2016 Work Comp Fee Schedule: Unveiling Surgical Code Updates
In case you missed it, every single fee in the workers’ comp Physician Fee Schedule changed on January 1, 2016. Yes, every single one.
My recent article, 2016 Changes to Workers’ Comp Physician and Non-Physician Fee Schedule, summarizes the major changes. Today’s article takes a closer look and explains how the new fee schedule impacts your bottom line.
Surgical Code Fee Reductions
The table below displays the surgical procedure codes most frequently used by 1,400+ daisyBill users. Sorted by frequency, the table compares the old December 2015 fees to the new January 2016 fees for surgical procedures rendered in both facility and non-facility settings.
As you can see, the new fee schedule reduces ALL procedure codes fees for surgical procedures. Most surgical procedure code fees decrease by at least 6%.
Procedure Code |
Description |
Facility Dec 2015 Fee |
Facility Jan 2016 Fee |
Facility Fee % Change |
Non-Facility Dec 2015 Fee |
Non-Facility Jan 2016 Fee |
Non-Facility Fee % Change |
20610 |
Drain/inj joint/bursa w/o us |
$71.93 |
$67.47 |
-6.20% |
$95.34 |
$89.32 |
-6.31% |
20550 |
Inj tendon sheath/ligament |
$65.41 |
$61.03 |
-6.70% |
$94.23 |
$87.92 |
-6.70% |
29240 |
Strapping of shoulder |
$28.95 |
$27.02 |
-6.67% |
$46.36 |
$43.26 |
-6.69% |
62284 |
Injection for myelogram |
$136.58 |
$126.73 |
-7.21% |
$299.26 |
$278.53 |
-6.93% |
64483 |
Inj foramen epidural l/s |
$179.81 |
$168.34 |
-6.38% |
$358.10 |
$338.06 |
-5.60% |
64484 |
Inj foramen epidural add-on |
$81.71 |
$77.16 |
-5.57% |
$141.14 |
$133.73 |
-5.25% |
29826 |
Shoulder arthroscopy/surgery |
$274.64 |
$253.98 |
-7.52% |
$274.64 |
$253.98 |
-7.52% |
20605 |
Drain/inj joint/bursa w/o us |
$57.88 |
$54.36 |
-6.08% |
$78.89 |
$74.53 |
-5.53% |
17000 |
Destruct premalg lesion |
$84.73 |
$79.77 |
-5.85% |
$106.94 |
$100.50 |
-6.02% |
29823 |
Shoulder arthroscopy/surgery |
$983.55 |
$923.61 |
-6.09% |
$983.55 |
$923.61 |
-6.09% |
17003 |
Destruct premalg les 2-14 |
$3.73 |
$3.48 |
-6.70% |
$9.13 |
$8.52 |
-6.68% |
29530 |
Strapping of knee |
$28.35 |
$26.81 |
-5.43% |
$45.16 |
$43.06 |
-4.65% |
64555 |
Implant neuroelectrodes |
$246.51 |
$228.90 |
-7.14% |
$342.56 |
$319.08 |
-6.85% |
62311 |
Inject spine lumbar/sacral |
$142.26 |
$133.86 |
-5.90% |
$364.97 |
$346.16 |
-5.15% |
17004 |
Destroy premal lesions 15/> |
$157.66 |
$148.19 |
-6.01% |
$241.71 |
$226.61 |
-6.25% |
29877 |
Knee arthroscopy/surgery |
$988.55 |
$926.34 |
-6.29% |
$988.55 |
$926.34 |
-6.29% |
64450 |
N block other peripheral |
$72.45 |
$68.16 |
-5.92% |
$130.68 |
$121.94 |
-6.69% |
29881 |
Knee arthroscopy/surgery |
$862.08 |
$808.28 |
-6.24% |
$862.08 |
$808.28 |
-6.24% |
62310 |
Inject spine cerv/thoracic |
$172.54 |
$162.68 |
-5.71% |
$394.66 |
$373.30 |
-5.41% |
Stay tuned for future articles with similar tables for radiology, Evaluation / Management, California-specific codes, and more–including codes with increased reimbursement.
If you’d rather get all the information in one fell swoop, download the slides and video from our recent webinar. The downloads include all the tables and provide step-by-step instructions for calculating the new reimbursements.
Or, to make it super easy to keep up with this and other frequent fee schedule changes, sign up for the daisyBill Calculator. It’s easy, instant, and FREE for a three day trial.
TRY THE CALCULATOR
DaisyBill provides content as an insightful service to its readers and clients. It does not offer legal advice and cannot guarantee the accuracy or suitability of its content for a particular purpose.
