Speech by CS0IGqB

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									WCA                                WORKERS' COMPENSATION FEE SCHEDULE 2005                                                  Medicine
HCSD                                                                                                                               1

CPT®                                                                                                      RVU-MI          MAP
CODE          MOD                                     DESCRIPTION                                                       CF=$48.49
90281                 Human ig, im                                                                              0.00         AWP
90283                 Human ig, iv                                                                              0.00         AWP
90287                 Botulinum antitoxin                                                                       0.00         AWP
90288                 Botulism ig, iv                                                                           0.00         AWP
90291                 Cmv ig, iv                                                                                0.00         AWP
90296                 Diphtheria antitoxin                                                                      0.00         AWP
90371                 Hep b ig, im                                                                              0.00         AWP
90375                 Rabies ig, im/sc                                                                          0.00         AWP
90376                 Rabies ig, heat treated                                                                   0.00         AWP
90378                 Rsv ig, im, 50mg                                                                          0.00         AWP
90379                 Rsv ig, iv                                                                                0.00         AWP
90384                 Rh ig, full-dose, im                                                                      0.00         AWP
90385                 Rh ig, minidose, im                                                                       0.00         AWP
90386                 Rh ig, iv                                                                                 0.00         AWP
90389                 Tetanus ig, im                                                                            0.00         AWP
90393                 Vaccina ig, im                                                                            0.00         AWP
90396                 Varicella-zoster ig, im                                                                   0.00         AWP
90399                 Immune globulin                                                                           0.00         AWP
90471                 Immunization admin                                                                        0.23        $11.15
90472                 Immunization admin, each add                                                              0.16         $7.76
90473                 Immune admin oral/nasal                                                                   0.00         AWP
90474                 Immune admin oral/nasal addl                                                              0.00         AWP
90476                 Adenovirus vaccine, type 4                                                                0.00         AWP
90477                 Adenovirus vaccine, type 7                                                                0.00         AWP
90581                 Anthrax vaccine, sc                                                                       0.00         AWP
90585                 Bcg vaccine, percut                                                                       0.00         AWP
90586                 Bcg vaccine, intravesical                                                                 0.00         AWP
90632                 Hep a vaccine, adult im                                                                   0.00         AWP
90633                 Hep a vacc, ped/adol, 2 dose                                                              0.00         AWP
90634                 Hep a vacc, ped/adol, 3 dose                                                              0.00         AWP
90636                 Hep a/hep b vacc, adult im                                                                0.00         AWP
90645                 Hib vaccine, hboc, im                                                                     0.00         AWP
90646                 Hib vaccine, prp-d, im                                                                    0.00         AWP
90647                 Hib vaccine, prp-omp, im                                                                  0.00         AWP
90648                 Hib vaccine, prp-t, im                                                                    0.00         AWP
90655                 Flu vaccine, 6-35 mo, im                                                                  0.00         AWP
90657                 Flu vaccine, 6-35 mo, im                                                                  0.00         AWP
90658                 Flu vaccine, 3 yrs, im                                                                    0.00         AWP
90659                 Flu vaccine, whole, im                                                                    0.00         AWP
90660                 Flu vaccine, nasal                                                                        0.00         AWP
90665                 Lyme disease vaccine, im                                                                  0.00         AWP
90669                 Pneumococcal vacc, ped <5                                                                 0.00         AWP
90675                 Rabies vaccine, im                                                                        0.00         AWP
90676                 Rabies vaccine, id                                                                        0.00         AWP
90680                 Rotovirus vaccine, oral                                                                   0.00         AWP
90690                 Typhoid vaccine, oral                                                                     0.00         AWP
90691                 Typhoid vaccine, im                                                                       0.00         AWP
90692                 Typhoid vaccine, h-p, sc/id                                                               0.00         AWP
90693                 Typhoid vaccine, akd, sc                                                                  0.00         AWP
90698                 Dtap-hib-ip vaccine, im                                                                   0.00         AWP

Procedure codes and abbreviated descriptors are from "2005 Physicians' Current Procedural Terminology (CPT)." Refer to CPT for complete
descriptors.

Fees are determined by the WCA using 2004 Relative Value Unit data.
WCA                                WORKERS' COMPENSATION FEE SCHEDULE 2005                                                  Medicine
HCSD                                                                                                                               2

CPT®                                                                                                      RVU-MI          MAP
CODE          MOD                                     DESCRIPTION                                                       CF=$48.49
90700                 Dtap vaccine, im                                                                          0.00         AWP
90701                 Dtp vaccine, im                                                                           0.00         AWP
90702                 Dt vaccine < 7, im                                                                        0.00         AWP
90703                 Tetanus vaccine, im                                                                       0.00         AWP
90704                 Mumps vaccine, sc                                                                         0.00         AWP
90705                 Measles vaccine, sc                                                                       0.00         AWP
90706                 Rubella vaccine, sc                                                                       0.00         AWP
90707                 Mmr vaccine, sc                                                                           0.00         AWP
90708                 Measles-rubella vaccine, sc                                                               0.00         AWP
90710                 Mmrv vaccine, sc                                                                          0.00         AWP
90712                 Oral poliovirus vaccine                                                                   0.00         AWP
90713                 Poliovirus, ipv, sc                                                                       0.00         AWP
90715                 Tdap vaccine >7 im                                                                        0.00         AWP
90716                 Chicken pox vaccine, sc                                                                   0.00         AWP
90717                 Yellow fever vaccine, sc                                                                  0.00         AWP
90718                 Td vaccine > 7, im                                                                        0.00         AWP
90719                 Diphtheria vaccine, im                                                                    0.00         AWP
90720                 Dtp/hib vaccine, im                                                                       0.00         AWP
90721                 Dtap/hib vaccine, im                                                                      0.00         AWP
90723                 Dtap-hep b-ipv vaccine, im                                                                0.00         AWP
90725                 Cholera vaccine, injectable                                                               0.00         AWP
90727                 Plague vaccine, im                                                                        0.00         AWP
90732                 Pneumococcal vaccine                                                                      0.00         AWP
90733                 Meningococcal vaccine, sc                                                                 0.00         AWP
90734                 Meningococcal vaccine, im                                                                 0.00         AWP
90735                 Encephalitis vaccine, sc                                                                  0.00         AWP
90740                 Hepb vacc, ill pat 3 dose im                                                              0.00         AWP
90743                 Hep b vacc, adol, 2 dose, im                                                              0.00         AWP
90744                 Hepb vacc ped/adol 3 dose im                                                              0.00         AWP
90746                 Hep b vaccine, adult, im                                                                  0.00         AWP
90747                 Hepb vacc, ill pat 4 dose im                                                              0.00         AWP
90748                 Hep b/hib vaccine, im                                                                     0.00         AWP
90749                 Vaccine toxoid                                                                            0.00         AWP
90780                 IV infusion therapy, 1 hour                                                               2.48       $120.26
90781                 IV infusion, additional hour                                                              0.72        $34.91
90782                 Injection, sc/im                                                                          0.52        $25.21
90783                 Injection, ia                                                                             0.54        $26.18
90784                 Injection, iv                                                                             1.06        $51.40
90788                 Injection of antibiotic                                                                   0.47        $22.79
90799                 Ther/prophylactic/dx inject                                                               0.00         AWP
90801                 Psy dx interview                                                                          4.20       $203.66
90802                 Intac psy dx interview                                                                    4.47       $216.75
90804                 Psytx, office, 20-30 min                                                                  1.82        $88.25
90805                 Psytx, off, 20-30 min w/e&m                                                               1.99        $96.50
90806                 Psytx, off, 45-50 min                                                                     2.72       $131.89
90807                 Psytx, off, 45-50 min w/e&m                                                               2.91       $141.11
90808                 Psytx, office, 75-80 min                                                                  4.07       $197.35
90809                 Psytx, off, 75-80, w/e&m                                                                  4.21       $204.14
90810                 Intac psytx, off, 20-30 min                                                               1.94        $94.07
90811                 Intac psytx, 20-30, w/e&m                                                                 2.18       $105.71

Procedure codes and abbreviated descriptors are from "2005 Physicians' Current Procedural Terminology (CPT)." Refer to CPT for complete
descriptors.

Fees are determined by the WCA using 2004 Relative Value Unit data.
WCA                                WORKERS' COMPENSATION FEE SCHEDULE 2005                                                  Medicine
HCSD                                                                                                                               3

CPT®                                                                                                      RVU-MI          MAP
CODE          MOD                                     DESCRIPTION                                                       CF=$48.49
90812                 Intac psytx, off, 45-50 min                                                               2.95       $143.05
90813                 Intac psytx, 45-50 min w/e&m                                                              3.09       $149.83
90814                 Intac psytx, off, 75-80 min                                                               4.26       $206.57
90815                 Intac psytx, 75-80 w/e&m                                                                  4.37       $211.90
90816                 Psytx, hosp, 20-30 min                                                                    1.83        $88.74
90817                 Psytx, hosp, 20-30 min w/e&m                                                              1.99        $96.50
90818                 Psytx, hosp, 45-50 min                                                                    2.74       $132.86
90819                 Psytx, hosp, 45-50 min w/e&m                                                              2.89       $140.14
90821                 Psytx, hosp, 75-80 min                                                                    4.07       $197.35
90822                 Psytx, hosp, 75-80 min w/e&m                                                              4.20       $203.66
90823                 Intac psytx, hosp, 20-30 min                                                              1.96        $95.04
90824                 Intac psytx, hsp 20-30 w/e&m                                                              2.14       $103.77
90826                 Intac psytx, hosp, 45-50 min                                                              2.90       $140.62
90827                 Intac psytx, hsp 45-50 w/e&m                                                              3.04       $147.41
90828                 Intac psytx, hosp, 75-80 min                                                              4.26       $206.57
90829                 Intac psytx, hsp 75-80 w/e&m                                                              4.35       $210.93
90845                 Psychoanalysis                                                                            2.53       $122.68
90846                 Family psytx w/o patient                                                                  2.64       $128.01
90847                 Family psytx w/patient                                                                    3.22       $156.14
90849                 Multiple family group psytx                                                               0.90        $43.64
90853                 Group psychotherapy                                                                       0.88        $42.67
90857                 Intac group psytx                                                                         0.99        $48.01
90862                 Medication management                                                                     1.42        $68.86
90865                 Narcosynthesis                                                                            4.68       $226.93
90870                 Electroconvulsive therapy                                                                 2.83       $137.23
90871                 Electroconvulsive therapy                                                                 4.02       $194.93
90875                 Psychophysiological therapy                                                               2.22       $107.65
90876                 Psychophysiological therapy                                                               3.22       $156.14
90880                 Hypnotherapy                                                                              3.42       $165.84
90882                 Environmental manipulation                                                                0.00           BR
90885                 Psy evaluation of records                                                                 1.41        $68.37
90887                 Consultation with family                                                                  2.43       $117.83
90889                 Preparation of report                                                                     0.00           BR
90899                 Psychiatric service/therapy                                                               0.00           BR
90901                 Biofeedback train, any meth                                                               1.12        $54.31
90911                 Biofeedback peri/uro/rectal                                                               2.63       $127.53
90918                 ESRD related services, month                                                             19.59       $949.92
90919                 ESRD related services, month                                                             13.47       $653.16
90920                 ESRD related services, month                                                             11.77       $570.73
90921                 ESRD related services, month                                                              7.37       $357.37
90922                 ESRD related services, day                                                                0.62        $30.06
90923                 Esrd related services, day                                                                0.44        $21.34
90924                 Esrd related services, day                                                                0.39        $18.91
90925                 Esrd related services, day                                                                0.26        $12.61
90935                 Hemodialysis, one evaluation                                                              2.01        $97.46
90937                 Hemodialysis, repeated eval                                                               3.30       $160.02
90939                 Hemodialysis study, transcut                                                              0.00           BR
90940                 Hemodialysis access study                                                                 0.00           BR
90945                 Dialysis, one evaluation                                                                  2.12       $102.80
90947                 Dialysis, repeated eval                                                                   3.38       $163.90

Procedure codes and abbreviated descriptors are from "2005 Physicians' Current Procedural Terminology (CPT)." Refer to CPT for complete
descriptors.

Fees are determined by the WCA using 2004 Relative Value Unit data.
WCA                                WORKERS' COMPENSATION FEE SCHEDULE 2005                                                  Medicine
HCSD                                                                                                                               4

CPT®                                                                                                      RVU-MI           MAP
CODE          MOD                                     DESCRIPTION                                                       CF=$48.49
90989                 Dialysis training, complete                                                               0.00            BR
90993                 Dialysis training, incompl                                                                0.00            BR
90997                 Hemoperfusion                                                                             3.43        $166.32
90999                 Dialysis procedure                                                                        0.00            BR
91000                 Esophageal intubation                                                                     1.19         $57.70
91000         TC      Esophageal intubation                                                                     0.10          $4.85
91000         26      Esophageal intubation                                                                     1.09         $52.85
91010                 Esophagus motility study                                                                  4.26        $206.57
91010         TC      Esophagus motility study                                                                  2.41        $116.86
91010         26      Esophagus motility study                                                                  1.85         $89.71
91011                 Esophagus motility study                                                                  5.00        $242.45
91011         TC      Esophagus motility study                                                                  2.80        $135.77
91011         26      Esophagus motility study                                                                  2.20        $106.68
91012                 Esophagus motility study                                                                  5.15        $249.72
91012         TC      Esophagus motility study                                                                  2.98        $144.50
91012         26      Esophagus motility study                                                                  2.17        $105.22
91020                 Gastric motility                                                                          4.70        $227.90
91020         TC      Gastric motility                                                                          2.58        $125.10
91020         26      Gastric motility                                                                          2.11        $102.31
91030                 Acid perfusion of esophagus                                                               3.46        $167.78
91030         TC      Acid perfusion of esophagus                                                               2.11        $102.31
91030         26      Acid perfusion of esophagus                                                               1.35         $65.46
91052                 Gastric analysis test                                                                     3.13        $151.77
91052         TC      Gastric analysis test                                                                     1.95         $94.56
91052         26      Gastric analysis test                                                                     1.18         $57.22
91055                 Gastric intubation for smear                                                              3.49        $169.23
91055         TC      Gastric intubation for smear                                                              2.14        $103.77
91055         26      Gastric intubation for smear                                                              1.35         $65.46
91060                 Gastric saline load test                                                                  0.85         $41.22
91060         TC      Gastric saline load test                                                                  0.20          $9.70
91060         26      Gastric saline load test                                                                  0.65         $31.52
91065                 Breath hydrogen test                                                                      2.23        $108.13
91065         TC      Breath hydrogen test                                                                      1.93         $93.59
91065         26      Breath hydrogen test                                                                      0.30         $14.55
91100                 Pass intestine bleeding tube                                                              1.56         $75.64
91105                 Gastric intubation treatment                                                              0.51         $24.73
91110                 Gi tract capsule endoscopy                                                               25.03      $1,213.70
91110         TC      Gi tract capsule endoscopy                                                               19.95        $967.38
91110         26      Gi tract capsule endoscopy                                                                5.08        $246.33
91122                 Anal pressure record                                                                      8.32        $403.44
91122         TC      Anal pressure record                                                                      5.63        $273.00
91122         26      Anal pressure record                                                                      2.69        $130.44
91123                 Irrigate fecal impaction                                                                  0.00            BR
91132                 Electrogastrography                                                                       0.00            BR
91132         TC      Electrogastrography                                                                       0.00            BR
91132         26      Electrogastrography                                                                       0.81         $39.28
91133                 Electrogastrography w/test                                                                0.00            BR
91133         TC      Electrogastrography w/test                                                                0.00            BR
91133         26      Electrogastrography w/test                                                                1.01         $48.97
91299                 Gastroenterology procedure                                                                0.00            BR

Procedure codes and abbreviated descriptors are from "2005 Physicians' Current Procedural Terminology (CPT)." Refer to CPT for complete
descriptors.

Fees are determined by the WCA using 2004 Relative Value Unit data.
WCA                                WORKERS' COMPENSATION FEE SCHEDULE 2005                                                  Medicine
HCSD                                                                                                                               5

CPT®                                                                                                      RVU-MI          MAP
CODE          MOD                             DESCRIPTION                                                               CF=$48.49
91299         TC  Gastroenterology procedure                                                                    0.00           BR
91299         26  Gastroenterology procedure                                                                    0.00           BR
92002             Eye exam, new patient                                                                         1.91        $92.62
92004             Eye exam, new patient                                                                         3.48       $168.75
92012             Eye exam established pat                                                                      1.73        $83.89
92014             Eye exam & treatment                                                                          2.55       $123.65
92015             Refraction                                                                                    1.90        $92.13
92018             New eye exam & treatment                                                                      3.73       $180.87
92019             Eye exam & treatment                                                                          1.99        $96.50
92020             Special eye evaluation                                                                        0.73        $35.40
92060             Special eye evaluation                                                                        1.47        $71.28
92060         TC  Special eye evaluation                                                                        0.45        $21.82
92060         26  Special eye evaluation                                                                        1.02        $49.46
92065             Orthoptic/pleoptic training                                                                   0.96        $46.55
92065         TC  Orthoptic/pleoptic training                                                                   0.41        $19.88
92065         26  Orthoptic/pleoptic training                                                                   0.55        $26.67
92070             Fitting of contact lens                                                                       1.82        $88.25
92081             Visual field examination(s)                                                                   1.26        $61.10
92081         TC  Visual field examination(s)                                                                   0.72        $34.91
92081         26  Visual field examination(s)                                                                   0.54        $26.18
92082             Visual field examination(s)                                                                   1.64        $79.52
92082         TC  Visual field examination(s)                                                                   0.98        $47.52
92082         26  Visual field examination(s)                                                                   0.66        $32.00
92083             Visual field examination(s)                                                                   1.89        $91.65
92083         TC  Visual field examination(s)                                                                   1.13        $54.79
92083         26  Visual field examination(s)                                                                   0.76        $36.85
92100             Serial tonometry exam(s)                                                                      2.25       $109.10
92120             Tonography & eye evaluation                                                                   1.91        $92.62
92130             Water provocation tonography                                                                  2.10       $101.83
92135             Opthalmic dx imaging                                                                          1.18        $57.22
92135         TC  Opthalmic dx imaging                                                                          0.64        $31.03
92135         26  Opthalmic dx imaging                                                                          0.54        $26.18
92136             Ophthalmic biometry                                                                           2.48       $120.26
92136         TC  Ophthalmic biometry                                                                           1.66        $80.49
92136         26  Ophthalmic biometry                                                                           0.83        $40.25
92140             Glaucoma provocative tests                                                                    1.47        $71.28
92225             Special eye exam, initial                                                                     0.63        $30.55
92226             Special eye exam, subsequent                                                                  0.57        $27.64
92230             Eye exam with photos                                                                          2.33       $112.98
92235             Eye exam with photos                                                                          3.94       $191.05
92235         TC  Eye exam with photos                                                                          2.69       $130.44
92235         26  Eye exam with photos                                                                          1.25        $60.61
92240             Icg angiography                                                                               8.33       $403.92
92240         TC  Icg angiography                                                                               6.66       $322.94
92240         26  Icg angiography                                                                               1.66        $80.49
92250             Eye exam with photos                                                                          2.22       $107.65
92250         TC  Eye exam with photos                                                                          1.55        $75.16
92250         26  Eye exam with photos                                                                          0.67        $32.49
92260             Ophthalmoscopy/dynamometry                                                                    0.52        $25.21
92265             Eye muscle evaluation                                                                         2.80       $135.77

Procedure codes and abbreviated descriptors are from "2005 Physicians' Current Procedural Terminology (CPT)." Refer to CPT for complete
descriptors.

Fees are determined by the WCA using 2004 Relative Value Unit data.
WCA                                WORKERS' COMPENSATION FEE SCHEDULE 2005                                                  Medicine
HCSD                                                                                                                               6

CPT®                                                                                                      RVU-MI          MAP
CODE          MOD                             DESCRIPTION                                                               CF=$48.49
92265         TC  Eye muscle evaluation                                                                         1.64        $79.52
92265         26  Eye muscle evaluation                                                                         1.16        $56.25
92270             Electro-oculography                                                                           2.52       $122.19
92270         TC  Electro-oculography                                                                           1.26        $61.10
92270         26  Electro-oculography                                                                           1.26        $61.10
92275             Electroretinography                                                                           3.05       $147.89
92275         TC  Electroretinography                                                                           1.55        $75.16
92275         26  Electroretinography                                                                           1.50        $72.74
92283             Color vision examination                                                                      1.05        $50.91
92283         TC  Color vision examination                                                                      0.78        $37.82
92283         26  Color vision examination                                                                      0.27        $13.09
92284             Dark adaptation eye exam                                                                      2.60       $126.07
92284         TC  Dark adaptation eye exam                                                                      2.24       $108.62
92284         26  Dark adaptation eye exam                                                                      0.36        $17.46
92285             Eye photography                                                                               1.32        $64.01
92285         TC  Eye photography                                                                               1.00        $48.49
92285         26  Eye photography                                                                               0.32        $15.52
92286             Internal eye photography                                                                      4.11       $199.29
92286         TC  Internal eye photography                                                                      3.11       $150.80
92286         26  Internal eye photography                                                                      1.00        $48.49
92287             Internal eye photography                                                                      3.56       $172.62
92310             Contact lens fitting                                                                          2.41       $116.86
92311             Contact lens fitting                                                                          2.38       $115.41
92312             Contact lens fitting                                                                          2.54       $123.16
92313             Contact lens fitting                                                                          2.15       $104.25
92314             Prescription of contact lens                                                                  1.67        $80.98
92315             Prescription of contact lens                                                                  1.43        $69.34
92316             Prescription of contact lens                                                                  1.72        $83.40
92317             Prescription of contact lens                                                                  1.53        $74.19
92325             Modification of contact lens                                                                  0.41        $19.88
92326             Replacement of contact lens                                                                   1.77        $85.83
92330             Fitting of artificial eye                                                                     2.30       $111.53
92335             Fitting of artificial eye                                                                     1.49        $72.25
92340             Fitting of spectacles                                                                         1.10        $53.34
92341             Fitting of spectacles                                                                         1.24        $60.13
92342             Fitting of spectacles                                                                         1.32        $64.01
92352             Special spectacles fitting                                                                    1.13        $54.79
92353             Special spectacles fitting                                                                    1.34        $64.98
92354             Special spectacles fitting                                                                    9.10       $441.26
92355             Special spectacles fitting                                                                    4.35       $210.93
92358             Eye prosthesis service                                                                        1.08        $52.37
92370             Repair & adjust spectacles                                                                    0.92        $44.61
92371             Repair & adjust spectacles                                                                    0.66        $32.00
92390             Supply of spectacles                                                                          0.00           BR
92391             Supply of contact lenses                                                                      0.00           BR
92392             Supply of low vision aids                                                                     3.83       $185.72
92393             Supply of artificial eye                                                                     13.03       $631.82
92395             Supply of spectacles                                                                          1.50        $72.74
92396             Supply of contact lenses                                                                      2.31       $112.01
92499             Eye service or procedure                                                                      0.00           BR

Procedure codes and abbreviated descriptors are from "2005 Physicians' Current Procedural Terminology (CPT)." Refer to CPT for complete
descriptors.

Fees are determined by the WCA using 2004 Relative Value Unit data.
WCA                                WORKERS' COMPENSATION FEE SCHEDULE 2005                                                  Medicine
HCSD                                                                                                                               7

CPT®                                                                                                      RVU-MI          MAP
CODE          MOD                             DESCRIPTION                                                               CF=$48.49
92499         TC  Eye service or procedure                                                                      0.00           BR
92499         26  Eye service or procedure                                                                      0.00           BR
92502             Ear and throat examination                                                                    2.84       $137.71
92504             Ear microscopy examination                                                                    0.70        $33.94
92506             Speech/hearing evaluation                                                                     3.60       $174.56
92507             Speech/hearing therapy                                                                        1.71        $82.92
92508             Speech/hearing therapy                                                                        0.81        $39.28
92510             Rehab for ear implant                                                                         3.77       $182.81
92511             Nasopharyngoscopy                                                                             4.09       $198.32
92512             Nasal function studies                                                                        1.69        $81.95
92516             Facial nerve function test                                                                    1.37        $66.43
92520             Laryngeal function studies                                                                    1.37        $66.43
92526             Oral function therapy                                                                         2.27       $110.07
92531             Spontaneous nystagmus study                                                                   0.00           BR
92532             Positional nystagmus test                                                                     0.00           BR
92533             Caloric vestibular test                                                                       0.00           BR
92534             Optokinetic nystagmus test                                                                    0.00           BR
92541             Spontaneous nystagmus test                                                                    1.47        $71.28
92541         TC  Spontaneous nystagmus test                                                                    0.82        $39.76
92541         26  Spontaneous nystagmus test                                                                    0.65        $31.52
92542             Positional nystagmus test                                                                     1.46        $70.80
92542         TC  Positional nystagmus test                                                                     0.94        $45.58
92542         26  Positional nystagmus test                                                                     0.52        $25.21
92543             Caloric vestibular test                                                                       0.68        $32.97
92543         TC  Caloric vestibular test                                                                       0.50        $24.25
92543         26  Caloric vestibular test                                                                       0.18         $8.73
92544             Optokinetic nystagmus test                                                                    1.17        $56.73
92544         TC  Optokinetic nystagmus test                                                                    0.76        $36.85
92544         26  Optokinetic nystagmus test                                                                    0.41        $19.88
92545             Oscillating tracking test                                                                     1.09        $52.85
92545         TC  Oscillating tracking test                                                                     0.72        $34.91
92545         26  Oscillating tracking test                                                                     0.37        $17.94
92546             Sinusoidal rotational test                                                                    2.16       $104.74
92546         TC  Sinusoidal rotational test                                                                    1.71        $82.92
92546         26  Sinusoidal rotational test                                                                    0.45        $21.82
92547             Supplemental electrical test                                                                  1.28        $62.07
92548             Posturography                                                                                 4.04       $195.90
92548         TC  Posturography                                                                                 3.22       $156.14
92548         26  Posturography                                                                                 0.82        $39.76
92551             Pure tone hearing test, air                                                                   0.00           BR
92552             Pure tone audiometry, air                                                                     0.53        $25.70
92553             Audiometry, air & bone                                                                        0.79        $38.31
92555             Speech threshold audiometry                                                                   0.46        $22.31
92556             Speech audiometry, complete                                                                   0.70        $33.94
92557             Comprehensive hearing test                                                                    1.46        $70.80
92559             Group audiometric testing                                                                     0.00           BR
92560             Bekesy audiometry, screen                                                                     0.00           BR
92561             Bekesy audiometry, diagnosis                                                                  0.85        $41.22
92562             Loudness balance test                                                                         0.49        $23.76
92563             Tone decay hearing test                                                                       0.46        $22.31

Procedure codes and abbreviated descriptors are from "2005 Physicians' Current Procedural Terminology (CPT)." Refer to CPT for complete
descriptors.

Fees are determined by the WCA using 2004 Relative Value Unit data.
WCA                                WORKERS' COMPENSATION FEE SCHEDULE 2005                                                  Medicine
HCSD                                                                                                                               8

CPT®                                                                                                      RVU-MI          MAP
CODE          MOD                                     DESCRIPTION                                                       CF=$48.49
92564                 Sisi hearing test                                                                         0.58        $28.12
92565                 Stenger test, pure tone                                                                   0.48        $23.28
92567                 Tympanometry                                                                              0.65        $31.52
92568                 Acoustic reflex testing                                                                   0.46        $22.31
92569                 Acoustic reflex decay test                                                                0.49        $23.76
92571                 Filtered speech hearing test                                                              0.47        $22.79
92572                 Staggered spondaic word test                                                              0.11         $5.33
92573                 Lombard test                                                                              0.44        $21.34
92575                 Sensorineural acuity test                                                                 0.34        $16.49
92576                 Synthetic sentence test                                                                   0.55        $26.67
92577                 Stenger test, speech                                                                      0.88        $42.67
92579                 Visual audiometry (vra)                                                                   0.86        $41.70
92582                 Conditioning play audiometry                                                              0.86        $41.70
92583                 Select picture audiometry                                                                 1.07        $51.88
92584                 Electrocochleography                                                                      2.96       $143.53
92585                 Auditor evoke potent, compre                                                              2.95       $143.05
92585         TC      Auditor evoke potent, compre                                                              2.17       $105.22
92585         26      Auditor evoke potent, compre                                                              0.78        $37.82
92586                 Auditor evoke potent, limit                                                               2.17       $105.22
92587                 Evoked auditory test                                                                      1.78        $86.31
92587         TC      Evoked auditory test                                                                      1.56        $75.64
92587         26      Evoked auditory test                                                                      0.23        $11.15
92588                 Evoked auditory test                                                                      2.32       $112.50
92588         TC      Evoked auditory test                                                                      1.76        $85.34
92588         26      Evoked auditory test                                                                      0.56        $27.15
92590                 Hearing aid exam, one ear                                                                 0.00           BR
92591                 Hearing aid exam, both ears                                                               0.00           BR
92592                 Hearing aid check, one ear                                                                0.00           BR
92593                 Hearing aid check, both ears                                                              0.00           BR
92594                 Electro hearng aid test, one                                                              0.00           BR
92595                 Electro hearng aid tst, both                                                              0.00           BR
92596                 Ear protector evaluation                                                                  0.72        $34.91
92597                 Oral speech device eval                                                                   2.68       $129.95
92601                 Cochlear implt f/up exam < 7                                                              3.56       $172.62
92602                 Reprogram cochlear implt < 7                                                              2.51       $121.71
92603                 Cochlear implt f/up exam 7 >                                                              2.38       $115.41
92604                 Reprogram cochlear implt 7 >                                                              1.63        $79.04
92605                 Eval for nonspeech device rx                                                              0.00           BR
92606                 Non-speech device service                                                                 0.00           BR
92607                 Ex for speech device rx, 1hr                                                              3.33       $161.47
92608                 Ex for speech device rx addl                                                              0.78        $37.82
92609                 Use of speech device service                                                              1.69        $81.95
92610                 Evaluate swallowing function                                                              3.61       $175.05
92611                 Motion fluoroscopy/swallow                                                                3.61       $175.05
92612                 Endoscopy swallow tst (fees)                                                              4.19       $203.17
92613                 Endoscopy swallow tst (fees)                                                              1.23        $59.64
92614                 Laryngoscopic sensory test                                                                3.89       $188.63
92615                 Eval laryngoscopy sense tst                                                               1.12        $54.31
92616                 Fees w/laryngeal sense test                                                               5.39       $261.36
92617                 Interprt fees/laryngeal test                                                              1.36        $65.95

Procedure codes and abbreviated descriptors are from "2005 Physicians' Current Procedural Terminology (CPT)." Refer to CPT for complete
descriptors.

Fees are determined by the WCA using 2004 Relative Value Unit data.
WCA                                WORKERS' COMPENSATION FEE SCHEDULE 2005                                                  Medicine
HCSD                                                                                                                               9

CPT®                                                                                                      RVU-MI           MAP
CODE          MOD                                     DESCRIPTION                                                       CF=$48.49
92700                 Ent procedure/service                                                                     0.00            BR
92950                 Heart/lung resuscitation cpr                                                              5.43        $263.30
92953                 Temporary external pacing                                                                 0.49         $23.76
92960                 Cardioversion electric, ext                                                               9.18        $445.14
92961                 Cardioversion, electric, int                                                              7.27        $352.52
92970                 Cardioassist, internal                                                                    5.14        $249.24
92971                 Cardioassist, external                                                                    2.82        $136.74
92973                 Percut coronary thrombectomy                                                              4.97        $241.00
92974                 Cath place, cardio brachytx                                                               4.64        $224.99
92975                 Dissolve clot, heart vessel                                                              10.84        $525.63
92977                 Dissolve clot, heart vessel                                                               9.10        $441.26
92978                 Intravasc us, heart add-on                                                                7.83        $379.68
92978         TC      Intravasc us, heart add-on                                                                5.11        $247.78
92978         26      Intravasc us, heart add-on                                                                2.71        $131.41
92979                 Intravasc us, heart add-on                                                                4.74        $229.84
92979         TC      Intravasc us, heart add-on                                                                2.59        $125.59
92979         26      Intravasc us, heart add-on                                                                2.15        $104.25
92980                 Insert intracoronary stent                                                               23.21      $1,125.45
92981                 Insert intracoronary stent                                                                6.45        $312.76
92982                 Coronary artery dilation                                                                 17.21        $834.51
92984                 Coronary artery dilation                                                                  4.59        $222.57
92986                 Revision of aortic valve                                                                 37.03      $1,795.58
92987                 Revision of mitral valve                                                                 38.45      $1,864.44
92990                 Revision of pulmonary valve                                                              29.83      $1,446.46
92992                 Revision of heart chamber                                                                 0.00            BR
92993                 Revision of heart chamber                                                                 0.00            BR
92995                 Coronary atherectomy                                                                     18.94        $918.40
92996                 Coronary atherectomy add-on                                                               5.05        $244.87
92997                 Pul art balloon repr, percut                                                             18.85        $914.04
92998                 Pul art balloon repr, percut                                                              9.19        $445.62
93000                 Electrocardiogram, complete                                                               0.75         $36.37
93005                 Electrocardiogram, tracing                                                                0.49         $23.76
93010                 Electrocardiogram report                                                                  0.26         $12.61
93012                 Transmission of ecg                                                                       6.44        $312.28
93014                 Report on transmitted ecg                                                                 0.77         $37.34
93015                 Cardiovascular stress test                                                                3.04        $147.41
93016                 Cardiovascular stress test                                                                0.65         $31.52
93017                 Cardiovascular stress test                                                                1.94         $94.07
93018                 Cardiovascular stress test                                                                0.45         $21.82
93024                 Cardiac drug stress test                                                                  3.06        $148.38
93024         TC      Cardiac drug stress test                                                                  1.30         $63.04
93024         26      Cardiac drug stress test                                                                  1.76         $85.34
93025                 Microvolt t-wave assess                                                                   9.23        $447.56
93025         TC      Microvolt t-wave assess                                                                   8.12        $393.74
93025         26      Microvolt t-wave assess                                                                   1.10         $53.34
93040                 Rhythm ECG with report                                                                    0.41         $19.88
93041                 Rhythm ECG, tracing                                                                       0.17          $8.24
93042                 Rhythm ECG, report                                                                        0.24         $11.64
93224                 ECG monitor/report, 24 hrs                                                                4.70        $227.90
93225                 ECG monitor/record, 24 hrs                                                                1.42         $68.86

Procedure codes and abbreviated descriptors are from "2005 Physicians' Current Procedural Terminology (CPT)." Refer to CPT for complete
descriptors.

Fees are determined by the WCA using 2004 Relative Value Unit data.
WCA                                WORKERS' COMPENSATION FEE SCHEDULE 2005                                                  Medicine
HCSD                                                                                                                              10

CPT®                                                                                                      RVU-MI          MAP
CODE          MOD                                DESCRIPTION                                                            CF=$48.49
93226                 ECG monitor/report, 24 hrs                                                                2.50       $121.23
93227                 ECG monitor/review, 24 hrs                                                                0.78        $37.82
93230                 ECG monitor/report, 24 hrs                                                                5.01       $242.93
93231                 Ecg monitor/record, 24 hrs                                                                1.77        $85.83
93232                 ECG monitor/report, 24 hrs                                                                2.47       $119.77
93233                 ECG monitor/review, 24 hrs                                                                0.78        $37.82
93235                 ECG monitor/report, 24 hrs                                                                3.59       $174.08
93236                 ECG monitor/report, 24 hrs                                                                2.93       $142.08
93237                 ECG monitor/review, 24 hrs                                                                0.65        $31.52
93268                 ECG record/review                                                                         8.62       $417.98
93270                 ECG recording                                                                             1.42        $68.86
93271                 Ecg/monitoring and analysis                                                               6.44       $312.28
93272                 Ecg/review, interpret only                                                                0.77        $37.34
93278                 ECG/signal-averaged                                                                       1.78        $86.31
93278         TC      ECG/signal-averaged                                                                       1.40        $67.89
93278         26      ECG/signal-averaged                                                                       0.38        $18.43
93303                 Echo transthoracic                                                                        6.31       $305.97
93303         TC      Echo transthoracic                                                                        4.38       $212.39
93303         26      Echo transthoracic                                                                        1.93        $93.59
93304                 Echo transthoracic                                                                        3.33       $161.47
93304         TC      Echo transthoracic                                                                        2.24       $108.62
93304         26      Echo transthoracic                                                                        1.09        $52.85
93307                 Echo exam of heart                                                                        5.78       $280.27
93307         TC      Echo exam of heart                                                                        4.38       $212.39
93307         26      Echo exam of heart                                                                        1.39        $67.40
93308                 Echo exam of heart                                                                        3.04       $147.41
93308         TC      Echo exam of heart                                                                        2.24       $108.62
93308         26      Echo exam of heart                                                                        0.80        $38.79
93312                 Echo transesophageal                                                                      7.71       $373.86
93312         TC      Echo transesophageal                                                                      4.44       $215.30
93312         26      Echo transesophageal                                                                      3.27       $158.56
93313                 Echo transesophageal                                                                      1.32        $64.01
93314                 Echo transesophageal                                                                      6.30       $305.49
93314         TC      Echo transesophageal                                                                      4.44       $215.30
93314         26      Echo transesophageal                                                                      1.86        $90.19
93315                 Echo transesophageal                                                                      0.00           BR
93315         TC      Echo transesophageal                                                                      0.00           BR
93315         26      Echo transesophageal                                                                      4.14       $200.75
93316                 Echo transesophageal                                                                      1.35        $65.46
93317                 Echo transesophageal                                                                      0.00           BR
93317         TC      Echo transesophageal                                                                      0.00           BR
93317         26      Echo transesophageal                                                                      2.70       $130.92
93318                 Echo transesophageal intraop                                                              0.00           BR
93318         TC      Echo transesophageal intraop                                                              0.00           BR
93318         26      Echo transesophageal intraop                                                              2.88       $139.65
93320                 Doppler echo exam, heart                                                                  2.55       $123.65
93320         TC      Doppler echo exam, heart                                                                  1.99        $96.50
93320         26      Doppler echo exam, heart                                                                  0.56        $27.15
93321                 Doppler echo exam, heart                                                                  1.54        $74.67
93321         TC      Doppler echo exam, heart                                                                  1.30        $63.04

Procedure codes and abbreviated descriptors are from "2005 Physicians' Current Procedural Terminology (CPT)." Refer to CPT for complete
descriptors.

Fees are determined by the WCA using 2004 Relative Value Unit data.
WCA                                WORKERS' COMPENSATION FEE SCHEDULE 2005                                                  Medicine
HCSD                                                                                                                              11

CPT®                                                                                                      RVU-MI           MAP
CODE          MOD                              DESCRIPTION                                                              CF=$48.49
93321         26  Doppler echo exam, heart                                                                      0.24         $11.64
93325             Doppler color flow add-on                                                                     3.50        $169.72
93325         TC  Doppler color flow add-on                                                                     3.38        $163.90
93325         26  Doppler color flow add-on                                                                     0.12          $5.82
93350             Echo transthoracic                                                                            4.19        $203.17
93350         TC  Echo transthoracic                                                                            2.06         $99.89
93350         26  Echo transthoracic                                                                            2.13        $103.28
93501             Right heart catheterization                                                                  23.98      $1,162.79
93501         TC  Right heart catheterization                                                                  19.30        $935.86
93501         26  Right heart catheterization                                                                   4.68        $226.93
93503             Insert/place heart catheter                                                                   4.09        $198.32
93505             Biopsy of heart lining                                                                        9.15        $443.68
93505         TC  Biopsy of heart lining                                                                        2.35        $113.95
93505         26  Biopsy of heart lining                                                                        6.80        $329.73
93508             Cath placement, angiography                                                                  20.93      $1,014.90
93508         TC  Cath placement, angiography                                                                  14.09        $683.22
93508         26  Cath placement, angiography                                                                   6.85        $332.16
93510             Left heart catheterization                                                                   49.43      $2,396.86
93510         TC  Left heart catheterization                                                                   42.21      $2,046.76
93510         26  Left heart catheterization                                                                    7.22        $350.10
93511             Left heart catheterization                                                                   49.37      $2,393.95
93511         TC  Left heart catheterization                                                                   41.07      $1,991.48
93511         26  Left heart catheterization                                                                    8.30        $402.47
93514             Left heart catheterization                                                                   52.45      $2,543.30
93514         TC  Left heart catheterization                                                                   41.07      $1,991.48
93514         26  Left heart catheterization                                                                   11.37        $551.33
93524             Left heart catheterization                                                                   64.98      $3,150.88
93524         TC  Left heart catheterization                                                                   53.71      $2,604.40
93524         26  Left heart catheterization                                                                   11.28        $546.97
93526             Rt & Lt heart catheters                                                                      64.98      $3,150.88
93526         TC  Rt & Lt heart catheters                                                                      55.20      $2,676.65
93526         26  Rt & Lt heart catheters                                                                       9.79        $474.72
93527             Rt & Lt heart catheters                                                                      65.53      $3,177.55
93527         TC  Rt & Lt heart catheters                                                                      53.71      $2,604.40
93527         26  Rt & Lt heart catheters                                                                      11.82        $573.15
93528             Rt & Lt heart catheters                                                                      68.26      $3,309.93
93528         TC  Rt & Lt heart catheters                                                                      53.71      $2,604.40
93528         26  Rt & Lt heart catheters                                                                      14.55        $705.53
93529             Rt, lt heart catheterization                                                                 61.58      $2,986.01
93529         TC  Rt, lt heart catheterization                                                                 53.71      $2,604.40
93529         26  Rt, lt heart catheterization                                                                  7.88        $382.10
93530             Rt heart cath, congenital                                                                    26.22      $1,271.41
93530         TC  Rt heart cath, congenital                                                                    19.30        $935.86
93530         26  Rt heart cath, congenital                                                                     6.92        $335.55
93531             R & l heart cath, congenital                                                                 68.58      $3,325.44
93531         TC  R & l heart cath, congenital                                                                 55.20      $2,676.65
93531         26  R & l heart cath, congenital                                                                 13.38        $648.80
93532             R & l heart cath, congenital                                                                 69.64      $3,376.84
93532         TC  R & l heart cath, congenital                                                                 53.71      $2,604.40
93532         26  R & l heart cath, congenital                                                                 15.93        $772.45

Procedure codes and abbreviated descriptors are from "2005 Physicians' Current Procedural Terminology (CPT)." Refer to CPT for complete
descriptors.

Fees are determined by the WCA using 2004 Relative Value Unit data.
WCA                                WORKERS' COMPENSATION FEE SCHEDULE 2005                                                  Medicine
HCSD                                                                                                                              12

CPT®                                                                                                      RVU-MI           MAP
CODE          MOD                                 DESCRIPTION                                                           CF=$48.49
93533                 R & l heart cath, congenital                                                             64.55      $3,130.03
93533         TC      R & l heart cath, congenital                                                             53.71      $2,604.40
93533         26      R & l heart cath, congenital                                                             10.84        $525.63
93539                 Injection, cardiac cath                                                                   0.59         $28.61
93540                 Injection, cardiac cath                                                                   0.63         $30.55
93541                 Injection for lung angiogram                                                              0.43         $20.85
93542                 Injection for heart x-rays                                                                0.43         $20.85
93543                 Injection for heart x-rays                                                                0.44         $21.34
93544                 Injection for aortography                                                                 0.38         $18.43
93545                 Inject for coronary x-rays                                                                0.59         $28.61
93555                 Imaging, cardiac cath                                                                     8.30        $402.47
93555         TC      Imaging, cardiac cath                                                                     7.06        $342.34
93555         26      Imaging, cardiac cath                                                                     1.24         $60.13
93556                 Imaging, cardiac cath                                                                    12.34        $598.37
93556         TC      Imaging, cardiac cath                                                                    11.06        $536.30
93556         26      Imaging, cardiac cath                                                                     1.27         $61.58
93561                 Cardiac output measurement                                                                1.37         $66.43
93561         TC      Cardiac output measurement                                                                0.65         $31.52
93561         26      Cardiac output measurement                                                                0.72         $34.91
93562                 Cardiac output measurement                                                                0.65         $31.52
93562         TC      Cardiac output measurement                                                                0.41         $19.88
93562         26      Cardiac output measurement                                                                0.24         $11.64
93571                 Heart flow reserve measure                                                                7.93        $384.53
93571         TC      Heart flow reserve measure                                                                5.11        $247.78
93571         26      Heart flow reserve measure                                                                2.82        $136.74
93572                 Heart flow reserve measure                                                                5.04        $244.39
93572         TC      Heart flow reserve measure                                                                2.59        $125.59
93572         26      Heart flow reserve measure                                                                2.45        $118.80
93580                 Transcath closure of asd                                                                 28.73      $1,393.12
93581                 Transcath closure of vsd                                                                 37.76      $1,830.98
93600                 Bundle of His recording                                                                   5.55        $269.12
93600         TC      Bundle of His recording                                                                   2.25        $109.10
93600         26      Bundle of His recording                                                                   3.30        $160.02
93602                 Intra-atrial recording                                                                    4.60        $223.05
93602         TC      Intra-atrial recording                                                                    1.28         $62.07
93602         26      Intra-atrial recording                                                                    3.32        $160.99
93603                 Right ventricular recording                                                               5.22        $253.12
93603         TC      Right ventricular recording                                                               1.94         $94.07
93603         26      Right ventricular recording                                                               3.29        $159.53
93609                 Map tachycardia, add-on                                                                  11.59        $562.00
93609         TC      Map tachycardia, add-on                                                                   3.10        $150.32
93609         26      Map tachycardia, add-on                                                                   8.49        $411.68
93610                 Intra-atrial pacing                                                                       6.31        $305.97
93610         TC      Intra-atrial pacing                                                                       1.58         $76.61
93610         26      Intra-atrial pacing                                                                       4.73        $229.36
93612                 Intraventricular pacing                                                                   6.60        $320.03
93612         TC      Intraventricular pacing                                                                   1.87         $90.68
93612         26      Intraventricular pacing                                                                   4.73        $229.36
93613                 Electrophys map 3d, add-on                                                               11.35        $550.36
93615                 Esophageal recording                                                                      1.74         $84.37

Procedure codes and abbreviated descriptors are from "2005 Physicians' Current Procedural Terminology (CPT)." Refer to CPT for complete
descriptors.

Fees are determined by the WCA using 2004 Relative Value Unit data.
WCA                                WORKERS' COMPENSATION FEE SCHEDULE 2005                                                  Medicine
HCSD                                                                                                                              13

CPT®                                                                                                      RVU-MI           MAP
CODE          MOD                            DESCRIPTION                                                                CF=$48.49
93615         TC  Esophageal recording                                                                          0.36         $17.46
93615         26  Esophageal recording                                                                          1.38         $66.92
93616             Esophageal recording                                                                          2.47        $119.77
93616         TC  Esophageal recording                                                                          0.36         $17.46
93616         26  Esophageal recording                                                                          2.11        $102.31
93618             Heart rhythm pacing                                                                          11.16        $541.15
93618         TC  Heart rhythm pacing                                                                           4.52        $219.17
93618         26  Heart rhythm pacing                                                                           6.65        $322.46
93619             Electrophysiology evaluation                                                                 20.52        $995.01
93619         TC  Electrophysiology evaluation                                                                  8.79        $426.23
93619         26  Electrophysiology evaluation                                                                 11.73        $568.79
93620             Electrophysiology evaluation                                                                  0.00            BR
93620         TC  Electrophysiology evaluation                                                                  0.00            BR
93620         26  Electrophysiology evaluation                                                                 18.35        $889.79
93621             Electrophysiology evaluation                                                                  0.00            BR
93621         TC  Electrophysiology evaluation                                                                  0.00            BR
93621         26  Electrophysiology evaluation                                                                  3.38        $163.90
93622             Electrophysiology evaluation                                                                  0.00            BR
93622         TC  Electrophysiology evaluation                                                                  0.00            BR
93622         26  Electrophysiology evaluation                                                                  6.22        $301.61
93623             Stimulation, pacing heart                                                                     0.00            BR
93623         TC  Stimulation, pacing heart                                                                     0.00            BR
93623         26  Stimulation, pacing heart                                                                     4.45        $215.78
93624             Electrophysiologic study                                                                     10.08        $488.78
93624         TC  Electrophysiologic study                                                                      2.28        $110.56
93624         26  Electrophysiologic study                                                                      7.80        $378.22
93631             Heart pacing, mapping                                                                        19.93        $966.41
93631         TC  Heart pacing, mapping                                                                         7.56        $366.58
93631         26  Heart pacing, mapping                                                                        12.37        $599.82
93640             Evaluation heart device                                                                      13.59        $658.98
93640         TC  Evaluation heart device                                                                       8.14        $394.71
93640         26  Evaluation heart device                                                                       5.46        $264.76
93641             Electrophysiology evaluation                                                                 17.36        $841.79
93641         TC  Electrophysiology evaluation                                                                  8.14        $394.71
93641         26  Electrophysiology evaluation                                                                  9.23        $447.56
93642             Electrophysiology evaluation                                                                 15.79        $765.66
93642         TC  Electrophysiology evaluation                                                                  8.14        $394.71
93642         26  Electrophysiology evaluation                                                                  7.65        $370.95
93650             Ablate heart dysrhythm focus                                                                 16.70        $809.78
93651             Ablate heart dysrhythm focus                                                                 25.32      $1,227.77
93652             Ablate heart dysrhythm focus                                                                 27.51      $1,333.96
93660             Tilt table evaluation                                                                         4.57        $221.60
93660         TC  Tilt table evaluation                                                                         1.73         $83.89
93660         26  Tilt table evaluation                                                                         2.84        $137.71
93662             Intracardiac ecg (ice)                                                                        0.00            BR
93662         TC  Intracardiac ecg (ice)                                                                        0.00            BR
93662         26  Intracardiac ecg (ice)                                                                        5.09        $246.81
93668             Peripheral vascular rehab                                                                     0.00            BR
93701             Bioimpedance, thoracic                                                                        1.24         $60.13
93701         TC  Bioimpedance, thoracic                                                                        0.97         $47.04

Procedure codes and abbreviated descriptors are from "2005 Physicians' Current Procedural Terminology (CPT)." Refer to CPT for complete
descriptors.

Fees are determined by the WCA using 2004 Relative Value Unit data.
WCA                                WORKERS' COMPENSATION FEE SCHEDULE 2005                                                  Medicine
HCSD                                                                                                                              14

CPT®                                                                                                      RVU-MI          MAP
CODE          MOD                           DESCRIPTION                                                                 CF=$48.49
93701         26  Bioimpedance, thoracic                                                                        0.27        $13.09
93720             Total body plethysmography                                                                    1.09        $52.85
93721             Plethysmography tracing                                                                       0.84        $40.73
93722             Plethysmography report                                                                        0.25        $12.12
93724             Analyze pacemaker system                                                                     11.93       $578.49
93724         TC  Analyze pacemaker system                                                                      4.52       $219.17
93724         26  Analyze pacemaker system                                                                      7.42       $359.80
93727             Analyze ilr system                                                                            0.87        $42.19
93731             Analyze pacemaker system                                                                      1.27        $61.58
93731         TC  Analyze pacemaker system                                                                      0.58        $28.12
93731         26  Analyze pacemaker system                                                                      0.69        $33.46
93732             Analyze pacemaker system                                                                      1.99        $96.50
93732         TC  Analyze pacemaker system                                                                      0.60        $29.09
93732         26  Analyze pacemaker system                                                                      1.39        $67.40
93733             Telephone analy, pacemaker                                                                    1.13        $54.79
93733         TC  Telephone analy, pacemaker                                                                    0.86        $41.70
93733         26  Telephone analy, pacemaker                                                                    0.27        $13.09
93734             Analyze pacemaker system                                                                      0.96        $46.55
93734         TC  Analyze pacemaker system                                                                      0.39        $18.91
93734         26  Analyze pacemaker system                                                                      0.56        $27.15
93735             Analyze pacemaker system                                                                      1.67        $80.98
93735         TC  Analyze pacemaker system                                                                      0.53        $25.70
93735         26  Analyze pacemaker system                                                                      1.14        $55.28
93736             Telephonic analy, pacemaker                                                                   1.00        $48.49
93736         TC  Telephonic analy, pacemaker                                                                   0.76        $36.85
93736         26  Telephonic analy, pacemaker                                                                   0.24        $11.64
93740             Temperature gradient studies                                                                  0.41        $19.88
93740         TC  Temperature gradient studies                                                                  0.18         $8.73
93740         26  Temperature gradient studies                                                                  0.23        $11.15
93741             Analyze ht pace device sngl                                                                   1.94        $94.07
93741         TC  Analyze ht pace device sngl                                                                   0.76        $36.85
93741         26  Analyze ht pace device sngl                                                                   1.19        $57.70
93742             Analyze ht pace device sngl                                                                   2.10       $101.83
93742         TC  Analyze ht pace device sngl                                                                   0.76        $36.85
93742         26  Analyze ht pace device sngl                                                                   1.34        $64.98
93743             Analyze ht pace device dual                                                                   2.38       $115.41
93743         TC  Analyze ht pace device dual                                                                   0.83        $40.25
93743         26  Analyze ht pace device dual                                                                   1.55        $75.16
93744             Analyze ht pace device dual                                                                   2.52       $122.19
93744         TC  Analyze ht pace device dual                                                                   0.76        $36.85
93744         26  Analyze ht pace device dual                                                                   1.76        $85.34
93760             Cephalic thermogram                                                                           0.00           BR
93762             Peripheral thermogram                                                                         0.00           BR
93770             Measure venous pressure                                                                       0.29        $14.06
93770         TC  Measure venous pressure                                                                       0.05         $2.42
93770         26  Measure venous pressure                                                                       0.24        $11.64
93784             Ambulatory BP monitoring                                                                      2.00        $96.98
93786             Ambulatory BP recording                                                                       0.93        $45.10
93788             Ambulatory BP analysis                                                                        0.53        $25.70
93790             Review/report BP recording                                                                    0.54        $26.18

Procedure codes and abbreviated descriptors are from "2005 Physicians' Current Procedural Terminology (CPT)." Refer to CPT for complete
descriptors.

Fees are determined by the WCA using 2004 Relative Value Unit data.
WCA                                WORKERS' COMPENSATION FEE SCHEDULE 2005                                                  Medicine
HCSD                                                                                                                              15

CPT®                                                                                                      RVU-MI          MAP
CODE          MOD                                     DESCRIPTION                                                       CF=$48.49
93797                 Cardiac rehab                                                                             0.58        $28.12
93798                 Cardiac rehab/monitor                                                                     0.80        $38.79
93799                 Cardiovascular procedure                                                                  0.00           BR
93799         TC      Cardiovascular procedure                                                                  0.00           BR
93799         26      Cardiovascular procedure                                                                  0.00           BR
93875                 Extracranial study                                                                        2.15       $104.25
93875         TC      Extracranial study                                                                        1.83        $88.74
93875         26      Extracranial study                                                                        0.33        $16.00
93880                 Extracranial study                                                                        5.69       $275.91
93880         TC      Extracranial study                                                                        4.75       $230.33
93880         26      Extracranial study                                                                        0.94        $45.58
93882                 Extracranial study                                                                        4.03       $195.41
93882         TC      Extracranial study                                                                        3.36       $162.93
93882         26      Extracranial study                                                                        0.66        $32.00
93886                 Intracranial study                                                                        6.44       $312.28
93886         TC      Intracranial study                                                                        4.97       $241.00
93886         26      Intracranial study                                                                        1.47        $71.28
93888                 Intracranial study                                                                        4.37       $211.90
93888         TC      Intracranial study                                                                        3.40       $164.87
93888         26      Intracranial study                                                                        0.98        $47.52
93922                 Extremity study                                                                           2.52       $122.19
93922         TC      Extremity study                                                                           2.13       $103.28
93922         26      Extremity study                                                                           0.39        $18.91
93923                 Extremity study                                                                           4.07       $197.35
93923         TC      Extremity study                                                                           3.34       $161.96
93923         26      Extremity study                                                                           0.72        $34.91
93924                 Extremity study                                                                           4.97       $241.00
93924         TC      Extremity study                                                                           4.15       $201.23
93924         26      Extremity study                                                                           0.82        $39.76
93925                 Lower extremity study                                                                     6.36       $308.40
93925         TC      Lower extremity study                                                                     5.45       $264.27
93925         26      Lower extremity study                                                                     0.91        $44.13
93926                 Lower extremity study                                                                     4.49       $217.72
93926         TC      Lower extremity study                                                                     3.87       $187.66
93926         26      Lower extremity study                                                                     0.62        $30.06
93930                 Upper extremity study                                                                     5.24       $254.09
93930         TC      Upper extremity study                                                                     4.52       $219.17
93930         26      Upper extremity study                                                                     0.72        $34.91
93931                 Upper extremity study                                                                     3.72       $180.38
93931         TC      Upper extremity study                                                                     3.25       $157.59
93931         26      Upper extremity study                                                                     0.47        $22.79
93965                 Extremity study                                                                           2.53       $122.68
93965         TC      Extremity study                                                                           2.01        $97.46
93965         26      Extremity study                                                                           0.52        $25.21
93970                 Extremity study                                                                           5.70       $276.39
93970         TC      Extremity study                                                                           4.64       $224.99
93970         26      Extremity study                                                                           1.06        $51.40
93971                 Extremity study                                                                           4.02       $194.93
93971         TC      Extremity study                                                                           3.32       $160.99
93971         26      Extremity study                                                                           0.70        $33.94

Procedure codes and abbreviated descriptors are from "2005 Physicians' Current Procedural Terminology (CPT)." Refer to CPT for complete
descriptors.

Fees are determined by the WCA using 2004 Relative Value Unit data.
WCA                                WORKERS' COMPENSATION FEE SCHEDULE 2005                                                  Medicine
HCSD                                                                                                                              16

CPT®                                                                                                      RVU-MI          MAP
CODE          MOD                                     DESCRIPTION                                                       CF=$48.49
93975                 Vascular study                                                                            8.92       $432.53
93975         TC      Vascular study                                                                            6.18       $299.67
93975         26      Vascular study                                                                            2.74       $132.86
93976                 Vascular study                                                                            5.53       $268.15
93976         TC      Vascular study                                                                            3.73       $180.87
93976         26      Vascular study                                                                            1.80        $87.28
93978                 Vascular study                                                                            5.21       $252.63
93978         TC      Vascular study                                                                            4.19       $203.17
93978         26      Vascular study                                                                            1.02        $49.46
93979                 Vascular study                                                                            3.75       $181.84
93979         TC      Vascular study                                                                            3.04       $147.41
93979         26      Vascular study                                                                            0.71        $34.43
93980                 Penile vascular study                                                                     7.00       $339.43
93980         TC      Penile vascular study                                                                     5.13       $248.75
93980         26      Penile vascular study                                                                     1.87        $90.68
93981                 Penile vascular study                                                                     5.80       $281.24
93981         TC      Penile vascular study                                                                     5.15       $249.72
93981         26      Penile vascular study                                                                     0.65        $31.52
93990                 Doppler flow testing                                                                      4.24       $205.60
93990         TC      Doppler flow testing                                                                      3.84       $186.20
93990         26      Doppler flow testing                                                                      0.39        $18.91
94010                 Breathing capacity test                                                                   0.91        $44.13
94010         TC      Breathing capacity test                                                                   0.66        $32.00
94010         26      Breathing capacity test                                                                   0.25        $12.12
94014                 Patient recorded spirometry                                                               1.37        $66.43
94015                 Patient recorded spirometry                                                               0.62        $30.06
94016                 Review patient spirometry                                                                 0.75        $36.37
94060                 Evaluation of wheezing                                                                    1.59        $77.10
94060         TC      Evaluation of wheezing                                                                    1.15        $55.76
94060         26      Evaluation of wheezing                                                                    0.44        $21.34
94070                 Evaluation of wheezing                                                                    3.87       $187.66
94070         TC      Evaluation of wheezing                                                                    3.02       $146.44
94070         26      Evaluation of wheezing                                                                    0.85        $41.22
94150                 Vital capacity test                                                                       0.60        $29.09
94150         TC      Vital capacity test                                                                       0.47        $22.79
94150         26      Vital capacity test                                                                       0.12         $5.82
94200                 Lung function test (MBC/MVV)                                                              0.62        $30.06
94200         TC      Lung function test (MBC/MVV)                                                              0.45        $21.82
94200         26      Lung function test (MBC/MVV)                                                              0.17         $8.24
94240                 Residual lung capacity                                                                    1.10        $53.34
94240         TC      Residual lung capacity                                                                    0.73        $35.40
94240         26      Residual lung capacity                                                                    0.37        $17.94
94250                 Expired gas collection                                                                    0.81        $39.28
94250         TC      Expired gas collection                                                                    0.64        $31.03
94250         26      Expired gas collection                                                                    0.17         $8.24
94260                 Thoracic gas volume                                                                       0.82        $39.76
94260         TC      Thoracic gas volume                                                                       0.62        $30.06
94260         26      Thoracic gas volume                                                                       0.20         $9.70
94350                 Lung nitrogen washout curve                                                               1.13        $54.79
94350         TC      Lung nitrogen washout curve                                                               0.76        $36.85

Procedure codes and abbreviated descriptors are from "2005 Physicians' Current Procedural Terminology (CPT)." Refer to CPT for complete
descriptors.

Fees are determined by the WCA using 2004 Relative Value Unit data.
WCA                                WORKERS' COMPENSATION FEE SCHEDULE 2005                                                  Medicine
HCSD                                                                                                                              17

CPT®                                                                                                      RVU-MI          MAP
CODE          MOD                            DESCRIPTION                                                                CF=$48.49
94350         26  Lung nitrogen washout curve                                                                   0.37        $17.94
94360             Measure airflow resistance                                                                    1.11        $53.82
94360         TC  Measure airflow resistance                                                                    0.74        $35.88
94360         26  Measure airflow resistance                                                                    0.37        $17.94
94370             Breath airway closing volume                                                                  1.05        $50.91
94370         TC  Breath airway closing volume                                                                  0.68        $32.97
94370         26  Breath airway closing volume                                                                  0.37        $17.94
94375             Respiratory flow volume loop                                                                  0.99        $48.01
94375         TC  Respiratory flow volume loop                                                                  0.55        $26.67
94375         26  Respiratory flow volume loop                                                                  0.44        $21.34
94400             CO2 breathing response curve                                                                  1.41        $68.37
94400         TC  CO2 breathing response curve                                                                  0.85        $41.22
94400         26  CO2 breathing response curve                                                                  0.55        $26.67
94450             Hypoxia response curve                                                                        1.18        $57.22
94450         TC  Hypoxia response curve                                                                        0.60        $29.09
94450         26  Hypoxia response curve                                                                        0.58        $28.12
94620             Pulmonary stress test/simple                                                                  3.34       $161.96
94620         TC  Pulmonary stress test/simple                                                                  2.44       $118.32
94620         26  Pulmonary stress test/simple                                                                  0.90        $43.64
94621             Pulm stress test/complex                                                                      3.87       $187.66
94621         TC  Pulm stress test/complex                                                                      1.85        $89.71
94621         26  Pulm stress test/complex                                                                      2.02        $97.95
94640             Airway inhalation treatment                                                                   0.36        $17.46
94642             Aerosol inhalation treatment                                                                  0.00           BR
94656             Initial ventilator mgmt                                                                       2.59       $125.59
94657             Continued ventilator mgmt                                                                     1.94        $94.07
94660             Pos airway pressure, CPAP                                                                     1.53        $74.19
94662             Neg press ventilation, cnp                                                                    1.06        $51.40
94664             Evaluate pt use of inhaler                                                                    0.41        $19.88
94667             Chest wall manipulation                                                                       0.65        $31.52
94668             Chest wall manipulation                                                                       0.50        $24.25
94680             Exhaled air analysis, o2                                                                      2.31       $112.01
94680         TC  Exhaled air analysis, o2                                                                      1.94        $94.07
94680         26  Exhaled air analysis, o2                                                                      0.37        $17.94
94681             Exhaled air analysis, o2/co2                                                                  3.11       $150.80
94681         TC  Exhaled air analysis, o2/co2                                                                  2.82       $136.74
94681         26  Exhaled air analysis, o2/co2                                                                  0.30        $14.55
94690             Exhaled air analysis                                                                          2.15       $104.25
94690         TC  Exhaled air analysis                                                                          2.04        $98.92
94690         26  Exhaled air analysis                                                                          0.11         $5.33
94720             Monoxide diffusing capacity                                                                   1.42        $68.86
94720         TC  Monoxide diffusing capacity                                                                   1.05        $50.91
94720         26  Monoxide diffusing capacity                                                                   0.37        $17.94
94725             Membrane diffusion capacity                                                                   3.48       $168.75
94725         TC  Membrane diffusion capacity                                                                   3.11       $150.80
94725         26  Membrane diffusion capacity                                                                   0.37        $17.94
94750             Pulmonary compliance study                                                                    1.70        $82.43
94750         TC  Pulmonary compliance study                                                                    1.37        $66.43
94750         26  Pulmonary compliance study                                                                    0.33        $16.00
94760             Measure blood oxygen level                                                                    0.09         $4.36

Procedure codes and abbreviated descriptors are from "2005 Physicians' Current Procedural Terminology (CPT)." Refer to CPT for complete
descriptors.

Fees are determined by the WCA using 2004 Relative Value Unit data.
WCA                                WORKERS' COMPENSATION FEE SCHEDULE 2005                                                  Medicine
HCSD                                                                                                                              18

CPT®                                                                                                      RVU-MI          MAP
CODE          MOD                                  DESCRIPTION                                                          CF=$48.49
94761                 Measure blood oxygen level                                                                0.21        $10.18
94762                 Measure blood oxygen level                                                                0.63        $30.55
94770                 Exhaled carbon dioxide test                                                               2.00        $96.98
94770         TC      Exhaled carbon dioxide test                                                               1.79        $86.80
94770         26      Exhaled carbon dioxide test                                                               0.22        $10.67
94772                 Breath recording, infant                                                                  0.00           BR
94772         TC      Breath recording, infant                                                                  0.00           BR
94772         26      Breath recording, infant                                                                  0.00           BR
94799                 Pulmonary service/procedure                                                               0.00           BR
94799         TC      Pulmonary service/procedure                                                               0.00           BR
94799         26      Pulmonary service/procedure                                                               0.00           BR
95004                 Percut allergy skin tests                                                                 0.12         $5.82
95010                 Percut allergy titrate test                                                               0.51        $24.73
95015                 Id allergy titrate-drug/bug                                                               0.33        $16.00
95024                 Id allergy test, drug/bug                                                                 0.17         $8.24
95027                 Id allergy titrate-airborne                                                               0.17         $8.24
95028                 Id allergy test-delayed type                                                              0.26        $12.61
95044                 Allergy patch tests                                                                       0.23        $11.15
95052                 Photo patch test                                                                          0.28        $13.58
95056                 Photosensitivity tests                                                                    0.20         $9.70
95060                 Eye allergy tests                                                                         0.39        $18.91
95065                 Nose allergy test                                                                         0.23        $11.15
95070                 Bronchial allergy tests                                                                   2.33       $112.98
95071                 Bronchial allergy tests                                                                   2.97       $144.02
95075                 Ingestion challenge test                                                                  1.89        $91.65
95078                 Provocative testing                                                                       0.30        $14.55
95115                 Immunotherapy, one injection                                                              0.42        $20.37
95117                 Immunotherapy injections                                                                  0.54        $26.18
95120                 Immunotherapy, one injection                                                              0.00           BR
95125                 Immunotherapy, many antigens                                                              0.00           BR
95130                 Immunotherapy, insect venom                                                               0.00           BR
95131                 Immunotherapy, insect venoms                                                              0.00           BR
95132                 Immunotherapy, insect venoms                                                              0.00           BR
95133                 Immunotherapy, insect venoms                                                              0.00           BR
95134                 Immunotherapy, insect venoms                                                              0.00           BR
95144                 Antigen therapy services                                                                  0.23        $11.15
95145                 Antigen therapy services                                                                  0.41        $19.88
95146                 Antigen therapy services                                                                  0.52        $25.21
95147                 Antigen therapy services                                                                  0.50        $24.25
95148                 Antigen therapy services                                                                  0.66        $32.00
95149                 Antigen therapy services                                                                  0.89        $43.16
95165                 Antigen therapy services                                                                  0.28        $13.58
95170                 Antigen therapy services                                                                  0.22        $10.67
95180                 Rapid desensitization                                                                     3.69       $178.93
95199                 Allergy immunology services                                                               0.00           BR
95250                 Glucose monitoring, cont                                                                  3.83       $185.72
95805                 Multiple sleep latency test                                                              19.08       $925.19
95805         TC      Multiple sleep latency test                                                              16.34       $792.33
95805         26      Multiple sleep latency test                                                               2.75       $133.35
95806                 Sleep study, unattended                                                                   6.36       $308.40

Procedure codes and abbreviated descriptors are from "2005 Physicians' Current Procedural Terminology (CPT)." Refer to CPT for complete
descriptors.

Fees are determined by the WCA using 2004 Relative Value Unit data.
WCA                                WORKERS' COMPENSATION FEE SCHEDULE 2005                                                  Medicine
HCSD                                                                                                                              19

CPT®                                                                                                      RVU-MI           MAP
CODE          MOD                           DESCRIPTION                                                                 CF=$48.49
95806         TC  Sleep study, unattended                                                                       3.97        $192.51
95806         26  Sleep study, unattended                                                                       2.39        $115.89
95807             Sleep study, attended                                                                        14.44        $700.20
95807         TC  Sleep study, attended                                                                        12.07        $585.27
95807         26  Sleep study, attended                                                                         2.37        $114.92
95808             Polysomnography, 1-3                                                                         16.80        $814.63
95808         TC  Polysomnography, 1-3                                                                         12.91        $626.01
95808         26  Polysomnography, 1-3                                                                          3.90        $189.11
95810             Polysomnography, 4 or more                                                                   21.86      $1,059.99
95810         TC  Polysomnography, 4 or more                                                                   16.76        $812.69
95810         26  Polysomnography, 4 or more                                                                    5.11        $247.78
95811             Polysomnography w/cpap                                                                       23.64      $1,146.30
95811         TC  Polysomnography w/cpap                                                                       18.12        $878.64
95811         26  Polysomnography w/cpap                                                                        5.52        $267.66
95812             Eeg, 41-60 minutes                                                                            5.37        $260.39
95812         TC  Eeg, 41-60 minutes                                                                            3.70        $179.41
95812         26  Eeg, 41-60 minutes                                                                            1.67         $80.98
95813             Eeg, over 1 hour                                                                              7.10        $344.28
95813         TC  Eeg, over 1 hour                                                                              4.47        $216.75
95813         26  Eeg, over 1 hour                                                                              2.63        $127.53
95816             Eeg, awake and drowsy                                                                         4.58        $222.08
95816         TC  Eeg, awake and drowsy                                                                         2.90        $140.62
95816         26  Eeg, awake and drowsy                                                                         1.68         $81.46
95819             Eeg, awake and asleep                                                                         5.13        $248.75
95819         TC  Eeg, awake and asleep                                                                         3.45        $167.29
95819         26  Eeg, awake and asleep                                                                         1.68         $81.46
95822             Eeg, coma or sleep only                                                                       5.86        $284.15
95822         TC  Eeg, coma or sleep only                                                                       4.19        $203.17
95822         26  Eeg, coma or sleep only                                                                       1.67         $80.98
95824             Eeg, cerebral death only                                                                      0.00            BR
95824         TC  Eeg, cerebral death only                                                                      0.00            BR
95824         26  Eeg, cerebral death only                                                                      1.21         $58.67
95827             Eeg, all night recording                                                                      4.21        $204.14
95827         TC  Eeg, all night recording                                                                      2.61        $126.56
95827         26  Eeg, all night recording                                                                      1.60         $77.58
95829             Surgery electrocorticogram                                                                   38.48      $1,865.90
95829         TC  Surgery electrocorticogram                                                                   28.96      $1,404.27
95829         26  Surgery electrocorticogram                                                                    9.52        $461.62
95830             Insert electrodes for EEG                                                                     5.29        $256.51
95831             Limb muscle testing, manual                                                                   0.65         $31.52
95832             Hand muscle testing, manual                                                                   0.57         $27.64
95833             Body muscle testing, manual                                                                   0.95         $46.07
95834             Body muscle testing, manual                                                                   1.16         $56.25
95851             Range of motion measurements                                                                  0.56         $27.15
95852             Range of motion measurements                                                                  0.39         $18.91
95857             Tensilon test                                                                                 1.20         $58.19
95858             Tensilon test & myogram                                                                       2.86        $138.68
95858         TC  Tensilon test & myogram                                                                       0.48         $23.28
95858         26  Tensilon test & myogram                                                                       2.38        $115.41
95860             Muscle test, one limb                                                                         2.57        $124.62

Procedure codes and abbreviated descriptors are from "2005 Physicians' Current Procedural Terminology (CPT)." Refer to CPT for complete
descriptors.

Fees are determined by the WCA using 2004 Relative Value Unit data.
WCA                                WORKERS' COMPENSATION FEE SCHEDULE 2005                                                  Medicine
HCSD                                                                                                                              20

CPT®                                                                                                      RVU-MI          MAP
CODE          MOD                            DESCRIPTION                                                                CF=$48.49
95860         TC  Muscle test, one limb                                                                         1.07        $51.88
95860         26  Muscle test, one limb                                                                         1.49        $72.25
95861             Muscle test, 2 limbs                                                                          3.27       $158.56
95861         TC  Muscle test, 2 limbs                                                                          0.87        $42.19
95861         26  Muscle test, 2 limbs                                                                          2.39       $115.89
95863             Muscle test, 3 limbs                                                                          3.96       $192.02
95863         TC  Muscle test, 3 limbs                                                                          1.07        $51.88
95863         26  Muscle test, 3 limbs                                                                          2.89       $140.14
95864             Muscle test, 4 limbs                                                                          5.13       $248.75
95864         TC  Muscle test, 4 limbs                                                                          2.06        $99.89
95864         26  Muscle test, 4 limbs                                                                          3.07       $148.86
95867             Muscle test cran nerv unilat                                                                  1.92        $93.10
95867         TC  Muscle test cran nerv unilat                                                                  0.67        $32.49
95867         26  Muscle test cran nerv unilat                                                                  1.25        $60.61
95868             Muscle test cran nerve bilat                                                                  2.64       $128.01
95868         TC  Muscle test cran nerve bilat                                                                  0.81        $39.28
95868         26  Muscle test cran nerve bilat                                                                  1.83        $88.74
95869             Muscle test, thor paraspinal                                                                  0.83        $40.25
95869         TC  Muscle test, thor paraspinal                                                                  0.26        $12.61
95869         26  Muscle test, thor paraspinal                                                                  0.56        $27.15
95870             Muscle test, nonparaspinal                                                                    0.83        $40.25
95870         TC  Muscle test, nonparaspinal                                                                    0.26        $12.61
95870         26  Muscle test, nonparaspinal                                                                    0.56        $27.15
95872             Muscle test, one fiber                                                                        2.99       $144.99
95872         TC  Muscle test, one fiber                                                                        0.71        $34.43
95872         26  Muscle test, one fiber                                                                        2.28       $110.56
95875             Limb exercise test                                                                            2.83       $137.23
95875         TC  Limb exercise test                                                                            1.13        $54.79
95875         26  Limb exercise test                                                                            1.70        $82.43
95900             Motor nerve conduction test                                                                   1.79        $86.80
95900         TC  Motor nerve conduction test                                                                   1.14        $55.28
95900         26  Motor nerve conduction test                                                                   0.64        $31.03
95903             Motor nerve conduction test                                                                   1.91        $92.62
95903         TC  Motor nerve conduction test                                                                   0.99        $48.01
95903         26  Motor nerve conduction test                                                                   0.92        $44.61
95904             Sense nerve conduction test                                                                   1.52        $73.70
95904         TC  Sense nerve conduction test                                                                   1.00        $48.49
95904         26  Sense nerve conduction test                                                                   0.52        $25.21
95920             Intraop nerve test add-on                                                                     4.95       $240.03
95920         TC  Intraop nerve test add-on                                                                     1.47        $71.28
95920         26  Intraop nerve test add-on                                                                     3.49       $169.23
95921             Autonomic nerv function test                                                                  1.76        $85.34
95921         TC  Autonomic nerv function test                                                                  0.41        $19.88
95921         26  Autonomic nerv function test                                                                  1.34        $64.98
95922             Autonomic nerv function test                                                                  1.89        $91.65
95922         TC  Autonomic nerv function test                                                                  0.41        $19.88
95922         26  Autonomic nerv function test                                                                  1.47        $71.28
95923             Autonomic nerv function test                                                                  3.13       $151.77
95923         TC  Autonomic nerv function test                                                                  1.75        $84.86
95923         26  Autonomic nerv function test                                                                  1.38        $66.92

Procedure codes and abbreviated descriptors are from "2005 Physicians' Current Procedural Terminology (CPT)." Refer to CPT for complete
descriptors.

Fees are determined by the WCA using 2004 Relative Value Unit data.
WCA                                WORKERS' COMPENSATION FEE SCHEDULE 2005                                                  Medicine
HCSD                                                                                                                              21

CPT®                                                                                                      RVU-MI          MAP
CODE          MOD                                     DESCRIPTION                                                       CF=$48.49
95925                 Somatosensory testing                                                                     1.87        $90.68
95925         TC      Somatosensory testing                                                                     1.04        $50.43
95925         26      Somatosensory testing                                                                     0.83        $40.25
95926                 Somatosensory testing                                                                     1.88        $91.16
95926         TC      Somatosensory testing                                                                     1.04        $50.43
95926         26      Somatosensory testing                                                                     0.84        $40.73
95927                 Somatosensory testing                                                                     1.94        $94.07
95927         TC      Somatosensory testing                                                                     1.04        $50.43
95927         26      Somatosensory testing                                                                     0.89        $43.16
95930                 Visual evoked potential test                                                              1.83        $88.74
95930         TC      Visual evoked potential test                                                              1.30        $63.04
95930         26      Visual evoked potential test                                                              0.53        $25.70
95933                 Blink reflex test                                                                         1.81        $87.77
95933         TC      Blink reflex test                                                                         0.92        $44.61
95933         26      Blink reflex test                                                                         0.89        $43.16
95934                 H-reflex test                                                                             1.05        $50.91
95934         TC      H-reflex test                                                                             0.26        $12.61
95934         26      H-reflex test                                                                             0.79        $38.31
95936                 H-reflex test                                                                             1.11        $53.82
95936         TC      H-reflex test                                                                             0.26        $12.61
95936         26      H-reflex test                                                                             0.85        $41.22
95937                 Neuromuscular junction test                                                               1.37        $66.43
95937         TC      Neuromuscular junction test                                                               0.38        $18.43
95937         26      Neuromuscular junction test                                                               0.98        $47.52
95950                 Ambulatory eeg monitoring                                                                 7.21       $349.61
95950         TC      Ambulatory eeg monitoring                                                                 4.80       $232.75
95950         26      Ambulatory eeg monitoring                                                                 2.41       $116.86
95951                 EEG monitoring/videorecord                                                                0.00           BR
95951         TC      EEG monitoring/videorecord                                                                0.00           BR
95951         26      EEG monitoring/videorecord                                                                9.25       $448.53
95953                 EEG monitoring/computer                                                                  12.03       $583.33
95953         TC      EEG monitoring/computer                                                                   7.31       $354.46
95953         26      EEG monitoring/computer                                                                   4.72       $228.87
95954                 EEG monitoring/giving drugs                                                               7.20       $349.13
95954         TC      EEG monitoring/giving drugs                                                               3.37       $163.41
95954         26      EEG monitoring/giving drugs                                                               3.83       $185.72
95955                 EEG during surgery                                                                        3.88       $188.14
95955         TC      EEG during surgery                                                                        2.35       $113.95
95955         26      EEG during surgery                                                                        1.53        $74.19
95956                 Eeg monitoring, cable/radio                                                              18.54       $899.00
95956         TC      Eeg monitoring, cable/radio                                                              13.79       $668.68
95956         26      Eeg monitoring, cable/radio                                                               4.75       $230.33
95957                 EEG digital analysis                                                                      5.04       $244.39
95957         TC      EEG digital analysis                                                                      1.98        $96.01
95957         26      EEG digital analysis                                                                      3.06       $148.38
95958                 EEG monitoring/function test                                                              8.63       $418.47
95958         TC      EEG monitoring/function test                                                              2.04        $98.92
95958         26      EEG monitoring/function test                                                              6.59       $319.55
95961                 Electrode stimulation, brain                                                              6.33       $306.94
95961         TC      Electrode stimulation, brain                                                              1.47        $71.28

Procedure codes and abbreviated descriptors are from "2005 Physicians' Current Procedural Terminology (CPT)." Refer to CPT for complete
descriptors.

Fees are determined by the WCA using 2004 Relative Value Unit data.
WCA                                WORKERS' COMPENSATION FEE SCHEDULE 2005                                                  Medicine
HCSD                                                                                                                              22

CPT®                                                                                                      RVU-MI          MAP
CODE          MOD                             DESCRIPTION                                                               CF=$48.49
95961         26  Electrode stimulation, brain                                                                  4.86       $235.66
95962             Electrode stim, brain add-on                                                                  6.62       $321.00
95962         TC  Electrode stim, brain add-on                                                                  1.47        $71.28
95962         26  Electrode stim, brain add-on                                                                  5.16       $250.21
95965             Meg, spontaneous                                                                              0.00           BR
95965         TC  Meg, spontaneous                                                                              0.00           BR
95965         26  Meg, spontaneous                                                                             12.45       $603.70
95966             Meg, evoked, single                                                                           0.00           BR
95966         TC  Meg, evoked, single                                                                           0.00           BR
95966         26  Meg, evoked, single                                                                           6.23       $302.09
95967             Meg, evoked, each add’l                                                                       0.00           BR
95967         TC  Meg, evoked, each add’l                                                                       0.00           BR
95967         26  Meg, evoked, each add’l                                                                       5.27       $255.54
95970             Analyze neurostim, no prog                                                                    0.72        $34.91
95971             Analyze neurostim, simple                                                                     1.24        $60.13
95972             Analyze neurostim, complex                                                                    2.60       $126.07
95973             Analyze neurostim, complex                                                                    1.51        $73.22
95974             Cranial neurostim, complex                                                                    4.77       $231.30
95975             Cranial neurostim, complex                                                                    2.65       $128.50
95990             Spin/brain pump refil & main                                                                  1.63        $79.04
95991             Spin/brain pump refil & main                                                                  2.35       $113.95
95999             Neurological procedure                                                                        0.00           BR
96000             Motion analysis, video/3d                                                                     2.44       $118.32
96001             Motion test w/ft press meas                                                                   2.91       $141.11
96002             Dynamic surface emg                                                                           0.62        $30.06
96003             Dynamic fine wire emg                                                                         0.61        $29.58
96004             Phys review of motion tests                                                                   3.37       $163.41
96100             Psychological testing                                                                         2.17       $105.22
96105             Assessment of aphasia                                                                         2.17       $105.22
96110             Developmental test, lim                                                                       0.60        $29.09
96111             Developmental test, extend                                                                    4.14       $200.75
96115             Neurobehavior status exam                                                                     2.17       $105.22
96117             Neuropsych test battery                                                                       2.17       $105.22
96150             Assess lth/behave, init                                                                       0.75        $36.37
96151             Assess hlth/behave, subseq                                                                    0.72        $34.91
96152             Intervene hlth/behave, indiv                                                                  0.69        $33.46
96153             Intervene hlth/behave, group                                                                  0.17         $8.24
96154             Interv hlth/behav, fam w/pt                                                                   0.68        $32.97
96155             Interv hlth/behav fam no pt                                                                   0.68        $32.97
96400             Chemotherapy, sc/im                                                                           1.31        $63.52
96405             Intralesional chemo admin                                                                     2.92       $141.59
96406             Intralesional chemo admin                                                                     3.96       $192.02
96408             Chemotherapy, push technique                                                                  3.21       $155.65
96410             Chemotherapy,infusion method                                                                  4.51       $218.69
96412             Chemo, infuse method add-on                                                                   1.07        $51.88
96414             Chemo, infuse method add-on                                                                   5.56       $269.60
96420             Chemotherapy, push technique                                                                  3.16       $153.23
96422             Chemotherapy,infusion method                                                                  5.54       $268.63
96423             Chemo, infuse method add-on                                                                   2.18       $105.71
96425             Chemotherapy,infusion method                                                                  5.08       $246.33

Procedure codes and abbreviated descriptors are from "2005 Physicians' Current Procedural Terminology (CPT)." Refer to CPT for complete
descriptors.

Fees are determined by the WCA using 2004 Relative Value Unit data.
WCA                                WORKERS' COMPENSATION FEE SCHEDULE 2005                                                  Medicine
HCSD                                                                                                                              23

CPT®                                                                                                      RVU-MI          MAP
CODE          MOD                                 DESCRIPTION                                                           CF=$48.49
96440                 Chemotherapy, intracavitary                                                              11.15       $540.66
96445                 Chemotherapy, intracavitary                                                              10.96       $531.45
96450                 Chemotherapy, into CNS                                                                    9.40       $455.81
96520                 Port pump refill & main                                                                   4.24       $205.60
96530                 Syst pump refill & main                                                                   3.16       $153.23
96542                 Chemotherapy injection                                                                    6.01       $291.42
96545                 Provide chemotherapy agent                                                                0.00           BR
96549                 Chemotherapy, unspecified                                                                 0.00           BR
96567                 Photodynamic tx, skin                                                                     1.07        $51.88
96570                 Photodynamic tx, 30 min                                                                   1.61        $78.07
96571                 Photodynamic tx, addl 15 min                                                              0.81        $39.28
96900                 Ultraviolet light therapy                                                                 0.52        $25.21
96902                 Trichogram                                                                                0.69        $33.46
96910                 Photochemotherapy with UV-B                                                               1.16        $56.25
96912                 Photochemotherapy with UV-A                                                               1.45        $70.31
96913                 Photochemotherapy, UV-A or B                                                              2.00        $96.98
96920                 Laser tx, skin < 250 sq cm                                                                9.08       $440.29
96921                 Laser tx, skin 250-500 sq cm                                                              9.17       $444.65
96922                 Laser tx, skin > 500 sq cm                                                               11.05       $535.81
96999                 Dermatological procedure                                                                  0.00           BR
99000                 Specimen handling                                                                         0.00         $5.00
99001                 Specimen handling                                                                         0.00         $5.00
99002                 Device handling                                                                           0.00           BR
99024                 Postop follow-up visit                                                                    0.00           BR
99026                 In-hospital on call service                                                               0.00           BR
99027                 Out-of-hosp on call service                                                               0.00           BR
99050                 Medical services after hrs                                                                0.00         $5.00
99052                 Medical services at night                                                                 0.00         $5.00
99054                 Medical servcs, unusual hrs                                                               0.00        $12.00
99056                 Non-office medical services                                                               0.00           BR
99058                 Office emergency care                                                                     0.00           BR
99070                 Special supplies                                                                          0.00           BR
99071                 Patient education materials                                                               0.00           BR
99075                 Medical testimony                                                                         0.00           BR
99078                 Group health education                                                                    0.00           BR
99080                 Special reports or forms                                                                  0.00           BR
99082                 Unusual physician travel                                                                  0.00           BR
99090                 Computer data analysis                                                                    0.00           BR
99091                 Collect/review data from pt                                                               0.00           BR
99100                 Special anesthesia service                                                                0.00           BR
99116                 Anesthesia with hypothermia                                                               0.00           BR
99135                 Special anesthesia procedure                                                              0.00           BR
99140                 Emergency anesthesia                                                                      0.00           BR
99141                 Sedation, iv/im or inhalant                                                               2.85       $138.20
99142                 Sedation, oral/rectal/nasal                                                               1.69        $81.95
99170                 Anogenital exam, child                                                                    3.69       $178.93
99172                 Ocular function screen                                                                    0.00           BR
99173                 Visual acuity screen                                                                      0.00           BR
99175                 Induction of vomiting                                                                     1.62        $78.55
99183                 Hyperbaric oxygen therapy                                                                 7.46       $361.74

Procedure codes and abbreviated descriptors are from "2005 Physicians' Current Procedural Terminology (CPT)." Refer to CPT for complete
descriptors.

Fees are determined by the WCA using 2004 Relative Value Unit data.
WCA                                WORKERS' COMPENSATION FEE SCHEDULE 2005                                                  Medicine
HCSD                                                                                                                              24

CPT®                                                                                                      RVU-MI          MAP
CODE          MOD                                     DESCRIPTION                                                       CF=$48.49
99185                Regional hypothermia                                                                       0.73        $35.40
99186                Total body hypothermia                                                                     2.80       $135.77
99190                Special pump services                                                                      0.00           BR
99191                Special pump services                                                                      0.00           BR
99192                Special pump services                                                                      0.00           BR
99195                Phlebotomy                                                                                 0.48        $23.28
99199                Special service/proc/report                                                                0.00           BR
99199             32 Special service/proc/report (See R 418.101502)                                                         $25.00




Procedure codes and abbreviated descriptors are from "2005 Physicians' Current Procedural Terminology (CPT)." Refer to CPT for complete
descriptors.

Fees are determined by the WCA using 2004 Relative Value Unit data.

								
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