Response: We appreciate the College of American Pathologists’s review of the PE direct inputs, which led to our E:\FR\FM\01DER2.SGM 01DER2 69646 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations proposal. We are finalizing our proposal for these changes in the equipment times in the PE database. e. PE Issues from Rulemaking for CY 2006 In the CY 2006 PFS final rule with comment period (70 FR 70116), we explained that we were not implementing the PERC or other proposed PE changes for CY 2006 due to issues with the PE methodology. In the CY 2007 PFS proposed rule, we proposed that the PERC and other PE changes originally proposed for CY 2006 would be implemented and effective with the CY 2007 PFS (71 FR 48987). The following subsections, (i) through (x), summarize the PE proposals from the CY 2006 PFS final rule with comment period. (i) PE Recommendations on CPEP Inputs for CY 2006 We proposed to use a clinical labor time of 167 minutes for the service period for CPT code 36522, Extracorporeal Photopheresis; maintain the nonfacility setting PE RVUs for CPT code 78350, single photon bone densitometry; and remove the PE inputs for the nonfacility setting for CPT codes 76975, GI endoscopic ultrasound, and 15852, Dressing change not for burn. (70 FR 70136 through 70137) (ii) Supply Items for CPT Code 95015 (Which is Used for Intradermal Allergy Tests with Drugs, Biologicals, or Venoms) We proposed to implement the allergy and immunology specialty’s recommendation to change the test substance in CPT code 95015 to venom, at $10.70 (from single antigen, at $5.18) and the quantity to 0.3 ml (from 0.1 ml) (70 FR 70138). rmajette on PROD1PC67 with RULES2 (iii) Flow Cytometry Services Based on information from the society representing independent laboratories, we proposed to implement the following direct PE inputs: • Clinical Labor: We proposed to change the staff type in the service (intra) period in both CPT codes 88184 and 88185 to cytotechnologist, at $0.45 per minute (currently lab technician, at $0.33 per minute). • Supplies: We proposed to change the antibody cost for both CPT codes 88184 and 88185 to $8.50 (from $3.544). • Equipment: We proposed to add the following equipment to CPT code 88184: • Computer. • Printer. • Slide strainer. • Biohazard hood. • Wash assistant. VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 • FAC loader. We proposed to add a computer and printer to the equipment for CPT code 88185 (70 FR 70138). (iv) Low Osmolar Contrast Media (LOCM) and High Osmolar Contrast Media (HOCM) Because separate payment is available for both types of contrast media, we proposed to delete LOCM and HOCM from the PE database in this final rule with comment period (70 FR 70138). Comment: Several specialty organizations expressed their appreciation for implementing the recommendations for the PE changes in section (i) of this section to CPT codes 36522, 78350, 76975 and 15852; in section (ii) of this section for changing the amount and test substance inputs in CPT 95015; in section (iii) of this section for implementing the PE changes to the flow cytometry CPT codes 88184 and 88185; and in section (iv) of this section for removing the LOCM and HOCM from the PE database because they are separately reimbursed. Response: We will implement these changes for CY 2007. (v) Imaging Rooms We proposed to implement the updates for the contents and prices of 5 ‘‘rooms’’ used in imaging procedures including— • Basic radiology room; • Radiographic-fluoroscopic room; • Mammography room; • Computed tomography (CT) room; and • Magnetic resonance imaging (MRI) room (70 FR 70139). Comment: Two commenters questioned why the contents and prices for ultrasound ‘‘rooms’’ were not being updated in CY 2007 proposed rule. Response: The imaging rooms proposals that appeared in this year’s proposed rule were deferred from the previous year. These imaging rooms all contained equipment without updated pricing information. The two ultrasound rooms, general and vascular, were valued during the repricing of the equipment for the PE database that occurred during rulemaking for CY 2005. (vi) Equipment Pricing for Select Services and Procedures We proposed to accept the following equipment pricing information provided by various specialty societies for select services and procedures as discussed in the CY 2006 PFS final rule with comment period (70 FR 70139). • Equipment pricing for certain radiology services received from the PO 00000 Frm 00024 Fmt 4701 Sfmt 4700 ACR as presented in Table 15 of the CY 2006 PFS proposed rule. • Equipment pricing on the ultrasound color doppler transducers and vaginal probe received from the American College of Obstetrics and Gynecology (ACOG). • Equipment pricing for CPT code 36522, extracorporeal photopheresis. • Pricing of the EMG botox machine used in CPT code 92265 as presented by the American Academy of Ophthalmology (AAO). (vii) Supply Item for In Situ Hybridization Codes (CPT Codes 88365, 88367, and 88368) We proposed to implement the Society for Clinical Pathologists’ request to change the probe quantity to 1.5 for CPT code 88367, In situ hybridization, auto, which is equal to the quantity in the other two codes in the family. (viii) Supply Item for Percutaneous Vertebroplasty Procedures (CPT codes 22520 and 22525) Based on documentation provided by the Society for Interventional Radiology, we proposed to implement a new price of $696.00 for the vertebroplasty kit, to replace a temporary price of $660.50 that was a placeholder price from the CY 2006 PFS final rule with comment period (70 FR 70139). (ix) Clinical Labor for G-Codes Related to Home Health and Hospice Physician Supervision, Certification and Recertification We proposed to apply the refinements made to the PE inputs to CPT codes 99375 and 99378 for home health and hospice supervision to four G-codes that are related to home health and hospice physician supervision, certification and recertification, G0179, GO180, GO181, and GO182. These G-codes are incorrectly valued for clinical labor. These G-codes are crosswalked from CPT codes 99375 and 99378, which underwent PEAC refinement in January 2003 for the CY 2004 PFS. However, at that time we inadvertently did not apply the new refinements to these specific Gcodes (70 FR 70139 through 70140). (x) Programmers for Implantable Neurostimulators and Intrathecal Drug Infusion Pumps Although we had initially proposed in the CY 2006 PFS proposed rule to remove two programmers from the PE database (EQ208 for medication pump from two codes (CPT codes 62367 and 62368) and EQ209 for the neurostimulator from 8 codes (CPT codes 95970 through 97979)), based on comments received as discussed in the E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations CY 2006 PFS final rule with comment period (70 FR 70140), we determined that we will retain these programmers in the database. In addition, we added ‘‘with printer’’ to the description of EQ208, based on comments received. We proposed to implement these decisions for CY 2007. Comment: Commenters expressed appreciation for the implementation of these changes that had been deferred from the previous year. Response: We will implement the PE changes noted in sections (vi) through (x) of this section for CY 2007. f. Other PE Issues for CY 2007 (i) Clarification With Respect to NonFacility PE RVUs In the CY 2006 PFS final rule with comment period (70 FR 70335), we provided a clarification in Addendum A concerning use of ‘‘NA’’ in the PE RVU columns for Addendum B. Commenters requested that further clarification be made concerning the payment amount for procedures performed in the nonfacility setting if there is an ‘‘NA’’ in the non-facility PE RVU column. In the CY 2007 PFS proposed rule, we clarified that our policy is that the service will be paid at the facility PE RVU rate if the Medicare carrier pays for the service in the non-facility setting. In the CY 2007 PFS proposed rule (71 FR 48982), we proposed revisions to Addendum A to include this clarification. Comment: Commenters expressed appreciation for this clarification. Response: We have modified Addendum A to include this clarification. rmajette on PROD1PC67 with RULES2 (ii) Supply for CPT Code 50384, Removal (Via Snare/Capture) of Internally Dwelling Ureteral Stent Via Percutaneous Approach, Including Radiological Supervision and Interpretation Upon review of the RUCrecommended direct PE inputs for CPT code 50384, a new procedure for the 2006 CPT codes, we identified the inappropriate inclusion of a ureteral stent that we proposed to delete for CY 2007. We believe that the addition of the ureteral stent, valued by the specialty at $162, to CPT code 50384, which is the procedure for the removal of a stent, was an inadvertent error by the specialty during the April 2005 RUC meeting. Comment: The commenters agreed with the deletion of the ureteral stent from this service. Response: This stent will be removed from CPT code 50384 in the PE database. VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 (iii) Cardiac Monitoring Services We requested more specific PE information on remote cardiac event monitoring services in the CY 2007 PFS proposed rule as a result of a comment and response discussion in last year’s final rule related to these services and an inappropriate fit with the direct PE model used for typical physicians’ services. These services are overwhelmingly performed by specialized IDTFs that are paid under the PFS, but frequently maintain more extensive operating hours than the typical physician office due to the characteristics of cardiac monitoring services. Specifically, we requested data to indicate the typical number and type of transmissions or other encounters per day between the beneficiary and the IDTF for each of the remote monitoring services. We also requested the number and type of clinical staff, as well as the corresponding times, that are necessary to ensure that appropriate services are available for each patient. Additionally, we requested assistance in identifying any other direct PE inputs for typical supplies and equipment relating to these services, and any data that would reflect indirect PE, such as overhead and non-clinical payroll expenses. Because we believe that the following codes, predominately performed by specialized IDTFs, represent atypical PE scenarios, we requested PE information for these services: • Cardiac event monitoring (CPT codes 93271, 93012 and 93270). • Pacemaker monitoring (CPT codes 93733 and 93736). • Holter monitoring (CPT codes 93232, 93226, 93231 and 93225). • INR monitoring (HCPCS codes G0248 and G0249). Comment: Several commenters voiced concern about the dramatic decrease in the PE RVUs for these services and most agreed that the remote cardiac monitoring services do not fit the PE model for physicians’ services and believed that the information that we requested could be useful to value these technical services. One commenter submitted the requested information after conducting a survey of 7 large IDTFs specializing in these remote cardiac monitoring services. For each of the 11 CPT/HCPCS codes referenced above in this section, the commenter provided recommendations for the direct PE inputs, including the type of clinical labor and the related minutes for their service, the needed disposable supplies and the equipment costs, the number of minutes in use, and the respective life of each piece of equipment. In addition, two PO 00000 Frm 00025 Fmt 4701 Sfmt 4700 69647 commenters suggested that CPT code 92326 (remote, real-time, wireless cardiac monitoring) be added to the above list of services: Response: We appreciate that the provider group conducted such a detailed survey to capture the costs of these services. We have reviewed the direct inputs that were forwarded by the commenter and have accepted many of their recommendations, some with modifications, for all these codes. For example, we used the ‘‘discounted’’ purchase prices for the equipment which is our standard policy rather than the additional list prices that were also included. The specific direct inputs for the following CPT/HCPCS codes: 93012, 93271, 93270, 93733, 93736, 93232, 93226, 93231, 93225, G0248 and G0249 are included in the PE database that is posted with this rule on the CMS Web site. We will consider these inputs interim, for CY 2007, and will continue to work with the provider group to appropriately value these services. For the request to include CPT code 93236 in this list of codes, we would note that this procedure is not valued in the nonfacility setting and has no direct inputs. CPT code 93236 is discussed in the following comment and response. g. Specific PE Concerns Raised by Commenters (i) Wireless Cardiac Monitoring Comment: One commenter expressed concern about the impact of the PE methodology proposal and stated that there is not a CPT code that accurately represents ‘‘remote, real-time cardiac monitoring through wireless communications and computerized arrhythmia detection technology’’ service. The commenter requested that a HCPCS code be created specifically for this service and provided direct input recommendations that could be used to price this new code. In the event that we could not create a HCPCS code, the commenter requested that the direct inputs be applied to the CPT code 93236 which is currently being used to bill for this service. Response: We are reluctant to create a HCPCS code at this time because the commenter has not demonstrated a compelling need for a distinct code for this service. Because this code is currently not valued in the nonfacility setting, we proposed to carrier price this service for CY 2007. We suggest that if the commenter believes a distinct code is necessary to describe this service, the provider should work with the specialty and contact the CPT Editorial Panel to pursue this matter. We will maintain E:\FR\FM\01DER2.SGM 01DER2 69648 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations our proposal to carrier price this service for CY 2007. (ii) Endovenous Ablation Services, CPT Codes 36475, 36476, 36478, and 36479 Comment: We received numerous comments with concerns about the decrease in PE RVUs proposed for CY 2007. In addition, a few commenters noted a disparity between the cost of supplies for the RF and the laser ablation procedures, CPT codes 36475 and 36478, respectively. One commenter supplied documentation to support that the price of the endovascular laser kit, at $677, in the PE database is not typical. This commenter presented a range of prices from $275 to $315 as typical. The commenter also demonstrated that 3 other supplies listed for CPT code 36478 were duplicated as they are part of the kit. Another commenter noted a price of $360 for the laser kit. Response: We reviewed the supplies in the laser kit and the other supplies for this endovenous service and believe that the hydrophilic guide wire, the vascular sheath and the vessel dilator are duplicated. These items were removed from the database for CPT code 36478. In addition, based on the information and documentation supplied, we used the $360 laser kit to average with the existing price of $677 to obtain the new price of $519. We have also made this change to the PE database. While we realize that the PE RVUs were negatively impacted by the change in the PE methodology, it is also important to ensure that the direct inputs accurately reflect the typical resources used to provide each service. rmajette on PROD1PC67 with RULES2 (iii) Development of Nonfacility PE for Arthroscopic Procedures Comment: We received comments requesting that we establish direct PE inputs for five arthroscopy codes for the nonfacility setting, including CPT codes 29870, 29805, 29830, 29840 and 29900. Response: The RUC discussed this request at its October 2006 meeting and determined that the procedures are not safe to perform in the physician’s office. We support the RUC’s decision not to value these arthroscopy procedures in the nonfacility setting and will continue to use the ‘‘NA’’ indicator in the PE RVU column for the nonfacility setting in Addendum B. (iv) Audiologist Wage Rate Comment: One commenter requested that we add 25 percent to the professional audiologists wage rate per minute which is now $0.52. The commenter contended that the fringe benefits factor was not applied at the VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 time we established the clinical labor rates for CY 2002. Response: We used data from the Bureau of Labor Statistics (BLS) to establish the base wage rate for audiologists when we repriced the clinical staff wage rates for CY 2002. We also applied a 33.6 percent fringe benefit factor to all wage rates, including the wage rate for audiology. Therefore, we will maintain the wage rate for audiologists until the time that all clinical labor wages are updated in future rulemaking. (v) Medical Physicists Wage Rate Comment: Several commenters recommended that we accept the 2005 survey data on hourly wages, inflated to 2006, that was presented by the association representing medical physicists. They contend that we inappropriately used the wage rate for health physicists, instead of medical physicists, when we updated the clinical labor wage rates for CY 2002. Response: In the PFS final rule for CY 2002, we finalized our proposal to price the physicist staff type on the average salary data for all certified health physicists from the 1999 survey conducted by the American Academy of Health Physics and the American Board of Health Physics. At the time we were revising the wage rates, this was the best information available. Further, the source of the majority of wage rates in the CY 2002 PFS final rule was the BLS. In the case of medical physicists, we were unable to obtain salary data from BLS. We agree with the commenters that this revised 2005 salary data is more appropriate than our current salary data. We will utilize this revised data, deflated to 2002, to keep all salary data on the same scale. As a result of this information, we will change the wage rate per minute for the two following clinical staff types: (a) Medical physicists from $1.21 to $1.523; and (b) medical dosimetrists/medical physicists from $0.92 to $1.075. (vi) Home Visit E/M Services Comment: We received a comment that stated that the home care clinical labor times are incorrectly reported in our PE database with each lacking 6 minutes in the pre-service period. In addition, the commenter stated that a supply item, specula tips, is missing in one service. Another commenter voiced support for the efforts of the home care physician group. Response: We have verified that our PE database is correct. For the CPT codes 99341, 99342, and 99343, there is a total 12 minutes labor for each code, with 6 minutes assigned to the pre- PO 00000 Frm 00026 Fmt 4701 Sfmt 4700 service period and 6 minutes assigned to the postservice period. Also, the supply item the commenters reported as missing is included in the PE database. (vii) Supply Inputs for CPT 31730 Comment: Prior to the publication of the CY 2007 PFS proposed rule, we received documentation from the association representing pulmonary physicians that specified the contents of the fast track supply tray for CPT code 31730. The specialty was complying with our request for information on supply items needing specialty input in last year’s final rule. Response: We thank the specialty group for its submission of the fast track supply tray contents and note that we accepted this documentation and the $750 price in our proposed rule. However, we regret that we did not remove the duplicated supply items from the PE database at that time. The following supplies will be removed from the inputs for CPT 31730 because they are already contained in the fast track tray: alcohol pads, 6 cc syringe with needle, 27G needle and 4x4 gauze pads. The PE RVUs that appear in this rule reflect the removal of these supply items. (viii) Supply Costs for CPT Code 58565 Comment: One commenter noted that the cost of the kit used for hysteroscopic tubal implant for sterilization (supply code SA076) has increased in price from $980 to $1245. The specialty society representing gynecology and obstetrics services did not supply supporting documentation. Response: We appreciate that this commenter has reviewed the direct inputs for accuracy. However, lacking any documentation to substantiate this request for a higher price, we will maintain the $980 price for the kit in the PE database for CY 2007. We will add this supply to the table requiring specialty input and will review any documentation provided by the specialty as part of a future rulemaking. (ix) Bone Density Testing Services Comment: Many commenters requested that we review the costs related to bone density testing (DXA) services, particularly related to CPT codes 76075 and 76076 used for detection and quantification of osteoporosis. These commenters state that the current direct inputs in the PE database identify the low cost pencil beam technology ($41,000) as the equipment utilized in performing these DXA services in place of the higher cost fan beam technology ($85,000). Commenters contended that the E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations rmajette on PROD1PC67 with RULES2 majority of densitometers sold are of the higher cost fan beam variety. Another commenter noted that the DXA services using the fan beam technology should also contain ‘‘phantom’’ equipment to be used to perform the daily quality check on this equipment. Response: We have changed the PE database to reflect the fan beam DXA technology for CPT codes 76075 and 76076. In addition, we have added, on an interim basis, the ‘‘solid water calibration check phantom’’ to the equipment file in the PE database for the family of codes using the fan beam technology for 15 minutes each, based on the survey information presented by one commenter noting that these DXA services are performed, on average, twice daily. We ask the medical specialty to provide us with the correct information on the specific ‘‘phantom’’ used for the fan beam DXA technology, including pricing verification. While reviewing the PE database for these services, we discovered a rank order anomaly between CPT code 76075 and 76076 that apparently is due to a change in the clinical labor from the April 2006 PERC meeting where CPT code 76075 was used as a reference code. We have added back the 5 minutes of labor time in the PE database to CPT code 76075 to correct this rank order anomaly. (x) PE Missing for CPT Code 28890 Comment: One commenter stated that the non-facility inputs for CPT code 28890, Extracorporeal shock wave, high energy, performed by a physician, requiring anesthesia other than local, including ultrasound guidance, involving the plantar fascia, lacked enough clinical staff to assist the physician with applying the regional (anesthetic) block and that the ultrasound equipment was not included in the PE database for this ‘‘shockwave’’ service. Response: In the CY 2006 PFS final rule with comment, we assigned nonfacility PE inputs for CPT code 28890, because we believed these services were being performed in the office. (This assignment of PE for CPT 28890 is discussed in a subsequent section of this rule.) Since the ‘‘shockwave’’ machine was the only equipment listed in the PE database, we added the ultrasound equipment for 36 minutes, to the PE database, but we question whether additional staff is needed to assist the physician during the procedure since one nurse ‘‘blend’’ (RN/ LPN/MTA) staff type is currently assigned for this procedure. We would entertain future discussions on this issue with interested parties, including the specialty organization involved in VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 performing this procedure in the office. For CY 2007, we have maintained the current clinical labor assignment in the PE database. h. Concerns About Decreases in PE RVUs for Women’s Health and Other Services Many commenters raised concerns regarding payment for services that affect women’s health: Comment: We received many comments regarding the proposed decrease in PE RVUs for either specific services or for given specialties. Many commenters raised concerns regarding payment for services that affect women’s health. Commenters opposed the proposed decrease in payment for the axial bone density testing (DXA) service, CPT code 76075, which is used for detection and quantification of osteoporosis, and CPT code 76077, which is used for vertebral fracture assessment. The commenters raised the concern that the proposed decrease in payment for these services would severely restrict patient access to bone density testing, thereby undermining our effort to effectively screen Medicare beneficiaries for osteoporosis and vertebral fractures. These commenters identified what they believed to be flaws in the direct input data and with the utilization rate applied to the DXA machine. The commenters also requested that we keep the payment for these services at the current level. We received several comments that expressed concern about the decrease in payment for computer-aided detection (CAD) services, CPT codes 76082 and 76083, both add-on procedures that are billed in combination with an appropriate mammography service. The commenters stressed that CAD systems for mammography are diagnostic tools that can increase breast cancer detection rates, especially in the early stages. One commenter contended that the decrease in payment for this service could cripple the ability of physicians to offer this highest quality screening service to the broadest patient population. Several commenters expressed concern about the proposed RVUs for the various radiation therapy codes involved in breast brachytherapy, as well as brachytherapy for ovarian and cervical cancer. A society representing brachytherapy stated that the proposed reductions may force providers to resort to other less beneficial cancer treatments. One commenter contended that the proposals could deny a greater number of African American women access to an important, patient friendly and proven breast cancer treatment. The PO 00000 Frm 00027 Fmt 4701 Sfmt 4700 69649 above concerns were echoed in comments from a society representing NPs and a society concerned with research on women’s health. We also received several comments regarding a related service, CPT code 19296, Placement of a radiotherapy afterloading balloon catheter into the breast for interstitial radioelement application. Commenters expressed concern regarding the proposed decrease in payment for this service and predicted that this decrease from 129.74 RVUs in 2006 to 89.31 RVUs in 2010 would cause the service not to be offered in a physician’s office to Medicare patients. We received comments that expressed concern regarding the proposed decrease in payments for a number of other services. These include: The surgical hysteroscopy service, CPT code 58565; the chemodenervation procedures, CPT codes 64612, 64613 and 64614; the EMG-guided Botox therapy, CPT 92265; and endovenous ablation procedures, CPT codes 36475, 36476, 36478 and 36479. We also received comments regarding the effect on certain specialties of our proposed payments. One commenter stated that the proposed cuts could diminish Medicare patients’ access to cardiac care. Many commenters requested that we reconsider the cuts for interventional radiology, and others requested that we reverse any decrease for anesthesiology. Another commenter expressed concern regarding the decreases for this specialty. Commenters opposed the changes to the RVUs that would cause a total 14 percent decrease in payment for clinical social workers. In addition, other commenters expressed concern regarding our proposed payments for gastroenterology, neonatology, pain management, radiosurgery and phlebology. Response: We understand the concern expressed by all of these commenters. However, payments made for services on the PFS can only reflect, in a budget neutral manner, the relative resources required to perform each service. With the exception of the requested changes to the equipment direct inputs for the DXA service, the commenters have not provided specific information regarding the relative resources required for the services in question that would support the requested changes in payment. We also do not believe it would be equitable to keep the payment for any specific service at the current rate when there are many other services that will see decreases in payment. We would note that one of the main reasons for the proposed 4-year transition of our new PE methodology was to give specialties E:\FR\FM\01DER2.SGM 01DER2 69650 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations rmajette on PROD1PC67 with RULES2 and practitioners the opportunity to work with us to determine whether any changes in our payment calculation for such services is warranted and we are open to further discussion on this issue. We also applaud the commenters who have stressed the importance of women’s health issues. We certainly share their commitment to ensuring that those services that meet the health care needs of women remain accessible to our beneficiaries. In addition, we appreciate the important role that all of the preventive screening services play in helping to maintain the health of these beneficiaries. In response to comments, we have revised our equipment database to reflect the correct DXA equipment. It should also be noted that, although payment for the CAD service itself is decreasing, payment for most mammography services is increasing, which could potentially offset any reductions to the providers of CAD. However, we will request that the RUC review again the PE inputs for the DXA and CAD services to ensure that the direct inputs associated with these services are accurately reflected in our PE database. i. Equipment Utilization and Interest Rate Assumptions Comment: Many specialty societies, MedPAC, and the RUC all offered comments about the 11 percent interest rate and the 50 percent utilization rate used to calculate the price per minute for each piece of equipment. MedPAC stressed the importance of obtaining a reliable source for updating the yearly interest rate that physicians would pay when borrowing money to buy equipment. They believe that we should select the Federal Reserve Board because of the frequent updating, issued quarterly. MedPAC notes that interest rates, of more than one year, ranged from 5.3 percent to 6.0 percent over the past 5 years. Other commenters suggested that we adopt the prime interest rate plus 2 percent, while the RUC and several specialty societies noted that we should select a competitive market rate. One commenter suggested using caution in our selection process and requested that the interest rate be examined before future changes are made. For updating the current 50 percent utilization rate, many commenters, including the MedPAC and the RUC, suggested that this rate should be higher. These comments stressed that by using the assumption that equipment is VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 in use 50 percent of the time when the utilization is actually higher, our price per minute would be too high. The RUC recommended we use a rate higher than 50 percent and permit individual specialty societies to present support for lower rates for specific equipment items. While the overall comments contained a broad array of suggested revisions to the utilization rate, a few specialty organizations believed that the utilization rate should be lower than 50 percent. Several comments, specific to equipment for bone density testing (DXA), believe the utilization rate to be closer to 20 percent for these services performed in primary care physicians’ offices and requested that we review this utilization to more appropriately measure the actual utilization of this equipment. MedPAC suggested that we begin our updating process by looking at the higher-priced equipment, and noted a study it conducted of imaging providers in six markets that indicated 70 percent and 90 percent utilization rates for CT and MRI, respectively. A few commenters noted that they would like for us to assign code-specific equipment utilization rates, although they did not forward possible avenues for us to follow in making the determinations of these assignments. Response: We agree with commenters that the proposed interest rate of 11 percent and the proposed 50 percent utilization rate should be examined for accuracy. We are committed to working with all interested parties to define the most accurate utilization and interest rate information for equipment used in the performance of physicians’ services. We do not believe that we have sufficient empirical evidence to justify a change in this final rule, but we will continue to work with the physician community to examine, and potentially revise, these estimates in future rulemaking. We have used the 11 percent interest rate and the 50 percent utilization rate to determine the valuation for equipment reflected in the PE RVUs in Addendum B. j. Further Review of PE Direct Inputs Comment: Several commenters, including the RUC and MedPAC, recommended that we establish an update process to ensure that the direct PE inputs—wage rates of clinical staff, purchase price of supplies, and purchase price of equipment—are updated for completeness and accuracy. MedPAC requested that we establish a PO 00000 Frm 00028 Fmt 4701 Sfmt 4700 timeline, recurring at least every 5 years, for the comprehensive review of the PE database direct inputs. Both MedPAC and the RUC made suggestions that the new, higher-priced supplies and equipment may need to be updated more frequently because their prices may decrease over time as other companies manufacture them. Response: We appreciate the commenters’ remarks regarding the establishment of a regular update process for the direct inputs utilized in the calculation of resource-based PE RVUs. We plan to examine this issue with both the RUC and interested specialty organizations, as well as with the medical community to determine the most useful approach to updating our direct PE inputs. Additionally, we encourage interested parties to continue working with the RUC to develop direct inputs for those services absent inputs and to correct any errors contained in our direct input database. k. Supply and Equipment Items Needing Specialty Input We have identified certain supply and equipment items for which we were unable to verify the pricing information in Table 3: Supply Items Needing Specialty Input for Pricing and Table 4: Equipment Items Needing Specialty Input for Pricing. In our CY 2007 PFS proposed rule, we listed both supply and equipment items for which pricing documentation was needed from the medical specialty societies and, for many of these items, we received sufficient documentation in the form of catalog listings, vendor Web sites, invoices, and manufacturer quotes. We have accepted the documented prices for many of these items and these prices are reflected in the PE RVUs in Addendum B of this final rule with comment period. For the items listed in Tables 3 and 4, we are requesting that commenters provide pricing information on items in these tables along with acceptable documentation, as noted in the footnote to each table, to support recommended prices. In Tables 5 and 6, we have listed new supplies and equipment from the new CPT codes for CY 2007 that are discussed elsewhere in this final rule with comment period. These items have been added to the PE database and, where priced, are reflected in the PE RVUs in Addendum B. BILLING CODE 4120–01–P E:\FR\FM\01DER2.SGM 01DER2 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00029 Fmt 4701 Sfmt 4725 E:\FR\FM\01DER2.SGM 01DER2 69651 ER01DE06.004</GPH> rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00030 Fmt 4701 Sfmt 4725 E:\FR\FM\01DER2.SGM 01DER2 ER01DE06.005</GPH> rmajette on PROD1PC67 with RULES2 69652 69653 BILLING CODE 4120–01–C VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00031 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 ER01DE06.006</GPH> rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69654 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations TABLE 5.—PRACTICE EXPENSE SUPPLY ITEM ADDITIONS FOR CY 2007 Equip code NA NA NA NA NA NA NA .......... .......... .......... .......... .......... .......... .......... Supply description Unit Unit price Agent, embolic 1 .................................................... Bolster covers, disposable .................................... Filter, mouthpiece .................................................. Gas, argon ............................................................. Kit, capsule, ESO, endoscopy w-application ........ Kit, gold markers, fiducial, 3 per kit ...................... Probe, cryoablation, (Viscia ICE 30 or 40) ........... Vial ......... Item ........ Unit ........ Cu ft ....... Kit ........... Kit ........... Item ........ *CPT code(s) associated with item ...................... 0.06 4.6 0.25 450 119 1589 Supply category 37210 96904 95012 19105 91111 55876 19105 Accessory, Procedure. Gown, drape. Infection control. Accessory, Procedure. Kit, Pack, Tray. Kit, Pack, Tray. Accessory, Procedure. *CPT codes and descriptions only are copyright 2007 American Medical Association. All Rights Reserved. Applicable FARS/DFARS77373y. 1. Price verification needed. Item(s) added to table of equipment requiring specialty input. TABLE 6.—PRACTICE EXPENSE EQUIPMENT ITEM ADDITIONS FOR CY 2007 Equip code . NA ........... NA NA NA NA NA NA NA ........... ........... ........... ........... ........... ........... ........... NA ........... NA ........... NA ........... NA ........... NA NA NA NA NA ........... ........... ........... ........... ........... Equipment description Life AV projection system (integrated headphone, video goggles, transducer, control unit w-remote-Cinema Vision). camera mount-floor 2 ........................................... cross slide attachment 2 ...................................... cryoablation system, fibroadenoma ..................... dermal imaging software 2 ................................... dermoscopy attachments 2 .................................. Gammaknife ........................................................ generator, spine, IDET, w-extension ................... genetic counseling, pedigree, software 2 ............. image-acquisition software and hardware (Brainwave RealTime, PA, Hardware). lens, macro, 35–70 mm 2 .................................... monitoring system, nitric oxide w-computer (Acerine, NIOX). radioactive source 3 ............................................. speakers, sound field (brainstem implant) .......... SRS system, Lincac ............................................ SRS system, SBRT, six-systems, average ......... strobe, 400 watts (Studio)(2) 2 ............................. Unit price *CPT code(s) associated with item Equipment category 5 3800 70554 IMAGING EQUIP. 15 10 3 5 5 7 5 1 2300 1 650 3870000 28299 OTHER EQUIPMENT. OTHER EQUIPMENT . OTHER EQUIPMENT. OTHER EQUIPMENT. OTHER EQUIPMENT. IMAGING EQUIP. OTHER EQUIPMENT. 5 3 .................... 108807 96904 96904 19105 96904 96904 77371 22526 22527 96040 70554 5 5 .................... 39200 96904 95012 OTHER EQUIPMENT. OTHER EQUIPMENT. .................... 5 7 7 10 .................... 1775 4350000 4000000 1 1500 77371 92640 77372 77373 96904 IMAGING EQUIP. OTHER EQUIPMENT. IMAGING EQUIP. IMAGING EQUIP. OTHER EQUIPMENT. 1 500 24950 1 4500 DOCUMENTATION. IMAGING EQUIP. *CPT codes and descriptions only are copyright 2007 American Medical Association. All Rights Reserved. Applicable FARS/DFARS77373y. 1. Prices interim for CY 2007—Acceptable documentation required for price verification. 2. Price verification needed. Item(s) added to table of equipment requiring specialty input. 3. Discussion with CMS necessary to establish appropriate value. rmajette on PROD1PC67 with RULES2 B. Geographic Practice Cost Indices (GPCIs) Section 1848(e)(1)(A) of the Act requires us to develop separate GPCIs to measure resource cost differences among localities compared to the national average for each of the three fee schedule components. While requiring that the PE and malpractice GPCIs reflect the full relative cost differences, section 1848(e)(1)(A)(iii) of the Act requires that the physician work GPCIs reflect only one-quarter of the relative cost differences compared to the national average. Section 1848(e)(1)(C) of the Act requires us, in consultation with appropriate physician representatives, to review the GPCIs at least every 3 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 years and allows us to make adjustments based on our review. This section of the Act also requires us to phase-in the adjustment over 2 years, implementing only one-half of any adjustment in the first year if more than 1 year has elapsed since the last GPCI revision. CMS is currently working with Acumen, LLC to review and revise the GPCIs in accordance with the requirement that GPCIs be revised at least every 3 years. We expect to implement any revisions based on our review in January 2008. In addition, section 412 of the MMA amended section 1848(e)(1) of the Act to establish a floor of 1.0 for the work GPCI for any locality where the GPCI would otherwise fall below 1.0 for purposes of payment for services furnished on or PO 00000 Frm 00032 Fmt 4701 Sfmt 4700 after January 1, 2004 and before January 1, 2007. Beginning on January 1, 2007, the 1.00 floor will be removed and the work GPCI will revert to the fully implemented value. The values for the work GPCI and subsequent changes to the geographic adjustment factor (GAF) published in the CY 2007 PFS proposed rule reflect the removal of the 1.0 floor. For many payment localities, this change had no impact on the GAF; however, the GAFs for a number of payment localities were reduced due to this change. The impact of this change on the GAFs for those payment localities was shown in Table 3 of the CY 2007 PFS proposed rule (71 FR 48993). In the CY 2007 PFS proposed rule, we also published the proposed GPCIs for E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 2007 in Addendum D and the proposed GAFs for 2007 in Addendum E (71 FR 49246 through 49249). The GPCIs shown in Addendum D represent the fully implemented value and reflect 2007 BN scaling coefficients provided by our Office of the Actuary. In the CY 2005 PFS proposed rule, we discussed issues relating to changes to the GPCI payment localities (69 FR 47504). In that proposed rule, we noted that we look for the support of a State medical society as the impetus for changes to existing payment localities. Because the GPCIs for each locality are calculated using the average of the county-specific data from all of the counties in the locality, removing high cost counties from a locality will result in lower GPCIs for the remaining counties. Therefore, because of this redistributive impact, we have refrained, in the past, from making changes to payment localities unless the State medical association provides evidence that any proposed change has statewide support. We requested suggestions on alternative ways that we could administratively reconfigure payment localities that could be developed and proposed in future rulemaking. In addition, MEDPAC and the General Accounting Office (GAO) have both expressed interest in studying the physician payment localities. We intend 69655 to work with both groups to study our current methodology and develop alternative options. We received the following comments in response to our GPCI proposals. Comment: During the comment period, commenters advised us of two errors in Table 3 (there were two entries for Kansas and there was a mistake in the equation for calculating the GAF). We were also advised of typographical errors in Addendum D. Response: We appreciate that these were brought to our attention. Table 7 contains the corrected information and we have corrected Addendum D in this final rule. TABLE 7.—PAYMENT LOCALITIES WITH NEGATIVE PERCENT CHANGE IN GAF 1 BETWEEN 2006 AND 2007 DUE TO REMOVAL OF THE 1.000 WORK FLOOR 2006 GAF rmajette on PROD1PC67 with RULES2 Locality name Fort Worth, TX ......................................................................................................................................... Rest of Michigan ...................................................................................................................................... Rest of New York .................................................................................................................................... Rest of Maryland ..................................................................................................................................... Metropolitan St. Louis, MO ...................................................................................................................... Rest of Pennsylvania ............................................................................................................................... Ohio ......................................................................................................................................................... Austin, TX ................................................................................................................................................ New Hampshire ....................................................................................................................................... Minnesota ................................................................................................................................................ Galveston, TX .......................................................................................................................................... Metropolitan Kansas City, MO ................................................................................................................. Fort Lauderdale, FL ................................................................................................................................. Arizona ..................................................................................................................................................... Wisconsin ................................................................................................................................................. Colorado .................................................................................................................................................. East St. Louis, IL ..................................................................................................................................... New Orleans, LA ..................................................................................................................................... Rest of Washington ................................................................................................................................. Indiana ..................................................................................................................................................... Beaumont, TX .......................................................................................................................................... Alabama ................................................................................................................................................... Virginia ..................................................................................................................................................... Southern Maine ....................................................................................................................................... Rest of Georgia ....................................................................................................................................... Tennessee ............................................................................................................................................... Utah ......................................................................................................................................................... South Carolina ......................................................................................................................................... Rest of Illinois .......................................................................................................................................... Rest of Florida ......................................................................................................................................... West Virginia ............................................................................................................................................ North Carolina .......................................................................................................................................... New Mexico ............................................................................................................................................. Rest of Louisiana ..................................................................................................................................... Kentucky .................................................................................................................................................. Kansas* .................................................................................................................................................... Rest of Oregon ........................................................................................................................................ Vermont ................................................................................................................................................... Virgin Islands ........................................................................................................................................... Rest of Texas .......................................................................................................................................... Idaho ........................................................................................................................................................ Iowa ......................................................................................................................................................... Rest of Maine .......................................................................................................................................... Oklahoma ................................................................................................................................................. Mississippi ................................................................................................................................................ Arkansas .................................................................................................................................................. Puerto Rico .............................................................................................................................................. Nebraska .................................................................................................................................................. Wyoming .................................................................................................................................................. VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00033 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 0.998 0.986 0.952 0.982 0.978 0.950 0.970 1.020 1.010 0.980 0.991 0.987 1.022 0.999 0.956 0.998 1.003 0.984 0.984 0.937 0.951 0.923 0.958 0.992 0.943 0.933 0.960 0.930 0.952 0.982 0.942 0.951 0.947 0.936 0.932 0.936 0.946 0.968 1.007 0.947 0.922 0.927 0.936 0.913 0.919 0.905 0.905 0.925 0.934 01DER2 2007 GAF 0.996 0.984 0.950 0.978 0.974 0.946 0.966 1.015 1.005 0.975 0.986 0.981 1.016 0.993 0.950 0.991 0.996 0.977 0.976 0.930 0.942 0.914 0.948 0.981 0.932 0.921 0.948 0.917 0.938 0.968 0.928 0.936 0.932 0.919 0.915 0.919 0.929 0.950 0.989 0.929 0.904 0.909 0.916 0.893 0.898 0.884 0.883 0.902 0.910 Percent change ¥0.17 ¥0.20 ¥0.21 ¥0.36 ¥0.41 ¥0.44 ¥0.44 ¥0.47 ¥0.50 ¥0.53 ¥0.54 ¥0.56 ¥0.59 ¥0.65 ¥0.65 ¥0.67 ¥0.68 ¥0.73 ¥0.77 ¥0.79 ¥0.96 ¥0.99 ¥1.06 ¥1.09 ¥1.14 ¥1.27 ¥1.30 ¥1.41 ¥1.43 ¥1.45 ¥1.47 ¥1.55 ¥1.57 ¥1.78 ¥1.80 ¥1.81 ¥1.81 ¥1.82 ¥1.83 ¥1.87 ¥1.91 ¥1.97 ¥2.14 ¥2.14 ¥2.31 ¥2.34 ¥2.44 ¥2.44 ¥2.55 69656 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations TABLE 7.—PAYMENT LOCALITIES WITH NEGATIVE PERCENT CHANGE IN GAF 1 BETWEEN 2006 AND 2007 DUE TO REMOVAL OF THE 1.000 WORK FLOOR—Continued 2006 GAF Locality name Montana ................................................................................................................................................... Rest of Missouri* ..................................................................................................................................... North Dakota ............................................................................................................................................ South Dakota ........................................................................................................................................... rmajette on PROD1PC67 with RULES2 1 Calculation 0.902 0.883 0.895 0.891 Percent change ¥2.83 ¥2.97 ¥3.16 ¥3.35 for the GAF: (0.52466*work gpci) + (0.03865*mp gpci) + (0.43669*pe gpci) Comment: We received several comments indicating that the GPCIs for Puerto Rico are inadequate because they do not take into consideration the higher costs of living in Puerto Rico. Commenters are concerned that physicians in Puerto Rico will relocate to areas with higher GPCIs. Their comments focused on suggested revisions to the data used in calculating the GPCIs for Puerto Rico with the intent of raising the GPCI for Puerto Rico. Response: We want to ensure that beneficiaries have access to high quality care in all parts of the United States; however, we do not use relative costs of living in the calculation of the GPCIs as the commenters are requesting. Relative costs of living among payment localities are already accounted for within other measures of relative resource cost that we use in calculating GPCIs, and we do not believe it would be appropriate to use different measures of resource cost for some localities than are used for others. Comment: We received numerous comments reflecting concerns about the negative impact on physician payments resulting from removal of the MMAmandated floor of 1.0 on the physician work GPCI. Comments also stated that GPCIs should not be applied to physician work as a general policy. Response: The 1.000 floor is being removed for services furnished after December 31, 2006, because the MMA provision established the floor only for services furnished on or after January 1, 2004, and before January 1, 2007. We do not have the legal authority to extend application of the floor beyond the statutory timeframe. In addition, application of GPCIs to the work RVUs is required by the statute. Comment: We received numerous comments requesting that we administratively change the relative values for codes that have a TC and a PC. The focus of the comments was that for many codes the TC has a higher malpractice relative value than the PC. A suggestion was made that we administratively change the TC RVU to equal the PC RVU. VerDate Aug<31>2005 0.928 0.910 0.924 0.922 2007 GAF 10:50 Nov 30, 2006 Jkt 211001 Response: The commenters are suggesting a change in methodology for calculating the malpractice RVUs. We did not make any proposals relating to this methodology; therefore, comments relating to malpractice RVU policy are outside the scope of this rule. We appreciate the commenters’ suggestions, and if we were to propose changes to malpractice RVU policy, we would consider the commenters’ suggestions in future rulemaking. Comment: Commenters indicated that they were troubled about the data used in developing the GPCIs. Specifically, the proxy categories used in the wage determination and the real estate data used in the rent portion of the PE GPCI are of the greatest concern. They stated that our data do not reflect true costs and, therefore, put many practitioners in rural areas at a disadvantage and create inequities between payment localities. Response: We have previously addressed the issue of rental data in the CY 2005 PFS final rule (69 FR 66261). We stated that the Department of Housing and Urban Development (HUD) rental data may be the subject of concern, but we believe it remains the best data source to fulfill our requirements that the data be available for all areas, be updated annually, and retain consistency area-to-area and yearto-year. In that same rule, we discussed our belief that the wage proxies we use are the best tools available for the development of the GPCIs. However, we will consider the possibility of using different wage proxies or wage data sources for some future update of the GPCIs. C. Medicare Telehealth Services As discussed in the CY 2007 PFS proposed rule (71 FR 48994), section 1834(m)(4)(F) of the Act defines telehealth services as professional consultations, office visits, and office psychiatry services (identified as of July 1, 2000 by CPT codes 99241 through 99275, 99201 through 99215, 90804 through 90809, and 90862) and any additional service specified by the Secretary. In addition, the statute requires us to establish a process for PO 00000 Frm 00034 Fmt 4701 Sfmt 4700 adding services to or deleting services from the list of telehealth services on an annual basis. In the December 31, 2002 Federal Register (67 FR 79988), we established a process for adding services to or deleting services from the list of Medicare telehealth services. This process provides the public an ongoing opportunity to submit requests for adding services. We assign any request to make additions to the list of Medicare telehealth services to one of the following categories: • Category #1: Services that are similar to office and other outpatient visits, consultation, and office psychiatry services. In reviewing these requests, we look for similarities between the proposed and existing telehealth services for the roles of, and interactions among, the beneficiary, the physician (or other practitioner) at the distant site and, if necessary, the telepresenter. We also look for similarities in the telecommunications system used to deliver the proposed service, for example, the use of interactive audio and video equipment. • Category #2: Services that are not similar to the current list of telehealth services. Our review of these requests includes an assessment of whether the use of a telecommunications system to deliver the service produces similar diagnostic findings or therapeutic interventions as compared with the face-to-face ‘‘hands on’’ delivery of the same service. Requestors should submit evidence showing that the use of a telecommunications system does not affect the diagnosis or treatment plan as compared to a face-to-face delivery of the requested service. Since establishing the process, we have added the following to the list of Medicare telehealth services: Psychiatric diagnostic interview examination; ESRD services with two to three visits per month and four or more visits per month (although we require at least one visit a month by a physician, CNS, NP, or PA to examine the vascular access site); and individual medical nutritional therapy. E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations Requests to add services to the list of Medicare telehealth services must be submitted and received no later than December 31 of each CY to be considered for the next proposed rule. For example, requests submitted before the end of CY 2005 are considered for the CY 2007 proposed rule. For more information on submitting a request for an addition to the list of Medicare telehealth services, visit our Web site at https://www.cms.hhs.gov/telehealth. We received the following requests for additional approved services in CY 2005: Nursing facility care; speech language pathology; audiology; and physical therapy services. After reviewing the public requests, we explained that section 1834(m)(4)(C)(ii) of the Act defines a telehealth originating site as a physician’s or practitioner’s office; or a hospital, critical access hospital (CAH), rural health clinic, or Federally qualified health center (FQHC). SNFs are not defined in the statute as originating sites. The authority to allow SNFs to serve as telehealth originating sites is dependent upon HHS submitting the Report to Congress on permitting a SNF to be an originating site (as required by the section 418 of the MMA) and the Secretary concluding in the Report that it is advisable to include a SNF as a Medicare telehealth originating site and that mechanisms could be established to ensure that use of a telecommunications system does not serve as a substitute for the required inperson physician or practitioner visits to SNF residents. As discussed in the CY 2007 PFS proposed rule, given that SNFs are not defined in the statute as a telehealth originating site and HHS is currently reviewing the Report to Congress, it would not be appropriate to approve nursing facility care for telehealth at this time. In addition, we explained that the statute permits only a physician, as defined by section 1861(r) of the Act or a practitioner as described in section 1842(b)(18)(C) of the Act (CNS, NP, PA, nurse midwife, clinical psychologist, clinical social worker, registered dietitian or other nutrition professional), to furnish Medicare telehealth services. Since speech language pathologists, audiologists and physical therapists are not permitted under the statute to provide and receive payment for Medicare telehealth services at the distant site, we could not fully consider the request to add speech therapy, audiology services and physical therapy to the list of Medicare telehealth services (71 FR 48994). VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 We received the following comments on the Medicare telehealth services. Comment: Some commenters stated that the process for adding services to the list of Medicare telehealth services does not require an originating site to be approved prior to the approval of a service for telehealth (and mentioned that we previously approved ESRDrelated visits furnished under the monthly capitation payment (MCP) for telehealth without the approval of a dialysis center as an originating site). The commenters believe that approving nursing facility services for telehealth is mutually exclusive from the Report to Congress on permitting a SNF to be a Medicare telehealth originating site and that the findings of the report are not necessary to approve services for telehealth. Moreover, the commenters requested that we approve nursing facility care for telehealth (initial nursing facility care, subsequent nursing facility care, nursing facility discharge services and other nursing facility services) prior to the completion of the Report to Congress on permitting a SNF to be an originating site. Response: As previously discussed in this section, the MMA specifically requires an evaluation of SNFs as potential originating sites for the furnishing of telehealth services, and a Report to Congress on such evaluation. The law provides the authority to add SNFs as an originating site if the Secretary concludes in the report that it is advisable to do so, and that mechanisms could be established to ensure that the use of telehealth does not substitute for the required in-person physician or practitioner visits to SNF residents (which could have significant implications for the type of services we would approve for telehealth). As such, we believe that a decision to add (or not add) nursing facility care to the list of Medicare telehealth services is related to the conclusions reached in the Report to Congress on permitting a SNF to serve as an originating site. Given that the conclusions of the Report to Congress are not final, we do not believe that it would be appropriate to consider the request to add nursing facility care to the list of Medicare telehealth services at this time. We intend to review and consider the recommendations of the Report to Congress once it is issued and would address the request to approve nursing facility care for telehealth in future rulemaking. Comment: One commenter expressed support for expanding telehealth services and for allowing SNFs to serve as a telehealth originating site. PO 00000 Frm 00035 Fmt 4701 Sfmt 4700 69657 Response: We appreciate the comment on the use of SNFs as telehealth originating sites. As discussed earlier in this section, the Report to Congress that could permit an SNF to serve as an originating site is currently under review within HHS. We expect to address this issue in future rulemaking after the Report to Congress is issued. Comment: Two commenters requested clarification on whether the public would need to resubmit a request to approve nursing facility care for telehealth if it is determined that SNFs could be added as an originating site. Response: After the Report to Congress is issued regarding SNFs as a telehealth originating site, we will address the requests to approve nursing facility care for telehealth and discuss our review through future rulemaking. It would not be necessary to resubmit a request to approve nursing facility care for telehealth. Comment: Commenters stated that we added medical nutritional therapy (MNT) to the list of telehealth services in the CY 2006 PFS rule without nutrition professionals being authorized to furnish telehealth services. The commenters note that physical therapists, audiologists, and speech language pathologists currently cannot furnish Medicare telehealth services and requested an explanation as to why we cannot also consider approving audiology, speech language pathology, and physical therapy services for telehealth. Response: The statute permits a physician, as defined by section 1861(r) of the Act or a practitioner as described in section 1842(b)(18)(C) of the Act (that is, CNS, NP, PA, nurse midwife, clinical psychologist, clinical social worker, registered dietitian or other nutrition professional), to furnish Medicare telehealth services. Registered dietitians or nutrition professionals are included in the statutory definition of practitioner under section 1842(c)(18)(C)(vi), and thus, are permitted under the statute to furnish telehealth services (and are the only practitioners permitted by the statute to furnish MNT). As such, when approving individual MNT for telehealth, registered dietitians and nutrition professionals as defined in § 410.134 were added to the list of practitioners that may furnish and receive payment for a telehealth service in the CY 2006 PFS final rule with comment period (70 FR 70160). In contrast, speech language pathologists, audiologists and physical therapists are not permitted under the statute to provide and receive payment for Medicare telehealth services at the E:\FR\FM\01DER2.SGM 01DER2 69658 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations distant site. Therefore, we do not believe it would be appropriate to consider adding audiology, speech language pathology, and physical therapy services for telehealth. Comment: Two commenters requested that we provide clarification on when the telehealth Report to Congress, as required by section 223(d) of the BIPA, would be completed and submitted to Congress. Another commenter urged us to expedite the completion of the telehealth report (as required by the BIPA). Response: The Report to Congress on additional sites and settings, practitioners, and geographic areas that may be appropriate for Medicare telehealth payment, as required by section 223(d) of the BIPA, is under development. We will work to expedite the completion of this report. rmajette on PROD1PC67 with RULES2 D. Miscellaneous Coding Issues The following sections address specific coding issues related to payment for services under the PFS. 1. Global Period for Remote Afterloading High Intensity Brachytherapy Procedures CPT code 77783, Remote afterloading high intensity brachytherapy; 9–12 source positions or catheters, resides in a family of codes with varying numbers of source positions. All of the codes in the family, CPT codes 77781 through 77784, are currently designated as 90day global services. CPT codes 77781 through 77784 are used to treat many clinical conditions, but primarily patients with prostate cancer, breast cancer and sarcoma. Patients with any of these conditions usually receive several treatments (2 through 10) over a 2 to 10-day period of time. Due to the increasing variability in treatment regimens, it is difficult to assign RVUs for a ‘‘typical’’ patient based on a global period of 90 days. Therefore, we proposed that this family of codes (CPT codes 77781, 77782, 77783 and 77784) be assigned a global period of ‘‘XXX’’, which will permit separate payment each time the services are provided and allow payment to be based on the actual service(s) provided. We will request that the RUC revalue the work RVUs and the PE inputs for these services if a change in the global period is finalized. However we proposed, on an interim basis, to revise the work RVUs and PE inputs to reflect the removal of the postoperative visit, CPT code 99212 that is currently assigned to these services. The interim work RVUs for these services are as follows: • CPT code 77781 = 1.21 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 • CPT code 77782 = 2.04 • CPT code 77783 = 3.27 • CPT code 77784 = 5.15 We proposed to delete the registered nurse (RN) time in the postservice period, as well as the patient gowns for the postservice visit. We also noted that, to the extent that these services are performed as staged procedures, providers may make use of applicable modifiers. We received the following comments on these coding issues. Comment: Many commenters concurred with our proposal. However, some commenters wanted either a reconsideration of the proposed work RVU reduction, or if needed, a reduction in the CF. One commenter agreed with the global period revision but recommended establishment of a threshold for brachytherapy codes at a maximum of 10 percent per year. Another commenter concurred with the change in the global period; however, the commenter recommended no change in the work RVUs or a reduction to the 1992 levels, and prior to any work RVU changes it was recommended that such changes be reviewed by the RUC. In addition, the RUC, in its comments, agreed to include a review of the brachytherapy codes on its April 2007 meeting agenda and several commenters expressed an interest in working with the RUC on the work RVUs and PE inputs. Response: We believe that the commenters misunderstood the intent of the proposed work RVU reductions. They are designed to allow the billing of the brachytherapy physician service codes on a more frequent basis than is currently permitted, and are reflective of the present course of treatment regimens. The current codes have a 90day global period and are to be billed only once for the entirety of physician services provided during the specified time period. Comment: Some commenters expressed concern that the PE inputs for the brachytherapy codes should not be reduced to reflect the removal of a postoperative visit because there is no visit. Response: A post-operative visit is included within the current PE inputs for the current 90-day global period brachytherapy codes. The change to a global period of ‘‘XXX’’ necessitates the removal of this visit from the PE inputs because the codes could be billed several times during a course of treatment, and each occurrence would not include a post-operative visit. The brachytherapy family of codes (CPT codes 77781, 77782, 77783 and 77784) will be assigned a global period of ‘‘XXX’’, which will permit separate PO 00000 Frm 00036 Fmt 4701 Sfmt 4700 payment each time the services are provided and allow payment to be based on the actual service(s) provided. Because of the change in the global period a request will be made to the RUC for a revaluation of the work RVUs and the PE inputs for these services. On an interim basis the work RVUs and the PE inputs will be revised as delineated in the proposed rule. In addition, the RN time in the postservice period, as well as the patient gowns for the postservice visit will be deleted from the PE database as proposed. Separate payment will be made for medically necessary post-therapy visits based on the documented level of E/M service for the post procedure encounter(s). We also note that appropriate modifiers are to be used when these services are performed as staged procedures. 2. Assignment of RVUs for Proton Beam Treatment Delivery Services As discussed in the CY 2006 PFS proposed rule, we have received a request to assign PE inputs for the nonfacility setting to Proton Beam treatment delivery services represented by CPT codes 77520 through 77525. These services are currently carrier-priced; therefore, payment in the facility or non-facility setting is established by each carrier. To the extent that physicians and suppliers wish to have national RVUs assigned for these services, we encourage them to use the established process at the AMA–RUC. Comment: We received several comments in response to this discussion. Two commenters stated that due to the relatively limited availability of these services in freestanding environments given the small number of proton therapy centers at this point in time, these services should remain carrier priced. However, one commenter indicated that allowances established by carriers do not appear to account for capital and operating costs. This commenter referenced payment amounts proposed for hospital OPDs under the Outpatient Prospective Payment System (OPPS), and urged us to provide guidance to carriers in establishing appropriate payment for these services under the PFS. Other commenters suggested that RVUs should be established for these services. Many of these commenters expressed agreement with the payment rate for these services under OPPS. These commenters were concerned that since each State has its own CMScontracted carrier, variations exist in proton therapy coverage and reimbursement under the PFS. These E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations commenters requested that we provide payment rates for carriers to use when these services are furnished in freestanding centers so that payments are consistent with payment rates under OPPS. We also received comments from the AMA–RUC and ASTRO regarding this discussion. The RUC reiterated the process that is used to develop RVUs and ASTRO indicated it would be willing to participate in the development of RVUs for these services. Response: As discussed in the CY 2006 PFS proposed rule, at the present time payment for these services is established at the carrier level. The carriers have discretion to establish payment using available information about these services. Should providers wish to have RVUs established for these services, we would request that they use the AMA–RUC process that has been established for recommending RVUs and direct PE inputs used to compute national RVUs for PFS services to CMS. E. Deficit Reduction Act (DRA) The Deficit Reduction Act of 2005 (DRA) (Pub. L. 109–171), was enacted February 8, 2006 and included provisions that affect the Medicare program. The following section addresses the specific DRA provisions that were addressed in the CY 2007 PFS proposed rule (71 FR 48996). rmajette on PROD1PC67 with RULES2 1. Section 5102—Adjustments for Payments to Imaging Services Section 5102 of the DRA includes two provisions that affect payments of imaging services under the Medicare PFS. The first provision addresses payment for certain multiple imaging procedures for CY 2007 and application of BN while the second provision addresses limiting the payment amount under PFS to the OPD payment amount for the TC of certain imaging services. a. Payment for Multiple Imaging Procedures for 2007 In general, Medicare prices diagnostic imaging procedures in the following three ways: • The PC represents the physician’s interpretation (PC-only services are billed with the 26 modifier). • The TC represents PE and includes clinical staff, supplies, and equipment (TC-only services are billed with the TC modifier). • The global service represents both PC and TC. As discussed in the CY 2006 PFS final rule with comment period (70 FR 70261), in the CY 2006 PFS proposed rule (70 FR 45764 through 46064), we had proposed to reduce payment for the VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 TC of selected diagnostic imaging procedures belonging to one of eleven imaging families when the procedures are performed on contiguous body areas by 50 percent for CY 2006. However, in the final rule with comment period, we stated that we would phase-in the 50 percent reduction over 2 years beginning with a 25 percent reduction in 2006. We also sought additional data and comments on the appropriateness of 50 percent as the final level of reduction. The reduction applies to the TC and the technical portion of the global service, but does not apply to the PC of the service. Currently, we make full payment for the highest priced procedure and reduce payment for each additional procedure by 25 percent, when more than one procedure from the same imaging family is performed during the same session on the same day. As described in the CY 2006 PFS final rule with comment period, at the time, the statute required us to make changes such as this in a budget neutral manner, meaning that the estimated savings generated by the application of the multiple imaging procedure payment reduction were used to increase payment for other physician fee schedule services. We increased the CY 2006 PE RVUs by 0.3 percent to offset the estimated savings generated by the multiple imaging payment reduction policy. Subsequent to the publication of the CY 2006 PFS final rule with comment period, section 5102(a) of the DRA (Multiple Procedure Payment Reduction for Imaging Exempted From Budget Neutrality), required that ‘‘effective for fee schedules established beginning with 2007, reduced expenditures attributable to the multiple procedure payment reduction for imaging under the CY 2006 PFS final rule with comment period (42 CFR 405, et al.) insofar as it relates to the PFSs for 2006 and 2007’’ are exempted from the BN provision. As a result, we proposed to remove the 0.3 percent increase to the CY 2006 PE RVUs from the CY 2007 PE RVUs in accordance with the statute. In addition, in response to our request for data on the appropriateness of the 50 percent reduction in the CY 2006 PFS final rule with comment period (70 FR 70261), the ACR provided information for 25 code combinations supporting a reduction of between 21 and 44 percent. Given the expected interaction between the multiple procedure imaging policy and the further imaging payment reductions mandated by section 5102(b) of the DRA, along with the new information we have received from the ACR on the multiple imaging procedure PO 00000 Frm 00037 Fmt 4701 Sfmt 4700 69659 policy as it applies to common combinations of imaging services, we believe it would be prudent to maintain the multiple imaging payment reduction at its current 25 percent level while we continue to examine the appropriate payment levels. Therefore, we proposed to continue the multiple imaging payment reduction for CY 2007 at the 25 percent level. We would proceed through future rulemaking in the event we determine that revisions to the policy are warranted. b. Reduction in TC for Imaging Services Under the PFS to OPD Payment Amount Section 5102(b)(1) of the DRA amended section 1848 of the Act and requires that, for imaging services, if— ‘‘(i) The technical component (including the technical component portion of a global fee) of the service established for a year under the fee schedule * * * without application of the geographic adjustment factor * * *, exceeds (ii) The Medicare OPD fee schedule amount established under the prospective payment system for hospital outpatient department services * * * for such service for such year, determined without regard to geographic adjustment * * *, the Secretary shall substitute the amount described in clause (ii), adjusted by the geographic adjustment factor [under the PFS] * * *, for the fee schedule amount for such technical component for such year.’’ As required by the statute, for imaging services (described below in this section) furnished on or after January 1, 2007, we will cap the TC of the PFS payment amount for the year (prior to geographic adjustment) by the CY 2007 OPPS payment amount (prior to geographic adjustment). We will then apply the PFS geographic adjustment to the capped payment amount. Section 5102(b)(2) of the DRA exempts the estimated savings from this provision from the PFS BN requirement. Section 5102(b)(1) of the DRA defines imaging services as ‘‘* * * imaging and computer-assisted imaging services, including X-ray, ultrasound (including echocardiography), nuclear medicine (including positron emission tomography), MRI, CT, and fluoroscopy, but excluding diagnostic and screening mammography.’’ To apply section 5102(b) of the DRA, we needed to determine the CPT and alpha-numeric HCPCS codes that fall within the scope of ‘‘imaging services’’ defined by the DRA provision. In general, we believe that imaging services provide visual information regarding areas of the body that are not E:\FR\FM\01DER2.SGM 01DER2 69660 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations normally visible, thereby assisting in the diagnosis or treatment of illness or injury. We began by considering the CPT 7XXXX series codes for radiology services and then adding in other CPT codes and alpha-numeric HCPCS codes that describe imaging services. We then excluded nuclear medicine services that were either non-imaging diagnostic or treatment services. We also excluded all codes for unlisted procedures, since we would not know in advance of any specific clinical scenario whether or not the unlisted procedure was an imaging service. We excluded all mammography services, consistent with the statute. We excluded radiation oncology services that were not imaging or computerassisted imaging services. We also excluded all HCPCS codes for imaging services that are not separately paid under the OPPS since there would be no corresponding OPPS payment to serve as a TC cap. We excluded any service where the CPT code describes a procedure for which fluoroscopy, ultrasound, or another imaging modality is either included in the code whether or not it is used or is employed peripherally in the performance of the main procedure, for example, CPT code 31622 for bronchoscopy with or without fluoroscopic guidance and CPT code 43242 for upper gastrointestinal endoscopy with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/ biopsy(s). In these cases, we are unable to clearly distinguish imaging from nonimaging services because, for example, a specific procedure may or may not utilize an imaging modality, or the use of an imaging technology cannot be segregated from the performance of the main procedure. Note that we included carrier priced services since these services are within the statutory definition of imaging services and are also within the statutory definition of PFS services (that is, carrier-priced TCs of PET scans). A list of proposed codes that identify imaging services defined by the DRA OPPS cap provision was found in Addendum F of the proposed rule. To the extent changes are made to codes for services already on the list, we proposed to update the list through program instructions to our contractors. To the extent that the same imaging service is coded differently under the PFS and the OPPS, we proposed to crosswalk the code under the PFS to the appropriate code under the OPPS that could be reported for the same service provided in the hospital outpatient setting. These crosswalks are listed in Table 8. TABLE 8.—CROSSWALKS MFS Code Descriptor OPPS Code 74185 .......... 76093 * ........ 76094 * ........ 71555 .......... 73725 .......... 72198 .......... Mri angio, abdom w or w/o dye ...................................... Magnetic image, breast .................................................. Magnetic image, both breasts ........................................ Mri angio chest w or w/o dye ......................................... Mr ang lwr ext w or w/o dye ........................................... Mr angio pelvis w/o & w/dye .......................................... C8900 C8905 C8908 C8909 C8912 C8918 .......... .......... ......... .......... .......... .......... Desc MRA w/cont, abd. MRI w/o fol w/cont, brst, un. MRI w/o fol w/cont, breast. MRA w/cont, chest. MRA w/cont, lwr ext. MRA w/cont, pelvis. * Note: These codes have been renumbered for CY 2007. New code number is reflected in Addendum F. c. Interaction of the Multiple Imaging Payment Reduction and the OPPS Cap For CY 2007 imaging services potentially subject to both the multiple imaging reduction and the OPPS cap, we proposed to first apply the multiple imaging payment reduction and then apply the OPPS cap to the reduced amount as illustrated in Table 9. TABLE 9 Pre-OPPS cap MPFS rate HCPCS rmajette on PROD1PC67 with RULES2 7XXX1 .............................................................................................................. 7XXX2 .............................................................................................................. We considered first applying the OPPS cap and then applying the multiple procedure reduction. However, as indicated in the CY 2006 OPPS final rule, we received public comments suggesting that the OPPS payment rates may implicitly include at least some multiple imaging discount. While we continue to examine this issue, we believe the most appropriate policy is to apply the multiple imaging payment reduction prior to the application of the OPPS cap. i. OPPS Cap Comment: Many commenters criticized the OPPS cap, maintaining VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 $341.89 552.86 that OPPS rate was never intended to reflect the cost of providing individual physicians’ services. They indicated that it is methodologically unjustifiable, and that it undermines the resourcebased system. One commenter noted that physician costs are determined on a per procedure basis, whereas hospital costs are not determined on a per procedure basis because expensive capital equipment is allocated over other procedures within a revenue center. Given this methodological difference, the commenter indicated that it is not surprising that the cost of a procedure under the PFS is greater than under PO 00000 Frm 00038 Fmt 4701 Sfmt 4700 25% Multiple imaging reduction $256.42 414.65 OPPS cap rate $316.55 391.83 Final MPFS payment $256.42 391.83 OPPS. Another commenter noted that we need to recognize that the delivery of care has shifted from the hospital to physicians’ offices; that there is an increased complexity of care; and the need to practice defensive medicine due to the threat of malpractice lawsuits. One commenter noted that hospital and IDTF payments should not be the same. Various commenters indicated that the cap will have a devastating impact and threatens the future viability of outpatient imaging. Commenters predicted that the consequences will include: • Reduced patient access to diagnostic technologies capable of E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations preventing the onset of more serious conditions, requiring more complex and expensive treatment later. • Shifting of procedures back to hospitals. • Increased volume to offset the affects of the payment cuts. • Conversion of IDTFs ownership and legal structure to allow billing under OPPS, negating any savings from the cap. A few commenters requested a delay in implementing the cap and requested that we consider co-sponsoring H.R.5704 that calls for a 2-year moratorium on imaging cuts. Response: We acknowledge the commenters concerns and appreciate their comments. However, we are obligated to implement the statutory provision. We will continue to work with the Congress and specialty societies to ensure equitable payments and proper access to care. Comment: Several commenters requested that the following procedure codes be excluded from the OPPS cap: • Non-invasive vascular diagnostic study codes (CPT codes 93875–93990 and G0365) because they either contain no imaging or are predominately nonimaging in nature. Particularly noted were transcranial Doppler procedures and duplex scans. • Imaging guidance procedures that are integral to the performance of interventional treatment or diagnostic procedures. CPT codes cited were: 75894, 75896, 75901–75945, 75952, 75954, 75962, 75966, 75970, 75989– 75996, 76940–76948 and 76965. • Nuclear medicine codes 78020, 78135, 78140, 78190, and 78282, based on the fact that other nuclear medicine codes, such as radioisotope lab codes were excluded. • Codes performed in conjunction with radiation therapy (CPT codes 76370, 76950, 76965, 77417, and 77421) because they are never performed for diagnostic purposes. The commenters were pleased that we excluded radiation oncology codes. • Positron Emission Tomography (PET), PET/ CT, and CT/Computed Tomographic Angiography (CTA) and Category III codes used to report emerging technologies because they are carrier-priced codes and, therefore, not paid under the PFS. • Codes for imaging service that are not separately paid under OPPS since there is no corresponding OPPS payment to serve as a TC cap. Codes cited were cardiac catheterization codes 93555 and 93556 and code 0152T. Additionally, several commenters proposed the following definition of medical imaging procedures for the VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 purpose of the DRA provision: ‘‘Medical imaging uses noninvasive techniques to view all parts of the body and thereby diagnose an array of medical conditions. These techniques include the use of ionizing radiation (X-rays and CT scans), MRI, ultrasound and scans obtained after the injection of radio nucleotides (such as bone scans and PET).’’ Response: The DRA defines imaging service subject to the OPPS cap as ‘‘imaging and computer-assisted imaging services, including x-ray, ultrasound (including echocardiography), nuclear medicine, (including positron emission tomography [PET], magnetic resonance imaging [MRI], computed tomography [CT], and fluoroscopy, but excluding diagnostic and screening mammography.’’ The DRA does not distinguish between diagnostic and therapeutic imaging. We have no authority to modify the statutory definition of imaging services. Therefore, we cannot exclude certain non-invasive diagnostic study procedures, imaging guidance procedures, nuclear medicine procedures, and radiation oncology imaging procedures. However, in our review of the codes in response to comments, we determined that there are certain non-invasive vascular diagnostic study codes that do not involve the generation of an image, (that is, codes 93875, 93922, 93923, 93924 and 93965.) Therefore, we are removing these codes from the list of codes subject to the OPPS cap. Additionally, we note that imaging guidance procedures that are separately billed, are appropriately included on the list of codes subject to the cap. However, codes 75952, 75954, and 75993–75996 were inadvertently included on the list. These codes do not have a TC and we are removing them from the list. Regarding carrier-priced services, all physicians’ services (as defined by the statute under section 1848(j)(3) of the Act) are paid under the PFS, regardless of how they are priced. Carrier-priced services are services for which an alternative methodology is used to arrive at TC payment under the PFS, and, therefore, they are subject to the DRA provision. The same is true of Category III codes to the extent that they are carrier-priced (and to the extent they are not carrier-priced, there is no basis to exempt these codes from application of the cap). Regarding codes that are not separately paid under the OPPS, we agree that there is no corresponding OPPS payment to serve as a TC cap. PO 00000 Frm 00039 Fmt 4701 Sfmt 4700 69661 Because these codes meet the statutory definition of procedures subject to the OPPS cap, we will retain these codes on the list of procedures subject to the cap, but payments for the procedures will not be affected by the cap. Comment: One commenter noted that the Ambulatory Payment Classification (APC) groups are intended to set an average payment, where some lower cost procedures are paid at a higher average rate, and some higher cost procedures are paid at a lower average rate. In crosswalking from the PFS to the OPPS payment, the commenter noted that it would be more equitable to crosswalk to the median cost by CPT code, rather than using the median cost per the APC grouping payment. One commenter requested exclusion of codes bundled under OPPS having no additional APC payment, but having a TC amount under PFS. The commenter noted that the list of bundled services under the APC payments will vary from year-to-year and it is inappropriate to not make a payment under PFS as there is no packaging of the service into another procedure. Another commenter noted that drugs and radiopharmaceuticals are bundled into some OPPS procedures. They indicated that these should be unbundled to achieve more parity in the payment systems. Response: The DRA is specific in its requirements to compare the TC of a service for a year to the Medicare OPD fee schedule amount. Therefore, we will crosswalk the TC to the corresponding OPD fee schedule service and use that rate as a cap. For the same reason, we must use the OPD payment amount even if there are drugs or radiopharmaceuticals bundled into a particular OPD payment amount. In regard to the concern that bundled services vary year to year, we intend to review the relevant OPD and PFS codes to determine the appropriate crosswalk for a given year. We recognize that there will be changes and we believe our process will help to ensure that TC codes are being crosswalked to the most appropriate OPD codes. ii. Multiple Procedure Payment Reduction Comment: Many commenters expressed appreciation for our decision to apply the multiple procedure payment reduction prior to application of the OPPS cap, and for maintaining the reduction at 25 percent. However, the commenters also indicated that the multiple procedure payment reduction is duplicative, inappropriate and excessive in light of the OPPS cap, and requested its elimination. Other E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 69662 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations commenters requested continued evaluation, indicating a 25 percent reduction is greater than what is justified by any efficiencies achieved in, performing multiple procedures. One commenter noted we had previously stated that our multiple procedure analysis does not disprove earlier assertions by physician and industry representatives that some portion of multiple procedure efficiencies may be already reflected in OPPS payment rates. Conversely, MedPAC indicated that it is unclear why the DRA OPPS cap justifies maintaining the 25 percent reduction since the DRA policy applies only to those services where the TC exceeds the OPPS rate. In addition, MedPAC requested more information on the ACR data cited in the CY 2007 PFS proposed rule (71 FR 48996). Response: When we proposed the multiple procedure payment reduction last year, as recommended by MedPAC, our data supported a 50 percent payment reduction. However, we agreed to phase-in the reduction over two years to allow for a transition of the changes in payment for these services attributable to the reduction policy and to provide further opportunity for public comment. Subsequently, the Congress passed the DRA provision capping imaging procedures at the OPPS payment rate. In view of the DRA provision, and additional data received from ACR, we determined that it is more appropriate to retain the multiple procedure payment reduction at 25 percent, rather than to increase it to 50 percent as previously proposed. We share the concerns of the providers of imaging services that excessive reductions could be harmful to both physicians and patients. Therefore, we believe it is more appropriate to maintain the 25 percent reduction level while we continue to examine this issue. The list of codes that identify imaging services defined by the DRA OPPS cap provision can be found in Addendum F to this final rule with comment period. Note that the list in the proposed rule was affected by the renumbering of CPT codes that is effective January 1, 2007. Addendum F in this final rule with comment period reflects the renumbering of CPT codes that is effective January 1, 2007, and also reflects the removal of certain codes in response to comments, as discussed previously in this section. Payment for an individual service on this list will only be capped if the PFS TC payment amount exceeds the OPPS payment amount. VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 2. Section 5107—Revisions to Payments for Therapy Services Section 1833(g) of the Act applies an annual per beneficiary combined cap beginning January 1, 1999 on outpatient physical therapy and speech-language pathology services and a similar separate cap on outpatient occupational therapy services. These caps apply to expenses incurred for the respective therapy services under Medicare Part B, with the exception of outpatient hospital services. The caps were in effect from January 1, 1999 through December 31, 1999, from September 1, 2003 through December 7, 2003, and beginning January 1, 2006. In 2000 through 2002, and from December 8, 2003 through December 31, 2005, the Congress placed moratoria on implementation of the caps. Section 1833(g)(2) of the Act provides that, for 1999 through 2001, the caps were $1500, and for years after 2001, the caps are equal to the preceding year’s cap increased by the percentage increase in the Medicare Economic Index (MEI) (except that if an increase for a year is not a multiple of $10, it is rounded to the nearest multiple of $10). As discussed in the CY 2006 PFS proposed rule, we implemented the separate statutory limits of $1740 for outpatient physical therapy and speechlanguage pathology services and $1740 for occupational therapy on January 1, 2006. The DRA was enacted on February 8, 2006. Section 5107(a) of the DRA required the Secretary to develop an exceptions process for the therapy caps effective January 1, 2006. The exceptions process applies only to expenses incurred in 2006. Details of the exceptions process were published in a manual change on February 13, 2006 (CR 4364). The change request consists of three transmittals with current numbers of— • Transmittal 855, CR 4364, Pub. L. 100–04; • Transmittal 47, CR 4365, Pub. L. 100–02; and • Transmittal 140, CR 4364, Pub. L. 100–08. The transmittals are available on the CMS Web site at https:// www.cms.hhs.gov/Transmittals/. In accordance with the statute, the therapy caps will remain in effect, but without the exceptions process, for expenses incurred beginning on January 1, 2007. The dollar amount of each therapy cap in CY 2007 will be $1780 (which is the CY 2006 rate ($1740) increased by the percentage increase in the MEI), rounded to the nearest multiple of $10. As noted previously in this section, under the statute, the PO 00000 Frm 00040 Fmt 4701 Sfmt 4700 exceptions process will not apply to therapy services after December 31, 2006, but the therapy caps will remain inapplicable to therapy services provided in the outpatient hospital setting as provided under section 1833(g) of the Act. Comment: We received six comments about therapy caps. All indicated that the cap exception process was working well to assure provision of needed therapy services. Some commenters acknowledged that we do not have the authority to extend therapy cap exceptions, but they requested that we be aggressive in urging the Congress to intervene to extend the exceptions or remove the caps. Several commenters urged us to place a high priority in resources and funding on continuing to conduct research that could be used to identify alternatives to the cap that would ensure that patients receive medically necessary therapy services. Some commenters cited the Medicare Payment Advisory Commission (MedPAC) recommendations of June 2006 regarding continued research into measuring patient condition and treatment outcomes as a basis for reforming the payment system. Commenters also mentioned the Government Accountability Office publication issued in November 2005 (GAO–06–59) recommending that DHHS ‘‘expedite development of a process for ensuring that these services were considered in its efforts to standardize existing patient assessment instruments.’’ Specifically, the one commenter, while recognizing important priorities in allocating limited funds, strongly urged us to conduct research and pilot studies leading to alternatives to therapy caps that ensure the needs of patients are met through high quality care. Another commenter agreed and also noted strong support for development of a condition-based payment as a viable alternative to caps. We received no negative comments concerning the exception process or our efforts to develop alternative payment systems based on the patient’s need for services. Response: As commenters noted, we do not have the authority to extend the exceptions process beyond the December 31, 2006, statutory expiration date. We will continue, to the extent that resources allow, pursuing a payment policy that encourages provision of high quality, covered services to all beneficiaries who need them. Section 5107(b) of the DRA requires the Secretary to implement edits for clinically illogical combinations of E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations procedure codes and other edits to limit inappropriate payment for therapy services by July 1, 2006. As explained in the CY 2006 PFS proposed rule, in January 2006, we implemented Correct Coding Initiative (CCI) edits for the therapy providers that bill the fiscal intermediaries, thus, addressing the section 5107 of the DRA requirement for edits for clinically illogical combinations of procedure codes. Adoption of these code edits ensures that these providers of outpatient Part B therapy services, including SNFs, comprehensive outpatient rehabilitation facilities, certain outpatient physical therapy and speech-language therapy providers (rehabilitation agencies) and home health agencies (HHAs) (where beneficiary is not under a Part A plan of care) meet the same CCI edit requirements as those that have been in place for physicians, private practice therapists, and OPPS hospitals. We also noted that we are considering the implementation of other edits in the future to further address concerns about inappropriate payment for therapy services. Comment: MedPAC indicated that the CCI code-pair edits we have implemented are a good start in controlling inappropriate billing, but encouraged further work and consultation with experts to develop other clinically appropriate edits for therapy services. Response: We appreciate the MedPAC’s remarks and will consider its suggestions in the implementation of future edits. 3. Section 5112—Addition of Ultrasound Screening for Abdominal Aortic Aneurysm (AAA) rmajette on PROD1PC67 with RULES2 a. Coverage Section 5112 of the DRA amended section 1861 of the Act to provide for coverage under Part B of ultrasound screening for AAAs, effective for services furnished on or after January 1, 2007, subject to certain eligibility and other limitations. This screening test will be available even if the qualifying patient does not present signs or symptoms of disease or illness. To conform the regulations to the statutory requirements of section 5112 of the DRA, we proposed to include an exception in § 411.15(a)(1) to permit coverage for ultrasound screening for AAAs that meet the conditions for coverage that we proposed to specify under new § 410.19(b) (Conditions for coverage of an ultrasound screening for abdominal aortic aneurysms). We also proposed to add a new § 411.15(k)(12). VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 As provided in the DRA, this new coverage allows payment for a one-time only screening examination. We proposed new § 410.19(b) to provide for the coverage of the screening examinations for AAAs as specified in section 5112 of the DRA. We also proposed to add new § 410.19(c) (Limitation on coverage of ultrasound screening for abdominal aortic aneurysms.) to provide the limitation on coverage for an individual who is not an eligible beneficiary as defined in new § 410.19(a). We proposed the definitions set forth in new § 410.19(a) to implement the statutory provisions and to help the reader in understanding the provisions of this regulation. The definitions include the following terms: • Eligible beneficiary. • Ultrasound screening for abdominal aortic aneurysms. Specifically, section 5112(a)(1) of the DRA amended section 1861 of the Act to provide that coverage of ultrasound screening for AAAs will be available for an individual: (1) Who receives a referral for such as ultrasound screening as a result of an initial preventive physical examination (IPPE) (as defined in section 1861(ww)(1) of the Act); (2) who has not been previously furnished such as ultrasound screening under this title; and (3) who has a family history of AAA or manifests risk factors included in a beneficiary category recommended for screening by the United States Preventive Services Task Force (USPSTF) regarding AAAs. Section 5112(a)(2) of the DRA also adds a definition of the term ‘‘ultrasound screening for an Abdominal Aortic Aneurysm’’ to mean, ‘‘(1) a procedure using sound waves (or other procedures using alternative technologies, of commensurate accuracy and cost, that the Secretary may specify) provided for the early detection of abdominal aortic aneurysm; and (2) includes a physician’s interpretation of the results of the procedure.’’ Based on this provision, we reviewed the 2005 USPSTF recommendations and related material on ultrasound screening for AAAs which includes— • A recommendation for a one-time ultrasound screening for men aged 65 to 75 who have smoked at least 100 cigarettes in their lifetime; • No recommendation for, or against, ultrasound screening for AAAs for men who have not smoked at least 100 cigarettes in their lifetime; and • A recommendation against routine screening for AAAs in women. Based on the statutory language and the USPSTF recommendations outlined in this section, we proposed to define PO 00000 Frm 00041 Fmt 4701 Sfmt 4700 69663 the term ‘‘eligible beneficiary’’ for coverage of ultrasound screening examinations for AAA to mean an individual who— • Has received a referral for an ultrasound screening as a result of an IPPE (as defined in section 1861(ww)(1) of the Act); • Has not been previously furnished such a covered ultrasound screening examination under the Medicare program; and • Is included in at least one of the following risk categories: + Has a family history of an AAA. + Is a man age 65 to 75 years who smoked at least 100 cigarettes in his lifetime. + Is an individual who manifests other risk factors that are described in a benefit category recommended by the USPSTF regarding an AAA that has been determined by the Secretary through the NCD process. To facilitate our consideration of possible expansions of coverage in the future for identifying other risk factors in a benefit category recommended for screening for the early detection of AAAs by the USPSTF, and alternative screening technologies to ultrasound screening for AAAs of commensurate accuracy and cost, we proposed to add language to our regulations that would allow us to make determinations through the NCD process. The NCD process would allow the Secretary to expand coverage more quickly following an assessment of those subjects than is possible under the standard rulemaking process. We intend to use the NCD process, which includes an opportunity for public comments, for evaluating the medical and scientific issues relating to the coverage of alternative screening technologies and the identification of other risk factors for AAAs recommended by the USPSTF that may be brought to our attention in the future. Use of an NCD to establish a change in the scope of benefits is authorized by section 1871(a)(2) of the Act. An aggrieved party can challenge an NCD under the procedures established by section 1869(f) of the Act. We proposed to add these coverage provisions in new § 410.19 (a)(1)(i) and § 410.19(a)(2)(iii)(C). Section 5112(b) of DRA also amended section 1861(ww)(2) of the Act (the IPPE benefit) by adding the new ultrasound screening benefit to the list of preventive services for which physicians and other qualified nonphysician practitioners (NPPs) must provide ‘‘education, counseling and referral’’ to new beneficiaries who take advantage of the IPPE benefit within the first 6 months after the effective date of E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 69664 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations their first Part B coverage period. Therefore, we also proposed to amend § 410.16(a)(7) of the regulations so that it reflects the additional responsibilities that physicians and qualified NPPs will have under the IPPE benefit for the new ultrasound screening benefit. We received 14 comments that generally supported the proposal to implement section 5112 of the DRA that provides for Medicare coverage of ultrasound screening for AAAs. Several commenters had suggestions for revising certain specific coverage provisions of the proposal. Comment: Several commenters addressed the issue of the need for certification of qualification requirements for the Medicare providers or suppliers who furnish beneficiaries with the new ultrasound screening for AAAs. A commenter referenced the USPSTF recommendations that state, ‘‘There is good evidence that abdominal ultrasonography, performed in a setting with adequate quality assurance (that is, in an accredited facility with credentialed technologists), is an accurate screening test for AAA.’’ The commenter noted that the proposed rule did not mention the qualifications of the people performing the screening and strongly recommended that quality standards be applied to any laboratories performing this testing. Response: Section 5112 of the DRA provides for coverage of a one-time ultrasound screening for AAAs for beneficiaries, subject to certain eligibility and other limitations. However, section 5112 does not expressly address the subject of quality standards for the providers or suppliers of these services and, therefore, in the absence of a clearly demonstrated need for quality or qualification standards that are specifically targeted to ultrasound screenings for AAAs, we do not believe it is appropriate to establish at this time such detailed standards for these services. We believe that any Medicare provider or supplier that is authorized to provide covered diagnostic ultrasound services is qualified to provide covered ultrasound screening services for AAAs. The ultrasound test is conducted in a similar manner whether the test is for a screening or diagnostic purpose. We are adding language at § 410.19(b) to reflect this condition. Comment: Two commenters expressed concern that many beneficiaries who became entitled to Medicare Part B coverage for the first time before the IPPE benefit became effective (January 2005) will not be able to qualify for coverage of the ultrasound VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 screenings for AAAs because of the IPPE referral requirement for the exam. Response: The commenters are correct that the IPPE referral requirement for coverage of the ultrasound screening for AAAs will preclude many older beneficiaries from qualifying for coverage of the exam, but that requirement is specified in section 5112 of the DRA. It would require a change in the statute to permit us to expand the scope of the benefit to older beneficiaries who do not satisfy this requirement. Comment: Several commenters suggested that we should implement safeguards against providers billing for duplicative testing for the AAA screening and an abdominal or retroperitoneal ultrasound exam (with a diagnosis such as abdominal pain) later the same or the next day. Response: We agree that the potential for duplicative billing for the screening and the diagnostic ultrasound test of the same type does exist. Therefore, we will work with our contractors to implement the necessary safeguards to insure that this type of billing does not occur. Comment: Several commenters are concerned that the proposed rule does not provide any guidance on the meaning of the statutory IPPE referral requirement for coverage of the AAA screening service. The commenter suggests that the term ‘‘referral’’ should be interpreted to include a practitioner’s ‘‘direction to receive care from a qualified provider’’ that may be provided orally or in written form during or after the eligible beneficiary receives his or her IPPE service. Response: Section 410.16(a)(7) (as modified in this final rule) provides that each eligible beneficiary who takes advantage of that benefit is entitled (among other things) to education, counseling, and referral, including a brief written plan such as a checklist provided to the beneficiary for obtaining appropriate screening and other preventive services that are covered as separate Medicare benefits, such as the ultrasound screening for AAAs. Based on this referral provision for the IPPE benefit, we believe there is considerable flexibility that is allowed the IPPE provider in making referrals to qualified Medicare providers of screening and other preventive services, such as the AAA screening service. However, at a minimum, we believe § 410.16(a)(7)of the IPPE regulation requires that the referral include a brief written plan provided the beneficiary for obtaining, if appropriate, the AAA screening service from a qualified Medicare provider. Comment: Several commenters recommended that we monitor the PO 00000 Frm 00042 Fmt 4701 Sfmt 4700 utilization of the new AAA screening benefit over the next couple of years to determine if beneficiary access to this service is a concern that requires our efforts to ensure appropriate beneficiary awareness and utilization of the benefit. Response: We agree that we should monitor use of this benefit to ensure that there is appropriate beneficiary awareness and use of the service. Comment: A commenter urged us to implement a targeted campaign to educate beneficiaries and physicians about the new screening benefit and to encourage their use of it. Response: We will release the appropriate manual and transmittal instructions and other information, including a ‘‘Medicare Learning Network (MLN) Matters’’ provider education article, an updated new ‘‘Medicare Preventive Services Guide,’’ and other information. We would encourage the medical community to contribute to this effort by distributing their own communications, bulletins, or other publications to physicians, qualified NPPs, and beneficiaries. Except for the additional language added at § 410.19(b) relating to the ability of a provider or supplier to furnish ultrasound diagnostic services, we are finalizing this section as proposed to provide for coverage of the AAA screening service for beneficiaries under the statute, subject to the statutory eligibility and other limitations. b. Payment Beginning January 1, 2007, we proposed to pay for ultrasound screening for AAAs through the use of a new HCPCS code G0389, Ultrasound, B-scan and/or real time with image documentation; for abdominal aortic aneurysm (AAA) screening. We proposed that payment for this service be made at the same level as CPT code 76775, Ultrasound, retroperitoneal (eg, renal, aorta, nodes), B-scan and/or real time with image documentation; limited. CPT code 76775 is used to bill for the service when it is provided as a diagnostic test, and we believe the service associated with the HCPCS codereflects equivalent resources and work intensity to those contained in CPT code 76775. In addition, since the DRA provides that the Medicare Part B deductible will not apply for ultrasound screening for AAA (as defined in section 1861(bbb) of the Act), we proposed to revise § 410.160 to include an exception from the Medicare Part B deductible for the ultrasound screening for AAA as described in § 410.19 (Conditions for E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations rmajette on PROD1PC67 with RULES2 coverage of an ultrasound screening for abdominal aortic aneurysms). Comment: Commenters were in agreement with the proposed payment amount for this service. Response: We will adopt the proposed values for this new HCPCS code (that is, make it equivalent to CPT code 76775). This service will be identified by the following code number and descriptor G0389, Ultrasound, B-scan and/or real time with image documentation; for abdominal aortic aneurysm (AAA) screening. We will also finalize the proposed revisions to § 410.160 to include an exception from the Medicare Part B deductible for the ultrasound screening for AAA as described in § 410.19. 4. Section 5113—Non-Application of the Part B Deductible for Colorectal Cancer Screening Tests Current Medicare policy requires that, with limited exceptions, incurred expenses for covered part B services are subject to, and count toward meeting the Part B annual deductible. Section 5113 of the DRA amended section 1833(b) of the Act to provide for an exception to the application of the Part B deductible for colorectal cancer screening tests. Beginning January 1, 2007, colorectal cancer screening services, as described in section 1861(pp)(1) of the Act, are no longer subject to the Part B deductible. The conditions for and limitations on coverage for colorectal cancer screening tests under Medicare Part B are described in § 410.37. To conform our regulations to this statutory change, we proposed to revise § 410.160 to include an exception from the Part B annual deductible for the colorectal cancer screening services described in § 410.37. Comment: Commenters were supportive of this conforming change. However, it was pointed out that we had failed to address the situation where a colorectal cancer screening service actually results in a beneficiary having a biopsy or a growth removed, requiring the service to be coded as a diagnostic procedure. Clarification was requested as to whether in such situations, the deductible would still be waived. Response: Section 1834(d)(3)(D) of the Act states ‘‘if during the course of such screening colonoscopy, a lesion or growth is detected which results in a biopsy or removal of the lesion or growth, payment under this part shall not be made for the screening colonoscopy but shall be made for the procedure classified as a colonoscopy with such biopsy or removal.’’ Based on this statutory language, in such VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 instances the test or procedure is no longer classified as a ‘‘screening test.’’ Thus, the deductible would not be waived in such situations. After reviewing the public comments, we are finalizing § 410.160 as proposed. 5. Section 5114—Addition of Diabetes Outpatient Self-Management Training Services (DSMT) and Medical Nutrition Therapy (MNT) for the FQHC Program Section 5114 of the DRA amended section 1861(aa)(3) the Act to add DSMT and MNT services to the list of Medicare covered and reimbursed services under the Medicare FQHC benefit, effective for services provided on or after January 1, 2006. Although this statutory change has already been implemented in administrative instructions, we proposed to conform the regulations to the new statutory requirement. FQHCs certified as DSMT and MNT providers have been allowed to bundle the cost of those services into their FQHC payment rates. But before the enactment of the DRA, the provision of these services would not generate a separate FQHC visit payment. Effective for services furnished on or after January 1, 2006, FQHCs that are certified providers of DSMT and MNT services can receive per visit payments for covered services furnished by registered dietitians or nutrition professionals. That is, if all relevant program requirements are met, these services are included under the Medicare FQHC benefit as billable visits. In public response to the proposed rule, we received a small number of comments expressing support for our proposal. Therefore, we will finalize the changes as proposed. To conform the regulations, we are amending § 405.2446(b) to expand the scope of FQHC services to include certified providers of DSMT and MNT services by adding a new paragraph (b)(10). We are also revising § 405.2463 by— • Revising paragraph (a) to expand the definition of an FQHC visit to include certified providers of DSMT and MNT services under new paragraph (a)(1)(ii)(B). We are also revising the definition of an rural health clinic (RHC) visit in new paragraph (a)(1)(i) to include a face-to-face encounter between a patient and a clinical psychologist or clinical social worker to conform to statutory language at section 1861(aa)(1)(B) of the Act. We also proposed to redesignate and revise paragraphs (b) and (c) as new paragraphs (a)(2) and (a)(3), respectively. PO 00000 Frm 00043 Fmt 4701 Sfmt 4700 69665 • We are incorporating paragraph (a)(2) into (a)(1), and redesignating and revising current paragraph (a)(3) as new paragraph (b). We also clarify that it is generally permissible for both FQHCs and RHCs to furnish, when necessary, most types of medical and other health visits on the same day to the same patient. We also amend this paragraph to permit a separate additional FQHC visit for DSMT and MNT services (which may occur on the same date of service when the beneficiary receives care from their FQHC physician or NPP) when reasonable and necessary, consistent with the Congressional mandate under section 5114 of the DRA to provide coverage and adequate access to these services in the FQHC setting. • Finally, we are redesignating and revising current paragraph (a)(4) as new paragraph (c). F. Payment for Covered Outpatient Drugs and Biologicals (ASP Issues) Medicare Part B covers a limited number of prescription drugs and biologicals. For the purposes of this final rule with comment period, the term ‘‘drugs’’ will hereinafter refer to both drugs and biologicals. Medicare Part B covered drugs not paid on a cost or prospective payment basis generally fall into the following three categories: • Drugs furnished incident to a physician’s service. • Durable medical equipment (DME) drugs. • Drugs specifically covered by statute (for example, certain immunosuppressive drugs). Beginning in CY 2005, the vast majority of Medicare Part B drugs not paid on a cost or prospective payment basis are paid under the average sales price (ASP) methodology. The ASP methodology is based on data submitted to us quarterly by manufacturers. In addition to the payment for the drug, Medicare currently pays a furnishing fee for blood clotting factors, a dispensing fee for inhalation drugs, and a supplying fee to pharmacies for certain Part B drugs. In January 2006, the drug coverage available to Medicare beneficiaries expanded with the implementation of the Medicare Part D benefit. The Medicare Part D benefit does not change Medicare Part B drug coverage. This section of the preamble discusses changes and issues related to the determination of the payment amounts for covered Part B drugs and furnishing blood clotting factor. This section also discusses changes to how manufacturers calculate and report ASP data to us. E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 69666 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 1. ASP Issues Section 303(c) of the MMA amended title XVIII of the Act by adding new section 1847A. This new section revised the payment methodology for the vast majority of drugs and biologicals not paid on a cost or prospective payment basis furnished on or after January 1, 2005. The ASP reporting requirements are set forth in section 1927(b) of the Act. Manufacturers must submit ASP data for each 11-digit NDC to us quarterly. The manufacturers’ submissions are due to CMS no later than 30 days after the last day of each calendar quarter. The methodology for developing Medicare drug payment allowances based on the manufacturers’ submitted ASP data is described in the regulations in part 414, subpart K. We update the Part B drug payment amounts quarterly based on the data we receive. On April 6, 2004, we published the Manufacturer’s Submission of Average Sales Price Data for Medicare Part B Drugs and Biologicals (ASP) interim final rule with comment period (IFC) (69 FR 17935) to implement the ASP calculation and reporting requirements. Manufacturers were required to submit their initial quarterly ASP data to us shortly thereafter, by April 30, 2004. We received comments on the April 6, 2004 IFC from drug manufacturers, pharmacies, physicians, national associations of the pharmaceutical industry, national associations of physicians, and consultants. These comments addressed a variety of aspects of calculating and reporting ASPs. On September 16, 2004, we published the Manufacturer’s Submission of Average Sales Price Data for Medicare Part B Drugs and Biologicals (ASP) final rule (69 FR 55763) addressing only the comments pertaining to the methodology for estimating lagged price concessions. We have also addressed ASP calculation and reporting requirements in other proposed and final rules and information collection notices, including rulemaking to implement the Competitive Acquisition Program for Part B Drugs and Biologicals (CAP) (70 FR 39069, 70 FR 45842, 70 FR 70215, 70 FR 70477, and 71 FR 48130). In addition, we have posted official agency guidance, including responses to frequently asked questions, on our Web site to implement the ASP provisions in accordance with section 1847A(c)(5)(C) of the Act. In the CY 2007 PFS proposed rule, we stated that we intended to finalize the April 6, 2004 IFC in the near future and that we may publish the final rule as part of this rulemaking, or as a separate VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 final rule. We also stated that because the comments received during the comment period in response to the April 6, 2004 IFC were made during the initial months of manufacturers’ experience with calculating and reporting ASPs and prior to publication of payment amounts based on the ASP methodology, we believed there was good reason to give the public an opportunity to provide additional comments. Therefore, we sought comments on the ASP reporting provisions in the April 6, 2004 IFC, as well as several topics specifically discussed in the CY 2007 PFS proposed rule. These topics included: Fees not considered price concessions, excluded sales known on a lagged basis, nominal sales, and other price concession issues. In this final rule with comment period, we are responding to comments received on the April 6, 2004 IFC and the CY 2007 PFS proposed rule and revising provisions related to the estimation methodology for price concessions known on a lagged basis, which were finalized in the September 16, 2004 final rule. Except as otherwise specified in this final rule with comment, we are finalizing the provisions of part 414, subpart J as presented in the April 6, 2004 IFC. a. Comments Not Related to ASP Reporting As stated in the CY 2007 PFS proposed rule, we received numerous comments on the use and potential impacts of the ASP payment methodology. The April 6, 2004 IFC implemented provisions of the MMA related to how manufacturers calculate ASP and report their ASP data. Thus, comments about the appropriateness and use of 106 percent of the ASP as a basis for Medicare Part B drug payment rates are outside the scope of the final ASP reporting rule. Implementation of the ASP payment methodology as the basis for establishing payment amounts for the vast majority of Part B drugs was discussed in notice and comment rulemaking in the CY 2005 PFS proposed and final rules (69 FR 47520 and 69 FR 66299). Comments about the ASP payment methodology that address issues other than how manufacturers calculate and report their ASPs are outside the scope of this rulemaking. Other topics for which we received comments that are not within the scope of this rulemaking and are not otherwise addressed are as follows: • How the ASP-based payment rates are calculated; • How NDCs are assigned to billing codes; PO 00000 Frm 00044 Fmt 4701 Sfmt 4700 • Requests for billing codes for specific products; • Whether alternative payment methodologies or exceptions to the ASPbased payment should be considered; • Billing and claims processing and adjudication issues; • Variation in local coverage policies: • Whether Part B policies apply to Medicaid and/or Part D; • Issues related to Competitive Acquisition of Outpatient Drugs and Biologicals Under Part B (CAP); and • Issues pertaining to the content and format of the quarterly Part B drug pricing files. b. Fees Not Considered Price Concessions Section 1847A(c)(5)(A) of the Act states that the ASP is to be calculated by the manufacturer on a quarterly basis. As a part of that calculation, manufacturers must take into account price concessions such as— • Volume discounts; • Prompt pay discounts; • Cash discounts; • Free goods that are contingent on any purchase requirement; • Chargebacks; and • Rebates (other than rebates under the Medicaid drug rebate programs). If the data on these price concessions are lagged, then the manufacturer is required to estimate costs attributable to these price concessions using the required ratio methodology as specified in § 414.804(a)(3). This methodology was finalized in the September 16, 2004 final rule based on comments submitted in response to the April 6, 2004 IFC. In the CY 2007 PFS proposed rule, we proposed modifications to the requirements for estimating lagged price concessions specified § 414.804(a)(3) to conform with other proposals put forth in the proposed rule. Comments received in response to the proposed rule related to potential impacts on the estimation of lagged price concessions are discussed in the appropriate subsections in this section. In response to the April 6, 2004 IFC, commenters representing drug manufacturers, national associations of wholesalers and distributors, and physicians and other health care providers requested clarification and detailed guidance on the treatment of administrative fees, service fees and fees paid to pharmacy benefit managers (PBMs) in the ASP calculation. We posted guidance on our Web site (https://questions.cms.hhs.gov/cgi-bin/ cmshhs.cfg) to clarify that in the absence of specific guidance in the Act or Federal regulations, the manufacturer may make reasonable assumptions in its E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations calculations of ASP, consistent with the general requirements and intent of the Act, Federal regulations, and its customary business practices. These assumptions should be submitted along with the ASP data. In December 2004, we posted further guidance on our Web site addressing service fees and administrative fees paid to buyers (https://questions.cms.hhs.gov/cgi-bin/ cmshhs.cfg). On July 6, 2005, we restated our guidance on service fees in the preamble of the Competitive Acquisition of Outpatient Drugs and Biologicals Under Part B (CAP) interim final rule with comment (70 FR 39069). Subsequently, we received requests for clarification on how fees paid to entities such as group purchasing organizations (GPOs) or PBMs must be treated for purposes of the ASP calculation. Therefore, we proposed to further clarify in the final ASP reporting rule that, beginning with the ASP reporting for sales during the first quarter of CY 2007, bona fide service fees that are paid by a manufacturer to an entity, whether or not the entity takes title to the drug, are not considered price concessions under § 414.804(a)(2) insofar as, and to the extent that, they satisfy the definition of a bona fide service fee that we proposed at § 414.802. In § 414.802, we proposed to define bona fide service fees as fees paid by a manufacturer to an entity that represent fair market value for a bona fide, itemized service actually performed on behalf of the manufacturer that the manufacturer would otherwise perform (or contract for) in the absence of the service arrangement, and that are not passed on, in whole or in part, to a client or customer of an entity, whether or not the entity takes title to the drug. We further proposed that our current guidance, which provides that bona fide service fees means expenses that would have generally been paid for by the manufacturer at the same rate had these services been performed by other entities, would remain in effect unless we adopted an alternative approach. Further, we proposed to clarify in the final ASP reporting rule that fees, including service fees, administrative fees and other fees, paid to GPOs or PBMs are not considered price concessions under § 414.804(a)(2) insofar as, and to the extent that, they satisfy the definition of a bona fide service fee that we proposed at § 414.802. In the CY 2007 PFS proposed rule, we discussed comments to the April 6, 2004 IFC that provided some insight into the types of activities that are performed in the distribution of drugs. We noted that these comments did not VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 provide detailed information about whether and how one would determine the extent to which these activities are bona fide services actually performed on behalf of the manufacturer. To better understand the scope of appropriate bona fide services and how they may vary across categories of drugs, we sought comment on the specific types of services entities performed on behalf of the manufacturer and the necessity of those services in the efficient distribution of drugs. We also stated that we were considering providing further guidance on the types of services that may qualify as bona fide services for purposes of the ASP calculation. We also indicated that we were considering providing further guidance on or revising the approach or methodology manufacturers must use to determine the fair market value of bona fide services performed on their behalf and whether the service fee paid was passed on in whole or in part, as well as activities that should not be considered bona fide services performed on behalf of manufacturers, and bona fide services that may be appropriate for all or specific types of products or circumstances. We also sought comments on the costs and relative costs of services performed on behalf of manufacturers. Specifically related to the determination of whether or not a fee represents fair market value for ASP purposes, we solicited comments on the potential appropriateness of fees tied to performance of a service, fixed fee, revenue generated by product sales, or other basis. In addition, we requested comments on the appropriate methods for determining whether a fee is passed on in whole or in part and on how Medicare’s guidance on the treatment of service fees for ASP calculation purposes may differ with the treatment of service fees for financial accounting or other purposes, and any implications that this may have for manufacturers. Comment: We received numerous comments on the topic of service fees. Among the commenters there was general agreement with our clarification that the treatment of bona fide service fees in the ASP calculation should not be conditioned on whether or not the entity takes title to the drug. However, many commenters objected to a definition of bona fide service fee that would limit in any way the services or amount of fee that a manufacturer would establish in a contract with any partner in the distribution of drugs or that otherwise would limit flexibility and evolution in the industry. Many of the commenters on this issue were opposed to establishing a list of bona PO 00000 Frm 00045 Fmt 4701 Sfmt 4700 69667 fide services; while a few commenters requested that certain services such as ‘‘pick, pack and ship,’’ chargeback administration, data services, and patient care programs be specifically included in a list of bona fide services. A few commenters stated that such a list, even if the list were illustrative, would be helpful in standardizing the treatment of service fees across manufacturers’ ASP calculations. Other commenters cautioned that establishing a list of bona fide services would require ongoing refinement in order for manufacturers to accurately calculate ASPs as service fee arrangements evolved. Several commenters recommended that we adopt a more general standard for evaluating whether an arrangement represents a bona fide service fee arrangement. However, very few suggestions for modifying the wording of the proposed definition of bona fide service fee were offered. One commenter recommended changing ‘‘itemized’’ to ‘‘supply chain’’ to address concerns regarding how fair market value may be determined, and several commenters recommended that we delete the requirement that the fees not be passed on; these comments are discussed in more detail below in this section. In discussing how a more general standard might be applied, several commenters suggested allowing the marketplace to decide the appropriate scope of services and fair market value. These commenters stated that this approach would result in a satisfactory means of determining fees that are not price concessions (that is, are bona fide and not passed on) by virtue of the competitiveness of the market for drug distribution service. Under this approach, any service and price agreed to in an arm’s-length contract with the manufacturer would be sufficient for determining that the services were bona fide and at fair market value for ASP purposes. Other commenters, who support a general standard, suggest that so long as a service is ‘‘reasonably necessary’’ or ‘‘necessary and useful’’ in meeting a manufacturer’s business needs, it should be considered to be both bona fide and a service performed on behalf of the manufacturer. These commenters emphasize that the purpose of the service should determine whether it was performed on behalf of the manufacturer. As a result, in the opinion of these commenters, all activities related to distributing drugs are services a manufacturer would either have to perform or contract for if it did not have the capacity to perform E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 69668 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations the activity or chose not to perform the activity. Some of the comments in support of a general standard pointed to the personal services safe harbor from antikickback penalties as specified in 42 CFR 1001.952(d)(7) as a potential benchmark for purposes of identifying services and fees that would be excluded from the ASP calculation. Other commenters recommended that any reasonable method of determining fair market value should be acceptable. However, several commenters requested that we specify the acceptable methods for determining fair market value. A small number of commenters requested that we specifically address whether the income method, market method or cost method could be used to estimate the range for fair market value of the bona fide service fee arrangement for ASP purposes. These commenters did not provide details on the applicability of these three methods for estimating fair market value for commonly performed drug distribution services. Many commenters stated that, regardless of the method used to determine fair market value, manufacturers should be permitted to calculate fair market value across a set of services (in lieu of determining fair market value for each itemized service specified in an arrangement), and that it would be impossible to calculate fair market value adequately for certain low-volume or value-added services or certain services that can only be performed by the purchaser (for example, in the case of wholesalers, compiling, and sharing retail customer data). Some commenters noted that service fee contracts may be broadly constructed for a set of services across a number of drugs without itemizing each service or activity. To reflect market practices and trends, as noted above in this section, one commenter recommended that we revise the proposed definition of bona fide service fees to remove the word ‘‘itemized’’ and, in its place, insert ‘‘supply chain.’’ Several commenters supported our proposed definition of bona fide service fees in general, while also suggesting that we refine or eliminate the ‘‘not passed on’’ requirement because it is not needed if the services included in an arrangement are bona fide and the fee represents fair market value. A number of commenters offered that including ‘‘itemized’’ in the definition was unnecessary for the same reason. While a few commenters stated that specific requirements not to pass on fees and terms requiring disclosure of any fees passed on could be written in the bona fide service fee contracts. In contrast, VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 several commenters stated that for a variety of reasons, manufacturers may not know or be able to accurately certify that a fee is not passed on in whole or in part. These commenters identified anti-trust constraints as one such reason. Commenters asked that: (1) We clarify that services that can only be performed by the party that takes possession of the drug from the manufacturer may be considered to be bona fide services; and (2) we remove the limitation in our current guidance that bona fide service fees must be at the same rate had these services been performed by other entities. We did not receive comments on services that should not be considered bona fide services, or on the costs or relative costs of services performed on behalf of manufacturers. Response: After consideration of the comments received, we are finalizing our proposed definition of bona fide service fees at § 414.802 which specifies that in order for a fee to be determined not to be a price concession, and thus to be excluded from the calculation of the ASP, the following conditions must be met: • The fee paid must be for a bona fide, itemized service that is actually performed on behalf of the manufacturer; • The manufacturer would otherwise perform or contract for the service in the absence of the service arrangement; • The fee represents fair market value; and • The fee is not passed on in whole or in part to a client or customer of any entity. We believe that if a fee satisfies the definition of bona fide services fees it can be excluded from the calculation of the ASP. We believe the specificity and scope of this definition provides an appropriate safeguard against the potential risk for inappropriately higher ASPs, while adopting a more general standard, a more limited definition or relying solely on market forces, as some commenters suggested, would not. This is because, taken together, this four elements describe those situations in which we believe a fee paid is compensation for services rather than a price concession for drugs. We disagree with the comments that recommended alternative standards because a definition with greater breadth or less specificity or both would not as clearly distinguish bona fide services fees from price concessions and could result in inappropriately high ASPs and insconsistent treatment of services fees (for example, if we were to permit a fee for any services at any price to be PO 00000 Frm 00046 Fmt 4701 Sfmt 4700 excluded from the calculation of ASP or to eliminate the ‘‘not passed on’’ or ‘‘itemized’’ requirements.) However, we found many of the comments informative with respect to how our definition of a bona fide service fee is met and we discuss below in this section how these comments have been incorporated into our guidance. In codifying the definition of bona fide service fees, we seek to clarify a framework for differentiating between those price concessions that must be included in the calculation of ASP and bona fide service fees,which are not included in the calculation of ASP. Beginning with the effective date of this final rule with comment, the definition of bona fide service fees will apply to the ASP reporting for sales during the first calendar quarter of 2007. Additional guidance is discussed below. (1) Bona fide, Itemized, Actually Performed on Behalf of the Manufacturer and ‘‘Otherwise Performed’’ The first and second elements of the definition of bona fide service fees relate to the scope of bona fide services for which a fee paid does not represent a price concession for ASP purposes. To be considered a bona fide service fee, the fee must be for services that are: Bona fide, itemized, actually performed on behalf of the manufacturer, and those the manufacturer would otherwise perform or contract for in the absence of the service arrangement. Some commenters requested further guidance on these elements. We were persuaded by comments that referenced the necessity or usefulness of services. Therefore, we interpret these elements of the definition to encompass any reasonably necessary or useful services of value to the manufacturer that are associated with the efficient distribution of drugs. In response to commenters’ concerns, we are clarifying that services ‘‘on behalf of’’ the manufacturer include both those the manufacturer has the capacity to perform, and those that can only be performed by another entity. Although some commenters provided us with general information on what they would view to be bona fide services, to avoid inadverently limiting the scope of what could constitute a bona fide service, we will not establish a list of ‘‘bona fide services’’ at this time. (2) Fair Market Value The third element of the definition of bona fide service fees specifies that the fees must represent fair market value. In response to comments, we are refining our current guidance to address E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations rmajette on PROD1PC67 with RULES2 concerns that it may not permit exclusion from ASP of fees for services that can only be performed by the entity to which the fee is paid. Therefore, our guidance is that bona fide service fees means expenses that generally would have been paid for by the manufacturer at the same rate had these services been performed by other or similarly situated entities. In addition, we tend to agree with the commenters that, in certain circumstances, it may be appropriate to calculate fair market value for a set of itemized bona fide services, rather than fair market value for each individual itemized service, when the nature of the itemized services warrants such treatment. We also tend to agree that the appropriate method or methods for determining whether a fee represents fair market value may depend upon the specifics of the contracting terms, such as the activities the entity will perform and the agreed-upon mechanism for establishing the payment (for example, percentage of goods purchased). We believe manufacturers are wellequipped to determine the most appropriate, industry-accepted method for determining fair market value of drug distribution services for which they contract. Therefore, we are not mandating the specific method manufacturers must use to determine whether a fee represents fair market value for purposes of excluding bona fide service fees from the calculation of ASP. (3) ‘‘Not Passed On’’ We appreciate the commenter views on the fourth element of the definition of bona fide service fees, which specifies that the bona fide service fee must not be passed on, in whole or in part, to a client or customer of an entity. At this time, we understand that there may be significant barriers that limit a manufacturer’s ability to determine whether a fee that otherwise meets the definition of ‘‘bona fide service fee’’ described in this rule is passed on, in whole or in part, to a client or customer of any entity. Nevertheless, we believe that it is essential to retain the ‘‘not passed on’’ element in the definition of bona fide service fees. The ‘‘not passed on’’ element is, in our view, a key factor in distinguishing a price concession from a bona fide service fee because, if a fee that is passed on is excluded from the ASP calculation, then there is a greater risk of the ASP being inappropriately higher. However, we recognize that, in some instances, manufacturers may have no effective way of knowing whether a fee paid that meets the other elements of VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 the definition of ‘‘bona fide service fee’’ is passed on. Although we decided to retain the ‘‘not passed on’’ requirement in the definition of bona fide service fees because of its importance in distinguishing bona fide service fees from price concessions, we believe it is appropriate to seek to balance our goal of ensuring appropriate Medicare payments are made with the level of burden a manufacturer would have to undertake to validate that a fee was not passed on. Therefore, with respect to certifying to the accuracy of their ASP calculations when it is unknown to the manufacturer whether the fee paid was passed on in whole or in part to a client or customer of any entity, we are clarifying, in this preamble, how manufacturers may address this concern. If a manufacturer has determined that a fee paid meets the other elements of the definition of ‘‘bona fide service fee,’’ then the manufacturer may presume, in the absence of any evidence or notice to the contrary, that the fee paid is not passed on to a client or customer of any entity. Comment: Several commenters indicated that some of the fees that they believe would meet our definition of bona fide services fees for ASP purposes would be treated as a reduction to revenues for financial accounting purposes. Commenters asked us to clarify that the treatment of service fees for ASP purposes and financial accounting purposes may be different, and that if a fee meets our definition of a bona fide service fee it can be excluded from the ASP regardless of its treatment for financial accounting purposes. Response: Fees that meet our definition of bona fide service fees are not considered price concessions for purposes of the ASP calculation, regardless of how they are treated for financial accounting purposes. Comment: Many commenters asserted that all fees and other payments to GPOs and PBMs should be excluded from ASP because the statute requires only that sales to purchasers be included in ASP, and, they argue, GPOs and PBMs are not purchasers, do not take title to and possession of products, and the fees paid to GPOs and PBMs are not passed on to physicians (or other providers) in a manner that can be attributable to a particular purchase or drug. Commenters asked that, if we consider fees paid to GPOs and PBMs to be price concessions (except to the extent that the fees are bona fide service fees for purposes of the ASP calculation), we allow fees paid to the GPOs and PBMs under arrangements that meet the antikickback safe harbor for purchasing PO 00000 Frm 00047 Fmt 4701 Sfmt 4700 69669 arrangements to be excluded from the ASP calculation without having to meet our definition of bona fide service fees. Other commenters expressed concern that considering GPO and PBM fees to be price concessions could artificially deflate ASP such that it would not accurately reflect the costs incurred by physicians and other providers. Another commenter suggested that we provide additional guidance on payments to managed care organizations. Response: We note that we did not make a specific proposal with respect to how PBM and GPO fees must be treated for ASP purposes other than to say that to the extent that such fees meet the definition of ‘‘bona fide service fee,’’ they are excluded from the calculation of ASP. We are continuing to develop our understanding of the variety of agreements made with entities such as PBMs and GPOs and the possible effects of these arrangements on the calculation of ASP and provider acquisition costs. For this reason, at this time we believe it is premature for us to provide specific guidance with respect to treatment of fees paid by manufacturers to PBMs and GPOs in the ASP calculation (other than to specify, as we proposed, that PBM and GPO fees that meet the definition of ‘‘bona fide service fees’’ are excluded from the calculation of ASP). Instead, we will continue to consider the comments received and to study the matter further. In addition, we may take into consideration how fees paid to these entities are addressed in the context of the Medicaid drug rebate program. We also note that the MedPAC commented that in the upcoming year it would be continuing to examine the issue of the average prices physicians pay and the effect of price concessions that might not be passed on to physicians. In the absence of specific guidance, the manufacturer may make reasonable assumptions in its calculations of ASP, consistent with the general requirements and the intent of the Act, Federal regulations, and its customary business practices. These assumptions should be submitted along with the ASP data. Recognizing that the treatment of fees to PBMs and GPOs in the ASP calculation may have implications for the integrity of the ASP payment methodology, we will be paying close attention to this issue and may provide more specific guidance in the future through rulemaking or through program instruction or other guidance (consistent with our authority under section 1847A(c)(5)(C) of the Act). Comment: Many commenters noted that the Congress excluded wholesaler E:\FR\FM\01DER2.SGM 01DER2 69670 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations rmajette on PROD1PC67 with RULES2 prompt pay discounts from the calculation of average manufacturer price (AMP) under the DRA. Commenters asserted that we have the authority to extend this provision to ASP reporting and thus could exclude wholesaler prompt pay discounts from ASP reporting. Response: We do not agree that extending the DRA provision to ASP reporting would be consistent with Congressional intent. Section 1847A(c)(3) does not specify a carve-out for prompt pay discounts extended to wholesalers. Therefore, along with all other prompt pay discounts, prompt payment discounts extended to wholesalers must be included in the calculation of ASP. c. Estimation Methodology for Lagged Exempted Sales Section 1847A(c)(2) of the Act requires manufacturers to exclude from the calculation of ASP those sales that are exempt from inclusion in the determination of Medicaid best price (BP). In the comments on the April 6, 2004 IFC, commenters requested more guidance on the method manufacturers should use to exclude exempted sales that are known on a lagged basis. Manufacturers identify exempted sales based on direct sales and through chargeback and rebate data that may not be sufficiently available at the time the ASP is calculated. In the absence of specific guidance on how to account for lagged exempted sales (that is, exempted sales identified through chargeback or rebate processes), manufacturers have relied upon assumptions in accordance with their customary business practices to develop their approach for excluding these sales from the ASP calculation. In our work with manufacturers that submit ASP data, we understand that some manufacturers have used a ratio methodology for estimating exempted sales known on a lagged basis that is similar to the ratio methodology manufacturers must use to estimate price concessions known on a lagged basis. To establish a uniform approach, we proposed to require, in the final ASP reporting rule, that all manufacturers use a 12-month (or less, if applicable) rolling average ratio methodology to estimate exempted sales known on a lagged basis (through chargebacks or rebates) to more accurately exclude these sales from the ASP calculation. Specifically, for exempted sales known on a lagged basis, the manufacturer would sum the lagged exempted sales for the most recent 12-month period available (or the number of months the VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 NDC has been sold for NDCs with less than 12 months of sales, except for redesignated NDCs as described in section II.F.1.e.). The manufacturer then calculates a percentage using this summed amount as the numerator and the sales (the number of units after nonlagged exempted sales have been subtracted from total sales) for the same period (12 months or less, if applicable) as the denominator. The result would be a rolling average percentage estimate for lagged exempted sales that is applied to the sales (the number of units after nonlagged exempted sales have been subtracted from total sales) for the quarter being reported. The product that results from multiplying the rolling average percentage estimate of lagged exempted sales and sales (the number of units after non-lagged exempted sales have been subtracted from total sales) would determine the number of lagged exempted sales (in units) to be excluded from the denominator of the ASP calculation. Manufacturers would be required to make a corresponding adjustment to the numerator of the ASP calculation to ensure that the total in dollars for the reporting quarter does not include revenue related to lagged, exempted sales excluded from the denominator using the proposed estimation methodology. Further, manufacturers would be required to remove the dollar value of lagged exempted sales from their estimates of lagged price concessions by subtracting the dollar value of estimated lagged exempted sales from the denominator as specified in § 414.804(a)(3)(i). Our proposed methodology for excluding lagged, exempted sales is similar to the methodology manufacturers are required to use to estimate price concessions known on a lagged basis, and was recommended by manufacturers. We believe requiring similar methods to estimate both lagged exempted sales and lagged price concessions would be reasonable and reduces potential errors in the manufacturers’ ASP calculations, while ensuring that exempted sales are appropriately removed from the ASP calculation. In addition, using an estimation methodology to remove lagged exempted sales would reduce the likelihood of quarter-to-quarter variations in the ASP. We sought comments on the proposed methodology for excluding exempted sales known on a lagged basis from the ASP calculation and estimate of lagged price concessions. We also solicited suggestions on appropriate alternative methodologies that may be less complex. PO 00000 Frm 00048 Fmt 4701 Sfmt 4700 Comment: We received comments that were supportive of our approach. However, some commenters stated that the proposed methodology would be overly complex and inappropriate for certain types of exempted sales known on a lagged basis. Several commenters stated that the proposed methodology would be helpful and useful for accurately excluding from the ASP calculation sales excluded based on the type of entity to which the sale is made and known on a lagged basis (for example, sales relating to subclauses (I), (II), and (IV) of section 1927(c)(1)(C)(i) of the Act). However, most of these commenters cautioned that use of the proposed methodology to estimate and exclude from the ASP calculation sales which are excluded on the basis of rebates paid to State pharmacy assistance programs and Part D plans or qualified retiree prescription drug plans (for example, prices under clauses (III) and (VI) of section 1927(c)(1)(C)(i) of the Act) and known on a lagged basis would be: (1) Inadequate to fully and accurately account and adjust for other price concessions applicable to these sales; and (2) may lead to an inappropriately low ASP if a manufacturer is unable to identify and remove all price concessions associated with an exempted sale. Some commenters supported an alternative, two-pronged approach. Lagged sales excluded based on the type of entity to which the sale is made would be removed from the ASP using the proposed methodology if the manufacturer determined that a 12month rolling average estimation methodology was necessary to accurately exclude these lagged exempted sales from the ASP calculation. On the other hand, the manufacturer would either not make any adjustment for or use reasonable assumptions to determine the best method for excluding any prices under a State pharmaceutical assistance program, and any prices charged which are negotiated by a prescription drug plan under Part D of title XVIII, by an MA–PD plan under Part C of title XVIII or by a qualified retiree prescription drug plan as defined in section 1860D– 22(a)(2) of the Act. Several commenters suggested we adopt an approach that would permit manufacturers not to exclude certain exempted sales because: (1) Current information sources may not distinguish all exempted sales; (2) certain sales may satisfy more than one of the exemptions from the determination of BP so there would be a potential for over counting excluded sales (for example, a sale to a 340B E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations hospital that is also reimbursed by Medicare Part D); and (3) in some instances the manufacturer may be unable to fully identify and adjust for the price concessions granted along the distribution chain associated with certain exempted sales (for example, the portion of volume discounts granted to distributors and pharmacies that were based on excluded sales). In addition, a few commenters noted that we did not specify a standard method for making the necessary corresponding adjustment to the numerator of the ASP calculation to ensure that the total in dollars for the reporting quarter does not include revenue related to lagged, exempted sales excluded from the denominator using the proposed estimation methodology. These commenters suggested that the excluded sales be valued at the manufacturer’s wholesale acquisition cost (less customary prompt pay discounts) for purposes of making the necessary adjustment. A few manufacturers supported our proposal for calculating excluded sales known on a lagged basis; however, one manufacturer requested that we consider requiring use of a revenuebased ratio instead of or as an alternative to the proposed units-based ratio. This commenter recommended that manufacturers be given a choice between a revenue-based or a unitsbased method to fit their data systems. Another manufacturer noted that a revenue-based ratio would result in unintended results if the price of the drug changed during the 12-month period used to establish the estimation ratio; therefore, a ratio methodology based on units such as the one we proposed should be required. Response: Section 1847A(c)(2) of the Act requires that manufacturers exclude certain sales from their ASP calculations. The statute does not make the exclusion of these sales from the ASP calculation optional. Therefore, we do not have the discretion to permit manufacturers not to exclude sales from ASP that are exempt from the determination of BP. Manufacturers must comply with the requirements in § 414.804(a)(4)(i). In this final rule with comment period we are revising § 414.804(a)(4)(i) by adding a reference to nominal prices, as well as sales exempt from inclusion in the determination of BP. We believe that this revision conforms the regulatory text to the language of the statute. To establish a uniform approach for excluding exempted sales known on a lagged basis, we proposed to amend § 414.804(a)(4) to require that all manufacturers use a 12-month (or less, if applicable) rolling average ratio VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 methodology to more accurately estimate and exclude these sales from the ASP calculation. Our proposal was based on comments we received in response to the April 6, 2004 IFC and subsequent feedback from a few manufacturers. The comments received in response to the proposed rule reflect a broader set of manufacturers’ perspectives. Some commenters indicated that for certain types of exempted sales the proposed methodology for excluding lagged exempted sales from the ASP calculation might lead to inaccuracies in the ASP calculation in their particular circumstances. At the same time, a number of commenters supported the proposed methodology. We recognize these commenters’ concerns regarding the difficulties in tracking both the exempted sale and its associated price concessions. Given the range of comments, we do not believe it is not advisable to mandate the use of the methodology, which we proposed at § 414.804(a)(4)(iii), for excluding lagged exempted sales. We recognize the proposed ratio methodology may not be the most accurate method for identifying and excluding certain types of exempted sales known on a lagged basis. However we also believe that our proposed ratio methodology may be appropriate for identifying and excluding lagged exempted sales in some instances. For this reason, we are not including the methodology in our regulations, but are allowing the manufacturers to use the methodology where applicable. We did not receive specific comments on our proposed modifications to § 414.804(a)(1) and (3) clarifying further that exempted sales are excluded from the ASP calculation. We are finalizing those clarifications as proposed. d. Nominal Sales Section 1847A(c)(2)(B) of the Act requires manufacturers to exclude from the ASP calculation sales that are merely nominal in amount, as applied for purposes of section 1927(c)(1)(C)(ii)(III) of the Act, except as the Secretary may otherwise provide. In the preamble to the April 6, 2004 IFC, we stated that, for ASP purposes, sales to an entity that are nominal in amount are defined in the Medicaid drug rebate agreement (see sample agreement at https://www.cms.hhs.gov/ MedicaidDrugRebateProgram/ downloads/rebateagreement.pdf). That is, for ASP purposes, a sale at a nominal price is a sale at a price less than 10 percent of the AMP in the same quarter for which the AMP is computed. PO 00000 Frm 00049 Fmt 4701 Sfmt 4700 69671 Effective January 1, 2007, the DRA revises the AMP calculation (to omit customary prompt pay discounts extended to wholesalers), adds a monthly AMP reporting requirement, and establishes limitations on nominal sales (only sales to certain entities may qualify as nominal sales). Section 1927(c)(1)(D) of the Act limits the nominal sales exclusion to sales at a nominal price made to the following entities: • Covered entities as described in section 340B(a)(4) of the Public Health Services Act. • Intermediate care facilities for the mentally retarded (ICFs/MR). • State-owned or operated nursing facilities. • Any other facility or entity that the Secretary determines is a safety net provider to which sales of such drugs at a nominal price would be appropriate based on the factors described in section 1927(c)(1)(D)(ii) of the Act. In light of the DRA changes affecting which sales may be considered sales at a nominal price or merely nominal in amount, for purposes of section 1927(c)(1)(C)(ii)(III), the CY 2007 PFS proposed rule sought to clarify the method manufacturers must follow in 2007 to identify such sales for ASP reporting purposes and to exclude sales at a nominal price from the calculation of ASP. For 2007 and beyond, we proposed to continue to rely on the Medicaid threshold (less than 10 percent of AMP) to determine whether a sale is at a nominal price and to apply the limitations in section 1927(c)(1)(D) of the Act for determining the types of sales that can be considered to be sales at a nominal price for purposes of the ASP calculation. We made this proposal for several reasons. As we indicated in the CY 2007 PFS proposed rule, we believe this approach helps maintain continuity in the ASP calculation and minimizes manufacturers’ reporting burden, as Medicare continues to follow the Medicaid approach for identifying sales at a nominal price and manufacturers can use a single method for identifying nominal sales for both ASP and AMP purposes. In addition, we believe the DRA modifications to section 1927 of the Act will have minimal effect on reported ASPs. We expect that the exclusion of customary prompt pay discounts extended to wholesalers from AMP would lead to a modest increase in AMP, and as a result a modest increase in the nominal price threshold for purposes of ASP reporting. At the same time, we anticipate that the limitation on the types of entities to which the E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 69672 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations nominal sales exclusion may apply, as specified in section 1927(c)(1)(D) of the Act, will result in a modest reduction in the number of sales that qualify for the nominal sales exclusion for purposes of ASP reporting because we believe that the entities outlined in section 1927(c)(1)(D) of the Act generally represent the types of entities to which manufacturers sell at a nominal price. Consequently, we expect these two countervailing changes would have a minimal overall impact on nominal sales that would be excluded from the ASP calculation. For these reasons, we proposed to continue to rely on the application of section 1927(c)(1)(C)(ii)(III) of the Act (as limited by section 1927(c)(1)(D) of the Act) for identifying sales to an entity at a nominal price for purposes of excluding such sales from the manufacturer’s calculation of the ASP. We solicited comments on our proposal to continue use of the AMP as the basis for identifying the threshold for sales at a nominal price for purposes of the exclusion from the ASP calculation and on whether an alternative threshold is necessary or desirable to ensure the accuracy of the ASP payment methodology. Specifically, we sought comments on whether sales at less than 10 percent of the ASP (instead of the AMP) should be used as the threshold for determining whether a sale to an entity identified in section 1927(c)(1)(D) of the Act is at a nominal price. We also sought comments on our belief that the new limitations in section 1927(c)(1)(D) of the Act, if applied for ASP purposes, will have minimal impact on reported ASPs. Comment: We received comments supporting our proposals to continue to rely on the application of section 1927(c)(1)(C)(ii)(III) of the Act, as modified by section 1927(c)(1)(D) of the Act, to identify and exclude sales at a nominal price from the ASP calculation. These commenters agreed that using the same standard for Medicare and Medicaid purposes would reduce reporting burden. Response: We appreciate the comments in support of our proposal. We are adopting our proposal to continue to rely on the Medicaid threshold (less than 10 percent of AMP) to determine whether a sale is at a nominal price, and to apply the limitations in section 1927(c)(1)(D) of the Act for purposes of identifying sales at a nominal price in determining the ASP. Comment: We received a few comments suggesting that the Secretary provide a list of additional types of VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 safety net providers that would qualify for the nominal sales exclusion. Response: The issue of whether the Secretary should designate additional types of entities that would qualify as safety net providers for purposes of section 1927(c)(1)(D) of the Act is outside of the scope of this rulemaking. Comment: We received a comment suggesting that because of the short timeframe for performing the ASP calculation, manufacturers should be allowed to identify sales at a nominal price for ASP purposes using the AMP for the previous quarter provided that the manufacturer does this consistently across all of its products. Response: We are concerned that the commenter’s suggestion that we allow use of last quarter’s AMP to identify sales at a nominal price in the current quarter could have an adverse impact on the accuracy of the ASP calculation. It is possible for the AMP to change substantially from one quarter to the next (for example, when generic products first become available). In such situations, using the current quarter’s AMP, as opposed to last quarter’s AMP, would generally result in a more accurate identification of sales at a nominal price. Consequently, we are continuing to require that for ASP calculation purposes nominal sales in a reporting quarter be identified based on the AMP for the same quarter. In the CY 2007 PFS proposed rule, we also responded to requests for clarification on a technical aspect related to the identification of nominal sales. Specifically, some manufacturers have asked whether sales at a nominal price are identified by performing a series of calculations once or whether the manufacturer repeats the series of calculations until no remaining ASP eligible sales are below the nominal threshold. Manufacturers must identify sales at a nominal price by performing the following steps once— • The manufacturer calculates the AMP for the reporting quarter to identify the dollar amount that represents 10 percent of the AMP for that reporting period. • The manufacturer then identifies sales at prices below this amount and excludes these sales from the ASP calculation. • Beginning in 2007, only those sales that meet the criteria discussed previously and are to an entity identified in section 1927(c)(1)(D) of the Act shall be excluded from the calculation of ASP. We received no comments concerning this clarification; therefore we are finalizing the clarification as proposed. PO 00000 Frm 00050 Fmt 4701 Sfmt 4700 e. Other Price Concession Issues In our ongoing work with manufacturers that submit ASP data, some manufacturers have posed questions or raised concerns about how the estimate of lagged price concessions is done prior to having 12 months of data for a NDC and, when a product is redesignated with a new NDC, whether price concessions from the prior NDC must be included in calculating the ASP for the new NDC. Manufacturers and other stakeholders have also asked us about how Medicare’s ASP guidance concerning price concessions is to be applied when drugs are sold under bundling arrangements. In response, we proposed clarifications and solicited comment on these issues. (1) Price Concessions for NDCs With Less Than 12 Months of Sales To address situations when a NDC with price concessions known on a lagged basis has not been sold for a full 12 months, we proposed to revise § 414.804(a)(3) to specify that the period used to estimate lagged price concessions is the total number of months the NDC has been sold. We proposed to require that manufacturers use less than 12 months of data in the estimation methodology for lagged price concessions for NDCs with less than 12 months of sales (except when the manufacturer has redesignated the product’s NDC, as discussed in this section). We also clarified in the preamble of the proposed rule that manufacturers may include the current ASP reporting quarter in the most recent 12-month period (or less for NDCs with less than 12 months of sales) so long as the manufacturer follows this approach in calculating the ASP for all of its reported NDCs. Comment: We received a number of comments supporting our proposal. Response: We are finalizing our proposal. We will require that manufacturers use less than 12 months of data in the estimation methodology for lagged price concessions for NDCs with less than 12 months of sales (except when the manufacturer has redesignated the product’s NDC, as discussed in this section). (2) Redesignated NDCs From time to time, a manufacturer may change the NDC assigned to a specific product and package size while continuing or offering price concessions that span across sales of the product under its prior and redesignated NDCs. For example, an NDC may be changed to reflect a change in the labeler code E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations while lagged price concessions in place under the prior NDC remain in effect and carry over to the redesignated NDC. Another example would be a manufacturer that modifies its package design or other non-drug feature of the NDC and assigns a new NDC to reflect the revised packaging. We proposed to clarify in the final ASP reporting rule that, when an NDC is changed (except when a product is repackaged or relabeled by a different manufacturer or relabeler or is privately labeled) and lagged price concessions offered for the prior NDC remain in effect, the manufacturer must use 12 months (or the total number of months of sales of the prior and redesignated NDCs if the total number of months of sales is less than 12 months) of sales and price concession data from the prior and redesignated NDCs to estimate lagged price concessions applicable to the redesignated NDC. In establishing this methodology, we are relying on our authority under section 1847A(c)(5)(A) of the Act. We sought comments on our proposed refinements to the estimation of lagged price concessions for NDCs with less than 12 months of sales and when a manufacturer redesignates the NDC assigned to a product. We also solicited suggestions for potentially clarifying these policies further. Comment: We received a number of comments supporting our proposal. In addition, some commenters asked for more guidance concerning what circumstances the policy regarding redesignated NDCs would or would not apply to. In particular, some commenters suggested the policy should not apply when there is a change in the 9-digit NDC (that is, a change in the product code). We also received comments asking for clarification on how manufacturers should combine price concessions in situations where the NDC is redesignated and both products are sold for a time concurrently. Some commenters asked whether the lagged price concessions for the prior and redesignated NDCs should be combined to create a single lagged price concession ratio to be used to estimate lagged price concessions for the prior and redesignated NDC, and if so, how long this practice should occur. In addition, some commenters noted that the Food and Drug Administration (FDA) has issued a proposed rule concerning the assignment of NDC codes, and that the issue of redesignated NDCs and the ASP calculation may need to be revisited when the FDA finalizes its regulation. Response: In making our proposal, we intended our proposal to apply in VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 instances when a manufacturer redesignates an NDC meaning the manufacturer establishes a new NDC as a replacement for a prior NDC for the same product and package size. After reviewing the comments, we are finalizing our proposal. When a manufacturer redesignates an NDC (except when a product is repackaged or relabeled by a different manufacturer or relabeler or is privately labeled) for a specific drug product and package size and lagged price concessions offered for the prior NDC remain in effect, the manufacturer must use 12 months (or the total number of months of sales of the prior and redesignated NDCs if the total number of months of sales is less than 12 months) of sales and price concession data from the prior and redesignated NDCs to estimate lagged price concessions applicable to the redesignated NDC. Several commenters recommended that we clarify that this policy would never apply to a change in the product code for an NDC. We disagree and believe the policy could apply to a change in the product code depending on the circumstances. When an NDC is redesignated as a replacement for a prior NDC for a specific drug product and package size and lagged price concessions for the prior NDC remain in effect, we believe the policy described previously should apply regardless of which segment of the NDC code is changed. Several commenters asked for guidance concerning how to handle situations where the redesignated NDC and prior NDC are for a time sold concurrently. If the redesignated NDC is a replacement for the prior NDC and if the two NDCs are sold for only a limited time concurrently, then we agree with commenters’ suggestion that lagged price concessions that are based on sales of the prior NDC and redesignated NDC should be combined to calculate a single lagged price concessions ratio (for the applicable price concessions) that would be applied to the ASP calculation for the prior NDC and for the redesignated NDC. In this situation, the manufacturer should combine the lagged price concession data that are based on sales of the prior NDC and redesignated NDC as described previously until the last lot sold of the prior NDC expires. Finally, we agree that the FDA’s proposed regulations concerning the assignment of NDC codes, once they are finalized, may have implications for our policy concerning redesignated NDCs, and we may revisit this issue in the future, if we believe it is warranted. PO 00000 Frm 00051 Fmt 4701 Sfmt 4700 69673 (3) Bundled Price Concessions The statute requires that the ASP include volume discounts, prompt pay discounts, cash discounts, free goods that are contingent on any purchase requirement, chargebacks, and rebates (other than rebates under section 1927 of the Act). Thus far, we have not provided specific guidance in the ASP context on the issue of how to allocate price concessions across drugs that are sold under bundling arrangements. In the absence of specific guidance, the manufacturer may make reasonable assumptions in its calculations of ASP, consistent with the general requirements and the intent of the Act, Federal regulations, and its customary business practices. Manufacturers should include these assumptions in their ASP submissions. As we indicated in the CY 2007 PFS proposed rule, we expect manufacturers of drugs reimbursed by Medicare Part B to comply with all applicable laws, regulations, and legal decisions including, but not limited to the Stark law, other relevant anti-kickback laws, antitrust laws, and laws governing fair trade practices (71 FR 49003). Our discussion of this issue in the proposed rule or in this final rule with comment period should not be construed as an endorsement or authorization of any pricing practices that contravene any laws, legal decisions, or regulations. In the CY 2007 PFS proposed rule, we indicated that we would like to better understand how bundling affects sales of Part B drugs and the ASP calculation, and any concerns stakeholders may have on this issue (71 FR 49003). Furthermore, we indicated that we are considering providing guidance, through rulemaking or through program instruction or other guidance (consistent with our authority under section 1847A(c)(5)(C) of the Act) on the methodology manufacturers must use for apportioning price concessions across Part B drugs sold under bundling arrangements for purposes of the calculation of ASP. We also noted that in considering this issue our goal is to ensure that the ASP is an accurate reflection of market prices for Part B drugs and that the treatment of bundled price concessions in the ASP calculation does not create inappropriate financial incentives. In the CY 2007 PFS proposed rule, we solicited comments on a number of issues related to bundled price concessions, including how frequently Part B drugs are sold under bundling arrangements, the different structures of bundling arrangements that may exist (for example, the number of products E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 69674 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations included in a bundling arrangement; whether the price concessions are contingent on the purchase of only one product, the purchase of multiple products, or the inclusion of one or more products on a formulary; and the timing of the price concessions), and the extent to which sales of Part B drugs are bundled with sales of non-Part B drugs or non-drug products. We also sought comments on what effect bundling arrangements may have on the ASP calculation, on beneficiary access to high quality, appropriate care (including access to drugs that may not have clinical alternatives), and on costs to the Medicare program and beneficiaries. In addition, we solicited comments on whether additional guidance on apportioning bundled price concessions for purposes of the calculation of ASP is needed and potential methodologies that Medicare could consider requiring. Furthermore, we solicited comments on how variation in the structure of bundling arrangements may affect the impact of potential apportionment methodologies on the ASP calculation. Comment: Some commenters recommended that we provide guidance on the treatment of bundled price concessions in the ASP calculation. A number of these commenters stated that having specific guidance on this issue would promote consistency in ASP reporting across manufacturers. In addition, many commenters believed that we should issue another proposed rule with a specific proposal and offer an opportunity for public comment before finalizing any policy. Many of these commenters were also concerned about how the treatment of bundled price concessions in the ASP calculation would affect providers who do not purchase the drug as part of a bundling arrangement. Some commenters did not take a position on whether specific guidance was needed on the treatment of bundled price concessions in the ASP calculation, citing both the general desirability of having guidance on various ASP reporting issues and concerns that a specific methodology with regard to bundled price concessions and ASP might be inflexible and hinder beneficial arrangements. While most commenters did not offer a specific suggestion on a potential methodology for the treatment of bundled price concessions in the ASP calculation, a few commenters did. One commenter suggested that Medicare adopt for ASP purposes the apportionment methodology that the Medicaid rebate program requires manufacturers to use in the calculation VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 of AMP and BP. The current Medicaid National Drug Rebate Agreement states that ‘‘for Bundled Sales, the allocation of the discount is made proportionately to the dollar value of the units of each drug sold under the bundled arrangement.’’ Another commenter suggested that we adopt the current Medicaid rebate program methodology for apportioning bundled price concessions described above, but create an exception for dominant drugs without significant clinical alternatives. This commenter stated that drug manufacturers do not have an incentive to provide discounts on dominant drugs that do not have significant clinical alternatives. As a result, the commenter believes that in situations where a ‘‘dominant’’ drug is bundled with non-dominant drugs, none of the bundled price concessions should be apportioned to the ‘‘dominant’’ drug. Furthermore, the commenter stated that if the Medicaid methodology were employed without an exception for dominant drugs, there would be the potential to lower the ASP for a dominant drug in a bundle while increasing the ASP for the other, nondominant drugs in that bundle. The commenter believes such a policy would result in an unfair competitive advantage and would impose additional costs on the public health system and the Medicare program. The commenter stated that determining whether a bundling arrangement contained a dominant drug would be relatively easy for manufacturers, and suggested a number of criteria such as a drug’s indication and risk profile, whether it is a single source product, its patentprotected status, the drug’s market share, the relative magnitude of incentives provided on the drug both before and after it is inclusion in the bundle, the effect of the introduction of the drug into the bundle on the sales volume of other products in the bundle, and Medicare expenditures on the drug relative to potential alternatives. In contrast, another commenter urged us not to adopt a methodology where price concessions offered on drugs sold under bundling arrangements are allocated across those drugs based on specified criteria. The commenter stated that the ASP is intended to reflect the prices available in the market for each product, and they believe reallocating discounts across drugs is unnecessary and could result in inaccurate ASPs, impaired beneficiary access, and inappropriate financial incentives. Another commenter stated that manufacturers should be allowed to make reasonable assumptions concerning the treatment of bundled PO 00000 Frm 00052 Fmt 4701 Sfmt 4700 price concessions in the ASP calculation, and that any bundled price concessions that meet a safe harbor to the OIG anti-kickback statute should be handled like nonbundled price concessions for ASP calculation purposes. We also received some comments expressing satisfaction with current contracts with drug manufacturers, and raising concerns that the establishment of guidelines concerning the treatment of bundled price concessions in the ASP calculation may require them to renegotiate those contracts. In addition, we received some comments expressing concern about the affect of bundling arrangements on physician and health care provider’s choice of products. A number of commenters also raised the issue of Part B drugs being bundled with non-Part B drugs or other products. Some stated that when Part B drugs are bundled with other products, the bundled price concessions should not be apportioned from other products to Part B drugs, citing concerns that the Part B drug payment rates would be inappropriately low. However, another commenter believes that bundled price concessions should be allocated from non-Part B drug products to Part B drugs, stating that it otherwise results in government overpayments. A number of other commenters offered suggestions on how a bundle should be defined, with several commenters suggesting that discounts contingent on the placement of one or more products on a formulary should not constitute a bundle. We also received comments recommending that for the purposes of the ASP calculation we only consider bundling arrangements to exist in situations where several different products are sold for a single price, and the individual products do not have separately identifiable prices. Finally, we note that the MedPAC commented that it would be examining the issue of bundled price concessions and the ASP in the upcoming year. Response: In considering the issue of bundled price concessions, our goal is to ensure the accuracy of the ASP calculation and to prevent the treatment of bundled price concessions in the ASP calculation from creating inappropriate financial incentives. A number of comments suggested, that potential bundling arrangements may be complex and vary widely in terms of the structure and types of performance requirements upon which a bundled discount may be conditioned, the magnitude of price concessions, and the characteristics of the drugs or other products included in the bundle (for example, whether the bundle includes E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations Part B drugs only or other products, the market position of products in the bundle, the relative sales volume of products in the bundle, and how commonly a particular product is sold under a bundling arrangement). Given the potentially wide range of bundling arrangements that might exist, based on the information we currently have about such arrangements, we are not in a position to determine, at this time, whether there is a universal approach for treating bundled price concessions in the ASP calculation that would address all potential structures of bundling arrangements in a manner that would achieve our goal of ensuring the accuracy of the ASP payment methodology and preventing inappropriate financial incentives. Furthermore, we note that we received a comment suggesting that Medicare adopt a special policy concerning the treatment of bundled price concessions in the ASP calculation for bundling arrangements that include dominant drugs without significant clinical alternatives. We do not believe it would be feasible for the Medicare program to establish a definition of a dominant drug without significant clinical alternatives that would be precise enough to clearly delineate when a product was or was not dominant, especially given the potential for great variation in the structure of bundling arrangements and the characteristics of drugs included in those arrangements. Since we do not yet fully understand the variety of bundling arrangements that exist in the marketplace and how they are likely to evolve over time, we believe it is important to be cautious in establishing a specific methodology that all manufacturers must follow for ASP purposes. Consequently, we are not establishing a specific methodology that manufacturers must use for the treatment of bundled price concessions for purposes of the ASP calculation at this time. In the absence of specific guidance, the manufacturer may make reasonable assumptions in its calculations of ASP, consistent with the general requirements and the intent of the Act, Federal regulations, and its customary business practices. Our intent in not being prescriptive in this area at this time is to allow manufacturers the flexibility to adopt a methodology with regard to the treatment of bundled price concessions in the ASP calculation that, based on their particular circumstances, will best ensure the accuracy of the ASP calculation and not create inappropriate financial incentives. VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 Recognizing that the treatment of bundled price concessions in the ASP calculation has implications for the integrity of the ASP payment methodology, we will be paying close attention to this issue and may provide more specific guidance in the future through rulemaking or through program instruction or other guidance (consistent with our authority under section 1847(c)(5)(C) of the Act) if we determine it is warranted. Furthermore, as we continue to monitor this issue, we want to be sure we are aware of concerns from all stakeholders, and thus we encourage the public to relay additional information or concerns to us on this issue as they may arise. In addition, we note that MedPAC has indicated it will be studying this issue in the upcoming year, and we look forward to its work in this area. Finally, we emphasize that we expect manufacturers of drugs reimbursed by Medicare Part B to comply with all applicable laws, regulations, and legal decisions including, but not limited to the Stark law, other relevant antikickback laws, antitrust laws, and laws governing fair trade practices. Our discussion of this issue should not be construed as an endorsement or authorization of any pricing practices that contravene any laws, legal decisions, or regulations. f. Other ASP Reporting Issues Comment: Several commenters stated that it can be difficult for manufacturers to determine which drugs are subject to the ASP reporting requirements, considering that section 1927(b)(3)(A)(iii) of the statute states that ASP data must be reported for drugs that are described in subparagraph (C), (D), (E), or (G) of section 1842(o)(1), or 1881(b)(13)(A)(ii) of the Act. Response: In general, these subparagraphs refer to broad categories of drugs covered by Medicare Part B such as drugs that are administered incident to a physician’s service in physician offices; certain immunosuppressive, oral anticancer, and oral anti-emetic drugs supplied by pharmacies; infusion drugs furnished through an item of DME; intravenous immune globulin (IVIG), inhalation drugs furnished through an item of DME, and separately payable drugs furnished by ESRD providers. Because Medicare Part B drugs are subject to local coverage determinations (LCDs) by the local claims processing contractors and the scope of Part B drug coverage varies among contractors, we do not maintain a list of all drugs covered under Part B at any given time in all PO 00000 Frm 00053 Fmt 4701 Sfmt 4700 69675 contractor jurisdictions. However, the following resources may be helpful and can be retrieved at https:// www.cms.hhs.gov/ McrPartBDrugAvgSalesPrice/ 02_aspfiles.asp#TopOfPage. The NDC to HCPCS crosswalk is posted quarterly on our Web site and lists a majority of billing codes used by providers to submit claims for drugs. We welcome ongoing feedback on the accuracy of the crosswalk. We also publish a list of many of the frequently administered drugs that are billed using the not otherwise classified billing codes. Comment: Several commenters suggested that we develop a formal process for requesting a determination of whether for a particular NDC the ASP reporting requirements apply. These commenters contend such a process is necessary particularly for drugs that may be typically self-administered, may be used for prevention or cosmetic purposes, are available in potentially noncovered forms, and new drugs for which LCDs have not yet been made. Response: Medicare Part B drug coverage under title XVIII is generally limited to certain drugs within specific benefit categories as described at the beginning of this section. For the most part, we believe manufacturers have identified the drugs for which they have an ASP reporting obligation. Medicare has established processes for issuing national, as well as local, coverage determinations for Part B drugs and other services. Therefore, we are not persuaded by the commenters that an entirely separate process is necessary for assisting manufacturers in determining whether a drug qualifies for coverage under Part B as a means of determining whether it is subject to the ASP reporting requirements. We encourage manufacturers to contact us directly to discuss the specifics of their ASP reporting concerns. Comment: One commenter asked us to clarify whether manufacturers have to include in their calculation of the ASP for a given NDC sales of that NDC that are used for purposes not covered by Medicare Part B. The commenter also wanted to know if NDCs that are labeled for Medicare noncovered indications are subject to the ASP reporting provisions. Response: With respect to whether a manufacturer may exclude sales for noncovered uses from its calculation of the ASP for an NDC and whether NDCs that are labeled for cosmetic or other typically noncovered use (for example, contraception) are exempt from the ASP reporting requirements, we believe the statute provides no such exclusion. E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 69676 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations Comment: Another commenter suggested that we clarify whether manufacturers are required to report ASP data for infusion drugs administered via DME and for a drug that is usually self-administered and not covered by Medicare Part B (even if Medicare utilization data suggests that there are small levels of utilization which a manufacturer believes are contractor mistakes). Response: Section 1927(b)(3)(A)(iii) of the Act specifies the drugs for which manufacturers have to report ASP data, and it includes infusion drugs furnished through an item of DME (by reference to section 1842(o)(1)(D) of the Act). Manufacturers must report ASP data for these drugs quarterly. With respect to drugs that a manufacturer believes are noncovered by Medicare despite a local claims processing contractor’s payments for the drug, we are aware of one such situation and have been working closely with the manufacturer to resolve the matter. We encourage manufacturers to contact us directly so that we can consider these issues on a case-by-case basis. Comment: One manufacturer expressed concern that submitting ASP data for a noncovered drug may be viewed as a claim for coverage. Response: We do not believe that reporting ASP data for a drug, in the absence of other actions, would be a claim of coverage for the drug. Comment: A few commenters requested clarification regarding when a manufacturer’s reporting obligation for an NDC ends. One commenter noted that ASP will not be a positive number unless there is product sold in a quarter, and suggest there is no need to report the ASP after the last lot is sold. Response: In the March 3, 2006 Federal Register (71 FR 10975), we clarified that manufacturers would no longer report ASP data for an NDC beginning the reporting period after they report the ASP data for the quarter during which the expiration date of the last lot sold occurs. We are aware that a manufacturer’s ASP will not be a positive value unless a reportable sale occurs in the reporting period. However, for single source drugs, manufacturers not only have a requirement to report ASP but also wholesale acquisition cost (WAC). Comment: Several commenters requested that we clarify whether the manufacturer that holds title to the NDC is always responsible for reporting the ASP data, and whether certain exceptions are permissible such as when manufacturers establish licensing agreements or a manufacturer divests a product but the NDC’s labeler code is VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 not changed. Some commenters stated that the title-holding manufacturer should determine which entity has the ASP reporting obligation. In addition, a commenter requested that manufacturers not be required to certify ASP data that they did not have access to or did not generate. One commenter suggested that a manufacturer’s ASP reporting obligation would cease upon the transfer of the product to another manufacturer with control over its pricing. Response: For ASP purposes, the definition of manufacturer has the same definition set forth in section 1927(k)(5) of the Act, which is the definition included in the Medicaid drug rebate statute. We believe that likewise the ASP reporting obligation should follow the process established under the Medicaid drug rebate program, and we see no reason to establish separate guidance at this time. Further, we believe that manufacturers have means of dealing with these issues within their business arrangements. Comment: One commenter recommended that we provide guidance that sales between wholly-owned subsidiaries of a common parent company would not constitute a sale for ASP reporting and calculation purposes. Response: We will consider the issue and any broader implications it may have for the ASP calculation, and may issue additional guidance if we determine it is appropriate. Comment: Some manufacturers supported maintaining the same definition of manufacturer for ASP purposes and for Medicaid AMP and BP purposes. Several commenters requested that we formally state that wholesalers and distributors do not have to report ASP data. A retail pharmacy chain requested that retail pharmacies be excluded from the definition of manufacturer in so far as they repackage drugs for purposes of dispensing drugs to customers under state law. Similarly, a mail order pharmacy requested that we clarify that mail order pharmacies are not considered manufacturers. One commenter suggested that only the holders of the product’s New Drug Approval, Abbreviated New Drug Approval, or Biologic License Application should be considered manufacturers or repackagers for the purposes of reporting ASP. Response: Under section 1847A of the Act, entities that fall under the definition of manufacturers in section 1927(k)(5) of the Act must report ASP data. This definition is separate from the FDA process for drug applications. We interpret manufacturer for ASP PO 00000 Frm 00054 Fmt 4701 Sfmt 4700 purposes to have the same meaning as under the Medicaid Rebate Agreement. Therefore, wholesalers that relabel or repackage NDCs and pharmacies must report ASP data to the extent that they qualify as manufacturers for Medicaid drug rebate purposes. Comment: A few commenters requested that we formalize our guidance on whether sales in the United States include sales to purchasers in the territories. Response: We are not addressing this issue in the regulations text. Comment: A few commenters requested that we incorporate into the regulation our current guidance on the treatment of returned units. Response: We issued guidance on our Web site in September 2004 instructing manufacturers not to make adjustments to the ASP calculation to account for returns. We stated in that guidance beginning with the data submission for sales during the third quarter of 2004 and thereafter, manufacturers should not subtract the value of the returns from the numerator of the ASP calculation and should not subtract the number of units returned from the denominator. In other words, the value of returns should not be included in the numerator and the number of returned units should not be included in the denominator when calculating the ASP for a reporting quarter. This continues be our guidance as we study the issue further, but we have decided not to place this guidance into the regulation text at this time. Comment: Some of the commenters noted that, at this time, manufacturers’ reasonable assumptions continue to be an important principle in ensuring that the calculation of ASP is appropriate. Several commenters suggested we include in the final rule guidance we have previously provided through Q&A that in the absence of guidance manufacturers may make reasonable assumptions and should provide those assumptions in their ASP submission. Response: We agree with these commenters; manufacturers’ reasonable assumptions remain an important aspect of ASP reporting. The complexities of each calculation can differ across manufacturers. Therefore, it is essential that each manufacturer examine the facts and complexities of its business practices and products to determine how it will comply with the ASP reporting requirements. We posted a frequently asked question on our Web site to inform manufacturers of the importance of reasonable assumptions. In that guidance we state, ‘‘In the absence of specific guidance in the Act or Federal regulations, the manufacturer E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations may make reasonable assumptions in its calculations of ASP, consistent with the general requirements and the intent of the Act, Federal regulations, and its customary business practices. These assumptions should be submitted along with the ASP data and the signed certification form.’’ Comment: Some commenters wanted to know whether data on nominal sales must be reported at this time as required under section 1927(b)(3)(A)(iii)(III) of the Act. Response: We currently consider the requirements of section 1927(b)(3)(A)(iii)(III) of the Act for the reporting of nominal prices for purposes of ASP to be met when the manufacturer reports its ASPs, to the extent that the ASPs accurately account for nominal prices that are excluded from the ASP calculation. Thus, we are not currently requiring this information to be separately reported from the ASP. As we gain more experience with the ASP system, we may require this information to be separately reported in the future. We note that our interpretation of the reporting requirement for nominal prices for purposes of ASP has no effect on any Medicaid reporting requirement. Comment: Several commenters stated that the statute does not require certification of the ASP by the manufacturer’s chief financial officer (CFO), chief executive officer (CEO) or individual who has delegated authority to sign for and reports directly to either the CFO or CEO. A large international manufacturer commented that it was impractical to have ASP reports certified by international executives. Another manufacturer commented that its organizational structure did not have executives matching the specified titles, and therefore, it was impossible to comply with this requirement. Further, many commenters stated that it was inappropriate to require certification of the ASP data until sufficient guidance on how to calculate the ASP has been established. A few commenters suggested that the certification language should be revised to acknowledge that reasonable assumptions had been made and to reflect the limited ability of manufacturers to accurately estimate lagged price concessions and determine whether fees were passed on in whole or in part. Another commenter stated that the penalties for failing to report accurate ASP data are a sufficient deterrent to abuse, and the certification is unnecessary and should be eliminated. Response: Because of the consequences for failing to submit accurate and timely ASP data, we continue to believe there is good reason VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 to require that each ASP report be certified by the manufacturer at this time. With the ASP data being the basis of Medicare payment rates for the vast majority of Part B covered drugs and biologicals, we believe that certification requirement is an important program safeguard. We acknowledge the operational constraints some manufacturers may experience in obtaining certain senior executive level signatures to coincide with the quarterly ASP reporting deadlines, although our experience is that nearly all manufacturers are able to do so without causing a delay in reporting their ASP data timely. Comment: Several commenters noted that the Medicaid AMP and BP can be restated within the specified time period. These commenters requested that we establish procedures to identify potentially errant ASP data and to allow for corrections of ASP data. Response: If a manufacturer has good cause for resubmitting its quarterly ASP data, it may do so following the submission instructions available at https://questions.cms.hhs.gov/cgi-bin/ cmshhs.cfg. Resubmission of ASP data does not constitute a release from liability for failure to submit timely and accurate ASP data. Comment: Several manufacturers suggested that the reasonable assumptions submitted along with the ASP data be afforded the same confidential protections as specified for the ASP data. Response: We provided guidance on our Web site addressing this issue. That guidance states, ‘‘As indicated in section 1927(b)(3)(D) of the Act, as amended by MMA section 303(i)(4)(D), information disclosed by the manufacturer in connection with the requirement for ASP data submission is confidential and, not withstanding other laws, shall not be disclosed by the Secretary (or contractor therewith) in a form which discloses the identity of a specific manufacturer or wholesaler, prices charged for drugs by such manufacturer or wholesaler, except as necessary by the Secretary to carry out the provisions of section 1847A or 1847B of the Act, and to permit the OIG, the Comptroller General, and the Director of the Congressional Budget Office to review the information provided. https://questions.cms.hhs.gov/ cgi-bin/cmshhs.cfg. As is good practice with any sensitive material, manufacturers should clearly mark their reported ASP data, if applicable, to indicate that the information contained therein is confidential, proprietary, or contains trade secrets, for example, as appropriate. PO 00000 Frm 00055 Fmt 4701 Sfmt 4700 69677 Comment: One commenter asked that we clarify that the number units to be reported are the number of units sold excluding exempted sales. Response: The commenter is correct. Effective with the publication of the FY 2007 IPPS final rule (August 18, 2006, 71 FR 47870), we revised the definition of unit in § 414.802. ‘‘Unit’’ means the product represented by the 11-digit NDC. During the first 3 years of the CAP (as defined in § 414.902), the method of counting units excludes units of CAP drugs (as defined in § 414.902) for use under the CAP (as defined in § 414.902). The CAP is the Competitive Acquisition for Outpatient Part B Drug and Biologicals which began in July 2006. Units of drugs sold to an approved CAP vendor for use under the CAP are excluded from the ASP calculation. Manufacturers must report the number of units sold after adjusting for exempted sales, including exempted sales known on a lagged basis. Comment: In response to the April 6, 2006 IFC, a commenter stated that some manufacturers submit AMP and then restate it in subsequent periods to take into account rebates. The commenter requested that we provide assurance that they will not be liable for misrepresentation of nominal sales, if the manufacturer bases its nominal sales on AMP for the reporting quarter and then the manufacturer modifies AMP subsequently to take into account rebates. Response: Nominal sales for ASP purposes are calculated based on the AMP for the reporting quarter. We have not provided guidance on how a manufacturer should handle identification of nominal sales if current reporting quarter AMP is subsequently restated for Medicaid purposes. We did not receive comments on this issue in response to our request in the proposed rule regarding the method manufacturers must use to identify nominal sales. We believe that maunfacturers may have considered this issue in making their comments in support of continued use of the AMP as the basis for determining nominal sales excluded from the calculation of ASP. We will continue to work with manufacturers to determine if further guidance on this issue is warranted. With regard to the comment concerning liability, if the Secretary determines that a manufacturer has made a misrepresentation in the reporting of its ASP for a drug, the Secretary may apply a civil money penalty as specified in section 1847A(d)(4) of the Act. Comment: One commenter suggests we explore methods of receiving ASP data by e-mail. This commenter also E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 69678 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations recommends we include information in the final rule on where and how to submit ASP data. Response: At this time, we do not permit electronic mail submission of ASP data because the confidentiality of the ASP data would not be assured. However, we continue to explore opportunities for enhancing the efficiency of the ASP submission process. Procedural information on how and where to submit ASP data is provided in a Q&A on our Web site. We believe it is best to provide information on the logistics of how and where to submit the ASP data through our Web site, which can be updated more quickly than a regulation. Comment: We received comments recommending we provide guidance in the final regulation on requirements related to the reporting of WAC and urged Addendum A to be revised to include this information. Response: In the CY 2006 PFS final rule, we clarified that manufacturers must report WAC for all single source drugs (including new drugs) each reporting period in addition to reporting ASP. Manufacturers must report the WAC in effect on the last day of the reporting period. Effective July 2006, we revised the reporting template, Addendum A, to include a specific column for reporting WAC. Addendum A can be found on our Web site at— https://www.cms.hhs.gov/ McrPartBDrugAvgSalesPrice/. Comment: We received comments suggesting that we publicize the NDC– HCPCS crosswalk and have a process for informing manufacturers of where changes have occurred, and a process for soliciting and responding to input on the crosswalk. Also, they suggest establishing procedures so manufacturers can determine whether we are defining package codes correctly. Response: Every quarter, we publish on the CMS Web site a crosswalk of NDCs to HCPCS codes. Included in the crosswalk is information on the package size and package quantity that we believe is reflected by each NDC. The crosswalk file provides an e-mail address (sec303aspdata@cms.hhs.gov) to which individuals can send comments. Furthermore, as of July 2006, manufacturers are now required to report with their ASP submission specific information on the package size of each NDC as specified in more detail in the Appendix A data elements guide on our Web site. Comment: We received comments requesting clarification of how and when civil monetary penalties would apply in certain situations where ASP was misreported. VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 Response: If the Secretary determines that manufacturer has made a misrepresentation in the reporting of its ASP for a drug, the Secretary may apply a civil money penalty in section 1847A(d)(4) of the Act. Comment: One commenter suggested that we consider requiring manufacturers to report ASP data monthly. Response: Section 1927(b)(3) of the Act sets forth the quarterly reporting requirement. We believe changes to the frequency of ASP reporting would require a statutory change. Comment: One commenter noted that for Medicaid BP determinations manufacturers may not exempt prices given to State pharmacy assistance programs that we have not identified as a State Pharmaceutical Assistance Program excluded from the Medicaid BP and may not exclude Medicaid supplemental rebates that are not under an approved supplemental rebate agreement. This commenter asked whether the same rule applies to excluding exempt sales from the ASP calculation. Response: To be excluded from the ASP calculation, the Medicaid supplemental rebates must be under an approved supplemental rebate agreement authorized by us through a Medicaid State plan, and the State pharmacy assistance programs must be identified by us as State Pharmaceutical Assistance Program excluded from the Medicaid BP. Comment: We received a comment in response to the April 6, 2004 IFC, asking us to provide more clarification on a methodology that we indicated manufacturers should use in situations where a manufacturer is unable to associate price concessions with individual 11-digit NDCs. The commenter requested information on several technical aspects of the formula, including one scenario involving bundled price concessions. Response: In the April 6, 2004 IFC with comment, we indicated that if a manufacturer is unable to associate price concessions to the individual NDC level, the manufacturer should associate those price concessions within the group of NDCs for which it can associate the price concessions based on the percentage of sales (in dollars) for the group of NDCs that is attributable to each individual NDC. This guidance was issued in the early stages of ASP implementation, and was intended to address situations where manufacturers are unable to associate price concessions to the 11-digit NDC level such as when a manufacturer reporting maintains data on rebates at the drug PO 00000 Frm 00056 Fmt 4701 Sfmt 4700 level rather than at the 11-digit NDC level. In response to the commenter’s request for clarification on a technical aspect of the methodology described above in a situation involving bundled price concessions, we are clarifying in this final rule with comment that this policy was not intended to be guidance on the treatment of bundled price concessions (for example, when price concessions on one drug are contingent on the purchase of one or more other drugs) in the ASP calculation. As discussed in more detail elsewhere in this preamble, we have not provided specific guidance on the methodology manufacturers should use for the treatment of bundled price concessions in the ASP calculation. In terms of the commenter’s request for additional clarification on other technical aspects of the calculation described above, we believe the level of detail prescribed on the technical aspects of the calculation is sufficient, given the variation in price concession offerings across manufacturers. After consideration of the public comments, we are finalizing subpart J (§§ 414.800 through 414.806) by—(1) revising § 414.802 and § 414.804 as specified in this section of the preamble to this final rule with comment; and (2) incorporating the provisions of § 414.800 and § 414.806 as specified in the April 6, 2004 IFC without change. 2. Intravenous Immune Globulin (IVIG) Comment: We received several comments urging the continuation of the 1-year temporary preadministrationrelated services fee for IVIG that we established for 2006. Commenters stated that there continue to be concerns with IVIG access and availability and that eliminating the fee will have an adverse impact on beneficiary access to care. Furthermore, some indicated that we did not provide any rationale in the proposed rule for why the fee was no longer needed. A number of commenters expressed concerns about the adequacy of Medicare’s drug and drug administration payment rates for IVIG, and made some suggestions for changes to these payment rates that they have previously expressed to us. For example, some urged us to take actions such as establishing separate HCPCS codes for each IVIG product, increasing payment for IVIG administration in physicians’ offices, and instituting a payment adjustment to the ASP-based payment rates for IVIG. One commenter provided information from a survey conducted of 800 patients with primary immune deficiency E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations syndrome. The commenter stated that since the beginning of 2005, Medicare patients receiving IVIG have been more likely than patients with other types of insurance to report a shift in site of care, increased intervals between infusions, reduced IVIG dosages, and adverse health effects, and they believe that this is the result of Medicare reimbursement issues. Response: We recognize the importance of IVIG to patients who need it and we are concerned about reports of problems with IVIG access and availability. Since 2005, we have taken several specific actions that are within our statutory authority in response to the IVIG concerns that have been raised, including creating separate billing codes for lyophilized and non–lyophilized IVIG in April 2005, having discussions with manufacturers about their ASP data to confirm that their ASPs have been developed in accordance with applicable guidance, and for 2006 establishing a temporary additional payment for IVIG preadministration– related services to compensate physicians and hospital OPDs for extra resources expended on locating and obtaining appropriate IVIG products and on scheduling patients infusions during a period where there may be temporary market instability. In addition, we continue to work with manufacturers, patient groups, and stakeholders to understand the present situation and to assess potential actions that could help ensure an adequate supply of IVIG and patients receiving appropriate, high quality care. Furthermore, there are currently two studies underway in HHS concerning IVIG. The HHS Assistant Secretary for Planning and Evaluation has commissioned a study to better understand the market for IVIG and evaluate the demand, supply, and access to IVIG. The HHS OIG is also conducting a study on availability and pricing of IVIG. We anticipate that these studies will provide more information on IVIG supply, demand, and pricing. With several studies on IVIG not yet completed and with comments from stakeholders suggesting that some beneficiaries are experiencing IVIG access issues such as delayed treatments and site of service shifts, we believe it is appropriate to continue the temporary IVIG preadministration-related services payment into CY 2007 to help ensure continued patient access to IVIG. We will continue to review IVIG access during CY 2007 as additional information becomes available, and we will discontinue this temporary preadministration-related service payment during CY 2007 through VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 rulemaking if we determine it is no longer warranted. Consequently, in 2007, we will temporarily allow a separate payment for each day of IVIG administration to physicians and hospital OPDs that administer IVIG to Medicare beneficiaries. This payment is for the extra resources expended on locating and obtaining appropriate IVIG products and on scheduling patients’ infusions during this time when there may continue to be transient disruptions in the marketplace. In 2007, the preadministration-related service payment will continue to be billed under the same HCPCS code as 2006: G0332, preadministration-related services for intravenous infusion of immunoglobulin, per infusion encounter (This service is to be billed in conjunction with administration of immunoglobulin). This payment will on average be about $71 per day of IVIG administration in physicians’ offices. The payment for preadministrationrelated services is in addition to the separate payments Medicare makes for the IVIG product itself and its administration. We note that for 2007 we reviewed and revised the resource based relative value units crosswalk for G0332. We continue to believe the administrative resources associated with IVIG preadministration-related services are similar to the clinical staff resources associated with ESRD management services, where both types of services are typically conducted over the course of a month, without requiring face-toface visits with clinical staff for this ongoing preparation for treatment of these patients. Considering the expected staff resources required to prepare for IVIG infusions for patients who require them, we believe those resources are greater than the lowest level ESRDrelated service described by HCPCS code G0319, End stage renal disease (ESRD) related services during the course of treatment, for patients 20 years of age and over; with one face-toface physician visit per month, but we do not believe they are as great as those required by the mid-level ESRD-related code G0318, End stage renal disease (ESRD) related services during the course of treatment, for patients 20 years of age and over; with 2 or 3 faceto-face physician visits per month. Therefore, for 2007, we have crosswalked G0332 to a 50 percent blend of the 2007 transitional PE RVUs for G0318 and G0319. As we did for 2006, we have not allocated physician work RVUs to G0332 since we do not believe there is physician work associated with G0332. PO 00000 Frm 00057 Fmt 4701 Sfmt 4700 69679 We believe that continuation of this temporary separate payment provided through G0332 in CY 2007 for the physician office and hospital outpatient resources associated with additional IVIG preadministration-related services will help facilitate beneficiary access to care in this current period where there may be continuing market fluctuations for IVIG products. At the same time, we will continue to work with the IVIG community, manufacturers, providers, and other stakeholders, and will be monitoring IVIG market developments and access to care closely. Commenters made several suggestions for changes to Medicare IVIG-related payments. Regarding comments requesting the establishment of brandspecific HCPCS codes for IVIG products, while HCPCS coding is outside the scope of this rulemaking, we note that HCPCS coding procedures do not provide for brand-specific coding. For further discussion of HCPCS coding procedures, see https:// www.cms.hhs.gov/medicare/hcpcs/ codpayproc.asp. Commenters also expressed concern regarding Medicare ASP+6 percent payment rates for IVIG, suggesting we make an adjustment to the payment rate. Section 1847(o)(1)(E) of the Act specifies that the payment amount for IVIG furnished in physicians’ offices and the home will be the amount provided under section 1847A of the Act. With limited exceptions not applicable here, section 1847A of the Act specifies that the payment amount is 106 percent of a drug’s ASP. We do not have the discretion to adjust the payment rate upward by adjusting the percentage that is added on to the ASP to arrive at the payment rate. While some commenters suggested we use inherent reasonableness authority to increase the IVIG payment rate, we do not believe that we have the data to support a determination concerning inherent reasonableness. Finally, we received several comments requesting that we classify IVIG therapy as a biological response modifier. We note that the term ‘‘biological response modifier’’ is used in the text preceding CY 2006 CPT codes, and as such, we refer commenters to the AMA CPT Editorial Panel, as they are the creators and maintainers of CPT codes and CPT code instructions. 3. Clotting Factor Furnishing Fee Section 303(e)(1) of the MMA added section 1842(o)(5) of the Act which requires the Secretary, beginning in CY 2005, to pay a furnishing fee, in an amount the Secretary determines to be appropriate, to hemophilia treatment E:\FR\FM\01DER2.SGM 01DER2 69680 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations centers and homecare companies for the items and services associated with the furnishing of blood clotting factor. Section 1842(o)(5)(C) of the Act specifies that the furnishing fee for clotting factor for years after CY 2006 and subsequent years will be equal to the fee for the previous year increased by the percentage increase in the consumer price index (CPI) for medical care for the 12-month period ending with June of the previous year. The 2006 furnishing fee for clotting factor is $0.146. The percent increase in the CPI for medical care for the 12month period ending with June 2006 is 4.1 percent. Consequently, the furnishing fee will be $0.152 per unit clotting factor for CY 2007. While the furnishing fee payment rate is calculated at 3 digits, the actual amount paid to providers and suppliers is rounded to 2 digits. rmajette on PROD1PC67 with RULES2 4. Widely Available Market Prices (WAMP) and Average Manufacturer Price (AMP) Threshold Section 1847A(d)(1) of the Act states that ‘‘the Inspector General of HHS shall conduct studies, which may include surveys to determine the widely available market prices (WAMP) of drugs and biologicals to which this section applies, as the Inspector General, in consultation with the Secretary, determines to be appropriate.’’ Section 1847A(d)(2) of the Act states that, ‘‘based upon such studies and other data for drugs and biologicals, the Inspector General shall compare the ASP under this section for drugs and biologicals with— • The WAMP for these drugs and biologicals (if any); and • The AMP (as determined under section 1927(k)(1) of the Act) for such drugs and biologicals.’’ Section 1847A(d)(3)(A) of the Act states that, ‘‘the Secretary may disregard the ASP for a drug or biological that exceeds the WAMP or the AMP for such drug or biological by the applicable threshold percentage (as defined in paragraph 1847A(d)(3)(B)).’’ The applicable threshold is specified as 5 percent for CY 2005. For CY 2006 and subsequent years, section 1847A(d)(3)(B) of the Act establishes that the applicable threshold is the percentage applied thereafter, subject to such adjustment as the Secretary may specify for the WAMP or the AMP, or both. In CY 2006, we specified an applicable threshold percentage of 5 percent for both the WAMP and AMP. We based this decision on the limited data available to support a change in the current threshold percentage. VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 For CY 2007, we proposed to specify an applicable threshold percentage of 5 percent for the WAMP and the AMP. At present, the OIG is continuing its comparison of both the WAMP and the AMP. Currently, we do not have data that suggests that another level is more appropriate. Therefore, we believe that continuing the 5 percent applicable threshold percentage for both the WAMP and AMP is appropriate. We received numerous comments regarding our decision to maintain the WAMP and AMP threshold at 5 percent, as well as our request for comments regarding operational issues surrounding implementation of the 5 percent threshold. Comment: Several comments supported our decision to continue using 5 percent as the threshold and commended us for requesting comments on the important operational issues associated with price comparisons. Other commenters acknowledged that that there are many operational issues involved with implementation of the 5 percent threshold and advised us to proceed cautiously before adjusting payment amounts. These commenters stated that the AMP and the ASP use different methodologies when accounting for price concessions and such differences could result in varied ASP and AMP values. They also indicated that we have never issued a final rule describing how the AMP is calculated. The commenters indicated that such differences must be accounted for prior to substituting the WAMP or the AMP for the ASP. Commenters also encouraged us to provide stakeholders with an opportunity to comment through rulemaking prior to proceeding with the substitutions of payment allowances. Commenters were particularly interested in the methodology utilized by the OIG in conducting its surveys. Response: We understand that there are complicated operational issues associated with potential payment rate substitutions. Therefore we will proceed cautiously and provide stakeholders, particularly manufacturers of drugs impacted by potential price substitutions, with adequate notice of our intentions regarding such, including the opportunity to provide input with regard to the processes for substituting the WAMP or the AMP for the ASP. As required by statute, we are finalizing our proposal to establish the WAMP and AMP threshold at 5 percent for CY 2007. PO 00000 Frm 00058 Fmt 4701 Sfmt 4700 5. Payment for Drugs Furnished During CY 2006 and Subsequent Years in Connection With the Furnishing of Renal Dialysis Services if Separately Billed by Renal Dialysis Facilities In the CY 2006 PFS final rule (70 FR 70116), we stated that payment for a drug furnished during CY 2006 in connection with renal dialysis services and separately billed by freestanding renal dialysis facilities and hospitalbased facilities would be based on section 1847A of the Act. For CY 2007, we clarified that the policy would extend for CY 2006 and subsequent years until otherwise specified. We received comments regarding our policy clarification of the policy, as well as our intention to extend the policy beyond CY 2006 until otherwise specified. Comment: Several commenters supported our decision to clarify that the payment policy for separately-billed ESRD drugs applied to CY 2006 and subsequent years until otherwise specified. These commenters viewed the current payment policy as the best option available under the statute, citing consistency with the methodology used to pay for other Part B drugs. Commenters indicated that the current methodology was more accurate and easier to administer than attempting to update a prior year’s acquisition cost data. Other commenters, while applauding our decision to clarify the policy, explicitly encouraged us to be more direct and expressly state that the payment for drugs furnished in connection with renal dialysis services and separately billed by freestanding renal dialysis facilities and hospitalbased facilities will be based on ASP+6 percent. They indicated that stating that payment would be based on ASP+6 percent rather than stating that payment will be based on section 1847A of the Act would avoid confusion, provide clarity for the provider community, and ensure consistency with current regulatory language. Response: We appreciate the commenters who acknowledge that the current payment methodology is the most appropriate option available. We also thank the commenters who noted the discrepancy between the preamble language and regulatory text. We acknowledge that we inadvertently made reference to ASP+6 percent in our regulatory text instead of referring to section 1847A of the Act. In accordance with section 1881(b)(13)(A)(iii), payment for drugs furnished in 2006 and subsequent years will be based on the acquisition costs or the amount determined under section 1847A of the Act, as the Secretary may specify. The E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations rmajette on PROD1PC67 with RULES2 amount determined under section 1847A of the Act, except in limited circumstances, is ASP+6 percent. Therefore, we are revising the regulatory text to state that payment for a drug furnished during CY 2006 and subsequent years, until otherwise specified, in connection with renal dialysis services and separately billed by freestanding renal dialysis facilities and hospital-based facilities is based on section 1847A of the Act. Comment: MedPAC expressed concern that there is no recent evidence that ASP+6 percent reflects the variation in the acquisition of costs of physicians and dialysis providers and thus, the current payment rate should not be set indefinitely. They also recommended that in the future we periodically collect acquisition cost data from providers to gauge the appropriate percentage of ASP for the payment amount, acknowledging that an analysis of this data could lead to a different percentage amount for the payment rate. Response: We acknowledge MedPAC’s recommendations. We will continue to monitor the payment methodology in relation to the acquisition costs of physician and dialysis providers for future analysis. 6. Other Issues Comment: We have received several comments requesting the creation or revision of billing codes for certain drug products. Response: Requests for the creation of new or revised billing codes for drug products is outside the scope of this rulemaking. There is a separate, wellestablished, process for the public to make requests for new or revised billing codes for drug products through the HCPCS panel. More information on the HCPCS coding process can be obtained at the following Web site: https:// www.cms.hhs.gov/MedHCPCSGenInfo/. Comment: We received a few comments recommending that Medicare increase the pharmacy supplying fee it pays for immunosuppressive, oral anticancer, and oral-antiemetic drugs for 2007. We also received a comment suggesting that we have a process in place to increase the supplying fee over time so that it remains adequate. In addition, we received a comment asking that we make clear in the final rule that we will continue to reimburse the supplying fee in 2007 at the 2006 rates. Response: We pay a supplying fee for Medicare Part B drugs and biologicals eligible for a supplying fee are immunosuppressive drugs described in section 1861(s)(2)(J) of the Act, oral anticancer chemotherapeutic drugs described in section 1861(s)(2)(Q) of the VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 Act, and oral anti-emetic drugs used as part of an anticancer chemotherapeutic regimen described in section 1861(s)(2)(T) of the Act. For 2006, we pay a supplying fee of $24 per prescription for the first prescription in a 30-day period, and $16 per prescription for all subsequent prescriptions in a 30-day period. Medicare also pays a special supplying fee rate of $50 for the first immunosuppressive prescription after a Medicare covered transplant. Since we did not propose a change to these rates for 2007, they will continue to be in effect in 2007. Comment: We received a comment asking that we clarify how infusion drugs administered through DME will be paid in 2007, in light of the competitive bidding program that is authorized to be phased-in beginning in 2007. Response: Beginning in 2004, infusion drugs furnished through an item of DME covered under section 1861(n) of the Act are paid at 95 percent of the AWP in effect as of October 1, 2003. These payment rates continue until such time as the Secretary establishes a competitive acquisition program for these drugs in specific competitive acquisition areas, in which case the payment rates in the competitive acquisition areas will be determined under the CAP. Beginning in 2007, the Secretary has the authority, under section 1847 of the Act, to phase-in implementation of the competitive acquisition program, which will be the subject of separate rulemaking. G. Revisions Related to Payment for Renal Dialysis Services Furnished by End Stage Renal Disease (ESRD) Facilities In the CY 2007 PFS proposed rule (71 FR 48982), we outlined the proposed updates to the case-mix adjusted composite rate payment system established under section 1881(b)(12) of the Act, added by section 623 of the MMA. These included updates to the drug add-on component of the composite rate system, as well as the wage index values used to adjust the labor component of the composite payment rate. Specifically, we proposed the following provisions which are described in more detail below in this section. • A method to annually calculate the growth update to the drug add-on adjustment required by section 1881(b)(12) of the Act, as well as an estimated growth update adjustment to the add-on amount for CY 2007. PO 00000 Frm 00059 Fmt 4701 Sfmt 4700 69681 • An update to the wage index adjustments to reflect the latest hospital wage data, including a BN adjustment to the wage index for CY 2007. We received a total of 10 comments from the ESRD community that represented major organizations and concerned individuals. The comments and responses are summarized in the following sections. Comment: Several comments focused on the need to specify that payment for separately billable ESRD drugs in CY 2007 will continue at ASP +6 percent. The comments cross referenced a section in the CY 2007 PFS proposed rule (71 FR 49004) that discussed proposals for establishing the ASP rate for WAMPs and AMP. This proposal preceded the section outlining the proposed payment changes for ESRD facilities, and thus led to some confusion regarding the use of the ASPbased payment methodology for separately billable ESRD drug payments in CY 2007. Response: As noted in section II.E.5., entitled, ‘‘Payment for Drugs Furnished during CY 2006 and Subsequent Years in Connection with the Furnishing of Renal Dialysis Services if Separately Billed by Renal Dialysis Facilities,’’ we proposed no policy changes to the approach that we currently use to pay for separately billed ESRD drugs. Therefore, for CY 2007, payment for separately billable drugs furnished by ESRD facilities will continue at ASP+6 percent in accordance with section 1847A of the Act. Comment: We received a comment recommending that we implement the MedPAC’s recommendation that the composite rate be equalized between hospital-based and independent dialysis facilities. The commenter stated that, notwithstanding the language under 1881(b)(7) of the Act, we had the statutory authority to administratively revise the current hospital-based/ independent facility rate structure to provide the same rate to both facility types. Response: While section 1881(b)(7) of the Act provided some discretion in establishing the initial composite payment rates, it did specify the need to differentiate between hospital-based and other renal dialysis facilities. Therefore, based on our analysis of cost differences, we established separate composite rates for hospital-based facilities and independent facilities. Section 1881(b)(12) of the Act, added by section 623(d) of MMA, established a new basic case-mix adjusted payment system. The statute instructed us to use, as one of the elements of the new system, the services comprising the E:\FR\FM\01DER2.SGM 01DER2 69682 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations rmajette on PROD1PC67 with RULES2 composite rate established under section 1881(b)(7) of the Act. We believe that the statute requires that we carry forward the composite rate structure established in accordance with section 1881(b)(7) of the Act prior to enactment of MMA. The statute directed us to substitute, in place of a payment system based solely on the composite rate established under section 1881(b)(7) of the Act, a payment system comprised of the original composite rate, incorporating the services included under that composite rate, plus a drug add-on component. Moreover, the 1.6 percent update established under section 623(a) of MMA clearly contemplated that the update would be applied to ‘‘such composite rate payment amounts * * *’’ in effect in the prior year. Therefore, in accordance with section 1881(b)(12) of the Act, we will continue to maintain the separate composite rates for hospital-based and freestanding facilities that were established under section 1881(b)(7) of the Act. 1. Growth Update to the Drug Add-On Adjustment to the Composite Rates Section 623(d) of the MMA added section 1881(b)(12)(B)(ii) of the Act which required the establishment of an add-on to the composite rate to account for changes in the drug payment methodology stemming from enactment of the MMA. Section 1881(b)(12)(C) of the Act provides that the drug add-on must reflect the difference in aggregate payments between the revised drug payment methodology for separately billable ESRD drugs (acquisition costs in CY 2005; ASP+6 percent in CY 2006) and the AWP payment methodology in effect in CY 2004. In addition, section 1881(b)(12)(F) of the Act requires that, beginning in CY 2006, we establish an annual update to the drug add-on to reflect the estimated growth in expenditures for separately billable drugs and biologicals furnished by ESRD facilities. This growth update applies only to the drug add-on portion of the case-mix adjusted payment system. The CY 2006 drug add-on adjustment to the composite rate is 14.5 percent. The drug add-on adjustment for CY 2006 incorporates an inflation adjustment of 1.4 percent. This computation is explained in detail in the CY 2006 PFS final rule with comment period (70 FR 70162). We note that the drug add-on adjustment of 14.7 percent that was published in the CY 2006 PFS final rule with comment period did not account for the 1.6 percent update to the composite rate portion of the basic case-mix adjusted VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 payment system that was subsequently enacted by the DRA, effective January 1, 2006. Since we compute the drug addon adjustment as a percentage of the weighted average base composite rate, the drug add-on percentage was decreased to account for the higher composite payment rate resulting in a 14.5 percent add-on adjustment for CY 2006. This adjustment was necessary to ensure that the total drug add-on dollars remained constant. a. Estimating Growth in Expenditures for Drugs and Biologicals for CY 2007 In developing the growth update to the drug add-on for CY 2006, we conducted a trend analysis of prior years’ ESRD drug expenditure data (2001 through 2004). All 4 years of data used for the trend analysis reflected expenditures associated with payment for separately billed drugs and biologicals under the AWP methodology. Therefore, we could develop growth estimates for CY 2006 using comparable historical expenditure data. To extend the trend analysis for CY 2007, we would need to include drug expenditure data from CY 2005. However, in CY 2005, section 1881(b)(13)(A)(ii) of the Act required that we use a different drug payment methodology, based on average acquisition costs, rather than the AWP methodology used in prior years. Therefore, ESRD drug expenditure data for CY 2005 are not comparable to expenditure data for CY 2001 through CY 2004 for trend analysis purposes. This data issue will extend to subsequent years’ data as well since we are now paying for separately billable drugs using ASP+6 percent. Because we do not have comparable data on which to base continuing trend analysis, we decided to re-evaluate our methodology for updating the drug add-on adjustment. Section 1881(b)(12)(F) of the Act specifies that the drug update must reflect ‘‘the estimated growth in expenditures for drugs and biologicals that are separately billable * * *’’ By referring to ‘‘expenditures’’, we believe the statute contemplates that the update would account for both increases in drug prices, as well as increases in utilization of those drugs. In order to meet this requirement, we proposed an update methodology that uses the producer price index (PPI) for prescription drugs as a proxy measure of drug pricing growth, in conjunction with an estimate of per patient growth in drug utilization. We proposed to estimate growth in per patient utilization of drugs by using historical data from 2004 and 2005. PO 00000 Frm 00060 Fmt 4701 Sfmt 4700 In addition, we indicated that we would reconsider our methodology for updating the drug add-on component of the payment system when we have sufficient historical data reflecting the revised drug payment methodology using ASP pricing. Comment: Commenters were generally favorable toward using a standard index to update the drug addon adjustment, but were concerned about the calculation of the utilization factor. They suggested that we use our National Health Expenditures (NHE) projection that uses only the Medicare Part B component of the projection to estimate prescription drug expenditures. Response: We do not believe that the Part B drug projections included in the NHE projections would be the best proxy for the growth in ESRD drug expenditures. The NHE projections are based on the economic, demographic and Medicare spending projections contained in the Medicare Trustees Report, as opposed to an independent forecast of economic assumptions, such as the Global Insights projections of the PPI for prescription drugs that are used in our Medicare market basket forecasts to update many of our payment systems. The NHE projection modeling approach is at an aggregate level. It does not capture the nuances of both labor and economic markets as accurately as does the specific PPI forecast from Global Insights, Inc. We believe that using the PPI is a more accurate predictor of ESRD drug pricing growth. In addition, we believe that estimating utilization from reported ESRD claims data, as discussed below in this section, is superior to using NHE’s Part B projections. b. Estimating Growth in Per Patient Drug Utilization To isolate and project the growth in per patient utilization of ESRD drugs for CY 2007, we needed to remove the enrollment and price growth components from the latest historical drug expenditure data and consider the residual utilization growth. We proposed to use total drug expenditure data from CYs 2004 and 2005 to estimate per patient utilization growth for CY 2007. We first estimated total drug expenditures. For the CY 2007 PFS proposed rule (71 FR 49007), we used the final CY 2004 ESRD facility claims data and the latest available CY 2005 ESRD facility claims data, updated through December 31, 2005. That is, for CY 2005 we used claims that were received, processed, paid, and passed to the National Claims History File as of December 31, 2005. For this final rule with comment period, we are using E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations more updated CY 2005 claims with dates of service for the same time period. This updated CY 2005 data file includes claims that were received, processed, paid, and passed to the National Claims History File as of June 30, 2006. For the proposed rule, we adjusted the December 2005 file to reflect our estimate of what the total drug expenditures would be using the final June 30, 2006 bill file for CY 2005. The net adjustment we applied to the CY 2005 claims data was an increase of 13 percent to the December 2005 expenditure data. For this final rule, we are using the CY 2005 claims file as of June 30, 2006, which represents the final claims file for that year. Next, we removed the enrollment and price growth components from total estimated drug expenditures for CYs 2004 and 2005. To calculate the per patient utilization growth, we removed the enrollment component by using the growth in enrollment data between 2004 and 2005. This was approximately 3 percent. To remove the price effect, we used a twostep process. For the proposed rule, we first calculated a weighted average between erythopoeitin (EPO) and nonEPO price growth factors to account for the growth in pre-MMA pricing between 2004 and 2005. Since EPO was priced at $10 per thousand units prior to the implementation of the MMA, there was no growth for EPO between 2004 and 2005. For the non-EPO drugs, we used the PPI as a proxy for the growth between the 2 years to maintain consistency with the established methodology for calculating the drug add-on adjustment for CY 2005 which used the PPI to estimate the price growth in separately billable drugs (69 FR 66321). For the proposed rule, we next incorporated the estimated negative 13 percent weighted price difference between 2005 AWP and 2005 AAP pricing as was published in the CY 2005 PFS final rule with comment period (69 FR 66319 through 66334). This two-step process accounts for the price effect from 2004 to 2005, that is, an overall 12 percent reduction in price between 2004 and 2005. For the proposed rule, following the removal of the enrollment and price effects from the expenditure data, we expected the residual growth to reflect the per patient utilization growth. To remove the enrollment and price effects, we divided the product of the enrollment growth of 3 percent (1.03) and the price reduction of 12 percent (1.00 ¥ 0.12 = 0.88) into the total drug expenditure decrease between 2004 and 2005 of 9 percent (1.00 ¥ 0.09 = 0.91). VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 The result was a proposed utilization factor equal to 1.00 ((0.91/1.03)/0.88) = 1.0). We observed no growth in per patient utilization of drugs between 2004 and 2005. Therefore, we projected no growth in per patient utilization for CY 2007. Comment: On commenter suggested that we should use the drug expenditure weights we developed in computing the drug add-on adjustment related to ASP pricing for 2006, rather than the weights developed by the OIG with respect to acquisition costs for 2005. This would have resulted in an overall price reduction of 13.2 percent rather than the overall reduction of 12 percent we used in our calculation. Response: We believe it would be more appropriate to use the published OIG weights as they represent the weights that were used to develop the 2005 drug add-on adjustment. If we were to use updated weights, it would be more appropriate to use actual 2005 weights. Preliminary analysis suggests that if we were to develop weights based on the most recent 2005 expenditure data, the resulting price reduction factor would be well under 13.2 percent. However, as discussed above in this section, we believe the price reduction calculation should be consistent with the calculation used to develop the 2005 drug add-on adjustment. Therefore, for this final rule with comment we are using the same 12 percent price reduction factor calculated in the proposed rule. Comment: One commenter indicated that their analysis resulted in a slightly different value for the reduction in total drug expenditures than we calculated between 2004 and 2005. Rather than the 9 percent reduction we calculated for the proposed rule, this commenter computed a 9.198 percent reduction using the 2004 5 percent sample file compared to the 2005 ESRD file. Response: Although the 2004 5 percent file may have contained a significant number of ESRD claims, our analysis uses 100 percent of the 2004 ESRD facility claims. As such, we believe the results calculated by the commenter are consistent with our results, but that slight differences would be expected when an incomplete file is used. For the final rule, using the latest, complete ESRD claims file for CY 2005 (June 30, 2006), we computed a 9.5 percent reduction in total ESRD facility drug expenditures between CY 2004 and CY 2005. Comment: We received one comment that the source of the 3 percent enrollment growth we projected for CY 2007 was unclear, and did not match PO 00000 Frm 00061 Fmt 4701 Sfmt 4700 69683 the Part B enrollment growth included in the 2006 Trustees Report. Response: The 3 percent enrollment growth projection represents the estimated growth factor specific to dialysis patients between CY 2004 and CY 2005. Comment: One comment expressed concern that we were basing payment policy on the assumption that the new EPO monitoring policy would decrease utilization of drugs. Response: The determination of the CY 2007 update was not based on an assumption that the new EPO monitoring policy would decrease utilization. The discussion of the EPO monitoring policy was only intended to illustrate the need to use the latest data available to determine utilization, especially since new policies such as the EPO monitoring could affect utilization growth in the future. The potential effect of the monitoring policy was not incorporated into the computation of the CY 2007 adjustment factor. i. Applying the Growth Update to the Drug Add-On Adjustment For CY 2006, we estimated the growth update by trending drug expenditures forward based on four years of AWP payment data (CY 2001 through CY 2004). We then applied the estimated growth update percentage to the total amount of drug add-on dollars established for CY 2005 to come up with a dollar amount for the CY 2006 growth update. In addition, we projected the growth in dialysis treatments for CY 2006 based on the projected growth in ESRD enrollment. We divided the projected total dialysis treatments for CY 2006 into the projected dollar amount of the CY 2006 growth to develop the per treatment growth update amount. This growth update amount, combined with the CY 2005 per treatment drug add-on amount, resulted in an average drug add-on amount per treatment of $18.88 (or a 14.5 percent adjustment to the composite rate) for CY 2006. Beginning in CY 2007, we proposed to annually update the per treatment drug add-on amount of $18.88 established in CY 2006 and convert the update to an adjustment factor as stipulated in section 1881(b)(12)(F) of the Act. By proposing to apply the update to the CY 2006 per treatment add-on amount, the need to estimate growth in dialysis treatments is eliminated for CY 2007 and future years. We received no comments on this proposed change and are therefore adopting this provision in this final rule. E:\FR\FM\01DER2.SGM 01DER2 69684 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations rmajette on PROD1PC67 with RULES2 ii. Update to the Drug Add-On Adjustment In the proposed rule, we estimated no growth in per patient utilization of ESRD drugs for CY 2007. Using the projected growth of the CY 2007 PPI for prescription drugs of 4.9 percent, we projected that the combined growth in per patient utilization and pricing for CY 2007 would result in an update equal to the PPI growth or 4.9 percent (1.0 × 1.049 = 1.049). This proposed update factor was applied to the CY 2006 average per treatment drug add-on amount of $18.88 (reflecting a 14.5 percent adjustment in CY 2006), resulting in a proposed weighted average increase to the composite rate of $0.93 for CY 2007 or a 0.6 percent increase in the CY 2006 drug add-on percentage. Thus, the total proposed drug add-on adjustment to the composite rate for CY 2007, including the growth update, was 15.2 percent (1.145 × 1.006 = 1.152). In addition, we proposed to continue to use this method to estimate the growth update to the drug add-on component of the case-mix adjusted payment system until we have at least 3 years worth of ASP-based historical drug expenditure data that could be used to conduct a trend analysis to estimate the growth in drug expenditures. Given the time lag in the availability of ASP drug expenditure data, we expect that the earliest we could consider using trend analysis to update the drug add-on adjustment would be 2010. We proposed to reevaluate our methodology for estimating the growth update at that time. Comment: We received comments requesting clarification concerning the PPI projections we use in calculating the growth update to the drug add-on adjustment. Response: We use the PPI for prescription drugs developed by Global Insight for the fourth quarter of 2007, which represents a four quarter average percent change projection between 2006 and 2007. For the final rule we are using the latest projection for 2007 which is 4.03 percent. Comment: A number of comments recommended that a mechanism be established to provide for forecasting error adjustment of prior estimates. This adjustment would be applied only for the years covered by the proposed interim methodology for updating the drug add-on adjustment. The comments suggest that once stable expenditure data is available to use historical trend analysis for updating the drug add-on adjustment, the forecast error VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 adjustment would no longer be necessary. Response: We have not accepted this recommendation. While we appreciate the concern related to accuracy of an update based on proxy measures for price and the proposed utilization computations, the very nature of estimating future expenditures under a prospective payment system requires that those estimates are based on the best historical data available. As such, we believe we have met our obligation under the statue in estimating the growth in ESRD drug expenditures for CY 2007. Moreover forecast error adjustments are rarely made in any of CMS’ prospective payment systems. We also note that even after ASP expenditure data become available for purposes of using trend analysis to estimate future expenditures, those estimates may not be the same as actual expenditures. That could also be the case for the 2006 update currently in effect. While the commenters are not suggesting that we revisit the 2006 update, we believe that once we set the policy of adjusting any year’s estimated update, we would need to do so for all years, not just those covered by the proposed interim update methodology. Comment: One commenter wanted an update on the steps we were taking to obtain drug utilization data from hospital-based ESRD facilities for purposes of refining the drug add-on adjustment related to those providers. In last year’s final rule we indicated that we would pursue options for obtaining that data (70 FR 70163). Response: We have determined that a separate data collection of historical drug dosing data for hospital based facilities would be both burdensome and costly. Therefore, we decided not to pursue that avenue for estimating the drug add-on amount related to those facilities. However, once we have 2006 ASP data, we will evaluate the difference in payments to hospital-based ESRD facilities under cost reimbursement compared to ASP-based payments to determine if our drug addon estimate was reasonable. iii. Final Growth Update to the Drug Add-On Adjustment for 2007 Similar to the proposed rule, we estimated no growth in per patient utilization of ESRD drugs for CY 2007. We removed the enrollment and price effects from the expenditure data to determine the per patient utilization growth. To do this, we divided the product of the enrollment growth of 3 percent (1.03) and the price reduction of 12 percent (1.00¥0.12 = 0.88) into the total drug expenditure decrease between PO 00000 Frm 00062 Fmt 4701 Sfmt 4700 2004 and 2005 of 9.5 percent (1.0¥0.095 = 0.0905). The result is a utilization factor equal to 1.0 ((0.905/ 1.03)/0.88) = 1.0). Using the projected growth of the CY 2007 PPI for prescription drugs of 4.03 percent, we projected that the combined growth in per patient utilization and pricing for CY 2007 would result in an update equal to the PPI growth or 4.03 percent (1.0 × 1.0403 = 1.0403). This update factor was applied to the CY 2006 average per treatment drug add-on amount of $18.88 (reflecting a 14.5 percent adjustment in CY 2006), resulting in a weighted average increase to the composite rate of $0.76 for CY 2007 or a 0.5 percent increase in the CY 2006 drug add-on percentage. Thus, the total drug add-on adjustment to the composite rate for CY 2007, including the growth update, is 15.1 percent (1.145 × 1.005 = 1.151). c. OIG Report on New Drug Codes Section 623(c)(1) of the MMA mandated that the OIG conduct two studies to determine the difference between the Medicare payment amount for separately billable ESRD drugs and the facilities’ acquisition costs for these drugs, as well as estimating the growth rate of expenditures for these drugs. The initial study, ‘‘Medicare Reimbursement for Existing End Stage Renal Disease Drugs’’ (OEI–03–04–00120), was completed in May 2004, and reported on existing ESRD drugs. This report was used to set the CY 2005 payment rates for ESRD drugs billed by independent dialysis facilities (69 FR 66322). The second study (‘‘Medicare Reimbursement for New ESRD Drugs’’ (OEI–03–06–00200)) focused on new drugs. New drugs for the purpose of this study were defined as an ESRD drug that did not have a billing code prior to January 1, 2004. One drug, darbepoetin alfa (Aranesp) accounted for the majority of all payments for new drugs. Therefore, this was the only new ESRD drug studied. The OIG report found that use of this drug was limited to a small number of facilities (only 157 facilities reported using this drug with concentrated use in approximately 55 of these facilities). Because of the recent changes we made to the drug payment methodology and the lack of comparable historical data, the OIG report made no estimate of an expenditure growth rate for this drug. Darbepoetin alfa (Aranesp) is currently paid as a separately billable drug at ASP+6 percent. Because of the recent (CY 2006) implementation of the ASP+6 percent drug payment methodology, the small number of facilities using this drug for ESRD E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations patients, and the lack of historical data for trending purposes, we have no data to indicate that any difference in payment methods for Aranesp (between CY 2004 and CY 2006) would affect our calculation of the drug add-on or of the growth update. Moreover, since Aranesp was approved in 2001 for use in ESRD patients, we believe that expenditures for Aranesp were reflected in the historical data used to establish the CY 2005 drug add-on under a generic drug code. Therefore, we proposed to make no additional changes to the drug addon adjustment for CY 2007. We received no comments on this issue. 2. Update to the Geographic Adjustments to the Composite Rates Section 1881(b)(12)(D) of the Act, added by section 623(d) of the MMA, gave the Secretary the authority to revise the wage indexes previously applied to the ESRD composite rates. The wage indexes are calculated for each urban and rural area. The purpose of the wage index is to adjust the composite rates for differing wage levels covering the areas in which ESRD facilities are located. rmajette on PROD1PC67 with RULES2 a. Updates to the CBSA Definitions In the CY 2007 proposed rule (71 FR 49008), we published revised CBSAbased geographic areas which reflected all of the changes announced by OMB in Bulletins 05–02 and 06–01 issued February 22, 2005 and December 5, 2005, respectively. Those bulletins changed the titles of several of the MSAs and Metropolitan Divisions used in connection with the urban wage index. b. Updated Wage Index Values In the CY 2006 PFS final rule with comment period, we stated that we intended to update the wage index values annually (70 FR 70167). Current ESRD wage index values for CY 2006 were developed from FY 2002 wage and employment data obtained from the Medicare hospital cost reports. The values are calculated without regard to geographic reclassifications authorized under sections 1886(d)(8) and (d)(10) of the Act and utilize pre-floor hospital data that is unadjusted for occupational mix. The methodology for calculating the CY 2006 wage index values was described in the CY 2006 PFS final rule with comment period (70 FR 70168). We proposed to use the same methodology for CY 2007, with the exception that FY 2003 hospital data will be used to develop the CY 2007 ESRD wage index values. For a detailed description of the development of the CY 2007 ESRD wage VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 index values based on FY 2003 hospital data see the FY 2007 IPPS final rule entitled, ‘‘Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates,’’ (71 FR 48016). Section F of the preamble to that final rule describes the cost report schedules, line items, data elements, adjustments, and wage index computations. The wage index data affecting ESRD composite rates for each urban and rural locale may also be accessed on the CMS Web site at: https://www.cms.hhs.gov/ AcuteInpatientPPS/WIFN/list.asp. The wage data are located in the section entitled, ‘‘FY 2007 Final Rule Occupational Mix Adjusted and Unadjusted Average Hourly Wage and Pre-Reclassified Wage Index by CBSA’’. Comment: One commenter criticized our use of hospital wage and employment data to develop the ESRD wage index. The commenter maintained that the use of hospital data presumed that wage levels in hospitals and freestanding ESRD facilities are similar, a conclusion which has not been substantiated. The commenter urged us to locate an alternative data source that reflects information directly tied to ESRD facilities. Response: Although the mix of occupations in hospitals is broader and more diverse, ESRD facilities compete with hospitals for labor. While the use of wage and employment data from freestanding ESRD facility cost reports would result in the development of a wage index which reflected ESRD wage levels among independent facilities, the administrative burden posed by the need for the Medicare fiscal intermediaries to engage in a separate data collection to compile, edit, and validate ESRD wage and employment data would be considerable. Given the similarity of the labor market for professional, technical, and nursing staff between hospitals and ESRD facilities, we believe our use of hospital wage and employment data obtained from the Medicare cost reports to develop the ESRD wage index is appropriate. (i) Wage Index Values for Areas With No Hospital Data In CY 2006, while adopting the CBSA designations, we identified a small number of ESRD facilities in both urban and rural geographic areas where there is no hospital wage data on which to base the calculations of the CY 2006 ESRD wage index values. The first situation was rural Massachusetts. Because there were no reasonable proxies for rural data within Massachusetts, we used the prior year’s acute care hospital wage index value for PO 00000 Frm 00063 Fmt 4701 Sfmt 4700 69685 rural Massachusetts. For CY 2007, we proposed to continue to use this value and requested public input on an alternative methodology. Since there may be additional rural areas in the future similarly impacted by a lack of hospital wage data on which to derive a hospital wage index, we stated that we were considering alternative methodologies for imputing a rural wage index for areas in States where no hospital wage data are available. We also described an alternative methodology whereby we would impute a rural wage index value by using a simple average CBSA-based rural wage index value at the Census Division level. For CY 2007, hospital wage data are not available to compute a rural wage index for ESRD facilities in rural Massachusetts, and this proposed alternative methodology could be applied in this case. Massachusetts is located in Census Division I (New England). Under this proposed alternative methodology, the States in Census Division I for which rural wage index values are available would be used; this would result in a simple average proposed rural wage index value of 1.0227 (1.0770 after applying BNF). Rural Puerto Rico is similar to rural Massachusetts in that there are ESRD facilities where there are no acute care hospitals and, therefore, no hospital data. However, the situation for facilities in rural Puerto Rico is different in that the floor would be applied to rural Puerto Rico ESRD facilities. All areas in Puerto Rico that have an index are eligible for the floor because they have wage-index values that are less than 0.8000. For CY 2007, we proposed to apply the floor to rural Puerto Rico. The third situation involves an urban area in Hinesville, GA (CBSA 25980). For CY 2006, we used a wage index value based on the average of the wage index values in all of the other urban areas within the same State to serve as a reasonable proxy for the urban areas without hospital wage index data. Specifically, we used the average wage index value for all urban areas within the State of Georgia as the urban wage index for purposes of calculating the value for Hinesville for CY 2006. For CY 2007, we proposed to continue using this method for Hinesville, GA (CBSA 25980). We solicited comments on maintaining our current policy for establishing wage index values for rural and urban areas without hospitals or adopting an alternative approach. We also indicated that we would continue to evaluate existing hospital wage data and, possibly, wage data from other E:\FR\FM\01DER2.SGM 01DER2 69686 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations sources, such as the Bureau of Labor Statistics, to determine if other methodologies of imputing a wage index value where hospital wage data are not available may be feasible. We received no comments on maintaining our current policy for establishing wage index values for rural and urban areas without hospitals, or an alternative approach for developing wage index values for rural areas without hospitals for CY 2007 and subsequent years. Therefore, for CY 2007, we will maintain our current policies for establishing wage index values for rural and urban areas: • For rural Massachusetts, we will continue to use the prior year’s acute care hospital wage index value for rural Massachusetts. • For rural Puerto Rico, we will apply the CY 2007 ESRD wage index floor. • For Hinesville, GA (CBSA 25980), we will use the average wage index value for all urban areas within the State of Georgia as the urban wage index for purposes of calculating the value for Hinesville for CY 2007. (ii) Second Year of the Transition For each transition year, the share of the blended wage-adjusted base payment rate that is derived from the MSA-based and CBSA-based wage index values is shown in Table 10. In the CY 2007 PFS proposed rule, we proposed no changes to the transition. CY 2007 is the second year of the 4-year transition period. Consistent with the transition blends, we are implementing a 50/50 blend between an ESRD facility’s MSA-based composite rate, and its CY 2007 CBSA-based rate reflecting its revised wage index values. For CY 2007, we are reducing the wage index floor to 0.80. As we stated in the CY 2006 PFS final rule with comment period, we intend to reassess the continuing need for a wage index floor in CY 2008 and CY 2009 (70 FR 70169 through 70170). The wage index floors, caps, and blended shares of the composite rates applicable to all ESRD facilities during CYs 2007 through 2009 are shown in Table 10. They are identical to the values shown in Table 20 of the CY 2006 PFS final rule with comment period (70 FR 70170) for the applicable years. TABLE 10.—WAGE INDEX TRANSITION BLEND Old MSA (percent) CY payment Floor Ceiling 2007 .................................................. 2008 .................................................. 2009 .................................................. 0.80* ................................................. Reassess .......................................... Reassess .......................................... None ................................................. None ................................................. None ................................................. 50 25 0 New CBSA (percent) 50 75 100 *Each wage index floor is multiplied by a BN adjustment factor. For CY 2007 the BN adjustment is 1.052818 resulting in an actual wage index floor of 0.8423. The following is an example of how the wage-adjusted composite rates would be blended during CY 2007 and the 2 subsequent transition years. Example: An ESRD facility has a wage-adjusted composite rate (without regard to any case-mix adjustments) of $135.00 per treatment in CY 2006. Using CBSA-based geographic area designations, the facility’s CY 2007 wage-adjusted composite rate, reflecting its wage index value as shown in Addendum H, would be $145.00. During the remaining 3 years of the 4year transition period to the new CBSAbased wage index values, this facility’s blended rate through CY 2009 would be calculated as follows: CY 2007 = (0.50 $135.00) + (0.50 × $145.00) = $140.00 CY 2008 = (0.25 × $135.00) + (0.75 × $145.00) = $142.50 CY 2009 = (0.00 × $135.00) + (1.00 × $145.00) = $145.00 We note that this hypothetical example assumes that the calculated wage-adjusted composite rate of $145.00 for CY 2007 does not change in CYs 2008 and 2009. In actuality, the wageadjusted composite rate would change because of annual revisions to the wage index. However, the example serves only to demonstrate the effect on the composite rate of the CBSA-based wage index values which will be phased-in during the remaining 3 years of the transition period. Comment: One commenter representing a number of dialysis facilities in Puerto Rico disagreed with our proposal to reduce the wage index floor to 0.80, pointing out that wage index values have not been realistically updated in quite some time. The commenter was concerned with further reductions in composite payments and recommended that the reduction in the wage index floor for CY 2007 be suspended. Another commenter also recommended that the impact of any further planned proposed reductions in the wage index floor be thoroughly considered before implementation because of potential impact on the ability of dialysis facilities to recruit and retain qualified personnel. Response: We believe that the ESRD wage index should not be artificially constrained by the application of floors and ceilings. We eliminated the cap of 1.30 because of the effect it had on restricting payments in high wage areas. While we would like to eliminate the floor as well, we recognized that its immediate elimination could substantially reduce composite payments in locales where prevailing labor costs are lower. Accordingly, in CY 2006 we implemented a reduction in the wage index floor to 0.85, and proposed a further reduction to 0.80 in CY 2007. We plan to reassess the continuing application of the wage index floor in connection with the CY 2008 and CY 2009 updates to the composite payment rates. The actual wage index values for urban locales in Puerto Rico, without application of any floor and prior to the application of the CY 2007 the BN adjustment, are shown in Table 11. TABLE 11.—WAGE INDEX VALUES FOR URBAN LOCALES IN PUERTO RICO rmajette on PROD1PC67 with RULES2 CBSA code 10380 21940 25020 32420 38660 Urban area ................ ................ ................ ................ ................ VerDate Aug<31>2005 Wage index Aguadilla-Isabela-San Sebastian ......................................................................................................................... Fajardo .................................................................................................................................................................. Guayama .............................................................................................................................................................. Mayaguez ............................................................................................................................................................. Ponce .................................................................................................................................................................... 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00064 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 0.3922 0.4044 0.3241 0.3857 0.4851 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69687 TABLE 11.—WAGE INDEX VALUES FOR URBAN LOCALES IN PUERTO RICO—Continued CBSA code Urban area 41900 ................ 41980 ................ 49500 ................ San German-Cabo Rojo ....................................................................................................................................... San Juan-Caguas-Guaynabo ............................................................................................................................... Yauco .................................................................................................................................................................... rmajette on PROD1PC67 with RULES2 The proposed CY 2007 wage index floor of 0.80 is substantially higher than each of the above wage index values. After application of the BN adjustment to the wage index floor of 0.80, each area in Puerto Rico has a wage index of 0.8423 reflected in its composite rate. Therefore, we believe that the CY 2007 wage index floor of 0.80 compared to actual wage levels will not adversely affect access to care for dialysis patients in Puerto Rico. With respect to the commenter’s concern that the wage index values have not been updated in quite some time, we point out that the CY 2007 wage index values were developed from the latest available FY 2003 hospital wage and employment data obtained from the Medicare cost reports. While we will not suspend application of the proposed 0.80 wage index floor in CY 2007, we intend to carefully assess the potential impact of any further proposed reductions in the wage index floor for CY 2008 and following years. c. Budget Neutrality (BN) Adjustment Section 1881 (b)(12)(E)(i) of the Act, as added by section 623(d) of the MMA, requires that any revisions to the ESRD composite rate payment system as a result of the MMA provision (including the geographic adjustment) be made in a budget neutral manner. This means that aggregate payments to ESRD facilities in CY 2007 should be the same as aggregate payments that would have been made if we had not made any changes to the geographic adjusters. We note that the BN adjustment discussed in this final rule only addresses the impact of changes in the geographic adjustments. A separate BN adjustment was developed for the case-mix adjustments, currently in effect. Since we did not propose any changes to the case-mix measures for CY 2007, the current case-mix BN will remain in effect for CY 2007. For CY 2007, we again proposed to apply a BNF directly to the ESRD wage index values, as we did in CY 2006. As we explained in the CY 2006 PFS final rule with comment period (70 FR 70170 through 70171), we believe this is the simplest approach because it allows us to maintain our base composite rates during the transition from the current wage adjustments to the revised wage VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 Wage index adjustments described earlier in this section. Because the ESRD wage index is only applied to the labor-related portion of the composite rate, we computed the proposed BNF adjustment based on that proportion (53.711 percent). To compute the proposed CY 2007 wage index BNF, we used the proposed wage index values, 2005 outpatient claims (paid and processed as of December 31, 2005), and geographic location information for each facility. Using treatment counts from the 2005 claims and facility-specific CY 2006 composite rates, we computed the estimated total dollar amount each ESRD provider would have received in CY 2006 (the first year of the 4-year transition). The total of these payments became the target amount of expenditures for all ESRD facilities for CY 2007. Next, we computed the estimated dollar amount that would have been paid to the same ESRD facilities using the ESRD wage index for CY 2007 (the second year of the 4-year transition). The total of these payments became the second year new amount of wage-adjusted composite rate expenditures for all ESRD facilities. After comparing these dollar amounts (target amount divided by second year new amount), we calculated an adjustment factor that, when multiplied by the applicable CY 2007 ESRD wage index, would result in aggregate payments within the target amount of composite rate expenditures. The proposed BN adjustment factor for the CY 2007 wage index was 1.053069. To ensure BN we also must apply the BNF to the wage index floor of 0.8000 which resulted in a proposed adjusted wage index floor of 0.8425 for CY 2007. Comment: We received comments asking that we clarify the calculation of the wage index BNF so that commenters could understand that the BNF is being calculated correctly. One commenter asked that we provide both the data and the methodology so that they could assess the accuracy of our computations. Response: During the comment period on the CY 2007 PFS proposed rule, we made available an ESRD Composite Payment System File. This file contained select claim level data from the 2005 ESRD facility outpatient claims, updated through December 31, PO 00000 Frm 00065 Fmt 4701 Sfmt 4700 0.4893 0.4397 0.3861 2005. For more information on this file, see the following link: https:// www.cms.hhs.gov/IdentifiableDataFiles/ 05.asp#TopOfPage. After the publication of this final rule with comment period, we intend to make available the updated version of the CY 2005 outpatient claims (paid and processed as of June 30, 2006) that were used to compute the BNF. To compute the final CY 2007 ESRD wage index BNF, we used FY 2003 prefloor, pre-reclassified, non-occupational mix-adjusted hospital wage data to compute the wage index values, 2005 outpatient claims (paid and processed as of June 30, 2006), and geographic location information for each ESRD facility which may be found through Dialysis Facility Compare. The FY 2003 hospital wage index data for each urban and rural locale by CBSA may also be accessed on the CMS Web site at: https://www.cms.hhs.gov/ AcuteInpatientPPS/WIFN/list.asp. The wage index data are located in the section entitled, ‘‘FY 2007 Final Rule Occupational Mix Adjusted and Unadjusted Average Hourly Wage and Pre-Reclassified Wage Indexes by CBSA’’. Dialysis Facility Compare can be found by going to the following CMS Web site: https://www.cms.hhs.gov/ DialysisFacilityCompare/. Using treatment counts from the latest 2005 claims file and facility-specific CY 2006 composite rates, we computed the estimated total dollar amount each ESRD provider would have received in CY 2006 (the first year of the 4-year transition). The total of these payments became the target amount of expenditures for all ESRD facilities for CY 2007. Next, we computed the estimated dollar amount that would have been paid to the same ESRD facilities using the ESRD wage index for CY 2007 (the second year of the 4-year transition). The total of these payments became the second year new amount of wage-adjusted composite rate expenditures for all ESRD facilities. After comparing these dollar amounts (target amount divided by second year new amount), we calculated an adjustment factor that, when multiplied by the applicable FY 2007 wage index value, will result in aggregate payments to ESRD facilities that will remain E:\FR\FM\01DER2.SGM 01DER2 69688 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations within the target amount of composite rate expenditures. When making this calculation, the ESRD wage index floor value of 0.8000 is used whenever appropriate. The final BN adjustment factor for the CY 2007 wage index is 1.052818. To ensure BN we also must apply the BNF to all index values, including the wage index floor of 0.8000, which results in an adjusted wage index floor of 0.8423 for CY 2007. d. ESRD Wage Index Tables Addenda F and G show the CY 2007 ESRD wage index, including the BNF adjustment, for urban areas (Addendum F) and rural areas (Addendum G). rmajette on PROD1PC67 with RULES2 H. Private Contracts and Opt-Out Provision—Practitioner Definition Section 4507 of the BBA amended section 1802 of the Act to permit certain physicians and practitioners to opt-out of Medicare if certain conditions were met, and to provide through private contracts services that would otherwise be covered by Medicare. Before enactment of the BIPA (Pub. L. 106– 554), section 1802(b)(5)(C) of the Act, which refers to the definition of ‘‘practitioner’’ at section 1842(b)(18)(C) of the Act, did not include registered dietitians or nutrition professionals among the practitioners who may choose to opt-out of Medicare. Section 105(d) of the BIPA amended the definition of practitioner located at section 1842(b)(18)(c) of the Act to include registered dietitians or nutrition professionals. Because section 1802(b)(5)(C) of the Act references section 1842(b)(18)(c) of the Act in order to define the term practitioner for purposes of opting out of Medicare, current law permits registered dietitians or nutrition professionals to opt-out of Medicare. Because the definition of practitioner located at § 405.400 does not include registered dietitians or nutrition professionals, we proposed to amend that section so that it is consistent with section 1802(b)(5)(C) of the Act. Commenters were very supportive of our proposals. Therefore, we are finalizing the changes to § 405.400 as proposed. I. Changes to Reassignment and Physician Self-Referral Rules Relating to Diagnostic Tests In the CY 2007 PFS proposed rule, we stated that recent changes to our rules on reassignment of the right to receive Medicare payment may have led to some confusion as to whether the antimarkup and purchased interpretation requirements apply to certain situations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 where a reassignment has occurred under a contractual arrangement. We also stated that we were concerned about the existence of certain arrangements that are not within the intended purpose of our physician selfreferral rules, which allow physician group practices to bill for services furnished by a contractor physician in a ‘‘centralized building’’ as defined at § 411.351. We are concerned that allowing physician group practices or other suppliers to purchase or otherwise contract for the provision of diagnostic tests and then to realize a profit when billing Medicare may lead to patient and program abuse in the form of over utilization of services and result in higher costs to the Medicare program. We proposed to amend our reassignment regulations to clarify how the purchased test and purchased interpretation rules apply in the case of a reassignment made under the contractual arrangement exception set forth at § 424.80(d)(2). In addition, we proposed to change the definition of ‘‘centralized building’’ at § 411.351 of the physician self-referral regulations to place certain restrictions on what types of space ownership or leasing arrangements will qualify for purposes of the physician self-referral in-office ancillary services exception and physician services exception. We received numerous comments on our proposals. Instead of issuing final regulations at this time, we are studying the issues further and plan to issue final regulations in the near future. We remain committed to addressing revenue-driven arrangements that may be facilitating over utilization of diagnostic services, but do not wish to unduly impact legitimate group practice arrangements that enable Medicare beneficiaries to have the convenience of receiving medical services at one location. J. Supplier Access to Claims Billed on Reassignment Section 1842(b)(6) of the Act generally provides that Medicare may pay Part B benefits only to the physician or other supplier who performed the service, or to the beneficiary. This provision, known as the prohibition on reassignment, contains several exceptions. Section 952 of the MMA amended section 1842(b)(6)(A)(ii) of the Act to allow a physician or other person who was in a contractual arrangement rather than in an employee-employer relationship to reassign his or her right to bill and receive payment, irrespective of whether the services were performed on the premises of the entity. In implementing section 952 of the MMA, PO 00000 Frm 00066 Fmt 4701 Sfmt 4700 we amended § 424.80(d) to provide that a supplier, who reassigns his or her right to bill Medicare to an entity with which he or she is employed as an independent contractor, has the right to access the entity’s billing information concerning the services the supplier is alleged to have performed and for which the entity billed Medicare. We extended such a right in order to give added assurance that the services for which such an entity billed Medicare were in fact performed and were performed as billed. In the CY 2007 PFS proposed rule, we stated that we believe that employees, in addition to independent contractors, should have access to records on billings for services furnished by them (71 FR 49057 through 49058). We proposed changing the title of § 424.80(d) and amending § 424.80(d)(2) of our regulations to state that the individual supplier who reassigns his or her right to bill and receive Medicare payment to an entity has unrestricted access to claims information submitted by that entity for services furnished by the individual supplier, irrespective of whether the supplier is an employee or an independent contractor of the entity receiving payment. Under our proposal, if an entity receiving the reassigned benefits were to refuse to provide the billing information to the employee supplier requesting the information, the entity’s right to receive reassigned benefits could be revoked under § 424.82(c)(3) (which is currently the case with respect to an entity’s refusal to provide billing information to an independent contractor supplier). We are adopting the proposal without modification. Comment: Two commenters who support the proposal stated they are unsure how having unrestricted access to submitted claims data will correspond to improved program integrity. They believe that a more practical approach to ensure Medicare program integrity would be to incorporate physician involvement in compliance programs that are structured to address risk areas particular to their operations. These commenters are also concerned that providing unrestricted access to submitted claims data is not a clear requirement for a billing entity to meet. Response: We believe that by allowing a physician or other supplier access to billing information concerning services allegedly performed by that physician or other supplier, we gain more assurance that entities that are billing on reassignment are billing for services actually performed and are otherwise billing accurately for such services. E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations With respect to the commenters’ suggestion that physician involvement in compliance programs offers a more practical approach to ensure Medicare program integrity, we believe that physicians should be engaged already in compliance programs, and that such involvement should include the physician regularly requesting access to billing records for services that he or she allegedly performed and that are being billed to Medicare, through a reassignment, by the entity that employs the physician as an independent contractor or employee. We disagree that our proposal would pose an unclear requirement for entities to meet. An entity that bills Medicare for services that were allegedly performed by a physician or other supplier in the entity’s employ may not unreasonably refuse to provide access (or unreasonably delay in providing access) to the physician or other supplier with respect to the relevant billing information. We do not believe it is practical or necessary to attempt to define by regulation just how soon after a request an entity has to provide access, or whether, in a given case, an entity would be justified in refusing to provide access if the physician or supplier has already gained access to the records. Rather, we believe that entities should be guided by common sense and when in doubt may wish to err on the side of providing access, because an entity that unreasonably refuses to provide billing information or does not provide it in a timely manner may have its right to receive reassigned benefits revoked under § 424.82(c)(3). Comment: We received one comment opposing the proposal. According to this commenter, in section 952 of the MMA, the Congress authorized us to make changes to the reassignment rules with respect to contractor arrangements only. The Congress evidenced no intent to change the reassignment rules with respect to employees, and nor is there any evidence of which the commenter is aware that right of access by employee suppliers is a current program integrity issue. The commenter also believes that access to billing information is a matter that should be left to the terms of a provider’s employment contract. Response: For the reasons stated in the CY 2007 PFS proposed rule (71 FR 49057), we believe we are permitted, but not required, to make payment under the reassignment provisions. Moreover, we are under a statutory command, through section 1833(e) of the Act, to not make payment unless we are satisfied that payment is correct. Our rulemaking authority for our proposal is not based on section 952 of the MMA, VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 but rather on our general rulemaking authority found at sections 1102(a) and 1871(a) of the Act. We also believe for the reasons stated in the proposed rule that the same program integrity concerns with respect to contractor access to billing records also apply to employee access to billing records. And, we reiterate that we are aware of allegations of employee suppliers being denied access to their billing records. Moreover, we do not believe it is sufficient to leave it to physicians and other suppliers to negotiate access to billing records as a condition of their employment, as the parties may have unequal bargaining power. Comment: A commenter stated that if the supplier has claims liability, he or she should have access to the billing records, but that if the supplier does not have claims liability he or she should not have access to the billing records. Response: Irrespective of whether the supplier has claims liability, we have an interest in knowing whether we are paying correctly for services that were furnished or furnished as billed. Therefore, we wish to provide a right of access to billing information to all suppliers who are furnishing services and reassigning payment to their employers, and we encourage them to avail themselves of this right in order to ensure that we are paying properly. K. Coverage of Bone Mass Measurement In an IFC entitled ‘‘Medicare Coverage of and Payment for Bone Mass Measurements’’ published in the Federal Register on June 24, 1998 (63 FR 34320), we implemented section 4106 of the BBA by establishing a new section, § 410.31, Bone Mass Measurement: Conditions for Coverage and Frequency Standards. Section 4106 of the BBA statutorily defined BMM and individuals that are qualified to receive a BMM. The June 24, 1998 IFC, under the ‘‘reasonable and necessary’’ provisions of section 1862(a)(1)(A) of the Act, also established conditions for coverage of the tests that must be ordered by physicians or NPPs. Lastly, as directed by section 4106 of the BBA, we established frequency standards governing the time period when qualified individuals would be eligible to receive covered BMMs. 1. Provisions of the June 24, 1998 IFC The June 24, 1998 IFC implemented section 4106 of the BBA by establishing conditions for coverage and frequency standards for BMMs to ensure that they are paid for uniformly throughout the Medicare program and that they are reasonable and necessary for Medicare beneficiaries who are eligible to receive PO 00000 Frm 00067 Fmt 4701 Sfmt 4700 69689 these measurements. This section summarizes the provisions discussed in the June 24, 1998 IFC. a. Coverage Conditions and Frequency Standards We established conditions for coverage and frequency standards for medically necessary BMMs for five categories of Medicare beneficiaries in § 410.31. In § 410.31(a), we defined ‘‘bone mass measurement’’ based on the statutory definition in section 4106 of the BBA. In accordance with the ‘‘reasonable and necessary’’ provisions of section 1862(a)(1)(A) of the Act, we established the conditions for coverage of BMMs in § 410.31(b) of the regulations. Consistent with § 410.32 (Diagnostic x-ray tests, diagnostic laboratory tests, and diagnostic tests: Conditions), we provided that coverage be available for the BMM only if it is ordered by the physician or a qualified NPP (as defined in § 410.32(a)) treating the beneficiary following an evaluation of the beneficiary’s need for the test, including a determination as to the medically appropriate procedure to be used for the beneficiary. We believed that BMMs were not demonstrably reasonable and necessary unless (among other things) they are ordered by the physician treating the beneficiary following a careful evaluation of the beneficiary’s medical need, and they are employed to manage the beneficiary’s care. To ensure that the BMM is performed as accurately and consistently in accordance with appropriate quality assurance guidelines as possible, we required that it be performed under the appropriate supervision of a physician as defined in § 410.32(b)(3). To ensure that the BMM is medically appropriate for the five categories specified in the law, we provided that it be reasonable and necessary for diagnosing, treating, or monitoring the condition of the beneficiary who meets the coverage requirements specified in § 410.31(d). Furthermore, in § 410.31(c), we set forth limitations on the frequency for covering a BMM. Generally, we cover a BMM for a beneficiary if at least 23 months have passed since the month the last BMM was performed. However, we allow for coverage of follow-up BMMs performed more frequently than once every 23 months when medically necessary. We listed the following examples of situations where more frequent BMMs procedures may be medically necessary to include: • Monitoring beneficiaries on longterm glucocorticoid (steroid) therapy of more than 3 months. E:\FR\FM\01DER2.SGM 01DER2 69690 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations • Allowing for a confirmatory baseline BMM (either central or peripheral) to permit monitoring of beneficiaries in the future if the initial test was performed with a technique that is different from the proposed monitoring method. that the section does not apply to payment for BMMs. b. Beneficiaries Who May Be Covered In § 410.31(d), we amended our regulations to conform to the statutory requirement that the following categories of beneficiaries may receive Medicare coverage for a medically necessary BMM: • A woman who has been determined by the physician or a qualified NPP treating her to be estrogen-deficient and at clinical risk for osteoporosis, based on her medical history and other findings. • An individual with vertebral abnormalities as demonstrated by an xray to be indicative of osteoporosis, osteopenia, or vertebral fracture. • An individual receiving (or expecting to receive) glucocorticoid (steroid) therapy equivalent to 7.5 mg of prednisone, or greater, per day, for more than 3 months. • An individual with primary hyperparathyroidism. • An individual being monitored to assess the response to or efficacy of an FDA-approved osteoporosis drug therapy. rmajette on PROD1PC67 with RULES2 c. Waiver of Liability Section 410.31(e) provides that Medicare payment would be denied for a BMM in accordance with section 1862(a)(1)(A) of the Act if the regulatory standards are not satisfied. Existing regulations concerning limitation on liability are set forth in § 411.400 through § 411.406 and are applicable to denial of BMMs under § 410.31. d. Payments for BMMs Medicare payments for covered BMMs are paid for under the PFS (42 CFR part 414) as required by statute. In the June 24, 1998 IFC, we revised the definition of ‘‘physician services’’ in § 414.2 to include bone mass measurements. When BMM procedures are furnished to hospital inpatients and outpatients, the TCs of these procedures are payable under existing payment methods for hospital services. These methods include payments under the prospective payment system, on a reasonable cost basis, or under a special provision for determining payment rates for hospital outpatient radiology services. In the June 24, 1998 IFC, we revised § 414.50(a), regarding physician billing for purchased diagnostic tests, to clarify VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 e. Conforming Changes In the June 24, 1998 IFC, to allow for appropriate placement in the CFR of the BMM coverage requirements, we redesignated § 410.31 (Prescription drugs used in immunosuppressive therapy) as § 410.30. 2. Additional Scientific Evidence In 2004, the Surgeon General issued a report, Bone Health and Osteoporosis (U.S. Department of Health and Human Services, Bone Health and Osteoporosis: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General, 2004). This report provides scientific evidence related to the prevention, assessment, diagnosis, and treatment of bone disease. The report states that identification of those at risk of bone disease and fracture is important so that appropriate interventions can be implemented. However, as the report states, ‘‘Assessing the risk of bone disease and fracture remains a challenge. Not all of the risk factors have been identified, and the relative importance of those that are known remains unclear.’’ As bone strength is not measured directly, bone mineral density (BMD) remains the single best predictor of fracture risk, with the most widely accepted method for measuring BMD being the dual energy x-ray absorptiometry (DXA) for a bone density study at the axial skeleton (for example, hips and spine). As there are many sources of variability in the measurement of BMD, a quality control system related to both the methodology and reporting of test results is important to ensure the validity of DXA analysis. In addition to DXA of the axial skeleton, bone mass can also be measured using other techniques. These other techniques include DXA bone density study for the appendicular skeleton (for example, radius, wrist, heel); quantitative computerized tomography (QCT), BMD study for the axial skeleton or appendicular skeleton; radiographic absorptiometry (photodensitometry, radiogrammetry); single-photon absorptiometry (SPA); single energy x-ray absorptiometry (SXA) for the appendicular skeleton; and ultrasound BMD study for the appendicular skeleton. For these techniques (except for SPA which was not discussed), the 2004 Surgeon General report states, ‘‘While these methods do assess bone density and may provide an indication of fracture risk, it is important to note that the PO 00000 Frm 00068 Fmt 4701 Sfmt 4700 WHO [World Health Organization] recommendations and other guidelines for using BMD and interpreting BMD results for diagnosis are based on DXA measurements of the hip or spine.’’ The report further states, ‘‘Incorporating these techniques for bone assessment into future clinical trials and observational studies will help in better understanding their appropriate use as a means of predicting the risk of bone disease and fracture.’’ 3. Changes to the June 24, 1998 IFC We received 18 public comments on the June 24, 1998 IFC. The majority of the comments had specific recommendations for changes to the IFC. Based on the comments received on the IFC, the Surgeon General’s report, and other evidence, we proposed changes to § 410.31. We solicited comments on these proposals. 4. Analysis of and Response to Comments on the June 24, 1998 IFC and the CY 2007 PFS Proposed Rule In this final rule, we are responding to the public comments that we received on our proposed revisions to § 410.31. In addition, as we stated in CY 2007 proposed rule, we are responding to the public comments received on the June 24, 1998 IFC. We received approximately 35 timely public comments on our proposed revisions to the regulations regarding coverage for bone mass measurements (§ 410.31). Most commenters supported the proposed coverage revisions and noted their specific concerns and provided suggested revisions to several of the coverage provisions. However, most of the commenters expressed significant concerns regarding proposed payment reductions for these tests that would result from initiatives described in other sections of the proposed rule relative to PE and other payment calculations. Comments and our responses regarding the proposed payment reductions are detailed in section II.A.4. of the preamble to this final rule. The following is a summary of our proposals and the comments received and our responses on the coverage for bone mass measurement: a. ‘‘BMM’’ Definition (§ 410.31(a)) At § 410.31(a)(2), we proposed to revise the definition of ‘‘bone mass measurement’’ to remove coverage for the use of SPA, which uses isotope sources to measure BMD. Many medical experts indicate that SPA has largely been replaced by the newer techniques of DXA, which are believed to be superior in accuracy and precision. Medicare claims data in recent years E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations continue to show a steady decline in the use of the SPA procedure by the beneficiary population. Further, there is a lack of evidence to support continued use of SPA, an older procedure where the metrics have not been correlated with fracture rate. We proposed to revise the definition of a ‘‘bone mass measurement’’ to read, ‘‘Is performed with either a bone densitometer (other than a singlephoton or dual-photon absorptiometry) or with a bone sonometer system that has been cleared for marketing for this use by the FDA under 21 CFR part 807, or approved for marketing by the FDA for this use under 21 CFR part 814.’’ Comment: We requested comments on our proposal to noncover SPA, including any evidence of benefit for this technique, particularly in comparison with other alternatives. Most of the commenters supported the position that SPA has largely been replaced by the newer, more accurate, and precise techniques such as SEXA and DXA, and we should not continue to cover them. However, a commenter from the June 24, 1998 IFC suggested that while use of SPA devices (at the wrist) is declining as newer and faster equipment is becoming available, we should continue to cover their use indefinitely based on the view that their accuracy and precision are close to that of x-ray based techniques at the wrist and heel and that their radiation exposure is low. Response: We agree with the more recent comments concerning SPA and note that we proposed to noncover SPA tests beginning in CY 2007. In response to the June 24, 1998 IFC comment regarding continuing coverage indefinitely, we note that Medicare claims data in recent years continue to show a steady decline in the use of the SPA procedure by the beneficiary population as the more accurate and precise procedures have become much more widely available. We agree that there is a lack of evidence to support continued use of the older SPA procedure where the metrics have not been correlated with fracture risk. Therefore, we are revising the definition of ‘‘bone mass measurement’’ in § 410.31(a) to remove coverage for the use of SPA. As a result, the status indicator for CPT code 78350 will change from active (A) to noncovered (N) effective January 1, 2007. Comment: A June 24, 1998 IFC commenter expressed the view that available research and their experience had demonstrated that the use of peripheral DXA at the heel is superior to any other BMD test taken at any other peripheral site. The commenter believes VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 that the heel DXA is a superior approach for the initial osteoporosis screening because of its—(1) strong correlation to fracture probability; (2) the reactive nature of the heel to bone mass changes; (3) patient preference for a less threatening exam; (4) the elimination of radiation exposure to the abdomen that results from a central bone mass measurement; and (5) the ability of the peripheral heel DXA to deliver a service at a lower cost than most other BMM technologies. Response: Based on our review of the available medical literature, we have determined that there is insufficient evidence to conclude that peripheral DXA at the heel is a superior method of BMD measurement when compared to other peripheral sites. Thus, we are not making any changes to our proposal based on this comment. Comment: A commenter expressed concern about our statement in the June 24, 1998 IFC indicating that QCT can measure bone density at the spine and hip. The commenter indicated that only central (axial) DXA can measure BMD at the spine or hip and QCT is limited to the spine or the wrist. The commenter also stated that spine QCT exposes the patient to a significantly higher dose of radiation and that the technique is significantly less precise than central DXA or peripheral DXA or ultrasound. The commenter recommended that we drop coverage of this technique once there is sufficient geographic overlap between QCT and the alternative techniques, which are believed to be less costly, safer, and a more precise means of measuring bone mass than the QCT technique. Response: On the basis of our review of the existing medical literature, we have determined that QCT can provide both central (spine and hip) and peripheral BMD measurements but does expose the patient to significantly higher doses of radiation. Though the appropriate use of QCT has yet to be defined, it may be used as an alternative to spine and hip DXA measurements as a method for measuring BMD (Surgeon General’s Report, 2004). Therefore, we are not making any changes to our proposal as a result of this comment. Comment: Another commenter from the June 24, 1998 IFC stated that there is insufficient evidence to support the clinical utility of BMD measurements of an individual’s finger, tibia, or patella, which are performed by the use of either a peripheral x-ray or an ultrasound device, and suggested that measurement of those peripheral sites not be covered under Medicare. Response: Measurement of peripheral bone density for screening and initial PO 00000 Frm 00069 Fmt 4701 Sfmt 4700 69691 diagnosis can be accomplished by various techniques, though the appropriate use of these technologies in the prediction of bone disease and the risk of fracture has yet to be clearly defined. Therefore, we are not revising our proposal based on this comment. b. Conditions for Coverage (§ 410.31(b)) In § 410.31(b), we proposed to revise the conditions for coverage for BMMs by requiring that for a medically necessary BMM to be covered for an individual being monitored to assess the response to or efficacy of an FDA-approved osteoporosis drug therapy (§ 410.31(d)(5)) the individual would be required to meet the present conditions for coverage under § 410.31(b), and the monitoring would have to be performed by the use of an DXA system (axial system). We recognized that in the June 24, 1998 IFC, we allowed the physician or qualified NPP treating the beneficiary more flexibility in ordering those diagnostic measurements, but we proposed to limit that flexibility for the type of BMM that is used for monitoring individuals receiving osteoporosis drug therapy and other purposes (as discussed later in this section) because of new evidence and other information received since publication of the June 24, 1998 IFC that supports the need for requiring the use of the DXA measurement (axial skeleton) in those circumstances. In addition to the 2004 Surgeon General’s Report that recognized the superiority of the DXA (axial skeleton) for measuring bone mass over time, the International Society for Clinical Densitometry currently recommends that if an individual has a low bone mass using a peripheral measurement (appendicular skeleton) he or she should have a DXA (axial skeleton) performed for monitoring or confirmatory diagnostic purposes. Therefore, we also proposed to revise § 410.31(b) by adding a requirement that in the case of any individual who qualifies for a BMM as provided for in § 410.31(d) and who receives a confirmatory baseline BMM to permit monitoring in the future, Medicare may cover a medically necessary BMM for that individual, if the present conditions for coverage under § 410.31(b) are met, and the BMM is performed by a DXA system (axial skeleton) (if the initial measurement was not performed by this system). As indicated previously in this section, the most widely accepted method for measuring BMD is the use of DXA (Surgeons General’s Report 2004) at axial skeletal sites. DXA (axial skeleton) measures BMD at the hip and E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 69692 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations spine (sites likely to fracture in patients who have osteoporosis). DXA is precise, safe, and low in radiation exposure, and permits more accurate and reliable monitoring of individuals over time. DXA of the femoral neck is the best validated test to predict hip fracture and is comparable to forearm measurements for predicting fractures at other sites (Evidence Report/Technology Assessment No 28, Agency for Healthcare Research and Quality (AHRQ), January 2001). Comment: Several June 24, 1998 IFC commenters expressed concern regarding the following statement from the June 24, 1998 IFC that ‘‘there is a consensus that measurements of the central skeletal sites is the preferred method of assessment’’ as compared with measurements of peripheral skeletal sites. These commenters stated that peripheral devices provide basically the same measurement benefits as central devices and have the added advantages of being easier to use, allowing greater patient accessibility, and reducing patient radiation exposure. However, the majority of the commenters on both the IFC and the proposed rule, strongly supported the aforementioned statement from the IFC and expressed specific concern that the IFC allowed for coverage of peripheral BMMs that have not been demonstrated to be useful in monitoring patients who are receiving osteoporosis drug therapies. These commenters agreed that only central devices (especially the DXA device) were useful in monitoring patients receiving pharmacologic therapy and they specifically recommended that peripheral tests be limited to screening for osteoporosis, and not be used for monitoring patients receiving FDA-approved osteoporosis drug therapy. Response: As we indicated in the proposed rule, we agree that the most widely accepted method for measuring BMD is the use of dual x-ray absorptiometry (DXA) (Surgeon General’s report 2004) at central skeletal sites. DXA measures BMD at the hip and spine (sites likely to fracture in patients who have osteoporosis), is precise, safe, and low in radiation exposure, and permits monitoring over time. DXA of the femoral neck is the best validated test to predict hip fracture and is comparable to forearm measurements for predicting fracture at other sites (AHRQ report 2001). The World Health Organization (WHO) classification of BMD for the diagnosis of osteoporosis is based primarily on reference data obtained by DXA of the axial skeleton. When monitoring the effectiveness of therapy, these central skeletal sites are VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 more likely than peripheral sites to show an increase in BMD over time. For these reasons, we believe that the use of DXA at central sites is the best method for measuring BMD for both monitoring patients receiving FDA-approved osteoporosis drug therapy, and confirming BMD measurements performed on peripheral devices for patients who may be monitored in the future. In view of the comments received and our review of the medical literature, and other information, we are adopting our revision of § 410.31(b) without change. Comment: While most of the commenters supported our proposal to limit coverage of monitoring patients receiving osteoporosis drug therapy and for performing confirmatory baseline tests to the DXA of the central (axial) skeleton, several commenters urged us not to preclude coverage of QCT of the central (axial) skeleton for these purposes for individuals who have had an initial screening with a peripheral test. These commenters stated that the QCT technology has been relied upon for some time now by certain hospitals and imaging centers, and it would be unfair to them and their patients to preclude coverage for their tests in the final rule. Response: We agree with the commenters who supported our proposal to limit coverage of monitoring patients receiving osteoporosis drug therapy, for performing confirmatory baseline test to the DXA of the central (axial) skeleton, and to not allow coverage of the QCT for these purposes. (Surgeon General’s Report, 2004). The radiation exposure is significantly higher, for example, with the use of the lumbar spine QCT than is the case with the use of the DXA at central skeletal sites (Surgeon General’s Report, 2004). Therefore, we are not making any change to our proposal based on these comments. Comment: A commenter supported our proposal to change the conditions of coverage and standards on frequency of bone mass measurements to encourage the use of DXA of the axial skeleton for confirmatory baseline tests and for monitoring a patient’s response to therapy, but cautioned that the medical literature does not support the use of DXA or other BMMs to assess efficacy of osteoporosis therapies. The commenter recommended that CMS clarify that BMM is not appropriate for monitoring the efficacy of osteoporosis therapies in preventing bone fractures. Response: We recognize that the goals of monitoring patients are to increase adherence to treatment regimens and determine treatment response even PO 00000 Frm 00070 Fmt 4701 Sfmt 4700 though monitoring by densitometry has not been demonstrated to be effective in improving compliance (NIH Consensus Panel, 2001). Importantly, BMD changes are not correlated with the fracture risk reduction resulting from antiresorptive treatment (Roux, Garnero 2005). Therefore, while the efficacy of antiresorptive treatments has been verified in large trial powered to show reductions in fracture risk, it does not appear that fracture risk can be measured in individual patients being treated for osteoporosis. We are not making any changes to the final rule based on this comment. c. Bone Mass Measurement: Standards on Frequency of Coverage (§ 410.31(c)) To conform the examples of a BMM exception to the standards on frequency of coverage in § 410.31(c)(2) to the regulation change we proposed in § 410.31(b)(3), we proposed to revise the confirmatory baseline test example in § 410.31(c)(2)(ii) to read, ‘‘Allowing for a confirmatory baseline measurement to permit monitoring of beneficiaries in the future if the requirements of paragraph (b)(3) of this section are met.’’ Comment: A number of commenters offered recommendations on the exceptions in paragraph (c)(2) to the general rule in paragraph (c)(1) that provided that ‘‘Except as allowed under paragraph (c) (2) of this section, Medicare may cover a bone mass measurement (BMM) for a beneficiary if at least 23 months have passed since the month the last BMM was performed.’’ The exceptions specified were— (1) monitoring beneficiaries on long-term glucocorticoid (steroid) therapy of more than 3 months; and (2) allowing for a confirmatory baseline BMM to permit monitoring of beneficiaries in the future. These commenters indicated that in addition to the exceptions specified in paragraph (c)(2), there were certain individuals who were at higher risk of bone loss due to a disease, drug therapy, or other reasons who should be measured more frequently than once every 2 years. Most of these commenters recommended that these individuals should have a follow-up measurement at least once every 12 or every 12 to 18 months. Another commenter asked us to make an exception under paragraph (c) (2) for individuals with hyperparathyroidism who due to their diagnosis require both a DXA of the axial and the appendicular skeleton upon initial testing. Response: In establishing the frequency of coverage general rule in § 410.31(c)(1) of the IFC, we relied upon the guidance of the American Association of Clinical E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations Endocrinologists, the ACR, and the National Osteoporosis Foundation, which appeared to be generally in agreement for the need to follow certain clinical guidelines for performing follow-up BMMs to the initial BMM that is performed. Based on that information, we specified in the June 24, 1998 IFC a general frequency of coverage interval of one follow-up examination every 2 years, identifying examples of situations where more frequent BMMs may be covered when medically necessary. We have decided to basically retain that general frequency of coverage standard and continue to allow Medicare contractors to cover additional exceptions to the specified exception examples based on medical necessity, even though there is a lack of evidence that adjusting therapy based on serial densitometry at any level improves outcomes (AHRQ Report 2001). Followup testing should be done when the expected change in BMD is at least equal to or exceeds the least significant change, which is the smallest change in BMD that is beyond the range of error, as changes in BMD are usually small in proportion to the error inherent in the test itself (Baim, Wilson et al., 2005). Each DXA facility should determine its precision error and then calculate the least significant change (Baim, Wilson et al., 2005). Regarding the comment on individuals with hyperparathyroidism, we recognize that the mechanics of bone loss may be different for these patients than they are for estrogen-deficient postmenopausal women, resulting in fracture risks that may be different and more difficult to determine (Miller, Bilezikian, 2002). Thus, it may be medically necessary for a treating provider to perform both a DXA of the axial and the appendicular skeleton in the initial screening of patients with this diagnosis. However, we believe the evidence is insufficient to establish a national policy exception to the 2-year frequency standard for these individuals as specified in § 410.31(c). Nonetheless, we have decided to allow the treating provider to determine what is medically necessary in any particular case, subject to the review of the local Medicare contractor. Comment: A June 24, 1998 IFC commenter questioned whether we would cover bone mass measurements for individuals on steroid therapy every 6 months after the initial treatment, as well as a baseline exam at the start of therapy as was suggested in the reference to the recommendations of others in the June 24, 1998 IFC (63 FR 34234). Response: For those individuals on steroid therapy who are at high risk for VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 osteoporosis, as well as for other medical circumstances where it might be appropriate to cover more than one BMM every 2 years, the treating provider currently has considerable flexibility in accordance with our regulations to determine the frequency of testing in any particular case, subject to the review of the local Medicare contractor. However, in the absence of sufficient evidence in the medical literature to support any specific frequency interval for individuals receiving steroid therapy, we are not establishing any specific frequency interval for coverage of these individuals in this regulatory example of possible exceptions to the general standard in section § 410.31(c) of the final rule. Rather, we are leaving this to our local Medicare contractors, based on the best evidence that is available to them and their medical consultants. Comment: A June 24, 1998 IFC commenter expressed concern regarding our policy in § 410.31(c)(2)(ii) that allows coverage of a confirmatory baseline BMM (either central or peripheral) to permit monitoring of beneficiaries in the future if the initial test was performed with a technique that is different from the proposed monitoring method. That is, a qualified individual may be tested initially with DXA at the hip and spine and then have a confirmatory test with a peripheral device on which the patient is to be monitored every 2 years. The commenter suggested that this policy be revised to preclude coverage of the confirmatory test by the use of a peripheral device because its precision is significantly poorer than the stationary table DXA. The commenter believes that peripheral devices are best suited for screening and initial diagnosis and not for monitoring a patient’s response to drug therapy. Response: We agree that confirmatory testing with a peripheral device should be precluded from coverage. As stated in the Surgeon General’s report, as well as recommendations by the International Society of Clinical Densitometry (Journal of Clinical Densitomery 2004; 7:1–5), central skeletal sites are most appropriate for monitoring the effectiveness of therapy, as they are more likely than peripheral sites to show an increase in BMD in response to treatment. Therefore, we included a provision in the proposed rule revising § 410.31(c)(2)(ii) to preclude coverage of a confirmatory test that is performed with the use of a peripheral device and to limit such coverage to a central (axial) DXA. For the reasons described above, as well as the general support of the public PO 00000 Frm 00071 Fmt 4701 Sfmt 4700 69693 commenters on the proposed rule, we are adopting this revision as final without change. d. Bone Mass Measurement: Beneficiaries Who May Be Covered (§ 410.31(d)) The Congress has recognized that individuals receiving long-term glucocorticoid steroid therapy are qualified individuals for purposes of section 1861(rr)(1) of the Act. Therapy to prevent bone loss in most patients beginning long-term therapy has been recommended at a prednisone equivalent of greater than 5 mg/day for at least 3 months (McIlwain, 2003). Based on our review of the current evidence, we proposed to reduce the dosage equivalent in § 410.31(d)(3) from an average of 7.5 mg/day of prednisone for at least 3 months to an average of 5.0 mg/day of prednisone for the same period. Comment: A number of commenters expressed concern that certain categories of individuals that warranted inclusion under the BMM benefit were not covered and they recommended that the IFC be revised to include them in the final rule. However, a commenter noted that the Medicare law needed to be amended so that the legal definition of ‘‘qualified’’ individuals for BMM coverage keeps pace with additional current scientific and clinical evidence on who is at risk for osteoporosis. Overall, more than 27 additional categories of ‘‘qualified’’ individuals were recommended for coverage of bone mass measurements under the benefit. These included patients diagnosed with male hypogonadism, Parkinson’s disease, multiple sclerosis, myasthenia gravis, Gaucher’s disease, mastocytosis, malabsorption syndromes, history of bulimia, chronic lung disease, renal disease, diabetes mellitus, rheumatoid arthritis, secondary hyperparathyroidism and nonvertebral fractures, tobacco dependence, as well as patients on heparin therapy, anticonvulsant therapy, methotrexate therapy, thyroid replacement therapy, and antiepileptic drug therapy, etc. Response: We have carefully reviewed the above additional categories of individuals who have been recommended for Medicare coverage under the final rule, and have concluded that they do not qualify for coverage under the specific statutory language mentioned above. Section 1861(rr) of the Act provides that the term ‘‘qualified individual’’ for purposes of this benefit means ‘‘an individual who is (in accordance with regulations prescribed by the Secretary)—(A) an estrogen-deficient E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 69694 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations woman at clinical risk for osteoporosis; (B) an individual with vertebral abnormalities; (C) an individual receiving long-term glucocorticoid steroid therapy; (D) an individual with primary hyperparathyroidism; or (E) an individual being monitored to assess the responsive to or efficacy of an approved osteoporosis drug therapy.’’ Therefore, we believe a change in the Medicare statute would be required in order for us to cover these additional categories of individuals under the BMM benefit. Comment: Most of the commenters supported our broad interpretation of the statutory category of ‘‘An estrogendeficient woman and at clinical risk for osteoporosis’’ that was specified in the interim final regulation provision § 410.31(d)(1). A June 24, 1998 IFC commenter noted that because the risk factors associated with osteoporosis are so numerous and complex, it is appropriate to allow a woman’s treating physician or other treating practitioner to determine whether she is estrogendeficient or a clinical risk of osteoporosis. However, several June 24, 1998 IFC commenters were concerned about how the definition would be implemented by Medicare contractors. A commenter expressed concern that because there is not an existing ICD–9– CM diagnosis code to describe the condition of estrogen-deficient, this could result in the need for practitioners to use several other ICD–9–CM codes that describe conditions likely to result from estrogen deficient, and in variations in Medicare coverage from carrier to carrier. Response: We allowed the treating physician or other treating practitioner the discretion and flexibility to determine whether a female beneficiary is estrogen-deficient and at clinical risk for osteoporosis. Creating a code specifically for reimbursement when the condition is described by other codes is not required. Therefore, we are not making any changes to our proposals based on these comments. Comment: Several IFC commenters indicated that the beneficiary category in § 410.31(d)(5) of ‘‘An individual being monitored to assess the response to or efficacy of an FDA-approved osteoporosis drug therapy’’ is too limited and should be expanded to include coverage of individuals receiving other treatments, including certain medications that do not have FDA approval for osteoporosis treatment, and certain rehabilitation treatments such as therapy-weight lifting and similar interventions. A commenter noted, for example, that didronel, which has been approved by the FDA for the treatment of Paget’s VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 disease, is not FDA-approved for osteoporosis treatment but, its safety and efficacy in reducing or reversing steroid-induced osteoarthritis is supported by a large body medical literature. Response: We recognize that not all Medicare beneficiaries who are treated for osteoporosis are prescribed FDAapproved osteoporosis drug therapy. However, in implementing the statutory mandate in section 1861(rr)(2) of the Act to include as a ‘‘qualified individual’’ for Medicare-covered bone mass measurements ‘‘an individual being monitored to assess the response to, or efficacy of an approved osteoporosis drug therapy,’’ we do not believe it is appropriate for us to extend such coverage to beneficiaries who are receiving non-FDA approved osteoporosis drug therapies. Thus, we are not adopting the changes recommended by the commenters. Comment: A number of commenters addressed our proposal to revise § 410.31(d)(3) which stated that one of the categories of beneficiaries who was entitled to receive Medicare coverage for a medically necessary BMM was ‘‘An individual receiving (or expecting to receive) glucocorticoid (steroid) therapy equivalent to 7.5 mg of prednisone, or greater, per day for more than 3 months.’’ The majority of these commenters suggested that the minimum requirement of 7.5 mg of prednisone, or greater, per day provision was too strict, and that a dose requirement of 5.0 mg per day was more appropriate. However, several commenters stated that even lower dosage amounts than 5.0 mg have been shown to cause significant bone loss over prolonged periods of time, usually because of comorbidities such as rheumatoid arthritis. A commenter recommended that this beneficiary category be expanded to allow coverage for any patient taking steroids for longer than 3 months regardless of the dose that is taken by the patient. Another commenter was also concerned about the 7.5 mg of prednisone, or greater, per day provision, but suggested a minor change that would allow an individual receiving (or expecting to receive) glucocorticoid (steroid) therapy equivalent to an average of 7.5 mg of prednisone, or greater, per day for more than 3 months to be covered under the benefit. This commenter stated that use of the average measurement is more in line with the realities of modern medicine and would clarify that those individuals who are receiving the same dosage at different intervals (every other day) are eligible for coverage. PO 00000 Frm 00072 Fmt 4701 Sfmt 4700 Response: We agree that the minimum 7.5 mg of prednisone dose provision needs to be lowered and that use of an average dose measurement in specifying this standard is appropriate. Patients with glucocorticoid-induced osteoporosis appear to be at high risk for fractures. Researchers have reported that reductions in bone mass have been seen as early as 3 months after starting therapy (McIlwain, 2003). Therapy to prevent bone loss in most patients beginning long-term therapy has been recommended at a prednisone equivalent of ≥5 mg/day for at least 3 months (McIlwain, 2003). Based on the comments that we have received and our review of the current evidence, we are adopting our proposal to revise § 410.31(d)(3) to reduce the minimum dosage requirement from 7.5 mg to an average of 5.0 mg/day of prednisone for at least 3 months. Comment: Several IFC commenters expressed concern that Medicare beneficiaries at risk for osteoporosis due to their use of antiepileptic drugs are not eligible for an initial bone mass screening because they are not included in any of the five categories of patients defined as ‘‘qualified individuals.’’ The commenter indicates that if it is not possible to change this under current law is it possible for us to confirm that follow-up monitoring tests would be covered every 2 years for a patient on anti-epileptic drugs who shows signs of osteoporosis and who is then placed on osteoporosis FDA-approved drug therapy. Response: We agree that patients on antiepileptic drugs may be at increased risk for fractures. Still, the current law does not generally address this group of patients as ‘‘qualified’’ individuals under section 1861(rr) of the Act. Monitoring of individuals on antiepileptic drugs who may also be FDAapproved drug therapy for osteoporosis, of course, may be covered as provided under the BMM benefit. e. Use of the NCD Process (§ 410.31(f)) To facilitate future consideration of coverage of additional BMM systems for purposes of proposed paragraphs § 410.31(b)(2) and (b)(3), which will limit coverage of BMMs for monitoring individuals receiving osteoporosis drug therapy and for performing confirmatory baseline measurements, we proposed to identify additional BMM systems for those purposes through the NCD process. By using the NCD process, we could conduct a timely assessment of FDA-approved BMMs. Use of an NCD to add coverage of effective BMM systems for these purposes is authorized by the reasonable and necessary provision of E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations sections 1862(a)(1)(A) and 1871(a)(2) of the Act. Comment: One commenter requests that we give Medicare carriers discretion to cover new and advanced technologies that become available to screen for risk of fracture rather than requiring that such technologies be evaluated through the NCD as specified in the proposed rule. The commenter stated that the NCD process can be long and cumbersome, and that requiring that new technologies be added through this process could prevent beneficiaries from having access to these new and better technologies for some length of time. Response: The IFC implemented section 4106 of the BBA by establishing conditions for coverage and frequency standards for BMMs to ensure that (among other things) they are paid for uniformly throughout the Medicare program. To ensure that important new and advanced BMM technologies as defined under the statute and regulations are paid for uniformly under the program, we believe they should be identified and evaluated through the NCD process. By relying on the NCD process for this purpose, we believe we will able to conduct a timely assessment of FDA-approved BMMs for possible uniform coverage under the program that is not possible if we left this to local contractor discretion. In most circumstances, the NCD process is required to be completed within 9 to 12 months of the time that we accept a formal request for an NCD on a particular procedure. Comment: Several commenters noted that the WHO is currently in the process of developing a standardized methodology for determining fracture risk. A commenter indicated that although DXA is one important tool for measuring fracture risk, there are other clinical risk factors that are also important to evaluation, specifically to determine which patients are likely to best respond to treatment. The commenters suggested that employing the new risk assessment methodology may lead to better patient outcomes by helping providers better identify those patients who should be on therapy and they ask CMS to recognize this new assessment methodology for coverage under Medicare Part B when WHO completes its work on it. Response: We do not know enough about the parameters of the standardized methodology for determining fracture risk that the WHO is developing to respond very specifically to this comment. However, if this standardized methodology for measuring fracture risk relies on the use VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 of a device or technique that meets our definition of a BMM as defined in § 410.31(a), we believe it would be appropriate to consider evaluating any formal request for an NCD for such a device or technique, if it were submitted to us for evaluation. f. Other Issues Comment: A commenter questioned why there was no discussion in the IFC about the importance of ethnicity as a risk factor for low bone mass and osteoporosis. The commenter suggests that ethnicity is one of the most important risk factors for low bone mass and osteoporosis. Response: We agree that ethnicity as well as many other risk factors may result in certain individuals being considered to be more likely to develop osteoporosis than other individuals. For example, the National Osteoporosis Foundation (NOF) and other medical professional organizations have reported that Caucasians and Asians appear to be more at risk for developing osteoporosis than other ethnic groups. However, the NOF has also indicated that significant risk has been reported in people of all ethnic backgrounds, including AfricanAmericans and Hispanic-Americans. The reason that this subject was not discussed in the IFC was that ethnicity was not specifically identified in the BMM Amendment that was enacted in 1997 as a risk factor or medical indication that warranted Medicare coverage of bone mass measurements. Therefore, a careful examination of this subject is beyond the scope of this final rule. However, we expect that in completing an evaluation of the beneficiary’s need for the bone mass measurement, as provided in § 410.31(b)(1), the physician or other qualified practitioner (as these terms are defined in the regulation) will take ethnicity and other significant risk factors into account in ordering medically necessary tests for individual patients to the extent that it is possible to do so under the statutory beneficiary categories specified in § 410.31(d). Comment: Several commenters indicated that the IFC offered insufficient guidance on how to document the medical necessity of bone mass measurements performed on ‘‘qualified individuals’’ (§ 410.31(d)) by the use of ICD–9–CM diagnosis codes. The commenter suggested that we develop national guidelines that would help providers in documenting the medical necessity of bone mass measurements. Response: The IFC did not provide guidance on the ICD–9–CM diagnosis codes that could be used by physicians PO 00000 Frm 00073 Fmt 4701 Sfmt 4700 69695 or other providers in documenting Medicare claims for bone mass measurements. However, our original intent was that local Medicare contractors were to be responsible for developing those appropriate specific diagnostic coding guidelines for the physicians and other providers in their respective localities and for communicating those guidelines to them and to the general medical community, and they have been doing that successfully since 1998. We expect our contractors will continue to do this as necessary in the future. Comment: A commenter suggests the need for a unique CPT code or modifier to help distinguish a ‘‘confirmatory baseline bone mass measurement’’ from a BMM that may be in violation of the frequency of coverage standard of one follow-up monitoring test every 2 years. Response: We do not believe there is a need to establish a unique CPT code or modifier to distinguish a ‘‘confirmatory baseline bone mass measurement’’ for a BMM that may be in violation of the frequency of coverage standard of one follow-up monitoring test every 2 years because local Medicare contractors rely on the use of frequency screens (or edits) in determining whether follow-up tests are medically necessary for individual patients. These frequency screens (or edits) do not require the use of a unique CPT code or modifier by providers in billing for these follow-up tests in order for local contractors to be effective in making their medical necessity determinations. In view of the comments and our review of the medical literature, and other information, we are adopting our proposed revisions to § 410.31 as final without change. L. Independent Diagnostic Testing Facility (IDTF) Issues 1. IDTF Changes During the course of a national review in 2003–2004, the OIG found a potential $71 million in improper payments made to IDTFs (Review of Claims Billed by Independent Diagnostic Testing Facilities for Services Provided to Medicare Beneficiaries During Calendar Year 2001 (A–03–03–00002)). The OIG found that erroneous payments were made as the result of poor or missing documentation or lack of medical necessity. Moreover, in recent years, we have determined with the help of our contractors that a number of IDTFs in California and other States are perpetrating schemes to defraud the Medicare program. E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 69696 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations Since 2000, the number of IDTFs in California has increased by 40 percent, which is a far greater percentage increase than the Medicare population in that State. The number of IDTFs billing Medicare in California alone increased more than 400 percent from 2000 to 2005. The increased use of IDTF services has not lowered the use of diagnostic testing within other settings. The increased rates of utilization within IDTFs are likely to be unrealistic due to an increase in the need for diagnostic testing within California’s Medicare population. Also, these IDTFs are growing at a rate faster than we can survey these facilities. The actual growth of IDTFs is not a problem. However, the results of the OIG audit make it clear that we need to closely monitor IDTFs and establish standards to ensure quality care for Medicare beneficiaries. To address the erroneous payments identified by the OIG, we proposed to establish IDTF performance standards similar to those in § 424.57 which we adopted for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers in the Additional Supplier Standards final rule published in the October 11, 2000 Federal Register (65 FR 60366). In the CY 2007 PFS proposed rule, we proposed that each IDTF be required to be in compliance with the proposed fourteen suppler standards discussed in section II.L.2. of this final rule with comment period to obtain or retain enrollment in the Medicare program (71 FR 49061). Accordingly, at § 410.33(h), we proposed that if an IDTF fails to meet one or more of the standards at the time of enrollment or at the time of reenrollment, then its enrollment application would be denied. Also, if at any time we determine that an enrolled IDTF no longer meets the performance standards, its billing privileges would be revoked. We believe that these performance standards are needed to ensure that minimum quality standards are met to protect beneficiaries, as well as the Medicare Trust Fund. These standards are merely good business practices that will help to ensure that suppliers are providing a quality care to Medicare beneficiaries. Examples of the kind of standards are a primary business phone number and address. Another example is a posting of standards for review by patients and the public. For IDTFs, we proposed to adopt a number of standards that we adopted for DMEPOS suppliers, including supplier standard number 6 which requires a supplier to maintain a comprehensive liability insurance policy of $300,000 or 20 percent of its average annual VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 Medicare billings, whichever amount is greater, that covers both the place of business and all customers and employees of the IDTF. Furthermore, we proposed in the new performance standard number 7 that an IDTF agrees not to directly solicit patients. This provision does not preclude the IDTF from public advertisement or marketing its services to physicians and other suppliers, however it does prohibit recruitment of beneficiaries through direct solicitation. Additionally, the IDTF will be required to grant us, or our designated fee-for-service contractors, including our agents, to have access to the IDTF physical location, all equipment, and beneficiary medical records during normal business hours. For portable equipment, an IDTF will be required to maintain a catalog of portable equipment and be able to produce the cataloged equipment within 2 business days. If the IDTF denies this access, the IDTF’s Medicare enrollment will be immediately revoked. To ensure that equipment used by an IDTF is maintained and operates properly, we sought public comments regarding IDTF supplier standard number 11, which requires that an IDTF must have its testing equipment calibrated per equipment instructions or in compliance with applicable industry standards. Specifically, we sought public comments regarding the organizations or entities that may currently establish testing specifications for diagnostics equipment. Further, if these organizations or entities do not exist, we invited public comments on the establishment of a supplier standard that relies on the manufacturer’s maintenance and calibration standards. 2. Performance Standards for IDTFs The IDTF would be required to meet the following standards as of January 1, 2007 and any newly or reenrolling IDTF would be required to certify in its enrollment application that it meets and will continue to meet the standards. At § 410.33, we proposed to specify that the IDTF is required to— • Operate its business in compliance with all applicable Federal, State, and local licensure and regulatory requirements for the health and safety of patients; • Provide complete and accurate information on its enrollment application as stated in the ‘‘Requirements for Providers and Suppliers to Establish and Maintain Enrollment final rule’’ (April 21, 2006, 71 FR 20754). Any change in enrollment information must be reported to the designated fee-for-service contractor on PO 00000 Frm 00074 Fmt 4701 Sfmt 4700 the Medicare enrollment application within 30 calendar days; • Maintain a physical facility on an appropriate site. For the purposes of this standard, a post office box or commercial mailbox is not considered a physical facility. The physical facility must contain space for equipment appropriate to the services designated on the enrollment application, facilities for hand washing, adequate patient privacy accommodations, and the storage of both business records and current medical records; • Have all applicable testing equipment available at the physical site, excluding portable equipment. A catalog of portable equipment, including equipment serial numbers, must be maintained at the physical site. In addition, portable equipment must be made available for inspection within 2 business days of our inspection request. The IDTF will be required to maintain a current inventory of the equipment (including serial/registration numbers), provide this information to the designated fee-for-service contractor and notify the contractor of any changes in equipment; • Maintain a primary business phone under the name of the business. The business phone must be located at the designated site of the business. The telephone number or toll free numbers must be available in a local directory and through directory assistance; • Have a comprehensive liability insurance policy of at least $300,000 or 20 percent of its average annual Medicare billings, whichever amount is greater, that covers both the place of business and all customers and employees of the IDTF. The insurance policy must be carried by a non-relative owned company. The policy must list the serial numbers of any and all equipment used by the IDTF; • Agree not to directly solicit patients, which includes, but is not limited to, a prohibition on telephone, computer, or in-person contacts. The IDTF will accept only those patients referred for diagnostic testing by an attending physician, who is furnishing a consultation or treating a beneficiary for a specific medical problem and who uses the results in the management of the beneficiary’s specific medical problem. NPPs may order tests as set forth in § 410.32(a)(3); • Answer beneficiaries’ questions and respond to their complaints. Documentation of those contacts must be maintained at the physical site; • Openly post these standards for review by patients and the public; • Disclose to the government, any person having ownership, financial or E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations control interest, or any other legal interest in the supplier at the time of enrollment or within 30 days of a change; • Have its testing equipment calibrated per equipment instructions and in compliance with applicable national standards; • Have technical staff on duty with the appropriate credentials to perform tests. The IDTF must produce the applicable Federal or State licenses and/ or certifications of the individuals performing these services; • Have proper medical record storage and be able to retrieve medical records upon request from CMS or its designated fee-for-service contractor within 2 business days; and • Permit CMS, including its agents or its designated fee-for-service contractors, to conduct unannounced, on-site inspections to confirm the IDTF’s compliance with these standards. The IDTF is required to provide access, during regular business hours, to CMS and beneficiaries, as well as maintain a visible sign posting the normal business hours of the IDTF. 3. Supervision To ensure quality care is provided to Medicare beneficiaries, we proposed to revise § 410.33(b)(1) to read that physicians will be limited to providing supervision to ‘‘no more than three IDTF sites.’’ rmajette on PROD1PC67 with RULES2 4. Place of Service In addition to establishing specific performance standards for IDTFs, at § 410.33(i), we proposed to define the ‘‘point of the actual delivery of service’’ as the correct ‘‘Place of Service’’ for the claim form in the case of diagnostic testing performed outside the IDTF’s physical location. For example, when an IDTF performs a diagnostic test at a beneficiary’s residence, we believe that it is reasonable to establish the beneficiary’s residence as the ‘‘Place of Service.’’ Previously, there has been no set procedure, so therefore, we believe that the information is gathered at the collection point from the beneficiary, and this is the point service. While most diagnostic tests are performed in an office setting, we solicited public comments regarding the types of services that can be safely and appropriately used in a residential setting. 5. Analysis of and Responses to Public Comments Comment: Several commenters agreed with our proposal to limit the number of IDTFs that a physician can oversee to three. Conversely, some commenters VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 expressed concern about our proposal to limit the number of IDTFs that a physician can oversee. Response: While we understand the concerns associated with limiting the number of IDTFs that a physician can oversee to three, we believe that limiting the number of IDTFs that a physician can oversee will promote quality of care. We are defining the supervising physician to be the person who is listed in Attachment 2, Section E on the CMS– 855B enrollment application. Comment: Several commenters suggested that the proposed standards be revised to reflect that mobile IDTFs will have different needs and requirements from those IDTFs which are stationary. Response: We appreciate this comment and have revised our policy in this final rule with comment period to address IDTF performance standards for both fixed and mobile IDTFs. Comment: Several commenters recommended that we expand the proposed IDTF performance standards to all imaging services. Response: While we appreciate this comment, we will consider this change in a future rulemaking document. Comment: One commenter expressed concern regarding our proposal that an IDTF maintain a physical facility on an appropriate site and that IDTFs would be required to maintain a specified number of square feet per facility. Response: While we understand the commenter’s concern, it was never our intent to establish a minimum square foot requirement. We believe that the size of an IDTF can vary depending on the services performed. Accordingly, we believe that the size of a fixed-based IDTF should be of sufficient size to provide the services offered by the IDTF, such as maintaining records, and performing administrative tasks. Comment: Several commenters recommended that physicians can be proficient in analyzing test results without being considered a specialist in the field relating to that specific type of diagnostic testing. Response: This issue is outside of the scope of the provisions of the proposed rule, and therefore, we are not providing a response at this time. Comment: In lieu of the specific performance standards proposed, several commenters recommended that we use accreditation as a method for improving compliance and limiting fraud and abuse with IDTFs. Response: While we appreciate this comment, we are not able to adopt this recommendation. We believe that it is essential that we obtain additional PO 00000 Frm 00075 Fmt 4701 Sfmt 4700 69697 information from the public before adopting IDTF accreditation standards. Comment: Several commenters recommended establishing a grace period before carriers begin the revocation process for those IDTFs that fail to meet the new performance standards. Response: While we understand the concerns of the commenters, we do not believe that it is practical to delay implementation of these standards. With the publication of this final rule with comment period, all IDTFs are being notified of the new performance standards. Moreover, we believe that most IDTFs meet the performance standards that we are adopting, or that they can do so within the time period between the publication of this final rule with comment period and its effective date. In addition, as we put this policy into operation, we will consider phasing-in our implementation approach. In the event that an IDTF’s billing privileges are revoked, the supplier can appeal the revocation. Comment: Several commenters expressed the concern that an unannounced site visit by CMS or our representatives could be potentially disruptive to an IDTF’s operations. Response: We believe that unannounced site visits are a useful tool to ensure that IDTFs are meeting their enrollment requirements and performance standards. We will work closely with our contractors to limit any disruptions during a site visit. Comment: One commenter recommended that we eliminate the IDTF benefit. Response: We believe that establishing performance standards and the other changes in this regulation will improve quality and assist us in our efforts to reduce fraud and abuse in the Medicare program. Accordingly, we are finalizing this proposal. Comment: One commenter recommended eliminating the requirement to maintain a primary business phone located at the designated site for business, especially with regards to mobile IDTFs. Response: We believe that it is essential that fixed and mobile IDTFs maintain a primary business telephone number. Moreover, we believe the primary business telephone number for fixed-based IDTFs is located at the practice location for the IDTF. For mobile IDTFs, we believe that the primary business telephone number is the home location for the mobile facility. Comment: Several commenters recommended that we clarify where E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 69698 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations mobile IDTFs would store patient records. Response: We believe that it is appropriate for a mobile IDTF to store patient records at their home location. Comment: In lieu of the proposed performance standards, several commenters recommended that we implement modality specific standards to address the diverse nature of the services provided by IDTFs. Response: We are not able to adopt this recommendation because we believe that it is essential that we obtain additional information from the public before adopting modality-specific standards. Comment: Several commenters stated that our proposal for a physician to be responsible for overall operations and administration of an IDTF has no basis, and that a physician should solely play a clinical or technical role. Response: We believe that a supervising physician, as identified in Attachment 2 of the CMS–855B Medicare enrollment application, is fundamentally responsible for the proper administration of an IDTF’s services. Comment: Several commenters questioned our interpretation for the point-of-service for services provided outside the IDTF, specifically at the beneficiary’s residence. Response: The beneficiary’s location will be considered the place of service for pure, home-based testing. Those diagnostic tests which have another element outside of the testing location will continue to have the IDTF as the place of service of that diagnostic procedure. Comment: Several commenters recommended that there is a need for a supervising physician within an IDTF and that the language in the proposed rule stating that, ‘‘a physician could oversee no more than three IDTFs,’’ could be interpreted to mean that a physician does not have to oversee an IDTF. Response: We concur with this recommendation and believe that this standard should be interpreted as a physician will oversee one to no more than three IDTFs, not that an IDTF does not need a supervising physician. Comment: We received numerous comments concerning one aspect of performance standard 6. We proposed that the IDTF would have to maintain a comprehensive liability insurance policy of $300,000 or 20 percent of the IDTF’s Medicare billings, whichever amount is greater. We received comments suggesting the removal of the 20 percent condition as this would be an undue burden to the IDTF. VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 Additionally, we received comments suggesting that we establish a flat rate such as the $300,000 proposed, having a $300,000 policy for each facility, an increase to a $500,000 flat coverage, a comprehensive insurance policy of $1 million, or an aggregate rate of $3 million. Response: In order to reduce administrative burden associated with calculating comprehensive liability insurance for suppliers and to ensure compliance of this new standard, we will establish a comprehensive liability insurance amount of $300,000 per location for IDTFs. We agree with the recommendation that comprehensive liability insurance coverage of $300,000 per facility location is more appropriate, given that the likelihood of an incident occurring would increase as the number of facilities increases. We believe that the $300,000 per location represents the reasonable level of coverage for a facility’s comprehensive liability insurance and we will change performance standard 6 to reflect this change. Comment: One commenter suggested that we eliminate the provision that insurance policy must be carried by a non-relative-owned company. Response: Consistent with our DMEPOS supplier standards, we believe the comprehensive liability insurance must be obtained from a verified third party to ensure that the coverage exists. Comment: Several commenters recommended our performance standards address State requirements, and that we should develop a Federal set of standards that would not vary from State to State. Response: While we understand this concern, we believe that each State should continue to establish its own licensing requirements. Further, we believe that all IDTFs must maintain compliance with applicable Federal, State, and local licensure and regulatory requirements. Comment: Several commenters expressed concern with our proposed supplier standard 7 which states that an IDTF agrees not to directly solicit patients, and these commenters recommended that we remove or clarify standard seven. Response: We understand the concerns of the commenters, but we are not attempting to prohibit public advertising. Supplier standard 7 is designed to prohibit an IDTF or its representative from direct, person-toperson solicitation of beneficiaries by means of phone, computer, or in-person. Clearly, an IDTF can use public advertisement, including advertising on PO 00000 Frm 00076 Fmt 4701 Sfmt 4700 television, radio, internet, direct mailing, billboards, or newspapers. Comment: One commenter recommended that complaints by beneficiaries should be documented on paper and kept at a home office location. Response: At this time, we are not requiring that an IDTF collect and maintain a log of beneficiaries’ questions and complaints because we did not propose this requirement in the CY 2007 PFS proposed rule. In a future rulemaking document, we will address a formal collection process for this documentation. Comment: Several commenters expressed concern regarding the storage and specifications of medical records (namely the comprehensive medical records of the beneficiaries they are currently treating or have treated), as well as how we would be defining current medical records, largely due to the additional burden of HIPAA requirements associated with a patient’s comprehensive medical treatments. Response: We view current medical records as consisting of the services provided by the IDTF to its current and prior patients. Upon request, CMS or its contractors may request comprehensive medical records for an IDTF. Comment: Several commenters expressed support for IDTF supplier standard 11 which mandates the calibration of all IDTF testing equipment. These commenters recommended that we work with the National Electrical Manufacturers Association (NEMA) prior to establishing any calibration and maintenance requirements. Response: We appreciate these comments and intend to work with NEMA and other organizations in the development of calibration and maintenance requirements. Comment: We received a comment stating that IDTFs should not be required to post performance standards. Response: We believe that posting performance standards educates patients of an IDTF regarding their rights within the IDTF setting. Therefore, we will adopt this standard as proposed. Comment: Several commenters recommended that we postpone implementing the proposed IDTF performance standards in 2007 and work with industry to develop standards for the CY 2008 PFS. Response: Given the widespread support of IDTF performance standards, we believe it is appropriate to implement our proposed changes as soon as possible. Therefore, we will E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations implement the IDTF standards in this final rule with comment period. Comment: Several commenters recommended that our proposed 30-day timeframe for reporting changes in enrollment data was insufficient and that IDTFs should be allowed to continue to report changes within 90 days. Response: Consistent with the reporting requirements for DMEPOS suppliers, and given the fraud and abuse concerns in this area, we believe that it is appropriate to adopt the 30-day timeframe for IDTFs to report changes in enrollment information. 6. Provisions of the Final Rule. rmajette on PROD1PC67 with RULES2 a. Performance Standards for IDTFs We received numerous valuable comments concerning the proposed supplier standards and have revised them to reflect the issues brought forth during the comment period. Therefore, we have amended these new standards to reflect the differences in an IDTF’s setting and the services which they provide. We are adopting the provisions contained in the proposed rule as final with the following changes. We are revising supplier standard number 3 to address concerns regarding how performance standards affect mobile IDTFs, rather than fixed location IDTFs. Specifically, we are adopting a position that IDTF performance standards apply to the home location of the mobile IDTF, not the mobile vehicle. Accordingly, the home location of the mobile IDTF, not the mobile IDTF vehicle, is required to maintain patient records, a primary business phone, and meet all other performance standards met by fix location IDTFs. We are revising supplier standard number 6 to establish a set amount for comprehensive liability insurance in the amount of $300,000 per location (an amount similar to the amount of insurance coverage for DMEPOS suppliers). We are adopting, for IDTFs, supplier standard number 6 which requires a supplier to maintain a comprehensive liability insurance policy of $300,000 for each IDTF location, which covers both the place of business and all customers and employees of the IDTF. We believe that the second part of the proposed provision of 20 percent of its average annual Medicare billings, if greater than the $300,000 would be a burdensome task for supplier to calculate on annual basis and lead to compliance concerns. We are clarifying supplier standard number 7 that an IDTF agrees not to directly solicit patients. While this provision does not preclude an IDTF VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 from public advertisement or marketing of its services to beneficiaries, physicians and other suppliers, it does prohibit recruitment of beneficiaries through direct solicitation, namely through person-to-person contact, whether it be in-person, by computer, or telephone. Since we did not include the requirement in the CY 2007 PFS proposed rule, we are revising performance standard 8 and removing the sentence concerning the documentation of contacts concerning beneficiaries’ questions and complaints because we believe it would be unfair and confusing to the public, and would present an undue paperwork burden. We are revising supplier standard number 11 to state that each piece of diagnostic testing equipment be maintained and calibrated to its manufacturer’s standards. To ensure that equipment used by an IDTF is maintained and operates properly, we sought public comments regarding IDTF supplier standard number 11, which requires that an IDTF must have its testing equipment calibrated per equipment instructions or in compliance with applicable industry standards. Specifically, we sought public comments regarding the organizations or entities that may currently establish testing specifications for diagnostics equipment. We received a number of comments supporting this proposal with minor changes suggested by leaders within this industry. We are adopting a recommendation that we use each manufacturer’s maintenance and calibration standards which they have determined are appropriate for the diagnostic testing equipment they manufacture for use within these IDTFs. We will continue to consult with industry leaders regarding the best approaches to ensure that all IDTF testing equipment is maintained and calibrated in accordance with manufacturer’s specifications. We are clarifying supplier standard number 14 that fixed and mobile IDTFs are required to grant CMS, or our designated fee-for-service contractors, access to the IDTF physical location, all equipment, and beneficiary medical records during normal business hours. We also adopted the position that for portable equipment, an IDTF will be required to maintain a catalog of portable equipment and be able to produce the cataloged equipment within 2 business days. If the IDTF denies CMS or our designated fee-for-service contractor access to its fixed located or the home location for a mobile vehicle, the IDTF’s Medicare enrollment will be denied if initially enrolling or revoked PO 00000 Frm 00077 Fmt 4701 Sfmt 4700 69699 if currently enrolled in the Medicare program. Accordingly, at § 410.33(h), we are stating that if an IDTF fails to meet one or more of the standards at the time of enrollment, then the enrollment application would be denied. Also, we are adopting the position that if at any time we determine that an enrolled IDTF no longer meets one or more of the IDTF performance standards, the IDTF’s billing privileges would be revoked. As specified in § 410.33, the IDTF will be required to meet the following standards as of January 1, 2007 and any newly or reenrolling IDTF will be required to certify in its enrollment application that it meets and will continue to meet the standards. • Operate its business in compliance with all applicable Federal, State, and local licensure and regulatory requirements for the health and safety of patients; • Provide complete and accurate information on its enrollment application as stated in the ‘‘Requirements for Providers and Suppliers to Establish and Maintain Enrollment final rule’’ published in the April 21, 2006 Federal Register (71 FR 20754). Any change in enrollment information must be reported to the designated fee-for-service contractor on the Medicare enrollment application within 30 calendar days; • Maintain a physical facility on an appropriate site. For the purposes of this standard, a post office box or commercial mailbox is not considered a physical facility. The physical facility, including mobile units, must contain space for equipment appropriate to the services designated on the enrollment application, facilities for hand washing, adequate patient privacy accommodations, and the storage of both business records and current medical records within the office setting of the IDTF, or IDTF home office, not within the actual mobile unit; • Have all applicable diagnostic testing equipment available at the physical site, excluding portable diagnostic testing equipment. A catalog of portable diagnostic testing equipment, including diagnostic testing equipment serial numbers, must be maintained at the physical site. In addition, portable diagnostic testing equipment must be made available for inspection within 2 business days of our inspection request. The IDTF will be required to maintain a current inventory of the diagnostic testing equipment (including serial/registration numbers), provide this information to the designated fee-for-service contractor and E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 69700 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations notify the contractor of any changes in equipment; • Maintain a primary business phone under the name of the business. The primary business phone must be located at the designated site of the business, or within the home office of mobile IDTF units. The telephone number or toll free numbers must be available in a local directory and through directory assistance; • Have a comprehensive liability insurance policy of at least $300,000 per location that covers both the place of business and all customers and employees of the IDTF. The insurance policy must be carried by a non-relative owned company. The policy must list the serial numbers of any and all diagnostic equipment used by the IDTF, whether the equipment is stationary, in a mobile unit, or at the beneficiary’s residence; • Agree not to directly solicit patients, which includes, but is not limited to, a prohibition on telephone, computer, or in-person contracts. The IDTF will accept only those patients referred for diagnostic testing by an attending physician, who is furnishing a consultation or treating a beneficiary for a specific medical problem and who uses the results in the management of the beneficiary’s specific medical problem. NPPs may order tests as set forth in § 410.32(a)(3); • Answer beneficiaries’ questions and respond to their complaints; • Openly post these standards for review by patients and the public; • Disclose to the government, any person having ownership, financial or control interest, or any other legal interest in the supplier at the time of enrollment or within 30 days of a change; • Have its testing equipment calibrated and maintained per equipment instructions and in compliance with applicable manufacturers suggested maintenance and calibration standards; • Have technical staff on duty with the appropriate credentials to perform tests. The IDTF must produce the applicable Federal or State licenses and certifications of the individuals performing these services; • Have proper medical record storage and be able to retrieve medical records upon request from CMS or our designated fee-for-service contractor within 2 business days; and • Permit CMS, including our agents or our designated fee-for-service contractors, to conduct unannounced, on-site inspections to confirm the IDTF’s compliance with these standards. The IDTF is required to VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 provide access, during regular business hours, to CMS and beneficiaries, as well as maintain a visible sign posting the normal business hours of the IDTF. While we understand that these additional standards could lead certain IDTFs to withdraw from the Medicare program rather than comply with the new standards, we believe that legitimate businesses would not oppose these changes. Moreover, we emphasize that services provided by an IDTF are also readily available to beneficiaries through other avenues such as physicians’ offices, outpatient laboratories, outpatient radiology facilities, and outpatient clinics. We believe that the implementation of these standards would improve the quality of services provided to Medicare beneficiaries by IDTFs without any associated access concerns. home location of the mobile IDTF or portable x-ray supplier. However, when a diagnostic test contains a home-based element (that is, the beneficiary performs a portion of the testing in his or her residence) and a facility-based element (that is, an IDTF reads or monitors the test results), the place of service is not clearly established and the fixed location of the IDTF will remain as the place of service for these tests. Accordingly, diagnostic tests containing both home-based and facility-based elements are billed to the designated Medicare contractor associated with the practice location of the fixed IDTF. In a future rulemaking effort, we will seek public input regarding the appropriate place of service for diagnostic testing when services are rendered in multiple parts in different locations. b. Supervision M. Independent Laboratory Billing for the TC of Physician Pathology Services to Hospital Patients The TC of physician pathology services refers to the preparation of the slide involving tissue or cells that a pathologist will interpret. (In contrast, the pathologist’s interpretation of the slide is the PC service. If this service is furnished by the hospital pathologist for a hospital patient, it is separately billable. If the independent laboratory’s pathologist furnishes the PC service, it is usually billed with the TC service as a combined service.) In the CY 2000 PFS final rule (64 FR 59380 and 59408 through 59409), we stated that we would implement a policy to pay only the hospital for the TC of physician pathology services furnished to hospital patients. Before that proposal, any independent laboratory could bill the carrier under the PFS for the TC of physician pathology services for hospital patients. As stated in the CY 2000 PFS final rule, this policy has contributed to the Medicare program paying twice for the TC service, first through the inpatient prospective payment rate to the hospital where the patient is an inpatient and again to the independent laboratory that bills the carrier, instead of the hospital, for the TC service. Therefore, in the CY 2000 PFS final rule at § 415.130, we provided that, for services furnished on or after January 1, 2001, the carriers would no longer pay claims to the independent laboratory under the PFS for the TC of physician pathology services for hospital patients. Ordinarily, the provisions in the final PFS are implemented in the following year. However, in this case, the change to § 415.130 was delayed one year (until To ensure quality care is provided to Medicare beneficiaries, we are adopting the position to revise § 410.33(b)(1) to read that physicians will be limited to providing supervision to ‘‘no more than three (3) IDTF sites.’’ This reference to the supervising physician applies to the individual listed as the supervising physician in the Medicare enrollment application (that is, CMS–855 B, Attachment 2, Section E), not the physician supervising the interpretation of a diagnostic test. c. Place of Service In addition to establishing specific performance standards for IDTFs, we are defining the ‘‘point of the actual delivery of service’’ as the correct ‘‘Place of Service’’ on the claim form. In the case of diagnostic testing that is performed completely outside of a fixed facility location, we believe that the point of actual delivery of service is the beneficiary’s’ residence, or location where the test is being administered. As such, these services should be billed to the designated Medicare contractor. For example, when a diagnostic test is performed at a beneficiary’s residence, we believe that it is reasonable to establish the beneficiary’s residence as the ‘‘Place of Service’’ and that these services be billed to the designated Medicare contractor where the beneficiary resides. Previously, there has been no set policy regarding diagnostic testing performed by beneficiary. Accordingly, mobile IDTF and portable x-ray supplier services performed in beneficiary’s residence would be billed to the designated Medicare contractor where the beneficiary resides, rather than the PO 00000 Frm 00078 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations January 1, 2001), at the request of the industry, to allow independent laboratories and hospitals sufficient time to negotiate arrangements. Moreover, our full implementation of § 415.130 was further delayed through CY 2006. Most recently, under section 732 of the MMA, we were required to pay separately under Medicare Part B for the TC of physician pathology services for services furnished during 2005 and 2006. However, we continue to believe that hospital prospective payment amounts already compensate hospitals for the TC of physician pathology tests and that additional payment under the PFS is inappropriate. Therefore, we are amending § 415.130 to provide that, for services furnished after December 31, 2006, an independent laboratory may not bill the carrier for the TC of physician pathology services furnished to a hospital inpatient or outpatient. Under § 415.130(d), we will pay under the PFS for the TC of a physician pathology service furnished by an independent laboratory for services provided to an inpatient or outpatient of a ‘‘covered hospital’’ (as defined in § 415.130(a)(1)) on or before December 31, 2006. We received comments from individuals and groups. Comment: Several commenters stated that the policy, in the CY 2000 PFS final rule, was based on flawed assumptions and facts, and that the hospital’s inpatient payment rate does not include payment for this service. Response: We addressed specific comments regarding the establishment of the inpatient prospective payment system (IPPS) and the inclusion of the TC physician pathology costs in this payment system in the final rule published in the CY 2000 PFS final rule (64 FR 59408 through 59409). We believe that our discussion in that final rule is still valid. Comment: Several commenters indicated that hospitals and independent laboratories will have to set up costly and administratively complex billing systems and procedures. These commenters and others asked us to allow hospitals and independent laboratories that have these grandfathered arrangements to continue bill in the same manner. Response: We are not requiring the hospitals to establish new billing procedures or systems. The billing of TC physician pathology services involves the same billing procedures and processes that the hospital may have established for any outsourced diagnostic tests for hospital inpatients, such as MRI, CT scan, and ultrasound VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 scans. Only hospitals that have outsourced no other diagnostic services other than physician pathology services may have to establish new billing systems or procedures. Similarly, we are not requiring independent laboratories to establish new billing procedures and systems. Independent laboratories have similar billing systems in operation for clinical laboratory services that are provided to hospital inpatients. Also, neither individual laboratories nor any industry laboratory specialty group for independent laboratories has commented on this increased complexity, cost, and burden. Comment: One individual commented on a draft instruction that has been sent to the Medicare carriers for comment. The instruction implements the payment policy for physician pathology TC services beginning in 2007. Response: This item is not a subject of the proposed rule and we are not addressing this comment as part of this rule. The draft Internet Only Manual instructions are reviewed by carriers during their development. There is a formal review process for evaluation of these comments apart from the regulation process. Comment: Several commenters identified an issue involving proposed § 415.130. The commenters expressed concern that the effect of the proposed regulation would not be limited to the TC of physician services. Proposed § 415.130 reads, ‘‘For services furnished after December 31, 2006, an independent laboratory may not bill the carrier for physician pathology services furnished to a hospital inpatient or outpatient.’’ Response: We appreciate the issue that the commenters have identified through their careful reading of the proposed rule. The quoted sentence omitted the reference to the ‘‘technical component’’ of physician pathology services. We are revising the regulation text accordingly as this was clearly our intent. N. Public Consultation for Medicare Payment for New Outpatient Clinical Diagnostic Laboratory Tests Section 1833(h) of the Act requires the Secretary to establish fee schedules for clinical laboratory tests under Medicare Part B. We proposed to implement section 942(b) of the MMA which specifies annual procedures for consulting the public on how to establish payment for new clinical laboratory test codes to be included in the annual update of the clinical laboratory fee schedule. PO 00000 Frm 00079 Fmt 4701 Sfmt 4700 69701 1. Medicare, Medicaid, and SCHIP Benefits Improvement Protection Act of 2000 (BIPA) Section 531(b) of BIPA mandated that we establish, no later than 1 year after the date of enactment, procedures that permit public consultation for payment determinations for new clinical diagnostic laboratory tests under Medicare Part B in a manner consistent with the procedures established for implementing ICD–9–CM coding modifications. In the CY 2002 PFS final rule (66 FR 58743), we specified the procedures to implement section 531(b) of BIPA. These procedures were most recently used to determine the payments for new 2006 clinical laboratory fee schedule codes. First, we convened a public meeting to solicit expert input on the nature of the new tests before rate determinations were made. We have held these meetings each year since 2002 to receive this expert input on the next year’s codes. Our most recent meeting was announced in the Federal Register on May 27, 2005 (70 FR 30734) and occurred on July 18, 2005. In that meeting, we requested that presenters address the new test codes, each test’s purpose, method, cost, and a recommendation for one of two methods (crosswalking or gapfilling) for determining payment for the new clinical laboratory codes. Crosswalking and gapfilling are discussed in section II.N.2.d of this final rule with comment period. Following the public meeting, we posted a summary of the new codes and the payment recommendations that were presented during the public meeting on our Web site. The summary also displayed our tentative payment determinations and indicated a comment period for interested parties to submit written comments. After reviewing the comments received, we issued Medicare Transmittal 750, 2006 Annual Update for Clinical Laboratory Fee Schedule, which provided all instructions and final rate determinations for the 2006 clinical laboratory fee schedule including the new codes and fees, on November 18, 2005. 2. Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) In the CY 2007 PFS proposed rule (71 FR 49064), we proposed to implement section 942(b) of the MMA which requires that we establish procedures for consulting the public on how to establish payment for new clinical laboratory test codes to be included in E:\FR\FM\01DER2.SGM 01DER2 69702 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations the annual update of the clinical laboratory fee schedule. Similar procedures were already mandated by legislation in section 531(b) of the BIPA which requires payment determinations for new clinical diagnostic laboratory tests under Medicare Part B be made in a manner consistent with the procedures established for implementing ICD–9–CM coding modifications. Specifically, the MMA requires the Secretary to establish by regulation procedures for determining the basis for and amount of payment for a clinical diagnostic laboratory test that is assigned a new or substantially revised HCPCS code on or after January 1, 2005. We refer to these tests as ‘‘new tests.’’ a. Basis and Scope (§ 414.500) We proposed to add a new subpart implementing provisions of section 1833(h)(8) of the Act—procedures for determining the basis for, and amount of, payment for a new clinical diagnostic laboratory test with respect to which a new or substantially revised HCPCS code is assigned on or after January 1, 2005. We received no comments on this subpart. Therefore, we are finalizing § 414.500 as proposed. rmajette on PROD1PC67 with RULES2 b. Definition (§ 414.502) As specified in section 942(b) of the MMA, we are defining the term ‘‘Substantially Revised Healthcare Common Procedure Coding System Code’’ to mean a code for which there has been a substantive change to the definition of the test or procedure to which the code applies (such as a new analyte or a new methodology for measuring an existing analyte specific test). We did not receive comments on this subpart. Therefore, we are finalizing § 414.502 as proposed. c. Procedures for Public Consultation for Payment for a New Clinical Diagnostic Laboratory Test (§ 414.506) For a clinical laboratory test that is assigned a new or substantially revised code on or after January 1, 2005, section 1833(h)(8)(B) of the Act provides that determinations of payment amounts for new tests shall be made only after the Secretary: • Makes available to the public (through an Internet Web site and other appropriate mechanisms) a list that includes codes for which establishment of a payment amount is being considered for the next calendar year; • Publishes a Federal Register notice of a meeting to receive public comments and recommendations (and data on VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 which recommendations are based) on the appropriate basis for establishing payment amounts for the list of codes made available to the public on the same day the list of codes is made available; • Convenes a meeting that includes representatives of CMS officials involved in determining payment amounts, to receive public comments and recommendations (and data on which the recommendations are based) not less than 30 days after publication of the notice in the Federal Register; and • Considers the comments and recommendations (and accompanying data) received at the public meeting, develops and makes available to the public (through an Internet Web site and other appropriate mechanisms)— + A list of determinations for the appropriate basis for establishing a payment amount for each code, together with an explanation of the reasons for each determination, the data on which the determinations are based, and a request for public written comments on the proposed determination; and + A list of final determinations of the payment amounts for tests, together with the rationale for each determination, the data on which the determinations are based, and responses to comments and suggestions from the public. In the CY 2007 PFS proposed rule, we indicated these procedures have been most recently used to finalize the payments for new 2006 clinical laboratory fee schedule codes and we believe that our current process for providing for public consultation on the establishment of payment amounts for new clinical laboratory tests is consistent with the requirements of section 1833(h)(8)(B) of the Act. We currently make available to the public through a posting on the CMS Web site a list of new laboratory test codes for the next calendar year. We publish a Federal Register notice of a meeting to receive public comments and recommendations and convene the meeting with appropriate CMS officials in attendance. We consider the input received at the public meeting and we make available to the public on the CMS Web site a list of the proposed determinations and seek comment. We then make available to the public our final determinations in the instructions that we provide to our claims processing contractors to implement the Medicare Part B clinical laboratory fee schedule each year. The most significant change required by section 1833(h)(8)(A) of the Act with respect to our procedures for public PO 00000 Frm 00080 Fmt 4701 Sfmt 4700 consultation is that we codify this process in regulations. Therefore, we proposed to codify our current process for public consultation for new clinical diagnostic laboratory tests paid under the Medicare Part B clinical laboratory fee schedule at new Subpart G— Payment for New Clinical Diagnostic Laboratory Tests (§ 414.502 through § 414.506). Comment: Several comments supported the consultation process for new clinical diagnostic laboratory tests paid under the Medicare Part B clinical laboratory fee schedule. Commenters suggested changes to the meeting and posting of data presented in the meeting. For example, a commenter suggested we should require a 60-day time period from the Federal Register notice of the public meeting and the date of the public meeting. Commenters also requested that we post on the Internet additional detail regarding data and rationale used for public recommendations and final payment decisions. Response: We want to take this opportunity to explain the timeframes for the annual update to the clinical laboratory fee schedule. The Medicare Part B clinical laboratory fee schedule utilizes the codes developed by the AMA’s Current Procedural Terminology (CPT) Editorial Panel. The CPT codes are developed as the result of quarterly meetings throughout the year and the codes to be included in the upcoming year’s fee schedule (effective January 1st) are available as early as May. We then list the new clinical laboratory tests codes on our Web site in June along with registration information for the public meeting. We schedule the date of the public meeting not fewer than 30 days after announcing the meeting in the Federal Register. This timeframe results in a July date for the public meeting, followed by a posting of our tentative payment determinations and a comment period in September. The updated clinical laboratory fee schedule is prepared in October for release to our contractors during the first week in November. Our contractors have many information system steps to complete during the months of November and December so that the updated clinical laboratory fee schedule is ready to pay claims effective January 1st of the calendar year. With the constraints of the this process, we will strive to provide as much time as is feasible between the announcement of the meeting and the meeting itself. As required under both the statute and § 414.506, the public meeting will take place ‘‘not fewer’’ than 30 days after we publish notice of E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations the meeting in the Federal Register. Our proposed regulatory language allows us flexibility to provide additional time when feasible. However, extending the notification period announcing the date of the public meeting to 60 days from the Federal Register notice of the public meeting could cause delays to the ratesetting process and to the timely release of the updated clinical laboratory fee schedule. Commenters also requested that when we announce public recommendations or our determinations, we should include data and the rationale on which the recommendation or determination is based. However, we note that recommendations from the public meeting have sometimes lacked the detail requested by commenters. We have considered all payment recommendations received from the public, even those that have sometimes lacked the supporting detail requested by commenters. In some cases, companies have expressed concern about revealing data to laboratory competitors during the public meeting. When soliciting public input for the meeting, we will recommend that all participants in the public consultation process strive for transparency and try to provide as much supporting information as possible to assist us and others in evaluating the recommendation. As required by the statute, we will provide the rationale for our payment determinations. Comment: Two commenters stated that a whole new generation of diagnostic tests will contribute to treatment that is more tailored to the individual so that maintaining the current system for setting payment will not be sufficient because the new generation tests are more complex than the individual test codes currently paid under the clinical laboratory fee schedule. Also, the commenters indicated that some of the new generation tests may be performed by only one laboratory in the country so that establishing a payment amount for the new test becomes a de facto national price which may be insufficient for other laboratories in the future. Response: We appreciate the commenters’ recognition that establishing payment for new technology testing is complex and subject to many professional perspectives. In this rulemaking, we are complying with the MMA mandate to codify a public consultation process for payment of new clinical laboratory test codes. The statute requires that we host a public meeting to receive recommendations on individual test codes added to the Medicare Part B VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 clinical laboratory fee schedule. We state in the public meeting notice that presentations should address the new test code(s) and descriptor(s), the test purpose and method, costs and charges, and other background information. We certainly encourage presenters to include in their presentations market availability of the test and other information on the new technology. Also, a question and answer period is scheduled during the meeting to permit a robust discussion of each new test code. As noted, when we have hosted the public meetings in the past, the laboratory industry has sometimes submitted payment recommendations that are sparse of information and data supporting the payment recommendations. Thus, we do not believe opportunities for information gathering on new technology tests have been fully utilized within the public meeting process. While we can work with laboratories to explore other payment options for new technology tests, we must implement the statutorily required public meeting process. We encourage the laboratory industry to fully participate in this process and to include in its public recommendations data detailed background information on market availability and other concerns that laboratories have for the new technology test codes. Comment: We received a comment requesting that we establish a reconsideration process that would allow interested parties to request a formal review of payment rate determinations. The commenter suggested that interested parties be given an opportunity to request and receive a reconsideration of a CMS decision to crosswalk or gapfill a new or revised test code, CMS crosswalk determination, a contractor determination of a gapfill price, or a CMS calculation of the NLA for a new test. Response: We understand the concerns of the commenter, but we are not establishing a formal reconsideration process in this final rule. However, we are revising § 414.508 to provide that, if we gapfill a test, but determine after the first year of gapfilling that carrier-specific gapfilled amounts will not pay for the test appropriately, we may crosswalk the test. Furthermore, we expect to solicit comments on a potential reconsideration process in a future rulemaking. After careful review of the public comments, we are finalizing § 414.506 as proposed. PO 00000 Frm 00081 Fmt 4701 Sfmt 4700 69703 d. Payment for a New Clinical Diagnostic Laboratory Test— Crosswalking and Gapfilling (§ 414.508) We proposed to add new § 414.508 to indicate when, in establishing the payment amount for a new clinical laboratory test, one of two payment methods can be utilized. The first payment method, called ‘‘crosswalking,’’ is used if a new test is determined to be comparable to an existing test, multiple existing test codes, or a portion of an existing test code. We proposed that a new test code would be assigned the related existing local fee schedule amounts and national limitation amount (NLA). In new § 414.508, we proposed to use the second method, called ‘‘gapfilling,’’ when no comparable, existing test is available. Currently when using this method, manual instructions are provided to each Medicare carrier to determine a payment amount for its geographic area(s) for use in the first year, and the carrier-specific amounts are used to establish an NLA for following years. Consistent with our current process, the sources of information carriers examine in determining gapfill amounts, if available, include— • Charges for the test and routine discounts to charges; • Resources required to perform the test; • Payment amounts determined by other payers; and • Charges, payment amounts, and resources required for other tests that may be comparable or otherwise relevant. Currently, our manual instructions allow carriers to consider other sources of information as appropriate, including clinical studies and information provided by clinicians practicing in the area, manufacturers, or other interested parties. Carriers are also instructed to establish carrier specific amounts on or before March 31 of the year and to revise their carrier specific amount, if necessary, on or before September 1 of the year. In this manner, a carrier may revise its carrier specific amount based on additional information, but there is also a specific time frame to perform this revision so that we have adequate time to receive and use the carrier specific amounts for the calculation of the next year’s clinical laboratory fee schedule. In light of MMA provisions, we proposed to prospectively eliminate payment of new gapfilled tests at a carrier specific amount after the first year in new § 414.508. Section 1833(h)(8)(A) of the Act gives the E:\FR\FM\01DER2.SGM 01DER2 69704 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations Secretary authority to establish procedures for determining the payment amount for laboratory tests for which new or substantially revised HCPCS codes were established on or after January 1, 2005. Under this authority, in new § 414.508(b), we proposed to pay for a new gapfilled laboratory test under our existing methodology for the first year (the carrier would establish a gapfill amount.) Beginning in the second year, the test would be paid at the national limitation amount. This would result in consistent payment in geographic areas for a new test using the median of the carriers’ gapfilled amounts. Comment: Commenters were supportive of our proposal to set the price for gapfilled tests at the NLA. Other commenters suggested that the method used by contractors to determine their price for gapfilled tests should be more specific. Response: We appreciate the support for our proposal to establish the payment rate for a gapfilled test at the NLA. However, we do not agree specific changes to the gapfilling methodology should be made in the final rule, without a chance to receive multistakeholder input on the commenter’s suggestions. We do believe that we must engage the clinical laboratory community and our contractors in additional discussions regarding the procedures and data used to determine the payment amounts for gapfilled tests. We will plan to discuss with our contractors their experience establishing the gapfill amounts and also to host a forum or meeting during the upcoming year to listen to additional suggestions from the public. After participating in these additional information gathering steps, we will consider possible changes to the regulations for the 2008 proposed rule and/or additional subregulatory guidance if appropriate. As discussed above, in response to a comment suggesting that we establish a reconsideration process, we are revising § 414.508 to provide that we may crosswalk a test if we determine that carrier-specific gapfilled amounts will not pay for the test appropriately. We are finalizing § 414.508 with the exceptions noted above in this section. 3. Other Laboratory Issues rmajette on PROD1PC67 with RULES2 a. Quality In the CY 2007 PFS proposed rule (71 FR 49064), we discussed that we are exploring the development of measures related to the quality and efficiency of care, including those involving clinical laboratory fee schedule services. We stated our interest to work with VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 physicians, providers and the clinical laboratory community to identify ways to promote utilization decisions such as using a laboratory claims attachment standard involving the Logical Observation Identifiers Names and Codes (LOINC) database as a means for reporting test result data. This could be one possible component of a comprehensive system of collecting clinical laboratory test data. Detailed information on the LOINC reporting system is available at the Web site at https://www.loinc.org. Comment: Several commenters endorsed our interest in working with the laboratory community on laboratory quality of care initiatives. However, two commenters objected to LOINC reporting system as operationally burdensome for laboratory information systems because it would require merging a data quality field from the laboratory information system to the laboratory billing system, training information systems staff, and sending reference laboratory result data to the referral laboratory who prepares the claim. One of these commenters also stated that regulations on privacy of medical information should be considered. One commenter indicated that the LOINC reporting system requires narrative reporting for some microbiology tests which is not in a data quality field format. Response: We are pleased the commenters supported the development of measures related to the quality of clinical laboratory services. We agree that it is imperative to work with physicians, providers and the clinical laboratory community to identify quality measures that can efficiently be incorporated into the laboratory billing system. We understand the reporting of laboratory quality measures must reach compatibility with privacy rules. Furthermore, the important role of quality measures in the evolution of healthcare reporting will remain strong. While changes to information technology may be required, laboratories should be anticipating further interest to include a laboratory quality measure field in laboratory billing systems. b. Blood Glucose Monitoring in SNFs In the CY 2007 PFS proposed rule (71 FR 49064), we included a discussion of our longstanding policy on blood glucose monitoring in SNFs submitted for payment under the Medicare Part B clinical laboratory fee schedule. We explained that section 1862(a)(1)(A) of the Act requires that a service be reasonable and necessary for diagnosis and treatment to be eligible for coverage PO 00000 Frm 00082 Fmt 4701 Sfmt 4700 by Medicare. Our regulations at § 410.32(a) already require that, for any diagnostic test, including a clinical diagnostic laboratory test, to be considered reasonable and necessary, it must be both ordered by the physician and the ordering physician must use the result in the management of the beneficiary’s specific medical problem. Tests not ordered by the physician who is treating the beneficiary are not reasonable and necessary. In the context of blood glucose monitoring, we most recently explained this policy in Transmittal AB–00–108, which is available on our Web site at https://www.cms.gov/transmittals/ downloads/ab00108.pdf. This interpretation of § 410.32 also is the basis for our policy in section 90.1 of Chapter 7 of the Medicare Claims Processing Manual (‘‘Skilled Nursing Facility Part B Billing,’’ which is available on our Web site at https:// www.cms.hhs.gov/manuals/downloads/ clm104c07.pdf.) In addition, separate authority under section 1835(a)(2)(B) of the Act provides that, in the case of certain ‘‘medical and other health services’’ (including clinical diagnostic laboratory services), payment may be made for Part B services that are furnished by a provider of services only if a physician certifies— and recertifies where those services are furnished over a period of time, with such frequency, and accompanied by such supporting material, as may be provided by regulation—that those services were medically necessary. In the CY 2007 PFS proposed rule (71 FR 49065), we proposed to use our authority under section 1835(a)(2)(B) of the Act to amend § 424.24 to provide that, for each blood glucose test furnished to a resident of a SNF, the physician must certify that the test is medically necessary. We also proposed to clarify that a physician’s standing order is not sufficient to order a series of blood glucose tests. Comment: Many commenters explained that it is common medical practice in the nursing home for the physician to certify a standing order for a 1-month time period for the nurse to perform daily glucose monitoring fingerstick tests throughout the month and based on the results, the nursing staff dispense insulin, as needed by the patient. Thus, the commenters objected that the proposal will impose a burden on SNFs who perform tests under these situations. Response: This amendment to § 424.24 establishes a certification requirement that affects only services that are furnished by a provider of services for which the provider of E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations services seeks payment under Medicare Part B. To the extent payment is available under Medicare Part A or the services are not furnished by a provider of services (as defined under section 1861(u)of the Act), this certification requirement does not apply. Payment for glucose monitoring is encompassed under other payment systems that are available to the nursing homes. Medicare pays as part of the bundled payment to the facility for beneficiaries in a Part A-covered stay in a hospital or in a SNF. It is when the provider requests Medicare to separately pay for a blood glucose test under the outpatient Part B clinical laboratory fee schedule that the service must meet the certification requirement under § 424.24(f). We also note that the revisions to § 424.24 does not alter existing policies issued under section 1862(a)(1)(A) of the Act. As discussed above in this section, under § 410.32(a), the test must be ordered by the physician who is treating the beneficiary and the physician must use the results promptly in the management of the beneficiary’s specific medical condition. Comment: Some commenters raised concerns that coverage policies are not consistently describing diabetes care categories, glucose monitoring protocols, and an individual glucose test service. The commenters suggested more specific coverage policies would benefit providers. Response: We understand the suggestion that refinements to coverage policies could benefit providers. The 2002 NCD for blood glucose tests specifies coverage and frequency limitations for reimbursement under the Part B. The NCD is not specific to nursing home common practices and applies to all providers submitting claims for payment under the clinical laboratory fee schedule. During the years since the release of the NCD, laboratories along with other providers who seek payment from the clinical laboratory fee schedule have had opportunity to carefully review the NCD and request further refinements and examples to enhance the NCD’s interrelationship with payment under the clinical laboratory fee schedule. Interested parties can find more information on the coverage policy process on our Web site at https:// www.cms.hhs.gov/center/coverage.asp. With respect to the burden of this certification requirement, we believe that, by enacting section 1835(a)(2)(B) of the Act, the Congress recognized that it may be appropriate for the Secretary to impose conditions of payment for services furnished by providers of VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 services for which providers bill separately under Medicare Part B. We recognize the value of blood glucose testing and strongly support this testing when it is medically necessary. However, we must also ensure that blood glucose testing is medically necessary when furnished by a provider of services for which the provider bills Medicare Part B. We believe that this revision to § 424.24 strikes the appropriate balance between our commitment to beneficiary access to blood glucose testing and our obligation to ensure that each test is medically necessary. We do not believe that our amendment to § 424.24 imposes a new obligation. As discussed above in this section, § 410.32(a) and our program instructions already require that a laboratory test must be ordered by a physician and the ordering physician must use the result in the management of the beneficiary’s specific medical problem. However, as discussed in the proposed rule, we have received inquiries regarding the application of § 410.32(a) in the context of blood glucose testing provided by SNFs. In addition, we received a specific inquiry asking for clarification of section 90.1 of Chapter 7 of the Medicare Claims Processing Manual. Furthermore, we have become aware that some providers have filed claims before Administrative Law Judges challenging our policy regarding blood glucose testing in SNFs. To the extent there has been confusion regarding our policies, our amendment to § 424.24 provides a clear rule that, for payment to be made for blood glucose tests under Medicare part B to a provider of services, a physician must certify that each test is medically necessary. We also have clarified that a physician’s standing order is not sufficient to order a series of blood glucose tests. Comment: One commenter alerted that some home health providers are engaging in inappropriate physician ordering of clinical diagnostic blood glucose tests, for payment under the Part B benefit, so that the clarification to the regulation should apply not just to SNFs but also to home health agencies. Response: We agree with the commenter that the regulation should apply to providers of services who bill to the Medicare Part B clinical laboratory fee schedule, including home health agencies. We are revising § 424.24(f) to provide that the certification requirement applies to all providers of services. Comment: One commenter disagreed with our proposal stating that it would PO 00000 Frm 00083 Fmt 4701 Sfmt 4700 69705 impose an unfair burden on clinical laboratories that provide services to SNFs because the independent laboratory is not informed or responsible for the documentation requirements in the SNF. Response: Independent clinical laboratories are not providers of services, so our amendment to § 424.24 does not affect these entities. We disagree that an independent clinical laboratory that is providing services to SNF customers should not be informed or ensure the medical necessity documentation is sufficient. Independent clinical laboratories must comply with § 410.32(a). Furthermore, independent clinical laboratories must be certified under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) (Pub. L. 100–578). Under the standard for test requests at § 493.1241, the laboratory must have a written or electronic request for patient testing from an authorized person. An independent clinical laboratory, whether it is providing services to SNF customers or other provider types, must remain informed and involved to ensure the laboratory service is rendered in accordance with the regulation and instructions applicable for receiving payment under the clinical laboratory fee schedule. Comment: One commenter asserted that we are obligated to perform a Regulatory Impact Analysis for our proposal to clarify § 424.24 requiring the physician to certify each test is medically necessary and stating that a physician’s standing order is not sufficient to order blood glucose tests for payment under the Medicare Part B clinical laboratory fee schedule. Another commenter stated our amendment to § 424.24 does not comport with the Paperwork Reduction Act of 1995 to publish a notice in the Federal Register on collection of information. Response: We do not believe our amendment to § 424.24 requires a regulatory impact analysis or a Paperwork Reduction Act notice. We believe that § 424.24(f) does not impose any new obligations, but merely codifies as a condition of payment what has long been required under § 410.32(a) and our program instructions. After careful review of public comments, we are finalizing § 424.24(f) as proposed. c. Other Lab Issues—Proposed Clinical Diagnostic Laboratory Date of Service (DOS) for Stored Specimens In the CY 2007 PFS proposed rule (71 FR 49064), we proposed to add new § 414.510 to address concerns regarding E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 69706 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations the date of service of a clinical diagnostic laboratory test that use a stored (or ‘‘archived’’) specimen. In the final rule of coverage and administrative policies for clinical diagnostic laboratory services (66 FR 58792) that we published in the November 23, 2001 Federal Register, we adopted a policy under which the date of service for clinical diagnostic laboratory services generally is the date the specimen is collected. However, for laboratory tests that use an archived specimen, the date of service is the date the specimen was obtained from the storage. We defined an ‘‘archived’’ specimen as a specimen that is stored for more than 30 calendar days before testing. The date of service for these archived specimens is the date the specimen was obtained from storage. Specimens stored 30 days or less have a date of service of the date the specimen was collected. In situations in which a specimen is taken while the patient is treated in a hospital setting, but then later used for a test after the patient has been discharged from the hospital setting, date of service of a test may affect payment because, if the date of service falls during an inpatient stay or outpatient procedure, payment for the laboratory test usually is bundled with the hospital service. To address concerns raised for tests related to cancer recurrence and therapeutic interventions, we proposed to modify our policy so that the date of service would be the date the specimen is obtained from storage, even if the specimen is obtained less than 31 days from the date it was collected, without violating the unbundling rules as long as the following conditions are met: • The test is ordered by the patient’s physician at least 14 days following the date of the patient’s discharge from the hospital. • The test could not reasonably have been ordered while the patient was hospitalized. • The procedure performed while the beneficiary is a patient of the hospital is for purposes other than collection of the specimen needed for the test. • The test is reasonable and medically necessary. Comment: One commenter suggested adding a condition stating the test cannot be performed by the hospital laboratory. Response: We disagree that the regulations should limit the type of laboratory performing the test on the specimen. The purpose of the regulatory change is directed to date of service for specimens. Comment: Two commenters supported our proposal. However, one commenter expressed concern that on a VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 rare occasion a test that otherwise meets the conditions of the regulation may be ordered by the patient’s physician less than 14 days following the date of the discharge from the hospital. The commenter requested the regulation be revised to reflect these rare situations. Response: At this time, we do not believe it is appropriate to create an exception to the 14-day requirement. We remain very concerned that only tests that can legitimately be distinguished from the care a beneficiary receives in the hospital be subject to this provision regarding the date of service of the test, which results in separate payment for the test. We believe it is more difficult to determine that a test ordered less than 14 days before discharge is appropriately separable from the hospital stay that preceded the test. We would like more information about the circumstances and tests cited by the commenters before taking any additional action in this area. We are very concerned about the possibilities for unbundling care that appropriately should be associated with the hospital stay in these circumstances and will continue to review this policy in the future to ensure that our goal of appropriately recognizing hospital and post-hospital care is achieved. Comment: Two commenters suggested rewording the second condition which states the test could not reasonably have been ordered while the patient was hospitalized. The commenters suggested the necessity of the test they are concerned with is unrelated to the procedure performed in the hospital but is necessary to determine cancer recurrence and therapeutic interventions after the patient is discharged from the hospital. Response: We agree that the second criterion could be clarified, to state that it would be inappropriate to have collected the specimen other than during the procedure, and have done so in this final rule. Our intent in establishing this criterion was to ensure that tests that meet the definitions in this provision are not directly related to the care provided in the hospital, and we believe the modification we are finalizing meets that intent more clearly than our original proposal. Comment: Three commenters discussed several high complexity clinical laboratory tests that are performed on specimens collected as a part of an inpatient procedure. The tests determine the sensitivity of the patient’s cancer to particular types of chemotherapy. The specimen is prepared so that the live cancer cells, collected at the time of the procedure, PO 00000 Frm 00084 Fmt 4701 Sfmt 4700 are cultured at the laboratory and ultimately tested. The commenters believe the result of this type of laboratory test does not relate to the procedure performed in the hospital, nor would the result typically affect treatment during the hospital stay if it were available immediately. The commenters requested the regulation specify the date of service for these types of fresh tissue sample tests to be different than the date of service for fixed tissue samples to permit separate payment under Medicare Part B. Response: We agree with the commenters that these tests, which are almost always used to determine posthospital chemotherapy care for patients who also require hospital treatment for tumor removal or resection, appear to be unrelated to the hospital treatment in cases where it would be medically inappropriate to collect a test specimen other than at the time of surgery, especially when the specific drugs to be tested are ordered at least 14 days following hospital discharge, as discussed above for tests on stored tissue samples. We are very concerned about unbundling services that are appropriately associated with hospital treatment, and therefore, believe it is critical to move cautiously in the area of determining different dates of service for tests for which the specimen collection occurs during a hospital service. As a result, we are adding § 414.510(b)(4), specifically for chemotherapy sensitivity tests, because we understand that the results of these tests, even if they were available immediately and not several weeks following the collection of the specimen, would almost never affect the treatment regimen at the hospital. Therefore, we see a valid distinction between these tests and other tests of cultured specimens that give results after hospital discharge, but that are directly related to not only the condition for which the patient is hospitalized, but would typically be used for the specific care during the hospital stay as well, if available during the hospital stay. This section will allow separate payment for chemotherapy sensitivity tests, as identified by the Secretary in subregulatory guidance, from the inpatient procedure as long as certain criteria are met. We are finalizing § 414.510 as proposed with the exceptions noted above in this section. O. Criteria for National Certifying Bodies That Certify Advanced Practice Nurses Federal regulatory qualifications for NPs at § 410.75 require that an E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations individual be certified as an NP by a recognized national certifying body that has established standards for NPs. Similarly, Federal regulatory qualifications for clinical nurse specialists (CNSs) at § 410.76 require that an individual be certified as a CNS by a national certifying body that has established standards for CNSs and that is approved by the Secretary. Currently, there is not a list of recognized or approved national certifying bodies for NPs and CNSs in regulations. However, Chapter 15, section 200 of the Benefit Policy Manual, Pub. 100–02 contains a list of national certifying bodies that are recognized by Medicare as being appropriate for certification of NPs. Although the manual provision regarding CNS services at Chapter 15, section 210 of the Benefit Policy Manual lists only the American Nurses Credentialing Center as an approved national certifying body for CNSs, we indicated that the list of recognized certifying bodies in the manual provision for NP services would also apply for CNSs in the ‘‘Revisions to Payment Policies Under the CY 2003 Physician Fee Schedule and Inclusion of Registered Nurses in the Personnel Provision of the Critical Access Hospital Emergency Services Requirement for Frontier Areas and Remote Locations; Payment Policies final rule (December 31, 2002, 67 FR 79987). The national certifying bodies that are listed under the manual instruction at section 200, and that currently apply for both NPs and CNSs (collectively, advanced practice nurses) are as follows: • American Academy of Nurse Practitioners; • American Nurses Credentialing Center; • National Certification Corporation for Obstetric, Gynecologic and Neonatal Nursing Specialties; • National Certification Board of Pediatric Nurse Practitioners and Nurses; • Oncology Nurses Certification Corporation; • Critical Care Certification Corporation. In the December 31, 2002 final rule, in response to a public comment, we stated, ‘‘it is not the agency’s intention to be overly restrictive in our program requirements and consequently prevent qualified CNSs who specialize in areas of medicine other than those certified by the American Nurses Credentialing Center (ANCC) from participating under the CNS benefit and from rendering care to patients in need of specialized services. Furthermore, the intent of the revision to the certification requirement VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 for CNSs is to recognize all appropriate national certifying bodies for CNSs as the program does for NPs.’’ Accordingly, in an effort to recognize all appropriate national certifying bodies for CNSs and NPs, we added, at that time, the Oncology Nurses Certification Corporation (ONCC) and the Critical Care Certification Corporation (CCCC) to the list of recognized national certifying bodies for advanced practice nurses. The National Board on Certification of Hospice and Palliative Care Nurses (NBCHPN) has requested that we now follow the same course of action as we did for the ONCC and the CCCC by adding its name to the list of recognized national certifying bodies. That is, NBCHPN believes that it is an appropriate national certifying body based on its certification experience, principles, services, and the certification exam that it administers to advanced practice nurses who specialize in palliative care for hospice patients. The NBCHPN stated in information it sent to the agency that its organization is a well-established certification body with more than a 12-year history of certification and that it has been certifying advanced practice hospice and palliative nurses since 2003 in partnership with the ANCC. Starting in 2005, the NBCHPN became sole proprietor of the Advanced Certified Hospice and Palliative Nurse (ACHPN) examination. Master’s level NPs and CNSs sit for this ACHPN examination that is based on a role delineation study for the advanced practice level of hospice and palliative nursing. Additionally, the NBCHPN stated that it has met the requirements of the American Board of Nursing Specialties and is an active member of the Board of Specialties, as is the ANCC. The Executive Director of the NBCHPN stated that she believes that the absence of the NBCHPN from the current list of recognized national certifying bodies presents a barrier for advanced practice nurses in the hospice palliative care specialty because they are denied enrollment on the basis that they do not meet the certification qualification requirement. The Web site for the NBCHPN can be found at https:// www.nbchpn.com. We solicited public comments on whether it would be appropriate to include the NBCHPN under the list of recognized and approved national certifying bodies for NPs and CNSs under manual instructions for both NPs and CNSs. We also solicited public comments on criteria or standards that we could use to determine whether an organization is an appropriate national PO 00000 Frm 00085 Fmt 4701 Sfmt 4700 69707 certifying body for advanced practice nurses. We realize that the agency may receive other requests in the future from organizations that wish to be added to the list of recognized or approved national certifying bodies. In anticipation of those requests, we are interested in developing certification standards that would facilitate the process for making these decisions. We appreciate the comments that we received on these two issues related to the NP and CNS benefits. However, we are delaying our decision about whether to include the NBCHPN under the manual instruction listing of recognized national certifying bodies for NPs and CNSs until we have had more time to examine and investigate the comments that we received about this issue. In regards to the issue concerning our establishment of certification criteria or standards to determine whether an organization should be listed as a recognized national certifying body for NPs and CNSs (that is, advanced practice nurses), we will consider the information that we received in comments on this issue for future rulemaking, and would consider proposing specific certification standards that an organization must meet in order to be included under the manual instruction listing of recognized national certifying bodies for NPs and CNSs. P. Chiropractic Services Demonstration In the CY 2006 PFS final rule with comment period (70 FR 70266), we included a discussion of the 2-year demonstration authorized by section 651 of the MMA to evaluate the feasibility and advisability of covering chiropractic services under Medicare. These services extend beyond the current coverage for manipulation to care for neuromusculoskeletal conditions typical among eligible beneficiaries, and cover diagnostic and other services that a chiropractor is legally authorized to perform by the State or jurisdiction in which the treatment is provided. The demonstration is being conducted in four sites, two rural and two urban. The demonstration must be budget neutral as the statute requires the Secretary to ensure that the aggregate payment made under the Medicare program does not exceed the amount which would be paid in the absence of the demonstration. Ensuring BN requires that the Secretary develop a strategy for recouping funds should the demonstration result in costs higher than those that would occur in the absence of the demonstration. As we E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 69708 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations stated in the CY 2006 PFS final rule with comment period (70 FR 70266), we would make adjustments in the national chiropractor fee schedule to recover the costs of the demonstration in excess of the amount estimated to yield BN. We will assess BN by determining the change in costs based on a pre- and post-comparison of costs and the rate of change for specific diagnoses that are treated by chiropractors and physicians in the demonstration sites and control sites. We will not limit our analysis to reviewing only chiropractor claims, because the costs of the expanded chiropractor services may have an impact on other Medicare costs. Any needed reduction would be made in the 2010 and 2011 physician fee schedules as it will take approximately 2 years to complete the claims analysis. If we determine that the adjustment for BN is greater than 2 percent of spending for the chiropractor fee schedule codes (comprised of the 3 currently covered CPT codes 98940, 98941, and 98942), we would implement the adjustment over a 2-year period. However, if the adjustment is less than 2 percent of spending under the chiropractor fee schedule codes, we would implement the adjustment over a 1-year period. We will include the detailed analysis of BN and the proposed offset during the CY 2009 rulemaking process. Physical therapy (PT) services performed by chiropractors under the demonstration are subject to the PT therapy cap. These services are included under the cap because chiropractors are subject to the same rules as medical doctors for therapy services under the demonstration. Comment: One commenter indicated that it continues to oppose our methodology for assuring BN under the demonstration. Instead of the application of an adjustment to the national chiropractor fee schedule, the commenter recommends that we make an adjustment to the totality of services payable under the Part B Trust Fund and that this would be consistent with the requirements in section 651(f)(A) of the MMA. Response: Section 651(f)(1)(B) of the MMA requires that ‘‘* * * the Secretary shall ensure that the aggregate payments made by the Secretary under the Medicare program do not exceed the amount which the Secretary would have paid under the Medicare program if the demonstration projects under this section were not implemented.’’ The statute does not specify a specific methodology for ensuring BN. We believe our intended methodology meets the statutory requirements. VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 Q. Promoting Effective Use of Health Information Technology (HIT) We recognize the potential for health information technology (HIT) to facilitate improvements in the quality and efficiency of health care services. One recent RAND study found that broad adoption of electronic health records (EHRs) could save more than $81 billion annually and, at the same time, improve quality of care.1 The largest potential savings that the study identified was in the hospital setting because of shorter hospital stays promoted by better coordinated care; less nursing time spent on administrative tasks; better use of medications in hospitals; and better utilization of drugs, laboratory services, and radiology services in hospital outpatient settings. The study also identified potential quality gains through enhanced patient safety, decision support tools for evidencebased medicine, and reminder mechanisms for screening and preventive care. Despite these large potential benefits, the study found that only about 20 to 25 percent of hospitals have adopted HIT systems. It is important to note the caveats to the RAND study. The projected savings are across the health care sector, and any Federal savings would be a reduced portion of the total savings. In addition, there are significant assumptions made in the RAND study. National savings are projected in some cases based on one or two small studies. Also, the study assumes patient compliance, in the form of participation in disease management programs and following medical advice. For these reasons, extreme caution should be used in interpreting these results. In his 2004 State of the Union Address, the President announced a plan to ensure that most Americans have EHRs within 10 years.2 One part of this plan involves developing voluntary standards and promoting the adoption of interoperable HIT systems that use these standards. The 2007 Budget states that ‘‘The Administration supports the adoption of HIT as a normal cost of doing business to ensure patients receive high quality care.’’ Over the past several years, we have undertaken several activities to promote the adoption and effective use of HIT in 1 RAND News Release: Rand Study Says Computerizing Medical Records Could Save $81 Billion Annually and Improve the Quality of Medical Care, September 14, 2005, available at: https://rand.org/news/press.05/09.14.html. 2 Transforming Health Care: The President’s Health Information Technology Plan, available at: https://www.whhitehouse.gov/infocus/technology/ economic_policy200404/chap3.html. PO 00000 Frm 00086 Fmt 4701 Sfmt 4700 coordination with other Federal agencies and with the Office of the National Coordinator for HIT. One of those activities is promotion of data standards for clinical information, as well as for claims and administrative data. As noted above in this section, the Administration supports the adoption of HIT as a normal cost of doing business. The adoption and use of HIT may contribute to improved processes and outcomes of care, including shortened illnesses and the avoidance of adverse drug reactions. Nine commenters responded to our HIT proposals. The following is a summary of the comments addressing the use of HIT to enhance quality of care, the costs associated with HIT adoption, the importance of interoperability standards, and the impact of new rules related to Medicare fraud and abuse statutes. Comment: Several commenters stated that adoption of HIT could lead to improved quality, enhanced patient safety, and increased efficiency. Some commenters noted that HIT can reduce administrative costs; however, more commenters focused on the potential financial barriers to the adoption of HIT. We received several comments addressing the high costs associated with HIT implementation. Most commenters stated that adoption of HIT is not a normal cost of doing business in health care. Several commenters emphasized that any reduction in physician payment related to the sustainable growth rate (SGR) would make it difficult for physicians to invest in HIT. Some commenters noted that incentives, such as loans, grants, and tax credits, could aid physicians by reducing the burden of cost for implementing HIT. A few commenters stated that implementation of HIT should be a shared expense between providers, purchasers, and payers. Most commenters highlighted lack of interoperability standards as a current barrier to HIT implementation. Several commenters noted that interoperability standards are a critical component of any HIT system and must include a standard set of policies, procedures, and standards for data collection and documentation. One commenter stated that progress has been slow in disseminating standards and this discourages physician practices from making large investments in HIT that quickly may become obsolete. One commenter applauded new regulatory provisions related to HIT for physician self-referral and anti-kickback statutes. However, the commenter further stated that Medicare fraud and E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations abuse statutes continue to hinder the adoption of HIT because the rules are still unclear on some issues. We received a few comments noting that specific issues related to HIT use in health care, such as the protection of patient privacy and data stewardship, still need to be resolved. Response: We thank all commenters for their thoughtful and valuable discussion of the issues. In the HIT section of the preamble to the proposed rule, we recognized the potential for effective HIT to facilitate improvements in the quality and efficiency of health care services. We also pointed out our promotion of the adoption and effective use of HIT in coordination with other Federal agencies and the Office of the National Coordinator for HIT. Here, we will discuss three areas that we are emphasizing to promote the effective use of HIT, in light of the comments we received: (1) Value-based purchasing, (2) the recent CMS and OIG final rules regarding donation of certain HIT, and (3) infrastructure and interoperability standards. We continue our work toward the implementation of value-based purchasing payment system reforms because we believe that, among other advantages, value-based purchasing can encourage physicians to invest in activities, such as effective HIT, that have the potential to improve quality and decrease unnecessary costs. However, linking a portion of Medicare payments to valid measures of quality and effective use of resources could give physicians more direct incentives to implement innovative ideas and approaches that may result in improved value of care. We agree with the commenters that noted that the use of effective HIT could increase quality, efficiency, and patient safety. We also agree with the commenters that noted that effective use of HIT can be used to decrease the burden of reporting to value-based purchasing programs. However, we disagree with the commenters that recommended direct government funding of HIT. As stated in the President’s 2007 Budget, ‘‘the Administration supports the adoption of [HIT] as a normal cost of doing business to ensure patients receive high quality care.’’ Commenters noted that multiple stakeholders in the health care system, including purchasers and payers, benefit from provider adoption and use of effective HIT and should share in the cost. CMS and OIG have recently issued final rules to allow hospitals and other health care providers under some circumstances to donate electronic prescribing and EHRs technology to VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 physicians and others without running afoul of the Stark (physician selfreferral) and anti-kickback statutes. We believe that these rules facilitate the adoption of HIT by physicians and other health care providers who might otherwise have been unable or unwilling to invest in the technology. We also believe that these regulatory changes help to stimulate the adoption of effective HIT, and that, as HIT use spreads, the benefits relative to the costs of implementation may increase for all stakeholders. The majority of commenters pointed out that the current lack of HIT infrastructure, including lack of interoperability standards, is a major obstacle to adoption and effective use of HIT. To address the lack of infrastructure, the Secretary has undertaken a national strategy that calls for Federal agencies to collaborate with private stakeholders in the development of architecture, standards, certification processes, and methods of governance to facilitate the adoption of effective HIT. In September 2005, the Secretary selected 16 commissioners to serve on the American Health Information Community (AHIC), which is a federally chartered collaborative forum of private and public interests charged with advising the Secretary on how to make health information digital and interoperable. The goals of the Community include immediate access to vital medical information at the point of care, privacy protection, better data for research, and overall cost savings. The work of the Community has been divided among four workgroups: (1) The EHRs Workgroup, (2) the Chronic Care Workgroup, (3) the Consumer Empowerment Workgroup, and (4) the Biosurveillance Workgroup, (5) the Confidentiality, Privacy, and Security Workgroup, and (6) the Quality Workgroup. The AHIC Workgroups have made recommendations, as their initial ‘‘breakthroughs,’’ pertaining to: An electronic medication summary and registration history; secure messaging capabilities for individuals with chronic disease; biosurveillance monitoring; and, through secure means, broadening the availability and access to current and historical laboratory results and interpretations. More information about the Community is available at: https:// www.hhs.gov/healthit/ahic.html. R. Health Care Information Transparency Initiative The United States (U.S.) faces a dilemma in health care. Although the rate of increase in health care spending slowed last year, costs are still growing at an unsustainable rate. The U.S. PO 00000 Frm 00087 Fmt 4701 Sfmt 4700 69709 spends $1.9 trillion on health care, or 16 percent of the gross domestic product (GDP). By 2015, projections are that health care will consume 20 percent of GDP. As indicated in the 2006 Annual Report of the Boards of Trustees, the Medicare program alone consumes 3.2 percent of the GDP and by 2040 it will consume 8.0 percent of the GDP. Part of the reason health care costs are rising so quickly is that most consumers of health care, that is, patients, are frequently not aware of the actual cost of their health care. Health insurance coverage shields them from the full cost of services, and they have only limited information about the quality and costs of their care. Consequently, consumers do not have incentives or means to carefully shop for providers offering the best value. Thus, providers of health care are not subject to the competitive pressures that exist in other markets for offering quality services at the best possible price. Reducing the rate of increase in health care prices and avoiding health services that are of little value could help to stem the growth in health care spending, and potentially reduce the number of individuals who are unable to afford health insurance. Part of the President’s health care agenda is to expand Health Savings Accounts (HSAs), which would provide consumers with greater financial incentives to compare providers in terms of price and quality, and choose those physicians and services that offer the best value. In order to exercise those choices, consumers must have accessible and useful information on the price and quality of health care items and services. Typically, health care providers do not publicly quote or publish their prices. Moreover, list prices, or charges, generally differ from the actual prices negotiated and paid by different health plans. Thus, even if consumers were financially motivated to shop for the BP, it would be very difficult at the current time for them to access usable information. For these reasons, HHS has launched a major health care information transparency initiative. This effort builds on steps taken by CMS to make quality and price information available. For example, Medicare has provided unprecedented information about drug prices in the Medicare prescription drug benefit, and is now adding to these efforts in other areas. Medicare payment information for common elective procedures and other common admissions for all hospitals by county has been posted on our Web site at https://www.cms.hhs.gov/ HealthCareConInit/. E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 69710 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations On our Web site, we will be posting geographically-based Medicare payment information for common procedures for ambulatory surgery centers, hospitals, OPDs, and physician offices. In addition, a number of tools providing usable healthcare information are already available to Medicare beneficiaries. Supported by the public and private quality alliances, consumers can access ‘‘Compare’’ Web sites through www.medicare.gov where they can evaluate important aspects of their health care options for care at a hospital, nursing home, home health agency (HHA), and dialysis facility, as well as compare their costs and coverage when choosing a prescription drug plan. We are developing a new project with the goals of providing Medicare beneficiaries with more comprehensive information on quality and costs, including more complete measures of health outcomes, satisfaction, and volume of services that matter to consumers, and more comprehensive measures of costs for entire episodes of care, not just payments for particular services and admissions. We intend for this Medicare project to incorporate private health care data, Medicaid data, and Medicare data to measure cost and quality of care information at the physician and hospital levels. Under this project, quality, cost, pricing, and patient information will be reported to Medicare beneficiaries in a meaningful and transparent way. In response to the CY 2007 PFS proposed rule (71 FR 49064), we received the following comments on the transparency issue. Comment: Most commenters supported our efforts to release quality information to create a more transparent health care system so that patients and consumers will be able to make more informed decisions about their health care. Several commenters questioned the usefulness of price information and many suggested criteria for determining what information would be most credible, accessible and meaningful both to consumers and to providers and other stakeholders. The commenters stated that the information must be valid, reliable, and sensitive to the care being delivered in order for the information to be useable. Several commenters also noted the importance of relying on the AQA (a multistakeholder group identifying ambulatory quality measures) and the joint steering committee formed by AQA, the Hospital Quality Alliance (HQA), and the Quality Alliance Steering Committee, to be the forum where all stakeholders come together to identify useful measures. One VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 commenter also noted the important work of the AMA Consortium for Performance Improvement in bringing together multiple physician medical specialties. Response: We agree that physician price and quality information must be credible, accessible, and meaningful to consumers and other stakeholders. To ensure this is the case for our transparency efforts, we rely heavily on physician groups and broad stakeholder coalitions to help advise as to the measures we are using, particularly for quality and in considering episodes of care. We are actively working with the AMA Consortium for Performance Improvement, the AQA, the National Quality Forum (NQF), and various medical specialty groups to identify useful quality measures. We are conducting research and working directly with the AQA to identify potential episode of care measures. We are building on the model we used for inpatient and ambulatory surgery centers to provide the most accurate information possible when releasing Medicare payment data. By December 2006, we plan to release Medicare data, including the number of services, charges and payment rates for a group of common physicians’ services by locality. Comment: Many comments focused on the usefulness of price information. One commenter questioned the premise that consumers should use price information in health care decisions. Several other commenters noted the limitations of price information and the need for consumers and patients to understand the context for it. They added that providing price information on health care services should not be placed in the same class as shopping for airline tickets or hotel accommodations. They further questioned whether price plays a significant role in choosing a physician or hospital, particularly when a patient is facing a life threatening illness. Other commenters have advised that the price is subject to individual health plan benefit packages and could change depending on the course of beneficiary illness. Further, in an emergency, additional services may be required which will therefore raise the costs of services for beneficiaries. Response: We agree that making health care decisions, including the selection of providers, is a serious undertaking. For this reason, it is critical that consumers, patients, and their families have information which will help them make important health care decisions. For those patients in the early stages of illness, or those who may need preventive care, choosing a PO 00000 Frm 00088 Fmt 4701 Sfmt 4700 provider based on the knowledge of the potential overall costs of care, and taking into account whether the physician is effective at helping the patient prevent life threatening illnesses, could help the patient avoid unnecessary costs later on. For patients with life threatening illnesses, cost is also at issue. However, most insurance, including Medicare, does require cost sharing, and if information on price and quality is available it may be possible for beneficiaries to choose high quality providers at a reduced cost, which would therefore minimize the patient’s out-of-pocket costs. We also agree that it is important to recognize that beneficiary out-of-pocket costs are in part driven by the type of coverage the beneficiary has and whether the beneficiary has any supplemental coverage. Combining information on multiple services related to the same clinical condition into a broader episode of care could provide a prospective patient and his or her family even more useful cost and quality information. For example, if a patient has a serious illness, he or she (or his or her family) would be better able to choose a physician or other health care provider that more closely suits the patient’s preferences by comparing, before treatment: (1) The cost of treatment; (2) the various types of services and treatments associated with that particular illness; and (3) the outcome for patients with similar health conditions. Comment: One commenter questioned whether releasing price information could increase health care costs because the pricing information could encourage patients to delay necessary care and which presumably may result in more advanced disease. The commenter stated that price information should not be released for E/M, and preventive services. Response: We believe that the release of price information will not inhibit a patient’s use of appropriate health care services, in particular, preventive or evaluative services. It is our expectation that the transparency of price and quality information will encourage patients to obtain health care services that are proven in quality of care and outcomes for patients and the provision of these chosen services should result in a decrease in the overall costs of health care. Comment: One commenter thought that payment information should be broken into the work component, PE and malpractice. They further suggested arraying information to reflect the relative costliness of different settings of E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations care for the same services, such as ambulatory surgery centers, OPDs, or physicians’ offices. Response: We agree that those separate service components could be of some interest, but we do not understand how they would be of benefit to the patient or consumer when he or she is making health care decisions. Such service component break outs provide no information on out-of-pocket or overall costs as to the specific service or as to a broader episode of care that takes into consideration care delivered across settings and time. We believe that providing comparative information on the costs of care in different settings when the services and patient needs are similar is an interesting concept. We will consider suggestions as to how this type of data may be provided. Comment: One commenter stated that it is inappropriate to make public efficiency information, cost and utilization ratings without commensurate quality data, and that efficiency measurement should be restricted to areas where this type of data are available, and risk adjusted. Further, the commenter added that payers should make their methodology and data sources easily available to physicians. Response: We agree that both cost and quality data are important for consumers to make informed decisions about providers and treatment options. We are exploring a range of options for how to measure efficiency, including risk adjustment options. We also agree that it is important for physicians to understand how cost and quality data are being measured. Comment: One commenter questioned whether all the resources going into the transparency efforts might be better spent supporting physician adoption of EHRs, patient registries, and group medical visits. Response: Our transparency efforts are aimed at helping consumers make better informed health care decisions. We have many other initiatives aimed at supporting these other important physician tools, for example, Quality Improvement Organizations (QIOs) are working across the country to provide technical assistance to physicians to help these physicians redesign work practices to adopt EHRs. Several significant initiatives, including the Physician Group Practice demonstration and the Medicare Health Support program are identifying effective care management strategies, including the physician adoption of EHRs, patient registries, and group medical visits as recommended by the commenter. VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 Further, we are working with the Department to lessen the barriers to IT adoption by identifying and endorsing standards for seamless movement of information across settings. Comment: One commenter said the primary driver of health care costs was the lack of productivity increases in health care and questioned whether providing more information to consumers would have any impact on the efficiency of the system. The commenter stated that the reason for this lack of productivity improvement was due to the labor intensive nature of our health care system since the United States government did not purchase HIT directly for providers. Response: We agree that health care is labor intensive and that increased adoption of effective HIT has the potential to improve productivity. For these reasons, increasing adoption of effective HIT, including EHRs is one the most important initiatives for this administration. As we have stated previously in our other responses in this section, we have in place a number of initiatives aimed at lessening the barriers to adoption and initiatives supporting both hospitals and physicians. However, we strongly support the notion that market forces, including consumers empowered to make more informed health care decisions, are also critical for improving the value of the health system. Comment: One commenter stated that health plans should be required to release their fee schedules showing total charges and methods of calculating fees for physicians and hospitals. Response: The purpose of our transparency initiative is to make it easier for consumers and patients to make better informed health care decisions based on their own unique health circumstances. We have partnered with the Agency for Healthcare Research and Quality, and we are exploring, in the context of the AQA and the Quality Alliance Steering Committee, a variety of options for releasing pricing, payment and episode of care costs. Comment: One commenter questioned whether physicians could report directly to us or to carriers on the clinical quality measures currently reflected in the Physician Voluntary Reporting Program (PVRP) initiative instead of through the established mechanism of G-codes or CPT category II codes (if available). Response: Currently, the PVRP data are not reported publicly, as would be the case in a transparency initiative, but are provided confidentially to physicians. These measures are based PO 00000 Frm 00089 Fmt 4701 Sfmt 4700 69711 on the work of a multi-stakeholder consensus process through the National Quality Forum and the AQA. We are also relying on this process to identify physician quality measures for transparency. The PVRP can be a building-block for future efforts to measure physician quality. Further, we are seeking to benefit the Medicare program by applying quality measures developed by the private sector to comprehensive data on physicians’ services to improve the quality of Medicare services, and to provide Medicare beneficiaries with useful quality information. Specifically, under a new Medicare project that will begin in six areas, data from Medicare and private purchasers are being combined to create quality measures that will be reported to Medicare beneficiaries. Information on physician performance on quality will be used for feedback to physicians on services provided to Medicare beneficiaries, and information on physician performance will be made available to beneficiaries. The purpose of this important project is to encourage improvements in the quality of Medicare services, and provide information to Medicare beneficiaries that will permit them to make more informed choices about how and where they will receive their care. Over time, using the experience of these initiatives, we will identify which measures and what data collection mechanisms are best used to release physician specific information to Medicare beneficiaries. Regarding the earlier comment about G-code reporting, we chose the path of reporting quality measures on claims through G-codes because those claims could be built on existing data systems, creating fewer burdens for physician offices and CMS. Physicians, predominantly, already use claims supported data systems so, therefore, we believe at this time it is the most practical system. In the future, we hope to be able to accept, and for physicians to be able to report, using the electronic means outlined by the commenter. We ask the commenter to work with us to ensure that EHRs and other information systems are designed to collect the clinical data components necessary to measure a broad range of quality indicators. Comment: A commenter also suggested that group practices should be allowed to create scores for their whole group and report at the aggregate level. The commenter stated that group practices have internal mechanisms, including incentive structures, for improving quality that should be used. E:\FR\FM\01DER2.SGM 01DER2 69712 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations rmajette on PROD1PC67 with RULES2 Response: We recognize that comparing groups of physicians by price and quality measures could be useful both for consumers and patients in regions where these groups are widely available. We also appreciate the usefulness of the data for internal quality improvement for physician groups. However, for purposes of consumer choice, it may be important to have physician-specific information. Even with a group, beneficiaries would want to know the physician’s treatment patterns, including quality information, to best suit the beneficiary’s needs or preferences. We agree that information on both price and quality on individual physicians would be useful for consumers and patients. S. Bad Debt Payment for Services Associated With Reasonable Charge/Fee Schedules Under the Medicare program, payment may be made for unrecovered costs (bad debt) attributable to uncollectible deductible and coinsurance of Medicare beneficiaries as specified in § 413.89 and the Provider Reimbursement Manual (PRM) (CMS Pub. 15 Part 1, Chapter 3). Entities currently eligible to receive Medicare bad debt payments, with some limitations, include hospitals, skilled nursing facilities (SNFs), CAHs, RHCs, ESRD facilities, FQHCs, community mental health clinics, health maintenance organizations (HMOs) reimbursed on a cost basis, competitive medical plans (CMPs), and health care pre-payment plans. The bad debt policy for ESRD facilities is set forth in § 413.178. The current bad debt regulation at § 413.89(i) excludes payment of bad debts specifically for those services furnished by anesthetists paid under a fee schedule. In the February 10, 2003 Federal Register, we published the Provider Bad Debt Payment proposed rule where we proposed to amend the language in the existing bad debt regulations to clarify that bad debts are not recognized or reimbursed for all covered services paid for under a reasonable charge-based methodology or a fee schedule (68 FR 6682). As stated in that proposed rule, the proposed amendment was intended to clarify our longstanding policy and is not a change in policy. In this final rule with comment period, we are finalizing the amendment to the regulations, as proposed in the February 10, 2003 proposed rule, to clarify that payment of bad debts for covered services paid for under a reasonable charge-based methodology or a fee schedule is not allowable. In the VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 February 10, 2006 Federal Register (71 FR 6991), we issued a notice extending the timeline for publication of a final rule associated with provisions of the February 10, 2003 proposed rule by one year to February 10, 2007. At this time, we are not finalizing other proposed provisions of the February 10, 2003 proposed rule. We received the following comment regarding this provision from the February 10, 2003 proposed rule. Comment: A commenter stated that the clarification of policy that bad debt reimbursement is not available for services paid under a fee schedule is a change in policy for outpatient therapy. Response: During the initial stages of developing the Medicare program in 1966, the issue of ‘‘bad debt’’ arose but was not mentioned explicitly in the statute. However, at that time, based on the intent of the anti-cross-subsidization principle found in the definition of ‘‘reasonable cost’’ at section 1861(v)(1)(A) of the Act, Medicare adopted the policy to pay for the unrecovered costs attributable to uncollectible deductible and coinsurance of Medicare beneficiaries. Accordingly, we believe that this statutory prohibition on crosssubsidization does not apply where services are reimbursed on anything other than the basis of ‘‘reasonable costs’’. The Medicare program has never allowed payment of bad debts for services paid for on the basis of a fee schedule or reasonable charge methodology, such as but not limited to, services of physicians, suppliers, certified registered nurse anesthetists, or NPs. Under a fee schedule or reasonable charge methodology, Medicare does not share proportionately in an entity’s incurred costs but rather makes payment for a specific service. The payment is not related to the cost of a service and thus, does not embody the concept of unrecovered costs due to uncollected amounts of deductibles and coinsurance. Thus, payment of bad debt applies only to services reimbursed on the basis of reasonable cost or to services paid under one of Medicare’s prospective payment systems that have a basis in reasonable costs that do not reflect Medicare payment of bad debts during a specified provider base period. Accordingly, when outpatient therapy services began to be paid for on a fee schedule methodology, payment of bad debts associated with these services was no longer available. Therefore, we do not agree with the commenter and we are revising § 413.89(i) and adding new § 413.178(d) as proposed. PO 00000 Frm 00090 Fmt 4701 Sfmt 4700 III. Revisions to the Payment Policies of Ambulance Services under the Fee Schedule for Ambulance Services and the Ambulance Inflation Factor Update for CY 2007. Under the ambulance fee schedule, the Medicare program pays for transportation services for Medicare beneficiaries when other means of transportation are contraindicated. Ambulance services are classified into different levels of ground (including water) and air ambulance services based on the medically necessary treatment provided during transport. These services include the following levels of service: • For Ground— + Basic Life Support (BLS) + Advanced Life Support, Level 1 (ALS1) + Advanced Life Support, Level 2 (ALS2) + Specialty Care Transport (SCT) + Paramedic ALS Intercept (PI) • For Air— + Fixed Wing Air Ambulance (FW) + Rotary Wing Air Ambulance (RW) A. History of Medicare Ambulance Services 1. Statutory Coverage of Ambulance Services Under sections 1834(l) and 1861(s)(7) of the Social Security Act (the Act), Medicare Part B (Supplemental Medical Insurance) covers and pays for ambulance services, to the extent prescribed in regulations, when the use of other methods of transportation would be contraindicated by the beneficiary’s medical condition. The House Ways and Means Committee and Senate Finance Committee Reports that accompanied the 1965 Social Security Amendments suggest that the Congress intended that— • The ambulance benefit cover transportation services only if other means of transportation are contraindicated by the beneficiary’s medical condition; and • Only ambulance service to local facilities be covered unless necessary services are not available locally, in which case, transportation to the nearest facility furnishing those services is covered (H.R. Rep. No. 213, 89th Cong., 1st Sess. 37 and Rep. No. 404, 89th Cong., 1st Sess. Pt 1, 43 (1965)). The reports indicate that transportation may also be provided from one hospital to another, to the beneficiary’s home, or to an extended care facility. 2. Medicare Regulations for Ambulance Services E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations rmajette on PROD1PC67 with RULES2 Our regulations relating to ambulance services are set forth at 42 CFR part 410, subpart B and 42 CFR part 414, subpart H. Section 410.10(i) lists ambulance services as one of the covered medical and other health services under Medicare Part B. Therefore, ambulance services are subject to basic conditions and limitations set forth at § 410.12 and to specific conditions and limitations included at § 410.40. Part 414, subpart H, describes how payment is made for ambulance services covered by Medicare. The national fee schedule for ambulance services is being phased in over a 5-year transition period beginning April 1, 2002 as specified in § 414.615. As of January 1, 2006, the total payment amount for air ambulance providers and suppliers is based on 100 percent of the national ambulance fee schedule. In accordance with section 414 of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA) (Pub. L. 108–173), we added § 414.617 which specifies that for ambulance services furnished during the period July 1, 2004 through December 31, 2009, the ground ambulance base rate is subject to a floor amount, which is determined by establishing nine fee schedules based on each of the nine census divisions, and using the same methodology as was used to establish the national fee schedule. If the regional fee schedule methodology for a given census division results in an amount that is lower than or equal to the national ground base rate, then it is not used, and the national fee schedule amount applies for all providers and suppliers in the census division. If the regional fee schedule methodology for a given census division results in an amount that is greater than the national ground base rate, then the fee schedule portion of the base rate for that census division is equal to a blend of the national rate and the regional rate. For CY 2006, this blend is 40 percent regional ground base rate and 60 percent national ground base rate. As of January 1, 2007, the total payment amount for ground ambulance providers and suppliers will be based on either 100 percent of the national ambulance fee schedule or 80 percent of the national ambulance fee schedule and 20 percent of the regional ambulance fee schedule. B. Provisions of the Final Regulation In this rule, we are finalizing changes to the fee schedule for payment of ambulance services by adopting revised geographic designations for urban and rural areas as set forth in OMB’s CoreBased Statistical Areas (CBSAs) standard. We are adding the definition VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 of ‘‘urban area’’ as defined by the Executive Office of Management and Budget (OMB). In addition, we are removing the definition of ‘‘Goldsmith modification’’ and amending our definition of ‘‘rural area’’ to include areas determined to be rural under the most recent version of the Goldsmith modification. We are withdrawing our proposal to change the language of our regulation defining ‘‘specialty care transport (SCT)’’ to conform to our existing payment policies. In response to public comments, we are broadening and clarifying our interpretation of the existing language and responding to other issues associated with the definition of SCT. In addition, we are discontinuing our annual review of the original CF assumptions and of the original air ambulance rates from the initial implementation of the fee schedule in 2002 because we have not identified any significant differences from those assumptions in the 4 years since the implementation of the fee schedule. We will continue to monitor payment and billing data on an ongoing basis and make adjustments to the CF and to air ambulance rates as appropriate to reflect any significant changes in these data. Finally, in response to public comment, we are withdrawing our proposal to revise our current definition of ‘‘Emergency response’’ to further specify the conditions that warrant a higher payment for immediate response. Our reasons for withdrawing our proposal are explained in section III.B.4. of this preamble. 1. Adoption of New Geographic Standards for the Ambulance Fee Schedule Historically, the Medicare ambulance fee schedule has used the same geographic area designations as the acute care hospital IPPS and other Medicare payment systems to take into account appropriate urban and rural differences. This provides a consistent and objective national definition for ambulance payment purposes within the ambulance fee schedule and generally across Medicare payment systems. It also utilizes geographic area designations that more realistically reflect rural and urban populations, resulting in more accurate payments for ambulance services. Accordingly, we are adopting OMB’s CBSA-based geographic area designations, which have been adopted for the IPPS, to more accurately identify urban and rural areas for ambulance fee schedule payment purposes. We are also adopting the most recent modification of the Goldsmith PO 00000 Frm 00091 Fmt 4701 Sfmt 4700 69713 Modification, consistent with the provisions of section 1834(l), to more accurately determine rural census tracts within metropolitan areas. These changes will affect whether certain areas are recognized as rural or urban. The distinction between urban and rural is important for ambulance payment purposes because ambulance payments are based on the point of pickup for the transport, and the point of pick-up for urban and rural transport is paid differently. Of particular significance to the ambulance fee schedule, the changes would affect whether or not certain areas are eligible for certain rural bonus payments under the ambulance fee schedule. For example, the changes would affect whether or not certain areas are recognized as what we refer to as ‘‘Super Rural Bonus’’ areas established by section 414(c) of the MMA and set forth in section 1834(l)(12) of the Act. That section specifies that, for services furnished during the period July 1, 2004 through December 31, 2009, the payment amount for the ground ambulance base rate is increased by a ‘‘percent increase’’ (Super Rural Bonus) where the ambulance transport originates in a rural area (which includes Goldsmith areas) that we determine to be in the lowest 25th percentile of all rural populations arrayed by population density. a. Core-Based Statistical Areas (CBSAs): Revised Office of Management and Budget (OMB) Metropolitan Area Definitions In the February 27, 2002 final rule (67 FR 9100), we stated that we could not easily adopt and implement, within the timeframe necessary to implement the fee schedule, a methodology for recognizing geographic population density disparities other than MSA/ nonMSA. We also stated that we would consider alternative methodologies that may more appropriately address payment to isolated, low-volume rural ambulance providers and suppliers at a later date. The application of any rural adjustment is determined by the geographic location of the beneficiary at the time he or she is placed on board the ambulance. We are now finalizing the adoption of OMB’s revised geographic area designations for urban and rural areas and the most recent modification of the Goldsmith Modification to address payment to those isolated, lowvolume rural providers and suppliers. Prior to the 2000 decennial census, geographic areas were consistently defined by OMB as Metropolitan Statistical Areas (MSAs) with an MSA being defined as an urban area and E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 69714 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations anything outside an MSA being defined as a rural area. In addition, for purposes of ambulance policy, we recognized the 1990 update of Goldsmith areas (generally, rural census tracts within counties that covered large tracts of land with one predominant urban area only) as rural areas (65 FR 55077 through 55100). In Fall 1998, OMB chartered the Metropolitan Area Standards Review Committee to examine the Metropolitan Area (MA) standards and develop recommendations for possible changes to those standards. Three notices related to the review of the standards were published on the following dates in the Federal Register, providing an opportunity for public comment on the recommendations of the Committee: December 21, 1998 (63 FR 70525 through 70561); October 20, 1999 (64 FR 56627 through 56644); and August 22, 2000 (65 FR 51059 through 51077). In the December 27, 2000, Federal Register (65 FR 82227 through 82238), OMB announced its new standards. In that notice, OMB defined a CBSA, beginning in 2003, as ‘‘a geographic entity associated with at least one core of 10,000 or more population, plus adjacent territory that has a high degree of social and economic integration with the core as measured by commuting ties.’’ CBSAs are conceptually areas that contain a recognized population nucleus and adjacent communities that have a high degree of integration with that nucleus. The purpose of the new OMB standards is to provide nationally consistent definitions for collecting, tabulating, and publishing Federal statistics for a set of geographic areas. The OMB standards designate and define two categories of CBSAs: Metropolitan Statistical Areas (MSAs); and Micropolitan Statistical Areas (65 FR 82227 through 82238). According to OMB, MSAs are based on urbanized areas of 50,000 or more population and Micropolitan Statistical Areas (referred to in this discussion as Micropolitan Areas) are based on urban clusters of at least 10,000 population but less than 50,000 population. Counties that do not fall within CBSAs are deemed ‘‘Outside CBSAs.’’ Under the ambulance fee schedule, MSAs would continue to be recognized as urban areas and all other areas outside MSAs (including Micropolitan Areas, areas ‘‘Outside CBSAs’’, and areas that are determined to be rural under the most recent modification of the Goldsmith Modification) would be recognized as rural areas. As noted previously, these designations are important because under the ambulance fee schedule, Medicare transports are VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 designated either urban or rural based on the pick-up point of the transport. As of June 6, 2003, the new OMB definitions recognized 49 new MSAs and 565 new Micropolitan Areas, and extensively revised the composition of many of the existing MSAs. There are 1,090 counties in MSAs under the new definitions (previously, there were 848 counties in MSAs). Of these 1,090 counties, 737 are in the same MSA as they were prior to the changes, 65 are in a different MSA, and 288 were not previously designated to any MSA (69 FR 49027). There are 674 counties in Micropolitan Areas. Of these, 41 were previously in an MSA, while 633 were not previously designated to an MSA. There are five counties that previously were designated to an MSA, but are no longer designated to either an MSA or a new Micropolitan Area (Carter County, Kentucky; St. James Parish, Louisiana; Kane County, Utah; Culpepper County, Virginia; and King George County, Virginia) (69 FR 49027). Our adoption of CBSA-based geographic area designations means that ambulance providers and suppliers that pick up Medicare beneficiaries in areas that are now outside of MSAs (but had been within MSA areas) may experience increases in payment, while those ambulance providers and suppliers that pick up Medicare beneficiaries in areas that are now within MSA areas (but had been outside of MSAs) may experience decreases in payment. The use of updated geographical areas means the recognition of new urban and rural boundaries based on the population migration that occurred over a 10-year period, between 1990 and 2000. We believe that updating the MSA definition to conform with OMB’s CBSA-based geographic area designations, coupled with updating the Goldsmith Modification (that is, using the current Rural Urban Commuting Areas (RUCAs) version, as discussed in section III.B.1.b of this final rule), will more accurately reflect the contemporary urban and rural nature of areas across the country for ambulance payment purposes and cause ambulance fee schedule payments to become more accurate. As of October 1, 2004, the IPPS adopted OMB’s revised metropolitan area definitions to identify ‘‘urban areas’’ for payment purposes. Under the IPPS, MSAs are considered urban areas and Micropolitan Areas and areas ‘‘Outside CBSAs’’ are considered rural areas as specified in § 412.64(b). We are adopting similar CBSA-based designations of ‘‘urban area’’ and ‘‘rural PO 00000 Frm 00092 Fmt 4701 Sfmt 4700 area’’ under the ambulance fee schedule for the reasons discussed. Therefore, we are revising § 414.605 to include a definition of urban area and to reflect OMB’s revised CBSA-based geographic area designations in our definition of rural area. Comment: Some commenters suggested that we should mitigate any financial impact of the CBSA-based geographic changes by holding negatively-affected ambulance companies harmless or by adopting a phase-in of the CBSA-based geographic changes. Response: While we understand the concern of some ambulance companies about the CBSA-based geographic changes, we think most negative impacts will be mitigated when we incorporate the updated Goldsmith Modification using RUCAs, as we discuss in section III.B.1.b. of this final rule. The RUCAs allow us to continue to recognize sub-county rural areas in CBSA-based MSAs. Further, we believe that accurate payments to rural areas should not be further delayed. Ambulance payments will not reflect the population changes documented by the CY 2000 decennial census and reflected in CBSA-based geographic designations until CY 2007. Finally, ambulance providers and suppliers who benefit from the floor amount based on Regional fee schedules will continue to receive transition payments through CY 2009, mitigating the overall financial impacts of the ambulance fee schedule. Comment: Several commenters suggested delaying the implementation of the CBSA-based geographic changes until the findings of the GAO report on costs and access as they relate to ambulance services is published. The final report is currently due to be published by December 2007. Response: We contacted the GAO concerning this report. At this time, the draft findings are not available and GAO is not permitted to discuss the report until its release. In view of the mitigating effects of our use of RUCAs, and in light of the fact that no ‘‘super rural bonus’’ areas are affected by the CBSA-based geographic designations, we think that the better course of action is to finalize our adoption of CBSAbased urban and rural designations. However, we will maintain contact with the GAO and, when their findings are available, we will consider whether any further adjustments are necessary. b. Updated Goldsmith Modification: Rural Urban Commuting Areas (RUCAs) The Goldsmith Modification evolved from an outreach grant program sponsored by the Office of Rural Health E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations Policy of the Health Resources and Services Administration (HRSA). This program was created to establish an operational definition of rural populations lacking easy access to health services in Large Area Metropolitan Counties (LAMCs). Dr. Harold F. Goldsmith and his associates created a methodology for identifying rural census tracts located within a large metropolitan county of at least 1,225 square miles. Using a combination of data on population density and commuting patterns, census tracts were identified as being so isolated by distance or physical features that they were more rural than urban in character. The original Goldsmith Modification was developed using data from the 1980 census. To more accurately reflect current demographic and geographic characteristics of the nation, HRSA’s Office of Rural Health Policy, in partnership with the Department of Agriculture’s Economic Research Service and the University of Washington, developed an update to the Goldsmith modification designated as Rural-Urban Commuting Area Codes (RUCAs) (69 FR 47518 through 47519). Rather than being limited to LAMCs, RUCAs use urbanization, population density, and daily commuting data to categorize every census tract in the country. Thus, RUCAs are used to identify rural census tracts in all metropolitan counties. Section 1834(l) of the Act requires that we use the most recent modification of the Goldsmith Modification to determine rural census tracts within MSAs. Therefore, we are removing the definition of ‘‘Goldsmith modification’’ at § 414.605 and incorporating a reference to the most current version of the Goldsmith modification, which are the Rural Urban Commuting Areas (RUCAs), in the definition of ‘‘rural area.’’ Comment: We received numerous comments from members of the ambulance industry that were concerned about the geographic status of their pick-up areas. Ambulance companies located in areas that have been traditionally recognized as rural areas were concerned that population shifts based on whole county designations might not accurately reflect pockets of rurality within those counties. Response: The most recent modification of the Goldsmith Modification, which we are adopting in this final rule, uses RUCAs to recognize levels of rurality in census tracts located in every county across the nation. As a result, many counties that are designated urban at the county level based on population do, indeed, have VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 rural census tracts within them that will be recognized as rural areas through our use of RUCAs. While this may not mean that every commenter will be ultimately satisfied, we believe that using RUCAs to identify sub-county rural areas within urban counties will resolve many of the commenters’ concerns. Comment: Although a number of commenters were supportive of our use of RUCAs, they requested that we clarify how we intend to define rurality using RUCA categories. Response: The RUCA system is an updated version of the Goldsmith Modification that uses a 10-point scale of rurality. RUCA levels are assigned to a census tract based on the association of a given area’s population to the nearest urban commuting area as follows: (1) Metropolitan-area core: Primary flow within an urbanized area (UA). (2) Metropolitan-area high commuting: Primary flow 30% or more to a UA. (3) Metropolitan-area low commuting: Primary flow 5 percent to 30 percent to a UA. (4) Large town core: Primary flow within a place of 10,000 to 49,999. (5) Large town high commuting: Primary flow 30 percent or more to a place of 10,000 to 49,999. (6) Large town low commuting: Primary flow 5 percent to 30 percent to a place of 10,000 to 49,999. (7) Small town core: Primary flow within a place of 2,500 to 9,999. (8) Small town high commuting: Primary flow 30 percent or more to a place of 2,500 to 9,999. (9) Small town low commuting: Primary flow 5 percent to 30 percent to a place of 2,500 to 9,999. (10) Rural areas: Primary flow to a tract without a place of 2,500 or more. Furthermore, census tracts under RUCAs can be broken down by zip code for every county, allowing us to modify rural and urban areas within a given county. In the May 26, 2006 proposed rule (71 FR 30358), we did not specify where we would draw the line on the RUCA scale for urban/rural purposes. According to HRSA, the generally accepted breakpoint is to define a level less than 4.0 on the scale as urban and levels equal to or greater than 4.0 on the scale as rural. Under section 330A of the Public Health Service Act, the Office of Rural Health Policy within HRSA determines eligibility for its rural grant programs through the use of the RUCA code methodology. Under this methodology, any rural census tract that is in a RUCA code 4.0 or higher is determined to be a rural census tract. We agree with the majority of the PO 00000 Frm 00093 Fmt 4701 Sfmt 4700 69715 commenters who suggested that we follow HRSA’s guidelines and consider areas to be rural if they fall within RUCA levels 4 through 10. One commenter suggested that a rurality level of 2.0 might be a better breakpoint for EMS purposes. However, we believe that HRSA’s guidelines accurately identify rural areas for ambulance payment purposes and are generally consistent with Medicare payment policies. We will, therefore, consider any census tract falling at or above RUCA level 4.0 to be a rural area for purposes of payment for ambulance services. We are finalizing our proposal to use the most recent modification of the Goldsmith Modification incorporating RUCAs, as directed by section 1834(l) of the Act. We will use 4.0 on the RUCA scale as the delineation between rural and urban (4.0 and greater is rural and less than 4.0 is urban). Comment: One commenter discussed zip code areas that ‘‘bleed’’ from one type of geographic area to another, such as from rural to urban. This commenter was concerned that zip codes that were predominantly, but not totally, located within a rural area would not receive rural payments for ambulance pick-ups in those areas due to the urban influence of part of the zip code area. Response: When we review a claim for ambulance services, we specifically examine the zip code for the pick-up point to determine whether that zip code contains both urban and rural areas. Census tracts under RUCAs can be broken down by zip code for every county, which allows us to identify rural and urban areas within a given county. Generally, we would categorize a zip code as urban or rural, and make payment accordingly, based on where the bulk of the population in that zip code resides. Comment: Several commenters were concerned about the impact of the proposed CBSA-based geographic changes on the provisions of the Medicare Modernization Act (MMA) for rural service areas, specifically concerning the ‘‘Super Rural Bonus’’ areas. Response: The ‘‘Super Rural Bonus’’ areas are areas that we determine to be in the lowest 25th percentile of all rural populations arrayed by population density in accordance with section 1834(l)(12) of the Act. Ambulance pickups in these areas currently receive a 22.6 percent add-on to their Medicare payments. None of the Super Rural Bonus areas should be adversely affected by the proposed CBSA-based changes, as our use of RUCA levels will preserve the rural status of an area E:\FR\FM\01DER2.SGM 01DER2 69716 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations rmajette on PROD1PC67 with RULES2 whether or not it is located in a county which is designated as urban under the OMB definitions. Areas that do lose their rural status to become urban have become urban because of a significant increase in the surrounding population. Comment: One commenter stated that the ambulance is dispatched to the patient to provide care at his or her pick-up point and, therefore, the ambulance payment system should reflect this procedure. Another commenter suggested that we should retain the Goldsmith Modification in its current form and not update payments under the ambulance fee schedule to reflect the use of RUCAs. Response: We agree that the ambulance pick-up point is the determining factor in establishing payment under the ambulance fee schedule, and we intend to retain this procedure in the payment process. In addition, we agree that we need to recognize levels of rurality, and are doing so by adopting the updated Goldsmith Modification which uses RUCAs to identify rural areas within urban counties. We are directed by section 1834(l) of the Act to use the most recent update of the Goldsmith Modification in the payment process. Comment: Another commenter suggested that we allow ambulance companies to present data to justify rurality, similar to the IPPS hospital reclassification process. Response: Once again, we understand the concern of some ambulance companies to retain the rural status of their pick-up areas. However, as discussed in this section, we believe that, where applicable, the use of the RUCAs, and our ability to identify rural zip codes within census tracts, will address this concern in a consistent manner. Therefore, we do not believe it is necessary to complicate the payment process by developing an additional data submission and evaluation methodology. While the commenter directly referred to the hospital reclassification process that is administered under the IPPS, wherein hospitals can apply for geographic reclassification for purposes of determining the wage index adjustment to their inpatient payments, the hospital reclassification process was established by statute specifically for inpatient hospitals. Therefore, this IPPS reclassification methodology does not apply to ambulance services. 2. Specialty Care Transport (SCT) In the February 27, 2002 Federal Register (67 FR 9100), we published a final rule with comment period entitled ‘‘Fee Schedule for Payment of VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 Ambulance Services and Revisions to the Physician Certification Requirements for Coverage of Nonemergency Ambulance Services’’ that implemented the ambulance fee schedule. In that final rule, we defined SCT in § 414.605 as the ‘‘interfacility transportation of a critically injured or ill beneficiary by a ground ambulance vehicle, including medically necessary supplies and services, at a level of service beyond the scope of the EMT [(Emergency Medical Technician)]— Paramedic. SCT is necessary when a beneficiary’s condition requires ongoing care that must be furnished by one or more health professionals in an appropriate specialty area, for example, nursing, emergency medicine, respiratory care, cardiovascular care, or a paramedic with additional training.’’ Additionally, ambulance vehicle staff must be certified as emergency medical technicians and legally authorized to operate all lifesaving and life-sustaining equipment that are on board the vehicle as specified in § 410.41(b)(1). Typically, a SCT level of care occurs when the patient, who is already receiving a high level of care in the transferring facility, requires a further level of care that the transferring facility is not able to provide. We implemented the SCT level of payment for hospital-to-hospital ground ambulance transports upon implementation of the ambulance fee schedule on April 1, 2002 and we defined SCT at § 414.605. The definition of SCT in § 414.605 refers to ‘‘interfacility transportation.’’ As we stated in the preamble to the February 27, 2002 final rule with comment period (67 FR 9100), the SCT level of care includes the situation where a beneficiary is taken by ground ambulance from the hospital to an air ambulance and then from the air ambulance to the final destination hospital. Also, we stated in the preamble for both the September 12, 2000 proposed rule (65 FR 55077) and the February 27, 2002 final rule (67 FR 9108), that SCT was proposed as a level of interhospital service. As stated in our May 26, 2006 proposed rule, we based our payment for SCT-level ground ambulance transports on hospital-tohospital ambulance transportation data. Subsequent to the implementation of the ambulance fee schedule, we clarified our definition of SCT as hospital-to-hospital transport in a Program Memorandum to Medicare contractors, which was issued on September 27, 2002. (Program Memorandum Intermediaries/Carriers, Transmittal AB–02–130—Change Request 2295, September 27, 2002). PO 00000 Frm 00094 Fmt 4701 Sfmt 4700 That document and subsequent questions and answers related to the definition of SCT were made available to the public on the Ambulance policy Web page on the CMS Web site. In addition, we clarified our definition of SCT in the Medicare Benefit Policy Manual, Chapter 10— Ambulance Services, in which we stated that SCT is regarded as a highly-skilled level of care of a critically injured or ill patient during transfer from one hospital to another. We have also clarified our policy in Ambulance Open Door Forums, conference calls, and oral and paper communication written in response to questions posed by individuals and groups representing the ambulance industry. Despite our previous attempts to clarify the scope of SCT transport, we continued to receive questions from ambulance suppliers and providers and there was confusion on this point among the Medicare contractors. For this reason, we had proposed to change the definition of ‘‘specialty care transport’’ at § 414.605 to read ‘‘hospital-to-hospital’’ transport as opposed to ‘‘interfacility’’ transportation to conform our regulation text to our existing policy. Comment: Many commenters suggested that we expand the SCT level of ambulance service to include transportation for neonates and adults transported from the scene of an accident to a hospital, as well as transport between hospitals and between hospitals and skilled nursing facilities (SNFs). In addition, commenters requested a clearer definition of the terms ‘‘hospital’’ and ‘‘critical care.’’ Some commenters suggested that we reconvene the Negotiated Rulemaking Committee to develop a definition of ‘‘critical care.’’ Response: We carefully considered the commenters’’ recommendations to expand our interpretation of the term ‘‘interfacility’’ to include other origin and destination points in addition to hospitals. The SCT level of transport is intended to be used only for transfer of the most critically ill beneficiaries, who require ongoing specialized care beyond the scope of the EMT-paramedic. Typically, SCT level transport occurs when a beneficiary who is already receiving a high level of specialized care in one facility is moved to another facility to receive more specialized services. Although such specialized care is usually provided in a hospital, we recognize that some beneficiaries receive specialized care in a skilled nursing facility (SNF) and may require the SCT level of transport from the SNF to a hospital or from a hospital to a SNF. E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations Therefore, we are withdrawing our proposal to revise § 414.605 to read ‘‘hospital-to-hospital’’ instead of ‘‘interfacility’’ and expanding our interpretation of ‘‘interfacility’’ to include both hospitals and SNFs. In addition, in response to comments, we are further clarifying the kinds of facilities that we include as origin or destination points for ‘‘interfacility’’ transport for SCT purposes. Many of our Medicare contractors indicate that they have been administering the ‘‘interfacility’’ requirement in the SCT definition broadly, paying claims at the SCT level of service beyond the scope of ‘‘hospital-to-hospital.’’ An examination of the latest available claims data shows that SCT-level payments are made predominantly for hospital-to-hospital transportation, as expected, with a small percentage of SCT-level ambulance transports involving other origin and destination points, primarily SNFs. Therefore, for purposes of SCT payment, we consider a ‘‘facility’’ to include a SNF or a hospital that participates in the Medicare program. In addition, we consider the term ‘‘facility’’ to include a hospital-based facility that meets our requirements for provider-based status, as specified at § 413.65. Facilities that meet our requirements for provider-based status, like the main provider with which they are affiliated, are held to high standards of safety and patient care. Therefore, we believe that such facilities, due to their close association with a Medicare hospital and their adherence to high standards of care under our regulations, are also among the facilities equipped to provide the SCT level of care to patients and to provide the additional specialized care that is required under the SCT level of ambulance transport. We will continue to enforce our medical necessity requirements concerning all interfacility transports so that we can remain assured that they are occurring for only the most critical patients. We appreciate the request by commenters that we clarify the kinds of facilities we consider to be included for SCT payment purposes. As explained above, our claims data indicate that SCT level care is needed primarily during inter-hospital transfers and, in some cases, during transfers between a hospital and a SNF. Therefore, for purposes of SCT payment, we consider a ‘‘facility’’ to include only a SNF or a hospital that participates in the Medicare program, or a hospital-based facility that meets our requirements for provider-based status. Medicare hospitals include, but are not limited to, rehabilitation hospitals, VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 cancer hospitals, children’s hospitals, psychiatric hospitals, Critical Access Hopitals (CAHs), inpatient acute-care hospitals, and Sole Community Hospitals (SCHs). However, we do not agree with commenters who recommended that a more comprehensive definition of ‘‘critical care’’ is warranted at this time. The Negotiated Rulemaking Committee was unable to precisely define ‘‘critical care’’ at the time it originally convened and recognized that a definition provided at the State or local level would be expected to fit, since there are no national standards available (Summary Minutes, Medicare Ambulance Fee Schedule Negotiated Rulemaking, October 4 and 5, 1999). We have no additional data that would permit us to develop a more precise definition at this time. In addition, we believe that a more precise definition might conflict with State or local parameters already in place, as well as possibly limiting the scope of SCT payments in localities where a broader State or local definition would otherwise apply. ‘‘Critical care’’ will continue to be interpreted by our Medicare contractors in conjunction with directives provided at the State or local level. Comment: Many commenters also suggested that we consider including the ongoing monitoring of a patient by a specially-trained health care professional, beyond the scope of the EMT-Paramedic, to be within the realm of the SCT level of service. Response: We carefully considered these commenters’ concerns, and we agree that in cases where a critically injured or ill patient requires the SCTlevel of transport from one facility to another, the ongoing care that must be furnished by a health professional in an appropriate specialty area, beyond the scope of the EMT-Paramedic, may include ongoing determinations as to whether the patient requires specialized care during the transport. We do not require that specialized treatment actually be furnished during the transport to satisfy the standard for SCTlevel transport. However, we do require that the need for specialized treatment can only be ascertained by a health professional with specialized training beyond the scope of the EMTParamedic. We agree with commenters who indicated that an ambulance service should not be expected to bear the cost of an additional health professional to accompany a patient ‘‘just in case’’ the need for specialized treatment arises during transport. When such ‘‘specialized monitoring’’ is medically necessary, we agree that it is PO 00000 Frm 00095 Fmt 4701 Sfmt 4700 69717 part of the ongoing care that falls within the definition of SCT. Comment: One commenter stated that certain modifiers, such as the ‘‘D’’ modifier representing a stand-alone emergency room or the ‘‘I’’ modifier used when transferring a patient from the airport or helipad to the ambulance, exclude these types of ambulance transports from the SCT level of service. Response: The commenter is correct that we generally do not recognize either ‘‘D’’ or ‘‘I’’ modifier-type ambulance transports to be SCT level ambulance services. The ‘‘D’’ modifier would be used to describe a nonhospital-based, non-hospital-owned, or non-hospital-operated diagnostic facility or clinic. We have defined the SCT level of ambulance service as interfacility ground transportation, involving transport between hospitals, hospitalbased facilities and SNFs. Therefore, a stand-alone emergency room that is not provider-based or a freestanding clinic that is not provider-based would not meet the requirements for an origin or destination point for SCT level transport. The ‘‘I’’ modifier indicates an origin or destination that is a transfer point between ambulances, such as transfer from air to ground ambulance service at a helicopter pad. Unless the origin of the first leg of the transport is a facility and unless the SCT level of care is medically necessary after the transfer occurs, we would not consider the transport from the transfer point to the final destination to be SCT level transport. 3. Recalibration of the Ambulance Fee Schedule Conversion Factor In the February 27, 2002 final rule with comment period (67 FR 9102 and 9103), we indicated that we would adjust the CF if actual experience under the fee schedule was significantly different from the assumptions used to determine the initial CF and air ambulance rates. We specifically stated that we would monitor payment data and evaluate whether the assumptions used were accurate. We have continued to review our assumptions annually to determine whether or not a CF adjustment is warranted. We examined the effects of the relative volumes of the different levels of ambulance services (service mix) and the extent of low billing charges to determine whether we should adjust the CF to reflect actual practices. In the 4 years since the implementation of the ambulance fee schedule, no significant differences from our original assumptions have emerged. We have observed only insignificant differences, and, to date, no adjustments in any 1 E:\FR\FM\01DER2.SGM 01DER2 69718 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations rmajette on PROD1PC67 with RULES2 year have been warranted. It is for this reason that we believe it is appropriate to discontinue our annual review of the original CF assumptions. We also believe that the formal annual review of air ambulance rates should be discontinued as we will monitor all ambulance rates and make adjustments on an ‘‘as needed’’ basis. The ambulance industry has available multiple venues for notifying us of potential issues. These include the ambulance fee schedule open door forums and telephone calls to designated CMS personnel. As an additional safeguard, we generally conduct a review of ambulance data each year in preparation for issuing the Ambulance Inflation Factor (AIF). Therefore, we are revising § 414.610 (g) to indicate that we will monitor payment and billing data on an ongoing basis and adjust the CF and air ambulance rates as appropriate to reflect annual practices under the fee schedule. Comment: Commenters were supportive of our proposal to discontinue the annual practice of examining the low biller data and the CF via the rulemaking process. Response: We appreciate the support of the commenters on these points. We are finalizing our proposal to discontinue the annual practice of examining the low biller data and the CF, as well as air ambulance rates, and to change the language at § 414.610(g) to reflect this. 4. Hospital-to-Hospital Ambulance Service: Emergency Response In § 414.605, we define ‘‘emergency response’’ for purposes of ambulance service to mean ‘‘responding immediately at the BLS (Basic Life Support) or ALS1 (Advanced Life Support Level 1) level of service to a 911 call or the equivalent in areas without a 911 call system. An immediate response is one in which the ambulance entity begins as quickly as possible to take the steps necessary to respond to the call.’’ In our February 27, 2002 final rule with comment period (67 FR 9100), in our definition of ‘‘emergency response’’ we stated that the additional payment for emergency response is for the additional overhead cost of maintaining the resources required to respond immediately to a call and not for the cost of furnishing a certain level of service to the beneficiary. The current emergency response definition has created confusion for those transports that originate at a hospital emergency department and the ambulance is transporting the beneficiary to an emergency department VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 at another hospital for either admittance or treatment. For example, in most of these cases, the beneficiary must be stabilized prior to the transport. Therefore, the need to maintain a state of readiness to respond immediately to an urgent call, warranting a higher emergency response payment, does not appear to be applicable to these situations. Another example occurs when the ambulance is owned by the originating hospital. We stated in a Program Memorandum to the Medicare contractors (Transmittal AB–02–130, Change Request 2295, September 27, 2002) that upon receipt of a call for ambulance services, the dispatcher makes the determination of whether the call constitutes an Emergency response. When the ambulance service is already readily available at the originating hospital, an emergency call may not be necessary, much less through a dispatcher for a 911 service. While we recognize that there may be instances when an emergency response payment is warranted for a transport between two hospital emergency departments, we believe that payment based on readiness to respond immediately is not justified 100 percent of the time. For this reason, we believed our current definition of Emergency response needed to be clarified to reflect only circumstances where payment for immediate response is truly warranted. We proposed to revise the definition of Emergency response to mean that an ambulance entity— • Maintains readiness to respond to urgent calls at the BLS or ALS1 level of service; and • Responds immediately at the BLS or ALS1 level of service to 911 calls, the equivalent in areas without a 911 call system or radio calls within a hospital system when the ambulance entity is owned and operated by the hospital. Comment: We received many comments on revising the definition of ‘‘emergency response’’. Most commenters expressed concern that this revised definition would put private ambulance services at a disadvantage. They interpreted our proposed definition to include only ambulance services owned and operated by hospitals that respond to radio calls within a hospital system. Essentially, their interpretation of our proposed definition was that only ambulance services owned and operated by hospitals would be able to transport patients at the ‘‘emergency response’’ level of service and, therefore, be able to receive the higher ‘‘emergency response’’ payment as a result. PO 00000 Frm 00096 Fmt 4701 Sfmt 4700 Response: Certainly, this was not our intent. Our view of the problem we were attempting to address was the issue of ‘‘readiness’’ when responding to a 911 call. We expect ‘‘emergency response’’ payment to be made only in circumstances where readiness to respond immediately is truly required. Therefore, we proposed to clarify the circumstances under which we expected this to occur. However, we agree with comments stating that ambulance service calls generally do not originate through a 911 service but through the hospital’s radio dispatch at the location where the ambulance is stationed. Private ambulance services stationed at inpatient hospitals would, therefore, be at a disadvantage if we specify that responding to hospital radio calls only qualifies as ‘‘emergency response’’ when the ambulance entity is owned or operated by the hospital. This would not affect off-site ambulance services whose calls originate through a 911 or equivalent service. We agree that the proposed change in the definition of ‘‘emergency response’’ could have an unintended adverse effect on private ambulance services in these circumstances. Comment: Several commenters stated that our existing definition of emergency response more clearly reflects the intent of the Negotiated Rulemaking Committee in that all ambulance services should have equal access to the use of the emergency level of service by accessing it through established State protocols, such as 911 or an equivalent service. Response: We also agree that the current definition of emergency response is consistent with the Negotiated Rulemaking Committee’s intent and does not present other problems raised by commenters. For the BLS and ALS1 levels of service, an ambulance service that qualifies for an emergency response is assigned a higher relative value to recognize the additional costs incurred in responding immediately. We think that requiring an ambulance service to respond to a 911 call, or the equivalent in areas without a 911 call system, satisfies this requirement. Therefore, we are withdrawing our proposal to revise the ‘‘emergency response’’ definition and will retain the current definition at 414.605. We expect that the State protocol (a 911 call or the equivalent in areas without a 911 call system) for requesting emergency ambulance services will be followed in all instances. E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations C. Analysis of and Responses to Public Comments We received a total of 102 timely public comments in response to the May 26, 2006 proposed rule (71 FR 30358). Commenters included national trade associations, health care providers, hospitals, CMS contractors, and private citizens. All public comments were reviewed and grouped by like or related topics. Comments are addressed in the individual sections of discussion to which they apply. rmajette on PROD1PC67 with RULES2 D. Ambulance Inflation Factor (AIF) for 2007 Section 1834(l)(3)(B) of the Act provides the basis for updating payment amounts for ambulance services. Our regulations at § 414.610(f) provide that the ambulance fee schedule must be updated by the AIF annually, based on the CPI for all urban consumers (CPI-U) (U.S. city average) for the 12-month period ending with June of the previous year. For CY 2007, that percentage is 4.3 percent. Section 414.620 specifies that changes in payment rates resulting from incorporation of the AIF will be announced by notice in the Federal Register without opportunity for prior comment. We find it unnecessary to undertake notice and comment rulemaking because the statute and regulations specify the methods of computation of annual updates. This notice does not change policy, but merely applies the update methods specified in the statute and regulations. The national fee schedule for ambulance services has been phased in over a 5-year transition period beginning April 1, 2002 as specified in § 414.615. Prior to January 1, 2006, during the transition period, the AIF was applied separately to both the fee schedule portion of the blended payment amount (regardless of whether a national or regional fee schedule applied) and to the reasonable cost or charge portion of the blended payment amount, respectively, for each ambulance provider or supplier. Then, these two amounts were added together to determine the total payment amount for each provider or supplier. Beginning January 1, 2006, the total payment for air ambulance providers and suppliers is based on 100 percent of the national ambulance fee schedule, while the total payment amount for ground ambulance providers and suppliers is based on either 100 percent of the national ambulance fee schedule or a combination of the national ambulance VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 fee schedule and the regional ambulance fee schedule. As of January 1, 2007, the combination rate will be 80 percent of the national ambulance fee schedule and 20 percent of the regional ambulance fee schedule. IV. Five-Year Refinement of Relative Value Units Under the Physician Fee Schedule: Responses to Public Comments on the Five Year Review of Work Relative Value Units A. Scope of the Five-Year Review This final rule includes the culmination of the third 5-Year Review of work RVUs required by the statute. The work RVUs affected by this review will be effective for services furnished beginning January 1, 2007. In the June 29, 2006 proposed notice, ‘‘Five-Year Review of Work Relative Value Units Under the Physician Fee Schedule and Proposed Changes to the Practice Expense Methodology’’, we explained the process used to conduct the 5-Year Review of work RVUs. In response to our solicitation of public comments that appeared in the November 15, 2004 Federal Register (69 FR 66370), we received comments from approximately 35 specialty groups, organizations, and individuals involving over 500 Current Procedural Terminology (CPT) codes. After review by our medical staff, we shared these comments with the AMA’s Relative Value Update Committee (RUC) along with additional services we had identified as potentially misvalued. After a comprehensive review process, the RUC submitted work RVU recommendations for all of these codes except for the codes that were withdrawn or referred to the CPT Editorial Panel for further review or action, and CPT code 32020 for which no specialty society expressed an interest in conducting a survey. We analyzed all of the RUC recommendations by evaluating the methodology used by each workgroup to develop the recommendations, the recommended work RVUs, and the rationale for the RUC recommendations. When appropriate and feasible, if we had concerns about the application of a particular methodology, we assessed whether the recommended work RVUs were appropriate by using alternative methodologies. In conducting our review of the RUC recommendations we considered whether: (1) The code was part of a completed survey process; (2) the methodology used by the specialty society followed the standard RUC process; (3) the survey respondents stated the work had or had not changed PO 00000 Frm 00097 Fmt 4701 Sfmt 4700 69719 in the past 5 years; (4) databases (for example, Society of Thoracic Surgeons (STS), National Surgical Quality Improvement Program (NSQIP), and Medicare diagnosis-related group (DRG)) were used in lieu of the standard RUC methodology or as a supplement to the standard methodology; and (5) the intra-service work per unit of time (IWPUT) calculation was used to determine work RVUs in lieu of the standard RUC process. Although we recognize that the work values of codes may change over time, it is the responsibility of the specialty society to present compelling evidence that a code is misvalued. (For additional information on the review process, please see the June 29, 2006 proposed notice (71 FR 37172).) B. Review of Comments Many commenters expressed support for our proposed valuations of many of the services. However, other commenters expressed specific concern or disagreement with the proposed valuation of approximately 106 codes, with the major concern being that the codes would be undervalued. We convened a multi-specialty panel of physicians to assist us in the review of comments. The comments we did not submit for panel review are discussed at the end of this section. The panels were moderated by our medical staff and consisted of: • Clinicians representing the commenting specialty(s), based on our determination of those specialties which are most identified with the services in question. Although commenting specialties were welcomed to observe the entire refinement process, they were only involved in the discussion of those services for which they were invited to participate. • Primary care clinicians nominated by the American Academy of Family Physicians (AAFP) and the American College of Physicians. • Four carrier medical directors. • One to two clinicians who practice in related specialties and have knowledge of the services under review. We submitted 30 codes for evaluation by the panel. The panel discussed the work involved in each procedure under review in comparison to the work associated with other services on the fee schedule. We assembled a set of reference services and asked the panel members to compare the clinical aspects of the work for services they believed were incorrectly valued to one or more of the reference services. In compiling the reference set, we attempted to include: (1) Services that are commonly furnished for which work RVUs are not E:\FR\FM\01DER2.SGM 01DER2 69720 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations rmajette on PROD1PC67 with RULES2 controversial; (2) services that span the entire spectrum of work intensity from the easiest to the most difficult; and (3) at least three services performed by each of the major specialties so that each specialty would be represented. Group members were encouraged to make comparisons to these reference services. The intent of the panel process was to capture each participant’s independent judgment based on the discussion and his or her clinical experience. Following the discussion for each service, each participant rated the work for that procedure. Ratings were individual and confidential; there was no attempt to achieve consensus among the panel members. We then analyzed the ratings based on a presumption that the RVUs published in the proposed notice were correct. To overcome that presumption, the inaccuracy of the proposed RVUs had to be apparent to the broad range of physicians participating in the panel. Ratings of work were analyzed for consistency among the groups represented on the panel. In general terms, we used statistical tests to determine whether there was enough agreement among the groups on the panel, and if so, whether the agreedupon RVUs were significantly different from the proposed RVUs that appeared in the June 29, 2006 proposed notice to demonstrate that the proposed RVUs VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 should be modified. We did not modify the RVUs unless there was a clear indication for a change. If there was agreement across groups for change, but the groups did not agree on what the new RVUs should be, we eliminated the outlier group, and looked for agreement among the remaining groups as to the basis for new RVUs. We used the same methodology in analyzing the ratings that we first used in the refinement process for the CY 1993 physician fee schedule final rule published in the November 25, 1992 Federal Register which described the statistical tests in detail (57 FR 55938). Our decision to convene a multispecialty panel of physicians and to apply the statistical tests described above in this section was based on our need to balance the interests of those who commented on the work RVUs against the redistributive effects that would occur in other specialties. Of the 30 codes reviewed by the multispecialty panel, all were the subject of requests for increased values. Of the proposed codes that were reviewed, 11 increased, and 19 were not changed. Table 12 lists the codes reviewed during the 5-Year Review on which we received comments. This table includes the following information: • CPT/HCPCS Code. This is the CPT or alphanumeric HCPCS code for a service. PO 00000 Frm 00098 Fmt 4701 Sfmt 4700 • Modifier. A modifier -26 is shown if the work RVUs represent the professional component (PC) of the service. • Description. This is an abbreviated version of the narrative description of the code. • Proposed Work RVUs. This column includes the work RVUs proposed in the June 29, 2006 proposed notice for each reviewed code. • Requested Work RVUs. This column identifies the work RVUs requested by the commenters. If the commenters requested different RVUs, the table lists the highest requested RVUs. • RUC Recommendation. This column identifies the work RVUs recommended by the RUC that appeared in the June 29, 2006 proposed notice. • HCPAC Recommendation. This column identifies the work RVUs recommended by the HCPAC that appeared in the June 29, 2006 proposed notice. • 2007 Work RVUs. This column contains the work RVUs for the CY 2007 physician fee schedule. • Basis for Decision. This column indicates whether the CY 2007 work RVUs resulted from comments received or the refinement panel process. BILLING CODE 4120–01–P E:\FR\FM\01DER2.SGM 01DER2 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00099 Fmt 4701 Sfmt 4725 E:\FR\FM\01DER2.SGM 01DER2 69721 ER01DE06.007</GPH> rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00100 Fmt 4701 Sfmt 4725 E:\FR\FM\01DER2.SGM 01DER2 ER01DE06.008</GPH> rmajette on PROD1PC67 with RULES2 69722 BILLING CODE 4120–01–C rmajette on PROD1PC67 with RULES2 C. Discussion of Comments by Clinical Area 1. Dermatology and Plastic Surgery In addition to comments received in support of our proposed work RVUs for services reviewed by the RUC’s Workgroup 1, we received the following comments. For CPT code 17004, Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), all benign or premalignant lesions (e.g., actinic keratoses) other than skin tags or cutaneous vascular proliferative lesions; 15 or more lesions, the RUC considered a change to the work RVUs for this CPT code based on the understanding that when rank order anomalies arising from the 5-Year Review were identified, the specialty could bring these additional codes forward for re-evaluation at the February 2006 RUC meeting. A standard RUC survey was conducted for this code. During the discussion, the RUC agreed that the descriptor of the code VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 needed to be changed, as well as the intra-service descriptor and time to reflect only the destruction of premalignant lesions. The RUC agreed that, due to these changes, a work value halfway between the 25th and median survey percentile was appropriate and recommended work RVUs of 1.80 for CPT code 17004. CMS Proposed Valuation For CPT code 17004, we believed that the work associated with benign and pre-malignant lesions does not really differ; therefore, the recommended work RVUs for CPT code 17004 were too high. We used a ‘‘building block’’ methodology to develop our proposed RVUs for this service. That is, based on our proposed valuation of CPT code 17003 (the code used for 2–14 lesions), of 0.07 work RVUs for each additional lesion, the 14th lesion would equal 0.91 work RVUs (0.07 × 13 lesions) plus the 0.6 work RVUs for the initial lesion, base code CPT code 17000, which is billed once in conjunction with 17003, for a total of 1.51 work RVUs for the PO 00000 Frm 00101 Fmt 4701 Sfmt 4700 69723 service. We proposed to value CPT code 17004, at the level determined for the 15th lesion, at 1.58 work RVUs by adding the 0.07 work RVU increment of CPT code 17003 and the 0.6 work RVUs for the base code, CPT code 17000, which is not billed in conjunction with CPT code 17004. Comment: While the American Academy of Dermatology (AAD) was pleased that the RUC-recommended work RVUs were accepted for the 36 CPT codes for the excision of benign and malignant lesions, both the AADA and the RUC disagreed with our proposed valuation of 1.58 work RVUs for CPT code 17004 and requested that we accept the RUC-recommended 1.8 work RVUs. They continue to support the premise that benign and premalignant lesions are not comparable and believe that recent changes to the code descriptors made by the CPT editorial panel to CPT codes 17000– 17004 and CPT codes 17110–17111 for CPT 2007 also support this position. These descriptor changes specifically differentiate between destruction of pre- E:\FR\FM\01DER2.SGM 01DER2 ER01DE06.009</GPH> Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69724 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations malignant and benign lesions, respectively. The RUC and AADA maintain that the destruction of premalignant lesions in CPT 17004 requires a greater mental effort and judgment, technical skill, intensity and time than that for the destruction of benign lesions in CPT code 17111. In addition, the commenters presented data collected during the survey process to show that the median number of lesions destroyed in the typical service of CPT code 17004 was 22 lesions, and the average number was 23.439. Response: We have reviewed the information supplied by the RUC and the AADA, especially for the median number of lesions destroyed in the typical service of CPT code 17004. By applying the same calculations we used in the proposed rule to value the 15th lesion at 1.58 work RVUs, we determined that the RUC proposed work value of 1.8 work RVUs represents 18 lesions for a typical service for CPT code 17004. Final Decision: Based on these comments and our calculations, we now believe that the RUC recommendation is reasonable and will accept the RUCrecommended work value of 1.80 work RVUs for CPT 17004. rmajette on PROD1PC67 with RULES2 Other Issues Comment: The American Society of Plastic Surgeons (ASPS) was pleased that we agreed with the RUC recommendations for the codes performed by plastic surgeons. ASPS also clarified that the reason CPT code 19361 was withdrawn from the 5-Year Review process and sent to CPT was due to the ambiguity of the code descriptor, and not due to an invalid survey as was listed in Table 3 of the June 29, 2006 proposed notice (71 FR 37189). Response: We thank the society for the clarification and regret the erroneous rationale that was noted for the withdrawal of CPT code 19361 from this 5-Year Review process. 2. Orthopedic Surgery In addition to comments received in support of our proposed work RVUs for services reviewed by the RUC’s Workgroup 2, we received comments on the following CPT codes. For CPT code 27130, Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft; CPT code 27236, Open treatment of femoral fracture, proximal end, neck, internal fixation or prosthetic replacement; and CPT code 27447, Arthroplasty, knee, condyle and plateau; medial AND lateral VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 compartments with or without patella resurfacing (total knee arthroplasty), we originally presented these codes to the workgroup with data other than survey data supporting the work RVU requests. Because of concerns regarding the methodology used by the specialty society, the codes were temporarily withdrawn with the understanding that survey data could be presented at the October 2006 meeting. After reviewing the survey data in October 2006, the RUC did not find any compelling evidence to change the current work RVUs assigned to these services. Based on this review, the RUC recommended maintaining the current work RVUs of 20.09 work RVUs for CPT code 27130, 15.58 work RVUs for CPT code 27236, and 21.45 work RVUs for CPT code 27447, but also recommended using the new physician time survey data for each of these services. CMS Proposed Valuation We disagreed with the RUCrecommended values for CPT codes 27130, 27236 and 27447, based on the specialty’s presentation to the workgroup in August. We instead proposed alternative work RVUs determined by comparing these codes to services with similar times and adjusting for any differences in hospital visits. As a result of this analysis, we proposed 15.96 work RVUs for CPT code 27130, 12.77 work RVUs for CPT code 27236, and 19.30 work RVUs for CPT code 27447. Comment: Several commenters, including societies representing orthopedics and the RUC, expressed concern about the methodology we used to develop our proposed work RVUs for these services. Commenters questioned the comparisons we used to arrive at the proposed values (that is, high volume orthopedic procedures being compared to rarely furnished non-orthopedic procedures of lower risk and intensity), and also stated that our proposed work RVUs would create substantial rank order anomalies within the families. The American Academy of Orthopaedic Surgeons/American Association of Orthopaedic Surgeons (AAOS) and the American Society for Surgery of the Hand (ASSH) stated that we had misunderstood the method that was used to develop the RUC-recommended work RVUs for these procedures. They indicated that we were incorrect in stating that a RUC survey had not been conducted for these codes; the work RVU recommendations that were adopted by the RUC are based on surveys conducted by AAOS and are the result of extensive RUC review and discussion. PO 00000 Frm 00102 Fmt 4701 Sfmt 4700 AAOS acknowledged that the initial recommendations presented by AAOS in August 2005 were based on NSQIP and DRG data due to flaws in the original surveys. However, based on reservations expressed by CMS at that time, subsequent surveys were conducted. The RUC-recommended work RVU recommendations were then based on this survey data and the NSQIP data was used only as an adjunctive methodology to credit or discredit the survey data. In addition, these codes were compared with other RUC-reviewed codes to show that the recommended values and times placed the codes in proper rank order. The RUCrecommended values are further supported when compared to other procedures within the associated families. The commenters urged us to reconsider our position and accept the RUC recommendations. Response: The commenters are correct that we based our rejection of the RUCrecommended work RVU for these services (CPT codes 27130, 27236, and 27447) on the August workgroup presentation and had inadvertently overlooked the surveys that were presented at the October meeting. After reviewing the more recent survey data, we now agree that the RUC recommendations appear reasonable. Therefore, based on a review of the information provided by the commenters, we have decided to accept the RUC recommendation to maintain the current work RVUs of 20.09 for CPT code 27130, 15.58 work RVUs for CPT code 27236 and 21.45 work RVUs for CPT code 27447. 3. Gynecology, Urology, Pain Medicine, and Neurosurgery We received comments disagreeing with our proposed work RVUs on the following two services: CPT code 22612, Arthrodesis, posterior or posterolateral technique, single level; lumbar (with or without lateral transverse technique); and CPT code 63048, Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root(s), (e.g., spinal or lateral recess stenosis)), single vertebral segment; each additional segment, cervical, thoracic, or lumbar (List separately in addition to code for primary procedure.). The RUC had recommended increases in work RVUs for these two codes, but less than the increases requested by the specialty society. The RUC agreed that these procedures were undervalued due to increases in length of stay and the incorrect assumptions made in the E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations rmajette on PROD1PC67 with RULES2 previous valuation of the service. The specific RUC-recommended work RVUs were 22.00 work RVUs for CPT code 22612 and 3.55 work RVUs for CPT code 63048. CMS Proposed Valuation We had technical concerns with the recommendations for CPT codes 22612 and 63048. The workgroup had recommended the survey’s 25th percentile for CPT code 22612 to keep the appropriate rank order with the reference service, CPT code 22595, that the RUC stated is a more complex procedure. However, there was a typographical error in the information presented by the specialty society that listed the work RVUs for the reference code as 23.36, rather than the correct value of 19.36 work RVUs. Therefore, the recommended work value of 22.00 RVUs appeared appropriate and we proposed to maintain the current work RVUs of 20.97 for this service. There was what we believed to be an additional typographical error in the specialty society survey data for CPT code 63048. The summary information presented to the RUC lists the reference code as also being CPT code 63048. Therefore, there is no information submitted that compares the respondents’ estimates of complexity and intensity between CPT code 63048 and a reference code. Because we do not have sufficient information to decide if the recommended work RVUs are appropriate, we proposed to maintain the current work RVUs of 3.26 for CPT code 63048. Comment: We received comments from the North American Spine Society, the American Association of Orthopaedic Surgeons, the American Association of Neurological Surgeons (AANS), and the RUC requesting that we do not implement our proposed RVUs for these services (CPT codes 22612 and 63048), but rather accept the RUC-recommended work RVUs. The commenters stated that we had misunderstood the process used by the presenting societies to develop the suggested RVUs for both codes. The commenters stated that the survey respondents did not notice the values for a reference service, but rather were asked to compare the current work and intensity with the work and intensity of furnishing the procedure in 2000. Therefore, the societies contend, the misprint of the value for what was listed as a ‘‘reference’’ code had no effect on the valuation of CPT code 22595, nor did the absence of a separate reference code for CPT code 63048 negatively affect its valuation. According to the commenters, they believe that the VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 workgroup based its recommendation on the validity of the survey data and the building block methodology presented as additional rationale. The specialty society representing spine surgeons also commented that when the respondents were asked to rate how the complexity and intensity of these services had changed in the past 5 years, the ratings showed that the survey respondents believed that the intensity and complexity for both codes had increased. The AAFP questioned why we would propose a value for CPT code 22612 that, though equal to the current value, was still higher than a more complex reference code. According to the AAFP, the RUC appeared to be recommending that the ratio of work between CPT codes 22612 and 22595 was 0.942 work RVUs; therefore, we should have recommended a work value of 18.23 work RVUs for CPT code 22612. Response: We thank the commenters for clarifying the process used in surveying for these services. However, we still have concerns regarding the RUC recommendations for these services. First, though the survey respondents did not see the erroneous work RVUs listed for CPT code 22595, the reference code used for CPT code 22612, the workgroup did account for these errors. As a result, the RUC recommendation for CPT code 22612 was higher than the current work RVUs for CPT code 22595, a procedure the workgroup considered more complex. Second, although the survey respondents may have indicated on the rating scale that CPT codes 22612 and 63048 were more complex procedures in 2005 than they were in 2000, when they were asked simply whether the work for these services had changed in the last 5 years, 80 percent disagreed for CPT code 22612 and 50 percent disagreed for CPT code 63048. Therefore, based on the comments received, we referred this code to a multi-specialty refinement panel for review. Final Decision: As a result of our analysis of the refinement panel ratings, we have assigned 21.79 work RVUs to CPT code 22612 and 3.47 work RVUs to CPT code 63048. For CPT code 61697 Surgery of complex intracranial aneurysm, intracranial approach; carotid circulation; CPT code 61700 Surgery of simple intracranial aneurysm, intracranial approach; carotid circulation; and CPT code 61702 Surgery of simple intracranial aneurysm, intracranial approach; vertebrobasilar circulation), we received the following comments. PO 00000 Frm 00103 Fmt 4701 Sfmt 4700 69725 Comment: The AANS disagreed with the RUC recommendations that we proposed to accept for CPT codes 61697, 61700 and 61702 because of changes made by the workgroup to ‘‘standardize the pre-service and post-service times.’’ The commenter stated that the standard 60 minutes of pre-service time was not adequate for such complex neurological procedures and stated reasons for the need for extended times. AANS also objected to the adjustments made by the workgroup to the level and number of post-operative visits by changing each post-operative critical care visit to a single high level subsequent hospital care visit. The society stated its belief that this change ‘‘significantly understates the post-operative time and intensity of the work that was described by survey respondents,’’ and urged us to add the time and work RVUs of an additional critical care code, CPT code 99233, to all three services. Response: We do not believe that, based on this comment, we have sufficient information to make the requested change. Therefore, we referred this code to a multi-specialty refinement panel for review. Final Decision: As a result of our analysis of the refinement panel ratings, we have assigned 57.31 work RVUs to CPT code 61697. 4. Radiology, Pathology, and Other Miscellaneous Services In addition to comments received in support of our proposed work RVUs for services reviewed by the RUC’s Workgroup 4, we received the following comments. For CPT code 76075, Dual energy xray absorptiometry (DXA), bone density study, one or more sites; axial skeleton (e.g., hips, pelvis, spine), the RUC recommended a reduction from the current 0.30 work RVUs for the DXA service because the workgroup believed that the actual work is less intense and more mechanical than the specialty society’s description of the work. The RUC-recommended work RVUs for this code were 0.20 and we agreed with this recommendation. Comment: Many commenters, including individual providers, national and State organizations, specialty societies, manufacturers, and Congressional and State legislators, wrote expressing concern about the proposed reduction in payments for this service, some of which is attributable to the proposed work RVUs. These commenters expressed concern that the proposed reduction in payment would have a detrimental impact on beneficiary health and is contrary to a Surgeon General’s Report that E:\FR\FM\01DER2.SGM 01DER2 69726 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations rmajette on PROD1PC67 with RULES2 emphasized the importance of such testing. The ACR commented that, while they participated in the survey process that resulted in the RUC-recommended work RVU for this service, other specialties that provide this service such as family medicine, internal medicine and rheumatology were not represented. ACR encouraged us to consider comments from other specialty societies and organizations furnishing this service, including those that do not participate in the RUC process (such as the International Society for Clinical Densitometry (ISCD)), so that their views may be considered. ACR indicated that it would like to participate should it be determined that this will be addressed through a refinement panel. Other commenters, including specialty organizations and the ISCD, provided additional information regarding this service. Many of the commenters also expressed concern about the payment for CPT code 76077, although this code was not included in the 5-Year Review of work. Changes in payment for this code are attributed to the changes in PE methodology discussed in section II.A. of this final rule with comment period. Response: We proposed to accept the RUC-recommended work RVU of 0.20 for CPT code 76075, which was lower than the requested 0.30 work RVUs requested by the specialty. Therefore, based on the comments received, we referred this code to a multi-specialty refinement panel for review. Final Decision: As a result of our analysis of the refinement panel ratings, we have assigned 0.20 work RVUs to 76075. (Note: For 2007, CPT code 76075 has been renumbered to 77080.) For CPT code 95872, Needle electromyography using single fiber electrode, with quantitative measurement of jitter, blocking and/or fiber density, any/all sites of each muscle studied, the RUC agreed that there was compelling evidence that CPT code 95872 was undervalued and recommended increasing the existing work RVUs from 1.50 to 3.00 work RVUs. CMS Proposed Valuation We had concerns that the work recommendation for 95872, which was based on the survey’s 75th percentile for work, is inappropriate for this service. To determine our proposed valuation for CPT code 95872, we utilized a multitiered approach. First, we calculated the pre-service and post-service work RVUs using the surveyed physician time data. Then, to determine an intra-service work RVU, we subtracted the surveyed VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 intra-service time from the current time and multiplied this difference in time by the calculated IWPUT using the specialty recommended total work RVUs. Adding these calculated work RVUs resulted in a work valuation of slightly less than 2.00 work RVUs, which is approximately the same value as the survey median work RVU. In accordance with this analysis and the survey median, we proposed a work RVU of 2.00. Comment: The RUC believes, and specialty societies for neurology agree, that the RUC’s justification to increase the work of CPT code 95872 to 3.00 work RVUs is reasonable and outweighs our proposed valuation of 2.00 work RVUs, which is solely based on IWPUT. Commenters provided additional information concerning the activities associated with this procedure and requested acceptance of the RUCrecommended work RVUs. Response: Based on the comments received, we referred this code to a multi-specialty refinement panel for review. Final Decision: As a result of our analysis of the refinement panel ratings, we have assigned 2.88 work RVUs to CPT code 95872. 5. Evaluation and Management (E/M) Services Comment: There was strong support for the proposal to increase work RVUs for E/M services from many commenters, including specialty societies, the RUC, MedPAC and individual physicians. For example, specialty societies or organizations representing internal medicine, family physicians, thoracic medicine, rheumatology, endocrinology, neurology, HIV medicine, clinical oncology, group practice, infectious disease, critical care, physical medicine, emergency medicine, geriatrics, geriatric psychiatry, osteopathy, urology, gastroenterology, pediatrics, renal medicine, as well as the RUC, all expressed their appreciation for our acceptance of the RUC recommendations for E/M services. The American College of Physicians stated that our proposed E/M work RVUs are supported by data from the annual National Ambulatory Medical Care Survey which show that patients now have more chronic conditions, are older, and have more diagnoses per encounter. In addition, the commenter contended that the proposed increased values for E/M services would provide an incentive for appropriate E/M service utilization and would also ensure a sufficient supply of primary care physicians. Another commenter PO 00000 Frm 00104 Fmt 4701 Sfmt 4700 applauded the E/M proposals because ‘‘they correct the dramatic erosion of the relative weight accorded to E/M services over the past 14 years.’’ However, an umbrella specialty society for surgery raised several objections to our proposal. First, the commenter contended that the compelling evidence standard was not met because any false assumptions involved in the original valuation of the codes were corrected in the first 5-Year Review and because any increase in work for E/M services has been compensated by the billing of higherlevel office visits. Second, the commenter expressed concern that the proposal will lead to rank order anomalies because of the disproportionate distribution of values within the E/M family and suggested that we spread out the increases more proportionately by increasing the values of lower E/M codes and decreasing the proposed increases to CPT codes 99213 and 99214. These concerns were also echoed in the comments from the specialty societies representing colon and rectal surgery, vascular surgery, orthopaedic surgery, hand surgery, prosthetic urology and from other commenters. The specialty society representing otolaryngology submitted a similar comment that also stated that the proposed increases are excessive and unsupported by a careful analysis of the data, including an analysis of the IWPUT. In addition, the commenter stated that the IWPUTs that result from our proposal are illogical within families of codes and exceed the levels of many complex surgical procedures. The society recommended that we either maintain the 2006 work RVUs or transition the new work RVUs over several years. The society representing social workers, as well as individual social workers and other NPPs, commented that clinical social workers and other NPPs are unable to use the E/M codes and requested that we withdraw the proposed increase for E/M services until all Medicare providers can receive fair and adequate increases. The society representing psychologists recommended that we reduce the increase for E/M services because it is inequitable to reward some at the expense of others or that they be permitted to bill for E/M services. Response: We appreciate the strong support shown for our proposed work RVUs for E/M services and are appreciative of the thoughtful concerns raised by other commenters. We certainly understand how contentious this issue has been, particularly in light E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations of the large BN adjustment that our acceptance of the RUC recommendations for these services would require. The concerns surrounding the valuation of E/M services were discussed during at least three RUC meetings before consensus was finally reached. We believe the final RUC recommendations represented acceptable relative values for the E/M services in question. After reviewing the comments, we believe that the RUC recommendations for the E/M services should be implemented in full beginning January 1, 2007. With regard to the question of compelling evidence of the need for a change to the work RVUs, we believe that the rationale for revision of these RVUs did not rest solely on previous false assumptions, but also on the claim that there has been a change in the complexity of the patient population resulting in more diagnoses per encounter and more ambitious management goals. In reviewing the RUC’s recommendations for the 5-Year Review, we found the evidence in support of a change in the work for E/ M services as compelling as the evidence presented for most of the codes that we proposed to revise in this 5-Year Review. As to the comments regarding the IWPUTs of the E/M services, we are not yet convinced about the validity of the IWPUT analysis when applied to such ‘‘cognitive’’ services, particularly if such an analysis were to be used to negate the findings of acceptable surveys. In addition, even if there might be merit to the contention that the RUC recommendations will cause some rank order anomalies, we do not have the information that would be needed to rectify this; this is an issue that might be better handled by the RUC and the specialties involved. Though we are sympathetic to the concerns of those who would not benefit from an increase to E/M services, but would face potential reductions in payment as a result of the BN adjustment, we do not believe that the appropriate answer would be to deprive primary care physicians, and other practitioners who provide these services, of an increase that the commenters otherwise appeared to consider reasonable and commenters did not suggest other viable alternatives. We would be happy to work with any group or individual that believes they have been unfairly impacted by this change to determine if there is any other appropriate other measure that might address their concerns. We also do not believe that it would be either equitable or appropriate to transition the E/M increases, as VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 suggested by some commenters. The work RVUs for E/M services were accepted by a RUC consensus and we believe them to be reasonable. We have never before transitioned changes in work RVUs that we accept based on RUC recommendations, and we believe it would be unfair in this case to single out these increases for transition when other services that received even greater increases would benefit immediately. We did not propose to make any changes in our policy regarding the types of suppliers that can bill for E/M services, and are not making any changes at this time. Our Internet Only Manual 100–02 Chapter 15 Section 160 continues to state that ‘‘any therapeutic services that are billed by clinical psychologists (CPs) under CPT psychotherapy codes that include medical evaluation and management services are not covered.’’ Comment: Several commenters representing renal physicians and patients, as well as the RUC, requested that we make an adjustment for the ESRD-related services, which have been valued using the E/M codes as building blocks, by adding the increase in the E/M RVUs to these services. Response: Since the G-codes now used for these ESRD-related services have markedly different descriptors than the previously valued CPT codes, we are unable to determine at this time which levels of E/M visits are most appropriately associated with these Gcodes. As explained in the CY 2004 PFS final rule (68 FR 63218), we established RVUs for these G-codes to equal the aggregate payments for the services provided under the CPT codes that had been previously recognized for these services. Because we based our payment of the G-codes on the aggregate payments for CPT codes 90918–90921, the specific CPT codes that are buildingblocks of this payment system cannot be directly correlated. We suggest that the specialty could request that the CPT panel consider revising the CPT codes for these ESRD-related services to mirror our current G-codes; these could then be reviewed by the RUC to determine the level of E/M services that are typically associated with each code. Comment: An organization representing long term care providers commented that we stated incorrectly at the end of the discussion concerning the RUC recommendations for the E/M services that nursing facility codes are not part of the 5-Year Review process. The commenter clarified that the RUC requested that these codes not be surveyed until after the 5-Year Review, when there could be appropriately valued codes to use as reference PO 00000 Frm 00105 Fmt 4701 Sfmt 4700 69727 services. Though the surveys will be conducted after the RVUs for E/M services are published, the commenter requested that we review the recommendations and update the nursing facility E/M RVUs to become effective in January 2008. Response: The commenter is correct. The RUC recommended delaying the survey of these services pending RUC recommendations on E/M codes that could be used as reference services. If we receive the RUC’s recommendations in time, we will review the recommendations for the work RVUs for nursing facility E/M services and publish our proposals in next year’s proposed rule and will consider this part of the third 5-Year Review. Comment: The specialty society representing home care physicians stated that the home care visit and domiciliary care visit codes were not included in the 5-Year Review; the domiciliary codes so that they could be valued through the RUC and, the home visits so that they could be used as reference codes. The society recommended that we adjust the work RVUs for these codes to reflect the revalued comparable office E/M codes for new and established patients. The commenter contended that the home visit and domiciliary care codes have been ‘‘referenced’’ to the office visit codes in the past and the changes proposed through the 5-Year Review process should be reflected in these derivative code families. Response: It is unfortunate that these services were not included in the recent 5-Year Review and that the specialty did not propose them for review. We believe that it would be inappropriate to apply increases to these codes without a multi-specialty review of the work involved in these services. However, we would be willing to consider any RUC recommendations that might be forthcoming for revised work RVUs for the home visit and domiciliary care codes. Such a RUC review could be completed at the same time that the RUC is reviewing the nursing facility E/M services previously discussed in this section. As we indicated for the nursing facility E/M codes in the prior response, we would consider forthcoming RUC recommendations for the home care and domiciliary care E/ M codes as part of the third 5-Year Review because of the similarity to the other E/M services considered in this review. We continue to believe acceptance of the RUC recommendations for E/M services is appropriate and will implement the proposed work RVUs for E/M services beginning January 1, 2007. E:\FR\FM\01DER2.SGM 01DER2 69728 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations rmajette on PROD1PC67 with RULES2 6. Cardiothoracic Surgery We received a number of comments concerning the cardiothoracic surgery proposals. Comment: Commenters were supportive of the proposed valuation of the congenital cardiac surgery services and CPT code 32020, Tube thoracostomy with or without water seal (e.g., for abscess, hemothorax, empyema) (separate procedure) . However, commenters did not agree with the proposed work RVUs for the general thoracic and adult cardiac surgery codes. One commenter questioned why the work RVUs had not been maintained at the current levels. Commenters representing surgical specialties, including thoracic and cardiac surgery, questioned the methodology we used to arrive at the proposed work RVUs. They believe the proposed work values create rank order anomalies and disturb the relativity within the cardiothoracic family. Additionally, the commenters stated that we failed to include pre- and postservice work in the add-on codes, contrary to a policy stated in the CY 2002 physician fee schedule final rule (67 FR 79966). The commenters provided additional detailed information concerning the STS database, as well as their use of mean values for the intra-service time and the intensity survey methods used to estimate IWPUT. Response: As we discussed in the June 29, 2006 proposed notice, the general thoracic and adult cardiac surgery codes submitted to the RUC for review did not undergo the standard RUC survey methodology (71 FR 37218). Rather, the data pertaining to these codes were derived from the STS database, a voluntary registry developed by the STS that has reportedly captured data on approximately 70 percent of all cardiac surgical procedures in the United States. We believe the STS database represents a significant advance in the effort to improve the quality of patient care and we hope that this kind of data collection will be emulated by other specialties. We also believe that the time and visit data contained in this database could be a useful adjunct to the RUC’s validation of the standard RUC survey results. We appreciate the detailed information provided by the commenters in response to the concerns we had outlined in the June 29, 2006 proposed notice. Based upon a review of the specific information provided by the commenters concerning the STS database, as well as the information VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 provided specifically addressing the use of the mean values for the intra-service time and methodology used to estimate IWPUT, we will accept the RUCrecommended work RVUs for these services. We note that it is our responsibility to assure all medical specialties that we will review and evaluate their services using an approach that is accepted by the RUC and CMS. We will continue to work with the RUC to better determine how to use the alternative data sources such as the STS data to compare the relativity of services. Unless an alternative approach can be found that can be applied to all services, we would not want to see the RUC abandon its survey methodology. We understand that the standard RUC survey process is not flawless, but it does provide an even playing field for all specialties and we would be concerned if each specialty was allowed to develop its own unique method for estimating work RVUs. Therefore, we will work with the RUC and continue to review this issue to determine the appropriate use of data sources other than the RUC survey. Comment: The STS and the American Association for Thoracic Surgery (AATS) requested that we approve the RUC-recommended work RVUs of 49.41 for CPT code 33548, indicating that this was submitted as part of the 5-Year Review process since the valuation of this service was based on a reference code (CPT code 33542) that was in the refinement process. The commenter also stated that this was part of the RUC recommendations forwarded in September 2005. Response: We did not receive CPT code 33548 as part of the 5-Year Review process, and therefore, we will maintain the current value for this service. 7. General, Colorectal and Vascular Surgery For the following services, we received comments that disagreed with our proposed work RVUs. a. Vascular Surgery For CPT code 33877, Repair of thoracoabdominal aortic aneurysm with graft, with or without cardiopulmonary bypass; CPT code 34201, Embolectomy or thrombectomy, with or without catheter; femoropopliteal, aortoiliac artery, by leg incision; CPT code 35081, Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, abdominal aorta; CPT code 35102 Direct repair of aneurysm, pseudoaneurysm, or excision (partial or PO 00000 Frm 00106 Fmt 4701 Sfmt 4700 total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, abdominal aorta involving iliac vessels (common, hypogastric, external); CPT code 35556 Bypass graft, with vein; femoralpopliteal; CPT code 35566 Bypass graft, with vein; femoral-anterior tibial, posterior tibial; CPT code 35583 In-situ vein bypass; femoral-popliteal; and CPT code 35585, In-situ vein bypass; femoral-anterior tibial, posterior tibial, or peroneal artery, the RUC reviewed both the survey data and the NSQIP data for these services. For these codes, the RUC believed that physicians responding to the survey underestimated the intra-service time and that the NSQIP data more accurately reflected the actual intraservice times for these procedures. For CPT code 33877, the RUC accepted a work value greater than the survey’s 75th percentile that was derived from a building block approach using the NSQIP data for the service. For CPT codes 34201, 35102, 35556, 35566, and 35585, the RUC used the same methodology and accepted work values greater than the survey’s median percentile. However, for CPT codes 35081 and 35583, the recommended increase was no greater than the surveyed median work RVUs. The RUC-recommended work RVUs for these services were: 33877 = 64.04 work RVUs; 34201 = 18.31 work RVUs; 35081 = 31.00 work RVUs; 35102 = 36.28 work RVUs; 35556 = 27.25 work RVUs; 35566 = 32.00 work RVUs; 35583 = 26.00 work RVUs; and 35585 = 32.00 work RVUs. CMS Proposed Valuation We agreed with the RUCrecommended work RVUs for CPT codes 35081 and 35583. We disagreed with the RUC recommendations for CPT codes 33877, 34201, 35102, 35556, 35566, and 35585. For these services, the RUC used the NSQIP time data to increase the work values above the survey median, and for several codes above the 75th percentile. We rejected this use of the NSQIP data and proposed to use the survey median work RVUs for these CPT codes: 33877 = 53.00 work RVUs; 34201 = 17.00 work RVUs; 35102 = 34.00 work RVUs; 35556 = 25.00 work RVUs; 35566 = 30.00 work RVUs; and 35585 = 30.00 work RVUs. All of these proposed work RVUs are higher than the current values. Comment: We received comments from the American College of Surgeons (ACS) and Society for Vascular Surgery (SVS) concerning these CPT codes. The ACS and the SVS, as well as the RUC, E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations stated that our proposed work RVUs would undervalue several of the vascular surgery procedures. Both the ACS and the RUC maintained that we should accept the RUC recommendations for all these services. For CPT code 33877, the commenters contended that the proposed value would create a rank order anomaly with the partial esophagectomy service, CPT code 43118, for which we proposed 61.08 work RVUs, even though it is a less intense procedure. The ACS also maintained that, under our proposal, the IWPUT of this service would be too low. For CPT code 34201, the commenters disagreed with our proposal to reject the NSQIP-derived increase with one noting that we accepted the NSQIP-derived reduction in length of stay for CPT code 34201. The RUC commented that the presenting specialty assumed NSQIP time to be more accurate than RUC survey time and used NSQIP time when available, whether it increased or reduced the RUC survey times. For CPT code 35102, the commenters asserted that we proposed work RVUs that would decrease the IWPUT to 0.075, which is inconsistent with other similar surgical procedures. Therefore, they urged us to accept the RUC recommendation of 36.28 work RVUs for this service. For CPT codes 35556, 35566, 35583 and 35585, the commenters maintained that the NSQIP data demonstrated that survey respondents consistently underestimated their intra-service time. The ACS commented that our proposals would lead to low IWPUTs that are considerably less than similar surgical procedures. The RUC commented that we would be creating rank order anomalies between these codes and the total colectomy services, CPT codes 44150 and 44151. The SVS also disagreed with our proposed work RVUs for seven of its specialty’s services, and disagreed with the RUC recommendations for all but one of the codes. In the extensive and detailed comments we received, the society defended the use of the NSQIP data to deviate from the survey median, stating that NSQIP intra-service time and hospital length of stay were used even when it reduced the recommendation compared to the RUC survey. The commenter also offered additional rationale to support their requested work RVUs for CPT codes 33877, 35101, 35081, 35556, 35566, 35583 and 35585. In each case, the SVS presented the building block components for each service, a comparison with other vascular codes by IWPUT analysis, and a detailed VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 comparison to other selected procedures. The commenters also provided an additional discussion asserting that the number of hospital visits assigned by the RUC, and accepted by us, was underestimated for these services (with the exception of CPT code 33877.) Response: We appreciate the comments that were submitted on our proposed work RVUs for these vascular surgery services. However, we note that there is disagreement among the commenters, with ACS and the RUC requesting that we accept the RUC recommendations for these codes and the SVS requesting acceptance of yet higher values for all the services (with the exception of CPT code 33877.) In addition, we have concerns that the SVS-recommended IWPUTs, for all but CPT code 33877, might be overstated. Therefore, based on the comments, we are accepting the RUC-recommended work RVUs of 64.04 for CPT code 33877, but referred the other seven codes to a multi-specialty refinement panel for review. Final Decision: As a result of our analysis of the refinement panel ratings, we have assigned 17.94 work RVUs to CPT code 34201, 31.00 work RVUs to CPT code 35081, 34.00 work RVUs to CPT code 35102, 25.00 work RVUs to CPT code 35556, 30.00 work RVUs to CPT code 35566, 26.00 work RVUs to CPT code 35583, and 30.00 work RVUs to CPT code 35585. b. Colorectal Surgery For CPT code 44120, Enterectomy, resection of small intestine; single resection and anastomosis; CPT code 44130, Enteroenterostomy, anastomosis of intestine, with or without cutaneous enterostomy (separate procedure); and CPT code 47600, Cholecystectomy, the RUC believed the physicians responding to the survey underestimated their intraservice time. Therefore, the RUC applied what was believed to be an appropriate IWPUT to the additional NSQIP time and added the resulting work RVUs to the survey median. The RUC-recommended work values for these CPT codes were as follows: 44120 = 20.11 work RVUs; 44130 = 20.87 work RVUs; and 47600 = 15.88 work RVUs. CMS Proposed Valuation We had concerns with the RUC recommendation to use the NSQIP data to increase the work RVUs, for CPT codes 44120, 44130 and 47600, above the survey median, and, for 47600, above the 75th percentile. While we support the use of such a database as validation for survey results, we believe that the application of the NSQIP PO 00000 Frm 00107 Fmt 4701 Sfmt 4700 69729 IWPUT to the difference in intra-time between the survey and NSQIP is questionable for the following reasons. It is still not clear whether the NSQIP data is truly representative and the IWPUT applied to the additional time is higher than the IWPUT for the rest of the intra-time. In addition, this methodology assumes, without evidence, that there is a linear relationship between the survey respondents’ estimate of time and estimate of work RVUs; however, even if the survey time estimates had matched the NSQIP data, it is not clear whether or by how much the respondents would have increased their work value estimate. Finally, until we have available valid and representative data such as the NSQIP for all procedures, there is the risk that applying the data randomly could distort the relativity between services. Therefore, we proposed to use the median survey values of 18.00, 20.00 and 14.00 as the work RVUs for CPT codes 44120, 44130 and 47600, respectively. Comment: We received comments from the ACS and the American Society of Colon and Rectal Surgeons (ASCRS), as well as the RUC, urging us to accept the RUC recommendations for these 3 services. These commenters stated that the median work value that we proposed in the June 29, 2006 proposed notice for CPT code 44120 was incorrect; CPT code 44120 should be 19.00 work RVUs, not 18.00 work RVUs (71 FR 37228). The ACS presented a lengthy defense of the NSQIP data that was echoed in the ASCRS comments. For example, ACS contended that the NSQIP data on intra-service skin-to-skin time is verified through operating room logs and is the ‘‘absolute gold standard’’ for estimating surgeon intra-service time. The commenters also disagreed that this data cannot be used until it is available for all services, since the best data should always be used rather than relying on ‘‘the lowest common denominator.’’ The ACS further stated that a variety of different methodologies have been used to evaluate physician services and we have not, until now, required that one methodology be used for all codes. Finally, the ACS disputed our concerns that the NSQIP might not be representative, though it did agree that the number of Veterans Administration hospitals currently reporting is greater than the number of community and academic hospitals. For CPT codes 44120 and 44130, ASCRS and ACS, as well as the RUC, contended that two reference codes were considered by the workgroup that E:\FR\FM\01DER2.SGM 01DER2 69730 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations led the RUC to agree that the survey median work RVUs underestimated the total work of these procedures and would create rank order anomalies. For CPT code 47600, the ACS maintained that the RUC’s recommendation was based on a belief that the survey’s median work RVU underestimated the total work for this procedure because the survey respondents were not considering the correct patient demographics. The commenters stated that, if we did not accept the recommendations where the use of NSQIP resulted in a value greater than the survey median, we should also do the same for those recommendations that were lower than the median. The commenters emphasized that the RUC also used a comparison with a reference code to develop the recommendation for this procedure. Conversely, the American College of Physicians (ACP) expressed support for our decision to reject the RUC recommendations that were based on extraction of time information from the NSQIP database rather than the survey median. The ACP questioned the representative nature of the data in the database and stated that allowing work values to be adjusted from the survey median, based on dubious relationships between work and time, would hurt the integrity of the RBRVS and should not be allowed. Response: We appreciate the comments regarding the use of NSQIP data in the valuation of physician work. However, we would consider this the beginning of the discussion, not the end. There are still many issues that need to be fully explored (for example: what the criteria should be for the acceptance of a given database; whether databases can take the place of surveys; whether IWPUT should be used to create work RVUs, rather than to validate them; and, whether there is a linear relationship between survey respondents’ estimate of work and time.) In the case of these three services, CPT codes 44120, 44130 and 47600, although the commenters offered some valid points regarding the use of NSQIP, not all the concerns discussed in the proposed notice and summarized in this section of this final rule with comment period have been thoroughly discussed. Therefore, based on the comments received, we referred this code to a multi-specialty refinement panel for review. Final Decision: As a result of our analysis of the refinement panel ratings, we have assigned 18.00 work RVUs to CPT code 44120, 20.00 work RVUs to CPT code 44130, and 15.85 work RVUs to CPT code 47600. For the proctoscopy-anoscopy family of codes in Table 13, the RUC agreed that the surveyed median work RVUs, and often even the 25th percentile, were inconsistent with the reference code. Therefore, the RUC did not reference the surveyed RVUs in arriving at the recommendations. Rather, the RUC used the surveyed times for each service and applied what the workgroup considered an appropriate IWPUT to these times to arrive at the recommended work RVUs for this family. TABLE 13.—PROCTOSCOPY-ANOSCOPY FAMILY OF CODES CPT Code Descriptor 45300 ................................... Proctosigmoidoscopy, rigid; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure). Proctosigmoidoscopy, rigid; with dilation (e.g., balloon, guide wire, bougie). Proctosigmoidoscopy, rigid; with biopsy, single or multiple. Proctosigmoidoscopy, rigid; with removal of foreign body. Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery. Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by snare technique. Proctosigmoidoscopy, rigid; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique. Proctosigmoidoscopy, rigid; with control of bleeding (e.g., injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator). Proctosigmoidoscopy, rigid; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique (e.g., laser). Proctosigmoidoscopy, rigid; with decompression of volvulus. Proctosigmoidoscopy, rigid; with transendoscopic stent placement (includes predilation). Anoscopy; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure). Anoscopy; with dilation (e.g., balloon, guide wire, bougie). Anoscopy; with biopsy, single or multiple. Anoscopy; with removal of foreign body. Anoscopy; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery. Anoscopy; with removal of single tumor, polyp, or other lesion by snare technique. Anoscopy; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique. Anoscopy; with control of bleeding (e.g., injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator). Anoscopy; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique. 45303 45305 45307 45308 ................................... ................................... ................................... ................................... 45309 ................................... 45315 ................................... 45317 ................................... 45320 ................................... 45321 45327 46600 46604 46606 46608 46610 46611 46612 ................................... ................................... ................................... ................................... ................................... ................................... ................................... ................................... ................................... 46614 ................................... rmajette on PROD1PC67 with RULES2 46615 ................................... The specific RUC work RVU recommendations for these colon and rectal surgery CPT codes were as follows: 45300 = 0.91 work RVUs; 45303 = 2.22 work RVUs; 45305 = 2.01 work RVUs; 45307 = 2.22 work RVUs; 45308 = 2.01 work RVUs; 45309 = 2.22 work RVUs; 45315 = 2.22 work RVUs; 45317 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 = 1.08 work RVUs; 45320 = 2.43 work RVUs; 45321 = 2.76 work RVUs; 45327 = 3.63 work RVUs; 46600 = 0.49 work RVUs; 46604 = 1.08 work RVUs; 46606 = 1.76 work RVUs; 46608 = 1.95 work RVUs; 46610 = 1.95 work RVUs; 46611 = 1.08 work RVUs; 46612 = 2.14 work PO 00000 Frm 00108 Fmt 4701 Sfmt 4700 RVUs; 46614 = 1.08 work RVUs; and 46615 = 1.18 work RVUs. CMS Proposed Valuation We proposed not to accept the RUC recommendations for all the presented codes in the proctoscopy-anoscopy family. We proposed to maintain the E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations current work RVUs for CPT codes 45300, 45303, 45305, 45307, 45308, 45309, 45315, 45317, 45320, 45321, 45327, 46600, 46604, 46606, 46608, 46610, 46611, 46612, 46614 and 46615. As we stated in the June 29, 2006 proposed notice, we believe that the method used by the RUC to obtain work values for these services was flawed (71 FR 37229). The calculation of the recommended work RVUs depended solely on applying a workgroup-derived IWPUT to the surveyed physician time from surveys that were considered otherwise unusable. We also stated that we do not believe that the use of IWPUT, in the absence of other supporting data, has been previously accepted by the RUC. We believe the RUC has established rules that state that IWPUT cannot be the sole rationale for valuation and it appears that this workgroup might not have adhered to that standard. However, we stated that, if the specialty society wishes to resurvey these codes and the RUC submits work RVU recommendations to us, we would certainly be willing to consider them. Comment: The ASCRS expressed their appreciation for the opportunity to again present survey data to the RUC for these services and the ACS stated that it will be working with ASCRS to facilitate this process. The RUC commented that the specialty society recommendations for these services were presented at the October 2006 RUC meeting. Response: At the October 2006 RUC meeting, the Society presented the original surveys with additional rationales to support the requested work RVUs. After much discussion, the RUC decided that the original surveys were still not usable and that new surveys would be needed before a recommendation for revised work RVUs could be made. Therefore, we are maintaining the current work RVUs for this series of codes, as proposed. rmajette on PROD1PC67 with RULES2 Other Issues Comment: A few commenters, while agreeing with the increase in work RVUs for CPT code 19180 (total mastectomy), expressed concern that the work RVUs for CPT code 19160 (partial mastectomy) were not reviewed. These commenters believed that the work RVUs for CPT code 19160 should be addressed in a similar fashion and the work RVUs should be adjusted to avoid a potentially adverse impact on patient treatment for breast cancer. One of these commenters suggested that this disparity in work RVUs needed to be addressed before the next 5-year review, VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 as this disparity could impact on medical decision-making. Response: As part of the 5-year review process, the specialtysocieties were asked to identify whether the RUCrecommended changes in the work RVUS created anomalies within a family of codes. Any such potential anomalies identified by the specialty societies were then reviewed at subsequent RUC meetings. Unfortunately, this potential anomaly was not identified or reviewed. However, we will ask the RUC to review this code (CPT code 19160) and will consider this RUC recommendation as part of the third 5-Year Review. 8. Otolaryngology and Ophthalmology In addition to comments received in support of the proposed work RVUs for services reviewed by the RUC’s workgroup 8, we received the following comments. For CPT code 31360, Laryngectomy; total, without radical neck dissection; CPT code 31365, Laryngectomy; total, with radical neck dissection; CPT code 31390, Pharyngolaryngectomy, with radical neck dissection; without reconstruction; and CPT code 31395, Pharyngolaryngectomy, with radical neck dissection; with reconstruction, the specialty society presented survey data with the rationale that the current work RVUs create rank order anomalies, and that there also has been a change in the patient population. The RUC agreed that increasing the work RVUs of these procedures by accepting the 75th percentile of survey results corrected the specific rank order anomalies and also accounted for the change in the patient population. The RUCrecommended work RVUs for these CPT codes are as follows: 31360 = 28.00 work RVUs; 31365 = 37.00 work RVUs; 31390 = 40.00 work RVUs; and 31395 = 44.00 work RVUs. For CPT code 31367, Laryngectomy; subtotal supraglottic, without radical neck dissection and CPT code 31368, Laryngectomy; subtotal supraglottic, with radical neck dissection, the specialty society presented survey data with the rationale that the current work values are based on a flawed methodology that creates rank order anomalies, and that there also has been a change in patient population. The RUC agreed with the specialty society and recommended increasing the work RVUs for these services to maintain rank order between the codes in the family and to establish the correct intensity of the procedure based on the change in patient population. The RUCrecommended work RVUs for these CPT codes are as follows: 31367 = 27.36 PO 00000 Frm 00109 Fmt 4701 Sfmt 4700 69731 work RVUs; and 31368 = 36.00 work RVUs. For CPT code 41155, Glossectomy; composite procedure with resection floor of mouth, mandibular resection, and radical neck dissection (Commando type), the specialty society presented survey data, noting that the current work RVUs create a rank order anomaly. The RUC agreed that increasing the work RVUs would correct these rank order anomalies and that these increases were justified by the survey results. The RUC-recommended 40.00 work RVUs for CPT code 41155. For CPT code 42845, Radical resection of tonsil, tonsillar pillars, and/ or retromolar trigone; closure with other flap, the specialty society’s survey data demonstrated that the code was currently undervalued due to a previous flawed methodology. The RUC believed that the survey results reflected the appropriate physician work and time necessary in performing this procedure and recommended the 32.00 work RVUs for CPT code 42845. CMS Proposed Valuation For the laryngopharyngectomy procedures, including CPT codes 31360, 31365, 31367, 31368, 31390 and 31395, the number of hospital days decreased by at least 2 days and the post-operative outpatient visits increased by 1 day. However, in one instance the number of outpatient visits decreased (CPT code 31395). The median values for intraservice times were accepted by the RUC for these services, which is an indication that a lower value than the 75th percentile for work also may be appropriate. Therefore, we proposed using median values for these services resulting in the following work RVUs for these CPT codes: 31360 = 24.00 work RVUs; 31365 = 31.50 work RVUs; 31367 = 24.00 work RVUs; 31368 = 30.50 work RVUs; 31390 = 35.00 work RVUs; and 31395 = 39.50 work RVUs. CPT code 41155 was valued by the RUC at the 75th percentile for work, but CPT code 41150 was valued based on the median work value. The median values for intra-service times were accepted by the RUC for these services, which is an indication that a value other than the 75th percentile for work also may be appropriate. Therefore, we proposed 36.00 work RVUs of for CPT code 41155. CPT code 42845 was valued by the RUC at the 75th percentile for work rather than the median as the RUC recommended for the other procedures in this family (CPT codes 42842 and 42844). Therefore, we proposed 29.00 work RVUs for CPT code 42845. E:\FR\FM\01DER2.SGM 01DER2 69732 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations rmajette on PROD1PC67 with RULES2 Comment: The RUC and several specialty societies, including the American Head and Neck Society (AHNS) and the American Academy of Otolaryngology-Head and Neck Surgery (AAO–HNS), disagree with the proposed work RVUs for CPT codes 31360, 31365, 31367, 31368, 31390, 31395, 41135, 42845. They provided information, data, and rationales concerning the valuation of these services and, recommended that we accept the RUC recommendations. The specialty societies objected to our proposed RVUs on the grounds that they created rank order anomalies; they believe the reference codes used were a poor choice that resulted in an underestimation of work by the survey respondents; and they believe the codes had been undervalued for years. Response: Based on the comments received, we referred these codes to a multi-specialty refinement panel for review. Panel review is appropriate for reasons including the RUC acceptance of the median values for intra-service times, which is an indication that a value other than the 75th percentile for work may be appropriate, and the need for further discussion regarding the appropriateness of the reference codes chosen by the survey respondents as comparable services to the codes being valued. Final Decision: As a result of our analysis of the refinement panel ratings, we have assigned 26.22 work RVUs to CPT code 31360, 35.00 work RVUs to CPT code 31365, 27.00 work RVUs to CPT code 31367, 30.50 work RVUs to CPT code 31368, 38.33 work RVUs to CPT code 31390, 39.50 work RVUs to CPT code 31395, 40.00 work RVUs to CPT code 41155, and 29.00 work RVUs to CPT code 42845. Miscellaneous Issues Comment: The American Academy of Ophthalmology (AAO) stated its belief that the 5-Year Review process was fair in its consideration of the ophthalmic codes. However, the AAO expressed disappointment in the decrease in value for cataract surgery (CPT code 66984) and its hope that this ‘‘downward reimbursement reward’’ does not lead to a decrease in research and innovation in medical care. The AAO also expressed disappointment in our decision to unlink the long-standing relationship of the Ophthalmology Examination codes (92002–92014) to the E/M codes. The AAO urged us to reaffirm this linkage and increase those values to reflect the proposed increases in E/M services. If this is not possible, AAO suggested that the work values prior to the linkage in 1996 be restored since they were VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 lowered during the first 5-Year Review to facilitate the linkage process. Response: We acknowledge that currently the work RVUs for ophthalmology examination services are linked to the work RVUs for certain E/ M codes. However, the work RVUs for the E/M codes are being increased based on our acceptance of the rationale that the work required to furnish these services has itself changed. This increase in work RVUs also implies that the E/M services today are not exactly the same services to which we initially linked the eye examination services. Unfortunately, because the specialty did not bring the ophthalmology examination codes to the 5-Year review for evaluation of any change in the work of furnishing these services, it is not known to what extent, if at all, the work for the ophthalmology examination codes would have mirrored the change in the work of the E/M codes. We note that the E/M increases have been added to other services only when the E/M codes were clearly used as the building blocks for valuing the services, for example, for global surgical services with post-operative visits. Therefore, we will implement the work RVUs for CPT codes 92002–92014 as proposed. However, if received in time for next year’s proposed rule, we would be willing to consider any RUC recommendations for work RVUs for these services for implementation in FY 2008 and would consider this as part of the third 5-Year Review. Comment: For CPT code 69210 Removal impacted cerumen (separate procedure), one or both ears, while we accepted the RUC-recommended work RVUs for this service, in the June 29, 2006 proposed notice we had expressed concern about the valuation of this service for the use of this code for routine removal of ear wax and indicated we would monitor the use of this code for the appropriate circumstances (71 FR 37233). The RUC and other specialty societies provided additional information to address our concern with this valuation for the use of this code for routine removal of ear wax during a physical examination of a patient. One commenter believes that there is the potential for misuse of this code due to a lack of understanding by other specialties of the physician work included in this procedure. The commenter recommends that we issue clarifying instructions or an educational article so that this code will be used in a manner consistent with the criteria outlined by AAO–HNS and contained in the July 2005 issue of the AMA’s CPT Assistant. PO 00000 Frm 00110 Fmt 4701 Sfmt 4700 Response: We appreciate these comments and will consider the suggestions made by the commenters. 9. HCPAC codes In addition to comments received in support of the proposed work RVUs for services reviewed by the HCPAC, we received the following comments. For CPT code 10060, Incision and drainage of abscess (e.g., carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single; CPT code 11040, Debridement; skin, partial thickness; CPT code 11041 Debridement; skin, full thickness; CPT code 11042 Debridement; skin, and subcutaneous tissue; and CPT code 29580 Strapping; Unna boot, the HCPAC agreed with the specialty society that there was compelling evidence that the valuation of these services was incorrect due to a flawed methodology used in the previous Harvard valuation for the podiatric codes considered under the 5-Year Review. For CPT codes 10060 and 29580, the HCPAC supported an increase in the existing work values for these codes and recommended work RVUs of 1.50 for CPT code 10060 and 0.60 work RVUs for CPT code 29580, both of which represent the median of the survey data for these services. For CPT code 11040, the HCPAC did not support the work RVU increase recommended by the specialty society, but instead recommended 0.55 work RVUs, which represented the 25th percentile work RVU from the survey data. For CPT code 11041, the HCPAC recommended a decrease in the work RVUs and, based on the median from the survey data, recommended 0.80 work RVUs. For CPT code 11042, the HCPAC did not agree with the specialty society that the work RVUs should be increased to 1.20 work RVUs. The HCPAC recommended maintaining the current work RVUs of 1.12 for this CPT code, which was slightly higher than the survey’s 25th percentile work value of 1.10 work RVUs. The HCPAC-recommended work values for these services were as follows: 10060 = 1.50 work RVUs; 11040 = 0.55 work RVUs; 11041 = 0.80 work RVUs; 11042 = 1.12 work RVUs; and 29580 = 0.60 work RVUs. CMS Proposed Valuation For CPT code 10060, we compared the survey times with the current Harvard-based times used to value this service. These times are comparable E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations and, therefore, we proposed maintaining the current work RVUs of 1.17 for this code. For CPT codes 11040, 11041 and 11042, the survey times all reflect significant reductions from current Harvard-based times used to value these services. Based on this comparison, which shows decreases in time ranging from 47 percent to 68 percent, we believe that the low values from the surveys more accurately represent the valuation of these services. Therefore, we proposed to assign work RVUs as follows: 11040 = 0.48 work RVUs; 11041 = 0.60 work RVUs; and 11042 = 0.80 work RVUs. In addition, to ensure that the other codes in this family are properly valued, we recommended the RUC review the valuation of CPT codes 11043 and 11044. For CPT code 29580, we compared the current Harvard-based times with the survey times. For this code, there was a small reduction in survey time as compared to the current Harvard-based time used to value this service, and, therefore, we do not believe the recommended increase in work RVUs is supported. We proposed to assign 0.55 work RVUs to this service, which represents the 25th percentile of the survey and more accurately reflects the time associated with this service. Comment: The American Podiatric Medical Association (APMA) and the HCPAC disagreed with the rationale we provided to explain our disagreement with the HCPAC-recommended work RVUs for 5 CPT codes (11060, 11040, 11041, 11042, and 29580) that are predominantly provided by the podiatry specialty. The commenters noted that our proposed valuation of these services was based solely on a comparison of the RUC-surveyed times to the Harvardbased times, despite the HCPAC’s concurrence with the specialty that the current Harvard work values were incorrect due to a flawed methodology. In addition, the commenters noted that our proposed valuation fails to address the intensity measures inherent to each service. The specialty presented recent literature abstracts to demonstrate that the treatment of diabetic ulcers has become more complicated in recent years and also supports that the diabetic ulcer is the primary cause of infections and, ultimately, leads to amputations in this population. The APMA and the HCPAC urged us to consider these inherent risks in treating this population and to accept the HCPAC-recommended work RVUs. For CPT codes 11040, 11041 and 11042, the HCPAC recommended an increased work RVU for CPT 11040, a slight decrease in work RVUs for 11041, VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 and the same work RVUs for 11042. Based on their belief that there is increased complexity and inherent risks in treating the diabetic patient, the APMA and the HCPAC in their comments urged us to accept the HCPAC-recommended work RVUs for this family of codes at 0.55 work RVUs, 0.80 work RVUs and 1.2 work RVUs, respectively. The commenters also strongly object to our reliance on a timebased comparison from the RUC surveys and the Harvard data (which the HCPAC and APMA agreed was based on a flawed methodology) to derive the work RVUs for these debridement codes. For CPT code 11060, the APMA and the HCPAC requested that we accept the HCPAC recommendations for this 10day global service based on the lack of intensity measures in our valuation that relied on a comparison of the RUC surveyed time to the Harvard-based time which, as mentioned previously, had been determined to be based on a flawed methodology. The APMA believes that by using this time-based comparison and maintaining the current RVUs at 1.17 work RVUs, we are proposing to distort the relativity of CPT 10060 with other comparable services (for example, CPT codes 10140 and 11421) and results in an unreasonably low IWPUT, at 0.009. The HCPAC and the APMA urged us to accept the recommended work value at 1.5 work RVUs that represents an IWPUT of 0.031. For CPT code 29580, the specialty society indicated that the typical patient requiring the application of an Unna boot is a diabetic with lower extremity edema, often with the presence of an ulcer. The typical patient requires repetitive applications of this Unna boot strapping, so most applications will also require the removal of the Unna boot, a thorough cleansing of the area, physical examination, and a careful reapplication of the strapping material. The APMA believes that our valuation of 0.55 work RVUs—using just the surveyed time, without specifically addressing the intensity measures inherent to the care of the diabetic patient—undervalues this service. The HCPAC and the APMA urged us to adopt the recommended value (survey median) of 0.60 work RVUs. Response: We appreciate the comments and information forwarded by the HCPAC and the APMA. However, based on our review of the data and literature contained in their comments, we are not convinced that the complexity and intensity measures inherent to the treatment of the diabetic patient have changed significantly over the past 5 years. In addition, we PO 00000 Frm 00111 Fmt 4701 Sfmt 4700 69733 understand the specialty’s concern that the Harvard time data was flawed. However, we believe that the lower times presented from the survey do not warrant the recommended work RVUs. Nonetheless, we believe that the HCPAC and the APMA should have the opportunity to present their evidence relative to the work RVUs for these five codes to a multi-specialty panel for review. As such, we have referred CPT codes 10060, 11040, 11041, 11042, and 29580 for refinement. Final Decision: As a result of our analysis of the refinement panel ratings, we have assigned 1.17 work RVUs to CPT code 10060, 0.50 work RVUs to CPT code 11040, 0.60 work RVUs to CPT code 11041, 0.80 work RVUs to CPT code 11042, and 0.55 work RVUs to CPT code 29580. Other Issues Other commenters representing nutritionists and dietitians referenced the medical nutrition codes that were referred to the CPT Editorial Panel, indicating that these services should be assigned work RVUs. This issue is discussed in section II.B.4.c. of this final rule with comment period, as it was specifically addressed in the CY 2007 PFS proposed rule (71 FR 48982). D. Other Issues Under the 5-Year Review 1. Anesthesia Services Although anesthesia services are paid under the PFS, they are paid on the basis of an anesthesia code-specific base unit and time units that vary based on the anesthesia time of the case. Since anesthesia services do not have a work value per code as do other medical and surgical services, a work value must be imputed for each anesthesia code. As a result of its relationship with the RUC and the past recommendations for valuing anesthesia services, which were discussed in detail in the June 29, 2006 proposed notice (71 FR 37237), the American Society of Anesthesiologists (ASA) requested that we address the valuation of anesthesia services reported under CPT codes 00100 through 01999. The ASA furnished an analysis that builds on the methodology used in the last 5-Year Review for the valuation of work for anesthesia services. We recommended that the valuation of anesthesia services, namely the proposed valuation of the postinduction time, be referred to the AMA RUC for review and consideration. Comment: The RUC indicated that it will consider any specific CMS request and asked that we clarify the scope of review and elements of the anesthesia E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 69734 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations relativity that is supposed to be addressed. Many commenters, including individuals and a specialty group, expressed concern that the proposed reductions in payment for anesthesia services may lead to future manpower shortages and could affect the provision of surgical services. They asked us to work with the ASA and the RUC to appropriately value the work of anesthesia services. Response: We understand that the ASA and the RUC will be reviewing this issue in an upcoming meeting and will make a recommendation to CMS in 2007. A second issue concerning anesthesia services pertains to the impact of the revised work values for E/M services and their relationship to the valuation of pre- and post-anesthesia services, components of the building-block approach. The pre- and post-anesthesia services derive their work values from the lower level E/M codes for new patients, the subsequent hospital care codes, and the initial inpatient consultation codes. In the June 29, 2006 proposed notice, we proposed to increase the work of the pre- and post-anesthesia components of the 19 anesthesia codes, previously reviewed by the AMA RUC in the last 5-Year Review of work. Specifically, we proposed to increase the anesthesia work to reflect the increased work values for the E/M codes where there were increases in the work of those E/ M codes. Comment: One specialty group noted that we should refer the valuation of pre- and post-anesthesia issues to the RUC for its review and consideration, and should not make any changes in the value of pre- and post-anesthesia services at this time. The ASA requested that we increase the work of all anesthesia services, not just the 19 anesthesia codes, to account for the increase in work values for E/M codes. They noted that all anesthesia services have E/M services included in the preand post-anesthesia components and the work of all anesthesia services should be increased. Response: We disagree with the comment asking us to defer action on revaluing the work of anesthesia services to account for the increased work of certain E/M codes. We are making the adjustment, but will ask the RUC and the ASA to review the E/M codes assigned to the pre- and post-anesthesia periods to ensure that they are still clinically relevant. While we understand the concerns of the ASA, we are unable to make that type of adjustment across all anesthesia services. The pre- and post-anesthesia VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 components of the anesthesia service are not uniformly linked to the same E/ M code. Rather, the E/M code can vary based on the complexity of the anesthesia service. For example, for cataract anesthesia, the pre-anesthesia service is linked to a blend of CPT codes 99201 and 99202 and the postanesthesia service is linked to CPT code 99211. The work values for each of these E/M codes did not change in this 5-Year Review of work. Conversely, for anesthesia for coronary bypass surgery, the pre-anesthesia service is linked to CPT code 99232 and the post-anesthesia service is linked to a blend of CPT codes 99231 and 99232. The work value for each of these E/M services increased in this 5-Year Review of work. Thus, in the June 29, 2006 proposed notice, we proposed to increase the work for E/M services in anesthesia for coronary bypass surgery but made no adjustment in the work for cataract anesthesia (71 FR 37237). It is not clear how the pre- and postanesthesia services of the non-surveyed anesthesia codes would be tied to the 19 surveyed codes and whether the work of the proposed linked E/M services are increased. We will look at this issue in context of any proposed changes that may be made to anesthesia work next year. 2. Discussion of Post-Operative Visits included in the Global Surgical Packages We have established a national definition for a global surgical package so that payment is made consistently for the same set of services across all contractor jurisdictions. In constructing the RVUs for a global surgery service, all services that are believed to be typically included in the defined global period are built into the final resource-based RVUs and are not separately billable within the defined global period as reflected in the proposed work RVUs in Addenda B and C. This includes presurgery work, the intra-service time of actually furnishing the surgical procedure, and the post-operative (follow-up) visits associated with the monitoring and recovery of the patient. As stated above in this section, we proposed to apply the RUCrecommended new values for the E/M services to all surgical services with a 10-or 90-day global period. However, because of variations in the patient population and in practice patterns, there is some question whether the assumptions about the number and level of visits within the global period reflect the actual post-operative work furnished. Some surgeons have commented that they furnish more visits PO 00000 Frm 00112 Fmt 4701 Sfmt 4700 than are included in the global period for their services. It is also likely that some patients require fewer than the ‘‘typical’’ number of follow-up visits included in the global period. Although we are not proposing any changes to our global policy at this time, we solicited comments concerning our current policy of including these postoperative visits in the global surgical packages and what advantages or disadvantages might be associated with proposing a change to this policy in the future. We received several comments concerning incorporating the new E/M values into all surgical services with a 10- or 90-day global period. With respect to our request for comments concerning our current policy of including these post-operative visits in the global surgical packages, we also received many suggestions. These comments and suggestions are addressed in this section. Comment: Many commenters, including specialties representing primary care physicians and surgeons, as well as the RUC, supported the incorporation of the revised E/M work RVUs into the surgical global periods for each CPT code with a global of 010 and 090 as recommended by the RUC. Commenters, including the RUC, noted that we may have incorrectly implemented the RUC recommendation. They indicated that in implementing this proposal, we used discounted work RVUs, developed for pricing post services under the first 5-Year Review, rather than the undiscounted work RVUs that reflect the actual RVUs accepted by us for the E/M services. This resulted in incorrect, and lower, work RVUs being added to all of the services with post-operative visits in the 010 and 090 global periods and was contrary to the RUC recommendation that the full increase of the E/M be incorporated. The RUC requested that we review the calculations and implement the correct work RVUs for all procedures that have a 010 and 090 global period to reflect their recommendation. Other commenters stated that we should verify the accuracy of the data to ensure that the values, as recommended by the RUC, are appropriately implemented. A few commenters also suggested that, should changes be made to the valuation of the E/M services, these changes would need to be carried through to the global package revisions. Response: We have discussed this issue with the RUC and will ensure that the correct undiscounted values are incorporated. E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations rmajette on PROD1PC67 with RULES2 Comment: MedPAC stated that in comparison to other payment systems, the unit of payment under the PFS is very narrow and consists of many discrete services. MedPAC reiterated its longstanding concern that such a unit of payment might give physicians a financial incentive to increase payments by increasing the volume of services, which could lead to unnecessary services being provided. Therefore, in the absence of information suggesting that access to appropriate care is being compromised, MedPAC supports the current concept of packaging/bundling these services to encourage efficient and appropriate care. Several commenters representing surgical specialties agreed with this position, and additionally one commenter stated that such a change might also increase the risk of ‘‘fee splitting.’’ The commenter also supports the expansion of the global concept into disease management. Other commenters suggested that we drop the global surgical model and replace this concept with a system that measures the actual amount of postservice work included in these global surgical services. Commenters suggested that this would ‘‘level’’ the playing field for documentation requirements and be less detrimental to ‘‘centers for excellence’’ which usually provide more care than is currently included within the global period. Commenters also suggested there are additional advantages to eliminating the global surgical model including the valuation of services being straightforward, the reduction of errors in PE valuation, and the facilitation of research, quality improvement and utilization tracking. However, there would be an associated increase in the volume of claims to be processed. One commenter suggested that we meet with stakeholders prior to implementing such a change, while another commenter urged us to conduct a study on impact of revising the global surgical concept. Response: We appreciate these comments and suggestions and will consider these along with additional information as we continue to study this issue. 3. Budget Neutrality As discussed in the June 29, 2006 proposed notice, section 1848(c)(2)(B)(ii) of the Act requires that increases or decreases in RVUs for a year may not cause the amount of expenditures for the year to differ by more than $20 million from what expenditures would have been in the absence of these changes. If this threshold is exceeded, we must make VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 adjustments to preserve budget neutrality (BN). This year, we expected that BN adjustments would be required as a result of changes in RVUs resulting from the 5-Year Review. We considered making the statutorily required BN adjustments (under section 1848(c)(2)(B)(ii)(II) of the Act) to account for the 5-Year Review of physician work by reducing all work RVUs. We estimated that all work RVUs would have to have been reduced by 10 percent under this option. Alternatively, we considered making an adjustment to the PFS CF to meet the provisions of section 1848(c)(2)(B)(ii)(II) of the Act. This option would have required an estimated 5 percent reduction to the CF. We also noted that the application of the BN adjustments to the CF would negatively impact all PFS services; whereas the application of the BN adjustment to the work RVUs would impact only those services that have physician work RVUs. Because the need for BN adjustment would be largely due to changes proposed as a result of the 5-Year Review of work RVUs, we believed it was more equitable to apply the adjustment across services that have work RVUs. We proposed to establish a BN adjustor that would reduce all work RVUs by an estimated 10 percent to meet the BN provisions of section 1848(c)(2)(B)(ii)(II) of the Act. Comment: We received numerous comments on this issue. Many of the commenters were opposed to our proposal and requested that the adjustment be made to the CF for the following reasons: (1) Applying the BN adjustor to all work RVUs has been problematic in the past. (2) By imposing the full burden of BN on the pool of work values, we would be significantly mitigating the improved accuracy of the values that have now been assigned to E/M services. (3) This approach obfuscates the recommended changes of the RUC and could potentially have an inappropriate effect on relativity. (4) The application of a separate work adjustor is not consistent with our goal of cost transparency and may adversely affect payments by non-Medicare payers. These commenters, which include the AMA, the RUC, and the AMA-HCPAC, asserted that applying the BN adjustor to the work RVUs is contrary to our longstanding policy. In addition, they do not believe that we provided an adequate rationale for shifting to this new approach, which we have previously stated is neither appropriate, nor effective. These associations noted that when in the past we applied a BN PO 00000 Frm 00113 Fmt 4701 Sfmt 4700 69735 adjustor to the work RVUs, it caused considerable confusion among many non-Medicare payers, as well as physician practices that use the Medicare relative values as efficiency measures, and that the constant fluctuations in the work RVUs due to BN adjustments impeded the process of establishing work RVUs for new and revised services. In addition to these objections, numerous specialty societies, organizations, groups, and providers also indicated that an adjustment to the CF is preferable because it would recognize that BN is mandated for monetary reasons. Thus, the CF, as the monetary multiplier in the Medicare payment formula, is the most appropriate place to adjust for BN. A number of commenters, including representatives of some radiology and oncology providers, were supportive of our proposal because it fairly applies the required BN adjustment to the portion of the fee schedule that was the subject of review. A few commenters also stated that although the BN adjustment methodology set forth in the June 29, 2006 proposed notice is not ideal, they believe that it is the best of the available alternatives under the circumstances (71 FR 37241). These commenters also believe that making all BN and scaling adjustments on a fee-schedule-wide basis would apparently result in unacceptable fee-schedule-wide reductions and is clearly inequitable for TC services. Another commenter urged us to delay the implementation of the BN adjustor for 1 year to allow more time to explore ways to increase recognition of E/M services without imposing such a financial hardship on select physician and nonphysician providers and to allow physicians and nonphysicians the opportunity to work with us to suggest alternative approaches. Other commenters also discussed the interaction of the application of the BN adjustment and the DRA OPD cap on imaging services. As required by the DRA, reductions in imaging payments because of the OPD cap result in actual savings to the Medicare program (that is, they are not done in a budget neutral manner). The commenters note that if the BN is applied to the CF and not to the work RVUs, then the impact of the DRA cap on total Medicare spending is lower. This is because applying BN to the CF will narrow the payment differential between imaging services furnished in physicians’ offices and hospital OPDs, and thus reduce the effect of the DRA cap on payments for imaging services. E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 69736 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations Response: We appreciate the information presented by the commenters. We do not have the authority to delay implementing the BN adjustment and we must apply a BNF to offset the increases in work RVUs effective for 2007. We are very appreciative of the work the RUC and the specialty societies have done in the past several years to prepare for this 5-Year Review. As a result of their dedication and analysis, the work RVUs are now more accurate and reflective of the time and resources associated with them. We do not believe that applying the BN on the work RVUs would undermine or diminish the RUC or specialty societies’ contributions or the resulting improvements. Section 1848(c)(2)(B)(ii)(II) of the Act requires a BN adjustment. Regardless of whether the BN is achieved by applying an adjustment factor to the work RVUs, as we proposed in the proposed rule, or the CF, which is the preferred option of many of the commenters, the values associated with the work ultimately will be decreased. Therefore, we do not agree with the commenters’ suggestions that applying the BN to the work RVUs would do the system a great harm. Specifically, we disagree that it would significantly reverse the improved accuracy of the values that have now been assigned to E/M services. Further, we do not think that this approach would distort the relativity of the RVUs. Because such an adjustment is uniformly applied to all the work RVUs, it does not alter the relationship among them. We also note that this rule finalizes a change in the PE methodology. Changes to the PE RVUs are being budget neutralized within those PE RVUs. Applying BN adjustments at this time, within each set of RVUs, maintains equity and helps to ensure that the weights between work, PE and malpractice are consistent with the weighting used in the MEI. Therefore, for the reasons discussed above in this section, we will be applying the statutorily-required BN adjustment to the work RVUs as proposed in the proposed rule. We note that we previously applied a separate adjustor to the work RVUs following the first 5-Year Review of physician work in 1997. We understand that many commenters would find it preferable for us to make the required BN adjustment to the CF. However, we believe the best and most equitable approach to applying BN for this 5-Year Review of work is to adjust the work RVUs for 2007 using a separate adjustor for those RVUs. Achieving BN by adjusting the CF would have the effect of reducing VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 payment for all services on the fee schedule. This would include reductions to RVUs for a number of services that have no physician work and were, therefore, outside the scope of the 5-Year Review. We believe it would be unfair, given the significant negative update to the CF this year, to impose additional reducations resulting from the BN adjustment on codes that have no work values associated with them. We share the commenters’ concerns about transparency and recognize the Medicare PFS is used by other payors and for other purposes than just Medicare payments. To maintain a high level of transparency in the fee schedule, the Addendum B published in this rule will show the RVUs without the BN adjustment applied. This will serve as a reference for any interested party and should help to minimize any confusion about the unadjusted codes. There also is a discussion of the BN work adjustor and the payment formula for 2007 included in the section IX. of this final rule with comment period, ‘‘Anesthesia and Physician Fee Schedule Conversion Factors for 2007.’’ Payment for services will be calculated as follows: Payment = [(RVU work × BN adjustor × GPCI work) + (RVU PE × GPCI PE) + (RVU malpractice × GPCI malpractice)] × CF. We appreciate the commenters pointing out to us that the approach used in applying BN has an interactive effect with the DRA imaging OPD cap and has an effect on the total Medicare spending on physicians’ services. However, as previously described in this section, we continue to believe the most equitable way to adjust for changes in the work RVUs resulting from the 5Year Review is to apply a BN adjuster to work RVU. Comment: Some commenters suggested that applying the BN adjustment to the CF could also be applied to the PE BN application, but only after we have addressed all of the RUC’s recommendations related to the methodology and the PE relativity is stable. Ultimately, however, PEs for individual services should be evaluated under a 5-Year Review, at which point a similar application for BN to the CF could be appropriate. Response: We appreciate and will consider these suggestions as we proceed with the implementation of the revised PE methodology. 5-Year Review, including the methodology and data sources used in the review process. MedPAC stated that it continues to have concerns that overvalued services are ignored and referenced the MedPAC March 2006 Report to Congress. In this report, it recommended the creation of a standing panel to— • Assist in identifying misvalued services; • Establish a process for analyzing data to ensure automatic review of new services after a certain period; and • Periodically review all services. Several specialty societies expressed support for the existing RUC methodologies for estimating intensity, but also supported the use of objective data from large clinical databases and urged us not to discount the use of alternative data sources. Response: As indicated earlier in this section, we believe that it will be necessary for the RUC and the specialty societies to join us in further dialog concerning the role of alternative databases. There are still many questions that need to be fully explored including: what should the criteria be for the acceptance of a given database; can databases take the place of surveys; can IWPUT be used to create work RVUs, rather than just to validate them; is there a linear relationship between survey respondents’ estimate of work and time; and, can survey respondents accurately estimate IWPUTs. We are also continuing to examine how best to identify misvalued services. As part of this initiative, the RUC has indicated that it has established a subcommittee to suggest approaches to identifying overvalued services and the RUC’s Research Subcommittee has initiated discussion regarding existing time data and indicated its willingness to consider issues related to any other concerns that we and the specialty societies wish to address regarding the use of databases in the valuation of physician work. We look forward to working with these groups and will carefully evaluate suggestions and recommendations that are provided. 4. Review Process [If you choose to comment on issues in this section, please include the caption ‘‘Interim Relative Value Units’’ at the beginning of your comments.] Comment: MedPAC and several specialties, as well as the RUC, commented on the process used for the PO 00000 Frm 00114 Fmt 4701 Sfmt 4700 V. Refinement of Relative Value Units for Calendar Year 2007 and Response to Public Comments on Interim Relative Value Units for 2006 E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations A. Summary of Issues Discussed Related to the Adjustment of Relative Value Units Section V.B. and V.C. of this final rule with comment describes the methodology used to review the comments received on the RVUs for physician work and the process used to establish RVUs for new and revised CPT codes. Changes to codes on the PFS reflected in Addendum B are effective for services furnished beginning January 1, 2007 B. Process for Establishing Work Relative Value Units for the 2006 Physician Fee Schedule The CY 2006 PFS final rule with comment period (70 FR 70116) contained the work RVUs for Medicare payment for existing procedure codes under the PFS and interim RVUs for new and revised codes beginning January 1, 2006. We considered the RVUs for the interim codes to be subject to public comment under the annual refinement process. In this section, we summarize the refinements to the interim work RVUs published in the CY 2006 PFS final rule with comment period and our establishment of the work RVUs for new and revised codes for the CY 2007 PFS. C. Work Relative Value Unit Refinements of Interim Relative Value Units rmajette on PROD1PC67 with RULES2 1. Methodology (Includes Table titled ‘‘2006 Interim Work Relative Value Units for Codes Reviewed Under the Refinement Panel Process ‘‘) Although the RVUs in the CY 2006 PFS final rule with comment period were used to calculate 2006 payment amounts, we considered the RVUs for the new or revised codes to be interim. We accepted comments for a period of 60 days. We received substantive comments for 7 CPT codes with interim work RVUs. To evaluate these comments, we used a process similar to the process used since 1997. (See the CY 1998 PFS final rule published in the October 31, 1997 Federal Register (62 FR 59084) for the discussion of refinement of CPT codes with interim work RVUs.) We convened a multi-specialty panel of physicians to assist us in the review of the comments. The comments that we did not submit to panel review are discussed at the end of this section, as well as those that VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 were reviewed by the panel, which are contained in Table 14, 2006 Interim Work Relative Value Units for Codes Reviewed Under the Refinement Panel Process. We invited representatives from the organizations from which we received substantive comments to attend a panel for discussion of the code on which they had commented. The panel was moderated by our medical staff, and consisted of the following voting members: • Clinicians representing the commenting specialty(ies), based on our determination of those specialties which are most identified with the services in question. Although commenting specialties were welcomed to observe the entire refinement process, they were only involved in the discussion of those services for which they were invited to participate. • Primary care clinicians nominated by the AAFP and the American College of Physicians. • Four carrier medical directors. • One or two clinicians who practice in related specialties and have knowledge of the services under review. The panel discussed the work involved in the procedure under review in comparison to the work associated with other services under the PFS. We assembled a set of reference services and asked the panel members to compare the clinical aspects of the work for the service a commenter believed was incorrectly valued to one or more of the reference services. In compiling the reference set, we attempted to include: (1) Services that are commonly furnished for which work RVUs are not controversial; (2) services that span the entire spectrum of work intensity from the easiest to the most difficult; and (3) at least three services furnished by each of the major specialties so that each specialty would be represented. The intent of the panel process was to capture each participant’s independent judgment based on the discussion and his or her clinical experience. Following the discussion for each service, each participant rated the work for that procedure. Ratings were individual and confidential; there was no attempt to achieve consensus among the panel members. We then analyzed the ratings based on a presumption that the interim RVUs were correct. To overcome that presumption, the inaccuracy of the PO 00000 Frm 00115 Fmt 4701 Sfmt 4700 69737 interim RVUs had to be apparent to the broad range of physicians participating in each panel. Ratings of work were analyzed for consistency among the groups represented on each panel. In general terms, we used statistical tests to determine whether there was enough agreement among the groups on the panel and, if so, whether the agreedupon RVUs were significantly different from the interim RVUs published in Addendum C of the CY 2006 PFS final rule with comment to demonstrate that the interim RVUs should be modified. We did not modify the RVUs unless there was a clear indication for a change. If there was agreement across groups for change, but the groups did not agree on what the new RVUs should be, we eliminated the outlier group, and looked for agreement among the remaining groups as to the basis for new RVUs. We used the same methodology in analyzing the ratings that we first used in the refinement process for the CY 1993 PFS final rule published in the November 25, 1992 Federal Register which described the statistical tests in detail (57 FR 55938). Our decision to convene a multi-specialty panel of physicians and to apply the statistical tests described above in this section was based on our need to balance the interests of those who commented on the work RVUs against the redistributive effects that would occur in other specialties. Table 14 lists those interim codes reviewed under the refinement panel process described in this section. This table includes the following information: • CPT Code. This is the CPT code for a service. • Description. This is an abbreviated version of the narrative description of the code. • 2006 Work RVU. The work RVUs that appeared in the CY 2006 final rule are shown for each reviewed code. • Requested Work RVU. This column identifies the work RVUs requested by commenters. • 2007 Work RVU. This column contains the final RVUs for physician work as a result of the multi-specialty panel (Note: Values for 10- and 90-day global period codes do not reflect E/M increases. Increases due to E/M changes are reflected in Addenda B.) E:\FR\FM\01DER2.SGM 01DER2 69738 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations TABLE 14.—2006 INTERIM WORK RELATIVE VALUE UNITS FOR CODES REVIEWED UNDER THE REFINEMENT PANEL PROCESS CPT code 1 22523 22524 22525 88334 95251 1 All ...................................... ...................................... ...................................... ...................................... ...................................... 2006 Interim work RVU Mod Descriptor ........ ........ ........ ........ ........ PERCUT KYPHOPLASTY, THOR ......................................... PERCUT KYPHOPLASTY, LUMBAR .................................... PERCUT KYPHOPLASTY, ADD-ON ..................................... INTRAOP CYTO PATH CONSULT 2 .................................... GLUC MONITOR, CONT, PHYS I&R .................................... 8.94 8.54 4.47 0.59 0.52 Requested work RVU 2007 work RVU 2 8.94 8.54 4.67 0.80 0.85 8.94 8.54 4.47 0.73 0.85 CPT codes and descriptions copyright 2005 AMA. All rights reserved and applicable FARS/DFARS clauses apply. for 10- and 90-day global period codes do not reflect E/M increases. Increases due to E/M changes are reflected in Addendum B. rmajette on PROD1PC67 with RULES2 2 Values 2. Interim 2006 Codes For CPT code 22523, Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, one vertebral body, unilateral or bilateral cannulation (e.g., kyphoplasty); thoracic; CPT code 22524, Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, one vertebral body, unilateral or bilateral cannulation (e.g., kyphoplasty); lumbar; and CPT code 22525, Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device, one vertebral body, unilateral or bilateral cannulation (e.g. kyphoplasty); each additional thoracic or lumbar vertebral body (List separately in addition to code for primary procedure), the RUC recommended 8.94 work RVUs for CPT code 22523, 8.54 work RVUs for CPT code 22524 and 4.47 work RVUs for CPT code 22525, which we accepted. Comment: Commenters disagreed with the RUC-recommended work values for these services, which we had accepted. The commenters believed that the recommended values were primarily based on a comparison to vertobroplasty services and did not reflect important data that is associated with kyphoplasty procedures. Based on these comments, we referred these codes to the multispecialty validation panel for review. Response: As a result of the statistical analysis of the 2006 multi-specialty validation panel ratings, we have assigned 8.94 work RVUs to CPT code 22523, 8.54 work RVUs to CPT code 22524 and 4.47 work RVUs to CPT code 22525. For CPT code 88334, Pathology consultation during surgery; cytologic examination (e.g., touch prep, squash prep), each additional site, the RUC recommended a work RVU of 0.80 for this service based on a comparison of this procedure to CPT code 88332, VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 Pathology consultation during surgery; each additional tissue block, with frozen section(s). The RUC reviewed the specialty society’s survey data and noted that the surveyed CPT code 88334, when compared to the reference CPT code 88332 has higher intensity/ complexity measures (20 minutes) and an additional five minutes of intraservice time (15 minutes). Although CPT code 88334 has an additional 5 minutes of intra-service time, we believed that CPT code 88334 is very similar in work to CPT code 88332, and therefore, should be valued the same. We assigned 0.59 work RVUs to CPT code 88334. Comment: Commenters did not agree with our comparison of CPT code 88334 to 88332, as there is increased work mainly vested on the necessity to examine every field under 10X magnification in CPT code 88334, which is not inherent in the frozen section process represented by CPT code 88332. Based on these comments, we referred this code to the multispecialty validation panel for review. Response: As a result of the statistical analysis of the 2006 multi-specialty validation panel ratings, we have assigned 0.73 work RVUs to CPT code 88334. For CPT code 95251, Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for up to 72 hours; physician interpretation and report, the RUC recommended a work RVU of 0.85 for this service. We disagree with the RUC’s recommendation because we believe the work for this service is similar to CPT code 93268, Patient demand single or multiple event recording with presymptom memory loop, 24-hour attended monitoring, per 30-day period of time; includes transmission, physician review and interpretation, which involves the review of data over a 30-day period. Therefore, we assigned 0.52 work RVUs to 95251. PO 00000 Frm 00116 Fmt 4701 Sfmt 4700 Comment: Commenters disagreed with our comparison of CPT code 95251 to 93268, as they believe the amount and complexity of the data that needs to be reviewed for CPT code 95251 is considerable. Based on these comments, we referred this code to the multispecialty validation panel for review. Response: As a result of the statistical analysis of the 2006 multi-specialty validation panel ratings, we have assigned 0.85 work RVUs to CPT code 95251. For CPT code 61630, Balloon angioplasty, intracranial (e.g., atherosclerotic stenosis), percutaneous; CPT code 61635, Transcatheter placement of intravascular stent(s), intracranial (e.g., athersosclerotic stenosis), including balloon angioplasty if performed; CPT code 61640, Balloon dilatation of intracranial vasospasm, percutaneous, initial vessel; CPT code 61641, Balloon dilatation of intracranial vasospasm, percutaneous, initial vessel; each additional vessel in same vascular family; and CPT code 61642, Balloon dilatation of intracranial vasospasm, percutaneous, initial vessel; each additional vessel in different vascular family, the RUC recommended 21.08 work RVUs for CPT code 61630, 23.08 work RVUs for CPT code 61635, 12.32 work RVUs for CPT code 61640, 4.33 work RVUs for CPT code 61641 and 8.66 work RVUs for CPT code 61642. We assigned a status indicator of N for these services because they are noncovered under Medicare due to a National Coverage Decision (NCD). Comment: Commenters questioned the assignment of the status indicator of N for these services. Commenters also requested that the RVUS be published for these services. (Note: In the correction notice that appeared in the February 24, 2006 Federal Register (71 FR 9458), RVUs were published for CPT codes 61630 and 61635.) Response: Based on an NCD regarding the non-coverage of performance of percutaneous transluminal angioplasty to treat obstructive lesions of the E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations vertebral and cerebral arteries we will maintain the status indicator of N for these services. (Note: The RUCrecommended RVUs for these codes will be reflected in Addendum B.) For CPT codes 98960, Education and training for patient self-management by a qualified, nonphysician health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; individual patient; CPT code 98961, Education and training for patient self-management by a qualified, nonphysician health care professional using a standardized curriculum, faceto-face with the patient (could include caregiver/family) each 30 minutes; 2–4 patients; and CPT code 98962, Education and training for patient selfmanagement by a qualified, nonphysician health care professional using a standardized curriculum, faceto-face with the patient (could include caregiver/family) each 30 minutes; 5–8 patients, a status indicator of N was erroneously assigned for these services in the CY 2006 PFS final rule published in the November 21, 2005 Federal Register (70 FR 70282). The status indicator was corrected to B in the correction notice that appeared in the February 24, 2006 Federal Register (71 FR 9458). Comment: Commenters questioned the assigned status indicator of N for these services and urged acceptance of the RVUs, as physician education is a service covered under Medicare Part B and, as one commenter indicated, included and reported in an E/M code. However, the commenter stated that the E/M service that we might believe is appropriate (CPT code 99211) is not sufficient for the amount of time and work described by these services. Other commenters requested that the RUCassigned RVUs be published, even if they are not used for Medicare payment, as other payers use the PFS to establish payment. Response: As stated above in this section, the status indicator for these codes was corrected to a status indicator of B in the correction notice that appeared in the February 24, 2006 Federal Register (71 FR 9458). We believe these services are bundled into E/M services. Other than the diabetic education services (CPT codes G0108 and G0109) specified by the Congress, we do not cover separate education services outside of demonstrations or the Medicare Health Support program. For diabetic education services, CPT codes G0108 and G0109 should be used to bill for these services. CPT codes 98960–98962 will not be recognized as separate services for diabetic education. VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 Additional information on the DSMT benefit is available in § 410.140 through § 410.146, and on our Web site at https://www.cms.hhs.gov/ DiabetesSelfManagement/. We are available to discuss certification requirements with interested providers. As requested by the commenters, we have published the RUC-assigned RVUs for these codes. For CPT code 99143, Moderate sedation services (other than those services described by codes 00100– 01999) provided by the same physician performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status, under 5 years of age; first 30 minutes intra-service time, CPT code 99144, Moderate sedation services (other than those services described by codes 00100–01999) provided by the same physician performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status, age 5 years or older; first 30 minutes intra-service time, CPT code 99145, Moderate sedation services (other than those services described by codes 00100–01999) provided by the same physician performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status, age 5 years or older; each additional 15 minutes intra-service time, CPT code 99148, Moderate sedation services (other than those services described by codes 00100– 01999) provided by a physician other than the health care professional performing the diagnostic or therapeutic service that the sedation supports, under 5 years of age; first 30 minutes intra-service time, CPT code 99149, Moderate sedation services (other than those services described by codes 00100–01999) provided by a physician other than the health care professional performing the diagnostic or therapeutic service that the sedation supports, age 5 years or older; first 30 minutes intraservice time, and CPT code 99150, Moderate sedation services (other than those services described by codes 00100–01999) provided by a physician other than the health care professional performing the diagnostic or therapeutic service that the sedation supports, each PO 00000 Frm 00117 Fmt 4701 Sfmt 4700 69739 additional 15 minutes intra-service time, the CPT Editorial Panel created six new codes to accurately report 2 separate families of moderate sedation. One family describes the provision of moderate sedation services by the physician who is performing the diagnostic or therapeutic service and supervising an independent trained observer while the other family describes moderate sedation services performed by a physician (other than an anesthesiologist) other than the physician performing a diagnostic or therapeutic service. These new codes replace CPT code 99141, Sedation with or without analgesia (conscious sedation); intravenous, intra-muscular or inhalation, and CPT code 99142, Sedation with or without analgesia (conscious sedation); oral, rectal and/or intranasal, which were bundled under the PFS. The RUC recommended 0.70 work RVUs for CPT code 99143, 0.66 work RVUs for CPT code 99144, 0.23 work RVUs for CPT code 99145, 1.75 work RVUs for CPT code 99148, 1.65 work RVUs for CPT code 99149 and 0.47 work RVUs for CPT code 99150. We questioned whether the RUCassigned values are appropriate and carrier priced these codes in order to gather information for utilization and proper pricing. Comment: Commenters requested that the RUC-recommended value for these services be accepted as these values were based on valid surveys and vetted through the RUC process. The RUC also indicated it would be happy to provide any additional information that would address any concerns we might have. Response: We will maintain carrier pricing of these codes and will continue to monitor utilization. Comment: Commenters requested that we publish the RVUs for noncovered services for which we receive RUC recommendations. Response: In response to comments, we have published the RVUs for noncovered services for which we received RUC recommendations (with the exception of carrier-priced codes). In the CY 2006 PFS final rule with comment period (70 FR 66370), we also responded to the RUC recommendations on the PE inputs for the new and revised CPT codes for 2006. We received the following comments: Comment: Although we assigned nonfacility PE inputs based on information provided by the RUC for CPT code 28890, Extracorporeal shock wave, high energy, performed by a physician, requiring anesthesia other than local, including ultrasound guidance, involving the plantar fascia, one commenter expressed concern that the E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 69740 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations PE RVUs are not sufficient to cover the actual costs associated with the performance of this procedure in the office setting. The commenter acknowledged that a single payment scheme for the purchase or rental of the equipment associated with its service does not exist and believes the expense to be higher than what was represented in the PE database. The commenter indicated that a ‘‘technical fee’’ is frequently paid when the procedure is performed in the office setting. The costs associated with this ‘‘technical fee’’ can include: The shock wave equipment, a specialized transport truck, a service contract with the manufacturer, salary/benefits for technologist and the transport driver, medical director fee, anesthesia fee, supplies and training material, malpractice and liability insurance, and fuel cost. Response: Under the PFS, the PE component is based on the resources used to furnish each service and, for CPT code 28890, consists of a total of 133 minutes of clinical labor, disposable supplies, including the necessary items to provide the regional anesthetic block, and equipment over $500, including the ‘‘shock-wave’’ machine. The PE methodology utilizes the price of equipment (as if the physician owned it) and considers the time used for performing the procedure (36 minutes). Costs of leasing arrangements or per use fees are not recognized in our PE methodology. Therefore, we are maintaining the direct PE inputs for this service (except as discussed previously in this rule) because they are consistent with the typical clinical labor, supplies, and equipment needed to provide this service in the physician’s office. Comment: We received three comments concerning the PE inputs for CPT codes 36475, Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency, first vein treated, and 36476, Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency, second and subsequent veins treated in a single extremity, each through separate access sites (List separately in addition to code for primary location). Two comenters supported our proposal to add the tilt table for these services and also suggested the tilt table be added to CPT VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 codes 36478 and 36479—the entire endovenous family. One commenter requested that 15 minutes of clinical labor time be added to CPT codes 36475 and 36476. However, the commenters disagreed with the addition of 15 minutes of clinical labor time to CPT codes 36475 and 36476, indicating that the description of the physician work for these codes states that, when needed, the physician places the patient in the required position. One of these commenters indicated that this was also to be addressed at the February 2006 RUC meeting. Response: At the February 2006 RUC meeting, the PERC recommended the addition of the tilt table to the family of CPT codes, 36475, 36476, 36478 and 36479. However, the PERC did not accept the additional clinical labor time. The tilt table was added to the PE database for these CPT codes, in concert with the PERC recommendations for CY 2007, and the PE RVUs in Addendum B reflect these changes. D. Establishment of Interim Work Relative Value Units for New and Revised Physician’s Current Procedural Terminology (CPT) Codes and New Healthcare Common Procedure Coding System Codes (HCPCS) for 2007 (Includes Table titled ‘‘American Medical Association Specialty Relative Value Update Committee and Health Care Professionals Advisory Committee Recommendations and CMS’s Decisions for New and Revised 2007 CPT Codes’’) One aspect of establishing RVUs for 2007 was to assign interim work RVUs for all new and revised CPT codes. As described in our November 25, 1992 notice on the 1993 PFS (57 FR 55951) and in section III.B. of the CY 1997 PFS final rule (61 FR 59505), we established a process, based on recommendations received from the AMA’s RUC, for establishing interim work RVUs for new and revised codes. This year we received work RVU recommendations for 230 new and revised CPT codes from the RUC. Of the 230 codes, 56 were modified by editorial changes, 57 were renumbered and the work RVUs associated with these services were assigned to the new codes (not included in Table 15), and 1 code was renumbered and assigned a new work RVU (included in Table 15). Our staff and medical officers reviewed the RUC recommendations by comparing them to our reference set or to other comparable services for which PO 00000 Frm 00118 Fmt 4701 Sfmt 4700 work RVUs had previously been established. We also considered the relationships among the new and revised codes for which we received RUC recommendations and agreed with the majority of the relative relationships reflected in the RUC values. In some instances, although we agreed with the relationships, we nonetheless revised the work RVUs to achieve work neutrality within families of codes. That is, the work RVUs were adjusted so that the sum of the new or revised work RVUs (weighted by projected frequency of use) for a family will be the same as the sum of the current work RVUs (weighted by projected frequency of use) for the family of codes. We reviewed all the RUC recommendations and accepted approximately 98 percent of the RUCrecommended values. We received one recommendation from the Health Care Professional Advisory Committee (HCPAC), which we accepted. Table 15, titled ‘‘AMA RUC and HCPAC Recommendations and CMS Decisions for New and Revised 2007 CPT Codes,’’ lists the new or revised CPT codes, and their associated work RVUs, that will be interim in 2007. This table includes the following information: • A ‘‘#’’ identifies a new code for 2007. • CPT code. This is the CPT code for a service. • Modifier. A ‘‘26’’ in this column indicates that the work RVUs are for the PC of the code. • Description. This is an abbreviated version of the narrative description of the code. • RUC recommendations. This column identifies the work RVUs recommended by the RUC. • HCPAC recommendations. This column identifies the work RVUs recommended by the HCPAC. • CMS decision. This column indicates whether we agreed or we disagreed with the RUC recommendation. Codes for which we did not accept the RUC recommendation are discussed in greater detail following this table. • 2007 Work RVUs. This column establishes the interim 2007 work RVUs for physician work. (Note: Values for 10and 90-day global period codes reflect E/M increases from the 5-Year Review.) BILLING CODE 4120–01–P E:\FR\FM\01DER2.SGM 01DER2 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00119 Fmt 4701 Sfmt 4725 E:\FR\FM\01DER2.SGM 01DER2 69741 ER01DE06.010</GPH> rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00120 Fmt 4701 Sfmt 4725 E:\FR\FM\01DER2.SGM 01DER2 ER01DE06.011</GPH> rmajette on PROD1PC67 with RULES2 69742 69743 BILLING CODE 4120–01–C VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00121 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 ER01DE06.012</GPH> rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69744 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations Table 16, which is titled ‘‘AMA RUC Anesthesia Recommendations and CMS Decisions for New and Revised 2007 CPT Codes,’’ lists the new or revised CPT codes for anesthesia and their base units that will be interim in 2007. This table includes the following information: • CPT code. This is the CPT code for a service. • Description. This is an abbreviated version of the narrative description of the code. • RUC recommendations. This column identifies the base units recommended by the RUC. • CMS decision. This column indicates whether we agreed or we disagreed with the RUC recommendation. Codes for which we did not accept the RUC recommendation are discussed in greater detail following this table. • 2007 Base Units. This column establishes the 2007 base units for these services. TABLE 16.—AMA RUC ANESTHESIA RECOMMENDATIONS AND CMS DECISIONS FOR NEW AND REVISED CPT CODES RUC recommendation *CPT code Description #00625 ............................... #00626 ............................... ANES SPINE TRANTHOR W/O VENT ...................... ANES, SPINE TRANSTHOR W/VENT ...................... 13.00 13.00 2007 base units CMS decision Agree ................................ Agree ................................ 13.00 15.00 * All CPT codes copyright 2006 AMA. # New CPT code. E. Discussion of Codes for Which There Were no RUC Recommendations or for Which the RUC Recommendations Were Not Accepted rmajette on PROD1PC67 with RULES2 The following is a summary of our rationale for not accepting particular RUC work RVUs. It is arranged by type of service in CPT order. This summary refers only to work RVUs. For CPT code 22857, Total disc arthroplasty (artificial disc), anterior approach, including diskectomy to prepare interspace (other than for decompression), lumbar, single interspace; CPT code 22862, Revision including replacement of total disc arthroplasty (artificial disc) anterior approach, lumbar, single interspace (includes approach); and CPT code 22865, Removal of total disc arthroplasty (artificial disc), anterior approach, lumbar, single interspace, the RUC recommended 25.07 work RVUs for CPT code 22857, 30.57 work RVUs for CPT code 22862 and 29.57 work RVUs for CPT code 22865. We are assigning a status indicator of R (Restricted) to these services due to an NCD for non-coverage of Lumbar Artificial Disc Replacement with the ChariteTM lumbar artificial disc for patients over the age of 60. For CPT code 94005, Home ventilator management care plan oversight of a patient (patient not present) in home, domiciliary or rest home (e.g., assisted living) requiring review of status, review of laboratories and other studies and revision of orders and respiratory care plan (as appropriate), within a calendar month, 30 minutes or more, the RUCrecommended 1.50 work RVUs for this code. We are assigning a status indicator of B (Bundled) to this service because: (1) The patient is not present when this service is rendered and (2) we believe this service is captured in E/M services. (Note: The RUC-recommended RVUs for this code will be reflected in Addendum B.) For CPT code 96040, Medical genetics and genetic counseling services, each 30 minutes face-to-face with patient/ family, this procedure does not have any physician work and to the extent that these services are covered, we consider them bundled into E/M services and have assigned as status indicator of B. (Note: The RUCrecommended RVUs for this code will be reflected in Addendum B.) For CPT code 96904, Whole body integumentary photography, for monitoring of high risk patients with dysplastic nevus syndrome or a history of dysplastic nevi, or patients with a personal or familial history of melanoma, this procedure does not have any physician work. We have assigned a status indicator of R (Restricted) to this service, and will only recognize this code when services are performed on patients with melanoma and not when services are performed for screening based on family history (because we did not cover screenings). We will implement edits for situations involving patients with melanoma and/ or dysplastic nevus syndrome. For CPT code 99363, Anticoagulant management for an outpatient taking warfarin, physician review and interpretation of International Normalized Ratio (INR) testing, patient instructions, dosage adjustment (as needed), and ordering of additional tests; initial 90 days of therapy (must include a minimum of 8 INR measurements; and CPT code 99364, Anticoagulant management for a patient taking warfarin, physician review and interpretation of International Normalized Ratio (INR) testing, patient instructions, dosage adjustment (as needed), and ordering of additional tests; each subsequent 90 days of therapy (must include a minimum of three INR measurements), the RUC recommended 1.65 work RVUs for CPT code 99363 and 0.63 work RVUs for CPT code 99364. We believe these services are bundled into E/M services and have assigned a status indicator of B to these codes. (Note: The RUC-recommended RVUs for these codes will be reflected in Addendum B.) F. Additional Pricing Issue We are carrier-pricing the global and TC for the codes listed in Table 17. The TC is not paid in the facility setting under the PFS and the RUC did not forward recommendations in the nonfacility setting because these services are performed infrequently, if at all in the non-facility setting. Work RVUs will continue to be used to establish payment for the PC. TABLE 17.—CARRIER PRICED CODES CPT code * Mod Short descriptor 70170 ....... 70170 ....... .................. TC ............ X-RAY EXAM OF TEAR DUCT ....................................................................................................... X-RAY EXAM OF TEAR DUCT ....................................................................................................... VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00122 Fmt 4701 Sfmt 4700 Status indicator E:\FR\FM\01DER2.SGM 01DER2 Carrier Priced. Carrier Priced. Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69745 TABLE 17.—CARRIER PRICED CODES—Continued rmajette on PROD1PC67 with RULES2 CPT code * 70555 70555 71090 71090 73530 73530 74190 74190 74305 74305 74328 74328 74330 74330 74340 74340 74355 74355 74360 74360 74420 74420 74425 74425 74445 74445 74450 74450 74470 74470 74775 74775 75801 75801 75803 75803 75805 75805 75810 75810 75894 75894 75896 75896 75898 75898 75940 75940 75945 75945 75960 75960 75970 75970 75980 75980 75992 75992 76001 76001 76125 76125 76932 76932 76940 76940 76941 76941 76945 76945 76975 76975 ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... VerDate Aug<31>2005 Mod Short descriptor .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ FMRI BRAIN BY PHYS/PSYCH ...................................................................................................... FMRI BRAIN BY PHYS/PSYCH ...................................................................................................... X-RAY EXAM OF EYE SOCKETS .................................................................................................. X-RAY EXAM OF EYE SOCKETS .................................................................................................. X-RAY EXAM OF HIP ..................................................................................................................... X-RAY EXAM OF HIP ..................................................................................................................... X-RAY EXAM OF PERITONEUM ................................................................................................... X-RAY EXAM OF PERITONEUM ................................................................................................... X-RAY BILE DUCTS/PANCREAS ................................................................................................... X-RAY BILE DUCTS/PANCREAS ................................................................................................... X-RAY BILE DUCT ENDOSCOPY .................................................................................................. X-RAY BILE DUCT ENDOSCOPY .................................................................................................. X-RAY BILE/PANC ENDOSCOPY .................................................................................................. X-RAY BILE/PANC ENDOSCOPY .................................................................................................. X-RAY GUIDE FOR GI TUBE ......................................................................................................... X-RAY GUIDE FOR GI TUBE ......................................................................................................... X-RAY GUIDE, INTESTINAL TUBE ................................................................................................ X-RAY GUIDE, INTESTINAL TUBE ................................................................................................ X-RAY GUIDE, GI DILATION .......................................................................................................... X-RAY GUIDE, GI DILATION .......................................................................................................... CONTRST X-RAY, URINARY TRACT ............................................................................................ CONTRST X-RAY, URINARY TRACT ............................................................................................ CONTRST X-RAY, URINARY TRACT ............................................................................................ CONTRST X-RAY, URINARY TRACT ............................................................................................ X-RAY EXAM OF PENIS ................................................................................................................. X-RAY EXAM OF PENIS ................................................................................................................. X-RAY, URETHRA/BLADDER ......................................................................................................... X-RAY, URETHRA/BLADDER ......................................................................................................... X-RAY EXAM OF KIDNEY LESION ................................................................................................ X-RAY EXAM OF KIDNEY LESION ................................................................................................ X-RAY EXAM OF PERINEUM ........................................................................................................ X-RAY EXAM OF PERINEUM ........................................................................................................ LYMPH VESSEL X-RAY, ARM/LEG ............................................................................................... LYMPH VESSEL X-RAY, ARM/LEG ............................................................................................... LYMPH VESSEL X-RAY, ARMS/LEGS .......................................................................................... LYMPH VESSEL X-RAY, ARMS/LEGS .......................................................................................... LYMPH VESSEL X-RAY, TRUNK ................................................................................................... LYMPH VESSEL X-RAY, TRUNK ................................................................................................... VEIN X-RAY, SPLEEN/LIVER ......................................................................................................... VEIN X-RAY, SPLEEN/LIVER ......................................................................................................... X-RAYS, TRANSCATH THERAPY ................................................................................................. X-RAYS, TRANSCATH THERAPY ................................................................................................. X-RAYS, TRANSCATH THERAPY ................................................................................................. X-RAYS, TRANSCATH THERAPY ................................................................................................. FOLLOW-UP ANGIOGRAPHY ........................................................................................................ FOLLOW-UP ANGIOGRAPHY ........................................................................................................ X-RAY PLACEMENT, VEIN FILTER ............................................................................................... X-RAY PLACEMENT, VEIN FILTER ............................................................................................... INTRAVASCULAR US ..................................................................................................................... INTRAVASCULAR US ..................................................................................................................... TRANSCATH IV STENT RS & I ...................................................................................................... TRANSCATH IV STENT RS & I ...................................................................................................... VASCULAR BIOPSY ....................................................................................................................... VASCULAR BIOPSY ....................................................................................................................... CONTRAST X-RAY EXAM BILE DUCT .......................................................................................... CONTRAST X-RAY EXAM BILE DUCT .......................................................................................... ATHERECTOMY, X-RAY EXAM ..................................................................................................... ATHERECTOMY, X-RAY EXAM ..................................................................................................... FLUOROSCOPE EXAM, EXTENSIVE ............................................................................................ FLUOROSCOPE EXAM, EXTENSIVE ............................................................................................ CINE/VIDEO X-RAYS ADD-ON ...................................................................................................... CINE/VIDEO X-RAYS ADD-ON ...................................................................................................... ECHO GUIDE FOR HEART BIOPSY ............................................................................................. ECHO GUIDE FOR HEART BIOPSY ............................................................................................. US GUIDE, TISSUE ABLATION ..................................................................................................... US GUIDE, TISSUE ABLATION ..................................................................................................... ECHO GUIDE FOR TRANSFUSION .............................................................................................. ECHO GUIDE FOR TRANSFUSION .............................................................................................. ECHO GUIDE, VILLUS SAMPLING ................................................................................................ ECHO GUIDE, VILLUS SAMPLING ................................................................................................ GI ENDOSCOPIC ULTRASOUND .................................................................................................. GI ENDOSCOPIC ULTRASOUND .................................................................................................. 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00123 Fmt 4701 Sfmt 4700 Status indicator E:\FR\FM\01DER2.SGM 01DER2 Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. 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Priced. 69746 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations TABLE 17.—CARRIER PRICED CODES—Continued rmajette on PROD1PC67 with RULES2 CPT code * 76998 76998 77013 77013 77022 77022 92978 92978 92979 92979 93501 93501 93503 93505 93505 93508 93508 93510 93510 93511 93511 93524 93524 93526 93526 93527 93527 93528 93528 93529 93529 93530 93530 93531 93531 93539 93540 93541 93542 93543 93544 93545 93555 93555 93556 93556 93561 93561 93562 93562 93571 93571 93600 93600 93602 93602 93603 93603 93609 93609 93610 93610 93612 93612 93615 93615 93618 93618 93619 93619 93640 93640 ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... VerDate Aug<31>2005 Mod Short descriptor .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. .................. .................. .................. .................. .................. .................. .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ .................. TC ............ US GUIDE, INTRAOP ..................................................................................................................... US GUIDE, INTRAOP ..................................................................................................................... CT GUIDE FOR TISSUE ABLATION .............................................................................................. CT GUIDE FOR TISSUE ABLATION .............................................................................................. MRI FOR TISSUE ABLATION ......................................................................................................... MRI FOR TISSUE ABLATION ......................................................................................................... INTRAVASC US, HEART ADD-ON ................................................................................................. INTRAVASC US, HEART ADD-ON ................................................................................................. INTRAVASC US, HEART ADD-ON ................................................................................................. INTRAVASC US, HEART ADD-ON ................................................................................................. RIGHT HEART CATHETERIZATION .............................................................................................. RIGHT HEART CATHETERIZATION .............................................................................................. INSERT/PLACE HEART CATHETER ............................................................................................. BIOPSY OF HEART LINING ........................................................................................................... BIOPSY OF HEART LINING ........................................................................................................... CATH PLACEMENT, ANGIOGRAPHY ........................................................................................... CATH PLACEMENT, ANGIOGRAPHY ........................................................................................... LEFT HEART CATHETERIZATION ................................................................................................ LEFT HEART CATHETERIZATION ................................................................................................ LEFT HEART CATHETERIZATION ................................................................................................ LEFT HEART CATHETERIZATION ................................................................................................ LEFT HEART CATHETERIZATION ................................................................................................ LEFT HEART CATHETERIZATION ................................................................................................ RT & LT HEART CATHETERS ....................................................................................................... RT & LT HEART CATHETERS ....................................................................................................... RT & LT HEART CATHETERS ....................................................................................................... RT & LT HEART CATHETERS ....................................................................................................... RT & LT HEART CATHETERS ....................................................................................................... RT & LT HEART CATHETERS ....................................................................................................... RT, LT HEART CATHETERIZATION .............................................................................................. RT, LT HEART CATHETERIZATION .............................................................................................. RT HEART CATH, CONGENITAL .................................................................................................. RT HEART CATH, CONGENITAL .................................................................................................. R & L HEART CATH, CONGENITAL .............................................................................................. R & L HEART CATH, CONGENITAL .............................................................................................. INJECTION, CARDIAC CATH ......................................................................................................... INJECTION, CARDIAC CATH ......................................................................................................... INJECTION FOR LUNG ANGIOGRAM ........................................................................................... INJECTION FOR HEART X-RAYS ................................................................................................. INJECTION FOR HEART X-RAYS ................................................................................................. INJECTION FOR AORTOGRAPHY ................................................................................................ INJECT FOR CORONARY X-RAYS ............................................................................................... IMAGING, CARDIAC CATH ............................................................................................................ IMAGING, CARDIAC CATH ............................................................................................................ IMAGING, CARDIAC CATH ............................................................................................................ IMAGING, CARDIAC CATH ............................................................................................................ CARDIAC OUTPUT MEASUREMENT ............................................................................................ CARDIAC OUTPUT MEASUREMENT ............................................................................................ CARDIAC OUTPUT MEASUREMENT ............................................................................................ CARDIAC OUTPUT MEASUREMENT ............................................................................................ HEART FLOW RESERVE MEASURE ............................................................................................ HEART FLOW RESERVE MEASURE ............................................................................................ BUNDLE OF HIS RECORDING ...................................................................................................... BUNDLE OF HIS RECORDING ...................................................................................................... INTRA-ATRIAL RECORDING ......................................................................................................... INTRA-ATRIAL RECORDING ......................................................................................................... RIGHT VENTRICULAR RECORDING ............................................................................................ RIGHT VENTRICULAR RECORDING ............................................................................................ MAP TACHYCARDIA, ADD-ON ...................................................................................................... MAP TACHYCARDIA, ADD-ON ...................................................................................................... INTRA-ATRIAL PACING .................................................................................................................. INTRA-ATRIAL PACING .................................................................................................................. INTRAVENTRICULAR PACING ...................................................................................................... INTRAVENTRICULAR PACING ...................................................................................................... ESOPHAGEAL RECORDING ......................................................................................................... ESOPHAGEAL RECORDING ......................................................................................................... HEART RHYTHM PACING ............................................................................................................. HEART RHYTHM PACING ............................................................................................................. ELECTROPHYSIOLOGY EVALUATION ......................................................................................... ELECTROPHYSIOLOGY EVALUATION ......................................................................................... EVALUATION HEART DEVICE ...................................................................................................... EVALUATION HEART DEVICE ...................................................................................................... 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00124 Fmt 4701 Sfmt 4700 Status indicator E:\FR\FM\01DER2.SGM 01DER2 Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Carrier Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Priced. Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69747 TABLE 17.—CARRIER PRICED CODES—Continued CPT code * 93641 93641 96020 96020 ....... ....... ....... ....... Mod Short descriptor Status indicator .................. TC ............ .................. TC ............ ELECTROPHYSIOLOGY EVALUATION ......................................................................................... ELECTROPHYSIOLOGY EVALUATION ......................................................................................... FUNCTIONAL BRAIN MAPPING .................................................................................................... FUNCTIONAL BRAIN MAPPING .................................................................................................... Carrier Carrier Carrier Carrier Priced. Priced. Priced. Priced. rmajette on PROD1PC67 with RULES2 * All CPT codes copyright 2006 AMA. G. Establishment of Interim PE RVUs for New and Revised Physician’s Current Procedural Terminology (CPT) Codes and New Healthcare Common Procedure Coding System (HCPCS) Codes for 2007 We have developed a process for establishing interim PE RVUs for new and revised codes that is similar to that used for work RVUs. Under this process, the RUC recommends the PE direct inputs (the staff time, supplies and equipment) associated with each new code. We then review the recommendations in a manner similar to our evaluation of the recommended work RVUs. The RUC recommendations on the PE inputs for the new and revised 2007 codes were submitted to us as interim recommendations. We have accepted, in the interim, the PE recommendations submitted by the RUC for the codes listed in the table titled ‘‘AMA RUC and HCPAC RVU Recommendations and CMS Decisions for New and Revised 2007 CPT Codes’’ except as noted below in this section. For CPT code 15731, Forehead flap with preservation of vascular pedicle (e.g., axial pattern flap, parmedian forehead flap); and CPT code 15830, Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomy, we assigned 5 minutes for each post-operative visit for the digital camera used in the postoperative visits, rather than the entire clinical labor time for each postoperative period. For CPT code 22527, Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral including fluoroscopic guidance; one or more additional levels (List separately in addition to code for primary procedure, we deleted the ambulatory blood pressure monitor because it duplicates the function of the 3-channel ECG machine. For CPT code 55876, Placement of interstitial device(s) for radiation guidance (e.g., fiducial markers, dosimeter), prostate (via needle, any approach), single or multiple, we deleted one package of gold markers (contains 3 markers each) because we believe that the typical number of gold VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 markers used in this procedure is 2 or 3 and we entered an interim price of $119 per 3-pack. We are asking the specialty to provide us with: (a) Verification of the typical number of gold markers used in this procedure; and (b) documentation as to the typical price of these markers. For CPT code 76776, Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation, we deleted the color laser printer because it is contained in the ultrasound room that is also used for the procedure. For CPT code 77371, Radiation treatment delivery, stereotactic radiosurgery (SRS) (complete course of treatment of cerebral lesion[s] consisting of 1 session); multi-source Cobalt 60 based, we designated, as an interim measure, the $15,000 radiation source with a specific 1-month life (that was included in the list of direct-expense equipment items for this service), as an indirect expense because we believe it does not meet the criteria for inclusion as a direct expense. To the extent that the specialty disagrees with our decision to assign the radiation source cost as an indirect expense, the interim nature of this designation gives the specialty the opportunity to provide us with documentation to support their belief that the radiation source should be considered a direct expense. For CPT code 94644, Continuous inhalation with aerosol medication for acute airway obstruction; first hour, we did not include the peak flow meter as a supply item for this service because this item is reusable and was previously removed from the PE database at the time the supplies were re-priced. For CPT code 96040, Medical genetics and genetics counseling services, each 30 minutes face-to-face with patient/ family, the payment rate, at $0.567, for ‘‘genetic counselor’’ was created from a non-BLS source that listed a 2003 national annual average salary of $53,377. This salary was inflated to include fringe benefits ($53,377 multiplied by 1.366), then deflated by the MEI to the year 2002 (the same year as the other labor costs in the PE database), then divided by 2080 (the number of hours in a work year), and PO 00000 Frm 00125 Fmt 4701 Sfmt 4700 finally divided by 60 (the number minutes in an hour). We were not able to include a price for the pedigree software equipment as it was not provided with the PE inputs. For CPT code 96904, Whole body integumentary photography, for monitoring of high risk patients with dysplastic nevus syndrome or a history of dysplastic nevi, or patients with a personal or familial history of melanoma, the payment rate, at $0.383, for ‘‘medical photographers’’, was created from a non-BLS source that gave a 2003 national annual average salary of $36,000. This salary was inflated by a factor of 1.366 to include fringe benefits, then deflated by the MEI to 2002 (the labor base year), then divided by 2080 (the number of annual work hours), and lastly, divided by number 60 (the number of minutes in an hour). We are asking the specialty to submit acceptable documentation for all of the cameras and related equipment that are listed for this service. The prices submitted by the specialty have been entered on an interim basis for CY 2007. For CPT code 58240, Pelvic exenteration for gynecologic malignancy, with total abdominal hysterectomy or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), with removal of bladder and ureteral transplantations, and/or abdominoperineal resection of rectum and colon and colostomy, or any combination thereof, the supplies for this service were correctly entered as a quantity of 6—the number of postoperative visits (POVs)—rather than 4, as listed on the PE spreadsheet in the RUC recommendations. The correct labor and equipment times were entered as reflected by the level and number of POVs. For CPT code 92025, Computerized corneal topography, unilateral or bilateral with interpretation and report, the specific topography equipment (at $44,000) requested for this procedure was not included because we do not believe it is the typical unit used in physician offices. Instead, we used the existing topography unit (at $13,495) and added a printer and computer with E:\FR\FM\01DER2.SGM 01DER2 69748 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations monitor to the PE database for this service. VI. Physician Self-Referral Prohibition: Annual Update to the List of CPT/ HCPCS Codes A. General Section 1877 of the Act prohibits a physician from referring a Medicare beneficiary for certain designated health services (DHS) to a health care entity with which the physician (or a member of the physician’s immediate family) has a financial relationship, unless an exception applies. Section 1877 of the Act also prohibits the DHS entity from submitting claims to Medicare or billing the beneficiary or any other entity for Medicare DHS that are furnished as a result of a prohibited referral. As specified in our regulations at § 411.351, the following services are DHS: • Clinical laboratory services. • Physical therapy, occupational therapy, and speech-language pathology services. • Radiology and certain other imaging services. • Radiation therapy services and supplies. • Durable medical equipment and supplies. • Parenteral and enteral nutrients, equipment, and supplies. • Prosthetics, orthotics, and prosthetic devices and supplies. • Home health services. • Outpatient prescription drugs. • Inpatient and outpatient hospital services. rmajette on PROD1PC67 with RULES2 B. Nuclear Medicine In the CY 2006 PFS proposed rule (70 FR 45764), we sought public comments on a proposal to amend the definitions of ‘‘radiation and certain other imaging services’’ and ‘‘radiation therapy services and supplies’’ at § 411.351 to include nuclear medicine services and supplies. In the CY 2006 PFS final rule with comment (70 FR 70116), we finalized the proposal and provided a delayed effective date of January 1, 2007 for the new provisions. We included a list of the nuclear medicine CPT and HCPCS codes in Table 31 and Addendum H of the CY 2006 PFS final rule with comment (70 FR 70290 through 70295 and 70472 through 70476). In response to the CY 2006 PFS final rule with comment period, we received public comments from three organizations regarding the nuclear medicine issue. Because we had previously provided an opportunity for comment on the proposal in accordance VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 with the provisions of the Administrative Procedure Act (APA) (5 U.S.C. 551 et seq.), we are not required to respond further. Nevertheless, we are responding to the only comment that provided significant new information. Specifically, we are responding to the following comment from the AMA. Comment: The AMA stated that it does not recognize diagnostic and therapeutic nuclear medicine services as a subspecialty of radiology, contrary to our statement in the CY 2006 PFS final rule (70 FR 70285). In that rule and in the proposed rule, we had explained that radiology and other imaging services should include diagnostic nuclear medicine procedures, because, among a number of other reasons, the AMA recognizes nuclear medicine as a subspecialty of radiology. We also noted in the CY 2006 PFS final rule (70 FR 70285) that the AMA had not objected to this statement in the proposed rule. In its comment, the AMA has now stated that its CPT coding categories are not intended to be a determination of subspecialties. The AMA added that nuclear medicine should be recognized as its own specialty, separate from radiology, because it has its own board certification and residency program. Response: We accept the explanation by the AMA that it does not recognize diagnostic nuclear medicine services as a subspecialty of radiology. However, we continue to believe that we should include all forms of radiological imaging in the DHS category ‘‘radiology and other imaging services.’’ As we noted in both the CY 2006 PFS proposed (70 FR 45855) and final rules (70 FR 70285), although there may be differences of opinion as to whether diagnostic nuclear medicine is a subset of radiology, it is an imaging service covered by 1861(s)(3) of the Act, and of the type for which the Congress intended to prohibit referrals. C. Annual Update to the Code List 1. Background In § 411.351, we specify that the entire scope of four DHS categories is defined in a list of CPT/HCPCS codes (the Code List), which is updated annually to account for changes in the most recent CPT and HCPCS publications. The DHS categories defined and updated in this manner are: • Clinical laboratory services. • Physical therapy, occupational therapy, and speech-language pathology services. • Radiology and certain other imaging services. • Radiation therapy services and supplies. PO 00000 Frm 00126 Fmt 4701 Sfmt 4700 The Code List also identifies those items and services that may qualify for either of the following two exceptions to the physician self-referral prohibition: • EPO and other dialysis-related drugs furnished in or by an ESRD facility (§ 411.355(g)). • Preventive screening tests, immunizations or vaccines (§ 411.355(h)). The Code List was last updated in the CY 2006 PFS final rule with comment period (70 FR 70116). 2. Response to Comments We did not receive any comments relating to the Code List that became effective January 1, 2006. 3. Revisions Effective for 2007 The updated, comprehensive Code List effective January 1, 2007 appears as Addendum J in this final rule with comment and is available on our Web site at https://www.cms.hhs.gov/ PhysicianSelfReferral. Addendum J reflects the addition of CPT code 86960 to the list of CPT codes in the 80000 series that are excluded from the definition of ‘‘clinical laboratory services.’’ This code was a new CPT code last year and should have been added to the list of excluded 80000 series codes at that time. In addition, Addendum J reflects the changes indicated in Tables 18 and 19. Tables 18 and 19 identify the additions and deletions, respectively, to the comprehensive Code List that was published in Addendum H of the CY 2006 PFS final rule (70 FR 70472 through 70476). Tables 18 and 19 also identify the additions and deletions to the lists of codes used to identify the items and services that may qualify for the exceptions in § 411.355(g) (regarding EPO and other dialysis-related outpatient prescription drugs furnished in or by an ESRD facility) and in § 411.355(h) (regarding preventive screening tests, immunizations and vaccines). The additions specified in Table 18 generally reflect new CPT and HCPCS codes that become effective January 1, 2007, or that became effective since our last update. Although we included nuclear medicine codes in Addendum H of the CY 2006 PFS final rule, we are including them as additions in Table 18 since they will become effective January 1, 2007. In addition, Table 18 also reflects our decision to move several nuclear medicine procedures that had been added last year to the DHS category of ‘‘radiology and certain other imaging services’’ (but not effective until January 1, 2007) to the category of ‘‘clinical laboratory services.’’ We E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations determined that the following CPT codes do not involve imaging services and are categorized more appropriately as clinical laboratory services: 78110, 78111, 78120, 78121, 78122, 78130, 78191, 78270, 78271, 78272 and 78725. We are also adding CPT code 86960 to the excluded portion of the ‘‘clinical laboratory services’’ category. Additionally, we are adding several HCPCS codes for radiopharmaceuticals and high osmolar contrast materials to the category of ‘‘radiology of and certain other imaging services. We inadvertently omitted these codes in Addendum H of the CY 2006 PFS final rule with comment. Table 19 reflects the deletions necessary to conform the Code List to the most recent publications of CPT and HCPCS. It also reflects our decision to delete certain nuclear medicine services (CPT codes 78110, 78111, 78120, 78121, 78122, 78130, 78191, 78270, 78271, 78272 and 78725) from the category of ‘‘radiology and certain other imaging services’’ and to move them to the more appropriate category of ‘‘clinical laboratory services.’’ We will consider comments regarding the codes listed in Tables 18 and 19 and the addition on Addendum J of CPT code 86960 to the list of CPT codes in the 80000 series that are excluded from the definition of ‘‘clinical laboratory services.’’ Comments will be considered if we receive them by the date specified in the DATES section of this final rule with comment. We will not consider any comment that advocates a substantive change to any of the DHS defined in § 411.351. TABLE 18.—ADDITIONS TO THE PHYSICIAN SELF-REFERRAL LIST OF CPT 1/HCPCS CODES rmajette on PROD1PC67 with RULES2 CLINICAL LABORATORY SERVICES 78110 ................... Plasma volume, single. 78111 ................... Plasma volume, multiple. 78120 ................... Red cell mass, single. 78121 ................... Red cell mass, multiple. 78122 ................... Blood volume. 78130 ................... Red cell survival study. 78191 ................... Pylatelet survival. 78270 ................... Vit B-12 absorption exam. 78271 ................... Vit B-12 absrp exam, int fac. 78272 ................... Vit B-12 absorp, combined. 78725 ................... Kidney function study. G0394 .................. Blood occult test colorectal. PHYSICAL THERAPY, OCCUPATIONAL THERAPY, AND SPEECH-LANGUAGE PATHOLOGY SERVICES [No additions]. RADIOLOGY AND CERTAIN OTHER IMAGING SERVICES 0144T 0145T 0146T 0147T 0148T 0149T ................... ................... ................... ................... ................... ................... VerDate Aug<31>2005 Ct heart wo dye; qual calc. Ct heart w/wo dye funct. Ccta w/wo dye. Ccta w/wo, quan calcium. Ccta w/wo, strxr. Ccta w/wo, strxr quan calc. 10:50 Nov 30, 2006 Jkt 211001 TABLE 18.—ADDITIONS TO THE PHYSICIAN SELF-REFERRAL LIST OF CPT 1/HCPCS CODES—Continued 0150T 0151T 0159T 0174T 0175T 70554 70555 76776 77014 77051 ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... 77052 ................... 77055 77056 77057 77058 77059 77071 77072 77073 77074 77075 77076 77077 77078 77079 77080 77081 77082 77083 77084 78000 78001 78003 78006 78007 78010 78011 78015 78016 78018 78020 78070 78075 78099 78102 78103 78104 78135 78140 78185 78190 78195 78199 78201 78202 78205 78206 78215 78216 78220 78223 78230 78231 78232 78258 78261 78262 78264 78278 78282 78290 78291 78299 78300 78305 78306 78315 78320 78399 PO 00000 ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... Frm 00127 Ccta w/wo, disease strxr. Ct heart funct add-on. Cad breast mri. Cad crx with interp. Cad crx remote. Fmri brain by tech. Fmri brain by phys/psych. Us exam k transpl w/Doppler. Ct scan for therapy guide. Computer dx mammogram add-on. Comp screen mammogram add-on. Mammogram, one breast. Mammogram, both breasts. Mammogram, screening. Mri, one breast. Mri, both breasts. X-ray stress view. X-rays for bone age. X-rays, bone length studies. X-rays, bone survey, limited. X-rays, bone survey complete. X-rays, bone survey, infant. Joint survey, single view. Ct bone density, axial. Ct bone density, peripheral. Dxa bone density, axial. Dxa bone density/peripheral. Dxa bone density, vert fx. Radiographic absorptiometry. Magnetic image, bone marrow. Thyroid, single uptake. Thyroid, multiple uptakes. Thyroid suppress/stimul. Thyroid imaging with uptake. Thyroid image, mult uptakes. Thyroid imaging. Thyroid imaging with flow. Thyroid met imaging. Thyroid met imaging/studies. Thyroid met imaging, body. Thyroid met uptake. Parathyroid nuclear imaging. Adrenal nuclear imaging. Endocrine nuclear procedure. Bone marrow imaging, ltd. Bone marrow imaging, mult. Bone marrow imaging, body. Red cell survival kinetics. Red cell sequestration. Spleen imaging. Platelet survival, kinetics. Lymph system imaging. Blood/lymph nuclear exam. Liver imaging. Liver imaging with flow. Liver imaging (3D). Liver image (3D) with flow. Liver and spleen imaging. Liver & spleen image/flow. Liver function study. Hepatobiliary imaging. Salivary gland imaging. Serial salivary imaging. Salivary gland function exam. Esophageal motility study. Gastric mucosa imaging. Gastroesophageal reflux exam. Gastric emptying study. Acute GI blood loss imaging. GI protein loss exam. Meckel’s divert exam. Leveen/shunt patency exam. GI nuclear procedure. Bone imaging, limited area. Bone imaging, multiple areas. Bone imaging, whole body. Bone imaging, 3 phase. Bone imaging (3D). Musculosketal nuclear exam. Fmt 4701 Sfmt 4700 69749 TABLE 18.—ADDITIONS TO THE PHYSICIAN SELF-REFERRAL LIST OF CPT 1/HCPCS CODES—Continued 78414 78428 78445 78456 78457 78458 78459 78460 78461 78464 78465 78466 78468 78469 78472 78473 78478 78480 78481 78483 78491 78492 78494 78496 78499 78580 78584 78585 78586 78587 78588 78591 78593 78594 78596 78599 78600 78601 78605 78606 78607 78608 78609 78610 78615 78630 78635 78645 78647 78650 78660 78699 78700 78701 78707 78708 78709 78710 78730 78740 78761 78799 78800 78801 78802 78803 78804 78805 78806 78807 78811 78812 78813 78814 78815 78816 78890 78891 78999 91111 E:\FR\FM\01DER2.SGM ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... 01DER2 Non-imaging heart function. Cardiac shunt imaging. Vascular flow imaging. Acute venous thrombus image. Venous thrombosis imaging. Ven thrombosis images, bilat. Heart muscle imaging (PET). Heart muscle blood, single. Heart muscle blood, multiple. Heart image (3d), single. Heart image (3d), multiple. Heart infarct image. Heart infarct image (ef). Heart infarct image (3D). Gated heart, planar, single. Gated heart, multiple. Heart wall motion add-on. Heart function add-on. Heart first pass, single. Heart first pass, multiple. Heart image (pet), single. Heart image (pet), multiple. Heart image, spect. Heart first pass add-on. Cardiovascular nuclear exam. Lung perfusion imaging. Lung V/Q image single breath. Lung V/Q imaging. Aerosol lung image, single. Aerosol lung image, multiple. Perfusion lung image. Vent image, 1 breath, 1 proj. Vent image, 1 proj, gas. Vent image, mult proj, gas. Lung differential function. Respiratory nuclear exam. Brain imaging, ltd static. Brain imaging, ltd w/flow. Brain imaging, complete. Brain imaging, compl w/flow. Brain imaging (3D). Brain imaging (PET). Brain imaging (PET). Brain flow imaging only. Cerebral vascular flow image. Cerebrospinal fluid scan. CSF ventriculography. CSF shunt evaluation. Cerebrospinal fluid scan. CSF leakage imaging. Nuclear exam of tear flow. Nervous system nuclear exam. Kidney imaging, morphol. Kidney imaging with flow. K flow/funct image w/o drug. K flow/funct image w/drug. K flow/funct image, multiple. Kidney imaging (3D). Urinary bladder retention. Ureteral reflux study. Testicular imaging w/flow. Genitourinary nuclear exam. Tumor imaging, limited area. Tumor imaging, mult area. Tumor imaging, whole body. Tumor imaging (3D). Tumor imaging, whole body. Abscess imaging, ltd area. Abscess imaging, whole body. Nuclear localization/abscess. Tumor imaging (pet), limited. Tumor image (pet)/skull-thigh. Tumor image (pet) full body. Tumor image pet/ct, limited. Tumorimage pet/ct skull-thigh. Tumor image pet/ct full body. Nuclear medicine data proc. Nuclear med data proc. Nuclear diagnostic exam. Esophageal capsule endoscopy. 69750 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations TABLE 18.—ADDITIONS TO THE PHYSICIAN SELF-REFERRAL LIST OF CPT 1/HCPCS CODES—Continued A4641 A4642 A9500 A9502 A9503 A9504 A9505 A9507 A9508 A9510 A9512 A9516 A9521 A9524 A9526 A9528 A9529 A9531 A9532 A9536 A9537 A9538 A9539 A9540 A9541 A9542 A9544 A9546 A9547 A9548 A9550 A9551 A9552 A9553 A9554 A9555 A9556 A9557 A9558 A9559 A9560 A9561 A9562 A9565 A9566 A9567 A9568 A9700 G0389 Q9945 Q9946 ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... .................. .................. .................. Q9947 .................. Q9948 .................. Q9949 .................. Q9950 .................. Q9951 Q9952 Q9953 Q9954 Q9955 Q9956 Q9957 Q9958 .................. .................. .................. .................. .................. .................. .................. .................. Q9959 .................. Q9960 .................. rmajette on PROD1PC67 with RULES2 Q9961 .................. Q9962 .................. Q9963 .................. Q9964 .................. VerDate Aug<31>2005 Radiopharm dx agent. In111 satumomab. Tc99m sestamibi. Tc99m tetrofosmin. Tc99m medronate. Tc99m apcitide. TL201 thallium. In111 capromab. I131 iodobenguate, dx. Tc99m disofenin. Tc99m pertechnetate. I123 iodide cap, dx. Tc99m exametazime. I131 serum albumin, dx. Nitrogen N–13 ammonia. Iodine I131 iodide cap, dx. I131 iodide sol, dx. I131 max 100uCi. I125 serum albumin, dx. Tc99m depreotide. Tc99m mebrofenin. Tc99m pyrophosphate. Tc99m pentetate. Tc99m MAA. Tc99m sulfur colloid. In111 ibritumomab, dx. I131 tositumomab, dx. CO57/58. In111 oxyquinoline. In111 pentetate. Tc99m gluceptate. Tc99m succimer. F18 fdg. Cr51 chromate. I125 iothalamate, dx. Rb82 rubidium. Ga67 gallium. Tc99m bicisate. Xe133 xenon 10mci. Co57 cyano. Tc99m labeled rbc. Tc99m oxidronate. Tc99m mertiatide. In111 pentetreotide. Tc99m fanolesomab. Technetium TC-99m. Tc99m arcitumomab. Echocardiography contrast. Ultrasound exam AAA screen. LOCM<=149mg/ml iodine, 1 ml. LOCM 150–199mg/ml iodine, 1ml. LOCM 200–249mg/ml iodine, 1ml. LOCM 250–299mg/ml/iodine, 1ml. LOCM 300–349mg/ml iodine, 1ml. LOCM 350–399mg/ml iodine, 1ml. LOCM>=400 mg/ml iodine, 1ml. Inj Gad-base MR contrast, ml. Inj Fe-base MR contrast, ml. Oral MR contrast, 100 ml. Inj perflexane lip micros, ml. Inj octafluoropropane mic, ml. Inj perflutren lip micros, ml. HOCM <=149mg/ml iodine, 1ml. HOCM 150–199mg/ml iodine, 1ml. HOCM 200–249mg/ml iodine, 1ml. HOCM 250–299mg/ml iodine, 1ml. HOCM 300–349mg/ml iodine, 1ml. HOCM 350–399mg/ml iodine, 1ml. HOCM>= 400mg/ml iodine, 1ml. 10:50 Nov 30, 2006 Jkt 211001 TABLE 18.—ADDITIONS TO THE PHYSICIAN SELF-REFERRAL LIST OF CPT 1/HCPCS CODES—Continued RADIATION THERAPY SERVICES AND SUPPLIES 55875 ................... Transperi needle place, pros. 55876 ................... Place rt device/marker, pros. 77371 ................... Srs, multisource. 77372 ................... Srs, linear based. 77373 ................... Sbrt delivery. 77435 ................... Sbrt management. 79005 ................... Nuclear rx, oral admin. 79101 ................... Nuclear rx, iv admin. 79200 ................... Nuclear rx, intracav admin. 79300 ................... Nuclr rx, interstit colloid. 79403 ................... Hematopoietic nuclear tx. 79440 ................... Nuclear rx, intra-articular. 79445 ................... Nuclear rx, intra-arterial. 79999 ................... Nuclear medicine therapy. 92974 ................... Cath place, cardio brachytx. A9517 ................... I131 iodide cap, rx. A9527 ................... Iodine I–125 sodium iodide. A9530 ................... I131 iodide sol, rx. A9543 ................... Y90 ibritumomab, rx. A9545 ................... I131 tositumomab, rx. A9563 ................... P32 Na phosphate. A9564 ................... P32 chromic phosphate. A9600 ................... Sr89 strontium. A9605 ................... Sm 153 lexidronm. A9699 ................... Radiopharm rx agent noc. Q3001 .................. Brachytherapy Radioelements. DRUGS USED BY PATIENTS UNDERGOING DIALYSIS Q4081 .................. Epoetin alfa, 100 units ESRD. PREVENTIVE SCREENING TESTS, IMMUNIZATIONS AND VACCINES 77052 ................... Comp screen mammogram add-on. 77057 ................... Mammogram, screening. 82270 ................... Occult blood, feces. 90660 ................... Flu vaccine, nasal. G0389 .................. Ultrasound exam AAA screen. 1 CPT codes and descriptions only are copyright 2006 AMA. All rights are reserved and applicable FARS/DFARS clauses apply. TABLE 19.—DELETIONS TO THE PHYSICIAN SELF-REFERRAL LIST OF CPT 1/HCPCS CODES CLINICAL LABORATORY SERVICES G0107 .................. CA screen; fecal blood test. PHYSICAL THERAPY, OCCUPATIONAL THERAPY, AND SPEECH-LANGUAGE PATHOLOGY SERVICES [No deletions]. RADIOLOGY AND CERTAIN OTHER IMAGING SERVICES 76006 76020 76040 76061 76062 76065 76066 76070 76071 76075 76076 76077 76078 76082 ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... 76083 ................... 76090 ................... 76091 ................... 76092 ................... PO 00000 Frm 00128 X-ray stress view. X-rays for bone age. X-rays, bone evaluation. X-rays, bone survey. X-rays, bone survey. X-rays, bone evaluation. Joint survey, single view. Ct bone density, axial. Ct bone density, peripheral. Dxa bone density, axial. Dxa bone density/peripheral. Dxa bone density/v-fracture. Radiographic absorptiometry. Computer mammogram addon. Computer mammogram addon. Mammogram, one breast. Mammogram, both breasts. Mammogram, screening. Fmt 4701 Sfmt 4700 TABLE 19.—DELETIONS TO THE PHYSICIAN SELF-REFERRAL LIST OF CPT 1/HCPCS CODES—Continued 76093 76094 76370 76400 76778 78110 78111 78120 78121 78122 78130 78191 78270 78271 78272 78704 78715 78725 78760 A9511 ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... Magnetic image, breast. Magnetic image, both breasts. Ct scan for therapy guide. Magnetic image, bone marrow. Us exam kidney transplant. Plasma volume, single. Plasma volume, multiple. Red cell mass, single. Red cell mass, multiple. Blood volume. Red cell survival study. Platelet survival. Vit B-12 absorption exam. Vit B-12 absrp exam, int fac. Vit B-12 absorp, combined. Imaging renogram. Renal vascular flow exam. Kidney function study. Testicular imaging. Technetium TC 99m depreotide. A9513 ................... Technetium tc-99m mebrofenin. A9514 ................... Technetium tc-99m pyrophosphate. A9515 ................... Technetium tc-99m pentetate. A9519 ................... Technetiumtc-99m macroag albu. A9520 ................... Technetiumtc-99m sulfur clld. A9522 ................... Indium111ibritumomabtiuxetan. A9533 ................... I131 tositumomab diagnostic. Q3000 .................. Rubidium RB–82. Q3002 .................. Gallium ga 67. Q3003 .................. Technetium tc99m bicisate. Q3004 .................. Xenon xe 133. Q3005 .................. Technetium tc99m mertiatide. Q3006 .................. Technetium tc99m glucepatate. Q3007 .................. Sodium phosphate p32. Q3008 .................. Indium 111-in pentetreotide. Q3009 .................. Technetium tc99m oxidronate. Q3010 .................. Technetium tc99mlabeledrbcs. Q3011 .................. Chromic phosphate p32. Q3012 .................. Cyanocobalamin cobalt co57. RADIATION THERAPY SERVICES AND SUPPLIES 0082T ................... Stereotactic rad delivery. 0083T ................... Stereotactic rad tx mngmt. 55859 ................... Percut/needle insert, pros. A9523 ................... Yttrium90ibritumomabtiuxetan. A9532 ................... I125 serum albumin, dx. A9534 ................... I131 tositumomab therapeut. Q3007 .................. Sodium phosphate p32. Q3011 .................. Chromic phosphate p32. DRUGS USED BY PATIENTS UNDERGOING DIALYSIS J0886 ................... Epoetin alfa, esrd. PREVENTIVE SCREENING TESTS, IMMUNIZATIONS AND VACCINES 76083 ................... Computer mammogram addon. 76092 ................... Mammogram, screening. G0107 .................. CA screen; fecal blood test. 1 CPT codes and descriptions only are copyright 2006 AMA. All rights are reserved and applicable FARS/DFARS clauses apply. VII. Physician Fee Schedule Update for CY 2007 A. Physician Fee Schedule Update The PFS update is determined using a formula specified by statute. Under section 1848(d)(4) of the Act, the update is equal to the product of 1 plus the percentage increase in the MEI (divided by 100) and 1 plus the UAF. For CY 2007, the MEI is equal to 2.1 percent E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations (1.021). The UAF is ¥7.0 percent (0.930). The product of the MEI (1.021) and the UAF (0.930) equals the CY 2007 update of ¥5.0 percent (0.94953). Our calculations of these figures are explained in this section. B. The Percentage Change in the Medicare Economic Index (MEI) The MEI measures the weightedaverage annual price change for various inputs needed to produce physicians’ services. The MEI is a fixed-weight input price index, with an adjustment for the change in economy-wide multifactor productivity. This index, which has CY 2000 base year weights, is comprised of two broad categories: (1) Physician’s own time; and (2) physician’s PE. The physician’s own time component represents the net income portion of business receipts and primarily reflects the input of the physician’s own time into the production of physicians’ services in physicians’ offices. This category consists of two subcomponents: (1) Wages and salaries; and (2) fringe benefits. The physician’s PE category represents nonphysician inputs used in the production of services in physicians’ offices. This category consists of wages and salaries and fringe benefits for nonphysician staff and other nonlabor inputs. The physician’s PE component also includes the following categories of nonlabor inputs: Office expense; medical materials and supplies; professional liability insurance; medical equipment; prescription drugs; and 69751 other expenses. The components are adjusted to reflect productivity growth in physicians’ offices by the 10-year moving average of productivity in the private nonfarm business sector. Table 20 presents a listing of the MEI cost categories with associated weights and percent changes for price proxies for the 2007 update. For CY 2007, the increase in the MEI is 2.1 percent, which includes a 1.3 percent productivity offset based on the 10-year moving average of multifactor productivity. This is the result of a 3.3 percent increase in physician’s own time and a 3.6 percent increase in physician’s PE. Within the physician’s PE, the largest increase occurred in professional liability insurance, which increased 6.9 percent, and prescription drugs, which increased 7.7 percent. TABLE 20.—INCREASE IN THE MEDICARE ECONOMIC INDEX UPDATE FOR CY 2007 1 CY 2000 weights 2 Cost categories and price measures Medicare Economic Index Total, productivity adjusted 3 ................................................................................................. Productivity: 10-year moving average of multifactor productivity, private nonfarm business sector 3, 4 .......... Medicare Economic Index Total, without productivity adjustment 4 ................................................................................ 1. Physician’s Own Time 5 ........................................................................................................................................ a. Wages and Salaries: Average Hourly Earnings, private nonfarm ....................................................................... Fringe Benefits: Employment Cost Index, benefits, private nonfarm ............................................................... 2. Physician’s Practice Expense 5 ............................................................................................................................ a. Nonphysician Employee Compensation .............................................................................................................. (1) Wages and Salaries: Employment Cost Index, wages and salaries, weighted by occupation .................. (2) Fringe Benefits: Employment Cost Index, fringe benefits, white collar ...................................................... b. Office Expense: Consumer Price Index for Urban Areas (CPI–U), housing ....................................................... c. Drugs and Medical Materials and Supplies ......................................................................................................... (1) Medical Materials and Supplies: Producer Price Index (PPI), surgical appliances and supplies/CPI–U, medical equipment and supplies (equally weighted) .................................................................................... (2) Pharmaceuticals: Producer Price Index (PPI ethical prescription drugs) ................................................... d. Professional Liability Insurance: Professional liability insurance Premiums 6 ..................................................... e. Medical Equipment: PPI, medical instruments and equipment ........................................................................... f. Other Expenses ..................................................................................................................................................... CY 2007 percent changes N/A N/A 100.000 52.466 42.730 9.735 47.534 18.653 13.808 4.845 12.209 4.319 2.1 1.3 3.5 3.3 3.3 3.5 3.6 2.9 2.6 4.0 3.7 4.8 2.011 2.308 3.865 2.055 6.433 1.1 7.7 6.9 ¥0.1 2.2 rmajette on PROD1PC67 with RULES2 1. The rates of historical change are estimated for the 12-month period ending June 30, 2006, which is the period used for computing the CY 2007 update. The price proxy values are based upon the latest available Bureau of Labor Statistics data as of August 31, 2006. 2. The weights shown for the MEI components are the 2000 base-year weights, which may not sum to subtotals or totals because of rounding. The MEI is a fixed-weight, Laspeyres-type input price index whose category weights indicate the distribution of expenditures among the inputs to physicians’ services for CY 2000. To determine the MEI level for a given year, the price proxy level for each component is multiplied by its 2000 weight. The sum of these products (weights multiplied by the price index levels) over all cost categories yields the composite MEI level for a given year. The annual percent change in the MEI levels is an estimate of price change over time for a fixed market basket of inputs to physicians’ services. 3. These numbers may not sum due to rounding and the multiplicative nature of their relationship. 4. On March 23, 2006, Bureau of Labor Statistics introduced a new Multi Factor Productivity (MFP) series based on the 1997 NAICS classification system to replace its SIC based series published until 2005 (the last historical value was for 2002). The new series differs historically from the old MFP series and adds two new historical values through 2004. Therefore, we used the most recently available information (thru CY 2004) to develop the productivity adjustment for the CY 2007 update. 5. The measures of productivity, average hourly earnings, Employment Cost Indexes, as well as the various Producer and CPIs can be found on the BLS Web site at https://stats.bls.gov. 6. Derived from data collected from several major insurers (the latest available historical percent change data are for the period ending second quarter of 2006). Comment: Several commenters believe we are in violation of the Administrative Procedures Act (APA) for not proposing and soliciting comments on the incorporation of new Bureau of Labor Statistics Multifactor Productivity data in the MEI. Response: We disagree with the commenters’ claim that we are in VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 violation of the APA. The APA requires us to propose and solicit comments on substantive changes to our payment methodology. The PFS update published in this year’s proposed rule is based on the same MEI methodology proposed and adopted in the CY 2003 and CY 2004 PFS proposed and final PO 00000 Frm 00129 Fmt 4701 Sfmt 4700 rules. The CY 2003 final rule adopted the use of BLS’ private nonfarm business multifactor productivity (MFP) as the official data used to adjust the MEI for productivity. Specifically, consistent with the proposal made in the CY 2003 proposed rule (67 FR 43860), the CY 2003 final rule (67 FR E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 69752 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 80023) states ‘‘Thus, the productivity adjustment will be based on the latest available actual historical economywide multifactor productivity data, as measured by the BLS.’’ For the CY 2007 proposed rule, we followed this methodology and incorporated the latest available BLS private nonfarm business multifactor productivity. Comment: Several commenters believe the multifactor productivity estimate of 1.3 percent is high in light of the new Medicare initiatives such as the new Welcome to Medicare benefits, the new comprehensive Part D benefit, and compliance related to the Physician Voluntary Reporting Program (PVRP), which impose numerous time and paperwork burdens on physicians. Response: Our proposed and adopted methodology for calculating the MEI utilizes BLS’s private nonfarm business MFP as the proxy for productivity changes. We recognize that productivity in physicians’ offices for a given year may not equate to that of the economywide measure. For that reason, as well as to remove the effect of normal business cycles, we employ a 10-year moving average as the official measure. Also, CMS, in conjunction with the Assistant Secretary for Planning and Evaluation, is in the process of conducting a study on productivity in the physicians’ offices. This work is being done to determine if the presently-used economy-wide measure for multi-factor productivity provides a reasonable target for physicians. We will analyze the results from this study and carefully evaluate its findings and their applicability to future MEI updates. Comment: Several commenters believe it is not warranted that we assume and calculate increased productivity levels for physicians while the payment update process for other providers does not include assumed or automatic productivity adjustments. Response: Since its inception in the mid-1970’s, the MEI has included a productivity adjustment. The payment system for physicians’ services requires that factors affecting the payment update be reflected in the update formula itself. The statutory provision relating to the MEI contemplates that the Secretary would not increase payments except to the extent that the extent that the Secretary finds, on the basis of appropriate economic index data, that such higher level is justified by year-to-year economic changes. We have long maintained that an MEI framework that focuses solely on the inputs portion of the equation effectively ignores the efficiencies that are employed to produce the outputs associated with the provision of care. It VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 is necessary to account for these efficiencies to accurately reflect the net inflationary pressures encountered by physicians. The intent of the MEI is to represent industry-wide output prices for physicians’ services. We note that this index structure is similar to the CPI, which is an economy-wide output price index. The CPI implicitly incorporates a productivity adjustment. Except when the statute directs otherwise, the Medicare update for a number of types of services (for example, clinical diagnostic laboratory services, durable medical equipment, prosthetics and supplies) is based the CPI with its implicit productivity adjustment. With respect to updates for other types of Medicare providers, such as institutional providers, we note that the underlying payment methodology is completely different from the payment system for physicians’ services. Under the Medicare PFS, payments are made for unbundled services such as lab tests, follow-up visits, and x-rays. For institutions compensated by a PPS, a single payment is made for a bundle of services linked to treating a particular category of case (for instance, the services within one diagnosis-related group under the IPPS). Adjustments to payments associated with productivity and other payment framework-related considerations, when paying for bundled services, are addressed in other portions of the update process, such as via MedPAC recommendations and/or in the update itself when approved by the Congress. Comment: Several commenters requested that we examine and address the broader problem that the MEI only measures changes in specific types of practice costs that existed in 1973. They further stated that inputs to the MEI are vastly different now than when the MEI was first developed in the early 1970s and that an array of governmentimposed regulatory requirements now exist that did not in 1973. They claim that physician practice costs for these types of inputs are not currently taken into account for purposes of measuring the MEI, and therefore, the MEI undervalues actual medical cost increases. One commenter added that employee wages used in the MEI formula do not accurately reflect the skill mix of the industry and the MEI needs to be updated to account for the highly skilled staff necessary to deliver today’s level of medical care service. Response: We disagree with the commenter’s claim that the MEI only measures changes in specific types of practice costs that existed in 1973. The current MEI is based on costs reported PO 00000 Frm 00130 Fmt 4701 Sfmt 4700 by physicians for 2000, which would reflect changes in the distributions of the cost weights associated with the government-imposed regulatory requirements that applied in 2000. The 2000-based cost weights are derived from the 2003 AMA Physician Socioeconomic Characteristics publication (2003 Patient Care Physician Survey data), which measures physicians’ earnings and overall PEs for 2000. This is the latest available AMA data on physician expenses. We are currently researching alternative data sources for rebasing the MEI. Regarding skill mix, the current MEI uses the occupation mix for nonphysician wages from the 2000 Current Population Survey published by BLS. This reflected the latest occupation mix at the time of our most recent rebasing. We recognize that skill mix can change, thus, we will continue to use the most recently published data available to us for all future rebasings to ensure the MEI reflects the occupational blend at that time. Comment: Many commenters objected to the 0.5 percentage point reduction of the 2007 PFS update relative to the forecasted update in the President’s Budget and urged us to delay or withdraw any changes in the MEI until the proposed changes and the solicitation of public comments appear in a published Federal Register. Response: As stated previously, we did not make any methodological changes to the calculation of the MEI, and therefore, it is not necessary to delay use of the MFP-adjusted MEI in order to solicit and respond to public comments. As we indicated in the 2003 and 2004 physician fee schedule proposed and final rules, we are using the latest-available historical data in the calculation of the MEI applicable to a year. As such, we are not required to propose or solicit public comments on changes in the MEI that result from use of latest available data. The inclusion of more recent, historical MFP data in the MEI reflects our adopted methodology as finalized in the CY 2003 PFS final rule which states the MEI ‘‘productivity adjustment will be based on the latest available actual historical economywide multifactor productivity data, as measured by the BLS.’’ Comment: One commenter believes that there are alternative measures of multifactor productivity available from BLS and the Census Bureau. The commenter states that we should identify and consider these alternatives and seek public comment before changing the data used to calculate the MEI. E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations Response: In the CY 2003 PFS final rule, we presented the research we had completed on evaluating the most appropriate productivity adjustment for the MEI. This research included an evaluation of all currently available productivity estimates produced by BLS to develop a better understanding of the strengths and weaknesses of these measures. It also included a review of the theoretical foundation of the MEI to develop a better understanding of how labor and multifactor productivity relate to the current physician payment system. Additionally, we studied the sparse and fragmented publiclyavailable data to begin to develop preliminary estimates of trends in physician specific productivity to better understand the current market conditions facing physicians. For a list of the experts that participated in this analysis, as well as a full description of the options that were identified and evaluated (67 FR 80019). As stated earlier, CMS and ASPE are jointly sponsoring a study of physicians’ office productivity. We will be evaluating the results of that study to determine if the use of BLS’s private nonfarm business MFP is a reasonable target for physicians to achieve. Comment: Several commenters claim that in previous years, there have been extensive discussions in the proposed rule of the upcoming year’s update and the MEI. They further state that based on the impact table in the CY 2007 proposed rule, a –0.5 percent percentage point reduction in the update will result in a $375 million cut in physician payments in 2007. One commenter claimed that our actions this year, in contrast to previous years, suggest we are attempting to hide the revision in the MEI for CY 2007. Response: We disagree with the commenters’ claim that in previous years there has been extensive discussion of the upcoming year’s MEI update in the proposed rule. With the exception of those updates that include a rebased and revised MEI, a detailed discussion, as well as the percent changes in the MEI cost categories, has been provided only in the final rule. When we rebase and revise the MEI, we do include extensive discussion on the MEI and solicit comments on proposed methodological changes. Given the historical precedent, we disagree with the commenter’s suggestion that we were hiding any revision in the MEI. C. The Update Adjustment Factor (UAF) Section 1848(d) of the Act provides that the PFS update is equal to the product of the MEI and the UAF. The UAF is applied to make actual and target expenditures (referred to in the statute as ‘‘allowed expenditures’’) equal. Allowed expenditures are equal to actual expenditures in a base period updated each year by the SGR. The SGR sets the annual rate of growth in allowed expenditures and is determined by a formula specified in section 1848(f) of the Act. 1. Calculation Under Current Law Under section 1848(d)(4)(B) of the Act, the UAF for a year beginning with 2001 is equal to the sum of the following— • Prior Year Adjustment Component. An amount determined by— + Computing the difference (which may be positive or negative) between the amount of the allowed expenditures for physicians’ services for the prior year (the year prior to the year for which the update is being determined) and the amount of the actual expenditures for those services for that year; + Dividing that difference by the amount of the actual expenditures for those services for that year; and 69753 + Multiplying that quotient by 0.75. • Cumulative Adjustment Component. An amount determined by— + Computing the difference (which may be positive or negative) between the amount of the allowed expenditures for physicians’ services from April 1, 1996, through the end of the prior year and the amount of the actual expenditures for those services during that period; + Dividing that difference by actual expenditures for those services for the prior year as increased by the SGR for the year for which the UAF is to be determined; and + Multiplying that quotient by 0.33. Section 1848(d)(4)(E) of the Act requires the Secretary to recalculate allowed expenditures consistent with section 1848(f)(3) of the Act. Section 1848(f)(3) specifies that the SGR (and, in turn, allowed expenditures) for the upcoming CY (2007 in this case), the current CY (2006) and the preceding CY (2005) are to be determined on the basis of the best data available as of September 1 of the current year. Allowed expenditures are initially estimated and subsequently revised twice. The second revision occurs after the CY has ended (that is, we are making the final revision to 2005 allowed expenditures in this final rule with comment). Once the SGR and allowed expenditures for a year have been revised twice, they are final. Table 21 shows annual and cumulative allowed expenditures for physicians’ services from April 1, 1996 through the end of the current CY, including the transition period to a CY system that occurred in 1999. Also shown is the SGR corresponding with each period. The calculation of the SGR is discussed in detail below in this section. TABLE 21.—ANNUAL AND CUMULATIVE ALLOWED AND ACTUAL EXPENDITURES FOR PHYSICIANS’ SERVICES FROM APRIL 1, 1996 THROUGH THE END OF THE CURRENT CALENDAR YEAR Annual allowed expenditures ($ in billions) rmajette on PROD1PC67 with RULES2 Period 4/1/96–3/31/97 .................................. 4/1/97–3/31/98 .................................. 4/1/98–3/31/99 .................................. 1/1/99–3/31/99 .................................. 4/1/99–12/31/99 ................................ 1/1/99–12/31/99 ................................ 1/1/00–12/31/00 ................................ 1/1/01–12/31/01 ................................ 1/1/02–12/31/02 ................................ 1/1/03–12/31/03 ................................ 1/1/04–12/31/04 ................................ 1/1/05–12/31/05 ................................ 1/1/06–12/31/06 ................................ VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 Annual actual expenditures ($ in billions) $48.9 50.5 52.6 13.3 42.1 55.3 59.4 62.0 67.2 72.1 76.8 80.0 81.7 PO 00000 Frm 00131 Cumulative allowed expenditures ($ in billions) $48.9 49.4 50.5 13.1 39.5 52.6 58.1 66.3 71.0 78.2 87.1 92.0 94.9 Fmt 4701 $48.9 99.4 152.0 (1) (2) 194.0 253.4 315.4 382.6 454.6 531.5 611.5 693.3 Sfmt 4700 Cumulative actual expenditures ($ in billions) $48.9 98.4 148.9 148.9 188.4 188.4 246.5 312.8 383.7 461.9 549.0 641.0 735.9 E:\FR\FM\01DER2.SGM FY/CY SGR N/A FY 1998=3.2% FY 1999=4.2% FY 1999=4.2% FY 2000=6.9% FY 1999/2000 (3) CY 2000=7.3% CY 2001=4.5% CY 2002=8.3% CY 2003=7.3% CY 2004=6.6% CY 2005=4.2% CY 2006=2.1% 01DER2 69754 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations TABLE 21.—ANNUAL AND CUMULATIVE ALLOWED AND ACTUAL EXPENDITURES FOR PHYSICIANS’ SERVICES FROM APRIL 1, 1996 THROUGH THE END OF THE CURRENT CALENDAR YEAR—Continued Annual allowed expenditures ($ in billions) Period 1/1/07–12/31/07 ................................ Annual actual expenditures ($ in billions) 83.2 Cumulative allowed expenditures ($ in billions) NA Cumulative actual expenditures ($ in billions) 776.5 NA FY/CY SGR CY 2007=1.8% (1) Allowed expenditures for the first quarter of 1999 are based on the FY 1999 SGR. expenditures for the last three quarters of 1999 are based on the FY 2000 SGR. expenditures in the first year (April 1, 1996–March 31, 1997) are equal to actual expenditures. All subsequent figures are equal to quarterly allowed expenditure figures increased by the applicable SGR. Cumulative allowed expenditures are equal to the sum of annual allowed expenditures. We provide more detailed quarterly allowed and actual expenditure data on our web site at the following address: https://www. cms.hhs.gov/SustainableGRatesConFact/. We expect to update the web site with the most current information later this month. (2) Allowed (3) Allowed Consistent with section 1848(d)(4)(E) of the Act, Table 21 includes our final revision of allowed expenditures for 2005, a recalculation of allowed expenditures for 2006, and our initial estimate of allowed expenditures for 2007. To determine the UAF for 2007, the statute requires that we use allowed UAF = and actual expenditures from April 1, 1996 through December 31, 2006 and the 2007 SGR. Consistent with section 1848(d)(4)(E) of the Act, we will be making revisions to the 2006 and 2007 SGRs and 2006 and 2007 allowed expenditures. Because we have incomplete actual expenditure data for 2006, we are using an estimate for this period. Any difference between current estimates and final figures will be taken into account in determining the UAF for future years. We are using figures from Table 21 in the following statutory formula: Target 4/96 −12/06 − Actual4/96 −12/06 Target 06 − Actual06 × 0.75 + × 0.33 Actual06 Actual06 × SGR 07 UAF = Update Adjustment Factor Target06 = Allowed Expenditures for 2006 = $81.7 billion Actual06 = Estimated Actual Expenditures for 2006 = $94.9 billion Target 4/96–12/06 = Allowed Expenditures from 4/1/1996—12/31/2006 = $693.3 billion Actual 4/96–12/06 = Estimated Actual Expenditures from 4/1/1996—12/31/ 2006 = $735.9 billion SGR 07 = 1.8 percent (1.018) $81.7 − $94.9 $693.3 − $735.9 × .75 + × .33 = −0.250 $94.9 $94.9 × 1.018 A. Medicare Sustainable Growth Rate The SGR is an annual growth rate that applies to physicians’ services paid by Medicare. The use of the SGR is intended to control growth in aggregate Medicare expenditures for physicians’ services. Payments for services are not withheld if the percentage increase in actual expenditures exceeds the SGR. Rather, the PFS update, as specified in section 1848(d)(4) of the Act, is adjusted VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00132 Fmt 4701 Sfmt 4700 the Act, the SGR is estimated and subsequently revised twice (beginning with the FY and CY 2000 SGRs) based on later data. (The Act also provides for adjustments to be made to the SGRs for FY 1998 and FY 1999. See the February 28, 2003 Federal Register (68 FR 9567) for a discussion of these SGRs). Under section 1848(f)(3)(C)(ii) of the Act, there are no further revisions to the SGR once it has been estimated and subsequently revised in each of the 2 years following the preliminary estimate. In this final rule with comment, we are making our preliminary estimate of the 2007 SGR, a revision to the 2006 SGR, and our final revision to the 2005 SGR. B. Physicians’ Services Section 1848(f)(4)(A) of the Act defines the scope of physicians’ services covered by the SGR. The statute indicates that ‘‘the term physicians’’ services includes other items and services (such as clinical diagnostic laboratory tests and radiology services), specified by the Secretary, that are commonly performed or furnished by a E:\FR\FM\01DER2.SGM 01DER2 ER01DE06.001</MATH> rmajette on PROD1PC67 with RULES2 VIII. Allowed Expenditures for Physicians’ Services and the Sustainable Growth Rate based on a comparison of allowed expenditures (determined using the SGR) and actual expenditures. If actual expenditures exceed allowed expenditures, the update is reduced. If actual expenditures are less than allowed expenditures, the update is increased. Section 1848(f)(2) of the Act specifies that the SGR for a year (beginning with 2001) is equal to the product of the following four factors: (1) The estimated change in fees for physicians’ services; (2) The estimated change in the average number of Medicare fee-forservice beneficiaries;. (3) The estimated projected growth in real GDP per capita; and (4) The estimated change in expenditures due to changes in statute or regulations. In general, section 1848(f)(3) of the Act requires us to publish SGRs for 3 different time periods, no later than November 1 of each year, using the best data available as of September 1 of each year. Under section 1848(f)(3)(C)(i) of ER01DE06.000</MATH> Section 1848(d)(4)(D) of the Act indicates that the UAF determined under section 1848(d)(4)(B) of the Act for a year may not be less than ¥0.070 or greater than 0.03. Since ¥0.250 is less than ¥0.070, the UAF for 2006 will be ¥0.070. Section 1848(d)(4)(A)(ii) of the Act indicates that 1.0 should be added to the UAF determined under section 1848(d)(4)(B) of the Act. Thus, adding 1.0 to ¥0.070 makes the UAF equal to 0.930. rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations physician or in a physician’s office, but does not include services furnished to a Medicare+Choice plan enrollee.’’ We published a definition of physicians’ services for use in the SGR in the Federal Register (66 FR 55316) on November 1, 2001. We defined physicians’ services to include many of the medical and other health services listed in section 1861(s) of the Act. For purposes of determining allowed expenditures, actual expenditures, and SGRs, we have specified that physicians’ services include the following medical and other health services if bills for the items and services are processed and paid by Medicare carriers (and those paid through intermediaries where specified): • Physicians’ services. • Services and supplies furnished incident to physicians’ services. • Outpatient physical therapy services and outpatient occupational therapy services. • Antigens prepared by, or under the direct supervision of, a physician. • Services of PAs, certified registered nurse anesthetists, certified nurse midwives, clinical psychologists, clinical social workers, NPs, and certified nurse specialists. • Screening tests for prostate cancer, colorectal cancer, and glaucoma. • Screening mammography, screening pap smears, and screening pelvic exams. • Diabetes outpatient self-management training (DSMT) services. • MNT services. • Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests (including outpatient diagnostic laboratory tests paid through intermediaries). • X-ray, radium, and radioactive isotope therapy. • Surgical dressings, splints, casts, and other devices used for the reduction of fractures and dislocations. • Bone mass measurements. • An initial preventive physical exam. • Cardiovascular screening blood tests. • Diabetes screening tests. • Telehealth services. • Physician work and resources to establish and document the need for a power mobility device (70 FR 50940). Telehealth services and the power mobility device related services were added because they meet the statutory criteria for services to be included in the SGR (that is, these services are commonly performed or furnished by a physician or in a physician’s office) (70 FR 70305). VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 Summary of Comments on the Physician Update and the SGR We appreciate the comments we received expressing concern about the negative update for 2007 and the SGR formula. Those comments are summarized below, along with our responses. Comment: Commenters noted that physicians’ costs are rising, while fees are being cut. Under current law, the 2006 Medicare Trustees Report projected negative updates of about ¥5 percent for at least nine consecutive years. The cumulative impact of the projected reductions from 2007 to 2015 was estimated to be about ¥37 percent. Because commercial insurance carriers and Medicaid base their payment updates upon Medicare’s PFS, the overall negative impact is compounded and affects the entire health care industry. In contrast, the MEI increase over this same period is projected to be about 22 percent. Commenters noted that increases in their practice costs are outpacing most inflationary measures, and they predicted that costs to provide care will soon exceed reimbursement. Many physician practices are small businesses that operate on slim margins. With ever increasing costs, they will not have the resources to absorb payment cuts resulting from the SGR formula. The result will be that patient quality of care will be compromised, with doctors taking drastic measures to cut costs of health care delivery to remain solvent. Eventually, physicians will be unable to absorb the sustained losses, and they will refuse or limit Medicare patients, resulting in reduced access to care. A survey conducted by the AMA found that 45 percent of physicians will either stop accepting or decrease the number of new Medicare patients they accept if payments are cut for 2007. Inadequate access to care will lead to a deterioration in the health status of Medicare beneficiaries. Beneficiaries will be forced to seek care in inpatient settings, which will be more costly for Medicare, less efficient in delivering care, and yield worse health outcomes for beneficiaries. Commenters recommended that the SGR be replaced with an appropriate inflation rate linked to changes in the actual costs of medical practice. Commenters cited MedPAC’s recommendation to replace the SGR with a system that reflects the increases in practice costs and other medical inflation variables, which would be 2.8 percent for 2007. Other commenters suggested using the MEI, which is PO 00000 Frm 00133 Fmt 4701 Sfmt 4700 69755 estimated at 2.1 percent for 2007, to update the CF. Commenters suggested that we assume the leadership in pushing the Congress to enact legislation preventing a negative update for 2007, and to replace the SGR with a more sustainable system. Response: We are fully cognizant of the potential implications of more than 9 years of negative physician updates. We remain concerned regarding those trends, and are closely monitoring physicians’ participation in the Medicare program, as well as beneficiaries’ access to care. The formula for the SGR and the physician update are dictated by statute. We are required to follow this methodology when calculating the payment rates under the PFS. We are working closely and collaboratively with medical professionals and the Congress on the most effective Medicare payment methodologies to compensate physicians for providing services to Medicare beneficiaries. We are engaging physicians on issues of quality and performance with the goal of encouraging the most effective approaches to achieve better health outcomes for Medicare beneficiaries. We are committed to developing systems that enable us to encourage quality, and to improve care without increasing overall Medicare costs. Comment: Commenters requested that we implement administrative changes to the SGR calculation that would prevent a negative physician update for 2007. Specifically, many commenters requested that we remove the cost of Medicare-covered physicianadministered drugs from the SGR on a retrospective basis. Commenters noted that expenditures on these drugs increased from $1.8 billion in 1996, to $8.6 billion in 2004, and was estimated at $8.2 billion in 2005. The commenters opined that if we make the administrative changes now, worth about $100 billion, then the cost of legislation revising the payment methodology for physicians’ services will drop, and the likelihood of Congressional action to fix the SGR permanently will increase. Commenters expressed frustration that this recalculation has been requested numerous times, yet we have never implemented the change. Some commenters requested that we remove all nonphysician services from the SGR calculation. Commenters stated that the annual spending growth of many nonphysician services, including drugs and physical therapy, far outstrip the growth of physician services. E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 69756 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations Commenters requested separate funding pools for physician and nonphysician services, each with its own respective targets, to calculate separate update factors for physician and nonphysician services. Response: We carefully reviewed our authority to make administrative changes, most notably the feasibility of removing Part B drugs from the SGR baseline. We indicated in the past (most recently in 70 FR 70307) that administrative changes, such as retrospective removal of drugs from the SGR, are statutorily difficult. For example, the statute requires estimates of the SGR to be refined twice based on actual data. We see no legal basis to reestimate the SGR and recompute allowed expenditures for a year after the SGR has been estimated and revised twice. Further, our current estimates are that these administrative changes, including removing drugs retroactively from the SGR, would not provide relief to the negative updates projected for 2007 and the succeeding several years. As indicated above in this section, we are working with the Congress and health professional organizations on potential reforms that would improve the effectiveness of the payment methodology for physicians without increasing overall Medicare costs. In reference to removing all ‘‘nonphysician services’’ from the SGR, the statute provides the Secretary with clear authority to specify the services that are included in the SGR. Section 1848(f)(4)(A) of the Act indicates that the term ‘‘physicians’’ services’’ includes other items and services specified by the Secretary that are commonly performed or furnished by a physician or in a physician’s office. We published a definition of physicians’ services for use in the SGR in the Federal Register (66 FR 55316) on November 1, 2001. For purposes of determining allowed expenditures, actual expenditures, and SGRs, we defined physicians’ services to include many of the medical and other health services listed in section 1861(s) of the Act that meet the criterion of being commonly performed by a physician or are services and supplies furnished incident to physicians’ services. We disagree with the comments suggesting that the Secretary should not include drugs and physical therapy services in the definition of physicians’ services for purposes of determining allowed expenditures, actual expenditures, and the SGR. Further, we have no authority to create separate targets and update factors for what commenters are identifying as ‘‘physician’’ and ‘‘nonphysician’’ services. VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 Comment: Commenters noted that payment updates under the SGR are tied to GDP, which bears little relationship to Medicare beneficiaries’ health care needs or physician practice costs. Commenters noted that medical needs of individual patients are not related to the growth of the overall economy, and beneficiaries’ medical needs do not decline during economic downturns. Commenters stated that MEI is a better reflection than GDP of the growth in health care costs. Response: Under section 1848(d)(4) of the Act, the PFS update is equal to the product of the percentage increase in the MEI and the UAF. The UAF is determined by comparing allowed and actual expenditures from prior years and the current year, and adjusting the update to account for the difference. The SGR is used to calculate allowed expenditures, and the GDP is one of the components used to calculate the SGR as specified in section 1848(f)(2)(C) of the Act. The percentage change in the MEI is one of the key components used to update the PFS CF. In accounting for the weighted-average price change for various inputs involved with producing physicians’ services, the MEI measures inflation in physician practice costs and general wage levels. Elements of the MEI include measures of physicians’ PEs, including nonphysician employee compensation, office expenses, medical material and supplies, professional liability insurance, and medical equipment. The GDP is a general measure of economic growth. It is not intended to reflect factors specific to operating a medical practice because these are captured in the MEI. Currently, the statute requires that we use the GDP as a component of the SGR, which is then used to calculate the target level of expenditures. Although both MEI and GDP are included in the calculation of the conversion factor, the MEI has a more direct and greater impact on the physician update than GDP. Comment: Commenters believe that we continue to underestimate the impact of National and Local Coverage Decisions on physician spending. Through these coverage decisions, we are directly responsible for volume increases, and must adjust the SGR target accordingly. Response: We do not have the authority to pay for a service lacking a defined statutory benefit listed in section 1861(s) of the Act. However, we do have the authority to establish national coverage decisions (NCDs) for items and services that are included in a benefit category listed in section PO 00000 Frm 00134 Fmt 4701 Sfmt 4700 1861(s) of the Act. Further, we contract with Medicare carriers who may establish local coverage decisions (LCDs) for items and services that have a statutory benefit category. Factor 4 of the SGR (1848(f)(2)(D)) requires us to estimate expenditures ‘‘which will result from changes in law and regulations.’’ NCDs are not required to be issued by regulation, and we are not aware of any NCDs that have been issued via regulation. Although coverage decisions that reduce the coverage available for certain items and services must be published in the Federal Register, they are published as notices. Furthermore, as indicated above, LCDs are issued by contractors and are not binding on CMS or other contractors. As a result, it is unclear that we have the authority to consider NCDs or LCDs in our estimate of factor 4 of the SGR. Furthermore, while we may establish a national coveragae decision (NCD) for a new item of service with a defined statutory benefit category, the NCD does not necessarily increase Medicare spending to the extent that the service has or would have been covered at local carrier dicretion in the absence of a NCD. Because Medicare might cover these services without an NCD, it is unclear whether there are any additional costs associated with the NCDs. At this time, we do not intend to make any adjustment to the SGR to account for new NCDs. We continue to examine the issue, but we expect that NCDs have, at most, limited impact on Medicare spending for physicians’ services. (For a more detailed discussion see 70 FR 70308). Comment: Commenters stated that additional funds need to be added to the SGR allowed expenditures for all the ancillary costs associated with new benefits. New benefits adjust the target, but they generate other services whose costs are not added to the targeted allowed expenditures. For example, the new AAA ultrasound benefit may reveal health problems that will generate additional visits, tests, and other services that are not reflected in the SGR’s legislative factor. Response: Section 1848(f)(2) of the Act specifies that the SGR for a year (beginning with 2001) is equal to the product of four factors. One of these factors is the estimated change in expenditures due to changes in statute or regulations. For 2007, this factor includes the AAA ultrasound referenced by commenters. Our estimate of changes in expenditures arising from changes in law and regulations include induced spending impacts, when applicable and material. Our estimate of the additional E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations expenditures associated with this new benefit, like all of the figures used to determine the 2007 SGR, is an estimate that will be revised based on subsequent data. A 2-year look back window allows adjustments to the estimates to reflect actual impacts. Any differences between these estimates and the actual measurement of these figures will be included in future revisions of the SGR and allowed expenditures and incorporated into subsequent PFS updates. (See further discussion below for all the new benefits that adjusted the legislative factor in 2005, 2006, and 2007.) Comment: Commenters suggested that CMS compliance programs, such as HIPAA, increased overhead expenses by 15 to 20 percent, but their costs are not included in SGR allowed expenditures. Response: The statute provides the Secretary with clear authority to specify the services that are included in the SGR. Section 1848(f)(4)(A) of the Act indicates that the term ‘‘physicians’’ services’’ includes other items and services specified by the Secretary that are commonly performed or furnished by a physician or in a physician’s office. 69757 Overhead costs attributable to compliance programs do not meet the definition of physicians’ services for determining SGR allowed expenditures. C. Preliminary Estimate of the SGR for 2007 Our preliminary estimate of the 2007 SGR is 1.8 percent. We first estimated the 2007 SGR in March and made the estimate available to the MedPAC and on our Web site. Table 22 shows that March 2006 estimate and our current estimates of the factors included in the 2007 SGR. TABLE 22.—2007 SGR CALCULATION Statutory factors March estimate Current estimate Fees .................................................................... Enrollment .......................................................... Real Per Capita GDP ......................................... Law and Regulation ........................................... 2.6 percent (1.026) .......................................... ¥2.9 percent (0.971) ....................................... 2.2 percent (1.022) .......................................... ¥1.0 percent (0.990) ....................................... 2.2 percent (1.022). ¥0.9 percent (0.991). 2.0 percent (1.020). ¥1.5 percent (0.985). Total ............................................................ 0.7 percent (1.007) .......................................... 1.80 percent (1.018). Note: Consistent with section 1848(f)(2) of the Act, the statutory factors are multiplied, not added, to produce the total (that is, 1.022 × 0.991 × 1.020 × 0.985 = 1.018). A more detailed explanation of each figure is provided in section VII.F.1 of this preamble. D. Revised Sustainable Growth Rate for 2006 Our current estimate of the 2006 SGR is 2.1 percent. Table 23 shows our preliminary estimate of the 2006 SGR that was published in the CY 2006 Final Rule (70 FR 70309) and our current estimate. TABLE 23.—2006 SGR CALCULATION Statutory factors Estimate from CY 2006 final rule Fees .................................................................... Enrollment .......................................................... Real Per Capita GDP ......................................... Law and Regulation ........................................... 2.7 percent (1.027) .......................................... ¥3.1 percent (0.969) ....................................... 2.2 percent (1.022) .......................................... 0.0 percent (1.000) .......................................... 2.2 percent (1.022). ¥2.2 percent (0.978). 2.1 percent (1.021). 0.0 percent (1.000). Total ............................................................ 1.7 percent (1.017) .......................................... 2.1 percent (1.021). A more detailed explanation of each figure is provided in section VII.F.2 of this preamble. Current estimate E. Final Sustainable Growth Rate for 2005 The SGR for 2005 is 4.2 percent. Table 24 shows our preliminary estimate of the 2005 SGR from the CY 2005 PFS final rule with comment period (69 FR 66386), our revised estimate from the CY 2006 PFS final rule with comment period (70 FR 70309) and the final figures determined using the best available data as of September 1, 2006. TABLE 24.—2005 SGR CALCULATION Estimate from CY 2005 final rule Fees ............................................... Enrollment ...................................... Real Per Capita GDP .................... Law and Reg ................................. 1.3 percent (1.013) ....................... ¥0.3 percent (0.997) ................... 2.2 percent (1.022) ....................... 1.0 percent (1.010) ....................... 0.8 0.3 2.2 1.2 Total ........................................ rmajette on PROD1PC67 with RULES2 Statutory factors 4.3 percent (1.043) ....................... 4.6 percent (1.046) ....................... VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00135 Fmt 4701 Estimate from CY 2006 final rule percent percent percent percent Sfmt 4700 (1.008) (1.003) (1.022) (1.010) ....................... ....................... ....................... ....................... E:\FR\FM\01DER2.SGM Final 0.8 0.3 2.1 0.9 percent percent percent percent (1.008). (1.003). (1.021). (1.009). 4.2 percent (1.042). 01DER2 69758 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations A more detailed explanation of each figure is provided in section VII.F.3. F. Calculation of 2007, 2006, and 2005 Sustainable Growth Rates 1. Detail on the 2007 SGR All of the figures used to determine the 2007 SGR are estimates that will be revised based on subsequent data. Any differences between these estimates and the actual measurement of these figures will be included in future revisions of the SGR and allowed expenditures and incorporated into subsequent PFS updates. • Factor 1—Changes in Fees for Physicians’ Services (Before Applying Legislative Adjustments) for 2007 This factor is calculated as a weighted-average of the 2007 fee increases for the different types of services included in the definition of physicians’ services for the SGR. Medical and other health services paid using the PFS are estimated to account for approximately 81.4 percent of total allowed charges included in the SGR in 2007 and are updated using the MEI. The MEI for 2007 is 2.1 percent. Diagnostic laboratory tests are estimated to represent approximately 7.5 percent of Medicare allowed charges included in the SGR for 2007. Medicare payments for these tests are updated by the Consumer Price Index for Urban Areas (CPI–U). However, section 629 of the MMA specifies that diagnostic laboratory services will receive an update of 0.0 percent from 2004 through 2008. Drugs are estimated to represent 11.1 percent of Medicare allowed charges included in the SGR in 2007. We estimated a weighted-average change in fees for drugs included in the SGR (using the ASP+6 percent pricing methodology) of 4.0 percent for 2007. Table 25 shows the weighted-average of the MEI, laboratory and drug price changes for 2007. TABLE 25 Weight Physician .......... Laboratory ......... 0.814 0.075 TABLE 25—Continued Weight Drugs ................ Weighted-average ................ Update 0.111 4.0 1.000 2.2 We estimate that the weighted-average increase in fees for physicians’ services in 2007 under the SGR (before applying any legislative adjustments) will be 2.2 percent. • Factor 2—The Percentage Change in the Average Number of Part B Enrollees from 2006 to 2007 This factor is our estimate of the percent change in the average number of fee-for-service enrollees from 2006 to 2007. Services provided to Medicare Advantage (MA) plan enrollees are outside the scope of the SGR and are excluded from this estimate. OACT estimates that the average number of Medicare Part B fee-for-service enrollees Update will decrease by 0.9 percent from 2006 2.1 to 2007. Table 26 illustrates how this 0.0 figure was determined. TABLE 26 2006 2007 40.136 million ................................................... 6.369 million ..................................................... 33.768 million ................................................... ........................................................................... 40.735 million 7.265 million 33.470 million ¥0.9 percent An important factor affecting fee-forservice enrollment is beneficiary enrollment in MA plans. Because it is difficult to estimate the size of the MA enrollee population before the start of a CY, at this time we do not know how actual enrollment in MA plans will compare to current estimates. For this reason, the estimate may change substantially as actual Medicare fee-forservice enrollment for 2007 becomes known. rmajette on PROD1PC67 with RULES2 Overall ............................................................... Medicare Advantage (MA) ................................. Net ..................................................................... Percent Increase ............................................... • Factor 4—Percentage Change in Expenditures for Physicians’ Services Resulting From Changes in Statute or Regulations in 2007 Compared With 2006 The statutory and regulatory provisions that will affect expenditures in CY 2007 relative to CY 2006 are estimated to have an impact on expenditures of ¥1.5 percent. These provisions include the expiration of the work GPCI floor and DRA provisions adding the AAA ultrasound test to the Welcome to Medicare visit as a preventive benefit, and reducing payments for imaging services, which are discussed elsewhere in this final rule with comment. increases that apply for the different types of services included in the definition of physicians’ services for the SGR. We estimate that services paid using the PFS account for approximately 83.2 percent of total allowed charges included in the SGR in 2006. These services were updated using the 2006 MEI of 2.8 percent. We estimate that diagnostic laboratory tests represent approximately 7.1 percent of total allowed charges included in the SGR in 2006. Medicare payments for these tests are updated by the CPI–U. However, section 629 of the MMA specifies that diagnostic laboratory services will receive an update of 0.0 percent from 2004 through 2008. We estimate that drugs represent 9.7 percent of Medicare-allowed charges included in the SGR in 2006. Sections 303 and 304 of the MMA require Medicare to pay for most drugs at 106 percent of ASP beginning January 1, 2005. We now estimate a weightedaverage change in fees for drugs included in the SGR of ¥1.7 percent for 2006. The estimated weighted-average • Factor 3—Estimated Real Gross Domestic Product Per Capita Growth in 2007 We estimate that the growth in real GDP per capita from 2006 to 2007 will be 2.0 percent (based on the 10-year average GDP over the 10 years of 1998– 2007). Our past experience indicates that there have also been changes in estimates of real per capita GDP growth made before the year begins and the actual change in GDP computed after the year is complete. Thus, it is possible that this figure will change as actual information on economic performance becomes available to us in 2007. VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 2. Detail on the 2006 SGR A more detailed discussion of our revised estimates of the four elements of the 2006 SGR follows. • Factor 1—Changes in Fees for Physicians’ Services (Before Applying Legislative Adjustments) for 2006 This factor was calculated as a weighted-average of the 2006 fee PO 00000 Frm 00136 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations change in the CY 2006 PFS final rule was 4.1 percent. The decline in the estimate is due to the availability of some actual data. Table 27 shows the weighted-average of the MEI, laboratory and drug price changes for 2006. TABLE 27 Weight Physician .......... Laboratory ......... 0.832 0.071 estimate of this factor in the CY 2005 PFS final rule was 2.7 percent. TABLE 27—Continued Weight Update 0.097 ¥1.7 1.000 Drugs ................ Weighted-average ................ 69759 • Factor 2—The Percentage Change in the Average Number of Part B Enrollees from 2005 to 2006 2.2 After taking into account the elements described in Table 27, we estimate that the weighted-average increase in fees for Update physicians’ services in 2006 under the 2.8 SGR (before applying any legislative 0.0 adjustments) will be 2.2 percent. Our OACT estimates that the average number of Medicare Part B fee-forservice enrollees (excluding beneficiaries enrolled in M+C plans) decreased by 2.2 percent in 2006. Table 28 illustrates how we determined this figure. TABLE 28 2005 Overall .................................................................................................................................................. Medicare+Choice ................................................................................................................................. Net ........................................................................................................................................................ Percent Increase .................................................................................................................................. OACT’s estimate of the ¥2.2 percent change in the number of fee-for-service enrollees, net of M+C enrollment for 2006 compared to 2005, is greater than our original estimate of ¥3.1 percent in the CY 2006 PFS final rule (70 FR 70310). While our current projection based on data from 8 months of 2006 is greater than our original estimate of ¥3.1 percent when we had no actual data, it is still possible that our final estimate of this figure will be different once we have complete information on 2006 fee-for-service enrollment. rmajette on PROD1PC67 with RULES2 • Factor 3—Estimated Real Gross Domestic Product Per Capita Growth in 2006 We estimate that the growth in real GDP per capita will be 2.1 percent for 2006 (based on the 10-year average GDP over the 10 years of 1997–2006). Our past experience indicates that there have also been differences between our estimates of real per capita GDP growth made prior to the year’s end and the actual change in this factor. Thus, it is possible that this figure will change further as complete actual information on 2006 economic performance becomes available to us in 2007. • Factor 4—Percentage Change in Expenditures for Physicians’ Services Resulting From Changes in Statute or Regulations in 2006 Compared With 2005 The statutory and regulatory provisions that affect expenditures in CY 2006 relative to CY 2005 are estimated to have a net impact on expenditures of less than 0.05. These provisions include the expiration of the temporary higher payments to physicians in Alaska, the new power VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 wheelchair code for physicians, and the impact of the new IVIG service. 3. Detail On the 2005 SGR A more detailed discussion of our final revised estimates of the four elements of the 2005 SGR follows. • Factor 1—Changes in Fees for Physicians’ Services (Before Applying Legislative Adjustments) for 2005 This factor was calculated as a weighted-average of the 2005 fee increases that apply for the different types of services included in the definition of physicians’ services for the SGR. Services paid using the PFS accounted for approximately 84.2 percent of total Medicare-allowed charges included in the SGR for 2005 and are updated using the MEI. The MEI for 2005 was 3.1 percent. Diagnostic laboratory tests represented approximately 7.0 percent of total 2005 Medicare-allowed charges included in the SGR and are updated by the CPI–U. However, section 629 of the MMA specifies that diagnostic laboratory services will receive an update of 0.0 percent from 2004 through 2008. Drugs represented approximately 8.8 percent of total Medicare-allowed charges included in the SGR for 2005. Historically, Medicare paid for drugs under section 1842(o) of the Act at 95 percent of the AWP. However, with some exceptions, in 2004 sections 303 and 304 of the MMA generally required Medicare to pay for drugs at 85 percent of the AWP determined as of April 1, 2003, or a specified percentage of AWP based on studies by the Government Accountability Office and the OIG. We implemented section 303 and 304 of the PO 00000 Frm 00137 Fmt 4701 Sfmt 4700 2006 39.601 million .......... 5.084 million ............ 34.518 million .......... ................................. 40.136 million. 6.369 million. 33.768 million. ¥2.2 percent. MMA in an interim final rule making changes to the PFS for 2004, which appeared in the Federal Register on January 7, 2004 (69 FR 1086). Beginning on January 1, 2005, sections 303 and 304 of the MMA require Medicare to pay for most drugs at 106 percent of the ASP. Taking into account sections 303 and 304 of the MMA, we estimate a weighted-average change in fees for drugs included in the SGR of ¥21.0 percent for 2005. Table 29 shows the weighted-average of the MEI, laboratory, and drug price increases for 2005. TABLE 29 Weight Physician .......... Laboratory ......... Drugs ................ Weighted-average ................ Update 0.842 0.070 0.088 3.1 0.0 ¥21.0 1.000 0.8 After taking into account the elements described in Table 29, we estimate that the weighted-average increase in fees for physicians’ services in 2005 under the SGR (before applying any legislative adjustments) was 0.8 percent. This figure is a final one based on complete data for 2005. • Factor 2—The Percentage Change in the Average Number of Part B Enrollees from 2004 to 2005 We estimate the increase in the number of fee-for-service enrollees (excluding beneficiaries enrolled in M+C plans) from 2004 to 2005 was 0.3 percent. Our calculation of this factor is based on complete data from 2005. Table 30 illustrates the calculation of this factor. E:\FR\FM\01DER2.SGM 01DER2 69760 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations TABLE 30 2004 Overall .............. Medicare +Choice ............ Net .................... Percent Increase 39.099 million 4.683 million 34.416 million .................... of the MMA improved the procedures for paying the 10 percent PFS bonus 2005 payment for services provided in health professional shortage areas (HPSAs). 39.601 Taken together, all of the statutory million provisions for 2005, increased Medicare 5.084 spending for physicians’ services by 0.9 million percent. 34.518 million 0.3 percent • Factor 3—Estimated Real Gross Domestic Product Per Capita Growth in 2005 We estimate that the growth in real per capita GDP was 2.1 percent in 2005 (based on the 10-year average GDP over the 10 years of 1996–2005). This figure is a final one based on complete data for 2005. • Factor 4—Percentage Change in Expenditures for Physicians’ Services Resulting From Changes in Statute or Regulations in 2005 Compared With 2004 There are a number of statutory provisions that affected the 2005 SGR. Sections 303 and 304 of the MMA changed Medicare payment for drugs. These provisions also changed Medicare payments for the administration of drugs. Section 303(a)(1) of the MMA amended section 1848(c)(2) of the Act to require the Secretary to make a number of changes that increased Medicare payment for drug administration beginning January 1, 2004. Section 303(a)(4) of the MMA required an additional transitional adjustment (temporary increase) to Medicare’s payment for drug administration of 32 percent for 2004 and 3 percent for 2005. We also adopted changes to the codes and payment amounts for drug administration based on recommendations from the AMA’s CPT Editorial Panel and Relative Value Update Committee (RUC), under the authority of section 1848(c)(2)(J) of the Act. We further increased PFS payments by paying separately for injections provided on the same day as another PFS service. Section 413(a) of the MMA established a 5 percent increase in the PFS payment for services provided in physician scarcity areas. Section 413(b) IX. Anesthesia and Physician Fee Schedule Conversion Factors for CY 2007 The 2007 PFS CF will be $35.9848. The 2007 national average anesthesia CF is $15.3328. Both CFs will be subject to a separate, independent BN adjustor, as described below. A. Physician Fee Schedule Conversion Factor Under section 1848(d)(1)(A) of the Act, the PFS CF is equal to the CF for the previous year multiplied by the update determined under section 1848(d)(4) of the Act. We illustrate the calculation for the 2007 PFS CF in Table 31. TABLE 31 2006 Conversion Factor. 2007 Update .............. 2007 Conversion Factor. $37.8975 ¥5.0 percent (0.94953) $35.9848 Section 1848(c)(2)(B)(ii)(II) of the Act requires that increases or decreases in RVUs for a year may not cause the amount of expenditures for the year to differ by more than $20 million from what expenditures would have been in the absence of these changes. If this threshold is exceeded, we must make adjustments to preserve BN. The 5-Year Review of work RVUs would result in a change in expenditures that would exceed $20 million if we made no offsetting adjustments to either the CF or RVUs. As discussed in section IV.D of this final rule with comment period, we are applying the following BN adjustor to the work RVUs in order to calculate payment for a service: 2007 Work Adjustor: 10.1 percent (0.8994) Payment for services under the PFS will now be calculated as follows: Payment = [(RVU work x BN adjustor x GPCI work) + (RVU PE x GPCI PE) + (RVU malpractice x GPCI malpractice)] x CF.) B. Anesthesia Fee Schedule Conversion Factor Anesthesia services do not have RVUs like other PFS services. Therefore, we account for any necessary RVU adjustments through an adjustment to the anesthesia fee schedule CF to simulate changes to RVUs. We modeled the resource-based PE methodology using imputed anesthesia RVUs that were made comparable to other PFS services. The adjustment factor in Table 32 includes the combined effect of the PE adjustment and the BN adjustment. We used the following figures to determine the anesthesia fee schedule CF as shown in Table 32. TABLE 32 2006 Anesthesia Conversion Factor. 2007 Update .............. 2007 Combined Adjustment PE and BN. 2007 Anesthesia Conversion Factor. $17.7663 ¥5.0 percent (0.94953) 0.9089 $15.3328 X. Telehealth Originating Site Facility Fee Payment Amount Update Section 1834(m) of the Act establishes the payment amount for the Medicare telehealth originating site facility fee for telehealth services provided from October 1, 2001 through December 31 2002, at $20. For telehealth services provided on or after January 1 of each subsequent calendar year, the telehealth originating site facility fee is increased by the percentage increase in the MEI as defined in section 1842(i)(3) of the Act. The MEI increase for 2007 is 2.1 percent. Therefore, for CY 2007, the payment amount for HCPCS code ‘‘Q3014, telehealth originating site facility fee’’ is 80 percent of the lesser of the actual charge or $22.94. The Medicare telehealth originating site facility fee and MEI increase by the applicable time period are shown in Table 33. rmajette on PROD1PC67 with RULES2 TABLE 33 MEI increase (percent) Facility Fee $20.00 ..................................................................................................................................................... 20.60 ....................................................................................................................................................... 21.20 ....................................................................................................................................................... VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00138 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM N/A 3.0 2.9 01DER2 Period 10/01/2001–12/31/2002. 01/01/2003–12/31/2003. 01/01/2004–12/31/2004. Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69761 TABLE 33—Continued MEI increase (percent) Facility Fee 21.86 ....................................................................................................................................................... 22.47 ....................................................................................................................................................... 22.94 ....................................................................................................................................................... rmajette on PROD1PC67 with RULES2 XI. Provisions of the Final Rule The provisions of this final rule with comment restate the provisions of the CY 2007 PFS proposed rule, except as noted elsewhere in the preamble. XII. Waiver of Proposed Rulemaking and Delay in Effective Date We ordinarily publish a notice of proposed rulemaking in the Federal Register and invite public comment on the proposed rule. The notice of proposed rulemaking includes a reference to the legal authority under which the rule is proposed, and the terms and substances of the proposed rule or a description of the subjects and issues involved. This procedure can be waived, however, if an agency finds good cause that a notice-and-comment procedure is impracticable, unnecessary, or contrary to the public interest and incorporates a statement of the finding and its reasons in the rule issued. As discussed in sections IV. and V. of this final rule, we utilize HCPCS codes for Medicare payment purposes. The HCPCS is a national drug coding system comprised of Level I (CPT) codes and Level II (HCPCS National Codes) that are intended to provide uniformity to coding procedures, services, and supplies across all types of medical providers and suppliers. Level I (CPT) codes are copyrighted by the AMA and consist of several categories, including Category I codes which are 5-digit numeric codes, and Category III codes which are temporary codes to track emerging technology, services and procedures. The AMA issues an annual update of the CPT code set each Fall, with January 1 as the effective date for implementing the updated CPT codes. The HCPCS, including both Level I and Level II codes, is similarly updated annually on a CY basis. Annual coding changes are not available to the public until the Fall immediately preceding the annual January update of the PFS. Because of the timing of the release of these new codes, it is impracticable for CMS to provide prior notice and solicit comment on these codes and the RVUs assigned to them in advance of publication of the final rule that VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 implements the PFS. Yet, it is imperative that these coding changes be accounted for and recognized timely under the PFS for payment because services represented by these codes will be provided to Medicare beneficiaries by physicians during the CY in which they become effective. Moreover, regulations implementing HIPAA (42 CFR parts 160 and 162) require that the HCPCS be used to report health care services, including services paid under the PFS. We also assign interim RVUs to any new codes based on a review of the RUC recommendations for valuing these services. By reviewing these RUC recommendations for the new codes, we are able to assign RVUs to services based on input from the medical community and to establish payment for them, on an interim basis, that corresponds to the relative resources associated with providing the services. If we did not assign RVUs to new codes on an interim basis, the alternative would be to either not pay for these services during the initial CY or have each carrier establish a payment rate for these new codes. We believe both of these alternatives are contrary to the public interest, particularly since the RUC process allows for an assessment of the valuation of these services by the medical community prior to our establishing payment for these codes on an interim basis. Therefore, we believe it would be contrary to the public interest to delay establishment of fee schedule payment amounts for these codes. For the reasons outlined above in this section, we find good cause to waive the notice of proposed rulemaking for the interim RVUs for selected procedure codes identified in Addendum C and to establish RVUs for these codes on an interim final basis. We are providing a 60-day public comment period. In addition, we ordinarily publish a notice of proposed rulemaking in the Federal Register and provide a period for public comment before we make final the provisions of the notice. We can waive this procedure, however, if we find good cause that notice-andcomment procedure is impracticable, unnecessary, or contrary to the public interest and we incorporate a statement PO 00000 Frm 00139 Fmt 4701 Sfmt 4700 3.1 2.8 2.1 Period 01/01/2005–12/31/2005. 01/01/2006–12/31/2006. 01/01/2007–12/31/2007. of finding and its reasons in the notice issued. We find it unnecessary to undertake notice and comment rulemaking in this instance for the ambulance inflation factor because the law specifies the method of computation of annual updates, and we have no discretion in this matter. Further, we are merely applying the update method specified in statute and regulation. Therefore, under 5 U.S.C. 553(b)(B), for good cause, we waive notice and comment procedures for this ambulance inflation factor update. XIII. Collection of Information Requirements Under the Paperwork Reduction Act of 1995, we are required to provide 30day notice in the Federal Register and solicit public comment before a collection of information requirement is submitted to the OMB for review and approval. In order to fairly evaluate whether an information collection should be approved by OMB, section 3506(c)(2)(A) of the Paperwork Reduction Act of 1995 requires that we solicit comment on the following issues: • The need for the information collection and its usefulness in carrying out the proper functions of our agency. • The accuracy of our estimate of the information collection burden. • The quality, utility, and clarity of the information to be collected. • Recommendations to minimize the information collection burden on the affected public, including automated collection techniques. We solicited public comment on each of these issues for the following sections of this document that contain information collection requirements: Section 410.33 Independent Diagnostic Testing Facility Section 410.33(e)(1) imposes a recordkeeping requirement on multiState entities. Specifically, an independent diagnostic testing facility (IDTF) that operates across State boundaries must maintain documentation that its supervising physicians and technicians are licensed and certified in each of the States in which it operates. The burden associated with this requirement is the E:\FR\FM\01DER2.SGM 01DER2 69762 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations time and effort it takes the IDTF to collect and maintain the aforementioned information. While subject to the PRA, we believe this information collection requirement is exempt as defined in 5 CFR 1320.3(b)(2), because the time, effort, and financial resources necessary to comply with the requirement would be incurred by persons in the normal course of their activities (for example, in compiling and maintaining business records) and is considered to be usual and customary. Section 410.33(g) discusses the application certification standards that an IDTF must meet. An IDTF must complete an enrollment application and certify the information contained in the application. The certification is part of an application that is subject to the PRA. The burden associated with this requirement is the time and effort necessary to complete the application. This requirement is currently approved in OMB No. 0938–0685, with a current expiration date of April 30, 2009. rmajette on PROD1PC67 with RULES2 Payment for Covered Outpatient Drugs and Biologicals (ASP Issues) Section II.F.1 of the preamble provides background information pertaining to the use of average sales price (ASP) as the basis for our drug payment methodology. In accordance with section 1857 of the Act, Medicare Part B covered drugs and biologicals not paid on a cost of prospective payment basis are paid based on the ASP. The ASP data reporting requirements are outlined in section 1927(b) of the Act, and were implemented in the interim final rule with comment period that published on April 6, 2004 (69 FR 17935). The collection of ASP data imposes a reporting requirement on the public. The burden associated with this requirement is the time and effort required by manufacturers of Medicare Part B drugs and biologicals to calculate, record, and submit the required data to CMS. While this requirement is subject to the PRA, it is currently approved under OMB control number 0938–0921, with an expiration date of May 31, 2009. As required by section 3504(h) of the Paperwork Reduction Act of 1995, we have submitted a copy of this document to the OMB for its review of these information collection requirements. XIV. Response to Comments Because of the large number of public comments we normally receive on Federal Register documents, we are not able to acknowledge or respond to them individually. We will consider all comments we receive by the date and VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 time specified in the ‘‘DATES’’ section of this preamble, and, when we proceed with a subsequent document, we will respond to the comments in the preamble to that document. XV. Regulatory Impact Analysis We have examined the impact of this rule as required by Executive Order 12866 (September 1993, Regulatory Planning and Review), the Regulatory Flexibility Act (RFA) (September 19, 1980 Pub. L. 96–354), section 1102(b) of the Social Security Act, the Unfunded Mandates Reform Act of 1995 (Pub. L. 104–4), and Executive Order 13132. Executive Order 12866 (as amended by Executive Order 13258, which merely reassigns responsibilities of duties) directs agencies to assess all costs and benefits of available regulatory alternatives and, when regulation is necessary, to select regulatory approaches that maximize net benefits (including potential economic, environmental, public health and safety effects, distributive impacts, and equity). A regulatory impact analysis must be prepared for final rules with economically significant effects (that is, a final rule that would have an annual effect on the economy of $100 million or more in any one year, or would adversely affect in a material way the economy, a sector of the economy, productivity, competition, jobs, the environment, public health or safety, or State, local, or tribal governments or communities). As indicated in more detail below in this section, we estimate that the PFS provisions included in this final rule with comment period will redistribute more than $100 million in 1 year. We are considering this final rule with comment period to be economically significant because its provisions are estimated to result in an increase, decrease or aggregate redistribution of Medicare spending that will exceed $100 million. Therefore, this final rule with comment period is a major rule and we have prepared a regulatory impact analysis. The RFA requires that we analyze regulatory options for small businesses and other entities. We prepare a regulatory flexibility analysis unless we certify that a rule would not have a significant economic impact on a substantial number of small entities. The analysis must include a justification concerning the reason action is being taken, the kinds and number of small entities the rule affects, and an explanation of any meaningful options that achieve the objectives with less significant adverse economic impact on the small entities. PO 00000 Frm 00140 Fmt 4701 Sfmt 4700 Section 1102(b) of the Act requires us to prepare a regulatory impact analysis for any final rule that may have a significant impact on the operations of a substantial number of small rural hospitals. This analysis must conform to the provisions of section 604 of the RFA. For purposes of section 1102(b) of the Act, we define a small rural hospital as a hospital that is located outside a Metropolitan Statistical Area and has fewer than 100 beds. We have determined that this final rule with comment period would have minimal impact on small hospitals located in rural areas. Of the 201 hospital-based ESRD facilities located in rural areas, only 40 are affiliated with hospitals with fewer than 100 beds. For purposes of the RFA, physicians, NPPs, and suppliers are considered small businesses if they generate revenues of $6 million or less. Approximately 95 percent of physicians are considered to be small entities. There are about 980,000 physicians, other practitioners and medical suppliers that receive Medicare payment under the PFS. For purposes of the RFA, approximately 80 percent of clinical diagnostic laboratories are considered small businesses according to the Small Business Administration’s size standards. In addition, most ESRD facilities are considered small entities, either based on nonprofit status or by having revenues of $29 million or less in any year. We consider a substantial number of entities to be affected if the final rule is estimated to impact more than 5 percent of the total number of small entities. Based on our analysis of the 932 nonprofit ESRD facilities considered small entities in accordance with the above definitions, we estimate that the combined impact of the changes to payment for renal dialysis services included in this final rule with comment period would have a 0.8 percent increase in overall payments relative to current overall payments. IDTFs are suppliers under the Medicare program. For purposes of the RFA, suppliers with annual sales of $6 million or less are considered to be small entities. (Individuals and States are not included in the definition of a small entity.) We believe that our standards for IDTFs will help bar fraudulent suppliers from participating in the Medicare program and provide an added level of protection to Medicare beneficiaries. Therefore, we expect to have an impact on an unknown number of persons and entities who will effectively be prevented from practicing their aberrant billing activities. The vast E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations rmajette on PROD1PC67 with RULES2 majority of suppliers would not be significantly affected by this final rule with comment period. The reduction in program overpayments and the added level of protection to beneficiaries that we expect to achieve as a result of this final rule with comment period justifies the relatively small burden this final rule with comment period would impose on all small entities. Ambulance providers and suppliers for purposes of the RFA are also considered to be small entities. While we expect the initial change in geographic designations to have little, if any, overall effect on ambulance payments, application of the ambulance inflation factor (AIF) will result in an increase in payment rates for all ambulance services furnished by all types of ambulance providers. The analysis and discussion provided in this section, as well as elsewhere in this final rule with comment period, complies with the RFA requirements. Section 202 of the Unfunded Mandates Reform Act of 1995 also requires that agencies assess anticipated costs and benefits before issuing any rule that may result in expenditures in any year by State, local, or tribal governments, in the aggregate, or by the private sector, of $120 million. Medicare beneficiaries are considered to be part of the private sector for this purpose. We have examined this final rule with comment period in accordance with Executive Order 13132 and have determined that this regulation would not have any significant impact on the rights, roles, or responsibilities of State, local, or tribal governments. A discussion concerning the impact of this rule on beneficiaries is found later in this section. We have prepared the following analysis, which, together with the information provided in the rest of this preamble, meets all assessment requirements. The analysis explains the rationale for and purposes of this final rule with comment period; details the costs and benefits of the rule; analyzes alternatives; and presents the measures we proposed to use to minimize the burden on small entities. As indicated elsewhere in this final rule with comment period, we proposed to change VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 our methodology for calculating resource-based PE RVUs and make a variety of other changes to our regulations, payments, or payment policies to ensure that our payment systems reflect changes in medical practice and the relative value of services. We provide information for each of the policy changes in the relevant sections of this final rule with comment period. We are unaware of any relevant Federal rules that duplicate, overlap or conflict with this final rule with comment period. The relevant sections of this final rule with comment period contain a description of significant alternatives if applicable. A. RVU Impacts 1. Resource-Based Work and PE RVUs Section 1848(c)(2)(B)(ii) of the Act requires that increases or decreases in RVUs may not cause the amount of expenditures for the year to differ by more than $20 million from what expenditures would have been in the absence of these changes. If this threshold is exceeded, we make adjustments to preserve BN. This year, the estimated $4 billion impact of changes in work RVUs resulting from the 5-Year Review require that a budgetneutrality adjustment be made. As discussed in the June 29, 2006 proposed notice, we proposed making the statutorily required BN adjustment to account for the 5-Year Review of physician work by reducing all work RVUs. We estimated that all work RVUs would have to be reduced by 10 percent under this option. As discussed in section IV.D.1 of this final rule with comment period, we carefully reviewed the comments received concerning this issue, and to meet the BN provisions of section 1848(c)(2)(B)(ii)(II) of the Act, we are applying a BN adjustor of 0.8994 or ¥10.1 percent to the work RVUs. Table 34 shows the specialty-level impact of the work and PE RVU changes. Our estimates of changes in Medicare revenues for PFS services compare payment rates for CY 2006 with proposed payment rates for CY 2007 using CY 2005 Medicare utilization for all years. We are using CY 2005 Medicare claims processed and paid PO 00000 Frm 00141 Fmt 4701 Sfmt 4700 69763 through March 30, 2005, that we estimate are 98 percent complete. To the extent that there are year-to-year changes in the volume and mix of services provided by physicians, the actual impact on total Medicare revenues will be different than those shown in Table 34. The payment impacts reflect averages for each specialty based on Medicare utilization. The payment impact for an individual physician would be different from the average, based on the mix of services the physician provides. The average change in total revenues would be less than the impact displayed here because physicians furnish services to both Medicare and non-Medicare patients and specialties may receive substantial Medicare revenues for services that are not paid under the PFS. For instance, independent laboratories receive approximately 80 percent of their Medicare revenues from clinical laboratory services that are not paid under the PFS. Table 34 shows only the payment impact on PFS services. The following is an explanation of the information represented in Table 34. Note that this table does include the impact of the CY 2007 update. • Specialty: The physician specialty or type of practitioner/supplier. • Allowed Charges: Allowed charges are the Medicare Fee Schedule amounts for covered services and include copayments and deductibles (which are the financial responsibility of the beneficiary). These amounts have been summed across all services provided by physicians, practitioners, or suppliers with a specialty to arrive at the total allowed charges for the specialty. • Impact of Work RVU Changes from the five year review of work • Impact of PE RVU changes. The impact is shown for both 2007, which is the first year of the four year transition using the new methodology, and 2010, which is the year in which the methodology is fully implemented. • Combined impact of the finalized work and PE RVUs for both 2007 and 2010. BILLING CODE 4120–01–P E:\FR\FM\01DER2.SGM 01DER2 VerDate Aug<31>2005 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00142 Fmt 4701 Sfmt 4725 E:\FR\FM\01DER2.SGM 01DER2 ER01DE06.013</GPH> rmajette on PROD1PC67 with RULES2 69764 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00143 Fmt 4701 Sfmt 4725 E:\FR\FM\01DER2.SGM 01DER2 69765 ER01DE06.014</GPH> rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations BILLING CODE 4120–01–C 2. Section 5102 of the DRA Adjustments for Payments for Imaging Services As required by section 5102(a) of the DRA and described in section II.E.1. of this final rule with comment period, we are removing, from the PE RVUs under the PFS the 0.3 percent increase made to the PE RVUs in the CY 2006 PFS final rule with comment period to ensure the BN of the impact of the multiple imaging policy adopted for CY 2006. Section 5102(a) of the DRA exempts the CY 2006 and 2007 impact of the multiple imaging policy from BN. Because we proposed to maintain the current 25 percent payment reduction for multiple imaging procedures in CY 2007, there is no additional impact resulting from our policies for CY 2007. Section 5102 of the DRA also exempts the estimated savings from the application of the OPPS-based payment limitation on PFS imaging services from the PFS BN requirement. We estimate that the combined impact of the BN exemptions in section 5102 of the DRA would reduce PFS expenditures by approximately 0.9 percent in CY 2007. rmajette on PROD1PC67 with RULES2 3. Combined Impacts Table 35 shows the specialty-level impact of: The work and PE RVU changes, section 5102 of the DRA, and our most recent estimate (¥5.0 percent) of the CY 2007 Medicare PFS update. Additionally, the impacts in this final VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 rule with comment period reflect the use of updated physician time data from the AMA–RUC. Our estimates of changes in Medicare revenues for PFS services compare payment rates for CY 2006 with proposed payment rates for CY 2007 using CY 2005 Medicare utilization for all years. We are using CY 2005 Medicare claims processed and paid through March 30, 2005, that we estimate are 98 percent complete. To the extent that there are year-to-year changes in the volume and mix of services provided by physicians, the actual impact on total Medicare revenues will be different than those shown in Table 35. The payment impacts reflect averages for each specialty based on Medicare utilization. The payment impact for an individual physician would be different from the average, based on the mix of services the physician provides. The average change in total revenues would be less than the impact displayed here because physicians furnish services to both Medicare and non-Medicare patients and specialties may receive substantial Medicare revenues for services that are not paid under the PFS. For instance, independent laboratories receive approximately 80 percent of their Medicare revenues from clinical laboratory services that are not paid under the PFS. PO 00000 Frm 00144 Fmt 4701 Sfmt 4700 Table 35 shows only the payment impact on PFS services. The following is an explanation of the information represented in Table 35. • Specialty: The physician specialty or type of practitioner/supplier. • Allowed Charges: Allowed charges are the Medicare Fee Schedule amounts for covered services and include copayments and deductibles (which are the financial responsibility of the beneficiary.) These amounts have been summed across all services provided by physicians, practitioners, or suppliers with a specialty to arrive at the total allowed charges for the specialty. • Impact of Work and PE RVU Changes using the methodology finalized in this rule. • Impact of section 5102 of the DRA: The CY 2007 percentage decrease in allowed charges attributed to section 5102 of the DRA. • Combined impact of the finalized work and PE RVUs and section 5102 of the DRA. • CY 2007 Update: The percentage decrease in allowed charges attributed to the CY 2007 PFS conversion factor update (¥5.0 percent). • Combined impact with CY 2007 update: The CY 2007 percentage decrease in allowed charges attributed to the impact of the work and PE RVU changes, section 5102 of the DRA, and the CY 2007 update. BILLING CODE 4120–01–P E:\FR\FM\01DER2.SGM 01DER2 ER01DE06.015</GPH> 69766 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00145 Fmt 4701 Sfmt 4725 E:\FR\FM\01DER2.SGM 01DER2 69767 ER01DE06.016</GPH> rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations Table 36 shows the impact on total payments for selected high-volume procedures of all of the changes previously discussed. We selected these procedures because they are the most VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 commonly provided by a broad spectrum of physician specialties. There are separate columns that show the change in the facility rates and the nonfacility rates. For an explanation of PO 00000 Frm 00146 Fmt 4701 Sfmt 4700 facility and nonfacility PE refer to Addendum A of this final rule with comment period. E:\FR\FM\01DER2.SGM 01DER2 ER01DE06.017</GPH> rmajette on PROD1PC67 with RULES2 69768 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00147 Fmt 4701 Sfmt 4725 E:\FR\FM\01DER2.SGM 01DER2 69769 ER01DE06.018</GPH> rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69770 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00148 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 ER01DE06.019</GPH> rmajette on PROD1PC67 with RULES2 BILLING CODE 4120–01–C Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations B. Geographic Practice Cost Indices (GPCI)—Payment Localities As discussed in section II.B. of the preamble to this final rule with comment period, we proposed new GPCIs for 2007. In the CY 2005 PFS final rule with comment period, we published 2005 and 2006 GPCI and GAF values reflecting the 2-year phase-in of updated GPCI data. In 2007, the proposed GPCI and GAF values will reflect the removal of the 1.000 MMA floor from the physician work GPCI. The negative impact of these changes on a number of payment localities is shown in section II.B. in Table 7. C. Global Period for Remote Afterloading High Intensity Brachytherapy Procedures As discussed in section II.D.1. of this final rule with comment period, we are revising the global period for these services. We do not anticipate this change will have a significant impact on Medicare expenditures. Current brachytherapy coding allows for billing only one time for the entire physician services provided during a 90-day period. Any expected increase in the billing of brachytherapy physician services is offset by the reduction in the work RVUs. D. DRA 5112: Addition of the Ultrasound Screening for Abdominal Aortic Aneurysm to ‘‘Welcome to Medicare’’ Benefit As discussed in section II.E.3. of this final rule with comment period, section 5112 of the DRA authorizes coverage of an ultrasound screening for abdominal aortic aneurysms effective January 1, 2007, subject to certain eligibility and other limitations. We estimate that this new benefit would result in an increase in Medicare expenditures to physicians and other practitioners and suppliers of ultrasound services and related followup tests and treatment that may be required as a result of the coverage of these screening examinations. However, this is not expected to have a significant cost impact on the Medicare program because of the limited scope of the benefit. E. DRA 5113: Colorectal Screening Exemption From Part B Deductible As discussed in section II.E.4. of this final rule with comment period, beginning January 1, 2007, colorectal cancer screening services as described in section 1861(pp)(1) of the Act are no longer subject to the Part B deductible. While waiver of this deductible will be beneficial to Medicare beneficiaries, we do not anticipate that this change will have a significant cost impact on the Medicare program. F. Section 5114: Addition of Diabetes Outpatient Self-Management Training Services (DSMT) and Medical Nutrition Therapy (MNT) for the FQHC Program As discussed in section II.E.5. of this final rule with comment period, section 5114 of the DRA amended section 1861(aa)(3) the Act to add DSMT and MNT to the list of Medicare covered and reimbursed services under the Medicare FQHC benefit, effective for services provided on or after January 1, 2006. Although this statutory change has already been implemented in administrative instructions, we proposed to conform the regulations to meet the new statutory requirement. FQHCs certified as DSMT and MNT providers have been allowed to bundle the cost of those services into their FQHC payment rates. But before the enactment of the DRA, the provision of these services would not generate a separate FQHC visit payment. Effective for services furnished on or after January 1, 2006, FQHCs that are certified providers of DSMT and MNT services can receive per visit payments for covered services furnished by registered dietitians or nutrition professionals. Because there are a limited number of qualified centers for DSMT and MNT services, the increase in Medicare expenditures should be negligible. 69771 G. Payment for Covered Outpatient Drugs and Biologicals (ASP Issues) While it is difficult to quantify the impact of clarifications in ASP reporting guidelines on Medicare expenditures, we expect that the changes discussed in section II.F. of this final rule with comment period, for payment for covered outpatient drugs and biologicals, will have a minimal impact on Medicare expenditures. H. Provisions Related to Payment for Renal Dialysis Services Furnished by End State Renal Disease (ESRD) Facilities In section II.G. of this final rule with comment period, we discuss the ESRDrelated provisions. To understand the impact of the changes affecting payments to different categories of ESRD facilities, it is necessary to compare estimated payments under the current year (2006 payments) to estimated payments under the revisions to the composite rate payment system as discussed in II.G. of this final rule with comment period (2007 payments). To estimate the impact among various classes of ESRD facilities, it is imperative that the estimates of current payments and projected payments contain similar inputs. Therefore, we simulated payments only for those ESRD facilities that we are able to calculate both current 2006 payments and 2007 payments. ESRD providers were grouped into the categories based on characteristics provided in the Online Survey and Certification and Reporting (OSCAR) file and the most recent cost report data from the Healthcare Cost Report Information System (HCRIS). We also used the June 2006 update of CY 2005 National Claims History file as a basis for Medicare dialysis treatments and separately billable drugs and biologicals. Due to data limitations, we are unable to estimate current and proposed payments for 130 of the 4,669 ESRD facilities that bill for ESRD dialysis treatments. TABLE 37.—IMPACT OF CY 2007 CHANGES IN PAYMENTS TO HOSPITAL BASED AND INDEPENDENT ESRD FACILITIES [Percent change in composite rate payments to ESRD facilities (both program and beneficiaries)] rmajette on PROD1PC67 with RULES2 Number of facilities All Providers ..................................................................................................... Independent .............................................................................................. Hospital Based ......................................................................................... By Facility Size: Less than 5000 treatments ....................................................................... 5000 to 9999 treatments .......................................................................... Greater than 9999 treatments .................................................................. VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00149 Fmt 4701 Sfmt 4700 Number of dialysis treatments (in millions) Effect of changes in wage index 1 Overall effect 2 4,539 3,958 581 34.4 30.7 3.7 0.0 ¥0.1 0.4 0.5 0.5 1.0 1,628 1,756 1,155 4.6 12.9 16.9 ¥0.3 0.0 0.1 0.2 0.5 0.6 E:\FR\FM\01DER2.SGM 01DER2 69772 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations TABLE 37.—IMPACT OF CY 2007 CHANGES IN PAYMENTS TO HOSPITAL BASED AND INDEPENDENT ESRD FACILITIES— Continued [Percent change in composite rate payments to ESRD facilities (both program and beneficiaries)] Number of facilities By Type of Ownership: Profit ......................................................................................................... Nonprofit ................................................................................................... By Geographic Location: Rural ......................................................................................................... Urban ........................................................................................................ By Region: New England ............................................................................................ Middle Atlantic .......................................................................................... East North Central .................................................................................... West North Central ................................................................................... South Atlantic ........................................................................................... East South Central ................................................................................... West South Central .................................................................................. Mountain ................................................................................................... Pacific ....................................................................................................... Puerto Rico ............................................................................................... Number of dialysis treatments (in millions) Effect of changes in wage index 1 Overall effect 2 3,607 932 27.8 6.6 ¥0.1 0.3 0.4 0.8 1,217 3,322 7.0 27.4 ¥0.6 0.1 0.0 0.7 152 549 716 341 1,014 358 633 245 500 31 1.2 4.4 5.4 1.9 7.9 2.6 4.7 1.6 4.2 0.4 1.1 0.6 ¥0.5 ¥0.4 0.0 ¥1.1 ¥0.7 0.1 1.1 ¥1.6 1.6 1.1 0.1 0.1 0.5 ¥0.6 ¥0.1 0.7 1.7 ¥1.1 rmajette on PROD1PC67 with RULES2 1 This column shows the effect of wage index changes on ESRD providers. Composite rate payments computed using the current wage index are compared to composite rate payments using the CY 2007 wage index changes. 2 This column shows the percent change between CY 2007 and CY 2006 composite rate payments to ESRD facilities. The CY 2007 payments include the CY 2007 wage adjusted composite rate, and the 15.1 percent drug add-on times treatments. The CY 2006 payments to ESRD facilities includes the CY 2006 wage adjusted composite rate and the 14.5 percent drug add-on times treatments. Table 37 shows the impact of this year’s changes to CY 2007 payments to hospital-based and independent ESRD facilities. The first column of Table 37 identifies the type of ESRD provider, the second column indicates the number of ESRD facilities for each type, and the third column indicates the number of dialysis treatments. The fourth column shows the effect of CY 2007 changes to the ESRD wage index as it affects the composite rate payments to ESRD facilities. The fourth column compares aggregate ESRD wage adjusted composite rate payments in the second year of the transition (CY 2007) to aggregate ESRD wage adjusted composite rate payments in first year of the transition (CY 2006). In the second year of the transition (CY 2007), ESRD facilities receive 50 percent of the CBSA wage adjusted composite rate and 50 percent of the MSA wage adjusted composite rate. In the first year of the transition, ESRD facilities receive 25 percent of the CBSA wage adjusted composite rate and 75 percent of the MSA wage adjusted composite rate. The overall effect to all ESRD providers in aggregate is zero because the CY 2007 ESRD wage index has been multiplied by a BNF to comply with the statutory requirement that any wage index revisions be done in a manner that results in the same aggregate amount of expenditures as would have been made without any changes in the wage index. The decreases shown among census VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 regions is primarily due to reducing the wage index floor, as there were areas in these areas with wage index values below the floor. The fifth column shows the overall effect of the changes in composite rate payments to ESRD providers. The overall effect is measured as the difference between the projected CY 2007 payment with all changes in this final rule and CY 2006 payment. This payment amount is computed by multiplying the wage adjusted composite rate with the drug add-on for each provider times the number of dialysis treatments from 2005 claims. The projected CY 2007 payment is the transition year 2 wage-adjusted composite rate for each provider (with the 15.1 percent drug add-on) times dialysis treatments from CY 2005 claims. The CY 2006 current payment is the transition year 1 wage-adjusted composite rate for each provider (with the current 14.5 percent drug add-on) times dialysis treatments from CY 2005 claims. The overall impact to ESRD providers in aggregate is 0.5 percent. This increase corresponds to the 0.5 percent increase to the drug add-on. The variation seen in column 5 is due to variation in changes in the wage index (column 4). All provider types receive the same 0.5 percent increase to the drug add-on. Comment: We received a comment requesting that we update the impact table to reflect the current Puerto Rico PO 00000 Frm 00150 Fmt 4701 Sfmt 4700 ESRD provider count and treatment count. Response: The impact table shows the same provider count the commenter suggested. However, our tabulation of the 2005 claims data indicates that there are 0.4 million treatments rather than the 0.55 million treatment count furnished by the commenter. I. Private Contracts and Opt-out Provision The changes discussed in this final rule with comment period, for private contracts and the opt-out provision, are currently estimated to have no significant impact on Medicare expenditures as the number of physicians and practitioners who optout of Medicare is very small. J. Supplier Access to Claims Billed on Reassignment The reassignment provisions discussed in section II.J.2. of this final rule with comment period are amending the reassignment regulations so that employees will have the same ‘‘unrestricted access to billing records,’’ that has been afforded to independent contractors since January 1, 2005. We are simply extending this right to access one’s billing records to employees. This change should have no impact on Medicare expenditures. E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations K. Coverage of Bone Mass Measurement As discussed in section II.K. of this final rule with comment period, we discuss several revisions to § 410.31 relative to the definition of the term ‘‘Bone Mass Measurement’’ (§ 410.31(a)(2)), the conditions for coverage (§ 410.31(b)), the examples of exceptions to the standards on frequency of coverage (§ 410.31(c)(2)), and the category of individuals receiving glucocorticoid (steroid) therapy (§ 410.31(d)(3)). We also discuss the addition of a new paragraph (f) that would allow CMS, through the NCD process, to identify additional BMM systems for monitoring individuals receiving osteoporosis drug therapy and for performing confirmatory baseline measurements. We do not expect that this addition would have a significant cost impact on the Medicare program in the next several years. Based on the projected impact of the first three changes that would place greater reliance on the use of the more expensive DXA (axial skeleton) devices, we estimate that this revised benefit would result in an increase in Medicare payments for providers who use the DXA (axial skeleton) devices and a somewhat smaller decrease in payments to providers who use QCT (axial skeleton) and peripheral devices. However, we do not expect that these changes would have a significant cost impact on the Medicare program because, at present, a very small percentage of our total Medicare payments for bone mass measurements are being made to providers who use QCT or peripheral devices. In addition, we estimate that lowering the eligibility standard for coverage of individuals on steroid therapy from 7.5 mg/day to 5.0 mg/day of prednisone (the fourth change) would result in an increase in Medicare payment for testing of additional patients, but this modest lowering of the steroid standard is not expected to have a significant cost impact on the program. L. IDTF Changes The costs associated with these changes are as follows. rmajette on PROD1PC67 with RULES2 1. Liability Insurance Requirement (§ 424.57(c)(10)) We estimate that only 10 percent of IDTFs do not already have liability insurance that meets this requirement. Based on Medicare data as of June 2005, 10 percent of the total number of IDTF’s is approximately 559 suppliers. Using the previously highest estimate received ($1,800 annually), results in an approximate additional liability VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 insurance cost of $1 million annually (559 times $1,800) to the IDTF industry due to this final rule with comment period. 2. Primary Business Telephone Listed Under the Name of the Business Locally or Toll-free for Beneficiaries Requirement (§ 424.57(c)(9)) We estimate that only 1 percent of IDTFs do not already meet this requirement. Based on Medicare data as of June 2005, we determined that 1 percent of IDTFs is approximately 56 suppliers. Therefore, 56 times the approximate $600 annual cost of telephone service results in an additional cost of $33,600 annually. Total Cost = $1 million + $33,600 = approximately $1.04 million annually. M. Independent Lab Billing for TC Component of Physician Pathology Services for Hospital Patients The most current information on the number of affected hospitals and the impact on laboratories and hospitals comes from a report issued by GAO in September 2003. The GAO estimated that approximately 95 percent of the total of all Medicare hospitals on the prospective payment system, as well as CAHs sent the TC of physician pathology services to independent laboratories and the independent laboratories billed the carrier under the PFS. The GAO estimated that the median number of services sent by each hospital to outside independent laboratories was small, approximately 81 services. The GAO was unable to identify the number of laboratories billing for the TC service because a single laboratory may submit claims under multiple provider numbers. In general, the impact on the individual hospital is small; however, we do not know the impact on the individual independent laboratory. If the independent laboratories had not received payments from the carriers for these TC services for hospital patients, the GAO estimates that Medicare spending would have been $42 million less in 2001 and beneficiary cost sharing obligations for inpatient and outpatient services would have been reduced by $2 million. Based on what they learned from the hospital industry, the GAO thought that Medicare beneficiaries’ access to pathology services would not likely be affected if independent laboratories could no longer bill the carrier for these services. Hospital representatives indicated that they would likely continue to use independent PO 00000 Frm 00151 Fmt 4701 Sfmt 4700 69773 laboratories to provide TC pathology services. It is unclear if the hospitals contracting with independent laboratories would pay the laboratories at the same rates that the laboratories received by billing the Medicare carriers under the PFS. N. Public Consultation for Medicare Payment for New Outpatient Clinical Diagnostic Laboratory Tests This codification of our process for public consultation for new clinical diagnostic laboratory tests paid under the Medicare Part B clinical laboratory fee schedule does not increase or decrease payment amounts for existing clinical diagnostic laboratory tests because it does not alter our current methodology for calculating payment amounts for existing clinical diagnostic laboratory tests. For new tests, this change primarily codifies an existing process for the determination of payment amounts. Because any new laboratory tests to be gapfilled are unknown to us at the current time, we do not have any data to estimate the impact of our policy to pay for new gapfilled lab tests at the median of the local carrier amounts for all carriers rather than the lower of that amount and the local carrier amount. O. Bad Debt Payment for Services Associated With Reasonable Charge/Fee Schedules This is a clarification of a longstanding policy and, therefore, has no associated dollar impact. P. Revisions to Payment Policies Under the Ambulance Fee Schedule and the Ambulance Inflation Factor Update for CY 2007 We believe that the overall effect of adopting the CBSA-based geographic definitions, as well as the RUCAs will result in a redistribution of payments from urban to rural areas in some States and from rural to urban areas in other States; however, the RUCAs will enable rural areas with a rurality level of 4.0 or greater in all counties in all States to remain rural rather than only recognizing those rural areas in large counties per the Goldsmith Modification. We have included three tables to reflect the impact of the geographic changes. These three tables reflect the CBSA-based definitions, as well as the RUCAs. Table 38 is a Stateby-State analysis of urban and rural areas after all geographic changes have been implemented. As can be seen in this table, there is not a great deal of difference between the number of zip codes that move from rural to urban E:\FR\FM\01DER2.SGM 01DER2 69774 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations rmajette on PROD1PC67 with RULES2 (2,328—5.56 percent) and the number of zip codes that move from urban to rural (1,870—4.46 percent). There are a total of 41,888 zip codes—an average of 89.98 percent of all zip codes do not change their geographic designation. Table 39 is an analysis of all the areas to which commenters referred as specific concerns for them in response to the proposed rule. The table is arranged by State, and, within each State, by zip code area based on the information provided by the commenters (some commenters mentioned counties or townships). We translated those concerns into the appropriate zip code areas within each State. This table shows the actual RUCA rurality level of each of these zip code areas. If the area is, indeed, designated urban (a rurality level of less than 4.0), a ‘‘yes’’ is indicated in the ‘‘Urban Zip?’’ column, and the associated town or city is named in the following column as a reference point. Approximately half of the areas about which commenters were VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 specifically concerned remained rural once the RUCA rurality level was applied. The third and final table is Addendum I which shows all zip codes nationally by State and the rurality level associated with each zip code. In addition, we contend that with the use of updated geographical areas where rural areas are redesignated as urban areas, it will be more likely than not, that some level of population growth has occurred resulting in more ambulance trips overall than had occurred prior to the use of the updated geographical areas, even though these trips are paid at a lower rate per trip (areas designated as rural generally receive a higher payment per trip than areas designated as urban). In contrast, where urban areas are redesignated as rural, there will be fewer trips than were reported prior to the use of the updated geographical areas, but at higher rates. Thus, although ambulance suppliers and providers may bill fewer rural trips at the higher rate PO 00000 Frm 00152 Fmt 4701 Sfmt 4700 or more urban trips at the lower rate, we anticipate that the overall payments will remain the same. For these reasons, we estimate that this proposed rule will have no fiscal impact on the Medicare program because payments will, in effect, be redistributed. We estimate that the total program expenditure for CY 2007 for ambulance services covered by the Medicare program is approximately $4.8 billion. Application of an AIF of 4.3 percent will result in an additional total program expenditure for CY 2007 of approximately $206 million over CY 2006 expenditures. With respect to our SCT policies, while we believe ambulance suppliers and providers may now better understand the interfacility requirements and the personnel requirements for payment of SCT services, we do not expect any significant net impact on Medicare expenditures. BILLING CODE 4120–01–P E:\FR\FM\01DER2.SGM 01DER2 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00153 Fmt 4701 Sfmt 4725 E:\FR\FM\01DER2.SGM 01DER2 69775 ER01DE06.020</GPH> rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00154 Fmt 4701 Sfmt 4725 E:\FR\FM\01DER2.SGM 01DER2 ER01DE06.021</GPH> rmajette on PROD1PC67 with RULES2 69776 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00155 Fmt 4701 Sfmt 4725 E:\FR\FM\01DER2.SGM 01DER2 69777 ER01DE06.022</GPH> rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00156 Fmt 4701 Sfmt 4725 E:\FR\FM\01DER2.SGM 01DER2 ER01DE06.023</GPH> rmajette on PROD1PC67 with RULES2 69778 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00157 Fmt 4701 Sfmt 4725 E:\FR\FM\01DER2.SGM 01DER2 69779 ER01DE06.024</GPH> rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00158 Fmt 4701 Sfmt 4725 E:\FR\FM\01DER2.SGM 01DER2 ER01DE06.025</GPH> rmajette on PROD1PC67 with RULES2 69780 rmajette on PROD1PC67 with RULES2 BILLING CODE 4120–01–C R. Impact on Beneficiaries Q. Alternatives Considered This final rule with comment period contains a range of policies, including some provisions related to specific MMA provisions. The preamble provides descriptions of the statutory provisions that are addressed, identifies those policies when discretion has been exercised, presents rationale for our decisions and, where relevant, alternatives that were considered. There are a number of changes made in this final rule with comment period that would have an effect on beneficiaries. In general, we believe these changes, particularly the DRA provisions that provide for an exception to the application of the Part B deductible with respect to colorectal cancer screening tests and coverage of an ultrasound screening for the early detection of AAAs as part of the IPPE VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00159 Fmt 4701 Sfmt 4700 69781 benefit (referred to as the Welcome to Medicare benefit) will improve beneficiary access to services that are currently covered or expand the Medicare benefit package to include new services. As explained in more detail below in this section, the regulatory provisions may affect beneficiary liability in some cases. Any changes in aggregate beneficiary liability from a particular provision would be a function of the coinsurance (20 percent E:\FR\FM\01DER2.SGM 01DER2 ER01DE06.026</GPH> Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69782 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations if applicable for the particular provision after the beneficiary has met the deductible) and the effect of the aggregate cost (savings) of the provision on the calculation of the Medicare Part B premium rate (generally 25 percent of the provision’s cost or savings). To illustrate this point, as shown in Table 36, the 2006 national payment amount in the nonfacility setting for CPT code 99203 (Office/outpatient visit, new), is $97.02 which means that currently a beneficiary is responsible for 20 percent of this amount, or $19.40. Based on this final rule with comment period, the 2007 national payment amount in the nonfacility setting for CPT code 99203, as shown in Table 36, is $87.44 which means that, in 2007, the beneficiary coinsurance for this service would be $17.49. Policies discussed above in this section that do affect overall spending, such as DRA 5102 imaging provisions, would similarly impact beneficiaries’ coinsurance. S. Accounting Statement As required by OMB Circular A–4 (available at https:// www.whitehouse.gov/omb/circulars/ a004/a-4.pdf), in Table 40, we have prepared an accounting statement showing the classification of the expenditures associated with this final rule with comment period. This table provides our best estimate of the decrease in Medicare payments under the physician fee schedule as a result of the provisions presented in this final rule with comment period for CY 2007. All expenditures are classified as transfers. TABLE 40.—ACCOUNTING STATEMENT: CLASSIFICATION OF ESTIMATED CY 2007 EXPENDITURES ASSOCIATED WITH CY 2007 FINAL RULE PROVISIONS Category Transfers Annualized Monetized Transfers .............................................................. From Whom To Whom? ........................................................................... Estimated decrease in expenditures of $3.7 billion. Federal Government to physicians, other practitioners and suppliers who receive payment under the Medicare Physician Fee Schedule; ESRD Medicare Providers; ambulance suppliers, and Medicare suppliers billing for Part B drugs. In accordance with the provisions of Executive Order 12866, this final rule was reviewed by the Office of Management and Budget. 42 CFR Part 424 List of Subjects Emergency medical services, Health facilities, Health professions, Medicare, Reporting and recordkeeping requirements. 42 CFR Part 405 I Administrative practice and procedure, Health facilities, Health professions, Kidney diseases, Medical devices, Medicare, Reporting and recordkeeping requirements, Rural areas, X-rays. PART 405—FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED For the reasons set forth in the preamble, the Centers for Medicare & Medicaid Services amends 42 CFR chapter IV as follows: 42 CFR Part 410 Health facilities, Health professions, Kidney diseases, Laboratories, Medicare, Reporting and recordkeeping requirements, Rural areas, X-rays. 42 CFR Part 411. Kidney diseases, Medicare, Physician Referral, Reporting and recordkeeping requirements. 42 CFR Part 413 rmajette on PROD1PC67 with RULES2 42 CFR part 414 Subpart D—Private Contracts 2. Section 405.400 is amended by revising the definition of ‘‘Practitioner’’ to read as follows: § 405.400 Definitions. * Administrative practice and procedure, Health facilities, Health professions, Kidney diseases, Medicare, Reporting and recordkeeping. 42 CFR Part 415 Health facilities, Health professions, Medicare, Reporting and recordkeeping requirements. 10:50 Nov 30, 2006 Authority: Secs. 1102, 1861, 1862(a), 1871, 1874, 1881, and 1886(k) of the Social Security Act (42 U.S.C. 1302, 1395x, 1395y(a), 1395hh, 1395kk, 1395rr, and 1395ww(k)), and sec. 353 of the Public Health Service Act (42 U.S.C. 263a). I Health facilities, Kidney diseases, Medicare, Reporting and recordkeeping requirements. VerDate Aug<31>2005 1. The authority citation for part 405 continues to read as follows: I Jkt 211001 * * * * Practitioner means a physician assistant, nurse practitioner, clinical nurse specialist, certified registered nurse anesthetist, certified nurse midwife, clinical psychologist, clinical social worker, registered dietitian or nutrition professional, who is currently legally authorized to practice in that capacity by each State in which he or PO 00000 Frm 00160 Fmt 4701 Sfmt 4700 she furnishes services to patients or clients. * * * * * Subpart X—Rural Health Clinic and Federally Qualified Health Center Services Payment for Rural Health Clinic and Federally Qualified Health Center Services 3. Section 405.2446 is amended by adding paragraph (b)(10) to read as follows: I § 405.2446 Scope of services. * * * * * (b) * * * (10) Medical nutrition therapy services as specified in part 410, subpart G of this chapter, and diabetes outpatient self-management training services as specified in part 410, subpart H of this chapter. * * * * * I 4. Section 405.2463 is revised to read as follows: § 405.2463 What constitutes a visit. (a) Visit—(1) General. (i) For rural health clinics, a visit is a face-to-face encounter between a clinic or center patient and a physician, physician assistant, nurse practitioner, nurse midwife, visiting nurse, clinical psychologist, or clinical social worker. (ii) For FQHCs, a visit is— (A) A face-to-face encounter, as described in paragraph (a)(1)(i) of this section; or (B) A face-to-face encounter between a patient and a qualified provider of medical nutrition therapy services as E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations defined in part 410, subpart G of this chapter; or a qualified provider of outpatient diabetes self-management training services as defined in part 410, subpart H of this chapter. (2) Medical visit. A medical visit is a face-to-face encounter between a clinic or center patient and a physician, physician assistant, nurse practitioner, nurse midwife, or a visiting nurse; and for FQHCs only, a medical visit also includes a separately billable medical nutrition therapy visit or a diabetes outpatient self-management training visit. (3) Other health visit. An other health visit is a face-to-face encounter between a clinic or center patient and a clinical psychologist, clinical social worker, or other health professional for mental health services. (b) Encounters. Encounters with more than one health professional and multiple encounters with the same health professional that take place on the same day and at a single location constitute a single visit, except when one of the following conditions exist: (1) After the first encounter, the patient suffers illness or injury requiring additional diagnosis or treatment. (2) The patient has a medical visit and other health visit(s), as defined in paragraph (a) of this section. (c) Payment. Medicare pays for more than one visit per day when the conditions in paragraph (b) of this section are met or a separate visit under paragraph (a)(1)(ii)(B) of this section is made. PART 410—SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS 5. The authority citation for part 410 continues to read as follows: I Authority: Secs. 1102, 1834, and 1871 of the Social Security Act (42 U.S.C. 1302, 1395m, and 1395hh). Subpart B—Medical and Other Health Services 6. In § 410.16 paragraph (a) is amended by revising paragraph (7) of the definition of ‘‘initial preventive physical examination’’ to read as follows: I rmajette on PROD1PC67 with RULES2 § 410.16 Initial preventive physical examination: Conditions for and limitations on coverage. (a) * * * * * * * Initial preventive physical examination * * *. (7) Education, counseling, and referral, including a written plan such * VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 as a checklist provided to the beneficiary for obtaining the appropriate screening and other preventive services that are covered as separate Medicare Part B benefits as described in section 1861(s)(10), section 1861(jj), section 1861(nn), section 1861(oo), section 1861(pp), section 1861(qq)(1), section 1861(rr), section 1861(uu), section 1861(vv), section 1861(xx)(1), section 1861(yy), and section 1861(bbb) of the Act. * * * * * I 7. A new § 410.19 is added to read as follows: § 410.19 Ultrasound screening for abdominal aortic aneurysms: Condition for and limitation on coverage. (a) Definitions: As used in this section, the following definitions apply: Eligible beneficiary means an individual who— (1) Has received a referral for an ultrasound screening for an abdominal aortic aneurysm as a result of an initial preventive physical examination (as defined in section 1861(ww)(1) of the Act); (2) Has not been previously furnished an ultrasound screening for an abdominal aortic aneurysm under Medicare program; and (3) Is included in at least one of the following risk categories: (i) Has a family history of an abdominal aortic aneurysm. (ii) Is a man age 65 to 75 who has smoked at least 100 cigarettes in his lifetime. (iii) Is an individual who manifests other risk factors in a beneficiary category recommended for screening by the United States Preventive Services Task Force regarding abdominal aortic aneurysms, as specified by the Secretary through a national coverage determination process. Ultrasound screening for abdominal aortic aneurysms means the following services furnished to an asymptomatic individual for the early detection of an abdominal aortic aneurysm: (1) A procedure using soundwaves (or other procedures using alternative technologies of commensurate accuracy and cost, as specified by the Secretary through a national coverage determination process) provided for the early detection of abdominal aortic aneurysms. (2) Includes a physician’s interpretation of the results of the procedure. (b) Conditions for coverage of an ultrasound screening for abdominal aortic aneurysms. Medicare Part B pays for one ultrasound screening for an abdominal aortic aneurysm provided to PO 00000 Frm 00161 Fmt 4701 Sfmt 4700 69783 eligible beneficiaries, as described in this section, after a referral from a physician or a qualified nonphysician practitioner as defined in § 410.16(a), when the test is performed by a provider or supplier that is authorized to provide covered ultrasound diagnostic services. (c) Limitation on coverage of ultrasound screening for abdominal aortic aneurysms. Payment may not be made for an ultrasound screening for an abdominal aortic aneurysm that is performed for an individual that does not meet the definition of ‘‘eligible beneficiary’’ specified in this section. I 8. Section 410.31 is revised to read as follows: § 410.31 Bone mass measurement: Conditions for coverage and frequency standards. (a) Definition. As used in this section unless specified otherwise, the following definition applies: Bone mass measurement means a radiologic, radioisotopic, or other procedure that meets the following conditions: (1) Is performed for the purpose of identifying bone mass, detecting bone loss, or determining bone quality. (2) Is performed with either a bone densitometer (other than single-photon or dual-photon absorptiometry) or with a bone sonometer system that has been cleared for marketing for this use by the FDA under 21 CFR part 807, or approved for marketing by the FDA for this use under 21 CFR part 814. (3) Includes a physician’s interpretation of the results of the procedure. (b) Conditions for coverage. (1) Medicare covers a medically necessary bone mass measurement if the following conditions are met: (i) Following an evaluation of the beneficiary’s need for the measurement, including a determination as to the medically appropriate procedure to be used for the beneficiary, it is ordered by the physician or a qualified nonphysician practitioner (as these terms are defined in § 410.32(a)) treating the beneficiary. (ii) It is performed under the appropriate level of supervision of a physician (as set forth in § 410.32(b)). (iii) It is reasonable and necessary for diagnosing and treating the condition of a beneficiary who meets the conditions described in paragraph (d) of this section. (2) Medicare covers a medically necessary bone mass measurement for an individual defined under paragraph (d)(5) of this section if the conditions under paragraph (b)(1) of this section are met and the monitoring is performed E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 69784 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations by the use of a dual energy x-ray absorptiometry system (axial skeleton). (3) Medicare covers a medically necessary confirmatory baseline bone mass measurement for an individual defined under paragraph (d) of this section, if the conditions under paragraph (b)(1) of this section are met and the confirmatory baseline bone mass measurement is performed by a dual energy x-ray absorptiometry system (axial skeleton) and the initial measurement was not performed by a dual energy x-ray absorptiometry system (axial skeleton). (c) Standards on frequency of coverage—(1) General rule. Except as allowed under paragraph (c)(2) of this section, Medicare may cover a bone mass measurement for a beneficiary if at least 23 months have passed since the month the last bone mass measurement was performed. (2) Exception. If medically necessary, Medicare may cover a bone mass measurement for a beneficiary more frequently than allowed under paragraph (c)(1) of this section. Examples of situations where more frequent bone mass measurement procedures may be medically necessary include, but are not limited to the following medical circumstances: (i) Monitoring beneficiaries on longterm glucocorticoid (steroid) therapy of more than 3 months. (ii) Allowing for a confirmatory baseline measurement to permit monitoring of beneficiaries in the future if the requirements of paragraph (b)(3) of this section are met. (d) Beneficiaries who may be covered. The following categories of beneficiaries may receive Medicare coverage for a medically necessary bone mass measurement: (1) A woman who has been determined by the physician (or a qualified nonphysician practitioner) treating her to be estrogen-deficient and at clinical risk for osteoporosis, based on her medical history and other findings. (2) An individual with vertebral abnormalities as demonstrated by an xray to be indicative of osteoporosis, osteopenia, or vertebral fracture. (3) An individual receiving (or expecting to receive) glucocorticoid (steroid) therapy equivalent to an average of 5.0 mg of prednisone, or greater, per day for more than 3 months. (4) An individual with primary hyperparathyroidism. (5) An individual being monitored to assess the response to or efficacy of an FDA-approved osteoporosis drug therapy. VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 (e) Denial as not reasonable and necessary. If CMS determines that a bone mass measurement does not meet the conditions for coverage in paragraphs (b) or (d) of this section, or the standards on frequency of coverage in paragraph (c) of this section, it is excluded from Medicare coverage as not ‘‘reasonable’’ and ‘‘necessary’’ under section 1862(a)(1)(A) of the Act and § 411.15(k) of this chapter. (f) Use of the National Coverage Determination Process. For the purposes of paragraphs (b)(2) and (b)(3) of this section, CMS may determine through the National Coverage Determination process that additional bone mass measurement systems are reasonable and necessary under section 1862(a)(1) of the Act for monitoring and confirming baseline bone mass measurements. * * * * * I 9. Section 410.33 is amended by— I A. Revising paragraph (b)(1). I B. Revising paragraph (e). I C. Adding paragraphs (g) and (h). The revision and additions read as follows: § 410.33 facility. Independent diagnostic testing * * * * * (b) Supervising physician. (1) Each supervising physician must be limited to providing supervision to no more than three IDTF sites. The IDTF supervising physician is responsible for the overall operation and administration of the IDTFs, including the employment of personnel who are competent to perform test procedures, record and report test results promptly, accurately and proficiently, and for assuring compliance with the applicable regulations. * * * * * (e) Multi-State entities. (1) An IDTF that operates across State boundaries must— (i) Maintain documentation that its supervising physicians and technicians are licensed and certified in each of the States in which it operates; and (ii) Operate in compliance with all applicable Federal, State, and local licensure and regulatory requirements with regard to the health and safety of patients. (2) The point of the actual delivery of service means the place of service on the claim form. When the IDTF performs or administers an entire diagnostic test at the beneficiary’s location, the beneficiary’s location is the place of service. When one or more aspects of the diagnostic testing are PO 00000 Frm 00162 Fmt 4701 Sfmt 4700 performed at the IDTF, the IDTF is the place of service. * * * * * (g) Application certification standards. The IDTF must certify in its enrollment application that it meets the following standards and related requirements: (1) Operates its business in compliance with all applicable Federal and State licensure and regulatory requirements for the health and safety of patients. (2) Provides complete and accurate information on its enrollment application. Any change in enrollment information must be reported to the designated fee-for-service contractor on the Medicare enrollment application within 30 calendar days of the change. (3) Maintains a physical facility on an appropriate site. For the purposes of this standard, a post office box or commercial mail box is not considered a physical facility. The physical facility, including mobile units, must contain space for equipment appropriate to the services designated on the enrollment application, facilities for hand washing, adequate patient privacy accommodations, and the storage of both business records and current medical records within the office setting of the IDTF, or IDTF home office, not within the actual mobile unit. (4) Has all applicable diagnostic testing equipment available at the physical site excluding portable diagnostic testing equipment. The IDTF must— (i) Maintain a catalog of portable diagnostic equipment, including diagnostic testing equipment serial numbers at the physical site; (ii) Make portable diagnostic testing equipment available for inspection within 2 business days of a CMS inspection request. (iii) Maintain a current inventory of the diagnostic testing equipment, including serial and registration numbers and provide this information to the designated fee-for-service contractor upon request, and notify the contractor of any changes in equipment within 90 days. (5) Maintain a primary business phone under the name of the designated business. The IDTF must have its— (i) Primary business phone located at the designated site of the business or within the home office of the mobile IDTF units. (ii) Telephone or toll free telephone numbers available in a local directory and through directory assistance. (6) Have a comprehensive liability insurance policy of at least $300,000 per E:\FR\FM\01DER2.SGM 01DER2 rmajette on PROD1PC67 with RULES2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations location that covers both the place of business and all customers and employees of the IDTF. The policy must be carried by a nonrelative-owned company and list the serial numbers of any and all diagnostic equipment used by the IDTF, whether the equipment is stationary, in a mobile unit, or at the beneficiary’s residence. (7) Agree not to directly solicit patients, which include, but is not limited to, a prohibition on telephone, computer, or in-person contacts. The IDTF must accept only those patients referred for diagnostic testing by an attending physician, who is furnishing a consultation or treating a beneficiary for a specific medical problem and who uses the results in the management of the beneficiary’s specific medical problem. Nonphysician practitioners may order tests as set forth in § 410.32(a)(3). (8) Answer beneficiaries’ questions and respond to their complaints. (9) Openly post these standards for review by patients and the public. (10) Disclose to the government any person having ownership, financial, or control interest or any other legal interest in the supplier at the time of enrollment or within 30 days of a change. (11) Have its testing equipment calibrated and maintained per equipment instructions and in compliance with applicable manufacturers suggested maintenance and calibration standards. (12) Have technical staff on duty with the appropriate credentials to perform tests. The IDTF must be able to produce the applicable Federal or State licenses or certifications of the individuals performing these services. (13) Have proper medical record storage and be able to retrieve medical records upon request from CMS or its fee-for-service contractor within 2 business days. (14) Permit CMS, including its agents, or its designated fee-for-service contractors, to conduct unannounced, on-site inspections to confirm the IDTF’s compliance with these standards. The IDTF must— (i) Be accessible during regular business hours to CMS and beneficiaries; and (ii) Maintain a visible sign posting its normal business hours. (h) Failure to meet standards. If an IDTF fails to meet one or more of the standards in paragraph (g) of this section at the time of enrollment, its enrollment will be denied. CMS will revoke a supplier’s billing privileges if and IDTF is found not to meet the VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 standards in paragraph (g) or (b)(1) of this section. Subpart I—Payment of SMI Benefits 10. Section 410.160 is amended by adding paragraphs (b)(7) and (b)(8) to read as follows: I § 410.160 Part B annual deductible. * * * * * (b) * * * (7) Beginning January 1, 2007, colorectal cancer screening tests as described in § 410.37. (8) Beginning January 1, 2007, ultrasound screening for abdominal aortic aneurysms described in § 410.19. * * * * * PART 411—EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT 11. The authority citation for part 411 is amended to read as follows: I Authority: Secs. 1102, 1860D–1 through 1860D–42, 1871, and 1877 of the Social Security Act (42 U.S.C. 1302, 1395w–101 through 1395w–152, 1395hh, and 1395nn). Subpart A—General Exclusions and Exclusion of Particular Services 12. Section 411.15 is amended by— A. Revising paragraph (a)(1). B. Adding a new paragraph (k)(12). C. Revising paragraph (o). The revisions and addition read as follows: I I I I § 411.15 Particular services excluded from coverage. * * * * * (a) * * * (1) Examinations performed for a purpose other than treatment or diagnosis of a specific illness, symptoms, complaint, or injury, except for screening mammography, colorectal cancer screening tests, screening pelvic exams, prostate cancer screening tests, glaucoma screening exams, initial preventive physical examinations, or ultrasound screening for abdominal aortic aneurysms that meet the criteria specified in paragraphs (k)(6) through (k)(12) of this section. * * * * * (k) * * * (12) In the case of ultrasound screening for abdominal aortic aneurysms, with the goal of early detection of abdominal aortic aneurysms, subject to the conditions and limitation specified in § 410.19 of this chapter. * * * * * (o) Experimental or investigational devices. Experimental or investigational devices, except for certain devices— PO 00000 Frm 00163 Fmt 4701 Sfmt 4700 69785 (1) Categorized by the FDA as a Category A or B device defined in § 405.201(b) of this chapter; and (2) Furnished in accordance with the CMS clinical research policy. * * * * * PART 413—PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES 13. The authority citation for part 413 continues to read as follows: I Authority: Secs. 1102, 1138(b), 1812(d), 1814(b), 1815, 1833(a), (i), and (n), 1871, 1881, 1883, and 1886 of the Social Security Act (42 U.S.C. 1302, 1320b–8(b), 1395d(d), 1395f(b), 1395g, 1395l(a), (i), and (n), 1395hh, 1395rr, 1395tt, and 1395ww). Subpart F—Specific Categories of Costs 14. Section 413.89 is amended by revising paragraphs (a) and (i) to read as follows: I § 413.89 Bad debts, charity, and courtesy allowances. (a) Principle. Bad debts, charity, and courtesy allowances are deductions from revenue and are not to be included in allowable cost. However, subject to the limitations described under paragraph (h) of this section and the exception for services described under paragraph (i) of this section, bad debts attributable to the deductibles and coinsurance amounts are reimbursable under the program. * * * * * (i) Exception. Bad debts arising from covered services paid under a reasonable charge-based methodology or a fee schedule are not reimbursable under the program. Subpart H—Payment for End-Stage Renal Disease (ESRD) Services and Organ Procurement Costs 15. Section 413.178 is amended by adding paragraph (d) to read as follows: I § 413.178 Bad debts. * * * * * (d) Bad debts arising from covered ESRD services paid under a reasonable charge-based methodology or a fee schedule are not reimbursable under the program. E:\FR\FM\01DER2.SGM 01DER2 69786 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations PART 414—PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES 16. The authority citation for Part 414 continues to read as follows: * * * * * I Authority: Secs. 1102, 1871, and 1881(b)(l) of the Social Security Act (42 U.S.C. 1302, 1395hh, and 1395rr(b)(l)). 17. A new subpart G is added as follows: I Subpart G—Payment for New Clinical Diagnostic Laboratory Tests Sec. 414.500 Basis and scope. 414.502 Definitions. 414.504 [Reserved] 414.506 Procedures for public consultation for payment for a new clinical diagnostic laboratory test. 414.508 Payment for a new clinical diagnostic laboratory test. 414.510 Laboratory date of service for specimens. Subpart G—Payment for New Clinical Diagnostic Laboratory Tests § 414.500 Basis and scope. This subpart implements provisions of 1833(h)(8) of the Act—procedures for determining the basis for, and amount of, payment for a new clinical diagnostic laboratory test with respect to which a new or substantially revised Healthcare Common Procedure Coding System code is assigned on or after January 1, 2005. § 414.502 Definitions. For purposes of this subpart— Substantially Revised Healthcare Common Procedure Coding System Code means a code for which there has been a substantive change to the definition of the test or procedure to which the code applies (such as a new analyte or a new methodology for measuring an existing analyte specific test). § 414.504 [Reserved] rmajette on PROD1PC67 with RULES2 § 414.506 Procedures for public consultation for payment for a new clinical diagnostic laboratory test. For a new clinical diagnostic laboratory test that is assigned a new or substantially revised code on or after January 1, 2005, CMS determines the payment after the performance of the following: (a) CMS makes available to the public (through CMS’s Internet Web site) a list that includes codes for which establishment of a payment amount is being considered for the next calendar year. VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 (b) CMS publishes a Federal Register notice of a meeting to receive public comments and recommendations (and data on which recommendations are based) on the appropriate basis, as specified in § 414.508, for establishing payment amounts for the list of codes made available to the public. (c) Not fewer than 30 days after publication of the notice in the Federal Register, CMS convenes a meeting that includes representatives of CMS officials involved in determining payment amounts, to receive public comments and recommendations (and data on which the recommendations are based). (d) Considering the comments and recommendations (and accompanying data) received at the public meeting, CMS develops and makes available to the public (through an Internet Web site and other appropriate mechanisms) a list of— (1) Proposed determinations with respect to the appropriate basis for establishing a payment amount for each code, with an explanation of the reasons for each determination, the data on which the determinations are based, and a request for public written comments within a specified time period on the proposed determination; and (2) Final determinations of the payment amounts for tests, with the rationale for each determination, the data on which the determinations are based, and responses to comments and suggestions from the public. § 414.508 Payment for a new clinical diagnostic laboratory test. For a new clinical diagnostic laboratory test that is assigned a new or substantially revised code on or after January 1, 2005, CMS determines the payment amount based on either of the following: (a) Crosswalking. Crosswalking is used if it is determined that a new test is comparable to an existing test, multiple existing test codes, or a portion of an existing test code. (1) CMS assigns to the new test code, the local fee schedule amounts and national limitation amount of the existing test. (2) Payment for the new test code is made at the lesser of the local fee schedule amount or the national limitation amount. (b) Gapfilling. Gapfilling is used when no comparable existing test is available. (1) In the first year, carrier-specific amounts are established for the new test code using the following sources of information to determine gapfill amounts, if available: PO 00000 Frm 00164 Fmt 4701 Sfmt 4700 (i) Charges for the test and routine discounts to charges; (ii) Resources required to perform the test; (iii) Payment amounts determined by other payers; and (iv) Charges, payment amounts, and resources required for other tests that may be comparable or otherwise relevant. (2) In the second year, the test code is paid at the national limitation amount, which is the median of the carrier-specific amounts. (3) After the first year of gapfilling, CMS determines whether the carrierspecific amounts will pay for the test appropriately. If CMS determines that the carrier-specific amounts will not pay for the test appropriately, CMS may crosswalk the test. § 414.510 Laboratory date of service for specimens. The date of service for a laboratory test is as follows: (a) Except as provided under paragraph (b) of this section, the date of service of the test must be the date the specimen was collected. (b)(1) If a specimen was collected over a period that spans 2 calendar days, then the date of service must be the date the collection ended. (2) In the case of a test performed on a stored specimen, if a specimen was stored for— (i) Less than or equal to 30 calendar days from the date it was collected, the date of service of the test must be the date the test was performed only if— (A) The test is ordered by the patient’s physician at least 14 days following the date of the patient’s discharge from the hospital; (B) The specimen was collected while the patient was undergoing a hospital surgical procedure; (C) It would be medically inappropriate to have collected the sample other than during the hospital procedure for which the patient was admitted; (D) The results of the test do not guide treatment provided during the hospital stay; and (E) The test was reasonable and medically necessary for the treatment of an illness. (ii) More than 30 calendar days before testing, the specimen is considered to have been archived and the date of service of the test must be the date the specimen was obtained from storage. (3) In the case of a chemotherapy sensitivity test performed on live tissue, the date of service of the test must be the date the test was performed only if— E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations (i) The decision regarding the specific chemotherapeutic agents to test is made at least 14 days after discharge; (ii) The specimen was collected while the patient was undergoing a hospital surgical procedure; (iii) It would be medically inappropriate to have collected the sample other than during the hospital procedure for which the patient was admitted; (iv) The results of the test do not guide treatment provided during the hospital stay; and, (v) The test was reasonable and medically necessary for the treatment of an illness. (4) For purposes of this section, ‘‘chemotherapy sensitivity test’’ means a test identified by the Secretary as a test that requires a fresh tissue sample to test the sensitivity of tumor cells to various chemotherapeutic agents. The Secretary identifies such tests through program instructions. Subpart H—Fee Schedule for Ambulance Services 18. Section 414.605 is amended by— A. Removing the definition of ‘‘Goldsmith modification.’’ I B. Revising the definition of ‘‘rural area.’’ I C. Adding the definition of ‘‘urban area’’ in alphabetical order. The revisions and addition read as follows: Definitions. * * * * * Rural area means an area located outside an urban area, or a rural census tract within a Metropolitan Statistical Area as determined under the most recent version of the Goldsmith modification as determined by the Office of Rural Health Policy of the Health Resources and Services Administration. * * * * * Urban area means a Metropolitan Statistical Area, as defined by the Executive Office of Management and Budget. I 19. Section 414.610 is amended by revising paragraph (g) to read as follows: § 414.610 Basis of payment. rmajette on PROD1PC67 with RULES2 * * * * * (g) Adjustments. The Secretary monitors payment and billing data on an ongoing basis and adjusts the CF and air ambulance rates as appropriate to reflect actual practices under the fee schedule. These rates are not adjusted solely because of changes in the total number of ambulance transports. VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 20. Section 414.802 is amended by adding the definition of ‘‘Bona fide service fees’’ in alphabetical order to read as follows: I § 414.802 Definitions. * * * * * Bona fide service fees means fees paid by a manufacturer to an entity, that represent fair market value for a bona fide, itemized service actually performed on behalf of the manufacturer that the manufacturer would otherwise perform (or contract for) in the absence of the service arrangement, and that are not passed on in whole or in part to a client or customer of an entity, whether or not the entity takes title to the drug. * * * * * I 21. Section 414.804 is amended by revising paragraphs (a)(1) through (a)(4) to read as follows: § 414.804 I I § 414.605 Subpart J—Submission of Manufacturer’s Average Sales Price Data Basis of payment. (a) * * * (1) The manufacturer’s average sales price for a quarter for a drug represented by a particular 11-digit National Drug Code must be calculated as the manufacturer’s sales to all purchasers in the United States for that particular 11digit National Drug Code (after excluding sales as specified in paragraph (a)(4) of this section and then deducting price concessions as specified in paragraphs (a)(2) and (a)(3) of this section) divided by the total number of units sold by the manufacturer in that quarter (after excluding units associated with sales as specified in paragraph (a)(4) of this section). (2) Price concessions. (i) In calculating the manufacturer’s average sales price, a manufacturer must deduct price concessions. Price concessions include the following types of transactions and items: (A) Volume discounts. (B) Prompt pay discounts. (C) Cash discounts. (D) Free goods that are contingent on any purchase requirement. (E) Chargebacks and rebates (other than rebates under the Medicaid program). (ii) For the purposes of paragraph (a)(2)(i), bona fide services fees are not considered price concessions. (3) To the extent that data on price concessions, as described in paragraph (a)(2) of this section, are available on a lagged basis, the manufacturer must estimate this amount in accordance with the methodology described in this paragraph. PO 00000 Frm 00165 Fmt 4701 Sfmt 4700 69787 (i)(A) For each National Drug Code with at least 12 months of sales (including products for which the manufacturer has redesignated the National Drug Code for the specific product and package size and has 12 months of sales across the prior and current National Drug Codes), after adjusting for exempted sales, the manufacturer calculates a percentage equal to the sum of the price concessions for the most recent 12month period available associated with sales subject to the average sales price reporting requirement divided by the total in dollars for the sales subject to the average sales price reporting requirement for the same 12-month period. (B) For each National Drug Code with less than 12 months of sales, the calculation described in paragraph (i)(A) of this section is performed for the time period equaling the total number of months of sales. (ii) The manufacturer multiplies the applicable percentage described in paragraph (a)(3)(i)(A) or (a)(3)(i)(B) of this section by the total in dollars for the sales subject to the average sales price reporting requirement (after adjusting for exempted sales) for the quarter being submitted. (The manufacturer must carry a sufficient number of decimal places in the calculation of the price concessions percentage in order to round accurately the net total sales amount for the quarter to the nearest whole dollar.) The result of this multiplication is then subtracted from the total in dollars for the sales subject to the average sales price reporting requirement (after adjusting for exempted sales) for the quarter being submitted. (iii) The manufacturer uses the result of the calculation described in paragraph (a)(3)(ii) of this section as the numerator and the number of units sold in the quarter (after adjusting for exempted sales) as the denominator to calculate the manufacturer’s average sales price for the National Drug Code for the quarter being submitted. (iv) Example. After adjusting for exempted sales, the total lagged price concessions (discounts, rebates, etc.) over the most recent 12-month period available associated with sales for National Drug Code 12345–6789–01 subject to the ASP reporting requirement equal $200,000, and the total in dollars for the sales subject to the average sales price reporting requirement for the same period equals $600,000. The lagged price concessions percentage for this period equals 200,000/600,000 = 0.33333. The total in dollars for the sales subject to the E:\FR\FM\01DER2.SGM 01DER2 69788 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations average sales price reporting requirement for the quarter being reported, after accounting for nonlagged price concessions, equals $50,000 for 10,000 units sold. The manufacturer’s average sales price calculation for this National Drug Code for this quarter is: $50,000¥(0.33333 × $50,000) = $33,334 (net total sales amount); $33,334/10,000 = $3.33 (average sales price). (4) Exempted sales. (i) In calculating the manufacturer’s average sales price, a manufacturer must exclude sales that are exempt from inclusion in the determination of the best price under section 1927(c)(1)(C)(i) of the Act and sales that are merely nominal in amount as applied for purposes of section 1927(c)(1)(C)(ii)(III) of the Act, as limited by section 1927(c)(1)(D) of the Act. (ii) In determining nominal sales exempted under section 1927(c)(1)(C)(ii)(III) of the Act, the manufacturer calculates the average manufacturer price as defined in section 1927(k) of the Act and then identifies sales that are eligible to be considered a nominal sale under section 1927(c)(1)(D) of the Act and are at less than 10 percent of the average manufacturer price. To identify nominal sales, the manufacturer must use the average manufacturer price for the calendar quarter that is the same calendar quarter as the average sales price reporting period. * * * * * Subpart K—Payment for Drugs and Biologicals Under Part B 22. Section 414.904 is amended by revising paragraphs (d)(2)(iii) and (d)(3) to read as follows: I § 414.904 Average sales price as the basis for payment. rmajette on PROD1PC67 with RULES2 * * * * * (d) * * * (2) * * * (iii) Effective for drugs and biologicals furnished in CY 2006 and subsequent calendar years, the payment for such drugs and biologicals furnished in connection with renal dialysis services and separately billed by freestanding and hospital-based renal dialysis facilities not paid on a cost basis is the amount determined under section 1847A of the Act. (3) Widely available market price and average manufacturer price. If the Inspector General finds that the average sales price exceeds the widely available market price or the average manufacturer price by 5 percent or more in CYs 2005, 2006, and 2007, the VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 payment limit in the quarter following the transmittal of this information to the Secretary is the lesser of the widely available market price or 103 percent of the average manufacturer price. * * * * * PART 415—SERVICES FURNISHED BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS 23. The authority citation for part 415 continues to read as follows: I Authority: Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395hh). Subpart C—Part B Carrier Payments for Physician Services to Beneficiaries in Providers 24. Section 415.130 is amended by revising paragraph (d) to read as follows: I § 415.130 Conditions for payment: Physician pathology services. * * * * * (d) Physician pathology services furnished by an independent laboratory. The technical component of physician pathology services furnished by an independent laboratory to a hospital inpatient or outpatient on or before December 31, 2006 may be paid to the laboratory by the carrier under the physician fee schedule if the Medicare beneficiary is a patient of a covered hospital as defined in paragraph (a)(1) of this section. For services furnished after December 31, 2006, an independent laboratory may not bill the carrier for the technical component of physician pathology services furnished to a hospital inpatient or outpatient. (f) Blood glucose testing. For each blood glucose test, the physician must certify that the test is medically necessary. A physician’s standing order is not sufficient to order a series of blood glucose tests payable under the clinical laboratory fee schedule. * * * * * Subpart F—Limitations on Assignment and Reassignment of Claims 27. Section 424.80 is amended by— A. Revising the heading of paragraph (d). I B. Revising paragraph (d)(2) The revisions read as follows: I I § 424.80 Prohibition of reassignment of claims by suppliers. * * * * * (d) Reassignment to an entity under an employer-employee relationship or under a contractual arrangement: Conditions and limitations. (1) * * * (2) Access to records. The supplier who furnishes the service has unrestricted access to claims submitted by an entity for services provided by that supplier. This paragraph applies irrespective of whether the supplier is an employee or whether the service is provided under a contractual arrangement. If an entity refuses to provide, upon request, the billing information to the supplier performing the service, the entity’s right to receive reassigned benefits may be revoked under § 424.82(c)(3). (Catalog of Federal Domestic Assistance Program No. 93.774, Medicare— Supplementary Medical Insurance Program) PART 424—CONDITIONS FOR MEDICARE PAYMENT Dated: October 31, 2006. Leslie V. Norwalk, Acting Adminstrator, Centers for Medicare & Medicaid Services. Approved: November 1, 2006. Michael O. Leavitt, Secretary. I 25. The authority citation for part 424 continues to read as follows: Note: These addenda will not appear in the Code of Federal Regulations. Authority: Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395hh). Addendum A: Explanation and Use of Addenda B The addenda on the following pages provide various data pertaining to the Medicare fee schedule for physicians’ services furnished in 2007. Addendum B contains the RVUs for work, non-facility PE, facility PE, and malpractice expense, and other information for all services included in the PFS. In previous years, we have listed many services in Addendum B that are not paid under the PFS. To avoid publishing as many pages of codes for these services, we are not including clinical laboratory codes or the alphanumeric codes (Healthcare Common Procedure Coding System (HCPCS) codes not Subpart B—Certification and Plan of Treatment Requirements 26. Section 424.24 is amended by— A. Redesignating paragraph (f) as paragraph (g). I B. Adding a new paragraph (f). The addition reads as follows: I I § 424.24 Requirements for medical and other health services furnished by providers under Medicare Part B. * PO 00000 * * Frm 00166 * Fmt 4701 * Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations rmajette on PROD1PC67 with RULES2 included in CPT) not paid under the PFS in Addendum B. Addendum B—2007 Relative Value Units and Related Information Used in Determining Medicare Payments for 2007 This addendum contains the following information for each CPT code and alphanumeric HCPCS code, except for: Alphanumeric codes beginning with B (enteral and parenteral therapy), E (durable medical equipment), K (temporary codes for nonphysicians’ services or items), or L (orthotics); and codes for anesthesiology. Please also note the following: • An ‘‘NA’’ in the ‘‘Non-facility PE RVUs’’ column of Addendum B means that CMS has not developed a PE RVU in the non-facility setting for the service because it is typically performed in the hospital (for example, an open heart surgery is generally performed in the hospital setting and not a physician’s office). If there is an ‘‘NA’’ in the non-facility PE RVU column, and the contractor determines that this service can be performed in the non-facility setting, the service will be paid at the facility PE RVU rate. • Services that have an ‘‘NA’’ in the ‘‘Facility PE RVUs’’ column of Addendum B are typically not paid using the PFS when provided in a facility setting. These services (which include ‘‘incident to’’ services and the technical portion of diagnostic tests) are generally paid under either the outpatient hospital prospective payment system or bundled into the hospital inpatient prospective payment system payment. 1. CPT/HCPCS code. This is the CPT or alphanumeric HCPCS number for the service. Alphanumeric HCPCS codes are included at the end of this addendum. 2. Modifier. A modifier is shown if there is a technical component (modifier TC) and a professional component (PC) (modifier –26) for the service. If there is a PC and a TC for the service, Addendum B contains three entries for the code. A code for: The global values (both professional and technical); modifier –26 (PC); and, modifier TC. The global service is not designated by a modifier, and physicians must bill using the code without a modifier if the physician furnishes both the PC and the TC of the service. Modifier-53 is shown for a discontinued procedure, for example, a colonoscopy that is not completed. There will be RVUs for a code with this modifier. 3. Status indicator. This indicator shows whether the CPT/HCPCS code is in the PFS and whether it is separately payable if the service is covered. A = Active code. These codes are separately payable under the PFS if covered. There will be RVUs for codes with this status. The presence of an ‘‘A’’ indicator does not mean that Medicare has made a national coverage determination regarding the service. Carriers remain responsible for coverage decisions in the absence of a national Medicare policy. B = Bundled code. Payments for covered services are always bundled into payment for other services not specified. If RVUs are VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 shown, they are not used for Medicare payment. If these services are covered, payment for them is subsumed by the payment for the services to which they are incident (an example is a telephone call from a hospital nurse regarding care of a patient). C = Carriers price the code. Carriers will establish RVUs and payment amounts for these services, generally on an individual case basis following review of documentation, such as an operative report. D* = Deleted/discontinued code. E = Excluded from the PFS by regulation. These codes are for items and services that CMS chose to exclude from the fee schedule payment by regulation. No RVUs are shown, and no payment may be made under the PFS for these codes. Payment for them, when covered, continues under reasonable charge procedures. F = Deleted/discontinued codes. (Code not subject to a 90-day grace period.) These codes are deleted effective with the beginning of the year and are never subject to a grace period. This indicator is no longer effective beginning with the 2005 fee schedule as of January 1, 2005. G = Code not valid for Medicare purposes. Medicare uses another code for reporting of, and payment for, these services. (Codes subject to a 90-day grace period.) This indicator is no longer effective with the 2005 PFS as of January 1, 2005. H* = Deleted modifier. For 2000 and later years, either the TC or PC component shown for the code has been deleted and the deleted component is shown in the database with the H status indicator. I = Not valid for Medicare purposes. Medicare uses another code for the reporting of, and the payment for these services. (Codes not subject to a 90-day grace period.) L = Local codes. Carriers will apply this status to all local codes in effect on January 1, 1998 or subsequently approved by central office for use. Carriers will complete the RVUs and payment amounts for these codes. M = Measurement codes, used for reporting purposes only. There are no RVUs and no payment amounts for these codes. Medicare uses them to aid with performance measurement. No separate payment is made. These codes should be billed with a zero (($0.00) charge and are denied) on the MPFSDB. N = Non-covered service. These codes are noncovered services. Medicare payment may not be made for these codes. If RVUs are shown, they are not used for Medicare payment. R = Restricted coverage. Special coverage instructions apply. If the service is covered and no RVUs are shown, it is carrier-priced. T = There are RVUs for these services, but they are only paid if there are no other services payable under the PFS billed on the same date by the same provider. If any other services payable under the PFS are billed on the same date by the same provider, these services are bundled into the service(s) for which payment is made. X = Statutory exclusion. These codes represent an item or service that is not within PO 00000 Frm 00167 Fmt 4701 Sfmt 4700 69789 the statutory definition of ‘‘physicians’’ services’’ for PFS payment purposes. No RVUs are shown for these codes, and no payment may be made under the PFS. (Examples are ambulance services and clinical diagnostic laboratory services.) 4. Description of code. This is an abbreviated version of the narrative description of the code. 5. Physician work RVUs. These are the RVUs for the physician work for this service in 2007. As stated in the June 29, 2006 proposed notice, the RVUs for codes with a 10-or 90-day global period reflect the application of the RUC-recommended values for the E/ M services that are included as part of the global period for the service. Note: The separate budget neutrality adjustor is not reflected in these physician work RVUs. 6. Fully implemented non-facility practice expense RVUs. These are the fully implemented resource-based PE RVUs for non-facility settings. 7. Transitional Non-facility practice expense RVUs. These are the 2007 resourcebased PE RVUs for non-facility settings. 8. Fully implemented facility practice expense RVUs. These are the fully implemented resource-based PE RVUs for facility settings. 9. Transitional facility practice expense RVUs. These are the 2007 resource-based PE RVUs for facility settings. 10. Malpractice expense RVUs. These are the RVUs for the malpractice expense for the service for 2006. 11. Non-facility total. This is the sum of the work, fully implemented non-facility PE, and malpractice expense RVUs. 12. Transitional non-facility total. This is the sum of the work, 2007 transitional nonfacility PE, and malpractice expense RVUs. 13. Facility total. This is the sum of the work, fully implemented facility PE, and malpractice expense RVUs. 14. Transitional facility total. This is the sum of the work, 2007 transitional facility PE, and malpractice expense RVUs. 15. Global period. This indicator shows the number of days in the global period for the code (0, 10, or 90 days). An explanation of the alpha codes follows: MMM = Code describes a service furnished in uncomplicated maternity cases including antepartum care, delivery, and postpartum care. The usual global surgical concept does not apply. See the 1999 Physicians’ Current Procedural Terminology for specific definitions. XXX = The global concept does not apply. YYY = The global period is to be set by the carrier (for example, unlisted surgery codes). ZZZ = Code related to another service that is always included in the global period of the other service. (Note: Physician work and PE are associated with intra service time and in some instances in the post service time. *Codes with these indicators had a 90-day grace period before January 1, 2005. E:\FR\FM\01DER2.SGM 01DER2 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00168 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... 01DER2 2 Copyright 3+ Mod C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C N N N C C C Status Thermotx choroid vasc lesion .............................. Photocoagulat macular drusen ............................ Extracorp shock wv tx,ms nos ............................. Transcath cardiac reduction ................................. Measure remnant lipoproteins ............................. Endoscopic epidural lysis ..................................... Dexa body composition study .............................. Magnetic tx for incontinence ................................ Antiprothrombin antibody ..................................... Speculoscopy ....................................................... Speculoscopy w/direct sample ............................. Detect ur infect agnt w/cpas ................................ Ct perfusion w/contrast, cbf ................................. Co expired gas analysis ....................................... Cath lavage, mammary duct(s) ............................ Cath lavage, mammary duct(s) ............................ Implant ventricular device .................................... External circulation assist .................................... Removal circulation assist ................................... Implant total heart system .................................... Replace component heart syst ............................ Replace component heart syst ............................ Bone surgery using computer .............................. Bone surgery using computer .............................. Bone surgery using computer .............................. Cryopreservation, ovary tiss ................................ Cryopreservation, oocyte ..................................... Electrical impedance scan ................................... Destruction of tumor, breast ................................ Rep intradisc annulus;1 lev .................................. Rep intradisc annulus;>1lev ................................. Spectroscop eval expired gas .............................. Ocular photoscreen bilat ...................................... Ct colonography;screen ....................................... Ct colonography;screen ....................................... Ct colonography;screen ....................................... Ct colonography;dx .............................................. Ct colonography;dx .............................................. Ct colonography;dx .............................................. Description 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Physician Work RVUs 3 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented NonFacility PE RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Non-Facility PE RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented Facility PE RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Facility PE RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Mal-Practice RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented NonFacility Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Non-Facility Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented Facility Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007 codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 0016T 0017T 0019T 0024T 0026T 0027T 0028T 0029T 0030T 0031T 0032T 0041T 0042T 0043T 0046T 0047T 0048T 0049T 0050T 0051T 0052T 0053T 0054T 0055T 0056T 0058T 0059T 0060T 0061T 0062T 0063T 0064T 0065T 0066T 0066T 0066T 0067T 0067T 0067T HCPCS 2 CPT 1/ rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69790 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00169 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod C C C C C A N C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C Status Interp/rept heart sound ......................................... Analysis only heart sound .................................... Interp only heart sound ........................................ U/s leiomyomata ablate <200 .............................. U/s leiomyomata ablate >200 .............................. Delivery, comp imrt .............................................. Online physician e/m ............................................ Perq stent/chest vert art ....................................... Perq stent/chest vert art ....................................... Perq stent/chest vert art ....................................... S&i stent/chest vert art ......................................... S&i stent/chest vert art ......................................... S&i stent/chest vert art ......................................... Cereb therm perfusion probe ............................... Endovasc aort repr w/device ............................... Endovasc visc extnsn repr ................................... Endovasc aort repr rad s&i .................................. Endovasc visc extnsn s&i .................................... Temp prostate urethral stent ................................ Breath test heart reject ........................................ L ventricle fill pressure ......................................... Sperm eval hyaluronan ........................................ Rf tongue base vol reduxn ................................... Actigraphy testing, 3-day ..................................... Cervical artific disc ............................................... Artific disc addl ..................................................... Cervical artific diskectomy ................................... Artific diskectomy addl ......................................... Rev cervical artific disc ........................................ Rev artific disc addl .............................................. Implant corneal ring ............................................. Prosth retina receive&gen .................................... Extracorp shockwv tx,hi enrg ............................... Extracorp shockwv tx,anesth ............................... Holotranscobalamin .............................................. At rest cardio gas rebreathe ................................ Exerc cardio gas rebreathe .................................. Touch quant sensory test .................................... Vibrate quant sensory test ................................... Cool quant sensory test ....................................... Heat quant sensory test ....................................... Nos quant sensory test ........................................ Rbc membranes fatty acids ................................. Description 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Physician Work RVUs 3 0.00 0.00 0.00 0.00 0.00 13.15 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 16.80 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Non-Facility PE RVUs 0.00 0.00 0.00 0.00 0.00 NA 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented Facility PE RVUs 0.00 0.00 0.00 0.00 0.00 NA 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 0068T 0069T 0070T 0071T 0072T 0073T 0074T 0075T 0075T 0075T 0076T 0076T 0076T 0077T 0078T 0079T 0080T 0081T 0084T 0085T 0086T 0087T 0088T 0089T 0090T 0092T 0093T 0095T 0096T 0098T 0099T 0100T 0101T 0102T 0103T 0104T 0105T 0106T 0107T 0108T 0109T 0110T 0111T HCPCS 2 CPT 1/ Fully Implemented NonFacility PE RVUs 0.00 0.00 0.00 0.00 0.00 0.13 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Mal-Practice RVUs 0.00 0.00 0.00 0.00 0.00 13.28 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented NonFacility Total 0.00 0.00 0.00 0.00 0.00 16.93 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Non-Facility Total 0.00 0.00 0.00 0.00 0.00 NA 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented Facility Total 0.00 0.00 0.00 0.00 0.00 NA 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69791 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00170 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod C C C C C C C C C C C I I I C C C C C C C C C C C C C C C C C C C C C C C C C C C C C Status Med tx mngmt 15 min .......................................... Med tx mngmt subsqt .......................................... Med tx mngmt addl 15 min .................................. Scleral fistulization ............................................... Conjunctival drug placement ................................ Chd risk imt study ................................................ Chron care drug investigatn ................................. Esophageal implant injexn ................................... Perq cryoablate renal tumor ................................ Prostate saturation sampling ............................... Exhaled breath condensate ph ............................ Perq islet transplant ............................................. Open islet transplant ............................................ Laparoscopic islet transplnt ................................. CT heart wo dye; qual calc .................................. CT heart wo dye; qual calc .................................. CT heart wo dye; qual calc .................................. CT heart w/wo dye funct ...................................... CT heart w/wo dye funct ...................................... CT heart w/wo dye funct ...................................... CCTA w/wo dye ................................................... CCTA w/wo dye ................................................... CCTA w/wo dye ................................................... CCTA w/wo, quan calcium ................................... CCTA w/wo, quan calcium ................................... CCTA w/wo, quan calcium ................................... CCTA w/wo, strxr ................................................. CCTA w/wo, strxr ................................................. CCTA w/wo, strxr ................................................. CCTA w/wo, strxr quan calc ................................ CCTA w/wo, strxr quan calc ................................ CCTA w/wo, strxr quan calc ................................ CCTA w/wo, disease strxr ................................... CCTA w/wo, disease strxr ................................... CCTA w/wo, disease strxr ................................... CT heart funct add-on .......................................... CT heart funct add-on .......................................... CT heart funct add-on .......................................... Computer chest add-on ....................................... Tcath sensor aneurysm sac ................................. Study sensor aneurysm sac ................................ Lap impl gast curve electrd .................................. Lap remv gast curve electrd ................................ Description 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Physician Work RVUs 3 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Non-Facility PE RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented Facility PE RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 0115T 0116T 0117T 0123T 0124T 0126T 0130T 0133T 0135T 0137T 0140T 0141T 0142T 0143T 0144T 0144T 0144T 0145T 0145T 0145T 0146T 0146T 0146T 0147T 0147T 0147T 0148T 0148T 0148T 0149T 0149T 0149T 0150T 0150T 0150T 0151T 0151T 0151T 0152T 0153T 0154T 0155T 0156T HCPCS 2 CPT 1/ Fully Implemented NonFacility PE RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Mal-Practice RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented NonFacility Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Non-Facility Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented Facility Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69792 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00171 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... TC .... 26 ..... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod C C C C C C C C C C C C C C C C C C C C C C C A A A A A A A A A A A A A A A A A A A A Status Open impl gast curve electrd ............................... Open remv gast curve electrd ............................. Cad breast mri ..................................................... Cad breast mri ..................................................... Cad breast mri ..................................................... Tcranial magn stim tx plan ................................... Tcranial magn stim tx deliv .................................. Anal program gast neurostim ............................... Lumb artif diskectomy addl .................................. Remove lumb artif disc addl ................................ Revise lumb artif disc addl ................................... Tcath vsd close w/o bypass ................................. Tcath vsd close w bypass .................................... Rhinophototx light app bilat ................................. Place stereo cath brain ........................................ Anorectal fistula plug rpr ...................................... Lumbar spine proces distract ............................... Lumbar spine proces addl ................................... Iop monit io pressure ........................................... Cad cxr with interp ............................................... Cad cxr remote .................................................... Aqu canal dilat w/o retent .................................... Aqu canal dilat w retent ....................................... Fna w/o image ..................................................... Fna w/image ......................................................... Acne surgery ........................................................ Drainage of skin abscess ..................................... Drainage of skin abscess ..................................... Drainage of pilonidal cyst ..................................... Drainage of pilonidal cyst ..................................... Remove foreign body ........................................... Remove foreign body ........................................... Drainage of hematoma/fluid ................................. Puncture drainage of lesion ................................. Complex drainage, wound ................................... Debride infected skin ........................................... Debride infected skin add-on ............................... Debride genitalia & perineum .............................. Debride abdom wall ............................................. Debride genit/per/abdom wall .............................. Remove mesh from abd wall ............................... Debride skin, fx .................................................... Debride skin/muscle, fx ........................................ Description 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.27 1.27 1.19 1.19 2.42 1.19 2.47 1.23 2.71 1.55 1.22 2.27 0.60 0.30 10.80 14.24 13.10 5.00 4.19 4.94 Physician Work RVUs 3 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2.11 2.02 1.32 1.51 2.09 2.65 3.47 1.95 3.51 2.26 1.84 3.28 0.73 0.23 NA NA NA NA 6.72 7.04 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2.14 2.41 1.09 1.29 1.89 2.99 3.92 2.12 3.51 1.89 1.66 3.06 0.62 0.23 NA NA NA NA 6.83 7.88 Year 2007 Transitional Non-Facility PE RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.36 0.35 0.99 1.09 1.54 1.10 1.45 0.95 1.66 1.30 1.07 1.83 0.17 0.08 3.23 4.23 3.82 1.37 2.34 2.05 Fully Implemented Facility PE RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.50 0.40 0.84 0.97 1.51 1.11 1.49 0.97 1.75 1.29 1.08 1.94 0.21 0.10 3.73 5.23 4.59 1.86 2.55 2.27 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 0157T 0158T 0159T 0159T 0159T 0160T 0161T 0162T 0163T 0164T 0165T 0166T 0167T 0168T 0169T 0170T 0171T 0172T 0173T 0174T 0175T 0176T 0177T 10021 10022 10040 10060 10061 10080 10081 10120 10121 10140 10160 10180 11000 11001 11004 11005 11006 11008 11010 11011 HCPCS 2 CPT 1/ Fully Implemented NonFacility PE RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.10 0.08 0.05 0.12 0.26 0.11 0.24 0.12 0.33 0.19 0.14 0.35 0.07 0.04 0.67 0.96 1.28 0.61 0.66 0.74 Mal-Practice RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3.48 3.37 2.56 2.82 4.77 3.95 6.18 3.30 6.55 4.00 3.20 5.90 1.40 0.57 NA NA NA NA 11.57 12.72 Fully Implemented NonFacility Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3.51 3.76 2.33 2.60 4.57 4.29 6.63 3.47 6.55 3.63 3.02 5.68 1.29 0.57 NA NA NA NA 11.68 13.56 Year 2007 Transitional Non-Facility Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.73 1.70 2.23 2.40 4.22 2.40 4.16 2.30 4.70 3.04 2.43 4.45 0.84 0.42 14.70 19.43 18.20 6.98 7.19 7.73 Fully Implemented Facility Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.87 1.75 2.08 2.28 4.19 2.41 4.20 2.32 4.79 3.03 2.44 4.56 0.88 0.44 15.20 20.43 18.97 7.47 7.40 7.95 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX ZZZ ZZZ ZZZ XXX XXX XXX YYY YYY YYY XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX 010 010 010 010 010 010 010 010 010 010 000 ZZZ 000 000 000 ZZZ 010 000 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69793 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00172 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A R R R A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Debride skin/muscle/bone, fx ............................... Debride skin, partial ............................................. Debride skin, full .................................................. Debride skin/tissue ............................................... Debride tissue/muscle .......................................... Debride tissue/muscle/bone ................................. Trim skin lesion .................................................... Trim skin lesions, 2 to 4 ....................................... Trim skin lesions, over 4 ...................................... Biopsy, skin lesion ............................................... Biopsy, skin add-on .............................................. Removal of skin tags ........................................... Remove skin tags add-on .................................... Shave skin lesion ................................................. Shave skin lesion ................................................. Shave skin lesion ................................................. Shave skin lesion ................................................. Shave skin lesion ................................................. Shave skin lesion ................................................. Shave skin lesion ................................................. Shave skin lesion ................................................. Shave skin lesion ................................................. Shave skin lesion ................................................. Shave skin lesion ................................................. Shave skin lesion ................................................. Exc tr-ext b9+marg 0.5 < cm ............................... Exc tr-ext b9+marg 0.6–1 cm .............................. Exc tr-ext b9+marg 1.1–2 cm .............................. Exc tr-ext b9+marg 2.1–3 cm .............................. Exc tr-ext b9+marg 3.1–4 cm .............................. Exc tr-ext b9+marg > 4.0 cm ............................... Exc h-f-nk-sp b9+marg 0.5 < ............................... Exc h-f-nk-sp b9+marg 0.6–1 .............................. Exc h-f-nk-sp b9+marg 1.1–2 .............................. Exc h-f-nk-sp b9+marg 2.1–3 .............................. Exc h-f-nk-sp b9+marg 3.1–4 .............................. Exc h-f-nk-sp b9+marg > 4 cm ............................ Exc face-mm b9+marg 0.5 < cm ......................... Exc face-mm b9+marg 0.6–1 cm ......................... Exc face-mm b9+marg 1.1–2 cm ......................... Exc face-mm b9+marg 2.1–3 cm ......................... Exc face-mm b9+marg 3.1–4 cm ......................... Exc face-mm b9+marg > 4 cm ............................ Description 6.87 0.50 0.60 0.80 3.04 4.11 0.43 0.61 0.79 0.81 0.41 0.79 0.29 0.51 0.85 1.05 1.24 0.67 0.99 1.14 1.41 0.73 1.05 1.20 1.62 0.87 1.25 1.42 1.81 2.08 3.47 1.00 1.44 1.65 2.03 2.45 4.04 1.02 1.50 1.74 2.31 3.16 4.75 Physician Work RVUs 3 8.98 0.68 0.73 0.96 3.64 4.95 0.82 0.89 1.00 1.89 0.42 1.23 0.16 1.19 1.51 1.78 2.03 1.07 1.43 1.71 1.75 1.39 1.65 1.94 2.21 1.88 2.18 2.39 2.55 2.86 3.50 1.83 2.22 2.42 2.65 2.97 3.59 2.01 2.39 2.63 2.87 3.28 4.06 11.32 0.56 0.68 0.97 3.45 4.58 0.63 0.70 0.81 1.41 0.35 1.09 0.16 1.04 1.21 1.42 1.69 0.91 1.18 1.40 1.53 1.18 1.34 1.55 1.90 1.96 2.08 2.26 2.43 2.74 3.17 1.78 2.10 2.29 2.60 2.84 3.51 2.15 2.35 2.56 2.90 3.42 4.05 Year 2007 Transitional Non-Facility PE RVUs 3.14 0.17 0.19 0.25 2.71 3.68 0.12 0.17 0.21 0.40 0.21 0.90 0.11 0.21 0.39 0.50 0.57 0.21 0.39 0.49 0.53 0.33 0.50 0.58 0.76 0.94 1.15 1.21 1.57 1.64 2.08 0.94 1.17 1.53 1.66 1.78 2.32 1.32 1.56 1.66 1.84 2.09 2.67 Fully Implemented Facility PE RVUs 3.67 0.20 0.30 0.39 2.62 3.73 0.16 0.22 0.28 0.38 0.20 0.80 0.12 0.21 0.38 0.47 0.53 0.26 0.41 0.49 0.58 0.32 0.49 0.56 0.73 0.90 1.05 1.11 1.38 1.46 1.76 0.93 1.13 1.38 1.50 1.65 2.16 1.31 1.51 1.59 1.82 2.16 2.75 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 11012 11040 11041 11042 11043 11044 11055 11056 11057 11100 11101 11200 11201 11300 11301 11302 11303 11305 11306 11307 11308 11310 11311 11312 11313 11400 11401 11402 11403 11404 11406 11420 11421 11422 11423 11424 11426 11440 11441 11442 11443 11444 11446 HCPCS 2 CPT 1/ Fully Implemented NonFacility PE RVUs 1.16 0.06 0.10 0.13 0.32 0.43 0.05 0.07 0.10 0.03 0.02 0.04 0.02 0.03 0.04 0.05 0.07 0.07 0.07 0.07 0.13 0.04 0.05 0.06 0.10 0.06 0.10 0.13 0.17 0.21 0.32 0.09 0.13 0.16 0.20 0.25 0.44 0.08 0.13 0.16 0.22 0.30 0.43 Mal-Practice RVUs 17.01 1.24 1.43 1.89 7.00 9.49 1.30 1.57 1.89 2.73 0.85 2.06 0.47 1.73 2.40 2.88 3.34 1.81 2.49 2.92 3.29 2.16 2.75 3.20 3.93 2.81 3.53 3.94 4.53 5.15 7.29 2.92 3.79 4.23 4.88 5.67 8.07 3.11 4.02 4.53 5.40 6.74 9.24 Fully Implemented NonFacility Total 19.35 1.12 1.38 1.90 6.81 9.12 1.11 1.38 1.70 2.25 0.78 1.92 0.47 1.58 2.10 2.52 3.00 1.65 2.24 2.61 3.07 1.95 2.44 2.81 3.62 2.89 3.43 3.81 4.41 5.03 6.96 2.87 3.67 4.10 4.83 5.54 7.99 3.25 3.98 4.46 5.43 6.88 9.23 Year 2007 Transitional Non-Facility Total 11.17 0.73 0.89 1.18 6.07 8.22 0.60 0.85 1.10 1.24 0.64 1.73 0.42 0.75 1.28 1.60 1.88 0.95 1.45 1.70 2.07 1.10 1.60 1.84 2.48 1.87 2.50 2.76 3.55 3.93 5.87 2.03 2.74 3.34 3.89 4.48 6.80 2.42 3.19 3.56 4.37 5.55 7.85 Fully Implemented Facility Total 11.70 0.76 1.00 1.32 5.98 8.27 0.64 0.90 1.17 1.22 0.63 1.63 0.43 0.75 1.27 1.57 1.84 1.00 1.47 1.70 2.12 1.09 1.59 1.82 2.45 1.83 2.40 2.66 3.36 3.75 5.55 2.02 2.70 3.19 3.73 4.35 6.64 2.41 3.14 3.49 4.35 5.62 7.93 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 000 000 000 000 010 010 000 000 000 000 ZZZ 010 ZZZ 000 000 000 000 000 000 000 000 000 000 000 000 010 010 010 010 010 010 010 010 010 010 010 010 010 010 010 010 010 010 Global 69794 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00173 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A R A A A A A A A A A A A A A A A A R R Status Removal, sweat gland lesion ............................... Removal, sweat gland lesion ............................... Removal, sweat gland lesion ............................... Removal, sweat gland lesion ............................... Removal, sweat gland lesion ............................... Removal, sweat gland lesion ............................... Exc tr-ext mlg+marg 0.5 < cm ............................. Exc tr-ext mlg+marg 0.6–1 cm ............................. Exc tr-ext mlg+marg 1.1–2 cm ............................. Exc tr-ext mlg+marg 2.1–3 cm ............................. Exc tr-ext mlg+marg 3.1–4 cm ............................. Exc tr-ext mlg+marg > 4 cm ................................ Exc h-f-nk-sp mlg+marg 0.5 < ............................. Exc h-f-nk-sp mlg+marg 0.6–1 ............................. Exc h-f-nk-sp mlg+marg 1.1–2 ............................. Exc h-f-nk-sp mlg+marg 2.1–3 ............................. Exc h-f-nk-sp mlg+marg 3.1–4 ............................. Exc h-f-nk-sp mlg+mar > 4 cm ............................ Exc face-mm malig+marg 0.5 < ........................... Exc face-mm malig+marg 0.6–1 .......................... Exc face-mm malig+marg 1.1–2 .......................... Exc face-mm malig+marg 2.1–3 .......................... Exc face-mm malig+marg 3.1–4 .......................... Exc face-mm mlg+marg > 4 cm .......................... Trim nail(s) ........................................................... Debride nail, 1–5 .................................................. Debride nail, 6 or more ........................................ Removal of nail plate ........................................... Remove nail plate, add-on ................................... Drain blood from under nail ................................. Removal of nail bed ............................................. Remove nail bed/finger tip ................................... Biopsy, nail unit .................................................... Repair of nail bed ................................................. Reconstruction of nail bed ................................... Excision of nail fold, toe ....................................... Removal of pilonidal lesion .................................. Removal of pilonidal lesion .................................. Removal of pilonidal lesion .................................. Injection into skin lesions ..................................... Added skin lesions injection ................................. Correct skin color defects .................................... Correct skin color defects .................................... Description 3.14 4.35 2.92 4.35 3.66 4.81 1.58 2.02 2.22 2.77 3.12 4.97 1.59 2.03 2.36 3.06 3.57 4.56 1.62 2.12 2.57 3.37 4.29 6.21 0.17 0.32 0.54 1.10 0.57 0.37 2.40 3.48 1.31 1.60 2.91 0.71 2.63 5.98 7.23 0.52 0.80 1.61 1.93 Physician Work RVUs 3 5.14 6.11 5.31 6.61 5.58 6.46 2.75 3.46 3.85 4.06 4.36 5.49 2.85 3.51 3.91 4.13 4.44 4.96 3.06 3.64 4.04 4.29 5.06 5.88 0.38 0.47 0.55 1.35 0.55 0.80 2.99 4.14 2.04 3.45 3.74 2.69 3.47 6.66 7.97 0.92 1.02 2.42 2.70 5.06 6.48 5.16 6.77 5.19 6.64 2.66 2.89 3.08 3.32 3.62 4.42 2.66 2.90 3.20 3.53 3.92 4.71 2.75 3.18 3.56 3.92 4.78 5.78 0.28 0.37 0.47 1.11 0.47 0.61 2.37 3.28 1.69 2.83 3.10 2.01 3.48 5.90 7.62 0.72 0.75 3.38 3.65 Year 2007 Transitional Non-Facility PE RVUs 2.43 2.79 2.48 2.99 2.71 3.00 1.15 1.53 1.72 1.89 1.96 2.48 1.20 1.56 1.77 1.98 2.11 2.35 1.30 1.63 1.86 2.13 2.48 3.15 0.05 0.09 0.15 0.30 0.15 0.44 1.92 2.84 0.77 1.45 1.72 1.02 1.54 3.72 5.52 0.26 0.41 1.15 1.30 Fully Implemented Facility PE RVUs 2.12 2.60 2.13 2.76 2.37 2.82 1.02 1.30 1.38 1.47 1.53 1.92 1.01 1.32 1.49 1.68 1.86 2.38 1.16 1.56 1.75 2.00 2.46 3.39 0.07 0.11 0.20 0.40 0.20 0.37 1.79 2.95 0.77 1.70 2.19 0.83 1.51 3.41 5.18 0.22 0.37 1.11 1.28 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 11450 11451 11462 11463 11470 11471 11600 11601 11602 11603 11604 11606 11620 11621 11622 11623 11624 11626 11640 11641 11642 11643 11644 11646 11719 11720 11721 11730 11732 11740 11750 11752 11755 11760 11762 11765 11770 11771 11772 11900 11901 11920 11921 HCPCS 2 CPT 1/ Fully Implemented NonFacility PE RVUs 0.34 0.53 0.32 0.54 0.40 0.58 0.10 0.12 0.12 0.16 0.20 0.36 0.09 0.12 0.14 0.20 0.27 0.45 0.11 0.16 0.19 0.26 0.37 0.61 0.02 0.04 0.07 0.14 0.07 0.04 0.22 0.35 0.14 0.21 0.36 0.08 0.33 0.74 0.89 0.02 0.03 0.24 0.29 Mal-Practice RVUs 8.62 10.99 8.55 11.50 9.64 11.85 4.43 5.60 6.19 6.99 7.68 10.82 4.53 5.66 6.41 7.39 8.28 9.97 4.79 5.92 6.80 7.92 9.72 12.70 0.57 0.83 1.16 2.59 1.19 1.21 5.61 7.97 3.49 5.26 7.01 3.48 6.43 13.38 16.09 1.46 1.85 4.27 4.92 Fully Implemented NonFacility Total 8.54 11.36 8.40 11.66 9.25 12.03 4.34 5.03 5.42 6.25 6.94 9.75 4.34 5.05 5.70 6.79 7.76 9.72 4.48 5.46 6.32 7.55 9.44 12.60 0.47 0.73 1.08 2.35 1.11 1.02 4.99 7.11 3.14 4.64 6.37 2.80 6.44 12.62 15.74 1.26 1.58 5.23 5.87 Year 2007 Transitional Non-Facility Total 5.91 7.67 5.72 7.88 6.77 8.39 2.83 3.67 4.06 4.82 5.28 7.81 2.88 3.71 4.27 5.24 5.95 7.36 3.03 3.91 4.62 5.76 7.14 9.97 0.24 0.45 0.76 1.54 0.79 0.85 4.54 6.67 2.22 3.26 4.99 1.81 4.50 10.44 13.64 0.80 1.24 3.00 3.52 Fully Implemented Facility Total 5.60 7.48 5.37 7.65 6.43 8.21 2.70 3.44 3.72 4.40 4.85 7.25 2.69 3.47 3.99 4.94 5.70 7.39 2.89 3.84 4.51 5.63 7.12 10.21 0.26 0.47 0.81 1.64 0.84 0.78 4.41 6.78 2.22 3.51 5.46 1.62 4.47 10.13 13.30 0.76 1.20 2.96 3.50 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 010 010 010 010 010 010 010 010 010 010 010 010 010 010 010 010 010 010 000 000 000 000 ZZZ 000 010 010 000 010 010 010 010 090 090 000 000 000 000 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69795 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00174 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod R R R R R A A A N R N A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Correct skin color defects .................................... Therapy for contour defects ................................. Therapy for contour defects ................................. Therapy for contour defects ................................. Therapy for contour defects ................................. Insert tissue expander(s) ..................................... Replace tissue expander ..................................... Remove tissue expander(s) ................................. Insert contraceptive cap ....................................... Removal of contraceptive cap ............................. Removal/reinsert contra cap ................................ Implant hormone pellet(s) .................................... Insert drug implant device .................................... Remove drug implant device ............................... Remove/insert drug implant ................................. Repair superficial wound(s) ................................. Repair superficial wound(s) ................................. Repair superficial wound(s) ................................. Repair superficial wound(s) ................................. Repair superficial wound(s) ................................. Repair superficial wound(s) ................................. Repair superficial wound(s) ................................. Repair superficial wound(s) ................................. Repair superficial wound(s) ................................. Repair superficial wound(s) ................................. Repair superficial wound(s) ................................. Repair superficial wound(s) ................................. Repair superficial wound(s) ................................. Closure of split wound ......................................... Closure of split wound ......................................... Layer closure of wound(s) ................................... Layer closure of wound(s) ................................... Layer closure of wound(s) ................................... Layer closure of wound(s) ................................... Layer closure of wound(s) ................................... Layer closure of wound(s) ................................... Layer closure of wound(s) ................................... Layer closure of wound(s) ................................... Layer closure of wound(s) ................................... Layer closure of wound(s) ................................... Layer closure of wound(s) ................................... Layer closure of wound(s) ................................... Layer closure of wound(s) ................................... Description 0.49 0.84 1.19 1.69 1.85 11.01 7.86 3.21 1.48 1.78 3.30 1.48 1.48 1.78 3.30 1.72 1.88 2.26 2.88 3.68 4.13 1.78 2.01 2.48 3.21 3.94 4.72 5.54 2.64 1.86 2.17 2.49 2.94 3.44 4.06 4.68 2.39 2.76 3.16 3.65 4.26 4.66 2.49 Physician Work RVUs 3 0.94 0.87 1.19 1.75 1.77 NA NA 7.48 1.52 1.70 1.97 1.16 1.92 2.04 2.68 1.73 1.79 2.07 2.52 3.03 3.39 1.90 2.06 2.28 2.76 3.16 NA NA 3.75 1.85 3.90 5.22 4.58 5.26 5.37 5.94 3.85 4.49 5.34 5.07 5.63 6.17 4.12 1.09 1.07 1.42 1.83 2.27 NA NA 8.70 1.45 1.72 2.20 1.10 1.76 1.97 2.38 1.92 1.98 2.26 2.75 3.30 3.71 2.07 2.22 2.50 3.04 3.45 NA NA 3.80 1.83 2.69 4.19 3.54 5.21 5.51 6.05 2.87 3.57 3.74 5.21 6.28 6.30 3.48 Year 2007 Transitional Non-Facility PE RVUs 0.23 0.36 0.54 0.84 0.78 10.76 6.35 4.09 0.34 0.47 0.76 0.56 0.60 0.73 1.36 0.73 0.84 0.93 1.08 1.31 1.50 0.76 0.89 0.98 1.13 1.30 1.50 2.01 1.79 1.33 1.79 2.30 2.00 2.11 2.24 2.62 1.78 2.14 1.94 2.08 2.29 2.54 1.94 Fully Implemented Facility PE RVUs 0.25 0.38 0.52 0.72 0.87 10.48 6.19 3.87 0.51 0.63 1.14 0.55 0.66 0.81 1.44 0.76 0.89 0.99 1.17 1.46 1.73 0.78 0.92 1.04 1.22 1.47 1.79 2.19 1.89 1.39 1.17 1.92 1.59 2.14 2.47 2.88 1.29 1.63 1.69 2.23 2.64 2.95 1.57 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 11922 11950 11951 11952 11954 11960 11970 11971 11975 11976 11977 11980 11981 11982 11983 12001 12002 12004 12005 12006 12007 12011 12013 12014 12015 12016 12017 12018 12020 12021 12031 12032 12034 12035 12036 12037 12041 12042 12044 12045 12046 12047 12051 HCPCS 2 CPT 1/ Fully Implemented NonFacility PE RVUs 0.07 0.06 0.11 0.16 0.25 1.31 1.05 0.32 0.17 0.21 0.37 0.13 0.12 0.17 0.23 0.15 0.17 0.21 0.27 0.35 0.45 0.16 0.18 0.23 0.29 0.37 0.47 0.64 0.30 0.24 0.17 0.16 0.25 0.39 0.55 0.66 0.19 0.17 0.27 0.41 0.54 0.58 0.20 Mal-Practice RVUs 1.50 1.77 2.49 3.60 3.87 NA NA 11.01 3.17 3.69 5.64 2.77 3.52 3.99 6.21 3.60 3.84 4.54 5.67 7.06 7.97 3.84 4.25 4.99 6.26 7.47 NA NA 6.69 3.95 6.24 7.87 7.77 9.09 9.98 11.28 6.43 7.42 8.77 9.13 10.43 11.41 6.81 Fully Implemented NonFacility Total 1.65 1.97 2.72 3.68 4.37 NA NA 12.23 3.10 3.71 5.87 2.71 3.36 3.92 5.91 3.79 4.03 4.73 5.90 7.33 8.29 4.01 4.41 5.21 6.54 7.76 NA NA 6.74 3.93 5.03 6.84 6.73 9.04 10.12 11.39 5.45 6.50 7.17 9.27 11.08 11.54 6.17 Year 2007 Transitional Non-Facility Total 0.79 1.26 1.84 2.69 2.88 23.08 15.26 7.62 1.99 2.46 4.43 2.17 2.20 2.68 4.89 2.60 2.89 3.40 4.23 5.34 6.08 2.70 3.08 3.69 4.63 5.61 6.69 8.19 4.73 3.43 4.13 4.95 5.19 5.94 6.85 7.96 4.36 5.07 5.37 6.14 7.09 7.78 4.63 Fully Implemented Facility Total 0.81 1.28 1.82 2.57 2.97 22.80 15.10 7.40 2.16 2.62 4.81 2.16 2.26 2.76 4.97 2.63 2.94 3.46 4.32 5.49 6.31 2.72 3.11 3.75 4.72 5.78 6.98 8.37 4.83 3.49 3.51 4.57 4.78 5.97 7.08 8.22 3.87 4.56 5.12 6.29 7.44 8.19 4.26 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 ZZZ 000 000 000 000 090 090 090 XXX 000 XXX 000 XXX XXX XXX 010 010 010 010 010 010 010 010 010 010 010 010 010 010 010 010 010 010 010 010 010 010 010 010 010 010 010 010 Global 69796 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00175 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Layer closure of wound(s) ................................... Layer closure of wound(s) ................................... Layer closure of wound(s) ................................... Layer closure of wound(s) ................................... Layer closure of wound(s) ................................... Layer closure of wound(s) ................................... Repair of wound or lesion .................................... Repair of wound or lesion .................................... Repair wound/lesion add-on ................................ Repair of wound or lesion .................................... Repair of wound or lesion .................................... Repair wound/lesion add-on ................................ Repair of wound or lesion .................................... Repair of wound or lesion .................................... Repair wound/lesion add-on ................................ Repair of wound or lesion .................................... Repair of wound or lesion .................................... Repair of wound or lesion .................................... Repair wound/lesion add-on ................................ Late closure of wound .......................................... Skin tissue rearrangement ................................... Skin tissue rearrangement ................................... Skin tissue rearrangement ................................... Skin tissue rearrangement ................................... Skin tissue rearrangement ................................... Skin tissue rearrangement ................................... Skin tissue rearrangement ................................... Skin tissue rearrangement ................................... Skin tissue rearrangement ................................... Skin tissue rearrangement ................................... Wnd prep, ch/inf, trk/arm/lg .................................. Wnd prep, ch/inf addl 100 cm .............................. Wnd prep ch/inf, f/n/hf/g ....................................... Wnd prep, f/n/hf/g, addl cm ................................. Harvest cultured skin graft ................................... Skin pinch graft .................................................... Skin splt grft, trnk/arm/leg .................................... Skin splt grft t/a/l, add-on ..................................... Epidrm autogrft trnk/arm/leg ................................ Epidrm autogrft t/a/l add-on ................................. Epidrm a-grft face/nck/hf/g ................................... Epidrm a-grft f/n/hf/g addl .................................... Skn splt a-grft fac/nck/hf/g ................................... Description 2.81 3.14 3.47 4.44 5.25 5.97 3.14 3.93 1.24 3.32 4.36 1.44 3.80 6.48 2.19 3.82 4.46 6.34 2.38 11.84 6.83 9.60 7.66 11.18 8.44 12.67 9.07 13.67 13.26 10.82 3.65 0.80 4.58 1.60 2.00 5.37 9.74 1.72 10.88 1.85 11.19 2.50 10.96 Physician Work RVUs 3 4.89 5.36 5.40 6.05 6.23 7.47 4.44 5.99 1.37 4.60 6.74 1.40 5.03 7.97 1.88 4.72 5.55 7.60 2.03 NA 9.00 11.20 10.07 12.57 10.26 13.72 9.74 15.01 13.67 NA 4.12 0.92 4.77 1.28 3.86 7.71 9.91 2.51 9.01 0.90 9.31 1.24 11.33 3.64 3.77 4.02 4.87 6.62 6.47 4.15 4.99 1.22 4.26 5.32 1.48 4.53 6.42 1.72 4.83 4.99 6.42 1.96 NA 8.14 9.86 8.98 10.63 9.17 11.37 9.02 12.45 11.77 NA 4.12 0.92 4.77 1.28 4.39 7.11 11.91 3.43 10.26 1.19 9.24 1.50 10.87 Year 2007 Transitional Non-Facility PE RVUs 2.60 2.13 2.08 2.15 2.42 2.86 2.49 3.02 0.55 2.61 3.69 0.61 2.91 5.04 1.00 2.74 3.27 3.99 1.03 7.13 6.12 7.67 6.95 8.79 7.07 9.51 7.25 10.37 9.62 7.05 1.65 0.28 1.97 0.56 1.05 5.09 6.82 0.88 6.61 0.65 6.83 0.91 7.48 Fully Implemented Facility PE RVUs 1.72 1.68 1.74 2.13 2.89 3.53 2.35 2.77 0.57 2.41 3.02 0.63 2.74 4.38 1.02 2.76 3.17 4.03 1.11 7.15 5.63 7.22 6.64 8.41 7.17 8.88 7.39 9.72 9.28 7.12 1.65 0.28 1.97 0.56 1.11 5.11 7.57 1.10 6.90 0.76 7.22 1.07 7.71 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 12052 12053 12054 12055 12056 12057 13100 13101 13102 13120 13121 13122 13131 13132 13133 13150 13151 13152 13153 13160 14000 14001 14020 14021 14040 14041 14060 14061 14300 14350 15002 15003 15004 15005 15040 15050 15100 15101 15110 15111 15115 15116 15120 HCPCS 2 CPT 1/ Fully Implemented NonFacility PE RVUs 0.17 0.23 0.30 0.45 0.59 0.56 0.26 0.26 0.13 0.26 0.25 0.15 0.26 0.32 0.18 0.34 0.31 0.40 0.24 1.54 0.59 0.82 0.64 0.81 0.62 0.73 0.68 0.76 1.16 1.34 0.49 0.11 0.62 0.22 0.24 0.57 1.28 0.24 1.31 0.26 1.15 0.33 1.16 Mal-Practice RVUs 7.87 8.73 9.17 10.94 12.07 14.00 7.84 10.18 2.74 8.18 11.35 2.99 9.09 14.77 4.25 8.88 10.32 14.34 4.65 NA 16.42 21.62 18.37 24.56 19.32 27.12 19.49 29.44 28.09 NA 8.26 1.83 9.97 3.10 6.10 13.65 20.93 4.47 21.20 3.01 21.65 4.07 23.45 Fully Implemented NonFacility Total 6.62 7.14 7.79 9.76 12.46 13.00 7.55 9.18 2.59 7.84 9.93 3.07 8.59 13.22 4.09 8.99 9.76 13.16 4.58 NA 15.56 20.28 17.28 22.62 18.23 24.77 18.77 26.88 26.19 NA 8.26 1.83 9.97 3.10 6.63 13.05 22.93 5.39 22.45 3.30 21.58 4.33 22.99 Year 2007 Transitional Non-Facility Total 5.58 5.50 5.85 7.04 8.26 9.39 5.89 7.21 1.92 6.19 8.30 2.20 6.97 11.84 3.37 6.90 8.04 10.73 3.65 20.51 13.54 18.09 15.25 20.78 16.13 22.91 17.00 24.80 24.04 19.21 5.79 1.19 7.17 2.38 3.29 11.03 17.84 2.84 18.80 2.76 19.17 3.74 19.60 Fully Implemented Facility Total 4.70 5.05 5.51 7.02 8.73 10.06 5.75 6.96 1.94 5.99 7.63 2.22 6.80 11.18 3.39 6.92 7.94 10.77 3.73 20.53 13.05 17.64 14.94 20.40 16.23 22.28 17.14 24.15 23.70 19.28 5.79 1.19 7.17 2.38 3.35 11.05 18.59 3.06 19.09 2.87 19.56 3.90 19.83 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 010 010 010 010 010 010 010 010 ZZZ 010 010 ZZZ 010 010 ZZZ 010 010 010 ZZZ 090 090 090 090 090 090 090 090 090 090 090 000 ZZZ 000 ZZZ 000 090 090 ZZZ 090 ZZZ 090 ZZZ 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69797 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00176 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C Status Skn splt a-grft f/n/hf/g add ................................... Derm autograft, trnk/arm/leg ................................ Derm autograft t/a/l add-on .................................. Derm autograft face/nck/hf/g ................................ Derm autograft, f/n/hf/g add ................................. Cult epiderm grft t/arm/leg ................................... Cult epiderm grft t/a/l addl ................................... Cult epiderm graft t/a/l +% ................................... Cult epiderm graft, f/n/hf/g ................................... Cult epidrm grft f/n/hfg add .................................. Cult epiderm grft f/n/hfg +% ................................. Acell graft trunk/arms/legs ................................... Acell graft t/arm/leg add-on .................................. Acellular graft, f/n/hf/g .......................................... Acell graft, f/n/hf/g add-on .................................... Skin full graft, trunk .............................................. Skin full graft trunk add-on ................................... Skin full graft sclp/arm/leg .................................... Skin full graft add-on ............................................ Skin full grft face/genit/hf ..................................... Skin full graft add-on ............................................ Skin full graft een & lips ....................................... Skin full graft add-on ............................................ Apply skinallogrft, t/arm/lg .................................... Apply sknallogrft t/a/l addl .................................... Apply skin allogrft f/n/hf/g ..................................... Aply sknallogrft f/n/hfg add .................................. Aply acell alogrft t/arm/leg ................................... Aply acell grft t/a/l add-on .................................... Apply acell graft, f/n/hf/g ...................................... Aply acell grft f/n/hf/g add .................................... Apply cult skin substitute ..................................... Apply cult skin sub add-on ................................... Apply cult derm sub, t/a/l ..................................... Aply cult derm sub t/a/l add ................................. Apply cult derm sub f/n/hf/g ................................. Apply cult derm f/hf/g add .................................... Apply skin xenograft, t/a/l ..................................... Apply skn xenogrft t/a/l add ................................. Apply skin xgraft, f/n/hf/g ..................................... Apply skn xgrft f/n/hf/g add .................................. Apply acellular xenograft ...................................... Apply acellular xgraft add .................................... Description 2.67 7.41 1.50 10.91 1.50 9.30 2.00 2.50 10.05 2.75 3.00 5.99 1.55 7.99 2.45 8.97 1.32 7.95 1.19 10.15 1.86 11.39 2.23 4.65 1.00 5.36 1.50 3.99 1.00 4.50 1.43 3.76 0.50 3.93 1.15 4.21 1.45 4.38 1.00 4.89 1.50 5.93 0.00 Physician Work RVUs 3 3.47 8.09 0.71 9.56 0.69 7.29 0.92 1.09 7.74 1.20 1.39 3.68 0.66 5.33 1.08 9.97 2.13 10.46 2.03 12.05 2.54 13.08 2.97 3.38 0.48 3.77 0.69 3.16 0.47 3.42 0.72 3.80 0.72 4.46 0.58 4.36 0.69 4.97 1.02 5.11 1.20 7.11 0.00 4.24 9.42 0.98 9.79 0.84 8.17 1.21 1.44 7.80 1.47 1.68 3.79 0.68 5.40 1.10 9.54 2.45 9.50 2.25 10.66 2.47 10.93 2.76 3.25 0.47 3.66 0.69 3.18 0.46 3.46 0.70 3.95 0.64 4.47 0.58 4.50 0.70 4.25 1.67 4.86 1.29 6.95 0.00 Year 2007 Transitional Non-Facility PE RVUs 1.34 5.71 0.53 7.14 0.55 6.01 0.71 0.89 6.40 1.00 1.09 2.39 0.52 3.84 0.83 6.42 0.58 6.73 0.52 8.94 0.83 9.43 1.17 2.13 0.34 2.35 0.51 1.93 0.34 2.09 0.49 2.74 0.17 3.27 0.39 3.21 0.49 3.76 0.35 3.93 0.53 6.53 0.00 Fully Implemented Facility PE RVUs 1.72 6.18 0.61 7.88 0.64 6.33 0.82 1.02 6.82 1.18 1.29 2.37 0.60 3.96 0.95 6.26 0.61 6.69 0.55 8.20 0.89 8.79 1.34 2.21 0.39 2.49 0.57 2.15 0.39 2.35 0.55 2.75 0.19 3.13 0.44 3.20 0.56 3.95 0.42 3.83 0.60 6.59 0.00 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 15121 15130 15131 15135 15136 15150 15151 15152 15155 15156 15157 15170 15171 15175 15176 15200 15201 15220 15221 15240 15241 15260 15261 15300 15301 15320 15321 15330 15331 15335 15336 15340 15341 15360 15361 15365 15366 15400 15401 15420 15421 15430 15431 HCPCS 2 CPT 1/ Fully Implemented NonFacility PE RVUs 0.36 0.97 0.21 1.23 0.20 1.14 0.28 0.35 1.05 0.36 0.39 0.55 0.19 0.82 0.29 0.98 0.19 0.84 0.16 0.92 0.23 0.69 0.21 0.49 0.14 0.58 0.21 0.49 0.14 0.55 0.20 0.41 0.06 0.43 0.14 0.46 0.17 0.47 0.14 0.52 0.21 0.66 0.00 Mal-Practice RVUs 6.50 16.47 2.42 21.70 2.39 17.73 3.20 3.94 18.84 4.31 4.78 10.22 2.40 14.14 3.82 19.92 3.64 19.25 3.38 23.12 4.63 25.16 5.41 8.52 1.62 9.71 2.40 7.64 1.61 8.47 2.35 7.97 1.28 8.82 1.87 9.03 2.31 9.82 2.16 10.52 2.91 13.70 0.00 Fully Implemented NonFacility Total 7.27 17.80 2.69 21.93 2.54 18.61 3.49 4.29 18.90 4.58 5.07 10.33 2.42 14.21 3.84 19.49 3.96 18.29 3.60 21.73 4.56 23.01 5.20 8.39 1.61 9.60 2.40 7.66 1.60 8.51 2.33 8.12 1.20 8.83 1.87 9.17 2.32 9.10 2.81 10.27 3.00 13.54 0.00 Year 2007 Transitional Non-Facility Total 4.37 14.09 2.24 19.28 2.25 16.45 2.99 3.74 17.50 4.11 4.48 8.93 2.26 12.65 3.57 16.37 2.09 15.52 1.87 20.01 2.92 21.51 3.61 7.27 1.48 8.29 2.22 6.41 1.48 7.14 2.12 6.91 0.73 7.63 1.68 7.88 2.11 8.61 1.49 9.34 2.24 13.12 0.00 Fully Implemented Facility Total 4.75 14.56 2.32 20.02 2.34 16.77 3.10 3.87 17.92 4.29 4.68 8.91 2.34 12.77 3.69 16.21 2.12 15.48 1.90 19.27 2.98 20.87 3.78 7.35 1.53 8.43 2.28 6.63 1.53 7.40 2.18 6.92 0.75 7.49 1.73 7.87 2.18 8.80 1.56 9.24 2.31 13.18 0.00 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 ZZZ 090 ZZZ 090 ZZZ 090 ZZZ ZZZ 090 ZZZ ZZZ 090 ZZZ 090 ZZZ 090 ZZZ 090 ZZZ 090 ZZZ 090 ZZZ 090 ZZZ 090 ZZZ 090 ZZZ 090 ZZZ 010 ZZZ 090 ZZZ 090 ZZZ 090 ZZZ 090 ZZZ 090 ZZZ Global 69798 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00177 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A R R A A A A A A R R R A A A A A A R R R R R Status Form skin pedicle flap .......................................... Form skin pedicle flap .......................................... Form skin pedicle flap .......................................... Form skin pedicle flap .......................................... Skin graft .............................................................. Skin graft .............................................................. Skin graft .............................................................. Skin graft .............................................................. Transfer skin pedicle flap ..................................... Forehead flap w/vasc pedicle .............................. Muscle-skin graft, head/neck ............................... Muscle-skin graft, trunk ........................................ Muscle-skin graft, arm .......................................... Muscle-skin graft, leg ........................................... Island pedicle flap graft ........................................ Neurovascular pedicle graft ................................. Free myo/skin flap microvasc .............................. Free skin flap, microvasc ..................................... Free fascial flap, microvasc ................................. Composite skin graft ............................................ Derma-fat-fascia graft .......................................... Hair transplant punch grafts ................................. Hair transplant punch grafts ................................. Abrasion treatment of skin ................................... Abrasion treatment of skin ................................... Abrasion treatment of skin ................................... Abrasion treatment of skin ................................... Abrasion, lesion, single ........................................ Abrasion, lesions, add-on .................................... Chemical peel, face, epiderm .............................. Chemical peel, face, dermal ................................ Chemical peel, nonfacial ...................................... Chemical peel, nonfacial ...................................... Plastic surgery, neck ............................................ Revision of lower eyelid ....................................... Revision of lower eyelid ....................................... Revision of upper eyelid ...................................... Revision of upper eyelid ...................................... Removal of forehead wrinkles ............................. Removal of neck wrinkles .................................... Removal of brow wrinkles .................................... Removal of face wrinkles ..................................... Removal of skin wrinkles ..................................... Description 10.00 9.94 10.52 9.24 1.95 2.46 3.62 3.95 4.64 14.12 19.70 19.62 16.92 18.92 11.57 12.73 36.74 36.95 36.70 9.68 8.73 3.95 5.53 8.50 4.91 4.36 4.33 2.05 0.33 2.09 4.91 1.86 3.82 10.45 6.09 6.66 4.51 8.12 0.00 0.00 0.00 0.00 0.00 Physician Work RVUs 3 10.45 9.89 10.50 9.72 5.31 5.59 6.40 7.03 7.12 12.13 14.97 16.00 13.99 14.24 13.63 NA NA NA NA 10.35 NA 3.50 3.91 11.84 8.68 9.63 8.13 3.81 0.83 8.55 9.26 6.83 5.56 NA 6.53 6.78 5.38 7.65 0.00 0.00 0.00 0.00 0.00 11.09 9.59 10.64 9.74 7.03 4.92 7.44 7.04 7.14 12.13 17.27 17.58 17.17 17.04 11.01 NA NA NA NA 10.10 NA 4.05 4.99 11.60 7.35 9.80 7.19 3.47 1.03 7.17 8.38 7.03 6.10 NA 6.86 7.21 5.72 7.80 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Non-Facility PE RVUs 6.57 6.78 7.04 6.60 2.75 3.07 3.87 4.31 4.30 9.56 11.41 12.16 10.18 10.63 9.52 9.04 18.90 17.08 16.92 7.04 6.66 1.72 1.60 6.91 5.68 5.58 5.13 1.26 0.11 3.73 5.77 3.47 3.31 6.83 5.32 5.47 4.23 6.36 0.00 0.00 0.00 0.00 0.00 Fully Implemented Facility PE RVUs 6.71 6.53 7.60 6.81 2.98 3.33 3.88 4.19 4.23 9.56 12.01 12.32 10.96 11.45 8.58 9.04 20.15 20.46 20.41 7.21 6.68 1.41 2.50 7.92 5.44 6.31 4.42 1.31 0.15 3.24 5.04 4.21 4.11 7.09 5.50 5.65 4.43 6.41 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 15570 15572 15574 15576 15600 15610 15620 15630 15650 15731 15732 15734 15736 15738 15740 15750 15756 15757 15758 15760 15770 15775 15776 15780 15781 15782 15783 15786 15787 15788 15789 15792 15793 15819 15820 15821 15822 15823 15824 15825 15826 15828 15829 HCPCS 2 CPT 1/ Fully Implemented NonFacility PE RVUs 1.34 1.20 1.20 0.87 0.27 0.35 0.35 0.34 0.42 1.28 2.00 2.62 2.46 2.66 0.63 1.42 4.62 3.90 4.24 0.85 1.05 0.52 0.72 0.67 0.34 0.34 0.28 0.11 0.04 0.11 0.20 0.13 0.19 0.97 0.40 0.45 0.37 0.50 0.00 0.00 0.00 0.00 0.00 Mal-Practice RVUs 21.79 21.03 22.22 19.83 7.53 8.40 10.37 11.32 12.18 27.53 36.67 38.24 33.37 35.82 25.83 NA NA NA NA 20.88 NA 7.97 10.16 21.01 13.93 14.33 12.74 5.97 1.20 10.75 14.37 8.82 9.57 NA 13.02 13.89 10.26 16.27 0.00 0.00 0.00 0.00 0.00 Fully Implemented NonFacility Total 22.43 20.73 22.36 19.85 9.25 7.73 11.41 11.33 12.20 27.53 38.97 39.82 36.55 38.62 23.21 NA NA NA NA 20.63 NA 8.52 11.24 20.77 12.60 14.50 11.80 5.63 1.40 9.37 13.49 9.02 10.11 NA 13.35 14.32 10.60 16.42 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Non-Facility Total 17.91 17.92 18.76 16.71 4.97 5.88 7.84 8.60 9.36 24.96 33.11 34.40 29.56 32.21 21.72 23.19 60.26 57.93 57.86 17.57 16.44 6.19 7.85 16.08 10.93 10.28 9.74 3.42 0.48 5.93 10.88 5.46 7.32 18.25 11.81 12.58 9.11 14.98 0.00 0.00 0.00 0.00 0.00 Fully Implemented Facility Total 18.05 17.67 19.32 16.92 5.20 6.14 7.85 8.48 9.29 24.96 33.71 34.56 30.34 33.03 20.78 23.19 61.51 61.31 61.35 17.74 16.46 5.88 8.75 17.09 10.69 11.01 9.03 3.47 0.52 5.44 10.15 6.20 8.12 18.51 11.99 12.76 9.31 15.03 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 000 000 090 090 090 090 010 ZZZ 090 090 090 090 090 090 090 090 090 000 000 000 000 000 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69799 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00178 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod R A A A A A A A A A A A A C B A A A R R R R A A A A A A A A A A A A A A A A A A A C A Status Exc skin abd ......................................................... Excise excessive skin tissue ................................ Excise excessive skin tissue ................................ Excise excessive skin tissue ................................ Excise excessive skin tissue ................................ Excise excessive skin tissue ................................ Excise excessive skin tissue ................................ Excise excessive skin tissue ................................ Excise excessive skin tissue ................................ Graft for face nerve palsy .................................... Graft for face nerve palsy .................................... Flap for face nerve palsy ..................................... Skin and muscle repair, face ............................... Exc skin abd add-on ............................................ Removal of sutures .............................................. Removal of sutures .............................................. Dressing change not for burn .............................. Test for blood flow in graft ................................... Suction assisted lipectomy ................................... Suction assisted lipectomy ................................... Suction assisted lipectomy ................................... Suction assisted lipectomy ................................... Removal of tail bone ulcer ................................... Removal of tail bone ulcer ................................... Remove sacrum pressure sore ............................ Remove sacrum pressure sore ............................ Remove sacrum pressure sore ............................ Remove sacrum pressure sore ............................ Remove sacrum pressure sore ............................ Remove sacrum pressure sore ............................ Remove hip pressure sore ................................... Remove hip pressure sore ................................... Remove hip pressure sore ................................... Remove hip pressure sore ................................... Remove hip pressure sore ................................... Remove thigh pressure sore ................................ Remove thigh pressure sore ................................ Remove thigh pressure sore ................................ Remove thigh pressure sore ................................ Remove thigh pressure sore ................................ Remove thigh pressure sore ................................ Removal of pressure sore .................................... Initial treatment of burn(s) .................................... Description 16.90 12.65 11.70 11.97 12.79 10.41 9.37 8.07 10.32 14.76 25.69 40.68 14.04 0.00 0.78 0.86 0.86 1.95 0.00 0.00 0.00 0.00 8.15 10.23 9.96 11.60 13.54 15.58 13.04 15.00 10.11 12.24 12.27 13.57 23.80 7.91 11.41 12.14 13.39 16.59 16.55 0.00 0.89 Physician Work RVUs 3 NA NA NA NA NA NA 8.77 NA 9.42 NA NA NA NA 0.00 1.19 1.33 NA NA 0.00 0.00 0.00 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 0.73 NA NA NA NA NA NA 8.61 NA 8.97 NA NA NA NA 0.00 1.47 1.59 NA NA 0.00 0.00 0.00 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 0.83 Year 2007 Transitional Non-Facility PE RVUs 10.15 8.43 7.16 7.86 7.92 7.12 5.80 4.97 6.25 8.75 13.33 21.64 8.90 0.00 0.18 0.24 0.26 0.71 0.00 0.00 0.00 0.00 5.86 7.11 5.57 7.39 7.72 10.34 7.60 9.14 5.91 8.66 8.42 9.35 14.26 5.43 8.11 7.90 9.28 9.79 10.48 0.00 0.24 Fully Implemented Facility PE RVUs 10.15 8.36 7.95 7.73 7.64 6.87 6.98 5.79 6.36 9.67 14.58 22.59 9.20 0.00 0.27 0.29 0.31 0.76 0.00 0.00 0.00 0.00 5.63 7.19 5.65 7.74 7.96 10.33 8.07 9.65 6.11 9.25 8.56 9.57 14.34 5.42 7.92 7.79 9.06 10.53 10.90 0.00 0.26 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 15830 15832 15833 15834 15835 15836 15837 15838 15839 15840 15841 15842 15845 15847 15850 15851 15852 15860 15876 15877 15878 15879 15920 15922 15931 15933 15934 15935 15936 15937 15940 15941 15944 15945 15946 15950 15951 15952 15953 15956 15958 15999 16000 HCPCS 2 CPT 1/ Fully Implemented NonFacility PE RVUs 2.93 1.66 1.49 1.61 1.60 1.34 1.18 0.58 1.22 1.32 2.55 4.94 0.81 0.00 0.05 0.06 0.09 0.27 0.00 0.00 0.00 0.00 1.04 1.42 1.25 1.52 1.79 2.10 1.77 2.07 1.31 1.66 1.65 1.85 3.17 1.04 1.49 1.60 1.80 2.22 2.26 0.00 0.08 Mal-Practice RVUs NA NA NA NA NA NA 19.32 NA 20.96 NA NA NA NA 0.00 2.02 2.25 NA NA 0.00 0.00 0.00 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 1.70 Fully Implemented NonFacility Total NA NA NA NA NA NA 19.16 NA 20.51 NA NA NA NA 0.00 2.30 2.51 NA NA 0.00 0.00 0.00 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 1.80 Year 2007 Transitional Non-Facility Total 29.98 22.74 20.35 21.44 22.31 18.87 16.35 13.62 17.79 24.83 41.57 67.26 23.75 0.00 1.01 1.16 1.21 2.93 0.00 0.00 0.00 0.00 15.05 18.76 16.78 20.51 23.05 28.02 22.41 26.21 17.33 22.56 22.34 24.77 41.23 14.38 21.01 21.64 24.47 28.60 29.29 0.00 1.21 Fully Implemented Facility Total 29.98 22.67 21.14 21.31 22.03 18.62 17.53 14.44 17.90 25.75 42.82 68.21 24.05 0.00 1.10 1.21 1.26 2.98 0.00 0.00 0.00 0.00 14.82 18.84 16.86 20.86 23.29 28.01 22.88 26.72 17.53 23.15 22.48 24.99 41.31 14.37 20.82 21.53 24.25 29.34 29.71 0.00 1.23 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 YYY XXX 000 000 000 000 000 000 000 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 YYY 000 Global 69800 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00179 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A R C A A Status Dress/debrid p-thick burn, s ................................. Dress/debrid p-thick burn, m ................................ Dress/debrid p-thick burn, l .................................. Incision of burn scab, initi .................................... Escharotomy; add"l incision ............................... Destruct premalg lesion ....................................... Destruct premalg les, 2–14 .................................. Destroy premlg lesions 15+ ................................. Destruction of skin lesions ................................... Destruction of skin lesions ................................... Destruction of skin lesions ................................... Destruct b9 lesion, 1–14 ...................................... Destruct lesion, 15 or more ................................. Chemical cautery, tissue ...................................... Destruction of skin lesions ................................... Destruction of skin lesions ................................... Destruction of skin lesions ................................... Destruction of skin lesions ................................... Destruction of skin lesions ................................... Destruction of skin lesions ................................... Destruction of skin lesions ................................... Destruction of skin lesions ................................... Destruction of skin lesions ................................... Destruction of skin lesions ................................... Destruction of skin lesions ................................... Destruction of skin lesions ................................... Destruction of skin lesions ................................... Destruction of skin lesions ................................... Destruction of skin lesions ................................... Destruction of skin lesions ................................... Destruction of skin lesions ................................... Destruction of skin lesions ................................... Mohs, 1 stage, h/n/hf/g ........................................ Mohs addl stage ................................................... Mohs, 1 stage, t/a/l .............................................. Mohs, addl stage, t/a/l .......................................... Mohs surg, addl block .......................................... Cryotherapy of skin .............................................. Skin peel therapy ................................................. Hair removal by electrolysis ................................. Skin tissue procedure .......................................... Drainage of breast lesion ..................................... Drain breast lesion add-on ................................... Description 0.80 1.85 2.08 3.74 1.50 0.62 0.07 1.82 4.62 9.19 13.22 0.67 0.94 0.50 0.93 1.19 1.60 1.81 1.96 2.36 1.34 1.51 1.79 2.07 2.61 3.22 1.19 1.74 2.06 2.66 3.23 4.45 6.20 3.30 5.56 3.06 0.87 0.76 1.44 0.00 0.00 0.84 0.42 Physician Work RVUs 3 1.11 1.61 1.98 NA NA 1.42 0.10 2.43 4.72 7.36 9.56 1.76 2.29 1.32 1.43 2.51 2.86 3.09 3.30 3.56 2.46 2.69 3.00 3.25 3.66 3.95 2.38 2.77 3.18 3.60 4.05 4.45 10.79 6.92 9.95 6.41 1.15 0.34 1.85 0.00 0.00 1.82 0.23 1.25 1.72 2.12 NA NA 1.08 0.11 2.33 4.63 7.24 9.34 1.66 1.83 1.25 1.32 1.84 2.13 2.31 2.49 2.77 1.89 2.00 2.24 2.46 2.84 3.19 1.80 2.12 2.41 2.81 3.20 3.87 10.79 6.92 9.95 6.41 1.15 0.36 1.54 0.00 0.00 1.94 0.25 Year 2007 Transitional Non-Facility PE RVUs 0.56 0.89 0.97 1.29 0.49 0.75 0.03 1.39 3.32 5.27 6.99 0.87 1.14 0.38 0.73 1.09 1.30 1.40 1.47 1.64 1.12 1.25 1.40 1.53 1.79 2.04 1.05 1.36 1.53 1.81 2.09 2.52 3.16 1.68 2.83 1.55 0.44 0.34 1.02 0.00 0.00 0.23 0.12 Fully Implemented Facility PE RVUs 0.58 0.94 1.08 1.51 0.57 0.59 0.06 1.54 3.33 5.41 7.49 0.74 0.89 0.35 0.69 0.90 1.09 1.17 1.21 1.33 0.93 1.05 1.18 1.29 1.53 1.77 0.87 1.16 1.31 1.57 1.84 2.46 3.16 1.68 2.83 1.55 0.44 0.36 0.91 0.00 0.00 0.29 0.14 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 16020 16025 16030 16035 16036 17000 17003 17004 17106 17107 17108 17110 17111 17250 17260 17261 17262 17263 17264 17266 17270 17271 17272 17273 17274 17276 17280 17281 17282 17283 17284 17286 17311 17312 17313 17314 17315 17340 17360 17380 17999 19000 19001 HCPCS 2 CPT 1/ Fully Implemented NonFacility PE RVUs 0.08 0.19 0.24 0.46 0.20 0.03 0.01 0.11 0.35 0.63 0.54 0.05 0.05 0.06 0.04 0.05 0.06 0.07 0.08 0.09 0.05 0.06 0.07 0.08 0.10 0.16 0.05 0.07 0.08 0.11 0.13 0.23 0.24 0.13 0.22 0.12 0.03 0.05 0.06 0.00 0.00 0.08 0.04 Mal-Practice RVUs 1.99 3.65 4.30 NA NA 2.07 0.18 4.36 9.69 17.18 23.32 2.48 3.28 1.88 2.40 3.75 4.52 4.97 5.34 6.01 3.85 4.26 4.86 5.40 6.37 7.33 3.62 4.58 5.32 6.37 7.41 9.13 17.23 10.35 15.73 9.59 2.05 1.15 3.35 0.00 0.00 2.74 0.69 Fully Implemented NonFacility Total 2.13 3.76 4.44 NA NA 1.73 0.19 4.26 9.60 17.06 23.10 2.38 2.82 1.81 2.29 3.08 3.79 4.19 4.53 5.22 3.28 3.57 4.10 4.61 5.55 6.57 3.04 3.93 4.55 5.58 6.56 8.55 17.23 10.35 15.73 9.59 2.05 1.17 3.04 0.00 0.00 2.86 0.71 Year 2007 Transitional Non-Facility Total 1.44 2.93 3.29 5.49 2.19 1.40 0.11 3.32 8.29 15.09 20.75 1.59 2.13 0.94 1.70 2.33 2.96 3.28 3.51 4.09 2.51 2.82 3.26 3.68 4.50 5.42 2.29 3.17 3.67 4.58 5.45 7.20 9.60 5.11 8.61 4.73 1.34 1.15 2.52 0.00 0.00 1.15 0.58 Fully Implemented Facility Total 1.46 2.98 3.40 5.71 2.27 1.24 0.14 3.47 8.30 15.23 21.25 1.46 1.88 0.91 1.66 2.14 2.75 3.05 3.25 3.78 2.32 2.62 3.04 3.44 4.24 5.15 2.11 2.97 3.45 4.34 5.20 7.14 9.60 5.11 8.61 4.73 1.34 1.17 2.41 0.00 0.00 1.21 0.60 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 000 000 000 090 ZZZ 010 ZZZ 010 090 090 090 010 010 000 010 010 010 010 010 010 010 010 010 010 010 010 010 010 010 010 010 010 000 ZZZ 000 ZZZ ZZZ 010 010 000 YYY 000 ZZZ Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69801 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00180 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Incision of breast lesion ....................................... Injection for breast x-ray ...................................... Bx breast percut w/o image ................................. Biopsy of breast, open ......................................... Bx breast percut w/image .................................... Bx breast percut w/device .................................... Cryosurg ablate fa, each ...................................... Nipple exploration ................................................ Excise breast duct fistula ..................................... Removal of breast lesion ..................................... Excision, breast lesion ......................................... Excision, addl breast lesion ................................. Removal of chest wall lesion ............................... Revision of chest wall .......................................... Extensive chest wall surgery ............................... Place needle wire, breast .................................... Place needle wire, breast .................................... Place breast clip, percut ...................................... Place po breast cath for rad ................................ Place breast cath for rad ..................................... Place breast rad tube/caths ................................. Removal of breast tissue ..................................... Partical mastectomy ............................................. P-mastectomy w/ln removal ................................. Mast, simple, complete ........................................ Mast, subq ............................................................ Mast, radical ......................................................... Mast, rad, urban type ........................................... Mast, mod rad ...................................................... Suspension of breast ........................................... Reduction of large breast ..................................... Enlarge breast ...................................................... Enlarge breast with implant ................................. Removal of breast implant ................................... Removal of implant material ................................ Immediate breast prosthesis ................................ Delayed breast prosthesis ................................... Breast reconstruction ........................................... Correct inverted nipple(s) ..................................... Breast reconstruction ........................................... Breast reconstr w/lat flap ..................................... Breast reconstruction ........................................... Breast reconstruction ........................................... Description 3.74 1.53 1.27 3.20 2.00 3.69 3.69 4.35 3.72 5.84 6.59 2.93 17.60 21.86 24.82 1.27 0.63 0.00 3.63 1.72 6.00 5.20 6.03 13.88 15.67 7.81 17.23 17.85 17.95 10.98 15.91 6.65 8.52 6.35 8.39 6.32 12.40 8.99 8.37 20.57 23.17 42.40 21.70 Physician Work RVUs 3 6.58 2.46 2.05 4.28 3.22 9.55 45.93 6.35 6.22 5.06 5.53 NA NA NA NA 2.68 1.05 2.19 83.51 NA 23.09 7.95 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 10.09 7.85 NA NA NA NA 6.39 2.76 2.07 4.45 3.68 11.01 45.93 5.93 6.10 4.67 4.97 NA NA NA NA 2.81 1.17 2.57 114.92 NA 37.39 7.34 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 12.90 9.65 NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 3.02 0.43 0.33 1.75 0.56 1.01 1.00 3.24 3.14 3.36 3.64 0.76 10.26 15.88 16.99 0.36 0.18 0.00 1.20 0.47 2.20 3.82 3.60 6.15 7.00 4.93 8.16 8.62 8.77 7.28 10.25 4.69 6.62 5.13 6.34 2.96 9.23 6.77 5.03 15.91 17.30 23.56 10.28 Fully Implemented Facility PE RVUs 2.76 0.48 0.40 1.87 0.64 1.18 1.00 2.96 2.80 3.14 3.37 0.94 10.93 17.43 18.45 0.41 0.20 2.02 1.45 0.60 2.36 3.50 3.47 6.29 5.52 4.80 8.01 8.33 8.34 7.45 10.94 4.84 6.55 5.05 6.11 3.07 9.00 7.07 4.78 15.69 13.65 23.55 11.26 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 19020 19030 19100 19101 19102 19103 19105 19110 19112 19120 19125 19126 19260 19271 19272 19290 19291 19295 19296 19297 19298 19300 19301 19302 19303 19304 19305 19306 19307 19316 19318 19324 19325 19328 19330 19340 19342 19350 19355 19357 19361 19364 19366 HCPCS 2 CPT 1/ Fully Implemented NonFacility PE RVUs 0.45 0.09 0.16 0.39 0.14 0.30 0.30 0.57 0.48 0.73 0.80 0.38 2.14 2.63 3.00 0.07 0.04 0.01 0.36 0.17 0.43 0.69 0.79 1.80 1.18 1.04 1.93 2.08 2.13 1.64 2.93 0.84 1.33 0.91 1.26 1.06 1.84 1.41 0.92 2.94 2.93 6.24 3.25 Mal-Practice RVUs 10.77 4.08 3.48 7.87 5.36 13.54 49.92 11.27 10.42 11.63 12.92 NA NA NA NA 4.02 1.72 2.20 87.50 NA 29.52 13.84 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 20.49 17.14 NA NA NA NA Fully Implemented NonFacility Total 10.58 4.38 3.50 8.04 5.82 15.00 49.92 10.85 10.30 11.24 12.36 NA NA NA NA 4.15 1.84 2.58 118.91 NA 43.82 13.23 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 23.30 18.94 NA NA NA NA Year 2007 Transitional Non-Facility Total 7.21 2.05 1.76 5.34 2.70 5.00 4.99 8.16 7.34 9.93 11.03 4.07 30.00 40.37 44.81 1.70 0.85 0.01 5.19 2.36 8.63 9.71 10.42 21.83 23.85 13.78 27.32 28.55 28.85 19.90 29.09 12.18 16.47 12.39 15.99 10.34 23.47 17.17 14.32 39.42 43.40 72.20 35.23 Fully Implemented Facility Total 6.95 2.10 1.83 5.46 2.78 5.17 4.99 7.88 7.00 9.71 10.76 4.25 30.67 41.92 46.27 1.75 0.87 2.03 5.44 2.49 8.79 9.39 10.29 21.97 22.37 13.65 27.17 28.26 28.42 20.07 29.78 12.33 16.40 12.31 15.76 10.45 23.24 17.47 14.07 39.20 39.75 72.19 36.21 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 000 000 010 000 000 000 090 090 090 090 ZZZ 090 090 090 000 ZZZ ZZZ 000 ZZZ 000 090 090 090 090 090 090 090 090 090 090 090 090 090 090 ZZZ 090 090 090 090 090 090 090 Global 69802 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00181 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A C A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Breast reconstruction ........................................... Breast reconstruction ........................................... Breast reconstruction ........................................... Surgery of breast capsule .................................... Removal of breast capsule .................................. Revise breast reconstruction ............................... Design custom breast implant ............................. Breast surgery procedure .................................... Incision of abscess ............................................... Incision of deep abscess ..................................... Explore wound, neck ............................................ Explore wound, chest ........................................... Explore wound, abdomen .................................... Explore wound, extremity ..................................... Excise epiphyseal bar .......................................... Muscle biopsy ...................................................... Deep muscle biopsy ............................................. Needle biopsy, muscle ......................................... Bone biopsy, trocar/needle .................................. Bone biopsy, trocar/needle .................................. Bone biopsy, excisional ....................................... Bone biopsy, excisional ....................................... Open bone biopsy ................................................ Open bone biopsy ................................................ Injection of sinus tract .......................................... Inject sinus tract for x-ray .................................... Removal of foreign body ...................................... Removal of foreign body ...................................... Ther injection, carp tunnel ................................... Inj tendon sheath/ligament ................................... Inj tendon origin/insertion ..................................... Inj trigger point, 1/2 muscl ................................... Inject trigger points, =/> 3 .................................... Drain/inject, joint/bursa ......................................... Drain/inject, joint/bursa ......................................... Drain/inject, joint/bursa ......................................... Aspirate/inj ganglion cyst ..................................... Treatment of bone cyst ........................................ Insert and remove bone pin ................................. Apply, rem fixation device .................................... Application of head brace .................................... Application of pelvis brace ................................... Application of thigh brace .................................... Description 26.59 33.61 31.02 8.99 10.42 10.21 2.17 0.00 2.14 3.55 10.33 3.22 3.95 5.31 14.60 1.46 2.35 0.99 1.27 1.87 3.25 8.77 5.16 5.69 1.25 0.76 1.87 3.51 0.94 0.75 0.75 0.66 0.75 0.66 0.68 0.79 0.70 2.30 2.25 2.51 5.14 6.26 5.62 Physician Work RVUs 3 NA NA NA NA NA NA 4.54 0.00 2.78 3.70 NA 6.37 6.89 7.68 NA 3.13 3.81 4.99 2.59 12.62 NA NA NA NA 1.27 2.22 2.58 7.05 0.82 0.63 0.63 0.58 0.64 0.67 0.74 1.06 0.70 2.70 2.51 3.39 NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA 1.95 0.00 2.71 3.54 NA 6.03 7.32 8.36 NA 3.06 3.87 6.12 4.07 21.49 NA NA NA NA 2.01 2.74 2.83 8.62 0.93 0.69 0.67 0.69 0.78 0.66 0.76 0.98 0.71 3.31 2.40 3.14 NA NA NA Year 2007 Transitional Non-Facility PE RVUs 15.75 18.79 16.41 7.02 7.92 7.85 1.27 0.00 1.53 2.04 3.67 1.51 1.85 2.75 7.81 0.70 1.11 0.50 0.61 0.99 2.09 5.82 3.73 3.91 0.83 0.22 1.45 2.21 0.42 0.29 0.29 0.25 0.27 0.32 0.33 0.40 0.32 1.41 1.49 1.52 6.03 4.89 5.17 Fully Implemented Facility PE RVUs 16.46 18.89 17.90 6.93 7.85 7.74 1.06 0.00 1.68 2.20 4.26 1.59 1.89 3.23 7.23 0.74 1.17 0.60 0.75 1.10 2.44 6.38 3.56 4.10 1.36 0.24 1.68 2.52 0.50 0.25 0.32 0.21 0.23 0.34 0.35 0.42 0.35 1.73 1.54 1.59 5.19 5.36 4.92 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 19367 19368 19369 19370 19371 19380 19396 19499 20000 20005 20100 20101 20102 20103 20150 20200 20205 20206 20220 20225 20240 20245 20250 20251 20500 20501 20520 20525 20526 20550 20551 20552 20553 20600 20605 20610 20612 20615 20650 20660 20661 20662 20663 HCPCS 2 CPT 1/ 4.04 5.54 4.51 1.29 1.62 1.44 0.30 0.00 0.25 0.46 1.21 0.44 0.49 0.75 2.04 0.23 0.33 0.07 0.08 0.22 0.44 1.31 1.02 1.15 0.12 0.04 0.21 0.51 0.13 0.09 0.08 0.05 0.04 0.08 0.08 0.11 0.10 0.20 0.31 0.59 1.14 0.56 0.94 Mal-Practice RVUs NA NA NA NA NA NA 7.01 0.00 5.17 7.71 NA 10.03 11.33 13.74 NA 4.82 6.49 6.05 3.94 14.71 NA NA NA NA 2.64 3.02 4.66 11.07 1.89 1.47 1.46 1.29 1.43 1.41 1.50 1.96 1.50 5.20 5.07 6.49 NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA 4.42 0.00 5.10 7.55 NA 9.69 11.76 14.42 NA 4.75 6.55 7.18 5.42 23.58 NA NA NA NA 3.38 3.54 4.91 12.64 2.00 1.53 1.50 1.40 1.57 1.40 1.52 1.88 1.51 5.81 4.96 6.24 NA NA NA Year 2007 Transitional Non-Facility Total 46.38 57.94 51.94 17.30 19.96 19.50 3.74 0.00 3.92 6.05 15.21 5.17 6.29 8.81 24.45 2.39 3.79 1.56 1.96 3.08 5.78 15.90 9.91 10.75 2.20 1.02 3.53 6.23 1.49 1.13 1.12 0.96 1.06 1.06 1.09 1.30 1.12 3.91 4.05 4.62 12.31 11.71 11.73 Fully Implemented Facility Total 47.09 58.04 53.43 17.21 19.89 19.39 3.53 0.00 4.07 6.21 15.80 5.25 6.33 9.29 23.87 2.43 3.85 1.66 2.10 3.19 6.13 16.46 9.74 10.94 2.73 1.04 3.76 6.54 1.57 1.09 1.15 0.92 1.02 1.08 1.11 1.32 1.15 4.23 4.10 4.69 11.47 12.18 11.48 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 000 YYY 010 010 010 010 010 010 090 000 000 000 000 000 010 010 010 010 010 000 010 010 000 000 000 000 000 000 000 000 000 010 010 000 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69803 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00182 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A B A B A A A A A A A A A A A A A A A C Status Halo brace application ......................................... Removal of fixation device ................................... Removal of support implant ................................. Removal of support implant ................................. Apply bone fixation device ................................... Apply bone fixation device ................................... Adjust bone fixation device .................................. Remove bone fixation device ............................... Replantation, arm, complete ................................ Replant forearm, complete ................................... Replantation hand, complete ............................... Replantation digit, complete ................................. Replantation digit, complete ................................. Replantation thumb, complete ............................. Replantation thumb, complete ............................. Replantation foot, complete ................................. Removal of bone for graft .................................... Removal of bone for graft .................................... Remove cartilage for graft ................................... Remove cartilage for graft ................................... Removal of fascia for graft ................................... Removal of fascia for graft ................................... Removal of tendon for graft ................................. Removal of tissue for graft ................................... Spinal bone allograft ............................................ Spinal bone allograft ............................................ Spinal bone autograft ........................................... Spinal bone autograft ........................................... Spinal bone autograft ........................................... Fluid pressure, muscle ......................................... Fibula bone graft, microvasc ................................ Iliac bone graft, microvasc ................................... Mt bone graft, microvasc ..................................... Other bone graft, microvasc ................................ Bone/skin graft, microvasc ................................... Bone/skin graft, iliac crest .................................... Bone/skin graft, metatarsal .................................. Bone/skin graft, great toe ..................................... Electrical bone stimulation ................................... Electrical bone stimulation ................................... Us bone stimulation ............................................. Ablate, bone tumor(s) perq .................................. Musculoskeletal surgery ....................................... Description 9.86 1.33 1.76 5.90 3.67 6.40 5.97 4.20 42.30 51.14 62.77 31.74 26.42 31.74 27.24 42.56 5.77 7.98 5.41 6.42 5.42 6.84 6.59 5.70 0.00 1.81 0.00 2.79 3.02 1.26 40.02 40.93 42.33 39.21 45.11 44.26 44.19 46.95 0.62 2.60 0.62 7.27 0.00 Physician Work RVUs 3 NA 1.45 6.65 8.16 NA NA NA 5.35 NA NA NA NA NA NA NA NA 9.30 NA NA NA NA 7.57 NA NA 0.00 NA 0.00 NA NA 4.14 NA NA NA NA NA NA NA NA 0.99 NA 0.58 78.40 0.00 Fully Implemented NonFacility PE RVUs NA 1.98 10.32 8.63 NA NA NA 6.69 NA NA NA NA NA NA NA NA 8.65 NA NA NA NA 7.55 NA NA 0.00 NA 0.00 NA NA 6.17 NA NA NA NA NA NA NA NA 0.77 NA 0.75 101.76 0.00 Year 2007 Transitional Non-Facility PE RVUs 8.19 1.03 1.69 4.11 2.29 3.30 4.54 3.57 24.78 26.11 39.72 24.63 22.54 25.93 24.10 13.52 4.97 5.87 4.69 4.76 4.40 5.02 5.04 4.44 0.00 0.70 0.00 1.11 1.18 0.88 18.50 20.95 19.65 21.46 20.79 20.52 17.83 15.20 0.49 1.49 0.20 2.35 0.00 Fully Implemented Facility PE RVUs 7.33 1.27 2.00 3.82 2.46 3.65 5.22 3.92 21.91 32.26 41.60 34.50 31.58 33.89 33.38 20.09 5.50 6.63 5.06 5.53 4.27 4.91 5.67 4.67 0.00 0.87 0.00 1.37 1.47 0.96 22.83 23.79 19.12 25.26 25.17 24.17 19.89 22.67 0.53 1.66 0.31 2.82 0.00 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 20664 20665 20670 20680 20690 20692 20693 20694 20802 20805 20808 20816 20822 20824 20827 20838 20900 20902 20910 20912 20920 20922 20924 20926 20930 20931 20936 20937 20938 20950 20955 20956 20957 20962 20969 20970 20972 20973 20974 20975 20979 20982 20999 HCPCS 2 CPT 1/ 1.75 0.19 0.28 0.56 0.59 1.05 0.98 0.71 3.82 4.85 6.88 4.53 4.19 4.62 3.67 1.12 0.94 1.30 0.71 0.69 0.66 0.70 1.04 0.87 0.00 0.43 0.00 0.54 0.64 0.20 4.90 7.03 7.07 6.57 4.80 6.62 5.32 5.56 0.11 0.51 0.09 0.69 0.00 Mal-Practice RVUs NA 2.97 8.69 14.62 NA NA NA 10.26 NA NA NA NA NA NA NA NA 16.01 NA NA NA NA 15.11 NA NA 0.00 NA 0.00 NA NA 5.60 NA NA NA NA NA NA NA NA 1.72 NA 1.29 86.36 0.00 Fully Implemented NonFacility Total NA 3.50 12.36 15.09 NA NA NA 11.60 NA NA NA NA NA NA NA NA 15.36 NA NA NA NA 15.09 NA NA 0.00 NA 0.00 NA NA 7.63 NA NA NA NA NA NA NA NA 1.50 NA 1.46 109.72 0.00 Year 2007 Transitional Non-Facility Total 19.80 2.55 3.73 10.57 6.55 10.75 11.49 8.48 70.90 82.10 109.37 60.90 53.15 62.29 55.01 57.20 11.68 15.15 10.81 11.87 10.48 12.56 12.67 11.01 0.00 2.94 0.00 4.44 4.84 2.34 63.42 68.91 69.05 67.24 70.70 71.40 67.34 67.71 1.22 4.60 0.91 10.31 0.00 Fully Implemented Facility Total 18.94 2.79 4.04 10.28 6.72 11.10 12.17 8.83 68.03 88.25 111.25 70.77 62.19 70.25 64.29 63.77 12.21 15.91 11.18 12.64 10.35 12.45 13.30 11.24 0.00 3.11 0.00 4.70 5.13 2.42 67.75 71.75 68.52 71.04 75.08 75.05 69.40 75.18 1.26 4.77 1.02 10.78 0.00 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 010 010 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 XXX ZZZ XXX ZZZ ZZZ 000 090 090 090 090 090 090 090 090 000 000 000 000 YYY Global 69804 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00183 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C C A A A A A A A A A A A Status Incision of jaw joint ............................................... Resection of facial tumor ..................................... Excision of bone, lower jaw ................................. Excision of facial bone(s) ..................................... Contour of face bone lesion ................................. Excise max/zygoma b9 tumor .............................. Remove exostosis, mandible ............................... Remove exostosis, maxilla .................................. Excise max/zygoma mlg tumor ............................ Excise mandible lesion ........................................ Removal of jaw bone lesion ................................. Extensive jaw surgery .......................................... Remove mandible cyst complex .......................... Excise lwr jaw cyst w/repair ................................. Remove maxilla cyst complex ............................. Excis uppr jaw cyst w/repair ................................ Removal of jaw joint ............................................. Remove jaw joint cartilage ................................... Remove coronoid process ................................... Prepare face/oral prosthesis ................................ Prepare face/oral prosthesis ................................ Prepare face/oral prosthesis ................................ Prepare face/oral prosthesis ................................ Prepare face/oral prosthesis ................................ Prepare face/oral prosthesis ................................ Prepare face/oral prosthesis ................................ Prepare face/oral prosthesis ................................ Prepare face/oral prosthesis ................................ Prepare face/oral prosthesis ................................ Prepare face/oral prosthesis ................................ Prepare face/oral prosthesis ................................ Prepare face/oral prosthesis ................................ Maxillofacial fixation ............................................. Interdental fixation ................................................ Injection, jaw joint x-ray ....................................... Reconstruction of chin ......................................... Reconstruction of chin ......................................... Reconstruction of chin ......................................... Reconstruction of chin ......................................... Augmentation, lower jaw bone ............................. Augmentation, lower jaw bone ............................. Reduction of forehead .......................................... Reduction of forehead .......................................... Description 10.90 5.59 11.07 5.54 8.26 4.80 3.26 3.28 17.17 4.80 12.61 18.13 13.97 19.83 14.47 19.08 11.54 10.91 8.50 13.40 33.70 22.31 25.06 22.85 20.84 19.27 22.48 8.99 24.88 24.88 0.00 0.00 4.56 5.80 0.81 4.99 7.70 8.59 11.22 10.68 12.24 10.12 12.73 Physician Work RVUs 3 NA NA 12.54 8.74 9.34 7.20 5.98 6.07 13.31 7.27 NA NA NA NA NA NA NA NA NA 7.97 18.75 13.89 16.10 14.84 15.02 14.79 16.37 6.90 12.93 13.17 0.00 0.00 13.76 13.27 2.38 10.09 10.63 NA NA 68.54 87.23 NA NA Fully Implemented NonFacility PE RVUs NA NA 12.32 8.08 9.36 6.55 5.37 5.52 15.27 6.61 NA NA NA NA NA NA NA NA NA 11.26 28.19 19.60 22.39 20.44 18.26 17.79 20.92 7.94 21.04 20.75 0.00 0.00 12.09 10.49 3.84 10.46 9.96 NA NA 58.55 53.91 NA NA Year 2007 Transitional Non-Facility PE RVUs 5.97 4.35 8.77 5.89 6.37 4.71 3.53 3.40 9.67 4.71 7.60 10.18 11.72 9.92 11.48 9.25 8.28 7.61 6.21 4.90 12.57 8.45 9.41 8.66 8.57 8.05 8.99 3.64 8.82 9.02 0.00 0.00 5.11 9.91 0.21 6.96 7.56 7.75 10.14 7.14 8.01 6.43 8.83 Fully Implemented Facility PE RVUs 6.81 4.85 9.21 6.21 6.85 4.95 3.60 3.48 11.91 4.72 8.93 11.81 11.86 12.56 11.97 12.08 9.15 8.36 6.88 8.73 22.64 14.98 16.87 15.28 13.94 12.84 15.52 6.00 16.78 16.65 0.00 0.00 4.83 8.75 0.30 7.36 7.76 8.40 10.64 8.03 9.09 7.41 9.36 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 21010 21015 21025 21026 21029 21030 21031 21032 21034 21040 21044 21045 21046 21047 21048 21049 21050 21060 21070 21076 21077 21079 21080 21081 21082 21083 21084 21085 21086 21087 21088 21089 21100 21110 21116 21120 21121 21122 21123 21125 21127 21137 21138 HCPCS 2 CPT 1/ 1.11 0.70 1.32 0.60 0.94 0.54 0.48 0.47 1.72 0.54 1.12 1.52 1.86 2.13 1.77 1.59 1.47 1.38 1.27 2.00 4.56 3.16 3.75 3.21 3.12 2.89 2.19 1.27 3.72 3.45 0.00 0.00 0.34 0.72 0.06 0.60 0.90 1.07 1.40 0.79 1.52 1.32 1.75 Mal-Practice RVUs NA NA 24.93 14.88 18.54 12.54 9.72 9.82 32.20 12.61 NA NA NA NA NA NA NA NA NA 23.37 57.01 39.36 44.91 40.90 38.98 36.95 41.04 17.16 41.53 41.50 0.00 0.00 18.66 19.79 3.25 15.68 19.23 NA NA 80.01 100.99 NA NA Fully Implemented NonFacility Total NA NA 24.71 14.22 18.56 11.89 9.11 9.27 34.16 11.95 NA NA NA NA NA NA NA NA NA 26.66 66.45 45.07 51.20 46.50 42.22 39.95 45.59 18.20 49.64 49.08 0.00 0.00 16.99 17.01 4.71 16.05 18.56 NA NA 70.02 67.67 NA NA Year 2007 Transitional Non-Facility Total 17.98 10.64 21.16 12.03 15.57 10.05 7.27 7.15 28.56 10.05 21.33 29.83 27.55 31.88 27.72 29.92 21.29 19.90 15.98 20.30 50.83 33.92 38.22 34.72 32.53 30.21 33.66 13.90 37.42 37.35 0.00 0.00 10.01 16.43 1.08 12.55 16.16 17.41 22.76 18.61 21.77 17.87 23.31 Fully Implemented Facility Total 18.82 11.14 21.60 12.35 16.05 10.29 7.34 7.23 30.80 10.06 22.66 31.46 27.69 34.52 28.21 32.75 22.16 20.65 16.65 24.13 60.90 40.45 45.68 41.34 37.90 35.00 40.19 16.26 45.38 44.98 0.00 0.00 9.73 15.27 1.17 12.95 16.36 18.06 23.26 19.50 22.85 18.85 23.84 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 010 090 090 090 090 090 090 090 010 090 090 090 090 090 090 000 090 090 090 090 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69805 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00184 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Reduction of forehead .......................................... Reconstruct midface, lefort .................................. Reconstruct midface, lefort .................................. Reconstruct midface, lefort .................................. Reconstruct midface, lefort .................................. Reconstruct midface, lefort .................................. Reconstruct midface, lefort .................................. Reconstruct midface, lefort .................................. Reconstruct midface, lefort .................................. Reconstruct midface, lefort .................................. Reconstruct midface, lefort .................................. Reconstruct midface, lefort .................................. Reconstruct midface, lefort .................................. Reconstruct orbit/forehead ................................... Reconstruct orbit/forehead ................................... Reconstruct entire forehead ................................. Reconstruct entire forehead ................................. Contour cranial bone lesion ................................. Reconstruct cranial bone ..................................... Reconstruct cranial bone ..................................... Reconstruct cranial bone ..................................... Reconstruction of midface ................................... Reconst lwr jaw w/o graft ..................................... Reconst lwr jaw w/graft ........................................ Reconst lwr jaw w/o fixation ................................ Reconst lwr jaw w/fixation .................................... Reconstr lwr jaw segment .................................... Reconstr lwr jaw w/advance ................................ Reconstruct upper jaw bone ................................ Augmentation of facial bones .............................. Reduction of facial bones .................................... Face bone graft .................................................... Lower jaw bone graft ........................................... Rib cartilage graft ................................................. Ear cartilage graft ................................................. Reconstruction of jaw joint ................................... Reconstruction of jaw joint ................................... Reconstruction of jaw joint ................................... Reconstruction of lower jaw ................................. Reconstruction of jaw ........................................... Reconstruction of jaw ........................................... Reconstruct lower jaw bone ................................. Reconstruction of jaw ........................................... Description 14.90 19.27 19.98 20.75 23.64 24.54 26.14 25.78 28.84 31.05 34.98 42.90 46.95 28.07 33.43 22.53 25.46 10.18 32.45 35.57 38.49 22.97 18.65 21.54 18.88 20.55 15.48 16.62 15.36 11.15 7.58 11.40 11.94 11.06 7.31 15.77 14.32 24.03 13.35 12.88 12.78 24.05 12.54 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 32.41 12.40 43.70 86.14 NA 9.88 NA NA NA NA 13.48 NA NA 12.64 Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 24.85 11.20 29.58 52.95 NA 9.85 NA NA NA NA 14.17 NA NA 12.26 Year 2007 Transitional Non-Facility PE RVUs 8.50 11.69 10.64 8.80 12.72 9.16 13.75 13.05 11.57 21.78 13.28 15.10 24.15 13.88 13.17 11.17 12.78 7.10 14.40 15.57 21.42 14.93 9.93 11.48 13.47 13.41 11.21 6.96 11.25 7.83 7.52 7.81 8.10 6.94 6.05 9.64 8.95 14.17 11.07 8.14 6.81 12.11 7.59 Fully Implemented Facility PE RVUs 10.42 13.16 12.28 12.93 13.61 13.79 14.73 15.83 20.11 22.79 21.24 25.59 26.64 13.78 16.64 13.39 14.73 7.37 17.93 19.52 21.81 17.89 11.97 13.18 14.48 15.12 12.33 8.57 12.29 9.14 7.93 8.97 9.05 7.77 6.32 11.45 10.87 16.62 11.84 9.42 8.48 16.04 8.95 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 21139 21141 21142 21143 21145 21146 21147 21150 21151 21154 21155 21159 21160 21172 21175 21179 21180 21181 21182 21183 21184 21188 21193 21194 21195 21196 21198 21199 21206 21208 21209 21210 21215 21230 21235 21240 21242 21243 21244 21245 21246 21247 21248 HCPCS 2 CPT 1/ 1.18 2.36 2.39 1.66 2.85 3.10 1.85 2.56 2.31 2.49 6.66 8.20 4.14 3.56 4.84 2.81 3.49 1.32 2.81 4.48 5.72 1.70 2.24 2.03 1.64 2.08 1.44 1.39 1.33 1.09 0.90 1.30 1.53 1.29 0.61 2.25 1.79 3.26 1.25 1.19 1.35 2.84 1.55 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 44.65 20.88 56.40 99.61 NA 17.80 NA NA NA NA 27.55 NA NA 26.73 Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 37.09 19.68 42.28 66.42 NA 17.77 NA NA NA NA 28.24 NA NA 26.35 Year 2007 Transitional Non-Facility Total 24.58 33.32 33.01 31.21 39.21 36.80 41.74 41.39 42.72 55.32 54.92 66.20 75.24 45.51 51.44 36.51 41.73 18.60 49.66 55.62 65.63 39.60 30.82 35.05 33.99 36.04 28.13 24.97 27.94 20.07 16.00 20.51 21.57 19.29 13.97 27.66 25.06 41.46 25.67 22.21 20.94 39.00 21.68 Fully Implemented Facility Total 26.50 34.79 34.65 35.34 40.10 41.43 42.72 44.17 51.26 56.33 62.88 76.69 77.73 45.41 54.91 38.73 43.68 18.87 53.19 59.57 66.02 42.56 32.86 36.75 35.00 37.75 29.25 26.58 28.98 21.38 16.41 21.67 22.52 20.12 14.24 29.47 26.98 43.91 26.44 23.49 22.61 42.93 23.04 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 Global 69806 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00185 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A C A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Reconstruction of jaw ........................................... Reconstruct lower jaw bone ................................. Reconstruction of orbit ......................................... Revise eye sockets .............................................. Revise eye sockets .............................................. Revise eye sockets .............................................. Revise eye sockets .............................................. Revise eye sockets .............................................. Augmentation, cheek bone .................................. Revision, orbitofacial bones ................................. Revision of eyelid ................................................. Revision of eyelid ................................................. Revision of jaw muscle/bone ............................... Revision of jaw muscle/bone ............................... Cranio/maxillofacial surgery ................................. Treatment of nose fracture .................................. Treatment of nose fracture .................................. Treatment of nose fracture .................................. Treatment of nose fracture .................................. Treatment of nose fracture .................................. Treatment of nose fracture .................................. Treat nasal septal fracture ................................... Treat nasal septal fracture ................................... Treat nasoethmoid fracture .................................. Treat nasoethmoid fracture .................................. Treatment of nose fracture .................................. Treatment of sinus fracture .................................. Treatment of sinus fracture .................................. Treat nose/jaw fracture ........................................ Treat nose/jaw fracture ........................................ Treat nose/jaw fracture ........................................ Treat nose/jaw fracture ........................................ Treat cheek bone fracture .................................... Treat cheek bone fracture .................................... Treat cheek bone fracture .................................... Treat cheek bone fracture .................................... Treat cheek bone fracture .................................... Treat eye socket fracture ..................................... Treat eye socket fracture ..................................... Treat eye socket fracture ..................................... Treat eye socket fracture ..................................... Treat eye socket fracture ..................................... Treat eye socket fracture ..................................... Description 18.57 18.14 17.42 17.74 33.78 30.72 20.45 26.78 10.52 11.65 6.92 4.11 1.82 4.67 0.00 0.58 1.78 1.86 4.07 5.68 8.91 6.56 3.26 6.76 8.39 11.33 14.11 21.36 8.87 11.29 13.37 17.36 4.32 4.70 7.03 16.52 18.44 9.46 9.46 10.00 11.07 14.62 1.44 Physician Work RVUs 3 16.25 NA NA NA NA NA NA NA 11.23 NA NA NA NA NA 0.00 1.96 4.47 4.06 NA NA NA NA 5.91 NA NA NA NA NA 9.76 NA NA NA 5.63 6.84 NA NA NA NA NA NA NA NA 2.74 Fully Implemented NonFacility PE RVUs 16.60 NA NA NA NA NA NA NA 11.55 NA NA NA NA NA 0.00 2.20 4.29 3.95 NA NA NA NA 6.07 NA NA NA NA NA 9.82 NA NA NA 6.08 7.05 NA NA NA NA NA NA NA NA 2.64 Year 2007 Transitional Non-Facility PE RVUs 10.10 13.51 9.98 9.39 14.69 13.99 16.34 16.04 5.99 7.58 5.91 4.30 2.61 5.49 0.00 0.11 1.67 1.27 6.79 7.52 7.84 8.24 3.41 9.73 10.80 7.21 12.68 13.37 6.07 10.87 11.73 6.29 3.04 3.99 5.35 9.11 10.46 7.01 5.86 7.38 7.17 7.96 1.98 Fully Implemented Facility PE RVUs 12.04 15.48 11.36 11.92 21.85 17.80 18.91 19.17 6.94 8.02 5.92 4.44 2.55 5.06 0.00 0.14 1.83 1.53 8.16 9.16 9.18 9.27 3.53 12.95 13.13 8.10 14.77 15.72 6.90 11.87 15.08 9.91 3.37 4.41 5.79 10.40 11.11 7.96 6.77 8.56 7.64 8.76 1.90 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 21249 21255 21256 21260 21261 21263 21267 21268 21270 21275 21280 21282 21295 21296 21299 21310 21315 21320 21325 21330 21335 21336 21337 21338 21339 21340 21343 21344 21345 21346 21347 21348 21355 21356 21360 21365 21366 21385 21386 21387 21390 21395 21400 HCPCS 2 CPT 1/ 2.49 2.39 1.50 0.97 3.43 2.63 1.71 3.66 0.72 1.29 0.42 0.26 0.16 0.34 0.00 0.05 0.14 0.18 0.31 0.56 0.74 0.55 0.28 0.82 0.96 1.15 1.47 2.44 0.92 1.21 1.47 2.49 0.34 0.46 0.74 1.70 2.50 0.97 0.97 1.08 0.90 1.44 0.15 Mal-Practice RVUs 37.31 NA NA NA NA NA NA NA 22.47 NA NA NA NA NA 0.00 2.59 6.39 6.10 NA NA NA NA 9.45 NA NA NA NA NA 19.55 NA NA NA 10.29 12.00 NA NA NA NA NA NA NA NA 4.33 Fully Implemented NonFacility Total 37.66 NA NA NA NA NA NA NA 22.79 NA NA NA NA NA 0.00 2.83 6.21 5.99 NA NA NA NA 9.61 NA NA NA NA NA 19.61 NA NA NA 10.74 12.21 NA NA NA NA NA NA NA NA 4.23 Year 2007 Transitional Non-Facility Total 31.16 34.04 28.90 28.10 51.90 47.34 38.50 46.48 17.23 20.52 13.25 8.67 4.59 10.50 0.00 0.74 3.59 3.31 11.17 13.76 17.49 15.35 6.95 17.31 20.15 19.69 28.26 37.17 15.86 23.37 26.57 26.14 7.70 9.15 13.12 27.33 31.40 17.44 16.29 18.46 19.14 24.02 3.57 Fully Implemented Facility Total 33.10 36.01 30.28 30.63 59.06 51.15 41.07 49.61 18.18 20.96 13.26 8.81 4.53 10.07 0.00 0.77 3.75 3.57 12.54 15.40 18.83 16.38 7.07 20.53 22.48 20.58 30.35 39.52 16.69 24.37 29.92 29.76 8.03 9.57 13.56 28.62 32.05 18.39 17.20 19.64 19.61 24.82 3.49 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 YYY 000 010 010 090 090 090 090 090 090 090 090 090 090 090 090 090 090 010 010 090 090 090 090 090 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69807 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00186 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A C A A A A A A A A A A A A A A Status Treat eye socket fracture ..................................... Treat eye socket fracture ..................................... Treat eye socket fracture ..................................... Treat eye socket fracture ..................................... Treat mouth roof fracture ..................................... Treat mouth roof fracture ..................................... Treat mouth roof fracture ..................................... Treat craniofacial fracture .................................... Treat craniofacial fracture .................................... Treat craniofacial fracture .................................... Treat craniofacial fracture .................................... Treat craniofacial fracture .................................... Treat dental ridge fracture ................................... Treat dental ridge fracture ................................... Treat lower jaw fracture ....................................... Treat lower jaw fracture ....................................... Treat lower jaw fracture ....................................... Treat lower jaw fracture ....................................... Treat lower jaw fracture ....................................... Treat lower jaw fracture ....................................... Treat lower jaw fracture ....................................... Treat lower jaw fracture ....................................... Treat lower jaw fracture ....................................... Reset dislocated jaw ............................................ Reset dislocated jaw ............................................ Repair dislocated jaw ........................................... Treat hyoid bone fracture ..................................... Interdental wiring .................................................. Head surgery procedure ...................................... Drain neck/chest lesion ........................................ Drain chest lesion ................................................ Drainage of bone lesion ....................................... Biopsy of neck/chest ............................................ Remove lesion, neck/chest .................................. Remove lesion, neck/chest .................................. Remove tumor, neck/chest .................................. Partial removal of rib ............................................ Partial removal of rib ............................................ Removal of rib ...................................................... Removal of rib and nerves ................................... Partial removal of sternum ................................... Sternal debridement ............................................. Extensive sternum surgery .................................. Description 3.57 7.31 8.91 12.67 5.80 8.62 10.71 7.74 8.76 26.13 20.02 30.01 3.28 6.04 3.55 5.46 2.29 6.40 7.17 9.07 10.77 12.88 17.24 0.61 4.58 12.71 6.55 4.45 0.00 3.87 7.43 6.06 2.08 4.40 5.63 8.91 7.14 15.76 10.31 12.54 7.16 7.18 19.01 Physician Work RVUs 3 7.24 NA NA NA 12.12 NA NA NA NA NA NA NA 10.30 12.49 10.39 12.93 11.74 14.76 NA 41.16 42.36 NA NA 1.50 12.19 NA NA 11.98 0.00 6.39 NA NA 4.26 5.74 NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs 7.80 NA NA NA 10.03 NA NA NA NA NA NA NA 7.90 10.44 8.13 10.25 12.70 11.75 NA 28.64 31.30 NA NA 1.70 9.21 NA NA 9.33 0.00 6.41 NA NA 3.75 5.57 NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 3.15 5.17 5.99 8.08 9.01 6.88 7.41 9.40 7.26 12.56 10.73 14.45 7.65 8.65 7.65 9.65 5.90 11.63 5.76 12.67 13.25 8.42 10.26 0.18 9.19 7.95 9.65 9.18 0.00 3.44 4.78 4.74 1.73 3.41 4.02 4.46 5.82 8.21 5.47 7.12 4.90 5.64 10.75 Fully Implemented Facility PE RVUs 3.41 5.85 6.64 8.68 8.49 7.78 8.84 9.49 7.86 15.44 12.21 17.28 6.53 8.44 7.07 8.71 4.93 10.96 6.14 12.66 12.85 9.46 11.58 0.19 8.04 9.26 8.73 8.03 0.00 3.73 5.42 5.43 1.72 3.25 4.08 5.13 5.75 8.70 6.38 7.80 5.70 6.14 11.57 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 21401 21406 21407 21408 21421 21422 21423 21431 21432 21433 21435 21436 21440 21445 21450 21451 21452 21453 21454 21461 21462 21465 21470 21480 21485 21490 21495 21497 21499 21501 21502 21510 21550 21555 21556 21557 21600 21610 21615 21616 21620 21627 21630 HCPCS 2 CPT 1/ 0.38 0.73 0.94 1.44 0.73 0.99 1.27 0.70 0.81 2.79 1.99 3.10 0.38 0.78 0.33 0.63 0.27 0.74 0.82 0.98 1.27 1.50 1.97 0.06 0.51 1.97 0.46 0.50 0.00 0.43 0.97 0.80 0.16 0.56 0.65 1.08 0.99 3.08 1.45 1.87 0.98 1.02 2.59 Mal-Practice RVUs 11.19 NA NA NA 18.65 NA NA NA NA NA NA NA 13.96 19.31 14.27 19.02 14.30 21.90 NA 51.21 54.40 NA NA 2.17 17.28 NA NA 16.93 0.00 10.69 NA NA 6.50 10.70 NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total 11.75 NA NA NA 16.56 NA NA NA NA NA NA NA 11.56 17.26 12.01 16.34 15.26 18.89 NA 38.69 43.34 NA NA 2.37 14.30 NA NA 14.28 0.00 10.71 NA NA 5.99 10.53 NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 7.10 13.21 15.84 22.19 15.54 16.49 19.39 17.84 16.83 41.48 32.74 47.56 11.31 15.47 11.53 15.74 8.46 18.77 13.75 22.72 25.29 22.80 29.47 0.85 14.28 22.63 16.66 14.13 0.00 7.74 13.18 11.60 3.97 8.37 10.30 14.45 13.95 27.05 17.23 21.53 13.04 13.84 32.35 Fully Implemented Facility Total 7.36 13.89 16.49 22.79 15.02 17.39 20.82 17.93 17.43 44.36 34.22 50.39 10.19 15.26 10.95 14.80 7.49 18.10 14.13 22.71 24.89 23.84 30.79 0.86 13.13 23.94 15.74 12.98 0.00 8.03 13.82 12.29 3.96 8.21 10.36 15.12 13.88 27.54 18.14 22.21 13.84 14.34 33.17 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 000 090 090 090 090 YYY 090 090 090 010 090 090 090 090 090 090 090 090 090 090 Global 69808 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00187 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A C C A A A A A A C A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Extensive sternum surgery .................................. Hyoid myotomy & suspension ............................. Revision of neck muscle ...................................... Revision of neck muscle/rib ................................. Revision of neck muscle ...................................... Revision of neck muscle ...................................... Reconstruction of sternum ................................... Repair stern/nuss w/o scope ............................... Repair sternum/nuss w/scope .............................. Repair of sternum separation .............................. Treatment of rib fracture ...................................... Treatment of rib fracture ...................................... Treatment of rib fracture(s) .................................. Treat sternum fracture ......................................... Treat sternum fracture ......................................... Neck/chest surgery procedure ............................. Biopsy soft tissue of back .................................... Biopsy soft tissue of back .................................... Remove lesion, back or flank .............................. Remove tumor, back ............................................ I&d, p-spine, c/t/cerv-thor ..................................... I&d, p-spine, l/s/ls ................................................. Remove part of neck vertebra ............................. Remove part, thorax vertebra .............................. Remove part, lumbar vertebra ............................. Remove extra spine segment .............................. Remove part of neck vertebra ............................. Remove part, thorax vertebra .............................. Remove part, lumbar vertebra ............................. Remove extra spine segment .............................. Revision of neck spine ......................................... Revision of thorax spine ...................................... Revision of lumbar spine ..................................... Revise, extra spine segment ............................... Revision of neck spine ......................................... Revision of thorax spine ...................................... Revision of lumbar spine ..................................... Revise, extra spine segment ............................... Treat spine process fracture ................................ Treat spine fracture .............................................. Treat spine fracture .............................................. Treat odontoid fx w/o graft ................................... Treat odontoid fx w/graft ...................................... Description 19.51 14.89 6.23 9.83 5.72 7.10 17.47 0.00 0.00 11.35 0.98 2.80 6.92 1.31 7.65 0.00 2.08 4.54 5.06 18.38 12.57 12.46 10.80 10.88 10.88 2.34 13.80 13.87 13.87 2.32 25.13 20.74 20.77 6.03 22.69 22.84 22.84 6.03 2.08 3.69 9.91 22.54 25.15 Physician Work RVUs 3 NA NA NA NA NA NA NA 0.00 0.00 NA 1.35 NA NA 1.80 NA 0.00 4.42 5.44 6.01 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 2.15 3.01 9.82 NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA 0.00 0.00 NA 1.34 NA NA 1.82 NA 0.00 3.57 5.24 5.79 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 2.27 2.85 9.72 NA NA Year 2007 Transitional Non-Facility PE RVUs 9.58 7.99 4.03 4.71 4.36 4.60 8.85 0.00 0.00 5.43 1.35 3.53 5.21 1.80 5.46 0.00 1.89 3.43 3.76 8.60 7.87 7.83 8.09 8.02 7.27 0.90 9.17 9.02 9.12 0.89 14.86 12.55 12.67 2.39 13.56 12.30 13.25 2.18 1.81 2.53 7.43 13.42 14.18 Fully Implemented Facility PE RVUs 10.73 9.48 4.34 5.36 2.94 5.23 8.60 0.00 0.00 5.94 1.34 3.28 5.03 1.77 6.16 0.00 1.58 3.29 3.49 9.37 8.63 8.57 7.67 7.82 7.90 1.13 9.16 9.21 9.22 1.10 15.27 13.09 13.53 2.95 13.61 11.42 13.98 2.86 1.89 2.40 7.36 13.39 14.58 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 21632 21685 21700 21705 21720 21725 21740 21742 21743 21750 21800 21805 21810 21820 21825 21899 21920 21925 21930 21935 22010 22015 22100 22101 22102 22103 22110 22112 22114 22116 22210 22212 22214 22216 22220 22222 22224 22226 22305 22310 22315 22318 22319 HCPCS 2 CPT 1/ 2.66 1.06 0.32 1.43 0.91 1.21 2.37 0.00 0.00 1.63 0.09 0.38 0.94 0.16 1.11 0.00 0.14 0.60 0.66 2.48 1.74 1.72 2.14 1.91 1.88 0.44 2.77 2.53 2.64 0.50 5.46 3.91 3.92 1.29 5.08 4.13 4.19 1.29 0.39 0.50 1.86 5.30 6.05 Mal-Practice RVUs NA NA NA NA NA NA NA 0.00 0.00 NA 2.42 NA NA 3.27 NA 0.00 6.64 10.58 11.73 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 4.62 7.20 21.59 NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA 0.00 0.00 NA 2.41 NA NA 3.29 NA 0.00 5.79 10.38 11.51 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 4.74 7.04 21.49 NA NA Year 2007 Transitional Non-Facility Total 31.75 23.94 10.58 15.97 10.99 12.91 28.69 0.00 0.00 18.41 2.42 6.71 13.07 3.27 14.22 0.00 4.11 8.57 9.48 29.46 22.18 22.01 21.03 20.81 20.03 3.68 25.74 25.42 25.63 3.71 45.45 37.20 37.36 9.71 41.33 39.27 40.28 9.50 4.28 6.72 19.20 41.26 45.38 Fully Implemented Facility Total 32.90 25.43 10.89 16.62 9.57 13.54 28.44 0.00 0.00 18.92 2.41 6.46 12.89 3.24 14.92 0.00 3.80 8.43 9.21 30.23 22.94 22.75 20.61 20.61 20.66 3.91 25.73 25.61 25.73 3.92 45.86 37.74 38.22 10.27 41.38 38.39 41.01 10.18 4.36 6.59 19.13 41.23 45.78 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 YYY 010 090 090 090 090 090 090 090 090 ZZZ 090 090 090 ZZZ 090 090 090 ZZZ 090 090 090 ZZZ 090 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69809 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00188 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A B A A A Status Treat spine fracture .............................................. Treat neck spine fracture ..................................... Treat thorax spine fracture ................................... Treat each add spine fx ....................................... Manipulation of spine ........................................... Percut vertebroplasty thor .................................... Percut vertebroplasty lumb .................................. Percut vertebroplasty add"l ................................ Percut kyphoplasty, thor ...................................... Percut kyphoplasty, lumbar .................................. Percut kyphoplasty, add-on ................................. Idet, single level ................................................... Idet, 1 or more levels ........................................... Lat thorax spine fusion ......................................... Lat lumbar spine fusion ........................................ Lat thor/lumb, add"l seg ..................................... Neck spine fusion ................................................. Neck spine fusion ................................................. Thorax spine fusion .............................................. Lumbar spine fusion ............................................. Additional spinal fusion ........................................ Spine & skull spinal fusion ................................... Neck spinal fusion ................................................ Neck spine fusion ................................................. Thorax spine fusion .............................................. Lumbar spine fusion ............................................. Spine fusion, extra segment ................................ Lumbar spine fusion ............................................. Spine fusion, extra segment ................................ Fusion of spine ..................................................... Fusion of spine ..................................................... Fusion of spine ..................................................... Fusion of spine ..................................................... Fusion of spine ..................................................... Fusion of spine ..................................................... Kyphectomy, 1–2 segments ................................. Kyphectomy, 3 or more ........................................ Exploration of spinal fusion .................................. Insert spine fixation device .................................. Insert spine fixation device .................................. Insert spine fixation device .................................. Insert spine fixation device .................................. Insert spine fixation device .................................. Description 19.62 20.64 20.52 4.60 1.87 9.17 8.60 4.30 9.21 8.81 4.47 6.07 3.03 25.81 24.61 5.99 26.86 17.54 24.50 23.33 5.52 21.56 20.44 17.20 17.08 23.38 6.43 21.89 5.22 19.30 31.91 37.30 27.31 31.30 34.00 34.18 39.18 11.13 12.52 0.00 12.56 13.44 16.42 Physician Work RVUs 3 NA NA NA NA NA 42.34 43.56 NA NA NA NA 46.51 39.89 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA 56.83 52.87 NA NA NA NA 46.51 39.89 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA Year 2007 Transitional Non-Facility PE RVUs 12.10 12.24 12.37 1.83 1.06 4.07 3.90 1.30 4.69 4.54 1.66 2.08 0.70 13.92 13.52 2.35 15.32 10.84 13.15 11.57 2.12 13.24 12.74 11.37 10.96 12.72 2.53 12.75 2.04 11.22 16.28 18.33 13.94 15.00 16.90 16.75 19.61 7.15 4.91 0.00 4.93 5.32 6.54 Fully Implemented Facility PE RVUs 12.08 12.59 12.36 2.15 0.97 4.84 4.69 1.59 5.60 5.40 2.12 2.08 0.70 14.60 13.57 2.86 15.68 11.97 14.34 12.86 2.62 13.30 12.81 11.24 11.30 13.83 3.15 13.39 2.51 12.38 18.76 21.60 15.71 17.52 19.27 18.34 19.94 7.76 6.10 0.00 6.11 6.28 8.20 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 22325 22326 22327 22328 22505 22520 22521 22522 22523 22524 22525 22526 22527 22532 22533 22534 22548 22554 22556 22558 22585 22590 22595 22600 22610 22612 22614 22630 22632 22800 22802 22804 22808 22810 22812 22818 22819 22830 22840 22841 22842 22843 22844 HCPCS 2 CPT 1/ 3.88 4.43 3.99 0.94 0.36 1.72 1.60 0.82 1.72 1.60 0.82 1.16 0.58 4.35 3.16 1.25 5.61 4.46 4.35 3.16 1.25 4.79 4.41 3.73 3.53 4.47 1.38 4.73 1.16 3.76 6.17 7.00 4.93 5.15 5.30 6.47 7.67 2.30 2.79 0.00 2.75 2.86 3.19 Mal-Practice RVUs NA NA NA NA NA 53.23 53.76 NA NA NA NA 53.74 43.50 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA 67.72 63.07 NA NA NA NA 53.74 43.50 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA Year 2007 Transitional Non-Facility Total 35.60 37.31 36.88 7.37 3.29 14.96 14.10 6.42 15.62 14.95 6.95 9.31 4.31 44.08 41.29 9.59 47.79 32.84 42.00 38.06 8.89 39.59 37.59 32.30 31.57 40.57 10.34 39.37 8.42 34.28 54.36 62.63 46.18 51.45 56.20 57.40 66.46 20.58 20.22 0.00 20.24 21.62 26.15 Fully Implemented Facility Total 35.58 37.66 36.87 7.69 3.20 15.73 14.89 6.71 16.53 15.81 7.41 9.31 4.31 44.76 41.34 10.10 48.15 33.97 43.19 39.35 9.39 39.65 37.66 32.17 31.91 41.68 10.96 40.01 8.89 35.44 56.84 65.90 47.95 53.97 58.57 58.99 66.79 21.19 21.41 0.00 21.42 22.58 27.81 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 ZZZ 010 010 010 ZZZ 010 010 ZZZ 010 ZZZ 090 090 ZZZ 090 090 090 090 ZZZ 090 090 090 090 090 ZZZ 090 ZZZ 090 090 090 090 090 090 090 090 090 ZZZ XXX ZZZ ZZZ ZZZ Global 69810 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00189 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A R R R C A C A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Insert spine fixation device .................................. Insert spine fixation device .................................. Insert spine fixation device .................................. Insert pelv fixation device .................................... Reinsert spinal fixation ......................................... Remove spine fixation device .............................. Apply spine prosth device .................................... Remove spine fixation device .............................. Remove spine fixation device .............................. Lumbar artif diskectomy ....................................... Revise lumbar artif disc ....................................... Remove lumb artif disc ........................................ Spine surgery procedure ...................................... Remove abdominal wall lesion ............................ Abdomen surgery procedure ............................... Removal of calcium deposits ............................... Release shoulder joint ......................................... Drain shoulder lesion ........................................... Drain shoulder bursa ............................................ Drain shoulder bone lesion .................................. Exploratory shoulder surgery ............................... Exploratory shoulder surgery ............................... Biopsy shoulder tissues ....................................... Biopsy shoulder tissues ....................................... Removal of shoulder lesion ................................. Removal of shoulder lesion ................................. Remove tumor of shoulder .................................. Biopsy of shoulder joint ........................................ Shoulder joint surgery .......................................... Remove shoulder joint lining ................................ Incision of collarbone joint ................................... Explore treat shoulder joint .................................. Partial removal, collar bone ................................. Removal of collar bone ........................................ Remove shoulder bone, part ............................... Removal of bone lesion ....................................... Removal of bone lesion ....................................... Removal of bone lesion ....................................... Removal of humerus lesion ................................. Removal of humerus lesion ................................. Removal of humerus lesion ................................. Remove collar bone lesion .................................. Remove shoulder blade lesion ............................ Description 11.94 12.40 13.78 5.99 19.08 9.74 6.70 9.29 15.77 26.93 32.43 31.55 0.00 6.14 0.00 4.40 9.24 3.44 2.76 9.04 9.63 7.48 2.28 4.21 2.41 7.77 18.08 6.09 5.63 8.36 6.02 8.75 7.23 9.52 7.63 7.01 9.28 7.96 8.79 10.72 8.99 7.10 7.20 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA 0.00 7.78 NA 6.27 6.45 NA NA NA 2.96 7.64 3.70 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA 0.00 8.34 NA 7.11 7.51 NA NA NA 2.60 7.66 3.67 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 4.62 4.80 5.42 2.39 10.37 6.55 2.62 6.26 9.38 8.80 10.07 9.87 0.00 3.53 0.00 3.69 6.53 2.42 2.22 7.04 6.82 5.60 1.74 3.59 1.74 5.33 9.85 5.16 4.58 6.14 4.62 6.29 5.51 6.38 6.12 4.81 5.84 6.00 6.09 7.38 6.44 5.08 5.03 Fully Implemented Facility PE RVUs 5.71 5.95 6.62 2.98 11.39 6.88 3.18 6.66 9.59 8.80 10.07 9.87 0.00 3.30 0.00 4.24 7.30 2.78 2.60 7.96 7.60 6.22 1.65 3.88 1.77 5.50 10.12 5.53 5.14 6.88 5.43 7.12 6.22 7.27 6.88 5.12 7.04 6.83 6.71 8.09 7.15 5.79 5.97 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 22845 22846 22847 22848 22849 22850 22851 22852 22855 22857 22862 22865 22899 22900 22999 23000 23020 23030 23031 23035 23040 23044 23065 23066 23075 23076 23077 23100 23101 23105 23106 23107 23120 23125 23130 23140 23145 23146 23150 23155 23156 23170 23172 HCPCS 2 CPT 1/ 2.86 2.96 3.00 1.15 3.90 2.05 1.49 1.90 3.52 3.56 5.36 5.18 0.00 0.76 0.00 0.68 1.54 0.57 0.46 1.47 1.60 1.24 0.20 0.63 0.34 1.13 2.34 1.04 0.96 1.42 0.99 1.49 1.23 1.62 1.30 1.08 1.49 1.35 1.32 1.81 1.50 1.12 1.01 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA 0.00 12.86 NA 10.28 9.67 NA NA NA 5.44 12.48 6.45 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA 0.00 13.42 NA 11.12 10.73 NA NA NA 5.08 12.50 6.42 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 19.42 20.16 22.20 9.53 33.35 18.34 10.81 17.45 28.67 39.29 47.86 46.60 0.00 10.43 0.00 8.77 17.31 6.43 5.44 17.55 18.05 14.32 4.22 8.43 4.49 14.23 30.27 12.29 11.17 15.92 11.63 16.53 13.97 17.52 15.05 12.90 16.61 15.31 16.20 19.91 16.93 13.30 13.24 Fully Implemented Facility Total 20.51 21.31 23.40 10.12 34.37 18.67 11.37 17.85 28.88 39.29 47.86 46.60 0.00 10.20 0.00 9.32 18.08 6.79 5.82 18.47 18.83 14.94 4.13 8.72 4.52 14.40 30.54 12.66 11.73 16.66 12.44 17.36 14.68 18.41 15.81 13.21 17.81 16.14 16.82 20.62 17.64 14.01 14.18 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 ZZZ ZZZ ZZZ ZZZ 090 090 ZZZ 090 090 090 090 090 YYY 090 YYY 090 090 010 010 090 090 090 010 090 010 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69811 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00190 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Remove humerus lesion ...................................... Remove collar bone lesion .................................. Remove shoulder blade lesion ............................ Remove humerus lesion ...................................... Partial removal of scapula ................................... Removal of head of humerus .............................. Removal of collar bone ........................................ Removal of shoulder blade .................................. Partial removal of humerus .................................. Partial removal of humerus .................................. Partial removal of humerus .................................. Remove shoulder foreign body ............................ Remove shoulder foreign body ............................ Remove shoulder foreign body ............................ Injection for shoulder x-ray .................................. Muscle transfer,shoulder/arm ............................... Muscle transfers ................................................... Fixation of shoulder blade .................................... Incision of tendon & muscle ................................. Incise tendon(s) & muscle(s) ............................... Repair rotator cuff, acute ..................................... Repair rotator cuff, chronic .................................. Release of shoulder ligament .............................. Repair of shoulder ................................................ Repair biceps tendon ........................................... Remove/transplant tendon ................................... Repair shoulder capsule ...................................... Repair shoulder capsule ...................................... Repair shoulder capsule ...................................... Repair shoulder capsule ...................................... Repair shoulder capsule ...................................... Repair shoulder capsule ...................................... Reconstruct shoulder joint ................................... Reconstruct shoulder joint ................................... Revision of collar bone ........................................ Revision of collar bone ........................................ Reinforce clavicle ................................................. Reinforce shoulder bones .................................... Treat clavicle fracture ........................................... Treat clavicle fracture ........................................... Treat clavicle fracture ........................................... Treat clavicle dislocation ...................................... Treat clavicle dislocation ...................................... Description 9.90 8.85 8.47 9.76 7.36 10.24 12.69 13.16 15.36 18.41 25.44 1.87 7.51 12.23 1.00 18.29 16.62 13.73 8.43 10.90 12.63 13.55 10.09 14.75 10.05 10.53 13.58 14.55 15.68 15.60 16.16 15.55 17.75 22.47 11.42 13.79 12.04 14.40 2.13 3.74 7.47 2.21 3.67 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA 3.36 NA NA 2.55 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 2.64 4.02 NA 2.64 4.51 Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA 3.60 NA NA 3.23 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 2.81 4.31 NA 2.80 4.53 Year 2007 Transitional Non-Facility PE RVUs 7.33 7.09 6.92 7.56 5.44 6.82 7.51 8.28 9.12 6.61 13.64 1.54 5.91 8.06 0.29 11.32 9.75 8.60 5.99 6.98 7.87 8.27 6.64 9.82 6.83 6.85 8.24 8.64 9.40 9.15 9.66 10.14 10.25 12.32 7.40 8.38 6.55 8.93 2.64 3.63 5.61 2.64 3.93 Fully Implemented Facility PE RVUs 8.10 8.52 8.14 8.87 5.99 7.50 8.42 8.81 10.40 10.44 15.25 1.80 6.57 9.01 0.32 12.48 10.97 9.70 6.69 8.00 9.02 9.49 7.65 10.59 7.78 7.91 9.44 9.99 10.88 10.35 10.80 11.06 11.75 13.89 8.43 9.51 8.16 10.27 2.55 3.79 6.32 2.72 3.94 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 23174 23180 23182 23184 23190 23195 23200 23210 23220 23221 23222 23330 23331 23332 23350 23395 23397 23400 23405 23406 23410 23412 23415 23420 23430 23440 23450 23455 23460 23462 23465 23466 23470 23472 23480 23485 23490 23491 23500 23505 23515 23520 23525 HCPCS 2 CPT 1/ 1.65 1.47 1.37 1.63 1.17 1.71 1.94 2.03 2.49 3.06 3.95 0.24 1.27 2.03 0.06 2.94 2.74 2.30 1.45 1.88 2.17 2.32 1.74 2.32 1.74 1.83 2.33 2.50 2.67 2.60 2.77 2.47 2.99 3.67 1.95 2.34 1.47 2.47 0.30 0.61 1.28 0.34 0.46 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA 5.47 NA NA 3.61 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 5.07 8.37 NA 5.19 8.64 Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA 5.71 NA NA 4.29 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 5.24 8.66 NA 5.35 8.66 Year 2007 Transitional Non-Facility Total 18.88 17.41 16.76 18.95 13.97 18.77 22.14 23.47 26.97 28.08 43.03 3.65 14.69 22.32 1.35 32.55 29.11 24.63 15.87 19.76 22.67 24.14 18.47 26.89 18.62 19.21 24.15 25.69 27.75 27.35 28.59 28.16 30.99 38.46 20.77 24.51 20.06 25.80 5.07 7.98 14.36 5.19 8.06 Fully Implemented Facility Total 19.65 18.84 17.98 20.26 14.52 19.45 23.05 24.00 28.25 31.91 44.64 3.91 15.35 23.27 1.38 33.71 30.33 25.73 16.57 20.78 23.82 25.36 19.48 27.66 19.57 20.27 25.35 27.04 29.23 28.55 29.73 29.08 32.49 40.03 21.80 25.64 21.67 27.14 4.98 8.14 15.07 5.27 8.07 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 010 090 090 000 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 Global 69812 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00191 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C A A A A A A A A A A A A A Status Treat clavicle dislocation ...................................... Treat clavicle dislocation ...................................... Treat clavicle dislocation ...................................... Treat clavicle dislocation ...................................... Treat clavicle dislocation ...................................... Treat clavicle dislocation ...................................... Treat shoulder blade fx ........................................ Treat shoulder blade fx ........................................ Treat scapula fracture .......................................... Treat humerus fracture ........................................ Treat humerus fracture ........................................ Treat humerus fracture ........................................ Treat humerus fracture ........................................ Treat humerus fracture ........................................ Treat humerus fracture ........................................ Treat humerus fracture ........................................ Treat shoulder dislocation .................................... Treat shoulder dislocation .................................... Treat shoulder dislocation .................................... Treat dislocation/fracture ...................................... Treat dislocation/fracture ...................................... Treat dislocation/fracture ...................................... Treat dislocation/fracture ...................................... Fixation of shoulder .............................................. Fusion of shoulder joint ........................................ Fusion of shoulder joint ........................................ Amputation of arm & girdle .................................. Amputation at shoulder joint ................................ Amputation follow-up surgery .............................. Shoulder surgery procedure ................................ Drainage of arm lesion ......................................... Drainage of arm bursa ......................................... Drain arm/elbow bone lesion ............................... Exploratory elbow surgery ................................... Release elbow joint .............................................. Biopsy arm/elbow soft tissue ............................... Biopsy arm/elbow soft tissue ............................... Remove arm/elbow lesion .................................... Remove arm/elbow lesion .................................... Remove tumor of arm/elbow ................................ Biopsy elbow joint lining ....................................... Explore/treat elbow joint ....................................... Remove elbow joint lining .................................... Description 7.37 8.08 2.28 3.32 7.48 8.70 2.28 4.12 9.15 3.00 4.94 10.93 21.68 2.46 3.99 7.47 3.44 4.64 7.55 4.54 8.02 6.13 10.30 2.54 14.59 18.17 20.57 16.03 5.61 0.00 2.96 1.81 6.27 5.99 9.62 2.10 5.26 3.96 6.36 11.95 4.98 6.19 8.15 Physician Work RVUs 3 NA NA 2.62 3.75 NA NA 2.80 4.36 NA 4.08 5.42 NA NA 3.42 4.44 NA 3.27 NA NA 4.84 NA 6.16 NA NA NA NA NA NA NA 0.00 4.94 4.31 NA NA NA 4.16 8.25 7.16 NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA 2.80 4.08 NA NA 2.96 4.75 NA 4.43 5.97 NA NA 3.56 4.82 NA 3.65 NA NA 5.21 NA 6.66 NA NA NA NA NA NA NA 0.00 5.98 5.51 NA NA NA 3.45 8.76 7.30 NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 5.29 6.10 2.62 3.28 5.54 6.29 2.80 3.87 6.54 3.66 4.63 8.35 11.62 3.15 3.92 5.71 2.81 4.18 5.65 4.26 5.90 5.18 7.04 1.92 7.64 11.08 10.73 9.60 4.89 0.00 1.98 1.75 5.15 4.79 6.71 1.93 3.93 3.27 4.60 7.00 4.29 5.10 5.85 Fully Implemented Facility PE RVUs 5.77 6.75 2.43 3.34 6.16 7.06 2.87 4.20 7.37 3.58 4.99 8.71 13.51 3.02 4.19 6.40 2.77 4.17 6.20 4.61 6.60 5.67 7.84 2.11 9.72 10.40 11.47 9.84 5.03 0.00 2.23 2.07 5.72 5.26 7.49 1.79 4.08 3.37 4.80 7.56 4.46 5.72 6.61 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 23530 23532 23540 23545 23550 23552 23570 23575 23585 23600 23605 23615 23616 23620 23625 23630 23650 23655 23660 23665 23670 23675 23680 23700 23800 23802 23900 23920 23921 23929 23930 23931 23935 24000 24006 24065 24066 24075 24076 24077 24100 24101 24102 HCPCS 2 CPT 1/ 1.20 1.38 0.29 0.35 1.25 1.46 0.36 0.59 1.54 0.48 0.84 1.62 3.70 0.40 0.67 1.27 0.30 0.69 1.29 0.71 1.36 1.01 1.76 0.44 2.36 2.71 3.19 2.47 0.78 0.00 0.43 0.28 1.05 0.97 1.50 0.17 0.80 0.56 0.95 1.73 0.85 1.03 1.33 Mal-Practice RVUs NA NA 5.19 7.42 NA NA 5.44 9.07 NA 7.56 11.20 NA NA 6.28 9.10 NA 7.01 NA NA 10.09 NA 13.30 NA NA NA NA NA NA NA 0.00 8.33 6.40 NA NA NA 6.43 14.31 11.68 NA NA NA NA NA Fully Implemented NonFacility Total NA NA 5.37 7.75 NA NA 5.60 9.46 NA 7.91 11.75 NA NA 6.42 9.48 NA 7.39 NA NA 10.46 NA 13.80 NA NA NA NA NA NA NA 0.00 9.37 7.60 NA NA NA 5.72 14.82 11.82 NA NA NA NA NA Year 2007 Transitional Non-Facility Total 13.86 15.56 5.19 6.95 14.27 16.45 5.44 8.58 17.23 7.14 10.41 20.90 37.00 6.01 8.58 14.45 6.55 9.51 14.49 9.51 15.28 12.32 19.10 4.90 24.59 31.96 34.49 28.10 11.28 0.00 5.37 3.84 12.47 11.75 17.83 4.20 9.99 7.79 11.91 20.68 10.12 12.32 15.33 Fully Implemented Facility Total 14.34 16.21 5.00 7.01 14.89 17.22 5.51 8.91 18.06 7.06 10.77 21.26 38.89 5.88 8.85 15.14 6.51 9.50 15.04 9.86 15.98 12.81 19.90 5.09 26.67 31.28 35.23 28.34 11.42 0.00 5.62 4.16 13.04 12.22 18.61 4.06 10.14 7.89 12.11 21.24 10.29 12.94 16.09 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 010 090 090 090 090 090 YYY 010 010 090 090 090 010 090 090 090 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69813 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00192 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Removal of elbow bursa ...................................... Remove humerus lesion ...................................... Remove/graft bone lesion .................................... Remove/graft bone lesion .................................... Remove elbow lesion ........................................... Remove/graft bone lesion .................................... Remove/graft bone lesion .................................... Removal of head of radius ................................... Removal of arm bone lesion ................................ Remove radius bone lesion ................................. Remove elbow bone lesion .................................. Partial removal of arm bone ................................ Partial removal of radius ...................................... Partial removal of elbow ...................................... Radical resection of elbow ................................... Extensive humerus surgery ................................. Extensive humerus surgery ................................. Extensive radius surgery ...................................... Extensive radius surgery ...................................... Removal of elbow joint ......................................... Remove elbow joint implant ................................. Remove radius head implant ............................... Removal of arm foreign body .............................. Removal of arm foreign body .............................. Injection for elbow x-ray ....................................... Manipulate elbow w/anesth .................................. Muscle/tendon transfer ......................................... Arm tendon lengthening ....................................... Revision of arm tendon ........................................ Repair of arm tendon ........................................... Revision of arm muscles ...................................... Revision of arm muscles ...................................... Tenolysis, triceps ................................................. Repair of biceps tendon ....................................... Repair arm tendon/muscle ................................... Repair of ruptured tendon .................................... Repr elbow lat ligmnt w/tiss ................................. Reconstruct elbow lat ligmnt ................................ Repr elbw med ligmnt w/tissu .............................. Reconstruct elbow med ligmnt ............................. Repair of tennis elbow ......................................... Repair of tennis elbow ......................................... Repair of tennis elbow ......................................... Description 3.67 7.46 10.00 12.11 6.71 8.02 8.50 6.31 10.10 8.29 8.33 9.43 7.70 7.69 15.92 13.70 16.08 10.24 11.73 11.97 7.89 6.34 1.78 4.61 1.31 3.86 10.26 7.51 6.03 10.74 9.67 10.83 7.77 7.96 9.24 10.74 8.99 14.97 8.99 14.97 5.32 5.97 6.49 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 2.76 7.85 2.50 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 3.25 9.32 3.35 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 4.04 5.68 6.85 7.70 5.23 6.05 6.24 5.15 7.52 5.70 6.74 7.24 6.32 6.93 10.94 8.58 9.82 6.35 4.87 7.64 5.85 4.94 1.38 3.70 0.39 5.19 6.91 5.72 4.80 7.15 6.69 6.57 5.81 6.02 7.54 7.15 7.06 10.11 7.01 10.11 4.90 5.02 5.24 Fully Implemented Facility PE RVUs 4.30 6.42 7.12 8.73 5.75 6.13 6.83 5.80 8.52 6.84 7.52 8.64 7.63 8.18 11.45 9.64 11.09 7.39 5.40 8.21 6.63 5.56 1.57 4.10 0.43 5.58 7.86 6.46 5.39 7.44 7.58 8.15 6.53 6.74 7.83 8.18 7.88 11.17 7.77 11.03 5.41 5.70 5.95 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 24105 24110 24115 24116 24120 24125 24126 24130 24134 24136 24138 24140 24145 24147 24149 24150 24151 24152 24153 24155 24160 24164 24200 24201 24220 24300 24301 24305 24310 24320 24330 24331 24332 24340 24341 24342 24343 24344 24345 24346 24350 24351 24352 HCPCS 2 CPT 1/ 0.61 1.28 1.68 2.06 1.10 1.06 1.16 1.04 1.64 1.38 1.34 1.51 1.25 1.30 2.35 2.33 2.60 1.48 0.74 1.93 1.30 1.03 0.20 0.72 0.08 0.65 1.66 1.15 0.96 1.74 1.60 1.78 1.23 1.36 1.36 1.86 1.43 2.37 1.44 2.34 0.87 1.02 1.10 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 4.74 13.18 3.89 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 5.23 14.65 4.74 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 8.32 14.42 18.53 21.87 13.04 15.13 15.90 12.50 19.26 15.37 16.41 18.18 15.27 15.92 29.21 24.61 28.50 18.07 17.34 21.54 15.04 12.31 3.36 9.03 1.78 9.70 18.83 14.38 11.79 19.63 17.96 19.18 14.81 15.34 18.14 19.75 17.48 27.45 17.44 27.42 11.09 12.01 12.83 Fully Implemented Facility Total 8.58 15.16 18.80 22.90 13.56 15.21 16.49 13.15 20.26 16.51 17.19 19.58 16.58 17.17 29.72 25.67 29.77 19.11 17.87 22.11 15.82 12.93 3.55 9.43 1.82 10.09 19.78 15.12 12.38 19.92 18.85 20.76 15.53 16.06 18.43 20.78 18.30 28.51 18.20 28.34 11.60 12.69 13.54 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 010 090 000 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 Global 69814 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00193 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Repair of tennis elbow ......................................... Revision of tennis elbow ...................................... Reconstruct elbow joint ........................................ Reconstruct elbow joint ........................................ Reconstruct elbow joint ........................................ Replace elbow joint .............................................. Reconstruct head of radius .................................. Reconstruct head of radius .................................. Revision of humerus ............................................ Revision of humerus ............................................ Revision of humerus ............................................ Repair of humerus ............................................... Repair humerus with graft .................................... Revision of elbow joint ......................................... Decompression of forearm ................................... Reinforce humerus ............................................... Treat humerus fracture ........................................ Treat humerus fracture ........................................ Treat humerus fracture ........................................ Treat humerus fracture ........................................ Treat humerus fracture ........................................ Treat humerus fracture ........................................ Treat humerus fracture ........................................ Treat humerus fracture ........................................ Treat humerus fracture ........................................ Treat humerus fracture ........................................ Treat humerus fracture ........................................ Treat humerus fracture ........................................ Treat humerus fracture ........................................ Treat humerus fracture ........................................ Treat humerus fracture ........................................ Treat humerus fracture ........................................ Treat humerus fracture ........................................ Treat elbow fracture ............................................. Treat elbow fracture ............................................. Treat elbow dislocation ........................................ Treat elbow dislocation ........................................ Treat elbow dislocation ........................................ Treat elbow fracture ............................................. Treat elbow fracture ............................................. Treat elbow dislocation ........................................ Treat radius fracture ............................................. Treat radius fracture ............................................. Description 6.54 6.74 12.53 14.27 15.18 22.47 8.51 9.25 11.19 14.96 13.58 15.07 14.74 8.81 8.30 12.16 3.29 5.25 11.97 12.07 3.57 6.96 9.63 10.88 15.99 2.87 5.64 8.86 11.02 2.94 5.87 11.96 9.89 15.64 15.65 4.28 5.50 9.72 7.07 13.56 1.22 2.22 4.48 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 4.44 5.86 NA NA 4.73 6.82 NA NA NA 4.04 5.86 NA NA 4.43 6.02 NA NA NA NA 3.87 NA NA NA NA 1.47 3.43 5.19 Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 4.75 6.42 NA NA 5.08 7.59 NA NA NA 4.37 6.42 NA NA 4.68 6.70 NA NA NA NA 4.61 NA NA NA NA 1.75 3.69 5.76 Year 2007 Transitional Non-Facility PE RVUs 5.27 5.35 8.01 8.86 9.37 12.36 5.96 6.35 7.65 9.37 8.89 9.34 9.90 6.44 6.65 7.78 3.81 4.91 8.12 7.74 4.01 5.88 7.25 7.27 9.54 3.38 4.99 6.99 7.30 3.73 5.09 7.90 8.23 9.41 9.43 3.30 4.97 6.61 5.49 10.25 0.81 3.00 4.42 Fully Implemented Facility PE RVUs 5.93 6.07 9.11 10.15 9.87 13.37 6.89 7.24 8.55 10.08 10.13 9.64 10.64 7.40 8.22 8.89 3.71 5.27 9.07 8.77 4.03 6.44 8.34 8.16 10.88 3.24 5.39 7.87 8.13 3.72 5.65 8.60 8.89 10.78 10.62 3.45 5.26 7.52 6.06 13.10 0.80 2.81 4.70 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 24354 24356 24360 24361 24362 24363 24365 24366 24400 24410 24420 24430 24435 24470 24495 24498 24500 24505 24515 24516 24530 24535 24538 24545 24546 24560 24565 24566 24575 24576 24577 24579 24582 24586 24587 24600 24605 24615 24620 24635 24640 24650 24655 HCPCS 2 CPT 1/ 1.07 1.11 2.06 2.19 2.61 3.02 1.41 1.52 1.93 2.58 2.18 2.22 2.28 1.48 1.18 2.07 0.50 0.89 2.03 2.03 0.57 1.18 1.64 1.83 2.74 0.44 0.93 1.30 1.87 0.46 0.95 2.03 1.48 2.65 2.53 0.50 0.89 1.60 1.07 2.29 0.12 0.35 0.70 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 8.23 12.00 NA NA 8.87 14.96 NA NA NA 7.35 12.43 NA NA 7.83 12.84 NA NA NA NA 8.65 NA NA NA NA 2.81 6.00 10.37 Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 8.54 12.56 NA NA 9.22 15.73 NA NA NA 7.68 12.99 NA NA 8.08 13.52 NA NA NA NA 9.39 NA NA NA NA 3.09 6.26 10.94 Year 2007 Transitional Non-Facility Total 12.88 13.20 22.60 25.32 27.16 37.85 15.88 17.12 20.77 26.91 24.65 26.63 26.92 16.73 16.13 22.01 7.60 11.05 22.12 21.84 8.15 14.02 18.52 19.98 28.27 6.69 11.56 17.15 20.19 7.13 11.91 21.89 19.60 27.70 27.61 8.08 11.36 17.93 13.63 26.10 2.15 5.57 9.60 Fully Implemented Facility Total 13.54 13.92 23.70 26.61 27.66 38.86 16.81 18.01 21.67 27.62 25.89 26.93 27.66 17.69 17.70 23.12 7.50 11.41 23.07 22.87 8.17 14.58 19.61 20.87 29.61 6.55 11.96 18.03 21.02 7.12 12.47 22.59 20.26 29.07 28.80 8.23 11.65 18.84 14.20 28.95 2.14 5.38 9.88 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 010 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69815 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00194 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A C C A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Treat radius fracture ............................................. Treat radius fracture ............................................. Treat ulnar fracture .............................................. Treat ulnar fracture .............................................. Treat ulnar fracture .............................................. Fusion of elbow joint ............................................ Fusion/graft of elbow joint .................................... Amputation of upper arm ..................................... Amputation of upper arm ..................................... Amputation follow-up surgery .............................. Amputation follow-up surgery .............................. Amputate upper arm & implant ............................ Revision of amputation ........................................ Revision of upper arm .......................................... Upper arm/elbow surgery ..................................... Incision of tendon sheath ..................................... Incise flexor carpi radialis .................................... Decompress forearm 1 space .............................. Decompress forearm 1 space .............................. Decompress forearm 2 spaces ............................ Decompress forearm 2 spaces ............................ Drainage of forearm lesion .................................. Drainage of forearm bursa ................................... Treat forearm bone lesion .................................... Explore/treat wrist joint ......................................... Biopsy forearm soft tissues .................................. Biopsy forearm soft tissues .................................. Removal forearm lesion subcu ............................ Removal forearm lesion deep .............................. Remove tumor, forearm/wrist ............................... Incision of wrist capsule ....................................... Biopsy of wrist joint .............................................. Explore/treat wrist joint ......................................... Remove wrist joint lining ...................................... Remove wrist joint cartilage ................................. Excise tendon forearm/wrist ................................. Remove wrist tendon lesion ................................. Remove wrist tendon lesion ................................. Reremove wrist tendon lesion ............................. Remove wrist/forearm lesion ............................... Remove wrist/forearm lesion ............................... Excise wrist tendon sheath .................................. Partial removal of ulna ......................................... Description 8.22 9.74 2.60 4.79 8.92 11.27 14.18 10.04 10.02 7.19 10.72 13.32 16.30 0.00 0.00 3.44 3.68 5.97 13.69 10.62 17.77 5.30 4.18 7.54 7.41 2.01 4.18 3.78 4.97 9.90 5.55 3.94 4.74 5.91 7.50 6.81 3.96 3.44 4.58 9.89 7.38 4.42 6.10 Physician Work RVUs 3 NA NA 3.73 5.30 NA NA NA NA NA NA NA NA NA 0.00 0.00 NA NA NA NA NA NA NA NA NA NA 4.29 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA 4.02 5.83 NA NA NA NA NA NA NA NA NA 0.00 0.00 NA NA NA NA NA NA NA NA NA NA 3.49 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 6.55 7.02 3.16 4.51 6.50 7.68 8.61 6.49 6.50 4.95 5.93 8.42 8.90 0.00 0.00 5.06 3.87 6.90 11.53 7.27 9.14 6.24 5.46 8.87 5.93 1.97 5.46 4.89 6.89 8.95 5.48 4.30 4.84 5.85 7.20 5.32 5.28 4.11 4.56 10.27 9.11 4.66 5.89 Fully Implemented Facility PE RVUs 7.27 7.81 3.09 4.86 7.27 8.48 9.94 6.92 6.83 5.80 6.91 6.40 8.24 0.00 0.00 6.42 4.14 8.90 14.09 7.42 9.76 7.68 7.31 12.41 6.96 1.92 6.66 5.64 8.88 11.30 6.71 5.03 5.63 6.94 8.06 5.32 6.61 4.55 5.08 13.09 12.13 5.47 7.17 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 24665 24666 24670 24675 24685 24800 24802 24900 24920 24925 24930 24931 24935 24940 24999 25000 25001 25020 25023 25024 25025 25028 25031 25035 25040 25065 25066 25075 25076 25077 25085 25100 25101 25105 25107 25109 25110 25111 25112 25115 25116 25118 25119 HCPCS 2 CPT 1/ 1.41 1.62 0.41 0.81 1.52 1.63 2.38 1.53 1.61 1.14 1.68 1.90 2.14 0.00 0.00 0.55 0.55 0.93 2.04 1.36 1.83 0.81 0.63 1.24 1.15 0.15 0.64 0.55 0.74 1.42 0.85 0.59 0.75 0.92 0.99 0.96 0.62 0.53 0.70 1.31 1.11 0.68 0.96 Mal-Practice RVUs NA NA 6.74 10.90 NA NA NA NA NA NA NA NA NA 0.00 0.00 NA NA NA NA NA NA NA NA NA NA 6.45 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA 7.03 11.43 NA NA NA NA NA NA NA NA NA 0.00 0.00 NA NA NA NA NA NA NA NA NA NA 5.65 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 16.18 18.38 6.17 10.11 16.94 20.58 25.17 18.06 18.13 13.28 18.33 23.64 27.34 0.00 0.00 9.05 8.10 13.80 27.26 19.25 28.74 12.35 10.27 17.65 14.49 4.13 10.28 9.22 12.60 20.27 11.88 8.83 10.33 12.68 15.69 13.09 9.86 8.08 9.84 21.47 17.60 9.76 12.95 Fully Implemented Facility Total 16.90 19.17 6.10 10.46 17.71 21.38 26.50 18.49 18.46 14.13 19.31 21.62 26.68 0.00 0.00 10.41 8.37 15.80 29.82 19.40 29.36 13.79 12.12 21.19 15.52 4.08 11.48 9.97 14.59 22.62 13.11 9.56 11.12 13.77 16.55 13.09 11.19 8.52 10.36 24.29 20.62 10.57 14.23 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 YYY 090 090 090 090 090 090 090 090 090 090 010 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 Global 69816 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00195 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Removal of forearm lesion ................................... Remove/graft forearm lesion ................................ Remove/graft forearm lesion ................................ Removal of wrist lesion ........................................ Remove & graft wrist lesion ................................. Remove & graft wrist lesion ................................. Remove forearm bone lesion ............................... Partial removal of ulna ......................................... Partial removal of radius ...................................... Extensive forearm surgery ................................... Removal of wrist bone ......................................... Removal of wrist bones ....................................... Partial removal of radius ...................................... Partial removal of ulna ......................................... Injection for wrist x-ray ......................................... Remove forearm foreign body ............................. Removal of wrist prosthesis ................................. Removal of wrist prosthesis ................................. Manipulate wrist w/anesthes ................................ Repair forearm tendon/muscle ............................. Repair forearm tendon/muscle ............................. Repair forearm tendon/muscle ............................. Repair forearm tendon/muscle ............................. Repair forearm tendon/muscle ............................. Repair forearm tendon/muscle ............................. Repair forearm tendon sheath ............................. Revise wrist/forearm tendon ................................ Incise wrist/forearm tendon .................................. Release wrist/forearm tendon .............................. Fusion of tendons at wrist .................................... Fusion of tendons at wrist .................................... Transplant forearm tendon ................................... Transplant forearm tendon ................................... Revise palsy hand tendon(s) ............................... Revise palsy hand tendon(s) ............................... Repair/revise wrist joint ........................................ Revise wrist joint .................................................. Realignment of hand ............................................ Reconstruct ulna/radioulnar ................................. Revision of radius ................................................ Revision of radius ................................................ Revision of ulna ................................................... Revise radius & ulna ............................................ Description 6.16 7.55 7.62 5.32 6.96 6.03 6.43 7.27 7.57 11.34 6.01 8.02 5.28 5.22 1.45 5.20 6.66 9.70 3.86 7.89 7.90 9.96 6.06 7.10 8.82 8.82 7.28 5.34 6.61 8.88 8.47 8.26 9.70 10.56 12.76 12.38 11.60 13.25 11.44 8.97 10.41 8.62 12.77 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA 2.55 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA 3.22 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 7.92 8.77 8.80 5.23 6.17 5.55 8.13 6.41 8.53 10.54 5.58 6.88 4.99 5.29 0.44 6.54 5.37 6.77 5.15 9.28 9.00 10.08 7.92 8.38 9.24 6.57 8.49 9.15 8.17 7.29 6.80 8.85 9.65 10.08 11.10 10.46 7.81 7.07 9.45 9.28 10.08 9.12 11.08 Fully Implemented Facility PE RVUs 11.04 11.82 11.96 6.12 7.18 6.33 11.08 7.76 11.67 14.00 6.49 8.28 5.85 6.54 0.47 8.03 5.92 7.63 5.58 12.30 12.20 13.25 11.00 11.69 12.53 7.33 11.60 13.53 11.16 8.16 7.75 11.99 12.87 13.32 14.94 11.16 8.83 10.46 10.67 12.80 13.48 12.68 14.50 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 25120 25125 25126 25130 25135 25136 25145 25150 25151 25170 25210 25215 25230 25240 25246 25248 25250 25251 25259 25260 25263 25265 25270 25272 25274 25275 25280 25290 25295 25300 25301 25310 25312 25315 25316 25320 25332 25335 25337 25350 25355 25360 25365 HCPCS 2 CPT 1/ 1.00 1.06 1.27 0.80 1.02 1.03 1.01 1.14 1.18 1.78 0.88 1.19 0.79 0.81 0.09 0.72 1.01 1.26 0.62 1.19 1.18 1.47 0.95 1.11 1.36 1.31 1.08 0.82 1.00 1.26 1.29 1.21 1.41 1.58 1.75 1.61 1.84 1.93 1.61 1.46 1.74 1.41 2.16 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA 4.09 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA 4.76 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 15.08 17.38 17.69 11.35 14.15 12.61 15.57 14.82 17.28 23.66 12.47 16.09 11.06 11.32 1.98 12.46 13.04 17.73 9.63 18.36 18.08 21.51 14.93 16.59 19.42 16.70 16.85 15.31 15.78 17.43 16.56 18.32 20.76 22.22 25.61 24.45 21.25 22.25 22.50 19.71 22.23 19.15 26.01 Fully Implemented Facility Total 18.20 20.43 20.85 12.24 15.16 13.39 18.52 16.17 20.42 27.12 13.38 17.49 11.92 12.57 2.01 13.95 13.59 18.59 10.06 21.38 21.28 24.68 18.01 19.90 22.71 17.46 19.96 19.69 18.77 18.30 17.51 21.46 23.98 25.46 29.45 25.15 22.27 25.64 23.72 23.23 25.63 22.71 29.43 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 000 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69817 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00196 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Revise radius or ulna ........................................... Revise radius & ulna ............................................ Shorten radius or ulna ......................................... Lengthen radius or ulna ....................................... Shorten radius & ulna .......................................... Lengthen radius & ulna ........................................ Repair carpal bone, shorten ................................ Repair radius or ulna ........................................... Repair/graft radius or ulna ................................... Repair radius & ulna ............................................ Repair/graft radius & ulna .................................... Repair/graft radius or ulna ................................... Repair/graft radius & ulna .................................... Vasc graft into carpal bone .................................. Repair nonunion carpal bone ............................... Repair/graft wrist bone ......................................... Reconstruct wrist joint .......................................... Reconstruct wrist joint .......................................... Reconstruct wrist joint .......................................... Reconstruct wrist joint .......................................... Reconstruct wrist joint .......................................... Wrist replacement ................................................ Repair wrist joint(s) .............................................. Remove wrist joint implant ................................... Revision of wrist joint ........................................... Revision of wrist joint ........................................... Reinforce radius ................................................... Reinforce ulna ...................................................... Reinforce radius and ulna .................................... Treat fracture of radius ........................................ Treat fracture of radius ........................................ Treat fracture of radius ........................................ Treat fracture of radius ........................................ Treat fracture of radius ........................................ Treat fracture of radius ........................................ Treat fracture of ulna ........................................... Treat fracture of ulna ........................................... Treat fracture of ulna ........................................... Treat fracture radius & ulna ................................. Treat fracture radius & ulna ................................. Treat fracture radius & ulna ................................. Treat fracture radius/ulna ..................................... Treat fracture radius/ulna ..................................... Description 13.93 13.41 10.58 14.14 14.44 16.42 10.71 11.16 14.87 13.66 16.89 13.58 16.31 9.57 10.75 10.56 13.15 10.98 10.52 11.28 9.76 17.16 10.95 14.80 7.94 9.57 9.61 10.03 12.52 2.51 5.30 9.37 6.35 12.69 13.43 2.15 5.22 9.09 2.50 5.71 7.47 12.02 2.69 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 3.33 5.87 NA 6.00 NA NA 3.46 5.69 NA 3.38 5.97 NA NA 3.68 Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 3.51 6.37 NA 6.65 NA NA 3.69 5.93 NA 3.61 6.52 NA NA 3.99 Year 2007 Transitional Non-Facility PE RVUs 11.96 11.32 9.98 11.71 11.86 13.47 6.85 10.19 11.95 11.02 12.83 14.17 12.50 7.11 7.33 7.56 8.62 7.42 6.69 7.75 6.78 9.99 7.95 9.19 7.28 6.41 9.50 9.71 10.56 2.89 5.03 6.78 5.43 8.78 10.26 2.96 4.95 6.67 2.87 5.00 6.65 9.02 3.18 Fully Implemented Facility PE RVUs 15.04 15.15 13.43 15.34 14.94 16.55 7.76 13.94 15.94 15.14 16.91 19.59 15.54 7.28 8.13 8.94 9.66 8.52 8.25 8.71 7.69 11.44 8.48 10.30 9.46 9.75 12.67 13.27 14.12 2.76 5.32 7.29 5.90 9.69 12.69 2.89 5.21 7.41 2.67 5.32 7.06 9.39 3.02 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 25370 25375 25390 25391 25392 25393 25394 25400 25405 25415 25420 25425 25426 25430 25431 25440 25441 25442 25443 25444 25445 25446 25447 25449 25450 25455 25490 25491 25492 25500 25505 25515 25520 25525 25526 25530 25535 25545 25560 25565 25574 25575 25600 HCPCS 2 CPT 1/ 2.29 2.27 1.65 2.22 2.11 2.77 1.59 1.83 2.33 2.18 2.62 2.09 2.55 1.27 1.91 1.63 2.08 1.53 1.37 1.72 1.55 2.48 1.61 2.22 1.36 0.96 1.43 1.60 2.15 0.35 0.90 1.59 1.08 2.13 2.20 0.34 0.89 1.53 0.35 0.93 1.21 1.82 0.42 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 6.19 12.07 NA 13.43 NA NA 5.95 11.80 NA 6.23 12.61 NA NA 6.79 Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 6.37 12.57 NA 14.08 NA NA 6.18 12.04 NA 6.46 13.16 NA NA 7.10 Year 2007 Transitional Non-Facility Total 28.18 27.00 22.21 28.07 28.41 32.66 19.15 23.18 29.15 26.86 32.34 29.84 31.36 17.95 19.99 19.75 23.85 19.93 18.58 20.75 18.09 29.63 20.51 26.21 16.58 16.94 20.54 21.34 25.23 5.75 11.23 17.74 12.86 23.60 25.89 5.45 11.06 17.29 5.72 11.64 15.33 22.86 6.29 Fully Implemented Facility Total 31.26 30.83 25.66 31.70 31.49 35.74 20.06 26.93 33.14 30.98 36.42 35.26 34.40 18.12 20.79 21.13 24.89 21.03 20.14 21.71 19.00 31.08 21.04 27.32 18.76 20.28 23.71 24.90 28.79 5.62 11.52 18.25 13.33 24.51 28.32 5.38 11.32 18.03 5.52 11.96 15.74 23.23 6.13 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 Global 69818 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00197 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C A A Status Treat fracture radius/ulna ..................................... Treat fx distal radial ............................................. Treat fx rad extra-articul ....................................... Treat fx rad intra-articul ........................................ Treat fx radial 3+ frag .......................................... Treat wrist bone fracture ...................................... Treat wrist bone fracture ...................................... Treat wrist bone fracture ...................................... Treat wrist bone fracture ...................................... Treat wrist bone fracture ...................................... Treat wrist bone fracture ...................................... Treat wrist bone fracture ...................................... Pin ulnar styloid fracture ...................................... Treat fracture ulnar styloid ................................... Treat wrist dislocation .......................................... Treat wrist dislocation .......................................... Pin radioulnar dislocation ..................................... Treat wrist dislocation .......................................... Treat wrist dislocation .......................................... Treat wrist fracture ............................................... Treat wrist fracture ............................................... Treat wrist dislocation .......................................... Treat wrist dislocation .......................................... Fusion of wrist joint .............................................. Fusion/graft of wrist joint ...................................... Fusion/graft of wrist joint ...................................... Fusion of hand bones .......................................... Fuse hand bones with graft ................................. Fusion, radioulnar jnt/ulna .................................... Amputation of forearm ......................................... Amputation of forearm ......................................... Amputation follow-up surgery .............................. Amputation follow-up surgery .............................. Amputation of forearm ......................................... Amputate hand at wrist ........................................ Amputate hand at wrist ........................................ Amputation follow-up surgery .............................. Amputation of hand .............................................. Amputation follow-up surgery .............................. Amputation follow-up surgery .............................. Forearm or wrist surgery ...................................... Drainage of finger abscess .................................. Drainage of finger abscess .................................. Description 7.02 8.10 9.35 10.86 14.12 2.68 4.62 9.50 2.94 4.47 7.31 3.12 5.68 7.92 4.84 7.98 6.32 4.75 8.17 6.08 9.97 5.58 8.40 9.95 11.59 11.75 7.52 9.54 10.69 9.46 9.48 7.98 9.20 17.38 8.92 7.54 8.70 8.98 7.71 7.93 0.00 1.56 2.21 Physician Work RVUs 3 6.91 NA NA NA NA 3.90 5.59 NA 3.76 5.39 NA 3.85 NA NA NA NA NA 4.89 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 4.00 6.26 Fully Implemented NonFacility PE RVUs 7.15 NA NA NA NA 4.18 6.12 NA 4.08 5.80 NA 4.20 NA NA NA NA NA 5.46 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 5.17 8.17 Year 2007 Transitional Non-Facility PE RVUs 6.19 6.75 7.26 7.88 9.77 3.36 4.74 7.38 3.25 4.57 5.84 3.46 5.15 6.25 4.49 6.02 5.55 4.16 6.31 4.40 6.74 4.85 6.23 7.33 8.23 8.62 6.32 7.63 10.48 9.28 8.47 7.78 9.05 8.13 6.78 6.55 6.77 8.65 5.46 8.58 0.00 1.51 1.99 Fully Implemented Facility PE RVUs 6.21 8.41 7.26 7.88 9.77 3.17 4.99 7.71 3.02 4.07 6.43 3.24 5.40 6.81 4.66 6.75 6.00 4.53 7.05 4.66 7.54 5.34 6.88 8.65 9.75 9.58 7.47 8.83 13.43 11.74 11.34 10.77 11.47 16.19 7.58 6.93 7.76 10.92 5.77 10.74 0.00 1.60 2.24 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 25605 25606 25607 25608 25609 25622 25624 25628 25630 25635 25645 25650 25651 25652 25660 25670 25671 25675 25676 25680 25685 25690 25695 25800 25805 25810 25820 25825 25830 25900 25905 25907 25909 25915 25920 25922 25924 25927 25929 25931 25999 26010 26011 HCPCS 2 CPT 1/ 1.00 1.26 1.36 1.84 2.38 0.41 0.76 1.37 0.45 0.74 1.20 0.45 0.86 1.21 0.58 1.28 1.00 0.62 1.34 0.78 1.60 0.88 1.32 1.57 1.81 1.68 1.22 1.41 1.55 1.30 1.40 1.10 1.44 2.94 1.35 1.12 1.32 1.27 1.14 1.15 0.00 0.18 0.33 Mal-Practice RVUs 14.93 NA NA NA NA 6.99 10.97 NA 7.15 10.60 NA 7.42 NA NA NA NA NA 10.26 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 5.74 8.80 Fully Implemented NonFacility Total 15.17 NA NA NA NA 7.27 11.50 NA 7.47 11.01 NA 7.77 NA NA NA NA NA 10.83 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 6.91 10.71 Year 2007 Transitional Non-Facility Total 14.21 16.11 17.97 20.58 26.27 6.45 10.12 18.25 6.64 9.78 14.35 7.03 11.69 15.38 9.91 15.28 12.87 9.53 15.82 11.26 18.31 11.31 15.95 18.85 21.63 22.05 15.06 18.58 22.72 20.04 19.35 16.86 19.69 28.45 17.05 15.21 16.79 18.90 14.31 17.66 0.00 3.25 4.53 Fully Implemented Facility Total 14.23 17.77 17.97 20.58 26.27 6.26 10.37 18.58 6.41 9.28 14.94 6.81 11.94 15.94 10.08 16.01 13.32 9.90 16.56 11.52 19.11 11.80 16.60 20.17 23.15 23.01 16.21 19.78 25.67 22.50 22.22 19.85 22.11 36.51 17.85 15.59 17.78 21.17 14.62 19.82 0.00 3.34 4.78 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 YYY 010 010 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69819 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00198 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Drain hand tendon sheath ................................... Drainage of palm bursa ....................................... Drainage of palm bursa(s) ................................... Treat hand bone lesion ........................................ Decompress fingers/hand .................................... Decompress fingers/hand .................................... Release palm contracture .................................... Release palm contracture .................................... Incise finger tendon sheath .................................. Incision of finger tendon ....................................... Explore/treat hand joint ........................................ Explore/treat finger joint ....................................... Explore/treat finger joint ....................................... Biopsy hand joint lining ........................................ Biopsy finger joint lining ....................................... Biopsy finger joint lining ....................................... Removal hand lesion subcut ................................ Removal hand lesion, deep ................................. Remove tumor, hand/finger ................................. Release palm contracture .................................... Release palm contracture .................................... Release palm contracture .................................... Remove wrist joint lining ...................................... Revise finger joint, each ...................................... Revise finger joint, each ...................................... Tendon excision, palm/finger ............................... Remove tendon sheath lesion ............................. Removal of palm tendon, each ............................ Removal of finger tendon ..................................... Remove finger bone ............................................. Remove hand bone lesion ................................... Remove/graft bone lesion .................................... Removal of finger lesion ...................................... Remove/graft finger lesion ................................... Partial removal of hand bone ............................... Partial removal, finger bone ................................. Partial removal, finger bone ................................. Extensive hand surgery ....................................... Extensive hand surgery ....................................... Extensive finger surgery ...................................... Extensive finger surgery ...................................... Partial removal of finger ....................................... Removal of implant from hand ............................. Description 4.97 4.99 6.16 6.49 11.14 7.48 3.38 5.62 3.00 2.85 3.73 3.83 4.36 3.71 3.75 3.57 3.92 5.61 8.62 7.61 10.63 4.60 5.48 7.02 6.23 6.38 3.46 4.82 5.24 6.32 5.56 7.82 5.21 7.16 6.38 6.24 5.37 7.61 12.80 7.09 9.28 5.72 4.02 Physician Work RVUs 3 NA NA NA NA NA NA NA NA 9.03 NA NA NA NA NA NA NA 9.82 NA NA NA NA NA NA NA NA NA 8.99 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA 13.02 NA NA NA NA NA NA NA 12.27 NA NA NA NA NA NA NA NA NA 11.53 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 4.78 4.49 5.03 5.58 8.11 5.57 3.63 4.90 3.84 3.07 3.04 3.43 4.37 3.58 3.76 3.62 4.25 5.34 6.29 5.99 8.31 1.93 4.88 5.55 5.22 5.23 3.94 4.40 4.81 5.84 4.60 5.90 4.79 5.58 5.05 5.00 4.59 5.24 8.51 5.41 7.05 4.70 3.81 Fully Implemented Facility PE RVUs 5.21 4.96 5.55 6.16 7.93 6.13 3.95 5.46 3.92 3.40 3.28 3.69 4.73 3.99 4.11 3.94 4.64 5.84 6.87 6.72 8.72 2.31 5.23 6.23 5.84 5.85 4.08 4.81 5.26 5.98 5.16 6.64 5.26 6.13 5.70 5.61 5.14 6.13 9.16 5.99 6.39 5.17 4.19 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 26020 26025 26030 26034 26035 26037 26040 26045 26055 26060 26070 26075 26080 26100 26105 26110 26115 26116 26117 26121 26123 26125 26130 26135 26140 26145 26160 26170 26180 26185 26200 26205 26210 26215 26230 26235 26236 26250 26255 26260 26261 26262 26320 HCPCS 2 CPT 1/ 0.73 0.76 0.92 1.01 1.47 1.13 0.53 0.93 0.43 0.45 0.48 0.53 0.66 0.54 0.59 0.53 0.59 0.84 1.26 1.17 1.43 0.70 0.94 1.07 0.92 0.97 0.49 0.69 0.78 0.81 0.88 1.20 0.79 0.98 1.01 0.95 0.81 1.07 1.69 1.01 1.14 0.88 0.59 Mal-Practice RVUs NA NA NA NA NA NA NA NA 12.46 NA NA NA NA NA NA NA 14.33 NA NA NA NA NA NA NA NA NA 12.94 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA 16.45 NA NA NA NA NA NA NA 16.78 NA NA NA NA NA NA NA NA NA 15.48 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 10.48 10.24 12.11 13.08 20.72 14.18 7.54 11.45 7.27 6.37 7.25 7.79 9.39 7.83 8.10 7.72 8.76 11.79 16.17 14.77 20.37 7.23 11.30 13.64 12.37 12.58 7.89 9.91 10.83 12.97 11.04 14.92 10.79 13.72 12.44 12.19 10.77 13.92 23.00 13.51 17.47 11.30 8.42 Fully Implemented Facility Total 10.91 10.71 12.63 13.66 20.54 14.74 7.86 12.01 7.35 6.70 7.49 8.05 9.75 8.24 8.45 8.04 9.15 12.29 16.75 15.50 20.78 7.61 11.65 14.32 12.99 13.20 8.03 10.32 11.28 13.11 11.60 15.66 11.26 14.27 13.09 12.80 11.32 14.81 23.65 14.09 16.81 11.77 8.80 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 ZZZ 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 Global 69820 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00199 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Manipulate finger w/anesth .................................. Repair finger/hand tendon ................................... Repair/graft hand tendon ..................................... Repair finger/hand tendon ................................... Repair finger/hand tendon ................................... Repair/graft hand tendon ..................................... Repair finger/hand tendon ................................... Repair/graft hand tendon ..................................... Repair finger/hand tendon ................................... Revise hand/finger tendon ................................... Repair/graft hand tendon ..................................... Repair hand tendon ............................................. Repair/graft hand tendon ..................................... Excision, hand/finger tendon ................................ Graft hand or finger tendon ................................. Repair finger tendon ............................................ Repair/graft finger tendon .................................... Repair finger/hand tendon ................................... Repair/graft finger tendon .................................... Repair finger tendon ............................................ Repair finger tendon ............................................ Repair/graft finger tendon .................................... Realignment of tendons ....................................... Release palm/finger tendon ................................. Release palm & finger tendon ............................. Release hand/finger tendon ................................. Release forearm/hand tendon ............................. Incision of palm tendon ........................................ Incision of finger tendon ....................................... Incise hand/finger tendon ..................................... Fusion of finger tendons ...................................... Fusion of finger tendons ...................................... Tendon lengthening ............................................. Tendon shortening ............................................... Lengthening of hand tendon ................................ Shortening of hand tendon .................................. Transplant hand tendon ....................................... Transplant/graft hand tendon ............................... Transplant palm tendon ....................................... Transplant/graft palm tendon ............................... Revise thumb tendon ........................................... Tendon transfer with graft .................................... Hand tendon/muscle transfer ............................... Description 2.62 6.07 7.75 10.22 8.65 9.22 7.17 8.89 8.29 9.31 10.38 4.68 6.37 8.40 9.44 4.33 6.83 6.21 7.28 4.07 4.61 6.15 5.88 5.07 9.50 4.36 8.34 3.71 3.68 3.50 5.79 5.38 5.24 5.21 5.86 5.80 6.76 8.36 7.77 9.74 8.48 9.70 8.54 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 4.63 9.48 10.05 13.76 10.28 10.85 9.51 10.52 10.18 9.13 11.07 7.56 8.56 6.73 8.71 8.08 8.75 8.54 9.28 6.70 6.95 7.90 7.73 8.44 11.66 8.10 11.33 5.12 5.06 5.02 7.69 7.50 7.42 7.48 7.65 7.71 9.58 10.22 9.96 10.29 8.94 9.82 9.02 Fully Implemented Facility PE RVUs 4.82 13.33 14.03 17.22 14.29 15.19 13.71 15.03 14.58 12.24 15.31 10.85 12.09 10.52 13.12 11.26 12.41 12.01 12.72 9.37 9.83 10.63 10.61 12.18 14.87 11.88 14.66 6.78 6.73 6.61 10.35 10.42 10.05 10.17 10.79 10.60 13.68 14.18 14.01 11.62 11.85 12.66 11.98 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 26340 26350 26352 26356 26357 26358 26370 26372 26373 26390 26392 26410 26412 26415 26416 26418 26420 26426 26428 26432 26433 26434 26437 26440 26442 26445 26449 26450 26455 26460 26471 26474 26476 26477 26478 26479 26480 26483 26485 26489 26490 26492 26494 HCPCS 2 CPT 1/ 0.39 0.93 1.13 1.21 1.33 1.38 1.12 1.40 1.23 1.40 1.57 0.73 0.97 0.98 0.79 0.67 1.07 0.95 1.09 0.64 0.72 0.93 0.89 0.75 1.20 0.65 1.06 0.59 0.58 0.55 0.88 0.76 0.79 0.81 0.90 0.92 1.02 1.26 1.15 1.26 1.21 1.40 1.28 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 7.64 16.48 18.93 25.19 20.26 21.45 17.80 20.81 19.70 19.84 23.02 12.97 15.90 16.11 18.94 13.08 16.65 15.70 17.65 11.41 12.28 14.98 14.50 14.26 22.36 13.11 20.73 9.42 9.32 9.07 14.36 13.64 13.45 13.50 14.41 14.43 17.36 19.84 18.88 21.29 18.63 20.92 18.84 Fully Implemented Facility Total 7.83 20.33 22.91 28.65 24.27 25.79 22.00 25.32 24.10 22.95 27.26 16.26 19.43 19.90 23.35 16.26 20.31 19.17 21.09 14.08 15.16 17.71 17.38 18.00 25.57 16.89 24.06 11.08 10.99 10.66 17.02 16.56 16.08 16.19 17.55 17.32 21.46 23.80 22.93 22.62 21.54 23.76 21.80 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69821 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00200 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Revise thumb tendon ........................................... Finger tendon transfer .......................................... Finger tendon transfer .......................................... Revision of finger ................................................. Hand tendon reconstruction ................................. Hand tendon reconstruction ................................. Release thumb contracture .................................. Thumb tendon transfer ......................................... Fusion of knuckle joint ......................................... Fusion of knuckle joints ....................................... Fusion of knuckle joints ....................................... Release knuckle contracture ................................ Release finger contracture ................................... Revise knuckle joint ............................................. Revise knuckle with implant ................................. Revise finger joint ................................................ Revise/implant finger joint .................................... Repair hand joint .................................................. Repair hand joint with graft .................................. Repair hand joint with graft .................................. Reconstruct finger joint ........................................ Repair nonunion hand .......................................... Reconstruct finger joint ........................................ Construct thumb replacement .............................. Great toe-hand transfer ........................................ Single transfer, toe-hand ...................................... Double transfer, toe-hand .................................... Positional change of finger .................................. Toe joint transfer .................................................. Repair of web finger ............................................. Repair of web finger ............................................. Repair of web finger ............................................. Correct metacarpal flaw ....................................... Correct finger deformity ....................................... Lengthen metacarpal/finger ................................. Repair hand deformity .......................................... Reconstruct extra finger ....................................... Repair finger deformity ......................................... Repair muscles of hand ....................................... Release muscles of hand .................................... Excision constricting tissue .................................. Treat metacarpal fracture ..................................... Treat metacarpal fracture ..................................... Description 9.66 9.64 14.07 9.05 6.02 7.20 6.07 5.49 7.21 8.96 9.15 5.36 5.39 6.76 7.99 5.30 6.44 6.49 8.69 6.84 6.99 10.53 8.10 21.54 48.23 47.92 56.73 16.94 49.43 5.43 10.98 16.40 6.80 6.88 9.15 19.50 14.36 18.51 3.30 5.38 9.02 2.48 2.92 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 3.83 4.08 Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 3.67 4.44 Year 2007 Transitional Non-Facility PE RVUs 9.50 9.46 11.58 8.80 7.82 8.39 7.76 7.59 8.24 9.28 9.23 8.82 8.83 5.47 6.22 4.10 9.16 8.01 9.08 8.14 8.37 11.46 8.83 15.48 21.70 20.69 19.35 13.95 17.83 7.10 9.48 14.12 7.91 8.18 10.18 11.36 8.49 10.52 6.28 7.76 7.50 3.48 3.51 Fully Implemented Facility PE RVUs 12.30 12.54 15.02 11.98 10.54 11.11 10.70 10.40 11.23 12.45 12.35 12.62 12.69 5.97 6.90 3.83 9.53 10.91 12.31 11.06 11.19 14.14 11.85 17.06 29.76 22.18 32.99 17.12 29.45 9.13 11.63 16.39 10.99 11.01 14.12 13.07 9.03 13.09 8.79 10.29 8.49 2.86 3.62 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 26496 26497 26498 26499 26500 26502 26508 26510 26516 26517 26518 26520 26525 26530 26531 26535 26536 26540 26541 26542 26545 26546 26548 26550 26551 26553 26554 26555 26556 26560 26561 26562 26565 26567 26568 26580 26587 26590 26591 26593 26596 26600 26605 HCPCS 2 CPT 1/ 1.45 1.41 2.11 1.35 0.90 1.13 0.98 0.79 1.10 1.41 1.35 0.80 0.81 1.04 1.17 0.71 0.96 0.99 1.28 1.02 1.05 1.44 1.20 2.46 7.98 2.42 9.44 2.49 2.58 0.85 1.45 2.24 1.00 1.04 1.49 2.29 1.53 2.78 0.48 0.78 1.43 0.30 0.49 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 6.61 7.49 Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 6.45 7.85 Year 2007 Transitional Non-Facility Total 20.61 20.51 27.76 19.20 14.74 16.72 14.81 13.87 16.55 19.65 19.73 14.98 15.03 13.27 15.38 10.11 16.56 15.49 19.05 16.00 16.41 23.43 18.13 39.48 77.91 71.03 85.52 33.38 69.84 13.38 21.91 32.76 15.71 16.10 20.82 33.15 24.38 31.81 10.06 13.92 17.95 6.26 6.92 Fully Implemented Facility Total 23.41 23.59 31.20 22.38 17.46 19.44 17.75 16.68 19.54 22.82 22.85 18.78 18.89 13.77 16.06 9.84 16.93 18.39 22.28 18.92 19.23 26.11 21.15 41.06 85.97 72.52 99.16 36.55 81.46 15.41 24.06 35.03 18.79 18.93 24.76 34.86 24.92 34.38 12.57 16.45 18.94 5.64 7.03 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 Global 69822 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00201 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Treat metacarpal fracture ..................................... Treat metacarpal fracture ..................................... Treat metacarpal fracture ..................................... Treat thumb dislocation ........................................ Treat thumb fracture ............................................ Treat thumb fracture ............................................ Treat thumb fracture ............................................ Treat hand dislocation .......................................... Treat hand dislocation .......................................... Pin hand dislocation ............................................. Treat hand dislocation .......................................... Treat hand dislocation .......................................... Treat knuckle dislocation ..................................... Treat knuckle dislocation ..................................... Pin knuckle dislocation ......................................... Treat knuckle dislocation ..................................... Treat finger fracture, each ................................... Treat finger fracture, each ................................... Treat finger fracture, each ................................... Treat finger fracture, each ................................... Treat finger fracture, each ................................... Treat finger fracture, each ................................... Treat finger fracture, each ................................... Treat finger fracture, each ................................... Treat finger fracture, each ................................... Pin finger fracture, each ....................................... Treat finger fracture, each ................................... Treat finger dislocation ......................................... Treat finger dislocation ......................................... Pin finger dislocation ............................................ Treat finger dislocation ......................................... Thumb fusion with graft ....................................... Fusion of thumb ................................................... Thumb fusion with graft ....................................... Fusion of hand joint ............................................. Fusion/graft of hand joint ..................................... Fusion of knuckle ................................................. Fusion of knuckle with graft ................................. Fusion of finger joint ............................................ Fusion of finger jnt, add-on .................................. Fusion/graft of finger joint .................................... Fuse/graft added joint .......................................... Amputate metacarpal bone .................................. Description 5.40 5.43 5.38 4.01 4.47 5.80 7.72 3.74 4.71 5.60 7.09 8.06 3.74 4.26 5.19 5.79 1.70 3.39 5.30 6.03 1.99 3.90 5.86 1.74 3.15 4.46 4.21 3.07 3.78 4.87 4.25 8.33 7.21 8.37 7.67 8.86 7.03 8.59 4.76 1.74 7.44 3.89 7.67 Physician Work RVUs 3 NA NA NA 4.17 4.60 NA NA 3.54 4.88 NA NA NA 3.33 4.82 NA NA 2.58 4.09 NA NA 2.95 4.35 NA 2.24 3.80 NA NA 2.91 4.56 NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA 4.47 5.03 NA NA 4.08 5.32 NA NA NA 3.65 5.20 NA NA 2.73 4.60 NA NA 3.09 4.83 NA 2.42 4.27 NA NA 3.30 5.03 NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 4.91 5.27 4.78 3.52 3.92 5.65 5.93 2.96 4.18 5.59 5.47 6.18 2.96 4.11 4.74 4.95 2.31 3.43 5.24 5.04 2.67 3.64 5.01 2.24 2.99 4.89 4.04 2.54 3.83 5.04 4.10 8.71 8.69 8.97 8.19 9.18 8.31 9.17 7.54 0.72 8.72 1.61 8.32 Fully Implemented Facility PE RVUs 5.93 6.01 5.17 3.53 4.12 6.43 6.44 2.95 4.40 6.42 5.97 6.72 2.89 4.25 5.00 5.37 2.12 3.48 5.98 5.42 2.69 3.82 5.42 2.07 3.00 5.51 4.30 2.44 3.82 5.76 4.42 12.12 12.10 12.27 11.31 12.32 11.23 11.96 10.28 0.88 11.44 1.99 10.50 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 26607 26608 26615 26641 26645 26650 26665 26670 26675 26676 26685 26686 26700 26705 26706 26715 26720 26725 26727 26735 26740 26742 26746 26750 26755 26756 26765 26770 26775 26776 26785 26820 26841 26842 26843 26844 26850 26852 26860 26861 26862 26863 26910 HCPCS 2 CPT 1/ 0.87 0.88 0.86 0.39 0.67 0.94 0.90 0.39 0.77 0.91 1.09 1.24 0.35 0.66 0.81 0.91 0.24 0.53 0.84 0.95 0.31 0.58 0.91 0.22 0.42 0.71 0.66 0.27 0.54 0.77 0.68 1.30 1.18 1.32 1.15 1.33 1.06 1.22 0.73 0.27 1.10 0.56 1.16 Mal-Practice RVUs NA NA NA 8.57 9.74 NA NA 7.67 10.36 NA NA NA 7.42 9.74 NA NA 4.52 8.01 NA NA 5.25 8.83 NA 4.20 7.37 NA NA 6.25 8.88 NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA 8.87 10.17 NA NA 8.21 10.80 NA NA NA 7.74 10.12 NA NA 4.67 8.52 NA NA 5.39 9.31 NA 4.38 7.84 NA NA 6.64 9.35 NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 11.18 11.58 11.02 7.92 9.06 12.39 14.55 7.09 9.66 12.10 13.65 15.48 7.05 9.03 10.74 11.65 4.25 7.35 11.38 12.02 4.97 8.12 11.78 4.20 6.56 10.06 8.91 5.88 8.15 10.68 9.03 18.34 17.08 18.66 17.01 19.37 16.40 18.98 13.03 2.73 17.26 6.06 17.15 Fully Implemented Facility Total 12.20 12.32 11.41 7.93 9.26 13.17 15.06 7.08 9.88 12.93 14.15 16.02 6.98 9.17 11.00 12.07 4.06 7.40 12.12 12.40 4.99 8.30 12.19 4.03 6.57 10.68 9.17 5.78 8.14 11.40 9.35 21.75 20.49 21.96 20.13 22.51 19.32 21.77 15.77 2.89 19.98 6.44 19.33 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 ZZZ 090 ZZZ 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69823 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00202 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A C A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Amputation of finger/thumb .................................. Amputation of finger/thumb .................................. Hand/finger surgery .............................................. Drainage of pelvis lesion ...................................... Drainage of pelvis bursa ...................................... Drainage of bone lesion ....................................... Incision of hip tendon ........................................... Incision of hip tendon ........................................... Incision of hip tendon ........................................... Incision of hip tendon ........................................... Incision of hip tendons ......................................... Incision of hip/thigh fascia .................................... Drainage of hip joint ............................................. Exploration of hip joint ......................................... Denervation of hip joint ........................................ Excision of hip joint/muscle .................................. Biopsy of soft tissues ........................................... Biopsy of soft tissues ........................................... Remove hip/pelvis lesion ..................................... Remove hip/pelvis lesion ..................................... Remove tumor, hip/pelvis .................................... Biopsy of sacroiliac joint ...................................... Biopsy of hip joint ................................................. Removal of hip joint lining .................................... Removal of ischial bursa ...................................... Remove femur lesion/bursa ................................. Removal of hip bone lesion ................................. Removal of hip bone lesion ................................. Remove/graft hip bone lesion .............................. Partial removal of hip bone .................................. Partial removal of hip bone .................................. Extensive hip surgery ........................................... Extensive hip surgery ........................................... Extensive hip surgery ........................................... Extensive hip surgery ........................................... Extensive hip surgery ........................................... Removal of tail bone ............................................ Remove hip foreign body ..................................... Remove hip foreign body ..................................... Removal of hip prosthesis ................................... Removal of hip prosthesis ................................... Injection for hip x-ray ........................................... Injection for hip x-ray ........................................... Description 5.85 6.37 0.00 7.84 6.97 13.37 5.66 7.05 7.70 9.96 9.99 12.66 13.54 13.99 17.23 14.18 2.89 10.07 7.51 6.44 15.20 4.65 7.27 9.09 5.78 5.66 6.44 11.06 14.57 11.44 12.25 36.77 24.25 42.54 14.54 14.91 6.80 1.89 8.72 11.57 24.15 1.30 1.50 Physician Work RVUs 3 NA NA 0.00 NA 8.55 NA NA NA NA NA NA NA NA NA NA NA 4.99 NA 7.07 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 3.75 NA NA NA 2.97 3.61 Fully Implemented NonFacility PE RVUs NA NA 0.00 NA 10.51 NA NA NA NA NA NA NA NA NA NA NA 5.17 NA 7.10 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 4.35 NA NA NA 4.09 5.19 Year 2007 Transitional Non-Facility PE RVUs 8.39 7.99 0.00 6.28 4.86 8.67 4.57 5.24 5.85 6.82 6.86 8.12 8.14 8.49 9.74 9.01 1.77 5.70 4.55 4.64 8.24 3.76 5.68 6.51 4.43 4.64 5.12 7.49 8.86 7.97 8.56 16.74 12.83 20.10 8.87 7.50 4.75 1.54 5.67 7.47 13.11 0.42 0.48 Fully Implemented Facility PE RVUs 9.71 10.74 0.00 6.98 5.29 9.95 5.10 5.88 6.32 7.57 7.70 8.44 9.27 9.56 10.86 9.75 1.95 6.41 4.72 4.76 8.36 4.26 5.83 7.13 4.39 5.05 5.36 8.20 10.21 8.84 9.73 18.59 14.09 22.02 9.67 9.03 4.81 1.75 6.41 8.45 13.77 0.47 0.51 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 26951 26952 26989 26990 26991 26992 27000 27001 27003 27005 27006 27025 27030 27033 27035 27036 27040 27041 27047 27048 27049 27050 27052 27054 27060 27062 27065 27066 27067 27070 27071 27075 27076 27077 27078 27079 27080 27086 27087 27090 27091 27093 27095 HCPCS 2 CPT 1/ 0.71 0.95 0.00 1.22 1.11 2.17 0.98 1.24 1.12 1.73 1.70 1.85 2.27 2.33 2.16 2.27 0.27 1.35 1.03 0.92 2.07 0.60 1.08 1.47 0.80 0.93 1.01 1.80 1.85 1.75 1.93 5.66 3.71 6.14 2.23 1.95 0.93 0.25 1.35 1.95 3.85 0.13 0.14 Mal-Practice RVUs NA NA 0.00 NA 16.63 NA NA NA NA NA NA NA NA NA NA NA 8.15 NA 15.61 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 5.89 NA NA NA 4.40 5.25 Fully Implemented NonFacility Total NA NA 0.00 NA 18.59 NA NA NA NA NA NA NA NA NA NA NA 8.33 NA 15.64 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 6.49 NA NA NA 5.52 6.83 Year 2007 Transitional Non-Facility Total 14.95 15.31 0.00 15.34 12.94 24.21 11.21 13.53 14.67 18.51 18.55 22.63 23.95 24.81 29.13 25.46 4.93 17.12 13.09 12.00 25.51 9.01 14.03 17.07 11.01 11.23 12.57 20.35 25.28 21.16 22.74 59.17 40.79 68.78 25.64 24.36 12.48 3.68 15.74 20.99 41.11 1.85 2.12 Fully Implemented Facility Total 16.27 18.06 0.00 16.04 13.37 25.49 11.74 14.17 15.14 19.26 19.39 22.95 25.08 25.88 30.25 26.20 5.11 17.83 13.26 12.12 25.63 9.51 14.18 17.69 10.97 11.64 12.81 21.06 26.63 22.03 23.91 61.02 42.05 70.70 26.44 25.89 12.54 3.89 16.48 21.97 41.77 1.90 2.15 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 YYY 090 090 090 090 090 090 090 090 090 090 090 090 090 010 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 010 090 090 090 000 000 Global 69824 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00203 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Inject sacroiliac joint ............................................. Revision of hip tendon ......................................... Transfer tendon to pelvis ..................................... Transfer of abdominal muscle ............................. Transfer of spinal muscle ..................................... Transfer of iliopsoas muscle ................................ Transfer of iliopsoas muscle ................................ Reconstruction of hip socket ................................ Reconstruction of hip socket ................................ Partial hip replacement ........................................ Total hip arthroplasty ........................................... Total hip arthroplasty ........................................... Revise hip joint replacement ................................ Revise hip joint replacement ................................ Revise hip joint replacement ................................ Transplant femur ridge ......................................... Incision of hip bone .............................................. Revision of hip bone ............................................ Incision of hip bones ............................................ Revision of hip bones .......................................... Revision of pelvis ................................................. Incision of neck of femur ...................................... Incision/fixation of femur ...................................... Repair/graft femur head/neck .............................. Treat slipped epiphysis ........................................ Treat slipped epiphysis ........................................ Treat slipped epiphysis ........................................ Treat slipped epiphysis ........................................ Revise head/neck of femur .................................. Treat slipped epiphysis ........................................ Revision of femur epiphysis ................................. Reinforce hip bones ............................................. Treat pelvic ring fracture ...................................... Treat pelvic ring fracture ...................................... Treat tail bone fracture ......................................... Treat tail bone fracture ......................................... Treat pelvic fracture(s) ......................................... Treat pelvic ring fracture ...................................... Treat pelvic ring fracture ...................................... Treat pelvic ring fracture ...................................... Treat hip socket fracture ...................................... Treat hip socket fracture ...................................... Treat hip wall fracture .......................................... Description 1.40 9.16 9.20 11.21 11.90 13.63 12.46 19.10 15.95 16.46 21.61 25.49 30.13 22.55 23.55 12.66 18.72 21.87 23.92 26.03 20.89 17.74 20.06 17.46 9.29 12.78 15.94 12.78 13.83 15.98 9.67 14.09 5.98 10.08 1.87 7.25 10.45 15.73 14.65 20.93 6.72 13.97 15.45 Physician Work RVUs 3 2.48 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 4.66 NA 2.08 NA NA NA NA NA 5.29 NA NA Fully Implemented NonFacility PE RVUs 3.88 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 4.98 NA 2.19 NA NA NA NA NA 5.61 NA NA Year 2007 Transitional Non-Facility PE RVUs 0.33 6.36 4.89 7.41 7.96 8.67 8.17 10.85 9.54 9.72 11.95 13.64 14.94 11.90 12.30 7.84 10.78 12.05 12.50 13.61 7.12 10.47 11.77 9.86 5.83 8.30 9.74 8.29 8.59 9.86 6.71 8.76 4.66 6.65 2.08 11.14 6.55 9.29 8.74 11.45 5.19 8.52 9.04 Fully Implemented Facility PE RVUs 0.33 6.40 6.49 8.35 8.86 9.00 8.89 11.59 10.67 10.40 12.96 15.13 17.08 13.42 13.87 9.02 11.79 12.95 9.09 15.45 10.01 11.69 12.63 10.94 6.46 8.83 10.60 8.39 9.64 10.12 7.32 9.93 4.98 7.40 2.13 15.43 6.95 9.52 9.79 11.41 5.52 9.61 8.12 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 27096 27097 27098 27100 27105 27110 27111 27120 27122 27125 27130 27132 27134 27137 27138 27140 27146 27147 27151 27156 27158 27161 27165 27170 27175 27176 27177 27178 27179 27181 27185 27187 27193 27194 27200 27202 27215 27216 27217 27218 27220 27222 27226 HCPCS 2 CPT 1/ 0.08 1.57 0.95 1.86 1.73 2.19 1.95 3.09 2.62 2.55 3.51 4.05 4.95 3.68 3.85 2.12 2.97 3.58 3.92 4.22 3.17 2.95 3.11 2.82 1.46 2.23 2.62 2.09 2.26 1.57 2.40 2.38 0.96 1.65 0.28 1.06 1.98 2.64 2.42 3.49 1.07 2.20 2.49 Mal-Practice RVUs 3.96 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 11.60 NA 4.23 NA NA NA NA NA 13.08 NA NA Fully Implemented NonFacility Total 5.36 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 11.92 NA 4.34 NA NA NA NA NA 13.40 NA NA Year 2007 Transitional Non-Facility Total 1.81 17.09 15.04 20.48 21.59 24.49 22.58 33.04 28.11 28.73 37.07 43.18 50.02 38.13 39.70 22.62 32.47 37.50 40.34 43.86 31.18 31.16 34.94 30.14 16.58 23.31 28.30 23.16 24.68 27.41 18.78 25.23 11.60 18.38 4.23 19.45 18.98 27.66 25.81 35.87 12.98 24.69 26.98 Fully Implemented Facility Total 1.81 17.13 16.64 21.42 22.49 24.82 23.30 33.78 29.24 29.41 38.08 44.67 52.16 39.65 41.27 23.80 33.48 38.40 36.93 45.70 34.07 32.38 35.80 31.22 17.21 23.84 29.16 23.26 25.73 27.67 19.39 26.40 11.92 19.13 4.28 23.74 19.38 27.89 26.86 35.83 13.31 25.78 26.06 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 000 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69825 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00204 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C A A A A A A A A A A A A A Status Treat hip fracture(s) ............................................. Treat hip fracture(s) ............................................. Treat thigh fracture ............................................... Treat thigh fracture ............................................... Treat thigh fracture ............................................... Treat thigh fracture ............................................... Treat thigh fracture ............................................... Treat thigh fracture ............................................... Treat thigh fracture ............................................... Treat thigh fracture ............................................... Treat thigh fracture ............................................... Treat thigh fracture ............................................... Treat hip dislocation ............................................. Treat hip dislocation ............................................. Treat hip dislocation ............................................. Treat hip dislocation ............................................. Treat hip dislocation ............................................. Treat hip dislocation ............................................. Treat hip dislocation ............................................. Treat hip dislocation ............................................. Treat hip dislocation ............................................. Treat hip dislocation ............................................. Manipulation of hip joint ....................................... Fusion of sacroiliac joint ...................................... Fusion of pubic bones .......................................... Fusion of hip joint ................................................. Fusion of hip joint ................................................. Amputation of leg at hip ....................................... Amputation of leg at hip ....................................... Pelvis/hip joint surgery ......................................... Drain thigh/knee lesion ........................................ Drainage of bone lesion ....................................... Incise thigh tendon & fascia ................................. Incision of thigh tendon ........................................ Incision of thigh tendons ...................................... Exploration of knee joint ...................................... Biopsy, thigh soft tissues ..................................... Biopsy, thigh soft tissues ..................................... Neurectomy, hamstring ........................................ Neurectomy, popliteal .......................................... Removal of thigh lesion ....................................... Removal of thigh lesion ....................................... Remove tumor, thigh/knee ................................... Description 25.21 29.13 5.69 11.66 12.88 17.43 5.64 13.66 17.08 21.09 4.75 10.80 7.21 10.92 13.46 18.80 4.25 5.35 16.04 23.03 5.12 7.67 2.29 14.49 11.71 24.91 24.97 24.38 19.54 0.00 6.67 8.52 6.09 4.66 5.97 9.88 2.30 4.95 7.09 6.36 4.52 5.62 15.68 Physician Work RVUs 3 NA NA 4.99 NA NA NA NA NA NA NA 3.94 NA NA NA NA NA 2.40 NA NA NA NA NA NA NA NA NA NA NA NA 0.00 8.18 NA NA NA NA NA 4.12 NA NA NA 6.04 NA NA Fully Implemented NonFacility PE RVUs NA NA 5.38 NA NA NA NA NA NA NA 4.33 NA NA NA NA NA 3.24 NA NA NA NA NA NA NA NA NA NA NA NA 0.00 9.60 NA NA NA NA NA 3.66 NA NA NA 6.00 NA NA Year 2007 Transitional Non-Facility PE RVUs 13.50 15.10 4.92 6.02 8.08 10.26 4.70 8.12 9.75 11.52 3.94 7.03 4.30 6.53 8.28 10.61 1.41 2.56 9.50 12.96 3.99 5.57 1.90 9.10 7.86 12.92 13.54 12.56 9.83 0.00 4.67 6.09 4.63 4.07 4.82 6.85 1.91 3.84 5.45 4.77 3.61 4.06 8.58 Fully Implemented Facility PE RVUs 14.93 16.99 5.06 6.88 9.11 10.85 5.03 9.13 10.91 13.19 4.30 7.92 4.54 7.21 9.41 11.67 1.91 2.75 10.53 13.83 4.59 6.15 2.05 9.97 7.97 14.30 15.23 13.69 10.94 0.00 5.02 6.76 5.04 4.56 5.24 7.40 1.89 4.10 5.08 5.12 3.69 4.29 8.91 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 27227 27228 27230 27232 27235 27236 27238 27240 27244 27245 27246 27248 27250 27252 27253 27254 27256 27257 27258 27259 27265 27266 27275 27280 27282 27284 27286 27290 27295 27299 27301 27303 27305 27306 27307 27310 27323 27324 27325 27326 27327 27328 27329 HCPCS 2 CPT 1/ 4.06 4.67 0.95 1.86 2.12 2.72 0.89 2.17 2.78 3.53 0.81 1.82 0.62 1.66 2.25 3.18 0.46 0.69 2.65 3.75 0.63 1.29 0.39 2.54 1.87 3.93 3.13 3.44 2.96 0.00 1.04 1.43 1.01 0.85 1.04 1.61 0.24 0.75 1.09 1.06 0.64 0.84 2.15 Mal-Practice RVUs NA NA 11.63 NA NA NA NA NA NA NA 9.50 NA NA NA NA NA 7.11 NA NA NA NA NA NA NA NA NA NA NA NA 0.00 15.89 NA NA NA NA NA 6.66 NA NA NA 11.20 NA NA Fully Implemented NonFacility Total NA NA 12.02 NA NA NA NA NA NA NA 9.89 NA NA NA NA NA 7.95 NA NA NA NA NA NA NA NA NA NA NA NA 0.00 17.31 NA NA NA NA NA 6.20 NA NA NA 11.16 NA NA Year 2007 Transitional Non-Facility Total 42.77 48.90 11.56 19.54 23.08 30.41 11.23 23.95 29.61 36.14 9.50 19.65 12.13 19.11 23.99 32.59 6.12 8.60 28.19 39.74 9.74 14.53 4.58 26.13 21.44 41.76 41.64 40.38 32.33 0.00 12.38 16.04 11.73 9.58 11.83 18.34 4.45 9.54 13.63 12.19 8.77 10.52 26.41 Fully Implemented Facility Total 44.20 50.79 11.70 20.40 24.11 31.00 11.56 24.96 30.77 37.81 9.86 20.54 12.37 19.79 25.12 33.65 6.62 8.79 29.22 40.61 10.34 15.11 4.73 27.00 21.55 43.14 43.33 41.51 33.44 0.00 12.73 16.71 12.14 10.07 12.25 18.89 4.43 9.80 13.26 12.54 8.85 10.75 26.74 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 010 010 090 090 090 090 010 090 090 090 090 090 090 YYY 090 090 090 090 090 090 010 090 090 090 090 090 090 Global 69826 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00205 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Biopsy, knee joint lining ....................................... Explore/treat knee joint ........................................ Removal of knee cartilage ................................... Removal of knee cartilage ................................... Remove knee joint lining ...................................... Remove knee joint lining ...................................... Removal of kneecap bursa .................................. Removal of knee cyst .......................................... Remove knee cyst ............................................... Removal of kneecap ............................................ Remove femur lesion ........................................... Remove femur lesion/graft ................................... Remove femur lesion/graft ................................... Remove femur lesion/fixation ............................... Partial removal, leg bone(s) ................................. Extensive leg surgery ........................................... Injection for knee x-ray ........................................ Removal of foreign body ...................................... Repair of kneecap tendon .................................... Repair/graft kneecap tendon ................................ Repair of thigh muscle ......................................... Repair/graft of thigh muscle ................................. Incision of thigh tendon ........................................ Incision of thigh tendons ...................................... Incision of thigh tendons ...................................... Lengthening of thigh tendon ................................ Lengthening of thigh tendons .............................. Lengthening of thigh tendons .............................. Transplant of thigh tendon ................................... Transplants of thigh tendons ............................... Revise thigh muscles/tendons ............................. Repair of knee cartilage ....................................... Repair of knee ligament ....................................... Repair of knee ligament ....................................... Repair of knee ligaments ..................................... Autochondrocyte implant knee ............................. Osteochondral knee allograft ............................... Repair degenerated kneecap ............................... Revision of unstable kneecap .............................. Revision of unstable kneecap .............................. Revision/removal of kneecap ............................... Lat retinacular release open ................................ Reconstruction, knee ........................................... Description 5.02 5.93 8.34 7.43 9.07 10.43 4.23 5.98 6.58 8.54 7.89 9.97 11.02 4.73 11.34 17.93 0.96 5.12 7.34 10.64 8.00 10.99 5.44 7.38 9.51 6.50 8.68 12.10 8.04 12.46 9.21 8.51 8.96 10.71 13.57 24.53 19.79 11.46 10.14 10.09 10.12 5.28 9.67 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 2.72 8.28 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 3.47 9.61 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 4.12 4.85 6.17 5.74 6.51 7.08 4.05 4.90 5.26 6.30 5.88 6.88 7.56 1.91 8.15 10.56 0.32 4.05 6.09 7.58 6.37 8.00 4.57 5.55 6.76 5.02 6.21 8.02 5.94 8.44 6.19 6.11 6.46 6.71 8.47 13.71 11.90 7.64 6.98 6.93 6.94 4.72 6.73 Fully Implemented Facility PE RVUs 4.46 5.35 6.88 6.44 7.19 7.94 4.43 5.44 5.38 7.01 6.55 7.61 8.42 2.37 9.20 11.40 0.32 4.53 6.98 8.71 7.32 9.13 4.98 6.31 7.38 5.63 6.97 9.00 6.74 8.89 6.99 6.91 7.23 7.92 9.58 14.53 12.39 8.59 7.83 7.82 7.80 5.32 7.53 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 27330 27331 27332 27333 27334 27335 27340 27345 27347 27350 27355 27356 27357 27358 27360 27365 27370 27372 27380 27381 27385 27386 27390 27391 27392 27393 27394 27395 27396 27397 27400 27403 27405 27407 27409 27412 27415 27418 27420 27422 27424 27425 27427 HCPCS 2 CPT 1/ 0.86 1.02 1.43 1.26 1.51 1.75 0.72 1.00 0.98 1.41 1.32 1.65 1.96 0.82 1.84 2.80 0.08 0.84 1.24 1.80 1.36 1.86 0.92 1.23 1.57 1.10 1.47 2.05 1.34 1.83 1.31 1.44 1.51 1.79 2.25 4.36 4.36 1.89 1.72 1.71 1.71 0.90 1.63 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 3.76 14.24 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 4.51 15.57 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 10.00 11.80 15.94 14.43 17.09 19.26 9.00 11.88 12.82 16.25 15.09 18.50 20.54 7.46 21.33 31.29 1.36 10.01 14.67 20.02 15.73 20.85 10.93 14.16 17.84 12.62 16.36 22.17 15.32 22.73 16.71 16.06 16.93 19.21 24.29 42.60 36.05 20.99 18.84 18.73 18.77 10.90 18.03 Fully Implemented Facility Total 10.34 12.30 16.65 15.13 17.77 20.12 9.38 12.42 12.94 16.96 15.76 19.23 21.40 7.92 22.38 32.13 1.36 10.49 15.56 21.15 16.68 21.98 11.34 14.92 18.46 13.23 17.12 23.15 16.12 23.18 17.51 16.86 17.70 20.42 25.40 43.42 36.54 21.94 19.69 19.62 19.63 11.50 18.83 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 ZZZ 090 090 000 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69827 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00206 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Reconstruction, knee ........................................... Reconstruction, knee ........................................... Revision of thigh muscles .................................... Incision of knee joint ............................................ Revise kneecap .................................................... Revise kneecap with implant ............................... Revision of knee joint ........................................... Revision of knee joint ........................................... Revision of knee joint ........................................... Revision of knee joint ........................................... Revision of knee joint ........................................... Revision of knee joint ........................................... Total knee arthroplasty ........................................ Incision of thigh .................................................... Incision of thigh .................................................... Realignment of thigh bone ................................... Realignment of knee ............................................ Realignment of knee ............................................ Shortening of thigh bone ...................................... Lengthening of thigh bone ................................... Shorten/lengthen thighs ....................................... Repair of thigh ...................................................... Repair/graft of thigh ............................................. Surgery to stop leg growth ................................... Surgery to stop leg growth ................................... Surgery to stop leg growth ................................... Surgery to stop leg growth ................................... Revise/replace knee joint ..................................... Revise/replace knee joint ..................................... Removal of knee prosthesis ................................ Reinforce thigh ..................................................... Decompression of thigh/knee .............................. Decompression of thigh/knee .............................. Decompression of thigh/knee .............................. Decompression of thigh/knee .............................. Treatment of thigh fracture .................................. Treatment of thigh fracture .................................. Treatment of thigh fracture .................................. Treatment of thigh fracture .................................. Treatment of thigh fracture .................................. Treatment of thigh fracture .................................. Treatment of thigh fracture .................................. Treatment of thigh fracture .................................. Description 15.33 17.24 10.04 10.68 8.82 11.77 10.97 11.42 12.25 11.29 18.52 16.26 23.04 11.48 14.47 18.97 13.24 13.92 18.44 17.13 19.82 16.97 18.57 8.82 10.03 13.04 9.02 20.92 26.91 17.40 16.40 6.66 7.70 8.54 9.31 6.21 6.34 11.24 11.13 19.42 14.39 6.08 8.02 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 5.44 5.05 NA NA NA NA 5.71 NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 5.95 5.61 NA NA NA NA 6.27 NA Year 2007 Transitional Non-Facility PE RVUs 10.16 11.37 6.91 7.71 6.25 7.60 7.19 7.54 7.81 7.43 10.58 9.41 12.75 7.46 8.85 10.79 8.43 8.29 10.40 10.20 11.33 10.26 10.77 6.88 6.67 5.06 6.26 11.79 14.21 10.38 9.74 5.02 4.67 5.37 5.84 4.66 4.96 6.95 7.29 11.26 8.23 5.08 6.57 Fully Implemented Facility PE RVUs 10.97 12.15 7.73 8.29 6.99 8.31 6.29 6.92 8.64 8.40 11.91 10.81 14.14 8.32 10.15 12.07 9.52 9.51 10.27 11.42 12.10 11.41 12.20 7.13 7.47 8.50 7.12 13.07 15.97 11.37 10.99 5.46 5.24 5.81 6.58 4.91 5.28 7.82 8.04 12.40 9.44 5.38 7.61 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 27428 27429 27430 27435 27437 27438 27440 27441 27442 27443 27445 27446 27447 27448 27450 27454 27455 27457 27465 27466 27468 27470 27472 27475 27477 27479 27485 27486 27487 27488 27495 27496 27497 27498 27499 27500 27501 27502 27503 27506 27507 27508 27509 HCPCS 2 CPT 1/ 2.43 2.71 1.70 1.70 1.49 1.96 1.82 1.89 2.10 1.91 3.09 2.81 3.80 1.95 2.43 3.13 2.25 2.35 2.48 2.78 3.31 2.80 3.08 1.36 1.74 2.79 1.53 3.37 4.40 2.75 2.72 0.99 1.15 1.24 1.47 1.02 1.03 1.79 1.85 3.04 2.43 0.97 1.34 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 12.67 12.42 NA NA NA NA 12.76 NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 13.18 12.98 NA NA NA NA 13.32 NA Year 2007 Transitional Non-Facility Total 27.92 31.32 18.65 20.09 16.56 21.33 19.98 20.85 22.16 20.63 32.19 28.48 39.59 20.89 25.75 32.89 23.92 24.56 31.32 30.11 34.46 30.03 32.42 17.06 18.44 20.89 16.81 36.08 45.52 30.53 28.86 12.67 13.52 15.15 16.62 11.89 12.33 19.98 20.27 33.72 25.05 12.13 15.93 Fully Implemented Facility Total 28.73 32.10 19.47 20.67 17.30 22.04 19.08 20.23 22.99 21.60 33.52 29.88 40.98 21.75 27.05 34.17 25.01 25.78 31.19 31.33 35.23 31.18 33.85 17.31 19.24 24.33 17.67 37.36 47.28 31.52 30.11 13.11 14.09 15.59 17.36 12.14 12.65 20.85 21.02 34.86 26.26 12.43 16.97 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 Global 69828 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00207 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C A A A A A A A A A A A Status Treatment of thigh fracture .................................. Treatment of thigh fracture .................................. Treatment of thigh fracture .................................. Treatment of thigh fracture .................................. Treat thigh fx growth plate ................................... Treat thigh fx growth plate ................................... Treat thigh fx growth plate ................................... Treat kneecap fracture ......................................... Treat kneecap fracture ......................................... Treat knee fracture ............................................... Treat knee fracture ............................................... Treat knee fracture ............................................... Treat knee fracture ............................................... Treat knee fracture(s) .......................................... Treat knee fracture ............................................... Treat knee dislocation .......................................... Treat knee dislocation .......................................... Treat knee dislocation .......................................... Treat knee dislocation .......................................... Treat knee dislocation .......................................... Treat kneecap dislocation .................................... Treat kneecap dislocation .................................... Treat kneecap dislocation .................................... Fixation of knee joint ............................................ Fusion of knee ..................................................... Amputate leg at thigh ........................................... Amputate leg at thigh ........................................... Amputate leg at thigh ........................................... Amputation follow-up surgery .............................. Amputation follow-up surgery .............................. Amputate lower leg at knee ................................. Leg surgery procedure ......................................... Decompression of lower leg ................................ Decompression of lower leg ................................ Decompression of lower leg ................................ Drain lower leg lesion .......................................... Drain lower leg bursa ........................................... Incision of achilles tendon .................................... Incision of achilles tendon .................................... Treat lower leg bone lesion ................................. Explore/treat ankle joint ....................................... Exploration of ankle joint ...................................... Biopsy lower leg soft tissue ................................. Description 9.68 13.94 19.45 19.09 5.45 8.98 15.80 2.93 10.25 3.97 7.43 11.80 17.19 4.95 13.45 5.84 8.04 14.95 17.31 18.01 3.88 5.86 12.59 1.76 20.90 13.35 13.82 10.86 7.17 11.15 11.08 0.00 5.94 5.94 7.71 5.12 4.51 2.89 4.15 8.51 9.01 8.01 2.19 Physician Work RVUs 3 NA NA NA NA 5.69 NA NA 4.10 NA 4.83 6.45 NA NA 5.54 NA 5.31 NA NA NA NA 3.93 NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA 7.01 6.46 5.27 NA NA NA NA 3.86 Fully Implemented NonFacility PE RVUs NA NA NA NA 6.19 NA NA 4.43 NA 5.19 7.13 NA NA 5.98 NA 5.84 NA NA NA NA 4.61 NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA 7.37 6.18 7.08 NA NA NA NA 3.39 Year 2007 Transitional Non-Facility PE RVUs 6.36 9.13 11.89 12.01 5.06 6.07 9.92 3.53 7.00 4.27 5.68 8.28 10.33 4.92 8.05 4.61 6.14 9.35 10.63 10.66 3.41 4.46 7.89 1.62 12.38 6.12 7.44 5.48 4.75 6.05 6.34 0.00 3.84 4.26 4.37 3.90 3.44 1.80 2.68 5.79 6.20 5.39 1.76 Fully Implemented Facility PE RVUs 7.09 10.68 13.38 13.02 5.40 7.11 11.17 3.46 7.92 4.38 6.26 9.65 11.29 5.12 9.15 4.85 6.75 11.08 12.50 12.45 3.24 4.69 8.96 1.73 14.20 6.53 8.34 6.00 5.07 6.62 6.85 0.00 4.36 4.70 4.94 4.10 3.83 2.19 3.19 6.08 6.80 5.92 1.79 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 27510 27511 27513 27514 27516 27517 27519 27520 27524 27530 27532 27535 27536 27538 27540 27550 27552 27556 27557 27558 27560 27562 27566 27570 27580 27590 27591 27592 27594 27596 27598 27599 27600 27601 27602 27603 27604 27605 27606 27607 27610 27612 27613 HCPCS 2 CPT 1/ 1.53 2.38 3.13 3.01 0.81 1.22 2.56 0.47 1.75 0.65 1.26 2.01 2.74 0.84 2.28 0.76 1.36 2.51 2.98 3.09 0.40 0.94 2.13 0.30 3.38 1.75 2.03 1.45 1.02 1.57 1.65 0.00 0.86 0.80 1.10 0.74 0.69 0.41 0.69 1.31 1.40 1.13 0.20 Mal-Practice RVUs NA NA NA NA 11.95 NA NA 7.50 NA 9.45 15.14 NA NA 11.33 NA 11.91 NA NA NA NA 8.21 NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA 12.87 11.66 8.57 NA NA NA NA 6.25 Fully Implemented NonFacility Total NA NA NA NA 12.45 NA NA 7.83 NA 9.81 15.82 NA NA 11.77 NA 12.44 NA NA NA NA 8.89 NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA 13.23 11.38 10.38 NA NA NA NA 5.78 Year 2007 Transitional Non-Facility Total 17.57 25.45 34.47 34.11 11.32 16.27 28.28 6.93 19.00 8.89 14.37 22.09 30.26 10.71 23.78 11.21 15.54 26.81 30.92 31.76 7.69 11.26 22.61 3.68 36.66 21.22 23.29 17.79 12.94 18.77 19.07 0.00 10.64 11.00 13.18 9.76 8.64 5.10 7.52 15.61 16.61 14.53 4.15 Fully Implemented Facility Total 18.30 27.00 35.96 35.12 11.66 17.31 29.53 6.86 19.92 9.00 14.95 23.46 31.22 10.91 24.88 11.45 16.15 28.54 32.79 33.55 7.52 11.49 23.68 3.79 38.48 21.63 24.19 18.31 13.26 19.34 19.58 0.00 11.16 11.44 13.75 9.96 9.03 5.49 8.03 15.90 17.21 15.06 4.18 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 010 090 090 090 090 090 090 090 YYY 090 090 090 090 090 010 010 090 090 090 010 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69829 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00208 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Biopsy lower leg soft tissue ................................. Remove tumor, lower leg ..................................... Remove lower leg lesion ...................................... Remove lower leg lesion ...................................... Explore/treat ankle joint ....................................... Remove ankle joint lining ..................................... Remove ankle joint lining ..................................... Removal of tendon lesion .................................... Remove lower leg bone lesion ............................ Remove/graft leg bone lesion .............................. Remove/graft leg bone lesion .............................. Partial removal of tibia ......................................... Partial removal of fibula ....................................... Extensive lower leg surgery ................................. Extensive lower leg surgery ................................. Extensive ankle/heel surgery ............................... Injection for ankle x-ray ........................................ Repair achilles tendon ......................................... Repair/graft achilles tendon ................................. Repair of achilles tendon ..................................... Repair leg fascia defect ....................................... Repair of leg tendon, each .................................. Repair of leg tendon, each .................................. Repair of leg tendon, each .................................. Repair of leg tendon, each .................................. Repair lower leg tendons ..................................... Repair lower leg tendons ..................................... Release of lower leg tendon ................................ Release of lower leg tendons .............................. Revision of lower leg tendon ............................... Revise lower leg tendons ..................................... Revision of calf tendon ........................................ Revise lower leg tendon ...................................... Revise lower leg tendon ...................................... Revise additional leg tendon ................................ Repair of ankle ligament ...................................... Repair of ankle ligaments .................................... Repair of ankle ligament ...................................... Revision of ankle joint .......................................... Reconstruct ankle joint ......................................... Reconstruction, ankle joint ................................... Removal of ankle implant .................................... Incision of tibia ..................................................... Description 5.71 12.93 5.14 8.47 6.04 8.37 8.98 4.85 7.91 10.17 10.87 12.10 9.73 14.78 13.21 12.85 0.96 9.94 10.64 10.32 4.62 5.03 6.99 4.64 5.46 7.24 8.61 5.79 6.94 6.57 7.64 6.30 8.96 10.28 1.87 6.58 8.46 9.49 9.54 14.28 16.79 7.69 10.74 Physician Work RVUs 3 7.87 NA 6.38 10.05 NA NA NA 7.94 NA NA NA NA NA NA NA NA 2.62 NA NA NA 8.06 NA NA NA NA NA NA NA NA 8.84 NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs 7.32 NA 6.10 9.65 NA NA NA 7.66 NA NA NA NA NA NA NA NA 3.30 NA NA NA 8.41 NA NA NA NA NA NA NA NA 7.68 NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 4.03 8.12 3.79 5.32 4.62 5.63 5.99 3.81 5.70 7.19 7.01 8.24 6.82 9.54 8.45 6.70 0.30 6.34 6.51 6.03 3.69 3.92 4.91 3.95 4.50 4.78 5.80 4.40 4.79 4.65 5.41 4.56 5.53 6.76 0.73 5.03 5.47 5.97 5.21 8.77 9.95 5.72 6.95 Fully Implemented Facility PE RVUs 4.34 9.07 3.94 5.79 5.25 6.25 6.69 4.24 6.48 8.02 7.97 9.79 7.96 11.42 10.39 7.38 0.32 7.22 7.65 6.86 3.75 4.40 5.46 4.40 4.85 5.49 6.51 4.93 5.63 5.26 6.22 5.12 6.15 7.51 0.88 5.66 6.19 6.70 5.56 10.04 10.91 5.62 7.87 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 27614 27615 27618 27619 27620 27625 27626 27630 27635 27637 27638 27640 27641 27645 27646 27647 27648 27650 27652 27654 27656 27658 27659 27664 27665 27675 27676 27680 27681 27685 27686 27687 27690 27691 27692 27695 27696 27698 27700 27702 27703 27704 27705 HCPCS 2 CPT 1/ 0.78 1.84 0.72 1.25 0.97 1.28 1.48 0.74 1.31 1.66 1.85 1.89 1.46 2.42 2.06 1.76 0.08 1.59 1.72 1.58 0.69 0.79 1.09 0.76 0.89 1.11 1.37 0.93 1.15 0.97 1.24 1.00 1.33 1.64 0.32 1.05 1.28 1.47 1.30 2.38 2.77 1.27 1.81 Mal-Practice RVUs 14.36 NA 12.24 19.77 NA NA NA 13.53 NA NA NA NA NA NA NA NA 3.66 NA NA NA 13.37 NA NA NA NA NA NA NA NA 16.38 NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total 13.81 NA 11.96 19.37 NA NA NA 13.25 NA NA NA NA NA NA NA NA 4.34 NA NA NA 13.72 NA NA NA NA NA NA NA NA 15.22 NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 10.52 22.89 9.65 15.04 11.63 15.28 16.45 9.40 14.92 19.02 19.73 22.23 18.01 26.74 23.72 21.31 1.34 17.87 18.87 17.93 9.00 9.74 12.99 9.35 10.85 13.13 15.78 11.12 12.88 12.19 14.29 11.86 15.82 18.68 2.92 12.66 15.21 16.93 16.05 25.43 29.51 14.68 19.50 Fully Implemented Facility Total 10.83 23.84 9.80 15.51 12.26 15.90 17.15 9.83 15.70 19.85 20.69 23.78 19.15 28.62 25.66 21.99 1.36 18.75 20.01 18.76 9.06 10.22 13.54 9.80 11.20 13.84 16.49 11.65 13.72 12.80 15.10 12.42 16.44 19.43 3.07 13.29 15.93 17.66 16.40 26.70 30.47 14.58 20.42 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 000 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 ZZZ 090 090 090 090 090 090 090 090 Global 69830 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00209 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Incision of fibula ................................................... Incision of tibia & fibula ........................................ Realignment of lower leg ..................................... Revision of lower leg ............................................ Repair of tibia ....................................................... Repair/graft of tibia ............................................... Repair/graft of tibia ............................................... Repair of lower leg ............................................... Repair of lower leg ............................................... Repair of tibia epiphysis ....................................... Repair of fibula epiphysis ..................................... Repair lower leg epiphyses .................................. Repair of leg epiphyses ....................................... Repair of leg epiphyses ....................................... Reinforce tibia ...................................................... Treatment of tibia fracture .................................... Treatment of tibia fracture .................................... Treatment of tibia fracture .................................... Treatment of tibia fracture .................................... Treatment of tibia fracture .................................... Treatment of ankle fracture .................................. Treatment of ankle fracture .................................. Treatment of ankle fracture .................................. Treatment of fibula fracture .................................. Treatment of fibula fracture .................................. Treatment of fibula fracture .................................. Treatment of ankle fracture .................................. Treatment of ankle fracture .................................. Treatment of ankle fracture .................................. Treatment of ankle fracture .................................. Treatment of ankle fracture .................................. Treatment of ankle fracture .................................. Treatment of ankle fracture .................................. Treatment of ankle fracture .................................. Treatment of ankle fracture .................................. Treatment of ankle fracture .................................. Treat lower leg fracture ........................................ Treat lower leg fracture ........................................ Treat lower leg fracture ........................................ Treat lower leg fracture ........................................ Treat lower leg fracture ........................................ Treat lower leg joint ............................................. Treat lower leg dislocation ................................... Description 4.67 17.32 15.67 15.36 12.22 12.31 19.18 17.15 14.69 7.59 5.37 8.72 9.49 10.49 10.37 3.26 6.15 7.33 12.40 14.31 3.09 5.33 8.73 2.72 4.47 7.41 2.91 4.52 7.91 2.91 5.20 11.10 2.96 5.57 12.12 14.26 3.20 6.60 8.97 15.75 18.19 5.68 3.85 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 4.32 5.98 NA NA NA 4.29 5.58 NA 3.89 4.97 NA 4.06 5.00 NA 4.39 5.46 NA 4.02 5.44 NA NA 3.74 5.88 NA NA NA NA 4.31 Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 4.65 6.48 NA NA NA 4.58 6.14 NA 4.11 5.36 NA 4.36 5.48 NA 4.70 6.05 NA 4.29 6.14 NA NA 3.98 6.42 NA NA NA NA 4.37 Year 2007 Transitional Non-Facility PE RVUs 4.51 9.99 9.23 9.06 8.00 8.10 10.38 10.63 8.65 5.32 4.69 6.22 6.67 5.93 7.04 3.74 5.15 5.78 8.09 8.76 3.69 4.76 6.31 3.33 4.35 5.63 3.44 4.28 5.97 3.71 4.61 7.31 3.36 4.48 8.89 9.54 3.55 4.86 7.03 10.85 12.39 5.53 3.76 Fully Implemented Facility PE RVUs 4.83 8.60 10.36 10.34 9.05 8.87 11.87 11.59 9.92 6.15 4.87 6.27 7.66 5.65 7.89 3.82 5.54 6.29 8.91 9.92 3.62 5.14 6.99 3.24 4.57 6.26 3.36 4.56 6.71 3.70 5.02 8.25 3.40 5.00 10.21 10.99 3.56 5.25 8.37 12.28 13.55 6.47 3.83 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 27707 27709 27712 27715 27720 27722 27724 27725 27727 27730 27732 27734 27740 27742 27745 27750 27752 27756 27758 27759 27760 27762 27766 27780 27781 27784 27786 27788 27792 27808 27810 27814 27816 27818 27822 27823 27824 27825 27826 27827 27828 27829 27830 HCPCS 2 CPT 1/ 0.76 1.74 2.48 2.50 2.05 2.06 3.17 2.72 2.44 1.73 0.77 1.35 1.62 1.80 1.76 0.55 1.01 1.17 2.04 2.39 0.48 0.85 1.44 0.41 0.73 1.23 0.46 0.74 1.32 0.46 0.82 1.86 0.43 0.82 1.92 2.26 0.45 1.02 1.47 2.44 2.82 0.95 0.54 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 8.13 13.14 NA NA NA 7.86 11.76 NA 7.02 10.17 NA 7.43 10.26 NA 7.76 11.48 NA 7.41 11.83 NA NA 7.39 13.50 NA NA NA NA 8.70 Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 8.46 13.64 NA NA NA 8.15 12.32 NA 7.24 10.56 NA 7.73 10.74 NA 8.07 12.07 NA 7.68 12.53 NA NA 7.63 14.04 NA NA NA NA 8.76 Year 2007 Transitional Non-Facility Total 9.94 29.05 27.38 26.92 22.27 22.47 32.73 30.50 25.78 14.64 10.83 16.29 17.78 18.22 19.17 7.55 12.31 14.28 22.53 25.46 7.26 10.94 16.48 6.46 9.55 14.27 6.81 9.54 15.20 7.08 10.63 20.27 6.75 10.87 22.93 26.06 7.20 12.48 17.47 29.04 33.40 12.16 8.15 Fully Implemented Facility Total 10.26 27.66 28.51 28.20 23.32 23.24 34.22 31.46 27.05 15.47 11.01 16.34 18.77 17.94 20.02 7.63 12.70 14.79 23.35 26.62 7.19 11.32 17.16 6.37 9.77 14.90 6.73 9.82 15.94 7.07 11.04 21.21 6.79 11.39 24.25 27.51 7.21 12.87 18.81 30.47 34.56 13.10 8.22 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69831 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00210 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A C A A A A A A A A A A A A A A A A A A A A A A A Status Treat lower leg dislocation ................................... Treat lower leg dislocation ................................... Treat ankle dislocation ......................................... Treat ankle dislocation ......................................... Treat ankle dislocation ......................................... Treat ankle dislocation ......................................... Fixation of ankle joint ........................................... Fusion of ankle joint, open ................................... Fusion of tibiofibular joint ..................................... Amputation of lower leg ....................................... Amputation of lower leg ....................................... Amputation of lower leg ....................................... Amputation follow-up surgery .............................. Amputation follow-up surgery .............................. Amputation of foot at ankle .................................. Amputation of foot at ankle .................................. Decompression of leg .......................................... Decompression of leg .......................................... Decompression of leg .......................................... Leg/ankle surgery procedure ............................... Drainage of bursa of foot ..................................... Treatment of foot infection ................................... Treatment of foot infection ................................... Treat foot bone lesion .......................................... Incision of foot fascia ........................................... Incision of toe tendon ........................................... Incision of toe tendons ......................................... Exploration of foot joint ........................................ Exploration of foot joint ........................................ Exploration of toe joint ......................................... Decompression of tibia nerve .............................. Excision of foot lesion .......................................... Excision of foot lesion .......................................... Resection of tumor, foot ....................................... Biopsy of foot joint lining ...................................... Biopsy of foot joint lining ...................................... Biopsy of toe joint lining ....................................... Neurectomy, foot .................................................. Partial removal, foot fascia .................................. Removal of foot fascia ......................................... Removal of foot joint lining .................................. Removal of foot joint lining .................................. Removal of foot lesion ......................................... Description 4.62 6.67 4.65 6.34 10.16 11.56 2.36 15.21 9.42 15.24 13.32 9.67 8.64 9.88 10.23 10.72 7.82 7.78 12.42 0.00 2.75 5.78 8.95 9.30 4.50 2.89 4.19 5.06 4.72 4.43 5.14 3.58 4.77 10.55 4.30 3.98 3.49 6.20 5.29 6.58 5.15 4.63 4.65 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 4.05 6.78 7.88 NA 6.24 2.90 3.86 7.57 6.95 6.71 7.51 4.85 7.13 10.52 6.92 6.47 6.25 NA 7.20 7.94 7.28 7.64 7.74 Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 3.25 5.44 6.64 NA 4.97 2.50 3.44 6.40 5.63 5.59 6.27 4.07 5.81 9.20 5.40 5.30 5.10 NA 5.90 6.87 5.73 6.05 5.77 Year 2007 Transitional Non-Facility PE RVUs 4.01 4.77 3.64 4.92 6.90 7.75 1.70 9.24 6.55 6.77 7.47 5.52 5.10 5.75 6.27 5.33 4.87 5.14 7.38 0.00 1.65 3.66 4.67 5.55 3.06 2.38 3.09 3.71 3.37 3.22 3.71 2.79 3.33 5.91 3.30 2.98 2.81 3.53 3.64 3.92 3.52 3.67 4.26 Fully Implemented Facility PE RVUs 4.35 5.82 3.73 5.07 7.67 9.22 1.91 10.20 7.32 7.04 8.50 6.24 5.59 6.32 7.19 6.19 5.41 5.38 7.67 0.00 1.88 3.74 5.08 5.92 3.17 2.37 3.25 4.03 3.73 3.75 4.00 3.08 3.53 6.33 3.52 3.32 3.13 3.62 3.81 3.99 3.74 4.14 3.83 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 27831 27832 27840 27842 27846 27848 27860 27870 27871 27880 27881 27882 27884 27886 27888 27889 27892 27893 27894 27899 28001 28002 28003 28005 28008 28010 28011 28020 28022 28024 28035 28043 28045 28046 28050 28052 28054 28055 28060 28062 28070 28072 28080 HCPCS 2 CPT 1/ 0.73 1.03 0.46 1.00 1.71 1.95 0.39 2.37 1.59 1.76 1.99 1.29 1.22 1.40 1.51 1.46 1.10 1.10 1.65 0.00 0.33 0.61 1.12 1.16 0.57 0.36 0.59 0.72 0.62 0.58 0.70 0.46 0.63 1.36 0.60 0.53 0.46 0.74 0.70 0.83 0.73 0.68 0.47 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 7.13 13.17 17.95 NA 11.31 6.15 8.64 13.35 12.29 11.72 13.35 8.89 12.53 22.43 11.82 10.98 10.20 NA 13.19 15.35 13.16 12.95 12.86 Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 6.33 11.83 16.71 NA 10.04 5.75 8.22 12.18 10.97 10.60 12.11 8.11 11.21 21.11 10.30 9.81 9.05 NA 11.89 14.28 11.61 11.36 10.89 Year 2007 Transitional Non-Facility Total 9.36 12.47 8.75 12.26 18.77 21.26 4.45 26.82 17.56 23.77 22.78 16.48 14.96 17.03 18.01 17.51 13.79 14.02 21.45 0.00 4.73 10.05 14.74 16.01 8.13 5.63 7.87 9.49 8.71 8.23 9.55 6.83 8.73 17.82 8.20 7.49 6.76 10.47 9.63 11.33 9.40 8.98 9.38 Fully Implemented Facility Total 9.70 13.52 8.84 12.41 19.54 22.73 4.66 27.78 18.33 24.04 23.81 17.20 15.45 17.60 18.93 18.37 14.33 14.26 21.74 0.00 4.96 10.13 15.15 16.38 8.24 5.62 8.03 9.81 9.07 8.76 9.84 7.12 8.93 18.24 8.42 7.83 7.08 10.56 9.80 11.40 9.62 9.45 8.95 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 010 090 090 090 090 090 090 090 090 090 090 090 090 YYY 010 010 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 Global 69832 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00211 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Excise foot tendon sheath ................................... Excise foot tendon sheath ................................... Removal of foot lesion ......................................... Removal of toe lesions ........................................ Removal of ankle/heel lesion ............................... Remove/graft foot lesion ...................................... Remove/graft foot lesion ...................................... Removal of foot lesion ......................................... Remove/graft foot lesion ...................................... Remove/graft foot lesion ...................................... Removal of toe lesions ........................................ Part removal of metatarsal ................................... Part removal of metatarsal ................................... Part removal of metatarsal ................................... Part removal of metatarsal ................................... Removal of metatarsal heads .............................. Revision of foot .................................................... Removal of heel bone .......................................... Removal of heel spur ........................................... Part removal of ankle/heel ................................... Partial removal of foot bone ................................. Partial removal of toe ........................................... Partial removal of toe ........................................... Removal of ankle bone ........................................ Removal of metatarsal ......................................... Removal of toe ..................................................... Partial removal of toe ........................................... Partial removal of toe ........................................... Extensive foot surgery ......................................... Extensive foot surgery ......................................... Extensive foot surgery ......................................... Removal of foot foreign body ............................... Removal of foot foreign body ............................... Removal of foot foreign body ............................... Repair of foot tendon ........................................... Repair/graft of foot tendon ................................... Repair of foot tendon ........................................... Repair/graft of foot tendon ................................... Release of foot tendon ......................................... Release of foot tendons ....................................... Release of foot tendon ......................................... Release of foot tendons ....................................... Incision of foot tendon(s) ..................................... Description 4.83 3.90 4.46 3.69 5.72 7.80 6.56 5.17 7.23 5.62 4.21 4.13 5.06 4.54 5.88 11.61 8.94 6.02 5.45 5.64 7.56 4.88 3.56 9.30 7.03 4.14 3.71 3.79 9.85 9.05 6.17 1.98 4.69 5.79 4.65 6.96 4.42 6.41 4.58 5.67 3.70 4.58 4.28 Physician Work RVUs 3 7.83 7.00 6.84 6.55 8.25 NA NA 7.30 NA 7.90 6.43 7.02 7.37 7.30 8.50 13.43 9.60 8.00 7.30 8.14 8.60 6.85 6.01 NA 7.91 6.47 6.24 6.42 NA 8.89 7.22 4.03 6.80 7.40 6.95 8.05 6.73 7.61 6.47 6.97 6.09 7.03 6.35 Fully Implemented NonFacility PE RVUs 7.94 6.06 5.57 5.55 8.03 NA NA 5.94 NA 6.87 5.05 5.66 6.55 6.18 6.66 12.07 7.49 6.68 5.89 7.50 7.27 5.46 4.66 NA 7.39 5.24 4.79 5.03 NA 7.92 6.08 3.55 5.80 6.05 5.56 7.42 5.29 6.56 5.12 5.67 4.73 5.35 5.09 Year 2007 Transitional Non-Facility PE RVUs 3.82 3.21 3.24 3.05 4.12 5.01 4.22 3.53 4.52 3.80 3.05 3.13 3.36 3.33 4.72 8.37 5.47 4.09 3.65 4.02 4.89 3.52 2.70 5.96 4.20 3.06 2.93 3.00 5.43 4.75 3.70 1.36 3.26 3.69 3.29 4.14 3.23 3.96 3.13 3.39 2.78 3.36 2.94 Fully Implemented Facility PE RVUs 4.47 3.72 3.40 3.40 4.55 5.71 4.51 3.82 4.45 4.10 3.20 3.20 3.58 3.51 4.41 8.37 5.25 4.28 3.70 4.31 5.17 3.62 2.92 6.52 4.62 3.23 2.74 3.25 5.42 5.08 3.70 1.45 3.55 3.86 3.49 4.40 3.28 4.01 3.35 3.94 2.87 3.65 3.49 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 28086 28088 28090 28092 28100 28102 28103 28104 28106 28107 28108 28110 28111 28112 28113 28114 28116 28118 28119 28120 28122 28124 28126 28130 28140 28150 28153 28160 28171 28173 28175 28190 28192 28193 28200 28202 28208 28210 28220 28222 28225 28226 28230 HCPCS 2 CPT 1/ 0.76 0.61 0.59 0.49 0.82 1.14 0.91 0.70 0.97 0.74 0.53 0.54 0.67 0.61 0.63 1.42 1.03 0.84 0.70 0.77 0.98 0.60 0.45 1.26 0.92 0.53 0.47 0.49 1.33 1.12 0.73 0.22 0.61 0.73 0.61 0.91 0.58 0.81 0.57 0.69 0.46 0.58 0.55 Mal-Practice RVUs 13.42 11.51 11.89 10.73 14.79 NA NA 13.17 NA 14.26 11.17 11.69 13.10 12.45 15.01 26.46 19.57 14.86 13.45 14.55 17.14 12.33 10.02 NA 15.86 11.14 10.42 10.70 NA 19.06 14.12 6.23 12.10 13.92 12.21 15.92 11.73 14.83 11.62 13.33 10.25 12.19 11.18 Fully Implemented NonFacility Total 13.53 10.57 10.62 9.73 14.57 NA NA 11.81 NA 13.23 9.79 10.33 12.28 11.33 13.17 25.10 17.46 13.54 12.04 13.91 15.81 10.94 8.67 NA 15.34 9.91 8.97 9.31 NA 18.09 12.98 5.75 11.10 12.57 10.82 15.29 10.29 13.78 10.27 12.03 8.89 10.51 9.92 Year 2007 Transitional Non-Facility Total 9.41 7.72 8.29 7.23 10.66 13.95 11.69 9.40 12.72 10.16 7.79 7.80 9.09 8.48 11.23 21.40 15.44 10.95 9.80 10.43 13.43 9.00 6.71 16.52 12.15 7.73 7.11 7.28 16.61 14.92 10.60 3.56 8.56 10.21 8.55 12.01 8.23 11.18 8.28 9.75 6.94 8.52 7.77 Fully Implemented Facility Total 10.06 8.23 8.45 7.58 11.09 14.65 11.98 9.69 12.65 10.46 7.94 7.87 9.31 8.66 10.92 21.40 15.22 11.14 9.85 10.72 13.71 9.10 6.93 17.08 12.57 7.90 6.92 7.53 16.60 15.25 10.60 3.65 8.85 10.38 8.75 12.27 8.28 11.23 8.50 10.30 7.03 8.81 8.32 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 010 090 090 090 090 090 090 090 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69833 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00212 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Incision of toe tendon ........................................... Incision of foot tendon .......................................... Revision of foot tendon ........................................ Release of big toe ................................................ Revision of foot fascia .......................................... Release of midfoot joint ....................................... Revision of foot tendon ........................................ Revision of foot and ankle ................................... Release of midfoot joint ....................................... Release of foot contracture .................................. Release of toe joint, each .................................... Fusion of toes ...................................................... Repair of hammertoe ........................................... Repair of hammertoe ........................................... Partial removal of foot bone ................................. Repair hallux rigidus ............................................ Correction of bunion ............................................. Correction of bunion ............................................. Correction of bunion ............................................. Correction of bunion ............................................. Correction of bunion ............................................. Correction of bunion ............................................. Correction of bunion ............................................. Correction of bunion ............................................. Incision of heel bone ............................................ Incision of ankle bone .......................................... Incision of midfoot bones ..................................... Incise/graft midfoot bones .................................... Incision of metatarsal ........................................... Incision of metatarsal ........................................... Incision of metatarsal ........................................... Incision of metatarsals ......................................... Revision of big toe ............................................... Revision of toe ..................................................... Repair deformity of toe ........................................ Removal of sesamoid bone ................................. Repair of foot bones ............................................ Repair of metatarsals ........................................... Resect enlarged toe tissue .................................. Resect enlarged toe ............................................. Repair extra toe(s) ............................................... Repair webbed toe(s) ........................................... Reconstruct cleft foot ........................................... Description 3.43 3.43 7.85 4.40 5.97 8.08 12.91 17.01 10.53 4.82 3.84 5.24 4.65 4.61 5.81 8.11 5.72 8.72 11.10 8.63 9.31 9.31 8.01 11.39 9.61 9.62 9.29 10.63 5.91 6.39 5.36 13.96 5.48 4.60 5.06 4.91 9.25 8.41 7.04 8.60 4.31 5.98 14.67 Physician Work RVUs 3 5.99 6.33 8.43 6.48 7.50 8.68 10.85 15.61 10.49 6.99 5.89 7.41 6.78 6.56 8.70 9.53 8.24 10.46 14.65 9.22 9.71 10.52 9.32 10.68 NA NA 9.61 NA 8.39 9.55 7.96 NA 7.57 7.42 7.39 6.76 NA 10.03 8.13 8.75 6.80 7.83 NA Fully Implemented NonFacility PE RVUs 4.89 5.09 7.54 5.09 6.09 6.91 9.17 14.07 8.42 5.42 4.61 6.53 5.34 5.23 6.62 8.37 6.75 8.21 11.72 7.88 8.54 9.34 7.74 9.24 NA NA 8.36 NA 7.22 10.65 6.30 NA 6.20 5.93 5.80 5.36 NA 9.39 6.86 7.39 6.01 6.60 NA Year 2007 Transitional Non-Facility PE RVUs 2.72 3.09 4.43 3.04 3.82 4.79 6.50 9.85 6.11 3.51 2.70 3.63 3.41 3.10 4.78 5.44 4.02 6.27 7.07 4.68 4.91 5.41 4.65 5.86 6.15 5.81 5.16 5.70 3.91 4.51 3.88 7.85 3.46 3.28 3.70 3.30 5.83 5.53 4.14 4.55 3.20 3.94 6.32 Fully Implemented Facility PE RVUs 3.16 3.29 4.81 3.37 4.05 4.94 7.10 10.65 6.99 3.68 2.81 4.27 3.42 3.21 4.86 5.68 4.55 5.72 6.34 4.70 5.29 6.04 4.91 6.01 6.81 6.61 5.59 6.47 4.11 5.09 3.73 7.93 3.53 3.54 4.55 3.32 6.49 6.13 4.22 4.75 3.52 4.50 9.45 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 28232 28234 28238 28240 28250 28260 28261 28262 28264 28270 28272 28280 28285 28286 28288 28289 28290 28292 28293 28294 28296 28297 28298 28299 28300 28302 28304 28305 28306 28307 28308 28309 28310 28312 28313 28315 28320 28322 28340 28341 28344 28345 28360 HCPCS 2 CPT 1/ 0.44 0.44 1.06 0.58 0.82 1.14 1.57 2.60 1.54 0.62 0.46 0.73 0.59 0.57 0.65 1.02 0.82 0.91 1.13 1.09 1.19 1.32 1.05 1.37 1.54 1.42 1.27 1.27 0.84 0.90 0.70 2.05 0.70 0.63 0.73 0.63 1.43 1.27 0.84 1.01 0.51 0.80 2.29 Mal-Practice RVUs 9.86 10.20 17.34 11.46 14.29 17.90 25.33 35.22 22.56 12.43 10.19 13.38 12.02 11.74 15.16 18.66 14.78 20.09 26.88 18.94 20.21 21.15 18.38 23.44 NA NA 20.17 NA 15.14 16.84 14.02 NA 13.75 12.65 13.18 12.30 NA 19.71 16.01 18.36 11.62 14.61 NA Fully Implemented NonFacility Total 8.76 8.96 16.45 10.07 12.88 16.13 23.65 33.68 20.49 10.86 8.91 12.50 10.58 10.41 13.08 17.50 13.29 17.84 23.95 17.60 19.04 19.97 16.80 22.00 NA NA 18.92 NA 13.97 17.94 12.36 NA 12.38 11.16 11.59 10.90 NA 19.07 14.74 17.00 10.83 13.38 NA Year 2007 Transitional Non-Facility Total 6.59 6.96 13.34 8.02 10.61 14.01 20.98 29.46 18.18 8.95 7.00 9.60 8.65 8.28 11.24 14.57 10.56 15.90 19.30 14.40 15.41 16.04 13.71 18.62 17.30 16.85 15.72 17.60 10.66 11.80 9.94 23.86 9.64 8.51 9.49 8.84 16.51 15.21 12.02 14.16 8.02 10.72 23.28 Fully Implemented Facility Total 7.03 7.16 13.72 8.35 10.84 14.16 21.58 30.26 19.06 9.12 7.11 10.24 8.66 8.39 11.32 14.81 11.09 15.35 18.57 14.42 15.79 16.67 13.97 18.77 17.96 17.65 16.15 18.37 10.86 12.38 9.79 23.94 9.71 8.77 10.34 8.86 17.17 15.81 12.10 14.36 8.34 11.28 26.41 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 Global 69834 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00213 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Treatment of heel fracture ................................... Treatment of heel fracture ................................... Treatment of heel fracture ................................... Treat heel fracture ................................................ Treat/graft heel fracture ....................................... Treatment of ankle fracture .................................. Treatment of ankle fracture .................................. Treatment of ankle fracture .................................. Treat ankle fracture .............................................. Treat midfoot fracture, each ................................. Treat midfoot fracture, each ................................. Treat midfoot fracture ........................................... Treat midfoot fracture, each ................................. Treat metatarsal fracture ...................................... Treat metatarsal fracture ...................................... Treat metatarsal fracture ...................................... Treat metatarsal fracture ...................................... Treat big toe fracture ........................................... Treat big toe fracture ........................................... Treat big toe fracture ........................................... Treat big toe fracture ........................................... Treatment of toe fracture ..................................... Treatment of toe fracture ..................................... Treat toe fracture ................................................. Treat sesamoid bone fracture .............................. Treat sesamoid bone fracture .............................. Treat foot dislocation ............................................ Treat foot dislocation ............................................ Treat foot dislocation ............................................ Repair foot dislocation ......................................... Treat foot dislocation ............................................ Treat foot dislocation ............................................ Treat foot dislocation ............................................ Repair foot dislocation ......................................... Treat foot dislocation ............................................ Treat foot dislocation ............................................ Treat foot dislocation ............................................ Repair foot dislocation ......................................... Treat toe dislocation ............................................. Treat toe dislocation ............................................. Treat toe dislocation ............................................. Repair toe dislocation .......................................... Treat toe dislocation ............................................. Description 2.22 4.63 6.44 17.54 17.07 2.14 3.45 4.78 17.07 1.95 3.15 2.75 7.13 1.99 2.97 3.46 5.77 1.12 1.62 2.39 3.86 1.12 1.50 3.37 1.08 2.51 2.10 2.51 3.28 6.42 1.70 3.38 4.48 8.17 1.94 2.78 4.97 8.96 1.72 1.93 2.77 4.27 1.25 Physician Work RVUs 3 3.39 4.55 NA NA NA 3.14 3.78 NA NA 2.94 3.70 NA NA 2.82 3.18 NA NA 2.11 2.49 7.19 7.51 1.69 2.26 6.89 1.65 5.84 2.80 3.33 7.67 9.82 2.60 4.38 NA 9.96 3.06 3.77 NA NA 1.96 2.28 4.35 6.89 1.31 Fully Implemented NonFacility PE RVUs 3.57 4.76 NA NA NA 3.33 3.86 NA NA 3.07 3.49 NA NA 3.05 3.29 NA NA 2.04 2.25 7.99 7.95 1.57 1.98 7.36 1.49 6.91 2.50 2.59 7.10 9.88 2.47 3.89 NA 7.98 2.87 3.28 NA NA 1.67 2.09 3.99 5.44 1.27 Year 2007 Transitional Non-Facility PE RVUs 2.94 3.79 5.70 10.98 10.26 2.59 3.09 5.01 9.80 2.44 3.07 3.63 5.10 2.38 2.56 4.36 4.60 1.69 1.89 2.91 3.30 1.62 1.85 2.93 1.36 2.15 2.35 2.74 3.48 5.00 2.01 3.69 4.03 5.33 2.40 3.17 4.33 7.02 0.96 1.34 2.05 3.23 0.79 Fully Implemented Facility PE RVUs 3.02 4.41 6.52 12.71 12.25 2.57 3.58 5.69 10.72 2.46 3.33 4.02 6.01 2.43 3.05 4.83 5.23 1.65 2.02 3.12 3.75 1.55 1.88 3.31 1.42 2.08 2.39 2.44 4.16 5.50 2.25 3.71 4.14 5.71 2.61 3.13 4.60 7.79 0.99 1.48 2.48 3.26 0.79 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 28400 28405 28406 28415 28420 28430 28435 28436 28445 28450 28455 28456 28465 28470 28475 28476 28485 28490 28495 28496 28505 28510 28515 28525 28530 28531 28540 28545 28546 28555 28570 28575 28576 28585 28600 28605 28606 28615 28630 28635 28636 28645 28660 HCPCS 2 CPT 1/ 0.35 0.73 1.11 2.67 2.81 0.31 0.55 0.81 2.59 0.28 0.44 0.44 1.10 0.30 0.44 0.54 0.83 0.14 0.20 0.36 0.56 0.14 0.18 0.49 0.14 0.34 0.26 0.37 0.52 1.04 0.23 0.56 0.69 1.25 0.27 0.40 0.82 1.30 0.20 0.26 0.43 0.57 0.13 Mal-Practice RVUs 5.96 9.91 NA NA NA 5.59 7.78 NA NA 5.17 7.29 NA NA 5.11 6.59 NA NA 3.37 4.31 9.94 11.93 2.95 3.94 10.75 2.87 8.69 5.16 6.21 11.47 17.28 4.53 8.32 NA 19.38 5.27 6.95 NA NA 3.88 4.47 7.55 11.73 2.69 Fully Implemented NonFacility Total 6.14 10.12 NA NA NA 5.78 7.86 NA NA 5.30 7.08 NA NA 5.34 6.70 NA NA 3.30 4.07 10.74 12.37 2.83 3.66 11.22 2.71 9.76 4.86 5.47 10.90 17.34 4.40 7.83 NA 17.40 5.08 6.46 NA NA 3.59 4.28 7.19 10.28 2.65 Year 2007 Transitional Non-Facility Total 5.51 9.15 13.25 31.19 30.14 5.04 7.09 10.60 29.46 4.67 6.66 6.82 13.33 4.67 5.97 8.36 11.20 2.95 3.71 5.66 7.72 2.88 3.53 6.79 2.58 5.00 4.71 5.62 7.28 12.46 3.94 7.63 9.20 14.75 4.61 6.35 10.12 17.28 2.88 3.53 5.25 8.07 2.17 Fully Implemented Facility Total 5.59 9.77 14.07 32.92 32.13 5.02 7.58 11.28 30.38 4.69 6.92 7.21 14.24 4.72 6.46 8.83 11.83 2.91 3.84 5.87 8.17 2.81 3.56 7.17 2.64 4.93 4.75 5.32 7.96 12.96 4.18 7.65 9.31 15.13 4.82 6.31 10.39 18.05 2.91 3.67 5.68 8.10 2.17 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 010 010 010 090 010 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69835 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00214 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A C A A A A A A A A A A A A A A A A A A A A A A A Status Treat toe dislocation ............................................. Treat toe dislocation ............................................. Repair of toe dislocation ...................................... Fusion of foot bones ............................................ Fusion of foot bones ............................................ Fusion of foot bones ............................................ Fusion of foot bones ............................................ Fusion of foot bones ............................................ Revision of foot bones ......................................... Fusion of foot bones ............................................ Fusion of big toe joint .......................................... Fusion of big toe joint .......................................... Fusion of big toe joint .......................................... Amputation of midfoot .......................................... Amputation thru metatarsal .................................. Amputation toe & metatarsal ............................... Amputation of toe ................................................. Partial amputation of toe ...................................... High energy eswt, plantar f .................................. Foot/toes surgery procedure ................................ Application of body cast ....................................... Application of body cast ....................................... Application of body cast ....................................... Application of body cast ....................................... Application of body cast ....................................... Application of body cast ....................................... Application of body cast ....................................... Application of body cast ....................................... Application of body cast ....................................... Application of figure eight .................................... Application of shoulder cast ................................. Application of shoulder cast ................................. Application of long arm cast ................................ Application of forearm cast .................................. Apply hand/wrist cast ........................................... Apply finger cast .................................................. Apply long arm splint ........................................... Apply forearm splint ............................................. Apply forearm splint ............................................. Application of finger splint .................................... Application of finger splint .................................... Strapping of chest ................................................ Strapping of low back .......................................... Description 1.94 2.66 2.97 20.12 14.40 11.97 12.21 12.03 10.83 9.09 8.37 4.79 8.94 8.65 12.55 6.52 4.89 3.71 3.36 0.00 2.25 2.06 2.41 2.11 2.40 1.77 2.22 2.12 2.41 0.89 1.78 1.31 0.87 0.77 0.87 0.62 0.87 0.59 0.77 0.50 0.55 0.65 0.64 Physician Work RVUs 3 1.86 NA 6.70 NA NA NA NA NA NA 10.97 10.88 7.31 10.03 NA NA NA 7.73 7.20 4.79 0.00 4.73 3.36 3.36 3.80 3.60 3.67 3.61 3.94 4.17 1.12 2.90 1.25 1.27 1.23 1.26 1.03 1.09 0.96 1.01 0.43 0.62 0.61 0.61 Fully Implemented NonFacility PE RVUs 1.54 NA 7.03 NA NA NA NA NA NA 10.89 11.65 6.40 8.49 NA NA NA 7.60 7.04 5.48 0.00 3.40 3.30 3.07 3.34 3.26 3.63 2.75 3.96 3.47 1.26 2.96 1.48 1.32 1.25 1.28 0.98 1.20 1.01 1.16 0.46 0.71 0.69 0.69 Year 2007 Transitional Non-Facility PE RVUs 1.36 1.93 2.88 10.85 8.58 7.00 7.85 7.04 6.18 6.10 5.99 3.40 5.41 5.11 6.04 4.13 3.61 3.17 2.34 0.00 1.85 1.33 1.49 1.51 1.59 1.47 1.50 1.65 1.80 0.60 1.31 0.69 0.70 0.66 0.69 0.53 0.53 0.43 0.48 0.19 0.26 0.35 0.35 Fully Implemented Facility PE RVUs 1.41 2.42 3.23 12.04 9.46 7.93 8.32 7.63 6.65 6.37 6.49 3.66 5.49 5.62 5.74 4.39 3.74 3.40 2.15 0.00 1.76 1.66 1.57 1.44 1.79 1.55 1.51 1.84 2.02 0.55 1.43 0.71 0.74 0.68 0.65 0.50 0.52 0.40 0.47 0.18 0.25 0.34 0.38 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 28665 28666 28675 28705 28715 28725 28730 28735 28737 28740 28750 28755 28760 28800 28805 28810 28820 28825 28890 28899 29000 29010 29015 29020 29025 29035 29040 29044 29046 29049 29055 29058 29065 29075 29085 29086 29105 29125 29126 29130 29131 29200 29220 HCPCS 2 CPT 1/ 0.26 0.43 0.45 3.09 2.17 1.87 1.71 1.69 1.47 1.22 1.13 0.65 1.05 1.15 1.18 0.86 0.61 0.50 0.41 0.00 0.41 0.45 0.28 0.28 0.44 0.28 0.36 0.35 0.42 0.13 0.30 0.17 0.15 0.13 0.14 0.07 0.12 0.07 0.07 0.06 0.03 0.04 0.04 Mal-Practice RVUs 4.06 NA 10.12 NA NA NA NA NA NA 21.28 20.38 12.75 20.02 NA NA NA 13.23 11.41 8.56 0.00 7.39 5.87 6.05 6.19 6.44 5.72 6.19 6.41 7.00 2.14 4.98 2.73 2.29 2.13 2.27 1.72 2.08 1.62 1.85 0.99 1.20 1.30 1.29 Fully Implemented NonFacility Total 3.74 NA 10.45 NA NA NA NA NA NA 21.20 21.15 11.84 18.48 NA NA NA 13.10 11.25 9.25 0.00 6.06 5.81 5.76 5.73 6.10 5.68 5.33 6.43 6.30 2.28 5.04 2.96 2.34 2.15 2.29 1.67 2.19 1.67 2.00 1.02 1.29 1.38 1.37 Year 2007 Transitional Non-Facility Total 3.56 5.02 6.30 34.06 25.15 20.84 21.77 20.76 18.48 16.41 15.49 8.84 15.40 14.91 19.77 11.51 9.11 7.38 6.11 0.00 4.51 3.84 4.18 3.90 4.43 3.52 4.08 4.12 4.63 1.62 3.39 2.17 1.72 1.56 1.70 1.22 1.52 1.09 1.32 0.75 0.84 1.04 1.03 Fully Implemented Facility Total 3.61 5.51 6.65 35.25 26.03 21.77 22.24 21.35 18.95 16.68 15.99 9.10 15.48 15.42 19.47 11.77 9.24 7.61 5.92 0.00 4.42 4.17 4.26 3.83 4.63 3.60 4.09 4.31 4.85 1.57 3.51 2.19 1.76 1.58 1.66 1.19 1.51 1.06 1.31 0.74 0.83 1.03 1.06 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 010 010 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 YYY 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 Global 69836 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00215 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C A A A A A A A A A A A Status Strapping of shoulder ........................................... Strapping of elbow or wrist .................................. Strapping of hand or finger .................................. Application of hip cast .......................................... Application of hip casts ........................................ Application of long leg cast .................................. Application of long leg cast .................................. Apply long leg cast brace .................................... Application of long leg cast .................................. Apply short leg cast ............................................. Apply short leg cast ............................................. Apply short leg cast ............................................. Addition of walker to cast ..................................... Apply rigid leg cast ............................................... Application of leg cast .......................................... Application, long leg splint ................................... Application lower leg splint .................................. Strapping of hip .................................................... Strapping of knee ................................................. Strapping of ankle and/or ft ................................. Strapping of toes .................................................. Application of paste boot ..................................... Application of foot splint ....................................... Removal/revision of cast ...................................... Removal/revision of cast ...................................... Removal/revision of cast ...................................... Removal/revision of cast ...................................... Repair of body cast .............................................. Windowing of cast ................................................ Wedging of cast ................................................... Wedging of clubfoot cast ..................................... Casting/strapping procedure ................................ Jaw arthroscopy/surgery ...................................... Jaw arthroscopy/surgery ...................................... Shoulder arthroscopy, dx ..................................... Shoulder arthroscopy/surgery .............................. Shoulder arthroscopy/surgery .............................. Shoulder arthroscopy/surgery .............................. Shoulder arthroscopy/surgery .............................. Shoulder arthroscopy/surgery .............................. Shoulder arthroscopy/surgery .............................. Shoulder arthroscopy/surgery .............................. Shoulder arthroscopy/surgery .............................. Description 0.71 0.55 0.51 2.03 2.32 1.40 1.53 1.43 1.18 0.86 1.01 1.18 0.57 1.78 2.08 0.69 0.73 0.54 0.57 0.51 0.47 0.55 0.76 0.57 0.76 1.34 0.94 0.68 0.75 1.12 1.26 0.00 6.73 8.71 5.94 14.95 14.48 7.68 7.12 7.78 7.49 8.24 8.82 Physician Work RVUs 3 0.67 0.65 0.66 3.37 3.67 1.66 1.63 2.04 1.57 1.20 1.24 1.53 0.62 1.62 1.54 1.06 0.96 0.67 0.64 0.55 0.57 0.72 0.61 0.96 0.77 1.44 1.13 1.14 0.75 1.05 0.92 0.00 NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs 0.81 0.72 0.77 3.35 3.57 1.74 1.69 2.06 1.64 1.22 1.23 1.55 0.67 1.76 1.49 1.15 0.89 0.81 0.75 0.45 0.46 0.67 0.54 0.91 0.81 1.51 1.16 1.16 0.80 1.13 1.03 0.00 NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 0.39 0.36 0.37 1.61 1.75 0.95 0.95 0.94 0.85 0.66 0.67 0.81 0.25 0.94 0.88 0.45 0.46 0.38 0.36 0.32 0.31 0.34 0.27 0.26 0.37 0.64 0.41 0.34 0.35 0.49 0.45 0.00 4.96 5.70 4.75 9.45 9.32 5.68 5.22 5.70 5.63 6.09 6.59 Fully Implemented Facility PE RVUs 0.37 0.33 0.33 1.72 1.90 1.03 1.08 1.05 0.93 0.70 0.72 0.90 0.27 0.96 1.04 0.45 0.46 0.45 0.34 0.31 0.29 0.35 0.29 0.28 0.38 0.69 0.40 0.38 0.35 0.49 0.55 0.00 6.47 7.14 5.44 10.73 10.57 6.51 5.97 6.53 6.43 6.94 7.30 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 29240 29260 29280 29305 29325 29345 29355 29358 29365 29405 29425 29435 29440 29445 29450 29505 29515 29520 29530 29540 29550 29580 29590 29700 29705 29710 29715 29720 29730 29740 29750 29799 29800 29804 29805 29806 29807 29819 29820 29821 29822 29823 29824 HCPCS 2 CPT 1/ 0.06 0.05 0.03 0.35 0.40 0.24 0.26 0.25 0.20 0.14 0.15 0.20 0.08 0.27 0.27 0.08 0.09 0.03 0.05 0.06 0.06 0.07 0.09 0.08 0.13 0.20 0.09 0.12 0.12 0.18 0.21 0.00 0.99 1.38 1.02 2.50 2.42 1.32 1.22 1.33 1.28 1.41 1.42 Mal-Practice RVUs 1.44 1.25 1.20 5.75 6.39 3.30 3.42 3.72 2.95 2.20 2.40 2.91 1.27 3.67 3.89 1.83 1.78 1.24 1.26 1.12 1.10 1.34 1.46 1.61 1.66 2.98 2.16 1.94 1.62 2.35 2.39 0.00 NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total 1.58 1.32 1.31 5.73 6.29 3.38 3.48 3.74 3.02 2.22 2.39 2.93 1.32 3.81 3.84 1.92 1.71 1.38 1.37 1.02 0.99 1.29 1.39 1.56 1.70 3.05 2.19 1.96 1.67 2.43 2.50 0.00 NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 1.16 0.96 0.91 3.99 4.47 2.59 2.74 2.62 2.23 1.66 1.83 2.19 0.90 2.99 3.23 1.22 1.28 0.95 0.98 0.89 0.84 0.96 1.12 0.91 1.26 2.18 1.44 1.14 1.22 1.79 1.92 0.00 12.68 15.79 11.71 26.90 26.22 14.68 13.56 14.81 14.40 15.74 16.83 Fully Implemented Facility Total 1.14 0.93 0.87 4.10 4.62 2.67 2.87 2.73 2.31 1.70 1.88 2.28 0.92 3.01 3.39 1.22 1.28 1.02 0.96 0.88 0.82 0.97 1.14 0.93 1.27 2.23 1.43 1.18 1.22 1.79 2.02 0.00 14.19 17.23 12.40 28.18 27.47 15.51 14.31 15.64 15.20 16.59 17.54 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 YYY 090 090 090 090 090 090 090 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69837 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00216 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Shoulder arthroscopy/surgery .............................. Shoulder arthroscopy/surgery .............................. Arthroscop rotator cuff repr .................................. Elbow arthroscopy ................................................ Elbow arthroscopy/surgery ................................... Elbow arthroscopy/surgery ................................... Elbow arthroscopy/surgery ................................... Elbow arthroscopy/surgery ................................... Elbow arthroscopy/surgery ................................... Wrist arthroscopy ................................................. Wrist arthroscopy/surgery .................................... Wrist arthroscopy/surgery .................................... Wrist arthroscopy/surgery .................................... Wrist arthroscopy/surgery .................................... Wrist arthroscopy/surgery .................................... Wrist endoscopy/surgery ...................................... Knee arthroscopy/surgery .................................... Knee arthroscopy/surgery .................................... Tibial arthroscopy/surgery .................................... Tibial arthroscopy/surgery .................................... Hip arthroscopy, dx .............................................. Hip arthroscopy/surgery ....................................... Hip arthroscopy/surgery ....................................... Hip arthroscopy/surgery ....................................... Autgrft implnt, knee w/scope ................................ Allgrft implnt, knee w/scope ................................. Meniscal trnspl, knee w/scpe ............................... Knee arthroscopy, dx ........................................... Knee arthroscopy/drainage .................................. Knee arthroscopy/surgery .................................... Knee arthroscopy/surgery .................................... Knee arthroscopy/surgery .................................... Knee arthroscopy/surgery .................................... Knee arthroscopy/surgery .................................... Knee arthroscopy/surgery .................................... Knee arthroscopy/surgery .................................... Knee arthroscopy/surgery .................................... Knee arthroscopy/surgery .................................... Knee arthroscopy/surgery .................................... Knee arthroscopy/surgery .................................... Knee arthroscopy/surgery .................................... Knee arthroscopy/surgery .................................... Knee arthroscopy/surgery .................................... Description 7.68 9.05 15.44 5.80 6.33 6.53 7.61 6.92 7.77 5.59 6.06 6.42 7.58 6.80 7.13 6.24 8.18 13.08 10.60 14.12 8.85 9.95 10.97 10.97 14.48 18.18 24.89 5.11 6.60 6.09 7.10 6.36 8.72 8.15 8.84 9.30 8.56 9.45 11.61 8.13 10.03 8.34 9.98 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 5.69 6.25 9.43 4.53 4.89 5.01 5.60 5.17 5.72 4.66 4.95 4.99 5.55 5.14 5.21 5.33 5.26 8.32 7.38 8.76 6.25 6.66 7.64 7.55 9.57 11.28 14.00 4.19 5.04 5.62 5.20 4.93 6.24 6.00 6.29 6.49 6.19 6.53 7.67 6.02 7.07 6.09 7.06 Fully Implemented Facility PE RVUs 6.49 7.21 11.01 5.14 5.60 5.66 6.49 5.89 6.60 5.16 5.45 5.61 6.24 5.82 5.95 5.53 5.10 9.42 8.42 10.19 6.78 7.17 8.33 8.27 10.91 12.74 16.09 4.72 5.66 6.33 5.85 5.62 6.83 6.56 6.91 7.14 6.77 7.06 8.71 6.53 7.75 6.66 7.71 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 29825 29826 29827 29830 29834 29835 29836 29837 29838 29840 29843 29844 29845 29846 29847 29848 29850 29851 29855 29856 29860 29861 29862 29863 29866 29867 29868 29870 29871 29873 29874 29875 29876 29877 29879 29880 29881 29882 29883 29884 29885 29886 29887 HCPCS 2 CPT 1/ 1.32 1.55 2.67 0.99 1.08 1.13 1.22 1.19 1.30 0.84 0.92 1.04 0.99 1.07 1.08 0.86 1.25 2.35 1.85 2.40 1.36 1.59 1.62 1.42 2.40 2.79 4.36 0.85 1.14 1.04 1.11 1.09 1.37 1.28 1.39 1.47 1.34 1.50 1.93 1.27 1.58 1.30 1.57 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 14.69 16.85 27.54 11.32 12.30 12.67 14.43 13.28 14.79 11.09 11.93 12.45 14.12 13.01 13.42 12.43 14.69 23.75 19.83 25.28 16.46 18.20 20.23 19.94 26.45 32.25 43.25 10.15 12.78 12.75 13.41 12.38 16.33 15.43 16.52 17.26 16.09 17.48 21.21 15.42 18.68 15.73 18.61 Fully Implemented Facility Total 15.49 17.81 29.12 11.93 13.01 13.32 15.32 14.00 15.67 11.59 12.43 13.07 14.81 13.69 14.16 12.63 14.53 24.85 20.87 26.71 16.99 18.71 20.92 20.66 27.79 33.71 45.34 10.68 13.40 13.46 14.06 13.07 16.92 15.99 17.14 17.91 16.67 18.01 22.25 15.93 19.36 16.30 19.26 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 Global 69838 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00217 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A C A A A A A A A A A A A A A A A A A A A A R R R R R R A A A Status Knee arthroscopy/surgery .................................... Knee arthroscopy/surgery .................................... Ankle arthroscopy/surgery ................................... Ankle arthroscopy/surgery ................................... Scope, plantar fasciotomy .................................... Ankle arthroscopy/surgery ................................... Ankle arthroscopy/surgery ................................... Ankle arthroscopy/surgery ................................... Ankle arthroscopy/surgery ................................... Ankle arthroscopy/surgery ................................... Mcp joint arthroscopy, dx ..................................... Mcp joint arthroscopy, surg .................................. Mcp joint arthroscopy, surg .................................. Arthroscopy of joint .............................................. Drainage of nose lesion ....................................... Drainage of nose lesion ....................................... Intranasal biopsy .................................................. Removal of nose polyp(s) .................................... Removal of nose polyp(s) .................................... Removal of intranasal lesion ................................ Removal of intranasal lesion ................................ Revision of nose .................................................. Removal of nose lesion ....................................... Removal of nose lesion ....................................... Excise inferior turbinate ....................................... Resect inferior turbinate ....................................... Partial removal of nose ........................................ Removal of nose .................................................. Injection treatment of nose .................................. Nasal sinus therapy ............................................. Insert nasal septal button ..................................... Remove nasal foreign body ................................. Remove nasal foreign body ................................. Remove nasal foreign body ................................. Reconstruction of nose ........................................ Reconstruction of nose ........................................ Reconstruction of nose ........................................ Revision of nose .................................................. Revision of nose .................................................. Revision of nose .................................................. Revision of nose .................................................. Revision of nose .................................................. Repair nasal stenosis ........................................... Description 14.14 17.15 9.47 10.07 6.08 7.26 7.04 7.23 8.38 15.21 5.74 6.45 7.02 0.00 1.45 1.45 0.94 1.65 4.38 3.20 9.81 5.31 3.14 7.21 3.41 3.48 9.44 9.88 0.78 1.10 1.56 1.06 1.98 4.56 10.58 13.72 16.62 7.96 12.45 19.38 10.24 20.12 12.20 Physician Work RVUs 3 NA NA NA NA 8.90 NA NA NA NA NA NA NA NA 0.00 3.72 3.87 2.42 3.64 NA 16.92 NA 6.92 NA NA NA NA NA NA 1.88 2.32 5.41 4.13 NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA 6.94 NA NA NA NA NA NA NA NA 0.00 3.98 3.42 2.08 3.34 NA 14.09 NA 6.60 NA NA NA NA NA NA 1.69 2.16 4.53 4.51 NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 8.38 10.78 6.72 6.62 4.73 4.74 4.58 4.99 5.33 9.34 4.80 5.57 3.68 0.00 1.24 1.28 0.70 1.34 5.51 4.55 7.85 4.97 3.66 7.03 5.31 6.58 8.64 8.21 0.62 1.17 1.31 1.79 2.73 5.98 13.80 14.43 14.89 12.87 14.86 16.36 7.24 14.54 10.39 Fully Implemented Facility PE RVUs 9.75 12.02 7.31 7.46 4.18 5.29 5.25 5.66 5.98 10.24 5.60 6.09 5.83 0.00 1.35 1.42 0.79 1.51 5.70 4.61 8.86 5.74 3.62 8.00 5.52 6.29 10.42 9.71 0.71 1.28 1.48 1.88 3.01 6.78 15.07 17.39 17.16 15.23 18.23 20.51 9.27 18.82 11.58 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 29888 29889 29891 29892 29893 29894 29895 29897 29898 29899 29900 29901 29902 29999 30000 30020 30100 30110 30115 30117 30118 30120 30124 30125 30130 30140 30150 30160 30200 30210 30220 30300 30310 30320 30400 30410 30420 30430 30435 30450 30460 30462 30465 HCPCS 2 CPT 1/ 2.42 2.79 1.39 1.41 0.63 1.15 1.11 1.17 1.28 2.41 0.94 1.06 1.12 0.00 0.12 0.12 0.07 0.14 0.41 0.26 0.78 0.52 0.25 0.63 0.31 0.35 0.93 0.88 0.06 0.09 0.12 0.08 0.16 0.39 1.04 1.42 1.46 0.77 1.22 1.97 1.03 2.54 1.06 Mal-Practice RVUs NA NA NA NA 15.61 NA NA NA NA NA NA NA NA 0.00 5.29 5.44 3.43 5.43 NA 20.38 NA 12.75 NA NA NA NA NA NA 2.72 3.51 7.09 5.27 NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA 13.65 NA NA NA NA NA NA NA NA 0.00 5.55 4.99 3.09 5.13 NA 17.55 NA 12.43 NA NA NA NA NA NA 2.53 3.35 6.21 5.65 NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 24.94 30.72 17.58 18.10 11.44 13.15 12.73 13.39 14.99 26.96 11.48 13.08 11.82 0.00 2.81 2.85 1.71 3.13 10.30 8.01 18.44 10.80 7.05 14.87 9.03 10.41 19.01 18.97 1.46 2.36 2.99 2.93 4.87 10.93 25.42 29.57 32.97 21.60 28.53 37.71 18.51 37.20 23.65 Fully Implemented Facility Total 26.31 31.96 18.17 18.94 10.89 13.70 13.40 14.06 15.64 27.86 12.28 13.60 13.97 0.00 2.92 2.99 1.80 3.30 10.49 8.07 19.45 11.57 7.01 15.84 9.24 10.12 20.79 20.47 1.55 2.47 3.16 3.02 5.15 11.73 26.69 32.53 35.24 23.96 31.90 41.86 20.54 41.48 24.84 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 YYY 010 010 000 010 090 090 090 090 090 090 090 090 090 090 000 010 010 010 010 090 090 090 090 090 090 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69839 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00218 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A C A A A A A A A A A A A A A A A A A A A A A A A A A Status Repair of nasal septum ........................................ Repair nasal defect .............................................. Repair nasal defect .............................................. Release of nasal adhesions ................................. Repair upper jaw fistula ....................................... Repair mouth/nose fistula .................................... Intranasal reconstruction ...................................... Repair nasal septum defect ................................. Ablate inf turbinate, superf ................................... Cauterization, inner nose ..................................... Control of nosebleed ............................................ Control of nosebleed ............................................ Control of nosebleed ............................................ Repeat control of nosebleed ................................ Ligation, nasal sinus artery .................................. Ligation, upper jaw artery .................................... Ther fx, nasal inf turbinate ................................... Nasal surgery procedure ...................................... Irrigation, maxillary sinus ..................................... Irrigation, sphenoid sinus ..................................... Exploration, maxillary sinus ................................. Exploration, maxillary sinus ................................. Explore sinus, remove polyps .............................. Exploration behind upper jaw .............................. Exploration, sphenoid sinus ................................. Sphenoid sinus surgery ....................................... Exploration of frontal sinus .................................. Exploration of frontal sinus .................................. Removal of frontal sinus ...................................... Removal of frontal sinus ...................................... Removal of frontal sinus ...................................... Removal of frontal sinus ...................................... Removal of frontal sinus ...................................... Removal of frontal sinus ...................................... Exploration of sinuses .......................................... Removal of ethmoid sinus ................................... Removal of ethmoid sinus ................................... Removal of ethmoid sinus ................................... Removal of upper jaw .......................................... Removal of upper jaw .......................................... Nasal endoscopy, dx ............................................ Nasal/sinus endoscopy, dx .................................. Nasal/sinus endoscopy, dx .................................. Description 6.85 7.81 11.50 1.28 6.76 6.07 6.04 7.18 1.11 2.05 1.21 1.54 1.97 2.45 7.36 11.03 1.28 0.00 1.17 1.93 2.99 5.95 6.61 9.66 5.31 7.16 4.32 9.40 12.54 13.99 14.75 15.44 14.16 14.39 10.88 5.03 8.49 10.47 26.44 30.56 1.10 2.18 2.64 Physician Work RVUs 3 NA NA NA 4.94 8.19 7.52 NA NA 4.02 4.62 1.21 3.08 3.73 3.98 NA NA NA 0.00 3.01 NA 8.07 9.79 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 3.34 3.95 4.30 Fully Implemented NonFacility PE RVUs NA NA NA 4.81 7.88 7.52 NA NA 4.10 4.61 1.32 2.80 3.57 3.91 NA NA NA 0.00 2.88 NA 8.42 11.07 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 3.37 4.21 4.76 Year 2007 Transitional Non-Facility PE RVUs 7.42 7.06 10.15 1.88 4.75 4.10 8.15 7.13 1.97 2.32 0.29 0.39 0.48 0.68 5.88 8.23 1.53 0.00 1.25 2.52 5.19 6.05 6.53 7.30 6.17 7.74 5.73 8.59 10.47 14.79 11.98 13.04 11.82 10.83 12.38 7.45 8.32 9.59 16.55 17.27 0.70 1.02 1.15 Fully Implemented Facility PE RVUs 6.85 8.72 11.46 2.07 5.53 4.79 8.66 7.75 1.93 2.35 0.31 0.47 0.69 1.07 6.49 8.79 1.60 0.00 1.36 3.06 5.18 6.51 7.06 9.19 6.31 8.12 5.88 9.45 12.77 14.20 13.12 13.73 12.92 12.11 12.51 8.77 8.96 11.31 17.50 18.84 0.84 1.37 1.58 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 30520 30540 30545 30560 30580 30600 30620 30630 30801 30802 30901 30903 30905 30906 30915 30920 30930 30999 31000 31002 31020 31030 31032 31040 31050 31051 31070 31075 31080 31081 31084 31085 31086 31087 31090 31200 31201 31205 31225 31230 31231 31233 31235 HCPCS 2 CPT 1/ 0.46 0.67 1.71 0.10 0.89 0.70 0.57 0.61 0.09 0.16 0.11 0.13 0.17 0.20 0.58 0.80 0.12 0.00 0.09 0.15 0.29 0.60 0.59 0.87 0.49 0.62 0.38 0.75 1.23 2.47 1.19 1.73 1.07 1.44 0.94 0.29 0.82 0.67 1.59 1.78 0.09 0.20 0.26 Mal-Practice RVUs NA NA NA 6.32 15.84 14.29 NA NA 5.22 6.83 2.53 4.75 5.87 6.63 NA NA NA 0.00 4.27 NA 11.35 16.34 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 4.53 6.33 7.20 Fully Implemented NonFacility Total NA NA NA 6.19 15.53 14.29 NA NA 5.30 6.82 2.64 4.47 5.71 6.56 NA NA NA 0.00 4.14 NA 11.70 17.62 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 4.56 6.59 7.66 Year 2007 Transitional Non-Facility Total 14.73 15.54 23.36 3.26 12.40 10.87 14.76 14.92 3.17 4.53 1.61 2.06 2.62 3.33 13.82 20.06 2.93 0.00 2.51 4.60 8.47 12.60 13.73 17.83 11.97 15.52 10.43 18.74 24.24 31.25 27.92 30.21 27.05 26.66 24.20 12.77 17.63 20.73 44.58 49.61 1.89 3.40 4.05 Fully Implemented Facility Total 14.16 17.20 24.67 3.45 13.18 11.56 15.27 15.54 3.13 4.56 1.63 2.14 2.83 3.72 14.43 20.62 3.00 0.00 2.62 5.14 8.46 13.06 14.26 19.72 12.11 15.90 10.58 19.60 26.54 30.66 29.06 30.90 28.15 27.94 24.33 14.09 18.27 22.45 45.53 51.18 2.03 3.75 4.48 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 010 090 090 090 090 010 010 000 000 000 000 090 090 010 YYY 010 010 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 000 000 000 Global 69840 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00219 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A C A A A A A A A A A A A A A A A A A A A A A A A A A A Status Nasal/sinus endoscopy, surg ............................... Nasal/sinus endoscopy, surg ............................... Nasal/sinus endoscopy, surg ............................... Nasal/sinus endoscopy, surg ............................... Revision of ethmoid sinus .................................... Removal of ethmoid sinus ................................... Exploration maxillary sinus .................................. Endoscopy, maxillary sinus .................................. Sinus endoscopy, surgical ................................... Nasal/sinus endoscopy, surg ............................... Nasal/sinus endoscopy, surg ............................... Nasal/sinus endoscopy, surg ............................... Nasal/sinus endoscopy, surg ............................... Nasal/sinus endoscopy, surg ............................... Nasal/sinus endoscopy, surg ............................... Nasal/sinus endoscopy, surg ............................... Sinus surgery procedure ...................................... Removal of larynx lesion ...................................... Diagnostic incision, larynx .................................... Removal of larynx ................................................ Removal of larynx ................................................ Partial removal of larynx ...................................... Partial removal of larynx ...................................... Partial removal of larynx ...................................... Partial removal of larynx ...................................... Partial removal of larynx ...................................... Partial removal of larynx ...................................... Removal of larynx & pharynx ............................... Reconstruct larynx & pharynx .............................. Revision of larynx ................................................. Removal of epiglottis ............................................ Insert emergency airway ...................................... Change of windpipe airway .................................. Diagnostic laryngoscopy ...................................... Laryngoscopy with biopsy .................................... Remove foreign body, larynx ............................... Removal of larynx lesion ...................................... Injection into vocal cord ....................................... Laryngoscopy for aspiration ................................. Dx laryngoscopy, newborn ................................... Dx laryngoscopy excl nb ...................................... Dx laryngoscopy w/oper scope ............................ Laryngoscopy for treatment ................................. Description 2.98 3.26 9.23 2.61 4.64 6.95 3.29 5.45 8.84 3.91 4.57 18.50 19.45 15.79 17.36 20.20 0.00 15.71 5.62 29.57 38.47 30.23 33.85 27.23 25.73 25.23 28.23 42.17 43.46 11.48 11.32 2.33 0.65 0.61 1.92 2.16 2.07 2.10 1.80 2.56 2.63 2.57 3.27 Physician Work RVUs 3 4.53 4.46 NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 1.34 2.98 2.76 2.73 NA 3.07 NA 3.24 NA NA Fully Implemented NonFacility PE RVUs 5.03 5.04 NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 1.42 3.22 3.03 3.08 NA 3.42 NA 3.54 NA NA Year 2007 Transitional Non-Facility PE RVUs 1.25 1.34 6.34 1.15 1.74 2.42 1.34 1.98 2.97 1.52 1.72 8.19 8.80 7.37 8.00 8.92 0.00 13.59 9.20 18.32 20.91 20.48 22.44 20.39 19.49 19.17 20.68 23.64 25.96 11.54 7.94 0.44 0.20 0.55 0.92 0.95 0.97 0.99 0.85 1.11 1.13 1.13 1.31 Fully Implemented Facility PE RVUs 1.72 1.90 7.59 1.59 2.57 3.69 1.92 2.96 4.58 2.22 2.54 11.09 11.55 9.80 10.54 11.88 0.00 14.63 10.03 17.12 20.50 21.54 24.73 21.79 20.16 20.24 21.38 24.20 27.72 13.21 9.14 0.52 0.26 0.60 1.17 1.03 1.26 1.34 1.01 1.45 1.53 1.57 1.73 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 31237 31238 31239 31240 31254 31255 31256 31267 31276 31287 31288 31290 31291 31292 31293 31294 31299 31300 31320 31360 31365 31367 31368 31370 31375 31380 31382 31390 31395 31400 31420 31500 31502 31505 31510 31511 31512 31513 31515 31520 31525 31526 31527 HCPCS 2 CPT 1/ 0.28 0.27 0.62 0.24 0.45 0.73 0.33 0.55 0.92 0.39 0.46 1.40 1.69 1.21 1.28 1.53 0.00 1.17 0.46 1.38 1.98 1.79 2.21 1.75 1.63 1.71 1.68 2.24 2.49 0.83 0.83 0.17 0.05 0.05 0.16 0.19 0.18 0.17 0.14 0.20 0.21 0.21 0.26 Mal-Practice RVUs 7.79 7.99 NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 2.00 5.06 5.11 4.98 NA 5.01 NA 6.08 NA NA Fully Implemented NonFacility Total 8.29 8.57 NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 2.08 5.30 5.38 5.33 NA 5.36 NA 6.38 NA NA Year 2007 Transitional Non-Facility Total 4.51 4.87 16.19 4.00 6.83 10.10 4.96 7.98 12.73 5.82 6.75 28.09 29.94 24.37 26.64 30.65 0.00 30.47 15.28 49.27 61.36 52.50 58.50 49.37 46.85 46.11 50.59 68.05 71.91 23.85 20.09 2.94 0.90 1.21 3.00 3.30 3.22 3.26 2.79 3.87 3.97 3.91 4.84 Fully Implemented Facility Total 4.98 5.43 17.44 4.44 7.66 11.37 5.54 8.96 14.34 6.52 7.57 30.99 32.69 26.80 29.18 33.61 0.00 31.51 16.11 48.07 60.95 53.56 60.79 50.77 47.52 47.18 51.29 68.61 73.67 25.52 21.29 3.02 0.96 1.26 3.25 3.38 3.51 3.61 2.95 4.21 4.37 4.35 5.26 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 000 000 010 000 000 000 000 000 000 000 000 010 010 010 010 010 YYY 090 090 090 090 090 090 090 090 090 090 090 090 090 090 000 000 000 000 000 000 000 000 000 000 000 000 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69841 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00220 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A C A A A A A A A A A A A A A A A A Status Laryngoscopy and dilation ................................... Laryngoscopy and dilation ................................... Laryngoscopy w/fb removal ................................. Laryngoscopy w/fb & op scope ............................ Laryngoscopy w/biopsy ........................................ Laryngoscopy w/bx & op scope ........................... Laryngoscopy w/exc of tumor .............................. Larynscop w/tumr exc + scope ............................ Remove vc lesion w/scope .................................. Remove vc lesion scope/graft .............................. Laryngoscop w/arytenoidectom ........................... Larynscop, remve cart + scop ............................. Laryngoscope w/vc inj .......................................... Laryngoscop w/vc inj + scope .............................. Diagnostic laryngoscopy ...................................... Laryngoscopy with biopsy .................................... Remove foreign body, larynx ............................... Removal of larynx lesion ...................................... Diagnostic laryngoscopy ...................................... Revision of larynx ................................................. Revision of larynx ................................................. Treat larynx fracture ............................................. Revision of larynx ................................................. Revision of larynx ................................................. Reinnervate larynx ............................................... Larynx nerve surgery ........................................... Larynx surgery procedure .................................... Incision of windpipe .............................................. Incision of windpipe .............................................. Incision of windpipe .............................................. Incision of windpipe .............................................. Incision of windpipe .............................................. Surgery/speech prosthesis ................................... Puncture/clear windpipe ....................................... Repair windpipe opening ..................................... Repair windpipe opening ..................................... Visualization of windpipe ...................................... Endobronchial us add-on ..................................... Dx bronchoscope/wash ........................................ Dx bronchoscope/brush ....................................... Dx bronchoscope/lavage ...................................... Bronchoscopy w/biopsy(s) ................................... Bronchoscopy/lung bx, each ................................ Description 2.37 2.68 3.38 3.58 3.16 3.55 4.12 4.52 6.30 9.73 5.45 5.99 3.86 4.26 1.10 1.97 2.47 2.84 2.26 14.46 22.87 20.35 15.12 14.62 7.63 8.75 0.00 7.17 4.44 4.14 3.57 9.29 5.92 0.91 4.63 8.47 2.09 1.40 2.78 2.88 2.88 3.36 3.80 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA 3.96 NA 1.57 3.28 3.23 3.68 2.64 NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA 1.07 NA NA 2.22 6.00 5.23 6.01 5.36 5.50 7.00 Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA 5.24 NA 1.82 3.57 3.63 4.13 3.50 NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA 1.09 NA NA 2.50 5.73 5.55 6.32 5.67 5.73 7.02 Year 2007 Transitional Non-Facility PE RVUs 0.99 1.12 1.32 1.43 1.30 1.42 1.59 1.70 2.26 3.77 1.92 2.08 1.51 1.63 0.70 0.96 1.11 1.21 1.04 13.49 20.51 14.32 8.05 11.46 12.10 8.94 0.00 2.22 1.63 1.13 0.83 7.19 6.50 0.25 5.80 8.90 0.96 0.35 0.91 0.92 0.92 1.04 1.14 Fully Implemented Facility PE RVUs 1.34 1.56 1.79 2.06 1.82 2.04 2.30 2.51 3.17 4.67 2.84 3.05 2.16 2.36 0.84 1.21 1.43 1.44 1.37 15.31 24.48 17.19 8.96 13.07 14.67 10.15 0.00 2.95 2.21 1.57 1.10 7.99 6.92 0.33 5.94 8.76 1.14 0.50 1.02 1.02 1.02 1.17 1.26 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 31528 31529 31530 31531 31535 31536 31540 31541 31545 31546 31560 31561 31570 31571 31575 31576 31577 31578 31579 31580 31582 31584 31587 31588 31590 31595 31599 31600 31601 31603 31605 31610 31611 31612 31613 31614 31615 31620 31622 31623 31624 31625 31628 HCPCS 2 CPT 1/ 0.19 0.22 0.29 0.29 0.26 0.29 0.33 0.37 0.37 0.78 0.43 0.49 0.31 0.35 0.09 0.14 0.21 0.23 0.18 1.00 1.76 1.72 0.97 1.06 0.84 0.68 0.00 0.80 0.40 0.44 0.40 0.79 0.46 0.08 0.42 0.58 0.16 0.11 0.18 0.13 0.13 0.18 0.18 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA 8.13 NA 2.76 5.39 5.91 6.75 5.08 NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA 2.06 NA NA 4.47 7.51 8.19 9.02 8.37 9.04 10.98 Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA 9.41 NA 3.01 5.68 6.31 7.20 5.94 NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA 2.08 NA NA 4.75 7.24 8.51 9.33 8.68 9.27 11.00 Year 2007 Transitional Non-Facility Total 3.55 4.02 4.99 5.30 4.72 5.26 6.04 6.59 8.93 14.28 7.80 8.56 5.68 6.24 1.89 3.07 3.79 4.28 3.48 28.95 45.14 36.39 24.14 27.14 20.57 18.37 0.00 10.19 6.47 5.71 4.80 17.27 12.88 1.24 10.85 17.95 3.21 1.86 3.87 3.93 3.93 4.58 5.12 Fully Implemented Facility Total 3.90 4.46 5.46 5.93 5.24 5.88 6.75 7.40 9.84 15.18 8.72 9.53 6.33 6.97 2.03 3.32 4.11 4.51 3.81 30.77 49.11 39.26 25.05 28.75 23.14 19.58 0.00 10.92 7.05 6.15 5.07 18.07 13.30 1.32 10.99 17.81 3.39 2.01 3.98 4.03 4.03 4.71 5.24 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 090 090 090 090 090 090 090 YYY 000 000 000 000 090 090 000 090 090 000 ZZZ 000 000 000 000 000 Global 69842 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00221 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C A A A A A A A Status Bronchoscopy/needle bx, each ............................ Bronchoscopy dilate/fx repr ................................. Bronchoscopy, dilate w/stent ............................... Bronchoscopy/lung bx, add’l ................................ Bronchoscopy/needle bx add’l ............................. Bronchoscopy w/fb removal ................................. Bronchoscopy, bronch stents ............................... Bronchoscopy, stent add-on ................................ Bronchoscopy, revise stent .................................. Bronchoscopy w/tumor excise ............................. Bronchoscopy, treat blockage .............................. Diag bronchoscope/catheter ................................ Bronchoscopy, clear airways ............................... Bronchoscopy, reclear airway .............................. Bronchoscopy, inj for x-ray .................................. Injection for bronchus x-ray ................................. Bronchial brush biopsy ......................................... Clearance of airways ........................................... Clearance of airways ........................................... Intro, windpipe wire/tube ...................................... Repair of windpipe ............................................... Repair of windpipe ............................................... Repair of windpipe ............................................... Reconstruction of windpipe .................................. Repair/graft of bronchus ...................................... Reconstruct bronchus .......................................... Reconstruct windpipe ........................................... Reconstruct windpipe ........................................... Remove windpipe lesion ...................................... Remove windpipe lesion ...................................... Repair of windpipe injury ..................................... Repair of windpipe injury ..................................... Closure of windpipe lesion ................................... Repair of windpipe defect .................................... Revise windpipe scar ........................................... Airways surgical procedure .................................. Drainage of chest ................................................. Treatment of collapsed lung ................................ Treat lung lining chemically ................................. Insert pleural catheter .......................................... Insertion of chest tube ......................................... Exploration of chest ............................................. Exploration of chest ............................................. Description 4.09 3.81 4.36 1.03 1.32 3.67 4.30 1.58 4.88 4.93 5.02 3.49 3.16 2.72 2.17 1.11 2.12 1.06 1.96 2.85 15.19 17.19 23.36 31.58 23.48 24.51 19.70 24.77 18.29 25.34 8.10 13.34 4.58 6.98 4.54 0.00 1.54 2.19 2.19 4.17 3.29 11.20 12.21 Physician Work RVUs 3 12.05 NA NA 0.87 1.00 5.19 NA NA NA NA NA NA 4.76 4.47 5.27 NA 5.83 NA NA 25.35 NA NA NA NA NA NA NA NA NA NA NA NA 5.46 6.85 5.62 0.00 2.30 2.73 5.04 15.15 NA NA NA Fully Implemented NonFacility PE RVUs 13.70 NA NA 0.83 0.94 5.88 NA NA NA NA NA NA 5.05 4.76 6.79 NA 7.65 NA NA 7.98 NA NA NA NA NA NA NA NA NA NA NA NA 5.61 7.46 5.73 0.00 2.86 3.09 6.10 18.76 NA NA NA Year 2007 Transitional Non-Facility PE RVUs 1.21 1.26 1.41 0.25 0.32 1.15 1.38 0.42 1.56 1.54 1.51 1.07 0.99 0.88 0.65 0.28 0.77 0.26 0.45 0.74 16.21 22.30 9.76 11.46 8.80 8.91 8.12 9.28 5.60 9.79 8.33 6.32 3.02 4.08 3.37 0.00 0.41 0.94 0.59 1.42 0.94 6.07 6.40 Fully Implemented Facility PE RVUs 1.35 1.61 1.67 0.30 0.38 1.36 1.67 0.53 1.87 1.94 1.79 1.19 1.09 0.97 0.79 0.33 0.79 0.31 0.55 0.94 17.22 23.97 10.47 13.10 9.88 11.07 10.32 11.41 9.04 12.27 9.01 6.99 3.49 5.05 3.83 0.00 0.46 1.03 0.67 1.59 1.25 5.91 6.42 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 31629 31630 31631 31632 31633 31635 31636 31637 31638 31640 31641 31643 31645 31646 31656 31715 31717 31720 31725 31730 31750 31755 31760 31766 31770 31775 31780 31781 31785 31786 31800 31805 31820 31825 31830 31899 32000 32002 32005 32019 32020 32035 32036 HCPCS 2 CPT 1/ 0.16 0.32 0.34 0.18 0.16 0.24 0.31 0.13 0.22 0.46 0.35 0.20 0.16 0.14 0.15 0.07 0.14 0.07 0.14 0.21 1.05 1.29 2.95 4.53 2.84 3.02 1.65 2.25 1.59 3.30 0.79 1.83 0.38 0.53 0.44 0.00 0.08 0.12 0.23 0.42 0.43 1.26 1.43 Mal-Practice RVUs 16.30 NA NA 2.08 2.48 9.10 NA NA NA NA NA NA 8.08 7.33 7.59 NA 8.09 NA NA 28.41 NA NA NA NA NA NA NA NA NA NA NA NA 10.42 14.36 10.60 0.00 3.92 5.04 7.46 19.74 NA NA NA Fully Implemented NonFacility Total 17.95 NA NA 2.04 2.42 9.79 NA NA NA NA NA NA 8.37 7.62 9.11 NA 9.91 NA NA 11.04 NA NA NA NA NA NA NA NA NA NA NA NA 10.57 14.97 10.71 0.00 4.48 5.40 8.52 23.35 NA NA NA Year 2007 Transitional Non-Facility Total 5.46 5.39 6.11 1.46 1.80 5.06 5.99 2.13 6.66 6.93 6.88 4.76 4.31 3.74 2.97 1.46 3.03 1.39 2.55 3.80 32.45 40.78 36.07 47.57 35.12 36.44 29.47 36.30 25.48 38.43 17.22 21.49 7.98 11.59 8.35 0.00 2.03 3.25 3.01 6.01 4.66 18.53 20.04 Fully Implemented Facility Total 5.60 5.74 6.37 1.51 1.86 5.27 6.28 2.24 6.97 7.33 7.16 4.88 4.41 3.83 3.11 1.51 3.05 1.44 2.65 4.00 33.46 42.45 36.78 49.21 36.20 38.60 31.67 38.43 28.92 40.91 17.90 22.16 8.45 12.56 8.81 0.00 2.08 3.34 3.09 6.18 4.97 18.37 20.06 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 000 000 000 ZZZ ZZZ 000 000 ZZZ 000 000 000 000 000 000 000 000 000 000 000 000 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 YYY 000 000 000 000 000 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69843 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00222 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A R A A A A A A A A A A A A A Status Biopsy through chest wall .................................... Exploration/biopsy of chest .................................. Explore/repair chest ............................................. Re-exploration of chest ........................................ Explore chest free adhesions .............................. Removal of lung lesion(s) .................................... Remove/treat lung lesions ................................... Removal of lung lesion(s) .................................... Remove lung foreign body ................................... Open chest heart massage .................................. Drain, open, lung lesion ....................................... Drain, percut, lung lesion ..................................... Treat chest lining .................................................. Release of lung .................................................... Partial release of lung .......................................... Removal of chest lining ........................................ Free/remove chest lining ...................................... Needle biopsy chest lining ................................... Open biopsy chest lining ...................................... Biopsy, lung or mediastinum ................................ Puncture/clear lung .............................................. Removal of lung ................................................... Sleeve pneumonectomy ....................................... Removal of lung ................................................... Partial removal of lung ......................................... Bilobectomy .......................................................... Segmentectomy ................................................... Sleeve lobectomy ................................................. Completion pneumonectomy ............................... Lung volume reduction ......................................... Partial removal of lung ......................................... Repair bronchus add-on ...................................... Resect apical lung tumor ..................................... Resect apical lung tum/chest ............................... Removal of lung lesion ........................................ Thoracoscopy, diagnostic .................................... Thoracoscopy, diagnostic .................................... Thoracoscopy, diagnostic .................................... Thoracoscopy, diagnostic .................................... Thoracoscopy, diagnostic .................................... Thoracoscopy, diagnostic .................................... Thoracoscopy, surgical ........................................ Thoracoscopy, surgical ........................................ Description 10.06 16.08 25.15 14.27 15.33 16.54 27.10 16.70 16.82 13.02 18.48 3.99 12.93 26.41 16.63 15.16 27.04 1.76 8.89 1.93 2.18 27.17 56.37 63.60 25.71 27.28 25.30 42.80 42.83 25.09 24.48 4.68 31.61 36.41 30.22 5.45 5.95 7.80 8.77 6.92 8.39 10.77 18.70 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA 18.73 NA NA NA NA NA 2.01 NA 0.55 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA 20.21 NA NA NA NA NA 2.09 NA 0.64 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 5.19 7.06 9.99 6.88 7.05 7.44 10.34 7.50 8.75 5.86 8.77 1.13 6.39 12.07 7.51 6.94 11.58 0.48 4.78 0.55 0.61 11.08 18.56 23.01 10.34 11.17 9.64 15.21 15.69 10.65 10.39 1.37 12.26 13.69 12.20 2.10 2.24 2.98 3.06 2.55 3.01 5.29 7.75 Fully Implemented Facility PE RVUs 5.32 7.63 10.55 7.02 7.17 7.62 8.25 7.58 8.19 5.41 8.65 1.26 6.77 12.73 7.62 7.28 12.01 0.53 5.03 0.61 0.66 12.44 15.71 16.30 11.63 12.48 10.95 13.73 14.26 12.13 11.86 1.50 14.37 15.93 10.27 2.29 2.45 3.02 3.35 2.81 3.25 6.39 7.36 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 32095 32100 32110 32120 32124 32140 32141 32150 32151 32160 32200 32201 32215 32220 32225 32310 32320 32400 32402 32405 32420 32440 32442 32445 32480 32482 32484 32486 32488 32491 32500 32501 32503 32504 32540 32601 32602 32603 32604 32605 32606 32650 32651 HCPCS 2 CPT 1/ 1.22 2.24 3.22 1.63 1.90 1.97 2.01 2.01 2.04 1.31 2.14 0.24 1.69 3.57 2.07 2.00 3.52 0.10 1.07 0.11 0.12 3.69 3.85 3.72 3.50 3.67 3.04 3.52 3.81 2.99 3.26 0.65 4.38 5.09 2.08 0.80 0.87 1.14 1.25 1.00 1.22 1.58 1.87 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA 22.96 NA NA NA NA NA 3.87 NA 2.59 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA 24.44 NA NA NA NA NA 3.95 NA 2.68 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 16.47 25.38 38.36 22.78 24.28 25.95 39.45 26.21 27.61 20.19 29.39 5.36 21.01 42.05 26.21 24.10 42.14 2.34 14.74 2.59 2.91 41.94 78.78 90.33 39.55 42.12 37.98 61.53 62.33 38.73 38.13 6.70 48.25 55.19 44.50 8.35 9.06 11.92 13.08 10.47 12.62 17.64 28.32 Fully Implemented Facility Total 16.60 25.95 38.92 22.92 24.40 26.13 37.36 26.29 27.05 19.74 29.27 5.49 21.39 42.71 26.32 24.44 42.57 2.39 14.99 2.65 2.96 43.30 75.93 83.62 40.84 43.43 39.29 60.05 60.90 40.21 39.60 6.83 50.36 57.43 42.57 8.54 9.27 11.96 13.37 10.73 12.86 18.74 27.93 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 000 090 090 090 090 090 000 090 000 000 090 090 090 090 090 090 090 090 090 090 ZZZ 090 090 090 000 000 000 000 000 000 090 090 Global 69844 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00223 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A X A A A A C C A A A A A A A C A A A A A A A A A A Status Thoracoscopy, surgical ........................................ Thoracoscopy, surgical ........................................ Thoracoscopy, surgical ........................................ Thoracoscopy, surgical ........................................ Thoracoscopy, surgical ........................................ Thoracoscopy, surgical ........................................ Thoracoscopy, surgical ........................................ Thoracoscopy, surgical ........................................ Thoracoscopy, surgical ........................................ Thoracoscopy, surgical ........................................ Thoracoscopy, surgical ........................................ Thoracoscopy, surgical ........................................ Thoracoscopy, surgical ........................................ Thoracoscopy, surgical ........................................ Repair lung hernia ................................................ Close chest after drainage ................................... Close bronchial fistula .......................................... Reconstruct injured chest .................................... Donor pneumonectomy ........................................ Lung transplant, single ......................................... Lung transplant with bypass ................................ Lung transplant, double ....................................... Lung transplant with bypass ................................ Prepare donor lung, single ................................... Prepare donor lung, double ................................. Removal of rib(s) .................................................. Revise & repair chest wall ................................... Revise & repair chest wall ................................... Revision of lung ................................................... Therapeutic pneumothorax .................................. Total lung lavage .................................................. Perq rf ablate tx, pul tumor .................................. Chest surgery procedure ..................................... Drainage of heart sac .......................................... Repeat drainage of heart sac .............................. Incision of heart sac ............................................. Incision of heart sac ............................................. Incision of heart sac ............................................. Partial removal of heart sac ................................. Partial removal of heart sac ................................. Removal of heart sac lesion ................................ Removal of heart lesion ....................................... Removal of heart lesion ....................................... Description 29.00 18.09 20.44 16.09 13.18 12.85 11.65 11.86 17.69 13.27 14.91 24.56 14.22 21.45 15.59 14.83 49.79 22.33 0.00 40.94 44.65 50.11 53.88 0.00 0.00 23.69 23.17 29.18 21.22 1.84 7.31 5.68 0.00 2.24 2.24 8.44 14.87 13.65 22.27 25.30 16.85 27.33 24.05 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA 0.00 0.00 NA NA NA NA 1.53 NA 68.64 0.00 NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA 0.00 0.00 NA NA NA NA 1.68 NA 68.64 0.00 NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 11.23 7.47 7.98 7.03 6.01 6.07 5.61 5.93 7.47 6.20 6.71 9.47 6.40 8.65 7.10 7.10 18.95 11.82 0.00 20.90 23.73 23.29 26.52 0.00 0.00 9.79 9.62 11.32 8.62 0.63 1.87 1.77 0.00 1.04 1.11 5.05 6.51 5.96 9.22 9.93 7.58 10.75 9.45 Fully Implemented Facility PE RVUs 10.41 7.10 7.64 7.19 7.46 7.28 6.92 7.07 8.98 7.39 8.29 10.44 7.32 8.26 7.33 7.42 12.97 12.08 0.00 25.97 30.80 29.64 32.68 0.00 0.00 9.86 10.00 11.88 9.26 0.58 1.90 1.77 0.00 0.85 0.89 4.98 6.71 6.25 9.45 10.01 7.78 11.37 9.95 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 32652 32653 32654 32655 32656 32657 32658 32659 32660 32661 32662 32663 32664 32665 32800 32810 32815 32820 32850 32851 32852 32853 32854 32855 32856 32900 32905 32906 32940 32960 32997 32998 32999 33010 33011 33015 33020 33025 33030 33031 33050 33120 33130 HCPCS 2 CPT 1/ 2.73 1.89 1.63 1.90 1.90 2.00 1.70 1.62 2.09 1.93 2.18 2.73 2.33 2.16 1.99 1.94 3.28 2.53 0.00 5.58 6.02 7.07 7.22 0.00 0.00 2.94 3.16 3.98 2.89 0.16 0.55 0.36 0.00 0.14 0.15 0.65 1.80 1.81 2.84 3.14 2.15 3.70 3.01 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA 0.00 0.00 NA NA NA NA 3.53 NA 74.68 0.00 NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA 0.00 0.00 NA NA NA NA 3.68 NA 74.68 0.00 NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 42.96 27.45 30.05 25.02 21.09 20.92 18.96 19.41 27.25 21.40 23.80 36.76 22.95 32.26 24.68 23.87 72.02 36.68 0.00 67.42 74.40 80.47 87.62 0.00 0.00 36.42 35.95 44.48 32.73 2.63 9.73 7.81 0.00 3.42 3.50 14.14 23.18 21.42 34.33 38.37 26.58 41.78 36.51 Fully Implemented Facility Total 42.14 27.08 29.71 25.18 22.54 22.13 20.27 20.55 28.76 22.59 25.38 37.73 23.87 31.87 24.91 24.19 66.04 36.94 0.00 72.49 81.47 86.82 93.78 0.00 0.00 36.49 36.33 45.04 33.37 2.58 9.76 7.81 0.00 3.23 3.28 14.07 23.38 21.71 34.56 38.45 26.78 42.40 37.01 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 XXX 090 090 090 090 XXX XXX 090 090 090 090 000 000 000 YYY 000 000 090 090 090 090 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69845 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00224 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Heart revascularize (tmr) ..................................... Heart tmr w/other procedure ................................ Insert epicard eltrd, open ..................................... Insert epicard eltrd, endo ..................................... Insertion of heart pacemaker ............................... Insertion of heart pacemaker ............................... Insertion of heart pacemaker ............................... Insertion of heart electrode .................................. Insertion of heart electrode .................................. Insertion of pulse generator ................................. Insertion of pulse generator ................................. Upgrade of pacemaker system ............................ Reposition pacing-defib lead ................................ Insert lead pace-defib, one .................................. Insert lead pace-defib, dual ................................. Repair lead pace-defib, one ................................. Repair lead pace-defib, dual ................................ Revise pocket, pacemaker ................................... Revise pocket, pacing-defib ................................. Insert pacing lead & connect ............................... L ventric pacing lead add-on ............................... Reposition l ventric lead ....................................... Removal of pacemaker system ........................... Removal of pacemaker system ........................... Removal pacemaker electrode ............................ Remove electrode/thoracotomy ........................... Remove electrode/thoracotomy ........................... Remove electrode/thoracotomy ........................... Insert pulse generator .......................................... Remove pulse generator ...................................... Remove eltrd/thoracotomy ................................... Remove eltrd, transven ........................................ Eltrd/insert pace-defib .......................................... Ablate heart dysrhythm focus .............................. Ablate heart dysrhythm focus .............................. Ablate atria, lmtd .................................................. Ablate atria w/o bypass, ext ................................. Ablate atria w/bypass, exten ................................ Ablate heart dysrhythm focus .............................. Ablate atria w/bypass, endo ................................. Ablate atria w/o bypass endo .............................. Implant pat-active ht record ................................. Remove pat-active ht record ................................ Description 28.26 2.54 13.15 13.92 7.31 9.05 8.12 3.30 3.39 5.51 6.36 7.78 4.89 5.81 5.78 5.97 6.05 5.01 6.49 9.04 8.33 8.68 3.33 7.85 9.93 12.64 13.75 15.28 7.61 3.26 23.42 13.84 15.02 25.78 28.80 23.58 28.91 34.77 28.80 23.58 32.91 4.70 3.04 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 10.65 0.80 6.22 6.29 5.19 5.83 5.47 1.73 1.69 3.77 4.30 5.44 3.55 4.63 4.54 4.87 4.94 4.37 5.02 5.10 4.53 4.94 3.33 5.58 7.41 6.67 7.70 8.33 5.41 3.07 11.02 9.66 10.47 10.12 11.09 9.94 11.57 13.37 11.30 9.94 12.80 4.33 3.42 Fully Implemented Facility PE RVUs 10.82 1.39 6.22 6.29 4.64 4.95 4.95 1.37 1.41 3.46 3.87 5.03 3.27 4.31 4.31 4.44 4.44 4.31 4.70 4.28 3.57 4.10 3.29 5.08 6.96 7.24 7.76 8.23 4.79 2.99 11.35 9.08 8.89 10.80 11.52 9.94 11.57 13.37 11.65 9.94 12.80 4.10 3.50 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 33140 33141 33202 33203 33206 33207 33208 33210 33211 33212 33213 33214 33215 33216 33217 33218 33220 33222 33223 33224 33225 33226 33233 33234 33235 33236 33237 33238 33240 33241 33243 33244 33249 33250 33251 33254 33255 33256 33261 33265 33266 33282 33284 HCPCS 2 CPT 1/ 2.86 0.69 1.71 1.39 0.52 0.59 0.56 0.18 0.21 0.43 0.45 0.58 0.37 0.36 0.39 0.37 0.37 0.42 0.45 0.54 0.45 0.59 0.22 0.56 0.73 1.69 1.59 2.03 0.41 0.18 2.10 0.99 0.77 3.19 3.60 3.35 3.94 4.95 3.46 3.35 4.80 0.23 0.14 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 41.77 4.03 21.08 21.60 13.02 15.47 14.15 5.21 5.29 9.71 11.11 13.80 8.81 10.80 10.71 11.21 11.36 9.80 11.96 14.68 13.31 14.21 6.88 13.99 18.07 21.00 23.04 25.64 13.43 6.51 36.54 24.49 26.26 39.09 43.49 36.87 44.42 53.09 43.56 36.87 50.51 9.26 6.60 Fully Implemented Facility Total 41.94 4.62 21.08 21.60 12.47 14.59 13.63 4.85 5.01 9.40 10.68 13.39 8.53 10.48 10.48 10.78 10.86 9.74 11.64 13.86 12.35 13.37 6.84 13.49 17.62 21.57 23.10 25.54 12.81 6.43 36.87 23.91 24.68 39.77 43.92 36.87 44.42 53.09 43.91 36.87 50.51 9.03 6.68 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 ZZZ 090 090 090 090 090 000 000 090 090 090 090 090 090 090 090 090 090 000 ZZZ 000 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 Global 69846 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00225 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Repair of heart wound ......................................... Repair of heart wound ......................................... Exploratory heart surgery ..................................... Exploratory heart surgery ..................................... Repair major blood vessel(s) ............................... Repair major vessel ............................................. Repair major blood vessel(s) ............................... Insert major vessel graft ...................................... Insert major vessel graft ...................................... Insert major vessel graft ...................................... Repair of aortic valve ........................................... Valvuloplasty, open .............................................. Valvuloplasty, w/cp bypass .................................. Prepare heart-aorta conduit ................................. Replacement of aortic valve ................................ Replacement of aortic valve ................................ Replacement of aortic valve ................................ Replacement of aortic valve ................................ Replacement of aortic valve ................................ Replacement of aortic valve ................................ Repair of aortic valve ........................................... Revision, subvalvular tissue ................................. Revise ventricle muscle ....................................... Repair of aortic valve ........................................... Revision of mitral valve ........................................ Revision of mitral valve ........................................ Repair of mitral valve ........................................... Repair of mitral valve ........................................... Repair of mitral valve ........................................... Replacement of mitral valve ................................ Revision of tricuspid valve ................................... Valvuloplasty, tricuspid ......................................... Valvuloplasty, tricuspid ......................................... Replace tricuspid valve ........................................ Revision of tricuspid valve ................................... Revision of pulmonary valve ................................ Valvotomy, pulmonary valve ................................ Revision of pulmonary valve ................................ Revision of pulmonary valve ................................ Replacement, pulmonary valve ............................ Revision of heart chamber ................................... Revision of heart chamber ................................... Repair, prosth valve clot ...................................... Description 44.89 76.85 20.22 26.05 18.46 20.71 24.30 25.17 24.46 33.79 41.37 24.41 25.39 31.25 41.19 52.55 46.28 61.94 43.77 59.74 39.29 37.19 36.43 29.17 25.67 29.61 49.83 43.15 44.70 50.75 44.62 56.95 44.49 50.59 32.82 21.32 22.83 22.90 39.27 42.27 26.41 27.38 29.71 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 15.61 25.20 8.80 10.42 8.71 10.31 9.79 9.75 9.59 12.95 15.16 9.76 10.48 12.22 15.43 18.77 16.89 21.53 16.49 20.57 15.21 12.96 13.59 12.10 8.98 12.45 17.90 16.03 16.02 18.97 15.50 19.76 16.23 17.77 15.37 8.70 7.69 7.21 17.24 15.72 11.43 10.98 11.47 Fully Implemented Facility PE RVUs 10.83 14.26 9.39 10.77 8.34 9.91 10.22 10.13 10.28 13.24 15.54 12.57 13.35 13.96 17.58 19.03 16.66 19.44 19.42 20.75 14.40 12.26 13.52 13.23 9.42 13.35 14.26 16.86 18.53 17.71 12.35 14.62 14.20 14.16 14.08 10.19 9.24 10.70 12.47 15.46 11.83 12.53 12.42 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 33300 33305 33310 33315 33320 33321 33322 33330 33332 33335 33400 33401 33403 33404 33405 33406 33410 33411 33412 33413 33414 33415 33416 33417 33420 33422 33425 33426 33427 33430 33460 33463 33464 33465 33468 33470 33471 33472 33474 33475 33476 33478 33496 HCPCS 2 CPT 1/ 2.66 3.13 2.59 3.28 2.08 2.91 2.86 2.82 3.03 4.28 4.11 3.57 3.55 4.33 5.33 5.45 4.69 5.48 6.39 6.53 4.57 4.14 4.57 4.10 1.82 3.94 4.07 5.03 6.09 5.10 3.45 3.87 4.15 4.39 4.07 1.03 3.39 3.55 3.22 4.93 2.42 3.89 4.13 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 63.16 105.18 31.61 39.75 29.25 33.93 36.95 37.74 37.08 51.02 60.64 37.74 39.42 47.80 61.95 76.77 67.86 88.95 66.65 86.84 59.07 54.29 54.59 45.37 36.47 46.00 71.80 64.21 66.81 74.82 63.57 80.58 64.87 72.75 52.26 31.05 33.91 33.66 59.73 62.92 40.26 42.25 45.31 Fully Implemented Facility Total 58.38 94.24 32.20 40.10 28.88 33.53 37.38 38.12 37.77 51.31 61.02 40.55 42.29 49.54 64.10 77.03 67.63 86.86 69.58 87.02 58.26 53.59 54.52 46.50 36.91 46.90 68.16 65.04 69.32 73.56 60.42 75.44 62.84 69.14 50.97 32.54 35.46 37.15 54.96 62.66 40.66 43.80 46.26 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69847 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00226 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Repair heart vessel fistula ................................... Repair heart vessel fistula ................................... Coronary artery correction ................................... Coronary artery graft ............................................ Coronary artery graft ............................................ Repair artery w/tunnel .......................................... Repair artery, translocation .................................. Repair art, intramural ........................................... Endoscopic vein harvest ...................................... CABG, vein, single ............................................... CABG, vein, two ................................................... CABG, vein, three ................................................ CABG, vein, four .................................................. CABG, vein, five ................................................... Cabg, vein, six or more ........................................ CABG, artery-vein, single .................................... CABG, artery-vein, two ........................................ CABG, artery-vein, three ...................................... CABG, artery-vein, four ........................................ CABG, artery-vein, five ........................................ Cabg, art-vein, six or more .................................. Coronary artery, bypass/reop .............................. CABG, arterial, single .......................................... CABG, arterial, two .............................................. CABG, arterial, three ............................................ Cabg, arterial, four or more ................................. Removal of heart lesion ....................................... Repair of heart damage ....................................... Restore/remodel, ventricle ................................... Open coronary endarterectomy ........................... Closure of valve ................................................... Closure of valve ................................................... Anastomosis/artery-aorta ..................................... Repair anomaly w/conduit .................................... Repair by enlargement ......................................... Repair double ventricle ........................................ Repair double ventricle ........................................ Repair, modified fontan ........................................ Repair single ventricle .......................................... Repair single ventricle .......................................... Repair heart septum defect ................................. Revision of heart veins ........................................ Repair heart septum defects ................................ Description 27.82 19.43 21.69 22.29 25.30 38.35 37.80 31.35 0.31 34.87 38.34 43.87 45.26 47.97 49.65 3.61 7.93 10.49 12.59 14.14 16.08 10.13 33.64 39.77 44.64 48.32 48.08 56.93 53.96 4.44 30.15 29.18 31.37 31.72 31.24 35.49 36.49 35.76 38.96 48.60 29.50 27.98 29.37 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 11.05 8.27 9.27 10.66 10.14 12.28 15.56 11.76 0.10 13.19 14.46 16.24 16.82 17.64 18.57 1.11 2.43 3.21 3.88 4.32 4.96 3.10 12.81 14.98 16.61 17.55 17.51 20.52 20.04 1.34 12.45 13.60 12.10 13.40 11.28 12.57 12.91 12.53 16.41 18.25 11.02 10.98 12.30 Fully Implemented Facility PE RVUs 11.36 8.28 10.62 9.96 11.39 12.75 14.81 13.17 0.10 15.55 16.42 17.26 17.54 17.95 18.74 0.91 1.79 2.54 3.27 3.94 4.64 2.21 15.55 17.03 17.75 18.11 14.12 16.85 19.48 1.42 12.50 12.73 13.28 13.93 13.02 13.74 14.59 12.99 16.10 20.16 9.93 11.57 13.40 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 33500 33501 33502 33503 33504 33505 33506 33507 33508 33510 33511 33512 33513 33514 33516 33517 33518 33519 33521 33522 33523 33530 33533 33534 33535 33536 33542 33545 33548 33572 33600 33602 33606 33608 33610 33611 33612 33615 33617 33619 33641 33645 33647 HCPCS 2 CPT 1/ 3.87 1.91 3.00 1.78 3.36 2.19 4.66 4.06 0.04 4.41 4.56 4.67 4.88 4.77 5.13 0.39 0.73 1.04 1.37 1.78 2.13 0.88 4.56 4.70 5.03 5.44 4.38 5.21 5.53 0.65 4.42 3.82 4.41 4.74 4.56 4.37 5.30 4.32 5.66 6.46 3.23 3.79 3.32 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 42.74 29.61 33.96 34.73 38.80 52.82 58.02 47.17 0.45 52.47 57.36 64.78 66.96 70.38 73.35 5.11 11.09 14.74 17.84 20.24 23.17 14.11 51.01 59.45 66.28 71.31 69.97 82.66 79.53 6.43 47.02 46.60 47.88 49.86 47.08 52.43 54.70 52.61 61.03 73.31 43.75 42.75 44.99 Fully Implemented Facility Total 43.05 29.62 35.31 34.03 40.05 53.29 57.27 48.58 0.45 54.83 59.32 65.80 67.68 70.69 73.52 4.91 10.45 14.07 17.23 19.86 22.85 13.22 53.75 61.50 67.42 71.87 66.58 78.99 78.97 6.51 47.07 45.73 49.06 50.39 48.82 53.60 56.38 53.07 60.72 75.22 42.66 43.34 46.09 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 ZZZ 090 090 090 090 090 090 ZZZ ZZZ ZZZ ZZZ ZZZ ZZZ ZZZ 090 090 090 090 090 090 090 ZZZ 090 090 090 090 090 090 090 090 090 090 090 090 090 Global 69848 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00227 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Repair of heart defects ........................................ Repair of heart defects ........................................ Repair of heart chambers .................................... Close mult vsd ..................................................... Close mult vsd w/resection .................................. Cl mult vsd w/rem pul band ................................. Repair heart septum defect ................................. Repair heart septum defect ................................. Repair heart septum defect ................................. Reinforce pulmonary artery .................................. Repair of heart defects ........................................ Repair of heart defects ........................................ Repair of heart defects ........................................ Repair of heart defects ........................................ Repair of heart defects ........................................ Repair of heart defect .......................................... Repair of heart defect .......................................... Repair venous anomaly ....................................... Repair pul venous stenosis .................................. Repair heart-vein defect(s) .................................. Repair heart-vein defect ....................................... Revision of heart chamber ................................... Revision of heart chamber ................................... Revision of heart chamber ................................... Major vessel shunt ............................................... Major vessel shunt ............................................... Major vessel shunt ............................................... Major vessel shunt & graft ................................... Major vessel shunt ............................................... Major vessel shunt ............................................... Cavopulmonary shunting ..................................... Repair great vessels defect ................................. Repair great vessels defect ................................. Repair great vessels defect ................................. Repair great vessels defect ................................. Repair great vessels defect ................................. Repair great vessels defect ................................. Repair great vessels defect ................................. Repair great vessels defect ................................. Repair great vessels defect ................................. Repair great vessels defect ................................. Repair arterial trunk ............................................. Revision of pulmonary artery ............................... Description 31.75 34.77 36.58 35.87 36.87 38.37 32.16 34.29 34.67 20.20 31.38 35.49 37.49 27.11 30.28 27.13 29.05 27.55 37.04 36.01 28.80 22.04 24.16 22.34 22.06 22.44 22.44 22.44 23.41 25.14 8.00 39.02 40.58 31.54 32.83 34.53 33.95 42.62 43.15 43.85 43.16 41.74 27.26 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 11.45 12.42 12.25 17.82 18.17 18.82 13.24 19.66 9.41 8.60 9.20 10.06 21.95 11.46 11.65 11.13 8.66 10.56 13.46 13.29 14.82 9.45 10.74 7.53 11.40 7.78 7.13 9.22 8.53 9.42 2.21 10.56 10.55 12.38 10.10 13.32 9.93 15.19 11.37 11.68 14.16 11.42 9.70 Fully Implemented Facility PE RVUs 12.97 13.48 12.94 17.82 18.17 18.82 14.32 15.13 10.21 9.77 12.74 13.18 16.64 12.29 13.38 11.99 12.55 10.56 13.46 13.91 13.74 9.08 11.57 10.08 10.51 8.55 9.40 9.97 10.89 11.15 2.55 13.65 11.92 14.09 13.77 15.18 14.19 16.47 14.37 17.23 13.54 15.39 11.39 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 33660 33665 33670 33675 33676 33677 33681 33684 33688 33690 33692 33694 33697 33702 33710 33720 33722 33724 33726 33730 33732 33735 33736 33737 33750 33755 33762 33764 33766 33767 33768 33770 33771 33774 33775 33776 33777 33778 33779 33780 33781 33786 33788 HCPCS 2 CPT 1/ 4.49 4.00 4.65 4.95 5.44 5.68 4.45 3.39 4.73 1.97 4.58 5.28 4.09 3.68 4.43 3.84 1.30 4.00 5.03 5.03 3.68 1.92 3.09 3.25 1.16 3.26 3.14 3.01 3.70 3.82 1.19 5.74 5.68 4.81 4.99 5.09 5.49 6.20 2.92 3.68 5.97 5.71 4.03 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 47.69 51.19 53.48 58.64 60.48 62.87 49.85 57.34 48.81 30.77 45.16 50.83 63.53 42.25 46.36 42.10 39.01 42.11 55.53 54.33 47.30 33.41 37.99 33.12 34.62 33.48 32.71 34.67 35.64 38.38 11.40 55.32 56.81 48.73 47.92 52.94 49.37 64.01 57.44 59.21 63.29 58.87 40.99 Fully Implemented Facility Total 49.21 52.25 54.17 58.64 60.48 62.87 50.93 52.81 49.61 31.94 48.70 53.95 58.22 43.08 48.09 42.96 42.90 42.11 55.53 54.95 46.22 33.04 38.82 35.67 33.73 34.25 34.98 35.42 38.00 40.11 11.74 58.41 58.18 50.44 51.59 54.80 53.63 65.29 60.44 64.76 62.67 62.84 42.68 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 ZZZ 090 090 090 090 090 090 090 090 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69849 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00228 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A X C R X C R A A Status Aortic suspension ................................................. Repair vessel defect ............................................ Repair vessel defect ............................................ Repair septal defect ............................................. Repair septal defect ............................................. Revise major vessel ............................................. Revise major vessel ............................................. Revise major vessel ............................................. Remove aorta constriction ................................... Remove aorta constriction ................................... Remove aorta constriction ................................... Repair septal defect ............................................. Repair septal defect ............................................. Ascending aortic graft .......................................... Ascending aortic graft .......................................... Ascending aortic graft .......................................... Transverse aortic arch graft ................................. Thoracic aortic graft ............................................. Thoracoabdominal graft ....................................... Endovasc taa repr incl subcl ................................ Endovasc taa repr w/o subcl ............................... Insert endovasc prosth, taa ................................. Endovasc prosth, taa, add-on .............................. Endovasc prosth, delayed .................................... Artery transpose/endovas taa .............................. Car-car bp grft/endovas taa ................................. Remove lung artery emboli .................................. Remove lung artery emboli .................................. Surgery of great vessel ........................................ Repair pulmonary artery ...................................... Repair pulmonary atresia ..................................... Transect pulmonary artery ................................... Remove pulmonary shunt .................................... Rpr pul art unifocal w/o cpb ................................. Repr pul art, unifocal w/cpb ................................. Removal of donor heart/lung ............................... Prepare donor heart/lung ..................................... Transplantation, heart/lung .................................. Removal of donor heart ....................................... Prepare donor heart ............................................. Transplantation of heart ....................................... External circulation assist .................................... External circulation assist .................................... Description 17.23 18.24 20.18 21.23 26.41 16.61 17.63 20.10 21.21 22.77 21.85 24.28 32.35 59.33 43.94 58.71 45.93 35.68 68.85 34.48 29.48 20.99 8.20 17.99 15.92 20.00 29.59 24.83 28.30 25.14 32.58 24.09 5.49 31.25 44.68 0.00 0.00 61.68 0.00 0.00 89.08 19.33 10.91 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 0.00 NA 0.00 0.00 NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 0.00 NA 0.00 0.00 NA NA NA Year 2007 Transitional Non-Facility PE RVUs 7.30 7.53 7.93 8.96 10.44 8.41 5.93 8.57 8.95 9.57 9.12 9.85 13.00 20.58 16.07 19.98 16.64 13.12 21.75 10.50 9.27 6.95 2.00 6.20 4.15 6.30 11.28 9.41 10.87 10.38 11.32 11.47 2.14 10.16 14.32 0.00 0.00 23.24 0.00 0.00 30.80 5.63 2.95 Fully Implemented Facility PE RVUs 7.91 8.80 9.30 10.42 12.09 8.37 8.20 9.63 9.96 10.91 10.29 10.98 14.37 17.48 17.30 19.01 17.95 13.85 17.67 12.73 11.29 8.62 2.43 7.72 4.92 6.80 11.39 9.58 11.22 11.73 13.20 11.04 1.92 13.54 16.84 0.00 0.00 27.39 0.00 0.00 23.74 5.09 3.45 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 33800 33802 33803 33813 33814 33820 33822 33824 33840 33845 33851 33852 33853 33860 33861 33863 33870 33875 33877 33880 33881 33883 33884 33886 33889 33891 33910 33915 33916 33917 33920 33922 33924 33925 33926 33930 33933 33935 33940 33944 33945 33960 33961 HCPCS 2 CPT 1/ 2.46 2.27 3.20 3.13 3.85 2.35 2.68 2.89 2.16 3.22 3.18 2.16 4.48 5.76 6.37 6.59 6.62 4.89 5.94 2.75 2.33 2.11 0.86 1.80 2.18 2.73 3.70 1.44 3.67 3.70 4.38 3.10 0.82 4.61 6.22 0.00 0.00 9.06 0.00 0.00 6.26 2.67 0.88 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 0.00 NA 0.00 0.00 NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 0.00 NA 0.00 0.00 NA NA NA Year 2007 Transitional Non-Facility Total 26.99 28.04 31.31 33.32 40.70 27.37 26.24 31.56 32.32 35.56 34.15 36.29 49.83 85.67 66.38 85.28 69.19 53.69 96.54 47.73 41.08 30.05 11.06 25.99 22.25 29.03 44.57 35.68 42.84 39.22 48.28 38.66 8.45 46.02 65.22 0.00 0.00 93.98 0.00 0.00 126.14 27.63 14.74 Fully Implemented Facility Total 27.60 29.31 32.68 34.78 42.35 27.33 28.51 32.62 33.33 36.90 35.32 37.42 51.20 82.57 67.61 84.31 70.50 54.42 92.46 49.96 43.10 31.72 11.49 27.51 23.02 29.53 44.68 35.85 43.19 40.57 50.16 38.23 8.23 49.40 67.74 0.00 0.00 98.13 0.00 0.00 119.08 27.09 15.24 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 ZZZ 090 000 000 090 090 090 090 090 090 ZZZ 090 090 XXX XXX 090 XXX XXX 090 000 ZZZ Global 69850 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00229 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A C A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Insert ia percut device .......................................... Remove aortic assist device ................................ Aortic circulation assist ........................................ Aortic circulation assist ........................................ Insert balloon device ............................................ Remove intra-aortic balloon ................................. Implant ventricular device .................................... Implant ventricular device .................................... Remove ventricular device ................................... Remove ventricular device ................................... Insert intracorporeal device .................................. Remove intracorporeal device ............................. Cardiac surgery procedure .................................. Removal of artery clot .......................................... Removal of artery clot .......................................... Removal of artery clot .......................................... Removal of arm artery clot .................................. Removal of artery clot .......................................... Removal of artery clot .......................................... Removal of leg artery clot .................................... Removal of vein clot ............................................ Removal of vein clot ............................................ Removal of vein clot ............................................ Removal of vein clot ............................................ Removal of vein clot ............................................ Repair valve, femoral vein ................................... Reconstruct vena cava ........................................ Transposition of vein valve .................................. Cross-over vein graft ............................................ Leg vein fusion ..................................................... Endovas aaa repr w/sm tube ............................... Endovas aaa repr w/2-p part ............................... Endovas aaa repr w/3-p part ............................... Endovas aaa repr w/1-p part ............................... Endovas aaa repr w/long tube ............................. Endovas iliac a device addon .............................. Xpose for endoprosth, femorl .............................. Femoral endovas graft add-on ............................. Xpose for endoprosth, iliac .................................. Endovasc extend prosth, init ................................ Endovasc exten prosth, add"l ............................ Open aortic tube prosth repr ................................ Open aortoiliac prosth repr .................................. Description 4.84 0.64 6.74 11.91 9.75 14.93 20.97 22.97 20.07 22.51 45.93 64.86 0.00 17.78 16.91 10.85 10.85 26.41 19.38 17.73 26.41 13.29 28.41 21.00 10.83 16.74 27.86 19.80 19.05 17.77 21.46 23.71 24.74 23.71 22.59 4.12 6.74 4.79 9.74 12.72 4.12 35.10 37.85 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 2.48 0.27 2.56 6.08 3.92 7.81 6.64 7.92 9.36 10.47 14.39 24.94 0.00 6.62 6.89 4.40 4.47 8.81 6.77 6.52 9.58 5.22 9.66 7.66 4.45 6.91 10.76 7.24 9.25 7.87 7.39 8.18 8.09 8.06 7.23 1.10 1.72 1.20 2.46 5.12 1.14 10.77 12.09 Fully Implemented Facility PE RVUs 2.00 0.24 2.35 6.02 3.46 7.86 6.37 7.64 10.64 11.43 14.79 25.17 0.00 6.69 7.56 5.11 5.13 10.00 5.75 7.68 10.39 6.02 11.00 5.89 5.18 8.10 11.91 8.87 8.65 8.43 8.72 9.38 9.68 9.37 9.04 1.30 2.10 1.48 3.04 5.89 1.31 12.96 11.82 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 33967 33968 33970 33971 33973 33974 33975 33976 33977 33978 33979 33980 33999 34001 34051 34101 34111 34151 34201 34203 34401 34421 34451 34471 34490 34501 34502 34510 34520 34530 34800 34802 34803 34804 34805 34808 34812 34813 34820 34825 34826 34830 34831 HCPCS 2 CPT 1/ 0.35 0.07 0.82 1.25 1.26 1.74 3.07 3.26 2.81 3.31 6.97 8.59 0.00 1.85 2.21 1.41 1.40 3.56 1.45 2.36 3.10 1.55 3.84 1.18 1.41 2.35 3.63 2.33 2.29 1.74 2.46 2.33 2.01 2.30 2.01 0.59 1.18 0.67 1.50 1.28 0.44 4.55 4.89 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 7.67 0.98 10.12 19.24 14.93 24.48 30.68 34.15 32.24 36.29 67.29 98.39 0.00 26.25 26.01 16.66 16.72 38.78 27.60 26.61 39.09 20.06 41.91 29.84 16.69 26.00 42.25 29.37 30.59 27.38 31.31 34.22 34.84 34.07 31.83 5.81 9.64 6.66 13.70 19.12 5.70 50.42 54.83 Fully Implemented Facility Total 7.19 0.95 9.91 19.18 14.47 24.53 30.41 33.87 33.52 37.25 67.69 98.62 0.00 26.32 26.68 17.37 17.38 39.97 26.58 27.77 39.90 20.86 43.25 28.07 17.42 27.19 43.40 31.00 29.99 27.94 32.64 35.42 36.43 35.38 33.64 6.01 10.02 6.94 14.28 19.89 5.87 52.61 54.56 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 000 000 000 090 000 090 XXX XXX 090 090 XXX 090 YYY 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 ZZZ 000 ZZZ 000 090 ZZZ 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69851 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00230 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Open aortofemor prosth repr ............................... Xpose for endoprosth, iliac .................................. Xpose, endoprosth, brachial ................................ Endovasc iliac repr w/graft ................................... Repair defect of artery ......................................... Repair artery rupture, neck .................................. Repair defect of artery ......................................... Repair defect of artery ......................................... Repair artery rupture, arm ................................... Repair defect of artery ......................................... Repair artery rupture, chest ................................. Repair defect of arm artery .................................. Repair defect of artery ......................................... Repair artery rupture, aorta ................................. Repair defect of artery ......................................... Repair artery rupture, aorta ................................. Repair defect of artery ......................................... Repair artery rupture, groin .................................. Repair defect of artery ......................................... Repair artery rupture,spleen ................................ Repair defect of artery ......................................... Repair artery rupture, belly .................................. Repair defect of artery ......................................... Repair artery rupture, groin .................................. Repair defect of artery ......................................... Repair artery rupture, thigh .................................. Repair defect of artery ......................................... Repair artery rupture, knee .................................. Repair blood vessel lesion ................................... Repair blood vessel lesion ................................... Repair blood vessel lesion ................................... Repair blood vessel lesion ................................... Repair blood vessel lesion ................................... Repair blood vessel lesion ................................... Repair blood vessel lesion ................................... Repair blood vessel lesion ................................... Repair blood vessel lesion ................................... Repair blood vessel lesion ................................... Repair blood vessel lesion ................................... Repair blood vessel lesion ................................... Repair blood vessel lesion ................................... Repair blood vessel lesion ................................... Repair blood vessel lesion ................................... Description 37.85 11.98 5.34 16.77 20.70 22.12 19.18 18.50 23.10 22.09 25.62 17.94 33.37 41.93 35.35 50.81 36.37 43.49 26.17 32.44 31.41 37.76 26.29 32.44 20.83 25.03 23.61 27.53 15.01 31.58 18.72 15.05 29.85 13.33 16.84 13.76 10.85 24.50 36.47 26.54 15.22 21.08 17.94 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 11.60 3.29 1.60 6.22 7.62 7.80 7.55 6.40 7.93 8.67 9.46 6.53 11.05 13.12 10.39 15.02 11.62 13.25 8.58 10.48 10.47 12.07 8.89 10.27 7.11 8.41 7.91 9.06 5.75 11.75 6.91 6.23 10.10 5.31 6.44 5.40 6.72 10.09 13.87 8.54 5.89 7.73 6.50 Fully Implemented Facility PE RVUs 13.87 4.15 2.04 7.24 9.07 9.22 8.52 7.59 9.24 9.23 9.75 7.26 11.36 14.75 12.77 16.98 12.17 15.19 9.99 11.59 11.89 13.37 10.28 11.85 8.46 9.87 9.46 10.79 6.64 12.53 7.95 7.28 11.49 6.18 7.60 6.26 7.19 10.48 10.20 9.58 7.05 9.25 7.54 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 34832 34833 34834 34900 35001 35002 35005 35011 35013 35021 35022 35045 35081 35082 35091 35092 35102 35103 35111 35112 35121 35122 35131 35132 35141 35142 35151 35152 35180 35182 35184 35188 35189 35190 35201 35206 35207 35211 35216 35221 35226 35231 35236 HCPCS 2 CPT 1/ 4.85 1.70 0.76 2.00 2.81 3.00 1.77 2.55 3.10 2.87 3.17 2.45 4.01 5.44 5.14 6.40 4.48 5.76 3.47 4.08 4.30 4.75 3.80 4.30 2.90 3.36 3.24 3.61 1.00 4.36 2.53 2.16 4.01 1.80 2.34 1.87 1.48 3.20 2.65 3.37 2.02 2.89 2.43 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 54.30 16.97 7.70 24.99 31.13 32.92 28.50 27.45 34.13 33.63 38.25 26.92 48.43 60.49 50.88 72.23 52.47 62.50 38.22 47.00 46.18 54.58 38.98 47.01 30.84 36.80 34.76 40.20 21.76 47.69 28.16 23.44 43.96 20.44 25.62 21.03 19.05 37.79 52.99 38.45 23.13 31.70 26.87 Fully Implemented Facility Total 56.57 17.83 8.14 26.01 32.58 34.34 29.47 28.64 35.44 34.19 38.54 27.65 48.74 62.12 53.26 74.19 53.02 64.44 39.63 48.11 47.60 55.88 40.37 48.59 32.19 38.26 36.31 41.93 22.65 48.47 29.20 24.49 45.35 21.31 26.78 21.89 19.52 38.18 49.32 39.49 24.29 33.22 27.91 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 000 000 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 Global 69852 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00231 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A R A A Status Repair blood vessel lesion ................................... Repair blood vessel lesion ................................... Repair blood vessel lesion ................................... Repair blood vessel lesion ................................... Repair blood vessel lesion ................................... Repair blood vessel lesion ................................... Repair blood vessel lesion ................................... Repair blood vessel lesion ................................... Repair blood vessel lesion ................................... Repair blood vessel lesion ................................... Rechanneling of artery ......................................... Rechanneling of artery ......................................... Rechanneling of artery ......................................... Rechanneling of artery ......................................... Rechanneling of artery ......................................... Rechanneling of artery ......................................... Rechanneling of artery ......................................... Rechanneling of artery ......................................... Rechanneling of artery ......................................... Rechanneling of artery ......................................... Rechanneling of artery ......................................... Rechanneling of artery ......................................... Rechanneling of artery ......................................... Rechanneling of artery ......................................... Rechanneling of artery ......................................... Rechanneling of artery ......................................... Reoperation, carotid add-on ................................ Angioscopy ........................................................... Repair arterial blockage ....................................... Repair arterial blockage ....................................... Repair arterial blockage ....................................... Repair arterial blockage ....................................... Repair arterial blockage ....................................... Repair arterial blockage ....................................... Repair venous blockage ...................................... Repair arterial blockage ....................................... Repair arterial blockage ....................................... Repair arterial blockage ....................................... Repair arterial blockage ....................................... Repair arterial blockage ....................................... Repair arterial blockage ....................................... Repair venous blockage ...................................... Atherectomy, open ............................................... Description 25.50 28.15 31.83 18.98 18.88 15.75 24.50 25.72 29.93 17.06 19.53 21.27 23.52 24.52 23.52 9.25 28.52 16.51 27.61 26.10 24.53 19.78 30.11 32.22 15.23 18.50 3.19 3.00 10.05 6.90 6.03 7.34 9.48 8.62 6.03 8.62 10.05 6.90 6.03 7.35 9.48 6.03 11.06 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 60.53 65.60 47.16 46.08 59.59 47.48 35.61 NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 81.78 91.60 60.05 56.40 80.70 53.95 42.45 NA Year 2007 Transitional Non-Facility PE RVUs 9.93 12.02 9.78 6.61 7.22 5.70 9.65 9.61 9.76 6.43 6.87 7.14 7.72 7.97 7.72 2.38 9.66 5.97 9.00 8.53 7.93 6.53 9.69 10.55 5.48 6.30 0.85 0.75 3.18 2.11 1.82 2.29 2.90 2.52 1.78 3.41 4.66 2.76 2.47 2.93 3.25 1.97 3.98 Fully Implemented Facility PE RVUs 10.82 11.57 11.29 7.92 7.81 6.68 10.30 10.80 11.22 7.65 8.04 7.14 7.72 7.97 7.72 2.38 11.22 7.03 10.67 10.28 9.18 7.69 11.20 12.07 6.58 7.61 1.01 1.02 3.47 2.48 2.19 2.64 3.33 3.01 2.15 3.37 4.13 2.75 2.43 2.90 3.48 2.26 4.03 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 35241 35246 35251 35256 35261 35266 35271 35276 35281 35286 35301 35302 35303 35304 35305 35306 35311 35321 35331 35341 35351 35355 35361 35363 35371 35372 35390 35400 35450 35452 35454 35456 35458 35459 35460 35470 35471 35472 35473 35474 35475 35476 35480 HCPCS 2 CPT 1/ 3.53 3.86 4.13 2.63 2.61 2.10 3.16 3.49 3.97 2.35 2.68 2.98 3.26 3.41 3.26 1.34 3.42 2.25 3.83 3.78 3.35 2.67 4.15 4.33 2.14 2.63 0.46 0.43 1.25 0.94 0.87 1.04 1.26 1.21 0.83 0.69 0.67 0.58 0.51 0.57 0.62 0.34 1.28 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 69.84 76.32 54.64 52.62 67.51 57.58 41.98 NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 91.09 102.32 67.53 62.94 88.62 64.05 48.82 NA Year 2007 Transitional Non-Facility Total 38.96 44.03 45.74 28.22 28.71 23.55 37.31 38.82 43.66 25.84 29.08 31.39 34.50 35.90 34.50 12.97 41.60 24.73 40.44 38.41 35.81 28.98 43.95 47.10 22.85 27.43 4.50 4.18 14.48 9.95 8.72 10.67 13.64 12.35 8.64 12.72 15.38 10.24 9.01 10.85 13.35 8.34 16.32 Fully Implemented Facility Total 39.85 43.58 47.25 29.53 29.30 24.53 37.96 40.01 45.12 27.06 30.25 31.39 34.50 35.90 34.50 12.97 43.16 25.79 42.11 40.16 37.06 30.14 45.46 48.62 23.95 28.74 4.66 4.45 14.77 10.32 9.09 11.02 14.07 12.84 9.01 12.68 14.85 10.23 8.97 10.82 13.58 8.63 16.37 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 ZZZ 090 090 090 090 090 090 090 090 090 090 ZZZ ZZZ 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69853 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00232 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Atherectomy, open ............................................... Atherectomy, open ............................................... Atherectomy, open ............................................... Atherectomy, open ............................................... Atherectomy, open ............................................... Atherectomy, percutaneous ................................. Atherectomy, percutaneous ................................. Atherectomy, percutaneous ................................. Atherectomy, percutaneous ................................. Atherectomy, percutaneous ................................. Atherectomy, percutaneous ................................. Harvest vein for bypass ....................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Description 7.60 6.64 8.09 10.42 9.48 11.06 7.60 6.64 8.09 10.42 9.48 6.44 28.99 25.23 25.99 27.99 24.29 22.12 23.79 25.99 24.11 22.57 24.00 23.05 21.59 31.47 38.98 29.79 33.60 41.75 46.82 43.98 49.20 22.57 24.34 27.72 26.62 23.00 33.90 25.99 25.00 32.22 25.39 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 2.49 2.12 2.78 3.05 2.99 6.33 3.96 3.64 4.15 5.16 4.64 1.68 11.51 8.44 9.09 10.68 7.76 7.28 7.48 8.38 7.76 7.50 8.11 7.46 7.14 18.38 11.89 9.94 10.53 13.22 14.60 13.73 15.10 7.86 9.15 9.86 8.88 8.05 10.74 8.57 8.46 10.14 8.40 Fully Implemented Facility PE RVUs 2.78 2.45 2.96 3.59 3.40 5.11 3.46 3.30 3.89 4.64 4.45 1.94 9.22 9.21 9.35 9.24 9.57 8.83 9.37 9.06 7.04 8.60 9.40 9.18 8.81 13.97 13.83 11.28 12.34 13.22 14.60 13.73 15.10 9.03 10.07 11.08 9.51 9.17 12.67 10.03 9.71 11.07 10.23 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 35481 35482 35483 35484 35485 35490 35491 35492 35493 35494 35495 35500 35501 35506 35508 35509 35510 35511 35512 35515 35516 35518 35521 35522 35525 35526 35531 35533 35536 35537 35538 35539 35540 35548 35549 35551 35556 35558 35560 35563 35565 35566 35571 HCPCS 2 CPT 1/ 1.13 0.89 1.15 1.27 1.35 0.71 0.74 0.43 0.56 0.59 0.69 0.93 4.10 2.87 2.78 3.92 2.12 2.91 2.12 2.78 2.34 3.03 3.13 2.12 2.12 3.63 5.18 3.85 4.62 5.72 6.39 6.02 6.76 2.98 3.30 3.75 3.10 3.00 4.75 3.52 3.30 3.83 3.43 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 11.22 9.65 12.02 14.74 13.82 18.10 12.30 10.71 12.80 16.17 14.81 9.05 44.60 36.54 37.86 42.59 34.17 32.31 33.39 37.15 34.21 33.10 35.24 32.63 30.85 53.48 56.05 43.58 48.75 60.69 67.81 63.73 71.06 33.41 36.79 41.33 38.60 34.05 49.39 38.08 36.76 46.19 37.22 Fully Implemented Facility Total 11.51 9.98 12.20 15.28 14.23 16.88 11.80 10.37 12.54 15.65 14.62 9.31 42.31 37.31 38.12 41.15 35.98 33.86 35.28 37.83 33.49 34.20 36.53 34.35 32.52 49.07 57.99 44.92 50.56 60.69 67.81 63.73 71.06 34.58 37.71 42.55 39.23 35.17 51.32 39.54 38.01 47.12 39.05 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 000 000 000 000 000 000 000 000 000 000 000 ZZZ 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 Global 69854 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00233 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Harvest femoropopliteal vein ............................... Vein bypass graft ................................................. Vein bypass graft ................................................. Vein bypass graft ................................................. Harvest artery for cabg ........................................ Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Bypass graft, not vein .......................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Composite bypass graft ....................................... Composite bypass graft ....................................... Composite bypass graft ....................................... Bypass graft patency/patch .................................. Bypass graft/av fist patency ................................. Arterial transposition ............................................ Arterial transposition ............................................ Arterial transposition ............................................ Arterial transposition ............................................ Reimplant artery each .......................................... Reoperation, bypass graft .................................... Exploration, carotid artery .................................... Exploration, femoral artery ................................... Exploration popliteal artery .................................. Description 6.81 27.62 32.22 26.08 4.94 26.99 22.36 16.71 21.74 20.95 25.79 29.06 35.90 31.62 32.92 33.47 18.85 18.34 32.84 29.62 20.08 25.97 26.17 20.39 20.22 23.80 22.22 23.53 20.64 1.60 7.19 8.49 4.04 3.34 18.32 15.64 19.19 19.97 3.00 3.08 9.11 7.66 8.61 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 1.88 8.96 10.32 8.64 1.54 10.48 7.64 6.36 7.10 6.99 8.60 10.20 10.98 9.88 10.92 11.06 7.67 7.31 10.73 9.75 6.75 8.81 8.54 7.02 7.26 8.09 7.60 8.71 7.94 0.42 1.77 2.11 1.00 0.84 6.29 6.04 6.54 6.60 0.77 0.80 4.27 3.74 3.96 Fully Implemented Facility PE RVUs 2.15 9.85 11.74 10.75 1.60 9.09 8.67 7.50 7.85 8.25 10.02 11.53 13.12 11.69 10.92 11.06 8.43 8.03 12.51 11.27 7.96 10.24 10.12 8.21 8.51 9.50 8.98 10.16 9.01 0.50 2.23 2.64 1.26 1.06 7.87 7.30 8.09 8.06 0.96 0.97 4.93 4.26 4.49 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 35572 35583 35585 35587 35600 35601 35606 35612 35616 35621 35623 35626 35631 35636 35637 35638 35642 35645 35646 35647 35650 35651 35654 35656 35661 35663 35665 35666 35671 35681 35682 35683 35685 35686 35691 35693 35694 35695 35697 35700 35701 35721 35741 HCPCS 2 CPT 1/ 0.99 3.17 4.02 3.52 0.73 3.72 2.70 2.09 2.20 2.92 3.46 4.08 4.96 4.10 4.44 4.52 2.28 2.50 4.44 3.99 2.72 3.36 3.53 2.80 2.72 3.11 3.01 3.16 2.78 0.23 1.03 1.20 0.58 0.47 2.59 2.22 2.70 2.74 0.41 0.44 1.12 1.03 1.12 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 9.68 39.75 46.56 38.24 7.21 41.19 32.70 25.16 31.04 30.86 37.85 43.34 51.84 45.60 48.28 49.05 28.80 28.15 48.01 43.36 29.55 38.14 38.24 30.21 30.20 35.00 32.83 35.40 31.36 2.25 9.99 11.80 5.62 4.65 27.20 23.90 28.43 29.31 4.18 4.32 14.50 12.43 13.69 Fully Implemented Facility Total 9.95 40.64 47.98 40.35 7.27 39.80 33.73 26.30 31.79 32.12 39.27 44.67 53.98 47.41 48.28 49.05 29.56 28.87 49.79 44.88 30.76 39.57 39.82 31.40 31.45 36.41 34.21 36.85 32.43 2.33 10.45 12.33 5.88 4.87 28.78 25.16 29.98 30.77 4.37 4.49 15.16 12.95 14.22 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 ZZZ 090 090 090 ZZZ 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 ZZZ ZZZ ZZZ ZZZ ZZZ 090 090 090 090 ZZZ ZZZ 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69855 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00234 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C Status Exploration of artery/vein ..................................... Explore neck vessels ........................................... Explore chest vessels .......................................... Explore abdominal vessels .................................. Explore limb vessels ............................................ Repair vessel graft defect .................................... Removal of clot in graft ........................................ Removal of clot in graft ........................................ Revise graft w/vein ............................................... Revise graft w/vein ............................................... Revise graft w/nonauto graft ................................ Revise graft w/vein ............................................... Excision, graft, neck ............................................. Excision, graft, extremity ...................................... Excision, graft, thorax .......................................... Excision, graft, abdomen ..................................... Place needle in vein ............................................. Pseudoaneurysm injection trt ............................... Injection ext venography ...................................... Place catheter in vein .......................................... Place catheter in vein .......................................... Place catheter in vein .......................................... Place catheter in artery ........................................ Place catheter in artery ........................................ Place catheter in artery ........................................ Establish access to artery .................................... Establish access to artery .................................... Establish access to artery .................................... Artery to vein shunt .............................................. Establish access to aorta ..................................... Place catheter in aorta ......................................... Place catheter in artery ........................................ Place catheter in artery ........................................ Place catheter in artery ........................................ Place catheter in artery ........................................ Place catheter in artery ........................................ Place catheter in artery ........................................ Place catheter in artery ........................................ Place catheter in artery ........................................ Insertion of infusion pump .................................... Revision of infusion pump .................................... Removal of infusion pump ................................... Vessel injection procedure ................................... Description 5.84 7.99 36.81 10.87 6.72 24.39 10.64 17.74 17.28 19.22 23.07 24.57 8.26 9.44 33.39 37.14 0.18 1.96 0.95 2.43 3.14 3.51 2.52 3.02 3.51 3.02 2.01 2.01 2.01 2.52 3.02 4.67 5.27 6.29 1.01 4.67 5.27 6.29 1.01 9.82 5.55 4.05 0.00 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.46 2.12 8.25 10.77 19.01 19.49 19.05 18.12 17.56 11.13 9.04 10.28 9.84 11.52 13.27 25.27 27.05 44.27 3.61 28.42 26.82 44.34 3.10 NA NA NA 0.00 Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.54 2.68 7.80 17.17 25.62 19.09 20.78 19.62 22.14 11.84 10.29 12.15 11.87 12.99 15.70 26.59 28.57 52.65 4.72 31.17 29.18 48.22 3.81 NA NA NA 0.00 Year 2007 Transitional Non-Facility PE RVUs 3.47 3.95 13.20 4.86 3.47 8.19 4.39 6.12 6.12 6.68 8.96 9.43 4.29 4.69 10.72 11.28 0.06 0.77 0.35 0.71 0.92 1.11 0.97 0.93 0.89 1.21 0.56 0.69 0.57 0.74 0.96 1.77 1.90 2.16 0.34 2.06 1.88 2.26 0.36 4.82 3.19 2.66 0.00 Fully Implemented Facility PE RVUs 3.88 4.48 8.70 5.18 3.89 9.37 4.98 7.16 7.30 8.17 8.96 9.43 5.05 5.79 12.57 13.44 0.05 0.92 0.32 0.77 1.03 1.17 0.76 1.01 1.12 1.14 0.63 0.65 0.64 0.82 1.00 1.65 1.82 2.17 0.34 1.78 1.84 2.17 0.35 4.87 3.54 2.73 0.00 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 35761 35800 35820 35840 35860 35870 35875 35876 35879 35881 35883 35884 35901 35903 35905 35907 36000 36002 36005 36010 36011 36012 36013 36014 36015 36100 36120 36140 36145 36160 36200 36215 36216 36217 36218 36245 36246 36247 36248 36260 36261 36262 36299 HCPCS 2 CPT 1/ 0.75 0.95 1.95 1.34 0.78 3.01 1.41 2.40 2.28 2.56 3.19 3.41 1.15 1.30 4.44 4.92 0.01 0.17 0.05 0.20 0.27 0.23 0.25 0.19 0.21 0.26 0.14 0.16 0.11 0.26 0.24 0.27 0.31 0.44 0.07 0.31 0.38 0.47 0.07 1.29 0.70 0.54 0.00 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.65 4.25 9.25 13.40 22.42 23.23 21.82 21.33 21.28 14.41 11.19 12.45 11.96 14.30 16.53 30.21 32.63 51.00 4.69 33.40 32.47 51.10 4.18 NA NA NA 0.00 Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.73 4.81 8.80 19.80 29.03 22.83 23.55 22.83 25.86 15.12 12.44 14.32 13.99 15.77 18.96 31.53 34.15 59.38 5.80 36.15 34.83 54.98 4.89 NA NA NA 0.00 Year 2007 Transitional Non-Facility Total 10.06 12.89 51.96 17.07 10.97 35.59 16.44 26.26 25.68 28.46 35.22 37.41 13.70 15.43 48.55 53.34 0.25 2.90 1.35 3.34 4.33 4.85 3.74 4.14 4.61 4.49 2.71 2.86 2.69 3.52 4.22 6.71 7.48 8.89 1.42 7.04 7.53 9.02 1.44 15.93 9.44 7.25 0.00 Fully Implemented Facility Total 10.47 13.42 47.46 17.39 11.39 36.77 17.03 27.30 26.86 29.95 35.22 37.41 14.46 16.53 50.40 55.50 0.24 3.05 1.32 3.40 4.44 4.91 3.53 4.22 4.84 4.42 2.78 2.82 2.76 3.60 4.26 6.59 7.40 8.90 1.42 6.76 7.49 8.93 1.43 15.98 9.79 7.32 0.00 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 XXX 000 000 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX ZZZ XXX XXX XXX ZZZ 090 090 090 YYY Global 69856 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00235 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A X B A A A A A A A R R A A A A A A A A A A A A A A A A B A A A A A A A A A A A Status Bl draw < 3 yrs fem/jugular .................................. Bl draw < 3 yrs scalp vein ................................... Bl draw < 3 yrs other vein .................................... Non-routine bl draw > 3 yrs ................................. Routine venipuncture ........................................... Capillary blood draw ............................................ Vein access cutdown < 1 yr ................................. Vein access cutdown > 1 yr ................................. Blood transfusion service ..................................... Bl push transfuse, 2 yr or .................................... Bl exchange/transfuse, nb ................................... Bl exchange/transfuse non-nb ............................. Transfusion service, fetal ..................................... Injection(s), spider veins ...................................... Injection(s), spider veins ...................................... Injection therapy of vein ....................................... Injection therapy of veins ..................................... Endovenous rf, 1st vein ....................................... Endovenous rf, vein add-on ................................. Endovenous laser, 1st vein .................................. Endovenous laser vein addon ............................. Insertion of catheter, vein .................................... Insertion of catheter, vein .................................... Insertion of catheter, vein .................................... Apheresis wbc ...................................................... Apheresis rbc ....................................................... Apheresis platelets ............................................... Apheresis plasma ................................................. Apheresis, adsorp/reinfuse .................................. Apheresis, selective ............................................. Photopheresis ...................................................... Collect blood venous device ................................ Declot vascular device ......................................... Insert non-tunnel cv cath ..................................... Insert non-tunnel cv cath ..................................... Insert tunneled cv cath ......................................... Insert tunneled cv cath ......................................... Insert tunneled cv cath ......................................... Insert tunneled cv cath ......................................... Insert tunneled cv cath ......................................... Insert tunneled cv cath ......................................... Insert tunneled cv cath ......................................... Insert picc cath ..................................................... Description 0.38 0.31 0.18 0.18 0.00 0.00 1.01 0.76 0.00 1.03 2.23 2.43 6.58 0.00 0.00 1.09 1.60 6.72 3.38 6.72 3.38 6.98 3.51 1.09 1.74 1.74 1.74 1.74 1.74 1.22 1.67 0.00 0.00 2.68 2.50 5.11 4.81 6.26 6.01 6.21 6.01 6.51 1.92 Physician Work RVUs 3 0.33 0.29 0.30 0.31 0.00 0.00 NA NA 0.93 NA NA NA NA 0.00 0.00 2.42 2.56 36.10 5.92 31.10 6.38 NA NA 1.09 NA NA NA 10.42 44.78 49.33 34.98 0.00 0.32 4.09 2.85 14.29 14.36 20.75 21.79 22.81 17.44 112.19 5.53 Fully Implemented NonFacility PE RVUs 0.29 0.27 0.29 0.30 0.00 0.00 NA NA 0.99 NA NA NA NA 0.00 0.00 2.62 2.94 47.57 7.39 42.85 7.59 NA NA 3.19 NA NA NA 15.33 60.92 75.37 33.02 0.00 0.37 5.34 4.93 19.43 19.37 27.44 27.63 25.76 22.89 47.17 7.03 Year 2007 Transitional Non-Facility PE RVUs 0.11 0.08 0.08 0.05 0.00 0.00 0.21 0.22 0.00 0.44 0.80 0.75 1.69 0.00 0.00 0.65 0.80 1.95 0.88 2.03 0.99 2.08 1.17 0.31 0.58 0.61 0.52 0.54 0.52 0.39 0.87 0.00 0.06 0.62 0.57 2.24 2.18 2.52 2.54 2.60 2.48 2.64 0.55 Fully Implemented Facility PE RVUs 0.10 0.08 0.06 0.05 0.00 0.00 0.26 0.22 0.76 0.33 0.73 0.95 2.10 0.00 0.00 0.71 0.92 2.39 1.08 2.41 1.10 2.46 1.32 0.54 0.69 0.71 0.68 0.67 0.63 0.46 0.94 0.00 0.31 0.76 0.70 2.55 2.46 2.90 2.85 2.89 2.83 2.99 0.57 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 36400 36405 36406 36410 36415 36416 36420 36425 36430 36440 36450 36455 36460 36468 36469 36470 36471 36475 36476 36478 36479 36481 36500 36510 36511 36512 36513 36514 36515 36516 36522 36540 36550 36555 36556 36557 36558 36560 36561 36563 36565 36566 36568 HCPCS 2 CPT 1/ 0.03 0.03 0.01 0.01 0.00 0.00 0.07 0.06 0.06 0.10 0.21 0.15 0.79 0.00 0.00 0.12 0.19 0.37 0.18 0.37 0.18 0.55 0.20 0.10 0.08 0.08 0.17 0.08 0.08 0.08 0.13 0.00 0.37 0.11 0.19 0.57 0.57 0.57 0.57 0.84 0.57 0.57 0.11 Mal-Practice RVUs 0.74 0.63 0.49 0.50 0.00 0.00 NA NA 0.99 NA NA NA NA 0.00 0.00 3.63 4.35 43.19 9.48 38.19 9.94 NA NA 2.28 NA NA NA 12.24 46.60 50.63 36.78 0.00 0.69 6.88 5.54 19.97 19.74 27.58 28.37 29.86 24.02 119.27 7.56 Fully Implemented NonFacility Total 0.70 0.61 0.48 0.49 0.00 0.00 NA NA 1.05 NA NA NA NA 0.00 0.00 3.83 4.73 54.66 10.95 49.94 11.15 NA NA 4.38 NA NA NA 17.15 62.74 76.67 34.82 0.00 0.74 8.13 7.62 25.11 24.75 34.27 34.21 32.81 29.47 54.25 9.06 Year 2007 Transitional Non-Facility Total 0.52 0.42 0.27 0.24 0.00 0.00 1.29 1.04 0.06 1.57 3.24 3.33 9.06 0.00 0.00 1.86 2.59 9.04 4.44 9.12 4.55 9.61 4.88 1.50 2.40 2.43 2.43 2.36 2.34 1.69 2.67 0.00 0.43 3.41 3.26 7.92 7.56 9.35 9.12 9.65 9.06 9.72 2.58 Fully Implemented Facility Total 0.51 0.42 0.25 0.24 0.00 0.00 1.34 1.04 0.82 1.46 3.17 3.53 9.47 0.00 0.00 1.92 2.71 9.48 4.64 9.50 4.66 9.99 5.03 1.73 2.51 2.53 2.59 2.49 2.45 1.76 2.74 0.00 0.68 3.55 3.39 8.23 7.84 9.73 9.43 9.94 9.41 10.07 2.60 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX 000 000 010 010 000 ZZZ 000 ZZZ 000 000 000 000 000 000 000 000 000 000 XXX XXX 000 000 010 010 010 010 010 010 010 000 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69857 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00236 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A T A A A A A A A A A A A A A A A A A A A A A A A A A Status Insert picc cath ..................................................... Insert picvad cath ................................................. Insert picvad cath ................................................. Repair tunneled cv cath ....................................... Repair tunneled cv cath ....................................... Replace tunneled cv cath .................................... Replace cvad cath ............................................... Replace tunneled cv cath .................................... Replace tunneled cv cath .................................... Replace tunneled cv cath .................................... Replace picc cath ................................................. Replace picvad cath ............................................. Removal tunneled cv cath ................................... Removal tunneled cv cath ................................... Mech remov tunneled cv cath .............................. Mech remov tunneled cv cath .............................. Reposition venous catheter ................................. Inj w/fluor, eval cv device ..................................... Withdrawal of arterial blood ................................. Insertion catheter, artery ...................................... Insertion catheter, artery ...................................... Insertion catheter, artery ...................................... Insertion catheter, artery ...................................... Insert needle, bone cavity .................................... Insertion of cannula .............................................. Insertion of cannula .............................................. Insertion of cannula .............................................. Av fuse, uppr arm, cephalic ................................. Av fuse, uppr arm, basilic .................................... Av fusion/forearm vein ......................................... Av fusion direct any site ....................................... Insertion of cannula(s) ......................................... Insertion of cannula(s) ......................................... Artery-vein autograft ............................................. Artery-vein nonautograft ....................................... Open thrombect av fistula .................................... Av fistula revision, open ....................................... Av fistula revision ................................................. Repair A-V aneurysm ........................................... Artery to vein shunt .............................................. Dist revas ligation, hemo ..................................... External cannula declotting .................................. Cannula declotting ............................................... Description 1.82 5.33 5.31 0.67 3.21 3.51 1.31 3.45 5.21 5.26 1.20 4.81 2.27 3.32 3.59 0.75 1.21 0.74 0.32 1.15 2.11 2.10 1.40 1.20 2.43 3.96 2.62 11.81 14.39 14.39 9.15 5.51 22.82 10.00 12.00 8.01 10.50 11.95 11.11 7.43 21.59 2.01 2.52 Physician Work RVUs 3 4.19 22.38 24.27 3.19 5.69 8.70 3.82 14.84 20.00 20.04 3.73 21.71 1.79 3.55 10.24 2.44 1.90 2.15 0.50 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 3.32 NA Fully Implemented NonFacility PE RVUs 6.55 30.47 31.00 3.84 6.63 10.52 6.16 18.33 24.51 24.53 6.16 26.29 2.13 3.42 15.50 3.38 2.28 2.52 0.49 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 2.16 NA Year 2007 Transitional Non-Facility PE RVUs 0.55 2.26 2.36 0.21 1.50 1.82 0.39 1.55 2.20 2.27 0.52 2.17 1.17 1.56 1.20 0.39 0.38 0.24 0.08 0.17 0.49 0.91 0.20 0.33 1.55 1.34 1.03 4.81 5.22 5.31 4.01 3.79 8.80 4.31 4.23 3.25 3.84 4.23 4.33 3.88 7.09 0.62 1.22 Fully Implemented Facility PE RVUs 0.57 2.61 2.62 0.25 1.76 2.18 0.41 1.83 2.70 2.73 0.54 2.59 1.34 1.68 1.39 0.47 0.43 2.04 0.09 0.22 0.52 1.01 0.38 0.45 1.74 1.60 1.14 5.73 6.08 6.11 4.49 4.23 9.23 4.87 4.98 3.77 4.50 4.96 4.68 4.21 8.81 0.67 1.42 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 36569 36570 36571 36575 36576 36578 36580 36581 36582 36583 36584 36585 36589 36590 36595 36596 36597 36598 36600 36620 36625 36640 36660 36680 36800 36810 36815 36818 36819 36820 36821 36822 36823 36825 36830 36831 36832 36833 36834 36835 36838 36860 36861 HCPCS 2 CPT 1/ 0.19 0.57 0.57 0.20 0.19 0.19 0.19 0.19 0.19 0.19 0.19 0.19 0.24 0.44 0.21 0.05 0.07 0.05 0.02 0.07 0.26 0.21 0.14 0.11 0.25 0.45 0.35 1.90 1.96 1.95 1.23 0.79 2.89 1.35 1.66 1.09 1.44 1.65 1.37 0.98 3.02 0.11 0.27 Mal-Practice RVUs 6.20 28.28 30.15 4.06 9.09 12.40 5.32 18.48 25.40 25.49 5.12 26.71 4.30 7.31 14.04 3.24 3.18 2.94 0.84 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 5.44 NA Fully Implemented NonFacility Total 8.56 36.37 36.88 4.71 10.03 14.22 7.66 21.97 29.91 29.98 7.55 31.29 4.64 7.18 19.30 4.18 3.56 3.31 0.83 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 4.28 NA Year 2007 Transitional Non-Facility Total 2.56 8.16 8.24 1.08 4.90 5.52 1.89 5.19 7.60 7.72 1.91 7.17 3.68 5.32 5.00 1.19 1.66 1.03 0.42 1.39 2.86 3.22 1.74 1.64 4.23 5.75 4.00 18.52 21.57 21.65 14.39 10.09 34.51 15.66 17.89 12.35 15.78 17.83 16.81 12.29 31.70 2.74 4.01 Fully Implemented Facility Total 2.58 8.51 8.50 1.12 5.16 5.88 1.91 5.47 8.10 8.18 1.93 7.59 3.85 5.44 5.19 1.27 1.71 2.83 0.43 1.44 2.89 3.32 1.92 1.76 4.42 6.01 4.11 19.44 22.43 22.45 14.87 10.53 34.94 16.22 18.64 12.87 16.44 18.56 17.16 12.62 33.42 2.79 4.21 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 000 010 010 000 010 010 000 010 010 010 000 010 010 010 000 000 000 000 XXX 000 000 000 000 000 000 000 000 090 090 090 090 090 090 090 090 090 090 090 090 090 090 000 000 Global 69858 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00237 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A C A A A A A A A A A A A R N A A A C A A A A A A A A A A A A Status Percut thrombect av fistula .................................. Revision of circulation .......................................... Revision of circulation .......................................... Revision of circulation .......................................... Revision of circulation .......................................... Splice spleen/kidney veins ................................... Insert hepatic shunt (tips) .................................... Remove hepatic shunt (tips) ................................ Prim art mech thrombectomy ............................... Prim art m-thrombect add-on ............................... Sec art m-thrombect add-on ................................ Venous mech thrombectomy ............................... Venous m-thrombectomy add-on ......................... Thrombolytic therapy, stroke ................................ Transcatheter biopsy ............................................ Transcatheter therapy infuse ............................... Transcatheter therapy infuse ............................... Transcatheter retrieval ......................................... Transcatheter occlusion ....................................... Transcath iv stent, percut .................................... Transcath iv stent/perc addl ................................. Transcath iv stent, open ...................................... Transcath iv stent/open addl ................................ Change iv cath at thromb tx ................................ Embolization uterine fibroid .................................. Transcath stent, cca w/eps .................................. Transcath stent, cca w/o eps ............................... Iv us first vessel add-on ....................................... Iv us each add vessel add-on .............................. Endoscopy ligate perf veins ................................. Vascular endoscopy procedure ........................... Ligation of neck vein ............................................ Ligation of neck artery ......................................... Ligation of neck artery ......................................... Ligation of neck artery ......................................... Ligation of a-v fistula ............................................ Temporal artery procedure .................................. Ligation of neck artery ......................................... Ligation of chest artery ........................................ Ligation of abdomen artery .................................. Ligation of extremity artery .................................. Revision of major vein ......................................... Revision of major vein ......................................... Description 5.17 25.12 26.13 23.13 26.13 28.26 16.97 7.99 8.66 3.28 4.92 8.03 5.71 0.00 4.55 4.99 5.67 5.02 18.11 8.27 4.12 8.27 4.12 2.27 10.60 19.58 18.85 2.10 1.60 11.54 0.00 11.97 12.34 14.20 8.72 6.19 3.02 7.72 18.89 23.71 5.95 11.49 8.41 Physician Work RVUs 3 39.08 NA NA NA NA NA NA NA 47.39 15.41 32.55 46.31 40.43 0.00 NA NA NA 28.86 NA NA NA NA NA NA 46.03 NA NA NA NA NA 0.00 NA NA NA NA NA 4.20 NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs 49.54 NA NA NA NA NA NA NA 65.62 21.01 45.18 64.21 56.59 0.00 NA NA NA 31.87 NA NA NA NA NA NA 46.03 NA NA NA NA NA 0.00 NA NA NA NA NA 4.43 NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 2.50 8.82 9.06 8.11 8.95 9.32 5.11 2.51 2.78 0.94 1.41 2.59 1.93 0.00 1.32 2.11 3.42 1.81 5.30 3.81 1.56 2.43 1.05 0.67 3.13 10.08 5.75 0.81 0.52 5.42 0.00 5.11 4.81 5.57 4.89 3.08 1.84 4.01 7.92 7.89 3.37 4.94 4.19 Fully Implemented Facility PE RVUs 2.99 10.07 10.41 8.97 9.96 10.58 5.82 2.89 3.21 1.07 1.60 3.00 2.25 0.00 1.46 2.43 3.13 1.98 5.75 3.77 1.46 2.98 1.30 0.72 3.13 9.34 8.05 0.77 0.54 6.49 0.00 5.49 6.18 6.57 4.64 3.44 1.93 4.09 8.04 8.85 3.55 5.52 4.56 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 36870 37140 37145 37160 37180 37181 37182 37183 37184 37185 37186 37187 37188 37195 37200 37201 37202 37203 37204 37205 37206 37207 37208 37209 37210 37215 37216 37250 37251 37500 37501 37565 37600 37605 37606 37607 37609 37615 37616 37617 37618 37620 37650 HCPCS 2 CPT 1/ 0.29 2.02 3.26 2.82 3.35 3.41 1.00 0.47 0.55 0.21 0.32 0.51 0.37 0.00 0.27 0.33 0.43 0.29 1.48 0.60 0.31 1.17 0.59 0.15 0.60 1.09 1.04 0.21 0.19 1.54 0.00 1.33 1.41 1.99 1.23 0.85 0.36 0.68 2.33 2.98 0.67 0.91 1.01 Mal-Practice RVUs 44.54 NA NA NA NA NA NA NA 56.60 18.90 37.79 54.85 46.51 0.00 NA NA NA 34.17 NA NA NA NA NA NA 57.23 NA NA NA NA NA 0.00 NA NA NA NA NA 7.58 NA NA NA NA NA NA Fully Implemented NonFacility Total 55.00 NA NA NA NA NA NA NA 74.83 24.50 50.42 72.75 62.67 0.00 NA NA NA 37.18 NA NA NA NA NA NA 57.23 NA NA NA NA NA 0.00 NA NA NA NA NA 7.81 NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 7.96 35.96 38.45 34.06 38.43 40.99 23.08 10.97 11.99 4.43 6.65 11.13 8.01 0.00 6.14 7.43 9.52 7.12 24.89 12.68 5.99 11.87 5.76 3.09 14.33 30.75 25.64 3.12 2.31 18.50 0.00 18.41 18.56 21.76 14.84 10.12 5.22 12.41 29.14 34.58 9.99 17.34 13.61 Fully Implemented Facility Total 8.45 37.21 39.80 34.92 39.44 42.25 23.79 11.35 12.42 4.56 6.84 11.54 8.33 0.00 6.28 7.75 9.23 7.29 25.34 12.64 5.89 12.42 6.01 3.14 14.33 30.01 27.94 3.08 2.33 19.57 0.00 18.79 19.93 22.76 14.59 10.48 5.31 12.49 29.26 35.54 10.17 17.92 13.98 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 000 000 000 ZZZ ZZZ 000 000 XXX 000 000 000 000 000 000 ZZZ 000 ZZZ 000 000 090 090 ZZZ ZZZ 090 YYY 090 090 090 090 090 010 090 090 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69859 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00238 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A C A A A A A C A B R R I I I I I I I I I A A R R R A A A A A A Status Revision of major vein ......................................... Revise leg vein ..................................................... Ligate/strip short leg vein ..................................... Ligate/strip long leg vein ...................................... Removal of leg veins/lesion ................................. Ligation, leg veins, open ...................................... Phleb veins—extrem—to 20 ................................ Phleb veins—extrem 20+ ..................................... Revision of leg vein .............................................. Ligate/divide/excise vein ...................................... Revascularization, penis ...................................... Penile venous occlusion ...................................... Vascular surgery procedure ................................. Removal of spleen, total ...................................... Removal of spleen, partial ................................... Removal of spleen, total ...................................... Repair of ruptured spleen .................................... Laparoscopy, splenectomy .................................. Laparoscope proc, spleen .................................... Injection for spleen x-ray ...................................... Bl donor search management .............................. Harvest allogenic stem cells ................................ Harvest auto stem cells ....................................... Cryopreserve stem cells ...................................... Thaw preserved stem cells .................................. Wash harvest stem cells ...................................... T-cell depletion of harvest .................................... Tumor cell deplete of harvst ................................ Rbc depletion of harvest ...................................... Platelet deplete of harvest ................................... Volume deplete of harvest ................................... Harvest stem cell concentrte ............................... Bone marrow aspiration ....................................... Bone marrow biopsy ............................................ Bone marrow collection ........................................ Bone marrow/stem transplant .............................. Bone marrow/stem transplant .............................. Lymphocyte infuse transplant .............................. Drainage, lymph node lesion ............................... Drainage, lymph node lesion ............................... Incision of lymph channels ................................... Thoracic duct procedure ...................................... Thoracic duct procedure ...................................... Description 22.20 3.76 7.05 8.08 10.81 10.69 7.63 9.58 3.87 3.87 23.21 8.37 0.00 19.47 19.47 4.79 21.80 16.97 0.00 2.64 2.00 1.50 1.50 0.47 0.56 0.24 0.94 0.71 0.47 0.24 0.24 0.55 1.08 1.37 4.80 2.24 2.24 1.71 2.28 6.55 6.73 8.34 13.32 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA 4.90 NA NA 0.00 NA NA NA NA NA 0.00 NA 0.00 NA NA 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2.66 2.78 NA NA NA NA 3.58 NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA 5.12 NA NA 0.00 NA NA NA NA NA 0.00 NA 0.00 NA NA 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3.46 3.64 NA NA NA NA 4.12 NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 8.02 2.43 3.51 3.77 4.65 4.53 3.56 4.09 2.48 2.58 12.15 5.13 0.00 6.90 7.31 1.26 7.56 6.94 0.00 0.96 0.00 0.55 0.55 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.45 0.58 2.80 0.96 0.95 0.71 1.74 3.38 3.54 4.70 6.08 Fully Implemented Facility PE RVUs 8.79 2.70 3.92 4.25 5.29 5.14 4.36 5.01 2.76 2.69 9.85 4.56 0.00 6.35 6.72 1.55 6.87 7.27 0.00 0.91 0.00 0.64 0.64 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.50 0.63 3.12 1.01 1.02 0.76 1.97 4.18 3.69 5.44 6.68 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 37660 37700 37718 37722 37735 37760 37765 37766 37780 37785 37788 37790 37799 38100 38101 38102 38115 38120 38129 38200 38204 38205 38206 38207 38208 38209 38210 38211 38212 38213 38214 38215 38220 38221 38230 38240 38241 38242 38300 38305 38308 38380 38381 HCPCS 2 CPT 1/ 2.49 0.53 0.14 0.86 1.48 1.44 0.48 0.48 0.53 0.54 2.26 0.59 0.00 1.92 2.05 0.63 2.09 2.25 0.00 0.14 0.06 0.07 0.07 0.01 0.02 0.01 0.03 0.02 0.02 0.01 0.01 0.02 0.05 0.07 0.48 0.11 0.11 0.08 0.25 0.88 0.85 0.74 1.85 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA 9.31 NA NA 0.00 NA NA NA NA NA 0.00 NA 2.06 NA NA 0.48 0.58 0.25 0.97 0.73 0.49 0.25 0.25 0.57 3.79 4.22 NA NA NA NA 6.11 NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA 9.53 NA NA 0.00 NA NA NA NA NA 0.00 NA 2.06 NA NA 0.48 0.58 0.25 0.97 0.73 0.49 0.25 0.25 0.57 4.59 5.08 NA NA NA NA 6.65 NA NA NA NA Year 2007 Transitional Non-Facility Total 32.71 6.72 10.70 12.71 16.94 16.66 11.67 14.15 6.88 6.99 37.62 14.09 0.00 28.29 28.83 6.68 31.45 26.16 0.00 3.74 2.06 2.12 2.12 0.48 0.58 0.25 0.97 0.73 0.49 0.25 0.25 0.57 1.58 2.02 8.08 3.31 3.30 2.50 4.27 10.81 11.12 13.78 21.25 Fully Implemented Facility Total 33.48 6.99 11.11 13.19 17.58 17.27 12.47 15.07 7.16 7.10 35.32 13.52 0.00 27.74 28.24 6.97 30.76 26.49 0.00 3.69 2.06 2.21 2.21 0.48 0.58 0.25 0.97 0.73 0.49 0.25 0.25 0.57 1.63 2.07 8.40 3.36 3.37 2.55 4.50 11.61 11.27 14.52 21.85 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 YYY 090 090 ZZZ 090 090 YYY 000 XXX 000 000 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX 010 XXX XXX 000 010 090 090 090 090 Global 69860 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00239 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A C A A A A A A A A A A A A A A C A A A A A C A A A A A A Status Thoracic duct procedure ...................................... Biopsy/removal, lymph nodes .............................. Needle biopsy, lymph nodes ................................ Biopsy/removal, lymph nodes .............................. Biopsy/removal, lymph nodes .............................. Biopsy/removal, lymph nodes .............................. Biopsy/removal, lymph nodes .............................. Explore deep node(s), neck ................................. Removal, neck/armpit lesion ................................ Removal, neck/armpit lesion ................................ Removal, pelvic lymph nodes .............................. Removal, abdomen lymph nodes ........................ Laparoscopy, lymph node biop ............................ Laparoscopy, lymphadenectomy ......................... Laparoscopy, lymphadenectomy ......................... Laparoscope proc, lymphatic ............................... Removal of lymph nodes, neck ........................... Removal of lymph nodes, neck ........................... Removal of lymph nodes, neck ........................... Remove armpit lymph nodes ............................... Remove armpit lymph nodes ............................... Remove thoracic lymph nodes ............................ Remove abdominal lymph nodes ........................ Remove groin lymph nodes ................................. Remove groin lymph nodes ................................. Remove pelvis lymph nodes ................................ Remove abdomen lymph nodes .......................... Inject for lymphatic x-ray ...................................... Identify sentinel node ........................................... Access thoracic lymph duct ................................. Blood/lymph system procedure ............................ Exploration of chest ............................................. Exploration of chest ............................................. Removal chest lesion ........................................... Removal chest lesion ........................................... Visualization of chest ........................................... Chest procedure ................................................... Repair diaphragm laceration ................................ Repair paraesophageal hernia ............................. Repair of diaphragm hernia ................................. Repair of diaphragm hernia ................................. Repair of diaphragm hernia ................................. Repair of diaphragm hernia ................................. Description 10.51 3.76 1.14 6.69 6.95 6.35 8.26 6.08 6.99 15.42 10.92 11.29 9.28 14.70 16.86 0.00 12.68 21.72 23.72 10.57 13.71 4.88 4.88 13.49 21.78 13.98 17.56 1.29 0.52 4.51 0.00 7.49 13.11 15.04 19.47 8.00 0.00 13.89 17.09 108.67 16.63 16.22 17.23 Physician Work RVUs 3 NA 3.73 2.00 5.20 NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA 0.00 NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA 3.70 2.04 5.46 NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA 0.00 NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 5.45 2.02 0.67 2.98 3.70 3.46 4.09 3.77 4.22 7.27 5.77 5.23 3.99 6.95 6.21 0.00 6.01 9.38 10.00 5.02 6.06 1.45 1.27 5.98 8.66 6.97 8.02 0.70 0.46 2.84 0.00 4.34 6.14 6.26 8.06 4.18 0.00 5.92 6.63 30.82 6.90 6.39 6.59 Fully Implemented Facility PE RVUs 5.68 2.07 0.75 3.36 3.96 3.33 4.32 4.30 3.99 8.22 5.77 5.24 3.98 5.97 6.86 0.00 6.18 9.36 9.87 4.96 6.07 1.57 1.57 6.09 8.77 6.05 8.16 0.75 0.45 3.30 0.00 4.57 7.19 7.21 9.04 4.68 0.00 6.32 7.01 32.73 7.76 6.95 7.18 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 38382 38500 38505 38510 38520 38525 38530 38542 38550 38555 38562 38564 38570 38571 38572 38589 38700 38720 38724 38740 38745 38746 38747 38760 38765 38770 38780 38790 38792 38794 38999 39000 39010 39200 39220 39400 39499 39501 39502 39503 39520 39530 39531 HCPCS 2 CPT 1/ 1.37 0.49 0.09 0.72 0.84 0.80 1.12 0.60 0.88 1.76 1.20 1.32 1.13 1.15 1.91 0.00 0.72 1.20 1.28 1.32 1.74 0.72 0.64 1.72 2.48 1.40 1.89 0.13 0.06 0.32 0.00 0.89 1.76 2.03 2.46 0.82 0.00 1.78 2.17 10.98 2.24 2.11 2.22 Mal-Practice RVUs NA 7.98 3.23 12.61 NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA 0.00 NA NA NA NA NA NA Fully Implemented NonFacility Total NA 7.95 3.27 12.87 NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA 0.00 NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 17.33 6.27 1.90 10.39 11.49 10.61 13.47 10.45 12.09 24.45 17.89 17.84 14.40 22.80 24.98 0.00 19.41 32.30 35.00 16.91 21.51 7.05 6.79 21.19 32.92 22.35 27.47 2.12 1.04 7.67 0.00 12.72 21.01 23.33 29.99 13.00 0.00 21.59 25.89 150.47 25.77 24.72 26.04 Fully Implemented Facility Total 17.56 6.32 1.98 10.77 11.75 10.48 13.70 10.98 11.86 25.40 17.89 17.85 14.39 21.82 25.63 0.00 19.58 32.28 34.87 16.85 21.52 7.17 7.09 21.30 33.03 21.43 27.61 2.17 1.03 8.13 0.00 12.95 22.06 24.28 30.97 13.50 0.00 21.99 26.27 152.38 26.63 25.28 26.63 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 010 000 010 090 090 090 090 090 090 090 090 010 010 010 YYY 090 090 090 090 090 ZZZ ZZZ 090 090 090 090 000 000 090 YYY 090 090 090 090 010 YYY 090 090 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69861 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00240 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A C A A A A A A A A A A A A A A A C A A A A A A A A A A A A A A A R R R R R C Status Repair of diaphragm hernia ................................. Repair of diaphragm hernia ................................. Revision of diaphragm ......................................... Resect diaphragm, simple ................................... Resect diaphragm, complex ................................ Diaphragm surgery procedure ............................. Biopsy of lip .......................................................... Partial excision of lip ............................................ Partial excision of lip ............................................ Partial excision of lip ............................................ Reconstruct lip with flap ....................................... Reconstruct lip with flap ....................................... Partial removal of lip ............................................ Repair lip .............................................................. Repair lip .............................................................. Repair lip .............................................................. Repair cleft lip/nasal ............................................. Repair cleft lip/nasal ............................................. Repair cleft lip/nasal ............................................. Repair cleft lip/nasal ............................................. Repair cleft lip/nasal ............................................. Lip surgery procedure .......................................... Drainage of mouth lesion ..................................... Drainage of mouth lesion ..................................... Removal, foreign body, mouth ............................. Removal, foreign body, mouth ............................. Incision of lip fold ................................................. Biopsy of mouth lesion ......................................... Excision of mouth lesion ...................................... Excise/repair mouth lesion ................................... Excise/repair mouth lesion ................................... Excision of mouth lesion ...................................... Excise oral mucosa for graft ................................ Excise lip or cheek fold ........................................ Treatment of mouth lesion ................................... Repair mouth laceration ....................................... Repair mouth laceration ....................................... Reconstruction of mouth ...................................... Reconstruction of mouth ...................................... Reconstruction of mouth ...................................... Reconstruction of mouth ...................................... Reconstruction of mouth ...................................... Mouth surgery procedure ..................................... Description 14.51 15.67 14.58 12.97 19.75 0.00 1.22 4.35 4.74 4.71 7.61 9.20 5.45 3.69 4.32 5.37 13.97 17.03 14.09 14.54 15.69 0.00 1.19 2.57 1.26 2.73 0.31 0.98 1.33 2.33 3.45 3.70 2.72 2.45 1.30 1.78 2.50 9.03 9.03 12.62 16.57 19.13 0.00 Physician Work RVUs 3 NA NA NA NA NA 0.00 2.09 7.79 6.58 6.88 NA NA 7.35 5.94 7.07 8.13 NA NA NA NA NA 0.00 3.83 4.86 3.63 5.06 2.37 3.52 3.57 4.51 5.63 5.80 5.78 4.87 5.14 4.09 5.35 10.06 9.76 11.82 14.88 15.37 0.00 Fully Implemented NonFacility PE RVUs NA NA NA NA NA 0.00 1.75 7.12 6.60 7.38 NA NA 7.70 6.58 7.57 8.48 NA NA NA NA NA 0.00 3.18 4.23 3.45 4.63 1.97 2.87 3.05 3.92 5.11 5.33 5.32 4.28 4.23 3.81 4.83 9.85 9.99 11.92 15.54 16.64 0.00 Year 2007 Transitional Non-Facility PE RVUs 5.62 6.18 7.21 5.54 9.35 0.00 0.59 4.30 3.54 3.77 5.34 5.97 4.15 3.16 4.04 4.73 9.32 11.44 7.32 9.22 9.05 0.00 1.88 2.58 1.76 2.59 0.50 1.58 1.67 2.28 3.66 3.71 3.73 3.07 2.85 2.02 2.76 5.63 5.40 6.12 8.89 9.78 0.00 Fully Implemented Facility PE RVUs 6.07 6.48 7.46 6.10 9.34 0.00 0.61 4.32 3.89 4.03 6.06 7.01 4.47 3.26 4.21 4.88 9.13 11.36 8.02 9.72 9.97 0.00 1.80 2.70 1.83 2.76 0.50 1.51 1.66 2.37 3.83 3.93 3.91 3.09 2.54 2.07 2.98 6.64 6.44 7.39 10.89 12.35 0.00 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 39540 39541 39545 39560 39561 39599 40490 40500 40510 40520 40525 40527 40530 40650 40652 40654 40700 40701 40702 40720 40761 40799 40800 40801 40804 40805 40806 40808 40810 40812 40814 40816 40818 40819 40820 40830 40831 40840 40842 40843 40844 40845 40899 HCPCS 2 CPT 1/ 1.80 1.93 1.84 1.59 2.45 0.00 0.05 0.38 0.49 0.52 0.85 0.97 0.55 0.38 0.52 0.60 0.95 1.65 1.23 1.80 1.94 0.00 0.13 0.31 0.11 0.32 0.04 0.10 0.13 0.28 0.41 0.40 0.21 0.29 0.11 0.19 0.30 1.08 1.08 1.39 2.00 2.01 0.00 Mal-Practice RVUs NA NA NA NA NA 0.00 3.36 12.52 11.81 12.11 NA NA 13.35 10.01 11.91 14.10 NA NA NA NA NA 0.00 5.15 7.74 5.00 8.11 2.72 4.60 5.03 7.12 9.49 9.90 8.71 7.61 6.55 6.06 8.15 20.17 19.87 25.83 33.45 36.51 0.00 Fully Implemented NonFacility Total NA NA NA NA NA 0.00 3.02 11.85 11.83 12.61 NA NA 13.70 10.65 12.41 14.45 NA NA NA NA NA 0.00 4.50 7.11 4.82 7.68 2.32 3.95 4.51 6.53 8.97 9.43 8.25 7.02 5.64 5.78 7.63 19.96 20.10 25.93 34.11 37.78 0.00 Year 2007 Transitional Non-Facility Total 21.93 23.78 23.63 20.10 31.55 0.00 1.86 9.03 8.77 9.00 13.80 16.14 10.15 7.23 8.88 10.70 24.24 30.12 22.64 25.56 26.68 0.00 3.20 5.46 3.13 5.64 0.85 2.66 3.13 4.89 7.52 7.81 6.66 5.81 4.26 3.99 5.56 15.74 15.51 20.13 27.46 30.92 0.00 Fully Implemented Facility Total 22.38 24.08 23.88 20.66 31.54 0.00 1.88 9.05 9.12 9.26 14.52 17.18 10.47 7.33 9.05 10.85 24.05 30.04 23.34 26.06 27.60 0.00 3.12 5.58 3.20 5.81 0.85 2.59 3.12 4.98 7.69 8.03 6.84 5.83 3.95 4.04 5.78 16.75 16.55 21.40 29.46 33.49 0.00 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 YYY 000 090 090 090 090 090 090 090 090 090 090 090 090 090 090 YYY 010 010 010 010 000 010 010 010 090 090 090 090 010 010 010 090 090 090 090 090 YYY Global 69862 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00241 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C A A A R R R R A Status Drainage of mouth lesion ..................................... Drainage of mouth lesion ..................................... Drainage of mouth lesion ..................................... Drainage of mouth lesion ..................................... Drainage of mouth lesion ..................................... Drainage of mouth lesion ..................................... Incision of tongue fold .......................................... Drainage of mouth lesion ..................................... Drainage of mouth lesion ..................................... Drainage of mouth lesion ..................................... Drainage of mouth lesion ..................................... Biopsy of tongue .................................................. Biopsy of tongue .................................................. Biopsy of floor of mouth ....................................... Excision of tongue lesion ..................................... Excision of tongue lesion ..................................... Excision of tongue lesion ..................................... Excision of tongue lesion ..................................... Excision of tongue fold ......................................... Excision of mouth lesion ...................................... Partial removal of tongue ..................................... Partial removal of tongue ..................................... Tongue and neck surgery .................................... Removal of tongue ............................................... Tongue removal, neck surgery ............................ Tongue, mouth, jaw surgery ................................ Tongue, mouth, neck surgery .............................. Tongue, jaw, & neck surgery ............................... Repair tongue laceration ...................................... Repair tongue laceration ...................................... Repair tongue laceration ...................................... Fixation of tongue ................................................ Tongue to lip surgery ........................................... Reconstruction, tongue fold ................................. Tongue and mouth surgery .................................. Drainage of gum lesion ........................................ Removal foreign body, gum ................................. Removal foreign body,jawbone ............................ Excision, gum, each quadrant ............................. Excision of gum flap ............................................. Excision of gum lesion ......................................... Excision of gum lesion ......................................... Excision of gum lesion ......................................... Description 1.32 1.28 3.28 3.14 3.40 3.63 1.08 4.00 4.11 4.11 5.14 1.39 1.44 1.07 1.53 2.77 3.23 8.71 1.76 2.47 10.91 15.51 29.83 28.81 37.59 29.52 33.28 43.96 1.93 2.29 2.99 3.74 3.45 2.77 0.00 1.21 1.28 2.73 0.00 0.00 2.35 3.63 1.35 Physician Work RVUs 3 2.50 4.22 5.30 5.34 5.42 5.81 3.36 6.22 6.18 6.33 6.57 2.58 2.57 2.40 3.47 5.12 5.40 NA 4.26 5.32 NA NA NA NA NA NA NA NA 3.79 3.15 4.35 NA NA 5.72 0.00 4.74 4.72 5.91 0.00 0.00 4.66 6.50 3.62 Fully Implemented NonFacility PE RVUs 2.36 3.55 4.92 5.19 4.87 5.18 3.41 5.61 5.75 5.81 6.24 2.46 2.37 2.15 3.10 4.63 4.91 NA 3.53 4.59 NA NA NA NA NA NA NA NA 3.00 3.24 4.01 NA NA 4.90 0.00 3.13 3.18 4.16 0.00 0.00 4.08 5.80 3.20 Year 2007 Transitional Non-Facility PE RVUs 1.31 1.72 2.76 2.74 2.82 3.15 1.35 3.95 4.05 4.11 4.36 1.13 1.15 1.03 1.55 3.16 3.33 6.02 1.76 2.67 13.31 14.68 20.15 21.56 26.62 21.36 22.13 25.50 1.59 1.65 1.98 6.54 7.05 3.22 0.00 2.10 2.75 3.41 0.00 0.00 1.80 3.77 1.44 Fully Implemented Facility PE RVUs 1.39 1.72 3.07 2.95 3.11 3.47 1.54 4.09 4.18 4.25 4.52 1.35 1.28 1.11 1.62 3.21 3.44 6.90 1.83 2.77 14.81 15.81 22.45 25.39 29.56 23.87 24.30 26.48 1.28 1.58 2.18 7.22 7.71 3.52 0.00 1.49 2.35 3.13 0.00 0.00 1.85 3.95 2.04 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 41000 41005 41006 41007 41008 41009 41010 41015 41016 41017 41018 41100 41105 41108 41110 41112 41113 41114 41115 41116 41120 41130 41135 41140 41145 41150 41153 41155 41250 41251 41252 41500 41510 41520 41599 41800 41805 41806 41820 41821 41822 41823 41825 HCPCS 2 CPT 1/ 0.12 0.12 0.35 0.31 0.42 0.47 0.07 0.46 0.53 0.53 0.68 0.15 0.13 0.10 0.13 0.28 0.34 0.83 0.18 0.23 0.79 0.93 1.89 2.27 2.55 1.95 2.01 2.34 0.18 0.22 0.29 0.30 0.20 0.27 0.00 0.12 0.13 0.37 0.00 0.00 0.31 0.47 0.15 Mal-Practice RVUs 3.94 5.62 8.93 8.79 9.24 9.91 4.51 10.68 10.82 10.97 12.39 4.12 4.14 3.57 5.13 8.17 8.97 NA 6.20 8.02 NA NA NA NA NA NA NA NA 5.90 5.66 7.63 NA NA 8.76 0.00 6.07 6.13 9.01 0.00 0.00 7.32 10.60 5.12 Fully Implemented NonFacility Total 3.80 4.95 8.55 8.64 8.69 9.28 4.56 10.07 10.39 10.45 12.06 4.00 3.94 3.32 4.76 7.68 8.48 NA 5.47 7.29 NA NA NA NA NA NA NA NA 5.11 5.75 7.29 NA NA 7.94 0.00 4.46 4.59 7.26 0.00 0.00 6.74 9.90 4.70 Year 2007 Transitional Non-Facility Total 2.75 3.12 6.39 6.19 6.64 7.25 2.50 8.41 8.69 8.75 10.18 2.67 2.72 2.20 3.21 6.21 6.90 15.56 3.70 5.37 25.01 31.12 51.87 52.64 66.76 52.83 57.42 71.80 3.70 4.16 5.26 10.58 10.70 6.26 0.00 3.43 4.16 6.51 0.00 0.00 4.46 7.87 2.94 Fully Implemented Facility Total 2.83 3.12 6.70 6.40 6.93 7.57 2.69 8.55 8.82 8.89 10.34 2.89 2.85 2.28 3.28 6.26 7.01 16.44 3.77 5.47 26.51 32.25 54.17 56.47 69.70 55.34 59.59 72.78 3.39 4.09 5.46 11.26 11.36 6.56 0.00 2.82 3.76 6.23 0.00 0.00 4.51 8.05 3.54 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 010 010 090 090 090 090 010 090 090 090 090 010 010 010 010 090 090 090 010 090 090 090 090 090 090 090 090 090 010 010 010 090 090 090 YYY 010 010 010 000 000 010 090 010 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69863 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00242 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A R R R R R R C A A A A A A A A A A A A A A A A A A A A A A A C A A A A A A A A A A Status Excision of gum lesion ......................................... Excision of gum lesion ......................................... Excision of gum lesion ......................................... Removal of gum tissue ........................................ Treatment of gum lesion ...................................... Gum graft ............................................................. Repair gum ........................................................... Repair tooth socket .............................................. Dental surgery procedure .................................... Drainage mouth roof lesion .................................. Biopsy roof of mouth ............................................ Excision lesion, mouth roof .................................. Excision lesion, mouth roof .................................. Excision lesion, mouth roof .................................. Remove palate/lesion ........................................... Excision of uvula .................................................. Repair palate, pharynx/uvula ............................... Treatment mouth roof lesion ................................ Repair palate ........................................................ Repair palate ........................................................ Reconstruct cleft palate ....................................... Reconstruct cleft palate ....................................... Reconstruct cleft palate ....................................... Reconstruct cleft palate ....................................... Reconstruct cleft palate ....................................... Reconstruct cleft palate ....................................... Lengthening of palate .......................................... Lengthening of palate .......................................... Repair palate ........................................................ Repair nose to lip fistula ...................................... Preparation, palate mold ...................................... Insertion, palate prosthesis .................................. Palate/uvula surgery ............................................ Drainage of salivary gland ................................... Drainage of salivary gland ................................... Drainage of salivary gland ................................... Drainage of salivary gland ................................... Removal of salivary stone .................................... Removal of salivary stone .................................... Removal of salivary stone .................................... Biopsy of salivary gland ....................................... Biopsy of salivary gland ....................................... Excision of salivary cyst ....................................... Description 2.35 3.72 3.11 3.38 0.00 0.00 2.90 3.13 0.00 1.25 1.33 1.66 2.12 4.48 11.70 1.65 9.63 1.82 2.52 3.84 12.41 13.57 14.91 8.88 7.07 9.66 10.24 9.81 7.92 10.10 1.56 1.95 0.00 1.95 6.23 1.58 2.37 2.23 3.35 4.64 0.78 3.31 4.58 Physician Work RVUs 3 5.12 6.61 4.13 6.04 0.00 0.00 5.89 5.76 0.00 2.34 2.19 3.43 4.41 6.34 NA 4.24 NA 3.63 3.22 4.05 NA NA NA NA NA NA NA NA NA 9.65 2.25 2.83 0.00 2.93 NA 2.19 3.56 3.20 5.46 6.31 1.88 3.74 6.10 Fully Implemented NonFacility PE RVUs 3.10 5.79 3.88 5.23 0.00 0.00 5.24 5.07 0.00 2.51 2.11 2.76 3.52 5.87 NA 3.85 NA 4.10 3.11 3.92 NA NA NA NA NA NA NA NA NA 10.06 2.03 2.68 0.00 2.85 NA 2.24 3.34 3.16 5.04 6.11 1.71 3.94 5.96 Year 2007 Transitional Non-Facility PE RVUs 2.60 3.38 1.68 3.16 0.00 0.00 3.28 2.79 0.00 1.15 1.22 1.60 2.06 3.58 11.51 1.95 6.85 1.62 1.79 2.41 8.26 7.60 9.87 7.34 6.80 12.12 11.44 9.78 10.34 5.93 0.85 1.57 0.00 1.61 3.71 1.32 1.78 1.62 2.69 3.26 0.59 2.02 3.10 Fully Implemented Facility PE RVUs 2.23 3.59 2.64 3.51 0.00 0.00 3.42 3.08 0.00 1.23 1.33 1.56 2.35 3.86 11.71 2.06 7.33 2.12 2.02 2.88 9.72 9.45 11.06 8.64 6.79 15.83 13.89 14.10 11.48 6.78 1.07 1.80 0.00 1.76 4.47 1.49 2.01 1.79 3.03 3.76 0.69 2.34 3.48 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 41826 41827 41828 41830 41850 41870 41872 41874 41899 42000 42100 42104 42106 42107 42120 42140 42145 42160 42180 42182 42200 42205 42210 42215 42220 42225 42226 42227 42235 42260 42280 42281 42299 42300 42305 42310 42320 42330 42335 42340 42400 42405 42408 HCPCS 2 CPT 1/ 0.30 0.35 0.44 0.44 0.00 0.00 0.30 0.45 0.00 0.12 0.13 0.16 0.25 0.44 0.52 0.13 0.65 0.17 0.21 0.40 1.27 1.58 2.17 1.31 0.73 0.86 1.01 0.98 0.72 1.26 0.19 0.17 0.00 0.16 0.51 0.13 0.21 0.19 0.29 0.42 0.06 0.28 0.45 Mal-Practice RVUs 7.77 10.68 7.68 9.86 0.00 0.00 9.09 9.34 0.00 3.71 3.65 5.25 6.78 11.26 NA 6.02 NA 5.62 5.95 8.29 NA NA NA NA NA NA NA NA NA 21.01 4.00 4.95 0.00 5.04 NA 3.90 6.14 5.62 9.10 11.37 2.72 7.33 11.13 Fully Implemented NonFacility Total 5.75 9.86 7.43 9.05 0.00 0.00 8.44 8.65 0.00 3.88 3.57 4.58 5.89 10.79 NA 5.63 NA 6.09 5.84 8.16 NA NA NA NA NA NA NA NA NA 21.42 3.78 4.80 0.00 4.96 NA 3.95 5.92 5.58 8.68 11.17 2.55 7.53 10.99 Year 2007 Transitional Non-Facility Total 5.25 7.45 5.23 6.98 0.00 0.00 6.48 6.37 0.00 2.52 2.68 3.42 4.43 8.50 23.73 3.73 17.13 3.61 4.52 6.65 21.94 22.75 26.95 17.53 14.60 22.64 22.69 20.57 18.98 17.29 2.60 3.69 0.00 3.72 10.45 3.03 4.36 4.04 6.33 8.32 1.43 5.61 8.13 Fully Implemented Facility Total 4.88 7.66 6.19 7.33 0.00 0.00 6.62 6.66 0.00 2.60 2.79 3.38 4.72 8.78 23.93 3.84 17.61 4.11 4.75 7.12 23.40 24.60 28.14 18.83 14.59 26.35 25.14 24.89 20.12 18.14 2.82 3.92 0.00 3.87 11.21 3.20 4.59 4.21 6.67 8.82 1.53 5.93 8.51 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 010 090 010 010 000 000 090 090 YYY 010 010 010 010 090 090 090 090 010 010 010 090 090 090 090 090 090 090 090 090 090 010 010 YYY 010 090 010 010 010 090 090 000 010 090 Global 69864 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00243 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A C A A A A A A A A A A A A A A A A A A A A A A A Status Drainage of salivary cyst ...................................... Excise parotid gland/lesion .................................. Excise parotid gland/lesion .................................. Excise parotid gland/lesion .................................. Excise parotid gland/lesion .................................. Excise parotid gland/lesion .................................. Excise submaxillary gland .................................... Excise sublingual gland ....................................... Repair salivary duct ............................................. Repair salivary duct ............................................. Parotid duct diversion .......................................... Parotid duct diversion .......................................... Parotid duct diversion .......................................... Parotid duct diversion .......................................... Injection for salivary x-ray .................................... Closure of salivary fistula ..................................... Dilation of salivary duct ........................................ Dilation of salivary duct ........................................ Ligation of salivary duct ....................................... Salivary surgery procedure .................................. Drainage of tonsil abscess ................................... Drainage of throat abscess .................................. Drainage of throat abscess .................................. Biopsy of throat .................................................... Biopsy of throat .................................................... Biopsy of upper nose/throat ................................. Biopsy of upper nose/throat ................................. Excise pharynx lesion .......................................... Remove pharynx foreign body ............................. Excision of neck cyst ........................................... Excision of neck cyst ........................................... Remove tonsils and adenoids .............................. Remove tonsils and adenoids .............................. Removal of tonsils ................................................ Removal of tonsils ................................................ Removal of adenoids ........................................... Removal of adenoids ........................................... Removal of adenoids ........................................... Removal of adenoids ........................................... Extensive surgery of throat .................................. Extensive surgery of throat .................................. Extensive surgery of throat .................................. Excision of tonsil tags .......................................... Description 2.85 9.46 17.99 20.87 13.31 22.54 7.05 4.66 4.34 6.23 6.16 9.22 11.65 8.26 1.25 4.86 0.77 1.13 2.57 0.00 1.64 6.31 12.28 1.41 1.56 1.26 1.60 2.32 1.83 3.30 7.23 4.17 4.31 3.45 3.40 2.60 2.75 2.33 3.21 12.02 17.57 32.35 2.25 Physician Work RVUs 3 5.07 NA NA NA NA NA NA 5.90 5.82 6.80 NA NA NA NA 2.10 6.51 1.20 1.42 4.74 0.00 2.76 4.34 NA 2.28 3.84 3.34 3.56 2.99 2.14 5.75 NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs 4.66 NA NA NA NA NA NA 5.90 5.72 7.04 NA NA NA NA 2.93 6.56 1.13 1.37 4.31 0.00 2.68 4.71 NA 2.21 4.53 3.64 3.94 3.07 2.28 5.72 NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 2.40 4.99 7.87 8.72 6.17 8.98 3.53 3.70 3.66 4.39 5.95 7.56 8.76 6.43 0.35 3.38 0.61 0.73 2.24 0.00 1.53 2.91 6.69 1.19 1.54 1.38 1.49 1.47 1.26 3.43 5.77 2.57 2.73 2.45 2.46 2.23 2.44 1.77 2.45 11.08 14.17 19.29 2.13 Fully Implemented Facility PE RVUs 2.67 5.91 10.11 11.46 8.00 12.00 4.48 4.11 4.05 5.12 6.39 8.15 9.83 7.45 0.40 3.94 0.69 0.82 2.50 0.00 1.66 3.57 7.84 1.35 1.93 1.64 1.82 1.82 1.31 3.51 6.25 3.11 3.31 2.99 2.89 2.48 2.74 2.29 2.83 11.01 15.72 22.21 2.33 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 42409 42410 42415 42420 42425 42426 42440 42450 42500 42505 42507 42508 42509 42510 42550 42600 42650 42660 42665 42699 42700 42720 42725 42800 42802 42804 42806 42808 42809 42810 42815 42820 42821 42825 42826 42830 42831 42835 42836 42842 42844 42845 42860 HCPCS 2 CPT 1/ 0.27 0.91 1.43 1.65 1.05 1.81 0.59 0.42 0.41 0.55 0.49 1.04 0.93 0.66 0.07 0.43 0.07 0.09 0.23 0.00 0.13 0.44 0.91 0.11 0.12 0.10 0.13 0.19 0.16 0.29 0.61 0.31 0.35 0.25 0.27 0.20 0.22 0.21 0.26 0.71 1.16 1.99 0.18 Mal-Practice RVUs 8.19 NA NA NA NA NA NA 10.98 10.57 13.58 NA NA NA NA 3.42 11.80 2.04 2.64 7.54 0.00 4.53 11.09 NA 3.80 5.52 4.70 5.29 5.50 4.13 9.34 NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total 7.78 NA NA NA NA NA NA 10.98 10.47 13.82 NA NA NA NA 4.25 11.85 1.97 2.59 7.11 0.00 4.45 11.46 NA 3.73 6.21 5.00 5.67 5.58 4.27 9.31 NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 5.52 15.36 27.29 31.24 20.53 33.33 11.17 8.78 8.41 11.17 12.60 17.82 21.34 15.35 1.67 8.67 1.45 1.95 5.04 0.00 3.30 9.66 19.88 2.71 3.22 2.74 3.22 3.98 3.25 7.02 13.61 7.05 7.39 6.15 6.13 5.03 5.41 4.31 5.92 23.81 32.90 53.63 4.56 Fully Implemented Facility Total 5.79 16.28 29.53 33.98 22.36 36.35 12.12 9.19 8.80 11.90 13.04 18.41 22.41 16.37 1.72 9.23 1.53 2.04 5.30 0.00 3.43 10.32 21.03 2.87 3.61 3.00 3.55 4.33 3.30 7.10 14.09 7.59 7.97 6.69 6.56 5.28 5.71 4.83 6.30 23.74 34.45 56.55 4.76 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 000 090 000 000 090 YYY 010 010 090 010 010 010 010 010 010 090 090 090 090 090 090 090 090 090 090 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69865 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00244 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A C A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Excision of lingual tonsil ....................................... Partial removal of pharynx ................................... Revision of pharyngeal walls ............................... Revision of pharyngeal walls ............................... Repair throat wound ............................................. Reconstruction of throat ....................................... Repair throat, esophagus ..................................... Surgical opening of throat .................................... Control throat bleeding ......................................... Control throat bleeding ......................................... Control throat bleeding ......................................... Control nose/throat bleeding ................................ Control nose/throat bleeding ................................ Control nose/throat bleeding ................................ Throat surgery procedure .................................... Incision of esophagus .......................................... Throat muscle surgery ......................................... Incision of esophagus .......................................... Excision of esophagus lesion .............................. Excision of esophagus lesion .............................. Removal of esophagus ........................................ Removal of esophagus ........................................ Removal of esophagus ........................................ Removal of esophagus ........................................ Partial removal of esophagus .............................. Partial removal of esophagus .............................. Partial removal of esophagus .............................. Partial removal of esophagus .............................. Partial removal of esophagus .............................. Partial removal of esophagus .............................. Removal of esophagus ........................................ Removal of esophagus pouch ............................. Removal of esophagus pouch ............................. Esophagus endoscopy ......................................... Esoph scope w/submucous inj ............................ Esophagus endoscopy, biopsy ............................ Esoph scope w/sclerosis inj ................................. Esophagus endoscopy/ligation ............................ Esophagus endoscopy ......................................... Esophagus endoscopy/lesion .............................. Esophagus endoscopy ......................................... Esophagus endoscopy ......................................... Esoph endoscopy, dilation ................................... Description 5.44 18.92 25.77 33.61 5.26 8.16 9.33 7.92 2.35 5.69 7.31 5.76 6.54 7.53 0.00 8.14 7.91 21.70 9.55 16.99 43.97 82.66 47.27 79.85 92.78 43.52 66.86 51.22 43.97 82.91 68.83 12.41 26.09 1.59 2.09 1.89 3.76 3.78 2.60 2.40 2.90 2.80 2.10 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 3.54 5.55 5.12 NA NA NA 3.00 6.55 NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 3.98 4.86 5.44 NA NA NA 1.55 6.85 NA NA Year 2007 Transitional Non-Facility PE RVUs 8.02 13.98 17.59 21.36 2.75 10.30 12.97 9.34 1.61 4.15 4.77 3.52 4.15 4.50 0.00 4.35 4.20 10.06 5.10 7.22 16.57 25.71 17.08 27.82 28.93 15.32 21.36 18.28 15.73 25.89 23.97 6.01 9.99 0.93 1.19 0.99 1.97 2.07 1.28 1.23 1.42 1.55 1.13 Fully Implemented Facility PE RVUs 8.43 14.11 17.28 21.86 3.43 11.48 16.24 10.34 1.87 4.76 5.63 4.02 4.88 5.40 0.00 5.15 5.17 10.54 5.94 7.72 17.84 17.09 18.79 18.29 19.75 16.78 15.68 14.82 16.98 17.05 15.80 7.17 8.57 1.04 1.12 0.95 1.63 1.66 1.22 1.10 1.25 1.40 1.01 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 42870 42890 42892 42894 42900 42950 42953 42955 42960 42961 42962 42970 42971 42972 42999 43020 43030 43045 43100 43101 43107 43108 43112 43113 43116 43117 43118 43121 43122 43123 43124 43130 43135 43200 43201 43202 43204 43205 43215 43216 43217 43219 43220 HCPCS 2 CPT 1/ 0.44 1.05 1.28 1.87 0.50 0.72 0.88 0.80 0.19 0.45 0.58 0.39 0.51 0.62 0.00 0.87 0.70 2.59 0.93 2.32 5.24 4.08 5.81 4.43 3.06 5.19 4.11 3.91 5.42 4.16 3.74 1.16 2.34 0.13 0.15 0.15 0.30 0.28 0.22 0.20 0.26 0.24 0.17 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 5.26 7.79 7.16 NA NA NA 5.60 9.71 NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 5.70 7.10 7.48 NA NA NA 4.15 10.01 NA NA Year 2007 Transitional Non-Facility Total 13.90 33.95 44.64 56.84 8.51 19.18 23.18 18.06 4.15 10.29 12.66 9.67 11.20 12.65 0.00 13.36 12.81 34.35 15.58 26.53 65.78 112.45 70.16 112.10 124.77 64.03 92.33 73.41 65.12 112.96 96.54 19.58 38.42 2.65 3.43 3.03 6.03 6.13 4.10 3.83 4.58 4.59 3.40 Fully Implemented Facility Total 14.31 34.08 44.33 57.34 9.19 20.36 26.45 19.06 4.41 10.90 13.52 10.17 11.93 13.55 0.00 14.16 13.78 34.83 16.42 27.03 67.05 103.83 71.87 102.57 115.59 65.49 86.65 69.95 66.37 104.12 88.37 20.74 37.00 2.76 3.36 2.99 5.69 5.72 4.04 3.70 4.41 4.44 3.28 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 010 090 090 090 010 090 090 090 090 090 YYY 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 000 000 000 000 000 000 000 000 000 000 Global 69866 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00245 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C A A Status Esoph endoscopy, dilation ................................... Esoph endoscopy, repair ..................................... Esoph endoscopy, ablation .................................. Esoph endoscopy w/us exam .............................. Esoph endoscopy w/us fn bx ............................... Upper GI endoscopy, exam ................................. Uppr gi endoscopy, diagnosis .............................. Uppr gi scope w/submuc inj ................................. Endoscopic us exam, esoph ................................ Uppr gi endoscopy w/us fn bx ............................. Upper GI endoscopy, biopsy ............................... Esoph endoscope w/drain cyst ............................ Upper GI endoscopy with tube ............................ Uppr gi endoscopy w/us fn bx ............................. Upper gi endoscopy & inject ................................ Upper GI endoscopy/ligation ................................ Uppr gi scope dilate strictr ................................... Place gastrostomy tube ....................................... Operative upper GI endoscopy ............................ Uppr gi endoscopy/guide wire ............................. Esoph endoscopy, dilation ................................... Upper GI endoscopy/tumor .................................. Operative upper GI endoscopy ............................ Operative upper GI endoscopy ............................ Uppr gi endoscopy w/stent .................................. Uppr gi scope w/thrml txmnt ................................ Operative upper GI endoscopy ............................ Endoscopic ultrasound exam ............................... Endo cholangiopancreatograph ........................... Endo cholangiopancreatograph ........................... Endo cholangiopancreatograph ........................... Endo cholangiopancreatograph ........................... Endo cholangiopancreatograph ........................... Endo cholangiopancreatograph ........................... Endo cholangiopancreatograph ........................... Endo cholangiopancreatograph ........................... Endo cholangiopancreatograph ........................... Endo cholangiopancreatograph ........................... Endo cholangiopancreatograph ........................... Laparoscopy, fundoplasty .................................... Laparoscope proc, esoph .................................... Repair of esophagus ............................................ Repair esophagus and fistula .............................. Description 2.34 3.59 3.76 3.19 4.47 2.01 2.39 2.92 3.98 5.02 2.87 6.85 2.59 7.30 4.56 5.04 3.18 4.32 3.38 3.15 2.90 3.20 3.69 4.81 4.34 5.50 4.54 5.19 5.95 6.26 7.38 7.28 8.89 10.00 7.38 7.38 8.20 7.38 7.38 18.00 0.00 9.21 17.98 Physician Work RVUs 3 NA NA NA NA NA 4.96 5.26 6.69 NA NA 6.02 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA 5.23 5.19 6.47 NA NA 5.79 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA Year 2007 Transitional Non-Facility PE RVUs 1.29 1.84 1.87 1.75 2.39 1.02 1.37 1.67 2.17 2.57 1.57 3.49 1.43 3.73 2.40 2.68 1.65 2.14 1.80 1.80 1.64 1.65 1.95 2.56 2.28 2.04 2.41 2.72 3.11 3.27 3.78 3.79 4.52 5.03 3.69 3.94 4.18 3.79 3.86 6.70 0.00 5.20 7.65 Fully Implemented Facility PE RVUs 1.10 1.55 1.63 1.42 1.96 0.91 1.11 1.33 1.74 2.11 1.29 2.82 1.18 2.98 1.94 2.14 1.39 1.80 1.48 1.43 1.32 1.40 1.60 2.05 1.85 2.16 1.94 2.17 2.49 2.61 3.03 3.02 3.61 4.03 3.01 3.15 3.35 3.03 3.05 7.13 0.00 6.08 9.93 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 43226 43227 43228 43231 43232 43234 43235 43236 43237 43238 43239 43240 43241 43242 43243 43244 43245 43246 43247 43248 43249 43250 43251 43255 43256 43257 43258 43259 43260 43261 43262 43263 43264 43265 43267 43268 43269 43271 43272 43280 43289 43300 43305 HCPCS 2 CPT 1/ 0.19 0.28 0.34 0.23 0.34 0.17 0.19 0.21 0.43 0.43 0.22 0.56 0.21 0.53 0.33 0.37 0.26 0.34 0.27 0.23 0.22 0.26 0.29 0.35 0.32 0.36 0.33 0.35 0.43 0.46 0.54 0.54 0.65 0.73 0.54 0.54 0.60 0.54 0.54 2.28 0.00 1.12 1.54 Mal-Practice RVUs NA NA NA NA NA 7.14 7.84 9.82 NA NA 9.11 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA Fully Implemented NonFacility Total NA NA NA NA NA 7.41 7.77 9.60 NA NA 8.88 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA Year 2007 Transitional Non-Facility Total 3.82 5.71 5.97 5.17 7.20 3.20 3.95 4.80 6.58 8.02 4.66 10.90 4.23 11.56 7.29 8.09 5.09 6.80 5.45 5.18 4.76 5.11 5.93 7.72 6.94 7.90 7.28 8.26 9.49 9.99 11.70 11.61 14.06 15.76 11.61 11.86 12.98 11.71 11.78 26.98 0.00 15.53 27.17 Fully Implemented Facility Total 3.63 5.42 5.73 4.84 6.77 3.09 3.69 4.46 6.15 7.56 4.38 10.23 3.98 10.81 6.83 7.55 4.83 6.46 5.13 4.81 4.44 4.86 5.58 7.21 6.51 8.02 6.81 7.71 8.87 9.33 10.95 10.84 13.15 14.76 10.93 11.07 12.15 10.95 10.97 27.41 0.00 16.41 29.45 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 090 YYY 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69867 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00246 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C C A A A A A A A A A A A A Status Repair of esophagus ............................................ Repair esophagus and fistula .............................. Esophagoplasty congenital .................................. Tracheo-esophagoplasty cong ............................. Fuse esophagus & stomach ................................ Revise esophagus & stomach ............................. Revise esophagus & stomach ............................. Revise esophagus & stomach ............................. Repair of esophagus ............................................ Repair of esophagus ............................................ Fuse esophagus & intestine ................................ Fuse esophagus & intestine ................................ Surgical opening, esophagus ............................... Surgical opening, esophagus ............................... Surgical opening, esophagus ............................... Gastrointestinal repair .......................................... Gastrointestinal repair .......................................... Ligate esophagus veins ....................................... Esophagus surgery for veins ............................... Ligate/staple esophagus ...................................... Repair esophagus wound .................................... Repair esophagus wound .................................... Repair esophagus opening .................................. Repair esophagus opening .................................. Dilate esophagus ................................................. Dilate esophagus ................................................. Dilate esophagus ................................................. Dilate esophagus ................................................. Pressure treatment esophagus ............................ Free jejunum flap, microvasc ............................... Esophagus surgery procedure ............................. Surgical opening of stomach ............................... Surgical repair of stomach ................................... Surgical repair of stomach ................................... Surgical opening of stomach ............................... Incision of pyloric muscle ..................................... Biopsy of stomach ................................................ Biopsy of stomach ................................................ Excision of stomach lesion .................................. Excision of stomach lesion .................................. Removal of stomach ............................................ Removal of stomach ............................................ Removal of stomach ............................................ Description 26.18 29.23 48.17 53.15 23.18 22.86 22.47 22.15 22.06 22.93 22.86 24.10 19.31 21.87 17.68 39.90 45.50 25.47 26.36 24.55 16.28 28.70 16.65 24.91 1.38 1.51 2.57 3.06 3.79 0.00 0.00 12.71 22.47 25.56 15.01 11.21 1.91 13.64 16.26 20.25 33.91 39.40 39.90 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 2.66 6.28 12.96 6.93 NA 0.00 0.00 NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 2.64 6.12 13.55 6.72 NA 0.00 0.00 NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 10.10 9.97 17.28 18.37 8.83 8.39 8.37 9.33 8.23 9.54 9.09 10.08 8.02 9.59 8.17 15.81 16.89 13.73 9.44 10.37 7.55 11.93 6.96 10.37 0.93 1.02 1.48 1.64 1.74 0.00 0.00 5.24 8.13 9.02 6.86 4.85 0.82 5.43 6.08 7.55 11.09 12.47 12.62 Fully Implemented Facility PE RVUs 10.82 11.41 18.43 18.98 9.11 8.67 8.68 9.30 8.46 9.72 8.99 10.03 8.34 9.74 8.33 15.26 16.88 10.51 9.47 9.78 7.61 11.79 7.29 10.07 0.75 0.80 1.20 1.37 1.55 0.00 0.00 5.04 8.26 9.34 6.65 5.15 0.70 5.32 6.13 7.56 11.62 12.10 12.59 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 43310 43312 43313 43314 43320 43324 43325 43326 43330 43331 43340 43341 43350 43351 43352 43360 43361 43400 43401 43405 43410 43415 43420 43425 43450 43453 43456 43458 43460 43496 43499 43500 43501 43502 43510 43520 43600 43605 43610 43611 43620 43621 43622 HCPCS 2 CPT 1/ 3.61 4.01 5.47 6.65 2.74 2.76 2.60 2.85 2.63 2.94 2.46 2.92 1.42 2.47 2.06 4.97 4.50 1.96 3.05 2.84 1.72 3.53 1.43 3.03 0.11 0.11 0.20 0.24 0.31 0.00 0.00 1.45 2.65 3.10 1.48 1.36 0.14 1.58 1.94 2.36 3.96 4.04 4.30 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 4.15 7.90 15.73 10.23 NA 0.00 0.00 NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 4.13 7.74 16.32 10.02 NA 0.00 0.00 NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 39.89 43.21 70.92 78.17 34.75 34.01 33.44 34.33 32.92 35.41 34.41 37.10 28.75 33.93 27.91 60.68 66.89 41.16 38.85 37.76 25.55 44.16 25.04 38.31 2.42 2.64 4.25 4.94 5.84 0.00 0.00 19.40 33.25 37.68 23.35 17.42 2.87 20.65 24.28 30.16 48.96 55.91 56.82 Fully Implemented Facility Total 40.61 44.65 72.07 78.78 35.03 34.29 33.75 34.30 33.15 35.59 34.31 37.05 29.07 34.08 28.07 60.13 66.88 37.94 38.88 37.17 25.61 44.02 25.37 38.01 2.24 2.42 3.97 4.67 5.65 0.00 0.00 19.20 33.38 38.00 23.14 17.72 2.75 20.54 24.33 30.17 49.49 55.54 56.79 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 000 000 000 000 000 090 YYY 090 090 090 090 090 000 090 090 090 090 090 090 Global 69868 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00247 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A C C A A A C A A A A A A A A A A A A A A A A A N A A A A A A A A A A Status Removal of stomach, partial ................................ Removal of stomach, partial ................................ Removal of stomach, partial ................................ Removal of stomach, partial ................................ Removal of stomach, partial ................................ Vagotomy & pylorus repair .................................. Vagotomy & pylorus repair .................................. Lap gastric bypass/roux-en-y ............................... Lap gastr bypass incl smll i ................................. Lap impl electrode, antrum .................................. Lap revise/remv eltrd antrum ............................... Laparoscopy, vagus nerve ................................... Laparoscopy, vagus nerve ................................... Laparoscopy, gastrostomy ................................... Laparoscope proc, stom ...................................... Place gastrostomy tube ....................................... Nasal/orogastric w/stent ....................................... Change gastrostomy tube .................................... Reposition gastrostomy tube ............................... Lap, place gastr adjust band ............................... Lap, revise adjust gast band ................................ Lap, remove adjust gast band ............................. Lap, change adjust gast band ............................. Lap remov adj gast band/port .............................. Reconstruction of pylorus .................................... Fusion of stomach and bowel .............................. Fusion of stomach and bowel .............................. Fusion of stomach and bowel .............................. Place gastrostomy tube ....................................... Place gastrostomy tube ....................................... Place gastrostomy tube ....................................... Repair of stomach lesion ..................................... V-band gastroplasty ............................................. Gastroplasty w/o v-band ...................................... Gastroplasty duodenal switch .............................. Gastric bypass for obesity ................................... Gastric bypass incl small i ................................... Revision gastroplasty ........................................... Revise stomach-bowel fusion .............................. Revise stomach-bowel fusion .............................. Revise stomach-bowel fusion .............................. Revise stomach-bowel fusion .............................. Repair stomach opening ...................................... Description 24.38 35.01 33.01 36.51 2.06 19.43 19.68 29.24 31.37 0.00 0.00 10.13 12.13 8.38 0.00 4.62 0.81 1.10 2.01 17.85 20.64 15.62 20.64 15.66 15.35 16.80 22.40 21.63 10.75 8.38 17.26 22.70 20.90 21.08 33.12 27.23 30.10 32.57 27.45 28.56 27.76 28.92 11.36 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA 0.00 0.00 NA NA NA 0.00 NA NA 12.83 0.91 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA 0.00 0.00 NA NA NA 0.00 NA NA 4.77 1.11 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 8.63 11.36 10.86 11.88 0.53 7.37 7.72 10.23 11.14 0.00 0.00 4.63 5.18 4.39 0.00 1.90 0.23 0.39 0.59 7.47 8.16 5.99 8.16 6.14 5.88 6.28 8.14 7.92 5.19 5.15 7.14 8.22 6.75 7.81 12.43 10.05 10.67 11.35 9.44 9.78 9.53 10.12 5.04 Fully Implemented Facility PE RVUs 9.02 9.70 9.71 10.53 0.66 7.28 7.45 10.97 11.79 0.00 0.00 4.73 5.61 4.23 0.00 2.12 0.25 0.44 0.64 7.65 8.48 6.31 8.48 6.46 5.89 6.20 6.84 7.99 4.93 4.67 6.92 7.13 7.53 7.77 11.19 10.03 10.84 11.70 9.72 10.19 9.85 10.41 4.64 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 43631 43632 43633 43634 43635 43640 43641 43644 43645 43647 43648 43651 43652 43653 43659 43750 43752 43760 43761 43770 43771 43772 43773 43774 43800 43810 43820 43825 43830 43831 43832 43840 43842 43843 43845 43846 43847 43848 43850 43855 43860 43865 43870 HCPCS 2 CPT 1/ 2.99 2.99 3.06 3.33 0.27 2.26 2.25 3.16 3.54 0.00 0.00 1.33 1.55 1.01 0.00 0.43 0.02 0.09 0.13 2.19 2.55 1.93 2.56 1.85 1.82 1.94 2.04 2.54 1.25 1.03 1.98 2.06 2.45 2.46 4.06 3.19 3.56 3.88 3.28 3.47 3.31 3.51 1.27 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA 0.00 0.00 NA NA NA 0.00 NA NA 14.02 3.05 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA 0.00 0.00 NA NA NA 0.00 NA NA 5.96 3.25 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 36.00 49.36 46.93 51.72 2.86 29.06 29.65 42.63 46.05 0.00 0.00 16.09 18.86 13.78 0.00 6.95 1.06 1.58 2.73 27.51 31.35 23.54 31.36 23.65 23.05 25.02 32.58 32.09 17.19 14.56 26.38 32.98 30.10 31.35 49.61 40.47 44.33 47.80 40.17 41.81 40.60 42.55 17.67 Fully Implemented Facility Total 36.39 47.70 45.78 50.37 2.99 28.97 29.38 43.37 46.70 0.00 0.00 16.19 19.29 13.62 0.00 7.17 1.08 1.63 2.78 27.69 31.67 23.86 31.68 23.97 23.06 24.94 31.28 32.16 16.93 14.08 26.16 31.89 30.88 31.31 48.37 40.45 44.50 48.15 40.45 42.22 40.92 42.84 17.27 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 ZZZ 090 090 090 090 YYY YYY 090 090 090 YYY 010 000 000 000 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69869 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00248 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A C C A A A C A A A A A A A A A A A A A A A A A A R R R R C A A A A A A A A A A A A A Status Repair stomach-bowel fistula ............................... Impl/redo electrd, antrum ..................................... Revise/remove electrd antrum ............................. Revise gastric port, open ..................................... Remove gastric port, open ................................... Change gastric port, open ................................... Stomach surgery procedure ................................. Freeing of bowel adhesion ................................... Incision of small bowel ......................................... Insert needle cath bowel ...................................... Explore small intestine ......................................... Decompress small bowel ..................................... Incision of large bowel ......................................... Reduce bowel obstruction .................................... Correct malrotation of bowel ................................ Biopsy of bowel .................................................... Excise intestine lesion(s) ..................................... Excision of bowel lesion(s) .................................. Removal of small intestine ................................... Removal of small intestine ................................... Removal of small intestine ................................... Enterectomy w/o taper, cong ............................... Enterectomy w/taper, cong .................................. Enterectomy cong, add-on ................................... Bowel to bowel fusion .......................................... Enterectomy, cadaver donor ................................ Enterectomy, live donor ....................................... Intestine transplnt, cadaver .................................. Intestine transplant, live ....................................... Remove intestinal allograft ................................... Mobilization of colon ............................................ Partial removal of colon ....................................... Partial removal of colon ....................................... Partial removal of colon ....................................... Partial removal of colon ....................................... Partial removal of colon ....................................... Partial removal of colon ....................................... Partial removal of colon ....................................... Removal of colon ................................................. Removal of colon/ileostomy ................................. Removal of colon/ileostomy ................................. Removal of colon/ileostomy ................................. Colectomy w/ileoanal anast ................................. Description 27.05 0.00 0.00 4.54 4.24 6.34 0.00 18.38 14.18 2.62 16.14 16.23 16.43 15.44 25.53 2.01 13.96 16.44 20.74 4.44 19.93 42.02 49.09 4.44 21.98 0.00 0.00 0.00 0.00 0.00 2.23 22.46 29.75 27.63 29.75 28.45 35.14 33.56 29.99 34.73 34.23 37.23 35.49 Physician Work RVUs 3 NA 0.00 0.00 NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 0.00 0.00 0.00 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA 0.00 0.00 NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 0.00 0.00 0.00 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 9.37 0.00 0.00 3.38 2.94 3.86 0.00 6.64 5.55 0.69 6.03 6.31 6.16 5.86 8.56 0.90 5.56 6.18 7.21 1.14 7.08 13.91 14.80 1.05 8.02 0.00 0.00 0.00 0.00 0.00 0.57 8.14 11.90 10.35 10.70 9.58 13.42 11.05 12.68 14.10 13.56 14.79 15.67 Fully Implemented Facility PE RVUs 9.76 0.00 0.00 3.19 2.81 3.79 0.00 6.69 5.47 0.83 5.96 6.05 6.06 5.93 8.68 0.76 5.31 6.12 7.11 1.43 7.21 14.06 15.48 1.41 6.66 0.00 0.00 0.00 0.00 0.00 0.71 8.52 10.51 10.60 9.88 10.50 12.99 9.27 12.19 13.57 13.37 14.97 15.67 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 43880 43881 43882 43886 43887 43888 43999 44005 44010 44015 44020 44021 44025 44050 44055 44100 44110 44111 44120 44121 44125 44126 44127 44128 44130 44132 44133 44135 44136 44137 44139 44140 44141 44143 44144 44145 44146 44147 44150 44151 44155 44156 44157 HCPCS 2 CPT 1/ 3.27 0.00 0.00 0.25 0.51 0.70 0.00 2.15 1.64 0.35 1.86 1.87 1.90 1.86 2.91 0.17 1.55 1.87 2.25 0.58 2.27 4.69 5.77 0.61 1.88 0.00 0.00 0.00 0.00 0.00 0.28 2.71 2.53 3.05 2.86 3.29 3.41 2.56 3.04 3.49 3.28 3.95 3.93 Mal-Practice RVUs NA 0.00 0.00 NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 0.00 0.00 0.00 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA 0.00 0.00 NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 0.00 0.00 0.00 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 39.69 0.00 0.00 8.17 7.69 10.90 0.00 27.17 21.37 3.66 24.03 24.41 24.49 23.16 37.00 3.08 21.07 24.49 30.20 6.16 29.28 60.62 69.66 6.10 31.88 0.00 0.00 0.00 0.00 0.00 3.08 33.31 44.18 41.03 43.31 41.32 51.97 47.17 45.71 52.32 51.07 55.97 55.09 Fully Implemented Facility Total 40.08 0.00 0.00 7.98 7.56 10.83 0.00 27.22 21.29 3.80 23.96 24.15 24.39 23.23 37.12 2.94 20.82 24.43 30.10 6.45 29.41 60.77 70.34 6.46 30.52 0.00 0.00 0.00 0.00 0.00 3.22 33.69 42.79 41.28 42.49 42.24 51.54 45.39 45.22 51.79 50.88 56.15 55.09 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 YYY YYY 090 090 090 YYY 090 090 ZZZ 090 090 090 090 090 000 090 090 090 ZZZ 090 090 090 ZZZ 090 XXX XXX XXX XXX XXX ZZZ 090 090 090 090 090 090 090 090 090 090 090 090 Global 69870 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00249 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A C A A A A A A A A A A A A A A A A A A A A A A A A Status Colectomy w/neo-rectum pouch .......................... Removal of colon ................................................. Lap, enterolysis .................................................... Lap, jejunostomy .................................................. Lap, ileo/jejuno-stomy .......................................... Lap, colostomy ..................................................... Lap, enterectomy ................................................. Lap resect s/intestine, addl .................................. Laparo partial colectomy ...................................... Lap colectomy part w/ileum ................................. Lap part colectomy w/stoma ................................ L colectomy/coloproctostomy ............................... L colectomy/coloproctostomy ............................... Laparo total proctocolectomy ............................... Lap colectomy w/proctectomy .............................. Laparo total proctocolectomy ............................... Lap, mobil splenic fl add-on ................................. Lap, close enterostomy ........................................ Laparoscope proc, intestine ................................. Open bowel to skin .............................................. Ileostomy/jejunostomy .......................................... Revision of ileostomy ........................................... Revision of ileostomy ........................................... Devise bowel pouch ............................................. Colostomy ............................................................ Colostomy with biopsies ...................................... Revision of colostomy .......................................... Revision of colostomy .......................................... Revision of colostomy .......................................... Small bowel endoscopy ....................................... Small bowel endoscopy/biopsy ............................ Small bowel endoscopy ....................................... Small bowel endoscopy ....................................... Small bowel endoscopy ....................................... Small bowel endoscopy ....................................... Small bowel endoscopy ....................................... Small bowel endoscopy/stent .............................. Small bowel endoscopy ....................................... Small bowel endoscopy ....................................... Small bowel endoscopy ....................................... Small bowel endoscopy/biopsy ............................ Small bowel endoscopy ....................................... S bowel endoscope w/stent ................................. Description 36.49 20.78 0.77 0.53 17.27 19.20 23.26 4.44 26.29 22.86 29.63 31.79 33.86 29.88 36.87 34.37 3.50 28.49 0.00 13.65 17.49 9.33 16.61 23.46 19.75 13.15 9.12 17.06 19.47 2.59 2.87 3.49 3.73 3.31 4.40 4.51 4.79 4.40 3.49 5.25 5.52 7.12 7.46 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 15.97 7.57 2.15 2.15 8.19 8.77 8.37 1.14 9.00 7.88 10.58 10.24 12.17 11.27 13.85 13.26 0.89 9.59 0.00 5.58 6.45 4.65 6.88 9.35 7.66 9.41 4.96 6.96 7.58 1.53 1.67 1.96 2.04 1.81 2.42 2.46 2.58 2.16 1.74 2.48 2.84 3.61 3.34 Fully Implemented Facility PE RVUs 15.97 7.70 5.21 4.13 8.25 8.82 8.78 1.41 9.71 8.60 11.08 11.17 12.89 11.72 14.47 13.58 1.14 10.36 0.00 5.51 6.63 4.16 6.63 8.74 7.65 8.78 4.44 6.90 7.43 1.21 1.32 1.53 1.63 1.47 1.90 1.91 2.12 1.84 1.50 2.14 2.31 2.92 3.02 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 44158 44160 44180 44186 44187 44188 44202 44203 44204 44205 44206 44207 44208 44210 44211 44212 44213 44227 44238 44300 44310 44312 44314 44316 44320 44322 44340 44345 44346 44360 44361 44363 44364 44365 44366 44369 44370 44372 44373 44376 44377 44378 44379 HCPCS 2 CPT 1/ 4.06 2.37 1.86 1.27 1.96 2.24 2.85 0.57 3.11 2.75 3.46 3.67 3.88 3.42 4.17 3.78 0.44 3.38 0.00 1.60 1.99 0.92 1.75 2.38 2.26 1.54 0.99 1.97 2.13 0.19 0.21 0.27 0.27 0.24 0.32 0.33 0.37 0.35 0.27 0.42 0.40 0.52 0.62 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 56.52 30.72 4.78 3.95 27.42 30.21 34.48 6.15 38.40 33.49 43.67 45.70 49.91 44.57 54.89 51.41 4.83 41.46 0.00 20.83 25.93 14.90 25.24 35.19 29.67 24.10 15.07 25.99 29.18 4.31 4.75 5.72 6.04 5.36 7.14 7.30 7.74 6.91 5.50 8.15 8.76 11.25 11.42 Fully Implemented Facility Total 56.52 30.85 7.84 5.93 27.48 30.26 34.89 6.42 39.11 34.21 44.17 46.63 50.63 45.02 55.51 51.73 5.08 42.23 0.00 20.76 26.11 14.41 24.99 34.58 29.66 23.47 14.55 25.93 29.03 3.99 4.40 5.29 5.63 5.02 6.62 6.75 7.28 6.59 5.26 7.81 8.23 10.56 11.10 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 ZZZ 090 090 090 090 090 090 090 090 ZZZ 090 YYY 090 090 090 090 090 090 090 090 090 090 000 000 000 000 000 000 000 000 000 000 000 000 000 000 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69871 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00250 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C A A C A A A C A A A A A A Status Small bowel endoscopy ....................................... Small bowel endoscopy ....................................... Ileoscopy w/stent .................................................. Endoscopy of bowel pouch .................................. Endoscopy, bowel pouch/biop ............................. Colonoscopy ......................................................... Colonoscopy with biopsy ..................................... Colonoscopy for foreign body .............................. Colonoscopy for bleeding .................................... Colonoscopy & polypectomy ................................ Colonoscopy, lesion removal ............................... Colonoscopy w/snare ........................................... Colonoscopy w/stent ............................................ Intro, gastrointestinal tube .................................... Suture, small intestine .......................................... Suture, small intestine .......................................... Suture, large intestine .......................................... Repair of bowel lesion ......................................... Intestinal stricturoplasty ........................................ Repair bowel opening .......................................... Repair bowel opening .......................................... Repair bowel opening .......................................... Repair bowel-skin fistula ...................................... Repair bowel fistula .............................................. Repair bowel-bladder fistula ................................ Repair bowel-bladder fistula ................................ Surgical revision, intestine ................................... Suspend bowel w/prosthesis ............................... Intraop colon lavage add-on ................................ Prepare donor intestine ........................................ Prep donor intestine/venous ................................ Prep donor intestine/artery ................................... Unlisted procedure intestine ................................ Excision of bowel pouch ...................................... Excision of mesentery lesion ............................... Repair of mesentery ............................................. Bowel surgery procedure ..................................... Drain app abscess, open ..................................... Drain app abscess, percut ................................... Appendectomy ..................................................... Appendectomy add-on ......................................... Appendectomy ..................................................... Laparoscopy, appendectomy ............................... Description 1.05 1.27 2.94 1.82 2.12 2.82 3.13 3.82 4.31 3.81 4.83 4.42 4.70 0.49 24.64 28.03 18.06 22.00 18.08 14.35 17.20 27.82 24.12 25.04 23.83 27.27 17.88 17.40 3.10 0.00 5.00 7.00 0.00 11.94 13.63 12.03 0.00 12.44 3.37 10.52 1.53 14.39 9.35 Physician Work RVUs 3 NA NA NA 4.88 6.73 6.10 7.07 7.96 8.95 7.37 7.87 8.46 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA 0.00 NA NA NA 0.00 NA 18.75 NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA 3.73 6.66 5.34 6.73 7.32 8.78 6.78 7.14 7.97 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA 0.00 NA NA NA 0.00 NA 25.61 NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 0.75 0.79 1.64 0.90 1.06 1.37 1.60 1.81 2.24 1.74 2.07 2.09 2.33 0.14 7.71 9.08 6.12 7.95 6.61 5.54 6.22 9.00 8.13 8.38 9.79 9.48 6.59 6.29 0.78 0.00 1.26 1.83 0.00 5.54 5.63 5.03 0.00 5.04 0.95 4.07 0.41 5.44 4.21 Fully Implemented Facility PE RVUs 0.60 0.67 1.36 0.79 0.93 1.21 1.35 1.57 1.83 1.55 1.91 1.81 1.93 0.16 6.72 7.72 6.37 8.28 6.66 5.38 6.28 9.61 8.46 8.76 8.70 9.53 6.48 6.57 0.99 0.00 1.60 2.25 0.00 5.42 5.52 5.01 0.00 4.78 1.07 4.25 0.51 5.36 4.11 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 44380 44382 44383 44385 44386 44388 44389 44390 44391 44392 44393 44394 44397 44500 44602 44603 44604 44605 44615 44620 44625 44626 44640 44650 44660 44661 44680 44700 44701 44715 44720 44721 44799 44800 44820 44850 44899 44900 44901 44950 44955 44960 44970 HCPCS 2 CPT 1/ 0.08 0.12 0.21 0.15 0.20 0.26 0.27 0.32 0.34 0.34 0.42 0.38 0.39 0.03 2.12 2.42 2.12 2.52 2.07 1.51 1.86 3.27 2.78 2.93 2.14 2.81 2.00 1.84 0.37 0.00 0.37 0.97 0.00 1.47 1.59 1.39 0.00 1.33 0.22 1.31 0.20 1.63 1.14 Mal-Practice RVUs NA NA NA 6.85 9.05 9.18 10.47 12.10 13.60 11.52 13.12 13.26 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA 0.00 NA NA NA 0.00 NA 22.34 NA NA NA NA Fully Implemented NonFacility Total NA NA NA 5.70 8.98 8.42 10.13 11.46 13.43 10.93 12.39 12.77 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA 0.00 NA NA NA 0.00 NA 29.20 NA NA NA NA Year 2007 Transitional Non-Facility Total 1.88 2.18 4.79 2.87 3.38 4.45 5.00 5.95 6.89 5.89 7.32 6.89 7.42 0.66 34.47 39.53 26.30 32.47 26.76 21.40 25.28 40.09 35.03 36.35 35.76 39.56 26.47 25.53 4.25 0.00 6.63 9.80 0.00 18.95 20.85 18.45 0.00 18.81 4.54 15.90 2.14 21.46 14.70 Fully Implemented Facility Total 1.73 2.06 4.51 2.76 3.25 4.29 4.75 5.71 6.48 5.70 7.16 6.61 7.02 0.68 33.48 38.17 26.55 32.80 26.81 21.24 25.34 40.70 35.36 36.73 34.67 39.61 26.36 25.81 4.46 0.00 6.97 10.22 0.00 18.83 20.74 18.43 0.00 18.55 4.66 16.08 2.24 21.38 14.60 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 000 000 000 000 000 000 000 000 000 000 000 000 000 000 090 090 090 090 090 090 090 090 090 090 090 090 090 090 ZZZ XXX XXX XXX YYY 090 090 090 YYY 090 000 090 ZZZ 090 090 Global 69872 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00251 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod C A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Laparoscope proc, app ........................................ Drainage of pelvic abscess .................................. Drainage of rectal abscess .................................. Drainage of rectal abscess .................................. Biopsy of rectum .................................................. Removal of anorectal lesion ................................ Removal of rectum ............................................... Partial removal of rectum ..................................... Removal of rectum ............................................... Partial proctectomy .............................................. Partial removal of rectum ..................................... Partial removal of rectum ..................................... Remove rectum w/reservoir ................................. Removal of rectum ............................................... Removal of rectum and colon .............................. Partial proctectomy .............................................. Pelvic exenteration ............................................... Excision of rectal prolapse ................................... Excision of rectal prolapse ................................... Excise ileoanal reservior ...................................... Excision of rectal stricture .................................... Excision of rectal lesion ....................................... Excision of rectal lesion ....................................... Destruction, rectal tumor ...................................... Proctosigmoidoscopy dx ...................................... Proctosigmoidoscopy dilate ................................. Proctosigmoidoscopy w/bx ................................... Proctosigmoidoscopy fb ....................................... Proctosigmoidoscopy removal ............................. Proctosigmoidoscopy removal ............................. Proctosigmoidoscopy removal ............................. Proctosigmoidoscopy bleed ................................. Proctosigmoidoscopy ablate ................................ Proctosigmoidoscopy volvul ................................. Proctosigmoidoscopy w/stent ............................... Diagnostic sigmoidoscopy .................................... Sigmoidoscopy and biopsy .................................. Sigmoidoscopy w/fb removal ............................... Sigmoidoscopy & polypectomy ............................ Sigmoidoscopy for bleeding ................................. Sigmoidoscopy w/submuc inj ............................... Sigmoidoscopy & decompress ............................. Sigmoidoscopy w/tumr remove ............................ Description 0.00 6.20 2.00 8.43 3.96 5.04 30.57 17.89 33.05 33.09 30.63 27.56 33.35 26.25 28.93 18.70 48.89 18.37 22.15 30.63 5.77 16.17 12.48 10.29 0.38 0.44 1.01 0.94 0.83 2.01 1.40 1.50 1.58 1.17 1.65 0.96 1.15 1.79 1.79 2.73 1.46 2.36 2.34 Physician Work RVUs 3 0.00 NA 3.94 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 1.93 19.40 3.24 3.30 3.27 3.75 3.58 3.48 3.95 NA NA 2.49 3.24 5.60 5.61 NA 5.31 NA 5.84 Fully Implemented NonFacility PE RVUs 0.00 NA 4.02 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 1.63 18.86 2.78 3.10 2.31 3.05 3.04 2.69 3.17 NA NA 2.33 3.11 5.15 5.06 NA 3.74 NA 5.37 Year 2007 Transitional Non-Facility PE RVUs 0.00 3.50 1.58 4.52 2.83 3.06 11.97 7.05 10.43 11.67 10.43 9.45 11.79 9.47 10.33 7.12 17.38 6.79 9.35 11.94 3.42 6.61 5.41 5.60 0.35 0.38 0.53 0.51 0.49 0.83 0.65 0.66 0.75 0.65 0.82 0.62 0.79 1.04 0.99 1.55 0.91 1.25 1.28 Fully Implemented Facility PE RVUs 0.00 3.10 1.58 3.58 2.48 2.84 12.29 7.13 11.43 12.36 10.76 9.88 12.29 9.96 10.91 6.92 18.75 6.77 8.65 12.37 3.08 6.63 5.28 4.87 0.30 0.34 0.51 0.49 0.45 0.84 0.64 0.66 0.72 0.58 0.72 0.53 0.64 0.86 0.85 1.24 0.75 1.06 1.07 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 44979 45000 45005 45020 45100 45108 45110 45111 45112 45113 45114 45116 45119 45120 45121 45123 45126 45130 45135 45136 45150 45160 45170 45190 45300 45303 45305 45307 45308 45309 45315 45317 45320 45321 45327 45330 45331 45332 45333 45334 45335 45337 45338 HCPCS 2 CPT 1/ 0.00 0.52 0.25 0.55 0.44 0.59 3.36 2.07 3.43 3.49 3.36 2.88 3.36 2.90 3.25 1.86 4.33 1.80 2.36 2.82 0.61 1.68 1.35 1.13 0.04 0.05 0.11 0.11 0.09 0.22 0.15 0.15 0.16 0.13 0.16 0.08 0.09 0.16 0.15 0.20 0.11 0.21 0.19 Mal-Practice RVUs 0.00 NA 6.19 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 2.35 19.89 4.36 4.35 4.19 5.98 5.13 5.13 5.69 NA NA 3.53 4.48 7.55 7.55 NA 6.88 NA 8.37 Fully Implemented NonFacility Total 0.00 NA 6.27 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 2.05 19.35 3.90 4.15 3.23 5.28 4.59 4.34 4.91 NA NA 3.37 4.35 7.10 7.00 NA 5.31 NA 7.90 Year 2007 Transitional Non-Facility Total 0.00 10.22 3.83 13.50 7.23 8.69 45.90 27.01 46.91 48.25 44.42 39.89 48.50 38.62 42.51 27.68 70.60 26.96 33.86 45.39 9.80 24.46 19.24 17.02 0.77 0.87 1.65 1.56 1.41 3.06 2.20 2.31 2.49 1.95 2.63 1.66 2.03 2.99 2.93 4.48 2.48 3.82 3.81 Fully Implemented Facility Total 0.00 9.82 3.83 12.56 6.88 8.47 46.22 27.09 47.91 48.94 44.75 40.32 49.00 39.11 43.09 27.48 71.97 26.94 33.16 45.82 9.46 24.48 19.11 16.29 0.72 0.83 1.63 1.54 1.37 3.07 2.19 2.31 2.46 1.88 2.53 1.57 1.88 2.81 2.79 4.17 2.32 3.63 3.60 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 YYY 090 010 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69873 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00252 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... 53 ..... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A C A A A A A A A A A A A A A A A A A A C Status Sigmoidoscopy w/ablate tumr .............................. Sig w/balloon dilation ........................................... Sigmoidoscopy w/ultrasound ............................... Sigmoidoscopy w/us guide bx ............................. Sigmoidoscopy w/stent ........................................ Surgical colonoscopy ........................................... Diagnostic colonoscopy ....................................... Diagnostic colonoscopy ....................................... Colonoscopy w/fb removal ................................... Colonoscopy and biopsy ...................................... Colonoscopy, submucous inj ............................... Colonoscopy/control bleeding .............................. Lesion removal colonoscopy ................................ Lesion remove colonoscopy ................................ Lesion removal colonoscopy ................................ Colonoscopy dilate stricture ................................. Colonoscopy w/stent ............................................ Colonoscopy w/endoscope us ............................. Colonoscopy w/endoscopic fnb ........................... Lap, removal of rectum ........................................ Lap, remove rectum w/pouch .............................. Laparoscopic proc ................................................ Lap proctopexy w/sig resect ................................ Laparoscope proc, rectum ................................... Repair of rectum .................................................. Repair of rectum .................................................. Treatment of rectal prolapse ................................ Correct rectal prolapse ......................................... Correct rectal prolapse ......................................... Repair rectum/remove sigmoid ............................ Repair of rectocele ............................................... Exploration/repair of rectum ................................. Exploration/repair of rectum ................................. Repair rect/bladder fistula .................................... Repair fistula w/colostomy ................................... Repair rectourethral fistula ................................... Repair fistula w/colostomy ................................... Reduction of rectal prolapse ................................ Dilation of anal sphincter ..................................... Dilation of rectal narrowing .................................. Remove rectal obstruction ................................... Surg dx exam, anorectal ...................................... Rectum surgery procedure .................................. Description 3.14 1.89 2.60 4.05 2.92 3.51 3.69 0.96 4.68 4.43 4.19 5.68 5.86 4.69 5.30 4.57 5.90 5.09 6.54 32.79 36.29 19.31 26.38 0.00 7.64 8.20 0.55 18.02 14.72 24.67 11.42 17.82 26.22 20.18 23.19 20.24 24.01 2.96 2.32 2.82 3.16 1.80 0.00 Physician Work RVUs 3 5.74 10.20 NA NA NA NA 6.37 2.49 8.15 7.73 7.71 10.34 8.56 7.21 8.35 12.29 NA NA NA NA NA NA NA 0.00 NA NA 3.04 NA NA NA NA NA NA NA NA NA NA NA NA NA 4.25 NA 0.00 Fully Implemented NonFacility PE RVUs 4.03 7.18 NA NA NA NA 6.20 2.33 7.78 7.33 7.26 10.04 8.08 6.90 7.94 12.37 NA NA NA NA NA NA NA 0.00 NA NA 1.99 NA NA NA NA NA NA NA NA NA NA NA NA NA 4.30 NA 0.00 Year 2007 Transitional Non-Facility PE RVUs 1.69 1.05 1.48 2.20 1.56 1.57 1.85 0.62 2.25 2.27 2.19 2.93 2.69 2.24 2.63 2.21 2.95 2.60 3.17 13.03 13.67 7.21 8.91 0.00 4.39 5.14 0.41 5.83 6.63 9.06 5.55 8.18 10.95 9.30 9.27 9.39 11.05 1.69 1.65 1.81 2.05 0.80 0.00 Fully Implemented Facility PE RVUs 1.38 0.89 1.17 1.71 1.26 1.43 1.57 0.53 1.92 1.87 1.79 2.37 2.34 1.93 2.18 1.89 2.49 2.13 2.65 13.51 14.11 7.68 9.71 0.00 3.75 4.17 0.38 6.55 6.11 9.17 5.18 7.28 10.62 7.89 9.44 8.06 10.12 1.55 1.49 1.70 2.08 0.79 0.00 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 45339 45340 45341 45342 45345 45355 45378 45378 45379 45380 45381 45382 45383 45384 45385 45386 45387 45391 45392 45395 45397 45400 45402 45499 45500 45505 45520 45540 45541 45550 45560 45562 45563 45800 45805 45820 45825 45900 45905 45910 45915 45990 45999 HCPCS 2 CPT 1/ 0.26 0.15 0.19 0.30 0.23 0.36 0.30 0.08 0.39 0.35 0.30 0.41 0.48 0.38 0.42 0.39 0.48 0.42 0.42 3.63 3.67 2.03 2.82 0.00 0.75 0.86 0.05 1.85 1.55 2.62 1.13 1.84 3.11 1.86 2.03 1.58 2.32 0.30 0.27 0.30 0.30 0.17 0.00 Mal-Practice RVUs 9.14 12.24 NA NA NA NA 10.36 3.53 13.22 12.51 12.20 16.43 14.90 12.28 14.07 17.25 NA NA NA NA NA NA NA 0.00 NA NA 3.64 NA NA NA NA NA NA NA NA NA NA NA NA NA 7.71 NA 0.00 Fully Implemented NonFacility Total 7.43 9.22 NA NA NA NA 10.19 3.37 12.85 12.11 11.75 16.13 14.42 11.97 13.66 17.33 NA NA NA NA NA NA NA 0.00 NA NA 2.59 NA NA NA NA NA NA NA NA NA NA NA NA NA 7.76 NA 0.00 Year 2007 Transitional Non-Facility Total 5.09 3.09 4.27 6.55 4.71 5.44 5.84 1.66 7.32 7.05 6.68 9.02 9.03 7.31 8.35 7.17 9.33 8.11 10.13 49.45 53.63 28.55 38.11 0.00 12.78 14.20 1.01 25.70 22.90 36.35 18.10 27.84 40.28 31.34 34.49 31.21 37.38 4.95 4.24 4.93 5.51 2.77 0.00 Fully Implemented Facility Total 4.78 2.93 3.96 6.06 4.41 5.30 5.56 1.57 6.99 6.65 6.28 8.46 8.68 7.00 7.90 6.85 8.87 7.64 9.61 49.93 54.07 29.02 38.91 0.00 12.14 13.23 0.98 26.42 22.38 36.46 17.73 26.94 39.95 29.93 34.66 29.88 36.45 4.81 4.08 4.82 5.54 2.76 0.00 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 090 090 090 090 YYY 090 090 000 090 090 090 090 090 090 090 090 090 090 010 010 010 010 000 YYY Global 69874 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00253 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Placement of seton .............................................. Removal of rectal marker ..................................... Incision of rectal abscess ..................................... Incision of rectal abscess ..................................... Incision of anal abscess ....................................... Incision of rectal abscess ..................................... Incision of anal septum ........................................ Incision of anal sphincter ..................................... Incise external hemorrhoid ................................... Removal of anal fissure ....................................... Removal of anal crypt .......................................... Removal of anal crypts ........................................ Removal of anal tag ............................................. Ligation of hemorrhoid(s) ..................................... Removal of anal tags ........................................... Hemorrhoidectomy ............................................... Hemorrhoidectomy ............................................... Remove hemorrhoids & fissure ........................... Remove hemorrhoids & fistula ............................. Hemorrhoidectomy ............................................... Remove hemorrhoids & fissure ........................... Remove hemorrhoids & fistula ............................. Removal of anal fistula ........................................ Removal of anal fistula ........................................ Removal of anal fistula ........................................ Removal of anal fistula ........................................ Repair anal fistula ................................................ Removal of hemorrhoid clot ................................. Injection into hemorrhoid(s) ................................. Chemodenervation anal musc ............................. Diagnostic anoscopy ............................................ Anoscopy and dilation .......................................... Anoscopy and biopsy ........................................... Anoscopy, remove for body ................................. Anoscopy, remove lesion ..................................... Anoscopy .............................................................. Anoscopy, remove lesions ................................... Anoscopy, control bleeding .................................. Anoscopy .............................................................. Repair of anal stricture ......................................... Repair of anal stricture ......................................... Repr of anal fistula w/glue ................................... Repr per/vag pouch sngl proc ............................. Description 2.94 1.24 5.26 5.79 1.21 6.24 2.74 2.50 1.42 3.48 2.73 4.31 1.58 2.31 2.59 4.17 4.88 5.68 6.28 6.65 7.63 7.80 4.81 5.31 6.28 5.31 7.68 1.62 1.64 3.13 0.50 1.31 0.81 1.51 1.32 1.81 2.34 2.01 2.68 9.68 7.32 2.41 17.01 Physician Work RVUs 3 3.26 1.88 6.51 NA 3.17 NA NA 3.05 2.34 6.28 5.93 7.12 2.98 3.72 3.49 5.95 6.37 NA NA NA NA NA 6.26 6.60 NA 6.51 NA 2.40 3.60 3.29 1.43 12.51 3.88 3.90 4.12 2.80 5.24 2.56 2.26 NA NA NA NA Fully Implemented NonFacility PE RVUs 2.56 1.48 5.75 NA 2.70 NA NA 2.53 2.48 4.46 5.32 5.83 2.46 2.91 3.18 5.46 5.97 NA NA NA NA NA 5.31 5.12 NA 4.45 NA 2.19 2.48 3.10 1.53 9.97 3.81 4.28 4.05 3.20 5.20 2.38 2.43 NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 2.36 0.82 3.98 3.94 0.98 4.42 2.33 1.13 0.96 3.73 3.36 4.11 1.09 2.00 1.34 2.85 3.10 3.82 4.02 4.07 4.35 4.70 3.85 3.97 4.29 3.96 4.70 0.89 1.26 2.31 0.37 0.58 0.48 0.62 0.67 0.72 0.96 0.83 0.97 5.19 4.04 1.45 7.83 Fully Implemented Facility PE RVUs 1.98 0.74 3.68 3.15 0.88 3.54 1.96 1.13 0.93 3.08 2.81 3.65 0.99 1.81 1.30 2.67 2.90 3.11 3.46 3.40 3.79 3.97 3.09 3.22 3.51 3.05 3.93 0.86 1.18 2.05 0.35 0.61 0.44 0.64 0.63 0.77 0.98 0.84 1.05 4.45 3.77 1.30 7.77 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 46020 46030 46040 46045 46050 46060 46070 46080 46083 46200 46210 46211 46220 46221 46230 46250 46255 46257 46258 46260 46261 46262 46270 46275 46280 46285 46288 46320 46500 46505 46600 46604 46606 46608 46610 46611 46612 46614 46615 46700 46705 46706 46710 HCPCS 2 CPT 1/ 0.31 0.14 0.62 0.54 0.14 0.67 0.36 0.30 0.15 0.39 0.31 0.48 0.17 0.23 0.30 0.48 0.58 0.64 0.68 0.76 0.79 0.83 0.46 0.52 0.66 0.44 0.79 0.18 0.16 0.14 0.05 0.12 0.09 0.16 0.15 0.19 0.28 0.20 0.33 0.94 0.91 0.28 1.38 Mal-Practice RVUs 6.51 3.26 12.39 NA 4.52 NA NA 5.85 3.91 10.15 8.97 11.91 4.73 6.26 6.38 10.60 11.83 NA NA NA NA NA 11.53 12.43 NA 12.26 NA 4.20 5.40 6.56 1.98 13.94 4.78 5.57 5.59 4.80 7.86 4.77 5.27 NA NA NA NA Fully Implemented NonFacility Total 5.81 2.86 11.63 NA 4.05 NA NA 5.33 4.05 8.33 8.36 10.62 4.21 5.45 6.07 10.11 11.43 NA NA NA NA NA 10.58 10.95 NA 10.20 NA 3.99 4.28 6.37 2.08 11.40 4.71 5.95 5.52 5.20 7.82 4.59 5.44 NA NA NA NA Year 2007 Transitional Non-Facility Total 5.61 2.20 9.86 10.27 2.33 11.33 5.43 3.93 2.53 7.60 6.40 8.90 2.84 4.54 4.23 7.50 8.56 10.14 10.98 11.48 12.77 13.33 9.12 9.80 11.23 9.71 13.17 2.69 3.06 5.58 0.92 2.01 1.38 2.29 2.14 2.72 3.58 3.04 3.98 15.81 12.27 4.14 26.22 Fully Implemented Facility Total 5.23 2.12 9.56 9.48 2.23 10.45 5.06 3.93 2.50 6.95 5.85 8.44 2.74 4.35 4.19 7.32 8.36 9.43 10.42 10.81 12.21 12.60 8.36 9.05 10.45 8.80 12.40 2.66 2.98 5.32 0.90 2.04 1.34 2.31 2.10 2.77 3.60 3.05 4.06 15.07 12.00 3.99 26.16 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 010 010 090 090 010 090 090 010 010 090 090 090 010 010 010 090 090 090 090 090 090 090 090 090 090 090 090 010 010 010 000 000 000 000 000 000 000 000 000 090 090 010 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69875 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00254 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C A A A A A A A A A Status Repr per/vag pouch dbl proc ............................... Rep perf anoper fistu ........................................... Rep perf anoper/vestib fistu ................................. Construction of absent anus ................................ Construction of absent anus ................................ Construction of absent anus ................................ Repair of imperforated anus ................................ Repair of cloacal anomaly ................................... Repair of cloacal anomaly ................................... Repair of cloacal anomaly ................................... Repair of anal sphincter ....................................... Repair of anal sphincter ....................................... Reconstruction of anus ........................................ Removal of suture from anus .............................. Repair of anal sphincter ....................................... Repair of anal sphincter ....................................... Implant artificial sphincter .................................... Destruction, anal lesion(s) ................................... Destruction, anal lesion(s) ................................... Cryosurgery, anal lesion(s) .................................. Laser surgery, anal lesions .................................. Excision of anal lesion(s) ..................................... Destruction, anal lesion(s) ................................... Destruction of hemorrhoids .................................. Destruction of hemorrhoids .................................. Destruction of hemorrhoids .................................. Cryotherapy of rectal lesion ................................. Cryotherapy of rectal lesion ................................. Treatment of anal fissure ..................................... Treatment of anal fissure ..................................... Ligation of hemorrhoids ....................................... Ligation of hemorrhoids ....................................... Hemorrhoidopexy by stapling .............................. Anus surgery procedure ....................................... Needle biopsy of liver .......................................... Needle biopsy, liver add-on ................................. Open drainage, liver lesion .................................. Percut drain, liver lesion ...................................... Inject/aspirate liver cyst ........................................ Wedge biopsy of liver .......................................... Partial removal of liver ......................................... Extensive removal of liver .................................... Partial removal of liver ......................................... Description 36.32 7.54 17.14 30.17 35.66 33.42 39.66 58.46 64.93 70.91 12.02 9.19 8.81 2.88 17.21 15.16 14.66 1.91 1.88 1.88 1.88 1.88 2.78 3.79 2.44 3.70 2.70 4.70 2.33 2.05 2.13 2.60 5.49 0.00 1.90 1.90 19.27 3.69 18.37 12.78 38.82 59.35 52.91 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA 3.72 NA NA NA 3.63 3.88 3.80 8.62 4.10 9.60 5.40 3.68 6.15 4.16 5.78 2.84 2.79 4.81 4.64 NA 0.00 7.28 NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA 3.62 NA NA NA 2.84 3.15 3.31 9.00 3.48 8.91 5.15 3.52 5.19 3.12 4.44 2.20 2.07 3.65 3.95 NA 0.00 4.12 NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 14.26 3.74 9.59 11.55 13.63 14.57 16.09 21.37 19.68 21.07 5.83 4.42 4.63 2.28 8.24 6.51 6.87 1.31 1.21 1.61 1.21 1.20 1.55 2.81 1.09 2.62 1.90 3.64 1.05 0.96 2.99 2.66 3.11 0.00 0.58 0.49 8.15 1.05 7.80 6.33 14.08 18.83 17.09 Fully Implemented Facility PE RVUs 14.85 3.61 8.38 11.90 13.56 13.56 17.06 21.18 23.78 22.99 5.25 5.16 4.04 1.82 7.37 6.13 5.85 1.28 1.10 1.45 1.14 1.10 1.40 2.92 1.18 2.52 1.39 3.20 1.08 1.01 2.60 2.46 2.81 0.00 0.62 0.61 8.33 1.17 7.56 6.11 14.88 20.79 18.90 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 46712 46715 46716 46730 46735 46740 46742 46744 46746 46748 46750 46751 46753 46754 46760 46761 46762 46900 46910 46916 46917 46922 46924 46934 46935 46936 46937 46938 46940 46942 46945 46946 46947 46999 47000 47001 47010 47011 47015 47100 47120 47122 47125 HCPCS 2 CPT 1/ 3.67 0.92 1.58 2.47 3.21 2.42 3.20 6.40 7.70 3.37 1.10 0.94 0.94 0.19 1.59 1.43 1.24 0.17 0.19 0.11 0.21 0.22 0.26 0.32 0.23 0.34 0.14 0.58 0.23 0.19 0.19 0.27 0.75 0.00 0.12 0.25 1.81 0.22 1.84 1.53 4.66 7.21 6.47 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA 6.79 NA NA NA 5.71 5.95 5.79 10.71 6.20 12.64 9.51 6.35 10.19 7.00 11.06 5.40 5.03 7.13 7.51 NA 0.00 9.30 NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA 6.69 NA NA NA 4.92 5.22 5.30 11.09 5.58 11.95 9.26 6.19 9.23 5.96 9.72 4.76 4.31 5.97 6.82 NA 0.00 6.14 NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 54.25 12.20 28.31 44.19 52.50 50.41 58.95 86.23 92.31 95.35 18.95 14.55 14.38 5.35 27.04 23.10 22.77 3.39 3.28 3.60 3.30 3.30 4.59 6.92 3.76 6.66 4.74 8.92 3.61 3.20 5.31 5.53 9.35 0.00 2.60 2.64 29.23 4.96 28.01 20.64 57.56 85.39 76.47 Fully Implemented Facility Total 54.84 12.07 27.10 44.54 52.43 49.40 59.92 86.04 96.41 97.27 18.37 15.29 13.79 4.89 26.17 22.72 21.75 3.36 3.17 3.44 3.23 3.20 4.44 7.03 3.85 6.56 4.23 8.48 3.64 3.25 4.92 5.33 9.05 0.00 2.64 2.76 29.41 5.08 27.77 20.42 58.36 87.35 78.28 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 010 090 090 090 010 010 010 010 010 010 090 010 090 010 090 010 010 090 090 090 YYY 000 ZZZ 090 000 090 090 090 090 090 Global 69876 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00255 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A X R R A A A C C C A A A A A A A A A C A A A C A A A A A A A A A A A A A A A A A A A Status Partial removal of liver ......................................... Removal of donor liver ......................................... Transplantation of liver ......................................... Transplantation of liver ......................................... Partial removal, donor liver .................................. Partial removal, donor liver .................................. Partial removal, donor liver .................................. Prep donor liver, whole ........................................ Prep donor liver, 3-segment ................................ Prep donor liver, lobe split ................................... Prep donor liver/venous ....................................... Prep donor liver/arterial ........................................ Surgery for liver lesion ......................................... Repair liver wound ............................................... Repair liver wound ............................................... Repair liver wound ............................................... Repair liver wound ............................................... Laparo ablate liver tumor rf .................................. Laparo ablate liver cryosurg ................................ Laparoscope procedure, liver .............................. Open ablate liver tumor rf .................................... Open ablate liver tumor cryo ............................... Percut ablate liver rf ............................................. Liver surgery procedure ....................................... Incision of liver duct ............................................. Incision of bile duct .............................................. Incision of bile duct .............................................. Incise bile duct sphincter ..................................... Incision of gallbladder .......................................... Incision of gallbladder .......................................... Injection for liver x-rays ........................................ Injection for liver x-rays ........................................ Insert catheter, bile duct ...................................... Insert bile duct drain ............................................ Change bile duct catheter .................................... Revise/reinsert bile tube ...................................... Bile duct endoscopy add-on ................................ Biliary endoscopy thru skin .................................. Biliary endoscopy thru skin .................................. Biliary endoscopy thru skin .................................. Biliary endoscopy thru skin .................................. Biliary endoscopy thru skin .................................. Laparoscopy w/cholangio ..................................... Description 57.06 0.00 83.29 70.39 59.22 71.27 79.21 0.00 0.00 0.00 6.00 7.00 18.01 22.36 31.18 52.47 23.41 20.67 20.67 0.00 24.43 24.72 15.19 0.00 36.23 21.92 22.20 20.41 13.12 8.05 1.96 0.76 7.94 10.74 5.55 5.96 3.02 6.03 6.34 9.05 7.55 8.55 4.88 Physician Work RVUs 3 NA 0.00 NA NA NA NA NA 0.00 0.00 0.00 NA NA NA NA NA NA NA NA NA 0.00 NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA 13.94 28.88 NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA 0.00 NA NA NA NA NA 0.00 0.00 0.00 NA NA NA NA NA NA NA NA NA 0.00 NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA 14.80 32.56 NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 18.09 0.00 27.87 23.77 21.75 25.51 27.55 0.00 0.00 0.00 1.54 1.79 7.67 8.89 11.38 16.82 9.31 7.67 8.14 0.00 8.52 9.01 5.12 0.00 13.12 8.63 8.59 9.01 6.65 4.61 0.57 0.22 3.99 4.22 2.27 2.98 0.78 2.10 1.84 2.92 2.22 2.47 1.25 Fully Implemented Facility PE RVUs 20.24 0.00 30.59 26.20 22.14 26.55 28.98 0.00 0.00 0.00 1.92 2.24 7.33 8.87 11.52 18.09 8.86 8.02 8.14 0.00 9.14 9.44 5.83 0.00 13.35 8.72 8.75 8.52 6.09 5.32 0.62 0.24 4.76 4.87 2.67 3.53 0.96 2.30 2.01 3.24 2.40 2.70 1.57 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 47130 47133 47135 47136 47140 47141 47142 47143 47144 47145 47146 47147 47300 47350 47360 47361 47362 47370 47371 47379 47380 47381 47382 47399 47400 47420 47425 47460 47480 47490 47500 47505 47510 47511 47525 47530 47550 47552 47553 47554 47555 47556 47560 HCPCS 2 CPT 1/ 6.96 0.00 9.96 8.44 5.19 5.19 5.19 0.00 0.00 0.00 0.83 0.97 1.99 2.59 3.38 5.87 2.51 2.56 2.61 0.00 2.87 2.85 0.96 0.00 3.08 2.63 2.62 2.21 1.42 0.43 0.12 0.04 0.46 0.62 0.33 0.37 0.40 0.42 0.37 0.96 0.45 0.50 0.65 Mal-Practice RVUs NA 0.00 NA NA NA NA NA 0.00 0.00 0.00 NA NA NA NA NA NA NA NA NA 0.00 NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA 19.82 35.21 NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA 0.00 NA NA NA NA NA 0.00 0.00 0.00 NA NA NA NA NA NA NA NA NA 0.00 NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA 20.68 38.89 NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 82.11 0.00 121.12 102.60 86.16 101.97 111.95 0.00 0.00 0.00 8.37 9.76 27.67 33.84 45.94 75.16 35.23 30.90 31.42 0.00 35.82 36.58 21.27 0.00 52.43 33.18 33.41 31.63 21.19 13.09 2.65 1.02 12.39 15.58 8.15 9.31 4.20 8.55 8.55 12.93 10.22 11.52 6.78 Fully Implemented Facility Total 84.26 0.00 123.84 105.03 86.55 103.01 113.38 0.00 0.00 0.00 8.75 10.21 27.33 33.82 46.08 76.43 34.78 31.25 31.42 0.00 36.44 37.01 21.98 0.00 52.66 33.27 33.57 31.14 20.63 13.80 2.70 1.04 13.16 16.23 8.55 9.86 4.38 8.75 8.72 13.25 10.40 11.75 7.10 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 XXX 090 090 090 090 090 XXX 090 XXX XXX XXX 090 090 090 090 090 090 090 YYY 090 090 010 YYY 090 090 090 090 090 090 000 000 090 090 010 090 ZZZ 000 000 000 000 000 000 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69877 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00256 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A C A A A A A A A A A A A A A A A A A A A A A A A A C A A A A A A A A A A A A Status Laparo w/cholangio/biopsy ................................... Laparoscopic cholecystectomy ............................ Laparo cholecystectomy/graph ............................ Laparo cholecystectomy/explr .............................. Laparo cholecystoenterostomy ............................ Laparoscope proc, biliary ..................................... Removal of gallbladder ........................................ Removal of gallbladder ........................................ Removal of gallbladder ........................................ Removal of gallbladder ........................................ Removal of gallbladder ........................................ Remove bile duct stone ....................................... Exploration of bile ducts ....................................... Bile duct revision .................................................. Excision of bile duct tumor ................................... Excision of bile duct tumor ................................... Excision of bile duct cyst ..................................... Fusion of bile duct cyst ........................................ Fuse gallbladder & bowel .................................... Fuse upper gi structures ...................................... Fuse gallbladder & bowel .................................... Fuse gallbladder & bowel .................................... Fuse bile ducts and bowel ................................... Fuse liver ducts & bowel ...................................... Fuse bile ducts and bowel ................................... Fuse bile ducts and bowel ................................... Reconstruction of bile ducts ................................. Placement, bile duct support ............................... Fuse liver duct & intestine ................................... Suture bile duct injury .......................................... Bile tract surgery procedure ................................. Drainage of abdomen .......................................... Placement of drain, pancreas .............................. Removal of pancreatic stone ............................... Biopsy of pancreas, open .................................... Needle biopsy, pancreas ..................................... Resect/debride pancreas ..................................... Removal of pancreas lesion ................................ Partial removal of pancreas ................................. Partial removal of pancreas ................................. Pancreatectomy ................................................... Removal of pancreatic duct ................................. Partial removal of pancreas ................................. Description 5.17 11.63 12.03 14.21 12.56 0.00 17.35 15.90 20.84 21.13 22.99 9.57 16.39 28.62 25.77 33.59 21.42 19.07 18.21 21.86 21.10 24.08 38.14 52.01 42.14 56.01 26.04 17.47 24.80 22.31 0.00 31.82 39.56 18.96 14.38 4.68 49.05 18.33 26.19 27.26 30.42 20.26 52.63 Physician Work RVUs 3 NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA 8.98 NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA 8.21 NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 1.56 5.29 5.09 5.46 5.04 0.00 7.25 6.41 7.73 7.73 8.23 4.18 7.27 10.11 9.59 11.59 8.59 7.97 7.74 8.62 8.52 9.27 13.14 16.99 14.16 17.95 9.78 7.60 9.54 8.77 0.00 10.87 12.74 7.63 5.88 1.58 16.00 6.93 9.40 9.76 11.87 8.09 18.11 Fully Implemented Facility PE RVUs 1.82 5.06 5.24 5.82 5.28 0.00 6.40 6.47 7.87 7.84 8.44 4.71 7.37 11.13 9.83 12.20 8.46 7.85 7.53 8.57 8.40 9.27 11.41 12.33 11.93 14.16 9.98 8.01 9.62 8.83 0.00 11.34 13.58 7.38 5.66 1.85 16.41 6.86 9.49 9.80 11.95 7.72 19.14 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 47561 47562 47563 47564 47570 47579 47600 47605 47610 47612 47620 47630 47700 47701 47711 47712 47715 47719 47720 47721 47740 47741 47760 47765 47780 47785 47800 47801 47802 47900 47999 48000 48001 48020 48100 48102 48105 48120 48140 48145 48146 48148 48150 HCPCS 2 CPT 1/ 0.66 1.46 1.58 1.89 1.65 0.00 1.80 1.95 2.49 2.48 2.74 0.65 2.07 3.68 3.05 3.93 2.49 2.15 2.11 2.53 2.42 2.83 3.42 3.30 3.50 4.10 3.08 1.16 2.86 2.65 0.00 3.48 4.69 2.13 1.62 0.28 5.56 2.10 3.03 3.18 3.50 2.30 6.32 Mal-Practice RVUs NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA 13.94 NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA 13.17 NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 7.39 18.38 18.70 21.56 19.25 0.00 26.40 24.26 31.06 31.34 33.96 14.40 25.73 42.41 38.41 49.11 32.50 29.19 28.06 33.01 32.04 36.18 54.70 72.30 59.80 78.06 38.90 26.23 37.20 33.73 0.00 46.17 56.99 28.72 21.88 6.54 70.61 27.36 38.62 40.20 45.79 30.65 77.06 Fully Implemented Facility Total 7.65 18.15 18.85 21.92 19.49 0.00 25.55 24.32 31.20 31.45 34.17 14.93 25.83 43.43 38.65 49.72 32.37 29.07 27.85 32.96 31.92 36.18 52.97 67.64 57.57 74.27 39.10 26.64 37.28 33.79 0.00 46.64 57.83 28.47 21.66 6.81 71.02 27.29 38.71 40.24 45.87 30.28 78.09 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 000 090 090 090 090 YYY 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 YYY 090 090 090 090 010 090 090 090 090 090 090 090 Global 69878 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00257 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A N A A A A A A A A A X C A R A C A A A A A A A A A A A A A A A A A A A A A A A Status Pancreatectomy ................................................... Pancreatectomy ................................................... Pancreatectomy ................................................... Removal of pancreas ........................................... Pancreas removal/transplant ............................... Injection, intraop add-on ...................................... Surgery of pancreatic cyst ................................... Drain pancreatic pseudocyst ................................ Drain pancreatic pseudocyst ................................ Fuse pancreas cyst and bowel ............................ Fuse pancreas cyst and bowel ............................ Pancreatorrhaphy ................................................. Duodenal exclusion .............................................. Fuse pancreas and bowel .................................... Donor pancreatectomy ......................................... Prep donor pancreas ........................................... Prep donor pancreas/venous ............................... Transpl allograft pancreas ................................... Removal, allograft pancreas ................................ Pancreas surgery procedure ................................ Exploration of abdomen ....................................... Reopening of abdomen ........................................ Exploration behind abdomen ............................... Drain abdominal abscess ..................................... Drain abdominal abscess ..................................... Drain, open, abdom abscess ............................... Drain, percut, abdom abscess ............................. Drain, open, retrop abscess ................................. Drain, percut, retroper absc ................................. Drain to peritoneal cavity ..................................... Puncture, peritoneal cavity ................................... Removal of abdominal fluid ................................. Biopsy, abdominal mass ...................................... Removal of abdominal lesion ............................... Remove abdom lesion, complex .......................... Excise sacral spine tumor .................................... Multiple surgery, abdomen ................................... Excision of umbilicus ............................................ Removal of omentum ........................................... Diag laparo separate proc ................................... Laparoscopy, biopsy ............................................ Laparoscopy, aspiration ....................................... Laparo drain lymphocele ...................................... Description 48.47 52.61 48.70 29.27 0.00 1.95 18.03 17.06 3.99 18.07 21.86 22.10 30.25 27.96 0.00 0.00 4.30 37.03 19.24 0.00 12.44 17.55 15.98 26.46 3.37 16.41 3.99 18.42 3.69 12.12 1.35 1.26 1.73 10.94 15.67 37.66 15.70 8.93 12.41 5.09 5.39 5.96 10.13 Physician Work RVUs 3 NA NA NA NA 0.00 NA NA NA 19.06 NA NA NA NA NA 0.00 0.00 NA NA NA 0.00 NA NA NA NA 18.57 NA 18.77 NA 18.66 NA 2.58 2.85 2.27 NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA 0.00 NA NA NA 20.43 NA NA NA NA NA 0.00 0.00 NA NA NA 0.00 NA NA NA NA 20.43 NA 19.33 NA 19.38 NA 3.63 2.65 2.89 NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 16.65 17.98 17.01 11.98 0.00 0.85 8.04 7.53 1.14 6.80 7.76 8.11 10.32 9.93 0.00 0.00 1.14 20.54 9.42 0.00 5.22 6.44 6.34 9.84 0.96 6.51 1.14 7.17 1.06 5.23 0.40 0.43 0.50 4.86 6.46 12.77 6.26 4.30 5.65 2.45 2.56 2.64 4.69 Fully Implemented Facility PE RVUs 17.80 19.14 17.91 11.73 0.00 0.69 7.50 7.46 1.27 6.72 8.02 8.01 10.43 10.09 0.00 0.00 1.38 18.82 8.40 0.00 5.33 5.37 6.00 10.10 1.07 6.44 1.27 7.36 1.17 5.37 0.45 0.43 0.55 4.98 6.88 13.72 6.53 4.27 5.61 2.59 2.62 2.90 4.54 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 48152 48153 48154 48155 48160 48400 48500 48510 48511 48520 48540 48545 48547 48548 48550 48551 48552 48554 48556 48999 49000 49002 49010 49020 49021 49040 49041 49060 49061 49062 49080 49081 49180 49200 49201 49215 49220 49250 49255 49320 49321 49322 49323 HCPCS 2 CPT 1/ 5.80 6.31 5.84 3.27 0.00 0.15 2.03 1.83 0.24 2.06 2.61 2.38 3.42 3.28 0.00 0.00 0.31 4.19 2.08 0.00 1.52 1.37 1.51 2.85 0.20 1.70 0.24 1.75 0.22 1.39 0.08 0.09 0.10 1.24 1.88 4.38 1.89 1.08 1.43 0.65 0.70 0.71 1.20 Mal-Practice RVUs NA NA NA NA 0.00 NA NA NA 23.29 NA NA NA NA NA 0.00 0.00 NA NA NA 0.00 NA NA NA NA 22.14 NA 23.00 NA 22.57 NA 4.01 4.20 4.10 NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA 0.00 NA NA NA 24.66 NA NA NA NA NA 0.00 0.00 NA NA NA 0.00 NA NA NA NA 24.00 NA 23.56 NA 23.29 NA 5.06 4.00 4.72 NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 70.92 76.90 71.55 44.52 0.00 2.95 28.10 26.42 5.37 26.93 32.23 32.59 43.99 41.17 0.00 0.00 5.75 61.76 30.74 0.00 19.18 25.36 23.83 39.15 4.53 24.62 5.37 27.34 4.97 18.74 1.83 1.78 2.33 17.04 24.01 54.81 23.85 14.31 19.49 8.19 8.65 9.31 16.02 Fully Implemented Facility Total 72.07 78.06 72.45 44.27 0.00 2.79 27.56 26.35 5.50 26.85 32.49 32.49 44.10 41.33 0.00 0.00 5.99 60.04 29.72 0.00 19.29 24.29 23.49 39.41 4.64 24.55 5.50 27.53 5.08 18.88 1.88 1.78 2.38 17.16 24.43 55.76 24.12 14.28 19.45 8.33 8.71 9.57 15.87 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 XXX ZZZ 090 090 000 090 090 090 090 090 XXX XXX XXX 090 090 YYY 090 090 090 090 000 090 000 090 000 090 000 000 000 090 090 090 090 090 090 010 010 010 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69879 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00258 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A C A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Lap insertion perm ip cath ................................... Lap revision perm ip cath .................................... Lap w/omentopexy add-on ................................... Laparo proc, abdm/per/oment .............................. Air injection into abdomen ................................... Remove foreign body, adbomen .......................... Insrt abdom cath for chemotx .............................. Insert abdom drain, temp ..................................... Insert abdom drain, perm ..................................... Remove perm cannula/catheter ........................... Exchange drainage catheter ................................ Assess cyst, contrast inject .................................. Insert abdomen-venous drain .............................. Revise abdomen-venous shunt ........................... Injection, abdominal shunt ................................... Ligation of shunt ................................................... Removal of shunt ................................................. Insert subq exten to ip cath ................................. Embedded ip cath exit-site .................................. Rpr hern preemie reduc ....................................... Rpr ing hern premie, blocked .............................. Rpr ing hernia baby, reduc .................................. Rpr ing hernia baby, blocked ............................... Rpr ing hernia, init, reduce .................................. Rpr ing hernia, init blocked .................................. Prp i/hern init reduc >5 yr .................................... Prp i/hern init block >5 yr ..................................... Rerepair ing hernia, reduce ................................. Rerepair ing hernia, blocked ................................ Repair ing hernia, sliding ..................................... Repair lumbar hernia ........................................... Rpr rem hernia, init, reduce ................................. Rpr fem hernia, init blocked ................................. Rerepair fem hernia, reduce ................................ Rerepair fem hernia, blocked ............................... Rpr ventral hern init, reduc .................................. Rpr ventral hern init, block ................................... Rerepair ventrl hern, reduce ................................ Rerepair ventrl hern, block ................................... Hernia repair w/mesh ........................................... Rpr epigastric hern, reduce ................................. Rpr epigastric hern, blocked ................................ Rpr umbil hern, reduc < 5 yr ................................ Description 6.27 6.77 3.50 0.00 1.88 14.01 7.03 2.22 5.87 6.26 1.46 0.76 12.13 10.33 0.89 6.79 7.41 2.25 2.69 12.42 15.32 6.15 9.32 5.76 9.28 7.88 9.97 9.91 12.36 8.85 10.66 8.91 9.84 9.31 11.54 11.84 15.30 12.29 15.45 4.88 5.97 7.79 4.39 Physician Work RVUs 3 NA NA NA 0.00 2.30 NA NA NA NA NA 12.46 2.90 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA 0.00 2.88 NA NA NA NA NA 13.67 3.51 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 2.80 2.93 0.92 0.00 0.53 5.58 3.39 1.15 3.13 2.62 0.46 0.25 5.27 4.50 0.26 3.08 2.99 0.60 1.63 5.43 5.85 2.99 4.36 3.62 4.25 3.89 4.47 4.39 5.01 4.14 4.65 4.12 4.42 4.23 4.87 4.90 5.83 5.14 5.89 1.26 3.34 3.84 3.00 Fully Implemented Facility PE RVUs 2.80 2.93 0.92 0.00 0.60 5.51 3.52 1.11 3.15 2.82 0.51 0.28 5.51 4.70 0.29 3.71 3.31 0.60 1.63 5.15 6.04 2.96 4.29 3.24 4.21 3.78 4.46 4.42 5.18 4.09 4.72 4.12 4.41 4.25 4.95 5.08 6.00 5.19 6.06 1.57 3.21 3.56 2.69 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 49324 49325 49326 49329 49400 49402 49419 49420 49421 49422 49423 49424 49425 49426 49427 49428 49429 49435 49436 49491 49492 49495 49496 49500 49501 49505 49507 49520 49521 49525 49540 49550 49553 49555 49557 49560 49561 49565 49566 49568 49570 49572 49580 HCPCS 2 CPT 1/ 0.73 0.86 0.44 0.00 0.15 1.62 0.81 0.21 0.74 0.83 0.09 0.04 1.54 1.28 0.07 0.80 1.02 0.28 0.28 1.40 1.81 0.74 1.07 0.71 1.12 1.03 1.27 1.28 1.59 1.13 1.37 1.14 1.24 1.20 1.47 1.52 1.89 1.52 1.91 0.64 0.75 0.88 0.54 Mal-Practice RVUs NA NA NA 0.00 4.33 NA NA NA NA NA 14.01 3.70 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA 0.00 4.91 NA NA NA NA NA 15.22 4.31 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 9.80 10.56 4.86 0.00 2.56 21.21 11.23 3.58 9.74 9.71 2.01 1.05 18.94 16.11 1.22 10.67 11.42 3.13 4.60 19.25 22.98 9.88 14.75 10.09 14.65 12.80 15.71 15.58 18.96 14.12 16.68 14.17 15.50 14.74 17.88 18.26 23.02 18.95 23.25 6.78 10.06 12.51 7.93 Fully Implemented Facility Total 9.80 10.56 4.86 0.00 2.63 21.14 11.36 3.54 9.76 9.91 2.06 1.08 19.18 16.31 1.25 11.30 11.74 3.13 4.60 18.97 23.17 9.85 14.68 9.71 14.61 12.69 15.70 15.61 19.13 14.07 16.75 14.17 15.49 14.76 17.96 18.44 23.19 19.00 23.42 7.09 9.93 12.23 7.62 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 010 010 ZZZ YYY 000 090 090 000 090 010 000 000 090 090 000 010 010 ZZZ 010 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 ZZZ 090 090 090 Global 69880 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00259 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A C A A A C C A A A A A A A A A A A A A A A A A A A A A A A A A A Status Rpr umbil hern, block < 5 yr ................................ Rpr umbil hern, reduc > 5 yr ................................ Rpr umbil hern, block > 5 yr ................................ Repair spigelian hernia ........................................ Repair umbilical lesion ......................................... Repair umbilical lesion ......................................... Repair umbilical lesion ......................................... Repair umbilical lesion ......................................... Repair umbilical lesion ......................................... Laparo hernia repair initial ................................... Laparo hernia repair recur ................................... Laparo proc, hernia repair ................................... Repair of abdominal wall ..................................... Omental flap, extra-abdom .................................. Omental flap, intra-abdom ................................... Free omental flap, microvasc ............................... Abdomen surgery procedure ............................... Exploration of kidney ............................................ Renal abscess, open drain .................................. Renal abscess, percut drain ................................ Drainage of kidney ............................................... Exploration of kidney ............................................ Removal of kidney stone ..................................... Incision of kidney ................................................. Incision of kidney ................................................. Removal of kidney stone ..................................... Removal of kidney stone ..................................... Removal of kidney stone ..................................... Revise kidney blood vessels ................................ Exploration of kidney ............................................ Explore and drain kidney ..................................... Removal of kidney stone ..................................... Exploration of kidney ............................................ Biopsy of kidney ................................................... Biopsy of kidney ................................................... Remove kidney, open .......................................... Removal kidney open, complex ........................... Removal kidney open, radical .............................. Removal of kidney & ureter ................................. Removal of kidney & ureter ................................. Partial removal of kidney ..................................... Cryoablate renal mass open ................................ Removal of kidney lesion ..................................... Description 7.05 6.51 7.96 8.82 11.47 86.85 18.92 10.83 9.26 6.30 8.29 0.00 12.26 22.16 6.54 0.00 0.00 12.13 17.88 3.37 16.48 16.67 20.80 22.17 21.70 26.91 15.61 23.32 17.30 17.06 17.67 18.67 20.44 2.63 12.19 18.53 21.73 23.68 23.90 26.74 24.01 22.06 16.94 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA 0.00 0.00 NA NA 19.98 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA 0.00 0.00 NA NA 21.23 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 3.62 3.52 3.88 4.11 5.19 26.45 6.64 4.70 3.63 3.35 4.23 0.00 6.30 12.34 1.75 0.00 0.00 6.94 8.51 0.97 8.91 8.55 11.24 11.84 11.65 13.98 8.72 12.47 7.20 8.91 9.97 10.24 10.96 1.08 5.60 9.74 11.27 11.96 12.36 14.28 12.93 10.79 9.45 Fully Implemented Facility PE RVUs 3.50 3.35 3.77 4.09 5.29 27.99 7.42 5.07 6.14 3.23 4.09 0.00 6.24 14.49 2.16 0.00 0.00 5.64 7.93 1.07 7.33 7.08 8.68 7.51 9.07 10.91 6.88 9.68 7.64 7.30 7.71 7.93 8.57 1.24 5.16 7.86 8.92 9.42 9.71 11.25 9.98 9.56 7.37 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 49582 49585 49587 49590 49600 49605 49606 49610 49611 49650 49651 49659 49900 49904 49905 49906 49999 50010 50020 50021 50040 50045 50060 50065 50070 50075 50080 50081 50100 50120 50125 50130 50135 50200 50205 50220 50225 50230 50234 50236 50240 50250 50280 HCPCS 2 CPT 1/ 0.88 0.82 0.99 1.13 1.32 9.39 2.46 1.07 0.78 0.93 1.14 0.00 1.62 2.70 0.75 0.00 0.00 0.93 1.34 0.20 1.03 1.24 1.36 1.59 1.44 1.81 1.04 1.54 2.07 1.21 1.43 1.22 1.33 0.16 1.30 1.35 1.50 1.55 1.59 1.77 1.55 1.39 1.19 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA 0.00 0.00 NA NA 23.55 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA 0.00 0.00 NA NA 24.80 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 11.55 10.85 12.83 14.06 17.98 122.69 28.02 16.60 13.67 10.58 13.66 0.00 20.18 37.20 9.04 0.00 0.00 20.00 27.73 4.54 26.42 26.46 33.40 35.60 34.79 42.70 25.37 37.33 26.57 27.18 29.07 30.13 32.73 3.87 19.09 29.62 34.50 37.19 37.85 42.79 38.49 34.24 27.58 Fully Implemented Facility Total 11.43 10.68 12.72 14.04 18.08 124.23 28.80 16.97 16.18 10.46 13.52 0.00 20.12 39.35 9.45 0.00 0.00 18.70 27.15 4.64 24.84 24.99 30.84 31.27 32.21 39.63 23.53 34.54 27.01 25.57 26.81 27.82 30.34 4.03 18.65 27.74 32.15 34.65 35.20 39.76 35.54 33.01 25.50 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 YYY 090 090 ZZZ 090 YYY 090 090 000 090 090 090 090 090 090 090 090 090 090 090 090 090 000 090 090 090 090 090 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69881 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00260 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A X A C C A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C A A Status Removal of kidney lesion ..................................... Remove cadaver donor kidney ............................ Remove kidney, living donor ................................ Prep cadaver renal allograft ................................. Prep donor renal graft .......................................... Prep renal graft/venous ........................................ Prep renal graft/arterial ........................................ Prep renal graft/ureteral ....................................... Removal of kidney ............................................... Transplantation of kidney ..................................... Transplantation of kidney ..................................... Remove transplanted kidney ............................... Reimplantation of kidney ...................................... Change ureter stent, percut ................................. Remove ureter stent, percut ................................ Change ext/int ureter stent .................................. Remove renal tube w/fluoro ................................. Drainage of kidney lesion .................................... Instll rx agnt into rnal tub ..................................... Insert kidney drain ................................................ Insert ureteral tube ............................................... Injection for kidney x-ray ...................................... Create passage to kidney .................................... Measure kidney pressure ..................................... Change kidney tube ............................................. Revision of kidney/ureter ..................................... Revision of kidney/ureter ..................................... Repair of kidney wound ....................................... Close kidney-skin fistula ...................................... Repair renal-abdomen fistula ............................... Repair renal-abdomen fistula ............................... Revision of horseshoe kidney .............................. Laparo ablate renal cyst ...................................... Laparo ablate renal mass .................................... Laparo partial nephrectomy ................................. Laparoscopy, pyeloplasty ..................................... Laparo radical nephrectomy ................................ Laparoscopic nephrectomy .................................. Laparo removal donor kidney .............................. Laparo remove w/ureter ....................................... Laparoscope proc, renal ...................................... Kidney endoscopy ................................................ Kidney endoscopy ................................................ Description 16.00 0.00 22.28 0.00 0.00 4.00 3.50 3.34 13.86 40.45 45.68 18.68 29.66 5.50 5.00 2.00 1.10 1.96 1.96 3.37 4.15 0.76 3.37 2.09 1.46 21.12 25.68 21.07 18.73 24.21 26.13 20.95 16.76 21.18 27.18 23.27 24.93 21.69 26.24 25.26 0.00 5.59 5.98 Physician Work RVUs 3 NA 0.00 NA 0.00 0.00 NA NA NA NA NA NA NA NA 24.85 19.53 12.00 6.36 NA 1.51 NA NA 1.76 NA NA 11.29 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 4.62 4.32 Fully Implemented NonFacility PE RVUs NA 0.00 NA 0.00 0.00 NA NA NA NA NA NA NA NA 33.30 31.30 16.66 11.15 NA 1.56 NA NA 2.45 NA NA 15.06 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 4.26 4.35 Year 2007 Transitional Non-Facility PE RVUs 8.27 0.00 12.46 0.00 0.00 1.11 0.98 0.97 7.64 18.86 19.55 9.31 16.42 1.67 1.52 0.60 0.33 0.57 0.80 1.26 1.50 0.52 1.37 0.93 0.46 11.26 13.34 9.32 9.52 11.06 8.15 10.92 8.89 11.33 14.39 11.66 12.51 11.52 12.68 12.44 0.00 2.69 2.48 Fully Implemented Facility PE RVUs 6.91 0.00 11.10 0.00 0.00 1.29 1.13 1.09 6.78 16.32 18.53 7.68 13.12 1.81 1.66 0.65 0.36 0.62 0.67 1.46 1.71 0.63 1.47 1.04 0.51 8.72 10.10 8.62 7.95 9.51 9.43 8.97 7.08 8.93 11.24 9.31 10.01 9.15 11.50 9.99 0.00 2.15 2.25 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 50290 50300 50320 50323 50325 50327 50328 50329 50340 50360 50365 50370 50380 50382 50384 50387 50389 50390 50391 50392 50393 50394 50395 50396 50398 50400 50405 50500 50520 50525 50526 50540 50541 50542 50543 50544 50545 50546 50547 50548 50549 50551 50553 HCPCS 2 CPT 1/ 1.41 0.00 2.36 0.00 0.00 0.29 0.26 0.25 1.65 3.82 4.43 1.68 2.51 0.34 0.31 0.12 0.07 0.12 0.14 0.20 0.25 0.05 0.21 0.13 0.09 1.38 1.79 2.02 1.49 1.84 1.97 1.36 1.13 1.39 1.81 1.58 1.71 1.57 2.77 1.73 0.00 0.40 0.39 Mal-Practice RVUs NA 0.00 NA 0.00 0.00 NA NA NA NA NA NA NA NA 30.69 24.84 14.12 7.53 NA 3.61 NA NA 2.57 NA NA 12.84 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 10.61 10.69 Fully Implemented NonFacility Total NA 0.00 NA 0.00 0.00 NA NA NA NA NA NA NA NA 39.14 36.61 18.78 12.32 NA 3.66 NA NA 3.26 NA NA 16.61 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 10.25 10.72 Year 2007 Transitional Non-Facility Total 25.68 0.00 37.10 0.00 0.00 5.40 4.74 4.56 23.15 63.13 69.66 29.67 48.59 7.51 6.83 2.72 1.50 2.65 2.90 4.83 5.90 1.33 4.95 3.15 2.01 33.76 40.81 32.41 29.74 37.11 36.25 33.23 26.78 33.90 43.38 36.51 39.15 34.78 41.69 39.43 0.00 8.68 8.85 Fully Implemented Facility Total 24.32 0.00 35.74 0.00 0.00 5.58 4.89 4.68 22.29 60.59 68.64 28.04 45.29 7.65 6.97 2.77 1.53 2.70 2.77 5.03 6.11 1.44 5.05 3.26 2.06 31.22 37.57 31.71 28.17 35.56 37.53 31.28 24.97 31.50 40.23 34.16 36.65 32.41 40.51 36.98 0.00 8.14 8.62 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 XXX 090 XXX XXX XXX XXX XXX 090 090 090 090 090 000 000 000 000 000 000 000 000 000 000 000 000 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 YYY 000 000 Global 69882 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00261 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Kidney endoscopy & biopsy ................................. Kidney endoscopy & treatment ............................ Kidney endoscopy & treatment ............................ Renal scope w/tumor resect ................................ Kidney endoscopy ................................................ Kidney endoscopy ................................................ Kidney endoscopy & biopsy ................................. Kidney endoscopy ................................................ Kidney endoscopy & treatment ............................ Kidney endoscopy & treatment ............................ Fragmenting of kidney stone ............................... Perc rf ablate renal tumor .................................... Exploration of ureter ............................................. Insert ureteral support .......................................... Removal of ureter stone ...................................... Removal of ureter stone ...................................... Removal of ureter stone ...................................... Removal of ureter ................................................ Removal of ureter ................................................ Injection for ureter x-ray ....................................... Measure ureter pressure ...................................... Change of ureter tube/stent ................................. Injection for ureter x-ray ....................................... Revision of ureter ................................................. Release of ureter ................................................. Release of ureter ................................................. Release/revise ureter ........................................... Revise ureter ........................................................ Revise ureter ........................................................ Fusion of ureter & kidney ..................................... Fusion of ureter & kidney ..................................... Fusion of ureters .................................................. Splicing of ureters ................................................ Reimplant ureter in bladder ................................. Reimplant ureter in bladder ................................. Reimplant ureter in bladder ................................. Reimplant ureter in bladder ................................. Implant ureter in bowel ........................................ Fusion of ureter & bowel ...................................... Urine shunt to intestine ........................................ Construct bowel bladder ...................................... Construct bowel bladder ...................................... Revise urine flow .................................................. Description 6.52 6.61 7.58 10.90 9.53 10.33 11.00 13.96 10.97 11.84 9.64 6.77 17.04 16.66 17.12 16.30 16.08 18.67 20.87 0.76 1.51 1.18 1.16 16.54 20.49 17.80 20.05 8.17 12.00 19.92 21.07 19.92 21.07 19.80 19.51 20.52 22.08 16.23 22.38 22.06 23.89 30.48 33.57 Physician Work RVUs 3 5.13 5.30 5.76 NA NA NA NA NA NA NA 17.21 73.56 NA NA NA NA NA NA NA 4.00 2.03 NA 1.36 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs 4.89 4.76 5.25 NA NA NA NA NA NA NA 13.60 130.16 NA NA NA NA NA NA NA 4.73 3.09 NA 1.71 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 3.06 3.11 3.43 5.48 4.33 4.67 4.82 6.15 4.94 5.24 6.26 2.65 8.70 8.04 9.22 9.07 8.40 10.27 11.00 0.62 0.70 0.85 0.68 8.41 8.71 8.04 9.77 5.79 7.25 9.07 9.90 9.91 10.83 10.25 8.54 10.14 11.33 9.43 9.65 11.76 12.14 15.28 16.11 Fully Implemented Facility PE RVUs 2.51 2.50 2.84 4.60 3.49 3.79 4.01 5.01 3.98 4.28 4.65 2.90 7.17 7.06 7.53 7.02 6.80 7.98 8.71 0.51 0.79 1.01 0.71 7.44 8.73 7.86 8.47 4.65 5.98 8.07 8.46 8.23 8.69 8.25 8.71 8.69 9.05 7.20 9.22 9.27 9.51 12.16 13.15 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 50555 50557 50561 50562 50570 50572 50574 50575 50576 50580 50590 50592 50600 50605 50610 50620 50630 50650 50660 50684 50686 50688 50690 50700 50715 50722 50725 50727 50728 50740 50750 50760 50770 50780 50782 50783 50785 50800 50810 50815 50820 50825 50830 HCPCS 2 CPT 1/ 0.45 0.47 0.54 0.73 0.68 0.85 0.77 0.99 0.78 0.83 0.65 0.43 1.13 1.45 1.43 1.07 1.09 1.23 1.38 0.05 0.11 0.07 0.07 1.27 2.14 1.91 1.52 0.61 1.00 1.97 1.38 1.55 1.45 1.51 1.61 1.99 1.45 1.19 2.32 1.54 1.90 2.08 2.38 Mal-Practice RVUs 12.10 12.38 13.88 NA NA NA NA NA NA NA 27.50 80.76 NA NA NA NA NA NA NA 4.81 3.65 NA 2.59 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total 11.86 11.84 13.37 NA NA NA NA NA NA NA 23.89 137.36 NA NA NA NA NA NA NA 5.54 4.71 NA 2.94 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 10.03 10.19 11.55 17.11 14.54 15.85 16.59 21.10 16.69 17.91 16.55 9.85 26.87 26.15 27.77 26.44 25.57 30.17 33.25 1.43 2.32 2.10 1.91 26.22 31.34 27.75 31.34 14.57 20.25 30.96 32.35 31.38 33.35 31.56 29.66 32.65 34.86 26.85 34.35 35.36 37.93 47.84 52.06 Fully Implemented Facility Total 9.48 9.58 10.96 16.23 13.70 14.97 15.78 19.96 15.73 16.95 14.94 10.10 25.34 25.17 26.08 24.39 23.97 27.88 30.96 1.32 2.41 2.26 1.94 25.25 31.36 27.57 30.04 13.43 18.98 29.96 30.91 29.70 31.21 29.56 29.83 31.20 32.58 24.62 33.92 32.87 35.30 44.72 49.10 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 000 000 000 090 000 000 000 000 000 000 090 010 090 090 090 090 090 090 090 000 000 010 000 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69883 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00262 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A C A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Replace ureter by bowel ...................................... Appendico-vesicostomy ....................................... Transplant ureter to skin ...................................... Repair of ureter .................................................... Closure ureter/skin fistula .................................... Closure ureter/bowel fistula ................................. Release of ureter ................................................. Laparoscopy ureterolithotomy .............................. Laparo new ureter/bladder ................................... Laparo new ureter/bladder ................................... Laparoscope proc, ureter ..................................... Endoscopy of ureter ............................................. Endoscopy of ureter ............................................. Ureter endoscopy & biopsy .................................. Ureter endoscopy & treatment ............................. Ureter endoscopy & treatment ............................. Ureter endoscopy ................................................. Ureter endoscopy & catheter ............................... Ureter endoscopy & biopsy .................................. Ureter endoscopy & treatment ............................. Ureter endoscopy & treatment ............................. Drainage of bladder ............................................. Drainage of bladder ............................................. Drainage of bladder ............................................. Incise & treat bladder ........................................... Incise & treat bladder ........................................... Incise & drain bladder .......................................... Incise bladder/drain ureter ................................... Removal of bladder stone .................................... Removal of ureter stone ...................................... Remove ureter calculus ....................................... Drainage of bladder abscess ............................... Removal of bladder cyst ...................................... Removal of bladder lesion ................................... Removal of bladder lesion ................................... Removal of bladder lesion ................................... Repair of ureter lesion ......................................... Partial removal of bladder .................................... Partial removal of bladder .................................... Revise bladder & ureter(s) ................................... Removal of bladder .............................................. Removal of bladder & nodes ............................... Remove bladder/revise tract ................................ Description 22.19 22.21 16.93 14.89 15.66 20.04 15.78 17.87 25.63 23.69 0.00 5.83 6.23 6.74 6.78 6.04 7.13 6.88 9.16 9.03 6.84 0.78 1.02 4.27 7.56 7.68 4.43 7.68 7.87 9.82 9.82 6.61 10.92 10.08 15.29 13.58 13.77 17.10 23.03 23.50 27.31 34.00 35.14 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA 0.00 4.88 5.04 5.23 5.37 4.78 NA NA NA NA NA 0.94 2.40 4.76 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA 0.00 4.44 4.56 6.12 4.76 4.47 NA NA NA NA NA 1.69 4.13 5.39 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 12.08 12.57 9.17 8.18 8.50 10.38 8.32 8.89 12.65 12.18 0.00 2.82 3.32 3.51 3.18 2.79 3.34 3.05 3.98 3.70 3.13 0.28 0.30 2.39 5.37 4.83 3.74 5.27 5.43 6.49 6.42 4.28 5.86 6.58 8.76 7.39 7.60 9.00 11.64 12.22 13.55 17.03 17.87 Fully Implemented Facility PE RVUs 9.34 9.81 7.25 6.64 7.05 8.57 6.87 7.50 10.42 9.56 0.00 2.24 2.60 2.89 2.57 2.33 2.68 2.61 3.32 3.22 2.56 0.25 0.33 2.00 4.23 4.19 3.01 4.26 4.09 5.00 4.87 3.73 5.22 5.15 6.78 6.15 6.48 7.29 9.40 9.77 10.69 13.27 13.83 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 50840 50845 50860 50900 50920 50930 50940 50945 50947 50948 50949 50951 50953 50955 50957 50961 50970 50972 50974 50976 50980 51000 51005 51010 51020 51030 51040 51045 51050 51060 51065 51080 51500 51520 51525 51530 51535 51550 51555 51565 51570 51575 51580 HCPCS 2 CPT 1/ 1.47 1.57 1.29 1.14 1.01 1.28 1.26 1.36 2.17 1.71 0.00 0.41 0.43 0.48 0.48 0.41 0.52 0.49 0.64 0.66 0.48 0.05 0.10 0.28 0.47 0.58 0.31 0.52 0.49 0.62 0.63 0.43 1.03 0.69 0.99 1.05 1.23 1.31 1.70 1.63 1.72 2.17 2.25 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA 0.00 11.12 11.70 12.45 12.63 11.23 NA NA NA NA NA 1.77 3.52 9.31 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA 0.00 10.68 11.22 13.34 12.02 10.92 NA NA NA NA NA 2.52 5.25 9.94 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 35.74 36.35 27.39 24.21 25.17 31.70 25.36 28.12 40.45 37.58 0.00 9.06 9.98 10.73 10.44 9.24 10.99 10.42 13.78 13.39 10.45 1.11 1.42 6.94 13.40 13.09 8.48 13.47 13.79 16.93 16.87 11.32 17.81 17.35 25.04 22.02 22.60 27.41 36.37 37.35 42.58 53.20 55.26 Fully Implemented Facility Total 33.00 33.59 25.47 22.67 23.72 29.89 23.91 26.73 38.22 34.96 0.00 8.48 9.26 10.11 9.83 8.78 10.33 9.98 13.12 12.91 9.88 1.08 1.45 6.55 12.26 12.45 7.75 12.46 12.45 15.44 15.32 10.77 17.17 15.92 23.06 20.78 21.48 25.70 34.13 34.90 39.72 49.44 51.22 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 YYY 000 000 000 000 000 000 000 000 000 000 000 000 010 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 Global 69884 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00263 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Removal of bladder & nodes ............................... Remove bladder/revise tract ................................ Remove bladder/revise tract ................................ Remove bladder/create pouch ............................. Removal of pelvic structures ................................ Injection for bladder x-ray .................................... Preparation for bladder xray ................................ Injection for bladder x-ray .................................... Irrigation of bladder .............................................. Insert bladder catheter ......................................... Insert temp bladder cath ...................................... Insert bladder cath, complex ................................ Change of bladder tube ....................................... Change of bladder tube ....................................... Endoscopic injection/implant ................................ Treatment of bladder lesion ................................. Simple cystometrogram ....................................... Simple cystometrogram ....................................... Simple cystometrogram ....................................... Complex cystometrogram .................................... Complex cystometrogram .................................... Complex cystometrogram .................................... Urine flow measurement ...................................... Urine flow measurement ...................................... Urine flow measurement ...................................... Electro-uroflowmetry, first .................................... Electro-uroflowmetry, first .................................... Electro-uroflowmetry, first .................................... Urethra pressure profile ....................................... Urethra pressure profile ....................................... Urethra pressure profile ....................................... Anal/urinary muscle study .................................... Anal/urinary muscle study .................................... Anal/urinary muscle study .................................... Anal/urinary muscle study .................................... Anal/urinary muscle study .................................... Anal/urinary muscle study .................................... Urinary reflex study .............................................. Urinary reflex study .............................................. Urinary reflex study .............................................. Urine voiding pressure study ............................... Urine voiding pressure study ............................... Urine voiding pressure study ............................... Description 39.41 36.15 41.12 44.01 42.61 0.88 0.64 1.05 0.88 0.50 0.50 1.47 1.03 1.50 3.73 1.50 1.51 0.00 1.51 1.71 0.00 1.71 0.61 0.00 0.61 1.14 0.00 1.14 1.61 0.00 1.61 1.53 0.00 1.53 1.53 0.00 1.53 1.10 0.00 1.10 1.53 0.00 1.53 Physician Work RVUs 3 NA NA NA NA NA 4.09 NA 1.87 1.51 1.04 1.53 2.28 2.03 2.74 4.46 1.64 4.28 3.70 0.58 7.11 6.45 0.66 0.91 0.68 0.23 1.27 0.82 0.45 5.03 4.47 0.56 3.83 3.30 0.53 4.50 3.93 0.57 4.96 4.56 0.40 6.72 6.13 0.59 Fully Implemented NonFacility PE RVUs NA NA NA NA NA 4.81 NA 2.18 1.58 1.45 1.94 2.62 2.21 3.18 4.04 1.72 5.26 4.75 0.51 7.41 6.82 0.59 0.67 0.46 0.21 0.91 0.52 0.39 5.44 4.89 0.55 3.95 3.44 0.51 4.46 3.94 0.52 5.74 5.33 0.41 7.15 6.63 0.52 Year 2007 Transitional Non-Facility PE RVUs 19.91 17.70 20.06 21.67 20.37 0.29 0.41 0.68 0.35 0.25 0.34 0.82 0.86 1.20 1.78 0.76 4.28 3.70 0.58 7.11 6.45 0.66 0.91 0.68 0.23 1.27 0.82 0.45 5.03 4.47 0.56 3.83 3.30 0.53 4.50 3.93 0.57 4.96 4.56 0.40 6.72 6.13 0.59 Fully Implemented Facility PE RVUs 15.25 13.88 15.61 16.83 16.21 0.29 0.37 0.62 0.30 0.21 0.27 0.63 0.67 0.88 1.46 0.71 5.26 4.75 0.51 7.41 6.82 0.59 0.67 0.46 0.21 0.91 0.52 0.39 5.44 4.89 0.55 3.95 3.44 0.51 4.46 3.94 0.52 5.74 5.33 0.41 7.15 6.63 0.52 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 51585 51590 51595 51596 51597 51600 51605 51610 51700 51701 51702 51703 51705 51710 51715 51720 51725 51725 51725 51726 51726 51726 51736 51736 51736 51741 51741 51741 51772 51772 51772 51784 51784 51784 51785 51785 51785 51792 51792 51792 51795 51795 51795 HCPCS 2 CPT 1/ 2.49 2.28 2.60 2.78 2.82 0.06 0.04 0.07 0.06 0.04 0.04 0.10 0.07 0.11 0.29 0.14 0.16 0.04 0.12 0.18 0.05 0.13 0.06 0.01 0.05 0.11 0.02 0.09 0.20 0.05 0.15 0.16 0.04 0.12 0.15 0.04 0.11 0.20 0.13 0.07 0.22 0.10 0.12 Mal-Practice RVUs NA NA NA NA NA 5.03 NA 2.99 2.45 1.58 2.07 3.85 3.13 4.35 8.48 3.28 5.95 3.74 2.21 9.00 6.50 2.50 1.58 0.69 0.89 2.52 0.84 1.68 6.84 4.52 2.32 5.52 3.34 2.18 6.18 3.97 2.21 6.26 4.69 1.57 8.47 6.23 2.24 Fully Implemented NonFacility Total NA NA NA NA NA 5.75 NA 3.30 2.52 1.99 2.48 4.19 3.31 4.79 8.06 3.36 6.93 4.79 2.14 9.30 6.87 2.43 1.34 0.47 0.87 2.16 0.54 1.62 7.25 4.94 2.31 5.64 3.48 2.16 6.14 3.98 2.16 7.04 5.46 1.58 8.90 6.73 2.17 Year 2007 Transitional Non-Facility Total 61.81 56.13 63.78 68.46 65.80 1.23 1.09 1.80 1.29 0.79 0.88 2.39 1.96 2.81 5.80 2.40 5.95 3.74 2.21 9.00 6.50 2.50 1.58 0.69 0.89 2.52 0.84 1.68 6.84 4.52 2.32 5.52 3.34 2.18 6.18 3.97 2.21 6.26 4.69 1.57 8.47 6.23 2.24 Fully Implemented Facility Total 57.15 52.31 59.33 63.62 61.64 1.23 1.05 1.74 1.24 0.75 0.81 2.20 1.77 2.49 5.48 2.35 6.93 4.79 2.14 9.30 6.87 2.43 1.34 0.47 0.87 2.16 0.54 1.62 7.25 4.94 2.31 5.64 3.48 2.16 6.14 3.98 2.16 7.04 5.46 1.58 8.90 6.73 2.17 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 000 000 000 000 000 000 000 010 010 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69885 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00264 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... TC .... 26 ..... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A C A A A A A A A A A A A A A A A A A A A A A A Status Intraabdominal pressure test ............................... Intraabdominal pressure test ............................... Intraabdominal pressure test ............................... Us urine capacity measure .................................. Revision of bladder/urethra .................................. Revision of urinary tract ....................................... Attach bladder/urethra .......................................... Attach bladder/urethra .......................................... Repair bladder neck ............................................. Repair of bladder wound ...................................... Repair of bladder wound ...................................... Repair of bladder opening ................................... Repair bladder/vagina lesion ............................... Close bladder-uterus fistula ................................. Hysterectomy/bladder repair ................................ Correction of bladder defect ................................ Revision of bladder & bowel ................................ Construct bladder opening ................................... Laparo urethral suspension ................................. Laparo sling operation ......................................... Laparoscope proc, bla ......................................... Cystoscopy ........................................................... Cystoscopy, removal of clots ............................... Cystoscopy & ureter catheter .............................. Cystoscopy and biopsy ........................................ Cystoscopy & duct catheter ................................. Cystoscopy w/biopsy(s) ....................................... Cystoscopy and treatment ................................... Cystoscopy and treatment ................................... Cystoscopy and treatment ................................... Cystoscopy and treatment ................................... Cystoscopy and treatment ................................... Cystoscopy and radiotracer ................................. Cystoscopy and treatment ................................... Cystoscopy and treatment ................................... Cystoscopy & revise urethra ................................ Cystoscopy & revise urethra ................................ Cystoscopy and treatment ................................... Cystoscopy and treatment ................................... Cystoscopy and treatment ................................... Cystoscopy, implant stent .................................... Cystoscopy and treatment ................................... Cystoscopy and treatment ................................... Description 1.60 0.00 1.60 0.00 18.74 19.41 11.28 13.60 10.07 12.49 15.69 7.81 14.48 13.26 17.35 30.48 25.20 12.44 13.26 14.77 0.00 2.23 5.44 2.37 3.02 3.02 2.59 3.70 3.14 4.62 5.44 9.71 4.49 3.91 2.94 3.36 4.69 4.99 6.16 2.80 6.39 3.73 3.60 Physician Work RVUs 3 4.84 4.23 0.61 0.59 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 3.69 5.14 5.76 10.73 8.15 8.34 19.90 19.08 NA NA NA NA NA 7.68 7.05 9.34 NA NA 5.32 NA 4.13 4.39 Fully Implemented NonFacility PE RVUs 5.55 5.00 0.55 0.40 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 3.40 5.09 5.61 15.01 10.10 12.97 33.55 32.11 NA NA NA NA NA 11.93 10.04 14.00 NA NA 6.65 NA 3.99 4.11 Year 2007 Transitional Non-Facility PE RVUs 4.84 4.23 0.61 NA 10.21 10.65 5.81 6.87 5.92 6.87 8.56 4.76 8.11 7.86 10.38 11.52 13.31 7.36 5.98 6.66 0.00 1.34 2.65 1.40 1.65 1.66 1.41 1.88 1.65 2.34 2.71 4.48 2.38 2.00 1.55 1.78 2.34 2.51 2.95 1.58 3.05 1.92 1.89 Fully Implemented Facility PE RVUs 5.55 5.00 0.55 NA 8.22 8.87 5.62 6.50 5.04 6.03 7.14 4.15 6.57 6.19 9.05 11.93 10.55 5.87 6.10 6.32 0.00 0.91 2.06 1.02 1.28 1.28 1.03 1.47 1.28 1.83 2.13 3.60 1.83 1.57 1.22 1.38 1.83 1.96 2.40 1.21 2.44 1.52 1.47 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 51797 51797 51797 51798 51800 51820 51840 51841 51845 51860 51865 51880 51900 51920 51925 51940 51960 51980 51990 51992 51999 52000 52001 52005 52007 52010 52204 52214 52224 52234 52235 52240 52250 52260 52265 52270 52275 52276 52277 52281 52282 52283 52285 HCPCS 2 CPT 1/ 0.17 0.05 0.12 0.08 1.32 1.75 1.06 1.24 0.79 1.16 1.23 0.72 1.21 1.18 2.04 2.15 1.63 0.86 1.39 1.41 0.00 0.14 0.39 0.17 0.22 0.21 0.17 0.26 0.22 0.33 0.39 0.69 0.32 0.28 0.22 0.24 0.33 0.35 0.44 0.20 0.45 0.26 0.26 Mal-Practice RVUs 6.61 4.28 2.33 0.67 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 6.06 10.97 8.30 13.97 11.38 11.10 23.86 22.44 NA NA NA NA NA 10.84 10.65 14.36 NA NA 8.32 NA 8.12 8.25 Fully Implemented NonFacility Total 7.32 5.05 2.27 0.48 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 5.77 10.92 8.15 18.25 13.33 15.73 37.51 35.47 NA NA NA NA NA 15.09 13.64 19.02 NA NA 9.65 NA 7.98 7.97 Year 2007 Transitional Non-Facility Total 6.61 4.28 2.33 NA 30.27 31.81 18.15 21.71 16.78 20.52 25.48 13.29 23.80 22.30 29.77 44.15 40.14 20.66 20.63 22.84 0.00 3.71 8.48 3.94 4.89 4.89 4.17 5.84 5.01 7.29 8.54 14.88 7.19 6.19 4.71 5.38 7.36 7.85 9.55 4.58 9.89 5.91 5.75 Fully Implemented Facility Total 7.32 5.05 2.27 NA 28.28 30.03 17.96 21.34 15.90 19.68 24.06 12.68 22.26 20.63 28.44 44.56 37.38 19.17 20.75 22.50 0.00 3.28 7.89 3.56 4.52 4.51 3.79 5.43 4.64 6.78 7.96 14.00 6.64 5.76 4.38 4.98 6.85 7.30 9.00 4.21 9.28 5.51 5.33 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 000 000 000 XXX 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 YYY 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 Global 69886 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00265 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Cystoscopy and treatment ................................... Cystoscopy and treatment ................................... Cystoscopy and treatment ................................... Cystoscopy and treatment ................................... Cystoscopy and treatment ................................... Cystoscopy and treatment ................................... Remove bladder stone ......................................... Remove bladder stone ......................................... Cystoscopy and treatment ................................... Cystoscopy, stone removal .................................. Cystoscopy, inject material .................................. Cystoscopy and treatment ................................... Cystoscopy and treatment ................................... Create passage to kidney .................................... Cysto w/ureter stricture tx .................................... Cysto w/up stricture tx ......................................... Cysto w/renal stricture tx ..................................... Cysto/uretero, stricture tx ..................................... Cysto/uretero w/up stricture ................................. Cystouretero w/renal strict ................................... Cystouretero & or pyeloscope ............................. Cystouretero w/stone remove .............................. Cystouretero w/lithotripsy ..................................... Cystouretero w/biopsy .......................................... Cystouretero w/excise tumor ............................... Cystouretero w/congen repr ................................. Cystourethro cut ejacul duct ................................ Incision of prostate ............................................... Revision of bladder neck ..................................... Dilation prostatic urethra ...................................... Prostatectomy (TURP) ......................................... Control postop bleeding ....................................... Prostatectomy, first stage .................................... Prostatectomy, second stage ............................... Remove residual prostate .................................... Remove prostate regrowth ................................... Relieve bladder contracture ................................. Laser surgery of prostate ..................................... Laser surgery of prostate ..................................... Drainage of prostate abscess .............................. Incision of urethra ................................................ Incision of urethra ................................................ Incision of urethra ................................................ Description 4.58 5.30 5.50 5.30 2.81 5.20 6.71 9.18 4.69 6.15 5.18 5.03 2.83 4.82 6.11 6.61 7.31 7.81 8.31 9.34 5.85 6.87 7.96 7.33 8.81 10.06 5.27 7.63 9.39 7.49 15.13 8.84 9.07 7.81 7.19 7.65 6.89 11.15 12.00 7.39 2.30 4.35 1.77 Physician Work RVUs 3 NA NA NA NA 4.04 6.69 17.14 NA NA NA 17.83 20.45 12.45 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 42.04 42.58 NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA 4.53 8.17 25.99 NA NA NA 28.32 34.23 7.42 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 65.97 66.10 NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 2.33 2.68 2.16 2.57 1.47 2.55 3.09 4.17 2.27 2.89 2.39 2.41 1.60 2.35 3.11 3.35 3.62 4.00 4.22 4.62 3.03 3.56 4.01 3.75 4.35 5.54 2.24 5.59 6.31 5.00 8.64 5.63 6.00 5.49 4.68 4.90 4.50 7.05 7.38 5.05 1.83 3.84 0.97 Fully Implemented Facility PE RVUs 1.82 2.10 2.03 2.03 1.14 2.01 2.48 3.36 1.79 2.31 1.96 1.92 1.19 1.89 2.44 2.59 2.84 3.09 3.27 3.62 2.36 2.77 3.14 2.94 3.44 4.18 1.84 4.15 4.52 3.58 5.99 4.07 4.30 3.88 3.41 3.62 3.35 5.16 5.44 3.65 1.61 3.14 0.75 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 52290 52300 52301 52305 52310 52315 52317 52318 52320 52325 52327 52330 52332 52334 52341 52342 52343 52344 52345 52346 52351 52352 52353 52354 52355 52400 52402 52450 52500 52510 52601 52606 52612 52614 52620 52630 52640 52647 52648 52700 53000 53010 53020 HCPCS 2 CPT 1/ 0.32 0.38 0.46 0.38 0.20 0.37 0.48 0.65 0.33 0.44 0.37 0.36 0.21 0.35 0.43 0.46 0.51 0.55 0.58 0.65 0.41 0.49 0.57 0.52 0.63 0.68 0.40 0.54 0.60 0.48 0.87 0.57 0.56 0.48 0.47 0.51 0.47 0.73 0.79 0.48 0.16 0.24 0.13 Mal-Practice RVUs NA NA NA NA 7.05 12.26 24.33 NA NA NA 23.38 25.84 15.49 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 53.92 55.37 NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA 7.54 13.74 33.18 NA NA NA 33.87 39.62 10.46 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 77.85 78.89 NA NA NA NA Year 2007 Transitional Non-Facility Total 7.23 8.36 8.12 8.25 4.48 8.12 10.28 14.00 7.29 9.48 7.94 7.80 4.64 7.52 9.65 10.42 11.44 12.36 13.11 14.61 9.29 10.92 12.54 11.60 13.79 16.28 7.91 13.76 16.30 12.97 24.64 15.04 15.63 13.78 12.34 13.06 11.86 18.93 20.17 12.92 4.29 8.43 2.87 Fully Implemented Facility Total 6.72 7.78 7.99 7.71 4.15 7.58 9.67 13.19 6.81 8.90 7.51 7.31 4.23 7.06 8.98 9.66 10.66 11.45 12.16 13.61 8.62 10.13 11.67 10.79 12.88 14.92 7.51 12.32 14.51 11.55 21.99 13.48 13.93 12.17 11.07 11.78 10.71 17.04 18.23 11.52 4.07 7.73 2.65 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 090 000 090 090 090 090 090 090 090 090 090 090 090 090 090 010 090 000 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69887 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00266 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Incision of urethra ................................................ Drainage of urethra abscess ................................ Drainage of urethra abscess ................................ Drainage of urinary leakage ................................. Drainage of urinary leakage ................................. Biopsy of urethra .................................................. Removal of urethra .............................................. Removal of urethra .............................................. Treatment of urethra lesion .................................. Removal of urethra lesion .................................... Removal of urethra lesion .................................... Surgery for urethra pouch .................................... Removal of urethra gland .................................... Treatment of urethra lesion .................................. Treatment of urethra lesion .................................. Removal of urethra gland .................................... Repair of urethra defect ....................................... Revise urethra, stage 1 ........................................ Revise urethra, stage 2 ........................................ Reconstruction of urethra ..................................... Reconstruction of urethra ..................................... Reconstruct urethra, stage 1 ............................... Reconstruct urethra, stage 2 ............................... Reconstruction of urethra ..................................... Reconstruct urethra/bladder ................................. Male sling procedure ............................................ Remove/revise male sling .................................... Insert tandem cuff ................................................ Insert uro/ves nck sphincter ................................. Remove uro sphincter .......................................... Remove/replace ur sphincter ............................... Remov/replc ur sphinctr comp ............................. Repair uro sphincter ............................................. Revision of urethra ............................................... Revision of urethra ............................................... Urethrlys, transvag w/ scope ............................... Repair of urethra injury ........................................ Repair of urethra injury ........................................ Repair of urethra injury ........................................ Repair of urethra injury ........................................ Repair of urethra defect ....................................... Dilate urethra stricture .......................................... Dilate urethra stricture .......................................... Description 1.13 6.49 2.65 6.82 11.05 2.59 13.59 16.72 7.53 10.31 10.86 6.98 6.42 3.00 3.14 3.11 4.54 13.98 15.51 17.53 20.55 15.04 16.94 17.30 21.03 15.34 13.29 14.06 15.21 10.89 14.15 23.26 10.43 6.67 7.65 12.87 8.16 8.16 10.83 14.09 9.35 1.21 0.98 Physician Work RVUs 3 NA NA 1.99 NA NA 1.72 NA NA NA NA NA NA NA 2.48 2.99 2.30 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 1.16 1.38 Fully Implemented NonFacility PE RVUs NA NA 2.06 NA NA 1.42 NA NA NA NA NA NA NA 2.30 2.78 2.23 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 1.15 1.30 Year 2007 Transitional Non-Facility PE RVUs 0.83 4.48 1.46 4.98 4.60 1.32 7.88 9.34 5.08 6.55 7.04 4.84 4.76 1.87 2.03 1.73 2.82 8.31 9.07 9.97 11.14 6.61 9.42 8.81 11.21 9.39 8.56 8.18 8.96 7.17 8.58 12.68 6.76 4.85 5.21 7.53 5.09 5.50 6.85 7.96 6.23 0.58 0.53 Fully Implemented Facility PE RVUs 0.59 3.69 1.39 5.71 6.70 1.07 6.34 7.30 4.05 5.17 5.44 3.85 3.66 1.53 1.57 1.59 2.39 6.59 7.00 7.78 8.28 6.36 7.52 7.45 8.84 6.83 6.21 6.45 7.55 5.70 6.96 9.95 5.23 3.68 4.07 6.53 4.26 4.27 5.58 6.43 4.91 0.47 0.41 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 53025 53040 53060 53080 53085 53200 53210 53215 53220 53230 53235 53240 53250 53260 53265 53270 53275 53400 53405 53410 53415 53420 53425 53430 53431 53440 53442 53444 53445 53446 53447 53448 53449 53450 53460 53500 53502 53505 53510 53515 53520 53600 53601 HCPCS 2 CPT 1/ 0.08 0.45 0.28 0.52 0.92 0.20 0.89 1.10 0.49 0.73 0.72 0.52 0.49 0.25 0.24 0.30 0.32 0.98 1.10 1.16 1.37 0.96 1.13 1.15 1.41 0.96 0.82 0.94 0.99 0.72 0.95 1.50 0.68 0.43 0.50 0.90 0.62 0.54 0.74 1.05 0.61 0.09 0.07 Mal-Practice RVUs NA NA 4.92 NA NA 4.51 NA NA NA NA NA NA NA 5.73 6.37 5.71 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 2.46 2.43 Fully Implemented NonFacility Total NA NA 4.99 NA NA 4.21 NA NA NA NA NA NA NA 5.55 6.16 5.64 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 2.45 2.35 Year 2007 Transitional Non-Facility Total 2.04 11.42 4.39 12.32 16.57 4.11 22.36 27.16 13.10 17.59 18.62 12.34 11.67 5.12 5.41 5.14 7.68 23.27 25.68 28.66 33.06 22.61 27.49 27.26 33.65 25.69 22.67 23.18 25.16 18.78 23.68 37.44 17.87 11.95 13.36 21.30 13.87 14.20 18.42 23.10 16.19 1.88 1.58 Fully Implemented Facility Total 1.80 10.63 4.32 13.05 18.67 3.86 20.82 25.12 12.07 16.21 17.02 11.35 10.57 4.78 4.95 5.00 7.25 21.55 23.61 26.47 30.20 22.36 25.59 25.90 31.28 23.13 20.32 21.45 23.75 17.31 22.06 34.71 16.34 10.78 12.22 20.30 13.04 12.97 17.15 21.57 14.87 1.77 1.46 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 000 090 010 090 090 000 090 090 090 090 090 090 090 010 010 010 010 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 000 000 Global 69888 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00267 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... TC .... 2 Copyright 3+ Mod A A A A A A A A A C A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Dilate urethra stricture .......................................... Dilate urethra stricture .......................................... Dilate urethra stricture .......................................... Dilation of urethra ................................................. Dilation of urethra ................................................. Dilation of urethra ................................................. Prostatic microwave thermotx .............................. Prostatic rf thermotx ............................................. Prostatic water thermother ................................... Urology surgery procedure .................................. Slitting of prepuce ................................................ Slitting of prepuce ................................................ Drain penis lesion ................................................ Destruction, penis lesion(s) .................................. Destruction, penis lesion(s) .................................. Cryosurgery, penis lesion(s) ................................ Laser surg, penis lesion(s) ................................... Excision of penis lesion(s) ................................... Destruction, penis lesion(s) .................................. Biopsy of penis ..................................................... Biopsy of penis ..................................................... Treatment of penis lesion .................................... Treat penis lesion, graft ....................................... Treat penis lesion, graft ....................................... Treatment of penis lesion .................................... Partial removal of penis ....................................... Removal of penis ................................................. Remove penis & nodes ........................................ Remove penis & nodes ........................................ Circumcision w/regionl block ................................ Circumcision, neonate .......................................... Circum 28 days or older ...................................... Lysis penil circumic lesion ................................... Repair of circumcision .......................................... Frenulotomy of penis ........................................... Treatment of penis lesion .................................... Treatment of penis lesion .................................... Treatment of penis lesion .................................... Prepare penis study ............................................. Dynamic cavernosometry ..................................... Penile injection ..................................................... Penis study ........................................................... Penis study ........................................................... Description 1.28 1.62 1.35 0.71 0.72 0.76 9.98 10.68 5.54 0.00 1.56 2.21 5.33 1.26 1.23 1.26 1.26 1.95 2.44 1.90 3.51 10.79 14.29 16.83 6.82 10.88 14.43 21.66 27.99 1.90 2.50 3.29 3.27 3.27 2.77 1.08 8.84 2.42 1.34 2.04 1.19 1.31 0.00 Physician Work RVUs 3 NA 1.72 1.82 1.32 1.30 NA 49.30 46.49 29.12 0.00 2.72 3.07 NA 2.08 2.00 2.37 2.61 3.11 3.30 3.37 4.04 NA NA NA 5.90 NA NA NA NA 2.40 3.69 NA 4.02 NA NA 2.03 NA 3.34 1.41 1.87 1.40 1.52 1.02 Fully Implemented NonFacility PE RVUs NA 1.92 2.01 1.31 1.30 NA 82.87 78.20 48.79 0.00 2.86 3.15 NA 1.77 1.68 1.86 2.31 3.10 2.80 2.94 4.22 NA NA NA 4.75 NA NA NA NA 1.50 4.03 NA 4.49 NA NA 1.85 NA 3.72 1.16 1.50 1.07 1.16 0.71 Year 2007 Transitional Non-Facility PE RVUs 0.53 0.85 0.69 0.46 0.43 0.27 6.01 6.82 4.43 0.00 1.50 1.69 3.24 1.39 1.26 1.54 1.36 1.66 2.01 1.39 2.49 6.65 8.22 9.54 5.07 6.89 8.35 11.56 14.51 0.75 1.47 2.24 2.28 2.91 2.66 1.32 6.18 1.38 0.91 1.19 0.90 1.52 1.02 Fully Implemented Facility PE RVUs 0.44 0.66 0.54 0.35 0.33 0.26 4.46 4.98 3.25 0.00 1.07 1.26 2.72 1.12 0.92 1.23 0.96 1.21 1.43 0.96 2.07 5.23 6.38 7.48 3.86 5.23 6.45 9.02 11.25 1.09 1.19 1.73 1.65 2.23 2.04 1.06 5.06 1.06 0.70 0.95 0.66 1.16 0.71 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 53605 53620 53621 53660 53661 53665 53850 53852 53853 53899 54000 54001 54015 54050 54055 54056 54057 54060 54065 54100 54105 54110 54111 54112 54115 54120 54125 54130 54135 54150 54160 54161 54162 54163 54164 54200 54205 54220 54230 54231 54235 54240 54240 HCPCS 2 CPT 1/ 0.09 0.11 0.10 0.05 0.05 0.06 0.67 0.70 0.37 0.00 0.11 0.15 0.38 0.08 0.08 0.06 0.09 0.13 0.13 0.10 0.25 0.72 0.96 1.11 0.43 0.68 0.95 1.52 1.88 0.16 0.19 0.23 0.21 0.21 0.18 0.08 0.56 0.17 0.09 0.16 0.08 0.17 0.06 Mal-Practice RVUs NA 3.45 3.27 2.08 2.07 NA 59.95 57.87 35.03 0.00 4.39 5.43 NA 3.42 3.31 3.69 3.96 5.19 5.87 5.37 7.80 NA NA NA 13.15 NA NA NA NA 4.46 6.38 NA 7.50 NA NA 3.19 NA 5.93 2.84 4.07 2.67 3.00 1.08 Fully Implemented NonFacility Total NA 3.65 3.46 2.07 2.07 NA 93.52 89.58 54.70 0.00 4.53 5.51 NA 3.11 2.99 3.18 3.66 5.18 5.37 4.94 7.98 NA NA NA 12.00 NA NA NA NA 3.56 6.72 NA 7.97 NA NA 3.01 NA 6.31 2.59 3.70 2.34 2.64 0.77 Year 2007 Transitional Non-Facility Total 1.90 2.58 2.14 1.22 1.20 1.09 16.66 18.20 10.34 0.00 3.17 4.05 8.95 2.73 2.57 2.86 2.71 3.74 4.58 3.39 6.25 18.16 23.47 27.48 12.32 18.45 23.73 34.74 44.38 2.81 4.16 5.76 5.76 6.39 5.61 2.48 15.58 3.97 2.34 3.39 2.17 3.00 1.08 Fully Implemented Facility Total 1.81 2.39 1.99 1.11 1.10 1.08 15.11 16.36 9.16 0.00 2.74 3.62 8.43 2.46 2.23 2.55 2.31 3.29 4.00 2.96 5.83 16.74 21.63 25.42 11.11 16.79 21.83 32.20 41.12 3.15 3.88 5.25 5.13 5.71 4.99 2.22 14.46 3.65 2.13 3.15 1.93 2.64 0.77 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 000 000 000 000 000 000 090 090 090 YYY 010 010 010 010 010 010 010 010 010 000 010 090 090 090 090 090 090 090 090 000 010 010 010 010 010 010 090 000 000 000 000 000 000 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69889 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00268 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 26 ..... .......... TC .... 26 ..... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C A A A A A Status Penis study ........................................................... Penis study ........................................................... Penis study ........................................................... Penis study ........................................................... Revision of penis .................................................. Revision of penis .................................................. Reconstruction of urethra ..................................... Reconstruction of urethra ..................................... Reconstruction of urethra ..................................... Reconstruction of urethra ..................................... Reconstruction of urethra ..................................... Reconstruction of urethra ..................................... Reconstruction of urethra ..................................... Revise penis/urethra ............................................ Revise penis/urethra ............................................ Revise penis/urethra ............................................ Secondary urethral surgery .................................. Secondary urethral surgery .................................. Secondary urethral surgery .................................. Reconstruct urethra/penis .................................... Penis plastic surgery ............................................ Repair penis ......................................................... Repair penis ......................................................... Repair penis and bladder ..................................... Insert semi-rigid prosthesis .................................. Insert self-contd prosthesis .................................. Insert multi-comp penis pros ................................ Remove muti-comp penis pros ............................ Repair multi-comp penis pros .............................. Remove/replace penis prosth .............................. Remov/replc penis pros, comp ............................ Remove self-contd penis pros ............................. Remv/repl penis contain pros .............................. Remv/replc penis pros, compl ............................. Revision of penis .................................................. Revision of penis .................................................. Revision of penis .................................................. Repair of penis ..................................................... Preputial stretching .............................................. Biopsy of testis ..................................................... Biopsy of testis ..................................................... Excise lesion testis ............................................... Removal of testis ................................................. Description 1.31 2.22 0.00 2.22 11.07 13.15 12.49 14.36 17.90 12.28 13.85 17.40 16.87 16.74 18.22 21.44 9.58 16.91 18.17 25.95 12.65 14.03 16.38 22.59 9.09 10.26 14.39 12.76 13.73 16.48 18.14 8.75 11.87 15.94 12.26 10.93 6.71 0.00 1.12 1.31 3.47 9.23 5.25 Physician Work RVUs 3 0.50 1.26 0.37 0.89 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.86 NA NA NA NA Fully Implemented NonFacility PE RVUs 0.45 1.00 0.24 0.76 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.93 NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 0.50 1.26 0.37 0.89 6.88 7.98 7.66 8.68 10.20 6.26 8.02 9.96 9.76 9.87 10.33 12.03 6.50 9.93 6.33 13.90 7.63 5.67 8.41 7.41 5.87 8.29 8.32 7.79 8.40 9.56 10.63 6.12 8.04 9.33 7.69 7.06 5.01 0.00 0.49 0.80 2.44 5.77 3.78 Fully Implemented Facility PE RVUs 0.45 1.00 0.24 0.76 5.89 6.74 6.38 7.41 8.51 5.90 6.84 8.45 8.27 7.90 8.37 10.72 5.40 8.29 7.84 11.85 6.42 6.37 8.29 8.90 4.72 6.36 6.51 6.01 6.39 7.35 7.93 4.67 6.03 6.95 6.09 5.59 3.96 0.00 0.45 0.62 2.04 4.53 3.03 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 54240 54250 54250 54250 54300 54304 54308 54312 54316 54318 54322 54324 54326 54328 54332 54336 54340 54344 54348 54352 54360 54380 54385 54390 54400 54401 54405 54406 54408 54410 54411 54415 54416 54417 54420 54430 54435 54440 54450 54500 54505 54512 54520 HCPCS 2 CPT 1/ 0.11 0.18 0.02 0.16 0.76 0.88 0.84 1.24 1.21 1.39 0.92 1.14 1.11 0.98 1.21 2.21 0.63 1.54 1.23 2.25 0.84 0.93 0.86 1.54 0.64 0.73 0.95 0.86 0.90 1.10 1.13 0.58 0.77 1.00 0.81 0.72 0.43 0.00 0.08 0.10 0.27 0.67 0.50 Mal-Practice RVUs 1.92 3.66 0.39 3.27 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 2.06 NA NA NA NA Fully Implemented NonFacility Total 1.87 3.40 0.26 3.14 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 2.13 NA NA NA NA Year 2007 Transitional Non-Facility Total 1.92 3.66 0.39 3.27 18.71 22.01 20.99 24.28 29.31 19.93 22.79 28.50 27.74 27.59 29.76 35.68 16.71 28.38 25.73 42.10 21.12 20.63 25.65 31.54 15.60 19.28 23.66 21.41 23.03 27.14 29.90 15.45 20.68 26.27 20.76 18.71 12.15 0.00 1.69 2.21 6.18 15.67 9.53 Fully Implemented Facility Total 1.87 3.40 0.26 3.14 17.72 20.77 19.71 23.01 27.62 19.57 21.61 26.99 26.25 25.62 27.80 34.37 15.61 26.74 27.24 40.05 19.91 21.33 25.53 33.03 14.45 17.35 21.85 19.63 21.02 24.93 27.20 14.00 18.67 23.89 19.16 17.24 11.10 0.00 1.65 2.03 5.78 14.43 8.78 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 000 000 000 000 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 000 000 010 090 090 Global 69890 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00269 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A C A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Orchiectomy, partial ............................................. Removal of testis ................................................. Extensive testis surgery ....................................... Exploration for testis ............................................ Exploration for testis ............................................ Reduce testis torsion ........................................... Suspension of testis ............................................. Suspension of testis ............................................. Orchiopexy (Fowler-Stephens) ............................ Revision of testis .................................................. Repair testis injury ............................................... Relocation of testis(es) ........................................ Laparoscopy, orchiectomy ................................... Laparoscopy, orchiopexy ..................................... Laparoscope proc, testis ...................................... Drainage of scrotum ............................................. Biopsy of epididymis ............................................ Remove epididymis lesion ................................... Remove epididymis lesion ................................... Removal of epididymis ......................................... Removal of epididymis ......................................... Explore epididymis ............................................... Fusion of spermatic ducts .................................... Fusion of spermatic ducts .................................... Drainage of hydrocele .......................................... Removal of hydrocele .......................................... Removal of hydroceles ........................................ Repair of hydrocele .............................................. Drainage of scrotum abscess .............................. Explore scrotum ................................................... Removal of scrotum lesion .................................. Removal of scrotum ............................................. Revision of scrotum ............................................. Revision of scrotum ............................................. Incision of sperm duct .......................................... Removal of sperm duct(s) .................................... Prepare, sperm duct x-ray ................................... Repair of sperm duct ........................................... Ligation of sperm duct ......................................... Removal of hydrocele .......................................... Removal of sperm cord lesion ............................. Revise spermatic cord veins ................................ Revise spermatic cord veins ................................ Description 10.15 9.31 13.06 8.31 11.97 7.54 5.16 7.57 12.24 5.64 6.57 13.91 11.60 13.64 0.00 3.44 2.33 5.91 5.22 6.85 9.57 5.67 14.05 18.92 1.43 5.39 8.41 6.05 2.40 6.23 5.62 8.01 5.77 11.63 4.50 3.32 3.50 8.53 4.38 6.12 6.56 5.69 7.09 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA 1.86 NA NA NA 3.51 NA NA NA NA NA 8.24 7.70 NA NA 6.00 NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA 2.01 NA NA NA 3.63 NA NA NA NA NA 11.29 10.53 NA NA 6.74 NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 5.82 6.19 7.67 5.42 6.34 5.23 3.31 5.53 7.81 4.47 4.88 7.86 6.24 7.75 0.00 2.42 1.00 4.51 3.87 4.96 6.38 4.35 5.23 6.57 0.92 4.01 5.78 4.50 2.13 4.55 4.33 5.53 4.41 7.41 3.40 3.02 1.61 5.56 2.89 4.27 3.83 4.19 4.92 Fully Implemented Facility PE RVUs 5.10 4.72 6.07 4.21 5.45 3.96 2.65 4.18 6.00 3.36 3.87 6.57 5.26 6.00 0.00 2.05 0.93 3.39 3.05 3.72 4.82 3.29 5.64 7.28 0.72 3.17 4.42 3.43 1.70 3.48 3.29 4.26 3.35 5.87 2.63 2.41 1.39 4.43 2.12 3.38 3.39 3.30 3.77 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 54522 54530 54535 54550 54560 54600 54620 54640 54650 54660 54670 54680 54690 54692 54699 54700 54800 54830 54840 54860 54861 54865 54900 54901 55000 55040 55041 55060 55100 55110 55120 55150 55175 55180 55200 55250 55300 55400 55450 55500 55520 55530 55535 HCPCS 2 CPT 1/ 0.89 0.66 0.95 0.59 0.90 0.51 0.37 0.62 1.16 0.44 0.47 1.16 1.02 1.30 0.00 0.28 0.23 0.41 0.37 0.45 0.63 0.40 0.93 1.83 0.11 0.43 0.60 0.46 0.17 0.43 0.39 0.56 0.37 0.90 0.33 0.25 0.25 0.64 0.29 0.55 0.75 0.45 0.47 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA 3.40 NA NA NA 6.08 NA NA NA NA NA 13.07 11.27 NA NA 10.67 NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA 3.55 NA NA NA 6.20 NA NA NA NA NA 16.12 14.10 NA NA 11.41 NA NA NA NA Year 2007 Transitional Non-Facility Total 16.86 16.16 21.68 14.32 19.21 13.28 8.84 13.72 21.21 10.55 11.92 22.93 18.86 22.69 0.00 6.14 3.56 10.83 9.46 12.26 16.58 10.42 20.21 27.32 2.46 9.83 14.79 11.01 4.70 11.21 10.34 14.10 10.55 19.94 8.23 6.59 5.36 14.73 7.56 10.94 11.14 10.33 12.48 Fully Implemented Facility Total 16.14 14.69 20.08 13.11 18.32 12.01 8.18 12.37 19.40 9.44 10.91 21.64 17.88 20.94 0.00 5.77 3.49 9.71 8.64 11.02 15.02 9.36 20.62 28.03 2.26 8.99 13.43 9.94 4.27 10.14 9.30 12.83 9.49 18.40 7.46 5.98 5.14 13.60 6.79 10.05 10.70 9.44 11.33 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 010 090 090 090 090 090 090 090 YYY 010 000 090 090 090 090 090 090 090 000 090 090 090 010 090 090 090 090 090 090 090 000 090 010 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69891 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00270 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A C A A A A A A A A A A A A A A A A A A A A A A A A A C N N A A A A A A A A A A A A Status Revise hernia & sperm veins ............................... Laparo ligate spermatic vein ................................ Laparo proc, spermatic cord ................................ Incise sperm duct pouch ...................................... Incise sperm duct pouch ...................................... Remove sperm duct pouch .................................. Remove sperm pouch lesion ............................... Biopsy of prostate ................................................ Biopsy of prostate ................................................ Drainage of prostate abscess .............................. Drainage of prostate abscess .............................. Removal of prostate ............................................. Extensive prostate surgery .................................. Extensive prostate surgery .................................. Extensive prostate surgery .................................. Removal of prostate ............................................. Removal of prostate ............................................. Extensive prostate surgery .................................. Extensive prostate surgery .................................. Extensive prostate surgery .................................. Surgical exposure, prostate ................................. Extensive prostate surgery .................................. Extensive prostate surgery .................................. Laparo radical prostatectomy ............................... Electroejaculation ................................................. Cryoablate prostate .............................................. Transperi needle place, pros ............................... Place rt device/marker, pros ................................ Genital surgery procedure ................................... Sex transformation, M to F .................................. Sex transformation, F to M .................................. I & D of vulva/perineum ....................................... Drainage of gland abscess .................................. Surgery for vulva lesion ....................................... Lysis of labial lesion(s) ......................................... Hymenotomy ........................................................ Destroy, vulva lesions, sim .................................. Destroy vulva lesion/s compl ............................... Biopsy of vulva/perineum ..................................... Biopsy of vulva/perineum ..................................... Partial removal of vulva ....................................... Complete removal of vulva .................................. Extensive vulva surgery ....................................... Description 8.20 7.10 0.00 6.91 8.63 12.52 5.59 2.58 4.58 7.67 9.90 19.62 24.14 29.69 32.75 15.63 17.06 24.45 26.31 30.52 15.71 19.89 24.39 32.25 2.58 20.25 13.31 1.73 0.00 0.00 0.00 1.46 1.41 2.86 1.99 0.68 1.55 3.03 1.10 0.55 8.44 9.55 14.67 Physician Work RVUs 3 NA NA 0.00 NA NA NA NA 3.74 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 2.47 NA NA 2.04 0.00 0.00 0.00 1.17 1.50 NA 1.71 NA 1.63 2.36 0.90 0.36 NA NA NA Fully Implemented NonFacility PE RVUs NA NA 0.00 NA NA NA NA 4.08 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 1.77 NA NA 2.04 0.00 0.00 0.00 1.29 2.08 NA 1.79 NA 1.74 2.50 1.03 0.46 NA NA NA Year 2007 Transitional Non-Facility PE RVUs 4.30 4.60 0.00 4.99 4.95 7.38 3.91 1.36 2.92 4.87 6.37 10.80 12.66 15.26 16.73 8.89 9.49 12.99 13.85 15.29 8.84 10.98 13.14 16.38 1.46 11.57 8.03 1.03 0.00 0.00 0.00 1.15 0.77 1.58 1.56 0.51 1.22 1.72 0.35 0.15 4.41 4.78 6.31 Fully Implemented Facility PE RVUs 3.92 3.62 0.00 3.74 4.45 5.79 3.20 0.82 2.45 4.08 4.95 8.40 9.86 12.04 13.09 6.87 7.35 10.19 10.83 12.01 7.00 8.62 10.22 12.87 1.18 9.59 6.38 1.03 0.00 0.00 0.00 1.14 0.97 1.68 1.45 0.51 1.24 1.79 0.43 0.20 4.70 5.18 6.70 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 55540 55550 55559 55600 55605 55650 55680 55700 55705 55720 55725 55801 55810 55812 55815 55821 55831 55840 55842 55845 55860 55862 55865 55866 55870 55873 55875 55876 55899 55970 55980 56405 56420 56440 56441 56442 56501 56515 56605 56606 56620 56625 56630 HCPCS 2 CPT 1/ 0.94 0.57 0.00 0.62 0.64 0.92 0.47 0.11 0.32 0.95 0.70 1.34 1.60 2.05 2.17 1.01 1.10 1.61 1.73 2.03 1.02 1.49 1.63 2.17 0.16 1.38 0.89 0.28 0.00 0.00 0.00 0.17 0.16 0.34 0.20 0.08 0.18 0.33 0.13 0.07 0.90 1.02 1.49 Mal-Practice RVUs NA NA 0.00 NA NA NA NA 6.43 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 5.21 NA NA 4.05 0.00 0.00 0.00 2.80 3.07 NA 3.90 NA 3.36 5.72 2.13 0.98 NA NA NA Fully Implemented NonFacility Total NA NA 0.00 NA NA NA NA 6.77 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 4.51 NA NA 4.05 0.00 0.00 0.00 2.92 3.65 NA 3.98 NA 3.47 5.86 2.26 1.08 NA NA NA Year 2007 Transitional Non-Facility Total 13.44 12.27 0.00 12.52 14.22 20.82 9.97 4.05 7.82 13.49 16.97 31.76 38.40 47.00 51.65 25.53 27.65 39.05 41.89 47.84 25.57 32.36 39.16 50.80 4.20 33.20 22.23 3.04 0.00 0.00 0.00 2.78 2.34 4.78 3.75 1.27 2.95 5.08 1.58 0.77 13.75 15.35 22.47 Fully Implemented Facility Total 13.06 11.29 0.00 11.27 13.72 19.23 9.26 3.51 7.35 12.70 15.55 29.36 35.60 43.78 48.01 23.51 25.51 36.25 38.87 44.56 23.73 30.00 36.24 47.29 3.92 31.22 20.58 3.04 0.00 0.00 0.00 2.77 2.54 4.88 3.64 1.27 2.97 5.15 1.66 0.82 14.04 15.75 22.86 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 YYY 090 090 090 090 000 010 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 000 090 090 000 YYY XXX XXX 010 010 010 010 000 010 010 000 ZZZ 090 090 090 Global 69892 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00271 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Extensive vulva surgery ....................................... Extensive vulva surgery ....................................... Extensive vulva surgery ....................................... Extensive vulva surgery ....................................... Extensive vulva surgery ....................................... Extensive vulva surgery ....................................... Partial removal of hymen ..................................... Remove vagina gland lesion ................................ Repair of vagina ................................................... Repair clitoris ....................................................... Repair of perineum .............................................. Exam of vulva w/scope ........................................ Exam/biopsy of vulva w/scope ............................. Exploration of vagina ........................................... Drainage of pelvic abscess .................................. Drainage of pelvic fluid ........................................ I & d vaginal hematoma, pp ................................. I & d vag hematoma, non-ob ............................... Destroy vag lesions, simple ................................. Destroy vag lesions, complex .............................. Biopsy of vagina ................................................... Biopsy of vagina ................................................... Remove vagina wall, partial ................................. Remove vagina tissue, part ................................. Vaginectomy partial w/nodes ............................... Remove vagina wall, complete ............................ Remove vagina tissue, compl .............................. Vaginectomy w/nodes, compl .............................. Closure of vagina ................................................. Remove vagina lesion .......................................... Remove vagina lesion .......................................... Treat vagina infection ........................................... Insert uteri tandems/ovoids .................................. Insert pessary/other device .................................. Fitting of diaphragm/cap ...................................... Treat vaginal bleeding .......................................... Repair of vagina ................................................... Repair vagina/perineum ....................................... Revision of urethra ............................................... Repair of urethral lesion ....................................... Repair bladder & vagina ...................................... Repair rectum & vagina ....................................... Repair of vagina ................................................... Description 18.81 21.61 19.47 20.48 24.57 24.65 2.79 4.83 3.90 19.75 4.26 1.50 2.05 2.99 6.74 1.50 2.70 5.13 1.27 2.63 1.20 1.71 7.35 24.43 28.25 15.38 28.25 30.37 8.18 2.44 2.68 0.55 6.79 0.89 0.91 1.60 4.34 5.63 4.77 6.22 11.42 11.42 14.36 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA 1.19 1.52 NA NA 0.75 NA NA 1.50 2.01 0.92 1.58 NA NA NA NA NA NA NA 1.97 2.01 0.57 NA 1.03 0.56 1.83 NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA 1.28 1.69 NA NA 0.89 NA NA 1.61 2.22 1.04 1.74 NA NA NA NA NA NA NA 2.11 2.20 0.97 NA 1.02 1.25 2.08 NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 7.77 9.36 7.82 8.22 9.28 9.10 1.76 2.30 1.99 9.31 2.05 0.53 0.69 1.71 3.82 0.44 1.43 2.39 1.11 1.49 0.37 1.33 4.25 9.10 10.40 6.22 10.26 11.67 4.17 1.48 1.52 0.15 3.53 0.26 0.25 0.92 2.93 3.25 3.00 3.77 5.46 5.01 5.82 Fully Implemented Facility PE RVUs 8.54 9.47 8.40 9.12 10.62 10.23 1.81 2.50 2.14 9.39 2.23 0.62 0.86 1.72 3.81 0.55 1.48 2.53 1.12 1.63 0.45 1.40 4.20 10.12 11.03 7.01 12.02 11.99 4.49 1.53 1.62 0.20 4.30 0.32 0.31 1.18 2.90 3.39 3.08 3.49 4.22 3.93 5.08 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 56631 56632 56633 56634 56637 56640 56700 56740 56800 56805 56810 56820 56821 57000 57010 57020 57022 57023 57061 57065 57100 57105 57106 57107 57109 57110 57111 57112 57120 57130 57135 57150 57155 57160 57170 57180 57200 57210 57220 57230 57240 57250 57260 HCPCS 2 CPT 1/ 1.96 2.39 1.98 2.17 2.61 2.89 0.30 0.56 0.44 2.15 0.49 0.18 0.25 0.31 0.71 0.18 0.26 0.58 0.15 0.31 0.14 0.20 0.73 2.72 3.22 1.74 3.18 3.08 0.89 0.29 0.31 0.07 0.43 0.10 0.11 0.19 0.46 0.62 0.51 0.54 0.62 0.65 0.97 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA 2.87 3.82 NA NA 2.43 NA NA 2.92 4.95 2.26 3.49 NA NA NA NA NA NA NA 4.70 5.00 1.19 NA 2.02 1.58 3.62 NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA 2.96 3.99 NA NA 2.57 NA NA 3.03 5.16 2.38 3.65 NA NA NA NA NA NA NA 4.84 5.19 1.59 NA 2.01 2.27 3.87 NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 28.54 33.36 29.27 30.87 36.46 36.64 4.85 7.69 6.33 31.21 6.80 2.21 2.99 5.01 11.27 2.12 4.39 8.10 2.53 4.43 1.71 3.24 12.33 36.25 41.87 23.34 41.69 45.12 13.24 4.21 4.51 0.77 10.75 1.25 1.27 2.71 7.73 9.50 8.28 10.53 17.50 17.08 21.15 Fully Implemented Facility Total 29.31 33.47 29.85 31.77 37.80 37.77 4.90 7.89 6.48 31.29 6.98 2.30 3.16 5.02 11.26 2.23 4.44 8.24 2.54 4.57 1.79 3.31 12.28 37.27 42.50 24.13 43.45 45.44 13.56 4.26 4.61 0.82 11.52 1.31 1.33 2.97 7.70 9.64 8.36 10.25 16.26 16.00 20.41 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 010 010 010 090 010 000 000 010 090 000 010 010 010 010 000 010 090 090 090 090 090 090 090 010 010 000 090 000 000 010 090 090 090 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69893 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00272 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Extensive repair of vagina ................................... Insert mesh/pelvic flr addon ................................. Repair of bowel bulge .......................................... Repair of bowel pouch ......................................... Suspension of vagina ........................................... Colpopexy, extraperitoneal .................................. Colpopexy, intraperitoneal ................................... Repair paravaginal defect .................................... Revise/remove sling repair .................................. Repair bladder defect ........................................... Repair bladder & vagina ...................................... Construction of vagina ......................................... Construct vagina with graft .................................. Revise vag graft via vagina ................................. Revise vag graft, open abd .................................. Repair rectum-vagina fistula ................................ Repair rectum-vagina fistula ................................ Fistula repair & colostomy ................................... Fistula repair, transperine .................................... Repair urethrovaginal lesion ................................ Repair urethrovaginal lesion ................................ Repair bladder-vagina lesion ............................... Repair bladder-vagina lesion ............................... Repair vagina ....................................................... Dilation of vagina ................................................. Pelvic examination ............................................... Remove vaginal foreign body .............................. Exam of vagina w/scope ...................................... Exam/biopsy of vag w/scope ............................... Laparoscopy, surg, colpopexy ............................. Exam of cervix w/scope ....................................... Bx/curett of cervix w/scope .................................. Biopsy of cervix w/scope ..................................... Endocerv curettage w/scope ................................ Bx of cervix w/scope, leep ................................... Conz of cervix w/scope, leep ............................... Biopsy of cervix .................................................... Endocervical curettage ......................................... Cauterization of cervix ......................................... Cryocautery of cervix ........................................... Laser surgery of cervix ........................................ Conization of cervix .............................................. Conization of cervix .............................................. Description 15.86 4.88 7.47 13.57 16.62 7.84 11.58 13.51 11.49 14.01 12.69 8.54 13.91 7.74 16.46 8.58 15.24 17.02 10.48 7.55 8.81 8.78 13.11 19.87 2.27 1.75 2.44 1.60 2.20 16.93 1.50 2.33 1.99 1.85 2.83 3.43 1.20 1.16 1.90 1.92 1.92 4.06 3.62 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 1.23 1.59 NA 1.17 1.39 1.49 1.45 4.26 4.55 1.99 1.30 1.30 1.59 1.56 3.35 2.75 Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 1.32 1.78 NA 1.25 1.58 1.66 1.60 5.45 5.71 2.40 1.42 1.50 1.76 1.68 3.79 3.05 Year 2007 Transitional Non-Facility PE RVUs 6.29 1.53 4.28 5.68 7.01 4.40 5.21 6.75 6.50 7.13 6.21 4.37 6.06 4.01 6.75 4.47 6.19 7.02 4.90 5.12 5.22 5.41 7.25 9.05 0.98 0.92 1.50 0.57 0.73 6.96 0.74 0.96 0.66 0.63 1.10 1.07 0.64 1.06 0.90 1.26 1.27 2.50 2.25 Fully Implemented Facility PE RVUs 6.10 1.86 4.21 6.10 7.27 4.48 5.74 7.04 5.73 6.21 6.08 4.78 6.71 4.33 6.75 4.33 6.24 7.00 5.04 4.15 4.39 4.62 6.09 9.03 1.08 0.90 1.44 0.65 0.90 6.71 0.76 1.10 0.82 0.77 1.31 1.37 0.63 1.09 1.01 1.34 1.37 2.78 2.40 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 57265 57267 57268 57270 57280 57282 57283 57284 57287 57288 57289 57291 57292 57295 57296 57300 57305 57307 57308 57310 57311 57320 57330 57335 57400 57410 57415 57420 57421 57425 57452 57454 57455 57456 57460 57461 57500 57505 57510 57511 57513 57520 57522 HCPCS 2 CPT 1/ 1.32 0.64 0.79 1.42 1.68 1.02 1.02 1.41 0.90 1.12 1.21 0.93 1.58 0.91 1.68 0.87 1.73 2.02 1.14 0.54 0.65 0.69 1.06 1.92 0.26 0.18 0.24 0.19 0.27 1.76 0.18 0.28 0.24 0.22 0.34 0.41 0.12 0.14 0.23 0.23 0.23 0.49 0.41 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 3.02 4.06 NA 2.85 4.00 3.72 3.52 7.43 8.39 3.31 2.60 3.43 3.74 3.71 7.90 6.78 Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 3.11 4.25 NA 2.93 4.19 3.89 3.67 8.62 9.55 3.72 2.72 3.63 3.91 3.83 8.34 7.08 Year 2007 Transitional Non-Facility Total 23.47 7.05 12.54 20.67 25.31 13.26 17.81 21.67 18.89 22.26 20.11 13.84 21.55 12.66 24.89 13.92 23.16 26.06 16.52 13.21 14.68 14.88 21.42 30.84 3.51 2.85 4.18 2.36 3.20 25.65 2.42 3.57 2.89 2.70 4.27 4.91 1.96 2.36 3.03 3.41 3.42 7.05 6.28 Fully Implemented Facility Total 23.28 7.38 12.47 21.09 25.57 13.34 18.34 21.96 18.12 21.34 19.98 14.25 22.20 12.98 24.89 13.78 23.21 26.04 16.66 12.24 13.85 14.09 20.26 30.82 3.61 2.83 4.12 2.44 3.37 25.40 2.44 3.71 3.05 2.84 4.48 5.21 1.95 2.39 3.14 3.49 3.52 7.33 6.43 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 ZZZ 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 000 000 010 000 000 090 000 000 000 000 000 000 000 010 010 010 010 090 090 Global 69894 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00273 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A N A A A A A A Status Removal of cervix ................................................ Removal of cervix, radical .................................... Removal of residual cervix ................................... Remove cervix/repair pelvis ................................. Removal of residual cervix ................................... Remove cervix/repair vagina ............................... Remove cervix, repair bowel ............................... D&c of cervical stump .......................................... Revision of cervix ................................................. Revision of cervix ................................................. Dilation of cervical canal ...................................... Biopsy of uterus lining .......................................... Bx done w/colposcopy add-on ............................. Dilation and curettage .......................................... Myomectomy abdom method ............................... Myomectomy vag method .................................... Myomectomy abdom complex ............................. Total hysterectomy ............................................... Total hysterectomy ............................................... Partial hysterectomy ............................................. Extensive hysterectomy ....................................... Extensive hysterectomy ....................................... Removal of pelvis contents .................................. Vaginal hysterectomy ........................................... Vag hyst including t/o ........................................... Vag hyst w/t/o & vag repair ................................. Vag hyst w/urinary repair ..................................... Vag hyst w/enterocele repair ............................... Hysterectomy/revise vagina ................................. Hysterectomy/revise vagina ................................. Extensive hysterectomy ....................................... Vag hyst complex ................................................. Vag hyst incl t/o, complex .................................... Vag hyst t/o & repair, compl ................................ Vag hyst w/uro repair, compl ............................... Vag hyst w/enterocele, compl .............................. Insert intrauterine device ...................................... Remove intrauterine device ................................. Artificial insemination ........................................... Artificial insemination ........................................... Sperm washing .................................................... Catheter for hysterography .................................. Reopen fallopian tube .......................................... Description 5.19 29.77 13.19 14.00 6.24 9.84 9.26 1.69 4.22 4.53 0.77 1.53 0.77 3.54 15.69 8.81 20.24 17.21 21.73 16.50 23.00 30.76 49.02 14.02 15.81 17.10 18.23 15.20 16.90 18.20 23.30 20.17 21.96 23.25 24.23 21.45 1.01 1.27 0.92 1.10 0.23 0.88 4.67 Physician Work RVUs 3 NA NA NA NA NA NA NA 1.34 NA NA 0.70 1.12 0.39 2.68 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.62 1.04 0.96 1.03 0.15 2.11 NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA 1.44 NA NA 0.75 1.27 0.51 2.40 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 1.22 1.25 1.10 1.16 0.44 2.90 NA Year 2007 Transitional Non-Facility PE RVUs 3.09 10.74 5.61 6.21 3.62 4.76 4.66 1.05 3.27 2.89 0.41 0.58 0.21 1.65 6.21 4.24 7.30 6.55 8.12 6.34 8.18 10.77 17.78 5.78 6.25 6.62 7.01 5.94 6.66 7.03 8.05 7.38 7.81 8.29 8.48 7.24 0.23 0.35 0.25 0.31 0.07 0.55 2.04 Fully Implemented Facility PE RVUs 3.31 12.56 6.08 6.56 3.77 5.00 4.80 1.12 3.14 3.05 0.46 0.69 0.29 1.82 6.88 4.65 8.58 7.25 9.42 7.17 9.54 12.59 17.65 6.46 7.10 7.57 8.03 6.78 7.49 7.95 9.47 8.69 9.36 9.84 10.11 8.97 0.34 0.45 0.34 0.39 0.09 0.63 2.33 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 57530 57531 57540 57545 57550 57555 57556 57558 57700 57720 57800 58100 58110 58120 58140 58145 58146 58150 58152 58180 58200 58210 58240 58260 58262 58263 58267 58270 58275 58280 58285 58290 58291 58292 58293 58294 58300 58301 58321 58322 58323 58340 58345 HCPCS 2 CPT 1/ 0.58 3.35 1.49 1.52 0.67 1.09 0.92 0.20 0.41 0.49 0.09 0.18 0.09 0.39 1.82 0.97 2.33 1.85 2.48 1.64 2.55 3.38 4.23 1.57 1.80 1.95 2.07 1.74 1.92 2.07 2.71 2.30 2.53 2.68 2.79 2.40 0.12 0.15 0.10 0.13 0.03 0.09 0.41 Mal-Practice RVUs NA NA NA NA NA NA NA 3.23 NA NA 1.56 2.83 1.25 6.61 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 1.75 2.46 1.98 2.26 0.41 3.08 NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA 3.33 NA NA 1.61 2.98 1.37 6.33 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 2.35 2.67 2.12 2.39 0.70 3.87 NA Year 2007 Transitional Non-Facility Total 8.86 43.86 20.29 21.73 10.53 15.69 14.84 2.94 7.90 7.91 1.27 2.29 1.07 5.58 23.72 14.02 29.87 25.61 32.33 24.48 33.73 44.91 71.03 21.37 23.86 25.67 27.31 22.88 25.48 27.30 34.06 29.85 32.30 34.22 35.50 31.09 1.36 1.77 1.27 1.54 0.33 1.52 7.12 Fully Implemented Facility Total 9.08 45.68 20.76 22.08 10.68 15.93 14.98 3.01 7.77 8.07 1.32 2.40 1.15 5.75 24.39 14.43 31.15 26.31 33.63 25.31 35.09 46.73 70.90 22.05 24.71 26.62 28.33 23.72 26.31 28.22 35.48 31.16 33.85 35.77 37.13 32.82 1.47 1.87 1.36 1.62 0.35 1.60 7.41 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 010 090 090 000 000 ZZZ 010 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 XXX 000 000 000 000 000 010 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69895 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00274 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A C C A A A A A A A A A A A C A A Status Insert heyman uteri capsule ................................. Reopen fallopian tube .......................................... Endometr ablate, thermal ..................................... Endometrial cryoablation ...................................... Suspension of uterus ........................................... Suspension of uterus ........................................... Repair of ruptured uterus ..................................... Revision of uterus ................................................ Lsh, uterus 250 g or less ..................................... Lsh w/t/o ut 250 g or less .................................... Lsh uterus above 250 g ....................................... Lsh w/t/o uterus above 250 g .............................. Laparoscopic myomectomy ................................. Laparo-myomectomy, complex ............................ Lap radical hyst .................................................... Laparo-asst vag hysterectomy ............................. Laparo-vag hyst incl t/o ........................................ Laparo-vag hyst, complex .................................... Laparo-vag hyst w/t/o, compl ............................... Hysteroscopy, dx, sep proc ................................. Hysteroscopy, biopsy ........................................... Hysteroscopy, lysis .............................................. Hysteroscopy, resect septum ............................... Hysteroscopy, remove myoma ............................ Hysteroscopy, remove fb ..................................... Hysteroscopy, ablation ......................................... Hysteroscopy, sterilization ................................... Laparo proc, uterus .............................................. Hysteroscope procedure ...................................... Division of fallopian tube ...................................... Division of fallopian tube ...................................... Ligate oviduct(s) add-on ...................................... Occlude fallopian tube(s) ..................................... Laparoscopy, lysis ................................................ Laparoscopy, remove adnexa .............................. Laparoscopy, excise lesions ................................ Laparoscopy, tubal cautery .................................. Laparoscopy, tubal block ..................................... Laparoscopy, fimbrioplasty .................................. Laparoscopy, salpingostomy ................................ Laparo proc, oviduct-ovary .................................. Removal of fallopian tube .................................... Removal of ovary/tube(s) ..................................... Description 7.48 1.03 3.57 6.36 7.06 13.70 13.38 15.61 14.57 16.43 16.74 18.24 15.45 19.84 31.45 14.97 16.78 19.96 22.98 3.33 4.74 6.16 6.99 9.99 5.20 6.16 7.06 0.00 0.00 5.86 5.25 1.45 3.91 11.54 11.30 12.08 5.86 5.86 12.88 13.99 0.00 12.84 12.08 Physician Work RVUs 3 NA 1.32 22.66 42.90 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 2.72 3.57 NA NA NA 3.48 36.94 34.05 0.00 0.00 NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA Fully Implemented NonFacility PE RVUs NA 1.45 32.41 56.80 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 2.32 2.52 NA NA NA 2.63 51.38 45.68 0.00 0.00 NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA Year 2007 Transitional Non-Facility PE RVUs 3.81 0.87 1.71 1.85 3.82 5.88 5.45 6.20 6.14 6.66 6.73 7.16 5.93 7.10 12.74 6.16 6.59 7.13 8.33 1.24 1.67 2.05 2.29 3.14 1.77 2.06 3.36 0.00 0.00 2.91 2.67 0.40 1.98 4.52 4.01 4.78 2.95 2.94 4.75 5.19 0.00 5.53 5.10 Fully Implemented Facility PE RVUs 3.89 0.91 1.97 2.48 3.90 6.29 5.89 6.76 6.14 6.66 6.73 7.16 6.87 8.46 12.74 7.01 7.66 8.47 9.88 1.47 2.05 2.56 2.88 4.00 2.21 2.58 3.77 0.00 0.00 3.23 3.00 0.53 2.52 5.07 4.84 5.53 3.19 3.19 5.82 6.23 0.00 5.87 5.60 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 58346 58350 58353 58356 58400 58410 58520 58540 58541 58542 58543 58544 58545 58546 58548 58550 58552 58553 58554 58555 58558 58559 58560 58561 58562 58563 58565 58578 58579 58600 58605 58611 58615 58660 58661 58662 58670 58671 58672 58673 58679 58700 58720 HCPCS 2 CPT 1/ 0.56 0.12 0.43 0.82 0.75 1.45 1.47 1.79 1.68 1.69 1.73 1.89 1.78 2.31 3.52 1.73 1.73 2.31 2.28 0.40 0.57 0.74 0.84 1.21 0.63 0.74 1.19 0.00 0.00 0.66 0.59 0.18 0.47 1.40 1.34 1.43 0.67 0.68 1.60 1.70 0.00 1.51 1.39 Mal-Practice RVUs NA 2.47 26.66 50.08 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 6.45 8.88 NA NA NA 9.31 43.84 42.30 0.00 0.00 NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA Fully Implemented NonFacility Total NA 2.60 36.41 63.98 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 6.05 7.83 NA NA NA 8.46 58.28 53.93 0.00 0.00 NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA Year 2007 Transitional Non-Facility Total 11.85 2.02 5.71 9.03 11.63 21.03 20.30 23.60 22.39 24.78 25.20 27.29 23.16 29.25 47.71 22.86 25.10 29.40 33.59 4.97 6.98 8.95 10.12 14.34 7.60 8.96 11.61 0.00 0.00 9.43 8.51 2.03 6.36 17.46 16.65 18.29 9.48 9.48 19.23 20.88 0.00 19.88 18.57 Fully Implemented Facility Total 11.93 2.06 5.97 9.66 11.71 21.44 20.74 24.16 22.39 24.78 25.20 27.29 24.10 30.61 47.71 23.71 26.17 30.74 35.14 5.20 7.36 9.46 10.71 15.20 8.04 9.48 12.02 0.00 0.00 9.75 8.84 2.16 6.90 18.01 17.48 19.04 9.72 9.73 20.30 21.92 0.00 20.22 19.07 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 010 010 010 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 000 000 000 000 000 000 000 090 YYY YYY 090 090 ZZZ 010 090 010 090 090 090 090 090 YYY 090 090 Global 69896 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00275 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A C A C A A A A A A A A A A A A A A Status Revise fallopian tube(s) ....................................... Repair oviduct ...................................................... Revise ovarian tube(s) ......................................... Remove tubal obstruction .................................... Create new tubal opening .................................... Drainage of ovarian cyst(s) .................................. Drainage of ovarian cyst(s) .................................. Drain ovary abscess, open .................................. Drain ovary abscess, percut ................................ Drain pelvic abscess, percut ................................ Transposition, ovary(s) ......................................... Biopsy of ovary(s) ................................................ Partial removal of ovary(s) ................................... Removal of ovarian cyst(s) .................................. Removal of ovary(s) ............................................. Removal of ovary(s) ............................................. Resect ovarian malignancy .................................. Resect ovarian malignancy .................................. Resect ovarian malignancy .................................. Tah, rad dissect for debulk .................................. Tah rad debulk/lymph remove ............................. Bso, omentectomy w/tah ...................................... Resect recurrent gyn mal ..................................... Resect recur gyn mal w/lym ................................ Exploration of abdomen ....................................... Retrieval of oocyte ............................................... Transfer of embryo ............................................... Transfer of embryo ............................................... Genital surgery procedure ................................... Amniocentesis, diagnostic .................................... Amniocentesis, therapeutic .................................. Fetal cord puncture,prenatal ................................ Chorion biopsy ..................................................... Fetal contract stress test ...................................... Fetal contract stress test ...................................... Fetal contract stress test ...................................... Fetal non-stress test ............................................ Fetal non-stress test ............................................ Fetal non-stress test ............................................ Fetal scalp blood sample ..................................... Fetal monitor w/report .......................................... Fetal monitor/interpret only .................................. Transabdom amnioinfus w/us .............................. Description 14.79 15.56 15.56 13.85 14.69 4.54 6.34 4.62 11.71 3.37 11.70 6.51 11.87 12.33 8.12 19.42 18.24 24.15 27.15 33.97 36.97 22.65 26.06 29.06 15.68 3.52 0.00 3.82 0.00 1.30 3.00 3.44 2.20 0.66 0.00 0.66 0.53 0.00 0.53 1.99 0.89 0.74 5.24 Physician Work RVUs 3 NA NA NA NA NA 3.10 NA NA NA 19.03 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 1.82 0.00 1.93 0.00 1.72 NA NA 1.41 1.06 0.88 0.18 0.63 0.48 0.15 NA NA NA 4.33 Fully Implemented NonFacility PE RVUs NA NA NA NA NA 3.51 NA NA NA 20.75 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 2.19 0.00 2.49 0.00 1.98 NA NA 1.52 0.85 0.61 0.24 0.49 0.29 0.20 NA NA NA 4.95 Year 2007 Transitional Non-Facility PE RVUs 6.07 6.08 6.00 5.61 5.76 2.60 3.40 2.88 5.05 0.95 4.98 3.42 5.23 5.27 4.04 7.24 7.30 8.64 9.85 11.71 12.56 8.63 9.63 10.44 6.29 1.26 0.00 1.20 0.00 0.55 1.08 1.15 0.80 1.06 0.88 0.18 0.63 0.48 0.15 0.56 0.25 0.21 1.76 Fully Implemented Facility PE RVUs 6.87 7.04 6.71 6.44 6.62 2.83 3.48 3.19 5.17 1.08 5.59 3.53 5.49 5.58 4.09 8.29 8.13 9.99 11.28 13.83 14.92 9.89 9.63 10.44 7.09 1.43 0.00 1.67 0.00 0.64 1.33 1.44 0.98 0.85 0.61 0.24 0.49 0.29 0.20 0.72 0.33 0.27 2.17 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 58740 58750 58752 58760 58770 58800 58805 58820 58822 58823 58825 58900 58920 58925 58940 58943 58950 58951 58952 58953 58954 58956 58957 58958 58960 58970 58974 58976 58999 59000 59001 59012 59015 59020 59020 59020 59025 59025 59025 59030 59050 59051 59070 HCPCS 2 CPT 1/ 1.72 1.85 1.81 1.80 1.74 0.43 0.69 0.52 1.16 0.24 1.32 0.69 1.43 1.41 0.91 2.23 2.05 2.64 3.03 3.84 4.18 4.01 2.95 3.29 1.80 0.43 0.00 0.47 0.00 0.31 0.71 0.82 0.52 0.26 0.10 0.16 0.15 0.02 0.13 0.47 0.21 0.17 0.28 Mal-Practice RVUs NA NA NA NA NA 8.07 NA NA NA 22.64 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 5.77 0.00 6.22 0.00 3.33 NA NA 4.13 1.98 0.98 1.00 1.31 0.50 0.81 NA NA NA 9.85 Fully Implemented NonFacility Total NA NA NA NA NA 8.48 NA NA NA 24.36 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 6.14 0.00 6.78 0.00 3.59 NA NA 4.24 1.77 0.71 1.06 1.17 0.31 0.86 NA NA NA 10.47 Year 2007 Transitional Non-Facility Total 22.58 23.49 23.37 21.26 22.19 7.57 10.43 8.02 17.92 4.56 18.00 10.62 18.53 19.01 13.07 28.89 27.59 35.43 40.03 49.52 53.71 35.29 38.64 42.79 23.77 5.21 0.00 5.49 0.00 2.16 4.79 5.41 3.52 1.98 0.98 1.00 1.31 0.50 0.81 3.02 1.35 1.12 7.28 Fully Implemented Facility Total 23.38 24.45 24.08 22.09 23.05 7.80 10.51 8.33 18.04 4.69 18.61 10.73 18.79 19.32 13.12 29.94 28.42 36.78 41.46 51.64 56.07 36.55 38.64 42.79 24.57 5.38 0.00 5.96 0.00 2.25 5.04 5.70 3.70 1.77 0.71 1.06 1.17 0.31 0.86 3.18 1.43 1.18 7.69 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 000 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 000 000 000 YYY 000 000 000 000 000 000 000 000 000 000 000 XXX XXX 000 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69897 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00276 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A R R R Status Umbilical cord occlud w/us .................................. Fetal fluid drainage w/us ...................................... Fetal shunt placement, w/us ................................ Remove uterus lesion .......................................... Treat ectopic pregnancy ...................................... Treat ectopic pregnancy ...................................... Treat ectopic pregnancy ...................................... Treat ectopic pregnancy ...................................... Treat ectopic pregnancy ...................................... Treat ectopic pregnancy ...................................... Treat ectopic pregnancy ...................................... Treat ectopic pregnancy ...................................... D & c after delivery .............................................. Insert cervical dilator ............................................ Episiotomy or vaginal repair ................................ Revision of cervix ................................................. Revision of cervix ................................................. Repair of uterus ................................................... Obstetrical care .................................................... Obstetrical care .................................................... Obstetrical care .................................................... Antepartum manipulation ..................................... Deliver placenta ................................................... Antepartum care only ........................................... Antepartum care only ........................................... Care after delivery ................................................ Cesarean delivery ................................................ Cesarean delivery only ........................................ Cesarean delivery ................................................ Remove uterus after cesarean ............................ Vbac delivery ........................................................ Vbac delivery only ................................................ Vbac care after delivery ....................................... Attempted vbac delivery ....................................... Attempted vbac delivery only ............................... Attempted vbac after care .................................... Treatment of miscarriage ..................................... Care of miscarriage .............................................. Treatment of miscarriage ..................................... Treat uterus infection ........................................... Abortion ................................................................ Abortion ................................................................ Abortion ................................................................ Description 8.99 5.24 8.99 13.26 12.56 12.64 14.98 14.82 14.15 5.86 12.19 12.01 2.73 0.79 2.41 2.48 4.06 4.94 26.80 13.48 15.29 1.71 1.61 6.22 11.04 2.13 30.34 15.95 18.26 8.53 28.21 15.04 16.59 31.78 17.50 19.70 4.39 4.68 4.97 6.51 3.01 5.57 5.90 Physician Work RVUs 3 NA 3.86 NA NA NA NA NA NA NA NA NA NA 1.98 0.93 2.19 NA NA NA NA NA NA NA NA 4.22 7.77 1.08 NA NA NA NA NA NA NA NA NA NA 3.08 4.04 3.80 NA 2.01 3.15 NA Fully Implemented NonFacility PE RVUs NA 4.39 NA NA NA NA NA NA NA NA NA NA 2.96 1.13 2.18 NA NA NA NA NA NA NA NA 4.21 7.60 1.19 NA NA NA NA NA NA NA NA NA NA 2.68 4.33 4.15 NA 2.09 3.41 NA Year 2007 Transitional Non-Facility PE RVUs 2.86 1.70 2.40 5.81 5.42 5.37 6.05 5.07 5.72 2.88 5.21 4.89 1.18 0.22 1.03 1.00 1.23 1.40 14.26 3.75 4.95 0.64 0.44 1.70 3.02 0.71 15.91 4.49 6.21 2.39 14.51 4.26 5.15 16.28 4.80 6.66 2.35 3.45 3.15 3.44 1.79 2.59 2.63 Fully Implemented Facility PE RVUs 3.06 2.16 2.94 6.29 6.04 6.08 5.11 6.68 6.38 2.38 5.80 5.76 1.89 0.28 0.98 1.18 1.73 1.75 15.06 4.91 5.96 0.77 0.59 1.81 3.17 0.88 16.92 5.78 7.43 3.07 15.52 5.60 6.49 17.74 6.27 8.14 2.49 3.53 3.34 3.85 2.04 2.88 3.10 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 59072 59074 59076 59100 59120 59121 59130 59135 59136 59140 59150 59151 59160 59200 59300 59320 59325 59350 59400 59409 59410 59412 59414 59425 59426 59430 59510 59514 59515 59525 59610 59612 59614 59618 59620 59622 59812 59820 59821 59830 59840 59841 59850 HCPCS 2 CPT 1/ 0.16 0.28 0.16 2.95 2.73 2.79 3.39 3.31 3.14 1.29 2.79 2.74 0.64 0.19 0.57 0.59 0.88 1.17 5.50 3.22 3.52 0.40 0.38 1.14 1.98 0.50 6.25 3.80 4.13 1.95 5.87 3.59 3.89 6.61 4.17 4.50 0.95 0.95 1.06 1.44 0.71 1.24 1.28 Mal-Practice RVUs NA 9.38 NA NA NA NA NA NA NA NA NA NA 5.35 1.91 5.17 NA NA NA NA NA NA NA NA 11.58 20.79 3.71 NA NA NA NA NA NA NA NA NA NA 8.42 9.67 9.83 NA 5.73 9.96 NA Fully Implemented NonFacility Total NA 9.91 NA NA NA NA NA NA NA NA NA NA 6.33 2.11 5.16 NA NA NA NA NA NA NA NA 11.57 20.62 3.82 NA NA NA NA NA NA NA NA NA NA 8.02 9.96 10.18 NA 5.81 10.22 NA Year 2007 Transitional Non-Facility Total 12.01 7.22 11.55 22.02 20.71 20.80 24.42 23.20 23.01 10.03 20.19 19.64 4.55 1.20 4.01 4.07 6.17 7.51 46.56 20.45 23.76 2.75 2.43 9.06 16.04 3.34 52.50 24.24 28.60 12.87 48.59 22.89 25.63 54.67 26.47 30.86 7.69 9.08 9.18 11.39 5.51 9.40 9.81 Fully Implemented Facility Total 12.21 7.68 12.09 22.50 21.33 21.51 23.48 24.81 23.67 9.53 20.78 20.51 5.26 1.26 3.96 4.25 6.67 7.86 47.36 21.61 24.77 2.88 2.58 9.17 16.19 3.51 53.51 25.53 29.82 13.55 49.60 24.23 26.97 56.13 27.94 32.34 7.83 9.16 9.37 11.80 5.76 9.69 10.28 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 000 000 000 090 090 090 090 090 090 090 090 090 010 000 000 000 000 000 MMM MMM MMM MMM MMM MMM MMM MMM MMM MMM MMM ZZZ MMM MMM MMM MMM MMM MMM 090 090 090 090 010 010 090 Global 69898 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00277 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod R R R R R R A A C C C A A A A A A A A A A A A A A A A A A A A A A A A A A A A C C A A Status Abortion ................................................................ Abortion ................................................................ Abortion ................................................................ Abortion ................................................................ Abortion ................................................................ Abortion (mpr) ...................................................... Evacuate mole of uterus ...................................... Remove cerclage suture ...................................... Fetal invas px w/us .............................................. Laparo proc, ob care/deliver ................................ Maternity care procedure ..................................... Drain thyroid/tongue cyst ..................................... Aspirate/inject thyriod cyst ................................... Biopsy of thyroid .................................................. Remove thyroid lesion ......................................... Partial thyroid excision ......................................... Partial thyroid excision ......................................... Partial removal of thyroid ..................................... Partial removal of thyroid ..................................... Removal of thyroid ............................................... Removal of thyroid ............................................... Extensive thyroid surgery ..................................... Repeat thyroid surgery ......................................... Removal of thyroid ............................................... Removal of thyroid ............................................... Remove thyroid duct lesion ................................. Remove thyroid duct lesion ................................. Explore parathyroid glands .................................. Re-explore parathyroids ....................................... Explore parathyroid glands .................................. Autotransplant parathyroid ................................... Removal of thymus gland .................................... Removal of thymus gland .................................... Removal of thymus gland .................................... Explore adrenal gland .......................................... Explore adrenal gland .......................................... Remove carotid body lesion ................................ Remove carotid body lesion ................................ Laparoscopy adrenalectomy ................................ Laparo proc, endocrine ........................................ Endocrine surgery procedure ............................... Remove cranial cavity fluid .................................. Remove cranial cavity fluid .................................. Description 5.92 8.23 6.38 7.74 9.30 3.99 6.40 2.13 0.00 0.00 0.00 1.78 0.97 1.56 9.91 11.15 16.32 12.29 14.67 16.18 21.88 28.29 18.18 23.07 17.54 6.05 8.71 16.69 21.01 22.91 4.44 17.07 19.11 23.37 17.91 20.82 24.99 31.86 20.63 0.00 0.00 1.58 1.49 Physician Work RVUs 3 NA NA NA NA NA NA NA NA 0.00 0.00 0.00 2.03 1.86 1.20 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 0.00 NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA 0.00 0.00 0.00 1.95 1.52 1.35 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 0.00 NA NA Year 2007 Transitional Non-Facility PE RVUs 3.28 3.79 2.98 3.85 3.13 1.24 4.28 0.93 0.00 0.00 0.00 1.65 0.27 0.43 5.25 5.05 6.80 5.40 6.69 6.16 8.43 10.44 7.02 8.96 6.83 4.12 4.67 6.73 8.46 9.24 1.19 6.93 8.27 9.76 8.12 8.89 8.77 12.23 8.20 0.00 0.00 1.23 1.21 Fully Implemented Facility PE RVUs 3.63 4.73 3.40 4.01 4.32 1.73 4.43 1.08 0.00 0.00 0.00 1.70 0.32 0.51 5.80 5.49 7.45 5.96 7.22 7.23 9.68 13.22 8.24 10.08 8.14 4.53 5.54 7.23 9.13 10.50 1.51 7.95 9.22 10.89 7.72 8.62 10.41 12.25 8.04 0.00 0.00 1.02 1.10 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 59851 59852 59855 59856 59857 59866 59870 59871 59897 59898 59899 60000 60001 60100 60200 60210 60212 60220 60225 60240 60252 60254 60260 60270 60271 60280 60281 60500 60502 60505 60512 60520 60521 60522 60540 60545 60600 60605 60650 60659 60699 61000 61001 HCPCS 2 CPT 1/ 1.28 1.81 1.45 1.79 2.02 0.87 1.42 0.50 0.00 0.00 0.00 0.15 0.07 0.10 1.01 1.23 1.95 1.32 1.64 1.86 2.30 2.61 1.94 2.33 1.75 0.54 0.73 2.01 2.54 2.65 0.53 2.20 2.82 3.27 1.75 2.08 2.20 2.50 2.29 0.00 0.00 0.13 0.16 Mal-Practice RVUs NA NA NA NA NA NA NA NA 0.00 0.00 0.00 3.96 2.90 2.86 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 0.00 NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA 0.00 0.00 0.00 3.88 2.56 3.01 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 0.00 NA NA Year 2007 Transitional Non-Facility Total 10.48 13.83 10.81 13.38 14.45 6.10 12.10 3.56 0.00 0.00 0.00 3.58 1.31 2.09 16.17 17.43 25.07 19.01 23.00 24.20 32.61 41.34 27.14 34.36 26.12 10.71 14.11 25.43 32.01 34.80 6.16 26.20 30.20 36.40 27.78 31.79 35.96 46.59 31.12 0.00 0.00 2.94 2.86 Fully Implemented Facility Total 10.83 14.77 11.23 13.54 15.64 6.59 12.25 3.71 0.00 0.00 0.00 3.63 1.36 2.17 16.72 17.87 25.72 19.57 23.53 25.27 33.86 44.12 28.36 35.48 27.43 11.12 14.98 25.93 32.68 36.06 6.48 27.22 31.15 37.53 27.38 31.52 37.60 46.61 30.96 0.00 0.00 2.73 2.75 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 000 090 000 YYY YYY YYY 010 000 000 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 ZZZ 090 090 090 090 090 090 090 090 YYY YYY 000 000 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69899 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00278 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Remove brain cavity fluid ..................................... Injection into brain canal ...................................... Remove brain canal fluid ..................................... Injection into brain canal ...................................... Brain canal shunt procedure ................................ Twist drill hole ...................................................... Drill skull for implantation ..................................... Drill skull for drainage .......................................... Burr hole for puncture .......................................... Pierce skull for biopsy .......................................... Pierce skull for drainage ...................................... Pierce skull for drainage ...................................... Pierce skull & remove clot ................................... Pierce skull for drainage ...................................... Pierce skull, implant device ................................. Insert brain-fluid device ........................................ Pierce skull & explore .......................................... Pierce skull & explore .......................................... Open skull for exploration .................................... Open skull for exploration .................................... Open skull for drainage ........................................ Open skull for drainage ........................................ Open skull for drainage ........................................ Open skull for drainage ........................................ Implt cran bone flap to abdo ................................ Open skull for drainage ........................................ Open skull for drainage ........................................ Decompressive craniotomy .................................. Decompressive lobectomy ................................... Decompress eye socket ....................................... Explore/biopsy eye socket ................................... Explore orbit/remove lesion ................................. Explore orbit/remove object ................................. Subtemporal decompression ............................... Incise skull (press relief) ...................................... Relieve cranial pressure ...................................... Incise skull for surgery ......................................... Incise skull for surgery ......................................... Incise skull for brain wound ................................. Incise skull for surgery ......................................... Incise skull for surgery ......................................... Incise skull for surgery ......................................... Incise skull for surgery ......................................... Description 1.51 1.69 1.51 2.10 0.89 5.40 4.99 11.51 9.52 17.10 18.80 13.41 16.92 17.37 5.83 5.77 11.41 13.41 23.31 28.51 30.07 27.94 25.77 29.52 1.39 27.32 30.40 34.08 34.93 25.17 28.50 29.17 19.50 20.01 31.73 29.10 28.53 27.59 28.71 30.11 27.52 27.95 27.12 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 1.59 1.49 1.09 1.21 1.15 4.93 1.89 8.52 6.75 10.52 10.88 8.59 10.89 10.01 2.23 5.48 7.64 7.87 12.79 15.30 15.57 15.70 14.43 15.80 0.53 14.49 14.51 18.05 17.28 12.08 13.68 13.56 9.25 11.55 16.38 15.47 14.27 12.89 15.23 15.37 13.31 8.15 14.55 Fully Implemented Facility PE RVUs 1.40 1.42 1.23 1.37 1.05 4.18 2.37 7.49 6.18 10.04 10.50 8.01 9.83 9.88 2.74 4.37 7.05 7.76 12.82 15.31 15.17 15.03 13.38 15.96 0.58 14.69 15.72 16.26 16.38 13.31 15.11 15.07 10.29 11.23 16.70 15.41 14.22 13.93 15.44 16.15 13.72 13.49 14.38 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 61020 61026 61050 61055 61070 61105 61107 61108 61120 61140 61150 61151 61154 61156 61210 61215 61250 61253 61304 61305 61312 61313 61314 61315 61316 61320 61321 61322 61323 61330 61332 61333 61334 61340 61343 61345 61440 61450 61458 61460 61470 61480 61490 HCPCS 2 CPT 1/ 0.34 0.33 0.11 0.17 0.17 1.32 1.29 2.64 2.10 4.12 4.32 3.01 4.21 4.23 1.50 1.26 2.77 2.62 5.63 6.09 6.36 6.45 6.28 7.16 0.35 6.62 7.14 7.63 8.03 2.32 4.83 3.92 1.75 4.84 7.64 7.04 6.90 5.79 7.03 6.04 5.90 6.73 6.92 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 3.44 3.51 2.71 3.48 2.21 11.65 8.17 22.67 18.37 31.74 34.00 25.01 32.02 31.61 9.56 12.51 21.82 23.90 41.73 49.90 52.00 50.09 46.48 52.48 2.27 48.43 52.05 59.76 60.24 39.57 47.01 46.65 30.50 36.40 55.75 51.61 49.70 46.27 50.97 51.52 46.73 42.83 48.59 Fully Implemented Facility Total 3.25 3.44 2.85 3.64 2.11 10.90 8.65 21.64 17.80 31.26 33.62 24.43 30.96 31.48 10.07 11.40 21.23 23.79 41.76 49.91 51.60 49.42 45.43 52.64 2.32 48.63 53.26 57.97 59.34 40.80 48.44 48.16 31.54 36.08 56.07 51.55 49.65 47.31 51.18 52.30 47.14 48.17 48.42 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 000 000 000 000 000 090 000 090 090 090 090 090 090 090 000 090 090 090 090 090 090 090 090 090 ZZZ 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 Global 69900 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00279 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Removal of skull lesion ........................................ Remove infected skull bone ................................. Removal of brain lesion ....................................... Remove brain lining lesion ................................... Removal of brain abscess ................................... Removal of brain lesion ....................................... Implt brain chemotx add-on ................................. Removal of brain lesion ....................................... Remove brain lining lesion ................................... Removal of brain lesion ....................................... Removal of brain lesion ....................................... Removal of brain abscess ................................... Removal of brain lesion ....................................... Removal of brain lesion ....................................... Removal of brain lesion ....................................... Implant brain electrodes ....................................... Implant brain electrodes ....................................... Removal of brain lesion ....................................... Remove brain electrodes ..................................... Removal of brain lesion ....................................... Removal of brain tissue ....................................... Removal of brain tissue ....................................... Removal of brain tissue ....................................... Removal of brain tissue ....................................... Incision of brain tissue ......................................... Removal of brain tissue ....................................... Removal of brain tissue ....................................... Remove & treat brain lesion ................................ Excision of brain tumor ........................................ Removal of pituitary gland ................................... Removal of pituitary gland ................................... Release of skull seams ........................................ Release of skull seams ........................................ Incise skull/sutures ............................................... Incise skull/sutures ............................................... Excision of skull/sutures ....................................... Excision of skull/sutures ....................................... Excision of skull tumor ......................................... Excision of skull tumor ......................................... Removal of brain tissue ....................................... Incision of brain tissue ......................................... Remove foreign body, brain ................................. Incise skull for brain wound ................................. Description 19.05 16.22 30.63 36.99 27.10 26.45 1.38 39.69 43.28 56.89 46.84 31.41 29.76 53.90 45.43 16.28 21.36 22.88 13.05 37.59 36.35 39.35 34.15 31.30 30.81 33.03 31.18 27.26 46.23 33.31 23.27 15.44 20.27 24.00 23.16 26.35 33.82 28.35 34.59 32.32 36.84 26.38 28.29 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 10.77 9.66 17.32 18.85 14.74 14.50 0.52 20.75 21.16 26.11 22.54 15.77 16.01 22.15 18.59 10.39 11.94 13.39 9.03 18.76 17.80 19.10 15.75 16.15 16.34 16.46 16.59 14.60 22.72 16.89 11.56 5.64 6.64 12.94 13.91 8.16 19.40 14.57 16.53 16.91 17.10 14.37 15.43 Fully Implemented Facility PE RVUs 10.79 9.32 16.85 19.47 14.51 14.32 0.61 21.01 22.27 29.27 23.79 16.25 15.75 27.65 23.44 9.44 11.63 12.41 7.82 19.53 15.51 16.26 17.26 16.97 16.24 17.48 16.43 14.02 23.84 17.34 12.48 6.61 8.49 11.76 13.69 12.68 19.33 15.07 17.84 17.56 19.78 14.03 15.21 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 61500 61501 61510 61512 61514 61516 61517 61518 61519 61520 61521 61522 61524 61526 61530 61531 61533 61534 61535 61536 61537 61538 61539 61540 61541 61542 61543 61544 61545 61546 61548 61550 61552 61556 61557 61558 61559 61563 61564 61566 61567 61570 61571 HCPCS 2 CPT 1/ 4.11 3.22 7.35 9.08 6.54 6.35 0.35 9.65 10.63 11.21 11.39 7.62 7.16 7.07 6.15 3.79 5.12 5.44 3.02 9.21 6.94 6.94 8.32 8.32 6.60 8.03 7.56 5.97 10.63 7.67 3.43 0.98 1.06 4.65 5.80 1.36 8.51 5.17 8.78 6.94 6.54 5.88 6.79 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 33.93 29.10 55.30 64.92 48.38 47.30 2.25 70.09 75.07 94.21 80.77 54.80 52.93 83.12 70.17 30.46 38.42 41.71 25.10 65.56 61.09 65.39 58.22 55.77 53.75 57.52 55.33 47.83 79.58 57.87 38.26 22.06 27.97 41.59 42.87 35.87 61.73 48.09 59.90 56.17 60.48 46.63 50.51 Fully Implemented Facility Total 33.95 28.76 54.83 65.54 48.15 47.12 2.34 70.35 76.18 97.37 82.02 55.28 52.67 88.62 75.02 29.51 38.11 40.73 23.89 66.33 58.80 62.55 59.73 56.59 53.65 58.54 55.17 47.25 80.70 58.32 39.18 23.03 29.82 40.41 42.65 40.39 61.66 48.59 61.21 56.82 63.16 46.29 50.29 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 ZZZ 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69901 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00280 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A N N N N N A A A A Status Skull base/brainstem surgery ............................... Skull base/brainstem surgery ............................... Craniofacial approach, skull ................................. Craniofacial approach, skull ................................. Craniofacial approach, skull ................................. Craniofacial approach, skull ................................. Orbitocranial approach/skull ................................. Orbitocranial approach/skull ................................. Resect nasopharynx, skull ................................... Infratemporal approach/skull ................................ Infratemporal approach/skull ................................ Orbitocranial approach/skull ................................. Transtemporal approach/skull .............................. Transcochlear approach/skull .............................. Transcondylar approach/skull .............................. Transpetrosal approach/skull ............................... Resect/excise cranial lesion ................................. Resect/excise cranial lesion ................................. Resect/excise cranial lesion ................................. Resect/excise cranial lesion ................................. Resect/excise cranial lesion ................................. Resect/excise cranial lesion ................................. Transect artery, sinus .......................................... Transect artery, sinus .......................................... Transect artery, sinus .......................................... Transect artery, sinus .......................................... Remove aneurysm, sinus .................................... Resect/excise lesion, skull ................................... Resect/excise lesion, skull ................................... Repair dura .......................................................... Repair dura .......................................................... Endovasc tempory vessel occl ............................ Transcath occlusion, cns ..................................... Transcath occlusion, non-cns .............................. Intracranial angioplasty ........................................ Intracran angioplsty w/stent ................................. Dilate ic vasospasm, init ...................................... Dilate ic vasospasm add-on ................................. Dilate ic vasospasm add-on ................................. Intracranial vessel surgery ................................... Intracranial vessel surgery ................................... Intracranial vessel surgery ................................... Intracranial vessel surgery ................................... Description 36.43 55.11 34.34 38.88 34.93 38.41 37.61 42.46 27.28 46.87 46.87 42.98 33.57 39.31 40.73 36.41 29.84 31.04 32.40 41.94 40.82 45.45 9.88 29.63 7.41 27.84 44.94 35.63 46.60 18.58 22.01 9.95 20.12 16.60 22.07 24.28 12.32 4.33 8.66 32.40 63.31 41.49 67.32 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 15.92 26.26 21.02 25.23 30.66 26.09 25.81 25.16 24.16 23.59 24.23 27.88 19.59 18.79 23.14 21.31 18.60 22.56 17.90 24.64 20.93 26.88 3.81 11.43 2.86 8.34 27.87 19.60 26.91 10.25 11.17 3.16 6.30 4.91 6.44 6.95 2.85 1.00 2.00 17.11 27.79 20.79 30.80 Fully Implemented Facility PE RVUs 18.70 32.61 24.44 23.89 28.14 25.36 24.84 26.16 22.98 27.36 28.20 26.85 21.66 23.03 23.03 22.75 19.48 21.01 20.95 25.02 23.07 26.66 4.59 12.71 3.58 12.07 26.66 21.94 28.22 10.39 11.97 3.85 6.74 5.36 10.98 11.89 2.85 1.00 2.00 17.35 31.11 21.70 33.74 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 61575 61576 61580 61581 61582 61583 61584 61585 61586 61590 61591 61592 61595 61596 61597 61598 61600 61601 61605 61606 61607 61608 61609 61610 61611 61612 61613 61615 61616 61618 61619 61623 61624 61626 61630 61635 61640 61641 61642 61680 61682 61684 61686 HCPCS 2 CPT 1/ 5.34 5.58 3.37 3.92 7.21 9.21 8.18 7.03 4.37 5.31 5.66 10.07 3.98 3.40 8.84 5.70 3.79 6.63 2.86 8.97 6.90 10.75 2.56 7.68 1.89 4.31 8.45 4.73 8.26 3.72 3.95 1.05 1.96 1.24 2.02 2.21 0.71 0.25 0.50 7.95 15.90 10.31 16.71 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 57.69 86.95 58.73 68.03 72.80 73.71 71.60 74.65 55.81 75.77 76.76 80.93 57.14 61.50 72.71 63.42 52.23 60.23 53.16 75.55 68.65 83.08 16.25 48.74 12.16 40.49 81.26 59.96 81.77 32.55 37.13 14.16 28.38 22.75 30.53 33.44 15.88 5.58 11.16 57.46 107.00 72.59 114.83 Fully Implemented Facility Total 60.47 93.30 62.15 66.69 70.28 72.98 70.63 75.65 54.63 79.54 80.73 79.90 59.21 65.74 72.60 64.86 53.11 58.68 56.21 75.93 70.79 82.86 17.03 50.02 12.88 44.22 80.05 62.30 83.08 32.69 37.93 14.85 28.82 23.20 35.07 38.38 15.88 5.58 11.16 57.70 110.32 73.50 117.77 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 ZZZ ZZZ ZZZ ZZZ 090 090 090 090 090 000 000 000 090 090 000 ZZZ ZZZ 090 090 090 090 Global 69902 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00281 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Intracranial vessel surgery ................................... Intracranial vessel surgery ................................... Brain aneurysm repr, complx ............................... Brain aneurysm repr, complx ............................... Brain aneurysm repr, simple ................................ Inner skull vessel surgery .................................... Clamp neck artery ................................................ Revise circulation to head .................................... Revise circulation to head .................................... Revise circulation to head .................................... Fusion of skull arteries ......................................... Incise skull/brain surgery ..................................... Incise skull/brain surgery ..................................... Incise skull/brain biopsy ....................................... Brain biopsy w/ct/mr guide ................................... Implant brain electrodes ....................................... Incise skull for treatment ...................................... Treat trigeminal nerve .......................................... Treat trigeminal tract ............................................ Focus radiation beam .......................................... Brain surgery using computer .............................. Implant neuroelectrodes ....................................... Implant neuroelectrodes ....................................... Implant neuroelectrode ........................................ Implant neuroelectrde, addl ................................. Implant neuroelectrode ........................................ Implant neuroelectrde, add"l .............................. Implant neuroelectrodes ....................................... Implant neuroelectrodes ....................................... Revise/remove neuroelectrode ............................ Insrt/redo neurostim 1 array ................................. Implant neurostim arrays ..................................... Revise/remove neuroreceiver .............................. Treat skull fracture ............................................... Treat skull fracture ............................................... Treatment of head injury ...................................... Repair brain fluid leakage .................................... Reduction of skull defect ...................................... Reduction of skull defect ...................................... Reduction of skull defect ...................................... Repair skull cavity lesion ..................................... Incise skull repair ................................................. Repair of skull defect ........................................... Description 31.18 54.43 63.22 69.45 50.44 59.86 18.70 37.97 37.07 31.19 38.10 17.52 22.22 19.73 18.64 22.24 23.09 11.50 15.31 17.75 4.03 13.26 22.16 20.56 4.49 32.88 7.91 16.24 16.36 6.87 7.37 9.73 5.20 13.83 17.53 21.30 23.40 22.71 24.90 28.26 24.39 22.93 14.45 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 16.13 25.06 29.29 31.45 24.39 28.41 10.98 17.87 12.85 12.75 18.86 8.24 11.48 11.13 11.57 12.10 10.06 7.87 7.70 9.94 1.40 5.63 11.36 12.64 1.73 16.95 3.02 8.78 5.33 5.53 7.48 8.82 3.63 7.28 9.61 12.08 12.05 14.15 13.44 14.92 15.93 14.22 8.71 Fully Implemented Facility PE RVUs 16.57 26.87 28.33 27.88 26.95 26.63 10.59 18.91 14.58 13.42 19.57 9.54 11.99 10.74 11.01 9.56 11.70 6.40 8.61 10.08 1.87 7.16 11.89 11.99 2.14 17.75 3.76 9.47 7.76 4.81 5.85 6.97 3.66 5.95 9.00 11.80 12.60 12.27 13.38 15.26 17.84 15.14 8.42 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 61690 61692 61697 61698 61700 61702 61703 61705 61708 61710 61711 61720 61735 61750 61751 61760 61770 61790 61791 61793 61795 61850 61860 61863 61864 61867 61868 61870 61875 61880 61885 61886 61888 62000 62005 62010 62100 62115 62116 62117 62120 62121 62140 HCPCS 2 CPT 1/ 6.94 13.43 12.85 12.54 13.02 10.79 4.06 8.87 2.51 4.52 9.42 2.79 2.73 4.72 4.56 5.42 3.55 2.82 3.40 4.46 0.79 3.22 4.95 5.43 5.43 5.43 5.43 3.87 2.95 1.66 1.59 1.97 1.33 1.06 3.87 5.14 4.84 5.51 6.11 4.53 3.00 4.17 3.47 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 54.25 92.92 105.36 113.44 87.85 99.06 33.74 64.71 52.43 48.46 66.38 28.55 36.43 35.58 34.77 39.76 36.70 22.19 26.41 32.15 6.22 22.11 38.47 38.63 11.65 55.26 16.36 28.89 24.64 14.06 16.44 20.52 10.16 22.17 31.01 38.52 40.29 42.37 44.45 47.71 43.32 41.32 26.63 Fully Implemented Facility Total 54.69 94.73 104.40 109.87 90.41 97.28 33.35 65.75 54.16 49.13 67.09 29.85 36.94 35.19 34.21 37.22 38.34 20.72 27.32 32.29 6.69 23.64 39.00 37.98 12.06 56.06 17.10 29.58 27.07 13.34 14.81 18.67 10.19 20.84 30.40 38.24 40.84 40.49 44.39 48.05 45.23 42.24 26.34 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 ZZZ 090 090 090 ZZZ 090 ZZZ 090 090 090 090 090 010 090 090 090 090 090 090 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69903 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00282 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... TC .... 26 ..... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Repair of skull defect ........................................... Remove skull plate/flap ........................................ Replace skull plate/flap ........................................ Repair of skull & brain ......................................... Repair of skull with graft ...................................... Repair of skull with graft ...................................... Retr bone flap to fix skull ..................................... Neuroendoscopy add-on ...................................... Dissect brain w/scope .......................................... Remove colloid cyst w/scope ............................... Neuroendoscopy w/fb removal ............................ Remove brain tumor w/scope .............................. Remove pituit tumor w/scope .............................. Establish brain cavity shunt ................................. Establish brain cavity shunt ................................. Establish brain cavity shunt ................................. Replace/irrigate catheter ...................................... Establish brain cavity shunt ................................. Brain cavity shunt w/scope .................................. Establish brain cavity shunt ................................. Establish brain cavity shunt ................................. Replace/irrigate catheter ...................................... Replace/revise brain shunt .................................. Csf shunt reprogram ............................................ Csf shunt reprogram ............................................ Csf shunt reprogram ............................................ Remove brain cavity shunt .................................. Replace brain cavity shunt ................................... Epidural lysis mult sessions ................................. Epidural lysis on single day ................................. Drain spinal cord cyst .......................................... Needle biopsy, spinal cord ................................... Spinal fluid tap, diagnostic ................................... Drain cerebro spinal fluid ..................................... Inject epidural patch ............................................. Treat spinal cord lesion ........................................ Treat spinal cord lesion ........................................ Treat spinal canal lesion ...................................... Injection for myelogram ........................................ Percutaneous diskectomy .................................... Inject for spine disk x-ray ..................................... Inject for spine disk x-ray ..................................... Injection into disk lesion ....................................... Description 15.97 11.73 14.05 19.99 17.18 20.57 2.00 3.00 21.10 26.67 16.40 29.27 23.10 22.45 12.07 13.25 5.68 19.19 15.89 14.00 13.90 6.11 11.35 0.74 0.00 0.74 7.30 15.54 6.41 4.42 4.73 5.01 1.37 1.35 2.15 2.63 2.66 2.33 1.54 8.88 3.00 2.91 9.14 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 1.78 1.50 0.28 NA NA 9.04 5.62 6.44 6.62 2.30 3.06 1.66 4.21 3.69 3.90 3.58 NA 4.31 4.09 NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 1.55 1.20 0.35 NA NA 11.78 7.20 10.26 12.67 2.82 3.47 2.45 6.25 5.16 7.25 4.62 NA 6.43 5.47 NA Year 2007 Transitional Non-Facility PE RVUs 9.43 7.81 8.89 10.35 9.21 10.75 0.78 1.15 12.29 14.05 10.66 15.15 11.67 12.17 7.76 8.49 3.75 10.84 10.64 8.49 9.52 5.54 7.36 NA NA 0.28 5.94 9.37 2.86 1.27 1.63 1.61 0.53 0.60 0.57 1.06 0.89 1.06 0.62 4.08 1.09 1.02 3.19 Fully Implemented Facility PE RVUs 9.14 7.20 8.25 10.76 9.53 11.16 0.84 1.44 12.14 14.65 10.11 15.00 12.95 12.25 7.25 7.84 2.76 10.84 9.74 8.11 8.56 4.45 6.70 NA NA 0.35 5.00 8.88 3.11 1.38 2.01 1.88 0.55 0.68 0.68 1.02 0.89 0.96 0.67 5.18 1.31 1.18 4.15 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 62141 62142 62143 62145 62146 62147 62148 62160 62161 62162 62163 62164 62165 62180 62190 62192 62194 62200 62201 62220 62223 62225 62230 62252 62252 62252 62256 62258 62263 62264 62268 62269 62270 62272 62273 62280 62281 62282 62284 62287 62290 62291 62292 HCPCS 2 CPT 1/ 3.76 2.73 3.37 4.50 3.62 4.32 0.48 0.77 5.19 5.91 4.01 5.38 3.01 4.98 2.80 3.02 0.92 4.65 3.68 3.35 3.14 1.39 2.71 0.21 0.02 0.19 1.72 3.74 0.41 0.27 0.43 0.37 0.08 0.18 0.13 0.30 0.19 0.17 0.13 0.58 0.23 0.26 0.82 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 2.73 1.52 1.21 NA NA 15.86 10.31 11.60 12.00 3.75 4.59 3.94 7.14 6.54 6.40 5.25 NA 7.54 7.26 NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 2.50 1.22 1.28 NA NA 18.60 11.89 15.42 18.05 4.27 5.00 4.73 9.18 8.01 9.75 6.29 NA 9.66 8.64 NA Year 2007 Transitional Non-Facility Total 29.16 22.27 26.31 34.84 30.01 35.64 3.26 4.92 38.58 46.63 31.07 49.80 37.78 39.60 22.63 24.76 10.35 34.68 30.21 25.84 26.56 13.04 21.42 NA NA 1.21 14.96 28.65 9.68 5.96 6.79 6.99 1.98 2.13 2.85 3.99 3.74 3.56 2.29 13.54 4.32 4.19 13.15 Fully Implemented Facility Total 28.87 21.66 25.67 35.25 30.33 36.05 3.32 5.21 38.43 47.23 30.52 49.65 39.06 39.68 22.12 24.11 9.36 34.68 29.31 25.46 25.60 11.95 20.76 NA NA 1.28 14.02 28.16 9.93 6.07 7.17 7.26 2.00 2.21 2.96 3.95 3.74 3.46 2.34 14.64 4.54 4.35 14.11 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 ZZZ ZZZ 090 090 090 090 090 090 090 090 010 090 090 090 090 090 090 XXX XXX XXX 090 090 010 010 000 000 000 000 000 010 010 010 000 090 000 000 090 Global 69904 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00283 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A C C A A A A A A A A A A A A A A Status Injection into spinal artery .................................... Inject spine c/t ...................................................... Inject spine l/s (cd) ............................................... Inject spine w/cath, c/t ......................................... Inject spine w/cath l/s (cd) ................................... Implant spinal canal cath ..................................... Implant spinal canal cath ..................................... Remove spinal canal catheter ............................. Insert spine infusion device ................................. Implant spine infusion pump ................................ Implant spine infusion pump ................................ Remove spine infusion device ............................. Analyze spine infusion pump ............................... Analyze spine infusion pump ............................... Removal of spinal lamina ..................................... Removal of spinal lamina ..................................... Removal of spinal lamina ..................................... Removal of spinal lamina ..................................... Removal of spinal lamina ..................................... Removal of spinal lamina ..................................... Removal of spinal lamina ..................................... Removal of spinal lamina ..................................... Neck spine disk surgery ....................................... Low back disk surgery ......................................... Spinal disk surgery add-on .................................. Laminotomy, single cervical ................................. Laminotomy, single lumbar .................................. Laminotomy, add"l cervical ................................ Laminotomy, add"l lumbar ................................. Removal of spinal lamina ..................................... Removal of spinal lamina ..................................... Removal of spinal lamina ..................................... Remove spinal lamina add-on ............................. Cervical laminoplasty ........................................... C-laminoplasty w/graft/plate ................................. Decompress spinal cord ...................................... Decompress spinal cord ...................................... Decompress spine cord add-on ........................... Decompress spinal cord ...................................... Decompress spine cord add-on ........................... Neck spine disk surgery ....................................... Neck spine disk surgery ....................................... Spine disk surgery, thorax ................................... Description 12.77 1.91 1.54 2.04 1.87 8.04 11.54 6.60 3.68 6.59 8.58 6.57 0.48 0.75 17.51 17.64 16.28 15.78 16.72 20.70 21.90 17.18 16.05 13.03 3.15 20.18 18.61 0.00 0.00 17.82 17.12 15.22 3.47 21.88 25.38 23.42 21.73 5.25 26.09 3.26 19.47 4.04 22.75 Physician Work RVUs 3 NA 2.98 2.65 3.19 2.85 NA NA NA NA NA NA NA 0.41 0.59 NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA 4.35 4.35 5.09 4.45 NA NA NA NA NA NA NA 0.56 0.67 NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 5.56 0.57 0.53 0.48 0.47 4.16 7.79 3.61 3.45 4.00 4.77 3.85 0.11 0.18 10.01 9.91 9.86 9.30 9.94 12.16 12.09 10.54 10.09 8.74 1.22 11.20 10.78 0.00 0.00 10.53 9.98 9.49 1.35 8.91 11.79 12.55 11.54 2.00 13.58 1.26 11.24 1.56 11.28 Fully Implemented Facility PE RVUs 5.58 0.63 0.58 0.61 0.58 4.00 7.29 3.27 2.87 3.94 4.46 3.65 0.10 0.17 9.64 9.87 9.94 8.53 10.08 11.94 11.86 10.43 9.78 8.50 1.50 11.43 11.20 0.00 0.00 10.40 10.13 9.79 1.58 11.11 13.05 12.99 12.31 2.47 14.21 1.56 11.87 1.93 12.41 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 62294 62310 62311 62318 62319 62350 62351 62355 62360 62361 62362 62365 62367 62368 63001 63003 63005 63011 63012 63015 63016 63017 63020 63030 63035 63040 63042 63043 63044 63045 63046 63047 63048 63050 63051 63055 63056 63057 63064 63066 63075 63076 63077 HCPCS 2 CPT 1/ 1.24 0.12 0.09 0.12 0.11 1.02 2.25 0.71 0.34 0.80 1.18 0.86 0.03 0.06 3.77 3.73 3.35 3.38 3.49 4.76 4.59 3.64 3.72 3.01 0.79 4.68 4.26 0.00 0.00 3.99 3.56 3.24 0.72 4.67 4.67 5.29 4.76 1.22 5.71 0.69 4.63 0.96 3.99 Mal-Practice RVUs NA 5.01 4.28 5.35 4.83 NA NA NA NA NA NA NA 0.92 1.40 NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA 6.38 5.98 7.25 6.43 NA NA NA NA NA NA NA 1.07 1.48 NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 19.57 2.60 2.16 2.64 2.45 13.22 21.58 10.92 7.47 11.39 14.53 11.28 0.62 0.99 31.29 31.28 29.49 28.46 30.15 37.62 38.58 31.36 29.86 24.78 5.16 36.06 33.65 0.00 0.00 32.34 30.66 27.95 5.54 35.46 41.84 41.26 38.03 8.47 45.38 5.21 35.34 6.56 38.02 Fully Implemented Facility Total 19.59 2.66 2.21 2.77 2.56 13.06 21.08 10.58 6.89 11.33 14.22 11.08 0.61 0.98 30.92 31.24 29.57 27.69 30.29 37.40 38.35 31.25 29.55 24.54 5.44 36.29 34.07 0.00 0.00 32.21 30.81 28.25 5.77 37.66 43.10 41.70 38.80 8.94 46.01 5.51 35.97 6.93 39.15 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 000 000 000 000 090 090 090 090 090 090 090 XXX XXX 090 090 090 090 090 090 090 090 090 090 ZZZ 090 090 ZZZ ZZZ 090 090 090 ZZZ 090 090 090 090 ZZZ 090 ZZZ 090 ZZZ 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69905 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00284 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Spine disk surgery, thorax ................................... Removal of vertebral body ................................... Remove vertebral body add-on ........................... Removal of vertebral body ................................... Remove vertebral body add-on ........................... Removal of vertebral body ................................... Remove vertebral body add-on ........................... Removal of vertebral body ................................... Remove vertebral body add-on ........................... Removal of vertebral body ................................... Removal of vertebral body ................................... Remove vertebral body add-on ........................... Incise spinal cord tract(s) ..................................... Drainage of spinal cyst ........................................ Drainage of spinal cyst ........................................ Revise spinal cord ligaments ............................... Revise spinal cord ligaments ............................... Incise spinal column/nerves ................................. Incise spinal column/nerves ................................. Incise spinal column/nerves ................................. Incise spinal column & cord ................................. Incise spinal column & cord ................................. Incise spinal column & cord ................................. Incise spinal column & cord ................................. Incise spinal column & cord ................................. Incise spinal column & cord ................................. Release of spinal cord ......................................... Revise spinal cord vessels .................................. Revise spinal cord vessels .................................. Revise spinal cord vessels .................................. Excise intraspinal lesion ....................................... Excise intraspinal lesion ....................................... Excise intraspinal lesion ....................................... Excise intraspinal lesion ....................................... Excise intraspinal lesion ....................................... Excise intraspinal lesion ....................................... Excise intraspinal lesion ....................................... Excise intraspinal lesion ....................................... Biopsy/excise spinal tumor .................................. Biopsy/excise spinal tumor .................................. Biopsy/excise spinal tumor .................................. Biopsy/excise spinal tumor .................................. Biopsy/excise spinal tumor .................................. Description 3.28 25.97 4.36 29.34 3.19 37.38 4.32 30.78 3.03 33.92 33.92 4.82 22.08 19.66 24.18 20.40 22.69 16.36 18.76 18.79 21.97 21.54 25.14 23.95 29.75 31.32 21.31 43.73 44.49 44.48 23.69 24.55 19.32 19.89 29.67 29.79 27.37 26.34 25.73 25.56 22.26 21.99 30.14 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 1.22 13.78 1.69 13.89 1.19 16.99 1.66 14.24 1.14 17.38 17.09 1.82 12.80 11.44 13.56 10.98 7.18 10.19 10.26 10.89 8.89 12.35 14.08 13.61 8.93 9.29 11.92 21.43 21.71 21.59 13.27 13.44 11.35 10.95 15.96 15.57 14.52 14.02 13.67 13.92 12.31 12.22 16.25 Fully Implemented Facility PE RVUs 1.54 14.19 2.09 15.08 1.49 18.84 2.04 15.58 1.38 18.80 18.73 2.33 12.10 10.84 12.99 10.98 10.01 8.62 10.16 10.58 11.01 11.37 13.56 12.55 8.56 13.60 11.45 20.30 22.36 22.07 12.89 13.24 11.14 10.51 15.59 15.56 14.64 14.25 13.74 13.73 12.46 12.34 16.29 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 63078 63081 63082 63085 63086 63087 63088 63090 63091 63101 63102 63103 63170 63172 63173 63180 63182 63185 63190 63191 63194 63195 63196 63197 63198 63199 63200 63250 63251 63252 63265 63266 63267 63268 63270 63271 63272 63273 63275 63276 63277 63278 63280 HCPCS 2 CPT 1/ 0.66 5.56 1.02 4.49 0.59 6.22 0.82 4.22 0.48 5.71 5.71 0.69 4.87 4.49 5.70 3.96 5.32 2.80 3.25 6.36 3.27 4.88 5.78 5.38 6.45 1.40 4.97 9.04 10.44 10.67 5.45 5.56 4.38 3.70 6.84 6.92 6.20 5.76 5.82 5.85 5.03 4.56 7.29 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 5.16 45.31 7.07 47.72 4.97 60.59 6.80 49.24 4.65 57.01 56.72 7.33 39.75 35.59 43.44 35.34 35.19 29.35 32.27 36.04 34.13 38.77 45.00 42.94 45.13 42.01 38.20 74.20 76.64 76.74 42.41 43.55 35.05 34.54 52.47 52.28 48.09 46.12 45.22 45.33 39.60 38.77 53.68 Fully Implemented Facility Total 5.48 45.72 7.47 48.91 5.27 62.44 7.18 50.58 4.89 58.43 58.36 7.84 39.05 34.99 42.87 35.34 38.02 27.78 32.17 35.73 36.25 37.79 44.48 41.88 44.76 46.32 37.73 73.07 77.29 77.22 42.03 43.35 34.84 34.10 52.10 52.27 48.21 46.35 45.29 45.14 39.75 38.89 53.72 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 ZZZ 090 ZZZ 090 ZZZ 090 ZZZ 090 ZZZ 090 090 ZZZ 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 Global 69906 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00285 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Biopsy/excise spinal tumor .................................. Biopsy/excise spinal tumor .................................. Biopsy/excise spinal tumor .................................. Biopsy/excise spinal tumor .................................. Biopsy/excise spinal tumor .................................. Biopsy/excise spinal tumor .................................. Biopsy/excise spinal tumor .................................. Repair of laminectomy defect .............................. Removal of vertebral body ................................... Removal of vertebral body ................................... Removal of vertebral body ................................... Removal of vertebral body ................................... Removal of vertebral body ................................... Removal of vertebral body ................................... Removal of vertebral body ................................... Removal of vertebral body ................................... Remove vertebral body add-on ........................... Remove spinal cord lesion ................................... Stimulation of spinal cord ..................................... Remove lesion of spinal cord .............................. Implant neuroelectrodes ....................................... Implant neuroelectrodes ....................................... Revise/remove neuroelectrode ............................ Insrt/redo spine n generator ................................. Revise/remove neuroreceiver .............................. Repair of spinal herniation ................................... Repair of spinal herniation ................................... Repair of spinal herniation ................................... Repair of spinal herniation ................................... Repair spinal fluid leakage ................................... Repair spinal fluid leakage ................................... Graft repair of spine defect .................................. Install spinal shunt ............................................... Install spinal shunt ............................................... Revision of spinal shunt ....................................... Removal of spinal shunt ...................................... N block inj, trigeminal ........................................... N block inj, facial .................................................. N block inj, occipital ............................................. N block inj, vagus ................................................. N block inj, phrenic .............................................. N block inj, spinal accessor ................................. N block inj, cervical plexus .................................. Description 29.84 28.00 26.61 37.90 37.47 39.93 40.67 5.25 26.67 31.42 31.00 33.42 33.70 36.09 35.40 34.81 5.24 15.02 8.72 17.22 7.57 11.43 6.87 7.87 6.10 17.32 19.26 22.23 25.15 12.52 15.52 15.27 12.50 9.02 8.86 7.25 1.11 1.25 1.32 1.41 1.43 1.18 1.40 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 13.95 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 1.39 1.45 1.16 1.46 1.80 2.03 1.28 Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 48.25 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 1.77 1.57 1.39 1.55 2.33 2.50 1.70 Year 2007 Transitional Non-Facility PE RVUs 16.05 15.35 14.38 19.34 19.08 19.79 20.38 1.34 13.72 15.20 14.96 14.79 17.29 17.76 15.81 17.93 1.96 4.54 1.57 6.06 2.91 7.91 3.33 3.71 3.59 9.88 11.03 12.71 15.27 7.96 9.14 9.35 8.33 4.85 6.12 4.78 0.45 0.53 0.51 0.72 0.52 0.55 0.47 Fully Implemented Facility PE RVUs 16.13 15.33 14.58 19.78 19.69 20.26 20.53 1.94 14.15 15.46 15.62 16.37 17.27 17.97 17.30 17.08 2.44 5.18 2.08 8.46 3.11 7.15 3.54 4.03 3.56 10.20 11.03 12.86 14.00 7.77 9.33 9.11 7.59 4.78 5.47 4.02 0.44 0.58 0.47 0.82 0.48 0.46 0.49 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 63281 63282 63283 63285 63286 63287 63290 63295 63300 63301 63302 63303 63304 63305 63306 63307 63308 63600 63610 63615 63650 63655 63660 63685 63688 63700 63702 63704 63706 63707 63709 63710 63740 63741 63744 63746 64400 64402 64405 64408 64410 64412 64413 HCPCS 2 CPT 1/ 7.19 6.78 6.28 9.21 9.24 9.42 9.05 1.03 5.99 5.41 5.55 4.69 6.43 5.73 8.35 4.47 1.29 1.52 0.86 2.85 0.53 2.44 0.78 1.05 0.89 3.53 4.13 4.58 6.25 2.52 3.10 3.41 2.94 1.66 1.90 1.53 0.07 0.09 0.08 0.10 0.09 0.08 0.08 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 23.53 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 2.57 2.79 2.56 2.97 3.32 3.29 2.76 Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 57.83 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 2.95 2.91 2.79 3.06 3.85 3.76 3.18 Year 2007 Transitional Non-Facility Total 53.08 50.13 47.27 66.45 65.79 69.14 70.10 7.62 46.38 52.03 51.51 52.90 57.42 59.58 59.56 57.21 8.49 21.08 11.15 26.13 11.01 21.78 10.98 12.63 10.58 30.73 34.42 39.52 46.67 23.00 27.76 28.03 23.77 15.53 16.88 13.56 1.63 1.87 1.91 2.23 2.04 1.81 1.95 Fully Implemented Facility Total 53.16 50.11 47.47 66.89 66.40 69.61 70.25 8.22 46.81 52.29 52.17 54.48 57.40 59.79 61.05 56.36 8.97 21.72 11.66 28.53 11.21 21.02 11.19 12.95 10.55 31.05 34.42 39.67 45.40 22.81 27.95 27.79 23.03 15.46 16.23 12.80 1.62 1.92 1.87 2.33 2.00 1.72 1.97 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 ZZZ 090 090 090 090 090 090 090 090 ZZZ 090 000 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 000 000 000 000 000 000 000 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69907 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00286 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status N block inj, brachial plexus .................................. N block cont infuse, b plex .................................. N block inj, axillary ............................................... N block inj, suprascapular .................................... N block inj, intercost, sng ..................................... N block inj, intercost, mlt ...................................... N block inj, ilio-ing/hypogi .................................... N block inj, pudendal ........................................... N block inj, paracervical ....................................... N block inj, sciatic, sng ........................................ N blk inj, sciatic, cont inf ...................................... N block inj fem, single .......................................... N block inj fem, cont inf ....................................... N block inj, lumbar plexus .................................... N block, other peripheral ...................................... Inj paravertebral c/t .............................................. Inj paravertebral c/t add-on .................................. Inj paravertebral l/s .............................................. Inj paravertebral l/s add-on .................................. Inj foramen epidural c/t ........................................ Inj foramen epidural add-on ................................. Inj foramen epidural l/s ........................................ Inj foramen epidural add-on ................................. N block, spenopalatine gangl ............................... N block, carotid sinus s/p ..................................... N block, stellate ganglion ..................................... N block inj, hypogas plxs ..................................... N block, lumbar/thoracic ...................................... N block inj, celiac pelus ....................................... Apply neurostimulator .......................................... Implant neuroelectrodes ....................................... Implant neuroelectrodes ....................................... Implant neuroelectrodes ....................................... Implant neuroelectrodes ....................................... Implant neuroelectrodes ....................................... Implant neuroelectrodes ....................................... Implant neuroelectrodes ....................................... Implant neuroelectrodes ....................................... Implant neuroelectrodes ....................................... Implant neuroelectrodes ....................................... Revise/remove neuroelectrode ............................ Insrt/redo pn/gastr stimul ..................................... Revise/rmv pn/gastr stimul ................................... Description 1.48 3.85 1.44 1.32 1.18 1.68 1.75 1.46 1.45 1.48 3.61 1.50 3.36 3.24 1.27 1.85 1.29 1.41 0.98 2.20 1.54 1.90 1.33 1.36 1.12 1.22 2.20 1.35 1.58 0.18 2.33 2.29 2.38 7.07 1.78 8.15 4.37 4.64 4.14 14.15 2.08 2.42 1.75 Physician Work RVUs 3 1.48 NA 1.49 1.87 2.36 3.48 1.32 2.40 1.97 1.65 NA NA NA NA 1.29 3.79 1.20 3.64 1.09 3.71 1.46 3.76 1.59 1.10 1.87 1.88 1.65 2.56 2.58 0.20 2.50 2.55 2.48 19.89 2.47 NA NA NA NA NA 5.74 6.39 6.46 Fully Implemented NonFacility PE RVUs 2.47 NA 2.65 2.43 3.50 5.43 1.57 2.48 2.38 2.42 NA NA NA NA 1.25 6.37 2.05 6.07 1.86 6.55 2.50 6.86 2.86 1.21 2.96 3.06 2.45 4.50 3.98 0.26 2.75 2.96 2.59 27.51 3.08 NA NA NA NA NA 9.90 6.95 9.41 Year 2007 Transitional Non-Facility PE RVUs 0.34 0.58 0.35 0.52 0.44 0.52 0.55 0.79 0.55 0.52 0.59 0.21 0.47 0.49 0.50 0.70 0.33 0.59 0.23 0.80 0.37 0.74 0.32 0.73 0.49 0.43 0.64 0.51 0.58 0.06 1.37 1.36 1.34 3.90 1.29 5.50 1.96 2.84 2.69 6.79 2.23 2.47 2.20 Fully Implemented Facility PE RVUs 0.43 0.74 0.46 0.46 0.43 0.52 0.54 0.61 0.66 0.51 0.90 0.38 0.73 0.84 0.49 0.71 0.34 0.62 0.24 0.87 0.45 0.81 0.36 0.68 0.68 0.49 0.81 0.54 0.63 0.05 1.73 1.23 1.30 3.05 1.27 5.31 2.49 3.17 3.34 5.73 2.16 2.33 1.99 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 64415 64416 64417 64418 64420 64421 64425 64430 64435 64445 64446 64447 64448 64449 64450 64470 64472 64475 64476 64479 64480 64483 64484 64505 64508 64510 64517 64520 64530 64550 64553 64555 64560 64561 64565 64573 64575 64577 64580 64581 64585 64590 64595 HCPCS 2 CPT 1/ 0.09 0.31 0.11 0.07 0.08 0.11 0.13 0.10 0.16 0.10 0.20 0.09 0.18 0.15 0.13 0.11 0.08 0.10 0.07 0.12 0.10 0.11 0.08 0.10 0.07 0.07 0.11 0.08 0.10 0.01 0.18 0.19 0.22 0.51 0.13 1.60 0.61 1.04 0.36 1.05 0.20 0.19 0.19 Mal-Practice RVUs 3.05 NA 3.04 3.26 3.62 5.27 3.20 3.96 3.58 3.23 NA NA NA NA 2.69 5.75 2.57 5.15 2.14 6.03 3.10 5.77 3.00 2.56 3.06 3.17 3.96 3.99 4.26 0.39 5.01 5.03 5.08 27.47 4.38 NA NA NA NA NA 8.02 9.00 8.40 Fully Implemented NonFacility Total 4.04 NA 4.20 3.82 4.76 7.22 3.45 4.04 3.99 4.00 NA NA NA NA 2.65 8.33 3.42 7.58 2.91 8.87 4.14 8.87 4.27 2.67 4.15 4.35 4.76 5.93 5.66 0.45 5.26 5.44 5.19 35.09 4.99 NA NA NA NA NA 12.18 9.56 11.35 Year 2007 Transitional Non-Facility Total 1.91 4.74 1.90 1.91 1.70 2.31 2.43 2.35 2.16 2.10 4.40 1.80 4.01 3.88 1.90 2.66 1.70 2.10 1.28 3.12 2.01 2.75 1.73 2.19 1.68 1.72 2.95 1.94 2.26 0.25 3.88 3.84 3.94 11.48 3.20 15.25 6.94 8.52 7.19 21.99 4.51 5.08 4.14 Fully Implemented Facility Total 2.00 4.90 2.01 1.85 1.69 2.31 2.42 2.17 2.27 2.09 4.71 1.97 4.27 4.23 1.89 2.67 1.71 2.13 1.29 3.19 2.09 2.82 1.77 2.14 1.87 1.78 3.12 1.97 2.31 0.24 4.24 3.71 3.90 10.63 3.18 15.06 7.47 8.85 7.84 20.93 4.44 4.94 3.93 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 000 010 000 000 000 000 000 000 000 000 010 000 010 010 000 000 ZZZ 000 ZZZ 000 ZZZ 000 ZZZ 000 000 000 000 000 000 000 010 010 010 010 010 090 090 090 090 090 010 010 010 Global 69908 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00287 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Injection treatment of nerve ................................. Injection treatment of nerve ................................. Injection treatment of nerve ................................. Destroy nerve, face muscle ................................. Destroy nerve, neck muscle ................................ Destroy nerve, extrem musc ................................ Injection treatment of nerve ................................. Destr paravertebrl nerve l/s ................................. Destr paravertebral n add-on ............................... Destr paravertebrl nerve c/t ................................. Destr paravertebral n add-on ............................... Injection treatment of nerve ................................. Injection treatment of nerve ................................. Chemodenerv eccrine glands .............................. Chemodenerv eccrine glands .............................. Injection treatment of nerve ................................. Injection treatment of nerve ................................. Revise finger/toe nerve ........................................ Revise hand/foot nerve ........................................ Revise arm/leg nerve ........................................... Revision of sciatic nerve ...................................... Revision of arm nerve(s) ...................................... Revise low back nerve(s) ..................................... Revision of cranial nerve ..................................... Revise ulnar nerve at elbow ................................ Revise ulnar nerve at wrist .................................. Carpal tunnel surgery ........................................... Relieve pressure on nerve(s) ............................... Release foot/toe nerve ......................................... Internal nerve revision .......................................... Incision of brow nerve .......................................... Incision of cheek nerve ........................................ Incision of chin nerve ........................................... Incision of jaw nerve ............................................ Incision of tongue nerve ....................................... Incision of facial nerve ......................................... Incise nerve, back of head ................................... Incise diaphragm nerve ........................................ Incision of vagus nerve ........................................ Incision of stomach nerves .................................. Incision of vagus nerve ........................................ Incision of pelvis nerve ........................................ Incise hip/thigh nerve ........................................... Description 3.46 5.62 7.17 1.98 1.98 2.20 2.86 3.02 0.99 3.82 1.16 3.02 2.78 0.70 0.88 2.64 3.78 6.10 4.61 6.22 7.98 11.29 10.44 6.86 7.06 4.89 4.84 4.74 4.21 3.10 4.81 5.45 5.13 6.26 6.12 6.75 5.64 6.46 7.59 14.97 7.49 6.94 7.46 Physician Work RVUs 3 5.24 7.49 9.40 1.63 1.37 1.62 3.36 4.00 1.61 4.60 2.31 2.78 2.46 0.77 0.82 3.93 4.80 NA NA NA NA NA NA NA NA NA 4.74 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs 8.32 9.04 9.00 2.27 2.54 2.82 4.64 6.82 2.62 6.99 3.98 2.74 3.75 0.85 0.90 6.02 8.17 NA NA NA NA NA NA NA NA NA 5.21 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 1.59 2.36 3.56 1.38 1.14 1.32 1.14 1.25 0.21 1.82 0.24 1.87 1.46 0.18 0.22 1.08 1.28 5.33 3.23 4.32 4.56 6.50 4.93 5.23 6.27 4.19 4.68 2.83 2.76 1.25 4.33 4.67 3.91 4.28 4.44 4.41 4.62 3.87 4.04 5.80 3.84 3.95 5.13 Fully Implemented Facility PE RVUs 1.64 2.23 3.67 1.34 1.20 1.31 1.28 1.34 0.22 1.93 0.26 1.53 1.75 0.27 0.34 1.34 1.87 4.23 3.29 4.73 4.86 6.03 4.38 5.79 6.06 4.44 5.19 2.99 2.78 1.44 3.71 4.21 3.99 4.53 4.95 4.63 3.98 4.34 4.22 5.67 3.55 3.63 5.18 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 64600 64605 64610 64612 64613 64614 64620 64622 64623 64626 64627 64630 64640 64650 64653 64680 64681 64702 64704 64708 64712 64713 64714 64716 64718 64719 64721 64722 64726 64727 64732 64734 64736 64738 64740 64742 64744 64746 64752 64755 64760 64761 64763 HCPCS 2 CPT 1/ 0.34 0.79 1.58 0.11 0.11 0.10 0.20 0.18 0.06 0.20 0.07 0.22 0.29 0.06 0.08 0.18 0.28 0.61 0.61 0.96 0.95 1.83 1.19 0.63 1.05 0.77 0.73 0.48 0.54 0.48 0.98 0.89 0.52 1.08 0.69 0.73 1.16 0.82 0.93 1.84 0.81 0.53 0.94 Mal-Practice RVUs 9.04 13.90 18.15 3.72 3.46 3.92 6.42 7.20 2.66 8.62 3.54 6.02 5.53 1.53 1.78 6.75 8.86 NA NA NA NA NA NA NA NA NA 10.31 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total 12.12 15.45 17.75 4.36 4.63 5.12 7.70 10.02 3.67 11.01 5.21 5.98 6.82 1.61 1.86 8.84 12.23 NA NA NA NA NA NA NA NA NA 10.78 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 5.39 8.77 12.31 3.47 3.23 3.62 4.20 4.45 1.26 5.84 1.47 5.11 4.53 0.94 1.18 3.90 5.34 12.04 8.45 11.50 13.49 19.62 16.56 12.72 14.38 9.85 10.25 8.05 7.51 4.83 10.12 11.01 9.56 11.62 11.25 11.89 11.42 11.15 12.56 22.61 12.14 11.42 13.53 Fully Implemented Facility Total 5.44 8.64 12.42 3.43 3.29 3.61 4.34 4.54 1.27 5.95 1.49 4.77 4.82 1.03 1.30 4.16 5.93 10.94 8.51 11.91 13.79 19.15 16.01 13.28 14.17 10.10 10.76 8.21 7.53 5.02 9.50 10.55 9.64 11.87 11.76 12.11 10.78 11.62 12.74 22.48 11.85 11.10 13.58 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 010 010 010 010 010 010 010 010 ZZZ 010 ZZZ 010 010 000 000 010 010 090 090 090 090 090 090 090 090 090 090 090 090 ZZZ 090 090 090 090 090 090 090 090 090 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69909 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00288 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Incise hip/thigh nerve ........................................... Sever cranial nerve .............................................. Incision of spinal nerve ........................................ Remove skin nerve lesion .................................... Remove digit nerve lesion ................................... Digit nerve surgery add-on .................................. Remove limb nerve lesion ................................... Limb nerve surgery add-on .................................. Remove nerve lesion ........................................... Remove sciatic nerve lesion ................................ Implant nerve end ................................................ Remove skin nerve lesion .................................... Removal of nerve lesion ...................................... Removal of nerve lesion ...................................... Biopsy of nerve .................................................... Remove sympathetic nerves ................................ Remove sympathetic nerves ................................ Remove sympathetic nerves ................................ Remove sympathetic nerves ................................ Remove sympathetic nerves ................................ Remove sympathetic nerves ................................ Remove sympathetic nerves ................................ Remove sympathetic nerves ................................ Repair of digit nerve ............................................. Repair nerve add-on ............................................ Repair of hand or foot nerve ................................ Repair of hand or foot nerve ................................ Repair of hand or foot nerve ................................ Repair nerve add-on ............................................ Repair of leg nerve .............................................. Repair/transpose nerve ........................................ Repair arm/leg nerve ........................................... Repair sciatic nerve ............................................. Nerve surgery ....................................................... Repair of arm nerves ........................................... Repair of low back nerves ................................... Repair of facial nerve ........................................... Repair of facial nerve ........................................... Fusion of facial/other nerve ................................. Fusion of facial/other nerve ................................. Fusion of facial/other nerve ................................. Subsequent repair of nerve ................................. Repair & revise nerve add-on .............................. Description 9.34 8.02 7.74 5.70 5.52 3.11 6.76 3.71 10.49 16.12 4.29 5.14 11.97 15.71 3.01 10.24 15.78 14.61 11.24 10.64 9.19 9.19 10.80 10.23 5.65 10.71 11.60 11.60 6.25 13.87 14.94 15.69 17.69 4.25 20.74 20.94 13.31 15.96 16.70 14.80 16.95 1.99 2.98 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 5.31 5.36 5.35 4.00 3.77 1.22 4.14 1.44 6.26 9.10 1.64 3.91 6.89 8.50 1.45 4.23 5.99 6.63 4.29 7.14 6.73 6.53 7.22 6.77 2.41 6.67 7.42 7.15 2.74 5.16 8.74 9.08 10.42 1.94 10.16 6.76 7.20 10.06 12.44 9.19 8.55 0.83 1.24 Fully Implemented Facility PE RVUs 5.26 5.50 5.03 3.87 3.70 1.43 3.86 1.73 6.51 9.65 2.00 3.57 7.12 8.74 1.53 4.91 6.87 5.98 5.03 7.13 7.19 7.06 7.90 7.00 2.80 6.99 7.62 7.53 3.11 7.48 9.07 9.49 10.68 2.13 11.37 10.64 8.37 12.66 12.98 10.87 8.68 1.02 1.46 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 64766 64771 64772 64774 64776 64778 64782 64783 64784 64786 64787 64788 64790 64792 64795 64802 64804 64809 64818 64820 64821 64822 64823 64831 64832 64834 64835 64836 64837 64840 64856 64857 64858 64859 64861 64862 64864 64865 64866 64868 64870 64872 64874 HCPCS 2 CPT 1/ 1.06 1.23 1.40 0.74 0.76 0.46 0.86 0.51 1.38 2.61 0.58 0.73 2.11 2.49 0.52 1.29 2.15 1.50 1.33 1.49 1.24 1.30 1.57 1.41 0.85 1.54 1.74 1.68 0.97 1.37 2.13 2.22 3.34 0.67 4.09 4.32 1.26 1.50 2.05 1.43 1.30 0.29 0.42 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 15.71 14.61 14.49 10.44 10.05 4.79 11.76 5.66 18.13 27.83 6.51 9.78 20.97 26.70 4.98 15.76 23.92 22.74 16.86 19.27 17.16 17.02 19.59 18.41 8.91 18.92 20.76 20.43 9.96 20.40 25.81 26.99 31.45 6.86 34.99 32.02 21.77 27.52 31.19 25.42 26.80 3.11 4.64 Fully Implemented Facility Total 15.66 14.75 14.17 10.31 9.98 5.00 11.48 5.95 18.38 28.38 6.87 9.44 21.20 26.94 5.06 16.44 24.80 22.09 17.60 19.26 17.62 17.55 20.27 18.64 9.30 19.24 20.96 20.81 10.33 22.72 26.14 27.40 31.71 7.05 36.20 35.90 22.94 30.12 31.73 27.10 26.93 3.30 4.86 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 ZZZ 090 ZZZ 090 090 ZZZ 090 090 090 000 090 090 090 090 090 090 090 090 090 ZZZ 090 090 090 ZZZ 090 090 090 090 ZZZ 090 090 090 090 090 090 090 ZZZ ZZZ Global 69910 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00289 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A C A A A A A A A A A A A A A A A A A A A A A A A A A Status Repair nerve/shorten bone .................................. Nerve graft, head or neck .................................... Nerve graft, head or neck .................................... Nerve graft, hand or foot ...................................... Nerve graft, hand or foot ...................................... Nerve graft, arm or leg ......................................... Nerve graft, arm or leg ......................................... Nerve graft, hand or foot ...................................... Nerve graft, hand or foot ...................................... Nerve graft, arm or leg ......................................... Nerve graft, arm or leg ......................................... Nerve graft add-on ............................................... Nerve graft add-on ............................................... Nerve pedicle transfer .......................................... Nerve pedicle transfer .......................................... Nerve repair w/allograft ........................................ Neurorraphy w/vein autograft ............................... Nervous system surgery ...................................... Revise eye ........................................................... Revise eye with implant ....................................... Removal of eye .................................................... Remove eye/insert implant .................................. Remove eye/attach implant ................................. Removal of eye .................................................... Remove eye/revise socket ................................... Remove eye/revise socket ................................... Revise ocular implant ........................................... Insert ocular implant ............................................. Insert ocular implant ............................................. Attach ocular implant ........................................... Revise ocular implant ........................................... Reinsert ocular implant ........................................ Removal of ocular implant ................................... Remove foreign body from eye ........................... Remove foreign body from eye ........................... Remove foreign body from eye ........................... Remove foreign body from eye ........................... Remove foreign body from eye ........................... Remove foreign body from eye ........................... Remove foreign body from eye ........................... Repair of eye wound ............................................ Repair of eye wound ............................................ Repair of eye wound ............................................ Description 3.37 17.50 20.72 16.11 17.22 15.61 16.74 20.26 21.81 19.25 20.82 10.20 11.81 14.98 19.90 11.21 14.21 0.00 7.13 6.93 8.10 8.64 9.70 15.42 18.18 19.32 3.18 8.22 8.40 9.23 6.32 9.87 7.22 0.71 0.84 0.71 0.93 8.78 12.29 14.06 1.92 4.49 5.03 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA 6.78 NA NA NA NA NA NA 0.59 0.74 0.60 0.81 NA NA NA 3.87 6.51 NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA 8.30 NA NA NA NA NA NA 0.63 0.79 0.63 0.87 NA NA NA 4.88 7.41 NA Year 2007 Transitional Non-Facility PE RVUs 0.78 9.04 9.96 9.24 10.07 9.09 9.88 10.27 12.07 10.59 11.50 3.94 4.38 7.01 6.35 5.21 5.97 0.00 6.95 7.04 8.19 8.42 9.12 11.71 13.21 13.86 3.18 8.03 8.01 8.65 6.51 8.92 7.32 0.34 0.41 0.29 0.44 7.05 9.13 10.01 1.24 3.31 3.47 Fully Implemented Facility PE RVUs 1.50 10.96 12.65 9.80 8.20 8.92 9.87 9.81 11.25 10.67 11.72 4.93 5.57 8.12 10.98 5.21 5.97 0.00 8.00 8.29 9.19 9.40 10.13 13.18 15.40 15.72 3.50 8.88 8.99 9.57 7.61 10.09 8.19 0.30 0.39 0.28 0.40 6.82 9.52 10.47 1.35 3.30 3.55 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 64876 64885 64886 64890 64891 64892 64893 64895 64896 64897 64898 64901 64902 64905 64907 64910 64911 64999 65091 65093 65101 65103 65105 65110 65112 65114 65125 65130 65135 65140 65150 65155 65175 65205 65210 65220 65222 65235 65260 65265 65270 65272 65273 HCPCS 2 CPT 1/ 0.47 1.63 2.09 2.30 1.63 2.48 2.62 2.58 3.17 2.55 2.78 1.37 1.55 2.01 3.17 1.74 1.91 0.00 0.32 0.34 0.35 0.37 0.42 0.81 1.30 1.02 0.19 0.35 0.36 0.40 0.31 0.50 0.31 0.03 0.04 0.05 0.04 0.37 0.57 0.62 0.09 0.19 0.22 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA 10.15 NA NA NA NA NA NA 1.33 1.62 1.36 1.78 NA NA NA 5.88 11.19 NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA 11.67 NA NA NA NA NA NA 1.37 1.67 1.39 1.84 NA NA NA 6.89 12.09 NA Year 2007 Transitional Non-Facility Total 4.62 28.17 32.77 27.65 28.92 27.18 29.24 33.11 37.05 32.39 35.10 15.51 17.74 24.00 29.42 18.16 22.09 0.00 14.40 14.31 16.64 17.43 19.24 27.94 32.69 34.20 6.55 16.60 16.77 18.28 13.14 19.29 14.85 1.08 1.29 1.05 1.41 16.20 21.99 24.69 3.25 7.99 8.72 Fully Implemented Facility Total 5.34 30.09 35.46 28.21 27.05 27.01 29.23 32.65 36.23 32.47 35.32 16.50 18.93 25.11 34.05 18.16 22.09 0.00 15.45 15.56 17.64 18.41 20.25 29.41 34.88 36.06 6.87 17.45 17.75 19.20 14.24 20.46 15.72 1.04 1.27 1.04 1.37 15.97 22.38 25.15 3.36 7.98 8.80 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 ZZZ 090 090 090 090 090 090 090 090 090 090 ZZZ ZZZ 090 090 090 090 YYY 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 000 000 000 000 090 090 090 010 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69911 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00290 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A N N N A N A A A A A A A A A A A A A A A A A A A A Status Repair of eye wound ............................................ Repair of eye wound ............................................ Repair of eye wound ............................................ Repair of eye wound ............................................ Repair of eye socket wound ................................ Removal of eye lesion ......................................... Biopsy of cornea .................................................. Removal of eye lesion ......................................... Removal of eye lesion ......................................... Corneal smear ...................................................... Curette/treat cornea ............................................. Curette/treat cornea ............................................. Treatment of corneal lesion ................................. Revision of cornea ............................................... Corneal transplant ................................................ Corneal transplant ................................................ Corneal transplant ................................................ Corneal transplant ................................................ Revision of cornea ............................................... Revision of cornea ............................................... Corneal tissue transplant ..................................... Revise cornea with implant .................................. Radial keratotomy ................................................ Correction of astigmatism .................................... Correction of astigmatism .................................... Ocular reconst, transplant .................................... Ocular reconst, transplant .................................... Ocular reconst, transplant .................................... Drainage of eye .................................................... Drainage of eye .................................................... Drainage of eye .................................................... Drainage of eye .................................................... Relieve inner eye pressure .................................. Incision of eye ...................................................... Laser surgery of eye ............................................ Incise inner eye adhesions .................................. Incise inner eye adhesions .................................. Incise inner eye adhesions .................................. Incise inner eye adhesions .................................. Incise inner eye adhesions .................................. Remove eye lesion .............................................. Remove implant of eye ........................................ Remove blood clot from eye ................................ Description 6.14 8.87 14.43 6.45 6.35 7.27 1.47 4.24 5.93 1.47 0.92 4.72 3.35 4.07 14.09 15.99 16.60 16.49 0.00 0.00 0.00 19.41 0.00 4.96 6.73 10.43 17.84 15.16 1.91 1.91 5.67 5.85 8.72 11.24 3.90 3.56 5.66 7.21 7.61 8.16 12.26 9.74 8.24 Physician Work RVUs 3 6.46 NA NA 8.98 NA 7.71 1.72 7.04 8.43 1.13 0.89 3.92 3.79 4.60 NA NA NA NA 0.00 0.00 0.00 NA 0.00 5.02 NA NA NA NA 1.46 1.77 NA 8.15 NA NA 3.63 3.38 NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs 6.35 NA NA 10.60 NA 8.18 2.01 8.40 9.74 1.25 0.97 4.05 4.00 4.91 NA NA NA NA 0.00 0.00 0.00 NA 0.00 5.40 NA NA NA NA 1.71 2.07 NA 9.54 NA NA 4.14 3.88 NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 4.04 6.10 8.83 4.59 4.61 6.09 0.90 4.10 4.76 0.90 0.68 3.58 3.71 3.54 10.60 11.41 11.13 11.10 0.00 0.00 0.00 12.24 0.00 4.08 5.52 9.29 12.11 10.67 1.08 1.08 4.87 4.76 7.94 7.65 2.75 2.18 4.88 5.94 6.39 6.61 9.25 7.80 6.04 Fully Implemented Facility PE RVUs 3.97 6.20 9.12 4.61 4.71 6.11 0.95 4.36 4.88 0.96 0.70 3.65 3.88 3.40 11.05 11.87 11.76 11.69 0.00 0.00 0.00 12.96 0.00 4.12 5.84 10.04 13.28 11.66 1.16 1.16 4.74 4.80 8.77 8.24 3.01 2.42 5.44 6.29 6.69 6.93 10.00 8.08 6.63 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 65275 65280 65285 65286 65290 65400 65410 65420 65426 65430 65435 65436 65450 65600 65710 65730 65750 65755 65760 65765 65767 65770 65771 65772 65775 65780 65781 65782 65800 65805 65810 65815 65820 65850 65855 65860 65865 65870 65875 65880 65900 65920 65930 HCPCS 2 CPT 1/ 0.26 0.38 0.64 0.27 0.31 0.30 0.07 0.21 0.25 0.07 0.04 0.21 0.16 0.17 0.61 0.70 0.74 0.73 0.00 0.00 0.00 0.87 0.00 0.21 0.28 0.44 0.44 0.44 0.09 0.09 0.24 0.25 0.40 0.52 0.19 0.18 0.28 0.31 0.32 0.35 0.54 0.41 0.37 Mal-Practice RVUs 12.86 NA NA 15.70 NA 15.28 3.26 11.49 14.61 2.67 1.85 8.85 7.30 8.84 NA NA NA NA 0.00 0.00 0.00 NA 0.00 10.19 NA NA NA NA 3.46 3.77 NA 14.25 NA NA 7.72 7.12 NA NA NA NA NA NA NA Fully Implemented NonFacility Total 12.75 NA NA 17.32 NA 15.75 3.55 12.85 15.92 2.79 1.93 8.98 7.51 9.15 NA NA NA NA 0.00 0.00 0.00 NA 0.00 10.57 NA NA NA NA 3.71 4.07 NA 15.64 NA NA 8.23 7.62 NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 10.44 15.35 23.90 11.31 11.27 13.66 2.44 8.55 10.94 2.44 1.64 8.51 7.22 7.78 25.30 28.10 28.47 28.32 0.00 0.00 0.00 32.52 0.00 9.25 12.53 20.16 30.39 26.27 3.08 3.08 10.78 10.86 17.06 19.41 6.84 5.92 10.82 13.46 14.32 15.12 22.05 17.95 14.65 Fully Implemented Facility Total 10.37 15.45 24.19 11.33 11.37 13.68 2.49 8.81 11.06 2.50 1.66 8.58 7.39 7.64 25.75 28.56 29.10 28.91 0.00 0.00 0.00 33.24 0.00 9.29 12.85 20.91 31.56 27.26 3.16 3.16 10.65 10.90 17.89 20.00 7.10 6.16 11.38 13.81 14.62 15.44 22.80 18.23 15.24 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 000 090 090 000 000 090 090 090 090 090 090 090 XXX XXX XXX 090 XXX 090 090 090 090 090 000 000 090 090 090 090 010 090 090 090 090 090 090 090 090 Global 69912 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00291 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Injection treatment of eye .................................... Injection treatment of eye .................................... Remove eye lesion .............................................. Glaucoma surgery ................................................ Glaucoma surgery ................................................ Glaucoma surgery ................................................ Glaucoma surgery ................................................ Glaucoma surgery ................................................ Incision of eye ...................................................... Implant eye shunt ................................................. Revise eye shunt ................................................. Repair eye lesion ................................................. Repair/graft eye lesion ......................................... Follow-up surgery of eye ..................................... Incision of iris ....................................................... Incision of iris ....................................................... Remove iris and lesion ........................................ Removal of iris ..................................................... Removal of iris ..................................................... Removal of iris ..................................................... Removal of iris ..................................................... Repair iris & ciliary body ...................................... Repair iris & ciliary body ...................................... Destruction, ciliary body ....................................... Ciliary transsleral therapy .................................... Ciliary endoscopic ablation .................................. Destruction, ciliary body ....................................... Destruction, ciliary body ....................................... Revision of iris ...................................................... Revision of iris ...................................................... Removal of inner eye lesion ................................ Incision, secondary cataract ................................ After cataract laser surgery .................................. Reposition intraocular lens ................................... Removal of lens lesion ......................................... Removal of lens material ..................................... Removal of lens material ..................................... Removal of lens material ..................................... Extraction of lens ................................................. Extraction of lens ................................................. Extraction of lens ................................................. Cataract surgery, complex ................................... Cataract surg w/iol, 1 stage ................................. Description 1.61 1.27 7.74 10.18 10.17 12.04 9.89 14.57 18.26 16.02 9.35 8.98 12.38 6.92 3.75 4.13 9.89 13.99 5.19 7.10 7.19 6.24 7.15 5.06 5.06 7.70 4.86 5.06 4.87 5.25 5.98 3.93 3.32 8.82 9.27 8.98 10.32 11.18 9.93 11.38 10.14 14.83 10.20 Physician Work RVUs 3 2.49 2.36 7.79 NA NA NA NA NA NA NA NA NA NA 9.53 NA NA NA NA NA NA NA NA NA 4.98 4.76 NA 5.50 4.70 5.20 5.29 5.75 NA 3.94 NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs 2.96 2.81 9.16 NA NA NA NA NA NA NA NA NA NA 11.15 NA NA NA NA NA NA NA NA NA 5.18 5.07 NA 5.72 4.99 5.49 5.56 6.00 NA 4.05 NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 1.33 1.19 5.11 9.13 9.11 9.88 9.06 12.02 15.25 10.18 7.35 7.28 8.51 5.48 4.09 4.46 8.62 9.51 4.38 5.58 5.61 5.27 6.97 3.77 3.74 6.56 4.44 3.77 4.36 4.24 4.79 4.78 3.53 8.07 6.65 6.59 7.40 7.74 6.95 7.82 7.34 9.40 6.37 Fully Implemented Facility PE RVUs 1.41 1.26 5.49 9.33 9.29 10.11 9.20 12.17 15.21 10.62 7.37 7.15 8.68 5.48 4.50 4.86 8.32 9.89 4.64 5.68 5.71 5.27 6.70 3.89 3.82 6.49 4.65 3.92 4.32 4.28 4.80 5.55 3.60 8.81 6.88 6.79 7.58 8.01 7.21 8.06 7.54 9.75 6.18 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 66020 66030 66130 66150 66155 66160 66165 66170 66172 66180 66185 66220 66225 66250 66500 66505 66600 66605 66625 66630 66635 66680 66682 66700 66710 66711 66720 66740 66761 66762 66770 66820 66821 66825 66830 66840 66850 66852 66920 66930 66940 66982 66983 HCPCS 2 CPT 1/ 0.08 0.06 0.38 0.46 0.41 0.50 0.40 0.60 0.74 0.71 0.40 0.40 0.55 0.30 0.18 0.20 0.43 0.77 0.26 0.31 0.31 0.27 0.31 0.24 0.23 0.30 0.26 0.23 0.20 0.23 0.26 0.19 0.11 0.40 0.36 0.39 0.45 0.49 0.44 0.49 0.43 0.63 0.14 Mal-Practice RVUs 4.18 3.69 15.91 NA NA NA NA NA NA NA NA NA NA 16.75 NA NA NA NA NA NA NA NA NA 10.28 10.05 NA 10.62 9.99 10.27 10.77 11.99 NA 7.37 NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total 4.65 4.14 17.28 NA NA NA NA NA NA NA NA NA NA 18.37 NA NA NA NA NA NA NA NA NA 10.48 10.36 NA 10.84 10.28 10.56 11.04 12.24 NA 7.48 NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 3.02 2.52 13.23 19.77 19.69 22.42 19.35 27.19 34.25 26.91 17.10 16.66 21.44 12.70 8.02 8.79 18.94 24.27 9.83 12.99 13.11 11.78 14.43 9.07 9.03 14.56 9.56 9.06 9.43 9.72 11.03 8.90 6.96 17.29 16.28 15.96 18.17 19.41 17.32 19.69 17.91 24.86 16.71 Fully Implemented Facility Total 3.10 2.59 13.61 19.97 19.87 22.65 19.49 27.34 34.21 27.35 17.12 16.53 21.61 12.70 8.43 9.19 18.64 24.65 10.09 13.09 13.21 11.78 14.16 9.19 9.11 14.49 9.77 9.21 9.39 9.76 11.04 9.67 7.03 18.03 16.51 16.16 18.35 19.68 17.58 19.93 18.11 25.21 16.52 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 010 010 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69913 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00292 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A C A A A A A A A A A A A A A A A A A A A A A A A A A A A R A A A A A C A A A A Status Cataract surg w/iol, 1 stage ................................. Insert lens prosthesis ........................................... Exchange lens prosthesis .................................... Ophthalmic endoscope add-on ............................ Eye surgery procedure ......................................... Partial removal of eye fluid .................................. Partial removal of eye fluid .................................. Release of eye fluid ............................................. Replace eye fluid ................................................. Implant eye drug system ...................................... Injection eye drug ................................................. Incise inner eye strands ....................................... Laser surgery, eye strands .................................. Removal of inner eye fluid ................................... Strip retinal membrane ......................................... Laser treatment of retina ...................................... Laser treatment of retina ...................................... Repair detached retina ......................................... Repair detached retina ......................................... Repair detached retina ......................................... Repair detached retina ......................................... Repair detached retina ......................................... Rerepair detached retina ..................................... Release encircling material .................................. Remove eye implant material .............................. Remove eye implant material .............................. Treatment of retina ............................................... Treatment of retina ............................................... Treatment of retinal lesion ................................... Treatment of retinal lesion ................................... Treatment of retinal lesion ................................... Treatment of choroid lesion ................................. Ocular photodynamic ther .................................... Eye photodynamic ther add-on ............................ Treatment of retinal lesion ................................... Treatment of retinal lesion ................................... Reinforce eye wall ................................................ Reinforce/graft eye wall ....................................... Eye surgery procedure ......................................... Revise eye muscle ............................................... Revise two eye muscles ...................................... Revise eye muscle ............................................... Revise two eye muscles ...................................... Description 10.36 9.73 12.26 1.51 0.00 5.77 6.94 7.00 7.91 11.43 2.52 5.91 4.34 13.09 23.30 16.39 19.23 8.60 8.35 16.35 22.49 10.02 18.45 5.93 6.92 12.00 6.00 6.17 7.50 9.35 20.22 14.19 3.45 0.47 7.38 13.67 9.46 9.97 0.00 7.59 9.48 8.59 10.73 Physician Work RVUs 3 NA NA NA NA 0.00 NA NA NA 8.15 NA 2.24 NA 4.24 NA NA NA NA 8.80 7.70 NA NA 9.28 NA NA 7.61 NA 5.63 5.55 5.89 6.21 NA 9.66 3.04 0.24 6.24 10.36 NA NA 0.00 NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA 0.00 NA NA NA 8.95 NA 2.59 NA 4.51 NA NA NA NA 9.04 7.99 NA NA 9.99 NA NA 8.34 NA 5.80 5.68 6.06 6.48 NA 10.23 4.01 0.25 6.50 11.20 NA NA 0.00 NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 6.70 7.41 8.44 0.58 0.00 4.77 5.22 5.94 6.17 7.71 1.31 5.81 3.56 8.46 14.16 11.22 12.61 6.45 6.05 10.86 13.62 7.29 11.42 5.11 5.50 8.35 4.86 4.92 5.44 5.72 11.24 8.58 1.47 0.18 5.39 8.09 7.95 8.78 0.00 5.74 6.49 6.44 7.26 Fully Implemented Facility PE RVUs 7.24 7.44 8.99 0.66 0.00 4.84 5.36 6.32 6.21 7.93 1.42 5.84 3.62 8.96 15.16 11.94 13.41 6.51 6.13 11.19 14.22 7.37 11.71 5.09 5.52 8.49 4.86 4.93 5.49 5.84 11.92 8.90 1.72 0.20 5.49 8.43 8.87 9.61 0.00 5.95 6.69 6.52 7.44 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 66984 66985 66986 66990 66999 67005 67010 67015 67025 67027 67028 67030 67031 67036 67038 67039 67040 67101 67105 67107 67108 67110 67112 67115 67120 67121 67141 67145 67208 67210 67218 67220 67221 67225 67227 67228 67250 67255 67299 67311 67312 67314 67316 HCPCS 2 CPT 1/ 0.39 0.36 0.60 0.07 0.00 0.28 0.34 0.34 0.34 0.54 0.12 0.24 0.18 0.58 1.04 0.71 0.85 0.37 0.37 0.73 1.02 0.44 0.83 0.25 0.29 0.53 0.26 0.27 0.33 0.44 0.92 0.65 0.20 0.02 0.33 0.63 0.47 0.44 0.00 0.37 0.43 0.39 0.49 Mal-Practice RVUs NA NA NA NA 0.00 NA NA NA 16.40 NA 4.88 NA 8.76 NA NA NA NA 17.77 16.42 NA NA 19.74 NA NA 14.82 NA 11.89 11.99 13.72 16.00 NA 24.50 6.69 0.73 13.95 24.66 NA NA 0.00 NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA 0.00 NA NA NA 17.20 NA 5.23 NA 9.03 NA NA NA NA 18.01 16.71 NA NA 20.45 NA NA 15.55 NA 12.06 12.12 13.89 16.27 NA 25.07 7.66 0.74 14.21 25.50 NA NA 0.00 NA NA NA NA Year 2007 Transitional Non-Facility Total 17.45 17.50 21.30 2.16 0.00 10.82 12.50 13.28 14.42 19.68 3.95 11.96 8.08 22.13 38.50 28.32 32.69 15.42 14.77 27.94 37.13 17.75 30.70 11.29 12.71 20.88 11.12 11.36 13.27 15.51 32.38 23.42 5.12 0.67 13.10 22.39 17.88 19.19 0.00 13.70 16.40 15.42 18.48 Fully Implemented Facility Total 17.99 17.53 21.85 2.24 0.00 10.89 12.64 13.66 14.46 19.90 4.06 11.99 8.14 22.63 39.50 29.04 33.49 15.48 14.85 28.27 37.73 17.83 30.99 11.27 12.73 21.02 11.12 11.37 13.32 15.63 33.06 23.74 5.37 0.69 13.20 22.73 18.80 20.02 0.00 13.91 16.60 15.50 18.66 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 ZZZ YYY 090 090 090 090 090 000 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 000 ZZZ 090 090 090 090 YYY 090 090 090 090 Global 69914 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00293 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A C A A A A A A A A A A A A A A A A A C A A A A A A A A A A A A A A Status Revise eye muscle(s) ........................................... Revise eye muscle(s) add-on .............................. Eye surgery follow-up add-on .............................. Rerevise eye muscles add-on ............................. Revise eye muscle w/suture ................................ Eye suture during surgery .................................... Revise eye muscle add-on .................................. Release eye tissue ............................................... Destroy nerve of eye muscle ............................... Biopsy, eye muscle .............................................. Eye muscle surgery procedure ............................ Explore/biopsy eye socket ................................... Explore/drain eye socket ...................................... Explore/treat eye socket ...................................... Explore/treat eye socket ...................................... Explr/decompress eye socket .............................. Aspiration, orbital contents ................................... Explore/treat eye socket ...................................... Explore/treat eye socket ...................................... Explore/drain eye socket ...................................... Explr/decompress eye socket .............................. Explore/biopsy eye socket ................................... Inject/treat eye socket .......................................... Inject/treat eye socket .......................................... Inject/treat eye socket .......................................... Insert eye socket implant ..................................... Revise eye socket implant ................................... Decompress optic nerve ...................................... Orbit surgery procedure ....................................... Drainage of eyelid abscess .................................. Incision of eyelid .................................................. Incision of eyelid fold ........................................... Remove eyelid lesion ........................................... Remove eyelid lesions ......................................... Remove eyelid lesions ......................................... Remove eyelid lesion(s) ....................................... Biopsy of eyelid .................................................... Revise eyelashes ................................................. Revise eyelashes ................................................. Revise eyelashes ................................................. Revise eyelashes ................................................. Remove eyelid lesion ........................................... Treat eyelid lesion ................................................ Description 8.92 5.40 5.13 5.56 5.05 2.49 6.00 8.29 2.98 2.87 0.00 10.97 9.00 10.17 10.09 17.78 1.76 21.62 14.99 14.56 18.96 15.11 1.44 1.27 1.40 11.52 11.93 14.21 0.00 1.37 1.04 1.24 1.39 1.89 2.24 4.47 1.48 0.71 1.40 1.72 5.61 2.06 1.71 Physician Work RVUs 3 NA NA NA NA NA NA NA NA 2.29 NA 0.00 NA NA NA NA NA NA NA NA NA NA NA 0.62 0.54 0.82 NA NA NA 0.00 4.41 3.78 3.90 1.44 1.74 2.26 NA 3.96 0.46 1.45 4.09 NA 4.00 3.31 Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA 2.51 NA 0.00 NA NA NA NA NA NA NA NA NA NA NA 0.66 0.65 0.65 NA NA NA 0.00 5.62 4.97 5.00 1.58 1.91 2.46 NA 3.49 0.57 1.66 5.17 NA 5.10 3.36 Year 2007 Transitional Non-Facility PE RVUs 6.83 2.07 1.95 2.13 1.92 0.95 2.29 6.32 1.80 1.71 0.00 9.79 8.53 8.87 9.02 12.12 0.64 14.75 12.78 12.23 12.71 12.71 0.49 0.41 0.65 10.13 10.16 11.42 0.00 1.22 1.12 1.20 0.94 1.13 1.48 3.74 0.70 0.46 1.31 1.38 4.23 1.52 1.47 Fully Implemented Facility PE RVUs 6.91 1.98 1.86 2.05 1.82 1.08 2.22 6.46 1.96 1.83 0.00 10.89 9.46 10.42 10.33 12.06 0.73 16.73 14.36 13.75 13.61 14.20 0.34 0.34 0.45 11.01 11.07 13.04 0.00 1.26 1.19 1.27 1.02 1.23 1.61 3.76 0.69 0.54 1.39 1.47 4.52 1.62 1.47 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 67318 67320 67331 67332 67334 67335 67340 67343 67345 67346 67399 67400 67405 67412 67413 67414 67415 67420 67430 67440 67445 67450 67500 67505 67515 67550 67560 67570 67599 67700 67710 67715 67800 67801 67805 67808 67810 67820 67825 67830 67835 67840 67850 HCPCS 2 CPT 1/ 0.41 0.22 0.21 0.23 0.20 0.13 0.25 0.37 0.17 0.15 0.00 0.56 0.44 0.48 0.50 0.65 0.09 1.15 0.86 0.70 0.90 0.68 0.05 0.05 0.03 0.72 0.60 0.68 0.00 0.07 0.05 0.06 0.07 0.09 0.11 0.19 0.06 0.04 0.07 0.08 0.28 0.10 0.07 Mal-Practice RVUs NA NA NA NA NA NA NA NA 5.44 NA 0.00 NA NA NA NA NA NA NA NA NA NA NA 2.11 1.86 2.25 NA NA NA 0.00 5.85 4.87 5.20 2.90 3.72 4.61 NA 5.50 1.21 2.92 5.89 NA 6.16 5.09 Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA 5.66 NA 0.00 NA NA NA NA NA NA NA NA NA NA NA 2.15 1.97 2.08 NA NA NA 0.00 7.06 6.06 6.30 3.04 3.89 4.81 NA 5.03 1.32 3.13 6.97 NA 7.26 5.14 Year 2007 Transitional Non-Facility Total 16.16 7.69 7.29 7.92 7.17 3.57 8.54 14.98 4.95 4.73 0.00 21.32 17.97 19.52 19.61 30.55 2.49 37.52 28.63 27.49 32.57 28.50 1.98 1.73 2.08 22.37 22.69 26.31 0.00 2.66 2.21 2.50 2.40 3.11 3.83 8.40 2.24 1.21 2.78 3.18 10.12 3.68 3.25 Fully Implemented Facility Total 16.24 7.60 7.20 7.84 7.07 3.70 8.47 15.12 5.11 4.85 0.00 22.42 18.90 21.07 20.92 30.49 2.58 39.50 30.21 29.01 33.47 29.99 1.83 1.66 1.88 23.25 23.60 27.93 0.00 2.70 2.28 2.57 2.48 3.21 3.96 8.42 2.23 1.29 2.86 3.27 10.41 3.78 3.25 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 ZZZ ZZZ ZZZ ZZZ ZZZ ZZZ 090 010 000 YYY 090 090 090 090 090 000 090 090 090 090 090 000 000 000 090 090 090 YYY 010 010 010 010 010 010 090 000 000 010 010 090 010 010 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69915 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00294 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C A A A A A A A A A A A Status Closure of eyelid by suture .................................. Revision of eyelid ................................................. Revision of eyelid ................................................. Repair brow defect ............................................... Repair eyelid defect ............................................. Repair eyelid defect ............................................. Repair eyelid defect ............................................. Repair eyelid defect ............................................. Repair eyelid defect ............................................. Repair eyelid defect ............................................. Revise eyelid defect ............................................. Revise eyelid defect ............................................. Correction eyelid w/implant .................................. Repair eyelid defect ............................................. Repair eyelid defect ............................................. Repair eyelid defect ............................................. Repair eyelid defect ............................................. Repair eyelid defect ............................................. Repair eyelid defect ............................................. Repair eyelid defect ............................................. Repair eyelid defect ............................................. Repair eyelid wound ............................................ Repair eyelid wound ............................................ Remove eyelid foreign body ................................ Revision of eyelid ................................................. Revision of eyelid ................................................. Revision of eyelid ................................................. Reconstruction of eyelid ....................................... Reconstruction of eyelid ....................................... Reconstruction of eyelid ....................................... Reconstruction of eyelid ....................................... Revision of eyelid ................................................. Incise/drain eyelid lining ....................................... Treatment of eyelid lesions .................................. Biopsy of eyelid lining .......................................... Remove eyelid lining lesion ................................. Remove eyelid lining lesion ................................. Remove eyelid lining lesion ................................. Remove eyelid lining lesion ................................. Treat eyelid by injection ....................................... Revise/graft eyelid lining ...................................... Revise/graft eyelid lining ...................................... Revise/graft eyelid lining ...................................... Description 1.35 4.47 5.87 6.69 7.47 9.68 6.42 7.83 6.84 5.19 5.46 7.38 6.23 3.70 3.21 5.37 6.08 3.42 3.09 5.94 5.84 3.62 6.27 1.35 5.88 5.75 8.83 9.87 12.96 12.93 9.21 0.00 1.39 0.85 1.35 1.79 2.38 4.99 1.86 0.49 6.44 8.43 8.22 Physician Work RVUs 3 2.44 5.60 6.59 7.56 9.29 NA 6.86 8.45 NA 5.74 6.42 NA 13.17 4.89 4.54 6.56 6.95 4.76 4.45 6.66 7.14 4.51 6.99 3.94 6.84 7.04 8.35 NA NA NA NA 0.00 1.28 0.62 2.40 3.15 4.44 6.86 1.64 0.47 9.44 NA NA Fully Implemented NonFacility PE RVUs 3.09 6.36 7.37 8.69 6.37 NA 8.89 9.34 NA 6.41 7.63 NA 17.49 5.98 5.62 7.68 8.08 5.83 5.55 7.76 8.48 5.41 8.14 5.02 8.18 8.27 8.94 NA NA NA NA 0.00 1.38 0.69 3.04 3.86 5.58 8.25 1.77 0.52 10.82 NA NA Year 2007 Transitional Non-Facility PE RVUs 0.87 3.71 4.66 4.78 5.53 6.67 4.54 5.61 4.69 4.30 4.37 5.28 4.80 2.79 2.59 4.31 4.60 2.67 2.53 4.52 4.25 1.88 3.77 1.27 4.53 4.49 6.01 6.49 8.14 8.16 6.25 0.00 1.10 0.37 0.89 1.54 1.76 4.20 1.53 0.30 5.52 6.23 6.18 Fully Implemented Facility PE RVUs 0.92 3.78 4.77 5.13 5.43 5.76 5.27 5.33 4.95 5.08 4.81 4.91 5.35 2.99 2.75 4.65 4.95 2.84 2.70 4.86 4.57 2.10 4.25 1.26 5.04 4.90 5.67 7.08 9.02 8.96 6.78 0.00 1.18 0.42 0.94 1.62 1.87 4.50 1.62 0.32 5.52 6.46 6.35 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 67875 67880 67882 67900 67901 67902 67903 67904 67906 67908 67909 67911 67912 67914 67915 67916 67917 67921 67922 67923 67924 67930 67935 67938 67950 67961 67966 67971 67973 67974 67975 67999 68020 68040 68100 68110 68115 68130 68135 68200 68320 68325 68326 HCPCS 2 CPT 1/ 0.07 0.19 0.25 0.38 0.54 0.60 0.47 0.41 0.46 0.28 0.31 0.31 0.28 0.19 0.16 0.28 0.36 0.17 0.15 0.30 0.30 0.19 0.39 0.06 0.36 0.33 0.37 0.53 0.75 0.75 0.50 0.00 0.06 0.04 0.07 0.09 0.12 0.24 0.09 0.02 0.27 0.44 0.35 Mal-Practice RVUs 3.86 10.26 12.71 14.63 17.30 NA 13.75 16.69 NA 11.21 12.19 NA 19.68 8.78 7.91 12.21 13.39 8.35 7.69 12.90 13.28 8.32 13.65 5.35 13.08 13.12 17.55 NA NA NA NA 0.00 2.73 1.51 3.82 5.03 6.94 12.09 3.59 0.98 16.15 NA NA Fully Implemented NonFacility Total 4.51 11.02 13.49 15.76 14.38 NA 15.78 17.58 NA 11.88 13.40 NA 24.00 9.87 8.99 13.33 14.52 9.42 8.79 14.00 14.62 9.22 14.80 6.43 14.42 14.35 18.14 NA NA NA NA 0.00 2.83 1.58 4.46 5.74 8.08 13.48 3.72 1.03 17.53 NA NA Year 2007 Transitional Non-Facility Total 2.29 8.37 10.78 11.85 13.54 16.95 11.43 13.85 11.99 9.77 10.14 12.97 11.31 6.68 5.96 9.96 11.04 6.26 5.77 10.76 10.39 5.69 10.43 2.68 10.77 10.57 15.21 16.89 21.85 21.84 15.96 0.00 2.55 1.26 2.31 3.42 4.26 9.43 3.48 0.81 12.23 15.10 14.75 Fully Implemented Facility Total 2.34 8.44 10.89 12.20 13.44 16.04 12.16 13.57 12.25 10.55 10.58 12.60 11.86 6.88 6.12 10.30 11.39 6.43 5.94 11.10 10.71 5.91 10.91 2.67 11.28 10.98 14.87 17.48 22.73 22.64 16.49 0.00 2.63 1.31 2.36 3.50 4.37 9.73 3.57 0.83 12.23 15.33 14.92 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 000 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 010 090 010 090 090 090 090 090 090 090 YYY 010 000 000 010 010 090 010 000 090 090 090 Global 69916 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00295 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A C A A A A A A A A A A A A A A A A A A A A A A A A A C A A A N A A A A A Status Revise/graft eyelid lining ...................................... Revise eyelid lining .............................................. Revise/graft eyelid lining ...................................... Separate eyelid adhesions ................................... Revise eyelid lining .............................................. Revise eyelid lining .............................................. Harvest eye tissue, alograft ................................. Eyelid lining surgery ............................................. Incise/drain tear gland .......................................... Incise/drain tear sac ............................................. Incise tear duct opening ....................................... Removal of tear gland .......................................... Partial removal, tear gland ................................... Biopsy of tear gland ............................................. Removal of tear sac ............................................. Biopsy of tear sac ................................................ Clearance of tear duct ......................................... Remove tear gland lesion .................................... Remove tear gland lesion .................................... Repair tear ducts .................................................. Revise tear duct opening ..................................... Create tear sac drain ........................................... Create tear duct drain .......................................... Create tear duct drain .......................................... Close tear duct opening ....................................... Close tear duct opening ....................................... Close tear system fistula ...................................... Dilate tear duct opening ....................................... Probe nasolacrimal duct ...................................... Probe nasolacrimal duct ...................................... Probe nasolacrimal duct ...................................... Explore/irrigate tear ducts .................................... Injection for tear sac x-ray ................................... Tear duct system surgery .................................... Drain external ear lesion ...................................... Drain external ear lesion ...................................... Drain outer ear canal lesion ................................. Pierce earlobes .................................................... Biopsy of external ear .......................................... Biopsy of external ear canal ................................ Remove external ear, partial ................................ Removal of external ear ....................................... Remove ear canal lesion(s) ................................. Description 9.25 5.63 8.26 4.84 5.04 8.41 4.97 0.00 1.71 2.32 0.96 12.49 12.41 4.60 8.58 4.42 3.67 11.93 14.86 7.67 2.08 9.78 9.70 9.87 1.75 1.38 8.09 0.96 2.63 2.39 3.24 1.27 0.80 0.00 1.47 2.13 1.50 0.00 0.81 0.85 3.47 4.08 8.03 Physician Work RVUs 3 NA 7.65 NA 7.08 6.62 NA NA 0.00 4.42 4.69 1.28 NA NA 5.38 NA NA 5.74 NA NA NA 3.12 NA NA NA 2.66 1.88 NA 1.82 3.50 NA 6.56 1.56 0.69 0.00 2.71 2.76 3.85 0.00 1.86 2.49 7.62 NA NA Fully Implemented NonFacility PE RVUs NA 8.97 NA 8.42 7.69 NA NA 0.00 5.53 5.82 1.88 NA NA 6.84 NA NA 7.56 NA NA NA 3.91 NA NA NA 3.32 2.17 NA 1.91 3.62 NA 7.82 1.59 0.83 0.00 2.84 2.89 3.96 0.00 1.75 2.38 6.96 NA NA Year 2007 Transitional Non-Facility PE RVUs 6.74 4.64 6.20 4.02 4.11 6.24 4.23 0.00 1.24 1.48 1.22 9.07 9.21 2.14 6.74 1.68 2.17 8.81 10.64 5.81 1.65 7.18 7.54 7.72 1.51 1.29 5.95 1.46 2.78 2.19 2.52 1.33 0.57 0.00 1.26 1.48 1.78 0.00 0.41 0.66 4.32 5.11 12.39 Fully Implemented Facility PE RVUs 7.15 4.70 6.34 4.08 4.16 6.36 4.61 0.00 1.68 1.95 1.26 9.57 10.29 2.10 7.25 1.94 2.52 9.25 11.17 5.94 1.76 7.69 7.78 8.13 1.60 1.31 3.87 1.48 2.70 2.36 2.74 1.17 0.65 0.00 1.34 1.74 1.99 0.00 0.40 0.74 4.43 5.91 13.06 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 68328 68330 68335 68340 68360 68362 68371 68399 68400 68420 68440 68500 68505 68510 68520 68525 68530 68540 68550 68700 68705 68720 68745 68750 68760 68761 68770 68801 68810 68811 68815 68840 68850 68899 69000 69005 69020 69090 69100 69105 69110 69120 69140 HCPCS 2 CPT 1/ 0.54 0.24 0.36 0.21 0.22 0.36 0.44 0.00 0.08 0.11 0.05 0.55 0.55 0.23 0.37 0.22 0.18 0.52 0.80 0.32 0.10 0.44 0.52 0.43 0.09 0.06 0.35 0.05 0.10 0.13 0.17 0.06 0.04 0.00 0.12 0.17 0.12 0.00 0.03 0.07 0.30 0.38 0.65 Mal-Practice RVUs NA 13.52 NA 12.13 11.88 NA NA 0.00 6.21 7.12 2.29 NA NA 10.21 NA NA 9.59 NA NA NA 5.30 NA NA NA 4.50 3.32 NA 2.83 6.23 NA 9.97 2.89 1.53 0.00 4.30 5.06 5.47 0.00 2.70 3.41 11.39 NA NA Fully Implemented NonFacility Total NA 14.84 NA 13.47 12.95 NA NA 0.00 7.32 8.25 2.89 NA NA 11.67 NA NA 11.41 NA NA NA 6.09 NA NA NA 5.16 3.61 NA 2.92 6.35 NA 11.23 2.92 1.67 0.00 4.43 5.19 5.58 0.00 2.59 3.30 10.73 NA NA Year 2007 Transitional Non-Facility Total 16.53 10.51 14.82 9.07 9.37 15.01 9.64 0.00 3.03 3.91 2.23 22.11 22.17 6.97 15.69 6.32 6.02 21.26 26.30 13.80 3.83 17.40 17.76 18.02 3.35 2.73 14.39 2.47 5.51 4.71 5.93 2.66 1.41 0.00 2.85 3.78 3.40 0.00 1.25 1.58 8.09 9.57 21.07 Fully Implemented Facility Total 16.94 10.57 14.96 9.13 9.42 15.13 10.02 0.00 3.47 4.38 2.27 22.61 23.25 6.93 16.20 6.58 6.37 21.70 26.83 13.93 3.94 17.91 18.00 18.43 3.44 2.75 12.31 2.49 5.43 4.88 6.15 2.50 1.49 0.00 2.93 4.04 3.61 0.00 1.24 1.66 8.20 10.37 21.74 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 010 YYY 010 010 010 090 090 000 090 000 010 090 090 090 010 090 090 090 010 010 090 010 010 010 010 010 000 YYY 010 010 010 XXX 000 000 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69917 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00296 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A R A A C A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Remove ear canal lesion(s) ................................. Extensive ear canal surgery ................................ Extensive ear/neck surgery .................................. Clear outer ear canal ........................................... Clear outer ear canal ........................................... Remove impacted ear wax .................................. Clean out mastoid cavity ...................................... Clean out mastoid cavity ...................................... Revise external ear .............................................. Rebuild outer ear canal ........................................ Rebuild outer ear canal ........................................ Outer ear surgery procedure ............................... Inflate middle ear canal ........................................ Inflate middle ear canal ........................................ Catheterize middle ear canal ............................... Incision of eardrum .............................................. Incision of eardrum .............................................. Remove ventilating tube ...................................... Create eardrum opening ...................................... Create eardrum opening ...................................... Exploration of middle ear ..................................... Eardrum revision .................................................. Mastoidectomy ..................................................... Mastoidectomy ..................................................... Remove mastoid structures ................................. Extensive mastoid surgery ................................... Extensive mastoid surgery ................................... Remove part of temporal bone ............................ Remove ear lesion ............................................... Remove ear lesion ............................................... Remove ear lesion ............................................... Remove ear lesion ............................................... Mastoid surgery revision ...................................... Mastoid surgery revision ...................................... Mastoid surgery revision ...................................... Mastoid surgery revision ...................................... Mastoid surgery revision ...................................... Repair of eardrum ................................................ Repair of eardrum ................................................ Repair eardrum structures ................................... Rebuild eardrum structures .................................. Rebuild eardrum structures .................................. Repair eardrum structures ................................... Description 2.65 13.49 23.06 0.77 1.20 0.61 0.83 1.42 6.69 10.85 17.03 0.00 0.83 0.63 2.65 1.35 1.75 0.85 1.54 1.98 7.62 5.61 9.12 12.44 13.05 13.58 20.24 37.27 1.22 11.04 19.69 35.71 13.31 13.64 14.08 14.08 18.55 4.44 5.94 9.93 12.82 12.17 13.39 Physician Work RVUs 3 6.55 NA NA 2.03 NA 0.56 2.38 3.68 9.77 NA NA 0.00 2.61 1.47 3.41 3.06 NA 2.18 3.07 NA NA NA NA NA NA NA NA NA 3.63 NA NA NA NA NA NA NA NA 4.52 10.10 NA NA NA NA Fully Implemented NonFacility PE RVUs 5.97 NA NA 2.29 NA 0.61 2.37 3.81 5.61 NA NA 0.00 2.27 1.30 3.48 3.13 NA 2.18 3.09 NA NA NA NA NA NA NA NA NA 3.71 NA NA NA NA NA NA NA NA 5.29 10.87 NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 3.13 10.66 15.03 0.57 1.15 0.16 0.62 1.75 4.69 14.30 18.32 0.00 0.62 0.56 1.81 1.43 1.70 0.62 1.47 1.74 8.39 7.03 7.90 10.15 14.94 15.02 18.19 24.53 1.72 13.17 16.74 22.78 10.98 11.71 15.18 11.82 17.69 2.35 5.36 10.61 12.22 12.04 14.97 Fully Implemented Facility PE RVUs 3.26 12.72 18.41 0.56 1.31 0.21 0.70 1.98 4.34 15.79 20.96 0.00 0.66 0.63 2.19 1.55 2.05 0.67 1.60 2.15 8.68 7.03 8.73 11.23 16.63 16.86 20.77 30.10 1.91 14.44 19.69 28.44 12.25 12.85 17.57 13.22 20.14 3.04 6.06 11.05 13.16 12.80 16.30 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 69145 69150 69155 69200 69205 69210 69220 69222 69300 69310 69320 69399 69400 69401 69405 69420 69421 69424 69433 69436 69440 69450 69501 69502 69505 69511 69530 69535 69540 69550 69552 69554 69601 69602 69603 69604 69605 69610 69620 69631 69632 69633 69635 HCPCS 2 CPT 1/ 0.21 1.22 1.93 0.06 0.10 0.05 0.07 0.12 0.72 0.85 1.37 0.00 0.07 0.05 0.21 0.11 0.15 0.07 0.13 0.19 0.61 0.45 0.73 1.00 1.05 1.09 1.54 2.93 0.10 0.89 1.59 2.92 1.07 1.10 1.14 1.14 1.50 0.36 0.48 0.80 1.03 0.98 1.08 Mal-Practice RVUs 9.41 NA NA 2.86 NA 1.22 3.28 5.22 17.18 NA NA 0.00 3.51 2.15 6.27 4.52 NA 3.10 4.74 NA NA NA NA NA NA NA NA NA 4.95 NA NA NA NA NA NA NA NA 9.32 16.52 NA NA NA NA Fully Implemented NonFacility Total 8.83 NA NA 3.12 NA 1.27 3.27 5.35 13.02 NA NA 0.00 3.17 1.98 6.34 4.59 NA 3.10 4.76 NA NA NA NA NA NA NA NA NA 5.03 NA NA NA NA NA NA NA NA 10.09 17.29 NA NA NA NA Year 2007 Transitional Non-Facility Total 5.99 25.37 40.02 1.40 2.45 0.82 1.52 3.29 12.10 26.00 36.72 0.00 1.52 1.24 4.67 2.89 3.60 1.54 3.14 3.91 16.62 13.09 17.75 23.59 29.04 29.69 39.97 64.73 3.04 25.10 38.02 61.41 25.36 26.45 30.40 27.04 37.74 7.15 11.78 21.34 26.07 25.19 29.44 Fully Implemented Facility Total 6.12 27.43 43.40 1.39 2.61 0.87 1.60 3.52 11.75 27.49 39.36 0.00 1.56 1.31 5.05 3.01 3.95 1.59 3.27 4.32 16.91 13.09 18.58 24.67 30.73 31.53 42.55 70.30 3.23 26.37 40.97 67.07 26.63 27.59 32.79 28.44 40.19 7.84 12.48 21.78 27.01 25.95 30.77 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 000 010 000 000 010 YYY 090 090 YYY 000 000 010 010 010 000 010 010 090 090 090 090 090 090 090 090 010 090 090 090 090 090 090 090 090 010 090 090 090 090 090 Global 69918 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00297 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A N A A A A A A A A A C A A A A A A A A A A C A A A A Status Rebuild eardrum structures .................................. Rebuild eardrum structures .................................. Revise middle ear & mastoid ............................... Revise middle ear & mastoid ............................... Revise middle ear & mastoid ............................... Revise middle ear & mastoid ............................... Revise middle ear & mastoid ............................... Revise middle ear & mastoid ............................... Release middle ear bone ..................................... Revise middle ear bone ....................................... Revise middle ear bone ....................................... Revise middle ear bone ....................................... Repair middle ear structures ................................ Repair middle ear structures ................................ Remove mastoid air cells ..................................... Remove middle ear nerve .................................... Close mastoid fistula ............................................ Implant/replace hearing aid .................................. Remove/repair hearing aid ................................... Implant temple bone w/stimul .............................. Temple bne implnt w/stimulat .............................. Temple bone implant revision .............................. Revise temple bone implant ................................ Release facial nerve ............................................ Release facial nerve ............................................ Repair facial nerve ............................................... Repair facial nerve ............................................... Middle ear surgery procedure .............................. Incise inner ear .................................................... Incise inner ear .................................................... Explore inner ear .................................................. Explore inner ear .................................................. Establish inner ear window .................................. Revise inner ear window ...................................... Remove inner ear ................................................ Remove inner ear & mastoid ............................... Incise inner ear nerve .......................................... Implant cochlear device ....................................... Inner ear surgery procedure ................................ Incise inner ear nerve .......................................... Release facial nerve ............................................ Release inner ear canal ....................................... Remove inner ear lesion ...................................... Description 15.29 15.18 12.77 16.91 15.45 17.09 16.57 18.23 9.71 11.94 15.80 15.49 9.80 9.81 11.62 9.58 8.28 0.00 10.50 14.31 18.80 15.29 19.05 14.57 27.44 16.18 16.91 0.00 8.61 13.39 14.55 12.52 10.40 10.32 11.15 13.80 22.65 17.60 0.00 27.44 29.22 29.22 32.21 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 16.76 16.73 11.45 14.23 12.98 17.27 17.17 17.60 8.74 9.64 12.34 11.45 9.02 8.93 10.27 9.74 7.75 0.00 9.54 10.72 12.14 11.42 20.38 12.90 16.59 11.32 12.06 0.00 8.84 10.68 9.96 9.50 9.91 11.73 10.20 9.94 13.59 11.99 0.00 15.54 17.57 15.70 18.08 Fully Implemented Facility PE RVUs 18.67 18.60 12.45 15.77 14.36 19.62 19.31 19.97 9.62 10.80 14.11 13.18 9.73 9.72 11.35 10.50 8.87 0.00 10.48 12.18 14.31 13.71 16.57 14.12 19.25 12.89 14.24 0.00 9.31 11.91 11.40 10.66 10.89 12.81 11.06 11.43 15.74 14.06 0.00 18.06 20.43 18.96 21.97 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 69636 69637 69641 69642 69643 69644 69645 69646 69650 69660 69661 69662 69666 69667 69670 69676 69700 69710 69711 69714 69715 69717 69718 69720 69725 69740 69745 69799 69801 69802 69805 69806 69820 69840 69905 69910 69915 69930 69949 69950 69955 69960 69970 HCPCS 2 CPT 1/ 1.23 1.22 1.03 1.36 1.24 1.37 1.33 1.46 0.78 0.96 1.27 1.25 0.79 0.79 0.93 0.81 0.67 0.00 0.83 1.13 1.48 0.90 3.22 1.16 2.45 1.27 1.14 0.00 0.69 1.06 1.12 1.00 0.90 0.79 0.90 1.07 1.70 1.36 0.00 2.29 2.49 2.18 2.42 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA Year 2007 Transitional Non-Facility Total 33.28 33.13 25.25 32.50 29.67 35.73 35.07 37.29 19.23 22.54 29.41 28.19 19.61 19.53 22.82 20.13 16.70 0.00 20.87 26.16 32.42 27.61 42.65 28.63 46.48 28.77 30.11 0.00 18.14 25.13 25.63 23.02 21.21 22.84 22.25 24.81 37.94 30.95 0.00 45.27 49.28 47.10 52.71 Fully Implemented Facility Total 35.19 35.00 26.25 34.04 31.05 38.08 37.21 39.66 20.11 23.70 31.18 29.92 20.32 20.32 23.90 20.89 17.82 0.00 21.81 27.62 34.59 29.90 38.84 29.85 49.14 30.34 32.29 0.00 18.61 26.36 27.07 24.18 22.19 23.92 23.11 26.30 40.09 33.02 0.00 47.79 52.14 50.36 56.60 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 XXX 090 090 090 090 090 090 090 090 090 YYY 090 090 090 090 090 090 090 090 090 090 YYY 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69919 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00298 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 2 Copyright 3+ Mod C R A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C C A A A A A A Status Temporal bone surgery ........................................ Microsurgery add-on ............................................ Contrast x-ray of brain ......................................... Contrast x-ray of brain ......................................... Contrast x-ray of brain ......................................... Contrast x-ray of brain ......................................... Contrast x-ray of brain ......................................... Contrast x-ray of brain ......................................... X-ray eye for foreign body ................................... X-ray eye for foreign body ................................... X-ray eye for foreign body ................................... X-ray exam of jaw ................................................ X-ray exam of jaw ................................................ X-ray exam of jaw ................................................ X-ray exam of jaw ................................................ X-ray exam of jaw ................................................ X-ray exam of jaw ................................................ X-ray exam of mastoids ....................................... X-ray exam of mastoids ....................................... X-ray exam of mastoids ....................................... X-ray exam of mastoids ....................................... X-ray exam of mastoids ....................................... X-ray exam of mastoids ....................................... X-ray exam of middle ear .................................... X-ray exam of middle ear .................................... X-ray exam of middle ear .................................... X-ray exam of facial bones .................................. X-ray exam of facial bones .................................. X-ray exam of facial bones .................................. X-ray exam of facial bones .................................. X-ray exam of facial bones .................................. X-ray exam of facial bones .................................. X-ray exam of nasal bones .................................. X-ray exam of nasal bones .................................. X-ray exam of nasal bones .................................. X-ray exam of tear duct ....................................... X-ray exam of tear duct ....................................... X-ray exam of tear duct ....................................... X-ray exam of eye sockets .................................. X-ray exam of eye sockets .................................. X-ray exam of eye sockets .................................. X-ray exam of eye sockets .................................. X-ray exam of eye sockets .................................. Description 0.00 3.46 1.19 0.00 1.19 1.19 0.00 1.19 0.17 0.00 0.17 0.18 0.00 0.18 0.25 0.00 0.25 0.18 0.00 0.18 0.34 0.00 0.34 0.34 0.00 0.34 0.19 0.00 0.19 0.26 0.00 0.26 0.17 0.00 0.17 0.00 0.00 0.30 0.21 0.00 0.21 0.28 0.00 Physician Work RVUs 3 0.00 NA 2.61 2.27 0.34 2.68 2.33 0.35 0.57 0.52 0.05 0.59 0.55 0.04 0.75 0.68 0.07 0.66 0.61 0.05 1.10 1.00 0.10 0.88 0.78 0.10 0.51 0.47 0.04 0.80 0.73 0.07 0.65 0.61 0.04 NA NA 0.08 0.68 0.62 0.06 0.82 0.74 Fully Implemented NonFacility PE RVUs 0.00 NA 4.20 3.82 0.38 1.98 1.60 0.38 0.51 0.45 0.06 0.59 0.53 0.06 0.72 0.64 0.08 0.68 0.62 0.06 0.95 0.84 0.11 0.85 0.74 0.11 0.64 0.58 0.06 0.85 0.77 0.08 0.60 0.54 0.06 NA NA 0.10 0.69 0.62 0.07 0.86 0.77 Year 2007 Transitional Non-Facility PE RVUs 0.00 1.31 NA NA 0.34 NA NA 0.35 NA NA 0.05 NA NA 0.04 NA NA 0.07 NA NA 0.05 NA NA 0.10 NA NA 0.10 NA NA 0.04 NA NA 0.07 NA NA 0.04 NA NA 0.08 NA NA 0.06 NA NA Fully Implemented Facility PE RVUs 0.00 1.67 NA NA 0.38 NA NA 0.38 NA NA 0.06 NA NA 0.06 NA NA 0.08 NA NA 0.06 NA NA 0.11 NA NA 0.11 NA NA 0.06 NA NA 0.08 NA NA 0.06 NA NA 0.10 NA NA 0.07 NA NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 69979 69990 70010 70010 70010 70015 70015 70015 70030 70030 70030 70100 70100 70100 70110 70110 70110 70120 70120 70120 70130 70130 70130 70134 70134 70134 70140 70140 70140 70150 70150 70150 70160 70160 70160 70170 70170 70170 70190 70190 70190 70200 70200 HCPCS 2 CPT 1/ 0.00 0.89 0.27 0.22 0.05 0.16 0.08 0.08 0.03 0.02 0.01 0.03 0.02 0.01 0.05 0.04 0.01 0.05 0.04 0.01 0.07 0.05 0.02 0.07 0.05 0.02 0.05 0.04 0.01 0.06 0.05 0.01 0.03 0.02 0.01 0.00 0.00 0.01 0.05 0.04 0.01 0.06 0.05 Mal-Practice RVUs 0.00 NA 4.07 2.49 1.58 4.03 2.41 1.62 0.77 0.54 0.23 0.80 0.57 0.23 1.05 0.72 0.33 0.89 0.65 0.24 1.51 1.05 0.46 1.29 0.83 0.46 0.75 0.51 0.24 1.12 0.78 0.34 0.85 0.63 0.22 NA NA 0.39 0.94 0.66 0.28 1.16 0.79 Fully Implemented NonFacility Total 0.00 NA 5.66 4.04 1.62 3.33 1.68 1.65 0.71 0.47 0.24 0.80 0.55 0.25 1.02 0.68 0.34 0.91 0.66 0.25 1.36 0.89 0.47 1.26 0.79 0.47 0.88 0.62 0.26 1.17 0.82 0.35 0.80 0.56 0.24 NA NA 0.41 0.95 0.66 0.29 1.20 0.82 Year 2007 Transitional Non-Facility Total 0.00 5.66 NA NA 1.58 NA NA 1.62 NA NA 0.23 NA NA 0.23 NA NA 0.33 NA NA 0.24 NA NA 0.46 NA NA 0.46 NA NA 0.24 NA NA 0.34 NA NA 0.22 NA NA 0.39 NA NA 0.28 NA NA Fully Implemented Facility Total 0.00 6.02 NA NA 1.62 NA NA 1.65 NA NA 0.24 NA NA 0.25 NA NA 0.34 NA NA 0.25 NA NA 0.47 NA NA 0.47 NA NA 0.26 NA NA 0.35 NA NA 0.24 NA NA 0.41 NA NA 0.29 NA NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 YYY ZZZ XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69920 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00299 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status X-ray exam of eye sockets .................................. X-ray exam of sinuses ......................................... X-ray exam of sinuses ......................................... X-ray exam of sinuses ......................................... X-ray exam of sinuses ......................................... X-ray exam of sinuses ......................................... X-ray exam of sinuses ......................................... X-ray exam, pituitary saddle ................................ X-ray exam, pituitary saddle ................................ X-ray exam, pituitary saddle ................................ X-ray exam of skull .............................................. X-ray exam of skull .............................................. X-ray exam of skull .............................................. X-ray exam of skull .............................................. X-ray exam of skull .............................................. X-ray exam of skull .............................................. X-ray exam of teeth ............................................. X-ray exam of teeth ............................................. X-ray exam of teeth ............................................. X-ray exam of teeth ............................................. X-ray exam of teeth ............................................. X-ray exam of teeth ............................................. Full mouth x-ray of teeth ...................................... Full mouth x-ray of teeth ...................................... Full mouth x-ray of teeth ...................................... X-ray exam of jaw joint ........................................ X-ray exam of jaw joint ........................................ X-ray exam of jaw joint ........................................ X-ray exam of jaw joints ...................................... X-ray exam of jaw joints ...................................... X-ray exam of jaw joints ...................................... X-ray exam of jaw joint ........................................ X-ray exam of jaw joint ........................................ X-ray exam of jaw joint ........................................ Magnetic image, jaw joint .................................... Magnetic image, jaw joint .................................... Magnetic image, jaw joint .................................... X-ray head for orthodontia ................................... X-ray head for orthodontia ................................... X-ray head for orthodontia ................................... Panoramic x-ray of jaws ...................................... Panoramic x-ray of jaws ...................................... Panoramic x-ray of jaws ...................................... Description 0.28 0.17 0.00 0.17 0.25 0.00 0.25 0.19 0.00 0.19 0.24 0.00 0.24 0.34 0.00 0.34 0.10 0.00 0.10 0.16 0.00 0.16 0.22 0.00 0.22 0.18 0.00 0.18 0.24 0.00 0.24 0.54 0.00 0.54 1.48 0.00 1.48 0.17 0.00 0.17 0.20 0.00 0.20 Physician Work RVUs 3 0.08 0.55 0.51 0.04 0.69 0.62 0.07 0.58 0.53 0.05 0.66 0.60 0.06 0.83 0.74 0.09 0.24 0.21 0.03 0.82 0.77 0.05 0.96 0.90 0.06 0.59 0.54 0.05 0.96 0.89 0.07 1.42 1.26 0.16 11.62 11.20 0.42 0.32 0.27 0.05 0.29 0.23 0.06 Fully Implemented NonFacility PE RVUs 0.09 0.65 0.59 0.06 0.82 0.74 0.08 0.51 0.45 0.06 0.70 0.62 0.08 0.96 0.85 0.11 0.30 0.25 0.05 0.58 0.51 0.07 0.89 0.81 0.08 0.56 0.50 0.06 0.93 0.85 0.08 2.08 1.89 0.19 11.67 11.20 0.47 0.42 0.35 0.07 0.56 0.49 0.07 Year 2007 Transitional Non-Facility PE RVUs 0.08 NA NA 0.04 NA NA 0.07 NA NA 0.05 NA NA 0.06 NA NA 0.09 NA NA 0.03 NA NA 0.05 NA NA 0.06 NA NA 0.05 NA NA 0.07 NA NA 0.16 NA NA 0.42 NA NA 0.05 NA NA 0.06 Fully Implemented Facility PE RVUs 0.09 NA NA 0.06 NA NA 0.08 NA NA 0.06 NA NA 0.08 NA NA 0.11 NA NA 0.05 NA NA 0.07 NA NA 0.08 NA NA 0.06 NA NA 0.08 NA NA 0.19 NA NA 0.47 NA NA 0.07 NA NA 0.07 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 70200 70210 70210 70210 70220 70220 70220 70240 70240 70240 70250 70250 70250 70260 70260 70260 70300 70300 70300 70310 70310 70310 70320 70320 70320 70328 70328 70328 70330 70330 70330 70332 70332 70332 70336 70336 70336 70350 70350 70350 70355 70355 70355 HCPCS 2 CPT 1/ 0.01 0.05 0.04 0.01 0.06 0.05 0.01 0.03 0.02 0.01 0.05 0.04 0.01 0.08 0.06 0.02 0.03 0.02 0.01 0.03 0.02 0.01 0.06 0.05 0.01 0.03 0.02 0.01 0.06 0.05 0.01 0.14 0.12 0.02 0.66 0.59 0.07 0.03 0.02 0.01 0.05 0.04 0.01 Mal-Practice RVUs 0.37 0.77 0.55 0.22 1.00 0.67 0.33 0.80 0.55 0.25 0.95 0.64 0.31 1.25 0.80 0.45 0.37 0.23 0.14 1.01 0.79 0.22 1.24 0.95 0.29 0.80 0.56 0.24 1.26 0.94 0.32 2.10 1.38 0.72 13.76 11.79 1.97 0.52 0.29 0.23 0.54 0.27 0.27 Fully Implemented NonFacility Total 0.38 0.87 0.63 0.24 1.13 0.79 0.34 0.73 0.47 0.26 0.99 0.66 0.33 1.38 0.91 0.47 0.43 0.27 0.16 0.77 0.53 0.24 1.17 0.86 0.31 0.77 0.52 0.25 1.23 0.90 0.33 2.76 2.01 0.75 13.81 11.79 2.02 0.62 0.37 0.25 0.81 0.53 0.28 Year 2007 Transitional Non-Facility Total 0.37 NA NA 0.22 NA NA 0.33 NA NA 0.25 NA NA 0.31 NA NA 0.45 NA NA 0.14 NA NA 0.22 NA NA 0.29 NA NA 0.24 NA NA 0.32 NA NA 0.72 NA NA 1.97 NA NA 0.23 NA NA 0.27 Fully Implemented Facility Total 0.38 NA NA 0.24 NA NA 0.34 NA NA 0.26 NA NA 0.33 NA NA 0.47 NA NA 0.16 NA NA 0.24 NA NA 0.31 NA NA 0.25 NA NA 0.33 NA NA 0.75 NA NA 2.02 NA NA 0.25 NA NA 0.28 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69921 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00300 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status X-ray exam of neck .............................................. X-ray exam of neck .............................................. X-ray exam of neck .............................................. Throat x-ray & fluoroscopy ................................... Throat x-ray & fluoroscopy ................................... Throat x-ray & fluoroscopy ................................... Speech evaluation, complex ................................ Speech evaluation, complex ................................ Speech evaluation, complex ................................ Contrast x-ray of larynx ........................................ Contrast x-ray of larynx ........................................ Contrast x-ray of larynx ........................................ X-ray exam of salivary gland ............................... X-ray exam of salivary gland ............................... X-ray exam of salivary gland ............................... X-ray exam of salivary duct ................................. X-ray exam of salivary duct ................................. X-ray exam of salivary duct ................................. Ct head/brain w/o dye .......................................... Ct head/brain w/o dye .......................................... Ct head/brain w/o dye .......................................... Ct head/brain w/dye ............................................. Ct head/brain w/dye ............................................. Ct head/brain w/dye ............................................. Ct head/brain w/o & w/dye ................................... Ct head/brain w/o & w/dye ................................... Ct head/brain w/o & w/dye ................................... Ct orbit/ear/fossa w/o dye .................................... Ct orbit/ear/fossa w/o dye .................................... Ct orbit/ear/fossa w/o dye .................................... Ct orbit/ear/fossa w/dye ....................................... Ct orbit/ear/fossa w/dye ....................................... Ct orbit/ear/fossa w/dye ....................................... Ct orbit/ear/fossa w/o&w/dye ............................... Ct orbit/ear/fossa w/o&w/dye ............................... Ct orbit/ear/fossa w/o&w/dye ............................... Ct maxillofacial w/o dye ....................................... Ct maxillofacial w/o dye ....................................... Ct maxillofacial w/o dye ....................................... Ct maxillofacial w/dye .......................................... Ct maxillofacial w/dye .......................................... Ct maxillofacial w/dye .......................................... Ct maxillofacial w/o & w/dye ................................ Description 0.17 0.00 0.17 0.32 0.00 0.32 0.84 0.00 0.84 0.44 0.00 0.44 0.17 0.00 0.17 0.38 0.00 0.38 0.85 0.00 0.85 1.13 0.00 1.13 1.27 0.00 1.27 1.28 0.00 1.28 1.38 0.00 1.38 1.45 0.00 1.45 1.14 0.00 1.14 1.30 0.00 1.30 1.42 Physician Work RVUs 3 0.53 0.48 0.05 1.59 1.50 0.09 1.40 1.17 0.23 1.57 1.46 0.11 0.80 0.75 0.05 2.20 2.09 0.11 4.62 4.38 0.24 6.14 5.82 0.32 7.48 7.12 0.36 7.99 7.63 0.36 9.43 9.04 0.39 10.81 10.40 0.41 6.39 6.07 0.32 7.89 7.52 0.37 9.81 Fully Implemented NonFacility PE RVUs 0.50 0.44 0.06 1.46 1.36 0.10 2.14 1.87 0.27 1.83 1.70 0.13 0.75 0.69 0.06 1.98 1.86 0.12 4.91 4.64 0.27 6.06 5.70 0.36 7.49 7.08 0.41 5.86 5.45 0.41 6.95 6.51 0.44 8.36 7.90 0.46 5.42 5.06 0.36 6.55 6.13 0.42 8.11 Year 2007 Transitional Non-Facility PE RVUs NA NA 0.05 NA NA 0.09 NA NA 0.23 NA NA 0.11 NA NA 0.05 NA NA 0.11 NA NA 0.24 NA NA 0.32 NA NA 0.36 NA NA 0.36 NA NA 0.39 NA NA 0.41 NA NA 0.32 NA NA 0.37 NA Fully Implemented Facility PE RVUs NA NA 0.06 NA NA 0.10 NA NA 0.27 NA NA 0.13 NA NA 0.06 NA NA 0.12 NA NA 0.27 NA NA 0.36 NA NA 0.41 NA NA 0.41 NA NA 0.44 NA NA 0.46 NA NA 0.36 NA NA 0.42 NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 70360 70360 70360 70370 70370 70370 70371 70371 70371 70373 70373 70373 70380 70380 70380 70390 70390 70390 70450 70450 70450 70460 70460 70460 70470 70470 70470 70480 70480 70480 70481 70481 70481 70482 70482 70482 70486 70486 70486 70487 70487 70487 70488 HCPCS 2 CPT 1/ 0.03 0.02 0.01 0.08 0.07 0.01 0.16 0.12 0.04 0.13 0.11 0.02 0.05 0.04 0.01 0.13 0.11 0.02 0.29 0.25 0.04 0.35 0.30 0.05 0.43 0.37 0.06 0.31 0.25 0.06 0.36 0.30 0.06 0.43 0.37 0.06 0.30 0.25 0.05 0.36 0.30 0.06 0.43 Mal-Practice RVUs 0.73 0.50 0.23 1.99 1.57 0.42 2.40 1.29 1.11 2.14 1.57 0.57 1.02 0.79 0.23 2.71 2.20 0.51 5.76 4.63 1.13 7.62 6.12 1.50 9.18 7.49 1.69 9.58 7.88 1.70 11.17 9.34 1.83 12.69 10.77 1.92 7.83 6.32 1.51 9.55 7.82 1.73 11.66 Fully Implemented NonFacility Total 0.70 0.46 0.24 1.86 1.43 0.43 3.14 1.99 1.15 2.40 1.81 0.59 0.97 0.73 0.24 2.49 1.97 0.52 6.05 4.89 1.16 7.54 6.00 1.54 9.19 7.45 1.74 7.45 5.70 1.75 8.69 6.81 1.88 10.24 8.27 1.97 6.86 5.31 1.55 8.21 6.43 1.78 9.96 Year 2007 Transitional Non-Facility Total NA NA 0.23 NA NA 0.42 NA NA 1.11 NA NA 0.57 NA NA 0.23 NA NA 0.51 NA NA 1.13 NA NA 1.50 NA NA 1.69 NA NA 1.70 NA NA 1.83 NA NA 1.92 NA NA 1.51 NA NA 1.73 NA Fully Implemented Facility Total NA NA 0.24 NA NA 0.43 NA NA 1.15 NA NA 0.59 NA NA 0.24 NA NA 0.52 NA NA 1.16 NA NA 1.54 NA NA 1.74 NA NA 1.75 NA NA 1.88 NA NA 1.97 NA NA 1.55 NA NA 1.78 NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69922 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00301 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Ct maxillofacial w/o & w/dye ................................ Ct maxillofacial w/o & w/dye ................................ Ct soft tissue neck w/o dye .................................. Ct soft tissue neck w/o dye .................................. Ct soft tissue neck w/o dye .................................. Ct soft tissue neck w/dye ..................................... Ct soft tissue neck w/dye ..................................... Ct soft tissue neck w/dye ..................................... Ct sft tsue nck w/o & w/dye ................................. Ct sft tsue nck w/o & w/dye ................................. Ct sft tsue nck w/o & w/dye ................................. Ct angiography, head ........................................... Ct angiography, head ........................................... Ct angiography, head ........................................... Ct angiography, neck ........................................... Ct angiography, neck ........................................... Ct angiography, neck ........................................... Mri orbit/face/neck w/o dye .................................. Mri orbit/face/neck w/o dye .................................. Mri orbit/face/neck w/o dye .................................. Mri orbit/face/neck w/dye ..................................... Mri orbit/face/neck w/dye ..................................... Mri orbit/face/neck w/dye ..................................... Mri orbt/fac/nck w/o & w/dye ................................ Mri orbt/fac/nck w/o & w/dye ................................ Mri orbt/fac/nck w/o & w/dye ................................ Mr angiography head w/o dye ............................. Mr angiography head w/o dye ............................. Mr angiography head w/o dye ............................. Mr angiography head w/dye ................................ Mr angiography head w/dye ................................ Mr angiography head w/dye ................................ Mr angiograph head w/o&w/dye .......................... Mr angiograph head w/o&w/dye .......................... Mr angiograph head w/o&w/dye .......................... Mr angiography neck w/o dye .............................. Mr angiography neck w/o dye .............................. Mr angiography neck w/o dye .............................. Mr angiography neck w/dye ................................. Mr angiography neck w/dye ................................. Mr angiography neck w/dye ................................. Mr angiograph neck w/o&w/dye ........................... Mr angiograph neck w/o&w/dye ........................... Description 0.00 1.42 1.28 0.00 1.28 1.38 0.00 1.38 1.45 0.00 1.45 1.75 0.00 1.75 1.75 0.00 1.75 1.35 0.00 1.35 1.62 0.00 1.62 2.15 0.00 2.15 1.20 0.00 1.20 1.20 0.00 1.20 1.80 0.00 1.80 1.20 0.00 1.20 1.20 0.00 1.20 1.80 0.00 Physician Work RVUs 3 9.41 0.40 6.12 5.75 0.37 7.58 7.19 0.39 9.50 9.09 0.41 16.19 15.68 0.51 16.29 15.77 0.52 13.49 13.11 0.38 14.46 14.00 0.46 17.82 17.21 0.61 15.03 14.69 0.34 14.98 14.64 0.34 22.88 22.37 0.51 15.01 14.67 0.34 15.81 15.47 0.34 22.85 22.34 Fully Implemented NonFacility PE RVUs 7.66 0.45 5.39 4.98 0.41 6.48 6.04 0.44 8.04 7.58 0.46 12.43 11.87 0.56 12.45 11.89 0.56 12.11 11.68 0.43 14.09 13.58 0.51 23.65 22.96 0.69 12.46 12.07 0.39 12.44 12.06 0.38 22.97 22.40 0.57 12.45 12.07 0.38 12.65 12.27 0.38 22.96 22.39 Year 2007 Transitional Non-Facility PE RVUs NA 0.40 NA NA 0.37 NA NA 0.39 NA NA 0.41 NA NA 0.51 NA NA 0.52 NA NA 0.38 NA NA 0.46 NA NA 0.61 NA NA 0.34 NA NA 0.34 NA NA 0.51 NA NA 0.34 NA NA 0.34 NA NA Fully Implemented Facility PE RVUs NA 0.45 NA NA 0.41 NA NA 0.44 NA NA 0.46 NA NA 0.56 NA NA 0.56 NA NA 0.43 NA NA 0.51 NA NA 0.69 NA NA 0.39 NA NA 0.38 NA NA 0.57 NA NA 0.38 NA NA 0.38 NA NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 70488 70488 70490 70490 70490 70491 70491 70491 70492 70492 70492 70496 70496 70496 70498 70498 70498 70540 70540 70540 70542 70542 70542 70543 70543 70543 70544 70544 70544 70545 70545 70545 70546 70546 70546 70547 70547 70547 70548 70548 70548 70549 70549 HCPCS 2 CPT 1/ 0.37 0.06 0.31 0.25 0.06 0.36 0.30 0.06 0.43 0.37 0.06 0.66 0.58 0.08 0.66 0.58 0.08 0.45 0.39 0.06 0.54 0.47 0.07 0.94 0.84 0.10 0.64 0.59 0.05 0.64 0.59 0.05 0.67 0.59 0.08 0.64 0.59 0.05 0.64 0.59 0.05 0.67 0.59 Mal-Practice RVUs 9.78 1.88 7.71 6.00 1.71 9.32 7.49 1.83 11.38 9.46 1.92 18.60 16.26 2.34 18.70 16.35 2.35 15.29 13.50 1.79 16.62 14.47 2.15 20.91 18.05 2.86 16.87 15.28 1.59 16.82 15.23 1.59 25.35 22.96 2.39 16.85 15.26 1.59 17.65 16.06 1.59 25.32 22.93 Fully Implemented NonFacility Total 8.03 1.93 6.98 5.23 1.75 8.22 6.34 1.88 9.92 7.95 1.97 14.84 12.45 2.39 14.86 12.47 2.39 13.91 12.07 1.84 16.25 14.05 2.20 26.74 23.80 2.94 14.30 12.66 1.64 14.28 12.65 1.63 25.44 22.99 2.45 14.29 12.66 1.63 14.49 12.86 1.63 25.43 22.98 Year 2007 Transitional Non-Facility Total NA 1.88 NA NA 1.71 NA NA 1.83 NA NA 1.92 NA NA 2.34 NA NA 2.35 NA NA 1.79 NA NA 2.15 NA NA 2.86 NA NA 1.59 NA NA 1.59 NA NA 2.39 NA NA 1.59 NA NA 1.59 NA NA Fully Implemented Facility Total NA 1.93 NA NA 1.75 NA NA 1.88 NA NA 1.97 NA NA 2.39 NA NA 2.39 NA NA 1.84 NA NA 2.20 NA NA 2.94 NA NA 1.64 NA NA 1.63 NA NA 2.45 NA NA 1.63 NA NA 1.63 NA NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69923 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00302 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... 2 Copyright 3+ Mod A A A A A A A A A A A A A C C A C C A C C A C C A A A A A A A A A A A A A A A A A A A Status Mr angiograph neck w/o&w/dye ........................... Mri brain w/o dye ................................................. Mri brain w/o dye ................................................. Mri brain w/o dye ................................................. Mri brain w/dye ..................................................... Mri brain w/dye ..................................................... Mri brain w/dye ..................................................... Mri brain w/o & w/dye .......................................... Mri brain w/o & w/dye .......................................... Mri brain w/o & w/dye .......................................... Fmri brain by tech ................................................ Fmri brain by tech ................................................ Fmri brain by tech ................................................ Fmri brain by phys/psych ..................................... Fmri brain by phys/psych ..................................... Fmri brain by phys/psych ..................................... Mri brain w/o dye ................................................. Mri brain w/o dye ................................................. Mri brain w/o dye ................................................. Mri brain w/dye ..................................................... Mri brain w/dye ..................................................... Mri brain w/dye ..................................................... Mri brain w/o & w/dye .......................................... Mri brain w/o & w/dye .......................................... Mri brain w/o & w/dye .......................................... Chest x-ray ........................................................... Chest x-ray ........................................................... Chest x-ray ........................................................... Chest x-ray ........................................................... Chest x-ray ........................................................... Chest x-ray ........................................................... Chest x-ray ........................................................... Chest x-ray ........................................................... Chest x-ray ........................................................... Chest x-ray ........................................................... Chest x-ray ........................................................... Chest x-ray ........................................................... Chest x-ray ........................................................... Chest x-ray ........................................................... Chest x-ray ........................................................... Chest x-ray and fluoroscopy ................................ Chest x-ray and fluoroscopy ................................ Chest x-ray and fluoroscopy ................................ Description 1.80 1.48 0.00 1.48 1.78 0.00 1.78 2.36 0.00 2.36 2.11 0.00 2.11 0.00 0.00 2.54 0.00 0.00 2.90 0.00 0.00 3.20 0.00 0.00 3.20 0.18 0.00 0.18 0.21 0.00 0.21 0.22 0.00 0.22 0.27 0.00 0.27 0.31 0.00 0.31 0.38 0.00 0.38 Physician Work RVUs 3 0.51 13.72 13.30 0.42 14.76 14.26 0.50 17.15 16.48 0.67 13.49 12.89 0.60 NA 0.00 0.72 0.00 0.00 0.84 0.00 0.00 1.02 0.00 0.00 0.95 0.40 0.35 0.05 0.54 0.48 0.06 0.54 0.48 0.06 0.67 0.60 0.07 0.84 0.76 0.08 1.53 1.39 0.14 Fully Implemented NonFacility PE RVUs 0.57 12.20 11.73 0.47 14.22 13.65 0.57 23.53 22.78 0.75 13.49 12.89 0.60 NA 0.00 0.72 0.00 0.00 1.06 0.00 0.00 1.19 0.00 0.00 1.17 0.50 0.44 0.06 0.58 0.51 0.07 0.66 0.59 0.07 0.79 0.70 0.09 0.84 0.74 0.10 1.06 0.93 0.13 Year 2007 Transitional Non-Facility PE RVUs 0.51 NA NA 0.42 NA NA 0.50 NA NA 0.67 NA NA 0.60 NA 0.00 0.72 0.00 0.00 0.84 0.00 0.00 1.02 0.00 0.00 0.95 NA NA 0.05 NA NA 0.06 NA NA 0.06 NA NA 0.07 NA NA 0.08 NA NA 0.14 Fully Implemented Facility PE RVUs 0.57 NA NA 0.47 NA NA 0.57 NA NA 0.75 NA NA 0.60 NA 0.00 0.72 0.00 0.00 1.06 0.00 0.00 1.19 0.00 0.00 1.17 NA NA 0.06 NA NA 0.07 NA NA 0.07 NA NA 0.09 NA NA 0.10 NA NA 0.13 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 70549 70551 70551 70551 70552 70552 70552 70553 70553 70553 70554 70554 70554 70555 70555 70555 70557 70557 70557 70558 70558 70558 70559 70559 70559 71010 71010 71010 71015 71015 71015 71020 71020 71020 71021 71021 71021 71022 71022 71022 71023 71023 71023 HCPCS 2 CPT 1/ 0.08 0.66 0.59 0.07 0.78 0.70 0.08 1.41 1.31 0.10 0.92 0.82 0.10 0.00 0.00 0.11 0.00 0.00 0.08 0.00 0.00 0.10 0.00 0.00 0.12 0.03 0.02 0.01 0.03 0.02 0.01 0.05 0.04 0.01 0.06 0.05 0.01 0.06 0.05 0.01 0.06 0.05 0.01 Mal-Practice RVUs 2.39 15.86 13.89 1.97 17.32 14.96 2.36 20.92 17.79 3.13 16.52 13.71 2.81 NA 0.00 3.37 0.00 0.00 3.82 0.00 0.00 4.32 0.00 0.00 4.27 0.61 0.37 0.24 0.78 0.50 0.28 0.81 0.52 0.29 1.00 0.65 0.35 1.21 0.81 0.40 1.97 1.44 0.53 Fully Implemented NonFacility Total 2.45 14.34 12.32 2.02 16.78 14.35 2.43 27.30 24.09 3.21 16.52 13.71 2.81 NA 0.00 3.37 0.00 0.00 4.04 0.00 0.00 4.49 0.00 0.00 4.49 0.71 0.46 0.25 0.82 0.53 0.29 0.93 0.63 0.30 1.12 0.75 0.37 1.21 0.79 0.42 1.50 0.98 0.52 Year 2007 Transitional Non-Facility Total 2.39 NA NA 1.97 NA NA 2.36 NA NA 3.13 NA NA 2.81 NA 0.00 3.37 0.00 0.00 3.82 0.00 0.00 4.32 0.00 0.00 4.27 NA NA 0.24 NA NA 0.28 NA NA 0.29 NA NA 0.35 NA NA 0.40 NA NA 0.53 Fully Implemented Facility Total 2.45 NA NA 2.02 NA NA 2.43 NA NA 3.21 NA NA 2.81 NA 0.00 3.37 0.00 0.00 4.04 0.00 0.00 4.49 0.00 0.00 4.49 NA NA 0.25 NA NA 0.29 NA NA 0.30 NA NA 0.37 NA NA 0.42 NA NA 0.52 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69924 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00303 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A C C A A A A A A A A A A A A A A A A A A A A A A A A A A Status Chest x-ray ........................................................... Chest x-ray ........................................................... Chest x-ray ........................................................... Chest x-ray and fluoroscopy ................................ Chest x-ray and fluoroscopy ................................ Chest x-ray and fluoroscopy ................................ Chest x-ray ........................................................... Chest x-ray ........................................................... Chest x-ray ........................................................... Contrast x-ray of bronchi ..................................... Contrast x-ray of bronchi ..................................... Contrast x-ray of bronchi ..................................... Contrast x-ray of bronchi ..................................... Contrast x-ray of bronchi ..................................... Contrast x-ray of bronchi ..................................... X-ray & pacemaker insertion ............................... X-ray & pacemaker insertion ............................... X-ray & pacemaker insertion ............................... X-ray exam of ribs ................................................ X-ray exam of ribs ................................................ X-ray exam of ribs ................................................ X-ray exam of ribs/chest ...................................... X-ray exam of ribs/chest ...................................... X-ray exam of ribs/chest ...................................... X-ray exam of ribs ................................................ X-ray exam of ribs ................................................ X-ray exam of ribs ................................................ X-ray exam of ribs/chest ...................................... X-ray exam of ribs/chest ...................................... X-ray exam of ribs/chest ...................................... X-ray exam of breastbone ................................... X-ray exam of breastbone ................................... X-ray exam of breastbone ................................... X-ray exam of breastbone ................................... X-ray exam of breastbone ................................... X-ray exam of breastbone ................................... Ct thorax w/o dye ................................................. Ct thorax w/o dye ................................................. Ct thorax w/o dye ................................................. Ct thorax w/dye .................................................... Ct thorax w/dye .................................................... Ct thorax w/dye .................................................... Ct thorax w/o & w/dye .......................................... Description 0.31 0.00 0.31 0.46 0.00 0.46 0.18 0.00 0.18 0.58 0.00 0.58 0.74 0.00 0.74 0.00 0.00 0.54 0.22 0.00 0.22 0.27 0.00 0.27 0.27 0.00 0.27 0.32 0.00 0.32 0.20 0.00 0.20 0.22 0.00 0.22 1.16 0.00 1.16 1.24 0.00 1.24 1.38 Physician Work RVUs 3 0.87 0.78 0.09 1.96 1.79 0.17 0.72 0.67 0.05 1.99 1.84 0.15 2.91 2.70 0.21 NA NA 0.29 0.58 0.52 0.06 0.71 0.64 0.07 0.73 0.66 0.07 1.00 0.92 0.08 0.59 0.53 0.06 0.72 0.65 0.07 6.08 5.75 0.33 7.54 7.19 0.35 9.52 Fully Implemented NonFacility PE RVUs 0.88 0.78 0.10 1.69 1.53 0.16 0.62 0.56 0.06 1.74 1.56 0.18 2.56 2.33 0.23 NA NA 0.23 0.63 0.56 0.07 0.75 0.66 0.09 0.84 0.75 0.09 1.00 0.90 0.10 0.69 0.62 0.07 0.77 0.70 0.07 6.24 5.87 0.37 7.50 7.10 0.40 9.36 Year 2007 Transitional Non-Facility PE RVUs NA NA 0.09 NA NA 0.17 NA NA 0.05 NA NA 0.15 NA NA 0.21 NA NA 0.29 NA NA 0.06 NA NA 0.07 NA NA 0.07 NA NA 0.08 NA NA 0.06 NA NA 0.07 NA NA 0.33 NA NA 0.35 NA Fully Implemented Facility PE RVUs NA NA 0.10 NA NA 0.16 NA NA 0.06 NA NA 0.18 NA NA 0.23 NA NA 0.23 NA NA 0.07 NA NA 0.09 NA NA 0.09 NA NA 0.10 NA NA 0.07 NA NA 0.07 NA NA 0.37 NA NA 0.40 NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 71030 71030 71030 71034 71034 71034 71035 71035 71035 71040 71040 71040 71060 71060 71060 71090 71090 71090 71100 71100 71100 71101 71101 71101 71110 71110 71110 71111 71111 71111 71120 71120 71120 71130 71130 71130 71250 71250 71250 71260 71260 71260 71270 HCPCS 2 CPT 1/ 0.06 0.05 0.01 0.10 0.08 0.02 0.03 0.02 0.01 0.11 0.08 0.03 0.16 0.13 0.03 0.00 0.00 0.02 0.05 0.04 0.01 0.05 0.04 0.01 0.06 0.05 0.01 0.07 0.06 0.01 0.05 0.04 0.01 0.05 0.04 0.01 0.36 0.31 0.05 0.42 0.37 0.05 0.52 Mal-Practice RVUs 1.24 0.83 0.41 2.52 1.87 0.65 0.93 0.69 0.24 2.68 1.92 0.76 3.81 2.83 0.98 NA NA 0.85 0.85 0.56 0.29 1.03 0.68 0.35 1.06 0.71 0.35 1.39 0.98 0.41 0.84 0.57 0.27 0.99 0.69 0.30 7.60 6.06 1.54 9.20 7.56 1.64 11.42 Fully Implemented NonFacility Total 1.25 0.83 0.42 2.25 1.61 0.64 0.83 0.58 0.25 2.43 1.64 0.79 3.46 2.46 1.00 NA NA 0.79 0.90 0.60 0.30 1.07 0.70 0.37 1.17 0.80 0.37 1.39 0.96 0.43 0.94 0.66 0.28 1.04 0.74 0.30 7.76 6.18 1.58 9.16 7.47 1.69 11.26 Year 2007 Transitional Non-Facility Total NA NA 0.41 NA NA 0.65 NA NA 0.24 NA NA 0.76 NA NA 0.98 NA NA 0.85 NA NA 0.29 NA NA 0.35 NA NA 0.35 NA NA 0.41 NA NA 0.27 NA NA 0.30 NA NA 1.54 NA NA 1.64 NA Fully Implemented Facility Total NA NA 0.42 NA NA 0.64 NA NA 0.25 NA NA 0.79 NA NA 1.00 NA NA 0.79 NA NA 0.30 NA NA 0.37 NA NA 0.37 NA NA 0.43 NA NA 0.28 NA NA 0.30 NA NA 1.58 NA NA 1.69 NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69925 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00304 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 2 Copyright 3+ Mod A A A A A A A A A A A A A A R R R A A A A A A A A A A A A A A A A A A A A A A A A A A Status Ct thorax w/o & w/dye .......................................... Ct thorax w/o & w/dye .......................................... Ct angiography, chest .......................................... Ct angiography, chest .......................................... Ct angiography, chest .......................................... Mri chest w/o dye ................................................. Mri chest w/o dye ................................................. Mri chest w/o dye ................................................. Mri chest w/dye .................................................... Mri chest w/dye .................................................... Mri chest w/dye .................................................... Mri chest w/o & w/dye .......................................... Mri chest w/o & w/dye .......................................... Mri chest w/o & w/dye .......................................... Mri angio chest w or w/o dye ............................... Mri angio chest w or w/o dye ............................... Mri angio chest w or w/o dye ............................... X-ray exam of spine ............................................. X-ray exam of spine ............................................. X-ray exam of spine ............................................. X-ray exam of spine ............................................. X-ray exam of spine ............................................. X-ray exam of spine ............................................. X-ray exam of neck spine .................................... X-ray exam of neck spine .................................... X-ray exam of neck spine .................................... X-ray exam of neck spine .................................... X-ray exam of neck spine .................................... X-ray exam of neck spine .................................... X-ray exam of neck spine .................................... X-ray exam of neck spine .................................... X-ray exam of neck spine .................................... X-ray exam of trunk spine .................................... X-ray exam of trunk spine .................................... X-ray exam of trunk spine .................................... X-ray exam of thoracic spine ............................... X-ray exam of thoracic spine ............................... X-ray exam of thoracic spine ............................... X-ray exam of thoracic spine ............................... X-ray exam of thoracic spine ............................... X-ray exam of thoracic spine ............................... X-ray exam of thoracic spine ............................... X-ray exam of thoracic spine ............................... Description 0.00 1.38 1.92 0.00 1.92 1.46 0.00 1.46 1.73 0.00 1.73 2.26 0.00 2.26 1.81 0.00 1.81 0.45 0.00 0.45 0.15 0.00 0.15 0.22 0.00 0.22 0.31 0.00 0.31 0.36 0.00 0.36 0.22 0.00 0.22 0.22 0.00 0.22 0.22 0.00 0.22 0.22 0.00 Physician Work RVUs 3 9.13 0.39 11.10 10.54 0.56 15.58 15.17 0.41 17.01 16.51 0.50 21.36 20.71 0.65 14.67 14.11 0.56 1.40 1.28 0.12 0.43 0.39 0.04 0.73 0.67 0.06 1.01 0.92 0.09 1.31 1.21 0.10 0.73 0.66 0.07 0.60 0.54 0.06 0.72 0.66 0.06 0.89 0.83 Fully Implemented NonFacility PE RVUs 8.92 0.44 12.53 11.92 0.61 12.65 12.19 0.46 14.76 14.21 0.55 24.56 23.84 0.72 12.52 11.93 0.59 1.23 1.09 0.14 0.46 0.41 0.05 0.69 0.62 0.07 1.00 0.90 0.10 1.27 1.15 0.12 0.61 0.53 0.08 0.69 0.62 0.07 0.78 0.71 0.07 0.96 0.89 Year 2007 Transitional Non-Facility PE RVUs NA 0.39 NA NA 0.56 NA NA 0.41 NA NA 0.50 NA NA 0.65 NA NA 0.56 NA NA 0.12 NA NA 0.04 NA NA 0.06 NA NA 0.09 NA NA 0.10 NA NA 0.07 NA NA 0.06 NA NA 0.06 NA NA Fully Implemented Facility PE RVUs NA 0.44 NA NA 0.61 NA NA 0.46 NA NA 0.55 NA NA 0.72 NA NA 0.59 NA NA 0.14 NA NA 0.05 NA NA 0.07 NA NA 0.10 NA NA 0.12 NA NA 0.08 NA NA 0.07 NA NA 0.07 NA NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 71270 71270 71275 71275 71275 71550 71550 71550 71551 71551 71551 71552 71552 71552 71555 71555 71555 72010 72010 72010 72020 72020 72020 72040 72040 72040 72050 72050 72050 72052 72052 72052 72069 72069 72069 72070 72070 72070 72072 72072 72072 72074 72074 HCPCS 2 CPT 1/ 0.46 0.06 0.48 0.39 0.09 0.51 0.45 0.06 0.60 0.52 0.08 0.78 0.68 0.10 0.67 0.59 0.08 0.08 0.06 0.02 0.03 0.02 0.01 0.05 0.04 0.01 0.07 0.06 0.01 0.08 0.06 0.02 0.03 0.02 0.01 0.05 0.04 0.01 0.06 0.05 0.01 0.07 0.06 Mal-Practice RVUs 9.59 1.83 13.50 10.93 2.57 17.55 15.62 1.93 19.34 17.03 2.31 24.40 21.39 3.01 17.15 14.70 2.45 1.93 1.34 0.59 0.61 0.41 0.20 1.00 0.71 0.29 1.39 0.98 0.41 1.75 1.27 0.48 0.98 0.68 0.30 0.87 0.58 0.29 1.00 0.71 0.29 1.18 0.89 Fully Implemented NonFacility Total 9.38 1.88 14.93 12.31 2.62 14.62 12.64 1.98 17.09 14.73 2.36 27.60 24.52 3.08 15.00 12.52 2.48 1.76 1.15 0.61 0.64 0.43 0.21 0.96 0.66 0.30 1.38 0.96 0.42 1.71 1.21 0.50 0.86 0.55 0.31 0.96 0.66 0.30 1.06 0.76 0.30 1.25 0.95 Year 2007 Transitional Non-Facility Total NA 1.83 NA NA 2.57 NA NA 1.93 NA NA 2.31 NA NA 3.01 NA NA 2.45 NA NA 0.59 NA NA 0.20 NA NA 0.29 NA NA 0.41 NA NA 0.48 NA NA 0.30 NA NA 0.29 NA NA 0.29 NA NA Fully Implemented Facility Total NA 1.88 NA NA 2.62 NA NA 1.98 NA NA 2.36 NA NA 3.08 NA NA 2.48 NA NA 0.61 NA NA 0.21 NA NA 0.30 NA NA 0.42 NA NA 0.50 NA NA 0.31 NA NA 0.30 NA NA 0.30 NA NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69926 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00305 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status X-ray exam of thoracic spine ............................... X-ray exam of trunk spine .................................... X-ray exam of trunk spine .................................... X-ray exam of trunk spine .................................... X-ray exam of trunk spine .................................... X-ray exam of trunk spine .................................... X-ray exam of trunk spine .................................... X-ray exam of lower spine ................................... X-ray exam of lower spine ................................... X-ray exam of lower spine ................................... X-ray exam of lower spine ................................... X-ray exam of lower spine ................................... X-ray exam of lower spine ................................... X-ray exam of lower spine ................................... X-ray exam of lower spine ................................... X-ray exam of lower spine ................................... X-ray exam of lower spine ................................... X-ray exam of lower spine ................................... X-ray exam of lower spine ................................... Ct neck spine w/o dye ......................................... Ct neck spine w/o dye ......................................... Ct neck spine w/o dye ......................................... Ct neck spine w/dye ............................................. Ct neck spine w/dye ............................................. Ct neck spine w/dye ............................................. Ct neck spine w/o & w/dye .................................. Ct neck spine w/o & w/dye .................................. Ct neck spine w/o & w/dye .................................. Ct chest spine w/o dye ........................................ Ct chest spine w/o dye ........................................ Ct chest spine w/o dye ........................................ Ct chest spine w/dye ............................................ Ct chest spine w/dye ............................................ Ct chest spine w/dye ............................................ Ct chest spine w/o & w/dye ................................. Ct chest spine w/o & w/dye ................................. Ct chest spine w/o & w/dye ................................. Ct lumbar spine w/o dye ...................................... Ct lumbar spine w/o dye ...................................... Ct lumbar spine w/o dye ...................................... Ct lumbar spine w/dye ......................................... Ct lumbar spine w/dye ......................................... Ct lumbar spine w/dye ......................................... Description 0.22 0.22 0.00 0.22 0.28 0.00 0.28 0.22 0.00 0.22 0.31 0.00 0.31 0.36 0.00 0.36 0.22 0.00 0.22 1.16 0.00 1.16 1.22 0.00 1.22 1.27 0.00 1.27 1.16 0.00 1.16 1.22 0.00 1.22 1.27 0.00 1.27 1.16 0.00 1.16 1.22 0.00 1.22 Physician Work RVUs 3 0.06 0.67 0.60 0.07 0.97 0.88 0.09 0.78 0.71 0.07 1.08 0.99 0.09 1.49 1.38 0.11 1.03 0.96 0.07 6.08 5.75 0.33 7.54 7.19 0.35 9.36 9.00 0.36 6.08 5.75 0.33 7.54 7.19 0.35 9.31 8.95 0.36 6.07 5.74 0.33 7.52 7.17 0.35 Fully Implemented NonFacility PE RVUs 0.07 0.72 0.65 0.07 0.81 0.72 0.09 0.75 0.68 0.07 1.03 0.93 0.10 1.36 1.24 0.12 0.98 0.91 0.07 6.24 5.87 0.37 7.49 7.10 0.39 9.30 8.89 0.41 6.24 5.87 0.37 7.49 7.10 0.39 9.29 8.88 0.41 6.24 5.87 0.37 7.49 7.10 0.39 Year 2007 Transitional Non-Facility PE RVUs 0.06 NA NA 0.07 NA NA 0.09 NA NA 0.07 NA NA 0.09 NA NA 0.11 NA NA 0.07 NA NA 0.33 NA NA 0.35 NA NA 0.36 NA NA 0.33 NA NA 0.35 NA NA 0.36 NA NA 0.33 NA NA 0.35 Fully Implemented Facility PE RVUs 0.07 NA NA 0.07 NA NA 0.09 NA NA 0.07 NA NA 0.10 NA NA 0.12 NA NA 0.07 NA NA 0.37 NA NA 0.39 NA NA 0.41 NA NA 0.37 NA NA 0.39 NA NA 0.41 NA NA 0.37 NA NA 0.39 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 72074 72080 72080 72080 72090 72090 72090 72100 72100 72100 72110 72110 72110 72114 72114 72114 72120 72120 72120 72125 72125 72125 72126 72126 72126 72127 72127 72127 72128 72128 72128 72129 72129 72129 72130 72130 72130 72131 72131 72131 72132 72132 72132 HCPCS 2 CPT 1/ 0.01 0.05 0.04 0.01 0.05 0.04 0.01 0.05 0.04 0.01 0.07 0.06 0.01 0.08 0.06 0.02 0.07 0.06 0.01 0.36 0.31 0.05 0.42 0.37 0.05 0.52 0.46 0.06 0.36 0.31 0.05 0.42 0.37 0.05 0.52 0.46 0.06 0.36 0.31 0.05 0.42 0.37 0.05 Mal-Practice RVUs 0.29 0.94 0.64 0.30 1.30 0.92 0.38 1.05 0.75 0.30 1.46 1.05 0.41 1.93 1.44 0.49 1.32 1.02 0.30 7.60 6.06 1.54 9.18 7.56 1.62 11.15 9.46 1.69 7.60 6.06 1.54 9.18 7.56 1.62 11.10 9.41 1.69 7.59 6.05 1.54 9.16 7.54 1.62 Fully Implemented NonFacility Total 0.30 0.99 0.69 0.30 1.14 0.76 0.38 1.02 0.72 0.30 1.41 0.99 0.42 1.80 1.30 0.50 1.27 0.97 0.30 7.76 6.18 1.58 9.13 7.47 1.66 11.09 9.35 1.74 7.76 6.18 1.58 9.13 7.47 1.66 11.08 9.34 1.74 7.76 6.18 1.58 9.13 7.47 1.66 Year 2007 Transitional Non-Facility Total 0.29 NA NA 0.30 NA NA 0.38 NA NA 0.30 NA NA 0.41 NA NA 0.49 NA NA 0.30 NA NA 1.54 NA NA 1.62 NA NA 1.69 NA NA 1.54 NA NA 1.62 NA NA 1.69 NA NA 1.54 NA NA 1.62 Fully Implemented Facility Total 0.30 NA NA 0.30 NA NA 0.38 NA NA 0.30 NA NA 0.42 NA NA 0.50 NA NA 0.30 NA NA 1.58 NA NA 1.66 NA NA 1.74 NA NA 1.58 NA NA 1.66 NA NA 1.74 NA NA 1.58 NA NA 1.66 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69927 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00306 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A N N N A A A A A A A A A A Status Ct lumbar spine w/o & w/dye ............................... Ct lumbar spine w/o & w/dye ............................... Ct lumbar spine w/o & w/dye ............................... Mri neck spine w/o dye ........................................ Mri neck spine w/o dye ........................................ Mri neck spine w/o dye ........................................ Mri neck spine w/dye ........................................... Mri neck spine w/dye ........................................... Mri neck spine w/dye ........................................... Mri chest spine w/o dye ....................................... Mri chest spine w/o dye ....................................... Mri chest spine w/o dye ....................................... Mri chest spine w/dye .......................................... Mri chest spine w/dye .......................................... Mri chest spine w/dye .......................................... Mri lumbar spine w/o dye ..................................... Mri lumbar spine w/o dye ..................................... Mri lumbar spine w/o dye ..................................... Mri lumbar spine w/dye ........................................ Mri lumbar spine w/dye ........................................ Mri lumbar spine w/dye ........................................ Mri neck spine w/o & w/dye ................................. Mri neck spine w/o & w/dye ................................. Mri neck spine w/o & w/dye ................................. Mri chest spine w/o & w/dye ................................ Mri chest spine w/o & w/dye ................................ Mri chest spine w/o & w/dye ................................ Mri lumbar spine w/o & w/dye ............................. Mri lumbar spine w/o & w/dye ............................. Mri lumbar spine w/o & w/dye ............................. Mr angio spine w/o&w/dye ................................... Mr angio spine w/o&w/dye ................................... Mr angio spine w/o&w/dye ................................... X-ray exam of pelvis ............................................ X-ray exam of pelvis ............................................ X-ray exam of pelvis ............................................ X-ray exam of pelvis ............................................ X-ray exam of pelvis ............................................ X-ray exam of pelvis ............................................ Ct angiograph pelv w/o&w/dye ............................ Ct angiograph pelv w/o&w/dye ............................ Ct angiograph pelv w/o&w/dye ............................ Ct pelvis w/o dye .................................................. Description 1.27 0.00 1.27 1.60 0.00 1.60 1.92 0.00 1.92 1.60 0.00 1.60 1.92 0.00 1.92 1.48 0.00 1.48 1.78 0.00 1.78 2.57 0.00 2.57 2.57 0.00 2.57 2.36 0.00 2.36 1.80 0.00 1.80 0.17 0.00 0.17 0.21 0.00 0.21 1.81 0.00 1.81 1.09 Physician Work RVUs 3 9.54 9.18 0.36 11.86 11.40 0.46 14.80 14.25 0.55 11.87 11.41 0.46 12.81 12.27 0.54 11.84 11.41 0.43 14.77 14.26 0.51 16.87 16.14 0.73 15.34 14.61 0.73 16.81 16.14 0.67 14.49 14.07 0.42 0.47 0.42 0.05 0.81 0.74 0.07 10.72 10.19 0.53 5.67 Fully Implemented NonFacility PE RVUs 9.34 8.93 0.41 11.76 11.25 0.51 14.26 13.64 0.62 12.69 12.18 0.51 13.76 13.15 0.61 12.66 12.18 0.48 14.23 13.65 0.58 23.52 22.70 0.82 23.12 22.31 0.81 23.45 22.70 0.75 13.31 12.69 0.62 0.56 0.50 0.06 0.76 0.69 0.07 12.15 11.57 0.58 6.12 Year 2007 Transitional Non-Facility PE RVUs NA NA 0.36 NA NA 0.46 NA NA 0.55 NA NA 0.46 NA NA 0.54 NA NA 0.43 NA NA 0.51 NA NA 0.73 NA NA 0.73 NA NA 0.67 NA NA 0.42 NA NA 0.05 NA NA 0.07 NA NA 0.53 NA Fully Implemented Facility PE RVUs NA NA 0.41 NA NA 0.51 NA NA 0.62 NA NA 0.51 NA NA 0.61 NA NA 0.48 NA NA 0.58 NA NA 0.82 NA NA 0.81 NA NA 0.75 NA NA 0.62 NA NA 0.06 NA NA 0.07 NA NA 0.58 NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 72133 72133 72133 72141 72141 72141 72142 72142 72142 72146 72146 72146 72147 72147 72147 72148 72148 72148 72149 72149 72149 72156 72156 72156 72157 72157 72157 72158 72158 72158 72159 72159 72159 72170 72170 72170 72190 72190 72190 72191 72191 72191 72192 HCPCS 2 CPT 1/ 0.52 0.46 0.06 0.66 0.59 0.07 0.79 0.70 0.09 0.71 0.64 0.07 0.79 0.70 0.09 0.71 0.64 0.07 0.78 0.70 0.08 1.42 1.31 0.11 1.42 1.31 0.11 1.41 1.31 0.10 0.74 0.64 0.10 0.03 0.02 0.01 0.05 0.04 0.01 0.47 0.39 0.08 0.36 Mal-Practice RVUs 11.33 9.64 1.69 14.12 11.99 2.13 17.51 14.95 2.56 14.18 12.05 2.13 15.52 12.97 2.55 14.03 12.05 1.98 17.33 14.96 2.37 20.86 17.45 3.41 19.33 15.92 3.41 20.58 17.45 3.13 17.03 14.71 2.32 0.67 0.44 0.23 1.07 0.78 0.29 13.00 10.58 2.42 7.12 Fully Implemented NonFacility Total 11.13 9.39 1.74 14.02 11.84 2.18 16.97 14.34 2.63 15.00 12.82 2.18 16.47 13.85 2.62 14.85 12.82 2.03 16.79 14.35 2.44 27.51 24.01 3.50 27.11 23.62 3.49 27.22 24.01 3.21 15.85 13.33 2.52 0.76 0.52 0.24 1.02 0.73 0.29 14.43 11.96 2.47 7.57 Year 2007 Transitional Non-Facility Total NA NA 1.69 NA NA 2.13 NA NA 2.56 NA NA 2.13 NA NA 2.55 NA NA 1.98 NA NA 2.37 NA NA 3.41 NA NA 3.41 NA NA 3.13 NA NA 2.32 NA NA 0.23 NA NA 0.29 NA NA 2.42 NA Fully Implemented Facility Total NA NA 1.74 NA NA 2.18 NA NA 2.63 NA NA 2.18 NA NA 2.62 NA NA 2.03 NA NA 2.44 NA NA 3.50 NA NA 3.49 NA NA 3.21 NA NA 2.52 NA NA 0.24 NA NA 0.29 NA NA 2.47 NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69928 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00307 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Ct pelvis w/o dye .................................................. Ct pelvis w/o dye .................................................. Ct pelvis w/dye ..................................................... Ct pelvis w/dye ..................................................... Ct pelvis w/dye ..................................................... Ct pelvis w/o & w/dye .......................................... Ct pelvis w/o & w/dye .......................................... Ct pelvis w/o & w/dye .......................................... Mri pelvis w/o dye ................................................ Mri pelvis w/o dye ................................................ Mri pelvis w/o dye ................................................ Mri pelvis w/dye ................................................... Mri pelvis w/dye ................................................... Mri pelvis w/dye ................................................... Mri pelvis w/o & w/dye ......................................... Mri pelvis w/o & w/dye ......................................... Mri pelvis w/o & w/dye ......................................... Mr angio pelvis w/o & w/dye ................................ Mr angio pelvis w/o & w/dye ................................ Mr angio pelvis w/o & w/dye ................................ X-ray exam sacroiliac joints ................................. X-ray exam sacroiliac joints ................................. X-ray exam sacroiliac joints ................................. X-ray exam sacroiliac joints ................................. X-ray exam sacroiliac joints ................................. X-ray exam sacroiliac joints ................................. X-ray exam of tailbone ......................................... X-ray exam of tailbone ......................................... X-ray exam of tailbone ......................................... Contrast x-ray of neck spine ................................ Contrast x-ray of neck spine ................................ Contrast x-ray of neck spine ................................ Contrast x-ray, thorax spine ................................. Contrast x-ray, thorax spine ................................. Contrast x-ray, thorax spine ................................. Contrast x-ray, lower spine .................................. Contrast x-ray, lower spine .................................. Contrast x-ray, lower spine .................................. Contrast x-ray, spine ............................................ Contrast x-ray, spine ............................................ Contrast x-ray, spine ............................................ Epidurography ...................................................... Epidurography ...................................................... Description 0.00 1.09 1.16 0.00 1.16 1.22 0.00 1.22 1.46 0.00 1.46 1.73 0.00 1.73 2.26 0.00 2.26 1.80 0.00 1.80 0.17 0.00 0.17 0.19 0.00 0.19 0.17 0.00 0.17 0.91 0.00 0.91 0.91 0.00 0.91 0.83 0.00 0.83 1.33 0.00 1.33 0.76 0.00 Physician Work RVUs 3 5.36 0.31 7.11 6.78 0.33 9.56 9.21 0.35 13.71 13.29 0.42 14.67 14.18 0.49 17.96 17.32 0.64 14.29 13.77 0.52 0.57 0.52 0.05 0.69 0.64 0.05 0.54 0.50 0.04 2.37 2.12 0.25 2.13 1.89 0.24 2.34 2.11 0.23 3.69 3.31 0.38 1.67 1.48 Fully Implemented NonFacility PE RVUs 5.77 0.35 7.20 6.83 0.37 9.06 8.67 0.39 12.19 11.72 0.47 14.18 13.63 0.55 23.71 22.99 0.72 12.41 11.84 0.57 0.58 0.52 0.06 0.69 0.63 0.06 0.61 0.55 0.06 4.37 4.09 0.28 3.98 3.72 0.26 3.83 3.58 0.25 5.81 5.40 0.41 2.15 1.95 Year 2007 Transitional Non-Facility PE RVUs NA 0.31 NA NA 0.33 NA NA 0.35 NA NA 0.42 NA NA 0.49 NA NA 0.64 NA NA 0.52 NA NA 0.05 NA NA 0.05 NA NA 0.04 NA NA 0.25 NA NA 0.24 NA NA 0.23 NA NA 0.38 NA NA Fully Implemented Facility PE RVUs NA 0.35 NA NA 0.37 NA NA 0.39 NA NA 0.47 NA NA 0.55 NA NA 0.72 NA NA 0.57 NA NA 0.06 NA NA 0.06 NA NA 0.06 NA NA 0.28 NA NA 0.26 NA NA 0.25 NA NA 0.41 NA NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 72192 72192 72193 72193 72193 72194 72194 72194 72195 72195 72195 72196 72196 72196 72197 72197 72197 72198 72198 72198 72200 72200 72200 72202 72202 72202 72220 72220 72220 72240 72240 72240 72255 72255 72255 72265 72265 72265 72270 72270 72270 72275 72275 HCPCS 2 CPT 1/ 0.31 0.05 0.41 0.36 0.05 0.48 0.43 0.05 0.51 0.45 0.06 0.60 0.52 0.08 1.02 0.92 0.10 0.67 0.59 0.08 0.03 0.02 0.01 0.05 0.04 0.01 0.05 0.04 0.01 0.29 0.25 0.04 0.26 0.22 0.04 0.26 0.22 0.04 0.39 0.33 0.06 0.26 0.22 Mal-Practice RVUs 5.67 1.45 8.68 7.14 1.54 11.26 9.64 1.62 15.68 13.74 1.94 17.00 14.70 2.30 21.24 18.24 3.00 16.76 14.36 2.40 0.77 0.54 0.23 0.93 0.68 0.25 0.76 0.54 0.22 3.57 2.37 1.20 3.30 2.11 1.19 3.43 2.33 1.10 5.41 3.64 1.77 2.69 1.70 Fully Implemented NonFacility Total 6.08 1.49 8.77 7.19 1.58 10.76 9.10 1.66 14.16 12.17 1.99 16.51 14.15 2.36 26.99 23.91 3.08 14.88 12.43 2.45 0.78 0.54 0.24 0.93 0.67 0.26 0.83 0.59 0.24 5.57 4.34 1.23 5.15 3.94 1.21 4.92 3.80 1.12 7.53 5.73 1.80 3.17 2.17 Year 2007 Transitional Non-Facility Total NA 1.45 NA NA 1.54 NA NA 1.62 NA NA 1.94 NA NA 2.30 NA NA 3.00 NA NA 2.40 NA NA 0.23 NA NA 0.25 NA NA 0.22 NA NA 1.20 NA NA 1.19 NA NA 1.10 NA NA 1.77 NA NA Fully Implemented Facility Total NA 1.49 NA NA 1.58 NA NA 1.66 NA NA 1.99 NA NA 2.36 NA NA 3.08 NA NA 2.45 NA NA 0.24 NA NA 0.26 NA NA 0.24 NA NA 1.23 NA NA 1.21 NA NA 1.12 NA NA 1.80 NA NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69929 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00308 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... 2 Copyright 3+ Mod A A A A C C A C C A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Epidurography ...................................................... X-ray c/t spine disk .............................................. X-ray c/t spine disk .............................................. X-ray c/t spine disk .............................................. Perq vertebroplasty, fluor ..................................... Perq vertebroplasty, fluor ..................................... Perq vertebroplasty, fluor ..................................... Perq vertebroplasty, ct ......................................... Perq vertebroplasty, ct ......................................... Perq vertebroplasty, ct ......................................... X-ray of lower spine disk ..................................... X-ray of lower spine disk ..................................... X-ray of lower spine disk ..................................... X-ray exam of collar bone .................................... X-ray exam of collar bone .................................... X-ray exam of collar bone .................................... X-ray exam of shoulder blade .............................. X-ray exam of shoulder blade .............................. X-ray exam of shoulder blade .............................. X-ray exam of shoulder ........................................ X-ray exam of shoulder ........................................ X-ray exam of shoulder ........................................ X-ray exam of shoulder ........................................ X-ray exam of shoulder ........................................ X-ray exam of shoulder ........................................ Contrast x-ray of shoulder ................................... Contrast x-ray of shoulder ................................... Contrast x-ray of shoulder ................................... X-ray exam of shoulders ...................................... X-ray exam of shoulders ...................................... X-ray exam of shoulders ...................................... X-ray exam of humerus ....................................... X-ray exam of humerus ....................................... X-ray exam of humerus ....................................... X-ray exam of elbow ............................................ X-ray exam of elbow ............................................ X-ray exam of elbow ............................................ X-ray exam of elbow ............................................ X-ray exam of elbow ............................................ X-ray exam of elbow ............................................ Contrast x-ray of elbow ........................................ Contrast x-ray of elbow ........................................ Contrast x-ray of elbow ........................................ Description 0.76 1.16 0.00 1.16 0.00 0.00 1.31 0.00 0.00 1.38 0.83 0.00 0.83 0.16 0.00 0.16 0.17 0.00 0.17 0.15 0.00 0.15 0.18 0.00 0.18 0.54 0.00 0.54 0.20 0.00 0.20 0.17 0.00 0.17 0.15 0.00 0.15 0.17 0.00 0.17 0.54 0.00 0.54 Physician Work RVUs 3 0.19 1.36 1.09 0.27 0.00 0.00 0.41 0.00 0.00 0.41 1.36 1.14 0.22 0.53 0.48 0.05 0.56 0.51 0.05 0.43 0.38 0.05 0.55 0.49 0.06 2.11 1.95 0.16 0.71 0.64 0.07 0.55 0.50 0.05 0.54 0.49 0.05 0.72 0.67 0.05 1.74 1.58 0.16 Fully Implemented NonFacility PE RVUs 0.20 6.90 6.56 0.34 0.00 0.00 0.46 0.00 0.00 0.46 6.44 6.18 0.26 0.56 0.51 0.05 0.58 0.52 0.06 0.50 0.45 0.05 0.61 0.55 0.06 2.24 2.06 0.18 0.73 0.66 0.07 0.61 0.55 0.06 0.56 0.51 0.05 0.66 0.60 0.06 2.15 1.97 0.18 Year 2007 Transitional Non-Facility PE RVUs 0.19 NA NA 0.27 0.00 0.00 0.41 0.00 0.00 0.41 NA NA 0.22 NA NA 0.05 NA NA 0.05 NA NA 0.05 NA NA 0.06 NA NA 0.16 NA NA 0.07 NA NA 0.05 NA NA 0.05 NA NA 0.05 NA NA 0.16 Fully Implemented Facility PE RVUs 0.20 NA NA 0.34 0.00 0.00 0.46 0.00 0.00 0.46 NA NA 0.26 NA NA 0.05 NA NA 0.06 NA NA 0.05 NA NA 0.06 NA NA 0.18 NA NA 0.07 NA NA 0.06 NA NA 0.05 NA NA 0.06 NA NA 0.18 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 72275 72285 72285 72285 72291 72291 72291 72292 72292 72292 72295 72295 72295 73000 73000 73000 73010 73010 73010 73020 73020 73020 73030 73030 73030 73040 73040 73040 73050 73050 73050 73060 73060 73060 73070 73070 73070 73080 73080 73080 73085 73085 73085 HCPCS 2 CPT 1/ 0.04 0.50 0.43 0.07 0.00 0.00 0.10 0.00 0.00 0.07 0.46 0.40 0.06 0.03 0.02 0.01 0.03 0.02 0.01 0.03 0.02 0.01 0.05 0.04 0.01 0.14 0.12 0.02 0.05 0.04 0.01 0.05 0.04 0.01 0.03 0.02 0.01 0.05 0.04 0.01 0.14 0.12 0.02 Mal-Practice RVUs 0.99 3.02 1.52 1.50 0.00 0.00 1.82 0.00 0.00 1.86 2.65 1.54 1.11 0.72 0.50 0.22 0.76 0.53 0.23 0.61 0.40 0.21 0.78 0.53 0.25 2.79 2.07 0.72 0.96 0.68 0.28 0.77 0.54 0.23 0.72 0.51 0.21 0.94 0.71 0.23 2.42 1.70 0.72 Fully Implemented NonFacility Total 1.00 8.56 6.99 1.57 0.00 0.00 1.87 0.00 0.00 1.91 7.73 6.58 1.15 0.75 0.53 0.22 0.78 0.54 0.24 0.68 0.47 0.21 0.84 0.59 0.25 2.92 2.18 0.74 0.98 0.70 0.28 0.83 0.59 0.24 0.74 0.53 0.21 0.88 0.64 0.24 2.83 2.09 0.74 Year 2007 Transitional Non-Facility Total 0.99 NA NA 1.50 0.00 0.00 1.82 0.00 0.00 1.86 NA NA 1.11 NA NA 0.22 NA NA 0.23 NA NA 0.21 NA NA 0.25 NA NA 0.72 NA NA 0.28 NA NA 0.23 NA NA 0.21 NA NA 0.23 NA NA 0.72 Fully Implemented Facility Total 1.00 NA NA 1.57 0.00 0.00 1.87 0.00 0.00 1.91 NA NA 1.15 NA NA 0.22 NA NA 0.24 NA NA 0.21 NA NA 0.25 NA NA 0.74 NA NA 0.28 NA NA 0.24 NA NA 0.21 NA NA 0.24 NA NA 0.74 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69930 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00309 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status X-ray exam of forearm ......................................... X-ray exam of forearm ......................................... X-ray exam of forearm ......................................... X-ray exam of arm, infant .................................... X-ray exam of arm, infant .................................... X-ray exam of arm, infant .................................... X-ray exam of wrist .............................................. X-ray exam of wrist .............................................. X-ray exam of wrist .............................................. X-ray exam of wrist .............................................. X-ray exam of wrist .............................................. X-ray exam of wrist .............................................. Contrast x-ray of wrist .......................................... Contrast x-ray of wrist .......................................... Contrast x-ray of wrist .......................................... X-ray exam of hand ............................................. X-ray exam of hand ............................................. X-ray exam of hand ............................................. X-ray exam of hand ............................................. X-ray exam of hand ............................................. X-ray exam of hand ............................................. X-ray exam of finger(s) ........................................ X-ray exam of finger(s) ........................................ X-ray exam of finger(s) ........................................ Ct upper extremity w/o dye .................................. Ct upper extremity w/o dye .................................. Ct upper extremity w/o dye .................................. Ct upper extremity w/dye ..................................... Ct upper extremity w/dye ..................................... Ct upper extremity w/dye ..................................... Ct uppr extremity w/o&w/dye ............................... Ct uppr extremity w/o&w/dye ............................... Ct uppr extremity w/o&w/dye ............................... Ct angio upr extrm w/o&w/dye ............................. Ct angio upr extrm w/o&w/dye ............................. Ct angio upr extrm w/o&w/dye ............................. Mri upper extremity w/o dye ................................ Mri upper extremity w/o dye ................................ Mri upper extremity w/o dye ................................ Mri upper extremity w/dye .................................... Mri upper extremity w/dye .................................... Mri upper extremity w/dye .................................... Mri uppr extremity w/o&w/dye .............................. Description 0.16 0.00 0.16 0.16 0.00 0.16 0.16 0.00 0.16 0.17 0.00 0.17 0.54 0.00 0.54 0.16 0.00 0.16 0.17 0.00 0.17 0.13 0.00 0.13 1.09 0.00 1.09 1.16 0.00 1.16 1.22 0.00 1.22 1.81 0.00 1.81 1.35 0.00 1.35 1.62 0.00 1.62 2.15 Physician Work RVUs 3 0.52 0.48 0.04 0.55 0.51 0.04 0.59 0.54 0.05 0.74 0.69 0.05 2.28 2.11 0.17 0.54 0.49 0.05 0.63 0.58 0.05 0.65 0.61 0.04 6.03 5.72 0.31 7.45 7.12 0.33 10.06 9.71 0.35 10.21 9.67 0.54 14.04 13.65 0.39 14.65 14.18 0.47 18.09 Fully Implemented NonFacility PE RVUs 0.56 0.51 0.05 0.55 0.50 0.05 0.55 0.50 0.05 0.63 0.57 0.06 1.89 1.71 0.18 0.54 0.49 0.05 0.60 0.54 0.06 0.51 0.47 0.04 5.50 5.15 0.35 6.58 6.21 0.37 8.38 7.99 0.39 11.22 10.64 0.58 12.24 11.81 0.43 14.15 13.63 0.52 23.72 Year 2007 Transitional Non-Facility PE RVUs NA NA 0.04 NA NA 0.04 NA NA 0.05 NA NA 0.05 NA NA 0.17 NA NA 0.05 NA NA 0.05 NA NA 0.04 NA NA 0.31 NA NA 0.33 NA NA 0.35 NA NA 0.54 NA NA 0.39 NA NA 0.47 NA Fully Implemented Facility PE RVUs NA NA 0.05 NA NA 0.05 NA NA 0.05 NA NA 0.06 NA NA 0.18 NA NA 0.05 NA NA 0.06 NA NA 0.04 NA NA 0.35 NA NA 0.37 NA NA 0.39 NA NA 0.58 NA NA 0.43 NA NA 0.52 NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 73090 73090 73090 73092 73092 73092 73100 73100 73100 73110 73110 73110 73115 73115 73115 73120 73120 73120 73130 73130 73130 73140 73140 73140 73200 73200 73200 73201 73201 73201 73202 73202 73202 73206 73206 73206 73218 73218 73218 73219 73219 73219 73220 HCPCS 2 CPT 1/ 0.03 0.02 0.01 0.03 0.02 0.01 0.03 0.02 0.01 0.03 0.02 0.01 0.12 0.10 0.02 0.03 0.02 0.01 0.03 0.02 0.01 0.03 0.02 0.01 0.30 0.25 0.05 0.36 0.31 0.05 0.44 0.39 0.05 0.47 0.39 0.08 0.45 0.39 0.06 0.54 0.47 0.07 0.94 Mal-Practice RVUs 0.71 0.50 0.21 0.74 0.53 0.21 0.78 0.56 0.22 0.94 0.71 0.23 2.94 2.21 0.73 0.73 0.51 0.22 0.83 0.60 0.23 0.81 0.63 0.18 7.42 5.97 1.45 8.97 7.43 1.54 11.72 10.10 1.62 12.49 10.06 2.43 15.84 14.04 1.80 16.81 14.65 2.16 21.18 Fully Implemented NonFacility Total 0.75 0.53 0.22 0.74 0.52 0.22 0.74 0.52 0.22 0.83 0.59 0.24 2.55 1.81 0.74 0.73 0.51 0.22 0.80 0.56 0.24 0.67 0.49 0.18 6.89 5.40 1.49 8.10 6.52 1.58 10.04 8.38 1.66 13.50 11.03 2.47 14.04 12.20 1.84 16.31 14.10 2.21 26.81 Year 2007 Transitional Non-Facility Total NA NA 0.21 NA NA 0.21 NA NA 0.22 NA NA 0.23 NA NA 0.73 NA NA 0.22 NA NA 0.23 NA NA 0.18 NA NA 1.45 NA NA 1.54 NA NA 1.62 NA NA 2.43 NA NA 1.80 NA NA 2.16 NA Fully Implemented Facility Total NA NA 0.22 NA NA 0.22 NA NA 0.22 NA NA 0.24 NA NA 0.74 NA NA 0.22 NA NA 0.24 NA NA 0.18 NA NA 1.49 NA NA 1.58 NA NA 1.66 NA NA 2.47 NA NA 1.84 NA NA 2.21 NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69931 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00310 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 2 Copyright 3+ Mod A A A A A A A A A A A N N N A A A A A A A A A A A A C C A A A A A A A A A A A A A A A Status Mri uppr extremity w/o&w/dye .............................. Mri uppr extremity w/o&w/dye .............................. Mri joint upr extrem w/o dye ................................ Mri joint upr extrem w/o dye ................................ Mri joint upr extrem w/o dye ................................ Mri joint upr extrem w/dye ................................... Mri joint upr extrem w/dye ................................... Mri joint upr extrem w/dye ................................... Mri joint upr extr w/o&w/dye ................................ Mri joint upr extr w/o&w/dye ................................ Mri joint upr extr w/o&w/dye ................................ Mr angio upr extr w/o&w/dye ............................... Mr angio upr extr w/o&w/dye ............................... Mr angio upr extr w/o&w/dye ............................... X-ray exam of hip ................................................. X-ray exam of hip ................................................. X-ray exam of hip ................................................. X-ray exam of hip ................................................. X-ray exam of hip ................................................. X-ray exam of hip ................................................. X-ray exam of hips ............................................... X-ray exam of hips ............................................... X-ray exam of hips ............................................... Contrast x-ray of hip ............................................ Contrast x-ray of hip ............................................ Contrast x-ray of hip ............................................ X-ray exam of hip ................................................. X-ray exam of hip ................................................. X-ray exam of hip ................................................. X-ray exam of pelvis & hips ................................. X-ray exam of pelvis & hips ................................. X-ray exam of pelvis & hips ................................. X-ray exam, sacroiliac joint .................................. X-ray exam, sacroiliac joint .................................. X-ray exam, sacroiliac joint .................................. X-ray exam of thigh .............................................. X-ray exam of thigh .............................................. X-ray exam of thigh .............................................. X-ray exam of knee, 1 or 2 .................................. X-ray exam of knee, 1 or 2 .................................. X-ray exam of knee, 1 or 2 .................................. X-ray exam of knee, 3 ......................................... X-ray exam of knee, 3 ......................................... Description 0.00 2.15 1.35 0.00 1.35 1.62 0.00 1.62 2.15 0.00 2.15 1.73 0.00 1.73 0.17 0.00 0.17 0.21 0.00 0.21 0.26 0.00 0.26 0.54 0.00 0.54 0.00 0.00 0.29 0.20 0.00 0.20 0.59 0.00 0.59 0.17 0.00 0.17 0.17 0.00 0.17 0.18 0.00 Physician Work RVUs 3 17.48 0.61 12.98 12.58 0.40 13.63 13.16 0.47 16.13 16.13 0.00 14.47 14.07 0.40 0.46 0.41 0.05 0.74 0.68 0.06 0.75 0.67 0.08 1.72 1.56 0.16 NA NA 0.08 0.78 0.71 0.07 1.10 0.96 0.14 0.52 0.47 0.05 0.56 0.51 0.05 0.71 0.65 Fully Implemented NonFacility PE RVUs 23.03 0.69 11.98 11.55 0.43 13.89 13.37 0.52 23.40 22.69 0.71 12.38 11.78 0.60 0.52 0.46 0.06 0.67 0.60 0.07 0.76 0.67 0.09 2.15 1.97 0.18 NA NA 0.10 0.68 0.61 0.07 1.98 1.82 0.16 0.61 0.55 0.06 0.58 0.52 0.06 0.65 0.59 Year 2007 Transitional Non-Facility PE RVUs NA 0.61 NA NA 0.40 NA NA 0.47 NA NA 0.00 NA NA 0.40 NA NA 0.05 NA NA 0.06 NA NA 0.08 NA NA 0.16 NA NA 0.08 NA NA 0.07 NA NA 0.14 NA NA 0.05 NA NA 0.05 NA NA Fully Implemented Facility PE RVUs NA 0.69 NA NA 0.43 NA NA 0.52 NA NA 0.71 NA NA 0.60 NA NA 0.06 NA NA 0.07 NA NA 0.09 NA NA 0.18 NA NA 0.10 NA NA 0.07 NA NA 0.16 NA NA 0.06 NA NA 0.06 NA NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 73220 73220 73221 73221 73221 73222 73222 73222 73223 73223 73223 73225 73225 73225 73500 73500 73500 73510 73510 73510 73520 73520 73520 73525 73525 73525 73530 73530 73530 73540 73540 73540 73542 73542 73542 73550 73550 73550 73560 73560 73560 73562 73562 HCPCS 2 CPT 1/ 0.84 0.10 0.45 0.39 0.06 0.54 0.47 0.07 0.94 0.84 0.10 0.69 0.59 0.10 0.03 0.02 0.01 0.05 0.04 0.01 0.05 0.04 0.01 0.15 0.12 0.03 0.00 0.00 0.01 0.05 0.04 0.01 0.15 0.12 0.03 0.05 0.04 0.01 0.03 0.02 0.01 0.05 0.04 Mal-Practice RVUs 18.32 2.86 14.78 12.97 1.81 15.79 13.63 2.16 19.22 16.97 2.25 16.89 14.66 2.23 0.66 0.43 0.23 1.00 0.72 0.28 1.06 0.71 0.35 2.41 1.68 0.73 NA NA 0.38 1.03 0.75 0.28 1.84 1.08 0.76 0.74 0.51 0.23 0.76 0.53 0.23 0.94 0.69 Fully Implemented NonFacility Total 23.87 2.94 13.78 11.94 1.84 16.05 13.84 2.21 26.49 23.53 2.96 14.80 12.37 2.43 0.72 0.48 0.24 0.93 0.64 0.29 1.07 0.71 0.36 2.84 2.09 0.75 NA NA 0.40 0.93 0.65 0.28 2.72 1.94 0.78 0.83 0.59 0.24 0.78 0.54 0.24 0.88 0.63 Year 2007 Transitional Non-Facility Total NA 2.86 NA NA 1.81 NA NA 2.16 NA NA 2.25 NA NA 2.23 NA NA 0.23 NA NA 0.28 NA NA 0.35 NA NA 0.73 NA NA 0.38 NA NA 0.28 NA NA 0.76 NA NA 0.23 NA NA 0.23 NA NA Fully Implemented Facility Total NA 2.94 NA NA 1.84 NA NA 2.21 NA NA 2.96 NA NA 2.43 NA NA 0.24 NA NA 0.29 NA NA 0.36 NA NA 0.75 NA NA 0.40 NA NA 0.28 NA NA 0.78 NA NA 0.24 NA NA 0.24 NA NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69932 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00311 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status X-ray exam of knee, 3 ......................................... X-ray exam, knee, 4 or more ............................... X-ray exam, knee, 4 or more ............................... X-ray exam, knee, 4 or more ............................... X-ray exam of knees ............................................ X-ray exam of knees ............................................ X-ray exam of knees ............................................ Contrast x-ray of knee joint .................................. Contrast x-ray of knee joint .................................. Contrast x-ray of knee joint .................................. X-ray exam of lower leg ....................................... X-ray exam of lower leg ....................................... X-ray exam of lower leg ....................................... X-ray exam of leg, infant ...................................... X-ray exam of leg, infant ...................................... X-ray exam of leg, infant ...................................... X-ray exam of ankle ............................................. X-ray exam of ankle ............................................. X-ray exam of ankle ............................................. X-ray exam of ankle ............................................. X-ray exam of ankle ............................................. X-ray exam of ankle ............................................. Contrast x-ray of ankle ......................................... Contrast x-ray of ankle ......................................... Contrast x-ray of ankle ......................................... X-ray exam of foot ............................................... X-ray exam of foot ............................................... X-ray exam of foot ............................................... X-ray exam of foot ............................................... X-ray exam of foot ............................................... X-ray exam of foot ............................................... X-ray exam of heel ............................................... X-ray exam of heel ............................................... X-ray exam of heel ............................................... X-ray exam of toe(s) ............................................ X-ray exam of toe(s) ............................................ X-ray exam of toe(s) ............................................ Ct lower extremity w/o dye .................................. Ct lower extremity w/o dye .................................. Ct lower extremity w/o dye .................................. Ct lower extremity w/dye ...................................... Ct lower extremity w/dye ...................................... Ct lower extremity w/dye ...................................... Description 0.18 0.22 0.00 0.22 0.17 0.00 0.17 0.54 0.00 0.54 0.17 0.00 0.17 0.16 0.00 0.16 0.16 0.00 0.16 0.17 0.00 0.17 0.54 0.00 0.54 0.16 0.00 0.16 0.17 0.00 0.17 0.16 0.00 0.16 0.13 0.00 0.13 1.09 0.00 1.09 1.16 0.00 1.16 Physician Work RVUs 3 0.06 0.83 0.76 0.07 0.64 0.58 0.06 2.32 2.15 0.17 0.51 0.46 0.05 0.57 0.53 0.04 0.55 0.50 0.05 0.64 0.59 0.05 1.83 1.67 0.16 0.52 0.48 0.04 0.63 0.58 0.05 0.54 0.49 0.05 0.62 0.58 0.04 6.04 5.73 0.31 7.50 7.17 0.33 Fully Implemented NonFacility PE RVUs 0.06 0.73 0.66 0.07 0.57 0.51 0.06 2.67 2.50 0.17 0.57 0.51 0.06 0.55 0.50 0.05 0.54 0.49 0.05 0.61 0.55 0.06 2.17 1.99 0.18 0.54 0.49 0.05 0.60 0.54 0.06 0.53 0.48 0.05 0.50 0.46 0.04 5.50 5.15 0.35 6.60 6.23 0.37 Year 2007 Transitional Non-Facility PE RVUs 0.06 NA NA 0.07 NA NA 0.06 NA NA 0.17 NA NA 0.05 NA NA 0.04 NA NA 0.05 NA NA 0.05 NA NA 0.16 NA NA 0.04 NA NA 0.05 NA NA 0.05 NA NA 0.04 NA NA 0.31 NA NA 0.33 Fully Implemented Facility PE RVUs 0.06 NA NA 0.07 NA NA 0.06 NA NA 0.17 NA NA 0.06 NA NA 0.05 NA NA 0.05 NA NA 0.06 NA NA 0.18 NA NA 0.05 NA NA 0.06 NA NA 0.05 NA NA 0.04 NA NA 0.35 NA NA 0.37 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 73562 73564 73564 73564 73565 73565 73565 73580 73580 73580 73590 73590 73590 73592 73592 73592 73600 73600 73600 73610 73610 73610 73615 73615 73615 73620 73620 73620 73630 73630 73630 73650 73650 73650 73660 73660 73660 73700 73700 73700 73701 73701 73701 HCPCS 2 CPT 1/ 0.01 0.05 0.04 0.01 0.03 0.02 0.01 0.17 0.14 0.03 0.03 0.02 0.01 0.03 0.02 0.01 0.03 0.02 0.01 0.03 0.02 0.01 0.15 0.12 0.03 0.03 0.02 0.01 0.03 0.02 0.01 0.03 0.02 0.01 0.03 0.02 0.01 0.30 0.25 0.05 0.36 0.31 0.05 Mal-Practice RVUs 0.25 1.10 0.80 0.30 0.84 0.60 0.24 3.03 2.29 0.74 0.71 0.48 0.23 0.76 0.55 0.21 0.74 0.52 0.22 0.84 0.61 0.23 2.52 1.79 0.73 0.71 0.50 0.21 0.83 0.60 0.23 0.73 0.51 0.22 0.78 0.60 0.18 7.43 5.98 1.45 9.02 7.48 1.54 Fully Implemented NonFacility Total 0.25 1.00 0.70 0.30 0.77 0.53 0.24 3.38 2.64 0.74 0.77 0.53 0.24 0.74 0.52 0.22 0.73 0.51 0.22 0.81 0.57 0.24 2.86 2.11 0.75 0.73 0.51 0.22 0.80 0.56 0.24 0.72 0.50 0.22 0.66 0.48 0.18 6.89 5.40 1.49 8.12 6.54 1.58 Year 2007 Transitional Non-Facility Total 0.25 NA NA 0.30 NA NA 0.24 NA NA 0.74 NA NA 0.23 NA NA 0.21 NA NA 0.22 NA NA 0.23 NA NA 0.73 NA NA 0.21 NA NA 0.23 NA NA 0.22 NA NA 0.18 NA NA 1.45 NA NA 1.54 Fully Implemented Facility Total 0.25 NA NA 0.30 NA NA 0.24 NA NA 0.74 NA NA 0.24 NA NA 0.22 NA NA 0.22 NA NA 0.24 NA NA 0.75 NA NA 0.22 NA NA 0.24 NA NA 0.22 NA NA 0.18 NA NA 1.49 NA NA 1.58 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69933 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00312 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A R R R A A A A A A A A A A A A A A A A Status Ct lwr extremity w/o&w/dye .................................. Ct lwr extremity w/o&w/dye .................................. Ct lwr extremity w/o&w/dye .................................. Ct angio lwr extr w/o&w/dye ................................ Ct angio lwr extr w/o&w/dye ................................ Ct angio lwr extr w/o&w/dye ................................ Mri lower extremity w/o dye ................................. Mri lower extremity w/o dye ................................. Mri lower extremity w/o dye ................................. Mri lower extremity w/dye .................................... Mri lower extremity w/dye .................................... Mri lower extremity w/dye .................................... Mri lwr extremity w/o&w/dye ................................ Mri lwr extremity w/o&w/dye ................................ Mri lwr extremity w/o&w/dye ................................ Mri jnt of lwr extre w/o dye .................................. Mri jnt of lwr extre w/o dye .................................. Mri jnt of lwr extre w/o dye .................................. Mri joint of lwr extr w/dye ..................................... Mri joint of lwr extr w/dye ..................................... Mri joint of lwr extr w/dye ..................................... Mri joint lwr extr w/o&w/dye ................................. Mri joint lwr extr w/o&w/dye ................................. Mri joint lwr extr w/o&w/dye ................................. Mr ang lwr ext w or w/o dye ................................ Mr ang lwr ext w or w/o dye ................................ Mr ang lwr ext w or w/o dye ................................ X-ray exam of abdomen ...................................... X-ray exam of abdomen ...................................... X-ray exam of abdomen ...................................... X-ray exam of abdomen ...................................... X-ray exam of abdomen ...................................... X-ray exam of abdomen ...................................... X-ray exam of abdomen ...................................... X-ray exam of abdomen ...................................... X-ray exam of abdomen ...................................... X-ray exam series, abdomen ............................... X-ray exam series, abdomen ............................... X-ray exam series, abdomen ............................... Ct abdomen w/o dye ............................................ Ct abdomen w/o dye ............................................ Ct abdomen w/o dye ............................................ Ct abdomen w/dye ............................................... Description 1.22 0.00 1.22 1.90 0.00 1.90 1.35 0.00 1.35 1.62 0.00 1.62 2.15 0.00 2.15 1.35 0.00 1.35 1.62 0.00 1.62 2.15 0.00 2.15 1.82 0.00 1.82 0.18 0.00 0.18 0.23 0.00 0.23 0.27 0.00 0.27 0.32 0.00 0.32 1.19 0.00 1.19 1.27 Physician Work RVUs 3 10.14 9.78 0.36 11.69 11.09 0.60 13.64 13.25 0.39 14.58 14.12 0.46 18.05 17.44 0.61 13.26 12.86 0.40 13.88 13.40 0.48 16.70 16.09 0.61 14.34 13.82 0.52 0.43 0.38 0.05 0.74 0.68 0.06 0.74 0.67 0.07 0.91 0.82 0.09 5.70 5.36 0.34 8.32 Fully Implemented NonFacility PE RVUs 8.40 8.01 0.39 11.61 10.99 0.62 12.14 11.71 0.43 14.12 13.61 0.51 23.70 23.02 0.68 12.05 11.62 0.43 13.95 13.43 0.52 23.37 22.68 0.69 12.44 11.86 0.58 0.55 0.49 0.06 0.68 0.60 0.08 0.72 0.63 0.09 0.85 0.75 0.10 5.97 5.59 0.38 7.53 Year 2007 Transitional Non-Facility PE RVUs NA NA 0.36 NA NA 0.60 NA NA 0.39 NA NA 0.46 NA NA 0.61 NA NA 0.40 NA NA 0.48 NA NA 0.61 NA NA 0.52 NA NA 0.05 NA NA 0.06 NA NA 0.07 NA NA 0.09 NA NA 0.34 NA Fully Implemented Facility PE RVUs NA NA 0.39 NA NA 0.62 NA NA 0.43 NA NA 0.51 NA NA 0.68 NA NA 0.43 NA NA 0.52 NA NA 0.69 NA NA 0.58 NA NA 0.06 NA NA 0.08 NA NA 0.09 NA NA 0.10 NA NA 0.38 NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 73702 73702 73702 73706 73706 73706 73718 73718 73718 73719 73719 73719 73720 73720 73720 73721 73721 73721 73722 73722 73722 73723 73723 73723 73725 73725 73725 74000 74000 74000 74010 74010 74010 74020 74020 74020 74022 74022 74022 74150 74150 74150 74160 HCPCS 2 CPT 1/ 0.44 0.39 0.05 0.47 0.39 0.08 0.45 0.39 0.06 0.54 0.47 0.07 0.94 0.84 0.10 0.45 0.39 0.06 0.54 0.47 0.07 0.94 0.84 0.10 0.67 0.59 0.08 0.03 0.02 0.01 0.05 0.04 0.01 0.05 0.04 0.01 0.06 0.05 0.01 0.35 0.30 0.05 0.42 Mal-Practice RVUs 11.80 10.17 1.63 14.06 11.48 2.58 15.44 13.64 1.80 16.74 14.59 2.15 21.14 18.28 2.86 15.06 13.25 1.81 16.04 13.87 2.17 19.79 16.93 2.86 16.83 14.41 2.42 0.64 0.40 0.24 1.02 0.72 0.30 1.06 0.71 0.35 1.29 0.87 0.42 7.24 5.66 1.58 10.01 Fully Implemented NonFacility Total 10.06 8.40 1.66 13.98 11.38 2.60 13.94 12.10 1.84 16.28 14.08 2.20 26.79 23.86 2.93 13.85 12.01 1.84 16.11 13.90 2.21 26.46 23.52 2.94 14.93 12.45 2.48 0.76 0.51 0.25 0.96 0.64 0.32 1.04 0.67 0.37 1.23 0.80 0.43 7.51 5.89 1.62 9.22 Year 2007 Transitional Non-Facility Total NA NA 1.63 NA NA 2.58 NA NA 1.80 NA NA 2.15 NA NA 2.86 NA NA 1.81 NA NA 2.17 NA NA 2.86 NA NA 2.42 NA NA 0.24 NA NA 0.30 NA NA 0.35 NA NA 0.42 NA NA 1.58 NA Fully Implemented Facility Total NA NA 1.66 NA NA 2.60 NA NA 1.84 NA NA 2.20 NA NA 2.93 NA NA 1.84 NA NA 2.21 NA NA 2.94 NA NA 2.48 NA NA 0.25 NA NA 0.32 NA NA 0.37 NA NA 0.43 NA NA 1.62 NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69934 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00313 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A R R R C C A A A A A A A A A A C C A A A A A A A A A Status Ct abdomen w/dye ............................................... Ct abdomen w/dye ............................................... Ct abdomen w/o & w/dye ..................................... Ct abdomen w/o & w/dye ..................................... Ct abdomen w/o & w/dye ..................................... Ct angio abdom w/o & w/dye ............................... Ct angio abdom w/o & w/dye ............................... Ct angio abdom w/o & w/dye ............................... Mri abdomen w/o dye .......................................... Mri abdomen w/o dye .......................................... Mri abdomen w/o dye .......................................... Mri abdomen w/dye .............................................. Mri abdomen w/dye .............................................. Mri abdomen w/dye .............................................. Mri abdomen w/o & w/dye ................................... Mri abdomen w/o & w/dye ................................... Mri abdomen w/o & w/dye ................................... Mri angio, abdom w orw/o dye ............................ Mri angio, abdom w orw/o dye ............................ Mri angio, abdom w orw/o dye ............................ X-ray exam of peritoneum ................................... X-ray exam of peritoneum ................................... X-ray exam of peritoneum ................................... Contrst x-ray exam of throat ................................ Contrst x-ray exam of throat ................................ Contrst x-ray exam of throat ................................ Contrast x-ray, esophagus ................................... Contrast x-ray, esophagus ................................... Contrast x-ray, esophagus ................................... Cine/vid x-ray, throat/esoph ................................. Cine/vid x-ray, throat/esoph ................................. Cine/vid x-ray, throat/esoph ................................. Remove esophagus obstruction .......................... Remove esophagus obstruction .......................... Remove esophagus obstruction .......................... X-ray exam, upper gi tract ................................... X-ray exam, upper gi tract ................................... X-ray exam, upper gi tract ................................... X-ray exam, upper gi tract ................................... X-ray exam, upper gi tract ................................... X-ray exam, upper gi tract ................................... X-ray exam, upper gi tract ................................... X-ray exam, upper gi tract ................................... Description 0.00 1.27 1.40 0.00 1.40 1.90 0.00 1.90 1.46 0.00 1.46 1.73 0.00 1.73 2.26 0.00 2.26 1.80 0.00 1.80 0.00 0.00 0.48 0.36 0.00 0.36 0.46 0.00 0.46 0.53 0.00 0.53 0.00 0.00 1.19 0.69 0.00 0.69 0.69 0.00 0.69 0.91 0.00 Physician Work RVUs 3 7.96 0.36 11.54 11.14 0.40 11.60 11.04 0.56 11.79 11.38 0.41 16.49 16.00 0.49 18.00 17.36 0.64 14.30 13.78 0.52 NA NA 0.14 1.65 1.55 0.10 1.89 1.76 0.13 1.81 1.66 0.15 0.00 0.00 0.38 2.14 1.95 0.19 2.40 2.21 0.19 3.70 3.44 Fully Implemented NonFacility PE RVUs 7.12 0.41 9.60 9.15 0.45 12.39 11.78 0.61 11.71 11.25 0.46 14.63 14.08 0.55 23.72 23.00 0.72 12.42 11.85 0.57 NA NA 0.16 1.40 1.28 0.12 1.48 1.33 0.15 1.57 1.40 0.17 0.00 0.00 0.39 1.80 1.58 0.22 1.89 1.67 0.22 2.94 2.65 Year 2007 Transitional Non-Facility PE RVUs NA 0.36 NA NA 0.40 NA NA 0.56 NA NA 0.41 NA NA 0.49 NA NA 0.64 NA NA 0.52 NA NA 0.14 NA NA 0.10 NA NA 0.13 NA NA 0.15 0.00 0.00 0.38 NA NA 0.19 NA NA 0.19 NA NA Fully Implemented Facility PE RVUs NA 0.41 NA NA 0.45 NA NA 0.61 NA NA 0.46 NA NA 0.55 NA NA 0.72 NA NA 0.57 NA NA 0.16 NA NA 0.12 NA NA 0.15 NA NA 0.17 0.00 0.00 0.39 NA NA 0.22 NA NA 0.22 NA NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 74160 74160 74170 74170 74170 74175 74175 74175 74181 74181 74181 74182 74182 74182 74183 74183 74183 74185 74185 74185 74190 74190 74190 74210 74210 74210 74220 74220 74220 74230 74230 74230 74235 74235 74235 74240 74240 74240 74241 74241 74241 74245 74245 HCPCS 2 CPT 1/ 0.36 0.06 0.49 0.43 0.06 0.47 0.39 0.08 0.51 0.45 0.06 0.60 0.52 0.08 1.02 0.92 0.10 0.67 0.59 0.08 0.00 0.00 0.02 0.08 0.06 0.02 0.08 0.06 0.02 0.09 0.07 0.02 0.00 0.00 0.05 0.11 0.08 0.03 0.11 0.08 0.03 0.17 0.13 Mal-Practice RVUs 8.32 1.69 13.43 11.57 1.86 13.97 11.43 2.54 13.76 11.83 1.93 18.82 16.52 2.30 21.28 18.28 3.00 16.77 14.37 2.40 NA NA 0.64 2.09 1.61 0.48 2.43 1.82 0.61 2.43 1.73 0.70 0.00 0.00 1.62 2.94 2.03 0.91 3.20 2.29 0.91 4.78 3.57 Fully Implemented NonFacility Total 7.48 1.74 11.49 9.58 1.91 14.76 12.17 2.59 13.68 11.70 1.98 16.96 14.60 2.36 27.00 23.92 3.08 14.89 12.44 2.45 NA NA 0.66 1.84 1.34 0.50 2.02 1.39 0.63 2.19 1.47 0.72 0.00 0.00 1.63 2.60 1.66 0.94 2.69 1.75 0.94 4.02 2.78 Year 2007 Transitional Non-Facility Total NA 1.69 NA NA 1.86 NA NA 2.54 NA NA 1.93 NA NA 2.30 NA NA 3.00 NA NA 2.40 NA NA 0.64 NA NA 0.48 NA NA 0.61 NA NA 0.70 0.00 0.00 1.62 NA NA 0.91 NA NA 0.91 NA NA Fully Implemented Facility Total NA 1.74 NA NA 1.91 NA NA 2.59 NA NA 1.98 NA NA 2.36 NA NA 3.08 NA NA 2.45 NA NA 0.66 NA NA 0.50 NA NA 0.63 NA NA 0.72 0.00 0.00 1.63 NA NA 0.94 NA NA 0.94 NA NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69935 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00314 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C C A C C A C C A Status X-ray exam, upper gi tract ................................... Contrst x-ray uppr gi tract .................................... Contrst x-ray uppr gi tract .................................... Contrst x-ray uppr gi tract .................................... Contrst x-ray uppr gi tract .................................... Contrst x-ray uppr gi tract .................................... Contrst x-ray uppr gi tract .................................... Contrst x-ray uppr gi tract .................................... Contrst x-ray uppr gi tract .................................... Contrst x-ray uppr gi tract .................................... X-ray exam of small bowel .................................. X-ray exam of small bowel .................................. X-ray exam of small bowel .................................. X-ray exam of small bowel .................................. X-ray exam of small bowel .................................. X-ray exam of small bowel .................................. X-ray exam of small bowel .................................. X-ray exam of small bowel .................................. X-ray exam of small bowel .................................. Contrast x-ray exam of colon ............................... Contrast x-ray exam of colon ............................... Contrast x-ray exam of colon ............................... Contrast x-ray exam of colon ............................... Contrast x-ray exam of colon ............................... Contrast x-ray exam of colon ............................... Contrast x-ray exam of colon ............................... Contrast x-ray exam of colon ............................... Contrast x-ray exam of colon ............................... Contrast x-ray, gallbladder ................................... Contrast x-ray, gallbladder ................................... Contrast x-ray, gallbladder ................................... Contrast x-rays, gallbladder ................................. Contrast x-rays, gallbladder ................................. Contrast x-rays, gallbladder ................................. X-ray bile ducts/pancreas .................................... X-ray bile ducts/pancreas .................................... X-ray bile ducts/pancreas .................................... X-rays at surgery add-on ..................................... X-rays at surgery add-on ..................................... X-rays at surgery add-on ..................................... X-ray bile ducts/pancreas .................................... X-ray bile ducts/pancreas .................................... X-ray bile ducts/pancreas .................................... Description 0.91 0.69 0.00 0.69 0.69 0.00 0.69 0.91 0.00 0.91 0.47 0.00 0.47 0.69 0.00 0.69 0.50 0.00 0.50 0.69 0.00 0.69 0.99 0.00 0.99 2.02 0.00 2.02 0.32 0.00 0.32 0.20 0.00 0.20 0.00 0.00 0.36 0.00 0.00 0.21 0.00 0.00 0.42 Physician Work RVUs 3 0.26 2.62 2.42 0.20 3.00 2.81 0.19 4.07 3.81 0.26 2.33 2.20 0.13 9.46 9.27 0.19 7.87 7.73 0.14 3.35 3.16 0.19 4.64 4.36 0.28 3.22 2.66 0.56 1.47 1.38 0.09 1.55 1.49 0.06 0.00 0.00 0.10 0.00 0.00 0.06 NA NA 0.12 Fully Implemented NonFacility PE RVUs 0.29 2.06 1.84 0.22 2.18 1.96 0.22 3.17 2.88 0.29 1.68 1.53 0.15 3.52 3.30 0.22 3.21 3.05 0.16 2.29 2.07 0.22 3.07 2.76 0.31 3.23 2.59 0.64 0.99 0.89 0.10 0.76 0.69 0.07 0.00 0.00 0.12 0.00 0.00 0.07 NA NA 0.14 Year 2007 Transitional Non-Facility PE RVUs 0.26 NA NA 0.20 NA NA 0.19 NA NA 0.26 NA NA 0.13 NA NA 0.19 NA NA 0.14 NA NA 0.19 NA NA 0.28 NA NA 0.56 NA NA 0.09 NA NA 0.06 0.00 0.00 0.10 0.00 0.00 0.06 NA NA 0.12 Fully Implemented Facility PE RVUs 0.29 NA NA 0.22 NA NA 0.22 NA NA 0.29 NA NA 0.15 NA NA 0.22 NA NA 0.16 NA NA 0.22 NA NA 0.31 NA NA 0.64 NA NA 0.10 NA NA 0.07 0.00 0.00 0.12 0.00 0.00 0.07 NA NA 0.14 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 74245 74246 74246 74246 74247 74247 74247 74249 74249 74249 74250 74250 74250 74251 74251 74251 74260 74260 74260 74270 74270 74270 74280 74280 74280 74283 74283 74283 74290 74290 74290 74291 74291 74291 74300 74300 74300 74301 74301 74301 74305 74305 74305 HCPCS 2 CPT 1/ 0.04 0.13 0.10 0.03 0.14 0.11 0.03 0.18 0.14 0.04 0.09 0.07 0.02 0.10 0.07 0.03 0.10 0.08 0.02 0.14 0.11 0.03 0.17 0.13 0.04 0.23 0.14 0.09 0.06 0.05 0.01 0.03 0.02 0.01 0.00 0.00 0.02 0.00 0.00 0.01 0.00 0.00 0.02 Mal-Practice RVUs 1.21 3.44 2.52 0.92 3.83 2.92 0.91 5.16 3.95 1.21 2.89 2.27 0.62 10.25 9.34 0.91 8.47 7.81 0.66 4.18 3.27 0.91 5.80 4.49 1.31 5.47 2.80 2.67 1.85 1.43 0.42 1.78 1.51 0.27 0.00 0.00 0.48 0.00 0.00 0.28 NA NA 0.56 Fully Implemented NonFacility Total 1.24 2.88 1.94 0.94 3.01 2.07 0.94 4.26 3.02 1.24 2.24 1.60 0.64 4.31 3.37 0.94 3.81 3.13 0.68 3.12 2.18 0.94 4.23 2.89 1.34 5.48 2.73 2.75 1.37 0.94 0.43 0.99 0.71 0.28 0.00 0.00 0.50 0.00 0.00 0.29 NA NA 0.58 Year 2007 Transitional Non-Facility Total 1.21 NA NA 0.92 NA NA 0.91 NA NA 1.21 NA NA 0.62 NA NA 0.91 NA NA 0.66 NA NA 0.91 NA NA 1.31 NA NA 2.67 NA NA 0.42 NA NA 0.27 0.00 0.00 0.48 0.00 0.00 0.28 NA NA 0.56 Fully Implemented Facility Total 1.24 NA NA 0.94 NA NA 0.94 NA NA 1.24 NA NA 0.64 NA NA 0.94 NA NA 0.68 NA NA 0.94 NA NA 1.34 NA NA 2.75 NA NA 0.43 NA NA 0.28 0.00 0.00 0.50 0.00 0.00 0.29 NA NA 0.58 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX ZZZ ZZZ ZZZ XXX XXX XXX Global 69936 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00315 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... 2 Copyright 3+ Mod A A A A A A C C A C C A C C A C C A A A A C C A C C A C C A A A A A A A A A A C C A C Status Contrast x-ray of bile ducts .................................. Contrast x-ray of bile ducts .................................. Contrast x-ray of bile ducts .................................. X-ray bile stone removal ...................................... X-ray bile stone removal ...................................... X-ray bile stone removal ...................................... X-ray bile duct endoscopy ................................... X-ray bile duct endoscopy ................................... X-ray bile duct endoscopy ................................... X-ray for pancreas endoscopy ............................. X-ray for pancreas endoscopy ............................. X-ray for pancreas endoscopy ............................. X-ray bile/panc endoscopy ................................... X-ray bile/panc endoscopy ................................... X-ray bile/panc endoscopy ................................... X-ray guide for GI tube ........................................ X-ray guide for GI tube ........................................ X-ray guide for GI tube ........................................ X-ray guide, stomach tube ................................... X-ray guide, stomach tube ................................... X-ray guide, stomach tube ................................... X-ray guide, intestinal tube .................................. X-ray guide, intestinal tube .................................. X-ray guide, intestinal tube .................................. X-ray guide, GI dilation ........................................ X-ray guide, GI dilation ........................................ X-ray guide, GI dilation ........................................ X-ray, bile duct dilation ........................................ X-ray, bile duct dilation ........................................ X-ray, bile duct dilation ........................................ Contrst x-ray, urinary tract ................................... Contrst x-ray, urinary tract ................................... Contrst x-ray, urinary tract ................................... Contrst x-ray, urinary tract ................................... Contrst x-ray, urinary tract ................................... Contrst x-ray, urinary tract ................................... Contrst x-ray, urinary tract ................................... Contrst x-ray, urinary tract ................................... Contrst x-ray, urinary tract ................................... Contrst x-ray, urinary tract ................................... Contrst x-ray, urinary tract ................................... Contrst x-ray, urinary tract ................................... Contrst x-ray, urinary tract ................................... Description 0.54 0.00 0.54 0.70 0.00 0.70 0.00 0.00 0.70 0.00 0.00 0.70 0.00 0.00 0.90 0.00 0.00 0.54 0.76 0.00 0.76 0.00 0.00 0.76 0.00 0.00 0.54 0.00 0.00 0.88 0.49 0.00 0.49 0.49 0.00 0.49 0.49 0.00 0.49 0.00 0.00 0.36 0.00 Physician Work RVUs 3 2.00 1.84 0.16 2.78 2.58 0.20 NA NA 0.22 0.00 0.00 0.22 NA NA 0.27 NA NA 0.16 2.07 1.85 0.22 NA NA 0.22 NA NA 0.24 0.00 0.00 0.26 2.45 2.31 0.14 2.59 2.43 0.16 3.09 2.95 0.14 NA NA 0.12 NA Fully Implemented NonFacility PE RVUs 3.00 2.82 0.18 2.19 1.97 0.22 NA NA 0.23 0.00 0.00 0.23 NA NA 0.29 NA NA 0.18 3.07 2.83 0.24 NA NA 0.24 NA NA 0.20 0.00 0.00 0.28 2.00 1.84 0.16 2.23 2.07 0.16 2.49 2.33 0.16 NA NA 0.12 NA Year 2007 Transitional Non-Facility PE RVUs NA NA 0.16 NA NA 0.20 NA NA 0.22 0.00 0.00 0.22 NA NA 0.27 NA NA 0.16 NA NA 0.22 NA NA 0.22 NA NA 0.24 0.00 0.00 0.26 NA NA 0.14 NA NA 0.16 NA NA 0.14 NA NA 0.12 NA Fully Implemented Facility PE RVUs NA NA 0.18 NA NA 0.22 NA NA 0.23 0.00 0.00 0.23 NA NA 0.29 NA NA 0.18 NA NA 0.24 NA NA 0.24 NA NA 0.20 0.00 0.00 0.28 NA NA 0.16 NA NA 0.16 NA NA 0.16 NA NA 0.12 NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 74320 74320 74320 74327 74327 74327 74328 74328 74328 74329 74329 74329 74330 74330 74330 74340 74340 74340 74350 74350 74350 74355 74355 74355 74360 74360 74360 74363 74363 74363 74400 74400 74400 74410 74410 74410 74415 74415 74415 74420 74420 74420 74425 HCPCS 2 CPT 1/ 0.19 0.17 0.02 0.14 0.11 0.03 0.00 0.00 0.03 0.00 0.00 0.03 0.00 0.00 0.04 0.00 0.00 0.02 0.20 0.17 0.03 0.00 0.00 0.03 0.00 0.00 0.02 0.00 0.00 0.04 0.13 0.11 0.02 0.13 0.11 0.02 0.14 0.12 0.02 0.00 0.00 0.02 0.00 Mal-Practice RVUs 2.73 2.01 0.72 3.62 2.69 0.93 NA NA 0.95 0.00 0.00 0.95 NA NA 1.21 NA NA 0.72 3.03 2.02 1.01 NA NA 1.01 NA NA 0.80 0.00 0.00 1.18 3.07 2.42 0.65 3.21 2.54 0.67 3.72 3.07 0.65 NA NA 0.50 NA Fully Implemented NonFacility Total 3.73 2.99 0.74 3.03 2.08 0.95 NA NA 0.96 0.00 0.00 0.96 NA NA 1.23 NA NA 0.74 4.03 3.00 1.03 NA NA 1.03 NA NA 0.76 0.00 0.00 1.20 2.62 1.95 0.67 2.85 2.18 0.67 3.12 2.45 0.67 NA NA 0.50 NA Year 2007 Transitional Non-Facility Total NA NA 0.72 NA NA 0.93 NA NA 0.95 0.00 0.00 0.95 NA NA 1.21 NA NA 0.72 NA NA 1.01 NA NA 1.01 NA NA 0.80 0.00 0.00 1.18 NA NA 0.65 NA NA 0.67 NA NA 0.65 NA NA 0.50 NA Fully Implemented Facility Total NA NA 0.74 NA NA 0.95 NA NA 0.96 0.00 0.00 0.96 NA NA 1.23 NA NA 0.74 NA NA 1.03 NA NA 1.03 NA NA 0.76 0.00 0.00 1.20 NA NA 0.67 NA NA 0.67 NA NA 0.67 NA NA 0.50 NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69937 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00316 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 2 Copyright 3+ Mod C A A A A A A A C C A C C A A A A C C A A A A A A A A A A A A A A A A C C A C C A A A Status Contrst x-ray, urinary tract ................................... Contrst x-ray, urinary tract ................................... Contrast x-ray, bladder ........................................ Contrast x-ray, bladder ........................................ Contrast x-ray, bladder ........................................ X-ray, male genital tract ....................................... X-ray, male genital tract ....................................... X-ray, male genital tract ....................................... X-ray exam of penis ............................................. X-ray exam of penis ............................................. X-ray exam of penis ............................................. X-ray, urethra/bladder .......................................... X-ray, urethra/bladder .......................................... X-ray, urethra/bladder .......................................... X-ray, urethra/bladder .......................................... X-ray, urethra/bladder .......................................... X-ray, urethra/bladder .......................................... X-ray exam of kidney lesion ................................ X-ray exam of kidney lesion ................................ X-ray exam of kidney lesion ................................ X-ray control, cath insert ...................................... X-ray control, cath insert ...................................... X-ray control, cath insert ...................................... X-ray control, cath insert ...................................... X-ray control, cath insert ...................................... X-ray control, cath insert ...................................... X-ray guide, GU dilation ....................................... X-ray guide, GU dilation ....................................... X-ray guide, GU dilation ....................................... X-ray measurement of pelvis ............................... X-ray measurement of pelvis ............................... X-ray measurement of pelvis ............................... X-ray, female genital tract .................................... X-ray, female genital tract .................................... X-ray, female genital tract .................................... X-ray, fallopian tube ............................................. X-ray, fallopian tube ............................................. X-ray, fallopian tube ............................................. X-ray exam of perineum ...................................... X-ray exam of perineum ...................................... X-ray exam of perineum ...................................... Heart mri for morph w/o dye ................................ Heart mri for morph w/o dye ................................ Description 0.00 0.36 0.32 0.00 0.32 0.38 0.00 0.38 0.00 0.00 1.14 0.00 0.00 0.33 0.33 0.00 0.33 0.00 0.00 0.54 0.54 0.00 0.54 0.54 0.00 0.54 0.54 0.00 0.54 0.34 0.00 0.34 0.38 0.00 0.38 0.00 0.00 0.61 0.00 0.00 0.62 1.60 0.00 Physician Work RVUs 3 NA 0.10 1.87 1.77 0.10 2.17 2.02 0.15 NA NA 0.43 NA NA 0.11 2.11 1.99 0.12 NA NA 0.15 1.99 1.83 0.16 2.00 1.84 0.16 2.18 2.00 0.18 0.61 0.51 0.10 1.67 1.56 0.11 0.00 0.00 0.15 NA NA 0.17 18.32 17.80 Fully Implemented NonFacility PE RVUs NA 0.12 1.33 1.23 0.10 1.48 1.35 0.13 NA NA 0.39 NA NA 0.11 1.79 1.68 0.11 NA NA 0.17 3.69 3.51 0.18 3.69 3.51 0.18 3.03 2.86 0.17 1.03 0.92 0.11 1.50 1.37 0.13 0.00 0.00 0.19 NA NA 0.20 13.38 12.85 Year 2007 Transitional Non-Facility PE RVUs NA 0.10 NA NA 0.10 NA NA 0.15 NA NA 0.43 NA NA 0.11 NA NA 0.12 NA NA 0.15 NA NA 0.16 NA NA 0.16 NA NA 0.18 NA NA 0.10 NA NA 0.11 0.00 0.00 0.15 NA NA 0.17 NA NA Fully Implemented Facility PE RVUs NA 0.12 NA NA 0.10 NA NA 0.13 NA NA 0.39 NA NA 0.11 NA NA 0.11 NA NA 0.17 NA NA 0.18 NA NA 0.18 NA NA 0.17 NA NA 0.11 NA NA 0.13 0.00 0.00 0.19 NA NA 0.20 NA NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 74425 74425 74430 74430 74430 74440 74440 74440 74445 74445 74445 74450 74450 74450 74455 74455 74455 74470 74470 74470 74475 74475 74475 74480 74480 74480 74485 74485 74485 74710 74710 74710 74740 74740 74740 74742 74742 74742 74775 74775 74775 75552 75552 HCPCS 2 CPT 1/ 0.00 0.02 0.08 0.06 0.02 0.08 0.06 0.02 0.00 0.00 0.07 0.00 0.00 0.02 0.12 0.10 0.02 0.00 0.00 0.02 0.24 0.22 0.02 0.24 0.22 0.02 0.20 0.17 0.03 0.08 0.06 0.02 0.09 0.07 0.02 0.00 0.00 0.03 0.00 0.00 0.03 0.66 0.59 Mal-Practice RVUs NA 0.48 2.27 1.83 0.44 2.63 2.08 0.55 NA NA 1.64 NA NA 0.46 2.56 2.09 0.47 NA NA 0.71 2.77 2.05 0.72 2.78 2.06 0.72 2.92 2.17 0.75 1.03 0.57 0.46 2.14 1.63 0.51 0.00 0.00 0.79 NA NA 0.82 20.58 18.39 Fully Implemented NonFacility Total NA 0.50 1.73 1.29 0.44 1.94 1.41 0.53 NA NA 1.60 NA NA 0.46 2.24 1.78 0.46 NA NA 0.73 4.47 3.73 0.74 4.47 3.73 0.74 3.77 3.03 0.74 1.45 0.98 0.47 1.97 1.44 0.53 0.00 0.00 0.83 NA NA 0.85 15.64 13.44 Year 2007 Transitional Non-Facility Total NA 0.48 NA NA 0.44 NA NA 0.55 NA NA 1.64 NA NA 0.46 NA NA 0.47 NA NA 0.71 NA NA 0.72 NA NA 0.72 NA NA 0.75 NA NA 0.46 NA NA 0.51 0.00 0.00 0.79 NA NA 0.82 NA NA Fully Implemented Facility Total NA 0.50 NA NA 0.44 NA NA 0.53 NA NA 1.60 NA NA 0.46 NA NA 0.46 NA NA 0.73 NA NA 0.74 NA NA 0.74 NA NA 0.74 NA NA 0.47 NA NA 0.53 0.00 0.00 0.83 NA NA 0.85 NA NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69938 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00317 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 2 Copyright 3+ Mod A A A A A A A A A A N A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Heart mri for morph w/o dye ................................ Heart mri for morph w/dye ................................... Heart mri for morph w/dye ................................... Heart mri for morph w/dye ................................... Cardiac MRI/function ............................................ Cardiac MRI/function ............................................ Cardiac MRI/function ............................................ Cardiac MRI/limited study .................................... Cardiac MRI/limited study .................................... Cardiac MRI/limited study .................................... Cardiac MRI/flow mapping ................................... Contrast x-ray exam of aorta ............................... Contrast x-ray exam of aorta ............................... Contrast x-ray exam of aorta ............................... Contrast x-ray exam of aorta ............................... Contrast x-ray exam of aorta ............................... Contrast x-ray exam of aorta ............................... Contrast x-ray exam of aorta ............................... Contrast x-ray exam of aorta ............................... Contrast x-ray exam of aorta ............................... X-ray aorta, leg arteries ....................................... X-ray aorta, leg arteries ....................................... X-ray aorta, leg arteries ....................................... Ct angio abdominal arteries ................................. Ct angio abdominal arteries ................................. Ct angio abdominal arteries ................................. Artery x-rays, head & neck .................................. Artery x-rays, head & neck .................................. Artery x-rays, head & neck .................................. Artery x-rays, arm ................................................ Artery x-rays, arm ................................................ Artery x-rays, arm ................................................ Artery x-rays, head & neck .................................. Artery x-rays, head & neck .................................. Artery x-rays, head & neck .................................. Artery x-rays, head & neck .................................. Artery x-rays, head & neck .................................. Artery x-rays, head & neck .................................. Artery x-rays, head & neck .................................. Artery x-rays, head & neck .................................. Artery x-rays, head & neck .................................. Artery x-rays, head & neck .................................. Artery x-rays, head & neck .................................. Description 1.60 2.00 0.00 2.00 1.83 0.00 1.83 1.74 0.00 1.74 0.00 0.49 0.00 0.49 1.14 0.00 1.14 1.14 0.00 1.14 1.79 0.00 1.79 2.40 0.00 2.40 1.49 0.00 1.49 1.31 0.00 1.31 1.31 0.00 1.31 1.66 0.00 1.66 1.31 0.00 1.31 1.66 0.00 Physician Work RVUs 3 0.52 23.65 22.72 0.93 26.45 25.67 0.78 27.01 26.18 0.83 0.00 6.39 6.14 0.25 3.52 3.03 0.49 3.25 2.85 0.40 3.72 3.01 0.71 12.15 11.40 0.75 3.37 2.85 0.52 3.73 3.26 0.47 3.78 3.31 0.47 4.96 4.26 0.70 3.92 3.48 0.44 4.84 4.27 Fully Implemented NonFacility PE RVUs 0.53 14.80 14.08 0.72 15.50 14.82 0.68 15.64 14.95 0.69 0.00 11.20 10.99 0.21 10.63 10.21 0.42 10.55 10.16 0.39 11.24 10.60 0.64 15.56 14.78 0.78 10.66 10.16 0.50 10.74 10.27 0.47 10.73 10.28 0.45 11.14 10.52 0.62 10.76 10.32 0.44 11.08 10.52 Year 2007 Transitional Non-Facility PE RVUs 0.52 NA NA 0.93 NA NA 0.78 NA NA 0.83 0.00 NA NA 0.25 NA NA 0.49 NA NA 0.40 NA NA 0.71 NA NA 0.75 NA NA 0.52 NA NA 0.47 NA NA 0.47 NA NA 0.70 NA NA 0.44 NA NA Fully Implemented Facility PE RVUs 0.53 NA NA 0.72 NA NA 0.68 NA NA 0.69 0.00 NA NA 0.21 NA NA 0.42 NA NA 0.39 NA NA 0.64 NA NA 0.78 NA NA 0.50 NA NA 0.47 NA NA 0.45 NA NA 0.62 NA NA 0.44 NA NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 75552 75553 75553 75553 75554 75554 75554 75555 75555 75555 75556 75600 75600 75600 75605 75605 75605 75625 75625 75625 75630 75630 75630 75635 75635 75635 75650 75650 75650 75658 75658 75658 75660 75660 75660 75662 75662 75662 75665 75665 75665 75671 75671 HCPCS 2 CPT 1/ 0.07 0.66 0.59 0.07 0.66 0.59 0.07 0.66 0.59 0.07 0.00 0.67 0.65 0.02 0.70 0.65 0.05 0.71 0.65 0.06 0.80 0.69 0.11 0.50 0.39 0.11 0.72 0.65 0.07 0.72 0.65 0.07 0.71 0.65 0.06 0.71 0.65 0.06 0.74 0.65 0.09 0.72 0.65 Mal-Practice RVUs 2.19 26.31 23.31 3.00 28.94 26.26 2.68 29.41 26.77 2.64 0.00 7.55 6.79 0.76 5.36 3.68 1.68 5.10 3.50 1.60 6.31 3.70 2.61 15.05 11.79 3.26 5.58 3.50 2.08 5.76 3.91 1.85 5.80 3.96 1.84 7.33 4.91 2.42 5.97 4.13 1.84 7.22 4.92 Fully Implemented NonFacility Total 2.20 17.46 14.67 2.79 17.99 15.41 2.58 18.04 15.54 2.50 0.00 12.36 11.64 0.72 12.47 10.86 1.61 12.40 10.81 1.59 13.83 11.29 2.54 18.46 15.17 3.29 12.87 10.81 2.06 12.77 10.92 1.85 12.75 10.93 1.82 13.51 11.17 2.34 12.81 10.97 1.84 13.46 11.17 Year 2007 Transitional Non-Facility Total 2.19 NA NA 3.00 NA NA 2.68 NA NA 2.64 0.00 NA NA 0.76 NA NA 1.68 NA NA 1.60 NA NA 2.61 NA NA 3.26 NA NA 2.08 NA NA 1.85 NA NA 1.84 NA NA 2.42 NA NA 1.84 NA NA Fully Implemented Facility Total 2.20 NA NA 2.79 NA NA 2.58 NA NA 2.50 0.00 NA NA 0.72 NA NA 1.61 NA NA 1.59 NA NA 2.54 NA NA 3.29 NA NA 2.06 NA NA 1.85 NA NA 1.82 NA NA 2.34 NA NA 1.84 NA NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69939 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00318 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery Artery x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, x-rays, head & neck .................................. neck ............................................... neck ............................................... neck ............................................... neck ............................................... neck ............................................... neck ............................................... spine .............................................. spine .............................................. spine .............................................. spine .............................................. spine .............................................. spine .............................................. arm/leg ........................................... arm/leg ........................................... arm/leg ........................................... arms/legs ....................................... arms/legs ....................................... arms/legs ....................................... kidney ............................................ kidney ............................................ kidney ............................................ kidneys .......................................... kidneys .......................................... kidneys .......................................... abdomen ........................................ abdomen ........................................ abdomen ........................................ adrenal gland ................................. adrenal gland ................................. adrenal gland ................................. adrenals ......................................... adrenals ......................................... adrenals ......................................... pelvis ............................................. pelvis ............................................. pelvis ............................................. lung ................................................ lung ................................................ lung ................................................ lungs .............................................. lungs .............................................. lungs .............................................. Description 1.66 1.31 0.00 1.31 1.66 0.00 1.66 1.31 0.00 1.31 2.18 0.00 2.18 1.14 0.00 1.14 1.31 0.00 1.31 1.14 0.00 1.14 1.49 0.00 1.49 1.14 0.00 1.14 1.14 0.00 1.14 1.31 0.00 1.31 1.14 0.00 1.14 1.31 0.00 1.31 1.66 0.00 1.66 Physician Work RVUs 3 0.57 3.71 3.26 0.45 4.41 3.81 0.60 3.71 3.25 0.46 3.81 3.15 0.66 3.87 3.46 0.41 4.75 4.28 0.47 3.78 3.32 0.46 5.13 4.37 0.76 3.51 3.16 0.35 3.72 3.32 0.40 5.11 4.53 0.58 3.69 3.30 0.39 2.96 2.55 0.41 3.30 2.79 0.51 Fully Implemented NonFacility PE RVUs 0.56 10.71 10.27 0.44 10.96 10.40 0.56 10.70 10.26 0.44 10.95 10.24 0.71 10.72 10.32 0.40 10.96 10.52 0.44 10.70 10.28 0.42 11.15 10.54 0.61 10.61 10.24 0.37 10.66 10.28 0.38 11.06 10.58 0.48 10.66 10.28 0.38 10.52 10.09 0.43 10.68 10.15 0.53 Year 2007 Transitional Non-Facility PE RVUs 0.57 NA NA 0.45 NA NA 0.60 NA NA 0.46 NA NA 0.66 NA NA 0.41 NA NA 0.47 NA NA 0.46 NA NA 0.76 NA NA 0.35 NA NA 0.40 NA NA 0.58 NA NA 0.39 NA NA 0.41 NA NA 0.51 Fully Implemented Facility PE RVUs 0.56 NA NA 0.44 NA NA 0.56 NA NA 0.44 NA NA 0.71 NA NA 0.40 NA NA 0.44 NA NA 0.42 NA NA 0.61 NA NA 0.37 NA NA 0.38 NA NA 0.48 NA NA 0.38 NA NA 0.43 NA NA 0.53 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 75671 75676 75676 75676 75680 75680 75680 75685 75685 75685 75705 75705 75705 75710 75710 75710 75716 75716 75716 75722 75722 75722 75724 75724 75724 75726 75726 75726 75731 75731 75731 75733 75733 75733 75736 75736 75736 75741 75741 75741 75743 75743 75743 HCPCS 2 CPT 1/ 0.07 0.72 0.65 0.07 0.72 0.65 0.07 0.71 0.65 0.06 0.78 0.65 0.13 0.72 0.65 0.07 0.72 0.65 0.07 0.70 0.65 0.05 0.70 0.65 0.05 0.70 0.65 0.05 0.71 0.65 0.06 0.71 0.65 0.06 0.71 0.65 0.06 0.71 0.65 0.06 0.72 0.65 0.07 Mal-Practice RVUs 2.30 5.74 3.91 1.83 6.79 4.46 2.33 5.73 3.90 1.83 6.77 3.80 2.97 5.73 4.11 1.62 6.78 4.93 1.85 5.62 3.97 1.65 7.32 5.02 2.30 5.35 3.81 1.54 5.57 3.97 1.60 7.13 5.18 1.95 5.54 3.95 1.59 4.98 3.20 1.78 5.68 3.44 2.24 Fully Implemented NonFacility Total 2.29 12.74 10.92 1.82 13.34 11.05 2.29 12.72 10.91 1.81 13.91 10.89 3.02 12.58 10.97 1.61 12.99 11.17 1.82 12.54 10.93 1.61 13.34 11.19 2.15 12.45 10.89 1.56 12.51 10.93 1.58 13.08 11.23 1.85 12.51 10.93 1.58 12.54 10.74 1.80 13.06 10.80 2.26 Year 2007 Transitional Non-Facility Total 2.30 NA NA 1.83 NA NA 2.33 NA NA 1.83 NA NA 2.97 NA NA 1.62 NA NA 1.85 NA NA 1.65 NA NA 2.30 NA NA 1.54 NA NA 1.60 NA NA 1.95 NA NA 1.59 NA NA 1.78 NA NA 2.24 Fully Implemented Facility Total 2.29 NA NA 1.82 NA NA 2.29 NA NA 1.81 NA NA 3.02 NA NA 1.61 NA NA 1.82 NA NA 1.61 NA NA 2.15 NA NA 1.56 NA NA 1.58 NA NA 1.85 NA NA 1.58 NA NA 1.80 NA NA 2.26 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69940 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00319 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A C C A C C A C C A C C A A A A C C A A A A A A A A A A A A A A Status Artery x-rays, lung ................................................ Artery x-rays, lung ................................................ Artery x-rays, lung ................................................ Artery x-rays, chest .............................................. Artery x-rays, chest .............................................. Artery x-rays, chest .............................................. Artery x-ray, each vessel ..................................... Artery x-ray, each vessel ..................................... Artery x-ray, each vessel ..................................... Visualize A–V shunt ............................................. Visualize A–V shunt ............................................. Visualize A–V shunt ............................................. Lymph vessel x-ray, arm/leg ................................ Lymph vessel x-ray, arm/leg ................................ Lymph vessel x-ray, arm/leg ................................ Lymph vessel x-ray,arms/legs ............................. Lymph vessel x-ray,arms/legs ............................. Lymph vessel x-ray,arms/legs ............................. Lymph vessel x-ray, trunk .................................... Lymph vessel x-ray, trunk .................................... Lymph vessel x-ray, trunk .................................... Lymph vessel x-ray, trunk .................................... Lymph vessel x-ray, trunk .................................... Lymph vessel x-ray, trunk .................................... Nonvascular shunt, x-ray ..................................... Nonvascular shunt, x-ray ..................................... Nonvascular shunt, x-ray ..................................... Vein x-ray, spleen/liver ......................................... Vein x-ray, spleen/liver ......................................... Vein x-ray, spleen/liver ......................................... Vein x-ray, arm/leg ............................................... Vein x-ray, arm/leg ............................................... Vein x-ray, arm/leg ............................................... Vein x-ray, arms/legs ........................................... Vein x-ray, arms/legs ........................................... Vein x-ray, arms/legs ........................................... Vein x-ray, trunk ................................................... Vein x-ray, trunk ................................................... Vein x-ray, trunk ................................................... Vein x-ray, chest .................................................. Vein x-ray, chest .................................................. Vein x-ray, chest .................................................. Vein x-ray, kidney ................................................ Description 1.14 0.00 1.14 1.14 0.00 1.14 0.36 0.00 0.36 1.84 0.00 1.84 0.00 0.00 0.81 0.00 0.00 1.17 0.00 0.00 0.81 0.00 0.00 1.17 0.47 0.00 0.47 0.00 0.00 1.14 0.70 0.00 0.70 1.06 0.00 1.06 1.14 0.00 1.14 1.14 0.00 1.14 1.14 Physician Work RVUs 3 3.30 2.96 0.34 4.38 3.77 0.61 2.43 2.31 0.12 2.94 2.42 0.52 NA NA 0.22 NA NA 0.31 NA NA 0.22 0.00 0.00 0.34 2.05 1.92 0.13 NA NA 0.34 2.92 2.65 0.27 3.00 2.68 0.32 2.77 2.44 0.33 2.81 2.48 0.33 2.88 Fully Implemented NonFacility PE RVUs 10.56 10.19 0.37 10.88 10.39 0.49 10.15 10.03 0.12 2.20 1.62 0.58 NA NA 0.26 NA NA 0.36 NA NA 0.26 0.00 0.00 0.37 1.22 1.07 0.15 NA NA 0.36 1.62 1.38 0.24 2.12 1.78 0.34 10.42 10.06 0.36 10.43 10.07 0.36 10.45 Year 2007 Transitional Non-Facility PE RVUs NA NA 0.34 NA NA 0.61 2.43 2.31 0.12 NA NA 0.52 NA NA 0.22 NA NA 0.31 NA NA 0.22 0.00 0.00 0.34 NA NA 0.13 NA NA 0.34 NA NA 0.27 NA NA 0.32 NA NA 0.33 NA NA 0.33 NA Fully Implemented Facility PE RVUs NA NA 0.37 NA NA 0.49 10.15 10.03 0.12 NA NA 0.58 NA NA 0.26 NA NA 0.36 NA NA 0.26 0.00 0.00 0.37 NA NA 0.15 NA NA 0.36 NA NA 0.24 NA NA 0.34 NA NA 0.36 NA NA 0.36 NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 75746 75746 75746 75756 75756 75756 75774 75774 75774 75790 75790 75790 75801 75801 75801 75803 75803 75803 75805 75805 75805 75807 75807 75807 75809 75809 75809 75810 75810 75810 75820 75820 75820 75822 75822 75822 75825 75825 75825 75827 75827 75827 75831 HCPCS 2 CPT 1/ 0.70 0.65 0.05 0.69 0.65 0.04 0.67 0.65 0.02 0.17 0.08 0.09 0.00 0.00 0.08 0.00 0.00 0.05 0.00 0.00 0.05 0.00 0.00 0.05 0.07 0.05 0.02 0.00 0.00 0.05 0.09 0.06 0.03 0.13 0.08 0.05 0.72 0.65 0.07 0.70 0.65 0.05 0.71 Mal-Practice RVUs 5.14 3.61 1.53 6.21 4.42 1.79 3.46 2.96 0.50 4.95 2.50 2.45 NA NA 1.11 NA NA 1.53 NA NA 1.08 0.00 0.00 1.56 2.59 1.97 0.62 NA NA 1.53 3.71 2.71 1.00 4.19 2.76 1.43 4.63 3.09 1.54 4.65 3.13 1.52 4.73 Fully Implemented NonFacility Total 12.40 10.84 1.56 12.71 11.04 1.67 11.18 10.68 0.50 4.21 1.70 2.51 NA NA 1.15 NA NA 1.58 NA NA 1.12 0.00 0.00 1.59 1.76 1.12 0.64 NA NA 1.55 2.41 1.44 0.97 3.31 1.86 1.45 12.28 10.71 1.57 12.27 10.72 1.55 12.30 Year 2007 Transitional Non-Facility Total NA NA 1.53 NA NA 1.79 3.46 2.96 0.50 NA NA 2.45 NA NA 1.11 NA NA 1.53 NA NA 1.08 0.00 0.00 1.56 NA NA 0.62 NA NA 1.53 NA NA 1.00 NA NA 1.43 NA NA 1.54 NA NA 1.52 NA Fully Implemented Facility Total NA NA 1.56 NA NA 1.67 11.18 10.68 0.50 NA NA 2.51 NA NA 1.15 NA NA 1.58 NA NA 1.12 0.00 0.00 1.59 NA NA 0.64 NA NA 1.55 NA NA 0.97 NA NA 1.45 NA NA 1.57 NA NA 1.55 NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX ZZZ ZZZ ZZZ XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69941 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00320 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C C A C C Status Vein x-ray, kidney ................................................ Vein x-ray, kidney ................................................ Vein x-ray, kidneys ............................................... Vein x-ray, kidneys ............................................... Vein x-ray, kidneys ............................................... Vein x-ray, adrenal gland ..................................... Vein x-ray, adrenal gland ..................................... Vein x-ray, adrenal gland ..................................... Vein x-ray, adrenal glands ................................... Vein x-ray, adrenal glands ................................... Vein x-ray, adrenal glands ................................... Vein x-ray, neck ................................................... Vein x-ray, neck ................................................... Vein x-ray, neck ................................................... Vein x-ray, skull .................................................... Vein x-ray, skull .................................................... Vein x-ray, skull .................................................... Vein x-ray, skull .................................................... Vein x-ray, skull .................................................... Vein x-ray, skull .................................................... Vein x-ray, eye socket ......................................... Vein x-ray, eye socket ......................................... Vein x-ray, eye socket ......................................... Vein x-ray, liver .................................................... Vein x-ray, liver .................................................... Vein x-ray, liver .................................................... Vein x-ray, liver .................................................... Vein x-ray, liver .................................................... Vein x-ray, liver .................................................... Vein x-ray, liver .................................................... Vein x-ray, liver .................................................... Vein x-ray, liver .................................................... Vein x-ray, liver .................................................... Vein x-ray, liver .................................................... Vein x-ray, liver .................................................... Venous sampling by catheter .............................. Venous sampling by catheter .............................. Venous sampling by catheter .............................. X-rays, transcath therapy ..................................... X-rays, transcath therapy ..................................... X-rays, transcath therapy ..................................... X-rays, transcath therapy ..................................... X-rays, transcath therapy ..................................... Description 0.00 1.14 1.49 0.00 1.49 1.14 0.00 1.14 1.49 0.00 1.49 1.14 0.00 1.14 1.14 0.00 1.14 1.14 0.00 1.14 0.70 0.00 0.70 1.44 0.00 1.44 1.44 0.00 1.44 1.14 0.00 1.14 1.14 0.00 1.14 0.54 0.00 0.54 0.00 0.00 1.31 0.00 0.00 Physician Work RVUs 3 2.55 0.33 3.50 3.06 0.44 3.17 2.74 0.43 3.44 3.00 0.44 3.37 2.88 0.49 3.11 2.73 0.38 3.85 3.42 0.43 2.87 2.65 0.22 2.95 2.53 0.42 3.17 2.70 0.47 2.87 2.53 0.34 2.84 2.51 0.33 2.71 2.55 0.16 NA NA 0.39 NA NA Fully Implemented NonFacility PE RVUs 10.09 0.36 10.70 10.22 0.48 10.53 10.14 0.39 10.67 10.20 0.47 10.59 10.17 0.42 10.52 10.13 0.39 10.70 10.31 0.39 1.61 1.38 0.23 10.54 10.08 0.46 10.60 10.13 0.47 10.44 10.08 0.36 10.44 10.08 0.36 10.27 10.09 0.18 NA NA 0.42 NA NA Year 2007 Transitional Non-Facility PE RVUs NA 0.33 NA NA 0.44 NA NA 0.43 NA NA 0.44 NA NA 0.49 NA NA 0.38 NA NA 0.43 NA NA 0.22 NA NA 0.42 NA NA 0.47 NA NA 0.34 NA NA 0.33 NA NA 0.16 NA NA 0.39 NA NA Fully Implemented Facility PE RVUs NA 0.36 NA NA 0.48 NA NA 0.39 NA NA 0.47 NA NA 0.42 NA NA 0.39 NA NA 0.39 NA NA 0.23 NA NA 0.46 NA NA 0.47 NA NA 0.36 NA NA 0.36 NA NA 0.18 NA NA 0.42 NA NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 75831 75831 75833 75833 75833 75840 75840 75840 75842 75842 75842 75860 75860 75860 75870 75870 75870 75872 75872 75872 75880 75880 75880 75885 75885 75885 75887 75887 75887 75889 75889 75889 75891 75891 75891 75893 75893 75893 75894 75894 75894 75896 75896 HCPCS 2 CPT 1/ 0.65 0.06 0.74 0.65 0.09 0.72 0.65 0.07 0.72 0.65 0.07 0.69 0.65 0.04 0.70 0.65 0.05 0.79 0.65 0.14 0.09 0.06 0.03 0.71 0.65 0.06 0.71 0.65 0.06 0.70 0.65 0.05 0.70 0.65 0.05 0.67 0.65 0.02 0.00 0.00 0.08 0.00 0.00 Mal-Practice RVUs 3.20 1.53 5.73 3.71 2.02 5.03 3.39 1.64 5.65 3.65 2.00 5.20 3.53 1.67 4.95 3.38 1.57 5.78 4.07 1.71 3.66 2.71 0.95 5.10 3.18 1.92 5.32 3.35 1.97 4.71 3.18 1.53 4.68 3.16 1.52 3.92 3.20 0.72 NA NA 1.78 NA NA Fully Implemented NonFacility Total 10.74 1.56 12.93 10.87 2.06 12.39 10.79 1.60 12.88 10.85 2.03 12.42 10.82 1.60 12.36 10.78 1.58 12.63 10.96 1.67 2.40 1.44 0.96 12.69 10.73 1.96 12.75 10.78 1.97 12.28 10.73 1.55 12.28 10.73 1.55 11.48 10.74 0.74 NA NA 1.81 NA NA Year 2007 Transitional Non-Facility Total NA 1.53 NA NA 2.02 NA NA 1.64 NA NA 2.00 NA NA 1.67 NA NA 1.57 NA NA 1.71 NA NA 0.95 NA NA 1.92 NA NA 1.97 NA NA 1.53 NA NA 1.52 NA NA 0.72 NA NA 1.78 NA NA Fully Implemented Facility Total NA 1.56 NA NA 2.06 NA NA 1.60 NA NA 2.03 NA NA 1.60 NA NA 1.58 NA NA 1.67 NA NA 0.96 NA NA 1.96 NA NA 1.97 NA NA 1.55 NA NA 1.55 NA NA 0.74 NA NA 1.81 NA NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69942 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00321 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... 2 Copyright 3+ Mod A C C A C C A A A A A A A C C A C C A C C A C C A C C A C C A C C A C C A C C A C C A Status X-rays, transcath therapy ..................................... Follow-up angiography ......................................... Follow-up angiography ......................................... Follow-up angiography ......................................... Intravascular cath exchange ................................ Intravascular cath exchange ................................ Intravascular cath exchange ................................ Remove cva device obstruct ................................ Remove cva device obstruct ................................ Remove cva device obstruct ................................ Remove cva lumen obstruct ................................ Remove cva lumen obstruct ................................ Remove cva lumen obstruct ................................ X-ray placement, vein filter .................................. X-ray placement, vein filter .................................. X-ray placement, vein filter .................................. Intravascular us .................................................... Intravascular us .................................................... Intravascular us .................................................... Intravascular us add-on ....................................... Intravascular us add-on ....................................... Intravascular us add-on ....................................... Endovasc repair abdom aorta .............................. Endovasc repair abdom aorta .............................. Endovasc repair abdom aorta .............................. Abdom aneurysm endovas rpr ............................. Abdom aneurysm endovas rpr ............................. Abdom aneurysm endovas rpr ............................. Iliac aneurysm endovas rpr .................................. Iliac aneurysm endovas rpr .................................. Iliac aneurysm endovas rpr .................................. Xray, endovasc thor ao repr ................................ Xray, endovasc thor ao repr ................................ Xray, endovasc thor ao repr ................................ Xray, endovasc thor ao repr ................................ Xray, endovasc thor ao repr ................................ Xray, endovasc thor ao repr ................................ Xray, place prox ext thor ao ................................ Xray, place prox ext thor ao ................................ Xray, place prox ext thor ao ................................ Xray, place dist ext thor ao .................................. Xray, place dist ext thor ao .................................. Xray, place dist ext thor ao .................................. Description 1.31 0.00 0.00 1.65 0.00 0.00 0.49 0.49 0.00 0.49 0.39 0.00 0.39 0.00 0.00 0.54 0.00 0.00 0.40 0.00 0.00 0.40 0.00 0.00 4.49 0.00 0.00 1.36 0.00 0.00 2.25 0.00 0.00 7.00 0.00 0.00 6.00 0.00 0.00 4.00 0.00 0.00 3.50 Physician Work RVUs 3 0.49 NA NA 0.56 0.00 0.00 0.15 3.94 3.80 0.14 1.54 1.43 0.11 NA NA 0.16 NA NA 0.15 0.00 0.00 0.13 0.00 0.00 1.27 0.00 0.00 0.39 0.00 0.00 0.64 0.00 0.00 1.78 0.00 0.00 1.56 0.00 0.00 0.98 0.00 0.00 0.86 Fully Implemented NonFacility PE RVUs 0.46 NA NA 0.55 0.00 0.00 0.16 2.09 1.93 0.16 1.47 1.34 0.13 NA NA 0.18 NA NA 0.14 0.00 0.00 0.14 0.00 0.00 1.44 0.00 0.00 0.44 0.00 0.00 0.75 0.00 0.00 2.47 0.00 0.00 2.12 0.00 0.00 1.41 0.00 0.00 1.24 Year 2007 Transitional Non-Facility PE RVUs 0.49 NA NA 0.56 0.00 0.00 0.15 NA NA 0.14 NA NA 0.11 NA NA 0.16 NA NA 0.15 0.00 0.00 0.13 0.00 0.00 1.27 0.00 0.00 0.39 0.00 0.00 0.64 0.00 0.00 1.78 0.00 0.00 1.56 0.00 0.00 0.98 0.00 0.00 0.86 Fully Implemented Facility PE RVUs 0.46 NA NA 0.55 0.00 0.00 0.16 NA NA 0.16 NA NA 0.13 NA NA 0.18 NA NA 0.14 0.00 0.00 0.14 0.00 0.00 1.44 0.00 0.00 0.44 0.00 0.00 0.75 0.00 0.00 2.47 0.00 0.00 2.12 0.00 0.00 1.41 0.00 0.00 1.24 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 75896 75898 75898 75898 75900 75900 75900 75901 75901 75901 75902 75902 75902 75940 75940 75940 75945 75945 75945 75946 75946 75946 75952 75952 75952 75953 75953 75953 75954 75954 75954 75956 75956 75956 75957 75957 75957 75958 75958 75958 75959 75959 75959 HCPCS 2 CPT 1/ 0.05 0.00 0.00 0.07 0.00 0.00 0.03 0.85 0.83 0.02 0.85 0.83 0.02 0.00 0.00 0.04 0.00 0.00 0.04 0.00 0.00 0.05 0.00 0.00 0.43 0.00 0.00 0.13 0.00 0.00 0.15 0.00 0.00 0.69 0.00 0.00 0.59 0.00 0.00 0.39 0.00 0.00 0.34 Mal-Practice RVUs 1.85 NA NA 2.28 0.00 0.00 0.67 5.28 4.63 0.65 2.78 2.26 0.52 NA NA 0.74 NA NA 0.59 0.00 0.00 0.58 0.00 0.00 6.19 0.00 0.00 1.88 0.00 0.00 3.04 0.00 0.00 9.47 0.00 0.00 8.15 0.00 0.00 5.37 0.00 0.00 4.70 Fully Implemented NonFacility Total 1.82 NA NA 2.27 0.00 0.00 0.68 3.43 2.76 0.67 2.71 2.17 0.54 NA NA 0.76 NA NA 0.58 0.00 0.00 0.59 0.00 0.00 6.36 0.00 0.00 1.93 0.00 0.00 3.15 0.00 0.00 10.16 0.00 0.00 8.71 0.00 0.00 5.80 0.00 0.00 5.08 Year 2007 Transitional Non-Facility Total 1.85 NA NA 2.28 0.00 0.00 0.67 NA NA 0.65 NA NA 0.52 NA NA 0.74 NA NA 0.59 0.00 0.00 0.58 0.00 0.00 6.19 0.00 0.00 1.88 0.00 0.00 3.04 0.00 0.00 9.47 0.00 0.00 8.15 0.00 0.00 5.37 0.00 0.00 4.70 Fully Implemented Facility Total 1.82 NA NA 2.27 0.00 0.00 0.68 NA NA 0.67 NA NA 0.54 NA NA 0.76 NA NA 0.58 0.00 0.00 0.59 0.00 0.00 6.36 0.00 0.00 1.93 0.00 0.00 3.15 0.00 0.00 10.16 0.00 0.00 8.71 0.00 0.00 5.80 0.00 0.00 5.08 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX ZZZ ZZZ ZZZ XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69943 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00322 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... 2 Copyright 3+ Mod C C A A A A A A A A A A A A A A A A C C A A A A C C A C C A A A A A A A C C A C C A C Status Transcath iv stent rs&i ......................................... Transcath iv stent rs&i ......................................... Transcath iv stent rs&i ......................................... Retrieval, broken catheter .................................... Retrieval, broken catheter .................................... Retrieval, broken catheter .................................... Repair arterial blockage ....................................... Repair arterial blockage ....................................... Repair arterial blockage ....................................... Repair artery blockage, each ............................... Repair artery blockage, each ............................... Repair artery blockage, each ............................... Repair arterial blockage ....................................... Repair arterial blockage ....................................... Repair arterial blockage ....................................... Repair artery blockage, each ............................... Repair artery blockage, each ............................... Repair artery blockage, each ............................... Vascular biopsy .................................................... Vascular biopsy .................................................... Vascular biopsy .................................................... Repair venous blockage ...................................... Repair venous blockage ...................................... Repair venous blockage ...................................... Contrast xray exam bile duct ............................... Contrast xray exam bile duct ............................... Contrast xray exam bile duct ............................... Contrast xray exam bile duct ............................... Contrast xray exam bile duct ............................... Contrast xray exam bile duct ............................... Xray control catheter change ............................... Xray control catheter change ............................... Xray control catheter change ............................... Abscess drainage under x-ray ............................. Abscess drainage under x-ray ............................. Abscess drainage under x-ray ............................. Atherectomy, x-ray exam ..................................... Atherectomy, x-ray exam ..................................... Atherectomy, x-ray exam ..................................... Atherectomy, x-ray exam ..................................... Atherectomy, x-ray exam ..................................... Atherectomy, x-ray exam ..................................... Atherectomy, x-ray exam ..................................... Description 0.00 0.00 0.82 4.24 0.00 4.24 0.54 0.00 0.54 0.36 0.00 0.36 1.31 0.00 1.31 0.36 0.00 0.36 0.00 0.00 0.83 0.54 0.00 0.54 0.00 0.00 1.44 0.00 0.00 1.44 0.72 0.00 0.72 1.19 0.00 1.19 0.00 0.00 0.54 0.00 0.00 0.36 0.00 Physician Work RVUs 3 NA NA 0.31 4.30 3.03 1.27 3.43 3.24 0.19 2.31 2.19 0.12 4.12 3.55 0.57 2.38 2.23 0.15 NA NA 0.26 3.11 2.95 0.16 NA NA 0.42 0.00 0.00 0.42 2.16 1.95 0.21 2.07 1.73 0.34 NA NA 0.23 0.00 0.00 0.15 0.00 Fully Implemented NonFacility PE RVUs NA NA 0.29 9.99 8.63 1.36 12.80 12.62 0.18 6.96 6.84 0.12 13.18 12.69 0.49 6.99 6.85 0.14 NA NA 0.28 12.72 12.54 0.18 NA NA 0.46 0.00 0.00 0.46 2.18 1.95 0.23 3.18 2.80 0.38 NA NA 0.20 0.00 0.00 0.14 0.00 Year 2007 Transitional Non-Facility PE RVUs NA NA 0.31 NA NA 1.27 NA NA 0.19 2.31 2.19 0.12 NA NA 0.57 2.38 2.23 0.15 NA NA 0.26 NA NA 0.16 NA NA 0.42 0.00 0.00 0.42 NA NA 0.21 NA NA 0.34 NA NA 0.23 0.00 0.00 0.15 0.00 Fully Implemented Facility PE RVUs NA NA 0.29 NA NA 1.36 NA NA 0.18 6.96 6.84 0.12 NA NA 0.49 6.99 6.85 0.14 NA NA 0.28 NA NA 0.18 NA NA 0.46 0.00 0.00 0.46 NA NA 0.23 NA NA 0.38 NA NA 0.20 0.00 0.00 0.14 0.00 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 75960 75960 75960 75961 75961 75961 75962 75962 75962 75964 75964 75964 75966 75966 75966 75968 75968 75968 75970 75970 75970 75978 75978 75978 75980 75980 75980 75982 75982 75982 75984 75984 75984 75989 75989 75989 75992 75992 75992 75993 75993 75993 75994 HCPCS 2 CPT 1/ 0.00 0.00 0.05 0.73 0.55 0.18 0.86 0.83 0.03 0.46 0.43 0.03 0.89 0.83 0.06 0.45 0.43 0.02 0.00 0.00 0.04 0.85 0.83 0.02 0.00 0.00 0.06 0.00 0.00 0.06 0.14 0.11 0.03 0.22 0.17 0.05 0.00 0.00 0.03 0.00 0.00 0.02 0.00 Mal-Practice RVUs NA NA 1.18 9.27 3.58 5.69 4.83 4.07 0.76 3.13 2.62 0.51 6.32 4.38 1.94 3.19 2.66 0.53 NA NA 1.13 4.50 3.78 0.72 NA NA 1.92 0.00 0.00 1.92 3.02 2.06 0.96 3.48 1.90 1.58 NA NA 0.80 0.00 0.00 0.53 0.00 Fully Implemented NonFacility Total NA NA 1.16 14.96 9.18 5.78 14.20 13.45 0.75 7.78 7.27 0.51 15.38 13.52 1.86 7.80 7.28 0.52 NA NA 1.15 14.11 13.37 0.74 NA NA 1.96 0.00 0.00 1.96 3.04 2.06 0.98 4.59 2.97 1.62 NA NA 0.77 0.00 0.00 0.52 0.00 Year 2007 Transitional Non-Facility Total NA NA 1.18 NA NA 5.69 NA NA 0.76 3.13 2.62 0.51 NA NA 1.94 3.19 2.66 0.53 NA NA 1.13 NA NA 0.72 NA NA 1.92 0.00 0.00 1.92 NA NA 0.96 NA NA 1.58 NA NA 0.80 0.00 0.00 0.53 0.00 Fully Implemented Facility Total NA NA 1.16 NA NA 5.78 NA NA 0.75 7.78 7.27 0.51 NA NA 1.86 7.80 7.28 0.52 NA NA 1.15 NA NA 0.74 NA NA 1.96 0.00 0.00 1.96 NA NA 0.98 NA NA 1.62 NA NA 0.77 0.00 0.00 0.52 0.00 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX ZZZ ZZZ ZZZ XXX XXX XXX ZZZ ZZZ ZZZ XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX ZZZ ZZZ ZZZ XXX Global 69944 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00323 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... .......... .......... TC .... 2 Copyright 3+ Mod C A C C A C C A A A A C C A A A A A A A A A A A A A A A A A A A A A A C C A I A C A A Status Atherectomy, x-ray exam ..................................... Atherectomy, x-ray exam ..................................... Atherectomy, x-ray exam ..................................... Atherectomy, x-ray exam ..................................... Atherectomy, x-ray exam ..................................... Atherectomy, x-ray exam ..................................... Atherectomy, x-ray exam ..................................... Atherectomy, x-ray exam ..................................... Fluoroscope examination ..................................... Fluoroscope examination ..................................... Fluoroscope examination ..................................... Fluoroscope exam, extensive .............................. Fluoroscope exam, extensive .............................. Fluoroscope exam, extensive .............................. X-ray, nose to rectum .......................................... X-ray, nose to rectum .......................................... X-ray, nose to rectum .......................................... X-ray exam of fistula ............................................ X-ray exam of fistula ............................................ X-ray exam of fistula ............................................ X-ray exam, breast specimen .............................. X-ray exam, breast specimen .............................. X-ray exam, breast specimen .............................. X-ray exam of body section ................................. X-ray exam of body section ................................. X-ray exam of body section ................................. Complex body section x-ray ................................ Complex body section x-ray ................................ Complex body section x-ray ................................ Complex body section x-rays ............................... Complex body section x-rays ............................... Complex body section x-rays ............................... Cine/video x-rays ................................................. Cine/video x-rays ................................................. Cine/video x-rays ................................................. Cine/video x-rays add-on ..................................... Cine/video x-rays add-on ..................................... Cine/video x-rays add-on ..................................... X-ray consultation ................................................ X-ray exam, dry process ...................................... Special x-ray contrast study ................................. 3d render w/o postprocess .................................. 3d render w/o postprocess .................................. Description 0.00 1.31 0.00 0.00 1.31 0.00 0.00 0.36 0.17 0.00 0.17 0.00 0.00 0.67 0.18 0.00 0.18 0.54 0.00 0.54 0.16 0.00 0.16 0.58 0.00 0.58 0.58 0.00 0.58 0.58 0.00 0.58 0.38 0.00 0.38 0.00 0.00 0.27 0.00 0.00 0.00 0.20 0.00 Physician Work RVUs 3 0.00 0.62 0.00 0.00 0.50 0.00 0.00 0.14 2.64 2.59 0.05 NA NA 0.21 0.51 0.46 0.05 1.01 0.85 0.16 0.29 0.25 0.04 3.41 3.22 0.19 5.17 4.99 0.18 7.61 7.43 0.18 1.83 1.70 0.13 NA NA 0.10 0.00 0.67 0.00 1.32 1.26 Fully Implemented NonFacility PE RVUs 0.00 0.50 0.00 0.00 0.48 0.00 0.00 0.13 1.68 1.63 0.05 NA NA 0.22 0.57 0.51 0.06 1.18 1.00 0.18 0.43 0.38 0.05 1.93 1.74 0.19 2.50 2.31 0.19 3.35 3.16 0.19 1.34 1.21 0.13 NA NA 0.09 0.00 0.48 0.00 2.95 2.88 Year 2007 Transitional Non-Facility PE RVUs 0.00 0.62 0.00 0.00 0.50 0.00 0.00 0.14 NA NA 0.05 NA NA 0.21 NA NA 0.05 NA NA 0.16 NA NA 0.04 NA NA 0.19 NA NA 0.18 NA NA 0.18 NA NA 0.13 NA NA 0.10 0.00 NA 0.00 NA NA Fully Implemented Facility PE RVUs 0.00 0.50 0.00 0.00 0.48 0.00 0.00 0.13 NA NA 0.05 NA NA 0.22 NA NA 0.06 NA NA 0.18 NA NA 0.05 NA NA 0.19 NA NA 0.19 NA NA 0.19 NA NA 0.13 NA NA 0.09 0.00 NA 0.00 NA NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 75994 75994 75995 75995 75995 75996 75996 75996 76000 76000 76000 76001 76001 76001 76010 76010 76010 76080 76080 76080 76098 76098 76098 76100 76100 76100 76101 76101 76101 76102 76102 76102 76120 76120 76120 76125 76125 76125 76140 76150 76350 76376 76376 HCPCS 2 CPT 1/ 0.00 0.07 0.00 0.00 0.05 0.00 0.00 0.02 0.08 0.07 0.01 0.00 0.00 0.05 0.03 0.02 0.01 0.08 0.06 0.02 0.03 0.02 0.01 0.10 0.07 0.03 0.11 0.08 0.03 0.14 0.11 0.03 0.08 0.06 0.02 0.00 0.00 0.01 0.00 0.02 0.00 0.10 0.08 Mal-Practice RVUs 0.00 2.00 0.00 0.00 1.86 0.00 0.00 0.52 2.89 2.66 0.23 NA NA 0.93 0.72 0.48 0.24 1.63 0.91 0.72 0.48 0.27 0.21 4.09 3.29 0.80 5.86 5.07 0.79 8.33 7.54 0.79 2.29 1.76 0.53 NA NA 0.38 0.00 0.69 0.00 1.62 1.34 Fully Implemented NonFacility Total 0.00 1.88 0.00 0.00 1.84 0.00 0.00 0.51 1.93 1.70 0.23 NA NA 0.94 0.78 0.53 0.25 1.80 1.06 0.74 0.62 0.40 0.22 2.61 1.81 0.80 3.19 2.39 0.80 4.07 3.27 0.80 1.80 1.27 0.53 NA NA 0.37 0.00 0.50 0.00 3.25 2.96 Year 2007 Transitional Non-Facility Total 0.00 2.00 0.00 0.00 1.86 0.00 0.00 0.52 NA NA 0.23 NA NA 0.93 NA NA 0.24 NA NA 0.72 NA NA 0.21 NA NA 0.80 NA NA 0.79 NA NA 0.79 NA NA 0.53 NA NA 0.38 0.00 NA 0.00 NA NA Fully Implemented Facility Total 0.00 1.88 0.00 0.00 1.84 0.00 0.00 0.51 NA NA 0.23 NA NA 0.94 NA NA 0.25 NA NA 0.74 NA NA 0.22 NA NA 0.80 NA NA 0.80 NA NA 0.80 NA NA 0.53 NA NA 0.37 0.00 NA 0.00 NA NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX ZZZ ZZZ ZZZ XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX ZZZ ZZZ ZZZ XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69945 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00324 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... 2 Copyright 3+ Mod A A A A A A A N N N C C C C C C C C C C C C A A A A A A A A A A A A A A A A A A A A A Status 3d render w/o postprocess .................................. 3d rendering w/postprocess ................................. 3d rendering w/postprocess ................................. 3d rendering w/postprocess ................................. CAT scan follow-up study .................................... CAT scan follow-up study .................................... CAT scan follow-up study .................................... Mr spectroscopy ................................................... Mr spectroscopy ................................................... Mr spectroscopy ................................................... Fluoroscopic procedure ........................................ Fluoroscopic procedure ........................................ Fluoroscopic procedure ........................................ Ct procedure ........................................................ Ct procedure ........................................................ Ct procedure ........................................................ Mri procedure ....................................................... Mri procedure ....................................................... Mri procedure ....................................................... Radiographic procedure ....................................... Radiographic procedure ....................................... Radiographic procedure ....................................... Echo exam of head .............................................. Echo exam of head .............................................. Echo exam of head .............................................. Ophth us, b & quant a ......................................... Ophth us, b & quant a ......................................... Ophth us, b & quant a ......................................... Ophth us, quant a only ........................................ Ophth us, quant a only ........................................ Ophth us, quant a only ........................................ Ophth us, b w/non-quant a .................................. Ophth us, b w/non-quant a .................................. Ophth us, b w/non-quant a .................................. Echo exam of eye, water bath ............................. Echo exam of eye, water bath ............................. Echo exam of eye, water bath ............................. Echo exam of eye, thickness ............................... Echo exam of eye, thickness ............................... Echo exam of eye, thickness ............................... Echo exam of eye ................................................ Echo exam of eye ................................................ Echo exam of eye ................................................ Description 0.20 0.79 0.00 0.79 0.98 0.00 0.98 1.40 0.00 1.40 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.63 0.00 0.63 1.55 0.00 1.55 0.94 0.00 0.94 0.94 0.00 0.94 0.66 0.00 0.66 0.17 0.00 0.17 0.54 0.00 0.54 Physician Work RVUs 3 0.06 1.28 1.05 0.23 4.45 4.17 0.28 9.31 8.99 0.32 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2.70 2.51 0.19 2.31 1.72 0.59 1.40 1.04 0.36 1.19 0.84 0.35 1.57 1.32 0.25 0.17 0.11 0.06 1.19 0.99 0.20 Fully Implemented NonFacility PE RVUs 0.07 3.09 2.83 0.26 3.98 3.67 0.31 10.94 10.51 0.43 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.92 1.69 0.23 2.73 2.07 0.66 2.17 1.78 0.39 1.97 1.57 0.40 1.75 1.47 0.28 0.15 0.07 0.08 1.39 1.16 0.23 Year 2007 Transitional Non-Facility PE RVUs 0.06 NA NA 0.23 NA NA 0.28 NA NA 0.32 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NA NA 0.19 NA NA 0.59 NA NA 0.36 NA NA 0.35 NA NA 0.25 NA NA 0.06 NA NA 0.20 Fully Implemented Facility PE RVUs 0.07 NA NA 0.26 NA NA 0.31 NA NA 0.43 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NA NA 0.23 NA NA 0.66 NA NA 0.39 NA NA 0.40 NA NA 0.28 NA NA 0.08 NA NA 0.23 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 76376 76377 76377 76377 76380 76380 76380 76390 76390 76390 76496 76496 76496 76497 76497 76497 76498 76498 76498 76499 76499 76499 76506 76506 76506 76510 76510 76510 76511 76511 76511 76512 76512 76512 76513 76513 76513 76514 76514 76514 76516 76516 76516 HCPCS 2 CPT 1/ 0.02 0.39 0.31 0.08 0.22 0.18 0.04 0.66 0.59 0.07 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.14 0.08 0.06 0.10 0.07 0.03 0.10 0.07 0.03 0.12 0.10 0.02 0.12 0.10 0.02 0.02 0.01 0.01 0.08 0.07 0.01 Mal-Practice RVUs 0.28 2.46 1.36 1.10 5.65 4.35 1.30 11.37 9.58 1.79 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3.47 2.59 0.88 3.96 1.79 2.17 2.44 1.11 1.33 2.25 0.94 1.31 2.35 1.42 0.93 0.36 0.12 0.24 1.81 1.06 0.75 Fully Implemented NonFacility Total 0.29 4.27 3.14 1.13 5.18 3.85 1.33 13.00 11.10 1.90 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2.69 1.77 0.92 4.38 2.14 2.24 3.21 1.85 1.36 3.03 1.67 1.36 2.53 1.57 0.96 0.34 0.08 0.26 2.01 1.23 0.78 Year 2007 Transitional Non-Facility Total 0.28 NA NA 1.10 NA NA 1.30 NA NA 1.79 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NA NA 0.88 NA NA 2.17 NA NA 1.33 NA NA 1.31 NA NA 0.93 NA NA 0.24 NA NA 0.75 Fully Implemented Facility Total 0.29 NA NA 1.13 NA NA 1.33 NA NA 1.90 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NA NA 0.92 NA NA 2.24 NA NA 1.36 NA NA 1.36 NA NA 0.96 NA NA 0.26 NA NA 0.78 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69946 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00325 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Echo exam of eye ................................................ Echo exam of eye ................................................ Echo exam of eye ................................................ Echo exam of eye ................................................ Echo exam of eye ................................................ Echo exam of eye ................................................ Us exam of head and neck .................................. Us exam of head and neck .................................. Us exam of head and neck .................................. Us exam, chest .................................................... Us exam, chest .................................................... Us exam, chest .................................................... Us exam, breast(s) ............................................... Us exam, breast(s) ............................................... Us exam, breast(s) ............................................... Us exam, abdom, complete ................................. Us exam, abdom, complete ................................. Us exam, abdom, complete ................................. Echo exam of abdomen ....................................... Echo exam of abdomen ....................................... Echo exam of abdomen ....................................... Us exam abdo back wall, comp ........................... Us exam abdo back wall, comp ........................... Us exam abdo back wall, comp ........................... Us exam abdo back wall, lim ............................... Us exam abdo back wall, lim ............................... Us exam abdo back wall, lim ............................... Us exam k transpl w/doppler ............................... Us exam k transpl w/doppler ............................... Us exam k transpl w/doppler ............................... Us exam, spinal canal .......................................... Us exam, spinal canal .......................................... Us exam, spinal canal .......................................... Ob us < 14 wks, single fetus ............................... Ob us < 14 wks, single fetus ............................... Ob us < 14 wks, single fetus ............................... Ob us < 14 wks, add"l fetus .............................. Ob us < 14 wks, add"l fetus .............................. Ob us < 14 wks, add"l fetus .............................. Ob us >/= 14 wks, sngl fetus ............................... Ob us >/= 14 wks, sngl fetus ............................... Ob us >/= 14 wks, sngl fetus ............................... Ob us >/= 14 wks, addl fetus ............................... Description 0.54 0.00 0.54 0.57 0.00 0.57 0.56 0.00 0.56 0.55 0.00 0.55 0.54 0.00 0.54 0.81 0.00 0.81 0.59 0.00 0.59 0.74 0.00 0.74 0.58 0.00 0.58 0.76 0.00 0.76 1.13 0.00 1.13 0.99 0.00 0.99 0.83 0.00 0.83 0.99 0.00 0.99 0.98 Physician Work RVUs 3 1.32 1.11 0.21 1.17 0.96 0.21 2.53 2.38 0.15 1.70 1.55 0.15 1.97 1.82 0.15 2.84 2.61 0.23 2.21 2.04 0.17 2.77 2.55 0.22 0.00 0.00 0.00 3.19 2.98 0.21 2.26 1.97 0.29 2.36 2.08 0.28 0.93 0.69 0.24 2.91 2.63 0.28 1.59 Fully Implemented NonFacility PE RVUs 1.49 1.26 0.23 1.32 1.09 0.23 1.83 1.66 0.17 1.54 1.37 0.17 1.41 1.24 0.17 2.39 2.13 0.26 1.77 1.58 0.19 2.36 2.12 0.24 1.61 1.42 0.19 2.45 2.22 0.23 1.89 1.56 0.33 2.43 2.10 0.33 1.24 0.96 0.28 2.56 2.23 0.33 1.44 Year 2007 Transitional Non-Facility PE RVUs NA NA 0.21 NA NA 0.21 NA NA 0.15 NA NA 0.15 NA NA 0.15 NA NA 0.23 NA NA 0.17 NA NA 0.22 NA NA 0.00 NA NA 0.21 NA NA 0.29 NA NA 0.28 0.93 0.69 0.24 NA NA 0.28 1.59 Fully Implemented Facility PE RVUs NA NA 0.23 NA NA 0.23 NA NA 0.17 NA NA 0.17 NA NA 0.17 NA NA 0.26 NA NA 0.19 NA NA 0.24 NA NA 0.19 NA NA 0.23 NA NA 0.33 NA NA 0.33 1.24 0.96 0.28 NA NA 0.33 1.44 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 76519 76519 76519 76529 76529 76529 76536 76536 76536 76604 76604 76604 76645 76645 76645 76700 76700 76700 76705 76705 76705 76770 76770 76770 76775 76775 76775 76776 76776 76776 76800 76800 76800 76801 76801 76801 76802 76802 76802 76805 76805 76805 76810 HCPCS 2 CPT 1/ 0.08 0.07 0.01 0.10 0.08 0.02 0.10 0.08 0.02 0.09 0.07 0.02 0.08 0.06 0.02 0.15 0.11 0.04 0.11 0.08 0.03 0.14 0.11 0.03 0.11 0.08 0.03 0.14 0.11 0.03 0.13 0.08 0.05 0.16 0.12 0.04 0.16 0.12 0.04 0.16 0.12 0.04 0.26 Mal-Practice RVUs 1.94 1.18 0.76 1.84 1.04 0.80 3.19 2.46 0.73 2.34 1.62 0.72 2.59 1.88 0.71 3.80 2.72 1.08 2.91 2.12 0.79 3.65 2.66 0.99 0.69 0.08 0.61 4.09 3.09 1.00 3.52 2.05 1.47 3.51 2.20 1.31 1.92 0.81 1.11 4.06 2.75 1.31 2.83 Fully Implemented NonFacility Total 2.11 1.33 0.78 1.99 1.17 0.82 2.49 1.74 0.75 2.18 1.44 0.74 2.03 1.30 0.73 3.35 2.24 1.11 2.47 1.66 0.81 3.24 2.23 1.01 2.30 1.50 0.80 3.35 2.33 1.02 3.15 1.64 1.51 3.58 2.22 1.36 2.23 1.08 1.15 3.71 2.35 1.36 2.68 Year 2007 Transitional Non-Facility Total NA NA 0.76 NA NA 0.80 NA NA 0.73 NA NA 0.72 NA NA 0.71 NA NA 1.08 NA NA 0.79 NA NA 0.99 NA NA 0.61 NA NA 1.00 NA NA 1.47 NA NA 1.31 1.92 0.81 1.11 NA NA 1.31 2.83 Fully Implemented Facility Total NA NA 0.78 NA NA 0.82 NA NA 0.75 NA NA 0.74 NA NA 0.73 NA NA 1.11 NA NA 0.81 NA NA 1.01 NA NA 0.80 NA NA 1.02 NA NA 1.51 NA NA 1.36 2.23 1.08 1.15 NA NA 1.36 2.68 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX ZZZ ZZZ ZZZ XXX XXX XXX ZZZ Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69947 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00326 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Ob us >/= 14 wks, addl fetus ............................... Ob us >/= 14 wks, addl fetus ............................... Ob us, detailed, sngl fetus ................................... Ob us, detailed, sngl fetus ................................... Ob us, detailed, sngl fetus ................................... Ob us, detailed, addl fetus ................................... Ob us, detailed, addl fetus ................................... Ob us, detailed, addl fetus ................................... Ob us nuchal meas, 1 gest .................................. Ob us nuchal meas, 1 gest .................................. Ob us nuchal meas, 1 gest .................................. Ob us nuchal meas, add-on ................................ Ob us nuchal meas, add-on ................................ Ob us nuchal meas, add-on ................................ Ob us, limited, fetus(s) ......................................... Ob us, limited, fetus(s) ......................................... Ob us, limited, fetus(s) ......................................... Ob us, follow-up, per fetus ................................... Ob us, follow-up, per fetus ................................... Ob us, follow-up, per fetus ................................... Transvaginal us, obstetric .................................... Transvaginal us, obstetric .................................... Transvaginal us, obstetric .................................... Fetal biophys profile w/nst ................................... Fetal biophys profile w/nst ................................... Fetal biophys profile w/nst ................................... Fetal biophys profil w/o nst .................................. Fetal biophys profil w/o nst .................................. Fetal biophys profil w/o nst .................................. Umbilical artery echo ........................................... Umbilical artery echo ........................................... Umbilical artery echo ........................................... Middle cerebral artery echo ................................. Middle cerebral artery echo ................................. Middle cerebral artery echo ................................. Echo exam of fetal heart ...................................... Echo exam of fetal heart ...................................... Echo exam of fetal heart ...................................... Echo exam of fetal heart ...................................... Echo exam of fetal heart ...................................... Echo exam of fetal heart ...................................... Echo exam of fetal heart ...................................... Echo exam of fetal heart ...................................... Description 0.00 0.98 1.90 0.00 1.90 1.78 0.00 1.78 1.18 0.00 1.18 0.99 0.00 0.99 0.65 0.00 0.65 0.85 0.00 0.85 0.75 0.00 0.75 1.05 0.00 1.05 0.77 0.00 0.77 0.50 0.00 0.50 0.70 0.00 0.70 1.67 0.00 1.67 0.83 0.00 0.83 0.58 0.00 Physician Work RVUs 3 1.32 0.27 2.98 2.45 0.53 3.87 3.37 0.50 2.06 1.73 0.33 1.11 0.84 0.27 1.73 1.55 0.18 2.33 2.09 0.24 1.94 1.73 0.21 2.15 1.86 0.29 1.57 1.36 0.21 0.55 0.41 0.14 1.83 1.63 0.20 4.29 3.80 0.49 2.71 2.47 0.24 1.04 0.87 Fully Implemented NonFacility PE RVUs 1.12 0.32 3.93 3.26 0.67 2.25 1.63 0.62 2.06 1.73 0.33 1.11 0.84 0.27 1.67 1.45 0.22 1.66 1.36 0.30 1.82 1.57 0.25 2.04 1.67 0.37 1.81 1.55 0.26 1.49 1.31 0.18 1.87 1.62 0.25 3.00 2.43 0.57 1.43 1.15 0.28 1.71 1.51 Year 2007 Transitional Non-Facility PE RVUs 1.32 0.27 NA NA 0.53 3.87 3.37 0.50 NA NA 0.33 NA NA 0.27 NA NA 0.18 NA NA 0.24 NA NA 0.21 NA NA 0.29 NA NA 0.21 NA NA 0.14 NA NA 0.20 NA NA 0.49 NA NA 0.24 NA NA Fully Implemented Facility PE RVUs 1.12 0.32 NA NA 0.67 2.25 1.63 0.62 NA NA 0.33 NA NA 0.27 NA NA 0.22 NA NA 0.30 NA NA 0.25 NA NA 0.37 NA NA 0.26 NA NA 0.18 NA NA 0.25 NA NA 0.57 NA NA 0.28 NA NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 76810 76810 76811 76811 76811 76812 76812 76812 76813 76813 76813 76814 76814 76814 76815 76815 76815 76816 76816 76816 76817 76817 76817 76818 76818 76818 76819 76819 76819 76820 76820 76820 76821 76821 76821 76825 76825 76825 76826 76826 76826 76827 76827 HCPCS 2 CPT 1/ 0.22 0.04 0.52 0.43 0.09 0.49 0.41 0.08 0.19 0.14 0.05 0.19 0.14 0.05 0.11 0.08 0.03 0.10 0.06 0.04 0.09 0.06 0.03 0.15 0.10 0.05 0.13 0.10 0.03 0.15 0.12 0.03 0.15 0.12 0.03 0.18 0.11 0.07 0.08 0.05 0.03 0.14 0.12 Mal-Practice RVUs 1.54 1.29 5.40 2.88 2.52 6.14 3.78 2.36 3.43 1.87 1.56 2.29 0.98 1.31 2.49 1.63 0.86 3.28 2.15 1.13 2.78 1.79 0.99 3.35 1.96 1.39 2.47 1.46 1.01 1.20 0.53 0.67 2.68 1.75 0.93 6.14 3.91 2.23 3.62 2.52 1.10 1.76 0.99 Fully Implemented NonFacility Total 1.34 1.34 6.35 3.69 2.66 4.52 2.04 2.48 3.43 1.87 1.56 2.29 0.98 1.31 2.43 1.53 0.90 2.61 1.42 1.19 2.66 1.63 1.03 3.24 1.77 1.47 2.71 1.65 1.06 2.14 1.43 0.71 2.72 1.74 0.98 4.85 2.54 2.31 2.34 1.20 1.14 2.43 1.63 Year 2007 Transitional Non-Facility Total 1.54 1.29 NA NA 2.52 6.14 3.78 2.36 NA NA 1.56 NA NA 1.31 NA NA 0.86 NA NA 1.13 NA NA 0.99 NA NA 1.39 NA NA 1.01 NA NA 0.67 NA NA 0.93 NA NA 2.23 NA NA 1.10 NA NA Fully Implemented Facility Total 1.34 1.34 NA NA 2.66 4.52 2.04 2.48 NA NA 1.56 NA NA 1.31 NA NA 0.90 NA NA 1.19 NA NA 1.03 NA NA 1.47 NA NA 1.06 NA NA 0.71 NA NA 0.98 NA NA 2.31 NA NA 1.14 NA NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 ZZZ ZZZ XXX XXX XXX ZZZ ZZZ ZZZ XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69948 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00327 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C C A A A A Status Echo exam of fetal heart ...................................... Echo exam of fetal heart ...................................... Echo exam of fetal heart ...................................... Echo exam of fetal heart ...................................... Transvaginal us, non-ob ...................................... Transvaginal us, non-ob ...................................... Transvaginal us, non-ob ...................................... Echo exam, uterus ............................................... Echo exam, uterus ............................................... Echo exam, uterus ............................................... Us exam, pelvic, complete ................................... Us exam, pelvic, complete ................................... Us exam, pelvic, complete ................................... Us exam, pelvic, limited ....................................... Us exam, pelvic, limited ....................................... Us exam, pelvic, limited ....................................... Us exam, scrotum ................................................ Us exam, scrotum ................................................ Us exam, scrotum ................................................ Us, transrectal ...................................................... Us, transrectal ...................................................... Us, transrectal ...................................................... Echograp trans r, pros study ............................... Echograp trans r, pros study ............................... Echograp trans r, pros study ............................... Us exam, extremity .............................................. Us exam, extremity .............................................. Us exam, extremity .............................................. Us exam infant hips, dynamic .............................. Us exam infant hips, dynamic .............................. Us exam infant hips, dynamic .............................. Us exam infant hips, static ................................... Us exam infant hips, static ................................... Us exam infant hips, static ................................... Echo guide, cardiocentesis .................................. Echo guide, cardiocentesis .................................. Echo guide, cardiocentesis .................................. Echo guide for heart biopsy ................................. Echo guide for heart biopsy ................................. Echo guide for heart biopsy ................................. Echo guide for artery repair ................................. Echo guide for artery repair ................................. Echo guide for artery repair ................................. Description 0.58 0.56 0.00 0.56 0.69 0.00 0.69 0.72 0.00 0.72 0.69 0.00 0.69 0.38 0.00 0.38 0.64 0.00 0.64 0.69 0.00 0.69 1.55 0.00 1.55 0.59 0.00 0.59 0.74 0.00 0.74 0.62 0.00 0.62 0.67 0.00 0.67 0.00 0.00 0.67 1.99 0.00 1.99 Physician Work RVUs 3 0.17 0.63 0.47 0.16 2.62 2.43 0.19 2.67 2.47 0.20 2.67 2.46 0.21 2.46 2.32 0.14 2.67 2.48 0.19 3.37 3.10 0.27 3.43 2.87 0.56 3.05 2.89 0.16 3.03 2.83 0.20 2.20 2.03 0.17 2.08 1.74 0.34 NA NA 0.35 5.81 5.17 0.64 Fully Implemented NonFacility PE RVUs 0.20 1.16 0.95 0.21 1.97 1.75 0.22 2.00 1.76 0.24 1.99 1.76 0.23 1.99 1.86 0.13 1.97 1.76 0.21 2.52 2.29 0.23 2.81 2.29 0.52 1.97 1.79 0.18 2.08 1.85 0.23 1.76 1.57 0.19 1.85 1.58 0.27 NA NA 0.28 6.67 6.01 0.66 Year 2007 Transitional Non-Facility PE RVUs 0.17 NA NA 0.16 NA NA 0.19 NA NA 0.20 NA NA 0.21 NA NA 0.14 NA NA 0.19 NA NA 0.27 NA NA 0.56 NA NA 0.16 NA NA 0.20 NA NA 0.17 NA NA 0.34 NA NA 0.35 NA NA 0.64 Fully Implemented Facility PE RVUs 0.20 NA NA 0.21 NA NA 0.22 NA NA 0.24 NA NA 0.23 NA NA 0.13 NA NA 0.21 NA NA 0.23 NA NA 0.52 NA NA 0.18 NA NA 0.23 NA NA 0.19 NA NA 0.27 NA NA 0.28 NA NA 0.66 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 76827 76828 76828 76828 76830 76830 76830 76831 76831 76831 76856 76856 76856 76857 76857 76857 76870 76870 76870 76872 76872 76872 76873 76873 76873 76880 76880 76880 76885 76885 76885 76886 76886 76886 76930 76930 76930 76932 76932 76932 76936 76936 76936 HCPCS 2 CPT 1/ 0.02 0.11 0.08 0.03 0.13 0.10 0.03 0.13 0.10 0.03 0.13 0.10 0.03 0.08 0.06 0.02 0.13 0.10 0.03 0.14 0.10 0.04 0.25 0.16 0.09 0.11 0.08 0.03 0.13 0.10 0.03 0.11 0.08 0.03 0.12 0.10 0.02 0.00 0.00 0.02 0.47 0.34 0.13 Mal-Practice RVUs 0.77 1.30 0.55 0.75 3.44 2.53 0.91 3.52 2.57 0.95 3.49 2.56 0.93 2.92 2.38 0.54 3.44 2.58 0.86 4.20 3.20 1.00 5.23 3.03 2.20 3.75 2.97 0.78 3.90 2.93 0.97 2.93 2.11 0.82 2.87 1.84 1.03 NA NA 1.04 8.27 5.51 2.76 Fully Implemented NonFacility Total 0.80 1.83 1.03 0.80 2.79 1.85 0.94 2.85 1.86 0.99 2.81 1.86 0.95 2.45 1.92 0.53 2.74 1.86 0.88 3.35 2.39 0.96 4.61 2.45 2.16 2.67 1.87 0.80 2.95 1.95 1.00 2.49 1.65 0.84 2.64 1.68 0.96 NA NA 0.97 9.13 6.35 2.78 Year 2007 Transitional Non-Facility Total 0.77 NA NA 0.75 NA NA 0.91 NA NA 0.95 NA NA 0.93 NA NA 0.54 NA NA 0.86 NA NA 1.00 NA NA 2.20 NA NA 0.78 NA NA 0.97 NA NA 0.82 NA NA 1.03 NA NA 1.04 NA NA 2.76 Fully Implemented Facility Total 0.80 NA NA 0.80 NA NA 0.94 NA NA 0.99 NA NA 0.95 NA NA 0.53 NA NA 0.88 NA NA 0.96 NA NA 2.16 NA NA 0.80 NA NA 1.00 NA NA 0.84 NA NA 0.96 NA NA 0.97 NA NA 2.78 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69949 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00328 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... 2 Copyright 3+ Mod A A A C C A C C A A A A C C A A A A A A A A A A A A A A A A C C A A A A C C A C C C A Status Us guide, vascular access ................................... Us guide, vascular access ................................... Us guide, vascular access ................................... Us guide, tissue ablation ...................................... Us guide, tissue ablation ...................................... Us guide, tissue ablation ...................................... Echo guide for transfusion ................................... Echo guide for transfusion ................................... Echo guide for transfusion ................................... Echo guide for biopsy .......................................... Echo guide for biopsy .......................................... Echo guide for biopsy .......................................... Echo guide, villus sampling ................................. Echo guide, villus sampling ................................. Echo guide, villus sampling ................................. Echo guide for amniocentesis .............................. Echo guide for amniocentesis .............................. Echo guide for amniocentesis .............................. Echo guide, ova aspiration .................................. Echo guide, ova aspiration .................................. Echo guide, ova aspiration .................................. Echo guidance radiotherapy ................................ Echo guidance radiotherapy ................................ Echo guidance radiotherapy ................................ Echo guidance radiotherapy ................................ Echo guidance radiotherapy ................................ Echo guidance radiotherapy ................................ Ultrasound exam follow-up .................................. Ultrasound exam follow-up .................................. Ultrasound exam follow-up .................................. GI endoscopic ultrasound .................................... GI endoscopic ultrasound .................................... GI endoscopic ultrasound .................................... Us bone density measure .................................... Us bone density measure .................................... Us bone density measure .................................... Us guide, intraop .................................................. Us guide, intraop .................................................. Us guide, intraop .................................................. Echo examination procedure ............................... Echo examination procedure ............................... Echo examination procedure ............................... Fluoroguide for vein device .................................. Description 0.30 0.00 0.30 0.00 0.00 2.00 0.00 0.00 1.34 0.67 0.00 0.67 0.00 0.00 0.67 0.38 0.00 0.38 0.38 0.00 0.38 0.58 0.00 0.58 1.34 0.00 1.34 0.40 0.00 0.40 0.00 0.00 0.81 0.05 0.00 0.05 0.00 0.00 1.20 0.00 0.00 0.00 0.38 Physician Work RVUs 3 0.58 0.49 0.09 NA NA 0.58 NA NA 0.43 4.64 4.42 0.22 NA NA 0.20 0.44 0.33 0.11 0.43 0.33 0.10 1.22 1.02 0.20 1.22 0.70 0.52 2.07 1.96 0.11 NA NA 0.29 0.10 0.09 0.01 NA NA 0.34 0.00 0.00 0.00 2.58 Fully Implemented NonFacility PE RVUs 0.51 0.41 0.10 NA NA 0.63 NA NA 0.46 3.43 3.21 0.22 NA NA 0.22 1.35 1.22 0.13 1.34 1.22 0.12 1.43 1.24 0.19 4.80 4.35 0.45 1.41 1.28 0.13 NA NA 0.28 0.66 0.64 0.02 NA NA 0.39 0.00 0.00 0.00 1.73 Year 2007 Transitional Non-Facility PE RVUs 0.58 0.49 0.09 NA NA 0.58 NA NA 0.43 NA NA 0.22 NA NA 0.20 NA NA 0.11 NA NA 0.10 NA NA 0.20 NA NA 0.52 NA NA 0.11 NA NA 0.29 NA NA 0.01 NA NA 0.34 0.00 0.00 0.00 NA Fully Implemented Facility PE RVUs 0.51 0.41 0.10 NA NA 0.63 NA NA 0.46 NA NA 0.22 NA NA 0.22 NA NA 0.13 NA NA 0.12 NA NA 0.19 NA NA 0.45 NA NA 0.13 NA NA 0.28 NA NA 0.02 NA NA 0.39 0.00 0.00 0.00 NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 76937 76937 76937 76940 76940 76940 76941 76941 76941 76942 76942 76942 76945 76945 76945 76946 76946 76946 76948 76948 76948 76950 76950 76950 76965 76965 76965 76970 76970 76970 76975 76975 76975 76977 76977 76977 76998 76998 76998 76999 76999 76999 77001 HCPCS 2 CPT 1/ 0.13 0.10 0.03 0.00 0.00 0.31 0.00 0.00 0.07 0.13 0.10 0.03 0.00 0.00 0.03 0.12 0.10 0.02 0.12 0.10 0.02 0.10 0.07 0.03 0.37 0.29 0.08 0.08 0.06 0.02 0.00 0.00 0.04 0.06 0.05 0.01 0.00 0.00 0.13 0.00 0.00 0.00 0.11 Mal-Practice RVUs 1.01 0.59 0.42 NA NA 2.89 NA NA 1.84 5.44 4.52 0.92 NA NA 0.90 0.94 0.43 0.51 0.93 0.43 0.50 1.90 1.09 0.81 2.93 0.99 1.94 2.55 2.02 0.53 NA NA 1.14 0.21 0.14 0.07 NA NA 1.67 0.00 0.00 0.00 3.07 Fully Implemented NonFacility Total 0.94 0.51 0.43 NA NA 2.94 NA NA 1.87 4.23 3.31 0.92 NA NA 0.92 1.85 1.32 0.53 1.84 1.32 0.52 2.11 1.31 0.80 6.51 4.64 1.87 1.89 1.34 0.55 NA NA 1.13 0.77 0.69 0.08 NA NA 1.72 0.00 0.00 0.00 2.22 Year 2007 Transitional Non-Facility Total 1.01 0.59 0.42 NA NA 2.89 NA NA 1.84 NA NA 0.92 NA NA 0.90 NA NA 0.51 NA NA 0.50 NA NA 0.81 NA NA 1.94 NA NA 0.53 NA NA 1.14 NA NA 0.07 NA NA 1.67 0.00 0.00 0.00 NA Fully Implemented Facility Total 0.94 0.51 0.43 NA NA 2.94 NA NA 1.87 NA NA 0.92 NA NA 0.92 NA NA 0.53 NA NA 0.52 NA NA 0.80 NA NA 1.87 NA NA 0.55 NA NA 1.13 NA NA 0.08 NA NA 1.72 0.00 0.00 0.00 NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 ZZZ ZZZ ZZZ XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX ZZZ Global 69950 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00329 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 2 Copyright 3+ Mod A A A A A A A A A A A A A A C C A A A A A A A C C A A A A A A A A A A A A A A A A A A Status Fluoroguide for vein device .................................. Fluoroguide for vein device .................................. Needle localization by xray .................................. Needle localization by xray .................................. Needle localization by xray .................................. Fluoroguide for spine inject .................................. Fluoroguide for spine inject .................................. Fluoroguide for spine inject .................................. Ct scan for localization ......................................... Ct scan for localization ......................................... Ct scan for localization ......................................... Ct scan for needle biopsy .................................... Ct scan for needle biopsy .................................... Ct scan for needle biopsy .................................... Ct guide for tissue ablation .................................. Ct guide for tissue ablation .................................. Ct guide for tissue ablation .................................. Ct scan for therapy guide .................................... Ct scan for therapy guide .................................... Ct scan for therapy guide .................................... Mr guidance for needle place .............................. Mr guidance for needle place .............................. Mr guidance for needle place .............................. Mri for tissue ablation ........................................... Mri for tissue ablation ........................................... Mri for tissue ablation ........................................... Stereotact guide for brst bx ................................. Stereotact guide for brst bx ................................. Stereotact guide for brst bx ................................. Guidance for needle, breast ................................ Guidance for needle, breast ................................ Guidance for needle, breast ................................ Computer dx mammogram add-on ...................... Computer dx mammogram add-on ...................... Computer dx mammogram add-on ...................... Comp screen mammogram add-on ..................... Comp screen mammogram add-on ..................... Comp screen mammogram add-on ..................... X-ray of mammary duct ....................................... X-ray of mammary duct ....................................... X-ray of mammary duct ....................................... X-ray of mammary ducts ...................................... X-ray of mammary ducts ...................................... Description 0.00 0.38 0.54 0.00 0.54 0.60 0.00 0.60 1.21 0.00 1.21 1.16 0.00 1.16 0.00 0.00 3.99 0.85 0.00 0.85 1.50 0.00 1.50 0.00 0.00 4.24 1.59 0.00 1.59 0.56 0.00 0.56 0.06 0.00 0.06 0.06 0.00 0.06 0.36 0.00 0.36 0.45 0.00 Physician Work RVUs 3 2.47 0.11 1.15 1.01 0.14 0.74 0.60 0.14 19.50 19.16 0.34 2.14 1.81 0.33 NA NA 1.19 4.43 4.16 0.27 9.20 8.76 0.44 NA NA 1.22 1.71 1.27 0.44 0.56 0.40 0.16 0.19 0.17 0.02 0.19 0.17 0.02 0.59 0.49 0.10 1.56 1.43 Fully Implemented NonFacility PE RVUs 1.60 0.13 1.40 1.24 0.16 1.28 1.13 0.15 11.38 10.99 0.39 7.02 6.65 0.37 NA NA 1.27 3.53 3.25 0.28 11.08 10.59 0.49 NA NA 1.34 6.19 5.69 0.50 1.26 1.08 0.18 0.38 0.36 0.02 0.38 0.36 0.02 2.21 2.09 0.12 3.25 3.10 Year 2007 Transitional Non-Facility PE RVUs NA 0.11 NA NA 0.14 NA NA 0.14 NA NA 0.34 NA NA 0.33 NA NA 1.19 NA NA 0.27 NA NA 0.44 NA NA 1.22 NA NA 0.44 NA NA 0.16 0.19 0.17 0.02 0.19 0.17 0.02 NA NA 0.10 NA NA Fully Implemented Facility PE RVUs NA 0.13 NA NA 0.16 NA NA 0.15 NA NA 0.39 NA NA 0.37 NA NA 1.27 NA NA 0.28 NA NA 0.49 NA NA 1.34 NA NA 0.50 NA NA 0.18 0.38 0.36 0.02 0.38 0.36 0.02 NA NA 0.12 NA NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 77001 77001 77002 77002 77002 77003 77003 77003 77011 77011 77011 77012 77012 77012 77013 77013 77013 77014 77014 77014 77021 77021 77021 77022 77022 77022 77031 77031 77031 77032 77032 77032 77051 77051 77051 77052 77052 77052 77053 77053 77053 77054 77054 HCPCS 2 CPT 1/ 0.10 0.01 0.09 0.07 0.02 0.10 0.07 0.03 0.47 0.42 0.05 0.47 0.42 0.05 0.00 0.00 0.18 0.20 0.16 0.04 0.64 0.55 0.09 0.00 0.00 0.24 0.46 0.37 0.09 0.09 0.07 0.02 0.02 0.01 0.01 0.02 0.01 0.01 0.16 0.14 0.02 0.21 0.19 Mal-Practice RVUs 2.57 0.50 1.78 1.08 0.70 1.44 0.67 0.77 21.18 19.58 1.60 3.77 2.23 1.54 NA NA 5.36 5.48 4.32 1.16 11.34 9.31 2.03 NA NA 5.70 3.76 1.64 2.12 1.21 0.47 0.74 0.27 0.18 0.09 0.27 0.18 0.09 1.11 0.63 0.48 2.22 1.62 Fully Implemented NonFacility Total 1.70 0.52 2.03 1.31 0.72 1.98 1.20 0.78 13.06 11.41 1.65 8.65 7.07 1.58 NA NA 5.44 4.58 3.41 1.17 13.22 11.14 2.08 NA NA 5.82 8.24 6.06 2.18 1.91 1.15 0.76 0.46 0.37 0.09 0.46 0.37 0.09 2.73 2.23 0.50 3.91 3.29 Year 2007 Transitional Non-Facility Total NA 0.50 NA NA 0.70 NA NA 0.77 NA NA 1.60 NA NA 1.54 NA NA 5.36 NA NA 1.16 NA NA 2.03 NA NA 5.70 NA NA 2.12 NA NA 0.74 0.27 0.18 0.09 0.27 0.18 0.09 NA NA 0.48 NA NA Fully Implemented Facility Total NA 0.52 NA NA 0.72 NA NA 0.78 NA NA 1.65 NA NA 1.58 NA NA 5.44 NA NA 1.17 NA NA 2.08 NA NA 5.82 NA NA 2.18 NA NA 0.76 0.46 0.37 0.09 0.46 0.37 0.09 NA NA 0.50 NA NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 ZZZ ZZZ XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX ZZZ ZZZ ZZZ ZZZ ZZZ ZZZ XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69951 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00330 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status X-ray of mammary ducts ...................................... Mammogram, one breast ..................................... Mammogram, one breast ..................................... Mammogram, one breast ..................................... Mammogram, both breasts .................................. Mammogram, both breasts .................................. Mammogram, both breasts .................................. Mammogram, screening ...................................... Mammogram, screening ...................................... Mammogram, screening ...................................... Mri, one breast ..................................................... Mri, one breast ..................................................... Mri, one breast ..................................................... Mri, both breasts .................................................. Mri, both breasts .................................................. Mri, both breasts .................................................. X-ray stress view .................................................. X-rays for bone age ............................................. X-rays for bone age ............................................. X-rays for bone age ............................................. X-rays, bone length studies ................................. X-rays, bone length studies ................................. X-rays, bone length studies ................................. X-rays, bone survey, limited ................................ X-rays, bone survey, limited ................................ X-rays, bone survey, limited ................................ X-rays, bone survey complete ............................. X-rays, bone survey complete ............................. X-rays, bone survey complete ............................. X-rays, bone survey, infant .................................. X-rays, bone survey, infant .................................. X-rays, bone survey, infant .................................. Joint survey, single view ...................................... Joint survey, single view ...................................... Joint survey, single view ...................................... Ct bone density, axial .......................................... Ct bone density, axial .......................................... Ct bone density, axial .......................................... Ct bone density, peripheral .................................. Ct bone density, peripheral .................................. Ct bone density, peripheral .................................. Dxa bone density, axial ........................................ Dxa bone density, axial ........................................ Description 0.45 0.70 0.00 0.70 0.87 0.00 0.87 0.70 0.00 0.70 1.63 0.00 1.63 1.63 0.00 1.63 0.41 0.19 0.00 0.19 0.27 0.00 0.27 0.45 0.00 0.45 0.54 0.00 0.54 0.70 0.00 0.70 0.31 0.00 0.31 0.25 0.00 0.25 0.22 0.00 0.22 0.20 0.00 Physician Work RVUs 3 0.13 1.51 1.31 0.20 1.93 1.69 0.24 1.33 1.13 0.20 20.61 20.15 0.46 20.51 20.05 0.46 0.76 0.39 0.34 0.05 0.64 0.55 0.09 1.34 1.21 0.13 2.14 1.98 0.16 1.91 1.73 0.18 0.64 0.53 0.11 4.52 4.45 0.07 0.72 0.66 0.06 0.79 0.73 Fully Implemented NonFacility PE RVUs 0.15 1.34 1.12 0.22 1.68 1.41 0.27 1.43 1.21 0.22 18.76 18.25 0.51 23.46 22.95 0.51 0.33 0.39 0.34 0.05 0.81 0.72 0.09 1.20 1.05 0.15 1.76 1.58 0.18 1.20 0.98 0.22 1.07 0.97 0.10 3.41 3.33 0.08 2.45 2.38 0.07 2.59 2.50 Year 2007 Transitional Non-Facility PE RVUs 0.13 NA NA 0.20 NA NA 0.24 NA NA 0.20 NA NA 0.46 NA NA 0.46 0.76 NA NA 0.05 NA NA 0.09 NA NA 0.13 NA NA 0.16 NA NA 0.18 NA NA 0.11 NA NA 0.07 NA NA 0.06 NA NA Fully Implemented Facility PE RVUs 0.15 NA NA 0.22 NA NA 0.27 NA NA 0.22 NA NA 0.51 NA NA 0.51 0.33 NA NA 0.05 NA NA 0.09 NA NA 0.15 NA NA 0.18 NA NA 0.22 NA NA 0.10 NA NA 0.08 NA NA 0.07 NA NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 77054 77055 77055 77055 77056 77056 77056 77057 77057 77057 77058 77058 77058 77059 77059 77059 77071 77072 77072 77072 77073 77073 77073 77074 77074 77074 77075 77075 77075 77076 77076 77076 77077 77077 77077 77078 77078 77078 77079 77079 77079 77080 77080 HCPCS 2 CPT 1/ 0.02 0.09 0.06 0.03 0.11 0.07 0.04 0.10 0.07 0.03 0.99 0.92 0.07 1.31 1.24 0.07 0.06 0.03 0.02 0.01 0.06 0.05 0.01 0.08 0.06 0.02 0.10 0.08 0.02 0.08 0.05 0.03 0.08 0.06 0.02 0.17 0.16 0.01 0.06 0.05 0.01 0.18 0.17 Mal-Practice RVUs 0.60 2.30 1.37 0.93 2.91 1.76 1.15 2.13 1.20 0.93 23.23 21.07 2.16 23.45 21.29 2.16 1.23 0.61 0.36 0.25 0.97 0.60 0.37 1.87 1.27 0.60 2.78 2.06 0.72 2.69 1.78 0.91 1.03 0.59 0.44 4.94 4.61 0.33 1.00 0.71 0.29 1.17 0.90 Fully Implemented NonFacility Total 0.62 2.13 1.18 0.95 2.66 1.48 1.18 2.23 1.28 0.95 21.38 19.17 2.21 26.40 24.19 2.21 0.80 0.61 0.36 0.25 1.14 0.77 0.37 1.73 1.11 0.62 2.40 1.66 0.74 1.98 1.03 0.95 1.46 1.03 0.43 3.83 3.49 0.34 2.73 2.43 0.30 2.97 2.67 Year 2007 Transitional Non-Facility Total 0.60 NA NA 0.93 NA NA 1.15 NA NA 0.93 NA NA 2.16 NA NA 2.16 1.23 NA NA 0.25 NA NA 0.37 NA NA 0.60 NA NA 0.72 NA NA 0.91 NA NA 0.44 NA NA 0.33 NA NA 0.29 NA NA Fully Implemented Facility Total 0.62 NA NA 0.95 NA NA 1.18 NA NA 0.95 NA NA 2.21 NA NA 2.21 0.80 NA NA 0.25 NA NA 0.37 NA NA 0.62 NA NA 0.74 NA NA 0.95 NA NA 0.43 NA NA 0.34 NA NA 0.30 NA NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69952 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00331 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A C C C A A A A A A A A A A A A Status Dxa bone density, axial ........................................ Dxa bone density/peripheral ................................ Dxa bone density/peripheral ................................ Dxa bone density/peripheral ................................ Dxa bone density, vert fx ..................................... Dxa bone density, vert fx ..................................... Dxa bone density, vert fx ..................................... Radiographic absorptiometry ............................... Radiographic absorptiometry ............................... Radiographic absorptiometry ............................... Magnetic image, bone marrow ............................ Magnetic image, bone marrow ............................ Magnetic image, bone marrow ............................ Radiation therapy planning .................................. Radiation therapy planning .................................. Radiation therapy planning .................................. Set radiation therapy field .................................... Set radiation therapy field .................................... Set radiation therapy field .................................... Set radiation therapy field .................................... Set radiation therapy field .................................... Set radiation therapy field .................................... Set radiation therapy field .................................... Set radiation therapy field .................................... Set radiation therapy field .................................... Set radiation therapy field .................................... Set radiation therapy field .................................... Set radiation therapy field .................................... Radiation therapy planning .................................. Radiation therapy planning .................................. Radiation therapy planning .................................. Radiation therapy dose plan ................................ Radiation therapy dose plan ................................ Radiation therapy dose plan ................................ Radiotherapy dose plan, imrt ............................... Radiotherapy dose plan, imrt ............................... Radiotherapy dose plan, imrt ............................... Teletx isodose plan simple .................................. Teletx isodose plan simple .................................. Teletx isodose plan simple .................................. Teletx isodose plan intermed ............................... Teletx isodose plan intermed ............................... Teletx isodose plan intermed ............................... Description 0.20 0.22 0.00 0.22 0.17 0.00 0.17 0.20 0.00 0.20 1.60 0.00 1.60 1.39 2.11 3.14 0.70 0.00 0.70 1.05 0.00 1.05 1.56 0.00 1.56 4.56 0.00 4.56 0.00 0.00 0.00 0.62 0.00 0.62 7.99 0.00 7.99 0.70 0.00 0.70 1.05 0.00 1.05 Physician Work RVUs 3 0.06 0.69 0.63 0.06 0.41 0.36 0.05 0.37 0.32 0.05 13.81 13.33 0.48 0.49 0.71 1.06 4.45 4.21 0.24 8.06 7.71 0.35 13.47 12.94 0.53 7.51 5.96 1.55 0.00 0.00 0.00 1.19 0.98 0.21 57.55 54.86 2.69 0.91 0.67 0.24 1.26 0.91 0.35 Fully Implemented NonFacility PE RVUs 0.09 0.80 0.72 0.08 0.71 0.65 0.06 0.71 0.64 0.07 12.24 11.73 0.51 0.51 0.74 1.10 3.89 3.66 0.23 6.45 6.11 0.34 8.63 8.12 0.51 23.92 22.44 1.48 0.00 0.00 0.00 1.45 1.25 0.20 37.25 34.66 2.59 1.79 1.56 0.23 2.32 1.98 0.34 Year 2007 Transitional Non-Facility PE RVUs 0.06 NA NA 0.06 NA NA 0.05 NA NA 0.05 NA NA 0.48 0.49 0.71 1.06 NA NA 0.24 NA NA 0.35 NA NA 0.53 NA NA 1.55 0.00 0.00 0.00 NA NA 0.21 NA NA 2.69 NA NA 0.24 NA NA 0.35 Fully Implemented Facility PE RVUs 0.09 NA NA 0.08 NA NA 0.06 NA NA 0.07 NA NA 0.51 0.51 0.74 1.10 NA NA 0.23 NA NA 0.34 NA NA 0.51 NA NA 1.48 0.00 0.00 0.00 NA NA 0.20 NA NA 2.59 NA NA 0.23 NA NA 0.34 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 77080 77081 77081 77081 77082 77082 77082 77083 77083 77083 77084 77084 77084 77261 77262 77263 77280 77280 77280 77285 77285 77285 77290 77290 77290 77295 77295 77295 77299 77299 77299 77300 77300 77300 77301 77301 77301 77305 77305 77305 77310 77310 77310 HCPCS 2 CPT 1/ 0.01 0.06 0.05 0.01 0.06 0.05 0.01 0.06 0.05 0.01 0.66 0.59 0.07 0.07 0.11 0.16 0.22 0.18 0.04 0.35 0.30 0.05 0.43 0.35 0.08 1.71 1.48 0.23 0.00 0.00 0.00 0.10 0.07 0.03 1.88 1.48 0.40 0.15 0.11 0.04 0.18 0.13 0.05 Mal-Practice RVUs 0.27 0.97 0.68 0.29 0.64 0.41 0.23 0.63 0.37 0.26 16.07 13.92 2.15 1.95 2.93 4.36 5.37 4.39 0.98 9.46 8.01 1.45 15.46 13.29 2.17 13.78 7.44 6.34 0.00 0.00 0.00 1.91 1.05 0.86 67.42 56.34 11.08 1.76 0.78 0.98 2.49 1.04 1.45 Fully Implemented NonFacility Total 0.30 1.08 0.77 0.31 0.94 0.70 0.24 0.97 0.69 0.28 14.50 12.32 2.18 1.97 2.96 4.40 4.81 3.84 0.97 7.85 6.41 1.44 10.62 8.47 2.15 30.19 23.92 6.27 0.00 0.00 0.00 2.17 1.32 0.85 47.12 36.14 10.98 2.64 1.67 0.97 3.55 2.11 1.44 Year 2007 Transitional Non-Facility Total 0.27 NA NA 0.29 NA NA 0.23 NA NA 0.26 NA NA 2.15 1.95 2.93 4.36 NA NA 0.98 NA NA 1.45 NA NA 2.17 NA NA 6.34 0.00 0.00 0.00 NA NA 0.86 NA NA 11.08 NA NA 0.98 NA NA 1.45 Fully Implemented Facility Total 0.30 NA NA 0.31 NA NA 0.24 NA NA 0.28 NA NA 2.18 1.97 2.96 4.40 NA NA 0.97 NA NA 1.44 NA NA 2.15 NA NA 6.27 0.00 0.00 0.00 NA NA 0.85 NA NA 10.98 NA NA 0.97 NA NA 1.44 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69953 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00332 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... .......... .......... .......... .......... TC .... 26 ..... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C C C A A A A A A A A Status Teletx isodose plan complex ............................... Teletx isodose plan complex ............................... Teletx isodose plan complex ............................... Special teletx port plan ........................................ Special teletx port plan ........................................ Special teletx port plan ........................................ Brachytx isodose calc simp ................................. Brachytx isodose calc simp ................................. Brachytx isodose calc simp ................................. Brachytx isodose calc interm ............................... Brachytx isodose calc interm ............................... Brachytx isodose calc interm ............................... Brachytx isodose plan compl ............................... Brachytx isodose plan compl ............................... Brachytx isodose plan compl ............................... Special radiation dosimetry .................................. Special radiation dosimetry .................................. Special radiation dosimetry .................................. Radiation treatment aid(s) .................................... Radiation treatment aid(s) .................................... Radiation treatment aid(s) .................................... Radiation treatment aid(s) .................................... Radiation treatment aid(s) .................................... Radiation treatment aid(s) .................................... Radiation treatment aid(s) .................................... Radiation treatment aid(s) .................................... Radiation treatment aid(s) .................................... Radiation physics consult .................................... Radiation physics consult .................................... Srs, multisource ................................................... Srs, linear based .................................................. Sbrt delivery ......................................................... External radiation dosimetry ................................ External radiation dosimetry ................................ External radiation dosimetry ................................ Radiation treatment delivery ................................ Radiation treatment delivery ................................ Radiation treatment delivery ................................ Radiation treatment delivery ................................ Radiation treatment delivery ................................ Radiation treatment delivery ................................ Radiation treatment delivery ................................ Radiation treatment delivery ................................ Description 1.56 0.00 1.56 0.95 0.00 0.95 0.93 0.00 0.93 1.39 0.00 1.39 2.09 0.00 2.09 0.87 0.00 0.87 0.54 0.00 0.54 0.84 0.00 0.84 1.24 0.00 1.24 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Physician Work RVUs 3 2.11 1.58 0.53 1.52 1.20 0.32 3.01 2.69 0.32 4.12 3.65 0.47 5.28 4.57 0.71 0.81 0.52 0.29 1.57 1.38 0.19 0.52 0.24 0.28 2.74 2.32 0.42 1.14 3.05 30.25 22.93 42.87 0.00 0.00 0.00 0.50 4.18 3.76 4.22 4.21 5.43 5.21 5.82 Fully Implemented NonFacility PE RVUs 2.90 2.39 0.51 3.64 3.33 0.31 2.75 2.44 0.31 3.97 3.52 0.45 5.54 4.86 0.68 0.79 0.51 0.28 1.53 1.35 0.18 1.75 1.48 0.27 3.43 3.02 0.41 2.52 3.38 30.25 22.93 42.87 0.00 0.00 0.00 1.45 2.37 2.27 2.38 2.38 2.93 2.87 3.02 Year 2007 Transitional Non-Facility PE RVUs NA NA 0.53 NA NA 0.32 NA NA 0.32 NA NA 0.47 NA NA 0.71 NA NA 0.29 NA NA 0.19 NA NA 0.28 NA NA 0.42 NA NA NA NA NA 0.00 0.00 0.00 NA NA NA NA NA NA NA NA Fully Implemented Facility PE RVUs NA NA 0.51 NA NA 0.31 NA NA 0.31 NA NA 0.45 NA NA 0.68 NA NA 0.28 NA NA 0.18 NA NA 0.27 NA NA 0.41 NA NA NA NA NA 0.00 0.00 0.00 NA NA NA NA NA NA NA NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 77315 77315 77315 77321 77321 77321 77326 77326 77326 77327 77327 77327 77328 77328 77328 77331 77331 77331 77332 77332 77332 77333 77333 77333 77334 77334 77334 77336 77370 77371 77372 77373 77399 77399 77399 77401 77402 77403 77404 77406 77407 77408 77409 HCPCS 2 CPT 1/ 0.22 0.14 0.08 0.26 0.21 0.05 0.18 0.13 0.05 0.25 0.18 0.07 0.36 0.25 0.11 0.06 0.02 0.04 0.10 0.07 0.03 0.15 0.11 0.04 0.23 0.17 0.06 0.16 0.18 0.13 0.13 0.13 0.00 0.00 0.00 0.11 0.11 0.11 0.11 0.11 0.12 0.12 0.12 Mal-Practice RVUs 3.89 1.72 2.17 2.73 1.41 1.32 4.12 2.82 1.30 5.76 3.83 1.93 7.73 4.82 2.91 1.74 0.54 1.20 2.21 1.45 0.76 1.51 0.35 1.16 4.21 2.49 1.72 1.30 3.23 30.38 23.06 43.00 0.00 0.00 0.00 0.61 4.29 3.87 4.33 4.32 5.55 5.33 5.94 Fully Implemented NonFacility Total 4.68 2.53 2.15 4.85 3.54 1.31 3.86 2.57 1.29 5.61 3.70 1.91 7.99 5.11 2.88 1.72 0.53 1.19 2.17 1.42 0.75 2.74 1.59 1.15 4.90 3.19 1.71 2.68 3.56 30.38 23.06 43.00 0.00 0.00 0.00 1.56 2.48 2.38 2.49 2.49 3.05 2.99 3.14 Year 2007 Transitional Non-Facility Total NA NA 2.17 NA NA 1.32 NA NA 1.30 NA NA 1.93 NA NA 2.91 NA NA 1.20 NA NA 0.76 NA NA 1.16 NA NA 1.72 NA NA NA NA NA 0.00 0.00 0.00 NA NA NA NA NA NA NA NA Fully Implemented Facility Total NA NA 2.15 NA NA 1.31 NA NA 1.29 NA NA 1.91 NA NA 2.88 NA NA 1.19 NA NA 0.75 NA NA 1.15 NA NA 1.71 NA NA NA NA NA 0.00 0.00 0.00 NA NA NA NA NA NA NA NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69954 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00333 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... TC .... 26 ..... .......... .......... .......... .......... .......... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... .......... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A C C C C C C C R R R R R R R R R R R R R R R A A Status Radiation treatment delivery ................................ Radiation treatment delivery ................................ Radiation treatment delivery ................................ Radiation treatment delivery ................................ Radiation treatment delivery ................................ Radiology port film(s) ........................................... Radiation tx delivery, imrt .................................... Stereoscopic x-ray guidance ................................ Stereoscopic x-ray guidance ................................ Stereoscopic x-ray guidance ................................ Neutron beam tx, simple ...................................... Neutron beam tx, complex ................................... Radiation tx management, x5 .............................. Radiation therapy management ........................... Stereotactic radiation trmt .................................... Sbrt management ................................................. Special radiation treatment .................................. Special radiation treatment .................................. Special radiation treatment .................................. Radiation therapy management ........................... Radiation therapy management ........................... Radiation therapy management ........................... Proton trmt, simple w/o comp .............................. Proton trmt, simple w/comp ................................. Proton trmt, intermediate ..................................... Proton treatment, complex ................................... Hyperthermia treatment ....................................... Hyperthermia treatment ....................................... Hyperthermia treatment ....................................... Hyperthermia treatment ....................................... Hyperthermia treatment ....................................... Hyperthermia treatment ....................................... Hyperthermia treatment ....................................... Hyperthermia treatment ....................................... Hyperthermia treatment ....................................... Hyperthermia treatment ....................................... Hyperthermia treatment ....................................... Hyperthermia treatment ....................................... Hyperthermia treatment ....................................... Hyperthermia treatment ....................................... Hyperthermia treatment ....................................... Infuse radioactive materials ................................. Infuse radioactive materials ................................. Description 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.39 0.00 0.39 0.00 0.00 3.70 1.81 7.92 13.00 2.09 0.00 2.09 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.56 0.00 1.56 2.09 0.00 2.09 1.56 0.00 1.56 2.09 0.00 2.09 1.56 0.00 1.56 4.94 0.00 Physician Work RVUs 3 5.76 6.84 6.86 7.72 7.71 0.36 13.15 2.00 1.87 0.13 13.19 8.59 1.43 0.80 2.71 4.63 1.95 1.24 0.71 0.00 0.00 0.00 0.00 0.00 0.00 0.00 9.71 9.28 0.43 17.34 16.71 0.63 17.04 16.52 0.52 25.91 25.21 0.70 9.46 9.07 0.39 4.61 2.94 Fully Implemented NonFacility PE RVUs 3.01 3.46 3.46 3.68 3.68 0.53 16.80 3.11 2.98 0.13 4.58 3.84 1.15 0.71 2.85 4.63 9.35 8.67 0.68 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5.09 4.61 0.48 7.87 7.22 0.65 6.93 6.42 0.51 10.02 9.35 0.67 5.05 4.56 0.49 3.33 1.73 Year 2007 Transitional Non-Facility PE RVUs NA NA NA NA NA NA NA NA NA 0.13 NA NA 1.43 0.80 2.71 NA NA NA 0.71 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NA NA 0.43 NA NA 0.63 NA NA 0.52 NA NA 0.70 NA NA 0.39 4.61 2.94 Fully Implemented Facility PE RVUs NA NA NA NA NA NA NA NA NA 0.13 NA NA 1.15 0.71 2.85 NA NA NA 0.68 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NA NA 0.48 NA NA 0.65 NA NA 0.51 NA NA 0.67 NA NA 0.49 3.33 1.73 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 77411 77412 77413 77414 77416 77417 77418 77421 77421 77421 77422 77423 77427 77431 77432 77435 77470 77470 77470 77499 77499 77499 77520 77522 77523 77525 77600 77600 77600 77605 77605 77605 77610 77610 77610 77615 77615 77615 77620 77620 77620 77750 77750 HCPCS 2 CPT 1/ 0.12 0.13 0.13 0.13 0.13 0.04 0.13 0.12 0.10 0.02 0.13 0.13 0.17 0.09 0.41 0.67 0.70 0.59 0.11 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.24 0.16 0.08 0.38 0.22 0.16 0.24 0.16 0.08 0.33 0.22 0.11 0.36 0.16 0.20 0.32 0.07 Mal-Practice RVUs 5.88 6.97 6.99 7.85 7.84 0.40 13.28 2.51 1.97 0.54 13.32 8.72 5.30 2.70 11.04 18.30 4.74 1.83 2.91 0.00 0.00 0.00 0.00 0.00 0.00 0.00 11.51 9.44 2.07 19.81 16.93 2.88 18.84 16.68 2.16 28.33 25.43 2.90 11.38 9.23 2.15 9.87 3.01 Fully Implemented NonFacility Total 3.13 3.59 3.59 3.81 3.81 0.57 16.93 3.62 3.08 0.54 4.71 3.97 5.02 2.61 11.18 18.30 12.14 9.26 2.88 0.00 0.00 0.00 0.00 0.00 0.00 0.00 6.89 4.77 2.12 10.34 7.44 2.90 8.73 6.58 2.15 12.44 9.57 2.87 6.97 4.72 2.25 8.59 1.80 Year 2007 Transitional Non-Facility Total NA NA NA NA NA NA NA NA NA 0.54 NA NA 5.30 2.70 11.04 NA NA NA 2.91 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NA NA 2.07 NA NA 2.88 NA NA 2.16 NA NA 2.90 NA NA 2.15 9.87 3.01 Fully Implemented Facility Total NA NA NA NA NA NA NA NA NA 0.54 NA NA 5.02 2.61 11.18 NA NA NA 2.88 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NA NA 2.12 NA NA 2.90 NA NA 2.15 NA NA 2.87 NA NA 2.25 8.59 1.80 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69955 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00334 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C C C A A A Status Infuse radioactive materials ................................. Apply intrcav radiat simple ................................... Apply intrcav radiat simple ................................... Apply intrcav radiat simple ................................... Apply intrcav radiat interm ................................... Apply intrcav radiat interm ................................... Apply intrcav radiat interm ................................... Apply intrcav radiat compl .................................... Apply intrcav radiat compl .................................... Apply intrcav radiat compl .................................... Apply interstit radiat simpl .................................... Apply interstit radiat simpl .................................... Apply interstit radiat simpl .................................... Apply interstit radiat inter ..................................... Apply interstit radiat inter ..................................... Apply interstit radiat inter ..................................... Apply interstit radiat compl ................................... Apply interstit radiat compl ................................... Apply interstit radiat compl ................................... High intensity brachytherapy ................................ High intensity brachytherapy ................................ High intensity brachytherapy ................................ High intensity brachytherapy ................................ High intensity brachytherapy ................................ High intensity brachytherapy ................................ High intensity brachytherapy ................................ High intensity brachytherapy ................................ High intensity brachytherapy ................................ High intensity brachytherapy ................................ High intensity brachytherapy ................................ High intensity brachytherapy ................................ Apply surface radiation ........................................ Apply surface radiation ........................................ Apply surface radiation ........................................ Radiation handling ............................................... Radiation handling ............................................... Radiation handling ............................................... Radium/radioisotope therapy ............................... Radium/radioisotope therapy ............................... Radium/radioisotope therapy ............................... Thyroid, single uptake .......................................... Thyroid, single uptake .......................................... Thyroid, single uptake .......................................... Description 4.94 3.82 0.00 3.82 5.73 0.00 5.73 8.60 0.00 8.60 4.67 0.00 4.67 7.49 0.00 7.49 11.23 0.00 11.23 1.21 0.00 1.21 2.04 0.00 2.04 3.27 0.00 3.27 5.15 0.00 5.15 1.14 0.00 1.14 1.05 0.00 1.05 0.00 0.00 0.00 0.19 0.00 0.19 Physician Work RVUs 3 1.67 6.32 5.06 1.26 7.70 5.76 1.94 10.39 7.51 2.88 7.51 5.80 1.71 7.90 5.40 2.50 11.43 7.62 3.81 4.43 4.02 0.41 12.47 11.78 0.69 24.34 23.23 1.11 45.87 44.12 1.75 2.07 1.67 0.40 1.47 1.12 0.35 0.00 0.00 0.00 1.72 1.67 0.05 Fully Implemented NonFacility PE RVUs 1.60 4.27 3.14 1.13 6.01 4.15 1.86 8.03 5.25 2.78 4.23 3.09 1.14 6.92 4.52 2.40 9.38 5.75 3.63 16.73 16.23 0.50 18.94 18.17 0.77 22.20 21.03 1.17 28.04 26.26 1.78 1.14 0.76 0.38 1.00 0.66 0.34 0.00 0.00 0.00 1.21 1.15 0.06 Year 2007 Transitional Non-Facility PE RVUs 1.67 6.32 5.06 1.26 7.70 5.76 1.94 10.39 7.51 2.88 7.51 5.80 1.71 7.90 5.40 2.50 11.43 7.62 3.81 NA NA 0.41 NA NA 0.69 NA NA 1.11 NA NA 1.75 2.07 1.67 0.40 NA NA 0.35 0.00 0.00 0.00 NA NA 0.05 Fully Implemented Facility PE RVUs 1.60 4.27 3.14 1.13 6.01 4.15 1.86 8.03 5.25 2.78 4.23 3.09 1.14 6.92 4.52 2.40 9.38 5.75 3.63 NA NA 0.50 NA NA 0.77 NA NA 1.17 NA NA 1.78 1.14 0.76 0.38 NA NA 0.34 0.00 0.00 0.00 NA NA 0.06 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 77750 77761 77761 77761 77762 77762 77762 77763 77763 77763 77776 77776 77776 77777 77777 77777 77778 77778 77778 77781 77781 77781 77782 77782 77782 77783 77783 77783 77784 77784 77784 77789 77789 77789 77790 77790 77790 77799 77799 77799 78000 78000 78000 HCPCS 2 CPT 1/ 0.25 0.33 0.14 0.19 0.48 0.19 0.29 0.66 0.23 0.43 0.57 0.13 0.44 0.61 0.22 0.39 0.84 0.27 0.57 1.14 1.06 0.08 1.19 1.06 0.13 1.25 1.06 0.19 1.35 1.06 0.29 0.08 0.02 0.06 0.07 0.02 0.05 0.00 0.00 0.00 0.07 0.06 0.01 Mal-Practice RVUs 6.86 10.47 5.20 5.27 13.91 5.95 7.96 19.65 7.74 11.91 12.75 5.93 6.82 16.00 5.62 10.38 23.50 7.89 15.61 6.78 5.08 1.70 15.70 12.84 2.86 28.86 24.29 4.57 52.37 45.18 7.19 3.29 1.69 1.60 2.59 1.14 1.45 0.00 0.00 0.00 1.98 1.73 0.25 Fully Implemented NonFacility Total 6.79 8.42 3.28 5.14 12.22 4.34 7.88 17.29 5.48 11.81 9.47 3.22 6.25 15.02 4.74 10.28 21.45 6.02 15.43 19.08 17.29 1.79 22.17 19.23 2.94 26.72 22.09 4.63 34.54 27.32 7.22 2.36 0.78 1.58 2.12 0.68 1.44 0.00 0.00 0.00 1.47 1.21 0.26 Year 2007 Transitional Non-Facility Total 6.86 10.47 5.20 5.27 13.91 5.95 7.96 19.65 7.74 11.91 12.75 5.93 6.82 16.00 5.62 10.38 23.50 7.89 15.61 NA NA 1.70 NA NA 2.86 NA NA 4.57 NA NA 7.19 3.29 1.69 1.60 NA NA 1.45 0.00 0.00 0.00 NA NA 0.25 Fully Implemented Facility Total 6.79 8.42 3.28 5.14 12.22 4.34 7.88 17.29 5.48 11.81 9.47 3.22 6.25 15.02 4.74 10.28 21.45 6.02 15.43 NA NA 1.79 NA NA 2.94 NA NA 4.63 NA NA 7.22 2.36 0.78 1.58 NA NA 1.44 0.00 0.00 0.00 NA NA 0.26 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 090 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX 000 000 000 XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69956 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00335 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C C C A A A A Status Thyroid, multiple uptakes ..................................... Thyroid, multiple uptakes ..................................... Thyroid, multiple uptakes ..................................... Thyroid suppress/stimul ....................................... Thyroid suppress/stimul ....................................... Thyroid suppress/stimul ....................................... Thyroid imaging with uptake ................................ Thyroid imaging with uptake ................................ Thyroid imaging with uptake ................................ Thyroid image, mult uptakes ................................ Thyroid image, mult uptakes ................................ Thyroid image, mult uptakes ................................ Thyroid imaging .................................................... Thyroid imaging .................................................... Thyroid imaging .................................................... Thyroid imaging with flow .................................... Thyroid imaging with flow .................................... Thyroid imaging with flow .................................... Thyroid met imaging ............................................ Thyroid met imaging ............................................ Thyroid met imaging ............................................ Thyroid met imaging/studies ................................ Thyroid met imaging/studies ................................ Thyroid met imaging/studies ................................ Thyroid met imaging, body .................................. Thyroid met imaging, body .................................. Thyroid met imaging, body .................................. Thyroid met uptake .............................................. Thyroid met uptake .............................................. Thyroid met uptake .............................................. Parathyroid nuclear imaging ................................ Parathyroid nuclear imaging ................................ Parathyroid nuclear imaging ................................ Adrenal nuclear imaging ...................................... Adrenal nuclear imaging ...................................... Adrenal nuclear imaging ...................................... Endocrine nuclear procedure ............................... Endocrine nuclear procedure ............................... Endocrine nuclear procedure ............................... Bone marrow imaging, ltd .................................... Bone marrow imaging, ltd .................................... Bone marrow imaging, ltd .................................... Bone marrow imaging, mult ................................. Description 0.26 0.00 0.26 0.33 0.00 0.33 0.49 0.00 0.49 0.50 0.00 0.50 0.39 0.00 0.39 0.45 0.00 0.45 0.67 0.00 0.67 0.82 0.00 0.82 0.86 0.00 0.86 0.60 0.00 0.60 0.82 0.00 0.82 0.74 0.00 0.74 0.00 0.00 0.00 0.55 0.00 0.55 0.75 Physician Work RVUs 3 2.12 2.05 0.07 1.76 1.67 0.09 5.86 5.72 0.14 2.81 2.67 0.14 3.94 3.83 0.11 4.27 4.14 0.13 5.10 4.91 0.19 8.12 7.89 0.23 7.47 7.23 0.24 1.68 1.51 0.17 3.19 2.96 0.23 11.04 10.83 0.21 0.00 0.00 0.00 3.91 3.76 0.15 5.09 Fully Implemented NonFacility PE RVUs 1.59 1.50 0.09 1.26 1.15 0.11 3.38 3.22 0.16 2.76 2.60 0.16 2.45 2.32 0.13 2.99 2.84 0.15 3.38 3.16 0.22 4.85 4.58 0.27 6.16 5.87 0.29 1.56 1.36 0.20 4.21 3.94 0.27 7.02 6.77 0.25 0.00 0.00 0.00 2.65 2.47 0.18 3.85 Year 2007 Transitional Non-Facility PE RVUs NA NA 0.07 NA NA 0.09 NA NA 0.14 NA NA 0.14 NA NA 0.11 NA NA 0.13 NA NA 0.19 NA NA 0.23 NA NA 0.24 1.68 1.51 0.17 NA NA 0.23 NA NA 0.21 0.00 0.00 0.00 NA NA 0.15 NA Fully Implemented Facility PE RVUs NA NA 0.09 NA NA 0.11 NA NA 0.16 NA NA 0.16 NA NA 0.13 NA NA 0.15 NA NA 0.22 NA NA 0.27 NA NA 0.29 1.56 1.36 0.20 NA NA 0.27 NA NA 0.25 0.00 0.00 0.00 NA NA 0.18 NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 78001 78001 78001 78003 78003 78003 78006 78006 78006 78007 78007 78007 78010 78010 78010 78011 78011 78011 78015 78015 78015 78016 78016 78016 78018 78018 78018 78020 78020 78020 78070 78070 78070 78075 78075 78075 78099 78099 78099 78102 78102 78102 78103 HCPCS 2 CPT 1/ 0.08 0.07 0.01 0.07 0.06 0.01 0.15 0.13 0.02 0.16 0.14 0.02 0.13 0.11 0.02 0.15 0.13 0.02 0.17 0.14 0.03 0.21 0.18 0.03 0.33 0.29 0.04 0.16 0.14 0.02 0.15 0.11 0.04 0.32 0.29 0.03 0.00 0.00 0.00 0.14 0.12 0.02 0.20 Mal-Practice RVUs 2.46 2.12 0.34 2.16 1.73 0.43 6.50 5.85 0.65 3.47 2.81 0.66 4.46 3.94 0.52 4.87 4.27 0.60 5.94 5.05 0.89 9.15 8.07 1.08 8.66 7.52 1.14 2.44 1.65 0.79 4.16 3.07 1.09 12.10 11.12 0.98 0.00 0.00 0.00 4.60 3.88 0.72 6.04 Fully Implemented NonFacility Total 1.93 1.57 0.36 1.66 1.21 0.45 4.02 3.35 0.67 3.42 2.74 0.68 2.97 2.43 0.54 3.59 2.97 0.62 4.22 3.30 0.92 5.88 4.76 1.12 7.35 6.16 1.19 2.32 1.50 0.82 5.18 4.05 1.13 8.08 7.06 1.02 0.00 0.00 0.00 3.34 2.59 0.75 4.80 Year 2007 Transitional Non-Facility Total NA NA 0.34 NA NA 0.43 NA NA 0.65 NA NA 0.66 NA NA 0.52 NA NA 0.60 NA NA 0.89 NA NA 1.08 NA NA 1.14 2.44 1.65 0.79 NA NA 1.09 NA NA 0.98 0.00 0.00 0.00 NA NA 0.72 NA Fully Implemented Facility Total NA NA 0.36 NA NA 0.45 NA NA 0.67 NA NA 0.68 NA NA 0.54 NA NA 0.62 NA NA 0.92 NA NA 1.12 NA NA 1.19 2.32 1.50 0.82 NA NA 1.13 NA NA 1.02 0.00 0.00 0.00 NA NA 0.75 NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX ZZZ ZZZ ZZZ XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69957 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00336 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C C Status Bone marrow imaging, mult ................................. Bone marrow imaging, mult ................................. Bone marrow imaging, body ................................ Bone marrow imaging, body ................................ Bone marrow imaging, body ................................ Plasma volume, single ......................................... Plasma volume, single ......................................... Plasma volume, single ......................................... Plasma volume, multiple ...................................... Plasma volume, multiple ...................................... Plasma volume, multiple ...................................... Red cell mass, single ........................................... Red cell mass, single ........................................... Red cell mass, single ........................................... Red cell mass, multiple ........................................ Red cell mass, multiple ........................................ Red cell mass, multiple ........................................ Blood volume ....................................................... Blood volume ....................................................... Blood volume ....................................................... Red cell survival study ......................................... Red cell survival study ......................................... Red cell survival study ......................................... Red cell survival kinetics ...................................... Red cell survival kinetics ...................................... Red cell survival kinetics ...................................... Red cell sequestration ......................................... Red cell sequestration ......................................... Red cell sequestration ......................................... Spleen imaging .................................................... Spleen imaging .................................................... Spleen imaging .................................................... Platelet survival, kinetics ...................................... Platelet survival, kinetics ...................................... Platelet survival, kinetics ...................................... Platelet survival .................................................... Platelet survival .................................................... Platelet survival .................................................... Lymph system imaging ........................................ Lymph system imaging ........................................ Lymph system imaging ........................................ Blood/lymph nuclear exam ................................... Blood/lymph nuclear exam ................................... Description 0.00 0.75 0.80 0.00 0.80 0.19 0.00 0.19 0.22 0.00 0.22 0.23 0.00 0.23 0.32 0.00 0.32 0.45 0.00 0.45 0.61 0.00 0.61 0.64 0.00 0.64 0.61 0.00 0.61 0.40 0.00 0.40 1.09 0.00 1.09 0.61 0.00 0.61 1.20 0.00 1.20 0.00 0.00 Physician Work RVUs 3 4.88 0.21 5.96 5.71 0.25 2.03 1.98 0.05 2.02 1.96 0.06 1.96 1.89 0.07 2.06 1.97 0.09 2.09 1.97 0.12 3.32 3.14 0.18 8.09 7.91 0.18 2.68 2.51 0.17 4.90 4.79 0.11 8.77 8.44 0.33 3.21 3.04 0.17 8.15 7.82 0.33 0.00 0.00 Fully Implemented NonFacility PE RVUs 3.60 0.25 4.75 4.48 0.27 1.28 1.21 0.07 2.50 2.42 0.08 1.85 1.77 0.08 2.79 2.68 0.11 4.09 3.94 0.15 3.12 2.92 0.20 5.84 5.63 0.21 3.77 3.58 0.19 3.10 2.97 0.13 6.77 6.39 0.38 6.46 6.27 0.19 5.40 5.01 0.39 0.00 0.00 Year 2007 Transitional Non-Facility PE RVUs NA 0.21 NA NA 0.25 NA NA 0.05 NA NA 0.06 NA NA 0.07 NA NA 0.09 NA NA 0.12 NA NA 0.18 NA NA 0.18 NA NA 0.17 NA NA 0.11 NA NA 0.33 NA NA 0.17 NA NA 0.33 0.00 0.00 Fully Implemented Facility PE RVUs NA 0.25 NA NA 0.27 NA NA 0.07 NA NA 0.08 NA NA 0.08 NA NA 0.11 NA NA 0.15 NA NA 0.20 NA NA 0.21 NA NA 0.19 NA NA 0.13 NA NA 0.38 NA NA 0.19 NA NA 0.39 0.00 0.00 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 78103 78103 78104 78104 78104 78110 78110 78110 78111 78111 78111 78120 78120 78120 78121 78121 78121 78122 78122 78122 78130 78130 78130 78135 78135 78135 78140 78140 78140 78185 78185 78185 78190 78190 78190 78191 78191 78191 78195 78195 78195 78199 78199 HCPCS 2 CPT 1/ 0.17 0.03 0.25 0.22 0.03 0.07 0.06 0.01 0.15 0.14 0.01 0.12 0.11 0.01 0.15 0.14 0.01 0.26 0.24 0.02 0.17 0.14 0.03 0.28 0.25 0.03 0.24 0.21 0.03 0.15 0.13 0.02 0.38 0.30 0.08 0.40 0.37 0.03 0.28 0.22 0.06 0.00 0.00 Mal-Practice RVUs 5.05 0.99 7.01 5.93 1.08 2.29 2.04 0.25 2.39 2.10 0.29 2.31 2.00 0.31 2.53 2.11 0.42 2.80 2.21 0.59 4.10 3.28 0.82 9.01 8.16 0.85 3.53 2.72 0.81 5.45 4.92 0.53 10.24 8.74 1.50 4.22 3.41 0.81 9.63 8.04 1.59 0.00 0.00 Fully Implemented NonFacility Total 3.77 1.03 5.80 4.70 1.10 1.54 1.27 0.27 2.87 2.56 0.31 2.20 1.88 0.32 3.26 2.82 0.44 4.80 4.18 0.62 3.90 3.06 0.84 6.76 5.88 0.88 4.62 3.79 0.83 3.65 3.10 0.55 8.24 6.69 1.55 7.47 6.64 0.83 6.88 5.23 1.65 0.00 0.00 Year 2007 Transitional Non-Facility Total NA 0.99 NA NA 1.08 NA NA 0.25 NA NA 0.29 NA NA 0.31 NA NA 0.42 NA NA 0.59 NA NA 0.82 NA NA 0.85 NA NA 0.81 NA NA 0.53 NA NA 1.50 NA NA 0.81 NA NA 1.59 0.00 0.00 Fully Implemented Facility Total NA 1.03 NA NA 1.10 NA NA 0.27 NA NA 0.31 NA NA 0.32 NA NA 0.44 NA NA 0.62 NA NA 0.84 NA NA 0.88 NA NA 0.83 NA NA 0.55 NA NA 1.55 NA NA 0.83 NA NA 1.65 0.00 0.00 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69958 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00337 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... 2 Copyright 3+ Mod C A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Blood/lymph nuclear exam ................................... Liver imaging ........................................................ Liver imaging ........................................................ Liver imaging ........................................................ Liver imaging with flow ......................................... Liver imaging with flow ......................................... Liver imaging with flow ......................................... Liver imaging (3D) ................................................ Liver imaging (3D) ................................................ Liver imaging (3D) ................................................ Liver image (3d) with flow .................................... Liver image (3d) with flow .................................... Liver image (3d) with flow .................................... Liver and spleen imaging ..................................... Liver and spleen imaging ..................................... Liver and spleen imaging ..................................... Liver & spleen image/flow .................................... Liver & spleen image/flow .................................... Liver & spleen image/flow .................................... Liver function study .............................................. Liver function study .............................................. Liver function study .............................................. Hepatobiliary imaging ........................................... Hepatobiliary imaging ........................................... Hepatobiliary imaging ........................................... Salivary gland imaging ......................................... Salivary gland imaging ......................................... Salivary gland imaging ......................................... Serial salivary imaging ......................................... Serial salivary imaging ......................................... Serial salivary imaging ......................................... Salivary gland function exam ............................... Salivary gland function exam ............................... Salivary gland function exam ............................... Esophageal motility study .................................... Esophageal motility study .................................... Esophageal motility study .................................... Gastric mucosa imaging ...................................... Gastric mucosa imaging ...................................... Gastric mucosa imaging ...................................... Gastroesophageal reflux exam ............................ Gastroesophageal reflux exam ............................ Gastroesophageal reflux exam ............................ Description 0.00 0.44 0.00 0.44 0.51 0.00 0.51 0.71 0.00 0.71 0.96 0.00 0.96 0.49 0.00 0.49 0.57 0.00 0.57 0.49 0.00 0.49 0.84 0.00 0.84 0.45 0.00 0.45 0.52 0.00 0.52 0.47 0.00 0.47 0.74 0.00 0.74 0.69 0.00 0.69 0.68 0.00 0.68 Physician Work RVUs 3 0.00 4.48 4.36 0.12 5.06 4.92 0.14 4.93 4.73 0.20 13.75 13.48 0.27 4.52 4.38 0.14 2.63 2.47 0.16 2.84 2.70 0.14 7.99 7.75 0.24 3.91 3.79 0.12 2.63 2.48 0.15 2.60 2.47 0.13 5.57 5.32 0.25 5.69 5.50 0.19 5.65 5.46 0.19 Fully Implemented NonFacility PE RVUs 0.00 3.00 2.86 0.14 3.55 3.39 0.16 5.85 5.62 0.23 8.12 7.80 0.32 3.46 3.30 0.16 3.41 3.23 0.18 3.63 3.47 0.16 4.95 4.68 0.27 2.72 2.58 0.14 3.17 3.00 0.17 3.42 3.27 0.15 3.74 3.49 0.25 4.68 4.45 0.23 4.77 4.55 0.22 Year 2007 Transitional Non-Facility PE RVUs 0.00 NA NA 0.12 NA NA 0.14 NA NA 0.20 NA NA 0.27 NA NA 0.14 NA NA 0.16 NA NA 0.14 NA NA 0.24 NA NA 0.12 NA NA 0.15 NA NA 0.13 NA NA 0.25 NA NA 0.19 NA NA 0.19 Fully Implemented Facility PE RVUs 0.00 NA NA 0.14 NA NA 0.16 NA NA 0.23 NA NA 0.32 NA NA 0.16 NA NA 0.18 NA NA 0.16 NA NA 0.27 NA NA 0.14 NA NA 0.17 NA NA 0.15 NA NA 0.25 NA NA 0.23 NA NA 0.22 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 78199 78201 78201 78201 78202 78202 78202 78205 78205 78205 78206 78206 78206 78215 78215 78215 78216 78216 78216 78220 78220 78220 78223 78223 78223 78230 78230 78230 78231 78231 78231 78232 78232 78232 78258 78258 78258 78261 78261 78261 78262 78262 78262 HCPCS 2 CPT 1/ 0.00 0.15 0.13 0.02 0.16 0.14 0.02 0.34 0.31 0.03 0.15 0.11 0.04 0.16 0.14 0.02 0.20 0.18 0.02 0.21 0.19 0.02 0.23 0.19 0.04 0.15 0.13 0.02 0.19 0.17 0.02 0.20 0.18 0.02 0.17 0.14 0.03 0.25 0.22 0.03 0.25 0.22 0.03 Mal-Practice RVUs 0.00 5.07 4.49 0.58 5.73 5.06 0.67 5.98 5.04 0.94 14.86 13.59 1.27 5.17 4.52 0.65 3.40 2.65 0.75 3.54 2.89 0.65 9.06 7.94 1.12 4.51 3.92 0.59 3.34 2.65 0.69 3.27 2.65 0.62 6.48 5.46 1.02 6.63 5.72 0.91 6.58 5.68 0.90 Fully Implemented NonFacility Total 0.00 3.59 2.99 0.60 4.22 3.53 0.69 6.90 5.93 0.97 9.23 7.91 1.32 4.11 3.44 0.67 4.18 3.41 0.77 4.33 3.66 0.67 6.02 4.87 1.15 3.32 2.71 0.61 3.88 3.17 0.71 4.09 3.45 0.64 4.65 3.63 1.02 5.62 4.67 0.95 5.70 4.77 0.93 Year 2007 Transitional Non-Facility Total 0.00 NA NA 0.58 NA NA 0.67 NA NA 0.94 NA NA 1.27 NA NA 0.65 NA NA 0.75 NA NA 0.65 NA NA 1.12 NA NA 0.59 NA NA 0.69 NA NA 0.62 NA NA 1.02 NA NA 0.91 NA NA 0.90 Fully Implemented Facility Total 0.00 NA NA 0.60 NA NA 0.69 NA NA 0.97 NA NA 1.32 NA NA 0.67 NA NA 0.77 NA NA 0.67 NA NA 1.15 NA NA 0.61 NA NA 0.71 NA NA 0.64 NA NA 1.02 NA NA 0.95 NA NA 0.93 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69959 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00338 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... TC .... 26 ..... .......... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 2 Copyright 3+ Mod A A A X X A A A A A A A A A A A A C C A A A A A A A C C C A A A A A A A A A A A A A A Status Gastric emptying study ........................................ Gastric emptying study ........................................ Gastric emptying study ........................................ Breath tst attain/anal c-14 .................................... Breath test analysis, c-14 .................................... Vit B-12 absorption exam .................................... Vit B-12 absorption exam .................................... Vit B-12 absorption exam .................................... Vit b-12 absrp exam, int fac ................................. Vit b-12 absrp exam, int fac ................................. Vit b-12 absrp exam, int fac ................................. Vit B-12 absorp, combined .................................. Vit B-12 absorp, combined .................................. Vit B-12 absorp, combined .................................. Acute GI blood loss imaging ................................ Acute GI blood loss imaging ................................ Acute GI blood loss imaging ................................ GI protein loss exam ............................................ GI protein loss exam ............................................ GI protein loss exam ............................................ Meckel"s divert exam ......................................... Meckel"s divert exam ......................................... Meckel"s divert exam ......................................... Leveen/shunt patency exam ................................ Leveen/shunt patency exam ................................ Leveen/shunt patency exam ................................ GI nuclear procedure ........................................... GI nuclear procedure ........................................... GI nuclear procedure ........................................... Bone imaging, limited area .................................. Bone imaging, limited area .................................. Bone imaging, limited area .................................. Bone imaging, multiple areas .............................. Bone imaging, multiple areas .............................. Bone imaging, multiple areas .............................. Bone imaging, whole body ................................... Bone imaging, whole body ................................... Bone imaging, whole body ................................... Bone imaging, 3 phase ........................................ Bone imaging, 3 phase ........................................ Bone imaging, 3 phase ........................................ Bone imaging (3D) ............................................... Bone imaging (3D) ............................................... Description 0.78 0.00 0.78 0.00 0.00 0.20 0.00 0.20 0.20 0.00 0.20 0.27 0.00 0.27 0.99 0.00 0.99 0.00 0.00 0.38 0.68 0.00 0.68 0.88 0.00 0.88 0.00 0.00 0.00 0.62 0.00 0.62 0.83 0.00 0.83 0.86 0.00 0.86 1.02 0.00 1.02 1.04 0.00 Physician Work RVUs 3 6.73 6.51 0.22 0.00 0.00 1.81 1.76 0.05 1.83 1.78 0.05 1.95 1.88 0.07 8.06 7.78 0.28 0.00 0.00 0.10 7.97 7.78 0.19 5.82 5.57 0.25 0.00 0.00 0.00 3.94 3.76 0.18 5.13 4.90 0.23 5.68 5.44 0.24 8.07 7.78 0.29 5.00 4.71 Fully Implemented NonFacility PE RVUs 4.98 4.73 0.25 0.00 0.00 1.67 1.60 0.07 1.75 1.68 0.07 2.30 2.21 0.09 5.92 5.60 0.32 0.00 0.00 0.12 4.45 4.23 0.22 3.98 3.69 0.29 0.00 0.00 0.00 3.00 2.80 0.20 4.24 3.97 0.27 4.84 4.56 0.28 5.86 5.53 0.33 5.95 5.61 Year 2007 Transitional Non-Facility PE RVUs NA NA 0.22 0.00 0.00 NA NA 0.05 NA NA 0.05 NA NA 0.07 NA NA 0.28 0.00 0.00 0.10 NA NA 0.19 NA NA 0.25 0.00 0.00 0.00 NA NA 0.18 NA NA 0.23 NA NA 0.24 NA NA 0.29 NA NA Fully Implemented Facility PE RVUs NA NA 0.25 0.00 0.00 NA NA 0.07 NA NA 0.07 NA NA 0.09 NA NA 0.32 0.00 0.00 0.12 NA NA 0.22 NA NA 0.29 0.00 0.00 0.00 NA NA 0.20 NA NA 0.27 NA NA 0.28 NA NA 0.33 NA NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 78264 78264 78264 78267 78268 78270 78270 78270 78271 78271 78271 78272 78272 78272 78278 78278 78278 78282 78282 78282 78290 78290 78290 78291 78291 78291 78299 78299 78299 78300 78300 78300 78305 78305 78305 78306 78306 78306 78315 78315 78315 78320 78320 HCPCS 2 CPT 1/ 0.25 0.22 0.03 0.00 0.00 0.11 0.10 0.01 0.11 0.10 0.01 0.14 0.13 0.01 0.29 0.25 0.04 0.00 0.00 0.02 0.19 0.16 0.03 0.20 0.16 0.04 0.00 0.00 0.00 0.17 0.14 0.03 0.23 0.19 0.04 0.26 0.22 0.04 0.29 0.25 0.04 0.35 0.31 Mal-Practice RVUs 7.76 6.73 1.03 0.00 0.00 2.12 1.86 0.26 2.14 1.88 0.26 2.36 2.01 0.35 9.34 8.03 1.31 0.00 0.00 0.50 8.84 7.94 0.90 6.90 5.73 1.17 0.00 0.00 0.00 4.73 3.90 0.83 6.19 5.09 1.10 6.80 5.66 1.14 9.38 8.03 1.35 6.39 5.02 Fully Implemented NonFacility Total 6.01 4.95 1.06 0.00 0.00 1.98 1.70 0.28 2.06 1.78 0.28 2.71 2.34 0.37 7.20 5.85 1.35 0.00 0.00 0.52 5.32 4.39 0.93 5.06 3.85 1.21 0.00 0.00 0.00 3.79 2.94 0.85 5.30 4.16 1.14 5.96 4.78 1.18 7.17 5.78 1.39 7.34 5.92 Year 2007 Transitional Non-Facility Total NA NA 1.03 0.00 0.00 NA NA 0.26 NA NA 0.26 NA NA 0.35 NA NA 1.31 0.00 0.00 0.50 NA NA 0.90 NA NA 1.17 0.00 0.00 0.00 NA NA 0.83 NA NA 1.10 NA NA 1.14 NA NA 1.35 NA NA Fully Implemented Facility Total NA NA 1.06 0.00 0.00 NA NA 0.28 NA NA 0.28 NA NA 0.37 NA NA 1.35 0.00 0.00 0.52 NA NA 0.93 NA NA 1.21 0.00 0.00 0.00 NA NA 0.85 NA NA 1.14 NA NA 1.18 NA NA 1.39 NA NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69960 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00339 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 26 ..... .......... TC .... 26 ..... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 2 Copyright 3+ Mod A N N N N C C C C C A A A A A A A A A A A A A A A A C C A A A A A A A A A A A A A A A Status Bone imaging (3D) ............................................... Bone mineral, single photon ................................ Bone mineral, single photon ................................ Bone mineral, single photon ................................ Bone mineral, dual photon ................................... Musculoskeletal nuclear exam ............................. Musculoskeletal nuclear exam ............................. Musculoskeletal nuclear exam ............................. Non-imaging heart function .................................. Non-imaging heart function .................................. Non-imaging heart function .................................. Cardiac shunt imaging ......................................... Cardiac shunt imaging ......................................... Cardiac shunt imaging ......................................... Vascular flow imaging .......................................... Vascular flow imaging .......................................... Vascular flow imaging .......................................... Acute venous thrombus image ............................ Acute venous thrombus image ............................ Acute venous thrombus image ............................ Venous thrombosis imaging ................................. Venous thrombosis imaging ................................. Venous thrombosis imaging ................................. Ven thrombosis images, bilat ............................... Ven thrombosis images, bilat ............................... Ven thrombosis images, bilat ............................... Heart muscle imaging (PET) ................................ Heart muscle imaging (PET) ................................ Heart muscle imaging (PET) ................................ Heart muscle blood, single .................................. Heart muscle blood, single .................................. Heart muscle blood, single .................................. Heart muscle blood, multiple ............................... Heart muscle blood, multiple ............................... Heart muscle blood, multiple ............................... Heart image (3d), single ...................................... Heart image (3d), single ...................................... Heart image (3d), single ...................................... Heart image (3d), multiple ................................... Heart image (3d), multiple ................................... Heart image (3d), multiple ................................... Heart infarct image ............................................... Heart infarct image ............................................... Description 1.04 0.22 0.00 0.22 0.30 0.00 0.00 0.00 0.00 0.00 0.45 0.78 0.00 0.78 0.49 0.00 0.49 1.00 0.00 1.00 0.77 0.00 0.77 0.90 0.00 0.90 0.00 0.00 1.50 0.86 0.00 0.86 1.23 0.00 1.23 1.09 0.00 1.09 1.46 0.00 1.46 0.69 0.00 Physician Work RVUs 3 0.29 0.00 0.00 0.00 NA 0.00 0.00 0.00 0.00 0.00 0.14 5.26 4.88 0.38 4.34 4.18 0.16 9.86 9.36 0.50 4.53 4.31 0.22 4.30 4.05 0.25 0.00 0.00 0.54 4.44 4.17 0.27 3.79 3.40 0.39 5.75 5.27 0.48 11.36 10.66 0.70 4.34 4.10 Fully Implemented NonFacility PE RVUs 0.34 0.82 0.75 0.07 NA 0.00 0.00 0.00 0.00 0.00 0.16 3.22 2.91 0.31 2.61 2.44 0.17 5.71 5.33 0.38 3.32 3.07 0.25 4.33 4.03 0.30 0.00 0.00 0.56 3.10 2.81 0.29 4.81 4.39 0.42 7.03 6.62 0.41 12.08 11.51 0.57 3.23 2.99 Year 2007 Transitional Non-Facility PE RVUs 0.29 NA NA 0.00 0.07 0.00 0.00 0.00 0.00 0.00 0.14 NA NA 0.38 NA NA 0.16 NA NA 0.50 NA NA 0.22 NA NA 0.25 0.00 0.00 0.54 NA NA 0.27 NA NA 0.39 NA NA 0.48 NA NA 0.70 NA NA Fully Implemented Facility PE RVUs 0.34 NA NA 0.07 0.11 0.00 0.00 0.00 0.00 0.00 0.16 NA NA 0.31 NA NA 0.17 NA NA 0.38 NA NA 0.25 NA NA 0.30 0.00 0.00 0.56 NA NA 0.29 NA NA 0.42 NA NA 0.41 NA NA 0.57 NA NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 78320 78350 78350 78350 78351 78399 78399 78399 78414 78414 78414 78428 78428 78428 78445 78445 78445 78456 78456 78456 78457 78457 78457 78458 78458 78458 78459 78459 78459 78460 78460 78460 78461 78461 78461 78464 78464 78464 78465 78465 78465 78466 78466 HCPCS 2 CPT 1/ 0.04 0.06 0.05 0.01 0.01 0.00 0.00 0.00 0.00 0.00 0.02 0.16 0.13 0.03 0.13 0.11 0.02 0.33 0.29 0.04 0.17 0.14 0.03 0.25 0.21 0.04 0.00 0.00 0.05 0.17 0.13 0.04 0.30 0.25 0.05 0.41 0.37 0.04 0.67 0.62 0.05 0.17 0.14 Mal-Practice RVUs 1.37 0.28 0.05 0.23 NA 0.00 0.00 0.00 0.00 0.00 0.61 6.20 5.01 1.19 4.96 4.29 0.67 11.19 9.65 1.54 5.47 4.45 1.02 5.45 4.26 1.19 0.00 0.00 2.09 5.47 4.30 1.17 5.32 3.65 1.67 7.25 5.64 1.61 13.49 11.28 2.21 5.20 4.24 Fully Implemented NonFacility Total 1.42 1.10 0.80 0.30 NA 0.00 0.00 0.00 0.00 0.00 0.63 4.16 3.04 1.12 3.23 2.55 0.68 7.04 5.62 1.42 4.26 3.21 1.05 5.48 4.24 1.24 0.00 0.00 2.11 4.13 2.94 1.19 6.34 4.64 1.70 8.53 6.99 1.54 14.21 12.13 2.08 4.09 3.13 Year 2007 Transitional Non-Facility Total 1.37 NA NA 0.23 0.38 0.00 0.00 0.00 0.00 0.00 0.61 NA NA 1.19 NA NA 0.67 NA NA 1.54 NA NA 1.02 NA NA 1.19 0.00 0.00 2.09 NA NA 1.17 NA NA 1.67 NA NA 1.61 NA NA 2.21 NA NA Fully Implemented Facility Total 1.42 NA NA 0.30 0.42 0.00 0.00 0.00 0.00 0.00 0.63 NA NA 1.12 NA NA 0.68 NA NA 1.42 NA NA 1.05 NA NA 1.24 0.00 0.00 2.11 NA NA 1.19 NA NA 1.70 NA NA 1.54 NA NA 2.08 NA NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69961 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00340 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A C C A C C A A A A A A A C C C A A A Status Heart infarct image ............................................... Heart infarct image (ef) ........................................ Heart infarct image (ef) ........................................ Heart infarct image (ef) ........................................ Heart infarct image (3D) ...................................... Heart infarct image (3D) ...................................... Heart infarct image (3D) ...................................... Gated heart, planar, single .................................. Gated heart, planar, single .................................. Gated heart, planar, single .................................. Gated heart, multiple ............................................ Gated heart, multiple ............................................ Gated heart, multiple ............................................ Heart wall motion add-on ..................................... Heart wall motion add-on ..................................... Heart wall motion add-on ..................................... Heart function add-on .......................................... Heart function add-on .......................................... Heart function add-on .......................................... Heart first pass, single ......................................... Heart first pass, single ......................................... Heart first pass, single ......................................... Heart first pass, multiple ...................................... Heart first pass, multiple ...................................... Heart first pass, multiple ...................................... Heart image (pet), single ..................................... Heart image (pet), single ..................................... Heart image (pet), single ..................................... Heart image (pet), multiple .................................. Heart image (pet), multiple .................................. Heart image (pet), multiple .................................. Heart image, spect ............................................... Heart image, spect ............................................... Heart image, spect ............................................... Heart first pass add-on ........................................ Heart first pass add-on ........................................ Heart first pass add-on ........................................ Cardiovascular nuclear exam .............................. Cardiovascular nuclear exam .............................. Cardiovascular nuclear exam .............................. Lung perfusion imaging ........................................ Lung perfusion imaging ........................................ Lung perfusion imaging ........................................ Description 0.69 0.80 0.00 0.80 0.92 0.00 0.92 0.98 0.00 0.98 1.47 0.00 1.47 0.50 0.00 0.50 0.30 0.00 0.30 0.98 0.00 0.98 1.47 0.00 1.47 0.00 0.00 1.50 0.00 0.00 1.87 1.19 0.00 1.19 0.50 0.00 0.50 0.00 0.00 0.00 0.74 0.00 0.74 Physician Work RVUs 3 0.24 5.98 5.56 0.42 6.21 5.77 0.44 5.95 5.56 0.39 7.54 6.94 0.60 0.80 0.56 0.24 0.70 0.55 0.15 5.07 4.57 0.50 6.86 6.07 0.79 0.00 0.00 0.60 0.00 0.00 0.91 6.19 5.65 0.54 0.92 0.67 0.25 0.00 0.00 0.00 4.83 4.61 0.22 Fully Implemented NonFacility PE RVUs 0.24 4.45 4.14 0.31 5.70 5.36 0.34 5.87 5.52 0.35 8.46 7.93 0.53 1.54 1.31 0.23 1.51 1.31 0.20 5.46 5.06 0.40 8.02 7.42 0.60 0.00 0.00 0.59 0.00 0.00 0.78 7.17 6.72 0.45 5.67 5.47 0.20 0.00 0.00 0.00 3.97 3.73 0.24 Year 2007 Transitional Non-Facility PE RVUs 0.24 NA NA 0.42 NA NA 0.44 NA NA 0.39 NA NA 0.60 NA NA 0.24 NA NA 0.15 NA NA 0.50 NA NA 0.79 0.00 0.00 0.60 0.00 0.00 0.91 NA NA 0.54 0.92 0.67 0.25 0.00 0.00 0.00 NA NA 0.22 Fully Implemented Facility PE RVUs 0.24 NA NA 0.31 NA NA 0.34 NA NA 0.35 NA NA 0.53 NA NA 0.23 NA NA 0.20 NA NA 0.40 NA NA 0.60 0.00 0.00 0.59 0.00 0.00 0.78 NA NA 0.45 5.67 5.47 0.20 0.00 0.00 0.00 NA NA 0.24 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 78466 78468 78468 78468 78469 78469 78469 78472 78472 78472 78473 78473 78473 78478 78478 78478 78480 78480 78480 78481 78481 78481 78483 78483 78483 78491 78491 78491 78492 78492 78492 78494 78494 78494 78496 78496 78496 78499 78499 78499 78580 78580 78580 HCPCS 2 CPT 1/ 0.03 0.22 0.19 0.03 0.31 0.28 0.03 0.34 0.30 0.04 0.48 0.42 0.06 0.12 0.10 0.02 0.12 0.10 0.02 0.31 0.28 0.03 0.46 0.41 0.05 0.00 0.00 0.06 0.00 0.00 0.07 0.35 0.30 0.05 0.32 0.30 0.02 0.00 0.00 0.00 0.21 0.18 0.03 Mal-Practice RVUs 0.96 7.00 5.75 1.25 7.44 6.05 1.39 7.27 5.86 1.41 9.49 7.36 2.13 1.42 0.66 0.76 1.12 0.65 0.47 6.36 4.85 1.51 8.79 6.48 2.31 0.00 0.00 2.16 0.00 0.00 2.85 7.73 5.95 1.78 1.74 0.97 0.77 0.00 0.00 0.00 5.78 4.79 0.99 Fully Implemented NonFacility Total 0.96 5.47 4.33 1.14 6.93 5.64 1.29 7.19 5.82 1.37 10.41 8.35 2.06 2.16 1.41 0.75 1.93 1.41 0.52 6.75 5.34 1.41 9.95 7.83 2.12 0.00 0.00 2.15 0.00 0.00 2.72 8.71 7.02 1.69 6.49 5.77 0.72 0.00 0.00 0.00 4.92 3.91 1.01 Year 2007 Transitional Non-Facility Total 0.96 NA NA 1.25 NA NA 1.39 NA NA 1.41 NA NA 2.13 NA NA 0.76 NA NA 0.47 NA NA 1.51 NA NA 2.31 0.00 0.00 2.16 0.00 0.00 2.85 NA NA 1.78 1.74 0.97 0.77 0.00 0.00 0.00 NA NA 0.99 Fully Implemented Facility Total 0.96 NA NA 1.14 NA NA 1.29 NA NA 1.37 NA NA 2.06 NA NA 0.75 NA NA 0.52 NA NA 1.41 NA NA 2.12 0.00 0.00 2.15 0.00 0.00 2.72 NA NA 1.69 6.49 5.77 0.72 0.00 0.00 0.00 NA NA 1.01 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX ZZZ ZZZ ZZZ XXX XXX XXX XXX XXX XXX Global 69962 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00341 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A C C C A A A A A A A A A A A A A Status Lung V/Q image single breath ............................. Lung V/Q image single breath ............................. Lung V/Q image single breath ............................. Lung V/Q imaging ................................................ Lung V/Q imaging ................................................ Lung V/Q imaging ................................................ Aerosol lung image, single ................................... Aerosol lung image, single ................................... Aerosol lung image, single ................................... Aerosol lung image, multiple ................................ Aerosol lung image, multiple ................................ Aerosol lung image, multiple ................................ Perfusion lung image ........................................... Perfusion lung image ........................................... Perfusion lung image ........................................... Vent image, 1 breath, 1 proj ................................ Vent image, 1 breath, 1 proj ................................ Vent image, 1 breath, 1 proj ................................ Vent image, 1 proj, gas ........................................ Vent image, 1 proj, gas ........................................ Vent image, 1 proj, gas ........................................ Vent image, mult proj, gas ................................... Vent image, mult proj, gas ................................... Vent image, mult proj, gas ................................... Lung differential function ...................................... Lung differential function ...................................... Lung differential function ...................................... Respiratory nuclear exam .................................... Respiratory nuclear exam .................................... Respiratory nuclear exam .................................... Brain imaging, ltd static ........................................ Brain imaging, ltd static ........................................ Brain imaging, ltd static ........................................ Brain imaging, ltd w/flow ...................................... Brain imaging, ltd w/flow ...................................... Brain imaging, ltd w/flow ...................................... Brain imaging, complete ...................................... Brain imaging, complete ...................................... Brain imaging, complete ...................................... Brain imaging, compl w/flow ................................ Brain imaging, compl w/flow ................................ Brain imaging, compl w/flow ................................ Brain imaging (3D) ............................................... Description 0.99 0.00 0.99 1.09 0.00 1.09 0.40 0.00 0.40 0.49 0.00 0.49 1.09 0.00 1.09 0.40 0.00 0.40 0.49 0.00 0.49 0.53 0.00 0.53 1.27 0.00 1.27 0.00 0.00 0.00 0.44 0.00 0.44 0.51 0.00 0.51 0.53 0.00 0.53 0.64 0.00 0.64 1.23 Physician Work RVUs 3 2.74 2.46 0.28 8.09 7.78 0.31 3.89 3.78 0.11 5.12 4.98 0.14 8.11 7.81 0.30 3.87 3.76 0.11 4.51 4.37 0.14 4.99 4.84 0.15 8.33 7.98 0.35 0.00 0.00 0.00 6.83 6.71 0.12 5.02 4.88 0.14 4.46 4.31 0.15 8.07 7.89 0.18 14.39 Fully Implemented NonFacility PE RVUs 3.34 3.02 0.32 6.53 6.18 0.35 3.02 2.89 0.13 3.51 3.35 0.16 4.70 4.35 0.35 3.21 3.08 0.13 3.84 3.68 0.16 5.12 4.95 0.17 7.70 7.30 0.40 0.00 0.00 0.00 3.98 3.84 0.14 3.93 3.77 0.16 3.80 3.63 0.17 5.08 4.88 0.20 8.83 Year 2007 Transitional Non-Facility PE RVUs NA NA 0.28 NA NA 0.31 NA NA 0.11 NA NA 0.14 NA NA 0.30 NA NA 0.11 NA NA 0.14 NA NA 0.15 NA NA 0.35 0.00 0.00 0.00 NA NA 0.12 NA NA 0.14 NA NA 0.15 NA NA 0.18 NA Fully Implemented Facility PE RVUs NA NA 0.32 NA NA 0.35 NA NA 0.13 NA NA 0.16 NA NA 0.35 NA NA 0.13 NA NA 0.16 NA NA 0.17 NA NA 0.40 0.00 0.00 0.00 NA NA 0.14 NA NA 0.16 NA NA 0.17 NA NA 0.20 NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 78584 78584 78584 78585 78585 78585 78586 78586 78586 78587 78587 78587 78588 78588 78588 78591 78591 78591 78593 78593 78593 78594 78594 78594 78596 78596 78596 78599 78599 78599 78600 78600 78600 78601 78601 78601 78605 78605 78605 78606 78606 78606 78607 HCPCS 2 CPT 1/ 0.21 0.17 0.04 0.35 0.30 0.05 0.16 0.14 0.02 0.16 0.14 0.02 0.23 0.18 0.05 0.16 0.14 0.02 0.20 0.18 0.02 0.27 0.25 0.02 0.42 0.37 0.05 0.00 0.00 0.00 0.16 0.14 0.02 0.20 0.18 0.02 0.20 0.18 0.02 0.24 0.21 0.03 0.40 Mal-Practice RVUs 3.94 2.63 1.31 9.53 8.08 1.45 4.45 3.92 0.53 5.77 5.12 0.65 9.43 7.99 1.44 4.43 3.90 0.53 5.20 4.55 0.65 5.79 5.09 0.70 10.02 8.35 1.67 0.00 0.00 0.00 7.43 6.85 0.58 5.73 5.06 0.67 5.19 4.49 0.70 8.95 8.10 0.85 16.02 Fully Implemented NonFacility Total 4.54 3.19 1.35 7.97 6.48 1.49 3.58 3.03 0.55 4.16 3.49 0.67 6.02 4.53 1.49 3.77 3.22 0.55 4.53 3.86 0.67 5.92 5.20 0.72 9.39 7.67 1.72 0.00 0.00 0.00 4.58 3.98 0.60 4.64 3.95 0.69 4.53 3.81 0.72 5.96 5.09 0.87 10.46 Year 2007 Transitional Non-Facility Total NA NA 1.31 NA NA 1.45 NA NA 0.53 NA NA 0.65 NA NA 1.44 NA NA 0.53 NA NA 0.65 NA NA 0.70 NA NA 1.67 0.00 0.00 0.00 NA NA 0.58 NA NA 0.67 NA NA 0.70 NA NA 0.85 NA Fully Implemented Facility Total NA NA 1.35 NA NA 1.49 NA NA 0.55 NA NA 0.67 NA NA 1.49 NA NA 0.55 NA NA 0.67 NA NA 0.72 NA NA 1.72 0.00 0.00 0.00 NA NA 0.60 NA NA 0.69 NA NA 0.72 NA NA 0.87 NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69963 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00342 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 2 Copyright 3+ Mod A A C C A C C A A A A A A A A A A A A A A A A A A A A A A A A A C C C A A A A A A A A Status Brain imaging (3D) ............................................... Brain imaging (3D) ............................................... Brain imaging (PET) ............................................. Brain imaging (PET) ............................................. Brain imaging (PET) ............................................. Brain imaging (PET) ............................................. Brain imaging (PET) ............................................. Brain imaging (PET) ............................................. Brain flow imaging only ........................................ Brain flow imaging only ........................................ Brain flow imaging only ........................................ Cerebral vascular flow image .............................. Cerebral vascular flow image .............................. Cerebral vascular flow image .............................. Cerebrospinal fluid scan ...................................... Cerebrospinal fluid scan ...................................... Cerebrospinal fluid scan ...................................... CSF ventriculography ........................................... CSF ventriculography ........................................... CSF ventriculography ........................................... CSF shunt evaluation ........................................... CSF shunt evaluation ........................................... CSF shunt evaluation ........................................... Cerebrospinal fluid scan ...................................... Cerebrospinal fluid scan ...................................... Cerebrospinal fluid scan ...................................... CSF leakage imaging ........................................... CSF leakage imaging ........................................... CSF leakage imaging ........................................... Nuclear exam of tear flow .................................... Nuclear exam of tear flow .................................... Nuclear exam of tear flow .................................... Nervous system nuclear exam ............................ Nervous system nuclear exam ............................ Nervous system nuclear exam ............................ Kidney imaging, morphol ..................................... Kidney imaging, morphol ..................................... Kidney imaging, morphol ..................................... Kidney imaging with flow ..................................... Kidney imaging with flow ..................................... Kidney imaging with flow ..................................... K flow/funct image w/o drug ................................ K flow/funct image w/o drug ................................ Description 0.00 1.23 0.00 0.00 1.50 0.00 0.00 1.50 0.30 0.00 0.30 0.42 0.00 0.42 0.68 0.00 0.68 0.61 0.00 0.61 0.57 0.00 0.57 0.90 0.00 0.90 0.61 0.00 0.61 0.53 0.00 0.53 0.00 0.00 0.00 0.45 0.00 0.45 0.49 0.00 0.49 0.96 0.00 Physician Work RVUs 3 14.04 0.35 0.00 0.00 0.43 0.00 0.00 0.43 4.19 4.10 0.09 5.06 4.94 0.12 8.11 7.92 0.19 8.05 7.88 0.17 7.97 7.81 0.16 13.60 13.36 0.24 8.17 7.99 0.18 4.03 3.87 0.16 0.00 0.00 0.00 4.26 4.12 0.14 5.04 4.90 0.14 5.15 4.88 Fully Implemented NonFacility PE RVUs 8.42 0.41 0.00 0.00 0.49 0.00 0.00 0.49 2.32 2.21 0.11 4.26 4.12 0.14 5.98 5.76 0.22 4.10 3.88 0.22 4.71 4.53 0.18 8.06 7.77 0.29 5.68 5.48 0.20 2.74 2.56 0.18 0.00 0.00 0.00 3.47 3.32 0.15 4.06 3.90 0.16 4.88 4.57 Year 2007 Transitional Non-Facility PE RVUs NA 0.35 0.00 0.00 0.43 0.00 0.00 0.43 NA NA 0.09 NA NA 0.12 NA NA 0.19 NA NA 0.17 NA NA 0.16 NA NA 0.24 NA NA 0.18 NA NA 0.16 0.00 0.00 0.00 NA NA 0.14 NA NA 0.14 NA NA Fully Implemented Facility PE RVUs NA 0.41 0.00 0.00 0.49 0.00 0.00 0.49 NA NA 0.11 NA NA 0.14 NA NA 0.22 NA NA 0.22 NA NA 0.18 NA NA 0.29 NA NA 0.20 NA NA 0.18 0.00 0.00 0.00 NA NA 0.15 NA NA 0.16 NA NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 78607 78607 78608 78608 78608 78609 78609 78609 78610 78610 78610 78615 78615 78615 78630 78630 78630 78635 78635 78635 78645 78645 78645 78647 78647 78647 78650 78650 78650 78660 78660 78660 78699 78699 78699 78700 78700 78700 78701 78701 78701 78707 78707 HCPCS 2 CPT 1/ 0.35 0.05 0.00 0.00 0.06 0.00 0.00 0.06 0.11 0.10 0.01 0.23 0.21 0.02 0.30 0.27 0.03 0.16 0.14 0.02 0.20 0.18 0.02 0.35 0.31 0.04 0.27 0.24 0.03 0.14 0.12 0.02 0.00 0.00 0.00 0.18 0.16 0.02 0.20 0.18 0.02 0.27 0.23 Mal-Practice RVUs 14.39 1.63 0.00 0.00 1.99 0.00 0.00 1.99 4.60 4.20 0.40 5.71 5.15 0.56 9.09 8.19 0.90 8.82 8.02 0.80 8.74 7.99 0.75 14.85 13.67 1.18 9.05 8.23 0.82 4.70 3.99 0.71 0.00 0.00 0.00 4.89 4.28 0.61 5.73 5.08 0.65 6.38 5.11 Fully Implemented NonFacility Total 8.77 1.69 0.00 0.00 2.05 0.00 0.00 2.05 2.73 2.31 0.42 4.91 4.33 0.58 6.96 6.03 0.93 4.87 4.02 0.85 5.48 4.71 0.77 9.31 8.08 1.23 6.56 5.72 0.84 3.41 2.68 0.73 0.00 0.00 0.00 4.10 3.48 0.62 4.75 4.08 0.67 6.11 4.80 Year 2007 Transitional Non-Facility Total NA 1.63 0.00 0.00 1.99 0.00 0.00 1.99 NA NA 0.40 NA NA 0.56 NA NA 0.90 NA NA 0.80 NA NA 0.75 NA NA 1.18 NA NA 0.82 NA NA 0.71 0.00 0.00 0.00 NA NA 0.61 NA NA 0.65 NA NA Fully Implemented Facility Total NA 1.69 0.00 0.00 2.05 0.00 0.00 2.05 NA NA 0.42 NA NA 0.58 NA NA 0.93 NA NA 0.85 NA NA 0.77 NA NA 1.23 NA NA 0.84 NA NA 0.73 0.00 0.00 0.00 NA NA 0.62 NA NA 0.67 NA NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69964 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00343 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A C C C A A A A A A A A A A A A A A A A A A Status K flow/funct image w/o drug ................................ K flow/funct image w/drug .................................... K flow/funct image w/drug .................................... K flow/funct image w/drug .................................... K flow/funct image, multiple ................................. K flow/funct image, multiple ................................. K flow/funct image, multiple ................................. Kidney imaging (3D) ............................................ Kidney imaging (3D) ............................................ Kidney imaging (3D) ............................................ Kidney function study ........................................... Kidney function study ........................................... Kidney function study ........................................... Urinary bladder retention ..................................... Urinary bladder retention ..................................... Urinary bladder retention ..................................... Ureteral reflux study ............................................. Ureteral reflux study ............................................. Ureteral reflux study ............................................. Testicular imaging w/flow ..................................... Testicular imaging w/flow ..................................... Testicular imaging w/flow ..................................... Genitourinary nuclear exam ................................. Genitourinary nuclear exam ................................. Genitourinary nuclear exam ................................. Tumor imaging, limited area ................................ Tumor imaging, limited area ................................ Tumor imaging, limited area ................................ Tumor imaging, mult areas .................................. Tumor imaging, mult areas .................................. Tumor imaging, mult areas .................................. Tumor imaging, whole body ................................. Tumor imaging, whole body ................................. Tumor imaging, whole body ................................. Tumor imaging (3D) ............................................. Tumor imaging (3D) ............................................. Tumor imaging (3D) ............................................. Tumor imaging, whole body ................................. Tumor imaging, whole body ................................. Tumor imaging, whole body ................................. Abscess imaging, ltd area .................................... Abscess imaging, ltd area .................................... Abscess imaging, ltd area .................................... Description 0.96 1.21 0.00 1.21 1.41 0.00 1.41 0.66 0.00 0.66 0.38 0.00 0.38 0.15 0.00 0.15 0.57 0.00 0.57 0.71 0.00 0.71 0.00 0.00 0.00 0.66 0.00 0.66 0.79 0.00 0.79 0.86 0.00 0.86 1.09 0.00 1.09 1.07 0.00 1.07 0.73 0.00 0.73 Physician Work RVUs 3 0.27 3.17 2.83 0.34 8.35 7.95 0.40 5.02 4.83 0.19 2.26 2.15 0.11 1.97 1.91 0.06 5.17 5.01 0.16 4.58 4.38 0.20 0.00 0.00 0.00 4.06 3.88 0.18 5.75 5.53 0.22 7.68 7.44 0.24 14.15 13.84 0.31 14.02 13.72 0.30 3.94 3.74 0.20 Fully Implemented NonFacility PE RVUs 0.31 4.45 4.06 0.39 5.79 5.34 0.45 5.85 5.64 0.21 2.00 1.87 0.13 1.68 1.57 0.11 3.02 2.84 0.18 3.73 3.50 0.23 0.00 0.00 0.00 3.73 3.52 0.21 4.81 4.55 0.26 6.29 6.01 0.28 8.73 8.37 0.36 12.08 11.73 0.35 3.73 3.49 0.24 Year 2007 Transitional Non-Facility PE RVUs 0.27 NA NA 0.34 NA NA 0.40 NA NA 0.19 NA NA 0.11 NA NA 0.06 NA NA 0.16 NA NA 0.20 0.00 0.00 0.00 NA NA 0.18 NA NA 0.22 NA NA 0.24 NA NA 0.31 NA NA 0.30 NA NA 0.20 Fully Implemented Facility PE RVUs 0.31 NA NA 0.39 NA NA 0.45 NA NA 0.21 NA NA 0.13 NA NA 0.11 NA NA 0.18 NA NA 0.23 0.00 0.00 0.00 NA NA 0.21 NA NA 0.26 NA NA 0.28 NA NA 0.36 NA NA 0.35 NA NA 0.24 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 78707 78708 78708 78708 78709 78709 78709 78710 78710 78710 78725 78725 78725 78730 78730 78730 78740 78740 78740 78761 78761 78761 78799 78799 78799 78800 78800 78800 78801 78801 78801 78802 78802 78802 78803 78803 78803 78804 78804 78804 78805 78805 78805 HCPCS 2 CPT 1/ 0.04 0.28 0.23 0.05 0.29 0.23 0.06 0.34 0.31 0.03 0.13 0.11 0.02 0.10 0.08 0.02 0.15 0.12 0.03 0.20 0.17 0.03 0.00 0.00 0.00 0.22 0.18 0.04 0.27 0.22 0.05 0.34 0.30 0.04 0.40 0.35 0.05 0.34 0.30 0.04 0.21 0.18 0.03 Mal-Practice RVUs 1.27 4.66 3.06 1.60 10.05 8.18 1.87 6.02 5.14 0.88 2.77 2.26 0.51 2.22 1.99 0.23 5.89 5.13 0.76 5.49 4.55 0.94 0.00 0.00 0.00 4.94 4.06 0.88 6.81 5.75 1.06 8.88 7.74 1.14 15.64 14.19 1.45 15.43 14.02 1.41 4.88 3.92 0.96 Fully Implemented NonFacility Total 1.31 5.94 4.29 1.65 7.49 5.57 1.92 6.85 5.95 0.90 2.51 1.98 0.53 1.93 1.65 0.28 3.74 2.96 0.78 4.64 3.67 0.97 0.00 0.00 0.00 4.61 3.70 0.91 5.87 4.77 1.10 7.49 6.31 1.18 10.22 8.72 1.50 13.49 12.03 1.46 4.67 3.67 1.00 Year 2007 Transitional Non-Facility Total 1.27 NA NA 1.60 NA NA 1.87 NA NA 0.88 NA NA 0.51 NA NA 0.23 NA NA 0.76 NA NA 0.94 0.00 0.00 0.00 NA NA 0.88 NA NA 1.06 NA NA 1.14 NA NA 1.45 NA NA 1.41 NA NA 0.96 Fully Implemented Facility Total 1.31 NA NA 1.65 NA NA 1.92 NA NA 0.90 NA NA 0.53 NA NA 0.28 NA NA 0.78 NA NA 0.97 0.00 0.00 0.00 NA NA 0.91 NA NA 1.10 NA NA 1.18 NA NA 1.50 NA NA 1.46 NA NA 1.00 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX ZZZ ZZZ ZZZ XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69965 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00344 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... 2 Copyright 3+ Mod A A A A A A C C A C C A C C A C C A C C A C C A B B B B B B C C C A A A A A A A A A C Status Abscess imaging, whole body ............................. Abscess imaging, whole body ............................. Abscess imaging, whole body ............................. Nuclear localization/abscess ................................ Nuclear localization/abscess ................................ Nuclear localization/abscess ................................ Tumor imaging (pet), limited ................................ Tumor imaging (pet), limited ................................ Tumor imaging (pet), limited ................................ Tumor image (pet)/skul-thigh ............................... Tumor image (pet)/skul-thigh ............................... Tumor image (pet)/skul-thigh ............................... Tumor image (pet) full body ................................. Tumor image (pet) full body ................................. Tumor image (pet) full body ................................. Tumor image pet/ct, limited ................................. Tumor image pet/ct, limited ................................. Tumor image pet/ct, limited ................................. Tumorimage pet/ct skul-thigh ............................... Tumorimage pet/ct skul-thigh ............................... Tumorimage pet/ct skul-thigh ............................... Tumor image pet/ct full body ............................... Tumor image pet/ct full body ............................... Tumor image pet/ct full body ............................... Nuclear medicine data proc ................................. Nuclear medicine data proc ................................. Nuclear medicine data proc ................................. Nuclear med data proc ........................................ Nuclear med data proc ........................................ Nuclear med data proc ........................................ Nuclear diagnostic exam ...................................... Nuclear diagnostic exam ...................................... Nuclear diagnostic exam ...................................... Nuclear rx, oral admin .......................................... Nuclear rx, oral admin .......................................... Nuclear rx, oral admin .......................................... Nuclear rx, iv admin ............................................. Nuclear rx, iv admin ............................................. Nuclear rx, iv admin ............................................. Nuclear rx, intracav admin ................................... Nuclear rx, intracav admin ................................... Nuclear rx, intracav admin ................................... Nuclr rx, interstit colloid ........................................ Description 0.86 0.00 0.86 1.09 0.00 1.09 0.00 0.00 1.54 0.00 0.00 1.93 0.00 0.00 2.00 0.00 0.00 2.20 0.00 0.00 2.44 0.00 0.00 2.50 0.05 0.00 0.05 0.10 0.00 0.10 0.00 0.00 0.00 1.80 0.00 1.80 1.96 0.00 1.96 1.99 0.00 1.99 0.00 Physician Work RVUs 3 7.85 7.61 0.24 13.41 13.11 0.30 0.00 0.00 0.44 0.00 0.00 0.56 0.00 0.00 0.58 0.00 0.00 0.62 0.00 0.00 0.70 0.00 0.00 0.72 0.38 0.37 0.01 0.86 0.84 0.02 0.00 0.00 0.00 1.70 1.20 0.50 2.04 1.37 0.67 2.13 1.55 0.58 0.00 Fully Implemented NonFacility PE RVUs 7.01 6.73 0.28 8.56 8.19 0.37 0.00 0.00 0.51 0.00 0.00 0.64 0.00 0.00 0.66 0.00 0.00 0.73 0.00 0.00 0.81 0.00 0.00 0.83 1.10 1.08 0.02 2.22 2.18 0.04 0.00 0.00 0.00 2.85 2.27 0.58 2.98 2.31 0.67 3.01 2.35 0.66 0.00 Year 2007 Transitional Non-Facility PE RVUs NA NA 0.24 NA NA 0.30 0.00 0.00 0.44 0.00 0.00 0.56 0.00 0.00 0.58 0.00 0.00 0.62 0.00 0.00 0.70 0.00 0.00 0.72 NA NA 0.01 NA NA 0.02 0.00 0.00 0.00 NA NA 0.50 NA NA 0.67 NA NA 0.58 0.00 Fully Implemented Facility PE RVUs NA NA 0.28 NA NA 0.37 0.00 0.00 0.51 0.00 0.00 0.64 0.00 0.00 0.66 0.00 0.00 0.73 0.00 0.00 0.81 0.00 0.00 0.83 NA NA 0.02 NA NA 0.04 0.00 0.00 0.00 NA NA 0.58 NA NA 0.67 NA NA 0.66 0.00 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 78806 78806 78806 78807 78807 78807 78811 78811 78811 78812 78812 78812 78813 78813 78813 78814 78814 78814 78815 78815 78815 78816 78816 78816 78890 78890 78890 78891 78891 78891 78999 78999 78999 79005 79005 79005 79101 79101 79101 79200 79200 79200 79300 HCPCS 2 CPT 1/ 0.39 0.35 0.04 0.39 0.35 0.04 0.00 0.00 0.11 0.00 0.00 0.11 0.00 0.00 0.11 0.00 0.00 0.11 0.00 0.00 0.11 0.00 0.00 0.11 0.07 0.06 0.01 0.14 0.13 0.01 0.00 0.00 0.00 0.22 0.14 0.08 0.22 0.14 0.08 0.23 0.14 0.09 0.00 Mal-Practice RVUs 9.10 7.96 1.14 14.89 13.46 1.43 0.00 0.00 2.09 0.00 0.00 2.60 0.00 0.00 2.69 0.00 0.00 2.93 0.00 0.00 3.25 0.00 0.00 3.33 0.50 0.43 0.07 1.10 0.97 0.13 0.00 0.00 0.00 3.72 1.34 2.38 4.22 1.51 2.71 4.35 1.69 2.66 0.00 Fully Implemented NonFacility Total 8.26 7.08 1.18 10.04 8.54 1.50 0.00 0.00 2.16 0.00 0.00 2.68 0.00 0.00 2.77 0.00 0.00 3.04 0.00 0.00 3.36 0.00 0.00 3.44 1.22 1.14 0.08 2.46 2.31 0.15 0.00 0.00 0.00 4.87 2.41 2.46 5.16 2.45 2.71 5.23 2.49 2.74 0.00 Year 2007 Transitional Non-Facility Total NA NA 1.14 NA NA 1.43 0.00 0.00 2.09 0.00 0.00 2.60 0.00 0.00 2.69 0.00 0.00 2.93 0.00 0.00 3.25 0.00 0.00 3.33 NA NA 0.07 NA NA 0.13 0.00 0.00 0.00 NA NA 2.38 NA NA 2.71 NA NA 2.66 0.00 Fully Implemented Facility Total NA NA 1.18 NA NA 1.50 0.00 0.00 2.16 0.00 0.00 2.68 0.00 0.00 2.77 0.00 0.00 3.04 0.00 0.00 3.36 0.00 0.00 3.44 NA NA 0.08 NA NA 0.15 0.00 0.00 0.00 NA NA 2.46 NA NA 2.71 NA NA 2.74 0.00 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69966 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00345 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... 26 ..... 26 ..... 26 ..... 26 ..... 26 ..... 26 ..... .......... .......... 26 ..... .......... 26 ..... .......... .......... .......... 26 ..... 26 ..... 26 ..... 26 ..... 26 ..... 26 ..... 26 ..... .......... .......... .......... .......... 26 ..... 26 ..... 2 Copyright 3+ Mod C A A A A A A A C C A C C C A A A A A A A A A A A A A A A A A A A A A A A C A A A A A Status Nuclr rx, interstit colloid ........................................ Nuclr rx, interstit colloid ........................................ Hematopoietic nuclear tx ..................................... Hematopoietic nuclear tx ..................................... Hematopoietic nuclear tx ..................................... Nuclear rx, intra-articular ...................................... Nuclear rx, intra-articular ...................................... Nuclear rx, intra-articular ...................................... Nuclear rx, intra-arterial ....................................... Nuclear rx, intra-arterial ....................................... Nuclear rx, intra-arterial ....................................... Nuclear medicine therapy .................................... Nuclear medicine therapy .................................... Nuclear medicine therapy .................................... Lab pathology consultation .................................. Lab pathology consultation .................................. Hemoglobin electrophoresis ................................. Genetic examination ............................................ Protein e-phoresis, serum .................................... Protein e-phoresis/urine/csf ................................. Western blot test .................................................. Protein, western blot test ..................................... Blood smear interpretation ................................... Bone marrow interpretation .................................. Fibrinolysins screen ............................................. Clotting assay, whole blood ................................. Blood platelet aggregation ................................... Physician blood bank service .............................. Physician blood bank service .............................. Physician blood bank service .............................. Fluorescent antibody, screen ............................... Fluorescent antibody, titer .................................... Serum immunoelectrophoresis ............................ Other immunoelectrophoresis .............................. Immunoelectrophoresis assay ............................. Immunofix e-phoresis, serum ............................... Immunfix e-phorsis/urine/csf ................................ Skin test, candida ................................................. Coccidioidomycosis skin test ............................... Histoplasmosis skin test ....................................... TB intradermal test ............................................... Dark field examination ......................................... Smear, special stain ............................................. Description 0.00 1.60 2.25 0.00 2.25 1.99 0.00 1.99 0.00 0.00 2.40 0.00 0.00 0.00 0.37 1.33 0.37 0.37 0.37 0.37 0.37 0.37 0.45 0.94 0.37 0.37 0.37 0.94 0.94 0.94 0.37 0.37 0.37 0.37 0.42 0.37 0.37 0.00 0.00 0.00 0.00 0.37 0.37 Physician Work RVUs 3 0.00 0.55 2.77 2.09 0.68 1.65 1.09 0.56 0.00 0.00 0.70 0.00 0.00 0.00 0.19 0.30 0.12 0.11 0.11 0.11 0.12 0.12 0.14 1.29 0.12 NA 0.12 0.38 0.38 0.38 0.12 0.12 0.12 0.11 0.13 0.12 0.12 0.00 0.12 0.14 0.16 0.12 0.11 Fully Implemented NonFacility PE RVUs 0.00 0.56 4.57 3.73 0.84 2.92 2.24 0.68 0.00 0.00 0.79 0.00 0.00 0.00 0.21 0.48 0.14 0.12 0.13 0.13 0.14 0.15 0.17 1.76 0.13 NA 0.15 0.39 0.44 0.43 0.14 0.14 0.14 0.13 0.17 0.14 0.14 0.00 0.25 0.28 0.23 0.12 0.15 Year 2007 Transitional Non-Facility PE RVUs 0.00 0.55 NA NA 0.68 NA NA 0.56 0.00 0.00 0.70 0.00 0.00 0.00 0.11 0.24 0.12 0.11 0.11 0.11 0.12 0.12 0.14 0.28 0.12 0.05 0.12 0.30 0.30 0.30 0.12 0.12 0.12 0.11 0.13 0.12 0.12 0.00 NA NA NA 0.12 0.11 Fully Implemented Facility PE RVUs 0.00 0.56 NA NA 0.84 NA NA 0.68 0.00 0.00 0.79 0.00 0.00 0.00 0.15 0.47 0.14 0.12 0.13 0.13 0.14 0.15 0.17 0.38 0.13 0.13 0.15 0.37 0.38 0.38 0.14 0.14 0.14 0.13 0.17 0.14 0.14 0.00 NA NA NA 0.12 0.15 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 79300 79300 79403 79403 79403 79440 79440 79440 79445 79445 79445 79999 79999 79999 80500 80502 83020 83912 84165 84166 84181 84182 85060 85097 85390 85396 85576 86077 86078 86079 86255 86256 86320 86325 86327 86334 86335 86485 86490 86510 86580 87164 87207 HCPCS 2 CPT 1/ 0.00 0.13 0.24 0.14 0.10 0.22 0.14 0.08 0.00 0.00 0.12 0.00 0.00 0.00 0.01 0.04 0.01 0.01 0.01 0.01 0.01 0.02 0.02 0.04 0.01 0.04 0.01 0.03 0.03 0.03 0.01 0.01 0.01 0.01 0.02 0.01 0.01 0.00 0.02 0.02 0.02 0.01 0.01 Mal-Practice RVUs 0.00 2.28 5.26 2.23 3.03 3.86 1.23 2.63 0.00 0.00 3.22 0.00 0.00 0.00 0.57 1.67 0.50 0.49 0.49 0.49 0.50 0.51 0.61 2.27 0.50 NA 0.50 1.35 1.35 1.35 0.50 0.50 0.50 0.49 0.57 0.50 0.50 0.00 0.14 0.16 0.18 0.50 0.49 Fully Implemented NonFacility Total 0.00 2.29 7.06 3.87 3.19 5.13 2.38 2.75 0.00 0.00 3.31 0.00 0.00 0.00 0.59 1.85 0.52 0.50 0.51 0.51 0.52 0.54 0.64 2.74 0.51 NA 0.53 1.36 1.41 1.40 0.52 0.52 0.52 0.51 0.61 0.52 0.52 0.00 0.27 0.30 0.25 0.50 0.53 Year 2007 Transitional Non-Facility Total 0.00 2.28 NA NA 3.03 NA NA 2.63 0.00 0.00 3.22 0.00 0.00 0.00 0.49 1.61 0.50 0.49 0.49 0.49 0.50 0.51 0.61 1.26 0.50 0.46 0.50 1.27 1.27 1.27 0.50 0.50 0.50 0.49 0.57 0.50 0.50 0.00 NA NA NA 0.50 0.49 Fully Implemented Facility Total 0.00 2.29 NA NA 3.19 NA NA 2.75 0.00 0.00 3.31 0.00 0.00 0.00 0.53 1.84 0.52 0.50 0.51 0.51 0.52 0.54 0.64 1.36 0.51 0.54 0.53 1.34 1.35 1.35 0.52 0.52 0.52 0.51 0.61 0.52 0.52 0.00 NA NA NA 0.50 0.53 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69967 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00346 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C Status Cytopath fl nongyn, smears ................................. Cytopath fl nongyn, smears ................................. Cytopath fl nongyn, smears ................................. Cytopath fl nongyn, filter ...................................... Cytopath fl nongyn, filter ...................................... Cytopath fl nongyn, filter ...................................... Cytopath fl nongyn, sm/fltr ................................... Cytopath fl nongyn, sm/fltr ................................... Cytopath fl nongyn, sm/fltr ................................... Cytopath, concentrate tech .................................. Cytopath, concentrate tech .................................. Cytopath, concentrate tech .................................. Cytopath, cell enhance tech ................................ Cytopath, cell enhance tech ................................ Cytopath, cell enhance tech ................................ Forensic cytopathology ........................................ Forensic cytopathology ........................................ Forensic cytopathology ........................................ Cytopath, c/v, interpret ......................................... Cytopath smear, other source ............................. Cytopath smear, other source ............................. Cytopath smear, other source ............................. Cytopath smear, other source ............................. Cytopath smear, other source ............................. Cytopath smear, other source ............................. Cytopath smear, other source ............................. Cytopath smear, other source ............................. Cytopath smear, other source ............................. Cytopathology eval of fna .................................... Cytopathology eval of fna .................................... Cytopathology eval of fna .................................... Cytopath eval, fna, report .................................... Cytopath eval, fna, report .................................... Cytopath eval, fna, report .................................... Cell marker study ................................................. Cell marker study ................................................. Cell marker study ................................................. Flowcytometry/ tc, 1 marker ................................. Flowcytometry/tc, add-on ..................................... Flowcytometry/read, 2–8 ...................................... Flowcytometry/read, 9–15 .................................... Flowcytometry/read, 16 & > ................................. Cytopathology procedure ..................................... Description 0.56 0.00 0.56 0.56 0.00 0.56 0.76 0.00 0.76 0.56 0.00 0.56 1.18 0.00 1.18 0.26 0.00 0.26 0.42 0.50 0.00 0.50 0.50 0.00 0.50 0.76 0.00 0.76 0.60 0.00 0.60 1.39 0.00 1.39 0.77 0.00 0.77 0.00 0.00 1.36 1.69 2.23 0.00 Physician Work RVUs 3 1.14 0.99 0.15 1.48 1.33 0.15 1.98 1.75 0.23 1.45 1.30 0.15 1.49 1.19 0.30 0.25 0.19 0.06 0.37 0.89 0.76 0.13 1.11 0.96 0.15 1.15 0.98 0.17 0.85 0.67 0.18 2.29 1.89 0.40 1.91 1.79 0.12 2.44 1.48 0.39 0.44 0.48 0.00 Fully Implemented NonFacility PE RVUs 0.93 0.71 0.22 1.39 1.17 0.22 1.66 1.35 0.31 1.27 1.05 0.22 1.85 1.39 0.46 0.27 0.17 0.10 0.21 0.85 0.66 0.19 0.99 0.79 0.20 1.05 0.76 0.29 0.76 0.52 0.24 2.18 1.64 0.54 1.97 1.69 0.28 1.60 0.85 0.44 0.54 0.68 0.00 Year 2007 Transitional Non-Facility PE RVUs NA NA 0.15 NA NA 0.15 NA NA 0.23 NA NA 0.15 NA NA 0.30 NA NA 0.06 0.37 NA NA 0.13 NA NA 0.15 NA NA 0.17 NA NA 0.18 NA NA 0.40 NA NA 0.12 NA NA 0.39 0.44 0.48 0.00 Fully Implemented Facility PE RVUs NA NA 0.22 NA NA 0.22 NA NA 0.31 NA NA 0.22 NA NA 0.46 NA NA 0.10 0.21 NA NA 0.19 NA NA 0.20 NA NA 0.29 NA NA 0.24 NA NA 0.54 NA NA 0.28 NA NA 0.44 0.54 0.68 0.00 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 88104 88104 88104 88106 88106 88106 88107 88107 88107 88108 88108 88108 88112 88112 88112 88125 88125 88125 88141 88160 88160 88160 88161 88161 88161 88162 88162 88162 88172 88172 88172 88173 88173 88173 88182 88182 88182 88184 88185 88187 88188 88189 88199 HCPCS 2 CPT 1/ 0.04 0.02 0.02 0.04 0.02 0.02 0.05 0.02 0.03 0.04 0.02 0.02 0.04 0.02 0.02 0.02 0.01 0.01 0.02 0.04 0.02 0.02 0.04 0.02 0.02 0.05 0.02 0.03 0.04 0.02 0.02 0.07 0.02 0.05 0.07 0.04 0.03 0.02 0.02 0.01 0.01 0.01 0.00 Mal-Practice RVUs 1.74 1.01 0.73 2.08 1.35 0.73 2.79 1.77 1.02 2.05 1.32 0.73 2.71 1.21 1.50 0.53 0.20 0.33 0.81 1.43 0.78 0.65 1.65 0.98 0.67 1.96 1.00 0.96 1.49 0.69 0.80 3.75 1.91 1.84 2.75 1.83 0.92 2.46 1.50 1.76 2.14 2.72 0.00 Fully Implemented NonFacility Total 1.53 0.73 0.80 1.99 1.19 0.80 2.47 1.37 1.10 1.87 1.07 0.80 3.07 1.41 1.66 0.55 0.18 0.37 0.65 1.39 0.68 0.71 1.53 0.81 0.72 1.86 0.78 1.08 1.40 0.54 0.86 3.64 1.66 1.98 2.81 1.73 1.08 1.62 0.87 1.81 2.24 2.92 0.00 Year 2007 Transitional Non-Facility Total NA NA 0.73 NA NA 0.73 NA NA 1.02 NA NA 0.73 NA NA 1.50 NA NA 0.33 0.81 NA NA 0.65 NA NA 0.67 NA NA 0.96 NA NA 0.80 NA NA 1.84 NA NA 0.92 NA NA 1.76 2.14 2.72 0.00 Fully Implemented Facility Total NA NA 0.80 NA NA 0.80 NA NA 1.10 NA NA 0.80 NA NA 1.66 NA NA 0.37 0.65 NA NA 0.71 NA NA 0.72 NA NA 1.08 NA NA 0.86 NA NA 1.98 NA NA 1.08 NA NA 1.81 2.24 2.92 0.00 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX ZZZ XXX XXX XXX XXX Global 69968 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00347 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... TC .... 26 ..... .......... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... TC .... 2 Copyright 3+ Mod C C A C A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Cytopathology procedure ..................................... Cytopathology procedure ..................................... Cyto/molecular report ........................................... Cytogenetic study ................................................. Surgical path, gross ............................................. Surgical path, gross ............................................. Surgical path, gross ............................................. Tissue exam by pathologist ................................. Tissue exam by pathologist ................................. Tissue exam by pathologist ................................. Tissue exam by pathologist ................................. Tissue exam by pathologist ................................. Tissue exam by pathologist ................................. Tissue exam by pathologist ................................. Tissue exam by pathologist ................................. Tissue exam by pathologist ................................. Tissue exam by pathologist ................................. Tissue exam by pathologist ................................. Tissue exam by pathologist ................................. Tissue exam by pathologist ................................. Tissue exam by pathologist ................................. Tissue exam by pathologist ................................. Decalcify tissue .................................................... Decalcify tissue .................................................... Decalcify tissue .................................................... Special stains ....................................................... Special stains ....................................................... Special stains ....................................................... Special stains ....................................................... Special stains ....................................................... Special stains ....................................................... Histochemical stain .............................................. Histochemical stain .............................................. Histochemical stain .............................................. Chemical histochemistry ...................................... Chemical histochemistry ...................................... Chemical histochemistry ...................................... Enzyme histochemistry ........................................ Enzyme histochemistry ........................................ Enzyme histochemistry ........................................ Microslide consultation ......................................... Microslide consultation ......................................... Microslide consultation ......................................... Description 0.00 0.00 0.52 0.00 0.08 0.00 0.08 0.13 0.00 0.13 0.22 0.00 0.22 0.75 0.00 0.75 1.59 0.00 1.59 2.80 0.00 2.80 0.24 0.00 0.24 0.54 0.00 0.54 0.24 0.00 0.24 0.45 0.00 0.45 0.42 0.00 0.42 0.53 0.00 0.53 1.63 1.83 0.00 Physician Work RVUs 3 0.00 0.00 0.27 0.00 0.58 0.56 0.02 1.28 1.24 0.04 1.53 1.47 0.06 2.16 1.95 0.21 4.46 3.98 0.48 6.25 5.41 0.84 0.25 0.18 0.07 2.46 2.31 0.15 1.91 1.85 0.06 1.97 1.83 0.14 2.96 2.83 0.13 3.22 3.07 0.15 0.74 2.19 1.73 Fully Implemented NonFacility PE RVUs 0.00 0.00 0.20 0.00 0.49 0.46 0.03 1.10 1.04 0.06 1.37 1.29 0.08 1.97 1.67 0.30 3.48 2.85 0.63 4.86 3.92 0.94 0.23 0.14 0.09 1.76 1.55 0.21 1.42 1.33 0.09 2.04 1.86 0.18 1.98 1.81 0.17 3.36 3.16 0.20 0.78 1.88 1.34 Year 2007 Transitional Non-Facility PE RVUs 0.00 0.00 0.27 0.00 NA NA 0.02 NA NA 0.04 NA NA 0.06 NA NA 0.21 NA NA 0.48 NA NA 0.84 NA NA 0.07 NA NA 0.15 NA NA 0.06 NA NA 0.14 NA NA 0.13 NA NA 0.15 0.49 NA NA Fully Implemented Facility PE RVUs 0.00 0.00 0.20 0.00 NA NA 0.03 NA NA 0.06 NA NA 0.08 NA NA 0.30 NA NA 0.63 NA NA 0.94 NA NA 0.09 NA NA 0.21 NA NA 0.09 NA NA 0.18 NA NA 0.17 NA NA 0.20 0.54 NA NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 88199 88199 88291 88299 88300 88300 88300 88302 88302 88302 88304 88304 88304 88305 88305 88305 88307 88307 88307 88309 88309 88309 88311 88311 88311 88312 88312 88312 88313 88313 88313 88314 88314 88314 88318 88318 88318 88319 88319 88319 88321 88323 88323 HCPCS 2 CPT 1/ 0.00 0.00 0.02 0.00 0.02 0.01 0.01 0.03 0.02 0.01 0.03 0.02 0.01 0.07 0.04 0.03 0.12 0.06 0.06 0.14 0.06 0.08 0.02 0.01 0.01 0.03 0.01 0.02 0.02 0.01 0.01 0.04 0.02 0.02 0.03 0.01 0.02 0.04 0.02 0.02 0.05 0.07 0.02 Mal-Practice RVUs 0.00 0.00 0.81 0.00 0.68 0.57 0.11 1.44 1.26 0.18 1.78 1.49 0.29 2.98 1.99 0.99 6.17 4.04 2.13 9.19 5.47 3.72 0.51 0.19 0.32 3.03 2.32 0.71 2.17 1.86 0.31 2.46 1.85 0.61 3.41 2.84 0.57 3.79 3.09 0.70 2.42 4.09 1.75 Fully Implemented NonFacility Total 0.00 0.00 0.74 0.00 0.59 0.47 0.12 1.26 1.06 0.20 1.62 1.31 0.31 2.79 1.71 1.08 5.19 2.91 2.28 7.80 3.98 3.82 0.49 0.15 0.34 2.33 1.56 0.77 1.68 1.34 0.34 2.53 1.88 0.65 2.43 1.82 0.61 3.93 3.18 0.75 2.46 3.78 1.36 Year 2007 Transitional Non-Facility Total 0.00 0.00 0.81 0.00 NA NA 0.11 NA NA 0.18 NA NA 0.29 NA NA 0.99 NA NA 2.13 NA NA 3.72 NA NA 0.32 NA NA 0.71 NA NA 0.31 NA NA 0.61 NA NA 0.57 NA NA 0.70 2.17 NA NA Fully Implemented Facility Total 0.00 0.00 0.74 0.00 NA NA 0.12 NA NA 0.20 NA NA 0.31 NA NA 1.08 NA NA 2.28 NA NA 3.82 NA NA 0.34 NA NA 0.77 NA NA 0.34 NA NA 0.65 NA NA 0.61 NA NA 0.75 2.22 NA NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69969 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00348 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 26 ..... .......... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Microslide consultation ......................................... Comprehensive review of data ............................ Path consult introp ............................................... Path consult intraop, 1 bloc ................................. Path consult intraop, 1 bloc ................................. Path consult intraop, 1 bloc ................................. Path consult intraop, add"l ................................. Path consult intraop, add"l ................................. Path consult intraop, add"l ................................. Intraop cyto path consult, 1 ................................. Intraop cyto path consult, 1 ................................. Intraop cyto path consult, 1 ................................. Intraop cyto path consult, 2 ................................. Intraop cyto path consult, 2 ................................. Intraop cyto path consult, 2 ................................. Immunohistochemistry ......................................... Immunohistochemistry ......................................... Immunohistochemistry ......................................... Immunofluorescent study ..................................... Immunofluorescent study ..................................... Immunofluorescent study ..................................... Immunofluorescent study ..................................... Immunofluorescent study ..................................... Immunofluorescent study ..................................... Electron microscopy ............................................. Electron microscopy ............................................. Electron microscopy ............................................. Scanning electron microscopy ............................. Scanning electron microscopy ............................. Scanning electron microscopy ............................. Analysis, skeletal muscle ..................................... Analysis, skeletal muscle ..................................... Analysis, skeletal muscle ..................................... Analysis, nerve ..................................................... Analysis, nerve ..................................................... Analysis, nerve ..................................................... Analysis, tumor ..................................................... Analysis, tumor ..................................................... Analysis, tumor ..................................................... Tumor immunohistochem/manual ........................ Tumor immunohistochem/manual ........................ Tumor immunohistochem/manual ........................ Tumor immunohistochem/comput ........................ Description 1.83 2.50 0.67 1.19 0.00 1.19 0.59 0.00 0.59 1.20 0.00 1.20 0.73 0.00 0.73 0.85 0.00 0.85 0.86 0.00 0.86 0.86 0.00 0.86 1.51 0.00 1.51 0.76 0.00 0.76 1.85 0.00 1.85 3.02 0.00 3.02 0.95 0.00 0.95 1.10 0.00 1.10 1.18 Physician Work RVUs 3 0.46 2.24 0.68 1.24 0.86 0.38 0.47 0.29 0.18 1.35 0.97 0.38 0.78 0.56 0.22 2.01 1.78 0.23 1.94 1.71 0.23 1.33 1.14 0.19 17.88 17.47 0.41 8.84 8.62 0.22 3.31 2.92 0.39 6.63 5.84 0.79 1.10 0.94 0.16 2.28 2.00 0.28 2.72 Fully Implemented NonFacility PE RVUs 0.54 2.76 0.66 1.14 0.66 0.48 0.46 0.23 0.23 1.15 0.66 0.49 0.65 0.40 0.25 1.60 1.27 0.33 1.67 1.34 0.33 1.28 0.97 0.31 11.48 10.90 0.58 4.88 4.58 0.30 7.41 6.72 0.69 4.79 3.65 1.14 0.91 0.57 0.34 1.87 1.45 0.42 2.94 Year 2007 Transitional Non-Facility PE RVUs 0.46 0.63 0.20 NA NA 0.38 NA NA 0.18 NA NA 0.38 NA NA 0.22 NA NA 0.23 NA NA 0.23 NA NA 0.19 NA NA 0.41 NA NA 0.22 NA NA 0.39 NA NA 0.79 NA NA 0.16 NA NA 0.28 NA Fully Implemented Facility PE RVUs 0.54 0.87 0.27 NA NA 0.48 NA NA 0.23 NA NA 0.49 NA NA 0.25 NA NA 0.33 NA NA 0.33 NA NA 0.31 NA NA 0.58 NA NA 0.30 NA NA 0.69 NA NA 1.14 NA NA 0.34 NA NA 0.42 NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 88323 88325 88329 88331 88331 88331 88332 88332 88332 88333 88333 88333 88334 88334 88334 88342 88342 88342 88346 88346 88346 88347 88347 88347 88348 88348 88348 88349 88349 88349 88355 88355 88355 88356 88356 88356 88358 88358 88358 88360 88360 88360 88361 HCPCS 2 CPT 1/ 0.05 0.07 0.02 0.08 0.04 0.04 0.04 0.02 0.02 0.08 0.04 0.04 0.04 0.02 0.02 0.05 0.02 0.03 0.05 0.02 0.03 0.05 0.02 0.03 0.13 0.07 0.06 0.09 0.06 0.03 0.13 0.06 0.07 0.19 0.07 0.12 0.17 0.07 0.10 0.08 0.02 0.06 0.17 Mal-Practice RVUs 2.34 4.81 1.37 2.51 0.90 1.61 1.10 0.31 0.79 2.63 1.01 1.62 1.55 0.58 0.97 2.91 1.80 1.11 2.85 1.73 1.12 2.24 1.16 1.08 19.52 17.54 1.98 9.69 8.68 1.01 5.29 2.98 2.31 9.84 5.91 3.93 2.22 1.01 1.21 3.46 2.02 1.44 4.07 Fully Implemented NonFacility Total 2.42 5.33 1.35 2.41 0.70 1.71 1.09 0.25 0.84 2.43 0.70 1.73 1.42 0.42 1.00 2.50 1.29 1.21 2.58 1.36 1.22 2.19 0.99 1.20 13.12 10.97 2.15 5.73 4.64 1.09 9.39 6.78 2.61 8.00 3.72 4.28 2.03 0.64 1.39 3.05 1.47 1.58 4.29 Year 2007 Transitional Non-Facility Total 2.34 3.20 0.89 NA NA 1.61 NA NA 0.79 NA NA 1.62 NA NA 0.97 NA NA 1.11 NA NA 1.12 NA NA 1.08 NA NA 1.98 NA NA 1.01 NA NA 2.31 NA NA 3.93 NA NA 1.21 NA NA 1.44 NA Fully Implemented Facility Total 2.42 3.44 0.96 NA NA 1.71 NA NA 0.84 NA NA 1.73 NA NA 1.00 NA NA 1.21 NA NA 1.22 NA NA 1.20 NA NA 2.15 NA NA 1.09 NA NA 2.61 NA NA 4.28 NA NA 1.39 NA NA 1.58 NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69970 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00349 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... 26 ..... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... 26 ..... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A C C C C C C A A A A A A C C C A A A A A A A A A A A A Status Tumor immunohistochem/comput ........................ Tumor immunohistochem/comput ........................ Nerve teasing preparations .................................. Nerve teasing preparations .................................. Nerve teasing preparations .................................. Insitu hybridization (fish) ...................................... Insitu hybridization (fish) ...................................... Insitu hybridization (fish) ...................................... Insitu hybridization, auto ...................................... Insitu hybridization, auto ...................................... Insitu hybridization, auto ...................................... Insitu hybridization, manual ................................. Insitu hybridization, manual ................................. Insitu hybridization, manual ................................. Protein, western blot tissue .................................. Protein analysis w/probe ...................................... Microdissection ..................................................... Microdissection ..................................................... Microdissection ..................................................... Eval molecular probes, 11–50 ............................. Eval molecular probes, 11–50 ............................. Eval molecular probes, 11–50 ............................. Eval molecul probes, 51–250 .............................. Eval molecul probes, 51–250 .............................. Eval molecul probes, 51–250 .............................. Eval molecul probes, 251–500 ............................ Eval molecul probes, 251–500 ............................ Eval molecul probes, 251–500 ............................ Surgical pathology procedure .............................. Surgical pathology procedure .............................. Surgical pathology procedure .............................. Chct for mal hyperthermia ................................... Exam,synovial fluid crystals ................................. Sample intestinal contents ................................... Sample intestinal contents ................................... Sample stomach contents .................................... Sample stomach contents .................................... Sample stomach contents .................................... Sample stomach contents .................................... Sample stomach contents .................................... Sample stomach contents .................................... Sputum specimen collection ................................ Collect sweat for test ........................................... Description 0.00 1.18 2.17 0.00 2.17 1.20 0.00 1.20 1.30 0.00 1.30 1.40 0.00 1.40 0.37 0.37 0.00 0.00 0.00 0.00 0.00 0.00 1.50 0.00 1.50 1.88 0.00 1.88 0.00 0.00 0.00 1.40 0.37 0.60 0.50 0.45 0.19 0.79 0.21 0.94 0.85 0.00 0.00 Physician Work RVUs 3 2.46 0.26 5.24 4.63 0.61 2.90 2.66 0.24 5.16 4.94 0.22 4.69 4.48 0.21 0.10 0.11 0.00 0.00 0.00 0.00 0.00 0.00 14.35 14.13 0.22 14.25 13.97 0.28 0.00 0.00 0.00 3.69 0.12 8.84 7.57 6.86 6.46 8.84 6.99 6.75 5.34 0.36 0.08 Fully Implemented NonFacility PE RVUs 2.51 0.43 4.83 3.99 0.84 2.32 1.88 0.44 4.31 3.85 0.46 2.96 2.46 0.50 0.12 0.15 0.00 0.00 0.00 0.00 0.00 0.00 8.90 8.36 0.54 8.84 8.15 0.69 0.00 0.00 0.00 3.59 0.15 3.58 3.56 3.02 2.78 3.63 3.05 3.25 3.43 0.41 0.10 Year 2007 Transitional Non-Facility PE RVUs NA 0.26 NA NA 0.61 NA NA 0.24 NA NA 0.22 NA NA 0.21 0.10 0.11 0.00 0.00 0.00 0.00 0.00 0.00 NA NA 0.22 NA NA 0.28 0.00 0.00 0.00 0.22 0.12 0.60 0.45 0.39 0.29 0.68 0.32 0.49 0.38 NA NA Fully Implemented Facility PE RVUs NA 0.43 NA NA 0.84 NA NA 0.44 NA NA 0.46 NA NA 0.50 0.12 0.15 0.00 0.00 0.00 0.00 0.00 0.00 NA NA 0.54 NA NA 0.69 0.00 0.00 0.00 0.26 0.15 0.31 0.24 0.20 0.12 0.36 0.15 0.33 0.34 NA NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 88361 88361 88362 88362 88362 88365 88365 88365 88367 88367 88367 88368 88368 88368 88371 88372 88380 88380 88380 88384 88384 88384 88385 88385 88385 88386 88386 88386 88399 88399 88399 89049 89060 89100 89105 89130 89132 89135 89136 89140 89141 89220 89230 HCPCS 2 CPT 1/ 0.07 0.10 0.15 0.06 0.09 0.05 0.02 0.03 0.12 0.06 0.06 0.12 0.06 0.06 0.01 0.01 0.00 0.00 0.00 0.00 0.00 0.00 0.12 0.06 0.06 0.16 0.08 0.08 0.00 0.00 0.00 0.06 0.01 0.03 0.02 0.02 0.01 0.04 0.01 0.04 0.03 0.02 0.02 Mal-Practice RVUs 2.53 1.54 7.56 4.69 2.87 4.15 2.68 1.47 6.58 5.00 1.58 6.21 4.54 1.67 0.48 0.49 0.00 0.00 0.00 0.00 0.00 0.00 15.97 14.19 1.78 16.29 14.05 2.24 0.00 0.00 0.00 5.15 0.50 9.47 8.09 7.33 6.66 9.67 7.21 7.73 6.22 0.38 0.10 Fully Implemented NonFacility Total 2.58 1.71 7.15 4.05 3.10 3.57 1.90 1.67 5.73 3.91 1.82 4.48 2.52 1.96 0.50 0.53 0.00 0.00 0.00 0.00 0.00 0.00 10.52 8.42 2.10 10.88 8.23 2.65 0.00 0.00 0.00 5.05 0.53 4.21 4.08 3.49 2.98 4.46 3.27 4.23 4.31 0.43 0.12 Year 2007 Transitional Non-Facility Total NA 1.54 NA NA 2.87 NA NA 1.47 NA NA 1.58 NA NA 1.67 0.48 0.49 0.00 0.00 0.00 0.00 0.00 0.00 NA NA 1.78 NA NA 2.24 0.00 0.00 0.00 1.68 0.50 1.23 0.97 0.86 0.49 1.51 0.54 1.47 1.26 NA NA Fully Implemented Facility Total NA 1.71 NA NA 3.10 NA NA 1.67 NA NA 1.82 NA NA 1.96 0.50 0.53 0.00 0.00 0.00 0.00 0.00 0.00 NA NA 2.10 NA NA 2.65 0.00 0.00 0.00 1.72 0.53 0.94 0.76 0.67 0.32 1.19 0.37 1.31 1.22 NA NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69971 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00350 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod C I I I I I E E E E X I I E I I E E I A A R R A A R R E E E E E E E E E E E E E E X X Status Pathology lab procedure ...................................... Human ig, im ........................................................ Human ig, iv ......................................................... Botulinum antitoxin ............................................... Botulism ig, iv ....................................................... Cmv ig, iv ............................................................. Diphtheria antitoxin .............................................. Hep b ig, im .......................................................... Rabies ig, im/sc .................................................... Rabies ig, heat treated ......................................... Rsv ig, im, 50mg .................................................. Rsv ig, iv .............................................................. Rh ig, full-dose, im ............................................... Rh ig, minidose, im .............................................. Rh ig, iv ................................................................ Tetanus ig, im ...................................................... Vaccina ig, im ....................................................... Varicella-zoster ig, im ........................................... Immune globulin ................................................... Immune admin 1 inj, < 8 yrs ................................ Immune admin addl inj, < 8 y .............................. Immune admin o or n, < 8 yrs ............................. Immune admin o/n, addl < 8 y ............................. Immunization admin ............................................. Immunization admin, each add ............................ Immune admin oral/nasal ..................................... Immune admin oral/nasal addl ............................. Adenovirus vaccine, type 4 .................................. Adenovirus vaccine, type 7 .................................. Anthrax vaccine, sc .............................................. Bcg vaccine, percut .............................................. Bcg vaccine, intravesical ...................................... Hep a vaccine, adult im ....................................... Hep a vacc, ped/adol, 2 dose .............................. Hep a vacc, ped/adol, 3 dose .............................. Hep a/hep b vacc, adult im .................................. Hib vaccine, hboc, im ........................................... Hib vaccine, prp-d, im .......................................... Hib vaccine, prp-omp, im ..................................... Hib vaccine, prp-t, im ........................................... H papilloma vacc 3 dose im ................................ Flu vaccine no preserv 6–35m ............................ Flu vaccine no preserv 3 & > ............................... Description 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.17 0.15 0.17 0.15 0.17 0.15 0.17 0.15 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Physician Work RVUs 3 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.45 0.12 0.17 0.10 0.45 0.12 0.16 0.07 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented NonFacility PE RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.35 0.13 0.17 0.11 0.35 0.13 0.18 0.09 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Non-Facility PE RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NA 0.04 0.07 0.03 NA 0.04 0.04 0.03 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented Facility PE RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NA 0.11 0.09 0.05 NA 0.11 0.06 0.05 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 89240 90281 90283 90287 90288 90291 90296 90371 90375 90376 90378 90379 90384 90385 90386 90389 90393 90396 90399 90465 90466 90467 90468 90471 90472 90473 90474 90476 90477 90581 90585 90586 90632 90633 90634 90636 90645 90646 90647 90648 90649 90655 90656 HCPCS 2 CPT 1/ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.01 0.01 0.01 0.01 0.01 0.01 0.01 0.01 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Mal-Practice RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.63 0.28 0.35 0.26 0.63 0.28 0.34 0.23 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented NonFacility Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.53 0.29 0.35 0.27 0.53 0.29 0.36 0.25 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Non-Facility Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NA 0.20 0.25 0.19 NA 0.20 0.22 0.19 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented Facility Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NA 0.27 0.27 0.21 NA 0.27 0.24 0.21 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX ZZZ XXX ZZZ XXX ZZZ XXX ZZZ XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69972 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00351 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod X X X E N E E E E E E E E E E E E E E E E E E E E E E E E E E E E I E E X E E E E X X Status Flu vaccine, 3 yrs, im ........................................... Flu vaccine, 3 yrs & >, im .................................... Flu vaccine, nasal ................................................ Lyme disease vaccine, im .................................... Pneumococcal vacc, ped <5 ................................ Rabies vaccine, im ............................................... Rabies vaccine, id ................................................ Rotovirus vacc 3 dose, oral ................................. Typhoid vaccine, oral ........................................... Typhoid vaccine, im ............................................. Typhoid vaccine, h-p, sc/id .................................. Typhoid vaccine, akd, sc ..................................... Dtap-hib-ip vaccine, im ........................................ Dtap vaccine, < 7 yrs, im ..................................... Dtp vaccine, im .................................................... Dt vaccine < 7, im ................................................ Tetanus vaccine, im ............................................. Mumps vaccine, sc .............................................. Measles vaccine, sc ............................................. Rubella vaccine, sc .............................................. Mmr vaccine, sc ................................................... Measles-rubella vaccine, sc ................................. Mmrv vaccine, sc ................................................. Oral poliovirus vaccine ......................................... Poliovirus, ipv, sc/im ............................................ Td vaccine no prsrv >/= 7 im ............................... Tdap vaccine >7 im .............................................. Chicken pox vaccine, sc ...................................... Yellow fever vaccine, sc ...................................... Td vaccine > 7, im ............................................... Diphtheria vaccine, im .......................................... Dtp/hib vaccine, im ............................................... Dtap/hib vaccine, im ............................................. Dtap-hep b-ipv vaccine, im .................................. Cholera vaccine, injectable .................................. Plague vaccine, im ............................................... Pneumococcal vaccine ........................................ Meningococcal vaccine, sc .................................. Meningococcal vaccine, im .................................. Encephalitis vaccine, sc ....................................... Zoster vacc, sc ..................................................... Hepb vacc, ill pat 3 dose im ................................ Hep b vacc, adol, 2 dose, im ............................... Description 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Physician Work RVUs 3 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented NonFacility PE RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Non-Facility PE RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented Facility PE RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 90657 90658 90660 90665 90669 90675 90676 90680 90690 90691 90692 90693 90698 90700 90701 90702 90703 90704 90705 90706 90707 90708 90710 90712 90713 90714 90715 90716 90717 90718 90719 90720 90721 90723 90725 90727 90732 90733 90734 90735 90736 90740 90743 HCPCS 2 CPT 1/ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Mal-Practice RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented NonFacility Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Non-Facility Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented Facility Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69973 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00352 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod X X X I E A A A A A A A A A A C A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Hepb vacc ped/adol 3 dose im ............................ Hep b vaccine, adult, im ...................................... Hepb vacc, ill pat 4 dose im ................................ Hep b/hib vaccine, im .......................................... Vaccine toxoid ...................................................... Hydration iv infusion, init ...................................... Hydrate iv infusion, add-on .................................. Ther/proph/diag iv inf, init .................................... Ther/proph/dg iv inf, add-on ................................. Tx/proph/dg addl seq iv inf .................................. Ther/diag concurrent inf ....................................... Ther/proph/diag inj, sc/im ..................................... Ther/proph/diag inj, ia .......................................... Ther/proph/diag inj, iv push ................................. Ther/proph/diag inj add-on ................................... Ther/prop/diag inj/inf proc .................................... Psy dx interview ................................................... Intac psy dx interview .......................................... Psytx, office, 20–30 min ....................................... Psytx, off, 20–30 min w/e&m ............................... Psytx, off, 45–50 min ........................................... Psytx, off, 45–50 min w/e&m ............................... Psytx, office, 75–80 min ....................................... Psytx, off, 75–80, w/e&m ..................................... Intac psytx, off, 20–30 min ................................... Intac psytx, 20–30, w/e&m ................................... Intac psytx, off, 45–50 min ................................... Intac psytx, 45–50 min w/e&m ............................. Intac psytx, off, 75–80 min ................................... Intac psytx, 75–80 w/e&m .................................... Psytx, hosp, 20–30 min ....................................... Psytx, hosp, 20–30 min w/e&m ........................... Psytx, hosp, 45–50 min ....................................... Psytx, hosp, 45–50 min w/e&m ........................... Psytx, hosp, 75–80 min ....................................... Psytx, hosp, 75–80 min w/e&m ........................... Intac psytx, hosp, 20–30 min ............................... Intac psytx, hsp 20–30 w/e&m ............................. Intac psytx, hosp, 45–50 min ............................... Intac psytx, hsp 45–50 w/e&m ............................. Intac psytx, hosp, 75–80 min ............................... Intac psytx, hsp 75–80 w/e&m ............................. Psychoanalysis ..................................................... Description 0.00 0.00 0.00 0.00 0.00 0.17 0.09 0.21 0.18 0.19 0.17 0.17 0.17 0.18 0.10 0.00 2.80 3.01 1.21 1.37 1.86 2.02 2.79 2.95 1.32 1.48 1.97 2.13 2.90 3.06 1.25 1.41 1.89 2.05 2.83 2.99 1.36 1.52 2.01 2.16 2.94 3.10 1.79 Physician Work RVUs 3 0.00 0.00 0.00 0.00 0.00 1.30 0.31 1.61 0.37 0.68 0.33 0.45 0.30 1.33 0.51 0.00 1.49 1.51 0.55 0.60 0.52 0.71 0.68 0.87 0.52 0.72 0.64 0.84 0.79 1.00 NA NA NA NA NA NA NA NA NA NA NA NA 0.39 Fully Implemented NonFacility PE RVUs 0.00 0.00 0.00 0.00 0.00 1.40 0.38 1.72 0.44 0.84 0.41 0.35 0.31 1.31 0.56 0.00 1.25 1.28 0.51 0.53 0.66 0.70 0.94 0.97 0.51 0.61 0.75 0.79 1.02 1.04 NA NA NA NA NA NA NA NA NA NA NA NA 0.53 Year 2007 Transitional Non-Facility PE RVUs 0.00 0.00 0.00 0.00 0.00 NA NA NA NA NA NA NA NA NA NA 0.00 0.60 0.66 0.22 0.24 0.33 0.36 0.49 0.53 0.24 0.26 0.35 0.38 0.52 0.54 0.32 0.36 0.43 0.47 0.60 0.64 0.34 0.38 0.46 0.49 0.61 0.66 0.32 Fully Implemented Facility PE RVUs 0.00 0.00 0.00 0.00 0.00 NA NA NA NA NA NA NA NA NA NA 0.00 0.85 0.90 0.34 0.38 0.53 0.56 0.80 0.82 0.38 0.41 0.57 0.60 0.87 0.85 0.43 0.44 0.63 0.61 0.91 0.87 0.45 0.46 0.66 0.63 0.95 0.90 0.49 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 90744 90746 90747 90748 90749 90760 90761 90765 90766 90767 90768 90772 90773 90774 90775 90779 90801 90802 90804 90805 90806 90807 90808 90809 90810 90811 90812 90813 90814 90815 90816 90817 90818 90819 90821 90822 90823 90824 90826 90827 90828 90829 90845 HCPCS 2 CPT 1/ 0.00 0.00 0.00 0.00 0.00 0.07 0.04 0.07 0.04 0.04 0.04 0.01 0.02 0.04 0.04 0.00 0.06 0.07 0.03 0.03 0.04 0.05 0.06 0.07 0.04 0.04 0.04 0.05 0.06 0.07 0.03 0.03 0.04 0.05 0.06 0.08 0.03 0.04 0.05 0.05 0.06 0.07 0.04 Mal-Practice RVUs 0.00 0.00 0.00 0.00 0.00 1.54 0.44 1.89 0.59 0.91 0.54 0.63 0.49 1.55 0.65 0.00 4.35 4.59 1.79 2.00 2.42 2.78 3.53 3.89 1.88 2.24 2.65 3.02 3.75 4.13 NA NA NA NA NA NA NA NA NA NA NA NA 2.22 Fully Implemented NonFacility Total 0.00 0.00 0.00 0.00 0.00 1.64 0.51 2.00 0.66 1.07 0.62 0.53 0.50 1.53 0.70 0.00 4.11 4.36 1.75 1.93 2.56 2.77 3.79 3.99 1.87 2.13 2.76 2.97 3.98 4.17 NA NA NA NA NA NA NA NA NA NA NA NA 2.36 Year 2007 Transitional Non-Facility Total 0.00 0.00 0.00 0.00 0.00 NA NA NA NA NA NA NA NA NA NA 0.00 3.46 3.74 1.46 1.64 2.23 2.43 3.34 3.55 1.60 1.78 2.36 2.56 3.48 3.67 1.60 1.80 2.36 2.57 3.49 3.71 1.73 1.94 2.52 2.70 3.61 3.83 2.15 Fully Implemented Facility Total 0.00 0.00 0.00 0.00 0.00 NA NA NA NA NA NA NA NA NA NA 0.00 3.71 3.98 1.58 1.78 2.43 2.63 3.65 3.84 1.74 1.93 2.58 2.78 3.83 3.98 1.71 1.88 2.56 2.71 3.80 3.94 1.84 2.02 2.72 2.84 3.95 4.07 2.32 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX ZZZ XXX ZZZ ZZZ ZZZ XXX XXX XXX ZZZ XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69974 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00353 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 2 Copyright 3+ Mod R R R A A A A A N N A N B B B C A A I I I I I I I I A A X A A X X A C A A A A A A A A Status Family psytx w/o patient ...................................... Family psytx w/patient .......................................... Multiple family group psytx .................................. Group psychotherapy ........................................... Intac group psytx .................................................. Medication management ...................................... Narcosynthesis ..................................................... Electroconvulsive therapy .................................... Psychophysiological therapy ................................ Psychophysiological therapy ................................ Hypnotherapy ....................................................... Environmental manipulation ................................. Psy evaluation of records .................................... Consultation with family ....................................... Preparation of report ............................................ Psychiatric service/therapy .................................. Biofeedback train, any meth ................................ Biofeedback peri/uro/rectal .................................. ESRD related services, month ............................. ESRD related services, month ............................. ESRD related services, month ............................. ESRD related services, month ............................. ESRD related services, day ................................. Esrd related services, day ................................... Esrd related services, day ................................... Esrd related services, day ................................... Hemodialysis, one evaluation .............................. Hemodialysis, repeated eval ................................ Hemodialysis access study .................................. Dialysis, one evaluation ....................................... Dialysis, repeated eval ......................................... Dialysis training, complete ................................... Dialysis training, incompl ..................................... Hemoperfusion ..................................................... Dialysis procedure ................................................ Esophageal intubation .......................................... Esophageal intubation .......................................... Esophageal intubation .......................................... Esophagus motility study ..................................... Esophagus motility study ..................................... Esophagus motility study ..................................... Esophagus motility study ..................................... Esophagus motility study ..................................... Description 1.83 2.21 0.59 0.59 0.63 0.95 2.84 1.88 1.20 1.90 2.19 0.00 0.97 1.48 0.00 0.00 0.41 0.89 11.16 8.53 7.26 4.46 0.37 0.28 0.24 0.15 1.22 2.11 0.00 1.28 2.16 0.00 0.00 1.84 0.00 0.73 0.00 0.73 1.25 0.00 1.25 1.50 0.00 Physician Work RVUs 3 0.51 0.74 0.30 0.27 0.36 0.62 1.19 1.91 0.52 0.67 0.57 0.00 0.22 0.61 0.00 0.00 0.47 1.37 4.68 3.02 2.73 1.70 0.16 0.10 0.09 0.05 NA NA 0.00 NA NA 0.00 0.00 NA 0.00 2.19 1.95 0.24 3.65 3.09 0.56 5.30 4.58 Fully Implemented NonFacility PE RVUs 0.62 0.80 0.28 0.26 0.31 0.46 1.32 1.93 0.81 1.04 0.92 0.00 0.33 0.77 0.00 0.00 0.61 1.51 5.75 3.76 3.50 2.26 0.20 0.12 0.11 0.07 NA NA 0.00 NA NA 0.00 0.00 NA 0.00 0.80 0.55 0.25 4.22 3.75 0.47 5.25 4.67 Year 2007 Transitional Non-Facility PE RVUs 0.43 0.49 0.20 0.20 0.21 0.27 0.65 0.39 0.28 0.44 0.39 0.00 0.22 0.34 0.00 0.00 0.11 0.30 3.74 2.55 2.27 1.61 0.12 0.08 0.08 0.05 0.55 0.79 0.00 0.56 0.80 0.00 0.00 0.51 0.00 2.19 1.95 0.24 3.65 3.09 0.56 5.30 4.58 Fully Implemented Facility PE RVUs 0.60 0.69 0.23 0.22 0.24 0.31 0.85 0.54 0.42 0.66 0.62 0.00 0.33 0.51 0.00 0.00 0.13 0.31 5.52 3.64 3.38 2.23 0.19 0.12 0.11 0.07 0.64 0.93 0.00 0.66 0.94 0.00 0.00 0.62 0.00 0.80 0.55 0.25 4.22 3.75 0.47 5.25 4.67 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 90846 90847 90849 90853 90857 90862 90865 90870 90875 90876 90880 90882 90885 90887 90889 90899 90901 90911 90918 90919 90920 90921 90922 90923 90924 90925 90935 90937 90940 90945 90947 90989 90993 90997 90999 91000 91000 91000 91010 91010 91010 91011 91011 HCPCS 2 CPT 1/ 0.04 0.05 0.02 0.01 0.01 0.02 0.12 0.04 0.04 0.05 0.05 0.00 0.02 0.04 0.00 0.00 0.02 0.06 0.36 0.29 0.23 0.14 0.01 0.01 0.01 0.01 0.04 0.07 0.00 0.04 0.07 0.00 0.00 0.06 0.00 0.04 0.01 0.03 0.12 0.06 0.06 0.13 0.06 Mal-Practice RVUs 2.38 3.00 0.91 0.87 1.00 1.59 4.15 3.83 1.76 2.62 2.81 0.00 1.21 2.13 0.00 0.00 0.90 2.32 16.20 11.84 10.22 6.30 0.54 0.39 0.34 0.21 NA NA 0.00 NA NA 0.00 0.00 NA 0.00 2.96 1.96 1.00 5.02 3.15 1.87 6.93 4.64 Fully Implemented NonFacility Total 2.49 3.06 0.89 0.86 0.95 1.43 4.28 3.85 2.05 2.99 3.16 0.00 1.32 2.29 0.00 0.00 1.04 2.46 17.27 12.58 10.99 6.86 0.58 0.41 0.36 0.23 NA NA 0.00 NA NA 0.00 0.00 NA 0.00 1.57 0.56 1.01 5.59 3.81 1.78 6.88 4.73 Year 2007 Transitional Non-Facility Total 2.30 2.75 0.81 0.80 0.85 1.24 3.61 2.31 1.52 2.39 2.63 0.00 1.21 1.86 0.00 0.00 0.54 1.25 15.26 11.37 9.76 6.21 0.50 0.37 0.33 0.21 1.81 2.97 0.00 1.88 3.03 0.00 0.00 2.41 0.00 2.96 1.96 1.00 5.02 3.15 1.87 6.93 4.64 Fully Implemented Facility Total 2.47 2.95 0.84 0.82 0.88 1.28 3.81 2.46 1.66 2.61 2.86 0.00 1.32 2.03 0.00 0.00 0.56 1.26 17.04 12.46 10.87 6.83 0.57 0.41 0.36 0.23 1.90 3.11 0.00 1.98 3.17 0.00 0.00 2.52 0.00 1.57 0.56 1.01 5.59 3.81 1.78 6.88 4.73 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX 000 XXX XXX XXX XXX XXX XXX XXX XXX 000 000 XXX XXX XXX XXX XXX XXX XXX XXX 000 000 XXX 000 000 XXX XXX 000 XXX 000 000 000 000 000 000 000 000 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69975 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00354 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... .......... TC .... 26 ..... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Esophagus motility study ..................................... Esophagus motility study ..................................... Esophagus motility study ..................................... Esophagus motility study ..................................... Gastric motility studies ......................................... Gastric motility studies ......................................... Gastric motility studies ......................................... Duodenal motility study ........................................ Duodenal motility study ........................................ Duodenal motility study ........................................ Acid perfusion of esophagus ............................... Acid perfusion of esophagus ............................... Acid perfusion of esophagus ............................... Gastroesophageal reflux test ............................... Gastroesophageal reflux test ............................... Gastroesophageal reflux test ............................... G-esoph reflx tst w/electrod ................................. G-esoph reflx tst w/electrod ................................. G-esoph reflx tst w/electrod ................................. Esoph imped function test ................................... Esoph imped function test ................................... Esoph imped function test ................................... Esoph imped funct test > 1h ................................ Esoph imped funct test > 1h ................................ Esoph imped funct test > 1h ................................ Esoph balloon distension tst ................................ Esoph balloon distension tst ................................ Esoph balloon distension tst ................................ Gastric analysis test ............................................. Gastric analysis test ............................................. Gastric analysis test ............................................. Gastric intubation for smear ................................. Gastric intubation for smear ................................. Gastric intubation for smear ................................. Breath hydrogen test ............................................ Breath hydrogen test ............................................ Breath hydrogen test ............................................ Pass intestine bleeding tube ................................ Gastric intubation treatment ................................. Gi tract capsule endoscopy ................................. Gi tract capsule endoscopy ................................. Gi tract capsule endoscopy ................................. Esophageal capsule endoscopy .......................... Description 1.50 1.46 0.00 1.46 1.44 0.00 1.44 1.44 0.00 1.44 0.91 0.00 0.91 0.97 0.00 0.97 1.59 0.00 1.59 0.97 0.00 0.97 1.10 0.00 1.10 0.97 0.00 0.97 0.79 0.00 0.79 0.94 0.00 0.94 0.20 0.00 0.20 1.08 0.37 3.64 0.00 3.64 1.00 Physician Work RVUs 3 0.72 5.48 4.78 0.70 4.78 4.16 0.62 3.09 2.47 0.62 2.90 2.47 0.43 4.10 3.68 0.42 11.29 10.57 0.72 3.38 2.95 0.43 2.78 2.27 0.51 9.27 8.89 0.38 2.98 2.60 0.38 2.41 2.13 0.28 1.29 1.23 0.06 2.14 1.74 20.51 18.81 1.70 18.65 Fully Implemented NonFacility PE RVUs 0.58 5.69 5.13 0.56 4.58 4.06 0.52 4.08 3.54 0.54 2.55 2.20 0.35 4.96 4.60 0.36 10.92 10.32 0.60 3.04 2.68 0.36 2.36 1.94 0.42 10.67 10.32 0.35 2.59 2.28 0.31 2.81 2.54 0.27 1.42 1.35 0.07 2.63 2.01 21.77 20.38 1.39 18.65 Year 2007 Transitional Non-Facility PE RVUs 0.72 5.48 4.78 0.70 4.78 4.16 0.62 3.09 2.47 0.62 2.90 2.47 0.43 4.10 3.68 0.42 11.29 10.57 0.72 3.38 2.95 0.43 2.78 2.27 0.51 9.27 8.89 0.38 2.98 2.60 0.38 2.41 2.13 0.28 1.29 1.23 0.06 0.37 0.07 NA NA 1.70 NA Fully Implemented Facility PE RVUs 0.58 5.69 5.13 0.56 4.58 4.06 0.52 4.08 3.54 0.54 2.55 2.20 0.35 4.96 4.60 0.36 10.92 10.32 0.60 3.04 2.68 0.36 2.36 1.94 0.42 10.67 10.32 0.35 2.59 2.28 0.31 2.81 2.54 0.27 1.42 1.35 0.07 0.30 0.09 NA NA 1.39 NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 91011 91012 91012 91012 91020 91020 91020 91022 91022 91022 91030 91030 91030 91034 91034 91034 91035 91035 91035 91037 91037 91037 91038 91038 91038 91040 91040 91040 91052 91052 91052 91055 91055 91055 91065 91065 91065 91100 91105 91110 91110 91110 91111 HCPCS 2 CPT 1/ 0.07 0.13 0.07 0.06 0.13 0.06 0.07 0.13 0.06 0.07 0.06 0.02 0.04 0.12 0.06 0.06 0.12 0.06 0.06 0.12 0.06 0.06 0.12 0.06 0.06 0.12 0.06 0.06 0.05 0.02 0.03 0.07 0.02 0.05 0.03 0.02 0.01 0.07 0.03 0.16 0.07 0.09 0.05 Mal-Practice RVUs 2.29 7.07 4.85 2.22 6.35 4.22 2.13 4.66 2.53 2.13 3.87 2.49 1.38 5.19 3.74 1.45 13.00 10.63 2.37 4.47 3.01 1.46 4.00 2.33 1.67 10.36 8.95 1.41 3.82 2.62 1.20 3.42 2.15 1.27 1.52 1.25 0.27 3.29 2.14 24.31 18.88 5.43 19.70 Fully Implemented NonFacility Total 2.15 7.28 5.20 2.08 6.15 4.12 2.03 5.65 3.60 2.05 3.52 2.22 1.30 6.05 4.66 1.39 12.63 10.38 2.25 4.13 2.74 1.39 3.58 2.00 1.58 11.76 10.38 1.38 3.43 2.30 1.13 3.82 2.56 1.26 1.65 1.37 0.28 3.78 2.41 25.57 20.45 5.12 19.70 Year 2007 Transitional Non-Facility Total 2.29 7.07 4.85 2.22 6.35 4.22 2.13 4.66 2.53 2.13 3.87 2.49 1.38 5.19 3.74 1.45 13.00 10.63 2.37 4.47 3.01 1.46 4.00 2.33 1.67 10.36 8.95 1.41 3.82 2.62 1.20 3.42 2.15 1.27 1.52 1.25 0.27 1.52 0.47 NA NA 5.43 NA Fully Implemented Facility Total 2.15 7.28 5.20 2.08 6.15 4.12 2.03 5.65 3.60 2.05 3.52 2.22 1.30 6.05 4.66 1.39 12.63 10.38 2.25 4.13 2.74 1.39 3.58 2.00 1.58 11.76 10.38 1.38 3.43 2.30 1.13 3.82 2.56 1.26 1.65 1.37 0.28 1.45 0.49 NA NA 5.12 NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 XXX XXX XXX XXX Global 69976 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00355 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... .......... .......... .......... .......... .......... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... 2 Copyright 3+ Mod A A A A A A A A B C C A C C A C C C A A A A N A A A A A A A A A A A A A A A A A A A A Status Esophageal capsule endoscopy .......................... Esophageal capsule endoscopy .......................... Rectal sensation test ............................................ Rectal sensation test ............................................ Rectal sensation test ............................................ Anal pressure record ............................................ Anal pressure record ............................................ Anal pressure record ............................................ Irrigate fecal impaction ......................................... Electrogastrography ............................................. Electrogastrography ............................................. Electrogastrography ............................................. Electrogastrography w/test ................................... Electrogastrography w/test ................................... Electrogastrography w/test ................................... Gastroenterology procedure ................................ Gastroenterology procedure ................................ Gastroenterology procedure ................................ Eye exam, new patient ........................................ Eye exam, new patient ........................................ Eye exam established pat .................................... Eye exam & treatment ......................................... Refraction ............................................................. New eye exam & treatment ................................. Eye exam & treatment ......................................... Special eye evaluation ......................................... Corneal topography .............................................. Corneal topography .............................................. Corneal topography .............................................. Special eye evaluation ......................................... Special eye evaluation ......................................... Special eye evaluation ......................................... Orthoptic/pleoptic training .................................... Orthoptic/pleoptic training .................................... Orthoptic/pleoptic training .................................... Fitting of contact lens ........................................... Visual field examination(s) ................................... Visual field examination(s) ................................... Visual field examination(s) ................................... Visual field examination(s) ................................... Visual field examination(s) ................................... Visual field examination(s) ................................... Visual field examination(s) ................................... Description 0.00 1.00 0.97 0.00 0.97 1.77 0.00 1.77 0.00 0.00 0.00 0.52 0.00 0.00 0.66 0.00 0.00 0.00 0.88 1.67 0.67 1.10 0.38 2.50 1.31 0.37 0.35 0.00 0.35 0.69 0.00 0.69 0.37 0.00 0.37 0.70 0.36 0.00 0.36 0.44 0.00 0.44 0.50 Physician Work RVUs 3 18.19 0.46 9.04 8.73 0.31 3.74 3.21 0.53 0.00 0.00 0.00 0.26 0.00 0.00 0.30 0.00 0.00 0.00 0.97 1.59 0.93 1.31 0.10 NA NA 0.26 0.44 0.32 0.12 0.79 0.55 0.24 0.88 0.79 0.09 0.94 0.96 0.85 0.11 1.36 1.21 0.15 1.56 Fully Implemented NonFacility PE RVUs 18.19 0.46 10.49 10.16 0.33 4.76 4.18 0.58 0.00 0.00 0.00 0.20 0.00 0.00 0.25 0.00 0.00 0.00 0.97 1.67 1.01 1.39 1.14 NA NA 0.32 0.44 0.32 0.12 0.75 0.47 0.28 0.62 0.48 0.14 1.04 0.95 0.81 0.14 1.26 1.08 0.18 1.46 Year 2007 Transitional Non-Facility PE RVUs NA 0.46 9.04 8.73 0.31 3.74 3.21 0.53 0.00 0.00 0.00 0.26 0.00 0.00 0.30 0.00 0.00 0.00 0.28 0.55 0.24 0.39 0.09 0.93 0.45 0.13 0.44 0.32 0.12 NA NA 0.24 NA NA 0.09 0.24 NA NA 0.11 NA NA 0.15 NA Fully Implemented Facility PE RVUs NA 0.46 10.49 10.16 0.33 4.76 4.18 0.58 0.00 0.00 0.00 0.20 0.00 0.00 0.25 0.00 0.00 0.00 0.33 0.65 0.28 0.45 0.14 1.04 0.53 0.15 0.44 0.32 0.12 NA NA 0.28 NA NA 0.14 0.30 NA NA 0.14 NA NA 0.18 NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 91111 91111 91120 91120 91120 91122 91122 91122 91123 91132 91132 91132 91133 91133 91133 91299 91299 91299 92002 92004 92012 92014 92015 92018 92019 92020 92025 92025 92025 92060 92060 92060 92065 92065 92065 92070 92081 92081 92081 92082 92082 92082 92083 HCPCS 2 CPT 1/ 0.02 0.03 0.11 0.04 0.07 0.21 0.08 0.13 0.00 0.00 0.00 0.02 0.00 0.00 0.03 0.00 0.00 0.00 0.02 0.04 0.02 0.03 0.01 0.07 0.03 0.01 0.02 0.01 0.01 0.03 0.01 0.02 0.02 0.01 0.01 0.02 0.02 0.01 0.01 0.02 0.01 0.01 0.02 Mal-Practice RVUs 18.21 1.49 10.12 8.77 1.35 5.72 3.29 2.43 0.00 0.00 0.00 0.80 0.00 0.00 0.99 0.00 0.00 0.00 1.87 3.30 1.62 2.44 0.49 NA NA 0.64 0.81 0.33 0.48 1.51 0.56 0.95 1.27 0.80 0.47 1.66 1.34 0.86 0.48 1.82 1.22 0.60 2.08 Fully Implemented NonFacility Total 18.21 1.49 11.57 10.20 1.37 6.74 4.26 2.48 0.00 0.00 0.00 0.74 0.00 0.00 0.94 0.00 0.00 0.00 1.87 3.38 1.70 2.52 1.53 NA NA 0.70 0.81 0.33 0.48 1.47 0.48 0.99 1.01 0.49 0.52 1.76 1.33 0.82 0.51 1.72 1.09 0.63 1.98 Year 2007 Transitional Non-Facility Total NA 1.49 10.12 8.77 1.35 5.72 3.29 2.43 0.00 0.00 0.00 0.80 0.00 0.00 0.99 0.00 0.00 0.00 1.18 2.26 0.93 1.52 0.48 3.50 1.79 0.51 0.81 0.33 0.48 NA NA 0.95 NA NA 0.47 0.96 NA NA 0.48 NA NA 0.60 NA Fully Implemented Facility Total NA 1.49 11.57 10.20 1.37 6.74 4.26 2.48 0.00 0.00 0.00 0.74 0.00 0.00 0.94 0.00 0.00 0.00 1.23 2.36 0.97 1.58 0.53 3.61 1.87 0.53 0.81 0.33 0.48 NA NA 0.99 NA NA 0.52 1.02 NA NA 0.51 NA NA 0.63 NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX 000 000 000 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69977 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00356 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... TC .... 26 ..... .......... .......... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... .......... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Visual field examination(s) ................................... Visual field examination(s) ................................... Serial tonometry exam(s) ..................................... Tonography & eye evaluation .............................. Water provocation tonography ............................. Opthalmic dx imaging .......................................... Opthalmic dx imaging .......................................... Opthalmic dx imaging .......................................... Ophthalmic biometry ............................................ Ophthalmic biometry ............................................ Ophthalmic biometry ............................................ Glaucoma provocative tests ................................. Special eye exam, initial ...................................... Special eye exam, subsequent ............................ Eye exam with photos .......................................... Eye exam with photos .......................................... Eye exam with photos .......................................... Eye exam with photos .......................................... Icg angiography .................................................... Icg angiography .................................................... Icg angiography .................................................... Eye exam with photos .......................................... Eye exam with photos .......................................... Eye exam with photos .......................................... Ophthalmoscopy/dynamometry ............................ Eye muscle evaluation ......................................... Eye muscle evaluation ......................................... Eye muscle evaluation ......................................... Electro-oculography ............................................. Electro-oculography ............................................. Electro-oculography ............................................. Electroretinography .............................................. Electroretinography .............................................. Electroretinography .............................................. Color vision examination ...................................... Color vision examination ...................................... Color vision examination ...................................... Dark adaptation eye exam ................................... Dark adaptation eye exam ................................... Dark adaptation eye exam ................................... Eye photography .................................................. Eye photography .................................................. Eye photography .................................................. Description 0.00 0.50 0.92 0.81 0.81 0.35 0.00 0.35 0.54 0.00 0.54 0.50 0.38 0.33 0.60 0.81 0.00 0.81 1.10 0.00 1.10 0.44 0.00 0.44 0.20 0.81 0.00 0.81 0.81 0.00 0.81 1.01 0.00 1.01 0.17 0.00 0.17 0.24 0.00 0.24 0.20 0.00 0.20 Physician Work RVUs 3 1.38 0.18 1.28 1.00 1.21 0.80 0.68 0.12 1.46 1.25 0.21 0.92 0.25 0.24 0.73 2.32 2.01 0.31 4.48 4.06 0.42 1.33 1.18 0.15 0.23 1.01 0.76 0.25 1.38 1.14 0.24 2.47 2.10 0.37 1.01 0.96 0.05 1.24 1.15 0.09 0.82 0.75 0.07 Fully Implemented NonFacility PE RVUs 1.25 0.21 1.33 1.05 1.26 0.79 0.65 0.14 1.60 1.37 0.23 0.97 0.23 0.22 1.33 2.54 2.18 0.36 5.70 5.22 0.48 1.48 1.30 0.18 0.25 1.37 1.10 0.27 1.50 1.19 0.31 2.08 1.66 0.42 0.89 0.82 0.07 1.72 1.64 0.08 0.95 0.86 0.09 Year 2007 Transitional Non-Facility PE RVUs NA 0.18 0.30 0.27 0.29 NA NA 0.12 NA NA 0.21 0.16 0.13 0.12 0.21 NA NA 0.31 NA NA 0.42 NA NA 0.15 0.07 NA NA 0.25 NA NA 0.24 NA NA 0.37 NA NA 0.05 NA NA 0.09 NA NA 0.07 Fully Implemented Facility PE RVUs NA 0.21 0.35 0.31 0.35 NA NA 0.14 NA NA 0.23 0.20 0.15 0.14 0.20 NA NA 0.36 NA NA 0.48 NA NA 0.18 0.09 NA NA 0.27 NA NA 0.31 NA NA 0.42 NA NA 0.07 NA NA 0.08 NA NA 0.09 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 92083 92083 92100 92120 92130 92135 92135 92135 92136 92136 92136 92140 92225 92226 92230 92235 92235 92235 92240 92240 92240 92250 92250 92250 92260 92265 92265 92265 92270 92270 92270 92275 92275 92275 92283 92283 92283 92284 92284 92284 92285 92285 92285 HCPCS 2 CPT 1/ 0.01 0.01 0.02 0.02 0.02 0.02 0.01 0.01 0.08 0.07 0.01 0.01 0.01 0.01 0.02 0.08 0.06 0.02 0.09 0.06 0.03 0.02 0.01 0.01 0.01 0.06 0.02 0.04 0.05 0.02 0.03 0.05 0.02 0.03 0.02 0.01 0.01 0.02 0.01 0.01 0.02 0.01 0.01 Mal-Practice RVUs 1.39 0.69 2.22 1.83 2.04 1.17 0.69 0.48 2.08 1.32 0.76 1.43 0.64 0.58 1.35 3.21 2.07 1.14 5.67 4.12 1.55 1.79 1.19 0.60 0.44 1.88 0.78 1.10 2.24 1.16 1.08 3.53 2.12 1.41 1.20 0.97 0.23 1.50 1.16 0.34 1.04 0.76 0.28 Fully Implemented NonFacility Total 1.26 0.72 2.27 1.88 2.09 1.16 0.66 0.50 2.22 1.44 0.78 1.48 0.62 0.56 1.95 3.43 2.24 1.19 6.89 5.28 1.61 1.94 1.31 0.63 0.46 2.24 1.12 1.12 2.36 1.21 1.15 3.14 1.68 1.46 1.08 0.83 0.25 1.98 1.65 0.33 1.17 0.87 0.30 Year 2007 Transitional Non-Facility Total NA 0.69 1.24 1.10 1.12 NA NA 0.48 NA NA 0.76 0.67 0.52 0.46 0.83 NA NA 1.14 NA NA 1.55 NA NA 0.60 0.28 NA NA 1.10 NA NA 1.08 NA NA 1.41 NA NA 0.23 NA NA 0.34 NA NA 0.28 Fully Implemented Facility Total NA 0.72 1.29 1.14 1.18 NA NA 0.50 NA NA 0.78 0.71 0.54 0.48 0.82 NA NA 1.19 NA NA 1.61 NA NA 0.63 0.30 NA NA 1.12 NA NA 1.15 NA NA 1.46 NA NA 0.25 NA NA 0.33 NA NA 0.30 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69978 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00357 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... TC .... 26 ..... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... TC .... 26 ..... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... TC .... 2 Copyright 3+ Mod A A A A N A A A N A A A A A N N N B B B B B N B C C C A A A A A A A A A A B B B B A A Status Internal eye photography ..................................... Internal eye photography ..................................... Internal eye photography ..................................... Internal eye photography ..................................... Contact lens fitting ............................................... Contact lens fitting ............................................... Contact lens fitting ............................................... Contact lens fitting ............................................... Prescription of contact lens .................................. Prescription of contact lens .................................. Prescription of contact lens .................................. Prescription of contact lens .................................. Modification of contact lens ................................. Replacement of contact lens ............................... Fitting of spectacles ............................................. Fitting of spectacles ............................................. Fitting of spectacles ............................................. Special spectacles fitting ...................................... Special spectacles fitting ...................................... Special spectacles fitting ...................................... Special spectacles fitting ...................................... Eye prosthesis service ......................................... Repair & adjust spectacles .................................. Repair & adjust spectacles .................................. Eye service or procedure ..................................... Eye service or procedure ..................................... Eye service or procedure ..................................... Ear and throat examination .................................. Ear microscopy examination ................................ Speech/hearing evaluation ................................... Speech/hearing therapy ....................................... Speech/hearing therapy ....................................... Nasopharyngoscopy ............................................. Nasal function studies .......................................... Facial nerve function test ..................................... Laryngeal function studies ................................... Oral function therapy ............................................ Spontaneous nystagmus study ............................ Positional nystagmus test .................................... Caloric vestibular test ........................................... Optokinetic nystagmus test .................................. Spontaneous nystagmus test ............................... Spontaneous nystagmus test ............................... Description 0.66 0.00 0.66 0.81 1.17 1.08 1.26 0.92 0.69 0.45 0.68 0.45 0.00 0.00 0.37 0.47 0.53 0.37 0.50 0.00 0.00 0.00 0.32 0.00 0.00 0.00 0.00 1.51 0.18 0.86 0.52 0.26 0.84 0.55 0.43 0.75 0.55 0.00 0.00 0.00 0.00 0.40 0.00 Physician Work RVUs 3 2.15 1.91 0.24 1.97 1.05 1.30 1.50 1.48 1.13 1.33 1.67 1.44 0.85 0.75 0.44 0.46 0.48 0.56 0.59 0.28 0.44 0.23 0.39 0.24 0.00 0.00 0.00 NA 0.55 3.28 1.18 0.51 2.92 0.94 1.15 0.87 1.67 0.00 0.00 0.00 0.00 1.10 0.99 Fully Implemented NonFacility PE RVUs 2.83 2.55 0.28 2.28 1.10 1.14 1.19 1.17 0.99 0.97 1.10 1.07 0.51 1.41 0.64 0.67 0.69 0.65 0.70 6.72 3.36 0.79 0.51 0.53 0.00 0.00 0.00 NA 0.51 2.76 1.13 0.51 3.21 1.09 1.19 0.60 1.65 0.00 0.00 0.00 0.00 1.05 0.88 Year 2007 Transitional Non-Facility PE RVUs NA NA 0.24 0.31 0.27 0.33 0.36 0.34 0.16 0.14 0.24 0.14 NA NA 0.08 0.11 0.12 0.08 0.12 NA NA NA 0.07 NA 0.00 0.00 0.00 0.79 0.05 0.25 0.15 0.08 0.62 0.16 0.13 0.21 0.16 0.00 0.00 0.00 0.00 NA NA Fully Implemented Facility PE RVUs NA NA 0.28 0.31 0.41 0.35 0.47 0.30 0.24 0.16 0.28 0.15 NA NA 0.13 0.16 0.19 0.13 0.17 NA NA NA 0.12 NA 0.00 0.00 0.00 1.03 0.08 0.36 0.21 0.11 0.74 0.18 0.20 0.35 0.19 0.00 0.00 0.00 0.00 NA NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 92286 92286 92286 92287 92310 92311 92312 92313 92314 92315 92316 92317 92325 92326 92340 92341 92342 92352 92353 92354 92355 92358 92370 92371 92499 92499 92499 92502 92504 92506 92507 92508 92511 92512 92516 92520 92526 92531 92532 92533 92534 92541 92541 HCPCS 2 CPT 1/ 0.04 0.02 0.02 0.02 0.04 0.03 0.03 0.02 0.01 0.01 0.02 0.01 0.01 0.06 0.01 0.01 0.01 0.01 0.02 0.10 0.01 0.05 0.02 0.02 0.00 0.00 0.00 0.05 0.01 0.03 0.02 0.01 0.03 0.02 0.01 0.03 0.02 0.00 0.00 0.00 0.00 0.04 0.02 Mal-Practice RVUs 2.85 1.93 0.92 2.80 2.26 2.41 2.79 2.42 1.83 1.79 2.37 1.90 0.86 0.81 0.82 0.94 1.02 0.94 1.11 0.38 0.45 0.28 0.73 0.26 0.00 0.00 0.00 NA 0.74 4.17 1.72 0.78 3.79 1.51 1.59 1.65 2.24 0.00 0.00 0.00 0.00 1.54 1.01 Fully Implemented NonFacility Total 3.53 2.57 0.96 3.11 2.31 2.25 2.48 2.11 1.69 1.43 1.80 1.53 0.52 1.47 1.02 1.15 1.23 1.03 1.22 6.82 3.37 0.84 0.85 0.55 0.00 0.00 0.00 NA 0.70 3.65 1.67 0.78 4.08 1.66 1.63 1.38 2.22 0.00 0.00 0.00 0.00 1.49 0.90 Year 2007 Transitional Non-Facility Total NA NA 0.92 1.14 1.48 1.44 1.65 1.28 0.86 0.60 0.94 0.60 NA NA 0.46 0.59 0.66 0.46 0.64 NA NA NA 0.41 NA 0.00 0.00 0.00 2.35 0.24 1.14 0.69 0.35 1.49 0.73 0.57 0.99 0.73 0.00 0.00 0.00 0.00 NA NA Fully Implemented Facility Total NA NA 0.96 1.14 1.62 1.46 1.76 1.24 0.94 0.62 0.98 0.61 NA NA 0.51 0.64 0.73 0.51 0.69 NA NA NA 0.46 NA 0.00 0.00 0.00 2.59 0.27 1.25 0.75 0.38 1.61 0.75 0.64 1.13 0.76 0.00 0.00 0.00 0.00 NA NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX 000 XXX XXX XXX XXX 000 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69979 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00358 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... TC .... 26 ..... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A N A A A A A N N A A A A A A A A A A A A A A A Status Spontaneous nystagmus test ............................... Positional nystagmus test .................................... Positional nystagmus test .................................... Positional nystagmus test .................................... Caloric vestibular test ........................................... Caloric vestibular test ........................................... Caloric vestibular test ........................................... Optokinetic nystagmus test .................................. Optokinetic nystagmus test .................................. Optokinetic nystagmus test .................................. Oscillating tracking test ........................................ Oscillating tracking test ........................................ Oscillating tracking test ........................................ Sinusoidal rotational test ...................................... Sinusoidal rotational test ...................................... Sinusoidal rotational test ...................................... Supplemental electrical test ................................. Posturography ...................................................... Posturography ...................................................... Posturography ...................................................... Pure tone hearing test, air ................................... Pure tone audiometry, air .................................... Audiometry, air & bone ........................................ Speech threshold audiometry .............................. Speech audiometry, complete ............................. Comprehensive hearing test ................................ Group audiometric testing .................................... Bekesy audiometry, screen .................................. Bekesy audiometry, diagnosis ............................. Loudness balance test ......................................... Tone decay hearing test ...................................... Sisi hearing test ................................................... Stenger test, pure tone ........................................ Tympanometry ..................................................... Acoustic refl threshold tst ..................................... Acoustic reflex decay test .................................... Filtered speech hearing test ................................ Staggered spondaic word test ............................. Sensorineural acuity test ...................................... Synthetic sentence test ........................................ Stenger test, speech ............................................ Visual audiometry (vra) ........................................ Conditioning play audiometry ............................... Description 0.40 0.33 0.00 0.33 0.10 0.00 0.10 0.26 0.00 0.26 0.23 0.00 0.23 0.29 0.00 0.29 0.00 0.50 0.00 0.50 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Physician Work RVUs 3 0.11 1.24 1.15 0.09 0.64 0.61 0.03 1.00 0.93 0.07 0.98 0.92 0.06 1.80 1.72 0.08 0.11 1.64 1.50 0.14 0.25 0.56 0.71 0.38 0.51 1.26 0.00 0.00 0.68 0.67 0.48 0.43 0.23 0.49 0.15 0.15 0.40 0.60 1.09 0.54 0.24 0.84 1.07 Fully Implemented NonFacility PE RVUs 0.17 1.16 1.02 0.14 0.59 0.54 0.05 0.93 0.82 0.11 0.85 0.75 0.10 1.94 1.82 0.12 0.09 2.10 1.87 0.23 0.25 0.47 0.67 0.38 0.56 1.21 0.00 0.00 0.71 0.48 0.41 0.46 0.36 0.51 0.32 0.35 0.39 0.22 0.50 0.47 0.60 0.76 0.82 Year 2007 Transitional Non-Facility PE RVUs 0.11 NA NA 0.09 NA NA 0.03 NA NA 0.07 NA NA 0.06 NA NA 0.08 0.11 NA NA 0.14 NA NA NA NA NA NA 0.00 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented Facility PE RVUs 0.17 NA NA 0.14 NA NA 0.05 NA NA 0.11 NA NA 0.10 NA NA 0.12 0.09 NA NA 0.23 NA NA NA NA NA NA 0.00 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 92541 92542 92542 92542 92543 92543 92543 92544 92544 92544 92545 92545 92545 92546 92546 92546 92547 92548 92548 92548 92551 92552 92553 92555 92556 92557 92559 92560 92561 92562 92563 92564 92565 92567 92568 92569 92571 92572 92575 92576 92577 92579 92582 HCPCS 2 CPT 1/ 0.02 0.03 0.02 0.01 0.02 0.01 0.01 0.03 0.02 0.01 0.03 0.02 0.01 0.03 0.02 0.01 0.06 0.15 0.13 0.02 0.01 0.04 0.06 0.04 0.06 0.12 0.00 0.00 0.06 0.04 0.04 0.05 0.04 0.06 0.04 0.04 0.04 0.01 0.02 0.05 0.07 0.06 0.06 Mal-Practice RVUs 0.53 1.60 1.17 0.43 0.76 0.62 0.14 1.29 0.95 0.34 1.24 0.94 0.30 2.12 1.74 0.38 0.17 2.29 1.63 0.66 0.26 0.60 0.77 0.42 0.57 1.38 0.00 0.00 0.74 0.71 0.52 0.48 0.27 0.55 0.19 0.19 0.44 0.61 1.11 0.59 0.31 0.90 1.13 Fully Implemented NonFacility Total 0.59 1.52 1.04 0.48 0.71 0.55 0.16 1.22 0.84 0.38 1.11 0.77 0.34 2.26 1.84 0.42 0.15 2.75 2.00 0.75 0.26 0.51 0.73 0.42 0.62 1.33 0.00 0.00 0.77 0.52 0.45 0.51 0.40 0.57 0.36 0.39 0.43 0.23 0.52 0.52 0.67 0.82 0.88 Year 2007 Transitional Non-Facility Total 0.53 NA NA 0.43 NA NA 0.14 NA NA 0.34 NA NA 0.30 NA NA 0.38 0.17 NA NA 0.66 NA NA NA NA NA NA 0.00 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Fully Implemented Facility Total 0.59 NA NA 0.48 NA NA 0.16 NA NA 0.38 NA NA 0.34 NA NA 0.42 0.15 NA NA 0.75 NA NA NA NA NA NA 0.00 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX ZZZ XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69980 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00359 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... TC .... 26 ..... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A N N N N N N A A A A A A B B A A A A A A A A A A A A A A A A I Status Select picture audiometry .................................... Electrocochleography ........................................... Auditor evoke potent, compre .............................. Auditor evoke potent, compre .............................. Auditor evoke potent, compre .............................. Auditor evoke potent, limit ................................... Evoked auditory test ............................................ Evoked auditory test ............................................ Evoked auditory test ............................................ Evoked auditory test ............................................ Evoked auditory test ............................................ Evoked auditory test ............................................ Hearing aid exam, one ear .................................. Hearing aid exam, both ears ............................... Hearing aid check, one ear .................................. Hearing aid check, both ears ............................... Electro hearng aid test, one ................................. Electro hearng aid tst, both .................................. Ear protector evaluation ....................................... Oral speech device eval ...................................... Cochlear implt f/up exam < 7 ............................... Reprogram cochlear implt < 7 ............................. Cochlear implt f/up exam 7 > ............................... Reprogram cochlear implt 7 > ............................. Eval for nonspeech device rx .............................. Non-speech device service .................................. Ex for speech device rx, 1hr ................................ Ex for speech device rx addl ............................... Use of speech device service .............................. Evaluate swallowing function ............................... Motion fluoroscopy/swallow ................................. Endoscopy swallow tst (fees) .............................. Endoscopy swallow tst (fees) .............................. Laryngoscopic sensory test ................................. Eval laryngoscopy sense tst ................................ Fees w/laryngeal sense test ................................ Interprt fees/laryngeal test ................................... Auditory function, 60 min ..................................... Auditory function, + 15 min .................................. Tinnitus assessment ............................................ Eval aud rehab status .......................................... Eval aud status rehab add-on .............................. Aud rehab pre-ling hear loss ............................... Description 0.00 0.00 0.50 0.00 0.50 0.00 0.13 0.00 0.13 0.36 0.00 0.36 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.86 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.27 0.71 1.27 0.63 1.88 0.79 0.00 0.00 0.00 0.00 0.00 0.00 Physician Work RVUs 3 0.69 1.16 1.91 1.77 0.14 1.40 0.62 0.58 0.04 1.02 0.92 0.10 0.00 0.00 0.00 0.00 0.00 0.00 0.93 1.69 4.87 3.34 3.17 2.09 0.00 0.00 4.27 0.86 2.29 1.61 1.85 2.74 0.23 2.24 0.19 2.92 0.23 1.87 0.40 1.82 1.85 0.42 0.00 Fully Implemented NonFacility PE RVUs 0.84 2.14 2.02 1.83 0.19 1.74 1.19 1.13 0.06 1.48 1.33 0.15 0.00 0.00 0.00 0.00 0.00 0.00 0.68 1.69 3.84 2.62 2.40 1.54 0.00 0.00 3.38 0.63 1.77 2.98 3.04 2.74 0.36 2.44 0.31 3.27 0.39 1.32 0.29 1.30 2.11 0.52 0.00 Year 2007 Transitional Non-Facility PE RVUs NA NA NA NA 0.14 NA NA NA 0.04 NA NA 0.10 0.00 0.00 0.00 0.00 0.00 0.00 NA 0.25 NA NA NA NA 0.00 0.00 NA NA NA NA NA 0.37 0.23 0.37 0.19 0.54 0.23 NA NA 1.82 NA 0.42 0.00 Fully Implemented Facility PE RVUs NA NA NA NA 0.19 NA NA NA 0.06 NA NA 0.15 0.00 0.00 0.00 0.00 0.00 0.00 NA 0.40 NA NA NA NA 0.00 0.00 NA NA NA NA NA 0.59 0.35 0.59 0.31 0.88 0.39 NA NA 1.30 NA 0.52 0.00 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 92583 92584 92585 92585 92585 92586 92587 92587 92587 92588 92588 92588 92590 92591 92592 92593 92594 92595 92596 92597 92601 92602 92603 92604 92605 92606 92607 92608 92609 92610 92611 92612 92613 92614 92615 92616 92617 92620 92621 92625 92626 92627 92630 HCPCS 2 CPT 1/ 0.08 0.21 0.17 0.14 0.03 0.14 0.12 0.11 0.01 0.14 0.13 0.01 0.00 0.00 0.00 0.00 0.00 0.00 0.06 0.03 0.07 0.07 0.07 0.07 0.00 0.00 0.05 0.05 0.04 0.08 0.08 0.04 0.05 0.04 0.05 0.06 0.05 0.06 0.06 0.06 0.06 0.02 0.00 Mal-Practice RVUs 0.77 1.37 2.58 1.91 0.67 1.54 0.87 0.69 0.18 1.52 1.05 0.47 0.00 0.00 0.00 0.00 0.00 0.00 0.99 2.58 4.94 3.41 3.24 2.16 0.00 0.00 4.32 0.91 2.33 1.69 1.93 4.05 0.99 3.55 0.87 4.86 1.07 1.93 0.46 1.88 1.91 0.44 0.00 Fully Implemented NonFacility Total 0.92 2.35 2.69 1.97 0.72 1.88 1.44 1.24 0.20 1.98 1.46 0.52 0.00 0.00 0.00 0.00 0.00 0.00 0.74 2.58 3.91 2.69 2.47 1.61 0.00 0.00 3.43 0.68 1.81 3.06 3.12 4.05 1.12 3.75 0.99 5.21 1.23 1.38 0.35 1.36 2.17 0.54 0.00 Year 2007 Transitional Non-Facility Total NA NA NA NA 0.67 NA NA NA 0.18 NA NA 0.47 0.00 0.00 0.00 0.00 0.00 0.00 NA 1.14 NA NA NA NA 0.00 0.00 NA NA NA NA NA 1.68 0.99 1.68 0.87 2.48 1.07 NA NA 1.88 NA 0.44 0.00 Fully Implemented Facility Total NA NA NA NA 0.72 NA NA NA 0.20 NA NA 0.52 0.00 0.00 0.00 0.00 0.00 0.00 NA 1.29 NA NA NA NA 0.00 0.00 NA NA NA NA NA 1.90 1.11 1.90 0.99 2.82 1.23 NA NA 1.36 NA 0.54 0.00 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX ZZZ XXX XXX ZZZ XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69981 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00360 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... TC .... 2 Copyright 3+ Mod I A C A A A A A A A A A A C C A C C A A A A A A A A C C A A A A A A A A A A A A A A A Status Aud rehab postling hear loss ............................... Aud brainstem implt programg ............................. Ent procedure/service .......................................... Heart/lung resuscitation cpr ................................. Temporary external pacing .................................. Cardioversion electric, ext .................................... Cardioversion, electric, int .................................... Cardioassist, internal ............................................ Cardioassist, external ........................................... Percut coronary thrombectomy ............................ Cath place, cardio brachytx ................................. Dissolve clot, heart vessel ................................... Dissolve clot, heart vessel ................................... Intravasc us, heart add-on ................................... Intravasc us, heart add-on ................................... Intravasc us, heart add-on ................................... Intravasc us, heart add-on ................................... Intravasc us, heart add-on ................................... Intravasc us, heart add-on ................................... Insert intracoronary stent ..................................... Insert intracoronary stent ..................................... Coronary artery dilation ........................................ Coronary artery dilation ........................................ Revision of aortic valve ........................................ Revision of mitral valve ........................................ Revision of pulmonary valve ................................ Revision of heart chamber ................................... Revision of heart chamber ................................... Coronary atherectomy .......................................... Coronary atherectomy add-on ............................. Pul art balloon repr, percut .................................. Pul art balloon repr, percut .................................. Electrocardiogram, complete ............................... Electrocardiogram, tracing ................................... Electrocardiogram report ...................................... Transmission of ecg ............................................. Report on transmitted ecg ................................... Cardiovascular stress test .................................... Cardiovascular stress test .................................... Cardiovascular stress test .................................... Cardiovascular stress test .................................... Cardiac drug stress test ....................................... Cardiac drug stress test ....................................... Description 0.00 0.00 0.00 3.79 0.23 2.25 4.59 3.51 1.77 3.28 3.00 7.24 0.00 0.00 0.00 1.80 0.00 0.00 1.44 14.82 4.16 10.96 2.97 22.70 23.48 18.12 0.00 0.00 12.07 3.26 11.98 5.99 0.17 0.00 0.17 0.00 0.52 0.75 0.45 0.00 0.30 1.17 0.00 Physician Work RVUs 3 0.00 1.40 0.00 3.24 NA 4.40 NA NA NA NA NA NA 1.70 NA NA 1.00 NA NA 0.80 NA NA NA NA NA NA NA 0.00 0.00 NA NA NA NA 0.34 0.27 0.07 4.15 0.21 1.91 0.23 1.53 0.15 2.41 1.82 Fully Implemented NonFacility PE RVUs 0.00 1.40 0.00 3.96 NA 5.83 NA NA NA NA NA NA 6.46 NA NA 0.78 NA NA 0.62 NA NA NA NA NA NA NA 0.00 0.00 NA NA NA NA 0.47 0.41 0.06 5.55 0.20 1.95 0.19 1.64 0.12 1.79 1.30 Year 2007 Transitional Non-Facility PE RVUs 0.00 1.40 0.00 0.79 0.07 1.48 2.52 1.63 1.09 1.82 1.70 3.94 NA NA NA 1.00 NA NA 0.80 8.43 2.31 6.30 1.64 15.88 16.33 11.32 0.00 0.00 6.92 1.81 5.27 2.79 NA NA 0.07 NA 0.21 NA 0.23 NA 0.15 NA NA Fully Implemented Facility PE RVUs 0.00 1.40 0.00 0.93 0.07 1.25 2.19 1.20 0.91 1.42 1.31 3.09 NA NA NA 0.78 NA NA 0.62 6.65 1.80 4.97 1.28 12.84 13.24 10.17 0.00 0.00 5.45 1.41 4.93 2.35 NA NA 0.06 NA 0.20 NA 0.19 NA 0.12 NA NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 92633 92640 92700 92950 92953 92960 92961 92970 92971 92973 92974 92975 92977 92978 92978 92978 92979 92979 92979 92980 92981 92982 92984 92986 92987 92990 92992 92993 92995 92996 92997 92998 93000 93005 93010 93012 93014 93015 93016 93017 93018 93024 93024 HCPCS 2 CPT 1/ 0.00 0.01 0.00 0.28 0.02 0.07 0.29 0.16 0.06 0.23 0.21 0.50 0.46 0.00 0.00 0.06 0.00 0.00 0.06 1.03 0.29 0.76 0.21 1.51 1.59 1.20 0.00 0.00 0.84 0.10 0.40 0.28 0.03 0.02 0.01 0.18 0.02 0.14 0.02 0.11 0.01 0.12 0.08 Mal-Practice RVUs 0.00 1.41 0.00 7.31 NA 6.72 NA NA NA NA NA NA 2.16 NA NA 2.86 NA NA 2.30 NA NA NA NA NA NA NA 0.00 0.00 NA NA NA NA 0.54 0.29 0.25 4.33 0.75 2.80 0.70 1.64 0.46 3.70 1.90 Fully Implemented NonFacility Total 0.00 1.41 0.00 8.03 NA 8.15 NA NA NA NA NA NA 6.92 NA NA 2.64 NA NA 2.12 NA NA NA NA NA NA NA 0.00 0.00 NA NA NA NA 0.67 0.43 0.24 5.73 0.74 2.84 0.66 1.75 0.43 3.08 1.38 Year 2007 Transitional Non-Facility Total 0.00 1.41 0.00 4.86 0.32 3.80 7.40 5.30 2.92 5.33 4.91 11.68 NA NA NA 2.86 NA NA 2.30 24.28 6.76 18.02 4.82 40.09 41.40 30.64 0.00 0.00 19.83 5.17 17.65 9.06 NA NA 0.25 NA 0.75 NA 0.70 NA 0.46 NA NA Fully Implemented Facility Total 0.00 1.41 0.00 5.00 0.32 3.57 7.07 4.87 2.74 4.93 4.52 10.83 NA NA NA 2.64 NA NA 2.12 22.50 6.25 16.69 4.46 37.05 38.31 29.49 0.00 0.00 18.36 4.77 17.31 8.62 NA NA 0.24 NA 0.74 NA 0.66 NA 0.43 NA NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX 000 000 000 000 000 000 ZZZ ZZZ 000 XXX ZZZ ZZZ ZZZ ZZZ ZZZ ZZZ 000 ZZZ 000 ZZZ 090 090 090 090 090 000 ZZZ 000 ZZZ XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69982 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00361 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 26 ..... .......... TC .... 26 ..... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... TC .... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A C A A A A A A A A A A A A A A A A A A A A A A A A A A Status Cardiac drug stress test ....................................... Microvolt t-wave assess ....................................... Microvolt t-wave assess ....................................... Microvolt t-wave assess ....................................... Rhythm ECG with report ...................................... Rhythm ECG, tracing ........................................... Rhythm ECG, report ............................................ ECG monitor/report, 24 hrs .................................. ECG monitor/record, 24 hrs ................................. ECG monitor/report, 24 hrs .................................. ECG monitor/review, 24 hrs ................................. ECG monitor/report, 24 hrs .................................. Ecg monitor/record, 24 hrs .................................. ECG monitor/report, 24 hrs .................................. ECG monitor/review, 24 hrs ................................. ECG monitor/report, 24 hrs .................................. ECG monitor/report, 24 hrs .................................. ECG monitor/review, 24 hrs ................................. ECG record/review ............................................... ECG recording ..................................................... Ecg/monitoring and analysis ................................ Ecg/review, interpret only ..................................... ECG/signal-averaged ........................................... ECG/signal-averaged ........................................... ECG/signal-averaged ........................................... Echo transthoracic ............................................... Echo transthoracic ............................................... Echo transthoracic ............................................... Echo transthoracic ............................................... Echo transthoracic ............................................... Echo transthoracic ............................................... Echo exam of heart .............................................. Echo exam of heart .............................................. Echo exam of heart .............................................. Echo exam of heart .............................................. Echo exam of heart .............................................. Echo exam of heart .............................................. Echo transesophageal ......................................... Echo transesophageal ......................................... Echo transesophageal ......................................... Echo transesophageal ......................................... Echo transesophageal ......................................... Echo transesophageal ......................................... Description 1.17 0.75 0.00 0.75 0.16 0.00 0.16 0.52 0.00 0.00 0.52 0.52 0.00 0.00 0.52 0.45 0.00 0.45 0.52 0.00 0.00 0.52 0.25 0.00 0.25 1.30 0.00 1.30 0.75 0.00 0.75 0.92 0.00 0.92 0.53 0.00 0.53 2.20 0.00 2.20 0.95 1.25 0.00 Physician Work RVUs 3 0.59 3.90 3.52 0.38 0.19 0.14 0.05 2.32 1.06 0.98 0.28 2.28 0.92 1.13 0.23 0.22 0.00 0.22 5.75 0.29 5.24 0.22 0.61 0.51 0.10 4.60 4.02 0.58 3.16 2.84 0.32 3.75 3.28 0.47 2.63 2.35 0.28 7.51 6.48 1.03 NA 7.21 6.63 Fully Implemented NonFacility PE RVUs 0.49 6.67 6.36 0.31 0.20 0.15 0.05 3.29 1.20 1.88 0.21 3.49 1.37 1.92 0.20 2.15 0.00 0.18 7.02 1.00 5.82 0.20 1.09 0.99 0.10 4.41 3.90 0.51 2.46 2.17 0.29 4.10 3.72 0.38 2.26 2.04 0.22 5.31 4.46 0.85 NA 4.99 4.49 Year 2007 Transitional Non-Facility PE RVUs 0.59 NA NA 0.38 NA NA 0.05 NA NA NA 0.28 NA NA NA 0.23 NA NA 0.22 NA NA NA 0.22 NA NA 0.10 NA NA 0.58 NA NA 0.32 NA NA 0.47 NA NA 0.28 NA NA 1.03 0.14 NA NA Fully Implemented Facility PE RVUs 0.49 NA NA 0.31 NA NA 0.05 NA NA NA 0.21 NA NA NA 0.20 NA NA 0.18 NA NA NA 0.20 NA NA 0.10 NA NA 0.51 NA NA 0.29 NA NA 0.38 NA NA 0.22 NA NA 0.85 0.19 NA NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 93024 93025 93025 93025 93040 93041 93042 93224 93225 93226 93227 93230 93231 93232 93233 93235 93236 93237 93268 93270 93271 93272 93278 93278 93278 93303 93303 93303 93304 93304 93304 93307 93307 93307 93308 93308 93308 93312 93312 93312 93313 93314 93314 HCPCS 2 CPT 1/ 0.04 0.14 0.11 0.03 0.02 0.01 0.01 0.24 0.08 0.14 0.02 0.26 0.11 0.13 0.02 0.16 0.00 0.02 0.28 0.08 0.18 0.02 0.12 0.11 0.01 0.27 0.23 0.04 0.15 0.13 0.02 0.26 0.23 0.03 0.15 0.13 0.02 0.37 0.29 0.08 0.06 0.33 0.29 Mal-Practice RVUs 1.80 4.79 3.63 1.16 0.37 0.15 0.22 3.08 1.14 1.12 0.82 3.06 1.03 1.26 0.77 0.83 0.00 0.69 6.55 0.37 5.42 0.76 0.98 0.62 0.36 6.17 4.25 1.92 4.06 2.97 1.09 4.93 3.51 1.42 3.31 2.48 0.83 10.08 6.77 3.31 NA 8.79 6.92 Fully Implemented NonFacility Total 1.70 7.56 6.47 1.09 0.38 0.16 0.22 4.05 1.28 2.02 0.75 4.27 1.48 2.05 0.74 2.76 0.00 0.65 7.82 1.08 6.00 0.74 1.46 1.10 0.36 5.98 4.13 1.85 3.36 2.30 1.06 5.28 3.95 1.33 2.94 2.17 0.77 7.88 4.75 3.13 NA 6.57 4.78 Year 2007 Transitional Non-Facility Total 1.80 NA NA 1.16 NA NA 0.22 NA NA NA 0.82 NA NA NA 0.77 NA NA 0.69 NA NA NA 0.76 NA NA 0.36 NA NA 1.92 NA NA 1.09 NA NA 1.42 NA NA 0.83 NA NA 3.31 1.15 NA NA Fully Implemented Facility Total 1.70 NA NA 1.09 NA NA 0.22 NA NA NA 0.75 NA NA NA 0.74 NA NA 0.65 NA NA NA 0.74 NA NA 0.36 NA NA 1.85 NA NA 1.06 NA NA 1.33 NA NA 0.77 NA NA 3.13 1.20 NA NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69983 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00362 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 26 ..... .......... TC .... 26 ..... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... 2 Copyright 3+ Mod A C C A A C C A C C A A A A A A A A A A A A A C C A C C C A C C A C C A C C A C C A C Status Echo transesophageal ......................................... Echo transesophageal ......................................... Echo transesophageal ......................................... Echo transesophageal ......................................... Echo transesophageal ......................................... Echo transesophageal ......................................... Echo transesophageal ......................................... Echo transesophageal ......................................... Echo transesophageal intraop ............................. Echo transesophageal intraop ............................. Echo transesophageal intraop ............................. Doppler echo exam, heart ................................... Doppler echo exam, heart ................................... Doppler echo exam, heart ................................... Doppler echo exam, heart ................................... Doppler echo exam, heart ................................... Doppler echo exam, heart ................................... Doppler color flow add-on .................................... Doppler color flow add-on .................................... Doppler color flow add-on .................................... Echo transthoracic ............................................... Echo transthoracic ............................................... Echo transthoracic ............................................... Right heart catheterization ................................... Right heart catheterization ................................... Right heart catheterization ................................... Insert/place heart catheter ................................... Biopsy of heart lining ........................................... Biopsy of heart lining ........................................... Biopsy of heart lining ........................................... Cath placement, angiography .............................. Cath placement, angiography .............................. Cath placement, angiography .............................. Left heart catheterization ..................................... Left heart catheterization ..................................... Left heart catheterization ..................................... Left heart catheterization ..................................... Left heart catheterization ..................................... Left heart catheterization ..................................... Left heart catheterization ..................................... Left heart catheterization ..................................... Left heart catheterization ..................................... Left heart catheterization ..................................... Description 1.25 0.00 0.00 2.78 0.95 0.00 0.00 1.83 0.00 0.00 2.20 0.38 0.00 0.38 0.15 0.00 0.15 0.07 0.00 0.07 1.48 0.00 1.48 0.00 0.00 3.02 0.00 0.00 0.00 4.37 0.00 0.00 4.09 0.00 0.00 4.32 0.00 0.00 5.02 0.00 0.00 7.04 0.00 Physician Work RVUs 3 0.58 0.00 0.00 1.35 NA 0.00 0.00 0.76 0.00 0.00 0.91 1.68 1.49 0.19 0.62 0.54 0.08 0.66 0.63 0.03 5.12 4.33 0.79 0.00 0.00 1.64 NA 0.00 0.00 2.37 0.00 0.00 2.27 0.00 0.00 2.38 NA NA 2.67 0.00 0.00 3.20 NA Fully Implemented NonFacility PE RVUs 0.50 0.00 0.00 1.10 NA 0.00 0.00 0.69 0.00 0.00 0.59 1.82 1.66 0.16 1.04 0.97 0.07 2.36 2.33 0.03 3.03 2.40 0.63 0.00 0.00 1.27 NA 0.00 0.00 1.85 0.00 0.00 2.13 0.00 0.00 2.22 NA NA 2.50 0.00 0.00 3.14 NA Year 2007 Transitional Non-Facility PE RVUs 0.58 0.00 0.00 1.35 0.26 0.00 0.00 0.76 0.00 0.00 0.91 1.68 1.49 0.19 0.62 0.54 0.08 0.66 0.63 0.03 NA NA 0.79 0.00 0.00 1.64 0.00 0.00 0.00 2.37 0.00 0.00 2.27 0.00 0.00 2.38 0.00 0.00 2.67 0.00 0.00 3.20 0.00 Fully Implemented Facility PE RVUs 0.50 0.00 0.00 1.10 0.25 0.00 0.00 0.69 0.00 0.00 0.59 1.82 1.66 0.16 1.04 0.97 0.07 2.36 2.33 0.03 NA NA 0.63 0.00 0.00 1.27 0.00 0.00 0.00 1.85 0.00 0.00 2.13 0.00 0.00 2.22 0.00 0.00 2.50 0.00 0.00 3.14 0.00 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 93314 93315 93315 93315 93316 93317 93317 93317 93318 93318 93318 93320 93320 93320 93321 93321 93321 93325 93325 93325 93350 93350 93350 93501 93501 93501 93503 93505 93505 93505 93508 93508 93508 93510 93510 93510 93511 93511 93511 93514 93514 93514 93524 HCPCS 2 CPT 1/ 0.04 0.00 0.00 0.09 0.05 0.00 0.00 0.08 0.00 0.00 0.14 0.13 0.12 0.01 0.09 0.08 0.01 0.22 0.21 0.01 0.18 0.13 0.05 0.00 0.00 0.21 0.00 0.00 0.00 0.30 0.00 0.00 0.28 0.00 0.00 0.30 0.00 0.00 0.35 0.00 0.00 0.49 0.00 Mal-Practice RVUs 1.87 0.00 0.00 4.22 NA 0.00 0.00 2.67 0.00 0.00 3.25 2.19 1.61 0.58 0.86 0.62 0.24 0.95 0.84 0.11 6.78 4.46 2.32 0.00 0.00 4.87 NA 0.00 0.00 7.04 0.00 0.00 6.64 0.00 0.00 7.00 NA NA 8.04 0.00 0.00 10.73 NA Fully Implemented NonFacility Total 1.79 0.00 0.00 3.97 NA 0.00 0.00 2.60 0.00 0.00 2.93 2.33 1.78 0.55 1.28 1.05 0.23 2.65 2.54 0.11 4.69 2.53 2.16 0.00 0.00 4.50 NA 0.00 0.00 6.52 0.00 0.00 6.50 0.00 0.00 6.84 NA NA 7.87 0.00 0.00 10.67 NA Year 2007 Transitional Non-Facility Total 1.87 0.00 0.00 4.22 1.26 0.00 0.00 2.67 0.00 0.00 3.25 2.19 1.61 0.58 0.86 0.62 0.24 0.95 0.84 0.11 NA NA 2.32 0.00 0.00 4.87 0.00 0.00 0.00 7.04 0.00 0.00 6.64 0.00 0.00 7.00 0.00 0.00 8.04 0.00 0.00 10.73 0.00 Fully Implemented Facility Total 1.79 0.00 0.00 3.97 1.25 0.00 0.00 2.60 0.00 0.00 2.93 2.33 1.78 0.55 1.28 1.05 0.23 2.65 2.54 0.11 NA NA 2.16 0.00 0.00 4.50 0.00 0.00 0.00 6.52 0.00 0.00 6.50 0.00 0.00 6.84 0.00 0.00 7.87 0.00 0.00 10.67 0.00 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX ZZZ ZZZ ZZZ ZZZ ZZZ ZZZ ZZZ ZZZ ZZZ XXX XXX XXX 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 Global 69984 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00363 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... .......... .......... .......... .......... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... 2 Copyright 3+ Mod C A C C A C C A C C A C C A C C A C C A C C A C C A C C C C C C C C C A C C A C C A C Status Left heart catheterization ..................................... Left heart catheterization ..................................... Rt & Lt heart catheters ......................................... Rt & Lt heart catheters ......................................... Rt & Lt heart catheters ......................................... Rt & Lt heart catheters ......................................... Rt & Lt heart catheters ......................................... Rt & Lt heart catheters ......................................... Rt & Lt heart catheters ......................................... Rt & Lt heart catheters ......................................... Rt & Lt heart catheters ......................................... Rt, lt heart catheterization .................................... Rt, lt heart catheterization .................................... Rt, lt heart catheterization .................................... Rt heart cath, congenital ...................................... Rt heart cath, congenital ...................................... Rt heart cath, congenital ...................................... R & l heart cath, congenital ................................. R & l heart cath, congenital ................................. R & l heart cath, congenital ................................. R & l heart cath, congenital ................................. R & l heart cath, congenital ................................. R & l heart cath, congenital ................................. R & l heart cath, congenital ................................. R & l heart cath, congenital ................................. R & l heart cath, congenital ................................. Injection, cardiac cath .......................................... Injection, cardiac cath .......................................... Injection for lung angiogram ................................ Injection for heart x-rays ...................................... Injection for heart x-rays ...................................... Injection for aortography ...................................... Inject for coronary x-rays ..................................... Imaging, cardiac cath ........................................... Imaging, cardiac cath ........................................... Imaging, cardiac cath ........................................... Imaging, cardiac cath ........................................... Imaging, cardiac cath ........................................... Imaging, cardiac cath ........................................... Cardiac output measurement ............................... Cardiac output measurement ............................... Cardiac output measurement ............................... Cardiac output measurement ............................... Description 0.00 6.94 0.00 0.00 5.98 0.00 0.00 7.27 0.00 0.00 8.99 0.00 0.00 4.79 0.00 0.00 4.22 0.00 0.00 8.34 0.00 0.00 9.99 0.00 0.00 6.69 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.81 0.00 0.00 0.83 0.00 0.00 0.50 0.00 Physician Work RVUs 3 NA 3.79 0.00 0.00 3.29 NA NA 4.03 NA NA 4.68 NA NA 2.64 NA NA 1.87 NA NA 3.77 0.00 0.00 4.09 0.00 0.00 3.09 NA NA NA NA NA NA NA 0.00 0.00 0.45 0.00 0.00 0.46 NA NA 0.14 NA Fully Implemented NonFacility PE RVUs NA 3.33 0.00 0.00 2.93 NA NA 3.49 NA NA 4.19 NA NA 2.36 NA NA 1.92 NA NA 3.63 0.00 0.00 4.21 0.00 0.00 2.87 NA NA NA NA NA NA NA 0.00 0.00 0.35 0.00 0.00 0.36 NA NA 0.16 NA Year 2007 Transitional Non-Facility PE RVUs 0.00 3.79 0.00 0.00 3.29 0.00 0.00 4.03 0.00 0.00 4.68 0.00 0.00 2.64 0.00 0.00 1.87 0.00 0.00 3.77 0.00 0.00 4.09 0.00 0.00 3.09 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NA NA 0.45 NA NA 0.46 NA NA 0.14 NA Fully Implemented Facility PE RVUs 0.00 3.33 0.00 0.00 2.93 0.00 0.00 3.49 0.00 0.00 4.19 0.00 0.00 2.36 0.00 0.00 1.92 0.00 0.00 3.63 0.00 0.00 4.21 0.00 0.00 2.87 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NA NA 0.35 NA NA 0.36 NA NA 0.16 NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 93524 93524 93526 93526 93526 93527 93527 93527 93528 93528 93528 93529 93529 93529 93530 93530 93530 93531 93531 93531 93532 93532 93532 93533 93533 93533 93539 93540 93541 93542 93543 93544 93545 93555 93555 93555 93556 93556 93556 93561 93561 93561 93562 HCPCS 2 CPT 1/ 0.00 0.48 0.00 0.00 0.42 0.00 0.00 0.51 0.00 0.00 0.62 0.00 0.00 0.33 0.00 0.00 0.29 0.00 0.00 0.58 0.00 0.00 0.69 0.00 0.00 0.47 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.03 0.00 0.00 0.03 0.00 0.00 0.02 0.00 Mal-Practice RVUs NA 11.21 0.00 0.00 9.69 NA NA 11.81 NA NA 14.29 NA NA 7.76 NA NA 6.38 NA NA 12.69 0.00 0.00 14.77 0.00 0.00 10.25 NA NA NA NA NA NA NA 0.00 0.00 1.29 0.00 0.00 1.32 NA NA 0.66 NA Fully Implemented NonFacility Total NA 10.75 0.00 0.00 9.33 NA NA 11.27 NA NA 13.80 NA NA 7.48 NA NA 6.43 NA NA 12.55 0.00 0.00 14.89 0.00 0.00 10.03 NA NA NA NA NA NA NA 0.00 0.00 1.19 0.00 0.00 1.22 NA NA 0.68 NA Year 2007 Transitional Non-Facility Total 0.00 11.21 0.00 0.00 9.69 0.00 0.00 11.81 0.00 0.00 14.29 0.00 0.00 7.76 0.00 0.00 6.38 0.00 0.00 12.69 0.00 0.00 14.77 0.00 0.00 10.25 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NA NA 1.29 NA NA 1.32 NA NA 0.66 NA Fully Implemented Facility Total 0.00 10.75 0.00 0.00 9.33 0.00 0.00 11.27 0.00 0.00 13.80 0.00 0.00 7.48 0.00 0.00 6.43 0.00 0.00 12.55 0.00 0.00 14.89 0.00 0.00 10.03 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NA NA 1.19 NA NA 1.22 NA NA 0.68 NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 XXX XXX XXX XXX XXX XXX 000 000 000 000 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69985 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00364 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 2 Copyright 3+ Mod C A C C A C C A A A C C A C C A C C A C C A C C A C C A A C C A C C A C C A C C A C C Status Cardiac output measurement ............................... Cardiac output measurement ............................... Heart flow reserve measure ................................. Heart flow reserve measure ................................. Heart flow reserve measure ................................. Heart flow reserve measure ................................. Heart flow reserve measure ................................. Heart flow reserve measure ................................. Transcath closure of asd ..................................... Transcath closure of vsd ...................................... Bundle of His recording ....................................... Bundle of His recording ....................................... Bundle of His recording ....................................... Intra-atrial recording ............................................. Intra-atrial recording ............................................. Intra-atrial recording ............................................. Right ventricular recording ................................... Right ventricular recording ................................... Right ventricular recording ................................... Map tachycardia, add-on ..................................... Map tachycardia, add-on ..................................... Map tachycardia, add-on ..................................... Intra-atrial pacing ................................................. Intra-atrial pacing ................................................. Intra-atrial pacing ................................................. Intraventricular pacing .......................................... Intraventricular pacing .......................................... Intraventricular pacing .......................................... Electrophys map 3d, add-on ................................ Esophageal recording .......................................... Esophageal recording .......................................... Esophageal recording .......................................... Esophageal recording .......................................... Esophageal recording .......................................... Esophageal recording .......................................... Heart rhythm pacing ............................................. Heart rhythm pacing ............................................. Heart rhythm pacing ............................................. Electrophysiology evaluation ................................ Electrophysiology evaluation ................................ Electrophysiology evaluation ................................ Electrophysiology evaluation ................................ Electrophysiology evaluation ................................ Description 0.00 0.16 0.00 0.00 1.80 0.00 0.00 1.44 17.97 24.39 0.00 0.00 2.12 0.00 0.00 2.12 0.00 0.00 2.12 0.00 0.00 4.99 0.00 0.00 3.02 0.00 0.00 3.02 6.99 0.00 0.00 0.99 0.00 0.00 1.49 0.00 0.00 4.25 0.00 0.00 7.31 0.00 0.00 Physician Work RVUs 3 NA 0.03 NA NA 0.99 0.00 0.00 0.75 NA NA NA NA 1.11 NA NA 1.09 NA NA 1.08 NA NA 2.73 NA NA 1.53 NA NA 1.48 NA NA NA 0.49 0.00 0.00 0.43 NA NA 2.36 NA NA 3.93 0.00 0.00 Fully Implemented NonFacility PE RVUs NA 0.05 NA NA 0.76 0.00 0.00 0.56 NA NA NA NA 0.90 NA NA 0.89 NA NA 0.88 NA NA 2.15 NA NA 1.25 NA NA 1.24 NA NA NA 0.33 0.00 0.00 0.43 NA NA 1.84 NA NA 3.37 0.00 0.00 Year 2007 Transitional Non-Facility PE RVUs NA 0.03 NA NA 0.99 0.00 0.00 0.75 9.73 13.39 NA NA 1.11 NA NA 1.09 NA NA 1.08 NA NA 2.73 NA NA 1.53 NA NA 1.48 3.83 NA NA 0.49 0.00 0.00 0.43 NA NA 2.36 NA NA 3.93 0.00 0.00 Fully Implemented Facility PE RVUs NA 0.05 NA NA 0.76 0.00 0.00 0.56 7.97 10.39 NA NA 0.90 NA NA 0.89 NA NA 0.88 NA NA 2.15 NA NA 1.25 NA NA 1.24 3.03 NA NA 0.33 0.00 0.00 0.43 NA NA 1.84 NA NA 3.37 0.00 0.00 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 93562 93562 93571 93571 93571 93572 93572 93572 93580 93581 93600 93600 93600 93602 93602 93602 93603 93603 93603 93609 93609 93609 93610 93610 93610 93612 93612 93612 93613 93615 93615 93615 93616 93616 93616 93618 93618 93618 93619 93619 93619 93620 93620 HCPCS 2 CPT 1/ 0.00 0.01 0.00 0.00 0.06 0.00 0.00 0.04 1.25 1.72 0.00 0.00 0.16 0.00 0.00 0.17 0.00 0.00 0.18 0.00 0.00 0.35 0.00 0.00 0.24 0.00 0.00 0.25 0.49 0.00 0.00 0.03 0.00 0.00 0.09 0.00 0.00 0.30 0.00 0.00 0.51 0.00 0.00 Mal-Practice RVUs NA 0.20 NA NA 2.85 0.00 0.00 2.23 NA NA NA NA 3.39 NA NA 3.38 NA NA 3.38 NA NA 8.07 NA NA 4.79 NA NA 4.75 NA NA NA 1.51 0.00 0.00 2.01 NA NA 6.91 NA NA 11.75 0.00 0.00 Fully Implemented NonFacility Total NA 0.22 NA NA 2.62 0.00 0.00 2.04 NA NA NA NA 3.18 NA NA 3.18 NA NA 3.18 NA NA 7.49 NA NA 4.51 NA NA 4.51 NA NA NA 1.35 0.00 0.00 2.01 NA NA 6.39 NA NA 11.19 0.00 0.00 Year 2007 Transitional Non-Facility Total NA 0.20 NA NA 2.85 0.00 0.00 2.23 28.95 39.50 NA NA 3.39 NA NA 3.38 NA NA 3.38 NA NA 8.07 NA NA 4.79 NA NA 4.75 11.31 NA NA 1.51 0.00 0.00 2.01 NA NA 6.91 NA NA 11.75 0.00 0.00 Fully Implemented Facility Total NA 0.22 NA NA 2.62 0.00 0.00 2.04 27.19 36.50 NA NA 3.18 NA NA 3.18 NA NA 3.18 NA NA 7.49 NA NA 4.51 NA NA 4.51 10.51 NA NA 1.35 0.00 0.00 2.01 NA NA 6.39 NA NA 11.19 0.00 0.00 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 000 000 ZZZ ZZZ ZZZ ZZZ ZZZ ZZZ 000 000 000 000 000 000 000 000 000 000 000 ZZZ ZZZ ZZZ 000 000 000 000 000 000 ZZZ 000 000 000 000 000 000 000 000 000 000 000 000 000 000 Global 69986 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00365 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... TC .... 26 ..... .......... .......... .......... .......... TC .... 2 Copyright 3+ Mod A C C A C C A C C A A A A C C A C C A C C A A A A A A A A A A C C A N A A A A A A A A Status Electrophysiology evaluation ................................ Electrophysiology evaluation ................................ Electrophysiology evaluation ................................ Electrophysiology evaluation ................................ Electrophysiology evaluation ................................ Electrophysiology evaluation ................................ Electrophysiology evaluation ................................ Stimulation, pacing heart ..................................... Stimulation, pacing heart ..................................... Stimulation, pacing heart ..................................... Electrophysiologic study ....................................... Electrophysiologic study ....................................... Electrophysiologic study ....................................... Heart pacing, mapping ......................................... Heart pacing, mapping ......................................... Heart pacing, mapping ......................................... Evaluation heart device ........................................ Evaluation heart device ........................................ Evaluation heart device ........................................ Electrophysiology evaluation ................................ Electrophysiology evaluation ................................ Electrophysiology evaluation ................................ Electrophysiology evaluation ................................ Electrophysiology evaluation ................................ Electrophysiology evaluation ................................ Ablate heart dysrhythm focus .............................. Ablate heart dysrhythm focus .............................. Ablate heart dysrhythm focus .............................. Tilt table evaluation .............................................. Tilt table evaluation .............................................. Tilt table evaluation .............................................. Intracardiac ecg (ice) ........................................... Intracardiac ecg (ice) ........................................... Intracardiac ecg (ice) ........................................... Peripheral vascular rehab .................................... Bioimpedance, thoracic ........................................ Bioimpedance, thoracic ........................................ Bioimpedance, thoracic ........................................ Total body plethysmography ................................ Plethysmography tracing ...................................... Plethysmography report ....................................... Analyze pacemaker system ................................. Analyze pacemaker system ................................. Description 11.57 0.00 0.00 2.10 0.00 0.00 3.10 0.00 0.00 2.85 4.80 0.00 4.80 0.00 0.00 7.59 0.00 0.00 3.51 0.00 0.00 5.92 4.88 0.00 4.88 10.49 16.23 17.65 1.89 0.00 1.89 0.00 0.00 2.80 0.00 0.17 0.00 0.17 0.17 0.00 0.17 4.88 0.00 Physician Work RVUs 3 6.34 0.00 0.00 1.15 0.00 0.00 1.68 0.00 0.00 1.56 NA NA 2.67 0.00 0.00 2.76 NA NA 1.92 NA NA 3.23 7.45 4.77 2.68 NA NA NA 3.05 2.04 1.01 0.00 0.00 1.53 0.40 0.70 0.64 0.06 1.19 1.14 0.05 3.53 0.91 Fully Implemented NonFacility PE RVUs 5.22 0.00 0.00 0.90 0.00 0.00 1.33 0.00 0.00 1.22 NA NA 2.31 0.00 0.00 2.77 NA NA 1.50 NA NA 2.54 8.90 6.57 2.33 NA NA NA 2.58 1.77 0.81 0.00 0.00 1.22 0.40 0.91 0.84 0.07 0.87 0.82 0.05 5.29 3.20 Year 2007 Transitional Non-Facility PE RVUs 6.34 0.00 0.00 1.15 0.00 0.00 1.68 0.00 0.00 1.56 2.67 0.00 2.67 0.00 0.00 2.76 NA NA 1.92 NA NA 3.23 7.45 4.77 2.68 6.06 8.88 9.68 3.05 2.04 1.01 0.00 0.00 1.53 NA NA NA 0.06 NA NA 0.05 3.53 0.91 Fully Implemented Facility PE RVUs 5.22 0.00 0.00 0.90 0.00 0.00 1.33 0.00 0.00 1.22 4.29 1.98 2.31 0.00 0.00 2.77 NA NA 1.50 NA NA 2.54 8.90 6.57 2.33 4.84 6.96 7.58 2.58 1.77 0.81 0.00 0.00 1.22 NA NA NA 0.07 NA NA 0.05 5.29 3.20 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 93620 93621 93621 93621 93622 93622 93622 93623 93623 93623 93624 93624 93624 93631 93631 93631 93640 93640 93640 93641 93641 93641 93642 93642 93642 93650 93651 93652 93660 93660 93660 93662 93662 93662 93668 93701 93701 93701 93720 93721 93722 93724 93724 HCPCS 2 CPT 1/ 0.80 0.00 0.00 0.15 0.00 0.00 0.22 0.00 0.00 0.20 0.46 0.13 0.33 0.00 0.00 0.97 0.00 0.00 0.24 0.00 0.00 0.41 0.57 0.42 0.15 0.73 1.13 1.23 0.08 0.02 0.06 0.00 0.00 0.09 0.01 0.02 0.01 0.01 0.07 0.06 0.01 0.39 0.24 Mal-Practice RVUs 18.71 0.00 0.00 3.40 0.00 0.00 5.00 0.00 0.00 4.61 NA NA 7.80 0.00 0.00 11.32 NA NA 5.67 NA NA 9.56 12.90 5.19 7.71 NA NA NA 5.02 2.06 2.96 0.00 0.00 4.42 0.41 0.89 0.65 0.24 1.43 1.20 0.23 8.80 1.15 Fully Implemented NonFacility Total 17.59 0.00 0.00 3.15 0.00 0.00 4.65 0.00 0.00 4.27 NA NA 7.44 0.00 0.00 11.33 NA NA 5.25 NA NA 8.87 14.35 6.99 7.36 NA NA NA 4.55 1.79 2.76 0.00 0.00 4.11 0.41 1.10 0.85 0.25 1.11 0.88 0.23 10.56 3.44 Year 2007 Transitional Non-Facility Total 18.71 0.00 0.00 3.40 0.00 0.00 5.00 0.00 0.00 4.61 7.93 0.13 7.80 0.00 0.00 11.32 NA NA 5.67 NA NA 9.56 12.90 5.19 7.71 17.28 26.24 28.56 5.02 2.06 2.96 0.00 0.00 4.42 NA NA NA 0.24 NA NA 0.23 8.80 1.15 Fully Implemented Facility Total 17.59 0.00 0.00 3.15 0.00 0.00 4.65 0.00 0.00 4.27 9.55 2.11 7.44 0.00 0.00 11.33 NA NA 5.25 NA NA 8.87 14.35 6.99 7.36 16.06 24.32 26.46 4.55 1.79 2.76 0.00 0.00 4.11 NA NA NA 0.25 NA NA 0.23 10.56 3.44 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 000 ZZZ ZZZ ZZZ ZZZ ZZZ ZZZ ZZZ ZZZ ZZZ 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 000 ZZZ ZZZ ZZZ XXX XXX XXX XXX XXX XXX XXX 000 000 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69987 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00366 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 26 ..... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... .......... TC .... 26 ..... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A B B B A A A A A A A A A A A A C C C N N B B B Status Analyze pacemaker system ................................. Analyze ilr system ................................................ Analyze pacemaker system ................................. Analyze pacemaker system ................................. Analyze pacemaker system ................................. Analyze pacemaker system ................................. Analyze pacemaker system ................................. Analyze pacemaker system ................................. Telephone analy, pacemaker ............................... Telephone analy, pacemaker ............................... Telephone analy, pacemaker ............................... Analyze pacemaker system ................................. Analyze pacemaker system ................................. Analyze pacemaker system ................................. Analyze pacemaker system ................................. Analyze pacemaker system ................................. Analyze pacemaker system ................................. Telephonic analy, pacemaker .............................. Telephonic analy, pacemaker .............................. Telephonic analy, pacemaker .............................. Temperature gradient studies .............................. Temperature gradient studies .............................. Temperature gradient studies .............................. Analyze ht pace device sngl ................................ Analyze ht pace device sngl ................................ Analyze ht pace device sngl ................................ Analyze ht pace device sngl ................................ Analyze ht pace device sngl ................................ Analyze ht pace device sngl ................................ Analyze ht pace device dual ................................ Analyze ht pace device dual ................................ Analyze ht pace device dual ................................ Analyze ht pace device dual ................................ Analyze ht pace device dual ................................ Analyze ht pace device dual ................................ Set-up cardiovert-defibrill ..................................... Set-up cardiovert-defibrill ..................................... Set-up cardiovert-defibrill ..................................... Cephalic thermogram ........................................... Peripheral thermogram ........................................ Measure venous pressure ................................... Measure venous pressure ................................... Measure venous pressure ................................... Description 4.88 0.52 0.45 0.00 0.45 0.92 0.00 0.92 0.17 0.00 0.17 0.38 0.00 0.38 0.74 0.00 0.74 0.15 0.00 0.15 0.16 0.00 0.16 0.80 0.00 0.80 0.91 0.00 0.91 1.03 0.00 1.03 1.18 0.00 1.18 0.00 0.00 0.00 0.00 0.00 0.16 0.00 0.16 Physician Work RVUs 3 2.62 0.65 0.79 0.55 0.24 1.17 0.67 0.50 0.92 0.84 0.08 0.70 0.50 0.20 0.97 0.57 0.40 0.90 0.83 0.07 0.04 0.00 0.04 1.04 0.60 0.44 1.18 0.67 0.51 1.22 0.65 0.57 1.37 0.72 0.65 0.00 0.00 0.00 0.00 0.00 0.04 0.00 0.04 Fully Implemented NonFacility PE RVUs 2.09 0.31 0.70 0.51 0.19 0.94 0.55 0.39 0.83 0.76 0.07 0.55 0.39 0.16 0.78 0.47 0.31 0.74 0.68 0.06 0.15 0.11 0.04 0.99 0.65 0.34 1.07 0.67 0.40 1.15 0.71 0.44 1.19 0.68 0.51 0.00 0.00 0.00 0.00 0.00 0.07 0.02 0.05 Year 2007 Transitional Non-Facility PE RVUs 2.62 0.65 NA NA 0.24 NA NA 0.50 NA NA 0.08 NA NA 0.20 NA NA 0.40 NA NA 0.07 NA NA 0.04 NA NA 0.44 NA NA 0.51 NA NA 0.57 NA NA 0.65 0.00 0.00 0.00 0.00 0.00 NA NA 0.04 Fully Implemented Facility PE RVUs 2.09 0.31 NA NA 0.19 NA NA 0.39 NA NA 0.07 NA NA 0.16 NA NA 0.31 NA NA 0.06 NA NA 0.04 NA NA 0.34 NA NA 0.40 NA NA 0.44 NA NA 0.51 0.00 0.00 0.00 0.00 0.00 NA NA 0.05 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 93724 93727 93731 93731 93731 93732 93732 93732 93733 93733 93733 93734 93734 93734 93735 93735 93735 93736 93736 93736 93740 93740 93740 93741 93741 93741 93742 93742 93742 93743 93743 93743 93744 93744 93744 93745 93745 93745 93760 93762 93770 93770 93770 HCPCS 2 CPT 1/ 0.15 0.02 0.05 0.04 0.01 0.07 0.04 0.03 0.07 0.06 0.01 0.03 0.02 0.01 0.06 0.04 0.02 0.07 0.06 0.01 0.02 0.01 0.01 0.07 0.04 0.03 0.07 0.04 0.03 0.07 0.04 0.03 0.08 0.04 0.04 0.00 0.00 0.00 0.00 0.00 0.02 0.01 0.01 Mal-Practice RVUs 7.65 1.19 1.29 0.59 0.70 2.16 0.71 1.45 1.16 0.90 0.26 1.11 0.52 0.59 1.77 0.61 1.16 1.12 0.89 0.23 0.22 0.01 0.21 1.91 0.64 1.27 2.16 0.71 1.45 2.32 0.69 1.63 2.63 0.76 1.87 0.00 0.00 0.00 0.00 0.00 0.22 0.01 0.21 Fully Implemented NonFacility Total 7.12 0.85 1.20 0.55 0.65 1.93 0.59 1.34 1.07 0.82 0.25 0.96 0.41 0.55 1.58 0.51 1.07 0.96 0.74 0.22 0.33 0.12 0.21 1.86 0.69 1.17 2.05 0.71 1.34 2.25 0.75 1.50 2.45 0.72 1.73 0.00 0.00 0.00 0.00 0.00 0.25 0.03 0.22 Year 2007 Transitional Non-Facility Total 7.65 1.19 NA NA 0.70 NA NA 1.45 NA NA 0.26 NA NA 0.59 NA NA 1.16 NA NA 0.23 NA NA 0.21 NA NA 1.27 NA NA 1.45 NA NA 1.63 NA NA 1.87 0.00 0.00 0.00 0.00 0.00 NA NA 0.21 Fully Implemented Facility Total 7.12 0.85 NA NA 0.65 NA NA 1.34 NA NA 0.25 NA NA 0.55 NA NA 1.07 NA NA 0.22 NA NA 0.21 NA NA 1.17 NA NA 1.34 NA NA 1.50 NA NA 1.73 0.00 0.00 0.00 0.00 0.00 NA NA 0.22 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 000 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69988 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00367 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... 2 Copyright 3+ Mod A A A A A A C C C A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Ambulatory BP monitoring ................................... Ambulatory BP recording ..................................... Ambulatory BP analysis ....................................... Review/report BP recording ................................. Cardiac rehab ....................................................... Cardiac rehab/monitor .......................................... Cardiovascular procedure .................................... Cardiovascular procedure .................................... Cardiovascular procedure .................................... Extracranial study ................................................. Extracranial study ................................................. Extracranial study ................................................. Extracranial study ................................................. Extracranial study ................................................. Extracranial study ................................................. Extracranial study ................................................. Extracranial study ................................................. Extracranial study ................................................. Intracranial study .................................................. Intracranial study .................................................. Intracranial study .................................................. Intracranial study .................................................. Intracranial study .................................................. Intracranial study .................................................. Tcd, vasoreactivity study ...................................... Tcd, vasoreactivity study ...................................... Tcd, vasoreactivity study ...................................... Tcd, emboli detect w/o inj .................................... Tcd, emboli detect w/o inj .................................... Tcd, emboli detect w/o inj .................................... Tcd, emboli detect w/inj ....................................... Tcd, emboli detect w/inj ....................................... Tcd, emboli detect w/inj ....................................... Extremity study ..................................................... Extremity study ..................................................... Extremity study ..................................................... Extremity study ..................................................... Extremity study ..................................................... Extremity study ..................................................... Extremity study ..................................................... Extremity study ..................................................... Extremity study ..................................................... Lower extremity study .......................................... Description 0.38 0.00 0.00 0.38 0.18 0.28 0.00 0.00 0.00 0.22 0.00 0.22 0.60 0.00 0.60 0.40 0.00 0.40 0.94 0.00 0.94 0.62 0.00 0.62 1.00 0.00 1.00 1.15 0.00 1.15 1.15 0.00 1.15 0.25 0.00 0.25 0.45 0.00 0.45 0.50 0.00 0.50 0.58 Physician Work RVUs 3 1.54 0.88 0.52 0.14 0.32 0.44 0.00 0.00 0.00 2.50 2.43 0.07 6.01 5.81 0.20 4.04 3.93 0.11 6.83 6.55 0.28 4.73 4.54 0.19 6.08 5.78 0.30 6.59 6.25 0.34 6.28 5.94 0.34 3.07 2.99 0.08 4.60 4.47 0.13 5.81 5.65 0.16 7.82 Fully Implemented NonFacility PE RVUs 1.54 0.90 0.51 0.13 0.31 0.46 0.00 0.00 0.00 2.38 2.30 0.08 5.67 5.47 0.20 3.63 3.50 0.13 6.77 6.42 0.35 4.36 4.14 0.22 5.20 4.82 0.38 5.52 5.09 0.43 5.34 4.91 0.43 2.78 2.70 0.08 4.18 4.03 0.15 5.05 4.88 0.17 7.05 Year 2007 Transitional Non-Facility PE RVUs NA NA NA 0.14 0.09 0.13 0.00 0.00 0.00 NA NA 0.07 NA NA 0.20 NA NA 0.11 NA NA 0.28 NA NA 0.19 NA NA 0.30 NA NA 0.34 NA NA 0.34 NA NA 0.08 NA NA 0.13 NA NA 0.16 NA Fully Implemented Facility PE RVUs NA NA NA 0.13 0.08 0.12 0.00 0.00 0.00 NA NA 0.08 NA NA 0.20 NA NA 0.13 NA NA 0.35 NA NA 0.22 NA NA 0.38 NA NA 0.43 NA NA 0.43 NA NA 0.08 NA NA 0.15 NA NA 0.17 NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 93784 93786 93788 93790 93797 93798 93799 93799 93799 93875 93875 93875 93880 93880 93880 93882 93882 93882 93886 93886 93886 93888 93888 93888 93890 93890 93890 93892 93892 93892 93893 93893 93893 93922 93922 93922 93923 93923 93923 93924 93924 93924 93925 HCPCS 2 CPT 1/ 0.03 0.01 0.01 0.01 0.01 0.01 0.00 0.00 0.00 0.12 0.11 0.01 0.39 0.35 0.04 0.26 0.22 0.04 0.45 0.39 0.06 0.32 0.27 0.05 0.45 0.39 0.06 0.45 0.39 0.06 0.45 0.39 0.06 0.15 0.13 0.02 0.26 0.22 0.04 0.30 0.25 0.05 0.39 Mal-Practice RVUs 1.95 0.89 0.53 0.53 0.51 0.73 0.00 0.00 0.00 2.84 2.54 0.30 7.00 6.16 0.84 4.70 4.15 0.55 8.22 6.94 1.28 5.67 4.81 0.86 7.53 6.17 1.36 8.19 6.64 1.55 7.88 6.33 1.55 3.47 3.12 0.35 5.31 4.69 0.62 6.61 5.90 0.71 8.79 Fully Implemented NonFacility Total 1.95 0.91 0.52 0.52 0.50 0.75 0.00 0.00 0.00 2.72 2.41 0.31 6.66 5.82 0.84 4.29 3.72 0.57 8.16 6.81 1.35 5.30 4.41 0.89 6.65 5.21 1.44 7.12 5.48 1.64 6.94 5.30 1.64 3.18 2.83 0.35 4.89 4.25 0.64 5.85 5.13 0.72 8.02 Year 2007 Transitional Non-Facility Total NA NA NA 0.53 0.28 0.42 0.00 0.00 0.00 NA NA 0.30 NA NA 0.84 NA NA 0.55 NA NA 1.28 NA NA 0.86 NA NA 1.36 NA NA 1.55 NA NA 1.55 NA NA 0.35 NA NA 0.62 NA NA 0.71 NA Fully Implemented Facility Total NA NA NA 0.52 0.27 0.41 0.00 0.00 0.00 NA NA 0.31 NA NA 0.84 NA NA 0.57 NA NA 1.35 NA NA 0.89 NA NA 1.44 NA NA 1.64 NA NA 1.64 NA NA 0.35 NA NA 0.64 NA NA 0.72 NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX 000 000 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69989 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00368 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Lower extremity study .......................................... Lower extremity study .......................................... Lower extremity study .......................................... Lower extremity study .......................................... Lower extremity study .......................................... Upper extremity study .......................................... Upper extremity study .......................................... Upper extremity study .......................................... Upper extremity study .......................................... Upper extremity study .......................................... Upper extremity study .......................................... Extremity study ..................................................... Extremity study ..................................................... Extremity study ..................................................... Extremity study ..................................................... Extremity study ..................................................... Extremity study ..................................................... Extremity study ..................................................... Extremity study ..................................................... Extremity study ..................................................... Vascular study ...................................................... Vascular study ...................................................... Vascular study ...................................................... Vascular study ...................................................... Vascular study ...................................................... Vascular study ...................................................... Vascular study ...................................................... Vascular study ...................................................... Vascular study ...................................................... Vascular study ...................................................... Vascular study ...................................................... Vascular study ...................................................... Penile vascular study ........................................... Penile vascular study ........................................... Penile vascular study ........................................... Penile vascular study ........................................... Penile vascular study ........................................... Penile vascular study ........................................... Doppler flow testing ............................................. Doppler flow testing ............................................. Doppler flow testing ............................................. Vent mgmt inpat, init day ..................................... Vent mgmt inpat, subq day .................................. Description 0.00 0.58 0.39 0.00 0.39 0.46 0.00 0.46 0.31 0.00 0.31 0.35 0.00 0.35 0.68 0.00 0.68 0.45 0.00 0.45 1.80 0.00 1.80 1.21 0.00 1.21 0.65 0.00 0.65 0.44 0.00 0.44 1.25 0.00 1.25 0.44 0.00 0.44 0.25 0.00 0.25 1.99 1.37 Physician Work RVUs 3 7.64 0.18 5.05 4.94 0.11 6.09 5.95 0.14 4.11 4.02 0.09 2.94 2.84 0.10 6.00 5.81 0.19 3.90 3.77 0.13 8.23 7.64 0.59 4.33 3.97 0.36 5.84 5.63 0.21 4.23 4.07 0.16 3.50 3.03 0.47 2.75 2.59 0.16 5.16 5.10 0.06 NA NA Fully Implemented NonFacility PE RVUs 6.85 0.20 4.31 4.18 0.13 5.54 5.38 0.16 3.64 3.54 0.10 2.83 2.71 0.12 5.44 5.22 0.22 3.67 3.52 0.15 7.78 7.18 0.60 4.33 3.94 0.39 4.85 4.63 0.22 3.46 3.31 0.15 3.02 2.59 0.43 2.85 2.70 0.15 4.28 4.20 0.08 NA NA Year 2007 Transitional Non-Facility PE RVUs NA 0.18 NA NA 0.11 NA NA 0.14 NA NA 0.09 NA NA 0.10 NA NA 0.19 NA NA 0.13 NA NA 0.59 NA NA 0.36 NA NA 0.21 NA NA 0.16 NA NA 0.47 NA NA 0.16 NA NA 0.06 0.39 0.33 Fully Implemented Facility PE RVUs NA 0.20 NA NA 0.13 NA NA 0.16 NA NA 0.10 NA NA 0.12 NA NA 0.22 NA NA 0.15 NA NA 0.60 NA NA 0.39 NA NA 0.22 NA NA 0.15 NA NA 0.43 NA NA 0.15 NA NA 0.08 0.34 0.33 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 93925 93925 93926 93926 93926 93930 93930 93930 93931 93931 93931 93965 93965 93965 93970 93970 93970 93971 93971 93971 93975 93975 93975 93976 93976 93976 93978 93978 93978 93979 93979 93979 93980 93980 93980 93981 93981 93981 93990 93990 93990 94002 94003 HCPCS 2 CPT 1/ 0.35 0.04 0.27 0.23 0.04 0.41 0.37 0.04 0.27 0.24 0.03 0.14 0.12 0.02 0.46 0.40 0.06 0.30 0.27 0.03 0.56 0.43 0.13 0.35 0.30 0.05 0.43 0.37 0.06 0.27 0.24 0.03 0.42 0.34 0.08 0.33 0.31 0.02 0.26 0.23 0.03 0.09 0.06 Mal-Practice RVUs 7.99 0.80 5.71 5.17 0.54 6.96 6.32 0.64 4.69 4.26 0.43 3.43 2.96 0.47 7.14 6.21 0.93 4.65 4.04 0.61 10.59 8.07 2.52 5.89 4.27 1.62 6.92 6.00 0.92 4.94 4.31 0.63 5.17 3.37 1.80 3.52 2.90 0.62 5.67 5.33 0.34 NA NA Fully Implemented NonFacility Total 7.20 0.82 4.97 4.41 0.56 6.41 5.75 0.66 4.22 3.78 0.44 3.32 2.83 0.49 6.58 5.62 0.96 4.42 3.79 0.63 10.14 7.61 2.53 5.89 4.24 1.65 5.93 5.00 0.93 4.17 3.55 0.62 4.69 2.93 1.76 3.62 3.01 0.61 4.79 4.43 0.36 NA NA Year 2007 Transitional Non-Facility Total NA 0.80 NA NA 0.54 NA NA 0.64 NA NA 0.43 NA NA 0.47 NA NA 0.93 NA NA 0.61 NA NA 2.52 NA NA 1.62 NA NA 0.92 NA NA 0.63 NA NA 1.80 NA NA 0.62 NA NA 0.34 2.47 1.76 Fully Implemented Facility Total NA 0.82 NA NA 0.56 NA NA 0.66 NA NA 0.44 NA NA 0.49 NA NA 0.96 NA NA 0.63 NA NA 2.53 NA NA 1.65 NA NA 0.93 NA NA 0.62 NA NA 1.76 NA NA 0.61 NA NA 0.36 2.42 1.76 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69990 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00369 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... TC .... 26 ..... .......... .......... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 2 Copyright 3+ Mod A B A A A A A A A A A A A A B B B A A A A A A A A A A A A A A A A A A A A A A A A A A Status Vent mgmt nf per day .......................................... Home vent mgmt supervision .............................. Breathing capacity test ......................................... Breathing capacity test ......................................... Breathing capacity test ......................................... Patient recorded spirometry ................................. Patient recorded spirometry ................................. Review patient spirometry .................................... Evaluation of wheezing ........................................ Evaluation of wheezing ........................................ Evaluation of wheezing ........................................ Evaluation of wheezing ........................................ Evaluation of wheezing ........................................ Evaluation of wheezing ........................................ Vital capacity test ................................................. Vital capacity test ................................................. Vital capacity test ................................................. Lung function test (MBC/MVV) ............................ Lung function test (MBC/MVV) ............................ Lung function test (MBC/MVV) ............................ Residual lung capacity ......................................... Residual lung capacity ......................................... Residual lung capacity ......................................... Expired gas collection .......................................... Expired gas collection .......................................... Expired gas collection .......................................... Thoracic gas volume ............................................ Thoracic gas volume ............................................ Thoracic gas volume ............................................ Lung nitrogen washout curve ............................... Lung nitrogen washout curve ............................... Lung nitrogen washout curve ............................... Measure airflow resistance .................................. Measure airflow resistance .................................. Measure airflow resistance .................................. Breath airway closing volume .............................. Breath airway closing volume .............................. Breath airway closing volume .............................. Respiratory flow volume loop ............................... Respiratory flow volume loop ............................... Respiratory flow volume loop ............................... CO2 breathing response curve ............................ CO2 breathing response curve ............................ Description 1.00 1.50 0.17 0.00 0.17 0.52 0.00 0.52 0.31 0.00 0.31 0.60 0.00 0.60 0.07 0.00 0.07 0.11 0.00 0.11 0.26 0.00 0.26 0.11 0.00 0.11 0.13 0.00 0.13 0.26 0.00 0.26 0.26 0.00 0.26 0.26 0.00 0.26 0.31 0.00 0.31 0.40 0.00 Physician Work RVUs 3 NA 0.69 0.73 0.69 0.04 0.82 0.68 0.14 1.31 1.23 0.08 0.99 0.84 0.15 0.48 0.46 0.02 0.48 0.45 0.03 0.81 0.75 0.06 0.51 0.48 0.03 0.76 0.73 0.03 0.62 0.55 0.07 0.95 0.89 0.06 0.59 0.52 0.07 0.72 0.64 0.08 1.02 0.92 Fully Implemented NonFacility PE RVUs NA 0.69 0.69 0.64 0.05 0.77 0.61 0.16 1.13 1.04 0.09 0.86 0.69 0.17 0.48 0.45 0.03 0.45 0.42 0.03 0.70 0.62 0.08 0.61 0.58 0.03 0.63 0.59 0.04 0.73 0.65 0.08 0.77 0.69 0.08 0.69 0.61 0.08 0.63 0.54 0.09 0.89 0.77 Year 2007 Transitional Non-Facility PE RVUs 0.24 NA NA NA 0.04 NA NA 0.14 1.31 1.23 0.08 NA NA 0.15 NA NA 0.02 NA NA 0.03 NA NA 0.06 NA NA 0.03 NA NA 0.03 NA NA 0.07 NA NA 0.06 NA NA 0.07 NA NA 0.08 NA NA Fully Implemented Facility PE RVUs 0.24 NA NA NA 0.05 NA NA 0.16 1.13 1.04 0.09 NA NA 0.17 NA NA 0.03 NA NA 0.03 NA NA 0.08 NA NA 0.03 NA NA 0.04 NA NA 0.08 NA NA 0.08 NA NA 0.08 NA NA 0.09 NA NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 94004 94005 94010 94010 94010 94014 94015 94016 94060 94060 94060 94070 94070 94070 94150 94150 94150 94200 94200 94200 94240 94240 94240 94250 94250 94250 94260 94260 94260 94350 94350 94350 94360 94360 94360 94370 94370 94370 94375 94375 94375 94400 94400 HCPCS 2 CPT 1/ 0.04 0.06 0.03 0.02 0.01 0.03 0.01 0.02 0.07 0.06 0.01 0.13 0.10 0.03 0.02 0.01 0.01 0.03 0.02 0.01 0.06 0.05 0.01 0.02 0.01 0.01 0.05 0.04 0.01 0.05 0.04 0.01 0.07 0.06 0.01 0.03 0.02 0.01 0.03 0.02 0.01 0.09 0.06 Mal-Practice RVUs NA 2.25 0.93 0.71 0.22 1.37 0.69 0.68 1.69 1.29 0.40 1.72 0.94 0.78 0.57 0.47 0.10 0.62 0.47 0.15 1.13 0.80 0.33 0.64 0.49 0.15 0.94 0.77 0.17 0.93 0.59 0.34 1.28 0.95 0.33 0.88 0.54 0.34 1.06 0.66 0.40 1.51 0.98 Fully Implemented NonFacility Total NA 2.25 0.89 0.66 0.23 1.32 0.62 0.70 1.51 1.10 0.41 1.59 0.79 0.80 0.57 0.46 0.11 0.59 0.44 0.15 1.02 0.67 0.35 0.74 0.59 0.15 0.81 0.63 0.18 1.04 0.69 0.35 1.10 0.75 0.35 0.98 0.63 0.35 0.97 0.56 0.41 1.38 0.83 Year 2007 Transitional Non-Facility Total 1.28 NA NA NA 0.22 NA NA 0.68 1.69 1.29 0.40 NA NA 0.78 NA NA 0.10 NA NA 0.15 NA NA 0.33 NA NA 0.15 NA NA 0.17 NA NA 0.34 NA NA 0.33 NA NA 0.34 NA NA 0.40 NA NA Fully Implemented Facility Total 1.28 NA NA NA 0.23 NA NA 0.70 1.51 1.10 0.41 NA NA 0.80 NA NA 0.11 NA NA 0.15 NA NA 0.35 NA NA 0.15 NA NA 0.18 NA NA 0.35 NA NA 0.35 NA NA 0.35 NA NA 0.41 NA NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69991 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00370 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A C A A A A A A A A A A A A A A A A A A A A A A A A Status CO2 breathing response curve ............................ Hypoxia response curve ...................................... Hypoxia response curve ...................................... Hypoxia response curve ...................................... Hast w/report ........................................................ Hast w/report ........................................................ Hast w/report ........................................................ Hast w/oxygen titrate ........................................... Hast w/oxygen titrate ........................................... Hast w/oxygen titrate ........................................... Surfactant admin thru tube .................................. Pulmonary stress test/simple ............................... Pulmonary stress test/simple ............................... Pulmonary stress test/simple ............................... Pulm stress test/complex ..................................... Pulm stress test/complex ..................................... Pulm stress test/complex ..................................... Airway inhalation treatment .................................. Aerosol inhalation treatment ................................ Cbt, 1st hour ........................................................ Cbt, each addl hour ............................................. Pos airway pressure, CPAP ................................ Neg press ventilation, cnp ................................... Evaluate pt use of inhaler .................................... Chest wall manipulation ....................................... Chest wall manipulation ....................................... Exhaled air analysis, o2 ....................................... Exhaled air analysis, o2 ....................................... Exhaled air analysis, o2 ....................................... Exhaled air analysis, o2/co2 ................................ Exhaled air analysis, o2/co2 ................................ Exhaled air analysis, o2/co2 ................................ Exhaled air analysis ............................................. Exhaled air analysis ............................................. Exhaled air analysis ............................................. Monoxide diffusing capacity ................................. Monoxide diffusing capacity ................................. Monoxide diffusing capacity ................................. Membrane diffusion capacity ............................... Membrane diffusion capacity ............................... Membrane diffusion capacity ............................... Pulmonary compliance study ............................... Pulmonary compliance study ............................... Description 0.40 0.40 0.00 0.40 0.31 0.00 0.31 0.40 0.00 0.40 1.16 0.64 0.00 0.64 1.42 0.00 1.42 0.00 0.00 0.00 0.00 0.76 0.76 0.00 0.00 0.00 0.26 0.00 0.26 0.20 0.00 0.20 0.07 0.00 0.07 0.26 0.00 0.26 0.26 0.00 0.26 0.23 0.00 Physician Work RVUs 3 0.10 1.03 0.94 0.09 1.13 1.05 0.08 1.58 1.48 0.10 0.35 0.79 0.62 0.17 3.17 2.71 0.46 0.36 0.00 0.92 0.34 0.82 NA 0.40 0.54 0.50 1.10 1.03 0.07 1.06 1.01 0.05 1.04 1.02 0.02 1.15 1.09 0.06 0.96 0.89 0.07 1.69 1.63 Fully Implemented NonFacility PE RVUs 0.12 0.89 0.78 0.11 1.05 0.96 0.09 1.53 1.41 0.12 0.35 2.06 1.87 0.19 2.45 2.00 0.45 0.32 0.00 0.92 0.34 0.69 NA 0.33 0.53 0.46 1.67 1.59 0.08 2.16 2.10 0.06 1.75 1.73 0.02 1.04 0.96 0.08 2.43 2.35 0.08 1.43 1.36 Year 2007 Transitional Non-Facility PE RVUs 0.10 NA NA 0.09 NA NA 0.08 NA NA 0.10 0.35 NA NA 0.17 NA NA 0.46 NA 0.00 NA NA 0.20 0.19 NA NA NA 1.10 1.03 0.07 NA NA 0.05 NA NA 0.02 NA NA 0.06 NA NA 0.07 NA NA Fully Implemented Facility PE RVUs 0.12 NA NA 0.11 NA NA 0.09 NA NA 0.12 0.35 NA NA 0.19 NA NA 0.45 NA 0.00 NA NA 0.22 0.22 NA NA NA 1.67 1.59 0.08 NA NA 0.06 NA NA 0.02 NA NA 0.08 NA NA 0.08 NA NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 94400 94450 94450 94450 94452 94452 94452 94453 94453 94453 94610 94620 94620 94620 94621 94621 94621 94640 94642 94644 94645 94660 94662 94664 94667 94668 94680 94680 94680 94681 94681 94681 94690 94690 94690 94720 94720 94720 94725 94725 94725 94750 94750 HCPCS 2 CPT 1/ 0.03 0.04 0.02 0.02 0.04 0.02 0.02 0.04 0.02 0.02 0.26 0.13 0.10 0.03 0.16 0.10 0.06 0.02 0.00 0.02 0.02 0.04 0.03 0.04 0.05 0.02 0.07 0.06 0.01 0.13 0.12 0.01 0.05 0.04 0.01 0.07 0.06 0.01 0.13 0.12 0.01 0.05 0.04 Mal-Practice RVUs 0.53 1.47 0.96 0.51 1.48 1.07 0.41 2.02 1.50 0.52 1.77 1.56 0.72 0.84 4.75 2.81 1.94 0.38 0.00 0.94 0.36 1.62 NA 0.44 0.59 0.52 1.43 1.09 0.34 1.39 1.13 0.26 1.16 1.06 0.10 1.48 1.15 0.33 1.35 1.01 0.34 1.97 1.67 Fully Implemented NonFacility Total 0.55 1.33 0.80 0.53 1.40 0.98 0.42 1.97 1.43 0.54 1.77 2.83 1.97 0.86 4.03 2.10 1.93 0.34 0.00 0.94 0.36 1.49 NA 0.37 0.58 0.48 2.00 1.65 0.35 2.49 2.22 0.27 1.87 1.77 0.10 1.37 1.02 0.35 2.82 2.47 0.35 1.71 1.40 Year 2007 Transitional Non-Facility Total 0.53 NA NA 0.51 NA NA 0.41 NA NA 0.52 1.77 NA NA 0.84 NA NA 1.94 NA 0.00 NA NA 1.00 0.98 NA NA NA 1.43 1.09 0.34 NA NA 0.26 NA NA 0.10 NA NA 0.33 NA NA 0.34 NA NA Fully Implemented Facility Total 0.55 NA NA 0.53 NA NA 0.42 NA NA 0.54 1.77 NA NA 0.86 NA NA 1.93 NA 0.00 NA NA 1.02 1.01 NA NA NA 2.00 1.65 0.35 NA NA 0.27 NA NA 0.10 NA NA 0.35 NA NA 0.35 NA NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69992 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00371 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 26 ..... .......... .......... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... .......... .......... .......... TC .... 26 ..... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A T T A A A A C C C C C C C C C C A A A A A A A A A A A A A A A A A I I I I I I I A A Status Pulmonary compliance study ............................... Measure blood oxygen level ................................ Measure blood oxygen level ................................ Measure blood oxygen level ................................ Exhaled carbon dioxide test ................................. Exhaled carbon dioxide test ................................. Exhaled carbon dioxide test ................................. Breath recording, infant ........................................ Breath recording, infant ........................................ Breath recording, infant ........................................ Ped home apnea rec, compl ................................ Ped home apnea rec, hk-up ................................ Ped home apnea rec, downld .............................. Ped home apnea rec, report ................................ Pulmonary service/procedure .............................. Pulmonary service/procedure .............................. Pulmonary service/procedure .............................. Percut allergy skin tests ....................................... Percut allergy titrate test ...................................... Exhaled nitric oxide meas .................................... Id allergy titrate-drug/bug ..................................... Id allergy test, drug/bug ....................................... Id allergy titrate-airborne ...................................... Id allergy test-delayed type .................................. Allergy patch tests ................................................ Photo patch test ................................................... Photosensitivity tests ............................................ Eye allergy tests ................................................... Nose allergy test .................................................. Bronchial allergy tests .......................................... Bronchial allergy tests .......................................... Ingestion challenge test ....................................... Immunotherapy, one injection .............................. Immunotherapy injections .................................... Immunotherapy, one injection .............................. Immunotherapy, many antigens ........................... Immunotherapy, insect venom ............................. Immunotherapy, insect venoms ........................... Immunotherapy, insect venoms ........................... Immunotherapy, insect venoms ........................... Immunotherapy, insect venoms ........................... Antigen therapy services ...................................... Antigen therapy services ...................................... Description 0.23 0.00 0.00 0.00 0.15 0.00 0.15 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.15 0.00 0.15 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.95 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.06 0.06 Physician Work RVUs 3 0.06 0.06 0.11 0.84 0.77 0.74 0.03 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.16 0.29 0.48 0.20 0.21 0.24 0.29 0.15 0.15 1.21 NA NA 0.79 0.88 0.67 0.22 0.27 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.26 0.34 Fully Implemented NonFacility PE RVUs 0.07 0.05 0.08 0.56 0.76 0.72 0.04 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.12 0.31 0.48 0.16 0.17 0.17 0.25 0.19 0.23 0.43 NA NA 1.91 2.41 0.78 0.35 0.44 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.21 0.33 Year 2007 Transitional Non-Facility PE RVUs 0.06 NA NA NA NA NA 0.03 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NA 0.04 NA 0.04 NA NA NA NA NA NA 0.00 0.00 NA NA 0.26 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.02 0.02 Fully Implemented Facility PE RVUs 0.07 NA NA NA NA NA 0.04 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NA 0.06 NA 0.06 NA NA NA NA NA NA 0.35 0.20 NA NA 0.35 0.29 0.38 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.02 0.02 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 94750 94760 94761 94762 94770 94770 94770 94772 94772 94772 94774 94775 94776 94777 94799 94799 94799 95004 95010 95012 95015 95024 95027 95028 95044 95052 95056 95060 95065 95070 95071 95075 95115 95117 95120 95125 95130 95131 95132 95133 95134 95144 95145 HCPCS 2 CPT 1/ 0.01 0.02 0.06 0.10 0.08 0.07 0.01 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.01 0.01 0.01 0.01 0.01 0.01 0.01 0.01 0.01 0.01 0.02 0.01 0.02 0.02 0.03 0.02 0.02 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.01 0.01 Mal-Practice RVUs 0.30 0.08 0.17 0.94 1.00 0.81 0.19 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.17 0.45 0.49 0.36 0.22 0.25 0.30 0.16 0.16 1.22 NA NA 0.81 0.90 1.65 0.24 0.29 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.33 0.41 Fully Implemented NonFacility Total 0.31 0.07 0.14 0.66 0.99 0.79 0.20 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.13 0.47 0.49 0.32 0.18 0.18 0.26 0.20 0.24 0.44 NA NA 1.93 2.43 1.76 0.37 0.46 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.28 0.40 Year 2007 Transitional Non-Facility Total 0.30 NA NA NA NA NA 0.19 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NA 0.20 NA 0.20 NA NA NA NA NA NA 0.02 0.01 NA NA 1.24 0.02 0.02 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.09 0.09 Fully Implemented Facility Total 0.31 NA NA NA NA NA 0.20 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 NA 0.22 NA 0.22 NA NA NA NA NA NA 0.37 0.21 NA NA 1.33 0.31 0.40 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.09 0.09 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX YYY YYY YYY YYY XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69993 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00372 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... 2 Copyright 3+ Mod A A A A A A A C A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Antigen therapy services ...................................... Antigen therapy services ...................................... Antigen therapy services ...................................... Antigen therapy services ...................................... Antigen therapy services ...................................... Antigen therapy services ...................................... Rapid desensitization ........................................... Allergy immunology services ............................... Glucose monitoring, cont ..................................... Gluc monitor, cont, phys i&r ................................ Multiple sleep latency test .................................... Multiple sleep latency test .................................... Multiple sleep latency test .................................... Sleep study, unattended ...................................... Sleep study, unattended ...................................... Sleep study, unattended ...................................... Sleep study, attended .......................................... Sleep study, attended .......................................... Sleep study, attended .......................................... Polysomnography, 1–3 ........................................ Polysomnography, 1–3 ........................................ Polysomnography, 1–3 ........................................ Polysomnography, 4 or more ............................... Polysomnography, 4 or more ............................... Polysomnography, 4 or more ............................... Polysomnography w/cpap .................................... Polysomnography w/cpap .................................... Polysomnography w/cpap .................................... Eeg, 41–60 minutes ............................................. Eeg, 41–60 minutes ............................................. Eeg, 41–60 minutes ............................................. Eeg, over 1 hour .................................................. Eeg, over 1 hour .................................................. Eeg, over 1 hour .................................................. Eeg, awake and drowsy ....................................... Eeg, awake and drowsy ....................................... Eeg, awake and drowsy ....................................... Eeg, awake and asleep ....................................... Eeg, awake and asleep ....................................... Eeg, awake and asleep ....................................... Eeg, coma or sleep only ...................................... Eeg, coma or sleep only ...................................... Eeg, coma or sleep only ...................................... Description 0.06 0.06 0.06 0.06 0.06 0.06 2.01 0.00 0.00 0.85 1.88 0.00 1.88 1.66 0.00 1.66 1.66 0.00 1.66 2.65 0.00 2.65 3.52 0.00 3.52 3.79 0.00 3.79 1.08 0.00 1.08 1.73 0.00 1.73 1.08 0.00 1.08 1.08 0.00 1.08 1.08 0.00 1.08 Physician Work RVUs 3 0.65 0.64 0.94 1.25 0.25 0.19 1.59 0.00 3.49 0.27 6.99 6.50 0.49 3.84 3.36 0.48 11.72 11.29 0.43 15.55 14.85 0.70 17.67 16.75 0.92 19.70 18.72 0.98 5.85 5.54 0.31 6.53 6.03 0.50 5.26 4.95 0.31 6.10 5.79 0.31 5.49 5.18 0.31 Fully Implemented NonFacility PE RVUs 0.49 0.48 0.67 0.91 0.21 0.15 1.92 0.00 3.95 0.21 14.70 14.08 0.62 3.46 2.93 0.53 11.82 11.31 0.51 13.79 12.92 0.87 17.54 16.42 1.12 19.32 18.12 1.20 4.49 4.07 0.42 5.40 4.75 0.65 4.10 3.68 0.42 3.76 3.34 0.42 4.82 4.40 0.42 Year 2007 Transitional Non-Facility PE RVUs 0.02 0.02 0.02 0.02 0.02 0.02 0.73 0.00 NA 0.27 NA NA 0.49 NA NA 0.48 NA NA 0.43 NA NA 0.70 NA NA 0.92 NA NA 0.98 NA NA 0.31 NA NA 0.50 NA NA 0.31 NA NA 0.31 NA NA 0.31 Fully Implemented Facility PE RVUs 0.03 0.02 0.03 0.03 0.02 0.03 0.88 0.00 NA 0.21 NA NA 0.62 NA NA 0.53 NA NA 0.51 NA NA 0.87 NA NA 1.12 NA NA 1.20 NA NA 0.42 NA NA 0.65 NA NA 0.42 NA NA 0.42 NA NA 0.42 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 95146 95147 95148 95149 95165 95170 95180 95199 95250 95251 95805 95805 95805 95806 95806 95806 95807 95807 95807 95808 95808 95808 95810 95810 95810 95811 95811 95811 95812 95812 95812 95813 95813 95813 95816 95816 95816 95819 95819 95819 95822 95822 95822 HCPCS 2 CPT 1/ 0.01 0.01 0.01 0.01 0.01 0.01 0.04 0.00 0.01 0.02 0.43 0.34 0.09 0.39 0.31 0.08 0.50 0.42 0.08 0.55 0.42 0.13 0.59 0.42 0.17 0.61 0.43 0.18 0.17 0.11 0.06 0.20 0.11 0.09 0.16 0.10 0.06 0.16 0.10 0.06 0.19 0.13 0.06 Mal-Practice RVUs 0.72 0.71 1.01 1.32 0.32 0.26 3.64 0.00 3.50 1.14 9.30 6.84 2.46 5.89 3.67 2.22 13.88 11.71 2.17 18.75 15.27 3.48 21.78 17.17 4.61 24.10 19.15 4.95 7.10 5.65 1.45 8.46 6.14 2.32 6.50 5.05 1.45 7.34 5.89 1.45 6.76 5.31 1.45 Fully Implemented NonFacility Total 0.56 0.55 0.74 0.98 0.28 0.22 3.97 0.00 3.96 1.08 17.01 14.42 2.59 5.51 3.24 2.27 13.98 11.73 2.25 16.99 13.34 3.65 21.65 16.84 4.81 23.72 18.55 5.17 5.74 4.18 1.56 7.33 4.86 2.47 5.34 3.78 1.56 5.00 3.44 1.56 6.09 4.53 1.56 Year 2007 Transitional Non-Facility Total 0.09 0.09 0.09 0.09 0.09 0.09 2.78 0.00 NA 1.14 NA NA 2.46 NA NA 2.22 NA NA 2.17 NA NA 3.48 NA NA 4.61 NA NA 4.95 NA NA 1.45 NA NA 2.32 NA NA 1.45 NA NA 1.45 NA NA 1.45 Fully Implemented Facility Total 0.10 0.09 0.10 0.10 0.09 0.10 2.93 0.00 NA 1.08 NA NA 2.59 NA NA 2.27 NA NA 2.25 NA NA 3.65 NA NA 4.81 NA NA 5.17 NA NA 1.56 NA NA 2.47 NA NA 1.56 NA NA 1.56 NA NA 1.56 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69994 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00373 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... .......... .......... .......... .......... .......... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 2 Copyright 3+ Mod C C A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Eeg, cerebral death only ...................................... Eeg, cerebral death only ...................................... Eeg, cerebral death only ...................................... Eeg, all night recording ........................................ Eeg, all night recording ........................................ Eeg, all night recording ........................................ Surgery electrocorticogram .................................. Surgery electrocorticogram .................................. Surgery electrocorticogram .................................. Insert electrodes for EEG .................................... Limb muscle testing, manual ............................... Hand muscle testing, manual .............................. Body muscle testing, manual ............................... Body muscle testing, manual ............................... Range of motion measurements .......................... Range of motion measurements .......................... Tensilon test ......................................................... Muscle test, one limb ........................................... Muscle test, one limb ........................................... Muscle test, one limb ........................................... Muscle test, 2 limbs ............................................. Muscle test, 2 limbs ............................................. Muscle test, 2 limbs ............................................. Muscle test, 3 limbs ............................................. Muscle test, 3 limbs ............................................. Muscle test, 3 limbs ............................................. Muscle test, 4 limbs ............................................. Muscle test, 4 limbs ............................................. Muscle test, 4 limbs ............................................. Muscle test, larynx ............................................... Muscle test, larynx ............................................... Muscle test, larynx ............................................... Muscle test, hemidiaphragm ................................ Muscle test, hemidiaphragm ................................ Muscle test, hemidiaphragm ................................ Muscle test cran nerv unilat ................................. Muscle test cran nerv unilat ................................. Muscle test cran nerv unilat ................................. Muscle test cran nerve bilat ................................. Muscle test cran nerve bilat ................................. Muscle test cran nerve bilat ................................. Muscle test, thor paraspinal ................................. Muscle test, thor paraspinal ................................. Description 0.00 0.00 0.74 1.08 0.00 1.08 6.20 0.00 6.20 1.70 0.28 0.29 0.47 0.60 0.16 0.11 0.53 0.96 0.00 0.96 1.54 0.00 1.54 1.87 0.00 1.87 1.99 0.00 1.99 1.57 0.00 1.57 1.25 0.00 1.25 0.79 0.00 0.79 1.18 0.00 1.18 0.37 0.00 Physician Work RVUs 3 0.00 0.00 0.22 11.46 11.17 0.29 25.25 23.42 1.83 2.98 0.38 0.36 0.47 0.54 0.26 0.21 0.59 1.15 0.83 0.32 1.67 1.15 0.52 1.94 1.35 0.59 2.19 1.55 0.64 1.35 0.88 0.47 1.33 0.93 0.40 1.12 0.88 0.24 1.43 1.07 0.36 1.02 0.90 Fully Implemented NonFacility PE RVUs 0.00 0.00 0.29 4.89 4.51 0.38 29.56 27.37 2.19 3.21 0.44 0.34 0.55 0.61 0.34 0.25 0.60 1.36 0.96 0.40 1.48 0.84 0.64 1.79 1.04 0.75 2.53 1.72 0.81 1.43 0.73 0.70 0.90 0.38 0.52 0.98 0.66 0.32 1.26 0.79 0.47 0.53 0.38 Year 2007 Transitional Non-Facility PE RVUs 0.00 0.00 0.22 NA NA 0.29 NA NA 1.83 0.43 0.09 0.10 0.13 0.18 0.04 0.03 0.17 NA NA 0.32 NA NA 0.52 NA NA 0.59 NA NA 0.64 NA NA 0.47 NA NA 0.40 NA NA 0.24 NA NA 0.36 NA NA Fully Implemented Facility PE RVUs 0.00 0.00 0.29 NA NA 0.38 NA NA 2.19 0.66 0.12 0.12 0.21 0.26 0.07 0.05 0.22 NA NA 0.40 NA NA 0.64 NA NA 0.75 NA NA 0.81 NA NA 0.70 NA NA 0.52 NA NA 0.32 NA NA 0.47 NA NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 95824 95824 95824 95827 95827 95827 95829 95829 95829 95830 95831 95832 95833 95834 95851 95852 95857 95860 95860 95860 95861 95861 95861 95863 95863 95863 95864 95864 95864 95865 95865 95865 95866 95866 95866 95867 95867 95867 95868 95868 95868 95869 95869 HCPCS 2 CPT 1/ 0.00 0.00 0.04 0.19 0.14 0.05 0.50 0.02 0.48 0.11 0.01 0.02 0.02 0.03 0.01 0.01 0.02 0.07 0.02 0.05 0.13 0.06 0.07 0.15 0.06 0.09 0.21 0.12 0.09 0.11 0.03 0.08 0.10 0.03 0.07 0.07 0.04 0.03 0.10 0.05 0.05 0.04 0.02 Mal-Practice RVUs 0.00 0.00 1.00 12.73 11.31 1.42 31.95 23.44 8.51 4.79 0.67 0.67 0.96 1.17 0.43 0.33 1.14 2.18 0.85 1.33 3.34 1.21 2.13 3.96 1.41 2.55 4.39 1.67 2.72 3.03 0.91 2.12 2.68 0.96 1.72 1.98 0.92 1.06 2.71 1.12 1.59 1.43 0.92 Fully Implemented NonFacility Total 0.00 0.00 1.07 6.16 4.65 1.51 36.26 27.39 8.87 5.02 0.73 0.65 1.04 1.24 0.51 0.37 1.15 2.39 0.98 1.41 3.15 0.90 2.25 3.81 1.10 2.71 4.73 1.84 2.89 3.11 0.76 2.35 2.25 0.41 1.84 1.84 0.70 1.14 2.54 0.84 1.70 0.94 0.40 Year 2007 Transitional Non-Facility Total 0.00 0.00 1.00 NA NA 1.42 NA NA 8.51 2.24 0.38 0.41 0.62 0.81 0.21 0.15 0.72 NA NA 1.33 NA NA 2.13 NA NA 2.55 NA NA 2.72 NA NA 2.12 NA NA 1.72 NA NA 1.06 NA NA 1.59 NA NA Fully Implemented Facility Total 0.00 0.00 1.07 NA NA 1.51 NA NA 8.87 2.47 0.41 0.43 0.70 0.89 0.24 0.17 0.77 NA NA 1.41 NA NA 2.25 NA NA 2.71 NA NA 2.89 NA NA 2.35 NA NA 1.84 NA NA 1.14 NA NA 1.70 NA NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69995 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00374 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Status Muscle test, thor paraspinal ................................. Muscle test, nonparaspinal .................................. Muscle test, nonparaspinal .................................. Muscle test, nonparaspinal .................................. Muscle test, one fiber ........................................... Muscle test, one fiber ........................................... Muscle test, one fiber ........................................... Guide nerv destr, elec stim .................................. Guide nerv destr, elec stim .................................. Guide nerv destr, elec stim .................................. Guide nerv destr, needle emg ............................. Guide nerv destr, needle emg ............................. Guide nerv destr, needle emg ............................. Limb exercise test ................................................ Limb exercise test ................................................ Limb exercise test ................................................ Motor nerve conduction test ................................ Motor nerve conduction test ................................ Motor nerve conduction test ................................ Motor nerve conduction test ................................ Motor nerve conduction test ................................ Motor nerve conduction test ................................ Sense nerve conduction test ............................... Sense nerve conduction test ............................... Sense nerve conduction test ............................... Intraop nerve test add-on ..................................... Intraop nerve test add-on ..................................... Intraop nerve test add-on ..................................... Autonomic nerv function test ............................... Autonomic nerv function test ............................... Autonomic nerv function test ............................... Autonomic nerv function test ............................... Autonomic nerv function test ............................... Autonomic nerv function test ............................... Autonomic nerv function test ............................... Autonomic nerv function test ............................... Autonomic nerv function test ............................... Somatosensory testing ......................................... Somatosensory testing ......................................... Somatosensory testing ......................................... Somatosensory testing ......................................... Somatosensory testing ......................................... Somatosensory testing ......................................... Description 0.37 0.37 0.00 0.37 2.88 0.00 2.88 0.37 0.00 0.37 0.37 0.00 0.37 1.10 0.00 1.10 0.42 0.00 0.42 0.60 0.00 0.60 0.34 0.00 0.34 2.11 0.00 2.11 0.90 0.00 0.90 0.96 0.00 0.96 0.90 0.00 0.90 0.54 0.00 0.54 0.54 0.00 0.54 Physician Work RVUs 3 0.12 0.99 0.87 0.12 1.72 0.77 0.95 0.94 0.82 0.12 0.95 0.83 0.12 1.31 0.99 0.32 0.93 0.79 0.14 1.02 0.84 0.18 0.86 0.75 0.11 1.79 1.12 0.67 1.12 0.88 0.24 1.64 1.36 0.28 2.11 1.87 0.24 3.12 2.95 0.17 2.95 2.79 0.16 Fully Implemented NonFacility PE RVUs 0.15 0.53 0.38 0.15 1.35 0.64 0.71 0.51 0.36 0.15 0.52 0.36 0.16 1.41 0.98 0.43 1.18 1.01 0.17 1.15 0.91 0.24 1.03 0.89 0.14 2.13 1.26 0.87 0.82 0.51 0.31 1.00 0.63 0.37 1.99 1.64 0.35 1.63 1.42 0.21 1.59 1.38 0.21 Year 2007 Transitional Non-Facility PE RVUs 0.12 NA NA 0.12 NA NA 0.95 0.94 0.82 0.12 0.95 0.83 0.12 NA NA 0.32 NA NA 0.14 NA NA 0.18 NA NA 0.11 1.79 1.12 0.67 NA NA 0.24 NA NA 0.28 NA NA 0.24 NA NA 0.17 NA NA 0.16 Fully Implemented Facility PE RVUs 0.15 NA NA 0.15 NA NA 0.71 0.51 0.36 0.15 0.52 0.36 0.16 NA NA 0.43 NA NA 0.17 NA NA 0.24 NA NA 0.14 2.13 1.26 0.87 NA NA 0.31 NA NA 0.37 NA NA 0.35 NA NA 0.21 NA NA 0.21 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 95869 95870 95870 95870 95872 95872 95872 95873 95873 95873 95874 95874 95874 95875 95875 95875 95900 95900 95900 95903 95903 95903 95904 95904 95904 95920 95920 95920 95921 95921 95921 95922 95922 95922 95923 95923 95923 95925 95925 95925 95926 95926 95926 HCPCS 2 CPT 1/ 0.02 0.04 0.02 0.02 0.13 0.05 0.08 0.04 0.02 0.02 0.04 0.02 0.02 0.11 0.06 0.05 0.04 0.02 0.02 0.05 0.02 0.03 0.04 0.02 0.02 0.23 0.07 0.16 0.06 0.02 0.04 0.07 0.02 0.05 0.07 0.02 0.05 0.10 0.06 0.04 0.09 0.06 0.03 Mal-Practice RVUs 0.51 1.40 0.89 0.51 4.73 0.82 3.91 1.35 0.84 0.51 1.36 0.85 0.51 2.52 1.05 1.47 1.39 0.81 0.58 1.67 0.86 0.81 1.24 0.77 0.47 4.13 1.19 2.94 2.08 0.90 1.18 2.67 1.38 1.29 3.08 1.89 1.19 3.76 3.01 0.75 3.58 2.85 0.73 Fully Implemented NonFacility Total 0.54 0.94 0.40 0.54 4.36 0.69 3.67 0.92 0.38 0.54 0.93 0.38 0.55 2.62 1.04 1.58 1.64 1.03 0.61 1.80 0.93 0.87 1.41 0.91 0.50 4.47 1.33 3.14 1.78 0.53 1.25 2.03 0.65 1.38 2.96 1.66 1.30 2.27 1.48 0.79 2.22 1.44 0.78 Year 2007 Transitional Non-Facility Total 0.51 NA NA 0.51 NA NA 3.91 1.35 0.84 0.51 1.36 0.85 0.51 NA NA 1.47 NA NA 0.58 NA NA 0.81 NA NA 0.47 4.13 1.19 2.94 NA NA 1.18 NA NA 1.29 NA NA 1.19 NA NA 0.75 NA NA 0.73 Fully Implemented Facility Total 0.54 NA NA 0.54 NA NA 3.67 0.92 0.38 0.54 0.93 0.38 0.55 NA NA 1.58 NA NA 0.61 NA NA 0.87 NA NA 0.50 4.47 1.33 3.14 NA NA 1.25 NA NA 1.38 NA NA 1.30 NA NA 0.79 NA NA 0.78 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX ZZZ ZZZ ZZZ ZZZ ZZZ ZZZ XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX ZZZ ZZZ ZZZ XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69996 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00375 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A A A C C A A A A A A A A A A A A A A Status Somatosensory testing ......................................... Somatosensory testing ......................................... Somatosensory testing ......................................... C motor evoked, uppr limbs ................................. C motor evoked, uppr limbs ................................. C motor evoked, uppr limbs ................................. C motor evoked, lwr limbs ................................... C motor evoked, lwr limbs ................................... C motor evoked, lwr limbs ................................... Visual evoked potential test ................................. Visual evoked potential test ................................. Visual evoked potential test ................................. Blink reflex test ..................................................... Blink reflex test ..................................................... Blink reflex test ..................................................... H-reflex test .......................................................... H-reflex test .......................................................... H-reflex test .......................................................... H-reflex test .......................................................... H-reflex test .......................................................... H-reflex test .......................................................... Neuromuscular junction test ................................ Neuromuscular junction test ................................ Neuromuscular junction test ................................ Ambulatory eeg monitoring .................................. Ambulatory eeg monitoring .................................. Ambulatory eeg monitoring .................................. EEG monitoring/videorecord ................................ EEG monitoring/videorecord ................................ EEG monitoring/videorecord ................................ EEG monitoring/computer .................................... EEG monitoring/computer .................................... EEG monitoring/computer .................................... EEG monitoring/giving drugs ............................... EEG monitoring/giving drugs ............................... EEG monitoring/giving drugs ............................... EEG during surgery ............................................. EEG during surgery ............................................. EEG during surgery ............................................. Eeg monitoring, cable/radio ................................. Eeg monitoring, cable/radio ................................. Eeg monitoring, cable/radio ................................. EEG digital analysis ............................................. Description 0.54 0.00 0.54 1.50 0.00 1.50 1.50 0.00 1.50 0.35 0.00 0.35 0.59 0.00 0.59 0.51 0.00 0.51 0.55 0.00 0.55 0.65 0.00 0.65 1.51 0.00 1.51 0.00 0.00 5.99 3.30 0.00 3.30 2.45 0.00 2.45 1.01 0.00 1.01 3.08 0.00 3.08 1.98 Physician Work RVUs 3 3.01 2.85 0.16 3.96 3.50 0.46 4.28 3.81 0.47 2.62 2.52 0.10 1.09 0.92 0.17 0.88 0.72 0.16 0.60 0.43 0.17 0.91 0.71 0.20 4.91 4.48 0.43 0.00 0.00 1.72 7.18 6.23 0.95 4.86 4.34 0.52 2.78 2.49 0.29 15.61 14.73 0.88 5.82 Fully Implemented NonFacility PE RVUs 1.63 1.40 0.23 3.25 2.65 0.60 3.48 2.87 0.61 2.34 2.20 0.14 1.04 0.82 0.22 0.55 0.34 0.21 0.49 0.27 0.22 0.68 0.43 0.25 4.18 3.59 0.59 0.00 0.00 2.34 7.52 6.31 1.21 4.38 3.47 0.91 2.43 2.09 0.34 15.47 14.27 1.20 3.37 Year 2007 Transitional Non-Facility PE RVUs NA NA 0.16 NA NA 0.46 NA NA 0.47 NA NA 0.10 NA NA 0.17 NA NA 0.16 NA NA 0.17 NA NA 0.20 NA NA 0.43 0.00 0.00 1.72 NA NA 0.95 NA NA 0.52 2.78 2.49 0.29 NA NA 0.88 NA Fully Implemented Facility PE RVUs NA NA 0.23 NA NA 0.60 NA NA 0.61 NA NA 0.14 NA NA 0.22 NA NA 0.21 NA NA 0.22 NA NA 0.25 NA NA 0.59 0.00 0.00 2.34 NA NA 1.21 NA NA 0.91 2.43 2.09 0.34 NA NA 1.20 NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 95927 95927 95927 95928 95928 95928 95929 95929 95929 95930 95930 95930 95933 95933 95933 95934 95934 95934 95936 95936 95936 95937 95937 95937 95950 95950 95950 95951 95951 95951 95953 95953 95953 95954 95954 95954 95955 95955 95955 95956 95956 95956 95957 HCPCS 2 CPT 1/ 0.10 0.06 0.04 0.09 0.03 0.06 0.09 0.03 0.06 0.03 0.01 0.02 0.10 0.06 0.04 0.04 0.02 0.02 0.05 0.02 0.03 0.10 0.02 0.08 0.51 0.43 0.08 0.00 0.00 0.32 0.60 0.43 0.17 0.19 0.06 0.13 0.22 0.17 0.05 0.59 0.43 0.16 0.23 Mal-Practice RVUs 3.65 2.91 0.74 5.55 3.53 2.02 5.87 3.84 2.03 3.00 2.53 0.47 1.78 0.98 0.80 1.43 0.74 0.69 1.20 0.45 0.75 1.66 0.73 0.93 6.93 4.91 2.02 0.00 0.00 8.03 11.08 6.66 4.42 7.50 4.40 3.10 4.01 2.66 1.35 19.28 15.16 4.12 8.03 Fully Implemented NonFacility Total 2.27 1.46 0.81 4.84 2.68 2.16 5.07 2.90 2.17 2.72 2.21 0.51 1.73 0.88 0.85 1.10 0.36 0.74 1.09 0.29 0.80 1.43 0.45 0.98 6.20 4.02 2.18 0.00 0.00 8.65 11.42 6.74 4.68 7.02 3.53 3.49 3.66 2.26 1.40 19.14 14.70 4.44 5.58 Year 2007 Transitional Non-Facility Total NA NA 0.74 NA NA 2.02 NA NA 2.03 NA NA 0.47 NA NA 0.80 NA NA 0.69 NA NA 0.75 NA NA 0.93 NA NA 2.02 0.00 0.00 8.03 NA NA 4.42 NA NA 3.10 4.01 2.66 1.35 NA NA 4.12 NA Fully Implemented Facility Total NA NA 0.81 NA NA 2.16 NA NA 2.17 NA NA 0.51 NA NA 0.85 NA NA 0.74 NA NA 0.80 NA NA 0.98 NA NA 2.18 0.00 0.00 8.65 NA NA 4.68 NA NA 3.49 3.66 2.26 1.40 NA NA 4.44 NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69997 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00376 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... TC .... 26 ..... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A C C A C C A C C A A A A A A A A A A A C A A A A A C C A B A A A Status EEG digital analysis ............................................. EEG digital analysis ............................................. EEG monitoring/function test ............................... EEG monitoring/function test ............................... EEG monitoring/function test ............................... Electrode stimulation, brain .................................. Electrode stimulation, brain .................................. Electrode stimulation, brain .................................. Electrode stim, brain add-on ................................ Electrode stim, brain add-on ................................ Electrode stim, brain add-on ................................ Meg, spontaneous ................................................ Meg, spontaneous ................................................ Meg, spontaneous ................................................ Meg, evoked, single ............................................. Meg, evoked, single ............................................. Meg, evoked, single ............................................. Meg, evoked, each add"l ................................... Meg, evoked, each add"l ................................... Meg, evoked, each add"l ................................... Analyze neurostim, no prog ................................. Analyze neurostim, simple ................................... Analyze neurostim, complex ................................ Analyze neurostim, complex ................................ Cranial neurostim, complex ................................. Cranial neurostim, complex ................................. Analyze neurostim brain/1h ................................. Analyz neurostim brain addon ............................. Spin/brain pump refil & main ............................... Spin/brain pump refil & main ............................... Neurological procedure ........................................ Motion analysis, video/3d ..................................... Motion test w/ft press meas ................................. Dynamic surface emg .......................................... Dynamic fine wire emg ........................................ Phys review of motion tests ................................. Functional brain mapping ..................................... Functional brain mapping ..................................... Functional brain mapping ..................................... Genetic counseling, 30 min ................................. Psycho testing by psych/phys .............................. Psycho testing by technician ............................... Psycho testing admin by comp ............................ Description 0.00 1.98 4.24 0.00 4.24 2.97 0.00 2.97 3.21 0.00 3.21 0.00 0.00 7.99 0.00 0.00 3.99 0.00 0.00 3.49 0.45 0.78 1.50 0.92 3.00 1.70 3.50 1.64 0.00 0.77 0.00 1.80 2.15 0.41 0.37 2.14 0.00 0.00 3.43 0.00 1.86 0.50 0.51 Physician Work RVUs 3 5.26 0.56 6.54 5.34 1.20 3.12 2.20 0.92 2.22 1.29 0.93 0.00 0.00 2.30 0.00 0.00 1.15 0.00 0.00 0.99 0.88 0.61 1.19 0.56 1.49 0.75 1.85 0.74 1.62 1.63 0.00 NA NA NA NA 0.55 NA 0.00 0.86 0.97 0.35 1.20 1.31 Fully Implemented NonFacility PE RVUs 2.59 0.78 4.25 2.64 1.61 2.75 1.53 1.22 2.59 1.31 1.28 0.00 0.00 3.14 0.00 0.00 1.57 0.00 0.00 1.13 0.86 0.66 1.21 0.61 1.65 0.86 1.91 0.84 1.53 1.53 0.00 NA NA NA NA 0.84 NA 0.00 0.86 0.97 0.58 0.80 0.49 Year 2007 Transitional Non-Facility PE RVUs NA 0.56 NA NA 1.20 NA NA 0.92 2.22 1.29 0.93 0.00 0.00 2.30 0.00 0.00 1.15 0.00 0.00 0.99 0.13 0.20 0.46 0.25 0.87 0.49 1.06 0.48 NA NA 0.00 0.58 0.54 0.11 0.14 0.55 NA 0.00 0.86 NA 0.33 0.09 0.09 Fully Implemented Facility PE RVUs NA 0.78 NA NA 1.61 NA NA 1.22 2.59 1.31 1.28 0.00 0.00 3.14 0.00 0.00 1.57 0.00 0.00 1.13 0.14 0.22 0.48 0.32 1.19 0.67 1.24 0.64 NA NA 0.00 0.54 0.63 0.14 0.13 0.84 NA 0.00 0.86 NA 0.56 0.15 0.15 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 95957 95957 95958 95958 95958 95961 95961 95961 95962 95962 95962 95965 95965 95965 95966 95966 95966 95967 95967 95967 95970 95971 95972 95973 95974 95975 95978 95979 95990 95991 95999 96000 96001 96002 96003 96004 96020 96020 96020 96040 96101 96102 96103 HCPCS 2 CPT 1/ 0.12 0.11 0.34 0.13 0.21 0.55 0.07 0.48 0.39 0.07 0.32 0.00 0.00 0.46 0.00 0.00 0.19 0.00 0.00 0.16 0.03 0.07 0.14 0.07 0.16 0.12 0.18 0.08 0.06 0.06 0.00 0.11 0.10 0.02 0.02 0.11 0.00 0.00 0.17 0.01 0.05 0.01 0.02 Mal-Practice RVUs 5.38 2.65 11.12 5.47 5.65 6.64 2.27 4.37 5.82 1.36 4.46 0.00 0.00 10.75 0.00 0.00 5.33 0.00 0.00 4.64 1.36 1.46 2.83 1.55 4.65 2.57 5.53 2.46 1.68 2.46 0.00 NA NA NA NA 2.80 NA 0.00 4.46 0.98 2.26 1.71 1.84 Fully Implemented NonFacility Total 2.71 2.87 8.83 2.77 6.06 6.27 1.60 4.67 6.19 1.38 4.81 0.00 0.00 11.59 0.00 0.00 5.75 0.00 0.00 4.78 1.34 1.51 2.85 1.60 4.81 2.68 5.59 2.56 1.59 2.36 0.00 NA NA NA NA 3.09 NA 0.00 4.46 0.98 2.49 1.31 1.02 Year 2007 Transitional Non-Facility Total NA 2.65 NA NA 5.65 NA NA 4.37 5.82 1.36 4.46 0.00 0.00 10.75 0.00 0.00 5.33 0.00 0.00 4.64 0.61 1.05 2.10 1.24 4.03 2.31 4.74 2.20 NA NA 0.00 2.49 2.79 0.54 0.53 2.80 NA 0.00 4.46 NA 2.24 0.60 0.62 Fully Implemented Facility Total NA 2.87 NA NA 6.06 NA NA 4.67 6.19 1.38 4.81 0.00 0.00 11.59 0.00 0.00 5.75 0.00 0.00 4.78 0.62 1.07 2.12 1.31 4.35 2.49 4.92 2.36 NA NA 0.00 2.45 2.88 0.57 0.52 3.09 NA 0.00 4.46 NA 2.47 0.66 0.68 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX ZZZ ZZZ ZZZ XXX XXX XXX XXX XXX XXX ZZZ ZZZ ZZZ XXX XXX XXX ZZZ XXX ZZZ XXX ZZZ XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 69998 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00377 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A N A A A A A A A A A A A A A A A A A A A T A C A A A A B R A A Status Assessment of aphasia ........................................ Developmental test, lim ........................................ Developmental test, extend ................................. Neurobehavioral status exam .............................. Neuropsych tst by psych/phys ............................. Neuropsych testing by tec ................................... Neuropsych tst admin w/comp ............................. Assess hlth/behave, init ....................................... Assess hlth/behave, subseq ................................ Intervene hlth/behave, indiv ................................. Intervene hlth/behave, group ............................... Interv hlth/behav, fam w/pt ................................... Interv hlth/behav fam no pt .................................. Chemo, anti-neopl, sq/im ..................................... Chemo hormon antineopl sq/im ........................... Chemo intralesional, up to 7 ................................ Chemo intralesional over 7 .................................. Chemo, iv push, sngl drug ................................... Chemo, iv push, addl drug ................................... Chemo, iv infusion, 1 hr ....................................... Chemo, iv infusion, addl hr .................................. Chemo prolong infuse w/pump ............................ Chemo iv infus each addl seq ............................. Chemo, ia, push tecnique .................................... Chemo ia infusion up to 1 hr ............................... Chemo ia infuse each addl hr .............................. Chemotherapy,infusion method ........................... Chemotherapy, intracavitary ................................ Chemotherapy, intracavitary ................................ Chemotherapy, into CNS ..................................... Refill/maint, portable pump .................................. Refill/maint pump/resvr syst ................................. Irrig drug delivery device ...................................... Chemotherapy injection ....................................... Chemotherapy, unspecified ................................. Photodynamic tx, skin .......................................... Photodynamic tx, 30 min ..................................... Photodynamic tx, addl 15 min ............................. Ultraviolet light therapy ........................................ Trichogram ........................................................... Whole body photography ..................................... Photochemotherapy with UV–B ........................... Photochemotherapy with UV–A ........................... Description 0.00 0.00 2.60 1.86 1.86 0.55 0.51 0.50 0.48 0.46 0.10 0.45 0.44 0.21 0.19 0.52 0.80 0.24 0.20 0.28 0.19 0.21 0.21 0.17 0.17 0.17 0.17 2.37 2.20 1.53 0.21 0.21 0.04 0.75 0.00 0.00 1.10 0.55 0.00 0.41 0.00 0.00 0.00 Physician Work RVUs 3 2.05 0.18 0.67 0.54 0.82 1.53 1.92 0.10 0.10 0.09 0.02 0.09 0.10 1.86 0.71 3.55 3.29 2.77 1.49 3.61 0.65 4.06 1.72 2.69 3.80 1.91 4.52 5.51 5.41 4.93 3.13 2.72 0.64 3.54 0.00 3.74 0.41 0.20 0.56 0.11 1.84 2.00 2.58 Fully Implemented NonFacility PE RVUs 1.83 0.18 0.96 0.76 1.25 1.15 1.04 0.16 0.16 0.15 0.04 0.15 0.16 1.34 0.94 2.71 3.08 2.88 1.58 4.05 0.74 4.47 1.89 2.67 4.57 1.89 4.48 7.48 7.38 6.45 3.60 2.66 0.68 4.07 0.00 2.40 0.38 0.19 0.47 0.16 1.84 1.24 1.59 Year 2007 Transitional Non-Facility PE RVUs NA NA 0.54 0.43 0.33 0.10 0.09 0.09 0.09 0.08 0.02 0.08 0.10 NA NA 0.23 0.28 NA NA NA NA NA NA NA NA NA NA 1.00 0.95 0.83 NA NA NA 0.33 0.00 NA 0.41 0.20 NA 0.10 NA NA NA Fully Implemented Facility PE RVUs NA NA 0.92 0.59 0.56 0.17 0.15 0.16 0.15 0.14 0.03 0.14 0.15 NA NA 0.24 0.29 NA NA NA NA NA NA NA NA NA NA 1.17 1.12 1.18 NA NA NA 0.58 0.00 NA 0.38 0.19 NA 0.15 NA NA NA Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 96105 96110 96111 96116 96118 96119 96120 96150 96151 96152 96153 96154 96155 96401 96402 96405 96406 96409 96411 96413 96415 96416 96417 96420 96422 96423 96425 96440 96445 96450 96521 96522 96523 96542 96549 96567 96570 96571 96900 96902 96904 96910 96912 HCPCS 2 CPT 1/ 0.18 0.18 0.18 0.18 0.18 0.18 0.02 0.01 0.01 0.01 0.01 0.01 0.02 0.01 0.01 0.03 0.03 0.06 0.06 0.08 0.07 0.08 0.07 0.08 0.08 0.02 0.08 0.17 0.14 0.09 0.06 0.06 0.01 0.07 0.00 0.04 0.11 0.03 0.02 0.01 0.01 0.04 0.05 Mal-Practice RVUs 2.23 0.36 3.45 2.58 2.86 2.26 2.45 0.61 0.59 0.56 0.13 0.55 0.56 2.08 0.91 4.10 4.12 3.07 1.75 3.97 0.91 4.35 2.00 2.94 4.05 2.10 4.77 8.05 7.75 6.55 3.40 2.99 0.69 4.36 0.00 3.78 1.62 0.78 0.58 0.53 1.85 2.04 2.63 Fully Implemented NonFacility Total 2.01 0.36 3.74 2.80 3.29 1.88 1.57 0.67 0.65 0.62 0.15 0.61 0.62 1.56 1.14 3.26 3.91 3.18 1.84 4.41 1.00 4.76 2.17 2.92 4.82 2.08 4.73 10.02 9.72 8.07 3.87 2.93 0.73 4.89 0.00 2.44 1.59 0.77 0.49 0.58 1.85 1.28 1.64 Year 2007 Transitional Non-Facility Total NA NA 3.32 2.47 2.37 0.83 0.62 0.60 0.58 0.55 0.13 0.54 0.56 NA NA 0.78 1.11 NA NA NA NA NA NA NA NA NA NA 3.54 3.29 2.45 NA NA NA 1.15 0.00 NA 1.62 0.78 NA 0.52 NA NA NA Fully Implemented Facility Total NA NA 3.70 2.63 2.60 0.90 0.68 0.67 0.64 0.61 0.14 0.60 0.61 NA NA 0.79 1.12 NA NA NA NA NA NA NA NA NA NA 3.71 3.46 2.80 NA NA NA 1.40 0.00 NA 1.59 0.77 NA 0.57 NA NA NA Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX 000 000 XXX ZZZ XXX ZZZ XXX ZZZ XXX XXX ZZZ XXX 000 000 000 XXX XXX XXX XXX XXX XXX ZZZ ZZZ XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 69999 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00378 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A C A A A A I I B A I A A A A A A A A A A A C A A A A A C A A A A A A A A R R A Status Photochemotherapy, UV–A or B .......................... Laser tx, skin < 250 sq cm .................................. Laser tx, skin 250–500 sq cm .............................. Laser tx, skin > 500 sq cm .................................. Dermatological procedure .................................... Pt evaluation ........................................................ Pt re-evaluation .................................................... Ot evaluation ........................................................ Ot re-evaluation .................................................... Athletic train eval .................................................. Athletic train reeval .............................................. Hot or cold packs therapy .................................... Mechanical traction therapy ................................. Electric stimulation therapy .................................. Vasopneumatic device therapy ............................ Paraffin bath therapy ............................................ Whirlpool therapy ................................................. Diathermy eg, microwave .................................... Infrared therapy .................................................... Ultraviolet therapy ................................................ Electrical stimulation ............................................ Electric current therapy ........................................ Contrast bath therapy .......................................... Ultrasound therapy ............................................... Hydrotherapy ........................................................ Physical therapy treatment .................................. Therapeutic exercises .......................................... Neuromuscular reeducation ................................. Aquatic therapy/exercises .................................... Gait training therapy ............................................. Massage therapy .................................................. Physical medicine procedure ............................... Manual therapy .................................................... Group therapeutic procedures ............................. Therapeutic activities ........................................... Cognitive skills development ................................ Sensory integration .............................................. Self care mngment training .................................. Community/work reintegration ............................. Wheelchair mngment training .............................. Work hardening .................................................... Work hardening add-on ....................................... Active wound care/20 cm or < ............................. Description 0.00 1.15 1.17 2.10 0.00 1.20 0.60 1.20 0.60 0.00 0.00 0.06 0.25 0.18 0.18 0.06 0.17 0.06 0.06 0.08 0.25 0.26 0.21 0.21 0.28 0.00 0.45 0.45 0.44 0.40 0.35 0.00 0.43 0.27 0.44 0.44 0.44 0.45 0.45 0.45 0.00 0.00 0.58 Physician Work RVUs 3 3.65 3.59 3.49 4.63 0.00 0.67 0.41 0.78 0.55 0.00 0.00 0.07 0.14 0.18 0.24 0.17 0.33 0.08 0.07 0.08 0.20 0.44 0.20 0.10 0.44 0.00 0.32 0.34 0.53 0.28 0.27 0.00 0.29 0.22 0.38 0.22 0.27 0.37 0.28 0.29 0.00 0.00 1.10 Fully Implemented NonFacility PE RVUs 2.17 2.80 2.82 3.77 0.00 0.73 0.43 0.86 0.64 0.00 0.00 0.06 0.13 0.19 0.20 0.12 0.24 0.07 0.06 0.07 0.17 0.31 0.16 0.10 0.35 0.00 0.28 0.32 0.43 0.25 0.24 0.00 0.26 0.19 0.34 0.21 0.25 0.34 0.27 0.28 0.00 0.00 0.77 Year 2007 Transitional Non-Facility PE RVUs NA 0.58 0.55 1.06 0.00 NA NA NA NA 0.00 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA 0.00 0.00 0.12 Fully Implemented Facility PE RVUs NA 0.57 0.57 0.73 0.00 NA NA NA NA 0.00 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA 0.00 0.00 0.53 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 96913 96920 96921 96922 96999 97001 97002 97003 97004 97005 97006 97010 97012 97014 97016 97018 97022 97024 97026 97028 97032 97033 97034 97035 97036 97039 97110 97112 97113 97116 97124 97139 97140 97150 97530 97532 97533 97535 97537 97542 97545 97546 97597 HCPCS 2 CPT 1/ 0.10 0.02 0.03 0.04 0.00 0.05 0.02 0.06 0.02 0.00 0.00 0.01 0.01 0.01 0.01 0.01 0.01 0.01 0.01 0.01 0.01 0.01 0.01 0.01 0.01 0.00 0.02 0.01 0.01 0.01 0.01 0.00 0.01 0.01 0.01 0.01 0.01 0.01 0.01 0.01 0.00 0.00 0.05 Mal-Practice RVUs 3.75 4.76 4.69 6.77 0.00 1.92 1.03 2.04 1.17 0.00 0.00 0.14 0.40 0.37 0.43 0.24 0.51 0.15 0.14 0.17 0.46 0.71 0.42 0.32 0.73 0.00 0.79 0.80 0.98 0.69 0.63 0.00 0.73 0.50 0.83 0.67 0.72 0.83 0.74 0.75 0.00 0.00 1.73 Fully Implemented NonFacility Total 2.27 3.97 4.02 5.91 0.00 1.98 1.05 2.12 1.26 0.00 0.00 0.13 0.39 0.38 0.39 0.19 0.42 0.14 0.13 0.16 0.43 0.58 0.38 0.32 0.64 0.00 0.75 0.78 0.88 0.66 0.60 0.00 0.70 0.47 0.79 0.66 0.70 0.80 0.73 0.74 0.00 0.00 1.40 Year 2007 Transitional Non-Facility Total NA 1.75 1.75 3.20 0.00 NA NA NA NA 0.00 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA 0.00 0.00 0.75 Fully Implemented Facility Total NA 1.74 1.77 2.87 0.00 NA NA NA NA 0.00 0.00 NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.00 NA NA NA NA NA 0.00 NA NA NA NA NA NA NA NA 0.00 0.00 1.16 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX 000 000 000 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX ZZZ XXX Global 70000 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00379 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A B A A A A A A A C A A A N N N N A A A A A A A A N B B B B B B B N N B B B B B B B B Status Active wound care > 20 cm ................................. Wound(s) care non-selective ............................... Neg press wound tx, < 50 cm .............................. Neg press wound tx, > 50 cm .............................. Physical performance test .................................... Assistive technology assess ................................ Orthotic mgmt and training .................................. Prosthetic training ................................................ C/o for orthotic/prosth use ................................... Physical medicine procedure ............................... Medical nutrition, indiv, in .................................... Med nutrition, indiv, subseq ................................. Medical nutrition, group ........................................ Acupunct w/o stimul 15 min ................................. Acupunct w/o stimul addl 15m ............................. Acupunct w/stimul 15 min .................................... Acupunct w/stimul addl 15m ................................ Osteopathic manipulation ..................................... Osteopathic manipulation ..................................... Osteopathic manipulation ..................................... Osteopathic manipulation ..................................... Osteopathic manipulation ..................................... Chiropractic manipulation ..................................... Chiropractic manipulation ..................................... Chiropractic manipulation ..................................... Chiropractic manipulation ..................................... Self-mgmt educ & train, 1 pt ................................ Self-mgmt educ/train, 2–4 pt ................................ Self-mgmt educ/train, 5–8 pt ................................ Specimen handling ............................................... Specimen handling ............................................... Device handling .................................................... Postop follow-up visit ........................................... In-hospital on call service .................................... Out-of-hosp on call service .................................. Medical services after hrs .................................... Med serv, eve/wkend/holiday ............................... Med serv 10pm–8am, 24 hr fac ........................... Med service out of office ...................................... Office emergency care ......................................... Out of office emerg med serv .............................. Special supplies ................................................... Patient education materials .................................. Description 0.80 0.00 0.55 0.60 0.45 0.62 0.45 0.45 0.25 0.00 0.45 0.37 0.25 0.60 0.50 0.65 0.55 0.45 0.65 0.87 1.03 1.19 0.45 0.65 0.87 0.40 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Physician Work RVUs 3 1.27 0.00 0.41 0.42 0.33 0.28 0.42 0.33 0.73 0.00 0.14 0.12 0.07 0.26 0.15 0.27 0.19 0.28 0.36 0.45 0.51 0.57 0.21 0.27 0.34 0.17 0.48 0.23 0.17 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented NonFacility PE RVUs 0.91 0.00 0.36 0.37 0.32 0.28 0.36 0.29 0.50 0.00 0.39 0.38 0.15 0.35 0.23 0.37 0.27 0.31 0.40 0.49 0.57 0.65 0.23 0.29 0.36 0.22 0.48 0.23 0.17 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Non-Facility PE RVUs 0.17 0.00 0.12 0.13 NA NA NA NA NA 0.00 0.11 0.09 0.06 0.14 0.12 0.15 0.13 0.12 0.17 0.23 0.26 0.30 0.12 0.18 0.24 0.09 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented Facility PE RVUs 0.64 0.00 0.20 0.21 NA NA NA NA NA 0.00 0.38 0.38 0.15 0.21 0.17 0.23 0.19 0.14 0.23 0.28 0.32 0.35 0.12 0.17 0.23 0.14 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 97598 97602 97605 97606 97750 97755 97760 97761 97762 97799 97802 97803 97804 97810 97811 97813 97814 98925 98926 98927 98928 98929 98940 98941 98942 98943 98960 98961 98962 99000 99001 99002 99024 99026 99027 99050 99051 99053 99056 99058 99060 99070 99071 HCPCS 2 CPT 1/ 0.05 0.00 0.02 0.03 0.02 0.02 0.03 0.02 0.02 0.00 0.01 0.01 0.01 0.03 0.03 0.03 0.03 0.02 0.03 0.03 0.04 0.05 0.01 0.01 0.02 0.01 0.01 0.01 0.01 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Mal-Practice RVUs 2.12 0.00 0.98 1.05 0.80 0.92 0.90 0.80 1.00 0.00 0.60 0.50 0.33 0.89 0.68 0.95 0.77 0.75 1.04 1.35 1.58 1.81 0.67 0.93 1.23 0.58 0.49 0.24 0.18 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented NonFacility Total 1.76 0.00 0.93 1.00 0.79 0.92 0.84 0.76 0.77 0.00 0.85 0.76 0.41 0.98 0.76 1.05 0.85 0.78 1.08 1.39 1.64 1.89 0.69 0.95 1.25 0.63 0.49 0.24 0.18 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Non-Facility Total 1.02 0.00 0.69 0.76 NA NA NA NA NA 0.00 0.57 0.47 0.32 0.77 0.65 0.83 0.71 0.59 0.85 1.13 1.33 1.54 0.58 0.84 1.13 0.50 0.01 0.01 0.01 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented Facility Total 1.49 0.00 0.77 0.84 NA NA NA NA NA 0.00 0.84 0.76 0.41 0.84 0.70 0.91 0.77 0.61 0.91 1.18 1.39 1.59 0.58 0.83 1.12 0.55 0.01 0.01 0.01 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX ZZZ XXX ZZZ 000 000 000 000 000 000 000 000 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 70001 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00380 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod N B B C B B B B B B C C C C C C A N N A A A A X X X A C A A A A A A A A A A A A A A A Status Medical testimony ................................................ Group health education ........................................ Special reports or forms ....................................... Unusual physician travel ...................................... Computer data analysis ....................................... Collect/review data from pt .................................. Special anesthesia service .................................. Anesthesia with hypothermia ............................... Special anesthesia procedure .............................. Emergency anesthesia ......................................... Mod cs by same phys, < 5 yrs ............................ Mod cs by same phys, 5 yrs + ............................ Mod cs by same phys add-on ............................. Mod cs diff phys < 5 yrs ...................................... Mod cs diff phys 5 yrs + ...................................... Mod cs diff phys add-on ...................................... Anogenital exam, child ......................................... Ocular function screen ......................................... Visual acuity screen ............................................. Induction of vomiting ............................................ Hyperbaric oxygen therapy .................................. Regional hypothermia .......................................... Total body hypothermia ....................................... Special pump services ......................................... Special pump services ......................................... Special pump services ......................................... Phlebotomy .......................................................... Special service/proc/report ................................... Office/outpatient visit, new ................................... Office/outpatient visit, new ................................... Office/outpatient visit, new ................................... Office/outpatient visit, new ................................... Office/outpatient visit, new ................................... Office/outpatient visit, est ..................................... Office/outpatient visit, est ..................................... Office/outpatient visit, est ..................................... Office/outpatient visit, est ..................................... Office/outpatient visit, est ..................................... Observation care discharge ................................. Observation care .................................................. Observation care .................................................. Observation care .................................................. Initial hospital care ............................................... Description 0.00 0.00 0.00 0.00 0.00 1.10 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.75 0.00 0.00 0.00 2.34 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.45 0.88 1.34 2.30 3.00 0.17 0.45 0.92 1.42 2.00 1.28 1.28 2.14 2.99 1.88 Physician Work RVUs 3 0.00 0.00 0.00 0.00 0.00 0.25 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.50 0.00 0.06 0.33 2.60 1.65 1.38 0.00 0.00 0.00 2.59 0.00 0.55 0.84 1.11 1.50 1.80 0.32 0.55 0.76 1.11 1.39 NA NA NA NA NA Fully Implemented NonFacility PE RVUs 0.00 0.00 0.00 0.00 0.00 0.25 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.70 0.00 0.06 1.13 3.08 0.89 1.68 0.00 0.00 0.00 0.98 0.00 0.51 0.80 1.13 1.50 1.78 0.37 0.54 0.71 1.05 1.34 NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 0.00 0.00 0.00 0.00 0.00 NA 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.50 0.00 NA NA 0.59 NA NA 0.00 0.00 0.00 NA 0.00 0.16 0.30 0.43 0.72 0.93 0.06 0.15 0.29 0.45 0.62 0.51 0.39 0.61 0.87 0.56 Fully Implemented Facility PE RVUs 0.00 0.00 0.00 0.00 0.00 NA 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.54 0.00 NA NA 0.69 NA NA 0.00 0.00 0.00 NA 0.00 0.15 0.31 0.47 0.71 0.95 0.06 0.16 0.25 0.42 0.64 0.53 0.43 0.69 0.99 0.48 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 99075 99078 99080 99082 99090 99091 99100 99116 99135 99140 99143 99144 99145 99148 99149 99150 99170 99172 99173 99175 99183 99185 99186 99190 99191 99192 99195 99199 99201 99202 99203 99204 99205 99211 99212 99213 99214 99215 99217 99218 99219 99220 99221 HCPCS 2 CPT 1/ 0.00 0.00 0.00 0.00 0.00 0.04 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.08 0.00 0.01 0.10 0.16 0.04 0.45 0.00 0.00 0.00 0.02 0.00 0.03 0.05 0.09 0.12 0.15 0.01 0.03 0.03 0.05 0.08 0.06 0.06 0.10 0.14 0.07 Mal-Practice RVUs 0.00 0.00 0.00 0.00 0.00 1.39 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3.33 0.00 0.07 0.43 5.10 1.69 1.83 0.00 0.00 0.00 2.61 0.00 1.03 1.77 2.54 3.92 4.95 0.50 1.03 1.71 2.58 3.47 NA NA NA NA NA Fully Implemented NonFacility Total 0.00 0.00 0.00 0.00 0.00 1.39 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3.53 0.00 0.07 1.23 5.58 0.93 2.13 0.00 0.00 0.00 1.00 0.00 0.99 1.73 2.56 3.92 4.93 0.55 1.02 1.66 2.52 3.42 NA NA NA NA NA Year 2007 Transitional Non-Facility Total 0.00 0.00 0.00 0.00 0.00 NA 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2.33 0.00 NA NA 3.09 NA NA 0.00 0.00 0.00 NA 0.00 0.64 1.23 1.86 3.14 4.08 0.24 0.63 1.24 1.92 2.70 1.85 1.73 2.85 4.00 2.51 Fully Implemented Facility Total 0.00 0.00 0.00 0.00 0.00 NA 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2.37 0.00 NA NA 3.19 NA NA 0.00 0.00 0.00 NA 0.00 0.63 1.24 1.90 3.13 4.10 0.24 0.64 1.20 1.89 2.72 1.87 1.77 2.93 4.12 2.43 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX ZZZ ZZZ ZZZ ZZZ XXX XXX ZZZ XXX XXX ZZZ 000 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 70002 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00381 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A A A A A A B A A A A A A A A A A A A A A A A A Status Initial hospital care ............................................... Initial hospital care ............................................... Subsequent hospital care .................................... Subsequent hospital care .................................... Subsequent hospital care .................................... Observ/hosp same date ....................................... Observ/hosp same date ....................................... Observ/hosp same date ....................................... Hospital discharge day ......................................... Hospital discharge day ......................................... Office consultation ................................................ Office consultation ................................................ Office consultation ................................................ Office consultation ................................................ Office consultation ................................................ Inpatient consultation ........................................... Inpatient consultation ........................................... Inpatient consultation ........................................... Inpatient consultation ........................................... Inpatient consultation ........................................... Emergency dept visit ............................................ Emergency dept visit ............................................ Emergency dept visit ............................................ Emergency dept visit ............................................ Emergency dept visit ............................................ Direct advanced life support ................................ Ped crit care transport ......................................... Ped crit care transport addl ................................. Critical care, first hour .......................................... Critical care, add"l 30 min ................................. Ped critical care, initial ......................................... Ped critical care, subseq ...................................... Neonate crit care, initial ....................................... Neonate critical care subseq ............................... Ic for lbw infant < 1500 gm .................................. Ic, lbw infant 1500–2500 gm ................................ Ic, infant pbw 2501–5000 gm .............................. Nursing facility care, init ....................................... Nursing facility care, init ....................................... Nursing facility care, init ....................................... Nursing fac care, subseq ..................................... Nursing fac care, subseq ..................................... Nursing fac care, subseq ..................................... Description 2.56 3.78 0.76 1.39 2.00 2.56 3.41 4.26 1.28 1.90 0.64 1.34 1.88 3.02 3.77 1.00 1.50 2.27 3.29 4.00 0.45 0.88 1.34 2.56 3.80 0.00 4.79 2.40 4.50 2.25 15.98 7.99 18.46 7.99 2.75 2.50 2.40 1.20 1.61 2.01 0.60 1.00 1.42 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA 0.66 1.09 1.45 1.96 2.30 NA NA NA NA NA NA NA NA NA NA 0.00 NA NA 2.30 0.84 NA NA NA NA NA NA NA 0.45 0.57 0.67 0.27 0.44 0.59 Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA 0.65 1.05 1.41 1.86 2.28 NA NA NA NA NA NA NA NA NA NA 0.00 NA NA 2.50 0.89 NA NA NA NA NA NA NA 0.48 0.62 0.73 0.27 0.45 0.61 Year 2007 Transitional Non-Facility PE RVUs 0.73 1.11 0.24 0.44 0.61 0.80 1.02 1.28 0.50 0.69 0.23 0.49 0.68 1.12 1.35 0.32 0.51 0.82 1.22 1.43 0.09 0.17 0.25 0.48 0.69 0.00 1.14 0.62 1.15 0.60 3.67 1.76 4.44 1.81 0.68 0.77 0.74 0.45 0.57 0.67 0.27 0.44 0.59 Fully Implemented Facility PE RVUs 0.74 1.05 0.23 0.39 0.54 0.87 1.12 1.40 0.53 0.72 0.22 0.47 0.64 0.97 1.27 0.26 0.50 0.72 1.04 1.37 0.09 0.15 0.30 0.47 0.71 0.00 1.37 0.76 1.25 0.63 4.48 2.24 5.14 2.36 0.87 0.84 0.82 0.48 0.62 0.73 0.27 0.45 0.61 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 99222 99223 99231 99232 99233 99234 99235 99236 99238 99239 99241 99242 99243 99244 99245 99251 99252 99253 99254 99255 99281 99282 99283 99284 99285 99288 99289 99290 99291 99292 99293 99294 99295 99296 99298 99299 99300 99304 99305 99306 99307 99308 99309 HCPCS 2 CPT 1/ 0.10 0.13 0.03 0.04 0.06 0.13 0.16 0.19 0.05 0.07 0.05 0.10 0.13 0.16 0.21 0.05 0.09 0.11 0.13 0.18 0.02 0.04 0.09 0.14 0.23 0.00 0.24 0.12 0.21 0.11 1.12 0.45 1.16 0.32 0.17 0.16 0.15 0.05 0.07 0.09 0.03 0.04 0.06 Mal-Practice RVUs NA NA NA NA NA NA NA NA NA NA 1.35 2.53 3.46 5.14 6.28 NA NA NA NA NA NA NA NA NA NA 0.00 NA NA 7.01 3.20 NA NA NA NA NA NA NA 1.70 2.25 2.77 0.90 1.48 2.07 Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA 1.34 2.49 3.42 5.04 6.26 NA NA NA NA NA NA NA NA NA NA 0.00 NA NA 7.21 3.25 NA NA NA NA NA NA NA 1.73 2.30 2.83 0.90 1.49 2.09 Year 2007 Transitional Non-Facility Total 3.39 5.02 1.03 1.87 2.67 3.49 4.59 5.73 1.83 2.66 0.92 1.93 2.69 4.30 5.33 1.37 2.10 3.20 4.64 5.61 0.56 1.09 1.68 3.18 4.72 0.00 6.17 3.14 5.86 2.96 20.77 10.20 24.06 10.12 3.60 3.43 3.29 1.70 2.25 2.77 0.90 1.48 2.07 Fully Implemented Facility Total 3.40 4.96 1.02 1.82 2.60 3.56 4.69 5.85 1.86 2.69 0.91 1.91 2.65 4.15 5.25 1.31 2.09 3.10 4.46 5.55 0.56 1.07 1.73 3.17 4.74 0.00 6.40 3.28 5.96 2.99 21.58 10.68 24.76 10.67 3.79 3.50 3.37 1.73 2.30 2.83 0.90 1.49 2.09 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX ZZZ XXX ZZZ XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 70003 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00382 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A B B A A A A A A A A A A A A A B B X B B B B B B B B I B I B Status Nursing fac care, subseq ..................................... Nursing fac discharge day ................................... Nursing fac discharge day ................................... Annual nursing fac assessmnt ............................. Domicil/r-home visit new pat ................................ Domicil/r-home visit new pat ................................ Domicil/r-home visit new pat ................................ Domicil/r-home visit new pat ................................ Domicil/r-home visit new pat ................................ Domicil/r-home visit est pat .................................. Domicil/r-home visit est pat .................................. Domicil/r-home visit est pat .................................. Domicil/r-home visit est pat .................................. Domicil/r-home care supervis .............................. Domicil/r-home care supervis .............................. Home visit, new patient ........................................ Home visit, new patient ........................................ Home visit, new patient ........................................ Home visit, new patient ........................................ Home visit, new patient ........................................ Home visit, est patient ......................................... Home visit, est patient ......................................... Home visit, est patient ......................................... Home visit, est patient ......................................... Prolonged service, office ...................................... Prolonged service, office ...................................... Prolonged service, inpatient ................................. Prolonged service, inpatient ................................. Prolonged serv, w/o contact ................................ Prolonged serv, w/o contact ................................ Physician standby services .................................. Physician/team conference .................................. Physician/team conference .................................. Anticoag mgmt, init .............................................. Anticoag mgmt, subseq ....................................... Physician phone consultation .............................. Physician phone consultation .............................. Physician phone consultation .............................. Home health care supervision ............................. Home health care supervision ............................. Hospice care supervision ..................................... Hospice care supervision ..................................... Nursing fac care supervision ............................... Description 1.77 1.13 1.50 1.20 1.01 1.52 2.27 3.03 3.78 0.76 1.26 2.02 3.03 1.25 1.80 1.01 1.52 2.27 3.03 3.78 0.76 1.26 2.02 3.03 1.77 1.77 1.71 1.71 2.10 1.00 1.20 0.00 0.00 1.65 0.63 0.00 0.00 0.00 1.10 1.73 1.10 1.73 1.10 Physician Work RVUs 3 0.74 0.41 0.52 0.45 0.44 0.58 0.74 0.94 1.13 0.36 0.48 0.67 0.92 0.58 0.76 0.44 0.58 0.77 0.93 1.10 0.37 0.49 0.67 0.92 0.66 0.68 NA NA 0.51 0.26 0.00 0.00 0.00 1.29 0.38 0.00 0.00 0.00 0.54 0.75 0.54 0.75 0.54 Fully Implemented NonFacility PE RVUs 0.77 0.44 0.57 0.48 0.48 0.66 0.88 1.11 1.35 0.39 0.56 0.78 1.09 0.58 0.76 0.47 0.66 0.90 1.12 1.35 0.39 0.56 0.79 1.12 0.74 0.73 NA NA 0.51 0.26 0.00 0.00 0.00 1.29 0.38 0.00 0.00 0.00 0.66 1.35 0.66 1.64 0.66 Year 2007 Transitional Non-Facility PE RVUs 0.74 0.41 0.52 0.45 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.51 0.53 0.52 0.51 0.51 0.26 0.00 0.00 0.00 0.38 0.15 0.00 0.00 0.00 0.25 0.40 0.25 0.40 0.25 Fully Implemented Facility PE RVUs 0.77 0.44 0.57 0.48 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 0.62 0.60 0.60 0.60 0.51 0.26 0.00 0.00 0.00 0.38 0.15 0.00 0.00 0.00 0.38 1.26 0.38 1.56 0.38 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 99310 99315 99316 99318 99324 99325 99326 99327 99328 99334 99335 99336 99337 99339 99340 99341 99342 99343 99344 99345 99347 99348 99349 99350 99354 99355 99356 99357 99358 99359 99360 99361 99362 99363 99364 99371 99372 99373 99374 99375 99377 99378 99379 HCPCS 2 CPT 1/ 0.08 0.05 0.06 0.05 0.05 0.07 0.10 0.13 0.16 0.04 0.06 0.09 0.13 0.06 0.07 0.05 0.07 0.10 0.13 0.16 0.04 0.06 0.09 0.13 0.08 0.07 0.07 0.08 0.09 0.04 0.05 0.00 0.00 0.07 0.04 0.00 0.00 0.00 0.05 0.07 0.05 0.07 0.04 Mal-Practice RVUs 2.59 1.59 2.08 1.70 1.50 2.17 3.11 4.10 5.07 1.16 1.80 2.78 4.08 1.89 2.63 1.50 2.17 3.14 4.09 5.04 1.17 1.81 2.78 4.08 2.51 2.52 NA NA 2.70 1.30 1.25 0.00 0.00 3.01 1.05 0.00 0.00 0.00 1.69 2.55 1.69 2.55 1.68 Fully Implemented NonFacility Total 2.62 1.62 2.13 1.73 1.54 2.25 3.25 4.27 5.29 1.19 1.88 2.89 4.25 1.89 2.63 1.53 2.25 3.27 4.28 5.29 1.19 1.88 2.90 4.28 2.59 2.57 NA NA 2.70 1.30 1.25 0.00 0.00 3.01 1.05 0.00 0.00 0.00 1.81 3.15 1.81 3.44 1.80 Year 2007 Transitional Non-Facility Total 2.59 1.59 2.08 1.70 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 2.36 2.37 2.30 2.30 2.70 1.30 1.25 0.00 0.00 2.10 0.82 0.00 0.00 0.00 1.40 2.20 1.40 2.20 1.39 Fully Implemented Facility Total 2.62 1.62 2.13 1.73 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 2.47 2.44 2.38 2.39 2.70 1.30 1.25 0.00 0.00 2.10 0.82 0.00 0.00 0.00 1.53 3.06 1.53 3.36 1.52 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX ZZZ ZZZ ZZZ ZZZ ZZZ ZZZ XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 70004 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00383 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod B N N N N N N N N N N N N N N N N N N N N N N A A A A A A N R R C I I I I I I I I I I Status Nursing fac care supervision ............................... Init pm e/m, new pat, inf ...................................... Init pm e/m, new pat 1–4 yrs ............................... Prev visit, new, age 5–11 .................................... Prev visit, new, age 12–17 .................................. Prev visit, new, age 18–39 .................................. Prev visit, new, age 40–64 .................................. Init pm e/m, new pat 65+ yrs ............................... Per pm reeval, est pat, inf ................................... Prev visit, est, age 1–4 ........................................ Prev visit, est, age 5–11 ...................................... Prev visit, est, age 12–17 .................................... Prev visit, est, age 18–39 .................................... Prev visit, est, age 40–64 .................................... Per pm reeval est pat 65+ yr ............................... Preventive counseling, indiv ................................ Preventive counseling, indiv ................................ Preventive counseling, indiv ................................ Preventive counseling, indiv ................................ Preventive counseling, group ............................... Preventive counseling, group ............................... Health risk assessment test ................................. Unlisted preventive service .................................. Initial care, normal newborn ................................. Newborn care, not in hosp ................................... Normal newborn care/hospital ............................. Newborn discharge day hosp .............................. Attendance, birth .................................................. Newborn resuscitation .......................................... Basic life disability exam ...................................... Work related disability exam ................................ Disability examination .......................................... Unlisted e&m service ........................................... Home visit, prenatal ............................................. Home visit, postnatal ............................................ Home visit, nb care .............................................. Home visit, resp therapy ...................................... Home visit mech ventilator ................................... Home visit, stoma care ........................................ Home visit, im injection ........................................ Home visit, cath maintain ..................................... Home visit day life activity ................................... Home visit, sing/m/fam couns .............................. Description 1.73 1.19 1.36 1.36 1.53 1.53 1.88 2.06 1.02 1.19 1.19 1.36 1.36 1.53 1.71 0.48 0.98 1.46 1.95 0.15 0.25 0.00 0.00 1.17 1.26 0.62 1.50 1.50 2.93 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Physician Work RVUs 3 0.75 0.99 1.03 1.02 1.06 1.06 1.14 1.27 0.86 0.89 0.89 0.93 0.93 0.97 1.11 0.36 0.47 0.58 0.70 0.22 0.24 0.22 0.00 NA 1.00 NA NA NA NA 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented NonFacility PE RVUs 0.93 1.37 1.41 1.37 1.43 1.43 1.59 1.72 0.98 1.04 1.02 1.08 1.10 1.18 1.30 0.56 0.77 0.96 1.17 0.19 0.25 0.22 0.00 NA 0.95 NA NA NA NA 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Non-Facility PE RVUs 0.40 0.27 0.31 0.31 0.35 0.35 0.43 0.48 0.24 0.27 0.27 0.31 0.31 0.35 0.40 0.11 0.23 0.34 0.45 0.03 0.06 NA 0.00 0.27 0.29 0.15 0.46 0.35 0.68 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented Facility PE RVUs 0.60 0.41 0.47 0.47 0.53 0.53 0.65 0.71 0.35 0.41 0.41 0.47 0.47 0.53 0.60 0.17 0.34 0.51 0.68 0.05 0.09 NA 0.00 0.35 0.37 0.19 0.56 0.44 0.87 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 99380 99381 99382 99383 99384 99385 99386 99387 99391 99392 99393 99394 99395 99396 99397 99401 99402 99403 99404 99411 99412 99420 99429 99431 99432 99433 99435 99436 99440 99450 99455 99456 99499 99500 99501 99502 99503 99504 99505 99506 99507 99509 99510 HCPCS 2 CPT 1/ 0.06 0.05 0.05 0.05 0.06 0.06 0.07 0.07 0.04 0.05 0.05 0.05 0.05 0.06 0.06 0.01 0.02 0.04 0.05 0.01 0.01 0.01 0.00 0.05 0.07 0.02 0.06 0.06 0.12 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Mal-Practice RVUs 2.54 2.23 2.44 2.43 2.65 2.65 3.09 3.40 1.92 2.13 2.13 2.34 2.34 2.56 2.88 0.85 1.47 2.08 2.70 0.38 0.50 0.23 0.00 NA 2.33 NA NA NA NA 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented NonFacility Total 2.72 2.61 2.82 2.78 3.02 3.02 3.54 3.85 2.04 2.28 2.26 2.49 2.51 2.77 3.07 1.05 1.77 2.46 3.17 0.35 0.51 0.23 0.00 NA 2.28 NA NA NA NA 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Non-Facility Total 2.19 1.51 1.72 1.72 1.94 1.94 2.38 2.61 1.30 1.51 1.51 1.72 1.72 1.94 2.17 0.60 1.23 1.84 2.45 0.19 0.32 NA 0.00 1.49 1.62 0.79 2.02 1.91 3.73 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented Facility Total 2.39 1.65 1.88 1.88 2.12 2.12 2.60 2.84 1.41 1.65 1.65 1.88 1.88 2.12 2.37 0.66 1.34 2.01 2.68 0.21 0.35 NA 0.00 1.57 1.70 0.83 2.12 2.00 3.92 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 70005 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00384 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod I I I I I R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R Status Home visit, fecal/enema mgmt ............................ Home visit for hemodialysis ................................. Home visit nos ..................................................... Home infusion/visit, 2 hrs ..................................... Home infusion, each addtl hr ............................... Repair/maint cont hemo equip ............................. Comprehensve oral evaluation ............................ Intraoral occlusal film ........................................... Extraoral first film ................................................. Extraoral ea additional film .................................. Dental bitewing single film ................................... Dental bitewings two films ................................... Dental bitewings four films ................................... Vert bitewings-sev to eight ................................... Viral culture .......................................................... Gen tst suscept oral disease ............................... Diag tst detect mucos abnorm ............................. Pulp vitality test .................................................... Gross exam, prep & report .................................. Micro exam, prep & report ................................... Micro w exam of surg margins ............................ Decalcification procedure ..................................... Spec stains for microorganis ............................... Spec stains not for microorg ................................ Immunohistochemical stains ................................ Tissue in-situ hybridization ................................... Cytopath smear prep & report ............................. Electron microscopy diagnost .............................. Direct immunofluorescence .................................. Indirect immunofluorescence ............................... Consult slides prep elsewher ............................... Consult inc prep of slides .................................... Other oral pathology procedu .............................. Unspecified diagnostic proce ............................... Space maintainer fxd unilat ................................. Fixed bilat space maintainer ................................ Remove unilat space maintain ............................. Remove bilat space maintain ............................... Recement space maintainer ................................ Dental unspec restorative pr ................................ Endodontic endosseous implan ........................... Endodontic procedure .......................................... Osseous surgery per quadrant ............................ Description 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Physician Work RVUs 3 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented NonFacility PE RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Non-Facility PE RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented Facility PE RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 99511 99512 99600 99601 99602 A4890 D0150 D0240 D0250 D0260 D0270 D0272 D0274 D0277 D0416 D0421 D0431 D0460 D0472 D0473 D0474 D0475 D0476 D0477 D0478 D0479 D0480 D0481 D0482 D0483 D0484 D0485 D0502 D0999 D1510 D1515 D1520 D1525 D1550 D2999 D3460 D3999 D4260 HCPCS 2 CPT 1/ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Mal-Practice RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented NonFacility Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Non-Facility Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented Facility Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX YYY YYY YYY YYY YYY YYY YYY XXX XXX XXX XXX YYY XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX YYY YYY YYY YYY YYY YYY YYY YYY YYY YYY YYY Global 70006 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00385 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R X Status Bone replce graft first site .................................... Bone replce graft each add ................................. Surgical revision procedure ................................. Pedicle soft tissue graft pr ................................... Free soft tissue graft proc .................................... Subepithelial tissue graft ...................................... Full mouth debridement ....................................... Localized delivery antimicro ................................. Facial moulage sectional ..................................... Facial moulage complete ..................................... Feeding aid .......................................................... Radiation applicator ............................................. Radiation shield .................................................... Radiation cone locator ......................................... Commissure splint ................................................ Dental connector bar ............................................ Extraction coronal remnants ................................ Extraction erupted tooth/exr ................................. Rem imp tooth w mucoper flp .............................. Impact tooth remov soft tiss ................................. Impact tooth remov part bony .............................. Impact tooth remov comp bony ........................... Impact tooth rem bony w/comp ........................... Tooth root removal ............................................... Oral antral fistula closure ..................................... Primary closure sinus perf ................................... Place device impacted tooth ................................ Brush biopsy ........................................................ Transseptal fiberotomy ......................................... Alveoloplasty not w/extracts ................................. Incision/drain abscess intra .................................. Incision/drain abscess extra ................................. Reshaping bone orthognathic .............................. Tx dental pain minor proc .................................... Analgesia .............................................................. Sedation (non-iv) .................................................. Other drugs/medicaments .................................... Treatment of complications .................................. Dental occlusal guard .......................................... Occlusion analysis ............................................... Limited occlusal adjustment ................................. Complete occlusal adjustment ............................. Admin influenza virus vac .................................... Description 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Physician Work RVUs 3 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented NonFacility PE RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Non-Facility PE RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented Facility PE RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT D4263 D4264 D4268 D4270 D4271 D4273 D4355 D4381 D5911 D5912 D5951 D5983 D5984 D5985 D5987 D6920 D7111 D7140 D7210 D7220 D7230 D7240 D7241 D7250 D7260 D7261 D7283 D7288 D7291 D7321 D7511 D7521 D7940 D9110 D9230 D9248 D9630 D9930 D9940 D9950 D9951 D9952 G0008 HCPCS 2 CPT 1/ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Mal-Practice RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented NonFacility Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Non-Facility Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented Facility Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 YYY YYY XXX YYY YYY YYY YYY YYY YYY YYY YYY YYY YYY YYY YYY YYY XXX XXX YYY YYY YYY YYY YYY YYY YYY XXX XXX XXX YYY XXX XXX XXX YYY YYY YYY XXX YYY YYY YYY YYY YYY YYY XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 70007 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00386 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .......... .......... .......... .......... .......... .......... .......... .......... 53 ..... .......... TC .... 26 ..... .......... .......... .......... .......... .......... TC .... 26 ..... .......... 53 ..... .......... TC .... 26 ..... .......... .......... .......... .......... .......... TC .... 26 ..... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod X X X A A X A A A A A A A A T T A A A A A N N N X A R R A A A A X X X X X A A X X X X Status Admin pneumococcal vaccine ............................. Admin hepatitis b vaccine .................................... Semen analysis .................................................... CA screen;pelvic/breast exam ............................. Prostate ca screening; dre ................................... Psa, total screening ............................................. CA screen;flexi sigmoidscope .............................. Colorectal scrn; hi risk ind ................................... Colorectal scrn; hi risk ind ................................... Colon CA screen;barium enema .......................... Colon CA screen;barium enema .......................... Colon CA screen;barium enema .......................... Diab manage trn per indiv ................................... Diab manage trn ind/group .................................. Glaucoma scrn hgh risk direc .............................. Glaucoma scrn hgh risk direc .............................. Colon ca scrn; barium enema .............................. Colon ca scrn; barium enema .............................. Colon ca scrn; barium enema .............................. Colon ca scrn not hi rsk ind ................................. Colon ca scrn not hi rsk ind ................................. Colon ca scrn; barium enema .............................. Colon ca scrn; barium enema .............................. Colon ca scrn; barium enema .............................. Screen cerv/vag thin layer ................................... Screen c/v thin layer by MD ................................ Trim nail(s) ........................................................... CORF skilled nursing service .............................. Single energy x-ray study .................................... Single energy x-ray study .................................... Single energy x-ray study .................................... Scr c/v cyto,autosys and md ................................ Scr c/v cyto,thinlayer,rescr ................................... Scr c/v cyto,thinlayer,rescr ................................... Scr c/v cyto,thinlayer,rescr ................................... Scr c/v cyto, automated sys ................................. Scr c/v cyto, autosys, rescr .................................. Extrnl counterpulse, per tx ................................... Wound closure by adhesive ................................. Linear acc stereo radsur com .............................. OPPS Service,sched team conf .......................... OPPS/PHP;activity therapy .................................. OPPS/PHP; train & educ serv ............................. Description 0.00 0.00 0.00 0.45 0.17 0.00 0.96 3.69 0.96 0.99 0.00 0.99 0.00 0.00 0.45 0.17 0.99 0.00 0.99 3.69 0.96 0.99 0.00 0.99 0.00 0.42 0.17 0.08 0.22 0.00 0.22 0.42 0.00 0.00 0.00 0.00 0.00 0.07 0.45 0.00 0.00 0.00 0.00 Physician Work RVUs 3 0.00 0.00 0.00 0.48 0.32 0.00 2.49 6.37 2.49 4.64 4.36 0.28 0.59 0.31 0.79 0.79 4.64 4.36 0.28 6.37 2.49 5.58 5.35 0.23 0.00 0.37 0.38 0.02 0.54 0.48 0.06 0.37 0.00 0.00 0.00 0.00 0.00 4.51 1.56 0.00 0.00 0.00 0.00 Fully Implemented NonFacility PE RVUs 0.00 0.00 0.00 0.51 0.37 0.00 2.33 6.20 2.33 3.07 2.76 0.31 0.77 0.44 0.74 0.60 3.07 2.76 0.31 6.20 2.33 3.32 2.98 0.34 0.00 0.21 0.28 0.03 0.79 0.72 0.07 0.21 0.00 0.00 0.00 0.00 0.00 3.81 1.84 0.00 0.00 0.00 0.00 Year 2007 Transitional Non-Facility PE RVUs 0.00 0.00 0.00 NA 0.06 0.00 0.62 1.85 0.62 NA NA 0.28 NA NA NA NA NA NA 0.28 1.85 0.62 NA NA 0.23 0.00 0.37 0.05 0.02 NA NA 0.06 0.37 0.00 0.00 0.00 0.00 0.00 NA 0.21 0.00 0.00 0.00 0.00 Fully Implemented Facility PE RVUs 0.00 0.00 0.00 NA 0.06 0.00 0.53 1.57 0.53 NA NA 0.31 NA NA NA NA NA NA 0.31 1.57 0.53 NA NA 0.34 0.00 0.21 0.07 0.03 NA NA 0.07 0.21 0.00 0.00 0.00 0.00 0.00 NA 0.22 0.00 0.00 0.00 0.00 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT G0009 G0010 G0027 G0101 G0102 G0103 G0104 G0105 G0105 G0106 G0106 G0106 G0108 G0109 G0117 G0118 G0120 G0120 G0120 G0121 G0121 G0122 G0122 G0122 G0123 G0124 G0127 G0128 G0130 G0130 G0130 G0141 G0143 G0144 G0145 G0147 G0148 G0166 G0168 G0173 G0175 G0176 G0177 HCPCS 2 CPT 1/ 0.00 0.00 0.00 0.02 0.01 0.00 0.08 0.30 0.08 0.17 0.13 0.04 0.01 0.01 0.01 0.01 0.17 0.13 0.04 0.30 0.08 0.18 0.13 0.05 0.00 0.02 0.01 0.01 0.06 0.05 0.01 0.02 0.00 0.00 0.00 0.00 0.00 0.01 0.03 0.00 0.00 0.00 0.00 Mal-Practice RVUs 0.00 0.00 0.00 0.95 0.50 0.00 3.53 10.36 3.53 5.80 4.49 1.31 0.60 0.32 1.25 0.97 5.80 4.49 1.31 10.36 3.53 6.75 5.48 1.27 0.00 0.81 0.56 0.11 0.82 0.53 0.29 0.81 0.00 0.00 0.00 0.00 0.00 4.59 2.04 0.00 0.00 0.00 0.00 Fully Implemented NonFacility Total 0.00 0.00 0.00 0.98 0.55 0.00 3.37 10.19 3.37 4.23 2.89 1.34 0.78 0.45 1.20 0.78 4.23 2.89 1.34 10.19 3.37 4.49 3.11 1.38 0.00 0.65 0.46 0.12 1.07 0.77 0.30 0.65 0.00 0.00 0.00 0.00 0.00 3.89 2.32 0.00 0.00 0.00 0.00 Year 2007 Transitional Non-Facility Total 0.00 0.00 0.00 NA 0.24 0.00 1.66 5.84 1.66 NA NA 1.31 NA NA NA NA NA NA 1.31 5.84 1.66 NA NA 1.27 0.00 0.81 0.23 0.11 NA NA 0.29 0.81 0.00 0.00 0.00 0.00 0.00 NA 0.69 0.00 0.00 0.00 0.00 Fully Implemented Facility Total 0.00 0.00 0.00 NA 0.24 0.00 1.57 5.56 1.57 NA NA 1.34 NA NA NA NA NA NA 1.34 5.56 1.57 NA NA 1.38 0.00 0.65 0.25 0.12 NA NA 0.30 0.65 0.00 0.00 0.00 0.00 0.00 NA 0.70 0.00 0.00 0.00 0.00 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX 000 000 000 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX 000 000 XXX XXX XXX XXX XXX 000 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX 000 XXX XXX XXX XXX Global 70008 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00387 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .......... .......... .......... .......... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... TC .... 26 ..... .......... TC .... 26 ..... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A C A A A A A A A A A N N N N N N A A A R R R R R R E N N N N N N E E E X X X A Status MD recertification HHA PT ................................... MD certification HHA patient ................................ Home health care supervision ............................. Hospice care supervision ..................................... Dstry eye lesn,fdr vssl tech .................................. Screeningmammographydigital ............................ Screeningmammographydigital ............................ Screeningmammographydigital ............................ Diagnosticmammographydigital ........................... Diagnosticmammographydigital ........................... Diagnosticmammographydigital ........................... Diagnosticmammographydigital ........................... Diagnosticmammographydigital ........................... Diagnosticmammographydigital ........................... PET img wholbod melano nonco ......................... PET img wholbod melano nonco ......................... PET img wholbod melano nonco ......................... PET not otherwise specified ................................ PET not otherwise specified ................................ PET not otherwise specified ................................ Therapeutic procd strg endur ............................... Oth resp proc, indiv .............................................. Oth resp proc, group ............................................ Initial foot exam pt lops ........................................ Followup eval of foot pt lop .................................. Routine footcare pt w lops ................................... Demonstrate use home inr mon .......................... Provide test material,equipm ............................... MD review interpret of test ................................... Linear acc based stero radio ............................... PET imaging initial dx .......................................... PET imaging initial dx .......................................... PET imaging initial dx .......................................... Current percep threshold tst ................................ Current percep threshold tst ................................ Current percep threshold tst ................................ Unsched dialysis ESRD pt hos ............................ Inject for sacroiliac joint ....................................... Inj for sacroiliac jt anesth ..................................... Cryopresevation Freeze+stora ............................. Thawing + expansion froz cel .............................. Bone marrow or psc harvest ................................ Removal of impacted wax md ............................. Description 0.45 0.67 1.73 1.73 0.00 0.70 0.00 0.70 0.87 0.00 0.87 0.70 0.00 0.70 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.88 0.45 0.50 0.00 0.00 0.18 0.00 0.00 0.00 1.50 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.61 Physician Work RVUs 3 0.48 0.56 0.82 0.84 0.00 2.66 2.46 0.20 3.14 2.90 0.24 2.50 2.30 0.20 0.00 0.00 0.00 0.00 0.00 0.00 0.21 0.23 0.31 0.84 0.55 0.68 3.36 2.41 0.08 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.61 Fully Implemented NonFacility PE RVUs 0.89 1.09 1.32 1.46 0.00 2.74 2.52 0.22 2.87 2.60 0.27 2.31 2.09 0.22 0.00 0.00 0.00 0.00 0.00 0.00 0.41 0.43 0.33 0.80 0.54 0.56 5.80 3.57 0.07 0.00 0.00 0.00 0.60 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.63 Year 2007 Transitional Non-Facility PE RVUs NA NA NA NA 0.00 NA NA 0.20 NA NA 0.24 NA NA 0.20 0.00 0.00 0.00 0.00 0.00 0.00 NA NA NA 0.30 0.15 0.17 NA NA NA 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.18 Fully Implemented Facility PE RVUs NA NA NA NA 0.00 NA NA 0.22 NA NA 0.27 NA NA 0.22 0.00 0.00 0.00 0.00 0.00 0.00 NA NA NA 0.31 0.16 0.20 NA NA NA 0.00 0.00 0.00 0.60 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.23 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT G0179 G0180 G0181 G0182 G0186 G0202 G0202 G0202 G0204 G0204 G0204 G0206 G0206 G0206 G0219 G0219 G0219 G0235 G0235 G0235 G0237 G0238 G0239 G0245 G0246 G0247 G0248 G0249 G0250 G0251 G0252 G0252 G0252 G0255 G0255 G0255 G0257 G0259 G0260 G0265 G0266 G0267 G0268 HCPCS 2 CPT 1/ 0.02 0.03 0.07 0.07 0.00 0.10 0.07 0.03 0.11 0.07 0.04 0.09 0.06 0.03 0.00 0.00 0.00 0.00 0.00 0.00 0.02 0.02 0.02 0.04 0.02 0.02 0.01 0.01 0.01 0.00 0.00 0.00 0.04 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.02 Mal-Practice RVUs 0.95 1.26 2.62 2.64 0.00 3.46 2.53 0.93 4.12 2.97 1.15 3.29 2.36 0.93 0.00 0.00 0.00 0.00 0.00 0.00 0.23 0.25 0.33 1.76 1.02 1.20 3.37 2.42 0.27 0.00 0.00 0.00 1.54 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.24 Fully Implemented NonFacility Total 1.36 1.79 3.12 3.26 0.00 3.54 2.59 0.95 3.85 2.67 1.18 3.10 2.15 0.95 0.00 0.00 0.00 0.00 0.00 0.00 0.43 0.45 0.35 1.72 1.01 1.08 5.81 3.58 0.26 0.00 0.00 0.00 2.14 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1.26 Year 2007 Transitional Non-Facility Total NA NA NA NA 0.00 NA NA 0.93 NA NA 1.15 NA NA 0.93 0.00 0.00 0.00 0.00 0.00 0.00 NA NA NA 1.22 0.62 0.69 NA NA NA 0.00 0.00 0.00 1.54 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.81 Fully Implemented Facility Total NA NA NA NA 0.00 NA NA 0.95 NA NA 1.18 NA NA 0.95 0.00 0.00 0.00 0.00 0.00 0.00 NA NA NA 1.23 0.63 0.72 NA NA NA 0.00 0.00 0.00 2.14 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.86 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX YYY XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX ZZZ XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX 000 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 70009 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00388 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod B A A A A A N A A A E E E E N X X X X X X X X X X A A A A A A A A A A A A A A A A A A Status Occlusive device in vein art ................................. MNT subs tx for change dx ................................. Group MNT 2 or more 30 mins ........................... Renal angio, cardiac cath .................................... Iliac art angio,cardiac cath ................................... Elec stim unattend for press ................................ Elect stim wound care not pd .............................. Elec stim other than wound ................................. Recon, CTA for surg plan .................................... Arthro, loose body + chondro .............................. Drug-eluting stents, single ................................... Drug-eluting stents,each add ............................... Non-cov surg proc,clin trial .................................. Non-cov proc, clinical trial .................................... Electromagnetic therapy onc ............................... Insert single chamber/cd ...................................... Insert dual chamber/cd ........................................ Inser/repos single icd+leads ................................ Insert reposit lead dual+gen ................................ Pre-op service LVRS complete ............................ Pre-op service LVRS 10–15dos .......................... Pre-op service LVRS 1–9 dos ............................. Post op service LVRS min 6 ................................ CBC/diffwbc w/o platelet ...................................... CBC without platelet ............................................ ESRD related svc 4+mo < 2yrs ........................... ESRD related svc 2–3mo <2yrs .......................... ESRD related svc 1 vst <2yrs .............................. ESRD related svs 4+mo 2–11yr .......................... ESRD relate svs 2–3 mo 2–11y .......................... ESRD related svs 1 mon 2–11y .......................... ESRD related svs 4+ mo 12–19 .......................... ESRD related svs 2–3mo/12–19 ......................... ESRD related svs 1vis/12–19y ............................ ESRD related svs 4+mo 20+yrs .......................... ESRD related svs 2–3 mo 20+y .......................... ESRD related svs 1visit 20+y .............................. ESD related svs home undr 2 ............................. ESRDrelatedsvs home mo 2–11y ........................ ESRD related svs hom mo12–19 ........................ ESRD related svs home mo 20+ ......................... ESRD relate svs home/dy <2yr ........................... ESRD relate home/day/ 2–11yr ........................... Description 0.00 0.37 0.25 0.25 0.25 0.18 0.00 0.18 0.00 1.48 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 12.74 10.61 8.49 9.73 8.11 6.49 8.28 6.90 5.52 5.09 4.24 3.39 10.61 8.11 6.90 4.24 0.35 0.23 Physician Work RVUs 3 0.00 0.12 0.07 NA NA 0.14 0.00 0.14 1.00 NA 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5.57 4.85 2.91 3.62 2.70 1.89 3.46 2.64 1.71 2.29 1.73 1.16 2.73 2.02 1.76 1.18 0.16 0.09 Fully Implemented NonFacility PE RVUs 0.00 0.38 0.15 NA NA 0.12 0.00 0.12 8.21 NA 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 7.80 6.54 4.99 4.45 3.62 2.83 4.18 3.41 2.63 2.72 2.22 1.72 6.01 3.45 3.19 2.08 0.22 0.11 Year 2007 Transitional Non-Facility PE RVUs 0.00 0.09 0.06 0.14 0.14 NA 0.00 NA NA 0.60 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5.57 4.85 2.91 3.62 2.70 1.89 3.46 2.64 1.71 2.29 1.73 1.16 2.73 2.02 1.76 1.18 0.16 0.09 Fully Implemented Facility PE RVUs 0.00 0.38 0.15 0.11 0.11 NA 0.00 NA NA 0.75 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 7.80 6.54 4.99 4.45 3.62 2.83 4.18 3.41 2.63 2.72 2.22 1.72 6.01 3.45 3.19 2.08 0.22 0.11 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT G0269 G0270 G0271 G0275 G0278 G0281 G0282 G0283 G0288 G0289 G0290 G0291 G0293 G0294 G0295 G0297 G0298 G0299 G0300 G0302 G0303 G0304 G0305 G0306 G0307 G0308 G0309 G0310 G0311 G0312 G0313 G0314 G0315 G0316 G0317 G0318 G0319 G0320 G0321 G0322 G0323 G0324 G0325 HCPCS 2 CPT 1/ 0.00 0.01 0.01 0.01 0.01 0.01 0.00 0.01 0.18 0.26 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.42 0.36 0.28 0.34 0.29 0.22 0.27 0.23 0.17 0.17 0.14 0.11 0.36 0.29 0.23 0.14 0.01 0.01 Mal-Practice RVUs 0.00 0.50 0.33 NA NA 0.33 0.00 0.33 1.18 NA 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 18.73 15.82 11.68 13.69 11.10 8.60 12.01 9.77 7.40 7.55 6.11 4.66 13.70 10.42 8.89 5.56 0.52 0.33 Fully Implemented NonFacility Total 0.00 0.76 0.41 NA NA 0.31 0.00 0.31 8.39 NA 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 20.96 17.51 13.76 14.52 12.02 9.54 12.73 10.54 8.32 7.98 6.60 5.22 16.98 11.85 10.32 6.46 0.58 0.35 Year 2007 Transitional Non-Facility Total 0.00 0.47 0.32 0.40 0.40 NA 0.00 NA NA 2.34 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 18.73 15.82 11.68 13.69 11.10 8.60 12.01 9.77 7.40 7.55 6.11 4.66 13.70 10.42 8.89 5.56 0.52 0.33 Fully Implemented Facility Total 0.00 0.76 0.41 0.37 0.37 NA 0.00 NA NA 2.49 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 20.96 17.51 13.76 14.52 12.02 9.54 12.73 10.54 8.32 7.98 6.60 5.22 16.98 11.85 10.32 6.46 0.58 0.35 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX ZZZ ZZZ XXX XXX XXX XXX ZZZ XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 70010 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00389 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... TC .... 26 ..... .......... .......... .......... .......... .......... .......... .......... .......... .......... TC .... 26 ..... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A X A A X X C C A A A A A A A A A A A A A A X X A A A A A X X X X X X X X X X X X X Status ESRD relate home/dy 12–19yr ............................ ESRD relate home/dy 20+yrs .............................. Fecal blood scrn immunoassay ........................... Electromagntic tx for ulcers ................................. Preadmin IV immunoglobulin ............................... Dispense fee initial 30 day ................................... Hospice evaluation preelecti ................................ Robot lin-radsurg com, first .................................. Robt lin-radsurg fractx 2–5 .................................. Percutaneous islet celltrans ................................. Laparoscopy islet cell trans ................................. Laparotomy islet cell transp ................................. Initial preventive exam ......................................... Bone marrow aspirate &biopsy ............................ Vessel mapping hemo access ............................. Vessel mapping hemo access ............................. Vessel mapping hemo access ............................. EKG for initial prevent exam ................................ EKG tracing for initial prev ................................... EKG interpret & report preve ............................... MD service required for PMD .............................. Smoke/tobacco counselng 3–10 .......................... Smoke/tobacco counseling >10 ........................... Hospital observation per hr .................................. Direct admit hospital observ ................................ Ultrasound exam AAA screen .............................. Ultrasound exam AAA screen .............................. Ultrasound exam AAA screen .............................. AV fistula or graft arterial ..................................... AV fistula or graft venous .................................... Blood occult test,colorectal .................................. Admin + supply, tositumomab .............................. MCCD, initial rate ................................................. MCCD,maintenance rate ...................................... MCCD, risk adj hi, initial ...................................... MCCD, risk adj lo, initial ...................................... MCCD, risk adj, maintenance .............................. MCCD, Home monitoring ..................................... MCCD, sch team conf .......................................... Mccd,phys coor-care ovrsght ............................... MCCD, risk adj, level 3 ........................................ MCCD, risk adj, level 4 ........................................ MCCD, risk adj, level 5 ........................................ Description 0.27 0.14 0.00 0.06 0.00 0.00 1.34 0.00 0.00 6.98 11.92 19.85 1.34 0.16 0.25 0.00 0.25 0.17 0.00 0.17 0.17 0.24 0.48 0.00 0.00 0.58 0.00 0.58 9.48 6.03 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Physician Work RVUs 3 0.10 0.06 0.00 0.15 NA 0.00 0.31 0.00 0.00 NA NA NA 1.11 0.16 5.16 5.10 0.06 0.34 0.27 0.07 0.04 0.07 0.13 0.00 0.00 2.29 2.12 0.17 46.08 59.59 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented NonFacility PE RVUs 0.12 0.08 0.00 0.14 1.97 0.00 0.46 0.00 0.00 NA NA NA 1.13 0.15 4.28 4.20 0.08 0.47 0.41 0.06 0.30 0.09 0.17 0.00 0.00 2.29 2.12 0.17 46.08 59.59 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Non-Facility PE RVUs 0.10 0.06 0.00 NA NA 0.00 0.31 0.00 0.00 2.08 5.09 8.63 0.43 0.07 NA NA 0.06 NA NA 0.07 0.04 0.07 0.13 0.00 0.00 NA NA 0.17 2.47 2.93 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented Facility PE RVUs 0.12 0.08 0.00 NA NA 0.00 0.46 0.00 0.00 2.46 5.24 8.72 0.47 0.06 NA NA 0.08 NA NA 0.06 0.06 0.09 0.16 0.00 0.00 NA NA 0.17 2.47 2.93 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT G0326 G0327 G0328 G0329 G0332 G0333 G0337 G0339 G0340 G0341 G0342 G0343 G0344 G0364 G0365 G0365 G0365 G0366 G0367 G0368 G0372 G0375 G0376 G0378 G0379 G0389 G0389 G0389 G0392 G0393 G0394 G3001 G9001 G9002 G9003 G9004 G9005 G9006 G9007 G9008 G9009 G9010 G9011 HCPCS 2 CPT 1/ 0.01 0.01 0.00 0.01 0.00 0.00 0.09 0.00 0.00 0.48 1.46 2.07 0.10 0.04 0.25 0.23 0.02 0.03 0.02 0.01 0.01 0.01 0.01 0.00 0.00 0.11 0.08 0.03 0.62 0.34 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Mal-Practice RVUs 0.38 0.21 0.00 0.22 NA 0.00 1.74 0.00 0.00 NA NA NA 2.55 0.36 5.66 5.33 0.33 0.54 0.29 0.25 0.22 0.32 0.62 0.00 0.00 2.98 2.20 0.78 56.18 65.96 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented NonFacility Total 0.40 0.23 0.00 0.21 1.97 0.00 1.89 0.00 0.00 NA NA NA 2.57 0.35 4.78 4.43 0.35 0.67 0.43 0.24 0.48 0.34 0.66 0.00 0.00 2.98 2.20 0.78 56.18 65.96 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Non-Facility Total 0.38 0.21 0.00 NA NA 0.00 1.74 0.00 0.00 9.54 18.47 30.55 1.87 0.27 NA NA 0.33 NA NA 0.25 0.22 0.32 0.62 0.00 0.00 NA NA 0.78 12.57 9.30 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented Facility Total 0.40 0.23 0.00 NA NA 0.00 1.89 0.00 0.00 9.92 18.62 30.64 1.91 0.26 NA NA 0.35 NA NA 0.24 0.24 0.34 0.65 0.00 0.00 NA NA 0.78 12.57 9.30 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX 000 090 090 XXX ZZZ XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX 000 000 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 70011 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00390 Fmt 4701 Sfmt 4700 .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... TC .... 26 ..... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod X N N N X X X X X X X X A A A A A A A A A A A C X C C B R Status Other Specified Case Mgmt ................................. ESRD demo bundle level I .................................. ESRD demo bundle-level II ................................. Demo-smoking cessation coun ............................ Amantadine HCL 100mg oral .............................. Zanamivir,inhalation pwd 10m ............................. Oseltamivir phosphate 75mg ............................... Rimantadine HCL 100mg oral ............................. Amantadine HCL oral brand ................................ Zanamivir, inh pwdr, brand .................................. Oseltamivir phosp, brand ..................................... Rimantadine HCL, brand ..................................... Low vision rehab occupationa ............................. Low vision rehab orient/mobi ............................... Low vision lowvision therapi ................................ Low vision rehabilate teache ............................... Visit for drug monitoring ....................................... Screening pap smear by phys ............................. Cardiokymography ............................................... Cardiokymography ............................................... Cardiokymography ............................................... Obtaining screen pap smear ................................ Set up port xray equipment ................................. Brachytherapy Radioelements ............................. Telehealth facility fee ........................................... Transport portable x-ray ....................................... Transport port x-ray multipl .................................. Transport portable EKG ....................................... Hearing service .................................................... Description 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.44 0.10 0.10 0.10 0.37 0.42 0.17 0.00 0.17 0.37 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Physician Work RVUs 3 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.10 0.02 0.02 0.02 0.89 0.37 0.30 0.25 0.05 0.75 0.45 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.24 0.22 0.22 0.18 0.48 0.21 0.42 0.36 0.06 0.69 0.35 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Non-Facility PE RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.10 0.02 0.02 0.02 0.07 0.37 NA NA 0.05 0.10 0.45 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented Facility PE RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.24 0.22 0.22 0.18 0.11 0.21 NA NA 0.06 0.13 0.35 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Facility PE RVUs codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT G9012 ... G9013 ... G9014 ... G9016 ... G9017 ... G9018 ... G9019 ... G9020 ... G9033 ... G9034 ... G9035 ... G9036 ... G9041 ... G9042 ... G9043 ... G9044 ... M0064 ... P3001 .... Q0035 ... Q0035 ... Q0035 ... Q0091 ... Q0092 ... Q3001 ... Q3014 ... R0070 ... R0075 ... R0076 ... V5299 .... HCPCS 2 CPT 1/ Fully Implemented NonFacility PE RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.01 0.01 0.01 0.01 0.01 0.02 0.03 0.02 0.01 0.02 0.01 0.00 0.00 0.00 0.00 0.00 0.00 Mal-Practice RVUs 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.55 0.13 0.13 0.13 1.27 0.81 0.50 0.27 0.23 1.14 0.46 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented NonFacility Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.69 0.33 0.33 0.29 0.86 0.65 0.62 0.38 0.24 1.08 0.36 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Non-Facility Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.55 0.13 0.13 0.13 0.45 0.81 NA NA 0.23 0.49 0.46 0.00 0.00 0.00 0.00 0.00 0.00 Fully Implemented Facility Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.69 0.33 0.33 0.29 0.49 0.65 NA NA 0.24 0.52 0.36 0.00 0.00 0.00 0.00 0.00 0.00 Year 2007 Transitional Facility Total ADDENDUM B.—2007 RELATIVE VALUE UNITS AND RELATED INFORMATION USED IN DETERMINING MEDICARE PAYMENTS FOR 2007—CONTINUED rmajette on PROD1PC67 with RULES2 XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global 70012 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations E:\FR\FM\01DER2.SGM 01DER2 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00391 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A R C A A A A A A A A A A A R R R A A A A A A A A A A A A A A A A A Status Wnd prep, ch/inf, trk/arm/lg ................................. Wnd prep, ch/inf addl 100 cm ............................. Wnd prep ch/inf, f/n/hf/g ...................................... Wnd prep, f/n/hf/g, addl cm ................................. Forehead flap w/vasc pedicle .............................. Exc skin abd ........................................................ Exc skin abd add-on ............................................ Destruct premalg les, 2-14 .................................. Destroy premlg lesions 15+ ................................. Mohs, 1 stage, h/n/hf/g ........................................ Mohs addl stage .................................................. Mohs, 1 stage, t/a/l .............................................. Mohs, addl stage, t/a/l ......................................... Mohs surg, addl block .......................................... Cryosurg ablate fa, each ..................................... Breast reconstr w/lat flap ..................................... Idet, single level ................................................... Idet, 1 or more levels ........................................... Lumbar artif diskectomy ....................................... Revise lumbar artif disc ....................................... Remove lumb artif disc ........................................ Excise tendon forearm/wrist ................................ Treat fx distal radial ............................................. Treat fx rad extra-articul ...................................... Treat fx rad intra-articul ....................................... Treat fx radial 3+ frag .......................................... Perq rf ablate tx, pul tumor .................................. Insert epicard eltrd, open ..................................... Insert epicard eltrd, endo ..................................... Ablate atria, lmtd .................................................. Ablate atria w/o bypass, ext ................................ Ablate atria w/bypass, exten ................................ Ablate atria w/bypass, endo ................................ Ablate atria w/o bypass endo .............................. Close mult vsd ..................................................... Close mult vsd w/resection .................................. Cl mult vsd w/rem pul band ................................. Repair heart septum defect ................................. Description 3.65 0.80 4.58 1.60 14.12 16.90 0.00 0.07 1.82 6.20 3.30 5.56 3.06 0.87 3.69 23.17 6.07 3.03 26.93 32.43 31.55 6.81 8.10 9.35 10.86 14.12 5.68 13.15 13.92 23.58 28.91 34.77 23.58 32.91 35.87 36.87 38.37 34.29 Physician Work RVUs 3 4.12 0.92 4.77 1.28 12.13 NA 0.00 0.11 2.33 10.79 6.92 9.95 6.41 1.15 45.93 NA 46.51 39.89 NA NA NA NA NA NA NA NA 68.64 NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs 4.12 0.92 4.77 1.28 12.13 NA 0.00 0.11 2.33 10.79 6.92 9.95 6.41 1.15 45.93 NA 46.51 39.89 NA NA NA NA NA NA NA NA 68.64 NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 1.65 0.28 1.97 0.56 9.56 10.15 0.00 0.06 1.54 3.16 1.68 2.83 1.55 0.44 1.00 13.65 2.08 0.70 8.80 10.07 9.87 5.32 8.41 7.26 7.88 9.77 1.77 6.22 6.29 9.94 11.57 13.37 9.94 12.80 17.82 18.17 18.82 15.13 Fully Implemented Facility PE RVUs 1.65 0.28 1.97 0.56 9.56 10.15 0.00 0.06 1.54 3.16 1.68 2.83 1.55 0.44 1.00 13.65 2.08 0.70 8.80 10.07 9.87 5.32 8.41 7.26 7.88 9.77 1.77 6.22 6.29 9.94 11.57 13.37 9.94 12.80 17.82 18.17 18.82 15.13 Year 2007 Transitional Facility PE RVUs ADDENDUM C.—CODES WITH INTERIM RVUS codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... 1 CPT 15002 15003 15004 15005 15731 15830 15847 17003 17004 17311 17312 17313 17314 17315 19105 19361 22526 22527 22857 22862 22865 25109 25606 25607 25608 25609 32998 33202 33203 33254 33255 33256 33265 33266 33675 33676 33677 33684 HCPCS 2 CPT 1/ rmajette on PROD1PC67 with RULES2 0.49 0.11 0.62 0.22 1.28 2.93 0.00 0.01 0.11 0.24 0.13 0.22 0.12 0.03 0.30 2.93 1.16 0.58 3.56 5.36 5.18 0.96 1.26 1.36 1.84 2.38 0.36 1.71 1.39 3.35 3.94 4.95 3.35 4.80 4.95 5.44 5.68 3.39 Mal-Practice RVUs 8.26 1.83 9.97 3.10 27.53 NA 0.00 0.19 4.26 17.23 10.35 15.73 9.59 2.05 49.92 NA 53.74 43.50 NA NA NA NA NA NA NA NA 74.68 NA NA NA NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total 8.26 1.83 9.97 3.10 27.53 NA 0.00 0.19 4.26 17.23 10.35 15.73 9.59 2.05 49.92 NA 53.74 43.50 NA NA NA NA NA NA NA NA 74.68 NA NA NA NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 5.79 1.19 7.17 2.38 24.96 29.98 0.00 0.14 3.47 9.60 5.11 8.61 4.73 1.34 4.99 39.75 9.31 4.31 39.29 47.86 46.60 13.09 17.77 17.97 20.58 26.27 7.81 21.08 21.60 36.87 44.42 53.09 36.87 50.51 58.64 60.48 62.87 52.81 Fully Implemented Facility Total 5.79 1.19 7.17 2.38 24.96 29.98 0.00 0.14 3.47 9.60 5.11 8.61 4.73 1.34 4.99 39.75 9.31 4.31 39.29 47.86 46.60 13.09 17.77 17.97 20.58 26.27 7.81 21.08 21.60 36.87 44.42 53.09 36.87 50.51 58.64 60.48 62.87 52.81 Year 2007 Transitional Facility Total 000 ZZZ 000 ZZZ 090 090 YYY ZZZ 010 000 ZZZ 000 ZZZ ZZZ 000 090 010 ZZZ 090 090 090 090 090 090 090 090 000 090 090 090 090 090 090 090 090 090 090 090 Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 01DER2 70013 VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00392 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A A C C C C A A A A A A A A A A A A A A A A A Status Repair heart septum defect ................................. Repair venous anomaly ....................................... Repair pul venous stenosis ................................. Rechanneling of artery ......................................... Rechanneling of artery ......................................... Rechanneling of artery ......................................... Rechanneling of artery ......................................... Rechanneling of artery ......................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Artery bypass graft ............................................... Revise graft w/nonauto graft ................................ Revise graft w/vein .............................................. Embolization uterine fibroid ................................. Lap impl electrode, antrum .................................. Lap revise/remv eltrd antrum ............................... Impl/redo electrd, antrum ..................................... Revise/remove electrd antrum ............................. Colectomy w/ileoanal anast ................................. Colectomy w/neo-rectum pouch .......................... Lap insertion perm ip cath ................................... Lap revision perm ip cath .................................... Lap w/omentopexy add-on .................................. Insert subq exten to ip cath ................................. Embedded ip cath exit-site .................................. Circumcision w/regionl block ............................... Place rt device/marker, pros ................................ Revise vag graft, open abd ................................. Removal of pelvis contents .................................. Lsh, uterus 250 g or less ..................................... Lsh w/t/o ut 250 g or less .................................... Lsh uterus above 250 g ....................................... Lsh w/t/o uterus above 250 g .............................. Lap radical hyst .................................................... Resect recurrent gyn mal .................................... Description 34.67 27.55 37.04 21.27 23.52 24.52 23.52 9.25 28.99 27.99 41.75 46.82 43.98 49.20 26.99 32.92 33.47 23.07 24.57 10.60 0.00 0.00 0.00 0.00 35.49 36.49 6.27 6.77 3.50 2.25 2.69 1.90 1.73 16.46 49.02 14.57 16.43 16.74 18.24 31.45 26.06 Physician Work RVUs 3 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 46.03 0.00 0.00 0.00 0.00 NA NA NA NA NA NA NA 1.50 2.04 NA NA NA NA NA NA NA NA Fully Implemented NonFacility PE RVUs NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 46.03 0.00 0.00 0.00 0.00 NA NA NA NA NA NA NA 1.50 2.04 NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility PE RVUs 10.21 10.56 13.46 7.14 7.72 7.97 7.72 2.38 9.22 9.24 13.22 14.60 13.73 15.10 9.09 10.92 11.06 8.96 9.43 3.13 0.00 0.00 0.00 0.00 15.67 15.97 2.80 2.93 0.92 0.60 1.63 1.09 1.03 6.75 17.65 6.14 6.66 6.73 7.16 12.74 9.63 Fully Implemented Facility PE RVUs 10.21 10.56 13.46 7.14 7.72 7.97 7.72 2.38 9.22 9.24 13.22 14.60 13.73 15.10 9.09 10.92 11.06 8.96 9.43 3.13 0.00 0.00 0.00 0.00 15.67 15.97 2.80 2.93 0.92 0.60 1.63 1.09 1.03 6.75 17.65 6.14 6.66 6.73 7.16 12.74 9.63 Year 2007 Transitional Facility PE RVUs 4.73 4.00 5.03 2.98 3.26 3.41 3.26 1.34 4.10 3.92 5.72 6.39 6.02 6.76 3.72 4.44 4.52 3.19 3.41 0.60 0.00 0.00 0.00 0.00 3.93 4.06 0.73 0.86 0.44 0.28 0.28 0.16 0.28 1.68 4.23 1.68 1.69 1.73 1.89 3.52 2.95 Mal-Practice RVUs ADDENDUM C.—CODES WITH INTERIM RVUS—CONTINUED codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 33688 33724 33726 35302 35303 35304 35305 35306 35501 35509 35537 35538 35539 35540 35601 35637 35638 35883 35884 37210 43647 43648 43881 43882 44157 44158 49324 49325 49326 49435 49436 54150 55876 57296 58240 58541 58542 58543 58544 58548 58957 HCPCS 2 CPT 1/ rmajette on PROD1PC67 with RULES2 NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 57.23 0.00 0.00 0.00 0.00 NA NA NA NA NA NA NA 3.56 4.05 NA NA NA NA NA NA NA NA Fully Implemented NonFacility Total NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA 57.23 0.00 0.00 0.00 0.00 NA NA NA NA NA NA NA 3.56 4.05 NA NA NA NA NA NA NA NA Year 2007 Transitional Non-Facility Total 49.61 42.11 55.53 31.39 34.50 35.90 34.50 12.97 42.31 41.15 60.69 67.81 63.73 71.06 39.80 48.28 49.05 35.22 37.41 14.33 0.00 0.00 0.00 0.00 55.09 56.52 9.80 10.56 4.86 3.13 4.60 3.15 3.04 24.89 70.90 22.39 24.78 25.20 27.29 47.71 38.64 Fully Implemented Facility Total 49.61 42.11 55.53 31.39 34.50 35.90 34.50 12.97 42.31 41.15 60.69 67.81 63.73 71.06 39.80 48.28 49.05 35.22 37.41 14.33 0.00 0.00 0.00 0.00 55.09 56.52 9.80 10.56 4.86 3.13 4.60 3.15 3.04 24.89 70.90 22.39 24.78 25.20 27.29 47.71 38.64 Year 2007 Transitional Facility Total 090 090 090 090 090 090 090 ZZZ 090 090 090 090 090 090 090 090 090 090 090 000 YYY YYY YYY YYY 090 090 010 010 ZZZ ZZZ 010 000 000 090 090 090 090 090 090 090 090 Global 70014 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00393 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .... .......... .......... .......... 26 ..... 26 ..... 26 ..... 26 ..... 26 ..... .......... .......... .......... .......... 26 ..... 26 ..... 26 ..... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... 26 ..... .......... .......... .......... .......... .......... .......... .......... .......... .......... 2 Copyright 3+ Mod A A A A A A A A A A A A A A A A A A A B A A A C C C C A A B R A A A A A B B Status Resect recur gyn mal w/lym ................................ Nerve repair w/allograft ........................................ Neurorraphy w/vein autograft .............................. Fmri brain by tech ................................................ Fmri brain by phys/psych ..................................... Us exam k transpl w/doppler ............................... Ob us nuchal meas, 1 gest ................................. Ob us nuchal meas, add-on ................................ Srs, multisource ................................................... Srs, linear based .................................................. Sbrt delivery ......................................................... Sbrt management ................................................ Urinary bladder retention ..................................... Esophageal capsule endoscopy .......................... Corneal topography ............................................. Aud brainstem implt programg ............................ Vent mgmt inpat, init day ..................................... Vent mgmt inpat, subq day .................................. Vent mgmt nf per day .......................................... Home vent mgmt supervision .............................. Surfactant admin thru tube .................................. Cbt, 1st hour ........................................................ Cbt, each addl hour ............................................. Ped home apnea rec, compl ............................... Ped home apnea rec, hk-up ................................ Ped home apnea rec, downld .............................. Ped home apnea rec, report ................................ Exhaled nitric oxide meas .................................... Functional brain mapping .................................... Genetic counseling, 30 min ................................. Whole body photography ..................................... Inpatient consultation ........................................... Inpatient consultation ........................................... Inpatient consultation ........................................... Inpatient consultation ........................................... Inpatient consultation ........................................... Anticoag mgmt, init .............................................. Anticoag mgmt, subseq ....................................... Description 29.06 11.21 14.21 2.11 2.54 0.76 1.18 0.99 0.00 0.00 0.00 13.00 0.15 1.00 0.35 0.00 1.99 1.37 1.00 1.50 1.16 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3.43 0.00 0.00 1.00 1.50 2.27 3.29 4.00 1.65 0.63 Physician Work RVUs 3 NA NA NA 0.60 0.72 0.23 0.33 0.27 30.25 22.93 42.87 4.63 0.11 0.46 0.12 1.40 NA NA NA 0.69 0.35 0.92 0.34 0.00 0.00 0.00 0.00 0.48 0.86 0.97 1.84 NA NA NA NA NA 1.29 0.38 Fully Implemented NonFacility PE RVUs NA NA NA 0.60 0.72 0.23 0.33 0.27 30.25 22.93 42.87 4.63 0.11 0.46 0.12 1.40 NA NA NA 0.69 0.35 0.92 0.34 0.00 0.00 0.00 0.00 0.48 0.86 0.97 1.84 NA NA NA NA NA 1.29 0.38 Year 2007 Transitional Non-Facility PE RVUs 10.44 5.21 5.97 0.60 0.72 0.23 0.33 0.27 NA NA NA NA 0.11 0.46 0.12 1.40 0.34 0.33 0.24 NA 0.35 NA NA 0.00 0.00 0.00 0.00 NA 0.86 NA NA 0.26 0.50 0.72 1.04 1.37 0.38 0.15 Fully Implemented Facility PE RVUs 10.44 5.21 5.97 0.60 0.72 0.23 0.33 0.27 NA NA NA NA 0.11 0.46 0.12 1.40 0.34 0.33 0.24 NA 0.35 NA NA 0.00 0.00 0.00 0.00 NA 0.86 NA NA 0.26 0.50 0.72 1.04 1.37 0.38 0.15 Year 2007 Transitional Facility PE RVUs 3.29 1.74 1.91 0.10 0.11 0.03 0.05 0.05 0.13 0.13 0.13 0.67 0.02 0.03 0.01 0.01 0.09 0.06 0.04 0.06 0.26 0.02 0.02 0.00 0.00 0.00 0.00 0.01 0.17 0.01 0.01 0.05 0.09 0.11 0.13 0.18 0.07 0.04 Mal-Practice RVUs ADDENDUM C.—CODES WITH INTERIM RVUS—CONTINUED codes and descriptions only are copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2006 American Dental Association. All rights reserved. Indicates RVUs are not used for Medicare payment. 1 CPT 58958 64910 64911 70554 70555 76776 76813 76814 77371 77372 77373 77435 78730 91111 92025 92640 94002 94003 94004 94005 94610 94644 94645 94774 94775 94776 94777 95012 96020 96040 96904 99251 99252 99253 99254 99255 99363 99364 HCPCS 2 CPT 1/ rmajette on PROD1PC67 with RULES2 NA NA NA 2.81 3.37 1.02 1.56 1.31 30.38 23.06 43.00 18.30 0.28 1.49 0.48 1.41 NA NA NA 2.25 1.77 0.94 0.36 0.00 0.00 0.00 0.00 0.49 4.46 0.98 1.85 NA NA NA NA NA 3.01 1.05 Fully Implemented NonFacility Total NA NA NA 2.81 3.37 1.02 1.56 1.31 30.38 23.06 43.00 18.30 0.28 1.49 0.48 1.41 NA NA NA 2.25 1.77 0.94 0.36 0.00 0.00 0.00 0.00 0.49 4.46 0.98 1.85 NA NA NA NA NA 3.01 1.05 Year 2007 Transitional Non-Facility Total 42.79 18.16 22.09 2.81 3.37 1.02 1.56 1.31 NA NA NA NA 0.28 1.49 0.48 1.41 2.42 1.76 1.28 NA 1.77 NA NA 0.00 0.00 0.00 0.00 NA 4.46 NA NA 1.31 2.09 3.10 4.46 5.55 2.10 0.82 Fully Implemented Facility Total 42.79 18.16 22.09 2.81 3.37 1.02 1.56 1.31 NA NA NA NA 0.28 1.49 0.48 1.41 2.42 1.76 1.28 NA 1.77 NA NA 0.00 0.00 0.00 0.00 NA 4.46 NA NA 1.31 2.09 3.10 4.46 5.55 2.10 0.82 Year 2007 Transitional Facility Total 090 090 090 XXX XXX XXX XXX XXX XXX XXX XXX XXX ZZZ XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX YYY YYY YYY YYY XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX Global Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 70015 70016 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM D.—2007 GEOGRAPHIC PRACTICE COST INDICES BY MEDICARE CARRIER AND LOCALITY rmajette on PROD1PC67 with RULES2 Carrier 00510 00831 00312 00520 31140 31140 31140 31140 31140 31146 31146 31146 31140 31146 00824 00591 00903 00902 00590 00590 00590 00511 00511 00833 05130 00952 00952 00952 00952 00630 00826 00650 00740 00660 00528 00528 31142 31142 00901 00901 31143 31143 00953 00953 00954 00512 00523 00740 00523 00740 03202 00655 00834 31144 00805 00805 00521 00801 00803 00803 00803 14330 05535 03302 00883 00522 00835 00835 00865 00865 00973 ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... VerDate Aug<31>2005 Locality 00 01 00 13 03 05 06 07 09 17 18 26 99 99 01 00 01 01 03 04 99 01 99 01 00 12 15 16 99 00 00 00 04 00 01 99 03 99 01 99 01 99 01 99 00 00 01 02 99 99 01 00 00 40 01 99 05 99 01 02 03 04 00 01 00 00 01 99 01 99 20 Work GPCI Locality name Alabama ..................................................................................................................... Alaska ........................................................................................................................ Arizona ....................................................................................................................... Arkansas .................................................................................................................... Marin/Napa/Solano, CA ............................................................................................. San Francisco, CA .................................................................................................... San Mateo, CA .......................................................................................................... Oakland/Berkley, CA ................................................................................................. Santa Clara, CA ........................................................................................................ Ventura, CA ............................................................................................................... Los Angeles, CA ........................................................................................................ Anaheim/Santa Ana, CA ........................................................................................... Rest of California * ..................................................................................................... Rest of California * ..................................................................................................... Colorado .................................................................................................................... Connecticut ................................................................................................................ DC + MD/VA Suburbs ............................................................................................... Delaware .................................................................................................................... Fort Lauderdale, FL ................................................................................................... Miami, FL ................................................................................................................... Rest of Florida ........................................................................................................... Atlanta, GA ................................................................................................................ Rest of Georgia ......................................................................................................... Hawaii/Guam ............................................................................................................. Idaho .......................................................................................................................... East St. Louis, IL ....................................................................................................... Suburban Chicago, IL ................................................................................................ Chicago, IL ................................................................................................................ Rest of Illinois ............................................................................................................ Indiana ....................................................................................................................... Iowa ........................................................................................................................... Kansas * ..................................................................................................................... Kansas * ..................................................................................................................... Kentucky .................................................................................................................... New Orleans, LA ....................................................................................................... Rest of Louisiana ....................................................................................................... Southern Maine ......................................................................................................... Rest of Maine ............................................................................................................ Baltimore/Surr. Cntys, MD ......................................................................................... Rest of Maryland ....................................................................................................... Metropolitan Boston ................................................................................................... Rest of Massachusetts .............................................................................................. Detroit, MI .................................................................................................................. Rest of Michigan ........................................................................................................ Minnesota .................................................................................................................. Mississippi ................................................................................................................. Metropolitan St. Louis, MO ........................................................................................ Metropolitan Kansas City, MO .................................................................................. Rest of Missouri * ....................................................................................................... Rest of Missouri * ....................................................................................................... Montana ..................................................................................................................... Nebraska ................................................................................................................... Nevada ...................................................................................................................... New Hampshire ......................................................................................................... Northern NJ ............................................................................................................... Rest of New Jersey ................................................................................................... New Mexico ............................................................................................................... Rest of New York ...................................................................................................... Manhattan, NY ........................................................................................................... NYC Suburbs/Long I., NY ......................................................................................... Poughkpsie/N NYC Suburbs, NY .............................................................................. Queens, NY ............................................................................................................... North Carolina ........................................................................................................... North Dakota ............................................................................................................. Ohio ........................................................................................................................... Oklahoma .................................................................................................................. Portland, OR .............................................................................................................. Rest of Oregon .......................................................................................................... Metropolitan Philadelphia, PA ................................................................................... Rest of Pennsylvania ................................................................................................. Puerto Rico ................................................................................................................ 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00394 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 0.982 1.017 0.987 0.961 1.035 1.060 1.073 1.054 1.083 1.028 1.041 1.034 1.007 1.007 0.986 1.038 1.048 1.012 0.988 1.000 0.973 1.010 0.979 1.005 0.968 0.988 1.018 1.025 0.974 0.985 0.967 0.968 0.968 0.970 0.986 0.970 0.980 0.962 1.012 0.993 1.030 1.007 1.037 0.997 0.991 0.960 0.992 0.989 0.950 0.950 0.950 0.959 1.003 0.981 1.058 1.043 0.972 0.997 1.065 1.052 1.014 1.032 0.971 0.946 0.992 0.964 1.002 0.968 1.016 0.992 0.906 PE GPCI MP GPCI 0.847 1.105 0.994 0.832 1.342 1.546 1.539 1.373 1.543 1.181 1.158 1.238 1.054 1.054 1.015 1.172 1.252 1.020 0.990 1.048 0.936 1.091 0.874 1.113 0.869 0.940 1.117 1.128 0.874 0.908 0.869 0.880 0.880 0.855 0.947 0.848 1.014 0.887 1.080 0.981 1.331 1.105 1.056 0.922 1.006 0.841 0.956 0.977 0.803 0.803 0.845 0.876 1.045 1.029 1.222 1.121 0.888 0.919 1.300 1.283 1.076 1.230 0.922 0.861 0.934 0.856 1.059 0.927 1.106 0.904 0.699 0.740 1.013 1.052 0.431 0.640 0.640 0.629 0.640 0.595 0.732 0.939 0.939 0.721 0.721 0.790 0.886 0.911 0.877 1.675 2.233 1.251 0.950 0.950 0.787 0.452 1.722 1.626 1.837 1.174 0.429 0.579 0.709 0.709 0.859 1.178 1.041 0.626 0.626 0.932 0.748 0.810 0.810 2.700 1.494 0.404 0.711 0.926 0.931 0.878 0.878 0.889 0.447 1.050 0.927 0.958 0.958 0.880 0.666 1.480 1.756 1.148 1.682 0.630 0.593 0.960 0.376 0.434 0.434 1.364 0.793 0.257 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 70017 ADDENDUM D.—2007 GEOGRAPHIC PRACTICE COST INDICES BY MEDICARE CARRIER AND LOCALITY—Continued Carrier 00524 00880 03402 05440 00900 00900 00900 00900 00900 00900 00900 00900 03502 31145 00973 00904 00836 00836 00884 00951 03602 ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... Locality 01 01 02 35 09 11 15 18 20 28 31 99 09 50 50 00 02 99 16 00 21 Work GPCI Locality name Rhode Island ............................................................................................................. South Carolina ........................................................................................................... South Dakota ............................................................................................................. Tennessee ................................................................................................................. Brazoria, TX ............................................................................................................... Dallas, TX .................................................................................................................. Galveston, TX ............................................................................................................ Houston, TX ............................................................................................................... Beaumont, TX ............................................................................................................ Fort Worth, TX ........................................................................................................... Austin, TX .................................................................................................................. Rest of Texas ............................................................................................................ Utah ........................................................................................................................... Vermont ..................................................................................................................... Virgin Islands ............................................................................................................. Virginia ....................................................................................................................... Seattle (King Cnty), WA ............................................................................................ Rest of Washington ................................................................................................... West Virginia ............................................................................................................. Wisconsin .................................................................................................................. Wyoming .................................................................................................................... 1.045 0.975 0.943 0.977 1.020 1.009 0.990 1.016 0.983 0.997 0.991 0.968 0.977 0.968 0.967 0.981 1.014 0.987 0.973 0.987 0.956 PE GPCI MP GPCI 0.991 0.894 0.877 0.881 0.963 1.064 0.954 1.016 0.862 0.991 1.048 0.866 0.938 0.970 1.015 0.942 1.133 0.980 0.820 0.920 0.855 0.895 0.388 0.359 0.621 1.277 1.044 1.277 1.276 1.277 1.044 0.970 1.120 0.651 0.505 0.987 0.569 0.805 0.805 1.522 0.777 0.920 * States are served by more than one carrier. ADDENDUM E.—2007 GAFS rmajette on PROD1PC67 with RULES2 Carrier 31140 31140 31140 00803 00803 31140 31140 31143 14330 00903 00805 31146 00953 00952 00591 31146 00952 31146 00805 00865 00590 00836 00831 00803 00833 00511 31143 00901 00900 00900 00834 31140 31146 00524 00590 00900 00902 00900 00835 31144 00900 00952 00832 ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... VerDate Aug<31>2005 Locality 09 06 05 01 02 07 03 01 04 01 01 26 01 16 00 18 15 17 99 01 04 02 01 03 01 01 99 01 11 18 00 99 99 01 03 31 01 09 01 40 28 12 00 Locality name GAF Santa Clara, CA ................................................................................................................................................ San Mateo, CA ................................................................................................................................................. San Francisco, CA ............................................................................................................................................ Manhattan, NY .................................................................................................................................................. NYC Suburbs/Long I., NY ................................................................................................................................. Oakland/Berkley, CA ......................................................................................................................................... Marin/Napa/Solano, CA .................................................................................................................................... Metropolitan Boston .......................................................................................................................................... Queens, NY ...................................................................................................................................................... DC + MD/VA Suburbs ....................................................................................................................................... Northern NJ ....................................................................................................................................................... Anaheim/Santa Ana, CA ................................................................................................................................... Detroit, MI ......................................................................................................................................................... Chicago, IL ........................................................................................................................................................ Connecticut ....................................................................................................................................................... Los Angeles, CA ............................................................................................................................................... Suburban Chicago, IL ....................................................................................................................................... Ventura, CA ...................................................................................................................................................... Rest of New Jersey .......................................................................................................................................... Metropolitan Philadelphia, PA ........................................................................................................................... Miami, FL .......................................................................................................................................................... Seattle (King Cnty), WA .................................................................................................................................... Alaska ............................................................................................................................................................... Poughkpsie/N NYC Suburbs, NY ..................................................................................................................... Hawaii/Guam ..................................................................................................................................................... Atlanta, GA ........................................................................................................................................................ Rest of Massachusetts ..................................................................................................................................... Baltimore/Surr. Cntys, MD ................................................................................................................................ Dallas, TX ......................................................................................................................................................... Houston, TX ...................................................................................................................................................... Nevada .............................................................................................................................................................. Rest of California * ............................................................................................................................................ Rest of California * ............................................................................................................................................ Rhode Island ..................................................................................................................................................... Fort Lauderdale, FL .......................................................................................................................................... Austin, TX ......................................................................................................................................................... Delaware ........................................................................................................................................................... Brazoria, TX ...................................................................................................................................................... Portland, OR ..................................................................................................................................................... New Hampshire ................................................................................................................................................ Fort Worth, TX .................................................................................................................................................. East St. Louis, IL .............................................................................................................................................. Arizona .............................................................................................................................................................. 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00395 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 1.265 1.259 1.256 1.184 1.180 1.177 1.154 1.153 1.144 1.132 1.126 1.120 1.110 1.102 1.091 1.088 1.085 1.084 1.074 1.069 1.069 1.058 1.055 1.046 1.044 1.043 1.042 1.039 1.035 1.026 1.023 1.017 1.017 1.016 1.015 1.015 1.011 1.005 1.005 1.000 0.996 0.995 0.993 70018 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM E.—2007 GAFS—Continued Carrier 00824 00973 00900 00953 00740 31142 00901 00836 00528 00954 00523 00590 00883 31145 00801 00951 00904 00910 00865 00900 00952 05535 00511 00521 00630 00835 00900 00884 05440 00650 00740 00528 00880 31142 00660 00510 00825 00826 05130 00655 00751 00512 00820 00522 00820 00520 00523 00740 00973 ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... Locality 01 50 15 99 02 03 99 99 01 00 01 99 00 50 99 00 00 09 99 20 99 00 99 05 00 99 99 16 35 00 04 99 01 99 00 00 21 00 00 00 01 00 01 00 02 13 99 99 20 Locality name GAF Colorado ............................................................................................................................................................ Virgin Islands .................................................................................................................................................... Galveston, TX ................................................................................................................................................... Rest of Michigan ............................................................................................................................................... Metropolitan Kansas City, MO .......................................................................................................................... Southern Maine ................................................................................................................................................. Rest of Maryland ............................................................................................................................................... Rest of Washington .......................................................................................................................................... New Orleans, LA ............................................................................................................................................... Minnesota .......................................................................................................................................................... Metropolitan St. Louis, MO ............................................................................................................................... Rest of Florida .................................................................................................................................................. Ohio ................................................................................................................................................................... Vermont ............................................................................................................................................................. Rest of New York .............................................................................................................................................. Wisconsin .......................................................................................................................................................... Virginia .............................................................................................................................................................. Utah ................................................................................................................................................................... Rest of Pennsylvania ........................................................................................................................................ Beaumont, TX ................................................................................................................................................... Rest of Illinois ................................................................................................................................................... North Carolina ................................................................................................................................................... Rest of Georgia ................................................................................................................................................. New Mexico ...................................................................................................................................................... Indiana .............................................................................................................................................................. Rest of Oregon ................................................................................................................................................. Rest of Texas .................................................................................................................................................... West Virginia ..................................................................................................................................................... Tennessee ........................................................................................................................................................ Kansas * ............................................................................................................................................................ Kansas * ............................................................................................................................................................ Rest of Louisiana .............................................................................................................................................. South Carolina .................................................................................................................................................. Rest of Maine .................................................................................................................................................... Kentucky ........................................................................................................................................................... Alabama ............................................................................................................................................................ Wyoming ........................................................................................................................................................... Iowa ................................................................................................................................................................... Idaho ................................................................................................................................................................. Nebraska ........................................................................................................................................................... Montana ............................................................................................................................................................ Mississippi ......................................................................................................................................................... North Dakota ..................................................................................................................................................... Oklahoma .......................................................................................................................................................... South Dakota .................................................................................................................................................... Arkansas ........................................................................................................................................................... Rest of Missouri * .............................................................................................................................................. Rest of Missouri * .............................................................................................................................................. Puerto Rico ....................................................................................................................................................... 0.991 0.989 0.985 0.984 0.982 0.981 0.978 0.977 0.976 0.975 0.974 0.968 0.965 0.951 0.950 0.950 0.948 0.947 0.946 0.942 0.938 0.936 0.932 0.932 0.930 0.929 0.929 0.927 0.921 0.919 0.919 0.919 0.917 0.916 0.915 0.914 0.910 0.909 0.905 0.903 0.902 0.898 0.895 0.894 0.891 0.884 0.883 0.883 0.790 * States are served by more than one carrier. ADDENDUM F.—CPT/HCPS IMAGING CODES DEFINED BY DRA 5102(B) rmajette on PROD1PC67 with RULES2 HCPCS/ CPT* 31620 37250 37251 51798 70010 70015 70030 70100 70110 70120 70130 70134 70140 70150 ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... VerDate Aug<31>2005 ADDENDUM F.—CPT/HCPS IMAGING CODES DEFINED BY DRA 5102(B)— Continued ADDENDUM F.—CPT/HCPS IMAGING CODES DEFINED BY DRA 5102(B)— Continued HCPCS/ CPT* HCPCS/ CPT* Short descriptor Endobronchial us add-on Iv us first vessel add-on Iv us each add vessel add-on Us urine capacity measure Contrast x-ray of brain Contrast x-ray of brain X-ray eye for foreign body X-ray exam of jaw X-ray exam of jaw X-ray exam of mastoids X-ray exam of mastoids X-ray exam of middle ear X-ray exam of facial bones X-ray exam of facial bones 10:50 Nov 30, 2006 Jkt 211001 70160 70170 70190 70200 70210 70220 70240 70250 70260 70300 70310 70320 PO 00000 ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... Frm 00396 Short descriptor X-ray exam of nasal bones X-ray exam of tear duct X-ray exam of eye sockets X-ray exam of eye sockets X-ray exam of sinuses X-ray exam of sinuses X-ray exam, pituitary saddle X-ray exam of skull X-ray exam of skull X-ray exam of teeth X-ray exam of teeth Full mouth x-ray of teeth Fmt 4701 Sfmt 4700 70328 70330 70332 70336 70350 70355 70360 70370 70371 70373 70380 70390 E:\FR\FM\01DER2.SGM ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... Short descriptor X-ray exam of jaw joint X-ray exam of jaw joints X-ray exam of jaw joint Magnetic image, jaw joint X-ray head for orthodontia Panoramic x-ray of jaws X-ray exam of neck Throat x-ray & fluoroscopy Speech evaluation, complex Contrast x-ray of larynx X-ray exam of salivary gland X-ray exam of salivary duct 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 70019 ADDENDUM F.—CPT/HCPS IMAGING CODES DEFINED BY DRA 5102(B)— Continued ADDENDUM F.—CPT/HCPS IMAGING CODES DEFINED BY DRA 5102(B)— Continued HCPCS/ CPT* rmajette on PROD1PC67 with RULES2 ADDENDUM F.—CPT/HCPS IMAGING CODES DEFINED BY DRA 5102(B)— Continued HCPCS/ CPT* HCPCS/ CPT* 70450 70460 70470 70480 70481 70482 70486 70487 70488 70490 70491 70492 70496 70498 70540 70542 70543 70544 70545 70546 70547 70548 70549 70551 70552 70553 70557 70558 70559 71010 71015 71020 71021 71022 71023 71030 71034 71035 71040 71060 71090 71100 71101 71110 71111 71120 71130 71250 71260 71270 71275 71550 71551 71552 71555 72010 72020 72040 72050 72052 72069 72070 72072 72074 72080 72090 72100 72110 72114 ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... VerDate Aug<31>2005 Short descriptor Ct head/brain w/o dye Ct head/brain w/dye Ct head/brain w/o & w/dye Ct orbit/ear/fossa w/o dye Ct orbit/ear/fossa w/dye Ct orbit/ear/fossa w/o&w/dye Ct maxillofacial w/o dye Ct maxillofacial w/dye Ct maxillofacial w/o & w/dye Ct soft tissue neck w/o dye Ct soft tissue neck w/dye Ct sft tsue nck w/o & w/dye Ct angiography, head Ct angiography, neck Mri orbit/face/neck w/o dye Mri orbit/face/neck w/dye Mri orbt/fac/nck w/o & w/dye Mr angiography head w/o dye Mr angiography head w/dye Mr angiograph head w/o&w/dye Mr angiography neck w/o dye Mr angiography neck w/dye Mr angiograph neck w/o&w/dye Mri brain w/o dye Mri brain w/dye Mri brain w/o & w/dye Mri brain w/o dye Mri brain w/dye Mri brain w/o & w/dye Chest x-ray Chest x-ray Chest x-ray Chest x-ray Chest x-ray Chest x-ray and fluoroscopy Chest x-ray Chest x-ray and fluoroscopy Chest x-ray Contrast x-ray of bronchi Contrast x-ray of bronchi X-ray & pacemaker insertion X-ray exam of ribs X-ray exam of ribs/chest X-ray exam of ribs X-ray exam of ribs/chest X-ray exam of breastbone X-ray exam of breastbone Ct thorax w/o dye Ct thorax w/dye Ct thorax w/o & w/dye Ct angiography, chest Mri chest w/o dye Mri chest w/dye Mri chest w/o & w/dye Mri angio chest w or w/o dye X-ray exam of spine X-ray exam of spine X-ray exam of neck spine X-ray exam of neck spine X-ray exam of neck spine X-ray exam of trunk spine X-ray exam of thoracic spine X-ray exam of thoracic spine X-ray exam of thoracic spine X-ray exam of trunk spine X-ray exam of trunk spine X-ray exam of lower spine X-ray exam of lower spine X-ray exam of lower spine 10:50 Nov 30, 2006 Jkt 211001 72120 72125 72126 72127 72128 72129 72130 72131 72132 72133 72141 72142 72146 72147 72148 72149 72156 72157 72158 72159 72170 72190 72191 72192 72193 72194 72195 72196 72197 72198 72200 72202 72220 72240 72255 72265 72270 72275 72285 72291 72293 72295 73000 73010 73020 73030 73040 73050 73060 73070 73080 73085 73090 73092 73100 73110 73115 73120 73130 73140 73200 73201 73202 73206 73218 73219 73220 73221 73222 PO 00000 ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... Frm 00397 Short descriptor X-ray exam of lower spine Ct neck spine w/o dye Ct neck spine w/dye Ct neck spine w/o & w/dye Ct chest spine w/o dye Ct chest spine w/dye Ct chest spine w/o & w/dye Ct lumbar spine w/o dye Ct lumbar spine w/dye Ct lumbar spine w/o & w/dye Mri neck spine w/o dye Mri neck spine w/dye Mri chest spine w/o dye Mri chest spine w/dye Mri lumbar spine w/o dye Mri lumbar spine w/dye Mri neck spine w/o & w/dye Mri chest spine w/o & w/dye Mri lumbar spine w/o & w/dye Mr angio spine w/o&w/dye X-ray exam of pelvis X-ray exam of pelvis Ct angiograph pelv w/o&w/dye Ct pelvis w/o dye Ct pelvis w/dye Ct pelvis w/o & w/dye Mri pelvis w/o dye Mri pelvis w/dye Mri pelvis w/o & w/dye Mr angio pelvis w/o & w/dye X-ray exam sacroiliac joints X-ray exam sacroiliac joints X-ray exam of tailbone Contrast x-ray of neck spine Contrast x-ray, thorax spine Contrast x-ray, lower spine Contrast x-ray, spine Epidurography X-ray c/t spine disk Percut vertebroplasty fluor Percut vertebroplasty, ct X-ray of lower spine disk X-ray exam of collar bone X-ray exam of shoulder blade X-ray exam of shoulder X-ray exam of shoulder Contrast x-ray of shoulder X-ray exam of shoulders X-ray exam of humerus X-ray exam of elbow X-ray exam of elbow Contrast x-ray of elbow X-ray exam of forearm X-ray exam of arm, infant X-ray exam of wrist X-ray exam of wrist Contrast x-ray of wrist X-ray exam of hand X-ray exam of hand X-ray exam of finger(s) Ct upper extremity w/o dye Ct upper extremity w/dye Ct uppr extremity w/o&w/dye Ct angio upr extrm w/o&w/dye Mri upper extremity w/o dye Mri upper extremity w/dye Mri uppr extremity w/o&w/dye Mri joint upr extrem w/o dye Mri joint upr extrem w/dye Fmt 4701 Sfmt 4700 73223 73225 73500 73510 73520 73525 73530 73540 73542 73550 73560 73562 73564 73565 73580 73590 73592 73600 73610 73615 73620 73630 73650 73660 73700 73701 73702 73706 73718 73719 73720 73721 73722 73723 73725 74000 74010 74020 74022 74150 74160 74170 74175 74181 74182 74183 74185 74190 74210 74220 74230 74235 74240 74241 74245 74246 74247 74249 74250 74251 74260 74270 74280 74283 74290 74291 74300 74301 74305 E:\FR\FM\01DER2.SGM ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... Short descriptor Mri joint upr extr w/o&w/dye Mr angio upr extr w/o&w/dye X-ray exam of hip X-ray exam of hip X-ray exam of hips Contrast x-ray of hip X-ray exam of hip X-ray exam of pelvis & hips X-ray exam, sacroiliac joint X-ray exam of thigh X-ray exam of knee, 1 or 2 X-ray exam of knee, 3 X-ray exam, knee, 4 or more X-ray exam of knees Contrast x-ray of knee joint X-ray exam of lower leg X-ray exam of leg, infant X-ray exam of ankle X-ray exam of ankle Contrast x-ray of ankle X-ray exam of foot X-ray exam of foot X-ray exam of heel X-ray exam of toe(s) Ct lower extremity w/o dye Ct lower extremity w/dye Ct lwr extremity w/o&w/dye Ct angio lwr extr w/o&w/dye Mri lower extremity w/o dye Mri lower extremity w/dye Mri lwr extremity w/o&w/dye Mri jnt of lwr extre w/o dye Mri joint of lwr extr w/dye Mri joint lwr extr w/o&w/dye Mr ang lwr ext w or w/o dye X-ray exam of abdomen X-ray exam of abdomen X-ray exam of abdomen X-ray exam series, abdomen Ct abdomen w/o dye Ct abdomen w/dye Ct abdomen w/o & w/dye Ct angio abdom w/o & w/dye Mri abdomen w/o dye Mri abdomen w/dye Mri abdomen w/o & w/dye Mri angio, abdom w orw/o dye X-ray exam of peritoneum Contrst x-ray exam of throat Contrast x-ray, esophagus Cine/vid x-ray, throat/esoph Remove esophagus obstruction X-ray exam, upper gi tract X-ray exam, upper gi tract X-ray exam, upper gi tract Contrst x-ray uppr gi tract Contrst x-ray uppr gi tract Contrst x-ray uppr gi tract X-ray exam of small bowel X-ray exam of small bowel X-ray exam of small bowel Contrast x-ray exam of colon Contrast x-ray exam of colon Contrast x-ray exam of colon Contrast x-ray, gallbladder Contrast x-rays, gallbladder X-ray bile ducts/pancreas X-rays at surgery add-on X-ray bile ducts/pancreas 01DER2 70020 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM F.—CPT/HCPS IMAGING CODES DEFINED BY DRA 5102(B)— Continued ADDENDUM F.—CPT/HCPS IMAGING CODES DEFINED BY DRA 5102(B)— Continued HCPCS/ CPT* rmajette on PROD1PC67 with RULES2 ADDENDUM F.—CPT/HCPS IMAGING CODES DEFINED BY DRA 5102(B)— Continued HCPCS/ CPT* HCPCS/ CPT* 74320 74327 74328 74329 74330 74340 74350 74355 74360 74363 74400 74410 74415 74420 74425 74430 74440 74445 74450 74455 74470 74475 74480 74485 74710 74740 74742 74775 75552 75553 75554 75555 75556 75600 75605 75625 75630 75635 75650 75658 75660 75662 75665 75671 75676 75680 75685 75705 75710 75716 75722 75724 75726 75731 75733 75736 75741 75743 75746 75756 75774 75790 75801 75803 75805 75807 75809 75810 75820 ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... VerDate Aug<31>2005 Short descriptor Contrast x-ray of bile ducts X-ray bile stone removal X-ray bile duct endoscopy X-ray for pancreas endoscopy X-ray bile/panc endoscopy X-ray guide for GI tube X-ray guide, stomach tube X-ray guide, intestinal tube X-ray guide, GI dilation X-ray, bile duct dilation Contrst x-ray, urinary tract Contrst x-ray, urinary tract Contrst x-ray, urinary tract Contrst x-ray, urinary tract Contrst x-ray, urinary tract Contrast x-ray, bladder X-ray, male genital tract X-ray exam of penis X-ray, urethra/bladder X-ray, urethra/bladder X-ray exam of kidney lesion X-ray control, cath insert X-ray control, cath insert X-ray guide, GU dilation X-ray measurement of pelvis X-ray, female genital tract X-ray, fallopian tube X-ray exam of perineum Heart mri for morph w/o dye Heart mri for morph w/dye Cardiac MRI/function Cardiac MRI/limited study Cardiac MRI/flow mapping Contrast x-ray exam of aorta Contrast x-ray exam of aorta Contrast x-ray exam of aorta X-ray aorta, leg arteries Ct angio abdominal arteries Artery x-rays, head & neck Artery x-rays, arm Artery x-rays, head & neck Artery x-rays, head & neck Artery x-rays, head & neck Artery x-rays, head & neck Artery x-rays, neck Artery x-rays, neck Artery x-rays, spine Artery x-rays, spine Artery x-rays, arm/leg Artery x-rays, arms/legs Artery x-rays, kidney Artery x-rays, kidneys Artery x-rays, abdomen Artery x-rays, adrenal gland Artery x-rays, adrenals Artery x-rays, pelvis Artery x-rays, lung Artery x-rays, lungs Artery x-rays, lung Artery x-rays, chest Artery x-ray, each vessel Visualize A-V shunt Lymph vessel x-ray, arm/leg Lymph vessel x-ray,arms/legs Lymph vessel x-ray, trunk Lymph vessel x-ray, trunk Nonvascular shunt, x-ray Vein x-ray, spleen/liver Vein x-ray, arm/leg 10:50 Nov 30, 2006 Jkt 211001 75822 75825 75827 75831 75833 75840 75842 75860 75870 75872 75880 75885 75887 75889 75891 75893 75894 75896 75898 75900 75901 75902 75940 75945 75946 75953 75956 75957 75958 75959 75960 75961 75962 75964 75966 75968 75970 75978 75980 75982 75984 75989 75992 76000 76001 76010 76080 76098 76100 76101 76102 76120 76125 76140 76150 76350 76376 76377 76380 76390 76496 76497 76498 76506 76510 76511 76512 76513 76514 PO 00000 ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... Frm 00398 Short descriptor Vein x-ray, arms/legs Vein x-ray, trunk Vein x-ray, chest Vein x-ray, kidney Vein x-ray, kidneys Vein x-ray, adrenal gland Vein x-ray, adrenal glands Vein x-ray, neck Vein x-ray, skull Vein x-ray, skull Vein x-ray, eye socket Vein x-ray, liver Vein x-ray, liver Vein x-ray, liver Vein x-ray, liver Venous sampling by catheter X-rays, transcath therapy X-rays, transcath therapy Follow-up angiography Intravascular cath exchange Remove cva device obstruct Remove cva lumen obstruct X-ray placement, vein filter Intravascular us Intravascular us add-on Abdom aneurysm endovas rpr Xray, endovasc thor ao repr Xray, endovasc thor ao repr Xray, place prox ext thor ao Xray, place dist ext thor ao Transcath iv stent rs&i Retrieval, broken catheter Repair arterial blockage Repair artery blockage, each Repair arterial blockage Repair artery blockage, each Vascular biopsy Repair venous blockage Contrast xray exam bile duct Contrast xray exam bile duct Xray control catheter change Abscess drainage under x-ray Atherectomy, x-ray exam Fluoroscope examination Fluoroscope exam, extensive X-ray, nose to rectum X-ray exam of fistula X-ray exam, breast specimen X-ray exam of body section Complex body section x-ray Complex body section x-rays Cine/video x-rays Cine/video x-rays add-on X-ray consultation X-ray exam, dry process Special x-ray contrast study 3d render w/o postprocess 3d rendering w/postprocess CAT scan follow-up study Mr spectroscopy Fluoroscopic procedure Ct procedure Mri procedure Echo exam of head Ophth us, b & quant a Ophth us, quant a only Ophth us, b w/non-quant a Echo exam of eye, water bath Echo exam of eye, thickness Fmt 4701 Sfmt 4700 76516 76519 76529 76536 76604 76645 76700 76705 76770 76775 76778 76800 76801 76802 76805 76810 76811 76812 76815 76816 76817 76818 76819 76820 76821 76825 76826 76827 76828 76830 76831 76856 76857 76870 76872 76873 76880 76885 76886 76930 76932 76936 76937 76940 76941 76942 76945 76946 76948 76950 76965 76970 76975 76977 76998 77001 77002 77003 77011 77012 77013 77014 77021 77022 77031 77032 77053 77054 77058 E:\FR\FM\01DER2.SGM ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... Short descriptor Echo exam of eye Echo exam of eye Echo exam of eye Us exam of head and neck Us exam, chest, b-scan Us exam, breast(s) Us exam, abdom, complete Echo exam of abdomen Us exam abdo back wall, comp Us exam abdo back wall, lim Us exam kidney transplant Us exam, spinal canal Ob us < 14 wks, single fetus Ob us < 14 wks, add?l fetus Ob us >/= 14 wks, sngl fetus Ob us >/= 14 wks, addl fetus Ob us, detailed, sngl fetus Ob us, detailed, addl fetus Ob us, limited, fetus(s) Ob us, follow-up, per fetus Transvaginal us, obstetric Fetal biophys profile w/nst Fetal biophys profil w/o nst Umbilical artery echo Middle cerebral artery echo Echo exam of fetal heart Echo exam of fetal heart Echo exam of fetal heart Echo exam of fetal heart Transvaginal us, non-ob Echo exam, uterus Us exam, pelvic, complete Us exam, pelvic, limited Us exam, scrotum Us, transrectal Echograp trans r, pros study Us exam, extremity Us exam infant hips, dynamic Us exam infant hips, static Echo guide, cardiocentesis Echo guide for heart biopsy Echo guide for artery repair Us guide, vascular access Us guide, tissue ablation Echo guide for transfusion Echo guide for biopsy Echo guide, villus sampling Echo guide for amniocentesis Echo guide, ova aspiration Echo guidance radiotherapy Echo guidance radiotherapy Ultrasound exam follow-up GI endoscopic ultrasound Us bone density measure Ultrasound guide intraoper Fluoroguide for vein device Needle localization by x-ray Fluoroguide for spine inject Ct scan for localization Ct scan for needle biopsy Ct guide for tissue ablation Ct scan for therapy guide Mr guidance for needle place Mri for tissue ablation Stereotactic breast biopsy X-ray of needle wire, breast X-ray of mammary duct X-ray of mammary ducts Magnetic image, breast 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 70021 ADDENDUM F.—CPT/HCPS IMAGING CODES DEFINED BY DRA 5102(B)— Continued ADDENDUM F.—CPT/HCPS IMAGING CODES DEFINED BY DRA 5102(B)— Continued HCPCS/ CPT* rmajette on PROD1PC67 with RULES2 ADDENDUM F.—CPT/HCPS IMAGING CODES DEFINED BY DRA 5102(B)— Continued HCPCS/ CPT* HCPCS/ CPT* Short descriptor 93304 ....... 93307 ....... 93308 ....... 93312 ....... 93313 ....... 93314 ....... 93315 ....... 93316 ....... 93317 ....... 93318 ....... 93320 ....... 93321 ....... 93325 ....... 93350 ....... 93555 ....... 93556 ....... 93571 ....... 93572 ....... 93880 ....... 93882 ....... 93886 ....... 93888 ....... 93890 ....... 93892 ....... 93893 ....... 93925 ....... 93926 ....... 93930 ....... 93931 ....... 93970 ....... 93971 ....... 93975 ....... 93976 ....... 93978 ....... 93979 ....... 93980 ....... 93981 ....... 93990 ....... 0028T ...... 0042T ...... 0066T ...... 0067T ...... 0080T ...... 0081T ...... 0144T ...... 0145T ...... 0146T ...... 0147T ...... 0148T ...... 0149T ...... 0150T ...... 0151T ...... 0152T ...... G0120 ...... G0122 ...... G0130 ...... G0219 ...... G0235 ...... G0275 ...... G0278 ...... G0288 ...... G0365 ...... Echo transthoracic Echo exam of heart Echo exam of heart Echo transesophageal Echo transesophageal Echo transesophageal Echo transesophageal Echo transesophageal Echo transesophageal Echo transesophageal intraop Doppler echo exam, heart Doppler echo exam, heart Doppler color flow add-on Echo transthoracic Imaging, cardiac cath Imaging, cardiac cath Heart flow reserve measure Heart flow reserve measure Extracranial study Extracranial study Intracranial study Intracranial study Tcd, vasoreactivity study Tcd, emboli detect w/o inj Tcd, emboli detect w/inj Lower extremity study Lower extremity study Upper extremity study Upper extremity study Extremity study Extremity study Vascular study Vascular study Vascular study Vascular study Penile vascular study Penile vascular study Doppler flow testing Dexa body composition study Ct perfusion w/contrast, cbf Ct colonography;screen Ct colonography;dx Endovasc aort repr rad s&i Endovasc visc extnsn s&i CT heart wo dye; qual calc CT heart w/wo dye funct CCTA w/wo dye CCTA w/wo, quan calcium CCTA w/wo, strxr CCTA w/wo, strxr quan calc CCTA w/wo, disease strxr CT heart funct add-on Computer chest add-on Colon ca scrn; barium enema Colon ca scrn; barium enema Single energy x-ray study PET img wholbod melano nonco PET not otherwise specified Renal angio, cardiac cath Iliac art angio,cardiac cath Recon, CTA for surg plan Vessel mapping hemo access 77059 77071 77072 77073 77074 77075 77076 77077 77078 77079 77080 77081 77082 77083 77084 77417 77421 78006 78007 78010 78011 78015 78016 78018 78020 78070 78075 78102 78103 78104 78135 78140 78185 78190 78195 78201 78202 78205 78206 78215 78216 78220 78223 78230 78231 78232 78258 78261 78262 78264 78278 78282 78290 78291 78300 78305 78306 78315 78320 78350 78351 78428 78445 78456 78457 78458 78459 78460 78461 ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... VerDate Aug<31>2005 Short descriptor Magnetic image, both breasts X-ray stress view X-rays for bone age X-rays, bone evaluation X-rays, bone survey X-rays, bone survey X-rays, bone evaluation Joint survey, single view Ct bone density, axial Ct bone density, peripheral Dxa bone density, axial Dxa bone density/peripheral Dxa bone density/v-fracture Radiographic absorptiometry Magnetic image, bone marrow Radiology port film(s) Stereoscopic x-ray guidance Thyroid imaging with uptake Thyroid image, mult uptakes Thyroid imaging Thyroid imaging with flow Thyroid met imaging Thyroid met imaging/studies Thyroid met imaging, body Thyroid met uptake Parathyroid nuclear imaging Adrenal nuclear imaging Bone marrow imaging, ltd Bone marrow imaging, mult Bone marrow imaging, body Red cell survival kinetics Red cell sequestration Spleen imaging Platelet survival, kinetics Lymph system imaging Liver imaging Liver imaging with flow Liver imaging (3D) Liver image (3d) with flow Liver and spleen imaging Liver & spleen image/flow Liver function study Hepatobiliary imaging Salivary gland imaging Serial salivary imaging Salivary gland function exam Esophageal motility study Gastric mucosa imaging Gastroesophageal reflux exam Gastric emptying study Acute GI blood loss imaging GI protein loss exam Meckel’s divert exam Leveen/shunt patency exam Bone imaging, limited area Bone imaging, multiple areas Bone imaging, whole body Bone imaging, 3 phase Bone imaging (3D) Bone mineral, single photon Bone mineral, dual photon Cardiac shunt imaging Vascular flow imaging Acute venous thrombus image Venous thrombosis imaging Ven thrombosis images, bilat Heart muscle imaging (PET) Heart muscle blood, single Heart muscle blood, multiple 10:50 Nov 30, 2006 Jkt 211001 78464 78465 78466 78468 78469 78472 78473 78478 78480 78481 78483 78491 78492 78494 78496 78580 78584 78585 78586 78587 78588 78591 78593 78594 78596 78600 78601 78605 78606 78607 78608 78609 78610 78615 78630 78635 78645 78647 78650 78660 78700 78701 78704 78707 78708 78709 78710 78715 78730 78740 78760 78761 78800 78801 78802 78803 78804 78805 78806 78807 78811 78812 78813 78814 78815 78816 78890 78891 93303 PO 00000 ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... Frm 00399 Short descriptor Heart image (3d), single Heart image (3d), multiple Heart infarct image Heart infarct image (ef) Heart infarct image (3D) Gated heart, planar, single Gated heart, multiple Heart wall motion add-on Heart function add-on Heart first pass, single Heart first pass, multiple Heart image (pet), single Heart image (pet), multiple Heart image, spect Heart first pass add-on Lung perfusion imaging Lung V/Q image single breath Lung V/Q imaging Aerosol lung image, single Aerosol lung image, multiple Perfusion lung image Vent image, 1 breath, 1 proj Vent image, 1 proj, gas Vent image, mult proj, gas Lung differential function Brain imaging, ltd static Brain imaging, ltd w/flow Brain imaging, complete Brain imaging, compl w/flow Brain imaging (3D) Brain imaging (PET) Brain imaging (PET) Brain flow imaging only Cerebral vascular flow image Cerebrospinal fluid scan CSF ventriculography CSF shunt evaluation Cerebrospinal fluid scan CSF leakage imaging Nuclear exam of tear flow Kidney imaging, static Kidney imaging with flow Imaging renogram Kidney flow/function image Kidney flow/function image Kidney flow/function image Kidney imaging (3D) Renal vascular flow exam Urinary bladder retention Ureteral reflux study Testicular imaging Testicular imaging/flow Tumor imaging, limited area Tumor imaging, mult areas Tumor imaging, whole body Tumor imaging (3D) Tumor imaging, whole body Abscess imaging, ltd area Abscess imaging, whole body Nuclear localization/abscess Tumor imaging (pet), limited Tumor image (pet)/skul-thigh Tumor image (pet) full body Tumor image pet/ct, limited Tumorimage pet/ct skul-thigh Tumor image pet/ct full body Nuclear medicine data proc Nuclear med data proc Echo transthoracic Fmt 4701 Sfmt 4700 * CPT codes are descriptors only are copyright 2006 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. E:\FR\FM\01DER2.SGM 01DER2 70022 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM G.—CY 2007 WAGE INDEX FOR URBAN AREAS BASED ON CBSA LABOR MARKET AREAS CBSA code Urban area (constituent counties) 10180 ....... Abilene, TX ............................................................................................................................................................................ Callahan County, TX. Jones County, TX. Taylor County, TX. ´ Aguadilla-Isabela-San Sebastian, PR ................................................................................................................................... Aguada Municipio, PR. Aguadilla Municipio, PR. ˜ Anasco Municipio, PR. Isabela Municipio, PR. Lares Municipio, PR. Moca Municipio, PR. ´ Rincon Municipio, PR. ´ San Sebastian Municipio, PR. Akron, OH .............................................................................................................................................................................. Portage County, OH. Summit County, OH. Albany, GA ............................................................................................................................................................................. Baker County, GA. Dougherty County, GA. Lee County, GA. Terrell County, GA. Worth County, GA. Albany-Schenectady-Troy, NY .............................................................................................................................................. Albany County, NY. Rensselaer County, NY. Saratoga County, NY. Schenectady County, NY. Schoharie County, NY. Albuquerque, NM ................................................................................................................................................................... Bernalillo County, NM. Sandoval County, NM. Torrance County, NM. Valencia County, NM. Alexandria, LA ....................................................................................................................................................................... Grant Parish, LA. Rapides Parish, LA. Allentown-Bethlehem-Easton, PA-NJ .................................................................................................................................... Warren County, NJ. Carbon County, PA. Lehigh County, PA. Northampton County, PA. Altoona, PA ............................................................................................................................................................................ Blair County, PA. Amarillo, TX ........................................................................................................................................................................... Armstrong County, TX. Carson County, TX. Potter County, TX. Randall County, TX. Ames, IA ................................................................................................................................................................................ Story County, IA. Anchorage, AK ....................................................................................................................................................................... Anchorage Municipality, AK. Matanuska-Susitna Borough, AK. Anderson, IN .......................................................................................................................................................................... Madison County, IN. Anderson, SC ........................................................................................................................................................................ Anderson County, SC. Ann Arbor, MI ........................................................................................................................................................................ Washtenaw County, MI. Anniston-Oxford, AL .............................................................................................................................................................. Calhoun County, AL. Appleton, WI .......................................................................................................................................................................... Calumet County, WI. Outagamie County, WI. Asheville, NC ......................................................................................................................................................................... Buncombe County, NC. Haywood County, NC. Henderson County, NC. Madison County, NC. Athens-Clarke County, GA .................................................................................................................................................... Clarke County, GA. 10380 ....... 10420 ....... 10500 ....... 10580 ....... 10740 ....... 10780 ....... 10900 ....... 11020 ....... 11100 ....... 11180 ....... 11260 ....... 11300 ....... 11340 ....... 11460 ....... 11500 ....... 11540 ....... rmajette on PROD1PC67 with RULES2 11700 ....... 12020 ....... VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00400 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM Wage index 01DER2 0.8423 0.8423 0.9111 0.9466 0.9181 0.9958 0.8429 1.0472 0.9277 0.9653 1.0276 1.2658 0.9140 0.9493 1.1398 0.8423 0.9954 0.9703 1.0377 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 70023 ADDENDUM G.—CY 2007 WAGE INDEX FOR URBAN AREAS BASED ON CBSA LABOR MARKET AREAS—Continued CBSA code 12060 ....... 12100 ....... 12220 ....... 12260 ....... 12420 ....... 12540 ....... 12580 ....... 12620 ....... 12700 ....... rmajette on PROD1PC67 with RULES2 12940 ....... VerDate Aug<31>2005 Wage index Urban area (constituent counties) Madison County, GA. Oconee County, GA. Oglethorpe County, GA. Atlanta-Sandy Springs-Marietta, GA ..................................................................................................................................... Barrow County, GA. Bartow County, GA. Butts County, GA. Carroll County, GA. Cherokee County, GA. Clayton County, GA. Cobb County, GA. Coweta County, GA. Dawson County, GA. DeKalb County, GA. Douglas County, GA. Fayette County, GA. Forsyth County, GA. Fulton County, GA. Gwinnett County, GA. Haralson County, GA. Heard County, GA. Henry County, GA. Jasper County, GA. Lamar County, GA. Meriwether County, GA. Newton County, GA. Paulding County, GA. Pickens County, GA. Pike County, GA. Rockdale County, GA. Spalding County, GA. Walton County, GA. Atlantic City, NJ ..................................................................................................................................................................... Atlantic County, NJ. Auburn-Opelika, AL ............................................................................................................................................................... Lee County, AL. Augusta-Richmond County, GA-SC ...................................................................................................................................... Burke County, GA. Columbia County, GA. McDuffie County, GA. Richmond County, GA. Aiken County, SC. Edgefield County, SC. Austin-Round Rock, TX ......................................................................................................................................................... Bastrop County, TX. Caldwell County, TX. Hays County, TX. Travis County, TX. Williamson County, TX. Bakersfield, CA ...................................................................................................................................................................... Kern County, CA. Baltimore-Towson, MD .......................................................................................................................................................... Anne Arundel County, MD. Baltimore County, MD. Carroll County, MD. Harford County, MD. Howard County, MD. Queen Anne’s County, MD. Baltimore City, MD. Bangor, ME ............................................................................................................................................................................ Penobscot County, ME. Barnstable Town, MA ............................................................................................................................................................ Barnstable County, MA. Baton Rouge, LA ................................................................................................................................................................... Ascension Parish, LA. East Baton Rouge Parish, LA. East Feliciana Parish, LA. Iberville Parish, LA. Livingston Parish, LA. Pointe Coupee Parish, LA. St. Helena Parish, LA. 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00401 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 1.0278 1.2456 0.8524 1.0178 0.9838 1.1291 1.0621 1.0224 1.3201 0.8511 70024 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM G.—CY 2007 WAGE INDEX FOR URBAN AREAS BASED ON CBSA LABOR MARKET AREAS—Continued CBSA code 12980 ....... 13020 ....... 13140 ....... 13380 ....... 13460 ....... 13644 ....... 13740 ....... 13780 ....... 13820 ....... 13900 ....... 13980 ....... 14020 ....... 14060 ....... 14260 ....... 14484 ....... 14500 ....... 14540 ....... 14740 ....... 14860 ....... rmajette on PROD1PC67 with RULES2 15180 ....... 15260 ....... 15380 ....... VerDate Aug<31>2005 Wage index Urban area (constituent counties) West Baton Rouge Parish, LA. West Feliciana Parish, LA. Battle Creek, MI ..................................................................................................................................................................... Calhoun County, MI. Bay City, MI ........................................................................................................................................................................... Bay County, MI. Beaumont-Port Arthur, TX ..................................................................................................................................................... Hardin County, TX. Jefferson County, TX. Orange County, TX. Bellingham, WA ..................................................................................................................................................................... Whatcom County, WA. Bend, OR ............................................................................................................................................................................... Deschutes County, OR. Bethesda-Gaithersburg-Frederick, MD .................................................................................................................................. Frederick County, MD. Montgomery County, MD. Billings, MT ............................................................................................................................................................................ Carbon County, MT. Yellowstone County, MT. Binghamton, NY ..................................................................................................................................................................... Broome County, NY. Tioga County, NY. Birmingham-Hoover, AL ........................................................................................................................................................ Bibb County, AL. Blount County, AL. Chilton County, AL. Jefferson County, AL. St. Clair County, AL. Shelby County, AL. Walker County, AL. Bismarck, ND ......................................................................................................................................................................... Burleigh County, ND. Morton County, ND. Blacksburg-Christiansburg-Radford, VA ................................................................................................................................ Giles County, VA. Montgomery County, VA. Pulaski County, VA. Radford City, VA. Bloomington, IN ..................................................................................................................................................................... Greene County, IN. Monroe County, IN. Owen County, IN. Bloomington-Normal, IL ......................................................................................................................................................... McLean County, IL. Boise City-Nampa, ID ............................................................................................................................................................ Ada County, ID. Boise County, ID. Canyon County, ID. Gem County, ID. Owyhee County, ID. Boston-Quincy, MA ................................................................................................................................................................ Norfolk County, MA. Plymouth County, MA. Suffolk County, MA. Boulder, CO ........................................................................................................................................................................... Boulder County, CO. Bowling Green, KY ................................................................................................................................................................ Edmonson County, KY. Warren County, KY. Bremerton-Silverdale, WA ..................................................................................................................................................... Kitsap County, WA. Bridgeport-Stamford-Norwalk, CT ......................................................................................................................................... Fairfield County, CT. Brownsville-Harlingen, TX ..................................................................................................................................................... Cameron County, TX. Brunswick, GA ....................................................................................................................................................................... Brantley County, GA. Glynn County, GA. McIntosh County, GA. Buffalo-Niagara Falls, NY ...................................................................................................................................................... 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00402 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 1.0278 0.9740 0.9049 1.1690 1.1310 1.1479 0.9172 0.9250 0.9364 0.8423 0.8647 0.8984 0.9416 0.9898 1.2296 1.0897 0.8578 1.1489 1.3328 0.9928 1.0701 0.9922 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 70025 ADDENDUM G.—CY 2007 WAGE INDEX FOR URBAN AREAS BASED ON CBSA LABOR MARKET AREAS—Continued CBSA code 15500 ....... 15540 ....... 15764 ....... 15804 ....... 15940 ....... 15980 ....... 16180 ....... 16220 ....... 16300 ....... 16580 ....... 16620 ....... 16700 ....... 16740 ....... 16820 ....... 16860 ....... 16940 ....... rmajette on PROD1PC67 with RULES2 16974 ....... VerDate Aug<31>2005 Wage index Urban area (constituent counties) Erie County, NY. Niagara County, NY. Burlington, NC ....................................................................................................................................................................... Alamance County, NC. Burlington-South Burlington, VT ............................................................................................................................................ Chittenden County, VT. Franklin County, VT. Grand Isle County, VT. Cambridge-Newton-Framingham, MA ................................................................................................................................... Middlesex County, MA. Camden, NJ ........................................................................................................................................................................... Burlington County, NJ. Camden County, NJ. Gloucester County, NJ. Canton-Massillon, OH ............................................................................................................................................................ Carroll County, OH. Stark County, OH. Cape Coral-Fort Myers, FL .................................................................................................................................................... Lee County, FL. Carson City, NV ..................................................................................................................................................................... Carson City, NV. Casper, WY ........................................................................................................................................................................... Natrona County, WY. Cedar Rapids, IA ................................................................................................................................................................... Benton County, IA. Jones County, IA. Linn County, IA. Champaign-Urbana, IL .......................................................................................................................................................... Champaign County, IL. Ford County, IL. Piatt County, IL. Charleston, WV ...................................................................................................................................................................... Boone County, WV. Clay County, WV. Kanawha County, WV. Lincoln County, WV. Putnam County, WV. Charleston-North Charleston, SC .......................................................................................................................................... Berkeley County, SC. Charleston County, SC. Dorchester County, SC. Charlotte-Gastonia-Concord, NC-SC .................................................................................................................................... Anson County, NC. Cabarrus County, NC. Gaston County, NC. Mecklenburg County, NC. Union County, NC. York County, SC. Charlottesville, VA ................................................................................................................................................................. Albemarle County, VA. Fluvanna County, VA. Greene County, VA. Nelson County, VA. Charlottesville City, VA. Chattanooga, TN-GA ............................................................................................................................................................. Catoosa County, GA. Dade County, GA. Walker County, GA. Hamilton County, TN. Marion County, TN. Sequatchie County, TN. Cheyenne, WY ....................................................................................................................................................................... Laramie County, WY. Chicago-Naperville-Joliet, IL .................................................................................................................................................. Cook County, IL. DeKalb County, IL. DuPage County, IL. Grundy County, IL. Kane County, IL. Kendall County, IL. McHenry County, IL. 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00403 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 0.9132 0.9974 1.1549 1.0941 0.9508 0.9835 1.0555 0.9628 0.9357 1.0153 0.8993 0.9628 1.0059 1.0660 0.9421 0.9539 1.1319 70026 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM G.—CY 2007 WAGE INDEX FOR URBAN AREAS BASED ON CBSA LABOR MARKET AREAS—Continued CBSA code 17020 ....... 17140 ....... 17300 ....... 17420 ....... 17460 ....... 17660 ....... 17780 ....... 17820 ....... 17860 ....... 17900 ....... 17980 ....... 18020 ....... rmajette on PROD1PC67 with RULES2 18140 ....... 18580 ....... VerDate Aug<31>2005 Wage index Urban area (constituent counties) Will County, IL. Chico, CA ............................................................................................................................................................................... Butte County, CA. Cincinnati-Middletown, OH-KY-IN ......................................................................................................................................... Dearborn County, IN. Franklin County, IN. Ohio County, IN. Boone County, KY. Bracken County, KY. Campbell County, KY. Gallatin County, KY. Grant County, KY. Kenton County, KY. Pendleton County, KY. Brown County, OH. Butler County, OH. Clermont County, OH. Hamilton County, OH. Warren County, OH. Clarksville, TN-KY .................................................................................................................................................................. Christian County, KY. Trigg County, KY. Montgomery County, TN. Stewart County, TN. Cleveland, TN ........................................................................................................................................................................ Bradley County, TN. Polk County, TN. Cleveland-Elyria-Mentor, OH ................................................................................................................................................. Cuyahoga County, OH. Geauga County, OH. Lake County, OH. Lorain County, OH. Medina County, OH. Coeur d’Alene, ID .................................................................................................................................................................. Kootenai County, ID. College Station-Bryan, TX ..................................................................................................................................................... Brazos County, TX. Burleson County, TX. Robertson County, TX. Colorado Springs, CO ........................................................................................................................................................... El Paso County, CO. Teller County, CO. Columbia, MO ........................................................................................................................................................................ Boone County, MO. Howard County, MO. Columbia, SC ......................................................................................................................................................................... Calhoun County, SC. Fairfield County, SC. Kershaw County, SC. Lexington County, SC. Richland County, SC. Saluda County, SC. Columbus, GA-AL .................................................................................................................................................................. Russell County, AL. Chattahoochee County, GA. Harris County, GA. Marion County, GA. Muscogee County, GA. Columbus, IN ......................................................................................................................................................................... Bartholomew County, IN. Columbus, OH ....................................................................................................................................................................... Delaware County, OH. Fairfield County, OH. Franklin County, OH. Licking County, OH. Madison County, OH. Morrow County, OH. Pickaway County, OH. Union County, OH. Corpus Christi, TX ................................................................................................................................................................. Aransas County, TX. 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00404 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 1.1637 1.0108 0.8882 0.8537 0.9896 0.9838 0.9523 1.0213 0.8993 0.9405 0.8674 0.9810 1.0641 0.9016 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 70027 ADDENDUM G.—CY 2007 WAGE INDEX FOR URBAN AREAS BASED ON CBSA LABOR MARKET AREAS—Continued CBSA code 18700 ....... 19060 ....... 19124 ....... 19140 ....... 19180 ....... 19260 ....... 19340 ....... 19380 ....... 19460 ....... 19500 ....... 19660 ....... 19740 ....... 19780 ....... 19804 ....... 20020 ....... rmajette on PROD1PC67 with RULES2 20100 ....... 20220 ....... 20260 ....... VerDate Aug<31>2005 Wage index Urban area (constituent counties) Nueces County, TX. San Patricio County, TX. Corvallis, OR .......................................................................................................................................................................... Benton County, OR. Cumberland, MD-WV ............................................................................................................................................................. Allegany County, MD. Mineral County, WV. Dallas-Plano-Irving, TX .......................................................................................................................................................... Collin County, TX. Dallas County, TX. Delta County, TX. Denton County, TX. Ellis County, TX. Hunt County, TX. Kaufman County, TX. Rockwall County, TX. Dalton, GA ............................................................................................................................................................................. Murray County, GA. Whitfield County, GA. Danville, IL ............................................................................................................................................................................. Vermilion County, IL. Danville, VA ........................................................................................................................................................................... Pittsylvania County, VA. Danville City, VA. Davenport-Moline-Rock Island, IA-IL ..................................................................................................................................... Henry County, IL. Mercer County, IL. Rock Island County, IL. Scott County, IA. Dayton, OH ............................................................................................................................................................................ Greene County, OH. Miami County, OH. Montgomery County, OH. Preble County, OH. Decatur, AL ............................................................................................................................................................................ Lawrence County, AL. Morgan County, AL. Decatur, IL ............................................................................................................................................................................. Macon County, IL. Deltona-Daytona Beach-Ormond Beach, FL ......................................................................................................................... Volusia County, FL. Denver-Aurora, CO ................................................................................................................................................................ Adams County, CO. Arapahoe County, CO. Broomfield County, CO. Clear Creek County, CO. Denver County, CO. Douglas County, CO. Elbert County, CO. Gilpin County, CO. Jefferson County, CO. Park County, CO. Des Moines-West Des Moines, IA ........................................................................................................................................ Dallas County, IA. Guthrie County, IA. Madison County, IA. Polk County, IA. Warren County, IA. Detroit-Livonia-Dearborn, MI ................................................................................................................................................. Wayne County, MI. Dothan, AL ............................................................................................................................................................................. Geneva County, AL. Henry County, AL. Houston County, AL. Dover, DE .............................................................................................................................................................................. Kent County, DE. Dubuque, IA ........................................................................................................................................................................... Dubuque County, IA. Duluth, MN-WI ....................................................................................................................................................................... Carlton County, MN. St. Louis County, MN. 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00405 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 1.2156 0.8892 1.0607 0.9573 0.9755 0.8897 0.9313 0.9514 0.8590 0.8604 0.9752 1.1507 0.9701 1.0824 0.8423 1.0367 0.9615 1.0572 70028 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM G.—CY 2007 WAGE INDEX FOR URBAN AREAS BASED ON CBSA LABOR MARKET AREAS—Continued CBSA code 20500 ....... 20740 ....... 20764 ....... 20940 ....... 21060 ....... 21140 ....... 21300 ....... 21340 ....... 21500 ....... 21604 ....... 21660 ....... 21780 ....... 21820 ....... 21940 ....... 22020 ....... 22140 ....... 22180 ....... 22220 ....... 22380 ....... 22420 ....... 22500 ....... rmajette on PROD1PC67 with RULES2 22520 ....... 22540 ....... 22660 ....... VerDate Aug<31>2005 Wage index Urban area (constituent counties) Douglas County, WI. Durham, NC ........................................................................................................................................................................... Chatham County, NC. Durham County, NC. Orange County, NC. Person County, NC. Eau Claire, WI ....................................................................................................................................................................... Chippewa County, WI. Eau Claire County, WI. Edison, NJ ............................................................................................................................................................................. Middlesex County, NJ. Monmouth County, NJ. Ocean County, NJ. Somerset County, NJ. El Centro, CA ......................................................................................................................................................................... Imperial County, CA. Elizabethtown, KY .................................................................................................................................................................. Hardin County, KY. Larue County, KY. Elkhart-Goshen, IN ................................................................................................................................................................ Elkhart County, IN. Elmira, NY .............................................................................................................................................................................. Chemung County, NY. El Paso, TX ............................................................................................................................................................................ El Paso County, TX. Erie, PA .................................................................................................................................................................................. Erie County, PA. Essex County, MA ................................................................................................................................................................. Essex County, MA. Eugene-Springfield, OR ......................................................................................................................................................... Lane County, OR. Evansville, IN-KY ................................................................................................................................................................... Gibson County, IN. Posey County, IN. Vanderburgh County, IN. Warrick County, IN. Henderson County, KY. Webster County, KY. Fairbanks, AK ........................................................................................................................................................................ Fairbanks North Star Borough, AK. Fajardo, PR ............................................................................................................................................................................ Ceiba Municipio, PR. Fajardo Municipio, PR. Luquillo Municipio, PR. Fargo, ND-MN ....................................................................................................................................................................... Cass County, ND. Clay County, MN. Farmington, NM ..................................................................................................................................................................... San Juan County, NM. Fayetteville, NC ..................................................................................................................................................................... Cumberland County, NC. Hoke County, NC. Fayetteville-Springdale-Rogers, AR-MO ............................................................................................................................... Benton County, AR. Madison County, AR. Washington County, AR. McDonald County, MO. Flagstaff, AZ .......................................................................................................................................................................... Coconino County, AZ. Flint, MI .................................................................................................................................................................................. Genesee County, MI. Florence, SC .......................................................................................................................................................................... Darlington County, SC. Florence County, SC. Florence-Muscle Shoals, AL .................................................................................................................................................. Colbert County, AL. Lauderdale County, AL. Fond du Lac, WI .................................................................................................................................................................... Fond du Lac County, WI. Fort Collins-Loveland, CO ..................................................................................................................................................... Larimer County, CO. 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00406 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 1.0345 1.0139 1.1781 0.9555 0.9156 0.9924 0.8675 0.9531 0.9293 1.0968 1.1450 0.9550 1.1643 0.8423 0.8686 0.9043 0.9417 0.9333 1.2214 1.1548 0.8831 0.8423 1.0595 1.0048 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 70029 ADDENDUM G.—CY 2007 WAGE INDEX FOR URBAN AREAS BASED ON CBSA LABOR MARKET AREAS—Continued CBSA code Urban area (constituent counties) 22744 ....... Fort Lauderdale-Pompano Beach-Deerfield Beach, FL ........................................................................................................ Broward County, FL. Fort Smith, AR-OK ................................................................................................................................................................. Crawford County, AR. Franklin County, AR. Sebastian County, AR. Le Flore County, OK. Sequoyah County, OK. Fort Walton Beach-Crestview-Destin, FL .............................................................................................................................. Okaloosa County, FL. Fort Wayne, IN ...................................................................................................................................................................... Allen County, IN. Wells County, IN. Whitley County, IN. Fort Worth-Arlington, TX ........................................................................................................................................................ Johnson County, TX. Parker County, TX. Tarrant County, TX. Wise County, TX. Fresno, CA ............................................................................................................................................................................. Fresno County, CA. Gadsden, AL .......................................................................................................................................................................... Etowah County, AL. Gainesville, FL ....................................................................................................................................................................... Alachua County, FL. Gilchrist County, FL. Gainesville, GA ...................................................................................................................................................................... Hall County, GA. Gary, IN ................................................................................................................................................................................. Jasper County, IN. Lake County, IN. Newton County, IN. Porter County, IN. Glens Falls, NY ...................................................................................................................................................................... Warren County, NY. Washington County, NY. Goldsboro, NC ....................................................................................................................................................................... Wayne County, NC. Grand Forks, ND-MN ............................................................................................................................................................. Polk County, MN. Grand Forks County, ND. Grand Junction, CO ............................................................................................................................................................... Mesa County, CO. Grand Rapids-Wyoming, MI .................................................................................................................................................. Barry County, MI. Ionia County, MI. Kent County, MI. Newaygo County, MI. Great Falls, MT ...................................................................................................................................................................... Cascade County, MT. Greeley, CO ........................................................................................................................................................................... Weld County, CO. Green Bay, WI ....................................................................................................................................................................... Brown County, WI. Kewaunee County, WI. Oconto County, WI. Greensboro-High Point, NC ................................................................................................................................................... Guilford County, NC. Randolph County, NC. Rockingham County, NC. Greenville, NC ....................................................................................................................................................................... Greene County, NC. Pitt County, NC. Greenville, SC ........................................................................................................................................................................ Greenville County, SC. Laurens County, SC. Pickens County, SC. Guayama, PR ........................................................................................................................................................................ Arroyo Municipio, PR. Guayama Municipio, PR. Patillas Municipio, PR. 22900 ....... 23020 ....... 23060 ....... 23104 ....... 23420 ....... 23460 ....... 23540 ....... 23580 ....... 23844 ....... 24020 ....... 24140 ....... 24220 ....... 24300 ....... 24340 ....... 24500 ....... 24540 ....... 24580 ....... 24660 ....... 24780 ....... rmajette on PROD1PC67 with RULES2 24860 ....... 25020 ....... VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00407 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM Wage index 01DER2 1.0668 0.8423 0.9100 1.0020 1.0074 1.1521 0.8492 0.9767 0.9431 0.9827 0.8764 0.9655 0.8423 1.0179 0.9954 0.9052 1.0109 1.0304 0.9334 0.9930 1.0322 0.8423 70030 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM G.—CY 2007 WAGE INDEX FOR URBAN AREAS BASED ON CBSA LABOR MARKET AREAS—Continued CBSA code Urban area (constituent counties) 25060 ....... Gulfport-Biloxi, MS ................................................................................................................................................................. Hancock County, MS. Harrison County, MS. Stone County, MS. Hagerstown-Martinsburg, MD-WV ......................................................................................................................................... Washington County, MD. Berkeley County, WV. Morgan County, WV. Hanford-Corcoran, CA ........................................................................................................................................................... Kings County, CA. Harrisburg-Carlisle, PA .......................................................................................................................................................... Cumberland County, PA. Dauphin County, PA. Perry County, PA. Harrisonburg, VA ................................................................................................................................................................... Rockingham County, VA. Harrisonburg City, VA. Hartford-West Hartford-East Hartford, CT ............................................................................................................................. Hartford County, CT. Litchfield County, CT. Middlesex County, CT. Tolland County, CT. Hattiesburg, MS ..................................................................................................................................................................... Forrest County, MS. Lamar County, MS. Perry County, MS. Hickory-Lenoir-Morganton, NC .............................................................................................................................................. Alexander County, NC. Burke County, NC. Caldwell County, NC. Catawba County, NC. Hinesville-Fort Stewart, GA ................................................................................................................................................... Liberty County, GA. Long County, GA. Holland-Grand Haven, MI ...................................................................................................................................................... Ottawa County, MI. Honolulu, HI ........................................................................................................................................................................... Honolulu County, HI. Hot Springs, AR ..................................................................................................................................................................... Garland County, AR. Houma-Bayou Cane-Thibodaux, LA ...................................................................................................................................... Lafourche Parish, LA. Terrebonne Parish, LA. Houston-Sugar Land-Baytown, TX ........................................................................................................................................ Austin County, TX. Brazoria County, TX. Chambers County, TX. Fort Bend County, TX. Galveston County, TX. Harris County, TX. Liberty County, TX. Montgomery County, TX. San Jacinto County, TX. Waller County, TX. Huntington-Ashland, WV-KY-OH ........................................................................................................................................... Boyd County, KY. Greenup County, KY. Lawrence County, OH. Cabell County, WV. Wayne County, WV. Huntsville, AL ......................................................................................................................................................................... Limestone County, AL. Madison County, AL. Idaho Falls, ID ....................................................................................................................................................................... Bonneville County, ID. Jefferson County, ID. Indianapolis-Carmel, IN ......................................................................................................................................................... Boone County, IN. Brown County, IN. Hamilton County, IN. Hancock County, IN. 25180 ....... 25260 ....... 25420 ....... 25500 ....... 25540 ....... 25620 ....... 25860 ....... 25980 ....... 26100 ....... 26180 ....... 26300 ....... 26380 ....... 26420 ....... 26580 ....... 26620 ....... rmajette on PROD1PC67 with RULES2 26820 ....... 26900 ....... VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00408 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM Wage index 01DER2 0.9386 0.9515 1.0825 0.9899 0.9552 1.1469 0.8423 0.9486 0.9663 0.9647 1.1682 0.9246 0.8509 1.0537 0.9472 0.9483 0.9568 1.0418 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 70031 ADDENDUM G.—CY 2007 WAGE INDEX FOR URBAN AREAS BASED ON CBSA LABOR MARKET AREAS—Continued CBSA code 26980 ....... 27060 ....... 27100 ....... 27140 ....... 27180 ....... 27260 ....... 27340 ....... 27500 ....... 27620 ....... 27740 ....... 27780 ....... 27860 ....... 27900 ....... 28020 ....... 28100 ....... rmajette on PROD1PC67 with RULES2 28140 ....... 28420 ....... VerDate Aug<31>2005 Wage index Urban area (constituent counties) Hendricks County, IN. Johnson County, IN. Marion County, IN. Morgan County, IN. Putnam County, IN. Shelby County, IN. Iowa City, IA .......................................................................................................................................................................... Johnson County, IA. Washington County, IA. Ithaca, NY .............................................................................................................................................................................. Tompkins County, NY. Jackson, MI ............................................................................................................................................................................ Jackson County, MI. Jackson, MS .......................................................................................................................................................................... Copiah County, MS. Hinds County, MS. Madison County, MS. Rankin County, MS. Simpson County, MS. Jackson, TN ........................................................................................................................................................................... Chester County, TN. Madison County, TN. Jacksonville, FL ..................................................................................................................................................................... Baker County, FL. Clay County, FL. Duval County, FL. Nassau County, FL. St. Johns County, FL. Jacksonville, NC .................................................................................................................................................................... Onslow County, NC. Janesville, WI ......................................................................................................................................................................... Rock County, WI. Jefferson City, MO ................................................................................................................................................................. Callaway County, MO. Cole County, MO. Moniteau County, MO. Osage County, MO. Johnson City, TN ................................................................................................................................................................... Carter County, TN. Unicoi County, TN. Washington County, TN. Johnstown, PA ....................................................................................................................................................................... Cambria County, PA. Jonesboro, AR ....................................................................................................................................................................... Craighead County, AR. Poinsett County, AR. Joplin, MO .............................................................................................................................................................................. Jasper County, MO. Newton County, MO. Kalamazoo-Portage, MI ......................................................................................................................................................... Kalamazoo County, MI. Van Buren County, MI. Kankakee-Bradley, IL ............................................................................................................................................................ Kankakee County, IL. Kansas City, MO-KS .............................................................................................................................................................. Franklin County, KS. Johnson County, KS. Leavenworth County, KS. Linn County, KS. Miami County, KS. Wyandotte County, KS. Bates County, MO. Caldwell County, MO. Cass County, MO. Clay County, MO. Clinton County, MO. Jackson County, MO. Lafayette County, MO. Platte County, MO. Ray County, MO. Kennewick-Richland-Pasco, WA ........................................................................................................................................... 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00409 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 1.0227 1.0452 1.0065 0.8708 0.9321 0.9649 0.8666 1.0165 0.8772 0.8468 0.9075 0.8423 0.9059 1.1269 1.0616 0.9997 1.0889 70032 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM G.—CY 2007 WAGE INDEX FOR URBAN AREAS BASED ON CBSA LABOR MARKET AREAS—Continued CBSA code 28660 ....... 28700 ....... 28740 ....... 28940 ....... 29020 ....... 29100 ....... 29140 ....... 29180 ....... 29340 ....... 29404 ....... 29460 ....... 29540 ....... 29620 ....... 29700 ....... 29740 ....... 29820 ....... 29940 ....... 30020 ....... 30140 ....... 30300 ....... 30340 ....... rmajette on PROD1PC67 with RULES2 30460 ....... VerDate Aug<31>2005 Wage index Urban area (constituent counties) Benton County, WA. Franklin County, WA. Killeen-Temple-Fort Hood, TX ............................................................................................................................................... Bell County, TX. Coryell County, TX. Lampasas County, TX. Kingsport-Bristol-Bristol, TN-VA ............................................................................................................................................ Hawkins County, TN. Sullivan County, TN. Bristol City, VA. Scott County, VA. Washington County, VA. Kingston, NY .......................................................................................................................................................................... Ulster County, NY. Knoxville, TN .......................................................................................................................................................................... Anderson County, TN. Blount County, TN. Knox County, TN. Loudon County, TN. Union County, TN. Kokomo, IN ............................................................................................................................................................................ Howard County, IN. Tipton County, IN. La Crosse, WI-MN ................................................................................................................................................................. Houston County, MN. La Crosse County, WI. Lafayette, IN .......................................................................................................................................................................... Benton County, IN. Carroll County, IN. Tippecanoe County, IN. Lafayette, LA .......................................................................................................................................................................... Lafayette Parish, LA. St. Martin Parish, LA. Lake Charles, LA ................................................................................................................................................................... Calcasieu Parish, LA. Cameron Parish, LA. Lake County-Kenosha County, IL-WI .................................................................................................................................... Lake County, IL. Kenosha County, WI. Lakeland, FL .......................................................................................................................................................................... Polk County, FL. Lancaster, PA ........................................................................................................................................................................ Lancaster County, PA. Lansing-East Lansing, MI ...................................................................................................................................................... Clinton County, MI. Eaton County, MI. Ingham County, MI. Laredo, TX ............................................................................................................................................................................. Webb County, TX. Las Cruces, NM ..................................................................................................................................................................... Dona Ana County, NM. Las Vegas-Paradise, NV ....................................................................................................................................................... Clark County, NV. Lawrence, KS ........................................................................................................................................................................ Douglas County, KS. Lawton, OK ............................................................................................................................................................................ Comanche County, OK. Lebanon, PA .......................................................................................................................................................................... Lebanon County, PA. Lewiston, ID-WA .................................................................................................................................................................... Nez Perce County, ID. Asotin County, WA. Lewiston-Auburn, ME ............................................................................................................................................................ Androscoggin County, ME. Lexington-Fayette, KY ........................................................................................................................................................... Bourbon County, KY. Clark County, KY. Fayette County, KY. Jessamine County, KY. Scott County, KY. Woodford County, KY. 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00410 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 0.9371 0.8423 0.9862 0.8685 1.0180 0.9924 0.9403 0.8727 0.8423 1.1128 0.9348 1.0095 1.0621 0.8423 0.9763 1.2034 0.8807 0.8491 0.9137 1.0373 0.9608 0.9666 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 70033 ADDENDUM G.—CY 2007 WAGE INDEX FOR URBAN AREAS BASED ON CBSA LABOR MARKET AREAS—Continued CBSA code Urban area (constituent counties) 30620 ....... Lima, OH ................................................................................................................................................................................ Allen County, OH. Lincoln, NE ............................................................................................................................................................................ Lancaster County, NE. Seward County, NE. Little Rock-North Little Rock, AR ........................................................................................................................................... Faulkner County, AR. Grant County, AR. Lonoke County, AR. Perry County, AR. Pulaski County, AR. Saline County, AR. Logan, UT-ID ......................................................................................................................................................................... Franklin County, ID. Cache County, UT. Longview, TX ......................................................................................................................................................................... Gregg County, TX. Rusk County, TX. Upshur County, TX. Longview, WA ........................................................................................................................................................................ Cowlitz County, WA. Los Angeles-Long Beach-Glendale, CA ................................................................................................................................ Los Angeles County, CA. Louisville-Jefferson County, KY-IN ........................................................................................................................................ Clark County, IN. Floyd County, IN. Harrison County, IN. Washington County, IN. Bullitt County, KY. Henry County, KY. Jefferson County, KY. Meade County, KY. Nelson County, KY. Oldham County, KY. Shelby County, KY. Spencer County, KY. Trimble County, KY. Lubbock, TX ........................................................................................................................................................................... Crosby County, TX. Lubbock County, TX. Lynchburg, VA ....................................................................................................................................................................... Amherst County, VA. Appomattox County, VA. Bedford County, VA. Campbell County, VA. Bedford City, VA. Lynchburg City, VA. Macon, GA ............................................................................................................................................................................. Bibb County, GA. Crawford County, GA. Jones County, GA. Monroe County, GA. Twiggs County, GA. Madera, CA ............................................................................................................................................................................ Madera County, CA. Madison, WI ........................................................................................................................................................................... Columbia County, WI. Dane County, WI. Iowa County, WI. Manchester-Nashua, NH ....................................................................................................................................................... Hillsborough County, NH. Merrimack County, NH. Mansfield, OH ........................................................................................................................................................................ Richland County, OH. ¨ Mayaguez, PR ....................................................................................................................................................................... Hormigueros Municipio, PR. ¨ Mayaguez Municipio, PR. McAllen-Edinburg-Mission, TX .............................................................................................................................................. Hidalgo County, TX. Medford, OR .......................................................................................................................................................................... Jackson County, OR. 30700 ....... 30780 ....... 30860 ....... 30980 ....... 31020 ....... 31084 ....... 31140 ....... 31180 ....... 31340 ....... 31420 ....... 31460 ....... 31540 ....... 31700 ....... 31900 ....... rmajette on PROD1PC67 with RULES2 32420 ....... 32580 ....... 32780 ....... VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00411 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM Wage index 01DER2 0.9520 1.0625 0.9360 0.9499 0.9252 1.0540 1.2381 0.9600 0.9068 0.9153 1.0022 0.8585 1.1413 1.0784 0.9761 0.8423 0.9236 1.1389 70034 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM G.—CY 2007 WAGE INDEX FOR URBAN AREAS BASED ON CBSA LABOR MARKET AREAS—Continued CBSA code Urban area (constituent counties) 32820 ....... Memphis, TN-MS-AR ............................................................................................................................................................. Crittenden County, AR. DeSoto County, MS. Marshall County, MS. Tate County, MS. Tunica County, MS. Fayette County, TN. Shelby County, TN. Tipton County, TN. Merced, CA ............................................................................................................................................................................ Merced County, CA. Miami-Miami Beach-Kendall, FL ............................................................................................................................................ Miami-Dade County, FL. Michigan City-La Porte, IN .................................................................................................................................................... LaPorte County, IN. Midland, TX ............................................................................................................................................................................ Midland County, TX. Milwaukee-Waukesha-West Allis, WI .................................................................................................................................... Milwaukee County, WI. Ozaukee County, WI. Washington County, WI. Waukesha County, WI. Minneapolis-St. Paul-Bloomington, MN-WI ........................................................................................................................... Anoka County, MN. Carver County, MN. Chisago County, MN. Dakota County, MN. Hennepin County, MN. Isanti County, MN. Ramsey County, MN. Scott County, MN. Sherburne County, MN. Washington County, MN. Wright County, MN. Pierce County, WI. St. Croix County, WI. Missoula, MT ......................................................................................................................................................................... Missoula County, MT. Mobile, AL .............................................................................................................................................................................. Mobile County, AL. Modesto, CA .......................................................................................................................................................................... Stanislaus County, CA. Monroe, LA ............................................................................................................................................................................ Ouachita Parish, LA. Union Parish, LA. Monroe, MI ............................................................................................................................................................................. Monroe County, MI. Montgomery, AL .................................................................................................................................................................... Autauga County, AL. Elmore County, AL. Lowndes County, AL. Montgomery County, AL. Morgantown, WV ................................................................................................................................................................... Monongalia County, WV. Preston County, WV. Morristown, TN ...................................................................................................................................................................... Grainger County, TN. Hamblen County, TN. Jefferson County, TN. Mount Vernon-Anacortes, WA ............................................................................................................................................... Skagit County, WA. Muncie, IN .............................................................................................................................................................................. Delaware County, IN. Muskegon-Norton Shores, MI ................................................................................................................................................ Muskegon County, MI. Myrtle Beach-Conway-North Myrtle Beach, SC .................................................................................................................... Horry County, SC. Napa, CA ............................................................................................................................................................................... Napa County, CA. Naples-Marco Island, FL ....................................................................................................................................................... Collier County, FL. 32900 ....... 33124 ....... 33140 ....... 33260 ....... 33340 ....... 33460 ....... 33540 ....... 33660 ....... 33700 ....... 33740 ....... 33780 ....... 33860 ....... 34060 ....... 34100 ....... 34580 ....... 34620 ....... rmajette on PROD1PC67 with RULES2 34740 ....... 34820 ....... 34900 ....... 34940 ....... VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00412 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM Wage index 01DER2 0.9868 1.2077 1.0330 0.9600 1.0303 1.0758 1.1524 0.9400 0.8423 1.2349 0.8423 1.0220 0.8432 0.8868 0.8423 1.1072 0.9014 1.0466 0.9275 1.4080 1.0466 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 70035 ADDENDUM G.—CY 2007 WAGE INDEX FOR URBAN AREAS BASED ON CBSA LABOR MARKET AREAS—Continued CBSA code Urban area (constituent counties) 34980 ....... Nashville-Davidson--Murfreesboro, TN ................................................................................................................................. Cannon County, TN. Cheatham County, TN. Davidson County, TN. Dickson County, TN. Hickman County, TN. Macon County, TN. Robertson County, TN. Rutherford County, TN. Smith County, TN. Sumner County, TN. Trousdale County, TN. Williamson County, TN. Wilson County, TN. Nassau-Suffolk, NY ............................................................................................................................................................... Nassau County, NY. Suffolk County, NY. Newark-Union, NJ-PA ............................................................................................................................................................ Essex County, NJ. Hunterdon County, NJ. Morris County, NJ. Sussex County, NJ. Union County, NJ. Pike County, PA. New Haven-Milford, CT ......................................................................................................................................................... New Haven County, CT. New Orleans-Metairie-Kenner, LA ......................................................................................................................................... Jefferson Parish, LA. Orleans Parish, LA. Plaquemines Parish, LA. St. Bernard Parish, LA. St. Charles Parish, LA. St. John the Baptist Parish, LA. St. Tammany Parish, LA. New York-White Plains-Wayne, NY-NJ ................................................................................................................................. Bergen County, NJ. Hudson County, NJ. Passaic County, NJ. Bronx County, NY. Kings County, NY. New York County, NY. Putnam County, NY. Queens County, NY. Richmond County, NY. Rockland County, NY. Westchester County, NY. Niles-Benton Harbor, MI ........................................................................................................................................................ Berrien County, MI. Norwich-New London, CT ..................................................................................................................................................... New London County, CT. Oakland-Fremont-Hayward, CA ............................................................................................................................................ Alameda County, CA. Contra Costa County, CA. Ocala, FL ............................................................................................................................................................................... Marion County, FL. Ocean City, NJ ...................................................................................................................................................................... Cape May County, NJ. Odessa, TX ............................................................................................................................................................................ Ector County, TX. Ogden-Clearfield, UT ............................................................................................................................................................. Davis County, UT. Morgan County, UT. Weber County, UT. Oklahoma City, OK ................................................................................................................................................................ Canadian County, OK. Cleveland County, OK. Grady County, OK. Lincoln County, OK. Logan County, OK. McClain County, OK. Oklahoma County, OK. 35004 ....... 35084 ....... 35300 ....... 35380 ....... 35644 ....... 35660 ....... 35980 ....... 36084 ....... 36100 ....... 36140 ....... 36220 ....... 36260 ....... rmajette on PROD1PC67 with RULES2 36420 ....... VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00413 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM Wage index 01DER2 1.0367 1.3331 1.2520 1.2584 0.9297 1.3873 0.9386 1.2562 1.6655 0.9335 1.1025 1.0605 0.9470 0.9310 70036 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM G.—CY 2007 WAGE INDEX FOR URBAN AREAS BASED ON CBSA LABOR MARKET AREAS—Continued CBSA code Urban area (constituent counties) 36500 ....... Olympia, WA .......................................................................................................................................................................... Thurston County, WA. Omaha-Council Bluffs, NE-IA ................................................................................................................................................ Harrison County, IA. Mills County, IA. Pottawattamie County, IA. Cass County, NE. Douglas County, NE. Sarpy County, NE. Saunders County, NE. Washington County, NE. Orlando-Kissimmee, FL ......................................................................................................................................................... Lake County, FL. Orange County, FL. Osceola County, FL. Seminole County, FL. Oshkosh-Neenah, WI ............................................................................................................................................................ Winnebago County, WI. Owensboro, KY ...................................................................................................................................................................... Daviess County, KY. Hancock County, KY. McLean County, KY. Oxnard-Thousand Oaks-Ventura, CA ................................................................................................................................... Ventura County, CA. Palm Bay-Melbourne-Titusville, FL ........................................................................................................................................ Brevard County, FL. Panama City-Lynn Haven, FL ............................................................................................................................................... Bay County, FL. Parkersburg-Marietta-Vienna, WV-OH .................................................................................................................................. Washington County, OH. Pleasants County, WV. Wirt County, WV. Wood County, WV. Pascagoula, MS ..................................................................................................................................................................... George County, MS. Jackson County, MS. Pensacola-Ferry Pass-Brent, FL ........................................................................................................................................... Escambia County, FL. Santa Rosa County, FL. Peoria, IL ............................................................................................................................................................................... Marshall County, IL. Peoria County, IL. Stark County, IL. Tazewell County, IL. Woodford County, IL. Philadelphia, PA .................................................................................................................................................................... Bucks County, PA. Chester County, PA. Delaware County, PA. Montgomery County, PA. Philadelphia County, PA. Phoenix-Mesa-Scottsdale, AZ ............................................................................................................................................... Maricopa County, AZ. Pinal County, AZ. Pine Bluff, AR ........................................................................................................................................................................ Cleveland County, AR. Jefferson County, AR. Lincoln County, AR. Pittsburgh, PA ........................................................................................................................................................................ Allegheny County, PA. Armstrong County, PA. Beaver County, PA. Butler County, PA. Fayette County, PA. Washington County, PA. Westmoreland County, PA. Pittsfield, MA .......................................................................................................................................................................... Berkshire County, MA. Pocatello, ID .......................................................................................................................................................................... Bannock County, ID. Power County, ID. 36540 ....... 36740 ....... 36780 ....... 36980 ....... 37100 ....... 37340 ....... 37460 ....... 37620 ....... 37700 ....... 37860 ....... 37900 ....... 37964 ....... 38060 ....... 38220 ....... rmajette on PROD1PC67 with RULES2 38300 ....... 38340 ....... 38540 ....... VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00414 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM Wage index 01DER2 1.1666 0.9949 0.9951 0.9807 0.9210 1.2156 0.9942 0.8451 0.8423 0.8649 0.8423 0.9456 1.1577 1.0830 0.8826 0.9132 1.0808 0.9896 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 70037 ADDENDUM G.—CY 2007 WAGE INDEX FOR URBAN AREAS BASED ON CBSA LABOR MARKET AREAS—Continued CBSA code Urban area (constituent counties) 38660 ....... Ponce, PR .............................................................................................................................................................................. ´ Juana Dıaz Municipio, PR. Ponce Municipio, PR. Villalba Municipio, PR. Portland-South Portland-Biddeford, ME ................................................................................................................................ Cumberland County, ME. Sagadahoc County, ME. York County, ME. Portland-Vancouver-Beaverton, OR-WA ............................................................................................................................... Clackamas County, OR. Columbia County, OR. Multnomah County, OR. Washington County, OR. Yamhill County, OR. Clark County, WA. Skamania County, WA. Port St. Lucie-Fort Pierce, FL ................................................................................................................................................ Martin County, FL. St. Lucie County, FL. Poughkeepsie-Newburgh-Middletown, NY ............................................................................................................................ Dutchess County, NY. Orange County, NY. Prescott, AZ ........................................................................................................................................................................... Yavapai County, AZ. Providence-New Bedford-Fall River, RI-MA .......................................................................................................................... Bristol County, MA. Bristol County, RI. Kent County, RI. Newport County, RI. Providence County, RI. Washington County, RI. Provo-Orem, UT .................................................................................................................................................................... Juab County, UT. Utah County, UT. Pueblo, CO ............................................................................................................................................................................ Pueblo County, CO. Punta Gorda, FL .................................................................................................................................................................... Charlotte County, FL. Racine, WI ............................................................................................................................................................................. Racine County, WI. Raleigh-Cary, NC ................................................................................................................................................................... Franklin County, NC. Johnston County, NC. Wake County, NC. Rapid City, SD ....................................................................................................................................................................... Meade County, SD. Pennington County, SD. Reading, PA ........................................................................................................................................................................... Berks County, PA. Redding, CA .......................................................................................................................................................................... Shasta County, CA. Reno-Sparks, NV ................................................................................................................................................................... Storey County, NV. Washoe County, NV. Richmond, VA ........................................................................................................................................................................ Amelia County, VA. Caroline County, VA. Charles City County, VA. Chesterfield County, VA. Cumberland County, VA. Dinwiddie County, VA. Goochland County, VA. Hanover County, VA. Henrico County, VA. King and Queen County, VA. King William County, VA. Louisa County, VA. New Kent County, VA. Powhatan County, VA. Prince George County, VA. Sussex County, VA. 38860 ....... 38900 ....... 38940 ....... 39100 ....... 39140 ....... 39300 ....... 39340 ....... 39380 ....... 39460 ....... 39540 ....... 39580 ....... 39660 ....... 39740 ....... 39820 ....... 39900 ....... rmajette on PROD1PC67 with RULES2 40060 ....... VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00415 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM Wage index 01DER2 0.8423 1.0431 1.2019 1.0352 1.1487 1.0356 1.1353 1.0041 0.9215 0.9902 0.9850 1.0385 0.9300 1.0130 1.3985 1.2595 0.9662 70038 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM G.—CY 2007 WAGE INDEX FOR URBAN AREAS BASED ON CBSA LABOR MARKET AREAS—Continued CBSA code 40140 ....... 40220 ....... 40340 ....... 40380 ....... 40420 ....... 40484 ....... 40580 ....... 40660 ....... 40900 ....... 40980 ....... 41060 ....... 41100 ....... 41140 ....... rmajette on PROD1PC67 with RULES2 41180 ....... 41420 ....... VerDate Aug<31>2005 Wage index Urban area (constituent counties) Colonial Heights City, VA. Hopewell City, VA. Petersburg City, VA. Richmond City, VA. Riverside-San Bernardino-Ontario, CA ................................................................................................................................. Riverside County, CA. San Bernardino County, CA. Roanoke, VA .......................................................................................................................................................................... Botetourt County, VA. Craig County, VA. Franklin County, VA. Roanoke County, VA. Roanoke City, VA. Salem City, VA. Rochester, MN ....................................................................................................................................................................... Dodge County, MN. Olmsted County, MN. Wabasha County, MN. Rochester, NY ....................................................................................................................................................................... Livingston County, NY. Monroe County, NY. Ontario County, NY. Orleans County, NY. Wayne County, NY. Rockford, IL ........................................................................................................................................................................... Boone County, IL. Winnebago County, IL. Rockingham County-Strafford County, NH ........................................................................................................................... Rockingham County, NH. Strafford County, NH. Rocky Mount, NC .................................................................................................................................................................. Edgecombe County, NC. Nash County, NC. Rome, GA .............................................................................................................................................................................. Floyd County, GA. Sacramento—Arden-Arcade—Roseville, CA ........................................................................................................................ El Dorado County, CA. Placer County, CA. Sacramento County, CA. Yolo County, CA. Saginaw-Saginaw Township North, MI ................................................................................................................................. Saginaw County, MI. St. Cloud, MN ........................................................................................................................................................................ Benton County, MN. Stearns County, MN. St. George, UT ...................................................................................................................................................................... Washington County, UT. St. Joseph, MO-KS ................................................................................................................................................................ Doniphan County, KS. Andrew County, MO. Buchanan County, MO. DeKalb County, MO. St. Louis, MO-IL ..................................................................................................................................................................... Bond County, IL. Calhoun County, IL. Clinton County, IL. Jersey County, IL. Macoupin County, IL. Madison County, IL. Monroe County, IL. St. Clair County, IL. Crawford County, MO. Franklin County, MO. Jefferson County, MO. Lincoln County, MO. St. Charles County, MO. St. Louis County, MO. Warren County, MO. Washington County, MO. St. Louis City, MO. Salem, OR ............................................................................................................................................................................. 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00416 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 1.1480 0.9104 1.2011 0.9469 1.0517 1.0696 0.9322 0.9679 1.4078 0.9343 1.0909 0.9754 1.0652 0.9481 1.0989 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 70039 ADDENDUM G.—CY 2007 WAGE INDEX FOR URBAN AREAS BASED ON CBSA LABOR MARKET AREAS—Continued CBSA code 41500 ....... 41540 ....... 41620 ....... 41660 ....... 41700 ....... 41740 ....... 41780 ....... 41884 ....... 41900 ....... 41940 ....... rmajette on PROD1PC67 with RULES2 41980 ....... VerDate Aug<31>2005 Wage index Urban area (constituent counties) Marion County, OR. Polk County, OR. Salinas, CA ............................................................................................................................................................................ Monterey County, CA. Salisbury, MD ........................................................................................................................................................................ Somerset County, MD. Wicomico County, MD. Salt Lake City, UT ................................................................................................................................................................. Salt Lake County, UT. Summit County, UT. Tooele County, UT. San Angelo, TX ..................................................................................................................................................................... Irion County, TX. Tom Green County, TX. San Antonio, TX .................................................................................................................................................................... Atascosa County, TX. Bandera County, TX. Bexar County, TX. Comal County, TX. Guadalupe County, TX. Kendall County, TX. Medina County, TX. Wilson County, TX. San Diego-Carlsbad-San Marcos, CA ................................................................................................................................... San Diego County, CA. Sandusky, OH ........................................................................................................................................................................ Erie County, OH. San Francisco-San Mateo-Redwood City, CA ...................................................................................................................... Marin County, CA. San Francisco County, CA. San Mateo County, CA. ´ San German-Cabo Rojo, PR ................................................................................................................................................. Cabo Rojo Municipio, PR. Lajas Municipio, PR. Sabana Grande Municipio, PR. ´ San German Municipio, PR. San Jose-Sunnyvale-Santa Clara, CA .................................................................................................................................. San Benito County, CA. Santa Clara County, CA. San Juan-Caguas-Guaynabo, PR ......................................................................................................................................... Aguas Buenas Municipio, PR. Aibonito Municipio, PR. Arecibo Municipio, PR. Barceloneta Municipio, PR. Barranquitas Municipio, PR. ´ Bayamon Municipio, PR. Caguas Municipio, PR. Camuy Municipio, PR. ´ Canovanas Municipio, PR. Carolina Municipio, PR. ˜ Catano Municipio, PR. Cayey Municipio, PR. Ciales Municipio, PR. Cidra Municipio, PR. ´ Comerıo Municipio, PR. Corozal Municipio, PR. Dorado Municipio, PR. Florida Municipio, PR. Guaynabo Municipio, PR. Gurabo Municipio, PR. Hatillo Municipio, PR. Humacao Municipio, PR. Juncos Municipio, PR. Las Piedras Municipio, PR. ´ Loıza Municipio, PR. ´ Manatı Municipio, PR. Maunabo Municipio, PR. Morovis Municipio, PR. Naguabo Municipio, PR. Naranjito Municipio, PR. Orocovis Municipio, PR. 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00417 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 1.5094 0.9426 0.9899 0.8804 0.9311 1.1954 0.9793 1.5966 0.8423 1.6364 0.8423 70040 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM G.—CY 2007 WAGE INDEX FOR URBAN AREAS BASED ON CBSA LABOR MARKET AREAS—Continued CBSA code 42020 ....... 42044 ....... 42060 ....... 42100 ....... 42140 ....... 42220 ....... 42260 ....... 42340 ....... 42540 ....... 42644 ....... 42680 ....... 43100 ....... 43300 ....... 43340 ....... 43580 ....... 43620 ....... 43780 ....... 43900 ....... 44060 ....... 44100 ....... rmajette on PROD1PC67 with RULES2 44140 ....... 44180 ....... VerDate Aug<31>2005 Wage index Urban area (constituent counties) Quebradillas Municipio, PR. ´ Rıo Grande Municipio, PR. San Juan Municipio, PR. San Lorenzo Municipio, PR. Toa Alta Municipio, PR. Toa Baja Municipio, PR. Trujillo Alto Municipio, PR. Vega Alta Municipio, PR. Vega Baja Municipio, PR. Yabucoa Municipio, PR. San Luis Obispo-Paso Robles, CA ....................................................................................................................................... San Luis Obispo County, CA. Santa Ana-Anaheim-Irvine, CA ............................................................................................................................................. Orange County, CA. Santa Barbara-Santa Maria, CA ............................................................................................................................................ Santa Barbara County, CA. Santa Cruz-Watsonville, CA .................................................................................................................................................. Santa Cruz County, CA. Santa Fe, NM ........................................................................................................................................................................ Santa Fe County, NM. Santa Rosa-Petaluma, CA .................................................................................................................................................... Sonoma County, CA. Sarasota-Bradenton-Venice, FL ............................................................................................................................................ Manatee County, FL. Sarasota County, FL. Savannah, GA ....................................................................................................................................................................... Bryan County, GA. Chatham County, GA. Effingham County, GA. Scranton—Wilkes-Barre, PA ................................................................................................................................................. Lackawanna County, PA. Luzerne County, PA. Wyoming County, PA. Seattle-Bellevue-Everett, WA ................................................................................................................................................ Sebastian-Vero Beach, FL .................................................................................................................................................... Indian River County, FL. Sheboygan, WI ...................................................................................................................................................................... Sheboygan County, WI. Sherman-Denison, TX ........................................................................................................................................................... Grayson County, TX. Shreveport-Bossier City, LA .................................................................................................................................................. Bossier Parish, LA. Caddo Parish, LA. De Soto Parish, LA. Sioux City, IA-NE-SD ............................................................................................................................................................. Woodbury County, IA. Dakota County, NE. Dixon County, NE. Union County, SD. Sioux Falls, SD ...................................................................................................................................................................... Lincoln County, SD. McCook County, SD. Minnehaha County, SD. Turner County, SD. South Bend-Mishawaka, IN-MI .............................................................................................................................................. St. Joseph County, IN. Cass County, MI. Spartanburg, SC .................................................................................................................................................................... Spartanburg County, SC. Spokane, WA ......................................................................................................................................................................... Spokane County, WA. Springfield, IL ......................................................................................................................................................................... Menard County, IL. Sangamon County, IL. Springfield, MA ...................................................................................................................................................................... Franklin County, MA. Hampden County, MA. Hampshire County, MA. Springfield, MO ...................................................................................................................................................................... Christian County, MO. Dallas County, MO. 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00418 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 1.2211 1.2079 1.1677 1.6273 1.1396 1.5228 1.0389 0.9845 0.8788 1.2038 1.0079 0.9503 0.8951 0.9333 0.9686 1.0064 1.0362 0.9659 1.0999 0.9360 1.0611 0.8916 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 70041 ADDENDUM G.—CY 2007 WAGE INDEX FOR URBAN AREAS BASED ON CBSA LABOR MARKET AREAS—Continued CBSA code 44220 ....... 44300 ....... 44700 ....... 44940 ....... 45060 ....... 45104 ....... 45220 ....... 45300 ....... 45460 ....... 45500 ....... 45780 ....... 45820 ....... 45940 ....... 46060 ....... 46140 ....... 46220 ....... 46340 ....... rmajette on PROD1PC67 with RULES2 46540 ....... 46660 ....... VerDate Aug<31>2005 Wage index Urban area (constituent counties) Greene County, MO. Polk County, MO. Webster County, MO. Springfield, OH ...................................................................................................................................................................... Clark County, OH. State College, PA .................................................................................................................................................................. Centre County, PA. Stockton, CA .......................................................................................................................................................................... San Joaquin County, CA. Sumter, SC ............................................................................................................................................................................ Sumter County, SC. Syracuse, NY ......................................................................................................................................................................... Madison County, NY. Onondaga County, NY. Oswego County, NY. Tacoma, WA .......................................................................................................................................................................... Pierce County, WA. Tallahassee, FL ..................................................................................................................................................................... Gadsden County, FL. Jefferson County, FL. Leon County, FL. Wakulla County, FL. Tampa-St. Petersburg-Clearwater, FL .................................................................................................................................. Hernando County, FL. Hillsborough County, FL. Pasco County, FL. Pinellas County, FL. Terre Haute, IN ...................................................................................................................................................................... Clay County, IN. Sullivan County, IN. Vermillion County, IN. Vigo County, IN. Texarkana, TX-Texarkana, AR .............................................................................................................................................. Miller County, AR. Bowie County, TX. Toledo, OH ............................................................................................................................................................................ Fulton County, OH. Lucas County, OH. Ottawa County, OH. Wood County, OH. Topeka, KS ............................................................................................................................................................................ Jackson County, KS. Jefferson County, KS. Osage County, KS. Shawnee County, KS. Wabaunsee County, KS. Trenton-Ewing, NJ ................................................................................................................................................................. Mercer County, NJ. Tucson, AZ ............................................................................................................................................................................ Pima County, AZ. Tulsa, OK ............................................................................................................................................................................... Creek County, OK. Okmulgee County, OK. Osage County, OK. Pawnee County, OK. Rogers County, OK. Tulsa County, OK. Wagoner County, OK. Tuscaloosa, AL ...................................................................................................................................................................... Greene County, AL. Hale County, AL. Tuscaloosa County, AL. Tyler, TX ................................................................................................................................................................................ Smith County, TX. Utica-Rome, NY ..................................................................................................................................................................... Herkimer County, NY. Oneida County, NY. Valdosta, GA .......................................................................................................................................................................... Brooks County, GA. Echols County, GA. Lanier County, GA. 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00419 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 0.9047 0.9248 1.2046 0.8510 1.0203 1.1359 0.9414 0.9627 0.9228 0.8532 1.0092 0.9191 1.1407 0.9688 0.8531 0.8993 0.9276 0.8839 0.8811 70042 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM G.—CY 2007 WAGE INDEX FOR URBAN AREAS BASED ON CBSA LABOR MARKET AREAS—Continued CBSA code 46700 ....... 47020 ....... 47220 ....... 47260 ....... 47300 ....... 47380 ....... 47580 ....... 47644 ....... 47894 ....... 47940 ....... rmajette on PROD1PC67 with RULES2 48140 ....... 48260 ....... 48300 ....... VerDate Aug<31>2005 Wage index Urban area (constituent counties) Lowndes County, GA. Vallejo-Fairfield, CA ............................................................................................................................................................... Solano County, CA. Victoria, TX ............................................................................................................................................................................ Calhoun County, TX. Goliad County, TX. Victoria County, TX. Vineland-Millville-Bridgeton, NJ ............................................................................................................................................. Cumberland County, NJ. Virginia Beach-Norfolk-Newport News, VA-NC ..................................................................................................................... Currituck County, NC. Gloucester County, VA. Isle of Wight County, VA. James City County, VA. Mathews County, VA. Surry County, VA. York County, VA. Chesapeake City, VA. Hampton City, VA. Newport News City, VA. Norfolk City, VA. Poquoson City, VA. Portsmouth City, VA. Suffolk City, VA. Virginia Beach City, VA. Williamsburg City, VA. Visalia-Porterville, CA ............................................................................................................................................................ Tulare County, CA. Waco, TX ............................................................................................................................................................................... McLennan County, TX. Warner Robins, GA ............................................................................................................................................................... Houston County, GA. Warren-Troy-Farmington Hills, MI ......................................................................................................................................... Lapeer County, MI. Livingston County, MI. Macomb County, MI. Oakland County, MI. St. Clair County, MI. Washington-Arlington-Alexandria, DC-VA-MD-WV ............................................................................................................... District of Columbia, DC. Calvert County, MD. Charles County, MD. Prince George’s County, MD. Arlington County, VA. Clarke County, VA. Fairfax County, VA. Fauquier County, VA. Loudoun County, VA. Prince William County, VA. Spotsylvania County, VA. Stafford County, VA. Warren County, VA. Alexandria City, VA. Fairfax City, VA. Falls Church City, VA. Fredericksburg City, VA. Manassas City, VA. Manassas Park City, VA. Jefferson County, WV. Waterloo-Cedar Falls, IA ....................................................................................................................................................... Black Hawk County, IA. Bremer County, IA. Grundy County, IA. Wausau, WI ........................................................................................................................................................................... Marathon County, WI. Weirton-Steubenville, WV-OH ............................................................................................................................................... Jefferson County, OH. Brooke County, WV. Hancock County, WV. Wenatchee, WA ..................................................................................................................................................................... Chelan County, WA. 10:50 Nov 30, 2006 Jkt 211001 PO 00000 Frm 00420 Fmt 4701 Sfmt 4700 E:\FR\FM\01DER2.SGM 01DER2 1.5937 0.9012 1.0351 0.9254 1.0494 0.9089 0.8823 1.0585 1.1638 0.8852 1.0235 0.8489 1.0892 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations 70043 ADDENDUM G.—CY 2007 WAGE INDEX FOR URBAN AREAS BASED ON CBSA LABOR MARKET AREAS—Continued CBSA code 48424 ....... 48540 ....... 48620 ....... 48660 ....... 48700 ....... 48864 ....... 48900 ....... 49020 ....... 49180 ....... 49340 ....... 49420 ....... 49500 ....... 49620 ....... 49660 ....... 49700 ....... 49740 ....... Wage index Urban area (constituent counties) Douglas County, WA. West Palm Beach-Boca Raton-Boynton Beach, FL .............................................................................................................. Palm Beach County, FL. Wheeling, WV-OH ................................................................................................................................................................. Belmont County, OH. Marshall County, WV. Ohio County, WV. Wichita, KS ............................................................................................................................................................................ Butler County, KS. Harvey County, KS. Sedgwick County, KS. Sumner County, KS. Wichita Falls, TX .................................................................................................................................................................... Archer County, TX. Clay County, TX. Wichita County, TX. Williamsport, PA .................................................................................................................................................................... Lycoming County, PA. Wilmington, DE-MD-NJ .......................................................................................................................................................... New Castle County, DE. Cecil County, MD. Salem County, NJ. Wilmington, NC ...................................................................................................................................................................... Brunswick County, NC. New Hanover County, NC. Pender County, NC. Winchester, VA-WV ............................................................................................................................................................... Frederick County, VA. Winchester City, VA. Hampshire County, WV. Winston-Salem, NC ............................................................................................................................................................... Davie County, NC. Forsyth County, NC. Stokes County, NC. Yadkin County, NC. Worcester, MA ....................................................................................................................................................................... Worcester County, MA. Yakima, WA ........................................................................................................................................................................... Yakima County, WA. Yauco, PR .............................................................................................................................................................................. ´ Guanica Municipio, PR. Guayanilla Municipio, PR. ˜ Penuelas Municipio, PR. Yauco Municipio, PR. York-Hanover, PA .................................................................................................................................................................. York County, PA. Youngstown-Warren-Boardman, OH-PA ............................................................................................................................... Mahoning County, OH. Trumbull County, OH. Mercer County, PA. Yuba City, CA ........................................................................................................................................................................ Sutter County, CA. Yuba County, CA. Yuma, AZ ............................................................................................................................................................................... Yuma County, AZ. 1.0159 0.8423 0.9542 0.8750 0.8569 1.1248 1.0354 1.0624 0.9766 1.1288 1.0367 0.8423 0.9893 0.9267 1.1297 0.9590 1 2 3 4 5 ADDENDUM H.—CY 2007 ESRD WAGE INDEX FOR RURAL AREAS BASED ON CBSA LABOR MARKET AREAS—Continued ADDENDUM H.—CY 2007 ESRD WAGE INDEX FOR RURAL AREAS BASED ON CBSA LABOR MARKET AREAS—Continued CBSA code rmajette on PROD1PC67 with RULES2 ADDENDUM H.—CY 2007 ESRD WAGE INDEX FOR RURAL AREAS BASED ON CBSA LABOR MARKET AREAS CBSA code Nonurban area CBSA code 6 ............... 7 ............... 8 ............... 10 ............. 11 ............. Colorado ................. Connecticut ............. Delaware ................. Florida ..................... Georgia ................... ............... ............... ............... ............... ............... VerDate Aug<31>2005 Wage index Nonurban area Alabama .................. Alaska ..................... Arizona .................... Arkansas ................. California ................. 10:50 Nov 30, 2006 0.8423 1.1224 0.9379 0.8423 1.2059 Jkt 211001 PO 00000 Frm 00421 Fmt 4701 Sfmt 4700 Wage index 0.9818 1.2327 1.0218 0.9048 0.8423 12 13 14 15 16 ............. ............. ............. ............. ............. E:\FR\FM\01DER2.SGM Nonurban area Hawaii ..................... Idaho ....................... Illinois ...................... Indiana .................... Iowa ........................ 01DER2 Wage index 1.1000 0.8549 0.8759 0.8989 0.9140 70044 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM H.—CY 2007 ESRD WAGE INDEX FOR RURAL AREAS BASED ON CBSA LABOR MARKET AREAS—Continued CBSA code 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 Nonurban area ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. ............. Wage index Kansas .................... Kentucky ................. Louisiana ................ Maine ...................... Maryland ................. Massachusetts ........ Michigan ................. Minnesota ............... Mississippi .............. Missouri .................. Montana .................. Nebraska ................ Nevada ................... New Hampshire ...... New Jersey 1 ........... New Mexico ............ New York ................ North Carolina ........ North Dakota .......... Ohio ........................ Oklahoma ............... Oregon .................... Pennsylvania .......... Puerto Rico ............. Rhode Island 1 ........ South Carolina ........ South Dakota .......... Tennessee .............. Texas ...................... Utah ........................ Vermont .................. Virgin Islands .......... Virginia .................... Washington ............. West Virginia .......... Wisconsin ............... Wyoming ................. 0.8423 0.8423 0.8423 0.8889 0.9397 1.0756 0.9541 0.9636 0.8423 0.8423 0.9044 0.9135 0.9416 1.1426 ................ 0.8772 0.8667 0.9042 0.8423 0.9115 0.8423 1.0268 0.8759 0.8423 ................ 0.9018 0.8928 0.8423 0.8423 0.8570 1.0259 0.8914 0.8423 1.0805 0.8423 1.0058 0.9786 1 All counties in the States of New Jersey and Rhode Island are urban. ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE rmajette on PROD1PC67 with RULES2 State AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK Zip code RUCA level 99501 99502 99503 99504 99505 99506 99507 99508 99509 99510 99511 99512 99513 99514 99515 99516 99517 99518 99519 99520 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Zip code State AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00422 Fmt 4701 RUCA level 99521 99522 99523 99524 99529 99530 99540 99546 99547 99548 99549 99550 99551 99552 99553 99554 99555 99556 99557 99558 99559 99561 99563 99564 99565 99566 99567 99568 99569 99571 99572 99573 99574 99575 99576 99577 99578 99579 99580 99581 99583 99584 99585 99586 99587 99588 99589 99590 99591 99599 99602 99603 99604 99605 99606 99607 99608 99609 99610 99611 99612 99613 99614 99615 99619 99620 99621 99622 99624 1.0 1.0 1.0 1.0 1.0 1.0 2.0 10.5 10.5 10.0 10.0 4.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 7.0 10.0 10.0 10.0 10.0 10.0 2.0 8.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 2.0 10.0 10.0 10.0 1.0 10.0 10.0 10.0 10.0 2.0 10.0 10.0 10.0 10.5 1.0 10.0 10.0 10.0 10.0 10.0 10.0 4.0 7.0 8.0 7.0 10.0 10.0 10.0 4.0 4.0 10.0 10.0 10.0 4.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 99625 99626 99627 99628 99629 99630 99631 99632 99633 99634 99635 99636 99637 99638 99639 99640 99641 99643 99644 99645 99647 99648 99649 99650 99651 99652 99653 99654 99655 99656 99657 99658 99659 99660 99661 99662 99663 99664 99665 99666 99667 99668 99669 99670 99671 99672 99674 99675 99676 99677 99678 99679 99680 99681 99682 99683 99684 99685 99686 99687 99688 99689 99690 99691 99692 99693 99694 99695 99697 10.0 10.0 10.0 10.0 4.1 10.0 10.0 10.0 10.0 10.0 7.0 10.0 10.0 10.5 10.0 10.0 7.0 4.0 4.0 2.0 10.0 10.0 10.0 10.0 10.0 5.2 10.0 4.1 10.0 10.0 10.0 10.0 10.0 10.5 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 8.0 10.0 10.0 8.0 2.0 10.0 10.0 10.0 10.0 10.0 7.0 10.0 10.0 5.2 10.0 7.3 10.0 5.2 5.0 10.1 7.0 10.0 7.3 10.0 5.0 1.0 4.0 70045 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK Zip code RUCA level 99701 99702 99703 99704 99705 99706 99707 99708 99709 99710 99711 99712 99714 99716 99720 99721 99722 99723 99724 99725 99726 99727 99729 99730 99731 99732 99733 99734 99736 99737 99738 99739 99740 99741 99742 99743 99744 99745 99746 99747 99748 99749 99750 99751 99752 99753 99754 99755 99756 99757 99758 99759 99760 99761 99762 99763 99764 99765 99766 99767 99768 99769 99770 99771 99772 99773 99774 99775 99776 1.0 7.3 1.0 10.4 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 10.0 10.0 10.0 7.0 10.0 1.0 10.4 10.6 10.0 10.0 10.0 10.0 10.0 10.0 10.6 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.6 10.6 10.6 7.0 10.0 10.0 10.0 10.4 10.0 10.4 10.0 10.4 10.6 7.0 10.6 10.0 10.0 10.0 10.4 10.0 10.0 10.6 10.0 10.0 10.6 10.4 1.0 10.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AK AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00423 Fmt 4701 RUCA level 99777 99778 99779 99780 99781 99782 99783 99784 99785 99786 99788 99789 99790 99791 99801 99802 99803 99811 99820 99821 99824 99825 99826 99827 99829 99830 99832 99833 99835 99836 99840 99841 99850 99901 99903 99918 99919 99921 99922 99923 99925 99926 99927 99928 99929 99950 35004 35005 35006 35007 35010 35011 35013 35014 35015 35016 35019 35020 35021 35022 35023 35031 35032 35033 35034 35035 35036 35038 35040 10.4 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.6 10.0 10.0 1.0 7.0 4.0 4.0 4.0 4.0 10.0 4.0 7.2 10.0 10.0 10.0 10.0 7.0 10.0 7.0 7.0 7.0 10.0 10.0 4.0 4.0 5.0 4.0 10.0 10.0 10.0 5.0 10.0 10.0 10.0 4.0 10.0 10.0 2.0 1.0 2.0 1.0 7.0 7.0 7.1 6.1 1.0 7.3 9.2 1.0 1.0 1.0 1.0 2.0 9.2 5.2 7.3 10.4 1.0 2.0 2.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 35041 35042 35043 35044 35045 35046 35048 35049 35051 35052 35053 35054 35055 35056 35057 35058 35060 35061 35062 35063 35064 35068 35070 35071 35072 35073 35074 35077 35078 35079 35080 35082 35083 35085 35087 35089 35091 35094 35096 35097 35098 35111 35112 35114 35115 35116 35117 35118 35119 35120 35121 35123 35124 35125 35126 35127 35128 35130 35131 35133 35135 35136 35137 35139 35142 35143 35144 35146 35147 1.0 7.0 2.0 9.2 7.3 8.3 1.0 2.0 2.0 7.1 5.2 10.4 4.0 4.0 5.0 5.0 1.0 1.0 2.0 2.0 1.0 1.0 5.0 1.0 8.0 1.0 2.0 5.0 2.0 2.0 1.0 8.0 5.0 2.0 3.0 8.0 2.0 2.0 3.0 2.0 5.0 2.0 2.0 1.0 2.0 2.0 1.0 2.0 1.0 2.0 7.1 1.0 1.0 3.0 1.0 1.0 7.1 2.0 3.0 2.0 3.0 8.0 1.0 1.0 1.0 2.0 1.0 2.0 2.0 70046 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL Zip code RUCA level 35148 35149 35150 35151 35160 35161 35171 35172 35173 35175 35176 35178 35179 35180 35181 35182 35183 35184 35185 35186 35187 35188 35201 35202 35203 35204 35205 35206 35207 35208 35209 35210 35211 35212 35213 35214 35215 35216 35217 35218 35219 35220 35221 35222 35223 35224 35225 35226 35228 35229 35230 35231 35232 35233 35234 35235 35236 35237 35238 35240 35242 35243 35244 35245 35246 35249 35253 35254 35255 2.0 4.0 4.0 5.2 4.0 4.0 2.0 2.0 1.0 2.0 2.0 2.0 5.0 2.0 1.0 3.0 5.0 2.0 2.0 2.0 10.4 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00424 Fmt 4701 RUCA level 35259 35260 35261 35263 35266 35277 35278 35279 35280 35281 35282 35283 35285 35286 35287 35288 35289 35290 35291 35292 35293 35294 35295 35296 35297 35298 35299 35401 35402 35403 35404 35405 35406 35407 35440 35441 35442 35443 35444 35446 35447 35448 35449 35452 35453 35456 35457 35458 35459 35460 35461 35462 35463 35464 35466 35468 35469 35470 35471 35473 35474 35475 35476 35477 35478 35480 35481 35482 35485 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.1 2.0 10.4 9.0 2.0 1.0 10.0 10.4 2.0 1.0 2.0 2.0 2.0 2.0 10.0 10.0 5.0 10.4 2.0 10.0 2.0 2.1 10.4 10.0 5.0 1.0 2.0 2.0 1.0 10.0 2.1 2.0 3.0 2.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 35486 35487 35490 35491 35501 35502 35503 35504 35540 35541 35542 35543 35544 35545 35546 35548 35549 35550 35551 35552 35553 35554 35555 35559 35560 35563 35564 35565 35570 35571 35572 35573 35574 35575 35576 35577 35578 35579 35580 35581 35582 35584 35585 35586 35587 35592 35593 35594 35601 35602 35603 35609 35610 35611 35612 35613 35614 35615 35616 35617 35618 35619 35620 35621 35622 35630 35631 35632 35633 1.0 1.0 2.1 10.4 4.2 4.2 5.0 5.2 10.0 10.0 8.3 9.0 10.0 7.0 8.3 10.0 10.5 5.2 7.0 10.0 10.0 8.0 7.0 10.0 5.0 10.0 10.0 7.0 10.0 10.0 10.0 10.5 10.5 10.6 10.5 10.6 5.2 5.2 5.0 10.6 10.0 2.0 8.0 10.0 5.2 10.0 10.0 10.0 1.0 1.0 1.0 1.0 2.0 4.2 4.2 2.0 5.2 5.2 2.0 2.0 2.0 2.0 5.2 3.0 2.0 1.0 1.0 1.0 2.0 70047 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL Zip code RUCA level 35634 35640 35643 35645 35646 35647 35648 35649 35650 35651 35652 35653 35654 35660 35661 35662 35670 35671 35672 35673 35674 35677 35699 35739 35740 35741 35742 35744 35745 35746 35747 35748 35749 35750 35751 35752 35754 35755 35756 35757 35758 35759 35760 35761 35762 35763 35764 35765 35766 35767 35768 35769 35771 35772 35773 35774 35775 35776 35801 35802 35803 35804 35805 35806 35807 35808 35809 35810 35811 2.0 2.0 2.0 2.0 2.0 5.2 2.0 1.0 2.0 3.0 2.0 7.3 9.2 1.0 1.0 1.0 2.1 5.2 3.0 2.0 1.0 2.0 1.0 2.0 7.3 1.0 2.0 6.0 5.2 10.6 2.0 2.0 2.0 2.0 5.2 5.0 2.0 5.0 2.0 1.0 1.0 2.0 2.0 2.0 1.0 1.0 2.0 10.5 5.2 1.0 4.0 4.0 6.0 10.6 2.0 5.2 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00425 Fmt 4701 RUCA level 35812 35813 35814 35815 35816 35824 35893 35894 35895 35896 35897 35898 35899 35901 35902 35903 35904 35905 35906 35907 35950 35951 35952 35953 35954 35956 35957 35958 35959 35960 35961 35962 35963 35964 35966 35967 35968 35971 35972 35973 35974 35975 35976 35978 35979 35980 35981 35983 35984 35986 35987 35988 35989 35990 36003 36005 36006 36008 36009 36010 36013 36015 36016 36017 36020 36022 36023 36024 36025 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 4.0 2.0 3.0 1.0 5.2 4.0 2.0 3.0 10.0 10.6 5.0 5.0 5.0 2.0 8.0 9.0 10.6 2.0 3.0 5.0 10.6 4.0 9.0 2.0 5.0 2.0 10.0 10.6 10.6 3.0 10.6 10.6 2.0 5.2 5.0 6.1 2.0 10.0 5.0 2.0 10.6 10.3 10.0 2.0 2.0 2.0 2.0 2.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 36026 36027 36028 36029 36030 36031 36032 36033 36034 36035 36036 36037 36038 36039 36040 36041 36042 36043 36045 36046 36047 36048 36049 36051 36052 36053 36054 36057 36061 36062 36064 36065 36066 36067 36068 36069 36071 36072 36075 36078 36079 36080 36081 36082 36083 36087 36088 36089 36091 36092 36093 36101 36102 36103 36104 36105 36106 36107 36108 36109 36110 36111 36112 36113 36114 36115 36116 36117 36118 8.0 7.0 10.6 2.0 10.6 5.2 2.0 10.6 6.0 5.0 2.0 10.6 8.0 2.0 2.0 3.0 2.0 2.0 2.0 2.0 2.0 10.0 10.0 2.0 2.0 8.0 2.0 2.0 8.0 10.0 2.0 2.0 2.0 2.0 2.0 2.0 10.4 7.0 2.0 2.0 5.0 2.0 4.0 4.0 4.2 4.2 4.2 7.0 8.3 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70048 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL Zip code RUCA level 36119 36120 36121 36123 36124 36125 36130 36131 36132 36133 36134 36135 36140 36141 36142 36177 36191 36201 36202 36203 36204 36205 36206 36207 36250 36251 36253 36254 36255 36256 36257 36258 36260 36261 36262 36263 36264 36265 36266 36267 36268 36269 36271 36272 36273 36274 36275 36276 36277 36278 36279 36280 36301 36302 36303 36304 36305 36310 36311 36312 36313 36314 36316 36317 36318 36319 36320 36321 36322 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 10.0 1.0 1.0 10.0 8.0 1.0 10.0 1.0 5.1 10.0 10.0 5.1 1.0 10.0 10.0 2.0 10.0 2.0 7.3 6.0 7.4 10.0 8.0 1.0 10.6 2.0 10.0 1.0 1.0 1.0 1.0 1.0 10.4 5.0 2.0 5.0 10.4 5.0 10.6 5.0 2.0 2.0 2.0 5.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00426 Fmt 4701 RUCA level 36323 36330 36331 36340 36343 36344 36345 36346 36349 36350 36351 36352 36353 36360 36361 36362 36370 36371 36373 36374 36375 36376 36401 36420 36421 36425 36426 36427 36429 36432 36435 36436 36439 36441 36442 36444 36445 36446 36449 36451 36453 36454 36455 36456 36457 36458 36460 36461 36462 36467 36470 36471 36473 36474 36475 36476 36477 36480 36481 36482 36483 36501 36502 36503 36504 36505 36507 36509 36511 10.5 4.2 4.2 7.0 2.0 10.4 2.0 10.5 2.0 1.0 5.0 2.0 2.0 4.2 4.2 4.2 2.0 1.0 10.4 5.0 2.0 2.0 10.0 7.0 7.0 8.0 7.0 7.0 10.0 10.6 10.6 8.0 7.0 10.6 10.6 8.0 8.0 8.0 8.0 10.6 9.0 8.0 10.6 10.0 8.0 8.0 7.0 7.0 7.0 7.0 7.0 8.0 8.0 8.0 8.0 7.0 10.6 10.3 8.0 10.6 8.0 8.0 8.0 8.0 8.0 2.0 7.3 1.0 8.4 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 36512 36513 36515 36518 36521 36522 36523 36524 36525 36526 36527 36528 36529 36530 36532 36533 36535 36536 36538 36539 36540 36541 36542 36543 36544 36545 36547 36548 36549 36550 36551 36553 36555 36556 36558 36559 36560 36561 36562 36564 36567 36568 36569 36570 36571 36572 36574 36575 36576 36577 36578 36579 36580 36581 36582 36583 36584 36585 36587 36590 36601 36602 36603 36604 36605 36606 36607 36608 36609 2.0 2.0 8.0 10.0 2.0 2.0 1.0 10.6 1.0 4.1 4.1 2.0 3.0 9.0 4.1 4.1 7.0 7.0 10.0 3.0 8.0 2.0 7.0 8.0 1.0 8.0 7.0 8.0 9.0 9.1 10.4 2.0 8.4 2.0 10.6 4.1 2.0 7.0 8.3 4.1 9.2 1.0 8.0 8.0 1.0 1.0 10.4 1.0 9.2 4.1 9.2 9.1 9.2 8.0 1.0 3.0 3.0 8.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70049 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL Zip code RUCA level 36610 36611 36612 36613 36614 36615 36616 36617 36618 36619 36621 36622 36623 36625 36626 36628 36630 36631 36633 36640 36641 36644 36652 36660 36663 36670 36671 36675 36685 36688 36689 36690 36691 36693 36695 36701 36702 36703 36720 36721 36722 36723 36726 36727 36728 36732 36736 36738 36740 36741 36742 36744 36745 36748 36749 36750 36751 36752 36753 36754 36756 36758 36759 36761 36762 36763 36764 36765 36766 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 4.0 4.0 10.5 10.6 10.6 10.5 10.0 10.6 10.5 7.0 10.6 10.6 9.0 10.0 7.0 7.3 7.0 10.6 5.0 10.6 10.6 2.0 10.0 10.6 10.0 5.0 5.0 2.0 7.0 10.6 9.0 9.0 10.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AL AR AR AR AR AR AR AR AR PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00427 Fmt 4701 RUCA level 36767 36768 36769 36773 36775 36776 36782 36783 36784 36785 36786 36790 36792 36793 36801 36802 36803 36804 36830 36831 36832 36849 36850 36851 36852 36853 36854 36855 36856 36858 36859 36860 36861 36862 36863 36865 36866 36867 36868 36869 36870 36871 36872 36874 36875 36877 36879 36901 36904 36906 36907 36908 36910 36912 36913 36915 36916 36919 36921 36922 36925 71601 71602 71603 71611 71612 71613 71630 71631 5.0 10.0 10.6 5.0 5.0 8.1 9.0 10.6 7.0 2.0 10.5 10.6 10.4 10.4 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 3.0 2.0 2.0 10.6 4.0 6.0 2.0 2.0 2.0 2.0 9.0 10.5 4.0 1.0 2.0 1.0 1.0 1.0 1.0 2.0 4.0 2.0 2.0 1.0 10.5 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 1.0 1.0 1.0 1.0 1.0 1.0 10.6 8.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 71635 71638 71639 71640 71642 71643 71644 71646 71647 71651 71652 71653 71654 71655 71656 71657 71658 71659 71660 71661 71662 71663 71665 71666 71667 71670 71671 71674 71675 71676 71677 71678 71701 71711 71720 71721 71722 71724 71725 71726 71728 71730 71731 71740 71742 71743 71744 71745 71747 71748 71749 71750 71751 71752 71753 71754 71758 71759 71762 71763 71764 71765 71766 71768 71770 71772 71801 71802 71820 7.0 7.0 7.0 7.0 8.0 10.4 10.4 7.0 8.0 8.0 10.4 7.4 7.0 7.0 7.0 7.0 10.6 10.4 10.4 10.6 7.0 10.6 2.0 10.6 10.2 8.0 7.0 10.6 8.0 8.0 8.0 10.0 4.0 4.0 5.0 10.2 6.0 4.0 9.0 5.0 10.2 4.0 4.0 5.0 7.0 10.2 10.6 10.0 5.0 9.0 5.0 4.0 5.0 5.0 4.0 4.0 5.0 4.0 5.0 10.5 5.0 5.0 10.6 4.0 5.0 10.2 4.0 4.0 7.3 70050 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR Zip code RUCA level 71822 71823 71825 71826 71827 71828 71831 71832 71833 71834 71835 71836 71837 71838 71839 71840 71841 71842 71844 71845 71846 71847 71851 71852 71853 71854 71855 71857 71858 71859 71860 71861 71862 71864 71865 71866 71901 71902 71903 71909 71910 71913 71914 71920 71921 71922 71923 71929 71932 71933 71935 71937 71940 71941 71942 71943 71944 71945 71949 71950 71951 71952 71953 71956 71957 71958 71959 71960 71961 7.3 10.6 5.0 10.0 10.5 6.0 6.0 7.0 10.6 2.0 6.0 10.6 2.0 6.0 2.0 2.0 8.0 8.0 6.0 10.5 10.6 5.0 8.0 7.0 7.3 1.0 5.0 7.4 6.0 6.0 10.5 5.0 6.0 6.0 8.3 8.3 1.0 1.0 1.0 2.0 2.0 1.0 1.0 5.0 5.0 10.6 4.0 2.0 7.0 2.0 10.0 8.0 10.6 3.0 3.0 10.4 10.6 8.0 2.0 10.4 1.0 10.0 7.0 2.0 10.4 10.6 10.0 10.0 10.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00428 Fmt 4701 RUCA level 71962 71964 71965 71966 71968 71969 71970 71971 71972 71973 71998 71999 72001 72002 72003 72004 72005 72006 72007 72010 72011 72012 72013 72014 72015 72016 72017 72018 72020 72021 72022 72023 72024 72025 72026 72027 72028 72029 72030 72031 72032 72033 72034 72035 72036 72037 72038 72039 72040 72041 72042 72043 72044 72045 72046 72047 72048 72051 72052 72053 72055 72057 72058 72059 72060 72061 72063 72064 72065 5.0 2.0 10.0 10.0 2.0 10.0 10.0 10.6 8.0 10.6 4.0 4.0 10.0 1.0 8.0 3.0 8.0 10.0 2.0 5.0 2.0 2.0 6.0 8.0 1.0 2.0 10.6 1.0 5.0 7.0 1.0 1.0 10.4 10.0 8.0 8.4 6.0 10.6 8.4 10.0 4.2 4.2 4.2 4.2 10.0 2.0 8.0 5.0 10.4 10.6 7.0 7.0 10.6 2.0 2.0 5.2 8.0 10.0 5.0 1.0 10.6 2.0 5.2 10.0 5.0 5.2 8.4 10.6 2.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 72066 72067 72068 72069 72070 72072 72073 72074 72075 72076 72078 72079 72080 72081 72082 72083 72084 72085 72086 72087 72088 72089 72099 72101 72102 72103 72104 72105 72106 72107 72108 72110 72111 72112 72113 72114 72115 72116 72117 72118 72119 72120 72121 72122 72123 72124 72125 72126 72127 72128 72129 72130 72131 72132 72133 72134 72135 72136 72137 72139 72140 72141 72142 72143 72145 72149 72150 72152 72153 10.4 10.6 5.0 10.6 2.0 10.4 8.0 10.0 7.0 1.0 1.0 2.0 8.4 5.0 5.0 2.0 3.0 4.0 2.0 1.0 10.0 1.0 1.0 10.0 2.0 1.0 7.3 9.1 5.1 6.0 7.0 7.4 5.2 7.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 5.0 2.0 10.0 1.0 10.4 10.1 6.0 3.0 3.0 10.6 9.0 2.0 3.0 10.6 2.0 2.0 5.0 5.0 8.0 10.5 2.0 4.0 4.0 4.0 2.0 3.0 10.0 70051 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR Zip code RUCA level 72156 72157 72158 72160 72164 72165 72166 72167 72168 72169 72170 72173 72175 72176 72178 72179 72180 72181 72182 72183 72189 72190 72198 72199 72201 72202 72203 72204 72205 72206 72207 72209 72210 72211 72212 72214 72215 72216 72217 72219 72221 72222 72223 72225 72227 72231 72260 72295 72301 72303 72310 72311 72312 72313 72315 72316 72319 72320 72321 72322 72324 72325 72326 72327 72328 72329 72330 72331 72332 8.4 8.4 1.0 7.0 1.0 5.0 10.6 2.0 10.4 7.0 10.6 5.1 3.0 2.0 4.0 8.0 2.0 5.2 10.4 1.0 10.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 5.0 8.0 5.0 10.6 4.0 4.0 4.0 8.0 5.0 5.0 8.0 1.0 5.0 2.0 5.0 10.6 10.6 2.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00429 Fmt 4701 RUCA level 72333 72335 72336 72338 72339 72340 72341 72342 72346 72347 72348 72350 72351 72352 72353 72354 72355 72358 72359 72360 72364 72365 72366 72367 72368 72369 72370 72372 72373 72374 72376 72377 72379 72383 72384 72386 72387 72389 72390 72391 72392 72394 72395 72396 72401 72402 72403 72404 72410 72411 72412 72413 72414 72415 72416 72417 72419 72421 72422 72424 72425 72426 72427 72428 72429 72430 72431 72432 72433 5.0 4.0 4.0 10.6 1.0 5.0 8.0 4.0 2.0 10.6 2.0 10.6 10.6 5.0 5.0 9.0 5.0 7.4 4.0 7.0 1.0 7.3 5.0 5.0 9.0 5.0 7.4 5.0 2.0 5.0 1.0 7.3 10.6 5.0 1.0 9.0 7.4 5.0 4.0 7.4 5.0 2.0 10.6 7.4 1.0 1.0 1.0 1.0 3.0 2.0 5.0 8.0 2.0 9.0 2.0 2.0 2.0 2.0 7.0 8.0 5.0 5.0 2.0 7.4 10.4 8.0 7.0 2.0 7.3 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 72434 72435 72436 72437 72438 72439 72440 72441 72442 72443 72444 72445 72447 72449 72450 72451 72453 72454 72455 72456 72457 72458 72459 72460 72461 72462 72464 72465 72466 72467 72469 72470 72471 72472 72473 72474 72475 72476 72478 72479 72482 72501 72503 72512 72513 72515 72517 72519 72520 72521 72522 72523 72524 72525 72526 72527 72528 72529 72530 72531 72532 72533 72534 72536 72537 72538 72539 72540 72542 9.0 8.0 5.0 2.0 7.4 1.0 10.6 9.2 7.4 5.0 8.0 3.0 2.0 8.0 4.0 4.0 8.0 7.0 7.0 9.2 10.3 9.0 9.0 8.0 10.5 8.0 8.0 3.0 10.6 2.0 10.6 8.0 8.0 7.3 8.0 4.0 10.4 7.3 8.0 10.4 9.0 4.0 4.0 10.0 10.6 10.5 10.0 10.5 10.0 10.2 5.0 8.0 5.0 7.0 5.0 5.0 10.5 7.0 10.6 10.5 10.2 10.0 5.0 10.0 5.0 10.5 10.0 10.0 7.0 70052 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR Zip code RUCA level 72543 72544 72545 72546 72550 72553 72554 72555 72556 72560 72561 72562 72564 72565 72566 72567 72568 72569 72571 72572 72573 72575 72576 72577 72578 72579 72581 72583 72584 72585 72587 72601 72602 72611 72613 72615 72616 72617 72619 72623 72624 72626 72628 72629 72630 72631 72632 72633 72634 72635 72636 72638 72639 72640 72641 72642 72644 72645 72648 72650 72651 72653 72654 72655 72657 72658 72659 72660 72661 7.0 5.0 7.0 8.0 5.0 5.0 10.0 10.0 10.0 10.0 10.0 5.0 5.0 10.0 10.5 10.0 5.0 10.2 5.0 10.6 10.0 4.0 10.5 10.2 10.5 5.0 10.6 10.5 10.0 10.0 10.0 5.0 5.0 5.0 10.0 5.0 7.0 5.0 10.5 5.0 5.0 5.0 10.5 10.0 5.0 10.0 10.0 5.0 10.5 5.0 6.0 7.0 10.0 5.0 5.0 5.0 5.0 10.0 5.0 10.0 5.0 4.0 4.0 10.5 10.0 5.0 5.0 8.0 10.5 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00430 Fmt 4701 RUCA level 72662 72663 72666 72668 72669 72670 72672 72675 72677 72679 72680 72682 72683 72685 72686 72687 72701 72702 72703 72704 72711 72712 72714 72715 72716 72717 72718 72719 72721 72722 72727 72728 72729 72730 72732 72733 72734 72735 72736 72737 72738 72739 72740 72741 72742 72744 72745 72747 72749 72751 72752 72753 72756 72757 72758 72760 72761 72762 72764 72765 72766 72768 72769 72770 72773 72774 72776 72801 72802 5.0 10.0 10.5 10.5 6.0 5.0 10.5 6.0 10.5 5.0 10.0 10.0 10.5 5.0 6.0 10.5 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 2.0 1.0 2.0 2.0 2.0 1.0 1.0 2.0 1.0 2.0 2.0 4.2 1.0 2.0 1.0 2.0 2.0 10.2 1.0 10.0 2.0 1.0 2.0 2.0 2.0 10.0 2.0 1.0 1.0 1.0 10.0 4.2 1.0 1.0 1.0 1.0 2.0 2.0 1.0 2.0 2.0 10.0 4.0 4.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR AR ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 72811 72812 72820 72821 72823 72824 72826 72827 72828 72829 72830 72832 72833 72834 72835 72837 72838 72839 72840 72841 72842 72843 72845 72846 72847 72851 72852 72853 72854 72855 72856 72857 72858 72860 72863 72865 72901 72902 72903 72904 72905 72906 72908 72913 72914 72916 72917 72918 72919 72921 72923 72924 72926 72927 72928 72930 72932 72933 72934 72935 72936 72937 72938 72940 72941 72943 72944 72945 72946 4.0 4.0 7.3 7.3 5.0 5.0 9.1 10.5 10.5 4.0 7.0 8.0 10.5 4.0 10.6 5.0 10.5 8.0 8.0 8.0 5.0 5.0 8.0 8.0 5.0 10.6 8.0 10.5 8.0 7.0 5.0 10.5 5.0 10.5 10.6 8.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 2.0 1.0 8.0 8.0 7.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 8.0 8.0 2.0 2.0 70053 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State AR AR AR AR AR AR AR AR AR AR AR AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ Zip code RUCA level 72947 72948 72949 72950 72951 72952 72955 72956 72957 72958 72959 85001 85002 85003 85004 85005 85006 85007 85008 85009 85010 85011 85012 85013 85014 85015 85016 85017 85018 85019 85020 85021 85022 85023 85024 85025 85026 85027 85028 85029 85030 85031 85032 85033 85034 85035 85036 85037 85038 85039 85040 85041 85042 85043 85044 85045 85046 85048 85050 85051 85053 85054 85055 85060 85061 85062 85063 85064 85065 2.0 2.0 7.3 8.0 8.0 2.0 2.0 1.0 1.0 7.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00431 Fmt 4701 RUCA level 85066 85067 85068 85069 85070 85071 85072 85073 85074 85075 85076 85077 85078 85079 85080 85082 85085 85086 85087 85098 85099 85201 85202 85203 85204 85205 85206 85207 85208 85209 85210 85211 85212 85213 85214 85215 85216 85217 85218 85219 85220 85221 85222 85223 85224 85225 85226 85227 85228 85230 85231 85232 85233 85234 85235 85236 85237 85239 85241 85242 85243 85244 85245 85246 85247 85248 85249 85250 85251 1.0 1.0 1.0 1.0 10.4 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.2 4.2 4.2 1.0 1.0 1.0 2.0 7.4 4.2 7.4 4.0 1.0 1.0 10.0 1.0 10.0 10.1 7.4 2.0 2.0 1.0 2.0 1.0 10.4 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 85252 85253 85254 85255 85256 85257 85258 85259 85260 85261 85262 85263 85264 85266 85267 85268 85269 85271 85272 85273 85274 85275 85277 85278 85279 85280 85281 85282 85283 85284 85285 85287 85289 85290 85291 85292 85296 85297 85299 85301 85302 85303 85304 85305 85306 85307 85308 85309 85310 85311 85312 85313 85318 85320 85321 85322 85323 85324 85325 85326 85327 85328 85329 85331 85332 85333 85334 85335 85336 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 10.1 1.0 1.0 2.0 2.0 1.0 10.1 7.1 1.0 1.0 1.0 1.0 4.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.1 7.4 10.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 7.3 2.0 2.0 2.0 7.0 2.0 1.0 4.0 2.0 1.0 2.0 10.4 4.0 1.0 2.0 70054 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ Zip code RUCA level 85337 85338 85339 85340 85341 85342 85343 85344 85345 85346 85347 85348 85349 85350 85351 85352 85353 85354 85355 85356 85357 85358 85359 85360 85361 85362 85363 85364 85365 85366 85367 85369 85371 85372 85373 85374 85375 85376 85377 85378 85379 85380 85381 85382 85383 85385 85387 85388 85390 85396 85501 85502 85530 85531 85532 85533 85534 85535 85536 85539 85540 85541 85542 85543 85544 85545 85546 85547 85548 2.0 2.0 1.0 2.0 2.0 1.0 2.0 7.0 1.0 7.0 10.4 10.3 2.0 2.0 1.0 10.1 1.0 2.0 2.0 10.1 10.3 1.0 7.0 4.0 1.0 2.0 1.0 1.0 1.0 1.0 2.0 1.0 7.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 4.0 8.0 4.0 4.0 7.0 10.3 5.0 5.0 4.0 7.0 4.0 7.4 5.0 5.0 10.5 4.0 4.0 4.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00432 Fmt 4701 RUCA level 85550 85551 85552 85553 85554 85601 85602 85603 85605 85606 85607 85608 85609 85610 85611 85613 85614 85615 85616 85617 85618 85619 85620 85621 85622 85623 85624 85625 85626 85627 85628 85629 85630 85631 85632 85633 85634 85635 85636 85637 85638 85639 85640 85641 85643 85644 85645 85646 85648 85650 85652 85653 85654 85655 85662 85670 85671 85701 85702 85703 85704 85705 85706 85707 85708 85709 85710 85711 85712 8.0 4.0 4.0 4.0 4.0 2.0 7.3 7.4 10.6 7.0 4.0 4.0 7.0 10.5 10.4 4.0 4.1 5.0 4.0 10.5 2.0 1.0 7.4 4.0 4.1 2.0 10.4 7.0 4.0 7.3 4.0 2.0 7.3 7.3 10.6 2.0 10.4 4.0 4.0 10.4 10.5 10.4 10.5 2.0 7.0 7.0 5.1 10.5 4.0 4.0 1.0 2.0 2.0 4.0 4.0 4.0 4.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 85713 85714 85715 85716 85717 85718 85719 85720 85721 85722 85723 85724 85725 85726 85728 85730 85731 85732 85733 85734 85735 85736 85737 85738 85739 85740 85741 85742 85743 85744 85745 85746 85747 85748 85749 85750 85751 85752 85754 85755 85757 85775 85777 85901 85902 85911 85912 85920 85922 85923 85924 85925 85926 85927 85928 85929 85930 85931 85932 85933 85934 85935 85936 85937 85938 85939 85940 85941 85942 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.0 7.0 7.0 7.0 7.0 7.0 7.0 10.6 7.0 7.0 7.0 10.6 7.0 7.0 7.0 7.0 10.6 7.0 7.0 7.0 7.0 7.0 7.0 7.0 7.0 7.0 70055 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ Zip code RUCA level 86001 86002 86003 86004 86011 86015 86016 86017 86018 86020 86021 86022 86023 86024 86025 86028 86029 86030 86031 86032 86033 86034 86035 86036 86038 86039 86040 86042 86043 86044 86045 86046 86047 86052 86053 86054 86301 86302 86303 86304 86305 86312 86313 86314 86320 86321 86322 86323 86324 86325 86326 86327 86329 86330 86331 86332 86333 86334 86335 86336 86337 86338 86339 86340 86341 86342 86343 86351 86401 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.0 10.4 7.3 9.0 10.6 10.4 2.1 7.0 7.0 7.0 10.0 7.0 7.0 7.0 10.0 2.0 10.6 2.1 10.0 7.0 10.0 10.0 8.0 7.3 10.4 7.0 10.6 8.0 9.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.4 10.4 10.5 2.0 4.0 9.0 4.0 2.0 2.0 1.0 4.0 2.0 2.0 2.0 10.5 7.0 10.4 1.0 7.0 7.0 9.0 10.5 2.0 9.0 4.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ AZ CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00433 Fmt 4701 RUCA level 86402 86403 86404 86405 86406 86409 86411 86412 86413 86426 86427 86429 86430 86431 86432 86433 86434 86435 86436 86437 86438 86439 86440 86441 86442 86443 86444 86445 86446 86502 86503 86504 86505 86506 86507 86508 86510 86511 86512 86514 86515 86520 86535 86538 86540 86544 86545 86547 86556 90001 90002 90003 90004 90005 90006 90007 90008 90009 90010 90011 90012 90013 90014 90015 90016 90017 90018 90019 90020 4.0 4.0 4.0 4.0 4.0 4.0 4.0 4.0 5.0 8.2 8.2 8.4 8.4 4.0 9.0 8.2 5.0 10.4 8.2 4.0 8.2 8.2 9.2 5.0 8.2 5.0 5.0 5.0 8.2 10.5 7.0 7.4 7.4 7.4 10.6 7.4 10.0 7.4 10.5 10.4 7.4 10.0 8.0 8.0 7.0 10.4 10.4 8.0 10.6 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 90021 90022 90023 90024 90025 90026 90027 90028 90029 90030 90031 90032 90033 90034 90035 90036 90037 90038 90039 90040 90041 90042 90043 90044 90045 90046 90047 90048 90049 90050 90051 90052 90053 90054 90055 90056 90057 90058 90059 90060 90061 90062 90063 90064 90065 90066 90067 90068 90069 90070 90071 90072 90073 90074 90075 90076 90077 90078 90079 90080 90081 90082 90083 90084 90086 90087 90088 90089 90091 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70056 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA Zip code RUCA level 90093 90094 90095 90096 90097 90099 90101 90102 90103 90174 90185 90189 90201 90202 90209 90210 90211 90212 90213 90220 90221 90222 90223 90224 90230 90231 90232 90233 90239 90240 90241 90242 90245 90247 90248 90249 90250 90251 90254 90255 90260 90261 90262 90263 90264 90265 90266 90267 90270 90272 90274 90275 90277 90278 90280 90290 90291 90292 90293 90294 90295 90296 90301 90302 90303 90304 90305 90306 90307 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00434 Fmt 4701 RUCA level 90308 90309 90310 90311 90312 90313 90397 90398 90401 90402 90403 90404 90405 90406 90407 90408 90409 90410 90411 90501 90502 90503 90504 90505 90506 90507 90508 90509 90510 90601 90602 90603 90604 90605 90606 90607 90608 90609 90610 90612 90620 90621 90622 90623 90624 90630 90631 90632 90633 90637 90638 90639 90640 90650 90651 90652 90659 90660 90661 90662 90665 90670 90671 90680 90701 90702 90703 90704 90706 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.3 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 90707 90710 90711 90712 90713 90714 90715 90716 90717 90720 90721 90723 90731 90732 90733 90734 90740 90742 90743 90744 90745 90746 90747 90748 90749 90755 90801 90802 90803 90804 90805 90806 90807 90808 90809 90810 90813 90814 90815 90822 90831 90832 90833 90834 90835 90840 90842 90844 90845 90846 90847 90848 90853 90888 90895 90899 91001 91003 91006 91007 91009 91010 91011 91012 91016 91017 91020 91021 91023 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70057 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA Zip code RUCA level 91024 91025 91030 91031 91040 91041 91042 91043 91046 91066 91077 91101 91102 91103 91104 91105 91106 91107 91108 91109 91110 91114 91115 91116 91117 91118 91121 91123 91124 91125 91126 91129 91131 91175 91182 91184 91185 91186 91187 91188 91189 91191 91201 91202 91203 91204 91205 91206 91207 91208 91209 91210 91214 91221 91222 91224 91225 91226 91301 91302 91303 91304 91305 91306 91307 91308 91309 91310 91311 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00435 Fmt 4701 RUCA level 91312 91313 91316 91319 91320 91321 91322 91324 91325 91326 91327 91328 91329 91330 91331 91333 91334 91335 91337 91340 91341 91342 91343 91344 91345 91346 91350 91351 91352 91353 91354 91355 91356 91357 91358 91359 91360 91361 91362 91363 91364 91365 91367 91371 91372 91376 91377 91380 91381 91382 91383 91384 91385 91386 91387 91388 91390 91392 91393 91394 91395 91396 91399 91401 91402 91403 91404 91405 91406 1.0 1.0 1.0 1.1 1.1 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 1.0 2.0 2.0 1.0 1.0 1.1 1.1 1.1 1.1 1.1 1.1 1.0 1.0 1.0 1.0 1.0 1.1 1.1 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 91407 91408 91409 91410 91411 91412 91413 91416 91423 91426 91436 91470 91482 91495 91496 91497 91499 91501 91502 91503 91504 91505 91506 91507 91508 91510 91521 91522 91523 91526 91601 91602 91603 91604 91605 91606 91607 91608 91609 91610 91611 91612 91614 91615 91616 91617 91618 91701 91702 91706 91708 91709 91710 91711 91714 91715 91716 91722 91723 91724 91729 91730 91731 91732 91733 91734 91735 91737 91739 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70058 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA Zip code RUCA level 91740 91741 91743 91744 91745 91746 91747 91748 91749 91750 91752 91754 91755 91756 91758 91759 91761 91762 91763 91764 91765 91766 91767 91768 91769 91770 91771 91772 91773 91775 91776 91778 91780 91784 91785 91786 91788 91789 91790 91791 91792 91793 91795 91797 91798 91799 91801 91802 91803 91804 91841 91896 91899 91901 91902 91903 91905 91906 91908 91909 91910 91911 91912 91913 91914 91915 91916 91917 91921 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00436 Fmt 4701 RUCA level 91931 91932 91933 91934 91935 91941 91942 91943 91944 91945 91946 91947 91948 91950 91951 91962 91963 91976 91977 91978 91979 91980 91987 91990 92003 92004 92007 92008 92009 92010 92011 92013 92014 92018 92019 92020 92021 92022 92023 92024 92025 92026 92027 92028 92029 92030 92033 92036 92037 92038 92039 92040 92046 92049 92051 92052 92054 92055 92056 92057 92058 92059 92060 92061 92064 92065 92066 92067 92068 2.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 1.0 10.4 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 1.0 2.0 10.1 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 92069 92070 92071 92072 92074 92075 92078 92079 92081 92082 92083 92084 92085 92086 92088 92090 92091 92092 92093 92096 92101 92102 92103 92104 92105 92106 92107 92108 92109 92110 92111 92112 92113 92114 92115 92116 92117 92118 92119 92120 92121 92122 92123 92124 92126 92127 92128 92129 92130 92131 92132 92133 92134 92135 92136 92137 92138 92139 92140 92142 92143 92145 92147 92149 92150 92152 92153 92154 92155 1.0 10.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 10.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70059 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA Zip code RUCA level 92158 92159 92160 92161 92162 92163 92164 92165 92166 92167 92168 92169 92170 92171 92172 92173 92174 92175 92176 92177 92178 92179 92182 92184 92186 92187 92190 92191 92192 92193 92194 92195 92196 92197 92198 92199 92201 92202 92203 92210 92211 92220 92222 92223 92225 92226 92227 92230 92231 92232 92233 92234 92235 92236 92239 92240 92241 92242 92243 92244 92247 92248 92249 92250 92251 92252 92253 92254 92255 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 4.0 4.2 1.0 4.2 4.2 7.3 1.0 1.0 1.0 9.2 2.0 2.0 8.0 1.0 1.0 1.0 1.0 1.0 7.1 1.0 4.2 1.0 2.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00437 Fmt 4701 RUCA level 92256 92257 92258 92259 92260 92261 92262 92263 92264 92266 92267 92268 92270 92273 92274 92275 92276 92277 92278 92280 92281 92282 92283 92284 92285 92286 92292 92301 92304 92305 92307 92308 92309 92310 92311 92312 92313 92314 92315 92316 92317 92318 92320 92321 92322 92323 92324 92325 92326 92327 92328 92329 92332 92333 92334 92335 92336 92337 92338 92339 92340 92341 92342 92344 92345 92346 92347 92350 92352 2.0 10.6 2.0 9.1 1.0 1.0 1.0 1.0 1.0 1.0 10.6 4.2 1.0 1.0 2.0 2.0 1.0 5.0 4.0 10.6 10.5 2.0 1.0 4.2 2.0 4.2 1.0 1.0 7.0 2.0 1.0 1.0 7.0 7.0 4.0 4.0 1.0 4.0 4.0 1.0 4.1 1.0 1.0 4.1 4.1 7.0 1.0 4.1 1.0 1.0 5.0 3.0 7.0 4.0 1.0 1.0 1.0 1.0 7.0 2.0 1.0 4.0 6.1 1.0 1.0 1.0 5.0 1.0 4.1 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 92354 92356 92357 92358 92359 92363 92364 92365 92366 92368 92369 92371 92372 92373 92374 92375 92376 92377 92378 92382 92384 92385 92386 92389 92391 92392 92393 92394 92395 92397 92398 92399 92401 92402 92403 92404 92405 92406 92407 92408 92410 92411 92412 92413 92414 92415 92418 92420 92423 92424 92427 92501 92502 92503 92504 92505 92506 92507 92508 92509 92513 92514 92515 92516 92517 92518 92519 92521 92522 1.0 1.0 1.0 2.0 1.0 7.0 7.0 7.0 7.0 2.0 1.0 3.0 3.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 5.0 2.0 4.0 5.0 1.0 1.0 1.0 1.0 1.0 2.0 7.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 70060 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA Zip code RUCA level 92530 92531 92532 92536 92539 92543 92544 92545 92546 92548 92549 92551 92552 92553 92554 92555 92556 92557 92561 92562 92563 92564 92567 92570 92571 92572 92581 92582 92583 92584 92585 92586 92587 92589 92590 92591 92592 92593 92595 92596 92599 92602 92603 92604 92605 92606 92607 92609 92610 92612 92614 92615 92616 92617 92618 92619 92620 92623 92624 92625 92626 92627 92628 92629 92630 92637 92646 92647 92648 1.0 1.0 1.0 3.0 10.4 1.0 1.0 1.0 1.0 1.0 10.4 1.0 1.0 1.0 1.0 1.0 1.0 1.0 3.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.1 1.1 1.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.1 1.0 1.0 1.0 1.0 1.1 1.1 1.1 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00438 Fmt 4701 RUCA level 92649 92650 92651 92652 92653 92654 92655 92656 92657 92658 92659 92660 92661 92662 92663 92672 92673 92674 92675 92676 92677 92678 92679 92683 92684 92685 92688 92690 92691 92692 92693 92694 92697 92698 92701 92702 92703 92704 92705 92706 92707 92708 92709 92710 92711 92712 92725 92728 92735 92780 92781 92782 92799 92801 92802 92803 92804 92805 92806 92807 92808 92809 92811 92812 92814 92815 92816 92817 92821 1.0 1.0 1.1 1.1 1.1 1.1 1.0 1.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.1 1.1 1.1 1.1 2.0 1.1 1.1 1.1 1.0 1.0 1.0 1.1 1.1 1.1 1.1 1.1 1.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 92822 92823 92825 92831 92832 92833 92834 92835 92836 92837 92838 92840 92841 92842 92843 92844 92845 92846 92850 92856 92857 92859 92860 92861 92862 92863 92864 92865 92866 92867 92868 92869 92870 92871 92877 92878 92879 92880 92881 92882 92883 92885 92886 92887 92899 93001 93002 93003 93004 93005 93006 93007 93009 93010 93011 93012 93013 93014 93015 93016 93020 93021 93022 93023 93024 93030 93031 93032 93033 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.2 4.2 1.1 1.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70061 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA Zip code RUCA level 93034 93035 93036 93040 93041 93042 93043 93044 93060 93061 93062 93063 93064 93065 93066 93067 93093 93094 93099 93101 93102 93103 93105 93106 93107 93108 93109 93110 93111 93116 93117 93118 93120 93121 93130 93140 93150 93160 93190 93199 93201 93202 93203 93204 93205 93206 93207 93208 93210 93212 93215 93216 93218 93219 93220 93221 93222 93223 93224 93225 93226 93227 93230 93232 93234 93235 93237 93238 93239 1.0 1.0 1.0 4.2 1.0 1.0 1.0 1.0 2.0 2.0 2.0 2.0 2.0 2.0 1.0 1.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 6.0 4.0 2.0 4.0 7.3 10.1 2.0 2.0 4.2 4.0 4.2 4.2 2.0 6.0 1.0 1.0 3.0 1.0 2.0 3.0 2.0 1.0 4.0 4.0 7.3 2.0 10.1 2.0 10.5 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00439 Fmt 4701 RUCA level 93240 93241 93242 93243 93244 93245 93246 93247 93249 93250 93251 93252 93254 93255 93256 93257 93258 93260 93261 93262 93263 93265 93266 93267 93268 93270 93271 93272 93274 93275 93276 93277 93278 93279 93280 93282 93283 93285 93286 93287 93290 93291 93292 93301 93302 93303 93304 93305 93306 93307 93308 93309 93311 93312 93313 93314 93380 93381 93382 93383 93384 93385 93386 93387 93388 93389 93390 93401 93402 7.3 1.0 10.4 2.0 10.1 4.0 4.0 4.2 10.4 5.0 2.0 2.0 10.4 2.0 9.1 1.0 1.0 2.0 6.0 10.1 2.0 2.0 10.5 1.0 4.2 2.0 10.1 10.4 4.2 4.2 2.0 1.0 1.0 1.0 4.2 4.0 7.3 2.0 9.1 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 93403 93405 93406 93407 93408 93409 93410 93412 93420 93421 93422 93423 93424 93426 93427 93428 93429 93430 93432 93433 93434 93435 93436 93437 93438 93440 93441 93442 93443 93444 93445 93446 93447 93448 93449 93450 93451 93452 93453 93454 93455 93456 93457 93458 93460 93461 93463 93464 93465 93475 93483 93501 93502 93504 93505 93510 93512 93513 93514 93515 93516 93517 93518 93519 93522 93523 93524 93526 93527 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 4.2 4.2 1.0 1.0 1.0 6.0 4.2 7.0 1.0 2.0 1.0 4.2 2.0 2.0 1.0 1.0 1.0 1.0 4.2 2.0 2.0 1.0 4.2 1.0 1.0 4.2 4.2 6.0 2.0 10.4 1.0 1.0 1.0 1.0 1.0 1.0 4.2 2.0 4.2 4.2 1.0 1.0 4.2 10.4 10.4 9.0 9.0 2.0 10.6 5.0 4.0 4.0 10.6 10.6 7.3 9.0 4.0 7.0 6.1 5.0 4.0 70062 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA Zip code RUCA level 93528 93529 93530 93531 93532 93534 93535 93536 93539 93541 93542 93543 93544 93545 93546 93549 93550 93551 93552 93553 93554 93555 93556 93558 93560 93561 93562 93563 93581 93584 93586 93590 93591 93592 93596 93599 93601 93602 93603 93604 93605 93606 93607 93608 93609 93610 93611 93612 93613 93614 93615 93616 93618 93619 93620 93621 93622 93623 93624 93625 93626 93627 93628 93630 93631 93633 93634 93635 93637 9.0 10.6 10.5 10.4 2.0 1.1 1.1 1.1 1.1 10.6 4.0 1.1 3.0 10.5 7.0 4.0 1.1 1.1 1.1 2.1 9.0 4.0 4.0 4.0 3.0 4.0 10.5 2.0 4.0 1.1 1.1 1.1 2.1 10.5 10.6 1.1 10.6 2.0 2.0 10.4 2.0 1.0 10.4 7.3 2.0 7.0 1.0 1.0 1.0 3.0 4.2 2.0 4.2 4.2 9.2 2.0 7.3 10.0 7.3 4.1 2.0 7.3 2.0 2.0 4.1 2.0 2.0 4.2 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00440 Fmt 4701 RUCA level 93638 93639 93640 93641 93642 93643 93644 93645 93646 93647 93648 93649 93650 93651 93652 93653 93654 93656 93657 93660 93661 93662 93664 93665 93666 93667 93668 93669 93670 93673 93675 93701 93702 93703 93704 93705 93706 93707 93708 93709 93710 93711 93712 93714 93715 93716 93717 93718 93720 93721 93722 93724 93725 93726 93727 93728 93729 93740 93741 93744 93745 93747 93750 93755 93760 93761 93762 93764 93765 1.0 1.0 7.3 2.0 2.0 10.4 7.0 3.0 7.4 4.2 3.0 4.2 1.0 2.0 2.0 3.0 4.2 10.4 2.0 7.3 9.2 4.1 2.0 9.2 4.2 2.0 7.3 10.4 4.2 4.1 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 93771 93772 93773 93774 93775 93776 93777 93778 93779 93780 93784 93786 93790 93791 93792 93793 93794 93844 93888 93901 93902 93905 93906 93907 93908 93912 93915 93920 93921 93922 93923 93924 93925 93926 93927 93928 93930 93932 93933 93940 93942 93943 93944 93950 93953 93954 93955 93960 93962 94002 94003 94005 94010 94011 94012 94013 94014 94015 94016 94017 94018 94019 94020 94021 94022 94023 94024 94025 94026 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.1 1.0 1.0 1.0 1.0 2.0 2.0 4.2 6.0 4.2 6.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.2 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 70063 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA Zip code RUCA level 94027 94028 94029 94030 94031 94035 94037 94038 94039 94040 94041 94042 94043 94044 94045 94059 94060 94061 94062 94063 94064 94065 94066 94067 94070 94071 94074 94080 94083 94085 94086 94087 94088 94089 94090 94096 94098 94099 94101 94102 94103 94104 94105 94106 94107 94108 94109 94110 94111 94112 94114 94115 94116 94117 94118 94119 94120 94121 94122 94123 94124 94125 94126 94127 94128 94129 94130 94131 94132 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00441 Fmt 4701 RUCA level 94133 94134 94135 94136 94137 94138 94139 94140 94141 94142 94143 94144 94145 94146 94147 94150 94151 94152 94153 94154 94155 94156 94157 94158 94159 94160 94161 94162 94163 94164 94165 94166 94167 94168 94169 94170 94171 94172 94175 94177 94188 94199 94203 94204 94205 94206 94207 94208 94209 94211 94229 94230 94232 94234 94235 94236 94237 94239 94240 94243 94244 94245 94246 94247 94248 94249 94250 94252 94253 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 94254 94256 94257 94258 94259 94261 94262 94263 94267 94268 94269 94271 94273 94274 94277 94278 94279 94280 94282 94283 94284 94285 94286 94287 94288 94289 94290 94291 94293 94294 94295 94296 94297 94298 94299 94301 94302 94303 94304 94305 94306 94307 94308 94309 94310 94401 94402 94403 94404 94405 94406 94407 94408 94409 94497 94501 94502 94503 94506 94507 94508 94509 94510 94511 94512 94513 94514 94515 94516 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.6 1.1 1.0 1.1 7.0 1.1 3.0 7.0 1.0 70064 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA Zip code RUCA level 94517 94518 94519 94520 94521 94522 94523 94524 94525 94526 94527 94528 94529 94530 94531 94533 94534 94535 94536 94537 94538 94539 94540 94541 94542 94543 94544 94545 94546 94547 94548 94549 94550 94551 94552 94553 94555 94556 94557 94558 94559 94560 94561 94562 94563 94564 94565 94566 94567 94568 94569 94570 94571 94572 94573 94574 94575 94576 94577 94578 94579 94580 94581 94582 94583 94585 94586 94587 94588 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.1 7.3 1.0 1.0 1.1 1.0 10.4 1.0 1.0 1.0 7.0 1.0 7.3 7.3 1.0 10.6 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00442 Fmt 4701 RUCA level 94589 94590 94591 94592 94595 94596 94597 94598 94599 94601 94602 94603 94604 94605 94606 94607 94608 94609 94610 94611 94612 94613 94614 94615 94617 94618 94619 94620 94621 94622 94623 94624 94625 94626 94627 94643 94649 94659 94660 94661 94662 94666 94701 94702 94703 94704 94705 94706 94707 94708 94709 94710 94712 94720 94801 94802 94803 94804 94805 94806 94807 94808 94820 94850 94875 94901 94903 94904 94912 1.0 1.0 1.0 10.4 1.0 1.0 1.0 1.0 9.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.1 1.1 1.1 1.1 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 94913 94914 94915 94920 94922 94923 94924 94925 94926 94927 94928 94929 94930 94931 94933 94937 94938 94939 94940 94941 94942 94945 94946 94947 94948 94949 94950 94951 94952 94953 94954 94955 94956 94957 94960 94963 94964 94965 94966 94970 94971 94972 94973 94974 94975 94976 94977 94978 94979 94998 94999 95001 95002 95003 95004 95005 95006 95007 95008 95009 95010 95011 95012 95013 95014 95015 95017 95018 95019 1.1 1.1 1.1 1.1 2.0 2.0 10.4 1.1 1.0 1.0 1.0 10.4 1.1 1.0 1.1 10.1 1.1 1.1 10.4 1.1 1.1 1.1 10.4 1.1 1.1 1.1 10.4 1.0 1.0 1.0 1.0 1.0 10.1 1.1 1.1 1.1 1.1 1.1 1.1 10.4 10.4 2.0 1.1 1.1 1.0 1.1 1.1 1.1 1.1 1.1 1.0 1.0 1.0 1.0 3.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 2.0 1.0 1.1 70065 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA Zip code RUCA level 95020 95021 95023 95024 95026 95030 95031 95032 95033 95035 95036 95037 95038 95039 95041 95042 95043 95044 95045 95046 95050 95051 95052 95053 95054 95055 95056 95060 95061 95062 95063 95064 95065 95066 95067 95070 95071 95073 95075 95076 95077 95101 95102 95103 95106 95108 95109 95110 95111 95112 95113 95114 95115 95116 95117 95118 95119 95120 95121 95122 95123 95124 95125 95126 95127 95128 95129 95130 95131 2.0 2.0 4.2 4.2 2.0 1.0 1.0 1.0 2.0 1.0 1.0 2.0 2.0 1.1 1.0 1.0 4.2 2.0 10.4 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.2 1.1 1.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00443 Fmt 4701 RUCA level 95132 95133 95134 95135 95136 95137 95138 95139 95140 95141 95142 95148 95150 95151 95152 95153 95154 95155 95156 95157 95158 95159 95160 95161 95164 95170 95171 95172 95173 95190 95191 95192 95193 95194 95196 95201 95202 95203 95204 95205 95206 95207 95208 95209 95210 95211 95212 95213 95215 95219 95220 95221 95222 95223 95224 95225 95226 95227 95228 95229 95230 95231 95232 95233 95234 95236 95237 95240 95241 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 3.0 7.0 7.0 10.6 10.6 10.4 10.4 3.0 10.5 7.0 2.0 1.0 10.0 10.6 1.0 2.0 2.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 95242 95245 95246 95247 95248 95249 95250 95251 95252 95253 95254 95255 95257 95258 95267 95269 95290 95296 95297 95298 95301 95303 95304 95305 95306 95307 95309 95310 95311 95312 95313 95314 95315 95316 95317 95318 95319 95320 95321 95322 95323 95324 95325 95326 95327 95328 95329 95330 95333 95334 95335 95336 95337 95338 95340 95341 95342 95343 95344 95345 95346 95347 95348 95350 95351 95352 95353 95354 95355 1.0 10.6 10.6 7.0 10.6 10.6 10.6 7.0 10.4 1.0 10.4 10.0 10.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 9.1 10.5 10.0 1.0 4.0 4.0 10.4 1.0 10.6 5.0 1.0 1.0 10.1 10.0 1.0 3.0 10.5 7.3 2.0 7.3 10.0 1.0 9.1 1.0 9.1 1.0 10.4 4.2 5.0 1.0 1.0 10.0 1.0 1.0 1.0 1.0 1.0 10.0 5.0 10.5 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70066 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA Zip code RUCA level 95356 95357 95358 95360 95361 95363 95364 95365 95366 95367 95368 95369 95370 95372 95373 95374 95375 95376 95377 95378 95379 95380 95381 95382 95383 95385 95386 95387 95388 95389 95391 95397 95401 95402 95403 95404 95405 95406 95407 95408 95409 95410 95412 95415 95416 95417 95418 95419 95420 95421 95422 95423 95424 95425 95426 95427 95428 95429 95430 95431 95432 95433 95435 95436 95437 95439 95441 95442 95443 1.0 1.0 1.0 9.1 4.1 4.2 5.0 1.0 1.0 1.0 1.0 10.4 4.0 5.0 4.0 7.3 5.0 1.0 1.0 1.0 5.0 1.0 1.0 1.0 5.0 10.4 2.0 4.2 1.0 10.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.3 10.4 10.5 4.2 10.0 4.0 1.0 10.3 10.4 4.0 7.4 4.0 2.0 10.4 10.5 10.0 10.0 1.0 4.2 10.3 4.2 4.0 2.0 7.0 1.0 2.0 4.2 4.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00444 Fmt 4701 RUCA level 95444 95445 95446 95448 95449 95450 95451 95452 95453 95454 95456 95457 95458 95459 95460 95461 95462 95463 95464 95465 95466 95467 95468 95469 95470 95471 95472 95473 95476 95480 95481 95482 95485 95486 95487 95488 95490 95492 95493 95494 95497 95501 95502 95503 95511 95514 95518 95519 95521 95524 95525 95526 95527 95528 95531 95532 95534 95536 95537 95538 95540 95542 95543 95545 95546 95547 95548 95549 95550 1.0 10.0 2.0 1.0 10.2 10.4 6.0 4.2 4.0 10.0 10.3 4.0 4.0 10.0 10.3 10.4 2.0 10.5 4.0 2.0 10.5 10.0 10.0 5.0 4.0 2.0 1.0 1.0 4.2 10.4 4.0 4.0 10.5 10.4 4.2 10.0 7.4 1.0 10.5 10.5 10.4 4.0 4.0 4.0 10.0 10.0 4.0 4.0 4.0 4.0 5.0 4.0 10.0 4.0 4.0 4.0 4.0 10.5 4.0 4.0 4.0 10.0 5.0 10.0 10.5 4.0 10.5 4.0 5.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 95551 95552 95553 95554 95555 95556 95558 95559 95560 95562 95563 95564 95565 95567 95568 95569 95570 95571 95573 95585 95587 95589 95595 95601 95602 95603 95604 95605 95606 95607 95608 95609 95610 95611 95612 95613 95614 95615 95616 95617 95618 95619 95620 95621 95623 95624 95625 95626 95627 95628 95629 95630 95631 95632 95633 95634 95635 95636 95637 95638 95639 95640 95641 95642 95644 95645 95646 95648 95650 4.0 10.6 10.0 10.0 10.2 10.5 10.5 10.0 10.0 7.4 10.0 4.0 7.4 5.0 10.0 10.0 10.2 10.0 10.5 10.0 10.0 10.0 10.6 7.0 2.0 1.0 1.0 1.0 10.5 10.5 1.0 1.0 1.0 1.0 10.1 4.2 2.0 10.4 1.0 1.0 1.0 4.2 4.2 1.0 2.0 1.0 1.0 1.0 10.5 1.0 10.4 1.0 2.0 1.0 2.0 2.0 2.0 5.2 10.5 2.0 1.0 7.0 10.6 7.0 9.0 6.0 9.0 2.0 1.0 70067 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA Zip code RUCA level 95651 95652 95653 95654 95655 95656 95658 95659 95660 95661 95662 95663 95664 95665 95666 95667 95668 95669 95670 95671 95672 95673 95674 95675 95676 95677 95678 95679 95680 95681 95682 95683 95684 95685 95686 95687 95688 95689 95690 95691 95692 95693 95694 95695 95696 95697 95698 95699 95701 95703 95709 95712 95713 95714 95715 95717 95720 95721 95722 95724 95726 95728 95735 95736 95741 95742 95743 95746 95747 2.0 1.0 10.5 7.0 2.0 5.2 1.0 2.0 1.0 1.0 1.0 1.0 2.0 10.6 9.0 4.2 2.0 7.0 1.0 1.0 2.0 1.0 2.0 7.0 6.0 1.0 1.0 10.5 10.4 2.0 2.0 2.0 5.2 7.0 1.0 1.0 1.0 10.4 10.4 1.0 3.0 2.0 7.3 4.2 1.0 4.2 6.0 7.0 2.0 2.0 4.2 4.2 2.0 2.0 2.0 2.0 2.0 5.0 2.0 2.0 4.2 5.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00445 Fmt 4701 RUCA level 95757 95758 95759 95762 95763 95765 95776 95798 95799 95812 95813 95814 95815 95816 95817 95818 95819 95820 95821 95822 95823 95824 95825 95826 95827 95828 95829 95830 95831 95832 95833 95834 95835 95836 95837 95838 95840 95841 95842 95843 95851 95852 95853 95857 95860 95864 95865 95866 95867 95873 95887 95894 95899 95901 95903 95910 95912 95913 95914 95915 95916 95917 95918 95919 95920 95922 95923 95924 95925 1.0 1.0 1.0 1.0 1.0 1.0 4.2 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.0 10.4 10.6 7.3 5.0 10.0 5.2 10.6 2.0 10.4 10.4 10.4 10.0 4.2 10.4 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 95926 95927 95928 95929 95930 95932 95934 95935 95936 95937 95938 95939 95940 95941 95942 95943 95944 95945 95946 95947 95948 95949 95950 95951 95953 95954 95955 95956 95957 95958 95959 95960 95961 95962 95963 95965 95966 95967 95968 95969 95970 95971 95972 95973 95974 95975 95976 95977 95978 95979 95980 95981 95982 95983 95984 95986 95987 95988 95991 95992 95993 96001 96002 96003 96006 96007 96008 96009 96010 1.0 1.0 1.0 1.0 5.2 7.0 10.0 10.4 10.4 6.0 1.0 10.6 4.2 5.2 2.0 10.4 10.4 4.2 5.0 10.0 7.3 4.2 10.6 2.0 2.0 4.1 10.6 10.0 10.4 4.2 4.2 5.0 1.0 2.0 7.3 4.2 4.2 4.1 4.2 4.1 10.6 10.0 10.4 1.0 4.2 5.0 1.0 5.0 4.1 10.6 10.0 10.4 1.0 10.0 10.0 4.2 7.0 7.0 1.0 1.0 1.0 1.0 1.0 1.0 10.0 1.0 2.0 10.0 10.0 70068 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA CA Zip code RUCA level 96011 96013 96014 96015 96016 96017 96019 96020 96021 96022 96023 96024 96025 96027 96028 96029 96031 96032 96033 96034 96035 96037 96038 96039 96040 96041 96044 96046 96047 96048 96049 96050 96051 96052 96054 96055 96056 96057 96058 96059 96061 96062 96063 96064 96065 96067 96068 96069 96070 96071 96073 96074 96075 96076 96078 96079 96080 96084 96085 96086 96087 96088 96089 96090 96091 96092 96093 96094 96095 2.0 7.3 10.6 10.3 10.3 2.0 1.0 10.0 7.4 2.0 10.5 10.0 10.6 10.6 10.3 7.4 10.6 10.6 2.0 8.0 7.2 10.6 8.0 10.0 10.3 10.0 8.0 10.0 2.0 10.0 1.0 10.0 2.0 10.0 10.0 7.2 10.0 10.6 10.5 5.0 5.0 2.0 5.0 8.0 2.0 7.0 10.0 2.0 2.0 7.3 2.0 7.4 5.0 2.0 7.2 1.0 4.0 2.0 10.6 10.0 2.0 2.0 1.0 7.2 10.0 7.4 10.0 7.0 2.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CA ..................................... CO .................................... CO .................................... CO .................................... CO .................................... CO .................................... CO .................................... CO .................................... CO .................................... CO .................................... CO .................................... CO .................................... CO .................................... CO .................................... PO 00000 Frm 00446 Fmt 4701 RUCA level 96096 96097 96099 96101 96103 96104 96105 96106 96107 96108 96109 96110 96111 96112 96113 96114 96115 96116 96117 96118 96119 96120 96121 96122 96123 96124 96125 96126 96127 96128 96129 96130 96132 96133 96134 96135 96136 96137 96140 96141 96142 96143 96145 96146 96148 96150 96151 96152 96154 96155 96156 96157 96158 96160 96161 96162 80001 80002 80003 80004 80005 80006 80007 80010 80011 80012 80013 80014 80015 2.0 7.0 1.0 7.0 10.0 10.6 7.0 10.0 10.6 10.3 10.4 10.6 5.0 10.6 10.4 8.0 10.6 10.3 8.0 10.4 10.0 10.5 10.4 7.0 10.0 10.4 10.4 10.4 8.0 8.0 7.0 8.0 10.0 10.6 10.5 7.0 8.0 10.0 4.2 5.0 5.0 4.2 4.2 2.0 4.2 4.0 4.0 4.0 4.0 4.0 4.0 4.0 4.0 7.3 7.3 5.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 80016 80017 80018 80019 80020 80021 80022 80024 80025 80026 80027 80028 80030 80031 80033 80034 80035 80036 80037 80038 80040 80041 80042 80044 80045 80046 80047 80101 80102 80103 80104 80105 80106 80107 80108 80109 80110 80111 80112 80113 80116 80117 80118 80120 80121 80122 80123 80124 80125 80126 80127 80128 80129 80130 80131 80132 80133 80134 80135 80136 80137 80138 80150 80151 80154 80155 80160 80161 80162 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.1 2.1 2.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.4 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70069 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO Zip code RUCA level 80163 80165 80166 80201 80202 80203 80204 80205 80206 80207 80208 80209 80210 80211 80212 80214 80215 80216 80217 80218 80219 80220 80221 80222 80223 80224 80225 80226 80227 80228 80229 80230 80231 80232 80233 80234 80235 80236 80237 80238 80239 80241 80243 80244 80246 80247 80248 80249 80250 80251 80252 80255 80256 80257 80259 80260 80261 80262 80263 80264 80265 80266 80270 80271 80273 80274 80275 80279 80280 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00447 Fmt 4701 RUCA level 80281 80285 80290 80291 80292 80293 80294 80295 80299 80301 80302 80303 80304 80305 80306 80307 80308 80309 80310 80314 80321 80322 80323 80328 80329 80401 80402 80403 80419 80420 80421 80422 80423 80424 80425 80426 80427 80428 80429 80430 80432 80433 80434 80435 80436 80437 80438 80439 80440 80442 80443 80444 80446 80447 80448 80449 80451 80452 80453 80454 80455 80456 80457 80459 80461 80463 80465 80466 80467 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.3 2.0 10.1 5.0 7.4 2.0 5.0 10.1 8.0 7.4 10.0 10.3 2.0 10.0 4.0 10.4 2.0 10.4 2.0 10.3 10.0 4.0 10.4 10.0 10.0 2.0 10.0 10.0 10.4 1.0 1.0 2.0 10.0 2.0 10.5 7.4 5.0 1.0 2.1 8.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 80468 80469 80470 80471 80473 80474 80475 80476 80477 80478 80479 80480 80481 80482 80483 80487 80488 80497 80498 80501 80502 80503 80504 80510 80511 80512 80513 80514 80515 80516 80517 80520 80521 80522 80523 80524 80525 80526 80527 80528 80530 80532 80533 80534 80535 80536 80537 80538 80539 80540 80541 80542 80543 80544 80545 80546 80547 80549 80550 80551 80553 80601 80602 80603 80610 80611 80612 80614 80615 10.5 8.0 2.0 1.0 10.0 1.0 2.0 10.4 7.0 10.0 8.0 10.0 2.0 10.0 8.0 7.0 7.0 4.0 4.0 1.0 1.0 1.0 1.0 2.0 7.3 2.0 1.0 3.0 9.1 2.1 7.3 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 3.0 9.1 1.0 9.1 1.0 2.0 1.0 1.0 1.0 2.0 1.0 9.1 9.1 1.0 2.0 2.0 1.0 2.0 2.0 2.0 1.0 2.0 1.0 2.0 2.1 10.4 10.4 1.0 2.0 70070 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO Zip code RUCA level 80620 80621 80622 80623 80624 80631 80632 80633 80634 80638 80639 80640 80642 80643 80644 80645 80646 80648 80649 80650 80651 80652 80653 80654 80701 80705 80720 80721 80722 80723 80726 80727 80728 80729 80731 80732 80733 80734 80735 80736 80737 80740 80741 80742 80743 80744 80745 80746 80747 80749 80750 80751 80754 80755 80757 80758 80759 80801 80802 80804 80805 80807 80808 80809 80810 80812 80813 80814 80815 1.0 2.0 2.0 3.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 2.0 1.0 1.0 10.4 5.0 2.1 3.0 2.0 5.0 10.5 4.0 4.0 10.0 10.0 5.0 7.2 10.5 7.0 10.2 10.4 10.0 10.4 10.3 10.0 10.0 5.0 10.0 10.6 5.0 10.4 10.6 10.0 10.5 10.0 10.5 10.0 5.0 4.0 10.4 10.0 10.6 10.0 7.0 10.6 10.0 10.0 7.0 7.0 2.0 2.0 10.0 10.6 10.0 2.0 10.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00448 Fmt 4701 RUCA level 80816 80817 80818 80819 80820 80821 80822 80823 80824 80825 80826 80827 80828 80829 80830 80831 80832 80833 80834 80835 80836 80840 80841 80860 80861 80862 80863 80864 80866 80901 80903 80904 80905 80906 80907 80908 80909 80910 80911 80912 80913 80914 80915 80916 80917 80918 80919 80920 80921 80922 80925 80926 80928 80929 80930 80931 80932 80933 80934 80935 80936 80937 80940 80941 80942 80943 80944 80945 80946 2.0 1.0 10.0 2.0 10.0 10.0 7.0 10.0 7.0 10.0 10.0 10.0 10.0 1.0 10.4 2.0 2.0 2.0 10.0 10.4 10.6 1.0 1.0 2.0 10.6 10.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 80947 80949 80950 80960 80962 80970 80977 80995 80997 81001 81002 81003 81004 81005 81006 81007 81008 81009 81010 81011 81012 81019 81020 81021 81022 81023 81024 81025 81027 81029 81030 81033 81034 81036 81038 81039 81040 81041 81043 81044 81045 81046 81047 81049 81050 81052 81054 81055 81057 81058 81059 81062 81063 81064 81067 81069 81071 81073 81076 81077 81081 81082 81084 81087 81089 81090 81091 81092 81101 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 7.0 10.0 2.0 2.0 7.0 2.0 10.6 10.0 7.0 10.6 10.6 10.0 7.0 10.4 10.3 10.3 10.6 7.0 10.0 7.0 10.6 10.6 7.0 7.0 7.0 10.6 7.0 10.6 10.6 10.6 10.6 10.0 7.0 2.0 10.0 10.0 10.6 7.0 10.6 7.0 10.0 10.0 7.0 10.0 8.0 8.0 7.0 70071 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO Zip code RUCA level 81102 81120 81121 81122 81123 81124 81125 81126 81127 81128 81129 81130 81131 81132 81133 81134 81135 81136 81137 81138 81140 81141 81143 81144 81146 81147 81148 81149 81151 81152 81153 81154 81155 81157 81201 81210 81211 81212 81215 81220 81221 81222 81223 81224 81225 81226 81227 81228 81230 81231 81232 81233 81235 81236 81237 81239 81240 81241 81242 81243 81244 81246 81247 81248 81251 81252 81253 81290 81301 7.0 10.6 10.0 5.0 10.6 10.3 10.0 10.0 10.0 10.0 10.6 10.0 10.0 10.6 10.6 10.0 7.0 8.0 10.5 10.0 10.3 10.6 10.0 7.0 8.0 10.0 10.6 10.0 10.6 10.0 10.0 10.0 10.0 10.0 7.0 8.0 7.0 4.0 4.0 10.6 5.0 10.6 10.6 10.0 10.0 5.0 7.0 7.4 7.0 8.0 10.6 10.6 10.0 8.0 8.0 8.0 3.0 8.0 7.0 10.6 5.0 4.0 8.0 10.0 7.4 10.0 10.0 5.0 4.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO CO PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00449 Fmt 4701 RUCA level 81302 81303 81320 81321 81323 81324 81325 81326 81327 81328 81329 81330 81331 81332 81334 81335 81401 81402 81410 81411 81413 81414 81415 81416 81418 81419 81420 81422 81423 81424 81425 81426 81427 81428 81429 81430 81431 81432 81433 81434 81435 81501 81502 81503 81504 81505 81506 81520 81521 81522 81523 81524 81525 81526 81527 81601 81602 81610 81611 81612 81615 81620 81621 81623 81624 81625 81626 81630 81631 4.0 5.0 10.6 7.0 10.3 10.6 10.0 5.0 8.0 10.6 5.0 10.6 8.0 10.6 10.3 8.0 4.0 4.0 10.6 10.0 10.6 10.6 10.6 7.4 10.6 10.6 10.6 10.0 10.0 10.0 5.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.6 10.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 2.0 2.0 1.0 2.0 7.0 7.0 10.0 7.0 7.0 10.3 4.0 8.0 7.0 2.0 7.0 7.0 2.0 4.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State CO .................................... CO .................................... CO .................................... CO .................................... CO .................................... CO .................................... CO .................................... CO .................................... CO .................................... CO .................................... CO .................................... CO .................................... CO .................................... CO .................................... CO .................................... CO .................................... CO .................................... CO .................................... CO .................................... CO .................................... CO .................................... CO .................................... CO .................................... CO .................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... CT ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 81632 81633 81635 81636 81637 81638 81639 81640 81641 81642 81643 81645 81646 81647 81648 81649 81650 81652 81653 81654 81655 81656 81657 81658 06001 06002 06006 06010 06011 06013 06016 06018 06019 06020 06021 06022 06023 06024 06025 06026 06027 06028 06029 06030 06031 06032 06033 06034 06035 06037 06039 06040 06041 06042 06043 06045 06050 06051 06052 06053 06057 06058 06059 06060 06061 06062 06063 06064 06065 4.0 10.0 7.0 7.0 5.0 8.0 8.0 10.0 10.0 8.0 2.0 4.0 2.0 8.0 10.0 4.0 7.0 8.0 8.0 10.3 4.0 8.0 4.0 4.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.0 2.0 2.0 3.0 1.0 1.0 10.0 1.0 1.0 2.0 1.0 1.0 1.0 10.0 1.0 1.0 1.0 1.0 1.0 10.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 10.5 2.0 1.0 2.0 1.0 2.0 1.0 2.0 70072 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT Zip code RUCA level 06066 06067 06068 06069 06070 06071 06072 06073 06074 06075 06076 06077 06078 06079 06080 06081 06082 06083 06084 06085 06087 06088 06089 06090 06091 06092 06093 06094 06095 06096 06098 06101 06102 06103 06104 06105 06106 06107 06108 06109 06110 06111 06112 06114 06115 06117 06118 06119 06120 06123 06126 06127 06128 06129 06131 06132 06133 06134 06137 06138 06140 06141 06142 06143 06144 06145 06146 06147 06150 1.0 1.0 10.0 10.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 1.0 10.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 9.1 1.0 1.0 9.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00450 Fmt 4701 RUCA level 06151 06152 06153 06154 06155 06156 06160 06161 06167 06176 06180 06183 06199 06226 06230 06231 06232 06233 06234 06235 06237 06238 06239 06241 06242 06243 06244 06245 06246 06247 06248 06249 06250 06251 06254 06255 06256 06258 06259 06260 06262 06263 06264 06265 06266 06267 06268 06269 06277 06278 06279 06280 06281 06282 06320 06330 06331 06332 06333 06334 06335 06336 06338 06339 06340 06349 06350 06351 06353 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 10.5 2.0 2.0 6.1 4.2 6.1 2.0 4.1 4.2 6.1 3.0 6.1 3.0 1.0 1.0 6.1 2.0 3.0 4.0 4.1 2.0 1.0 4.0 10.5 10.5 1.0 1.0 6.1 6.1 4.1 4.0 10.5 4.1 4.1 2.0 3.0 4.1 4.0 3.0 3.0 1.0 1.0 2.0 2.0 1.0 2.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 06354 06355 06357 06359 06360 06365 06370 06371 06372 06373 06374 06375 06376 06377 06378 06379 06380 06382 06383 06384 06385 06386 06387 06388 06389 06401 06403 06404 06405 06408 06409 06410 06411 06412 06413 06414 06415 06416 06417 06418 06419 06420 06422 06423 06424 06426 06430 06431 06432 06436 06437 06438 06439 06440 06441 06442 06443 06444 06447 06450 06451 06454 06455 06456 06457 06459 06460 06461 06467 4.2 1.0 1.0 2.0 1.0 2.0 1.0 1.0 1.0 6.1 2.0 1.0 1.0 6.1 1.0 4.1 1.0 1.0 1.0 2.0 1.0 1.0 2.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 1.0 1.0 2.1 2.1 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 70073 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT Zip code RUCA level 06468 06469 06470 06471 06472 06473 06474 06475 06477 06478 06479 06480 06481 06482 06483 06484 06487 06488 06489 06490 06491 06492 06493 06494 06495 06497 06498 06501 06502 06503 06504 06505 06506 06507 06508 06509 06510 06511 06512 06513 06514 06515 06516 06517 06518 06519 06520 06521 06524 06525 06530 06531 06532 06533 06534 06535 06536 06537 06538 06540 06601 06602 06604 06605 06606 06607 06608 06610 06611 1.0 2.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00451 Fmt 4701 RUCA level 06612 06614 06615 06650 06673 06699 06701 06702 06703 06704 06705 06706 06708 06710 06712 06716 06720 06721 06722 06723 06724 06725 06726 06749 06750 06751 06752 06753 06754 06755 06756 06757 06758 06759 06762 06763 06770 06776 06777 06778 06779 06781 06782 06783 06784 06785 06786 06787 06790 06791 06792 06793 06794 06795 06796 06798 06801 06804 06807 06810 06811 06812 06813 06814 06816 06817 06820 06824 06825 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 6.0 3.0 2.1 3.0 3.0 1.0 6.0 10.4 3.0 4.2 1.0 3.0 1.0 1.0 10.4 4.2 1.0 1.0 1.0 3.0 2.1 10.4 1.0 1.0 4.2 4.2 4.2 10.4 10.4 1.0 10.4 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT CT DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 06828 06829 06830 06831 06832 06836 06838 06840 06842 06850 06851 06852 06853 06854 06855 06856 06857 06858 06859 06860 06870 06875 06876 06877 06878 06879 06880 06881 06883 06888 06889 06890 06896 06897 06901 06902 06903 06904 06905 06906 06907 06910 06911 06912 06913 06914 06920 06921 06922 06925 06926 06927 06928 20001 20002 20003 20004 20005 20006 20007 20008 20009 20010 20011 20012 20013 20015 20016 20017 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70074 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC Zip code RUCA level 20018 20019 20020 20022 20023 20024 20026 20027 20029 20030 20032 20033 20035 20036 20037 20038 20039 20040 20041 20042 20043 20044 20045 20046 20047 20049 20050 20051 20052 20053 20055 20056 20057 20058 20059 20060 20061 20062 20063 20064 20065 20066 20067 20068 20069 20070 20071 20073 20074 20075 20076 20077 20078 20080 20081 20082 20088 20090 20091 20097 20098 20099 20201 20202 20203 20204 20206 20207 20208 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00452 Fmt 4701 RUCA level 20210 20211 20212 20213 20214 20215 20216 20217 20218 20219 20220 20221 20222 20223 20224 20226 20227 20228 20229 20230 20231 20232 20233 20235 20237 20238 20239 20240 20241 20242 20244 20245 20250 20251 20254 20260 20261 20262 20265 20266 20268 20270 20277 20289 20299 20301 20303 20306 20307 20310 20314 20315 20317 20318 20319 20330 20332 20336 20337 20338 20340 20350 20355 20370 20372 20373 20374 20375 20376 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 20380 20388 20389 20390 20391 20392 20393 20394 20395 20398 20401 20402 20403 20404 20405 20406 20407 20408 20409 20410 20411 20412 20413 20414 20415 20416 20418 20419 20420 20421 20422 20423 20424 20425 20426 20427 20428 20429 20431 20433 20434 20435 20436 20437 20439 20440 20441 20442 20444 20447 20451 20453 20456 20460 20463 20468 20469 20470 20472 20500 20501 20502 20503 20504 20505 20506 20507 20508 20509 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70075 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DC DE DE DE Zip code RUCA level 20510 20511 20515 20520 20521 20522 20523 20524 20525 20526 20527 20528 20529 20530 20531 20532 20533 20534 20535 20536 20537 20538 20539 20540 20541 20542 20543 20544 20546 20547 20548 20549 20550 20551 20552 20553 20554 20555 20557 20558 20559 20560 20565 20566 20570 20571 20572 20573 20575 20576 20577 20578 20579 20580 20581 20585 20586 20590 20591 20593 20594 20597 20599 56901 56915 56920 19701 19702 19703 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00453 Fmt 4701 RUCA level 19706 19707 19708 19709 19710 19711 19712 19713 19714 19715 19716 19717 19718 19720 19721 19725 19726 19730 19731 19732 19733 19734 19735 19736 19801 19802 19803 19804 19805 19806 19807 19808 19809 19810 19850 19880 19884 19885 19886 19887 19889 19890 19891 19892 19893 19894 19895 19896 19897 19898 19899 19901 19902 19903 19904 19905 19906 19930 19931 19933 19934 19936 19938 19939 19940 19941 19943 19944 19945 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.4 4.0 10.5 1.0 1.0 2.1 7.4 1.0 6.0 2.0 7.4 7.2 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE DE FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 19946 19947 19950 19951 19952 19953 19954 19955 19956 19958 19960 19961 19962 19963 19964 19966 19967 19968 19969 19970 19971 19973 19975 19977 19979 19980 32003 32004 32006 32007 32008 32009 32011 32013 32024 32025 32026 32030 32033 32034 32035 32038 32040 32041 32042 32043 32044 32046 32050 32052 32053 32054 32055 32056 32058 32059 32060 32061 32062 32063 32064 32065 32066 32067 32068 32071 32072 32073 32079 2.0 7.4 10.5 5.0 2.0 2.0 2.0 2.1 4.0 4.0 4.2 1.0 1.0 4.2 2.0 5.0 7.4 5.0 4.0 7.4 4.0 4.0 4.2 2.1 1.0 2.0 1.0 1.0 1.0 4.0 10.5 2.0 2.0 10.0 5.0 4.0 9.0 1.0 2.1 4.2 4.2 5.2 7.1 2.0 2.0 1.0 2.0 2.0 1.0 7.0 10.4 7.3 4.0 4.0 8.3 10.6 7.4 4.0 6.0 7.1 7.0 1.0 10.0 1.0 1.0 10.5 8.1 1.0 1.0 70076 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL Zip code RUCA level 32080 32082 32083 32084 32085 32086 32087 32091 32092 32094 32095 32096 32097 32099 32102 32105 32110 32111 32112 32113 32114 32115 32116 32117 32118 32119 32120 32121 32122 32123 32124 32125 32126 32127 32128 32129 32130 32131 32132 32133 32134 32135 32136 32137 32138 32139 32140 32141 32142 32145 32147 32148 32149 32151 32157 32158 32159 32160 32162 32164 32168 32169 32170 32173 32174 32175 32176 32177 32178 1.0 1.0 9.0 1.0 1.0 1.0 8.1 7.3 1.0 6.0 1.0 5.0 2.0 1.0 3.0 2.0 4.1 1.0 7.4 2.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.1 4.0 1.0 2.0 2.0 1.0 1.0 4.1 5.0 7.4 5.0 1.0 1.0 2.1 5.0 5.0 5.0 4.1 6.0 2.0 2.0 2.0 2.0 4.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 4.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00454 Fmt 4701 RUCA level 32179 32180 32181 32182 32183 32185 32187 32189 32190 32192 32193 32195 32198 32201 32202 32203 32204 32205 32206 32207 32208 32209 32210 32211 32212 32214 32215 32216 32217 32218 32219 32220 32221 32222 32223 32224 32225 32226 32227 32228 32229 32230 32231 32232 32233 32234 32235 32236 32237 32238 32239 32240 32241 32244 32245 32246 32247 32250 32254 32255 32256 32257 32258 32259 32260 32266 32267 32276 32277 2.0 2.0 6.0 2.0 2.0 5.0 4.0 5.0 3.0 2.0 7.4 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 32290 32301 32302 32303 32304 32305 32306 32307 32308 32309 32310 32311 32312 32313 32314 32315 32316 32317 32318 32320 32321 32322 32323 32324 32326 32327 32328 32329 32330 32331 32332 32333 32334 32335 32336 32337 32340 32341 32343 32344 32345 32346 32347 32348 32350 32351 32352 32353 32355 32356 32357 32358 32359 32360 32361 32362 32395 32399 32401 32402 32403 32404 32405 32406 32407 32408 32409 32410 32411 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.0 10.4 10.6 10.6 7.3 2.0 2.0 10.3 7.0 4.1 10.0 2.0 2.0 10.1 10.1 2.0 1.0 7.0 7.0 2.0 10.1 10.1 2.0 7.0 7.0 10.4 4.1 2.0 4.1 2.0 8.0 10.0 2.0 8.0 10.1 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70077 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL Zip code RUCA level 32412 32413 32417 32420 32421 32422 32423 32424 32425 32426 32427 32428 32430 32431 32432 32433 32434 32435 32437 32438 32439 32440 32442 32443 32444 32445 32446 32447 32448 32449 32452 32454 32455 32456 32457 32459 32460 32461 32462 32463 32464 32465 32466 32501 32502 32503 32504 32505 32506 32507 32508 32509 32511 32512 32513 32514 32516 32520 32521 32522 32523 32524 32526 32530 32531 32533 32534 32535 32536 1.0 1.0 1.0 8.0 10.6 8.0 9.0 7.0 9.0 9.0 9.0 7.0 10.6 10.6 8.0 8.0 8.0 7.0 2.0 2.0 2.0 10.6 8.0 8.0 1.0 9.0 8.0 8.0 7.0 10.6 9.0 10.4 10.5 7.3 7.3 10.4 10.6 1.0 2.0 7.0 10.0 10.4 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 5.1 1.0 1.0 9.1 2.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00455 Fmt 4701 RUCA level 32537 32538 32539 32540 32541 32542 32544 32547 32548 32549 32550 32559 32560 32561 32562 32563 32564 32565 32566 32567 32568 32569 32570 32571 32572 32573 32574 32575 32576 32577 32578 32579 32580 32581 32582 32583 32588 32589 32590 32591 32592 32593 32594 32595 32596 32597 32598 32601 32602 32603 32604 32605 32606 32607 32608 32609 32610 32611 32612 32613 32614 32615 32616 32617 32618 32619 32621 32622 32625 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.4 1.0 1.0 1.0 1.0 1.0 5.1 2.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 2.0 10.4 2.0 2.0 10.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 32626 32627 32628 32631 32633 32634 32635 32639 32640 32641 32643 32644 32648 32653 32654 32655 32656 32658 32662 32663 32664 32666 32667 32668 32669 32680 32681 32683 32686 32692 32693 32694 32696 32697 32701 32702 32703 32704 32706 32707 32708 32709 32710 32712 32713 32714 32715 32716 32718 32719 32720 32721 32722 32723 32724 32725 32726 32727 32728 32730 32732 32733 32735 32736 32738 32739 32744 32745 32746 10.0 1.0 7.0 2.0 2.0 2.0 1.0 10.0 2.0 1.0 2.0 10.0 10.6 1.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 3.0 2.0 7.0 2.0 10.0 2.0 7.0 10.4 2.0 2.0 7.3 1.0 1.0 1.0 1.0 1.1 1.0 1.0 1.0 1.0 1.0 1.1 1.0 1.0 1.0 1.0 1.0 1.1 1.1 1.1 1.1 1.1 1.1 1.0 1.0 1.1 1.0 2.0 1.0 1.0 3.0 1.1 1.1 1.1 1.0 1.0 70078 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL Zip code RUCA level 32747 32750 32751 32752 32753 32754 32756 32757 32759 32762 32763 32764 32765 32766 32767 32768 32771 32772 32773 32774 32775 32776 32777 32778 32779 32780 32781 32782 32783 32784 32789 32790 32791 32792 32793 32794 32795 32796 32798 32799 32801 32802 32803 32804 32805 32806 32807 32808 32809 32810 32811 32812 32814 32815 32816 32817 32818 32819 32820 32821 32822 32824 32825 32826 32827 32828 32829 32830 32831 1.0 1.0 1.0 1.0 1.1 1.0 1.0 1.0 1.0 1.0 1.1 2.0 1.0 1.0 3.0 1.0 1.0 1.0 1.0 1.1 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00456 Fmt 4701 RUCA level 32832 32833 32834 32835 32836 32837 32839 32853 32854 32855 32856 32857 32858 32859 32860 32861 32862 32867 32868 32869 32872 32877 32878 32885 32886 32887 32890 32891 32893 32896 32897 32898 32899 32901 32902 32903 32904 32905 32906 32907 32908 32909 32910 32911 32912 32919 32920 32922 32923 32924 32925 32926 32927 32931 32932 32934 32935 32936 32937 32940 32941 32948 32949 32950 32951 32952 32953 32954 32955 2.0 2.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 32956 32957 32958 32959 32960 32961 32962 32963 32964 32965 32966 32967 32968 32969 32970 32971 32976 32978 33001 33002 33004 33008 33009 33010 33011 33012 33013 33014 33015 33016 33017 33018 33019 33020 33021 33022 33023 33024 33025 33026 33027 33028 33029 33030 33031 33032 33033 33034 33035 33036 33037 33039 33040 33041 33042 33043 33044 33045 33050 33051 33052 33054 33055 33056 33060 33061 33062 33063 33064 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 4.0 4.0 2.0 4.0 4.0 7.2 7.2 7.2 4.0 7.0 7.0 7.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70079 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL Zip code RUCA level 33065 33066 33067 33068 33069 33070 33071 33072 33073 33074 33075 33076 33077 33081 33082 33083 33084 33090 33092 33093 33097 33101 33102 33107 33109 33110 33111 33112 33114 33116 33119 33121 33122 33124 33125 33126 33127 33128 33129 33130 33131 33132 33133 33134 33135 33136 33137 33138 33139 33140 33141 33142 33143 33144 33145 33146 33147 33148 33149 33150 33151 33152 33153 33154 33155 33156 33157 33158 33159 1.0 1.0 1.0 1.0 1.0 4.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00457 Fmt 4701 RUCA level 33160 33161 33162 33163 33164 33165 33166 33167 33168 33169 33170 33172 33173 33174 33175 33176 33177 33178 33179 33180 33181 33182 33183 33184 33185 33186 33187 33188 33189 33190 33192 33193 33194 33195 33196 33197 33199 33231 33233 33234 33238 33239 33242 33243 33245 33247 33255 33256 33257 33261 33265 33266 33269 33280 33283 33296 33299 33301 33302 33303 33304 33305 33306 33307 33308 33309 33310 33311 33312 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 33313 33314 33315 33316 33317 33318 33319 33320 33321 33322 33323 33324 33325 33326 33327 33328 33329 33330 33331 33332 33334 33335 33336 33337 33338 33339 33340 33345 33346 33348 33349 33351 33355 33359 33388 33394 33401 33402 33403 33404 33405 33406 33407 33408 33409 33410 33411 33412 33413 33414 33415 33416 33417 33418 33419 33420 33421 33422 33424 33425 33426 33427 33428 33429 33430 33431 33432 33433 33434 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.1 1.0 1.0 1.0 1.0 70080 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL Zip code RUCA level 33435 33436 33437 33438 33439 33440 33441 33442 33443 33444 33445 33446 33447 33448 33454 33455 33458 33459 33460 33461 33462 33463 33464 33465 33466 33467 33468 33469 33470 33471 33474 33475 33476 33477 33478 33480 33481 33482 33483 33484 33486 33487 33488 33493 33496 33497 33498 33499 33503 33508 33509 33510 33511 33513 33514 33521 33523 33524 33525 33526 33527 33530 33534 33537 33538 33539 33540 33541 33542 1.0 1.0 1.0 2.0 2.0 4.2 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.4 1.0 1.0 2.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.1 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 9.0 10.4 7.3 2.1 1.1 1.1 1.1 1.0 1.0 1.0 2.1 9.0 1.1 1.1 1.1 1.1 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00458 Fmt 4701 RUCA level 33543 33544 33547 33548 33549 33550 33556 33558 33559 33563 33564 33565 33566 33567 33568 33569 33570 33571 33572 33573 33574 33575 33576 33583 33584 33585 33586 33587 33592 33593 33594 33595 33597 33598 33601 33602 33603 33604 33605 33606 33607 33608 33609 33610 33611 33612 33613 33614 33615 33616 33617 33618 33619 33620 33621 33622 33623 33624 33625 33626 33629 33630 33631 33633 33634 33635 33637 33647 33650 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 2.0 2.0 2.0 2.0 1.0 1.0 10.4 2.0 1.0 1.0 2.1 1.0 1.0 10.4 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 33651 33655 33660 33661 33662 33663 33664 33672 33673 33674 33675 33677 33679 33680 33681 33682 33684 33685 33686 33687 33688 33689 33690 33694 33697 33701 33702 33703 33704 33705 33706 33707 33708 33709 33710 33711 33712 33713 33714 33715 33716 33728 33729 33730 33731 33732 33733 33734 33736 33737 33738 33740 33741 33742 33743 33744 33747 33755 33756 33757 33758 33759 33760 33761 33762 33763 33764 33765 33766 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70081 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL Zip code RUCA level 33767 33769 33770 33771 33772 33773 33774 33775 33776 33777 33778 33779 33780 33781 33782 33784 33785 33786 33801 33802 33803 33804 33805 33806 33807 33809 33810 33811 33813 33815 33820 33823 33825 33826 33827 33830 33831 33834 33835 33836 33837 33838 33839 33840 33841 33843 33844 33845 33846 33847 33848 33849 33850 33851 33852 33853 33854 33855 33856 33857 33858 33859 33860 33862 33863 33865 33867 33868 33870 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.2 1.0 4.0 4.0 2.0 4.2 4.2 4.0 1.0 2.0 2.0 1.0 1.0 1.0 9.2 7.3 1.0 1.0 1.0 4.2 2.1 1.0 1.0 1.0 4.0 1.0 1.0 1.0 1.0 5.0 2.0 2.1 1.0 4.0 1.0 4.0 1.0 2.0 4.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00459 Fmt 4701 RUCA level 33871 33872 33873 33875 33876 33877 33880 33881 33882 33883 33884 33885 33888 33890 33896 33897 33898 33901 33902 33903 33904 33905 33906 33907 33908 33909 33910 33911 33912 33913 33914 33915 33916 33917 33918 33919 33920 33921 33922 33924 33927 33928 33930 33931 33932 33935 33936 33938 33944 33945 33946 33947 33948 33949 33950 33951 33952 33953 33954 33955 33956 33957 33960 33965 33970 33971 33972 33975 33980 4.0 4.0 4.0 4.0 5.0 2.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.2 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 2.0 2.0 1.0 1.0 4.2 1.0 1.0 4.2 2.0 1.0 7.4 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 4.0 1.0 2.0 2.0 2.0 4.2 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 33981 33982 33983 33990 33991 33993 33994 34101 34102 34103 34104 34105 34106 34107 34108 34109 34110 34112 34113 34114 34116 34117 34119 34120 34133 34134 34135 34136 34137 34138 34139 34140 34141 34142 34143 34145 34146 34201 34202 34203 34204 34205 34206 34207 34208 34209 34210 34211 34212 34215 34216 34217 34218 34219 34220 34221 34222 34223 34224 34228 34229 34230 34231 34232 34233 34234 34235 34236 34237 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 2.0 4.1 4.1 4.1 4.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70082 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL Zip code RUCA level 34238 34239 34240 34241 34242 34243 34250 34251 34260 34264 34265 34266 34267 34268 34269 34270 34272 34274 34275 34276 34277 34278 34280 34281 34282 34284 34285 34286 34287 34288 34289 34292 34293 34295 34420 34421 34423 34428 34429 34430 34431 34432 34433 34434 34436 34442 34445 34446 34447 34448 34449 34450 34451 34452 34453 34460 34461 34464 34465 34470 34471 34472 34473 34474 34475 34476 34477 34478 34479 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 4.0 4.0 4.0 4.0 5.2 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 4.0 10.5 4.0 2.0 2.0 2.0 10.6 6.1 5.0 4.0 4.0 4.0 4.0 4.0 10.0 4.0 4.0 4.0 4.0 4.0 4.0 4.0 4.0 1.0 1.0 1.0 2.0 1.0 1.0 2.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00460 Fmt 4701 RUCA level 34480 34481 34482 34483 34484 34487 34488 34489 34491 34492 34498 34601 34602 34603 34604 34605 34606 34607 34608 34609 34610 34611 34613 34614 34636 34637 34638 34639 34652 34653 34654 34655 34656 34660 34661 34667 34668 34669 34673 34674 34677 34679 34680 34681 34682 34683 34684 34685 34688 34689 34690 34691 34692 34695 34697 34698 34705 34711 34712 34713 34714 34715 34729 34731 34734 34736 34737 34739 34740 1.0 2.0 1.0 1.0 9.0 4.0 2.0 2.0 2.0 2.0 10.0 1.0 2.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 2.0 2.0 2.0 1.0 1.0 2.0 1.0 2.1 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FL FM FM FM FM GA GA GA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 34741 34742 34743 34744 34745 34746 34747 34748 34749 34753 34755 34756 34758 34759 34760 34761 34762 34769 34770 34771 34772 34773 34777 34778 34785 34786 34787 34788 34789 34797 34945 34946 34947 34948 34949 34950 34951 34952 34953 34954 34956 34957 34958 34972 34973 34974 34979 34981 34982 34983 34984 34985 34986 34987 34988 34990 34991 34992 34994 34995 34996 34997 96941 96942 96943 96944 30002 30003 30004 2.0 2.0 2.0 2.0 2.0 2.0 2.0 1.0 1.0 2.0 2.0 2.0 2.1 2.1 1.0 1.0 1.0 2.0 2.0 2.1 2.0 2.1 1.0 1.0 7.3 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 4.0 4.0 4.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 R R R R 1.0 1.0 1.0 70083 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA Zip code RUCA level 30005 30006 30007 30008 30009 30010 30011 30012 30013 30014 30015 30016 30017 30018 30019 30021 30022 30023 30024 30025 30026 30028 30029 30030 30031 30032 30033 30034 30035 30036 30037 30038 30039 30040 30041 30042 30043 30044 30045 30046 30047 30048 30049 30052 30054 30055 30056 30058 30060 30061 30062 30063 30064 30065 30066 30067 30068 30069 30070 30071 30072 30074 30075 30076 30077 30078 30079 30080 30081 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00461 Fmt 4701 RUCA level 30082 30083 30084 30085 30086 30087 30088 30090 30091 30092 30093 30094 30095 30096 30097 30098 30099 30101 30102 30103 30104 30105 30106 30107 30108 30109 30110 30111 30112 30113 30114 30115 30116 30117 30118 30119 30120 30121 30122 30123 30124 30125 30126 30127 30129 30132 30133 30134 30135 30137 30138 30139 30140 30141 30142 30143 30144 30145 30146 30147 30148 30149 30150 30151 30152 30153 30154 30156 30157 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 5.0 9.2 1.0 1.0 2.0 5.0 4.2 3.0 1.0 4.2 3.0 1.0 1.0 4.2 4.2 4.2 4.2 4.1 4.1 1.0 4.1 2.0 4.2 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 4.2 5.0 3.0 1.0 1.0 2.0 1.0 4.1 1.0 1.0 2.0 1.0 4.2 2.0 1.0 7.3 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 30160 30161 30162 30163 30164 30165 30168 30169 30170 30171 30172 30173 30175 30176 30177 30178 30179 30180 30182 30183 30184 30185 30187 30188 30189 30204 30205 30206 30212 30213 30214 30215 30216 30217 30218 30219 30220 30222 30223 30224 30228 30229 30230 30232 30233 30234 30236 30237 30238 30240 30241 30248 30250 30251 30252 30253 30256 30257 30258 30259 30260 30261 30263 30264 30265 30266 30268 30269 30270 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 5.2 5.1 1.0 1.0 2.0 10.0 2.0 4.1 2.0 2.0 10.4 2.0 5.1 2.0 2.0 1.0 1.0 7.1 2.0 2.0 1.0 1.0 1.0 1.0 2.0 6.0 2.0 6.0 5.1 10.5 1.0 1.0 1.0 2.0 5.0 1.0 2.0 2.0 1.0 1.0 1.0 4.0 4.0 2.0 1.0 5.2 1.0 1.0 2.0 2.0 2.0 5.1 1.0 4.0 4.1 4.1 1.0 1.0 2.0 1.0 1.0 70084 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA Zip code RUCA level 30271 30272 30273 30274 30275 30276 30277 30281 30284 30285 30286 30287 30288 30289 30290 30291 30292 30293 30294 30295 30296 30297 30298 30301 30302 30303 30304 30305 30306 30307 30308 30309 30310 30311 30312 30313 30314 30315 30316 30317 30318 30319 30320 30321 30322 30324 30325 30326 30327 30328 30329 30330 30331 30332 30333 30334 30336 30337 30338 30339 30340 30341 30342 30343 30344 30345 30346 30347 30348 4.1 1.0 1.0 1.0 4.1 2.0 1.0 1.0 1.0 5.2 4.2 1.0 1.0 2.0 1.0 1.0 2.0 10.4 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00462 Fmt 4701 RUCA level 30349 30350 30353 30354 30355 30356 30357 30358 30359 30360 30361 30362 30363 30364 30366 30368 30369 30370 30371 30374 30375 30376 30377 30378 30379 30380 30384 30385 30386 30387 30388 30389 30390 30392 30394 30396 30398 30399 30401 30410 30411 30412 30413 30414 30415 30417 30420 30421 30423 30424 30425 30426 30427 30428 30429 30434 30436 30438 30439 30441 30442 30445 30446 30447 30448 30449 30450 30451 30452 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.0 10.6 10.6 9.0 7.0 7.0 5.0 7.0 10.6 10.6 7.0 8.0 10.6 10.6 7.3 10.6 7.0 7.0 8.0 10.0 7.0 9.0 7.0 10.6 9.2 5.0 7.0 9.2 5.0 7.0 5.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 30453 30454 30455 30456 30457 30458 30459 30460 30461 30464 30467 30470 30471 30473 30474 30475 30477 30499 30501 30502 30503 30504 30506 30507 30510 30511 30512 30513 30514 30515 30516 30517 30518 30519 30520 30521 30522 30523 30525 30527 30528 30529 30530 30531 30533 30534 30535 30536 30537 30538 30539 30540 30541 30542 30543 30544 30545 30546 30547 30548 30549 30552 30553 30554 30555 30557 30558 30559 30560 10.0 4.0 9.2 10.6 7.4 4.0 4.0 4.0 4.0 10.6 8.0 8.0 10.6 9.0 7.0 7.0 10.6 10.0 1.0 1.0 1.0 1.0 1.0 1.0 4.2 5.2 10.0 10.4 10.0 1.0 10.6 2.0 1.0 1.0 7.0 10.5 8.0 6.0 10.0 2.1 10.4 7.3 7.1 4.2 9.1 2.0 4.2 4.2 10.0 5.0 7.3 8.0 10.0 1.0 1.0 4.2 10.0 10.0 10.4 2.0 10.4 10.0 10.5 2.1 10.0 5.0 3.0 10.0 10.0 70085 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA Zip code RUCA level 30562 30563 30564 30565 30566 30567 30568 30571 30572 30573 30575 30576 30577 30580 30581 30582 30596 30597 30598 30599 30601 30602 30603 30604 30605 30606 30607 30608 30609 30612 30619 30620 30621 30622 30623 30624 30625 30627 30628 30629 30630 30631 30633 30634 30635 30638 30639 30641 30642 30643 30645 30646 30647 30648 30650 30655 30656 30660 30662 30663 30664 30665 30666 30667 30668 30669 30671 30673 30677 10.0 4.2 2.0 2.0 1.0 2.0 10.0 10.0 10.0 10.0 2.0 10.0 4.0 6.0 10.0 10.0 4.2 9.1 4.0 7.3 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 1.0 2.0 10.6 8.0 2.0 2.0 2.0 2.0 10.6 2.0 7.0 8.0 1.0 7.0 2.0 7.0 7.0 2.0 2.0 2.0 2.0 7.3 4.1 2.0 8.0 7.0 2.0 10.6 10.6 2.0 2.0 8.0 8.0 2.0 7.0 1.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00463 Fmt 4701 RUCA level 30678 30680 30683 30701 30703 30705 30707 30708 30710 30711 30719 30720 30721 30722 30724 30725 30726 30728 30730 30731 30732 30733 30734 30735 30736 30738 30739 30740 30741 30742 30746 30747 30750 30751 30752 30753 30755 30756 30757 30802 30803 30805 30806 30807 30808 30809 30810 30811 30812 30813 30814 30815 30816 30817 30818 30819 30820 30821 30822 30823 30824 30828 30830 30833 30901 30903 30904 30905 30906 10.6 2.0 1.0 4.2 4.2 2.0 1.0 2.0 1.0 2.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 8.3 5.0 10.5 5.2 5.0 5.2 5.2 1.0 2.0 2.0 1.0 1.0 1.0 5.2 4.0 1.0 2.0 2.0 4.0 1.0 1.0 2.0 2.0 10.0 2.0 8.1 10.6 8.1 1.0 10.4 2.0 1.0 1.0 2.0 1.0 2.0 3.0 10.4 7.3 10.4 9.0 7.0 10.0 7.3 10.6 7.3 10.4 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 30907 30909 30910 30911 30912 30913 30914 30916 30917 30919 30999 31001 31002 31003 31004 31005 31006 31007 31008 31009 31010 31011 31012 31013 31014 31015 31016 31017 31018 31019 31020 31021 31022 31023 31024 31025 31026 31027 31028 31029 31030 31031 31032 31033 31034 31035 31036 31037 31038 31039 31040 31041 31042 31044 31045 31046 31047 31049 31050 31051 31052 31054 31055 31057 31058 31059 31060 31061 31062 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.5 5.0 10.0 1.0 1.0 10.0 10.6 1.0 5.0 4.0 9.0 10.5 7.1 7.0 4.0 2.0 2.0 8.0 5.0 2.0 4.0 5.0 7.0 7.0 2.0 7.0 4.0 1.0 9.1 4.2 10.5 2.0 2.0 4.0 8.0 7.0 7.0 10.0 10.0 4.0 10.6 10.5 2.0 10.0 2.0 7.1 5.0 2.0 7.4 2.0 10.5 7.0 6.0 2.0 4.0 10.6 4.0 4.0 70086 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA Zip code RUCA level 31063 31064 31065 31066 31067 31068 31069 31070 31071 31072 31075 31076 31077 31078 31079 31081 31082 31083 31084 31085 31086 31087 31088 31089 31090 31091 31092 31093 31094 31095 31096 31097 31098 31099 31106 31107 31119 31126 31131 31132 31139 31141 31145 31146 31150 31156 31191 31192 31193 31195 31196 31197 31198 31199 31201 31202 31203 31204 31205 31206 31207 31208 31209 31210 31211 31212 31213 31216 31217 7.0 10.1 5.0 10.1 7.0 7.0 7.1 10.6 10.5 5.0 5.0 10.0 10.6 10.1 10.5 10.0 7.0 7.0 5.0 2.0 9.1 7.4 1.0 7.0 10.0 10.6 7.4 1.0 8.4 1.0 10.5 5.2 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00464 Fmt 4701 RUCA level 31220 31221 31294 31295 31296 31297 31298 31299 31301 31302 31303 31304 31305 31307 31308 31309 31310 31312 31313 31314 31315 31316 31318 31319 31320 31321 31322 31323 31324 31326 31327 31328 31329 31331 31333 31401 31402 31403 31404 31405 31406 31407 31408 31409 31410 31411 31412 31414 31415 31416 31418 31419 31420 31421 31422 31498 31499 31501 31502 31503 31510 31512 31513 31515 31516 31518 31519 31520 31521 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 7.1 2.0 2.0 2.0 1.0 2.0 1.0 1.0 1.0 2.0 2.0 2.0 2.0 2.0 2.0 10.4 2.0 2.0 2.0 2.0 2.0 10.4 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 4.0 4.0 7.0 5.0 7.0 7.0 5.0 10.3 5.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 31522 31523 31524 31525 31527 31532 31533 31534 31535 31537 31539 31542 31543 31544 31545 31546 31547 31548 31549 31550 31551 31552 31553 31554 31555 31556 31557 31558 31560 31561 31562 31563 31564 31565 31566 31567 31568 31569 31598 31599 31601 31602 31603 31604 31605 31606 31620 31622 31623 31624 31625 31626 31627 31629 31630 31631 31632 31634 31635 31636 31637 31638 31639 31641 31642 31643 31645 31647 31648 1.0 2.0 1.0 1.0 2.0 8.0 4.0 4.0 5.0 7.4 7.0 5.0 10.4 8.0 4.0 4.0 4.0 4.0 10.6 4.0 6.0 4.0 10.4 5.0 5.0 10.5 10.5 4.0 5.0 1.0 3.0 10.3 4.0 2.0 2.0 5.0 2.0 5.0 4.0 4.0 1.0 1.0 1.0 1.0 2.0 2.0 7.3 10.6 7.0 10.0 2.0 5.0 7.3 8.0 7.0 7.0 2.0 7.0 10.4 2.0 5.0 2.0 7.0 2.0 10.5 7.3 9.1 7.3 2.0 70087 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA Zip code RUCA level 31649 31650 31698 31699 31701 31702 31703 31704 31705 31706 31707 31708 31709 31710 31711 31712 31714 31716 31719 31720 31721 31722 31727 31730 31733 31735 31738 31739 31743 31744 31747 31749 31750 31753 31756 31757 31758 31760 31763 31764 31765 31768 31769 31771 31772 31773 31774 31775 31776 31778 31779 31780 31781 31782 31783 31784 31787 31788 31789 31790 31791 31792 31793 31794 31795 31796 31798 31799 31801 2.0 10.0 1.0 2.0 1.0 1.0 1.0 10.4 1.0 1.0 1.0 1.0 4.0 4.0 5.0 5.0 7.4 2.0 4.0 5.0 1.0 5.0 4.0 7.3 5.0 5.0 5.0 7.0 5.0 5.0 5.0 5.0 4.0 4.0 5.0 4.0 4.0 5.0 1.0 5.0 5.0 4.0 7.4 5.0 2.0 5.0 7.4 5.0 4.0 5.0 7.0 5.0 9.1 1.0 9.0 10.6 2.0 5.0 9.1 9.0 7.1 4.0 5.0 4.0 5.0 2.0 7.4 4.0 2.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA GA PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00465 Fmt 4701 RUCA level 31803 31804 31805 31806 31807 31808 31810 31811 31812 31814 31815 31816 31820 31821 31822 31823 31824 31825 31826 31827 31829 31830 31831 31832 31833 31836 31901 31902 31903 31904 31905 31906 31907 31908 31909 31914 31917 31993 31994 31995 31997 31998 31999 39813 39815 39817 39818 39819 39823 39824 39825 39826 39827 39828 39829 39832 39834 39836 39837 39840 39841 39842 39845 39846 39851 39852 39854 39859 39861 10.4 2.0 2.0 10.5 2.0 2.0 2.0 2.0 2.0 3.0 10.4 7.0 2.0 3.0 6.0 3.0 10.5 10.4 3.0 10.4 2.0 10.6 2.0 10.0 4.0 8.3 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.4 5.0 4.0 4.0 4.0 7.0 10.6 5.0 2.0 7.4 7.4 7.4 10.6 5.0 7.0 10.0 7.0 10.6 7.3 7.4 10.4 10.0 4.0 7.0 5.0 10.6 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State GA .................................... GA .................................... GA .................................... GA .................................... GA .................................... GA .................................... GA .................................... GA .................................... GA .................................... GU .................................... GU .................................... GU .................................... GU .................................... GU .................................... GU .................................... GU .................................... GU .................................... GU .................................... GU .................................... GU .................................... GU .................................... GU .................................... GU .................................... GU .................................... GU .................................... GU .................................... GU .................................... GU .................................... GU .................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... HI ...................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 39862 39866 39867 39870 39877 39885 39886 39897 39901 96911 96912 96913 96914 96915 96916 96917 96918 96919 96921 96922 96923 96925 96926 96927 96928 96929 96930 96931 96932 96701 96703 96704 96705 96706 96707 96708 96709 96710 96712 96713 96714 96715 96716 96717 96718 96719 96720 96721 96722 96725 96726 96727 96728 96729 96730 96731 96732 96733 96734 96737 96738 96739 96740 96741 96742 96743 96744 96745 96746 2.0 2.0 8.0 2.0 2.0 10.6 10.6 8.0 1.0 R R R R R R R R R R R R R R R R R R R R 1.0 5.0 10.2 4.0 1.0 1.0 4.0 1.0 4.0 2.0 10.0 10.5 4.0 4.0 4.1 10.5 7.0 4.0 4.0 10.5 7.2 10.2 7.0 4.0 10.6 4.1 2.0 4.0 4.0 2.0 10.2 7.0 4.0 4.0 4.0 10.0 8.0 2.0 4.0 5.0 70088 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI Zip code RUCA level 96747 96748 96749 96750 96751 96752 96753 96754 96755 96756 96757 96759 96760 96761 96762 96763 96764 96765 96766 96767 96768 96769 96770 96771 96772 96773 96774 96776 96777 96778 96779 96780 96781 96782 96783 96784 96785 96786 96788 96789 96790 96791 96792 96793 96795 96796 96797 96801 96802 96803 96804 96805 96806 96807 96808 96809 96810 96811 96812 96813 96814 96815 96816 96817 96818 96819 96820 96821 96822 4.0 7.0 4.0 4.0 5.0 7.2 4.0 10.5 7.0 4.0 10.6 1.0 4.0 4.0 4.1 7.0 5.0 4.0 4.0 4.0 4.0 4.0 10.6 5.0 10.5 5.0 5.0 10.6 10.5 5.0 5.0 5.0 4.0 1.0 4.0 4.0 5.0 1.0 4.0 1.0 4.0 2.0 1.0 4.0 2.0 7.2 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI HI IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA PO 00000 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... Frm 00466 Fmt 4701 RUCA level 96823 96824 96825 96826 96827 96828 96830 96835 96836 96837 96838 96839 96840 96841 96842 96843 96844 96846 96847 96848 96849 96850 96853 96854 96857 96858 96859 96860 96861 96862 96863 96898 50001 50002 50003 50005 50006 50007 50008 50009 50010 50011 50012 50013 50014 50015 50020 50021 50022 50023 50025 50026 50027 50028 50029 50031 50032 50033 50034 50035 50036 50037 50038 50039 50040 50041 50042 50043 50044 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 2.0 10.4 2.0 5.0 10.6 2.0 10.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 8.0 1.0 7.0 7.0 10.0 10.4 5.0 2.0 10.0 10.5 1.0 2.0 8.0 1.0 4.2 4.2 1.0 2.0 10.5 10.6 10.6 10.6 9.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 50046 50047 50048 50049 50050 50051 50052 50054 50055 50056 50057 50058 50059 50060 50061 50062 50063 50064 50065 50066 50067 50068 50069 50070 50071 50072 50073 50074 50075 50076 50078 50101 50102 50103 50104 50105 50106 50107 50108 50109 50110 50111 50112 50115 50116 50117 50118 50119 50120 50122 50123 50124 50125 50126 50127 50128 50129 50130 50131 50132 50133 50134 50135 50136 50137 50138 50139 50140 50141 2.1 2.0 10.0 7.0 10.6 10.5 10.0 2.0 3.0 3.0 3.0 10.6 7.0 10.0 1.0 3.0 2.0 10.6 10.6 2.0 10.0 8.0 1.0 2.0 10.6 2.0 2.0 10.0 10.4 10.6 4.0 10.6 10.6 10.6 10.0 1.0 5.0 10.6 10.0 2.0 10.0 1.0 7.0 10.4 9.0 10.0 2.0 9.0 5.0 10.0 10.0 2.1 4.1 7.0 2.0 10.4 7.0 10.4 1.0 8.0 10.0 2.1 5.0 10.0 10.5 7.3 2.0 10.0 5.0 70089 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA Zip code RUCA level 50142 50143 50144 50145 50146 50147 50148 50149 50150 50151 50152 50153 50154 50155 50156 50157 50158 50160 50161 50162 50163 50164 50165 50166 50167 50168 50169 50170 50171 50173 50174 50177 50197 50198 50201 50206 50207 50208 50210 50211 50212 50213 50214 50216 50217 50218 50219 50220 50222 50223 50225 50226 50227 50228 50229 50230 50231 50232 50233 50234 50235 50236 50237 50238 50239 50240 50241 50242 50243 4.0 10.5 10.6 2.0 2.0 10.0 5.0 8.0 9.0 8.0 2.0 10.5 2.0 2.0 2.0 10.6 4.0 2.0 3.0 5.0 3.0 10.4 10.0 2.0 2.0 2.0 2.0 6.1 10.6 10.6 8.0 7.0 7.3 7.3 2.0 10.0 10.5 4.0 2.0 1.0 10.5 7.3 10.4 10.4 10.6 2.0 7.0 7.3 2.0 10.5 10.4 2.0 10.6 2.0 2.0 10.6 10.4 6.1 2.0 5.0 10.6 2.0 2.0 8.0 10.5 2.0 2.0 8.0 2.0 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA PO 00000 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... Frm 00467 Fmt 4701 RUCA level 50244 50246 50247 50248 50249 50250 50251 50252 50254 50255 50256 50257 50258 50259 50261 50262 50263 50264 50265 50266 50268 50269 50271 50272 50273 50274 50275 50276 50277 50278 50301 50302 50303 50304 50305 50306 50307 50308 50309 50310 50311 50312 50313 50314 50315 50316 50317 50318 50319 50320 50321 50322 50323 50325 50327 50328 50329 50330 50331 50332 50333 50334 50335 50336 50338 50339 50340 50347 50350 2.1 10.6 10.5 2.0 10.6 10.4 10.5 10.4 8.0 10.0 9.0 2.0 10.0 10.0 1.0 10.6 1.0 10.6 1.0 1.0 10.0 10.0 8.0 8.0 7.1 8.0 8.0 2.0 10.4 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 50359 50360 50361 50362 50363 50364 50367 50368 50369 50380 50381 50391 50392 50393 50394 50395 50396 50397 50398 50401 50402 50420 50421 50423 50424 50426 50427 50428 50430 50431 50432 50433 50434 50435 50436 50438 50439 50440 50441 50444 50446 50447 50448 50449 50450 50451 50452 50453 50454 50455 50456 50457 50458 50459 50460 50461 50464 50465 50466 50467 50468 50469 50470 50471 50472 50473 50475 50476 50477 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 4.0 10.6 10.0 10.6 10.6 10.6 10.6 7.2 10.0 10.6 10.6 5.0 10.0 8.0 7.0 7.4 10.6 5.0 7.0 10.0 10.0 10.0 5.0 10.6 10.6 10.0 10.6 10.6 10.6 10.6 5.0 5.0 5.0 10.5 10.6 7.4 5.0 10.6 10.6 5.0 10.5 5.0 10.6 5.0 10.6 10.6 10.6 10.6 5.0 70090 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA Zip code RUCA level 50478 50479 50480 50481 50482 50483 50484 50501 50510 50511 50514 50515 50516 50517 50518 50519 50520 50521 50522 50523 50524 50525 50526 50527 50528 50529 50530 50531 50532 50533 50535 50536 50538 50539 50540 50541 50542 50543 50544 50545 50546 50548 50551 50552 50554 50556 50557 50558 50559 50560 50561 50562 50563 50565 50566 50567 50568 50569 50570 50571 50573 50574 50575 50576 50577 50578 50579 50581 50582 10.6 5.0 10.6 10.6 7.2 10.6 10.0 4.0 10.5 7.0 10.0 10.5 5.0 10.6 5.0 8.0 8.0 5.0 10.6 5.0 5.0 7.0 7.0 10.6 10.6 7.4 5.0 8.0 5.0 7.0 10.5 7.0 10.5 10.6 10.0 8.0 10.6 5.0 5.0 10.6 10.0 7.4 10.5 10.5 10.0 10.0 5.0 10.6 10.6 10.6 10.5 10.6 10.5 10.5 5.0 10.5 5.0 5.0 8.0 10.0 10.0 10.0 10.5 10.5 10.6 10.0 10.5 10.0 8.0 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA PO 00000 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... Frm 00468 Fmt 4701 RUCA level 50583 50585 50586 50588 50590 50591 50592 50593 50594 50595 50597 50598 50599 50601 50602 50603 50604 50605 50606 50607 50608 50609 50611 50612 50613 50614 50616 50619 50620 50621 50622 50623 50624 50625 50626 50627 50628 50629 50630 50631 50632 50633 50634 50635 50636 50638 50641 50642 50643 50644 50645 50647 50648 50649 50650 50651 50652 50653 50654 50655 50657 50658 50659 50660 50661 50662 50664 50665 50666 10.0 10.5 10.5 4.0 10.0 10.6 4.0 10.0 5.0 7.0 10.6 8.0 10.6 10.6 10.0 10.6 10.1 10.0 10.0 10.6 10.0 10.5 10.0 10.4 1.0 1.0 7.0 10.6 7.0 10.5 2.0 1.0 2.0 10.0 2.0 10.0 10.6 10.4 10.6 10.0 10.2 10.6 1.0 10.2 10.0 10.4 10.4 10.4 2.0 7.3 10.6 2.0 2.0 10.6 10.6 2.0 10.4 10.5 8.0 10.6 2.0 10.6 7.0 2.0 7.0 7.0 10.4 10.1 10.6 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 50667 50668 50669 50670 50671 50672 50673 50674 50675 50676 50677 50680 50681 50682 50701 50702 50703 50704 50706 50707 50799 50801 50830 50831 50833 50835 50836 50837 50839 50840 50841 50842 50843 50845 50846 50847 50848 50849 50851 50853 50854 50857 50858 50859 50860 50861 50862 50863 50864 50936 50940 50947 50950 50980 50981 51001 51002 51003 51004 51005 51006 51007 51008 51009 51010 51011 51012 51014 51015 1.0 10.1 2.0 2.0 10.6 10.6 10.1 10.0 10.4 9.0 7.3 10.4 10.6 10.6 1.0 1.0 1.0 1.0 2.0 1.0 1.0 7.0 8.0 8.0 10.6 10.0 10.6 10.0 10.0 10.6 10.0 7.0 10.6 10.0 10.0 8.0 8.0 10.0 10.6 10.6 10.0 10.0 10.0 10.0 10.0 8.0 10.6 10.0 10.3 1.0 1.0 1.0 1.0 1.0 1.0 10.6 5.0 7.0 10.1 10.6 10.0 2.0 7.3 10.0 10.4 10.6 7.0 10.6 2.0 70091 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA Zip code RUCA level 51016 51018 51019 51020 51022 51023 51024 51025 51026 51027 51028 51029 51030 51031 51033 51034 51035 51036 51037 51038 51039 51040 51041 51044 51045 51046 51047 51048 51049 51050 51051 51052 51053 51054 51055 51056 51058 51060 51061 51062 51063 51101 51102 51103 51104 51105 51106 51108 51109 51111 51201 51230 51231 51232 51234 51235 51237 51238 51239 51240 51241 51242 51243 51244 51245 51246 51247 51248 51249 10.1 10.1 10.1 10.0 7.0 10.6 2.0 10.0 2.0 7.0 10.4 10.3 2.0 7.3 10.5 10.4 10.3 7.0 10.6 2.0 2.0 7.3 7.0 2.0 7.3 10.0 5.0 10.1 10.6 10.3 10.4 2.0 10.5 1.0 2.0 2.0 10.0 10.6 10.6 2.0 10.4 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.0 10.4 10.6 10.6 10.6 10.4 10.0 10.6 10.6 10.4 10.4 10.4 10.0 7.0 10.6 10.4 7.0 10.6 7.0 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA PO 00000 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... Frm 00469 Fmt 4701 RUCA level 51250 51301 51331 51333 51334 51338 51340 51341 51342 51343 51344 51345 51346 51347 51349 51350 51351 51354 51355 51357 51358 51360 51363 51364 51365 51366 51401 51430 51431 51432 51433 51436 51439 51440 51441 51442 51443 51444 51445 51446 51447 51448 51449 51450 51451 51452 51453 51454 51455 51458 51459 51460 51461 51462 51463 51465 51466 51467 51501 51502 51503 51510 51520 51521 51523 51525 51526 51527 51528 7.0 4.0 4.0 5.0 7.4 5.0 4.0 5.0 10.6 5.0 7.4 10.6 10.5 5.0 10.6 10.6 4.0 10.6 4.0 5.0 10.5 4.0 4.0 4.0 8.0 5.0 7.0 8.0 10.0 10.3 10.0 8.0 8.0 10.6 8.0 7.0 8.0 8.0 10.0 10.6 10.6 8.0 10.6 10.0 8.0 8.0 10.5 10.3 10.6 10.0 8.0 8.0 8.0 10.6 10.6 8.0 10.0 8.0 1.0 1.0 1.0 1.0 8.0 10.1 10.4 2.0 2.0 10.6 8.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 51529 51530 51531 51532 51533 51534 51535 51536 51537 51540 51541 51542 51543 51544 51545 51546 51548 51549 51550 51551 51552 51553 51554 51555 51556 51557 51558 51559 51560 51561 51562 51563 51564 51565 51566 51570 51571 51572 51573 51575 51576 51577 51578 51579 51591 51593 51601 51602 51603 51630 51631 51632 51636 51637 51638 51639 51640 51645 51646 51647 51648 51649 51650 51651 51652 51653 51654 51656 52001 10.4 10.6 10.6 8.0 2.0 7.1 10.6 2.0 7.0 2.0 2.0 2.0 10.0 10.6 10.4 10.1 2.0 2.0 10.1 2.0 8.0 2.0 7.1 7.1 10.1 10.4 10.6 2.0 2.0 2.0 10.6 2.0 10.4 10.6 7.0 10.6 2.0 10.6 10.3 2.0 2.0 10.1 10.6 10.4 7.0 7.0 7.0 7.0 7.0 8.0 8.0 7.0 8.0 8.0 10.6 10.6 10.4 10.6 8.0 8.0 10.4 10.6 10.6 8.0 10.4 10.4 10.4 10.6 1.0 70092 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA Zip code RUCA level 52002 52003 52004 52030 52031 52032 52033 52035 52036 52037 52038 52039 52040 52041 52042 52043 52044 52045 52046 52047 52048 52049 52050 52052 52053 52054 52056 52057 52060 52064 52065 52066 52068 52069 52070 52071 52072 52073 52074 52075 52076 52077 52078 52079 52099 52101 52132 52133 52134 52135 52136 52140 52141 52142 52144 52146 52147 52149 52151 52154 52155 52156 52157 52158 52159 52160 52161 52162 52163 1.0 1.0 1.0 3.0 7.3 10.1 9.0 10.6 10.6 10.6 8.0 2.0 7.3 10.6 8.0 10.0 10.0 2.0 2.0 10.6 10.0 10.0 10.6 10.0 2.0 3.0 10.0 7.0 7.0 10.5 10.4 10.0 2.0 10.5 10.5 3.0 10.0 2.0 10.5 7.3 10.6 10.6 10.4 8.3 1.0 7.0 10.3 8.0 10.6 10.0 7.0 10.6 10.0 10.0 10.3 10.6 10.0 7.0 10.4 10.6 10.3 10.0 10.6 10.6 10.0 10.6 8.0 10.0 10.3 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA PO 00000 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... Frm 00470 Fmt 4701 RUCA level 52164 52165 52166 52168 52169 52170 52171 52172 52175 52201 52202 52203 52204 52205 52206 52207 52208 52209 52210 52211 52212 52213 52214 52215 52216 52217 52218 52219 52220 52221 52222 52223 52224 52225 52226 52227 52228 52229 52231 52232 52233 52235 52236 52237 52240 52241 52242 52243 52244 52245 52246 52247 52248 52249 52251 52252 52253 52254 52255 52257 52301 52302 52305 52306 52307 52308 52309 52310 52312 10.0 8.0 10.0 10.3 10.0 10.6 10.0 7.0 10.0 10.6 2.0 10.4 10.4 7.1 2.0 8.3 7.3 2.0 10.4 10.6 10.4 2.0 2.0 10.6 10.6 10.4 2.0 2.0 10.4 10.6 10.6 10.6 10.4 10.6 10.6 2.0 2.0 10.4 10.4 10.6 1.0 2.0 10.4 10.6 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 10.4 2.0 10.4 7.3 7.1 10.6 10.6 2.0 10.4 1.0 2.0 3.0 10.4 10.0 8.3 7.3 7.1 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 52313 52314 52315 52316 52317 52318 52319 52320 52321 52322 52323 52324 52325 52326 52327 52328 52329 52330 52332 52333 52334 52335 52336 52337 52338 52339 52340 52341 52342 52344 52345 52346 52347 52348 52349 52350 52351 52352 52353 52354 52355 52356 52358 52359 52361 52362 52401 52402 52403 52404 52405 52406 52407 52408 52409 52410 52411 52497 52498 52499 52501 52530 52531 52533 52534 52535 52536 52537 52538 10.4 7.1 2.0 10.0 1.0 2.0 1.0 2.0 10.4 1.0 10.4 1.0 10.4 10.4 2.0 1.0 10.4 10.6 2.0 2.1 10.4 10.0 2.0 3.0 2.0 7.0 1.0 1.0 7.0 2.0 2.0 10.4 10.0 10.6 7.3 2.0 2.0 2.0 7.3 2.0 10.0 10.6 2.0 10.6 10.4 10.4 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 5.0 7.0 8.0 5.0 10.6 5.0 10.5 10.5 70093 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA Zip code RUCA level 52540 52542 52543 52544 52548 52549 52550 52551 52552 52553 52554 52555 52556 52557 52560 52561 52562 52563 52565 52566 52567 52568 52569 52570 52571 52572 52573 52574 52576 52577 52580 52581 52583 52584 52585 52586 52588 52590 52591 52593 52594 52595 52601 52619 52620 52621 52623 52624 52625 52626 52627 52630 52631 52632 52635 52637 52638 52639 52640 52641 52642 52644 52645 52646 52647 52648 52649 52650 52651 10.6 10.0 5.0 7.0 5.0 8.0 10.0 10.6 10.5 5.0 5.0 8.0 7.0 7.0 10.5 5.0 10.0 10.6 10.6 5.0 8.0 10.6 9.0 10.0 10.6 10.6 10.0 8.0 10.6 4.0 8.0 8.0 10.0 10.5 10.6 5.0 10.6 10.0 10.0 10.6 10.6 4.0 4.0 5.0 10.6 10.6 5.0 5.0 5.0 10.0 4.0 8.0 10.5 4.0 8.0 5.0 5.0 5.0 10.5 7.0 7.0 8.0 8.0 10.5 10.3 10.5 8.0 5.0 10.6 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA IA ID ID ID ID ID PO 00000 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... Frm 00471 Fmt 4701 RUCA level 52652 52653 52654 52655 52656 52657 52658 52659 52660 52701 52720 52721 52722 52726 52727 52728 52729 52730 52731 52732 52733 52736 52737 52738 52739 52742 52745 52746 52747 52748 52749 52750 52751 52752 52753 52754 52755 52756 52757 52758 52759 52760 52761 52765 52766 52767 52768 52769 52771 52772 52773 52774 52776 52777 52778 52801 52802 52803 52804 52805 52806 52807 52808 52809 83201 83202 83203 83204 83205 7.0 10.5 10.3 4.0 10.5 10.5 5.0 10.3 5.0 5.0 5.0 10.4 1.0 2.0 5.0 1.0 3.0 4.0 5.0 4.0 4.0 4.0 10.4 10.4 5.0 7.3 2.0 2.0 10.4 2.0 4.0 5.0 3.0 10.5 1.0 5.0 1.0 2.0 7.3 2.0 4.0 5.0 4.0 2.0 7.3 1.0 2.0 5.2 4.0 7.3 2.0 3.0 7.3 3.0 5.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 83206 83209 83210 83211 83212 83213 83214 83215 83217 83218 83220 83221 83223 83226 83227 83228 83229 83230 83232 83233 83234 83235 83236 83237 83238 83239 83241 83243 83244 83245 83246 83250 83251 83252 83253 83254 83255 83256 83261 83262 83263 83271 83272 83274 83276 83277 83278 83281 83283 83285 83286 83287 83301 83302 83303 83311 83312 83313 83314 83316 83318 83320 83321 83322 83323 83324 83325 83327 83328 1.0 1.0 10.5 7.3 10.1 10.4 2.0 4.2 10.6 2.0 8.0 4.2 8.0 10.0 10.0 10.6 7.0 7.0 10.6 7.0 2.0 10.3 10.4 7.3 7.0 7.0 10.6 10.0 10.4 2.0 2.0 2.0 10.0 10.0 10.3 7.0 10.4 4.2 8.0 5.0 7.3 10.1 8.0 2.0 7.0 5.0 10.0 2.0 10.6 2.0 10.6 8.0 4.0 5.0 4.0 10.5 10.5 7.0 7.0 10.6 4.0 7.0 10.6 10.6 5.0 10.6 10.5 10.6 5.0 70094 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID Zip code RUCA level 83330 83332 83333 83334 83335 83336 83337 83338 83340 83341 83342 83343 83344 83346 83347 83348 83349 83350 83352 83353 83354 83355 83401 83402 83403 83404 83405 83406 83415 83420 83421 83422 83423 83424 83425 83427 83428 83429 83431 83433 83434 83435 83436 83438 83440 83441 83442 83443 83444 83445 83446 83447 83448 83449 83450 83451 83452 83454 83455 83460 83462 83463 83464 83465 83466 83467 83468 83469 83501 7.0 10.6 7.0 5.0 10.5 4.0 10.6 7.4 7.0 5.0 10.5 10.6 10.5 10.2 10.2 7.0 10.6 7.2 10.6 7.0 7.0 10.6 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.5 10.5 10.5 10.0 10.5 10.4 2.0 2.0 10.0 2.0 10.0 2.0 10.4 10.5 7.4 4.0 4.0 2.0 2.0 10.4 7.4 10.0 10.5 5.0 2.0 10.4 10.5 10.5 1.0 10.5 4.0 7.0 7.0 10.3 10.3 7.0 7.0 10.3 7.0 1.0 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID PO 00000 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... Frm 00472 Fmt 4701 RUCA level 83520 83522 83523 83524 83525 83526 83530 83531 83533 83535 83536 83537 83539 83540 83541 83542 83543 83544 83545 83546 83547 83548 83549 83552 83553 83554 83555 83601 83602 83604 83605 83606 83607 83610 83611 83612 83615 83616 83617 83619 83622 83623 83624 83626 83627 83628 83629 83630 83631 83632 83633 83634 83635 83636 83637 83638 83639 83641 83642 83643 83644 83645 83647 83648 83650 83651 83652 83653 83654 7.0 10.6 10.4 2.0 10.0 10.6 7.0 7.0 10.0 10.5 10.0 10.5 10.0 2.0 2.0 10.0 10.4 7.0 2.0 10.3 10.0 2.0 10.0 10.0 10.3 7.0 10.4 10.5 2.0 10.5 1.1 1.1 1.1 10.6 10.4 10.0 10.0 1.0 7.1 4.0 2.0 10.5 10.5 1.1 10.5 7.1 2.0 1.1 2.0 10.0 10.5 2.0 10.0 7.1 2.0 10.0 2.0 2.0 1.0 10.0 2.1 10.6 4.2 7.2 10.5 1.1 1.1 1.1 10.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ID ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 83655 83656 83657 83660 83661 83666 83669 83670 83671 83672 83676 83677 83680 83686 83687 83701 83702 83703 83704 83705 83706 83707 83708 83709 83711 83712 83713 83714 83715 83716 83717 83719 83720 83721 83722 83723 83724 83725 83726 83727 83728 83729 83730 83731 83732 83733 83735 83744 83756 83757 83799 83801 83802 83803 83804 83805 83806 83808 83809 83810 83811 83812 83813 83814 83815 83816 83821 83822 83823 5.0 1.1 10.3 10.1 4.0 2.0 2.0 10.3 10.0 7.4 2.0 10.4 1.0 1.1 1.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 10.6 2.0 10.4 7.0 5.0 10.6 9.0 2.0 10.3 10.6 9.0 1.0 1.0 1.0 10.0 10.4 5.0 70095 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State Zip code RUCA level 83824 83825 83826 83827 83830 83832 83833 83834 83835 83836 83837 83839 83840 83841 83842 83843 83844 83845 83846 83847 83848 83849 83850 83851 83852 83853 83854 83855 83856 83857 83858 83860 83861 83864 83865 83866 83867 83868 83869 83870 83871 83872 83873 83874 83876 83877 83888 60001 60002 60004 60005 60006 60007 60008 60009 60010 60011 60012 60013 60014 60015 60016 60017 60018 60019 60020 60021 60022 60025 10.3 7.0 10.0 10.3 7.0 10.5 2.0 10.5 1.0 10.3 7.0 10.6 7.0 7.0 2.0 4.0 4.0 10.0 10.6 7.0 10.0 10.6 10.6 10.3 7.0 10.0 1.0 10.5 10.6 10.5 2.1 8.0 7.0 7.0 7.0 7.0 10.6 10.6 2.1 10.3 5.0 10.5 10.6 7.0 10.4 1.0 7.0 7.3 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... ID ...................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... PO 00000 Frm 00473 Fmt 4701 RUCA level 60026 60029 60030 60031 60033 60034 60035 60037 60038 60039 60040 60041 60042 60043 60044 60045 60046 60047 60048 60049 60050 60051 60053 60055 60056 60060 60061 60062 60064 60065 60067 60068 60069 60070 60071 60072 60073 60074 60075 60076 60077 60078 60079 60081 60082 60083 60084 60085 60086 60087 60088 60089 60090 60091 60092 60093 60094 60095 60096 60097 60098 60099 60101 60102 60103 60104 60105 60106 60107 1.0 1.0 2.0 2.0 7.3 2.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 60108 60109 60110 60111 60112 60113 60115 60116 60117 60118 60119 60120 60121 60122 60123 60125 60126 60128 60129 60130 60131 60132 60133 60134 60135 60136 60137 60138 60139 60140 60141 60142 60143 60144 60145 60146 60147 60148 60150 60151 60152 60153 60154 60155 60156 60157 60159 60160 60161 60162 60163 60164 60165 60168 60170 60171 60172 60173 60174 60175 60176 60177 60178 60179 60180 60181 60183 60184 60185 1.0 2.0 1.0 2.1 1.0 4.2 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.1 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 1.0 2.1 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 70096 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL Zip code RUCA level 60186 60187 60188 60189 60190 60191 60192 60193 60194 60195 60196 60197 60199 60201 60202 60203 60204 60208 60209 60296 60297 60301 60302 60303 60304 60305 60398 60399 60401 60402 60406 60407 60408 60409 60410 60411 60412 60415 60416 60417 60419 60420 60421 60422 60423 60424 60425 60426 60428 60429 60430 60431 60432 60433 60434 60435 60436 60437 60438 60439 60440 60441 60442 60443 60444 60445 60446 60447 60448 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 7.3 2.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 3.0 1.0 1.0 1.0 1.0 1.0 1.0 3.0 1.0 1.0 1.0 1.0 ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... PO 00000 Frm 00474 Fmt 4701 RUCA level 60449 60450 60451 60452 60453 60454 60455 60456 60457 60458 60459 60460 60461 60462 60463 60464 60465 60466 60467 60468 60469 60470 60471 60472 60473 60474 60475 60476 60477 60478 60479 60480 60481 60482 60490 60491 60499 60501 60502 60503 60504 60505 60506 60507 60510 60511 60512 60513 60514 60515 60516 60517 60518 60519 60520 60521 60522 60523 60525 60526 60527 60530 60531 60532 60534 60536 60537 60538 60539 2.0 4.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.5 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 9.1 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 3.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 3.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 10.4 2.0 1.0 1.0 2.0 2.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 60540 60541 60542 60543 60544 60545 60546 60548 60549 60550 60551 60552 60553 60554 60555 60556 60557 60558 60559 60560 60561 60563 60564 60565 60566 60567 60568 60570 60572 60585 60586 60597 60598 60599 60601 60602 60603 60604 60605 60606 60607 60608 60609 60610 60611 60612 60613 60614 60615 60616 60617 60618 60619 60620 60621 60622 60623 60624 60625 60626 60628 60629 60630 60631 60632 60633 60634 60636 60637 1.0 2.0 1.0 1.0 1.0 2.0 1.0 2.0 2.0 2.0 2.0 2.0 10.4 1.0 1.0 2.0 4.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70097 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL Zip code RUCA level 60638 60639 60640 60641 60643 60644 60645 60646 60647 60649 60651 60652 60653 60654 60655 60656 60657 60659 60660 60661 60663 60664 60665 60666 60667 60668 60669 60670 60671 60672 60673 60674 60675 60677 60678 60679 60680 60681 60682 60683 60684 60685 60686 60687 60688 60689 60690 60691 60693 60694 60695 60696 60697 60699 60701 60706 60707 60712 60714 60803 60804 60805 60827 60901 60902 60910 60911 60912 60913 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 3.0 3.0 2.1 ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... PO 00000 Frm 00475 Fmt 4701 RUCA level 60914 60915 60917 60918 60919 60920 60921 60922 60924 60926 60927 60928 60929 60930 60931 60932 60933 60934 60935 60936 60938 60939 60940 60941 60942 60944 60945 60946 60948 60949 60950 60951 60952 60953 60954 60955 60956 60957 60959 60960 60961 60962 60963 60964 60966 60967 60968 60969 60970 60973 60974 61001 61006 61007 61008 61010 61011 61012 61013 61014 61015 61016 61018 61019 61020 61021 61024 61025 61027 1.0 1.0 2.1 10.6 10.4 7.3 10.6 2.0 10.6 10.6 2.0 3.0 10.5 3.0 3.0 3.0 7.3 10.5 2.1 7.3 7.0 10.6 2.0 2.0 7.3 2.0 7.0 10.4 10.6 4.1 2.0 3.0 9.0 10.6 7.1 7.0 2.0 7.3 10.4 3.0 2.1 10.6 3.0 2.0 7.0 10.6 10.6 2.0 7.0 10.6 7.0 10.6 10.4 10.5 1.0 2.0 1.0 1.0 4.0 10.5 2.0 1.0 5.2 5.2 2.0 4.0 2.0 1.0 7.4 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 61028 61030 61031 61032 61036 61037 61038 61039 61041 61042 61043 61044 61046 61047 61048 61049 61050 61051 61052 61053 61054 61057 61058 61059 61060 61061 61062 61063 61064 61065 61067 61068 61070 61071 61072 61073 61074 61075 61077 61078 61079 61080 61081 61084 61085 61087 61088 61089 61091 61101 61102 61103 61104 61105 61106 61107 61108 61109 61110 61111 61112 61114 61115 61125 61126 61130 61131 61132 61201 10.6 10.5 5.0 4.0 7.3 4.0 2.1 5.0 10.6 6.0 2.0 5.0 10.5 2.0 7.4 2.0 5.0 10.5 2.0 10.0 7.0 4.0 4.0 10.6 5.0 7.0 5.0 2.0 7.4 1.0 5.0 4.2 5.2 4.0 1.0 1.0 7.0 10.6 2.0 10.5 1.0 1.0 4.0 2.0 10.5 10.6 1.0 7.4 7.4 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70098 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL Zip code RUCA level 61204 61230 61231 61232 61233 61234 61235 61236 61237 61238 61239 61240 61241 61242 61243 61244 61250 61251 61252 61254 61256 61257 61258 61259 61260 61261 61262 61263 61264 61265 61266 61270 61272 61273 61274 61275 61276 61277 61278 61279 61281 61282 61283 61284 61285 61299 61301 61310 61311 61312 61313 61314 61315 61316 61317 61318 61319 61320 61321 61322 61323 61324 61325 61326 61327 61328 61329 61330 61331 1.0 5.0 7.3 1.0 10.1 10.5 9.1 1.0 2.0 10.1 1.0 1.0 1.0 2.0 5.0 1.0 3.0 3.0 4.0 7.3 1.0 2.0 10.5 2.0 9.0 3.0 2.0 2.0 1.0 1.0 1.0 7.4 9.0 2.0 10.1 2.0 2.0 10.5 2.0 2.0 2.0 1.0 5.0 1.0 10.5 1.0 4.0 7.4 4.0 10.5 4.0 10.6 7.0 4.0 10.5 3.0 10.2 4.0 6.0 7.0 7.0 4.0 6.0 5.0 10.5 10.5 4.0 10.5 7.4 ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... PO 00000 Frm 00476 Fmt 4701 RUCA level 61332 61333 61334 61335 61336 61337 61338 61340 61341 61342 61344 61345 61346 61348 61349 61350 61353 61354 61356 61358 61359 61360 61361 61362 61363 61364 61367 61368 61369 61370 61371 61372 61373 61374 61375 61376 61377 61378 61379 61401 61402 61410 61411 61412 61413 61414 61415 61416 61417 61418 61419 61420 61421 61422 61423 61424 61425 61426 61427 61428 61430 61431 61432 61433 61434 61435 61436 61437 61438 6.0 10.2 6.0 10.5 10.5 7.0 10.6 5.0 9.1 7.4 10.6 10.6 10.6 4.0 10.5 4.0 3.0 4.0 7.0 6.0 7.0 9.1 10.6 4.0 5.0 4.0 3.0 8.0 10.4 6.0 7.4 7.4 6.0 10.5 10.4 10.6 10.4 3.0 8.0 4.0 4.0 5.0 5.0 5.0 3.0 5.0 10.5 4.0 10.5 5.0 7.4 5.0 10.4 7.4 5.0 10.4 5.0 10.4 6.0 5.0 4.0 10.5 2.0 2.0 7.4 5.0 2.0 5.0 5.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 61439 61440 61441 61442 61443 61447 61448 61449 61450 61451 61452 61453 61454 61455 61458 61459 61460 61462 61465 61466 61467 61468 61469 61470 61471 61472 61473 61474 61475 61476 61477 61478 61479 61480 61482 61483 61484 61485 61486 61488 61489 61490 61491 61501 61516 61517 61519 61520 61523 61524 61525 61526 61528 61529 61530 61531 61532 61533 61534 61535 61536 61537 61539 61540 61541 61542 61543 61544 61545 4.0 5.0 10.5 9.0 4.0 6.0 4.0 10.4 10.6 2.0 10.6 6.0 10.2 4.0 2.0 10.5 10.2 4.0 2.0 2.0 5.0 2.0 5.0 7.4 10.2 5.0 10.5 5.0 5.0 9.0 10.5 10.5 10.4 10.2 10.5 10.4 10.5 5.0 2.0 5.0 2.0 3.0 10.4 10.5 10.4 2.0 3.0 4.2 2.0 3.0 1.0 2.0 1.0 2.0 7.1 2.0 2.0 2.0 2.0 1.0 2.0 7.3 2.0 10.1 10.4 10.5 3.0 10.5 2.0 70099 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL Zip code RUCA level 61546 61547 61548 61550 61552 61553 61554 61555 61558 61559 61560 61561 61562 61563 61564 61565 61567 61568 61569 61570 61571 61572 61601 61602 61603 61604 61605 61606 61607 61610 61611 61612 61613 61614 61615 61616 61625 61628 61629 61630 61632 61633 61634 61635 61636 61637 61638 61639 61640 61641 61643 61644 61650 61651 61652 61653 61654 61655 61656 61701 61702 61704 61709 61710 61720 61721 61722 61723 61724 2.0 2.0 2.0 1.0 1.0 2.0 1.0 1.0 1.0 2.0 10.5 10.4 2.0 6.0 1.0 2.0 8.3 2.0 2.0 2.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 3.0 2.0 5.2 2.0 ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... PO 00000 Frm 00477 Fmt 4701 RUCA level 61725 61726 61727 61728 61729 61730 61731 61732 61733 61734 61735 61736 61737 61738 61739 61740 61741 61742 61743 61744 61745 61747 61748 61749 61750 61751 61752 61753 61754 61755 61756 61758 61759 61760 61761 61764 61769 61770 61771 61772 61773 61774 61775 61776 61777 61778 61790 61791 61799 61801 61802 61803 61810 61811 61812 61813 61814 61815 61816 61817 61818 61820 61821 61822 61824 61825 61826 61830 61831 2.0 2.0 7.3 2.0 2.1 2.0 2.0 2.0 2.0 2.0 10.4 2.0 2.0 7.1 7.4 10.2 10.5 2.1 10.2 1.0 2.0 3.0 1.0 8.3 7.3 4.2 2.0 2.0 2.0 2.0 2.0 1.0 3.0 10.4 1.0 4.0 10.5 2.0 7.1 2.0 9.0 2.0 10.6 1.0 10.4 8.3 1.0 1.0 1.0 1.0 1.0 1.0 2.1 2.0 2.0 10.4 2.0 1.0 2.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 61832 61833 61834 61839 61840 61841 61842 61843 61844 61845 61846 61847 61848 61849 61850 61851 61852 61853 61854 61855 61856 61857 61858 61859 61862 61863 61864 61865 61866 61870 61871 61872 61873 61874 61875 61876 61877 61878 61880 61882 61883 61884 61910 61911 61912 61913 61914 61917 61919 61920 61924 61925 61928 61929 61930 61931 61932 61933 61936 61937 61938 61940 61941 61942 61943 61944 61949 61951 61953 1.0 1.0 1.0 2.0 2.0 2.1 10.4 2.0 2.1 2.0 1.0 4.1 3.0 2.0 2.1 2.0 2.0 2.0 2.0 2.0 7.1 2.1 2.1 2.0 4.1 2.0 2.0 2.0 4.1 2.0 2.0 2.0 2.0 1.0 2.0 2.1 2.0 4.1 2.0 10.4 1.0 2.0 7.0 10.0 5.0 10.0 8.3 10.6 2.0 4.0 10.6 2.0 10.5 10.4 10.4 10.5 10.6 8.0 2.0 2.0 4.0 10.6 2.0 10.4 10.5 7.0 7.0 7.3 7.3 70100 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL Zip code RUCA level 61955 61956 61957 62001 62002 62006 62009 62010 62011 62012 62013 62014 62015 62016 62017 62018 62019 62021 62022 62023 62024 62025 62026 62027 62028 62030 62031 62032 62033 62034 62035 62036 62037 62040 62044 62045 62046 62047 62048 62049 62050 62051 62052 62053 62054 62056 62058 62059 62060 62061 62062 62063 62065 62067 62069 62070 62071 62074 62075 62076 62077 62078 62079 62080 62081 62082 62083 62084 62085 7.0 2.0 10.5 2.0 1.1 2.0 7.3 1.1 8.0 2.1 2.0 3.0 8.0 10.6 9.0 1.1 9.0 2.0 2.0 10.4 1.1 1.0 1.0 10.6 2.0 7.3 7.3 9.0 7.3 1.0 1.1 2.0 2.0 1.0 10.5 10.4 1.0 10.4 1.0 7.0 10.6 9.0 7.3 10.4 10.5 7.0 2.0 1.0 1.0 2.0 1.0 10.6 10.4 2.0 10.4 10.4 1.0 2.0 7.3 7.3 9.0 10.6 2.1 8.0 10.5 7.4 4.2 1.1 7.3 ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... PO 00000 Frm 00478 Fmt 4701 RUCA level 62086 62087 62088 62089 62090 62091 62092 62093 62094 62095 62097 62098 62201 62202 62203 62204 62205 62206 62207 62208 62214 62215 62216 62217 62218 62219 62220 62221 62222 62223 62224 62225 62226 62230 62231 62232 62233 62234 62236 62237 62238 62239 62240 62241 62242 62243 62244 62245 62246 62247 62248 62249 62250 62252 62253 62254 62255 62256 62257 62258 62259 62260 62261 62262 62263 62264 62265 62266 62268 9.1 1.0 9.1 7.0 1.0 8.0 7.4 7.3 9.0 1.1 2.0 7.4 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 3.0 2.0 7.4 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.3 7.4 1.0 7.0 1.0 1.0 9.0 10.6 1.0 1.0 8.0 3.0 2.0 2.0 2.0 7.0 8.3 2.0 7.1 4.0 7.4 3.0 1.0 2.0 2.0 2.0 1.0 7.0 2.0 3.0 8.3 7.0 2.0 2.0 2.0 9.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 62269 62271 62272 62273 62274 62275 62277 62278 62279 62280 62281 62282 62284 62285 62286 62288 62289 62292 62293 62294 62295 62297 62298 62301 62305 62306 62310 62311 62312 62313 62314 62316 62319 62320 62321 62323 62324 62325 62326 62329 62330 62334 62336 62338 62339 62340 62341 62343 62344 62345 62346 62347 62348 62349 62351 62352 62353 62354 62355 62356 62357 62358 62359 62360 62361 62362 62363 62365 62366 1.0 2.0 7.0 3.0 7.0 3.0 3.0 7.3 3.0 8.0 2.0 1.0 8.3 2.0 7.3 7.0 1.0 7.3 2.0 1.0 2.0 3.0 2.0 4.0 4.0 4.0 10.6 10.6 10.5 10.6 10.6 10.6 10.6 5.0 7.0 10.6 5.0 5.0 5.0 10.5 10.6 10.5 7.0 5.0 5.0 10.6 4.0 10.5 10.6 10.5 5.0 5.0 5.0 5.0 5.0 9.0 7.0 10.5 9.0 10.6 10.6 10.5 5.0 5.0 9.0 10.6 7.0 5.0 10.6 70101 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL Zip code RUCA level 62367 62370 62373 62374 62375 62376 62378 62379 62380 62401 62410 62411 62413 62414 62415 62417 62418 62419 62420 62421 62422 62423 62424 62425 62426 62427 62428 62431 62432 62433 62434 62435 62436 62438 62439 62440 62441 62442 62443 62444 62445 62446 62447 62448 62449 62450 62451 62452 62454 62458 62459 62460 62461 62462 62463 62464 62465 62466 62467 62468 62469 62471 62473 62474 62475 62476 62477 62478 62479 10.6 10.6 5.0 5.0 8.0 5.0 8.0 5.0 10.6 4.0 8.0 10.2 8.0 5.0 8.0 7.4 8.0 8.0 7.0 8.0 9.0 3.0 5.0 8.0 5.0 8.0 10.6 9.0 9.0 8.0 6.0 5.0 10.5 9.0 7.4 5.0 7.3 7.0 5.0 5.0 4.0 8.0 6.0 7.4 8.0 7.0 7.0 8.0 7.0 5.0 8.0 10.6 5.0 5.0 5.0 7.0 10.5 10.6 4.0 10.5 5.0 7.0 5.0 9.0 8.0 10.0 3.0 8.0 8.0 ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... PO 00000 Frm 00479 Fmt 4701 RUCA level 62480 62481 62501 62510 62512 62513 62514 62515 62517 62518 62519 62520 62521 62522 62523 62524 62525 62526 62530 62531 62532 62533 62534 62535 62536 62537 62538 62539 62540 62541 62543 62544 62545 62546 62547 62548 62549 62550 62551 62553 62554 62555 62556 62557 62558 62560 62561 62563 62565 62567 62568 62570 62571 62572 62573 62601 62610 62611 62612 62613 62615 62617 62618 62621 62622 62624 62625 62626 62627 8.0 9.0 2.0 4.2 5.2 2.0 2.0 2.0 2.0 10.5 4.2 2.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 3.0 2.0 1.0 1.0 1.0 3.0 2.0 4.2 10.5 10.5 2.0 2.0 5.0 2.0 10.5 1.0 2.0 2.0 9.0 1.0 4.2 5.0 7.4 2.0 3.0 1.0 1.0 7.0 3.0 4.2 4.2 8.0 3.0 2.0 2.0 5.0 10.5 2.0 2.0 2.0 9.0 7.0 5.0 7.0 8.0 1.0 7.0 2.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 62628 62629 62630 62631 62633 62634 62635 62638 62639 62640 62642 62643 62644 62649 62650 62651 62655 62656 62659 62660 62661 62662 62663 62664 62665 62666 62667 62668 62670 62671 62672 62673 62674 62675 62677 62681 62682 62683 62684 62685 62688 62689 62690 62691 62692 62693 62694 62695 62701 62702 62703 62704 62705 62706 62707 62708 62711 62712 62713 62715 62716 62719 62721 62722 62723 62726 62736 62739 62746 5.0 1.0 10.6 5.0 10.4 4.2 5.0 2.0 8.0 2.0 2.0 5.0 7.0 10.4 4.2 4.2 9.0 4.2 2.0 4.2 2.0 2.0 5.0 3.0 5.0 4.2 10.4 5.2 2.0 5.0 10.6 2.0 10.4 2.0 2.0 7.0 10.4 10.4 1.0 2.1 2.0 2.0 2.0 10.5 2.0 1.0 5.0 4.2 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70102 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL Zip code RUCA level 62756 62757 62761 62762 62763 62764 62765 62766 62767 62769 62776 62777 62781 62786 62791 62794 62796 62801 62803 62805 62806 62807 62808 62809 62810 62811 62812 62814 62815 62816 62817 62818 62819 62820 62821 62822 62823 62824 62825 62827 62828 62829 62830 62831 62832 62833 62834 62835 62836 62837 62838 62839 62840 62841 62842 62843 62844 62845 62846 62847 62848 62849 62850 62851 62852 62853 62854 62855 62856 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 10.5 9.0 10.0 8.0 9.0 8.0 5.0 7.0 7.0 5.0 10.0 5.0 8.0 10.0 9.0 9.0 7.0 9.0 10.6 8.0 7.0 10.6 5.0 8.0 5.0 9.0 7.0 10.0 7.0 9.0 9.0 7.0 10.6 7.0 7.0 4.0 10.6 8.0 10.6 10.6 5.0 6.0 10.5 8.0 10.6 10.6 7.0 8.0 8.0 8.0 7.0 ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL IL ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... ....................................... PO 00000 Frm 00480 Fmt 4701 RUCA level 62857 62858 62859 62860 62861 62862 62863 62864 62865 62866 62867 62868 62869 62870 62871 62872 62874 62875 62876 62877 62878 62879 62880 62881 62882 62883 62884 62885 62886 62887 62888 62889 62890 62891 62892 62893 62894 62895 62896 62897 62898 62899 62901 62902 62903 62905 62906 62907 62908 62909 62910 62912 62914 62915 62916 62917 62918 62919 62920 62921 62922 62923 62924 62926 62927 62928 62930 62931 62932 10.6 6.0 7.4 8.0 7.0 9.0 7.0 4.0 9.0 5.0 10.4 8.0 10.6 7.4 10.4 5.0 7.0 9.0 9.0 10.5 10.6 6.0 10.6 7.4 5.0 5.0 9.0 8.0 10.6 8.4 9.0 5.0 9.0 9.0 9.0 5.0 5.0 10.6 7.0 7.0 5.0 8.0 4.0 5.0 4.0 9.2 7.0 10.5 10.0 10.0 5.0 10.5 7.0 4.0 10.5 4.0 4.0 10.0 8.0 4.0 5.0 10.0 5.0 8.0 5.0 10.0 7.4 10.0 5.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IL ....................................... IN ...................................... IN ...................................... IN ...................................... IN ...................................... IN ...................................... IN ...................................... IN ...................................... IN ...................................... IN ...................................... IN ...................................... IN ...................................... IN ...................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 62933 62934 62935 62938 62939 62940 62941 62942 62943 62944 62946 62947 62948 62949 62950 62951 62952 62953 62954 62955 62956 62957 62958 62959 62960 62961 62962 62963 62964 62965 62966 62967 62969 62970 62971 62972 62973 62974 62975 62976 62977 62979 62982 62983 62984 62985 62987 62988 62990 62992 62993 62994 62995 62996 62997 62998 62999 46001 46011 46012 46013 46014 46015 46016 46017 46018 46030 46031 46032 4.0 10.0 10.5 10.5 10.5 6.0 10.0 6.0 9.0 10.5 4.0 10.0 4.0 4.0 6.0 6.0 7.0 8.0 10.0 10.5 10.0 5.0 5.0 4.0 7.4 8.0 5.0 10.0 10.6 4.0 5.0 9.0 5.0 10.0 5.0 9.0 10.6 5.0 6.0 10.6 8.4 10.4 10.5 10.5 10.0 9.0 5.0 5.0 5.0 10.6 5.0 10.5 10.0 10.6 10.6 9.2 10.5 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70103 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN Zip code RUCA level 46033 46034 46035 46036 46037 46038 46039 46040 46041 46044 46045 46047 46048 46049 46050 46051 46052 46055 46056 46057 46058 46060 46061 46062 46063 46064 46065 46067 46068 46069 46070 46071 46072 46074 46075 46076 46077 46082 46102 46103 46104 46105 46106 46107 46110 46111 46112 46113 46115 46117 46118 46120 46121 46122 46123 46124 46125 46126 46127 46128 46129 46130 46131 46133 46135 46140 46142 46143 46144 1.0 1.0 10.5 4.2 1.0 1.0 3.0 1.0 4.0 2.1 7.3 7.3 1.0 9.1 3.0 2.0 4.1 1.0 2.1 6.0 2.0 1.0 1.0 1.0 1.0 1.0 2.0 4.0 2.0 2.0 2.0 2.0 7.3 1.0 2.0 9.1 1.0 1.0 2.0 2.0 3.0 2.0 1.0 1.0 2.0 1.0 1.0 1.0 3.0 2.0 2.0 2.0 2.0 1.0 1.0 1.0 4.1 2.0 9.0 2.0 2.0 2.0 1.0 9.0 7.3 2.0 1.0 1.0 2.0 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN PO 00000 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... Frm 00481 Fmt 4701 RUCA level 46146 46147 46148 46149 46150 46151 46154 46155 46156 46157 46158 46160 46161 46162 46163 46164 46165 46166 46167 46168 46170 46171 46172 46173 46175 46176 46180 46181 46182 46183 46184 46186 46201 46202 46203 46204 46205 46206 46207 46208 46209 46211 46214 46216 46217 46218 46219 46220 46221 46222 46223 46224 46225 46226 46227 46228 46229 46230 46231 46234 46235 46236 46237 46239 46240 46241 46242 46244 46247 9.0 2.0 2.0 2.0 9.0 4.1 2.0 7.4 9.0 2.0 1.0 2.0 2.0 2.0 1.0 2.0 2.0 2.0 1.0 1.0 7.3 8.3 2.0 7.4 2.0 4.2 2.0 2.0 5.2 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 46249 46250 46251 46253 46254 46255 46256 46259 46260 46266 46268 46274 46275 46277 46278 46280 46282 46283 46285 46290 46291 46295 46296 46298 46301 46302 46303 46304 46307 46308 46310 46311 46312 46319 46320 46321 46322 46323 46324 46325 46327 46340 46341 46342 46345 46346 46347 46348 46349 46350 46352 46355 46356 46360 46361 46365 46366 46368 46371 46372 46373 46374 46375 46376 46377 46379 46380 46381 46382 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 1.0 1.0 2.0 2.0 2.0 1.0 1.0 1.0 2.0 1.0 1.0 2.1 7.3 1.0 2.0 2.0 1.0 7.3 1.0 2.0 2.0 2.0 2.0 10.4 2.0 70104 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN Zip code RUCA level 46383 46384 46385 46390 46391 46392 46393 46394 46401 46402 46403 46404 46405 46406 46407 46408 46409 46410 46411 46501 46502 46504 46506 46507 46508 46510 46511 46513 46514 46515 46516 46517 46524 46526 46527 46528 46530 46531 46532 46534 46536 46537 46538 46539 46540 46542 46543 46544 46545 46546 46550 46552 46553 46554 46555 46556 46561 46562 46563 46565 46566 46567 46570 46571 46572 46573 46574 46580 46581 1.0 1.0 1.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.5 4.0 10.5 7.3 1.0 5.0 5.0 10.5 4.0 1.0 1.0 1.0 1.0 5.0 1.0 1.0 1.0 1.0 9.0 9.0 9.0 2.0 4.0 5.0 5.0 10.1 10.4 2.0 1.0 1.0 1.0 9.0 2.0 1.0 2.0 6.0 1.0 1.0 5.0 4.0 10.0 5.0 7.3 10.5 10.4 4.0 2.0 7.3 4.0 4.0 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN PO 00000 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... Frm 00482 Fmt 4701 RUCA level 46582 46590 46595 46601 46604 46612 46613 46614 46615 46616 46617 46619 46620 46624 46626 46628 46629 46634 46635 46637 46660 46680 46699 46701 46702 46703 46704 46705 46706 46710 46711 46713 46714 46720 46721 46723 46725 46730 46731 46732 46733 46737 46738 46740 46741 46742 46743 46745 46746 46747 46748 46750 46755 46759 46760 46761 46763 46764 46765 46766 46767 46769 46770 46771 46772 46773 46774 46776 46777 4.0 4.0 7.3 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.5 5.0 4.0 1.0 6.0 4.2 3.0 7.0 4.2 7.3 9.2 7.4 2.0 7.3 6.0 8.3 9.0 4.2 5.2 4.2 10.6 1.0 6.0 2.0 2.0 10.6 5.0 1.0 4.2 4.0 8.0 9.0 7.0 3.0 10.6 1.0 8.0 7.3 7.0 2.0 10.6 10.5 2.0 1.0 5.0 2.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 46778 46779 46780 46781 46782 46783 46784 46785 46786 46787 46788 46789 46791 46792 46793 46794 46795 46796 46797 46798 46799 46801 46802 46803 46804 46805 46806 46807 46808 46809 46814 46815 46816 46818 46819 46825 46835 46845 46850 46851 46852 46853 46854 46855 46856 46857 46858 46859 46860 46861 46862 46863 46864 46865 46866 46867 46868 46869 46885 46895 46896 46897 46898 46899 46901 46902 46903 46904 46910 8.0 6.0 4.2 8.0 4.2 2.0 6.0 5.2 9.0 10.6 2.0 9.0 2.0 10.5 4.2 9.2 9.0 9.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 9.0 70105 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN Zip code RUCA level 46911 46912 46913 46914 46915 46916 46917 46919 46920 46921 46922 46923 46926 46928 46929 46930 46931 46932 46933 46935 46936 46937 46938 46939 46940 46941 46942 46943 46945 46946 46947 46950 46951 46952 46953 46957 46958 46959 46960 46961 46962 46965 46967 46968 46970 46971 46974 46975 46977 46978 46979 46980 46982 46984 46985 46986 46987 46988 46989 46990 46991 46992 46994 46995 46996 46998 47001 47003 47006 3.0 7.0 2.0 2.0 2.0 10.4 10.4 3.0 2.0 10.5 7.0 7.3 10.5 5.0 10.4 4.0 7.0 2.0 4.0 10.6 2.0 1.0 4.0 10.6 6.0 5.0 4.0 7.0 7.0 7.0 4.0 5.0 10.5 4.0 4.0 7.4 4.2 2.0 8.0 4.0 7.0 1.0 5.0 8.0 4.2 4.2 5.0 7.0 7.3 5.0 2.0 7.0 5.0 6.0 8.0 5.0 4.0 5.0 7.4 5.0 5.0 4.0 5.0 2.0 7.0 2.0 2.0 6.0 7.0 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN PO 00000 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... Frm 00483 Fmt 4701 RUCA level 47010 47011 47012 47016 47017 47018 47019 47020 47021 47022 47023 47024 47025 47030 47031 47032 47033 47034 47035 47036 47037 47038 47039 47040 47041 47042 47043 47060 47102 47104 47106 47107 47108 47110 47111 47112 47114 47115 47116 47117 47118 47119 47120 47122 47123 47124 47125 47126 47129 47130 47131 47132 47133 47134 47135 47136 47137 47138 47139 47140 47141 47142 47143 47144 47145 47146 47147 47150 47151 2.0 10.0 2.0 2.0 10.4 5.1 10.5 10.4 10.6 2.0 10.0 9.2 4.1 3.0 10.4 2.0 7.0 10.5 2.0 7.0 10.5 10.4 10.4 10.5 9.0 10.6 10.4 2.0 4.0 2.0 2.0 2.0 8.0 2.0 2.0 2.0 2.0 2.0 10.5 2.0 10.5 1.0 2.0 1.0 10.5 2.0 10.6 2.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 10.4 5.0 4.0 2.0 2.0 2.0 2.0 1.0 2.0 1.0 2.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 47160 47161 47162 47163 47164 47165 47166 47167 47170 47172 47174 47175 47177 47190 47199 47201 47202 47203 47220 47223 47224 47225 47226 47227 47228 47229 47230 47231 47232 47234 47235 47236 47240 47243 47244 47245 47246 47247 47249 47250 47260 47261 47263 47264 47265 47270 47272 47273 47274 47280 47281 47282 47283 47302 47303 47304 47305 47306 47307 47308 47320 47322 47324 47325 47326 47327 47330 47331 47334 2.0 2.0 2.0 2.0 2.0 2.0 2.0 7.3 4.0 1.0 10.4 10.5 2.0 1.0 1.0 1.0 1.0 1.0 5.0 5.0 5.0 7.4 1.0 5.0 4.0 5.0 5.0 5.0 2.0 5.2 5.0 2.0 4.0 7.2 2.0 4.2 2.0 1.0 5.0 4.0 5.0 4.0 4.0 5.0 4.2 5.0 5.0 4.2 4.0 1.0 5.0 5.0 5.2 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 4.0 4.0 10.5 8.0 5.0 4.0 4.0 1.0 70106 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN Zip code RUCA level 47335 47336 47337 47338 47339 47340 47341 47342 47344 47345 47346 47348 47351 47352 47353 47354 47355 47356 47357 47358 47359 47360 47361 47362 47366 47367 47368 47369 47370 47371 47373 47374 47375 47380 47381 47382 47383 47384 47385 47386 47387 47388 47390 47392 47393 47394 47396 47401 47402 47403 47404 47405 47406 47407 47408 47420 47421 47424 47426 47427 47429 47430 47431 47432 47433 47434 47435 47436 47437 5.0 7.3 5.0 2.0 5.0 2.0 5.0 2.0 2.0 5.0 5.0 7.0 6.1 5.0 10.5 3.0 6.0 2.0 5.0 3.0 10.6 5.2 4.0 4.0 5.0 1.0 2.0 8.0 5.0 7.0 9.1 4.0 4.0 2.0 8.0 8.0 1.0 6.1 5.0 5.2 5.0 2.0 7.4 5.0 5.0 7.3 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 6.1 4.2 7.1 1.0 10.0 1.0 4.2 2.0 7.0 3.0 1.0 10.0 5.0 5.0 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN PO 00000 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... Frm 00484 Fmt 4701 RUCA level 47438 47439 47441 47443 47445 47446 47448 47449 47451 47452 47453 47454 47455 47456 47457 47458 47459 47460 47462 47463 47464 47465 47467 47468 47469 47470 47471 47490 47501 47512 47513 47514 47515 47516 47519 47520 47521 47522 47523 47524 47525 47527 47528 47529 47531 47532 47535 47536 47537 47541 47542 47545 47546 47547 47549 47550 47551 47552 47553 47556 47557 47558 47561 47562 47564 47567 47568 47573 47574 9.1 2.0 7.0 10.6 7.0 5.0 10.0 10.6 6.1 10.5 2.0 9.0 10.0 2.0 7.1 1.0 2.0 3.0 6.1 1.0 1.0 10.6 4.2 2.0 10.0 5.0 10.4 1.0 4.0 5.0 5.0 10.6 10.6 5.0 10.5 7.0 5.0 10.6 10.5 4.0 10.6 5.0 5.0 10.0 10.0 10.5 5.0 10.5 10.4 10.5 7.2 4.0 4.0 4.0 4.0 10.0 10.6 10.5 7.4 10.5 5.0 10.5 5.0 10.0 5.0 7.0 5.0 5.0 8.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 47575 47576 47577 47578 47579 47580 47581 47584 47585 47586 47588 47590 47591 47596 47597 47598 47601 47610 47611 47612 47613 47614 47615 47616 47617 47618 47619 47620 47629 47630 47631 47633 47634 47635 47637 47638 47639 47640 47647 47648 47649 47654 47660 47665 47666 47670 47683 47701 47702 47703 47704 47705 47706 47708 47710 47711 47712 47713 47714 47715 47716 47719 47720 47721 47722 47724 47725 47727 47728 5.0 10.6 10.5 5.0 10.5 5.0 10.5 9.1 5.0 7.0 8.0 5.0 4.0 5.0 5.0 3.0 2.0 1.0 10.4 2.0 2.0 2.0 10.0 2.0 2.0 2.0 2.0 7.1 1.0 1.0 3.0 2.0 2.0 10.4 2.0 2.0 2.0 8.0 9.1 2.0 8.0 2.0 9.1 3.0 8.0 7.3 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 2.0 1.0 1.0 70107 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN Zip code RUCA level 47730 47731 47732 47733 47734 47735 47736 47737 47739 47740 47741 47744 47747 47750 47801 47802 47803 47804 47805 47807 47808 47809 47811 47812 47813 47814 47830 47831 47832 47833 47834 47836 47837 47838 47840 47841 47842 47845 47846 47847 47848 47849 47850 47851 47852 47853 47854 47855 47856 47857 47858 47859 47860 47861 47862 47863 47864 47865 47866 47868 47869 47870 47871 47872 47874 47875 47876 47878 47879 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.1 7.1 10.6 10.0 4.2 3.0 5.2 9.0 3.0 3.0 7.1 9.1 3.0 10.4 9.0 2.0 2.0 4.2 7.3 4.2 10.4 2.0 7.1 4.2 2.0 10.6 7.1 2.0 2.0 1.0 7.3 9.0 2.0 2.0 1.0 1.0 1.0 7.1 2.0 7.1 1.0 1.0 2.0 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN IN PO 00000 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... Frm 00485 Fmt 4701 RUCA level 47880 47881 47882 47884 47885 47901 47902 47903 47904 47905 47906 47907 47909 47916 47917 47918 47920 47921 47922 47923 47924 47925 47926 47928 47929 47930 47932 47933 47934 47935 47936 47937 47938 47939 47940 47941 47942 47943 47944 47946 47948 47949 47950 47951 47952 47954 47955 47957 47958 47959 47960 47962 47963 47964 47965 47966 47967 47968 47969 47970 47971 47974 47975 47977 47978 47980 47981 47982 47983 7.1 4.2 7.3 7.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 10.4 7.3 2.0 10.4 10.0 2.0 1.0 7.3 8.0 2.0 3.0 2.0 7.3 4.0 4.0 4.0 4.0 4.0 4.0 4.0 5.2 1.0 10.4 3.0 10.4 10.6 10.0 10.5 8.0 10.0 10.5 5.2 6.1 10.6 10.5 10.6 7.3 1.0 10.4 10.4 4.0 2.0 6.1 5.2 7.3 2.0 2.0 2.0 2.0 10.6 7.0 3.0 2.0 7.3 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State IN ...................................... IN ...................................... IN ...................................... IN ...................................... IN ...................................... IN ...................................... IN ...................................... IN ...................................... IN ...................................... IN ...................................... IN ...................................... IN ...................................... IN ...................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... KS ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 47984 47986 47987 47988 47989 47990 47991 47992 47993 47994 47995 47996 47997 66002 66006 66007 66008 66010 66012 66013 66014 66015 66016 66017 66018 66019 66020 66021 66023 66024 66025 66026 66027 66030 66031 66032 66033 66035 66036 66039 66040 66041 66042 66043 66044 66045 66046 66047 66048 66049 66050 66051 66052 66053 66054 66056 66058 66060 66061 66062 66063 66064 66066 66067 66070 66071 66072 66073 66075 10.4 10.4 10.5 10.5 5.0 5.0 3.0 2.0 2.0 6.1 10.4 1.0 7.3 4.0 7.3 2.0 10.4 10.4 1.0 2.0 10.1 10.6 5.0 10.0 2.0 2.0 5.0 2.0 5.0 2.0 2.1 2.0 4.2 2.0 2.0 7.0 7.0 10.0 7.1 10.6 10.1 5.0 5.2 4.2 1.0 1.0 1.0 1.0 4.2 1.0 2.0 1.0 2.0 2.0 3.0 10.4 5.0 10.4 1.0 1.0 1.0 7.1 3.0 4.2 2.0 7.1 10.1 2.0 10.4 70108 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS Zip code RUCA level 66076 66077 66078 66079 66080 66083 66085 66086 66087 66088 66090 66091 66092 66093 66094 66095 66097 66101 66102 66103 66104 66105 66106 66109 66110 66111 66112 66113 66115 66117 66118 66119 66160 66201 66202 66203 66204 66205 66206 66207 66208 66209 66210 66211 66212 66213 66214 66215 66216 66217 66218 66219 66220 66221 66222 66223 66224 66225 66226 66227 66250 66251 66276 66279 66282 66283 66285 66286 66401 3.0 4.0 5.2 5.2 5.2 2.0 2.0 2.0 10.4 10.4 2.0 10.6 3.0 10.6 10.0 5.2 10.4 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.4 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00486 Fmt 4701 RUCA level 66402 66403 66404 66406 66407 66408 66409 66411 66412 66413 66414 66415 66416 66417 66418 66419 66420 66422 66423 66424 66425 66426 66427 66428 66429 66431 66432 66434 66436 66438 66439 66440 66441 66442 66449 66451 66501 66502 66503 66505 66506 66507 66508 66509 66510 66512 66514 66515 66516 66517 66518 66520 66521 66522 66523 66524 66526 66527 66528 66531 66532 66533 66534 66535 66536 66537 66538 66539 66540 2.0 10.3 10.0 10.3 10.4 10.0 2.0 10.6 10.3 2.0 2.0 10.0 2.0 10.0 2.0 2.0 1.0 10.4 2.0 10.6 10.0 10.5 10.6 10.0 2.0 2.0 10.5 7.0 7.3 10.3 10.6 2.0 4.0 4.0 4.0 2.0 10.4 4.0 4.0 4.0 4.0 10.4 7.0 2.0 10.4 2.0 5.0 10.0 2.0 4.0 10.3 10.5 10.5 10.0 10.4 2.0 10.4 10.0 2.0 4.0 10.6 2.0 10.0 5.0 10.4 2.0 10.0 2.0 2.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 66541 66542 66543 66544 66546 66547 66548 66549 66550 66552 66554 66555 66601 66603 66604 66605 66606 66607 66608 66609 66610 66611 66612 66614 66615 66616 66617 66618 66619 66620 66621 66622 66624 66625 66626 66628 66629 66634 66636 66637 66638 66642 66647 66652 66653 66658 66667 66675 66683 66686 66692 66699 66701 66710 66711 66712 66713 66714 66716 66717 66720 66724 66725 66728 66732 66733 66734 66735 66736 10.3 1.0 2.0 10.6 2.0 7.4 10.6 10.5 10.0 2.0 4.0 7.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.0 9.0 5.0 5.0 7.3 9.0 8.0 9.0 7.0 5.0 7.3 2.0 10.6 10.6 5.0 5.0 10.6 70109 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS Zip code RUCA level 66738 66739 66740 66741 66742 66743 66746 66748 66749 66751 66753 66754 66755 66756 66757 66758 66759 66760 66761 66762 66763 66767 66769 66770 66771 66772 66773 66775 66776 66777 66778 66779 66780 66781 66782 66783 66801 66830 66833 66834 66835 66838 66839 66840 66842 66843 66845 66846 66849 66850 66851 66852 66853 66854 66855 66856 66857 66858 66859 66860 66861 66862 66863 66864 66865 66866 66868 66869 66870 8.0 2.0 9.0 5.0 7.0 7.2 5.0 10.6 7.0 8.0 5.0 8.0 10.6 5.0 7.4 10.0 10.0 4.0 10.0 4.0 4.0 10.4 8.0 2.0 10.6 10.6 5.0 10.6 9.0 10.0 9.0 8.0 5.0 5.0 5.0 10.6 4.0 5.0 5.0 10.4 5.0 10.0 7.0 10.5 3.0 10.5 10.5 10.0 10.0 10.5 10.5 10.6 10.6 5.0 10.6 10.6 10.6 10.0 10.0 10.6 10.6 10.5 10.6 5.0 5.0 10.5 5.0 10.5 10.6 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00487 Fmt 4701 RUCA level 66871 66872 66873 66901 66930 66932 66933 66935 66936 66937 66938 66939 66940 66941 66942 66943 66944 66945 66946 66948 66949 66951 66952 66953 66955 66956 66958 66959 66960 66961 66962 66963 66964 66966 66967 66968 66970 67001 67002 67003 67004 67005 67008 67009 67010 67012 67013 67016 67017 67018 67019 67020 67021 67022 67023 67024 67025 67026 67028 67029 67030 67031 67035 67036 67037 67038 67039 67041 67042 10.6 10.0 10.0 7.0 10.0 10.0 10.0 10.0 10.0 10.0 10.3 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.3 10.6 10.0 10.0 10.0 10.0 10.6 10.0 10.0 10.0 10.0 10.0 10.6 10.0 10.0 10.0 10.0 10.0 2.0 1.0 10.0 2.0 4.0 10.5 10.0 2.0 3.0 2.0 2.0 2.0 10.0 10.5 2.0 10.3 10.6 10.5 10.0 2.0 1.0 10.3 10.0 2.0 2.0 10.6 10.4 1.0 10.5 2.0 4.2 4.2 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 67045 67047 67049 67050 67051 67052 67053 67054 67055 67056 67057 67058 67059 67060 67061 67062 67063 67065 67066 67067 67068 67070 67071 67072 67073 67074 67101 67102 67103 67104 67105 67106 67107 67108 67109 67110 67111 67112 67114 67117 67118 67119 67120 67122 67123 67124 67127 67128 67131 67132 67133 67134 67135 67137 67138 67140 67142 67143 67144 67146 67147 67149 67150 67151 67152 67154 67155 67156 67159 7.0 10.6 10.4 2.0 10.4 2.0 10.5 10.0 1.0 2.0 10.0 10.4 10.0 1.0 10.0 7.4 7.0 10.0 10.3 1.0 7.3 10.0 10.0 3.0 7.0 3.0 1.0 10.5 2.0 10.0 2.0 2.0 10.5 2.0 10.0 1.0 2.0 10.6 4.2 4.2 2.0 10.4 2.0 10.6 2.0 7.0 10.0 10.6 2.0 3.0 2.0 10.3 2.0 10.6 10.0 10.6 10.6 10.0 2.0 2.0 1.0 2.0 10.0 7.4 7.3 2.0 10.0 4.0 10.6 70110 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS Zip code RUCA level 67201 67202 67203 67204 67205 67206 67207 67208 67209 67210 67211 67212 67213 67214 67215 67216 67217 67218 67219 67220 67221 67223 67226 67227 67228 67230 67231 67232 67233 67235 67236 67251 67256 67257 67259 67260 67275 67276 67277 67278 67301 67330 67332 67333 67334 67335 67336 67337 67340 67341 67342 67344 67345 67346 67347 67349 67351 67352 67353 67354 67355 67356 67357 67360 67361 67363 67364 67401 67402 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 5.0 10.5 10.5 10.0 5.0 10.5 4.0 4.0 5.0 10.5 5.0 10.4 10.4 5.0 10.4 5.0 10.4 10.4 5.0 10.0 10.5 4.0 10.0 10.0 4.0 10.5 4.0 4.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00488 Fmt 4701 RUCA level 67410 67416 67417 67418 67420 67422 67423 67425 67427 67428 67430 67431 67432 67436 67437 67438 67439 67441 67442 67443 67444 67445 67446 67447 67448 67449 67450 67451 67452 67454 67455 67456 67457 67458 67459 67460 67464 67466 67467 67468 67470 67473 67474 67475 67476 67478 67480 67481 67482 67483 67484 67485 67487 67490 67491 67492 67501 67502 67504 67505 67510 67511 67512 67513 67514 67515 67516 67518 67519 7.0 5.0 10.3 10.0 7.0 5.0 10.0 5.0 10.6 5.0 10.3 10.6 7.0 10.5 10.0 10.0 7.0 10.6 5.0 5.0 10.6 10.3 10.3 10.6 5.0 10.5 10.3 10.6 10.3 10.3 10.0 7.4 10.6 10.6 10.3 4.0 10.5 10.3 10.5 10.6 5.0 10.0 10.0 10.0 5.0 7.0 10.5 10.0 10.6 10.0 10.5 10.3 10.6 7.0 10.5 10.6 4.0 4.0 4.0 4.0 5.0 5.0 7.0 10.0 5.0 10.0 10.0 10.0 10.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 67520 67521 67522 67523 67524 67525 67526 67529 67530 67543 67544 67545 67546 67547 67548 67550 67552 67553 67554 67556 67557 67559 67560 67561 67563 67564 67565 67566 67567 67568 67570 67572 67573 67574 67575 67576 67578 67579 67581 67583 67584 67585 67601 67621 67622 67623 67625 67626 67627 67628 67629 67631 67632 67634 67635 67637 67638 67639 67640 67642 67643 67644 67645 67646 67647 67648 67649 67650 67651 10.5 10.0 5.0 10.6 10.6 10.2 10.2 10.6 4.0 5.0 5.0 10.0 10.5 10.0 10.5 7.0 10.0 10.0 7.0 10.0 10.0 10.0 10.0 5.0 10.0 5.0 10.5 5.0 5.0 5.0 6.0 10.0 7.0 10.6 10.0 10.0 10.0 7.0 5.0 5.0 10.0 5.0 4.0 10.3 7.0 10.0 10.0 10.6 5.0 10.0 7.0 10.0 10.5 10.6 10.0 5.0 10.0 10.3 10.6 10.0 10.0 10.3 7.0 10.6 10.6 10.6 10.6 10.0 10.0 70111 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS Zip code RUCA level 67653 67654 67656 67657 67658 67659 67660 67661 67663 67664 67665 67667 67669 67671 67672 67673 67674 67675 67701 67730 67731 67732 67733 67734 67735 67736 67737 67738 67739 67740 67741 67743 67744 67745 67747 67748 67749 67751 67752 67753 67756 67757 67758 67761 67762 67764 67801 67831 67834 67835 67836 67837 67838 67839 67840 67841 67842 67843 67844 67846 67849 67850 67851 67853 67854 67855 67857 67859 67860 10.0 7.0 10.0 10.5 10.6 10.0 5.0 7.0 10.5 10.6 7.0 4.0 10.0 5.0 10.0 10.6 5.0 10.0 7.0 10.0 10.0 10.3 8.0 10.3 7.0 10.0 10.0 10.0 10.0 10.0 8.0 10.3 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.3 10.0 10.0 10.0 10.0 10.0 10.0 4.0 10.5 5.0 10.5 10.0 10.5 10.5 10.0 10.5 10.5 5.0 4.0 10.5 4.0 10.5 10.0 5.0 10.5 10.5 10.0 10.0 5.0 10.5 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KS KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00489 Fmt 4701 RUCA level 67861 67862 67863 67864 67865 67867 67868 67869 67870 67871 67876 67877 67878 67879 67880 67882 67901 67905 67950 67951 67952 67953 67954 40003 40004 40006 40007 40008 40009 40010 40011 40012 40013 40014 40018 40019 40020 40022 40023 40025 40026 40027 40031 40032 40033 40036 40037 40040 40041 40045 40046 40047 40048 40049 40050 40051 40052 40055 40056 40057 40058 40059 40060 40061 40062 40063 40065 40066 40067 10.0 10.0 7.0 10.0 10.5 10.5 5.0 10.5 10.0 7.0 5.0 10.0 10.0 10.0 7.0 5.0 4.0 4.0 10.0 7.0 10.6 10.0 10.0 5.0 4.2 3.0 10.0 6.1 8.0 2.0 3.0 6.1 5.1 1.0 1.0 2.0 5.1 2.0 1.0 1.0 1.0 1.0 2.0 2.0 7.0 10.0 10.5 10.0 1.0 6.0 2.0 1.0 4.2 10.5 10.4 5.0 5.0 2.0 1.0 10.0 3.0 1.0 8.0 10.5 8.0 7.0 4.2 4.2 2.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 40068 40069 40070 40071 40075 40076 40077 40078 40104 40107 40108 40109 40110 40111 40115 40117 40118 40119 40121 40129 40140 40142 40143 40144 40145 40146 40150 40152 40153 40155 40157 40159 40160 40161 40162 40164 40165 40170 40171 40175 40176 40177 40178 40201 40202 40203 40204 40205 40206 40207 40208 40209 40210 40211 40212 40213 40214 40215 40216 40217 40218 40219 40220 40221 40222 40223 40224 40225 40228 2.0 10.5 10.4 2.0 3.0 5.0 2.0 10.0 3.0 5.2 10.1 1.0 1.0 10.0 3.0 2.0 1.0 10.0 1.0 1.0 10.4 10.1 10.0 10.0 3.0 10.4 2.0 3.0 10.0 1.0 3.0 1.0 1.0 3.0 2.1 3.0 1.0 10.0 10.4 2.0 3.0 1.0 3.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70112 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY Zip code RUCA level 40229 40231 40232 40233 40241 40242 40243 40245 40250 40251 40252 40253 40255 40256 40257 40258 40259 40261 40266 40268 40269 40270 40272 40280 40281 40282 40283 40285 40287 40289 40290 40291 40292 40293 40294 40295 40296 40297 40298 40299 40310 40311 40312 40313 40316 40317 40319 40320 40322 40324 40328 40329 40330 40334 40336 40337 40339 40340 40342 40346 40347 40348 40350 40351 40353 40355 40356 40357 40358 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.4 10.5 9.0 7.0 10.5 8.0 8.0 4.2 10.5 4.2 8.0 8.0 7.4 5.0 7.3 5.0 4.1 2.0 7.4 6.0 3.0 4.2 10.5 8.0 4.2 10.4 2.0 4.2 10.6 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00490 Fmt 4701 RUCA level 40359 40360 40361 40362 40363 40366 40370 40371 40372 40374 40376 40379 40380 40383 40384 40385 40386 40387 40390 40391 40392 40402 40403 40404 40405 40409 40410 40419 40421 40422 40423 40434 40437 40440 40442 40444 40445 40446 40447 40448 40452 40456 40460 40461 40464 40467 40468 40472 40473 40475 40476 40481 40484 40486 40488 40489 40492 40495 40502 40503 40504 40505 40506 40507 40508 40509 40510 40511 40512 10.5 10.5 4.2 4.2 10.5 10.5 5.2 10.6 9.1 10.5 7.4 5.2 7.4 4.1 4.1 5.2 4.1 10.5 7.3 4.2 4.2 10.5 4.0 4.0 4.0 7.4 7.4 10.5 10.0 4.0 4.0 10.0 5.0 4.0 10.5 7.4 7.4 7.4 10.0 7.2 4.0 7.4 10.6 6.0 4.0 10.5 5.0 7.3 7.4 4.2 4.2 10.0 7.2 10.5 10.0 10.5 7.4 7.3 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 40513 40514 40515 40516 40517 40522 40523 40524 40526 40533 40536 40544 40546 40550 40555 40574 40575 40576 40577 40578 40579 40580 40581 40582 40583 40584 40585 40586 40587 40588 40589 40590 40591 40592 40593 40594 40595 40596 40598 40601 40602 40603 40604 40618 40619 40620 40621 40622 40701 40702 40724 40729 40730 40734 40737 40740 40741 40742 40743 40744 40745 40751 40754 40755 40759 40763 40769 40771 40801 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 4.0 4.0 4.0 4.0 4.0 4.0 4.0 4.0 4.0 4.0 5.0 5.0 7.4 10.2 5.0 4.0 5.0 5.0 5.0 5.0 5.0 5.0 8.0 5.0 10.6 8.0 7.4 4.0 8.0 70113 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY Zip code RUCA level 40803 40806 40807 40808 40810 40813 40815 40816 40818 40819 40820 40823 40824 40826 40827 40828 40829 40830 40831 40840 40843 40844 40845 40847 40849 40854 40855 40856 40858 40862 40863 40865 40868 40870 40873 40874 40902 40903 40906 40913 40914 40915 40921 40923 40927 40930 40931 40932 40935 40939 40940 40941 40943 40944 40946 40949 40951 40953 40955 40958 40962 40964 40965 40972 40977 40979 40981 40982 40983 10.0 7.0 7.0 9.0 9.0 10.2 8.0 10.0 8.0 7.0 8.0 7.0 7.0 10.0 10.0 8.0 7.0 7.0 7.0 10.0 8.0 10.0 10.5 8.0 8.0 7.0 7.0 10.5 10.0 10.0 8.0 8.0 10.0 8.0 7.0 10.0 6.0 10.3 7.4 6.0 8.0 10.3 10.6 9.0 8.0 8.4 8.0 7.0 10.3 10.5 10.5 7.0 9.0 8.0 9.0 10.3 7.0 10.3 10.5 6.0 7.0 7.0 4.0 10.6 10.5 10.0 10.6 8.4 9.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00491 Fmt 4701 RUCA level 40988 40995 40997 40999 41001 41002 41003 41004 41005 41006 41007 41008 41010 41011 41012 41014 41015 41016 41017 41018 41019 41022 41030 41031 41033 41034 41035 41037 41039 41040 41041 41042 41043 41044 41045 41046 41048 41049 41051 41052 41053 41054 41055 41056 41059 41061 41062 41063 41064 41065 41071 41072 41073 41074 41075 41076 41080 41081 41083 41085 41086 41091 41092 41093 41094 41095 41096 41097 41098 6.0 10.6 8.4 9.0 1.0 10.4 8.0 2.0 1.0 2.0 2.0 7.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 7.3 2.0 5.0 2.0 8.0 8.0 10.1 7.0 1.0 2.0 2.0 8.0 2.0 1.0 10.6 1.0 2.0 2.0 2.0 10.2 4.0 1.0 2.0 4.0 2.0 10.6 10.6 1.0 1.0 1.0 1.0 1.0 1.0 2.0 10.6 8.0 1.0 2.0 1.0 2.0 10.6 1.0 2.0 4.0 2.0 8.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 41099 41101 41102 41105 41114 41121 41124 41128 41129 41132 41135 41137 41139 41141 41142 41143 41144 41146 41149 41156 41159 41160 41164 41166 41168 41169 41171 41173 41174 41175 41179 41180 41181 41183 41189 41201 41203 41204 41214 41216 41219 41222 41224 41226 41230 41231 41232 41234 41238 41240 41250 41254 41255 41256 41257 41260 41262 41263 41264 41265 41267 41268 41271 41274 41301 41307 41310 41311 41313 1.0 1.0 1.0 1.0 1.0 1.0 10.6 10.6 2.0 8.3 10.0 10.0 1.0 10.0 10.6 7.3 2.0 8.3 10.6 2.0 10.6 10.6 10.6 10.0 2.0 1.0 10.6 10.6 4.0 4.0 10.5 9.1 7.3 1.0 10.0 8.0 10.0 8.0 10.0 10.6 8.0 8.0 10.0 8.0 7.3 10.6 8.0 7.0 8.0 7.0 10.6 10.0 8.0 7.0 8.0 8.0 10.0 8.0 8.0 7.0 10.0 8.0 8.0 7.0 10.0 8.0 8.0 10.0 10.0 70114 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY Zip code RUCA level 41314 41317 41332 41333 41338 41339 41342 41344 41347 41348 41351 41352 41360 41362 41364 41365 41366 41367 41368 41385 41386 41390 41397 41408 41410 41413 41419 41421 41422 41425 41426 41433 41451 41459 41464 41465 41472 41477 41501 41502 41503 41512 41513 41514 41517 41519 41520 41522 41524 41526 41527 41528 41531 41534 41535 41537 41538 41539 41540 41542 41543 41544 41546 41547 41548 41549 41553 41554 41555 10.0 8.0 8.0 10.0 10.0 8.0 10.0 10.0 10.0 8.0 10.0 8.0 10.0 10.0 10.0 10.0 8.0 8.0 10.0 8.0 10.0 8.0 10.0 8.0 10.0 7.0 10.0 7.0 10.0 8.0 10.0 10.0 7.0 7.0 10.0 10.0 7.0 7.0 9.0 9.0 10.6 9.0 10.6 10.6 10.0 10.0 10.0 9.0 10.0 9.0 10.6 10.0 10.0 9.0 10.0 10.0 10.0 9.0 10.0 9.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00492 Fmt 4701 RUCA level 41557 41558 41559 41560 41561 41562 41563 41564 41566 41567 41568 41571 41572 41601 41602 41603 41604 41605 41606 41607 41612 41615 41616 41619 41621 41622 41630 41631 41632 41635 41636 41640 41642 41643 41645 41647 41649 41650 41651 41653 41655 41659 41660 41663 41666 41667 41669 41701 41702 41712 41713 41714 41719 41721 41722 41723 41725 41727 41729 41730 41731 41735 41736 41739 41740 41743 41745 41746 41747 9.0 10.0 10.6 9.0 9.0 10.3 9.0 10.0 10.0 10.0 10.0 10.0 8.0 10.6 10.6 10.0 10.0 10.0 10.0 10.6 10.0 10.0 10.6 10.6 10.6 10.6 10.6 10.6 10.0 10.6 10.6 10.6 10.0 10.6 10.6 10.6 10.6 10.0 10.6 10.6 10.6 10.0 10.6 10.0 10.6 10.0 10.0 8.0 8.0 8.0 8.0 10.0 8.0 10.6 8.0 8.0 9.0 8.0 8.0 10.0 10.3 10.3 8.0 8.0 9.0 8.0 10.6 8.0 8.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 41749 41751 41754 41759 41760 41762 41763 41764 41766 41772 41773 41774 41775 41776 41777 41778 41804 41810 41812 41815 41817 41819 41821 41822 41824 41825 41826 41828 41831 41832 41833 41834 41835 41836 41837 41838 41839 41840 41843 41844 41845 41847 41848 41849 41855 41858 41859 41861 41862 41901 41902 41903 41904 41905 41906 42001 42002 42003 42020 42021 42022 42023 42024 42025 42027 42028 42029 42031 42032 10.0 8.0 8.0 10.6 8.0 10.0 10.3 10.0 10.0 9.0 8.0 8.0 10.0 10.0 10.0 8.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.6 10.0 10.0 10.0 10.0 10.6 10.0 10.0 10.6 10.0 10.6 10.0 10.0 10.0 10.0 10.6 10.0 10.0 10.6 10.0 10.0 10.0 10.0 10.0 10.0 10.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 4.0 4.0 5.0 10.5 10.2 10.5 10.5 7.4 5.0 10.5 10.5 10.6 10.6 70115 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY Zip code RUCA level 42033 42035 42036 42037 42038 42039 42040 42041 42044 42045 42047 42048 42049 42050 42051 42053 42054 42055 42056 42058 42060 42061 42063 42064 42066 42069 42070 42071 42076 42078 42079 42081 42082 42083 42084 42085 42086 42087 42088 42101 42102 42103 42104 42120 42122 42123 42124 42127 42128 42129 42130 42131 42133 42134 42135 42140 42141 42142 42150 42151 42152 42153 42154 42156 42157 42159 42160 42163 42164 7.0 5.0 5.0 7.0 10.6 5.0 5.0 7.4 10.0 5.0 10.5 9.0 5.0 10.5 5.0 5.0 5.0 10.6 10.2 5.0 5.0 5.0 5.0 7.0 4.0 5.0 10.5 4.0 5.0 10.5 5.0 5.0 5.0 5.0 7.0 5.0 5.0 10.5 5.0 1.0 1.0 1.0 1.0 8.3 2.0 5.0 5.0 7.4 2.0 10.5 5.0 5.0 10.0 7.3 7.3 10.0 4.0 4.0 7.3 10.0 4.0 8.3 6.0 5.0 10.0 2.0 5.0 2.0 7.3 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00493 Fmt 4701 RUCA level 42166 42167 42170 42171 42201 42202 42203 42204 42206 42207 42209 42210 42211 42214 42215 42216 42217 42219 42220 42221 42223 42232 42234 42235 42236 42240 42241 42251 42252 42254 42256 42257 42259 42261 42262 42265 42266 42267 42270 42273 42274 42275 42276 42280 42283 42285 42286 42287 42288 42301 42302 42303 42304 42320 42321 42322 42323 42324 42325 42326 42327 42328 42330 42332 42333 42334 42337 42338 42339 5.0 10.0 2.0 2.0 10.4 10.4 10.0 10.4 10.6 2.0 10.4 2.0 7.4 6.0 5.0 10.5 5.0 10.4 10.5 1.0 1.0 5.2 10.4 1.0 5.0 4.2 4.2 10.4 10.4 5.0 8.0 2.0 10.4 10.4 1.0 7.0 1.0 10.4 1.0 10.4 2.0 10.4 7.0 10.0 10.6 2.0 10.4 10.4 10.4 1.0 1.0 1.0 1.0 7.3 6.0 10.4 6.0 9.0 6.0 6.0 10.4 8.0 4.0 4.0 7.3 1.0 6.0 7.3 9.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 42343 42344 42345 42347 42348 42349 42350 42351 42352 42354 42355 42356 42361 42364 42366 42367 42368 42369 42370 42371 42372 42374 42375 42376 42377 42378 42402 42403 42404 42406 42408 42409 42410 42411 42413 42419 42420 42431 42436 42437 42440 42441 42442 42444 42445 42450 42451 42452 42453 42455 42456 42457 42458 42459 42460 42461 42462 42463 42464 42501 42502 42503 42516 42518 42519 42528 42533 42539 42541 2.0 10.5 10.5 7.3 7.0 8.0 3.0 10.4 2.0 8.0 2.0 1.0 8.0 7.0 2.0 10.5 10.4 8.0 8.0 10.4 3.0 4.0 1.0 2.0 1.0 2.0 1.0 10.5 10.5 2.0 7.2 10.4 4.0 8.0 5.0 1.0 1.0 4.0 5.0 7.0 4.0 5.0 5.0 10.4 7.0 7.4 2.0 2.0 5.0 10.4 10.4 2.0 2.0 10.6 10.6 8.0 7.0 10.5 5.0 4.0 4.0 4.0 10.0 5.0 5.0 10.5 4.0 10.5 10.0 70116 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY KY LA LA LA LA LA LA LA Zip code RUCA level 42544 42553 42558 42564 42565 42566 42567 42602 42603 42629 42631 42633 42634 42635 42638 42642 42647 42649 42653 42701 42702 42711 42712 42713 42715 42716 42717 42718 42719 42720 42721 42722 42724 42726 42728 42729 42731 42732 42733 42735 42740 42741 42742 42743 42746 42748 42749 42753 42754 42755 42757 42758 42759 42762 42764 42765 42776 42782 42783 42784 42786 42788 70001 70002 70003 70004 70005 70006 70009 5.0 5.0 5.0 4.0 10.5 10.0 5.0 10.0 8.0 10.0 10.5 7.0 6.0 10.0 10.5 10.0 10.5 10.0 10.5 1.0 1.0 10.0 8.3 10.0 8.0 3.0 10.0 4.0 4.0 7.0 8.0 10.6 2.0 8.0 7.0 10.6 10.5 2.0 5.0 7.0 2.0 8.0 8.0 10.5 10.6 7.3 7.4 9.2 7.0 7.0 10.0 4.0 10.0 7.0 3.0 10.6 2.0 10.0 2.0 2.0 10.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00494 Fmt 4701 RUCA level 70010 70011 70030 70031 70032 70033 70036 70037 70038 70039 70040 70041 70043 70044 70047 70049 70050 70051 70052 70053 70054 70055 70056 70057 70058 70059 70060 70062 70063 70064 70065 70067 70068 70069 70070 70071 70072 70073 70075 70076 70078 70079 70080 70081 70082 70083 70084 70085 70086 70087 70090 70091 70092 70094 70096 70112 70113 70114 70115 70116 70117 70118 70119 70121 70122 70123 70124 70125 70126 1.0 1.0 5.1 2.0 1.0 1.0 2.0 1.0 7.3 2.0 2.0 7.3 1.0 1.0 2.0 2.0 7.3 4.1 7.4 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 4.1 4.1 2.0 7.4 1.0 1.0 1.0 4.1 2.0 2.0 5.1 2.0 2.0 7.3 4.1 1.0 10.4 1.0 9.2 7.3 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 70127 70128 70129 70130 70131 70139 70140 70141 70142 70143 70145 70146 70148 70149 70150 70151 70152 70153 70154 70156 70157 70158 70159 70160 70161 70162 70163 70164 70165 70166 70167 70170 70172 70174 70175 70176 70177 70178 70179 70181 70182 70183 70184 70185 70186 70187 70189 70190 70195 70301 70302 70310 70339 70340 70341 70342 70343 70344 70345 70346 70352 70353 70354 70355 70356 70357 70358 70359 70360 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.3 4.0 4.2 4.0 1.0 1.0 4.2 4.2 1.0 2.0 4.2 2.0 2.0 4.2 2.0 1.0 1.0 70117 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA Zip code RUCA level 70361 70363 70364 70371 70372 70373 70374 70375 70377 70380 70381 70390 70391 70392 70393 70394 70395 70397 70401 70402 70403 70404 70420 70421 70422 70426 70427 70429 70431 70433 70434 70435 70436 70437 70438 70441 70442 70443 70444 70445 70446 70447 70448 70449 70450 70451 70452 70453 70454 70455 70456 70457 70458 70459 70460 70461 70462 70463 70464 70465 70466 70467 70469 70470 70471 70501 70502 70503 70504 1.0 1.0 1.0 1.0 1.0 4.2 1.0 2.0 1.0 4.0 4.0 4.2 4.2 4.0 4.2 1.0 1.0 2.0 4.0 4.0 4.0 4.0 2.1 4.0 7.2 5.0 4.2 4.2 2.1 1.1 1.1 2.1 7.2 2.0 6.0 10.4 10.5 5.0 10.5 1.1 5.0 2.1 1.1 2.0 10.0 4.0 1.1 3.0 4.0 5.0 7.2 2.1 1.1 1.1 1.1 1.1 2.0 4.2 2.1 10.5 4.0 5.0 1.1 1.1 1.1 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00495 Fmt 4701 RUCA level 70505 70506 70507 70508 70509 70510 70511 70512 70513 70514 70515 70516 70517 70518 70519 70520 70521 70522 70523 70524 70525 70526 70527 70528 70529 70531 70532 70533 70534 70535 70537 70538 70540 70541 70542 70543 70544 70546 70548 70549 70550 70551 70552 70554 70555 70556 70558 70559 70560 70562 70563 70569 70570 70571 70575 70576 70577 70578 70580 70581 70582 70583 70584 70585 70586 70589 70591 70592 70593 1.0 1.0 1.0 1.0 1.0 4.2 4.2 2.0 4.2 4.0 10.5 6.1 2.0 1.0 7.1 1.0 2.0 4.0 9.2 4.0 7.3 4.2 4.2 4.2 1.0 6.1 10.5 4.2 6.0 4.0 6.1 4.0 4.0 4.2 10.6 6.1 9.2 4.0 7.4 9.2 4.2 4.2 5.0 7.0 2.0 6.0 1.0 6.0 4.2 4.2 4.2 4.2 4.2 4.2 4.2 7.0 5.0 7.1 7.0 7.3 7.1 1.0 2.0 7.0 7.0 5.0 7.3 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 70596 70598 70601 70602 70605 70606 70607 70609 70611 70612 70615 70616 70629 70630 70631 70632 70633 70634 70637 70638 70639 70640 70643 70644 70645 70646 70647 70648 70650 70651 70652 70653 70654 70655 70656 70657 70658 70659 70660 70661 70662 70663 70664 70665 70668 70669 70704 70706 70707 70710 70711 70712 70714 70715 70718 70719 70721 70722 70723 70725 70726 70727 70728 70729 70730 70732 70733 70734 70736 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 10.4 2.0 2.0 4.0 10.5 7.0 8.0 10.4 2.0 10.4 10.4 2.0 2.0 10.4 2.0 10.4 2.0 6.0 10.4 10.0 10.5 2.0 10.4 7.3 2.0 2.0 10.5 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 4.1 2.0 10.0 1.0 10.6 1.0 4.1 2.0 2.0 10.6 1.0 1.0 1.0 1.0 2.0 2.0 2.0 2.0 1.0 8.3 70118 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA Zip code RUCA level 70737 70738 70739 70740 70743 70744 70747 70748 70749 70750 70752 70753 70754 70755 70756 70757 70759 70760 70761 70762 70763 70764 70765 70767 70769 70770 70772 70773 70774 70775 70776 70777 70778 70780 70782 70783 70784 70785 70786 70787 70788 70789 70791 70792 70801 70802 70803 70804 70805 70806 70807 70808 70809 70810 70811 70812 70813 70814 70815 70816 70817 70818 70819 70820 70821 70822 70823 70825 70826 1.0 1.0 1.0 4.1 7.4 2.0 10.6 2.0 7.1 10.4 8.3 10.6 2.0 2.0 2.0 2.0 8.3 7.1 3.0 8.3 7.4 4.1 4.1 1.0 1.0 1.0 2.0 7.1 1.0 10.1 7.0 2.0 1.0 2.0 10.1 7.1 10.1 1.0 1.0 10.1 5.2 3.0 1.0 10.6 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00496 Fmt 4701 RUCA level 70827 70831 70833 70835 70836 70837 70874 70879 70883 70884 70892 70893 70894 70895 70896 70898 71001 71002 71003 71004 71006 71007 71008 71009 71016 71018 71019 71021 71023 71024 71025 71027 71028 71029 71030 71031 71032 71033 71034 71036 71037 71038 71039 71040 71043 71044 71045 71046 71047 71048 71049 71050 71051 71052 71055 71058 71060 71061 71063 71064 71065 71066 71067 71068 71069 71070 71071 71072 71073 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.4 3.0 9.0 2.0 2.0 2.0 10.5 1.0 3.0 9.0 8.0 9.0 2.0 5.2 8.0 2.0 9.0 2.0 2.0 5.0 2.0 2.0 8.0 8.0 1.0 8.0 5.2 7.0 2.0 2.0 3.0 2.0 2.0 9.0 2.0 2.0 1.0 7.3 4.2 4.2 2.0 2.0 8.3 2.0 9.0 4.0 2.0 2.0 2.0 10.5 9.0 9.2 5.2 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 71075 71078 71079 71080 71082 71101 71102 71103 71104 71105 71106 71107 71108 71109 71110 71111 71112 71113 71115 71118 71119 71120 71129 71130 71133 71134 71135 71136 71137 71138 71148 71149 71151 71152 71153 71154 71156 71161 71162 71163 71164 71165 71166 71171 71172 71201 71202 71203 71207 71208 71209 71210 71211 71212 71213 71218 71219 71220 71221 71222 71223 71225 71226 71227 71229 71230 71232 71233 71234 7.0 2.0 9.0 9.0 7.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 9.0 4.2 4.2 10.5 5.0 2.0 3.0 5.2 5.2 8.0 7.0 4.0 2.0 70119 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA Zip code RUCA level 71235 71237 71238 71240 71241 71242 71243 71245 71247 71249 71250 71251 71253 71254 71256 71259 71260 71261 71263 71264 71266 71268 71269 71270 71272 71273 71275 71276 71277 71279 71280 71281 71282 71284 71286 71291 71292 71294 71295 71301 71302 71303 71306 71307 71309 71315 71316 71320 71322 71323 71324 71325 71326 71327 71328 71329 71330 71331 71333 71334 71336 71339 71340 71341 71342 71343 71345 71346 71348 5.0 10.6 2.0 1.0 2.0 10.0 8.0 4.0 7.0 8.0 5.0 7.0 10.0 7.0 10.5 2.0 10.6 5.2 10.0 5.2 10.6 6.0 7.1 4.0 4.0 4.0 5.0 10.3 10.5 7.1 2.0 1.0 4.0 4.0 10.3 1.0 2.0 1.0 8.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.5 9.0 7.3 2.0 8.0 2.0 10.0 9.0 2.0 9.0 7.0 2.0 9.0 7.4 8.0 10.6 10.0 9.0 7.0 10.0 5.0 2.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA LA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00497 Fmt 4701 RUCA level 71350 71351 71353 71354 71355 71356 71357 71358 71359 71360 71361 71362 71363 71365 71366 71367 71368 71369 71371 71373 71375 71377 71378 71401 71403 71404 71405 71406 71407 71409 71410 71411 71414 71415 71416 71417 71418 71419 71422 71423 71424 71425 71426 71427 71428 71429 71430 71431 71432 71433 71434 71435 71438 71439 71440 71441 71443 71446 71447 71448 71449 71450 71452 71454 71455 71456 71457 71458 71459 9.0 7.0 6.0 10.5 9.0 6.0 10.0 5.0 1.0 1.0 1.0 9.0 10.0 1.0 10.0 10.6 10.0 10.6 8.0 4.0 10.0 10.0 10.6 10.0 9.0 8.0 1.0 8.0 2.0 2.0 7.0 5.0 4.0 10.0 5.0 10.1 2.0 9.0 8.0 2.0 2.0 10.0 9.0 2.0 5.0 9.0 10.1 2.0 10.4 10.1 5.0 10.0 2.0 9.0 7.0 10.0 7.3 7.3 2.0 10.1 8.0 5.0 5.0 10.4 2.0 5.0 4.0 4.0 4.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State LA ..................................... LA ..................................... LA ..................................... LA ..................................... LA ..................................... LA ..................................... LA ..................................... LA ..................................... LA ..................................... LA ..................................... LA ..................................... LA ..................................... LA ..................................... LA ..................................... LA ..................................... LA ..................................... LA ..................................... LA ..................................... LA ..................................... LA ..................................... LA ..................................... LA ..................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... MA .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 71460 71461 71462 71463 71465 71466 71467 71468 71469 71471 71472 71473 71474 71475 71477 71479 71480 71483 71485 71486 71496 71497 01001 01002 01003 01004 01005 01007 01008 01009 01010 01011 01012 01013 01014 01020 01021 01022 01026 01027 01028 01029 01030 01031 01032 01033 01034 01035 01036 01037 01038 01039 01040 01041 01050 01053 01054 01056 01057 01059 01060 01061 01062 01063 01066 01068 01069 01070 01071 9.0 7.4 9.0 7.0 10.6 2.0 2.0 5.0 5.0 4.0 2.0 8.0 7.3 7.3 1.0 10.6 10.6 7.0 2.0 9.0 7.3 4.0 1.0 4.1 4.1 4.1 2.0 4.1 2.0 1.0 2.1 2.0 2.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 10.4 1.0 2.1 2.0 1.0 2.0 1.0 1.0 2.0 1.0 2.0 1.0 1.0 2.0 1.0 6.1 1.0 2.0 4.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 70120 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA Zip code RUCA level 01072 01073 01074 01075 01077 01079 01080 01081 01082 01083 01084 01085 01086 01088 01089 01090 01092 01093 01094 01095 01096 01097 01098 01101 01102 01103 01104 01105 01106 01107 01108 01109 01111 01114 01115 01116 01118 01119 01128 01129 01133 01138 01139 01144 01151 01152 01195 01199 01201 01202 01203 01220 01222 01223 01224 01225 01226 01227 01229 01230 01235 01236 01237 01238 01240 01242 01243 01244 01245 6.1 2.0 2.0 1.0 1.0 1.0 1.0 2.1 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 2.0 3.0 2.1 1.0 2.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.2 10.6 2.0 1.0 2.0 1.0 1.0 3.0 7.3 2.0 7.3 1.0 7.3 7.3 7.3 2.0 7.3 10.6 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00498 Fmt 4701 RUCA level 01247 01252 01253 01254 01255 01256 01257 01258 01259 01260 01262 01263 01264 01266 01267 01270 01301 01302 01330 01331 01337 01338 01339 01340 01341 01342 01343 01344 01346 01347 01349 01350 01351 01354 01355 01360 01364 01366 01367 01368 01370 01373 01375 01376 01378 01379 01380 01420 01430 01431 01432 01434 01436 01438 01440 01441 01450 01451 01452 01453 01460 01462 01463 01464 01467 01468 01469 01470 01471 4.2 7.3 10.4 2.0 10.4 5.2 10.6 9.0 9.0 7.3 9.0 9.0 7.3 3.0 4.2 2.0 4.2 4.2 10.5 4.2 5.0 10.5 6.0 6.0 10.5 3.0 5.2 6.0 6.0 4.2 4.2 6.0 4.2 5.0 6.1 5.0 4.2 3.0 6.0 2.1 10.5 3.0 4.1 4.2 6.0 6.0 6.0 1.0 2.1 2.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.1 1.0 1.0 1.0 2.0 1.0 2.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 01472 01473 01474 01475 01477 01501 01503 01504 01505 01506 01507 01508 01509 01510 01515 01516 01517 01518 01519 01520 01521 01522 01523 01524 01525 01526 01527 01529 01531 01532 01534 01535 01536 01537 01538 01540 01541 01542 01543 01545 01546 01550 01560 01561 01562 01564 01566 01568 01569 01570 01571 01580 01581 01582 01583 01585 01586 01588 01590 01601 01602 01603 01604 01605 01606 01607 01608 01609 01610 1.0 1.0 1.0 2.0 2.0 1.0 2.0 1.0 1.0 2.0 2.0 2.0 2.0 1.0 2.0 1.0 2.1 1.0 1.0 1.0 2.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.1 1.0 1.0 2.0 1.0 1.0 1.0 1.0 2.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70121 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA Zip code RUCA level 01611 01612 01613 01614 01615 01653 01654 01655 01701 01702 01703 01704 01705 01718 01719 01720 01721 01730 01731 01740 01741 01742 01745 01746 01747 01748 01749 01752 01754 01756 01757 01760 01770 01772 01773 01775 01776 01778 01784 01801 01803 01805 01806 01807 01808 01810 01812 01813 01815 01821 01822 01824 01826 01827 01830 01831 01832 01833 01834 01835 01840 01841 01842 01843 01844 01845 01850 01851 01852 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00499 Fmt 4701 RUCA level 01853 01854 01860 01862 01863 01864 01865 01866 01867 01876 01879 01880 01885 01886 01887 01888 01889 01890 01899 01901 01902 01903 01904 01905 01906 01907 01908 01910 01913 01915 01921 01922 01923 01929 01930 01931 01936 01937 01938 01940 01944 01945 01949 01950 01951 01952 01960 01961 01965 01966 01969 01970 01971 01982 01983 01984 01985 02018 02019 02020 02021 02025 02026 02027 02030 02031 02032 02035 02038 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 02040 02041 02043 02044 02045 02047 02048 02050 02051 02052 02053 02054 02055 02056 02059 02060 02061 02062 02065 02066 02067 02070 02071 02072 02081 02090 02093 02101 02102 02103 02104 02105 02106 02107 02108 02109 02110 02111 02112 02113 02114 02115 02116 02117 02118 02119 02120 02121 02122 02123 02124 02125 02126 02127 02128 02129 02130 02131 02132 02133 02134 02135 02136 02137 02138 02139 02140 02141 02142 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70122 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA Zip code RUCA level 02143 02144 02145 02148 02149 02150 02151 02152 02153 02155 02156 02163 02169 02170 02171 02176 02180 02184 02185 02186 02187 02188 02189 02190 02191 02196 02199 02201 02203 02204 02205 02206 02207 02208 02209 02210 02211 02212 02215 02216 02217 02222 02228 02238 02239 02241 02266 02269 02283 02284 02293 02295 02297 02301 02302 02303 02304 02305 02322 02324 02325 02327 02330 02331 02332 02333 02334 02337 02338 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00500 Fmt 4701 RUCA level 02339 02340 02341 02343 02344 02345 02346 02347 02348 02349 02350 02351 02355 02356 02357 02358 02359 02360 02361 02362 02364 02366 02367 02368 02370 02375 02379 02381 02382 02420 02421 02445 02446 02447 02451 02452 02453 02454 02455 02456 02457 02458 02459 02460 02461 02462 02464 02465 02466 02467 02468 02471 02472 02474 02475 02476 02477 02478 02479 02481 02482 02492 02493 02494 02495 02532 02534 02535 02536 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.6 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 02537 02538 02539 02540 02541 02542 02543 02552 02553 02554 02556 02557 02558 02559 02561 02562 02563 02564 02565 02568 02571 02573 02574 02575 02576 02584 02601 02630 02631 02632 02633 02634 02635 02636 02637 02638 02639 02641 02642 02643 02644 02645 02646 02647 02648 02649 02650 02651 02652 02653 02655 02657 02659 02660 02661 02662 02663 02664 02666 02667 02668 02669 02670 02671 02672 02673 02675 02702 02703 1.0 1.0 10.6 1.0 1.0 1.0 1.0 10.6 1.0 7.0 1.0 7.0 1.0 1.0 1.0 1.0 1.0 7.0 1.0 7.0 1.0 7.0 1.0 10.6 1.0 7.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 7.3 1.0 1.0 1.0 1.0 2.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70123 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MA MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD Zip code RUCA level 02712 02713 02714 02715 02717 02718 02719 02720 02721 02722 02723 02724 02725 02726 02738 02739 02740 02741 02742 02743 02744 02745 02746 02747 02748 02760 02761 02762 02763 02764 02766 02767 02768 02769 02770 02771 02777 02779 02780 02783 02790 02791 05501 05544 20601 20602 20603 20604 20606 20607 20608 20609 20610 20611 20612 20613 20615 20616 20617 20618 20619 20620 20621 20622 20623 20624 20625 20626 20627 1.0 10.6 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.1 2.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 2.0 6.0 1.0 2.0 6.0 2.0 3.0 2.0 1.0 3.0 2.0 2.0 6.0 4.2 5.0 3.0 2.0 1.0 3.0 2.0 6.0 5.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00501 Fmt 4701 RUCA level 20628 20629 20630 20632 20634 20635 20636 20637 20639 20640 20643 20645 20646 20650 20653 20656 20657 20658 20659 20660 20661 20662 20664 20667 20670 20674 20675 20676 20677 20678 20680 20682 20684 20685 20686 20687 20688 20689 20690 20692 20693 20695 20697 20701 20703 20704 20705 20706 20707 20708 20709 20710 20711 20712 20714 20715 20716 20717 20718 20719 20720 20721 20722 20723 20724 20725 20726 20731 20732 5.0 4.2 5.0 3.0 4.2 2.0 5.0 2.0 2.0 2.0 2.0 2.0 2.0 5.0 4.2 5.0 4.2 2.0 2.0 2.0 2.0 2.1 2.0 4.2 4.2 5.0 2.0 3.0 2.0 2.0 5.0 6.0 5.0 3.0 4.2 5.0 4.2 2.0 5.0 5.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 20733 20735 20736 20737 20738 20740 20741 20742 20743 20744 20745 20746 20747 20748 20749 20750 20751 20752 20753 20754 20755 20757 20758 20759 20762 20763 20764 20765 20768 20769 20770 20771 20772 20773 20774 20775 20776 20777 20778 20779 20781 20782 20783 20784 20785 20787 20788 20790 20791 20792 20794 20797 20799 20810 20811 20812 20813 20814 20815 20816 20817 20818 20824 20825 20827 20830 20832 20833 20837 2.1 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.1 1.0 1.0 2.0 1.0 1.0 2.0 1.0 1.0 1.0 2.1 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.1 2.1 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 70124 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD Zip code RUCA level 20838 20839 20841 20842 20847 20848 20849 20850 20851 20852 20853 20854 20855 20857 20859 20860 20861 20862 20866 20868 20871 20872 20874 20875 20876 20877 20878 20879 20880 20882 20883 20884 20885 20886 20889 20891 20892 20894 20895 20896 20897 20898 20899 20901 20902 20903 20904 20905 20906 20907 20908 20910 20911 20912 20913 20914 20915 20916 20918 20993 20997 21001 21005 21009 21010 21012 21013 21014 21015 2.0 2.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.1 1.1 1.1 2.0 1.0 1.0 1.1 1.1 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00502 Fmt 4701 RUCA level 21017 21018 21020 21022 21023 21027 21028 21029 21030 21031 21032 21034 21035 21036 21037 21040 21041 21042 21043 21044 21045 21046 21047 21048 21050 21051 21052 21053 21054 21055 21056 21057 21060 21061 21062 21065 21071 21074 21075 21076 21077 21078 21082 21084 21085 21087 21088 21090 21092 21093 21094 21098 21102 21104 21105 21106 21108 21111 21113 21114 21117 21120 21122 21123 21128 21130 21131 21132 21133 1.1 1.1 2.0 1.0 1.0 1.0 1.1 1.0 1.0 10.1 1.0 2.1 2.0 2.1 1.0 1.1 1.0 1.0 1.0 1.0 1.0 1.0 1.1 2.0 1.1 1.0 1.0 2.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 10.1 1.0 2.0 1.0 1.0 1.0 1.1 1.0 1.0 1.1 1.1 2.0 1.0 2.0 1.0 1.0 1.0 2.0 2.0 2.0 1.0 1.0 2.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.1 2.0 2.1 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 21136 21139 21140 21144 21146 21150 21152 21153 21154 21155 21156 21157 21158 21160 21161 21162 21163 21201 21202 21203 21204 21205 21206 21207 21208 21209 21210 21211 21212 21213 21214 21215 21216 21217 21218 21219 21220 21221 21222 21223 21224 21225 21226 21227 21228 21229 21230 21231 21233 21234 21235 21236 21237 21239 21240 21241 21244 21250 21251 21252 21263 21264 21265 21268 21270 21273 21274 21275 21278 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.1 2.0 1.1 2.0 2.0 2.1 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70125 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD Zip code RUCA level 21279 21280 21281 21282 21283 21284 21285 21286 21287 21288 21289 21290 21297 21298 21401 21402 21403 21404 21405 21409 21411 21412 21501 21502 21503 21504 21505 21520 21521 21522 21523 21524 21528 21529 21530 21531 21532 21536 21538 21539 21540 21541 21542 21543 21545 21550 21555 21556 21557 21560 21561 21562 21601 21606 21607 21609 21610 21612 21613 21617 21619 21620 21622 21623 21624 21625 21626 21627 21628 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 4.0 4.0 4.0 4.0 10.6 5.0 10.5 8.4 4.0 5.0 4.0 5.0 10.6 5.0 10.5 8.4 5.0 4.0 8.0 5.0 5.0 5.0 7.0 5.0 4.0 4.0 4.0 8.0 4.0 4.0 4.0 10.6 5.0 8.0 10.2 4.0 10.4 2.0 7.0 5.0 7.0 10.2 5.0 5.0 5.0 8.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00503 Fmt 4701 RUCA level 21629 21631 21632 21634 21635 21636 21638 21639 21640 21641 21643 21644 21645 21647 21648 21649 21650 21651 21652 21653 21654 21655 21656 21657 21658 21659 21660 21661 21662 21663 21664 21665 21666 21667 21668 21669 21670 21671 21672 21673 21675 21676 21677 21678 21679 21681 21682 21683 21684 21685 21686 21687 21688 21690 21701 21702 21703 21704 21705 21709 21710 21711 21713 21714 21715 21716 21717 21718 21719 7.4 5.0 7.4 5.0 9.1 10.5 9.1 10.5 3.0 7.4 6.0 10.6 8.0 5.0 5.0 3.0 9.1 8.0 10.2 10.2 5.0 5.0 7.0 10.0 2.0 6.0 10.4 10.6 5.0 10.2 5.0 5.0 2.1 8.0 10.6 5.0 3.0 5.0 5.0 5.0 5.0 5.0 5.0 8.0 5.0 10.4 10.4 10.4 10.4 10.4 10.4 10.4 10.4 7.0 1.1 1.1 1.1 1.1 1.1 1.1 1.1 2.0 2.0 1.1 2.1 2.1 1.1 1.1 4.2 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 21720 21721 21722 21723 21727 21733 21734 21737 21738 21740 21741 21742 21746 21747 21748 21749 21750 21754 21755 21756 21757 21758 21759 21762 21765 21766 21767 21769 21770 21771 21773 21774 21775 21776 21777 21778 21779 21780 21781 21782 21783 21784 21787 21788 21790 21791 21792 21793 21794 21795 21797 21798 21801 21802 21803 21804 21810 21811 21813 21814 21817 21821 21822 21824 21826 21829 21830 21835 21836 1.0 1.0 2.0 2.1 9.1 1.0 1.0 2.1 2.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.1 1.1 3.0 2.1 2.1 2.1 1.1 2.1 5.0 1.0 1.1 1.1 2.0 2.1 1.1 2.1 2.1 1.1 2.0 3.0 2.0 1.0 2.0 1.0 2.0 3.0 2.0 1.1 2.1 2.1 1.1 2.1 1.0 2.0 2.0 1.0 1.0 1.0 1.0 2.0 4.2 5.0 2.0 7.0 2.0 2.0 2.0 1.0 3.0 1.0 5.0 7.3 70126 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME Zip code RUCA level 21837 21838 21840 21841 21842 21843 21849 21850 21851 21852 21853 21856 21857 21861 21862 21863 21864 21865 21866 21867 21869 21870 21871 21872 21874 21875 21890 21901 21902 21903 21904 21911 21912 21913 21914 21915 21916 21917 21918 21919 21920 21921 21922 21930 03901 03902 03903 03904 03905 03906 03907 03908 03909 03910 03911 04001 04002 04003 04004 04005 04006 04007 04008 04009 04010 04011 04013 04014 04015 2.0 10.6 2.0 10.4 4.2 4.2 1.0 2.0 7.3 2.0 7.3 2.0 7.3 2.0 4.2 10.5 3.0 2.0 2.0 7.3 6.0 2.0 7.3 5.0 2.0 1.0 7.3 2.0 1.1 1.1 1.1 2.0 2.0 2.0 2.0 2.0 1.0 2.0 2.1 2.0 1.0 1.0 1.0 2.0 1.0 3.0 1.0 1.0 1.0 10.4 10.4 1.0 3.0 3.0 3.0 6.1 2.0 5.2 2.0 1.0 1.0 1.0 5.2 10.4 10.0 4.2 1.0 7.1 2.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00504 Fmt 4701 RUCA level 04016 04017 04019 04020 04021 04022 04024 04027 04028 04029 04030 04032 04033 04034 04037 04038 04039 04040 04041 04042 04043 04046 04047 04048 04049 04050 04051 04053 04054 04055 04056 04057 04061 04062 04063 04064 04066 04068 04069 04070 04071 04072 04073 04074 04075 04076 04077 04078 04079 04082 04083 04084 04085 04086 04087 04088 04090 04091 04092 04093 04094 04095 04096 04097 04098 04101 04102 04103 04104 10.6 1.0 2.0 2.0 1.0 10.0 2.0 2.0 2.0 2.0 2.0 1.0 1.0 1.0 10.0 1.0 2.0 3.0 2.0 2.0 7.1 7.1 2.0 2.0 2.0 2.0 10.6 4.2 3.0 2.0 6.1 3.0 2.0 1.0 1.0 1.0 5.2 2.0 2.0 1.0 2.0 1.0 4.2 1.0 2.0 6.1 2.0 1.0 5.2 1.0 4.2 2.0 2.0 4.2 2.0 10.6 3.0 2.0 1.0 2.0 7.1 6.1 1.0 2.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 04105 04106 04107 04108 04109 04110 04112 04116 04122 04123 04124 04210 04211 04212 04216 04217 04219 04220 04221 04222 04223 04224 04225 04226 04227 04228 04230 04231 04234 04236 04237 04238 04239 04240 04241 04243 04250 04252 04253 04254 04255 04256 04257 04258 04259 04260 04261 04262 04263 04265 04266 04267 04268 04270 04271 04274 04275 04276 04278 04280 04281 04282 04283 04284 04285 04286 04287 04288 04289 1.0 1.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.0 10.6 10.0 2.0 10.6 2.0 1.0 10.6 10.0 10.0 10.3 9.1 2.1 10.6 10.3 2.0 10.6 2.0 10.6 1.0 1.0 1.0 2.0 2.0 3.0 9.1 10.0 2.0 7.0 2.0 6.1 2.0 10.0 10.6 2.0 6.1 2.0 10.6 7.0 10.6 7.0 2.1 7.0 7.0 10.0 1.0 7.0 2.0 2.0 6.1 10.0 10.6 5.2 2.0 10.6 70127 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME Zip code RUCA level 04290 04291 04292 04294 04330 04332 04333 04336 04338 04341 04342 04343 04344 04345 04346 04347 04348 04349 04350 04351 04352 04353 04354 04355 04357 04358 04359 04360 04363 04364 04401 04402 04406 04408 04410 04411 04412 04413 04414 04415 04416 04417 04418 04419 04420 04421 04422 04423 04424 04426 04427 04428 04429 04430 04431 04434 04435 04438 04441 04442 04443 04444 04448 04449 04450 04451 04453 04454 04455 9.1 2.1 9.1 10.3 4.0 4.0 4.0 4.0 4.0 5.0 10.5 5.0 4.0 4.0 5.0 4.0 5.0 6.1 6.1 5.0 5.0 5.0 10.5 5.0 5.0 5.0 4.0 5.0 5.0 5.0 1.0 1.0 10.0 10.0 2.0 1.0 1.0 10.0 10.0 10.0 10.4 2.0 2.0 2.0 10.0 10.0 2.0 1.0 10.0 10.4 2.0 2.0 2.0 10.6 10.0 2.0 2.0 10.6 10.0 10.0 10.0 1.0 2.0 2.0 2.0 9.1 2.0 10.0 2.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00505 Fmt 4701 RUCA level 04456 04457 04459 04460 04461 04462 04463 04464 04467 04468 04469 04471 04472 04473 04474 04475 04476 04478 04479 04481 04485 04487 04488 04489 04490 04491 04492 04493 04495 04496 04497 04530 04535 04536 04537 04538 04539 04541 04543 04544 04547 04548 04549 04551 04553 04554 04555 04556 04558 04562 04563 04564 04565 04567 04568 04570 04571 04572 04573 04574 04575 04576 04578 04579 04605 04606 04607 04609 04611 2.0 10.4 9.1 10.6 1.0 7.0 10.4 10.0 2.0 1.0 1.0 8.0 10.0 1.0 2.0 2.0 10.0 10.0 10.0 10.4 10.0 9.1 2.0 1.0 10.0 10.0 10.0 2.0 2.0 2.0 8.0 4.2 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.2 5.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 5.0 10.2 10.0 5.0 5.0 10.0 10.0 10.0 10.5 10.0 10.5 10.0 10.0 10.5 5.0 10.0 10.0 10.0 7.0 10.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 04612 04613 04614 04615 04616 04617 04619 04622 04623 04624 04625 04626 04627 04628 04629 04630 04631 04634 04635 04637 04640 04642 04643 04644 04645 04646 04648 04649 04650 04652 04653 04654 04655 04656 04657 04658 04660 04662 04664 04666 04667 04668 04669 04671 04672 04673 04674 04675 04676 04677 04679 04680 04681 04683 04684 04685 04686 04691 04693 04694 04730 04732 04733 04734 04735 04736 04737 04738 04739 10.0 10.0 10.0 10.0 10.0 10.0 7.0 10.0 10.0 10.0 10.6 10.0 10.0 10.6 10.0 10.0 10.0 10.0 10.0 10.6 10.0 10.0 10.0 7.0 10.0 10.6 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.6 10.6 10.0 10.6 7.0 10.0 10.6 10.6 10.6 10.0 10.6 7.0 10.0 10.6 7.0 10.0 10.0 10.6 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.6 7.0 10.6 8.0 8.0 8.0 7.0 10.0 8.0 10.0 70128 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME ME Zip code RUCA level 04740 04741 04742 04743 04744 04745 04746 04747 04750 04751 04756 04757 04758 04759 04760 04761 04762 04763 04764 04765 04766 04768 04769 04770 04772 04773 04774 04775 04776 04777 04779 04780 04781 04783 04785 04786 04787 04788 04841 04843 04846 04847 04848 04849 04850 04851 04852 04853 04854 04855 04856 04857 04858 04859 04860 04861 04862 04863 04864 04865 04901 04903 04910 04911 04912 04915 04917 04918 04920 10.3 10.0 10.3 10.0 10.0 10.3 10.6 10.6 10.6 10.6 7.0 8.0 8.0 10.6 8.0 8.0 9.0 8.0 8.0 9.0 8.0 10.6 7.0 10.0 10.3 7.0 10.0 10.6 10.6 9.0 9.0 10.6 10.0 9.0 10.6 8.0 8.0 10.0 4.0 7.4 4.0 10.5 10.6 10.6 10.6 10.0 10.0 10.0 5.0 10.5 10.5 10.5 5.0 10.5 10.5 4.0 10.5 10.0 4.0 10.5 4.0 4.0 5.0 10.6 10.6 7.0 5.0 5.0 10.6 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... ME .................................... MH .................................... MH .................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... PO 00000 Frm 00506 Fmt 4701 RUCA level 04921 04922 04923 04924 04925 04926 04927 04928 04929 04930 04932 04933 04935 04936 04937 04938 04939 04940 04941 04942 04943 04944 04945 04947 04949 04950 04951 04952 04953 04954 04955 04956 04957 04958 04961 04962 04963 04964 04965 04966 04967 04969 04970 04971 04972 04973 04974 04975 04976 04978 04979 04981 04982 04983 04984 04985 04986 04987 04988 04989 04992 96960 96970 48001 48002 48003 48004 48005 48006 8.0 10.5 10.0 9.0 10.0 5.0 5.0 3.0 10.6 10.4 2.0 2.0 5.0 10.0 4.0 7.0 2.0 7.0 9.0 10.6 10.6 4.0 10.0 10.0 9.0 7.0 8.0 9.0 2.0 10.0 10.6 10.3 10.6 10.6 10.0 5.0 4.0 10.0 10.6 10.0 7.0 2.0 10.0 10.0 10.6 9.0 10.6 4.0 7.4 10.5 10.6 10.6 10.0 10.3 10.3 10.0 10.5 10.5 10.5 5.0 7.0 R R 1.0 2.0 2.0 1.0 2.0 2.1 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 48007 48009 48012 48014 48015 48017 48021 48022 48023 48025 48026 48027 48028 48030 48032 48034 48035 48036 48037 48038 48039 48040 48041 48042 48043 48044 48045 48046 48047 48048 48049 48050 48051 48054 48059 48060 48061 48062 48063 48064 48065 48066 48067 48068 48069 48070 48071 48072 48073 48074 48075 48076 48079 48080 48081 48082 48083 48084 48085 48086 48088 48089 48090 48091 48092 48093 48094 48095 48096 1.0 1.0 1.0 2.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 2.0 2.0 1.0 2.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 70129 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI Zip code RUCA level 48097 48098 48099 48101 48102 48103 48104 48105 48106 48107 48108 48109 48110 48111 48112 48113 48114 48115 48116 48117 48118 48120 48121 48122 48123 48124 48125 48126 48127 48128 48130 48131 48133 48134 48135 48136 48137 48138 48139 48140 48141 48143 48144 48145 48146 48150 48151 48152 48153 48154 48157 48158 48159 48160 48161 48162 48164 48165 48166 48167 48168 48169 48170 48173 48174 48175 48176 48177 48178 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 2.0 1.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.1 3.0 1.0 1.0 1.0 1.0 2.0 1.0 2.0 2.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 2.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI PO 00000 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... Frm 00507 Fmt 4701 RUCA level 48179 48180 48182 48183 48184 48185 48186 48187 48188 48189 48190 48191 48192 48193 48195 48197 48198 48201 48202 48203 48204 48205 48206 48207 48208 48209 48210 48211 48212 48213 48214 48215 48216 48217 48218 48219 48220 48221 48222 48223 48224 48225 48226 48227 48228 48229 48230 48231 48232 48233 48234 48235 48236 48237 48238 48239 48240 48242 48243 48244 48255 48260 48264 48265 48266 48267 48268 48269 48272 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 48275 48277 48278 48279 48288 48301 48302 48303 48304 48306 48307 48308 48309 48310 48311 48312 48313 48314 48315 48316 48317 48318 48320 48321 48322 48323 48324 48325 48326 48327 48328 48329 48330 48331 48332 48333 48334 48335 48336 48340 48341 48342 48343 48346 48347 48348 48350 48353 48356 48357 48359 48360 48361 48362 48363 48366 48367 48370 48371 48374 48375 48376 48377 48380 48381 48382 48383 48386 48387 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 70130 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI Zip code RUCA level 48390 48391 48393 48397 48398 48401 48410 48411 48412 48413 48414 48415 48416 48417 48418 48419 48420 48421 48422 48423 48426 48427 48428 48429 48430 48432 48433 48434 48435 48436 48437 48438 48439 48440 48441 48442 48444 48445 48446 48449 48450 48451 48453 48454 48455 48456 48457 48458 48460 48461 48462 48463 48464 48465 48466 48467 48468 48469 48470 48471 48472 48473 48475 48476 48480 48501 48502 48503 48504 1.0 1.0 1.0 1.0 1.0 3.0 9.0 1.0 2.0 7.0 3.0 3.0 10.4 2.1 3.0 10.6 1.0 3.0 2.0 1.0 9.0 10.6 2.0 2.0 1.0 10.6 1.0 10.0 3.0 2.1 1.0 2.1 1.0 2.0 10.6 2.0 2.0 9.0 4.1 2.0 1.0 2.1 10.6 3.0 2.0 10.0 2.0 1.0 2.0 3.0 2.0 2.1 3.0 10.0 3.0 10.6 10.6 3.0 10.6 7.0 9.0 1.0 10.6 2.0 2.0 1.0 1.0 1.0 1.0 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI PO 00000 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... Frm 00508 Fmt 4701 RUCA level 48505 48506 48507 48509 48519 48529 48531 48532 48550 48551 48552 48553 48554 48555 48556 48557 48559 48601 48602 48603 48604 48605 48606 48607 48608 48609 48610 48611 48612 48613 48614 48615 48616 48617 48618 48619 48620 48621 48622 48623 48624 48625 48626 48627 48628 48629 48630 48631 48632 48633 48634 48635 48636 48637 48638 48640 48641 48642 48647 48649 48650 48651 48652 48653 48654 48655 48656 48657 48658 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.0 4.0 6.0 3.0 6.1 6.0 10.4 7.4 6.0 10.0 4.0 10.0 9.2 1.0 9.0 7.0 2.0 9.0 5.0 7.0 7.0 2.1 6.0 6.0 2.1 10.0 10.0 2.0 2.0 4.0 4.0 4.0 10.0 6.1 10.4 7.0 5.0 9.0 10.0 2.0 9.0 4.0 10.4 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 48659 48661 48662 48663 48667 48670 48674 48686 48701 48703 48705 48706 48707 48708 48710 48720 48721 48722 48723 48724 48725 48726 48727 48728 48729 48730 48731 48732 48733 48734 48735 48736 48737 48738 48739 48740 48741 48742 48743 48744 48745 48746 48747 48748 48749 48750 48754 48755 48756 48757 48758 48759 48760 48761 48762 48763 48764 48765 48766 48767 48768 48769 48770 48787 48801 48802 48804 48805 48806 10.0 10.0 6.0 1.0 4.0 4.0 4.0 4.0 10.4 10.0 10.0 1.0 1.0 1.0 2.1 10.0 10.0 2.0 9.0 1.0 10.0 7.0 3.0 10.0 9.0 7.0 10.6 1.0 10.4 7.1 7.0 10.4 10.0 8.0 10.6 10.0 3.0 10.0 8.0 10.4 10.0 2.0 1.0 8.0 10.0 7.0 10.0 10.0 10.0 2.0 9.1 10.0 3.0 10.0 6.0 7.0 7.0 10.0 10.0 10.4 9.1 9.1 10.6 7.1 4.0 4.0 4.0 1.0 3.0 70131 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI Zip code RUCA level 48807 48808 48809 48811 48812 48813 48815 48816 48817 48818 48819 48820 48821 48822 48823 48824 48825 48826 48827 48829 48830 48831 48832 48833 48834 48835 48836 48837 48838 48840 48841 48842 48843 48844 48845 48846 48847 48848 48849 48850 48851 48852 48853 48854 48855 48856 48857 48858 48859 48860 48861 48862 48863 48864 48865 48866 48867 48870 48871 48872 48873 48874 48875 48876 48877 48878 48879 48880 48881 3.0 2.0 3.0 7.0 6.0 2.0 2.0 2.1 4.2 9.0 2.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 2.0 10.0 5.0 10.4 5.0 2.0 7.0 2.0 2.1 1.0 7.3 1.0 5.2 1.0 2.0 2.0 6.1 4.2 7.4 2.0 9.1 10.6 6.1 10.0 2.0 2.0 2.1 10.4 2.0 4.0 4.0 6.1 2.0 7.4 2.1 1.0 2.0 3.0 4.2 7.0 10.4 2.0 6.1 10.4 2.0 2.0 5.0 5.0 2.0 4.0 2.0 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI PO 00000 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... Frm 00509 Fmt 4701 RUCA level 48882 48883 48884 48885 48886 48887 48888 48889 48890 48891 48892 48893 48894 48895 48896 48897 48901 48906 48907 48908 48909 48910 48911 48912 48913 48915 48916 48917 48918 48919 48921 48922 48924 48929 48930 48933 48937 48950 48951 48956 48980 49001 49002 49003 49004 49005 49006 49007 49008 49009 49010 49011 49012 49013 49014 49015 49016 49017 49018 49019 49020 49021 49022 49023 49024 49026 49027 49028 49029 2.0 5.0 9.0 8.3 9.0 3.0 9.0 5.0 2.0 6.0 2.0 5.0 2.0 2.0 4.0 9.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 8.0 2.0 2.0 9.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 3.0 1.0 1.0 1.0 2.0 9.0 5.0 2.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 49030 49031 49032 49033 49034 49035 49036 49038 49039 49040 49041 49042 49043 49045 49046 49047 49048 49050 49051 49052 49053 49055 49056 49057 49058 49060 49061 49062 49063 49064 49065 49066 49067 49068 49069 49070 49071 49072 49073 49074 49075 49076 49077 49078 49079 49080 49081 49082 49083 49084 49085 49087 49088 49089 49090 49091 49092 49093 49094 49095 49096 49097 49098 49099 49101 49102 49103 49104 49106 5.0 3.0 10.5 2.0 2.0 3.0 4.0 2.0 2.0 10.5 1.0 9.0 3.0 3.0 3.0 7.3 1.0 2.0 2.0 2.0 1.0 2.0 9.0 3.0 7.3 2.0 10.4 2.0 9.0 10.5 2.0 10.4 3.0 7.3 7.3 3.0 2.0 10.4 9.0 1.0 4.0 3.0 1.0 4.2 2.0 4.2 1.0 5.0 2.0 2.0 1.0 1.0 2.0 10.5 7.0 4.0 9.1 7.3 10.5 3.0 2.0 2.0 2.0 9.0 2.0 3.0 7.3 7.3 1.0 70132 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI Zip code RUCA level 49107 49111 49112 49113 49115 49116 49117 49119 49120 49121 49125 49126 49127 49128 49129 49130 49201 49202 49203 49204 49220 49221 49224 49227 49228 49229 49230 49232 49233 49234 49235 49236 49237 49238 49239 49240 49241 49242 49245 49246 49247 49248 49249 49250 49251 49252 49253 49254 49255 49256 49257 49258 49259 49261 49262 49263 49264 49265 49266 49267 49268 49269 49270 49271 49272 49274 49275 49276 49277 1.0 2.0 2.1 2.0 3.0 2.0 7.3 2.0 1.0 1.0 2.0 1.0 1.0 3.0 7.3 2.0 1.0 1.0 1.0 1.0 6.0 4.2 7.3 10.0 9.2 2.0 2.0 10.0 2.0 2.0 5.0 2.0 2.0 6.1 7.0 2.0 2.0 7.0 10.0 2.0 5.0 5.2 2.0 10.6 2.0 10.0 6.0 1.0 5.0 5.0 10.6 10.6 2.0 1.0 10.6 2.0 2.0 6.1 9.0 2.0 5.0 2.0 3.0 9.0 2.1 10.0 2.0 6.1 2.0 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI PO 00000 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... Frm 00510 Fmt 4701 RUCA level 49278 49279 49280 49281 49282 49283 49284 49285 49286 49287 49288 49289 49301 49302 49303 49304 49305 49306 49307 49309 49310 49311 49312 49314 49315 49316 49317 49318 49319 49320 49321 49322 49323 49325 49326 49327 49328 49329 49330 49331 49332 49333 49335 49336 49337 49338 49339 49340 49341 49342 49343 49344 49345 49346 49347 49348 49349 49351 49355 49356 49357 49401 49402 49403 49404 49405 49406 49408 49409 5.0 5.2 5.0 2.0 2.0 1.0 2.0 3.0 4.2 6.1 10.0 4.2 2.0 1.0 2.0 10.0 10.5 1.0 4.0 6.1 4.0 2.0 6.1 2.0 1.0 2.0 1.0 2.0 2.0 5.0 1.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 6.0 2.0 2.0 3.0 2.0 5.0 2.0 6.0 1.0 5.0 2.0 2.0 2.0 5.1 2.0 2.0 10.4 1.0 2.0 2.0 2.0 1.0 8.0 2.0 2.0 8.0 2.0 2.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 49410 49411 49412 49413 49415 49416 49417 49418 49419 49420 49421 49422 49423 49424 49425 49426 49427 49428 49429 49430 49431 49434 49435 49436 49437 49440 49441 49442 49443 49444 49445 49446 49448 49449 49450 49451 49452 49453 49454 49455 49456 49457 49458 49459 49460 49461 49463 49464 49468 49501 49502 49503 49504 49505 49506 49507 49508 49509 49510 49512 49514 49515 49516 49518 49519 49523 49525 49528 49530 9.0 9.0 7.0 7.0 1.0 2.0 1.0 1.0 2.0 10.0 10.4 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 2.0 7.0 1.0 2.0 10.0 7.1 1.0 1.0 1.0 1.0 1.0 1.0 10.6 2.1 10.0 3.0 2.1 10.6 2.0 8.0 10.6 1.0 2.0 8.0 10.4 2.0 7.1 7.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70133 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI Zip code RUCA level 49534 49544 49546 49548 49550 49555 49560 49588 49599 49601 49610 49611 49612 49613 49614 49615 49616 49617 49618 49619 49620 49621 49622 49623 49625 49626 49627 49628 49629 49630 49631 49632 49633 49634 49635 49636 49637 49638 49639 49640 49642 49643 49644 49645 49646 49648 49649 49650 49651 49653 49654 49655 49656 49657 49659 49660 49663 49664 49665 49666 49667 49668 49670 49673 49674 49675 49676 49677 49679 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 5.0 4.0 10.0 10.5 10.6 10.6 10.0 10.0 6.0 5.0 8.0 5.0 5.0 10.0 9.0 10.5 7.0 10.0 10.0 5.0 10.5 10.6 10.5 5.0 7.0 10.0 10.5 4.0 5.0 10.0 6.0 9.0 5.0 9.0 10.5 9.2 5.0 5.0 5.0 5.0 10.5 10.5 5.0 9.0 5.0 10.0 7.0 5.0 5.0 10.5 5.0 10.5 5.0 10.5 4.0 10.2 10.6 9.2 7.4 10.0 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI PO 00000 ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... Frm 00511 Fmt 4701 RUCA level 49680 49682 49683 49684 49685 49686 49688 49689 49690 49696 49701 49705 49706 49707 49709 49710 49711 49712 49713 49715 49716 49717 49718 49719 49720 49721 49722 49723 49724 49725 49726 49727 49728 49729 49730 49733 49734 49735 49736 49737 49738 49739 49740 49743 49744 49745 49746 49747 49748 49749 49751 49752 49753 49755 49756 49757 49759 49760 49761 49762 49764 49765 49766 49768 49769 49770 49774 49775 49776 5.0 10.2 5.0 4.0 4.0 4.0 5.0 10.6 4.0 4.0 9.0 10.6 8.0 4.0 10.0 5.0 9.0 7.0 10.6 5.0 8.0 8.0 9.0 10.0 9.0 7.0 8.0 10.3 5.0 10.0 10.0 9.0 10.6 10.0 8.0 9.0 8.0 8.0 5.0 10.3 7.0 7.0 10.3 10.6 5.0 10.0 10.5 5.0 10.6 9.0 8.0 5.0 5.0 8.0 10.0 10.6 10.6 10.6 7.0 10.0 8.0 10.0 4.0 10.6 8.0 8.0 5.0 7.0 6.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI MI ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... ...................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 49777 49778 49779 49780 49781 49782 49783 49784 49785 49786 49788 49790 49791 49792 49793 49795 49796 49797 49799 49801 49802 49805 49806 49807 49808 49812 49814 49815 49816 49817 49818 49819 49820 49821 49822 49825 49826 49827 49829 49831 49833 49834 49835 49836 49837 49838 49839 49840 49841 49845 49847 49848 49849 49852 49853 49854 49855 49858 49861 49862 49863 49864 49865 49866 49868 49870 49871 49872 49873 5.0 5.0 7.0 5.0 7.0 10.0 4.0 4.0 5.0 5.0 5.0 5.0 9.0 10.6 5.0 8.0 7.0 8.0 10.6 4.0 4.0 7.2 10.0 5.0 4.0 10.5 6.0 5.0 10.0 8.0 5.0 5.0 10.6 5.0 10.0 10.0 10.0 10.6 4.0 5.0 5.0 5.0 10.5 10.3 4.0 10.6 10.0 10.3 5.0 10.5 10.0 5.0 4.0 5.0 8.0 7.0 4.0 4.0 4.0 10.0 10.5 5.0 4.0 4.0 7.0 5.0 4.0 5.0 10.0 70134 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State Zip code RUCA level 49874 49876 49877 49878 49879 49880 49881 49883 49884 49885 49886 49887 49891 49892 49893 49894 49895 49896 49901 49902 49903 49905 49908 49910 49911 49912 49913 49915 49916 49917 49918 49919 49920 49921 49922 49925 49927 49929 49930 49931 49934 49935 49938 49942 49945 49946 49947 49948 49950 49952 49953 49955 49958 49959 49960 49961 49962 49963 49964 49965 49967 49968 49969 49970 49971 55001 55002 55003 55005 10.0 5.0 5.0 5.0 6.0 5.0 5.0 10.3 10.0 5.0 10.0 5.0 10.0 5.0 5.0 4.0 10.0 10.5 7.2 10.6 10.6 5.0 10.0 10.0 10.6 10.0 7.2 7.0 5.0 7.2 10.5 10.0 10.6 4.0 4.0 10.0 7.0 10.0 4.0 4.0 5.0 7.0 7.0 7.2 5.0 10.0 10.0 10.0 10.5 5.0 10.0 5.0 10.0 10.6 10.0 10.0 10.0 5.0 7.0 5.0 10.0 10.6 10.0 10.0 10.0 2.0 2.0 2.0 2.0 MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MI ...................................... MN .................................... MN .................................... MN .................................... MN .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00512 Fmt 4701 RUCA level 55006 55007 55008 55009 55010 55011 55012 55013 55014 55016 55017 55018 55019 55020 55021 55024 55025 55026 55027 55029 55030 55031 55032 55033 55036 55037 55038 55040 55041 55042 55043 55044 55045 55046 55047 55049 55051 55052 55053 55054 55055 55056 55057 55060 55063 55065 55066 55067 55068 55069 55070 55071 55072 55073 55074 55075 55076 55077 55078 55079 55080 55082 55083 55084 55085 55087 55088 55089 55090 2.0 10.4 7.3 7.1 2.0 2.0 2.0 2.0 1.0 1.0 2.0 2.0 4.2 2.0 4.2 1.0 2.0 5.0 5.0 7.3 8.3 2.0 2.0 2.0 3.0 10.4 1.0 2.0 7.4 1.0 2.0 1.0 2.0 2.0 2.0 5.0 8.3 5.2 5.0 2.0 1.0 2.0 4.2 4.0 3.0 2.0 4.0 3.0 1.0 2.0 2.0 1.0 10.0 2.0 2.0 1.0 1.0 1.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 5.0 2.0 5.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 55092 55101 55102 55103 55104 55105 55106 55107 55108 55109 55110 55111 55112 55113 55114 55115 55116 55117 55118 55119 55120 55121 55122 55123 55124 55125 55126 55127 55128 55129 55133 55144 55145 55146 55150 55155 55161 55164 55165 55166 55168 55169 55170 55171 55172 55175 55177 55182 55187 55188 55190 55191 55199 55301 55302 55303 55304 55305 55306 55307 55308 55309 55310 55311 55312 55313 55314 55315 55316 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 3.0 1.0 1.0 1.0 1.0 10.4 2.0 2.0 10.0 1.0 6.0 2.0 10.5 2.0 1.0 70135 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN Zip code RUCA level 55317 55318 55319 55320 55321 55322 55323 55324 55325 55327 55328 55329 55330 55331 55332 55333 55334 55335 55336 55337 55338 55339 55340 55341 55342 55343 55344 55345 55346 55347 55348 55349 55350 55352 55353 55354 55355 55356 55357 55358 55359 55360 55361 55362 55363 55364 55365 55366 55367 55368 55369 55370 55371 55372 55373 55374 55375 55376 55377 55378 55379 55380 55381 55382 55383 55384 55385 55386 55387 1.0 1.0 2.1 3.0 7.3 2.0 1.0 9.0 10.5 1.0 2.0 9.0 2.0 1.0 10.6 10.6 10.0 10.0 7.3 1.0 2.0 2.0 2.0 2.0 10.5 1.0 1.0 1.0 1.0 1.0 1.0 2.0 4.0 2.0 2.0 3.0 7.0 1.0 2.0 2.0 1.0 2.0 1.0 2.0 2.0 1.0 2.0 2.0 2.0 2.0 1.0 3.0 2.0 1.0 2.0 2.0 1.0 2.0 2.1 1.0 1.0 2.0 10.4 2.0 2.0 1.0 6.0 1.0 2.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00513 Fmt 4701 RUCA level 55388 55389 55390 55391 55392 55393 55394 55395 55396 55397 55398 55399 55401 55402 55403 55404 55405 55406 55407 55408 55409 55410 55411 55412 55413 55414 55415 55416 55417 55418 55419 55420 55421 55422 55423 55424 55425 55426 55427 55428 55429 55430 55431 55432 55433 55434 55435 55436 55437 55438 55439 55440 55441 55442 55443 55444 55445 55446 55447 55448 55449 55450 55454 55455 55458 55459 55460 55467 55468 2.0 9.0 2.0 1.0 1.0 1.0 2.0 10.4 10.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 55470 55472 55473 55474 55478 55479 55480 55483 55484 55485 55486 55487 55488 55550 55551 55552 55553 55554 55555 55556 55557 55558 55559 55560 55561 55562 55563 55564 55565 55566 55567 55568 55569 55570 55571 55572 55573 55574 55575 55576 55577 55578 55579 55580 55581 55582 55583 55584 55585 55586 55587 55588 55589 55590 55591 55592 55593 55594 55595 55596 55597 55598 55599 55601 55602 55603 55604 55605 55606 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 2.0 1.0 2.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 1.0 1.0 2.0 2.0 2.0 2.0 2.0 2.0 10.6 3.0 8.3 10.0 10.0 10.0 70136 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN Zip code RUCA level 55607 55609 55612 55613 55614 55615 55616 55701 55702 55703 55704 55705 55706 55707 55708 55709 55710 55711 55712 55713 55716 55717 55718 55719 55720 55721 55722 55723 55724 55725 55726 55730 55731 55732 55733 55734 55735 55736 55738 55741 55742 55744 55745 55746 55747 55748 55749 55750 55751 55752 55753 55756 55757 55758 55760 55763 55764 55765 55766 55767 55768 55769 55771 55772 55775 55777 55779 55780 55781 8.3 7.3 10.0 10.0 10.6 10.0 7.3 1.0 3.0 6.0 10.0 10.5 10.6 10.5 5.0 8.0 5.0 3.0 10.0 7.4 8.0 3.0 4.2 7.4 4.2 8.0 8.0 6.0 3.0 10.5 6.0 7.0 7.0 5.0 2.0 4.0 10.0 3.0 6.1 5.0 8.0 7.0 7.0 4.0 4.0 10.6 4.2 5.0 5.0 10.0 10.5 10.0 6.0 7.4 10.4 3.0 8.0 6.1 3.0 10.5 4.0 10.5 10.5 10.5 8.0 4.0 2.0 5.0 6.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00514 Fmt 4701 RUCA level 55782 55783 55784 55785 55786 55787 55790 55791 55792 55793 55795 55796 55797 55798 55801 55802 55803 55804 55805 55806 55807 55808 55810 55811 55812 55814 55815 55816 55901 55902 55903 55904 55905 55906 55909 55910 55912 55917 55918 55919 55920 55921 55922 55923 55924 55925 55926 55927 55929 55931 55932 55933 55934 55935 55936 55939 55940 55941 55942 55943 55944 55945 55946 55947 55949 55950 55951 55952 55953 9.0 10.0 8.0 10.6 8.0 10.4 9.0 2.0 4.0 8.0 10.0 7.0 4.2 6.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.5 5.0 4.0 10.2 5.0 2.0 2.0 7.3 10.4 2.0 10.4 5.2 10.4 10.4 2.0 7.3 2.0 10.5 2.0 2.0 2.0 10.4 2.0 2.0 4.0 10.5 2.0 10.0 10.4 1.0 10.0 4.0 10.5 10.5 10.5 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 55954 55955 55956 55957 55959 55960 55961 55962 55963 55964 55965 55967 55968 55969 55970 55971 55972 55973 55974 55975 55976 55977 55979 55981 55982 55983 55985 55987 55988 55990 55991 55992 56001 56002 56003 56006 56007 56009 56010 56011 56013 56014 56016 56017 56019 56020 56021 56022 56023 56024 56025 56026 56027 56028 56029 56030 56031 56032 56033 56034 56035 56036 56037 56039 56041 56042 56043 56044 56045 10.0 2.0 2.0 2.0 5.0 2.0 10.1 10.5 2.0 7.1 10.4 2.0 10.0 5.0 5.0 10.5 2.0 10.4 10.6 10.1 2.0 10.5 10.5 10.0 10.4 7.3 10.4 4.0 4.0 2.0 2.0 7.3 4.0 4.0 4.0 4.0 4.0 5.0 10.2 2.0 7.0 10.6 5.0 5.0 10.0 5.0 5.0 10.5 10.6 4.0 10.0 10.2 8.0 10.6 5.0 4.0 4.0 5.0 10.6 5.0 6.0 5.0 10.2 5.0 5.0 5.0 5.0 2.0 6.0 70137 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN Zip code RUCA level 56046 56047 56048 56050 56051 56052 56054 56055 56056 56057 56058 56060 56062 56063 56065 56068 56069 56071 56072 56073 56074 56075 56078 56080 56081 56082 56083 56084 56085 56087 56088 56089 56090 56091 56093 56096 56097 56098 56101 56110 56111 56113 56114 56115 56116 56117 56118 56119 56120 56121 56122 56123 56125 56127 56128 56129 56131 56132 56134 56136 56137 56138 56139 56140 56141 56142 56143 56144 56145 5.0 8.0 6.0 5.0 10.6 7.3 5.0 5.0 7.0 10.5 7.3 10.6 10.5 4.0 10.2 10.0 7.3 2.0 10.6 4.0 5.0 5.0 10.2 5.0 7.0 4.0 10.0 4.0 7.4 10.0 10.5 5.0 10.2 10.6 7.4 10.6 10.0 10.6 7.0 10.5 8.0 10.5 10.0 5.0 10.4 10.2 7.0 5.0 10.6 5.0 10.0 10.0 10.0 5.0 10.6 10.2 10.0 5.0 10.4 10.5 10.5 10.4 8.0 8.0 10.0 10.5 7.0 8.0 10.6 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00515 Fmt 4701 RUCA level 56146 56147 56149 56150 56151 56152 56153 56155 56156 56157 56158 56159 56160 56161 56162 56164 56165 56166 56167 56168 56169 56170 56171 56172 56173 56174 56175 56176 56177 56178 56180 56181 56183 56185 56186 56187 56201 56207 56208 56209 56210 56211 56212 56214 56215 56216 56218 56219 56220 56221 56222 56223 56224 56225 56226 56227 56228 56229 56230 56231 56232 56235 56236 56237 56239 56240 56241 56243 56244 10.4 10.4 10.5 10.6 10.0 10.0 10.5 10.5 7.0 5.0 10.4 10.6 10.6 10.5 10.6 7.0 5.0 10.0 10.2 5.0 5.0 8.0 10.2 10.0 10.4 10.6 10.5 10.5 7.0 10.5 10.5 5.0 10.6 10.5 10.6 4.0 4.0 8.0 7.0 5.0 10.0 10.0 10.0 10.6 7.0 5.0 10.6 10.0 10.0 8.0 10.5 10.5 10.6 10.0 10.3 10.0 10.6 10.2 10.0 10.3 10.6 8.0 10.0 10.6 5.0 10.0 7.0 10.6 7.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 56245 56248 56249 56251 56252 56253 56255 56256 56257 56258 56260 56262 56263 56264 56265 56266 56267 56270 56271 56273 56274 56276 56277 56278 56279 56280 56281 56282 56283 56284 56285 56287 56288 56289 56291 56292 56293 56294 56295 56296 56297 56301 56302 56303 56304 56307 56308 56309 56310 56311 56312 56313 56314 56315 56316 56317 56318 56319 56320 56321 56323 56324 56325 56326 56327 56328 56329 56330 56331 10.6 10.0 7.0 5.0 10.2 5.0 10.5 10.0 10.0 4.0 7.0 10.6 10.5 10.2 7.0 10.6 7.0 10.6 10.2 5.0 10.0 10.0 10.0 10.6 4.0 10.5 5.0 5.0 7.0 10.6 10.0 10.6 5.0 5.0 10.2 10.5 10.6 10.6 10.6 10.0 10.6 1.0 1.0 1.0 1.0 10.1 4.0 10.5 2.0 10.0 10.0 10.4 10.4 5.0 10.0 10.4 9.0 4.0 2.0 1.0 10.6 5.0 10.0 5.0 5.0 8.0 2.0 10.4 10.6 70138 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN Zip code RUCA level 56332 56333 56334 56335 56336 56338 56339 56340 56341 56342 56343 56344 56345 56347 56349 56350 56352 56353 56354 56355 56356 56357 56358 56359 56360 56361 56362 56363 56364 56367 56368 56369 56371 56372 56373 56374 56375 56376 56377 56378 56379 56381 56382 56384 56385 56386 56387 56388 56389 56393 56395 56396 56397 56398 56399 56401 56425 56430 56431 56433 56434 56435 56436 56437 56438 56440 56441 56442 56443 5.0 2.0 10.5 7.3 10.6 10.6 10.0 2.0 5.0 10.4 5.0 10.4 7.3 7.0 10.0 10.0 7.3 10.4 5.0 4.0 7.3 2.0 9.1 10.0 5.0 10.5 10.4 10.4 10.4 1.0 3.0 1.0 3.0 1.0 8.3 1.0 2.0 10.4 1.0 7.0 1.0 10.0 10.4 10.4 10.0 10.4 1.0 1.0 10.6 1.0 1.0 1.0 1.0 1.0 1.0 4.0 4.0 10.0 10.0 8.0 10.6 10.0 5.0 10.6 10.6 10.6 7.4 10.5 10.5 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00516 Fmt 4701 RUCA level 56444 56446 56447 56448 56449 56450 56452 56453 56455 56456 56458 56459 56461 56464 56465 56466 56467 56468 56469 56470 56472 56473 56474 56475 56477 56478 56479 56481 56482 56484 56501 56502 56510 56511 56514 56515 56516 56517 56518 56519 56520 56521 56522 56523 56524 56525 56527 56528 56529 56531 56533 56534 56535 56536 56537 56538 56540 56541 56542 56543 56544 56545 56546 56547 56548 56549 56550 56551 56552 5.0 10.6 10.5 10.5 5.0 10.0 10.0 10.6 5.0 10.5 8.0 5.0 5.0 10.6 5.0 10.5 8.0 5.0 10.6 8.0 5.0 5.0 10.5 8.0 10.6 10.6 7.0 10.6 7.0 10.0 7.0 7.0 10.4 8.0 2.0 6.0 10.0 8.0 10.0 10.4 4.0 10.6 5.0 8.3 10.5 2.0 10.6 6.0 1.0 10.5 5.0 6.0 10.6 2.0 4.0 4.0 8.0 10.0 10.0 5.0 8.0 10.0 2.0 2.0 10.4 2.0 10.4 10.6 2.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 56553 56554 56556 56557 56560 56561 56562 56563 56565 56566 56567 56568 56569 56570 56571 56572 56573 56574 56575 56576 56577 56578 56579 56580 56581 56583 56584 56585 56586 56587 56588 56589 56590 56591 56592 56593 56594 56601 56619 56621 56623 56626 56627 56628 56629 56630 56631 56633 56634 56636 56637 56639 56641 56644 56646 56647 56649 56650 56651 56652 56653 56654 56655 56657 56658 56659 56660 56661 56662 5.0 3.0 10.6 10.0 1.0 1.0 1.0 1.0 5.0 10.0 10.0 8.3 10.6 8.0 10.0 10.0 10.0 10.4 10.6 10.0 8.0 8.0 5.0 2.0 10.4 10.0 10.0 2.0 10.2 10.0 10.5 10.0 10.5 10.6 10.6 8.0 5.0 4.0 4.0 10.5 10.0 10.0 8.0 10.6 8.0 10.2 8.0 10.0 10.0 8.0 10.6 10.6 10.0 10.0 10.0 10.2 7.0 10.0 10.0 10.0 8.0 8.0 10.0 9.0 8.0 10.0 8.0 8.0 10.6 70139 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MN MO MO MO MO MO MO Zip code RUCA level 56663 56666 56667 56668 56669 56670 56671 56672 56673 56676 56678 56679 56680 56681 56682 56683 56684 56685 56686 56687 56688 56701 56710 56711 56713 56714 56715 56716 56720 56721 56722 56723 56724 56725 56726 56727 56728 56729 56731 56732 56733 56734 56735 56736 56737 56738 56740 56741 56742 56744 56748 56750 56751 56754 56755 56756 56757 56758 56759 56760 56761 56762 56763 63001 63005 63006 63010 63011 63012 10.2 10.0 10.2 8.0 8.0 10.0 10.0 10.6 10.3 10.5 5.0 7.0 10.6 10.0 10.3 5.0 10.0 10.0 10.0 4.0 10.6 7.0 10.4 10.0 10.4 8.0 10.6 7.0 10.0 1.0 2.0 8.3 10.3 8.0 10.3 10.3 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.6 10.3 8.0 10.0 10.0 10.6 10.4 10.6 10.6 7.0 8.0 10.0 10.3 10.4 8.0 10.3 8.0 10.3 10.4 10.6 2.0 1.0 1.0 1.0 1.0 1.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00517 Fmt 4701 RUCA level 63013 63014 63015 63016 63017 63019 63020 63021 63022 63023 63024 63025 63026 63028 63030 63031 63032 63033 63034 63036 63037 63038 63039 63040 63041 63042 63043 63044 63045 63047 63048 63049 63050 63051 63052 63053 63055 63056 63057 63060 63061 63065 63066 63068 63069 63070 63071 63072 63073 63074 63077 63079 63080 63084 63087 63088 63089 63090 63091 63099 63101 63102 63103 63104 63105 63106 63107 63108 63109 6.1 10.5 2.0 2.0 1.0 1.0 2.0 1.0 1.0 2.0 1.0 2.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 3.0 3.0 2.0 2.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 2.0 6.1 1.0 2.0 2.0 2.0 2.0 10.5 2.0 1.0 3.0 2.0 2.0 1.0 2.0 7.3 7.3 7.3 3.0 1.0 2.0 4.2 8.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 63110 63111 63112 63113 63114 63115 63116 63117 63118 63119 63120 63121 63122 63123 63124 63125 63126 63127 63128 63129 63130 63131 63132 63133 63134 63135 63136 63137 63138 63139 63140 63141 63143 63144 63145 63146 63147 63150 63151 63155 63156 63157 63158 63160 63163 63164 63166 63167 63169 63171 63177 63178 63179 63180 63182 63188 63190 63195 63196 63197 63198 63199 63301 63302 63303 63304 63330 63332 63333 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.4 2.0 10.4 70140 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO Zip code RUCA level 63334 63336 63338 63339 63341 63342 63343 63344 63345 63346 63347 63348 63349 63350 63351 63352 63353 63357 63359 63361 63362 63363 63365 63366 63367 63368 63369 63370 63373 63376 63377 63378 63379 63381 63382 63383 63384 63385 63386 63387 63388 63389 63390 63401 63430 63431 63432 63433 63434 63435 63436 63437 63438 63439 63440 63441 63442 63443 63445 63446 63447 63448 63450 63451 63452 63453 63454 63456 63457 7.0 10.4 1.0 7.0 2.0 2.0 2.0 10.4 5.0 1.0 2.0 2.0 2.0 10.4 10.4 5.0 7.0 2.0 10.0 10.0 2.0 10.6 1.0 1.0 1.0 1.0 2.0 2.0 2.0 1.0 2.0 2.0 2.0 7.1 7.4 7.1 10.0 1.0 2.0 2.0 5.0 2.0 2.0 4.0 5.0 8.0 10.0 10.6 10.0 10.5 5.0 10.6 10.2 10.0 10.2 10.6 10.0 10.0 10.5 10.0 10.5 5.0 10.6 10.6 10.5 10.0 5.0 10.0 10.2 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00518 Fmt 4701 RUCA level 63458 63459 63460 63461 63462 63463 63464 63465 63466 63467 63468 63469 63471 63472 63473 63474 63501 63530 63531 63532 63533 63534 63535 63536 63537 63538 63539 63540 63541 63543 63544 63545 63546 63547 63548 63549 63551 63552 63555 63556 63557 63558 63559 63560 63561 63563 63565 63566 63567 63601 63620 63621 63622 63623 63624 63625 63626 63627 63628 63629 63630 63631 63632 63633 63636 63637 63638 63640 63645 10.0 5.0 10.0 7.4 10.0 10.0 10.0 5.0 5.0 4.0 10.0 10.0 5.0 5.0 10.5 10.0 4.0 10.5 10.5 8.0 5.0 10.6 5.0 10.5 10.5 10.6 10.6 5.0 5.0 10.0 10.0 10.0 5.0 10.5 10.5 10.5 10.0 7.0 10.0 10.0 8.0 10.6 5.0 10.0 5.0 10.0 10.0 8.0 10.0 4.0 10.0 9.0 10.6 10.0 6.0 10.0 2.0 2.0 3.0 10.0 2.0 10.6 10.0 10.0 10.0 5.0 10.0 4.0 8.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 63648 63650 63651 63653 63654 63655 63656 63660 63661 63662 63663 63664 63665 63666 63670 63673 63674 63675 63701 63702 63703 63705 63730 63732 63735 63736 63737 63738 63739 63740 63742 63743 63744 63745 63746 63747 63748 63750 63751 63752 63755 63758 63760 63763 63764 63766 63767 63769 63770 63771 63772 63774 63775 63776 63779 63780 63781 63782 63783 63784 63785 63787 63801 63820 63821 63822 63823 63824 63825 9.0 7.4 4.0 4.0 10.0 8.0 10.0 9.0 7.3 5.0 7.4 7.1 10.0 10.0 7.3 8.0 2.0 10.0 4.0 4.0 4.0 4.0 10.5 8.0 10.5 5.0 8.0 10.5 5.0 5.0 5.0 5.0 5.0 4.0 8.0 5.0 8.0 6.0 10.2 4.0 4.0 5.0 10.2 6.0 10.2 5.0 5.0 5.0 5.0 10.5 10.5 10.5 8.0 8.0 4.0 5.0 5.0 6.0 8.0 4.0 5.0 6.0 4.0 7.4 10.5 10.6 6.0 4.0 8.0 70141 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO Zip code RUCA level 63826 63827 63828 63829 63830 63833 63834 63837 63839 63840 63841 63845 63846 63847 63848 63849 63850 63851 63852 63853 63855 63857 63860 63862 63863 63866 63867 63868 63869 63870 63873 63874 63875 63876 63877 63878 63879 63880 63881 63882 63901 63902 63931 63932 63933 63934 63935 63936 63937 63938 63939 63940 63941 63942 63943 63944 63945 63950 63951 63952 63953 63954 63955 63956 63957 63960 63961 63962 63963 7.4 10.6 5.0 10.5 7.0 10.6 7.4 6.0 7.4 10.6 7.0 7.4 9.0 6.0 10.6 10.6 9.0 7.0 6.0 7.4 10.5 4.0 7.0 10.0 7.0 10.6 5.0 5.0 7.0 10.6 7.0 10.6 10.5 10.5 7.4 7.0 10.6 6.0 7.4 7.4 4.0 4.0 10.0 5.0 10.6 6.0 10.5 10.6 10.2 5.0 5.0 5.0 10.0 10.0 10.2 10.0 5.0 6.0 6.0 5.0 10.0 5.0 10.0 10.0 10.0 10.6 5.0 5.0 6.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00519 Fmt 4701 RUCA level 63964 63965 63966 63967 64001 64011 64012 64013 64014 64015 64016 64017 64018 64019 64020 64021 64022 64024 64028 64029 64030 64034 64035 64036 64037 64040 64048 64050 64051 64052 64053 64054 64055 64056 64057 64058 64060 64061 64062 64063 64064 64065 64066 64067 64068 64069 64070 64071 64072 64073 64074 64075 64076 64077 64078 64079 64080 64081 64082 64083 64084 64085 64086 64087 64088 64089 64090 64092 64093 10.0 10.0 6.0 5.0 7.3 2.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 4.2 10.4 7.3 9.1 2.0 2.0 1.0 1.0 1.0 2.0 2.0 7.3 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 2.0 1.0 1.0 2.0 9.1 1.0 1.0 2.0 7.3 1.0 1.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 1.0 1.0 2.0 7.1 2.0 1.0 2.0 2.0 2.0 1.0 4.2 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 64096 64097 64098 64101 64102 64105 64106 64108 64109 64110 64111 64112 64113 64114 64116 64117 64118 64119 64120 64121 64123 64124 64125 64126 64127 64128 64129 64130 64131 64132 64133 64134 64136 64137 64138 64139 64141 64142 64144 64145 64146 64147 64148 64149 64150 64151 64152 64153 64154 64155 64156 64157 64158 64160 64161 64163 64164 64165 64166 64167 64168 64170 64171 64172 64173 64179 64180 64183 64184 10.4 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 2.0 2.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70142 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO Zip code RUCA level 64185 64187 64188 64189 64190 64191 64192 64193 64194 64195 64196 64197 64198 64199 64401 64402 64420 64421 64422 64423 64424 64426 64427 64428 64429 64430 64431 64432 64433 64434 64436 64437 64438 64439 64440 64441 64442 64443 64444 64445 64446 64447 64448 64449 64451 64453 64454 64455 64456 64457 64458 64459 64461 64463 64465 64466 64467 64468 64469 64470 64471 64473 64474 64475 64476 64477 64478 64479 64480 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.1 10.0 10.5 2.0 2.0 5.0 7.0 10.6 2.0 5.0 7.3 2.0 5.0 5.0 5.0 5.0 1.0 10.4 10.0 2.0 2.0 10.5 10.6 2.0 2.0 5.0 10.0 7.3 2.1 2.0 10.4 10.4 3.0 5.0 10.5 5.0 8.0 2.0 5.0 10.4 2.0 10.4 8.0 4.0 7.3 10.4 8.0 10.4 2.0 5.0 5.0 2.0 5.0 5.0 2.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00520 Fmt 4701 RUCA level 64481 64482 64483 64484 64485 64486 64487 64489 64490 64491 64492 64493 64494 64496 64497 64498 64499 64501 64502 64503 64504 64505 64506 64507 64508 64601 64620 64622 64623 64624 64625 64628 64630 64631 64632 64633 64635 64636 64637 64638 64639 64640 64641 64642 64643 64644 64645 64646 64647 64648 64649 64650 64651 64652 64653 64654 64655 64656 64657 64658 64659 64660 64661 64664 64667 64668 64670 64671 64672 10.6 10.0 2.0 2.0 2.0 10.5 5.0 10.4 2.0 10.0 3.0 2.0 2.0 10.0 7.3 10.0 10.5 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.0 10.4 10.6 10.6 10.4 10.4 7.0 10.6 8.0 10.6 7.0 8.0 10.4 10.4 8.0 10.6 10.4 8.0 10.6 10.6 10.4 10.0 10.0 10.4 10.4 10.4 10.4 7.0 8.0 10.6 10.4 10.0 8.0 10.0 10.6 10.6 10.6 10.0 8.0 10.0 10.6 10.4 10.4 10.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 64673 64674 64676 64679 64680 64681 64682 64683 64686 64688 64689 64701 64720 64722 64723 64724 64725 64726 64728 64730 64733 64734 64735 64738 64739 64740 64741 64742 64743 64744 64745 64746 64747 64748 64750 64752 64755 64756 64759 64761 64762 64763 64765 64766 64767 64769 64770 64771 64772 64776 64777 64778 64779 64780 64781 64783 64784 64788 64789 64790 64801 64802 64803 64804 64830 64831 64832 64833 64834 10.6 10.6 10.6 8.0 10.6 10.6 10.6 7.0 8.0 8.0 10.4 7.1 3.0 3.0 3.0 10.6 2.0 8.3 8.0 7.3 6.1 2.0 7.0 10.6 2.0 8.0 8.0 2.0 7.1 7.0 3.0 2.0 2.0 8.0 8.0 3.0 2.0 10.0 7.0 6.1 10.6 10.6 8.0 7.0 8.0 10.6 8.0 8.0 7.0 10.6 7.3 8.0 10.6 10.6 10.6 8.0 8.0 8.3 10.6 8.0 1.0 1.0 1.0 1.0 2.0 10.4 2.0 5.2 1.0 70143 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO Zip code RUCA level 64835 64836 64840 64841 64842 64843 64844 64847 64848 64849 64850 64853 64854 64855 64856 64857 64858 64859 64861 64862 64863 64864 64865 64866 64867 64868 64869 64870 64873 64874 64944 64999 65001 65010 65011 65013 65014 65016 65017 65018 65020 65022 65023 65024 65025 65026 65031 65032 65034 65035 65036 65037 65038 65039 65040 65041 65042 65043 65046 65047 65048 65049 65050 65051 65052 65053 65054 65055 65058 1.0 4.2 2.0 1.0 10.0 10.0 6.1 10.4 2.0 2.0 4.0 10.0 10.4 2.0 10.4 2.0 4.0 5.2 2.0 5.2 10.4 1.0 3.0 10.0 2.0 10.0 2.0 1.0 2.0 8.0 1.0 1.0 2.0 2.0 10.0 10.4 8.0 2.0 10.0 7.1 10.0 2.0 2.0 2.0 3.0 7.0 7.0 2.0 10.0 10.1 7.0 10.0 10.0 2.0 2.0 7.0 3.0 2.0 2.0 10.0 2.0 10.0 3.0 10.1 10.0 2.0 2.0 7.1 10.1 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00521 Fmt 4701 RUCA level 65059 65061 65062 65063 65064 65065 65066 65067 65068 65069 65072 65074 65075 65076 65077 65078 65079 65080 65081 65082 65083 65084 65085 65101 65102 65103 65104 65105 65106 65107 65108 65109 65110 65111 65201 65202 65203 65205 65211 65212 65215 65216 65217 65218 65230 65231 65232 65233 65236 65237 65239 65240 65243 65244 65246 65247 65248 65250 65251 65254 65255 65256 65257 65258 65259 65260 65261 65262 65263 2.0 8.0 8.0 2.0 9.1 10.0 7.0 5.0 9.1 10.6 10.0 2.0 10.4 2.0 5.0 10.0 10.0 2.0 7.0 10.0 10.0 10.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.4 3.0 5.0 7.3 10.0 10.6 5.0 7.1 5.2 5.0 10.0 8.0 7.3 7.3 4.0 10.4 2.0 2.0 5.2 10.5 5.0 5.0 10.0 3.0 10.5 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 65264 65265 65270 65274 65275 65276 65278 65279 65280 65281 65282 65283 65284 65285 65286 65287 65299 65301 65302 65305 65320 65321 65322 65323 65324 65325 65326 65327 65329 65330 65332 65333 65334 65335 65336 65337 65338 65339 65340 65344 65345 65347 65348 65349 65350 65351 65354 65355 65360 65401 65402 65409 65436 65438 65439 65440 65441 65443 65444 65446 65449 65452 65453 65456 65457 65459 65461 65462 65463 5.0 4.0 4.2 7.3 10.0 10.6 5.2 2.0 5.0 10.5 10.0 10.0 2.0 10.5 10.0 9.1 1.0 4.0 4.0 7.4 5.0 10.5 10.6 8.0 10.6 10.5 10.0 10.5 10.0 10.2 5.0 5.0 5.0 10.5 7.4 5.0 10.5 5.0 4.0 5.0 4.0 5.0 10.6 10.2 4.0 10.5 10.0 10.0 7.0 4.0 4.0 4.0 6.0 10.0 10.0 8.0 10.6 6.0 10.0 9.0 10.6 10.5 7.0 9.0 4.0 10.5 6.0 6.0 5.0 70144 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO Zip code RUCA level 65464 65466 65468 65470 65473 65479 65483 65484 65486 65501 65529 65532 65534 65535 65536 65541 65542 65543 65546 65548 65550 65552 65555 65556 65557 65559 65560 65564 65565 65566 65567 65570 65571 65572 65580 65582 65583 65584 65586 65588 65589 65590 65591 65601 65603 65604 65605 65606 65607 65608 65609 65610 65611 65612 65613 65614 65615 65616 65617 65618 65619 65620 65622 65623 65624 65625 65626 65627 65629 10.0 10.0 10.0 5.0 4.0 10.0 10.0 10.0 10.4 8.0 6.0 4.0 5.0 9.0 5.0 10.3 10.5 5.0 10.0 10.5 5.0 10.5 10.0 5.0 10.5 7.4 7.0 10.0 10.6 10.0 10.5 10.5 10.0 5.0 6.0 10.1 4.0 4.0 10.6 10.0 10.0 2.0 10.5 7.1 10.0 2.0 7.0 10.5 10.0 7.3 10.0 2.0 5.0 2.0 7.1 5.0 4.0 4.0 7.1 10.0 1.0 2.0 2.0 10.6 10.4 7.0 5.0 5.0 2.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00522 Fmt 4701 RUCA level 65630 65631 65632 65633 65634 65635 65636 65637 65638 65640 65641 65644 65645 65646 65647 65648 65649 65650 65652 65653 65654 65655 65656 65657 65658 65660 65661 65662 65663 65664 65666 65667 65668 65669 65672 65673 65674 65675 65676 65679 65680 65681 65682 65685 65686 65688 65689 65690 65692 65701 65702 65704 65705 65706 65707 65708 65710 65711 65712 65713 65714 65715 65717 65720 65721 65722 65723 65724 65725 2.0 2.0 5.0 2.0 10.0 10.4 2.0 10.0 10.6 8.0 9.0 2.0 2.0 10.4 10.6 2.0 8.0 7.1 2.0 5.0 8.0 10.5 10.4 2.0 10.0 10.5 10.4 10.5 7.1 2.0 10.0 10.4 10.4 2.0 4.0 4.0 8.0 2.0 10.5 5.0 5.0 5.0 10.0 7.3 10.5 5.0 10.6 10.6 7.4 5.0 10.4 10.4 3.0 7.1 2.0 7.0 7.1 7.0 7.3 2.0 1.0 10.5 10.4 2.0 1.0 5.0 7.0 10.6 7.1 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO MO .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 65726 65727 65728 65729 65730 65731 65732 65733 65734 65735 65737 65738 65739 65740 65741 65742 65744 65745 65746 65747 65752 65753 65754 65755 65756 65757 65759 65760 65761 65762 65764 65765 65766 65767 65768 65769 65770 65771 65772 65773 65774 65775 65776 65777 65778 65779 65781 65783 65784 65785 65786 65787 65788 65789 65790 65791 65793 65801 65802 65803 65804 65805 65806 65807 65808 65809 65810 65814 65817 4.0 7.1 2.0 10.5 2.0 5.0 10.0 5.0 8.0 10.0 10.5 2.0 4.0 5.0 10.0 2.0 5.0 10.6 2.0 9.2 10.0 2.0 2.0 8.0 8.0 2.0 5.0 10.0 10.5 10.5 10.6 1.0 10.0 10.6 10.6 8.0 2.0 5.0 10.6 10.0 10.6 5.0 5.0 5.0 10.6 10.6 2.0 10.6 10.0 10.0 10.0 10.6 5.0 5.0 5.0 7.4 10.5 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70145 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State MO MO MO MP MP MP MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS Zip code RUCA level 65890 65898 65899 96950 96951 96952 38601 38602 38603 38606 38609 38610 38611 38614 38617 38618 38619 38620 38621 38622 38623 38625 38626 38627 38628 38629 38630 38631 38632 38633 38634 38635 38637 38638 38639 38641 38642 38643 38644 38645 38646 38647 38649 38650 38651 38652 38654 38655 38658 38659 38661 38663 38664 38665 38666 38668 38669 38670 38671 38672 38673 38674 38675 38676 38677 38679 38680 38683 38685 1.0 1.0 1.0 R R R 5.0 9.1 10.4 7.0 7.0 10.6 2.0 4.0 6.0 9.1 10.6 8.0 10.6 7.0 10.6 10.6 10.3 8.0 10.6 10.0 4.0 4.0 2.0 10.6 7.3 7.3 1.0 7.3 6.0 1.0 2.0 7.0 6.0 4.0 7.0 10.4 7.3 8.4 2.0 7.0 1.0 5.0 8.0 9.1 2.0 10.6 10.3 9.1 7.0 7.3 4.0 10.6 1.0 2.0 5.0 10.0 5.0 10.3 5.0 2.0 1.0 10.0 9.1 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00523 Fmt 4701 RUCA level 38686 38701 38702 38703 38704 38720 38721 38722 38723 38725 38726 38730 38731 38732 38733 38736 38737 38738 38739 38740 38744 38745 38746 38748 38749 38751 38753 38754 38756 38758 38759 38760 38761 38762 38764 38765 38767 38768 38769 38771 38772 38773 38774 38776 38778 38780 38781 38782 38801 38802 38803 38804 38820 38821 38824 38825 38826 38827 38828 38829 38833 38834 38835 38838 38839 38841 38843 38844 38846 1.0 4.0 4.0 4.0 4.0 5.0 10.0 4.0 7.4 5.0 5.0 4.0 5.0 4.0 4.0 10.2 7.4 7.4 4.0 9.2 5.0 10.0 9.2 7.4 4.0 4.0 4.0 7.0 5.0 4.0 5.0 4.0 7.2 5.0 4.0 10.0 4.0 7.4 5.0 7.4 5.0 5.0 9.2 4.0 5.0 5.0 5.0 4.0 4.0 4.0 4.0 4.0 7.4 7.4 6.0 7.4 4.0 10.0 9.2 8.0 6.0 4.0 4.0 10.0 7.0 5.0 7.4 9.0 5.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 38847 38848 38849 38850 38851 38852 38854 38855 38856 38857 38858 38859 38860 38862 38863 38864 38865 38866 38868 38869 38870 38871 38873 38874 38875 38876 38877 38878 38879 38880 38901 38902 38912 38913 38914 38915 38916 38917 38920 38921 38922 38923 38924 38925 38926 38927 38928 38929 38930 38935 38940 38941 38943 38944 38945 38946 38947 38948 38949 38950 38951 38952 38953 38954 38955 38957 38958 38959 38960 9.2 9.0 5.0 8.0 7.0 6.0 7.0 5.0 9.2 5.0 5.0 9.2 5.0 5.0 7.4 8.0 5.0 5.0 5.0 5.0 8.0 9.0 10.0 9.0 7.0 8.4 7.0 10.6 4.0 8.0 4.0 4.0 5.0 10.0 9.0 10.0 7.0 5.0 8.0 7.4 10.6 5.0 9.2 5.0 4.0 8.0 10.2 5.0 4.0 4.0 5.0 7.2 5.0 10.2 4.0 7.2 5.0 9.2 5.0 6.0 9.0 10.2 9.2 4.0 7.0 10.5 7.4 7.2 4.0 70146 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS Zip code RUCA level 38961 38962 38963 38964 38965 38966 38967 39038 39039 39040 39041 39042 39043 39044 39045 39046 39047 39051 39054 39056 39057 39058 39059 39060 39061 39062 39063 39066 39067 39069 39071 39072 39073 39074 39077 39078 39079 39080 39081 39082 39083 39086 39087 39088 39090 39092 39094 39095 39096 39097 39098 39107 39108 39109 39110 39111 39112 39113 39114 39115 39116 39117 39119 39120 39121 39122 39130 39140 39144 9.2 7.4 10.5 7.0 7.0 10.5 7.0 7.0 4.2 5.2 2.0 1.0 1.0 2.0 2.0 2.0 2.0 8.0 10.0 1.0 9.0 1.0 2.0 1.0 10.0 10.1 7.0 2.0 8.0 9.0 2.0 2.0 2.0 8.0 2.0 2.0 9.1 8.0 9.0 2.0 7.3 9.0 3.0 5.0 7.0 8.0 9.1 7.0 9.0 8.0 3.0 8.0 8.0 8.0 1.0 7.3 10.1 10.0 10.1 8.0 10.0 3.0 10.0 4.0 4.0 4.0 1.0 10.0 10.6 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00524 Fmt 4701 RUCA level 39145 39146 39148 39149 39150 39151 39152 39153 39154 39156 39157 39158 39159 39160 39161 39162 39163 39165 39166 39167 39168 39169 39170 39171 39173 39174 39175 39176 39177 39179 39180 39181 39182 39183 39189 39190 39191 39192 39193 39194 39201 39202 39203 39204 39205 39206 39207 39208 39209 39210 39211 39212 39213 39215 39216 39217 39218 39225 39232 39235 39236 39250 39269 39271 39272 39282 39283 39284 39286 2.0 9.1 2.0 9.0 10.6 1.0 8.0 10.0 2.0 5.0 1.0 1.0 10.0 8.0 2.0 5.0 2.0 4.0 8.0 2.0 10.5 9.2 2.0 8.0 4.2 1.0 2.0 5.0 10.0 4.2 4.0 4.0 4.0 4.0 9.0 4.0 6.0 8.0 1.0 4.2 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 39288 39289 39296 39298 39301 39302 39303 39304 39305 39307 39309 39320 39322 39323 39324 39325 39326 39327 39328 39330 39332 39335 39336 39337 39338 39339 39341 39342 39345 39346 39347 39348 39350 39352 39354 39355 39356 39358 39359 39360 39361 39362 39363 39364 39365 39366 39367 39401 39402 39403 39404 39406 39407 39421 39422 39423 39425 39426 39427 39428 39429 39436 39437 39439 39440 39441 39442 39443 39451 1.0 1.0 1.0 1.0 4.0 4.0 4.0 4.0 4.0 4.0 5.0 5.0 8.0 9.0 8.0 5.0 5.0 9.0 6.0 10.5 9.0 5.0 9.0 6.0 10.0 8.0 10.6 5.0 7.0 8.0 10.0 5.0 8.0 10.5 6.0 10.5 10.0 10.5 8.0 10.0 10.6 10.0 10.5 5.0 10.6 5.0 8.0 1.0 1.0 1.0 1.0 1.0 1.0 10.4 10.5 10.4 2.0 6.1 10.4 10.0 8.0 2.0 4.0 5.0 4.0 4.0 4.0 5.0 10.0 70147 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS Zip code RUCA level 39452 39455 39456 39457 39459 39460 39461 39462 39463 39464 39465 39466 39470 39474 39475 39476 39477 39478 39479 39480 39481 39482 39483 39501 39502 39503 39505 39506 39507 39520 39521 39522 39525 39529 39530 39531 39532 39533 39534 39535 39540 39552 39553 39555 39556 39558 39560 39561 39562 39563 39564 39565 39566 39567 39568 39569 39571 39572 39573 39574 39576 39577 39581 39595 39601 39602 39603 39629 39630 10.4 3.0 10.0 6.1 3.0 5.0 10.0 10.4 4.2 5.2 2.0 4.2 10.0 10.0 2.0 10.1 5.0 10.0 3.0 5.0 10.5 2.0 8.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 9.1 1.0 1.0 1.0 2.1 1.0 1.0 1.0 1.0 2.0 2.1 9.1 2.0 1.0 9.1 1.0 1.0 5.0 5.0 5.0 5.0 10.5 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MS MT MT MT MT MT MT MT MT MT PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00525 Fmt 4701 RUCA level 39631 39632 39633 39635 39638 39641 39643 39645 39647 39648 39649 39652 39653 39654 39656 39657 39661 39662 39663 39664 39665 39666 39667 39668 39669 39701 39702 39703 39704 39705 39710 39730 39735 39736 39737 39739 39740 39741 39743 39744 39745 39746 39747 39750 39751 39752 39753 39754 39755 39756 39759 39760 39762 39766 39767 39769 39771 39772 39773 39776 59001 59002 59003 59004 59006 59007 59008 59010 59011 10.0 5.0 10.0 4.0 10.0 10.0 8.0 10.5 10.5 4.0 4.0 5.0 10.5 10.5 10.0 5.0 10.5 5.0 10.0 10.5 10.5 5.0 10.0 9.0 10.0 4.0 4.0 4.0 4.0 4.0 5.0 7.4 10.0 4.0 10.0 10.6 5.0 8.0 5.0 10.0 10.0 9.0 8.0 5.0 6.0 6.0 4.0 8.0 8.0 9.2 4.0 4.0 4.0 5.0 10.0 5.0 10.0 10.0 8.0 8.4 10.0 2.0 10.0 10.0 2.0 10.0 10.0 10.0 10.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 59012 59013 59014 59015 59016 59018 59019 59020 59022 59024 59025 59026 59027 59028 59029 59030 59031 59032 59033 59034 59035 59036 59037 59038 59039 59041 59043 59044 59046 59047 59050 59052 59053 59054 59055 59057 59058 59059 59061 59062 59063 59064 59065 59066 59067 59068 59069 59070 59071 59072 59073 59074 59075 59076 59077 59078 59079 59081 59082 59083 59084 59085 59086 59087 59088 59089 59101 59102 59103 10.0 2.0 10.4 2.0 10.0 10.3 10.0 10.0 10.6 2.0 10.5 2.0 8.0 10.0 10.4 10.0 10.6 10.6 10.0 7.0 10.0 10.0 2.0 10.0 10.0 2.0 10.0 2.0 10.4 7.0 10.0 10.0 10.0 10.0 10.0 2.0 10.0 10.0 10.0 10.0 2.0 2.0 8.0 10.0 10.4 10.0 10.4 10.0 10.0 10.4 10.4 10.4 10.4 10.0 10.0 10.0 2.0 10.0 7.0 10.0 10.0 10.0 10.3 10.0 2.0 10.0 1.0 1.0 1.0 70148 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT Zip code RUCA level 59104 59105 59106 59107 59108 59111 59112 59114 59115 59116 59117 59201 59211 59212 59213 59214 59215 59217 59218 59219 59221 59222 59223 59225 59226 59230 59231 59240 59241 59242 59243 59244 59247 59248 59250 59252 59253 59254 59255 59256 59257 59258 59259 59260 59261 59262 59263 59270 59273 59274 59275 59276 59301 59311 59312 59313 59314 59315 59316 59317 59318 59319 59322 59323 59324 59326 59327 59330 59332 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.0 10.0 10.0 10.6 10.6 10.6 10.6 10.0 10.0 10.6 10.0 10.6 10.6 10.0 7.0 7.0 10.6 10.6 10.0 10.6 10.6 10.0 10.6 10.6 10.0 10.0 10.0 7.0 10.0 10.0 10.0 10.6 10.6 10.0 10.6 10.0 7.0 10.6 10.6 10.0 10.0 7.0 10.0 10.0 10.0 10.0 10.6 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.6 10.0 7.0 10.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00526 Fmt 4701 RUCA level 59333 59336 59337 59338 59339 59341 59343 59344 59345 59347 59349 59351 59353 59354 59401 59402 59403 59404 59405 59406 59410 59411 59412 59414 59416 59417 59418 59419 59420 59421 59422 59424 59425 59427 59430 59432 59433 59434 59435 59436 59440 59441 59442 59443 59444 59445 59446 59447 59448 59450 59451 59452 59453 59454 59456 59457 59460 59461 59462 59463 59464 59465 59466 59467 59468 59469 59471 59472 59474 10.0 8.0 10.0 8.0 10.6 10.6 10.0 10.0 10.0 10.0 10.6 8.0 10.0 10.0 1.0 1.0 1.0 1.0 1.0 1.0 10.2 8.0 2.0 2.0 7.0 7.0 10.6 10.0 10.4 2.0 10.0 10.6 7.0 7.0 10.6 10.6 10.4 8.0 7.0 10.4 2.0 10.6 10.4 2.0 7.0 10.6 10.0 10.6 10.6 10.0 10.6 10.6 10.0 10.6 7.0 7.0 10.0 10.0 10.6 2.0 10.6 2.0 10.6 10.4 10.4 10.6 10.6 2.0 7.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 59477 59479 59480 59482 59483 59484 59485 59486 59487 59489 59501 59520 59521 59522 59523 59524 59525 59526 59527 59528 59529 59530 59531 59532 59535 59537 59538 59540 59542 59544 59545 59546 59547 59601 59602 59604 59620 59623 59624 59625 59626 59631 59632 59633 59634 59635 59636 59638 59639 59640 59641 59642 59643 59644 59645 59647 59648 59701 59702 59703 59707 59710 59711 59713 59714 59715 59716 59717 59718 2.0 10.6 2.0 10.6 2.0 10.6 2.0 10.6 2.0 10.6 4.0 10.0 5.0 10.0 10.5 10.0 10.5 10.0 10.0 10.5 10.0 10.5 10.0 10.5 10.5 10.0 10.0 10.5 10.0 10.0 10.0 10.0 10.5 4.0 4.0 4.0 4.0 4.0 4.0 4.0 4.0 5.0 5.0 5.0 5.0 4.0 4.0 5.0 10.2 5.0 10.0 10.0 10.0 10.0 10.0 10.0 5.0 4.0 4.0 4.0 4.0 10.0 7.4 10.5 5.0 4.0 10.5 4.0 5.0 70149 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT Zip code RUCA level 59719 59720 59721 59722 59724 59725 59727 59728 59729 59730 59731 59732 59733 59735 59736 59739 59740 59741 59743 59745 59746 59747 59748 59749 59750 59751 59752 59754 59755 59756 59758 59759 59760 59761 59762 59771 59772 59773 59801 59802 59803 59804 59806 59807 59808 59812 59820 59821 59823 59824 59825 59826 59827 59828 59829 59830 59831 59832 59833 59834 59835 59837 59840 59841 59842 59843 59844 59845 59846 5.0 10.0 10.0 7.0 10.0 7.0 5.0 10.5 10.0 10.5 10.5 7.0 10.5 10.0 10.0 10.0 10.0 10.2 5.0 10.0 7.0 10.0 5.0 10.0 5.0 10.0 10.5 10.0 10.0 8.0 10.5 10.5 10.5 10.0 10.0 4.0 4.0 5.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 10.4 2.0 10.0 1.0 2.0 10.6 10.3 10.3 10.0 10.0 10.0 2.0 2.0 7.0 10.0 7.0 7.0 10.0 10.5 10.0 10.0 2.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT MT NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00527 Fmt 4701 RUCA level 59847 59848 59851 59853 59854 59855 59856 59858 59859 59860 59863 59864 59865 59866 59867 59868 59870 59871 59872 59873 59874 59875 59901 59902 59903 59904 59910 59911 59912 59913 59914 59915 59916 59917 59918 59919 59920 59921 59922 59923 59925 59926 59927 59928 59929 59930 59931 59932 59933 59934 59935 59936 59937 27006 27007 27009 27010 27011 27012 27013 27014 27016 27017 27018 27019 27020 27021 27022 27023 2.0 10.0 1.0 10.0 10.5 10.0 10.0 10.0 10.0 7.0 10.4 10.0 10.0 10.0 10.0 2.0 10.1 10.6 10.4 10.0 10.0 10.6 4.0 4.0 4.0 4.0 8.0 10.2 7.4 4.0 8.0 8.0 6.0 10.0 10.0 4.0 5.0 6.0 5.0 7.0 5.0 4.0 7.4 6.0 6.0 10.0 6.0 5.0 10.0 10.0 10.6 4.0 7.4 1.0 3.0 1.0 1.0 9.1 1.0 5.0 7.3 2.0 10.5 2.0 2.0 9.1 1.0 2.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 27024 27025 27027 27028 27030 27031 27040 27041 27042 27043 27045 27046 27047 27048 27049 27050 27051 27052 27053 27054 27055 27094 27098 27099 27101 27102 27103 27104 27105 27106 27107 27108 27109 27110 27111 27113 27114 27115 27116 27117 27120 27127 27130 27150 27151 27152 27155 27156 27157 27198 27199 27201 27202 27203 27204 27205 27207 27208 27209 27212 27213 27214 27215 27216 27217 27220 27228 27229 27230 6.0 2.0 7.3 7.3 4.2 4.2 1.0 2.0 10.4 2.0 1.0 10.4 3.0 6.0 4.2 1.0 1.0 2.0 2.0 5.0 7.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 4.0 5.0 8.0 8.0 10.6 10.4 8.0 2.0 1.0 1.0 1.0 1.0 2.0 10.0 5.0 70150 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC Zip code RUCA level 27231 27233 27235 27237 27239 27242 27243 27244 27247 27248 27249 27252 27253 27256 27258 27259 27260 27261 27262 27263 27264 27265 27278 27281 27282 27283 27284 27285 27288 27289 27291 27292 27293 27294 27295 27298 27299 27301 27302 27305 27306 27310 27311 27312 27313 27314 27315 27316 27317 27320 27321 27322 27323 27325 27326 27330 27331 27332 27340 27341 27342 27343 27344 27349 27350 27351 27355 27356 27357 2.0 2.0 2.1 4.0 3.0 5.0 1.0 1.0 10.6 5.0 1.0 6.0 1.0 6.0 1.0 10.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 5.0 1.0 2.0 1.0 1.0 4.0 4.0 2.0 4.2 4.2 4.2 5.2 10.4 5.2 1.0 1.0 3.0 10.6 2.1 2.0 2.0 2.0 2.0 2.0 6.0 4.1 4.1 4.1 4.1 4.1 10.0 6.1 4.0 4.0 5.0 1.0 5.0 1.0 8.3 7.0 2.0 1.0 4.2 6.0 10.6 2.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00528 Fmt 4701 RUCA level 27358 27359 27360 27361 27370 27371 27373 27374 27375 27376 27377 27379 27395 27401 27402 27403 27404 27405 27406 27407 27408 27409 27410 27411 27412 27413 27415 27416 27417 27419 27420 27425 27427 27429 27435 27438 27455 27480 27495 27497 27498 27499 27501 27502 27503 27504 27505 27506 27507 27508 27509 27510 27511 27512 27513 27514 27515 27516 27517 27518 27519 27520 27521 27522 27523 27524 27525 27526 27527 2.0 1.0 1.0 1.0 1.0 7.0 1.0 5.2 4.1 5.0 2.0 10.4 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 2.0 2.0 6.0 7.3 8.3 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 3.0 2.1 1.0 4.2 2.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 27528 27529 27530 27531 27532 27533 27534 27536 27537 27539 27540 27541 27542 27543 27544 27545 27546 27549 27551 27552 27553 27555 27556 27557 27559 27560 27562 27563 27564 27565 27568 27569 27570 27571 27572 27573 27574 27576 27577 27581 27582 27583 27584 27586 27587 27588 27589 27591 27592 27593 27594 27596 27597 27599 27601 27602 27603 27604 27605 27606 27607 27608 27609 27610 27611 27612 27613 27614 27615 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 5.0 1.0 1.0 2.0 6.0 1.0 5.2 1.0 7.3 7.1 10.0 7.3 10.5 4.2 5.0 2.0 2.1 1.0 2.1 10.5 2.1 7.0 5.2 5.2 10.5 1.0 2.0 7.3 9.1 4.2 4.2 2.0 7.0 2.0 5.0 10.0 1.0 1.0 10.5 2.0 2.0 4.2 10.5 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70151 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC Zip code RUCA level 27616 27617 27619 27620 27621 27622 27623 27624 27625 27626 27627 27628 27629 27634 27635 27636 27640 27650 27656 27658 27661 27668 27675 27676 27690 27695 27697 27698 27699 27701 27702 27703 27704 27705 27706 27707 27708 27709 27710 27711 27712 27713 27715 27717 27722 27801 27802 27803 27804 27805 27806 27807 27808 27809 27810 27811 27812 27813 27814 27816 27817 27818 27819 27820 27821 27822 27823 27824 27825 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 9.0 10.5 6.1 10.2 2.0 10.5 1.0 2.0 4.0 6.0 2.0 5.0 7.0 10.5 10.0 6.0 5.2 3.0 10.0 7.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00529 Fmt 4701 RUCA level 27826 27827 27828 27829 27830 27831 27832 27833 27834 27835 27836 27837 27839 27840 27841 27842 27843 27844 27845 27846 27847 27849 27850 27851 27852 27853 27854 27855 27856 27857 27858 27860 27861 27862 27863 27864 27865 27866 27867 27868 27869 27870 27871 27872 27873 27874 27875 27876 27877 27878 27879 27880 27881 27882 27883 27884 27885 27886 27887 27888 27889 27890 27891 27892 27893 27894 27895 27896 27897 10.0 1.0 2.0 2.0 2.0 10.5 5.0 1.0 1.0 1.0 1.0 2.0 6.0 9.0 9.0 5.0 5.0 2.0 10.5 10.6 10.0 10.0 5.0 5.0 10.5 10.0 10.0 7.0 1.0 9.0 1.0 10.5 3.0 10.0 2.0 10.4 5.0 10.5 10.0 2.0 10.0 4.0 3.0 10.0 5.0 7.3 10.0 10.5 10.0 1.0 1.0 5.0 5.0 3.0 5.0 2.0 10.0 4.2 6.0 3.0 4.2 4.0 2.0 7.0 4.0 4.0 4.0 4.0 10.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 27906 27907 27909 27910 27915 27916 27917 27919 27920 27921 27922 27923 27924 27925 27926 27927 27928 27929 27930 27932 27935 27936 27937 27938 27939 27941 27942 27943 27944 27946 27947 27948 27949 27950 27953 27954 27956 27957 27958 27959 27960 27962 27964 27965 27966 27967 27968 27969 27970 27972 27973 27974 27976 27978 27979 27980 27981 27982 27983 27985 27986 28001 28002 28006 28007 28009 28010 28012 28016 4.0 4.0 4.0 7.0 10.5 5.0 2.0 6.0 10.5 6.0 9.0 5.0 10.0 10.6 10.4 10.4 10.6 2.0 10.5 7.0 10.6 10.5 10.4 10.4 5.0 5.0 9.0 10.5 10.5 10.4 5.0 4.0 4.0 2.0 10.5 7.4 2.0 10.0 2.0 10.5 10.0 7.0 5.0 5.0 5.0 7.0 10.5 10.6 10.6 10.5 6.0 6.0 6.0 10.5 10.4 8.0 7.4 10.5 10.0 10.5 9.0 4.0 4.0 2.1 7.3 4.0 4.0 1.0 1.0 70152 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC Zip code RUCA level 28017 28018 28019 28020 28021 28023 28024 28025 28026 28027 28031 28032 28033 28034 28035 28036 28037 28038 28039 28040 28041 28042 28043 28052 28053 28054 28055 28056 28070 28071 28072 28073 28074 28075 28076 28077 28078 28079 28080 28081 28082 28083 28086 28088 28089 28090 28091 28092 28093 28097 28098 28101 28102 28103 28104 28105 28106 28107 28108 28109 28110 28111 28112 28114 28115 28117 28119 28120 28123 5.0 5.0 4.0 5.2 9.1 1.0 5.0 1.0 1.0 1.0 1.0 1.0 4.0 2.1 1.0 1.0 2.0 3.0 4.2 5.0 4.2 5.0 4.0 1.0 1.0 1.0 1.0 1.0 1.0 5.0 4.2 3.0 5.0 1.0 5.0 2.1 1.0 1.0 2.0 1.0 1.0 1.0 2.0 1.0 4.0 5.0 8.3 4.0 4.0 2.0 1.0 1.0 9.1 2.0 1.0 1.0 1.0 2.0 1.0 5.0 1.0 1.0 1.0 5.0 2.0 2.0 9.1 1.0 2.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00530 Fmt 4701 RUCA level 28124 28125 28126 28127 28128 28129 28130 28133 28134 28135 28136 28137 28138 28139 28144 28145 28146 28147 28150 28151 28152 28159 28160 28163 28164 28166 28167 28168 28169 28170 28173 28174 28201 28202 28203 28204 28205 28206 28207 28208 28209 28210 28211 28212 28213 28214 28215 28216 28217 28218 28219 28220 28221 28222 28223 28224 28225 28226 28227 28228 28229 28230 28231 28232 28233 28234 28235 28236 28237 2.1 5.2 1.0 5.0 6.0 3.0 1.0 2.0 1.0 2.0 4.0 5.0 4.2 5.0 4.2 4.2 4.2 4.2 4.0 4.0 5.0 4.2 4.0 2.0 1.0 6.1 5.0 2.0 9.1 7.3 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 28240 28241 28242 28243 28244 28246 28247 28250 28253 28254 28255 28256 28258 28260 28261 28262 28265 28266 28269 28270 28271 28272 28273 28274 28275 28277 28278 28280 28281 28282 28283 28284 28285 28286 28287 28288 28289 28290 28296 28297 28299 28301 28302 28303 28304 28305 28306 28307 28308 28309 28310 28311 28312 28314 28315 28318 28319 28320 28323 28325 28326 28327 28328 28329 28330 28331 28332 28333 28334 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 4.0 6.1 5.0 10.6 2.0 2.0 3.0 5.0 7.0 7.0 4.0 1.0 10.6 1.0 4.2 70153 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC Zip code RUCA level 28335 28337 28338 28339 28340 28341 28342 28343 28344 28345 28347 28348 28349 28350 28351 28352 28353 28355 28356 28357 28358 28359 28360 28361 28362 28363 28364 28365 28366 28367 28368 28369 28370 28371 28372 28373 28374 28375 28376 28377 28378 28379 28380 28382 28383 28384 28385 28386 28387 28388 28390 28391 28392 28393 28394 28395 28396 28398 28399 28401 28402 28403 28404 28405 28406 28407 28408 28409 28410 4.2 7.0 6.0 4.2 5.0 8.0 6.1 5.0 6.1 4.0 6.1 1.0 10.6 4.0 5.0 4.0 4.0 5.0 2.0 2.0 4.0 4.0 4.0 1.0 5.0 6.1 6.0 2.0 9.0 6.0 5.0 5.0 4.0 2.0 7.4 4.0 4.0 5.0 1.0 7.4 7.3 4.0 4.0 9.1 5.0 7.3 8.3 2.0 4.0 4.0 1.0 2.0 10.6 8.0 4.0 2.0 5.0 7.0 8.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00531 Fmt 4701 RUCA level 28411 28412 28420 28421 28422 28423 28424 28425 28428 28429 28430 28431 28432 28433 28434 28435 28436 28438 28439 28441 28442 28443 28444 28445 28446 28447 28448 28449 28450 28451 28452 28453 28454 28455 28456 28457 28458 28459 28460 28461 28462 28463 28464 28465 28466 28467 28468 28469 28470 28472 28478 28479 28480 28501 28502 28503 28504 28508 28509 28510 28511 28512 28513 28515 28516 28518 28519 28520 28521 1.0 1.0 10.6 2.0 2.0 10.4 7.0 2.0 1.0 1.0 10.6 8.0 8.0 10.6 10.6 2.0 2.0 8.0 10.6 8.0 8.0 2.0 8.0 2.0 7.0 8.0 9.0 1.0 8.0 1.0 10.6 10.0 2.0 8.0 2.0 2.0 10.0 10.6 2.0 10.0 10.0 10.4 7.0 10.6 7.0 7.3 7.3 7.3 10.6 7.0 3.0 2.0 1.0 4.0 4.0 4.0 4.0 10.4 10.2 10.5 5.0 4.0 1.0 10.2 4.0 10.0 4.0 5.0 10.6 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 28522 28523 28524 28525 28526 28527 28528 28529 28530 28531 28532 28533 28537 28538 28539 28540 28541 28542 28543 28544 28545 28546 28547 28551 28552 28553 28554 28555 28556 28557 28560 28561 28562 28563 28564 28570 28571 28572 28573 28574 28575 28577 28578 28579 28580 28581 28582 28583 28584 28585 28586 28587 28589 28590 28594 28601 28602 28603 28604 28605 28606 28607 28608 28609 28610 28611 28612 28613 28615 5.0 5.0 4.0 5.0 5.0 5.0 5.0 10.2 2.0 5.0 4.0 4.0 10.2 3.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 6.1 10.2 5.0 3.0 2.0 10.5 4.0 4.0 4.0 4.0 4.0 4.0 5.0 10.5 10.0 5.0 2.0 4.0 5.0 2.0 5.0 10.5 5.0 7.3 10.5 7.3 5.0 5.0 10.2 5.0 1.0 7.3 1.0 1.0 1.0 5.0 10.2 5.0 4.0 4.0 2.1 1.0 2.0 1.0 1.0 10.5 70154 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC Zip code RUCA level 28616 28617 28618 28619 28621 28622 28623 28624 28625 28626 28627 28628 28629 28630 28631 28633 28634 28635 28636 28637 28638 28640 28641 28642 28643 28644 28645 28646 28647 28649 28650 28651 28652 28653 28654 28655 28656 28657 28658 28659 28660 28661 28662 28663 28664 28665 28666 28667 28668 28669 28670 28671 28672 28673 28674 28675 28676 28677 28678 28679 28680 28681 28682 28683 28684 28685 28687 28688 28689 10.0 10.0 4.0 1.0 7.0 10.0 10.0 5.0 4.0 6.0 10.0 1.0 10.0 1.0 10.0 1.0 5.0 5.0 10.6 1.0 1.0 10.0 10.0 7.0 10.0 10.0 1.0 10.0 7.0 5.0 2.0 4.0 10.0 10.0 5.0 1.0 4.0 10.0 1.0 4.0 5.0 1.0 10.0 10.0 10.0 5.0 1.0 1.0 10.0 8.4 8.4 1.0 10.0 3.0 4.0 10.0 7.0 4.0 10.6 5.0 1.0 2.0 3.0 8.0 6.0 8.0 4.0 4.0 5.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00532 Fmt 4701 RUCA level 28690 28691 28692 28693 28694 28697 28698 28699 28701 28702 28704 28705 28707 28708 28709 28710 28711 28712 28713 28714 28715 28716 28717 28718 28719 28720 28721 28722 28723 28724 28725 28726 28727 28728 28729 28730 28731 28732 28733 28734 28735 28736 28737 28738 28739 28740 28741 28742 28743 28744 28745 28746 28747 28748 28749 28750 28751 28752 28753 28754 28755 28756 28757 28758 28760 28761 28762 28763 28765 1.0 10.0 5.0 10.0 10.0 5.0 5.0 4.0 2.0 10.0 1.0 10.0 7.0 5.0 2.0 2.0 1.0 4.2 10.0 10.0 1.0 1.0 10.0 5.0 10.0 10.5 1.0 10.0 7.0 1.0 7.0 1.0 1.0 1.0 2.0 2.0 2.0 1.0 10.0 8.0 2.0 10.0 7.0 1.0 1.0 10.0 10.0 2.0 10.4 8.0 1.0 10.5 5.0 2.0 7.0 10.4 2.0 7.0 2.0 2.0 10.0 10.0 1.0 1.0 1.0 8.3 9.0 8.0 10.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 28766 28768 28770 28771 28772 28773 28774 28775 28776 28777 28778 28779 28781 28782 28783 28784 28785 28786 28787 28788 28789 28790 28791 28792 28793 28801 28802 28803 28804 28805 28806 28810 28813 28814 28815 28816 28901 28902 28903 28904 28905 28906 28909 58001 58002 58004 58005 58006 58007 58008 58009 58011 58012 58013 58015 58016 58017 58018 58021 58027 58029 58030 58031 58032 58033 58035 58036 58038 58040 5.0 4.2 1.0 10.0 5.0 10.4 5.0 8.0 1.0 10.0 1.0 7.0 8.0 10.4 8.0 2.0 2.0 1.0 1.0 7.0 10.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 4.0 10.1 2.0 2.0 2.0 10.1 10.2 10.0 10.1 2.0 10.0 2.0 10.0 10.0 2.0 2.0 10.0 2.0 5.0 8.0 10.0 10.0 10.0 2.0 2.0 10.0 70155 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND Zip code RUCA level 58041 58042 58043 58045 58046 58047 58048 58049 58051 58052 58053 58054 58056 58057 58058 58059 58060 58061 58062 58063 58064 58065 58067 58068 58069 58071 58072 58074 58075 58076 58077 58078 58079 58081 58102 58103 58104 58105 58106 58107 58108 58109 58121 58122 58123 58124 58125 58126 58201 58202 58203 58204 58205 58206 58207 58208 58210 58212 58214 58216 58218 58219 58220 58222 58223 58224 58225 58227 58228 10.5 2.0 10.0 10.0 10.0 1.0 2.0 8.0 2.0 2.0 10.5 10.0 10.0 10.0 10.5 2.0 10.0 10.2 8.0 8.0 10.1 10.0 10.0 10.0 10.0 10.1 7.0 4.0 4.0 4.0 2.0 1.0 2.0 10.2 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.3 7.3 1.0 7.3 1.0 10.6 10.0 2.0 10.0 10.4 10.0 10.0 10.0 10.4 10.0 10.6 10.6 2.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00533 Fmt 4701 RUCA level 58229 58230 58231 58233 58235 58236 58237 58238 58239 58240 58241 58243 58244 58249 58250 58251 58254 58255 58256 58257 58258 58259 58260 58261 58262 58265 58266 58267 58269 58270 58271 58272 58273 58274 58275 58276 58277 58278 58281 58282 58301 58310 58311 58313 58316 58317 58318 58319 58321 58323 58324 58325 58327 58329 58330 58331 58332 58335 58337 58338 58339 58341 58343 58344 58345 58346 58348 58351 58352 10.6 10.0 10.6 10.6 2.0 10.6 7.0 10.0 10.0 10.4 10.0 10.6 2.0 10.0 10.6 2.0 10.0 10.0 2.0 10.0 2.0 10.0 10.0 8.0 10.0 10.0 2.0 10.4 10.0 10.6 10.0 10.0 10.6 10.0 2.0 10.6 10.0 2.0 10.0 10.0 7.0 10.0 10.0 7.0 10.0 10.0 10.0 10.0 10.3 10.0 10.0 8.0 10.3 10.0 10.3 10.0 10.0 10.6 10.0 10.3 10.0 10.0 10.6 10.0 10.3 10.6 10.0 10.6 10.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 58353 58355 58356 58357 58359 58361 58362 58363 58365 58366 58367 58368 58369 58370 58372 58374 58377 58379 58380 58381 58382 58384 58385 58386 58401 58402 58405 58413 58415 58416 58418 58420 58421 58422 58423 58424 58425 58426 58428 58429 58430 58431 58433 58436 58438 58439 58440 58441 58442 58443 58444 58445 58448 58451 58452 58454 58455 58456 58458 58460 58461 58463 58464 58466 58467 58472 58474 58475 58476 10.0 10.0 10.0 10.6 7.0 10.0 8.0 10.0 10.0 10.0 10.0 7.0 10.0 10.6 10.0 10.0 8.0 10.6 10.0 10.6 8.0 10.0 7.0 10.6 4.0 4.0 4.0 10.0 10.0 10.0 10.0 5.0 10.0 10.0 10.0 5.0 10.0 5.0 10.4 8.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 5.0 10.0 10.0 10.0 8.0 10.0 10.0 10.0 5.0 5.0 10.0 10.0 5.0 70156 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND Zip code RUCA level 58477 58478 58479 58480 58481 58482 58483 58484 58486 58487 58488 58490 58492 58494 58495 58496 58497 58501 58502 58503 58504 58505 58506 58507 58520 58521 58523 58524 58528 58529 58530 58531 58532 58533 58535 58538 58540 58541 58542 58544 58545 58549 58552 58554 58558 58559 58560 58561 58562 58563 58564 58565 58566 58568 58569 58570 58571 58572 58573 58575 58576 58577 58579 58580 58581 58601 58602 58620 58621 2.0 10.0 8.0 8.0 8.0 10.4 5.0 10.0 10.0 10.4 10.0 10.0 8.0 2.0 10.0 5.0 5.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.4 2.0 7.0 10.0 2.0 10.0 10.4 10.0 2.0 10.0 2.0 10.0 10.0 10.6 10.0 10.0 10.0 10.0 10.0 1.0 2.0 10.4 2.0 10.0 10.0 10.4 10.0 10.4 2.0 10.0 10.0 10.0 10.0 2.0 10.0 10.0 10.4 10.4 10.4 10.6 10.0 4.0 4.0 10.0 10.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00534 Fmt 4701 RUCA level 58622 58623 58625 58626 58627 58630 58631 58632 58634 58636 58638 58639 58640 58641 58642 58643 58644 58645 58646 58647 58649 58650 58651 58652 58653 58654 58655 58656 58701 58702 58703 58704 58705 58707 58710 58711 58712 58713 58716 58718 58721 58722 58723 58725 58727 58730 58731 58733 58734 58735 58736 58737 58740 58741 58744 58746 58747 58748 58750 58752 58755 58756 58757 58758 58759 58760 58761 58762 58763 10.2 10.0 10.5 10.5 10.0 5.0 10.4 10.0 10.0 10.5 10.4 10.0 10.5 5.0 10.5 10.0 10.5 10.0 10.0 10.5 10.0 10.5 10.0 10.5 10.0 10.0 10.2 10.5 4.0 4.0 4.0 7.4 7.4 4.0 10.0 10.5 10.0 10.5 10.0 5.0 10.0 5.0 10.0 10.5 10.0 10.0 10.5 5.0 10.5 5.0 10.0 10.0 7.4 10.5 10.0 10.5 10.0 10.0 10.5 10.0 10.5 5.0 10.0 10.0 10.0 10.5 10.5 10.5 10.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 58765 58768 58769 58770 58771 58772 58773 58775 58776 58778 58779 58781 58782 58783 58784 58785 58787 58788 58789 58790 58792 58793 58794 58795 58801 58802 58830 58831 58833 58835 58838 58843 58844 58845 58847 58849 58852 58853 58854 58856 68001 68002 68003 68004 68005 68007 68008 68009 68010 68014 68015 68016 68017 68018 68019 68020 68022 68023 68025 68026 68028 68029 68030 68031 68033 68034 68036 68037 68038 10.0 5.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 5.0 5.0 10.5 10.0 10.0 5.0 10.5 10.5 10.5 10.5 10.5 10.5 10.0 10.5 4.0 4.0 10.5 10.6 10.0 10.0 10.6 5.0 10.0 5.0 10.0 5.0 10.5 5.0 10.0 5.0 5.0 2.0 2.0 10.6 1.0 2.0 7.3 7.3 1.0 5.0 5.2 2.0 2.0 5.2 10.4 10.0 1.0 2.0 4.2 4.2 2.0 2.0 2.0 10.5 2.0 2.0 5.0 2.0 10.0 70157 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE Zip code RUCA level 68039 68040 68041 68042 68044 68045 68046 68047 68048 68050 68055 68056 68057 68058 68059 68061 68062 68063 68064 68065 68066 68067 68068 68069 68070 68071 68072 68073 68101 68102 68103 68104 68105 68106 68107 68108 68109 68110 68111 68112 68113 68114 68116 68117 68118 68119 68120 68122 68123 68124 68127 68128 68130 68131 68132 68133 68134 68135 68136 68137 68138 68139 68142 68144 68145 68147 68152 68154 68155 10.0 2.0 2.0 2.0 10.5 10.4 1.0 10.0 2.0 2.0 10.0 1.0 10.5 2.0 2.0 10.4 10.4 10.5 2.0 2.0 7.3 10.0 2.0 1.0 2.0 10.4 10.5 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00535 Fmt 4701 RUCA level 68157 68164 68172 68175 68176 68178 68179 68180 68181 68182 68183 68197 68198 68301 68303 68304 68305 68307 68309 68310 68313 68314 68315 68316 68317 68318 68319 68320 68321 68322 68323 68324 68325 68326 68327 68328 68329 68330 68331 68332 68333 68335 68336 68337 68338 68339 68340 68341 68342 68343 68344 68345 68346 68347 68348 68349 68350 68351 68352 68354 68355 68357 68358 68359 68360 68361 68362 68364 68365 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 6.0 10.0 2.1 7.0 2.0 5.0 4.0 2.0 2.0 10.0 8.0 2.0 5.0 8.0 10.6 10.6 10.0 10.0 2.0 10.0 10.0 10.0 5.0 10.4 2.0 5.0 10.4 7.3 10.0 2.0 10.6 10.6 2.0 10.0 10.6 10.6 10.4 2.0 10.0 8.0 2.0 10.0 2.0 10.6 10.0 7.0 10.0 7.0 6.0 2.0 10.4 2.0 10.0 10.0 2.0 10.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 68366 68367 68368 68370 68371 68372 68375 68376 68377 68378 68380 68381 68382 68401 68402 68403 68404 68405 68406 68407 68409 68410 68413 68414 68415 68416 68417 68418 68419 68420 68421 68422 68423 68424 68428 68429 68430 68431 68433 68434 68436 68437 68438 68439 68440 68441 68442 68443 68444 68445 68446 68447 68448 68450 68452 68453 68454 68455 68456 68457 68458 68460 68461 68462 68463 68464 68465 68466 68467 2.1 8.0 2.0 10.0 10.3 2.0 10.0 10.6 10.6 10.6 10.0 5.0 8.0 10.3 2.0 2.0 2.0 2.0 10.0 2.1 2.0 7.0 2.0 10.6 5.0 10.0 10.4 2.0 2.0 10.0 10.6 5.0 2.0 10.6 2.0 10.6 2.0 8.0 10.6 7.3 10.0 8.0 2.0 2.0 10.6 10.0 8.0 10.4 10.0 10.0 10.4 10.0 8.0 10.0 10.5 10.0 2.0 2.0 2.0 8.0 6.0 8.0 2.0 2.0 2.0 10.0 10.6 5.0 7.0 70158 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE Zip code RUCA level 68501 68502 68503 68504 68505 68506 68507 68508 68509 68510 68512 68514 68516 68517 68520 68521 68522 68523 68524 68526 68527 68528 68529 68531 68532 68542 68583 68588 68601 68602 68620 68621 68622 68623 68624 68626 68627 68628 68629 68631 68632 68633 68634 68635 68636 68637 68638 68640 68641 68642 68643 68644 68647 68648 68649 68651 68652 68653 68654 68655 68658 68659 68660 68661 68662 68663 68664 68665 68666 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 2.0 1.0 1.0 1.0 2.0 1.0 1.0 2.0 1.0 1.0 2.0 2.0 1.0 1.0 1.0 4.0 4.0 10.0 4.2 10.0 10.5 5.0 10.4 10.0 10.6 10.0 10.5 7.0 10.5 4.0 10.4 10.0 10.0 10.5 10.5 10.0 10.5 10.0 10.5 5.0 2.0 10.2 10.5 10.0 5.0 10.6 10.0 5.0 10.5 10.0 7.4 10.6 10.6 10.5 10.0 10.6 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00536 Fmt 4701 RUCA level 68667 68669 68701 68702 68710 68711 68713 68714 68715 68716 68717 68718 68719 68720 68722 68723 68724 68725 68726 68727 68728 68729 68730 68731 68732 68733 68734 68735 68736 68738 68739 68740 68741 68742 68743 68745 68746 68747 68748 68749 68751 68752 68753 68755 68756 68757 68758 68759 68760 68761 68763 68764 68765 68766 68767 68768 68769 68770 68771 68773 68774 68776 68777 68778 68779 68780 68781 68783 68784 10.4 10.4 4.0 4.0 10.4 10.6 10.6 10.0 5.0 10.6 10.6 10.0 10.0 10.0 10.0 10.6 10.0 10.6 10.0 10.6 10.4 10.0 10.2 1.0 10.4 2.0 10.6 10.6 10.5 4.0 10.5 10.6 2.0 10.6 2.0 10.6 10.0 5.0 10.5 10.6 10.1 5.0 10.0 10.0 10.0 10.1 10.5 10.0 10.0 10.0 7.0 10.0 10.5 10.6 5.0 10.5 10.5 10.1 10.6 10.0 10.5 1.0 10.0 10.0 4.0 10.6 5.0 10.0 10.4 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 68785 68786 68787 68788 68789 68790 68791 68792 68801 68802 68803 68810 68812 68813 68814 68815 68816 68817 68818 68819 68820 68821 68822 68823 68824 68825 68826 68827 68828 68831 68832 68833 68834 68835 68836 68837 68838 68840 68841 68842 68843 68844 68845 68846 68847 68848 68849 68850 68852 68853 68854 68855 68856 68858 68859 68860 68861 68862 68863 68864 68865 68866 68869 68870 68871 68872 68873 68874 68875 10.4 10.0 7.0 7.0 10.0 10.6 10.6 10.5 4.0 4.0 4.0 5.0 5.0 10.6 10.3 10.0 10.6 10.5 7.4 10.3 10.2 10.0 7.0 10.0 5.0 10.6 7.4 5.0 10.6 10.2 5.0 10.0 5.0 10.2 5.0 10.0 10.2 5.0 5.0 10.0 10.6 10.5 4.0 10.6 4.0 4.0 4.0 4.0 10.5 10.5 5.0 10.3 10.6 10.2 10.0 10.6 5.0 10.0 5.0 5.0 5.0 10.2 10.2 5.0 10.5 5.0 10.2 10.6 10.0 70159 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE Zip code RUCA level 68876 68878 68879 68881 68882 68883 68901 68902 68920 68922 68923 68924 68925 68926 68927 68928 68929 68930 68932 68933 68934 68935 68936 68937 68938 68939 68940 68941 68942 68943 68944 68945 68946 68947 68948 68949 68950 68952 68954 68955 68956 68957 68958 68959 68960 68961 68964 68966 68967 68969 68970 68971 68972 68973 68974 68975 68976 68977 68978 68979 68980 68981 68982 69001 69020 69021 69022 69023 69024 5.0 5.0 10.0 10.6 10.0 5.0 4.0 4.0 10.6 10.0 10.3 5.0 5.0 10.0 10.3 10.2 10.0 10.2 10.5 10.5 10.5 10.5 10.0 10.5 10.5 10.0 10.3 10.5 10.5 10.0 10.5 5.0 10.0 10.5 10.0 7.0 5.0 10.5 10.5 5.0 5.0 10.0 10.3 7.4 10.0 10.0 10.0 10.6 10.0 10.6 10.5 10.6 10.0 5.0 10.0 10.5 10.5 10.6 10.0 10.5 10.5 10.5 5.0 7.0 8.0 10.0 10.0 10.0 10.6 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00537 Fmt 4701 RUCA level 69025 69026 69027 69028 69029 69030 69032 69033 69034 69036 69037 69038 69039 69040 69041 69042 69043 69044 69045 69046 69101 69103 69120 69121 69122 69123 69125 69127 69128 69129 69130 69131 69132 69133 69134 69135 69138 69140 69141 69142 69143 69144 69145 69146 69147 69148 69149 69150 69151 69152 69153 69154 69155 69156 69157 69160 69161 69162 69163 69165 69166 69167 69168 69169 69170 69171 69190 69201 69210 10.0 8.0 10.0 10.0 6.0 10.0 10.0 10.0 8.0 8.0 10.0 10.0 10.0 10.6 10.0 10.0 10.6 10.6 10.0 10.0 4.0 4.0 10.6 10.0 10.0 5.0 10.5 10.3 7.0 10.0 7.4 10.3 5.0 7.0 10.0 10.6 7.0 10.0 10.3 10.0 5.0 10.3 7.0 10.3 10.0 10.0 10.3 10.0 5.0 10.0 7.0 10.0 10.3 10.3 10.0 7.0 10.0 7.0 10.5 5.0 10.0 10.5 10.0 5.0 5.0 7.4 10.0 7.0 10.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NE NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 69211 69212 69214 69216 69217 69218 69219 69220 69221 69301 69331 69333 69334 69335 69336 69337 69339 69340 69341 69343 69345 69346 69347 69348 69350 69351 69352 69353 69354 69355 69356 69357 69358 69360 69361 69363 69365 69366 69367 03031 03032 03033 03034 03036 03037 03038 03040 03041 03042 03043 03044 03045 03046 03047 03048 03049 03051 03052 03053 03054 03055 03057 03060 03061 03062 03063 03064 03070 03071 7.0 7.0 10.0 7.0 10.0 7.0 7.0 7.0 10.6 7.0 10.5 10.0 10.5 10.0 10.5 7.0 10.6 10.0 4.0 10.0 10.2 10.5 10.0 10.3 10.0 10.0 10.2 4.0 10.6 4.0 5.0 5.0 10.2 10.0 4.0 4.0 10.0 10.0 10.6 1.0 1.0 2.1 2.1 2.0 3.0 1.0 2.1 1.0 2.0 3.0 2.0 1.0 2.0 3.0 2.1 2.1 1.0 1.0 1.0 1.0 1.0 2.1 1.0 1.0 1.0 1.0 1.0 2.1 10.4 70160 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH Zip code RUCA level 03073 03076 03077 03079 03082 03084 03086 03087 03101 03102 03103 03104 03105 03106 03107 03108 03109 03110 03111 03215 03216 03217 03218 03220 03221 03222 03223 03224 03225 03226 03227 03229 03230 03231 03233 03234 03235 03237 03238 03240 03241 03242 03243 03244 03245 03246 03247 03249 03251 03252 03253 03254 03255 03256 03257 03258 03259 03260 03261 03262 03263 03264 03266 03268 03269 03272 03273 03274 03275 1.0 1.0 2.0 1.0 2.1 10.4 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 9.0 6.0 10.6 6.0 5.0 10.5 10.5 9.0 5.0 6.0 6.0 10.0 5.0 10.5 6.0 10.0 5.2 4.0 6.0 10.6 6.0 5.0 10.5 10.5 7.4 7.0 4.0 4.0 4.0 10.6 4.0 10.5 10.5 10.5 6.0 10.0 5.2 10.0 5.0 6.0 10.6 5.0 7.0 9.0 6.0 6.0 10.5 5.0 9.0 4.2 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00538 Fmt 4701 RUCA level 03276 03278 03279 03280 03281 03282 03284 03287 03289 03290 03291 03293 03298 03299 03301 03302 03303 03304 03305 03307 03431 03435 03440 03441 03442 03443 03444 03445 03446 03447 03448 03449 03450 03451 03452 03455 03456 03457 03458 03461 03462 03464 03465 03466 03467 03468 03469 03470 03561 03570 03574 03575 03576 03579 03580 03581 03582 03583 03584 03585 03586 03587 03588 03589 03590 03592 03593 03595 03597 4.0 5.0 10.6 9.0 2.1 6.0 5.0 10.5 5.0 3.0 3.0 10.6 10.5 10.5 4.2 4.2 4.2 4.2 4.2 5.0 4.0 4.0 10.6 5.0 3.0 5.0 5.0 5.0 5.0 6.0 5.0 8.0 5.0 8.0 7.0 5.0 5.0 5.0 7.0 10.6 5.0 5.0 5.0 5.0 5.0 7.0 5.0 5.0 7.0 4.0 10.3 10.6 10.5 5.0 10.3 4.0 10.0 10.5 10.6 10.6 10.6 10.5 5.0 10.5 10.0 10.0 10.5 10.6 10.5 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 03598 03601 03602 03603 03604 03605 03607 03608 03609 03740 03741 03743 03745 03746 03748 03749 03750 03751 03752 03753 03754 03755 03756 03765 03766 03768 03769 03770 03771 03773 03774 03777 03779 03780 03781 03782 03784 03785 03801 03802 03803 03804 03805 03809 03810 03811 03812 03813 03814 03815 03816 03817 03818 03819 03820 03821 03822 03823 03824 03825 03826 03827 03830 03832 03833 03835 03836 03837 03838 10.6 9.0 5.0 7.0 5.0 9.0 9.0 10.5 10.5 10.6 5.0 7.0 5.0 5.0 4.0 4.0 5.0 9.0 9.0 5.0 7.0 4.0 4.0 10.0 4.0 5.0 5.0 5.0 10.6 7.0 10.0 6.0 6.0 10.0 5.0 9.0 4.0 10.0 1.0 1.0 1.0 1.0 1.0 10.5 10.5 1.0 10.0 10.0 10.0 2.0 10.0 10.0 10.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 2.0 3.0 10.0 1.0 2.0 10.0 6.0 10.0 70161 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NH NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ Zip code RUCA level 03839 03840 03841 03842 03843 03844 03845 03846 03847 03848 03849 03850 03851 03852 03853 03854 03855 03856 03857 03858 03859 03860 03862 03864 03865 03866 03867 03868 03869 03870 03871 03872 03873 03874 03875 03878 03882 03883 03884 03885 03886 03887 03890 03894 03896 03897 07001 07002 07003 07004 07005 07006 07007 07008 07009 07010 07011 07012 07013 07014 07015 07016 07017 07018 07019 07020 07021 07022 07023 1.0 1.0 1.0 1.0 1.0 2.0 10.0 10.0 10.0 1.0 10.0 10.0 1.0 1.0 10.0 1.0 3.0 3.0 3.0 1.0 1.0 10.0 1.0 10.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 3.0 1.0 1.0 10.0 1.0 10.0 10.0 2.0 3.0 10.0 3.0 10.0 10.0 10.0 10.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00539 Fmt 4701 RUCA level 07024 07026 07027 07028 07029 07030 07031 07032 07033 07034 07035 07036 07039 07040 07041 07042 07043 07044 07045 07046 07047 07050 07051 07052 07054 07055 07057 07058 07059 07060 07061 07062 07063 07064 07065 07066 07067 07068 07069 07070 07071 07072 07073 07074 07075 07076 07077 07078 07079 07080 07081 07082 07083 07086 07087 07088 07090 07091 07092 07093 07094 07095 07096 07097 07099 07101 07102 07103 07104 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 07105 07106 07107 07108 07109 07110 07111 07112 07114 07175 07182 07184 07188 07189 07191 07192 07193 07194 07195 07197 07198 07199 07201 07202 07203 07204 07205 07206 07207 07208 07302 07303 07304 07305 07306 07307 07308 07309 07310 07311 07390 07395 07399 07401 07403 07405 07407 07410 07416 07417 07418 07419 07420 07421 07422 07423 07424 07428 07430 07432 07435 07436 07438 07439 07440 07442 07444 07446 07450 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 2.0 2.0 1.0 2.0 2.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 70162 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ Zip code RUCA level 07451 07452 07456 07457 07458 07460 07461 07462 07463 07465 07470 07474 07477 07480 07481 07495 07498 07501 07502 07503 07504 07505 07506 07507 07508 07509 07510 07511 07512 07513 07514 07522 07524 07533 07538 07543 07544 07601 07602 07603 07604 07605 07606 07607 07608 07620 07621 07624 07626 07627 07628 07630 07631 07632 07640 07641 07642 07643 07644 07645 07646 07647 07648 07649 07650 07652 07653 07656 07657 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00540 Fmt 4701 RUCA level 07660 07661 07662 07663 07666 07670 07675 07676 07677 07699 07701 07702 07703 07704 07709 07710 07711 07712 07715 07716 07717 07718 07719 07720 07721 07722 07723 07724 07726 07727 07728 07730 07731 07732 07733 07734 07735 07737 07738 07739 07740 07746 07747 07748 07750 07751 07752 07753 07754 07755 07756 07757 07758 07760 07762 07763 07764 07765 07777 07799 07801 07802 07803 07806 07820 07821 07822 07823 07825 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 07826 07827 07828 07829 07830 07831 07832 07833 07834 07836 07837 07838 07839 07840 07842 07843 07844 07845 07846 07847 07848 07849 07850 07851 07852 07853 07855 07856 07857 07860 07863 07865 07866 07869 07870 07871 07874 07875 07876 07877 07878 07879 07880 07881 07882 07885 07890 07901 07902 07920 07921 07922 07924 07926 07927 07928 07930 07931 07932 07933 07934 07935 07936 07938 07939 07940 07945 07946 07950 2.0 2.0 1.0 2.0 2.0 2.0 2.0 2.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 2.0 1.0 2.0 1.0 2.0 1.0 1.0 2.0 1.0 1.0 2.0 1.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 2.0 1.0 1.0 1.0 2.0 2.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70163 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ Zip code RUCA level 07960 07961 07962 07963 07970 07974 07976 07977 07978 07979 07980 07981 07983 07999 08001 08002 08003 08004 08005 08006 08007 08008 08009 08010 08011 08012 08014 08015 08016 08018 08019 08020 08021 08022 08023 08025 08026 08027 08028 08029 08030 08031 08032 08033 08034 08035 08036 08037 08038 08039 08041 08042 08043 08045 08046 08048 08049 08050 08051 08052 08053 08054 08055 08056 08057 08059 08060 08061 08062 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.2 1.0 1.0 2.1 1.0 1.0 2.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.2 2.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00541 Fmt 4701 RUCA level 08063 08064 08065 08066 08067 08068 08069 08070 08071 08072 08073 08074 08075 08076 08077 08078 08079 08080 08081 08083 08084 08085 08086 08087 08088 08089 08090 08091 08092 08093 08094 08095 08096 08097 08098 08099 08101 08102 08103 08104 08105 08106 08107 08108 08109 08110 08201 08202 08203 08204 08205 08210 08212 08213 08214 08215 08217 08218 08219 08220 08221 08223 08224 08225 08226 08230 08231 08232 08234 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.2 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 2.0 4.2 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 08240 08241 08242 08243 08244 08245 08246 08247 08248 08250 08251 08252 08260 08270 08302 08310 08311 08312 08313 08314 08315 08316 08317 08318 08319 08320 08321 08322 08323 08324 08326 08327 08328 08329 08330 08332 08340 08341 08342 08343 08344 08345 08346 08347 08348 08349 08350 08352 08353 08360 08361 08362 08401 08402 08403 08404 08405 08406 08501 08502 08504 08505 08510 08511 08512 08514 08515 08518 08520 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.2 3.0 2.0 1.0 4.2 2.1 2.0 1.0 2.0 1.0 2.0 4.2 2.0 2.0 5.2 2.1 1.0 2.1 1.0 2.0 1.0 1.0 3.0 1.0 1.0 2.0 1.0 2.0 3.0 1.0 1.0 2.0 3.0 4.2 4.2 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 4.2 2.0 2.0 2.1 1.0 2.0 70164 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ Zip code RUCA level 08525 08526 08527 08528 08530 08533 08534 08535 08536 08540 08541 08542 08543 08544 08550 08551 08553 08554 08555 08556 08557 08558 08559 08560 08561 08562 08570 08601 08602 08603 08604 08605 08606 08607 08608 08609 08610 08611 08618 08619 08620 08625 08628 08629 08638 08640 08641 08645 08646 08647 08648 08650 08666 08677 08690 08691 08695 08701 08720 08721 08722 08723 08724 08730 08731 08732 08733 08734 08735 2.0 2.0 1.0 1.0 3.0 4.2 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 1.0 2.0 2.0 2.0 1.0 2.0 1.0 2.0 4.2 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.2 4.2 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ NJ PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00542 Fmt 4701 RUCA level 08736 08738 08739 08740 08741 08742 08750 08751 08752 08753 08754 08755 08756 08757 08758 08759 08801 08802 08803 08804 08805 08807 08808 08809 08810 08812 08816 08817 08818 08820 08821 08822 08823 08824 08825 08826 08827 08828 08829 08830 08831 08832 08833 08834 08835 08836 08837 08840 08844 08846 08848 08850 08852 08853 08854 08855 08857 08858 08859 08861 08862 08863 08865 08867 08868 08869 08870 08871 08872 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State NJ ..................................... NJ ..................................... NJ ..................................... NJ ..................................... NJ ..................................... NJ ..................................... NJ ..................................... NJ ..................................... NJ ..................................... NJ ..................................... NJ ..................................... NJ ..................................... NJ ..................................... NJ ..................................... NJ ..................................... NJ ..................................... NJ ..................................... NJ ..................................... NJ ..................................... NJ ..................................... NJ ..................................... NJ ..................................... NJ ..................................... NJ ..................................... NJ ..................................... NJ ..................................... NJ ..................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 08873 08875 08876 08877 08878 08879 08880 08882 08884 08885 08886 08887 08888 08889 08890 08896 08899 08901 08902 08903 08904 08905 08906 08922 08933 08988 08989 87001 87002 87004 87005 87006 87007 87008 87009 87010 87011 87012 87013 87014 87015 87016 87017 87018 87020 87021 87022 87023 87024 87025 87026 87027 87028 87029 87031 87032 87034 87035 87036 87037 87038 87040 87041 87042 87043 87044 87045 87046 87047 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 4.2 1.0 5.0 10.6 10.1 2.0 10.4 2.0 7.0 10.0 10.4 4.0 2.0 2.0 10.5 10.4 4.0 4.0 2.0 2.0 2.0 2.0 2.0 10.4 10.6 10.0 2.0 2.0 4.0 2.0 10.4 2.0 10.1 4.0 2.0 2.0 2.0 2.0 10.5 10.0 2.0 70165 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM Zip code RUCA level 87048 87049 87051 87052 87053 87056 87059 87060 87061 87062 87063 87064 87068 87070 87072 87083 87101 87102 87103 87104 87105 87106 87107 87108 87109 87110 87111 87112 87113 87114 87115 87116 87117 87118 87119 87120 87121 87122 87123 87124 87125 87131 87144 87151 87153 87154 87158 87174 87176 87181 87184 87185 87187 87190 87191 87192 87193 87194 87195 87196 87197 87198 87199 87301 87302 87305 87310 87311 87312 1.0 4.0 4.0 2.0 2.0 2.0 2.0 2.0 2.0 10.6 10.4 10.5 2.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 4.0 4.0 5.0 4.0 5.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00543 Fmt 4701 RUCA level 87313 87315 87316 87317 87319 87320 87321 87322 87323 87325 87326 87327 87328 87347 87357 87364 87365 87375 87401 87402 87410 87412 87413 87415 87416 87417 87418 87419 87420 87421 87455 87461 87499 87500 87501 87502 87503 87504 87505 87506 87507 87508 87509 87510 87511 87512 87513 87514 87515 87516 87517 87518 87519 87520 87521 87522 87523 87524 87525 87527 87528 87529 87530 87531 87532 87533 87535 87537 87538 10.5 5.0 4.0 4.0 4.0 9.2 10.2 4.0 10.5 5.0 4.0 5.0 9.2 5.0 4.0 7.3 10.5 4.0 1.0 1.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 10.1 7.3 1.0 7.3 7.3 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 2.0 1.0 10.5 4.0 10.2 10.2 10.2 10.0 10.5 5.0 10.0 10.2 10.0 4.0 4.0 4.0 10.2 4.0 4.0 10.0 4.0 10.5 4.0 4.0 4.0 2.0 4.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 87539 87540 87543 87544 87545 87548 87549 87551 87552 87553 87554 87556 87557 87558 87560 87562 87564 87565 87566 87567 87569 87571 87573 87574 87575 87576 87577 87578 87579 87580 87581 87582 87583 87592 87594 87701 87710 87711 87712 87713 87714 87715 87718 87722 87723 87724 87728 87729 87730 87731 87732 87733 87734 87735 87736 87740 87742 87743 87745 87746 87747 87749 87750 87752 87753 87801 87820 87821 87823 10.5 2.0 10.5 4.0 4.0 10.5 5.0 10.0 2.0 10.5 10.5 10.2 4.0 10.2 2.0 2.0 10.2 2.0 4.0 4.0 2.0 4.0 2.0 2.0 10.0 4.0 5.0 4.0 10.5 10.2 10.5 4.0 4.0 1.0 1.0 4.0 10.0 7.0 10.5 10.5 10.0 10.5 10.0 10.5 10.5 7.0 10.0 10.0 10.0 5.0 10.5 10.0 10.5 10.5 10.5 7.0 5.0 10.0 5.0 10.0 10.0 10.0 10.5 10.5 10.5 7.0 10.0 10.0 10.6 70166 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM Zip code RUCA level 87824 87825 87827 87828 87829 87830 87831 87832 87901 87930 87931 87933 87935 87936 87937 87939 87940 87941 87942 87943 88001 88002 88003 88004 88005 88006 88007 88008 88009 88011 88012 88020 88021 88022 88023 88024 88025 88026 88027 88028 88029 88030 88031 88032 88033 88034 88036 88038 88039 88040 88041 88042 88043 88044 88045 88046 88047 88048 88049 88051 88052 88053 88054 88055 88056 88058 88061 88062 88063 10.0 10.6 10.0 10.6 10.0 10.0 10.6 7.0 7.0 10.3 10.3 10.3 7.0 10.4 10.4 7.0 10.4 10.4 10.3 10.3 1.0 10.4 1.0 1.0 1.0 1.0 1.0 1.0 7.0 1.0 1.0 10.6 1.0 7.2 7.2 2.0 10.2 7.2 2.1 10.2 4.0 4.0 4.0 1.0 1.0 7.2 4.0 4.0 10.0 5.0 5.0 10.3 5.0 2.1 7.0 1.0 2.1 2.1 5.0 10.2 1.0 4.0 10.4 10.2 10.6 2.1 4.0 4.0 1.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM NM PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00544 Fmt 4701 RUCA level 88065 88072 88081 88101 88102 88103 88112 88113 88114 88115 88116 88118 88119 88120 88121 88122 88123 88124 88125 88126 88130 88132 88133 88134 88135 88136 88201 88202 88203 88210 88211 88213 88220 88221 88230 88231 88232 88240 88241 88242 88244 88250 88252 88253 88254 88255 88256 88260 88262 88263 88264 88265 88267 88268 88301 88310 88311 88312 88314 88316 88317 88318 88321 88323 88324 88325 88330 88336 88337 4.0 2.1 2.0 4.0 4.0 4.0 5.0 10.2 10.6 4.0 10.2 10.2 10.0 5.0 10.3 10.2 10.2 5.0 10.2 10.2 4.0 10.2 5.0 10.0 5.0 10.0 4.0 4.0 4.0 4.0 4.0 10.6 4.0 4.0 10.2 7.2 10.5 4.0 4.0 4.0 4.0 5.0 10.5 10.5 4.0 4.0 5.0 7.4 7.4 5.0 10.6 4.0 10.6 4.0 10.6 4.0 4.0 7.0 5.0 10.3 2.0 10.6 10.4 10.3 7.0 2.0 10.5 7.0 4.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NM .................................... NV ..................................... NV ..................................... NV ..................................... NV ..................................... NV ..................................... NV ..................................... NV ..................................... NV ..................................... NV ..................................... NV ..................................... NV ..................................... NV ..................................... NV ..................................... NV ..................................... NV ..................................... NV ..................................... NV ..................................... NV ..................................... NV ..................................... NV ..................................... NV ..................................... NV ..................................... NV ..................................... NV ..................................... NV ..................................... NV ..................................... NV ..................................... NV ..................................... NV ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 88338 88339 88340 88341 88342 88343 88344 88345 88346 88347 88348 88349 88350 88351 88352 88353 88354 88355 88401 88410 88411 88414 88415 88416 88417 88418 88419 88421 88422 88424 88426 88427 88430 88431 88433 88434 88435 88436 88437 88439 88901 88905 89001 89003 89004 89005 89006 89007 89008 89009 89010 89011 89012 89013 89014 89015 89016 89017 89018 89019 89020 89021 89022 89023 89024 89025 89026 89027 89028 10.3 2.0 10.6 10.3 2.0 7.0 2.0 7.0 7.0 2.0 7.0 2.0 2.0 7.0 5.0 7.0 2.0 7.0 7.0 10.0 10.6 10.0 10.0 5.0 7.0 10.0 10.0 5.0 10.0 10.0 10.6 10.3 10.6 5.0 7.0 10.6 7.0 10.0 10.0 5.0 1.0 1.0 10.0 10.0 2.0 2.0 2.0 2.0 10.0 1.0 10.0 1.0 1.0 10.0 1.0 1.0 1.0 10.0 2.0 2.0 10.0 2.0 10.0 10.0 7.3 2.0 2.0 7.3 7.3 70167 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV Zip code RUCA level 89029 89030 89031 89032 89033 89036 89039 89040 89041 89042 89043 89044 89045 89046 89047 89048 89049 89052 89053 89060 89061 89070 89074 89077 89081 89084 89085 89086 89087 89101 89102 89103 89104 89105 89106 89107 89108 89109 89110 89111 89112 89113 89114 89115 89116 89117 89118 89119 89120 89121 89122 89123 89124 89125 89126 89127 89128 89129 89130 89131 89132 89133 89134 89135 89136 89137 89138 89139 89140 7.3 1.0 1.0 1.0 1.0 1.0 10.4 2.0 10.4 10.0 10.0 10.0 10.0 10.4 10.0 4.2 10.0 1.0 2.0 4.2 4.2 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00545 Fmt 4701 RUCA level 89141 89142 89143 89144 89145 89146 89147 89148 89149 89150 89151 89152 89153 89154 89155 89156 89157 89159 89160 89161 89162 89163 89164 89165 89166 89170 89173 89177 89178 89179 89180 89185 89191 89193 89195 89199 89301 89310 89311 89314 89315 89316 89317 89318 89319 89402 89403 89404 89405 89406 89407 89408 89409 89410 89411 89412 89413 89414 89415 89418 89419 89420 89421 89422 89423 89424 89425 89426 89427 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.0 10.3 8.0 7.0 7.0 10.0 7.0 7.0 7.0 4.2 2.0 7.0 2.0 4.0 4.0 2.0 10.0 4.2 4.0 2.0 4.0 8.0 7.0 10.6 10.6 8.0 7.0 8.0 1.0 2.0 7.0 7.0 6.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV NV ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 89428 89429 89430 89431 89432 89433 89434 89435 89436 89438 89439 89440 89442 89444 89445 89446 89447 89448 89449 89450 89451 89452 89460 89496 89501 89502 89503 89504 89505 89506 89507 89509 89510 89511 89512 89513 89515 89520 89521 89523 89533 89555 89557 89570 89595 89599 89701 89702 89703 89704 89705 89706 89711 89712 89713 89714 89721 89801 89802 89803 89815 89820 89821 89822 89823 89824 89825 89826 89828 1.0 10.4 10.3 1.0 1.0 1.0 1.0 1.0 1.0 8.0 1.0 2.0 2.0 10.5 7.0 7.0 7.0 4.0 4.0 4.2 4.2 4.2 4.2 4.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 4.0 4.0 5.0 7.0 10.0 10.5 4.0 4.0 10.0 10.0 5.0 70168 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State NV NV NV NV NV NV NV NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY Zip code RUCA level 89830 89831 89832 89833 89834 89835 89883 00501 00544 06390 10001 10002 10003 10004 10005 10006 10007 10008 10009 10010 10011 10012 10013 10014 10015 10016 10017 10018 10019 10020 10021 10022 10023 10024 10025 10026 10027 10028 10029 10030 10031 10032 10033 10034 10035 10036 10037 10038 10039 10040 10041 10043 10044 10045 10046 10047 10048 10055 10060 10069 10072 10079 10080 10081 10082 10087 10090 10094 10095 7.0 10.5 10.5 10.5 10.0 7.0 7.0 1.0 1.0 7.3 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00546 Fmt 4701 RUCA level 10096 10098 10099 10101 10102 10103 10104 10105 10106 10107 10108 10109 10110 10111 10112 10113 10114 10115 10116 10117 10118 10119 10120 10121 10122 10123 10124 10125 10126 10128 10129 10130 10131 10132 10133 10138 10149 10150 10151 10152 10153 10154 10155 10156 10157 10158 10159 10160 10161 10162 10163 10164 10165 10166 10167 10168 10169 10170 10171 10172 10173 10174 10175 10176 10177 10178 10179 10184 10185 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 10196 10197 10199 10203 10211 10212 10213 10242 10249 10256 10257 10258 10259 10260 10261 10265 10268 10269 10270 10271 10272 10273 10274 10275 10276 10277 10278 10279 10280 10281 10282 10285 10286 10292 10301 10302 10303 10304 10305 10306 10307 10308 10309 10310 10311 10312 10313 10314 10451 10452 10453 10454 10455 10456 10457 10458 10459 10460 10461 10462 10463 10464 10465 10466 10467 10468 10469 10470 10471 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70169 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY Zip code RUCA level 10472 10473 10474 10475 10499 10501 10502 10503 10504 10505 10506 10507 10509 10510 10511 10512 10514 10516 10517 10518 10519 10520 10521 10522 10523 10524 10526 10527 10528 10530 10532 10533 10535 10536 10537 10538 10540 10541 10542 10543 10545 10546 10547 10548 10549 10550 10551 10552 10553 10557 10558 10560 10562 10566 10567 10570 10571 10572 10573 10576 10577 10578 10579 10580 10583 10587 10588 10589 10590 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00547 Fmt 4701 RUCA level 10591 10594 10595 10596 10597 10598 10601 10602 10603 10604 10605 10606 10607 10610 10650 10701 10702 10703 10704 10705 10706 10707 10708 10709 10710 10801 10802 10803 10804 10805 10901 10910 10911 10912 10913 10914 10915 10916 10917 10918 10919 10920 10921 10922 10923 10924 10925 10926 10927 10928 10930 10931 10932 10933 10940 10941 10943 10949 10950 10952 10953 10954 10956 10958 10959 10960 10962 10963 10964 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 2.0 1.0 1.0 1.0 3.0 2.0 2.0 3.0 1.0 2.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 3.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 3.0 2.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 10965 10968 10969 10970 10973 10974 10975 10976 10977 10979 10980 10981 10982 10983 10984 10985 10986 10987 10988 10989 10990 10992 10993 10994 10996 10997 10998 11001 11002 11003 11004 11005 11010 11020 11021 11022 11023 11024 11025 11026 11027 11030 11040 11041 11042 11043 11044 11050 11051 11052 11053 11054 11055 11096 11099 11101 11102 11103 11104 11105 11106 11109 11120 11201 11202 11203 11204 11205 11206 1.0 1.0 2.0 1.0 3.0 1.0 2.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 3.0 1.0 2.0 3.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 3.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70170 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY Zip code RUCA level 11207 11208 11209 11210 11211 11212 11213 11214 11215 11216 11217 11218 11219 11220 11221 11222 11223 11224 11225 11226 11228 11229 11230 11231 11232 11233 11234 11235 11236 11237 11238 11239 11240 11241 11242 11243 11244 11245 11247 11248 11249 11251 11252 11254 11255 11256 11351 11352 11354 11355 11356 11357 11358 11359 11360 11361 11362 11363 11364 11365 11366 11367 11368 11369 11370 11371 11372 11373 11374 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00548 Fmt 4701 RUCA level 11375 11377 11378 11379 11380 11381 11385 11386 11390 11405 11411 11412 11413 11414 11415 11416 11417 11418 11419 11420 11421 11422 11423 11424 11425 11426 11427 11428 11429 11430 11431 11432 11433 11434 11435 11436 11439 11451 11484 11499 11501 11507 11509 11510 11514 11516 11518 11520 11530 11531 11535 11536 11542 11545 11547 11548 11549 11550 11551 11552 11553 11554 11555 11556 11557 11558 11559 11560 11561 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 11563 11564 11565 11566 11568 11569 11570 11571 11572 11575 11576 11577 11579 11580 11581 11582 11583 11588 11590 11592 11593 11594 11595 11596 11597 11598 11599 11690 11691 11692 11693 11694 11695 11697 11701 11702 11703 11704 11705 11706 11707 11708 11709 11710 11713 11714 11715 11716 11717 11718 11719 11720 11721 11722 11724 11725 11726 11727 11729 11730 11731 11732 11733 11735 11736 11737 11738 11739 11740 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70171 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY Zip code RUCA level 11741 11742 11743 11745 11746 11747 11749 11750 11751 11752 11753 11754 11755 11756 11757 11758 11760 11762 11763 11764 11765 11766 11767 11768 11769 11770 11771 11772 11773 11774 11775 11776 11777 11778 11779 11780 11782 11783 11784 11786 11787 11788 11789 11790 11791 11792 11793 11794 11795 11796 11797 11798 11801 11802 11803 11804 11805 11815 11819 11853 11854 11855 11901 11930 11931 11932 11933 11934 11935 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 7.3 2.0 2.0 2.0 1.0 2.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00549 Fmt 4701 RUCA level 11937 11939 11940 11941 11942 11944 11946 11947 11948 11949 11950 11951 11952 11953 11954 11955 11956 11957 11958 11959 11960 11961 11962 11963 11964 11965 11967 11968 11969 11970 11971 11972 11973 11975 11976 11977 11978 11980 12007 12008 12009 12010 12015 12016 12017 12018 12019 12020 12022 12023 12024 12025 12027 12028 12029 12031 12032 12033 12035 12036 12037 12040 12041 12042 12043 12045 12046 12047 12050 7.3 7.3 1.0 1.0 1.0 7.3 1.0 2.0 2.0 1.0 1.0 1.0 2.0 1.0 10.1 1.0 2.0 7.3 2.0 1.0 1.0 1.0 2.0 2.0 10.4 10.4 1.0 1.0 1.0 2.0 7.3 1.0 1.0 7.3 2.0 1.0 1.0 1.0 2.0 1.0 2.0 4.2 7.3 4.2 10.4 1.0 1.0 1.1 2.0 2.0 10.4 3.0 1.0 2.0 10.4 10.6 5.0 1.0 2.0 10.6 10.4 2.0 2.0 7.3 7.0 2.0 2.0 1.0 2.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 12051 12052 12053 12054 12055 12056 12057 12058 12059 12060 12061 12062 12063 12064 12065 12066 12067 12068 12069 12070 12071 12072 12073 12074 12075 12076 12077 12078 12082 12083 12084 12085 12086 12087 12089 12090 12092 12093 12094 12095 12106 12107 12108 12110 12111 12115 12116 12117 12118 12120 12121 12122 12123 12124 12125 12128 12130 12131 12132 12133 12134 12136 12137 12138 12139 12140 12141 12143 12144 7.3 2.0 2.0 1.0 2.0 2.0 10.4 7.3 2.0 10.4 1.0 2.0 2.0 10.2 1.0 2.0 2.0 4.0 4.0 4.2 10.4 10.4 2.0 2.0 10.5 10.4 1.0 4.0 2.0 10.4 1.0 2.0 4.2 2.0 7.4 7.4 2.0 10.4 2.0 4.0 2.0 2.0 10.0 1.0 1.0 10.4 5.0 4.0 2.0 2.0 2.0 2.0 2.0 2.0 10.4 1.0 2.0 10.4 2.0 10.4 10.5 10.4 2.0 2.0 10.0 2.0 2.0 2.0 1.0 70172 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY Zip code RUCA level 12147 12148 12149 12150 12151 12153 12154 12155 12156 12157 12158 12159 12160 12161 12164 12165 12166 12167 12168 12169 12170 12172 12173 12174 12175 12176 12177 12179 12180 12181 12182 12183 12184 12185 12186 12187 12188 12189 12190 12192 12193 12194 12195 12196 12197 12198 12201 12202 12203 12204 12205 12206 12207 12208 12209 12210 12211 12212 12214 12220 12222 12223 12224 12225 12226 12227 12228 12229 12230 2.0 1.0 10.6 1.0 1.0 1.0 2.0 10.2 1.0 2.0 1.0 1.0 10.6 1.0 10.0 10.4 10.4 10.0 2.0 2.0 2.0 4.0 2.0 2.0 10.6 10.4 4.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 10.6 1.0 1.0 10.5 2.0 2.0 10.4 10.4 1.0 10.2 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00550 Fmt 4701 RUCA level 12231 12232 12233 12234 12235 12236 12237 12238 12239 12240 12241 12242 12243 12244 12245 12246 12247 12248 12249 12250 12252 12255 12256 12257 12260 12261 12262 12288 12301 12302 12303 12304 12305 12306 12307 12308 12309 12325 12345 12401 12402 12404 12405 12406 12407 12409 12410 12411 12412 12413 12414 12416 12417 12418 12419 12420 12421 12422 12423 12424 12427 12428 12429 12430 12431 12432 12433 12434 12435 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 3.0 10.6 10.0 10.0 3.0 3.0 1.0 2.0 10.6 7.3 3.0 1.0 10.4 1.0 3.0 10.0 10.4 10.4 10.4 10.4 7.3 1.0 10.0 10.4 2.0 2.0 10.0 8.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 12436 12438 12439 12440 12441 12442 12443 12444 12446 12448 12449 12450 12451 12452 12453 12454 12455 12456 12457 12458 12459 12460 12461 12463 12464 12465 12466 12468 12469 12470 12471 12472 12473 12474 12475 12477 12480 12481 12482 12483 12484 12485 12486 12487 12489 12490 12491 12492 12493 12494 12495 12496 12498 12501 12502 12503 12504 12506 12507 12508 12510 12511 12512 12513 12514 12515 12516 12517 12518 10.4 10.0 10.4 2.0 10.4 10.4 1.0 10.4 3.0 3.0 1.0 10.4 10.6 10.4 2.0 10.4 10.0 2.0 3.0 7.3 10.0 10.4 2.0 9.0 3.0 10.4 1.0 10.4 2.0 10.6 2.1 1.0 10.6 10.0 1.0 2.0 10.0 2.0 10.6 7.3 2.0 10.4 1.0 2.1 3.0 2.0 2.0 10.4 1.0 2.0 3.0 10.4 2.0 2.0 10.4 10.4 7.3 2.0 7.3 1.0 2.1 1.0 1.0 5.0 2.0 2.0 10.0 10.0 1.0 70173 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY Zip code RUCA level 12520 12521 12522 12523 12524 12525 12526 12527 12528 12529 12530 12531 12533 12534 12537 12538 12540 12541 12542 12543 12544 12545 12546 12547 12548 12549 12550 12551 12552 12553 12555 12561 12563 12564 12565 12566 12567 12568 12569 12570 12571 12572 12574 12575 12577 12578 12580 12581 12582 12583 12584 12585 12586 12588 12589 12590 12592 12593 12594 12601 12602 12603 12604 12701 12719 12720 12721 12722 12723 1.0 5.0 3.0 6.0 1.0 2.0 10.5 1.0 1.0 10.4 5.0 2.0 1.0 4.0 1.0 1.0 2.1 10.4 1.0 2.1 10.5 2.0 3.0 1.0 2.0 2.1 1.0 1.0 1.0 1.0 1.0 2.0 1.0 2.0 4.0 3.0 3.0 1.0 1.0 1.0 7.3 3.0 3.0 1.0 1.0 2.0 2.0 2.0 1.0 7.3 1.0 2.1 1.0 3.0 1.0 1.0 2.0 10.0 2.0 1.0 1.0 1.0 1.0 7.0 10.5 10.6 3.0 3.0 10.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00551 Fmt 4701 RUCA level 12724 12725 12726 12727 12729 12732 12733 12734 12736 12737 12738 12740 12741 12742 12743 12745 12746 12747 12748 12749 12750 12751 12752 12754 12758 12759 12760 12762 12763 12764 12765 12766 12767 12768 12769 12770 12771 12775 12776 12777 12778 12779 12780 12781 12782 12783 12784 12785 12786 12787 12788 12789 12790 12791 12792 12801 12803 12804 12808 12809 12810 12811 12812 12814 12815 12816 12817 12819 12820 10.6 10.4 10.4 10.4 4.2 10.5 7.0 9.0 10.0 10.5 9.0 10.6 10.0 8.3 10.5 10.0 4.2 10.6 10.6 10.6 10.0 8.3 10.4 7.0 10.6 10.6 10.0 10.6 7.0 10.4 10.6 10.6 10.6 7.0 3.0 10.5 4.2 9.0 10.6 9.0 7.0 7.0 4.2 3.0 10.4 10.6 7.0 4.2 10.6 9.0 10.6 7.0 3.0 10.6 10.5 1.0 1.0 1.0 3.0 2.0 2.0 10.4 10.0 10.4 3.0 10.4 3.0 10.4 2.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 12821 12822 12823 12824 12827 12828 12831 12832 12833 12834 12835 12836 12837 12838 12839 12841 12842 12843 12844 12845 12846 12847 12848 12849 12850 12851 12852 12853 12854 12855 12856 12857 12858 12859 12860 12861 12862 12863 12864 12865 12866 12870 12871 12872 12873 12874 12878 12879 12883 12884 12885 12886 12887 12901 12903 12910 12911 12912 12913 12914 12915 12916 12917 12918 12919 12920 12921 12922 12923 2.0 7.1 9.1 10.4 2.0 1.0 1.1 7.3 2.1 9.1 3.0 3.0 10.4 2.0 1.0 10.4 10.0 10.4 2.0 2.0 2.0 10.0 9.1 7.3 2.0 10.6 10.6 10.4 10.4 10.6 10.4 10.6 10.6 2.1 3.0 10.4 3.0 1.1 10.0 10.4 1.1 10.6 2.1 10.6 10.4 3.0 2.0 10.6 7.0 2.1 2.0 10.4 10.4 4.0 4.0 5.0 5.0 5.0 8.0 10.5 10.2 5.0 10.2 5.0 10.5 10.2 5.0 10.6 5.0 70174 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY Zip code RUCA level 12924 12926 12927 12928 12929 12930 12932 12933 12934 12935 12936 12937 12939 12941 12942 12943 12944 12945 12946 12949 12950 12952 12953 12955 12956 12957 12958 12959 12960 12961 12962 12964 12965 12966 12967 12969 12970 12972 12973 12974 12975 12976 12977 12978 12979 12980 12981 12983 12985 12986 12987 12989 12992 12993 12995 12996 12997 12998 13020 13021 13022 13024 13026 13027 13028 13029 13030 13031 13032 5.0 10.2 8.0 9.0 5.0 10.5 10.0 5.0 5.0 5.0 10.0 10.5 7.0 10.6 10.0 10.0 5.0 7.0 7.0 10.6 10.0 5.0 4.0 5.0 10.6 5.0 5.0 5.0 10.6 10.6 5.0 10.0 10.6 5.0 10.6 5.0 8.0 5.0 10.6 10.6 5.0 8.0 7.0 5.0 10.5 10.5 5.0 7.0 5.0 7.0 8.0 8.0 5.0 10.0 4.0 10.0 8.0 10.6 2.0 4.2 4.2 4.2 10.4 1.0 2.0 1.0 1.0 1.0 4.2 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00552 Fmt 4701 RUCA level 13033 13034 13035 13036 13037 13039 13040 13041 13042 13043 13044 13045 13051 13052 13053 13054 13056 13057 13060 13061 13062 13063 13064 13065 13066 13068 13069 13071 13072 13073 13074 13076 13077 13078 13080 13081 13082 13083 13084 13087 13088 13089 13090 13092 13093 13101 13102 13103 13104 13107 13108 13110 13111 13112 13113 13114 13115 13116 13117 13118 13119 13120 13121 13122 13123 13124 13126 13129 13131 2.0 5.0 2.0 2.0 2.0 1.0 5.0 1.0 2.0 4.2 2.0 4.0 2.0 3.0 2.0 5.0 4.0 1.0 2.0 10.4 1.0 2.0 3.0 4.0 1.0 2.0 4.2 10.4 3.0 2.0 6.1 2.0 4.0 1.0 2.0 10.4 1.0 3.0 2.0 5.2 1.0 1.0 1.0 6.1 4.2 4.0 2.0 2.0 1.0 2.0 1.0 2.0 3.0 2.0 2.0 2.0 4.2 1.0 3.0 7.4 2.0 1.0 2.0 2.0 2.0 10.6 4.2 3.0 2.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 13132 13134 13135 13136 13137 13138 13139 13140 13141 13142 13143 13144 13145 13146 13147 13148 13152 13153 13154 13155 13156 13157 13158 13159 13160 13162 13163 13164 13165 13166 13167 13201 13202 13203 13204 13205 13206 13207 13208 13209 13210 13211 13212 13214 13215 13217 13218 13219 13220 13221 13224 13225 13235 13244 13250 13251 13252 13260 13261 13290 13301 13302 13303 13304 13305 13308 13309 13310 13312 2.0 10.4 1.0 10.6 1.0 2.0 5.2 3.0 5.2 10.4 10.4 3.0 3.0 10.5 5.2 4.0 2.0 2.0 10.5 10.6 3.0 3.0 5.2 2.0 5.0 3.0 4.2 2.0 4.0 3.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.4 2.0 5.2 2.0 10.6 3.0 10.4 10.4 10.6 70175 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY Zip code RUCA level 13313 13314 13315 13316 13317 13318 13319 13320 13321 13322 13323 13324 13325 13326 13327 13328 13329 13331 13332 13333 13334 13335 13337 13338 13339 13340 13341 13342 13343 13345 13346 13348 13350 13352 13353 13354 13355 13357 13360 13361 13362 13363 13364 13365 13367 13368 13401 13402 13403 13404 13406 13407 13408 13409 13410 13411 13413 13415 13416 13417 13418 13420 13421 13424 13425 13426 13428 13431 13433 2.0 3.0 10.5 10.5 7.0 2.0 1.0 10.0 1.0 1.0 1.0 2.0 10.0 10.5 10.6 2.0 10.5 2.0 8.0 10.0 10.4 10.5 10.5 2.0 7.0 4.1 1.0 10.5 8.0 10.6 7.0 10.5 4.2 2.0 10.0 2.0 8.0 4.2 10.0 10.1 2.0 5.2 3.0 7.4 7.4 10.0 3.0 8.0 1.0 7.4 2.0 4.2 10.4 6.1 7.0 10.6 1.0 10.5 2.0 1.0 3.0 2.0 4.2 2.0 2.0 3.0 7.0 2.0 10.6 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00553 Fmt 4701 RUCA level 13435 13436 13437 13438 13439 13440 13441 13442 13449 13450 13452 13454 13455 13456 13457 13459 13460 13461 13464 13465 13468 13469 13470 13471 13472 13473 13475 13476 13477 13478 13479 13480 13482 13483 13484 13485 13486 13488 13489 13490 13491 13492 13493 13494 13495 13501 13502 13503 13504 13505 13599 13601 13602 13603 13605 13606 13607 13608 13611 13612 13613 13614 13615 13616 13617 13618 13619 13620 13621 2.0 10.0 3.0 2.0 10.4 4.2 4.2 4.2 4.2 10.0 10.0 9.0 2.0 1.0 10.5 10.6 10.6 4.2 10.6 8.0 10.0 1.0 6.0 5.2 2.0 10.0 10.5 4.2 4.2 5.0 1.0 2.0 10.5 5.2 10.4 3.0 5.2 10.0 10.0 2.0 2.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 4.0 4.0 5.0 5.0 10.2 5.0 10.5 4.0 6.0 10.5 4.0 5.0 7.0 5.0 5.0 10.6 5.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 13622 13623 13624 13625 13626 13627 13628 13630 13631 13632 13633 13634 13635 13636 13637 13638 13639 13640 13641 13642 13643 13645 13646 13647 13648 13649 13650 13651 13652 13654 13655 13656 13657 13658 13659 13660 13661 13662 13664 13665 13666 13667 13668 13669 13670 13671 13672 13673 13674 13675 13676 13677 13678 13679 13680 13681 13682 13683 13684 13685 13687 13690 13691 13692 13693 13694 13695 13696 13697 5.0 10.6 10.2 8.0 7.4 5.0 5.0 10.6 5.0 5.0 10.6 5.0 10.6 10.5 4.0 4.0 10.6 10.2 10.2 7.4 5.0 7.4 10.6 7.0 10.6 6.0 5.0 5.0 10.6 5.0 6.0 10.2 5.0 10.5 10.5 10.5 10.5 4.0 4.0 5.0 10.6 5.0 8.0 4.0 10.6 5.0 8.0 4.0 5.0 10.2 7.0 10.6 5.0 10.2 7.0 10.6 5.0 6.0 10.6 5.0 8.0 10.6 5.0 10.2 5.0 10.5 10.6 6.0 6.0 70176 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY Zip code RUCA level 13699 13730 13731 13732 13733 13734 13736 13737 13738 13739 13740 13743 13744 13745 13746 13747 13748 13749 13750 13751 13752 13753 13754 13755 13756 13757 13758 13760 13761 13762 13763 13774 13775 13776 13777 13778 13780 13782 13783 13784 13786 13787 13788 13790 13794 13795 13796 13797 13801 13802 13803 13804 13806 13807 13808 13809 13810 13811 13812 13813 13814 13815 13820 13825 13826 13827 13830 13832 13833 7.0 10.4 10.0 1.0 10.4 2.0 2.0 1.0 4.0 10.0 10.0 2.1 2.0 1.0 2.0 5.0 1.0 1.0 5.0 5.0 10.0 10.0 3.0 10.0 10.0 10.0 10.6 1.0 1.0 1.0 1.0 10.0 10.5 10.5 2.0 10.4 9.0 10.0 10.0 2.0 5.0 2.0 10.0 1.0 2.0 1.0 5.0 2.0 10.6 2.0 5.0 10.6 10.0 5.0 10.5 9.0 10.5 2.0 2.0 2.0 7.0 7.0 4.0 5.0 2.0 2.0 9.0 10.6 2.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00554 Fmt 4701 RUCA level 13834 13835 13837 13838 13839 13840 13841 13842 13843 13844 13845 13846 13847 13848 13849 13850 13851 13856 13859 13860 13861 13862 13863 13864 13865 13901 13902 13903 13904 13905 14001 14004 14005 14006 14008 14009 14010 14011 14012 14013 14020 14021 14024 14025 14026 14027 14028 14029 14030 14031 14032 14033 14034 14035 14036 14037 14038 14039 14040 14041 14042 14043 14047 14048 14051 14052 14054 14055 14056 5.0 2.0 10.0 7.0 7.0 2.0 10.4 10.0 10.6 10.6 2.0 10.5 7.0 2.0 9.2 1.0 1.0 7.0 9.2 4.0 4.0 2.0 5.0 2.1 2.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 3.0 1.0 5.2 7.3 1.0 7.4 10.5 2.0 4.2 4.2 10.4 1.0 1.0 2.0 5.0 8.3 2.0 1.0 2.0 2.0 7.1 7.1 2.0 2.0 1.0 10.4 3.0 10.4 7.3 1.0 1.0 4.0 1.0 2.0 6.1 2.0 4.2 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 14057 14058 14059 14060 14061 14062 14063 14065 14066 14067 14068 14069 14070 14072 14075 14080 14081 14082 14083 14085 14086 14091 14092 14094 14095 14098 14101 14102 14103 14105 14107 14108 14109 14110 14111 14112 14113 14120 14125 14126 14127 14129 14130 14131 14132 14133 14134 14135 14136 14138 14139 14140 14141 14143 14144 14145 14150 14151 14166 14167 14168 14169 14170 14171 14172 14173 14174 14201 14202 1.0 6.0 1.0 10.5 2.0 5.0 4.0 8.3 10.6 5.1 1.0 2.0 7.1 1.0 1.0 2.0 2.0 2.0 2.0 1.0 1.0 2.0 1.0 4.1 4.1 10.4 7.3 2.0 7.0 6.0 1.0 5.2 1.0 1.0 2.0 1.0 2.0 1.0 6.0 5.0 1.0 7.1 10.6 2.0 1.0 8.3 2.0 2.0 2.0 10.4 2.0 1.0 7.1 2.0 1.0 3.0 1.0 1.0 4.0 3.0 7.1 2.0 2.0 3.0 2.0 7.3 1.0 1.0 1.0 70177 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY Zip code RUCA level 14203 14204 14205 14206 14207 14208 14209 14210 14211 14212 14213 14214 14215 14216 14217 14218 14219 14220 14221 14222 14223 14224 14225 14226 14227 14228 14231 14233 14240 14241 14260 14261 14263 14264 14265 14267 14269 14270 14272 14273 14276 14280 14301 14302 14303 14304 14305 14410 14411 14413 14414 14415 14416 14418 14420 14422 14423 14424 14425 14427 14428 14429 14430 14432 14433 14435 14437 14441 14443 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.3 10.4 2.0 7.0 2.0 3.0 1.0 2.0 2.0 2.0 1.0 10.6 2.0 2.0 1.0 4.1 10.6 2.0 3.0 10.6 2.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00555 Fmt 4701 RUCA level 14445 14449 14450 14452 14453 14454 14456 14461 14462 14463 14464 14466 14467 14468 14469 14470 14471 14472 14475 14476 14477 14478 14479 14480 14481 14482 14485 14486 14487 14488 14489 14502 14504 14505 14506 14507 14508 14510 14511 14512 14513 14514 14515 14516 14517 14518 14519 14520 14521 14522 14525 14526 14527 14529 14530 14532 14533 14534 14536 14537 14538 14539 14541 14542 14543 14544 14545 14546 14547 1.0 2.0 1.0 2.0 1.0 7.3 4.0 6.0 3.0 4.0 2.0 2.0 1.0 1.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 7.0 7.3 2.0 3.0 2.0 2.0 3.0 2.0 2.0 7.3 1.0 4.1 2.0 2.0 3.0 2.0 9.1 2.0 10.4 4.1 1.0 1.0 10.4 10.4 4.0 2.0 2.0 3.0 4.1 6.1 1.0 7.0 10.4 9.0 10.5 3.0 1.0 10.4 4.1 2.0 3.0 5.0 7.3 2.0 3.0 3.0 2.0 6.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 14548 14549 14550 14551 14555 14556 14557 14558 14559 14560 14561 14563 14564 14568 14569 14571 14572 14580 14585 14586 14588 14589 14590 14591 14592 14602 14603 14604 14605 14606 14607 14608 14609 14610 14611 14612 14613 14614 14615 14616 14617 14618 14619 14620 14621 14622 14623 14624 14625 14626 14627 14638 14639 14642 14643 14644 14645 14646 14647 14649 14650 14651 14652 14653 14664 14673 14683 14692 14694 4.1 10.6 10.6 2.0 2.0 9.1 2.0 2.0 1.0 2.0 6.0 2.0 1.0 2.0 7.0 2.0 10.4 1.0 2.0 1.0 3.0 2.0 10.4 10.4 3.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70178 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY Zip code RUCA level 14701 14702 14703 14704 14706 14707 14708 14709 14710 14711 14712 14714 14715 14716 14717 14718 14719 14720 14721 14722 14723 14724 14726 14727 14728 14729 14730 14731 14732 14733 14735 14736 14737 14738 14739 14740 14741 14742 14743 14744 14745 14747 14748 14750 14751 14752 14753 14754 14755 14756 14757 14758 14760 14766 14767 14769 14770 14772 14774 14775 14777 14778 14779 14781 14782 14783 14784 14785 14786 4.0 4.0 4.0 4.0 4.0 7.0 7.0 10.0 5.0 10.5 5.0 10.5 5.0 5.0 10.5 5.0 10.4 4.0 5.0 10.5 6.0 10.5 10.4 10.5 10.5 3.0 10.2 10.6 5.0 4.0 10.0 3.0 10.4 5.0 10.6 5.0 5.0 4.0 4.0 10.0 10.0 5.0 4.0 4.0 10.4 10.5 4.0 5.0 10.6 5.0 10.5 5.0 4.0 10.4 5.0 5.0 4.0 10.2 5.0 3.0 10.5 4.0 7.4 10.5 5.0 10.2 10.5 5.0 10.5 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY NY PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00556 Fmt 4701 RUCA level 14787 14788 14801 14802 14803 14804 14805 14806 14807 14808 14809 14810 14812 14813 14814 14815 14816 14817 14818 14819 14820 14821 14822 14823 14824 14825 14826 14827 14830 14831 14836 14837 14838 14839 14840 14841 14842 14843 14844 14845 14846 14847 14850 14851 14852 14853 14854 14855 14856 14857 14858 14859 14860 14861 14863 14864 14865 14867 14869 14870 14871 14872 14873 14874 14876 14877 14878 14879 14880 7.4 4.0 6.0 7.0 7.0 7.0 10.4 8.0 6.0 10.0 10.6 7.4 5.1 10.6 2.0 6.0 1.0 2.0 2.0 6.0 6.0 5.0 6.0 5.0 10.4 2.0 10.0 4.2 4.2 4.2 10.4 10.6 2.0 10.5 10.6 2.0 10.6 4.0 1.0 1.0 10.4 2.0 1.0 1.0 1.0 1.0 2.0 10.5 7.4 10.6 5.2 5.0 3.0 2.0 2.0 2.0 10.4 2.0 10.4 4.2 1.0 2.0 10.6 10.6 7.3 10.5 9.1 8.4 7.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State NY ..................................... NY ..................................... NY ..................................... NY ..................................... NY ..................................... NY ..................................... NY ..................................... NY ..................................... NY ..................................... NY ..................................... NY ..................................... NY ..................................... NY ..................................... NY ..................................... NY ..................................... NY ..................................... NY ..................................... NY ..................................... NY ..................................... NY ..................................... NY ..................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... OH .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 14881 14882 14883 14884 14885 14886 14887 14889 14891 14892 14893 14894 14895 14897 14898 14901 14902 14903 14904 14905 14925 43001 43002 43003 43004 43005 43006 43007 43008 43009 43010 43011 43013 43014 43015 43016 43017 43018 43019 43021 43022 43023 43025 43026 43027 43028 43029 43030 43031 43032 43033 43035 43036 43037 43040 43041 43044 43045 43046 43047 43048 43050 43054 43055 43056 43058 43060 43061 43062 2.0 2.0 2.0 6.0 10.5 2.0 10.6 2.0 7.3 4.0 10.6 1.0 7.0 7.0 6.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 2.0 1.0 2.1 9.0 2.0 1.0 6.0 6.1 2.0 2.0 5.0 2.0 1.0 1.0 2.0 5.0 2.0 4.0 1.0 1.0 1.0 2.1 5.0 2.0 2.0 2.0 2.0 2.0 1.0 2.0 5.2 2.0 2.0 6.1 2.0 1.0 6.0 2.0 4.0 1.0 1.0 1.0 1.0 6.0 2.0 2.0 70179 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH Zip code RUCA level 43064 43065 43066 43067 43068 43070 43071 43072 43073 43074 43076 43077 43078 43080 43081 43082 43083 43084 43085 43086 43093 43098 43101 43102 43103 43105 43106 43107 43109 43110 43111 43112 43113 43115 43116 43117 43119 43123 43125 43126 43127 43128 43130 43135 43136 43137 43138 43140 43142 43143 43144 43145 43146 43147 43148 43149 43150 43151 43152 43153 43154 43155 43156 43157 43158 43160 43162 43163 43164 2.0 1.0 2.0 2.0 1.0 10.5 2.1 3.0 2.0 2.0 2.0 2.0 4.2 2.1 1.0 1.0 4.2 6.0 1.0 1.0 1.0 1.0 3.0 2.0 2.0 2.0 5.2 5.2 1.0 1.0 7.4 2.0 4.2 5.0 2.0 2.0 1.0 1.0 1.0 2.0 7.4 6.0 4.2 3.0 1.0 1.0 7.4 7.1 4.0 2.0 5.0 3.0 2.0 1.0 2.0 3.0 5.2 7.1 8.3 9.1 2.0 5.2 3.0 2.0 7.4 4.0 2.0 4.2 3.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00557 Fmt 4701 RUCA level 43195 43196 43198 43199 43201 43202 43203 43204 43205 43206 43207 43209 43210 43211 43212 43213 43214 43215 43216 43217 43218 43219 43220 43221 43222 43223 43224 43226 43227 43228 43229 43230 43231 43232 43234 43235 43236 43240 43251 43260 43265 43266 43268 43270 43271 43272 43279 43287 43291 43299 43301 43302 43306 43307 43310 43311 43314 43315 43316 43317 43318 43319 43320 43321 43322 43323 43324 43325 43326 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 4.0 4.0 4.0 6.0 4.0 5.0 3.0 7.4 5.0 10.5 6.0 9.1 3.0 4.0 8.4 6.0 4.2 7.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 43330 43331 43332 43333 43334 43335 43336 43337 43338 43340 43341 43342 43343 43344 43345 43346 43347 43348 43349 43350 43351 43356 43357 43358 43359 43360 43402 43403 43406 43407 43408 43410 43412 43413 43414 43416 43420 43430 43431 43432 43433 43434 43435 43436 43437 43438 43439 43440 43441 43442 43443 43445 43446 43447 43449 43450 43451 43452 43456 43457 43458 43460 43462 43463 43464 43465 43466 43467 43468 7.0 9.2 5.0 10.5 2.0 5.0 6.0 4.0 7.3 8.0 5.0 5.2 10.5 10.0 8.0 9.0 6.0 9.2 2.0 2.0 7.0 5.2 6.0 6.0 8.4 6.0 4.2 4.2 3.0 5.0 2.0 7.4 2.0 6.0 4.2 2.0 4.0 2.0 10.5 2.0 4.0 1.0 5.0 10.0 6.0 1.0 4.0 6.0 2.0 5.2 2.0 2.0 4.0 1.0 6.0 2.0 5.2 4.0 10.0 3.0 6.0 1.0 5.2 1.0 3.0 1.0 3.0 3.0 2.0 70180 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH Zip code RUCA level 43469 43501 43502 43504 43505 43506 43510 43511 43512 43515 43516 43517 43518 43519 43520 43521 43522 43523 43524 43525 43526 43527 43528 43529 43530 43531 43532 43533 43534 43535 43536 43537 43540 43541 43542 43543 43545 43547 43548 43549 43550 43551 43552 43553 43554 43555 43556 43557 43558 43560 43565 43566 43567 43569 43570 43571 43601 43602 43603 43604 43605 43606 43607 43608 43609 43610 43611 43612 43613 2.0 10.6 7.0 2.0 10.6 7.0 9.1 5.2 4.0 2.0 10.6 10.6 10.6 4.0 7.0 8.0 2.0 8.0 10.6 2.0 7.3 8.4 1.0 10.6 4.0 10.6 9.1 9.1 8.0 8.0 6.0 1.0 2.0 5.2 1.0 7.0 7.0 2.0 8.4 9.2 7.0 1.0 1.0 7.0 10.6 7.0 6.0 9.0 2.0 1.0 4.2 1.0 7.0 5.2 10.6 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00558 Fmt 4701 RUCA level 43614 43615 43616 43617 43618 43619 43620 43623 43624 43635 43652 43654 43656 43657 43659 43660 43661 43666 43667 43681 43682 43697 43699 43701 43702 43711 43713 43716 43717 43718 43719 43720 43721 43722 43723 43724 43725 43727 43728 43730 43731 43732 43733 43734 43735 43736 43738 43739 43740 43746 43747 43748 43749 43750 43752 43754 43755 43756 43757 43758 43759 43760 43761 43762 43764 43766 43767 43768 43771 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 4.0 5.0 7.3 10.0 7.4 2.0 2.0 5.0 2.0 5.0 4.0 7.4 4.0 5.0 9.0 9.1 9.2 5.0 5.0 5.0 5.0 6.0 2.0 2.0 1.0 5.2 10.0 9.1 5.0 4.0 10.0 10.0 5.0 7.0 10.0 7.0 2.0 2.0 9.1 7.4 7.4 9.1 7.4 5.0 5.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 43772 43773 43777 43778 43779 43780 43782 43783 43786 43787 43788 43789 43791 43793 43802 43803 43804 43805 43811 43812 43821 43822 43824 43828 43830 43832 43836 43837 43840 43842 43843 43844 43845 43901 43902 43903 43905 43906 43907 43908 43909 43910 43912 43913 43914 43915 43916 43917 43920 43925 43926 43927 43928 43930 43931 43932 43933 43934 43935 43937 43938 43939 43940 43941 43942 43943 43944 43945 43946 5.0 6.0 5.0 6.0 6.0 5.0 9.1 3.0 10.0 9.0 6.0 10.0 4.0 10.0 5.0 7.4 10.0 6.0 5.0 4.0 10.2 5.0 5.0 4.0 5.0 7.4 4.0 5.0 5.0 10.2 6.0 6.0 5.0 2.0 2.0 2.0 1.0 2.0 7.4 2.0 1.0 2.0 1.0 1.0 10.0 10.6 1.0 2.1 4.0 2.0 1.0 1.0 1.0 2.0 10.6 2.0 2.0 1.0 1.0 1.0 1.0 2.1 2.0 2.1 2.0 2.0 2.0 6.0 10.6 70181 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH Zip code RUCA level 43947 43948 43950 43951 43952 43953 43961 43962 43963 43964 43967 43968 43970 43971 43972 43973 43974 43976 43977 43981 43983 43984 43985 43986 43988 44001 44003 44004 44005 44010 44011 44012 44017 44021 44022 44023 44024 44026 44028 44030 44032 44033 44035 44036 44039 44040 44041 44044 44045 44046 44047 44048 44049 44050 44052 44053 44054 44055 44056 44057 44060 44061 44062 44064 44065 44067 44068 44070 44072 1.0 2.1 1.0 2.0 1.0 1.0 1.0 6.0 1.0 1.0 2.0 4.0 2.0 1.0 1.0 5.0 7.4 3.0 2.0 7.4 2.0 3.0 2.0 3.0 6.0 1.0 10.5 4.2 4.2 2.0 1.0 1.0 1.0 7.1 1.0 1.0 2.0 1.0 2.0 4.0 10.5 2.0 1.0 1.0 1.0 2.0 4.2 1.0 1.0 3.0 7.2 5.0 7.1 2.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.1 2.0 2.0 1.0 4.0 1.0 1.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00559 Fmt 4701 RUCA level 44073 44074 44076 44077 44080 44081 44082 44084 44085 44086 44087 44088 44089 44090 44092 44093 44094 44095 44096 44097 44099 44101 44102 44103 44104 44105 44106 44107 44108 44109 44110 44111 44112 44113 44114 44115 44116 44117 44118 44119 44120 44121 44122 44123 44124 44125 44126 44127 44128 44129 44130 44131 44132 44133 44134 44135 44136 44137 44138 44139 44140 44141 44142 44143 44144 44145 44146 44147 44149 1.0 1.0 10.4 1.0 7.1 1.0 5.0 2.0 2.0 2.0 1.0 4.2 1.0 7.1 1.0 10.5 1.0 1.0 1.0 1.0 10.4 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 44178 44181 44185 44188 44189 44190 44191 44192 44193 44194 44195 44197 44198 44199 44201 44202 44203 44210 44211 44212 44214 44215 44216 44217 44221 44222 44223 44224 44230 44231 44232 44233 44234 44235 44236 44237 44240 44241 44242 44243 44250 44251 44253 44254 44255 44256 44258 44260 44262 44264 44265 44266 44270 44272 44273 44274 44275 44276 44278 44280 44281 44282 44285 44286 44287 44288 44301 44302 44303 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.1 1.0 1.0 1.0 1.0 1.0 6.0 4.1 1.0 3.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 2.0 2.0 3.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 3.0 2.0 5.0 2.0 4.1 4.1 1.0 1.0 1.0 2.1 1.0 2.0 2.1 3.0 1.0 3.0 10.5 1.0 2.0 1.0 1.0 1.0 1.0 6.0 2.0 1.0 1.0 1.0 70182 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH Zip code RUCA level 44304 44305 44306 44307 44308 44309 44310 44311 44312 44313 44314 44315 44316 44317 44319 44320 44321 44322 44325 44326 44328 44333 44334 44372 44393 44396 44398 44399 44401 44402 44403 44404 44405 44406 44408 44410 44411 44412 44413 44415 44416 44417 44418 44420 44422 44423 44424 44425 44427 44428 44429 44430 44431 44432 44436 44437 44438 44439 44440 44441 44442 44443 44444 44445 44446 44449 44450 44451 44452 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 2.0 1.0 1.0 3.0 1.0 2.1 2.1 9.1 9.1 2.0 2.0 2.0 1.0 1.0 10.6 2.0 1.0 10.1 2.0 2.1 1.0 3.0 9.1 2.0 1.0 1.0 7.1 1.0 6.0 1.0 1.0 1.0 3.0 1.0 2.1 2.0 2.0 2.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00560 Fmt 4701 RUCA level 44453 44454 44455 44460 44470 44471 44473 44481 44482 44483 44484 44485 44486 44487 44488 44490 44491 44492 44493 44501 44502 44503 44504 44505 44506 44507 44509 44510 44511 44512 44513 44514 44515 44555 44598 44599 44601 44606 44607 44608 44609 44610 44611 44612 44613 44614 44615 44617 44618 44619 44620 44621 44622 44624 44625 44626 44627 44628 44629 44630 44631 44632 44633 44634 44636 44637 44638 44639 44640 2.0 1.0 9.1 4.2 2.0 1.0 2.0 2.0 2.0 1.0 1.0 1.0 2.0 2.0 2.0 3.0 9.1 9.1 10.6 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.2 5.0 10.1 2.0 4.2 10.5 6.0 2.0 2.0 1.0 7.1 10.0 10.4 4.2 2.0 4.0 4.0 10.0 10.6 2.0 10.5 9.0 5.0 1.0 7.1 1.0 10.6 5.0 10.4 9.0 6.0 4.0 4.2 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 44641 44643 44644 44645 44646 44647 44648 44650 44651 44652 44653 44654 44656 44657 44659 44660 44661 44662 44663 44665 44666 44667 44669 44670 44671 44672 44675 44676 44677 44678 44679 44680 44681 44682 44683 44685 44687 44688 44689 44690 44691 44693 44695 44697 44699 44701 44702 44703 44704 44705 44706 44707 44708 44709 44710 44711 44712 44714 44718 44720 44721 44730 44735 44750 44760 44767 44798 44799 44802 1.0 2.0 2.0 2.0 1.0 1.0 1.0 4.2 3.0 1.0 4.0 10.5 5.2 7.1 10.0 10.5 6.0 2.0 4.0 4.2 2.1 7.4 2.0 2.0 5.2 4.2 2.0 5.0 4.0 5.2 4.0 4.0 10.5 5.0 4.0 1.0 10.5 2.0 10.0 10.0 4.0 5.0 6.0 2.0 5.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 6.0 70183 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH Zip code RUCA level 44804 44805 44807 44809 44811 44813 44814 44815 44816 44817 44818 44820 44822 44824 44825 44826 44827 44828 44830 44833 44836 44837 44838 44839 44840 44841 44842 44843 44844 44845 44846 44847 44848 44849 44850 44851 44853 44854 44855 44856 44857 44859 44860 44861 44862 44864 44865 44866 44867 44870 44871 44874 44875 44878 44880 44881 44882 44883 44887 44888 44889 44890 44901 44902 44903 44904 44905 44906 44907 4.0 4.0 6.0 4.0 7.3 2.0 2.0 6.0 2.0 6.0 6.0 4.0 2.0 1.0 6.0 6.1 4.2 7.3 4.0 4.2 6.0 6.0 4.0 1.0 5.0 6.0 7.0 2.0 8.0 8.0 2.0 4.2 4.0 8.4 3.0 10.5 6.0 10.5 5.0 4.2 4.2 5.0 8.4 4.0 1.0 6.0 3.0 6.0 5.0 1.0 1.0 4.0 4.1 2.0 6.0 4.0 8.0 4.0 10.5 4.0 2.0 4.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00561 Fmt 4701 RUCA level 44999 45001 45002 45003 45004 45005 45011 45012 45013 45014 45015 45018 45025 45026 45030 45032 45033 45034 45036 45039 45040 45041 45042 45043 45044 45050 45051 45052 45053 45054 45055 45056 45061 45062 45063 45064 45065 45066 45067 45068 45069 45070 45071 45073 45099 45101 45102 45103 45105 45106 45107 45110 45111 45112 45113 45114 45115 45118 45119 45120 45121 45122 45123 45130 45131 45132 45133 45135 45138 1.0 1.0 1.0 6.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 4.2 1.0 1.0 1.0 2.0 1.0 1.0 1.0 2.0 1.0 9.1 1.0 1.0 1.0 4.0 1.0 1.0 10.4 2.0 2.0 2.0 1.0 2.0 5.2 2.0 2.0 2.0 2.0 2.0 7.1 2.0 7.4 2.0 7.1 6.0 8.0 6.0 5.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 45140 45142 45144 45145 45146 45147 45148 45150 45152 45153 45154 45155 45156 45157 45158 45159 45160 45162 45164 45165 45166 45167 45168 45169 45171 45172 45174 45176 45177 45201 45202 45203 45204 45205 45206 45207 45208 45209 45210 45211 45212 45213 45214 45215 45216 45217 45218 45219 45220 45221 45222 45223 45224 45225 45226 45227 45228 45229 45230 45231 45232 45233 45234 45235 45236 45237 45238 45239 45240 1.0 6.0 10.4 2.0 5.2 1.0 5.2 1.0 2.0 2.0 2.0 8.0 2.0 1.0 2.0 5.0 2.0 2.0 4.0 7.4 5.0 10.4 2.0 5.0 2.0 8.0 1.0 2.0 4.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70184 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH Zip code RUCA level 45241 45242 45243 45244 45245 45246 45247 45248 45249 45250 45251 45252 45253 45254 45255 45258 45262 45263 45264 45267 45268 45269 45270 45271 45273 45274 45275 45277 45280 45296 45298 45299 45301 45302 45303 45304 45305 45306 45307 45308 45309 45310 45311 45312 45314 45315 45316 45317 45318 45319 45320 45321 45322 45323 45324 45325 45326 45327 45328 45330 45331 45332 45333 45334 45335 45336 45337 45338 45339 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 6.0 5.0 2.0 1.0 6.0 2.0 3.0 2.0 10.5 9.1 2.0 7.1 1.0 2.0 2.0 2.0 2.0 7.3 3.0 1.0 1.0 1.0 2.0 2.0 1.0 3.0 2.0 4.2 5.0 5.0 6.0 2.0 6.0 2.0 2.0 2.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00562 Fmt 4701 RUCA level 45340 45341 45342 45343 45344 45345 45346 45347 45348 45349 45350 45351 45352 45353 45354 45356 45358 45359 45360 45361 45362 45363 45365 45367 45368 45369 45370 45371 45372 45373 45374 45377 45378 45380 45381 45382 45383 45384 45385 45387 45388 45389 45390 45401 45402 45403 45404 45405 45406 45407 45408 45409 45410 45412 45413 45414 45415 45416 45417 45418 45419 45420 45422 45423 45424 45426 45427 45428 45429 6.0 1.0 1.0 1.0 2.0 2.0 5.0 5.2 10.5 1.0 10.5 10.5 4.2 4.0 2.0 4.2 2.0 2.0 4.0 2.0 10.5 5.0 4.0 4.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 2.0 7.4 2.0 3.0 1.0 1.0 1.0 2.0 10.5 2.0 7.4 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 45430 45431 45432 45433 45434 45435 45437 45439 45440 45441 45448 45449 45454 45458 45459 45463 45469 45470 45475 45479 45481 45482 45490 45501 45502 45503 45504 45505 45506 45601 45612 45613 45614 45616 45617 45618 45619 45620 45621 45622 45623 45624 45628 45629 45630 45631 45633 45634 45636 45638 45640 45642 45643 45644 45645 45646 45647 45648 45650 45651 45652 45653 45654 45656 45657 45658 45659 45660 45661 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 5.0 8.0 5.0 9.0 4.0 8.1 1.0 5.0 7.0 10.5 5.0 5.0 5.0 5.2 5.0 5.0 5.2 10.0 5.2 1.0 7.0 8.0 5.0 5.2 2.0 8.0 5.0 5.0 9.0 10.0 5.0 5.0 10.5 9.0 5.0 5.0 2.0 10.4 8.0 70185 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH Zip code RUCA level 45662 45663 45669 45671 45672 45673 45674 45675 45677 45678 45679 45680 45681 45682 45683 45684 45685 45686 45687 45688 45690 45692 45693 45694 45695 45696 45697 45698 45699 45701 45710 45711 45712 45713 45714 45715 45716 45717 45719 45720 45721 45723 45724 45727 45729 45732 45734 45735 45739 45740 45741 45742 45743 45744 45745 45746 45750 45760 45761 45764 45766 45767 45768 45769 45770 45771 45772 45773 45775 4.0 5.0 1.0 5.0 9.2 5.0 5.0 1.0 4.0 2.0 10.4 1.0 6.0 5.0 8.0 5.0 5.0 6.0 5.0 2.0 7.4 7.0 7.3 4.0 10.5 2.0 8.1 10.0 5.0 4.0 5.0 5.0 2.0 2.0 1.0 2.0 7.4 7.4 4.0 3.0 2.0 2.0 2.0 8.3 2.0 5.0 10.0 5.0 2.0 5.0 6.0 2.0 3.0 2.0 2.0 2.0 1.0 7.4 4.0 7.4 5.0 2.0 2.0 9.2 10.6 10.6 3.0 2.0 6.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00563 Fmt 4701 RUCA level 45776 45777 45778 45779 45780 45782 45783 45784 45786 45787 45788 45789 45801 45802 45804 45805 45806 45807 45808 45809 45810 45812 45813 45814 45815 45816 45817 45819 45820 45821 45822 45826 45827 45828 45830 45831 45832 45833 45835 45836 45837 45838 45839 45840 45841 45843 45844 45845 45846 45848 45849 45850 45851 45853 45854 45855 45856 45858 45859 45860 45861 45862 45863 45864 45865 45866 45867 45868 45869 9.2 5.0 5.0 10.6 4.0 5.0 2.0 2.0 10.1 10.1 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.3 9.0 10.4 5.0 10.6 4.0 7.3 4.2 1.0 10.4 4.0 4.0 9.0 4.0 3.0 9.0 5.0 7.1 9.0 9.0 9.0 5.0 4.0 4.0 5.0 9.0 10.4 6.0 10.5 7.3 10.5 2.0 10.4 10.4 1.0 7.0 10.6 5.0 9.0 10.5 10.5 10.5 5.0 10.6 7.0 4.0 5.0 5.0 7.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OH OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 45870 45871 45872 45873 45874 45875 45876 45877 45879 45880 45881 45882 45883 45884 45885 45886 45887 45888 45889 45890 45891 45893 45894 45895 45896 45897 45898 45899 45944 45950 45999 73001 73002 73003 73004 73005 73006 73007 73008 73009 73010 73011 73013 73014 73015 73016 73017 73018 73019 73020 73021 73022 73023 73024 73026 73027 73028 73029 73030 73031 73032 73033 73034 73036 73038 73039 73040 73041 73042 4.2 10.0 9.2 10.5 5.0 7.3 10.4 10.6 7.0 10.4 5.0 10.5 10.5 4.2 7.0 5.0 2.0 4.2 5.0 5.0 4.0 3.0 5.0 4.2 2.0 9.0 5.0 5.0 1.0 1.0 1.0 10.6 10.5 1.0 2.0 7.0 10.1 2.0 1.0 10.4 2.0 10.5 1.0 2.0 10.0 2.0 10.4 4.0 1.1 1.0 10.6 4.1 4.0 10.6 2.1 2.0 2.0 10.4 10.6 2.0 10.6 10.6 1.0 4.1 10.6 10.6 10.4 10.0 8.0 70186 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK Zip code RUCA level 73043 73044 73045 73047 73048 73049 73050 73051 73052 73053 73054 73055 73056 73057 73058 73059 73061 73062 73063 73064 73065 73066 73067 73068 73069 73070 73071 73072 73073 73074 73075 73077 73078 73079 73080 73082 73083 73084 73085 73086 73089 73090 73092 73093 73094 73095 73096 73097 73098 73099 73101 73102 73103 73104 73105 73106 73107 73108 73109 73110 73111 73112 73113 73114 73115 73116 73117 73118 73119 10.6 2.0 2.0 10.4 10.6 2.0 2.0 2.1 7.0 10.4 2.0 7.4 2.0 10.6 2.0 2.0 10.5 10.0 2.0 1.0 2.0 1.0 10.5 1.1 1.1 1.1 1.1 1.1 2.0 8.0 7.0 7.0 2.0 2.0 7.3 10.5 1.0 1.0 1.0 7.0 2.0 4.1 5.0 3.0 7.0 3.0 7.0 1.0 10.6 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00564 Fmt 4701 RUCA level 73120 73121 73122 73123 73124 73125 73126 73127 73128 73129 73130 73131 73132 73134 73135 73136 73137 73139 73140 73141 73142 73143 73144 73145 73146 73147 73148 73149 73150 73151 73152 73153 73154 73155 73156 73157 73159 73160 73162 73163 73164 73165 73167 73169 73170 73172 73173 73178 73179 73184 73185 73189 73190 73193 73194 73195 73196 73197 73198 73199 73401 73402 73403 73425 73430 73432 73433 73434 73435 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 4.0 4.0 4.0 10.0 9.0 10.6 10.6 10.5 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 73436 73437 73438 73439 73440 73441 73442 73443 73444 73446 73447 73448 73449 73450 73453 73455 73456 73458 73459 73460 73461 73463 73476 73481 73487 73488 73491 73501 73502 73503 73505 73506 73507 73520 73521 73522 73523 73526 73527 73528 73529 73530 73531 73532 73533 73534 73536 73537 73538 73539 73540 73541 73542 73543 73544 73546 73547 73548 73549 73550 73551 73552 73553 73554 73555 73556 73557 73558 73559 5.0 10.5 10.5 10.6 10.6 10.0 5.0 5.0 5.0 7.0 9.2 10.5 5.0 9.0 10.0 9.2 10.5 5.0 10.0 7.0 9.0 10.5 10.6 10.5 5.0 10.5 4.0 1.0 1.0 1.0 1.0 1.0 1.0 10.5 4.0 4.0 4.0 5.0 2.0 2.0 5.0 10.6 10.4 5.0 4.0 4.0 4.0 5.0 2.0 5.0 2.0 2.0 7.0 2.0 10.0 10.4 10.5 10.5 5.0 10.0 10.6 2.0 10.4 7.4 7.0 4.0 2.0 1.0 10.5 70187 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK Zip code RUCA level 73560 73561 73562 73564 73565 73566 73567 73568 73569 73570 73571 73572 73573 73601 73620 73622 73624 73625 73626 73627 73628 73632 73638 73639 73641 73642 73644 73645 73646 73647 73648 73650 73651 73654 73655 73658 73659 73660 73661 73662 73663 73664 73666 73667 73668 73669 73673 73701 73702 73703 73705 73706 73716 73717 73718 73719 73720 73722 73724 73726 73727 73728 73729 73730 73731 73733 73734 73735 73736 5.0 10.0 10.4 10.5 10.0 10.5 2.0 10.4 10.0 10.5 10.0 7.1 10.5 7.0 7.0 10.6 10.6 10.6 10.6 7.0 10.6 7.0 10.6 10.6 10.6 10.6 7.0 10.6 10.0 10.6 7.0 10.6 7.0 10.0 10.5 10.0 10.0 10.6 10.6 7.0 10.0 10.6 10.6 10.0 10.6 10.6 10.5 4.0 4.0 4.0 4.0 4.0 10.5 7.0 10.2 10.0 5.0 10.0 10.6 10.5 5.0 10.0 10.2 5.0 10.6 5.0 8.0 5.0 4.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00565 Fmt 4701 RUCA level 73737 73738 73739 73741 73742 73743 73744 73746 73747 73749 73750 73753 73754 73755 73756 73757 73758 73759 73760 73761 73762 73763 73764 73766 73768 73770 73771 73772 73773 73801 73802 73832 73834 73835 73838 73840 73841 73842 73843 73844 73847 73848 73851 73852 73853 73855 73857 73858 73859 73860 73901 73931 73932 73933 73937 73938 73939 73942 73944 73945 73946 73947 73949 73950 73951 74001 74002 74003 74004 10.0 5.0 10.5 10.5 10.5 5.0 10.6 10.6 10.0 10.0 7.0 5.0 4.0 10.6 8.0 8.0 10.0 10.0 10.2 10.5 2.0 10.0 8.0 10.5 10.2 10.0 10.0 7.0 5.0 4.0 4.0 10.0 10.0 10.5 10.0 10.5 5.0 7.0 10.5 5.0 5.0 10.0 10.0 10.2 5.0 10.0 5.0 10.5 10.5 10.6 10.2 10.0 10.0 10.0 10.0 5.0 10.2 4.0 10.2 10.2 10.0 10.0 10.5 5.0 10.2 3.0 3.0 4.0 4.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 74005 74006 74008 74009 74010 74011 74012 74013 74014 74015 74016 74017 74018 74019 74020 74021 74022 74023 74026 74027 74028 74029 74030 74031 74032 74033 74034 74035 74036 74037 74038 74039 74041 74042 74043 74044 74045 74046 74047 74048 74050 74051 74052 74053 74054 74055 74056 74058 74059 74060 74061 74062 74063 74066 74067 74068 74070 74071 74072 74073 74074 74075 74076 74077 74078 74079 74080 74081 74082 4.0 4.0 1.0 7.0 7.1 1.0 1.0 1.0 1.0 1.0 2.0 4.1 4.1 4.1 2.0 2.0 5.0 7.4 9.0 10.5 2.0 4.0 2.0 4.1 5.0 2.0 2.0 7.3 2.0 1.0 2.0 2.0 2.0 10.5 1.0 2.0 10.0 2.0 2.0 7.4 1.0 2.0 2.0 2.0 7.3 2.0 7.0 10.5 5.0 2.0 2.0 7.4 1.0 1.0 1.0 2.0 2.0 7.1 4.0 1.0 4.0 4.0 4.0 4.0 4.0 10.6 2.0 2.0 2.0 70188 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK Zip code RUCA level 74083 74084 74085 74101 74102 74103 74104 74105 74106 74107 74108 74110 74112 74114 74115 74116 74117 74119 74120 74121 74126 74127 74128 74129 74130 74131 74132 74133 74134 74135 74136 74137 74141 74145 74146 74147 74148 74149 74150 74152 74153 74155 74156 74157 74158 74159 74169 74170 74171 74172 74182 74183 74184 74186 74187 74189 74192 74193 74194 74301 74330 74331 74332 74333 74335 74337 74338 74339 74340 4.0 7.3 6.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.0 10.3 6.0 8.0 10.6 4.0 10.6 5.0 4.0 10.6 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00566 Fmt 4701 RUCA level 74342 74343 74344 74345 74346 74347 74349 74350 74352 74354 74355 74358 74359 74360 74361 74362 74363 74364 74365 74366 74367 74368 74369 74370 74401 74402 74403 74421 74422 74423 74425 74426 74427 74428 74429 74430 74431 74432 74434 74435 74436 74437 74438 74440 74441 74442 74444 74445 74446 74447 74450 74451 74452 74454 74455 74456 74457 74458 74459 74460 74461 74462 74463 74464 74465 74467 74468 74469 74470 10.0 10.5 7.0 7.0 10.6 6.0 7.0 10.6 10.6 4.0 4.0 4.0 6.0 5.0 7.0 7.0 5.0 6.0 10.6 10.6 10.6 6.0 10.6 10.5 4.0 4.0 4.0 2.0 2.0 5.0 5.0 7.0 5.0 10.6 1.0 5.0 7.4 10.5 5.0 10.6 2.0 7.4 10.6 10.6 10.5 5.0 4.0 2.0 7.3 4.2 5.0 5.0 6.0 2.0 5.0 4.2 5.0 2.0 7.0 7.4 10.0 7.0 5.0 4.0 4.0 7.3 5.0 5.0 5.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 74471 74472 74477 74501 74502 74521 74522 74523 74525 74528 74529 74530 74531 74533 74534 74535 74536 74538 74540 74542 74543 74545 74546 74547 74549 74552 74553 74554 74555 74556 74557 74558 74559 74560 74561 74562 74563 74565 74567 74569 74570 74571 74572 74574 74576 74577 74578 74601 74602 74603 74604 74630 74631 74632 74633 74636 74637 74640 74641 74643 74644 74646 74647 74650 74651 74652 74653 74701 74702 5.0 10.6 7.3 4.0 4.0 9.0 4.0 10.0 8.0 5.0 6.0 9.0 10.5 8.0 5.0 5.0 10.0 10.6 9.0 8.0 10.0 7.0 5.0 5.0 10.0 10.6 5.0 4.0 8.0 10.6 10.0 10.0 7.0 5.0 6.0 10.0 8.0 4.0 10.0 9.0 10.5 10.0 5.0 9.0 9.0 10.0 7.0 4.0 4.0 4.0 4.0 8.0 7.4 10.6 10.5 10.0 5.0 5.0 5.0 10.0 10.5 7.4 10.2 10.0 10.5 10.5 7.4 4.0 4.0 70189 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK Zip code RUCA level 74720 74721 74722 74723 74724 74726 74727 74728 74729 74730 74731 74733 74734 74735 74736 74737 74738 74740 74741 74743 74745 74747 74748 74750 74752 74753 74754 74755 74756 74759 74760 74761 74764 74766 74801 74802 74804 74818 74820 74821 74824 74825 74826 74827 74829 74830 74831 74832 74833 74834 74836 74837 74839 74840 74842 74843 74844 74845 74848 74849 74850 74851 74852 74854 74855 74856 74857 74859 74860 2.0 5.0 10.6 5.0 10.6 5.0 10.6 7.0 5.0 5.0 2.0 2.0 10.6 10.6 7.0 7.0 8.0 10.6 2.0 7.0 7.0 2.0 9.0 10.6 10.6 5.0 10.6 10.6 10.6 10.6 10.6 10.6 10.6 10.6 4.2 4.2 4.2 7.0 4.0 4.0 6.1 5.0 3.0 10.5 10.4 9.0 10.5 6.1 8.0 7.3 7.0 7.0 10.0 4.2 5.0 5.0 5.0 10.6 7.0 10.5 8.0 2.0 4.2 9.0 2.0 9.2 2.0 7.0 10.4 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00567 Fmt 4701 RUCA level 74864 74865 74866 74867 74868 74869 74871 74872 74873 74875 74878 74880 74881 74883 74884 74901 74902 74930 74931 74932 74935 74936 74937 74939 74940 74941 74942 74943 74944 74945 74946 74947 74948 74949 74951 74953 74954 74955 74956 74957 74959 74960 74962 74963 74964 74965 74966 97001 97002 97004 97005 97006 97007 97008 97009 97010 97011 97013 97014 97015 97016 97017 97018 97019 97020 97021 97022 97023 97024 10.4 5.0 9.0 10.6 7.0 9.0 5.0 10.5 4.2 6.1 3.0 10.6 2.0 10.0 7.0 1.0 2.0 3.0 8.0 3.0 8.0 2.0 7.0 7.0 7.0 3.0 8.0 8.0 8.0 7.3 2.0 7.3 2.0 10.0 3.0 7.3 2.0 7.3 3.0 10.6 2.0 8.0 10.6 10.6 5.0 10.5 8.0 10.5 2.0 2.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 10.2 1.0 10.4 2.0 4.1 2.0 2.0 10.5 2.0 2.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 97026 97027 97028 97029 97030 97031 97032 97033 97034 97035 97036 97037 97038 97039 97040 97041 97042 97044 97045 97048 97049 97050 97051 97053 97054 97055 97056 97057 97058 97060 97062 97063 97064 97065 97067 97068 97070 97071 97075 97076 97077 97078 97080 97101 97102 97103 97106 97107 97108 97109 97110 97111 97112 97113 97114 97115 97116 97117 97118 97119 97121 97122 97123 97124 97125 97127 97128 97130 97131 2.0 1.0 2.0 10.5 1.0 4.0 2.0 10.5 1.0 1.0 1.0 10.5 2.0 10.5 5.0 10.2 2.0 5.0 1.0 1.0 2.0 10.5 4.1 4.1 2.0 2.0 4.1 10.5 4.0 1.0 1.0 10.5 2.0 10.5 2.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 5.2 7.4 4.0 2.0 8.0 8.0 2.0 7.4 2.0 10.6 1.0 4.2 2.0 1.0 2.0 10.3 2.0 4.0 10.6 1.0 1.0 2.0 2.0 4.2 10.6 10.6 70190 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR Zip code RUCA level 97132 97133 97134 97135 97136 97137 97138 97140 97141 97143 97144 97145 97146 97147 97148 97149 97201 97202 97203 97204 97205 97206 97207 97208 97209 97210 97211 97212 97213 97214 97215 97216 97217 97218 97219 97220 97221 97222 97223 97224 97225 97227 97228 97229 97230 97231 97232 97233 97236 97238 97239 97240 97242 97251 97253 97254 97255 97256 97258 97259 97266 97267 97268 97269 97271 97272 97280 97281 97282 2.0 2.0 7.0 10.6 10.3 10.4 7.4 1.0 7.0 7.0 2.0 7.4 4.0 10.3 2.0 10.6 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00568 Fmt 4701 RUCA level 97283 97286 97290 97291 97292 97293 97294 97296 97298 97299 97301 97302 97303 97304 97305 97306 97307 97308 97309 97310 97311 97312 97313 97314 97321 97322 97324 97325 97326 97327 97329 97330 97331 97333 97335 97336 97338 97339 97341 97342 97343 97344 97345 97346 97347 97348 97350 97351 97352 97355 97357 97358 97359 97360 97361 97362 97364 97365 97366 97367 97368 97369 97370 97371 97372 97373 97374 97375 97376 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.2 4.2 2.0 2.0 8.0 10.5 10.5 1.0 1.0 1.0 5.0 7.4 4.1 1.0 7.0 2.0 8.0 10.4 7.4 2.0 10.4 2.0 2.0 4.2 2.0 4.0 8.0 3.0 2.0 3.0 4.2 4.2 7.0 7.0 8.0 7.0 8.0 7.0 1.0 10.4 7.0 4.2 5.0 6.1 7.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 97377 97378 97380 97381 97383 97384 97385 97386 97388 97389 97390 97391 97392 97394 97396 97401 97402 97403 97404 97405 97406 97407 97408 97409 97410 97411 97412 97413 97414 97415 97416 97417 97419 97420 97423 97424 97425 97426 97427 97428 97429 97430 97431 97432 97434 97435 97436 97437 97438 97439 97440 97441 97442 97443 97444 97446 97447 97448 97449 97450 97451 97452 97453 97454 97455 97456 97457 97458 97459 2.0 7.4 8.0 4.2 2.0 2.0 2.0 7.4 7.0 2.0 7.0 8.0 2.0 7.0 7.4 1.0 1.0 1.0 1.0 1.0 10.0 4.0 1.0 2.0 10.0 7.4 10.4 2.0 10.5 4.0 5.0 10.5 2.0 4.0 7.2 2.0 10.4 2.0 2.0 2.0 10.0 10.4 2.0 4.0 2.0 10.4 10.4 2.0 2.0 7.0 1.0 7.4 10.0 10.2 10.0 2.0 10.2 2.0 5.0 10.0 2.0 2.0 10.4 2.0 2.0 2.0 5.0 10.5 4.0 70191 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR Zip code RUCA level 97461 97462 97463 97464 97465 97466 97467 97469 97470 97472 97473 97476 97477 97478 97479 97480 97481 97482 97484 97486 97487 97488 97489 97490 97491 97492 97493 97494 97495 97496 97497 97498 97499 97501 97502 97503 97504 97520 97522 97523 97524 97525 97526 97527 97528 97530 97531 97532 97533 97534 97535 97536 97537 97538 97539 97540 97541 97543 97544 97601 97602 97603 97604 97620 97621 97622 97623 97624 97625 2.0 5.0 7.3 10.0 10.0 10.5 7.4 10.5 4.0 2.0 7.4 10.0 1.0 1.0 5.0 10.4 5.0 1.0 10.0 5.0 2.0 2.0 2.0 2.0 10.0 7.3 8.0 4.0 4.0 4.0 5.0 10.6 10.5 1.0 1.0 1.0 1.0 1.0 2.0 10.5 2.0 2.0 4.2 4.2 4.2 2.0 10.5 5.0 4.2 10.5 1.0 2.0 4.2 5.0 2.0 1.0 2.0 5.0 10.2 4.0 4.0 4.0 10.4 10.0 10.5 10.2 10.2 10.5 5.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00569 Fmt 4701 RUCA level 97626 97627 97630 97632 97633 97634 97635 97636 97637 97638 97639 97640 97641 97701 97702 97707 97708 97709 97710 97711 97712 97720 97721 97722 97730 97731 97732 97733 97734 97735 97736 97737 97738 97739 97741 97750 97751 97752 97753 97754 97756 97758 97759 97760 97761 97801 97810 97812 97813 97814 97817 97818 97819 97820 97823 97824 97825 97826 97827 97828 97830 97833 97834 97835 97836 97837 97838 97839 97840 10.5 5.0 7.0 10.5 5.0 4.0 7.0 10.0 10.0 10.0 10.5 10.0 10.0 1.0 1.0 1.0 1.0 1.0 10.3 10.6 2.0 7.0 10.3 10.3 10.6 10.4 7.0 10.4 10.6 10.0 10.3 10.4 7.0 2.0 7.0 10.0 5.0 5.0 4.0 4.0 4.1 7.0 10.4 10.6 10.0 4.0 10.5 10.0 10.5 7.0 10.0 7.4 8.0 10.0 10.0 5.0 10.0 5.0 10.2 10.0 10.0 8.0 10.6 4.0 10.0 8.0 4.0 10.0 10.6 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... OR .................................... PA ..................................... PA ..................................... PA ..................................... PA ..................................... PA ..................................... PA ..................................... PA ..................................... PA ..................................... PA ..................................... PA ..................................... PA ..................................... PA ..................................... PA ..................................... PA ..................................... PA ..................................... PA ..................................... PA ..................................... PA ..................................... PA ..................................... PA ..................................... PA ..................................... PA ..................................... PA ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 97841 97842 97843 97844 97845 97846 97848 97850 97856 97857 97859 97861 97862 97864 97865 97867 97868 97869 97870 97873 97874 97875 97876 97877 97880 97882 97883 97884 97885 97886 97901 97902 97903 97904 97905 97906 97907 97908 97909 97910 97911 97913 97914 97917 97918 97920 15001 15003 15004 15005 15006 15007 15009 15010 15012 15014 15015 15017 15018 15019 15020 15021 15022 15024 15025 15026 15027 15028 15030 5.0 10.0 10.0 7.4 10.0 10.0 10.0 4.0 10.0 10.0 4.0 10.0 7.4 10.0 10.0 5.0 5.0 10.0 10.6 10.0 10.0 5.0 10.2 8.0 5.0 4.0 5.0 8.0 10.0 5.0 10.5 10.0 5.0 10.3 7.0 5.0 7.0 5.0 10.5 10.0 5.0 7.2 4.0 10.0 10.5 5.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.1 1.0 1.0 1.0 1.0 2.0 1.1 2.0 1.1 1.0 1.0 2.0 1.0 1.0 1.0 70192 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA Zip code RUCA level 15031 15032 15033 15034 15035 15036 15037 15038 15042 15043 15044 15045 15046 15047 15049 15050 15051 15052 15053 15054 15055 15056 15057 15059 15060 15061 15062 15063 15064 15065 15066 15067 15068 15069 15071 15072 15074 15075 15076 15077 15078 15081 15082 15083 15084 15085 15086 15087 15088 15089 15090 15091 15095 15096 15101 15102 15104 15106 15108 15110 15112 15116 15120 15122 15123 15126 15127 15129 15130 1.0 1.0 1.1 1.0 1.0 2.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 2.0 2.0 2.0 1.0 1.0 1.0 4.0 2.0 1.0 1.1 1.1 1.0 1.0 1.0 1.1 1.0 2.0 1.0 1.1 1.0 1.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00570 Fmt 4701 RUCA level 15131 15132 15133 15134 15135 15136 15137 15139 15140 15142 15143 15144 15145 15146 15147 15148 15189 15201 15202 15203 15204 15205 15206 15207 15208 15209 15210 15211 15212 15213 15214 15215 15216 15217 15218 15219 15220 15221 15222 15223 15224 15225 15226 15227 15228 15229 15230 15231 15232 15233 15234 15235 15236 15237 15238 15239 15240 15241 15242 15243 15244 15250 15251 15252 15253 15254 15255 15257 15258 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 15259 15260 15261 15262 15263 15264 15265 15267 15268 15270 15272 15274 15275 15276 15277 15278 15279 15281 15282 15283 15285 15286 15289 15290 15295 15301 15310 15311 15312 15313 15314 15315 15316 15317 15320 15321 15322 15323 15324 15325 15327 15329 15330 15331 15332 15333 15334 15336 15337 15338 15339 15340 15341 15342 15344 15345 15346 15347 15348 15349 15350 15351 15352 15353 15354 15357 15358 15359 15360 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 8.3 2.0 2.0 2.0 1.1 3.0 8.1 1.0 7.0 1.0 2.0 2.0 2.0 7.0 3.0 2.0 2.0 1.1 1.0 2.0 7.0 1.0 8.3 3.0 1.0 2.0 8.3 1.0 8.3 2.0 8.1 1.0 7.0 8.1 1.0 7.0 8.3 8.1 8.1 7.0 2.0 8.3 2.0 70193 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA Zip code RUCA level 15361 15362 15363 15364 15365 15366 15367 15368 15370 15376 15377 15378 15379 15380 15401 15410 15411 15412 15413 15415 15416 15417 15419 15420 15421 15422 15423 15424 15425 15427 15428 15429 15430 15431 15432 15433 15434 15435 15436 15437 15438 15439 15440 15442 15443 15444 15445 15446 15447 15448 15449 15450 15451 15454 15455 15456 15458 15459 15460 15461 15462 15463 15464 15465 15466 15467 15468 15469 15470 1.0 8.1 1.0 8.1 2.0 1.1 1.0 2.0 7.3 2.0 2.0 2.0 2.0 8.3 1.0 2.1 10.5 1.1 3.0 3.0 1.0 3.0 3.0 3.0 2.0 3.0 1.1 10.5 1.0 2.0 1.0 3.0 1.0 1.0 1.1 3.0 1.1 2.1 1.0 2.0 2.0 3.0 2.0 3.0 2.1 3.0 1.0 2.0 3.0 2.0 2.1 3.0 3.0 2.1 1.0 1.0 2.1 2.0 2.1 2.0 2.0 3.0 2.0 1.0 2.0 2.1 2.1 2.0 2.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00571 Fmt 4701 RUCA level 15472 15473 15474 15475 15476 15477 15478 15479 15480 15482 15483 15484 15485 15486 15488 15489 15490 15492 15501 15502 15510 15520 15521 15522 15530 15531 15532 15533 15534 15535 15536 15537 15538 15539 15540 15541 15542 15544 15545 15546 15547 15548 15549 15550 15551 15552 15553 15554 15555 15557 15558 15559 15560 15561 15562 15563 15564 15565 15601 15605 15606 15610 15611 15612 15613 15615 15616 15617 15618 1.0 2.0 3.0 3.0 2.0 1.1 2.1 2.0 2.1 2.0 1.1 1.0 10.5 1.0 2.1 1.0 2.0 1.1 4.0 4.0 4.0 4.0 9.0 7.0 10.5 10.5 7.4 10.6 10.6 10.6 10.0 7.0 6.0 9.0 10.5 4.0 10.6 10.5 5.0 10.5 10.5 10.5 4.0 10.6 10.5 7.4 10.5 9.0 4.0 5.0 10.0 10.6 4.0 4.0 10.0 10.5 5.0 10.0 1.0 1.0 1.0 2.0 1.0 1.0 2.0 1.0 1.0 1.0 2.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 15619 15620 15621 15622 15623 15624 15625 15626 15627 15628 15629 15631 15632 15633 15634 15635 15636 15637 15638 15639 15640 15641 15642 15644 15646 15647 15650 15655 15656 15658 15660 15661 15662 15663 15664 15665 15666 15668 15670 15671 15672 15673 15674 15675 15676 15677 15678 15679 15680 15681 15682 15683 15684 15685 15686 15687 15688 15689 15690 15691 15692 15693 15695 15696 15697 15698 15701 15705 15710 1.0 2.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 2.0 1.0 1.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 2.0 1.0 1.0 1.0 2.0 1.0 1.0 2.0 2.0 2.0 1.0 2.0 1.0 2.0 2.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 4.0 4.0 9.0 70194 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA Zip code RUCA level 15711 15712 15713 15714 15715 15716 15717 15720 15721 15722 15723 15724 15725 15727 15728 15729 15730 15731 15732 15733 15734 15736 15737 15738 15739 15740 15741 15742 15744 15745 15746 15747 15748 15750 15752 15753 15754 15756 15757 15758 15759 15760 15761 15762 15763 15764 15765 15767 15770 15771 15772 15773 15774 15775 15776 15777 15778 15779 15780 15781 15783 15784 15801 15821 15822 15823 15824 15825 15827 10.5 5.0 4.0 9.0 7.0 7.2 7.2 5.2 10.5 9.0 4.0 5.0 2.0 4.0 5.0 5.0 8.0 4.0 5.0 7.0 5.0 6.0 9.0 9.0 5.0 7.0 9.0 9.0 9.0 5.0 5.0 5.0 4.0 7.2 4.0 10.5 4.0 6.0 5.0 9.0 5.0 9.1 9.0 9.1 5.0 9.0 5.0 7.0 9.0 9.0 9.0 9.0 6.0 9.0 9.0 5.0 9.0 1.0 9.0 7.0 2.0 9.0 4.0 5.0 5.0 5.0 10.5 7.0 5.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00572 Fmt 4701 RUCA level 15828 15829 15831 15832 15834 15840 15841 15845 15846 15847 15848 15849 15851 15853 15856 15857 15860 15861 15863 15864 15865 15866 15868 15870 15901 15902 15904 15905 15906 15907 15909 15915 15920 15921 15922 15923 15924 15925 15926 15927 15928 15929 15930 15931 15934 15935 15936 15937 15938 15940 15942 15943 15944 15945 15946 15948 15949 15951 15952 15953 15954 15955 15956 15957 15958 15959 15960 15961 15962 10.0 8.0 5.0 8.0 8.0 6.0 5.0 7.2 5.0 7.0 5.0 5.0 5.0 7.4 5.0 4.0 10.4 8.0 5.0 8.0 5.0 5.0 5.0 6.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 6.1 2.0 7.3 2.0 3.0 2.0 3.0 7.3 2.0 4.0 1.0 7.3 1.0 2.0 10.5 2.0 2.0 2.0 2.0 2.0 2.0 1.0 3.0 7.3 5.2 1.0 1.0 2.0 6.1 2.0 2.0 5.2 2.0 1.0 3.0 3.0 3.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 15963 16001 16002 16003 16016 16017 16018 16020 16021 16022 16023 16024 16025 16027 16028 16029 16030 16033 16034 16035 16036 16037 16038 16039 16040 16041 16045 16046 16048 16049 16050 16051 16052 16053 16054 16055 16056 16057 16058 16059 16061 16063 16066 16101 16102 16103 16105 16107 16108 16110 16111 16112 16113 16114 16115 16116 16117 16120 16121 16123 16124 16125 16127 16130 16131 16132 16133 16134 16136 1.0 4.2 2.0 4.2 5.2 5.2 6.0 6.0 9.2 6.0 2.0 2.0 5.2 2.0 10.6 4.2 6.0 2.0 5.2 9.2 10.0 2.0 9.2 4.2 6.0 6.0 4.2 1.0 6.0 6.0 6.0 6.1 6.1 2.0 10.0 1.0 2.0 9.2 10.0 2.0 5.2 2.0 1.0 4.0 4.0 4.0 4.0 4.0 4.0 5.0 5.0 5.2 7.3 9.0 2.0 5.2 1.0 5.2 1.0 1.0 2.0 7.3 4.0 9.0 5.0 5.2 3.0 6.0 1.0 70195 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA Zip code RUCA level 16137 16140 16141 16142 16143 16145 16146 16148 16150 16151 16153 16154 16155 16156 16157 16159 16160 16161 16172 16201 16210 16211 16212 16213 16214 16215 16217 16218 16220 16221 16222 16223 16224 16225 16226 16228 16229 16230 16232 16233 16234 16235 16236 16238 16239 16240 16242 16244 16245 16246 16248 16249 16250 16253 16254 16255 16256 16257 16258 16259 16260 16261 16262 16263 16301 16311 16312 16313 16314 7.1 5.2 2.0 5.2 5.2 10.0 1.0 1.0 1.0 9.0 10.0 2.0 5.2 5.2 2.0 2.0 2.0 1.0 7.3 4.2 5.2 5.0 2.0 10.0 7.0 4.2 10.0 6.0 10.0 10.6 10.0 10.6 10.6 10.0 4.2 4.2 1.0 10.6 10.6 10.0 10.6 10.6 4.2 4.2 10.0 10.0 10.6 5.0 10.6 5.0 10.6 5.0 5.0 10.6 10.6 10.0 5.0 10.6 10.0 5.2 10.0 5.2 4.2 5.0 4.0 9.0 6.0 4.0 5.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00573 Fmt 4701 RUCA level 16316 16317 16319 16321 16322 16323 16326 16327 16328 16329 16331 16332 16333 16334 16335 16340 16341 16342 16343 16344 16345 16346 16347 16350 16351 16352 16353 16354 16360 16361 16362 16364 16365 16366 16367 16368 16369 16370 16371 16372 16373 16374 16375 16388 16401 16402 16403 16404 16405 16406 16407 16410 16411 16412 16413 16415 16416 16417 16420 16421 16422 16423 16424 16426 16427 16428 16430 16432 16433 5.0 9.0 4.0 10.0 10.0 7.0 10.6 5.0 7.0 5.0 10.6 10.6 7.0 10.6 4.0 5.0 9.0 10.6 4.0 4.0 5.0 4.0 5.0 6.0 5.0 4.0 10.0 7.0 10.5 10.0 10.6 4.0 4.0 4.0 4.0 4.0 4.0 10.0 5.0 10.6 10.5 10.5 10.6 4.0 2.0 6.0 10.4 10.5 6.0 10.5 7.3 2.0 2.0 7.1 7.3 1.0 5.0 1.0 5.0 1.0 5.0 1.0 10.5 2.0 2.0 2.0 2.0 2.0 4.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 16434 16435 16436 16438 16440 16441 16442 16443 16444 16475 16501 16502 16503 16504 16505 16506 16507 16508 16509 16510 16511 16512 16514 16515 16522 16530 16531 16532 16533 16534 16538 16541 16544 16546 16550 16553 16554 16563 16565 16601 16602 16603 16611 16613 16616 16617 16619 16620 16621 16622 16623 16624 16625 16627 16629 16630 16631 16633 16634 16635 16636 16637 16638 16639 16640 16641 16644 16645 16646 10.4 10.5 5.0 2.0 10.4 2.0 2.0 2.0 7.1 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 2.0 10.4 1.0 2.0 9.2 10.5 6.0 6.0 3.0 2.0 10.4 2.0 2.0 2.0 10.6 10.5 1.0 3.0 2.0 5.0 2.0 2.0 2.0 2.0 5.0 3.0 70196 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA Zip code RUCA level 16647 16648 16650 16651 16652 16654 16655 16656 16657 16659 16660 16661 16662 16663 16664 16665 16666 16667 16668 16669 16670 16671 16672 16673 16674 16675 16677 16678 16679 16680 16681 16682 16683 16684 16685 16686 16689 16691 16692 16693 16694 16695 16698 16699 16701 16720 16724 16725 16726 16727 16728 16729 16730 16731 16732 16733 16734 16735 16738 16740 16743 16744 16745 16746 16748 16749 16750 16801 16802 5.0 1.0 10.4 9.2 4.0 4.0 3.0 10.4 5.0 10.4 4.0 5.0 2.0 9.2 10.4 1.0 7.3 9.0 3.0 4.0 3.0 9.2 10.6 2.0 10.5 3.0 7.3 10.4 10.6 9.2 5.0 2.0 2.0 1.0 6.0 2.0 10.0 10.0 10.5 2.0 10.6 10.4 9.2 2.0 4.0 10.0 10.5 4.0 10.5 5.0 10.5 6.0 10.5 6.0 5.0 10.5 10.5 7.0 5.0 10.5 10.0 6.0 6.0 10.0 10.0 10.5 10.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00574 Fmt 4701 RUCA level 16803 16804 16805 16820 16821 16822 16823 16825 16826 16827 16828 16829 16830 16832 16833 16834 16835 16836 16837 16838 16839 16840 16841 16843 16844 16845 16847 16848 16849 16850 16851 16852 16853 16854 16855 16856 16858 16859 16860 16861 16863 16864 16865 16866 16868 16870 16871 16872 16873 16874 16875 16876 16877 16878 16879 16881 16882 16901 16910 16911 16912 16914 16915 16917 16918 16920 16921 16922 16923 1.0 1.0 1.0 2.0 6.1 4.2 2.0 5.0 2.0 1.0 2.0 2.0 4.0 2.0 4.0 6.1 2.0 5.0 4.0 4.0 6.1 6.1 2.0 4.0 2.0 5.0 6.1 5.2 6.1 5.0 1.0 2.0 2.0 2.0 5.0 2.0 6.1 2.0 6.1 5.0 5.0 2.0 1.0 7.3 1.0 2.0 10.5 2.0 4.0 2.0 2.0 5.0 2.0 5.0 6.1 5.0 2.0 8.0 10.0 8.0 8.0 10.0 10.0 9.0 10.6 10.5 8.0 10.0 10.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 16925 16926 16927 16928 16929 16930 16932 16933 16935 16936 16937 16938 16939 16940 16941 16942 16943 16945 16946 16947 16948 16950 17001 17002 17003 17004 17005 17006 17007 17008 17009 17010 17011 17012 17013 17014 17016 17017 17018 17019 17020 17021 17022 17023 17024 17025 17026 17027 17028 17029 17030 17032 17033 17034 17035 17036 17037 17038 17039 17040 17041 17042 17043 17044 17045 17046 17047 17048 17049 2.0 10.6 10.0 10.6 3.0 10.0 9.0 7.0 9.0 3.0 10.0 10.0 9.0 10.5 10.0 10.5 9.0 10.0 9.0 10.0 10.0 10.6 1.0 10.5 1.0 10.5 2.0 10.1 4.1 1.0 4.0 1.0 1.0 1.0 4.1 3.0 1.0 10.4 2.0 1.0 2.0 10.0 4.1 2.0 2.0 1.0 2.1 1.0 2.0 5.0 2.0 2.0 1.0 1.0 10.0 1.0 2.0 1.0 2.0 2.0 1.0 1.0 1.0 4.0 2.0 1.0 10.1 3.0 10.4 70197 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA Zip code RUCA level 17050 17051 17052 17053 17054 17055 17056 17057 17058 17059 17060 17061 17062 17063 17064 17065 17066 17067 17068 17069 17070 17071 17072 17073 17074 17075 17076 17077 17078 17080 17081 17082 17083 17084 17085 17086 17087 17088 17089 17090 17091 17093 17094 17097 17098 17099 17101 17102 17103 17104 17105 17106 17107 17108 17109 17110 17111 17112 17113 17120 17121 17122 17123 17124 17125 17126 17127 17128 17129 1.0 5.0 6.0 1.0 5.0 1.0 10.4 1.0 10.0 10.4 5.0 7.1 2.0 4.0 1.0 4.1 5.0 2.0 2.0 2.0 1.0 10.1 1.0 2.0 2.0 5.0 10.4 1.0 1.0 2.0 4.1 10.0 1.0 4.0 1.0 6.0 2.0 2.0 1.0 2.0 1.0 1.0 10.4 3.0 3.0 4.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00575 Fmt 4701 RUCA level 17130 17140 17177 17201 17210 17211 17212 17213 17214 17215 17217 17219 17220 17221 17222 17223 17224 17225 17228 17229 17231 17232 17233 17235 17236 17237 17238 17239 17240 17241 17243 17244 17246 17247 17249 17250 17251 17252 17253 17254 17255 17256 17257 17260 17261 17262 17263 17264 17265 17266 17267 17268 17270 17271 17272 17301 17302 17303 17304 17306 17307 17309 17310 17311 17312 17313 17314 17315 17316 1.0 1.0 1.0 4.0 10.5 10.6 10.0 10.0 4.2 10.0 10.5 10.5 10.5 10.5 4.0 10.0 10.5 2.0 10.0 10.0 10.5 5.0 10.0 4.0 10.5 4.2 3.0 10.0 6.1 5.2 10.0 5.0 5.0 4.2 10.0 4.2 10.5 4.0 10.0 4.0 10.0 2.0 4.0 6.0 4.0 10.5 4.2 10.0 5.0 5.2 3.0 4.2 2.0 10.5 4.2 5.2 2.0 6.0 6.0 6.0 6.0 2.0 5.0 2.0 1.0 1.0 3.0 1.0 5.2 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 17317 17318 17319 17320 17321 17322 17323 17324 17325 17326 17327 17329 17331 17332 17333 17334 17337 17339 17340 17342 17343 17344 17345 17347 17349 17350 17352 17353 17354 17355 17356 17358 17360 17361 17362 17363 17364 17365 17366 17368 17370 17371 17372 17375 17401 17402 17403 17404 17405 17406 17407 17415 17501 17502 17503 17504 17505 17506 17507 17508 17509 17512 17516 17517 17518 17519 17520 17521 17522 1.0 1.0 1.0 6.1 3.0 2.0 1.0 5.2 4.0 4.0 2.0 5.2 4.2 4.2 4.2 4.2 5.2 1.0 6.0 1.0 6.0 4.2 1.0 1.0 2.0 4.2 3.0 5.0 2.0 2.0 1.0 1.0 1.0 2.0 2.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 10.4 5.2 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 10.4 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 70198 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA Zip code RUCA level 17527 17528 17529 17532 17533 17534 17535 17536 17537 17538 17540 17543 17545 17547 17549 17550 17551 17552 17554 17555 17557 17560 17562 17563 17564 17565 17566 17567 17568 17569 17570 17572 17573 17575 17576 17577 17578 17579 17580 17581 17582 17583 17584 17585 17601 17602 17603 17604 17605 17606 17607 17608 17699 17701 17702 17703 17705 17720 17721 17722 17723 17724 17726 17727 17728 17729 17730 17731 17735 2.0 1.0 10.1 2.0 1.0 10.1 2.0 3.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 2.0 1.0 2.0 2.0 1.0 1.0 1.0 4.1 1.0 1.0 1.0 1.0 10.1 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.2 2.0 5.1 10.0 4.2 5.1 2.0 10.5 4.0 10.0 10.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00576 Fmt 4701 RUCA level 17737 17738 17739 17740 17742 17744 17745 17747 17748 17749 17750 17751 17752 17754 17756 17758 17759 17760 17762 17763 17764 17765 17767 17768 17769 17771 17772 17773 17774 17776 17777 17778 17779 17801 17810 17812 17813 17814 17815 17820 17821 17822 17823 17824 17827 17829 17830 17831 17832 17833 17834 17835 17836 17837 17839 17840 17841 17842 17843 17844 17845 17846 17847 17850 17851 17853 17855 17856 17857 2.0 10.5 5.1 4.2 9.1 1.0 4.2 10.5 4.2 4.0 5.2 5.2 5.2 1.0 2.0 10.0 1.0 10.5 2.0 2.0 10.5 10.0 5.2 10.0 4.2 2.0 5.0 10.5 9.1 2.0 4.0 10.5 4.2 4.0 5.2 10.5 6.0 5.0 4.0 5.0 4.0 4.0 6.0 6.0 5.0 5.0 10.4 4.0 7.4 10.5 4.0 5.0 10.4 4.0 4.0 7.4 5.0 10.5 5.0 5.0 5.0 5.0 4.0 4.0 7.4 6.0 5.0 5.2 4.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 17858 17859 17860 17861 17862 17864 17865 17866 17867 17868 17870 17872 17876 17877 17878 17880 17881 17882 17883 17884 17885 17886 17887 17888 17889 17901 17920 17921 17922 17923 17925 17929 17930 17931 17932 17933 17934 17935 17936 17938 17941 17942 17943 17944 17945 17946 17948 17949 17951 17952 17953 17954 17957 17959 17960 17961 17963 17964 17965 17966 17967 17968 17970 17972 17974 17976 17978 17979 17980 5.0 4.0 6.0 10.5 10.5 5.0 4.0 4.0 10.4 4.0 4.0 4.0 4.0 6.0 5.0 5.0 6.0 6.0 5.0 4.0 5.0 4.0 5.2 5.0 5.0 4.0 5.0 4.0 6.1 6.0 6.0 4.0 4.0 4.0 4.0 4.0 4.0 4.0 4.0 10.5 10.5 6.1 4.0 4.0 4.0 4.0 6.0 4.0 4.0 6.0 4.0 4.0 3.0 4.0 3.0 5.0 6.0 10.5 4.0 6.0 2.0 10.5 4.0 4.0 4.0 4.0 10.5 6.1 3.0 70199 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA Zip code RUCA level 17981 17982 17983 17985 18001 18002 18003 18010 18011 18012 18013 18014 18015 18016 18017 18018 18020 18025 18030 18031 18032 18034 18035 18036 18037 18038 18039 18040 18041 18042 18043 18044 18045 18046 18049 18050 18051 18052 18053 18054 18055 18056 18058 18059 18060 18062 18063 18064 18065 18066 18067 18068 18069 18070 18071 18072 18073 18074 18076 18077 18078 18079 18080 18081 18083 18084 18085 18086 18087 6.0 6.0 10.5 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 2.0 10.5 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 2.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00577 Fmt 4701 RUCA level 18088 18091 18092 18098 18099 18101 18102 18103 18104 18105 18106 18109 18175 18195 18201 18202 18210 18211 18212 18214 18216 18218 18219 18220 18221 18222 18223 18224 18225 18229 18230 18231 18232 18234 18235 18237 18239 18240 18241 18242 18244 18245 18246 18247 18248 18249 18250 18251 18252 18254 18255 18256 18301 18320 18321 18322 18323 18324 18325 18326 18327 18328 18330 18331 18332 18333 18334 18335 18336 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 3.0 3.0 1.0 6.0 1.0 4.2 1.0 4.2 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 4.2 1.0 1.0 1.0 1.0 4.2 2.0 2.0 1.0 4.2 2.1 1.0 2.0 1.0 4.2 1.0 4.2 1.0 1.0 2.1 4.2 4.2 4.2 4.2 10.5 2.0 10.5 10.5 4.2 2.0 4.2 10.5 6.0 10.5 4.2 4.2 4.2 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 18337 18340 18341 18342 18343 18344 18346 18347 18348 18349 18350 18351 18352 18353 18354 18355 18356 18357 18360 18370 18371 18372 18373 18401 18403 18405 18407 18410 18411 18413 18414 18415 18416 18417 18419 18420 18421 18424 18425 18426 18427 18428 18430 18431 18433 18434 18435 18436 18437 18438 18439 18440 18441 18443 18444 18445 18446 18447 18448 18449 18451 18452 18453 18454 18455 18456 18457 18458 18459 2.0 4.2 4.2 10.5 2.1 10.5 10.4 10.4 10.4 4.2 10.4 2.1 10.5 2.0 4.2 6.0 4.2 10.5 4.2 6.0 2.0 4.2 2.0 1.0 1.0 10.6 1.0 1.0 1.0 1.0 2.0 10.6 2.0 10.6 2.0 2.0 1.0 2.0 10.4 10.0 2.0 10.6 2.0 8.0 1.0 1.0 10.4 10.4 10.6 10.4 10.4 2.0 2.0 10.6 2.0 10.4 2.0 1.0 1.0 10.4 10.4 1.0 10.4 10.4 10.4 2.0 10.4 4.2 10.4 70200 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA Zip code RUCA level 18460 18461 18462 18463 18464 18465 18466 18469 18470 18471 18472 18473 18501 18502 18503 18504 18505 18507 18508 18509 18510 18512 18514 18515 18517 18518 18519 18522 18540 18577 18601 18602 18603 18610 18611 18612 18614 18615 18616 18617 18618 18619 18621 18622 18623 18624 18625 18626 18627 18628 18629 18630 18631 18632 18634 18635 18636 18640 18641 18642 18643 18644 18651 18653 18654 18655 18656 18657 18660 10.4 10.6 10.4 10.4 3.0 2.0 10.4 10.6 2.0 1.0 10.4 8.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 1.0 4.0 4.2 5.0 1.0 10.0 2.0 10.0 1.0 1.0 10.0 2.0 2.0 10.0 3.0 2.0 10.0 1.0 10.0 10.6 10.6 4.0 10.0 1.0 5.2 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 7.2 5.2 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00578 Fmt 4701 RUCA level 18661 18690 18701 18702 18703 18704 18705 18706 18707 18708 18709 18710 18711 18761 18762 18763 18764 18765 18766 18767 18768 18769 18773 18774 18801 18810 18812 18813 18814 18815 18816 18817 18818 18820 18821 18822 18823 18824 18825 18826 18827 18828 18829 18830 18831 18832 18833 18834 18837 18840 18842 18843 18844 18845 18846 18847 18848 18850 18851 18853 18854 18901 18910 18911 18912 18913 18914 18915 18916 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.4 4.0 2.0 10.4 10.6 10.0 10.4 10.5 2.0 2.0 1.0 1.0 2.0 10.4 2.0 10.4 7.1 10.0 10.6 2.0 10.5 10.6 10.6 2.0 10.6 4.0 2.0 10.4 10.4 10.6 10.6 7.1 10.6 6.0 10.6 10.0 10.6 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 18917 18918 18920 18921 18922 18923 18924 18925 18926 18927 18928 18929 18930 18931 18932 18933 18934 18935 18936 18938 18940 18942 18943 18944 18946 18947 18949 18950 18951 18953 18954 18955 18956 18957 18958 18960 18962 18963 18964 18966 18968 18969 18970 18971 18972 18974 18976 18977 18979 18980 18981 18991 19001 19002 19003 19004 19006 19007 19008 19009 19010 19012 19013 19014 19015 19016 19017 19018 19019 2.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70201 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA Zip code RUCA level 19020 19021 19022 19023 19025 19026 19027 19028 19029 19030 19031 19032 19033 19034 19035 19036 19037 19038 19039 19040 19041 19043 19044 19046 19047 19048 19049 19050 19052 19053 19054 19055 19056 19057 19058 19059 19061 19063 19064 19065 19066 19067 19070 19072 19073 19074 19075 19076 19078 19079 19080 19081 19082 19083 19085 19086 19087 19088 19089 19090 19091 19092 19093 19094 19095 19096 19098 19099 19101 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00579 Fmt 4701 RUCA level 19102 19103 19104 19105 19106 19107 19108 19109 19110 19111 19112 19113 19114 19115 19116 19118 19119 19120 19121 19122 19123 19124 19125 19126 19127 19128 19129 19130 19131 19132 19133 19134 19135 19136 19137 19138 19139 19140 19141 19142 19143 19144 19145 19146 19147 19148 19149 19150 19151 19152 19153 19154 19155 19160 19161 19162 19170 19171 19172 19173 19175 19176 19177 19178 19179 19181 19182 19183 19184 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 19185 19187 19188 19191 19192 19193 19194 19195 19196 19197 19244 19255 19301 19310 19311 19312 19316 19317 19318 19319 19320 19330 19331 19333 19335 19339 19340 19341 19342 19343 19344 19345 19346 19347 19348 19350 19351 19352 19353 19354 19355 19357 19358 19360 19362 19363 19365 19366 19367 19369 19371 19372 19373 19374 19375 19376 19380 19381 19382 19383 19390 19395 19397 19398 19399 19401 19403 19404 19405 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70202 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA Zip code RUCA level 19406 19407 19408 19409 19415 19420 19421 19422 19423 19424 19425 19426 19428 19429 19430 19432 19435 19436 19437 19438 19440 19441 19442 19443 19444 19446 19450 19451 19453 19454 19455 19456 19457 19460 19462 19464 19465 19468 19470 19472 19473 19474 19475 19477 19478 19480 19481 19482 19483 19484 19485 19486 19487 19488 19489 19490 19492 19493 19494 19495 19496 19501 19503 19504 19505 19506 19507 19508 19510 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 2.0 2.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PA PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00580 Fmt 4701 RUCA level 19511 19512 19516 19518 19519 19520 19522 19523 19525 19526 19529 19530 19533 19534 19535 19536 19538 19539 19540 19541 19542 19543 19544 19545 19547 19548 19549 19550 19551 19554 19555 19557 19559 19560 19562 19564 19565 19567 19601 19602 19603 19604 19605 19606 19607 19608 19609 19610 19611 19612 19640 00601 00602 00603 00604 00605 00606 00610 00611 00612 00613 00614 00616 00617 00622 00623 00624 00627 00631 2.0 2.0 2.0 1.0 1.0 2.0 2.0 1.0 2.0 2.0 3.0 7.3 1.0 3.0 2.0 2.0 7.3 2.0 2.1 2.0 1.0 2.1 2.0 2.0 2.0 2.0 5.0 2.0 1.0 2.0 2.0 3.0 2.0 1.0 2.0 7.3 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 R U U U U R U R U U U U U U U U U R ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 00636 00637 00638 00641 00646 00647 00650 00652 00653 00656 00659 00660 00662 00664 00667 00669 00670 00674 00676 00677 00678 00680 00681 00682 00683 00685 00687 00688 00690 00692 00693 00694 00698 00703 00704 00705 00707 00714 00715 00716 00717 00718 00719 00720 00721 00723 00725 00726 00727 00728 00729 00730 00731 00732 00733 00734 00735 00736 00737 00738 00739 00740 00741 00742 00744 00745 00751 00754 00757 U U R R U R U U R U U U R R R R R U U R R U U U U R U U U U U U U U R R R R U U U U U R U R U U U U U U U U U U U U U U U U U U U U R U R 70203 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR PR Zip code RUCA level 00765 00766 00767 00769 00771 00772 00773 00775 00777 00778 00780 00782 00783 00784 00785 00786 00791 00792 00794 00795 00901 00902 00906 00907 00908 00909 00910 00911 00912 00913 00914 00915 00916 00917 00918 00919 00920 00921 00922 00923 00924 00925 00926 00927 00928 00929 00930 00931 00933 00934 00935 00936 00937 00938 00939 00940 00949 00950 00951 00952 00953 00954 00955 00956 00957 00958 00959 00960 00961 R U U R U U U R U U U U U R R R U U R U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State PR ..................................... PR ..................................... PR ..................................... PR ..................................... PR ..................................... PR ..................................... PR ..................................... PR ..................................... PR ..................................... PR ..................................... PR ..................................... PR ..................................... PR ..................................... PR ..................................... PR ..................................... PR ..................................... PR ..................................... PR ..................................... PR ..................................... PR ..................................... PR ..................................... PW .................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... PO 00000 Frm 00581 Fmt 4701 RUCA level 00962 00963 00965 00966 00968 00969 00970 00971 00975 00976 00977 00978 00979 00981 00982 00983 00984 00985 00986 00987 00988 96940 02801 02802 02804 02806 02807 02808 02809 02812 02813 02814 02815 02816 02817 02818 02822 02823 02824 02825 02826 02827 02828 02829 02830 02831 02832 02833 02835 02836 02837 02838 02839 02840 02841 02842 02852 02854 02857 02858 02859 02860 02861 02862 02863 02864 02865 02871 02872 U U U U U U U U U U U U U U U U U U U U U R 2.0 1.0 3.0 1.0 2.0 4.1 1.0 2.0 2.0 2.0 2.0 1.0 2.0 1.0 2.0 1.0 1.0 2.0 1.0 2.0 1.0 2.0 1.0 1.0 3.0 3.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... RI ...................................... SC ..................................... SC ..................................... SC ..................................... SC ..................................... SC ..................................... SC ..................................... SC ..................................... SC ..................................... SC ..................................... SC ..................................... SC ..................................... SC ..................................... SC ..................................... SC ..................................... SC ..................................... SC ..................................... SC ..................................... SC ..................................... SC ..................................... SC ..................................... SC ..................................... SC ..................................... SC ..................................... SC ..................................... SC ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 02873 02874 02875 02876 02877 02878 02879 02880 02881 02882 02883 02885 02886 02887 02888 02889 02891 02892 02893 02894 02895 02896 02898 02901 02902 02903 02904 02905 02906 02907 02908 02909 02910 02911 02912 02914 02915 02916 02917 02918 02919 02920 02921 02940 29001 29002 29003 29006 29009 29010 29014 29015 29016 29018 29020 29030 29031 29032 29033 29036 29037 29038 29039 29040 29041 29042 29044 29045 29046 3.0 1.0 2.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.1 2.0 1.0 2.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 9.1 1.0 7.4 2.0 5.0 7.4 10.5 6.1 2.0 5.0 4.2 6.1 5.0 5.0 1.0 2.0 6.0 5.0 5.0 2.0 10.6 7.0 2.0 2.0 7.4 70204 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC Zip code RUCA level 29047 29048 29051 29052 29053 29054 29055 29056 29058 29059 29061 29062 29063 29065 29067 29069 29070 29071 29072 29073 29074 29075 29078 29079 29080 29081 29082 29101 29102 29104 29105 29106 29107 29108 29111 29112 29113 29114 29115 29116 29117 29118 29122 29123 29125 29126 29127 29128 29129 29130 29132 29133 29135 29137 29138 29142 29143 29145 29146 29147 29148 29150 29151 29152 29153 29154 29160 29161 29162 6.0 3.0 10.0 2.0 2.0 2.0 10.5 9.0 5.0 10.4 2.0 6.1 1.0 6.1 6.0 2.0 2.0 1.0 1.0 1.0 5.0 2.0 4.2 4.2 10.6 10.6 10.5 10.5 10.6 2.0 3.0 6.1 5.2 4.2 10.4 5.2 6.0 2.0 4.0 4.0 4.0 4.0 2.0 2.0 2.0 5.2 2.0 6.1 10.4 2.0 7.1 4.0 10.5 3.0 7.0 10.5 10.0 5.0 6.0 1.0 10.4 1.0 1.0 1.0 2.0 1.0 2.0 2.0 10.4 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00582 Fmt 4701 RUCA level 29163 29164 29166 29168 29169 29170 29171 29172 29175 29176 29177 29178 29180 29201 29202 29203 29204 29205 29206 29207 29208 29209 29210 29211 29212 29214 29215 29216 29217 29218 29219 29220 29221 29222 29223 29224 29225 29226 29227 29228 29229 29230 29240 29250 29260 29290 29292 29301 29302 29303 29304 29305 29306 29307 29316 29318 29319 29320 29321 29322 29323 29324 29325 29329 29330 29331 29332 29333 29334 10.5 2.1 10.4 2.0 1.0 1.0 1.0 1.0 6.1 7.1 2.0 10.5 7.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.2 2.0 2.0 1.0 4.0 1.0 2.0 2.0 6.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 29335 29336 29338 29340 29341 29342 29346 29348 29349 29351 29353 29355 29356 29360 29364 29365 29368 29369 29370 29372 29373 29374 29375 29376 29377 29378 29379 29384 29385 29386 29388 29390 29391 29395 29401 29402 29403 29404 29405 29406 29407 29409 29410 29412 29413 29414 29415 29416 29417 29418 29419 29420 29422 29423 29424 29425 29426 29429 29430 29431 29432 29433 29434 29435 29436 29437 29438 29439 29440 2.0 1.0 1.0 4.0 4.0 4.0 1.0 1.0 1.0 5.0 2.0 10.5 2.0 4.0 4.2 1.0 2.0 1.0 6.0 2.0 2.0 2.0 2.1 2.0 1.0 1.0 4.2 6.0 1.0 1.0 2.1 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 2.0 5.0 2.0 2.0 2.0 2.0 2.0 2.0 1.0 4.2 70205 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC Zip code RUCA level 29442 29445 29446 29447 29448 29449 29450 29451 29452 29453 29455 29456 29457 29458 29461 29464 29465 29466 29468 29469 29470 29471 29472 29474 29475 29476 29477 29479 29481 29482 29483 29484 29485 29487 29488 29492 29493 29501 29502 29503 29504 29505 29506 29510 29511 29512 29516 29518 29519 29520 29525 29526 29527 29528 29530 29532 29536 29540 29541 29542 29543 29544 29545 29546 29547 29550 29551 29554 29555 4.2 1.0 10.4 10.4 2.0 2.0 2.0 1.0 10.4 2.0 2.0 1.0 2.0 2.0 7.1 1.0 1.0 1.0 2.0 7.1 2.0 2.0 2.0 2.0 5.0 2.0 10.4 2.0 10.0 1.0 1.0 1.0 1.0 2.0 5.0 2.0 5.0 1.0 1.0 1.0 1.0 1.0 1.0 7.2 2.0 4.0 5.0 10.6 7.0 7.0 5.0 1.0 2.0 1.0 2.0 4.1 4.0 1.0 2.0 4.0 6.0 2.0 2.0 2.0 5.0 4.2 4.2 10.0 10.4 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00583 Fmt 4701 RUCA level 29556 29560 29563 29564 29565 29566 29567 29568 29569 29570 29571 29572 29573 29574 29575 29576 29577 29578 29579 29580 29581 29582 29583 29584 29585 29587 29588 29589 29590 29591 29592 29593 29594 29596 29597 29598 29601 29602 29603 29604 29605 29606 29607 29608 29609 29610 29611 29612 29613 29614 29615 29616 29617 29620 29621 29622 29623 29624 29625 29626 29627 29628 29630 29631 29632 29633 29634 29635 29636 7.0 7.3 6.0 9.0 6.0 1.0 5.0 2.0 2.0 6.0 7.0 1.0 4.0 7.0 1.0 1.0 1.0 1.0 1.0 9.0 2.0 1.0 2.0 9.2 7.3 1.0 1.0 7.0 9.0 2.0 6.0 6.1 6.0 8.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.4 1.0 1.0 1.0 1.0 1.0 1.0 2.0 10.6 4.2 4.2 4.2 4.2 4.2 2.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 29638 29639 29640 29641 29642 29643 29644 29645 29646 29647 29648 29649 29650 29651 29652 29653 29654 29655 29656 29657 29658 29659 29661 29662 29664 29665 29666 29667 29669 29670 29671 29672 29673 29675 29676 29677 29678 29679 29680 29681 29682 29683 29684 29685 29686 29687 29688 29689 29690 29691 29692 29693 29695 29696 29697 29698 29702 29703 29704 29706 29708 29709 29710 29712 29714 29715 29716 29717 29718 6.1 10.4 1.0 1.0 1.0 5.0 2.1 2.1 4.0 5.0 4.0 4.0 1.0 1.0 1.0 5.0 2.0 2.0 4.2 1.0 5.0 2.0 2.0 2.0 5.0 4.2 5.0 4.2 2.0 4.2 1.0 4.2 1.0 5.0 5.0 4.2 4.2 4.2 2.0 2.0 2.0 2.0 2.0 2.0 5.0 1.0 2.0 2.0 2.0 5.0 5.0 5.0 5.0 5.0 2.0 1.0 5.0 2.0 2.1 4.0 1.0 8.0 2.0 3.0 3.0 1.0 1.0 3.0 9.0 70206 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC Zip code RUCA level 29720 29721 29722 29724 29726 29727 29728 29729 29730 29731 29732 29733 29734 29741 29742 29743 29744 29745 29801 29802 29803 29804 29805 29808 29809 29810 29812 29813 29816 29817 29819 29821 29822 29824 29826 29827 29828 29829 29831 29832 29834 29835 29836 29838 29839 29840 29841 29842 29843 29844 29845 29846 29847 29848 29849 29850 29851 29853 29856 29860 29861 29899 29901 29902 29903 29904 29905 29906 29907 4.0 4.0 4.0 3.0 2.1 9.0 7.3 3.0 1.1 1.1 1.1 1.1 1.1 9.0 3.0 3.0 4.0 2.1 1.0 1.0 1.0 1.0 2.0 9.0 2.0 7.0 8.0 8.0 1.0 10.6 5.0 2.0 2.0 7.3 10.4 8.0 1.0 1.0 2.0 10.6 1.0 10.5 7.0 2.0 1.0 10.0 1.0 2.0 10.6 2.0 2.0 8.0 2.0 5.0 8.0 1.0 1.0 10.4 2.0 2.0 1.0 10.5 4.0 4.0 4.0 4.0 4.0 4.0 4.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SC SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00584 Fmt 4701 RUCA level 29909 29910 29911 29912 29913 29914 29915 29916 29918 29920 29921 29922 29923 29924 29925 29926 29927 29928 29929 29931 29932 29933 29934 29935 29936 29938 29939 29940 29941 29943 29944 29945 57001 57002 57003 57004 57005 57006 57007 57010 57012 57013 57014 57015 57016 57017 57018 57020 57021 57022 57024 57025 57026 57027 57028 57029 57030 57031 57032 57033 57034 57035 57036 57037 57038 57039 57040 57041 57042 5.0 5.0 8.0 7.4 7.0 5.0 4.0 10.5 7.0 5.0 7.0 10.6 7.0 7.0 4.0 4.0 10.5 4.0 10.5 5.0 7.0 7.0 8.4 4.0 7.4 4.0 7.0 5.0 5.0 8.4 7.0 5.0 10.4 5.0 2.0 10.4 2.0 4.0 4.0 5.0 10.4 7.1 10.4 10.1 8.3 10.4 2.0 2.0 10.4 2.0 10.4 2.0 5.0 3.0 10.4 10.0 2.0 5.0 1.0 2.0 3.0 2.0 10.4 5.0 1.0 2.0 5.0 2.0 7.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 57043 57044 57045 57046 57047 57048 57049 57050 57051 57052 57053 57054 57055 57056 57057 57058 57059 57061 57062 57063 57064 57065 57066 57067 57068 57069 57070 57071 57072 57073 57075 57076 57077 57078 57079 57101 57103 57104 57105 57106 57107 57108 57109 57110 57117 57118 57186 57188 57189 57192 57193 57194 57195 57196 57197 57198 57201 57212 57213 57214 57216 57217 57218 57219 57220 57221 57223 57224 57225 10.1 5.0 10.0 5.0 10.1 10.4 1.0 8.0 10.5 10.0 10.1 8.0 2.0 2.0 8.0 10.4 10.5 4.0 10.0 10.5 1.0 10.4 10.5 5.0 2.0 4.0 10.4 5.0 5.0 5.0 8.3 8.0 2.0 4.0 4.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 4.0 10.5 10.0 10.5 7.0 10.5 10.0 10.0 5.0 10.5 10.5 10.0 10.5 70207 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD Zip code RUCA level 57226 57227 57231 57232 57233 57234 57235 57236 57237 57238 57239 57241 57242 57243 57245 57246 57247 57248 57249 57251 57252 57253 57255 57256 57257 57258 57259 57260 57261 57262 57263 57264 57265 57266 57268 57269 57270 57271 57272 57273 57274 57276 57278 57279 57301 57311 57312 57313 57314 57315 57317 57319 57321 57322 57323 57324 57325 57326 57328 57329 57330 57331 57332 57334 57335 57337 57339 57340 57341 10.0 10.6 10.0 10.0 10.5 10.5 5.0 10.5 10.0 10.0 10.0 10.5 10.5 5.0 5.0 8.0 10.0 10.5 10.5 7.0 7.0 7.0 10.0 10.0 10.0 10.5 8.0 10.0 10.0 10.0 5.0 8.0 8.0 10.0 10.0 8.0 10.0 10.0 5.0 10.0 10.0 5.0 10.0 10.6 4.0 5.0 10.0 10.0 10.5 10.0 10.0 10.4 10.0 5.0 10.0 5.0 10.0 10.0 10.0 10.0 10.0 10.5 5.0 5.0 10.0 10.0 10.0 5.0 10.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00585 Fmt 4701 RUCA level 57342 57344 57345 57346 57348 57349 57350 57353 57354 57355 57356 57358 57359 57361 57362 57363 57364 57365 57366 57367 57368 57369 57370 57371 57373 57374 57375 57376 57379 57380 57381 57382 57383 57384 57385 57386 57399 57401 57402 57420 57421 57422 57424 57426 57427 57428 57429 57430 57432 57433 57434 57435 57436 57437 57438 57439 57440 57441 57442 57445 57446 57448 57449 57450 57451 57452 57454 57455 57456 10.0 10.0 10.0 10.0 5.0 10.0 4.0 10.0 10.0 10.0 10.0 10.0 10.5 10.0 10.0 5.0 10.0 10.0 10.5 10.0 10.5 10.0 10.0 10.0 10.0 10.4 10.5 10.0 5.0 10.0 5.0 10.0 10.5 5.0 10.5 5.0 4.0 4.0 4.0 10.6 10.0 10.0 10.3 5.0 5.0 10.0 10.6 10.0 10.5 10.5 10.6 10.0 10.6 10.0 10.0 10.6 10.6 5.0 10.0 5.0 10.5 10.0 10.5 10.0 10.2 10.6 10.0 10.0 10.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 57457 57460 57461 57465 57466 57467 57468 57469 57470 57471 57472 57473 57474 57475 57476 57477 57479 57481 57501 57520 57521 57522 57523 57528 57529 57531 57532 57533 57534 57536 57537 57538 57540 57541 57542 57543 57544 57547 57548 57551 57552 57553 57555 57559 57560 57562 57563 57564 57566 57567 57568 57569 57570 57571 57572 57574 57576 57577 57579 57580 57584 57585 57601 57620 57621 57622 57623 57625 57626 10.0 5.0 10.3 10.3 10.0 10.0 10.0 7.0 10.0 10.0 10.6 10.0 5.0 10.0 10.3 10.6 5.0 5.0 4.0 10.5 10.0 5.0 10.0 10.3 10.0 10.0 4.0 10.0 10.3 5.0 4.0 10.0 10.0 10.3 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.5 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 7.0 10.3 10.0 7.0 10.0 10.0 10.0 10.0 10.0 10.4 70208 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD Zip code RUCA level 57630 57631 57632 57633 57634 57636 57638 57639 57640 57641 57642 57644 57645 57646 57648 57649 57650 57651 57652 57656 57657 57658 57659 57660 57661 57701 57702 57703 57706 57709 57714 57716 57717 57718 57719 57720 57722 57724 57725 57730 57732 57735 57736 57737 57738 57741 57744 57745 57747 57748 57750 57751 57752 57754 57755 57756 57758 57759 57760 57761 57762 57763 57764 57766 57767 57769 57770 57772 57773 10.0 10.6 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.6 10.0 10.0 10.0 1.0 1.0 1.0 7.3 1.0 10.6 8.0 7.4 1.0 1.0 10.0 10.4 10.0 2.0 10.0 10.5 10.3 10.4 10.4 10.4 2.0 10.4 2.0 7.0 10.4 10.0 2.0 8.0 10.3 10.0 8.0 10.4 10.0 10.6 2.0 10.6 10.3 7.0 10.3 2.0 2.0 7.0 8.0 10.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD SD TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00586 Fmt 4701 RUCA level 57775 57776 57777 57779 57780 57782 57783 57785 57787 57788 57790 57791 57792 57793 57794 57799 37010 37011 37012 37013 37014 37015 37016 37018 37019 37020 37022 37023 37024 37025 37026 37027 37028 37029 37030 37031 37032 37033 37034 37035 37036 37037 37040 37041 37042 37043 37044 37046 37047 37048 37049 37050 37051 37052 37055 37056 37057 37058 37059 37060 37061 37062 37063 37064 37065 37066 37067 37068 37069 2.0 10.0 10.4 10.5 2.0 10.3 4.0 7.3 10.4 10.6 2.0 2.0 10.4 10.5 10.3 4.0 1.0 1.0 10.6 1.0 2.0 2.0 2.0 9.1 8.0 5.2 2.0 2.0 1.0 2.0 2.0 1.0 2.0 4.2 7.0 2.0 2.0 10.4 2.0 2.0 5.2 2.1 1.0 1.0 1.0 1.0 1.0 2.0 8.0 2.0 2.0 2.0 5.2 2.0 4.2 4.2 7.3 10.4 10.6 2.1 10.5 2.0 5.2 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 37070 37071 37072 37073 37074 37075 37076 37077 37078 37079 37080 37082 37083 37085 37086 37087 37088 37089 37090 37091 37095 37096 37097 37098 37101 37110 37111 37115 37116 37118 37119 37121 37122 37127 37128 37129 37130 37131 37132 37133 37134 37135 37136 37137 37138 37140 37141 37142 37143 37144 37145 37146 37148 37149 37150 37151 37152 37153 37155 37160 37161 37162 37165 37166 37167 37171 37172 37174 37175 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 8.0 2.0 2.0 2.0 7.3 2.1 1.1 4.1 4.1 1.1 2.0 7.0 10.6 10.0 10.0 2.0 6.0 4.0 4.0 1.0 1.0 2.1 7.1 1.0 1.0 1.1 1.1 1.1 1.1 1.1 1.1 1.1 10.6 2.0 5.2 3.0 1.0 3.0 2.0 2.0 2.0 8.0 8.0 2.0 7.1 2.1 10.6 8.0 1.0 2.1 1.0 4.0 4.0 4.0 5.2 7.0 1.1 2.0 1.0 2.0 10.0 70209 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN Zip code RUCA level 37178 37179 37180 37181 37183 37184 37185 37186 37187 37188 37189 37190 37191 37201 37202 37203 37204 37205 37206 37207 37208 37209 37210 37211 37212 37213 37214 37215 37216 37217 37218 37219 37220 37221 37222 37224 37227 37228 37229 37230 37232 37234 37235 37236 37237 37238 37239 37240 37241 37242 37243 37244 37245 37246 37247 37248 37249 37250 37301 37302 37303 37304 37305 37306 37307 37308 37309 37310 37311 10.0 2.0 5.2 5.2 5.0 5.2 7.0 2.0 2.0 2.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.5 1.0 4.0 2.0 10.5 5.0 2.0 2.1 5.2 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00587 Fmt 4701 RUCA level 37312 37313 37314 37315 37316 37317 37318 37320 37321 37322 37323 37324 37325 37326 37327 37328 37329 37330 37331 37332 37333 37334 37335 37336 37337 37338 37339 37340 37341 37342 37343 37345 37347 37348 37349 37350 37351 37352 37353 37354 37355 37356 37357 37359 37360 37361 37362 37363 37364 37365 37366 37367 37369 37370 37371 37373 37374 37375 37376 37377 37378 37379 37380 37381 37382 37383 37384 37385 37387 1.0 10.4 10.5 1.0 2.0 10.0 4.0 1.0 7.3 10.5 1.0 5.0 2.0 10.0 10.4 8.3 5.0 5.0 7.2 8.3 10.0 7.3 8.3 2.1 10.3 8.3 10.4 2.0 1.0 8.4 1.0 6.0 2.0 8.3 7.4 1.0 1.0 5.0 2.1 7.0 7.4 10.6 5.0 8.3 5.0 2.0 2.0 1.0 1.0 10.4 10.6 10.0 2.0 5.2 4.0 2.0 2.0 10.0 10.0 1.0 4.0 1.0 7.3 8.0 5.0 10.0 1.0 10.5 10.6 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 37388 37389 37391 37394 37396 37397 37398 37401 37402 37403 37404 37405 37406 37407 37408 37409 37410 37411 37412 37414 37415 37416 37419 37421 37422 37424 37450 37501 37544 37601 37602 37604 37605 37614 37615 37616 37617 37618 37620 37621 37625 37640 37641 37642 37643 37644 37645 37650 37656 37657 37658 37659 37660 37662 37663 37664 37665 37669 37680 37681 37682 37683 37684 37686 37687 37688 37690 37691 37692 4.0 7.4 10.0 5.0 2.0 2.0 4.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 5.0 1.0 1.0 1.0 1.0 1.0 8.1 5.2 1.0 1.0 1.0 1.0 7.3 2.0 8.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 9.0 2.0 1.0 7.4 1.0 2.0 10.0 8.0 2.0 9.0 2.0 70210 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN Zip code RUCA level 37694 37699 37701 37705 37707 37708 37709 37710 37711 37713 37714 37715 37716 37717 37719 37721 37722 37723 37724 37725 37726 37727 37729 37730 37731 37732 37733 37737 37738 37742 37743 37744 37745 37748 37752 37753 37754 37755 37756 37757 37760 37762 37763 37764 37765 37766 37769 37770 37771 37772 37773 37774 37777 37778 37779 37801 37802 37803 37804 37806 37807 37809 37810 37811 37813 37814 37815 37816 37818 2.0 2.0 1.0 2.0 6.0 2.0 2.0 5.2 10.4 5.2 4.0 6.0 4.2 4.2 4.2 1.0 5.0 5.0 6.0 6.1 10.6 5.0 5.0 6.0 8.0 10.6 10.6 2.0 10.5 2.0 4.0 4.0 4.0 4.0 5.0 5.0 2.0 10.6 10.0 4.0 1.0 10.5 4.1 6.1 10.0 4.0 4.0 9.0 1.0 1.0 8.0 2.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 2.0 2.0 5.0 5.0 2.0 1.0 1.0 1.0 1.0 5.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00588 Fmt 4701 RUCA level 37819 37820 37821 37822 37824 37825 37826 37828 37829 37830 37831 37840 37841 37843 37845 37846 37847 37848 37849 37851 37852 37853 37854 37857 37860 37861 37862 37863 37864 37865 37866 37867 37868 37869 37870 37871 37872 37873 37874 37876 37877 37878 37879 37880 37881 37882 37885 37886 37887 37888 37890 37891 37892 37901 37902 37909 37912 37914 37915 37916 37917 37918 37919 37920 37921 37922 37923 37924 37927 10.5 2.1 4.0 4.0 8.0 8.0 5.0 2.0 5.0 4.2 4.2 4.2 7.0 5.0 4.2 3.0 10.6 10.4 1.0 6.0 10.6 1.0 4.0 7.0 2.0 10.4 4.0 4.0 4.0 1.0 3.0 5.0 4.0 10.0 6.0 2.0 10.6 2.0 7.3 5.0 1.0 2.0 7.0 6.0 10.4 2.0 10.4 2.0 7.4 10.4 1.0 2.0 10.3 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 37928 37929 37930 37931 37932 37933 37934 37938 37939 37940 37950 37955 37990 37995 37996 37997 37998 38001 38002 38004 38006 38007 38008 38010 38011 38012 38014 38015 38016 38017 38018 38019 38021 38023 38024 38025 38027 38028 38029 38030 38034 38036 38037 38039 38040 38041 38042 38044 38045 38046 38047 38048 38049 38050 38052 38053 38054 38055 38057 38058 38059 38060 38061 38063 38066 38067 38068 38069 38070 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.4 1.0 2.0 10.4 4.0 7.0 2.0 2.0 4.0 1.0 2.0 1.0 1.0 1.0 7.3 10.5 2.0 4.0 4.0 1.0 2.0 1.0 5.0 10.5 2.0 8.0 2.0 8.0 8.0 7.0 9.0 2.0 2.0 4.0 2.0 2.0 10.5 10.6 1.0 1.0 1.0 2.0 2.0 4.0 2.0 10.6 7.0 2.0 2.0 2.0 6.1 4.0 70211 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN Zip code RUCA level 38071 38074 38075 38076 38077 38079 38080 38083 38088 38101 38103 38104 38105 38106 38107 38108 38109 38110 38111 38112 38113 38114 38115 38116 38117 38118 38119 38120 38122 38124 38125 38126 38127 38128 38129 38130 38131 38132 38133 38134 38135 38136 38137 38138 38139 38140 38141 38142 38143 38145 38146 38147 38148 38150 38151 38152 38157 38159 38161 38163 38165 38166 38167 38168 38173 38174 38175 38177 38181 2.0 7.0 7.0 2.0 10.5 10.5 10.5 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00589 Fmt 4701 RUCA level 38182 38183 38184 38186 38187 38188 38190 38193 38194 38195 38197 38201 38220 38221 38222 38223 38224 38225 38226 38229 38230 38231 38232 38233 38235 38236 38237 38238 38240 38241 38242 38251 38253 38254 38255 38256 38257 38258 38259 38260 38261 38271 38281 38301 38302 38303 38305 38308 38310 38311 38313 38314 38315 38316 38317 38318 38320 38321 38324 38326 38327 38328 38329 38330 38331 38332 38333 38334 38336 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.0 9.0 10.5 5.0 4.0 5.0 10.6 9.0 10.6 10.0 5.0 6.0 6.0 9.0 5.0 7.0 7.0 5.0 10.6 4.0 5.0 5.0 6.0 8.0 5.0 7.4 9.0 4.0 5.0 4.0 4.0 4.0 1.0 1.0 1.0 1.0 1.0 10.6 10.0 2.0 1.0 8.0 8.0 10.0 10.0 8.0 2.0 10.6 10.6 9.0 8.0 10.0 7.0 7.3 3.0 8.0 3.0 10.4 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 38337 38338 38339 38340 38341 38342 38343 38344 38345 38346 38347 38348 38351 38352 38355 38356 38357 38358 38359 38361 38362 38363 38365 38366 38367 38368 38369 38370 38371 38372 38374 38375 38376 38377 38378 38379 38380 38381 38382 38387 38388 38389 38390 38391 38392 38393 38401 38402 38425 38449 38450 38451 38452 38453 38454 38455 38456 38457 38459 38460 38461 38462 38463 38464 38468 38469 38471 38472 38473 3.0 7.3 5.0 7.1 9.0 10.0 7.3 10.6 8.3 8.0 3.0 2.0 7.3 3.0 2.0 2.0 5.0 7.3 10.6 9.0 2.0 10.6 10.6 2.0 8.4 8.0 7.0 9.0 8.0 7.0 8.0 7.0 10.6 7.1 1.0 9.0 10.6 9.0 7.3 10.6 8.3 4.0 10.6 2.0 2.0 8.4 4.2 4.2 10.0 9.0 10.0 5.0 10.4 8.0 10.4 9.0 5.0 5.0 8.0 8.0 5.0 7.4 6.0 4.0 5.0 5.0 10.4 9.2 8.0 70212 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TN TX TX TX TX TX TX TX TX Zip code RUCA level 38474 38475 38476 38477 38478 38481 38482 38483 38485 38486 38487 38488 38501 38502 38503 38504 38505 38506 38541 38542 38543 38544 38545 38547 38548 38549 38550 38551 38552 38553 38554 38555 38556 38557 38558 38559 38560 38562 38563 38564 38565 38567 38568 38569 38570 38571 38572 38573 38574 38575 38577 38578 38579 38580 38581 38582 38583 38585 38587 38588 38589 73301 73344 75001 75002 75006 75007 75008 75009 5.0 8.0 2.0 8.0 7.0 5.0 5.1 5.0 10.0 5.0 5.1 2.0 4.0 4.0 4.0 10.0 4.0 4.0 8.0 5.0 8.0 5.0 5.0 10.4 5.0 10.6 5.0 10.5 10.6 10.0 5.0 4.0 10.0 4.0 5.0 8.0 10.6 5.0 10.4 5.0 10.0 10.4 8.4 10.4 7.4 5.0 5.0 8.0 7.2 10.0 10.6 5.0 8.0 5.0 5.0 5.0 8.0 10.6 8.0 6.0 10.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00590 Fmt 4701 RUCA level 75010 75011 75013 75014 75015 75016 75017 75019 75020 75021 75022 75023 75024 75025 75026 75027 75028 75029 75030 75032 75034 75035 75037 75038 75039 75040 75041 75042 75043 75044 75045 75046 75047 75048 75049 75050 75051 75052 75053 75054 75056 75057 75058 75060 75061 75062 75063 75065 75067 75068 75069 75070 75071 75074 75075 75076 75077 75078 75080 75081 75082 75083 75085 75086 75087 75088 75089 75090 75091 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 3.0 1.0 1.0 1.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 1.0 1.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 75092 75093 75094 75097 75098 75099 75101 75102 75103 75104 75105 75106 75109 75110 75114 75115 75116 75117 75118 75119 75120 75121 75123 75124 75125 75126 75127 75132 75134 75135 75137 75138 75140 75141 75142 75143 75144 75146 75147 75148 75149 75150 75151 75152 75153 75154 75155 75156 75157 75158 75159 75160 75161 75163 75164 75165 75166 75167 75168 75169 75172 75173 75180 75181 75182 75185 75187 75189 75201 1.0 1.0 1.0 2.0 1.0 2.0 4.2 4.0 3.0 1.0 6.1 1.0 4.0 4.0 2.0 1.0 1.0 2.0 2.0 4.2 4.2 2.0 1.0 6.1 2.0 2.0 10.6 2.0 1.0 2.0 1.0 1.0 7.0 1.0 2.0 2.0 5.0 1.0 2.0 6.0 1.0 1.0 4.0 2.0 5.0 1.0 6.1 2.0 2.0 2.0 1.0 4.2 2.0 2.0 2.0 4.1 2.0 2.0 4.1 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 70213 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX Zip code RUCA level 75202 75203 75204 75205 75206 75207 75208 75209 75210 75211 75212 75214 75215 75216 75217 75218 75219 75220 75221 75222 75223 75224 75225 75226 75227 75228 75229 75230 75231 75232 75233 75234 75235 75236 75237 75238 75239 75240 75241 75242 75243 75244 75245 75246 75247 75248 75249 75250 75251 75252 75253 75254 75258 75260 75261 75262 75263 75264 75265 75266 75267 75270 75275 75277 75283 75284 75285 75286 75287 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00591 Fmt 4701 RUCA level 75295 75301 75303 75310 75312 75313 75315 75320 75323 75326 75336 75339 75342 75346 75353 75354 75355 75356 75357 75358 75359 75360 75363 75364 75367 75368 75369 75370 75371 75372 75373 75374 75376 75378 75379 75380 75381 75382 75386 75387 75388 75389 75390 75391 75392 75393 75394 75395 75396 75397 75398 75401 75402 75403 75404 75407 75409 75410 75411 75412 75413 75414 75415 75416 75417 75418 75420 75421 75422 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 4.0 4.0 4.0 2.0 2.0 10.0 5.0 6.0 3.0 2.0 9.0 5.0 10.5 7.0 10.5 5.0 6.1 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 75423 75424 75425 75426 75428 75429 75431 75432 75433 75434 75435 75436 75437 75438 75439 75440 75441 75442 75443 75444 75446 75447 75448 75449 75450 75451 75452 75453 75454 75455 75456 75457 75458 75459 75460 75461 75462 75468 75469 75470 75471 75472 75473 75474 75475 75476 75477 75478 75479 75480 75481 75482 75483 75485 75486 75487 75488 75489 75490 75491 75492 75493 75494 75495 75496 75497 75501 75503 75504 2.0 2.0 5.0 7.4 7.4 7.4 10.2 10.6 10.5 5.0 5.0 5.0 5.0 9.0 3.0 10.4 10.6 2.0 3.0 10.0 10.6 8.0 9.0 9.0 9.0 8.0 3.0 6.1 2.0 10.2 10.2 10.0 2.0 2.0 4.0 4.0 4.0 5.0 9.0 5.0 10.2 3.0 5.0 2.0 7.0 8.0 5.0 10.2 3.0 10.6 5.0 4.0 4.0 2.0 5.0 10.0 8.0 1.0 2.0 2.1 9.0 5.0 8.0 2.0 10.5 10.0 1.0 1.0 1.0 70214 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX Zip code RUCA level 75505 75507 75550 75551 75554 75555 75556 75558 75559 75560 75561 75562 75563 75564 75565 75566 75567 75568 75569 75570 75571 75572 75573 75574 75599 75601 75602 75603 75604 75605 75606 75607 75608 75615 75630 75631 75633 75636 75637 75638 75639 75640 75641 75642 75643 75644 75645 75647 75650 75651 75652 75653 75654 75656 75657 75658 75659 75660 75661 75662 75663 75666 75667 75668 75669 75670 75671 75672 75680 1.0 1.0 8.0 7.3 8.0 8.3 8.1 5.0 2.0 3.0 2.0 10.6 10.6 10.5 8.3 3.0 2.0 10.5 1.0 2.0 10.5 8.1 2.0 2.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 10.5 10.6 7.0 10.6 7.0 10.6 8.3 2.0 2.0 4.0 8.0 10.6 2.0 2.0 2.0 5.2 5.0 4.0 4.0 10.0 10.5 5.0 2.0 1.0 2.0 4.2 4.2 4.2 6.0 10.6 8.0 4.0 4.0 4.0 4.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00592 Fmt 4701 RUCA level 75681 75682 75683 75684 75685 75686 75687 75688 75689 75691 75692 75693 75694 75701 75702 75703 75704 75705 75706 75707 75708 75709 75710 75711 75712 75713 75750 75751 75752 75754 75755 75756 75757 75758 75759 75760 75762 75763 75764 75765 75766 75770 75771 75772 75773 75778 75779 75780 75782 75783 75784 75785 75788 75789 75790 75791 75792 75797 75798 75799 75801 75802 75803 75831 75832 75833 75834 75835 75838 10.5 10.4 2.0 10.4 8.3 8.0 5.0 4.0 5.0 2.0 2.0 1.0 4.0 1.0 1.0 1.0 2.0 2.0 2.0 2.0 1.0 2.0 1.0 1.0 1.0 1.0 2.0 4.0 5.0 2.0 3.0 2.0 2.0 2.0 4.0 5.0 2.0 10.5 9.2 10.4 4.0 3.0 2.0 9.2 7.3 2.0 4.0 2.0 10.5 10.0 10.5 9.2 5.0 2.0 10.4 1.0 2.0 3.0 1.0 1.0 4.0 4.0 4.0 10.0 10.0 10.0 5.0 7.0 10.6 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 75839 75840 75844 75845 75846 75847 75848 75849 75850 75851 75852 75853 75855 75856 75858 75859 75860 75861 75862 75865 75880 75882 75884 75886 75901 75902 75903 75904 75915 75925 75926 75928 75929 75930 75931 75932 75933 75934 75935 75936 75937 75938 75939 75941 75942 75943 75944 75946 75947 75948 75949 75951 75954 75956 75958 75959 75960 75961 75962 75963 75964 75965 75966 75968 75969 75972 75973 75974 75975 5.0 10.6 10.6 10.0 10.0 10.6 10.5 7.0 10.0 10.0 8.0 5.0 10.0 10.0 10.6 10.6 7.0 10.0 6.0 10.0 10.0 4.0 10.0 10.0 4.0 4.0 4.0 4.0 4.0 10.0 5.0 10.0 10.5 10.0 8.0 10.6 10.0 10.5 8.0 10.6 5.0 10.6 10.5 5.0 8.0 5.0 5.0 5.0 10.0 10.0 5.0 8.0 10.6 9.0 4.0 10.0 10.5 4.0 4.0 4.0 4.0 4.0 10.6 10.0 5.0 10.0 8.0 10.6 10.5 70215 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX Zip code RUCA level 75976 75977 75978 75979 75980 75990 76001 76002 76003 76004 76005 76006 76007 76008 76009 76010 76011 76012 76013 76014 76015 76016 76017 76018 76019 76020 76021 76022 76023 76028 76031 76033 76034 76035 76036 76039 76040 76041 76043 76044 76048 76049 76050 76051 76052 76053 76054 76055 76058 76059 76060 76061 76063 76064 76065 76066 76067 76068 76070 76071 76073 76077 76078 76082 76084 76085 76086 76087 76088 5.0 10.6 4.0 8.0 5.0 8.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 4.1 4.1 1.0 4.2 1.0 1.0 1.0 2.0 10.0 2.0 4.2 4.2 2.0 1.0 2.0 1.0 1.0 3.0 4.1 4.1 1.0 2.0 1.0 2.0 2.0 2.0 4.0 4.0 10.0 2.0 2.0 10.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00593 Fmt 4701 RUCA level 76092 76093 76094 76095 76096 76097 76098 76099 76101 76102 76103 76104 76105 76106 76107 76108 76109 76110 76111 76112 76113 76114 76115 76116 76117 76118 76119 76120 76121 76122 76123 76124 76126 76127 76129 76130 76131 76132 76133 76134 76135 76136 76137 76140 76147 76148 76150 76155 76161 76162 76163 76164 76177 76178 76179 76180 76181 76182 76185 76191 76192 76193 76195 76196 76197 76198 76199 76201 76202 1.0 5.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 76203 76204 76205 76206 76207 76208 76209 76210 76225 76226 76227 76228 76230 76233 76234 76238 76239 76240 76241 76244 76245 76246 76247 76248 76249 76250 76251 76252 76253 76255 76258 76259 76261 76262 76263 76264 76265 76266 76267 76268 76270 76271 76272 76273 76299 76301 76302 76305 76306 76307 76308 76309 76310 76311 76351 76352 76354 76357 76360 76363 76364 76365 76366 76367 76369 76370 76371 76372 76373 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 10.4 2.0 2.1 2.0 7.0 3.0 3.0 3.0 10.4 4.2 4.2 1.0 2.0 3.0 2.0 1.0 2.0 10.2 10.4 10.2 10.2 7.0 2.1 2.0 8.0 1.0 3.0 2.0 10.5 2.1 3.0 1.0 8.0 3.0 3.0 7.1 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 10.4 7.1 2.0 2.0 7.3 10.0 5.0 7.1 2.0 2.0 2.0 2.0 10.0 8.0 5.0 70216 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX Zip code RUCA level 76374 76377 76379 76380 76384 76385 76388 76389 76401 76402 76424 76426 76427 76429 76430 76431 76432 76433 76435 76436 76437 76439 76442 76443 76444 76445 76446 76448 76449 76450 76452 76453 76454 76455 76457 76458 76459 76460 76461 76462 76463 76464 76465 76466 76467 76468 76469 76470 76471 76472 76474 76475 76476 76481 76483 76484 76485 76486 76487 76490 76491 76501 76502 76503 76504 76505 76508 76511 76513 7.0 2.0 10.4 7.0 4.0 4.0 10.6 10.4 4.0 4.0 7.0 7.0 10.6 8.0 10.4 10.6 5.0 5.0 10.6 10.5 7.0 2.0 7.0 10.4 10.5 10.6 7.4 7.0 10.5 7.0 10.6 10.4 10.6 10.6 10.5 7.0 10.6 7.0 4.0 4.2 10.4 10.4 5.0 7.0 5.0 7.4 10.4 10.6 10.5 10.5 8.0 10.4 4.2 7.0 10.0 10.5 2.0 10.4 2.0 2.0 10.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00594 Fmt 4701 RUCA level 76518 76519 76520 76522 76523 76524 76525 76526 76527 76528 76530 76531 76533 76534 76537 76538 76539 76540 76541 76542 76543 76544 76545 76546 76547 76548 76549 76550 76554 76556 76557 76558 76559 76561 76564 76565 76566 76567 76569 76570 76571 76573 76574 76577 76578 76579 76596 76597 76598 76599 76621 76622 76623 76624 76626 76627 76628 76629 76630 76631 76632 76633 76634 76635 76636 76637 76638 76639 76640 10.4 10.4 7.3 1.0 10.6 2.0 2.0 2.0 2.0 4.0 2.0 7.0 1.0 2.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.3 2.0 10.4 2.0 4.0 1.0 2.0 2.0 10.6 2.0 7.3 2.0 10.4 2.0 2.0 2.0 2.0 2.0 2.0 2.0 4.0 4.0 4.0 9.0 10.6 4.1 2.0 5.0 3.0 8.0 10.0 2.0 8.0 2.0 2.0 8.4 10.1 3.0 10.6 2.0 5.0 2.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 76641 76642 76643 76644 76645 76648 76649 76650 76651 76652 76653 76654 76655 76656 76657 76660 76661 76664 76665 76666 76667 76670 76671 76673 76675 76676 76678 76679 76680 76681 76682 76684 76685 76686 76687 76689 76690 76691 76692 76693 76701 76702 76703 76704 76705 76706 76707 76708 76710 76711 76712 76714 76715 76716 76795 76797 76798 76799 76801 76802 76803 76804 76820 76821 76823 76824 76825 76827 76828 5.0 7.0 1.0 8.4 7.0 10.4 10.4 8.0 2.0 10.4 8.0 2.0 2.0 10.4 2.0 3.0 7.3 2.0 10.4 8.0 7.0 2.0 3.0 10.4 2.0 3.0 10.1 5.0 10.6 5.0 2.0 2.0 2.0 7.0 8.0 2.0 10.4 2.0 10.6 10.5 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 4.0 4.0 4.0 10.0 7.0 5.0 7.0 7.0 5.0 8.0 70217 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX Zip code RUCA level 76831 76832 76834 76836 76837 76841 76842 76844 76845 76848 76849 76852 76853 76854 76855 76856 76857 76858 76859 76861 76862 76864 76865 76866 76867 76869 76870 76871 76872 76873 76874 76875 76877 76878 76880 76882 76883 76884 76885 76886 76887 76888 76890 76901 76902 76903 76904 76905 76906 76908 76909 76930 76932 76933 76934 76935 76936 76937 76939 76940 76941 76943 76945 76949 76950 76951 76953 76955 76957 10.6 10.6 7.0 10.3 10.0 10.0 10.0 10.0 10.6 10.0 7.0 10.3 10.6 10.3 10.4 10.0 5.0 10.3 10.0 10.1 10.4 10.0 10.3 10.4 10.3 10.0 10.0 10.6 10.3 10.6 10.3 10.1 7.0 10.6 10.0 10.6 10.3 10.6 8.0 1.0 8.0 10.6 5.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.4 7.0 10.4 2.0 2.0 10.4 10.4 1.0 2.0 10.4 7.0 10.4 10.4 7.0 10.0 10.4 2.0 2.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00595 Fmt 4701 RUCA level 76958 77001 77002 77003 77004 77005 77006 77007 77008 77009 77010 77011 77012 77013 77014 77015 77016 77017 77018 77019 77020 77021 77022 77023 77024 77025 77026 77027 77028 77029 77030 77031 77032 77033 77034 77035 77036 77037 77038 77039 77040 77041 77042 77043 77044 77045 77046 77047 77048 77049 77050 77051 77052 77053 77054 77055 77056 77057 77058 77059 77060 77061 77062 77063 77064 77065 77066 77067 77068 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 77069 77070 77071 77072 77073 77074 77075 77076 77077 77078 77079 77080 77081 77082 77083 77084 77085 77086 77087 77088 77089 77090 77091 77092 77093 77094 77095 77096 77097 77098 77099 77201 77202 77203 77204 77205 77206 77207 77208 77209 77210 77212 77213 77215 77216 77217 77218 77219 77220 77221 77222 77223 77224 77225 77226 77227 77228 77229 77230 77231 77233 77234 77235 77236 77237 77238 77240 77241 77242 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70218 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX Zip code RUCA level 77243 77244 77245 77248 77249 77250 77251 77252 77253 77254 77255 77256 77257 77258 77259 77261 77262 77263 77265 77266 77267 77268 77269 77270 77271 77272 77273 77274 77275 77277 77279 77280 77281 77282 77284 77287 77288 77289 77290 77291 77292 77293 77297 77298 77299 77301 77302 77303 77304 77305 77306 77315 77316 77318 77320 77325 77326 77327 77328 77331 77332 77333 77334 77335 77336 77337 77338 77339 77340 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.2 2.0 5.2 4.2 4.2 5.2 1.0 2.0 2.0 4.0 1.0 10.6 7.1 2.0 10.4 10.6 2.0 4.0 10.6 1.0 2.0 1.0 1.0 4.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00596 Fmt 4701 RUCA level 77341 77342 77343 77344 77345 77346 77347 77348 77349 77350 77351 77353 77354 77355 77356 77357 77358 77359 77360 77362 77363 77364 77365 77367 77368 77369 77371 77372 77373 77374 77375 77376 77377 77378 77379 77380 77381 77382 77383 77384 77385 77386 77387 77388 77389 77391 77393 77396 77399 77401 77402 77404 77406 77410 77411 77412 77413 77414 77415 77417 77418 77419 77420 77422 77423 77426 77428 77429 77430 4.0 4.0 4.0 4.0 1.0 1.0 1.0 4.0 4.0 10.6 10.6 2.0 2.0 2.0 2.0 1.0 5.0 6.1 10.6 2.0 2.0 6.1 1.0 4.0 7.1 7.1 10.4 2.0 1.0 3.0 2.0 3.0 1.0 5.0 1.0 2.0 2.0 2.0 1.0 2.0 2.0 2.0 2.0 1.0 1.0 1.0 2.0 1.0 10.6 1.0 1.0 4.0 1.0 1.0 1.0 10.6 1.0 4.0 4.0 2.0 7.3 10.2 10.6 2.0 2.0 5.2 7.4 1.0 2.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 77431 77432 77433 77434 77435 77436 77437 77440 77441 77442 77443 77444 77445 77446 77447 77448 77449 77450 77451 77452 77453 77454 77455 77456 77457 77458 77459 77460 77461 77463 77464 77465 77466 77467 77468 77469 77470 77471 77473 77474 77475 77476 77477 77478 77479 77480 77481 77482 77483 77484 77485 77486 77487 77488 77489 77491 77492 77493 77494 77496 77497 77501 77502 77503 77504 77505 77506 77507 77508 2.0 4.0 2.0 7.3 10.4 10.4 4.0 10.2 2.0 10.6 10.4 2.0 7.1 2.0 2.0 10.4 1.0 1.0 2.0 7.3 7.3 10.4 5.0 10.2 10.5 10.2 1.0 10.6 2.0 2.0 1.0 7.4 2.0 4.0 4.0 1.0 10.6 1.0 7.1 7.1 10.6 2.0 1.0 1.0 1.0 2.0 1.0 4.0 10.5 2.0 2.0 2.0 1.0 7.3 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70219 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX Zip code RUCA level 77510 77511 77512 77514 77515 77516 77517 77518 77519 77520 77521 77522 77530 77531 77532 77533 77534 77535 77536 77538 77539 77541 77542 77545 77546 77547 77549 77550 77551 77552 77553 77554 77555 77560 77561 77562 77563 77564 77565 77566 77568 77571 77572 77573 77574 77575 77577 77578 77580 77581 77582 77583 77584 77585 77586 77587 77588 77590 77591 77592 77597 77598 77611 77612 77613 77614 77615 77616 77617 1.1 1.0 1.0 10.1 1.0 1.0 1.1 1.0 3.0 1.0 1.0 1.0 1.0 1.0 1.0 3.0 1.0 2.0 1.0 7.3 1.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.1 1.0 2.0 7.3 1.0 1.1 3.0 1.0 1.0 1.1 1.0 1.0 1.0 1.0 7.3 2.0 1.0 1.0 1.0 7.3 2.0 1.0 3.0 1.0 1.0 1.0 1.1 1.1 1.1 2.0 1.0 4.2 3.0 2.0 5.0 3.0 10.4 3.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00597 Fmt 4701 RUCA level 77619 77622 77623 77624 77625 77626 77627 77629 77630 77631 77632 77639 77640 77641 77642 77643 77650 77651 77655 77656 77657 77659 77660 77661 77662 77663 77664 77665 77670 77701 77702 77703 77704 77705 77706 77707 77708 77709 77710 77713 77720 77725 77726 77801 77802 77803 77805 77806 77807 77808 77830 77831 77833 77834 77835 77836 77837 77838 77840 77841 77842 77843 77844 77845 77850 77852 77853 77855 77856 1.0 2.0 3.0 8.0 2.0 5.2 1.0 2.0 4.2 4.2 5.2 4.2 1.0 1.0 1.0 1.0 3.0 1.0 1.0 7.1 1.0 2.0 10.4 7.3 1.0 2.0 10.4 7.3 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 10.4 9.0 4.0 4.0 5.0 7.1 10.4 7.1 1.0 1.0 1.0 1.0 1.0 1.0 10.4 7.1 8.0 10.4 10.4 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 77857 77859 77861 77862 77863 77864 77865 77866 77867 77868 77869 77870 77871 77872 77873 77875 77876 77878 77879 77880 77881 77882 77901 77902 77903 77904 77905 77950 77951 77954 77957 77960 77961 77962 77963 77964 77967 77968 77969 77970 77971 77973 77974 77975 77976 77977 77978 77979 77982 77983 77984 77986 77987 77988 77989 77990 77991 77993 77994 77995 78001 78002 78003 78004 78005 78006 78007 78008 78009 10.4 7.1 10.4 1.0 10.4 7.0 10.4 1.0 7.1 7.3 7.3 10.4 10.4 10.4 9.0 10.4 10.4 10.4 10.4 5.2 1.0 10.4 1.0 1.0 1.0 1.0 2.0 10.4 2.0 7.0 7.0 2.0 10.5 10.5 2.0 10.0 7.0 1.0 7.0 10.5 10.5 2.0 8.0 10.6 1.0 2.0 10.5 4.0 4.0 10.5 10.0 10.0 7.0 2.0 7.0 10.4 7.0 2.0 7.0 7.0 7.0 1.0 10.4 2.0 7.3 2.0 10.0 4.1 2.0 70220 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX Zip code RUCA level 78010 78011 78012 78013 78014 78015 78016 78017 78019 78021 78022 78023 78024 78025 78026 78027 78028 78029 78039 78040 78041 78042 78043 78044 78045 78046 78049 78050 78052 78054 78055 78056 78057 78058 78059 78060 78061 78062 78063 78064 78065 78066 78067 78069 78070 78071 78072 78073 78074 78075 78076 78101 78102 78104 78107 78108 78109 78111 78112 78113 78114 78115 78116 78117 78118 78119 78121 78122 78123 5.0 10.5 4.1 7.3 7.0 2.0 7.1 7.0 10.1 7.0 7.0 1.0 4.0 4.0 4.1 7.3 4.0 4.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.1 2.0 1.0 10.0 2.0 7.3 4.0 2.0 10.0 7.3 4.1 2.0 4.1 2.0 2.0 10.4 2.0 2.0 10.0 10.0 2.0 7.3 10.0 7.0 2.0 5.0 5.0 2.0 1.0 1.0 10.4 2.0 10.4 2.0 4.2 10.4 10.4 7.0 7.0 2.0 10.5 4.2 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00598 Fmt 4701 RUCA level 78124 78125 78130 78131 78132 78133 78135 78140 78141 78142 78143 78144 78145 78146 78147 78148 78150 78151 78152 78154 78155 78156 78159 78160 78161 78162 78163 78164 78201 78202 78203 78204 78205 78206 78207 78208 78209 78210 78211 78212 78213 78214 78215 78216 78217 78218 78219 78220 78221 78222 78223 78224 78225 78226 78227 78228 78229 78230 78231 78232 78233 78234 78235 78236 78237 78238 78239 78240 78241 2.0 5.0 4.2 4.2 2.0 2.0 4.2 10.5 10.0 5.0 10.4 10.4 5.0 5.0 2.0 1.0 1.0 10.6 2.0 1.0 4.2 4.2 10.6 10.4 2.0 5.0 2.0 10.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.4 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 78242 78243 78244 78245 78246 78247 78248 78249 78250 78251 78252 78253 78254 78255 78256 78257 78258 78259 78260 78261 78262 78263 78264 78265 78266 78268 78269 78270 78275 78278 78279 78280 78283 78284 78285 78286 78287 78288 78289 78291 78292 78293 78294 78295 78296 78297 78298 78299 78330 78332 78333 78335 78336 78338 78339 78340 78341 78342 78343 78344 78347 78349 78350 78351 78352 78353 78355 78357 78358 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 4.0 4.0 4.2 4.2 10.0 2.0 10.6 10.0 4.0 5.2 1.0 1.0 10.0 7.0 2.0 2.0 8.0 7.0 7.0 4.0 70221 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX Zip code RUCA level 78359 78360 78361 78362 78363 78364 78368 78369 78370 78371 78372 78373 78374 78375 78376 78377 78379 78380 78381 78382 78383 78384 78385 78387 78389 78390 78391 78393 78401 78402 78403 78404 78405 78406 78407 78408 78409 78410 78411 78412 78413 78414 78415 78416 78417 78418 78419 78426 78427 78460 78461 78463 78465 78466 78467 78468 78469 78470 78471 78472 78473 78474 78475 78476 78477 78478 78480 78501 78502 1.0 7.3 7.3 4.2 4.0 4.0 2.0 1.0 2.0 1.0 2.0 7.3 1.0 7.0 10.6 7.0 5.0 2.0 4.0 4.0 2.0 7.4 10.0 7.3 10.5 2.0 10.5 10.6 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00599 Fmt 4701 RUCA level 78503 78504 78505 78516 78520 78521 78522 78523 78526 78535 78536 78537 78538 78539 78540 78541 78543 78545 78547 78548 78549 78550 78551 78552 78553 78557 78558 78559 78560 78561 78562 78563 78564 78565 78566 78567 78568 78569 78570 78572 78573 78574 78575 78576 78577 78578 78579 78580 78582 78583 78584 78585 78586 78588 78589 78590 78591 78592 78593 78594 78595 78596 78597 78598 78599 78602 78604 78605 78606 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.4 1.0 1.0 1.0 1.0 1.0 1.0 4.0 5.2 5.2 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.2 1.0 2.0 7.0 2.0 1.0 1.0 2.0 10.4 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.2 1.0 4.2 4.2 2.0 4.0 4.0 1.0 10.4 1.0 10.5 10.4 1.0 1.0 2.0 2.0 1.0 4.2 10.5 1.0 2.0 7.0 2.0 10.4 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 78607 78608 78609 78610 78611 78612 78613 78614 78615 78616 78617 78618 78619 78620 78621 78622 78623 78624 78626 78627 78628 78629 78630 78631 78632 78634 78635 78636 78638 78639 78640 78641 78642 78643 78644 78645 78646 78648 78650 78651 78652 78653 78654 78655 78656 78657 78658 78659 78660 78661 78662 78663 78664 78666 78667 78669 78670 78671 78672 78673 78674 78675 78676 78677 78680 78681 78682 78683 78691 8.0 2.0 10.4 1.0 9.0 2.0 1.0 10.6 2.0 2.0 2.0 10.5 2.0 2.0 2.0 5.2 2.0 7.0 2.0 2.0 2.0 7.0 1.0 10.5 10.6 2.0 10.4 10.4 4.2 9.0 4.2 1.0 2.0 7.0 2.0 2.0 1.0 7.3 2.0 1.0 1.0 2.0 7.0 5.2 5.2 10.6 7.0 2.0 1.0 5.2 2.0 10.4 1.0 4.2 4.2 2.0 4.2 8.0 8.0 2.0 2.0 8.0 3.0 10.6 1.0 1.0 1.0 1.0 1.0 70222 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX Zip code RUCA level 78701 78702 78703 78704 78705 78708 78709 78710 78711 78712 78713 78714 78715 78716 78717 78718 78719 78720 78721 78722 78723 78724 78725 78726 78727 78728 78729 78730 78731 78732 78733 78734 78735 78736 78737 78738 78739 78741 78742 78744 78745 78746 78747 78748 78749 78750 78751 78752 78753 78754 78755 78756 78757 78758 78759 78760 78761 78762 78763 78764 78765 78766 78767 78768 78769 78772 78773 78774 78778 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 2.0 1.0 2.0 1.0 2.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00600 Fmt 4701 RUCA level 78779 78780 78781 78783 78785 78786 78788 78789 78799 78801 78802 78827 78828 78829 78830 78832 78833 78834 78836 78837 78838 78839 78840 78841 78842 78843 78847 78850 78851 78852 78853 78860 78861 78870 78871 78872 78873 78877 78879 78880 78881 78883 78884 78885 78886 78931 78932 78933 78934 78935 78938 78940 78941 78942 78943 78944 78945 78946 78947 78948 78949 78950 78951 78952 78953 78954 78956 78957 78959 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 4.0 8.0 10.0 10.5 10.6 10.5 10.0 7.0 8.0 10.2 10.5 7.0 4.0 4.0 4.0 4.0 4.0 8.0 10.0 4.0 4.0 4.0 7.3 4.0 10.2 10.2 10.0 10.2 10.0 10.0 10.5 10.4 10.5 10.0 7.3 6.0 10.5 7.4 7.0 8.0 10.6 10.6 10.6 7.3 7.0 6.0 7.0 8.0 2.0 8.0 10.6 6.0 10.6 7.0 2.0 10.5 7.0 2.0 10.6 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 78960 78961 78962 78963 79001 79002 79003 79005 79007 79008 79009 79010 79011 79012 79013 79014 79015 79016 79018 79019 79021 79022 79024 79025 79027 79029 79031 79032 79033 79034 79035 79036 79039 79040 79041 79042 79043 79044 79045 79046 79051 79052 79053 79054 79056 79057 79058 79059 79061 79062 79063 79064 79065 79066 79068 79070 79072 79073 79077 79078 79079 79080 79081 79082 79083 79084 79085 79086 79087 7.0 10.5 10.6 8.0 10.4 10.2 10.0 10.6 4.0 4.0 10.0 10.4 10.0 1.0 4.0 10.0 2.0 2.0 7.0 2.0 2.0 7.0 10.0 4.0 7.0 4.0 10.0 4.0 7.0 10.0 7.0 5.0 10.4 10.6 5.0 10.6 10.6 7.0 4.0 10.0 7.0 5.0 10.0 4.0 10.0 10.2 7.2 10.5 10.0 7.0 10.6 10.5 4.0 4.0 10.1 7.0 4.0 4.0 10.0 5.0 10.0 10.4 7.0 10.0 5.0 10.0 10.6 10.6 10.6 70223 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX Zip code RUCA level 79088 79091 79092 79093 79094 79095 79096 79097 79098 79101 79102 79103 79104 79105 79106 79107 79108 79109 79110 79111 79114 79116 79117 79118 79119 79120 79121 79123 79124 79159 79163 79165 79166 79167 79168 79170 79171 79172 79174 79175 79178 79180 79181 79182 79184 79185 79186 79187 79189 79201 79220 79221 79223 79225 79226 79227 79229 79230 79231 79232 79233 79234 79235 79236 79237 79239 79240 79241 79243 7.0 2.0 10.4 7.0 2.0 10.0 10.0 10.4 10.4 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.0 10.0 10.5 10.0 7.4 10.0 10.5 10.0 10.0 7.4 10.0 10.0 10.0 7.4 10.0 10.0 10.0 10.0 10.5 10.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00601 Fmt 4701 RUCA level 79244 79245 79247 79248 79250 79251 79252 79255 79256 79257 79258 79259 79261 79311 79312 79313 79314 79316 79320 79322 79323 79324 79325 79326 79329 79330 79331 79336 79338 79339 79342 79343 79344 79345 79346 79347 79350 79351 79353 79355 79356 79357 79358 79359 79360 79363 79364 79366 79367 79369 79370 79371 79372 79373 79376 79377 79378 79379 79380 79381 79382 79383 79401 79402 79403 79404 79405 79406 79407 10.0 10.0 5.0 10.0 2.0 10.0 7.4 10.0 10.0 10.0 10.5 8.0 10.0 2.0 10.6 2.0 10.5 7.0 7.0 10.4 7.0 7.0 10.0 10.5 2.0 7.3 4.0 4.2 4.2 7.3 10.6 2.0 7.0 10.6 10.5 7.0 1.0 10.6 5.2 10.6 7.3 10.4 2.0 10.6 10.3 2.0 2.0 2.0 4.2 7.3 10.0 10.6 4.2 7.3 10.6 10.2 7.0 10.5 4.2 2.0 1.0 7.3 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 79408 79409 79410 79411 79412 79413 79414 79415 79416 79423 79424 79430 79452 79453 79457 79464 79490 79491 79493 79499 79501 79502 79503 79504 79505 79506 79508 79510 79511 79512 79516 79517 79518 79519 79520 79521 79525 79526 79527 79528 79529 79530 79532 79533 79534 79535 79536 79537 79538 79539 79540 79541 79543 79544 79545 79546 79547 79548 79549 79550 79553 79556 79560 79561 79562 79563 79565 79566 79567 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.4 10.0 7.0 10.4 7.0 10.5 2.0 2.0 5.0 7.0 4.0 5.0 10.0 8.0 10.0 7.0 2.0 4.0 5.0 10.0 10.0 2.0 10.3 2.0 10.0 10.5 2.0 10.5 8.0 10.6 10.0 2.0 10.5 10.6 10.5 10.0 10.6 10.6 4.0 4.0 7.0 4.0 10.5 2.0 2.0 2.0 10.6 10.3 7.0 70224 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX Zip code RUCA level 79601 79602 79603 79604 79605 79606 79607 79608 79697 79698 79699 79701 79702 79703 79704 79705 79706 79707 79708 79710 79711 79712 79713 79714 79718 79719 79720 79721 79730 79731 79733 79734 79735 79738 79739 79740 79741 79742 79743 79744 79745 79748 79749 79752 79754 79755 79756 79758 79759 79760 79761 79762 79763 79764 79765 79766 79768 79769 79770 79772 79776 79777 79778 79780 79781 79782 79783 79785 79786 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 2.0 1.0 10.2 4.0 5.0 10.3 4.0 4.0 10.0 7.3 4.0 10.6 7.0 10.5 10.5 7.0 2.0 10.3 10.0 10.0 7.0 5.0 10.6 10.0 10.2 10.0 7.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 4.0 4.0 2.0 10.3 10.0 5.0 10.0 7.3 10.6 4.0 5.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00602 Fmt 4701 RUCA level 79788 79789 79821 79830 79831 79832 79834 79835 79836 79837 79838 79839 79842 79843 79845 79846 79847 79848 79849 79851 79852 79853 79854 79855 79901 79902 79903 79904 79905 79906 79907 79908 79910 79911 79912 79913 79914 79915 79916 79917 79918 79920 79922 79923 79924 79925 79926 79927 79928 79929 79930 79931 79932 79934 79935 79936 79937 79938 79940 79941 79942 79943 79944 79945 79946 79947 79948 79949 79950 7.0 8.0 1.0 7.0 7.0 7.0 8.0 1.0 2.0 10.4 2.0 10.4 10.6 10.0 7.0 7.0 10.0 10.0 1.0 10.0 8.0 2.0 10.6 10.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 79951 79952 79953 79954 79955 79958 79960 79961 79966 79968 79973 79974 79975 79976 79977 79978 79980 79982 79983 79984 79985 79986 79987 79988 79989 79990 79991 79992 79993 79994 79995 79996 79997 79998 79999 88510 88511 88512 88513 88514 88515 88516 88517 88518 88519 88520 88521 88523 88524 88525 88526 88527 88528 88529 88530 88531 88532 88533 88534 88535 88536 88538 88539 88540 88541 88542 88543 88544 88545 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70225 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX TX UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT Zip code RUCA level 88546 88547 88548 88549 88550 88553 88554 88555 88556 88557 88558 88559 88560 88561 88562 88563 88565 88566 88567 88568 88569 88570 88571 88572 88573 88574 88575 88576 88577 88578 88579 88580 88581 88582 88583 88584 88585 88586 88587 88588 88589 88590 88595 84001 84002 84003 84004 84006 84007 84008 84010 84011 84013 84014 84015 84016 84017 84018 84020 84021 84022 84023 84024 84025 84026 84027 84028 84029 84030 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.3 10.3 1.0 1.0 1.0 10.3 4.0 1.0 1.0 2.0 1.0 1.0 1.0 10.6 2.0 1.0 10.0 7.0 10.0 10.6 1.0 10.6 10.0 10.0 3.0 10.6 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00603 Fmt 4701 RUCA level 84031 84032 84033 84034 84035 84036 84037 84038 84039 84040 84041 84042 84043 84044 84046 84047 84049 84050 84051 84052 84053 84054 84055 84056 84057 84058 84059 84060 84061 84062 84063 84064 84065 84066 84067 84068 84069 84070 84071 84072 84073 84074 84075 84076 84078 84079 84080 84082 84083 84084 84085 84086 84087 84088 84089 84090 84091 84092 84093 84094 84095 84097 84098 84101 84102 84103 84104 84105 84106 10.0 7.0 10.6 7.0 5.0 10.6 1.0 10.0 10.6 1.0 1.0 1.0 1.0 1.0 10.0 1.0 7.0 2.0 10.0 10.6 10.3 1.0 10.6 1.0 1.0 1.0 1.0 7.3 10.6 1.0 10.0 10.0 1.0 7.0 1.0 7.3 2.0 1.0 2.0 10.0 10.0 4.1 1.0 10.6 4.0 4.0 2.0 7.0 7.0 1.0 10.6 10.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 84107 84108 84109 84110 84111 84112 84113 84114 84115 84116 84117 84118 84119 84120 84121 84122 84123 84124 84125 84126 84127 84128 84130 84131 84132 84133 84134 84136 84138 84139 84141 84143 84144 84145 84147 84148 84150 84151 84152 84153 84157 84158 84165 84170 84171 84180 84184 84189 84190 84199 84201 84244 84301 84302 84304 84305 84306 84307 84308 84309 84310 84311 84312 84313 84314 84315 84316 84317 84318 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.5 4.2 7.4 2.0 7.4 10.5 2.0 7.4 2.0 7.4 7.4 10.6 10.5 1.0 10.6 2.0 1.0 70226 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT Zip code RUCA level 84319 84320 84321 84322 84323 84324 84325 84326 84327 84328 84329 84330 84331 84332 84333 84334 84335 84336 84337 84338 84339 84340 84341 84401 84402 84403 84404 84405 84407 84408 84409 84412 84414 84415 84501 84510 84511 84512 84513 84515 84516 84518 84520 84521 84522 84523 84525 84526 84527 84528 84529 84530 84531 84532 84533 84534 84535 84536 84537 84539 84540 84542 84601 84602 84603 84604 84605 84606 84620 1.0 2.0 1.0 1.0 1.0 4.2 1.0 1.0 1.0 2.0 10.6 10.6 10.6 1.0 2.0 7.4 1.0 10.6 7.4 2.0 1.0 4.2 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 8.0 7.0 7.0 10.5 7.0 10.0 10.5 5.0 10.5 10.0 10.0 10.6 4.0 4.0 10.5 4.0 10.6 10.0 7.0 7.0 8.0 10.6 10.0 10.5 5.0 7.0 4.0 1.0 1.0 1.0 1.0 1.0 1.0 10.6 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00604 Fmt 4701 RUCA level 84621 84622 84623 84624 84626 84627 84628 84629 84630 84631 84632 84633 84634 84635 84636 84637 84638 84639 84640 84642 84643 84644 84645 84646 84647 84648 84649 84650 84651 84652 84653 84654 84655 84656 84657 84660 84662 84663 84664 84665 84667 84701 84710 84711 84712 84713 84714 84715 84716 84717 84718 84719 84720 84721 84722 84723 84724 84725 84726 84728 84729 84730 84731 84732 84733 84734 84735 84736 84737 7.0 7.0 10.6 7.0 2.0 7.0 3.0 10.6 7.0 10.6 10.6 2.0 7.0 8.0 10.6 10.6 7.0 7.3 7.0 7.0 7.0 10.6 3.0 10.6 10.6 7.3 7.0 8.0 2.0 10.6 2.0 10.6 2.0 10.6 7.0 2.0 10.6 1.0 1.0 7.0 10.6 7.0 10.6 7.0 10.0 10.0 5.0 10.0 10.0 10.0 10.0 10.2 4.0 4.0 2.0 10.6 8.0 2.0 10.0 8.0 10.6 7.0 10.0 10.6 1.0 10.0 10.0 10.0 7.1 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT UT VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 84738 84739 84740 84741 84742 84743 84744 84745 84746 84747 84749 84750 84751 84752 84753 84754 84755 84756 84757 84758 84759 84760 84761 84762 84763 84764 84765 84766 84767 84770 84771 84772 84773 84774 84775 84776 84779 84780 84781 84782 84783 84784 84790 84791 20101 20102 20103 20104 20105 20106 20107 20108 20109 20110 20111 20112 20113 20115 20116 20117 20118 20119 20120 20121 20122 20124 20128 20129 20130 1.0 8.0 10.6 7.0 4.0 10.6 7.0 7.1 7.1 10.0 10.0 10.6 10.0 10.0 5.0 8.0 10.6 5.0 10.1 10.6 10.0 10.2 10.2 10.6 7.1 10.0 1.0 8.0 7.1 1.0 1.0 10.2 10.0 7.1 10.0 10.0 7.1 1.0 2.0 1.0 1.0 7.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 70227 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA Zip code RUCA level 20131 20132 20134 20135 20136 20137 20138 20139 20140 20141 20142 20143 20144 20146 20147 20148 20149 20151 20152 20153 20155 20156 20158 20159 20160 20163 20164 20165 20166 20167 20168 20169 20170 20171 20172 20175 20176 20177 20178 20180 20181 20182 20184 20185 20186 20187 20188 20189 20190 20191 20192 20193 20194 20195 20196 20197 20198 20199 22003 22009 22015 22025 22026 22027 22030 22031 22032 22033 22034 2.0 2.0 2.0 2.0 1.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00605 Fmt 4701 RUCA level 22035 22036 22037 22038 22039 22040 22041 22042 22043 22044 22046 22047 22060 22066 22067 22079 22081 22082 22092 22093 22095 22096 22101 22102 22103 22106 22107 22108 22109 22116 22118 22119 22120 22121 22122 22124 22125 22134 22135 22150 22151 22152 22153 22156 22158 22159 22160 22161 22172 22180 22181 22182 22183 22184 22185 22191 22192 22193 22194 22195 22199 22201 22202 22203 22204 22205 22206 22207 22209 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 22210 22211 22212 22213 22214 22215 22216 22217 22218 22219 22222 22223 22225 22226 22227 22229 22230 22234 22240 22241 22242 22243 22244 22245 22246 22301 22302 22303 22304 22305 22306 22307 22308 22309 22310 22311 22312 22313 22314 22315 22320 22321 22331 22332 22333 22334 22336 22401 22402 22403 22404 22405 22406 22407 22408 22412 22427 22428 22430 22432 22433 22435 22436 22437 22438 22442 22443 22446 22448 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 2.0 10.4 10.4 1.0 10.0 9.0 10.0 8.0 8.1 8.0 10.0 7.0 2.1 10.4 70228 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA Zip code RUCA level 22451 22454 22456 22460 22463 22469 22471 22472 22473 22476 22480 22481 22482 22485 22488 22501 22503 22504 22507 22508 22509 22511 22513 22514 22517 22520 22523 22524 22526 22528 22529 22530 22534 22535 22538 22539 22542 22544 22545 22546 22547 22548 22552 22553 22554 22555 22556 22558 22560 22565 22567 22570 22572 22576 22577 22578 22579 22580 22581 22601 22602 22603 22604 22610 22611 22620 22622 22623 22624 10.4 8.1 10.0 10.0 1.0 10.0 2.0 10.6 10.0 8.0 10.0 10.4 10.0 10.4 10.0 3.0 10.0 8.1 10.0 3.0 8.0 10.0 10.0 3.0 10.0 10.0 10.0 10.0 10.4 10.0 10.0 10.0 2.1 2.0 2.0 10.0 9.0 10.4 1.0 3.0 10.4 10.6 3.0 1.0 1.0 1.0 1.0 10.0 7.3 1.0 9.0 10.0 10.6 10.0 10.0 10.0 10.0 2.1 10.0 1.0 1.0 2.0 1.0 5.2 7.3 10.4 2.0 4.2 2.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00606 Fmt 4701 RUCA level 22625 22626 22627 22630 22637 22638 22639 22640 22641 22642 22643 22644 22645 22646 22649 22650 22652 22654 22655 22656 22657 22660 22663 22664 22701 22709 22711 22712 22713 22714 22715 22716 22718 22719 22720 22721 22722 22723 22724 22725 22726 22727 22728 22729 22730 22731 22732 22733 22734 22735 22736 22737 22738 22739 22740 22741 22742 22743 22746 22747 22748 22749 22801 22802 22803 22807 22810 22811 22812 2.0 7.3 10.4 4.2 2.0 1.0 2.0 10.4 9.0 2.0 2.0 9.0 2.0 10.4 6.1 7.0 10.6 2.0 1.0 2.0 7.3 9.0 1.0 7.0 7.3 10.6 10.4 2.0 8.3 10.6 10.6 10.4 10.6 10.4 2.0 10.4 10.6 10.4 2.0 10.6 10.6 10.4 2.0 7.3 10.6 10.4 10.6 7.3 2.0 8.3 10.6 2.0 10.6 2.0 10.4 10.6 2.0 10.4 2.0 10.4 10.4 10.4 1.0 1.0 1.0 1.0 9.0 2.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 22815 22820 22821 22824 22827 22830 22831 22832 22833 22834 22835 22840 22841 22842 22843 22844 22845 22846 22847 22848 22849 22850 22851 22853 22901 22902 22903 22904 22905 22906 22907 22908 22909 22910 22911 22920 22922 22923 22924 22931 22932 22935 22936 22937 22938 22939 22940 22942 22943 22945 22946 22947 22948 22949 22952 22954 22957 22958 22959 22960 22963 22964 22965 22967 22968 22969 22971 22972 22973 2.0 2.0 2.0 8.0 2.0 2.0 2.0 2.0 1.0 2.0 7.0 2.0 1.0 10.6 2.0 10.4 9.0 1.0 10.6 1.0 3.0 2.0 10.6 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.1 2.0 2.0 1.0 2.0 2.0 2.0 2.0 2.0 2.0 6.0 2.0 3.0 2.0 1.0 2.0 2.0 10.6 10.4 4.0 10.4 7.0 10.1 2.0 7.0 2.0 10.4 2.0 10.4 2.0 2.0 2.0 3.0 2.0 70229 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA Zip code RUCA level 22974 22976 22980 22987 22989 23001 23002 23003 23004 23005 23009 23011 23014 23015 23017 23018 23021 23022 23023 23024 23025 23027 23030 23031 23032 23035 23038 23039 23040 23043 23045 23047 23050 23055 23056 23058 23059 23060 23061 23062 23063 23064 23065 23066 23067 23068 23069 23070 23071 23072 23075 23076 23079 23081 23083 23084 23085 23086 23089 23090 23091 23092 23093 23101 23102 23103 23105 23106 23107 2.0 10.4 4.0 2.0 10.6 1.0 2.0 2.0 10.4 1.0 2.0 3.0 2.0 2.0 2.0 1.0 10.4 10.1 2.0 2.0 10.4 2.0 2.0 10.4 10.0 10.4 2.0 2.0 2.0 10.4 10.4 2.0 10.4 10.1 10.4 1.0 1.0 1.0 2.0 1.0 2.0 10.4 2.0 10.4 3.0 10.4 2.0 10.4 10.4 1.0 1.0 10.4 10.0 1.0 2.0 10.1 2.0 2.0 3.0 1.0 2.0 10.4 3.0 2.0 2.0 2.0 2.0 2.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00607 Fmt 4701 RUCA level 23108 23109 23110 23111 23112 23113 23114 23115 23116 23117 23119 23120 23123 23124 23125 23126 23127 23128 23129 23130 23131 23138 23139 23140 23141 23146 23147 23148 23149 23150 23153 23154 23155 23156 23160 23161 23162 23163 23168 23169 23170 23173 23175 23176 23177 23178 23180 23181 23183 23184 23185 23186 23187 23188 23190 23191 23192 23218 23219 23220 23221 23222 23223 23224 23225 23226 23227 23228 23229 3.0 10.4 3.0 1.0 1.0 1.0 1.0 7.3 1.0 2.0 10.4 2.0 10.4 2.0 10.4 2.0 1.0 10.4 2.0 10.4 1.0 10.4 2.0 2.0 2.0 2.0 2.0 2.0 10.4 1.0 2.0 2.0 2.0 3.0 2.0 2.0 1.0 10.4 2.0 10.4 3.0 1.0 10.4 10.4 2.0 2.0 10.0 7.3 2.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 23230 23231 23232 23233 23234 23235 23236 23237 23238 23240 23241 23242 23249 23250 23255 23260 23261 23269 23270 23272 23273 23274 23275 23276 23278 23279 23280 23282 23284 23285 23286 23288 23289 23290 23291 23292 23293 23294 23295 23297 23298 23301 23302 23303 23304 23306 23307 23308 23310 23313 23314 23315 23316 23320 23321 23322 23323 23324 23325 23326 23327 23328 23336 23337 23341 23345 23347 23350 23354 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.0 9.0 9.0 2.0 10.0 10.0 10.0 10.0 10.0 1.0 3.0 10.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.0 9.0 10.0 10.0 10.0 10.0 10.0 70230 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA Zip code RUCA level 23356 23357 23358 23359 23389 23395 23396 23397 23398 23399 23401 23404 23405 23407 23408 23409 23410 23412 23413 23414 23415 23416 23417 23418 23419 23420 23421 23422 23423 23424 23426 23427 23429 23430 23431 23432 23433 23434 23435 23436 23437 23438 23439 23440 23441 23442 23443 23450 23451 23452 23453 23454 23455 23456 23457 23458 23459 23460 23461 23462 23463 23464 23465 23466 23467 23468 23471 23479 23480 9.0 10.0 10.0 10.0 10.0 9.0 9.0 2.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 9.0 9.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 1.0 10.0 10.0 10.0 2.0 2.0 1.0 1.0 4.1 1.0 1.0 5.1 5.1 4.1 10.0 10.0 9.0 10.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00608 Fmt 4701 RUCA level 23482 23483 23486 23487 23488 23501 23502 23503 23504 23505 23506 23507 23508 23509 23510 23511 23512 23513 23514 23515 23517 23518 23519 23520 23521 23523 23529 23530 23541 23551 23601 23602 23603 23604 23605 23606 23607 23608 23609 23612 23628 23630 23631 23651 23653 23661 23662 23663 23664 23665 23666 23667 23668 23669 23670 23681 23690 23691 23692 23693 23694 23696 23701 23702 23703 23704 23705 23707 23708 10.0 9.0 10.0 2.0 9.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 23709 23801 23803 23804 23805 23806 23821 23822 23824 23827 23828 23829 23830 23831 23832 23833 23834 23836 23837 23838 23839 23840 23841 23842 23843 23844 23845 23846 23847 23850 23851 23856 23857 23860 23866 23867 23868 23870 23872 23873 23874 23875 23876 23878 23879 23881 23882 23883 23884 23885 23887 23888 23889 23890 23891 23893 23894 23897 23898 23899 23901 23909 23915 23917 23919 23920 23921 23922 23923 1.0 1.0 1.0 1.0 1.0 1.0 10.6 2.0 7.3 10.6 10.6 10.0 2.0 1.0 1.0 2.0 1.0 1.0 10.6 2.0 3.0 2.0 2.0 2.0 10.6 9.0 9.0 3.0 7.0 2.0 7.0 7.0 9.0 1.0 3.0 3.0 7.0 7.0 2.0 9.0 10.6 1.0 10.6 3.0 8.0 2.0 3.0 2.0 3.0 2.0 9.0 10.4 10.6 3.0 3.0 9.0 2.0 2.0 3.0 2.0 7.2 7.0 8.0 10.0 8.0 9.0 10.0 7.3 10.0 70231 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA Zip code RUCA level 23924 23927 23930 23934 23936 23937 23938 23939 23941 23942 23943 23944 23947 23950 23952 23954 23955 23958 23959 23960 23962 23963 23964 23966 23967 23968 23970 23974 23976 24001 24002 24003 24004 24005 24006 24007 24008 24009 24010 24011 24012 24013 24014 24015 24016 24017 24018 24019 24020 24022 24023 24024 24025 24026 24027 24028 24029 24030 24031 24032 24033 24034 24035 24036 24037 24038 24040 24042 24043 7.0 10.0 7.3 10.0 10.0 10.0 10.0 10.1 10.0 10.6 7.2 10.6 10.0 8.0 10.6 10.6 7.3 7.1 10.0 7.0 10.0 10.0 10.0 10.3 10.0 10.0 7.0 10.6 10.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00609 Fmt 4701 RUCA level 24044 24045 24048 24050 24053 24054 24055 24058 24059 24060 24061 24062 24063 24064 24065 24066 24067 24068 24069 24070 24072 24073 24076 24077 24078 24079 24082 24083 24084 24085 24086 24087 24088 24089 24090 24091 24092 24093 24094 24095 24101 24102 24104 24105 24111 24112 24113 24114 24115 24120 24121 24122 24124 24126 24127 24128 24129 24130 24131 24132 24133 24134 24136 24137 24138 24139 24141 24142 24143 1.0 1.0 1.0 1.0 10.5 5.0 5.0 4.2 2.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 1.0 2.0 2.0 10.4 1.0 10.5 1.0 4.0 10.4 10.2 2.0 4.2 2.0 2.0 2.0 10.6 5.0 2.0 10.4 8.3 10.6 2.0 2.0 2.0 8.4 2.0 10.4 1.0 4.0 4.0 4.0 4.0 10.5 2.0 2.0 10.6 4.2 2.0 2.0 4.2 2.0 2.0 4.2 10.2 10.6 2.0 8.4 2.0 9.0 4.2 4.2 4.2 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 24146 24147 24148 24149 24150 24151 24153 24155 24156 24157 24161 24162 24165 24167 24168 24171 24174 24175 24176 24177 24178 24179 24184 24185 24201 24202 24203 24209 24210 24211 24212 24215 24216 24217 24218 24219 24220 24221 24224 24225 24226 24228 24230 24236 24237 24239 24243 24244 24245 24246 24248 24250 24251 24256 24258 24260 24263 24265 24266 24269 24270 24271 24272 24273 24277 24279 24280 24281 24282 7.3 10.6 4.0 2.0 2.0 7.3 1.0 1.0 1.0 1.0 9.0 2.0 5.0 10.6 4.0 10.5 8.3 1.0 3.0 10.5 1.0 1.0 3.0 10.5 1.0 2.0 1.0 1.0 4.2 5.2 4.2 7.0 7.0 10.6 10.0 7.0 10.0 10.0 10.0 10.0 10.6 10.6 8.0 6.1 10.6 10.0 8.0 2.0 2.0 7.0 10.5 2.0 2.0 10.0 2.0 10.0 10.0 10.0 10.0 10.6 2.0 2.0 10.6 7.0 10.0 8.0 10.0 10.5 10.0 70232 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA Zip code RUCA level 24283 24290 24292 24293 24301 24311 24312 24313 24314 24315 24316 24317 24318 24319 24322 24323 24324 24325 24326 24327 24328 24330 24333 24340 24343 24347 24348 24350 24351 24352 24354 24360 24361 24363 24366 24368 24370 24374 24375 24377 24378 24380 24381 24382 24401 24402 24407 24411 24412 24413 24415 24416 24421 24422 24426 24430 24431 24432 24433 24435 24437 24438 24439 24440 24441 24442 24445 24448 24450 10.6 1.0 10.0 7.0 7.4 10.6 10.6 8.0 10.6 10.5 10.6 5.0 10.6 10.6 10.3 10.3 7.4 10.0 10.6 5.0 6.0 8.0 7.0 6.1 10.0 8.4 10.6 8.0 5.0 10.0 7.0 8.0 5.0 10.0 10.6 10.3 10.0 10.3 10.6 10.6 10.0 10.4 10.6 7.0 4.0 4.0 4.0 10.5 10.0 10.0 10.6 7.0 10.2 7.0 7.0 10.5 10.5 10.5 10.0 10.6 10.5 2.0 10.6 10.5 2.0 10.0 10.0 7.0 10.6 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA VA PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00610 Fmt 4701 RUCA level 24457 24458 24459 24460 24463 24464 24465 24467 24468 24469 24471 24472 24473 24474 24476 24477 24479 24482 24483 24484 24485 24486 24487 24501 24502 24503 24504 24505 24506 24512 24513 24514 24515 24517 24520 24521 24522 24523 24526 24527 24528 24529 24530 24531 24533 24534 24535 24536 24538 24539 24540 24541 24543 24544 24549 24550 24551 24553 24554 24555 24556 24557 24558 24562 24563 24565 24566 24569 24570 7.0 10.0 10.5 10.0 4.0 10.4 10.0 2.0 10.0 10.5 1.0 10.5 10.6 7.0 10.6 7.4 10.2 4.0 10.6 10.0 10.5 2.0 10.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 7.3 9.0 10.1 10.1 8.3 2.0 2.0 10.4 10.0 2.0 10.4 10.1 8.0 9.0 2.0 2.0 8.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 2.0 2.0 10.6 2.0 9.0 8.0 2.0 8.0 10.4 2.0 8.0 8.3 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VA ..................................... VI ...................................... VI ...................................... VI ...................................... VI ...................................... VI ...................................... VI ...................................... VI ...................................... VI ...................................... VI ...................................... VI ...................................... VI ...................................... VI ...................................... VI ...................................... VI ...................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 24571 24572 24574 24576 24577 24578 24579 24580 24581 24585 24586 24588 24589 24590 24592 24593 24594 24595 24597 24598 24599 24601 24602 24603 24604 24605 24606 24607 24608 24609 24612 24613 24614 24618 24619 24620 24622 24624 24627 24628 24630 24631 24634 24635 24637 24639 24640 24641 24646 24647 24649 24651 24656 24657 24658 00801 00802 00803 00804 00805 00820 00821 00822 00823 00824 00830 00831 00840 00841 8.3 1.0 2.0 10.4 8.0 10.6 10.6 10.0 2.0 8.0 2.0 2.0 8.0 2.0 7.0 10.1 2.0 10.1 8.0 8.0 2.0 10.6 10.6 10.0 10.6 4.0 4.0 10.0 7.4 7.0 7.0 4.0 10.0 10.0 10.6 10.0 10.6 10.0 10.0 10.0 10.6 10.0 10.6 4.0 10.6 7.0 7.0 7.0 10.0 7.0 10.0 7.4 10.0 10.6 10.0 R R R R R R R R R R R R R R 70233 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State Zip code RUCA level 00850 00851 05001 05009 05030 05031 05032 05033 05034 05035 05036 05037 05038 05039 05040 05041 05042 05043 05045 05046 05047 05048 05049 05050 05051 05052 05053 05054 05055 05056 05058 05059 05060 05061 05062 05065 05067 05068 05069 05070 05071 05072 05073 05074 05075 05076 05077 05079 05081 05083 05084 05085 05086 05088 05089 05091 05101 05141 05142 05143 05144 05146 05148 05149 05150 05151 05152 05153 05154 R R 5.0 5.0 7.4 10.5 10.0 10.5 10.0 10.0 10.0 10.0 10.5 10.5 10.5 10.0 10.0 5.0 5.0 10.0 5.0 5.0 7.4 10.6 10.5 5.0 10.5 5.0 5.0 10.0 5.0 5.0 10.0 10.0 10.0 10.5 10.5 10.5 10.0 10.5 10.5 10.5 10.5 5.0 5.0 10.5 10.5 10.5 10.5 5.0 10.5 10.5 10.5 5.0 7.4 10.5 7.0 10.6 9.0 10.6 10.6 10.6 10.0 10.6 7.0 8.0 10.0 9.0 10.6 VI ...................................... VI ...................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00611 Fmt 4701 RUCA level 05155 05156 05158 05159 05161 05201 05250 05251 05252 05253 05254 05255 05257 05260 05261 05262 05301 05302 05303 05304 05340 05341 05342 05343 05344 05345 05346 05350 05351 05352 05353 05354 05355 05356 05357 05358 05359 05360 05361 05362 05363 05401 05402 05403 05404 05405 05406 05407 05439 05440 05441 05442 05443 05444 05445 05446 05447 05448 05449 05450 05451 05452 05453 05454 05455 05456 05457 05458 05459 10.0 7.0 10.6 10.6 10.6 4.0 10.0 10.0 10.5 10.0 10.0 10.0 4.0 5.0 5.0 5.0 7.0 7.0 7.0 7.0 10.0 10.0 10.0 10.6 7.0 10.3 8.0 10.5 10.3 10.5 10.6 8.0 10.6 10.0 7.0 10.6 10.6 10.6 10.0 10.3 10.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.1 8.3 10.0 10.4 2.0 2.0 1.0 10.6 8.3 1.0 10.6 1.0 1.0 1.0 2.0 8.3 2.0 8.3 2.0 8.3 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 05460 05461 05462 05463 05464 05465 05466 05468 05469 05470 05471 05472 05473 05474 05476 05477 05478 05479 05481 05482 05483 05485 05486 05487 05488 05489 05490 05491 05492 05494 05495 05601 05602 05603 05604 05609 05620 05633 05640 05641 05647 05648 05649 05650 05651 05652 05653 05654 05655 05656 05657 05658 05660 05661 05662 05663 05664 05665 05666 05667 05669 05670 05671 05672 05673 05674 05675 05676 05677 8.0 2.0 2.0 10.1 2.0 1.0 2.0 1.0 10.4 10.6 10.6 10.6 2.0 10.1 10.6 2.0 7.1 7.1 7.1 1.0 8.3 8.3 2.0 2.0 8.0 2.0 2.0 7.2 10.0 2.0 1.0 4.0 4.0 4.0 4.0 4.0 4.0 4.0 5.0 4.0 5.0 5.0 4.0 5.0 5.0 10.0 10.0 4.0 10.0 10.0 10.0 5.0 3.0 10.0 10.4 7.4 7.4 10.0 5.0 5.0 7.4 4.0 9.1 10.4 10.0 10.0 10.5 9.1 9.1 70234 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT VT Zip code RUCA level 05678 05679 05680 05681 05682 05701 05702 05730 05731 05732 05733 05734 05735 05736 05737 05738 05739 05740 05741 05742 05743 05744 05745 05746 05747 05748 05750 05751 05753 05757 05758 05759 05760 05761 05762 05763 05764 05765 05766 05767 05768 05769 05770 05772 05773 05774 05775 05776 05777 05778 05819 05820 05821 05822 05823 05824 05825 05826 05827 05828 05829 05830 05832 05833 05836 05837 05838 05839 05840 4.0 5.0 10.0 5.0 5.0 4.0 4.0 5.0 7.2 7.2 10.5 10.6 7.2 5.0 5.0 10.5 10.0 7.0 10.5 5.0 7.2 5.0 10.5 10.5 10.6 10.6 10.5 10.5 7.0 10.2 5.0 5.0 10.6 10.0 5.0 5.0 10.5 5.0 10.6 10.0 10.0 10.6 10.6 10.5 5.0 10.5 10.0 10.0 4.0 10.6 7.0 10.0 10.6 10.6 7.0 9.0 10.6 10.0 10.0 10.6 10.3 10.3 8.0 10.6 10.0 10.0 7.0 10.0 10.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... VT ..................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... PO 00000 Frm 00612 Fmt 4701 RUCA level 05841 05842 05843 05845 05846 05847 05848 05849 05850 05851 05853 05855 05857 05858 05859 05860 05861 05862 05863 05866 05867 05868 05871 05872 05873 05874 05875 05901 05902 05903 05904 05905 05906 05907 98001 98002 98003 98004 98005 98006 98007 98008 98009 98010 98011 98012 98013 98014 98015 98019 98020 98021 98022 98023 98024 98025 98026 98027 98028 98029 98030 98031 98032 98033 98034 98035 98036 98037 98038 10.0 10.0 10.0 10.0 10.0 10.0 7.0 7.0 7.0 7.0 10.6 7.0 10.6 10.0 10.6 10.6 7.0 10.0 7.0 10.6 10.6 10.6 8.0 10.6 10.6 10.6 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 98039 98040 98041 98042 98043 98045 98046 98047 98050 98051 98052 98053 98054 98055 98056 98057 98058 98059 98061 98062 98063 98064 98065 98068 98070 98071 98072 98073 98074 98075 98077 98082 98083 98087 98089 98092 98093 98101 98102 98103 98104 98105 98106 98107 98108 98109 98110 98111 98112 98113 98114 98115 98116 98117 98118 98119 98121 98122 98124 98125 98126 98127 98129 98131 98132 98133 98134 98136 98138 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 7.3 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70235 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA Zip code RUCA level 98139 98141 98144 98145 98146 98148 98151 98154 98155 98158 98160 98161 98164 98165 98166 98168 98170 98171 98174 98175 98177 98178 98181 98184 98185 98188 98190 98191 98194 98195 98198 98199 98201 98203 98204 98205 98206 98207 98208 98213 98220 98221 98222 98223 98224 98225 98226 98227 98228 98229 98230 98231 98232 98233 98235 98236 98237 98238 98239 98240 98241 98243 98244 98245 98247 98248 98249 98250 98251 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 2.0 4.2 4.2 2.0 2.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 1.0 1.0 2.0 2.0 1.0 5.0 7.3 2.0 10.0 2.0 10.0 2.0 2.0 2.0 10.0 2.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00613 Fmt 4701 RUCA level 98252 98253 98255 98256 98257 98258 98259 98260 98261 98262 98263 98264 98266 98267 98270 98271 98272 98273 98274 98275 98276 98277 98278 98279 98280 98281 98282 98283 98284 98286 98287 98288 98290 98291 98292 98293 98294 98295 98296 98297 98303 98304 98305 98310 98311 98312 98314 98315 98320 98321 98322 98323 98324 98325 98326 98327 98328 98329 98330 98331 98332 98333 98335 98336 98337 98338 98339 98340 98342 2.0 2.0 1.0 2.0 2.0 2.0 2.0 2.0 10.0 10.1 1.0 7.1 2.0 2.0 2.0 2.0 1.0 1.0 1.0 1.0 2.0 4.0 4.0 10.0 10.0 10.0 2.0 2.0 1.0 10.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 1.0 10.0 2.0 2.0 10.3 1.0 1.0 1.0 1.0 1.0 10.4 1.0 1.0 1.0 7.4 8.0 10.0 1.0 2.0 1.0 2.0 7.0 1.0 1.0 1.0 10.5 1.0 1.0 8.0 2.1 2.1 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 98343 98344 98345 98346 98348 98349 98350 98351 98352 98353 98354 98355 98356 98357 98358 98359 98360 98361 98362 98363 98364 98365 98366 98367 98368 98370 98371 98372 98373 98374 98375 98376 98377 98378 98380 98381 98382 98383 98384 98385 98386 98387 98388 98390 98391 98392 98393 98394 98395 98396 98397 98398 98401 98402 98403 98404 98405 98406 98407 98408 98409 98411 98412 98413 98415 98416 98418 98421 98422 4.0 1.0 1.0 2.1 2.0 2.0 7.0 2.0 1.0 1.0 1.0 5.0 10.5 10.0 8.0 1.0 1.0 10.0 4.0 4.0 1.0 10.4 1.0 1.0 7.0 1.0 1.0 1.0 1.0 1.0 1.0 10.4 10.0 1.0 2.1 10.0 7.4 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 10.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70236 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA Zip code RUCA level 98424 98430 98431 98433 98438 98439 98442 98443 98444 98445 98446 98447 98450 98455 98460 98464 98465 98466 98467 98471 98477 98481 98492 98493 98497 98498 98499 98501 98502 98503 98504 98505 98506 98507 98508 98509 98511 98512 98513 98516 98520 98522 98524 98526 98527 98528 98530 98531 98532 98533 98535 98536 98537 98538 98539 98540 98541 98542 98544 98546 98547 98548 98550 98552 98554 98555 98556 98557 98558 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 5.0 2.0 10.5 7.0 2.0 2.0 4.2 5.0 5.0 7.4 7.4 4.0 5.0 5.0 1.0 7.4 5.0 4.2 5.2 10.5 5.2 4.0 5.0 7.0 5.2 1.0 3.0 2.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00614 Fmt 4701 RUCA level 98559 98560 98561 98562 98563 98564 98565 98566 98568 98569 98570 98571 98572 98575 98576 98577 98579 98580 98581 98582 98583 98584 98585 98586 98587 98588 98589 98590 98591 98592 98593 98595 98596 98597 98599 98601 98602 98603 98604 98605 98606 98607 98609 98610 98611 98612 98613 98614 98616 98617 98619 98620 98621 98622 98623 98624 98625 98626 98628 98629 98631 98632 98635 98637 98638 98639 98640 98641 98642 7.4 10.5 7.0 7.4 5.0 10.5 5.0 5.0 10.4 7.4 5.0 7.4 5.0 5.0 2.0 7.0 4.2 2.0 2.0 5.0 5.0 4.2 5.0 7.0 10.5 2.0 2.0 7.0 10.5 6.1 10.5 10.5 5.0 2.0 1.0 2.0 6.0 7.1 1.0 5.0 2.0 1.0 1.0 10.0 2.0 10.4 6.0 10.6 7.1 6.0 7.0 7.0 10.4 1.0 4.0 7.0 2.0 1.0 6.0 2.0 7.0 1.0 6.0 8.0 10.6 5.1 8.0 8.0 2.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 98643 98644 98645 98647 98648 98649 98650 98651 98660 98661 98662 98663 98664 98665 98666 98667 98668 98670 98671 98672 98673 98674 98675 98682 98683 98684 98685 98686 98687 98801 98802 98807 98811 98812 98813 98814 98815 98816 98817 98819 98821 98822 98823 98824 98826 98827 98828 98829 98830 98831 98832 98833 98834 98836 98837 98840 98841 98843 98844 98845 98846 98847 98848 98849 98850 98851 98852 98853 98855 10.4 7.0 2.0 10.4 5.1 2.0 4.0 5.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 6.0 1.0 4.0 6.0 7.1 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.1 10.0 10.0 10.0 2.0 7.3 7.3 8.0 2.0 10.1 7.4 7.0 10.4 10.0 2.0 7.0 10.0 10.6 5.0 10.0 10.0 1.0 4.0 7.0 7.0 10.0 10.0 10.4 10.0 2.0 7.0 8.0 1.0 8.0 10.1 5.0 10.6 70237 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA Zip code RUCA level 98856 98857 98858 98859 98860 98862 98901 98902 98903 98904 98907 98908 98909 98920 98921 98922 98923 98925 98926 98929 98930 98932 98933 98934 98935 98936 98937 98938 98939 98940 98941 98942 98943 98944 98946 98947 98948 98950 98951 98952 98953 99001 99003 99004 99005 99006 99008 99009 99011 99012 99013 99014 99015 99016 99017 99018 99019 99020 99021 99022 99023 99025 99026 99027 99029 99030 99031 99032 99033 10.0 10.5 10.4 10.0 5.0 10.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 4.2 7.3 2.0 7.3 4.0 2.0 7.4 6.0 2.0 4.0 10.5 2.0 2.0 6.0 2.0 7.3 7.3 1.0 7.3 4.2 5.0 2.0 4.2 4.0 2.0 10.4 4.2 1.0 2.0 7.1 2.0 2.0 10.4 2.0 4.1 2.0 2.0 7.1 2.0 1.0 10.4 2.0 1.0 7.1 1.0 4.1 2.0 1.0 2.0 1.0 10.4 2.0 2.0 10.4 10.4 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00615 Fmt 4701 RUCA level 99034 99036 99037 99039 99040 99101 99102 99103 99104 99105 99107 99109 99110 99111 99113 99114 99115 99116 99117 99118 99119 99121 99122 99123 99124 99125 99126 99127 99128 99129 99130 99131 99133 99134 99135 99136 99137 99138 99139 99140 99141 99143 99144 99146 99147 99148 99149 99150 99151 99152 99153 99154 99155 99156 99157 99158 99159 99160 99161 99163 99164 99165 99166 99167 99169 99170 99171 99173 99174 2.0 2.0 1.0 2.0 10.0 8.0 4.0 10.0 10.2 10.0 10.0 10.0 2.0 7.4 10.5 8.0 10.0 10.0 10.0 10.0 10.0 10.0 10.4 10.0 10.0 10.4 10.3 10.4 10.2 10.0 10.2 10.6 10.0 10.4 10.0 10.5 10.6 10.0 10.0 10.0 10.3 10.5 10.4 10.3 10.0 2.0 10.4 10.0 10.3 10.0 10.0 10.4 10.0 2.0 10.3 10.2 10.4 10.0 10.2 4.0 4.0 4.0 10.0 10.3 10.0 10.4 10.4 10.4 7.4 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA WA .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 99176 99179 99180 99181 99185 99201 99202 99203 99204 99205 99206 99207 99208 99209 99210 99211 99212 99213 99214 99215 99216 99217 99218 99219 99220 99223 99224 99228 99251 99252 99256 99258 99260 99299 99301 99302 99320 99321 99322 99323 99324 99326 99327 99328 99329 99330 99332 99333 99335 99336 99337 99338 99341 99343 99344 99345 99346 99347 99348 99349 99350 99352 99353 99354 99356 99357 99359 99360 99361 10.2 10.5 10.0 10.4 10.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 10.0 7.0 2.0 4.0 7.3 7.0 7.4 5.0 2.0 7.0 10.5 1.0 1.0 1.0 1.0 10.0 7.3 7.0 7.3 1.0 10.4 2.0 10.0 7.3 1.0 1.0 1.0 7.0 10.0 5.0 5.0 5.0 70238 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State Zip code RUCA level 99362 99363 99371 99401 99402 99403 53001 53002 53003 53004 53005 53006 53007 53008 53010 53011 53012 53013 53014 53015 53016 53017 53018 53019 53020 53021 53022 53023 53024 53026 53027 53029 53031 53032 53033 53034 53035 53036 53037 53038 53039 53040 53042 53044 53045 53046 53047 53048 53049 53050 53051 53052 53056 53057 53058 53059 53060 53061 53062 53063 53064 53065 53066 53069 53070 53072 53073 53074 53075 4.0 5.0 10.0 1.0 1.0 1.0 3.0 3.0 1.0 2.0 1.0 10.4 1.0 1.0 10.5 2.0 1.0 2.0 7.0 2.0 10.5 2.0 1.0 2.0 2.0 2.0 1.0 9.1 1.0 9.1 2.0 1.0 1.0 7.0 2.0 2.0 3.0 2.0 2.0 3.0 10.5 6.1 7.3 1.0 1.0 1.0 4.2 10.4 2.0 7.0 1.0 1.0 1.0 2.0 1.0 2.0 4.1 7.3 7.3 2.0 1.0 2.0 1.0 1.0 2.0 1.0 7.1 2.0 2.0 WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WA .................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00616 Fmt 4701 RUCA level 53076 53078 53079 53080 53081 53082 53083 53085 53086 53088 53089 53090 53091 53092 53093 53094 53095 53097 53098 53099 53101 53102 53103 53104 53105 53108 53109 53110 53114 53115 53118 53119 53120 53121 53122 53125 53126 53127 53128 53129 53130 53132 53137 53138 53139 53140 53141 53142 53143 53144 53146 53147 53148 53149 53150 53151 53152 53153 53154 53156 53157 53158 53159 53167 53168 53170 53171 53172 53176 2.0 2.0 2.0 1.0 1.0 1.0 1.0 1.0 2.0 7.0 1.0 4.1 10.4 1.0 2.0 4.2 4.1 1.0 4.2 3.0 4.2 2.0 1.0 2.0 4.2 2.1 2.0 1.0 4.0 4.0 1.0 2.0 2.0 7.0 1.0 9.1 2.0 1.0 4.2 1.0 1.0 1.0 5.2 4.2 9.1 1.0 1.0 1.0 1.0 1.0 1.0 4.2 4.2 2.0 1.0 1.0 4.2 1.0 1.0 2.0 4.2 1.0 4.2 2.0 2.0 2.0 1.0 1.0 7.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 53177 53178 53179 53181 53182 53183 53184 53185 53186 53187 53188 53189 53190 53191 53192 53194 53195 53201 53202 53203 53204 53205 53206 53207 53208 53209 53210 53211 53212 53213 53214 53215 53216 53217 53218 53219 53220 53221 53222 53223 53224 53225 53226 53227 53228 53233 53234 53235 53237 53259 53263 53267 53268 53270 53274 53277 53278 53280 53281 53284 53285 53288 53290 53293 53295 53401 53402 53403 53404 1.0 2.0 2.0 2.0 9.1 1.0 9.1 2.0 1.0 1.0 1.0 1.0 4.0 9.1 2.0 2.0 4.2 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 70239 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI Zip code RUCA level 53405 53406 53407 53408 53490 53501 53502 53503 53504 53505 53506 53507 53508 53510 53511 53512 53515 53516 53517 53518 53520 53521 53522 53523 53525 53526 53527 53528 53529 53530 53531 53532 53533 53534 53535 53536 53537 53538 53540 53541 53542 53543 53544 53545 53546 53547 53548 53549 53550 53551 53553 53554 53555 53556 53557 53558 53559 53560 53561 53562 53563 53565 53566 53569 53570 53571 53572 53573 53574 1.0 1.0 1.0 1.0 1.0 1.0 6.0 2.0 10.4 2.0 10.6 2.0 2.0 10.5 1.0 1.0 2.0 10.4 2.0 9.0 7.3 2.0 5.0 2.0 10.4 10.6 1.0 2.0 2.0 10.0 2.0 2.0 7.3 2.0 7.3 7.1 1.0 4.0 9.0 10.5 1.0 10.6 2.0 1.0 1.0 1.0 1.0 4.0 5.0 7.3 10.6 10.5 2.0 9.0 10.4 1.0 2.0 2.0 3.0 1.0 1.0 10.6 4.0 10.6 2.0 2.0 2.0 10.6 2.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00617 Fmt 4701 RUCA level 53575 53576 53577 53578 53579 53580 53581 53582 53583 53584 53585 53586 53587 53588 53589 53590 53591 53593 53594 53595 53596 53597 53598 53599 53701 53702 53703 53704 53705 53706 53707 53708 53711 53713 53714 53715 53716 53717 53718 53719 53725 53726 53744 53774 53777 53778 53779 53782 53783 53784 53785 53786 53788 53789 53790 53791 53792 53793 53794 53801 53802 53803 53804 53805 53806 53807 53808 53809 53810 2.0 2.0 10.6 7.3 10.4 10.6 7.0 2.0 7.3 9.0 4.0 10.4 10.5 10.4 1.0 1.0 1.0 1.0 7.3 7.3 1.0 1.0 2.0 10.4 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 10.6 10.6 10.4 10.6 7.0 10.6 10.4 10.4 10.6 10.6 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 53811 53812 53813 53816 53817 53818 53820 53821 53824 53825 53826 53827 53901 53910 53911 53913 53916 53917 53919 53920 53922 53923 53924 53925 53926 53927 53928 53929 53930 53931 53932 53933 53934 53935 53936 53937 53939 53940 53941 53942 53943 53944 53946 53947 53948 53949 53950 53951 53952 53953 53954 53955 53956 53957 53958 53959 53960 53961 53962 53963 53964 53965 53968 53969 54001 54002 54003 54004 54005 2.0 10.4 7.0 10.6 7.0 4.0 6.1 7.0 2.0 10.5 8.0 10.6 7.3 10.0 2.0 4.0 4.0 4.0 10.4 9.0 9.0 10.4 10.6 7.3 10.0 10.0 2.0 10.6 9.0 10.4 2.0 10.5 10.0 10.4 10.6 10.6 10.0 4.0 8.0 8.0 10.6 9.0 10.6 10.0 7.0 10.6 10.6 7.3 10.6 10.6 3.0 2.0 6.0 6.0 7.4 7.4 2.0 6.0 10.6 4.0 10.6 7.4 10.6 3.0 7.3 7.3 3.0 10.6 10.6 70240 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI Zip code RUCA level 54006 54007 54009 54010 54011 54013 54014 54015 54016 54017 54020 54021 54022 54023 54024 54025 54026 54027 54028 54082 54101 54102 54103 54104 54106 54107 54110 54111 54112 54113 54114 54115 54119 54120 54121 54123 54124 54125 54126 54127 54128 54129 54130 54131 54135 54136 54137 54138 54139 54140 54141 54143 54149 54150 54151 54152 54153 54154 54155 54156 54157 54159 54160 54161 54162 54165 54166 54169 54170 10.0 9.1 10.4 10.4 10.4 10.4 5.2 2.0 2.0 7.3 10.4 2.0 4.2 2.0 10.4 2.0 3.0 10.4 7.3 2.0 2.0 10.5 10.0 10.5 2.0 3.0 7.3 3.0 10.5 1.0 10.5 1.0 10.5 5.0 10.2 7.3 10.4 10.5 2.0 7.3 10.6 3.0 1.0 1.0 10.0 1.0 3.0 10.0 10.4 1.0 2.0 4.0 10.0 10.0 4.0 7.3 7.3 7.3 1.0 10.5 5.0 5.0 7.0 10.5 2.0 7.3 7.0 1.0 2.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00618 Fmt 4701 RUCA level 54171 54173 54174 54175 54177 54180 54182 54201 54202 54204 54205 54207 54208 54209 54210 54211 54212 54213 54214 54215 54216 54217 54220 54221 54226 54227 54228 54229 54230 54232 54234 54235 54240 54241 54245 54246 54247 54301 54302 54303 54304 54305 54306 54307 54308 54311 54313 54324 54344 54401 54402 54403 54404 54405 54406 54407 54408 54409 54410 54411 54412 54413 54414 54415 54416 54417 54418 54420 54421 2.0 1.0 10.4 10.0 10.5 2.1 3.0 7.3 10.6 8.3 2.0 10.5 2.0 10.6 10.0 10.0 10.0 8.0 4.0 5.0 10.4 2.0 4.0 4.0 7.0 5.2 5.0 2.0 10.5 7.3 10.0 7.0 2.0 4.0 5.0 10.0 5.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 7.0 5.0 5.0 2.0 7.0 10.2 2.0 10.2 6.0 10.1 10.2 10.0 1.0 8.0 10.5 10.6 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 54422 54423 54424 54425 54426 54427 54428 54429 54430 54432 54433 54434 54435 54436 54437 54439 54440 54441 54442 54443 54446 54447 54448 54449 54450 54451 54452 54454 54455 54456 54457 54458 54459 54460 54462 54463 54464 54465 54466 54467 54469 54470 54471 54472 54473 54474 54475 54476 54479 54480 54481 54484 54485 54486 54487 54488 54489 54490 54491 54492 54493 54494 54495 54498 54499 54501 54511 54512 54513 10.6 5.0 8.0 7.0 2.0 2.0 10.6 10.1 8.0 10.1 10.6 10.6 5.2 10.5 10.0 10.6 2.0 4.0 5.2 5.0 10.5 10.6 2.0 4.0 7.0 7.0 4.2 10.2 1.0 10.0 5.0 5.0 10.0 10.6 10.6 8.0 7.0 10.6 6.0 4.0 4.0 8.0 2.0 4.0 5.0 1.0 4.0 1.0 5.0 8.0 4.0 5.0 10.6 10.0 7.4 10.5 5.0 8.0 10.6 4.0 10.0 4.0 4.0 10.6 10.1 8.0 10.0 10.0 10.0 70241 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI Zip code RUCA level 54514 54515 54517 54519 54520 54521 54524 54525 54526 54527 54529 54530 54531 54532 54534 54536 54537 54538 54539 54540 54541 54542 54543 54545 54546 54547 54548 54550 54552 54554 54555 54556 54557 54558 54559 54560 54561 54562 54563 54564 54565 54566 54568 54601 54602 54603 54610 54611 54612 54613 54614 54615 54616 54618 54619 54620 54621 54622 54623 54624 54625 54626 54627 54628 54629 54630 54631 54632 54634 10.0 10.0 8.0 10.0 10.0 10.0 10.0 7.0 8.0 10.0 10.0 8.0 10.0 7.4 7.0 8.0 10.0 10.0 10.0 10.0 10.0 10.0 8.0 10.0 10.6 10.0 10.0 7.0 10.0 10.0 10.0 10.0 10.0 10.0 8.0 10.0 10.0 8.0 8.0 10.0 8.0 10.0 10.0 1.0 1.0 1.0 10.0 8.0 10.0 10.0 2.0 7.0 10.0 10.6 10.6 7.3 2.0 6.0 2.0 2.0 3.0 10.6 10.4 10.6 5.0 10.4 10.0 2.0 10.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI PO 00000 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... Frm 00619 Fmt 4701 RUCA level 54635 54636 54637 54638 54639 54640 54641 54642 54643 54644 54645 54646 54648 54649 54650 54651 54652 54653 54654 54655 54656 54657 54658 54659 54660 54661 54662 54664 54665 54666 54667 54669 54670 54701 54702 54703 54720 54721 54722 54723 54724 54725 54726 54727 54728 54729 54730 54731 54732 54733 54734 54735 54736 54737 54738 54739 54740 54741 54742 54743 54745 54746 54747 54748 54749 54750 54751 54754 54755 9.0 1.0 10.6 8.0 10.0 10.6 10.6 8.0 7.0 2.0 10.0 10.6 10.6 7.0 1.0 10.0 10.6 2.0 10.0 10.0 7.3 10.6 2.0 9.0 7.0 3.0 7.0 10.6 7.0 8.0 10.4 2.0 10.6 1.0 1.0 1.0 1.0 10.0 10.4 5.2 7.1 6.0 2.0 2.0 10.6 1.0 5.0 8.0 2.0 10.6 6.0 4.0 10.4 5.0 2.0 2.0 10.4 10.4 2.0 10.4 3.0 10.0 10.0 2.0 6.0 10.5 4.0 8.0 10.4 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 54756 54757 54758 54759 54760 54761 54762 54763 54764 54765 54766 54767 54768 54769 54770 54771 54772 54773 54774 54801 54805 54806 54810 54812 54813 54814 54816 54817 54818 54819 54820 54821 54822 54824 54826 54827 54828 54829 54830 54832 54834 54835 54836 54837 54838 54839 54840 54841 54842 54843 54844 54845 54846 54847 54848 54849 54850 54853 54854 54855 54856 54857 54858 54859 54861 54862 54864 54865 54867 10.0 3.0 10.4 10.0 10.4 10.5 10.6 10.5 10.4 10.5 8.0 10.4 10.4 10.0 10.4 10.0 10.5 10.0 1.0 7.0 10.6 7.0 3.0 7.0 10.0 10.0 10.3 10.0 7.0 10.6 2.0 10.0 8.0 10.4 10.0 10.0 10.0 10.0 10.0 10.3 10.0 10.0 2.0 10.0 2.0 10.3 10.4 7.0 2.0 10.0 10.4 10.0 8.0 10.3 7.0 2.0 10.3 10.0 2.0 8.0 10.3 10.0 10.4 10.0 7.0 10.0 2.0 10.4 10.0 70242 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI WI Zip code RUCA level 54868 54870 54871 54872 54873 54874 54875 54876 54880 54888 54889 54890 54891 54893 54895 54896 54901 54902 54903 54904 54906 54909 54911 54912 54913 54914 54915 54919 54921 54922 54923 54926 54927 54928 54929 54930 54931 54932 54933 54934 54935 54936 54937 54940 54941 54942 54943 54944 54945 54946 54947 54948 54949 54950 54952 54956 54957 54960 54961 54962 54963 54964 54965 54966 54967 54968 54969 54970 54971 7.0 7.0 10.6 10.0 2.0 2.0 10.0 10.0 1.0 8.0 10.6 10.0 10.3 10.0 10.6 10.0 1.0 1.0 1.0 1.0 1.0 5.0 1.0 1.0 1.0 1.0 1.0 1.0 5.0 2.0 7.3 10.0 2.0 9.0 7.0 10.0 2.0 2.0 7.0 7.3 1.0 1.0 1.0 2.0 10.6 1.0 10.0 2.0 10.0 7.0 2.0 10.6 10.0 10.6 1.0 1.0 1.0 10.0 7.1 10.0 2.0 2.0 3.0 10.5 3.0 10.6 2.0 3.0 7.0 ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... ..................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WI ..................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... WV .................................... PO 00000 Frm 00620 Fmt 4701 RUCA level 54974 54975 54976 54977 54978 54979 54980 54981 54982 54983 54984 54985 54986 54990 24701 24712 24714 24715 24716 24719 24724 24726 24729 24731 24732 24733 24736 24737 24738 24739 24740 24747 24751 24801 24808 24811 24813 24815 24816 24817 24818 24820 24821 24822 24823 24824 24825 24826 24827 24828 24829 24830 24831 24834 24836 24839 24842 24843 24844 24845 24846 24847 24848 24849 24850 24851 24852 24853 24854 2.0 7.1 10.0 10.0 10.6 2.0 2.0 7.0 10.0 10.6 10.0 1.0 2.0 10.0 4.0 4.0 5.0 5.0 10.5 10.5 5.0 10.5 5.0 5.0 4.0 5.0 5.0 4.0 4.0 4.0 4.0 5.0 4.0 7.0 7.0 10.0 10.0 10.0 10.6 10.0 7.4 7.0 10.0 10.0 10.0 10.0 6.0 10.0 10.0 10.6 7.0 7.0 6.0 10.0 7.0 10.0 7.0 10.6 10.0 10.0 10.0 10.5 7.0 10.0 10.0 10.0 7.0 7.0 7.4 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 24855 24856 24857 24859 24860 24861 24862 24866 24867 24868 24869 24870 24871 24872 24873 24874 24878 24879 24880 24881 24882 24884 24887 24888 24892 24894 24895 24896 24897 24898 24899 24901 24902 24910 24915 24916 24917 24918 24920 24924 24925 24927 24931 24934 24935 24936 24938 24941 24943 24944 24945 24946 24950 24951 24954 24957 24961 24962 24963 24966 24970 24974 24976 24977 24981 24983 24984 24985 24986 6.0 7.0 7.4 10.0 7.4 6.0 10.0 10.0 10.0 6.0 10.0 7.4 7.0 10.0 10.0 10.0 7.0 10.0 10.0 10.6 10.0 10.0 5.0 7.0 10.0 10.0 7.0 10.0 6.0 10.0 10.0 7.0 7.0 10.6 10.0 8.0 7.0 10.6 10.0 10.0 10.3 10.0 10.6 10.0 10.0 10.3 10.6 10.0 8.0 10.0 10.6 10.0 10.0 10.6 10.0 10.6 7.0 10.0 10.6 10.0 10.3 10.0 10.0 10.6 10.0 10.6 10.0 10.0 7.0 70243 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV Zip code RUCA level 24991 24993 25002 25003 25004 25005 25007 25008 25009 25010 25011 25015 25019 25021 25022 25024 25025 25026 25028 25030 25031 25033 25035 25036 25039 25040 25043 25044 25045 25046 25047 25048 25049 25051 25053 25054 25057 25059 25060 25061 25062 25063 25064 25067 25070 25071 25075 25076 25079 25081 25082 25083 25085 25086 25088 25090 25093 25102 25103 25106 25107 25108 25109 25110 25111 25112 25113 25114 25115 10.6 10.6 1.0 1.0 5.0 2.0 5.0 5.0 2.0 10.0 1.0 1.0 10.4 10.0 10.6 2.0 1.0 2.0 10.0 10.4 1.0 2.0 1.0 1.0 1.0 1.0 10.4 5.0 2.0 2.0 7.0 5.0 2.0 2.0 7.1 1.0 1.0 10.4 5.0 1.0 5.0 3.0 1.0 1.0 2.0 2.0 1.0 10.6 2.0 10.1 2.0 1.0 1.0 1.0 10.4 1.0 10.1 1.0 1.0 10.5 1.0 3.0 2.0 1.0 10.4 1.0 10.4 10.0 4.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00621 Fmt 4701 RUCA level 25118 25119 25121 25123 25124 25125 25126 25130 25132 25133 25134 25136 25139 25140 25141 25142 25143 25147 25148 25149 25150 25152 25154 25156 25159 25160 25161 25162 25164 25165 25168 25169 25173 25174 25177 25180 25181 25183 25185 25186 25187 25193 25201 25202 25203 25204 25205 25206 25208 25209 25211 25213 25214 25231 25234 25235 25239 25241 25243 25244 25245 25247 25248 25251 25252 25253 25259 25260 25261 2.0 2.0 9.0 5.0 1.0 10.4 1.0 7.0 1.0 3.0 1.0 1.0 2.0 5.0 3.0 2.0 1.0 1.0 2.0 10.0 3.0 1.0 2.0 2.0 1.0 1.0 2.0 1.0 10.4 2.0 2.0 2.0 2.0 5.0 1.0 5.0 10.1 10.6 1.0 1.0 10.5 10.1 1.0 1.0 7.1 10.0 7.0 10.0 10.0 5.0 10.4 2.0 1.0 2.0 10.6 10.6 10.6 10.6 8.3 2.0 2.0 10.5 2.0 2.0 10.6 10.5 2.0 10.5 10.6 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 25262 25264 25265 25266 25267 25268 25270 25271 25275 25276 25279 25281 25285 25286 25287 25301 25302 25303 25304 25305 25306 25309 25311 25312 25313 25314 25315 25317 25320 25321 25322 25323 25324 25325 25326 25327 25328 25329 25330 25331 25332 25333 25334 25335 25336 25337 25338 25339 25350 25356 25357 25358 25360 25361 25362 25364 25365 25375 25387 25389 25392 25396 25401 25402 25410 25411 25413 25414 25419 10.6 10.6 10.5 2.0 10.0 10.6 8.0 7.3 10.6 7.0 2.0 2.0 3.0 8.3 5.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 10.0 2.0 4.2 1.0 70244 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV Zip code RUCA level 25420 25421 25422 25423 25425 25427 25428 25429 25430 25431 25432 25434 25437 25438 25440 25441 25442 25443 25444 25446 25501 25502 25503 25504 25505 25506 25507 25508 25510 25511 25512 25514 25515 25517 25520 25521 25523 25524 25526 25529 25530 25534 25535 25537 25540 25541 25544 25545 25547 25550 25555 25557 25559 25560 25562 25564 25565 25567 25569 25570 25571 25572 25573 25601 25606 25607 25608 25611 25612 2.0 2.0 3.0 2.0 2.0 2.0 2.0 6.0 6.0 10.4 2.0 2.0 2.0 4.2 2.0 4.2 6.0 7.3 2.0 3.0 3.0 10.5 10.5 1.0 10.6 2.0 1.0 8.0 1.0 2.0 2.0 3.0 10.5 3.0 10.5 2.0 10.4 10.0 1.0 3.0 1.0 10.4 2.0 2.1 3.0 1.0 10.4 2.1 9.0 4.0 2.0 2.0 2.0 1.0 1.0 2.0 3.0 2.0 1.0 2.0 2.0 2.0 2.0 7.0 10.6 10.6 10.0 10.6 10.6 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00622 Fmt 4701 RUCA level 25614 25617 25621 25624 25625 25628 25630 25632 25634 25635 25636 25637 25638 25639 25644 25646 25647 25649 25650 25651 25652 25653 25654 25661 25665 25666 25667 25669 25670 25671 25672 25674 25676 25678 25682 25685 25686 25687 25688 25690 25691 25692 25694 25696 25697 25699 25701 25702 25703 25704 25705 25706 25707 25708 25709 25710 25711 25712 25713 25714 25715 25716 25717 25718 25719 25720 25721 25722 25723 7.0 10.6 10.0 7.0 7.0 10.6 10.6 10.6 10.6 10.6 7.0 7.0 10.6 7.0 10.6 7.0 7.0 8.0 10.0 10.0 7.0 7.0 10.6 7.0 7.0 10.0 7.0 10.4 10.6 10.0 10.0 10.0 10.0 10.6 10.0 10.0 10.0 7.0 10.6 10.6 7.0 10.6 10.0 10.6 10.0 10.4 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 25724 25725 25726 25727 25728 25729 25755 25770 25771 25772 25773 25774 25775 25776 25777 25778 25779 25801 25802 25810 25811 25812 25813 25816 25817 25818 25820 25823 25825 25826 25827 25831 25832 25833 25836 25837 25839 25840 25841 25843 25844 25845 25846 25847 25848 25849 25851 25853 25854 25855 25856 25857 25859 25860 25862 25864 25865 25866 25868 25870 25871 25873 25875 25876 25878 25879 25880 25882 25901 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 4.0 4.0 10.5 10.5 10.5 4.0 4.0 5.0 4.0 5.0 5.0 5.0 10.5 4.0 6.0 4.0 5.0 4.0 10.5 5.0 4.0 5.0 5.0 5.0 10.0 4.0 4.0 10.5 4.0 4.0 5.0 10.5 4.0 5.0 5.0 4.0 4.0 10.5 4.0 5.0 4.0 10.5 10.5 4.0 4.0 10.5 10.5 4.0 4.0 4.0 10.5 4.0 70245 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV Zip code RUCA level 25902 25904 25906 25907 25908 25909 25911 25913 25914 25915 25916 25917 25918 25919 25920 25921 25922 25926 25927 25928 25931 25932 25934 25936 25938 25942 25943 25951 25958 25961 25962 25965 25966 25967 25969 25971 25972 25976 25977 25978 25979 25981 25984 25985 25986 25989 26003 26030 26031 26032 26033 26034 26035 26036 26037 26038 26039 26040 26041 26047 26050 26055 26056 26058 26059 26060 26062 26070 26074 5.0 4.0 4.0 6.0 5.0 4.0 4.0 10.5 4.0 5.0 10.5 5.0 4.0 4.0 5.0 4.0 5.0 4.0 4.0 10.5 4.0 5.0 4.0 6.0 10.5 4.0 10.5 10.6 10.0 10.0 10.6 10.6 10.6 10.6 10.5 4.0 10.0 6.0 10.6 10.5 10.5 10.0 10.0 10.6 6.0 5.0 1.0 2.1 1.0 2.0 2.0 4.0 1.0 2.0 1.0 1.0 2.0 1.0 1.0 2.0 4.0 2.0 4.0 2.1 2.0 2.0 1.0 2.1 1.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00623 Fmt 4701 RUCA level 26075 26101 26102 26103 26104 26105 26106 26120 26121 26133 26134 26136 26137 26138 26141 26142 26143 26146 26147 26148 26149 26150 26151 26152 26155 26159 26160 26161 26162 26164 26167 26169 26170 26173 26175 26178 26180 26181 26184 26186 26187 26201 26202 26203 26205 26206 26208 26209 26210 26215 26217 26218 26219 26222 26224 26228 26229 26230 26234 26236 26237 26238 26241 26250 26253 26254 26257 26259 26260 2.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 10.6 10.0 2.0 10.6 1.0 2.0 10.6 10.6 2.0 10.6 1.0 10.6 2.0 8.0 7.0 2.0 2.0 10.6 7.0 10.6 2.0 9.0 10.6 7.0 2.0 2.0 1.0 2.0 10.0 1.0 7.0 8.0 10.0 10.6 10.0 10.6 10.0 8.0 8.0 10.0 8.0 8.0 10.0 8.0 8.0 7.0 8.0 8.0 8.0 8.0 9.0 7.0 10.6 8.0 8.0 8.0 8.0 10.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 26261 26263 26264 26266 26267 26268 26269 26270 26271 26273 26275 26276 26278 26280 26282 26283 26285 26287 26288 26289 26291 26292 26293 26294 26296 26298 26301 26302 26306 26320 26321 26323 26325 26327 26330 26332 26334 26335 26337 26338 26339 26342 26343 26346 26347 26348 26349 26351 26354 26361 26362 26366 26369 26372 26374 26376 26377 26378 26384 26385 26386 26404 26405 26408 26410 26411 26412 26415 26416 7.0 8.0 10.0 10.0 8.0 8.0 10.6 8.0 10.0 10.6 10.6 8.0 8.0 10.6 10.6 8.0 8.0 10.6 10.0 10.0 10.0 10.0 8.0 10.6 8.0 10.0 4.0 4.0 4.0 10.0 8.0 4.0 10.4 10.4 4.0 5.0 7.4 10.0 2.0 8.0 5.0 10.0 10.6 10.4 7.4 10.6 9.0 10.0 7.4 5.0 10.4 4.0 4.0 10.6 2.0 10.6 10.6 10.6 10.0 5.0 5.0 5.0 9.0 5.0 10.4 5.0 10.6 10.4 9.0 70246 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV Zip code RUCA level 26419 26421 26422 26424 26425 26426 26430 26431 26434 26435 26436 26437 26438 26440 26443 26444 26447 26448 26451 26452 26456 26461 26463 26501 26502 26504 26505 26506 26507 26508 26519 26520 26521 26524 26525 26527 26529 26531 26534 26537 26541 26542 26543 26544 26546 26547 26554 26555 26559 26560 26561 26562 26563 26566 26568 26570 26571 26572 26574 26575 26576 26578 26581 26582 26585 26586 26587 26588 26590 10.6 10.4 4.0 7.4 10.6 5.0 10.0 5.0 10.0 7.4 10.5 10.6 4.0 9.0 10.0 10.6 10.6 5.0 5.0 7.0 10.5 4.0 5.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 2.0 2.0 2.0 2.0 1.0 2.0 1.0 1.0 7.3 2.0 2.0 1.0 1.0 2.0 2.0 4.0 4.0 4.0 4.0 10.6 10.0 4.0 4.0 5.0 5.0 4.0 4.0 4.0 10.0 4.0 4.0 10.0 5.0 5.0 4.0 5.0 4.0 2.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV WV PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00624 Fmt 4701 RUCA level 26591 26601 26610 26611 26615 26617 26619 26621 26623 26624 26627 26629 26631 26636 26638 26639 26641 26651 26656 26660 26662 26667 26671 26674 26675 26676 26678 26679 26680 26681 26684 26690 26691 26704 26705 26707 26710 26711 26714 26716 26717 26719 26720 26722 26726 26731 26739 26743 26750 26753 26755 26757 26761 26763 26764 26767 26801 26802 26804 26807 26808 26810 26812 26814 26815 26817 26818 26823 26824 4.0 10.0 8.0 10.0 10.0 10.4 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 10.0 7.0 10.4 10.6 8.0 10.4 7.0 10.5 7.0 8.0 9.0 9.0 10.5 8.0 9.0 10.4 8.0 2.0 10.6 10.6 5.0 2.0 2.0 10.6 4.0 5.0 10.6 10.4 4.0 10.6 10.6 4.0 4.0 5.0 10.0 10.0 10.0 10.4 10.6 4.0 10.0 10.4 10.0 10.4 2.0 10.0 10.0 10.0 10.4 2.0 10.0 2.0 10.0 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State WV WV WV WV WV WV WV WV WV WV WV WV WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... E:\FR\FM\01DER2.SGM 01DER2 Zip code RUCA level 26833 26836 26838 26845 26847 26851 26852 26855 26865 26866 26884 26886 82001 82002 82003 82005 82006 82007 82008 82009 82010 82050 82051 82052 82053 82054 82055 82058 82059 82060 82061 82063 82070 82071 82072 82073 82081 82082 82083 82084 82190 82201 82210 82212 82213 82214 82215 82217 82218 82219 82221 82222 82223 82224 82225 82227 82229 82240 82242 82243 82244 82301 82310 82321 82322 82323 82324 82325 82327 8.0 10.0 10.0 10.0 7.0 10.0 10.0 8.0 2.0 10.4 10.0 10.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 5.0 5.0 2.0 2.0 5.0 5.0 1.0 2.0 1.0 5.0 4.0 4.0 4.0 4.0 2.0 2.0 5.0 5.0 8.0 7.0 7.0 10.3 10.6 10.6 10.6 10.6 7.0 10.3 10.6 10.0 10.3 10.0 10.0 10.0 10.6 7.0 10.0 10.6 10.6 7.0 10.3 7.0 10.5 7.0 10.6 10.6 10.6 70247 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued rmajette on PROD1PC67 with RULES2 State WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY Zip code RUCA level 82329 82331 82332 82334 82335 82336 82401 82410 82411 82412 82414 82420 82421 82422 82423 82426 82428 82430 82431 82432 82433 82434 82435 82440 82441 82442 82443 82450 82501 82510 82512 82513 82514 82515 82516 82520 82523 82524 82601 82602 82604 82605 82609 82615 82620 82630 82633 82635 82636 82637 82638 82639 82640 82642 82643 82644 82646 82648 82649 82701 82710 82711 82712 82713 82714 82715 82716 82717 82718 10.6 10.6 7.0 7.0 10.6 10.5 7.0 10.0 10.0 10.0 7.0 10.0 10.0 10.0 10.0 10.0 10.0 7.0 10.0 10.0 8.0 10.0 7.0 7.0 10.0 8.0 7.0 7.0 4.0 5.0 10.0 10.0 10.0 7.0 10.0 7.0 5.0 4.0 1.0 1.0 1.0 1.0 1.0 1.0 2.0 1.0 7.0 2.0 1.0 10.4 10.3 10.3 10.3 10.3 2.0 1.0 1.0 1.0 10.3 7.0 10.5 10.5 10.0 10.5 10.5 10.3 4.0 4.0 4.0 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... VerDate Aug<31>2005 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued 10:50 Nov 30, 2006 Jkt 211001 Zip code State WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY WY PO 00000 .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... .................................... Frm 00625 Fmt 4701 RUCA level 82720 82721 82723 82725 82727 82729 82730 82731 82732 82801 82831 82832 82833 82834 82835 82836 82837 82838 82839 82840 82842 82844 82845 82901 82902 82922 82923 82925 82929 82930 82931 82932 82933 82934 82935 82936 82937 82938 82939 82941 82942 82943 82944 82945 83001 83002 83011 83012 83013 83014 83025 83101 83110 83111 83112 83113 83114 83115 83116 83118 83119 83120 83121 83122 83123 83124 83126 83127 83128 10.5 10.5 10.3 4.0 5.0 10.0 10.3 4.0 5.0 4.0 5.0 5.0 4.0 7.0 5.0 5.0 5.0 5.0 5.0 7.0 5.0 5.0 4.0 4.0 4.0 10.0 10.0 10.0 4.0 4.0 4.0 4.0 10.5 4.0 4.0 10.5 10.5 4.0 10.5 10.0 4.0 4.0 10.5 4.0 4.0 4.0 10.2 10.2 10.2 4.0 4.0 7.0 10.0 10.0 10.2 10.0 10.6 10.0 7.0 10.2 10.0 10.2 7.0 10.2 10.6 7.0 10.0 10.2 10.2 ADDENDUM I.—RUCA RURALITY LEVEL BY STATE AND ZIP CODE— Continued Sfmt 4700 State WY .................................... Zip code RUCA level 83414 10.2 R = Rural U = Urban The use of either ‘‘R✖ or ‘‘U✖ as an indicator in the ‘‘RUCA Level’’ column signifies that this area is either a military installation or located outside the 50 United States. Therefore, a RUCA level is not available for it. ADDENDUM J.—LIST OF CPT 1/ HCPCS CODES USED TO DESCRIBE CERTAIN DESIGNATED HEALTH SERVICE CATEGORIES 2 UNDER SECTION 1877 OF THE SOCIAL SECURITY ACT [Effective date January 1, 2007] CLINICAL LABORATORY SERVICES INCLUDE CPT codes for all clinical laboratory services in the 80000 series, except EXCLUDE CPT codes for the following blood component collection services: 86890 ................... Autologous blood process 86891 ................... Autologous blood, op salvage 86927 ................... Plasma, fresh frozen 86930 ................... Frozen blood prep 86931 ................... Frozen blood thaw 86932 ................... Frozen blood freeze/thaw 86945 ................... Blood product/irradiation 86950 ................... Leukacyte transfusion 86960 ................... Vol reduction of blood/prod 86965 ................... Pooling blood platelets 86985 ................... Split blood or products INCLUDE the following CPT and HCPCS level 2 codes for other clinical laboratory services: 0026T ................... Measure remnant lipoproteins 0030T ................... Antiprothrombin antibody 0041T ................... Detect ur infect agnt w/cpas 0043T ................... Co expired gas analysis 0058T ................... Cryopreservation, ovary tiss 0059T ................... Cryopreservation, oocyte 0064T ................... Spectroscop eval expired gas 0085T ................... Breath test heart reject 0087T ................... Sperm eval hyaluronan 0103T ................... Holotranscobalamin 0104T ................... At rest cardio gas rebreathe 0111T ................... RBC membranes fatty acids 0140T ................... Exhaled breath condensate ph 36415 ................... Routine venipuncture 78110 ................... Plasma volume, single 78111 ................... Plasma volume, multiple 78120 ................... Red cell mass, single 78121 ................... Red cell mass, multiple 78122 ................... Blood volume 78130 ................... Red cell survival study 78191 ................... Platelet survival 78270 ................... Vit B-12 absorption exam 78271 ................... Vit B-12 absrp exam, int fac 78272 ................... Vit B-12 absorp, combined 78725 ................... Kidney function study 78267 ................... Breath tst attain/anal c-14 78268 ................... Breath test analysis c-14 G0027 .................. Semen analysis G0103 .................. Psa, total screening G0123 .................. Screen cerv/vag thin layer G0124 .................. Screen c/v thin layer by MD G0141 .................. Scr c/v cyto,autosys and md G0143 .................. Scr c/v cyto,thinlayer,rescr G0144 .................. Scr c/v cyto,thinlayer,rescr G0145 .................. Scr c/v cyto,thinlayer,rescr G0147 .................. Scr c/v cyto, automated sys G0148 .................. Scr c/v cyto, autosys, rescr G0306 .................. CBC/diffwbc w/o platelet E:\FR\FM\01DER2.SGM 01DER2 70248 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM J.—LIST OF CPT 1/ HCPCS CODES USED TO DESCRIBE CERTAIN DESIGNATED HEALTH SERVICE CATEGORIES 2 UNDER SECTION 1877 OF THE SOCIAL SECURITY ACT—Continued ADDENDUM J.—LIST OF CPT 1/ HCPCS CODES USED TO DESCRIBE CERTAIN DESIGNATED HEALTH SERVICE CATEGORIES 2 UNDER SECTION 1877 OF THE SOCIAL SECURITY ACT—Continued [Effective date January 1, 2007] [Effective date January 1, 2007] rmajette on PROD1PC67 with RULES2 G0307 .................. CBC without platelet G0328 .................. Fecal blood scrn immunoassay G0394 .................. Blood occult test colorectal P2028 ................... Cephalin floculation test P2029 ................... Congo red blood test P2033 ................... Blood thymol turbidity P2038 ................... Blood mucoprotein P3000 ................... Screen pap by tech w md supv P3001 ................... Screening pap smear by phys P9612 ................... Catheterize for urine spec P9615 ................... Urine specimen collect mult Q0111 .................. Wet mounts/w preparations Q0112 .................. Potassium hydroxide preps Q0113 .................. Pinworm examinations Q0114 .................. Fern test Q0115 .................. Post-coital mucous exam PHYSICAL THERAPY, OCCUPATIONAL THERAPY, AND SPEECH-LANGUAGE PATHOLOGY INCLUDE the following CPT and HCPCS codes for physical therapy/occupational therapy/speech-language pathology services: 0019T ................... Extracorp shock wv tx,ms nos 0029T ................... Magnetic tx for incontinence 64550 ................... Apply neurostimulator 90901 ................... Biofeedback train, any meth 90911 ................... Biofeedback peri/uro/rectal 92506 ................... Speech/hearing evaluation 92507 ................... Speech/hearing therapy 92508 ................... Speech/hearing therapy 92526 ................... Oral function therapy 92597 ................... Oral speech device eval 92607 ................... Ex for speech device rx, 1hr 92608 ................... Ex for speech device rx addl 92609 ................... Use of speech device service 92610 ................... Evaluate swallowing function 92611 ................... Motion fluoroscopy/swallow 92612 ................... Endoscopy swallow tst (fees) 92614 ................... Laryngoscopic sensory test 92616 ................... Fees w/laryngeal sense test 93797 ................... Cardiac rehab 93798 ................... Cardiac rehab/monitor 94667 ................... Chest wall manipulation 94668 ................... Chest wall manipulation 95831 ................... Limb muscle testing, manual 95832 ................... Hand muscle testing, manual 95833 ................... Body muscle testing, manual 95834 ................... Body muscle testing, manual 95851 ................... Range of motion measurements 95852 ................... Range of motion measurements 96000 ................... Motion analysis, video/3d 96001 ................... Motion test w/ft press meas 96002 ................... Dynamic surface emg 96003 ................... Dynamic fine wire emg 96105 ................... Assessment of aphasia 96110 ................... Developmental test, lim 96111 ................... Developmental test, extend 97001 ................... Pt evaluation 97002 ................... Pt re-evaluation 97003 ................... Ot evaluation 97004 ................... Ot re-evaluation 97010 ................... Hot or cold packs therapy 97012 ................... Mechanical traction therapy 97016 ................... Vasopneumatic device therapy 97018 ................... Paraffin bath therapy 97022 ................... Whirlpool therapy 97024 ................... Diathermy eg, microwave 97026 ................... Infrared therapy 97028 ................... Ultraviolet therapy 97032 ................... Electrical stimulation 97033 ................... Electric current therapy 97034 ................... Contrast bath therapy 97035 ................... Ultrasound therapy VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 ADDENDUM J.—LIST OF CPT 1/ HCPCS CODES USED TO DESCRIBE CERTAIN DESIGNATED HEALTH SERVICE CATEGORIES 2 UNDER SECTION 1877 OF THE SOCIAL SECURITY ACT—Continued 97036 ................... Hydrotherapy 97039 ................... Physical therapy treatment 97110 ................... Therapeutic exercises 97112 ................... Neuromuscular reeducation 97113 ................... Aquatic therapy/exercises 97116 ................... Gait training therapy 97124 ................... Massage therapy 97139 ................... Physical medicine procedure 97140 ................... Manual therapy 97150 ................... Group therapeutic procedures 97530 ................... Therapeutic activities 97532 ................... Cognitive skills development 97533 ................... Sensory integration 97535 ................... Self care mngment training 97537 ................... Community/work reintegration 97542 ................... Wheelchair mngment training 97545 ................... Work hardening 97546 ................... Work hardening add-on 97597 ................... Active wound care/20cm or < 97598 ................... Active wound care > 20cm 97602 ................... Wound(s) care nonselective 97605 ................... Neg press wound tx, < 50 cm 97606 ................... Neg press wound tx, > 50 cm 97750 ................... Physical performance test 97755 ................... Assistive technology assess 97760 ................... Orthotic mgmt and training 97761 ................... Prosthetic training 97762 ................... C/O for orthotic/prosth use 97799 ................... Physical medicine procedure G0281 .................. Elec stim unattend for press G0283 .................. Elec stim other than wound G0329 .................. Electromagntic tx for ulcers RADIOLOGY AND CERTAIN OTHER IMAGING SERVICES INCLUDE the following CPT and HCPCS codes: 0028T ................... Dexa body composition study 0042T ................... Ct perfusion w/contrast, cbf 0067T ................... Ct colonography;dx 0144T ................... Ct heart wo dye; qual calc 0145T ................... Ct heart w/wo dye funct 0146T ................... Ccta w/wo dye 0147T ................... Ccta w/wo, quan calcium 0148T ................... Ccta w/wo, strxr 0149T ................... Ccta w/wo, strxr quan calc 0150T ................... Ccta w/wo, disease strxr 0151T ................... Ct heart funct add-on 0159T ................... Cad breast mri 0174T ................... Cad crx with interp 0175T ................... Cad crx remote 51798 ................... Us urine capacity measure 70100 ................... X-ray exam of jaw 70110 ................... X-ray exam of jaw 70120 ................... X-ray exam of mastoids 70130 ................... X-ray exam of mastoids 70134 ................... X-ray exam of middle ear 70140 ................... X-ray exam of facial bones 70150 ................... X-ray exam of facial bones 70160 ................... X-ray exam of nasal bones 70190 ................... X-ray exam of eye sockets 70200 ................... X-ray exam of eye sockets 70210 ................... X-ray exam of sinuses 70220 ................... X-ray exam of sinuses 70240 ................... X-ray exam, pituitary saddle 70250 ................... X-ray exam of skull 70260 ................... X-ray exam of skull 70300 ................... X-ray exam of teeth 70310 ................... X-ray exam of teeth 70320 ................... Full mouth x-ray of teeth 70328 ................... X-ray exam of jaw joint 70330 ................... X-ray exam of jaw joints 70336 ................... Magnetic image, jaw joint 70350 ................... X-ray head for orthodontia 70355 ................... Panoramic x-ray of jaws 70360 ................... X-ray exam of neck 70370 ................... Throat x-ray & fluoroscopy PO 00000 Frm 00626 Fmt 4701 Sfmt 4700 [Effective date January 1, 2007] 70371 70380 70450 70460 70470 70480 70481 70482 70486 70487 70488 70490 70491 70492 70496 70498 70540 70542 70543 70544 70545 70546 70547 70548 70549 70551 70552 70553 70554 70555 71010 71015 71020 71021 71022 71023 71030 71034 71035 71100 71101 71110 71111 71120 71130 71250 71260 71270 71275 71550 71551 71552 71555 72010 72020 72040 72050 72052 72069 72070 72072 72074 72080 72090 72100 72110 72114 72120 72125 72126 72127 72128 72129 72130 72131 E:\FR\FM\01DER2.SGM ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... 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................... ................... ................... ................... 01DER2 Speech evaluation, complex X-ray exam of salivary gland Ct head/brain w/o dye Ct head/brain w/dye Ct head/brain w/o & w/dye Ct orbit/ear/fossa w/o dye Ct orbit/ear/fossa w/dye Ct orbit/ear/fossa w/o &w/dye Ct maxillofacial w/o dye Ct maxillofacial w/dye Ct maxillofacial w/o & w/dye Ct soft tissue neck w/o dye Ct soft tissue neck w/dye Ct sft tsue nck w/o & w/dye Ct angiography, head Ct angiography, neck Mri orbit/face/neck w/o dye Mri orbit/face/neck w/dye Mri orbt/fac/nck w/o & w/dye Mr angiography head w/o dye Mr angiography head w/dye Mr angiograph head w/o&w/dye Mr angiography neck w/o dye Mr angiography neck w/dye Mr angiograph neck w/o&w/dye Mri brain w/o dye Mri brain w/dye Mri brain w/o & w/dye Fmri brain by tech Fmri brain by phys/psych Chest x-ray Chest x-ray Chest x-ray Chest x-ray Chest x-ray Chest x-ray and fluoroscopy Chest x-ray Chest x-ray and fluoroscopy Chest x-ray X-ray exam of ribs X-ray exam of ribs/chest X-ray exam of ribs X-ray exam of ribs/chest X-ray exam of breastbone X-ray exam of breastbone Ct thorax w/o dye Ct thorax w/dye Ct thorax w/o & w/dye Ct angiography, chest Mri chest w/o dye Mri chest w/dye Mri chest w/o & w/dye Mri angio chest w or w/o dye X-ray exam of spine X-ray exam of spine X-ray exam of neck spine X-ray exam of neck spine X-ray exam of neck spine X-ray exam of trunk spine X-ray exam of thoracic spine X-ray exam of thoracic spine X-ray exam of thoracic spine X-ray exam of trunk spine X-ray exam of trunk spine X-ray exam of lower spine X-ray exam of lower spine X-ray exam of lower spine X-ray exam of lower spine Ct neck spine w/o dye Ct neck spine w/dye Ct neck spine w/o & w/dye Ct chest spine w/o dye Ct chest spine w/dye Ct chest spine w/o & w/dye Ct lumbar spine w/o dye Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM J.—LIST OF CPT 1/ HCPCS CODES USED TO DESCRIBE CERTAIN DESIGNATED HEALTH SERVICE CATEGORIES 2 UNDER SECTION 1877 OF THE SOCIAL SECURITY ACT—Continued ADDENDUM J.—LIST OF CPT 1/ HCPCS CODES USED TO DESCRIBE CERTAIN DESIGNATED HEALTH SERVICE CATEGORIES 2 UNDER SECTION 1877 OF THE SOCIAL SECURITY ACT—Continued [Effective date January 1, 2007] ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... 72192 72193 72194 72195 72196 72197 72198 72200 72202 72220 73000 73010 73020 73030 73050 73060 73070 73080 73090 73092 73100 73110 73120 73130 73140 73200 73201 73202 rmajette on PROD1PC67 with RULES2 72132 72133 72141 72142 72146 72147 72148 72149 72156 72157 72158 72170 72190 72191 ................... ................... ................... ................... ................... ................... ................... 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VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 ADDENDUM J.—LIST OF CPT 1/ HCPCS CODES USED TO DESCRIBE CERTAIN DESIGNATED HEALTH SERVICE CATEGORIES 2 UNDER SECTION 1877 OF THE SOCIAL SECURITY ACT—Continued [Effective date January 1, 2007] Ct lumbar spine w/dye Ct lumbar spine w/o & w/dye Mri neck spine w/o dye Mri neck spine w/dye Mri chest spine w/o dye Mri chest spine w/dye Mri lumbar spine w/o dye Mri lumbar spine w/dye Mri neck spine w/o & w/dye Mri chest spine w/o & w/dye Mri lumbar spine w/o & w/dye X-ray exam of pelvis X-ray exam of pelvis Ct angiograph pelv w/o & w/ dye Ct pelvis w/o dye Ct pelvis w/dye Ct pelvis w/o & w/dye Mri pelvis w/o dye Mri pelvis w/dye Mri pelvis w/o & w/dye Mr angio pelvis w/o & w/dye X-ray exam sacroiliac joints X-ray exam sacroiliac joints X-ray exam of tailbone X-ray exam of collar bone X-ray exam of shoulder blade X-ray exam of shoulder X-ray exam of shoulder X-ray exam of shoulders X-ray exam of humerus X-ray exam of elbow X-ray exam of elbow X-ray exam of forearm X-ray exam of arm, infant X-ray exam of wrist X-ray exam of wrist X-ray exam of hand X-ray exam of hand X-ray exam of finger(s) Ct upper extremity w/o dye Ct upper extremity w/dye Ct uppr extremity w/o & w/ dye Ct angio upr extrm w/o & w/dye Mri upper extremity w/o dye Mri upper extremity w/dye Mri uppr extremity w/o & w/dye Mri joint upr extrem w/o dye Mri joint upr extrem w/dye Mri joint upr extr w/o&w/dye X-ray exam of hip X-ray exam of hip X-ray exam of hips X-ray exam of pelvis & hips X-ray exam of thigh X-ray exam of knee, 1 or 2 X-ray exam of knee, 3 X-ray exam, knee, 4 or more X-ray exam of knees X-ray exam of lower leg X-ray exam of leg, infant X-ray exam of ankle X-ray exam of ankle X-ray exam of foot X-ray exam of foot X-ray exam of heel X-ray exam of toe(s) Ct lower extremity w/o dye Ct lower extremity w/dye Ct lwr extremity w/o&w/dye Ct angio lwr extr w/o&w/dye Mri lower extremity w/o dye Mri lower extremity w/dye Mri lwr extremity w/o&w/dye 73721 73722 73723 73725 74000 74010 74020 74022 74150 74160 74170 74175 74181 74182 74183 74185 74210 74220 74230 74240 74241 74245 74246 74247 74249 74250 74290 74291 74710 75552 75553 75554 75555 75635 76000 76010 76100 76101 76102 76120 76125 76150 76376 76377 76380 76499 76506 76510 76511 76512 76513 76514 76516 76519 76536 76604 76645 76700 76705 76770 76775 76776 76800 76801 76802 76805 76810 76811 76812 76815 76816 76818 76819 76820 76821 PO 00000 ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... Frm 00627 Mri jnt of lwr extre w/o dye Mri joint of lwr extr w/dye Mri joint lwr extr w/o&w/dye Mr ang lwr ext w or w/o dye X-ray exam of abdomen X-ray exam of abdomen X-ray exam of abdomen X-ray exam series, abdomen Ct abdomen w/o dye Ct abdomen w/dye Ct abdomen w/o & w/dye Ct angio abdom w/o & w/dye Mri abdomen w/o dye Mri abdomen w/dye Mri abdomen w/o & w/dye Mri angio, abdom w orw/o dye Contrst x-ray exam of throat Contrast x-ray, esophagus Cine/vid x-ray, throat/esoph X-ray exam, upper gi tract X-ray exam, upper gi tract X-ray exam, upper gi tract Contrst x-ray uppr gi tract Contrst x-ray uppr gi tract Contrst x-ray uppr gi tract X-ray exam of small bowel Contrast x-ray, gallbladder Contrast x-rays, gallbladder X-ray measurement of pelvis Heart mri for morph w/o dye Heart mri for morph w/dye Cardiac MRI/function Cardiac MRI/limited study Ct angio abdominal arteries Fluoroscope examination X-ray, nose to rectum X-ray exam of body section Complex body section x-ray Complex body section x-rays Cine/video x-rays Cine/video x-rays add-on X-ray exam, dry process 3d render w/o postprocess 3d rendering w/postprocess CAT scan follow-up study Radiographic procedure Echo exam of head Ophth us, b & quant a Ophth us, quant a only Ophth us, b w/non-quant a Echo exam of eye, water bath Echo exam of eye, thickness Echo exam of eye Echo exam of eye Us exam of head and neck Us exam, chest Us exam, breast(s) Us exam, abdom, complete Echo exam of abdomen Us exam abdo back wall, comp Us exam abdo back wall, lim Us exam k transpl w/Doppler Us exam, spinal canal Ob us < 14 wks, single fetus Ob us < 14 wks, add?l fetus Ob us >/= 14 wks, sngl fetus Ob us >/= 14 wks, addl fetus Ob us, detailed, sngl fetus Ob us, detailed, addl fetus Ob us, limited, fetus(s) Ob us, follow-up, per fetus Fetal biophys profile w/nst Fetal biophys profil w/o nst Umbilical artery echo Middle cerebral artery echo Fmt 4701 Sfmt 4700 70249 [Effective date January 1, 2007] 76825 76826 76827 76828 76856 76857 76870 76880 76885 76886 76970 76977 76999 77014 77051 ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... 77052 ................... 77055 77056 77057 77058 77059 77071 77072 77073 77074 77075 77076 77077 77078 77079 77080 77081 77082 77083 77084 78000 78001 78003 78006 78007 78010 78011 78015 78016 78018 78020 78070 78075 78099 78102 78103 78104 78135 78140 78185 78190 78195 78199 78201 78202 78205 78206 78215 78216 78220 78223 78230 78231 78232 78258 78261 78262 78264 E:\FR\FM\01DER2.SGM ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... 01DER2 Echo exam of fetal heart Echo exam of fetal heart Echo exam of fetal heart Echo exam of fetal heart Us exam, pelvic, complete Us exam, pelvic, limited Us exam, scrotum Us exam, extremity Us exam infant hips, dynamic Us exam infant hips, static Ultrasound exam follow-up Us bone density measure Echo examination procedure Ct scan for therapy guide Computer dx mammogram add-on Comp screen mammogram add-on Mammogram, one breast Mammogram, both breasts Mammogram, screening Mri, one breast Mri, both breasts X-ray stress view X-rays for bone age X-rays, bone length studies X-rays, bone survey, limited X-rays, bone survey complete X-rays, bone survey, infant Joint survey, single view Ct bone density, axial Ct bone density, peripheral Dxa bone density, axial Dxa bone density/peripheral Dxa bone density, vert fx Radiographic absorptiometry Magnetic image, bone marrow Thyroid, single uptake Thyroid, multiple uptakes Thyroid suppress/stimul Thyroid imaging with uptake Thyroid image, mult uptakes Thyroid imaging Thyroid imaging with flow Thyroid met imaging Thyroid met imaging/studies Thyroid met imaging, body Thyroid met uptake Parathyroid nuclear imaging Adrenal nuclear imaging Endocrine nuclear procedure Bone marrow imaging, ltd Bone marrow imaging, mult Bone marrow imaging, body Red cell survival kinetics Red cell sequestration Spleen imaging Platelet survival, kinetics Lymph system imaging Blood/lymph nuclear exam Liver imaging Liver imaging with flow Liver imaging (3D) Liver image (3d) with flow Liver and spleen imaging Liver & spleen image/flow Liver function study Hepatobiliary imaging Salivary gland imaging Serial salivary imaging Salivary gland function exam Esophageal motility study Gastric mucosa imaging Gastroesophageal reflux exam Gastric emptying study 70250 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM J.—LIST OF CPT 1/ HCPCS CODES USED TO DESCRIBE CERTAIN DESIGNATED HEALTH SERVICE CATEGORIES 2 UNDER SECTION 1877 OF THE SOCIAL SECURITY ACT—Continued ADDENDUM J.—LIST OF CPT 1/ HCPCS CODES USED TO DESCRIBE CERTAIN DESIGNATED HEALTH SERVICE CATEGORIES 2 UNDER SECTION 1877 OF THE SOCIAL SECURITY ACT—Continued rmajette on PROD1PC67 with RULES2 [Effective date January 1, 2007] 78278 78282 78290 78291 78299 78300 78305 78306 78315 78320 78350 78399 78414 78428 78445 78456 78457 78458 78459 78460 78461 78464 78465 78466 78468 78469 78472 78473 78478 78480 78481 78483 78491 78492 78494 78496 78499 78580 78584 78585 78586 78587 78588 78591 78593 78594 78596 78599 78600 78601 78605 78606 78607 78608 78609 78610 78615 78630 78635 78645 78647 78650 78660 78699 78700 78701 78707 78708 78709 78710 78730 78740 78761 78799 78800 ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... 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VerDate Aug<31>2005 [Effective date January 1, 2007] Acute GI blood loss imaging GI protein loss exam Meckel?s divert exam Leveen/shunt patency exam GI nuclear procedure Bone imaging, limited area Bone imaging, multiple areas Bone imaging, whole body Bone imaging, 3 phase Bone imaging (3D) Bone mineral, single photon Musculoskeletal nuclear exam Non-imaging heart function Cardiac shunt imaging Vascular flow imaging Acute venous thrombus image Venous thrombosis imaging Ven thrombosis images, bilat Heart muscle imaging (PET) Heart muscle blood, single Heart muscle blood, multiple Heart image (3d), single Heart image (3d), multiple Heart infarct image Heart infarct image (ef) Heart infarct image (3D) Gated heart, planar, single Gated heart, multiple Heart wall motion add-on Heart function add-on Heart first pass, single Heart first pass, multiple Heart image (pet), single Heart image (pet), multiple Heart image, spect Heart first pass add-on Cardiovascular nuclear exam Lung perfusion imaging Lung V/Q image single breath Lung V/Q imaging Aerosol lung image, single Aerosol lung image, multiple Perfusion lung image Vent image, 1 breath, 1 proj Vent image, 1 proj, gas Vent image, mult proj, gas Lung differential function Respiratory nuclear exam Brain imaging, ltd static Brain imaging, ltd w/flow Brain imaging, complete Brain imaging, compl w/flow Brain imaging (3D) Brain imaging (PET) Brain imaging (PET) Brain flow imaging only Cerebral vascular flow image Cerebrospinal fluid scan CSF ventriculography CSF shunt evaluation Cerebrospinal fluid scan CSF leakage imaging Nuclear exam of tear flow Nervous system nuclear exam Kidney imaging, morphol Kidney imaging with flow K flow/funct image w/o drug K flow/funct image w/drug K flow/funct image, multiple Kidney imaging (3D) Urinary bladder retention Ureteral reflux study Testicular imaging w/flow Genitourinary nuclear exam Tumor imaging, limited area 10:50 Nov 30, 2006 Jkt 211001 ADDENDUM J.—LIST OF CPT 1/ HCPCS CODES USED TO DESCRIBE CERTAIN DESIGNATED HEALTH SERVICE CATEGORIES 2 UNDER SECTION 1877 OF THE SOCIAL SECURITY ACT—Continued 78801 78802 78803 78804 78805 78806 78807 78811 78812 78813 78814 78815 78816 78890 78891 78999 91110 91111 93303 93304 93307 93308 93320 ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... 93321 ................... 93325 ................... 93875 93880 93882 93886 93888 93890 93892 93922 93923 93924 93925 93926 93930 93931 93965 93970 93971 93975 93976 93978 93979 93980 93981 93990 A4641 A4642 A9500 A9502 A9503 A9504 A9505 A9507 A9508 A9510 A9512 A9516 A9521 A9524 A9526 A9528 A9529 A9531 A9532 A9536 PO 00000 ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... Frm 00628 Tumor imaging, mult areas Tumor imaging, whole body Tumor imaging (3D) Tumor imaging, whole body Abscess imaging, ltd area Abscess imaging, whole body Nuclear localization/abscess Tumor imaging (pet), limited Tumor image (pet)/skull-thigh Tumor image (pet) full body Tumor image pet/ct, limited Tumorimage pet/ct skull-thigh Tumor image pet/ct full body Nuclear medicine data proc Nuclear med data proc Nuclear diagnostic exam Gi tract capsule endoscopy Esophageal capsule endoscopy Echo transthoracic Echo transthoracic Echo exam of heart Echo exam of heart Doppler echo exam, heart [if used in conjunction with 93303-93308] Doppler echo exam, heart [if used in conjunction with 93303-93308] Doppler color flow add-on [if used in conjunction with 93303-93308] Extracranial study Extracranial study Extracranial study Intracranial study Intracranial study Tcd, vasoreactivity study Tcd, emboli detect w/o inj Extremity study Extremity study Extremity study Lower extremity study Lower extremity study Upper extremity study Upper extremity study Extremity study Extremity study Extremity study Vascular study Vascular study Vascular study Vascular study Penile vascular study Penile vascular study Doppler flow testing Radiopharm dx agent noc In111 satumomab Tc99m sestamibi Tc99m tetrofosmin Tc99m medronate Tc99m apcitide TL201 thallium In111 capromab I131 iodobenguate, dx Tc99m disofenin Tc99m pertechnetate I123 iodide cap, dx Tc99m exametazime I131 serum albumin, dx Nitrogen N-13 ammonia Iodine I-131 iodide cap, dx I131 iodide sol, dx I131 max 100uCi I125 serum albumin, dx TC99m depreotide Fmt 4701 Sfmt 4700 [Effective date January 1, 2007] A9537 A9538 A9539 A9540 A9541 A9542 A9544 A9546 A9547 A9548 A9550 A9551 A9552 A9553 A9554 A9555 A9556 A9557 A9558 A9559 A9560 A9561 A9562 A9565 A9566 A9567 A9568 A9700 G0130 G0202 G0204 G0206 G0288 G0389 Q0092 Q9945 ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... .................. .................. .................. .................. .................. .................. .................. .................. Tc99m mebrofenin Tc99m pyrophosphate Tc99m pentetate Tc99m MAA Tc99m sulfur colloid In111 ibritumomab, dx I131 tositumomab, dx CO57/58 In111 oxyquinoline In111 pentetate Tc99m gluceptate Tc99m succimer F18 fdg Cr51 chromate I125 iothalamate, dx Rb82 rubidium Ga67 gallium Tc99m bicisate Xe133 xenon 10mci Co57 cyano Tc99m labeled rbc Tc99m oxidronate Tc99m mertiatide In111 pentetreotide Tc99m fanolesomab Technetium TC-99m Tc99m arcitumomab Echocardiography contrast Single energy x-ray study Screeningmammographydigital Diagnosticmammographydigital Diagnosticmammographydigital Recon, CTA for surg plan Ultrasound exam AAA screen Set up port xray equipment LOCM <=149mg/ml iodine, 1 ml Q9946 .................. LOCM 150-199mg/ml iodine,1ml Q9947 .................. LOCM 200-249mg/ml iodine,1ml Q9948 .................. LOCM 250-299mg/ml/iodine,1ml Q9949 .................. LOCM 300-349mg/ml iodine,1ml Q9950 .................. LOCM 350-399mg/ml iodine,1ml Q9951 .................. LOCM>=400 mg/ml iodine,1ml Q9952 .................. Inj Gad-base MR contrast, ml Q9953 .................. Inj Fe-base MR contrast, ml Q9954 .................. Oral MR contrast, 100ml Q9955 .................. Inj perflexane lip micros,ml Q9956 .................. Inj octafluoropropane mic,ml Q9957 .................. Inj perflutren lip micros,ml Q9958 .................. HOCM <=149 mg/ml iodine, 1ml Q9959 .................. HOCM 150-199mg/ml iodine,1ml Q9960 .................. HOCM 200-249mg/ml iodine,1ml Q9961 .................. HOCM 250-299mg/ml iodine,1ml Q9962 .................. HOCM 300-349mg/ml iodine,1ml Q9963 .................. HOCM 350-399mg/ml iodine,1ml Q9964 .................. HOCM>=400mg/ml iodine, 1ml R0070 ................... Transport portable x-ray R0075 ................... Transport port x-ray multipl RADIATION THERAPY SERVICES AND SUPPLIES INCLUDE the following CPT and HCPCS codes: 0073T ................... Delivery, comp imrt 19296 ................... Place po breast cath for rad 19297 ................... Place breast cath for rad E:\FR\FM\01DER2.SGM 01DER2 Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / Rules and Regulations ADDENDUM J.—LIST OF CPT 1/ HCPCS CODES USED TO DESCRIBE CERTAIN DESIGNATED HEALTH SERVICE CATEGORIES 2 UNDER SECTION 1877 OF THE SOCIAL SECURITY ACT—Continued ADDENDUM J.—LIST OF CPT 1/ HCPCS CODES USED TO DESCRIBE CERTAIN DESIGNATED HEALTH SERVICE CATEGORIES 2 UNDER SECTION 1877 OF THE SOCIAL SECURITY ACT—Continued rmajette on PROD1PC67 with RULES2 [Effective date January 1, 2007] 19298 31643 55875 55876 57155 58346 61770 61793 77261 77262 77263 77280 77285 77290 77295 77299 77300 77301 77305 77310 77315 77321 77326 77327 77328 77331 77332 77333 77334 77336 77370 77371 77372 77373 77399 77401 77402 77403 77404 77406 77407 77408 77409 77411 77412 77413 77414 77416 77417 77418 77421 77422 77423 77427 77431 77432 77435 77470 77499 77520 77522 77523 77525 77600 77605 77610 77615 77620 77750 77761 77762 77763 77776 77777 77778 ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... VerDate Aug<31>2005 10:50 Nov 30, 2006 Jkt 211001 ADDENDUM J.—LIST OF CPT 1/ HCPCS CODES USED TO DESCRIBE CERTAIN DESIGNATED HEALTH SERVICE CATEGORIES 2 UNDER SECTION 1877 OF THE SOCIAL SECURITY ACT—Continued [Effective date January 1, 2007] Place breast rad tube/caths Diag bronchoscope/catheter Transperi needle place, pros Place rt device/marker, pros Insert uteri tandems/ovoids Insert heyman uteri capsule Incise skull for treatment Focus radiation beam Radiation therapy planning Radiation therapy planning Radiation therapy planning Set radiation therapy field Set radiation therapy field Set radiation therapy field Set radiation therapy field Radiation therapy planning Radiation therapy dose plan Radiotherapy dose plan, imrt Teletx isodose plan simple Teletx isodose plan intermed Teletx isodose plan complex Special teletx port plan Brachytx isodose calc simp Brachytx isodose calc interm Brachytx isodose plan compl Special radiation dosimetry Radiation treatment aid(s) Radiation treatment aid(s) Radiation treatment aid(s) Radiation physics consult Radiation physics consult Srs, multisource Srs, linear based Sbrt delivery External radiation dosimetry Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Radiology port film(s) Radiation tx delivery, imrt Stereoscopic x-ray guidance Neutron beam tx, simple Neutron beam tx, complex Radiation tx management, x5 Radiation therapy management Stereotactic radiation trmt Sbrt management Special radiation treatment Radiation therapy management Proton trmt, simple w/o comp Proton trmt, simple w/comp Proton trmt, intermediate Proton treatment, complex Hyperthermia treatment Hyperthermia treatment Hyperthermia treatment Hyperthermia treatment Hyperthermia treatment Infuse radioactive materials Apply intrcav radiat simple Apply intrcav radiat interm Apply intrcav radiat compl Apply interstit radiat simpl Apply interstit radiat inter Apply interstit radiat compl 77781 ................... High intensity brachytherapy 77782 ................... High intensity brachytherapy 77783 ................... High intensity brachytherapy 77784 ................... High intensity brachytherapy 77789 ................... Apply surface radiation 77790 ................... Radiation handling 77799 ................... Radium/radioisotope therapy 79005 ................... Nuclear rx, oral admin 79101 ................... Nuclear rx, iv admin 79200 ................... Nuclear rx, intracav admin 79300 ................... Nuclr rx, interstit colloid 79403 ................... Hematopoietic nuclear tx 79440 ................... Nuclear rx, intra-articular 79445 ................... Nuclear rx, intra-arterial 79999 ................... Nuclear medicine therapy 92974 ................... Cath place, cardio brachytx A9517 ................... I131 iodide cap, rx A9527 ................... Iodine I-125 sodium iodide A9530 ................... I131 iodide sol, rx A9543 ................... Y90 ibritumomab, rx A9545 ................... I131 tositumomab, rx A9563 ................... P32 Na phosphate A9564 ................... P32 chromic phosphate A9600 ................... Sr89 strontium A9605 ................... Sm 153 lexidronm A9699 ................... Radiopharm rx agent noc G0173 .................. Stereo radiosurgery,complete G0243 .................. Multisour photon stero treat G0251 .................. Linear acc based stero radio G0339 .................. Robot lin-radsurg com, first G0340 .................. Robt lin-radsurg fractx 2-5 Q3001 .................. Brachytherapy Radioelements EPO AND OTHER DIALYSIS-RELATED DRUGS The physician self-referral prohibition does not apply to the following codes for EPO and other dialysis-related drugs furnished in or by an ESRD facility if the conditions in §411.355(g) are satisfied: J0630 ................... Calcitonin salmon injection J0636 ................... Inj calcitriol per 0.1 mcg J0882 ................... Darbepoetin alfa, esrd use J0895 ................... Deferoxamine mesylate inj J1270 ................... Injection, doxercalciferol J1751 ................... Iron dextran 165 injection J1752 ................... Iron dextran 267 injection J1756 ................... Iron sucrose injection J1955 ................... Inj levocarnitine per 1 gm J2501 ................... Paricalcitol J2916 ................... Na ferric gluconate complex J2993 ................... Reteplase injection J2995 ................... Inj streptokinase/250000 IU J2997 ................... Alteplase recombinant J3364 ................... Urokinase 5000 IU injection P9041 ................... Albumin (human),5%, 50ml P9045 ................... Albumin (human), 5%, 250ml P9046 ................... Albumin (human), 25%, 20ml P9047 ................... Albumin (human), 25%, 50ml Q4081 .................. Epoetin alfa, 100 units ESRD PREVENTIVE SCREENING TESTS, IMMUNIZATIONS AND VACCINES The physician self-referral prohibition does not apply to the following tests if they are performed for screening purposes and satisfy the conditions in §411.355(h): 77052 ................... Comp screen mammogram add-on 77057 ................... Mammogram, screening 80061 ................... Lipid panel [only when billed with one of the following ICD9-CM codes: V81.0, V81.1, or V.81.2] 82270 ................... Occult blood, feces PO 00000 Frm 00629 Fmt 4701 Sfmt 4700 70251 [Effective date January 1, 2007] 82465 ................... Assay, bld/serum cholesterol [only when billed with one of the following ICD-9-CM codes: V81.0, V81.1, or V.81.2] 82947 ................... Assay, glucose, blood quant [only when billed with ICD-9CM code V77.1] 82950 ................... Glucose test [only when billed with ICD-9-CM code V77.1] 82951 ................... Glucose tolerance test (GTT) [only when billed with ICD-9CM code V77.1] 83718 ................... Assay of lipoprotein [only when billed with one of the following ICD-9-CM codes: V81.0, V81.1, or V.81.2] 84478 ................... Assay of triglycerides [only when billed with one of the following ICD-9-CM codes: V81.0, V81.1, or V.81.2] G0103 .................. Psa, total screening G0123 .................. Screen cerv/vag thin layer G0124 .................. Screen c/v thin layer by MD G0141 .................. Scr c/v cyto,autosys and md G0143 .................. Scr c/v cyto,thinlayer,rescr G0144 .................. Scr c/v cyto,thinlayer,rescr G0145 .................. Scr c/v cyto,thinlayer,rescr G0147 .................. Scr c/v cyto, automated sys G0148 .................. Scr c/v cyto, autosys, rescr G0202 .................. Screeningmammographydigital G0328 .................. Fecal blood scrn immunoassay G0389 .................. Ultrasound exam AAA screen P3000 ................... Screen pap by tech w md supv P3001 ................... Screening pap smear by phys The physician self-referral prohibition does not apply to the following immunization and vaccine codes if they satisfy the conditions in §411.355(h): 90655 ................... Flu vaccine no preserv 6-35m 90656 ................... Flu vaccine no preserv 3 & > 90657 ................... Flu vaccine, 3 yrs, im 90658 ................... Flu vaccine 3 yrs & >, im 90660 ................... Flu vaccine, nasal 90732 ................... Pneumococcal vaccine 90740 ................... Hepb vacc, ill pat 3 dose im 90743 ................... Hepb vacc, adol, 2 dose, im 90744 ................... Hepb vacc ped/adol 3 dose im 90746 ................... Hepb vaccine, adult, im 90747 ................... Hepb vacc, ill pat 4 dose im 1 CPT codes and descriptions only are copyright 2006 American Medical Association. All rights are reserved and applicable FARS/ DFARS clauses apply. 2 This list does not include codes for the following designated health service (DHS) categories: durable medical equipment and supplies; parenteral and enteral nutrients, equipment and supplies; prosthetics, orthotics, and prosthetic devices and supplies; home health services; outpatient prescription drugs; and inpatient and outpatient hospital services. For the definitions of these DHS categories, refer to §411.351. For more information, refer to https://cms.hhs.gov/medlearn/refphys.asp. [FR Doc. 06–9086 Filed 11–1–06; 5:00 pm] BILLING CODE 4120–01–P E:\FR\FM\01DER2.SGM 01DER2

Agencies

[Federal Register Volume 71, Number 231 (Friday, December 1, 2006)]
[Rules and Regulations]
[Pages 69624-70251]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 06-9086]



[[Page 69623]]

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Part II

Book 2 of 2 Books

Pages 69623-70274





Department of Health and Human Services





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Centers for Medicare & Medicaid Services



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42 CFR Parts 405, 410, et al.



Medicare Program; Revisions to Payment Policies, etc.; Final Rule

Federal Register / Vol. 71, No. 231 / Friday, December 1, 2006 / 
Rules and Regulations

[[Page 69624]]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 405, 410, 411, 414, 415, and 424

[CMS-1321-FC and CMS-1317-F]
RINs 0938-AO24 and 0938-AO11


Medicare Program; Revisions to Payment Policies, Five-Year Review 
of Work Relative Value Units, Changes to the Practice Expense 
Methodology Under the Physician Fee Schedule, and Other Changes to 
Payment Under Part B; Revisions to the Payment Policies of Ambulance 
Services Under the Fee Schedule for Ambulance Services; and Ambulance 
Inflation Factor Update for CY 2007

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Final rule with comment period.

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SUMMARY: This final rule with comment period addresses certain 
provisions of the Deficit Reduction Act of 2005, as well as making 
other changes to Medicare Part B payment policy. These changes are 
intended to ensure that our payment systems are updated to reflect 
changes in medical practice and the relative value of services. This 
final rule with comment period also discusses geographic practice cost 
indices (GPCI) changes; requests for additions to the list of 
telehealth services; payment for covered outpatient drugs and 
biologicals; payment for renal dialysis services; policies related to 
private contracts and opt-out; policies related to bone mass 
measurement (BMM) services, independent diagnostic testing facilities 
(IDTFs), the physician self-referral prohibition; laboratory billing 
for the technical component (TC) of physician pathology services; the 
clinical laboratory fee schedule; certification of advanced practice 
nurses; health information technology, the health care information 
transparency initiative; updates the list of certain services subject 
to the physician self-referral prohibitions, finalizes ASP reporting 
requirements, and codifies Medicare's longstanding policy that payment 
of bad debts associated with services paid under a fee schedule/charge-
based system are not allowable.
    We are also finalizing the calendar year (CY) 2006 interim RVUs and 
are issuing interim RVUs for new and revised procedure codes for CY 
2007.
    In addition, this rule includes revisions to payment policies under 
the fee schedule for ambulance services and the ambulance inflation 
factor update for CY 2007.
    As required by the statute, we are announcing that the physician 
fee schedule update for CY 2007 is -5.0 percent, the initial estimate 
for the sustainable growth rate for CY 2007 is 2.0 percent and the CF 
for CY 2007 is $35.9848.

DATES: Effective Date: These regulations are effective on January 1, 
2007.
    Comment Date: Comments will be considered if we receive them at one 
of the addresses provided below, no later than 5 p.m. on January 2, 
2007.

ADDRESSES: In commenting, please refer to file code CMS-1321-FC. 
Because of staff and resource limitations, we cannot accept comments by 
facsimile (FAX) transmission.
    You may submit comments in one of three ways (no duplicates, 
please):
    1. Electronically. You may submit electronic comments on specific 
issues in this regulation to https://www.cms.hhs.gov/eRulemaking. Click 
on the link ``Submit electronic comments on CMS regulations with an 
open comment period.'' (Attachments should be in Microsoft Word, 
WordPerfect, or Excel; however, we prefer Microsoft Word.)
    2. By mail. You may mail written comments (one original and two 
copies) to the following address ONLY: Centers for Medicare & Medicaid 
Services, Department of Health and Human Services, Attention: CMS-1321-
FC, P.O. Box 8014, Baltimore, MD 21244-8014.
    Please allow sufficient time for mailed comments to be received 
before the close of the comment period.
    3. By express or overnight mail. You may send written comments (one 
original and two copies) to the following address only: Centers for 
Medicare & Medicaid Services, Department of Health and Human Services, 
Attention: CMS-1321-FC, Mail Stop C4-26-05, 7500 Security Boulevard, 
Baltimore, MD 21244-1850.
    4. By hand or courier. If you prefer, you may deliver (by hand or 
courier) your written comments (one original and two copies) before the 
close of the comment period to one of the following addresses. If you 
intend to deliver your comments to the Baltimore address, please call 
telephone number (410) 786-7197 in advance to schedule your arrival 
with one of our staff members.
    Room 445-G, Hubert H. Humphrey Building, 200 Independence Avenue, 
SW., Washington, DC 20201; or 7500 Security Boulevard, Baltimore, MD 
21244-1850.
    (Because access to the interior of the HHH Building is not readily 
available to persons without Federal Government identification, 
commenters are encouraged to leave their comments in the CMS drop slots 
located in the main lobby of the building. A stamp-in clock is 
available for persons wishing to retain a proof of filing by stamping 
in and retaining an extra copy of the comments being filed.)
    Comments mailed to the addresses indicated as appropriate for hand 
or courier delivery may be delayed and received after the comment 
period.
    Submission of comments on paperwork requirements. You may submit 
comments on this document's paperwork requirements by mailing your 
comments to the addresses provided at the end of the ``Collection of 
Information Requirements'' section in this document.
    For information on viewing public comments, see the beginning of 
the SUPPLEMENTARY INFORMATION section.

FOR FURTHER INFORMATION CONTACT: Pam West, (410) 786-2302 (for issues 
related to practice expense).
    Stephanie Monroe, (410) 786-6864 (for issues related to the 
geographic practice cost index).
    Craig Dobyski, (410) 786-4584 (for issues related to list of 
telehealth services).
    Roberta Epps, (410) 786-4503 (for issues related to diagnostic 
imaging services).
    Bill Larson, (410) 786-4639 (for issues related to coverage of bone 
mass measurement and addition of ultrasound screening for abdominal 
aortic aneurysm to the ``Welcome to Medicare'' benefit).
    Dorothy Shannon, (410) 786-3396 (for issues related to the 
outpatient therapy cap).
    Catherine Jansto, (410) 786-7762 (for issues related to payment for 
covered outpatient drugs and biologicals).
    Henry Richter, (410) 786-4562 (for issues related to payments for 
end-stage renal disease facilities).
    Fred Grabau, (410) 786-0206 (for issues related to private 
contracts and opt-out provision).
    David Walczak, (410) 786-4475 (for issues related to reassignment 
provisions).
    August Nemec, (410) 786-0612 (for issues related to independent 
diagnostic testing facilities).
    Anita Greenberg, (410) 786-4601 (for issues related to the clinical 
laboratory fee schedule).
    James Menas, (410) 786-4507 (for issues related to payment for 
physician pathology services).
    Anne Tayloe, (410) 786-4546; or

[[Page 69625]]

    Glenn McGuirk, (410) 786-5723 (for issues related to the ambulance 
fee schedule.
    Diane Milstead, (410) 786-3355 or Gaysha Brooks, (410) 786-9649 
(for all other issues).

SUPPLEMENTARY INFORMATION: Submitting Comments: We welcome comments 
from the public on the following issues: interim Relative Value Units 
(RVUs) for selected procedure codes identified in Addendum C and the 
physician self-referral designated health services (DHS) listed in 
Tables 18 and 19. You can assist us by referencing the file code CMS-
1321-FC and the specific ``issue identifier'' that precedes the section 
on which you choose to comment.
    Inspection of Public Comments: All comments received before the 
close of the comment period are available for viewing by the public, 
including any personally identifiable or confidential business 
information that is included in a comment. We post all comments 
received before the close of the comment period on the following Web 
site as soon as possible after they have been received: https://
www.cms.hhs.gov/eRulemaking. Click on the link ``Electronic Comments on 
CMS Regulations'' on that Web site to view public comments.
    Comments received timely will also be available for public 
inspection as they are received, generally beginning approximately 3 
weeks after publication of a document, at the headquarters of the 
Centers for Medicare & Medicaid Services, 7500 Security Boulevard, 
Baltimore, Maryland 21244, Monday through Friday of each week from 8:30 
a.m. to 4 p.m. To schedule an appointment to view public comments, 
phone 1-800-743-3951.
    This Federal Register document is also available from the Federal 
Register online database through Government Printing Office Access, a 
service of the U.S. Government Printing Office. The Web site address 
is: https://www.access.gpo.gov/nara/.
    Information on the physician fee schedule can also be found on the 
CMS homepage. You can access this data by using the following 
directions:
    1. Go to the following Web site: https://www.cms.hhs.gov/
PhysicianFeeSched/.
    2. Select ``PFS Federal Regulation Notices.''
    To assist readers in referencing sections contained in this 
preamble, we are providing the following table of contents. Some of the 
issues discussed in this preamble affect the payment policies, but do 
not require changes to the regulations in the Code of Federal 
Regulations. Information on the regulation's impact appears throughout 
the preamble and is not exclusively in section VI.

Table of Contents

I. Background
    A. Development of the Relative Value System
    B. Components of the Fee Schedule Payment Amounts
    C. Most Recent Changes to the Fee Schedule
II. Provisions of the Final Rule
    A. Resource-Based Practice Expense Relative Value Units
    1. Current Methodology
    2. Proposals for Revising the PE Methodology
    3. Specific Changes to the Indirect PE Methodology for Calendar 
Year 2007
    4. Additional PE Issues for CY 2007
    a. RUC Recommendations for Direct PE Inputs and Other PE Input 
Issues
    b. Payment for Splint and Cast Supplies
    c. Medical Nutrition Therapy Services
    d. Surgical Pathology Codes
    e. PE Issues from Rulemaking for CY 2006
    f. Other PE Issues for CY 2007
    g. Specific PE Concerns Raised by Commenters
    h. Concerns About Decreases in PE RVUs
    i. Equipment Utilization and Interest Rate Assumptions
    j. Further Review of PE Direct Inputs
    k. Supply and Equipment Items Needing Specialty Input
    B. Geographic Practice Cost Indices (GPCIs)
    C. Medicare Telehealth Services
    D. Miscellaneous Coding Issues
    1. Global Period for Remote Afterloading High Intensity 
Brachytherapy Procedures
    2. Assignment of RVUS for Proton Beam Treatment Delivery 
Services
    E. Deficit Reduction Act (DRA)
    1. Section 5102--Adjustments for Payments to Imaging Services
    a. Payment for Multiple Imaging Procedures for 2007
    b. Reduction in TC for Imaging Services Under the PFS to OPD 
Payment Amount
    c. Interaction of the Multiple Imaging Payment Reduction and the 
OPPS Cap
    2. Section 5107--Revisions to Payments for Therapy Services
    3. Section 5112--Addition of Ultrasound Screening for Abdominal 
Aortic Aneurysm (AAA)
    a. Coverage
    b. Payment
    4. Section 5113--Non-Application of the Part B Deductible for 
Colorectal Cancer Screening Tests
    5. Section 5114--Addition of Diabetes Outpatient Self-Management 
Training Services (DSMT) and Medical Nutrition Therapy (MNT) for the 
FQHC Program
    F. Payment for Covered Outpatient Drugs and Biologicals (ASP 
Issues)
    1. ASP Issues
    2. Intravenous Immune Globulin (IVIG)
    3. Clotting Factor Furnishing Fee
    4. Widely Available Market Prices (WAMP) and Average 
Manufacturer Price (AMP) Threshold
    5. Payment for Drugs Furnished During CY 2006 and Subsequent 
Years in Connection With the Furnishing of Renal Dialysis Services 
if Separately Billed by Renal Dialysis Facilities
    6. Other Issues
    G. Revisions Related to Payment for Renal Dialysis Services 
Furnished by End Stage Renal Disease (ESRD) Facilities
    1. Growth Update to the Drug Add-on Adjustment to the Composite 
Rate
    2. Update to the Geographic Adjustments to the Composite Rates
    H. Private Contracts and Opt-Out Provision--Practitioner 
Definition
    I. Changes to Reassignment and Physician Self-Referral Rules 
Relating to Diagnostic Tests
    J. Supplier Access to Claims Billed on Reassignment
    K. Coverage of Bone Mass Measurement
    1. Provisions of the June 24, 1998 IFC
    2. Additional Scientific Evidence
    3. Changes to the June 24, 1998 IFC
    4. Analysis of and Response to Comments on the June 24, 1998 IFC 
and the CY 2007 PFS Proposed Rule
    L. Independent Diagnostic Testing Facility (IDTF) Issues
    1. IDTF Changes
    2. Performance Standards for IDTFs
    3. Supervision
    4. Place of Service
    5. Analysis of and Response to Public Comments
    6. Provisions of the Final Rule
    M. Independent Laboratory Billing for the TC of Physician 
Pathology Services to Hospital Patients
    N. Public Consultation for Medicare Payment for New Outpatient 
Clinical Diagnostic Laboratory Tests
    1. Medicare, Medicaid, and SCHIP Benefits Improvement Protection 
Act of 2000 (BIPA)
    2. Medicare Prescription Drug, Improvement, and Modernization 
Act of 2003 (MMA)
    3. Other Laboratory Issues
    a. Quality
    b. Blood Glucose Monitoring in SNFs
    c. Other Lab Issues--Clinical Diagnostic Laboratory Date of 
Service (DOS) for Stored Specimens
    O. Criteria for National Certifying Bodies that Certify Advanced 
Practice Nurses
    P. Chiropractic Services Demonstration
    Q. Promoting Effective Use of Health Information Technology 
(HIT)
    R. Health Care Information Transparency Initiative
    S. Bad Debt Payment for Services Associated with Reasonable 
Charge/Fee Schedules
III. Revisions to the Payment Policies of Ambulance Services Under 
the Fee Schedule for Ambulance Services and the Ambulance Inflation 
Factor Update for CY 2007
    A. History of Medicare Ambulance Services
    B. Provisions of the Final Regulation
    C. Analysis of and Responses to Public Comments
    D. Ambulance Inflation Factor (AIF) for 2007

[[Page 69626]]

IV. Five-Year Refinement of Relative Value Units Under the Physician 
Fee Schedule: Responses to Public Comments on the Five-Year Review 
of Work Relative Value Units
    A. Scope of Five-Year Review
    B. Review of Comments (Includes Table entitled ``Work RVU 
Revisions in Response to the June 29, 2006 proposed notice'')
    C. Discussion of Comments by Clinical Area
    1. Dermatology and Plastic Surgery
    2. Orthopedic Surgery
    3. Gynecology, Urology, Pain Medicine, and Neurosurgery
    4. Radiology, Pathology, and Other Miscellaneous Services
    5. Evaluation and Management Services
    6. Cardiothoracic Surgery
    7. General, Colorectal and Vascular Surgery
    8. Otolaryngology and Ophthalmology
    9. HCPAC codes
    D. Other Issues Under the 5-Year Review
    1. Anesthesia Services
    2. Discussion of Post-Operative Visits included in the Global 
Surgical Packages
    3. Budget Neutrality
    4. Review Process
V. Refinement of Relative Value Units for Calendar Year 2007 and 
Response to Public Comments on Interim Relative Value Units for 2006
    A. Summary of Issues Discussed Related to the Adjustment of 
Relative Value Units
    B. Process for Establishing Work Relative Value Units for the 
2006 Physician Fee Schedule
    C. Work Relative Value Unit Refinements of Interim Relative 
Value Units
    1. Methodology (Includes table entitled ``2006 Interim Work 
Relative Value Units for Codes Reviewed Under the Refinement Panel 
Process'')
    2. Interim 2006 Codes
    D. Establishment of Interim Work Relative Value Units for New 
and Revised Physician's Current Procedural Terminology (CPT) Codes 
and New Healthcare Common Procedure Coding System Codes (HCPCS) for 
2007 (Includes Table titled ``American Medical Association Specialty 
Relative Value Update Committee and Health Care Professionals 
Advisory Committee Recommendations and CMS' Decisions for New and 
Revised 2007 CPT Codes'')
    E. Discussion of Codes for Which There Were No RUC 
Recommendations or for Which the RUC Recommendations Were Not 
Accepted
    F. Additional Pricing Issue
    G. Establishment of Interim PE RVUs for New and Revised 
Physician's Current Procedural Terminology (CPT) Codes and New 
Healthcare Common Procedure Coding System (HCPCS) Codes for 2007
VI. Physician Self-Referral Prohibition: Annual Update to the List 
of CPT/HCPCS Codes
    A. General
    B. Nuclear Medicine
    C. Annual Update to the Code List
VII. Physician Fee Schedule Update for CY 2007
    A. Physician Fee Schedule Update
    B. The Percentage Change in the Medicare Economic Index (MEI)
    C. The Update Adjustment Factor (UAF)
VIII. Allowed Expenditures for Physicians' Services and the 
Sustainable Growth Rate
    A. Medicare Sustainable Growth Rate
    B. Physicians' Services
    C. Preliminary Estimate of the SGR for 2007
    D. Revised Sustainable Growth Rate for 2006
    E. Final Sustainable Growth Rate for 2005
    F. Calculation of 2007, 2006, and 2005 Sustainable Growth Rates
IX. Anesthesia and Physician Fee Schedule Conversion Factors for CY 
2007
    A. Physician Fee Schedule Conversion Factor
    B. Anesthesia Fee Schedule Conversion Factor
X. Telehealth Originating Site Facility Fee Payment Amount Update
    XI. Provisions of the Final Rule
    XII. Waiver of Proposed Rulemaking and Delay in Effective Date
    XIII. Collection of Information Requirements
    XIV. Response to Comments
    XV. Regulatory Impact Analysis
    A. RVU Impacts
    1. Resource-Based Work and PE RVUs
    2. Section 5102 of the DRA Adjustments for Payments for Imaging 
Services
    3. Combined Impacts
    B. Geographic Practice Cost Indices (GPCI) Payment Localities
    C. Global Period for Remote Afterloading High Intensity 
Brachytherapy Procedures
    D. DRA 5112: Addition of Ultrasound Screening for Abdominal 
Aortic Aneurysm to ``Welcome to Medicare'' Benefit
    E. DRA 5113: Colorectal Screening Exemption from Part B 
Deductible
    F. Section 5114: Addition of Diabetes Outpatient Self-management 
Training Services (DSMT) and Medical Nutrition Therapy (MNT) for the 
FQHC Program
    G. Payment for Covered Outpatient Drugs and Biologicals (ASP 
Issues)
    H. Provisions Related to Payment for Renal Dialysis Services 
Furnished by End State Renal Disease (ESRD) Facilities
I. Private Contracts and Opt-out Provision
    J. Supplier Access to Claims Billed on Reassignment
    K. Coverage of Bone Mass Measurement
    L. IDTF Changes
    M. Independent Lab Billing for TC Component of Physician 
Pathology Services for Hospital Patients
    N. Public Consultation for Medicare Payment for New Outpatient 
Clinical Diagnostic Laboratory Tests
    O. Bad Debt Payment for Services Associated with Reasonable 
Charge/Fee Schedules
    P. Revisions to Payment Policies under the Ambulance Fee 
Schedule and the Ambulance Inflation Factor Update for CY 2007
    Q. Alternatives Considered
    R. Impact on Beneficiaries
    S. Accounting Statement
Addendum A--Explanation and Use of Addendum B.
Addendum B--2007 Relative Value Units and Related Information Used 
in Determining Medicare Payments for 2006.
Addendum C--Codes with Interim RVUs
Addendum D--2007 Geographic Practice Cost Indices by Medicare 
Carrier and Locality
Addendum E--GAF Addenda
Addendum F--Addendum F: CPT/HCPCS Imaging Codes Defined by DRA 
5102(b)
Addendum G--CY 2007 Wage Index For Urban Areas Based On CBSA Labor 
Market Areas
Addendum H--CY 2007 ESRD Wage Index for Rural Areas Based on CBSA 
Labor Market Areas
Addendum I--RUCA Rurality Level by State and Zip Code
Addendum J--Updated List of CPT/HCPCS Codes Used to Describe Certain 
Designated Health Services Under the Physician Self-Referral 
Provision
    In addition, because of the many organizations and terms to 
which we refer by acronym in this final rule with comment period, we 
are listing these acronyms and their corresponding terms in 
alphabetical order below:

AAA Abdominal aortic aneurysm
AAD American Academy of Dermatology
AAFP American Academy of Family Physicians
AANS American Association of Neurological Surgeons
AAO American Academy of Ophthalmology
AAOS American Academy of Orthopaedic Surgeons
AATS American Association for Thoracic Surgery
ACC American College of Cardiology
ACG American College of Gastroenterology
ACHPN Advanced Certified Hospice and Palliative Nurse
ACOG American College of Obstetrics and Gynecology
ACR American College of Radiology
ACS American College of Surgeons
ADA American Dietetic Association
AFROC Association of Freestanding Radiation Oncology Centers
AGA American Gastroenterological Association
AMA American Medical Association
AMP Average manufacturer price
APC Ambulatory payment classification
ASA American Society of Anesthesiologists
ASC Ambulatory surgical center
ASCRS American Society of Colon and Rectal Surgeons
ASGE American Society of Gastrointestinal Endoscopy
ASP Average sales price
ASSH American Society for Surgery of the Hand
ASTRO American Society for Therapeutic Radiology and Oncology
AUA American Urological Association
BBA Balanced Budget Act of 1997 (Pub. L. 105-33)
BBRA [Medicare, Medicaid and State Child Health Insurance Program] 
Balanced Budget Refinement Act of 1999 (Pub. L. 106-113)

[[Page 69627]]

BIPA Medicare, Medicaid, and SCHIP Benefits Improvement Protection 
Act of 2000
BLS Bureau of Labor Statistics
BMD Bone mineral density
BMM Bone mass measurement
BN Budget neutrality
BNF Budget neutrality factor
BP Best price
CAD Computer-aided detection
CAH Critical access hospital
CAP Competitive acquisition program
CBSA Core-Based Statistical Area
CCI Correct Coding Initiative
CEO Chief executive officer
CF Conversion factor
CFO Chief financial officer
CFR Code of Federal Regulations
CMP Competitive medical plan
CMS Centers for Medicare & Medicaid Services
CNS Clinical nurse specialist
CPI Consumer Price Index
CPT (Physicians') Current Procedural Terminology (4th Edition, 2002, 
copyrighted by the American Medical Association)
CT Computed tomography
CTA Computed tomographic angiography
CY Calendar year
DHS Designated health services
DME Durable medical equipment
DMEPOS Durable medical equipment, prosthetics, orthotics, and 
supplies
DRA Deficit Reduction Act
DSMT Diabetes outpatient self-management training services
DXA Dual energy x-ray absorptiometry
E/M Evaluation and management
EPO Erythopoeitin
ESRD End stage renal disease
FAX Facsimile
FDA Food and Drug Administration (HHS)
FQHC Federally qualified health center
FR Federal Register
GAF Geographic adjustment factor
GAO Government Accountability Office
GDP Gross domestic product
GPO Group purchasing organization
GPCI Geographic practice cost index
HCPAC Health Care Professional Advisory Committee
HCPCS Healthcare Common Procedure Coding System
HCRIS Healthcare Cost Report Information System
HSA Health Savings Account
HHA Home health agency
HHS [Department of] Health and Human Services
HIT Health information technology
HMO Health maintenance organization
HOCM High osmolar contrast media
HPSA Health Professional Shortage Area
HRSA Health Resources Services Administration (HHS)
HUD [Department of] Housing and Urban Development
ICF Intermediate care facilities
IDTF Independent diagnostic testing facility
IFC Interim final rule with comment period
IPPE Initial preventive physical examination
IPPS Inpatient prospective payment system
IVIG Intravenous immune globulin
IWPUT Intra-service work per unit of time
JCAAI Joint Council of Allergy, Asthma, and Immunology
LCD Local coverage determination
LOCM Low osmolar contrast media
LOINC Logical Observation Identifiers Names and Codes
MA Medicare Advantage
MCP Monthly capitation payment
MedPAC Medicare Payment Advisory Commission
MEI Medicare Economic Index
MLN Medicare Learning Network
MMA Medicare Prescription Drug, Improvement, and Modernization Act 
of 2003 (Pub. L. 108-173)
MNT Medical nutrition therapy
MRA Magnetic resonance angiography
MRI Magnetic resonance imaging
MSA Metropolitan statistical area
MSVP Multi-specialty visit package
NCD National coverage determination
NCQDIS National Coalition of Quality Diagnostic Imaging Services
NDC National drug code
NEMA National Electrical Manufacturers Association
NHE National health expenditures
NOP National Osteoporosis Foundation
NP Nurse practitioner
NPP Nonphysician practitioners
NPWP Nonphysician Work Pool
NSQIP National Surgical Quality Improvement Program
OBRA Omnibus Budget Reconciliation Act
OIG Office of Inspector General
OMB Office of Management and Budget
OPD Outpatient Department
OPPS Outpatient prospective payment system
OSCAR Online Survey and Certification and Reporting
PA Physician assistant
PBM Pharmacy benefit managers
PC Professional component
PE Practice Expense
PE/HR Practice expense per hour
PEAC Practice Expense Advisory Committee
PERC Practice Expense Review Committee
PET Positron emission tomography
PFS Physician Fee Schedule
PLI Professional liability insurance
PPI Producer price index
PPO Preferred provider organization
PPS Prospective payment system
PRA Paperwork Reduction Act
PRM Provider Reimbursement Manual
PT Physical therapy
QCT Quantitative computerized tomography
RFA Regulatory Flexibility Act
RHC Rural health clinic
RIA Regulatory impact analysis
RN Registered nurse
RUC [AMA's Specialty Society] Relative (Value) Update Committee
RVU Relative value unit
SGR Sustainable growth rate
SMS [AMA's] Socioeconomic Monitoring System
SNF Skilled nursing facility
SNM Society for Nuclear Medicine
SPA Single photon absorptiometry
STS Society of Thoracic Surgeons
SVS Society for Vascular Surgery
SXA Single energy x-ray absorptiometry
TA Technology Assessment
TC Technical Component
UAF Update adjustment factor
UPIN Unique Physician Identification Number
USPSTF United States Preventive Services Task Force
VA [Department of] Veteran Affairs
WAC Wholesale acquisition cost
WAMP Widely available market price
WHO World Health Organization

I. Background

    Since January 1, 1992, Medicare has paid for physicians' services 
under section 1848 of the Social Security Act (the Act), ``Payment for 
Physicians' Services.'' The Act requires that payments under the 
physician fee schedule (PFS) be based on national uniform relative 
value units (RVUs) based on the resources used in furnishing a service. 
Section 1848(c) of the Act requires that national RVUs be established 
for physician work, practice expense (PE), and malpractice expense. 
Before the establishment of the resource-based relative value system, 
Medicare payment for physicians' services was based on reasonable 
charges.

A. Development of the Relative Value System

1. Work RVUs
    The concepts and methodology underlying the PFS were enacted as 
part of the Omnibus Budget Reconciliation Act (OBRA) of 1989 (Pub. L. 
101-239), and OBRA 1990 (Pub. L. 101-508). The final rule, published 
November 25, 1991 (56 FR 59502), set forth the fee schedule for payment 
for physicians' services beginning January 1, 1992. Initially, only the 
physician work RVUs were resource-based, and the PE and malpractice 
RVUs were based on average allowable charges.
    The physician work RVUs established for the implementation of the 
fee schedule in January 1992 were developed with extensive input from 
the physician community. A research team at the Harvard School of 
Public Health developed the original physician work RVUs for most codes 
in a cooperative agreement with the Department of Health and Human 
Services (HHS). In constructing the code-specific vignettes for the 
original physician work RVUs, Harvard worked with panels of experts, 
both inside and outside the Federal government, and obtained input from 
numerous physician specialty groups.
    Section 1848(b)(2)(A) of the Act specifies that the RVUs for 
radiology services are based on relative value scale we adopted under 
section

[[Page 69628]]

1834(b)(1)(A) of the Act, (the American College of Radiology (ACR) 
relative value scale), which we integrated into the overall PFS. 
Section 1848(b)(2)(B) of the Act specifies that the RVUs for anesthesia 
services are based on RVUs from a uniform relative value guide. We 
established a separate conversion factor (CF) for anesthesia services, 
and we continue to utilize time units as a factor in determining 
payment for these services. As a result, there is a separate payment 
methodology for anesthesia services.
    We establish physician work RVUs for new and revised codes based on 
recommendations received from the American Medical Association's (AMA) 
Specialty Society Relative Value Update Committee (RUC).
2. Practice Expense Relative Value Units (PE RVUs)
    Section 121 of the Social Security Act Amendments of 1994 (Pub. L. 
103-432), enacted on October 31, 1994, amended section 
1848(c)(2)(C)(ii) of the Act and required us to develop resource-based 
PE RVUs for each physician's service beginning in 1998. We were to 
consider general categories of expenses (such as office rent and wages 
of personnel, but excluding malpractice expenses) comprising PEs.
    Section 4505(a) of the Balanced Budget Act of 1997 (BBA) (Pub. L. 
105-33), amended section 1848(c)(2)(C)(ii) of the Act to delay 
implementation of the resource-based PE RVU system until January 1, 
1999. In addition, section 4505(b) of the BBA provided for a 4-year 
transition period from charge-based PE RVUs to resource-based RVUs.
    We established the resource-based PE RVUs for each physician's 
service in a final rule, published November 2, 1998 (63 FR 58814), 
effective for services furnished in 1999. Based on the requirement to 
transition to a resource-based system for PE over a 4-year period, 
resource-based PE RVUs did not become fully effective until 2002.
    This resource-based system was based on two significant sources of 
actual PE data: The Clinical Practice Expert Panel (CPEP) data and the 
AMA's Socioeconomic Monitoring System (SMS) data. The CPEP data were 
collected from panels of physicians, practice administrators, and 
nonphysicians (for example, registered nurses) nominated by physician 
specialty societies and other groups. The CPEP panels identified the 
direct inputs required for each physician's service in both the office 
setting and out-of-office setting. The AMA's SMS data provided 
aggregate specialty-specific information on hours worked and PEs.
    Separate PE RVUs are established for procedures that can be 
performed in both a nonfacility setting, such as a physician's office, 
and a facility setting, such as a hospital outpatient department (OPD). 
The difference between the facility and nonfacility RVUs reflects the 
fact that a facility receives separate payment from Medicare for its 
costs of providing the service, apart from payment under the PFS. The 
nonfacility RVUs reflect all of the direct and indirect PEs of 
providing a particular service.
    Section 212 of the Balanced Budget Refinement Act of 1999 (BBRA) 
(Pub. L. 106-113) directed the Secretary of Health and Human Services 
(the Secretary) to establish a process under which we accept and use, 
to the maximum extent practicable and consistent with sound data 
practices, data collected or developed by entities and organizations to 
supplement the data we normally collect in determining the PE 
component. On May 3, 2000, we published the interim final rule (65 FR 
25664) that set forth the criteria for the submission of these 
supplemental PE survey data. The criteria were modified in response to 
comments received, and published in the Federal Register (65 FR 65376) 
as part of a November 1, 2000 final rule. The PFS final rules published 
in 2001 and 2003, respectively, (66 FR 55246 and 68 FR 63196) extended 
the period during which we would accept these supplemental data.
3. Resource-Based Malpractice RVUs
    Section 4505(f) of the BBA amended section 1848(c) of the Act to 
require us to implement resource-based malpractice RVUs for services 
furnished on or after 2000. The resource-based malpractice RVUs were 
implemented in the PFS final rule published November 2, 1999 (64 FR 
59380) (hereinafter referred to as the CY 2000 PFS final rule). The 
malpractice RVUs were based on malpractice insurance premium data 
collected from commercial and physician-owned insurers from all the 
States, the District of Columbia, and Puerto Rico.
4. Refinements to the RVUs
    Section 1848(c)(2)(B)(i) of the Act requires that we review all 
RVUs no less often than every 5 years. The first 5-year review of the 
physician work RVUs went into effect in 1997, published on November 22, 
1996 (61 FR 59489). The second 5-year review of work RVUs went into 
effect in 2002, published on November 1, 2001 (66 FR 55246). The third 
5-year review is being finalized in this rule for CY 2007.
    In 1999, the AMA's RUC established the Practice Expense Advisory 
Committee (PEAC) for the purpose of refining the direct PE inputs. 
Through March 2004, the PEAC provided recommendations to CMS for over 
7,600 codes (all but a few hundred of the codes currently listed in the 
AMA's Current Procedural Terminology (CPT) codes).
    In the November 15, 2004, PFS final rule (69 FR 66236) (hereinafter 
referred to as the CY 2005 PFS final rule), we implemented the first 5-
year review of the malpractice RVUs (69 FR 66263).
5. Adjustments to RVUS Are Budget Neutral
    Section 1848(c)(2)(B)(ii)(II) of the Act provides that adjustments 
in RVUs for a year may not cause total PFS payments to differ by more 
than $20 million from what they would have been if the adjustments were 
not made. In accordance with section 1848(c)(2)(B)(ii)(II) of the Act, 
if adjustments to RVUs cause expenditures to change by more than $20 
million, we make adjustments to ensure that expenditures do not 
increase or decrease by more than $20 million.

B. Components of the Fee Schedule Payment Amounts

    To calculate the payment for every physician service, the 
components of the fee schedule (physician work, PE, and malpractice 
RVUs) are adjusted by a geographic practice cost index (GPCI). The 
GPCIs reflect the relative costs of physician work, PEs, and 
malpractice insurance in an area compared to the national average costs 
for each component.
    Payments are converted to dollar amounts through the application of 
a CF, which is calculated by the Office of the Actuary and is updated 
annually for inflation.
    The general formula for calculating the Medicare fee schedule 
amount for a given service and fee schedule area can be expressed as:

Payment = [(RVU work x GPCI work) + (RVU PE x GPCI PE) + (RVU 
malpractice x GPCI malpractice)] x CF.

    However, as discussed in section IV.D of this final rule with 
comment period, due to the need to meet the budget neutrality (BN) 
provisions of 1848(c)(2)(B)(ii), we are applying a BN adjustor to the 
work RVUs in order to calculate payment for a service. Therefore, 
payment for services will now be calculated as follows:


[[Page 69629]]


Payment = [(RVU work x BN adjustor x GPCI work) + (RVU PE x GPCI PE) + 
(RVU malpractice x GPCI malpractice)] x CF.)

C. Most Recent Changes to the Fee Schedule

    The final rule with comment period that appeared in the Federal 
Register on November 21, 2005 (70 FR 70116) (hereinafter referred to as 
the CY 2006 PFS final rule with comment period) addressed Medicare Part 
B payment policy including the PFS that is applicable for CY 2006; and 
finalized certain provisions of the interim final rule to implement the 
Competitive Acquisition Program (CAP) for Part B Drugs.
    It also revised Medicare Part B payment and related policies 
regarding: physician work, PE and malpractice RVUs; Medicare telehealth 
services; multiple diagnostic imaging procedures; covered outpatient 
drugs and biologicals; supplemental payments to Federally Qualified 
Health Centers (FQHCs); renal dialysis services; coverage for glaucoma 
screening services; National Coverage Determination (NCD) timeframes; 
and physician referrals for nuclear medicine services and supplies to 
health care entities with which physicians have financial 
relationships.
    In addition, the rule finalized the interim RVUs for CY 2005 and 
issued interim RVUs for new and revised procedure codes for CY 2006. 
The rule also updated the codes subject to the physician self-referral 
prohibition and discussed payment policies relating to teaching 
anesthesia services, therapy caps, private contracts and opt-out, and 
chiropractic and oncology demonstrations.
    In accordance with section 1848(d)(1)(E)(i) of the Act, we also 
announced that the PFS update for CY 2006 would be -4.4 percent; the 
initial estimate for the sustainable growth rate for CY 2006 would be 
1.7 percent; and the CF for CY 2006 would be $36.1770. However, 
subsequent to publication of the CY 2006 PFS final rule with comment 
period, section 5104 of the Deficit Reduction Act (DRA) of 2005 (Pub. 
L. 109-171, February 8, 2006), was enacted which amended section 
1848(d) of the statute. As a result of this statutory change we 
maintained the CY 2005 CF of $37.8975 for CY 2006.
    We also note that the Five-Year Review of Work Relative Value Units 
Under the Physician Fee Schedule and Proposed Changes to the Practice 
Expense Methodology proposed notice appeared in the Federal Register on 
June 29, 2006 (71 FR 37170). In that notice, we proposed revisions to 
work RVUs affecting payment for physicians' services. The revisions 
reflect changes in medical practice, coding changes, and new data on 
relative value components that affect the relative amount of physician 
work required to perform each service, as required by the statute. We 
also proposed revisions to our methodology for calculating PE RVUs, 
including changes based on supplemental survey data for PE. This 
revised methodology would be used to establish payment for services 
beginning January 1, 2007.
    In this final rule with comment period, we are responding to the 
comments received on that notice. To the extent that comments received 
were outside the scope of the proposed notice, they are not addressed 
in this rule.
    Work RVU revisions will be fully implemented for services furnished 
to Medicare beneficiaries on or after January 1, 2007. The changes in 
PE methodology will be phased-in over a 4-year period; although, as we 
gain experience with the new methodology, we will reexamine this policy 
beginning next year and propose necessary revisions through future 
rulemaking.

II. Provisions of the Proposed Rule

A. Resource-Based Practice Expense (PE) Relative Value Units (RVUs)

    Practice expense (PE) is the portion of the resources used in 
furnishing the service that reflects the general categories of 
physician and practitioner expenses, such as office rent and personnel 
wages but excluding malpractice expenses, as specified in section 
1848(c)(1)(B) of the Act.
    Section 121 of the Social Security Amendments of 1994 (Pub. L. 103-
432), enacted on October 31, 1994, required CMS to develop a 
methodology for a resource-based system for determining PE RVUs for 
each physician's service. Until that time, PEs were based on historical 
allowed charges. This legislation stated that the revised PE 
methodology must consider the staff, equipment, and supplies used in 
the provision of various medical and surgical services in various 
settings beginning in 1998. The Secretary has interpreted this to mean 
that Medicare payments for each service would be based on the relative 
PE resources typically involved with furnishing the service.
    The initial implementation of resource-based PE RVUs was delayed 
from January 1, 1998, until January 1, 1999, by section 4505(a) of the 
BBA. In addition, section 4505(b) of the BBA required that the new 
payment methodology be phased-in over 4 years, effective for services 
furnished in CY 1999, and fully effective in CY 2002. The first step 
toward implementation of the statute was to adjust the PE values for 
certain services for CY 1998. Section 4505(d) of the BBA required that, 
in developing the resource-based PE RVUs, the Secretary must:
     Use, to the maximum extent possible, generally accepted 
cost accounting principles that recognize all staff, equipment, 
supplies, and expenses, not solely those that can be linked to specific 
procedures.
     Develop a refinement method to be used during the 
transition.
     Consider, in the course of notice and comment rulemaking, 
impact projections that compare new proposed payment amounts to data on 
actual physician PE.
    Beginning in CY 1999, we began the 4-year transition to resource-
based PE RVUs. In CY 2002, the resource-based PE RVUs were fully 
transitioned.
1. Current Methodology
    The following sections discuss the current PE methodology.
a. Data Sources
    There are two primary data sources used to calculate PE. The AMA's 
Socioeconomic Monitoring System (SMS) survey data are used to develop 
the PE per hour (PE/HR) for each specialty. The second source of data 
used to calculate PE was originally developed by the Clinical Practice 
Expert Panels (CPEP). The CPEP data include the supplies, equipment and 
staff times specific to each procedure.
    The AMA developed the SMS survey in 1981 and discontinued it in 
1999. Beginning in 2002, we incorporated the 1999 SMS survey data into 
our calculation of the PE RVUs, using a 5-year average of SMS survey 
data. (See Revisions to Payment Policies and Five-Year Review of and 
Adjustments to the Relative Value Units Under the Physician Fee 
Schedule for CY 2002 final rule, published November 1, 2001 (66 FR 
55246) (hereinafter referred to as CY 2002 PFS final rule).) The SMS PE 
survey data are adjusted to a common year, 1995. The SMS data provide 
the following six categories of PE costs:
     Clinical payroll expenses, which are payroll expenses 
(including fringe benefits) for nonphysician personnel.
     Administrative payroll expenses, which are payroll 
expenses (including fringe benefits) for nonphysician personnel 
involved in administrative, secretarial or clerical activities.

[[Page 69630]]

     Office expenses, which include expenses for rent, mortgage 
interest, depreciation on medical buildings, utilities and telephones.
     Medical material and supply expenses, which include 
expenses for drugs, x-ray films, and disposable medical products.
     Medical equipment expenses, which include expenses 
depreciation, leases, and rent of medical equipment used in the 
diagnosis or treatment of patients.
     All other expenses, which include expenses for legal 
services, accounting, office management, professional association 
memberships, and any professional expenses not previously mentioned in 
this section.
    In accordance with section 212 of the BBRA, we established a 
process to supplement the SMS data for a specialty with data collected 
by entities and organizations other than the AMA (that is, the 
specialty itself). (See the Criteria for Submitting Supplemental 
Practice Expense Survey Data interim final rule with comment period, 
(May 3, 2000, 65 FR 25664).) Originally, the deadline to submit 
supplementary survey data was through August 1, 2001. In the CY 2002 
PFS final rule (66 FR 55246), the deadline was extended through August 
1, 2003. To ensure maximum opportunity for specialties to submit 
supplementary survey data, we extended the deadline to submit surveys 
until March 1, 2005 in the Revisions to Payment Policies Under the 
Physician Fee Schedule for CY 2004 final rule, (November 7, 2003; 68 FR 
63196) (hereinafter referred to as CY 2004 PFS final rule).
    The CPEPs consisted of panels of physicians, practice 
administrators, and nonphysicians (registered nurses (RNs), for 
example) who were nominated by physician specialty societies and other 
groups. There were 15 CPEPs consisting of 180 members from more than 61 
specialties and subspecialties. Approximately 50 percent of the 
panelists were physicians.
    The CPEPs identified specific inputs involved in each physician's 
service provided in an office or facility setting. The inputs 
identified were the quantity and type of nonphysician labor, medical 
supplies, and medical equipment.
    In 1999, the AMA's RUC established the Practice Expense Advisory 
Committee (PEAC). From 1999 to March 2004, the PEAC, a multi-specialty 
committee, reviewed the original CPEP inputs and provided us with 
recommendations for refining these direct PE inputs for existing CPT 
codes. Through its last meeting in March 2004, the PEAC provided 
recommendations for over 7,600 codes which we have reviewed and 
accepted. As a result, the current PE inputs differ markedly from those 
originally recommended by the CPEPs. The PEAC has now been replaced by 
the Practice Expense Review Committee (PERC), which acts to assist the 
RUC in recommending PE inputs.
b. Allocation of PE to Services
    To establish PE RVUs for specific services, it is necessary to 
establish the direct and indirect PE associated with each service. Our 
current approach allocates aggregate specialty practice costs to 
specific procedures and, thus, is often referred to as a ``top-down'' 
approach. The specialty PEs are derived from the AMA's SMS survey and 
supplementary survey data. The PEs for a given specialty are allocated 
to the services furnished by that specialty on the basis of the direct 
input data and work RVUs assigned to each CPT code. The specific 
process is outlined in the June 29, 2006 proposed notice (71 FR 37242).
c. Other Methodological Issues: Nonphysician Work Pool (NPWP)
    As an interim measure, until we could further analyze the effect of 
the top-down methodology on the Medicare payment for services with no 
physician work (including the technical components (TCs) of radiation 
oncology, radiology and other diagnostic tests), we created a separate 
PE pool for these services. However, any specialty society could 
request that its services be removed from the nonphysician work pool 
(NPWP). The specific steps for the NPWP calculation are detailed in the 
June 29, 2006 proposed notice (71 FR 37243).
d. Facility/Non-facility Costs
    Procedures that can be furnished in a physician's office, as well 
as in a hospital, have two PE RVUs: facility and non-facility. The non-
facility setting includes physicians' offices, patients' homes, 
freestanding imaging centers, and independent pathology labs. Facility 
settings include hospitals, ambulatory surgical centers (ASCs), and 
skilled nursing facilities (SNFs). The methodology for calculating the 
PE RVU is the same for both facility and non-facility RVUs, but is 
applied independently to yield two separate PE RVUs. Because the PEs 
for services provided in a facility setting are generally included in 
the payment to the facility (rather than the payment to the physician 
under the fee schedule), the PE RVUs are generally lower for services 
provided in the facility setting.
2. Proposals for Revising the PE Methodology
    We have three major goals for our resource-based PE methodology:
     To ensure that the PE portion of PFS payments reflect, to 
the greatest extent possible, the relative resources required for each 
of the services on the PFS. This could only be accomplished by using 
the best available data to calculate the PE RVUs.
     To develop a payment system for PE that is understandable 
and at least somewhat intuitive, so that specialties could better 
predict the impacts of changes in the PE data.
     To stabilize the PE portion of PFS payments so that 
changes in PE RVUs do not produce large fluctuations in the payment for 
given procedures from year-to-year.
    In the CY 2006 PFS proposed rule (70 FR 45764), we proposed the 
following changes to the PE methodology that we believed would help in 
achieving these three major goals:
     Using the PE/HR data from seven specialty-specific 
supplementary surveys.
     Calculating the direct PE using a bottom-up methodology.
     Eliminating the NPWP.
    We also proposed an indirect PE methodology that was to assign to 
each service the higher of the current indirect PE RVUs or the indirect 
PE RVUs calculated using the supplementary survey data.
    In the CY 2006 PFS final rule with comment period (70 FR 70116), we 
withdrew these proposals primarily because a programming error for the 
indirect PE RVU calculation had led to the publication of inaccurate 
proposed PE RVUs. On February 15, 2006, we sponsored a PE Town Hall 
Meeting and invited the public, including all specialty representatives 
to attend. At this meeting, we supplied a detailed description of the 
bottom-up approach to the calculation of resource-based PE RVUs. Three 
examples were examined in detail that illustrated the impact of the 
various assumptions that could be used under a bottom-up approach. We 
specifically requested input from all interested parties on possible 
changes to our PE methodology, including the move to a bottom-up 
approach and the various methods of calculating indirect PE.
    We reviewed the approximately 35 comments that we received in 
response to our solicitation. Many of the comments were combined 
efforts from related specialty organizations. Additionally, the AMA RUC 
also supplied a letter that captured the

[[Page 69631]]

comments of nearly 30 specialty organizations. The following is a 
summary of the comments received as a result of the February 15, 2006 
PE Town Hall meeting.
     Delaying Implementation of Changes to the Current PE 
Methodology: There were mixed opinions from commenters on whether we 
should proceed with a proposal to use a bottom-up approach. Some 
commenters emphasized that the CPEP data has been refined and is now 
the best available source of data, and asserted that it should be used 
for the calculation of resource-based PE RVUs. Other comments suggested 
a delay in changing to a bottom-up approach because of the other issues 
that are affecting PFS payments this year (such as, the effect of 
imaging payment provisions in the DRA, the impact of the negative 
update, and the uncertainty regarding the impact of the 5-Year Review 
of work RVUs).
     Transition to a Bottom-Up Approach: The majority of 
commenters requested a minimum 1-year transition to a maximum 3-year 
transition period to fully implement any change to a bottom-up 
approach. All of the commenters supported a transition period whether 
or not they supported the implementation of a bottom-up approach.
     Use of Supplemental Survey Data: Many commenters stated 
that, irrespective of what we proposed for CY 2007, the supplemental 
survey data that has already been accepted should be used. Other 
commenters believed that the supplemental survey data grossly 
overstated PEs and should not be utilized in the development of 
resource-based PE RVUs.
     Multi-Specialty PE Survey: The majority of commenters 
supported the construction and use of a multi-specialty survey to 
collect PE data. Commenters believed that the supplemental survey data 
is inflated and that the SMS survey data are outdated.
     Review Equipment Utilization Assumptions and Interest 
Rates: Many commenters supported the review and revision of both the 
current utilization assumptions and the interest rates associated with 
high cost equipment. Commenters had mixed reactions as to whether the 
utilization rates should be higher or lower, and some suggested that we 
review the possibility of equipment-specific utilization assumptions 
for the future. Most commenters believed that the current 11 percent 
interest rate is significantly higher then the actual interest rates 
and many commenters suggested a rate of approximately prime plus 2 
percent.
     Proxy Work RVUs for No Physician Work Services: Commenters 
were divided on the assignment of a proxy work RVU to services that 
contain no physician work. Some commenters believed that no physician 
work services are unfairly penalized under any bottom-up approach, 
while other comments stated that the inclusion of a proxy work RVU 
would double count the clinical labor associated with the no physician 
work services.
    After considering these comments, we made the following proposals 
for direct PEs in the June 29, 2006 proposed notice (71 FR 37245).
a. Use a Bottom-up Method to Calculate the Direct PEs
    We believe that we have consistently made a good faith effort to 
ensure fairness in our PE RVU-setting system by using the best data 
available at any one time. The reason we did not adopt the bottom-up 
methodology originally proposed in 1997 and instead adopted the top-
down methodology finalized in 1998 was because we recognized the 
concerns among the physician community that the resource input data 
developed in 1995 by the CPEP were less reliable than the aggregate 
specialty cost data derived from the SMS process.
    However, the situation has now changed. The PEAC/PERC/RUC has 
completed the refinement of the original CPEP data and we believe that 
the refined PE inputs now, in general, accurately capture the relative 
direct costs of PFS services. Conversely, although we have now accepted 
supplementary survey data from 13 specialties, we have not received 
updated aggregate cost data from most specialties. Thus, we believe 
that, in the aggregate, the refined direct input data represent more 
reliably the relative direct cost PE inputs for physicians' services.
    Therefore, instead of using the top-down approach to calculate the 
direct PE RVUs, where the aggregate CPEP/RUC costs for each specialty 
are scaled to match the aggregate SMS costs, we proposed to adopt a 
bottom-up method of determining the relative direct costs for each 
service. Under this method, the direct costs would be determined by 
adding the costs of the resources (that is, the clinical staff, 
equipment and supplies) typically required to provide the service. The 
costs of the resources, in turn, would be calculated from the refined 
direct PE inputs in our PE database.
    We believe that this proposed change, which was welcomed by most 
commenters in the CY 2006 PFS proposed rule, will lead to greater 
stability and accuracy in the PE portion of our payment system. 
Currently, under the top-down methodology, the need to scale the CPEP 
costs to equal the SMS costs has meant that any changes in the direct 
PE inputs for one service often leads to unexpected results for other 
services where the inputs have not been altered. In addition, the 
current PE RVUs for a procedure do not necessarily change 
proportionately with changes in the direct inputs, creating possible 
anomalous values. We believe that our proposed bottom-up methodology 
would resolve these issues, so that changes in the PE RVUs would be 
more intuitive and would result in fewer surprises.
b. Use the PE/HR Data from the 7 Surveys We Have Previously Accepted 
and, in addition, Use the PE/HR Data from the Survey Submitted by the 
National Coalition of Quality Diagnostic Imaging Services (NCQDIS)
    As explained in the CY 2005 PFS final rule with comment period (69 
FR 66242), we received surveys from the American College of Cardiology 
(ACC), the American College of Radiology (ACR), and the American 
Society for Therapeutic Radiology and Oncology (ASTRO) by March 1, 
2004. The data submitted by the ACC and the ACR met our criteria. 
However, as requested by the ACC and the ACR, we deferred using their 
data until issues related to the NPWP could be addressed. (The survey 
data from ASTRO did not meet the precision criteria established for 
supplemental surveys; therefore, we did not accept or use it in the 
calculation of PE RVUs for 2005.)
    In March 2005, we also received surveys from the Association of 
Freestanding Radiation Oncology Centers (AFROC), the American 
Urological Association (AUA), the American Academy of Dermatology 
(AAD), the Joint Council of Allergy, Asthma, and Immunology (JCAAI), 
the NCQDIS, and a joint survey from the American Gastroenterological 
Association (AGA), the American Society of Gastrointestinal Endoscopy 
(ASGE) and the American College of Gastroenterology (ACG).
    All the surveys, with the exception of the survey from NCQDIS, met 
our criteria. Therefore, we proposed in the CY 2006 PFS proposed rule 
(70 FR 45775) to use the survey data from all the surveys meeting our 
criteria in the calculation of PE RVUs for 2006; but, as discussed in 
the CY 2006 PFS final rule with comment period (70 FR 70116) and

[[Page 69632]]

above in this section, this proposal was not finalized.
    We contracted with the Lewin Group (Lewin) to evaluate whether the 
supplemental survey data that were submitted met our criteria and to 
make recommendations to us regarding their suitability for use in 
calculating PE RVUs. As described in the CY 2006 PFS proposed rule (70 
FR 45775), Lewin recommended blending the radiation oncology data from 
the AFROC survey data with the ASTRO survey data submitted in 2004 to 
calculate the PE/HR. According to Lewin, the goal of the AFROC survey 
was to represent the population of freestanding radiation oncology 
centers only. To develop an overall average for the radiation oncology 
PE pool, Lewin recommended we use the AFROC survey for freestanding 
radiation oncology centers, and the hospital-based subset of last 
year's ASTRO survey. We agreed that this blending of the AFROC and 
ASTRO data was a reasonable way to calculate an average PE/HR that 
fully reflects the practice of radiation oncology in all settings. 
Blending the survey data overcame the initial problem that the ASTRO 
data do not meet the precision criteria as discussed in the CY 2005 PFS 
final rule (69 FR 66242). In addition, as discussed in the CY 2006 PFS 
proposed rule (70 FR 45776), blending of the data allowed for a broader 
base of radiation oncology providers to be represented.
    Also, as discussed in the CY 2006 PFS proposed rule (70 FR 45764), 
Lewin indicated that the survey data submitted by the NCQDIS on 
independent diagnostic testing facilities (IDTFs) did not meet our 
precision criterion. However, upon further analysis, Lewin agreed with 
NCQDIS' determination that the inclusion of one inaccurate record 
skewed the findings outside the acceptable precision range. Lewin 
recalculated the precision level at 8.1 percent of the mean PE/HR 
(weighted by the number of physicians in the practice). Lewin indicated 
that the level of precision for the total PE/HR satisfies the level of 
precision requirement, and recommended acceptance of the survey.
    We proposed to use the PE/HR data from all of these surveys, 
including the NCQDIS survey, in the calculation of the PE RVUs for 
2007. For radiation oncology, we proposed to use the new PE/HR derived 
from combining the AFROC and ASTRO survey data, as recommended by 
Lewin. The proposed figures for PE per physician hour were listed in 
Table 52 in the June 29, 2006 proposed notice (71 FR 37246).
    Section 303(a)(1)(B) of the Medicare Prescription Drug, 
Improvement, and Modernization Act of 2003 (MMA) (Pub. L. 108-173) 
added section 1848(c)(2)(I) of the Act to require CMS to use survey 
data submitted by a specialty group where at least 40 percent of the 
specialty's payments for Part B services are attributable to the 
administration of drugs in 2002 to adjust PE RVUs for drug 
administration services. The statute applies to surveys that include 
expenses for the administration of drugs and biologicals, and were 
received by March 1, 2005 for determining the CY 2006 PE RVUs. Section 
303(a)(1)(A)(ii) of the MMA also added section 1848(c)(2)(B)(iv)(II) of 
the Act to provide an exemption from budget neutrality (BN) in 2005 and 
2006 for any additional expenditures resulting from the use of these 
surveys. In the Changes to Medicare Payment for Drugs and Physician Fee 
Schedule Payments for CY 2004 interim final rule published January 7, 
2004 (69 FR 1084), we stated that the specialties of urology, 
gynecology, and rheumatology meet this criteria. As described in the CY 
2006 PFS final rule with comment period (70 FR 70116), we accepted for 
the purposes of calculating the 2006 PE RVUs for drug administration 
services the new survey data from the AUA and exempted from the BN 
adjustment any impacts of accepting these data for purposes of 
calculating PE RVUs for drug administration services.

    (Note: Rheumatology and gynecology did not submit supplemental 
survey data.)
c. Eliminate the NPWP and Calculate the PE RVUs for all Services Using 
the Same Methodology
    Primarily because of the lack of representative SMS data or 
accurate direct cost inputs for specialties such as radiology and 
radiation oncology, the adoption of the top-down approach necessitated 
the creation of the NPWP. This separate work pool was created to 
allocate PE RVUs for TC codes and codes that are not furnished by 
physicians and, thus, have no work RVUs. In the CY 2000 Physician Fee 
Schedule; Payment Policies and Relative Value Unit Adjustment final 
rule, we indicated that ``the purpose of this pool was only to protect 
the (TC) services from the substantial decreases'' caused by inaccurate 
CPEP data and the lack of physician work RVU in the allocation of the 
indirect costs (64 FR 59406). Unfortunately, the services priced by the 
NPWP methodology have proven to be especially vulnerable to any change 
in the work pool's composition. This has led to significant 
fluctuations from year-to-year in the PE RVUs calculated for these 
services.
    The major specialties comprising the NPWP (radiology, radiation 
oncology and cardiology) have now submitted supplemental survey data 
that we have accepted and proposed to use in their PE calculations. 
(See the discussion on supplementary surveys above in this section.) 
Now that we have representative aggregate PE data for these 
specialties, and with the completion of the refinement of the direct 
cost inputs, the continued necessity and equity of treating these 
technical services outside the PE methodology applied to other services 
is questionable.
    Therefore, we proposed to eliminate the NPWP and to calculate the 
PE RVUs for the services currently in the work pool by the same 
methodology used for all other services. This would also allow the use 
of the refined CPEP/RUC data to price the direct costs of individual 
services, rather than utilizing the pre-1998 charge-based PE RVUs. In 
addition, the revised methodology would lead to greater stability for 
the PE RVUs for these services and would lead to more intuitive results 
than have occurred with the NPWP methodology.
d. Modify the Current Indirect PE RVUs Methodology
    As described previously, the SMS and supplementary survey data are 
the source for the specialty-specific aggregate indirect costs used in 
our PE calculations. We then allocate the indirect costs to particular 
codes on the basis of the direct costs allocated to a code and the work 
RVUs. In the CY 2006 PFS proposed rule (70 FR 45764), we stated that we 
had no information that would indicate that the current indirect PE 
methodology is inaccurate. At that time, we also were not aware of any 
alternative approaches or data sources that we could use to calculate 
more appropriately the indirect PE, other than the new supplementary 
survey data, which we proposed to incorporate into our PE calculations. 
Therefore, in the CY 2006 PFS proposed rule, we proposed to use the 
current indirect PEs in our calculation, incorporating the new survey 
data into the codes furnished by the specialties submitting the surveys 
(71 FR 45764). We also indicated in

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