P.O. Box 510949 Milwaukee, WI 53203 800 669-3337 414 272-6666 Fax info@medicaldatafiles.com
Record Layout / Sample Data
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MedicalDataFiles.Com
P.O. Box 510949 Milwaukee, WI 53203 800 669-3337 414 272-6666 Fax info@medicaldatafiles.com Record Layout / Sample Data |
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File Description / Details: |
| Description: | DMEPOS Codes, Descriptions and Fees (all localities) |
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Record Layout: |
| Field | Type | Size | Description |
| HCPCS | Char | 5 | All current year active and deleted codes subject to DMEPOS floors and ceilings. |
| DESC | Char | 29 | Short Description |
| MOD | Char | 2 |
NU--Purchased, New RR--Rented, UE--Purchased, Used |
| JURIS | Char | 2 | D--DMERC jurisdiction, L--Local Part B Carrier jurisdiction, J--Joint DMERC/Local Carrier jurisdiction |
| CATG | Char | 2 | IN--Inexpensive and Other Routinely Purchased Items, FS--Frequently Serviced Items, CR--Capped Rental Items, OX--Oxygen and Oxygen Equipment, OS--Ostomy, Tracheostomy & Urological Items, SD--Surgical Dressings, PO--Prosthetics & Orthotics, SU--Supplies, TE--Transcutaneous Electrical Nerve Stimulators |
| CEILING | Num | 10.2 | Maximum fee schedule amount |
| FLOOR | Num | 9.2 | Minimum fee schedule amount |
| STATE | Num | 10.2 | State fee schedules for all localities |
| HCPCS | MOD | MOD2 | Description | JURIS | CATG | CEIL | FLR | AL | AR | AZ | CA | CO | CT | DC | DE | FL | GA | IA | ID | IL | IN | KS | KY | LA | MA | MD | ME | MI | MN | MO | MS | MT | NC | ND | NE | NH | NJ | NM | NV | NY | OH | OK | OR | PA | RI | SC | SD | TN | TX | UT | VA | VT | WA | WI | WV | WY | AK | HI | PR | VI |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A4217 | AU | Sterile water/saline, 500 ml | D | OS | $3.13 | $2.66 | $2.66 | $3.13 | $3.13 | $2.66 | $3.13 | $3.13 | $2.78 | $3.13 | $3.13 | $3.13 | $3.13 | $2.66 | $3.13 | $3.13 | $2.66 | $2.66 | $3.13 | $2.66 | $3.13 | $2.66 | $3.13 | $3.13 | $2.66 | $2.83 | $2.66 | $2.66 | $3.01 | $2.72 | $2.66 | $3.13 | $3.13 | $2.66 | $2.66 | $3.13 | $2.70 | $3.13 | $3.44 | $2.66 | $2.66 | $3.13 | $2.66 | $3.13 | $2.66 | $2.84 | $3.05 | $3.13 | $3.13 | $3.13 | $3.13 | $1.53 | $2.70 | $3.13 | $2.66 | |
| A4217 | Sterile water/saline, 500 ml | D | SU | $3.13 | $2.66 | $2.66 | $3.13 | $3.13 | $2.66 | $3.13 | $3.13 | $2.78 | $3.13 | $3.13 | $3.13 | $3.13 | $2.66 | $3.13 | $3.13 | $2.66 | $2.66 | $3.13 | $2.66 | $3.13 | $2.66 | $3.13 | $3.13 | $2.66 | $2.83 | $2.66 | $2.66 | $3.01 | $2.72 | $2.66 | $3.13 | $3.13 | $2.66 | $2.66 | $3.13 | $2.70 | $3.13 | $3.44 | $2.66 | $2.66 | $3.13 | $2.66 | $3.13 | $2.66 | $2.84 | $3.05 | $3.13 | $3.13 | $3.13 | $3.13 | $1.53 | $2.70 | $3.13 | $2.66 | ||
| A4233 | NU | Alkalin batt for glucose mon | D | IN | $0.80 | $0.68 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.95 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | $0.80 | |
| A4450 | AW | Non-waterproof tape | D | OS | $0.11 | $0.09 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.13 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | $0.11 | |
| A4450 | AV | Non-waterproof tape | D | OS | $0.09 | $0.08 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.11 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | |
| A4450 | AU | Non-waterproof tape | D | OS | $0.09 | $0.08 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.11 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | $0.09 | |
| A4604 | NU | Tubing with heating element | D | IN | $66.81 | $56.79 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $80.16 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | $66.81 | |
| E0617 | RR | KF | Automatic ext defibrillator | D | CR | $337.57 | $286.93 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $405.08 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 | $337.57 |
| K0608 | UE | KF | Repl garment for AED | D | IN | $100.93 | $85.79 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $121.12 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 | $100.93 |
| L0112 | Cranial cervical orthosis | D | PO | $1,437.61 | $1,078.20 | $1,213.49 | $1,213.38 | $1,178.03 | $1,178.03 | $1,220.18 | $1,178.03 | $1,178.03 | $1,178.03 | $1,213.49 | $1,213.49 | $1,201.01 | $1,178.03 | $1,206.95 | $1,206.95 | $1,201.01 | $1,213.49 | $1,213.38 | $1,178.03 | $1,178.03 | $1,178.03 | $1,206.95 | $1,206.95 | $1,201.01 | $1,213.49 | $1,220.18 | $1,213.49 | $1,220.18 | $1,201.01 | $1,178.03 | $1,178.03 | $1,213.38 | $1,178.03 | $1,178.03 | $1,206.95 | $1,213.38 | $1,178.03 | $1,295.84 | $1,178.03 | $1,213.49 | $1,220.18 | $1,213.49 | $1,213.38 | $1,220.18 | $1,178.03 | $1,178.03 | $1,178.03 | $1,206.95 | $1,178.03 | $1,220.18 | $1,178.03 | $1,178.03 | $1,178.03 | $1,295.84 | ||
| L8047 | KM | Nasal septal prosthesis | D | PO | $1,344.58 | $1,008.44 | $1,107.63 | $1,092.14 | $1,165.33 | $1,165.33 | $1,064.34 | $1,190.62 | $1,133.86 | $1,133.86 | $1,107.63 | $1,107.63 | $1,041.04 | $1,112.26 | $1,129.84 | $1,129.84 | $1,041.04 | $1,107.63 | $1,092.14 | $1,190.62 | $1,133.86 | $1,190.62 | $1,129.84 | $1,129.84 | $1,041.04 | $1,107.63 | $1,064.34 | $1,107.63 | $1,064.34 | $1,041.04 | $1,190.62 | $1,236.56 | $1,092.14 | $1,165.33 | $1,236.56 | $1,129.84 | $1,092.14 | $1,112.26 | $1,048.18 | $1,190.62 | $1,107.63 | $1,064.34 | $1,107.63 | $1,092.14 | $1,064.34 | $1,133.86 | $1,190.62 | $1,112.26 | $1,129.84 | $1,133.86 | $1,064.34 | $1,248.75 | $1,195.57 | $1,133.86 | $1,324.11 | |
| L8047 | Nasal septal prosthesis | D | PO | $1,415.34 | $1,061.50 | $1,165.92 | $1,149.62 | $1,226.65 | $1,226.65 | $1,120.35 | $1,253.28 | $1,193.51 | $1,193.51 | $1,165.92 | $1,165.92 | $1,095.84 | $1,170.79 | $1,189.30 | $1,189.30 | $1,095.84 | $1,165.92 | $1,149.62 | $1,253.28 | $1,193.51 | $1,253.28 | $1,189.30 | $1,189.30 | $1,095.84 | $1,165.92 | $1,120.35 | $1,165.92 | $1,120.35 | $1,095.84 | $1,253.28 | $1,301.63 | $1,149.62 | $1,226.65 | $1,301.63 | $1,189.30 | $1,149.62 | $1,170.79 | $1,103.35 | $1,253.28 | $1,165.92 | $1,120.35 | $1,165.92 | $1,149.62 | $1,120.35 | $1,193.51 | $1,253.28 | $1,170.79 | $1,189.30 | $1,193.51 | $1,120.35 | $1,314.47 | $1,258.51 | $1,193.51 | $1,393.80 | ||
| Q0480 | Driver pneumatic vad, rep | L | PO | $92,712.63 | $69,534.47 | $78,239.88 | $78,232.54 | $75,952.87 | $75,952.87 | $78,828.82 | $75,952.87 | $75,952.87 | $75,952.87 | $78,239.88 | $78,239.88 | $77,435.96 | $75,952.87 | $77,818.28 | $77,818.28 | $77,435.96 | $78,239.88 | $78,232.54 | $75,952.87 | $75,952.87 | $75,952.87 | $77,818.28 | $77,818.28 | $77,435.96 | $78,239.88 | $78,828.82 | $78,239.88 | $78,828.82 | $77,435.96 | $75,952.87 | $75,952.87 | $78,232.54 | $75,952.87 | $75,952.87 | $77,818.28 | $78,232.54 | $75,952.87 | $83,548.15 | $75,952.87 | $78,239.88 | $78,828.82 | $78,239.88 | $78,232.54 | $78,828.82 | $75,952.87 | $75,952.87 | $75,952.87 | $77,818.28 | $75,952.87 | $78,828.82 | $75,952.87 | $75,952.87 | $75,952.87 | $83,548.15 | ||
| V2020 | Vision svcs frames purchases | D | PO | $71.81 | $53.86 | $69.24 | $57.83 | $71.81 | $71.81 | $63.11 | $60.88 | $53.86 | $53.86 | $69.24 | $69.24 | $56.74 | $60.90 | $64.62 | $64.62 | $56.74 | $69.24 | $57.83 | $60.88 | $53.86 | $60.88 | $64.62 | $64.62 | $56.74 | $69.24 | $63.11 | $69.24 | $63.11 | $56.74 | $60.88 | $53.86 | $57.83 | $71.81 | $53.86 | $64.62 | $57.83 | $60.90 | $40.75 | $60.88 | $69.24 | $63.11 | $69.24 | $57.83 | $63.11 | $53.86 | $60.88 | $60.90 | $64.62 | $53.86 | $63.11 | $79.33 | $84.81 | $53.86 | $53.86 |
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03/10/08 |