Minn. R. agency 120, ch. 2740, ACTUARIAL EQUIVALENCE OF QUALIFIED PLANS AND QUALIFIED MEDICARE SUPPLEMENT PLANS, pt. 2740.9919

Current through Register Vol. 49, No. 25, December 16, 2024

Part 2740.9919 - TABLE OF SURGICAL FACTORS TO DEVELOP SURG VALUE

CPT4 Code	Surgical Factor	Description

SKIN
10060	.7710	Abscess, incision, and drainage, simple
11400	2.0161	Benign lesion removal of (up to 0.5 cm.)
11750	.4368	Nail, permanent removal of
12011	1.9732	Simple wound, simple repair (up to 2.5 cm.)
17100	4.6520	Benign skin lesion, destruction of

MUSCULOSKELETAL
20610	1.9226	Major joint or bursa, injection or aspiration of
27130	.1565	Total hip joint replacement, simple
29425	1.0286	Application walking cast

CARDIOVASCULAR
33512	.1111	Coronary bypass, three arteries
93547	.2166	Left heart catheterization with coronary angiogram

DIGESTIVE SYSTEM
43235	.4514	Gastroscopy, diagnostic
43844	.0569	Stomach bypass for morbid obesity
44950	.2618	Appendectomy
45300	2.7170	Proctosigmoidoscopy, diagnostic
47600	.3765	Gallbladder, removal of
49505	.3086	Inguinal hernia repair, unilateral

URINARY SYSTEM
52601	.1579	Prostate resection (TUR), complete
53670	3.5273	Urinary bladder catheterization

MALE GENITAL
54150	.8509	Circumcision by clamp, newborn

FEMALE GENITAL
58120	.8470	Uterus, dilation and curettage (D&C), nonobstetrical
58150	.4792	Uterus, removal of
58980	.9455	Laparoscopy, diagnostic

NERVOUS SYSTEM
63030	.0694	Laminotomy herniated disc, lumbar
64721	.1988	Carpal tunnel syndrome repair

EYE
66980	.2003	Cataract removal, intraocular lens insertion

EAR
69437	.3934	Tympanostomy with ventilating tube insertion

10 SR 474

Statutory Authority: MS s 62E.09