Code Changed 2011-01-01
43234 - CPT® Code
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Changed Code for 2011
This code was changed for 2011.
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® Assistant is the official newsletter on CPT coding, published by the AMA. The CPT Assistant Archives are available to subscribers as an add-on.
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The following CPT® Assistant Articles refer to this code (43234):
2007
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The following DecisionHealth® Articles are linked to this code (43234):
Coder Pink Sheets
Part B News
Answer Books
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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.
Medicare vs. My Fee Evaluation
| Modifier |
Medicare Allowed |
150% |
200% |
My Fee |
| (none) |
$123.22 |
$184.82 |
$246.43 |
(your fee)
|
Note: Subscribers with the Hospital/Facility product will see calculated values below.
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Medicare Participating - Assignment Accepted (Mandatory)
| Modifier |
Allowed |
Medicare 80% |
Patient Pays |
|
| (none) |
$123.22 |
$##.## |
$##.## |
|
Medicare Non-Participating - Assignment Accepted (Check To Doctor)
| Modifier |
Allowed |
Medicare 80% |
Patient Pays |
Limiting Charge (Amount Billed) |
| (none) |
$##.## |
$##.## |
$##.## |
$##.## |
Medicare Non-Participating - Assignment NOT Accepted (Check To Patient)
| Modifier |
Allowed |
Medicare 80% |
Patient Pays |
Limiting Charge (Amount Billed) |
| (none) |
$##.## |
$##.## |
$##.## |
$##.## |
Medicare vs. My Fee Evaluation
| Modifier |
Medicare Allowed |
150% |
200% |
My Fee |
| (none) |
$289.66 |
$434.49 |
$579.32 |
(your fee)
|
Note: Subscribers will see the calculated values below.
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Medicare Participating - Assignment Accepted (Mandatory)
| Modifier |
Allowed |
Medicare 80% |
Patient Pays |
|
| (none) |
$289.66 |
$##.## |
$##.## |
|
Medicare Non-Participating - Assignment Accepted (Check To Doctor)
| Modifier |
Allowed |
Medicare 80% |
Patient Pays |
Limiting Charge (Amount Billed) |
| (none) |
$##.## |
$##.## |
$##.## |
$##.## |
Medicare Non-Participating - Assignment NOT Accepted (Check To Patient)
| Modifier |
Allowed |
Medicare 80% |
Patient Pays |
Limiting Charge (Amount Billed) |
| (none) |
$##.## |
$##.## |
$##.## |
$##.## |
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.
RVU Components (by modifier)
| Modifier | Work | Practice Expense | Malpractice Expense | Total |
| (none) | 2.01 | 1.27 | 0.34 | 3.62 |
Note: Subscribers with the Hospital/Facility product will see calculated values below.
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Practitioner Labor
| Pre-Service | Intra-Service | Post-Service | Total Time* |
| ## | ## | ## | ## min |
* Total Time may be greater than the displayed components.
Work RVU Components (by modifier)
| Modifier | National Unadjusted Work RVU | Work GPCI | Adjusted Work RVU |
| (none) | ##.## | ##.## | 2.01 |
Clinical Labor - Direct Expense
| Staff | Staff Rate | Pre Time | Intra Time | Post Time | Total Time* |
| RN/LPN/MTA | .37 / min | ## min | ## min | ## min | ## min |
| RN | .51 / 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 |
| stretcher, endoscopy | $##.## | ## years | ## min |
| table, instrument, mobile | $##.## | ## years | ## min |
| table, power | $##.## | ## years | ## min |
| ECG, 3-channel (with SpO2, NIBP, temp, resp) | $##.## | ## years | ## min |
| IV infusion pump | $##.## | ## 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 |
| kit, needle-free injection system | $##.## | ## | kit | $##.## |
| pack, moderate sedation | $##.## | ## | pack | $##.## |
| 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 | $##.## |
| iv tubing (extension) | $##.## | ## | foot | $##.## |
| syringe 50-60ml | $##.## | ## | item | $##.## |
| canister, suction | $##.## | ## | item | $##.## |
| endoscopic cytology brush | $##.## | ## | item | $##.## |
| nasal cannula | $##.## | ## | 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) | ##.## | ##.## | 1.27 |
MP RVU Components (by modifier)
| Modifier | National Unadjusted MP RVU | MP GPCI | Adjusted MP RVU |
| (none) | ##.## | ##.## | 0.34 |
RVU Components (by modifier)
| Modifier | Work | Practice Expense | Malpractice Expense | Total |
| (none) | 2.01 | 6.16 | 0.34 | 8.51 |
Note: Subscribers will see the calculated values below.
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Practitioner Labor
| Pre-Service | Intra-Service | Post-Service | Total Time* |
| ## | ## | ## | ## min |
* Total Time may be greater than the displayed components.
Work RVU Components (by modifier)
| Modifier | National Unadjusted Work RVU | Work GPCI | Adjusted Work RVU |
| (none) | ##.## | ##.## | 2.01 |
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 |
| RN | .51 / 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 |
| stretcher, endoscopy | $##.## | ## years | ## min |
| table, instrument, mobile | $##.## | ## years | ## min |
| table, power | $##.## | ## years | ## min |
| ECG, 3-channel (with SpO2, NIBP, temp, resp) | $##.## | ## years | ## min |
| IV infusion pump | $##.## | ## 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 |
| kit, needle-free injection system | $##.## | ## | kit | $##.## |
| pack, moderate sedation | $##.## | ## | pack | $##.## |
| 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 | $##.## |
| iv tubing (extension) | $##.## | ## | foot | $##.## |
| syringe 50-60ml | $##.## | ## | item | $##.## |
| canister, suction | $##.## | ## | item | $##.## |
| endoscopic cytology brush | $##.## | ## | item | $##.## |
| nasal cannula | $##.## | ## | 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) | ##.## | ##.## | 6.16 |
MP RVU Components (by modifier)
| Modifier | National Unadjusted MP RVU | MP GPCI | Adjusted MP RVU |
| (none) | ##.## | ##.## | 0.34 |
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