Free Industrial Commission of Arizona's - Arizona

Industrial Commission of Arizona's 2009 Staff Analysis of Physicians and Pharmaceutical Fee Schedule

by

Laura L. McGrory, Director Teresa Hilton, Commission Secretary Larry Etchechury, Consultant

March 24, 2009

INDEX

Page Introduction Purpose Part I ....................................... ....................................... ....................................... Table A - Codes to be Deleted . . . . . . . . . . . . . . . . . . . . Part II ....................................... A. Issues ................................... ............................... 3 3 4 4 5 5-7 7 8-11 12 13-49 50-52 53-54

B. New Codes

Table B ­ New Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . Part III ....................................... Table C ­ Surgery Codes (25000-39599) . . . . . . . . . . . Table D ­ Eval. & Mgmt. Codes . . . . . . . . . . . . . . . . . . Table E ­ Physical Medicine Codes . . . . . . . . . . . . . . . .

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INTRODUCTION

The information contained in this document is based, in part, on a review of the following documents: 1.) Current Procedural Terminology ("CPT ®") 2008, Fourth Edition, American Medical Association ("CPT ®-4"); 2.) Relative Values for Physicians, 2008, Ingenix, and 3.) The latest fee schedules from the states of Colorado, Nevada, New Mexico, North Carolina, Oregon, Utah and Washington. Commission staff trusts that this document will provide the necessary foundation to evaluate the existing ICA Fee Schedule, as well as any comments that might be received during the public hearing process.

PURPOSE

The focus of this year's report will be to update the Fee Schedule to incorporate the changes in the American Medical Association's 2008 edition of the CPT ®-4 and to review the values of new and selected codes from Surgery, Evaluation & Management and Physical Medicine. It is important to note that this document is a preliminary document that is provided to the general public and the Commissioners of the Industrial Commission of Arizona ("ICA") simultaneously. It is intended to serve as a foundational document for future discussions that may arise during the public hearing process. At the conclusion of the public hearing process, Commission staff will provide a supplemental staff report to the Commissioners, including an analysis of the public comments received, along with staff recommendations. The Commissioners, at a later duly noticed public meeting, will discuss the issues and take official action, which will be incorporated in this year's 2009 Fee Schedule.

®

CPT only © 2008 American Medical Association. All Rights Reserved.

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PART I

1.

This part of the staff study attempts to conform the ICA Fee Schedule to the changes that have taken place in the CPT ®-4. Staff is recommending the adoption of changes contained in Table A, which is a listing of the procedural codes that the American Medical Association has deleted from the 2008 edition of the CPT ®-4 publication. TABLE A Codes to be Deleted 01905 24350 24351 24352 24354 24356 32000 32002 32005 32019 32020 36540 36550 43750 47719 49200 49201 51000 51005 51010 52510 60001 67038 74350 75552 75553 75554 75555 75556 78615 86586 99361 99362 99371 99372 99373

2.

For copyright reasons, the Commission is not permitted to include in its Fee Schedule, the descriptors associated with five-digit CPT ® codes. Nevertheless, to ensure that the Fee Schedule is current and reflects the latest changes to the CPT ®, staff recommends that the Commission adopt by reference terminology changes to CPT ® codes.

®

CPT only © 2008 American Medical Association. All Rights Reserved.

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PART II This section addresses issues that have arisen since the last fee schedule process, new codes, and any codes that may be impacted by the addition of new codes. A. ISSUES

1.

Applicability of Pharmaceutical Fee Schedule to Medicines Dispensed by a Physician. A dispute recently arose between an insurance carrier and a physician regarding the applicability of the ICA fee schedule to medicines dispensed by a physician. The insurance carrier asserted that the fee schedule applies only to medicines dispensed by a pharmacy. The physician asserted that the fee schedule includes medicines dispensed by a physician. Arizona Revised Statute § 23-907(B) authorizes the Commission to "fix a schedule of fees...for prescription medicines required to treat an injured worker." (Emphasis added). The authorizing statute does not limit the setting of fees to medicines dispensed by a pharmacy and there is no language in the 2008 Fee Schedule that imposes such a limitation. Moreover, while it is true that the 2008 Fee Schedule does not expressly address a physician's dispensing of medications, it was the intent of the Commission to include within the Fee Schedule any entity that dispenses prescription drugs to an injured worker. Evidence of this intent is reflected in supporting documents for the 2008 fee schedule which contain a discussion of the application of code 99070 to retail prescription drugs by physicians (with the discussion focusing on the applicability of the pharmacy fee schedule as opposed to this code). For these reasons, we disagree with the insurance carrier's position that the pharmaceutical fee schedule does not apply to medicines dispensed by a physician.

2.

Dispensing Fee for Pharmaceuticals. In October of 2008, the Commission addressed the issue of dispensing fees for pharmaceuticals by establishing a dispensing fee of $7.00 per prescription. At that time, the Commission stated that they would revisit the issue during the fee schedule process in 2009. The dispensing fee also was raised as an issue in the foregoing dispute when the insurance carrier reduced the physician's dispensing fee to $3.00. The physician stated that the $7.00 dispensing fee (approved by the Commission in 2008) was the applicable fee. The insurance carrier asserted that, in addition to the inapplicability of the Fee Schedule to medicines dispensed by a physician, a physician who dispenses repackaged drugs for profit is not entitled to a dispensing fee of $7.00. In this regard, the insurance carrier wrote, "the ICA's desire to protect pharmacies was embodied in the increase of the fill fee from $4.00 to $7.00 per fill. Since many pharmacies are at risk for the first fill of medications due to the nature of workers' compensation, this was meant to protect them from the initial loss. This rationale does not apply to the physician's office".

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The insurance carrier raises an interesting issue, especially when one considers the purpose of a dispensing fee. Higher dispensing fees are paid, in part, to account for the extra administrative costs/risks uniquely associated with the workers' compensation system, including the risk of non-payment for initial prescriptions. With respect to pharmacies, prescriptions are generally filled before an industrial claim is accepted or denied. If a claim is not accepted, then there is a greater likelihood that the prescription provided to the injured worker by the pharmacy during this time will not be paid. As to physicians, the administrative costs and burdens may be similar, but the risks of non-payment are different. As the file of record for workers' compensation claims, we know that the majority of physicians attending to injured workers during the initial phase of a claim typically fall into two categories: those physicians that are a part of an occupational clinic that has a contract with the injured worker's employer or a personal or family physician that is included in the injured workers' private health plan. In either case, the risk of non-payment for that office visit (and any medication dispensed during that visit) is reduced or eliminated because the cost of that visit will be borne by the employer through their contract or the private health insurer if the claim is denied. In other words, the non-payment risks associated with prescription drugs, appears at best, to be minimal for the physician who dispenses medications. If a claim has not been accepted, the physician has the option to determine the level of risk of payment and choose to either fill the prescription or to refer the prescription to a pharmacy for filling. Given the dissimilar risks associated with non-payment of prescription drugs, should there be a separate and reduced dispensing fee for physicians that dispense prescription medications? We will be discussing and addressing this issue during this year's fee schedule process. 3. Applicability of Fee Schedule's Average Wholesale Price ("AWP") Formula to "Repackaged" Medicines. The dispute described above also included an issue regarding the AWP established by a "Repackager" to determine the payment for the repackaged medicines dispensed by the physician. 1 Effective October 1, 2008, the Commission adopted a drug payment provision that utilizes a discount 2 from "average wholesale price" plus a dispensing fee. In adopting this provision, the Commission intended that the payment of a drug be based on the AWP established by a wholesaler that sells the drug (either brand name or generic) to a pharmacy. There was no discussion of, nor consideration given to, the use of an AWP established by an entity that "repackages" drugs for distribution directly to
1

It appears that AWP's set by Repackagers are higher than the AWP's set by wholesalers that provide the same/similar drugs to pharmacies. As a result, the reimbursement rate is higher (for the same drug) if the Repackager's AWP is used to calculate the drug payment. 2 A 15% discount from the average wholesale price (AWP) for generic drugs and a 5% discount from the average wholesale price (AWP) for brand name drugs. 6

physicians. Further, while the Arizona Fee Schedule applies to the dispensing of prescription drugs, regardless of whether the drug is dispensed by a retail establishment or by a physician, the Commission intended that the reimbursement rate be essentially the same: it is based on the AWP of a wholesaler that sells the drug to a pharmacy. By utilizing this approach, we recognize that limited discretion is vested in the payer to select the AWP to use when dealing with payment for repackaged drugs. We do not believe, however, that this approach will result in unfair reimbursements. Rather, it is intended to result in consistency in payments for medications. Additionally, because the AWP information is published by a variety of sources (e.g. Red Book, MediSpan), the information is readily available and can be disclosed by the payer to the entity that seeks reimbursement for the dispensing of repackaged medications. In view of the foregoing, it is the intention of staff to recommend that payment for drugs be based on an AWP established by a wholesaler that sells that brand name or generic drug to a pharmacy plus a dispensing fee of seven dollars (per prescription). As a note for future discussions, the Commission intends to address the continued use of AWP in its Fee Schedule drug payment formula. It is well known that average wholesale price is self-reported data compiled by commercial publishers of drug pricing drug data. It does not reflect actual transaction prices for a drug and, for this reason, its use to establish drug reimbursements has been widely criticized. Charges of manipulation of AWP data has led to lawsuits and a great deal of attention on a national level. With on-going challenges and changes in federal law, it is probable that average wholesale price costing may not be available in the future. In fact, some publishers of the AWP data have said that they will discontinue publishing AWP within the next two years. As a result, after this fee schedule process is concluded, we intend to begin discussions with the affected parties to look at alternatives to this costing methodology. Anyone wishing to comment on this future issue is encouraged to do so.

B.

NEW CODES

Table B contains a listing of the procedural codes that have been added to the the CPT ®-4. The values associated with each code are based on a review of the workers' compensation fee schedules from the states of Colorado, Nevada, New Mexico, North Carolina, Oregon, Utah and Washington. The follow-up days associated with each procedure are taken from the 2008 Ingenix publication entitled, Relative Values for Physicians. We did not include any codes that were affected by these new codes.

®

CPT only © 2008 American Medical Association. All Rights Reserved.

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TABLE B New Procedure Codes & Values Procedure Code 01935 01936 20555 20985 20986 20987 21073 22206 22207 22208 24357 24358 24359 27267 27268 27269 27416 27726 27767 27768 27769 28446 29828 29904 29905 29906 29907 32421 32422 32550 32551 32560 33257 33258 33259 33864 34806 35523 36591 36592 36593 41019
8

Recommended ($) Value ASA ­ 5 + TM 5 + TM 593 268 By Report "BR" BR 533 4,149 4,098 1,040 783 920 1,131 922 1,206 2,728 2,135 1,608 452 696 1,203 2,081 1,598 1,076 1,160 1,222 1,493 229 330 746 333 334 1,106 1,248 1,630 5,936 194 2,432 40 49 62 877

Follow-up Days 0 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 0 0 0 0 0 90 90 0

TABLE B New Procedure Codes & Values (Continued) Procedure Code 49203 49204 49205 49440 49441 49442 49446 49450 49451 49452 49460 49465 50385 50386 50593 51100 51101 51102 52649 55920 57285 57423 58570 58571 58572 58573 60300 67041 67042 67043 67113 67229 68816 75557 75558 75559 75560 75561 75562 75563 75564
9

Recommended ($) Value 2,049 2,614 2,991 1,006 1,890 970 990 690 732 898 731 154 1,195 774 1,408 123 158 632 1,915 830 1,200 1,659 1,646 1,806 2,044 2,311 141 2,106 2,411 2,531 2,779 1,830 616 T ­ 1,235 PC ­ 350 T ­ 1,626 PC ­ 350 T ­ 1,787 PC ­ 350 T ­ 1,283 PC ­ 350 T ­ 1,336 PC ­ 255 T ­ 1,271 PC ­ 222 T ­ 1,498 PC ­ 275 T ­ 1,495 PC ­ 259

Follow-up
Days

90 90 90 10 10 10 0 0 0 0 0 0 0 0 10 0 0 10 90 0 90 90 90 90 90 90 0 90 90 90 90 90 10 -

TABLE B New Procedure Codes & Values (Continued) Procedure Code 80047 82610 83993 84704 86356 86486 87500 87809 88381 89322 89331 90284 90661 90662 90663 90769 90770 90771 90776 93982 95980 95981 95982 96125 97005 97006 98966 98967 98968 98969 99174 99605 99606 99607 99366 99367 99368 99406 99407 99408
10

Recommended ($) Value T ­ 39 PC ­ 17 T ­ 27 PC ­ 9 T ­ 42 PC ­ 15 T ­ 37 PC ­ 9 T ­ 121 PC ­ 42 T ­ 23 PC ­ 9 T ­ 69 PC ­ 17 T ­ 47 PC ­ 15 T ­ 340 PC ­ 76 30 38 22 BR BR BR 262 26 63 BR 79 79 36 74 187 89 60 26 50 74 40 29 BR BR BR 65 130 55 24 44 52

Follow-up Days -

Procedure Code 99409 99441 99442 99443 99444 99477

TABLE B New Procedure Codes & Values (Continued) Recommended ($) Value 102 22 40 60 40 643

Follow-up Days -

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PART III This section of the Staff Study addresses values for affected codes that have not been evaluated in some time. Historically, we have taken one section at a time and used that along with the addition of new codes and those codes that were impacted by these new codes as a focus for our updating process. Over the past couple of years, we realized that this process resulted in the untimely evaluation of too many codes. Accordingly, the decision was made to evaluate at least one section of the Fee Schedule annually, along with a part of the Surgery Section. Last year, we reviewed surgical codes 10000 thru 24999. This year we are reviewing codes 25000 thru 39599. In 2010, we will review surgery codes 40000 thru 59899. In 2011, we will review codes 60000 thru 69990 and in 2012, we will start the review process at the beginning of the section.

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TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 25000 25001 25020 25023 25024 25025 25028 25031 25035 25040 25065 25066 25075 25076 25077 25085 25100 25101 25105 25107 25109 25110 25111 25112 25115 25116 25118 25119 25120 25125 25126 25130 25135 25136 25145 25150 25151 25170 25210 25215 25230 25240 25246 25248 25250 25251 25259 25260 25263 25265 25270 25272 25274 13 Current $ Value 455.20 464 284.50 711.20 1,085 1,760 711.20 256 341.40 727 178 310 340 507 1,069 768.10 512.10 583.20 825 640.10 759 649 494 601 967.20 967.20 924.60 782.30 768.10 953 825 900.48 1,156.97 1,076.42 284.50 768.10 768.10 1,052.60 668.50 953 597.40 597.40 110 199.10 708 3,535 481 640.10 768.10 1,137.90 512.10 640.10 768.10 Proposed $ Value 575 506 784 1,364 1,168 1,810 711 422 1,038 912 247 620 537 765 1,411 768 661 796 1,004 960 647 No Change "NC" 512 642 1,335 1,157 747 1,001 961 1,095 1,102 900 1,157 1,076 1,092 927 1,000 1,501 779 1,272 692 792 229 745 1,037 3,168 605 1,154 1,042 1,348 946 1,057 1,192

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 25275 25280 25290 25295 25300 25301 25310 25312 25315 25316 25320 25332 25335 25337 25350 25355 25360 25365 25370 25375 25390 25391 25392 25393 25394 25400 25405 25415 25420 25425 25426 25430 25431 25440 25441 25442 25443 25444 25445 25446 25447 25449 25450 25455 25490 25491 25492 25500 25505 25515 25520 25525 25526 25530 14 Current $ Value 985 640.10 455.20 774.70 1,024.10 896.10 1,288.41 1,519.66 1,024.10 2,042.23 1,098 1,763.55 1,381 1,077 1,363.61 1,855.71 1,329.95 1,898.94 825 1,251.70 1,410.64 1,180.60 1,322.80 1,493.50 1,151 1,896 2,251 1,422.40 1,635.80 1,180.60 1,493.50 1,023 1,009 1,635.76 1,076 1,063 1,126 1,126 1,126 1,635.80 1,160 654.30 569 810.80 1,059 1,109 1,365 SV 516 1,259 1,000 2,203 3,612 SV Proposed $ Value 1,040 1,064 975 997 1,277 1,095 1,288 1,520 1,392 1,747 1,497 1,764 1,849 1,391 1,364 1,856 1,330 1,899 1,743 1,825 1,478 1,757 1,759 2,302 1,199 NC NC 1,546 2,037 1,862 2,113 1,094 1,226 1,656 1,551 1,377 1,523 1,643 1,486 2,372 1,537 1,623 1,074 1,184 1,290 1,352 1,605 353 721 NC NC NC NC 373

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 25535 25545 25560 25565 25574 25575 25600 25605 25606 25607 25608 25609 25622 25624 25628 25630 25635 25645 25650 25651 25652 25660 25670 25671 25675 25676 25680 25685 25690 25695 25800 25805 25810 25820 25825 25830 25900 25905 25907 25909 25915 25920 25922 25924 25927 25929 25931 25999 26010 26011 26020 26025 26030 26034 15 Current $ Value 486 1,309 SV 720 1,564 1,780 412 880 1,031 1,011 1,154 1,473 216 342 1,176.69 SV 564 756 656 603 889 118 900 733 360 756 640 1,562.40 594 940 1,568 2,155 2,155 960 1,274 1,077 1,018 918 772 853.40 1,929 753.90 284.50 753.90 853.40 284.50 853.40 BR 111 333 642 647 665 568 Proposed $ Value 669 NC 365 787 1,531 NC 427 917 1,044 1,085 1,331 1,711 439 627 1,177 449 593 884 NC 720 919 456 948 799 598 982 693 1,562 706 1,185 NC NC NC 1,095 1,559 1,401 1,095 1,220 970 1,105 2,042 1,060 930 1,095 1,157 885 1,095 NC 279 437 653 699 933 817

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 26035 26037 26040 26045 26055 26060 26070 26075 26080 26100 26105 26110 26115 26116 26117 26121 26123 *26125 26130 26135 26140 26145 26160 26170 26180 26185 26200 26205 26210 26215 26230 26235 26236 26250 26255 26260 26261 26262 26320 26340 26350 26352 26356 26357 26358 26370 26372 26373 26390 26392 26410 26412 26415 26416 16 Current $ Value 1,480 1,500 357 525 508 323 628 568 490 642 508 406 305 663.83 1,500 1,407 1,750 570 904 940 814 940 366 632.95 663.83 681.91 775 972 684 900 647 568 412 980 1,313 980 1,178 1,050 695 369 1,093 1,407.73 1,320 1,496.52 1,625.49 1,152.80 1,413 1,152.80 1,152.80 1,345.39 540.82 849 1,127 1,175.40 Proposed $ Value NC NC 471 800 679 401 NC 571 585 NC 613 491 665 704 NC NC NC NC NC 1,119 1,015 1,032 904 633 714 719 907 1,078 701 1,216 808 791 697 NC 1,414 987 NC NC NC 475 1,274 1,408 NC 1,497 1,625 1,260 1,455 1,153 1,338 1,448 898 1,056 1,162 1,399

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 26418 26420 26426 26428 26432 26433 26434 26437 26440 26442 26445 26449 26450 26455 26460 26471 26474 26476 26477 26478 26479 26480 26483 26485 26489 26490 26492 26494 26496 26497 26498 26499 26500 26502 26508 26510 26516 26517 26518 26520 26525 26530 26531 26535 26536 26540 26541 26542 26545 26546 26548 26550 26551 26553 17 Current $ Value 587.50 853 961.12 1,254.88 705.45 705.45 806 795 707 888 508 791 490 369 357 823 647 663 663 852.65 852.65 1,129.15 1,497.90 1,313 1,627 1,275 1,627 1,485 1,750 1,525.39 1,965.13 1,568 841 940 940 1,287.17 819 1,134 1,400 790 790 990 1,137 882 1,137 953 1,392 1,175.70 1,308.61 1,222.73 940.56 1,520 6,466.35 6,466.35 Proposed $ Value 880 1,169 964 1,255 770 873 1,051 1,007 1,031 1,056 965 1,280 645 641 480 961 917 879 880 853 858 1,129 1,498 1,325 NC NC NC 1,537 NC 1,525 1,965 1,845 1,010 1,102 1,026 1,287 961 1,221 NC 1,077 1,082 NC NC NC NC 1,004 NC 1,176 1,309 1,316 1,061 2,437 6,576 6,466

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 26554 26555 26556 26560 26561 26562 26565 26567 26568 26580 26587 26590 26591 26593 26596 26600 26605 26607 26608 26615 26641 26645 26650 26665 26670 26675 26676 26685 26686 26700 26705 26706 26715 26720 26725 26727 26735 26740 26742 26746 26750 26755 26756 26765 26770 26775 26776 26785 26820 26841 26842 26843 26844 26850 18 Current $ Value 7,642.05 1,536.94 6,466.35 1,137 1,392 2,000 980 980 1,219 2,650 875 1,410 850 840 1,549 SV 313 668.50 782.32 711.20 285 470.28 881.78 1,066.80 253 647.97 499.45 767 1,050 249 346 470.28 822.99 SV 273 442.32 705.42 SV 562.91 860 SV 231 288.43 480.10 236.34 211.02 327.13 538.16 1,295 1,000 1,263 1,000 1,263 963 Proposed $ Value 7,758 2,112 6,466 NC 1,537 2,730 NC 1,082 1,342 NC 1,157 2,086 NC 957 NC 299 471 685 782 795 387 587 882 1,067 365 648 747 852 1,364 348 455 661 823 282 422 582 747 328 563 1,028 191 319 317 530 287 366 528 557 NC 1,025 1,274 1,076 NC 1,056

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 26852 26860 *26861 26862 *26863 26910 26951 26952 26989 26990 26991 26992 27000 27001 27003 27005 27006 27025 27030 27033 27035 27036 27040 27041 27047 27048 27049 27050 27052 27054 27060 27062 27065 27066 27067 27070 27071 27075 27076 27077 27078 27079 27080 27086 27087 27090 27091 27093 27095 27096 27097 27098 27100 27105 19 Current $ Value 1,134 696 280 963 398 955 509 579 BR 711.20 213.40 469.40 405 574 792 711 569 953 1,522 1,322.80 1,635.80 1,939.91 225 687 516 598 1,351 569 1,322.80 1,920.20 284.50 455.20 632 1,012 1,443 1,002 1,111 1,747 2,033 2,396 1,252 1,234 621 136 674 1,322.80 3,698.20 123 241.80 248 1,137.90 1,493.50 1,422.40 1,493.50 Proposed $ Value 1,271 1,021 316 966 442 978 863 1,023 NC 825 620 1,506 516 634 1,049 873 1,056 1,287 1,858 1,889 2,189 1,940 282 867 686 796 1,544 677 1,323 1,920 686 709 767 1,256 1,809 1,203 1,421 3,618 2,710 4,220 1,579 1,648 754 322 899 1,673 3,698 324 532 418 1,167 1,494 1,675 1,759

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 27110 27111 27120 27122 27125 27130 27132 27134 27137 27138 27140 27146 27147 27151 27156 27158 27161 27165 27170 27175 27176 27177 27178 27179 27181 27185 27187 27193 27194 27200 27202 27215 27216 27217 27218 27220 27222 27226 27227 27228 27230 27232 27235 27236 27238 27240 27244 27245 27246 27248 27250 27252 27253 27254 20 Current $ Value 1,920.20 1,422.40 2,275.80 1,920.20 3,129 4,281.40 2,973 4,622.80 3,129 3,129 1,137.90 1,920.20 2,062.50 2,159 2,289 2,347 2,062.50 2,062.50 2,275.80 SV 1,920.20 2,204.70 1,991.40 1,493.50 2,275.80 753.90 1,731 370 1,162 SV 479 2,025 3,520 3,500 5,012 SV 954 3,094 7,294 9,531 SV 1,134 2,430 2,520 SV 1,134 2,340 3,584 SV 846 548 562 1,760 2,538 Proposed $ Value 1,942 1,816 2,731 2,449 NC 4,281 3,808 4,623 3,326 3,435 1,604 1,997 2,434 2,870 3,046 2,667 2,332 2,603 2,475 1,310 1,956 2,205 1,991 1,591 2,276 1,029 2,272 718 NC 254 998 NC NC NC NC 697 1,408 NC NC NC 648 1,215 NC NC 693 1,489 2,423 NC 589 1,250 748 1,095 1,985 NC

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 27256 27257 27258 27259 27265 27266 27267 27268 27269 27275 27280 27282 27284 27286 27290 27295 27299 27301 27303 27305 27306 27307 27310 27323 27324 27325 27326 27327 27328 27329 27330 27331 27332 27333 27334 27335 27340 27345 27347 27350 27355 27356 27357 *27358 27360 27365 27370 27372 27380 27381 27385 27386 27390 27391 21 Current $ Value SV 540 2,070 2,340 612 612 New New New 544 1,674 2,046 3,520 3,696 4,693.90 2,844.80 BR 213.40 341.40 469.40 241.80 355.60 1,251.70 204 419 1,242 1,174 386 557 1,408 953 1,265.90 1,507.70 1,920.20 1,322.80 1,977.10 412.50 725.40 586 1,081 981.50 999 1,422.40 551 1,024.10 1,379.70 56.90 270.30 953 1,137.90 1,137.90 1,493.50 549 715 Proposed $ Value 623 1,348 2,225 2,786 704 900 922 1,206 2,728 NC 1,733 NC NC NC 4,694 2,845 NC 665 1,071 731 510 634 1,333 282 546 NC NC 595 655 1,607 NC 1,266 1,508 1,920 1,512 1,977 614 891 782 1,201 1,101 1,291 1,457 619 1,330 1,918 195 782 1,152 1,654 1,291 1,753 731 956

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 27392 27393 27394 27395 27396 27397 27400 27403 27405 27407 27409 27412 27415 27416 27418 27420 27422 27424 27425 27427 27428 27429 27430 27435 27437 27438 27440 27441 27442 27443 27445 27446 27447 27448 27450 27454 27455 27457 27465 27466 27468 27470 27472 27475 27477 27479 27485 27486 27487 27488 27495 27496 27497 27498 22 Current $ Value 962 691 806 1,272 1,422.40 1,635.80 1,493.50 993 1,322.80 1,493.50 1,706.90 3,951 3,298 New 1,316 1,800 1,800 1,800 1,800 1,750 2,240 3,474 1,422.40 1,322.80 1,422.40 1,877.60 2,418.10 2,347 2,275.80 2,702.60 3,940.10 3,200.40 4,281.40 1,237.50 1,778 1,920.20 1,137.90 1,322.80 1,920.20 2,489.20 2,844.80 1,920.20 2,204.70 1,322.80 1,493.50 1,920.20 1,038.40 2,323 4,551.70 2,204.70 1,912 554 678 773 Proposed $ Value 1,192 786 1,018 1,419 1,422 1,636 1,494 1,312 1,384 1,546 1,986 NC NC 2,135 1,865 NC NC NC NC NC 2,456 NC 1,445 1,323 1,422 1,878 2,418 NC 2,276 2,703 3,940 3,200 4,281 1,828 2,206 2,220 1,899 2,047 1,984 2,489 2,845 1,986 2,284 1,353 1,636 1,920 1,283 2,682 4,552 2,560 2,521 734 850 965

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 27499 27500 27501 27502 27503 27506 27507 27508 27509 27510 27511 27513 27514 27516 27517 27519 27520 27524 27530 27532 27535 27536 27538 27540 27550 27552 27556 27557 27558 27560 27562 27566 27570 27580 27590 27591 27592 27594 27596 27598 27599 27600 27601 27602 27603 27604 27605 27606 27607 27610 27612 27613 27614 27615 23 Current $ Value 891 SV SV 954 1,606 2,450 2,250 SV 1,470 954 2,451 2,891 2,194 SV 846 1,800 SV 1,368 SV 594 1,905 2,450 SV 1,674 SV 396 1,800 2,411 3,040 SV 306 1,440 306 2,430 1,237.50 1,351.30 1,095.30 284.50 625.90 1,180.60 BR 469.40 443 597.40 142.20 297 120.90 241.80 341.40 853.40 853.40 159 437 1,181 Proposed $ Value 1,180 787 844 1,239 NC NC NC 797 NC 1,088 NC NC NC 768 1,203 2,092 451 NC 581 915 NC NC 706 NC 458 796 2,049 NC NC 398 704 1,742 325 NC 1,540 1,489 1,342 796 1,351 1,555 NC 663 682 848 794 414 581 476 845 1,101 1,079 371 686 1,585

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 27618 27619 27620 27625 27626 27630 27635 27637 27638 27640 27641 27645 27646 27647 27648 27650 27652 27654 27656 27658 27659 27664 27665 27675 27676 27680 27681 27685 27686 27687 27690 27691 *27692 27695 27696 27698 27700 27702 27703 27704 27705 27707 27709 27712 27715 27720 27722 27724 27725 27726 27727 27730 27732 27734 24 Current $ Value 405 704 853.40 1,137.90 1,135 452 953 1,237.50 1,132 1,440 756 1,934 611.60 1,237.50 54.10 1,072 1,189 1,322.80 569 597.40 753.90 455 596 778 913 469.40 569 668.50 753.90 668.50 753.90 953 241.80 953 1,322.80 1,322.80 1,294.40 1,807 1,683 772 1,180.60 597.40 1,635.80 1,635.80 2,275.80 1,422.40 1,635.80 1,778 1,778 New 1,422.40 953 569 1,180.60 Proposed $ Value 651 1,056 926 1,244 1,341 611 1,209 1,393 1,507 1,582 1,225 NC 1,511 1,619 229 1,311 1,403 1,467 628 680 957 610 756 820 981 687 823 776 893 738 976 1,156 260 1,039 1,323 1,501 1,555 2,678 2,549 1,140 1,511 670 1,706 1,797 2,276 1,824 1,774 2,196 2,460 1,608 2,001 1,046 783 1,237

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 27740 27742 27745 27750 27752 27756 27758 27759 27760 27762 27766 27767 27768 27769 27780 27781 27784 27786 27788 27792 27808 27810 27814 27816 27818 27822 27823 27824 27825 27826 27827 27828 27829 27830 27831 27832 27840 27842 27846 27848 27860 27870 27871 27880 27881 27882 27884 27886 27888 27889 27892 27893 27894 27899 25 Current $ Value 1,706.90 2,062.50 1,088 SV 720 1,440 2,050 2,250 SV 414 1,080 New New New SV 420 954 SV 392 954 SV 570 1,314 SV 720 1,653 1,800 SV 850 1,638 2,618 3,038 1,050 397 420 939 433 575 1,046 1,109 111 2,282 1,953 1,137 1,299 913 627 929 1,093 1,038.40 494 493 611 BR Proposed $ Value 1,707 2,063 1,450 509 810 NC NC 2,235 462 648 1,133 452 696 1,203 352 544 NC 456 593 1,076 427 780 1,445 323 863 NC 1,872 461 867 NC NC NC NC 498 583 NC 447 591 1,296 1,485 278 NC 1,290 1,511 1,720 1,188 925 1,233 1,442 1,370 1,155 1,155 1,810 NC

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 28001 28002 28003 28005 28008 28010 28011 28020 28022 28024 28035 28043 28045 28046 28050 28052 28054 28055 28060 28062 28070 28072 28080 28086 28088 28090 28092 28100 28102 28103 28104 28106 28107 28108 28110 28111 28112 28113 28114 28116 28118 28119 28120 28122 28124 28126 28130 28140 28150 28153 28160 28171 28173 28175 26 Current $ Value 179 654.30 638 680 184.90 56.90 120.90 569 341.40 241.80 753.90 294 491 856 569 341.40 241.80 989 469.40 839.20 569 341.40 327.20 597.40 469.40 417 318 579 826 683 469.40 768 578 426.70 424 668.50 384.10 120.90 1,137.90 668.50 469.40 469.40 569 455.20 341.40 426 953 569 413 427 446 983 807 636 Proposed $ Value 251 654 869 925 616 357 452 761 561 581 912 509 709 1,164 619 588 552 NC 749 1,046 720 598 566 826 655 625 509 780 868 912 719 912 823 624 571 759 641 666 1,290 912 850 761 774 918 694 557 1,095 893 557 575 595 999 1,116 813

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 28190 28192 28193 28200 28202 28208 28210 28220 28222 28225 28226 28230 28232 28234 28238 28240 28250 28260 28261 28262 28264 28270 28272 28280 28285 28286 28288 28289 28290 28292 28293 28294 28296 28297 28298 28299 28300 28302 28304 28305 28306 28307 28308 28309 28310 28312 28313 28315 28320 28322 28340 28341 28344 28345 27 Current $ Value 137 368 447 569 753.90 270.30 412.50 469.40 569 270.30 341.40 284.50 135.10 92.50 668.50 341.40 469.40 753.90 853.40 1,322.80 1,137.90 410 324 410 505 461 436 647 625.90 773 1,034 1,000 1,018 1,033 947 1,084 905 1,054 871 1,149 668.50 698 622 920 532 512 420 509 1,018 728 762 908 451 638 Proposed $ Value 299 506 614 694 936 528 811 637 760 519 642 534 380 369 1,018 627 792 937 1,160 1,889 1,280 563 445 562 674 625 586 687 839 1,038 1,389 1,107 1,241 1,095 1,055 1,365 1,068 1,064 1,175 1,550 804 935 788 1,056 721 659 593 690 1,020 995 955 1,140 565 835

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 28360 28400 28405 28406 28415 28420 28430 28435 28436 28445 28446 28450 28455 28456 28465 28470 28475 28476 28485 28490 28495 28496 28505 28510 28515 28525 28530 28531 28540 28545 28546 28555 28570 28575 28576 28585 28600 28605 28606 28615 28630 28635 28636 28645 28660 28665 28666 28675 28705 28715 28725 28730 28735 28737 28 Current $ Value 1,451 SV 414 616 1,827 1,832 SV 486 616 1,516.90 New SV 234 616 712 SV 270 500 720 SV 126 261 475 SV 125 360 280 406 140 245 416 944.02 128 325 756 1,082 139 234 376 720 154 350 546 486 103 250 537 288 2,250 1,780 1,693.73 1,285 1,176 978 Proposed $ Value 1,818 371 607 832 1,836 1,914 347 521 663 1,712 2,081 321 431 NC 952 321 399 512 784 157 229 454 747 149 213 634 NC 563 303 449 644 983 268 448 NC 1,317 307 369 629 1,067 210 NC NC 647 158 NC NC 606 2,317 1,934 1,694 1,334 1,372 1,176

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 28740 28750 28755 28760 28800 28805 28810 28820 28825 28890 28899 29000 29010 29015 29020 29025 29035 29040 29044 29046 29049 29055 29058 29065 29075 29085 29086 29105 29125 29126 29130 29131 29200 29220 29240 29260 29280 29305 29325 29345 29355 29358 29365 29405 29425 29435 29440 29445 29450 29505 29515 29520 29530 29540 29 Current $ Value 530 846 508 720 953 953 569 284.50 241.80 543 BR 237 284.50 355.60 284.50 355.60 142.24 241.80 184.90 199.10 56.90 184.90 71.10 64 49.80 49.80 86 49.80 42.70 68 38 55 52 59 56 45 41 184.90 241.80 92.50 120.90 227.60 56.90 71.12 85.30 106.70 28.50 207 42.70 64 49.80 27 27 27 Proposed $ Value 892 994 641 852 955 1,103 750 634 493 NC NC 432 346 366 340 392 294 270 333 366 136 239 154 132 105 105 104 108 88 118 53 112 64 80 77 54 53 310 336 191 207 236 161 130 146 178 56 259 111 99 96 78 71 53

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 29550 29580 29590 29700 29705 29710 29715 29720 29730 29740 29750 29799 29800 29804 29805 29806 29807 29819 29820 29821 29822 29823 29824 29825 29826 29827 29828 29830 29834 29835 29836 29837 29838 29840 29843 29844 29845 29846 29847 29848 29850 29851 29855 29856 29860 29861 29862 29863 29866 29867 29868 29870 29871 29873 30 Current $ Value 27 35.60 27 69 85.30 102 106 52 58 86 101 BR 602 1,310 576 2,521 2,450 2,100 1,780 2,130 1,878 2,130 1,543 2,130 2,448 2,450 New 989 2,315 1,874 2,366 1,711 2,366 1,031 1,585 1,860 2,212 2,061 2,109 1,312 1,636 2,371 1,869 2,134 1,147 2,219 2,259 2,532 2,586 3,080 4,169 905 1,406 771 Proposed $ Value 53 79 118 84 99 127 123 72 67 96 129 NC 820 1,347 735 NC NC NC NC NC NC NC NC 1,385 NC NC 1,598 NC 1,936 NC NC NC 2,042 NC 1,461 1,478 1,742 1,901 1,901 NC NC NC NC NC NC NC NC NC NC NC NC NC NC 1,088

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 29874 29875 29876 29877 29879 29880 29881 29882 29883 29884 29885 29886 29887 29888 29889 29891 29892 29893 29894 29895 29897 29898 29899 29900 29901 29902 29904 29905 29906 29907 29999 30000 30020 30100 30110 30115 30117 30118 30120 30124 30125 30130 30140 30150 30160 30200 30210 30220 30300 30310 30320 30400 30410 30420 31 Current $ Value 1,720 1,937 2,135 2,135 2,135 2,800 2,135 2,765 3,062 2,135 2,577 2,061 2,135 4,072 3,804 2,040 2,040 894 1,743 1,628 1,628 2,420 1,534 701 770 826 New New New New BR 120.90 135.10 71.10 142.24 384.10 138 129.40 953 270.30 327.20 184.90 682.80 2,304.30 1,216 66 73 174 42.70 341.40 1,152.10 1,095.30 1,564.60 1,778 Proposed $ Value NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC NC 1,935 NC NC NC NC NC 1,660 724 799 837 1,076 1,160 1,222 1,493 NC 278 164 149 224 600 579 1,192 NC 340 969 382 683 1,763 1,264 124 150 234 229 341 1,152 1,511 1,960 2,140

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 30430 30435 30450 30460 30462 30465 30520 30540 30545 30560 30580 30600 30620 30630 30801 30802 30901 30903 30905 30906 30915 30920 30930 30999 31000 31002 31020 31030 31032 31040 31050 31051 31070 31075 31080 31081 31084 31085 31086 31087 31090 31200 31201 31205 31225 31230 31231 31233 31235 31237 31238 31239 31240 31254 32 Current $ Value 241.80 725.40 1,095.30 1,276 2,554 2,080 1,095.30 1,024.10 1,920.20 42.70 953 1,450.90 1,066.80 926 42.67 99.57 42.70 61.20 184.90 184.90 953 1,906 110 BR 35.60 78.20 369.80 1,095.30 836 1,265.90 643 871 953 1,493.50 1,536.20 1,536.20 2,119.40 1,877.60 2,116.21 2,116.21 2,418.10 611.60 753.90 1,223.30 2,347 2,702.60 146 250 246 300 509 1,329 409 1,000 Proposed $ Value 1,003 1,673 2,285 1,412 2,620 NC 1,095 1,101 1,920 211 NC 910 1,067 1,001 176 282 139 187 293 339 NC NC 124 NC 165 229 500 1,133 1,112 1,542 861 1,169 NC 1,494 1,563 1,746 2,148 2,183 2,116 2,116 2,418 726 1,126 1,341 2,713 3,169 267 388 409 511 527 NC NC NC

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 31255 31256 31267 31276 31287 31288 31290 31291 31292 31293 31294 31299 31300 31320 31360 31365 31367 31368 31370 31375 31380 31382 31390 31395 31400 31420 **31500 31502 31505 31510 31511 31512 31513 31515 31525 31526 31527 31528 31529 31530 31531 31535 31536 31540 31541 31545 31546 31560 31561 31570 31571 31575 31576 31577 33 Current $ Value 1,300.10 1,000 739 797 620 725 2,014 2,115 1,634 1,788 2,044 BR 1,493.50 483.60 2,418.10 3,698.20 2,418.10 3,698.24 2,702.60 2,204.70 2,204.70 2,204.70 2,233.20 3,532 1,920.20 1,493.50 199 72 60 298.70 298.70 298.70 298.70 169 270.30 355.60 361 294 297 384.10 597.40 384.10 597.40 656 782.30 949 1,447 1,422.40 1,863.30 782.30 725.40 213.40 355.60 355.60 Proposed $ Value 1,300 880 756 1,106 691 819 2,292 2,408 1,679 1,837 2,099 NC 1,941 801 2,701 3,803 2,831 3,741 2,791 2,607 2,918 2,704 3,872 4,553 1,920 1,494 NC 91 130 306 311 310 299 219 378 400 482 NC NC 462 597 444 497 NC 625 NC NC 1,422 1,863 782 725 213 356 446

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 31578 31579 31580 31582 31584 31587 31588 31590 31595 31599 31600 31603 31605 31610 31611 31612 31613 31614 31615 *31620 31622 31623 31624 31625 31628 31629 31630 31631 *31632 *31633 31635 31636 *31637 31638 31640 31641 31643 31645 31646 31656 31715 31717 31720 31725 31730 31750 31755 31760 31766 31770 31775 31780 31781 31785 34 Current $ Value 625.90 267 1,664.20 938.80 625.90 880 1,304 702 835 BR 458 498 455 852 690 121 371 748 389 347 501 549 464 543 639 823 716 645 118 140 716 591 213 653 747 1,048 466 484 484 403 78.20 82.50 78.20 113.80 263 896.10 896.10 1,408.20 2,662 1,678.40 1,763.80 2,275.80 2,275.80 1,445 Proposed $ Value 626 359 1,862 2,941 2,371 1,531 1,761 1,819 1,382 NC 605 NC NC 1,105 826 NC 507 1,083 NC 455 519 570 530 567 678 1,079 NC NC 123 148 NC NC NC NC NC NC NC 500 NC NC 80 196 87 161 576 2,073 2,274 2,274 2,936 2,274 2,307 2,622 3,063 1,971

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 31786 31800 31805 31820 31825 31830 31899 32035 32036 32095 32100 32110 32120 32124 32140 32141 32150 32151 32160 32200 32201 32215 32220 32225 32310 32320 32400 32402 32405 32420 32421 32422 32440 32442 32445 32480 32482 32484 32486 32488 32491 32500 *32501 32503 32504 32540 32550 32551 32560 32601 32602 32603 32604 32605 35 Current $ Value 2,097 896.10 896.10 455.20 455.20 455.20 BR 768.10 839.20 782.30 1,289 1,392 1,145 1,326 1,483 1,706.90 1,364 1,263 979 1,383.73 522.28 1,045 2,007 1,444 1,706.90 2,275.80 185 852 233 208 New New 3,174.39 2,545 2,633 2,204.70 2,148 2,202 2,347 2,517 3,409.53 2,233.83 822.89 4,634 5,300 1,778 New New New 474 523 592 664 548 Proposed $ Value 2,834 1,209 1,765 603 887 620 NC 1,057 1,212 1,000 1,552 1,845 1,382 1,469 1,575 2,033 1,588 1,622 1,365 1,572 616 1,280 2,464 1,586 2,333 2,557 211 1,123 276 NC 229 330 3,174 3,388 4,147 2,432 2,716 2,762 3,123 3,350 3,410 2,357 823 NC NC 1,980 746 333 334 638 702 828 919 740

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 32606 32650 32651 32652 32653 32654 32655 32656 32657 32658 32659 32660 32661 32662 32663 32664 32665 32800 32810 32815 32820 32850 32851 32852 32853 32854 32855 32856 32900 32905 32906 32940 32960 32997 32998 32999 33010 33011 33015 33020 33025 33030 33031 33050 33120 33130 33140 *33141 33202 33203 33206 33207 33208 33210 36 Current $ Value 645 947 1,310 1,820 1,237 1,262 1,417 1,389 1,455 1,341 1,372 2,003 1,170 1,651 1,889 1,311 1,583 896.10 668.50 1,038.40 2,315 999 5,878.90 6,519.68 7,054.20 7,642.05 BR BR 1,180.60 1,900 2,396 1,237.50 99.60 602 5,547 BR 216 191 579 1,479 1,422.40 2,289 1,949 1,422.40 3,129.30 1,778 3,046 1,567 1,182 1,253 995.70 995.70 995.70 355.60 Proposed $ Value 873 1,268 1,905 2,657 1,649 1,819 1,972 1,764 2,047 1,937 1,774 2,638 1,733 1,919 2,748 1,923 2,308 1,310 1,484 3,548 3,072 1,546 5,879 6,520 7,054 7,642 3,629 4,185 2,110 2,179 2,693 1,995 198 620 4,757 NC 259 205 686 1,517 1,517 2,707 2,855 1,733 4,086 2,677 NC NC 1,382 1,426 996 1,143 1,164 380

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 33211 33212 33213 33214 33215 33216 33217 33218 33220 33222 33223 33224 *33225 33226 33233 33234 33235 33236 33237 33238 33240 33241 33243 33244 33249 33250 33251 33254 33255 33256 *33257 *33258 *33259 33261 33265 33266 33282 33284 33300 33305 33310 33315 33320 33321 33322 33330 33332 33335 33400 33401 33403 33404 33405 33406 37 Current $ Value 367 355.60 660 1,324 480 900 579 426.70 548 601 683 1,220 1,220 950 301 967.47 1,117.58 868 1,246 1,407 716 296 1,704 1,005 1,746 2,500 3,000 2,062 2,576 3,079 New New New 3,000 2,138 2,930 738 573 1,422.40 2,489.20 1,778 2,844.80 1,422.40 2,429 2,489 2,489.20 2,489.20 3,556 2,844.80 2,975 3,031 3,666 3,556 4,470 Proposed $ Value 393 838 800 1,466 525 964 717 756 714 899 1,235 NC 1,127 NC 418 1,719 1,910 1,771 1,901 2,074 1,348 964 3,672 2,696 2,360 NC 3,098 2,547 2,938 3,456 1,106 1,248 1,630 NC 2,209 3,283 742 576 2,074 3,002 2,183 3,456 1,784 3,456 3,888 3,888 4,061 4,838 3,668 3,457 3,730 4,222 5,021 5,710

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 33410 33411 33412 33413 33414 33415 33416 33417 33420 33422 33425 33426 33427 33430 33460 33463 33464 33465 33468 33470 33471 33472 33474 33475 33476 33478 33496 33500 33501 33502 33503 33504 33505 33506 33507 *33508 33510 33511 33512 33513 33514 33516 **33517 **33518 **33519 **33521 **33522 **33523 *33530 33533 33534 33535 33536 33542 38 Current $ Value 5,330 4,421 4,530 4,769 4,358 2,844.80 3,545 2,844.80 2,133.60 3,129.30 3,413.80 3,690 4,225 3,556 3,129.30 3,626 3,725 3,556 3,840.50 2,275.80 2,888 2,275.80 2,844.80 3,945 3,129.30 3,413.80 4,492.50 2,587 2,111 2,135 2,489.20 3,556 3,793 3,793 4,470 850 3,556 3,510 3,822 4,134 4,445 4,757 347 693 1,040 1,387 1,734 2,080 1,127 3,659 4,115 4,570 5,026 3,844 Proposed $ Value NC 5,291 5,647 5,970 5,412 3,821 3,821 3,912 2,911 3,912 4,198 4,094 NC 4,094 3,705 4,516 3,931 4,257 4,436 2,735 3,085 4,007 4,007 4,933 4,170 4,491 4,108 4,128 2,120 2,547 2,820 3,639 4,179 4,194 NC 39 3,821 4,094 4,367 4,711 4,912 5,762 351 NC 1,103 1,501 1,723 NC 1,190 4,003 4,276 NC 5,632 4,185

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 33545 33548 *33572 33600 33602 33606 33608 33610 33611 33612 33615 33617 33619 33641 33645 33647 33660 33665 33670 33675 33676 33677 33681 33684 33688 33690 33692 33694 33697 33702 33710 33720 33722 33724 33726 33730 33732 33735 33736 33737 33750 33755 33762 33764 33766 33767 *33768 33770 33771 33774 33775 33776 33777 33778 39 Current $ Value 4,598 5,885 458 4,004 3,651 4,358 4,400 4,358 4,470 4,518 4,428 4,527 5,072 2,560.30 2,844.80 3,337 3,413.80 3,556 4,267.20 3,401 3,508 3,646 2,851 3,556 355.60 1,422.40 3,982.70 4,267.20 4,527 2,844.80 3,738 3,556 3,651 2,442 3,221 3,556 3,687 2,275.80 3,065 2,275.80 2,563 2,583 2,583 2,583 2,636 3,121 1,072 4,513 4,584 3,634 3,701 4,043 3,768 4,591 Proposed $ Value 4,845 NC 610 4,053 3,912 NC 4,579 NC NC 4,884 4,628 5,149 6,331 3,093 3,366 3,366 3,957 4,061 4,147 3,802 3,931 4,061 3,411 4,003 4,003 2,183 4,003 4,267 4,967 3,684 4,003 3,730 3,912 2,678 3,629 4,194 3,932 2,365 3,388 2,547 2,729 2,729 2,729 3,027 2,729 3,378 NC 5,016 5,098 4,003 4,139 4,321 4,257 5,114

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 33779 33780 33781 33786 33788 33800 33802 33803 33813 33814 33820 33822 33824 33840 33845 33851 33852 33853 33860 33861 33863 33864 33870 33875 33877 33880 33881 33883 *33884 33886 33889 33891 33910 33915 33916 33917 33920 33922 *33924 33925 33926 33930 33933 33935 33940 33944 33945 33960 *33961 33967 33968 33970 33971 33973 40 Current $ Value 4,605 4,645 4,618 4,267.20 2,489.20 1,736 1,706.90 2,133.60 2,529 3,317 1,422.40 1,706.90 2,133.60 2,133.60 2,844.80 2,926 3,075 4,411 3,982.70 4,280 4,392 New 5,689.60 2,133.60 5,359 4,613 3,963 2,932 1,090 2,533 2,180 2,782 3,129.30 2,133.60 2,609 3,722 4,439 2,975 566 4,571 6,175 BR BR 18,811.20 BR BR BR 1,740 1,091 800 230 1,066.80 584 1,056 Proposed $ Value 4,749 5,076 4,911 4,871 2,944 2,050 2,183 2,547 2,547 3,548 2,140 2,232 2,554 2,729 3,002 3,002 3,184 NC 5,232 5,295 5,199 5,936 6,038 4,594 5,658 NC NC NC NC NC NC NC 3,283 2,409 3,318 NC NC 3,366 691 NC NC 2,183 4,730 18,811 1,910 3,257 14,377 3,110 NC NC 259 1,067 1,144 NC

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 33974 33975 33976 33977 33978 33979 33980 33999 34001 34051 34101 34111 34151 34201 34203 34401 34421 34451 34471 34490 34501 34502 34510 34520 34530 34800 34802 34803 34804 34805 34806 *34808 34812 *34813 34820 34825 *34826 34830 34831 34832 34833 34834 34900 35001 35002 35005 35011 35013 35021 35022 35045 35081 35082 35091 41 Current $ Value 1,106 2,106 2,869 1,843 2,106 3,199 2,805 BR 1,275 1,323 1,034 901 1,920.20 1,422.40 1,179 1,834.90 1,351.30 1,834.90 1,564.60 1,820.70 970 2,709 1,192 1,619 1,505 3,422 3,482 3,376 3,482 3,119 New 564 910 812 1,313 1,695 556 4,046 4,445 4,445 1,618 1,000 1,514 2,275.80 1,899 1,602 1,422.40 1,856 2,347 2,133 1,368 2,944.40 3,271.50 3,030 Proposed $ Value 1,910 2,360 NC 2,359 2,696 3,352 4,883 NC 1,583 1,901 1,071 1,180 2,164 1,627 1,646 2,384 1,779 2,142 1,752 1,480 1,338 3,366 1,618 2,160 1,936 NC NC NC NC 2,856 194 NC NC NC NC NC NC NC NC NC NC 722 1,546 2,546 2,409 2,143 1,901 2,102 2,830 2,354 1,782 2,921 3,696 3,569

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 35092 35102 35103 35111 35112 35121 35122 35131 35132 35141 35142 35151 35152 35180 35182 35184 35188 35189 35190 35201 35206 35207 35211 35216 35221 35226 35231 35236 35241 35246 35251 35256 35261 35266 35271 35276 35281 35286 35301 35302 35303 35304 35305 *35306 35311 35321 35331 35341 35351 35355 35361 35363 35371 35372 42 Current $ Value 3,720 2,749 3,542 2,432.30 1,655 2,659.90 2,972 2,432.30 2,350 1,778 1,870 1,920.20 1,469 1,157 1,563 1,238 1,256 1,689 1,337 1,593.10 1,593.10 1,200 1,920.20 1,920.20 1,920.20 1,593.10 1,593.10 1,593.10 1,920.20 1,920.20 1,920.20 1,593.10 1,593.10 1,593.10 2,019.80 1,920.20 1,920.20 1,593.10 2,133.60 1,821 2,001 2,082 2,001 752 2,714 1,692.70 2,347 2,844.80 2,574 2,561 3,110 3,431 1,635.80 1,419 Proposed $ Value 4,412 3,173 3,820 2,615 2,729 2,820 3,323 2,618 2,894 2,052 2,270 2,147 2,274 1,775 2,365 1,725 1,685 2,765 1,764 2,055 1,996 1,996 2,825 2,398 2,398 1,593 2,246 2,246 3,120 2,575 2,808 1,918 1,746 2,081 2,765 2,312 2,580 1,728 2,419 1,987 2,160 2,333 2,246 864 3,566 1,920 2,494 3,267 2,713 NC 3,307 3,653 1,834 1,728

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code *35390 *35400 35450 35452 35454 35456 35458 35459 35460 35470 35471 35472 35473 35474 35475 35476 35480 35481 35482 35483 35484 35485 35490 35491 35492 35493 35494 35495 *35500 35501 35506 35508 35509 35510 35511 35512 35515 35516 35518 35521 35522 35523 35525 35526 35531 35533 35536 35537 35538 35539 35540 35548 35549 35551 43 Current $ Value 297 430.95 1,234 616 832 968 1,112 1,223 524 1,239 1,314 689 891 1,027 1,132 524 1,344 652 873 1,046 1,162 782 1,315 638 854 1,024 1,137 765 519 2,574 2,574 2,895 2,574 2,087 2,574 2,040 2,895 2,574 3,003 2,574 1,989 New 1,886 2,854 3,363 3,754 2,854 3,520 3,933 3,696 4,121 2,895 3,472 3,303 Proposed $ Value 388 431 1,259 773 NC NC 1,199 NC 734 2,777 3,078 2,071 1,969 2,742 1,939 1,516 1,415 820 NC NC 1,197 982 1,323 722 899 1,082 1,226 888 528 2,575 2,975 NC 2,843 2,595 NC 2,544 NC NC NC NC 2,469 2,432 2,354 2,911 3,437 NC 2,973 4,061 4,486 4,147 4,666 2,949 NC 3,535

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 35556 35558 35560 35563 35565 35566 35571 *35572 35583 35585 35587 *35600 35601 35606 35612 35616 35621 35623 35626 35631 35636 35637 35638 35642 35645 35646 35647 35650 35651 35654 35656 35661 35663 35665 35666 35671 *35681 *35682 *35683 *35685 *35686 35691 35693 35694 35695 *35697 *35700 35701 35721 35741 35761 35800 35820 35840 44 Current $ Value 2,787 2,574 3,218 2,682 2,682 3,218 3,218 917 2,233 2,568 2,352 684 2,308 1,956 1,897 1,906 1,871 2,278 2,591 3,131 2,750 2,800 2,845 1,714 1,674 2,892 3,931 1,835 2,889 2,431 1,934.50 1,824 2,112 1,984 2,204.70 1,881 1,211 810 912 346 451 2,135 1,347 1,559 1,559 249 269 711.20 597.40 597.40 633 654 1,116 921 Proposed $ Value NC 2,999 3,368 NC NC 3,252 NC NC 2,425 2,857 2,383 NC 2,420 2,183 2,183 2,183 2,183 2,331 2,664 3,190 2,814 2,886 2,933 2,765 2,765 2,911 NC 2,141 3,374 2,547 2,274 1,863 2,183 2,183 2,365 2,323 NC NC NC 415 NC 2,254 1,863 2,166 2,166 324 330 856 775 820 770 899 2,354 1,263

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 35860 35870 35875 35876 35879 35881 35883 35884 35901 35903 35905 35907 36000 36002 36005 36010 36011 36012 36013 36014 36015 36100 36120 36140 36145 36160 36200 36215 36216 36217 *36218 36245 36246 36247 *36248 36260 36261 36262 36299 36405 36406 36410 36415 36416 36425 36430 36450 36455 36460 36468 36469 36470 36471 36475 45 Current $ Value 612 2,152 1,007 638 2,239 2,620 2,043 2,170 845 919 1,422.40 1,400 21.30 281 74 170.70 277 343 260 294 343 312.90 312.90 170.70 85.30 241.80 332 412 487 581 212 467 487 581 212 959 424 332 BR 49.80 19 21.30 10 10 92.50 54 362 271 938 99 164 73 106 2,809 Proposed $ Value 826 2,881 1,228 1,679 NC NC 2,246 2,419 1,132 1,260 2,957 3,284 86 323 422 352 528 792 528 792 792 704 621 528 707 528 704 1,092 1,320 1,876 264 1,232 1,320 1,753 264 1,276 582 448 NC 52 60 27 18 NC 93 63 605 864 NC NC NC 102 148 3,154

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code *36476 36478 *36479 36481 36500 36510 36511 36512 36513 36514 36515 36516 36522 36556 36558 36561 36563 36565 36566 36569 36571 36575 36576 36578 36580 36581 36582 36583 36584 36585 36589 36590 36591 36592 36593 36595 36596 36597 36598 36600 36620 36625 36640 36660 36680 36800 36810 36815 36818 36819 36820 36821 36822 36823 46 Current $ Value 561 2,590 566 711 199 135 145 145 145 145 229 229 249 313 735 1,041 1,073 1,063 1,111 278 928 171 519 588 205 640 930 805 207 651 218 501 New New New 580 141 160 322 35.60 106.70 170.70 265 179 140 654 299 298.70 1,438 1,839 1,663 1,331 607 BR Proposed $ Value 653 2,735 664 864 306 141 180 180 180 508 2,069 2,473 440 411 1,278 1,710 1,792 1,383 2,543 450 1,981 220 557 706 394 866 1,552 1,371 410 1,704 234 627 40 49 62 1,060 231 201 NC 41 113 174 NC NC 147 370 573 382 NC NC NC NC 836 2,094

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 36825 36830 36831 36832 36833 36834 36835 36838 36860 36861 36870 37140 37145 37160 37180 37181 37182 37183 37184 *37185 *37186 37187 37188 37195 37200 37201 37202 37203 37204 37205 *37206 37207 *37208 37209 37210 37215 37216 *37250 *37251 37500 37501 37565 37600 37605 37606 37607 37609 37615 37616 37617 37618 37620 37650 37660 47 Current $ Value 1,422.40 1,180.60 705 888 1,117 1,034 1,422.40 1,804 426.70 426.70 947 2,347 2,314 2,347 2,347 2,484 2,275 1,530 1,177 431 646 1,095 791 640.87 331 706 553 490 1,765 1,183 550 1,176 569 297 1,342 2,691 2,598 254.45 176.36 1,166 BR 625.90 597.40 739.70 621 512 298.70 612 1,087 1,307 547 1,422.40 492 907 Proposed $ Value 1,583 1,419 764 974 1,171 1,366 1,422 2,042 405 427 2,534 2,820 2,729 2,820 2,820 3,314 NC 1,092 3,682 1,206 2,481 3,579 3,083 709 422 1,037 743 1,373 2,246 2,203 1,299 1,486 768 562 1,936 NC NC 254 176 NC NC 1,092 819 1,002 885 625 356 800 1,497 1,761 723 1,429 764 1,221

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 37700 37718 37722 37735 37760 37765 37766 37780 37785 37788 37790 37799 38100 38101 *38102 38115 38120 38129 38200 38204 38205 38206 38207 38208 38209 38210 38211 38212 38213 38214 38215 38220 38221 38230 38240 38241 38242 38300 38305 38308 38380 38381 38382 38500 38505 38510 38520 38525 38530 38542 38550 38555 38562 38564 48 Current $ Value 660 708 836 1,640 725.40 669 824 184.90 106.70 775 759 BR 2,400 2,400 438 2,400 2,088 BR 156.50 250 198 198 102 111 98 106 167 106 106 88 167 299 320 339 552 499 225 119 361 461 646 1,165 838 261 134 379 463 413 640 565 569 1,195 977 1,041 Proposed $ Value NC 719 864 1,668 1,728 913 1,114 422 359 1,778 1,728 NC NC NC 583 NC NC NC 289 NC NC NC NC 88 71 109 121 88 71 74 123 NC NC 665 NC NC NC 163 491 622 868 1,563 1,124 351 178 510 622 553 819 600 725 1,525 1,275 1,385

TABLE C ARIZONA PHYSICIANS' FEE SCHEDULE SURGERY Code 38570 38571 38572 38589 38700 38720 38724 38740 38745 *38746 *38747 38760 38765 38770 38780 38790 38792 38794 38999 39000 39010 39200 39220 39400 39499 39501 39502 39503 39520 39530 39531 39540 39541 39545 39560 39561 39599 Current $ Value 1,429 1,996 2,326 BR 1,019 1,778 1,778 661 998 415 462 953 1,920.20 1,610 2,631.40 270.30 BR 400 BR 554.70 1,066.80 1,706.90 1,706.90 597.40 BR 2,400 2,500 3,402 1,662 1,778 1,778 2,500 1,621.50 1,991.40 2,183 2,910 BR Proposed $ Value NC NC NC NC 1,352 2,101 2,101 801 1,307 555 594 1,181 1,984 1,801 2,631 273 173 498 NC 778 1,318 1,707 1,848 809 NC NC NC 4,577 2,250 2,160 1,999 NC 1,728 1,991 NC NC NC

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TABLE D ARIZONA PHYSICIANS' FEE SCHEDULE EVALUATION AND MANAGEMENT Code 99201 99202 99203 99204 99205 99211 99212 99213 99214 99215 99217 99218 99219 99220 99221 99222 99223 99231 99232 99233 99234 99235 99236 99238 99239 99241 99242 99243 99244 99245 99251 99252 99253 99254 99255 99281 99282 99283 99284 99285 99288 99289 *99290 99291 *99292 99293 99294 99295 99296 99298 99299 99300 99304 99305 50 Current $ Value 48 85 106 151 231 27 45 63 95 137 93 93 155 216 94 161 217 55 86 127 168 238 285 95 133 68 124 154 196 278 71 130 160 200 271 35 50 110 171 251 190 455 228 300 154 1,459 722 1,097 585 251 239 248 77 102 No Change (NC) No Change (NC) NC 119 169 NC 29 50 76 114 165 NC 102 178 223 109 186 241 62 102 190 195 269 323 149 179 82 141 182 237 322 86 135 190 248 338 36 69 137 205 306 314 407 218 347 178 1,385 678 1,241 662 NC 219 219 134 135

TABLE D ARIZONA PHYSICIANS' FEE SCHEDULE EVALUATION AND MANAGEMENT Code 99306 99307 99308 99309 99310 99315 99316 99318 99324 99325 99326 99327 99328 99334 99335 99336 99337 99339 99340 99341 99342 99343 99344 99345 99347 99348 99349 99350 *99354 *99355 *99356 *99357 *99358 *99359 99360 99363 99364 99366 99367 99368 99374 99375 99377 99378 99379 99380 99381 99382 99383 99384 99385 99386 99387 99391 51 Current $ Value 125 40 66 92 116 98 117 79 70 100 145 191 236 53 84 129 190 57 BR 81 121 181 235 287 64 102 157 229 164 137 161 126 157 83 112 126 46 New New New 105 147 106 165 104 148 116 130 127 138 138 162 176 92 No Change (NC) 169 52 80 121 152 NC 132 101 NC 131 190 251 311 69 110 170 250 NC 42 91 NC NC NC NC 68 NC NC NC NC NC NC NC NC 84 124 NC NC 65 130 55 NC NC 96 NC 96 150 159 165 182 191 191 217 233 114

TABLE D ARIZONA PHYSICIANS' FEE SCHEDULE EVALUATION AND MANAGEMENT Code 99392 99393 99394 99395 99396 99397 99401 99402 99403 99404 99406 99407 99408 99409 99411 99412 99420 99429 99431 99432 99433 99435 99436 99440 99441 99442 99443 99444 99450 99455 99456 99477 99499 Current $ Value 103 101 112 113 125 138 29 58 88 117 New New New New 15 22 RNE BR 90 103 53 125 123 205 New New New New BR 230 266 New BR No Change (NC) 133 133 152 159 168 179 41 78 112 146 24 44 52 102 74 127 132 BR 124 134 66 164 164 249 22 40 60 40 150 220 254 643 BR

52

TABLE E ARIZONA PHYSICIANS' FEE SCHEDULE PHYSICAL MEDICINE Code 97001 97002 97003 97004 97005 97006 97010 97012 97014 97016 97018 97022 97024 97026 97028 97032 97033 97034 97035 97036 97039 97110 97112 97113 97116 97124 97139 97140 97150 97530 97532 97533 97535 97537 97542 97545 *97546 97597 97598 97602 97605 97606 97750 97755 97760 97761 97762 97799 97802 97803 97804 97810 *97811 97813 53 Current $ Value 100 52 100 50 New New 15 20 20 23 22 22 22 21 21 25 34 20 20 33 22 36 37 39 30 28 22 36 31 44 47 47 43 34 35 144 58 67 86 29 BR BR 47 47 36 36 30 BR 29 29 12 30 26 33 Proposed $ Value 119 64 No Change "NC" 60 89 60 NC 25 24 25 NC 27 NC 17 NC 27 NC 23 23 38 NC 41 41 NC 33 38 NC 41 NC NC 51 51 50 44 42 NC 66 92 116 56 46 NC 52 NC 41 40 38 BR 47 41 24 37 30 39

TABLE E ARIZONA PHYSICIANS' FEE SCHEDULE PHYSICAL MEDICINE Code *97814 98925 98926 98927 98928 98929 98940 98941 98942 98943 98960 98961 98962 98966 98967 98968 98969 Current $ Value 29 39 55 73 85 97 39 55 73 27 31 37 40 New New New New Proposed $ Value 33 59 70 88 103 114 50 61 79 47 NC 18 15 26 50 74 40

54