Back
Outpatient Hospital Fee Schedule Reference Extract
RF797 - Bundled Driver Procedures
Procedure From
Procedure To
Begin Date
End Date
C1300
C1300
20111001
99999999
C8921
C8921
20111001
99999999
C8922
C8922
20111001
99999999
C8923
C8923
20111001
99999999
C8924
C8924
20111001
99999999
C8925
C8925
20111001
99999999
C8926
C8926
20111001
99999999
C8927
C8927
20111001
99999999
C8928
C8928
20111001
99999999
C8929
C8929
20090101
99999999
C8930
C8930
20090101
99999999
C8957
C8957
20111001
99999999
C9704
C9704
20050701
99999999
C9713
C9713
20050701
99999999
C9716
C9716
20111001
99999999
C9718
C9721
20050701
99999999
C9724
C9724
20111001
99999999
C9725
C9725
20111001
99999999
C9726
C9726
20111001
99999999
C9729
C9729
20110401
99999999
C9732
C9732
20120101
99999999
G0008
G0008
20111001
99999999
G0009
G0009
20111001
99999999
G0010
G0010
20111001
99999999
G0104
G0104
20111001
99999999
G0105
G0105
20050701
99999999
G0106
G0106
20111001
99999999
G0117
G0118
20050701
99999999
G0120
G0120
20111001
99999999
G0121
G0121
20050701
99999999
G0127
G0127
20050701
99999999
G0166
G0166
20050701
99999999
G0173
G0173
20111001
99999999
G0186
G0186
20050701
99999999
G0247
G0247
20050701
99999999
G0251
G0251
20111001
99999999
G0257
G0257
20111001
99999999
G0260
G0260
20050701
99999999
G0267
G0267
20050701
99999999
G0290
G0291
20050701
99999999
G0297
G0300
20050701
99999999
G0302
G0302
20111001
99999999
G0303
G0303
20111001
99999999
G0304
G0304
20111001
99999999
G0305
G0305
20111001
99999999
G0339
G0339
20111001
99999999
G0340
G0340
20050701
99999999
G0365
G0365
20111001
99999999
G0404
G0404
20090101
99999999
G0413
G0413
20090101
99999999
G0416
G0416
20090101
99999999
G0417
G0417
20090101
99999999
G0418
G0418
20090101
99999999
G0419
G0419
20090101
99999999
G0451
G0451
20120101
99999999
G3001
G3001
20111001
99999999
Q0091
Q0091
20111001
99999999
Q2023
Q2023
20090701
20090930
Q4115
Q4115
20090701
99999999
Q4116
Q4116
20090701
99999999
0073T
0073T
20111001
99999999
0186T
0186T
20111001
99999999
0190T
0190T
20111001
99999999
0191T
0191T
20111001
99999999
0192T
0192T
20111001
99999999
0199T
0199T
20090701
99999999
0200T
0200T
20090701
99999999
0201T
0201T
20090701
99999999
0202T
0202T
20090701
99999999
0213T
0213T
20111001
99999999
0216T
0216T
20111001
99999999
0218T
0218T
20111001
99999999
0234T
0234T
20110101
99999999
0236T
0236T
20110101
99999999
0237T
0237T
20110101
99999999
0238T
0238T
20110101
99999999
0245T
0245T
20110101
99999999
0246T
0246T
20110101
99999999
0247T
0247T
20110101
99999999
0248T
0248T
20110101
99999999
0249T
0249T
20110101
99999999
0251T
0251T
20110101
99999999
0252T
0252T
20110101
99999999
0253T
0253T
20110101
99999999
0276T
0276T
20120101
99999999
0277T
0277T
20120101
99999999
0278T
0278T
20120101
99999999
0282T
0282T
20120101
99999999
0283T
0283T
20120101
99999999
0284T
0284T
20120101
99999999
0285T
0285T
20120101
99999999
0288T
0288T
20120101
99999999
0296T
0296T
20120101
99999999
0301T
0301T
20120101
99999999
10000
11001
20050701
99999999
11010
11971
20050701
99999999
11976
11976
20050701
99999999
12001
15261
20050701
99999999
15271
15271
20120101
99999999
15272
15272
20120101
99999999
15273
15273
20120101
99999999
15274
15274
20120101
99999999
15275
15275
20120101
99999999
15276
15276
20120101
99999999
15277
15277
20120101
99999999
15278
15278
20120101
99999999
15300
15750
20050701
99999999
15760
15776
20050701
99999999
15777
15777
20120101
99999999
15780
15851
20050701
99999999
15876
16030
20050701
99999999
16035
16035
20111001
99999999
17000
19020
20050701
99999999
19100
19182
20050701
99999999
19240
19260
20050701
99999999
19295
19304
20050701
20090930
19296
19304
20091001
99999999
19307
19357
20050701
99999999
19366
19366
20050701
99999999
19370
20500
20050701
99999999
20520
20526
20050701
99999999
20527
20527
20120101
99999999
20550
20650
20050701
99999999
20660
20660
20090101
99999999
20662
20663
20050701
99999999
20670
20694
20050701
99999999
20696
20696
20090101
99999999
20697
20697
20090101
99999999
20804
20804
20050701
99999999
20806
20806
20050701
99999999
20812
20812
20050701
99999999
20820
20823
20050701
99999999
20826
20826
20050701
99999999
20828
20834
20050701
99999999
20840
20926
20050701
99999999
20950
20950
20050701
99999999
20960
20960
20050701
99999999
20971
20973
20050701
99999999
20979
21044
20050701
20090930
20982
21044
20091001
99999999
21046
21110
20050701
99999999
21120
21139
20050701
99999999
21144
21144
20050701
99999999
21150
21150
20050701
99999999
21172
21172
20090101
99999999
21175
21175
20050701
99999999
21181
21181
20050701
99999999
21193
21193
20111001
99999999
21195
21195
20050701
99999999
21198
21246
20050701
99999999
21248
21254
20050701
99999999
21256
21256
20111001
99999999
21260
21267
20050701
99999999
21270
21340
20050701
99999999
21345
21345
20050701
99999999
21350
21356
20050701
99999999
21360
21360
20111001
99999999
21365
21365
20111001
99999999
21380
21380
20050701
99999999
21385
21385
20111001
99999999
21386
21386
20090101
99999999
21387
21387
20090101
99999999
21390
21390
20050701
99999999
21395
21395
20111001
99999999
21400
21421
20050701
99999999
21440
21502
20050701
99999999
21511
21610
20050701
99999999
21633
21700
20050701
99999999
21720
21725
20050701
99999999
21741
21743
20050701
99999999
21800
21805
20050701
99999999
21820
21820
20050701
99999999
21899
21935
20050701
99999999
21936
21936
20100101
99999999
22100
22107
20050701
99999999
22111
22111
20050701
99999999
22113
22113
20050701
99999999
22115
22115
20050701
99999999
22120
22203
20091001
99999999
22120
22207
20050701
20090930
22208
22208
20080101
20090930
22222
22222
20050701
99999999
22230
22315
20050701
99999999
22330
22525
20050701
99999999
22550
22550
20050701
99999999
22551
22551
20050701
20110930
22552
22552
20050701
20110930
22555
22555
20050701
99999999
22560
22565
20050701
99999999
22612
22625
20050701
99999999
22640
22735
20050701
99999999
22820
22820
20050701
99999999
22851
22851
20111001
99999999
22899
23195
20050701
99999999
23330
23331
20050701
99999999
23355
23470
20050701
99999999
23480
23810
20050701
99999999
23921
24201
20091001
99999999
23921
24410
20050701
20090930
24300
24410
20091001
99999999
24420
24420
20111001
99999999
24430
24802
20050701
99999999
24925
24925
20050701
99999999
24935
24935
20050701
99999999
24999
25240
20050701
99999999
25248
25830
20050701
99999999
25907
25907
20050701
99999999
25909
25909
20111001
99999999
25922
25922
20050701
99999999
25929
25929
20050701
99999999
25931
25931
20111001
99999999
25999
26340
20050701
99999999
26341
26341
20120101
99999999
26352
26550
20050701
99999999
26552
26552
20050701
99999999
26555
26555
20050701
99999999
26557
26991
20050701
99999999
26995
27004
20050701
99999999
27006
27006
20111001
99999999
27010
27015
20050701
99999999
27026
27026
20050701
99999999
27027
27027
20090101
99999999
27031
27035
20050701
99999999
27040
27052
20050701
99999999
27057
27057
20090101
99999999
27059
27059
20100101
99999999
27060
27067
20050701
99999999
27080
27087
20050701
99999999
27097
27115
20050701
99999999
27126
27127
20050701
99999999
27135
27135
20050701
99999999
27157
27157
20050701
99999999
27179
27179
20111001
99999999
27190
27214
20050701
99999999
27216
27216
20050701
20090930
27220
27220
20050701
99999999
27224
27225
20050701
99999999
27230
27230
20050701
99999999
27234
27235
20050701
99999999
27238
27238
20050701
99999999
27242
27242
20050701
99999999
27246
27246
20050701
99999999
27250
27252
20050701
99999999
27255
27257
20050701
99999999
27265
27267
20091001
99999999
27265
27275
20050701
20090930
27275
27275
20091001
99999999
27281
27281
20050701
99999999
27299
27301
20050701
99999999
27304
27361
20050701
99999999
27364
27364
20100101
99999999
27372
27444
20050701
99999999
27446
27446
20050701
99999999
27449
27449
20050701
99999999
27452
27452
20050701
99999999
27460
27462
20050701
99999999
27475
27475
20050701
99999999
27479
27479
20090101
99999999
27490
27490
20050701
99999999
27496
27504
20050701
99999999
27508
27510
20050701
99999999
27512
27512
20050701
99999999
27516
27518
20050701
99999999
27520
27534
20050701
99999999
27537
27538
20050701
99999999
27550
27554
20050701
99999999
27560
27570
20050701
99999999
27594
27594
20050701
99999999
27599
27641
20050701
99999999
27647
27647
20050701
99999999
27650
27700
20091001
99999999
27650
27702
20050701
20090930
27704
27709
20050701
99999999
27720
27720
20111001
99999999
27722
27722
20111001
99999999
27726
27726
20111001
99999999
27730
27871
20050701
99999999
27884
27884
20050701
99999999
27889
28760
20050701
99999999
28805
28805
20111001
99999999
28810
29581
20050701
99999999
29582
29582
20120101
99999999
29583
29583
20120101
99999999
29584
29584
20120101
99999999
29590
30220
20050701
99999999
30310
31205
20050701
99999999
31231
31288
20050701
99999999
31292
31320
20050701
99999999
31400
31582
20050701
99999999
31585
31586
20050701
99999999
31588
31615
20050701
99999999
31622
31626
20050701
99999999
31627
31627
20050701
20110930
31628
31700
20050701
99999999
31717
31720
20050701
99999999
31730
31755
20050701
99999999
31785
31785
20050701
99999999
31820
32020
20050701
99999999
32201
32201
20050701
99999999
32315
32315
20050701
99999999
32400
32400
20050701
99999999
32405
32420
20050701
99999999
32421
32421
20080101
99999999
32422
32422
20080101
99999999
32450
32450
20050701
99999999
32485
32485
20050701
99999999
32490
32490
20050701
99999999
32545
32552
20050701
99999999
32553
32553
20050701
20110930
32560
32606
20050701
99999999
32607
32607
20120101
99999999
32608
32608
20120101
99999999
32609
32609
20120101
99999999
32700
32705
20050701
99999999
32960
32960
20050701
99999999
32998
32998
20111001
99999999
32999
33011
20050701
99999999
33035
33035
20050701
99999999
33100
33100
20050701
99999999
33206
33220
20050701
99999999
33221
33221
20120101
99999999
33222
33226
20050701
99999999
33227
33227
20120101
99999999
33228
33228
20120101
99999999
33229
33229
20120101
99999999
3323F
3323F
20050701
99999999
33230
33230
20120101
99999999
33231
33231
20120101
99999999
33233
33235
20050701
99999999
33240
33240
20111001
99999999
33241
33242
20050701
99999999
33244
33244
20050701
99999999
33247
33248
20050701
99999999
33249
33249
20111001
99999999
33260
33260
20050701
99999999
33262
33262
20120101
99999999
33263
33263
20120101
99999999
33264
33264
20120101
99999999
33282
33284
20050701
99999999
33350
33350
20050701
99999999
33407
33408
20050701
99999999
33450
33452
20050701
99999999
33480
33492
20050701
99999999
33520
33520
20050701
99999999
33525
33528
20050701
99999999
33532
33532
20050701
99999999
33560
33570
20050701
99999999
33575
33575
20050701
99999999
33640
33640
20050701
99999999
33643
33643
20050701
99999999
33649
33649
20050701
99999999
33682
33682
20050701
99999999
33696
33696
20050701
99999999
33698
33698
20050701
99999999
33738
33739
20050701
99999999
33782
33782
20050701
20110930
33783
33783
20050701
20110930
33784
33785
20050701
99999999
33810
33812
20050701
99999999
33830
33830
20050701
99999999
33850
33850
20050701
99999999
33855
33855
20050701
99999999
33865
33865
20050701
99999999
33950
33950
20050701
99999999
33972
33972
20050701
99999999
33999
33999
20050701
99999999
34101
34111
20050701
99999999
34201
34203
20050701
99999999
34421
34421
20050701
99999999
34471
34501
20050701
99999999
34510
34530
20050701
99999999
35011
35011
20050701
99999999
35180
35180
20050701
99999999
35184
35188
20050701
99999999
35190
35207
20050701
99999999
35226
35236
20050701
99999999
35256
35266
20050701
99999999
35286
35286
20050701
99999999
35321
35321
20050701
99999999
35458
35476
20050701
99999999
35484
35500
20050701
99999999
35685
35686
20050701
99999999
35761
35761
20050701
99999999
35860
35860
20050701
99999999
35875
35900
20050701
99999999
35903
35903
20050701
99999999
35910
35910
20050701
99999999
36002
36002
20111001
99999999
36101
36101
20050701
99999999
36147
36147
20100101
99999999
36230
36230
20050701
99999999
36260
36262
20050701
99999999
36420
36480
20050701
20090930
36430
36480
20091001
99999999
36485
36497
20050701
99999999
36511
36537
20050701
99999999
36550
36590
20091001
99999999
36550
36597
20050701
20090930
36593
36597
20091001
99999999
36598
36598
20111001
99999999
36640
36640
20050701
99999999
36680
36821
20050701
99999999
36825
36870
20050701
99999999
37183
37188
20050701
99999999
37191
37191
20120101
99999999
37192
37192
20120101
99999999
37193
37193
20120101
99999999
37195
37210
20050701
99999999
37220
37220
20110101
99999999
37221
37221
20110101
99999999
37222
37222
20110101
99999999
37223
37223
20110101
99999999
37224
37224
20110101
99999999
37225
37225
20110101
99999999
37226
37226
20110101
99999999
37227
37227
20110101
99999999
37228
37228
20110101
99999999
37229
37229
20110101
99999999
37230
37230
20110101
99999999
37231
37231
20110101
99999999
37232
37232
20110101
99999999
37233
37233
20110101
99999999
37234
37234
20110101
99999999
37235
37235
20110101
99999999
37250
37615
20050701
20090930
37400
37615
20091001
99999999
37619
37619
20120101
99999999
37620
37651
20050701
99999999
37700
37787
20050701
99999999
37790
37790
20050701
99999999
37799
37799
20050701
20110930
38090
38090
20050701
99999999
38120
38129
20050701
99999999
38205
38205
20050701
20110930
38206
38206
20050701
99999999
38207
38207
20111001
99999999
38208
38208
20111001
99999999
38209
38209
20111001
99999999
38210
38210
20111001
99999999
38211
38211
20111001
99999999
38212
38212
20111001
99999999
38213
38213
20111001
99999999
38214
38214
20111001
99999999
38215
38215
20111001
99999999
38220
38230
20050701
99999999
38232
38232
20120101
99999999
38240
38308
20050701
99999999
38500
38555
20050701
99999999
38570
38721
20050701
99999999
38740
38745
20050701
99999999
38760
38761
20050701
99999999
38766
38766
20050701
99999999
38771
38771
20050701
99999999
38791
38791
20050701
99999999
38999
38999
20050701
99999999
39020
39020
20050701
99999999
39400
39400
20050701
99999999
39500
39500
20050701
99999999
39510
39510
20050701
99999999
39547
39547
20050701
99999999
40490
40801
20050701
99999999
40805
41120
20050701
99999999
41250
42425
20050701
99999999
42440
42510
20050701
99999999
42600
42808
20050701
99999999
42810
42844
20050701
99999999
42860
42892
20050701
99999999
42895
42950
20050701
99999999
42955
42960
20050701
99999999
42962
42970
20050701
99999999
42972
43040
20050701
99999999
43105
43106
20050701
99999999
43110
43111
20050701
99999999
43115
43115
20050701
99999999
43119
43120
20050701
99999999
43130
43130
20050701
99999999
43136
43273
20091001
99999999
43136
43289
20050701
20090930
43280
43280
20091001
99999999
43281
43281
20091001
20110930
43282
43282
20091001
20110930
43283
43283
20091001
20110930
43289
43289
20091001
99999999
43321
43321
20050701
99999999
43420
43420
20090101
99999999
43450
43458
20050701
99999999
43499
43499
20050701
99999999
43510
43510
20050701
99999999
43600
43600
20050701
99999999
43625
43630
20050701
99999999
43648
43750
20050701
99999999
43755
43755
20110101
99999999
43760
43761
20050701
99999999
43830
43831
20050701
99999999
43834
43834
20050701
99999999
43844
43844
20050701
99999999
43870
43870
20050701
99999999
43885
44000
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