X339

PDF page 356 / C4

X313 Level 4 - per patient, per course of treatment.........................                                  811.15
# X302 Teleradiotherapy - x-ray, 150 KVP or higher, radium, cobalt,
          cesium betatron linear accelerator - amount payable per
          treatment visit .....................................................................                   15.90
  X304 Minor teleradiotherapy - x-ray, 150 KVP or less - amount
          payable per treatment visit .................................................                           11.95
      Intracavitary treatment planning for contact x-ray therapy including sigmoidoscopy or
      proctoscopy
# X305 - first application ................................................................... 170.85
# X306 - repeat application ...............................................................     85.50
# X337 Placement of fiducial markers into the prostate......................                   122.30
# X338 Placement of rectal spacer .....................................................        223.65
# X339 Placement of fiducial markers into the vagina ........................                   76.45
      Payment rules:
      X337, X338 and X339 include any imaging or other guidance required – if performed.
      Obtaining and interpreting any images in conjunction with X337, X338 and X339 are not
      eligible for payment to any physician.

Master, record 6710. Record Layout PDF, page 1.

X33920260401999999990000076450000000000000000000000000000000000000000000000

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.