STANDARD DATA DICTIONARY #162.97 -- FEE BASIS CPT RVU FILE 3/24/25 PAGE 1
STORED IN ^FB(162.97, (23350 ENTRIES) SITE: WWW.BMIRWIN.COM UCI: VISTA,VISTA (VERSION 3.5)
DATA NAME GLOBAL DATA
ELEMENT TITLE LOCATION TYPE
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This file contains by calendar year all relative value units associated with a service rendered. The Service rendered is defined
with CPT Codes. This is a table file that should not be altered at the station unless instructed to do so. The relative values
are set by the Health Care Finance Administration.
Per VHA Directive 10-93-142, this file definition should not be modified.
DD ACCESS: @
WR ACCESS: @
DEL ACCESS: @
LAYGO ACCESS: @
AUDIT ACCESS: @
CROSS
REFERENCED BY: CPT CODE-MODIFIER(B)
LAST MODIFIED: JUL 8,2021@12:12:41
162.97,.01 CPT CODE-MODIFIER 0;1 FREE TEXT (Required)
INPUT TRANSFORM: K:X[""""!($A(X)=45) X I $D(X) K:$L(X)>8!($L(X)<5)!('(X?5AN)&'(X?5AN1"-"2AN)) X I $D(X) D INPUT^FBAA
UTL5
LAST EDITED: SEP 12, 1995
HELP-PROMPT: Answer must be 5-8 characters in length. Answer must be a valid CPT code or a valid CPT code
followed by a dash (-) followed by a valid CPT modifier
DESCRIPTION: Answer must be a valid CPT code/modifier combination. This is a table file and should not be
changed at the station level without direction from IRM Field Office.
TECHNICAL DESCR:
The data stored in this field is owned by the AMA. CPT is a way of assigning a code to a service.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
CROSS-REFERENCE: 162.97^B
1)= S ^FB(162.97,"B",$E(X,1,30),DA)=""
2)= K ^FB(162.97,"B",$E(X,1,30),DA)
162.97,.02 CONVERSION CATEGORY 0;2 POINTER TO FEE BASIS HCFA CONVERSION FILE (#162.99)
LAST EDITED: JUN 15, 1999
DESCRIPTION: This field is a pointer to an entry in the HCFA conversion file. It classifies codes so, a
conversion factor may be determined during the calculation of payment.
162.97,1 CALENDAR YEAR CY;0 Multiple #162.971 (Add New Entry without Asking)
DESCRIPTION: For each service rendered there are a set of relative value units by calendar year. These RVUs are
established by Health Care Finance Administration.
TECHNICAL DESCR:
Do not alter these table entries unless instructed to do so by your IRM Field Office.
162.971,.01 CALENDAR YEAR 0;1 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>9999)!(X<1900)!(X?.E1"."1N.N) X
LAST EDITED: SEP 12, 1995
HELP-PROMPT: Type a Number between 1900 and 9999, 0 Decimal Digits
DESCRIPTION:
For each service rendered there are a set of relative value units by calendar year.
CROSS-REFERENCE: 162.971^B
1)= S ^FB(162.97,DA(1),"CY","B",$E(X,1,30),DA)=""
2)= K ^FB(162.97,DA(1),"CY","B",$E(X,1,30),DA)
162.971,.02 MODIFIER LEVEL 0;2 FREE TEXT
INPUT TRANSFORM: K:$L(X)>30!($L(X)<1) X
LAST EDITED: SEP 14, 1995
HELP-PROMPT: Answer must be 1-30 characters in length.
DESCRIPTION: This field ties a multiplier to a CPT-modifier combination when a CPT-Modifier combination has
not been defined in the schedule directly.
162.971,.03 WORK RELATIVE VALUE UNIT 0;3 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99999.99)!(X<0)!(X?.E1"."3N.N) X
LAST EDITED: MAY 03, 1999
HELP-PROMPT: Type a Number between 0 and 99999.99, 2 Decimal Digits
DESCRIPTION: This is the work relative value unit associated with a CPT code. These units are set by Health
Care Finance Administration.
162.971,.04 NON-FAC PRACTICE EXPENSE RVU 0;4 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99999.99)!(X<0)!(X?.E1"."3N.N) X
LAST EDITED: MAY 03, 1999
HELP-PROMPT: Type a Number between 0 and 99999.99, 2 Decimal Digits
DESCRIPTION: This is the practice expense relative value unit for the CPT code when performed in a
non-facility setting.
162.971,.05 FACILITY PRACTICE EXPENSE RVU 0;5 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99999.99)!(X<0)!(X?.E1"."3N.N) X
LAST EDITED: MAY 03, 1999
HELP-PROMPT: Type a Number between 0 and 99999.99, 2 Decimal Digits
DESCRIPTION: This is the practice expense relative value unit for the CPT code when performed in a facility
setting such as inpatient or outpatient hospital settings, emergency rooms, skilled nursing
facilities, or ambulatory surgical centers.
162.971,.06 MALPRACTICE EXPENSE RVU 0;6 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99999.99)!(X<0)!(X?.E1"."3N.N) X
LAST EDITED: MAY 03, 1999
HELP-PROMPT: Type a Number between 0 and 99999.99, 2 Decimal Digits
DESCRIPTION: This is the malpractice relative value unit associated with a CPT code. These units are set by
Health Care Finance Administration.
162.971,.07 BASE UNITS 0;7 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99999.99)!(X<0)!(X?.E1"."3N.N) X
LAST EDITED: MAY 03, 1999
HELP-PROMPT: Type a Number between 0 and 99999.99, 2 Decimal Digits
DESCRIPTION: For anesthesia codes (00100-01999) this field holds the base unit. HCFA plans on changing the
calculation for anesthesia payments in the near future to be like all other codes but for now the
fee is calculated by:
(base units + actual time in minutes/15) times anesthesia conversion
factor). In all other CPT codes this field will be null.
162.971,.08 NONPAYABLE 0;8 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>1)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: NOV 10, 2005
HELP-PROMPT: Type 0 for "NO", 1 for "YES"
DESCRIPTION:
Indicates if the CPT/CPT MOD is NOT used for Medicare payment.
FILES POINTED TO FIELDS
FEE BASIS HCFA CONVERSION
(#162.99) CONVERSION CATEGORY (#.02)
INPUT TEMPLATE(S):
PRINT TEMPLATE(S):
SORT TEMPLATE(S):
FORM(S)/BLOCK(S):