CPT 43200 - FindACode.com

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Fees

Calculated for Na (00000)

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* Note: Medicare may or may NOT reimburse you for this code. The fees provided below are based on values established by CMS/Medicare. Please check with your local Medicare contact on whether this code is eligible for reimbursement.

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Facility (Hospital, etc.)

Modifier	Medicare Allowed	150%	200%	My Fee
(none)	$106.88	$160.32	$213.76	(your fee)

Modifier	Allowed	Medicare 80%	Patient Pays
(none)	$106.88	$##.##	$##.##

Modifier	Allowed	Medicare 80%	Patient Pays	Limiting Charge (Amount Billed)
(none)	$##.##	$##.##	$##.##	$##.##

Modifier	Allowed	Medicare 80%	Patient Pays	Limiting Charge (Amount Billed)
(none)	$##.##	$##.##	$##.##	$##.##

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Non-Facility (Office, etc.)

Modifier	Medicare Allowed	150%	200%	My Fee
(none)	$222.27	$333.40	$444.53	(your fee)

Modifier	Allowed	Medicare 80%	Patient Pays
(none)	$222.27	$##.##	$##.##

Modifier	Allowed	Medicare 80%	Patient Pays	Limiting Charge (Amount Billed)
(none)	$##.##	$##.##	$##.##	$##.##

Modifier	Allowed	Medicare 80%	Patient Pays	Limiting Charge (Amount Billed)
(none)	$##.##	$##.##	$##.##	$##.##

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RVUs - Relative Value Units

Calculated for Na (00000)

Click Here and update your Location/Bookmarks/Fee Schedules to see geographic-specific data below.

* Note: Medicare may or may NOT reimburse you for this code. The fees provided below are based on values established by CMS/Medicare. Please check with your local Medicare contact on whether this code is eligible for reimbursement.

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Facility 3.14 (Hospital, etc.)

RVU Components (by modifier)

Modifier	Work	Practice Expense	Malpractice Expense	Total
(none)	1.59	1.32	0.23	3.14

Note: Subscribers with the Hospital/Facility product will see calculated values below.

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Practitioner Work Component: 1.59

Pre-Service	Intra-Service	Post-Service	Total Time*
##	##	##	## min

Modifier	National Unadjusted Work RVU	Work GPCI	Adjusted Work RVU
(none)	##.##	##.##	1.59

Practice Expense: 1.32

Clinical Labor - Direct Expense

Staff	Staff Rate	Pre Time	Intra Time	Post Time	Total Time*
RN/LPN/MTA	.37 / min	## min	## min	## min	## min

* Total Time may be greater than the displayed components.

Equipment - Direct Expense

Item	Purchase Price	Expected Life	Total Time
light, surgical	$##.##	## years	## min
table, power	$##.##	## years	## min
suction machine (Gomco)	$##.##	## years	## min
endoscope disinfector, rigid or fiberoptic, w-cart	$##.##	## years	## min
video system, endoscopy (processor, digital capture, monitor, printer, cart)	$##.##	## years	## min
videoscope, gastroscopy	$##.##	## years	## min

Supplies - Direct Expense

Item	Unit Price	Quantity	Unit	Amount
pack, minimum multi-specialty visit	$##.##	##	pack	$##.##
cap, surgical	$##.##	##	item	$##.##
drape, non-sterile, sheet 40in x 60in	$##.##	##	item	$##.##
gloves, non-sterile	$##.##	##	pair	$##.##
gown, staff, impervious	$##.##	##	item	$##.##
mask, surgical, with face shield	$##.##	##	item	$##.##
shoe covers, surgical	$##.##	##	pair	$##.##
syringe 50-60ml	$##.##	##	item	$##.##
canister, suction	$##.##	##	item	$##.##
endoscopic cytology brush	$##.##	##	item	$##.##
tubing, suction, non-latex (6ft uou)	$##.##	##	item	$##.##
tubing, suction, non-latex (6ft) with Yankauer tip (1)	$##.##	##	item	$##.##
applicator, cotton-tipped, non-sterile 6in	$##.##	##	item	$##.##
gauze, sterile 4in x 4in (10 pack uou)	$##.##	##	item	$##.##
basin, irrigation	$##.##	##	item	$##.##
basin, emesis	$##.##	##	item	$##.##
lubricating jelly (K-Y) (5gm uou)	$##.##	##	item	$##.##
swab-pad, alcohol	$##.##	##	item	$##.##
cup, biopsy-specimen non-sterile 4oz	$##.##	##	item	$##.##
cleaning brush, endoscope	$##.##	##	item	$##.##
endoscope anti-fog solution	$##.##	##	ml	$##.##
enzymatic detergent	$##.##	##	oz	$##.##
glutaraldehyde 3.4% (Cidex, Maxicide, Wavicide)	$##.##	##	oz	$##.##
glutaraldehyde test strips (Cidex, Metrex)	$##.##	##	item	$##.##
scrub brush (impregnated)	$##.##	##	item	$##.##

Indirect Expenses (clerical,overhead, and other) are also included in the practice expense.

PE RVU Components (by modifier)

Modifier	National Unadjusted PE RVU	PE GPCI	Adjusted PE RVU
(none)	##.##	##.##	1.32

Malpractice Component: 0.23

Modifier	National Unadjusted MP RVU	MP GPCI	Adjusted MP RVU
(none)	##.##	##.##	0.23

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Non-Facility 6.53 (Office, etc.)

RVU Components (by modifier)

Modifier	Work	Practice Expense	Malpractice Expense	Total
(none)	1.59	4.71	0.23	6.53

Note: Subscribers will see the calculated values below.

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Practitioner Work Component: 1.59

Pre-Service	Intra-Service	Post-Service	Total Time*
##	##	##	## min

Modifier	National Unadjusted Work RVU	Work GPCI	Adjusted Work RVU
(none)	##.##	##.##	1.59

Practice Expense: 4.71

Clinical Labor (Non-Facility)- Direct Expense

Staff	Staff Rate	Pre Time	Intra Time	Post Time	Total Time*
RN/LPN/MTA	.37 / min	## min	## min	## min	## min

* Total Time may be greater than the displayed components.

Equipment (Non-Facility)- Direct Expense

Item	Purchase Price	Expected Life	Total Time
light, surgical	$##.##	## years	## min
table, power	$##.##	## years	## min
suction machine (Gomco)	$##.##	## years	## min
endoscope disinfector, rigid or fiberoptic, w-cart	$##.##	## years	## min
video system, endoscopy (processor, digital capture, monitor, printer, cart)	$##.##	## years	## min
videoscope, gastroscopy	$##.##	## years	## min

Supplies (Non-Facility)- Direct Expense

Item	Unit Price	Quantity	Unit	Amount
pack, minimum multi-specialty visit	$##.##	##	pack	$##.##
cap, surgical	$##.##	##	item	$##.##
drape, non-sterile, sheet 40in x 60in	$##.##	##	item	$##.##
gloves, non-sterile	$##.##	##	pair	$##.##
gown, staff, impervious	$##.##	##	item	$##.##
mask, surgical, with face shield	$##.##	##	item	$##.##
shoe covers, surgical	$##.##	##	pair	$##.##
syringe 50-60ml	$##.##	##	item	$##.##
canister, suction	$##.##	##	item	$##.##
endoscopic cytology brush	$##.##	##	item	$##.##
tubing, suction, non-latex (6ft uou)	$##.##	##	item	$##.##
tubing, suction, non-latex (6ft) with Yankauer tip (1)	$##.##	##	item	$##.##
applicator, cotton-tipped, non-sterile 6in	$##.##	##	item	$##.##
gauze, sterile 4in x 4in (10 pack uou)	$##.##	##	item	$##.##
basin, irrigation	$##.##	##	item	$##.##
basin, emesis	$##.##	##	item	$##.##
lubricating jelly (K-Y) (5gm uou)	$##.##	##	item	$##.##
swab-pad, alcohol	$##.##	##	item	$##.##
cup, biopsy-specimen non-sterile 4oz	$##.##	##	item	$##.##
cleaning brush, endoscope	$##.##	##	item	$##.##
endoscope anti-fog solution	$##.##	##	ml	$##.##
enzymatic detergent	$##.##	##	oz	$##.##
glutaraldehyde 3.4% (Cidex, Maxicide, Wavicide)	$##.##	##	oz	$##.##
glutaraldehyde test strips (Cidex, Metrex)	$##.##	##	item	$##.##
scrub brush (impregnated)	$##.##	##	item	$##.##

Indirect Expenses (clerical,overhead, and other) are also included in the practice expense.

PE RVU Components (by modifier)

Modifier	National Unadjusted PE RVU	PE GPCI	Adjusted PE RVU
(none)	##.##	##.##	4.71

Malpractice Component: 0.23

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CPT^{^®} Code Set - 43200

2010

2008

1999

1998

1997

1994

1991

Coder Pink Sheets

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CPT® Code Set - 43200

2010

2008

1999

1998

1997

1994

1991

Coder Pink Sheets

Part B News

Answer Books

Questions? Suggestions? Problems? Tell us!

CPT^{^®} Code Set - 43200