G441

PDF page 25 / GP11

Payment for Diagnostic and Therapeutic Services Rendered at a Hospital
  The technical component of a diagnostic and therapeutic service listed below and rendered in a
  hospital is payable at 86.10% of the listed fee in the column headed “T”.
  G104A, G111A, G121A, G127A, G140A, G143A, G146A, G149A, G152A, G153A, G167A,
  G174A,G181A, G209A, G284A, G308A, G310A, G311A, G315A, G414A, G440A, G441A, G442A,
  G443A,G448A, G451A, G455A, G466A, G471A, G519A, G540A, G541A, G542A, G544A, G554A,
  G570A,G574A, G582A, G585A, G647A, G648A, G651A, G652A, G654A, G655A, G682A, G683A,
  G684A,G685A, G686A, G687A, G688A, G689A, G694A, G695A, G815A, G850A, G851A, G852A,
  G853A,G854A, G855A, G856A, G857A, G858A, J301B, J304B, J324B, J327B

PDF page 513 / J99

Impedance audiometry by manual or automated methods
   G442 - technical component .......................................................... 3.80
   G529 - professional component .....................................................              1.86
       Note:
       G442, G529 may include stapedial reflex and/or compliance testing.
      Sound field audiometry (infants and children)
   G448 - technical component .......................................................... 25.20
   G450 - professional component .....................................................         5.70
      Note:
      The amount payable is reduced to nil if any claim is submitted for G525, G441 or G526
      rendered to the patient on the same day.

Master, record 2152. Record Layout PDF, page 1.

G44120260401999999990000020800000000000000000000000000000000000000000000000

Auxiliary master fields are preserved as raw scaled values. The linked layout calls them zero-filled, but this edition contains non-zero values. They are not presented as final dollar fees or PDF units.