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| | HCPCS |
MOD |
DESCRIPTION |
STATUS CODE |
PEIA Facility RVU |
PEIA Non-Facility RVU |
July 2005 PEIA Facility |
July 2005 PEIA Non-Facility |
PEIA Non-RBRVS |
| 27894 | | Decompression of leg | A | 23.6828 | 23.6828 | $997.69 | $997.69 | |
| 27899 | | Leg/ankle surgery procedure | C | 0.0000 | 0.0000 | | | |
| 28001 | | Drainage of bursa of foot | A | 5.7784 | 6.6384 | $243.20 | $279.45 | |
| 28002 | | Treatment of foot infection | A | 10.3476 | 11.3663 | $435.40 | $478.40 | |
| 28003 | | Treatment of foot infection | A | 17.4786 | 18.3219 | $735.93 | $771.76 | |
| 28005 | | Treat foot bone lesion | A | 18.6004 | 18.6004 | $783.56 | $783.56 | |
| 28008 | | Incision of foot fascia | A | 9.5346 | 10.6619 | $401.68 | $448.89 | |
| 28010 | | Incision of toe tendon | A | 6.3644 | 6.3644 | $267.65 | $267.65 | |
| 28011 | | Incision of toe tendons | A | 9.3499 | 9.3499 | $393.68 | $393.68 | |
| 28020 | | Exploration of foot joint | A | 11.4559 | 13.0257 | $482.19 | $548.37 | |
| 28022 | | Exploration of foot joint | A | 10.5062 | 11.6251 | $442.57 | $489.78 | |
| 28024 | | Exploration of toe joint | A | 10.0240 | 11.1012 | $422.34 | $467.86 | |
| 28030 | | Removal of foot nerve | A | 12.3622 | 12.3622 | $520.55 | $520.55 | |
| 28035 | | Decompression of tibia nerve | A | 11.4190 | 12.8886 | $480.93 | $542.89 | |
| 28043 | | Excision of foot lesion | A | 8.0983 | 8.6327 | $340.99 | $363.75 | |
| 28045 | | Excision of foot lesion | A | 10.3474 | 11.8254 | $435.83 | $498.21 | |
| 28046 | | Resection of tumor, foot | A | 21.2013 | 23.1134 | $893.15 | $973.66 | |
| 28050 | | Biopsy of foot joint lining | A | 9.7438 | 10.8293 | $410.11 | $456.06 | |
| 28052 | | Biopsy of foot joint lining | A | 9.0078 | 10.2436 | $379.35 | $431.19 | |
| 28054 | | Biopsy of toe joint lining | A | 8.0584 | 9.3026 | $339.30 | $391.99 | |
| 28060 | | Partial removal, foot fascia | A | 11.3753 | 12.7113 | $479.24 | $535.30 | |
| 28062 | | Removal of foot fascia | A | 13.3669 | 15.4544 | $562.70 | $650.79 | |
| 28070 | | Removal of foot joint lining | A | 11.3205 | 12.4895 | $476.71 | $526.03 | |
| 28072 | | Removal of foot joint lining | A | 10.9590 | 11.9777 | $461.54 | $504.11 | |
| 28080 | | Removal of foot lesion | A | 8.6059 | 9.8000 | $362.49 | $412.64 | |
| 28086 | | Excise foot tendon sheath | A | 11.8105 | 14.5660 | $497.37 | $613.70 | |
| 28088 | | Excise foot tendon sheath | A | 9.6043 | 11.1574 | $404.21 | $469.97 | |
| 28090 | | Removal of foot lesion | A | 9.7451 | 11.1563 | $410.54 | $469.97 | |
| 28092 | | Removal of toe lesions | A | 8.6159 | 10.0270 | $362.49 | $422.34 | |
| 28100 | | Removal of ankle/heel lesion | A | 12.9077 | 15.6381 | $543.73 | $658.80 | |
| 28102 | | Remove/graft foot lesion | A | 17.4833 | 17.4833 | $736.36 | $736.36 | |
| 28103 | | Remove/graft foot lesion | A | 14.1403 | 14.1403 | $595.57 | $595.57 | |
| 28104 | | Removal of foot lesion | A | 11.3070 | 12.6096 | $476.29 | $531.09 | |
| 28106 | | Remove/graft foot lesion | A | 14.9006 | 14.9006 | $627.61 | $627.61 | |
| 28107 | | Remove/graft foot lesion | A | 12.1479 | 14.0851 | $511.70 | $593.47 | |
| 28108 | | Removal of toe lesions | A | 9.0775 | 10.1964 | $382.30 | $429.50 | |
| 28110 | | Part removal of metatarsal | A | 9.0142 | 10.6759 | $379.35 | $449.74 | |
| 28111 | | Part removal of metatarsal | A | 10.8880 | 13.0757 | $458.59 | $550.90 | |
| 28112 | | Part removal of metatarsal | A | 10.0506 | 11.9127 | $423.18 | $501.58 | |
| 28113 | | Part removal of metatarsal | A | 11.0103 | 12.4632 | $463.65 | $525.18 | |
| 28114 | | Removal of metatarsal heads | A | 22.7419 | 25.4557 | $958.06 | $1,072.71 | |
| 28116 | | Revision of foot | A | 16.4009 | 17.7536 | $690.83 | $747.74 | |
| 28118 | | Removal of heel bone | A | 13.0825 | 14.6690 | $550.90 | $617.91 | |
| 28119 | | Removal of heel spur | A | 11.4100 | 12.8295 | $480.51 | $540.36 | |
| 28120 | | Part removal of ankle/heel | A | 12.2886 | 14.6850 | $517.60 | $618.34 | |
| 28122 | | Partial removal of foot bone | A | 15.7655 | 17.0764 | $664.28 | $719.50 | |
| 28124 | | Partial removal of toe | A | 10.3539 | 11.4728 | $435.83 | $483.03 | |
| 28126 | | Partial removal of toe | A | 7.8863 | 8.9050 | $331.72 | $374.71 | |
| 28130 | | Removal of ankle bone | A | 18.9240 | 18.9240 | $797.47 | $797.47 | |
| 28140 | | Removal of metatarsal | A | 14.7173 | 16.7714 | $620.02 | $706.43 | |
| 28150 | | Removal of toe | A | 9.0326 | 10.3268 | $380.19 | $434.98 | |
| 28153 | | Partial removal of toe | A | 7.8509 | 9.2120 | $330.45 | $387.78 | |
| 28160 | | Partial removal of toe | A | 8.5572 | 9.5843 | $360.38 | $403.37 | |
| 28171 | | Extensive foot surgery | A | 19.6710 | 19.6710 | $828.66 | $828.66 | |
| 28173 | | Extensive foot surgery | A | 17.8435 | 19.8475 | $751.53 | $835.83 | |
| 28175 | | Extensive foot surgery | A | 12.2204 | 13.8904 | $514.65 | $585.04 | |
| 28190 | | Removal of foot foreign body | A | 4.1147 | 5.7096 | $172.81 | $240.25 | |
| 28192 | | Removal of foot foreign body | A | 10.1338 | 11.6618 | $426.55 | $491.04 | |
| 28193 | | Removal of foot foreign body | A | 12.0006 | 13.4034 | $505.37 | $564.38 | |
| 28200 | | Repair of foot tendon | A | 10.1022 | 11.3881 | $425.29 | $479.66 | |
| 28202 | | Repair/graft of foot tendon | A | 14.3801 | 16.6513 | $605.69 | $701.79 | |
| 28208 | | Repair of foot tendon | A | 9.5381 | 10.7990 | $401.68 | $454.79 | |
| 28210 | | Repair/graft of foot tendon | A | 13.1218 | 14.9504 | $552.58 | $629.72 | |
| 28220 | | Release of foot tendon | A | 9.7565 | 10.8003 | $410.96 | $454.79 | |
| 28222 | | Release of foot tendons | A | 11.9740 | 12.9009 | $504.53 | $543.31 | |
| 28225 | | Release of foot tendon | A | 8.0346 | 9.1869 | $338.46 | $386.93 | |
| 28226 | | Release of foot tendons | A | 10.0655 | 10.9423 | $424.02 | $460.69 | |
| 28230 | | Incision of foot tendon(s) | A | 9.6335 | 10.4685 | $405.48 | $440.46 | |
| 28232 | | Incision of toe tendon | A | 8.0235 | 9.0338 | $337.62 | $380.19 | |
| 28234 | | Incision of foot tendon | A | 7.9951 | 9.0973 | $336.35 | $382.72 | |
| 28238 | | Revision of foot tendon | A | 16.2641 | 18.1929 | $684.93 | $766.28 | |
| 28240 | | Release of big toe | A | 9.6784 | 10.6387 | $407.59 | $448.05 | |
| 28250 | | Revision of foot fascia | A | 12.8254 | 14.0695 | $539.94 | $592.62 | |
| 28260 | | Release of midfoot joint | A | 16.8783 | 17.9889 | $711.07 | $757.85 | |
| 28261 | | Revision of foot tendon | A | 24.3632 | 25.4571 | $1,026.35 | $1,072.29 | |
| 28262 | | Revision of foot and ankle | A | 35.6545 | 37.8589 | $1,502.22 | $1,595.37 | |
| 28264 | | Release of midfoot joint | A | 22.8412 | 23.2170 | $962.28 | $978.30 | |
| 28270 | | Release of foot contracture | A | 10.4542 | 11.4228 | $440.04 | $480.93 | |
| 28272 | | Release of toe joint, each | A | 8.1329 | 9.2434 | $342.25 | $389.46 | |
| 28280 | | Fusion of toes | A | 11.9699 | 13.4395 | $504.11 | $566.07 | |
| 28285 | | Repair of hammertoe | A | 9.9418 | 11.1442 | $418.54 | $469.12 | |
| 28286 | | Repair of hammertoe | A | 9.6864 | 10.9723 | $408.01 | $461.96 | |
| 28288 | | Partial removal of foot bone | A | 11.5198 | 12.3965 | $485.14 | $522.23 | |
| 28289 | | Repair hallux rigidus | A | 16.1000 | 17.9537 | $678.19 | $756.59 | |
| 28290 | | Correction of bunion | A | 13.0163 | 14.2938 | $548.37 | $601.90 | |
| 28292 | | Correction of bunion | A | 15.4903 | 17.1018 | $652.48 | $720.34 | |
| 28293 | | Correction of bunion | A | 18.9952 | 22.8696 | $800.42 | $963.54 | |
| 28294 | | Correction of bunion | A | 17.0774 | 19.3486 | $719.50 | $815.18 | |
| 28296 | | Correction of bunion | A | 18.6996 | 20.9875 | $787.78 | $884.30 | |
| 28297 | | Correction of bunion | A | 19.9023 | 22.1484 | $838.36 | $933.20 | |
| 28298 | | Correction of bunion | A | 16.4907 | 18.3361 | $694.63 | $772.60 | |
| 28299 | | Correction of bunion | A | 21.3842 | 23.6387 | $901.16 | $996.00 | |
| 28300 | | Incision of heel bone | A | 21.7907 | 21.7907 | $918.44 | $918.44 | |
| 28302 | | Incision of ankle bone | A | 21.2160 | 21.2160 | $894.00 | $894.00 | |
| 28304 | | Incision of midfoot bones | A | 19.2392 | 21.0846 | $810.54 | $888.10 | |
| 28305 | | Incise/graft midfoot bones | A | 21.3959 | 21.3959 | $901.58 | $901.58 | |
| 28306 | | Incision of metatarsal | A | 12.8405 | 15.0616 | $540.78 | $634.35 | |
| 28307 | | Incision of metatarsal | A | 14.5298 | 19.3227 | $612.01 | $814.33 | |
| 28308 | | Incision of metatarsal | A | 11.2766 | 12.9967 | $475.03 | $547.52 | |
| 28309 | | Incision of metatarsals | A | 27.8356 | 27.8356 | $1,172.61 | $1,172.61 | |
| 28310 | | Revision of big toe | A | 11.3081 | 13.1367 | $476.29 | $553.42 | |
| 28312 | | Revision of toe | A | 10.2025 | 11.7055 | $429.93 | $493.15 | |
| 28313 | | Repair deformity of toe | A | 12.0822 | 12.4496 | $508.75 | $524.34 | |
| 28315 | | Removal of sesamoid bone | A | 10.2620 | 11.5646 | $432.45 | $487.25 | |
| 28320 | | Repair of foot bones | A | 20.7040 | 20.7040 | $872.50 | $872.50 | |
| 28322 | | Repair of metatarsals | A | 18.8784 | 21.2498 | $795.37 | $895.26 | |
| 28340 | | Resect enlarged toe tissue | A | 14.0608 | 15.8978 | $592.62 | $669.76 | |
| 28341 | | Resect enlarged toe | A | 16.8021 | 18.5723 | $707.69 | $782.30 | |
| 28344 | | Repair extra toe(s) | A | 9.4530 | 11.2149 | $398.31 | $472.50 | |
| 28345 | | Repair webbed toe(s) | A | 13.2011 | 14.4619 | $555.95 | $609.06 | |
| 28360 | | Reconstruct cleft foot | A | 31.5607 | 31.5607 | $1,329.83 | $1,329.83 | |
| 28400 | | Treatment of heel fracture | A | 6.0851 | 6.5694 | $255.85 | $276.50 | |
| 28405 | | Treatment of heel fracture | A | 11.4251 | 11.6004 | $480.93 | $488.51 | |
| 28406 | | Treatment of heel fracture | A | 16.5225 | 16.5225 | $695.89 | $695.89 | |
| 28415 | | Treat heel fracture | A | 38.0240 | 38.0240 | $1,602.12 | $1,602.12 | |
| 28420 | | Treat/graft heel fracture | A | 38.8863 | 38.8863 | $1,638.37 | $1,638.37 | |
| 28430 | | Treatment of ankle fracture | A | 5.4807 | 6.1737 | $230.56 | $260.06 | |
| 28435 | | Treatment of ankle fracture | A | 8.7267 | 8.8436 | $367.54 | $372.18 | |
| 28436 | | Treatment of ankle fracture | A | 12.8928 | 12.8928 | $542.89 | $542.89 | |
| 28445 | | Treat ankle fracture | A | 35.4611 | 35.4611 | $1,494.63 | $1,494.63 | |
| 28450 | | Treat midfoot fracture, each | A | 5.1320 | 5.6664 | $215.80 | $238.14 | |
| 28455 | | Treat midfoot fracture, each | A | 7.7418 | 7.7418 | $325.81 | $325.81 | |
| 28456 | | Treat midfoot fracture | A | 7.9831 | 7.9831 | $335.93 | $335.93 | |
| 28465 | | Treat midfoot fracture, each | A | 16.7799 | 16.7799 | $706.85 | $706.85 | |
| 28470 | | Treat metatarsal fracture | A | 5.2387 | 5.8065 | $220.44 | $244.47 | |
| 28475 | | Treat metatarsal fracture | A | 7.4464 | 7.5466 | $313.59 | $317.81 | |
| 28476 | | Treat metatarsal fracture | A | 9.7838 | 9.7838 | $411.80 | $411.80 | |
| 28485 | | Treat metatarsal fracture | A | 13.7092 | 13.7092 | $577.45 | $577.45 | |
| 28490 | | Treat big toe fracture | A | 3.0442 | 3.3531 | $127.71 | $140.78 | |
| 28495 | | Treat big toe fracture | A | 4.1355 | 4.2273 | $174.07 | $177.87 | |
| 28496 | | Treat big toe fracture | A | 6.4973 | 10.7224 | $273.55 | $451.42 | |
| 28505 | | Treat big toe fracture | A | 9.3538 | 12.8608 | $393.68 | $541.62 | |
| 28510 | | Treatment of toe fracture | A | 2.9105 | 2.9105 | $122.23 | $122.23 | |
| 28515 | | Treatment of toe fracture | A | 3.7900 | 3.7900 | $159.32 | $159.32 | |
| 28525 | | Treat toe fracture | A | 8.1472 | 11.5540 | $343.10 | $486.83 | |
| 28530 | | Treat sesamoid bone fracture | A | 2.8472 | 2.8472 | $119.70 | $119.70 | |
| 28531 | | Treat sesamoid bone fracture | A | 5.4902 | 9.8322 | $231.40 | $414.33 | |
| 28540 | | Treat foot dislocation | A | 5.0882 | 5.0882 | $214.12 | $214.12 | |
| 28545 | | Treat foot dislocation | A | 5.9494 | 5.9494 | $250.37 | $250.37 | |
| 28546 | | Treat foot dislocation | A | 9.0293 | 11.1418 | $380.19 | $469.12 | |
| 28555 | | Repair foot dislocation | A | 15.3684 | 18.9005 | $647.42 | $796.21 | |
| 28570 | | Treat foot dislocation | A | 4.5245 | 4.5996 | $190.09 | $193.46 | |
| 28575 | | Treat foot dislocation | A | 8.7553 | 8.7553 | $368.39 | $368.39 | |
| 28576 | | Treat foot dislocation | A | 10.5240 | 10.5240 | $443.41 | $443.41 | |
| 28585 | | Repair foot dislocation | A | 17.9856 | 19.2298 | $757.43 | $810.12 | |
| 28600 | | Treat foot dislocation | A | 5.2556 | 5.3641 | $220.86 | $225.50 | |
| 28605 | | Treat foot dislocation | A | 6.9860 | 6.9860 | $294.20 | $294.20 | |
| 28606 | | Treat foot dislocation | A | 12.2312 | 12.2312 | $515.07 | $515.07 | |
| 28615 | | Repair foot dislocation | A | 19.8616 | 19.8616 | $836.67 | $836.67 | |
| 28630 | | Treat toe dislocation | A | 3.3286 | 3.8046 | $139.93 | $160.17 | |
| 28635 | | Treat toe dislocation | A | 4.2735 | 4.6827 | $179.55 | $196.84 | |
| 28636 | | Treat toe dislocation | A | 6.7538 | 7.7975 | $284.09 | $328.34 | |
| 28645 | | Repair toe dislocation | A | 9.3631 | 10.7659 | $394.52 | $453.53 | |
| 28660 | | Treat toe dislocation | A | 2.4326 | 2.8251 | $102.00 | $118.86 | |
| 28665 | | Treat toe dislocation | A | 4.1583 | 4.1583 | $174.92 | $174.92 | |
| 28666 | | Treat toe dislocation | A | 6.6104 | 9.3659 | $278.19 | $394.10 | |
| 28675 | | Repair of toe dislocation | A | 7.5969 | 10.7615 | $319.49 | $453.11 | |
| 28705 | | Fusion of foot bones | A | 41.8886 | 41.8886 | $1,764.82 | $1,764.82 | |
| 28715 | | Fusion of foot bones | A | 30.1598 | 30.1598 | $1,270.82 | $1,270.82 | |
| 28725 | | Fusion of foot bones | A | 26.1977 | 26.1977 | $1,103.90 | $1,103.90 | |
| 28730 | | Fusion of foot bones | A | 24.8380 | 24.8380 | $1,046.58 | $1,046.58 | |
| 28735 | | Fusion of foot bones | A | 24.3351 | 24.3351 | $1,025.08 | $1,025.08 | |
| 28737 | | Revision of foot bones | A | 21.4063 | 21.4063 | $901.58 | $901.58 | |
| 28740 | | Fusion of foot bones | A | 18.4999 | 22.1739 | $779.35 | $934.04 | |
| 28750 | | Fusion of big toe joint | A | 17.4875 | 21.8712 | $736.78 | $921.39 | |
| 28755 | | Fusion of big toe joint | A | 10.5762 | 12.5385 | $445.52 | $528.13 | |
| 28760 | | Fusion of big toe joint | A | 16.7684 | 18.8225 | $706.43 | $792.84 | |
| 28800 | | Amputation of midfoot | A | 17.8381 | 17.8381 | $751.53 | $751.53 | |
| 28805 | | Amputation thru metatarsal | A | 17.9764 | 17.9764 | $757.01 | $757.01 | |
| 28810 | | Amputation toe & metatarsal | A | 13.5246 | 13.5246 | $569.86 | $569.86 | |
| 28820 | | Amputation of toe | A | 10.1042 | 13.2522 | $425.29 | $558.06 | |
| 28825 | | Partial amputation of toe | A | 8.5743 |
**NEW** Plan Year 2010 Summary Plan Description
*NEW* H1N1 (Swine Flu) Virus Fact Sheet
*NEW* Intergovernmental Transfer Accounts
*NEW* Shopper's Guide Plan Year 2010
*NEW* Employer Premiums (PY 2010)
Benefit Coordinator Supply Order Form
Finance Board Meeting Agenda (8-27-09)
FY 2008 Year-End OPEB Journal Entries for Non-State Agencies
FY 2008 Year-End OPEB Journal Entries for State Agencies
FY 2009 Months Credit Billing
FY 2009 Year-End OPEB Journal Entries for State Agencies
FY 2009 Year-End OPEB Journal Entries for State Agencies Without Months Credit Info.
Healthy Tomorrows Flyer
Latest BC Reference Manual (PY06)
Mountaineer Flexible Benefits Training (2010)
News Release - PEIA Selects Humana to Administer Retirees' Health Plan
Non-State Agency Premiums for Plan Year 2008 with RHBT
OPEB Plan Participation Standards 2009
Plan Year 2010 Rate Tables
Web Contributions System Instructions
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