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Gap
Code License $199
Although RBRVS is the most
widely used RVS (Relative Value Scale) it does not
provide fee information for procedures and services
not priced by Medicare. This results in
"gaps" in medical fee schedules. Private
payers including managed care who adopt RBRVS
methodology are forced to price their gap claims on an
individual basis or use UCR or RNC tables. Since RBRVS
was selected as a logical and less expensive
alternative to historic charge data (UCR/RNC/Percentiles)
many payers simply pay out the claim while other defer
to a review panel, bypassing the
regular
adjudication. This slows down the claims review process and often results in disputes and
appeals with payers.
RBRVS EZ-Fees Gap Codes are
provided under a license agreement with Relative Value
Studies, Inc. (RVSI) publishers of the Complete
RBRVS. We have selected RVSI's Gap solution based
on their reputation and experience in developing accurate,
user-friendly coding and reimbursement guidelines for
health care providers, consultants, and payers.
Integration of Gap Codes into
RBRVS EZ-Fees is seamless. Simply enter your Gap
license number under (Help-Upgrades-Gap License) and
all Gap codes will appear on the main screen with a
status indicator "g". Since Gaps codes
were designed for the RBRVS formula using the same CF
(Conversion Factor) and GPCIs (Geographic
Practice Cost Indicators) there is no math or
adjustments.
All
versions
of RBRVS EZ-Fees are upgradeable to include Gap
Codes.
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Gap
Licenses are single user and non refundable
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Gap
Code List for 2008:15431,
15824, 15825, 15826, 15828, 15829,
15847, 15876, 15877, 15878, 15879,
17380, 21088, 21742, 21743, 24940,
32850, 32855, 32856, 33930, 33933,
33940, 33944, 36415, 36416, 36468,
36469, 37195, 41820, 41821, 41850,
41870, 43496, 43647, 43648, 43881,
43882, 44132, 44133, 44135, 44136,
44137, 44715, 47133, 47143, 47144,
47145, 48550, 48551, 49906, 50300,
50323, 50325, 58974, 63043, 63044,
65760, 65765, 65767, 65771, 69090,
69710, 70170, 70170 TC, 70555, 70555 TC,
70557, 70557 TC, 70558, 70558 TC, 70559,
70559 TC, 71090, 71090 TC, 72291, 72291
TC, 72292, 72292 TC, 73530, 73530 TC,
74190, 74190 TC, 74235, 74235 TC, 74300,
74300 TC, 74301, 74301 TC, 74305, 74305
TC, 74328, 74328 TC, 74329, 74329 TC,
74330, 74330 TC, 74340, 74340 TC, 74355,
74355 TC, 74360, 74360 TC, 74363, 74363
TC, 74420, 74420 TC, 74425, 74425 TC,
74445, 74445 TC, 74450, 74450 TC, 74470,
74470 TC, 74742, 74742 TC, 74775, 74775
TC, 75556, 75801, 75801 TC, 75803, 75803
TC, 75805, 75805 TC, 75807, 75807 TC,
75810, 75810 TC, 75894, 75894 TC, 75896,
75896 TC, 75898, 75898 TC, 75900, 75900
TC, 75940, 75940 TC, 75945, 75945 TC,
75946, 75946 TC, 75952, 75952 TC, 75953,
75953 TC, 75954, 75954 TC, 75960, 75960
TC, 75970, 75970 TC, 75980, 75980 TC,
75982, 75982 TC, 75992, 75992 TC, 75993,
75993 TC, 75994, 75994 TC, 75995, 75995
TC, 75996, 75996 TC, 76001, 76001 TC,
76125, 76125 TC, 76140, 76350, 76932,
76932 TC, 76940, 76940 TC, 76941, 76941
TC, 76945, 76945 TC, 76975, 76975 TC,
76998, 76998 TC, 77013, 77013 TC, 77022,
77022 TC, 78267, 78268, 78282, 78282 TC,
78414, 78414 TC, 78459, 78459 TC, 78491,
78491 TC, 78492, 78492 TC, 78608, 78608
TC, 78609, 78609 TC, 78811, 78811 TC,
78812, 78812 TC, 78813, 78813 TC, 78814,
78814 TC, 78815, 78815 TC, 78816, 78816
TC, 79300, 79300 TC, 79445, 79445 TC,
80048, 80050, 80051, 80053, 80055,
80061, 80069, 80074, 80076, 80100,
80101, 80102, 80103, 80150, 80152,
80154, 80156, 80157, 80158, 80160,
80162, 80164, 80166, 80168, 80170,
80172, 80173, 80174, 80176, 80178,
80182, 80184, 80185, 80186, 80188,
80190, 80192, 80194, 80195, 80196,
80197, 80198, 80200, 80201, 80202,
80299, 80400, 80402, 80406, 80408,
80410, 80412, 80414, 80415, 80416,
80417, 80418, 80420, 80422, 80424,
80426, 80428, 80430, 80432, 80434,
80435, 80436, 80438, 80439, 80440,
81000, 81001, 81002, 81003, 81005,
81007, 81015, 81020, 81025, 81050,
82000, 82003, 82009, 82010, 82013,
82016, 82017, 82024, 82030, 82040,
82042, 82043, 82044, 82045, 82055,
82075, 82085, 82088, 82101, 82103,
82104, 82105, 82106, 82107, 82108,
82120, 82127, 82128, 82131, 82135,
82136, 82139, 82140, 82143, 82145,
82150, 82154, 82157, 82160, 82163,
82164, 82172, 82175, 82180, 82190,
82205, 82232, 82239, 82240, 82247,
82248, 82252, 82261, 82270, 82271,
82272, 82274, 82286, 82300, 82306,
82307, 82308, 82310, 82330, 82331,
82340, 82355, 82360, 82365, 82370,
82373, 82374, 82375, 82376, 82378,
82379, 82380, 82382, 82383, 82384,
82387, 82390, 82397, 82415, 82435,
82436, 82438, 82441, 82465, 82480,
82482, 82485, 82486, 82487, 82488,
82489, 82491, 82492, 82495, 82507,
82520, 82523, 82525, 82528, 82530,
82533, 82540, 82541, 82542, 82543,
82544, 82550, 82552, 82553, 82554,
82565, 82570, 82575, 82585, 82595,
82600, 82607, 82608, 82615, 82626,
82627, 82633, 82634, 82638, 82646,
82649, 82651, 82652, 82654, 82656,
82657, 82658, 82664, 82666, 82668,
82670, 82671, 82672, 82677, 82679,
82690, 82693, 82696, 82705, 82710,
82715, 82725, 82726, 82728, 82731,
82735, 82742, 82746, 82747, 82757,
82759, 82760, 82775, 82776, 82784,
82785, 82787, 82800, 82803, 82805,
82810, 82820, 82926, 82928, 82938,
82941, 82943, 82945, 82946, 82947,
82948, 82950, 82951, 82952, 82953,
82955, 82960, 82962, 82963, 82965,
82975, 82977, 82978, 82979, 82980,
82985, 83001, 83002, 83003, 83008,
83009, 83010, 83012, 83013, 83014,
83015, 83018, 83020, 83021, 83026,
83030, 83033, 83036, 83037, 83045,
87400, 87420, 87425, 87427, 87430,
87449, 87450, 87451, 87470, 87471,
87472, 87475, 87476, 87477, 87480,
87481, 87482, 87485, 87486, 87487,
87490, 87491, 87492, 87495, 87496,
87497, 87498, 87510, 87511, 87512,
87515, 87516, 87517, 87520, 87521,
87522, 87525, 87526, 87527, 87528,
87529, 87530, 87531, 87532, 87533,
87534, 87535, 87536, 87537, 87538,
87539, 87540, 87541, 87542, 87550,
87551, 87552, 87555, 87556, 87557,
87560, 87561, 87562, 87580, 87581,
87582, 87590, 87591, 87592, 87620,
87621, 87622, 87640, 87641, 87650,
87651, 87652, 87653, 87660, 87797,
87798, 87799, 87800, 87801, 87802,
87803, 87804, 83050, 83051, 83055,
83060, 83065, 83068, 83069, 83070,
83071, 83080, 83088, 83090, 83150,
83491, 83497, 83498, 83499, 83500,
83505, 83516, 83518, 83519, 83520,
83525, 83527, 83528, 83540, 83550,
83570, 83582, 83586, 83593, 83605,
83615, 83625, 83630, 83631, 83632,
83633, 83634, 83655, 83661, 83662,
83663, 83664, 83670, 83690, 83695,
83698, 83700, 83701, 83704, 83718,
83719, 83721, 83727, 83735, 83775,
83785, 83788, 83789, 83805, 83825,
83835, 83840, 83857, 83858, 83864,
83866, 83872, 83873, 83874, 83880,
83883, 83885, 83887, 83890, 83891,
83892, 83893, 83894, 83896, 83897,
83898, 83900, 83901, 83902, 83903,
83904, 83905, 83906, 83907, 83908,
83909, 83912, 83914, 83915, 83916,
83918, 83919, 83921, 83925, 83930,
83935, 83937, 83945, 83950, 83970,
83986, 83992, 84022, 84030, 84035,
84060, 84061, 84066, 84075, 84078,
84080, 84081, 84085, 84087, 84100,
84105, 84106, 84110, 84119, 84120,
84126, 84127, 84132, 84133, 84134,
84135, 84138, 84140, 84143, 84144,
84146, 84150, 84152, 84153, 84154,
84155, 84156, 84157, 84160, 84163,
84165, 84166, 84181, 84182, 84202,
84203, 84206, 84207, 84210, 84220,
84228, 84233, 84234, 84235, 84238,
84244, 84252, 84255, 84260, 84270,
84275, 84285, 84295, 84300, 84302,
84305, 84307, 84311, 84315, 84375,
84376, 84377, 84378, 84379, 84392,
84402, 84403, 84425, 84430, 84432,
84436, 84437, 84439, 84442, 84443,
84445, 84446, 84449, 84450, 84460,
84466, 84478, 84479, 84480, 84481,
84482, 84484, 84485, 84488, 84490,
84510, 84512, 84520, 84525, 84540,
84545, 84550, 84560, 84577, 84578,
84580, 84583, 84585, 84586, 84588,
84590, 84591, 84597, 84600, 84620,
84630, 84681, 84702, 84703, 84830,
85002, 85004, 85007, 85008, 85009,
85013, 85014, 85018, 85025, 85027,
85032, 85041, 85044, 85045, 85046,
85048, 85049, 85055, 85130, 85170,
85175, 85210, 85220, 85230, 85240,
85244, 85245, 85246, 85247, 85250,
85260, 85270, 85280, 85290, 85291,
85292, 85293, 85300, 85301, 85302,
85303, 85305, 85306, 85307, 85335,
85337, 85345, 85347, 85348, 85360,
85362, 85366, 85370, 85378, 85379,
85380, 85384, 85385, 85390, 85400,
85410, 85415, 85420, 85421, 85441,
85445, 85460, 85461, 85475, 85520,
85525, 85530, 85536, 85540, 85547,
85549, 85555, 85557, 85576, 85597,
85610, 85611, 85612, 85613, 85635,
85651, 85652, 85660, 85670, 85675,
85705, 85730, 85732, 85810, 86000,
86001, 86003, 86005, 86021, 86022,
86023, 86038, 86039, 86060, 86063,
86140, 86141, 86146, 86147, 86148,
86155, 86156, 86157, 86160, 86161,
86162, 86171, 86185, 86200, 86215,
86225, 86226, 86235, 86243, 86255,
86256, 86277, 86280, 86294, 86300,
86301, 86304, 86308, 86309, 86310,
86316, 86317, 86318, 86320, 86325,
86327, 86329, 86331, 86332, 86334,
86335, 86336, 86337, 86340, 86341,
86343, 86344, 86353, 86355, 86357,
86359, 86360, 86361, 86367, 86376,
86378, 86382, 86384, 86403, 86406,
86430, 86431, 86480, 86485, 86590,
86592, 86593, 86602, 86603, 86606,
86609, 86611, 86612, 86615, 86617,
86618, 86619, 86622, 86625, 86628,
86631, 86632, 86635, 86638, 86641,
86644, 86645, 86648, 86651, 86652,
86653, 86654, 86658, 86663, 86664,
86665, 86666, 86668, 86671, 86674,
86677, 86682, 86684, 86687, 86688,
86689, 86692, 86694, 86695, 86696,
86698, 86701, 86702, 86703, 86704,
86705, 86706, 86707, 86708, 86709,
86710, 86713, 86717, 86720, 86723,
86727, 86729, 86732, 86735, 86738,
86741, 86744, 86747, 86750, 86753,
86756, 86757, 86759, 86762, 86765,
86768, 86771, 86774, 86777, 86778,
86781, 86784, 86787, 86788, 86789,
86790, 86793, 86800, 86803, 86804,
86805, 86806, 86807, 86808, 86812,
86813, 86816, 86817, 86821, 86822,
86850, 86860, 86870, 86880, 86885,
86886, 86890, 86891, 86900, 86901,
86903, 86904, 86905, 86906, 86910,
86911, 86920, 86921, 86922, 86923,
86927, 86930, 86931, 86932, 86940,
86941, 86945, 86950, 86960, 86965,
86970, 86971, 86972, 86975, 86976,
86977, 86978, 86985, 87001, 87003,
87015, 87040, 87045, 87046, 87070,
87071, 87073, 87075, 87076, 87077,
87081, 87084, 87086, 87088, 87101,
87102, 87103, 87106, 87107, 87109,
87110, 87116, 87118, 87140, 87143,
87147, 87149, 87152, 87158, 87164,
87166, 87168, 87169, 87172, 87176,
87177, 87181, 87184, 87185, 87186,
87187, 87188, 87190, 87197, 87205,
87206, 87207, 87209, 87210, 87220,
87230, 87250, 87252, 87253, 87254,
87255, 87260, 87265, 87267, 87269,
87270, 87271, 87272, 87273, 87274,
87275, 87276, 87277, 87278, 87279,
87280, 87281, 87283, 87285, 87290,
87299, 87300, 87301, 87305, 87320,
87324, 87327, 87328, 87329, 87332,
87335, 87336, 87337, 87338, 87339,
87340, 87341, 87350, 87380, 87385,
87390, 87391, 87807, 87808, 87810,
87850, 87880, 87899, 87900, 87901,
87902, 87903, 87904, 88000, 88005,
88007, 88012, 88014, 88016, 88020,
88025, 88027, 88028, 88029, 88036,
88037, 88040, 88130, 88140, 88142,
88143, 88147, 88148, 88150, 88152,
88153, 88154, 88155, 88164, 88165,
88166, 88167, 88174, 88175, 88230,
88233, 88235, 88237, 88239, 88240,
88241, 88245, 88248, 88249, 88261,
88262, 88263, 88264, 88267, 88269,
88271, 88272, 88273, 88274, 88275,
88280, 88283, 88285, 88289, 88371,
88372, 88380, 88380 26, 88380 TC, 88384,
88384 26, 88384 TC, 88400, 89050, 89051,
89055, 89060, 89125, 89160, 89190,
89225, 89235, 89250, 89300, 89310,
89320, 89321, 89325, 89329, 89330,
90281, 90283, 90287, 90288, 90291,
90296, 90371, 90375, 90376, 90378,
90379, 90384, 90385, 90386, 90389,
90393, 90396, 90399, 90476, 90477,
90581, 90585, 90586, 90632, 90633,
90634, 90636, 90645, 90646, 90647,
90648, 90655, 90656, 90657, 90658,
90660, 90665, 90669, 90675, 90676,
90680, 90690, 90691, 90692, 90693,
90698, 90700, 90701, 90702, 90703,
90704, 90705, 90706, 90707, 90708,
90710, 90712, 90713, 90714, 90715,
90716, 90717, 90718, 90719, 90720,
90721, 90723, 90725, 90727, 90732,
90733, 90734, 90735, 90740, 90743,
90744, 90746, 90747, 90748, 90749,
90882, 90889, 90989, 90993, 91123,
92531, 92532, 92533, 92534, 92559,
92560, 92590, 92591, 92592, 92593,
92594, 92595, 92978, 92978 TC, 92979,
92979 TC, 92992, 92993, 93235, 93236,
93315, 93315 TC, 93317, 93317 TC, 93318,
93318 TC, 93501, 93501 TC, 93503, 93505,
93505 TC, 93508, 93508 TC, 93510, 93510
TC, 93511, 93511 TC, 93514, 93514 TC,
93524, 93524 TC, 93526, 93526 TC, 93527,
93527 TC, 93528, 93528 TC, 93529, 93529
TC, 93530, 93530 TC, 93531, 93531 TC,
93532, 93532 TC, 93533, 93533 TC, 93539,
93540, 93541, 93542, 93543, 93544,
93545, 93555, 93555 TC, 93556, 93556 TC,
93561, 93561 TC, 93562, 93562 TC, 93571,
93571 TC, 93572, 93572 TC, 93600, 93600
TC, 93602, 93602 TC, 93603, 93603 TC,
93609, 93609 TC, 93610, 93610 TC, 93612,
93612 TC, 93615, 93615 TC, 93616, 93616
TC, 93618, 93618 TC, 93619, 93619 TC,
93620, 93620 TC, 93621, 93621 TC, 93622,
93622 TC, 93623, 93623 TC, 93624, 93624
TC, 93631, 93631 TC, 93640, 93640 TC,
93641, 93641 TC, 93662, 93662 TC, 93760,
93762, 94642, 95120, 95125, 95130,
95131, 95132, 95133, 95134, 95824, 95824
TC, 95951, 95951 TC, 95965, 95965 TC,
95966, 95966 TC, 95967, 95967 TC, 96020,
96020 TC, 97005, 97006, 97039, 97139,
97545, 97546, 97602, 99000, 99001,
99002, 99026, 99027, 99050, 99056,
99058, 99075, 99090, 99100, 99116,
99135, 99140, 99143, 99144, 99145,
99148, 99149, 99150, 99172, 99190,
99191, 99192, 99288, 99361, 99362,
99371, 99372, 99373, 99450, 99455,
99456, 99500, 99501, 99502, 99503,
99504, 99505, 99506, 99507, 99509,
99510, 99511, 99512, 99601, 99602,
A0225, A4263, A4300, A4550, G0008,
G0009, G0010, G0027, G0103, G0123,
G0143, G0144, G0145, G0147, G0148, G0252
TC, G0265, G0266, P2031, P2038, P3000,
P7001, P9612, P9615, Q0111, Q0112,
Q0113, Q0114, Q0115, Q3014, R0070,
R0075, S0601, S0605, S0610, S0612,
S0620, S0621, S0800, S0810, S2205,
S2206, S2207, S2208, S2209, S2300,
S2340, S2350, S2351, S3652, S9090,
0084T, 0174T
CPT Codes and Descriptions © 2007 AMA All
Rights Reserved
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RBRVS
EZ-Fees®
GAP
Table
 
|
|
GAP
Codes
-
A
complete way of determining reimbursement
for every service and procedure physicians
perform
-
Over
1600 CPT HCPCS Codes including 900
pathology codes.
-
Integrates
with directly in RBRVS EZ-Fees main RBRVS
-
Includes
RVSI GAP ASCII file
-
Exports
to ACSII, Access & dBASE
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