Deleting duplicate rows with condition
Would that work? SQL version only.

SELECT *
FROM
(
SELECT ROW_NUMBER() OVER (PARTITION BY CPT4, CPT4MOD, ITEMCHARGE ORDER BY EFF_DATE DESC) AS RowNo
    , *
FROM #table
) AS T
WHERE T.RowNo = 1


You can check it here:
http://data.stackexchange.com/stackoverflow/query/260027/delting-duplicate-rows-with-condition