CMS 2010 (BSA) Use File (PUF) General Documentation ......research sample. It is also disjoint from...
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CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 1
CMS 2010 Basic Stand Alone (BSA) Outpatient Procedures Public Use File (PUF)
General Documentation
1. Overview of the PUF
This release contains the Basic Stand Alone (BSA) Outpatient Procedures Public Use File (PUF) named “CMS 2010 BSA Outpatient Procedures PUF” with information from 2010 Medicare outpatient claims.1 The CMS 2010 BSA Outpatient Procedures PUF is a procedure‐level file in which each record is a procedure in an outpatient claim incurred by a 5% sample of Medicare beneficiaries. There are some demographic and claim‐related variables provided in this PUF as detailed below. However, as claim or beneficiary identities are not provided, it is not possible to link procedures that belong to the same claim or beneficiary in the CMS 2010 BSA Outpatient Procedures PUF.
When the variables were selected for inclusion in this PUF, priority was given to the measures most commonly reported/studied in health services research. However, most variables could not be included in the CMS 2010 BSA Outpatient Procedures PUF because the inclusion of more information would increase the risk of identification of beneficiaries.
2. Source Data for the PUF
The CMS 2010 BSA Outpatient Procedures PUF originates from a 5% simple random sample of beneficiaries drawn (without replacement) from the 100% Beneficiary Summary File for reference year 2010. The sample that is used for the CMS 2010 BSA Outpatient Procedures PUF is disjoint from the existing 5% CMS research sample2 in the sense that there is no overlap in terms of the beneficiaries in the CMS 2010 BSA Outpatient Procedures PUF and the 5% CMS research sample. It is also disjoint from the other BSA PUFs (i.e., CMS 2010 Inpatient Claims PUF, CMS 2010 PDE PUF, CMS 2010 DME Line Items PUF, and CMS 2010 Hospice Beneficiary PUF, CMS 2010 SNF Beneficiary PUF, CMS 2010 HHA Beneficiary PUF, and CMS 2010 Carrier Line Items PUF) that have been released so far. This property prevents users from linking data across multiple files for identification purposes.
The 100% Beneficiary Summary File is created annually and contains demographic, entitlement and enrollment data for beneficiaries
a. who were documented as being alive for some part of the reference year of the Beneficiary Summary File, and
1 Claims with outpatient services ending in 2010, defined by the “claim through date.” 2 http://www.resdac.org/tools/TBs/TN‐011_How5percentMedicarefilescreated_508.pdf
b. who were entitled to Medicare benefits during the reference year, and c. who were enrolled in the Medicare Part A and/or Part B for at least one month in the
reference year.
The 5% sample of outpatient procedures is created by collecting the outpatient procedures for the beneficiaries in the 5% random sample of beneficiaries. The 5% random sample contains approximately 2.5 million beneficiaries. To create the CMS 2010 BSA Outpatient Procedures PUF, all claims that belong to those 2.5 million beneficiaries are collected. These claims are then transformed so that each record of the PUF is not one claim, but one procedure of a claim.
As part of the PUF preparation steps, only a small number of procedures were removed (before suppression) from the file because of data anomalies or denied services. Out of the 2,503,543 beneficiaries, there are 1,181,723 beneficiaries with at least one outpatient claim, and the remaining 1,321,820 beneficiaries do not have any outpatient claims in 2010. To protect the privacy of Medicare beneficiaries, a total of 1,658,243 procedures incurred by 369,037 beneficiaries and comprising 737,298 claims are suppressed from the PUF, leaving 33,600,194 procedures and 6,697,804 claims incurred by 1,173,818 beneficiaries in the CMS 2010 BSA Outpatient Procedures PUF. Note that suppressing a procedure may or may not exclude a beneficiary from the PUF. The exclusion of a beneficiary depends on whether or not the beneficiary has one or more additional procedures remaining in the PUF. Consequently, not all 369,037 beneficiaries and 737,298 claims are excluded. Table 1 below provides the number of procedures and the total Medicare payments for the procedures.
Table 1: Suppression in CMS 2010 BSA Outpatient Procedures PUF
Category Formula Medicare Payments(2) Number of Procedures
Initial 5% Sample(1) (a) 2,332,484,794 35,258,437
Suppressed (b) 327,606,764 1,658,243
CMS 2010 BSA Outpatient Procedures (HCPCS) PUF
(c) =(a)‐(b) 2,004,878,030 33,600,194
(1) 4,422,778 procedures are suppressed initially because of invalid HCPCS codes or denied procedures. (2) The Medicare Payments for the procedures provided in this table are computed using actual payment amounts
for the procedures from the outpatient claim file.
3. Content of the PUF
The most important aspects of the CMS 2010 BSA Outpatient Procedures PUF are as follows:
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i. It contains claims for a simple random sample of 5% of the 2010 beneficiary population. Out of approximately 2.5 million beneficiaries in the 5% sample, about 1.2 million had claims, resulting in a PUF of 33,600,194 procedures, after protecting the privacy of Medicare beneficiaries.
ii. It contains six (6) analytic variables (in addition to a unique procedure key): Age, gender, ICD‐9 primary diagnosis code, HCPCS procedure code, count of number of services, and Medicare payment for procedures. Some of these variables have been aggregated or coarsened in order to protect individuals from identification while retaining the analytic value of the data.
iii. A procedure is only included in the PUF if the combination of all six (6) variables is shared by at least eleven (11) beneficiaries in the population. For some combinations of values of the six (6) variables, there are fewer than eleven (11) procedures in the PUF (e.g., only one or two procedures).
iv. Procedures cannot be linked by claim or beneficiary and cannot be linked to any external data source by means of the procedure ID. The procedure ID is a cryptographic key specific to this Outpatient Procedures PUF and not available elsewhere. The CMS 2010 BSA Outpatient Procedures PUF is sorted by this procedure ID to ensure that the relative positions of each procedure in the PUF and in the original source data are totally uncorrelated.
4. Analytic Variables of the PUF
CMS 2010 BSA Outpatient Procedures PUF contains seven (7) variables: A procedure count and six (6) analytic variables, listed below.
i. Gender (BENE_SEX_IDENT_CD): The beneficiary’s gender, (1) male or (2) female.
ii. Age (BENE_AGE_CAT_CD): The beneficiary’s age, reported in six categories: (1) under 65, (2) 65 ‐ 69, (3) 70 ‐ 74, (4) 75‐79, (5) 80‐84, (6) 85 and older.
iii. ICD‐9 primary diagnosis code (OP_CLM_ICD9_DIAG_CD): “International Classification of Diseases” version 9.3 This is a three‐digit code. In the PUF, 869 such codes are observed. The variable is blank (or missing) when there does not exist a primary diagnosis on the procedure. There are only 2 such records in the PUF.
iv. HCPCS procedure codes (OP_HCPCS_CD): These are HCPCS codes (HCPCS Level I and Level II) and take on 3,867 possible values in the PUF.
3 See http://www.cdc.gov/nchs/data/icd9/icdguide10.pdf
v. Count of services (OP_HCPCS_UNIT_CNT): This is the count of the total number of
services associated with the procedure. This variable is not rounded. There are some records in the PUF for which count of services is equal to zero (0).
vi. Medicare payment on procedures (OP_HCPCS_PMT_AMT): The amount paid by Medicare for the associated procedure. Payment amount is rounded according to the rule in Table 2.
vii. Procedure count (PROC_CNT): Total number of procedures associated with the record (i.e., combination of the analytic variables).
The detailed definitions and frequency distributions of these variables are provided in the Data Dictionary & Codebook together with this document.
5. Analytic Utility of the PUF
Table 3 presents the number of procedures, claims and beneficiaries in the initial 5% sample and CMS 2010 BSA OP Procedures PUF.
Table 4 through Table 7 present the distribution of procedures and beneficiaries in the PUF by gender, age and number of months in 2010 for which the beneficiary was enrolled in Part B of Medicare. Note that CMS 2010 BSA OP Procedures PUF includes procedures for beneficiaries who were enrolled in Medicare Part B for less than a full year.
Table 8 and Table 9 provide the distribution of the number of procedures and claims per beneficiary in the CMS 2010 BSA OP Procedures PUF.
Table 10 shows the distribution of the number of procedures per claim. A claim can have many procedures, but as shown in Table 10, more than half of the claims have only one or two procedures.
Table 11 and Table 12 compare the distribution of procedures by gender and age of beneficiaries in the CMS 2010 BSA OP Procedures PUF, the initial 5% sample and the entire population. The figures presented in those tables indicate that the PUF, despite the suppression of 5% of the procedures in the original sample, provides good estimates of population parameters. Table 13 through Table 15 provide the same comparison for the ICD‐9‐CM diagnosis codes, HCPCS codes, and count of services, respectively.
Table 16 shows the suppression percentages of individual ICD‐9‐CM diagnosis codes in the CMS 2010 BSA OP Procedures PUF from the initial 5% sample. 143 ICD‐9 diagnosis codes have
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suppression rates from the initial 5% sample of 10% or less. Care should be exercised in using statistics for ICD‐9 diagnosis codes with high suppression.
Table 17 shows number of procedures, count of services and Medicare payments by HCPCS code in the CMS 2010 BSA OP Procedures PUF. The weighted mean (Medicare payments divided by service counts for each HCPCS code) is compared with the mean from the initial 5% sample. Medicare payments in the CMS 2010 BSA OP Procedures PUF are rounded according to the rules in Table 2. The means in the initial 5% sample and in the CMS 2010 BSA OP Procedures PUF may differ for several reasons. First, the payments in the PUF are rounded while the mean payments shown in Table 17 for the initial 5% sample are based on actual payments. Second, approximately 4.7 % (or 1,658,243 procedures) of the initial 5% sample is suppressed in the de‐identification process so the number of procedures for each HCPCS code differ between the initial 5% sample and the CMS 2010 BSA OP Procedures PUF. Some HCPCS codes are already sparsely represented in the initial 5% sample and suppression may decrease the sample size for these HCPCS codes further, exacerbating differences in mean payment per service count between the two files. Though there are 7,243 HCPCS codes in the initial 5% sample, over 70 percent of those procedures is comprised of the top 58 most frequent HCPCS codes. Thus, many of the HCPCS codes in the CMS 2010 BSA OP Procedures PUF are infrequent and care should be exercised in using statistics for the higher risk HCPCS codes. Table 17 also provides the suppression rates for each HCPCS code in the CMS 2010 BSA OP Procedures PUF.
It is important to note that the 5% sample is 5% of beneficiaries, not procedures, so multiplying payments in the initial 5% sample by 20 may not yield a good approximation of total payments in 2010 associated with each HCPCS code.
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Table 2: Rounding Rule for Total Medicare Payments
Value of Medicare Payment Amount ($)
Rounding Rule
0 ‐ 100 Round to the nearest multiple of 10
100 ‐ 1,000 Round to the nearest multiple of 50
1,000 ‐ 10,000 Round to the nearest multiple of 100
Greater than 10,000 Round to the nearest multiple of 1,000
Table 3: Size of initial 5% sample and OP PUF in 2010
File Number of Procedures
Number of Claims
Number of Beneficiaries
Initial 5% sample(1) 35,258,437 7,435,102 1,181,723
OP PUF 33,600,194 6,697,804 1,173,818
(1) The following data cleaning steps were taken: (i) remove invalid HCPCS codes; (ii) remove denied services.
Table 4: Distribution of Procedures for Male Beneficiaries by Number of Months of Part B Enrollment in 2010 and Age of Beneficiary
Months of Part B
Enrollment(1) Under 65 65 ‐ 69 70 ‐ 74 75 ‐ 79 80 ‐ 84
85 and above
Total
1 6,406 2,971 1,334 1,437 1,830 2,632 16,6102 10,914 7,899 3,389 4,158 5,101 6,591 38,0523 20,577 11,784 7,396 6,811 7,565 12,573 66,7064 27,779 18,052 8,610 9,571 10,122 14,671 88,8055 33,959 21,320 9,702 12,855 12,027 18,129 107,9926 53,849 26,927 14,871 13,467 13,336 18,767 141,2177 44,163 25,965 15,436 14,042 19,389 20,340 139,3358 54,245 25,197 24,638 17,609 19,028 28,182 168,8999 53,673 34,390 18,439 19,221 17,932 26,544 170,19910 70,571 37,376 20,393 21,682 26,619 30,541 207,18211 68,057 36,407 21,677 30,482 25,798 33,236 215,65712 3,980,098 1,947,883 2,142,487 1,884,839 1,578,716 1,416,146 12,950,169
Total 4,424,291 2,196,171 2,288,372 2,036,174 1,737,463 1,628,352 14,310,823
(1) Number of months enrolled in 2010. Months of enrollment for a beneficiary is replaced with one (1) if it was equal to zero (0) in the Beneficiary Summary File.
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Table 5: Distribution of Procedures for Female Beneficiaries by Number of Months of Part B Enrollment in 2010 and Age of Beneficiary
Months of Part B
Enrollment(1) Under 65 65 ‐ 69 70 ‐ 74 75 ‐ 79 80 ‐ 84
85 and above
Total
1 4,525 3,007 946 1,274 2,063 5,110 16,9252 9,864 8,106 3,441 3,229 4,824 11,105 40,5693 17,003 13,215 5,804 6,756 9,362 18,203 70,3434 23,497 17,887 7,553 9,343 9,609 24,279 92,1685 33,295 22,967 8,191 10,412 10,345 28,631 113,8416 41,747 34,253 13,510 13,292 17,913 33,619 154,3347 44,760 31,676 12,144 15,369 17,392 35,777 157,1188 45,524 33,151 14,391 18,176 18,872 43,013 173,1279 56,207 34,981 17,749 19,000 22,478 47,122 197,53710 57,743 44,204 17,231 20,139 25,899 57,170 222,38611 54,023 44,159 19,243 20,386 27,817 63,798 229,42612 4,083,107 2,546,419 2,825,111 2,585,371 2,482,132 3,299,457 17,821,597
Total 4,471,295 2,834,025 2,945,314 2,722,747 2,648,706 3,667,284 19,289,371
(1) Number of months enrolled in 2010. Months of enrollment for a beneficiary is replaced with one (1) if it was equal to zero (0) in the Beneficiary Summary File.
Table 6: Distribution of Male Beneficiaries by Number of Months of Part B Enrollment in 2010 and Age of Beneficiary
Months of Part B
Enrollment(1) Under 65 65 ‐ 69 70 ‐ 74 75 ‐ 79 80 ‐ 84
85 and above
Total
1 451 371 134 150 174 270 1,5502 622 721 197 214 323 420 2,4973 831 940 307 308 370 632 3,3884 921 1,110 319 319 377 638 3,6845 953 1,262 322 361 410 669 3,9776 1,374 1,781 484 410 438 666 5,1537 1,151 1,327 320 372 434 610 4,2148 1,056 1,320 388 382 418 668 4,2329 1,093 1,447 356 359 435 662 4,35210 1,232 1,533 375 369 478 716 4,70311 1,138 1,595 355 452 475 755 4,77012 88,059 81,966 88,156 71,264 56,223 47,538 433,206
Total 98,881 95,373 91,713 74,960 60,555 54,244 475,726
(1) Number of months enrolled in 2010. Months of enrollment for a beneficiary is replaced with one (1) if it was equal to zero (0) in the Beneficiary Summary File.
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Table 7: Distribution of Female Beneficiaries by Number of Months of Part B Enrollment in 2010 and Age of Beneficiary
Months of Part B
Enrollment(1) Under 65 65 ‐ 69 70 ‐ 74 75 ‐ 79 80 ‐ 84
85 and above
Total
1 441 473 96 100 194 490 1,7942 707 914 170 227 332 744 3,0943 837 1,253 246 312 427 1,010 4,0854 1,009 1,636 241 326 388 1,091 4,6915 1,043 1,752 276 333 416 1,090 4,9106 1,445 2,388 442 385 495 1,120 6,2757 1,289 1,926 297 366 442 1,149 5,4698 1,101 1,906 307 363 458 1,214 5,3499 1,206 1,959 318 343 476 1,244 5,54610 1,249 2,148 326 369 504 1,400 5,99611 1,226 2,073 328 393 530 1,455 6,00512 99,367 116,426 123,560 105,552 92,399 107,574 644,878
Total 110,920 134,854 126,607 109,069 97,061 119,581 698,092
(1) Number of months enrolled in 2010. Months of enrollment for a beneficiary is replaced with one (1) if it was equal to zero (0) in the Beneficiary Summary File.
Table 8: Distribution of Procedures by Beneficiaries
Number of Procedures per beneficiary
Number of beneficiaries with OP
procedures
Total number of procedures
Percentage of beneficiaries with OP
procedures (%)
(a) (b) (c)=(a)*(b) (d)=(b)/1,173,818
1‐9 506,563 2,148,107 43.2%10‐19 260,859 3,631,313 22.2%20‐29 135,744 3,261,418 11.6%30‐39 79,175 2,699,867 6.7%40‐49 49,890 2,202,227 4.3%50‐59 32,334 1,751,667 2.8%60‐69 22,413 1,438,616 1.9%70‐79 15,711 1,166,237 1.3%80‐89 11,281 950,174 1.0%90‐99 8,369 788,805 0.7%
100 or more 51,479 13,561,763 4.4%Total 1,173,818 33,600,194 100.0%
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Table 9: Distribution of Claims by Beneficiary
Number of claims per beneficiary
Number of beneficiaries with OP
claims
Total number of OP claims
Percentage of beneficiaries with OP
claims (%)
(a) (b) (c)=(a)*(b) (d)=(b)/1,173,818
1 272,592 272,592 23.2%2 190,426 380,852 16.2%3 140,920 422,760 12.0%4 106,525 426,100 9.1%5 81,405 407,025 6.9%6 63,204 379,224 5.4%7 49,642 347,494 4.2%8 39,598 316,784 3.4%9 31,747 285,723 2.7%10 26,144 261,440 2.2%11 21,937 241,307 1.9%12 19,432 233,184 1.7%13 16,772 218,036 1.4%14 14,528 203,392 1.2%15 12,360 185,400 1.1%16 10,661 170,576 0.9%17 9,188 156,196 0.8%18 8,049 144,882 0.7%19 6,929 131,651 0.6%
20 or more 51,759 1,513,186 4.4%Total 1,173,818 272,592 100.0%
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Table 10: Distribution of Procedures by Claim
Number of procedures per claim
Number of claims with OP procedures
Total number of procedures
Percentage of claims with OP procedures
(%)
(a) (b) (c)=(a)*(b) (d)=(b)/6,697,804
1 2,224,270 2,224,270 33.2%2 1,453,079 2,906,158 21.7%3 689,498 2,068,494 10.3%4 497,563 1,990,252 7.4%5 347,320 1,736,600 5.2%6 269,493 1,616,958 4.0%7 197,064 1,379,448 2.9%8 154,025 1,232,200 2.3%9 120,333 1,082,997 1.8%10 95,706 957,060 1.4%11 75,835 834,185 1.1%12 64,524 774,288 1.0%13 50,545 657,085 0.8%14 41,391 579,474 0.6%15 33,956 509,340 0.5%16 28,356 453,696 0.4%17 23,372 397,324 0.3%18 20,571 370,278 0.3%19 17,413 330,847 0.3%
20 or more 293,490 11,499,240 4.4%Total 6,697,804 33,600,194 100.0%
Table 11: Distribution of Procedures by Gender of Beneficiary
Gender Population (%) Initial 5% Sample (%) PUF (%)
Male 42.760 42.753 42.592Female 57.240 57.247 57.409
Note: Percentages may not add up to 100% due to rounding.
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Table 12: Distribution of Procedures by Age Categories
Age Population (%) Initial 5% Sample (%) PUF (%)
Under 65 26.099 26.214 26.47565‐69 15.204 15.063 14.97170‐74 15.569 15.649 15.57675‐79 14.326 14.233 14.16380‐84 13.126 13.120 13.054
85 and Older 15.677 15.722 15.761
Note: Percentages may not add up to 100% due to rounding.
Table 13: Distribution of Procedures by ICD‐9‐CM Diagnosis Codes
ICD‐9 CM code Population (%) Initial 5% Sample (%) PUF (%)
585 20.478 20.552 21.503V58 3.579 3.550 3.632786 3.389 3.399 3.515V57 3.258 3.289 3.412250 3.248 3.248 3.356401 3.129 3.148 3.269780 2.800 2.787 2.873272 2.417 2.433 2.535427 2.127 2.155 2.227719 2.106 2.076 2.145285 1.817 1.826 1.868599 1.529 1.526 1.569789 1.491 1.490 1.527724 1.339 1.346 1.380V76 1.289 1.287 1.335728 1.239 1.244 1.281414 1.201 1.206 1.237787 1.046 1.039 1.059428 1.027 1.021 1.039781 1.022 0.999 1.030
All other values 40.469 40.379 38.208 Note: Percentages may not add up to 100% due to rounding.
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Table 14: Distribution of Procedures by HCPCS Codes
HCPCS Code Population (%) Initial 5% Sample (%) PUF (%)
36415 5.945 5.945 6.22390999 5.592 5.595 5.86797110 4.614 4.631 4.762A4657 4.242 4.259 4.468Q4081 3.851 3.876 4.05085025 3.596 3.588 3.74680053 2.799 2.799 2.912J2501 2.547 2.537 2.65885610 2.418 2.421 2.52897530 2.070 2.072 2.11180048 1.817 1.818 1.88680061 1.499 1.501 1.56497112 1.288 1.290 1.30797116 1.264 1.256 1.28799213 1.243 1.243 1.27393005 1.157 1.158 1.19684443 1.124 1.120 1.164J1270 1.024 1.034 1.08297140 0.973 0.988 1.007J1756 0.922 0.925 0.966
All other values 50.015 49.944 47.943
Note: Percentages may not add up to 100% due to rounding.
Table 15: Distribution of Procedures by Count of Services
Count of Services Population (%) Initial 5% Sample (%) PUF (%)
0 0.005% 0.005% 0.002%1 82.634% 82.635% 83.068%2 6.071% 6.057% 5.882%3 1.702% 1.691% 1.565%4 2.215% 2.210% 2.170%5 0.598% 0.598% 0.568%6 0.241% 0.243% 0.219%7 0.148% 0.148% 0.135%8 0.314% 0.321% 0.308%9 0.072% 0.067% 0.058%10 0.533% 0.539% 0.531%
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Count of Services Population (%) Initial 5% Sample (%) PUF (%)
11 0.039% 0.039% 0.033%12 0.118% 0.117% 0.113%13 0.030% 0.029% 0.025%14 0.062% 0.062% 0.059%15 0.083% 0.086% 0.081%16 0.065% 0.065% 0.062%17 0.020% 0.020% 0.017%18 0.057% 0.056% 0.055%19 0.016% 0.016% 0.012%
20 or more 4.978% 4.997% 5.038% Note: Percentages may not add up to 100% due to rounding.
Table 16: ICD‐9‐CM Diagnosis Codes Suppression Percentages from Initial 5% Sample
0%‐5% 5%‐10% 10%‐20% 20%‐30% 30%‐40% 40%‐50% 50%‐75% 75%‐100%(1)
042 070 080 090 054 050 010 002
174 110 038 031 078 088 011 003
185 162 053 034 099 142 066 006
244 203 79 041 133 152 075 070
250 211 150 112 141 175 097 010
268 238 153 131 146 190 098 030
272 241 154 135 156 212 111 033
276 242 155 136 158 223 114 035
285 257 157 151 186 224 115 036
294 266 172 161 196 235 117 039
295 274 173 171 199 237 138 040
296 275 182 179 208 243 140 047
401 280 183 180 210 306 144 052
414 282 188 184 214 317 145 057
427 286 189 195 225 334 147 061
428 290 191 201 232 337 148 074
438 300 193 209 270 349 149 077
585 305 197 216 291 358 159 082
599 311 198 220 293 360 160 087
640 327 200 226 297 378 163 090
715 331 202 227 299 442 164 091
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0%‐5% 5%‐10% 10%‐20% 20%‐30% 30%‐40% 40%‐50% 50%‐75% 75%‐100%(1)
719 332 204 236 301 460 170 094
723 338 205 239 308 464 176 116
724 345 217 253 314 474 187 127
728 346 218 255 318 475 192 128
733 362 233 256 335 485 194 129
780 365 240 259 339 512 213 130
781 366 245 263 350 529 215 132
784 386 246 271 359 532 219 137
786 403 251 283 364 557 221 143
787 415 252 302 367 567 222 165
788 424 269 307 370 582 228 206
789 433 273 310 375 645 229 207
790 434 277 312 394 685 230 231
V03 435 278 319 397 690 249 234
V04 436 279 343 404 694 258 254
V42 453 281 344 405 705 260 261
V57 458 284 351 423 731 264 262
V58 462 287 355 430 801 315 265
V72 465 288 357 444 806 324 267
V76 466 289 361 456 811 336 313
486 292 369 463 834 341 316
490 298 371 472 835 347 320
491 303 373 487 841 353 322
493 304 374 514 870 363 323
496 309 377 516 884 376 325
511 333 379 523 886 383 330
530 340 381 524 890 384 352
535 342 396 526 911 385 387
558 348 431 527 914 395 390
562 354 447 528 934 398 417
564 356 470 533 943 420 445
571 368 478 540 945 421 476
578 372 482 552 958 448 483
592 380 492 565 966 452 488
593 382 494 566 975 471 495
600 388 507 581 980 480 500
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0%‐5% 5%‐10% 10%‐20% 20%‐30% 30%‐40% 40%‐50% 50%‐75% 75%‐100%(1)
610 389 519 583 987 481 506
611 402 521 597 V02 501 508
616 410 522 617 V05 513 510
625 411 531 624 V16 534 517
626 412 537 628 V64 541 520
627 413 556 635 V69 543 542
646 416 572 637 V78 568 551
648 425 575 647 570 629
682 426 576 651 580 670
707 429 591 654 587 671
710 432 594 658 589 683
714 437 596 680 606 712
716 440 598 684 612 713
721 441 603 693 615 732
722 443 605 695 619 734
726 446 614 700 652 743
729 451 622 701 657 744
782 454 632 736 661 752
783 455 639 738 663 754
785 457 641 739 676 755
791 459 642 745 691 757
793 461 649 746 697 760
799 473 656 753 741 800
812 477 666 758 742 817
813 515 674 853 747 818
820 518 686 872 748 827
840 525 698 880 750 833
845 536 703 892 751 837
847 550 706 893 759 838
873 553 709 907 797 839
920 555 711 915 798 861
922 560 720 917 803 862
924 569 735 919 809 863
959 573 737 921 829 864
996 574 756 930 830 865
V06 577 792 931 832 868
0%‐5% 5%‐10% 10%‐20% 20%‐30% 30%‐40% 40%‐50% 50%‐75% 75%‐100%(1)
V08 579 795 933 851 869
V15 584 802 944 860 871
V22 586 810 962 866 895
V43 588 814 963 867 900
V45 590 815 964 874 901
V53 595 816 967 875 903
V54 601 822 968 876 904
V67 602 823 970 877 906
V70 604 826 972 878 908
607 846 V13 885 909
608 848 V17 894 928
618 852 V55 912 932
620 854 V66 927 937
621 879 936 939
623 905 938 940
631 913 941 946
633 916 942 947
634 918 949 948
643 977 952 955
644 989 953 956
655 990 971 957
659 992 974 960
681 997 976 973
692 999 983 984
696 V01 986 985
702 V07 991 988
704 V24 993 V11
708 V65 994 V14
717 V68 V09 V19
718 V73 V18 V46
725 V74 V26 V47
727 V81 V40 V61
730 V41 V63
794 V44 V75
796 V50 V79
805 V51 V80
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 16
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 17
0%‐5% 5%‐10% 10%‐20% 20%‐30% 30%‐40% 40%‐50% 50%‐75% 75%‐100%(1)
807 V52 V84
808 V59 V85
821 V60 V86
824 V87 V88
825 V89
831
836
842
843
844
850
881
882
883
891
897
910
923
935
965
969
995
998
V10
V12
V23
V25
V28
V49
V56
V62
V71
V77
V82 (1) ICD‐9 diagnosis codes are excluded from this table if they do not appear in the 5% sample or if they are fully
suppressed (suppression of 100%) from the CMS 2010 BSA OP Procedures PUF.
Table 17: Medicare Payment and Suppression Rates in CMS 2010 BSA OP Procedures PUF by HCPCS Code
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
142 879 13,935 90,030 6.5 5.9 10.2 40 ‐ 50
630 1 1 20 20.0 4.9 308.2 75 ‐ 100
0073T 324 324 99,450 306.9 325.0 5.6 50 ‐ 75
740 10 40 1,020 25.5 7.1 259.2 75 ‐ 100
810 95 1,368 11,660 8.5 6.9 23.2 75 ‐ 100
0171T 38 38 175,900 4,628.9 4,915.4 5.8 50 ‐ 75
0172T 10 10 22,900 2,290.0 2,596.7 11.8 75 ‐ 100
0174T 2 2 20 10.0 8.9 12.4 75 ‐ 100
0183T 384 384 20,080 52.3 49.6 5.4 50 ‐ 75
0187T 11 11 440 40.0 40.5 1.2 10 ‐ 20
0192T 11 11 23,200 2,109.1 2,049.3 2.9 50 ‐ 75
10021 121 121 10,270 84.9 76.8 10.5 50 ‐ 75
10022 2,649 2,695 627,940 233.0 223.4 4.3 10 ‐ 20
10040 14 14 690 49.3 41.1 20.0 50 ‐ 75
10060 3,118 3,118 232,520 74.6 75.8 1.6 10 ‐ 20
10061 860 860 68,220 79.3 82.6 4.0 10 ‐ 20
10080 21 21 1,640 78.1 72.2 8.2 30 ‐ 40
10081 2 2 1,350 675.0 610.2 10.6 75 ‐ 100
10120 215 215 31,820 148.0 137.7 7.5 40 ‐ 50
10140 290 290 184,050 634.7 601.9 5.4 40 ‐ 50
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 18
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 19
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
10160 163 163 12,480 76.6 75.1 2.0 50 ‐ 75
10180 24 24 24,750 1,031.3 794.2 29.9 75 ‐ 100
11000 49 49 3,980 81.2 73.1 11.1 50 ‐ 75
11010 4 4 400 100.0 202.7 50.7 75 ‐ 100
11012 18 18 1,900 105.6 167.7 37.0 50 ‐ 75
11040 4,976 5,139 377,920 73.5 78.4 6.3 10 ‐ 20
11041 7,638 7,981 580,670 72.8 77.7 6.3 10 ‐ 20
11042 29,716 31,196 4,378,020 140.3 146.9 4.5 5 ‐ 10
11043 1,957 1,982 271,980 137.2 144.2 4.9 10 ‐ 20
11044 607 607 251,500 414.3 418.6 1.0 30 ‐ 40
11055 740 740 29,560 39.9 39.9 0.0 20 ‐ 30
11056 734 734 32,470 44.2 43.1 2.6 20 ‐ 30
11057 125 125 5,590 44.7 42.4 5.4 40 ‐ 50
11100 3,437 3,437 262,490 76.4 76.9 0.7 10 ‐ 20
11101 704 789 18,400 23.3 24.6 5.3 20 ‐ 30
11200 177 177 7,730 43.7 48.5 9.9 50 ‐ 75
11201 5 5 100 20.0 31.5 36.5 75 ‐ 100
11300 57 57 2,430 42.6 39.5 7.8 50 ‐ 75
11301 66 66 2,540 38.5 40.5 4.9 50 ‐ 75
11302 26 26 970 37.3 40.5 7.9 50 ‐ 75
11306 14 14 580 41.4 42.3 2.1 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 20
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
11307 2 2 40 20.0 35.0 42.9 75 ‐ 100
11310 74 74 2,650 35.8 35.6 0.6 50 ‐ 75
11311 49 49 1,800 36.7 40.0 8.3 50 ‐ 75
11312 6 6 120 20.0 37.6 46.8 75 ‐ 100
11400 78 78 14,860 190.5 168.9 12.8 50 ‐ 75
11401 198 198 34,000 171.7 159.2 7.9 50 ‐ 75
11402 383 383 65,330 170.6 179.7 5.1 40 ‐ 50
11403 226 226 84,650 374.6 347.5 7.8 50 ‐ 75
11404 101 101 90,650 897.5 799.7 12.2 50 ‐ 75
11406 308 308 269,300 874.4 804.8 8.6 40 ‐ 50
11420 29 29 11,050 381.0 321.2 18.6 75 ‐ 100
11421 54 54 21,250 393.5 314.2 25.2 75 ‐ 100
11422 171 171 61,350 358.8 349.1 2.8 50 ‐ 75
11423 70 70 65,050 929.3 797.9 16.5 50 ‐ 75
11424 10 10 9,100 910.0 788.6 15.4 75 ‐ 100
11426 42 42 48,700 1,159.5 1,082.5 7.1 50 ‐ 75
11440 131 131 19,050 145.4 157.9 7.9 50 ‐ 75
11441 157 157 23,100 147.1 157.4 6.5 40 ‐ 50
11442 183 183 64,700 353.6 343.2 3.0 40 ‐ 50
11443 50 50 17,300 346.0 354.5 2.4 50 ‐ 75
11444 2 2 600 300.0 331.1 9.4 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 21
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
11450 11 11 13,700 1,245.5 1,097.9 13.4 40 ‐ 50
11462 5 5 5,900 1,180.0 1,071.6 10.1 50 ‐ 75
11470 5 5 5,600 1,120.0 1,004.1 11.5 50 ‐ 75
11600 19 19 7,650 402.6 334.2 20.5 75 ‐ 100
11601 77 77 13,200 171.4 170.6 0.5 50 ‐ 75
11602 374 374 64,610 172.8 184.8 6.5 20 ‐ 30
11603 262 262 98,060 374.3 354.0 5.7 30 ‐ 40
11604 184 184 59,700 324.5 323.6 0.3 20 ‐ 30
11606 478 478 364,700 763.0 755.5 1.0 20 ‐ 30
11620 3 3 1,050 350.0 350.3 0.1 75 ‐ 100
11621 32 32 5,100 159.4 237.6 32.9 50 ‐ 75
11622 168 168 59,200 352.4 344.1 2.4 30 ‐ 40
11623 105 105 85,750 816.7 776.2 5.2 40 ‐ 50
11624 55 55 42,350 770.0 695.5 10.7 50 ‐ 75
11626 117 117 116,450 995.3 1,006.5 1.1 30 ‐ 40
11640 101 101 34,250 339.1 326.7 3.8 30 ‐ 40
11641 240 240 80,170 334.0 324.2 3.0 20 ‐ 30
11642 585 585 185,760 317.5 321.2 1.2 20 ‐ 30
11643 353 353 107,850 305.5 321.3 4.9 10 ‐ 20
11644 125 125 99,750 798.0 765.0 4.3 30 ‐ 40
11646 161 161 172,600 1,072.0 1,029.3 4.1 20 ‐ 30
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 22
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
11719 534 534 9,350 17.5 20.8 15.9 20 ‐ 30
11720 563 563 22,130 39.3 38.6 1.8 20 ‐ 30
11721 4,287 4,287 160,960 37.5 39.9 6.0 10 ‐ 20
11730 304 304 13,260 43.6 44.6 2.2 30 ‐ 40
11732 23 23 460 20.0 24.3 17.7 50 ‐ 75
11740 39 39 890 22.8 24.5 6.9 50 ‐ 75
11750 258 259 49,010 189.2 182.3 3.8 30 ‐ 40
11752 6 6 6,700 1,116.7 1,110.5 0.6 75 ‐ 100
11760 41 41 1,840 44.9 55.4 19.0 50 ‐ 75
11765 19 19 880 46.3 49.0 5.5 75 ‐ 100
11770 16 16 19,100 1,193.8 1,114.9 7.1 30 ‐ 40
11771 5 5 6,100 1,220.0 1,314.4 7.2 40 ‐ 50
11772 9 9 10,700 1,188.9 1,181.5 0.6 30 ‐ 40
11900 82 82 4,060 49.5 45.6 8.6 50 ‐ 75
11970 73 73 159,800 2,189.0 2,359.9 7.2 40 ‐ 50
11971 4 4 4,700 1,175.0 949.4 23.8 75 ‐ 100
11980 2 2 80 40.0 35.7 12.0 50 ‐ 75
11981 1 1 40 40.0 60.4 33.8 75 ‐ 100
11983 4 4 130 32.5 74.8 56.6 50 ‐ 75
12001 6,609 6,609 425,000 64.3 64.7 0.6 10 ‐ 20
12002 4,989 4,989 324,170 65.0 65.6 0.9 5 ‐ 10
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 23
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
12004 667 667 44,350 66.5 66.8 0.4 20 ‐ 30
12005 159 159 10,600 66.7 68.1 2.1 20 ‐ 30
12006 8 8 490 61.3 71.0 13.7 75 ‐ 100
12011 3,700 3,700 236,130 63.8 64.0 0.3 10 ‐ 20
12013 2,009 2,009 128,240 63.8 64.5 1.1 10 ‐ 20
12014 215 215 13,890 64.6 66.9 3.4 30 ‐ 40
12015 87 87 5,540 63.7 64.9 1.8 30 ‐ 40
12016 4 4 260 65.0 65.7 1.1 75 ‐ 100
12020 68 68 15,750 231.6 220.8 4.9 40 ‐ 50
12021 2 2 300 150.0 166.9 10.1 75 ‐ 100
12031 237 237 8,920 37.6 54.3 30.8 40 ‐ 50
12032 911 911 98,540 108.2 115.4 6.2 20 ‐ 30
12034 221 221 9,310 42.1 50.3 16.3 40 ‐ 50
12035 52 52 2,340 45.0 52.6 14.4 50 ‐ 75
12036 1 1 150 150.0 140.5 6.8 75 ‐ 100
12041 100 100 4,390 43.9 49.6 11.5 50 ‐ 75
12042 205 205 8,620 42.0 49.0 14.3 40 ‐ 50
12044 12 12 540 45.0 53.8 16.4 75 ‐ 100
12051 413 413 17,990 43.6 49.5 11.9 30 ‐ 40
12052 473 473 24,130 51.0 57.4 11.1 20 ‐ 30
12053 67 67 3,090 46.1 50.2 8.2 40 ‐ 50
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 24
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
12054 41 41 2,070 50.5 55.9 9.7 40 ‐ 50
12055 2 2 300 150.0 243.1 38.3 75 ‐ 100
13101 100 100 12,150 121.5 161.7 24.9 40 ‐ 50
13102 51 51 5,950 116.7 122.4 4.7 50 ‐ 75
13120 4 4 330 82.5 108.4 23.9 75 ‐ 100
13121 203 203 21,950 108.1 121.6 11.1 30 ‐ 40
13122 96 96 3,000 31.3 33.2 5.7 40 ‐ 50
13131 56 56 5,540 98.9 138.5 28.6 50 ‐ 75
13132 507 507 68,800 135.7 156.0 13.0 20 ‐ 30
13133 50 50 4,260 85.2 86.8 1.8 50 ‐ 75
13150 6 6 600 100.0 167.0 40.1 50 ‐ 75
13151 83 83 10,500 126.5 146.1 13.4 30 ‐ 40
13152 113 113 16,350 144.7 160.9 10.1 30 ‐ 40
13160 55 55 69,700 1,267.3 1,244.2 1.9 30 ‐ 40
14000 29 29 19,500 672.4 694.5 3.2 75 ‐ 100
14001 2 2 850 425.0 731.8 41.9 75 ‐ 100
14020 101 101 82,650 818.3 793.8 3.1 50 ‐ 75
14021 15 15 11,900 793.3 796.8 0.4 75 ‐ 100
14040 384 384 295,500 769.5 728.4 5.6 40 ‐ 50
14041 94 94 74,500 792.6 763.7 3.8 40 ‐ 50
14060 544 544 423,300 778.1 772.9 0.7 30 ‐ 40
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 25
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
14061 63 63 48,000 761.9 760.8 0.1 40 ‐ 50
14301 57 57 64,350 1,128.9 1,116.5 1.1 50 ‐ 75
14302 21 21 13,350 635.7 671.3 5.3 50 ‐ 75
15002 81 81 14,250 175.9 176.8 0.5 50 ‐ 75
15004 167 167 33,350 199.7 193.1 3.4 40 ‐ 50
15100 127 127 158,900 1,251.2 1,230.8 1.7 50 ‐ 75
15120 96 96 116,450 1,213.0 1,192.4 1.7 50 ‐ 75
15175 4 4 1,000 250.0 162.7 53.7 75 ‐ 100
15220 70 70 37,800 540.0 658.7 18.0 50 ‐ 75
15221 5 5 500 100.0 126.0 20.6 75 ‐ 100
15240 91 91 50,350 553.3 659.7 16.1 50 ‐ 75
15241 11 11 1,100 100.0 123.0 18.7 50 ‐ 75
15260 332 332 227,550 685.4 686.4 0.1 20 ‐ 30
15300 4 4 1,000 250.0 215.8 15.8 75 ‐ 100
15330 8 8 800 100.0 129.5 22.8 75 ‐ 100
15331 1 1 100 100.0 114.3 12.5 75 ‐ 100
15335 5 5 500 100.0 134.7 25.8 75 ‐ 100
15340 1,105 1,105 181,650 164.4 174.2 5.6 10 ‐ 20
15341 247 247 20,690 83.8 87.8 4.6 30 ‐ 40
15360 58 58 8,700 150.0 156.7 4.3 30 ‐ 40
15365 963 963 147,390 153.1 160.0 4.3 10 ‐ 20
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 26
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
15366 9 9 720 80.0 99.4 19.5 50 ‐ 75
15400 11 11 2,750 250.0 237.0 5.5 75 ‐ 100
15420 7 7 700 100.0 148.5 32.7 50 ‐ 75
15430 829 829 193,750 233.7 252.9 7.6 20 ‐ 30
15576 3 3 3,700 1,233.3 1,125.7 9.6 75 ‐ 100
15630 12 12 15,000 1,250.0 1,146.4 9.0 75 ‐ 100
15650 2 2 2,500 1,250.0 1,120.9 11.5 75 ‐ 100
15731 3 3 3,600 1,200.0 1,093.7 9.7 75 ‐ 100
15732 47 47 60,300 1,283.0 1,120.4 14.5 50 ‐ 75
15734 7 7 9,000 1,285.7 1,106.8 16.2 75 ‐ 100
15740 3 3 2,500 833.3 669.4 24.5 75 ‐ 100
15760 12 12 15,000 1,250.0 1,124.3 11.2 50 ‐ 75
15821 2 2 3,600 1,800.0 1,464.2 22.9 75 ‐ 100
15822 107 107 190,300 1,778.5 1,650.8 7.7 20 ‐ 30
15823 388 388 668,200 1,722.2 1,688.8 2.0 10 ‐ 20
15830 10 10 12,100 1,210.0 1,015.8 19.1 50 ‐ 75
15847 3 3 1,750 583.3 604.6 3.5 50 ‐ 75
15850 3 3 450 150.0 124.6 20.4 75 ‐ 100
15877 1 1 650 650.0 693.1 6.2 75 ‐ 100
15946 4 4 2,550 637.5 749.2 14.9 40 ‐ 50
16000 33 33 1,570 47.6 45.9 3.7 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 27
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
16020 691 691 55,840 80.8 79.6 1.5 20 ‐ 30
16025 53 53 4,270 80.6 80.0 0.8 50 ‐ 75
16030 7 7 560 80.0 79.9 0.1 75 ‐ 100
17000 5,631 5,631 234,620 41.7 42.1 1.0 10 ‐ 20
17003 3,995 8,663 97,620 11.3 11.6 2.6 20 ‐ 30
17004 437 437 64,580 147.8 144.0 2.6 20 ‐ 30
17110 1,579 1,579 61,740 39.1 40.5 3.5 20 ‐ 30
17111 25 25 2,040 81.6 78.8 3.6 50 ‐ 75
17250 993 995 75,360 75.7 75.6 0.1 30 ‐ 40
17260 3 3 250 83.3 61.9 34.6 75 ‐ 100
17261 63 63 4,310 68.4 69.8 2.0 50 ‐ 75
17262 103 103 6,950 67.5 68.2 1.0 30 ‐ 40
17263 6 6 380 63.3 71.0 10.8 50 ‐ 75
17271 17 17 1,110 65.3 57.9 12.8 50 ‐ 75
17272 14 14 770 55.0 66.2 16.9 50 ‐ 75
17280 20 20 1,510 75.5 72.9 3.6 50 ‐ 75
17281 47 47 6,510 138.5 123.5 12.1 40 ‐ 50
17282 33 33 4,430 134.2 129.1 4.0 40 ‐ 50
17311 1,304 1,343 265,430 197.6 199.5 1.0 5 ‐ 10
17312 698 780 95,050 121.9 125.9 3.2 5 ‐ 10
17313 144 144 31,550 219.1 218.5 0.3 10 ‐ 20
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 28
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
17314 42 43 5,200 120.9 134.8 10.3 20 ‐ 30
17315 35 35 4,050 115.7 124.7 7.2 40 ‐ 50
17999 66 66 1,180 17.9 21.6 17.1 50 ‐ 75
19000 371 371 82,350 222.0 222.6 0.3 10 ‐ 20
19001 44 44 1,770 40.2 41.8 3.8 20 ‐ 30
19020 6 6 5,850 975.0 916.8 6.3 50 ‐ 75
19100 48 48 11,450 238.5 220.7 8.1 40 ‐ 50
19101 162 162 205,500 1,268.5 1,217.8 4.2 30 ‐ 40
19102 1,682 1,694 681,930 402.6 394.5 2.1 10 ‐ 20
19103 2,940 2,971 2,355,100 792.7 783.7 1.1 5 ‐ 10
19120 879 879 1,152,400 1,311.0 1,279.5 2.5 10 ‐ 20
19125 974 974 1,294,950 1,329.5 1,313.1 1.2 10 ‐ 20
19126 22 22 14,400 654.5 665.3 1.6 50 ‐ 75
19290 1 1 60 60.0 827.7 92.8 75 ‐ 100
19296 15 15 45,600 3,040.0 2,630.2 15.6 30 ‐ 40
19297 31 31 93,400 3,012.9 2,916.1 3.3 20 ‐ 30
19300 16 16 20,200 1,262.5 1,252.3 0.8 30 ‐ 40
19301 1,465 1,465 1,934,200 1,320.3 1,312.5 0.6 5 ‐ 10
19302 148 148 314,100 2,122.3 2,050.5 3.5 10 ‐ 20
19303 287 287 471,700 1,643.6 1,679.3 2.1 10 ‐ 20
19304 18 18 29,400 1,633.3 1,654.8 1.3 50 ‐ 75
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
19307 234 234 464,450 1,984.8 1,997.5 0.6 10 ‐ 20
19316 26 26 28,300 1,088.5 1,165.1 6.6 50 ‐ 75
19318 86 86 243,750 2,834.3 2,585.1 9.6 30 ‐ 40
19328 12 12 14,450 1,204.2 1,311.6 8.2 50 ‐ 75
19330 8 8 9,950 1,243.8 1,396.6 10.9 50 ‐ 75
19340 47 47 111,600 2,374.5 2,331.3 1.9 50 ‐ 75
19350 20 20 23,900 1,195.0 1,212.6 1.5 50 ‐ 75
19357 19 19 65,800 3,463.2 3,537.7 2.1 75 ‐ 100
19370 5 5 6,450 1,290.0 1,171.8 10.1 75 ‐ 100
19371 34 34 45,100 1,326.5 1,456.6 8.9 50 ‐ 75
19380 39 39 76,400 1,959.0 2,150.6 8.9 50 ‐ 75
19499 15 15 10,100 673.3 1,026.1 34.4 75 ‐ 100
20103 9 9 5,750 638.9 598.1 6.8 75 ‐ 100
20205 43 43 39,350 915.1 877.9 4.2 50 ‐ 75
20206 37 37 15,100 408.1 403.8 1.1 75 ‐ 100
20220 100 100 44,050 440.5 413.1 6.6 50 ‐ 75
20225 157 157 138,300 880.9 903.3 2.5 50 ‐ 75
20240 6 6 7,000 1,166.7 1,153.4 1.2 75 ‐ 100
20526 128 130 16,760 128.9 121.3 6.3 30 ‐ 40
20550 606 613 77,290 126.1 112.9 11.7 30 ‐ 40
20551 76 76 10,290 135.4 108.3 25.0 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 29
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
20552 1,297 1,297 145,130 111.9 106.3 5.3 10 ‐ 20
20553 601 601 72,600 120.8 112.3 7.6 20 ‐ 30
20600 448 448 53,690 119.8 100.4 19.3 40 ‐ 50
20605 877 877 105,110 119.9 109.0 10.0 30 ‐ 40
20610 14,801 15,041 1,742,440 115.8 111.3 4.0 5 ‐ 10
20612 6 6 900 150.0 78.0 92.3 75 ‐ 100
20665 11 11 350 31.8 35.3 9.9 50 ‐ 75
20670 88 88 80,850 918.8 860.2 6.8 40 ‐ 50
20680 875 875 965,800 1,103.8 1,063.5 3.8 20 ‐ 30
20690 37 37 62,100 1,678.4 1,531.9 9.6 40 ‐ 50
20694 76 76 89,800 1,181.6 1,075.1 9.9 30 ‐ 40
20900 3 3 2,400 800.0 1,040.6 23.1 75 ‐ 100
20926 6 6 600 100.0 258.2 61.3 75 ‐ 100
20999 8 8 6,050 756.3 999.9 24.4 75 ‐ 100
21012 1 1 400 400.0 528.9 24.4 75 ‐ 100
21089 2 2 100 50.0 52.2 4.2 50 ‐ 75
21235 11 11 9,750 886.4 1,023.6 13.4 75 ‐ 100
21310 19 19 960 50.5 49.3 2.4 50 ‐ 75
21315 1 1 800 800.0 815.8 1.9 75 ‐ 100
21320 12 12 9,100 758.3 767.7 1.2 75 ‐ 100
21365 6 6 13,400 2,233.3 2,227.8 0.2 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 30
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
21390 2 2 4,500 2,250.0 2,105.6 6.9 75 ‐ 100
21453 2 2 4,500 2,250.0 2,410.4 6.7 50 ‐ 75
21462 2 2 4,200 2,100.0 2,110.2 0.5 75 ‐ 100
21480 43 43 2,170 50.5 52.1 3.1 30 ‐ 40
21550 1 1 900 900.0 865.9 3.9 75 ‐ 100
21552 34 34 40,000 1,176.5 1,075.3 9.4 50 ‐ 75
21554 8 8 9,400 1,175.0 1,112.7 5.6 50 ‐ 75
21555 2 2 1,800 900.0 784.8 14.7 75 ‐ 100
21556 7 7 8,300 1,185.7 1,118.8 6.0 75 ‐ 100
21800 109 110 9,860 89.6 84.1 6.5 20 ‐ 30
21930 2 2 1,800 900.0 738.6 21.9 75 ‐ 100
21931 46 46 56,100 1,219.6 1,131.9 7.7 40 ‐ 50
21933 16 16 18,600 1,162.5 1,128.0 3.1 50 ‐ 75
22310 2 2 500 250.0 223.0 12.1 75 ‐ 100
22520 243 243 400,450 1,647.9 1,609.3 2.4 10 ‐ 20
22521 226 226 358,750 1,587.4 1,574.1 0.8 10 ‐ 20
22522 69 69 57,500 833.3 855.0 2.5 30 ‐ 40
22523 555 555 2,622,800 4,725.8 4,673.3 1.1 10 ‐ 20
22524 561 561 2,501,800 4,459.5 4,406.9 1.2 20 ‐ 30
22525 235 235 551,600 2,347.2 2,388.2 1.7 20 ‐ 30
22851 2 2 1,200 600.0 693.6 13.5 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 31
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
22903 9 9 10,400 1,155.6 1,034.5 11.7 75 ‐ 100
23071 17 17 19,700 1,158.8 1,180.4 1.8 50 ‐ 75
23073 6 6 6,900 1,150.0 1,208.0 4.8 75 ‐ 100
23120 251 251 213,350 850.0 916.5 7.3 20 ‐ 30
23130 52 52 126,300 2,428.8 2,192.8 10.8 50 ‐ 75
23350 1 1 50 50.0 78.0 35.9 75 ‐ 100
23405 25 25 20,450 818.0 846.9 3.4 50 ‐ 75
23410 207 207 384,700 1,858.5 1,839.9 1.0 20 ‐ 30
23412 435 435 753,300 1,731.7 1,779.5 2.7 20 ‐ 30
23415 14 14 30,500 2,178.6 2,100.7 3.7 50 ‐ 75
23420 150 150 331,900 2,212.7 2,160.2 2.4 30 ‐ 40
23430 105 105 129,500 1,233.3 1,327.6 7.1 30 ‐ 40
23500 34 34 3,090 90.9 94.8 4.1 30 ‐ 40
23515 15 15 50,700 3,380.0 3,437.8 1.7 50 ‐ 75
23545 1 1 250 250.0 251.8 0.7 75 ‐ 100
23600 86 86 8,750 101.7 110.1 7.6 30 ‐ 40
23605 33 33 32,700 990.9 986.6 0.4 30 ‐ 40
23615 46 46 155,900 3,389.1 3,388.8 0.0 30 ‐ 40
23630 3 3 10,000 3,333.3 3,206.0 4.0 75 ‐ 100
23650 518 518 48,070 92.8 95.5 2.8 10 ‐ 20
23655 136 136 99,950 734.9 683.8 7.5 20 ‐ 30
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 32
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
23665 21 21 5,350 254.8 258.2 1.3 40 ‐ 50
23675 2 2 170 85.0 92.6 8.2 75 ‐ 100
23700 92 92 55,650 604.9 596.9 1.3 40 ‐ 50
23929 25 25 1,040 41.6 103.7 59.9 40 ‐ 50
23931 6 6 6,000 1,000.0 855.5 16.9 50 ‐ 75
24071 7 7 8,500 1,214.3 1,054.0 15.2 75 ‐ 100
24105 110 110 124,100 1,128.2 1,024.4 10.1 30 ‐ 40
24140 5 5 8,000 1,600.0 1,484.8 7.8 75 ‐ 100
24357 1 1 1,600 1,600.0 1,376.4 16.2 75 ‐ 100
24358 11 11 19,200 1,745.5 1,630.1 7.1 40 ‐ 50
24359 8 8 13,200 1,650.0 1,610.3 2.5 50 ‐ 75
24500 11 11 960 87.3 115.4 24.4 50 ‐ 75
24505 6 6 540 90.0 104.4 13.8 50 ‐ 75
24515 7 7 23,500 3,357.1 3,330.7 0.8 50 ‐ 75
24577 2 2 500 250.0 212.1 17.9 50 ‐ 75
24600 33 33 2,940 89.1 92.3 3.5 30 ‐ 40
24605 11 11 8,150 740.9 701.5 5.6 50 ‐ 75
24650 13 13 1,160 89.2 87.2 2.3 30 ‐ 40
24655 10 10 2,500 250.0 241.8 3.4 10 ‐ 20
24665 2 2 4,700 2,350.0 2,024.2 16.1 75 ‐ 100
24670 2 2 180 90.0 115.3 21.9 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 33
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
24685 80 80 193,100 2,413.8 2,366.3 2.0 30 ‐ 40
25000 105 105 116,850 1,112.9 1,031.5 7.9 30 ‐ 40
25020 12 12 20,400 1,700.0 1,730.7 1.8 20 ‐ 30
25071 3 3 3,600 1,200.0 1,064.3 12.8 75 ‐ 100
25105 2 2 3,200 1,600.0 1,581.3 1.2 75 ‐ 100
25111 138 138 153,900 1,115.2 1,015.4 9.8 20 ‐ 30
25115 25 25 30,400 1,216.0 1,033.2 17.7 50 ‐ 75
25116 6 6 6,250 1,041.7 960.2 8.5 75 ‐ 100
25290 1 1 1,700 1,700.0 1,084.2 56.8 75 ‐ 100
25310 65 65 159,200 2,449.2 2,415.1 1.4 50 ‐ 75
25312 11 11 25,600 2,327.3 2,455.4 5.2 50 ‐ 75
25400 11 11 26,000 2,363.6 2,444.2 3.3 50 ‐ 75
25447 248 248 409,850 1,652.6 1,657.9 0.3 20 ‐ 30
25505 1 1 250 250.0 239.7 4.3 75 ‐ 100
25545 1 1 2,300 2,300.0 2,362.7 2.7 75 ‐ 100
25560 1 1 80 80.0 101.5 21.2 75 ‐ 100
25565 10 10 2,550 255.0 252.2 1.1 30 ‐ 40
25600 151 151 14,470 95.8 97.7 1.9 20 ‐ 30
25605 569 569 146,680 257.8 256.9 0.4 10 ‐ 20
25606 140 140 178,000 1,271.4 1,189.5 6.9 10 ‐ 20
25607 276 276 952,400 3,450.7 3,324.0 3.8 10 ‐ 20
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 34
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
25608 233 233 808,900 3,471.7 3,428.7 1.3 10 ‐ 20
25609 182 182 633,900 3,483.0 3,404.8 2.3 10 ‐ 20
25635 1 1 250 250.0 197.5 26.6 75 ‐ 100
25651 6 6 3,950 658.3 701.9 6.2 50 ‐ 75
25652 27 27 32,000 1,185.2 1,309.3 9.5 30 ‐ 40
25999 15 15 630 42.0 57.2 26.6 50 ‐ 75
26010 69 69 5,450 79.0 76.5 3.3 30 ‐ 40
26011 9 9 6,000 666.7 629.4 5.9 50 ‐ 75
26040 9 9 14,600 1,622.2 1,575.2 3.0 50 ‐ 75
26045 12 12 17,100 1,425.0 1,409.2 1.1 50 ‐ 75
26055 1,491 1,491 1,042,750 699.4 685.8 2.0 5 ‐ 10
26115 5 5 4,400 880.0 805.3 9.3 75 ‐ 100
26121 29 29 42,600 1,469.0 1,329.3 10.5 50 ‐ 75
26123 179 179 268,600 1,500.6 1,454.9 3.1 20 ‐ 30
26125 107 107 47,650 445.3 450.7 1.2 10 ‐ 20
26145 61 61 32,500 532.8 546.1 2.4 40 ‐ 50
26160 240 240 183,200 763.3 729.3 4.7 30 ‐ 40
26356 3 3 2,100 700.0 938.3 25.4 75 ‐ 100
26410 1 1 800 800.0 626.0 27.8 75 ‐ 100
26418 23 23 15,650 680.4 690.4 1.4 50 ‐ 75
26440 8 8 4,050 506.3 643.4 21.3 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 35
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
26455 3 3 2,550 850.0 614.9 38.2 75 ‐ 100
26480 68 68 50,950 749.3 872.9 14.2 30 ‐ 40
26483 7 7 5,200 742.9 782.9 5.1 50 ‐ 75
26530 1 1 2,000 2,000.0 1,627.6 22.9 75 ‐ 100
26531 16 16 27,500 1,718.8 2,250.2 23.6 75 ‐ 100
26535 3 3 6,000 2,000.0 1,940.8 3.1 75 ‐ 100
26536 26 26 66,600 2,561.5 2,595.7 1.3 50 ‐ 75
26600 34 34 3,210 94.4 89.2 5.8 40 ‐ 50
26605 10 10 900 90.0 88.4 1.8 50 ‐ 75
26608 17 17 22,800 1,341.2 1,226.3 9.4 50 ‐ 75
26615 17 17 40,600 2,388.2 2,196.7 8.7 50 ‐ 75
26700 14 14 1,200 85.7 95.3 10.1 50 ‐ 75
26720 20 20 1,830 91.5 89.4 2.3 50 ‐ 75
26725 36 36 3,290 91.4 87.0 5.1 40 ‐ 50
26727 27 27 35,600 1,318.5 1,166.0 13.1 40 ‐ 50
26735 32 32 41,200 1,287.5 1,187.1 8.5 40 ‐ 50
26742 13 13 1,180 90.8 116.9 22.3 50 ‐ 75
26750 12 12 1,110 92.5 83.0 11.4 50 ‐ 75
26755 5 5 440 88.0 80.9 8.8 75 ‐ 100
26756 1 1 1,300 1,300.0 1,211.6 7.3 75 ‐ 100
26765 16 16 20,250 1,265.6 1,265.2 0.0 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 36
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
26770 161 161 14,910 92.6 88.0 5.2 20 ‐ 30
26775 2 2 1,500 750.0 609.0 23.2 75 ‐ 100
26850 1 1 750 750.0 1,082.8 30.7 75 ‐ 100
26860 42 42 54,450 1,296.4 1,303.1 0.5 50 ‐ 75
26861 11 11 7,950 722.7 732.5 1.3 50 ‐ 75
26951 45 45 35,500 788.9 751.0 5.0 50 ‐ 75
26952 5 5 4,200 840.0 785.3 7.0 75 ‐ 100
26989 1 1 40 40.0 62.2 35.7 75 ‐ 100
27062 9 9 9,000 1,000.0 950.4 5.2 50 ‐ 75
27093 1 1 150 150.0 127.5 17.6 75 ‐ 100
27096 51 51 7,610 149.2 205.4 27.4 50 ‐ 75
27193 6 6 530 88.3 139.3 36.6 50 ‐ 75
27250 58 58 5,090 87.8 89.4 1.8 20 ‐ 30
27252 16 16 11,850 740.6 752.2 1.5 50 ‐ 75
27257 1 1 700 700.0 721.2 2.9 75 ‐ 100
27265 259 259 22,940 88.6 95.0 6.7 10 ‐ 20
27266 186 186 138,550 744.9 708.9 5.1 20 ‐ 30
27299 3 3 280 93.3 191.7 51.3 75 ‐ 100
27305 3 3 1,650 550.0 629.3 12.6 75 ‐ 100
27327 1 1 1,200 1,200.0 1,105.6 8.5 75 ‐ 100
27337 5 5 5,700 1,140.0 1,095.8 4.0 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 37
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
27339 1 1 1,200 1,200.0 1,229.9 2.4 75 ‐ 100
27340 16 16 18,000 1,125.0 998.4 12.7 40 ‐ 50
27345 6 6 6,050 1,008.3 890.7 13.2 75 ‐ 100
27385 3 3 3,400 1,133.3 1,016.4 11.5 75 ‐ 100
27446 39 39 256,100 6,566.7 6,369.0 3.1 30 ‐ 40
27520 8 8 720 90.0 93.2 3.4 50 ‐ 75
27524 35 35 85,000 2,428.6 2,316.1 4.9 40 ‐ 50
27530 3 3 270 90.0 116.0 22.4 75 ‐ 100
27560 10 10 880 88.0 98.7 10.8 40 ‐ 50
27570 233 233 175,700 754.1 728.7 3.5 20 ‐ 30
27630 4 4 4,500 1,125.0 1,044.2 7.7 75 ‐ 100
27650 28 28 68,200 2,435.7 2,448.6 0.5 50 ‐ 75
27664 3 3 4,800 1,600.0 1,587.9 0.8 75 ‐ 100
27685 14 14 19,800 1,414.3 1,330.2 6.3 75 ‐ 100
27687 12 12 13,400 1,116.7 1,224.3 8.8 75 ‐ 100
27691 12 12 15,700 1,308.3 1,860.4 29.7 75 ‐ 100
27695 3 3 4,900 1,633.3 1,177.9 38.7 75 ‐ 100
27698 3 3 5,000 1,666.7 1,225.8 36.0 50 ‐ 75
27720 2 2 4,700 2,350.0 2,343.4 0.3 50 ‐ 75
27726 1 1 2,400 2,400.0 2,239.4 7.2 75 ‐ 100
27760 2 2 180 90.0 84.5 6.5 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 38
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
27766 7 7 16,500 2,357.1 2,175.2 8.4 50 ‐ 75
27780 1 1 90 90.0 104.6 14.0 75 ‐ 100
27786 70 70 6,690 95.6 137.9 30.7 30 ‐ 40
27788 7 7 640 91.4 108.4 15.7 50 ‐ 75
27792 83 83 196,000 2,361.4 2,322.2 1.7 10 ‐ 20
27808 3 3 270 90.0 137.2 34.4 75 ‐ 100
27810 29 29 7,500 258.6 255.0 1.4 30 ‐ 40
27814 115 115 274,600 2,387.8 2,237.0 6.7 20 ‐ 30
27818 34 34 8,700 255.9 241.4 6.0 20 ‐ 30
27822 46 46 110,700 2,406.5 2,410.6 0.2 30 ‐ 40
27829 10 10 11,500 1,150.0 1,549.0 25.8 50 ‐ 75
27840 4 4 1,000 250.0 258.1 3.1 50 ‐ 75
27899 5 5 200 40.0 119.2 66.4 75 ‐ 100
28008 24 24 25,700 1,070.8 921.8 16.2 50 ‐ 75
28010 3 3 3,200 1,066.7 860.5 24.0 75 ‐ 100
28035 13 13 10,100 776.9 698.0 11.3 50 ‐ 75
28039 3 3 3,600 1,200.0 1,090.6 10.0 75 ‐ 100
28043 1 1 450 450.0 686.0 34.4 75 ‐ 100
28060 6 6 6,500 1,083.3 988.2 9.6 50 ‐ 75
28080 92 92 86,300 938.0 884.5 6.0 30 ‐ 40
28090 22 22 22,800 1,036.4 928.2 11.7 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 39
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
28092 3 3 3,500 1,166.7 761.2 53.3 75 ‐ 100
28104 24 24 25,350 1,056.3 944.5 11.8 50 ‐ 75
28108 39 39 36,950 947.4 931.5 1.7 50 ‐ 75
28110 60 60 47,450 790.8 826.2 4.3 40 ‐ 50
28112 4 4 2,150 537.5 783.7 31.4 75 ‐ 100
28113 1 1 550 550.0 846.8 35.0 75 ‐ 100
28119 50 50 43,200 864.0 869.0 0.6 50 ‐ 75
28120 8 8 4,300 537.5 746.5 28.0 75 ‐ 100
28122 13 13 14,050 1,080.8 936.5 15.4 75 ‐ 100
28124 19 19 17,350 913.2 817.6 11.7 75 ‐ 100
28160 16 16 11,350 709.4 795.7 10.8 75 ‐ 100
28190 25 25 10,900 436.0 411.7 5.9 50 ‐ 75
28230 1 1 550 550.0 661.1 16.8 75 ‐ 100
28232 39 39 27,800 712.8 705.3 1.1 50 ‐ 75
28234 41 41 24,450 596.3 685.0 12.9 50 ‐ 75
28270 277 277 182,150 657.6 655.1 0.4 30 ‐ 40
28272 4 4 2,200 550.0 672.2 18.2 75 ‐ 100
28285 2,078 2,078 1,444,250 695.0 700.6 0.8 10 ‐ 20
28288 61 61 37,350 612.3 718.6 14.8 50 ‐ 75
28289 64 64 64,000 1,000.0 967.2 3.4 30 ‐ 40
28290 37 37 58,800 1,589.2 1,426.8 11.4 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 40
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
28292 210 210 338,650 1,612.6 1,561.0 3.3 20 ‐ 30
28293 45 45 74,300 1,651.1 1,607.3 2.7 40 ‐ 50
28296 433 433 695,100 1,605.3 1,564.6 2.6 10 ‐ 20
28297 16 16 22,600 1,412.5 1,567.9 9.9 50 ‐ 75
28298 43 43 65,400 1,520.9 1,557.4 2.3 50 ‐ 75
28299 88 88 139,700 1,587.5 1,546.0 2.7 30 ‐ 40
28300 5 5 13,500 2,700.0 2,624.6 2.9 75 ‐ 100
28306 6 6 3,100 516.7 799.8 35.4 75 ‐ 100
28308 126 126 73,400 582.5 649.9 10.4 40 ‐ 50
28312 2 2 1,100 550.0 598.0 8.0 75 ‐ 100
28313 34 34 18,050 530.9 590.7 10.1 50 ‐ 75
28315 4 4 2,200 550.0 807.5 31.9 75 ‐ 100
28322 8 8 21,900 2,737.5 2,621.3 4.4 50 ‐ 75
28415 1 1 3,400 3,400.0 3,350.9 1.5 75 ‐ 100
28470 48 48 4,600 95.8 88.7 8.0 40 ‐ 50
28485 41 41 96,600 2,356.1 2,137.7 10.2 40 ‐ 50
28490 6 6 520 86.7 109.6 20.9 50 ‐ 75
28510 17 17 1,560 91.8 85.7 7.1 40 ‐ 50
28515 13 13 1,150 88.5 86.3 2.5 40 ‐ 50
28645 2 2 1,950 975.0 1,123.7 13.2 75 ‐ 100
28660 2 2 170 85.0 81.1 4.8 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 41
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
28725 1 1 2,700 2,700.0 2,578.4 4.7 75 ‐ 100
28730 4 4 11,100 2,775.0 2,548.5 8.9 75 ‐ 100
28740 2 2 5,200 2,600.0 2,396.6 8.5 75 ‐ 100
28750 123 123 341,500 2,776.4 2,711.3 2.4 40 ‐ 50
28755 13 13 8,000 615.4 678.1 9.2 50 ‐ 75
28805 1 1 1,100 1,100.0 1,016.7 8.2 75 ‐ 100
28810 57 57 60,900 1,068.4 971.5 10.0 50 ‐ 75
28820 162 162 167,850 1,036.1 892.0 16.2 40 ‐ 50
28825 92 92 99,150 1,077.7 966.8 11.5 50 ‐ 75
28890 4 4 6,400 1,600.0 1,692.2 5.4 30 ‐ 40
28899 86 86 3,980 46.3 62.7 26.2 40 ‐ 50
29065 32 32 4,550 142.2 110.8 28.3 50 ‐ 75
29075 241 241 31,870 132.2 120.0 10.2 30 ‐ 40
29085 1 1 50 50.0 58.6 14.7 75 ‐ 100
29105 807 807 45,810 56.8 56.3 0.9 20 ‐ 30
29125 5,187 5,192 288,870 55.6 55.9 0.5 10 ‐ 20
29126 117 117 6,430 55.0 57.2 3.8 50 ‐ 75
29130 920 920 51,470 55.9 53.9 3.7 30 ‐ 40
29131 10 10 580 58.0 51.7 12.2 75 ‐ 100
29200 6 6 330 55.0 44.2 24.4 75 ‐ 100
29240 528 528 28,940 54.8 52.9 3.6 20 ‐ 30
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 42
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
29260 68 68 3,780 55.6 54.0 3.0 50 ‐ 75
29280 35 35 2,030 58.0 54.3 6.8 50 ‐ 75
29345 4 4 600 150.0 131.8 13.8 75 ‐ 100
29405 217 217 27,650 127.4 126.4 0.8 30 ‐ 40
29425 31 31 4,250 137.1 146.4 6.4 50 ‐ 75
29445 509 509 58,450 114.8 125.8 8.7 20 ‐ 30
29505 1,081 1,081 60,010 55.5 57.1 2.8 20 ‐ 30
29515 2,981 2,984 164,480 55.1 55.3 0.4 10 ‐ 20
29520 5 5 290 58.0 46.8 23.9 75 ‐ 100
29530 634 634 35,670 56.3 53.0 6.2 30 ‐ 40
29540 323 323 17,640 54.6 48.1 13.5 50 ‐ 75
29550 49 49 2,760 56.3 56.4 0.2 50 ‐ 75
29580 9,313 9,836 639,710 65.0 69.9 7.0 10 ‐ 20
29581 6,970 7,135 464,060 65.0 69.3 6.2 10 ‐ 20
29700 29 29 1,670 57.6 58.7 1.9 50 ‐ 75
29705 12 12 710 59.2 58.0 2.1 75 ‐ 100
29799 110 111 6,330 57.0 56.2 1.4 50 ‐ 75
29805 8 8 6,150 768.8 902.1 14.8 75 ‐ 100
29806 18 18 42,600 2,366.7 2,377.8 0.5 50 ‐ 75
29807 149 149 356,200 2,390.6 2,327.1 2.7 30 ‐ 40
29819 6 6 14,300 2,383.3 2,385.6 0.1 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 43
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
29820 17 17 40,700 2,394.1 2,201.7 8.7 50 ‐ 75
29821 4 4 5,900 1,475.0 2,056.9 28.3 75 ‐ 100
29822 520 520 421,600 810.8 865.3 6.3 10 ‐ 20
29823 410 410 983,100 2,397.8 2,335.4 2.7 20 ‐ 30
29824 977 977 772,050 790.2 807.0 2.1 10 ‐ 20
29825 31 31 64,500 2,080.6 2,111.9 1.5 50 ‐ 75
29826 2,504 2,504 5,327,150 2,127.5 2,111.6 0.8 5 ‐ 10
29827 1,640 1,640 2,171,400 1,324.0 1,362.7 2.8 5 ‐ 10
29828 255 255 312,500 1,225.5 1,293.9 5.3 10 ‐ 20
29846 4 4 6,200 1,550.0 1,491.1 4.0 75 ‐ 100
29848 389 389 610,050 1,568.3 1,506.8 4.1 10 ‐ 20
29862 4 4 9,800 2,450.0 2,341.6 4.6 75 ‐ 100
29870 3 3 4,500 1,500.0 1,447.5 3.6 75 ‐ 100
29873 47 47 72,700 1,546.8 1,517.0 2.0 40 ‐ 50
29874 4 4 6,200 1,550.0 1,635.6 5.2 75 ‐ 100
29875 260 260 416,400 1,601.5 1,564.4 2.4 20 ‐ 30
29876 198 198 318,700 1,609.6 1,582.4 1.7 30 ‐ 40
29877 105 105 163,900 1,561.0 1,485.5 5.1 40 ‐ 50
29879 255 255 359,300 1,409.0 1,342.7 4.9 20 ‐ 30
29880 1,471 1,471 2,083,300 1,416.2 1,392.9 1.7 5 ‐ 10
29881 2,035 2,035 2,921,750 1,435.7 1,411.1 1.7 5 ‐ 10
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 44
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
29882 1 1 1,500 1,500.0 1,346.9 11.4 75 ‐ 100
29884 2 2 3,000 1,500.0 1,400.1 7.1 75 ‐ 100
29888 12 12 54,800 4,566.7 4,889.0 6.6 75 ‐ 100
29893 24 24 26,000 1,083.3 1,017.4 6.5 40 ‐ 50
29999 244 244 194,100 795.5 866.8 8.2 30 ‐ 40
30000 1 1 200 200.0 189.9 5.3 75 ‐ 100
30100 1 1 400 400.0 343.2 16.6 75 ‐ 100
30120 1 1 1,300 1,300.0 1,259.2 3.2 75 ‐ 100
30130 13 13 10,950 842.3 753.5 11.8 75 ‐ 100
30140 272 272 412,500 1,516.5 1,466.6 3.4 20 ‐ 30
30220 1 1 400 400.0 369.8 8.2 75 ‐ 100
30300 3 3 110 36.7 47.5 22.7 75 ‐ 100
30465 2 2 4,600 2,300.0 2,287.2 0.6 75 ‐ 100
30520 581 581 486,550 837.4 866.4 3.3 10 ‐ 20
30801 14 14 2,800 200.0 201.6 0.8 40 ‐ 50
30802 34 34 14,300 420.6 479.5 12.3 40 ‐ 50
30901 3,156 3,156 164,050 52.0 52.6 1.1 0 ‐ 5
30903 238 238 13,090 55.0 59.9 8.2 10 ‐ 20
30905 256 256 12,680 49.5 58.1 14.8 10 ‐ 20
30906 10 10 500 50.0 57.4 12.9 50 ‐ 75
30930 55 55 44,800 814.5 772.8 5.4 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 45
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
30999 34 34 1,130 33.2 34.5 3.8 50 ‐ 75
31020 4 4 5,100 1,275.0 1,061.9 20.1 75 ‐ 100
31200 2 2 4,400 2,200.0 2,093.5 5.1 75 ‐ 100
31231 529 529 52,310 98.9 102.2 3.2 30 ‐ 40
31237 88 88 107,350 1,219.9 1,203.1 1.4 50 ‐ 75
31238 55 55 65,300 1,187.3 1,152.5 3.0 40 ‐ 50
31239 16 16 24,600 1,537.5 1,588.1 3.2 50 ‐ 75
31240 29 29 19,650 677.6 777.8 12.9 40 ‐ 50
31254 96 96 183,000 1,906.3 1,785.6 6.8 50 ‐ 75
31255 419 419 880,650 2,101.8 2,053.5 2.4 20 ‐ 30
31256 225 225 313,800 1,394.7 1,384.1 0.8 30 ‐ 40
31267 335 335 464,750 1,387.3 1,380.9 0.5 20 ‐ 30
31276 267 267 354,550 1,327.9 1,320.9 0.5 20 ‐ 30
31287 112 112 153,700 1,372.3 1,317.7 4.1 30 ‐ 40
31288 88 88 122,150 1,388.1 1,336.3 3.9 40 ‐ 50
31299 20 20 570 28.5 33.3 14.4 50 ‐ 75
31300 1 1 1,300 1,300.0 1,238.6 5.0 75 ‐ 100
31500 1,604 1,604 172,730 107.7 112.5 4.3 20 ‐ 30
31502 66 66 4,900 74.2 73.6 0.8 40 ‐ 50
31505 1 1 40 40.0 39.8 0.5 75 ‐ 100
31525 21 21 22,750 1,083.3 976.7 10.9 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 46
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
31528 4 4 4,700 1,175.0 1,028.2 14.3 75 ‐ 100
31535 142 142 162,600 1,145.1 1,095.0 4.6 50 ‐ 75
31536 114 114 131,300 1,151.8 1,142.3 0.8 40 ‐ 50
31540 36 36 41,100 1,141.7 1,108.3 3.0 50 ‐ 75
31541 149 149 169,350 1,136.6 1,093.7 3.9 30 ‐ 40
31570 38 38 45,100 1,186.8 1,130.7 5.0 40 ‐ 50
31571 68 68 103,500 1,522.1 1,482.7 2.7 30 ‐ 40
31575 1,666 1,666 162,990 97.8 97.4 0.4 20 ‐ 30
31579 392 392 91,450 233.3 238.6 2.2 20 ‐ 30
31588 12 12 27,100 2,258.3 2,286.8 1.2 50 ‐ 75
31599 16 16 700 43.8 55.7 21.4 75 ‐ 100
31611 1 1 1,300 1,300.0 1,351.0 3.8 75 ‐ 100
31613 4 4 5,200 1,300.0 1,140.6 14.0 50 ‐ 75
31615 24 24 8,800 366.7 391.6 6.4 50 ‐ 75
31622 628 628 279,300 444.7 451.7 1.5 30 ‐ 40
31623 995 995 494,350 496.8 500.4 0.7 10 ‐ 20
31624 1,194 1,194 506,750 424.4 431.0 1.5 20 ‐ 30
31625 549 549 189,250 344.7 361.8 4.7 20 ‐ 30
31626 9 9 3,250 361.1 420.9 14.2 50 ‐ 75
31628 825 825 256,000 310.3 327.4 5.2 20 ‐ 30
31629 460 460 161,750 351.6 379.3 7.3 20 ‐ 30
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 47
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
31630 14 14 17,900 1,278.6 1,304.1 2.0 50 ‐ 75
31631 3 3 3,700 1,233.3 1,299.1 5.1 50 ‐ 75
31632 37 37 9,250 250.0 253.5 1.4 30 ‐ 40
31633 54 54 13,500 250.0 269.6 7.3 40 ‐ 50
31635 6 6 3,000 500.0 429.3 16.5 75 ‐ 100
31641 11 11 14,000 1,272.7 1,188.8 7.1 75 ‐ 100
31643 2 2 1,000 500.0 456.8 9.5 75 ‐ 100
31645 35 35 11,500 328.6 413.3 20.5 75 ‐ 100
31720 72 73 1,460 20.0 21.9 8.7 50 ‐ 75
31899 3 3 1,000 333.3 392.5 15.1 75 ‐ 100
32400 2 2 1,000 500.0 515.2 3.0 75 ‐ 100
32405 1,779 1,779 922,000 518.3 512.7 1.1 10 ‐ 20
32421 1,762 1,762 514,370 291.9 285.1 2.4 10 ‐ 20
32422 386 386 112,450 291.3 284.2 2.5 20 ‐ 30
32550 31 31 49,400 1,593.5 1,603.3 0.6 50 ‐ 75
32551 53 53 13,300 250.9 227.5 10.3 50 ‐ 75
32552 20 20 1,490 74.5 108.4 31.3 50 ‐ 75
32553 27 27 16,200 600.0 599.2 0.1 40 ‐ 50
32998 3 3 7,800 2,600.0 2,740.3 5.1 75 ‐ 100
32999 3 3 750 250.0 258.1 3.1 75 ‐ 100
33010 3 3 900 300.0 247.9 21.0 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 48
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
33207 288 288 1,955,400 6,789.6 6,670.3 1.8 30 ‐ 40
33208 1,455 1,455 12,023,400 8,263.5 8,118.7 1.8 10 ‐ 20
33210 86 86 114,800 1,334.9 1,521.5 12.3 40 ‐ 50
33212 367 367 2,022,100 5,509.8 5,390.8 2.2 10 ‐ 20
33213 1,955 1,955 12,097,400 6,187.9 6,028.0 2.7 10 ‐ 20
33215 67 67 81,000 1,209.0 1,080.7 11.9 30 ‐ 40
33216 74 74 180,900 2,444.6 2,275.9 7.4 40 ‐ 50
33220 2 2 1,200 600.0 744.2 19.4 75 ‐ 100
33222 32 32 21,550 673.4 704.7 4.4 50 ‐ 75
33223 66 66 33,750 511.4 664.5 23.0 30 ‐ 40
33224 11 11 135,000 12,272.7 11,369.7 7.9 50 ‐ 75
33225 287 287 2,336,700 8,141.8 8,174.2 0.4 40 ‐ 50
33233 2,586 2,586 1,606,890 621.4 620.7 0.1 5 ‐ 10
33234 20 20 11,950 597.5 648.2 7.8 50 ‐ 75
33235 45 45 27,750 616.7 645.1 4.4 50 ‐ 75
33240 1,549 1,549 32,027,000 20,675.9 20,278.8 2.0 5 ‐ 10
33241 1,736 1,736 1,071,540 617.2 627.0 1.6 5 ‐ 10
33244 74 74 44,550 602.0 670.7 10.2 30 ‐ 40
33249 816 816 21,198,000 25,977.9 25,691.3 1.1 10 ‐ 20
33282 145 145 594,500 4,100.0 4,081.0 0.5 30 ‐ 40
33284 75 75 26,750 356.7 366.6 2.7 30 ‐ 40
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 49
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
33999 4 4 600 150.0 265.5 43.5 75 ‐ 100
35206 6 6 10,800 1,800.0 1,640.5 9.7 75 ‐ 100
35226 4 4 1,700 425.0 402.2 5.7 75 ‐ 100
35460 27 27 64,500 2,388.9 2,589.1 7.7 50 ‐ 75
35470 468 469 891,900 1,901.7 1,934.9 1.7 20 ‐ 30
35471 112 112 173,400 1,548.2 1,791.7 13.6 40 ‐ 50
35472 5 5 6,500 1,300.0 1,598.4 18.7 75 ‐ 100
35473 498 499 832,500 1,668.3 1,756.0 5.0 20 ‐ 30
35474 1,462 1,485 2,497,500 1,681.8 1,743.6 3.5 10 ‐ 20
35475 463 463 1,155,400 2,495.5 2,469.1 1.1 20 ‐ 30
35476 4,180 4,210 10,334,400 2,454.7 2,420.1 1.4 5 ‐ 10
35493 577 580 2,358,700 4,066.7 4,039.1 0.7 20 ‐ 30
35495 177 177 625,200 3,532.2 3,561.0 0.8 30 ‐ 40
35761 4 4 7,300 1,825.0 1,699.6 7.4 75 ‐ 100
35870 4 4 0 0.0 0.7 100.0 50 ‐ 75
35903 19 19 34,150 1,797.4 1,709.9 5.1 50 ‐ 75
36000 388 388 5,310 13.7 23.4 41.5 50 ‐ 75
36002 38 38 3,500 92.1 91.8 0.3 40 ‐ 50
36147 5,224 5,233 394,500 75.4 83.6 9.8 5 ‐ 10
36410 1 1 10 10.0 21.8 54.1 75 ‐ 100
36415 2,091,040 2,112,536 2,348,010 1.1 3.6 69.4 0 ‐ 5
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 50
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
36416 3,505 3,505 31,310 8.9 8.8 1.1 10 ‐ 20
36430 29,103 29,103 5,284,590 181.6 186.5 2.6 5 ‐ 10
36470 6 6 210 35.0 42.0 16.7 50 ‐ 75
36471 26 26 1,130 43.5 45.4 4.2 30 ‐ 40
36475 152 152 363,700 2,392.8 2,408.8 0.7 30 ‐ 40
36476 15 15 10,550 703.3 727.1 3.3 50 ‐ 75
36478 82 82 112,100 1,367.1 1,364.4 0.2 20 ‐ 30
36512 51 51 30,850 604.9 629.2 3.9 20 ‐ 30
36514 489 489 289,100 591.2 617.7 4.3 50 ‐ 75
36522 108 108 197,300 1,826.9 1,854.8 1.5 50 ‐ 75
36556 492 492 280,850 570.8 547.8 4.2 50 ‐ 75
36558 1,199 1,199 1,460,400 1,218.0 1,218.3 0.0 20 ‐ 30
36561 3,423 3,423 5,544,300 1,619.7 1,583.5 2.3 20 ‐ 30
36565 8 8 10,900 1,362.5 1,396.9 2.5 75 ‐ 100
36569 1,818 1,818 1,068,850 587.9 579.5 1.4 30 ‐ 40
36571 151 151 200,700 1,329.1 1,253.1 6.1 50 ‐ 75
36575 27 27 9,050 335.2 325.0 3.1 50 ‐ 75
36576 5 5 2,900 580.0 569.1 1.9 50 ‐ 75
36578 31 31 40,550 1,308.1 1,172.6 11.6 50 ‐ 75
36580 26 26 14,150 544.2 551.7 1.4 50 ‐ 75
36581 607 607 763,650 1,258.1 1,244.5 1.1 10 ‐ 20
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 51
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
36582 27 27 42,600 1,577.8 1,506.8 4.7 50 ‐ 75
36584 46 46 27,100 589.1 584.8 0.7 50 ‐ 75
36585 1 1 1,300 1,300.0 1,245.7 4.4 75 ‐ 100
36589 1,436 1,436 437,200 304.5 305.5 0.3 10 ‐ 20
36590 1,028 1,028 574,250 558.6 554.2 0.8 20 ‐ 30
36591 5,359 5,359 179,440 33.5 35.8 6.4 20 ‐ 30
36592 460 460 13,310 28.9 31.6 8.5 50 ‐ 75
36593 703 718 92,120 128.3 124.8 2.8 30 ‐ 40
36595 38 38 31,200 821.1 855.9 4.1 40 ‐ 50
36596 14 14 5,350 382.1 439.0 13.0 50 ‐ 75
36597 7 7 4,050 578.6 523.7 10.5 75 ‐ 100
36598 278 278 32,840 118.1 114.2 3.4 20 ‐ 30
36600 2,244 2,247 31,230 13.9 17.2 19.2 20 ‐ 30
36680 14 14 1,040 74.3 75.6 1.7 50 ‐ 75
36815 5 5 8,100 1,620.0 1,530.1 5.9 50 ‐ 75
36818 355 355 731,600 2,060.8 2,070.8 0.5 20 ‐ 30
36819 399 399 829,000 2,077.7 2,130.5 2.5 20 ‐ 30
36820 80 80 165,400 2,067.5 2,094.7 1.3 40 ‐ 50
36821 1,334 1,334 2,763,800 2,071.8 2,076.5 0.2 5 ‐ 10
36825 94 94 192,500 2,047.9 2,090.0 2.0 40 ‐ 50
36830 761 761 1,567,900 2,060.3 2,061.7 0.1 10 ‐ 20
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 52
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
36831 268 268 420,300 1,568.3 1,604.4 2.3 10 ‐ 20
36832 513 513 1,036,050 2,019.6 2,005.1 0.7 10 ‐ 20
36833 230 230 444,400 1,932.2 1,949.9 0.9 10 ‐ 20
36838 25 25 52,000 2,080.0 2,095.6 0.7 50 ‐ 75
36861 2 2 1,600 800.0 959.0 16.6 50 ‐ 75
36870 1,137 1,137 1,585,400 1,394.4 1,434.9 2.8 5 ‐ 10
37184 17 17 16,950 997.1 1,121.2 11.1 50 ‐ 75
37186 19 19 19,050 1,002.6 1,064.5 5.8 40 ‐ 50
37187 5 5 5,200 1,040.0 1,186.6 12.4 75 ‐ 100
37195 8 8 1,100 137.5 124.4 10.5 40 ‐ 50
37200 37 37 60,200 1,627.0 1,615.5 0.7 50 ‐ 75
37201 36 36 19,950 554.2 788.4 29.7 50 ‐ 75
37202 9 9 4,550 505.6 586.7 13.8 75 ‐ 100
37203 68 68 110,500 1,625.0 1,597.3 1.7 50 ‐ 75
37204 186 186 933,400 5,018.3 5,038.6 0.4 50 ‐ 75
37205 2,445 2,445 13,074,200 5,347.3 5,281.0 1.3 10 ‐ 20
37206 554 554 1,464,300 2,643.1 2,718.3 2.8 20 ‐ 30
37207 1 1 5,000 5,000.0 5,598.9 10.7 75 ‐ 100
37210 8 8 42,000 5,250.0 5,259.0 0.2 30 ‐ 40
37607 312 312 364,000 1,166.7 1,195.9 2.4 20 ‐ 30
37609 295 295 294,850 999.5 1,000.1 0.1 30 ‐ 40
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 53
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
37620 202 202 481,300 2,382.7 2,334.7 2.1 40 ‐ 50
37700 7 7 9,800 1,400.0 1,433.5 2.3 75 ‐ 100
37722 5 5 12,400 2,480.0 2,388.7 3.8 75 ‐ 100
37765 79 79 80,150 1,014.6 1,073.4 5.5 30 ‐ 40
37766 50 50 47,250 945.0 968.8 2.5 30 ‐ 40
37785 1 1 700 700.0 1,093.6 36.0 75 ‐ 100
37799 166 166 4,990 30.1 28.9 4.2 30 ‐ 40
38206 90 90 55,550 617.2 617.4 0.0 30 ‐ 40
38207 81 81 15,550 192.0 185.0 3.8 40 ‐ 50
38208 9 9 1,550 172.2 185.2 7.0 50 ‐ 75
38214 22 22 6,600 300.0 307.8 2.5 50 ‐ 75
38220 226 226 35,450 156.9 160.7 2.4 30 ‐ 40
38221 2,173 2,173 341,560 157.2 162.5 3.3 10 ‐ 20
38241 9 9 15,700 1,744.4 1,806.4 3.4 50 ‐ 75
38500 514 514 496,400 965.8 999.4 3.4 20 ‐ 30
38505 219 219 85,200 389.0 383.5 1.4 40 ‐ 50
38510 151 151 195,400 1,294.0 1,227.3 5.4 40 ‐ 50
38525 1,295 1,295 1,056,600 815.9 851.6 4.2 10 ‐ 20
38530 1 1 600 600.0 918.1 34.6 75 ‐ 100
38542 1 1 2,500 2,500.0 2,668.4 6.3 75 ‐ 100
38570 3 3 6,200 2,066.7 2,041.7 1.2 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 54
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
38571 7 7 25,300 3,614.3 3,757.3 3.8 50 ‐ 75
38572 13 13 27,000 2,076.9 2,213.2 6.2 40 ‐ 50
38740 1 1 2,500 2,500.0 2,506.3 0.3 75 ‐ 100
38745 4 4 9,900 2,475.0 2,501.7 1.1 75 ‐ 100
38792 42 42 6,060 144.3 163.1 11.5 20 ‐ 30
38999 12 12 2,200 183.3 182.9 0.2 75 ‐ 100
39400 213 213 360,600 1,693.0 1,709.7 1.0 30 ‐ 40
40490 5 5 1,000 200.0 179.6 11.4 75 ‐ 100
40510 1 1 1,300 1,300.0 1,217.6 6.8 75 ‐ 100
40530 5 5 6,500 1,300.0 1,202.9 8.1 75 ‐ 100
40650 2 2 800 400.0 367.4 8.9 75 ‐ 100
40800 5 5 380 76.0 88.2 13.8 50 ‐ 75
40808 6 6 1,200 200.0 169.2 18.2 75 ‐ 100
41120 3 3 3,900 1,300.0 1,356.1 4.1 75 ‐ 100
41250 14 14 740 52.9 54.1 2.2 40 ‐ 50
41800 71 71 5,420 76.3 75.9 0.5 30 ‐ 40
41874 59 59 52,100 883.1 900.3 1.9 50 ‐ 75
41899 241 241 11,180 46.4 71.1 34.7 20 ‐ 30
42140 6 6 1,200 200.0 271.5 26.3 50 ‐ 75
42145 28 28 29,400 1,050.0 1,015.5 3.4 50 ‐ 75
42299 5 5 150 30.0 33.8 11.2 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 55
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
42400 10 10 4,000 400.0 391.0 2.3 75 ‐ 100
42410 12 12 27,300 2,275.0 2,256.3 0.8 75 ‐ 100
42415 46 46 104,900 2,280.4 2,309.3 1.3 50 ‐ 75
42420 15 15 33,300 2,220.0 2,350.4 5.5 50 ‐ 75
42440 30 30 67,100 2,236.7 2,260.1 1.0 50 ‐ 75
42699 6 6 300 50.0 54.1 7.6 75 ‐ 100
42700 4 4 750 187.5 169.5 10.6 40 ‐ 50
42808 1 1 1,300 1,300.0 1,155.5 12.5 75 ‐ 100
42821 7 7 8,700 1,242.9 1,072.0 15.9 50 ‐ 75
42826 56 56 73,100 1,305.4 1,288.7 1.3 40 ‐ 50
42960 2 2 100 50.0 48.0 4.2 50 ‐ 75
42999 1 1 50 50.0 38.0 31.6 75 ‐ 100
43200 165 165 45,650 276.7 289.8 4.5 50 ‐ 75
43202 20 20 7,100 355.0 334.8 6.0 50 ‐ 75
43215 22 22 9,600 436.4 389.8 12.0 50 ‐ 75
43220 8 8 3,550 443.8 409.4 8.4 75 ‐ 100
43226 19 19 7,000 368.4 373.6 1.4 50 ‐ 75
43228 130 130 151,900 1,168.5 1,157.9 0.9 10 ‐ 20
43234 2 2 900 450.0 437.3 2.9 75 ‐ 100
43235 6,238 6,238 2,314,100 371.0 378.3 1.9 10 ‐ 20
43236 321 321 143,300 446.4 433.2 3.0 20 ‐ 30
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 56
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
43237 5 5 2,200 440.0 422.2 4.2 75 ‐ 100
43239 28,289 28,284 10,480,930 370.6 377.8 1.9 5 ‐ 10
43242 605 605 252,600 417.5 425.2 1.8 30 ‐ 40
43244 296 296 120,050 405.6 400.2 1.3 20 ‐ 30
43245 206 206 70,200 340.8 350.5 2.8 30 ‐ 40
43246 896 896 378,700 422.7 415.7 1.7 20 ‐ 30
43247 672 672 270,800 403.0 398.0 1.3 20 ‐ 30
43248 1,830 1,830 589,550 322.2 329.1 2.1 10 ‐ 20
43249 2,598 2,598 800,650 308.2 315.7 2.4 10 ‐ 20
43250 93 93 25,350 272.6 335.0 18.6 50 ‐ 75
43251 426 426 122,450 287.4 313.7 8.4 30 ‐ 40
43255 225 225 76,100 338.2 346.0 2.3 40 ‐ 50
43256 18 18 24,400 1,355.6 1,390.7 2.5 75 ‐ 100
43258 400 400 138,700 346.8 362.9 4.4 20 ‐ 30
43259 829 829 305,000 367.9 375.3 2.0 20 ‐ 30
43260 93 93 110,000 1,182.8 1,204.0 1.8 50 ‐ 75
43261 95 95 72,450 762.6 847.5 10.0 50 ‐ 75
43262 674 674 592,900 879.7 894.2 1.6 20 ‐ 30
43263 7 7 4,100 585.7 599.0 2.2 40 ‐ 50
43264 583 583 380,650 652.9 706.1 7.5 20 ‐ 30
43265 42 42 25,950 617.9 665.9 7.2 30 ‐ 40
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 57
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
43268 360 360 512,500 1,423.6 1,393.1 2.2 30 ‐ 40
43269 541 541 764,050 1,412.3 1,385.8 1.9 30 ‐ 40
43271 182 182 114,650 629.9 710.5 11.3 40 ‐ 50
43273 44 44 26,200 595.5 640.5 7.0 50 ‐ 75
43280 57 57 204,300 3,584.2 3,558.8 0.7 40 ‐ 50
43450 1,321 1,320 208,050 157.6 166.0 5.1 10 ‐ 20
43453 11 11 1,650 150.0 179.2 16.3 50 ‐ 75
43456 23 23 3,600 156.5 168.3 7.0 40 ‐ 50
43458 36 36 7,550 209.7 251.4 16.6 40 ‐ 50
43499 27 27 9,000 333.3 363.0 8.2 50 ‐ 75
43752 1 1 50 50.0 56.7 11.8 75 ‐ 100
43760 2,019 2,020 255,630 126.5 126.1 0.3 10 ‐ 20
43761 29 29 11,650 401.7 410.0 2.0 40 ‐ 50
43999 78 78 34,100 437.2 423.8 3.2 30 ‐ 40
44180 27 27 55,300 2,048.1 1,986.1 3.1 50 ‐ 75
44360 1 1 500 500.0 513.9 2.7 75 ‐ 100
44361 8 8 4,000 500.0 510.4 2.0 75 ‐ 100
44366 1 1 500 500.0 531.8 6.0 75 ‐ 100
44372 1 1 500 500.0 495.1 1.0 75 ‐ 100
44377 2 2 1,050 525.0 502.0 4.6 75 ‐ 100
44380 1 1 500 500.0 480.0 4.2 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 58
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
44388 60 60 24,700 411.7 409.4 0.6 50 ‐ 75
44389 10 10 4,100 410.0 417.3 1.7 75 ‐ 100
44392 2 2 800 400.0 362.7 10.3 75 ‐ 100
44394 13 13 5,200 400.0 376.1 6.4 75 ‐ 100
44500 4 4 1,400 350.0 310.4 12.8 75 ‐ 100
44799 26 26 36,500 1,403.8 1,414.1 0.7 75 ‐ 100
44950 4 4 5,600 1,400.0 1,243.2 12.6 50 ‐ 75
44970 132 132 275,800 2,089.4 2,041.2 2.4 30 ‐ 40
45005 2 2 1,400 700.0 753.0 7.0 50 ‐ 75
45100 8 8 9,900 1,237.5 1,272.3 2.7 75 ‐ 100
45171 32 32 24,250 757.8 736.3 2.9 50 ‐ 75
45172 8 8 9,900 1,237.5 1,257.0 1.6 75 ‐ 100
45300 88 88 22,750 258.5 262.2 1.4 50 ‐ 75
45330 705 705 197,500 280.1 274.8 1.9 30 ‐ 40
45331 368 368 105,700 287.2 288.1 0.3 30 ‐ 40
45333 4 4 1,950 487.5 478.7 1.8 75 ‐ 100
45334 29 29 14,350 494.8 493.8 0.2 50 ‐ 75
45335 20 20 3,150 157.5 224.9 30.0 50 ‐ 75
45338 63 63 30,900 490.5 475.8 3.1 50 ‐ 75
45339 14 14 6,850 489.3 439.0 11.5 50 ‐ 75
45341 66 66 32,250 488.6 488.0 0.1 40 ‐ 50
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 59
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
45378 17,919 17,919 7,330,440 409.1 414.0 1.2 5 ‐ 10
45380 19,221 19,215 8,124,370 422.8 428.3 1.3 0 ‐ 5
45381 1,070 1,070 334,650 312.8 323.9 3.4 10 ‐ 20
45382 131 131 48,300 368.7 364.3 1.2 40 ‐ 50
45383 994 994 376,450 378.7 388.5 2.5 20 ‐ 30
45384 4,422 4,422 1,678,700 379.6 389.6 2.6 5 ‐ 10
45385 13,243 13,241 4,554,900 344.0 351.4 2.1 0 ‐ 5
45386 1 1 400 400.0 326.8 22.4 75 ‐ 100
45541 1 1 1,700 1,700.0 1,623.2 4.7 75 ‐ 100
45560 21 21 25,250 1,202.4 1,160.5 3.6 50 ‐ 75
45900 4 4 1,150 287.5 239.9 19.8 50 ‐ 75
45990 5 5 6,200 1,240.0 1,095.6 13.2 75 ‐ 100
46020 15 15 19,000 1,266.7 1,307.8 3.1 50 ‐ 75
46030 1 1 150 150.0 288.4 48.0 75 ‐ 100
46040 66 66 83,500 1,265.2 1,234.2 2.5 20 ‐ 30
46050 28 28 20,800 742.9 688.7 7.9 50 ‐ 75
46080 40 40 49,700 1,242.5 1,222.4 1.6 40 ‐ 50
46083 35 35 3,470 99.1 96.5 2.7 30 ‐ 40
46200 46 46 57,400 1,247.8 1,223.9 2.0 20 ‐ 30
46221 255 255 49,700 194.9 195.6 0.4 20 ‐ 30
46230 6 6 7,500 1,250.0 1,143.1 9.4 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 60
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
46250 23 23 28,600 1,243.5 1,115.8 11.4 40 ‐ 50
46255 103 103 129,600 1,258.3 1,222.8 2.9 20 ‐ 30
46260 184 184 233,500 1,269.0 1,213.0 4.6 20 ‐ 30
46270 58 58 72,200 1,244.8 1,192.6 4.4 30 ‐ 40
46275 12 12 15,500 1,291.7 1,163.8 11.0 50 ‐ 75
46280 9 9 11,400 1,266.7 1,250.6 1.3 50 ‐ 75
46320 17 17 21,000 1,235.3 1,016.4 21.5 50 ‐ 75
46600 273 273 10,370 38.0 37.3 1.9 30 ‐ 40
46606 24 24 8,700 362.5 322.7 12.3 50 ‐ 75
46615 2 2 2,600 1,300.0 1,106.3 17.5 75 ‐ 100
46700 1 1 1,200 1,200.0 1,014.3 18.3 75 ‐ 100
46707 2 2 3,300 1,650.0 1,107.8 48.9 75 ‐ 100
46910 14 14 15,700 1,121.4 983.2 14.1 50 ‐ 75
46916 1 1 100 100.0 96.4 3.7 75 ‐ 100
46917 4 4 4,500 1,125.0 1,132.7 0.7 50 ‐ 75
46922 50 50 48,500 970.0 972.7 0.3 50 ‐ 75
46924 30 30 35,200 1,173.3 1,127.7 4.0 50 ‐ 75
46930 27 27 4,800 177.8 188.8 5.8 50 ‐ 75
46945 3 3 2,200 733.3 655.8 11.8 75 ‐ 100
46946 23 23 13,350 580.4 579.6 0.1 50 ‐ 75
46947 121 121 201,600 1,666.1 1,620.1 2.8 20 ‐ 30
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 61
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
46999 44 44 9,100 206.8 217.2 4.8 50 ‐ 75
47000 1,499 1,499 775,800 517.5 511.1 1.3 10 ‐ 20
47379 77 77 72,200 937.7 1,210.4 22.5 40 ‐ 50
47382 5 5 14,000 2,800.0 2,827.7 1.0 75 ‐ 100
47525 151 151 115,800 766.9 746.8 2.7 50 ‐ 75
47562 3,034 3,034 6,202,250 2,044.2 2,014.4 1.5 5 ‐ 10
47563 1,314 1,314 2,698,800 2,053.9 1,993.0 3.1 5 ‐ 10
48102 42 42 21,200 504.8 512.5 1.5 50 ‐ 75
49021 8 8 6,300 787.5 789.5 0.3 75 ‐ 100
49080 3,477 3,477 1,019,140 293.1 283.8 3.3 10 ‐ 20
49081 474 474 141,360 298.2 272.2 9.6 20 ‐ 30
49180 226 226 118,100 522.6 512.8 1.9 50 ‐ 75
49320 33 33 60,300 1,827.3 1,828.7 0.1 75 ‐ 100
49321 5 5 7,500 1,500.0 1,630.5 8.0 75 ‐ 100
49322 2 2 2,700 1,350.0 1,147.2 17.7 75 ‐ 100
49324 125 125 229,900 1,839.2 1,795.1 2.5 30 ‐ 40
49325 33 33 61,300 1,857.6 1,753.4 5.9 30 ‐ 40
49326 3 3 2,700 900.0 960.2 6.3 75 ‐ 100
49329 82 82 90,150 1,099.4 1,225.9 10.3 50 ‐ 75
49420 2 2 3,100 1,550.0 1,684.6 8.0 75 ‐ 100
49421 107 107 169,900 1,587.9 1,549.3 2.5 40 ‐ 50
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 62
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
49422 110 110 117,100 1,064.5 1,042.6 2.1 30 ‐ 40
49423 23 23 19,050 828.3 789.9 4.9 75 ‐ 100
49435 8 8 3,200 400.0 393.5 1.7 50 ‐ 75
49436 1 1 750 750.0 865.2 13.3 75 ‐ 100
49440 48 48 21,400 445.8 427.0 4.4 50 ‐ 75
49446 7 7 3,050 435.7 415.5 4.9 75 ‐ 100
49450 265 265 91,950 347.0 356.3 2.6 20 ‐ 30
49451 86 86 29,150 339.0 346.7 2.2 40 ‐ 50
49452 194 194 67,900 350.0 397.1 11.9 20 ‐ 30
49465 40 40 2,090 52.3 61.9 15.5 40 ‐ 50
49505 2,946 2,946 4,955,550 1,682.1 1,673.5 0.5 5 ‐ 10
49507 280 280 469,250 1,675.9 1,641.6 2.1 10 ‐ 20
49520 390 390 627,200 1,608.2 1,625.3 1.1 10 ‐ 20
49521 50 50 84,300 1,686.0 1,595.9 5.6 20 ‐ 30
49525 104 104 176,500 1,697.1 1,636.7 3.7 20 ‐ 30
49550 26 26 41,750 1,605.8 1,462.2 9.8 40 ‐ 50
49553 12 12 20,000 1,666.7 1,608.6 3.6 50 ‐ 75
49560 567 567 918,050 1,619.1 1,535.0 5.5 20 ‐ 30
49561 186 186 305,000 1,639.8 1,555.5 5.4 10 ‐ 20
49565 95 95 157,500 1,657.9 1,587.9 4.4 20 ‐ 30
49566 32 32 52,100 1,628.1 1,589.1 2.5 40 ‐ 50
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 63
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
49568 696 696 582,750 837.3 852.0 1.7 5 ‐ 10
49570 38 38 62,800 1,652.6 1,506.5 9.7 40 ‐ 50
49572 21 21 34,100 1,623.8 1,451.5 11.9 50 ‐ 75
49585 580 580 778,700 1,342.6 1,292.1 3.9 10 ‐ 20
49587 242 242 364,250 1,505.2 1,412.7 6.5 20 ‐ 30
49590 3 3 5,100 1,700.0 1,609.7 5.6 75 ‐ 100
49650 652 652 1,602,150 2,457.3 2,398.6 2.4 10 ‐ 20
49651 120 120 233,700 1,947.5 2,055.5 5.3 20 ‐ 30
49652 112 112 406,100 3,625.9 3,557.3 1.9 50 ‐ 75
49653 31 31 113,500 3,661.3 3,616.6 1.2 50 ‐ 75
49654 112 112 405,800 3,623.2 3,524.8 2.8 30 ‐ 40
49655 29 29 104,400 3,600.0 3,592.5 0.2 50 ‐ 75
49656 18 18 65,300 3,627.8 3,647.4 0.5 50 ‐ 75
49659 18 18 27,800 1,544.4 1,502.6 2.8 50 ‐ 75
49999 22 22 28,700 1,304.5 1,326.3 1.6 75 ‐ 100
50080 13 13 31,800 2,446.2 2,503.8 2.3 40 ‐ 50
50081 7 7 16,800 2,400.0 2,407.2 0.3 50 ‐ 75
50200 587 587 300,200 511.4 499.8 2.3 20 ‐ 30
50387 9 9 7,300 811.1 825.8 1.8 75 ‐ 100
50389 23 23 8,650 376.1 321.5 17.0 50 ‐ 75
50390 45 45 18,150 403.3 430.7 6.4 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 64
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
50392 43 43 34,100 793.0 829.3 4.4 75 ‐ 100
50393 70 70 92,150 1,316.4 1,342.8 2.0 50 ‐ 75
50395 11 11 7,900 718.2 1,054.7 31.9 75 ‐ 100
50398 492 492 399,650 812.3 807.1 0.6 30 ‐ 40
50590 2,094 2,094 3,712,200 1,772.8 1,763.9 0.5 0 ‐ 5
50592 5 5 13,100 2,620.0 2,604.5 0.6 75 ‐ 100
50593 8 8 21,500 2,687.5 2,764.6 2.8 75 ‐ 100
50688 23 23 18,500 804.3 774.9 3.8 75 ‐ 100
50961 1 1 1,300 1,300.0 1,254.7 3.6 75 ‐ 100
51040 96 96 130,600 1,360.4 1,279.8 6.3 40 ‐ 50
51050 3 3 3,900 1,300.0 1,010.8 28.6 75 ‐ 100
51102 148 148 148,500 1,003.4 963.1 4.2 40 ‐ 50
51700 647 647 64,710 100.0 107.5 7.0 20 ‐ 30
51701 3,638 3,639 125,370 34.5 35.2 2.0 20 ‐ 30
51702 16,098 16,109 555,800 34.5 35.6 3.1 10 ‐ 20
51703 211 211 12,230 58.0 55.6 4.3 40 ‐ 50
51705 660 660 67,320 102.0 107.9 5.5 20 ‐ 30
51710 3 3 1,050 350.0 364.4 4.0 75 ‐ 100
51715 274 274 452,700 1,652.2 1,612.5 2.5 20 ‐ 30
51720 1,215 1,215 176,850 145.6 147.3 1.2 10 ‐ 20
51725 77 77 8,000 103.9 128.7 19.3 40 ‐ 50
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 65
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
51726 154 154 20,730 134.6 142.2 5.3 30 ‐ 40
51727 15 15 2,260 150.7 131.1 15.0 50 ‐ 75
51728 382 382 51,710 135.4 143.5 5.6 10 ‐ 20
51729 280 280 44,010 157.2 154.1 2.0 20 ‐ 30
51736 47 47 1,980 42.1 54.4 22.6 40 ‐ 50
51741 1,163 1,163 48,760 41.9 43.0 2.6 10 ‐ 20
51784 615 615 19,200 31.2 32.7 4.6 10 ‐ 20
51785 36 36 1,930 53.6 58.7 8.7 40 ‐ 50
51792 4 4 120 30.0 39.2 23.5 75 ‐ 100
51797 598 598 33,820 56.6 57.7 1.9 10 ‐ 20
51798 4,004 4,004 143,800 35.9 36.0 0.3 10 ‐ 20
51860 1 1 650 650.0 651.9 0.3 75 ‐ 100
52000 4,449 4,449 1,593,810 358.2 356.7 0.4 10 ‐ 20
52001 24 24 15,100 629.2 736.3 14.5 50 ‐ 75
52005 763 763 996,600 1,306.2 1,270.7 2.8 30 ‐ 40
52204 699 699 896,300 1,282.3 1,222.3 4.9 20 ‐ 30
52214 359 359 461,100 1,284.4 1,239.5 3.6 40 ‐ 50
52224 359 359 494,700 1,378.0 1,313.6 4.9 30 ‐ 40
52234 886 886 1,147,300 1,294.9 1,263.0 2.5 20 ‐ 30
52235 727 727 944,200 1,298.8 1,279.1 1.5 10 ‐ 20
52240 399 399 528,550 1,324.7 1,312.1 1.0 10 ‐ 20
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 66
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
52260 104 104 87,150 838.0 813.9 3.0 30 ‐ 40
52265 3 3 1,050 350.0 410.3 14.7 75 ‐ 100
52275 53 53 72,300 1,364.2 1,231.8 10.7 40 ‐ 50
52276 246 246 327,200 1,330.1 1,266.0 5.1 20 ‐ 30
52277 5 5 6,800 1,360.0 1,231.3 10.5 50 ‐ 75
52281 450 450 400,750 890.6 846.8 5.2 30 ‐ 40
52310 434 434 358,100 825.1 829.9 0.6 30 ‐ 40
52315 2 2 2,600 1,300.0 1,169.3 11.2 75 ‐ 100
52317 142 142 166,800 1,174.6 1,113.3 5.5 30 ‐ 40
52318 82 82 98,850 1,205.5 1,128.3 6.8 30 ‐ 40
52320 76 76 89,750 1,180.9 1,179.8 0.1 20 ‐ 30
52325 24 24 32,000 1,333.3 1,254.3 6.3 30 ‐ 40
52330 35 35 40,250 1,150.0 1,141.9 0.7 40 ‐ 50
52332 3,113 3,113 3,466,450 1,113.5 1,145.1 2.8 10 ‐ 20
52341 15 15 9,850 656.7 817.4 19.7 50 ‐ 75
52344 63 63 41,800 663.5 794.8 16.5 50 ‐ 75
52351 177 177 147,250 831.9 970.5 14.3 50 ‐ 75
52352 408 408 340,800 835.3 852.2 2.0 10 ‐ 20
52353 1,127 1,127 2,173,950 1,929.0 1,917.8 0.6 5 ‐ 10
52354 104 104 84,150 809.1 909.6 11.0 50 ‐ 75
52450 9 9 12,000 1,333.3 1,171.8 13.8 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 67
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
52500 113 113 134,550 1,190.7 1,082.8 10.0 40 ‐ 50
52601 603 603 1,153,550 1,913.0 1,876.7 1.9 10 ‐ 20
52630 87 87 166,100 1,909.2 1,921.7 0.7 40 ‐ 50
52640 26 26 34,050 1,309.6 1,239.2 5.7 50 ‐ 75
52647 6 6 14,400 2,400.0 2,297.7 4.5 50 ‐ 75
52648 1,050 1,050 2,624,450 2,499.5 2,472.2 1.1 10 ‐ 20
52649 83 83 205,900 2,480.7 2,507.7 1.1 10 ‐ 20
53020 3 3 3,200 1,066.7 808.9 31.9 75 ‐ 100
53230 3 3 4,800 1,600.0 1,635.2 2.2 40 ‐ 50
53265 2 2 2,200 1,100.0 871.0 26.3 75 ‐ 100
53410 1 1 1,600 1,600.0 1,782.8 10.3 75 ‐ 100
53440 60 60 322,400 5,373.3 5,421.0 0.9 40 ‐ 50
53445 30 30 308,000 10,266.7 9,867.7 4.0 50 ‐ 75
53446 9 9 14,500 1,611.1 1,651.2 2.4 50 ‐ 75
53447 2 2 20,700 10,350.0 9,887.3 4.7 75 ‐ 100
53600 9 9 1,400 155.6 141.3 10.1 50 ‐ 75
53601 4 4 240 60.0 57.1 5.1 50 ‐ 75
53620 2 2 2,000 1,000.0 1,032.4 3.1 75 ‐ 100
53661 3 3 180 60.0 53.3 12.6 75 ‐ 100
53850 2 2 5,000 2,500.0 2,178.3 14.8 75 ‐ 100
53852 2 2 5,000 2,500.0 2,532.4 1.3 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 68
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
53899 229 229 10,180 44.5 66.5 33.1 30 ‐ 40
54001 16 16 17,300 1,081.3 945.5 14.4 50 ‐ 75
54055 1 1 1,100 1,100.0 724.2 51.9 50 ‐ 75
54056 10 10 430 43.0 49.6 13.3 30 ‐ 40
54057 3 3 3,300 1,100.0 994.9 10.6 50 ‐ 75
54060 1 1 550 550.0 751.8 26.8 75 ‐ 100
54065 6 6 6,150 1,025.0 1,067.2 4.0 50 ‐ 75
54150 24 24 28,900 1,204.2 1,082.8 11.2 40 ‐ 50
54161 308 308 366,200 1,189.0 1,111.9 6.9 20 ‐ 30
54200 5 5 500 100.0 102.2 2.2 0 ‐ 5
54220 10 10 1,000 100.0 107.1 6.6 10 ‐ 20
54235 49 49 5,100 104.1 114.6 9.2 10 ‐ 20
54360 8 8 13,600 1,700.0 1,814.6 6.3 30 ‐ 40
54401 12 12 116,300 9,691.7 9,675.2 0.2 50 ‐ 75
54405 138 138 1,369,800 9,926.1 9,824.1 1.0 10 ‐ 20
54406 6 6 10,100 1,683.3 1,622.1 3.8 50 ‐ 75
54408 3 3 5,000 1,666.7 1,656.5 0.6 50 ‐ 75
54410 19 19 191,100 10,057.9 9,522.3 5.6 50 ‐ 75
54450 1 1 150 150.0 127.7 17.5 75 ‐ 100
54520 43 43 60,500 1,407.0 1,383.2 1.7 50 ‐ 75
54530 4 4 6,400 1,600.0 1,602.1 0.1 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 69
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
54700 4 4 5,200 1,300.0 1,220.5 6.5 50 ‐ 75
54830 7 7 7,800 1,114.3 989.4 12.6 50 ‐ 75
54840 36 36 43,100 1,197.2 1,098.8 9.0 40 ‐ 50
54860 3 3 3,600 1,200.0 1,067.0 12.5 75 ‐ 100
55000 4 4 1,000 250.0 165.3 51.2 50 ‐ 75
55040 159 159 260,250 1,636.8 1,586.7 3.2 10 ‐ 20
55041 14 14 22,800 1,628.6 1,614.2 0.9 30 ‐ 40
55060 14 14 17,200 1,228.6 1,106.7 11.0 50 ‐ 75
55100 23 23 15,150 658.7 590.0 11.6 30 ‐ 40
55175 2 2 2,400 1,200.0 971.3 23.5 75 ‐ 100
55250 1 1 1,100 1,100.0 602.0 82.7 75 ‐ 100
55500 42 42 43,950 1,046.4 919.8 13.8 30 ‐ 40
55520 261 261 167,400 641.4 654.7 2.0 10 ‐ 20
55530 1 1 1,200 1,200.0 1,233.3 2.7 75 ‐ 100
55559 2 2 1,800 900.0 903.2 0.4 75 ‐ 100
55700 1,113 1,113 700,540 629.4 609.1 3.3 10 ‐ 20
55706 23 23 15,050 654.3 595.7 9.8 40 ‐ 50
55860 4 4 4,000 1,000.0 1,015.7 1.5 20 ‐ 30
55873 123 123 784,700 6,379.7 6,243.0 2.2 10 ‐ 20
55875 371 371 861,800 2,322.9 2,308.5 0.6 5 ‐ 10
55876 200 200 122,200 611.0 618.8 1.3 5 ‐ 10
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 70
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
55899 34 34 1,440 42.4 101.2 58.1 50 ‐ 75
56405 96 96 7,660 79.8 84.5 5.6 20 ‐ 30
56420 33 33 2,700 81.8 76.5 6.9 20 ‐ 30
56440 2 2 2,100 1,050.0 1,007.1 4.3 75 ‐ 100
56501 14 14 15,500 1,107.1 1,052.8 5.2 50 ‐ 75
56515 10 10 11,400 1,140.0 1,105.7 3.1 40 ‐ 50
56605 82 82 15,580 190.0 158.9 19.6 50 ‐ 75
56606 12 12 480 40.0 57.9 30.9 50 ‐ 75
56620 38 38 39,550 1,040.8 1,045.7 0.5 40 ‐ 50
56740 9 9 9,400 1,044.4 1,031.7 1.2 50 ‐ 75
56810 7 7 3,700 528.6 763.2 30.7 50 ‐ 75
56820 3 3 200 66.7 76.7 13.0 75 ‐ 100
56821 1 1 80 80.0 128.0 37.5 75 ‐ 100
57061 10 10 10,300 1,030.0 1,014.5 1.5 50 ‐ 75
57065 1 1 1,000 1,000.0 1,081.7 7.6 75 ‐ 100
57100 8 8 2,800 350.0 297.9 17.5 75 ‐ 100
57120 54 54 78,950 1,462.0 1,422.8 2.8 20 ‐ 30
57135 11 11 11,800 1,072.7 875.1 22.6 75 ‐ 100
57150 14 14 1,130 80.7 83.3 3.1 40 ‐ 50
57155 110 110 40,050 364.1 364.1 0.0 20 ‐ 30
57160 315 315 24,150 76.7 76.7 0.0 10 ‐ 20
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 71
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
57180 9 9 900 100.0 95.8 4.4 30 ‐ 40
57200 4 4 4,100 1,025.0 853.4 20.1 50 ‐ 75
57240 324 324 387,200 1,195.1 1,205.5 0.9 10 ‐ 20
57250 175 175 237,100 1,354.9 1,351.6 0.2 10 ‐ 20
57260 181 181 226,950 1,253.9 1,230.9 1.9 10 ‐ 20
57265 50 50 99,500 1,990.0 1,904.3 4.5 30 ‐ 40
57267 340 340 313,500 922.1 937.9 1.7 5 ‐ 10
57268 18 18 21,650 1,202.8 1,200.7 0.2 30 ‐ 40
57282 153 153 285,400 1,865.4 1,830.2 1.9 10 ‐ 20
57283 21 21 38,350 1,826.2 1,612.4 13.3 30 ‐ 40
57285 32 32 59,300 1,853.1 1,830.4 1.2 30 ‐ 40
57287 35 35 64,700 1,848.6 1,696.2 9.0 50 ‐ 75
57288 1,218 1,218 2,297,900 1,886.6 1,852.3 1.9 5 ‐ 10
57295 23 23 22,550 980.4 888.2 10.4 50 ‐ 75
57410 27 27 28,800 1,066.7 1,024.3 4.1 50 ‐ 75
57420 9 9 1,650 183.3 147.3 24.4 75 ‐ 100
57421 22 22 4,250 193.2 161.5 19.6 50 ‐ 75
57425 30 30 36,700 1,223.3 1,219.4 0.3 20 ‐ 30
57452 43 43 3,500 81.4 74.3 9.6 50 ‐ 75
57454 77 77 14,550 189.0 172.6 9.5 20 ‐ 30
57455 27 27 5,050 187.0 160.1 16.8 40 ‐ 50
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 72
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
57456 26 26 4,850 186.5 169.9 9.8 40 ‐ 50
57460 15 15 15,900 1,060.0 1,039.7 2.0 40 ‐ 50
57461 3 3 3,200 1,066.7 954.4 11.8 75 ‐ 100
57500 8 8 2,550 318.8 303.9 4.9 75 ‐ 100
57505 12 12 3,250 270.8 288.6 6.2 75 ‐ 100
57513 3 3 3,200 1,066.7 809.6 31.8 50 ‐ 75
57520 42 42 42,150 1,003.6 991.9 1.2 50 ‐ 75
57522 68 68 70,450 1,036.0 955.7 8.4 30 ‐ 40
58100 270 270 21,920 81.2 80.1 1.4 20 ‐ 30
58120 300 300 316,600 1,055.3 988.8 6.7 20 ‐ 30
58260 61 61 69,500 1,139.3 1,173.3 2.9 30 ‐ 40
58262 12 12 11,100 925.0 1,415.7 34.7 50 ‐ 75
58263 2 2 1,800 900.0 1,185.0 24.1 75 ‐ 100
58270 7 7 8,100 1,157.1 1,338.4 13.5 50 ‐ 75
58301 6 6 420 70.0 70.1 0.1 50 ‐ 75
58350 2 2 1,750 875.0 1,073.5 18.5 50 ‐ 75
58353 34 34 64,300 1,891.2 1,814.5 4.2 20 ‐ 30
58541 5 5 18,800 3,760.0 3,798.3 1.0 75 ‐ 100
58542 4 4 14,200 3,550.0 3,614.4 1.8 75 ‐ 100
58550 13 13 47,500 3,653.8 3,629.7 0.7 50 ‐ 75
58552 84 84 154,400 1,838.1 1,931.3 4.8 40 ‐ 50
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 73
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
58555 11 11 10,450 950.0 924.8 2.7 50 ‐ 75
58558 1,474 1,474 1,581,450 1,072.9 1,053.7 1.8 10 ‐ 20
58561 16 16 30,000 1,875.0 1,886.5 0.6 50 ‐ 75
58563 199 199 338,200 1,699.5 1,630.1 4.3 10 ‐ 20
58565 13 13 26,700 2,053.8 2,052.0 0.1 10 ‐ 20
58570 10 10 21,100 2,110.0 2,016.8 4.6 50 ‐ 75
58571 37 37 60,800 1,643.2 1,866.9 12.0 50 ‐ 75
58660 7 7 14,300 2,042.9 1,840.6 11.0 50 ‐ 75
58661 266 266 694,900 2,612.4 2,617.2 0.2 30 ‐ 40
58662 46 46 84,200 1,830.4 1,791.0 2.2 50 ‐ 75
58670 36 36 75,800 2,105.6 2,041.2 3.2 20 ‐ 30
58671 31 31 62,600 2,019.4 1,944.0 3.9 20 ‐ 30
58999 36 36 310 8.6 13.7 37.2 50 ‐ 75
59000 11 11 2,150 195.5 190.3 2.7 10 ‐ 20
59015 1 1 200 200.0 178.5 12.0 0 ‐ 5
59020 4 4 330 82.5 78.5 5.1 50 ‐ 75
59025 597 597 49,110 82.3 88.1 6.6 10 ‐ 20
59151 4 4 8,300 2,075.0 2,058.3 0.8 0 ‐ 5
59320 3 3 3,000 1,000.0 1,086.1 7.9 40 ‐ 50
59430 1 1 100 100.0 105.8 5.5 0 ‐ 5
59812 19 19 20,300 1,068.4 1,077.7 0.9 20 ‐ 30
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 74
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
59820 37 37 40,400 1,091.9 1,096.3 0.4 10 ‐ 20
59821 1 1 1,000 1,000.0 1,049.9 4.8 0 ‐ 5
59899 25 25 240 9.6 5.3 81.1 40 ‐ 50
60100 535 536 126,350 235.7 229.5 2.7 10 ‐ 20
60200 6 6 15,000 2,500.0 2,482.3 0.7 75 ‐ 100
60210 12 12 31,200 2,600.0 2,563.6 1.4 75 ‐ 100
60220 151 151 385,400 2,552.3 2,572.3 0.8 30 ‐ 40
60225 6 6 15,200 2,533.3 2,528.3 0.2 75 ‐ 100
60240 132 132 336,500 2,549.2 2,578.5 1.1 30 ‐ 40
60252 7 7 15,800 2,257.1 2,286.9 1.3 50 ‐ 75
60260 2 2 4,400 2,200.0 2,306.4 4.6 75 ‐ 100
60271 6 6 13,800 2,300.0 2,340.3 1.7 50 ‐ 75
60300 37 37 8,500 229.7 203.5 12.9 30 ‐ 40
60500 307 307 676,600 2,203.9 2,155.9 2.2 10 ‐ 20
60502 3 3 6,600 2,200.0 2,495.4 11.8 75 ‐ 100
60512 7 7 4,200 600.0 625.3 4.0 75 ‐ 100
61055 6 6 2,100 350.0 364.9 4.1 75 ‐ 100
61070 7 7 2,450 350.0 341.1 2.6 75 ‐ 100
61885 96 96 1,208,000 12,583.3 14,113.0 10.8 40 ‐ 50
61886 67 67 1,149,000 17,149.3 16,700.3 2.7 40 ‐ 50
61888 2 2 2,200 1,100.0 1,205.8 8.8 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 75
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
62230 2 2 4,300 2,150.0 2,218.4 3.1 50 ‐ 75
62252 8 8 800 100.0 120.3 16.9 50 ‐ 75
62264 168 168 107,050 637.2 639.3 0.3 20 ‐ 30
62267 2 2 500 250.0 213.3 17.2 75 ‐ 100
62270 966 966 193,220 200.0 196.1 2.0 20 ‐ 30
62272 28 28 5,600 200.0 208.9 4.3 50 ‐ 75
62273 52 52 10,250 197.1 198.2 0.6 30 ‐ 40
62281 2 2 300 150.0 309.8 51.6 75 ‐ 100
62282 24 24 8,150 339.6 333.5 1.8 50 ‐ 75
62287 4 4 7,400 1,850.0 1,896.0 2.4 75 ‐ 100
62310 2,674 2,674 995,160 372.2 366.7 1.5 5 ‐ 10
62311 16,547 16,547 5,936,740 358.8 359.7 0.3 0 ‐ 5
62318 19 19 6,700 352.6 374.7 5.9 50 ‐ 75
62319 125 125 48,650 389.2 383.9 1.4 30 ‐ 40
62350 73 73 99,300 1,360.3 1,461.8 6.9 50 ‐ 75
62355 1 1 300 300.0 398.0 24.6 75 ‐ 100
62362 118 118 1,385,000 11,737.3 11,706.1 0.3 30 ‐ 40
62365 8 8 15,300 1,912.5 1,883.4 1.5 50 ‐ 75
62367 131 131 13,500 103.1 114.3 9.8 30 ‐ 40
62368 1,572 1,572 169,760 108.0 117.0 7.7 10 ‐ 20
63005 24 24 60,400 2,516.7 2,498.8 0.7 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 76
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
63020 2 2 5,000 2,500.0 2,591.4 3.5 75 ‐ 100
63030 566 566 1,514,300 2,675.4 2,715.6 1.5 10 ‐ 20
63035 84 84 125,000 1,488.1 1,710.0 13.0 30 ‐ 40
63042 17 17 43,400 2,552.9 2,564.3 0.4 50 ‐ 75
63047 300 300 761,500 2,538.3 2,458.7 3.2 20 ‐ 30
63048 216 216 277,700 1,285.6 1,290.0 0.3 10 ‐ 20
63056 15 15 38,200 2,546.7 2,467.2 3.2 50 ‐ 75
63650 547 550 1,861,800 3,385.1 3,402.4 0.5 30 ‐ 40
63655 72 72 323,800 4,497.2 4,598.6 2.2 50 ‐ 75
63661 32 32 14,300 446.9 571.1 21.7 50 ‐ 75
63662 9 9 4,050 450.0 496.7 9.4 50 ‐ 75
63663 15 15 10,700 713.3 773.8 7.8 50 ‐ 75
63664 3 3 2,550 850.0 845.2 0.6 75 ‐ 100
63685 391 391 4,817,000 12,319.7 12,240.0 0.7 20 ‐ 30
63688 89 89 99,300 1,115.7 1,116.5 0.1 30 ‐ 40
64400 81 81 11,550 142.6 123.0 15.9 30 ‐ 40
64402 55 55 7,400 134.5 112.3 19.8 50 ‐ 75
64405 297 297 60,610 204.1 188.4 8.3 30 ‐ 40
64413 6 6 540 90.0 135.0 33.3 75 ‐ 100
64415 391 391 37,380 95.6 99.0 3.4 10 ‐ 20
64416 55 55 11,000 200.0 188.5 6.1 20 ‐ 30
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 77
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
64417 19 19 1,840 96.8 110.0 12.0 75 ‐ 100
64418 24 24 3,960 165.0 160.9 2.5 50 ‐ 75
64420 8 8 1,600 200.0 162.2 23.3 75 ‐ 100
64421 34 34 12,550 369.1 354.0 4.3 50 ‐ 75
64425 36 36 6,700 186.1 174.5 6.6 50 ‐ 75
64445 67 67 19,800 295.5 265.1 11.5 50 ‐ 75
64446 2 2 400 200.0 188.9 5.9 75 ‐ 100
64447 20 20 3,690 184.5 134.6 37.1 75 ‐ 100
64450 303 303 45,920 151.6 139.0 9.1 50 ‐ 75
64455 19 19 2,200 115.8 108.2 7.0 50 ‐ 75
64479 218 218 82,700 379.4 389.5 2.6 30 ‐ 40
64480 58 58 5,800 100.0 107.4 6.9 40 ‐ 50
64483 7,834 7,834 3,169,270 404.6 404.0 0.1 0 ‐ 5
64484 3,146 3,180 339,040 106.6 108.3 1.6 5 ‐ 10
64490 952 952 408,600 429.2 425.8 0.8 10 ‐ 20
64491 794 794 68,720 86.5 88.4 2.1 10 ‐ 20
64492 554 554 45,890 82.8 85.0 2.6 10 ‐ 20
64493 4,291 4,291 1,891,190 440.7 438.7 0.5 5 ‐ 10
64494 3,409 3,410 331,690 97.3 98.8 1.5 5 ‐ 10
64495 2,097 2,097 203,250 96.9 97.5 0.6 5 ‐ 10
64505 3 3 450 150.0 128.0 17.2 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 78
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
64510 54 54 21,050 389.8 368.9 5.7 40 ‐ 50
64520 95 95 33,750 355.3 338.7 4.9 50 ‐ 75
64530 11 11 3,800 345.5 323.3 6.9 50 ‐ 75
64550 991 991 10,450 10.5 13.0 19.2 10 ‐ 20
64555 2 2 6,600 3,300.0 3,374.0 2.2 75 ‐ 100
64561 131 131 451,000 3,442.7 3,470.3 0.8 30 ‐ 40
64573 18 18 176,400 9,800.0 9,333.0 5.0 40 ‐ 50
64581 152 152 693,300 4,561.2 4,580.2 0.4 30 ‐ 40
64585 22 22 11,350 515.9 712.1 27.6 50 ‐ 75
64590 308 308 3,873,000 12,574.7 12,431.9 1.1 10 ‐ 20
64595 23 23 25,300 1,100.0 1,119.2 1.7 50 ‐ 75
64610 1 1 1,100 1,100.0 917.4 19.9 75 ‐ 100
64612 264 264 38,680 146.5 132.6 10.5 30 ‐ 40
64613 409 409 88,350 216.0 212.8 1.5 20 ‐ 30
64614 344 344 66,840 194.3 181.8 6.9 20 ‐ 30
64622 1,374 1,374 998,950 727.0 728.7 0.2 10 ‐ 20
64623 2,164 2,333 563,850 241.7 231.6 4.4 10 ‐ 20
64626 193 193 75,400 390.7 403.1 3.1 30 ‐ 40
64627 329 367 27,050 73.7 76.2 3.3 20 ‐ 30
64640 42 42 10,800 257.1 320.5 19.8 75 ‐ 100
64680 1 1 200 200.0 289.7 31.0 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 79
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
64704 2 2 1,500 750.0 674.4 11.2 75 ‐ 100
64708 3 3 3,200 1,066.7 758.4 40.7 75 ‐ 100
64718 436 436 396,650 909.7 884.4 2.9 10 ‐ 20
64719 68 68 58,350 858.1 810.7 5.8 30 ‐ 40
64721 3,112 3,112 2,790,650 896.7 884.1 1.4 0 ‐ 5
64727 34 34 16,650 489.7 541.0 9.5 30 ‐ 40
64782 2 2 1,000 500.0 735.8 32.0 75 ‐ 100
64788 1 1 1,000 1,000.0 1,334.8 25.1 75 ‐ 100
64831 1 1 2,100 2,100.0 1,801.5 16.6 75 ‐ 100
64999 16 16 1,760 110.0 60.8 80.9 75 ‐ 100
65105 1 1 2,000 2,000.0 2,027.0 1.3 75 ‐ 100
65205 68 68 3,450 50.7 67.4 24.8 30 ‐ 40
65220 53 53 2,570 48.5 49.4 1.8 20 ‐ 30
65222 39 39 1,990 51.0 48.0 6.3 40 ‐ 50
65400 5 5 2,350 470.0 688.0 31.7 75 ‐ 100
65420 7 7 5,400 771.4 822.5 6.2 50 ‐ 75
65426 98 98 115,400 1,177.6 1,156.1 1.9 20 ‐ 30
65430 2 2 100 50.0 53.4 6.4 75 ‐ 100
65436 2 2 1,700 850.0 831.3 2.2 75 ‐ 100
65710 2 2 3,200 1,600.0 1,739.3 8.0 75 ‐ 100
65730 40 40 68,500 1,712.5 1,726.2 0.8 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 80
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
65755 40 40 68,100 1,702.5 1,724.6 1.3 40 ‐ 50
65756 196 196 338,700 1,728.1 1,728.3 0.0 10 ‐ 20
65772 33 33 13,450 407.6 469.1 13.1 20 ‐ 30
65780 8 8 13,100 1,637.5 1,698.4 3.6 75 ‐ 100
65805 23 23 17,250 750.0 744.3 0.8 50 ‐ 75
65850 9 9 10,500 1,166.7 1,059.0 10.2 50 ‐ 75
65855 512 512 137,150 267.9 283.5 5.5 5 ‐ 10
65875 5 5 5,700 1,140.0 965.1 18.1 75 ‐ 100
66030 24 24 2,450 102.1 138.3 26.2 40 ‐ 50
66170 269 269 311,850 1,159.3 1,165.8 0.6 10 ‐ 20
66172 45 45 52,800 1,173.3 1,125.6 4.2 40 ‐ 50
66180 217 217 479,900 2,211.5 2,196.3 0.7 10 ‐ 20
66185 6 6 6,600 1,100.0 1,004.7 9.5 75 ‐ 100
66250 20 20 16,300 815.0 750.7 8.6 75 ‐ 100
66625 1 1 800 800.0 597.4 33.9 75 ‐ 100
66710 22 22 18,000 818.2 813.6 0.6 40 ‐ 50
66711 43 43 18,150 422.1 457.5 7.7 20 ‐ 30
66761 409 409 110,650 270.5 284.1 4.8 5 ‐ 10
66821 2,520 2,520 643,640 255.4 255.4 0.0 5 ‐ 10
66825 13 13 14,400 1,107.7 910.6 21.6 75 ‐ 100
66850 33 33 48,000 1,454.5 1,122.4 29.6 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 81
Number of Procedures in PUF
HCPCS Code(1)
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
66852 39 39 60,700 1,556.4 1,382.7 12.6 50 ‐ 75
66982 1,695 1,695 1,876,550 1,107.1 1,098.8 0.8 0 ‐ 5
66983 21 21 21,200 1,009.5 867.1 16.4 50 ‐ 75
66984 27,783 27,743 29,980,650 1,080.7 1,077.8 0.3 0 ‐ 5
66985 21 21 22,600 1,076.2 835.3 28.8 50 ‐ 75
66986 56 56 42,800 764.3 786.0 2.8 50 ‐ 75
66999 98 98 10,850 110.7 157.7 29.8 40 ‐ 50
67005 15 15 8,000 533.3 647.8 17.7 50 ‐ 75
67010 21 21 44,400 2,114.3 2,174.4 2.8 50 ‐ 75
67015 1 1 2,000 2,000.0 2,177.7 8.2 75 ‐ 100
67025 64 64 34,750 543.0 618.3 12.2 40 ‐ 50
67027 3 3 7,200 2,400.0 2,301.5 4.3 75 ‐ 100
67028 2,926 2,926 505,780 172.9 173.9 0.6 5 ‐ 10
67031 9 9 2,250 250.0 237.0 5.5 50 ‐ 75
67036 232 232 492,000 2,120.7 2,132.4 0.5 30 ‐ 40
67039 106 106 227,200 2,143.4 2,168.8 1.2 40 ‐ 50
67040 278 278 589,400 2,120.1 2,123.6 0.2 30 ‐ 40
67041 500 500 1,009,550 2,019.1 1,968.8 2.6 20 ‐ 30
67042 492 492 977,700 1,987.2 1,965.4 1.1 10 ‐ 20
67043 5 5 8,400 1,680.0 1,763.3 4.7 75 ‐ 100
67101 1 1 1,100 1,100.0 738.1 49.0 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 82
Number of Procedures in PUF
HCPCS Code(1)
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
67105 16 16 4,300 268.8 230.1 16.8 50 ‐ 75
67107 35 35 74,000 2,114.3 2,109.6 0.2 20 ‐ 30
67108 386 386 826,100 2,140.2 2,089.0 2.5 10 ‐ 20
67110 3 3 3,300 1,100.0 855.3 28.6 75 ‐ 100
67112 12 12 23,800 1,983.3 1,898.5 4.5 75 ‐ 100
67113 222 222 471,700 2,124.8 2,115.0 0.5 20 ‐ 30
67145 26 26 6,500 250.0 231.9 7.8 40 ‐ 50
67210 180 180 47,000 261.1 261.9 0.3 10 ‐ 20
67218 3 3 3,300 1,100.0 1,227.3 10.4 75 ‐ 100
67221 16 16 5,200 325.0 320.7 1.3 5 ‐ 10
67228 218 218 56,200 257.8 277.5 7.1 20 ‐ 30
67255 96 96 54,750 570.3 612.2 6.8 20 ‐ 30
67311 37 37 51,200 1,383.8 1,384.3 0.0 50 ‐ 75
67312 29 29 33,500 1,155.2 1,133.5 1.9 20 ‐ 30
67314 13 13 12,950 996.2 1,084.6 8.2 50 ‐ 75
67320 1 1 550 550.0 582.4 5.6 75 ‐ 100
67332 2 2 1,150 575.0 586.7 2.0 75 ‐ 100
67335 24 24 14,350 597.9 676.0 11.6 30 ‐ 40
67500 76 76 7,600 100.0 97.3 2.8 10 ‐ 20
67515 1 1 200 200.0 162.8 22.9 75 ‐ 100
67700 10 10 1,700 170.0 148.1 14.8 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 83
Number of Procedures in PUF
HCPCS Code(1)
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
67800 30 30 5,300 176.7 194.4 9.1 20 ‐ 30
67810 18 18 2,990 166.1 200.1 17.0 75 ‐ 100
67820 78 78 4,150 53.2 53.4 0.4 40 ‐ 50
67825 2 2 350 175.0 244.5 28.4 75 ‐ 100
67840 64 64 18,900 295.3 332.6 11.2 50 ‐ 75
67875 22 22 4,400 200.0 254.1 21.3 75 ‐ 100
67900 77 77 153,400 1,992.2 1,884.5 5.7 30 ‐ 40
67903 7 7 9,250 1,321.4 1,136.0 16.3 75 ‐ 100
67904 310 310 332,800 1,073.5 1,073.4 0.0 10 ‐ 20
67908 18 18 18,500 1,027.8 1,085.9 5.4 50 ‐ 75
67911 27 27 22,250 824.1 902.3 8.7 50 ‐ 75
67914 4 4 3,500 875.0 851.7 2.7 75 ‐ 100
67916 17 17 15,650 920.6 913.9 0.7 50 ‐ 75
67917 227 227 225,250 992.3 953.1 4.1 10 ‐ 20
67921 22 22 20,000 909.1 992.6 8.4 50 ‐ 75
67923 36 36 32,000 888.9 922.1 3.6 40 ‐ 50
67924 84 84 81,250 967.3 951.6 1.6 20 ‐ 30
67938 1 1 100 100.0 187.7 46.7 75 ‐ 100
67950 25 25 14,100 564.0 725.4 22.2 50 ‐ 75
67961 64 64 54,800 856.3 845.7 1.3 50 ‐ 75
67966 35 35 27,350 781.4 834.6 6.4 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 84
Number of Procedures in PUF
HCPCS Code(1)
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
67971 1 1 850 850.0 751.5 13.1 75 ‐ 100
67999 7 7 910 130.0 170.0 23.5 50 ‐ 75
68110 3 3 2,400 800.0 661.8 20.9 75 ‐ 100
68200 31 31 1,730 55.8 54.2 3.0 50 ‐ 75
68320 2 2 2,700 1,350.0 1,320.5 2.2 75 ‐ 100
68326 2 2 900 450.0 516.0 12.8 75 ‐ 100
68440 17 17 1,950 114.7 129.7 11.6 50 ‐ 75
68520 1 1 1,400 1,400.0 1,255.2 11.5 75 ‐ 100
68720 101 101 144,100 1,426.7 1,473.5 3.2 20 ‐ 30
68761 72 72 12,830 178.2 152.6 16.8 50 ‐ 75
68801 13 13 1,010 77.7 73.0 6.4 50 ‐ 75
68810 5 5 1,000 200.0 199.4 0.3 75 ‐ 100
68815 91 91 46,850 514.8 611.3 15.8 30 ‐ 40
68840 31 31 3,100 100.0 170.7 41.4 40 ‐ 50
69000 24 24 1,830 76.3 71.7 6.4 40 ‐ 50
69100 57 57 10,320 181.1 162.5 11.4 40 ‐ 50
69110 1 1 900 900.0 824.7 9.1 75 ‐ 100
69200 191 191 6,690 35.0 37.1 5.7 20 ‐ 30
69210 2,674 2,674 96,580 36.1 35.7 1.1 10 ‐ 20
69220 54 54 2,670 49.4 48.6 1.6 50 ‐ 75
69420 3 3 600 200.0 171.4 16.7 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 85
Number of Procedures in PUF
HCPCS Code(1)
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
69433 83 83 35,050 422.3 416.7 1.3 40 ‐ 50
69436 208 208 212,650 1,022.4 942.9 8.4 30 ‐ 40
69610 1 1 1,300 1,300.0 1,158.0 12.3 75 ‐ 100
69620 1 1 1,300 1,300.0 1,034.6 25.7 75 ‐ 100
69631 32 32 73,100 2,284.4 2,398.2 4.7 50 ‐ 75
69641 2 2 4,400 2,200.0 2,228.9 1.3 75 ‐ 100
69660 1 1 2,200 2,200.0 2,275.9 3.3 75 ‐ 100
69714 7 7 48,100 6,871.4 6,658.3 3.2 75 ‐ 100
69930 67 67 1,830,000 27,313.4 26,713.7 2.2 20 ‐ 30
70030 365 365 14,280 39.1 42.3 7.6 40 ‐ 50
70100 20 20 750 37.5 38.6 2.8 75 ‐ 100
70110 188 188 6,690 35.6 37.1 4.0 40 ‐ 50
70140 20 20 700 35.0 36.7 4.6 75 ‐ 100
70150 388 388 13,290 34.3 38.2 10.2 30 ‐ 40
70160 670 670 23,770 35.5 36.7 3.3 20 ‐ 30
70200 98 98 3,580 36.5 38.8 5.9 50 ‐ 75
70210 239 239 7,980 33.4 35.7 6.4 40 ‐ 50
70220 1,117 1,117 38,560 34.5 37.0 6.8 20 ‐ 30
70250 362 362 12,350 34.1 36.5 6.6 50 ‐ 75
70260 173 173 10,140 58.6 58.5 0.2 50 ‐ 75
70300 1 1 20 20.0 24.6 18.7 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 86
Number of Procedures in PUF
HCPCS Code(1)
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
70310 2 2 40 20.0 23.3 14.2 50 ‐ 75
70320 33 33 670 20.3 24.4 16.8 50 ‐ 75
70330 41 41 1,500 36.6 38.6 5.2 50 ‐ 75
70336 21 21 4,200 200.0 301.6 33.7 50 ‐ 75
70355 196 196 6,530 33.3 35.1 5.1 50 ‐ 75
70360 1,017 1,017 35,720 35.1 35.7 1.7 20 ‐ 30
70370 4 4 200 50.0 57.1 12.4 75 ‐ 100
70371 665 665 35,650 53.6 55.8 3.9 20 ‐ 30
70390 3 3 450 150.0 162.7 7.8 50 ‐ 75
70450 108,469 108,490 16,946,800 156.2 165.9 5.8 5 ‐ 10
70460 270 270 69,900 258.9 295.4 12.4 50 ‐ 75
70470 4,257 4,257 1,019,550 239.5 266.0 10.0 20 ‐ 30
70480 672 672 76,300 113.5 144.1 21.2 30 ‐ 40
70481 58 58 11,600 200.0 233.2 14.2 50 ‐ 75
70482 20 20 4,000 200.0 236.2 15.3 75 ‐ 100
70486 5,778 5,778 760,030 131.5 152.9 14.0 10 ‐ 20
70487 139 139 28,550 205.4 265.8 22.7 50 ‐ 75
70488 26 26 5,200 200.0 248.9 19.6 75 ‐ 100
70490 575 575 83,460 145.1 187.2 22.5 50 ‐ 75
70491 4,273 4,273 1,342,920 314.3 319.3 1.6 20 ‐ 30
70492 276 276 58,300 211.2 264.6 20.2 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 87
Number of Procedures in PUF
HCPCS Code(1)
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
70496 1,235 1,235 465,250 376.7 382.8 1.6 30 ‐ 40
70498 1,655 1,655 386,440 233.5 258.4 9.6 20 ‐ 30
70540 21 21 4,700 223.8 407.8 45.1 75 ‐ 100
70543 382 382 193,100 505.5 525.9 3.9 50 ‐ 75
70544 1,912 1,912 1,077,950 563.8 562.7 0.2 30 ‐ 40
70546 22 22 9,550 434.1 611.6 29.0 75 ‐ 100
70547 112 112 28,000 250.0 379.2 34.1 50 ‐ 75
70548 111 111 32,150 289.6 449.5 35.6 50 ‐ 75
70549 377 377 148,700 394.4 467.2 15.6 40 ‐ 50
70551 9,334 9,334 2,364,230 253.3 271.1 6.6 10 ‐ 20
70552 193 193 51,200 265.3 294.6 9.9 50 ‐ 75
70553 17,290 17,290 6,501,500 376.0 395.7 5.0 10 ‐ 20
71010 161,178 163,021 5,678,920 34.8 35.8 2.8 0 ‐ 5
71020 270,609 270,771 9,782,090 36.1 36.9 2.2 0 ‐ 5
71021 36 36 1,330 36.9 34.1 8.2 50 ‐ 75
71022 52 52 2,030 39.0 39.9 2.3 50 ‐ 75
71023 17 17 910 53.5 54.8 2.4 75 ‐ 100
71030 111 111 4,050 36.5 36.5 0.0 50 ‐ 75
71035 657 732 26,310 35.9 36.7 2.2 30 ‐ 40
71090 2 2 60 30.0 622.6 95.2 75 ‐ 100
71100 6,135 6,135 217,950 35.5 36.8 3.5 10 ‐ 20
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 88
Number of Procedures in PUF
HCPCS Code(1)
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
71101 5,955 5,955 222,440 37.4 39.1 4.3 10 ‐ 20
71110 387 387 13,490 34.9 38.1 8.4 40 ‐ 50
71111 331 331 19,900 60.1 61.6 2.4 40 ‐ 50
71120 262 262 9,080 34.7 36.7 5.4 30 ‐ 40
71130 7 7 260 37.1 42.6 12.9 75 ‐ 100
71250 23,687 23,687 3,313,690 139.9 155.3 9.9 10 ‐ 20
71260 36,070 36,070 11,695,430 324.2 325.2 0.3 5 ‐ 10
71270 2,137 2,137 580,580 271.7 298.4 8.9 30 ‐ 40
71275 10,689 10,689 2,715,750 254.1 272.2 6.6 10 ‐ 20
71550 58 58 27,400 472.4 392.0 20.5 50 ‐ 75
71552 15 15 5,050 336.7 465.5 27.7 75 ‐ 100
72010 96 96 6,040 62.9 59.3 6.1 40 ‐ 50
72020 2,000 2,092 70,390 33.6 35.2 4.5 10 ‐ 20
72040 7,950 7,963 281,160 35.3 37.2 5.1 10 ‐ 20
72050 9,622 9,622 573,640 59.6 59.6 0.0 10 ‐ 20
72052 1,799 1,799 108,190 60.1 61.1 1.6 20 ‐ 30
72069 231 231 7,790 33.7 35.5 5.1 20 ‐ 30
72070 5,072 5,072 183,020 36.1 37.8 4.5 10 ‐ 20
72072 5,665 5,665 199,040 35.1 37.0 5.1 10 ‐ 20
72074 187 187 6,410 34.3 37.3 8.0 40 ‐ 50
72080 366 366 12,890 35.2 37.0 4.9 40 ‐ 50
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 89
Number of Procedures in PUF
HCPCS Code(1)
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
72090 215 215 14,250 66.3 69.9 5.2 30 ‐ 40
72100 27,951 27,951 1,020,690 36.5 38.0 3.9 5 ‐ 10
72110 20,707 20,707 1,250,620 60.4 60.6 0.3 5 ‐ 10
72114 1,360 1,360 83,670 61.5 66.0 6.8 20 ‐ 30
72120 417 417 25,140 60.3 59.1 2.0 20 ‐ 30
72125 5,651 5,651 1,128,700 199.7 215.8 7.5 20 ‐ 30
72126 385 385 118,650 308.2 316.7 2.7 20 ‐ 30
72127 5 5 1,000 200.0 261.8 23.6 75 ‐ 100
72128 761 761 169,450 222.7 236.7 5.9 30 ‐ 40
72129 34 34 14,950 439.7 374.1 17.5 50 ‐ 75
72130 2 2 400 200.0 337.9 40.8 75 ‐ 100
72131 5,774 5,774 763,000 132.1 155.1 14.8 10 ‐ 20
72132 1,104 1,104 221,000 200.2 201.5 0.6 10 ‐ 20
72133 31 31 6,200 200.0 235.0 14.9 50 ‐ 75
72141 7,580 7,580 2,112,430 278.7 291.9 4.5 10 ‐ 20
72142 4 4 1,000 250.0 453.8 44.9 75 ‐ 100
72146 2,095 2,095 763,770 364.6 375.8 3.0 20 ‐ 30
72148 19,097 19,097 4,318,000 226.1 234.2 3.5 5 ‐ 10
72149 36 36 9,550 265.3 331.3 19.9 50 ‐ 75
72156 920 920 390,650 424.6 474.4 10.5 40 ‐ 50
72157 595 595 315,400 530.1 548.7 3.4 40 ‐ 50
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 90
Number of Procedures in PUF
HCPCS Code(1)
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
72158 4,676 4,676 1,584,450 338.8 354.4 4.4 10 ‐ 20
72170 23,177 23,177 827,610 35.7 36.7 2.7 5 ‐ 10
72190 622 622 22,420 36.0 40.0 10.0 30 ‐ 40
72191 2,145 2,145 1,041,450 485.5 478.0 1.6 10 ‐ 20
72192 34,116 34,116 10,523,760 308.5 306.8 0.6 5 ‐ 10
72193 40,638 40,638 19,135,010 470.9 464.2 1.4 5 ‐ 10
72194 7,527 7,527 3,585,050 476.3 469.8 1.4 10 ‐ 20
72195 676 676 172,550 255.3 317.5 19.6 40 ‐ 50
72196 12 12 3,500 291.7 452.9 35.6 75 ‐ 100
72197 552 552 215,450 390.3 494.4 21.1 50 ‐ 75
72200 76 76 2,610 34.3 36.5 6.0 50 ‐ 75
72202 462 462 16,590 35.9 38.0 5.5 30 ‐ 40
72220 2,303 2,303 80,110 34.8 36.3 4.1 20 ‐ 30
72240 275 275 101,700 369.8 372.4 0.7 10 ‐ 20
72255 2 2 700 350.0 362.3 3.4 75 ‐ 100
72265 1,333 1,333 499,500 374.7 372.6 0.6 5 ‐ 10
72270 261 261 96,800 370.9 371.6 0.2 10 ‐ 20
72275 5 5 190 38.0 88.3 57.0 75 ‐ 100
72285 1 1 1,300 1,300.0 768.3 69.2 75 ‐ 100
72291 2 2 100 50.0 89.1 43.9 75 ‐ 100
72295 62 84 82,400 981.0 13.9 6,957.6 40 ‐ 50
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 91
Number of Procedures in PUF
HCPCS Code(1)
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
73000 1,023 1,023 35,500 34.7 36.2 4.1 20 ‐ 30
73010 320 320 11,240 35.1 37.9 7.4 40 ‐ 50
73020 761 782 27,190 34.8 36.3 4.1 30 ‐ 40
73030 31,909 32,213 1,184,770 36.8 38.1 3.4 5 ‐ 10
73040 491 491 96,550 196.6 187.4 4.9 10 ‐ 20
73050 30 30 1,060 35.3 38.3 7.8 50 ‐ 75
73060 5,879 5,898 209,610 35.5 36.9 3.8 10 ‐ 20
73070 2,133 2,145 73,580 34.3 36.2 5.2 20 ‐ 30
73080 5,889 5,892 211,630 35.9 37.4 4.0 10 ‐ 20
73090 4,368 4,378 151,660 34.6 35.9 3.6 10 ‐ 20
73100 2,456 2,482 87,520 35.3 36.8 4.1 10 ‐ 20
73110 15,791 15,952 585,730 36.7 37.9 3.2 5 ‐ 10
73115 13 13 2,600 200.0 193.9 3.1 50 ‐ 75
73120 1,337 1,350 51,590 38.2 39.8 4.0 30 ‐ 40
73130 16,397 16,519 620,450 37.6 38.8 3.1 10 ‐ 20
73140 4,625 4,667 163,540 35.0 36.0 2.8 10 ‐ 20
73200 1,182 1,182 134,830 114.1 137.8 17.2 20 ‐ 30
73201 126 126 25,250 200.4 209.1 4.2 40 ‐ 50
73202 1 1 200 200.0 229.2 12.7 75 ‐ 100
73206 1 1 200 200.0 249.8 19.9 75 ‐ 100
73218 164 164 42,050 256.4 297.8 13.9 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 92
Number of Procedures in PUF
HCPCS Code(1)
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
73220 46 46 14,850 322.8 387.8 16.8 75 ‐ 100
73221 6,511 6,518 1,575,490 241.7 256.3 5.7 5 ‐ 10
73222 334 334 90,400 270.7 304.9 11.2 20 ‐ 30
73223 110 110 36,150 328.6 382.1 14.0 50 ‐ 75
73500 3,022 3,040 109,230 35.9 36.8 2.4 10 ‐ 20
73510 37,284 37,504 1,356,810 36.2 37.3 2.9 5 ‐ 10
73520 4,112 4,112 247,260 60.1 60.2 0.2 10 ‐ 20
73525 178 178 36,300 203.9 195.8 4.1 20 ‐ 30
73542 2 2 400 200.0 162.0 23.5 75 ‐ 100
73550 6,126 6,126 219,370 35.8 37.6 4.8 10 ‐ 20
73560 16,023 16,225 611,980 37.7 38.9 3.1 10 ‐ 20
73562 21,015 21,224 829,320 39.1 40.3 3.0 5 ‐ 10
73564 15,741 15,873 627,360 39.5 40.8 3.2 5 ‐ 10
73565 2,223 2,223 79,740 35.9 36.9 2.7 10 ‐ 20
73580 30 30 6,000 200.0 195.7 2.2 40 ‐ 50
73590 7,994 8,001 282,600 35.3 36.8 4.1 10 ‐ 20
73600 1,352 1,360 48,640 35.8 6.2 477.4 30 ‐ 40
73610 19,451 19,528 711,240 36.4 37.5 2.9 5 ‐ 10
73620 2,009 2,017 73,420 36.4 38.5 5.5 20 ‐ 30
73630 26,915 27,021 995,350 36.8 38.0 3.2 5 ‐ 10
73650 898 898 31,500 35.1 36.6 4.1 30 ‐ 40
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 93
Number of Procedures in PUF
HCPCS Code(1)
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
73660 1,672 1,672 58,390 34.9 36.1 3.3 20 ‐ 30
73700 2,538 2,539 306,540 120.7 141.7 14.8 20 ‐ 30
73701 105 107 21,650 202.3 240.4 15.8 50 ‐ 75
73702 11 11 2,200 200.0 237.7 15.9 75 ‐ 100
73706 118 118 39,700 336.4 332.7 1.1 50 ‐ 75
73718 982 982 245,570 250.1 283.1 11.7 30 ‐ 40
73720 395 395 131,000 331.6 380.4 12.8 40 ‐ 50
73721 9,113 9,157 2,227,010 243.2 256.9 5.3 5 ‐ 10
73722 47 47 12,600 268.1 294.5 9.0 40 ‐ 50
73723 184 184 60,950 331.3 378.5 12.5 50 ‐ 75
74000 19,308 19,375 673,920 34.8 35.8 2.8 5 ‐ 10
74010 890 890 30,990 34.8 37.7 7.7 30 ‐ 40
74020 11,691 11,691 443,470 37.9 40.1 5.5 10 ‐ 20
74022 17,089 17,089 1,032,470 60.4 60.6 0.3 5 ‐ 10
74150 5,996 5,996 1,057,290 176.3 194.0 9.1 20 ‐ 30
74160 6,459 6,459 1,696,430 262.6 277.6 5.4 30 ‐ 40
74170 4,164 4,164 1,010,020 242.6 272.1 10.8 20 ‐ 30
74175 899 899 220,190 244.9 268.1 8.7 30 ‐ 40
74181 947 947 199,400 210.6 245.4 14.2 30 ‐ 40
74182 2 2 500 250.0 319.6 21.8 75 ‐ 100
74183 2,675 2,675 911,250 340.7 366.3 7.0 20 ‐ 30
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 94
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
74190 2 2 300 150.0 151.3 0.9 75 ‐ 100
74210 82 82 4,220 51.5 56.7 9.2 40 ‐ 50
74220 4,815 4,815 255,180 53.0 54.0 1.9 10 ‐ 20
74230 5,969 5,969 323,570 54.2 55.7 2.7 10 ‐ 20
74240 882 882 46,440 52.7 55.0 4.2 20 ‐ 30
74241 618 618 32,750 53.0 54.4 2.6 30 ‐ 40
74245 457 457 39,430 86.3 92.6 6.8 30 ‐ 40
74246 1,500 1,500 79,390 52.9 55.1 4.0 10 ‐ 20
74247 966 966 51,200 53.0 56.9 6.9 20 ‐ 30
74249 617 617 53,280 86.4 87.9 1.7 20 ‐ 30
74250 1,402 1,402 72,270 51.5 52.9 2.6 10 ‐ 20
74251 2 2 180 90.0 112.4 19.9 75 ‐ 100
74261 56 56 6,400 114.3 125.8 9.1 50 ‐ 75
74270 1,272 1,272 65,450 51.5 54.9 6.2 20 ‐ 30
74280 857 857 73,850 86.2 88.7 2.8 20 ‐ 30
74283 2 2 100 50.0 52.4 4.6 75 ‐ 100
74300 46 46 4,620 100.4 100.1 0.3 50 ‐ 75
74305 150 150 24,450 163.0 163.2 0.1 30 ‐ 40
74400 568 568 57,310 100.9 103.3 2.3 20 ‐ 30
74410 38 38 3,800 100.0 108.0 7.4 40 ‐ 50
74415 290 290 29,400 101.4 105.5 3.9 20 ‐ 30
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 95
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
74420 2,778 2,784 290,350 104.3 112.2 7.0 5 ‐ 10
74425 142 142 14,800 104.2 109.2 4.6 40 ‐ 50
74430 324 324 33,450 103.2 112.7 8.4 20 ‐ 30
74450 45 45 4,600 102.2 115.2 11.3 50 ‐ 75
74455 133 133 13,850 104.1 111.9 7.0 30 ‐ 40
74740 29 29 4,850 167.2 160.6 4.1 10 ‐ 20
75557 15 15 3,000 200.0 234.0 14.5 75 ‐ 100
75561 148 148 57,350 387.5 410.7 5.6 40 ‐ 50
75563 16 16 5,500 343.8 356.0 3.4 50 ‐ 75
75571 44 44 1,530 34.8 40.1 13.2 50 ‐ 75
75572 132 132 25,300 191.7 198.2 3.3 20 ‐ 30
75573 6 6 1,150 191.7 201.0 4.6 75 ‐ 100
75574 531 531 102,900 193.8 200.3 3.2 20 ‐ 30
75625 1,210 1,210 1,837,650 1,518.7 1,434.3 5.9 10 ‐ 20
75630 290 290 442,700 1,526.6 1,451.2 5.2 20 ‐ 30
75635 1,731 1,731 370,350 214.0 231.2 7.4 10 ‐ 20
75650 460 460 1,091,820 2,373.5 2,307.9 2.8 30 ‐ 40
75662 1 1 2,300 2,300.0 2,211.1 4.0 75 ‐ 100
75665 46 46 72,000 1,565.2 1,555.9 0.6 40 ‐ 50
75671 179 179 437,900 2,446.4 2,419.4 1.1 30 ‐ 40
75680 27 27 33,500 1,240.7 1,113.2 11.5 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 96
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
75685 1 1 1,600 1,600.0 1,184.1 35.1 75 ‐ 100
75710 211 211 320,520 1,519.1 1,354.3 12.2 40 ‐ 50
75716 210 210 293,600 1,398.1 1,255.0 11.4 40 ‐ 50
75722 10 10 15,200 1,520.0 1,450.2 4.8 50 ‐ 75
75724 61 61 92,400 1,514.8 1,321.0 14.7 50 ‐ 75
75726 4 4 6,300 1,575.0 1,171.6 34.4 75 ‐ 100
75736 1 1 40 40.0 437.8 90.9 75 ‐ 100
75746 3 3 1,650 550.0 507.0 8.5 50 ‐ 75
75791 77 77 8,120 105.5 120.8 12.7 30 ‐ 40
75809 16 16 980 61.3 61.6 0.5 50 ‐ 75
75820 103 103 54,650 530.6 505.1 5.0 50 ‐ 75
75822 88 88 47,200 536.4 536.7 0.1 40 ‐ 50
75825 5 5 7,000 1,400.0 1,246.7 12.3 75 ‐ 100
75827 8 8 4,400 550.0 515.2 6.8 75 ‐ 100
75889 1 1 30 30.0 911.9 96.7 75 ‐ 100
75898 1 1 60 60.0 106.6 43.7 75 ‐ 100
75960 4 4 0 0.0 102.8 100.0 75 ‐ 100
75962 21 21 39,040 1,859.0 1,508.1 23.3 75 ‐ 100
75970 1 1 30 30.0 27.2 10.3 50 ‐ 75
75978 27 27 10,850 401.9 770.6 47.8 75 ‐ 100
75989 4 4 160 40.0 97.0 58.8 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 97
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
76000 461 461 32,740 71.0 79.5 10.7 50 ‐ 75
76001 7 7 370 52.9 155.1 65.9 75 ‐ 100
76080 281 281 46,050 163.9 163.9 0.0 40 ‐ 50
76098 179 179 38,510 215.1 175.9 22.3 30 ‐ 40
76100 25 25 1,480 59.2 57.6 2.8 50 ‐ 75
76120 39 39 1,950 50.0 52.9 5.5 50 ‐ 75
76376 82 82 6,540 79.8 84.0 5.0 75 ‐ 100
76377 7 7 950 135.7 120.1 13.0 75 ‐ 100
76380 490 490 34,370 70.1 80.3 12.7 40 ‐ 50
76496 1 1 50 50.0 52.5 4.8 75 ‐ 100
76497 10 10 700 70.0 65.5 6.9 75 ‐ 100
76498 26 26 5,200 200.0 223.2 10.4 50 ‐ 75
76499 71 81 2,930 36.2 38.9 6.9 75 ‐ 100
76510 75 75 18,000 240.0 221.3 8.5 30 ‐ 40
76511 1 1 60 60.0 85.7 30.0 75 ‐ 100
76512 322 322 20,230 62.8 64.0 1.9 30 ‐ 40
76513 5 5 380 76.0 66.3 14.6 75 ‐ 100
76514 450 450 4,850 10.8 13.6 20.6 10 ‐ 20
76516 22 22 1,020 46.4 48.1 3.5 20 ‐ 30
76519 587 587 37,260 63.5 63.8 0.5 10 ‐ 20
76536 10,624 10,624 648,970 61.1 61.5 0.7 5 ‐ 10
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 98
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
76604 322 322 13,480 41.9 47.6 12.0 30 ‐ 40
76645 20,520 20,520 875,160 42.6 42.8 0.5 0 ‐ 5
76700 17,598 17,598 1,275,860 72.5 74.6 2.8 10 ‐ 20
76705 15,317 15,335 964,670 62.9 64.0 1.7 10 ‐ 20
76770 13,698 13,698 908,330 66.3 68.4 3.1 10 ‐ 20
76775 8,634 8,634 534,820 61.9 63.3 2.2 10 ‐ 20
76776 310 310 19,000 61.3 68.6 10.6 20 ‐ 30
76801 328 328 19,540 59.6 64.7 7.9 10 ‐ 20
76802 5 5 200 40.0 39.0 2.6 50 ‐ 75
76805 277 277 16,850 60.8 61.1 0.5 10 ‐ 20
76810 1 1 60 60.0 57.8 3.8 50 ‐ 75
76811 123 123 11,590 94.2 93.0 1.3 10 ‐ 20
76812 3 3 120 40.0 39.8 0.5 40 ‐ 50
76813 44 44 1,820 41.4 50.7 18.3 20 ‐ 30
76815 232 232 9,540 41.1 48.0 14.4 10 ‐ 20
76816 232 234 9,650 41.2 45.6 9.6 10 ‐ 20
76817 330 330 13,270 40.2 46.1 12.8 10 ‐ 20
76818 75 75 4,530 60.4 83.7 27.8 30 ‐ 40
76819 149 149 9,090 61.0 60.2 1.3 10 ‐ 20
76820 65 65 2,600 40.0 40.0 0.0 0 ‐ 5
76825 21 21 9,500 452.4 462.6 2.2 30 ‐ 40
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 99
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
76826 4 4 1,400 350.0 347.7 0.7 20 ‐ 30
76827 20 20 870 43.5 46.7 6.9 30 ‐ 40
76828 5 5 200 40.0 37.9 5.5 40 ‐ 50
76830 7,766 7,766 483,650 62.3 63.6 2.0 5 ‐ 10
76831 24 24 2,350 97.9 100.9 3.0 40 ‐ 50
76856 7,687 7,687 494,510 64.3 66.3 3.0 5 ‐ 10
76857 814 814 33,550 41.2 47.8 13.8 30 ‐ 40
76870 2,252 2,252 137,420 61.0 61.8 1.3 10 ‐ 20
76872 939 939 56,830 60.5 62.9 3.8 10 ‐ 20
76873 211 211 12,350 58.5 69.0 15.2 5 ‐ 10
76880 1,700 1,706 104,250 61.1 62.3 1.9 30 ‐ 40
76936 5 5 350 70.0 74.6 6.2 75 ‐ 100
76937 1 1 20 20.0 73.9 72.9 75 ‐ 100
76942 194 194 32,090 165.4 190.5 13.2 50 ‐ 75
76970 13 13 570 43.8 44.2 0.9 75 ‐ 100
76999 73 73 2,960 40.5 43.5 6.9 50 ‐ 75
77001 5 5 360 72.0 87.3 17.5 75 ‐ 100
77002 65 65 4,920 75.7 114.8 34.1 75 ‐ 100
77003 1,041 1,041 106,030 101.9 118.0 13.6 20 ‐ 30
77012 24 24 4,150 172.9 202.6 14.7 75 ‐ 100
77014 328 328 55,150 168.1 183.7 8.5 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 100
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
77031 3 3 1,500 500.0 376.7 32.7 75 ‐ 100
77032 5 5 700 140.0 221.9 36.9 75 ‐ 100
77051 32,965 32,967 315,220 9.6 6.9 39.1 0 ‐ 5
77052 154,177 154,177 1,541,450 10.0 6.7 49.3 0 ‐ 5
77053 38 38 6,400 168.4 162.0 4.0 10 ‐ 20
77055 4,397 4,397 169,130 38.5 37.9 1.6 0 ‐ 5
77056 3,139 3,139 156,180 49.8 50.6 1.6 5 ‐ 10
77057 34,581 34,581 1,145,410 33.1 34.9 5.2 0 ‐ 5
77059 3 3 1,200 400.0 682.6 41.4 75 ‐ 100
77071 1 1 40 40.0 37.2 7.5 75 ‐ 100
77072 7 7 230 32.9 39.8 17.3 50 ‐ 75
77073 439 439 16,180 36.9 38.0 2.9 20 ‐ 30
77074 162 162 10,020 61.9 65.8 5.9 40 ‐ 50
77075 1,100 1,100 66,590 60.5 63.6 4.9 20 ‐ 30
77077 244 244 8,690 35.6 37.2 4.3 30 ‐ 40
77078 319 319 15,260 47.8 53.0 9.8 20 ‐ 30
77080 43,083 43,083 1,955,140 45.4 46.8 3.0 0 ‐ 5
77081 505 505 10,840 21.5 21.1 1.9 10 ‐ 20
77082 673 673 22,060 32.8 34.9 6.0 20 ‐ 30
77084 15 15 3,100 206.7 205.9 0.4 50 ‐ 75
77263 1 1 150 150.0 146.8 2.2 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 101
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
77280 6,857 6,976 485,230 69.6 72.3 3.7 5 ‐ 10
77285 99 99 17,350 175.3 176.5 0.7 30 ‐ 40
77290 8,685 8,685 1,520,890 175.1 182.8 4.2 5 ‐ 10
77295 3,862 3,862 2,349,450 608.4 661.6 8.0 10 ‐ 20
77299 1 1 70 70.0 66.4 5.4 75 ‐ 100
77300 11,096 33,026 2,276,300 68.9 68.6 0.4 10 ‐ 20
77301 1,833 1,833 1,117,400 609.6 694.7 12.2 10 ‐ 20
77305 122 122 8,230 67.5 71.0 4.9 30 ‐ 40
77310 19 19 1,250 65.8 76.3 13.8 50 ‐ 75
77315 2,172 2,197 377,300 171.7 186.6 8.0 10 ‐ 20
77321 545 545 95,500 175.2 177.9 1.5 10 ‐ 20
77326 87 87 5,810 66.8 68.2 2.1 20 ‐ 30
77327 65 65 11,150 171.5 183.4 6.5 20 ‐ 30
77328 438 438 73,850 168.6 185.8 9.3 5 ‐ 10
77331 2,053 3,432 235,880 68.7 69.3 0.9 10 ‐ 20
77332 1,997 2,042 240,440 117.7 123.0 4.3 10 ‐ 20
77333 294 294 37,700 128.2 126.6 1.3 20 ‐ 30
77334 11,511 21,696 2,676,500 123.4 128.1 3.7 10 ‐ 20
77336 32,273 32,273 2,231,320 69.1 70.4 1.8 5 ‐ 10
77338 2,180 2,181 275,450 126.3 155.8 18.9 10 ‐ 20
77370 1,507 1,507 103,840 68.9 71.4 3.5 10 ‐ 20
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 102
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
77371 39 39 236,100 6,053.8 6,458.9 6.3 75 ‐ 100
77399 60 60 4,070 67.8 246.4 72.5 50 ‐ 75
77401 462 462 34,970 75.7 77.5 2.3 20 ‐ 30
77403 712 712 53,930 75.7 77.2 1.9 30 ‐ 40
77404 509 509 36,920 72.5 74.7 2.9 30 ‐ 40
77406 10 10 1,500 150.0 135.1 11.0 75 ‐ 100
77408 413 413 32,120 77.8 76.1 2.2 30 ‐ 40
77409 107 107 7,500 70.1 72.7 3.6 50 ‐ 75
77412 287 287 36,800 128.2 129.4 0.9 40 ‐ 50
77413 45,958 46,054 5,718,060 124.2 126.6 1.9 5 ‐ 10
77414 41,334 41,411 4,917,150 118.7 125.1 5.1 5 ‐ 10
77416 6,936 6,938 844,050 121.7 130.6 6.8 10 ‐ 20
77417 130 130 5,280 40.6 52.9 23.3 50 ‐ 75
77418 54,620 54,706 18,541,650 338.9 347.2 2.4 10 ‐ 20
77421 133 133 19,250 144.7 137.6 5.2 75 ‐ 100
77427 46 46 9,200 200.0 177.1 12.9 50 ‐ 75
77470 2,748 2,748 854,200 310.8 309.6 0.4 10 ‐ 20
77522 582 582 494,700 850.0 835.8 1.7 5 ‐ 10
77750 2 2 200 100.0 123.9 19.3 75 ‐ 100
77778 25 25 17,000 680.0 840.3 19.1 50 ‐ 75
77785 645 689 325,700 472.7 483.1 2.2 20 ‐ 30
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 103
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
77786 314 409 196,000 479.2 490.0 2.2 30 ‐ 40
77787 42 47 23,900 508.5 502.7 1.2 50 ‐ 75
77790 4 4 1,250 312.5 328.0 4.7 75 ‐ 100
77799 11 11 2,750 250.0 241.9 3.3 30 ‐ 40
78000 29 29 2,340 80.7 81.5 1.0 50 ‐ 75
78001 33 33 2,670 80.9 82.7 2.2 50 ‐ 75
78006 602 602 91,750 152.4 150.6 1.2 10 ‐ 20
78007 936 936 142,210 151.9 152.9 0.7 10 ‐ 20
78010 162 162 14,790 91.3 90.4 1.0 40 ‐ 50
78015 1 1 200 200.0 195.1 2.5 50 ‐ 75
78018 388 388 79,400 204.6 205.8 0.6 10 ‐ 20
78070 904 904 138,190 152.9 153.2 0.2 10 ‐ 20
78102 17 17 2,700 158.8 169.6 6.4 50 ‐ 75
78104 1 1 150 150.0 168.6 11.0 75 ‐ 100
78195 1,147 1,147 188,000 163.9 171.4 4.4 5 ‐ 10
78201 11 11 2,200 200.0 186.6 7.2 50 ‐ 75
78202 1 1 200 200.0 218.8 8.6 75 ‐ 100
78205 21 21 4,200 200.0 190.0 5.3 50 ‐ 75
78206 3 3 600 200.0 184.7 8.3 75 ‐ 100
78215 96 96 18,550 193.2 183.8 5.1 40 ‐ 50
78220 47 47 8,900 189.4 180.7 4.8 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 104
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
78223 3,811 3,811 727,990 191.0 186.9 2.2 5 ‐ 10
78264 1,991 1,991 304,240 152.8 159.2 4.0 10 ‐ 20
78267 18 18 180 10.0 12.2 18.0 40 ‐ 50
78268 3 3 300 100.0 103.6 3.5 75 ‐ 100
78278 67 67 10,100 150.7 164.8 8.6 30 ‐ 40
78290 3 3 450 150.0 147.0 2.0 75 ‐ 100
78300 459 459 69,100 150.5 147.5 2.0 20 ‐ 30
78305 111 111 17,250 155.4 157.0 1.0 40 ‐ 50
78306 12,760 12,760 1,964,670 154.0 154.8 0.5 5 ‐ 10
78315 2,228 2,228 340,840 153.0 155.5 1.6 10 ‐ 20
78320 595 595 89,900 151.1 158.6 4.7 20 ‐ 30
78445 60 60 9,050 150.8 156.9 3.9 50 ‐ 75
78451 1,386 1,390 815,870 587.0 564.5 4.0 20 ‐ 30
78452 30,707 30,731 18,677,390 607.8 606.6 0.2 5 ‐ 10
78453 106 106 44,310 418.0 430.5 2.9 50 ‐ 75
78454 156 156 90,010 577.0 562.8 2.5 40 ‐ 50
78459 6 6 6,600 1,100.0 1,234.8 10.9 50 ‐ 75
78468 15 15 3,750 250.0 223.2 12.0 40 ‐ 50
78469 3 3 600 200.0 205.6 2.7 75 ‐ 100
78472 971 971 198,550 204.5 207.6 1.5 20 ‐ 30
78473 38 38 7,750 203.9 218.9 6.9 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 105
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
78483 4 4 800 200.0 199.9 0.1 75 ‐ 100
78492 458 458 514,400 1,123.1 1,138.6 1.4 20 ‐ 30
78494 23 23 4,800 208.7 208.9 0.1 50 ‐ 75
78499 12 14 2,800 200.0 188.0 6.4 50 ‐ 75
78580 470 470 64,550 137.3 134.4 2.2 30 ‐ 40
78584 47 47 9,400 200.0 195.3 2.4 50 ‐ 75
78585 1,113 1,113 223,550 200.9 210.6 4.6 20 ‐ 30
78586 2 2 300 150.0 137.6 9.0 50 ‐ 75
78587 97 97 12,850 132.5 140.0 5.4 50 ‐ 75
78588 839 839 170,650 203.4 201.3 1.0 20 ‐ 30
78593 128 128 17,800 139.1 130.7 6.4 40 ‐ 50
78594 43 43 5,500 127.9 132.0 3.1 50 ‐ 75
78596 123 123 24,950 202.8 201.9 0.4 40 ‐ 50
78607 31 31 14,750 475.8 461.9 3.0 50 ‐ 75
78608 74 74 60,500 817.6 870.6 6.1 40 ‐ 50
78630 66 66 29,750 450.8 455.9 1.1 40 ‐ 50
78645 28 28 3,300 117.9 137.5 14.3 30 ‐ 40
78707 313 313 75,800 242.2 238.8 1.4 30 ‐ 40
78708 427 427 104,250 244.1 240.6 1.5 20 ‐ 30
78709 65 65 16,000 246.2 235.3 4.6 50 ‐ 75
78725 13 13 1,950 150.0 136.6 9.8 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 106
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
78800 38 38 7,600 200.0 197.0 1.5 50 ‐ 75
78801 56 56 22,400 400.0 398.6 0.4 40 ‐ 50
78802 63 63 25,350 402.4 409.7 1.8 50 ‐ 75
78803 313 313 127,100 406.1 409.4 0.8 40 ‐ 50
78804 40 40 29,750 743.8 771.2 3.6 75 ‐ 100
78805 127 127 51,350 404.3 393.8 2.7 50 ‐ 75
78806 86 86 34,700 403.5 406.8 0.8 50 ‐ 75
78807 2 2 400 200.0 212.0 5.7 75 ‐ 100
78811 2 2 1,700 850.0 838.8 1.3 75 ‐ 100
78812 152 152 121,250 797.7 996.0 19.9 50 ‐ 75
78814 54 54 43,400 803.7 810.4 0.8 50 ‐ 75
78815 10,825 10,825 8,907,950 822.9 842.6 2.3 10 ‐ 20
78816 499 499 408,600 818.8 831.0 1.5 40 ‐ 50
78999 15 15 1,230 82.0 87.9 6.7 75 ‐ 100
79005 369 369 54,750 148.4 141.4 5.0 10 ‐ 20
79101 22 22 3,300 150.0 137.8 8.9 50 ‐ 75
79403 4 4 1,050 262.5 278.0 5.6 75 ‐ 100
79445 17 17 2,550 150.0 139.6 7.4 30 ‐ 40
80047 12,053 12,057 116,420 9.7 10.5 7.6 10 ‐ 20
80048 633,666 634,354 7,871,160 12.4 13.2 6.1 0 ‐ 5
80051 69,781 69,788 186,150 2.7 5.6 51.8 0 ‐ 5
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 107
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
80053 978,438 978,440 17,420,060 17.8 17.2 3.5 0 ‐ 5
80061 525,373 525,373 9,126,180 17.4 17.0 2.4 0 ‐ 5
80069 40,987 40,987 461,490 11.3 13.4 15.7 5 ‐ 10
80074 2,296 2,296 160,520 69.9 70.2 0.4 20 ‐ 30
80076 137,603 137,603 1,527,850 11.1 10.4 6.7 0 ‐ 5
80100 4,377 4,954 113,030 22.8 24.4 6.6 20 ‐ 30
80101 3,530 13,776 270,910 19.7 19.1 3.1 30 ‐ 40
80102 867 987 19,790 20.1 21.0 4.3 20 ‐ 30
80150 95 102 2,040 20.0 20.6 2.9 50 ‐ 75
80152 71 71 2,120 29.9 26.6 12.4 50 ‐ 75
80154 755 755 21,700 28.7 26.3 9.1 20 ‐ 30
80156 6,290 6,296 132,370 21.0 22.7 7.5 10 ‐ 20
80157 43 43 860 20.0 18.8 6.4 50 ‐ 75
80158 5,442 5,444 152,830 28.1 25.2 11.5 10 ‐ 20
80160 20 20 400 20.0 28.8 30.6 50 ‐ 75
80162 25,714 25,715 578,780 22.5 22.7 0.9 5 ‐ 10
80164 17,329 17,356 353,470 20.4 20.9 2.4 5 ‐ 10
80166 6 6 120 20.0 20.9 4.3 50 ‐ 75
80168 21 21 420 20.0 31.0 35.5 50 ‐ 75
80170 491 527 10,770 20.4 25.4 19.7 40 ‐ 50
80173 21 21 260 12.4 18.8 34.0 40 ‐ 50
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 108
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
80174 9 9 180 20.0 25.3 20.9 50 ‐ 75
80178 6,638 6,641 73,770 11.1 11.3 1.8 5 ‐ 10
80182 95 95 1,880 19.8 22.0 10.0 40 ‐ 50
80184 2,963 2,969 59,580 20.1 18.2 10.4 10 ‐ 20
80185 17,764 17,783 380,900 21.4 21.5 0.5 5 ‐ 10
80186 496 496 9,940 20.0 20.9 4.3 30 ‐ 40
80188 241 241 4,840 20.1 25.3 20.6 30 ‐ 40
80194 1 1 20 20.0 21.5 7.0 75 ‐ 100
80195 3,204 3,204 63,160 19.7 20.2 2.5 5 ‐ 10
80196 6,882 6,893 76,130 11.0 12.4 11.3 5 ‐ 10
80197 28,392 28,404 578,780 20.4 20.8 1.9 0 ‐ 5
80198 1,643 1,643 33,730 20.5 22.9 10.5 20 ‐ 30
80200 266 295 6,100 20.7 27.8 25.5 50 ‐ 75
80201 394 394 7,930 20.1 18.0 11.7 10 ‐ 20
80202 8,944 9,062 178,620 19.7 21.0 6.2 10 ‐ 20
80299 5,317 5,515 115,070 20.9 21.9 4.6 10 ‐ 20
80400 52 52 2,600 50.0 50.0 0.0 50 ‐ 75
80500 20 20 200 10.0 13.5 25.9 75 ‐ 100
81000 22,581 22,603 93,330 4.1 8.3 50.6 5 ‐ 10
81001 300,346 300,752 610,860 2.0 6.2 67.7 0 ‐ 5
81002 19,945 19,951 26,170 1.3 4.7 72.3 5 ‐ 10
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 109
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
81003 130,331 130,462 125,780 1.0 4.0 75.0 0 ‐ 5
81005 485 485 130 0.3 5.2 94.2 40 ‐ 50
81015 4,207 4,207 10,190 2.4 6.2 61.3 10 ‐ 20
81025 10,664 10,664 103,540 9.7 9.2 5.4 0 ‐ 5
81050 2,889 2,948 1,630 0.6 4.8 87.5 10 ‐ 20
82003 7,320 7,355 222,750 30.3 30.3 0.0 5 ‐ 10
82009 2,516 2,521 22,780 9.0 7.1 26.8 10 ‐ 20
82010 691 691 7,120 10.3 11.5 10.4 20 ‐ 30
82024 681 681 39,810 58.5 53.0 10.4 30 ‐ 40
82040 31,456 31,456 36,390 1.2 3.1 61.3 5 ‐ 10
82042 1,059 1,059 7,870 7.4 6.7 10.4 20 ‐ 30
82043 69,065 69,065 748,330 10.8 9.7 11.3 0 ‐ 5
82044 2,522 2,522 25,350 10.1 9.7 4.1 10 ‐ 20
82055 21,810 22,062 446,540 20.2 18.4 9.8 5 ‐ 10
82075 232 237 4,550 19.2 16.9 13.6 20 ‐ 30
82085 1,519 1,519 15,410 10.1 14.2 28.9 20 ‐ 30
82088 963 976 56,390 57.8 55.1 4.9 30 ‐ 40
82103 1,079 1,079 21,020 19.5 19.4 0.5 20 ‐ 30
82104 234 234 4,670 20.0 21.5 7.0 30 ‐ 40
82105 4,528 4,528 89,940 19.9 23.9 16.7 5 ‐ 10
82106 1 1 20 20.0 21.8 8.3 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 110
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
82107 20 20 1,600 80.0 80.5 0.6 50 ‐ 75
82108 539 539 18,210 33.8 32.0 5.6 10 ‐ 20
82127 2 2 40 20.0 19.8 1.0 75 ‐ 100
82131 240 240 4,800 20.0 28.5 29.8 40 ‐ 50
82135 5 5 100 20.0 23.0 13.0 75 ‐ 100
82136 1 1 20 20.0 20.9 4.3 75 ‐ 100
82139 25 25 500 20.0 22.5 11.1 75 ‐ 100
82140 7,472 7,473 152,540 20.4 22.3 8.5 10 ‐ 20
82145 168 168 3,310 19.7 21.8 9.6 30 ‐ 40
82150 64,564 64,650 774,560 12.0 11.9 0.8 0 ‐ 5
82157 20 20 800 40.0 41.5 3.6 50 ‐ 75
82164 1,211 1,211 24,130 19.9 20.8 4.3 20 ‐ 30
82172 269 288 5,720 19.9 21.7 8.3 30 ‐ 40
82175 267 267 7,460 27.9 25.6 9.0 50 ‐ 75
82180 70 70 700 10.0 14.9 32.9 50 ‐ 75
82190 3 3 60 20.0 20.4 2.0 75 ‐ 100
82205 141 141 2,790 19.8 16.7 18.6 40 ‐ 50
82232 4,558 4,558 90,810 19.9 23.6 15.7 10 ‐ 20
82239 14 14 170 12.1 17.5 30.9 50 ‐ 75
82247 28,826 28,828 13,180 0.5 2.5 80.0 5 ‐ 10
82248 34,153 34,153 28,830 0.8 4.4 81.8 5 ‐ 10
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 111
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
82270 7,801 7,801 10,850 1.4 6.0 76.7 10 ‐ 20
82271 170 170 180 1.1 6.3 82.5 50 ‐ 75
82272 6,276 6,276 9,800 1.6 6.1 73.8 10 ‐ 20
82274 3,230 3,230 62,730 19.4 21.8 11.0 10 ‐ 20
82300 54 54 1,500 27.8 27.9 0.4 50 ‐ 75
82306 129,517 129,517 5,207,830 40.2 42.7 5.9 0 ‐ 5
82308 147 147 5,860 39.9 37.9 5.3 50 ‐ 75
82310 40,240 40,288 59,590 1.5 3.3 54.5 0 ‐ 5
82330 6,841 6,851 58,730 8.6 8.2 4.9 20 ‐ 30
82340 1,755 1,755 18,080 10.3 9.4 9.6 10 ‐ 20
82355 181 181 3,530 19.5 19.9 2.0 10 ‐ 20
82360 503 503 9,630 19.1 20.3 5.9 10 ‐ 20
82365 1,037 1,039 20,120 19.4 18.7 3.7 10 ‐ 20
82370 88 88 1,760 20.0 19.8 1.0 10 ‐ 20
82373 2 2 40 20.0 24.1 17.0 75 ‐ 100
82374 20,085 20,085 3,880 0.2 1.7 88.2 5 ‐ 10
82375 2,147 2,153 39,700 18.4 16.2 13.6 30 ‐ 40
82376 47 47 470 10.0 9.1 9.9 50 ‐ 75
82378 20,138 20,138 626,360 31.1 29.0 7.2 5 ‐ 10
82379 53 53 1,060 20.0 23.8 16.0 50 ‐ 75
82380 43 43 430 10.0 13.9 28.1 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 112
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
82382 13 13 260 20.0 28.0 28.6 75 ‐ 100
82383 2 2 80 40.0 34.2 17.0 75 ‐ 100
82384 433 433 16,520 38.2 37.4 2.1 40 ‐ 50
82390 838 838 16,100 19.2 15.6 23.1 20 ‐ 30
82397 547 547 10,850 19.8 20.2 2.0 30 ‐ 40
82435 23,376 23,383 5,680 0.2 1.8 88.9 5 ‐ 10
82436 675 675 5,880 8.7 6.9 26.1 30 ‐ 40
82438 16 16 160 10.0 7.3 37.0 75 ‐ 100
82441 3 3 30 10.0 9.9 1.0 75 ‐ 100
82465 15,727 15,727 16,280 1.0 3.5 71.4 5 ‐ 10
82480 7 7 170 24.3 17.8 36.5 75 ‐ 100
82486 67 67 1,970 29.4 25.1 17.1 50 ‐ 75
82487 16 16 320 20.0 22.9 12.7 50 ‐ 75
82489 9 9 270 30.0 25.3 18.6 75 ‐ 100
82491 1,612 1,672 48,910 29.3 29.5 0.7 20 ‐ 30
82492 73 73 1,950 26.7 26.0 2.7 50 ‐ 75
82495 15 15 450 30.0 26.8 11.9 75 ‐ 100
82507 275 275 10,220 37.2 41.0 9.3 20 ‐ 30
82520 165 165 3,220 19.5 21.2 8.0 30 ‐ 40
82523 1,378 1,378 37,750 27.4 25.1 9.2 10 ‐ 20
82525 676 676 13,420 19.9 18.2 9.3 30 ‐ 40
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 113
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
82530 343 343 6,860 20.0 26.0 23.1 30 ‐ 40
82533 5,087 5,412 111,940 20.7 24.2 14.5 10 ‐ 20
82540 57 57 570 10.0 8.8 13.6 50 ‐ 75
82541 1,266 1,266 36,690 29.0 24.9 16.5 20 ‐ 30
82542 1,821 1,821 47,930 26.3 1.9 1,284.2 20 ‐ 30
82543 20 20 510 25.5 27.5 7.3 75 ‐ 100
82544 115 115 3,420 29.7 28.5 4.2 50 ‐ 75
82550 219,285 231,170 1,915,610 8.3 7.3 13.7 0 ‐ 5
82552 3,050 3,300 68,110 20.6 21.9 5.9 20 ‐ 30
82553 146,794 160,656 2,907,780 18.1 17.8 1.7 0 ‐ 5
82565 187,280 187,340 529,520 2.8 4.8 41.7 0 ‐ 5
82570 59,737 60,030 633,130 10.5 8.2 28.0 0 ‐ 5
82575 4,703 4,703 53,210 11.3 16.0 29.4 10 ‐ 20
82585 13 13 130 10.0 12.0 16.7 75 ‐ 100
82595 398 398 3,980 10.0 9.9 1.0 30 ‐ 40
82607 88,310 88,310 1,853,740 21.0 22.9 8.3 0 ‐ 5
82608 21 21 420 20.0 21.6 7.4 75 ‐ 100
82610 93 93 1,820 19.6 18.7 4.8 40 ‐ 50
82615 3 3 30 10.0 11.6 13.8 75 ‐ 100
82626 154 154 6,110 39.7 35.0 13.4 50 ‐ 75
82627 682 682 20,030 29.4 31.4 6.4 20 ‐ 30
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 114
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
82646 9 9 290 32.2 35.1 8.3 75 ‐ 100
82651 84 84 3,340 39.8 39.1 1.8 40 ‐ 50
82652 6,610 6,610 378,750 57.3 54.0 6.1 10 ‐ 20
82656 28 28 560 20.0 19.2 4.2 40 ‐ 50
82657 31 31 930 30.0 39.1 23.3 75 ‐ 100
82664 106 106 5,050 47.6 45.2 5.3 50 ‐ 75
82668 2,166 2,166 61,570 28.4 27.5 3.3 10 ‐ 20
82670 1,536 1,536 61,040 39.7 40.0 0.8 10 ‐ 20
82671 28 28 1,280 45.7 42.4 7.8 50 ‐ 75
82672 96 96 2,860 29.8 36.0 17.2 50 ‐ 75
82677 104 104 3,090 29.7 32.6 8.9 30 ‐ 40
82679 42 42 1,490 35.5 33.8 5.0 50 ‐ 75
82693 1 1 20 20.0 25.3 20.9 75 ‐ 100
82705 444 444 4,040 9.1 7.6 19.7 20 ‐ 30
82710 110 110 2,070 18.8 24.4 23.0 30 ‐ 40
82715 4 4 80 20.0 22.6 11.5 50 ‐ 75
82728 68,298 68,298 1,422,310 20.8 20.8 0.0 0 ‐ 5
82731 73 73 6,350 87.0 92.3 5.7 10 ‐ 20
82746 45,335 45,335 944,400 20.8 22.2 6.3 0 ‐ 5
82747 2,697 2,697 51,910 19.2 23.5 18.3 20 ‐ 30
82784 21,594 39,441 474,710 12.0 13.1 8.4 10 ‐ 20
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 115
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
82785 2,009 2,009 39,690 19.8 23.3 15.0 10 ‐ 20
82787 231 419 4,270 10.2 10.2 0.0 50 ‐ 75
82800 234 234 2,370 10.1 15.5 34.8 50 ‐ 75
82803 15,433 15,959 523,790 32.8 33.0 0.6 10 ‐ 20
82805 7,215 7,448 300,620 40.4 42.4 4.7 20 ‐ 30
82810 1,063 1,358 15,650 11.5 12.6 8.7 20 ‐ 30
82820 164 164 1,640 10.0 16.2 38.3 40 ‐ 50
82941 208 208 6,160 29.6 25.7 15.2 50 ‐ 75
82943 3 3 50 16.7 19.1 12.6 75 ‐ 100
82945 2,863 2,877 28,980 10.1 6.2 62.9 10 ‐ 20
82947 72,453 74,858 197,110 2.6 3.7 29.7 5 ‐ 10
82948 50,578 77,222 205,850 2.7 5.7 52.6 10 ‐ 20
82950 634 634 6,610 10.4 8.4 23.8 20 ‐ 30
82951 891 891 17,810 20.0 21.2 5.7 20 ‐ 30
82952 555 650 5,220 8.0 6.5 23.1 30 ‐ 40
82955 165 165 1,650 10.0 14.4 30.6 40 ‐ 50
82960 41 41 410 10.0 9.1 9.9 50 ‐ 75
82962 112,845 170,464 332,740 2.0 3.6 44.4 5 ‐ 10
82963 105 105 3,150 30.0 28.9 3.8 50 ‐ 75
82977 15,589 15,589 54,980 3.5 5.4 35.2 5 ‐ 10
82985 576 576 11,180 19.4 21.0 7.6 20 ‐ 30
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 116
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
83001 2,652 2,652 79,870 30.1 27.5 9.5 10 ‐ 20
83002 2,026 2,026 60,950 30.1 27.6 9.1 10 ‐ 20
83003 112 120 2,400 20.0 23.3 14.2 50 ‐ 75
83009 25 25 2,440 97.6 83.6 16.7 50 ‐ 75
83010 2,167 2,167 43,160 19.9 18.3 8.7 10 ‐ 20
83013 195 195 18,640 95.6 83.8 14.1 40 ‐ 50
83014 67 67 670 10.0 12.8 21.9 30 ‐ 40
83015 10 10 300 30.0 36.3 17.4 75 ‐ 100
83018 23 23 690 30.0 30.6 2.0 75 ‐ 100
83020 541 544 10,320 19.0 18.3 3.8 30 ‐ 40
83021 843 853 23,250 27.3 25.4 7.5 20 ‐ 30
83030 25 25 250 10.0 7.2 38.9 50 ‐ 75
83036 269,789 269,789 3,333,440 12.4 16.0 22.5 0 ‐ 5
83037 330 330 3,650 11.1 16.1 31.1 20 ‐ 30
83045 33 33 350 10.6 11.1 4.5 50 ‐ 75
83050 1,166 1,166 10,920 9.4 9.7 3.1 30 ‐ 40
83051 180 180 1,800 10.0 9.6 4.2 30 ‐ 40
83070 19 19 190 10.0 6.9 44.9 50 ‐ 75
83088 17 17 680 40.0 42.3 5.4 50 ‐ 75
83090 4,499 4,499 90,420 20.1 25.7 21.8 10 ‐ 20
83497 393 393 7,650 19.5 17.8 9.6 30 ‐ 40
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 117
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
83498 39 39 1,500 38.5 37.6 2.4 50 ‐ 75
83516 6,330 7,773 140,400 18.1 17.5 3.4 20 ‐ 30
83518 92 92 920 10.0 11.3 11.5 50 ‐ 75
83519 1,816 2,032 42,500 20.9 23.5 11.1 30 ‐ 40
83520 4,125 4,751 98,490 20.7 21.4 3.3 20 ‐ 30
83525 1,223 1,224 24,120 19.7 17.2 14.5 20 ‐ 30
83527 1 1 10 10.0 17.5 42.9 75 ‐ 100
83540 71,822 71,885 758,700 10.6 10.0 6.0 0 ‐ 5
83550 52,148 52,150 563,410 10.8 13.2 18.2 0 ‐ 5
83586 3 3 60 20.0 18.8 6.4 75 ‐ 100
83605 9,939 10,039 189,620 18.9 15.8 19.6 10 ‐ 20
83615 68,117 68,253 330,090 4.8 5.4 11.1 0 ‐ 5
83625 28 28 560 20.0 19.5 2.6 75 ‐ 100
83630 694 694 20,210 29.1 28.8 1.0 20 ‐ 30
83631 11 11 330 30.0 32.9 8.8 50 ‐ 75
83655 488 488 9,490 19.4 17.2 12.8 40 ‐ 50
83661 2 2 60 30.0 19.0 57.9 50 ‐ 75
83690 91,013 91,073 1,033,810 11.4 11.4 0.0 0 ‐ 5
83695 591 591 11,740 19.9 19.3 3.1 20 ‐ 30
83698 74 74 3,680 49.7 50.5 1.6 50 ‐ 75
83700 20 20 400 20.0 18.3 9.3 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 118
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
83701 1,158 1,158 37,210 32.1 30.2 6.3 20 ‐ 30
83704 819 819 38,050 46.5 42.7 8.9 10 ‐ 20
83718 7,612 7,612 82,240 10.8 12.7 15.0 5 ‐ 10
83721 25,283 25,283 309,690 12.2 15.5 21.3 0 ‐ 5
83735 162,697 163,217 1,766,060 10.8 10.1 6.9 0 ‐ 5
83785 9 9 340 37.8 31.3 20.8 75 ‐ 100
83789 408 411 12,210 29.7 28.2 5.3 40 ‐ 50
83825 331 331 6,490 19.6 22.1 11.3 40 ‐ 50
83835 895 903 18,450 20.4 27.5 25.8 20 ‐ 30
83840 270 273 5,220 19.1 22.2 14.0 30 ‐ 40
83872 25 25 250 10.0 8.7 14.9 50 ‐ 75
83873 74 74 1,480 20.0 24.9 19.7 50 ‐ 75
83874 41,622 44,739 1,023,600 22.9 22.9 0.0 5 ‐ 10
83876 23 23 1,140 49.6 47.3 4.9 75 ‐ 100
83880 99,916 99,916 5,268,200 52.7 52.7 0.0 0 ‐ 5
83883 9,513 13,588 262,670 19.3 19.3 0.0 10 ‐ 20
83887 161 161 4,620 28.7 32.2 10.9 30 ‐ 40
83890 1,137 1,187 11,330 9.5 6.9 37.7 30 ‐ 40
83891 2,819 3,003 27,190 9.1 7.3 24.7 20 ‐ 30
83892 855 1,035 8,630 8.3 6.5 27.7 40 ‐ 50
83893 13 29 200 6.9 13.1 47.3 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 119
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
83894 797 938 8,060 8.6 6.0 43.3 40 ‐ 50
83896 1,695 4,114 26,780 6.5 6.6 1.5 50 ‐ 75
83898 2,339 3,395 68,340 20.1 19.8 1.5 40 ‐ 50
83900 773 799 31,820 39.8 35.1 13.4 50 ‐ 75
83901 611 1,143 13,480 11.8 15.4 23.4 50 ‐ 75
83902 658 692 11,500 16.6 16.8 1.2 20 ‐ 30
83903 251 423 8,550 20.2 20.8 2.9 50 ‐ 75
83904 340 517 9,400 18.2 23.1 21.2 50 ‐ 75
83907 258 261 5,050 19.3 17.6 9.7 40 ‐ 50
83908 145 177 3,570 20.2 20.7 2.4 50 ‐ 75
83909 661 789 14,100 17.9 19.4 7.7 50 ‐ 75
83912 3,169 3,170 30,360 9.6 8.2 17.1 20 ‐ 30
83913 77 77 1,480 19.2 17.3 11.0 40 ‐ 50
83914 134 312 6,220 19.9 15.9 25.2 75 ‐ 100
83915 18 18 360 20.0 17.1 17.0 75 ‐ 100
83916 164 166 4,950 29.8 29.2 2.1 40 ‐ 50
83918 115 115 2,300 20.0 28.7 30.3 50 ‐ 75
83919 2 2 40 20.0 23.6 15.3 50 ‐ 75
83921 3,573 3,573 72,100 20.2 27.2 25.7 10 ‐ 20
83925 1,837 2,074 60,730 29.3 28.1 4.3 10 ‐ 20
83930 1,618 1,618 16,530 10.2 10.1 1.0 20 ‐ 30
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 120
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
83935 1,688 1,688 17,460 10.3 10.5 1.9 20 ‐ 30
83937 191 191 7,040 36.9 38.2 3.4 30 ‐ 40
83945 282 282 5,500 19.5 20.0 2.5 20 ‐ 30
83950 5 5 450 90.0 92.3 2.5 50 ‐ 75
83951 8 8 720 90.0 89.7 0.3 30 ‐ 40
83970 44,767 45,068 2,702,270 60.0 59.4 1.0 0 ‐ 5
83986 797 797 5,790 7.3 5.4 35.2 30 ‐ 40
83992 48 48 960 20.0 21.7 7.8 40 ‐ 50
83993 6 6 180 30.0 34.9 14.0 50 ‐ 75
84022 5 5 100 20.0 23.9 16.3 75 ‐ 100
84030 6 6 60 10.0 42.6 76.5 50 ‐ 75
84060 85 85 850 10.0 11.1 9.9 30 ‐ 40
84066 245 245 3,100 12.7 15.9 20.1 10 ‐ 20
84075 32,028 32,028 19,670 0.6 2.7 77.8 5 ‐ 10
84078 39 39 390 10.0 11.9 16.0 50 ‐ 75
84080 779 779 13,750 17.7 19.8 10.6 30 ‐ 40
84081 1 1 20 20.0 21.4 6.5 75 ‐ 100
84100 97,438 97,529 68,100 0.7 4.1 82.9 0 ‐ 5
84105 408 408 4,100 10.0 8.0 25.0 20 ‐ 30
84110 14 14 140 10.0 12.5 20.0 50 ‐ 75
84120 27 27 540 20.0 23.3 14.2 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 121
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
84132 68,252 68,492 293,210 4.3 4.6 6.5 0 ‐ 5
84133 1,175 1,175 11,690 9.9 6.6 50.0 20 ‐ 30
84134 8,817 8,817 158,990 18.0 19.3 6.7 10 ‐ 20
84140 14 14 420 30.0 32.1 6.5 75 ‐ 100
84144 528 528 15,670 29.7 29.8 0.3 30 ‐ 40
84145 70 70 2,100 30.0 27.8 7.9 50 ‐ 75
84146 3,273 3,273 98,940 30.2 29.2 3.4 10 ‐ 20
84152 839 839 26,370 31.4 31.2 0.6 20 ‐ 30
84153 67,478 67,478 2,112,610 31.3 28.4 10.2 0 ‐ 5
84154 5,538 5,538 165,030 29.8 27.1 10.0 5 ‐ 10
84155 21,055 21,055 26,460 1.3 2.4 45.8 5 ‐ 10
84156 26,803 26,803 278,660 10.4 6.3 65.1 0 ‐ 5
84157 3,214 3,215 32,530 10.1 6.1 65.6 10 ‐ 20
84160 770 770 7,680 10.0 7.3 37.0 20 ‐ 30
84163 22 22 420 19.1 19.4 1.5 5 ‐ 10
84165 21,611 21,611 440,640 20.4 16.7 22.2 5 ‐ 10
84166 4,278 4,279 124,350 29.1 25.8 12.8 10 ‐ 20
84181 29 29 580 20.0 25.7 22.2 75 ‐ 100
84182 55 55 1,700 30.9 31.1 0.6 50 ‐ 75
84202 4 4 80 20.0 21.3 6.1 75 ‐ 100
84206 16 16 480 30.0 29.6 1.4 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 122
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
84207 750 750 27,870 37.2 37.9 1.8 40 ‐ 50
84210 2 2 40 20.0 14.8 35.1 75 ‐ 100
84233 33 33 2,930 88.8 89.5 0.8 30 ‐ 40
84234 27 27 2,370 87.8 88.6 0.9 30 ‐ 40
84235 4 4 280 70.0 70.0 0.0 75 ‐ 100
84238 414 415 20,670 49.8 52.1 4.4 40 ‐ 50
84244 917 917 26,690 29.1 30.5 4.6 20 ‐ 30
84252 18 18 530 29.4 27.3 7.7 75 ‐ 100
84255 71 71 2,830 39.9 33.8 18.0 50 ‐ 75
84260 108 108 3,770 34.9 33.7 3.6 50 ‐ 75
84270 1,474 1,474 40,550 27.5 27.9 1.4 20 ‐ 30
84295 33,817 33,850 32,350 1.0 2.7 63.0 5 ‐ 10
84300 3,425 3,425 33,520 9.8 7.6 28.9 10 ‐ 20
84302 28 28 280 10.0 7.2 38.9 75 ‐ 100
84305 552 552 15,260 27.6 29.1 5.2 30 ‐ 40
84307 1 1 30 30.0 26.4 13.6 75 ‐ 100
84311 171 171 1,770 10.4 11.0 5.5 50 ‐ 75
84315 92 92 0 0.0 3.7 100.0 40 ‐ 50
84376 4 4 40 10.0 10.8 7.4 75 ‐ 100
84378 103 103 1,830 17.8 15.8 12.7 40 ‐ 50
84392 62 62 620 10.0 11.1 9.9 20 ‐ 30
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 123
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
84402 4,276 4,276 160,130 37.4 35.2 6.3 10 ‐ 20
84403 15,406 15,421 598,470 38.8 36.6 6.0 5 ‐ 10
84425 1,354 1,354 37,220 27.5 29.3 6.1 20 ‐ 30
84431 3 3 60 20.0 18.5 8.1 50 ‐ 75
84432 1,674 1,674 32,410 19.4 22.2 12.6 10 ‐ 20
84436 29,299 29,299 321,150 11.0 11.1 0.9 0 ‐ 5
84439 104,714 104,714 1,262,660 12.1 15.0 19.3 0 ‐ 5
84442 51 51 1,020 20.0 22.5 11.1 50 ‐ 75
84443 391,054 391,160 8,777,880 22.4 26.3 14.8 0 ‐ 5
84445 237 237 15,140 63.9 62.5 2.2 50 ‐ 75
84446 440 440 8,720 19.8 20.7 4.3 30 ‐ 40
84450 91,233 91,233 171,100 1.9 4.5 57.8 0 ‐ 5
84460 105,797 105,797 255,970 2.4 4.8 50.0 0 ‐ 5
84466 13,470 13,470 269,460 20.0 18.6 7.5 5 ‐ 10
84478 10,057 10,057 20,390 2.0 2.2 9.1 10 ‐ 20
84479 9,326 9,326 99,390 10.7 10.5 1.9 5 ‐ 10
84480 12,356 12,356 248,720 20.1 20.8 3.4 5 ‐ 10
84481 12,972 12,972 270,510 20.9 24.7 15.4 10 ‐ 20
84482 133 133 2,490 18.7 25.3 26.1 50 ‐ 75
84484 249,902 278,738 4,200,620 15.1 18.4 17.9 0 ‐ 5
84510 5 5 50 10.0 13.6 26.5 40 ‐ 50
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 124
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
84512 849 867 17,820 20.6 30.8 33.1 40 ‐ 50
84520 132,811 133,142 122,630 0.9 3.1 71.0 0 ‐ 5
84525 4 4 40 10.0 5.4 85.2 75 ‐ 100
84540 624 628 6,220 9.9 7.0 41.4 30 ‐ 40
84545 172 172 1,690 9.8 8.8 11.4 20 ‐ 30
84550 72,721 72,721 160,950 2.2 4.8 54.2 0 ‐ 5
84560 606 606 6,060 10.0 8.6 16.3 30 ‐ 40
84585 217 217 4,220 19.4 22.5 13.8 40 ‐ 50
84586 22 22 860 39.1 36.6 6.8 50 ‐ 75
84588 17 17 840 49.4 48.5 1.9 75 ‐ 100
84590 429 429 8,340 19.4 18.0 7.8 30 ‐ 40
84591 46 46 890 19.3 17.5 10.3 50 ‐ 75
84597 33 33 660 20.0 24.5 18.4 50 ‐ 75
84600 120 120 2,400 20.0 24.0 16.7 40 ‐ 50
84630 859 859 14,800 17.2 16.0 7.5 30 ‐ 40
84681 1,763 1,763 48,600 27.6 27.9 1.1 10 ‐ 20
84702 728 728 13,070 18.0 19.9 9.5 10 ‐ 20
84703 7,771 7,771 83,690 10.8 11.8 8.5 0 ‐ 5
84704 2 2 40 20.0 26.0 23.1 75 ‐ 100
84999 17 17 8,170 480.6 242.6 98.1 75 ‐ 100
85002 745 745 10,990 14.8 12.5 18.4 30 ‐ 40
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 125
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
85004 1,545 1,545 16,060 10.4 11.2 7.1 20 ‐ 30
85007 48,395 48,396 136,000 2.8 6.9 59.4 5 ‐ 10
85008 288 288 1,480 5.1 9.2 44.6 50 ‐ 75
85009 10 10 100 10.0 11.6 13.8 75 ‐ 100
85013 37 37 20 0.5 5.2 90.4 75 ‐ 100
85014 47,506 48,162 50,630 1.1 4.1 73.2 0 ‐ 5
85018 50,530 51,143 68,730 1.3 4.5 71.1 0 ‐ 5
85025 1,258,721 1,259,788 14,964,970 11.9 12.8 7.0 0 ‐ 5
85027 299,731 300,071 3,321,150 11.1 10.4 6.7 0 ‐ 5
85032 27 27 410 15.2 22.0 30.9 75 ‐ 100
85041 47 47 10 0.2 4.7 95.7 50 ‐ 75
85044 3,078 3,078 32,270 10.5 8.0 31.3 10 ‐ 20
85045 14,582 14,582 150,210 10.3 6.6 56.1 5 ‐ 10
85046 2,709 2,709 27,250 10.1 8.1 24.7 10 ‐ 20
85048 3,689 3,689 6,310 1.7 5.7 70.2 10 ‐ 20
85049 6,657 6,680 66,890 10.0 6.8 47.1 10 ‐ 20
85055 10 10 380 38.0 32.7 16.2 75 ‐ 100
85060 7 7 160 22.9 29.1 21.3 75 ‐ 100
85097 1,413 1,416 32,910 23.2 25.2 7.9 10 ‐ 20
85130 2 2 20 10.0 30.7 67.4 75 ‐ 100
85210 25 25 330 13.2 17.5 24.6 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 126
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
85220 16 16 480 30.0 27.6 8.7 75 ‐ 100
85230 7 7 210 30.0 27.9 7.5 75 ‐ 100
85240 313 313 7,980 25.5 23.8 7.1 40 ‐ 50
85244 3 3 90 30.0 36.2 17.1 75 ‐ 100
85245 118 118 3,300 28.0 29.7 5.7 50 ‐ 75
85246 114 114 3,020 26.5 30.1 12.0 50 ‐ 75
85247 35 35 1,010 28.9 28.9 0.0 50 ‐ 75
85250 44 44 1,260 28.6 25.8 10.9 50 ‐ 75
85260 20 20 600 30.0 30.8 2.6 75 ‐ 100
85270 31 31 930 30.0 25.1 19.5 50 ‐ 75
85280 5 5 150 30.0 25.7 16.7 75 ‐ 100
85291 1 1 10 10.0 12.2 18.0 75 ‐ 100
85300 492 494 9,380 19.0 17.7 7.3 40 ‐ 50
85301 49 49 980 20.0 18.2 9.9 50 ‐ 75
85302 130 130 2,600 20.0 22.1 9.5 50 ‐ 75
85303 563 563 11,340 20.1 23.5 14.5 30 ‐ 40
85305 201 201 4,100 20.4 20.6 1.0 40 ‐ 50
85306 536 538 10,760 20.0 24.9 19.7 30 ‐ 40
85307 141 141 2,820 20.0 23.8 16.0 50 ‐ 75
85335 47 47 940 20.0 19.6 2.0 50 ‐ 75
85345 5 5 0 0.0 5.6 100.0 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 127
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
85347 4,956 7,238 53,890 7.4 6.0 23.3 5 ‐ 10
85348 88 104 880 8.5 5.5 54.5 20 ‐ 30
85362 80 80 850 10.6 14.4 26.4 50 ‐ 75
85370 3 3 30 10.0 19.9 49.7 75 ‐ 100
85378 4,190 4,190 60,170 14.4 17.9 19.6 10 ‐ 20
85379 25,029 25,038 360,810 14.4 18.8 23.4 5 ‐ 10
85380 1,330 1,330 16,020 12.0 17.6 31.8 20 ‐ 30
85384 2,033 2,035 20,410 10.0 12.7 21.3 20 ‐ 30
85385 6 6 60 10.0 12.3 18.7 75 ‐ 100
85390 13 13 130 10.0 7.0 42.9 75 ‐ 100
85397 1 1 30 30.0 25.4 18.1 75 ‐ 100
85420 11 11 110 10.0 11.9 16.0 75 ‐ 100
85460 10 10 100 10.0 9.7 3.1 50 ‐ 75
85461 1 1 10 10.0 7.0 42.9 50 ‐ 75
85520 261 261 5,190 19.9 19.6 1.5 50 ‐ 75
85525 53 53 1,060 20.0 16.2 23.5 50 ‐ 75
85536 21 21 210 10.0 9.5 5.3 50 ‐ 75
85540 89 89 890 10.0 14.6 31.5 40 ‐ 50
85549 13 13 390 30.0 24.5 22.4 75 ‐ 100
85576 2,533 2,897 86,270 29.8 30.0 0.7 30 ‐ 40
85597 142 142 3,860 27.2 21.6 25.9 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 128
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
85610 849,395 850,782 9,407,430 11.1 7.3 52.1 0 ‐ 5
85611 60 60 760 12.7 8.5 49.4 50 ‐ 75
85612 12 12 130 10.8 12.9 16.3 75 ‐ 100
85613 1,011 1,011 10,400 10.3 13.5 23.7 20 ‐ 30
85651 45,250 45,250 480,310 10.6 6.6 60.6 0 ‐ 5
85652 41,598 41,598 37,690 0.9 4.9 81.6 0 ‐ 5
85660 417 428 4,290 10.0 8.1 23.5 20 ‐ 30
85670 225 225 2,250 10.0 9.2 8.7 50 ‐ 75
85705 45 45 450 10.0 14.8 32.4 50 ‐ 75
85730 154,282 155,236 1,708,420 11.0 10.0 10.0 0 ‐ 5
85732 349 350 3,500 10.0 10.8 7.4 40 ‐ 50
85810 223 223 4,170 18.7 16.9 10.7 30 ‐ 40
86000 2 2 20 10.0 8.7 14.9 75 ‐ 100
86001 13 27 230 8.5 8.7 2.3 75 ‐ 100
86003 1,507 5,531 44,160 8.0 7.7 3.9 50 ‐ 75
86005 4 4 40 10.0 10.4 3.8 75 ‐ 100
86021 901 901 17,460 19.4 22.7 14.5 40 ‐ 50
86022 235 235 6,220 26.5 27.8 4.7 50 ‐ 75
86023 67 82 1,600 19.5 21.7 10.1 50 ‐ 75
86038 21,084 21,084 423,880 20.1 18.4 9.2 5 ‐ 10
86039 3,869 3,869 77,080 19.9 17.0 17.1 10 ‐ 20
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 129
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
86060 252 252 2,560 10.2 12.4 17.7 40 ‐ 50
86063 39 39 390 10.0 9.5 5.3 50 ‐ 75
86077 2 2 20 10.0 13.9 28.1 75 ‐ 100
86078 3 3 60 20.0 25.0 20.0 75 ‐ 100
86140 50,129 50,129 544,770 10.9 8.9 22.5 0 ‐ 5
86141 12,131 12,131 247,250 20.4 19.7 3.6 5 ‐ 10
86146 166 291 9,110 31.3 27.4 14.2 75 ‐ 100
86147 967 1,520 43,690 28.7 27.1 5.9 50 ‐ 75
86148 74 74 1,480 20.0 21.9 8.7 50 ‐ 75
86156 15 15 150 10.0 8.9 12.4 75 ‐ 100
86157 53 53 530 10.0 12.3 18.7 50 ‐ 75
86160 4,708 6,974 117,030 16.8 17.7 5.1 20 ‐ 30
86161 120 150 2,690 17.9 17.4 2.9 50 ‐ 75
86162 642 642 19,090 29.7 29.1 2.1 30 ‐ 40
86171 50 50 500 10.0 14.1 29.1 50 ‐ 75
86200 3,087 3,087 62,100 20.1 20.0 0.5 10 ‐ 20
86215 6 6 120 20.0 18.1 10.5 75 ‐ 100
86225 3,751 3,751 75,160 20.0 20.1 0.5 10 ‐ 20
86226 13 13 260 20.0 17.9 11.7 75 ‐ 100
86235 4,529 7,997 210,750 26.4 24.2 9.1 30 ‐ 40
86255 3,566 3,620 69,100 19.1 18.1 5.5 20 ‐ 30
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 130
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
86256 1,425 1,582 30,270 19.1 18.9 1.1 40 ‐ 50
86294 29 29 870 30.0 27.1 10.7 50 ‐ 75
86300 10,348 10,624 320,980 30.2 30.5 1.0 5 ‐ 10
86301 2,407 2,407 72,120 30.0 30.5 1.6 10 ‐ 20
86304 6,540 6,540 198,530 30.4 31.0 1.9 5 ‐ 10
86305 31 31 930 30.0 32.7 8.3 40 ‐ 50
86308 634 634 6,730 10.6 10.1 5.0 20 ‐ 30
86316 1,187 1,202 33,790 28.1 30.6 8.2 20 ‐ 30
86317 689 952 19,480 20.5 19.7 4.1 50 ‐ 75
86318 241 241 4,890 20.3 23.0 11.7 50 ‐ 75
86320 694 694 20,820 30.0 34.1 12.0 20 ‐ 30
86325 235 235 7,050 30.0 32.8 8.5 40 ‐ 50
86329 12 12 240 20.0 21.3 6.1 75 ‐ 100
86331 108 130 2,430 18.7 15.3 22.2 50 ‐ 75
86332 6 6 180 30.0 32.1 6.5 75 ‐ 100
86334 9,868 9,868 296,670 30.1 32.7 8.0 5 ‐ 10
86335 3,330 3,332 133,420 40.0 42.1 5.0 10 ‐ 20
86336 106 106 2,130 20.1 23.3 13.7 20 ‐ 30
86337 35 35 1,040 29.7 31.4 5.4 40 ‐ 50
86340 188 188 3,730 19.8 21.5 7.9 40 ‐ 50
86341 162 162 4,290 26.5 26.6 0.4 30 ‐ 40
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 131
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
86343 10 10 200 20.0 18.3 9.3 50 ‐ 75
86352 582 582 58,160 99.9 97.3 2.7 10 ‐ 20
86353 477 478 32,510 68.0 67.3 1.0 20 ‐ 30
86355 739 739 32,160 43.5 44.0 1.1 20 ‐ 30
86356 91 91 1,250 13.7 22.0 37.7 50 ‐ 75
86357 620 620 27,010 43.6 44.3 1.6 20 ‐ 30
86359 3,089 3,089 140,330 45.4 47.7 4.8 10 ‐ 20
86360 4,271 4,271 259,150 60.7 57.9 4.8 10 ‐ 20
86361 1,453 1,453 61,750 42.5 40.8 4.2 10 ‐ 20
86367 114 119 5,820 48.9 51.3 4.7 40 ‐ 50
86376 3,202 3,206 63,750 19.9 21.1 5.7 10 ‐ 20
86382 3 3 60 20.0 24.0 16.7 75 ‐ 100
86384 1 1 20 20.0 16.3 22.7 75 ‐ 100
86403 643 654 6,730 10.3 15.3 32.7 40 ‐ 50
86406 4 4 80 20.0 14.9 34.2 75 ‐ 100
86430 6,012 6,012 64,850 10.8 9.8 10.2 10 ‐ 20
86431 9,057 9,063 94,120 10.4 9.2 13.0 5 ‐ 10
86480 541 541 47,160 87.2 84.0 3.8 30 ‐ 40
86485 4 4 0 0.0 3.4 100.0 75 ‐ 100
86510 22 22 0 0.0 4.0 100.0 75 ‐ 100
86580 1,808 1,808 7,760 4.3 5.7 24.6 10 ‐ 20
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 132
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
86592 8,956 8,962 89,400 10.0 6.7 49.3 5 ‐ 10
86593 283 283 2,830 10.0 6.5 53.8 30 ‐ 40
86606 142 149 2,650 17.8 18.1 1.7 50 ‐ 75
86609 12 38 700 18.4 17.4 5.7 75 ‐ 100
86611 8 8 80 10.0 15.5 35.5 75 ‐ 100
86612 86 86 1,570 18.3 17.1 7.0 50 ‐ 75
86615 54 87 1,670 19.2 19.8 3.0 50 ‐ 75
86617 933 1,135 22,700 20.0 26.5 24.5 40 ‐ 50
86618 4,657 4,685 95,820 20.5 25.4 19.3 20 ‐ 30
86622 5 5 50 10.0 12.5 20.0 75 ‐ 100
86625 18 18 350 19.4 17.3 12.1 50 ‐ 75
86631 19 23 440 19.1 15.8 20.9 75 ‐ 100
86632 6 10 180 18.0 17.6 2.3 75 ‐ 100
86635 381 417 7,650 18.3 15.5 18.1 50 ‐ 75
86638 4 4 80 20.0 19.6 2.0 75 ‐ 100
86641 1 1 20 20.0 16.3 22.7 75 ‐ 100
86644 1,120 1,120 22,320 19.9 20.8 4.3 20 ‐ 30
86645 345 345 6,330 18.3 21.3 14.1 30 ‐ 40
86648 19 19 330 17.4 20.1 13.4 75 ‐ 100
86663 210 210 4,150 19.8 20.5 3.4 40 ‐ 50
86664 377 377 7,410 19.7 21.2 7.1 30 ‐ 40
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 133
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
86665 656 793 20,970 26.4 25.8 2.3 50 ‐ 75
86666 187 229 2,630 11.5 20.7 44.4 50 ‐ 75
86671 50 57 1,040 18.2 15.9 14.5 75 ‐ 100
86674 40 40 840 21.0 29.8 29.5 50 ‐ 75
86677 5,105 5,315 110,700 20.8 23.3 10.7 10 ‐ 20
86682 13 13 260 20.0 17.3 15.6 75 ‐ 100
86684 13 13 230 17.7 20.2 12.4 50 ‐ 75
86687 127 127 1,270 10.0 12.3 18.7 30 ‐ 40
86688 55 55 1,100 20.0 17.6 13.6 40 ‐ 50
86689 39 39 1,160 29.7 28.7 3.5 50 ‐ 75
86692 9 9 180 20.0 22.4 10.7 50 ‐ 75
86694 270 287 5,670 19.8 20.2 2.0 40 ‐ 50
86695 432 439 8,680 19.8 19.2 3.1 30 ‐ 40
86696 397 401 11,960 29.8 27.6 8.0 30 ‐ 40
86698 96 106 1,950 18.4 16.8 9.5 50 ‐ 75
86701 196 196 1,960 10.0 15.3 34.6 40 ‐ 50
86703 1,431 1,431 28,010 19.6 19.5 0.5 20 ‐ 30
86704 3,630 3,630 72,370 19.9 17.6 13.1 10 ‐ 20
86705 767 767 15,340 20.0 17.7 13.0 20 ‐ 30
86706 6,509 6,523 123,330 18.9 15.8 19.6 10 ‐ 20
86707 232 232 4,540 19.6 16.9 16.0 40 ‐ 50
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 134
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
HCPCS Code(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
86708 2,113 2,113 42,460 20.1 18.2 10.4 10 ‐ 20
86709 1,006 1,006 20,110 20.0 16.6 20.5 20 ‐ 30
86710 62 66 1,320 20.0 23.1 13.4 50 ‐ 75
86713 20 22 440 20.0 22.5 11.1 75 ‐ 100
86735 123 123 2,040 16.6 15.6 6.4 50 ‐ 75
86738 243 250 5,100 20.4 23.9 14.6 50 ‐ 75
86747 84 100 1,810 18.1 20.1 10.0 50 ‐ 75
86753 51 51 830 16.3 19.4 16.0 75 ‐ 100
86757 94 110 3,280 29.8 31.0 3.9 50 ‐ 75
86759 13 13 260 20.0 19.2 4.2 50 ‐ 75
86762 422 422 8,220 19.5 19.9 2.0 30 ‐ 40
86765 154 154 2,840 18.4 17.5 5.1 40 ‐ 50
86774 45 45 820 18.2 19.6 7.1 50 ‐ 75
86777 246 246 4,850 19.7 20.2 2.5 30 ‐ 40
86778 75 75 1,430 19.1 19.2 0.5 50 ‐ 75
86780 839 840 16,410 19.5 18.5 5.4 30 ‐ 40
86787 706 712 12,880 18.1 17.5 3.4 30 ‐ 40
86788 17 17 340 20.0 24.1 17.0 75 ‐ 100
86789 34 34 680 20.0 22.0 9.1 50 ‐ 75
86790 100 100 1,950 19.5 18.1 7.7 50 ‐ 75
86800 3,112 3,112 60,890 19.6 22.1 11.3 10 ‐ 20
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 135
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
HCPCS Code(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
86803 7,640 7,640 154,120 20.2 20.8 2.9 10 ‐ 20
86804 127 127 2,540 20.0 26.4 24.2 40 ‐ 50
86805 18 20 1,380 69.0 59.3 16.4 50 ‐ 75
86806 3 6 300 50.0 54.0 7.4 75 ‐ 100
86807 1,215 1,280 75,030 58.6 57.5 1.9 10 ‐ 20
86808 294 294 11,760 40.0 42.6 6.1 20 ‐ 30
86812 400 400 15,990 40.0 38.8 3.1 30 ‐ 40
86813 128 128 10,140 79.2 84.3 6.0 30 ‐ 40
86816 1 1 40 40.0 39.9 0.3 75 ‐ 100
86817 52 52 4,670 89.8 98.3 8.6 50 ‐ 75
86822 2 2 100 50.0 52.4 4.6 50 ‐ 75
86825 7 7 700 100.0 98.2 1.8 75 ‐ 100
86850 57,995 58,743 647,460 11.0 13.2 16.7 0 ‐ 5
86860 208 209 4,180 20.0 20.9 4.3 30 ‐ 40
86870 2,739 2,940 60,460 20.6 22.6 8.8 20 ‐ 30
86880 2,561 3,027 27,440 9.1 6.6 37.9 20 ‐ 30
86885 4,773 4,829 47,900 9.9 6.5 52.3 10 ‐ 20
86886 408 408 4,080 10.0 6.8 47.1 40 ‐ 50
86890 144 146 6,700 45.9 45.7 0.4 40 ‐ 50
86900 66,445 67,245 662,080 9.8 6.3 55.6 0 ‐ 5
86901 64,156 64,475 639,680 9.9 6.3 57.1 0 ‐ 5
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 136
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
HCPCS Code(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
86903 2,271 4,828 54,160 11.2 12.7 11.8 30 ‐ 40
86904 65 78 780 10.0 14.6 31.5 50 ‐ 75
86905 955 1,531 16,580 10.8 13.1 17.6 40 ‐ 50
86906 33 33 330 10.0 17.0 41.2 50 ‐ 75
86920 24,017 36,759 421,800 11.5 13.7 16.1 10 ‐ 20
86921 1,560 2,240 25,880 11.6 14.9 22.1 30 ‐ 40
86922 7,887 12,344 280,520 22.7 24.6 7.7 20 ‐ 30
86923 5,565 8,960 99,000 11.0 12.2 9.8 20 ‐ 30
86927 59 69 690 10.0 13.3 24.8 75 ‐ 100
86940 17 17 170 10.0 12.6 20.6 75 ‐ 100
86941 14 14 280 20.0 18.4 8.7 75 ‐ 100
86945 1,981 2,662 31,540 11.8 16.9 30.2 20 ‐ 30
86960 14 14 140 10.0 13.4 25.4 75 ‐ 100
86965 246 246 4,920 20.0 20.6 2.9 40 ‐ 50
86970 14 14 140 10.0 19.6 49.0 75 ‐ 100
86971 2 2 20 10.0 17.6 43.2 75 ‐ 100
86972 4 4 40 10.0 12.4 19.4 75 ‐ 100
86975 2 4 140 35.0 41.6 15.9 75 ‐ 100
86977 85 87 3,560 40.9 40.5 1.0 30 ‐ 40
86978 37 39 780 20.0 26.4 24.2 50 ‐ 75
86985 5 5 60 12.0 17.0 29.4 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 137
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
HCPCS Code(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
86999 71 97 970 10.0 32.3 69.0 75 ‐ 100
87015 6,272 6,550 62,970 9.6 9.4 2.1 10 ‐ 20
87040 58,501 75,917 1,281,170 16.9 20.3 16.7 5 ‐ 10
87045 11,704 11,776 140,990 12.0 15.9 24.5 5 ‐ 10
87046 9,437 12,808 155,800 12.2 13.7 10.9 10 ‐ 20
87070 59,594 60,885 693,710 11.4 14.7 22.4 5 ‐ 10
87071 1,557 1,563 15,810 10.1 15.8 36.1 30 ‐ 40
87073 275 276 2,770 10.0 17.3 42.2 50 ‐ 75
87075 11,341 11,590 123,970 10.7 15.1 29.1 10 ‐ 20
87076 1,165 1,223 12,620 10.3 12.9 20.2 30 ‐ 40
87077 83,656 92,769 1,008,570 10.9 12.2 10.7 5 ‐ 10
87081 14,895 15,137 158,530 10.5 10.4 1.0 10 ‐ 20
87084 20 20 340 17.0 17.2 1.2 50 ‐ 75
87086 169,179 169,446 1,960,880 11.6 13.2 12.1 0 ‐ 5
87088 62,059 63,248 735,100 11.6 13.2 12.1 0 ‐ 5
87101 570 570 5,700 10.0 12.0 16.7 30 ‐ 40
87102 7,216 7,487 75,480 10.1 12.4 18.5 10 ‐ 20
87103 90 90 900 10.0 14.6 31.5 50 ‐ 75
87106 1,083 1,107 11,330 10.2 14.7 30.6 30 ‐ 40
87107 274 282 2,900 10.3 14.9 30.9 40 ‐ 50
87109 22 22 440 20.0 22.1 9.5 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 138
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
HCPCS Code(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
87110 18 18 540 30.0 29.1 3.1 75 ‐ 100
87116 6,410 6,708 124,110 18.5 16.6 11.4 10 ‐ 20
87118 125 125 2,370 19.0 16.5 15.2 50 ‐ 75
87140 17 18 180 10.0 8.7 14.9 75 ‐ 100
87143 18 21 420 20.0 19.2 4.2 75 ‐ 100
87147 6,482 6,999 66,250 9.5 7.8 21.8 10 ‐ 20
87149 90 94 2,820 30.0 29.0 3.4 50 ‐ 75
87153 1 1 150 150.0 124.7 20.3 75 ‐ 100
87158 19 19 190 10.0 7.8 28.2 75 ‐ 100
87168 5 5 50 10.0 6.1 63.9 75 ‐ 100
87169 1 1 10 10.0 7.0 42.9 75 ‐ 100
87172 12 12 120 10.0 6.5 53.8 50 ‐ 75
87176 776 783 7,830 10.0 9.4 6.4 30 ‐ 40
87177 6,070 6,245 72,610 11.6 14.9 22.1 10 ‐ 20
87181 925 952 7,190 7.6 6.6 15.2 40 ‐ 50
87184 5,363 5,661 63,260 11.2 12.1 7.4 10 ‐ 20
87185 919 928 6,000 6.5 5.7 14.0 40 ‐ 50
87186 110,341 121,768 1,388,910 11.4 13.8 17.4 0 ‐ 5
87187 27 31 350 11.3 18.3 38.3 75 ‐ 100
87188 19 79 680 8.6 10.3 16.5 75 ‐ 100
87205 46,298 47,868 461,100 9.6 6.9 39.1 5 ‐ 10
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 139
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
HCPCS Code(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
87206 7,151 7,937 77,860 9.8 8.1 21.0 10 ‐ 20
87207 190 194 1,880 9.7 9.5 2.1 50 ‐ 75
87209 3,068 3,146 86,260 27.4 24.3 12.8 10 ‐ 20
87210 3,608 3,713 37,270 10.0 7.0 42.9 10 ‐ 20
87220 589 589 5,780 9.8 7.6 28.9 40 ‐ 50
87230 1,397 1,405 41,710 29.7 30.0 1.0 20 ‐ 30
87252 706 716 27,230 38.0 37.3 1.9 40 ‐ 50
87253 58 58 1,690 29.1 26.5 9.8 50 ‐ 75
87254 326 335 9,670 28.9 27.6 4.7 50 ‐ 75
87255 81 81 4,030 49.8 48.0 3.8 50 ‐ 75
87260 57 57 1,110 19.5 15.9 22.6 50 ‐ 75
87265 6 6 120 20.0 30.1 33.6 50 ‐ 75
87269 373 373 7,100 19.0 16.7 13.8 20 ‐ 30
87270 3 3 60 20.0 16.2 23.5 50 ‐ 75
87271 160 160 2,750 17.2 15.3 12.4 20 ‐ 30
87272 417 422 8,010 19.0 17.2 10.5 20 ‐ 30
87275 135 135 2,680 19.9 18.7 6.4 50 ‐ 75
87276 158 158 3,140 19.9 18.8 5.9 50 ‐ 75
87278 90 90 1,770 19.7 16.4 20.1 40 ‐ 50
87279 118 127 2,480 19.5 16.2 20.4 50 ‐ 75
87280 61 61 1,210 19.8 16.3 21.5 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 140
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
HCPCS Code(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
87281 96 96 1,900 19.8 17.4 13.8 40 ‐ 50
87290 8 8 160 20.0 18.4 8.7 75 ‐ 100
87299 40 40 790 19.8 16.2 22.2 50 ‐ 75
87300 54 54 1,000 18.5 18.4 0.5 50 ‐ 75
87301 29 29 580 20.0 16.7 19.8 50 ‐ 75
87305 266 266 3,270 12.3 14.6 15.8 30 ‐ 40
87320 33 33 650 19.7 19.8 0.5 40 ‐ 50
87324 13,250 13,455 273,340 20.3 18.9 7.4 5 ‐ 10
87327 28 28 510 18.2 19.0 4.2 75 ‐ 100
87328 2,593 2,627 52,520 20.0 18.0 11.1 10 ‐ 20
87329 3,373 3,400 68,150 20.0 18.3 9.3 10 ‐ 20
87332 11 11 220 20.0 16.7 19.8 75 ‐ 100
87335 82 82 1,640 20.0 19.3 3.6 40 ‐ 50
87336 78 78 1,530 19.6 17.1 14.6 40 ‐ 50
87337 69 69 1,380 20.0 17.1 17.0 40 ‐ 50
87338 838 838 16,460 19.6 23.6 16.9 20 ‐ 30
87339 419 419 7,780 18.6 19.0 2.1 20 ‐ 30
87340 13,298 13,298 137,960 10.4 15.0 30.7 5 ‐ 10
87341 69 69 690 10.0 14.9 32.9 50 ‐ 75
87350 269 269 5,170 19.2 16.7 15.0 30 ‐ 40
87385 63 63 1,260 20.0 17.4 14.9 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 141
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
HCPCS Code(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
87390 2 2 60 30.0 26.6 12.8 75 ‐ 100
87400 2,003 2,627 45,990 17.5 18.8 6.9 20 ‐ 30
87420 5 5 100 20.0 16.7 19.8 75 ‐ 100
87425 211 211 4,300 20.4 19.4 5.2 20 ‐ 30
87427 1,957 2,090 39,920 19.1 17.2 11.0 10 ‐ 20
87430 1,565 1,565 31,920 20.4 18.8 8.5 10 ‐ 20
87449 2,374 2,419 45,030 18.6 17.6 5.7 20 ‐ 30
87450 22 22 220 10.0 13.4 25.4 75 ‐ 100
87451 46 46 460 10.0 14.6 31.5 40 ‐ 50
87476 46 46 2,160 47.0 63.5 26.0 50 ‐ 75
87480 476 476 14,180 29.8 28.8 3.5 10 ‐ 20
87481 1 1 50 50.0 45.2 10.6 75 ‐ 100
87486 6 6 260 43.3 45.5 4.8 75 ‐ 100
87490 506 506 15,510 30.7 30.2 1.7 10 ‐ 20
87491 5,484 5,489 259,760 47.3 46.9 0.9 5 ‐ 10
87493 1,248 1,248 60,600 48.6 51.2 5.1 20 ‐ 30
87496 216 216 10,590 49.0 51.2 4.3 40 ‐ 50
87497 3,771 3,771 217,940 57.8 60.8 4.9 10 ‐ 20
87510 472 472 14,060 29.8 28.8 3.5 10 ‐ 20
87511 1 1 50 50.0 32.6 53.4 50 ‐ 75
87515 4 4 120 30.0 28.7 4.5 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 142
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
HCPCS Code(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
87516 6 6 290 48.3 57.0 15.3 75 ‐ 100
87517 642 642 38,490 60.0 60.4 0.7 20 ‐ 30
87520 3 3 90 30.0 28.7 4.5 50 ‐ 75
87521 333 333 18,900 56.8 60.5 6.1 30 ‐ 40
87522 2,858 2,859 173,270 60.6 64.5 6.0 10 ‐ 20
87529 87 89 4,330 48.7 52.6 7.4 50 ‐ 75
87532 3 3 150 50.0 58.6 14.7 75 ‐ 100
87533 6 6 360 60.0 55.5 8.1 50 ‐ 75
87535 29 29 1,240 42.8 45.7 6.3 50 ‐ 75
87536 6,162 6,164 621,240 100.8 115.6 12.8 5 ‐ 10
87541 4 4 200 50.0 48.7 2.7 75 ‐ 100
87555 1 1 30 30.0 35.7 16.0 75 ‐ 100
87556 14 14 700 50.0 48.9 2.2 75 ‐ 100
87560 1 1 30 30.0 28.1 6.8 75 ‐ 100
87581 5 5 250 50.0 47.9 4.4 75 ‐ 100
87590 526 527 16,100 30.6 29.9 2.3 10 ‐ 20
87591 5,309 5,312 251,040 47.3 46.8 1.1 5 ‐ 10
87620 30 30 900 30.0 30.6 2.0 50 ‐ 75
87621 2,002 2,042 94,340 46.2 45.6 1.3 10 ‐ 20
87640 89 89 4,410 49.6 49.9 0.6 50 ‐ 75
87641 2,845 2,845 134,190 47.2 48.2 2.1 20 ‐ 30
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 143
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
HCPCS Code(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
87650 109 109 3,270 30.0 28.6 4.9 20 ‐ 30
87651 1 1 50 50.0 61.9 19.2 75 ‐ 100
87653 12 12 600 50.0 49.2 1.6 30 ‐ 40
87660 463 463 13,790 29.8 28.6 4.2 10 ‐ 20
87797 36 37 1,080 29.2 27.9 4.7 50 ‐ 75
87798 1,467 1,566 76,880 49.1 49.4 0.6 30 ‐ 40
87799 4,186 4,747 275,330 58.0 62.4 7.1 10 ‐ 20
87800 244 244 14,520 59.5 56.8 4.8 20 ‐ 30
87801 298 328 32,090 97.8 94.6 3.4 40 ‐ 50
87802 8 8 160 20.0 18.9 5.8 75 ‐ 100
87803 637 648 13,960 21.5 21.9 1.8 20 ‐ 30
87804 2,147 2,453 46,440 18.9 20.1 6.0 20 ‐ 30
87808 77 77 1,530 19.9 16.7 19.2 30 ‐ 40
87810 16 16 280 17.5 16.2 8.0 40 ‐ 50
87850 4 4 40 10.0 14.2 29.6 50 ‐ 75
87880 3,078 3,079 62,490 20.3 18.6 9.1 10 ‐ 20
87899 2,938 3,519 63,620 18.1 16.8 7.7 20 ‐ 30
87900 50 50 9,300 186.0 176.9 5.1 30 ‐ 40
87901 246 246 77,050 313.2 333.6 6.1 10 ‐ 20
87902 426 426 123,950 291.0 292.0 0.3 20 ‐ 30
87903 9 9 6,000 666.7 599.9 11.1 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 144
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
HCPCS Code(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
87904 13 32 1,240 38.8 33.7 15.1 40 ‐ 50
87905 24 24 480 20.0 17.9 11.7 50 ‐ 75
87999 9 9 1,700 188.9 534.3 64.6 50 ‐ 75
88104 1,584 1,712 17,320 10.1 13.4 24.6 20 ‐ 30
88106 60 60 600 10.0 12.8 21.9 50 ‐ 75
88107 75 75 1,600 21.3 29.5 27.8 50 ‐ 75
88108 3,879 3,951 41,060 10.4 14.8 29.7 10 ‐ 20
88112 8,907 9,322 240,050 25.8 28.0 7.9 10 ‐ 20
88142 6,250 6,250 184,710 29.6 28.9 2.4 0 ‐ 5
88143 110 110 3,300 30.0 29.9 0.3 30 ‐ 40
88148 1 1 10 10.0 15.8 36.7 75 ‐ 100
88150 63 63 1,260 20.0 15.5 29.0 30 ‐ 40
88160 102 102 1,040 10.2 13.1 22.1 50 ‐ 75
88161 145 150 1,500 10.0 15.1 33.8 50 ‐ 75
88162 25 25 570 22.8 25.3 9.9 75 ‐ 100
88164 252 252 5,010 19.9 15.7 26.8 10 ‐ 20
88172 2,377 2,740 68,110 24.9 28.5 12.6 20 ‐ 30
88173 6,338 6,871 172,210 25.1 27.8 9.7 10 ‐ 20
88174 26 26 700 26.9 28.9 6.9 30 ‐ 40
88175 4,219 4,219 157,640 37.4 35.3 5.9 5 ‐ 10
88182 228 229 4,880 21.3 28.1 24.2 30 ‐ 40
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 145
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
HCPCS Code(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
88184 4,867 4,867 49,840 10.2 13.8 26.1 10 ‐ 20
88185 5,715 29,436 344,960 11.7 13.7 14.6 30 ‐ 40
88187 346 346 3,460 10.0 9.3 7.5 20 ‐ 30
88188 85 85 1,990 23.4 33.5 30.1 50 ‐ 75
88189 510 510 12,840 25.2 30.9 18.4 20 ‐ 30
88199 6 6 60 10.0 8.5 17.6 75 ‐ 100
88230 11 11 1,650 150.0 129.1 16.2 75 ‐ 100
88233 1 1 150 150.0 143.0 4.9 75 ‐ 100
88235 3 3 600 200.0 177.0 13.0 50 ‐ 75
88237 2,202 2,297 393,600 171.4 153.1 12.0 20 ‐ 30
88239 8 8 1,090 136.3 144.3 5.5 75 ‐ 100
88240 91 91 910 10.0 13.4 25.4 30 ‐ 40
88241 9 9 90 10.0 14.6 31.5 50 ‐ 75
88261 103 103 25,750 250.0 246.5 1.4 30 ‐ 40
88262 818 818 163,600 200.0 181.9 10.0 10 ‐ 20
88264 1,200 1,200 238,250 198.5 185.9 6.8 10 ‐ 20
88267 1 1 250 250.0 248.1 0.8 75 ‐ 100
88269 3 3 750 250.0 238.2 5.0 20 ‐ 30
88271 1,015 1,891 50,330 26.6 27.8 4.3 40 ‐ 50
88274 133 135 6,690 49.6 54.1 8.3 40 ‐ 50
88275 939 1,524 87,420 57.4 62.5 8.2 30 ‐ 40
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 146
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
HCPCS Code(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
88280 879 1,189 44,340 37.3 36.1 3.3 20 ‐ 30
88285 101 101 3,030 30.0 28.5 5.3 40 ‐ 50
88300 3,420 3,467 35,590 10.3 12.6 18.3 10 ‐ 20
88302 1,772 1,835 19,500 10.6 13.9 23.7 20 ‐ 30
88304 14,466 15,136 374,340 24.7 26.8 7.8 10 ‐ 20
88305 134,720 199,383 5,206,370 26.1 28.0 6.8 5 ‐ 10
88307 10,161 12,922 520,060 40.2 42.2 4.7 10 ‐ 20
88309 445 459 18,160 39.6 44.1 10.2 30 ‐ 40
88311 6,398 6,680 66,720 10.0 8.6 16.3 5 ‐ 10
88312 14,024 16,238 177,020 10.9 13.2 17.4 10 ‐ 20
88313 13,135 18,509 200,880 10.9 12.6 13.5 10 ‐ 20
88314 90 129 1,310 10.2 11.8 13.6 50 ‐ 75
88318 1 1 10 10.0 13.3 24.8 75 ‐ 100
88319 48 60 2,420 40.3 40.5 0.5 75 ‐ 100
88321 801 801 8,080 10.1 12.4 18.5 20 ‐ 30
88323 118 118 2,980 25.3 1.0 2,430.0 50 ‐ 75
88325 27 27 1,080 40.0 52.9 24.4 75 ‐ 100
88329 165 175 1,830 10.5 12.8 18.0 40 ‐ 50
88331 4,961 6,360 153,150 24.1 25.5 5.5 10 ‐ 20
88332 1,239 2,138 22,920 10.7 12.3 13.0 20 ‐ 30
88333 746 858 8,830 10.3 12.4 16.9 20 ‐ 30
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 147
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
88334 139 167 1,690 10.1 11.6 12.9 50 ‐ 75
88342 16,205 33,570 832,930 24.8 27.4 9.5 20 ‐ 30
88346 440 1,245 32,000 25.7 27.5 6.5 50 ‐ 75
88347 448 496 12,580 25.4 35.2 27.8 40 ‐ 50
88348 234 234 23,900 102.1 128.8 20.7 30 ‐ 40
88358 44 44 910 20.7 24.7 16.2 40 ‐ 50
88360 1,410 2,807 71,440 25.5 28.6 10.8 20 ‐ 30
88361 864 1,579 60,850 38.5 42.4 9.2 20 ‐ 30
88365 200 281 10,910 38.8 45.4 14.5 50 ‐ 75
88367 136 270 10,390 38.5 45.7 15.8 50 ‐ 75
88368 733 1,321 51,050 38.6 43.5 11.3 30 ‐ 40
88384 4 4 40 10.0 11.6 13.8 50 ‐ 75
88385 2 2 60 30.0 25.3 18.6 75 ‐ 100
88399 10 10 100 10.0 8.6 16.3 75 ‐ 100
89050 1,276 1,303 12,720 9.8 8.1 21.0 20 ‐ 30
89051 6,056 6,163 62,990 10.2 9.0 13.3 10 ‐ 20
89055 3,142 3,148 31,130 9.9 7.1 39.4 10 ‐ 20
89060 1,735 1,743 17,910 10.3 11.0 6.4 10 ‐ 20
89100 2 2 140 70.0 71.7 2.4 75 ‐ 100
89125 130 130 1,240 9.5 7.2 31.9 30 ‐ 40
89160 28 28 280 10.0 8.9 12.4 40 ‐ 50
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 148
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
89190 114 114 1,140 10.0 7.3 37.0 50 ‐ 75
89220 48 48 480 10.0 16.6 39.8 50 ‐ 75
89310 2 2 20 10.0 11.3 11.5 30 ‐ 40
89320 17 17 340 20.0 17.2 16.3 30 ‐ 40
89321 3 3 60 20.0 22.0 9.1 50 ‐ 75
89322 6 6 120 20.0 22.1 9.5 20 ‐ 30
89343 1 1 40 40.0 38.8 3.1 50 ‐ 75
90371 33 33 2,970 90.0 90.8 0.9 50 ‐ 75
90375 11 11 1,650 150.0 131.6 14.0 75 ‐ 100
90471 25,947 25,947 505,150 19.5 20.0 2.5 5 ‐ 10
90472 513 553 11,040 20.0 20.3 1.5 40 ‐ 50
90585 15 15 1,350 90.0 85.6 5.1 50 ‐ 75
90655 66 66 990 15.0 18.0 16.7 20 ‐ 30
90656 10,139 10,157 132,580 13.1 13.0 0.8 10 ‐ 20
90657 1,018 1,018 15,400 15.1 13.9 8.6 5 ‐ 10
90658 68,074 68,074 887,530 13.0 13.2 1.5 0 ‐ 5
90660 152 152 2,630 17.3 17.6 1.7 10 ‐ 20
90662 1,071 1,071 19,970 18.6 18.7 0.5 20 ‐ 30
90670 3 3 140 46.7 62.3 25.0 75 ‐ 100
90675 287 287 43,050 150.0 142.8 5.0 30 ‐ 40
90703 5 5 80 16.0 21.0 23.8 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 149
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
90714 251 251 4,750 18.9 20.5 7.8 50 ‐ 75
90715 69 69 1,610 23.3 30.7 24.1 75 ‐ 100
90718 332 332 5,070 15.3 19.4 21.1 50 ‐ 75
90732 19,075 19,075 772,330 40.5 42.1 3.8 10 ‐ 20
90733 2 2 160 80.0 79.4 0.8 75 ‐ 100
90740 4,756 4,759 477,060 100.2 99.8 0.4 0 ‐ 5
90744 21 72 1,480 20.6 21.4 3.7 50 ‐ 75
90746 460 535 21,910 41.0 40.4 1.5 40 ‐ 50
90747 7,498 7,606 745,520 98.0 91.8 6.8 0 ‐ 5
90801 4,991 5,002 483,010 96.6 100.9 4.3 10 ‐ 20
90802 5 5 490 98.0 117.5 16.6 50 ‐ 75
90804 11,273 11,424 1,021,660 89.4 88.2 1.4 5 ‐ 10
90805 4,176 4,176 278,410 66.7 65.9 1.2 5 ‐ 10
90806 24,386 24,494 2,430,320 99.2 101.7 2.5 5 ‐ 10
90807 1,512 1,512 141,590 93.6 95.9 2.4 10 ‐ 20
90808 77 77 6,930 90.0 112.1 19.7 50 ‐ 75
90809 2 2 200 100.0 81.8 22.2 75 ‐ 100
90810 2 2 120 60.0 99.0 39.4 75 ‐ 100
90811 8 8 500 62.5 66.7 6.3 40 ‐ 50
90812 1 1 100 100.0 101.8 1.8 75 ‐ 100
90816 35 35 8,140 232.6 165.1 40.9 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 150
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
90818 1,066 1,103 177,030 160.5 157.9 1.6 5 ‐ 10
90819 7 7 700 100.0 118.3 15.5 50 ‐ 75
90821 98 98 14,700 150.0 163.5 8.3 10 ‐ 20
90845 11 11 1,100 100.0 102.2 2.2 50 ‐ 75
90846 53 53 6,850 129.2 129.0 0.2 40 ‐ 50
90847 299 299 35,300 118.1 132.5 10.9 30 ‐ 40
90849 19 19 950 50.0 46.6 7.3 75 ‐ 100
90853 91,236 200,156 9,693,640 48.4 49.3 1.8 5 ‐ 10
90857 1,114 1,540 77,360 50.2 51.8 3.1 20 ‐ 30
90862 23,453 23,453 1,750,830 74.7 75.3 0.8 0 ‐ 5
90870 3,975 3,975 1,270,600 319.6 322.7 1.0 5 ‐ 10
90899 248 248 15,680 63.2 65.6 3.7 50 ‐ 75
90901 98 98 2,940 30.0 29.3 2.4 50 ‐ 75
90911 261 261 15,270 58.5 59.7 2.0 30 ‐ 40
90935 982 982 330,900 337.0 340.7 1.1 50 ‐ 75
90940 13 13 130 10.0 10.8 7.4 50 ‐ 75
90945 181,256 181,256 10,291,230 56.8 56.6 0.4 0 ‐ 5
90947 16,841 16,841 918,270 54.5 55.3 1.4 5 ‐ 10
90989 473 473 37,750 79.8 72.0 10.8 50 ‐ 75
90993 1,687 1,687 247,850 146.9 144.5 1.7 0 ‐ 5
90999 1,971,246 1,971,247 246,392,350 125.0 126.0 0.8 0 ‐ 5
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 151
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
91010 691 691 136,900 198.1 195.0 1.6 10 ‐ 20
91012 2 2 400 200.0 181.7 10.1 75 ‐ 100
91020 20 20 4,000 200.0 192.5 3.9 30 ‐ 40
91034 150 150 29,550 197.0 187.9 4.8 10 ‐ 20
91035 172 172 34,000 197.7 189.6 4.3 10 ‐ 20
91037 23 23 4,550 197.8 189.3 4.5 30 ‐ 40
91038 60 60 12,000 200.0 191.8 4.3 20 ‐ 30
91065 187 187 13,250 70.9 79.3 10.6 20 ‐ 30
91105 133 133 8,770 65.9 62.2 5.9 50 ‐ 75
91110 269 269 136,050 505.8 496.8 1.8 30 ‐ 40
91120 26 26 810 31.2 50.9 38.7 40 ‐ 50
91122 189 189 30,110 159.3 160.2 0.6 10 ‐ 20
91132 7 7 420 60.0 60.9 1.5 10 ‐ 20
91299 2 2 120 60.0 69.1 13.2 75 ‐ 100
92002 108 108 8,040 74.4 81.3 8.5 50 ‐ 75
92004 1,079 1,079 80,740 74.8 75.1 0.4 20 ‐ 30
92012 6,268 6,268 313,210 50.0 50.5 1.0 5 ‐ 10
92014 6,818 6,818 399,540 58.6 59.7 1.8 5 ‐ 10
92018 4 4 3,200 800.0 735.0 8.8 75 ‐ 100
92020 668 668 21,670 32.4 32.5 0.3 10 ‐ 20
92025 182 182 9,580 52.6 52.1 1.0 30 ‐ 40
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 152
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
92060 149 149 8,190 55.0 56.1 2.0 30 ‐ 40
92081 61 61 1,970 32.3 32.8 1.5 30 ‐ 40
92082 145 145 7,890 54.4 55.8 2.5 30 ‐ 40
92083 3,732 3,732 199,110 53.4 53.5 0.2 5 ‐ 10
92120 5 5 300 60.0 56.6 6.0 75 ‐ 100
92135 8,832 9,276 390,880 42.1 44.1 4.5 5 ‐ 10
92136 793 793 40,110 50.6 49.9 1.4 10 ‐ 20
92225 247 248 8,440 34.0 37.7 9.8 30 ‐ 40
92226 732 732 42,690 58.3 59.6 2.2 10 ‐ 20
92235 1,020 1,044 136,480 130.7 135.2 3.3 10 ‐ 20
92240 17 17 1,700 100.0 141.2 29.2 40 ‐ 50
92250 1,808 1,808 95,930 53.1 53.5 0.7 10 ‐ 20
92270 1 1 30 30.0 33.1 9.4 75 ‐ 100
92275 22 22 2,250 102.3 107.1 4.5 50 ‐ 75
92283 2 2 60 30.0 39.4 23.9 75 ‐ 100
92284 6 6 360 60.0 82.0 26.8 30 ‐ 40
92285 203 203 10,500 51.7 53.4 3.2 40 ‐ 50
92286 37 37 4,150 112.2 112.3 0.1 40 ‐ 50
92499 3 3 90 30.0 34.8 13.8 75 ‐ 100
92504 3 3 30 10.0 12.8 21.9 75 ‐ 100
92506 8,232 8,232 911,700 110.8 120.2 7.8 10 ‐ 20
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 153
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
92507 92,662 92,669 4,684,650 50.6 50.6 0.0 5 ‐ 10
92508 4,495 4,495 106,740 23.7 24.5 3.3 20 ‐ 30
92511 104 104 4,390 42.2 45.3 6.8 50 ‐ 75
92520 59 59 2,970 50.3 52.2 3.6 30 ‐ 40
92526 159,140 159,268 12,622,310 79.3 78.5 1.0 5 ‐ 10
92540 358 358 26,520 74.1 74.7 0.8 10 ‐ 20
92541 120 120 5,360 44.7 27.8 60.8 10 ‐ 20
92542 52 52 2,220 42.7 46.8 8.8 40 ‐ 50
92543 444 1,388 104,720 75.4 72.9 3.4 20 ‐ 30
92544 31 31 1,340 43.2 46.1 6.3 50 ‐ 75
92545 39 39 1,700 43.6 45.7 4.6 40 ‐ 50
92546 202 202 15,350 76.0 76.8 1.0 10 ‐ 20
92548 128 128 9,170 71.6 72.5 1.2 30 ‐ 40
92550 602 602 15,110 25.1 26.2 4.2 10 ‐ 20
92552 178 178 4,480 25.2 25.3 0.4 30 ‐ 40
92553 101 101 6,570 65.0 61.0 6.6 30 ‐ 40
92555 73 73 1,810 24.8 23.7 4.6 30 ‐ 40
92556 108 108 2,750 25.5 27.3 6.6 30 ‐ 40
92557 3,883 3,883 255,370 65.8 65.8 0.0 5 ‐ 10
92567 2,185 2,185 50,400 23.1 23.8 2.9 10 ‐ 20
92568 230 230 5,760 25.0 25.6 2.3 20 ‐ 30
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 154
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
92570 142 142 3,590 25.3 25.7 1.6 20 ‐ 30
92576 1 1 20 20.0 24.5 18.4 75 ‐ 100
92579 19 19 1,360 71.6 70.7 1.3 30 ‐ 40
92582 7 7 490 70.0 71.5 2.1 50 ‐ 75
92584 21 21 3,150 150.0 139.5 7.5 20 ‐ 30
92585 131 131 19,650 150.0 141.3 6.2 30 ‐ 40
92586 1 1 60 60.0 67.3 10.8 75 ‐ 100
92587 112 112 4,850 43.3 43.7 0.9 20 ‐ 30
92588 130 130 5,890 45.3 45.2 0.2 20 ‐ 30
92597 158 158 13,130 83.1 97.8 15.0 40 ‐ 50
92603 23 23 2,010 87.4 136.5 36.0 40 ‐ 50
92604 303 303 27,670 91.3 101.3 9.9 10 ‐ 20
92607 34 34 3,900 114.7 119.3 3.9 50 ‐ 75
92609 376 376 25,810 68.6 67.5 1.6 50 ‐ 75
92610 16,144 16,146 1,447,220 89.6 89.6 0.0 5 ‐ 10
92611 5,457 5,457 526,370 96.5 100.1 3.6 5 ‐ 10
92612 152 152 16,950 111.5 125.2 10.9 40 ‐ 50
92626 75 75 6,640 88.5 92.4 4.2 30 ‐ 40
92700 44 44 1,080 24.5 30.2 18.9 40 ‐ 50
92950 2,656 2,718 295,070 108.6 115.5 6.0 10 ‐ 20
92953 22 22 2,250 102.3 113.7 10.0 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 155
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
92960 3,863 3,891 1,056,650 271.6 278.8 2.6 0 ‐ 5
92961 10 10 2,650 265.0 282.7 6.3 50 ‐ 75
92973 11 11 11,050 1,004.5 1,101.1 8.8 50 ‐ 75
92977 67 67 5,880 87.8 98.4 10.8 20 ‐ 30
92978 1 1 0 0.0 625.5 100.0 75 ‐ 100
92980 1,051 1,051 4,776,900 4,545.1 4,480.3 1.4 10 ‐ 20
92981 99 99 220,500 2,227.3 2,246.4 0.9 20 ‐ 30
92982 348 348 882,800 2,536.8 2,533.5 0.1 10 ‐ 20
92984 67 67 89,200 1,331.3 1,350.3 1.4 10 ‐ 20
92986 3 3 7,800 2,600.0 2,649.5 1.9 75 ‐ 100
93005 401,952 424,592 9,187,710 21.6 22.5 4.0 0 ‐ 5
93010 9,021 9,437 95,810 10.2 9.3 9.7 10 ‐ 20
93012 128 128 8,600 67.2 64.6 4.0 75 ‐ 100
93015 80 80 6,350 79.4 89.9 11.7 50 ‐ 75
93016 416 416 8,680 20.9 25.3 17.4 10 ‐ 20
93017 39,447 39,494 5,435,460 137.6 130.5 5.4 0 ‐ 5
93018 442 442 4,670 10.6 15.7 32.5 10 ‐ 20
93024 3 3 450 150.0 137.3 9.2 75 ‐ 100
93041 8,559 8,660 98,260 11.3 15.2 25.7 10 ‐ 20
93042 28 28 280 10.0 7.2 38.9 50 ‐ 75
93225 6,833 6,833 313,180 45.8 47.6 3.8 5 ‐ 10
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 156
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
93226 6,091 6,091 286,460 47.0 48.9 3.9 5 ‐ 10
93227 119 119 3,210 27.0 25.0 8.0 20 ‐ 30
93231 2,106 2,106 91,770 43.6 46.0 5.2 10 ‐ 20
93232 1,769 1,769 78,930 44.6 47.0 5.1 10 ‐ 20
93233 34 34 680 20.0 24.2 17.4 40 ‐ 50
93236 1,235 1,235 51,010 41.3 47.8 13.6 30 ‐ 40
93270 985 985 40,910 41.5 45.3 8.4 20 ‐ 30
93271 404 404 34,980 86.6 91.5 5.4 20 ‐ 30
93272 7 7 140 20.0 24.0 16.7 50 ‐ 75
93278 7 7 70 10.0 14.3 30.1 75 ‐ 100
93279 999 999 15,490 15.5 16.9 8.3 5 ‐ 10
93280 4,932 4,932 77,430 15.7 16.1 2.5 5 ‐ 10
93281 105 105 1,710 16.3 16.4 0.6 30 ‐ 40
93282 765 765 23,580 30.8 31.7 2.8 10 ‐ 20
93283 1,374 1,374 42,060 30.6 31.2 1.9 10 ‐ 20
93284 1,246 1,246 38,130 30.6 31.8 3.8 5 ‐ 10
93285 11 11 220 20.0 15.3 30.7 50 ‐ 75
93288 1,741 1,741 26,130 15.0 15.4 2.6 5 ‐ 10
93289 780 780 23,590 30.2 30.7 1.6 10 ‐ 20
93290 113 113 1,420 12.6 14.7 14.3 30 ‐ 40
93291 22 22 300 13.6 14.2 4.2 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 157
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
93293 7,903 7,903 242,600 30.7 30.4 1.0 0 ‐ 5
93294 2 2 60 30.0 32.3 7.1 75 ‐ 100
93296 3,672 3,672 110,700 30.1 30.6 1.6 0 ‐ 5
93299 74 74 2,220 30.0 30.4 1.3 30 ‐ 40
93303 75 75 34,500 460.0 438.7 4.9 50 ‐ 75
93304 6 6 2,100 350.0 351.6 0.5 75 ‐ 100
93306 51,921 51,921 18,351,750 353.5 352.5 0.3 5 ‐ 10
93307 2,181 2,181 457,260 209.7 206.7 1.5 20 ‐ 30
93308 818 818 167,900 205.3 206.3 0.5 30 ‐ 40
93312 2,944 2,944 1,331,800 452.4 451.4 0.2 10 ‐ 20
93313 37 37 13,000 351.4 358.0 1.8 40 ‐ 50
93315 1 1 450 450.0 460.9 2.4 75 ‐ 100
93318 2 2 950 475.0 497.4 4.5 75 ‐ 100
93320 384 384 33,560 87.4 88.3 1.0 50 ‐ 75
93321 4 4 120 30.0 59.9 49.9 75 ‐ 100
93325 428 428 30,050 70.2 70.3 0.1 50 ‐ 75
93350 4,535 4,535 1,617,310 356.6 352.2 1.2 10 ‐ 20
93351 1,238 1,238 562,300 454.2 449.9 1.0 10 ‐ 20
93501 622 622 1,151,550 1,851.4 1,821.6 1.6 20 ‐ 30
93503 5 5 2,700 540.0 656.4 17.7 75 ‐ 100
93505 386 386 255,400 661.7 696.4 5.0 20 ‐ 30
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 158
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
93508 1,603 1,603 2,297,500 1,433.3 1,443.7 0.7 10 ‐ 20
93510 17,551 17,551 28,578,240 1,628.3 1,621.2 0.4 0 ‐ 5
93526 2,887 2,887 5,133,200 1,778.0 1,770.3 0.4 10 ‐ 20
93527 27 27 26,250 972.2 1,076.6 9.7 20 ‐ 30
93539 19 19 1,340 70.5 123.9 43.1 50 ‐ 75
93540 23 23 1,300 56.5 143.0 60.5 50 ‐ 75
93543 172 172 11,110 64.6 118.2 45.3 40 ‐ 50
93544 6 6 200 33.3 122.5 72.8 75 ‐ 100
93545 209 209 17,310 82.8 154.5 46.4 30 ‐ 40
93555 176 176 13,730 78.0 142.3 45.2 30 ‐ 40
93556 211 211 14,550 69.0 146.0 52.7 30 ‐ 40
93580 15 15 128,100 8,540.0 8,510.5 0.3 50 ‐ 75
93600 27 27 15,300 566.7 615.1 7.9 30 ‐ 40
93602 34 34 19,450 572.1 574.2 0.4 20 ‐ 30
93603 5 5 2,750 550.0 567.2 3.0 75 ‐ 100
93609 3 3 120 40.0 620.4 93.6 50 ‐ 75
93610 33 33 19,100 578.8 588.0 1.6 30 ‐ 40
93612 5 5 2,750 550.0 573.2 4.0 50 ‐ 75
93618 6 6 3,300 550.0 585.6 6.1 50 ‐ 75
93619 3 3 28,300 9,433.3 5,546.2 70.1 75 ‐ 100
93620 1,140 1,140 8,813,400 7,731.1 7,149.5 8.1 10 ‐ 20
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 159
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
93621 3 3 120 40.0 577.5 93.1 50 ‐ 75
93642 202 202 118,450 586.4 584.1 0.4 20 ‐ 30
93650 169 169 392,500 2,322.5 2,306.6 0.7 10 ‐ 20
93651 79 79 457,620 5,792.7 5,609.9 3.3 40 ‐ 50
93660 870 870 173,000 198.9 211.7 6.0 10 ‐ 20
93701 383 383 7,650 20.0 20.9 4.3 10 ‐ 20
93721 1,173 1,173 45,960 39.2 43.4 9.7 20 ‐ 30
93722 1 1 10 10.0 7.6 31.6 75 ‐ 100
93724 21 21 360 17.1 18.5 7.6 50 ‐ 75
93750 11 11 970 88.2 87.8 0.5 50 ‐ 75
93786 101 101 4,350 43.1 42.4 1.7 30 ‐ 40
93788 60 60 2,580 43.0 42.8 0.5 30 ‐ 40
93797 3,809 3,818 93,850 24.6 25.2 2.4 5 ‐ 10
93798 138,667 138,945 3,517,390 25.3 27.2 7.0 0 ‐ 5
93799 169 174 7,450 42.8 43.7 2.1 50 ‐ 75
93875 225 225 16,070 71.4 76.6 6.8 50 ‐ 75
93880 32,503 32,503 3,229,120 99.3 102.7 3.3 5 ‐ 10
93882 114 114 10,390 91.1 91.1 0.0 50 ‐ 75
93886 142 142 13,500 95.1 98.7 3.6 30 ‐ 40
93888 47 47 2,020 43.0 41.6 3.4 50 ‐ 75
93922 5,124 5,124 214,230 41.8 44.2 5.4 10 ‐ 20
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 160
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
93923 7,675 7,675 541,760 70.6 71.6 1.4 10 ‐ 20
93924 1,233 1,233 87,500 71.0 73.7 3.7 20 ‐ 30
93925 4,428 4,428 415,500 93.8 98.9 5.2 10 ‐ 20
93926 2,402 2,402 146,750 61.1 65.8 7.1 10 ‐ 20
93930 57 57 5,310 93.2 100.0 6.8 50 ‐ 75
93931 289 289 17,650 61.1 64.1 4.7 40 ‐ 50
93965 772 772 54,730 70.9 78.3 9.5 30 ‐ 40
93970 13,814 13,814 1,338,440 96.9 102.7 5.6 10 ‐ 20
93971 29,066 29,066 1,885,830 64.9 66.3 2.1 5 ‐ 10
93975 2,552 2,552 239,160 93.7 113.7 17.6 20 ‐ 30
93976 1,111 1,111 105,310 94.8 99.1 4.3 30 ‐ 40
93978 1,421 1,421 134,240 94.5 109.7 13.9 20 ‐ 30
93979 235 235 13,860 59.0 66.7 11.5 40 ‐ 50
93980 21 21 1,970 93.8 99.6 5.8 20 ‐ 30
93982 7 7 280 40.0 41.5 3.6 30 ‐ 40
93990 410 410 24,640 60.1 82.6 27.2 20 ‐ 30
94002 626 626 100,600 160.7 168.0 4.3 40 ‐ 50
94003 18 18 2,800 155.6 174.9 11.0 75 ‐ 100
94010 8,211 8,211 297,100 36.2 36.8 1.6 10 ‐ 20
94016 1 1 20 20.0 23.0 13.0 75 ‐ 100
94060 14,544 14,544 1,092,770 75.1 76.0 1.2 5 ‐ 10
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 161
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
94070 465 465 65,950 141.8 130.5 8.7 10 ‐ 20
94150 1,234 1,252 34,340 27.4 26.5 3.4 30 ‐ 40
94200 1,010 1,010 27,650 27.4 26.4 3.8 20 ‐ 30
94240 8,125 8,125 293,530 36.1 37.3 3.2 5 ‐ 10
94250 206 206 6,940 33.7 35.7 5.6 50 ‐ 75
94260 6,548 6,548 233,940 35.7 36.2 1.4 5 ‐ 10
94350 1,297 1,297 46,830 36.1 39.2 7.9 20 ‐ 30
94360 6,076 6,076 166,920 27.5 27.4 0.4 5 ‐ 10
94370 194 194 2,140 11.0 13.7 19.7 30 ‐ 40
94375 1,992 1,992 76,100 38.2 37.8 1.1 10 ‐ 20
94400 6 6 140 23.3 21.2 9.9 50 ‐ 75
94450 2 2 40 20.0 24.5 18.4 75 ‐ 100
94620 2,196 2,196 79,120 36.0 38.3 6.0 10 ‐ 20
94621 229 229 33,800 147.6 149.6 1.3 30 ‐ 40
94640 55,709 73,554 1,426,830 19.4 18.7 3.7 10 ‐ 20
94642 146 146 10,960 75.1 75.6 0.7 50 ‐ 75
94644 800 800 29,470 36.8 37.2 1.1 20 ‐ 30
94645 95 101 3,640 36.0 37.4 3.7 50 ‐ 75
94660 1,117 1,117 84,230 75.4 68.6 9.9 50 ‐ 75
94664 10,053 10,100 195,430 19.3 18.8 2.7 10 ‐ 20
94667 196 197 3,910 19.8 19.9 0.5 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 162
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
94668 729 909 14,220 15.6 16.0 2.5 30 ‐ 40
94680 59 59 8,850 150.0 85.0 76.5 75 ‐ 100
94681 55 55 2,180 39.6 38.6 2.6 50 ‐ 75
94690 6 6 140 23.3 26.7 12.7 75 ‐ 100
94720 17,229 17,229 628,130 36.5 37.2 1.9 5 ‐ 10
94725 236 236 8,310 35.2 35.9 1.9 30 ‐ 40
94750 340 340 9,200 27.1 43.9 38.3 40 ‐ 50
94760 10,312 11,604 62,830 5.4 5.5 1.8 30 ‐ 40
94761 7,260 7,260 27,780 3.8 7.5 49.3 40 ‐ 50
94762 1,189 1,189 46,740 39.3 38.0 3.4 50 ‐ 75
94770 86 86 2,510 29.2 26.4 10.6 75 ‐ 100
94799 2,206 2,263 57,610 25.5 25.1 1.6 40 ‐ 50
95004 1 48 1,300 27.1 21.8 24.3 75 ‐ 100
95012 19 19 570 30.0 30.2 0.7 50 ‐ 75
95024 3 3 90 30.0 22.3 34.5 75 ‐ 100
95060 1 1 80 80.0 78.3 2.2 75 ‐ 100
95070 82 82 11,650 142.1 132.4 7.3 30 ‐ 40
95075 2 2 400 200.0 206.2 3.0 75 ‐ 100
95115 865 865 15,010 17.4 21.2 17.9 20 ‐ 30
95117 1,023 1,023 16,270 15.9 21.7 26.7 20 ‐ 30
95165 104 481 9,600 20.0 18.0 11.1 40 ‐ 50
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 163
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
95250 101 101 8,290 82.1 83.6 1.8 20 ‐ 30
95805 127 127 63,050 496.5 493.0 0.7 10 ‐ 20
95806 2 2 200 100.0 110.2 9.3 75 ‐ 100
95807 24 24 11,650 485.4 454.8 6.7 50 ‐ 75
95808 18 18 8,600 477.8 526.6 9.3 50 ‐ 75
95810 8,258 8,258 4,132,550 500.4 503.9 0.7 0 ‐ 5
95811 8,695 8,695 4,407,450 506.9 511.9 1.0 0 ‐ 5
95812 210 210 21,350 101.7 105.3 3.4 30 ‐ 40
95813 91 91 9,250 101.6 108.7 6.5 30 ‐ 40
95816 2,481 2,481 253,100 102.0 107.2 4.9 10 ‐ 20
95819 2,602 2,602 266,270 102.3 108.2 5.5 10 ‐ 20
95822 11 11 1,100 100.0 124.6 19.7 50 ‐ 75
95831 390 390 7,790 20.0 20.8 3.8 20 ‐ 30
95832 10 10 200 20.0 19.2 4.2 50 ‐ 75
95833 2 2 60 30.0 27.3 9.9 75 ‐ 100
95851 642 642 7,000 10.9 13.2 17.4 10 ‐ 20
95852 83 83 830 10.0 10.9 8.3 50 ‐ 75
95860 1,785 1,785 114,240 64.0 65.0 1.5 10 ‐ 20
95861 1,440 1,440 91,800 63.8 65.5 2.6 10 ‐ 20
95863 7 7 450 64.3 64.8 0.8 75 ‐ 100
95864 4 4 240 60.0 62.7 4.3 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 164
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
95867 9 9 590 65.6 66.6 1.5 75 ‐ 100
95868 1 1 60 60.0 68.6 12.5 75 ‐ 100
95869 23 23 700 30.4 54.4 44.1 50 ‐ 75
95870 315 343 11,050 32.2 36.5 11.8 40 ‐ 50
95872 2 2 120 60.0 67.0 10.4 75 ‐ 100
95900 2,027 5,120 167,160 32.6 32.6 0.0 20 ‐ 30
95903 2,545 6,639 213,880 32.2 33.8 4.7 20 ‐ 30
95904 4,112 13,104 427,750 32.6 33.1 1.5 20 ‐ 30
95921 28 28 1,720 61.4 65.2 5.8 50 ‐ 75
95922 29 29 900 31.0 32.9 5.8 50 ‐ 75
95923 25 25 1,540 61.6 64.8 4.9 50 ‐ 75
95925 53 53 7,950 150.0 144.7 3.7 50 ‐ 75
95926 46 46 6,900 150.0 143.3 4.7 50 ‐ 75
95930 79 79 11,850 150.0 146.0 2.7 40 ‐ 50
95934 596 596 25,680 43.1 45.1 4.4 20 ‐ 30
95937 2 2 120 60.0 68.1 11.9 75 ‐ 100
95950 5 5 2,300 460.0 459.9 0.0 50 ‐ 75
95951 71 71 34,200 481.7 480.8 0.2 40 ‐ 50
95953 139 139 70,300 505.8 499.2 1.3 20 ‐ 30
95958 9 9 900 100.0 108.2 7.6 10 ‐ 20
95965 3 3 8,700 2,900.0 2,909.0 0.3 40 ‐ 50
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 165
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
95970 117 117 7,750 66.2 66.3 0.2 30 ‐ 40
95971 73 73 5,970 81.8 86.5 5.4 40 ‐ 50
95972 285 285 23,590 82.8 88.3 6.2 10 ‐ 20
95974 94 94 8,310 88.4 85.5 3.4 30 ‐ 40
95978 210 210 17,810 84.8 98.2 13.6 20 ‐ 30
95979 9 9 750 83.3 88.7 6.1 50 ‐ 75
95982 2 2 170 85.0 82.2 3.4 50 ‐ 75
95990 887 887 86,610 97.6 103.5 5.7 10 ‐ 20
95991 450 450 43,770 97.3 99.7 2.4 10 ‐ 20
96101 33 40 5,550 138.8 89.2 55.6 50 ‐ 75
96102 6 6 900 150.0 95.9 56.4 75 ‐ 100
96103 7 7 420 60.0 68.3 12.2 50 ‐ 75
96105 28 29 1,710 59.0 72.9 19.1 75 ‐ 100
96116 115 122 17,950 147.1 139.5 5.4 40 ‐ 50
96118 179 410 27,350 66.7 57.0 17.0 50 ‐ 75
96119 82 160 12,850 80.3 105.9 24.2 50 ‐ 75
96125 103 105 7,850 74.8 76.2 1.8 50 ‐ 75
96150 62 200 6,790 34.0 31.0 9.7 75 ‐ 100
96151 30 91 3,340 36.7 33.5 9.6 50 ‐ 75
96152 110 343 10,130 29.5 28.1 5.0 75 ‐ 100
96153 7 23 740 32.2 29.5 9.2 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 166
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
96360 33,467 33,485 2,020,430 60.3 60.8 0.8 10 ‐ 20
96361 61,311 132,833 2,672,530 20.1 20.5 2.0 10 ‐ 20
96365 102,721 103,643 9,773,670 94.3 97.4 3.2 10 ‐ 20
96366 28,331 45,993 927,260 20.2 22.8 11.4 20 ‐ 30
96367 19,001 22,884 704,150 30.8 32.2 4.3 10 ‐ 20
96368 147 147 2,620 17.8 21.8 18.3 50 ‐ 75
96369 7 7 700 100.0 98.5 1.5 75 ‐ 100
96372 157,229 182,138 3,618,280 19.9 20.3 2.0 5 ‐ 10
96373 58 63 1,890 30.0 31.8 5.7 50 ‐ 75
96374 161,089 162,071 4,868,880 30.0 29.8 0.7 0 ‐ 5
96375 120,285 177,969 5,269,850 29.6 29.5 0.3 5 ‐ 10
96376 1,576 1,733 28,370 16.4 20.4 19.6 50 ‐ 75
96379 47 47 940 20.0 25.1 20.3 75 ‐ 100
96401 3,277 3,482 105,760 30.4 30.7 1.0 20 ‐ 30
96402 3,022 3,078 98,180 31.9 34.5 7.5 10 ‐ 20
96409 6,240 6,249 617,900 98.9 104.7 5.5 10 ‐ 20
96411 5,281 5,925 365,820 61.7 61.2 0.8 10 ‐ 20
96413 47,608 47,651 8,360,410 175.5 181.9 3.5 5 ‐ 10
96415 15,650 23,742 740,010 31.2 34.3 9.0 10 ‐ 20
96416 2,217 2,217 382,450 172.5 175.1 1.5 10 ‐ 20
96417 10,735 11,744 736,400 62.7 64.9 3.4 5 ‐ 10
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 167
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
96420 23 23 1,380 60.0 58.0 3.4 40 ‐ 50
96422 3 3 600 200.0 173.7 15.1 75 ‐ 100
96445 16 16 2,580 161.3 155.0 4.1 50 ‐ 75
96450 53 53 9,200 173.6 188.3 7.8 50 ‐ 75
96521 615 620 60,670 97.9 95.4 2.6 50 ‐ 75
96522 53 53 5,300 100.0 101.9 1.9 50 ‐ 75
96523 6,263 6,263 183,830 29.4 28.7 2.4 10 ‐ 20
96549 14 14 280 20.0 19.7 1.5 50 ‐ 75
96567 110 110 18,100 164.5 155.8 5.6 20 ‐ 30
96900 653 653 19,590 30.0 28.7 4.5 30 ‐ 40
96910 856 856 25,960 30.3 30.4 0.3 30 ‐ 40
96912 23 23 690 30.0 41.4 27.5 75 ‐ 100
96913 6 6 900 150.0 169.6 11.6 75 ‐ 100
96999 2 2 20 10.0 16.8 40.5 75 ‐ 100
97001 137,719 137,719 7,927,260 57.6 56.9 1.2 0 ‐ 5
97002 9,207 9,207 277,840 30.2 32.2 6.2 5 ‐ 10
97003 47,455 47,455 2,884,730 60.8 60.9 0.2 0 ‐ 5
97004 1,179 1,179 43,570 37.0 37.9 2.4 20 ‐ 30
97010 994 994 7,150 7.2 8.5 15.3 30 ‐ 40
97012 17,341 17,341 184,280 10.6 12.4 14.5 0 ‐ 5
97014 19 19 190 10.0 11.3 11.5 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 168
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
97016 7,042 7,042 71,740 10.2 12.6 19.0 10 ‐ 20
97018 5,759 5,759 57,920 10.1 7.3 38.4 10 ‐ 20
97022 7,773 7,773 100,940 13.0 15.2 14.5 10 ‐ 20
97024 31,181 31,219 26,760 0.9 4.6 80.4 10 ‐ 20
97026 1,969 1,969 30 0.0 4.3 100.0 20 ‐ 30
97028 210 210 1,230 5.9 6.0 1.7 50 ‐ 75
97032 26,398 29,183 335,330 11.5 13.7 16.1 10 ‐ 20
97033 5,362 5,663 112,210 19.8 20.3 2.5 10 ‐ 20
97034 277 277 2,880 10.4 12.8 18.8 30 ‐ 40
97035 125,210 127,352 1,358,230 10.7 10.4 2.9 0 ‐ 5
97039 145 145 2,620 18.1 30.0 39.7 50 ‐ 75
97110 1,600,020 2,804,237 63,397,610 22.6 22.7 0.4 0 ‐ 5
97112 438,988 574,053 13,324,390 23.2 23.9 2.9 0 ‐ 5
97113 29,699 77,055 2,124,430 27.6 28.1 1.8 10 ‐ 20
97116 432,388 504,880 10,133,330 20.1 20.4 1.5 0 ‐ 5
97124 14,405 15,133 296,360 19.6 18.7 4.8 10 ‐ 20
97139 18 18 250 13.9 17.9 22.3 75 ‐ 100
97140 338,428 443,246 9,117,020 20.6 21.3 3.3 0 ‐ 5
97150 76,804 76,881 1,031,720 13.4 15.0 10.7 5 ‐ 10
97530 709,211 1,058,160 25,443,630 24.0 24.2 0.8 0 ‐ 5
97532 37,957 78,890 1,570,460 19.9 14.0 42.1 10 ‐ 20
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 169
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
97533 620 828 16,560 20.0 20.5 2.4 50 ‐ 75
97535 210,761 341,951 8,247,270 24.1 22.8 5.7 5 ‐ 10
97537 363 661 14,280 21.6 22.5 4.0 50 ‐ 75
97542 33,423 54,649 1,173,570 21.5 22.3 3.6 10 ‐ 20
97597 18,002 18,002 1,159,940 64.4 63.0 2.2 10 ‐ 20
97598 2,158 2,158 149,470 69.3 68.3 1.5 30 ‐ 40
97602 2,253 2,253 99,570 44.2 45.5 2.9 20 ‐ 30
97605 3,475 3,475 132,930 38.3 42.9 10.7 20 ‐ 30
97606 262 262 16,840 64.3 65.2 1.4 50 ‐ 75
97750 2,668 3,452 78,380 22.7 24.7 8.1 20 ‐ 30
97755 9 32 910 28.4 28.0 1.4 75 ‐ 100
97760 21,473 30,076 826,560 27.5 26.6 3.4 10 ‐ 20
97761 1,109 1,543 35,660 23.1 24.1 4.1 40 ‐ 50
97762 1,423 1,672 48,990 29.3 28.1 4.3 40 ‐ 50
97802 2,375 8,416 167,570 19.9 20.3 2.0 20 ‐ 30
97803 1,621 3,651 66,470 18.2 18.7 2.7 10 ‐ 20
97804 101 309 2,800 9.1 9.0 1.1 30 ‐ 40
98925 98 98 1,940 19.8 22.2 10.8 40 ‐ 50
98926 68 68 1,360 20.0 25.4 21.3 50 ‐ 75
98927 53 53 1,060 20.0 32.6 38.7 50 ‐ 75
98928 43 43 860 20.0 31.2 35.9 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 170
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
98929 10 10 200 20.0 36.6 45.4 75 ‐ 100
98940 120 120 2,860 23.8 41.4 42.5 40 ‐ 50
98941 46 46 1,920 41.7 30.4 37.2 50 ‐ 75
98942 53 53 1,060 20.0 19.2 4.2 20 ‐ 30
99051 4 4 400 100.0 96.8 3.3 75 ‐ 100
99070 4 4 0 0.0 17.3 100.0 75 ‐ 100
99100 24 24 520 21.7 13.8 57.2 50 ‐ 75
99144 10 10 590 59.0 46.4 27.2 75 ‐ 100
99195 2,607 2,607 77,820 29.9 32.2 7.1 10 ‐ 20
99201 6,393 6,393 306,990 48.0 54.3 11.6 30 ‐ 40
99202 7,713 7,713 430,270 55.8 60.9 8.4 30 ‐ 40
99203 13,618 13,618 976,130 71.7 74.5 3.8 20 ‐ 30
99204 9,908 9,908 896,650 90.5 93.9 3.6 20 ‐ 30
99205 4,027 4,027 590,690 146.7 136.1 7.8 20 ‐ 30
99211 251,946 252,106 12,027,760 47.7 48.5 1.6 0 ‐ 5
99212 303,369 303,634 20,671,930 68.1 69.0 1.3 0 ‐ 5
99213 427,689 428,101 25,758,480 60.2 61.4 2.0 0 ‐ 5
99214 239,290 239,435 16,947,060 70.8 71.4 0.8 0 ‐ 5
99215 36,516 36,519 3,272,050 89.6 90.9 1.4 10 ‐ 20
99217 709 709 42,490 59.9 34.4 74.1 30 ‐ 40
99218 110 110 6,690 60.8 15.4 294.8 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 171
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
99219 353 353 34,310 97.2 23.7 310.1 50 ‐ 75
99220 190 190 28,350 149.2 46.5 220.9 50 ‐ 75
99222 4 4 400 100.0 96.2 4.0 75 ‐ 100
99232 6 6 360 60.0 67.6 11.2 75 ‐ 100
99234 8 8 800 100.0 49.2 103.3 75 ‐ 100
99235 42 42 6,300 150.0 51.2 193.0 50 ‐ 75
99236 10 10 2,000 200.0 61.9 223.1 75 ‐ 100
99238 4 4 240 60.0 69.9 14.2 75 ‐ 100
99242 1 1 60 60.0 79.5 24.5 75 ‐ 100
99245 1 1 100 100.0 104.9 4.7 50 ‐ 75
99281 26,371 26,371 1,017,310 38.6 40.1 3.7 10 ‐ 20
99282 75,278 75,282 4,577,670 60.8 61.3 0.8 5 ‐ 10
99283 236,349 236,398 22,484,190 95.1 98.1 3.1 0 ‐ 5
99284 238,624 238,668 42,298,840 177.2 183.1 3.2 0 ‐ 5
99285 141,269 141,294 44,504,830 315.0 313.3 0.5 5 ‐ 10
99291 5,129 5,129 1,886,400 367.8 368.9 0.3 20 ‐ 30
99292 18 18 1,800 100.0 98.6 1.4 75 ‐ 100
99304 68 68 5,170 76.0 87.6 13.2 75 ‐ 100
99305 268 268 18,570 69.3 83.7 17.2 50 ‐ 75
99306 285 285 18,940 66.5 75.9 12.4 50 ‐ 75
99307 5,898 5,898 432,250 73.3 76.4 4.1 30 ‐ 40
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 172
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
99308 8,511 8,511 614,750 72.2 74.9 3.6 20 ‐ 30
99309 2,120 2,120 175,870 83.0 85.4 2.8 40 ‐ 50
99310 156 156 12,410 79.6 88.2 9.8 50 ‐ 75
99315 152 152 12,780 84.1 89.7 6.2 50 ‐ 75
99316 9 9 1,060 117.8 94.3 24.9 75 ‐ 100
99318 89 89 6,720 75.5 81.2 7.0 50 ‐ 75
99334 239 239 15,600 65.3 66.8 2.2 50 ‐ 75
99335 184 184 14,170 77.0 79.1 2.7 50 ‐ 75
99336 31 31 2,440 78.7 78.5 0.3 75 ‐ 100
99347 1 1 60 60.0 81.4 26.3 75 ‐ 100
99348 39 39 2,700 69.2 75.9 8.8 75 ‐ 100
99349 3 3 220 73.3 96.0 23.6 75 ‐ 100
99385 1 1 100 100.0 88.4 13.1 75 ‐ 100
99386 2 2 200 100.0 79.4 25.9 75 ‐ 100
99387 8 8 720 90.0 86.6 3.9 50 ‐ 75
99395 31 31 2,610 84.2 81.5 3.3 20 ‐ 30
99396 122 122 10,970 89.9 86.6 3.8 20 ‐ 30
99397 1,209 1,209 111,850 92.5 93.2 0.8 20 ‐ 30
99401 188 188 16,930 90.1 84.8 6.3 50 ‐ 75
99406 317 317 6,230 19.7 17.6 11.9 40 ‐ 50
99407 144 144 2,880 20.0 19.4 3.1 30 ‐ 40
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 173
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
99499 19 19 490 25.8 26.1 1.1 75 ‐ 100
A0425 30,707 185,315 1,212,030 6.5 6.4 1.6 30 ‐ 40
A0426 2,387 2,387 494,000 207.0 213.8 3.2 20 ‐ 30
A0427 19,138 18,971 6,246,850 329.3 339.8 3.1 5 ‐ 10
A0428 8,446 8,432 1,382,650 164.0 176.4 7.0 10 ‐ 20
A0429 8,106 8,054 2,231,800 277.1 289.2 4.2 10 ‐ 20
A0430 14 14 46,200 3,300.0 3,245.5 1.7 75 ‐ 100
A0431 467 467 1,682,200 3,602.1 3,497.8 3.0 50 ‐ 75
A0433 529 529 254,900 481.9 496.0 2.8 30 ‐ 40
A0434 276 276 154,900 561.2 574.3 2.3 50 ‐ 75
A4209 1,606 1,927 180 0.1 0.4 75.0 0 ‐ 5
A4216 1,126 1,540 700 0.5 1.6 68.8 50 ‐ 75
A4218 14 17 0 0.0 2.4 100.0 75 ‐ 100
A4310 1,488 2,935 22,070 7.5 5.5 36.4 50 ‐ 75
A4311 9 9 90 10.0 11.5 13.0 75 ‐ 100
A4312 6 6 120 20.0 13.1 52.7 75 ‐ 100
A4314 186 186 1,770 9.5 13.3 28.6 50 ‐ 75
A4320 275 322 310 1.0 4.0 75.0 75 ‐ 100
A4321 27 27 0 0.0 1.9 100.0 50 ‐ 75
A4322 372 372 0 0.0 2.4 100.0 40 ‐ 50
A4328 2 2 20 10.0 6.7 49.3 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 174
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
A4333 1 1 0 0.0 2.1 100.0 75 ‐ 100
A4338 603 603 5,700 9.5 9.5 0.0 50 ‐ 75
A4340 7 7 80 11.4 19.9 42.7 75 ‐ 100
A4344 68 68 660 9.7 10.9 11.0 75 ‐ 100
A4346 21 21 240 11.4 17.0 32.9 75 ‐ 100
A4349 8 14 20 1.4 1.7 17.6 75 ‐ 100
A4351 49 49 0 0.0 1.4 100.0 75 ‐ 100
A4353 202 204 1,970 9.7 5.9 64.4 50 ‐ 75
A4355 58 58 580 10.0 6.3 58.7 75 ‐ 100
A4357 1,189 1,189 11,480 9.7 7.2 34.7 40 ‐ 50
A4358 307 307 1,820 5.9 4.8 22.9 50 ‐ 75
A4369 13 13 0 0.0 1.9 100.0 75 ‐ 100
A4414 211 211 0 0.0 4.1 100.0 75 ‐ 100
A4450 2 2 0 0.0 0.1 100.0 75 ‐ 100
A4452 1,380 1,752 0 0.0 0.3 100.0 40 ‐ 50
A4565 14 14 20 1.4 5.7 75.4 75 ‐ 100
A4606 60 60 370 6.2 8.5 27.1 75 ‐ 100
A4623 1,537 1,644 1,070 0.7 4.7 85.1 50 ‐ 75
A4629 550 1,210 4,870 4.0 3.8 5.3 75 ‐ 100
A4641 1 4 300 75.0 106.2 29.4 75 ‐ 100
A4657 1,501,133 2,913,947 521,610 0.2 0.4 50.0 0 ‐ 5
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 175
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
A4750 111 113 50 0.4 6.6 93.9 20 ‐ 30
A4755 165 259 820 3.2 4.5 28.9 20 ‐ 30
A4913 47,436 72,414 112,280 1.6 3.4 52.9 0 ‐ 5
A5063 145 145 0 0.0 2.2 100.0 50 ‐ 75
A5105 1 1 0 0.0 4.3 100.0 75 ‐ 100
A6010 2 2 60 30.0 10.8 177.8 75 ‐ 100
A6011 57 57 0 0.0 1.9 100.0 40 ‐ 50
A6021 636 641 10,590 16.5 14.5 13.8 30 ‐ 40
A6022 43 43 860 20.0 18.0 11.1 50 ‐ 75
A6196 1,267 1,545 11,380 7.4 6.0 23.3 40 ‐ 50
A6197 232 249 2,550 10.2 13.7 25.5 50 ‐ 75
A6199 101 102 80 0.8 4.6 82.6 50 ‐ 75
A6203 311 313 20 0.1 2.6 96.2 50 ‐ 75
A6204 75 75 750 10.0 4.9 104.1 50 ‐ 75
A6206 56 56 20 0.4 2.6 84.6 50 ‐ 75
A6207 106 107 380 3.6 5.2 30.8 50 ‐ 75
A6209 1,121 1,393 10,620 7.6 5.7 33.3 40 ‐ 50
A6210 356 374 3,880 10.4 11.8 11.9 50 ‐ 75
A6211 13 13 140 10.8 13.9 22.3 75 ‐ 100
A6212 1,151 1,350 12,220 9.1 7.6 19.7 50 ‐ 75
A6213 75 75 340 4.5 5.5 18.2 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 176
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
A6214 48 48 480 10.0 8.5 17.6 50 ‐ 75
A6216 2,153 9,123 0 0.0 0.2 100.0 50 ‐ 75
A6219 645 985 170 0.2 0.8 75.0 50 ‐ 75
A6220 98 128 70 0.5 2.1 76.2 75 ‐ 100
A6222 569 719 170 0.2 1.7 88.2 50 ‐ 75
A6223 130 131 0 0.0 2.0 100.0 75 ‐ 100
A6231 5 5 0 0.0 4.7 100.0 75 ‐ 100
A6234 614 651 5,720 8.8 5.1 72.5 50 ‐ 75
A6235 16 16 160 10.0 13.5 25.9 75 ‐ 100
A6237 122 122 1,060 8.7 6.1 42.6 50 ‐ 75
A6238 7 7 140 20.0 18.2 9.9 75 ‐ 100
A6240 19 19 190 10.0 10.3 2.9 20 ‐ 30
A6242 25 26 250 9.6 5.0 92.0 75 ‐ 100
A6248 93 95 930 9.8 13.1 25.2 50 ‐ 75
A6250 151 159 0 0.0 2.4 100.0 50 ‐ 75
A6251 305 408 0 0.0 1.6 100.0 75 ‐ 100
A6252 1,118 1,570 2,070 1.3 2.6 50.0 40 ‐ 50
A6253 51 51 290 5.7 3.8 50.0 75 ‐ 100
A6254 7 7 0 0.0 1.3 100.0 75 ‐ 100
A6255 2 2 0 0.0 2.8 100.0 75 ‐ 100
A6257 1,334 1,352 0 0.0 1.2 100.0 40 ‐ 50
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 177
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
A6258 793 816 420 0.5 3.0 83.3 40 ‐ 50
A6259 5 5 0 0.0 6.7 100.0 75 ‐ 100
A6260 1 1 0 0.0 217.2 100.0 75 ‐ 100
A6261 14 14 50 3.6 9.9 63.6 75 ‐ 100
A6266 189 190 0 0.0 1.8 100.0 75 ‐ 100
A6402 3,956 6,906 0 0.0 0.1 100.0 50 ‐ 75
A6403 18 18 0 0.0 0.4 100.0 75 ‐ 100
A6407 5 5 0 0.0 1.9 100.0 75 ‐ 100
A6441 77 77 0 0.0 0.8 100.0 50 ‐ 75
A6442 2 2 0 0.0 0.1 100.0 75 ‐ 100
A6443 572 1,012 0 0.0 0.4 100.0 40 ‐ 50
A6445 25 25 0 0.0 0.3 100.0 75 ‐ 100
A6446 539 786 0 0.0 0.3 100.0 50 ‐ 75
A6447 16 16 0 0.0 0.8 100.0 75 ‐ 100
A6448 7 7 0 0.0 1.0 100.0 75 ‐ 100
A6449 38 46 0 0.0 1.3 100.0 75 ‐ 100
A6453 10 10 0 0.0 0.5 100.0 75 ‐ 100
A6454 222 236 0 0.0 0.8 100.0 50 ‐ 75
A6456 110 120 20 0.2 2.0 90.0 50 ‐ 75
A6457 132 195 0 0.0 1.0 100.0 50 ‐ 75
A7521 16 16 640 40.0 35.3 13.3 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 178
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
A7525 192 192 0 0.0 1.7 100.0 75 ‐ 100
A7526 384 384 0 0.0 2.8 100.0 30 ‐ 40
A9150 2 2 0 0.0 1.1 100.0 75 ‐ 100
A9500 1,109 1,749 145,540 83.2 87.7 5.1 30 ‐ 40
A9502 287 469 41,010 87.4 88.8 1.6 40 ‐ 50
A9503 267 267 5,470 20.5 32.5 36.9 50 ‐ 75
A9505 105 228 7,680 33.7 42.1 20.0 75 ‐ 100
A9510 10 10 420 42.0 40.9 2.7 75 ‐ 100
A9512 1 2 100 50.0 6.0 733.3 75 ‐ 100
A9517 257 7,078 93,360 13.2 13.2 0.0 40 ‐ 50
A9530 1 100 900 9.0 8.8 2.3 75 ‐ 100
A9537 123 123 3,790 30.8 39.4 21.8 40 ‐ 50
A9539 1 1 20 20.0 33.5 40.3 75 ‐ 100
A9540 65 65 1,050 16.2 24.4 33.6 50 ‐ 75
A9541 22 22 770 35.0 59.1 40.8 75 ‐ 100
A9543 2 2 58,000 29,000.0 29,504.0 1.7 75 ‐ 100
A9552 57 57 12,200 214.0 217.8 1.7 75 ‐ 100
A9558 11 18 480 26.7 39.8 32.9 75 ‐ 100
A9560 1 1 100 100.0 52.0 92.3 75 ‐ 100
A9561 19 19 490 25.8 21.7 18.9 75 ‐ 100
A9567 5 5 150 30.0 37.0 18.9 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 179
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
A9579 8 122 220 1.8 3.5 48.6 75 ‐ 100
A9581 83 850 8,050 9.5 10.0 5.0 50 ‐ 75
A9604 15 15 67,500 4,500.0 4,942.4 9.0 50 ‐ 75
B4087 2 2 20 10.0 64.3 84.4 75 ‐ 100
C1300 16,855 66,582 5,618,470 84.4 85.3 1.1 10 ‐ 20
C1716 1 1 30 30.0 35.5 15.5 75 ‐ 100
C1717 1,022 1,363 255,550 187.5 186.1 0.8 5 ‐ 10
C1725 6 6 1,500 250.0 185.2 35.0 75 ‐ 100
C1729 1 1 0 0.0 20.5 100.0 75 ‐ 100
C1760 12 12 3,800 316.7 241.2 31.3 75 ‐ 100
C1769 5 5 150 30.0 60.2 50.2 75 ‐ 100
C1780 169 169 27,880 165.0 169.2 2.5 10 ‐ 20
C1781 25 25 2,770 110.8 214.8 48.4 50 ‐ 75
C1894 3 3 40 13.3 64.7 79.4 75 ‐ 100
C2616 65 65 975,000 15,000.0 14,651.3 2.4 20 ‐ 30
C2638 28 1,021 34,650 33.9 33.8 0.3 50 ‐ 75
C2639 45 3,028 87,470 28.9 29.4 1.7 50 ‐ 75
C2641 14 798 36,450 45.7 46.6 1.9 75 ‐ 100
C8900 57 57 18,250 320.2 478.9 33.1 50 ‐ 75
C8901 11 11 2,200 200.0 300.4 33.4 75 ‐ 100
C8902 178 178 66,350 372.8 474.0 21.4 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 180
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
C8903 1 1 300 300.0 260.5 15.2 75 ‐ 100
C8905 60 60 20,200 336.7 339.7 0.9 20 ‐ 30
C8906 61 61 16,350 268.0 280.7 4.5 20 ‐ 30
C8907 18 18 3,600 200.0 201.0 0.5 40 ‐ 50
C8908 1,238 1,238 418,050 337.7 341.4 1.1 5 ‐ 10
C8909 4 4 1,050 262.5 386.9 32.2 75 ‐ 100
C8910 2 2 400 200.0 246.8 19.0 75 ‐ 100
C8911 12 12 4,100 341.7 476.8 28.3 75 ‐ 100
C8912 30 30 14,450 481.7 541.0 11.0 50 ‐ 75
C8914 58 58 32,250 556.0 590.9 5.9 50 ‐ 75
C8923 54 54 23,250 430.6 425.3 1.2 50 ‐ 75
C8924 4 4 1,650 412.5 404.1 2.1 75 ‐ 100
C8925 93 93 40,300 433.3 435.9 0.6 40 ‐ 50
C8928 579 579 248,450 429.1 429.5 0.1 10 ‐ 20
C8929 1,971 1,971 856,950 434.8 437.4 0.6 10 ‐ 20
C8930 273 273 117,400 430.0 428.7 0.3 30 ‐ 40
C8957 35 35 5,750 164.3 173.1 5.1 75 ‐ 100
C9113 113 113 1,380 12.2 15.5 21.3 50 ‐ 75
C9255 59 8,970 46,100 5.1 5.3 3.8 20 ‐ 30
C9256 4 28 4,400 157.1 157.6 0.3 50 ‐ 75
C9257 1,040 7,049 10,950 1.6 1.2 33.3 10 ‐ 20
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 181
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
C9359 1 1 60 60.0 62.4 3.8 75 ‐ 100
C9399 24 24 126,000 5,250.0 4,826.4 8.8 75 ‐ 100
C9728 10 10 5,850 585.0 597.8 2.1 75 ‐ 100
D0150 1 1 600 600.0 458.7 30.8 75 ‐ 100
D7140 30 32 18,350 573.4 560.4 2.3 50 ‐ 75
D7210 7 7 4,150 592.9 591.0 0.3 75 ‐ 100
G0008 84,879 84,878 1,920,150 22.6 23.0 1.7 0 ‐ 5
G0009 19,124 19,124 455,680 23.8 24.4 2.5 5 ‐ 10
G0010 11,928 11,934 218,070 18.3 16.8 8.9 0 ‐ 5
G0101 1,780 1,780 80,940 45.5 44.7 1.8 10 ‐ 20
G0102 27 27 210 7.8 18.2 57.1 50 ‐ 75
G0103 45,548 45,548 1,456,550 32.0 29.3 9.2 0 ‐ 5
G0104 39 39 7,450 191.0 216.1 11.6 40 ‐ 50
G0105 3,584 3,584 1,379,250 384.8 386.7 0.5 5 ‐ 10
G0108 7,320 13,853 302,620 21.8 22.4 2.7 5 ‐ 10
G0109 5,857 26,755 281,330 10.5 11.6 9.5 5 ‐ 10
G0121 4,614 4,614 1,747,540 378.7 377.3 0.4 0 ‐ 5
G0123 6,526 6,526 190,460 29.2 28.0 4.3 0 ‐ 5
G0124 61 61 1,900 31.1 33.2 6.3 5 ‐ 10
G0127 498 498 9,080 18.2 19.8 8.1 20 ‐ 30
G0128 13 21 170 8.1 6.8 19.1 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 182
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
G0129 30 30 4,100 136.7 105.9 29.1 75 ‐ 100
G0143 289 289 8,590 29.7 28.7 3.5 10 ‐ 20
G0144 55 55 1,650 30.0 29.6 1.4 20 ‐ 30
G0145 5,802 5,802 219,350 37.8 36.1 4.7 0 ‐ 5
G0147 78 78 1,580 20.3 16.0 26.9 10 ‐ 20
G0148 42 42 840 20.0 15.8 26.6 5 ‐ 10
G0166 471 471 39,610 84.1 81.7 2.9 50 ‐ 75
G0168 8 8 140 17.5 30.9 43.4 75 ‐ 100
G0173 5 5 13,700 2,740.0 2,959.9 7.4 75 ‐ 100
G0175 33 33 3,070 93.0 93.9 1.0 50 ‐ 75
G0177 413 602 33,680 55.9 82.3 32.1 50 ‐ 75
G0179 6 6 240 40.0 34.4 16.3 75 ‐ 100
G0180 5 5 240 48.0 46.3 3.7 75 ‐ 100
G0202 153,220 153,220 11,489,490 75.0 76.2 1.6 0 ‐ 5
G0204 19,213 19,213 1,658,510 86.3 87.7 1.6 0 ‐ 5
G0206 23,802 23,802 1,653,050 69.5 68.8 1.0 0 ‐ 5
G0237 3,648 7,238 95,550 13.2 13.2 0.0 30 ‐ 40
G0238 3,395 9,503 111,580 11.7 12.3 4.9 40 ‐ 50
G0239 6,687 6,693 133,540 20.0 21.2 5.7 10 ‐ 20
G0246 3 3 150 50.0 53.6 6.7 75 ‐ 100
G0249 37 37 3,330 90.0 90.3 0.3 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 183
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
G0251 387 387 294,350 760.6 828.3 8.2 30 ‐ 40
G0257 2,702 2,712 992,550 366.0 368.6 0.7 20 ‐ 30
G0260 2,776 2,798 1,029,950 368.1 366.0 0.6 5 ‐ 10
G0269 6 6 400 66.7 134.9 50.6 75 ‐ 100
G0270 48 129 2,280 17.7 18.2 2.7 40 ‐ 50
G0271 1 3 30 10.0 9.0 11.1 75 ‐ 100
G0281 3,024 3,024 30,240 10.0 9.7 3.1 40 ‐ 50
G0283 193,428 193,553 1,996,900 10.3 10.0 3.0 0 ‐ 5
G0289 1 1 80 80.0 193.2 58.6 75 ‐ 100
G0290 3,528 3,528 21,977,200 6,229.4 6,213.9 0.2 5 ‐ 10
G0291 384 384 1,189,700 3,098.2 3,198.9 3.1 10 ‐ 20
G0306 618 618 6,180 10.0 11.7 14.5 30 ‐ 40
G0307 615 615 6,250 10.2 9.7 5.2 30 ‐ 40
G0328 974 974 19,170 19.7 22.0 10.5 20 ‐ 30
G0329 343 343 3,430 10.0 6.8 47.1 50 ‐ 75
G0339 268 268 765,300 2,855.6 2,956.8 3.4 40 ‐ 50
G0340 648 648 1,287,300 1,986.6 2,060.1 3.6 40 ‐ 50
G0364 1,199 1,199 43,340 36.1 36.6 1.4 10 ‐ 20
G0365 247 252 23,410 92.9 103.3 10.1 20 ‐ 30
G0378 240 2,769 65,580 23.7 17.4 36.2 75 ‐ 100
G0379 1,496 1,496 418,860 280.0 243.5 15.0 30 ‐ 40
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 184
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
G0380 1,092 1,092 38,400 35.2 34.8 1.1 30 ‐ 40
G0381 2,578 2,578 129,720 50.3 49.3 2.0 20 ‐ 30
G0382 3,859 3,859 307,480 79.7 78.7 1.3 20 ‐ 30
G0383 787 787 87,150 110.7 119.6 7.4 40 ‐ 50
G0384 53 53 10,250 193.4 213.2 9.3 75 ‐ 100
G0389 194 194 12,170 62.7 65.6 4.4 30 ‐ 40
G0390 4 4 2,700 675.0 661.3 2.1 75 ‐ 100
G0397 8 8 300 37.5 36.6 2.5 40 ‐ 50
G0399 13 13 1,300 100.0 107.8 7.2 30 ‐ 40
G0402 306 306 26,160 85.5 86.3 0.9 10 ‐ 20
G0404 99 99 2,030 20.5 23.9 14.2 30 ‐ 40
G0405 6 6 40 6.7 12.2 45.1 50 ‐ 75
G0410 74,473 217,062 11,421,430 52.6 55.7 5.6 0 ‐ 5
G0411 9,899 33,621 1,495,670 44.5 47.9 7.1 5 ‐ 10
G0416 22 22 6,150 279.5 287.5 2.8 30 ‐ 40
G0417 4 4 1,700 425.0 432.5 1.7 50 ‐ 75
G0422 152 152 3,040 20.0 24.1 17.0 30 ‐ 40
G0424 23,231 25,829 1,041,510 40.3 41.3 2.4 5 ‐ 10
G0430 2,566 2,578 53,350 20.7 23.7 12.7 20 ‐ 30
G0431 23,075 59,553 1,178,240 19.8 19.4 2.1 10 ‐ 20
G9141 6,665 6,665 159,180 23.9 23.6 1.3 10 ‐ 20
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 185
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
H2012 5 5 300 60.0 55.5 8.1 0 ‐ 5
J0129 1,342 102,288 1,610,000 15.7 15.7 0.0 10 ‐ 20
J0130 38 123 57,200 465.0 451.7 2.9 50 ‐ 75
J0132 28 1,083 2,280 2.1 2.2 4.5 75 ‐ 100
J0150 884 1,900 16,640 8.8 9.8 10.2 20 ‐ 30
J0152 3,057 7,066 494,030 69.9 65.0 7.5 10 ‐ 20
J0170 972 1,012 3,860 3.8 4.2 9.5 10 ‐ 20
J0180 12 735 85,800 116.7 102.8 13.5 75 ‐ 100
J0207 71 71 17,750 250.0 259.1 3.5 50 ‐ 75
J0256 97 52,300 156,900 3.0 2.9 3.4 75 ‐ 100
J0278 39 205 0 0.0 0.9 100.0 30 ‐ 40
J0280 26 27 20 0.7 2.3 69.6 50 ‐ 75
J0290 15 60 150 2.5 3.1 19.4 75 ‐ 100
J0295 5 9 50 5.6 8.7 35.6 75 ‐ 100
J0330 50 347 50 0.1 1.1 90.9 75 ‐ 100
J0360 10 10 100 10.0 9.8 2.0 75 ‐ 100
J0456 241 241 3,410 14.1 19.1 26.2 50 ‐ 75
J0461 23 1,424 100 0.1 0.2 50.0 75 ‐ 100
J0475 289 1,471 238,050 161.8 161.8 0.0 30 ‐ 40
J0476 20 24 1,360 56.7 59.6 4.9 50 ‐ 75
J0500 3 3 40 13.3 18.3 27.3 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 186
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
J0583 3,725 979,958 2,308,390 2.4 2.3 4.3 5 ‐ 10
J0585 914 167,741 728,390 4.3 4.3 0.0 40 ‐ 50
J0587 4 150 1,200 8.0 8.3 3.6 75 ‐ 100
J0595 28 45 100 2.2 4.0 45.0 75 ‐ 100
J0610 78 291 0 0.0 1.1 100.0 50 ‐ 75
J0630 19 9,160 4,340 0.5 0.9 44.4 75 ‐ 100
J0636 18,333 293,349 73,830 0.3 0.3 0.0 0 ‐ 5
J0637 37 370 3,330 9.0 9.6 6.3 75 ‐ 100
J0690 5,589 16,590 5,320 0.3 1.5 80.0 20 ‐ 30
J0692 189 585 1,650 2.8 4.0 30.0 30 ‐ 40
J0694 4 4 50 12.5 1.1 1,036.4 75 ‐ 100
J0696 1,994 7,797 26,480 3.4 6.0 43.3 50 ‐ 75
J0698 1 1 10 10.0 17.7 43.5 75 ‐ 100
J0702 17 22 200 9.1 5.2 75.0 75 ‐ 100
J0710 2 2 0 0.0 3.8 100.0 75 ‐ 100
J0713 3,227 8,946 12,880 1.4 2.2 36.4 5 ‐ 10
J0718 18 7,200 22,900 3.2 3.1 3.2 30 ‐ 40
J0735 73 77 4,770 61.9 65.8 5.9 75 ‐ 100
J0740 63 63 37,800 600.0 598.9 0.2 20 ‐ 30
J0744 102 288 520 1.8 7.4 75.7 75 ‐ 100
J0780 494 498 650 1.3 3.5 62.9 20 ‐ 30
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 187
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
J0833 8 8 470 58.8 56.9 3.3 75 ‐ 100
J0834 272 272 19,040 70.0 69.6 0.6 30 ‐ 40
J0850 1 3 2,100 700.0 738.2 5.2 75 ‐ 100
J0878 2,866 1,770,517 590,250 0.3 0.4 25.0 50 ‐ 75
J0881 9,464 1,545,408 3,571,530 2.3 2.3 0.0 20 ‐ 30
J0882 30,896 2,202,732 5,155,240 2.3 2.3 0.0 5 ‐ 10
J0885 13,497 358,233 2,723,340 7.6 7.9 3.8 20 ‐ 30
J0894 475 23,750 558,300 23.5 23.6 0.4 50 ‐ 75
J0895 3 3 30 10.0 9.7 3.1 75 ‐ 100
J1030 312 395 2,240 5.7 8.1 29.6 50 ‐ 75
J1040 585 631 7,980 12.6 14.1 10.6 40 ‐ 50
J1055 2 2 120 60.0 62.2 3.5 0 ‐ 5
J1080 37 37 440 11.9 24.7 51.8 50 ‐ 75
J1094 1 20 0 0.0 1.4 100.0 75 ‐ 100
J1100 725 7,469 1,960 0.3 1.3 76.9 50 ‐ 75
J1110 16 16 460 28.8 31.5 8.6 40 ‐ 50
J1160 32 33 120 3.6 4.9 26.5 50 ‐ 75
J1165 1 20 10 0.5 1.8 72.2 75 ‐ 100
J1170 1,634 1,930 4,460 2.3 4.3 46.5 40 ‐ 50
J1200 1,492 1,502 2,550 1.7 3.5 51.4 30 ‐ 40
J1205 54 54 16,050 297.2 281.1 5.7 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 188
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
J1212 40 40 2,100 52.5 54.3 3.3 30 ‐ 40
J1245 17 76 140 1.8 8.1 77.8 75 ‐ 100
J1250 22 22 200 9.1 11.8 22.9 75 ‐ 100
J1260 30 300 750 2.5 5.0 50.0 75 ‐ 100
J1265 1 10 10 1.0 1.6 37.5 75 ‐ 100
J1267 8 450 180 0.4 0.5 20.0 75 ‐ 100
J1270 363,555 1,742,162 4,315,870 2.5 2.4 4.2 0 ‐ 5
J1300 82 7,380 1,230,000 166.7 168.5 1.1 30 ‐ 40
J1327 854 16,819 302,170 18.0 17.9 0.6 20 ‐ 30
J1410 5 5 350 70.0 72.0 2.8 75 ‐ 100
J1440 2,550 2,761 512,550 185.6 154.5 20.1 20 ‐ 30
J1441 2,975 3,062 845,350 276.1 273.1 1.1 20 ‐ 30
J1453 701 79,238 103,650 1.3 1.4 7.1 20 ‐ 30
J1459 636 39,640 1,124,450 28.4 25.5 11.4 50 ‐ 75
J1561 671 39,110 1,171,700 30.0 29.6 1.4 50 ‐ 75
J1566 348 18,624 440,050 23.6 25.2 6.3 50 ‐ 75
J1568 13 620 18,600 30.0 29.0 3.4 75 ‐ 100
J1569 839 52,068 1,561,960 30.0 30.5 1.6 50 ‐ 75
J1572 364 20,400 586,200 28.7 28.8 0.3 50 ‐ 75
J1580 7,276 9,250 450 0.0 1.0 100.0 0 ‐ 5
J1610 2,355 2,542 174,130 68.5 66.0 3.8 20 ‐ 30
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 189
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
J1630 26 27 130 4.8 30.5 84.3 75 ‐ 100
J1640 18 5,634 37,300 6.6 6.5 1.5 75 ‐ 100
J1642 525 19,930 1,070 0.1 0.1 0.0 75 ‐ 100
J1644 1,647 10,282 3,590 0.3 0.5 40.0 50 ‐ 75
J1645 3 6 120 20.0 12.3 62.6 75 ‐ 100
J1650 307 1,544 8,900 5.8 5.4 7.4 75 ‐ 100
J1652 853 8,287 38,020 4.6 4.8 4.2 50 ‐ 75
J1670 52 52 8,760 168.5 116.4 44.8 75 ‐ 100
J1720 5 5 50 10.0 5.4 85.2 75 ‐ 100
J1740 872 2,563 296,050 115.5 115.8 0.3 10 ‐ 20
J1742 90 104 26,300 252.9 250.7 0.9 20 ‐ 30
J1745 3,811 162,411 7,526,750 46.3 46.7 0.9 20 ‐ 30
J1750 1,070 6,536 72,600 11.1 11.8 5.9 30 ‐ 40
J1756 324,620 33,329,167 9,979,740 0.3 0.3 0.0 0 ‐ 5
J1790 12 12 40 3.3 4.6 28.3 75 ‐ 100
J1815 9 363 120 0.3 0.5 40.0 75 ‐ 100
J1817 9 9 0 0.0 2.1 100.0 75 ‐ 100
J1885 2,659 6,446 11,260 1.7 2.4 29.2 40 ‐ 50
J1940 1,344 2,680 5,330 2.0 2.6 23.1 30 ‐ 40
J1950 53 300 120,500 401.7 396.7 1.3 40 ‐ 50
J1953 177 13,610 5,450 0.4 0.4 0.0 40 ‐ 50
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 190
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
J1955 11,434 15,589 38,880 2.5 4.5 44.4 0 ‐ 5
J1956 1,024 1,951 15,310 7.8 12.4 37.1 50 ‐ 75
J2001 425 4,663 1,580 0.3 0.5 40.0 50 ‐ 75
J2020 76 399 10,070 25.2 27.0 6.7 75 ‐ 100
J2060 1,279 1,434 2,380 1.7 4.1 58.5 30 ‐ 40
J2150 3 3 0 0.0 4.4 100.0 75 ‐ 100
J2175 744 800 2,600 3.3 4.9 32.7 50 ‐ 75
J2250 4,588 12,015 18,730 1.6 2.1 23.8 40 ‐ 50
J2270 2,145 2,494 8,010 3.2 5.1 37.3 40 ‐ 50
J2275 23 25 80 3.2 0.3 966.7 75 ‐ 100
J2278 1 500 2,600 5.2 5.5 5.5 75 ‐ 100
J2280 21 84 430 5.1 5.8 12.1 75 ‐ 100
J2300 185 246 290 1.2 4.6 73.9 50 ‐ 75
J2310 9 11 70 6.4 6.5 1.5 75 ‐ 100
J2323 1,185 350,417 2,377,370 6.8 6.7 1.5 5 ‐ 10
J2325 45 675 20,250 30.0 30.6 2.0 10 ‐ 20
J2353 623 17,000 1,462,900 86.1 87.7 1.8 40 ‐ 50
J2357 1,752 107,375 1,673,310 15.6 15.6 0.0 10 ‐ 20
J2360 55 55 820 14.9 16.9 11.8 50 ‐ 75
J2370 34 34 170 5.0 1.4 257.1 75 ‐ 100
J2405 7,062 26,564 25,920 1.0 1.9 47.4 30 ‐ 40
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 191
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
J2430 647 1,639 21,340 13.0 15.3 15.0 20 ‐ 30
J2469 8,093 78,052 1,188,500 15.2 15.4 1.3 5 ‐ 10
J2501 893,088 4,591,209 13,435,830 2.9 2.8 3.6 0 ‐ 5
J2505 5,629 5,629 10,742,600 1,908.4 1,915.4 0.4 10 ‐ 20
J2543 10 28 120 4.3 7.5 42.7 75 ‐ 100
J2550 4,986 5,152 4,330 0.8 2.6 69.2 10 ‐ 20
J2562 1 24 5,400 225.0 232.7 3.3 75 ‐ 100
J2650 18 90 180 2.0 1.8 11.1 5 ‐ 10
J2710 66 641 130 0.2 0.6 66.7 75 ‐ 100
J2730 2 2 140 70.0 70.7 1.0 30 ‐ 40
J2765 955 963 900 0.9 3.0 70.0 30 ‐ 40
J2778 1,489 7,598 2,569,700 338.2 335.9 0.7 0 ‐ 5
J2780 56 112 480 4.3 4.2 2.4 75 ‐ 100
J2785 13,269 49,086 1,861,300 37.9 41.5 8.7 5 ‐ 10
J2790 27 27 1,850 68.5 62.3 10.0 30 ‐ 40
J2794 753 63,540 253,240 4.0 4.0 0.0 20 ‐ 30
J2795 6 602 440 0.7 0.4 75.0 75 ‐ 100
J2796 182 5,875 211,500 36.0 35.6 1.1 50 ‐ 75
J2805 74 74 3,420 46.2 54.4 15.1 50 ‐ 75
J2820 41 490 9,800 20.0 18.8 6.4 75 ‐ 100
J2850 23 218 3,550 16.3 17.6 7.4 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 192
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
J2916 41,126 293,513 1,262,980 4.3 4.2 2.4 0 ‐ 5
J2920 78 110 300 2.7 4.6 41.3 75 ‐ 100
J2930 1,374 1,731 7,890 4.6 5.6 17.9 30 ‐ 40
J2993 15 28 30,000 1,071.4 1,114.8 3.9 50 ‐ 75
J2997 14,144 48,918 1,359,430 27.8 30.4 8.6 5 ‐ 10
J3010 4,297 5,380 15,270 2.8 3.2 12.5 30 ‐ 40
J3030 52 52 1,960 37.7 42.5 11.3 40 ‐ 50
J3101 75 3,260 116,800 35.8 42.5 15.8 40 ‐ 50
J3230 1 1 10 10.0 8.0 25.0 75 ‐ 100
J3240 252 259 220,150 850.0 852.6 0.3 10 ‐ 20
J3243 86 8,550 8,280 1.0 0.9 11.1 75 ‐ 100
J3250 18 18 0 0.0 3.7 100.0 5 ‐ 10
J3260 652 955 350 0.4 1.8 77.8 10 ‐ 20
J3300 193 10,561 26,350 2.5 2.4 4.2 50 ‐ 75
J3301 508 2,206 6,020 2.7 3.5 22.9 50 ‐ 75
J3302 4 36 100 2.8 3.9 28.2 75 ‐ 100
J3315 75 209 30,200 144.5 146.7 1.5 20 ‐ 30
J3360 81 132 170 1.3 4.1 68.3 75 ‐ 100
J3370 26,889 47,290 171,040 3.6 3.0 20.0 5 ‐ 10
J3396 10 1,500 11,000 7.3 7.5 2.7 50 ‐ 75
J3410 54 92 220 2.4 3.5 31.4 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 193
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
J3411 36 43 210 4.9 7.6 35.5 50 ‐ 75
J3420 1,227 1,227 4,750 3.9 7.5 48.0 20 ‐ 30
J3430 7 70 60 0.9 1.5 40.0 75 ‐ 100
J3470 165 168 3,230 19.2 23.2 17.2 10 ‐ 20
J3471 79 5,054 2,840 0.6 0.4 50.0 20 ‐ 30
J3475 4 28 10 0.4 1.2 66.7 75 ‐ 100
J3480 34 327 250 0.8 0.8 0.0 75 ‐ 100
J3487 5,268 20,794 3,646,800 175.4 176.4 0.6 10 ‐ 20
J3488 4,418 21,551 3,614,700 167.7 166.0 1.0 5 ‐ 10
J3490 482 516 6,830 13.2 2.0 560.0 75 ‐ 100
J7030 2,142 2,493 22,830 9.2 9.8 6.1 40 ‐ 50
J7040 405 409 3,370 8.2 1.1 645.5 50 ‐ 75
J7050 2,082 2,239 5,870 2.6 5.7 54.4 40 ‐ 50
J7060 82 93 800 8.6 2.0 330.0 75 ‐ 100
J7070 18 21 210 10.0 9.3 7.5 75 ‐ 100
J7120 920 940 10,680 11.4 10.5 8.6 50 ‐ 75
J7308 87 91 9,100 100.0 105.6 5.3 10 ‐ 20
J7321 640 793 58,000 73.1 75.8 3.6 10 ‐ 20
J7323 238 313 29,840 95.3 93.9 1.5 20 ‐ 30
J7324 200 259 36,360 140.4 131.4 6.8 20 ‐ 30
J7325 556 15,855 149,430 9.4 10.3 8.7 30 ‐ 40
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 194
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
J7502 51 2,234 5,550 2.5 2.5 0.0 75 ‐ 100
J7506 140 3,800 0 0.0 0.2 100.0 50 ‐ 75
J7507 270 10,666 28,350 2.7 2.7 0.0 50 ‐ 75
J7511 17 69 22,200 321.7 320.8 0.3 50 ‐ 75
J7515 4 271 180 0.7 0.7 0.0 75 ‐ 100
J7517 180 11,151 16,790 1.5 1.5 0.0 50 ‐ 75
J7518 13 2,880 7,200 2.5 2.5 0.0 50 ‐ 75
J7520 1 1 10 10.0 8.0 25.0 75 ‐ 100
J8501 908 31,387 133,750 4.3 4.5 4.4 30 ‐ 40
J9001 409 2,547 962,400 377.9 377.5 0.1 30 ‐ 40
J9010 120 360 168,000 466.7 478.6 2.5 50 ‐ 75
J9025 1,433 259,816 1,026,430 4.0 4.2 4.8 50 ‐ 75
J9031 802 802 72,180 90.0 88.3 1.9 10 ‐ 20
J9033 424 83,210 1,275,700 15.3 15.2 0.7 50 ‐ 75
J9035 2,113 116,405 5,399,240 46.4 47.5 2.3 50 ‐ 75
J9041 2,565 78,258 2,439,050 31.2 30.8 1.3 20 ‐ 30
J9055 837 43,222 1,696,300 39.2 39.2 0.0 50 ‐ 75
J9155 19 1,840 3,550 1.9 2.4 20.8 40 ‐ 50
J9171 1,896 198,485 2,785,490 14.0 14.5 3.4 40 ‐ 50
J9178 12 800 1,500 1.9 2.1 9.5 75 ‐ 100
J9185 426 481 57,980 120.5 121.8 1.1 20 ‐ 30
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 195
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
J9190 21 42 140 3.3 8.7 62.1 75 ‐ 100
J9200 14 14 420 30.0 33.1 9.4 50 ‐ 75
J9201 4,172 33,673 3,861,000 114.7 116.2 1.3 20 ‐ 30
J9202 349 965 149,700 155.1 165.7 6.4 10 ‐ 20
J9206 1,048 13,723 77,850 5.7 8.6 33.7 50 ‐ 75
J9207 47 2,820 144,900 51.4 52.3 1.7 50 ‐ 75
J9209 18 82 340 4.1 3.6 13.9 75 ‐ 100
J9214 90 4,500 54,700 12.2 12.5 2.4 75 ‐ 100
J9217 2,169 6,815 1,156,150 169.6 184.0 7.8 10 ‐ 20
J9218 2 90 300 3.3 3.1 6.5 50 ‐ 75
J9225 8 8 9,400 1,175.0 1,946.8 39.6 40 ‐ 50
J9245 12 12 13,500 1,125.0 1,212.7 7.2 75 ‐ 100
J9263 1,197 380,718 1,737,690 4.6 4.7 2.1 50 ‐ 75
J9264 371 79,650 596,950 7.5 7.5 0.0 50 ‐ 75
J9268 5 5 5,000 1,000.0 990.6 0.9 75 ‐ 100
J9280 447 2,185 38,210 17.5 15.7 11.5 20 ‐ 30
J9290 86 165 11,300 68.5 64.9 5.5 40 ‐ 50
J9291 59 59 8,600 145.8 132.4 10.1 40 ‐ 50
J9293 86 378 13,790 36.5 35.6 2.5 50 ‐ 75
J9303 14 730 49,700 68.1 71.7 5.0 75 ‐ 100
J9305 848 79,149 3,234,280 40.9 41.5 1.4 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 196
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
J9310 3,666 26,777 12,254,050 457.6 459.5 0.4 20 ‐ 30
J9330 213 5,325 213,000 40.0 35.0 14.3 40 ‐ 50
J9340 39 110 9,950 90.5 91.3 0.9 40 ‐ 50
J9350 701 935 785,800 840.4 839.6 0.1 10 ‐ 20
J9355 1,683 54,459 2,857,750 52.5 50.0 5.0 30 ‐ 40
J9395 996 12,380 803,900 64.9 61.8 5.0 10 ‐ 20
L0120 148 148 2,920 19.7 18.1 8.8 40 ‐ 50
L0140 35 35 1,200 34.3 34.0 0.9 75 ‐ 100
L0172 17 17 1,680 98.8 71.6 38.0 75 ‐ 100
L0472 2 2 700 350.0 300.4 16.5 75 ‐ 100
L0625 5 5 200 40.0 37.1 7.8 75 ‐ 100
L1820 2 2 200 100.0 90.3 10.7 75 ‐ 100
L1830 708 708 41,930 59.2 57.0 3.9 30 ‐ 40
L1902 18 18 1,070 59.4 51.3 15.8 50 ‐ 75
L1906 25 25 1,850 74.0 63.2 17.1 50 ‐ 75
L1930 5 5 800 160.0 118.3 35.2 75 ‐ 100
L3030 2 2 120 60.0 45.8 31.0 75 ‐ 100
L3650 108 108 4,020 37.2 31.8 17.0 50 ‐ 75
L3660 20 20 1,460 73.0 48.7 49.9 75 ‐ 100
L3670 126 126 7,410 58.8 49.7 18.3 50 ‐ 75
L3675 1 1 30 30.0 80.8 62.9 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 197
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
L3702 9 9 1,800 200.0 176.6 13.3 50 ‐ 75
L3763 1 1 200 200.0 202.5 1.2 75 ‐ 100
L3806 2 2 600 300.0 193.3 55.2 75 ‐ 100
L3807 14 14 2,100 150.0 93.5 60.4 75 ‐ 100
L3808 174 174 32,010 184.0 163.0 12.9 50 ‐ 75
L3906 58 58 12,150 209.5 197.5 6.1 50 ‐ 75
L3908 409 413 15,850 38.4 36.7 4.6 40 ‐ 50
L3913 81 82 13,300 162.2 137.0 18.4 50 ‐ 75
L3919 4 4 600 150.0 118.4 26.7 75 ‐ 100
L3923 12 12 720 60.0 45.8 31.0 75 ‐ 100
L3925 13 13 500 38.5 35.3 9.1 75 ‐ 100
L3927 7 7 140 20.0 19.4 3.1 75 ‐ 100
L3933 14 14 2,100 150.0 96.8 55.0 75 ‐ 100
L4350 202 203 12,500 61.6 60.0 2.7 30 ‐ 40
L4360 44 44 8,860 201.4 162.8 23.7 75 ‐ 100
L4386 74 74 7,400 100.0 92.2 8.5 50 ‐ 75
L4396 1 1 100 100.0 102.4 2.3 75 ‐ 100
L5301 1 1 2,000 2,000.0 1,841.8 8.6 75 ‐ 100
L5629 1 1 250 250.0 228.9 9.2 75 ‐ 100
L5637 1 1 200 200.0 251.2 20.4 75 ‐ 100
L5671 1 1 400 400.0 365.9 9.3 75 ‐ 100
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 198
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
L5673 2 4 2,000 500.0 543.6 8.0 75 ‐ 100
L5910 1 1 250 250.0 292.8 14.6 75 ‐ 100
L5940 1 1 350 350.0 381.4 8.2 75 ‐ 100
L7900 6 6 2,350 391.7 392.1 0.1 20 ‐ 30
L8000 155 366 10,190 27.8 28.3 1.8 30 ‐ 40
L8015 3 3 120 40.0 41.3 3.1 75 ‐ 100
L8020 5 5 750 150.0 115.6 29.8 50 ‐ 75
L8030 54 60 15,300 255.0 246.8 3.3 30 ‐ 40
L8509 63 63 5,040 80.0 87.0 8.0 20 ‐ 30
L8681 1 1 800 800.0 607.9 31.6 75 ‐ 100
M0064 703 703 66,870 95.1 96.0 0.9 10 ‐ 20
P3000 494 494 9,880 20.0 15.7 27.4 10 ‐ 20
P9010 8 9 1,400 155.6 170.1 8.5 75 ‐ 100
P9016 21,350 37,484 5,485,830 146.4 144.6 1.2 10 ‐ 20
P9017 165 291 15,660 53.8 60.3 10.8 75 ‐ 100
P9021 2,296 3,842 452,390 117.7 109.6 7.4 20 ‐ 30
P9022 20 40 8,000 200.0 186.8 7.1 75 ‐ 100
P9031 25 121 9,680 80.0 86.9 7.9 75 ‐ 100
P9032 164 430 49,950 116.2 120.1 3.2 30 ‐ 40
P9034 175 185 67,950 367.3 364.7 0.7 50 ‐ 75
P9035 2,134 2,447 986,800 403.3 327.5 23.1 30 ‐ 40
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 199
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
P9036 11 11 3,300 300.0 252.2 19.0 75 ‐ 100
P9037 1,458 1,589 874,250 550.2 540.4 1.8 20 ‐ 30
P9038 147 177 33,900 191.5 175.8 8.9 30 ‐ 40
P9040 3,312 5,628 1,124,800 199.9 192.3 4.0 10 ‐ 20
P9041 11 660 8,800 13.3 13.5 1.5 75 ‐ 100
P9045 186 1,639 81,950 50.0 48.5 3.1 75 ‐ 100
P9047 1,104 3,480 173,970 50.0 51.4 2.7 30 ‐ 40
P9051 22 28 2,800 100.0 119.5 16.3 40 ‐ 50
P9056 7 13 1,650 126.9 132.0 3.9 75 ‐ 100
P9058 70 129 29,300 227.1 234.1 3.0 50 ‐ 75
P9059 15 25 1,300 52.0 61.8 15.9 75 ‐ 100
P9603 20,094 66,366 38,860 0.6 0.8 25.0 10 ‐ 20
P9604 39,022 42,490 172,620 4.1 4.7 12.8 5 ‐ 10
P9612 2,773 2,773 2,310 0.8 4.7 83.0 10 ‐ 20
P9615 92 92 0 0.0 3.0 100.0 30 ‐ 40
Q0081 14 14 260 18.6 29.5 36.9 75 ‐ 100
Q0091 1,443 1,443 16,140 11.2 9.3 20.4 10 ‐ 20
Q0092 171 172 2,120 12.3 14.8 16.9 40 ‐ 50
Q0111 197 199 1,970 9.9 6.7 47.8 30 ‐ 40
Q0112 56 56 520 9.3 6.0 55.0 50 ‐ 75
Q0114 2 2 20 10.0 9.9 1.0 50 ‐ 75
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 200
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
Q0138 344 173,420 108,660 0.6 0.6 0.0 20 ‐ 30
Q0139 3,380 1,679,141 1,069,370 0.6 0.6 0.0 0 ‐ 5
Q0179 8 8 30 3.8 6.9 44.9 75 ‐ 100
Q0512 213 375 4,860 13.0 12.7 2.4 5 ‐ 10
Q1003 31 31 5,780 186.5 157.2 18.6 40 ‐ 50
Q3014 203 203 4,060 20.0 18.9 5.8 50 ‐ 75
Q3025 479 1,261 188,950 149.8 141.1 6.2 30 ‐ 40
Q4081 1,360,653 105,950,000 80,750,790 0.8 0.8 0.0 0 ‐ 5
Q4101 923 40,296 1,052,770 26.1 26.6 1.9 20 ‐ 30
Q4102 511 6,856 23,890 3.5 3.8 7.9 50 ‐ 75
Q4106 941 34,451 1,087,910 31.6 31.5 0.3 20 ‐ 30
Q4107 3 48 3,600 75.0 80.7 7.1 75 ‐ 100
Q4116 1 1 30 30.0 28.6 4.9 75 ‐ 100
Q9963 12 244 10 0.0 0.5 100.0 75 ‐ 100
Q9965 45 45 1,070 23.8 1.2 1,883.3 75 ‐ 100
Q9966 13 125 210 1.7 1.2 41.7 75 ‐ 100
Q9967 1,315 99,747 53,370 0.5 0.7 28.6 75 ‐ 100
Q9968 319 8,486 11,350 1.3 1.5 13.3 40 ‐ 50
R0070 110 110 11,480 104.4 96.9 7.7 50 ‐ 75
R0075 50 50 1,130 22.6 33.1 31.7 50 ‐ 75
T1015 1,740 1,740 103,560 59.5 57.4 3.7 30 ‐ 40
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 201
CMS 2010 BSA Outpatient Procedures PUF General Documentation Page 202
HCPCS Code(1)
Number of Procedures in PUF
Count of Services in
PUF
Total Medicare Payment in PUF
($)
Mean Medicare Payment in PUF(2) ($)
Mean Medicare Payment in Initial 5% Sample(2) ($)
Difference in Means (%)
Suppression Rate (%)(1)
(a) (b) (c) (d) = (c)/(b) (e)
(f)= 100* abs[(e)‐(d)]/(e) (3)
(g)
V2020 1 1 40 40.0 42.2 5.2 75 ‐ 100
V2630 30 30 4,870 162.3 156.4 3.8 40 ‐ 50
V2632 589 589 67,630 114.8 121.9 5.8 5 ‐ 10
V2785 78 78 84,800 1,087.2 1,506.5 27.8 50 ‐ 75
(1) HCPCS codes that are fully suppressed (i.e., HCPCS codes that do not appear in the CMS 2010 BSA OP Procedures PUF) are not included in this table. Hence, the actual suppression rate for any HCPCS code in this table is less than 100%.
(2) Mean Medicare Payment in PUF and Mean Medicare Payment in Initial 5% Sample are both weighted means. Mean Medicare Payment in PUF is calculated by dividing total (rounded) Medicare payment by the count of services in the PUF. Mean Medicare Payment in Initial 5% Sample is calculated by dividing total actual (not rounded) Medicare payment in the initial 5% sample (not shown) by the count of services in the initial 5% sample (not shown) for each HCPCS code. A number of procedures are excluded from the initial 5% sample because of missing or invalid HCPCS codes or denied services.
(3) “abs[ ]” stands for absolute value of the term inside the brackets.