				
2006 Parenteral and Enteral Nutrition  Items and Services (PEN) Fee Schedule				
				
		2nd	NATIONAL	
HCPCS	MODIFIER 1	MODIFIER 2	FEE SCHEDULE	SHORT DESCRIPTION
B4034			$6.12	Enter feed supkit syr by day
B4035			$11.66	Enteral feed supp pump per d
B4036			$8.00	Enteral feed sup kit grav by
B4081			$21.62	Enteral ng tubing w/ stylet
B4082			$16.09	Enteral ng tubing w/o stylet
B4083			$2.46	Enteral stomach tube levine
B4086			$35.69	Gastrostomy/jejunostomy tube
B4149			$1.57	EF blenderized foods
B4150			$0.67	EF complet w/intact nutrient
B4152			$0.56	EF calorie dense>/=1.5Kcal
B4153			$1.91	EF hydrolyzed/amino acids
B4154			$1.22	EF spec metabolic noninherit
B4155			$0.95	EF incomplete/modular
B4164			$16.48	Parenteral 50% dextrose solu
B4168			$24.01	Parenteral sol amino acid 3.
B4176			$46.46	Parenteral sol amino acid 7-
B4178			$55.78	Parenteral sol amino acid >
B4180			$23.63	Parenteral sol carb > 50%
B4185			$0.00	Parenteral sol 10 gm lipids
B4189			$172.31	Parenteral sol amino acid &
B4193			$222.67	Parenteral sol 52-73 gm prot
B4197			$271.08	Parenteral sol 74-100 gm pro
B4199			$309.77	Parenteral sol > 100gm prote
B4216			$7.49	Parenteral nutrition additiv
B4220			$7.76	Parenteral supply kit premix
B4222			$9.57	Parenteral supply kit homemi
B4224			$24.25	Parenteral administration ki
B5000			$11.52	Parenteral sol renal-amirosy
B5100			$4.51	Parenteral sol hepatic-fream
B9000	NU		"$1,226.26"	Enter infusion pump w/o alrm
B9000	RR		$112.68	Enter infusion pump w/o alrm
B9000	UE		$919.69	Enter infusion pump w/o alrm
B9002	NU		"$1,226.26"	Enteral infusion pump w/ ala
B9002	RR		$118.77	Enteral infusion pump w/ ala
B9002	UE		$919.69	Enteral infusion pump w/ ala
B9004	NU		"$2,446.04"	Parenteral infus pump portab
B9004	RR		$387.23	Parenteral infus pump portab
B9004	UE		"$1,834.53"	Parenteral infus pump portab
B9006	NU		"$2,446.04"	Parenteral infus pump statio
B9006	RR		$387.23	Parenteral infus pump statio
B9006	UE		"$1,834.53"	Parenteral infus pump statio
E0776	NU	BA	$101.98	Iv pole
E0776	RR	BA	$25.81	Iv pole
E0776	UE	BA	$76.49	Iv pole
