Medical Reimbursement Final Project

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CHARGE CODE CODE DESCRIPTION CPT CODE REV CODE REVENUE AREA CHARGE MEDICARE VOL TPP VOL MCR Reimb TPP Reimb*.62 MCR Cost TPP Cost MCR Profit TPP Profit Overall MCR Profit Overall TPP Profit
49210 BIOPSY BREAST 1ST LESION STRTCTC 19081 320 1137 2980.8 56 150
49211 BIOPSY BREAST ADD LESION STRTCTC 19083 320 1137 2980.8 56 160
49212 BIOPSY BREAST 1ST LESION STRTCTC 19085 320 1137 2980.8 23 101
49213 BIOPSY BREAST PERCUT W/O IMAGING GUIDANCE 19100 360 1137 826.8 58 115
49214 BIOPSY OF BREAST, OPEN 19101 360 1137 3944.25 37 76
49217 CRYOSURG ABLATE FIBROADENOMA, EACH 19105 360 1137 6059.85 21 32
49218 NIPPLE EXPLORATION 19110 360 1137 3944.25 12 14
49219 EXCISE BREAST DUCT FISTULA 19112 360 1137 3944.25 14 17
49220 REMOVAL OF BREAST LESION 19120 360 1137 3944.25 76 87
49221 EXCISION, BREAST LESION 19125 360 1137 3944.25 45 90
49223 REMOVAL OF CHEST WALL LESION 19260 360 1137 3076.44 22 43
49227 PLACE BALLOON CATHETER FOR RADIOELEMENT APP 19296 360 1137 10810.92 5 24
49229 PLACE BRACHYTHERAPY CATHETER 19298 360 1137 10810.92 10 32
49230 REMOVAL OF BREAST TISSUE 19300 360 1137 3944.25 21 68
49231 PARTIAL MASTECTOMY 19301 360 1137 3944.25 24 45
49232 P-MASTECTOMY W LYMPHADENECTOMY 19302 360 1137 7608.72 21 65
49233 MASTECTOMY, SIMPLE, COMPLETE 19303 360 1137 6059.85 18 47
49234 MASTECTOMY, SUBCUTANEOUS 19304 360 1137 6059.85 17 56
49235 MASTECTOMY, MODIFIED RADICAL 19307 360 1137 7608.72 15 63
49236 SUSPENSION OF BREAST 19316 360 1137 6059.85 11 2
49237 REDUCTION OF LARGE BREAST 19318 360 1137 7608.72 9 12
49238 ENLARGE BREAST 19324 360 1137 7608.72 0 23
49239 ENLARGE BREASE WITH IMPLANT 19325 360 1137 10810.92 0 25
49240 REMOVAL OF BREAST IMPLANT 19328 360 1137 6059.85 5 13
49241 REMOVAL OF BREAST IMPLANT MATERIAL 19330 360 1137 6059.85 0 16
49242 IMMEDIATE BREAST PROSTHESIS 19340 360 1137 7608.72 0 34
49243 DELAYED BREAST PROSTHESIS 19342 360 1137 10810.92 17 27
49244 BREAST RECONSTRUCTION 19350 360 1137 3944.25 4 47
49245 CORRECT INVERTED NIPPLE(S) 19355 360 1137 6059.85 0 3
49246 BREAST RECONSTRUCTION 19357 360 1137 10810.92 6 25
49247 BREAST RECONSTRUCTION 19366 360 1137 6059.85 7 24
49248 SURGERY OF BREAST CAPSULE 19370 360 1137 6059.85 5 12
49249 REMOVAL OF BREAST CAPSULE 19371 360 1137 6059.85 6 9
49250 REVISE BREAST RECONSTRUCTION 19380 360 1137 7608.72 4 8
49251 DESIGN CUSTOM BREAST IMPLANT 19396 360 1137 6059.85 0 23
49252 BREAST SURGERY PROCEDURE 19499 360 1137 3944.25 2 1

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