CY 2017 Medicare FINAL Fee Schedule Changes …

1 CPT/HCPCSModDescription2017 FINAL Work RVUs2017 FINAL Non-Facility PE RVUs2017 FINAL Facility PE RVUs2017 FINAL Malpractice RVUs2017 FINAL Total Non-Facility RVUs2017 FINAL Total Facility RVUs2017 FINAL Medicare Facility Payment (CF )2016 FINAL Medicare Facility Payment (CF )Percent Difference ( FINAL 2016 vs. FINAL 2017 )Reimbursement + G0500 Moderate Sedation ( FINAL 2017 )Percent change : CY 2017 Reimbursement + Moderate Sedation vs. CY 201643180 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 $ $ $ 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 $ $ $ 2017 Medicare FINAL Fee Schedule Changes (National Estimates)

2 CPT/HCPCSModDescription2017 FINAL Work RVUs2017 FINAL Non-Facility PE RVUs2017 FINAL Facility PE RVUs2017 FINAL Malpractice RVUs2017 FINAL Total Non-Facility RVUs2017 FINAL Total Facility RVUs2017 FINAL Medicare Facility Payment (CF )2016 FINAL Medicare Facility Payment (CF )Percent Difference ( FINAL 2016 vs. FINAL 2017 )Reimbursement + G0500 Moderate Sedation ( FINAL 2017 )Percent change : CY 2017 Reimbursement + Moderate Sedation vs. CY 2016CY 2017 Medicare FINAL Fee Schedule Changes (National Estimates)43244 Egd varices $ $ $ dilate $ $ $ 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 $ $ $ remove forgn body $ $ $ stent exchange $ $ $ ea duct/ampulla $ $ $ lesion ablate $ $ $ with $1, $1, of $ $ of $1, $1, of $1, $1.

3 Bowel $ $ $ bowel $ $ $ bowel $ $ $ bowel $ $ $ bowel $ $ $ FINAL Work RVUs2017 FINAL Non-Facility PE RVUs2017 FINAL Facility PE RVUs2017 FINAL Malpractice RVUs2017 FINAL Total Non-Facility RVUs2017 FINAL Total Facility RVUs2017 FINAL Medicare Facility Payment (CF )2016 FINAL Medicare Facility Payment (CF )Percent Difference ( FINAL 2016 vs. FINAL 2017 )Reimbursement + G0500 Moderate Sedation ( FINAL 2017 )Percent change : CY 2017 Reimbursement + Moderate Sedation vs. CY 2016CY 2017 Medicare FINAL Fee Schedule Changes (National Estimates)44366 Small bowel $ $ $ bowel $ $ $ bowel $ $ $ bowel $ $ $ bowel $ $ $ bowel $ $ $ bowel $ $ $ bowel $ $ $ bowel endoscope $ $ $ bowel endoscopy $ $ $ bowel endoscopy $ $ $ bowel $ $ $ bowel $ $ $ of bowel $ $ $ bowel $ $ $ thru stoma $ $ $ thru stoma $ $ $ with $ $ $ for foreign $ $ $ for $ $ $ & $ $ $ $ $ $ with $ $ $ w/stent $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ w/ndl $ $ $ $ $ $ gastrointestinal $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ FINAL Work RVUs2017 FINAL Non-Facility PE RVUs2017 FINAL Facility PE RVUs2017 FINAL Malpractice RVUs2017 FINAL Total Non-Facility RVUs2017 FINAL Total Facility RVUs2017 FINAL Medicare Facility Payment (CF )

4 2016 FINAL Medicare Facility Payment (CF )Percent Difference ( FINAL 2016 vs. FINAL 2017 )Reimbursement + G0500 Moderate Sedation ( FINAL 2017 )Percent change : CY 2017 Reimbursement + Moderate Sedation vs. CY 2016CY 2017 Medicare FINAL Fee Schedule Changes (National Estimates)45317 Proctosigmoidoscopy $ $ $ $ $ $ $ $ $ $ $ $ $ $ and $ $ $ w/fb $ $ $ & $ $ $ for $ $ $ w/submuc $ $ $ & $ $ $ w/tumr $ $ $ w/tndsc balloon $ $ $ $ $ $ w/us guide $ $ $ $ $ $ w/plcmt $ $ $ $ $ $ w/band $ $ $ $ $ $ $ $ $ w/fb $ $ $ and $ $ $ submucous $ $ $ w/control $ $ $ w/lesion $ $ $ w/lesion $ $ $ w/balloon $ $ $ $ $ $ w/stent $ $ $ $ $ $ w/endoscope $ $ $ w/endoscopic $ $ $ $ $ $ removal of $2, $2, remove rectum $2, $2, w/band $ $ $ of rectal $ $ FINAL Work RVUs2017 FINAL Non-Facility PE RVUs2017 FINAL Facility PE RVUs2017 FINAL Malpractice RVUs2017 FINAL Total Non-Facility RVUs2017 FINAL Total Facility RVUs2017 FINAL Medicare Facility Payment (CF )

5 2016 FINAL Medicare Facility Payment (CF )Percent Difference ( FINAL 2016 vs. FINAL 2017 )Reimbursement + G0500 Moderate Sedation ( FINAL 2017 )Percent change : CY 2017 Reimbursement + Moderate Sedation vs. CY 2016CY 2017 Medicare FINAL Fee Schedule Changes (National Estimates)45905 Dilation 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 & $ $ 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 $ colonography $ FINAL Work RVUs2017 FINAL Non-Facility PE RVUs2017 FINAL Facility PE RVUs2017 FINAL Malpractice RVUs2017 FINAL Total Non-Facility RVUs2017 FINAL Total Facility RVUs2017 FINAL Medicare Facility Payment (CF )2016 FINAL Medicare Facility Payment (CF )Percent Difference ( FINAL 2016 vs.)

6 FINAL 2017 )Reimbursement + G0500 Moderate Sedation ( FINAL 2017 )Percent change : CY 2017 Reimbursement + Moderate Sedation vs. CY 2016CY 2017 Medicare FINAL Fee Schedule Changes (National Estimates)78258 Esophageal 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 $ 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 > $ FINAL Work RVUs2017 FINAL Non-Facility PE RVUs2017 FINAL Facility PE RVUs2017 FINAL Malpractice RVUs2017 FINAL Total Non-Facility RVUs2017 FINAL Total Facility RVUs2017 FINAL Medicare Facility Payment (CF )

7 2016 FINAL Medicare Facility Payment (CF )Percent Difference ( FINAL 2016 vs. FINAL 2017 )Reimbursement + G0500 Moderate Sedation ( FINAL 2017 )Percent change : CY 2017 Reimbursement + Moderate Sedation vs. CY 2016CY 2017 Medicare FINAL Fee Schedule Changes (National Estimates)91040 Esoph balloon distension balloon distension balloon distension $ hydrogen/methane hydrogen/methane $ hydrogen/methane $ $ tract capsule tract capsule $ tract capsule $ $ capsule capsule capsule $ wireless capsule wireless capsule wireless capsule $ motility 6 hr $ $ sensation sensation sensation $ pressure pressure $ pressure $ $ $ $ $ $ $ procedure00NA00 NANANANA91299 TCGastroenterology procedure00NA00 NANANANA9129926 Gastroenterology procedure000000$ swallowing $ $ swallow tst (fees) $ $ swallow tst (fees)

8 $ $ FINAL Work RVUs2017 FINAL Non-Facility PE RVUs2017 FINAL Facility PE RVUs2017 FINAL Malpractice RVUs2017 FINAL Total Non-Facility RVUs2017 FINAL Total Facility RVUs2017 FINAL Medicare Facility Payment (CF )2016 FINAL Medicare Facility Payment (CF )Percent Difference ( FINAL 2016 vs. FINAL 2017 )Reimbursement + G0500 Moderate Sedation ( FINAL 2017 )Percent change : CY 2017 Reimbursement + Moderate Sedation vs. CY 2016CY 2017 Medicare FINAL Fee Schedule Changes (National Estimates)93615 Esophageal recording00NA00 NANANANA93615 TCEsophageal recording00NA00 NANA$ $ $ recording00NA00 NANANANA93616 TCEsophageal recording00NA00 NANA$ $ $ anal gast n-stim $ $ anal gast n-stim $ $ sed same phys/qhp 5/> $ $ visit $ $ visit $ $ visit $ $ visit $ $ visit $ $ visit $ $ visit $ $ visit $ $ visit $ $ visit $ $ care $ $ observation $ $ observation $ $ observation $ $ hospital $ $ hospital $ $ hospital $ $ observation $ $ observation $ $ observation $ $ hospital $ $ hospital $ $ hospital $ $ same $ $ same $ $ same $ $ discharge $ $ discharge $ $ $ $ FINAL Work RVUs2017 FINAL Non-Facility PE RVUs2017 FINAL Facility PE RVUs2017 FINAL Malpractice RVUs2017 FINAL Total Non-Facility RVUs2017 FINAL Total Facility RVUs2017 FINAL Medicare Facility

9 Payment (CF )2016 FINAL Medicare Facility Payment (CF )Percent Difference ( FINAL 2016 vs. FINAL 2017 )Reimbursement + G0500 Moderate Sedation ( FINAL 2017 )Percent change : CY 2017 Reimbursement + Moderate Sedation vs. CY 2016CY 2017 Medicare FINAL Fee Schedule Changes (National Estimates)99242 Office $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ advanced life support000000$ $ service $ $ service $ $ service $ $ service $ $ service w/o $ serv w/o contact $ counseling $ $ counseling $ $ counseling $ $ counseling $ $ counseling $ $ counseling $ $ chron care w/o pt $ $ chron care addl 30 $ $ care mgmt srvc 20 $ $ care mgmt 14 day $ $ care mgmt 7 day $ $ care plan 30 $ $ care plan addl 30 $ $ screen;flexi $ $ scrn; hi risk $ $ $ scrn; hi risk $ $ $ ca screen;barium ca screen;barium $ ca screen;barium $ $ ca scrn; barium ca scrn; barium ca scrn.

10 Barium $ FINAL Work RVUs2017 FINAL Non-Facility PE RVUs2017 FINAL Facility PE RVUs2017 FINAL Malpractice RVUs2017 FINAL Total Non-Facility RVUs2017 FINAL Total Facility RVUs2017 FINAL Medicare Facility Payment (CF )2016 FINAL Medicare Facility Payment (CF )Percent Difference ( FINAL 2016 vs. FINAL 2017 )Reimbursement + G0500 Moderate Sedation ( FINAL 2017 )Percent change : CY 2017 Reimbursement + Moderate Sedation vs. CY 2016CY 2017 Medicare FINAL Fee Schedule Changes (National Estimates)G0121 Colon ca scrn not hi rsk $ $ $ ca scrn not hi rsk $ $ $ ca scrn; barium ca scrn; barium ca scrn; barium $ blood scrn immunoassay000000$ $ interv $ $ interv >30 $ $ preventive $ $ alcohol screen 15 $ $ alcohol misuse $ $ screen $ $ inten beh couns std $ $ behave ther cardio $ $ counsel obesity $ $ perm pacing cardiovert000000$ $ test interpt& pathology $ $ intraop neuro $ $ document visit by $ $ microbiota prep $ $ prostate brachy comp rat000000$ $ inpt pharm $ $ prp for ulcers000000$ $ outpt clinic visit000000$ $ ca scr, sto bas dnaNANANANANANANA$ sedation endo service- GI only $ $ for cognitive $ $ assessment of $ $