New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 57 - PODIATRY SERVICES
Subchapter 3 - CENTERS FOR MEDICARE AND MEDICAID SERVICES CMS HEALTHCARE COMMON PROCEDURE CODING SYSTEM (HCPCS)
Section 10:57-3.2 - HCPCS procedure codes and maximum fee allowance

Universal Citation: NJ Admin Code 10:57-3.2

Current through Register Vol. 56, No. 18, September 16, 2024

(a) MEDICINE

IND HCPCS Code Mod Maximum Fee Allowance S $ NS Anes Basic Units
90703 17.72 3.40
9392222.0021.00
9392226 9.00 8.00
93922TC13.0013.00
93923 45.00 42.00
93923 26 18.10 15.10
93923 TC 26.90 22.00
9396530.0028.00
939652612.0010.00
93965TC18.0018.00
93970 62.00 58.00
939702624.0020.00
93970TC38.0038.00
9397130.0028.00
939712612.0010.00
93971 TC NA 18.00
96360 20.22 17.19
96361 7.12 6.05
96365 38.35 32.60
96366 11.39 9.68
96367 16.53 14.05
96368 11.03 9.37
96369 89.74 76.28
96370 8.13 6.91
9637135.3830.97
963728.727.41
963739.878.39
9637420.7817.66
963758.847.51
9637614.1412.01
963792.502.50
9902522.0017.00
99199B.R.B.R.
N9920124.7821.06
N9920241.0834.92
N9920358.0249.31
N9920487.5974.45
N99205109.8993.40
N9921116.0014.00
N9921224.4120.22
N9921339.8533.87
N9921458.2149.48
N9921577.7666.10
N9921738.6432.84
N9922153.1745.19
N9922271.8861.10
N99223106.2490.30
N9923123.5020.60
N9923238.2032.47
N9923354.5946.40
N9923469.8059.33
N9923588.9075.56
N99236114.2397.10
9923838.6432.84
N9923956.6448.14
N9924144.0037.00
N9924264.7054.40
N9924364.7054.40
N9924491.1077.90
N9924591.1077.90
N9925134.5029.30
N9925264.7054.40
N9925364.7054.40
N9925491.1077.90
N9925591.1077.90
N9926116.0014.00
9926223.5020.60
9926323.5020.60
9928116.0014.00
9928223.5020.60
9928332.2327.40
9928461.1151.94
9928589.9276.43
N9930445.6738.82
N9930566.0756.16
N9930684.5771.88
N9930722.3919.03
N9930835.0829.81
N9930946.6239.63
N9931068.9558.60
N9931538.8333.01
N9931655.8047.43
N9931848.6641.36
N9932428.0623.85
N9932540.5634.47
N9932670.3659.81
N9933430.6526.05
N9933548.2641.02
N9933668.7358.42
N9934129.1824.81
N9934241.9435.65
N9934363.8258.07
9934496.0581.64
99345116.8399.30
N9934735.0035.00
9934851.5051.50
9934968.1457.92
9935094.4380.26
N99499B.R.B.R.
N99600B.R.B.R.

(b) SURGERY

IND HCPCS Code Mod Follow Up Days Maximum Fee Allowance S $ NS Anes Basic Units
10021049.0045.003
10021TC019.0019.000
1002126030.0026.000
10022087.0078.003
10022TC026.0026.000
1002226061.0052.000
10060013.0011.003
100611048.0042.003
10120018.0016.003
101213034.0029.003
10140018.0016.003
10160013.0011.003
1018014100.0085.003
11000013.0011.003
110010 6.00 5.003
11040013.0011.003
11041013.0011.003
11042016.0014.003
11043 0 23.93 20.34 3
11044048.0042.003
11055013.0011.003
11056018.0015.003
11057023.0020.003
11100713.0011.003
111010 5.00 4.003
11300018.0016.003
11301022.0020.003
11302027.0024.003
11303032.0027.003
11305018.0016.003
11306022.0020.003
11307027.0024.003
11308032.0027.003
114001518.0016.003
114011522.0020.003
114021527.0024.003
114031532.0027.003
114041532.0027.003
114061532.0027.003
114201518.0016.003
114211522.0020.003
114221527.0024.003
114231532.0027.003
114241532.0027.003
114261532.0027.003
114701591.0078.005
116009037.0032.003
116019047.0042.003
116029061.0053.003
116049080.0070.003
116069092.0080.003
116209061.0053.003
116219090.0079.003
1162290121.00105.003
1162390140.00121.003
1162490162.00139.003
1162690186.00160.003
117190 5.00 5.003
11720013.0011.003
E11721021.0018.003
11730 0 11.58 9.84 3
11732 0 3.91 3.32 3
11740016.0014.003
117503042.0037.003
117523059.0050.003
11755025.0020.003
117606042.0037.003
117629069.0059.003
117656021.0018.003
11900016.0014.003
11901016.0014.003
119810100.0085.003
119820100.0085.003
119830180.00153.003
12001018.0016.003
12002024.0021.003
12004030.0026.003
12005746.0039.003
12006757.0048.003
12007782.5070.003
12020757.0048.005
12021757.0048.005
120413030.0026.003
120423067.0059.004
120443082.5070.004
120453099.0084.004
1204630110.0094.004
1204730143.00120.004
131313067.0059.004
1313230145.00126.004
1316030121.00103.003
1330030242.00210.004
1404060193.00168.004
1404160242.00210.004
1430060242.00210.004
1435060193.00168.003
150001070.5060.003
15001040.0034.000
15050 30 62.87 53.44 4
1510045121.00105.003
151014561.0053.004
1512045182.00158.004
151214561.0053.004
1522045151.00131.004
152213076.0065.003
1524045151.00131.004
152413076.0065.003
15342036.0031.000
+ 15343012.0010.000
153504568.0054.003
15351054.0046.000
154004568.0054.003
15401050.0043.000
1557245217.00185.003
1557445217.00185.005
156104589.0077.004
1562045121.00105.004
15850035.0035.003
15851035.0035.003
15852035.0035.003
16000016.0014.005
16010035.0035.003
160150100.0085.003
16020016.0014.000
16025024.0020.000
16030032.0027.000
16035 0 21.07 17.91 3
+ 16036040.0034.000
17000016.0014.003
170030 5.00 4.003
17004052.0046.003
171060111.7595.003
171070212.80180.903
171080322.85274.403
17110016.0014.003
17111023.0020.003
17250016.0014.003
172701529.2024.813
172711543.7437.203
172721552.2044.363
172731561.4852.263
172741576.8165.303
172761594.2780.153
173040100.0085.003
17305025.0021.003
17306025.0021.003
17307025.0021.003
17310015.0013.003
17340018.0015.003
20000018.0016.003
20005045.0040.004
20206029.0025.003
20520751.0045.003
205257102.0090.004
D20550013.0011.005
E20551013.0011.003
E20552013.0011.003
E20553013.0011.003
D20600013.0011.003
D20605013.0011.003
20615080.0068.003
20650055.0047.004
20670 0 42.82 36.40 3
2068021121.00105.004
20690 0 65.48 55.66 5
20692 21 211.75 180.00 3
2069321136.15115.003
206942160.5051.003
2083890400.00340.004
2090030113.0096.003
2095760616.00524.006
275303074.0065.003
2753290121.00105.003
2753590242.00210.003
2753690242.00210.003
2760330114.0097.003
27604 0 54.65 46.45 3
27605 15 38.34 32.59
276063063.0054.003
2760730228.00194.003
2761060182.00158.003
2761230182.00158.003
27613 0 28.18 23.95 3
27614 0 64.45 54.78 3
2761560228.00194.003
27618 0 50.28 42.74 3
276193057.0049.003
2762060182.00158.003
2762590211.00184.003
2762660228.00194.003
276303090.0079.003
2763560228.00194.004
2763760285.00243.004
2763860285.00243.004
2764060211.00184.004
2764160211.00184.004
2764590342.00291.004
2764690342.00291.004
2764790371.00316.004
27648018.0016.003
2765090227.00197.004
2765290314.00267.004
2765490314.00267.004
27656 90 911.18 774.50 3
2765890121.00105.003
2765990121.00105.003
276649090.0079.003
276659090.0079.003
2767530171.00146.003
2767630200.00170.003
2768030143.00122.003
2768130171.00146.003
2768590151.00131.004
2768690202.00175.003
2768730171.00146.003
2769090182.00158.003
2769190342.00291.003
E276923029.0025.003
2769590302.00263.003
2769690342.00291.003
2769890227.00197.003
2770090249.00216.003
2770590272.00236.003
2770790113.00100.003
2770990350.00298.003
2771290288.00251.003
2771590570.00485.004
2772090399.00340.003
2772290428.00364.003
2772590570.00485.004
2772790570.00485.004
2773090257.00219.003
2773230143.00122.003
2773490314.00267.003
2774090302.00263.003
2774290439.00382.003
2774560200.00170.003
2775030114.0097.003
2775290121.00105.003
2775690211.00184.003
2775890314.00267.003
277609079.0068.003
277629079.0068.003
2776690151.00131.003
27780745.0039.003
277813045.0039.003
2778490121.00105.003
277869072.0063.003
277889079.0068.003
2779290151.00131.003
2780830100.0085.003
2781090121.00105.003
2781490211.00184.003
2781630100.0085.003
2781890121.00105.003
2782290242.00210.003
2782390242.00210.003
2782430100.0085.003
2782590121.00105.003
2782690242.00210.003
2782790242.00210.003
2782890242.00210.003
2782990305.00263.003
278303060.0051.003
278313080.0068.003
2783290164.00142.003
278404561.0053.000
278424561.0053.003
2784690305.00263.003
2784860275.00233.003
27860061.0053.003
2787090302.00263.003
2787190302.00263.003
2788090242.00210.003
2788160266.00226.003
2788290155.00137.004
27884 0 63.9354.34 4
2788690242.00210.003
2788890242.00210.003
2788960242.00210.003
2789290127.00108.003
2789390127.00108.003
2789490147.00125.003
28001 0 31.4826.76 3
28002 0 49.2641.87 3
2800330100.0085.003
2800530150.00128.003
280086061.0053.003
28010 0 25.7721.90 3
28011037.0032.003
2802060109.0095.003
2802260109.0095.003
28024 60 52.1844.35 3
2803030143.00122.003
2803530171.00146.003
28043 0 45.1638.39 3
28045057.0049.003
2804660228.00194.003
2805030171.00146.003
2805230103.0088.003
280543086.0074.003
2806030143.00122.003
2806260228.00194.003
2807030171.00146.003
2807230103.0088.003
2808030121.00105.003
2808630160.00136.003
2808830114.0097.003
280903090.0079.003
280923061.0053.003
2810060121.00105.004
2810260200.00170.003
2810360200.00170.003
2810430143.00122.004
2810660200.00170.003
2810760200.00170.003
2810860121.00105.004
281103069.0059.003
2811130171.00146.003
2811230103.0088.003
2811330103.0088.003
2811490242.00210.003
2811630171.00146.003
2811830143.00122.003
2811930143.00122.003
281206090.0079.004
281226090.0079.004
281246090.0079.004
2812630143.00122.003
2813090211.00184.003
2814060121.00105.003
281509090.0079.003
281533069.0059.003
281609090.0079.003
2817190371.00316.003
2817390371.00316.003
2817590371.00316.003
28190 0 29.1424.77 3
28192 30 52.8544.92 4
28193 30 59.8150.84 4
2820090121.00105.003
2820230161.00137.003
282089061.0053.003
2821030103.0088.003
2822060113.0099.003
2822260139.00119.003
2822560113.0099.003
2822660139.00119.003
28230 30 49.2641.87 3
2823260139.00119.003
2823460139.00119.003
2823830171.00146.003
282403061.0053.003
2825030143.00122.003
2826030171.00146.003
2826160200.00170.003
2826260212.00184.003
2826460285.00243.003
282703069.0059.003
28272 30 44.4837.80 3
282804561.0053.003
282859090.0079.003
282863068.0057.003
282882172.0063.003
2828990228.00194.003
282906090.0079.003
2829290139.00121.003
2829390242.00210.003
2829490141.00123.003
2829660200.00170.003
2830560217.00185.003
2830690113.00100.003
2830760217.00185.003
2830890113.00100.003
2830960257.00219.003
283103069.0059.003
28312 30 58.5549.77 3
283139090.0079.003
283156055.0047.003
2832060200.00170.003
2832230143.00122.003
283409090.0079.003
283419090.0079.003
28344 45 63.1253.65 3
283459090.0079.003
284003068.0059.003
284059090.0079.003
2840660228.00194.003
2841590151.00131.003
2842090300.00255.003
284303082.0072.003
284359090.0079.003
2843630175.00149.003
2844560275.00234.003
284503041.0036.003
284559061.0053.003
2845630121.00103.003
2846590121.00105.003
28470 30 24.5820.72 3
284759042.0037.003
284763082.0070.003
284859090.0079.003
284903018.0016.003
284953030.0026.003
284963060.0051.003
2850530120.00102.003
285103018.0016.003
285153030.0026.003
285253090.0077.003
285303018.0016.003
285313059.0050.003
285404561.0053.000
285454561.0053.003
285463069.0059.003
2855590211.00184.003
285704561.0053.000
285754561.0053.003
2857645118.00100.003
2858590211.00184.003
286004561.0053.000
286054561.0053.003
286063069.0059.003
2861530143.00122.003
286304561.0053.000
28635765.0055.003
28636785.0072.003
2864590121.00105.003
28660016.0014.000
28665035.0030.003
286664580.0068.003
28675 60 65.7355.87 3
2870590361.00307.003
2871590272.00236.003
2872590182.00158.003
2873060203.00173.003
2873560226.00192.003
2873760200.00170.003
2874090166.00126.003
287509090.0079.003
287559090.0079.003
2876090200.00173.003
2880090211.00184.003
2880590211.00184.003
2881090121.00105.003
28820 45 63.6754.12 3
28820 50 45 94.9680.71 3
28825 45 60.9451.80 3
28825 50 45 90.8977.25 3
288990B.R.B.R.0
29345053.0042.003
29355047.0042.003
29358241.0034.853
29365053.0042.003
E D29405042.0037.003
E D29425047.0042.003
E D29435066.0053.003
E D29440012.0010.003
E D29450024.0021.003
E D2945050037.0032.003
E D29505048.0042.003
E D29515042.0037.003
E D29540018.0016.003
E D29550016.0014.003
E D29580018.0016.003
E D29590012.0010.003
E D29700014.0012.003
E D29705014.0012.003
E D2973009.008.003
E D 29740 0 11.059.39 3
E D 29750 0 11.329.62 3
E D2975050015.0013.003
E D297990B.R.B.R.0
2989190236.00201.003
2989290243.00206.003
2989390137.00116.003
2989430100.0085.003
2989590200.00170.004
2989760100.0085.003
2989860150.00128.003
29899 90 225.00191.00 3
299090BRBR0
2999990BRBR3
E D36410018.0016.000
E N D3641501.801.800
36470 0 16.7014.19
36471 0 20.0317.02
E64450018.0016.000
646141077.0065.000
647029079.0068.003
6470490105.0091.003
6470890242.00210.003
647269090.0077.003
64774 30 45.9639.06 3
647763053.0045.003
647783030.0026.003
647823079.0068.003
647833070.0060.003
6478430131.00114.004
648319079.0068.003
648323043.0037.003
6483490105.0091.003
6485690210.00183.003
6485790158.00137.003
97601035.0030.000

NOTE: "+" means that these add-on codes are always performed in addition to the primary procedure only, by the same practitioner. These add-on codes are exempt from multiple surgical pricing methodologies.

(c) RADIOLOGY

INDHCPCS CodeModMaximum Fee Allowance S $ NSAnnes Basic Units
7360010.003
73600263.60
73600TC6.40
7361013.003
73610265.40
73610TC7.60
7361528.803
736152610.80
73615TC18.00
7362010.003
73620263.60
73620TC6.40
7363013.003
73630265.40
73630TC7.60
7365010.003
73650263.60
73650TC6.40
736605.003
73660263.60
73660TC1.40

(d) PATHOLOGY & LABORATORY SERVICES

INDHCPCS CodeModMaximum Fee Allowance
810001.20
829481.50
850021.20
850081.20
8667115.00
870709.00
870766.00
870843.00
871018.00
871028.00
871038.00
871068.00
872102.40
872202.40

Disclaimer: These regulations may not be the most recent version. New Jersey may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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