|
CPT Code |
Description |
Current ASC Group(1) |
Current Payment(1) |
Proposed APC(2) |
APC Group Definition(2) |
Proposed APC Payment(2) |
Reimbursment Impact |
|
19100 |
Breast Biopsy; Core |
1 |
$314 |
122 |
Level II needle biopsy,aspiration |
$186 |
($128) |
|
19101 |
Breast Biopsy; incisional |
2 |
$422 |
197 |
Incision/Excision Breast |
$411 |
($11) |
|
19125 |
Excision of breast lesion identified by preoperative placement
of radiological marker |
3 |
$482 |
197 |
Incision/Excision Breast |
$411 |
($71) |
|
19160 |
Mastectomy; partial |
3 |
$482 |
198 |
Breast reconstruction/ mastectomy |
$596 |
$114 |
|
19290 |
Preoperative placement of needle localization wire |
1 |
$314 |
197 |
Incision/Excision Breast |
$411 |
$97 |
|
38500 |
Biopsy or excision of lymph node(s); superficial |
2 |
$422 |
396 |
Lymph node excision |
$440 |
$18 |
|
38510 |
Biopsy or excision of lymph node(s); deep cervical node(s) |
2 |
$422 |
396 |
Lymph node excision |
$440 |
$18 |
|
38520 |
Biopsy or excision of lymph node(s); deep cervical node(s) with
excision of scalene fat pad |
2 |
$422 |
396 |
Lymph node excision |
$440 |
$18 |
|
38525 |
Biopsy or excision of lymph node(s); deep axillary node(s) |
2 |
$422 |
396 |
Lymph node excision |
$440 |
$18 |
|
38530 |
Biospy or excision of lymph node(s); internal mammary node(s) |
2 |
$422 |
396 |
Lymph node excision |
$440 |
$18 |
