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2024-468-E-Health Dept-UNC Healthcare System -BCCCP Mammogram Screening
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2024-468-E-Health Dept-UNC Healthcare System -BCCCP Mammogram Screening
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Last modified
11/19/2024 8:04:21 AM
Creation date
11/19/2024 8:04:14 AM
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Contract
Date
8/8/2024
Contract Starting Date
8/8/2024
Contract Ending Date
8/15/2024
Contract Document Type
Contract
Amount
$4,500.00
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2024 Office Fee <br />Code Fee Allowed <br />Excision of cyst, fibroadenoma or other benign or malignant tumor, 19120 475.44$ Yes <br /> aberrant breast tissue, duct lesion, nipple or areolar lesion; open; <br /> one or more lesions <br />Excision of breast lesion identified by preoperative placement of 19125 523.51$ Yes <br /> radiological marker; open; single lesion <br /> Each additional lesion separately identified by a preoperative 19126 143.78$ Yes <br /> radiological marker <br />Placement of breast localization device, percutaneous; mammographic 19281 220.81$ Yes <br /> guidance; first lesion (6) <br /> Each additional lesion (6)19282 155.74$ Yes <br />Placement of breast localization device, percutaneous; stereotactic 19283 236.32$ Yes <br /> guidance; first lesion (6) <br /> Each additional lesion (6)19284 172.24$ Yes <br />Placement of breast localization device, percutaneous; ultrasound 19285 332.52$ Yes <br /> guidance; first lesion (6) <br /> Each additional lesion (6)19286 270.98$ Yes <br />Needle biopsy of axillary lymph node 38505 159.57$ Yes <br />Ultrasonic guidance for needle placement, imaging 76942 53.67$ No <br /> supervision and interpretation 76942-TC 25.69$ <br />76942-26 27.98$ <br />Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic 88172 51.75$ No <br /> study to determine adequacy of specimen(s), first evaluation episode 88172TC 19.62$ <br />88172-26 32.13$ <br />Cytopathology, evaluation of fine need aspirate; immediate cytohistologic 88177 27.38$ No <br /> study to determine adequacy of specimen(s), each separate additional 88177TC 7.58$ <br /> evaluation episode 88177-26 19.80$ <br />Cytopathology, evaluation of fine needle aspirate; interpretation and report 88173 154.38$ No <br />88173TC 90.71$ <br />88173-26 63.67$ <br />Surgical pathology, gross and microscopic examination 88305 66.42$ No <br />88305TC 32.36$ <br />88305-26 34.06$ <br />Surgical pathology, gross and microscopic examination; requiring microscopic 88307 264.34$ No <br /> evaluation of surgical margins 88307TC 189.77$ <br />88307-26 74.57$ <br />Morphometric analysis, tumor immunohistochemistry, per specimen; manual 88360 110.87$ <br /> 88360TC 72.99$ <br /> 88360-26 37.89$ <br />Morphometric analysis, tumor immunohistochemistry, per specimen; 88361 110.15$ <br /> using computer-assisted technology 88361TC 70.26$ <br /> 88361-26 39.89$ <br />00400 19.48$ <br />Moderate anesthesia, 10-22 minutes for individuals 5 years or older 99156 68.94$ <br /> Each additional 15 minutes (8)99157 54.76$ <br />Anesthesia for procedures on the integumentary system, anterior trunk, not <br />otherwise specified (7) <br />2024 Services Fee Schedule (1) <br />North Carolina Breast and Cervical Cancer Control Program <br />Breast Cancer Screening and Diagnostic Procedures <br />Docusign Envelope ID: E3FD8286-9BF1-4ABB-A975-EA9FB3BD2524
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