2016 Medicare Physician Final Fee Schedule …

1 2016 Medicare Physician Final Fee Schedule reimbursement & RVU ChangesCPT/HCPCSModDescription2016 WorkRVUs2015 Work RVUs2016 Total Non-Facility RVUs2015 Total Non-facility RVUs2016 Total Facility RVUs2015 Total Facility RVUs2016 Medicare Payment (CF )2015 Medicare Payment (CF )Percent Difference ( Final 2016 vs. Final 2015)43180 Esophagoscopy rigid $ $ rigid trnso $ $ rig trnso $ $ rig trnso $ $ rig trnso rem $ $ rigid $ $ guide wire $ $ flex dx $ $ flex trnsn $ $ flexible $ $ scope w/submucous $ $ flex $ $ scope w/sclerosis $ $ $ $ optical $ $ mucosal $ $ stent $ $ retro $ $ dilate balloon $ $ flex remove $ $ Medicare Physician Final Fee Schedule reimbursement & RVU ChangesCPT/HCPCSModDescription2016 WorkRVUs2015 Work RVUs2016 Total Non-Facility RVUs2015 Total Non-facility RVUs2016 Total Facility RVUs2015 Total Facility RVUs2016 Medicare Payment (CF )2015 Medicare Payment (CF )Percent Difference ( Final 2016 vs.)

2 Final 2015)43216 Esophagoscopy lesion $ $ snare les $ $ balloon < $ $ endoscopy $ $ control $ $ lesion $ $ ultrasound $ $ w/us needle $ $ balloon dil esoph30 mm/> $ $ diagnostic brush $ $ gi scope w/submuc $ $ us exam $ $ us fine needle $ $ biopsy $ $ w/transmural drain $ $ tube/cath $ $ us fine needle $ $ injection $ $ varices $ $ dilate $ $ Medicare Physician Final Fee Schedule reimbursement & RVU ChangesCPT/HCPCSModDescription2016 WorkRVUs2015 Work RVUs2016 Total Non-Facility RVUs2015 Total Non-facility RVUs2016 Total Facility RVUs2015 Total Facility RVUs2016 Medicare Payment (CF )2015 Medicare Payment (CF )Percent Difference ( Final 2016 vs.

3 Final 2015)43246 Egd place gastrostomy $ $ remove foreign $ $ guide wire $ $ egd dilation <30 $ $ cautery tumor $ $ remove lesion $ $ optical $ $ us transmural $ $ endo mucosal $ $ control bleeding $ $ w/thrml txmnt $ $ us exam $ $ w/specimen $ $ $ $ $ $ sphincter pressure $ $ remove duct $ $ lithotripsy $ $ endoscopic stent $ $ lesion $ $ $ $ duct stent $ $ Medicare Physician Final Fee Schedule reimbursement & RVU ChangesCPT/HCPCSModDescription2016 WorkRVUs2015 Work RVUs2016 Total Non-Facility RVUs2015 Total Non-facility RVUs2016 Total Facility RVUs2015 Total Facility RVUs2016 Medicare Payment (CF )2015 Medicare Payment (CF )Percent Difference ( Final 2016 vs.

4 Final 2015)43275 Ercp remove forgn body $ $ stent exchange $ $ ea duct/ampulla $ $ lesion ablate $ $ with $1, $1, of $ $ of $1, $1, of $1, $1, bowel $ $ bowel $ $ bowel $ $ bowel $ $ bowel $ $ bowel $ $ bowel $ $ bowel $ $ bowel $ $ bowel $ $ bowel $ $ bowel $ $ bowel $ $ bowel endoscope $ $ bowel endoscopy $ $ Medicare Physician Final Fee Schedule reimbursement & RVU ChangesCPT/HCPCSModDescription2016 WorkRVUs2015 Work RVUs2016 Total Non-Facility RVUs2015 Total Non-facility RVUs2016 Total Facility RVUs2015 Total Facility RVUs2016 Medicare Payment (CF )2015 Medicare Payment (CF )Percent Difference ( Final 2016 vs. Final 2015)44381 Small bowel endoscopy $ $ bowel $ $ bowel $ $ of bowel $ $ bowel $ $ thru stoma $ $ thru stoma $ with $ $ for foreign $ $ for $ $ & $ $ $ $ with $ $ w/stent $ $ $ $ $ $ $ $ $ $ w/ndl $ $ $ $ gastrointestinal $ $ $ $ $ $ Medicare Physician Final Fee Schedule reimbursement & RVU ChangesCPT/HCPCSModDescription2016 WorkRVUs2015 Work RVUs2016 Total Non-Facility RVUs2015 Total Non-facility RVUs2016 Total Facility RVUs2015 Total Facility RVUs2016 Medicare Payment (CF )2015 Medicare Payment (CF )Percent Difference ( Final 2016 vs.

5 Final 2015)45305 Proctosigmoidoscopy $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ and $ $ w/fb $ $ & $ $ for $ $ w/submuc $ $ & $ $ w/tumr $ $ w/tndsc balloon $ $ Medicare Physician Final Fee Schedule reimbursement & RVU ChangesCPT/HCPCSModDescription2016 WorkRVUs2015 Work RVUs2016 Total Non-Facility RVUs2015 Total Non-facility RVUs2016 Total Facility RVUs2015 Total Facility RVUs2016 Medicare Payment (CF )2015 Medicare Payment (CF )Percent Difference ( Final 2016 vs. Final 2015)45341 Sigmoidoscopy $ $ w/us guide $ $ $ $ w/plcmt $ $ $ $ w/band $ $ $ $ $ $ w/fb $ $ and $ $ submucous $ $ w/control $ $ w/lesion $ $ w/lesion $ $ w/balloon $ $ $ $ w/stent $ $ $ $ w/endoscope $ $ Medicare Physician Final Fee Schedule reimbursement & RVU ChangesCPT/HCPCSModDescription2016 WorkRVUs2015 Work RVUs2016 Total Non-Facility RVUs2015 Total Non-facility RVUs2016 Total Facility RVUs2015 Total Facility RVUs2016 Medicare Payment (CF )2015 Medicare Payment (CF )Percent Difference ( Final 2016 vs.

6 Final 2015)45392 Colonoscopy w/endoscopic $ $ $ $ removal of $2, $2, remove rectum $2, $2, w/band $ $ of rectal $ $ of anal $ $ of rectal $ $ rectal $ $ external $ $ of anal $ $ anal ext $ $ of hemorrhoid(s) $ $ of anal $ $ ext hem groups 2+ $ $ int/ext hem 1 $ $ in/ex hem grp & $ $ in/ex hem grp $ $ in/ex hem groups 2+ $ $ in/ex hem grps & $ $ Medicare Physician Final Fee Schedule reimbursement & RVU ChangesCPT/HCPCSModDescription2016 WorkRVUs2015 Work RVUs2016 Total Non-Facility RVUs2015 Total Non-facility RVUs2016 Total Facility RVUs2015 Total Facility RVUs2016 Medicare Payment (CF )2015 Medicare Payment (CF )Percent Difference ( Final 2016 vs.

7 Final 2015)46262 Remove in/ex hem grps $ $ anal fist $ $ anal fist $ $ anal fist $ $ anal fist 2 $ $ anal $ $ of hemorrhoid $ $ into hemorrhoid(s) $ $ anal $ $ anoscopy $ $ $ $ and $ $ and $ $ anoscopy & $ $ remove for $ $ remove $ $ $ $ remove $ $ control $ $ $ $ esophagus $ colonography $ $ colonography dx $ $ Medicare Physician Final Fee Schedule reimbursement & RVU ChangesCPT/HCPCSModDescription2016 WorkRVUs2015 Work RVUs2016 Total Non-Facility RVUs2015 Total Non-facility RVUs2016 Total Facility RVUs2015 Total Facility RVUs2016 Medicare Payment (CF )2015 Medicare Payment (CF )Percent Difference ( Final 2016 vs. Final 2015)7426326Ct colonography $ $ motility motility motility $ mucosa $ reflux $ emptying $ $ exam by $ exam by $ $ exam by exam by $ exam by $ $ motility motility $ motility $ $ motil w/ motil w/ motil w/ $ motility motility motility $ motility motility motility $ perfusion of perfusion of $ Medicare Physician Final Fee Schedule reimbursement & RVU ChangesCPT/HCPCSModDescription2016 WorkRVUs2015 Work RVUs2016 Total Non-Facility RVUs2015 Total Non-facility RVUs2016 Total Facility RVUs2015 Total Facility RVUs2016 Medicare Payment (CF )2015 Medicare Payment (CF )Percent Difference ( Final 2016 vs.

8 Final 2015)9103026 Acid perfusion of $ $ reflux reflux $ reflux $ $ reflx tst reflx tst $ reflx tst $ $ imped function imped function $ imped function $ $ imped funct test > imped funct test > imped funct test > $ balloon distension balloon distension balloon distension $ hydrogen/methane hydrogen/methane hydrogen/methane $ tract capsule tract capsule $ tract capsule $ $ capsule Medicare Physician Final Fee Schedule reimbursement & RVU ChangesCPT/HCPCSModDescription2016 WorkRVUs2015 Work RVUs2016 Total Non-Facility RVUs2015 Total Non-facility RVUs2016 Total Facility RVUs2015 Total Facility RVUs2016 Medicare Payment (CF )2015 Medicare Payment (CF )Percent Difference ( Final 2016 vs.

9 Final 2015)91111 TCEsophageal capsule $ capsule $ $ wireless capsule wireless capsule $ wireless capsule $ $ motility 6 hr $ $ sensation sensation sensation $ pressure pressure pressure $ $ $ $ $ $ $ $ procedure0000 NANANANANA91299 TCGastroenterology procedure0000 NANANANANA9129926 Gastroenterology $ Medicare Physician Final Fee Schedule reimbursement & RVU ChangesCPT/HCPCSModDescription2016 WorkRVUs2015 Work RVUs2016 Total Non-Facility RVUs2015 Total Non-facility RVUs2016 Total Facility RVUs2015 Total Facility RVUs2016 Medicare Payment (CF )2015 Medicare Payment (CF )Percent Difference ( Final 2016 vs. Final 2015)92610 Evaluate swallowing $ $ swallow tst (fees) $ $ swallow tst (fees)

10 $ $ recording0000 NANANANANA93615 TCEsophageal recording0000 NANANANANA9361526 Esophageal $ recording0000 NANANANANA93616 TCEsophageal $ $ $ anal gast n-stim $ $ anal gast n-stim $ $ visit $ $ visit $ $ visit $ $ visit $ $ visit $ $ visit $ $ visit $ $ visit $ $ visit $ $ visit $ $ care $ $ observation $ $ observation $ $ observation $ $ Medicare Physician Final Fee Schedule reimbursement & RVU ChangesCPT/HCPCSModDescription2016 WorkRVUs2015 Work RVUs2016 Total Non-Facility RVUs2015 Total Non-facility RVUs2016 Total Facility RVUs2015 Total Facility RVUs2016 Medicare Payment (CF )2015 Medicare Payment (CF )Percent Difference ( Final 2016 vs.)