Addendum C. - Final HCPCS Codes Payable Under the 2013 OPPS by APC

CPT codes and descriptions only are copyright 2011 American Medical 

Association. All Rights Reserved. Applicable FARS/DFARS Apply. 

Dental codes (D codes) are copyright 2011/12 American Dental 

Association. All Rights Reserved.

APC HCPCS Group Title

0001 Level I Photochemotherapy

0001 96900

0001 96910

0001 96912

0002 Fine Needle Biopsy/Aspiration

0002 10021

0002 19001

0002 36680

0003 Bone Marrow Biopsy/Aspiration

0003 38220

0003 38221

0004 Level I Needle Biopsy/ Aspiration Except Bone Marrow

0004 10022

0004 19000

0004 19100

0004 20615

0004 47399

0004 48999

0004 54800

0004 55000

0004 60100

0004 60300

0004 62267

0005 Level II Needle Biopsy/Aspiration Except Bone Marrow

0005 19102

0005 20206

0005 38505

0005 42400

0006 Level I Incision & Drainage

0006 10060

0006 10061

0006 10080

0006 10160

0006 20950

0006 21725

0006 26010

0006 40800

0006 41800

0006 69000

0006 69020
0007 Level II Incision & Drainage

0007 10081

0007 10140

0007 20103

0007 23931

0007 26011

0007 28001

0007 38300

0007 55100

0007 57022

0007 69005

0008 Level III Incision and Drainage

0008 10180

0008 19020

0008 21501

0008 23030

0008 23031

0008 23930

0008 27301

0008 27603

0008 38305

0008 51080

0008 54015

0008 54115

0008 57023

0012 Level I Debridement & Destruction

0012 11719

0012 11740

0012 17003

0012 17999

0012 96999

0012 G0127

0013 Level II Debridement & Destruction

0013 0183T

0013 10040

0013 11001

0013 11055

0013 11056

0013 11101

0013 11200

0013 11201

0013 11300

0013 11301

0013 11302

0013 11305

0013 11306

0013 11307
0013 11310

0013 11311

0013 11720

0013 11721

0013 11730

0013 11732

0013 11765

0013 11900

0013 11901

0013 15786

0013 15787

0013 15788

0013 15793

0013 16000

0013 17000

0013 17110

0013 17340

0013 36468

0013 54056

0013 69220

0013 97602

0013 97605

0013 G0247

0015 Level III Debridement & Destruction

0015 11057

0015 11100

0015 11303

0015 11308

0015 11312

0015 11313

0015 15789

0015 15792

0015 16020

0015 16025

0015 16030

0015 16035

0015 17111

0015 17250

0015 17260

0015 17261

0015 17262

0015 17263

0015 17264

0015 17270

0015 17271

0015 17272

0015 17280
0015 17360

0015 17380

0015 36469

0015 36470

0015 36471

0015 45520

0015 46916

0015 54050

0015 96567

0015 96570

0015 96571

0015 96920

0015 96921

0015 96922

0015 97597

0015 97598

0015 97606

0016 Level IV Debridement & Destruction

0016 10120

0016 11000

0016 11042

0016 11043

0016 11045

0016 11046

0016 15783

0016 15850

0016 15851

0016 17004

0016 17106

0016 17107

0016 17108

0016 17266

0016 17273

0016 17274

0016 17276

0016 17281

0016 17282

0016 17283

0016 17284

0016 17286

0016 46900

0016 G0456

0016 G0457

0017 Level V Debridement & Destruction

0017 46910

0017 46917

0017 46922
0017 46924

0017 54055

0017 54057

0017 54060

0017 54065

0017 56501

0017 56515

0019 Level I Excision/ Biopsy

0019 11010

0019 11011

0019 11012

0019 11047

0019 11400

0019 11401

0019 11402

0019 11440

0019 11441

0019 11601

0019 11602

0019 11621

0019 11640

0019 11641

0019 11642

0019 11750

0019 11755

0019 11976

0019 15781

0019 15782

0019 15920

0019 15999

0019 20520

0019 24200

0019 41108

0020 Level II Excision/ Biopsy

0020 11044

0020 11403

0020 11420

0020 11421

0020 11422

0020 11442

0020 11443

0020 11444

0020 11600

0020 11603

0020 11604

0020 11620

0020 11622
0020 11623

0020 11643

0020 20005

0020 20220

0020 21011

0020 21012

0020 21013

0020 21014

0020 21920

0020 23065

0020 23330

0020 25065

0020 27040

0020 27041

0020 27086

0020 27323

0020 27613

0020 28190

0020 28193

0020 33284

0020 35226

0021 Level III Excision/ Biopsy

0021 10121

0021 11404

0021 11406

0021 11423

0021 11424

0021 11606

0021 11624

0021 11644

0021 15836

0021 15837

0021 15838

0021 15839

0021 19260

0021 20200

0021 20205

0021 20225

0021 20670

0021 21015

0021 21550

0021 21555

0021 21557

0021 21930

0021 21932

0021 21935

0021 22902
0021 22904

0021 23000

0021 23075

0021 23076

0021 23077

0021 24065

0021 24066

0021 24075

0021 24076

0021 24077

0021 24201

0021 25075

0021 25076

0021 25077

0021 26115

0021 26116

0021 26117

0021 26320

0021 27047

0021 27048

0021 27049

0021 27328

0021 27329

0021 27615

0021 27618

0021 27619

0021 28043

0021 28045

0021 28046

0021 28192

0021 37609

0021 54100

0021 69110

0021 69145

0022 Level IV Excision/ Biopsy

0022 11426

0022 11446

0022 11450

0022 11451

0022 11462

0022 11463

0022 11470

0022 11471

0022 11626

0022 11646

0022 11752

0022 11770
0022 11771

0022 11772

0022 11971

0022 15780

0022 15830

0022 15832

0022 15833

0022 15834

0022 15835

0022 15847

0022 15931

0022 15933

0022 15940

0022 15941

0022 15950

0022 15951

0022 20240

0022 20245

0022 20525

0022 20680

0022 21016

0022 21552

0022 21554

0022 21556

0022 21558

0022 21925

0022 21931

0022 21933

0022 21936

0022 22900

0022 22901

0022 22903

0022 22905

0022 23066

0022 23071

0022 23073

0022 23078

0022 23331

0022 24071

0022 24073

0022 24079

0022 25066

0022 25071

0022 25073

0022 25078

0022 26111

0022 26113
0022 26118

0022 27043

0022 27045

0022 27059

0022 27324

0022 27327

0022 27337

0022 27339

0022 27364

0022 27372

0022 27614

0022 27616

0022 27632

0022 27634

0022 28039

0022 28041

0022 28047

0022 54105

0022 60512

0022 69205

0028 Level I Breast Surgery

0028 19101

0028 19110

0028 19112

0028 19120

0028 19125

0028 19126

0028 19300

0028 19301

0028 19350

0028 19499

0028 C9726

0029 Level II Breast Surgery

0029 19105

0029 19303

0029 19304

0029 19316

0029 19328

0029 19330

0029 19355

0029 19366

0029 19370

0029 19371

0029 19396

0030 Level III Breast Surgery

0030 19302

0030 19307
0030 19318

0030 19324

0030 19340

0030 19380

0031 Level I Health and Behavior Services

0031 96153

0031 99406

0031 99407

0031 G0436

0035 Vascular Puncture and Minor Diagnostic Procedures

0035 0208T

0035 0209T

0035 0210T

0035 0211T

0035 36420

0035 36425

0035 36600

0035 76514

0035 92227

0035 92228

0035 93041

0035 93278

0035 93290

0035 93998

0037 Level IV Needle Biopsy/Aspiration Except Bone Marrow

0037 19103

0037 44901

0037 47011

0037 48511

0037 49021

0037 49041

0037 49061

0037 50021

0037 54500

0039 Level I Implantation of Neurostimulator Generator

0039 0268T

0039 0316T

0039 61885

0039 63685

0039 64590

0040 Level I Implantation/Revision/Replacement of Neurostimulator Electrodes

0040 0282T

0040 63650

0040 63663

0040 63664

0040 64553

0040 64555
0040 64561

0040 64565

0040 64569

0041 Level I Arthroscopy

0041 29800

0041 29804

0041 29805

0041 29822

0041 29824

0041 29826

0041 29830

0041 29834

0041 29835

0041 29836

0041 29837

0041 29838

0041 29840

0041 29843

0041 29844

0041 29845

0041 29846

0041 29848

0041 29850

0041 29870

0041 29871

0041 29873

0041 29874

0041 29875

0041 29876

0041 29877

0041 29879

0041 29880

0041 29881

0041 29882

0041 29883

0041 29884

0041 29886

0041 29887

0041 29894

0041 29895

0041 29897

0041 29898

0041 29900

0041 29901

0041 29902

0041 29904

0041 29905
0041 29906

0041 29999

0042 Level II Arthroscopy

0042 29806

0042 29807

0042 29819

0042 29820

0042 29821

0042 29823

0042 29825

0042 29827

0042 29828

0042 29847

0042 29851

0042 29855

0042 29856

0042 29860

0042 29861

0042 29862

0042 29863

0042 29866

0042 29867

0042 29868

0042 29885

0042 29891

0042 29899

0042 29907

0042 29914

0042 29915

0042 29916

0045 Bone/Joint Manipulation Under Anesthesia

0045 22505

0045 23655

0045 23700

0045 24300

0045 24605

0045 26775

0045 27194

0045 27252

0045 27257

0045 27266

0045 27275

0045 27552

0045 27562

0045 27570

0045 27842

0045 27860
0045 28635

0045 28665

0047 Arthroplasty without Prosthesis

0047 24360

0047 24365

0047 25332

0047 25447

0047 25449

0047 26530

0047 26535

0047 27437

0047 27440

0047 27441

0047 27442

0047 27443

0047 27700

0048 Level I Arthroplasty or Implantation with Prosthesis

0048 24362

0048 25443

0048 25444

0048 25445

0048 26531

0048 26536

0048 27438

0049 Level I Musculoskeletal Procedures Except Hand and Foot

0049 20662

0049 20694

0049 20999

0049 21502

0049 21700

0049 21720

0049 22999

0049 23035

0049 23100

0049 23140

0049 23935

0049 24100

0049 24105

0049 24110

0049 24120

0049 24310

0049 24925

0049 25000

0049 25001

0049 25028

0049 25031

0049 25035
0049 25085

0049 25100

0049 25109

0049 25110

0049 25111

0049 25112

0049 25115

0049 25116

0049 25248

0049 25295

0049 25907

0049 25909

0049 25922

0049 25931

0049 26990

0049 26991

0049 27000

0049 27050

0049 27052

0049 27057

0049 27060

0049 27062

0049 27065

0049 27087

0049 27305

0049 27306

0049 27340

0049 27345

0049 27347

0049 27390

0049 27391

0049 27497

0049 27594

0049 27600

0049 27601

0049 27606

0049 27607

0049 27630

0049 27656

0049 27658

0049 27659

0049 27675

0049 27704

0049 27884

0049 28002

0049 28003

0050 Level II Musculoskeletal Procedures Except Hand and Foot
0050 0101T

0050 0102T

0050 0200T

0050 0201T

0050 0221T

0050 0222T

0050 20250

0050 20251

0050 20555

0050 20650

0050 20663

0050 20690

0050 20692

0050 20693

0050 20696

0050 20900

0050 20902

0050 20924

0050 21600

0050 21610

0050 22520

0050 22521

0050 22522

0050 22851

0050 22899

0050 23020

0050 23040

0050 23044

0050 23101

0050 23105

0050 23106

0050 23107

0050 23120

0050 23125

0050 23145

0050 23146

0050 23150

0050 23155

0050 23156

0050 23170

0050 23172

0050 23174

0050 23180

0050 23182

0050 23184

0050 23190

0050 23195
0050 23400

0050 23405

0050 23406

0050 23440

0050 24000

0050 24006

0050 24101

0050 24102

0050 24115

0050 24116

0050 24125

0050 24126

0050 24130

0050 24134

0050 24136

0050 24138

0050 24140

0050 24145

0050 24147

0050 24149

0050 24155

0050 24160

0050 24164

0050 24301

0050 24305

0050 24320

0050 24332

0050 24343

0050 24345

0050 24357

0050 24358

0050 24359

0050 24495

0050 25020

0050 25023

0050 25024

0050 25025

0050 25040

0050 25101

0050 25105

0050 25107

0050 25118

0050 25119

0050 25120

0050 25125

0050 25126

0050 25130
0050 25135

0050 25136

0050 25145

0050 25150

0050 25151

0050 25170

0050 25210

0050 25215

0050 25230

0050 25240

0050 25250

0050 25251

0050 25260

0050 25263

0050 25265

0050 25270

0050 25272

0050 25274

0050 25275

0050 25280

0050 25290

0050 25300

0050 25301

0050 25310

0050 25315

0050 25392

0050 27001

0050 27003

0050 27006

0050 27027

0050 27035

0050 27066

0050 27067

0050 27080

0050 27097

0050 27098

0050 27235

0050 27307

0050 27310

0050 27330

0050 27331

0050 27332

0050 27333

0050 27334

0050 27335

0050 27350

0050 27355
0050 27356

0050 27357

0050 27358

0050 27360

0050 27380

0050 27381

0050 27385

0050 27386

0050 27392

0050 27393

0050 27394

0050 27396

0050 27403

0050 27425

0050 27435

0050 27475

0050 27479

0050 27496

0050 27498

0050 27499

0050 27602

0050 27604

0050 27610

0050 27612

0050 27620

0050 27625

0050 27626

0050 27635

0050 27637

0050 27638

0050 27640

0050 27641

0050 27647

0050 27664

0050 27665

0050 27676

0050 27680

0050 27681

0050 27685

0050 27686

0050 27687

0050 27695

0050 27696

0050 27698

0050 27707

0050 27709

0050 27730
0050 27732

0050 27734

0050 27740

0050 27889

0050 27892

0050 27893

0050 27894

0050 28890

0050 G0413

0051 Level III Musculoskeletal Procedures Except Hand and Foot

0051 11970

0051 20150

0051 20982

0051 21742

0051 21743

0051 23130

0051 23395

0051 23410

0051 23412

0051 23415

0051 23420

0051 23430

0051 23462

0051 23466

0051 23480

0051 24150

0051 24152

0051 24331

0051 24340

0051 24341

0051 24342

0051 24410

0051 24420

0051 24470

0051 24800

0051 25312

0051 25320

0051 25335

0051 25337

0051 25350

0051 25355

0051 25360

0051 25370

0051 25375

0051 25390

0051 25393

0051 25394
0051 25426

0051 25430

0051 25431

0051 25450

0051 25455

0051 25490

0051 25491

0051 25492

0051 25820

0051 27033

0051 27100

0051 27105

0051 27110

0051 27111

0051 27395

0051 27397

0051 27400

0051 27405

0051 27416

0051 27418

0051 27420

0051 27422

0051 27424

0051 27430

0051 27650

0051 27654

0051 27690

0051 27691

0051 27692

0051 27705

0051 27742

0052 Level IV Musculoskeletal Procedures Except Hand and Foot

0052 0171T

0052 0172T

0052 22523

0052 22524

0052 22525

0052 23397

0052 23450

0052 23455

0052 23460

0052 23465

0052 23485

0052 23490

0052 23491

0052 23800

0052 23802
0052 24330

0052 24344

0052 24346

0052 24400

0052 24430

0052 24435

0052 24498

0052 24802

0052 24935

0052 25316

0052 25365

0052 25391

0052 25400

0052 25405

0052 25415

0052 25420

0052 25425

0052 25440

0052 25800

0052 25805

0052 25810

0052 25825

0052 25830

0052 27179

0052 27407

0052 27409

0052 27412

0052 27415

0052 27427

0052 27428

0052 27429

0052 27652

0052 27745

0052 27870

0052 27871

0052 28715

0052 29888

0052 29889

0052 29892

0053 Level I Hand Musculoskeletal Procedures

0053 26020

0053 26025

0053 26030

0053 26034

0053 26035

0053 26037

0053 26040
0053 26055

0053 26060

0053 26070

0053 26075

0053 26080

0053 26100

0053 26105

0053 26110

0053 26125

0053 26130

0053 26140

0053 26145

0053 26160

0053 26170

0053 26180

0053 26185

0053 26200

0053 26210

0053 26215

0053 26230

0053 26235

0053 26236

0053 26250

0053 26260

0053 26262

0053 26410

0053 26418

0053 26432

0053 26433

0053 26437

0053 26440

0053 26445

0053 26450

0053 26455

0053 26460

0053 26471

0053 26474

0053 26476

0053 26477

0053 26478

0053 26479

0053 26500

0053 26508

0053 26520

0053 26525

0053 26540

0053 26542
0053 26560

0053 26580

0053 26587

0053 26590

0053 26593

0053 26596

0053 26951

0053 26952

0054 Level II Hand Musculoskeletal Procedures

0054 20822

0054 26045

0054 26121

0054 26123

0054 26135

0054 26205

0054 26350

0054 26352

0054 26356

0054 26357

0054 26358

0054 26370

0054 26372

0054 26373

0054 26390

0054 26392

0054 26412

0054 26415

0054 26416

0054 26420

0054 26426

0054 26428

0054 26434

0054 26442

0054 26449

0054 26480

0054 26483

0054 26485

0054 26489

0054 26490

0054 26492

0054 26494

0054 26496

0054 26497

0054 26498

0054 26499

0054 26502

0054 26510
0054 26516

0054 26517

0054 26518

0054 26541

0054 26545

0054 26546

0054 26548

0054 26550

0054 26555

0054 26561

0054 26562

0054 26565

0054 26567

0054 26568

0054 26591

0054 26820

0054 26841

0054 26842

0054 26843

0054 26844

0054 26850

0054 26852

0054 26860

0054 26861

0054 26862

0054 26863

0054 26910

0054 64821

0054 64822

0054 64823

0055 Level I Foot Musculoskeletal Procedures

0055 27605

0055 28005

0055 28008

0055 28010

0055 28011

0055 28020

0055 28022

0055 28024

0055 28050

0055 28052

0055 28054

0055 28060

0055 28062

0055 28070

0055 28072

0055 28080
0055 28086

0055 28088

0055 28090

0055 28092

0055 28100

0055 28104

0055 28108

0055 28110

0055 28111

0055 28112

0055 28113

0055 28114

0055 28116

0055 28118

0055 28119

0055 28120

0055 28122

0055 28124

0055 28126

0055 28130

0055 28140

0055 28150

0055 28153

0055 28160

0055 28171

0055 28173

0055 28175

0055 28200

0055 28202

0055 28208

0055 28220

0055 28222

0055 28225

0055 28226

0055 28230

0055 28232

0055 28234

0055 28240

0055 28250

0055 28260

0055 28261

0055 28262

0055 28270

0055 28272

0055 28280

0055 28285

0055 28286
0055 28288

0055 28289

0055 28302

0055 28306

0055 28307

0055 28308

0055 28310

0055 28312

0055 28313

0055 28315

0055 28340

0055 28341

0055 28344

0055 28345

0055 28755

0055 28805

0055 28810

0055 28820

0055 28825

0055 29893

0056 Level II Foot Musculoskeletal Procedures

0056 20972

0056 20973

0056 28102

0056 28103

0056 28106

0056 28107

0056 28210

0056 28238

0056 28264

0056 28300

0056 28304

0056 28305

0056 28309

0056 28320

0056 28322

0056 28360

0056 28446

0056 28705

0056 28725

0056 28730

0056 28735

0056 28737

0056 28740

0056 28750

0056 28760

0057 Bunion Procedures
0057 28290

0057 28292

0057 28293

0057 28294

0057 28296

0057 28297

0057 28298

0057 28299

0058 Level I Cast Application

0058 29000

0058 29020

0058 29025

0058 29040

0058 29049

0058 29058

0058 29085

0058 29086

0058 29105

0058 29125

0058 29126

0058 29440

0058 29450

0058 29505

0058 29515

0058 29580

0058 29581

0058 29700

0058 29705

0058 29715

0058 29720

0058 29730

0058 29740

0058 29750

0058 29799

0059 Level I Strapping

0059 29130

0059 29131

0059 29200

0059 29240

0059 29260

0059 29280

0059 29520

0059 29530

0059 29540

0059 29550

0059 29582

0059 29583
0059 29584

0060 Manipulation Therapy

0060 98925

0060 98926

0060 98927

0060 98928

0060 98929

0060 98940

0060 98941

0060 98942

0061 Level II Implantation/Revision/Replacement of Neurostimulator Electrodes

0061 43647

0061 63655

0061 64575

0061 64580

0061 64581

0062 Level I Treatment Fracture/Dislocation

0062 0245T

0062 0246T

0062 0247T

0062 0248T

0062 21336

0062 21805

0062 23532

0062 24538

0062 24566

0062 24582

0062 25606

0062 25651

0062 25670

0062 25671

0062 25676

0062 25685

0062 25695

0062 26608

0062 26650

0062 26676

0062 26685

0062 26715

0062 26727

0062 26735

0062 26746

0062 26756

0062 26765

0062 26776

0062 26785

0062 27509
0062 27756

0062 28406

0062 28436

0062 28456

0062 28476

0062 28496

0062 28505

0062 28525

0062 28531

0062 28545

0062 28546

0062 28576

0062 28585

0062 28606

0062 28636

0062 28645

0062 28666

0062 28675

0063 Level II Treatment Fracture/Dislocation

0063 23530

0063 23550

0063 23552

0063 23660

0063 23680

0063 24665

0063 24685

0063 25515

0063 25525

0063 25526

0063 25545

0063 25628

0063 25645

0063 25652

0063 26615

0063 26665

0063 27202

0063 27524

0063 27566

0063 27720

0063 27726

0063 27758

0063 27766

0063 27769

0063 27784

0063 27792

0063 27814

0063 27822
0063 27826

0063 27829

0063 27832

0063 27846

0063 27848

0063 28420

0063 28445

0063 28465

0063 28485

0063 28555

0063 28615

0064 Level III Treatment Fracture/Dislocation

0064 23515

0064 23585

0064 23615

0064 23616

0064 23630

0064 23670

0064 24515

0064 24516

0064 24545

0064 24546

0064 24575

0064 24579

0064 24586

0064 24587

0064 24615

0064 24635

0064 24666

0064 25574

0064 25575

0064 25607

0064 25608

0064 25609

0064 26686

0064 27722

0064 27759

0064 27823

0064 27827

0064 27828

0064 28415

0065 Level I Stereotactic Radiosurgery, MRgFUS, and MEG

0065 0301T

0065 77424

0065 77425

0065 95966

0065 95967
0065 G0251

0066 Level II Stereotactic Radiosurgery, MRgFUS, and MEG

0066 95965

0066 G0340

0067 Level III Stereotactic Radiosurgery, MRgFUS, and MEG

0067 0071T

0067 0072T

0067 G0173

0067 G0339

0069 Thoracoscopy

0069 32601

0069 32604

0069 32606

0069 32607

0069 32608

0069 32609

0069 39400

0070 Thoracentesis/Lavage Procedures

0070 32201

0070 32551

0070 32552

0070 32554

0070 32555

0070 32556

0070 32557

0070 32560

0070 32561

0070 32562

0070 32960

0070 32999

0070 33010

0070 33011

0070 33999

0070 49082

0070 49083

0070 49084

0071 Level I Endoscopy Upper Airway

0071 31505

0071 92511

0072 Level II Endoscopy Upper Airway

0072 31231

0072 31233

0072 31511

0072 31513

0072 31520

0072 31575

0073 Level III Endoscopy Upper Airway
0073 31577

0073 31579

0073 31717

0073 31730

0074 Level IV Endoscopy Upper Airway

0074 31235

0074 31237

0074 31238

0074 31510

0074 31512

0074 31515

0074 31525

0074 31526

0074 31530

0074 31531

0074 31535

0074 31536

0074 31540

0074 31570

0074 31576

0074 31578

0075 Level V Endoscopy Upper Airway

0075 31239

0075 31240

0075 31254

0075 31255

0075 31256

0075 31267

0075 31276

0075 31287

0075 31288

0075 31292

0075 31293

0075 31294

0075 31295

0075 31296

0075 31297

0075 31527

0075 31528

0075 31529

0075 31541

0075 31545

0075 31546

0075 31560

0075 31561

0075 31571

0076 Level I Endoscopy Lower Airway
0076 31622

0076 31623

0076 31624

0076 31625

0076 31628

0076 31632

0076 31633

0076 31635

0076 31637

0076 31643

0076 31645

0076 31646

0076 31649

0076 31899

0077 Level I Pulmonary Treatment

0077 31720

0077 94610

0077 94640

0077 94664

0077 94667

0077 94668

0077 G0237

0077 G0238

0077 G0239

0078 Level III Pulmonary Treatment

0078 0243T

0078 31502

0078 94060

0078 94642

0078 94660

0079 Ventilation Initiation and Management

0079 94002

0079 94003

0079 94662

0080 Diagnostic Cardiac Catheterization

0080 93451

0080 93452

0080 93453

0080 93454

0080 93455

0080 93456

0080 93457

0080 93458

0080 93459

0080 93460

0080 93461

0080 93462
0080 93530

0080 93531

0080 93532

0080 93533

0082 Coronary or Non-Coronary Atherectomy

0082 0234T

0082 0236T

0082 0237T

0082 0238T

0082 37204

0082 61623

0082 61626

0082 92924

0082 92925

0083 Coronary Angioplasty, Valvuloplasty, and Level I Endovascular Revascularization

0083 35458

0083 35460

0083 35471

0083 35472

0083 35475

0083 35476

0083 37220

0083 37222

0083 37223

0083 37224

0083 37228

0083 37232

0083 37234

0083 37235

0083 75962

0083 75966

0083 92920

0083 92921

0083 92986

0083 92987

0083 92990

0083 92997

0083 92998

0084 Level I Electrophysiologic Procedures

0084 93600

0084 93602

0084 93603

0084 93610

0084 93612

0084 93615

0084 93616

0084 93618
0084 93642

0085 Level II Electrophysiologic Procedures

0085 93619

0085 93620

0085 93624

0085 93650

0088 Thrombectomy

0088 34101

0088 34111

0088 34201

0088 34203

0088 34421

0088 34471

0088 34490

0088 34501

0088 34510

0088 34520

0088 34530

0088 35188

0088 35207

0088 35875

0088 35876

0088 35879

0088 35881

0088 35883

0088 35884

0088 36818

0088 36819

0088 36820

0088 36821

0088 36825

0088 36830

0088 36831

0088 36832

0088 36833

0088 36838

0088 37184

0088 37185

0088 37186

0088 37187

0088 37188

0088 92973

0089 Insertion/Replacement of Permanent Pacemaker and Electrodes

0089 0302T

0089 33206

0089 33207

0090 Level I Insertion/Replacement of Permanent Pacemaker
0090 0304T

0090 33212

0090 33227

0091 Level II Vascular Ligation

0091 36475

0091 37191

0091 37500

0091 37605

0091 37619

0091 37722

0091 37735

0092 Level I Vascular Ligation

0092 30915

0092 30920

0092 36476

0092 36478

0092 36479

0092 37501

0092 37606

0092 37607

0092 37615

0092 37650

0092 37700

0092 37718

0092 37760

0092 37761

0092 37765

0092 37766

0092 37780

0092 37785

0093 Vascular Reconstruction/Fistula Repair without Device

0093 35045

0093 35180

0093 35184

0093 35190

0093 35201

0093 35206

0093 35231

0093 35236

0093 35256

0093 35321

0093 35685

0093 35686

0093 35761

0093 35860

0093 35903

0093 37565
0093 37600

0093 75978

0094 Level I Resuscitation and Cardioversion

0094 31500

0094 92950

0094 92953

0094 99465

0095 Cardiac Rehabilitation

0095 93797

0095 93798

0095 G0422

0095 G0423

0096 Level II Noninvasive Physiologic Studies

0096 76936

0096 93923

0096 93924

0096 93965

0097 Level I Noninvasive Physiologic Studies

0097 0239T

0097 0296T

0097 0297T

0097 43755

0097 93225

0097 93226

0097 93270

0097 93786

0097 93788

0097 93799

0097 93922

0097 93982

0097 94762

0097 94775

0097 94776

0099 Electrocardiograms/Cardiography

0099 0223T

0099 0311T

0099 93005

0099 93701

0099 G0404

0100 Cardiac Stress Tests

0100 0179T

0100 93017

0100 93024

0100 93025

0100 Q0035

0101 Tilt Table Evaluation

0101 93660
0102 Level II Pulmonary Treatment

0102 G0424

0103 Miscellaneous Vascular Procedures

0103 35500

0103 37202

0103 92974

0103 93503

0103 93505

0104 Transcatheter Placement of Intracoronary Stents

0104 92928

0104 92929

0104 92933

0104 92934

0104 92937

0104 92938

0104 92941

0104 92943

0104 92944

0105 Repair/Revision/Removal of Pacemakers, AICDs, or Vascular Devices

0105 0307T

0105 0322T

0105 0324T

0105 0325T

0105 33215

0105 33218

0105 33220

0105 33226

0105 33233

0105 33234

0105 33235

0105 33241

0105 33244

0105 36261

0105 36262

0105 49422

0105 49429

0106 Insertion/Replacement of Pacemaker Leads and/or Electrodes

0106 0303T

0106 0320T

0106 33210

0106 33211

0106 33216

0106 33217

0107 Level I Implantation of Cardioverter-Defibrillators (ICDs)

0107 0319T

0107 0321T

0107 0323T
0107 33230

0107 33231

0107 33240

0107 33262

0107 33263

0107 33264

0108 Level II Implantation of Cardioverter-Defibrillators (ICDs)

0108 33249

0110 Transfusion

0110 36430

0110 36440

0110 36450

0110 36455

0110 36460

0110 38207

0110 38208

0110 38209

0110 38999

0111 Blood Product Exchange

0111 36511

0111 36512

0111 36513

0111 36514

0111 38206

0111 38242

0111 38243

0112 Apheresis and Stem Cell Procedures

0112 0263T

0112 0264T

0112 0265T

0112 36515

0112 36516

0112 36522

0112 38230

0112 38232

0112 38240

0112 38241

0113 Excision Lymphatic System

0113 38308

0113 38500

0113 38510

0113 38520

0113 38525

0113 38530

0113 38550

0113 38555

0113 38700
0113 38720

0113 38760

0114 Thyroid/Lymphadenectomy Procedures

0114 38542

0114 38740

0114 38745

0114 60200

0114 60210

0114 60212

0114 60220

0114 60225

0114 60240

0114 60280

0114 60281

0114 60699

0115 Cannula/Access Device Procedures

0115 36800

0115 36810

0115 36815

0115 36835

0115 36861

0115 49419

0121 Level I Tube or Catheter Changes or Repositioning

0121 36575

0121 36589

0121 44500

0121 49450

0121 49451

0121 49452

0121 49460

0121 51710

0121 61070

0126 Level I Urinary and Anal Procedures

0126 50391

0126 50686

0126 51101

0126 51703

0126 51741

0126 51784

0126 51792

0126 53601

0126 53660

0126 53661

0126 53899

0126 54240

0126 55899

0126 90911
0126 91120

0127 Level IV Stereotactic Radiosurgery, MRgFUS, and MEG

0127 77371

0129 Level I Closed Treatment Fracture

0129 21800

0129 21820

0129 22305

0129 23500

0129 23540

0129 23570

0129 23600

0129 23620

0129 23650

0129 23675

0129 23929

0129 24500

0129 24505

0129 24530

0129 24560

0129 24565

0129 24576

0129 24577

0129 24600

0129 24640

0129 24650

0129 24670

0129 24675

0129 24999

0129 25500

0129 25530

0129 25535

0129 25560

0129 25600

0129 25622

0129 25630

0129 25635

0129 25650

0129 25660

0129 25675

0129 25680

0129 25999

0129 26600

0129 26605

0129 26641

0129 26670

0129 26675

0129 26700
0129 26705

0129 26720

0129 26725

0129 26740

0129 26742

0129 26750

0129 26755

0129 26770

0129 26989

0129 27193

0129 27200

0129 27220

0129 27230

0129 27250

0129 27256

0129 27265

0129 27267

0129 27299

0129 27501

0129 27503

0129 27508

0129 27516

0129 27517

0129 27520

0129 27530

0129 27538

0129 27550

0129 27560

0129 27599

0129 27750

0129 27760

0129 27767

0129 27768

0129 27780

0129 27786

0129 27788

0129 27808

0129 27810

0129 27816

0129 27824

0129 27830

0129 27840

0129 27899

0129 28400

0129 28430

0129 28435

0129 28450
0129 28455

0129 28470

0129 28475

0129 28490

0129 28495

0129 28510

0129 28515

0129 28530

0129 28540

0129 28570

0129 28600

0129 28605

0129 28630

0129 28660

0129 28899

0130 Level I Laparoscopy

0130 38129

0130 38589

0130 43289

0130 43648

0130 43659

0130 44213

0130 44238

0130 44979

0130 45499

0130 47379

0130 47560

0130 47561

0130 47579

0130 49320

0130 49321

0130 49322

0130 49323

0130 49324

0130 49325

0130 49326

0130 49327

0130 49329

0130 49659

0130 50541

0130 50549

0130 50949

0130 51999

0130 54699

0130 55559

0130 58545

0130 58578
0130 58679

0130 59898

0130 60659

0131 Level II Laparoscopy

0131 38120

0131 38570

0131 38572

0131 43653

0131 44180

0131 44186

0131 44970

0131 47562

0131 47563

0131 47564

0131 49650

0131 49651

0131 50543

0131 50544

0131 50945

0131 50947

0131 50948

0131 51990

0131 51992

0131 54690

0131 55550

0131 57425

0131 58546

0131 58552

0131 58553

0131 58554

0131 58570

0131 58571

0131 58572

0131 58573

0131 58660

0131 58661

0131 58662

0131 58670

0131 58671

0131 58672

0131 58673

0131 59150

0131 59151

0132 Level III Laparoscopy

0132 38571

0132 43280

0132 43281
0132 43651

0132 43652

0132 43770

0132 44206

0132 44207

0132 44208

0132 49652

0132 49653

0132 49654

0132 49655

0132 49656

0132 49657

0132 54692

0132 58541

0132 58542

0132 58543

0132 58544

0132 58550

0133 Level I Skin Repair

0133 0299T

0133 0300T

0133 11760

0133 11954

0133 12001

0133 12002

0133 12004

0133 12005

0133 12006

0133 12007

0133 12011

0133 12013

0133 12014

0133 12015

0133 12016

0133 12017

0133 12041

0133 12054

0133 13122

0133 15272

0133 15276

0133 15775

0133 15776

0134 Level II Skin Repair

0134 11920

0134 11921

0134 11922

0134 11950
0134 11951

0134 11952

0134 12018

0134 12021

0134 12031

0134 12032

0134 12034

0134 12035

0134 12036

0134 12037

0134 12042

0134 12044

0134 12045

0134 12046

0134 12047

0134 12051

0134 12052

0134 12053

0134 12055

0134 12056

0134 12057

0134 13102

0134 13120

0134 13121

0134 13131

0134 13133

0134 13153

0134 15004

0134 15040

0134 15050

0134 15116

0134 15150

0134 15151

0134 15152

0134 15155

0134 15156

0134 15157

0134 15241

0134 15271

0134 15274

0134 15275

0134 15278

0134 15819

0135 Level III Skin Repair

0135 12020

0135 13100

0135 13101
0135 13132

0135 13150

0135 13151

0135 13152

0135 15002

0135 15003

0135 15005

0135 15110

0135 15111

0135 15221

0135 15273

0135 15277

0135 C9800

0136 Level IV Skin Repair

0136 11762

0136 14000

0136 14001

0136 14020

0136 14021

0136 14040

0136 14041

0136 14060

0136 14061

0136 15115

0136 15130

0136 15131

0136 15135

0136 15136

0136 15200

0136 15201

0136 15220

0136 15240

0136 15260

0136 15261

0136 15740

0136 15777

0136 15936

0136 15952

0136 15953

0136 15956

0136 15958

0136 20920

0136 20922

0136 20926

0136 23921

0136 25929

0136 33222
0136 33223

0136 43887

0137 Level V Skin Repair

0137 11960

0137 13160

0137 14301

0137 14302

0137 14350

0137 15100

0137 15101

0137 15120

0137 15121

0137 15570

0137 15572

0137 15574

0137 15576

0137 15600

0137 15610

0137 15620

0137 15630

0137 15650

0137 15731

0137 15732

0137 15734

0137 15736

0137 15738

0137 15750

0137 15760

0137 15770

0137 15820

0137 15821

0137 15822

0137 15823

0137 15824

0137 15825

0137 15826

0137 15828

0137 15829

0137 15840

0137 15841

0137 15842

0137 15845

0137 15876

0137 15877

0137 15878

0137 15879

0137 15922
0137 15934

0137 15935

0137 15937

0137 15944

0137 15945

0137 15946

0137 20101

0137 20102

0137 20910

0137 20912

0137 43886

0137 43888

0137 44312

0137 44340

0138 Level II Closed Treatment Fracture

0138 20660

0138 22310

0138 23520

0138 23525

0138 23545

0138 23575

0138 23665

0138 24535

0138 24655

0138 25505

0138 25520

0138 25565

0138 25605

0138 25624

0138 26340

0138 26341

0138 26645

0138 27238

0138 27246

0138 27500

0138 27510

0138 27818

0139 Level III Closed Treatment Fracture

0139 20697

0139 22315

0139 23505

0139 23605

0139 23625

0139 24620

0139 25259

0139 25690

0139 26607
0139 26706

0139 27502

0139 27532

0139 27752

0139 27762

0139 27781

0139 27825

0139 27831

0139 28405

0139 28575

0140 Esophageal Dilation without Endoscopy

0140 43450

0140 43453

0140 43456

0141 Level I Upper GI Procedures

0141 43200

0141 43202

0141 43204

0141 43235

0141 43236

0141 43239

0141 43241

0141 43243

0141 43247

0141 43248

0141 43499

0141 43510

0141 43761

0141 43831

0141 43999

0142 Level I Small Intestine Endoscopy

0142 44360

0142 44361

0142 44363

0142 44376

0142 44377

0142 44380

0142 44382

0142 91110

0143 Lower GI Endoscopy

0143 44385

0143 44386

0143 44388

0143 44389

0143 44390

0143 44391

0143 44392
0143 44393

0143 44394

0143 45355

0143 45378

0143 45379

0143 45380

0143 45381

0143 45382

0143 45383

0143 45384

0143 45385

0143 45386

0143 45391

0143 45392

0146 Level I Sigmoidoscopy and Anoscopy

0146 0227T

0146 45300

0146 45330

0146 45331

0146 45332

0146 45333

0146 45335

0146 46614

0147 Level II Sigmoidoscopy and Anoscopy

0147 45303

0147 45305

0147 45308

0147 45309

0147 45315

0147 45317

0147 45334

0147 45337

0147 45338

0147 45339

0147 45340

0147 45341

0147 45342

0147 46604

0147 46606

0147 46608

0147 46611

0148 Level I Anal/Rectal Procedures

0148 45900

0148 45999

0148 46030

0148 46050

0148 46221
0148 46500

0148 46930

0148 46942

0148 46999

0148 C9725

0149 Level III Anal/Rectal Procedures

0149 45000

0149 45108

0149 45150

0149 45160

0149 45171

0149 45190

0149 45500

0149 46020

0149 46045

0149 46200

0149 46250

0149 46255

0149 46257

0149 46258

0149 46260

0149 46261

0149 46262

0149 46270

0149 46275

0149 46280

0149 46285

0149 46700

0149 46706

0149 46753

0149 46945

0149 46946

0150 Level IV Anal/Rectal Procedures

0150 0184T

0150 0249T

0150 0288T

0150 45172

0150 45505

0150 45541

0150 45560

0150 46288

0150 46707

0150 46750

0150 46760

0150 46761

0150 46762

0150 46947
0151 Endoscopic Retrograde Cholangio-Pancreatography (ERCP)

0151 43260

0151 43261

0151 43262

0151 43263

0151 43264

0151 43265

0151 43267

0151 43271

0151 43272

0151 43273

0152 Level I Percutaneous Abdominal and Biliary Procedures

0152 47490

0152 47510

0152 47511

0152 47552

0152 47553

0152 47554

0152 47555

0152 47630

0152 47999

0153 Peritoneal and Abdominal Procedures

0153 44799

0153 44950

0153 44955

0153 49250

0153 49402

0153 49426

0153 49999

0153 55920

0154 Hernia/Hydrocele Procedures

0154 49491

0154 49492

0154 49495

0154 49496

0154 49500

0154 49501

0154 49505

0154 49507

0154 49520

0154 49521

0154 49525

0154 49540

0154 49550

0154 49553

0154 49555

0154 49557
0154 49560

0154 49561

0154 49565

0154 49566

0154 49568

0154 49570

0154 49572

0154 49580

0154 49582

0154 49585

0154 49587

0154 49590

0154 49600

0154 51500

0154 54530

0154 54550

0154 54640

0154 54650

0154 55040

0154 55041

0154 55535

0154 55540

0155 Level II Anal/Rectal Procedures

0155 45005

0155 45020

0155 45100

0155 45905

0155 45910

0155 45915

0155 45990

0155 46040

0155 46060

0155 46070

0155 46080

0155 46220

0155 46230

0155 46320

0155 46505

0155 46754

0155 46940

0155 49442

0156 Level III Urinary and Anal Procedures

0156 51720

0156 51725

0156 51726

0156 51727

0156 51728
0156 51729

0156 53600

0156 54450

0156 91117

0156 91122

0157 Colorectal Cancer Screening: Barium Enema

0157 G0106

0157 G0120

0158 Colorectal Cancer Screening: Colonoscopy

0158 G0105

0158 G0121

0159 Colorectal Cancer Screening: Flexible Sigmoidoscopy

0159 G0104

0160 Level I Cystourethroscopy and other Genitourinary Procedures

0160 50386

0160 50389

0160 50551

0160 50555

0160 50562

0160 50570

0160 50572

0160 50574

0160 50951

0160 50953

0160 50970

0160 50972

0160 51045

0160 52000

0160 52010

0160 52265

0161 Level II Cystourethroscopy and other Genitourinary Procedures

0161 50384

0161 50392

0161 50576

0161 50580

0161 50974

0161 50976

0161 52001

0161 52260

0161 52270

0161 52281

0161 52285

0161 52287

0161 52310

0161 53605

0161 74475

0161 74480
0161 74485

0162 Level III Cystourethroscopy and other Genitourinary Procedures

0162 50020

0162 50382

0162 50385

0162 50393

0162 50395

0162 50553

0162 50557

0162 50561

0162 50955

0162 50957

0162 50961

0162 50980

0162 51020

0162 51030

0162 51040

0162 51050

0162 51065

0162 51520

0162 51535

0162 51860

0162 51880

0162 52005

0162 52007

0162 52204

0162 52214

0162 52224

0162 52234

0162 52235

0162 52240

0162 52250

0162 52275

0162 52276

0162 52277

0162 52283

0162 52290

0162 52300

0162 52301

0162 52305

0162 52315

0162 52317

0162 52318

0162 52320

0162 52325

0162 52330

0162 52332
0162 52334

0162 52341

0162 52342

0162 52343

0162 52344

0162 52345

0162 52346

0162 52351

0162 52352

0162 52354

0162 52355

0162 52400

0162 52402

0162 52450

0162 52500

0162 52640

0162 52700

0162 55720

0162 55725

0163 Level IV Cystourethroscopy and other Genitourinary Procedures

0163 50575

0163 51060

0163 52282

0163 52327

0163 52353

0163 52601

0163 52630

0163 55875

0164 Level II Urinary and Anal Procedures

0164 46083

0164 50396

0164 51100

0164 51700

0164 51705

0164 51785

0164 51797

0164 53621

0164 53855

0164 54200

0164 54220

0164 54235

0164 54250

0165 Level IV Urinary and Anal Procedures

0165 50727

0165 51102

0165 53620

0165 53860
0165 54231

0165 55860

0166 Level I Urethral Procedures

0166 53000

0166 53010

0166 53020

0166 53025

0166 53040

0166 53060

0166 53080

0166 53085

0166 53200

0166 53215

0166 53235

0166 53250

0166 53260

0166 53265

0166 53270

0166 53275

0166 53460

0166 53502

0166 53510

0166 53665

0166 54000

0166 54001

0168 Level II Urethral Procedures

0168 51715

0168 53210

0168 53220

0168 53230

0168 53240

0168 53400

0168 53405

0168 53410

0168 53420

0168 53425

0168 53430

0168 53431

0168 53442

0168 53446

0168 53449

0168 53450

0168 53500

0168 53505

0168 53515

0168 53520

0169 Lithotripsy
0169 50590

0170 Dialysis

0170 90935

0170 G0257

0174 Level IV Laparoscopy

0174 47370

0174 47371

0174 50542

0177 Level I Echocardiogram with Contrast

0177 C8922

0177 C8923

0177 C8924

0177 C8927

0178 Level II Echocardiogram with Contrast

0178 C8921

0178 C8925

0178 C8926

0178 C8928

0178 C8929

0178 C8930

0181 Level II Male Genital Procedures

0181 37790

0181 54110

0181 54111

0181 54112

0181 54120

0181 54205

0181 54300

0181 54304

0181 54308

0181 54312

0181 54316

0181 54318

0181 54322

0181 54324

0181 54326

0181 54328

0181 54332

0181 54336

0181 54340

0181 54344

0181 54348

0181 54352

0181 54360

0181 54380

0181 54385

0181 54406
0181 54408

0181 54415

0181 54420

0181 54435

0181 54440

0181 54535

0183 Level I Male Genital Procedures

0183 54150

0183 54160

0183 54161

0183 54162

0183 54163

0183 54164

0183 54505

0183 54512

0183 54520

0183 54522

0183 54560

0183 54600

0183 54620

0183 54660

0183 54670

0183 54680

0183 54700

0183 54830

0183 54840

0183 54860

0183 54861

0183 54865

0183 54900

0183 54901

0183 55060

0183 55110

0183 55120

0183 55150

0183 55175

0183 55180

0183 55200

0183 55250

0183 55400

0183 55450

0183 55500

0183 55520

0183 55530

0183 55600

0183 55680

0184 Prostate Biopsy
0184 55700

0184 55705

0184 55706

0188 Level II Female Reproductive Proc

0188 56405

0188 56420

0188 56606

0188 56820

0188 56821

0188 57150

0188 57160

0188 57180

0188 57452

0188 57511

0188 58100

0188 58301

0188 59020

0188 59025

0188 59070

0188 59200

0189 Level III Female Reproductive Proc

0189 55870

0189 56605

0189 57156

0189 57420

0189 57421

0189 57454

0189 57455

0189 57456

0189 58321

0189 58322

0189 58323

0189 58970

0189 58974

0189 58976

0189 59000

0189 59012

0189 59015

0189 59030

0189 59072

0189 59074

0189 59076

0189 59866

0190 Level I Hysteroscopy

0190 58555

0190 58558

0190 58559
0190 58562

0190 58579

0191 Level I Female Reproductive Proc

0191 57170

0191 58999

0191 59897

0191 59899

0191 99170

0191 Q0091

0192 Level IV Female Reproductive Proc

0192 57020

0192 57100

0192 57155

0192 57500

0192 57505

0192 59001

0193 Level V Female Reproductive Proc

0193 56440

0193 56441

0193 56442

0193 56620

0193 56625

0193 56700

0193 56740

0193 56800

0193 56805

0193 56810

0193 57000

0193 57010

0193 57061

0193 57065

0193 57105

0193 57106

0193 57130

0193 57135

0193 57200

0193 57210

0193 57295

0193 57400

0193 57410

0193 57415

0193 57426

0193 57460

0193 57461

0193 57510

0193 57513

0193 57520
0193 57522

0193 57558

0193 57700

0193 57720

0193 57800

0193 58120

0193 58345

0193 58346

0193 58615

0193 58800

0193 58823

0193 58900

0193 59160

0193 59300

0193 59320

0193 59409

0193 59412

0193 59414

0193 59612

0193 59812

0193 59820

0193 59821

0193 59840

0193 59841

0193 59870

0193 59871

0195 Level VI Female Reproductive Procedures

0195 57107

0195 57109

0195 57120

0195 57230

0195 57240

0195 57250

0195 57260

0195 57267

0195 57268

0195 57287

0195 57289

0195 57291

0195 57292

0195 57300

0195 57320

0195 57330

0195 57335

0195 57530

0195 57550

0195 57555
0195 58145

0195 58260

0195 58262

0195 58263

0195 58270

0195 58350

0195 58353

0195 58600

0195 58770

0195 58805

0195 58820

0195 58920

0195 58925

0195 59100

0202 Level VII Female Reproductive Procedures

0202 51845

0202 57220

0202 57265

0202 57282

0202 57283

0202 57284

0202 57285

0202 57288

0202 57310

0202 57423

0202 57556

0202 58290

0202 58291

0202 58292

0202 58294

0202 58356

0202 58565

0203 Level IV Nerve Injections

0203 61791

0203 62263

0203 62264

0203 62281

0203 62282

0203 62319

0203 62355

0203 63746

0203 64600

0203 64620

0203 64635

0203 64680

0203 64681

0204 Level I Nerve Injections
0204 0214T

0204 0215T

0204 0217T

0204 0218T

0204 20526

0204 20527

0204 20550

0204 20551

0204 20552

0204 20553

0204 20600

0204 20605

0204 20610

0204 20612

0204 64400

0204 64402

0204 64408

0204 64410

0204 64455

0204 64491

0204 64492

0204 64494

0204 64495

0204 64505

0204 64508

0204 64566

0204 64611

0204 64612

0204 64615

0204 64632

0204 64634

0204 64650

0204 64653

0204 64999

0206 Level II Nerve Injections

0206 0229T

0206 0231T

0206 62270

0206 62272

0206 64405

0206 64412

0206 64413

0206 64415

0206 64417

0206 64418

0206 64420

0206 64425
0206 64435

0206 64447

0206 64450

0206 64480

0206 64484

0206 64613

0206 64614

0207 Level III Nerve Injections

0207 0213T

0207 0216T

0207 0228T

0207 0230T

0207 61000

0207 61001

0207 61020

0207 61026

0207 61050

0207 61055

0207 62194

0207 62268

0207 62273

0207 62280

0207 62292

0207 62294

0207 62310

0207 62311

0207 62318

0207 64416

0207 64421

0207 64430

0207 64445

0207 64446

0207 64448

0207 64449

0207 64479

0207 64483

0207 64490

0207 64493

0207 64510

0207 64517

0207 64520

0207 64530

0207 64630

0207 64633

0207 64636

0207 64640

0207 G0260
0208 Laminotomies and Laminectomies

0208 0274T

0208 0275T

0208 22100

0208 22101

0208 22102

0208 22103

0208 22222

0208 22551

0208 22554

0208 22612

0208 22614

0208 22856

0208 62351

0208 63001

0208 63003

0208 63005

0208 63011

0208 63012

0208 63015

0208 63016

0208 63017

0208 63020

0208 63030

0208 63035

0208 63040

0208 63042

0208 63045

0208 63046

0208 63047

0208 63048

0208 63055

0208 63056

0208 63057

0208 63064

0208 63066

0208 63075

0208 63076

0209 Level II Extended EEG, Sleep, and Cardiovascular Studies

0209 95782

0209 95783

0209 95805

0209 95807

0209 95808

0209 95810

0209 95811

0209 95950
0209 95951

0209 95953

0209 95956

0209 G0302

0209 G0303

0213 Level I Extended EEG, Sleep, and Cardiovascular Studies

0213 93229

0213 95800

0213 95801

0213 95806

0213 95812

0213 95813

0213 95816

0213 95819

0213 95822

0213 95827

0213 95958

0213 G0304

0213 G0305

0213 G0398

0213 G0399

0213 G0400

0215 Level I Nerve and Muscle Services

0215 0199T

0215 0278T

0215 95869

0215 95870

0215 95887

0215 95905

0215 95907

0215 95908

0215 95909

0215 95910

0215 95933

0215 95943

0215 95999

0216 Level III Nerve and Muscle Services

0216 90867

0216 90868

0216 90869

0216 92584

0216 92585

0216 95824

0216 95925

0216 95926

0216 95927

0216 95930
0216 95938

0216 95961

0216 95962

0216 96000

0216 96001

0218 Level II Nerve and Muscle Services

0218 0272T

0218 0273T

0218 0285T

0218 0310T

0218 92586

0218 95803

0218 95857

0218 95860

0218 95861

0218 95863

0218 95864

0218 95865

0218 95866

0218 95867

0218 95868

0218 95872

0218 95875

0218 95885

0218 95886

0218 95911

0218 95912

0218 95913

0218 95921

0218 95922

0218 95923

0218 95924

0218 95928

0218 95929

0218 95937

0218 95939

0218 95954

0218 95970

0218 95973

0218 95975

0218 95981

0218 96002

0218 96003

0220 Level I Nerve Procedures

0220 27325

0220 27326

0220 28035
0220 28055

0220 61790

0220 63600

0220 63610

0220 63615

0220 64605

0220 64610

0220 64702

0220 64704

0220 64708

0220 64712

0220 64713

0220 64714

0220 64716

0220 64718

0220 64719

0220 64721

0220 64722

0220 64726

0220 64727

0220 64732

0220 64734

0220 64736

0220 64738

0220 64740

0220 64742

0220 64744

0220 64746

0220 64761

0220 64763

0220 64771

0220 64772

0220 64774

0220 64776

0220 64778

0220 64782

0220 64783

0220 64784

0220 64787

0220 64788

0220 64790

0220 64795

0220 64802

0220 64804

0220 64820

0221 Level II Nerve Procedures

0221 0269T
0221 61720

0221 61770

0221 62287

0221 62365

0221 64570

0221 64766

0221 64786

0221 64792

0221 64831

0221 64832

0221 64834

0221 64835

0221 64836

0221 64837

0221 64840

0221 64856

0221 64857

0221 64858

0221 64859

0221 64861

0221 64862

0221 64864

0221 64865

0221 64870

0221 64872

0221 64874

0221 64876

0221 64885

0221 64886

0221 64890

0221 64891

0221 64892

0221 64893

0221 64895

0221 64896

0221 64897

0221 64898

0221 64901

0221 64902

0221 64905

0221 64907

0221 64910

0221 64911

0224 Implantation of Catheter/Reservoir/Shunt

0224 61215

0224 62230

0224 62350
0224 62360

0224 63741

0224 63744

0227 Implantation of Drug Infusion Device

0227 62361

0227 62362

0229 Level II Endovascular Revascularization of the Lower Extremity

0229 37183

0229 37205

0229 37206

0229 37207

0229 37208

0229 37210

0229 37221

0229 37225

0229 37226

0229 37229

0229 37230

0229 37233

0230 Level I Eye Tests & Treatments

0230 0181T

0230 0207T

0230 68200

0230 92020

0230 92025

0230 92060

0230 92065

0230 92081

0230 92082

0230 92132

0230 92133

0230 92134

0230 92140

0230 92225

0230 92226

0230 92250

0230 92260

0230 92265

0230 92270

0230 92283

0230 92284

0230 92285

0230 92312

0230 92317

0230 92326

0230 92354

0230 92355
0230 92358

0230 92499

0230 G0118

0231 Level III Eye Tests & Treatments

0231 65450

0231 67500

0231 67938

0231 68840

0231 92235

0231 92240

0231 92275

0232 Level I Anterior Segment Eye Procedures

0232 0124T

0232 65900

0232 66500

0232 66999

0232 76510

0233 Level III Anterior Segment Eye Procedures

0233 65235

0233 65400

0233 65410

0233 65420

0233 65436

0233 65772

0233 65775

0233 65778

0233 65779

0233 65865

0233 65880

0233 66020

0233 66030

0233 66250

0233 66700

0233 66710

0233 66720

0233 66840

0233 67880

0233 68130

0234 Level IV Anterior Segment Eye Procedures

0234 0099T

0234 0123T

0234 0308T

0234 65272

0234 65275

0234 65426

0234 65810

0234 65815
0234 65820

0234 65850

0234 65870

0234 65875

0234 65920

0234 66130

0234 66150

0234 66160

0234 66165

0234 66170

0234 66172

0234 66600

0234 66630

0234 66635

0234 66680

0234 66682

0234 66711

0234 66740

0234 66825

0234 68330

0234 68360

0234 68362

0234 68371

0235 Level I Posterior Segment Eye Procedures

0235 65260

0235 67141

0235 67208

0235 67220

0235 67221

0235 67225

0235 67299

0235 G0186

0237 Level II Posterior Segment Eye Procedures

0237 0186T

0237 0190T

0237 65265

0237 65280

0237 67005

0237 67030

0237 67101

0237 67110

0237 67115

0237 67120

0237 67218

0237 67227

0237 67255

0238 Level I Repair and Plastic Eye Procedures
0238 67028

0238 67345

0238 67505

0238 67515

0238 67599

0238 67700

0238 67800

0238 67805

0238 67810

0238 67825

0238 67999

0238 68020

0238 68399

0238 68400

0238 68440

0238 68530

0238 68705

0238 68760

0238 68761

0238 68810

0238 68899

0239 Level II Repair and Plastic Eye Procedures

0239 65435

0239 67710

0239 67801

0239 67830

0239 67840

0239 67850

0239 67875

0239 68100

0239 68135

0240 Level III Repair and Plastic Eye Procedures

0240 65175

0240 65270

0240 65600

0240 67250

0240 67400

0240 67412

0240 67415

0240 67715

0240 67808

0240 67835

0240 67882

0240 67901

0240 67903

0240 67904

0240 67906
0240 67908

0240 67909

0240 67911

0240 67912

0240 67914

0240 67915

0240 67916

0240 67917

0240 67921

0240 67922

0240 67923

0240 67924

0240 67930

0240 67935

0240 67950

0240 67961

0240 67966

0240 67971

0240 67974

0240 67975

0240 68115

0240 68326

0240 68340

0240 68420

0240 68510

0240 68525

0240 68540

0240 68700

0240 68811

0240 68815

0240 68816

0241 Level IV Repair and Plastic Eye Procedures

0241 65125

0241 65130

0241 65135

0241 65150

0241 67405

0241 67413

0241 67560

0241 67900

0241 67902

0241 67973

0241 68320

0241 68325

0241 68328

0241 68335

0241 68500
0241 68505

0241 68520

0241 68550

0241 68720

0241 68745

0241 68750

0241 68770

0242 Level V Repair and Plastic Eye Procedures

0242 65091

0242 65093

0242 65101

0242 65103

0242 65105

0242 65110

0242 65112

0242 65114

0242 65140

0242 65155

0242 67414

0242 67420

0242 67430

0242 67440

0242 67445

0242 67450

0242 67550

0242 67570

0243 Strabismus/Muscle Procedures

0243 65290

0243 67311

0243 67312

0243 67314

0243 67316

0243 67318

0243 67320

0243 67331

0243 67332

0243 67334

0243 67335

0243 67340

0243 67343

0243 67399

0244 Corneal and Amniotic Membrane Transplant

0244 65710

0244 65730

0244 65750

0244 65755

0244 65756
0244 65780

0244 65781

0244 65782

0246 Cataract Procedures with IOL Insert

0246 66982

0246 66983

0246 66984

0246 66985

0246 66986

0247 Laser Eye Procedures

0247 65855

0247 65860

0247 66761

0247 66762

0247 66770

0247 66821

0247 67031

0247 67105

0247 67145

0247 67210

0247 67228

0247 67229

0249 Cataract Procedures without IOL Insert

0249 66850

0249 66852

0249 66920

0249 66930

0250 Level I ENT Procedures

0250 21089

0250 21299

0250 21310

0250 21480

0250 21499

0250 21899

0250 30901

0250 30903

0250 30905

0250 30906

0250 30999

0250 31299

0250 31599

0250 40799

0250 40899

0250 41250

0250 41599

0250 41899

0250 42299
0250 42699

0250 42960

0250 42970

0250 42999

0250 69399

0250 69799

0250 69949

0250 69979

0251 Level II ENT Procedures

0251 21450

0251 30000

0251 30020

0251 30560

0251 31000

0251 40490

0251 40806

0251 40808

0251 40818

0251 40830

0251 41005

0251 41009

0251 41015

0251 41251

0251 42000

0251 42180

0251 42280

0251 42310

0251 42320

0251 42660

0251 42700

0251 69100

0251 69400

0251 69401

0251 69420

0251 92502

0252 Level III ENT Procedures

0252 20100

0252 20500

0252 21085

0252 21110

0252 21295

0252 21400

0252 21401

0252 21497

0252 30100

0252 30110

0252 30200
0252 30210

0252 31002

0252 31603

0252 31605

0252 31615

0252 40650

0252 40652

0252 40654

0252 40801

0252 40831

0252 41000

0252 41010

0252 41018

0252 41100

0252 41115

0252 41252

0252 41821

0252 42100

0252 42300

0252 43020

0252 60000

0252 69222

0252 69433

0252 C9727

0253 Level IV ENT Procedures

0253 21235

0253 21282

0253 21315

0253 21320

0253 21337

0253 21451

0253 21452

0253 21495

0253 30117

0253 30220

0253 30310

0253 30801

0253 30802

0253 40500

0253 40520

0253 40810

0253 40812

0253 40819

0253 40820

0253 41008

0253 41017

0253 41105
0253 41110

0253 41112

0253 41113

0253 41500

0253 41510

0253 41806

0253 41822

0253 41825

0253 42104

0253 42106

0253 42140

0253 42160

0253 42281

0253 42330

0253 42340

0253 42600

0253 42650

0253 42720

0253 42800

0253 42802

0253 42804

0253 42972

0253 69105

0253 69405

0253 69421

0253 69424

0253 69436

0253 69540

0253 69801

0254 Level V ENT Procedures

0254 21026

0254 21029

0254 21030

0254 21031

0254 21032

0254 21040

0254 21044

0254 21073

0254 21076

0254 21121

0254 21122

0254 21123

0254 21125

0254 21137

0254 21195

0254 21198

0254 21230
0254 21296

0254 21325

0254 21330

0254 21335

0254 21339

0254 21345

0254 21356

0254 21440

0254 21445

0254 21485

0254 21685

0254 30115

0254 30118

0254 30120

0254 30124

0254 30130

0254 30140

0254 30320

0254 30400

0254 30430

0254 30520

0254 30630

0254 30930

0254 31020

0254 31040

0254 31200

0254 31201

0254 31205

0254 31300

0254 31600

0254 31601

0254 31611

0254 31613

0254 31785

0254 31820

0254 31825

0254 31830

0254 40510

0254 40525

0254 40530

0254 40805

0254 40814

0254 40816

0254 40840

0254 40843

0254 41006

0254 41007
0254 41016

0254 41019

0254 41114

0254 41116

0254 41120

0254 41512

0254 41520

0254 41530

0254 41805

0254 41820

0254 41826

0254 41827

0254 41828

0254 41830

0254 41850

0254 41872

0254 41874

0254 42120

0254 42182

0254 42225

0254 42235

0254 42260

0254 42305

0254 42335

0254 42405

0254 42408

0254 42409

0254 42500

0254 42508

0254 42806

0254 42808

0254 42810

0254 42820

0254 42821

0254 42826

0254 42831

0254 42835

0254 42836

0254 42870

0254 42900

0254 42955

0254 42962

0254 43030

0254 43420

0254 60502

0254 62000

0254 69120
0254 69150

0254 69300

0254 69610

0254 69620

0254 69666

0254 69667

0254 69676

0254 69700

0255 Level II Anterior Segment Eye Procedures

0255 65286

0255 65800

0255 66505

0255 66625

0255 66820

0255 66830

0255 66940

0256 Level VI ENT Procedures

0256 21010

0256 21025

0256 21034

0256 21046

0256 21047

0256 21048

0256 21049

0256 21050

0256 21060

0256 21070

0256 21077

0256 21079

0256 21080

0256 21081

0256 21082

0256 21083

0256 21084

0256 21086

0256 21087

0256 21088

0256 21100

0256 21120

0256 21127

0256 21138

0256 21139

0256 21150

0256 21172

0256 21175

0256 21181

0256 21193
0256 21199

0256 21206

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0256 21249

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0256 21270

0256 21275

0256 21280

0256 21338

0256 21340

0256 21346

0256 21355

0256 21360

0256 21365

0256 21385

0256 21386

0256 21387

0256 21390

0256 21395

0256 21406

0256 21407

0256 21408

0256 21421

0256 21453

0256 21454

0256 21461

0256 21462

0256 21465

0256 21470

0256 21490

0256 30125

0256 30150

0256 30160
0256 30410

0256 30420

0256 30435

0256 30450

0256 30460

0256 30462

0256 30465

0256 30540

0256 30545

0256 30580

0256 30600

0256 30620

0256 31030

0256 31032

0256 31050

0256 31051

0256 31070

0256 31075

0256 31080

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0256 31084

0256 31085

0256 31086

0256 31087

0256 31090

0256 31320

0256 31400

0256 31420

0256 31580

0256 31582

0256 31588

0256 31590

0256 31595

0256 31610

0256 31612

0256 31614

0256 31750

0256 31755

0256 40527

0256 40700

0256 40701

0256 40702

0256 40720

0256 40761

0256 40842

0256 40844

0256 40845
0256 41823

0256 41870

0256 42107

0256 42145

0256 42200

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0256 42210

0256 42215

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0256 42227

0256 42410

0256 42415

0256 42420

0256 42425

0256 42440

0256 42450

0256 42505

0256 42507

0256 42509

0256 42510

0256 42665

0256 42725

0256 42815

0256 42825

0256 42830

0256 42842

0256 42844

0256 42860

0256 42890

0256 42892

0256 42950

0256 43130

0256 60252

0256 60260

0256 60271

0256 60500

0256 60520

0256 61330

0256 61334

0256 69140

0256 69310

0256 69320

0256 69440

0256 69450

0256 69501

0256 69502
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0256 69511

0256 69530

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0256 69820

0256 69840

0256 69905

0256 69910

0256 69915

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0256 69970

0259 Level VII ENT Procedures

0259 69930

0260 Level I Plain Film Except Teeth

0260 70030

0260 70100
0260 70130

0260 70140

0260 70160

0260 70190

0260 70210

0260 70240

0260 70250

0260 70328

0260 70330

0260 70350

0260 70360

0260 70380

0260 71010

0260 71015

0260 71020

0260 71021

0260 71022

0260 71035

0260 71100

0260 71120

0260 71130

0260 72020

0260 72040

0260 72069

0260 72070

0260 72074

0260 72080

0260 72100

0260 72170

0260 72190

0260 72200

0260 72202

0260 72220

0260 73000

0260 73010

0260 73020

0260 73030

0260 73050

0260 73060

0260 73070

0260 73080

0260 73090

0260 73092

0260 73100

0260 73110

0260 73120

0260 73130
0260 73140

0260 73500

0260 73510

0260 73540

0260 73550

0260 73560

0260 73562

0260 73565

0260 73590

0260 73592

0260 73600

0260 73610

0260 73620

0260 73630

0260 73650

0260 73660

0260 74000

0260 74010

0260 74020

0260 76010

0260 76499

0260 77071

0260 77072

0260 77077

0260 77082

0261 Level II Plain Film Except Teeth Including Bone Density Measurement

0261 70110

0261 70120

0261 70134

0261 70150

0261 70200

0261 70220

0261 70260

0261 71030

0261 71101

0261 71110

0261 71111

0261 72010

0261 72050

0261 72052

0261 72072

0261 72090

0261 72110

0261 72114

0261 72120

0261 73520

0261 73564
0261 74022

0261 74710

0261 75809

0261 76100

0261 77073

0261 77074

0261 77075

0261 77076

0261 G0130

0262 Plain Film of Teeth

0262 70300

0262 70310

0262 70320

0262 70355

0263 Level I Miscellaneous Radiology Procedures

0263 70170

0263 70373

0263 70390

0263 74190

0263 74305

0263 74470

0263 74740

0263 76080

0263 76101

0263 76102

0263 77053

0263 77054

0265 Level I Diagnostic and Screening Ultrasound

0265 76506

0265 76516

0265 76529

0265 76604

0265 76645

0265 76802

0265 76812

0265 76813

0265 76814

0265 76815

0265 76816

0265 76817

0265 76820

0265 76821

0265 76827

0265 76828

0265 76857

0265 76882

0265 76885
0265 76886

0265 76970

0265 76999

0265 93888

0266 Level II Diagnostic and Screening Ultrasound

0266 76511

0266 76512

0266 76513

0266 76519

0266 76536

0266 76700

0266 76705

0266 76770

0266 76775

0266 76776

0266 76800

0266 76801

0266 76805

0266 76810

0266 76818

0266 76819

0266 76830

0266 76856

0266 76870

0266 76872

0266 76881

0266 93890

0266 93892

0266 93893

0266 93926

0266 93931

0266 93971

0266 93979

0266 93990

0266 G0389

0267 Level III Diagnostic and Screening Ultrasound

0267 36002

0267 75945

0267 76811

0267 76831

0267 76873

0267 76975

0267 93880

0267 93882

0267 93886

0267 93925

0267 93930
0267 93970

0267 93975

0267 93976

0267 93978

0267 93980

0267 93981

0267 G0365

0269 Level II Echocardiogram Without Contrast

0269 93304

0269 93306

0269 93307

0269 93313

0269 93315

0269 93350

0270 Level III Echocardiogram Without Contrast

0270 93303

0270 93312

0270 93316

0270 93318

0270 93351

0272 Fluoroscopy

0272 43752

0272 43756

0272 43757

0272 70370

0272 70371

0272 71023

0272 71034

0272 76000

0272 76120

0272 76496

0274 Myelography

0274 70010

0274 70015

0274 72240

0274 72255

0274 72265

0274 72270

0275 Arthrography

0275 70332

0275 73040

0275 73085

0275 73115

0275 73525

0275 73580

0275 73615

0276 Level I Digestive Radiology
0276 74210

0276 74220

0276 74230

0276 74250

0276 74260

0276 74290

0276 74291

0277 Level II Digestive Radiology

0277 49465

0277 74240

0277 74241

0277 74245

0277 74246

0277 74247

0277 74249

0277 74251

0277 74270

0277 74280

0277 74283

0278 Diagnostic Urography

0278 74400

0278 74410

0278 74415

0278 74420

0278 74425

0278 74430

0278 74440

0278 74445

0278 74450

0278 74455

0278 74775

0279 Level II Angiography and Venography

0279 36221

0279 36222

0279 36223

0279 36225

0279 36251

0279 36252

0279 36253

0279 36254

0279 75600

0279 75605

0279 75625

0279 75630

0279 75658

0279 75705

0279 75710
0279 75716

0279 75726

0279 75731

0279 75733

0279 75736

0279 75741

0279 75743

0279 75810

0279 75825

0279 75831

0279 75833

0279 75840

0279 75842

0279 75885

0279 75889

0279 75891

0279 75893

0280 Level III Angiography and Venography

0280 36224

0280 36226

0282 Miscellaneous Computed Axial Tomography

0282 76380

0282 76497

0283 Computed Tomography with Contrast

0283 70460

0283 70481

0283 70487

0283 70491

0283 71260

0283 72126

0283 72129

0283 72132

0283 72193

0283 73201

0283 73701

0283 74160

0283 74262

0284 Magnetic Resonance Imaging and Magnetic Resonance Angiography with Contrast

0284 70542

0284 70545

0284 70548

0284 70552

0284 70558

0284 71551

0284 72142

0284 72147

0284 72149
0284 72196

0284 73219

0284 73222

0284 73719

0284 73722

0284 74182

0284 C8900

0284 C8903

0284 C8906

0284 C8909

0284 C8912

0284 C8918

0284 C8931

0284 C8934

0288 Bone Density:Axial Skeleton

0288 77078

0288 77080

0293 Level VI Anterior Segment Eye Procedures

0293 65770

0299 Hyperthermia and Radiation Treatment Procedures

0299 77470

0299 77600

0299 77605

0299 77610

0299 77615

0299 77620

0300 Level I Radiation Therapy

0300 77401

0300 77402

0300 77403

0300 77404

0300 77406

0300 77407

0300 77789

0301 Level II Radiation Therapy

0301 77408

0301 77409

0301 77411

0301 77412

0301 77413

0301 77414

0301 77416

0301 77422

0301 77423

0301 77750

0303 Treatment Device Construction

0303 77332
0303 77333

0303 77334

0304 Level I Therapeutic Radiation Treatment Preparation

0304 77280

0304 77299

0304 77300

0304 77305

0304 77310

0304 77326

0304 77331

0304 77336

0304 77370

0304 77399

0305 Level II Therapeutic Radiation Treatment Preparation

0305 77285

0305 77290

0305 77315

0305 77321

0305 77327

0305 77328

0305 77338

0308 Positron Emission Tomography (PET) imaging

0308 78459

0308 78491

0308 78492

0308 78608

0308 78811

0308 78812

0308 78813

0308 78814

0308 78815

0308 78816

0310 Level III Therapeutic Radiation Treatment Preparation

0310 32553

0310 49411

0310 55876

0310 77295

0310 77301

0310 C9728

0312 Radioelement Applications

0312 77761

0312 77762

0312 77763

0312 77776

0312 77777

0312 77799

0313 Brachytherapy
0313 0182T

0313 77785

0313 77786

0313 77787

0315 Level II Implantation of Neurostimulator Generator

0315 61886

0317 Level II Miscellaneous Radiology Procedures

0317 74320

0317 75801

0317 75803

0317 75805

0317 75807

0317 76098

0317 78071

0317 78072

0318 Implantation of Neurostimulator Pulse Generator and Electrode

0318 0283T

0318 64568

0319 Level III Endovascular Revascularization of the Lower Extremity

0319 37227

0319 37231

0320 Electroconvulsive Therapy

0320 90870

0322 Brief Individual Psychotherapy

0322 90832

0322 90899

0323 Extended Individual Psychotherapy

0323 90791

0323 90792

0323 90834

0323 90837

0323 90839

0323 90845

0323 90865

0323 90880

0324 Family Psychotherapy

0324 90846

0324 90847

0325 Group Psychotherapy

0325 90849

0325 90853

0330 Dental Procedures

0330 D0150

0330 D0240

0330 D0250

0330 D0260

0330 D0270
0330 D0272

0330 D0274

0330 D0277

0330 D0460

0330 D1510

0330 D1515

0330 D1520

0330 D1525

0330 D1550

0330 D2999

0330 D3460

0330 D3999

0330 D4260

0330 D4263

0330 D4264

0330 D4268

0330 D4270

0330 D4273

0330 D4355

0330 D4381

0330 D5911

0330 D5912

0330 D5983

0330 D5984

0330 D5985

0330 D5987

0330 D6920

0330 D7111

0330 D7140

0330 D7210

0330 D7220

0330 D7230

0330 D7240

0330 D7241

0330 D7250

0330 D7260

0330 D7261

0330 D7291

0330 D7940

0330 D9630

0330 D9930

0330 D9940

0330 D9950

0330 D9951

0330 D9952

0331 Combined Abdomen and Pelvis CT without Contrast

0331 74176
0332 Computed Tomography without Contrast

0332 70450

0332 70480

0332 70486

0332 70490

0332 71250

0332 72125

0332 72128

0332 72131

0332 72192

0332 73200

0332 73700

0332 74150

0332 74261

0333 Computed Tomography without Contrast followed by Contrast

0333 70470

0333 70482

0333 70488

0333 70492

0333 71270

0333 72127

0333 72130

0333 72133

0333 72194

0333 73202

0333 73702

0333 74170

0334 Combined Abdomen and Pelvis CT with Contrast

0334 74174

0334 74177

0334 74178

0336 Magnetic Resonance Imaging and Magnetic Resonance Angiography without Contrast

0336 70336

0336 70540

0336 70544

0336 70547

0336 70551

0336 70554

0336 70555

0336 70557

0336 71550

0336 72141

0336 72146

0336 72148

0336 72195

0336 73218

0336 73221
0336 73718

0336 73721

0336 74181

0336 75557

0336 75559

0336 76498

0336 77084

0336 C8901

0336 C8904

0336 C8907

0336 C8910

0336 C8913

0336 C8919

0336 C8932

0336 C8935

0337 Magnetic Resonance Imaging and Magnetic Resonance Angiography without Contrast f

0337 70543

0337 70546

0337 70549

0337 70553

0337 70559

0337 71552

0337 72156

0337 72157

0337 72158

0337 72197

0337 73220

0337 73223

0337 73720

0337 73723

0337 74183

0337 75561

0337 75563

0337 C8902

0337 C8905

0337 C8908

0337 C8911

0337 C8914

0337 C8920

0337 C8933

0337 C8936

0340 Minor Ancillary Procedures

0340 0126T

0340 0206T

0340 0226T

0340 0232T

0340 11980
0340 11981

0340 11982

0340 11983

0340 15852

0340 15860

0340 19290

0340 19295

0340 20665

0340 20979

0340 30300

0340 40804

0340 42809

0340 43753

0340 43754

0340 46600

0340 51701

0340 51702

0340 51736

0340 51798

0340 69200

0340 69210

0340 75571

0340 76977

0340 94644

0340 94645

0340 94780

0340 94781

0340 G0293

0340 G0294

0340 G0364

0340 G0455

0341 Skin Tests

0341 0106T

0341 0107T

0341 0108T

0341 0109T

0341 0110T

0341 86485

0341 86486

0341 86490

0341 86510

0341 86580

0342 Level I Pathology

0342 80502

0342 86077

0342 86152

0342 86153
0342 88160

0342 88161

0342 88177

0342 88185

0342 88199

0342 88299

0342 88300

0342 88311

0342 88321

0342 88329

0342 88332

0342 88334

0342 88363

0342 88375

0342 88399

0342 89049

0342 89240

0342 89398

0343 Level III Pathology

0343 85097

0343 88173

0343 88182

0343 88305

0343 88323

0343 88342

0343 88346

0343 88355

0343 88356

0343 88358

0343 88360

0343 88361

0343 88365

0343 88367

0343 89230

0343 89260

0343 89261

0343 89280

0344 Level IV Pathology

0344 0058T

0344 0059T

0344 88307

0344 88325

0344 88362

0344 88368

0344 89250

0344 89251

0344 89253
0344 89254

0344 89255

0344 89258

0344 89264

0344 89268

0344 89272

0344 89281

0344 89290

0344 89291

0344 89335

0344 89342

0344 89343

0344 89344

0344 89346

0344 89352

0344 89353

0344 89354

0344 89356

0345 Level I Transfusion Laboratory Procedures

0345 86850

0345 86891

0345 86902

0345 86904

0345 86905

0345 86906

0345 86920

0345 86921

0345 86923

0345 86927

0345 86945

0345 86950

0345 86960

0345 86970

0345 86971

0345 86972

0345 86976

0345 86985

0345 86999

0346 Level II Transfusion Laboratory Procedures

0346 86860

0346 86922

0346 86965

0346 86978

0347 Level III Transfusion Laboratory Procedures

0347 86870

0347 86890

0347 86930
0347 86931

0347 86932

0347 86975

0347 86977

0350 Administration of flu and PPV vaccine

0350 G0008

0350 G0009

0360 Level I Alimentary Tests

0360 91037

0360 91040

0360 91065

0360 91132

0360 91133

0360 91299

0360 95079

0361 Level II Alimentary Tests

0361 0240T

0361 0241T

0361 91010

0361 91013

0361 91020

0361 91022

0361 91030

0361 91034

0361 91035

0361 91038

0361 91112

0361 95076

0363 Level I Otorhinolaryngologic Function Tests

0363 92512

0363 92516

0363 92541

0363 92542

0363 92544

0363 92545

0363 92587

0363 92588

0364 Level I Audiometry

0364 92550

0364 92552

0364 92555

0364 92556

0364 92562

0364 92563

0364 92564

0364 92565

0364 92567
0364 92568

0364 92571

0364 92575

0364 92576

0364 92583

0364 92596

0364 92700

0365 Level II Audiometry

0365 0212T

0365 92553

0365 92557

0365 92561

0365 92570

0365 92579

0365 92582

0365 92620

0365 92625

0365 92640

0366 Level III Audiometry

0366 92572

0366 92577

0366 92601

0366 92602

0366 92603

0366 92604

0366 92626

0367 Level I Pulmonary Test

0367 94011

0367 94012

0367 94150

0367 94200

0367 94250

0367 94375

0367 94400

0367 94690

0367 94726

0367 94727

0367 94728

0367 94750

0367 94799

0367 95012

0368 Level II Pulmonary Tests

0368 93740

0368 94010

0368 94014

0368 94015

0368 94450
0368 94452

0368 94453

0368 94620

0368 94729

0368 95071

0369 Level III Pulmonary Tests

0369 0244T

0369 94013

0369 94070

0369 94621

0369 94680

0369 94681

0369 94770

0369 94772

0369 95070

0370 Multiple Allergy Tests

0370 95056

0370 95060

0370 95180

0373 Level I Neuropsychological Testing

0373 96102

0373 96103

0373 96111

0373 96120

0377 Level II Cardiac Imaging

0377 78451

0377 78452

0377 78453

0377 78454

0378 Level II Pulmonary Imaging

0378 78582

0378 78598

0381 Single Allergy Tests

0381 95004

0381 95017

0381 95018

0381 95024

0381 95027

0381 95028

0381 95044

0381 95052

0381 95065

0381 95199

0382 Level II Neuropsychological Testing

0382 96101

0382 96116

0382 96118
0382 96119

0383 Cardiac Computed Tomographic Imaging

0383 75572

0383 75573

0383 75574

0384 GI Procedures with Stents

0384 43219

0384 43256

0384 43268

0384 43269

0384 44370

0384 44379

0384 44383

0384 44397

0384 45327

0384 45345

0384 45387

0385 Level I Prosthetic Urological Procedures

0385 53440

0385 53444

0385 54400

0386 Level II Prosthetic Urological Procedures

0386 53445

0386 53447

0386 54401

0386 54405

0386 54410

0386 54416

0387 Level II Hysteroscopy

0387 58560

0387 58561

0387 58563

0388 Discography

0388 72285

0388 72295

0389 Level I Non-imaging Nuclear Medicine

0389 78012

0389 78730

0389 78999

0390 Level I Endocrine Imaging

0390 78013

0390 78099

0391 Level II Endocrine Imaging

0391 78014

0391 78070

0392 Level II Non-imaging Nuclear Medicine

0392 38792
0392 78190

0392 78191

0392 78270

0392 78271

0392 78272

0392 78725

0392 78808

0393 Hematologic Processing & Studies

0393 38210

0393 38211

0393 38212

0393 38213

0393 38214

0393 38215

0393 78110

0393 78111

0393 78120

0393 78121

0393 78122

0393 78130

0393 78135

0393 78140

0394 Hepatobiliary Imaging

0394 78201

0394 78202

0394 78205

0394 78206

0394 78215

0394 78216

0394 78226

0394 78227

0395 GI Tract Imaging

0395 78230

0395 78231

0395 78232

0395 78258

0395 78261

0395 78262

0395 78264

0395 78278

0395 78282

0395 78290

0395 78291

0395 78299

0396 Bone Imaging

0396 78300

0396 78305
0396 78306

0396 78315

0396 78320

0396 78399

0397 Vascular Imaging

0397 75898

0397 78445

0397 78456

0397 78457

0397 78458

0397 C9733

0398 Level I Cardiac Imaging

0398 78414

0398 78428

0398 78466

0398 78468

0398 78469

0398 78472

0398 78473

0398 78481

0398 78483

0398 78494

0398 78499

0400 Hematopoietic Imaging

0400 78102

0400 78103

0400 78104

0400 78185

0400 78195

0400 78199

0401 Level I Pulmonary Imaging

0401 78579

0401 78580

0401 78597

0401 78599

0402 Level II Nervous System Imaging

0402 78601

0402 78606

0402 78607

0402 78630

0402 78635

0402 78647

0402 78650

0403 Level I Nervous System Imaging

0403 78600

0403 78605

0403 78610
0403 78645

0403 78660

0403 78699

0404 Renal and Genitourinary Studies

0404 78700

0404 78701

0404 78707

0404 78708

0404 78709

0404 78710

0404 78740

0404 78761

0404 78799

0406 Level I Tumor/Infection Imaging

0406 78015

0406 78016

0406 78018

0406 78800

0407 Level I Radionuclide Therapy

0407 79005

0407 79101

0407 79300

0407 79445

0407 79999

0408 Level III Tumor/Infection Imaging

0408 78075

0408 78804

0409 Red Blood Cell Tests

0409 86880

0409 86885

0409 86886

0409 86900

0409 86901

0412 Level III Radiation Therapy

0412 0073T

0412 77418

0413 Level II Radionuclide Therapy

0413 79200

0413 79403

0413 79440

0414 Level II Tumor/Infection Imaging

0414 78801

0414 78802

0414 78803

0414 78805

0414 78806

0414 78807
0415 Level II Endoscopy Lower Airway

0415 31626

0415 31629

0415 31630

0415 31631

0415 31634

0415 31636

0415 31638

0415 31640

0415 31641

0415 31647

0415 31648

0415 31651

0415 31660

0415 31661

0419 Level II Upper GI Procedures

0419 43201

0419 43205

0419 43206

0419 43215

0419 43217

0419 43220

0419 43226

0419 43227

0419 43231

0419 43232

0419 43237

0419 43238

0419 43240

0419 43242

0419 43244

0419 43245

0419 43246

0419 43249

0419 43250

0419 43251

0419 43252

0419 43255

0419 43258

0419 43259

0419 43458

0419 44100

0419 49440

0419 49441

0419 49446

0419 91111

0422 Level III Upper GI Procedures
0422 43216

0422 43228

0422 43257

0422 43830

0422 43870

0422 C9724

0423 Level II Percutaneous Abdominal and Biliary Procedures

0423 32998

0423 47382

0423 47556

0423 50592

0423 50593

0424 Level II Small Intestine Endoscopy

0424 44364

0424 44365

0424 44366

0424 44369

0424 44372

0424 44373

0424 44378

0425 Level II Arthroplasty or Implantation with Prosthesis

0425 23470

0425 23473

0425 24361

0425 24363

0425 24366

0425 24370

0425 24371

0425 25441

0425 25442

0425 25446

0425 27446

0425 69714

0425 69715

0425 69717

0425 69718

0426 Level II Strapping and Cast Application

0426 29010

0426 29015

0426 29035

0426 29044

0426 29046

0426 29055

0426 29065

0426 29075

0426 29305

0426 29325
0426 29345

0426 29355

0426 29358

0426 29365

0426 29405

0426 29425

0426 29435

0426 29445

0426 29710

0427 Level II Tube or Catheter Changes or Repositioning

0427 47525

0427 47530

0427 49423

0427 49435

0427 49436

0427 50387

0427 50398

0427 50688

0427 62225

0428 Level III Sigmoidoscopy and Anoscopy

0428 45307

0428 45320

0428 45321

0428 46610

0428 46612

0428 46615

0429 Level V Cystourethroscopy and other Genitourinary Procedures

0429 50080

0429 50081

0429 52647

0429 52648

0429 52649

0429 53850

0429 53852

0432 Level II Health and Behavior Services

0432 96150

0432 96151

0432 96152

0432 96154

0432 G0396

0432 G0397

0432 G0437

0432 G0442

0432 G0443

0432 G0444

0432 G0445

0432 G0446
0432 G0447

0432 G0451

0433 Level II Pathology

0433 80500

0433 86078

0433 86079

0433 88104

0433 88106

0433 88108

0433 88112

0433 88125

0433 88162

0433 88172

0433 88184

0433 88187

0433 88188

0433 88189

0433 88302

0433 88304

0433 88312

0433 88313

0433 88314

0433 88319

0433 88331

0433 88333

0433 88347

0433 89220

0433 89257

0433 89259

0434 Cardiac Defect Repair

0434 93580

0434 93581

0436 Level I Drug Administration

0436 90472

0436 90473

0436 90474

0436 95115

0436 95117

0436 95145

0436 95165

0436 96361

0436 96366

0436 96379

0436 96549

0436 G0010

0437 Level II Drug Administration

0437 90471
0437 95144

0437 95148

0437 95149

0437 95170

0437 96367

0437 96370

0437 96371

0437 96372

0437 96373

0437 96374

0437 96375

0437 96401

0437 96402

0437 96405

0437 96415

0438 Level III Drug Administration

0438 95146

0438 95147

0438 96360

0438 96411

0438 96417

0438 96420

0438 96423

0438 96542

0439 Level IV Drug Administration

0439 95990

0439 95991

0439 96365

0439 96369

0439 96406

0439 96409

0439 96440

0439 96446

0439 96521

0439 96522

0440 Level V Drug Administration

0440 96413

0440 96416

0440 96422

0440 96425

0440 96450

0440 C8957

0442 Dosimetric Drug Administration

0442 G3001

0604 Level 1 Hospital Clinic Visits

0604 99201

0604 99211
0604 G0101

0604 G0245

0604 G0246

0605 Level 2 Hospital Clinic Visits

0605 92012

0605 92014

0605 99202

0605 99212

0605 99213

0605 99460

0605 99463

0605 99495

0606 Level 3 Hospital Clinic Visits

0606 92002

0606 92004

0606 95250

0606 99203

0606 99214

0606 99496

0606 G0402

0606 M0064

0607 Level 4 Hospital Clinic Visits

0607 99204

0607 99215

0607 G0248

0607 G0249

0608 Level 5 Hospital Clinic Visits

0608 90945

0608 99205

0608 G0175

0608 G0379

0609 Level 1 Type A Emergency Visits

0609 99281

0613 Level 2 Type A Emergency Visits

0613 99282

0614 Level 3 Type A Emergency Visits

0614 99283

0615 Level 4 Type A Emergency Visits

0615 99284

0616 Level 5 Type A Emergency Visits

0616 99285

0617 Critical Care

0617 99291

0618 Trauma Response with Critical Care

0618 G0390

0621 Level I Vascular Access Procedures

0621 36555
0621 36556

0621 36568

0621 36569

0621 36576

0621 36580

0621 36584

0621 36590

0621 36596

0621 36597

0621 37211

0621 37212

0622 Level II Vascular Access Procedures

0622 36557

0622 36558

0622 36570

0622 36571

0622 36578

0622 36581

0622 36585

0622 36595

0622 37213

0622 37214

0623 Level III Vascular Access Procedures

0623 36260

0623 36560

0623 36561

0623 36563

0623 36565

0623 36566

0623 36582

0623 36583

0623 36640

0623 37192

0623 37193

0623 37197

0623 37200

0624 Phlebotomy and Minor Vascular Access Device Procedures

0624 36591

0624 36592

0624 37799

0624 96523

0624 99195

0626 Level 1 Type B Emergency Visits

0626 G0380

0627 Level 2 Type B Emergency Visits

0627 G0381

0628 Level 3 Type B Emergency Visits
0628 G0382

0629 Level 4 Type B Emergency Visits

0629 G0383

0630 Level 5 Type B Emergency Visits

0630 G0384

0648 Level IV Breast Surgery

0648 19296

0648 19297

0648 19298

0648 19325

0648 19342

0648 19357

0651 Complex Interstitial Radiation Source Application

0651 77778

0652 Insertion of Intraperitoneal and Pleural Catheters

0652 32550

0652 49418

0652 49421

0653 Vascular Reconstruction/Fistula Repair with Device

0653 35011

0653 35261

0653 35266

0653 35286

0653 36870

0654 Level II Insertion/Replacement of Permanent Pacemaker

0654 33213

0654 33221

0654 33228

0654 33229

0655 Insertion/Replacement/Conversion of a Permanent Dual Chamber Pacemaker or Pacing

0655 33208

0655 33214

0655 33224

0655 33225

0656 Transcatheter Placement of Intracoronary Drug-Eluting Stents

0656 C9600

0656 C9601

0656 C9602

0656 C9603

0656 C9604

0656 C9605

0656 C9606

0656 C9607

0656 C9608

0659 Hyperbaric Oxygen

0659 C1300

0660 Level II Otorhinolaryngologic Function Tests
0660 92520

0660 92540

0660 92543

0660 92546

0660 92548

0661 Level V Pathology

0661 88120

0661 88121

0661 88309

0661 88348

0661 88349

0661 G0416

0661 G0417

0661 G0418

0661 G0419

0662 CT Angiography

0662 70496

0662 70498

0662 71275

0662 72191

0662 73206

0662 73706

0662 74175

0662 75635

0664 Level I Proton Beam Radiation Therapy

0664 77520

0664 77522

0665 Bone Density:AppendicularSkeleton

0665 77081

0667 Level II Proton Beam Radiation Therapy

0667 77523

0667 77525

0668 Level I Angiography and Venography

0668 36147

0668 75746

0668 75756

0668 75791

0668 75820

0668 75822

0668 75827

0668 75860

0668 75870

0668 75872

0668 75880

0668 75887

0672 Level III Posterior Segment Eye Procedures

0672 0100T
0672 65285

0672 66220

0672 67010

0672 67015

0672 67025

0672 67027

0672 67036

0672 67039

0672 67040

0672 67041

0672 67042

0672 67043

0672 67107

0672 67108

0672 67112

0672 67113

0672 67121

0673 Level V Anterior Segment Eye Procedures

0673 0191T

0673 0192T

0673 0253T

0673 65930

0673 66155

0673 66174

0673 66175

0673 66180

0673 66185

0673 66225

0673 66605

0674 Prostate Cryoablation

0674 55873

0676 Thrombolysis and Other Device Revisions

0676 36593

0676 36598

0676 36860

0676 37195

0676 43760

0676 92977

0678 External Counterpulsation

0678 G0166

0679 Level II Resuscitation and Cardioversion

0679 92960

0679 92961

0680 Insertion of Patient Activated Event Recorders

0680 33282

0683 Level II Photochemotherapy

0683 96913
0685 Level III Needle Biopsy/Aspiration Except Bone Marrow

0685 32400

0685 32405

0685 47000

0685 48102

0685 49180

0685 50200

0685 50390

0685 62269

0687 Revision/Removal of Neurostimulator Electrodes

0687 0267T

0687 0270T

0687 0284T

0687 0313T

0687 61880

0687 63661

0687 63662

0687 64585

0688 Revision/Removal of Neurostimulator Pulse Generator Receiver

0688 0271T

0688 0314T

0688 0315T

0688 61888

0688 63688

0688 64595

0690 Level I Electronic Analysis of Devices

0690 0224T

0690 0225T

0690 0305T

0690 0306T

0690 0317T

0690 0327T

0690 0328T

0690 93279

0690 93280

0690 93281

0690 93282

0690 93283

0690 93284

0690 93285

0690 93288

0690 93289

0690 93291

0690 93292

0690 93293

0690 93296

0690 93299
0690 93724

0690 93745

0691 Level III Electronic Analysis of Devices

0691 62252

0691 62367

0691 62368

0691 62369

0691 62370

0692 Level II Electronic Analysis of Devices

0692 93271

0692 93750

0692 95971

0692 95972

0692 95974

0692 95978

0692 95979

0692 95982

0694 Mohs Surgery

0694 17311

0694 17312

0694 17313

0694 17314

0694 17315

0697 Level I Echocardiogram Without Contrast

0697 76825

0697 76826

0697 93308

0698 Level II Eye Tests & Treatments

0698 0198T

0698 65205

0698 65210

0698 65220

0698 65222

0698 65430

0698 67820

0698 68040

0698 68801

0698 92083

0698 92136

0698 92230

0698 92286

0698 92287

0698 92311

0698 92313

0698 92315

0698 92316

0698 92325
0698 92352

0698 92353

0698 92371

0698 G0117

0699 Level IV Eye Tests & Treatments

0699 67346

0699 68110

0699 92018

0699 92019

0701 Sr89 strontium

0701 A9600

0726 Dexrazoxane HCl injection

0726 J1190

0728 Filgrastim 300 mcg injection

0728 J1440

0731 Sargramostim injection

0731 J2820

0735 Ampho b cholesteryl sulfate

0735 J0288

0736 Amphotericin b liposome inj

0736 J0289

0738 Rasburicase

0738 J2783

0747 Chlorothiazide sodium inj

0747 J1205

0751 Mechlorethamine hcl inj

0751 J9230

0752 Dactinomycin injection

0752 J9120

0759 Naltrexone, depot form

0759 J2315

0800 Leuprolide acetate

0800 J1950

0802 Etoposide oral

0802 J8560

0807 Aldesleukin injection

0807 J9015

0809 Bcg live intravesical vac

0809 J9031

0810 Goserelin acetate implant

0810 J9202

0812 Carmustine injection

0812 J9050

0814 Asparaginase injection

0814 J9020

0820 Daunorubicin injection

0820 J9150
0821 Daunorubicin citrate inj

0821 J9151

0823 Docetaxel injection

0823 J9171

0825 Nelarabine injection

0825 J9261

0827 Floxuridine injection

0827 J9200

0828 Gemcitabine hcl injection

0828 J9201

0831 Ifosfamide injection

0831 J9208

0832 Idarubicin hcl injection

0832 J9211

0835 Cosyntropin injection NOS

0835 J0833

0836 Interferon alfa-2b inj

0836 J9214

0838 Interferon gamma 1-b inj

0838 J9216

0840 Inj melphalan hydrochl

0840 J9245

0842 Fludarabine phosphate inj

0842 J9185

0843 Pegaspargase injection

0843 J9266

0844 Pentostatin injection

0844 J9268

0849 Rituximab injection

0849 J9310

0850 Streptozocin injection

0850 J9320

0851 Thiotepa injection

0851 J9340

0856 Porfimer sodium injection

0856 J9600

0858 Inj cladribine

0858 J9065

0861 Leuprolide acetate injeciton

0861 J9218

0864 Mitoxantrone hydrochl

0864 J9293

0868 Oral aprepitant

0868 J8501

0873 Hyalgan/supartz inj per dose

0873 J7321

0874 Synvisc or synvisc-one
0874 J7325

0875 Euflexxa inj per dose

0875 J7323

0877 Orthovisc inj per dose

0877 J7324

0884 Rho d immune globulin inj

0884 J2790

0887 Azathioprine parenteral

0887 J7501

0890 Lymphocyte immune globulin

0890 J7504

0900 Alglucerase injection

0900 J0205

0901 Alpha 1 proteinase inhibitor

0901 J0256

0902 Injection,onabotulinumtoxinA

0902 J0585

0903 Cytomegalovirus imm IV /vial

0903 J0850

0910 Interferon beta-1b / .25 MG

0910 J1830

0913 Ganciclovir long act implant

0913 J7310

0917 Adenosine injection

0917 J0152

0925 Factor viii

0925 J7190

0927 Factor viii recombinant

0927 J7192

0928 Factor ix complex

0928 J7194

0929 Anti-inhibitor

0929 J7198

0931 Factor IX non-recombinant

0931 J7193

0932 Factor IX recombinant

0932 J7195

0933 Gamma globulin > 10 CC inj

0933 J1560

0934 Capecitabine, oral

0934 J8521

0943 Octagam injection

0943 J1568

0944 Gammagard liquid injection

0944 J1569

0945 Rhophylac injection

0945 J2791
0946 Hepagam b im injection

0946 J1571

0947 Flebogamma injection

0947 J1572

0948 Gamunex, Gamunex-C, Gammaked

0948 J1561

0949 Frozen plasma, pooled, sd

0949 P9023

0950 Whole blood for transfusion

0950 P9010

0951 Reclast injection

0951 J3488

0952 Cryoprecipitate each unit

0952 P9012

0954 RBC leukocytes reduced

0954 P9016

0955 Plasma, frz between 8-24hour

0955 P9059

0956 Plasma protein fract,5%,50ml

0956 P9043

0957 Platelets, each unit

0957 P9019

0958 Plaelet rich plasma unit

0958 P9020

0959 Red blood cells unit

0959 P9021

0960 Washed red blood cells unit

0960 P9022

0961 Albumin (human),5%, 50ml

0961 P9041

0963 Albumin (human), 5%, 250 ml

0963 P9045

0964 Albumin (human), 25%, 20 ml

0964 P9046

0965 Albumin (human), 25%, 50ml

0965 P9047

0966 Plasmaprotein fract,5%,250ml

0966 P9048

0967 Blood split unit

0967 P9011

0968 Platelets leukoreduced irrad

0968 P9033

0969 RBC leukoreduced irradiated

0969 P9040

1009 Cryoprecipitatereducedplasma

1009 P9044

1010 Blood, l/r, cmv-neg
1010 P9051

1011 Platelets, hla-m, l/r, unit

1011 P9052

1013 Platelets leukocytes reduced

1013 P9031

1015 Injection glatiramer acetate

1015 J1595

1016 Blood, l/r, froz/degly/wash

1016 P9054

1017 Plt, aph/pher, l/r, cmv-neg

1017 P9055

1018 Blood, l/r, irradiated

1018 P9056

1019 Plate pheres leukoredu irrad

1019 P9037

1020 Plt, pher, l/r cmv-neg, irr

1020 P9053

1021 RBC, frz/deg/wsh, l/r, irrad

1021 P9057

1022 RBC, l/r, cmv-neg, irrad

1022 P9058

1023 Pralidoxime chloride inj

1023 J2730

1052 Injection, voriconazole

1052 J3465

1064 I131 iodide cap, rx

1064 A9517

1083 Adalimumab injection

1083 J0135

1084 Denileukin diftitox inj

1084 J9160

1086 Temozolomide

1086 J8700

1138 Hepagam b intravenous, inj

1138 J1573

1139 Protein c concentrate

1139 J2724

1142 Supprelin LA implant

1142 J9226

1150 I131 iodide sol, rx

1150 A9530

1166 Cytarabine liposome inj

1166 J9098

1167 Inj, epirubicin hcl

1167 J9178

1168 Inj, temsirolimus

1168 J9330
1178 Busulfan injection

1178 J0594

1203 Verteporfin injection

1203 J3396

1207 Octreotide injection, depot

1207 J2353

1213 Antihemophilic viii/vwf comp

1213 J7186

1214 Inj IVIG privigen 500 mg

1214 J1459

1221 Dimethyl sulfoxide 50%

1221 J1212

1232 Mitomycin 5 MG inj

1232 J9280

1235 Valrubicin injection

1235 J9357

1236 Levoleucovorin injection

1236 J0641

1237 Inj iron dextran

1237 J1750

1238 Topotecan oral

1238 J8705

1239 Rotavirus vacc 2 dose oral

1239 90681

1240 Apligraf skin sub

1240 Q4101

1241 Oasis wound matrix skin sub

1241 Q4102

1242 Oasis burn matrix skin sub

1242 Q4103

1243 Integra BMWD skin sub

1243 Q4104

1244 Integra DRT

1244 Q4105

1245 Dermagraft skin sub

1245 Q4106

1246 Graftjacket skin sub

1246 Q4107

1247 Integra matrix skin sub

1247 Q4108

1248 Primatrix skin sub

1248 Q4110

1249 Cymetra allograft

1249 Q4112

1250 Graftjacket express allograf

1250 Q4113

1251 Integra flowable wound matri
1251 Q4114

1252 Gammagraft skin sub

1252 Q4111

1253 Triamcinolone A inj PRS-free

1253 J3300

1263 Antithrombin iii injection

1263 J7197

1268 Xyntha inj

1268 J7185

1270 Alloderm skin sub

1270 Q4116

1272 Acetylcysteine injection

1272 J0132

1274 Edetate calcium disodium inj

1274 J0600

1275 Vivaglobin, inj

1275 J1562

1280 Corticotropin injection

1280 J0800

1281 Bevacizumab injection

1281 C9257

1287 Alloskin skin sub

1287 Q4115

1289 AbobotulinumtoxinA

1289 J0586

1291 Rilonacept injection

1291 J2793

1295 Sm 153 lexidronam

1295 A9604

1296 Degarelix injection

1296 J9155

1297 Ferumoxytol, non-esrd

1297 Q0138

1307 Oral busulfan

1307 J8510

1311 Canakinumab injection

1311 J0638

1312 Hizentra injection

1312 J1559

1327 Imiglucerase injection

1327 J1786

1331 Olanzapine long-acting inj

1331 J2358

1332 Antithrombin recombinant

1332 J7196

1338 Methyl aminolevulinate, top

1338 J7309
1339 Oral fludarabine phosphate

1339 J8562

1340 Collagenase, clost hist inj

1340 J0775

1341 Amobarbital 125 MG inj

1341 J0300

1342 Matristem micromatrix

1342 Q4118

1343 Ganciclovir sodium injection

1343 J1570

1344 Gonadorelin hydroch/ 100 mcg

1344 J1620

1345 Theraskin

1345 Q4121

1347 Oxacillin sodium injeciton

1347 J2700

1349 Anidulafungin injection

1349 J0348

1350 Topotecan injection

1350 J9351

1351 Matristem wound matrix

1351 Q4119

1352 Wilate injection

1352 J7183

1353 Belimumab injection

1353 J0490

1354 Hydroxyprogesterone caproate

1354 J1725

1355 Itraconazole injection

1355 J1835

1357 Inj protirelin per 250 mcg

1357 J2725

1361 Enfuvirtide injection

1361 J1324

1408 Cyclophosphamide 100 MG inj

1408 J9070

1413 Lumizyme injection

1413 J0221

1414 Human fibrinogen conc inj

1414 J7178

1415 Glassia injection

1415 J0257

1416 Factor XIII anti-hem factor

1416 J7180

1417 Gel-one

1417 J7326

1419 Dermacell
1419 Q4122

1420 Aflibercept injection

1420 J0178

1421 Imported Lipodox inj

1421 Q2049

1422 Anthrax vaccine sc or im

1422 90581

1423 Minocycline hydrochloride

1423 J2265

1424 Nabilone oral

1424 J8650

1426 Eribulin mesylate injection

1426 J9179

1427 Alloskin

1427 Q4123

1428 Arthroflex

1428 Q4125

1429 Flexhd or allopatch hd

1429 Q4128

1430 Unite biomatrix

1430 Q4129

1431 Centruroides immune f(ab)

1431 J0716

1432 Arbutamine hcl injection

1432 J0395

1433 Calcitonin salmon injection

1433 J0630

1434 Testosterone enanthate inj

1434 J0900

1435 Injection estrone per 1 MG

1435 J1435

1437 Gatifloxacin injection

1437 J1590

1438 Diazoxide injection

1438 J1730

1439 Aprotonin, 10,000 kiu

1439 J0365

1440 Inj desmopressin acetate

1440 J2597

1441 Intraocular Fomivirsen na

1441 J1452

1442 Non-HEU TC-99M add-on/dose

1442 Q9969

1443 Icatibant injection

1443 J1744

1444 Oral everolimus

1444 J7527
1445 Methylnaltrexone injection

1445 J2212

1446 Visualization adjunct

1446 Q9968

1447 Interferon alfacon-1 inj

1447 J9212

1605 Abciximab injection

1605 J0130

1607 Eptifibatide injection

1607 J1327

1608 Etanercept injection

1608 J1438

1609 Rho(D) immune globulin h, sd

1609 J2792

1612 Daclizumab, parenteral

1612 J7513

1613 Trastuzumab injection

1613 J9355

1630 Hep b ig, im

1630 90371

1631 Baclofen intrathecal trial

1631 J0476

1633 Alefacept

1633 J0215

1643 Y90 ibritumomab, rx

1643 A9543

1645 I131 tositumomab, rx

1645 A9545

1670 Tetanus immune globulin inj

1670 J1670

1675 P32 Na phosphate

1675 A9563

1676 P32 chromic phosphate

1676 A9564

1683 Basiliximab

1683 J0480

1684 Corticorelin ovine triflutal

1684 J0795

1685 Darbepoetin alfa, non-esrd

1685 J0881

1686 Epoetin alfa, non-esrd

1686 J0885

1687 Digoxin immune fab (ovine)

1687 J1162

1688 Ethanolamine oleate

1688 J1430

1689 Fomepizole
1689 J1451

1690 Hemin

1690 J1640

1693 Lepirudin

1693 J1945

1694 Ziconotide injection

1694 J2278

1695 Nesiritide injection

1695 J2325

1696 Palifermin injection

1696 J2425

1697 Pegaptanib sodium injection

1697 J2503

1700 Inj secretin synthetic human

1700 J2850

1701 Treprostinil injection

1701 J3285

1704 Humate-P, inj

1704 J7187

1705 Factor viia

1705 J7189

1709 Azacitidine injection

1709 J9025

1710 Clofarabine injection

1710 J9027

1711 Vantas implant

1711 J9225

1712 Paclitaxel protein bound

1712 J9264

1716 Brachytx, non-str, Gold-198

1716 C1716

1717 Brachytx, non-str, HDR Ir-192

1717 C1717

1719 Brachytx, NS, Non-HDRIr-192

1719 C1719

1738 Oxaliplatin

1738 J9263

1739 Pegademase bovine, 25 iu

1739 J2504

1741 Urofollitropin, 75 iu

1741 J3355

1830 Power bone marrow bx needle

1830 C1830

1840 Telescopic intraocular lens

1840 C1840

1886 Catheter, ablation

1886 C1886
2210 Methyldopate hcl injection

2210 J0210

2616 Brachytx, non-str,Yttrium-90

2616 C2616

2632 Iodine I-125 sodium iodide

2632 A9527

2634 Brachytx, non-str, HA, I-125

2634 C2634

2635 Brachytx, non-str, HA, P-103

2635 C2635

2636 Brachy linear, non-str,P-103

2636 C2636

2638 Brachytx, stranded, I-125

2638 C2638

2639 Brachytx, non-stranded,I-125

2639 C2639

2640 Brachytx, stranded, P-103

2640 C2640

2641 Brachytx, non-stranded,P-103

2641 C2641

2642 Brachytx, stranded, C-131

2642 C2642

2643 Brachytx, non-stranded,C-131

2643 C2643

2698 Brachytx, stranded, NOS

2698 C2698

2699 Brachytx, non-stranded, NOS

2699 C2699

2731 Immune globulin, powder

2731 J1566

2770 Quinupristin/dalfopristin

2770 J2770

3041 Bivalirudin

3041 J0583

3043 Gamma globulin 1 CC inj

3043 J1460

3050 Sermorelin acetate injection

3050 Q0515

7000 Amifostine

7000 J0207

7011 Oprelvekin injection

7011 J2355

7034 Somatropin injection

7034 J2941

7035 Teniposide

7035 Q2017

7036 Urokinase 250,000 IU inj
7036 J3365

7038 Monoclonal antibodies

7038 J7505

7041 Tirofiban HCl

7041 J3246

7042 Capecitabine, oral

7042 J8520

7043 Infliximab injection

7043 J1745

7046 Doxil injection

7046 J9002

7048 Alteplase recombinant

7048 J2997

7049 Filgrastim 480 mcg injection

7049 J1441

7051 Leuprolide acetate implant

7051 J9219

7308 Aminolevulinic acid hcl top

7308 J7308

8000 Cardiac Electrophysiologic Evaluation and Ablation Composite

8000 93653

8000 93654

8000 93656

9001 Linezolid injection

9001 J2020

9002 Tenecteplase injection

9002 J3101

9003 Palivizumab

9003 90378

9004 Gemtuzumab ozogamicin inj

9004 J9300

9005 Reteplase injection

9005 J2993

9006 Tacrolimus injection

9006 J7525

9012 Arsenic trioxide injection

9012 J9017

9018 Inj, rimabotulinumtoxinB

9018 J0587

9019 Caspofungin acetate

9019 J0637

9022 IM inj interferon beta 1-a

9022 Q3025

9023 Rho d immune globulin

9023 J2788

9024 Amphotericin b lipid complex

9024 J0287
9032 Baclofen 10 MG injection

9032 J0475

9033 Cidofovir injection

9033 J0740

9038 Inj estrogen conjugate

9038 J1410

9042 Glucagon hydrochloride

9042 J1610

9044 Ibutilide fumarate injection

9044 J1742

9104 Antithymocyte globuln rabbit

9104 J7511

9108 Thyrotropin injection

9108 J3240

9110 Alemtuzumab injection

9110 J9010

9115 Zoledronic acid

9115 J3487

9119 Injection, pegfilgrastim 6mg

9119 J2505

9120 Injection, Fulvestrant

9120 J9395

9121 Injection, argatroban

9121 C9121

9122 Triptorelin pamoate

9122 J3315

9124 Daptomycin injection

9124 J0878

9125 Risperidone, long acting

9125 J2794

9126 Natalizumab injection

9126 J2323

9133 Rabies ig, im/sc

9133 90375

9134 Rabies ig, heat treated

9134 90376

9135 Varicella-zoster ig, im

9135 90396

9137 Bcg vaccine, percut

9137 90585

9139 Rabies vaccine, im

9139 90675

9140 Rabies vaccine, id

9140 90676

9143 Meningococcal vaccine, sc

9143 90733

9144 Encephalitis vaccine, sc
9144 90735

9145 Meningococcal vaccine, im

9145 90734

9207 Bortezomib injection

9207 J9041

9208 Agalsidase beta injection

9208 J0180

9209 Laronidase injection

9209 J1931

9210 Palonosetron hcl

9210 J2469

9213 Pemetrexed injection

9213 J9305

9214 Bevacizumab injection

9214 J9035

9215 Cetuximab injection

9215 J9055

9217 Leuprolide acetate suspnsion

9217 J9217

9224 Galsulfase injection

9224 J1458

9225 Fluocinolone acetonide implt

9225 J7311

9227 Micafungin sodium injection

9227 J2248

9228 Tigecycline injection

9228 J3243

9229 Ibandronate sodium injection

9229 J1740

9230 Abatacept injection

9230 J0129

9231 Decitabine injection

9231 J0894

9232 Idursulfase injection

9232 J1743

9233 Ranibizumab injection

9233 J2778

9234 Alglucosidase alfa injection

9234 J0220

9235 Panitumumab injection

9235 J9303

9236 Eculizumab injection

9236 J1300

9237 Inj, lanreotide acetate

9237 J1930

9240 Injection, ixabepilone

9240 J9207
9242 Injection, fosaprepitant

9242 J1453

9243 Bendamustine injection

9243 J9033

9244 Regadenoson injection

9244 J2785

9245 Romiplostim injection

9245 J2796

9248 Inj, clevidipine butyrate

9248 C9248

9249 Certolizumab pegol inj

9249 J0718

9250 Artiss fibrin sealant

9250 C9250

9251 C1 esterase inhibitor inj

9251 J0598

9252 Plerixafor injection

9252 J2562

9253 Temozolomide injection

9253 J9328

9255 Paliperidone palmitate inj

9255 J2426

9256 Dexamethasone intra implant

9256 J7312

9258 Telavancin injection

9258 J3095

9259 Pralatrexate injection

9259 J9307

9260 Ofatumumab injection

9260 J9302

9261 Ustekinumab injection

9261 J3357

9263 Ecallantide injection

9263 J1290

9264 Tocilizumab injection

9264 J3262

9265 Romidepsin injection

9265 J9315

9268 Capsaicin 8% patch

9268 J7335

9269 C-1 esterase, berinert

9269 J0597

9270 Gammaplex IVIG

9270 J1557

9271 Velaglucerase alfa

9271 J3385

9272 Inj, denosumab
9272 J0897

9273 Sipuleucel-T auto CD54+

9273 Q2043

9274 Crotalidae Poly Immune Fab

9274 J0840

9276 Cabazitaxel injection

9276 J9043

9278 Incobotulinumtoxin A

9278 J0588

9281 Injection, pegloticase

9281 J2507

9282 Inj, ceftaroline fosamil

9282 J0712

9283 Injection, acetaminophen

9283 J0131

9284 Ipilimumab injection

9284 J9228

9285 Patch, lidocaine/tetracaine

9285 C9285

9286 Belatacept injection

9286 J0485

9287 Brentuximab vedotin inj

9287 J9042

9289 Erwinaze injection

9289 J9019

9290 Inj, bupivacaine liposome

9290 C9290

9292 Injection, pertuzumab

9292 C9292

9293 Injection, glucarpidase

9293 C9293

9294 Inj, taliglucerase alfa

9294 C9294

9295 Injection, carfilzomib

9295 C9295

9296 Injection, ziv-aflibercept

9296 C9296

9300 Omalizumab injection

9300 J2357

9358 SurgiMend, fetal

9358 C9358

9360 SurgiMend, neonatal

9360 C9360

9363 Integra Meshed Bil Wound Mat

9363 C9363

9365 Oasis tri-layer wound matrix

9365 Q4124
9366 Epifix

9366 Q4131

9367 Endoform Dermal Template

9367 C9367

9368 Grafix core

9368 Q4132

9369 Grafix prime

9369 Q4133

9406 Iodine I-123 ioflupane

9406 A9584

9500 Platelets, irradiated

9500 P9032

9501 Platelet pheres leukoreduced

9501 P9035

9502 Platelet pheresis irradiated

9502 P9036

9503 Fr frz plasma donor retested

9503 P9060

9504 RBC deglycerolized

9504 P9039

9505 RBC irradiated

9505 P9038

9506 Granulocytes, pheresis unit

9506 P9050

9507 Platelets, pheresis

9507 P9034

9508 Plasma 1 donor frz w/in 8 hr

9508 P9017
er the 2013 OPPS by APC

Short Descriptor SI

Relative 

Weight

Payment 

Rate

National 

Unadjusted 

Copayment

S 0.5210 $37.15 .

Ultraviolet light therapy

Photochemotherapy with UV-B

Photochemotherapy with UV-A

T 1.7194 $122.62 .

Fna w/o image

Drain breast lesion add-on

Insert needle bone cavity

T 3.7917 $270.40 .

Bone marrow aspiration

Bone marrow biopsy

T 4.8451 $345.52 .

Fna w/image

Drainage of breast lesion

Bx breast percut w/o image

Treatment of bone cyst

Liver surgery procedure

Pancreas surgery procedure

Biopsy of epididymis

Drainage of hydrocele

Biopsy of thyroid

Aspir/inj thyroid cyst

Interdiscal perq aspir dx

T 8.7675 $625.24 .

Bx breast percut w/image

Needle biopsy muscle

Needle biopsy lymph nodes

Biopsy of salivary gland

T 1.7592 $125.45 .

Drainage of skin abscess

Drainage of skin abscess

Drainage of pilonidal cyst

Puncture drainage of lesion

Fluid pressure muscle

Revision of neck muscle

Drainage of finger abscess

Drainage of mouth lesion

Drainage of gum lesion

Drain external ear lesion

Drain outer ear canal lesio
T 10.1746 $725.58

.

Drainage of pilonidal cyst

Drainage of hematoma/fluid

Explore wound extremity

Drainage of arm bursa

Drainage of finger abscess

Drainage of bursa of foot

Drainage lymph node lesion

Drainage of scrotum abscess

I & d vaginal hematoma pp

Drain external ear lesion

T 18.4976 $1,319.12.

Complex drainage wound

Incision of breast lesion

Drain neck/chest lesion

Drain shoulder lesion

Drain shoulder bursa

Drainage of arm lesion

Drain thigh/knee lesion

Drain lower leg lesion

Drainage lymph node lesion

Drainage of bladder abscess

Drain penis lesion

Treatment of penis lesion

I & d vag hematoma non-ob

T 0.3982 $28.40.

Trim nail(s) any number

Drain blood from under nail

Destruct premalg les 2-14

Skin tissue procedure

Dermatological procedure

Trim nail(s)

T 1.0032 $71.54.

Wound ultrasound

Acne surgery

Debride infected skin add-o

Trim skin lesion

Trim skin lesions 2 to 4

Biopsy skin add-on

Removal of skin tags <w/15

Remove skin tags add-on

Shave skin lesion 0.5 cm/<

Shave skin lesion 0.6-1.0 c

Shave skin lesion 1.1-2.0 c

Shave skin lesion 0.5 cm/<

Shave skin lesion 0.6-1.0 c

Shave skin lesion 1.1-2.0 c
Shave skin lesion 0.5 cm/<

Shave skin lesion 0.6-1.0 c

Debride nail 1-5

Debride nail 6 or more

Removal of nail plate

Remove nail plate add-on

Excision of nail fold toe

Inject skin lesions </w 7

Inject skin lesions >7

Abrasion lesion single

Abrasion lesions add-on

Chemical peel face epiderm

Chemical peel nonfacial

Initial treatment of burn(s

Destruct premalg lesion

Destruct b9 lesion 1-14

Cryotherapy of skin

Injection(s) spider veins

Cryosurgery penis lesion(s)

Clean out mastoid cavity

Wound(s) care non-selective

Neg press wound tx </=50 cm

Routine footcare pt w lops

T 1.4998 $106.96.

Trim skin lesions over 4

Biopsy skin lesion

Shave skin lesion >2.0 cm

Shave skin lesion >2.0 cm

Shave skin lesion 1.1-2.0 c

Shave skin lesion >2.0 cm

Chemical peel face dermal

Chemical peel nonfacial

Dress/debrid p-thick burn s

Dress/debrid p-thick burn m

Dress/debrid p-thick burn l

Incision of burn scab initi

Destruct lesion 15 or more

Chemical cautery tissue

Destruction of skin lesions

Destruction of skin lesions

Destruction of skin lesions

Destruction of skin lesions

Destruction of skin lesions

Destruction of skin lesions

Destruction of skin lesions

Destruction of skin lesions

Destruction of skin lesions
Skin peel therapy

Hair removal by electrolysi

Injection(s) spider veins

Injection therapy of vein

Injection therapy of veins

Treatment of rectal prolaps

Cryosurgery anal lesion(s)

Destruction penis lesion(s)

Photodynamic tx skin

Photodynmc tx 30 min add-on

Photodynamic tx addl 15 min

Laser tx skin < 250 sq cm

Laser tx skin 250-500 sq cm

Laser tx skin >500 sq cm

Rmvl devital tis 20 cm/<

Rmvl devital tis addl 20cm/

Neg press wound tx >50 cm

T 2.9399 $209.65.

Remove foreign body

Debride infected skin

Deb subq tissue 20 sq cm/<

Deb musc/fascia 20 sq cm/<

Deb subq tissue add-on

Deb musc/fascia add-on

Dermabrasion suprfl any sit

Remove sutures same surgeon

Remove sutures diff surgeon

Destroy premal lesions 15/>

Destruction of skin lesions

Destruction of skin lesions

Destruction of skin lesions

Destruction of skin lesions

Destruction of skin lesions

Destruction of skin lesions

Destruction of skin lesions

Destruction of skin lesions

Destruction of skin lesions

Destruction of skin lesions

Destruction of skin lesions

Destruction of skin lesions

Destruction anal lesion(s)

Neg pre wound <50 sq cm

Neg pres wound >50 sq cm

T 19.8814 $1,417.80.

Destruction anal lesion(s)

Laser surgery anal lesions

Excision of anal lesion(s)
Destruction anal lesion(s)

Destruction penis lesion(s)

Laser surg penis lesion(s)

Excision of penis lesion(s)

Destruction penis lesion(s)

Destroy vulva lesions sim

Destroy vulva lesion/s comp

T 4.7170 $336.38.

Debride skin at fx site

Debride skin musc at fx sit

Deb skin bone at fx site

Deb bone add-on

Exc tr-ext b9+marg 0.5 cm<

Exc tr-ext b9+marg 0.6-1 cm

Exc tr-ext b9+marg 1.1-2 cm

Exc face-mm b9+marg 0.5 cm/

Exc face-mm b9+marg 0.6-1 c

Exc tr-ext mal+marg 0.6-1 c

Exc tr-ext mal+marg 1.1-2 c

Exc s/n/h/f/g mal+mrg 0.6-1

Exc f/e/e/n/l mal+mrg 0.5cm

Exc f/e/e/n/l mal+mrg 0.6-1

Exc f/e/e/n/l mal+mrg 1.1-2

Removal of nail bed

Biopsy nail unit

Remove contraceptive capsul

Dermabrasion segmental face

Dermabrasion other than fac

Removal of tail bone ulcer

Removal of pressure sore

Removal of foreign body

Removal of arm foreign body

Biopsy of floor of mouth

T 8.1838 $583.61.

Deb bone 20 sq cm/<

Exc tr-ext b9+marg 2.1-3cm/

Exc h-f-nk-sp b9+marg 0.5/<

Exc h-f-nk-sp b9+marg 0.6-1

Exc h-f-nk-sp b9+marg 1.1-2

Exc face-mm b9+marg 1.1-2 c

Exc face-mm b9+marg 2.1-3 c

Exc face-mm b9+marg 3.1-4 c

Exc tr-ext mal+marg 0.5 cm/

Exc tr-ext mal+marg 2.1-3 c

Exc tr-ext mal+marg 3.1-4 c

Exc h-f-nk-sp mal+marg 0.5/

Exc s/n/h/f/g mal+mrg 1.1-2
Exc s/n/h/f/g mal+mrg 2.1-3

Exc f/e/e/n/l mal+mrg 2.1-3

I&d abscess subfascial

Bone biopsy trocar/needle

Exc face les sc <2 cm

Exc face les sbq 2 cm/<

Exc face tum deep < 2 cm

Exc face tum deep 2 cm/>

Biopsy soft tissue of back

Biopsy shoulder tissues

Remove shoulder foreign bod

Biopsy forearm soft tissues

Biopsy of soft tissues

Biopsy of soft tissues

Remove hip foreign body

Biopsy thigh soft tissues

Biopsy lower leg soft tissu

Removal of foot foreign bod

Removal of foot foreign bod

Remove pat-active ht record

Repair blood vessel lesion

T 15.7299 $1,121.75.

Remove foreign body

Exc tr-ext b9+marg 3.1-4 cm

Exc tr-ext b9+marg >4.0 cm

Exc h-f-nk-sp b9+marg 2.1-3

Exc h-f-nk-sp b9+marg 3.1-4

Exc tr-ext mal+marg >4 cm

Exc s/n/h/f/g mal+mrg 3.1-4

Exc f/e/e/n/l mal+mrg 3.1-4

Excise excessive skin arm

Excise excess skin arm/hand

Excise excess skin fat pad

Excise excess skin & tissue

Removal of chest wall lesio

Muscle biopsy

Deep muscle biopsy

Bone biopsy trocar/needle

Removal of support implant

Resect face tum < 2 cm

Biopsy of neck/chest

Exc neck les sc < 3 cm

Resect neck tum < 5 cm

Exc back les sc < 3 cm

Exc back tum deep < 5 cm

Resect back tum < 5 cm

Exc abd les sc < 3 cm
Resect abd tum < 5 cm

Removal of calcium deposits

Exc shoulder les sc < 3 cm

Exc shoulder tum deep < 5 c

Resect shoulder tum < 5 cm

Biopsy arm/elbow soft tissu

Biopsy arm/elbow soft tissu

Exc arm/elbow les sc < 3 cm

Ex arm/elbow tum deep < 5 c

Resect arm/elbow tum < 5 cm

Removal of arm foreign body

Exc forearm les sc < 3 cm

Exc forearm tum deep < 3 cm

Resect forearm/wrist tum<3c

Exc hand les sc < 1.5 cm

Exc hand tum deep < 1.5 cm

Exc hand tum ra < 3 cm

Removal of implant from han

Exc hip/pelvis les sc < 3 c

Exc hip/pelv tum deep < 5 c

Resect hip/pelv tum < 5 cm

Exc thigh/knee tum deep <5c

Resect thigh/knee tum < 5 c

Resect leg/ankle tum < 5 cm

Exc leg/ankle tum < 3 cm

Exc leg/ankle tum deep <5 c

Exc foot/toe tum sc < 1.5 c

Exc foot/toe tum deep <1.5c

Resect foot/toe tumor < 3 c

Removal of foot foreign bod

Temporal artery procedure

Biopsy of penis

Remove external ear partial

Remove ear canal lesion(s)

T 23.2928 $1,661.08 $350.78

Exc h-f-nk-sp b9+marg >4 cm

Exc face-mm b9+marg >4 cm

Removal sweat gland lesion

Removal sweat gland lesion

Removal sweat gland lesion

Removal sweat gland lesion

Removal sweat gland lesion

Removal sweat gland lesion

Exc s/n/h/f/g mal+mrg >4 cm

Exc f/e/e/n/l mal+mrg >4 cm

Remove nail bed/finger tip

Remove pilonidal cyst simpl
Remove pilonidal cyst exten

Remove pilonidal cyst compl

Remove tissue expander(s)

Dermabrasion total face

Exc skin abd

Excise excessive skin thigh

Excise excessive skin leg

Excise excessive skin hip

Excise excessive skin buttc

Exc skin abd add-on

Remove sacrum pressure sore

Remove sacrum pressure sore

Remove hip pressure sore

Remove hip pressure sore

Remove thigh pressure sore

Remove thigh pressure sore

Bone biopsy excisional

Bone biopsy excisional

Removal of foreign body

Removal of support implant

Resect face tum 2 cm/>

Exc neck les sc 3 cm/>

Exc neck tum deep 5 cm/>

Exc neck tum deep < 5 cm

Resect neck tum 5 cm/>

Biopsy soft tissue of back

Exc back les sc 3 cm/>

Exc back tum deep 5 cm/>

Resect back tum 5 cm/>

Exc abdl tum deep < 5 cm

Exc abdl tum deep 5 cm/>

Exc abd les sc 3 cm/>

Resect abd tum 5 cm/>

Biopsy shoulder tissues

Exc shoulder les sc 3 cm/>

Exc shoulder tum deep 5 cm/

Resect shoulder tum 5 cm/>

Remove shoulder foreign bod

Exc arm/elbow les sc 3 cm/>

Ex arm/elbow tum deep 5 cm/

Resect arm/elbow tum 5 cm/>

Biopsy forearm soft tissues

Exc forearm les sc 3 cm/>

Exc forearm tum deep 3 cm/>

Resect forarm/wrist tum 3cm

Exc hand les sc 1.5 cm/>

Exc hand tum deep 1.5 cm/>
Exc hand tum ra 3 cm/>

Exc hip pelvis les sc 3 cm/

Exc hip/pelv tum deep 5 cm/

Resect hip/pelv tum 5 cm/>

Biopsy thigh soft tissues

Exc thigh/knee les sc < 3 c

Exc thigh/knee les sc 3 cm/

Exc thigh/knee tum dep 5cm/

Resect thigh/knee tum 5 cm/

Removal of foreign body

Biopsy lower leg soft tissu

Resect leg/ankle tum 5 cm/>

Exc leg/ankle les sc 3 cm/>

Exc leg/ankle tum dep 5 cm/

Exc foot/toe tum sc 1.5 cm/

Exc foot/toe tum dep 1.5cm/

Resect foot/toe tumor 3 cm/

Biopsy of penis

Autotransplant parathyroid

Clear outer ear canal

T 26.1210 $1,862.77.

Biopsy of breast open

Nipple exploration

Excise breast duct fistula

Removal of breast lesion

Excision breast lesion

Excision addl breast lesion

Removal of breast tissue

Partical mastectomy

Breast reconstruction

Breast surgery procedure

Rxt breast appl place/remov

T 34.4816 $2,458.99 $581.52

Cryosurg ablate fa each

Mast simple complete

Mast subq

Suspension of breast

Removal of breast implant

Removal of implant material

Correct inverted nipple(s)

Breast reconstruction

Surgery of breast capsule

Removal of breast capsule

Design custom breast implan

T 45.3768 $3,235.96 $747.07

P-mastectomy w/ln removal

Mast mod rad
Reduction of large breast

Enlarge breast

Immediate breast prosthesis

Revise breast reconstructio

S 0.3135 $22.36.

Intervene hlth/behave group

Behav chng smoking 3-10 min

Behav chng smoking > 10 min

Tobacco-use counsel 3-10 mi $0.00 X 0.3286 $23.43 .

Audiometry air only

Audiometry air & bone

Speech audiometry threshold

Speech audiom thresh & reco

Vein access cutdown < 1 yr

Vein access cutdown > 1 yr

Withdrawal of arterial bloo

Echo exam of eye thickness

Remote dx retinal imaging

Remote retinal imaging mgmt

Rhythm ecg tracing

ECG/signal-averaged

Icm device eval

Noninvas vasc dx study proc

T 15.6849 $1,118.54 $227.35

Bx breast percut w/device

Drain app abscess percut

Percut drain liver lesion

Drain pancreatic pseudocyst

Drain abdominal abscess

Drain percut abdom abscess

Drain percut retroper absc

Renal abscess percut drain

Biopsy of testis

S 229.8982 $16,394.73.

Implt/rpl crtd sns dev gen

Replc vagus nerve pls gen

Insrt/redo neurostim 1 arra

Insrt/redo spine n generato

Insrt/redo pn/gastr stimul

stimulator ElectrodesS 61.6966 $4,399.77.

Periph field stimul trial

Implant neuroelectrodes

Revise spine eltrd perq ara

Revise spine eltrd plate

Implant neuroelectrodes

Implant neuroelectrodes
Implant neuroelectrodes

Implant neuroelectrodes

Revise/repl vagus n eltrd

T 29.6106 $2,111.62.

Jaw arthroscopy/surgery

Jaw arthroscopy/surgery

Shoulder arthroscopy dx

Shoulder arthroscopy/surger

Shoulder arthroscopy/surger

Shoulder arthroscopy/surger

Elbow arthroscopy

Elbow arthroscopy/surgery

Elbow arthroscopy/surgery

Elbow arthroscopy/surgery

Elbow arthroscopy/surgery

Elbow arthroscopy/surgery

Wrist arthroscopy

Wrist arthroscopy/surgery

Wrist arthroscopy/surgery

Wrist arthroscopy/surgery

Wrist arthroscopy/surgery

Wrist endoscopy/surgery

Knee arthroscopy/surgery

Knee arthroscopy dx

Knee arthroscopy/drainage

Knee arthroscopy/surgery

Knee arthroscopy/surgery

Knee arthroscopy/surgery

Knee arthroscopy/surgery

Knee arthroscopy/surgery

Knee arthroscopy/surgery

Knee arthroscopy/surgery

Knee arthroscopy/surgery

Knee arthroscopy/surgery

Knee arthroscopy/surgery

Knee arthroscopy/surgery

Knee arthroscopy/surgery

Knee arthroscopy/surgery

Ankle arthroscopy/surgery

Ankle arthroscopy/surgery

Ankle arthroscopy/surgery

Ankle arthroscopy/surgery

Mcp joint arthroscopy dx

Mcp joint arthroscopy surg

Mcp joint arthroscopy surg

Subtalar arthro w/fb rmvl

Subtalar arthro w/exc
Subtalar arthro w/deb

Arthroscopy of joint

T 54.4111 $3,880.22 $782.23

Shoulder arthroscopy/surger

Shoulder arthroscopy/surger

Shoulder arthroscopy/surger

Shoulder arthroscopy/surger

Shoulder arthroscopy/surger

Shoulder arthroscopy/surger

Shoulder arthroscopy/surger

Arthroscop rotator cuff rep

Arthroscopy biceps tenodesi

Wrist arthroscopy/surgery

Knee arthroscopy/surgery

Tibial arthroscopy/surgery

Tibial arthroscopy/surgery

Hip arthroscopy dx

Hip arthro w/fb removal

Hip arthr0 w/debridement

Hip arthr0 w/synovectomy

Autgrft implnt knee w/scope

Allgrft implnt knee w/scope

Meniscal trnspl knee w/scpe

Knee arthroscopy/surgery

Ankle arthroscopy/surgery

Ankle arthroscopy/surgery

Subtalar arthro w/fusion

Hip arthro w/femoroplasty

Hip arthro acetabuloplasty

Hip arthro w/labral repair

T 14.5706 $1,039.07 $257.70

Manipulation of spine

Treat shoulder dislocation

Fixation of shoulder

Manipulate elbow w/anesth

Treat elbow dislocation

Treat finger dislocation

Treat pelvic ring fracture

Treat hip dislocation

Treat hip dislocation

Treat hip dislocation

Manipulation of hip joint

Treat knee dislocation

Treat kneecap dislocation

Fixation of knee joint

Treat ankle dislocation

Fixation of ankle joint
Treat toe dislocation

Treat toe dislocation

T 40.2172 $2,868.01.

Reconstruct elbow joint

Reconstruct head of radius

Revise wrist joint

Repair wrist joints

Remove wrist joint implant

Revise knuckle joint

Revise finger joint

Revise kneecap

Revision of knee joint

Revision of knee joint

Revision of knee joint

Revision of knee joint

Revision of ankle joint

T 62.4025 $4,450.11.

Reconstruct elbow joint

Reconstruct wrist joint

Reconstruct wrist joint

Reconstruct wrist joint

Revise knuckle with implant

Revise/implant finger joint

Revise kneecap with implant

T 21.8096 $1,555.31.

Application of pelvis brace

Remove bone fixation device

Musculoskeletal surgery

Drain chest lesion

Revision of neck muscle

Revision of neck muscle

Abdomen surgery procedure

Drain shoulder bone lesion

Biopsy of shoulder joint

Removal of bone lesion

Drain arm/elbow bone lesion

Biopsy elbow joint lining

Removal of elbow bursa

Remove humerus lesion

Remove elbow lesion

Revision of arm tendon

Amputation follow-up surger

Incision of tendon sheath

Incise flexor carpi radiali

Drainage of forearm lesion

Drainage of forearm bursa

Treat forearm bone lesion
Incision of wrist capsule

Biopsy of wrist joint

Excise tendon forearm/wrist

Remove wrist tendon lesion

Remove wrist tendon lesion

Reremove wrist tendon lesio

Remove wrist/forearm lesion

Remove wrist/forearm lesion

Remove forearm foreign body

Release wrist/forearm tendo

Amputation follow-up surger

Amputation follow-up surger

Amputate hand at wrist

Amputation follow-up surger

Drainage of pelvis lesion

Drainage of pelvis bursa

Incision of hip tendon

Biopsy of sacroiliac joint

Biopsy of hip joint

Buttock fasciotomy w/dbrdmt

Removal of ischial bursa

Remove femur lesion/bursa

Remove hip bone les super

Remove hip foreign body

Incise thigh tendon & fasci

Incision of thigh tendon

Removal of kneecap bursa

Removal of knee cyst

Remove knee cyst

Incision of thigh tendon

Incision of thigh tendons

Decompression of thigh/knee

Amputation follow-up surger

Decompression of lower leg

Decompression of lower leg

Incision of achilles tendon

Treat lower leg bone lesion

Removal of tendon lesion

Repair leg fascia defect

Repair of leg tendon each

Repair of leg tendon each

Repair lower leg tendons

Removal of ankle implant

Amputation follow-up surger

Treatment of foot infection

Treatment of foot infection

T 32.3471 $2,306.77.
Extracorp shockwv tx hi enr

Extracorp shockwv tx anesth

Perq sacral augmt unilat in

Perq sacral augmt bilat inj

Plmt post facet implt lumb

Plmt post facet implt addl

Open bone biopsy

Open bone biopsy

Place ndl musc/tis for rt

Insert and remove bone pin

Application of thigh brace

Apply bone fixation device

Apply bone fixation device

Adjust bone fixation device

Comp multiplane ext fixatio

Removal of bone for graft

Removal of bone for graft

Removal of tendon for graft

Partial removal of rib

Partial removal of rib

Percut vertebroplasty thor

Percut vertebroplasty lumb

Percut vertebroplasty addl

Apply spine prosth device

Spine surgery procedure

Release shoulder joint

Exploratory shoulder surger

Exploratory shoulder surger

Shoulder joint surgery

Remove shoulder joint linin

Incision of collarbone join

Explore treat shoulder join

Partial removal collar bone

Removal of collar bone

Removal of bone lesion

Removal of bone lesion

Removal of humerus lesion

Removal of humerus lesion

Removal of humerus lesion

Remove collar bone lesion

Remove shoulder blade lesio

Remove humerus lesion

Remove collar bone lesion

Remove shoulder blade lesio

Remove humerus lesion

Partial removal of scapula

Removal of head of humerus
Fixation of shoulder blade

Incision of tendon & muscle

Incise tendon(s) & muscle(s

Remove/transplant tendon

Exploratory elbow surgery

Release elbow joint

Explore/treat elbow joint

Remove elbow joint lining

Remove/graft bone lesion

Remove/graft bone lesion

Remove/graft bone lesion

Remove/graft bone lesion

Removal of head of radius

Removal of arm bone lesion

Remove radius bone lesion

Remove elbow bone lesion

Partial removal of arm bone

Partial removal of radius

Partial removal of elbow

Radical resection of elbow

Removal of elbow joint

Remove elbow joint implant

Remove radius head implant

Muscle/tendon transfer

Arm tendon lengthening

Repair of arm tendon

Tenolysis triceps

Repr elbow lat ligmnt w/tis

Repr elbw med ligmnt w/tiss

Repair elbow perc

Repair elbow w/deb open

Repair elbow deb/attch open

Decompression of forearm

Decompress forearm 1 space

Decompress forearm 1 space

Decompress forearm 2 spaces

Decompress forearm 2 spaces

Explore/treat wrist joint

Explore/treat wrist joint

Remove wrist joint lining

Remove wrist joint cartilag

Excise wrist tendon sheath

Partial removal of ulna

Removal of forearm lesion

Remove/graft forearm lesion

Remove/graft forearm lesion

Removal of wrist lesion
Remove & graft wrist lesion

Remove & graft wrist lesion

Remove forearm bone lesion

Partial removal of ulna

Partial removal of radius

Resect radius/ulnar tumor

Removal of wrist bone

Removal of wrist bones

Partial removal of radius

Partial removal of ulna

Removal of wrist prosthesis

Removal of wrist prosthesis

Repair forearm tendon/muscl

Repair forearm tendon/muscl

Repair forearm tendon/muscl

Repair forearm tendon/muscl

Repair forearm tendon/muscl

Repair forearm tendon/muscl

Repair forearm tendon sheat

Revise wrist/forearm tendon

Incise wrist/forearm tendon

Fusion of tendons at wrist

Fusion of tendons at wrist

Transplant forearm tendon

Revise palsy hand tendon(s)

Shorten radius & ulna

Incision of hip tendon

Incision of hip tendon

Incision of hip tendons

Buttock fasciotomy

Denervation of hip joint

Remove hip bone les deep

Remove/graft hip bone lesio

Removal of tail bone

Revision of hip tendon

Transfer tendon to pelvis

Treat thigh fracture

Incision of thigh tendons

Exploration of knee joint

Biopsy knee joint lining

Explore/treat knee joint

Removal of knee cartilage

Removal of knee cartilage

Remove knee joint lining

Remove knee joint lining

Removal of kneecap

Remove femur lesion
Remove femur lesion/graft

Remove femur lesion/graft

Remove femur lesion/fixatio

Partial removal leg bone(s)

Repair of kneecap tendon

Repair/graft kneecap tendon

Repair of thigh muscle

Repair/graft of thigh muscl

Incision of thigh tendons

Lengthening of thigh tendon

Lengthening of thigh tendon

Transplant of thigh tendon

Repair of knee cartilage

Lat retinacular release ope

Incision of knee joint

Surgery to stop leg growth

Surgery to stop leg growth

Decompression of thigh/knee

Decompression of thigh/knee

Decompression of thigh/knee

Decompression of lower leg

Drain lower leg bursa

Explore/treat ankle joint

Exploration of ankle joint

Explore/treat ankle joint

Remove ankle joint lining

Remove ankle joint lining

Remove lower leg bone lesio

Remove/graft leg bone lesio

Remove/graft leg bone lesio

Partial removal of tibia

Partial removal of fibula

Resect talus/calcaneus tum

Repair of leg tendon each

Repair of leg tendon each

Repair lower leg tendons

Release of lower leg tendon

Release of lower leg tendon

Revision of lower leg tendo

Revise lower leg tendons

Revision of calf tendon

Repair of ankle ligament

Repair of ankle ligaments

Repair of ankle ligament

Incision of fibula

Incision of tibia & fibula

Repair of tibia epiphysis
Repair of fibula epiphysis

Repair lower leg epiphyses

Repair of leg epiphyses

Amputation of foot at ankle

Decompression of leg

Decompression of leg

Decompression of leg

Hi enrgy eswt plantar fasci

Pelvic ring fracture uni/bi

T 48.2042 $3,437.59.

Replace tissue expander

Excise epiphyseal bar

Ablate bone tumor(s) perq

Repair stern/nuss w/o scope

Repair sternum/nuss w/scope

Remove shoulder bone part

Muscle transfer shoulder/ar

Repair rotator cuff acute

Repair rotator cuff chronic

Release of shoulder ligamen

Repair of shoulder

Repair biceps tendon

Repair shoulder capsule

Repair shoulder capsule

Revision of collar bone

Resect distal humerus tumor

Resect radius tumor

Revision of arm muscles

Repair of biceps tendon

Repair arm tendon/muscle

Repair of ruptured tendon

Revision of humerus

Revision of humerus

Revision of elbow joint

Fusion of elbow joint

Transplant forearm tendon

Repair/revise wrist joint

Realignment of hand

Reconstruct ulna/radioulnar

Revision of radius

Revision of radius

Revision of ulna

Revise radius or ulna

Revise radius & ulna

Shorten radius or ulna

Lengthen radius & ulna

Repair carpal bone shorten
Repair/graft radius & ulna

Vasc graft into carpal bone

Repair nonunion carpal bone

Revision of wrist joint

Revision of wrist joint

Reinforce radius

Reinforce ulna

Reinforce radius and ulna

Fusion of hand bones

Exploration of hip joint

Transfer of abdominal muscl

Transfer of spinal muscle

Transfer of iliopsoas muscl

Transfer of iliopsoas muscl

Lengthening of thigh tendon

Transplants of thigh tendon

Revise thigh muscles/tendon

Repair of knee ligament

Osteochondral knee autograf

Repair degenerated kneecap

Revision of unstable kneeca

Revision of unstable kneeca

Revision/removal of kneecap

Revision of thigh muscles

Repair achilles tendon

Repair of achilles tendon

Revise lower leg tendon

Revise lower leg tendon

Revise additional leg tendo

Incision of tibia

Repair of leg epiphyses

T 82.2078 $5,862.48.

Lumbar spine proces distrac

Lumbar spine process addl

Percut kyphoplasty thor

Percut kyphoplasty lumbar

Percut kyphoplasty add-on

Muscle transfers

Repair shoulder capsule

Repair shoulder capsule

Repair shoulder capsule

Repair shoulder capsule

Revision of collar bone

Reinforce clavicle

Reinforce shoulder bones

Fusion of shoulder joint

Fusion of shoulder joint
Revision of arm muscles

Reconstruct elbow lat ligmn

Reconstruct elbow med ligmn

Revision of humerus

Repair of humerus

Repair humerus with graft

Reinforce humerus

Fusion/graft of elbow joint

Revision of amputation

Revise palsy hand tendon(s)

Revise radius & ulna

Lengthen radius or ulna

Repair radius or ulna

Repair/graft radius or ulna

Repair radius & ulna

Repair/graft radius & ulna

Repair/graft radius or ulna

Repair/graft wrist bone

Fusion of wrist joint

Fusion/graft of wrist joint

Fusion/graft of wrist joint

Fuse hand bones with graft

Fusion radioulnar jnt/ulna

Revise head/neck of femur

Repair of knee ligament

Repair of knee ligaments

Autochondrocyte implant kne

Osteochondral knee allograf

Reconstruction knee

Reconstruction knee

Reconstruction knee

Repair/graft achilles tendo

Reinforce tibia

Fusion of ankle joint open

Fusion of tibiofibular join

Fusion of foot bones

Knee arthroscopy/surgery

Knee arthroscopy/surgery

Ankle arthroscopy/surgery

T 16.6230 $1,185.44 $249.64

Drain hand tendon sheath

Drainage of palm bursa

Drainage of palm bursas

Treat hand bone lesion

Decompress fingers/hand

Decompress fingers/hand

Release palm contracture
Incise finger tendon sheath

Incision of finger tendon

Explore/treat hand joint

Explore/treat finger joint

Explore/treat finger joint

Biopsy hand joint lining

Biopsy finger joint lining

Biopsy finger joint lining

Release palm contracture

Remove wrist joint lining

Revise finger joint each

Tendon excision palm/finger

Remove tendon sheath lesion

Removal of palm tendon each

Removal of finger tendon

Remove finger bone

Remove hand bone lesion

Removal of finger lesion

Remove/graft finger lesion

Partial removal of hand bon

Partial removal finger bone

Partial removal finger bone

Extensive hand surgery

Resect prox finger tumor

Resect distal finger tumor

Repair hand tendon

Repair finger tendon

Repair finger tendon

Repair finger tendon

Realignment of tendons

Release palm/finger tendon

Release hand/finger tendon

Incision of palm tendon

Incision of finger tendon

Incise hand/finger tendon

Fusion of finger tendons

Fusion of finger tendons

Tendon lengthening

Tendon shortening

Lengthening of hand tendon

Shortening of hand tendon

Hand tendon reconstruction

Release thumb contracture

Release knuckle contracture

Release finger contracture

Repair hand joint

Repair hand joint with graf
Repair of web finger

Repair hand deformity

Reconstruct extra finger

Repair finger deformity

Release muscles of hand

Excision constricting tissu

Amputation of finger/thumb

Amputation of finger/thumb

T 28.9725 $2,066.12.

Replantation digit complete

Release palm contracture

Release palm contracture

Release palm contracture

Revise finger joint each

Remove/graft bone lesion

Repair finger/hand tendon

Repair/graft hand tendon

Repair finger/hand tendon

Repair finger/hand tendon

Repair/graft hand tendon

Repair finger/hand tendon

Repair/graft hand tendon

Repair finger/hand tendon

Revise hand/finger tendon

Repair/graft hand tendon

Repair/graft hand tendon

Excision hand/finger tendon

Graft hand or finger tendon

Repair/graft finger tendon

Repair finger/hand tendon

Repair/graft finger tendon

Repair/graft finger tendon

Release palm & finger tendo

Release forearm/hand tendon

Transplant hand tendon

Transplant/graft hand tendo

Transplant palm tendon

Transplant/graft palm tendo

Revise thumb tendon

Tendon transfer with graft

Hand tendon/muscle transfer

Revise thumb tendon

Finger tendon transfer

Finger tendon transfer

Revision of finger

Hand tendon reconstruction

Thumb tendon transfer
Fusion of knuckle joint

Fusion of knuckle joints

Fusion of knuckle joints

Repair hand joint with graf

Reconstruct finger joint

Repair nonunion hand

Reconstruct finger joint

Construct thumb replacement

Positional change of finger

Repair of web finger

Repair of web finger

Correct metacarpal flaw

Correct finger deformity

Lengthen metacarpal/finger

Repair muscles of hand

Thumb fusion with graft

Fusion of thumb

Thumb fusion with graft

Fusion of hand joint

Fusion/graft of hand joint

Fusion of knuckle

Fusion of knuckle with graf

Fusion of finger joint

Fusion of finger jnt add-on

Fusion/graft of finger join

Fuse/graft added joint

Amputate metacarpal bone

Remove sympathetic nerves

Remove sympathetic nerves

Sympathectomy supfc palmar

T 22.2111 $1,583.94 $353.37

Incision of achilles tendon

Treat foot bone lesion

Incision of foot fascia

Incision of toe tendon

Incision of toe tendons

Exploration of foot joint

Exploration of foot joint

Exploration of toe joint

Biopsy of foot joint lining

Biopsy of foot joint lining

Biopsy of toe joint lining

Partial removal foot fascia

Removal of foot fascia

Removal of foot joint linin

Removal of foot joint linin

Removal of foot lesion
Excise foot tendon sheath

Excise foot tendon sheath

Removal of foot lesion

Removal of toe lesions

Removal of ankle/heel lesio

Removal of foot lesion

Removal of toe lesions

Part removal of metatarsal

Part removal of metatarsal

Part removal of metatarsal

Part removal of metatarsal

Removal of metatarsal heads

Revision of foot

Removal of heel bone

Removal of heel spur

Part removal of ankle/heel

Partial removal of foot bon

Partial removal of toe

Partial removal of toe

Removal of ankle bone

Removal of metatarsal

Removal of toe

Partial removal of toe

Partial removal of toe

Resect tarsal tumor

Resect metatarsal tumor

Resect phalanx of toe tumor

Repair of foot tendon

Repair/graft of foot tendon

Repair of foot tendon

Release of foot tendon

Release of foot tendons

Release of foot tendon

Release of foot tendons

Incision of foot tendon(s)

Incision of toe tendon

Incision of foot tendon

Release of big toe

Revision of foot fascia

Release of midfoot joint

Revision of foot tendon

Revision of foot and ankle

Release of foot contracture

Release of toe joint each

Fusion of toes

Repair of hammertoe

Repair of hammertoe
Partial removal of foot bon

Repair hallux rigidus

Incision of ankle bone

Incision of metatarsal

Incision of metatarsal

Incision of metatarsal

Revision of big toe

Revision of toe

Repair deformity of toe

Removal of sesamoid bone

Resect enlarged toe tissue

Resect enlarged toe

Repair extra toe(s)

Repair webbed toe(s)

Fusion of big toe joint

Amputation thru metatarsal

Amputation toe & metatarsal

Amputation of toe

Partial amputation of toe

Scope plantar fasciotomy

T 60.6876 $4,327.81.

Bone/skin graft metatarsal

Bone/skin graft great toe

Remove/graft foot lesion

Remove/graft foot lesion

Remove/graft foot lesion

Remove/graft foot lesion

Repair/graft of foot tendon

Revision of foot tendon

Release of midfoot joint

Incision of heel bone

Incision of midfoot bones

Incise/graft midfoot bones

Incision of metatarsals

Repair of foot bones

Repair of metatarsals

Reconstruct cleft foot

Osteochondral talus autogrf

Fusion of foot bones

Fusion of foot bones

Fusion of foot bones

Fusion of foot bones

Revision of foot bones

Fusion of foot bones

Fusion of big toe joint

Fusion of big toe joint

T 34.4317 $2,455.43.
Correction of bunion

Correction of bunion

Correction of bunion

Correction of bunion

Correction of bunion

Correction of bunion

Correction of bunion

Correction of bunion

S 1.3257 $94.54.

Application of body cast

Application of body cast

Application of body cast

Application of body cast

Application of figure eight

Application of shoulder cas

Apply hand/wrist cast

Apply finger cast

Apply long arm splint

Apply forearm splint

Apply forearm splint

Addition of walker to cast

Application of leg cast

Application long leg splint

Application lower leg splin

Application of paste boot

Apply multlay comprs lwr le

Removal/revision of cast

Removal/revision of cast

Removal/revision of cast

Repair of body cast

Windowing of cast

Wedging of cast

Wedging of clubfoot cast

Casting/strapping procedure

S 0.7563 $53.93.

Application of finger splin

Application of finger splin

Strapping of chest

Strapping of shoulder

Strapping of elbow or wrist

Strapping of hand or finger

Strapping of hip

Strapping of knee

Strapping of ankle and/or f

Strapping of toes

Apply multlay comprs upr le

Apply multlay comprs upr ar
Appl multlay comprs arm/han

S 0.2738 $19.53.

Osteopath manj 1-2 regions

Osteopath manj 3-4 regions

Osteopath manj 5-6 regions

Osteopath manj 7-8 regions

Osteopath manj 9-10 regions

Chiropract manj 1-2 regions

Chiropract manj 3-4 regions

Chiropractic manj 5 regions

ostimulator ElectrodesS 95.2427 $6,792.04.

Lap impl electrode antrum

Implant neuroelectrodes

Implant neuroelectrodes

Implant neuroelectrodes

Implant neuroelectrodes

T 26.7671 $1,908.84.

Open tx rib fx 1-2 ribs

Opn tx rib fx 3-4 ribs

Opn tx rib fx 5-6 ribs

Open tx rib fx 7/> ribs

Open tx septal fx w/wo stab

Treatment of rib fracture

Treat clavicle dislocation

Treat humerus fracture

Treat humerus fracture

Treat humerus fracture

Treat fx distal radial

Pin ulnar styloid fracture

Treat wrist dislocation

Pin radioulnar dislocation

Treat wrist dislocation

Treat wrist fracture

Treat wrist dislocation

Treat metacarpal fracture

Treat thumb fracture

Pin hand dislocation

Treat hand dislocation

Treat knuckle dislocation

Treat finger fracture each

Treat finger fracture each

Treat finger fracture each

Pin finger fracture each

Treat finger fracture each

Pin finger dislocation

Treat finger dislocation

Treatment of thigh fracture
Treatment of tibia fracture

Treatment of heel fracture

Treatment of ankle fracture

Treat midfoot fracture

Treat metatarsal fracture

Treat big toe fracture

Treat big toe fracture

Treat toe fracture

Treat sesamoid bone fractur

Treat foot dislocation

Treat foot dislocation

Treat foot dislocation

Repair foot dislocation

Treat foot dislocation

Treat toe dislocation

Repair toe dislocation

Treat toe dislocation

Repair of toe dislocation

T 52.7806 $3,763.94.

Treat clavicle dislocation

Treat clavicle dislocation

Treat clavicle dislocation

Treat shoulder dislocation

Treat dislocation/fracture

Treat radius fracture

Treat ulnar fracture

Treat fracture of radius

Treat fracture of radius

Treat fracture of radius

Treat fracture of ulna

Treat wrist bone fracture

Treat wrist bone fracture

Treat fracture ulnar styloi

Treat metacarpal fracture

Treat thumb fracture

Treat tail bone fracture

Treat kneecap fracture

Treat kneecap dislocation

Repair of tibia

Repair fibula nonunion

Treatment of tibia fracture

Optx medial ankle fx

Optx post ankle fx

Treatment of fibula fractur

Treatment of ankle fracture

Treatment of ankle fracture

Treatment of ankle fracture
Treat lower leg fracture

Treat lower leg joint

Treat lower leg dislocation

Treat ankle dislocation

Treat ankle dislocation

Treat/graft heel fracture

Treat ankle fracture

Treat midfoot fracture each

Treat metatarsal fracture

Repair foot dislocation

Repair foot dislocation

T 70.6785 $5,040.30.

Treat clavicle fracture

Treat scapula fracture

Treat humerus fracture

Treat humerus fracture

Treat humerus fracture

Treat dislocation/fracture

Treat humerus fracture

Treat humerus fracture

Treat humerus fracture

Treat humerus fracture

Treat humerus fracture

Treat humerus fracture

Treat elbow fracture

Treat elbow fracture

Treat elbow dislocation

Treat elbow fracture

Treat radius fracture

Treat fracture radius & uln

Treat fracture radius/ulna

Treat fx rad extra-articul

Treat fx rad intra-articul

Treat fx radial 3+ frag

Treat hand dislocation

Repair/graft of tibia

Treatment of tibia fracture

Treatment of ankle fracture

Treat lower leg fracture

Treat lower leg fracture

Treat heel fracture

S 13.7177 $978.25.

Mw therapy for breast tumor

Io rad tx delivery by x-ray

Io rad tx deliver by elctrn

Meg evoked single

Meg evoked each addl
Linear acc based stero radi

S 33.0205 $2,354.79.

Meg spontaneous

Robt lin-radsurg fractx 2-5

S 46.2838 $3,300.64.

U/s leiomyomata ablate <200

U/s leiomyomata ablate >200

Linear acc stereo radsur co

Robot lin-radsurg com, firs

T 35.9647 $2,564.75 $591.64

Thoracoscopy diagnostic

Thoracoscopy wbx sac

Thoracoscopy w/bx med space

Thoracoscopy w/bx infiltrat

Thoracoscopy w/bx nodule

Thoracoscopy w/bx pleura

Mediastinoscopy incl biopsy

T 5.7828 $412.39.

Drain percut lung lesion

Insertion of chest tube

Remove lung catheter

Aspirate pleura w/o imaging

Aspirate pleura w/ imaging

Insert cath pleura w/o imag

Insert cath pleura w/ image

Treat pleurodesis w/agent

Lyse chest fibrin init day

Lyse chest fibrin subq day

Therapeutic pneumothorax

Chest surgery procedure

Drainage of heart sac

Repeat drainage of heart sa

Cardiac surgery procedure

Abd paracentesis

Abd paracentesis w/imaging

Peritoneal lavage

T 1.0839 $77.30.

Diagnostic laryngoscopy

Nasopharyngoscopy

T 2.0036 $142.88.

Nasal endoscopy dx

Nasal/sinus endoscopy dx

Remove foreign body larynx

Injection into vocal cord

Dx laryngoscopy newborn

Diagnostic laryngoscopy

T 4.7291 $337.25 $67.83
Remove foreign body larynx

Diagnostic laryngoscopy

Bronchial brush biopsy

Intro windpipe wire/tube

T 18.9594 $1,352.05.

Nasal/sinus endoscopy dx

Nasal/sinus endoscopy surg

Nasal/sinus endoscopy surg

Laryngoscopy with biopsy

Removal of larynx lesion

Laryngoscopy for aspiration

Dx laryngoscopy excl nb

Dx laryngoscopy w/oper scop

Laryngoscopy w/fb removal

Laryngoscopy w/fb & op scop

Laryngoscopy w/biopsy

Laryngoscopy w/bx & op scop

Laryngoscopy w/exc of tumor

Laryngoscope w/vc inj

Laryngoscopy with biopsy

Removal of larynx lesion

T 28.4215 $2,026.82.

Nasal/sinus endoscopy surg

Nasal/sinus endoscopy surg

Revision of ethmoid sinus

Removal of ethmoid sinus

Exploration maxillary sinus

Endoscopy maxillary sinus

Sinus endoscopy surgical

Nasal/sinus endoscopy surg

Nasal/sinus endoscopy surg

Nasal/sinus endoscopy surg

Nasal/sinus endoscopy surg

Nasal/sinus endoscopy surg

Sinus endo w/balloon dil

Sinus endo w/balloon dil

Sinus endo w/balloon dil

Laryngoscopy for treatment

Laryngoscopy and dilation

Laryngoscopy and dilation

Larynscop w/tumr exc + scop

Remove vc lesion w/scope

Remove vc lesion scope/graf

Laryngoscop w/arytenoidecto

Larynscop remve cart + scop

Laryngoscop w/vc inj + scop

T 10.7117 $763.88 $189.82
Dx bronchoscope/wash

Dx bronchoscope/brush

Dx bronchoscope/lavage

Bronchoscopy w/biopsy(s)

Bronchoscopy/lung bx each

Bronchoscopy/lung bx addl

Bronchoscopy/needle bx addl

Bronchoscopy w/fb removal

Bronchoscopy stent add-on

Diag bronchoscope/catheter

Bronchoscopy clear airways

Bronchoscopy reclear airway

Bronchial valve remov init

Airways surgical procedure

S 0.4920 $35.09 $7.74

Clearance of airways

Surfactant admin thru tube

Airway inhalation treatment

Evaluate pt use of inhaler

Chest wall manipulation

Chest wall manipulation

Therapeutic procd strg endu

Oth resp proc, indiv

Oth resp proc, group

S 1.4155 $100.94.

Intm msr bronchodil wheeze

Change of windpipe airway

Evaluation of wheezing

Aerosol inhalation treatmen

Pos airway pressure cpap

S 3.4693 $247.41.

Vent mgmt inpat init day

Vent mgmt inpat subq day

Neg press ventilation cnp

T 37.1534 $2,649.52 $815.13

Right heart cath

Left hrt cath w/ventrclgrph

R&l hrt cath w/ventriclgrph

Coronary artery angio s&i

Coronary art/grft angio s&i

R hrt coronary artery angio

R hrt art/grft angio

L hrt artery/ventricle angi

L hrt art/grft angio

R&l hrt art/ventricle angio

R&l hrt art/ventricle angio

L hrt cath trnsptl puncture
Rt heart cath congenital

R & l heart cath congenital

R & l heart cath congenital

R & l heart cath congenital

T 107.5706 $7,671.18.

Trluml perip athrc renal ar

Trluml perip athrc abd aort

Trluml perip athrc brchiocp

Trluml perip athrc iliac ar

Transcatheter occlusion

Endovasc tempory vessel occ

Transcath occlusion non-cns

Prq card angio/athrect 1 ar

Prq card angio/athrect addl

dovascular RevascularizationT 56.4140 $4,023.05.

Repair arterial blockage

Repair venous blockage

Repair arterial blockage

Repair arterial blockage

Repair arterial blockage

Repair venous blockage

Iliac revasc

Iliac revasc add-on

Iliac revasc w/stent add-on

Fem/popl revas w/tla

Tib/per revasc w/tla

Tib/per revasc add-on

Revsc opn/prq tib/pero sten

Tib/per revasc stnt & ather

Repair arterial blockage

Repair arterial blockage

Prq cardiac angioplast 1 ar

Prq cardiac angio addl art

Revision of aortic valve

Revision of mitral valve

Revision of pulmonary valve

Pul art balloon repr percut

Pul art balloon repr percut

S 9.8911 $705.36.

Bundle of His recording

Intra-atrial recording

Right ventricular recording

Intra-atrial pacing

Intraventricular pacing

Esophageal recording

Esophageal recording

Heart rhythm pacing
Electrophysiology evaluatio

T 55.0013 $3,922.31 .

Electrophysiology evaluatio

Electrophysiology evaluatio

Electrophysiologic study

Ablate heart dysrhythm focu

T 43.4735 $3,100.23 $655.22

Removal of artery clot

Removal of arm artery clot

Removal of artery clot

Removal of leg artery clot

Removal of vein clot

Removal of vein clot

Removal of vein clot

Repair valve femoral vein

Transposition of vein valve

Cross-over vein graft

Leg vein fusion

Repair blood vessel lesion

Repair blood vessel lesion

Removal of clot in graft

Removal of clot in graft

Revise graft w/vein

Revise graft w/vein

Revise graft w/nonauto graf

Revise graft w/vein

Av fuse uppr arm cephalic

Av fuse uppr arm basilic

Av fusion/forearm vein

Av fusion direct any site

Artery-vein autograft

Artery-vein nonautograft

Open thrombect av fistula

Av fistula revision open

Av fistula revision

Dist revas ligation hemo

Prim art mech thrombectomy

Prim art m-thrombect add-on

Sec art m-thrombect add-on

Venous mech thrombectomy

Venous m-thrombectomy add-o

Prq coronary mech thrombect

d Electrodes T 115.4087 $8,230.14 .

Icar ischm mntrng sys compl

Insert heart pm atrial

Insert heart pm ventricular

T 92.7231 $6,612.36 $1,593.50
Icar ischm mntrng sys devic

Insert pulse gen sngl lead

Remove&replace pm gen singl

T 42.4137 $3,024.65.

Endovenous rf 1st vein

Ins endovas vena cava filtr

Endoscopy ligate perf veins

Ligation of neck artery

Ligation of inf vena cava

Ligate/strip long leg vein

Removal of leg veins/lesion

T 27.4658 $1,958.67.

Ligation nasal sinus artery

Ligation upper jaw artery

Endovenous rf vein add-on

Endovenous laser 1st vein

Endovenous laser vein addon

Vascular endoscopy procedur

Ligation of neck artery

Ligation of a-v fistula

Ligation of neck artery

Revision of major vein

Revise leg vein

Ligate/strip short leg vein

Ligate leg veins radical

Ligate leg veins open

Stab phleb veins xtr 10-20

Phleb veins - extrem 20+

Revision of leg vein

Ligate/divide/excise vein

T 30.1384 $2,149.26.

Repair defect of arm artery

Repair blood vessel lesion

Repair blood vessel lesion

Repair blood vessel lesion

Repair blood vessel lesion

Repair blood vessel lesion

Repair blood vessel lesion

Repair blood vessel lesion

Repair blood vessel lesion

Rechanneling of artery

Bypass graft patency/patch

Bypass graft/av fist patenc

Exploration of artery/vein

Explore limb vessels

Excision graft extremity

Ligation of neck vein
Ligation of neck artery

Repair venous blockage

S 2.2552 $160.83 $43.80

Insert emergency airway

Heart/lung resuscitation cp

Temporary external pacing

Nb resuscitation

S 1.1206 $79.91.

Cardiac rehab

Cardiac rehab/monitor

Intens cardiac rehab w/exer

Intens cardiac rehab no exe

S 1.5230 $108.61 $36.86

Echo guide for artery repai

Upr/lxtr art stdy 3+ lvls

Lwr xtr vasc stdy bilat

Extremity study

S 0.9328 $66.52.

Bioimpedance spectroscopy

Ext ecg recording

Ext ecg scan w/report

Dx gastr intub w/asp specs

Ecg monit/reprt up to 48 hr

Ecg monit/reprt up to 48 hr

Remote 30 day ecg rev/repor

Ambulatory BP recording

Ambulatory BP analysis

Cardiovascular procedure

Upr/l xtremity art 2 levels

Aneurysm pressure sens stud

Measure blood oxygen level

Ped home apnea rec hk-up

Ped home apnea rec downld

S 0.3740 $26.67.

Acoustic ecg w/i&r

Cal & alys cntrl artl press

Electrocardiogram tracing

Bioimpedance cv analysis

EKG tracing for initial pre

X 2.4795 $176.82 $41.07

64 lead ecg w/tracing

Cardiovascular stress test

Cardiac drug stress test

Microvolt t-wave assess

Cardiokymography

S 4.2562 $303.52 $100.24

Tilt table evaluation
S 0.5512 $39.31

.

Pulmonary rehab w exer

T 16.2173 $1,156.50.

Harvest vein for bypass

Transcatheter therapy infus

Cath place cardio brachytx

Insert/place heart catheter

Biopsy of heart lining

T 85.6848 $6,110.44.

Prq card stent w/angio 1 vs

Prq card stent w/angio addl

Prq card stent/ath/angio

Prq card stent/ath/angio

Prq revasc byp graft 1 vsl

Prq revasc byp graft addl

Prq card revasc mi 1 vsl

Prq card revasc chronic 1vs

Prq card revasc chronic add

 Vascular DevicesT 23.6020 $1,683.13.

Rmvl icar ischm mntrng dvce

Rmvl subq defib pls gen

Rmvl subq defib electrode

Repos subq defib eltrd &/ge

Reposition pacing-defib lea

Repair lead pace-defib one

Repair lead pace-defib dual

Reposition l ventric lead

Removal of pm generator

Removal of pacemaker system

Removal pacemaker electrode

Remove pulse generator

Remove eltrd transven

Revision of infusion pump

Removal of infusion pump

Remove tunneled ip cath

Removal of shunt

T 52.8101 $3,766.05.

Icar ischm mntrng sys eltrd

Insert subq defib electrode

Insert electrd/pm cath sngl

Insert card electrodes dual

Insert 1 electrode pm-defib

Insert 2 electrode pm-defib

T 315.6793 $22,512.04.

Insert subq defib w/eltrd

Insert subq defib pls gen

Rmvl & replc subq pls gen
Insrt pulse gen w/dual lead

Insrt pulse gen w/mult lead

Insrt pulse gen w/singl lea

Remv&replc cvd gen sing lea

Remv&replc cvd gen dual lea

Remv&replc cvd gen mult lea

T 430.2162 $30,680.01.

Nsert pace-defib w/lead

S 3.6520 $260.44.

Blood transfusion service

Bl push transfuse 2 yr/<

Bl exchange/transfuse nb

Bl exchange/transfuse non-n

Transfusion service fetal

Cryopreserve stem cells

Thaw preserved stem cells

Wash harvest stem cells

Blood/lymph system procedur

S 13.3306 $950.65.

Apheresis wbc

Apheresis rbc

Apheresis platelets

Apheresis plasma

Harvest auto stem cells

Transplt allo lymphocytes

Transplj hematopoietic boos

S 40.5074 $2,888.70.

Im B1 mrw cel ther cmpl

Im B1 mrw cel ther xcl hrvs

Im B1 mrw cel ther hrvst on

Apheresis adsorp/reinfuse

Apheresis selective

Photopheresis

Bone marrow harvest allogen

Bone marrow harvest autolog

Transplt allo hct/donor

Transplt autol hct/donor

T 25.5213 $1,820.00.

Incision of lymph channels

Biopsy/removal lymph nodes

Biopsy/removal lymph nodes

Biopsy/removal lymph nodes

Biopsy/removal lymph nodes

Biopsy/removal lymph nodes

Removal neck/armpit lesion

Removal neck/armpit lesion

Removal of lymph nodes neck
Removal of lymph nodes neck

Remove groin lymph nodes

T 51.4794 $3,671.15.

Explore deep node(s) neck

Remove armpit lymph nodes

Remove armpit lymph nodes

Remove thyroid lesion

Partial thyroid excision

Partial thyroid excision

Partial removal of thyroid

Partial removal of thyroid

Removal of thyroid

Remove thyroid duct lesion

Remove thyroid duct lesion

Endocrine surgery procedure

T 37.5770 $2,679.73.

Insertion of cannula

Insertion of cannula

Insertion of cannula

Artery to vein shunt

Cannula declotting

Insert tun ip cath w/port

T 6.1648 $439.63.

Repair tunneled cv cath

Removal tunneled cv cath

Intro gastrointestinal tube

Replace g/c tube perc

Replace duod/jej tube perc

Replace g-j tube perc

Fix g/colon tube w/device

Change of bladder tube

Brain canal shunt procedure

T 1.1497 $81.99.

Instll rx agnt into rnal tu

Measure ureter pressure

Drain bladder by trocar/cat

Insert bladder cath complex

Electro-uroflowmetry first

Anal/urinary muscle study

Urinary reflex study

Dilate urethra stricture

Dilation of urethra

Dilation of urethra

Urology surgery procedure

Penis study

Genital surgery procedure

Biofeedback peri/uro/rectal
Rectal sensation test

S 110.9266 $7,910.51.

Srs multisource

T 1.8741 $133.65.

Treatment of rib fracture

Treat sternum fracture

Closed tx spine process fx

Treat clavicle fracture

Treat clavicle dislocation

Treat shoulder blade fx

Treat humerus fracture

Treat humerus fracture

Treat shoulder dislocation

Treat dislocation/fracture

Shoulder surgery procedure

Treat humerus fracture

Treat humerus fracture

Treat humerus fracture

Treat humerus fracture

Treat humerus fracture

Treat humerus fracture

Treat humerus fracture

Treat elbow dislocation

Treat elbow dislocation

Treat radius fracture

Treat ulnar fracture

Treat ulnar fracture

Upper arm/elbow surgery

Treat fracture of radius

Treat fracture of ulna

Treat fracture of ulna

Treat fracture radius & uln

Treat fracture radius/ulna

Treat wrist bone fracture

Treat wrist bone fracture

Treat wrist bone fracture

Treat wrist bone fracture

Treat wrist dislocation

Treat wrist dislocation

Treat wrist fracture

Forearm or wrist surgery

Treat metacarpal fracture

Treat metacarpal fracture

Treat thumb dislocation

Treat hand dislocation

Treat hand dislocation

Treat knuckle dislocation
Treat knuckle dislocation

Treat finger fracture each

Treat finger fracture each

Treat finger fracture each

Treat finger fracture each

Treat finger fracture each

Treat finger fracture each

Treat finger dislocation

Hand/finger surgery

Treat pelvic ring fracture

Treat tail bone fracture

Treat hip socket fracture

Treat thigh fracture

Treat hip dislocation

Treat hip dislocation

Treat hip dislocation

Cltx thigh fx

Pelvis/hip joint surgery

Treatment of thigh fracture

Treatment of thigh fracture

Treatment of thigh fracture

Treat thigh fx growth plate

Treat thigh fx growth plate

Treat kneecap fracture

Treat knee fracture

Treat knee fracture(s)

Treat knee dislocation

Treat kneecap dislocation

Leg surgery procedure

Treatment of tibia fracture

Cltx medial ankle fx

Cltx post ankle fx

Cltx post ankle fx w/mnpj

Treatment of fibula fractur

Treatment of ankle fracture

Treatment of ankle fracture

Treatment of ankle fracture

Treatment of ankle fracture

Treatment of ankle fracture

Treat lower leg fracture

Treat lower leg dislocation

Treat ankle dislocation

Leg/ankle surgery procedure

Treatment of heel fracture

Treatment of ankle fracture

Treatment of ankle fracture

Treat midfoot fracture each
Treat midfoot fracture each

Treat metatarsal fracture

Treat metatarsal fracture

Treat big toe fracture

Treat big toe fracture

Treatment of toe fracture

Treatment of toe fracture

Treat sesamoid bone fractur

Treat foot dislocation

Treat foot dislocation

Treat foot dislocation

Treat foot dislocation

Treat toe dislocation

Treat toe dislocation

Foot/toes surgery procedure

T 38.2829 $2,730.07 $659.53

Laparoscope proc spleen

Laparoscope proc lymphatic

Laparoscope proc esoph

Lap revise/remv eltrd antru

Laparoscope proc stom

Lap mobil splenic fl add-on

Laparoscope proc intestine

Laparoscope proc app

Laparoscope proc rectum

Laparoscope procedure liver

Laparoscopy w/cholangio

Laparo w/cholangio/biopsy

Laparoscope proc biliary

Diag laparo separate proc

Laparoscopy biopsy

Laparoscopy aspiration

Laparo drain lymphocele

Lap insert tunnel ip cath

Lap revision perm ip cath

Lap w/omentopexy add-on

Lap ins device for rt

Laparo proc abdm/per/oment

Laparo proc hernia repair

Laparo ablate renal cyst

Laparoscope proc renal

Laparoscope proc ureter

Laparoscope proc bla

Laparoscope proc testis

Laparo proc spermatic cord

Laparoscopic myomectomy

Laparo proc uterus
Laparo proc oviduct-ovary

Laparo proc ob care/deliver

Laparo proc endocrine

T 48.8992 $3,487.15 $1,001.89

Laparoscopy splenectomy

Laparoscopy lymph node biop

Laparoscopy lymphadenectomy

Laparoscopy gastrostomy

Lap enterolysis

Lap jejunostomy

Laparoscopy appendectomy

Laparoscopic cholecystectom

Laparo cholecystectomy/grap

Laparo cholecystectomy/expl

Lap ing hernia repair init

Lap ing hernia repair recur

Laparo partial nephrectomy

Laparoscopy pyeloplasty

Laparoscopy ureterolithotom

Laparo new ureter/bladder

Laparo new ureter/bladder

Laparo urethral suspension

Laparo sling operation

Laparoscopy orchiectomy

Laparo ligate spermatic vei

Laparoscopy surg colpopexy

Laparo-myomectomy complex

Laparo-vag hyst incl t/o

Laparo-vag hyst complex

Laparo-vag hyst w/t/o compl

Tlh uterus 250 g or less

Tlh w/t/o 250 g or less

Tlh uterus over 250 g

Tlh w/t/o uterus over 250 g

Laparoscopy lysis

Laparoscopy remove adnexa

Laparoscopy excise lesions

Laparoscopy tubal cautery

Laparoscopy tubal block

Laparoscopy fimbrioplasty

Laparoscopy salpingostomy

Treat ectopic pregnancy

Treat ectopic pregnancy

T 71.8156 $5,121.39 $1,236.99

Laparoscopy lymphadenectomy

Laparoscopy fundoplasty

Lap paraesophag hern repair
Laparoscopy vagus nerve

Laparoscopy vagus nerve

Lap place gastr adj device

Lap part colectomy w/stoma

L colectomy/coloproctostomy

L colectomy/coloproctostomy

Lap vent/abd hernia repair

Lap vent/abd hern proc comp

Lap inc hernia repair

Lap inc hern repair comp

Lap inc hernia repair recur

Lap inc hern recur comp

Laparoscopy orchiopexy

Lsh uterus 250 g or less

Lsh w/t/o ut 250 g or less

Lsh uterus above 250 g

Lsh w/t/o uterus above 250

Laparo-asst vag hysterectom

T 1.2024 $85.75 $23.38

Esw wound healing init woun

Esw wound healing addl woun

Repair of nail bed

Tx contour defects >10.0 cc

Rpr s/n/ax/gen/trnk 2.5cm/<

Rpr s/n/ax/gen/trnk2.6-7.5c

Rpr s/n/ax/gen/trk7.6-12.5c

Rpr s/n/a/gen/trk12.6-20.0c

Rpr s/n/a/gen/trk20.1-30.0c

Rpr s/n/ax/gen/trnk >30.0 c

Rpr f/e/e/n/l/m 2.5 cm/<

Rpr f/e/e/n/l/m 2.6-5.0 cm

Rpr f/e/e/n/l/m 5.1-7.5 cm

Rpr f/e/e/n/l/m 7.6-12.5 cm

Rpr fe/e/en/l/m 12.6-20.0 c

Rpr fe/e/en/l/m 20.1-30.0 c

Intmd rpr n-hf/genit 2.5cm/

Intmd rpr face/mm 7.6-12.5c

Cmplx rpr s/a/l addl 5 cm/>

Skin sub graft t/a/l add-on

Skin sub graft f/n/hf/g add

Hair trnspl 1-15 punch grft

Hair trnspl >15 punch graft

T 3.5264 $251.48.

Correct skin color 6.0 cm/<

Corect skin color 6.1-20.0c

Correct skin color ea 20.0c

Tx contour defects 1 cc/<
Tx contour defects 1.1-5.0c

Tx contour defects 5.1-10cc

Rpr f/e/e/n/l/m >30.0 cm

Closure of split wound

Intmd rpr s/a/t/ext 2.5 cm/

Intmd rpr s/a/t/ext 2.6-7.5

Intmd rpr s/tr/ext 7.6-12.5

Intmd rpr s/a/t/ext 12.6-20

Intmd rpr s/a/t/ext 20.1-30

Intmd rpr s/tr/ext >30.0 cm

Intmd rpr n-hf/genit2.6-7.5

Intmd rpr n-hf/genit7.6-12.

Intmd rpr n-hf/genit12.6-20

Intmd rpr n-hf/genit20.1-30

Intmd rpr n-hf/genit >30.0c

Intmd rpr face/mm 2.5 cm/<

Intmd rpr face/mm 2.6-5.0 c

Intmd rpr face/mm 5.1-7.5 c

Intmd rpr face/mm 12.6-20 c

Intmd rpr face/mm 20.1-30.0

Intmd rpr face/mm >30.0 cm

Cmplx rpr trunk addl 5cm/<

Cmplx rpr s/a/l 1.1-2.5 cm

Cmplx rpr s/a/l 2.6-7.5 cm

Cmplx rpr f/c/c/m/n/ax/g/h/

Cmplx rpr f/c/c/m/n/ax/g/h/

Cmplx rpr e/n/e/l addl 5cm/

Wound prep f/n/hf/g

Harvest cultured skin graft

Skin pinch graft

Epidrm a-grft f/n/hf/g addl

Cult skin grft t/arm/leg

Cult skin grft t/a/l addl

Cult skin graft t/a/l +%

Cult skin graft f/n/hf/g

Cult skin grft f/n/hfg add

Cult epiderm grft f/n/hfg +

Skin full graft add-on

Skin sub graft trnk/arm/leg

Skn sub grft t/a/l child ad

Skin sub graft face/nk/hf/g

Skn sub grft f/n/hf/g ch ad

Plastic surgery neck

T 5.5162 $393.38.

Closure of split wound

Cmplx rpr trunk 1.1-2.5 cm

Cmplx rpr trunk 2.6-7.5 cm
Cmplx rpr f/c/c/m/n/ax/g/h/

Cmplx rpr e/n/e/l 1.0 cm/<

Cmplx rpr e/n/e/l 1.1-2.5 c

Cmplx rpr e/n/e/l 2.6-7.5 c

Wound prep trk/arm/leg

Wound prep addl 100 cm

Wnd prep f/n/hf/g addl cm

Epidrm autogrft trnk/arm/le

Epidrm autogrft t/a/l add-o

Skin full graft add-on

Skin sub grft t/arm/lg chil

Skn sub grft f/n/hf/g child

Dermal filler inj px/suppl

T 15.5878 $1,111.61.

Reconstruction of nail bed

Tis trnfr trunk 10 sq cm/<

Tis trnfr trunk 10.1-30sqcm

Tis trnfr s/a/l 10 sq cm/<

Tis trnfr s/a/l 10.1-30 sqc

Tis trnfr f/c/c/m/n/a/g/h/f

Tis trnfr f/c/c/m/n/a/g/h/f

Tis trnfr e/n/e/l 10 sq cm/

Tis trnfr e/n/e/l10.1-30sqc

Epidrm a-grft face/nck/hf/g

Derm autograft trnk/arm/leg

Derm autograft t/a/l add-on

Derm autograft face/nck/hf/

Derm autograft f/n/hf/g add

Skin full graft trunk

Skin full graft trunk add-o

Skin full graft sclp/arm/le

Skin full grft face/genit/h

Skin full graft een & lips

Skin full graft add-on

Island pedicle flap graft

Acellular derm matrix implt

Remove sacrum pressure sore

Remove thigh pressure sore

Remove thigh pressure sore

Remove thigh pressure sore

Remove thigh pressure sore

Removal of fascia for graft

Removal of fascia for graft

Removal of tissue for graft

Amputation follow-up surger

Amputation follow-up surger

Revise pocket pacemaker
Revise pocket for defib

Remove gastric port open

T 21.1752 $1,510.07.

Insert tissue expander(s)

Late closure of wound

Tis trnfr any 30.1-60 sq cm

Tis trnfr addl 30 sq cm/<

Filleted finger/toe flap

Skin splt grft trnk/arm/leg

Skin splt grft t/a/l add-on

Skn splt a-grft fac/nck/hf/

Skn splt a-grft f/n/hf/g ad

Skin pedicle flap trunk

Skin pedicle flap arms/legs

Pedcle fh/ch/ch/m/n/ax/g/h/

Pedicle e/n/e/l/ntroral

Delay flap trunk

Delay flap arms/legs

Delay flap f/c/c/n/ax/g/h/f

Delay flap eye/nos/ear/lip

Transfer skin pedicle flap

Forehead flap w/vasc pedicl

Muscle-skin graft head/neck

Muscle-skin graft trunk

Muscle-skin graft arm

Muscle-skin graft leg

Neurovascular pedicle flap

Composite skin graft

Derma-fat-fascia graft

Revision of lower eyelid

Revision of lower eyelid

Revision of upper eyelid

Revision of upper eyelid

Removal of forehead wrinkle

Removal of neck wrinkles

Removal of brow wrinkles

Removal of face wrinkles

Removal of skin wrinkles

Nerve palsy fascial graft

Nerve palsy muscle graft

Nerve palsy microsurg graft

Skin and muscle repair face

Suction lipectomy head&neck

Suction lipectomy trunk

Suction lipectomy upr extre

Suction lipectomy lwr extre

Removal of tail bone ulcer
Remove sacrum pressure sore

Remove sacrum pressure sore

Remove sacrum pressure sore

Remove hip pressure sore

Remove hip pressure sore

Remove hip pressure sore

Explore wound chest

Explore wound abdomen

Remove cartilage for graft

Remove cartilage for graft

Revise gastric port open

Change gastric port open

Revision of ileostomy

Revision of colostomy

T 5.5931 $398.86.

Apply rem fixation device

Closed tx vert fx w/o manj

Treat clavicle dislocation

Treat clavicle dislocation

Treat clavicle dislocation

Treat shoulder blade fx

Treat dislocation/fracture

Treat humerus fracture

Treat radius fracture

Treat fracture of radius

Treat fracture of radius

Treat fracture radius & uln

Treat fracture radius/ulna

Treat wrist bone fracture

Manipulate finger w/anesth

Manipulat palm cord post in

Treat thumb fracture

Treat thigh fracture

Treat thigh fracture

Treatment of thigh fracture

Treatment of thigh fracture

Treatment of ankle fracture

T 11.7147 $835.41.

Comp ext fixate strut chang

Closed tx vert fx w/manj

Treat clavicle fracture

Treat humerus fracture

Treat humerus fracture

Treat elbow fracture

Manipulate wrist w/anesthes

Treat wrist dislocation

Treat metacarpal fracture
Pin knuckle dislocation

Treatment of thigh fracture

Treat knee fracture

Treatment of tibia fracture

Cltx med ankle fx w/mnpj

Treatment of fibula fractur

Treat lower leg fracture

Treat lower leg dislocation

Treatment of heel fracture

Treat foot dislocation

T 6.7737 $483.05.

Dilate esophagus

Dilate esophagus

Dilate esophagus

T 8.7424 $623.45 $138.69

Esophagus endoscopy

Esophagus endoscopy biopsy

Esoph scope w/sclerosis inj

Uppr gi endoscopy diagnosis

Uppr gi scope w/submuc inj

Upper gi endoscopy biopsy

Upper GI endoscopy with tub

Upper gi endoscopy & inject

Operative upper GI endoscop

Uppr gi endoscopy/guide wir

Esophagus surgery procedure

Surgical opening of stomach

Reposition gastrostomy tube

Place gastrostomy tube

Stomach surgery procedure

T 10.5266 $750.68 $152.78

Small bowel endoscopy

Small bowel endoscopy/biops

Small bowel endoscopy

Small bowel endoscopy

Small bowel endoscopy/biops

Small bowel endoscopy

Small bowel endoscopy

Gi tract capsule endoscopy

T 9.6941 $691.32 $186.06

Endoscopy of bowel pouch

Endoscopy bowel pouch/biop

Colonoscopy

Colonoscopy with biopsy

Colonoscopy for foreign bod

Colonoscopy for bleeding

Colonoscopy & polypectomy
Colonoscopy lesion removal

Colonoscopy w/snare

Surgical colonoscopy

Diagnostic colonoscopy

Colonoscopy w/fb removal

Colonoscopy and biopsy

Colonoscopy submucous inj

Colonoscopy/control bleedin

Lesion removal colonoscopy

Lesion remove colonoscopy

Lesion removal colonoscopy

Colonoscopy dilate strictur

Colonoscopy w/endoscope us

Colonoscopy w/endoscopic fn

T 5.8940 $420.32.

Anoscopy hra w/biopsy

Proctosigmoidoscopy dx

Diagnostic sigmoidoscopy

Sigmoidoscopy and biopsy

Sigmoidoscopy w/fb removal

Sigmoidoscopy & polypectomy

Sigmoidoscopy w/submuc inj

Anoscopy control bleeding

T 10.0341 $715.56.

Proctosigmoidoscopy dilate

Proctosigmoidoscopy w/bx

Proctosigmoidoscopy removal

Proctosigmoidoscopy removal

Proctosigmoidoscopy removal

Proctosigmoidoscopy bleed

Sigmoidoscopy for bleeding

Sigmoidoscopy & decompress

Sigmoidoscopy w/tumr remove

Sigmoidoscopy w/ablate tumr

Sig w/balloon dilation

Sigmoidoscopy w/ultrasound

Sigmoidoscopy w/us guide bx

Anoscopy and dilation

Anoscopy and biopsy

Anoscopy remove for body

Anoscopy

T 6.1609 $439.35.

Reduction of rectal prolaps

Rectum surgery procedure

Removal of rectal marker

Incision of anal abscess

Ligation of hemorrhoid(s)
Injection into hemorrhoid(s

Destroy internal hemorrhoid

Treatment of anal fissure

Anus surgery procedure

Place endorectal app

T 25.6535 $1,829.43.

Drainage of pelvic abscess

Removal of anorectal lesion

Excision of rectal strictur

Excision of rectal lesion

Exc rect tum transanal part

Destruction rectal tumor

Repair of rectum

Placement of seton

Incision of rectal abscess

Removal of anal fissure

Remove ext hem groups 2+

Remove int/ext hem 1 group

Remove in/ex hem grp & fiss

Remove in/ex hem grp w/fist

Remove in/ex hem groups 2+

Remove in/ex hem grps & fis

Remove in/ex hem grps w/fis

Remove anal fist subq

Remove anal fist inter

Remove anal fist complex

Remove anal fist 2 stage

Repair of anal stricture

Repr of anal fistula w/glue

Reconstruction of anus

Remove by ligat int hem grp

Remove by ligat int hem grp

T 33.1772 $2,365.97.

Exc rectal tumor endoscopic

Ligation hemorrhoid w/us

Anoscopy w/rf delivery

Exc rect tum transanal full

Repair of rectum

Correct rectal prolapse

Repair of rectocele

Repair anal fistula

Repair anorectal fist w/plu

Repair of anal sphincter

Repair of anal sphincter

Repair of anal sphincter

Implant artificial sphincte

Hemorrhoidopexy by stapling
T 24.2214 $1,727.30

.

Endo cholangiopancreatograp

Endo cholangiopancreatograp

Endo cholangiopancreatograp

Endo cholangiopancreatograp

Endo cholangiopancreatograp

Endo cholangiopancreatograp

Endo cholangiopancreatograp

Endo cholangiopancreatograp

Endo cholangiopancreatograp

Endoscopic pancreatoscopy

T 28.4347 $2,027.76.

Incision of gallbladder

Insert catheter bile duct

Insert bile duct drain

Biliary endoscopy thru skin

Biliary endoscopy thru skin

Biliary endoscopy thru skin

Biliary endoscopy thru skin

Remove bile duct stone

Bile tract surgery procedur

T 25.9781 $1,852.58.

Unlisted procedure intestin

Appendectomy

Appendectomy add-on

Excision of umbilicus

Remove foreign body adbomen

Revise abdomen-venous shunt

Abdomen surgery procedure

Place needles pelvic for rt

T 34.0627 $2,429.11.

Rpr hern preemie reduc

Rpr ing hern premie blocked

Rpr ing hernia baby reduc

Rpr ing hernia baby blocked

Rpr ing hernia init reduce

Rpr ing hernia init blocked

Prp i/hern init reduc >5 yr

Prp i/hern init block >5 yr

Rerepair ing hernia reduce

Rerepair ing hernia blocked

Repair ing hernia sliding

Repair lumbar hernia

Rpr rem hernia init reduce

Rpr fem hernia init blocked

Rerepair fem hernia reduce

Rerepair fem hernia blocked
Rpr ventral hern init reduc

Rpr ventral hern init block

Rerepair ventrl hern reduce

Rerepair ventrl hern block

Hernia repair w/mesh

Rpr epigastric hern reduce

Rpr epigastric hern blocked

Rpr umbil hern reduc < 5 yr

Rpr umbil hern block < 5 yr

Rpr umbil hern reduc > 5 yr

Rpr umbil hern block > 5 yr

Repair spigelian hernia

Repair umbilical lesion

Removal of bladder cyst

Removal of testis

Exploration for testis

Suspension of testis

Orchiopexy (Fowler-Stephens

Removal of hydrocele

Removal of hydroceles

Revise spermatic cord veins

Revise hernia & sperm veins

T 17.9329 $1,278.85.

Drainage of rectal abscess

Drainage of rectal abscess

Biopsy of rectum

Dilation of anal sphincter

Dilation of rectal narrowin

Remove rectal obstruction

Surg dx exam anorectal

Incision of rectal abscess

Incision of rectal abscess

Incision of anal septum

Incision of anal sphincter

Excise anal ext tag/papilla

Removal of anal tags

Removal of hemorrhoid clot

Chemodenervation anal musc

Removal of suture from anus

Treatment of anal fissure

Place cecostomy tube perc

T 3.2577 $232.32.

Treatment of bladder lesion

Simple cystometrogram

Complex cystometrogram

Cystometrogram w/up

Cystometrogram w/vp
Cystometrogram w/vp&up

Dilate urethra stricture

Preputial stretching

Colon motility 6 hr study

Anal pressure record

S 2.5831 $184.21.

Colon CA screen;barium enem

Colon ca scrn; barium enema

T 8.5787 $611.77 $0.00

Colorectal scrn; hi risk in $0.00

Colon ca scrn not hi rsk in $0.00 S 5.8206 $415.08 $0.00

CA screen;flexi sigmoidscop $0.00 T 7.1482 $509.76 .

Remove stent via transureth

Remove renal tube w/fluoro

Kidney endoscopy

Kidney endoscopy & biopsy

Renal scope w/tumor resect

Kidney endoscopy

Kidney endoscopy

Kidney endoscopy & biopsy

Endoscopy of ureter

Endoscopy of ureter

Ureter endoscopy

Ureter endoscopy & catheter

Incise bladder/drain ureter

Cystoscopy

Cystoscopy & duct catheter

Cystoscopy and treatment

T 15.8635 $1,131.27.

Remove ureter stent percut

Insert kidney drain

Kidney endoscopy & treatmen

Kidney endoscopy & treatmen

Ureter endoscopy & biopsy

Ureter endoscopy & treatmen

Cystoscopy removal of clots

Cystoscopy and treatment

Cystoscopy & revise urethra

Cystoscopy and treatment

Cystoscopy and treatment

Cystoscopy chemodenervation

Cystoscopy and treatment

Dilate urethra stricture

X-ray control cath insert

X-ray control cath insert
X-ray guide gu dilation

T 26.7673 $1,908.86.

Renal abscess open drain

Change ureter stent percut

Change stent via transureth

Insert ureteral tube

Create passage to kidney

Kidney endoscopy

Kidney endoscopy & treatmen

Kidney endoscopy & treatmen

Ureter endoscopy & biopsy

Ureter endoscopy & treatmen

Ureter endoscopy & treatmen

Ureter endoscopy & treatmen

Incise & treat bladder

Incise & treat bladder

Incise & drain bladder

Removal of bladder stone

Remove ureter calculus

Removal of bladder lesion

Repair of ureter lesion

Repair of bladder wound

Repair of bladder opening

Cystoscopy & ureter cathete

Cystoscopy and biopsy

Cystoscopy w/biopsy(s)

Cystoscopy and treatment

Cystoscopy and treatment

Cystoscopy and treatment

Cystoscopy and treatment

Cystoscopy and treatment

Cystoscopy and radiotracer

Cystoscopy & revise urethra

Cystoscopy and treatment

Cystoscopy and treatment

Cystoscopy and treatment

Cystoscopy and treatment

Cystoscopy and treatment

Cystoscopy and treatment

Cystoscopy and treatment

Cystoscopy and treatment

Remove bladder stone

Remove bladder stone

Cystoscopy and treatment

Cystoscopy stone removal

Cystoscopy and treatment

Cystoscopy and treatment
Create passage to kidney

Cysto w/ureter stricture tx

Cysto w/up stricture tx

Cysto w/renal stricture tx

Cysto/uretero stricture tx

Cysto/uretero w/up strictur

Cystouretero w/renal strict

Cystouretero & or pyeloscop

Cystouretero w/stone remove

Cystouretero w/biopsy

Cystouretero w/excise tumor

Cystouretero w/congen repr

Cystourethro cut ejacul duc

Incision of prostate

Revision of bladder neck

Relieve bladder contracture

Drainage of prostate absces

Drainage of prostate absces

Drainage of prostate absces

ProceduresT 38.3814 $2,737.09.

Kidney endoscopy

Removal of ureter stone

Cystoscopy implant stent

Cystoscopy inject material

Cystouretero w/lithotripsy

Prostatectomy (TURP)

Remove prostate regrowth

Transperi needle place pros

T 2.1419 $152.75.

Incise external hemorrhoid

Measure kidney pressure

Drain bladder by needle

Irrigation of bladder

Change of bladder tube

Anal/urinary muscle study

Intraabdominal pressure tes

Dilate urethra stricture

Insert prost urethral stent

Treatment of penis lesion

Treatment of penis lesion

Penile injection

Penis study

T 19.7656 $1,409.54.

Revise ureter

Drain bl w/cath insertion

Dilate urethra stricture

Transurethral rf treatment
Dynamic cavernosometry

Surgical exposure prostate

T 21.5966 $1,540.12.

Incision of urethra

Incision of urethra

Incision of urethra

Incision of urethra

Drainage of urethra abscess

Drainage of urethra abscess

Drainage of urinary leakage

Drainage of urinary leakage

Biopsy of urethra

Removal of urethra

Removal of urethra lesion

Removal of urethra gland

Treatment of urethra lesion

Treatment of urethra lesion

Removal of urethra gland

Repair of urethra defect

Revision of urethra

Repair of urethra injury

Repair of urethra injury

Dilation of urethra

Slitting of prepuce

Slitting of prepuce

T 33.2789 $2,373.22.

Endoscopic injection/implan

Removal of urethra

Treatment of urethra lesion

Removal of urethra lesion

Surgery for urethra pouch

Revise urethra stage 1

Revise urethra stage 2

Reconstruction of urethra

Reconstruct urethra stage 1

Reconstruct urethra stage 2

Reconstruction of urethra

Reconstruct urethra/bladder

Remove/revise male sling

Remove uro sphincter

Repair uro sphincter

Revision of urethra

Urethrlys transvag w/ scope

Repair of urethra injury

Repair of urethra injury

Repair of urethra defect

T 39.8005 $2,838.29 $979.42
Fragmenting of kidney stone

S 6.9597 $496.32.

Hemodialysis one evaluation

Unsched dialysis ESRD pt ho

T 127.3348 $9,080.63 $2,020.00

Laparo ablate liver tumor r

Laparo ablate liver cryosur

Laparo ablate renal mass

S 6.0848 $433.93 $129.40

TTE w or w/o fol w/cont, f/

2D TTE w or w/o fol w/con,c

2D TTE w or w/o fol w/con,f

TEE w or w/o fol w/cont, mo

S 8.1101 $578.36 $172.48

TTE w or w/o fol w/cont, co

2D TEE w or w/o fol w/con,i

TEE w or w/o fol w/cont,con

TTE w or w/o fol w/con,stre

TTE w or wo fol wcon,Dopple

TTE w or w/o contr, cont EC

T 38.9199 $2,775.49 $607.88

Penile venous occlusion

Treatment of penis lesion

Treat penis lesion graft

Treat penis lesion graft

Partial removal of penis

Treatment of penis lesion

Revision of penis

Revision of penis

Reconstruction of urethra

Reconstruction of urethra

Reconstruction of urethra

Reconstruction of urethra

Reconstruction of urethra

Reconstruction of urethra

Reconstruction of urethra

Revise penis/urethra

Revise penis/urethra

Revise penis/urethra

Secondary urethral surgery

Secondary urethral surgery

Secondary urethral surgery

Reconstruct urethra/penis

Penis plastic surgery

Repair penis

Repair penis

Remove muti-comp penis pros
Repair multi-comp penis pro

Remove self-contd penis pro

Revision of penis

Revision of penis

Repair of penis

Extensive testis surgery

T 23.7942 $1,696.84.

Circumcision w/regionl bloc

Circumcision neonate

Circum 28 days or older

Lysis penil circumic lesion

Repair of circumcision

Frenulotomy of penis

Biopsy of testis

Excise lesion testis

Removal of testis

Orchiectomy partial

Exploration for testis

Reduce testis torsion

Suspension of testis

Revision of testis

Repair testis injury

Relocation of testis(es)

Drainage of scrotum

Remove epididymis lesion

Remove epididymis lesion

Removal of epididymis

Removal of epididymis

Explore epididymis

Fusion of spermatic ducts

Fusion of spermatic ducts

Repair of hydrocele

Explore scrotum

Removal of scrotum lesion

Removal of scrotum

Revision of scrotum

Revision of scrotum

Incision of sperm duct

Removal of sperm duct(s)

Repair of sperm duct

Ligation of sperm duct

Removal of hydrocele

Removal of sperm cord lesio

Revise spermatic cord veins

Incise sperm duct pouch

Remove sperm pouch lesion

T 13.5630 $967.22.
Biopsy of prostate

Biopsy of prostate

Prostate saturation samplin

T 1.6625 $118.56.

I & D of vulva/perineum

Drainage of gland abscess

Biopsy of vulva/perineum

Exam of vulva w/scope

Exam/biopsy of vulva w/scop

Treat vagina infection

Insert pessary/other device

Treat vaginal bleeding

Exam of cervix w/scope

Cryocautery of cervix

Biopsy of uterus lining

Remove intrauterine device

Fetal contract stress test

Fetal non-stress test

Transabdom amnioinfus w/us

Insert cervical dilator

T 3.2826 $234.09.

Electroejaculation

Biopsy of vulva/perineum

Ins vag brachytx device

Exam of vagina w/scope

Exam/biopsy of vag w/scope

Bx/curett of cervix w/scope

Biopsy of cervix w/scope

Endocerv curettage w/scope

Artificial insemination

Artificial insemination

Sperm washing

Retrieval of oocyte

Transfer of embryo

Transfer of embryo

Amniocentesis diagnostic

Fetal cord puncture prenata

Chorion biopsy

Fetal scalp blood sample

Umbilical cord occlud w/us

Fetal fluid drainage w/us

Fetal shunt placement w/us

Abortion (mpr)

T 23.5870 $1,682.06 $424.28

Hysteroscopy dx sep proc

Hysteroscopy biopsy

Hysteroscopy lysis
Hysteroscopy remove fb

Hysteroscope procedure

T 0.1157 $8.25 $1.73

Fitting of diaphragm/cap

Genital surgery procedure

Fetal invas px w/us

Maternity care procedure

Anogenital exam child

Obtaining screen pap smear $0.00 T 6.9849 $498.11 .

Drainage of pelvic fluid

Biopsy of vagina

Insert uteri tandem/ovoids

Biopsy of cervix

Endocervical curettage

Amniocentesis therapeutic

T 20.3967 $1,454.55.

Surgery for vulva lesion

Lysis of labial lesion(s)

Hymenotomy

Partial removal of vulva

Complete removal of vulva

Partial removal of hymen

Remove vagina gland lesion

Repair of vagina

Repair clitoris

Repair of perineum

Exploration of vagina

Drainage of pelvic abscess

Destroy vag lesions simple

Destroy vag lesions complex

Biopsy of vagina

Remove vagina wall partial

Remove vagina lesion

Remove vagina lesion

Repair of vagina

Repair vagina/perineum

Revise vag graft via vagina

Dilation of vagina

Pelvic examination

Remove vaginal foreign body

Revise prosth vag graft lap

Bx of cervix w/scope leep

Conz of cervix w/scope leep

Cauterization of cervix

Laser surgery of cervix

Conization of cervix
Conization of cervix

D&c of cervical stump

Revision of cervix

Revision of cervix

Dilation of cervical canal

Dilation and curettage

Reopen fallopian tube

Insert heyman uteri capsule

Occlude fallopian tube(s)

Drainage of ovarian cyst(s)

Drain pelvic abscess percut

Biopsy of ovary(s)

D & c after delivery

Episiotomy or vaginal repai

Revision of cervix

Obstetrical care

Antepartum manipulation

Deliver placenta

Vbac delivery only

Treatment of miscarriage

Care of miscarriage

Treatment of miscarriage

Abortion

Abortion

Evacuate mole of uterus

Remove cerclage suture

T 37.0120 $2,639.44.

Remove vagina tissue part

Vaginectomy partial w/nodes

Closure of vagina

Repair of urethral lesion

Repair bladder & vagina

Repair rectum & vagina

Repair of vagina

Insert mesh/pelvic flr addo

Repair of bowel bulge

Revise/remove sling repair

Repair bladder & vagina

Construction of vagina

Construct vagina with graft

Repair rectum-vagina fistul

Repair bladder-vagina lesio

Repair bladder-vagina lesio

Repair vagina

Removal of cervix

Removal of residual cervix

Remove cervix/repair vagina
Myomectomy vag method

Vaginal hysterectomy

Vag hyst including t/o

Vag hyst w/t/o & vag repair

Vag hyst w/enterocele repai

Reopen fallopian tube

Endometr ablate thermal

Division of fallopian tube

Create new tubal opening

Drainage of ovarian cyst(s)

Drain ovary abscess open

Partial removal of ovary(s)

Removal of ovarian cyst(s)

Remove uterus lesion

T 47.7547 $3,405.53 $981.50

Repair bladder neck

Revision of urethra

Extensive repair of vagina

Colpopexy extraperitoneal

Colpopexy intraperitoneal

Repair paravag defect open

Repair paravag defect vag

Repair bladder defect

Repair urethrovaginal lesio

Repair paravag defect lap

Remove cervix repair bowel

Vag hyst complex

Vag hyst incl t/o complex

Vag hyst t/o & repair compl

Vag hyst w/enterocele compl

Endometrial cryoablation

Hysteroscopy sterilization

T 12.0130 $856.68.

Treat trigeminal tract

Epidural lysis mult session

Epidural lysis on single da

Treat spinal cord lesion

Treat spinal canal lesion

Inject spine w/cath lmb/scr

Remove spinal canal cathete

Removal of spinal shunt

Injection treatment of nerv

Injection treatment of nerv

Destroy lumb/sac facet jnt

Injection treatment of nerv

Injection treatment of nerv

T 2.5607 $182.61.
Njx paravert w/us cer/thor

Njx paravert w/us cer/thor

Njx paravert w/us lumb/sac

Njx paravert w/us lumb/sac

Ther injection carp tunnel

Inj dupuytren cord w/enzyme

Inj tendon sheath/ligament

Inj tendon origin/insertion

Inj trigger point 1/2 muscl

Inject trigger points 3/>

Drain/inject joint/bursa

Drain/inject joint/bursa

Drain/inject joint/bursa

Aspirate/inj ganglion cyst

N block inj trigeminal

N block inj facial

N block inj vagus

N block inj phrenic

N block inj plantar digit

Inj paravert f jnt c/t 2 le

Inj paravert f jnt c/t 3 le

Inj paravert f jnt l/s 2 le

Inj paravert f jnt l/s 3 le

N block spenopalatine gangl

N block carotid sinus s/p

Neuroeltrd stim post tibial

Chemodenerv saliv glands

Destroy nerve face muscle

Chemodenerv musc migraine

N block inj common digit

Destroy c/th facet jnt addl

Chemodenerv eccrine glands

Chemodenerv eccrine glands

Nervous system surgery

T 4.0910 $291.74.

Njx tfrml eprl w/us cer/tho

Njx tfrml eprl w/us lumb/sa

Spinal fluid tap diagnostic

Drain cerebro spinal fluid

N block inj occipital

N block inj spinal accessor

N block inj cervical plexus

N block inj brachial plexus

N block inj axillary

N block inj suprascapular

N block inj intercost sng

N block inj ilio-ing/hypogi
N block inj paracervical

N block inj fem single

N block other peripheral

Inj foramen epidural add-on

Inj foramen epidural add-on

Destroy nerve neck muscle

Destroy nerve extrem musc

T 7.9333 $565.75.

Njx paravert w/us cer/thor

Njx paravert w/us lumb/sac

Njx tfrml eprl w/us cer/tho

Njx tfrml eprl w/us lumb/sa

Remove cranial cavity fluid

Remove cranial cavity fluid

Remove brain cavity fluid

Injection into brain canal

Remove brain canal fluid

Injection into brain canal

Replace/irrigate catheter

Drain spinal cord cyst

Inject epidural patch

Treat spinal cord lesion

Injection into disk lesion

Injection into spinal arter

Inject spine cerv/thoracic

Inject spine lumbar/sacral

Inject spine w/cath crv/thr

N block cont infuse b plex

N block inj intercost mlt

N block inj pudendal

N block inj sciatic sng

N blk inj sciatic cont inf

N block inj fem cont inf

N block inj lumbar plexus

Inj foramen epidural c/t

Inj foramen epidural l/s

Inj paravert f jnt c/t 1 le

Inj paravert f jnt l/s 1 le

N block stellate ganglion

N block inj hypogas plxs

N block lumbar/thoracic

N block inj celiac pelus

Injection treatment of nerv

Destroy cerv/thor facet jnt

Destroy l/s facet jnt addl

Injection treatment of nerv

Inj for sacroiliac jt anest
T 52.7056 $3,758.59

.

Perq lamot/lam crv/thrc

Perq lamot/lam lumbar

Remove part of neck vertebr

Remove part thorax vertebra

Remove part lumbar vertebra

Remove extra spine segment

Incis w/discectomy thoracic

Neck spine fuse&remov bel c

Neck spine fusion

Lumbar spine fusion

Spine fusion extra segment

Cerv artific diskectomy

Implant spinal canal cath

Remove spine lamina 1/2 crv

Remove spine lamina 1/2 thr

Remove spine lamina 1/2 lmb

Remove spine lamina 1/2 scr

Remove lamina/facets lumbar

Remove spine lamina >2 crvc

Remove spine lamina >2 thrc

Remove spine lamina >2 lmbr

Neck spine disk surgery

Low back disk surgery

Spinal disk surgery add-on

Laminotomy single cervical

Laminotomy single lumbar

Remove spine lamina 1 crvl

Remove spine lamina 1 thrc

Remove spine lamina 1 lmbr

Remove spinal lamina add-on

Decompress spinal cord thrc

Decompress spinal cord lmbr

Decompress spine cord add-o

Decompress spinal cord thrc

Decompress spine cord add-o

Neck spine disk surgery

Neck spine disk surgery

S 11.3041 $806.13 $268.73

Polysom <6 yrs 4/> paramtrs

Polysom <6 yrs cpap/bilvl

Multiple sleep latency test

Sleep study attended

Polysom any age 1-3> param

Polysom 6/> yrs 4/> param

Polysom 6/>yrs cpap 4/> par

Ambulatory eeg monitoring
EEG monitoring/videorecord

EEG monitoring/computer

Eeg monitor technol attende

Pre-op service LVRS complet

Pre-op service LVRS 10-15do

S 2.4204 $172.61 $53.58

Remote 30 day ecg tech supp

Slp stdy unattended

Slp stdy unatnd w/anal

Sleep study unatt&resp efft

Eeg 41-60 minutes

Eeg over 1 hour

Eeg awake and drowsy

Eeg awake and asleep

Eeg coma or sleep only

Eeg all night recording

EEG monitoring/function tes

Pre-op service LVRS 1-9 dos

Post op service LVRS min 6

Home sleep test/type 2 Port

Home sleep test/type 3 Port

Home sleep test/type 4 Port

S 0.6045 $43.11.

Physiologic tremor record

Tempr

Muscle test thor paraspinal

Muscle test nonparaspinal

Musc tst done w/n tst nonex

Motor &/ sens nrve cndj tes

Motor&/sens 1-2 nrv cndj ts

Motor&/sens 3-4 nrv cndj ts

Motor&/sens 5-6 nrv cndj ts

Motor&sens 7-8 nrv cndj tes

Blink reflex test

Parasymp&symp hrt rate test

Neurological procedure

S 2.5805 $184.02.

Tcranial magn stim tx plan

Tcranial magn stim tx deli

Tcran magn stim redetemine

Electrocochleography

Auditor evoke potent compre

Eeg cerebral death only

Somatosensory testing

Somatosensory testing

Somatosensory testing

Visual evoked potential tes
Somatosensory testing

Electrode stimulation brain

Electrode stim brain add-on

Motion analysis video/3d

Motion test w/ft press meas

S 1.1195 $79.83.

Interrogate crtd sns dev

Interrogate crtd sns w/pgrm

Periph field stimul analys

Motor function mapping ntms

Auditor evoke potent limit

Actigraphy testing

Cholinesterase challenge

Muscle test one limb

Muscle test 2 limbs

Muscle test 3 limbs

Muscle test 4 limbs

Muscle test larynx

Muscle test hemidiaphragm

Muscle test cran nerv unila

Muscle test cran nerve bila

Muscle test one fiber

Limb exercise test

Musc tst done w/nerv tst li

Musc test done w/n test com

Motor&sen 9-10 nrv cndj tes

Motor&sen 11-12 nrv cnd tes

Motor&sens 13/> nrv cnd tes

Autonomic nrv parasym inerv

Autonomic nrv adrenrg inerv

Autonomic nrv syst funj tes

Ans parasymp & symp w/tilt

C motor evoked uppr limbs

C motor evoked lwr limbs

Neuromuscular junction test

C motor evoked upr&lwr limb

EEG monitoring/giving drugs

Analyze neurostim no prog

Analyze neurostim complex

Cranial neurostim complex

Io anal gast n-stim subsq

Dynamic surface emg

Dynamic fine wire emg

T 18.8566 $1,344.72.

Neurectomy hamstring

Neurectomy popliteal

Decompression of tibia nerv
Neurectomy foot

Treat trigeminal nerve

Remove spinal cord lesion

Stimulation of spinal cord

Remove lesion of spinal cor

Injection treatment of nerv

Injection treatment of nerv

Revise finger/toe nerve

Revise hand/foot nerve

Revise arm/leg nerve

Revision of sciatic nerve

Revision of arm nerve(s)

Revise low back nerve(s)

Revision of cranial nerve

Revise ulnar nerve at elbow

Revise ulnar nerve at wrist

Carpal tunnel surgery

Relieve pressure on nerve(s

Release foot/toe nerve

Internal nerve revision

Incision of brow nerve

Incision of cheek nerve

Incision of chin nerve

Incision of jaw nerve

Incision of tongue nerve

Incision of facial nerve

Incise nerve back of head

Incise diaphragm nerve

Incision of pelvis nerve

Incise hip/thigh nerve

Sever cranial nerve

Incision of spinal nerve

Remove skin nerve lesion

Remove digit nerve lesion

Digit nerve surgery add-on

Remove limb nerve lesion

Limb nerve surgery add-on

Remove nerve lesion

Implant nerve end

Remove skin nerve lesion

Removal of nerve lesion

Biopsy of nerve

Sympathectomy cervical

Remove sympathetic nerves

Sympathectomy digital arter

T 34.7984 $2,481.58.

Rev/remvl crtd sns dev tota
Incise skull/brain surgery

Incise skull for treatment

Percutaneous diskectomy

Remove spine infusion devic

Remove vagus n eltrd

Incise hip/thigh nerve

Remove sciatic nerve lesion

Removal of nerve lesion

Repair of digit nerve

Repair nerve add-on

Repair of hand or foot nerv

Repair of hand or foot nerv

Repair of hand or foot nerv

Repair nerve add-on

Repair of leg nerve

Repair/transpose nerve

Repair arm/leg nerve

Repair sciatic nerve

Nerve surgery

Repair of arm nerves

Repair of low back nerves

Repair of facial nerve

Repair of facial nerve

Fusion of facial/other nerv

Subsequent repair of nerve

Repair & revise nerve add-o

Repair nerve/shorten bone

Nerve graft head/neck </4 c

Nerve graft head/neck >4 cm

Nerve graft hand/foot </4 c

Nerve graft hand/foot >4 cm

Nerve graft arm/leg <4 cm

Nerve graft arm/leg >4 cm

Nerve graft hand/foot </4 c

Nerve graft hand/foot >4 cm

Nerve graft arm/leg </4 cm

Nerve graft arm/leg >4 cm

Nerve graft add-on

Nerve graft add-on

Nerve pedicle transfer

Nerve pedicle transfer

Nerve repair w/allograft

Neurorraphy w/vein autograf

T 45.5890 $3,251.09.

Insert brain-fluid device

Replace/revise brain shunt

Implant spinal canal cath
Insert spine infusion devic

Install spinal shunt

Revision of spinal shunt

T 197.8775 $14,111.24.

Implant spine infusion pump

Implant spine infusion pump

T 121.3919 $8,656.82.

Remove hepatic shunt (tips)

Transcath iv stent percut

Transcath iv stent/perc add

Transcath iv stent open

Transcath iv stent/open add

Embolization uterine fibroi

Iliac revasc w/stent

Fem/popl revas w/ather

Fem/popl revasc w/stent

Tib/per revasc w/ather

Tib/per revasc w/stent

Tibper revasc w/ather add-o

S 0.6788 $48.41.

Corneal hysteresis

Clear eyelid gland w/heat

Treat eyelid by injection

Special eye evaluation

Corneal topography

Special eye evaluation

Orthoptic/pleoptic training

Visual field examination(s)

Visual field examination(s)

Cmptr ophth dx img ant segm

Cmptr ophth img optic nerve

Cptr ophth dx img post segm

Glaucoma provocative tests

Special eye exam initial

Special eye exam subsequent

Eye exam with photos

Ophthalmoscopy/dynamometry

Eye muscle evaluation

Electro-oculography

Color vision examination

Dark adaptation eye exam

Eye photography

Contact lens fitting

Rx corneoscleral cntact len

Replacement of contact lens

Fit spectacles single syste

Fit spectacles compound len
Aphakia prosth service temp

Eye service or procedure

Glaucoma scrn hgh risk dire

S 2.0317 $144.89.

Treatment of corneal lesion

Inject/treat eye socket

Remove eyelid foreign body

Explore/irrigate tear ducts

Eye exam with photos

Icg angiography

Electroretinography

T 2.0304 $144.79 $30.45

Conjunctival drug placement

Remove eye lesion

Incision of iris

Eye surgery procedure

Ophth us b & quant a

T 15.8380 $1,129.46.

Remove foreign body from ey

Removal of eye lesion

Biopsy of cornea

Removal of eye lesion

Curette/treat cornea

Correction of astigmatism

Correction of astigmatism

Cover eye w/membrane

Cover eye w/membrane suture

Incise inner eye adhesions

Incise inner eye adhesions

Injection treatment of eye

Injection treatment of eye

Follow-up surgery of eye

Destruction ciliary body

Ciliary transsleral therapy

Destruction ciliary body

Removal of lens material

Revision of eyelid

Remove eyelid lining lesion

T 23.5107 $1,676.62 $347.84

Implant corneal ring

Scleral fistulization

Insj ocular telescope prost

Repair of eye wound

Repair of eye wound

Removal of eye lesion

Drainage of eye

Drainage of eye
Relieve inner eye pressure

Incision of eye

Incise inner eye adhesions

Incise inner eye adhesions

Remove implant of eye

Remove eye lesion

Glaucoma surgery

Glaucoma surgery

Glaucoma surgery

Glaucoma surgery

Incision of eye

Remove iris and lesion

Removal of iris

Removal of iris

Repair iris & ciliary body

Repair iris & ciliary body

Ciliary endoscopic ablation

Destruction ciliary body

Reposition intraocular lens

Revise eyelid lining

Revise eyelid lining

Revise eyelid lining

Harvest eye tissue alograft

T 5.8389 $416.39.

Remove foreign body from ey

Treatment of retina

Treatment of retinal lesion

Treatment of choroid lesion

Ocular photodynamic ther

Eye photodynamic ther add-o

Eye surgery procedure

Dstry eye lesn,fdr vssl tec

T 20.2224 $1,442.12.

Suprachoroidal drug deliver

Place intraoc radiation src

Remove foreign body from ey

Repair of eye wound

Partial removal of eye flui

Incise inner eye strands

Repair detached retina

Repair detached retina

Release encircling material

Remove eye implant material

Treatment of retinal lesion

Treatment of retinal lesion

Reinforce/graft eye wall

T 3.2499 $231.76.
Injection eye drug

Destroy nerve of eye muscle

Inject/treat eye socket

Inject/treat eye socket

Orbit surgery procedure

Drainage of eyelid abscess

Remove eyelid lesion

Remove eyelid lesions

Biopsy eyelid & lid margin

Revise eyelashes

Revision of eyelid

Incise/drain eyelid lining

Eyelid lining surgery

Incise/drain tear gland

Incise tear duct opening

Clearance of tear duct

Revise tear duct opening

Close tear duct opening

Close tear duct opening

Probe nasolacrimal duct

Tear duct system surgery

T 8.6336 $615.69.

Curette/treat cornea

Incision of eyelid

Remove eyelid lesions

Revise eyelashes

Remove eyelid lesion

Treat eyelid lesion

Closure of eyelid by suture

Biopsy of eyelid lining

Remove eyelid lining lesion

T 19.1819 $1,367.92 $294.00

Removal of ocular implant

Repair of eye wound

Revision of cornea

Reinforce eye wall

Explore/biopsy eye socket

Explore/treat eye socket

Aspiration orbital contents

Incision of eyelid fold

Remove eyelid lesion(s)

Revise eyelashes

Revision of eyelid

Repair eyelid defect

Repair eyelid defect

Repair eyelid defect

Repair eyelid defect
Repair eyelid defect

Revise eyelid defect

Revise eyelid defect

Correction eyelid w/implant

Repair eyelid defect

Repair eyelid defect

Repair eyelid defect

Repair eyelid defect

Repair eyelid defect

Repair eyelid defect

Repair eyelid defect

Repair eyelid defect

Repair eyelid wound

Repair eyelid wound

Revision of eyelid

Revision of eyelid

Revision of eyelid

Reconstruction of eyelid

Reconstruction of eyelid

Reconstruction of eyelid

Remove eyelid lining lesion

Revise/graft eyelid lining

Separate eyelid adhesions

Incise/drain tear sac

Biopsy of tear gland

Biopsy of tear sac

Remove tear gland lesion

Repair tear ducts

Probe nasolacrimal duct

Probe nasolacrimal duct

Probe nl duct w/balloon

T 26.7000 $1,904.06 $382.94

Revise ocular implant

Insert ocular implant

Insert ocular implant

Revise ocular implant

Explore/drain eye socket

Explore/treat eye socket

Revise eye socket implant

Repair brow defect

Repair eyelid defect

Reconstruction of eyelid

Revise/graft eyelid lining

Revise/graft eyelid lining

Revise/graft eyelid lining

Revise/graft eyelid lining

Removal of tear gland
Partial removal tear gland

Removal of tear sac

Remove tear gland lesion

Create tear sac drain

Create tear duct drain

Create tear duct drain

Close tear system fistula

T 39.7223 $2,832.72 $597.36

Revise eye

Revise eye with implant

Removal of eye

Remove eye/insert implant

Remove eye/attach implant

Removal of eye

Remove eye/revise socket

Remove eye/revise socket

Attach ocular implant

Reinsert ocular implant

Explr/decompress eye socket

Explore/treat eye socket

Explore/treat eye socket

Explore/drain eye socket

Explr/decompress eye socket

Explore/biopsy eye socket

Insert eye socket implant

Decompress optic nerve

T 25.2082 $1,797.67 $412.25

Repair of eye socket wound

Revise eye muscle

Revise two eye muscles

Revise eye muscle

Revise two eye muscles

Revise eye muscle(s)

Revise eye muscle(s) add-on

Eye surgery follow-up add-o

Rerevise eye muscles add-on

Revise eye muscle w/suture

Eye suture during surgery

Revise eye muscle add-on

Release eye tissue

Eye muscle surgery procedur

T 41.6106 $2,967.38 $794.86

Corneal transplant

Corneal transplant

Corneal transplant

Corneal transplant

Corneal trnspl endothelial
Ocular reconst transplant

Ocular reconst transplant

Ocular reconst transplant

T 24.2659 $1,730.47 $490.32

Cataract surgery complex

Cataract surg w/iol 1 stage

Cataract surg w/iol 1 stage

Insert lens prosthesis

Exchange lens prosthesis

T 5.7604 $410.79 $102.26

Laser surgery of eye

Incise inner eye adhesions

Revision of iris

Revision of iris

Removal of inner eye lesion

After cataract laser surger

Laser surgery eye strands

Repair detached retina

Treatment of retina

Treatment of retinal lesion

Treatment of retinal lesion

Tr retinal les preterm inf

T 29.3838 $2,095.45 $499.26

Removal of lens material

Removal of lens material

Extraction of lens

Extraction of lens

T 1.0950 $78.09 $24.11

Prepare face/oral prosthesi

Cranio/maxillofacial surger

Closed tx nose fx w/o manj

Reset dislocated jaw

Head surgery procedure

Neck/chest surgery procedur

Control of nosebleed

Control of nosebleed

Control of nosebleed

Repeat control of nosebleed

Nasal surgery procedure

Sinus surgery procedure

Larynx surgery procedure

Lip surgery procedure

Mouth surgery procedure

Repair tongue laceration

Tongue and mouth surgery

Dental surgery procedure

Palate/uvula surgery
Salivary surgery procedure

Control throat bleeding

Control nose/throat bleedin

Throat surgery procedure

Outer ear surgery procedure

Middle ear surgery procedur

Inner ear surgery procedure

Temporal bone surgery

T 3.2225 $229.81.

Treat lower jaw fracture

Drainage of nose lesion

Drainage of nose lesion

Release of nasal adhesions

Irrigation maxillary sinus

Biopsy of lip

Incision of lip fold

Biopsy of mouth lesion

Excise oral mucosa for graf

Repair mouth laceration

Drainage of mouth lesion

Drainage of mouth lesion

Drainage of mouth lesion

Repair tongue laceration

Drainage mouth roof lesion

Repair palate

Preparation palate mold

Drainage of salivary gland

Drainage of salivary gland

Dilation of salivary duct

Drainage of tonsil abscess

Biopsy of external ear

Inflate middle ear canal

Inflate middle ear canal

Incision of eardrum

Ear and throat examination

T 6.9913 $498.57 $99.78

Explore wound neck

Injection of sinus tract

Prepare face/oral prosthesi

Interdental fixation

Revision of jaw muscle/bone

Closed tx orbit w/o manipul

Closed tx orbit w/ manipulj

Interdental wiring

Intranasal biopsy

Removal of nose polyp(s)

Injection treatment of nose
Nasal sinus therapy

Irrigation sphenoid sinus

Incision of windpipe

Incision of windpipe

Visualization of windpipe

Repair lip

Repair lip

Repair lip

Drainage of mouth lesion

Repair mouth laceration

Drainage of mouth lesion

Incision of tongue fold

Drainage of mouth lesion

Biopsy of tongue

Excision of tongue fold

Repair tongue laceration

Excision of gum flap

Biopsy roof of mouth

Drainage of salivary gland

Incision of esophagus

Drain thyroid/tongue cyst

Clean out mastoid cavity

Create eardrum opening

Insert palate implants

T 16.0895 $1,147.39.

Ear cartilage graft

Revision of eyelid

Closed tx nose fx w/o stabl

Closed tx nose fx w/ stablj

Closed tx septal&nose fx

Treat lower jaw fracture

Treat lower jaw fracture

Treat hyoid bone fracture

Removal of intranasal lesio

Insert nasal septal button

Remove nasal foreign body

Ablate inf turbinate superf

Ablate inf turbinate submuc

Partial excision of lip

Partial excision of lip

Excision of mouth lesion

Excise/repair mouth lesion

Excise lip or cheek fold

Treatment of mouth lesion

Drainage of mouth lesion

Drainage of mouth lesion

Biopsy of tongue
Excision of tongue lesion

Excision of tongue lesion

Excision of tongue lesion

Fixation of tongue

Tongue to lip surgery

Removal foreign body jawbon

Excision of gum lesion

Excision of gum lesion

Excision lesion mouth roof

Excision lesion mouth roof

Excision of uvula

Treatment mouth roof lesion

Insertion palate prosthesis

Removal of salivary stone

Removal of salivary stone

Closure of salivary fistula

Dilation of salivary duct

Drainage of throat abscess

Biopsy of throat

Biopsy of throat

Biopsy of upper nose/throat

Control nose/throat bleedin

Biopsy of external ear cana

Catheterize middle ear cana

Incision of eardrum

Remove ventilating tube

Create eardrum opening

Remove ear lesion

Incise inner ear

T 25.2377 $1,799.78.

Excision of facial bone(s)

Contour of face bone lesion

Excise max/zygoma b9 tumor

Remove exostosis mandible

Remove exostosis maxilla

Excise mandible lesion

Removal of jaw bone lesion

Mnpj of tmj w/anesth

Prepare face/oral prosthesi

Reconstruction of chin

Reconstruction of chin

Reconstruction of chin

Augmentation lower jaw bone

Reduction of forehead

Reconst lwr jaw w/o fixatio

Reconstr lwr jaw segment

Rib cartilage graft
Revision of jaw muscle/bone

Open tx nose fx uncomplicat

Open tx nose fx w/skele fix

Open tx nose & septal fx

Open nasoethmoid fx w/ fixj

Closed tx nose/jaw fx

Opn tx dprsd zygomatic arch

Treat dental ridge fracture

Treat dental ridge fracture

Reset dislocated jaw

Hyoid myotomy & suspension

Removal of nose polyp(s)

Removal of intranasal lesio

Revision of nose

Removal of nose lesion

Excise inferior turbinate

Resect inferior turbinate

Remove nasal foreign body

Reconstruction of nose

Revision of nose

Repair of nasal septum

Repair nasal septum defect

Ther fx nasal inf turbinate

Exploration maxillary sinus

Exploration behind upper ja

Removal of ethmoid sinus

Removal of ethmoid sinus

Removal of ethmoid sinus

Removal of larynx lesion

Incision of windpipe

Incision of windpipe

Surgery/speech prosthesis

Repair windpipe opening

Remove windpipe lesion

Closure of windpipe lesion

Repair of windpipe defect

Revise windpipe scar

Partial excision of lip

Reconstruct lip with flap

Partial removal of lip

Removal foreign body mouth

Excise/repair mouth lesion

Excision of mouth lesion

Reconstruction of mouth

Reconstruction of mouth

Drainage of mouth lesion

Drainage of mouth lesion
Drainage of mouth lesion

Place needles h&n for rt

Excision of tongue lesion

Excision of mouth lesion

Partial removal of tongue

Tongue suspension

Reconstruction tongue fold

Tongue base vol reduction

Removal foreign body gum

Excision gum each quadrant

Excision of gum lesion

Excision of gum lesion

Excision of gum lesion

Removal of gum tissue

Treatment of gum lesion

Repair gum

Repair tooth socket

Remove palate/lesion

Repair palate

Reconstruct cleft palate

Repair palate

Repair nose to lip fistula

Drainage of salivary gland

Removal of salivary stone

Biopsy of salivary gland

Excision of salivary cyst

Drainage of salivary cyst

Repair salivary duct

Parotid duct diversion

Biopsy of upper nose/throat

Excise pharynx lesion

Excision of neck cyst

Remove tonsils and adenoids

Remove tonsils and adenoids

Removal of tonsils

Removal of adenoids

Removal of adenoids

Removal of adenoids

Excision of lingual tonsil

Repair throat wound

Surgical opening of throat

Control throat bleeding

Throat muscle surgery

Repair esophagus opening

Re-explore parathyroids

Treat skull fracture

Removal of external ear
Extensive ear canal surgery

Revise external ear

Repair of eardrum

Repair of eardrum

Repair middle ear structure

Repair middle ear structure

Remove middle ear nerve

Close mastoid fistula

T 9.2948 $662.84.

Repair of eye wound

Drainage of eye

Incision of iris

Removal of iris

Incision secondary cataract

Removal of lens lesion

Extraction of lens

T 45.9788 $3,278.89.

Incision of jaw joint

Excision of bone lower jaw

Excise max/zygoma mal tumor

Remove mandible cyst comple

Excise lwr jaw cyst w/repai

Remove maxilla cyst complex

Excis uppr jaw cyst w/repai

Removal of jaw joint

Remove jaw joint cartilage

Remove coronoid process

Prepare face/oral prosthesi

Prepare face/oral prosthesi

Prepare face/oral prosthesi

Prepare face/oral prosthesi

Prepare face/oral prosthesi

Prepare face/oral prosthesi

Prepare face/oral prosthesi

Prepare face/oral prosthesi

Prepare face/oral prosthesi

Prepare face/oral prosthesi

Maxillofacial fixation

Reconstruction of chin

Augmentation lower jaw bone

Reduction of forehead

Reduction of forehead

Lefort ii anterior intrusio

Reconstruct orbit/forehead

Reconstruct orbit/forehead

Contour cranial bone lesion

Reconst lwr jaw w/o graft
Reconstr lwr jaw w/advance

Reconstruct upper jaw bone

Augmentation of facial bone

Reduction of facial bones

Face bone graft

Lower jaw bone graft

Reconstruction of jaw joint

Reconstruction of jaw joint

Reconstruction of jaw joint

Reconstruction of lower jaw

Reconstruction of jaw

Reconstruction of jaw

Reconstruction of jaw

Reconstruction of jaw

Reconstruction of orbit

Revise eye sockets

Revise eye sockets

Revise eye sockets

Revise eye sockets

Augmentation cheek bone

Revision orbitofacial bones

Revision of eyelid

Open nasoethmoid fx w/o fix

Perq tx nasoethmoid fx

Opn tx nasomax fx w/fixj

Perq tx malar fracture

Opn tx dprsd malar fracture

Opn tx complx malar fx

Opn tx orbit fx transantral

Opn tx orbit fx periorbital

Opn tx orbit fx combined

Opn tx orbit periorbtl impl

Opn tx orbit periorbt w/grf

Opn tx orbit fx w/o implant

Opn tx orbit fx w/implant

Opn tx orbit fx w/bone grft

Treat mouth roof fracture

Treat lower jaw fracture

Treat lower jaw fracture

Treat lower jaw fracture

Treat lower jaw fracture

Treat lower jaw fracture

Treat lower jaw fracture

Repair dislocated jaw

Removal of nose lesion

Partial removal of nose

Removal of nose
Reconstruction of nose

Reconstruction of nose

Revision of nose

Revision of nose

Revision of nose

Revision of nose

Repair nasal stenosis

Repair nasal defect

Repair nasal defect

Repair upper jaw fistula

Repair mouth/nose fistula

Intranasal reconstruction

Exploration maxillary sinus

Explore sinus remove polyps

Exploration sphenoid sinus

Sphenoid sinus surgery

Exploration of frontal sinu

Exploration of frontal sinu

Removal of frontal sinus

Removal of frontal sinus

Removal of frontal sinus

Removal of frontal sinus

Removal of frontal sinus

Removal of frontal sinus

Exploration of sinuses

Diagnostic incision larynx

Revision of larynx

Removal of epiglottis

Revision of larynx

Revision of larynx

Revision of larynx

Reinnervate larynx

Larynx nerve surgery

Incision of windpipe

Puncture/clear windpipe

Repair windpipe opening

Repair of windpipe

Repair of windpipe

Reconstruct lip with flap

Repair cleft lip/nasal

Repair cleft lip/nasal

Repair cleft lip/nasal

Repair cleft lip/nasal

Repair cleft lip/nasal

Reconstruction of mouth

Reconstruction of mouth

Reconstruction of mouth
Excision of gum lesion

Gum graft

Excision lesion mouth roof

Repair palate pharynx/uvula

Reconstruct cleft palate

Reconstruct cleft palate

Reconstruct cleft palate

Reconstruct cleft palate

Reconstruct cleft palate

Lengthening of palate

Lengthening of palate

Excise parotid gland/lesion

Excise parotid gland/lesion

Excise parotid gland/lesion

Excise parotid gland/lesion

Excise submaxillary gland

Excise sublingual gland

Repair salivary duct

Parotid duct diversion

Parotid duct diversion

Parotid duct diversion

Ligation of salivary duct

Drainage of throat abscess

Excision of neck cyst

Removal of tonsils

Removal of adenoids

Extensive surgery of throat

Extensive surgery of throat

Excision of tonsil tags

Partial removal of pharynx

Revision of pharyngeal wall

Reconstruction of throat

Removal of esophagus pouch

Removal of thyroid

Repeat thyroid surgery

Removal of thyroid

Explore parathyroid glands

Removal of thymus gland

Decompress eye socket

Explore orbit/remove object

Remove ear canal lesion(s)

Rebuild outer ear canal

Rebuild outer ear canal

Exploration of middle ear

Eardrum revision

Mastoidectomy

Mastoidectomy
Remove mastoid structures

Extensive mastoid surgery

Extensive mastoid surgery

Remove ear lesion

Remove ear lesion

Mastoid surgery revision

Mastoid surgery revision

Mastoid surgery revision

Mastoid surgery revision

Mastoid surgery revision

Repair eardrum structures

Rebuild eardrum structures

Rebuild eardrum structures

Repair eardrum structures

Rebuild eardrum structures

Rebuild eardrum structures

Revise middle ear & mastoid

Revise middle ear & mastoid

Revise middle ear & mastoid

Revise middle ear & mastoid

Revise middle ear & mastoid

Revise middle ear & mastoid

Release middle ear bone

Revise middle ear bone

Revise middle ear bone

Revise middle ear bone

Remove mastoid air cells

Remove/repair hearing aid

Release facial nerve

Release facial nerve

Repair facial nerve

Repair facial nerve

Explore inner ear

Explore inner ear

Establish inner ear window

Revise inner ear window

Remove inner ear

Remove inner ear & mastoid

Incise inner ear nerve

Release facial nerve

Release inner ear canal

Remove inner ear lesion

T 425.2643 $30,326.87 $7,921.74

Implant cochlear device

X 0.6443 $45.95 .

X-ray eye for foreign body

X-ray exam of jaw <4views
X-ray exam of mastoids

X-ray exam of facial bones

X-ray exam of nasal bones

X-ray exam of eye sockets

X-ray exam of sinuses

X-ray exam pituitary saddle

X-ray exam of skull

X-ray exam of jaw joint

X-ray exam of jaw joints

X-ray head for orthodontia

X-ray exam of neck

X-ray exam of salivary glan

Chest x-ray 1 view frontal

Chest x-ray stereo frontal

Chest x-ray 2vw frontal&lat

Chest x-ray frnt lat lordot

Chest x-ray frnt lat obliqu

Chest x-ray special views

X-ray exam ribs uni 2 views

X-ray exam breastbone 2/>vw

X-ray strenoclavic jt 3/>vw

X-ray exam of spine 1 view

X-ray exam neck spine 3/<vw

X-ray exam trunk spine stan

X-ray exam thorac spine 2vw

X-ray exam thorac spine4/>v

X-ray exam trunk spine 2 vw

X-ray exam l-s spine 2/3 vw

X-ray exam of pelvis

X-ray exam of pelvis

X-ray exam si joints

X-ray exam si joints 3/> vw

X-ray exam sacrum tailbone

X-ray exam of collar bone

X-ray exam of shoulder blad

X-ray exam of shoulder

X-ray exam of shoulder

X-ray exam of shoulders

X-ray exam of humerus

X-ray exam of elbow

X-ray exam of elbow

X-ray exam of forearm

X-ray exam of arm infant

X-ray exam of wrist

X-ray exam of wrist

X-ray exam of hand

X-ray exam of hand
X-ray exam of finger(s)

X-ray exam of hip

X-ray exam of hip

X-ray exam of pelvis & hips

X-ray exam of thigh

X-ray exam of knee 1 or 2

X-ray exam of knee 3

X-ray exam of knees

X-ray exam of lower leg

X-ray exam of leg infant

X-ray exam of ankle

X-ray exam of ankle

X-ray exam of foot

X-ray exam of foot

X-ray exam of heel

X-ray exam of toe(s)

X-ray exam of abdomen

X-ray exam of abdomen

X-ray exam of abdomen

X-ray nose to rectum

Radiographic procedure

X-ray stress view

X-rays for bone age

Joint survey single view

Dxa bone density vert fx

sity MeasurementX 0.9933 $70.84.

X-ray exam of jaw 4/> views

X-ray exam of mastoids

X-ray exam of middle ear

X-ray exam of facial bones

X-ray exam of eye sockets

X-ray exam of sinuses

X-ray exam of skull

Chest x-ray 4/> views

X-ray exam unilat ribs/ches

X-ray exam ribs bil 3 views

X-ray exam ribs/chest4/> vw

X-ray exam spine ap&lat

X-ray exam neck spine 4/5vw

X-ray exam neck spine 6/>vw

X-ray exam thorac spine 3vw

X-ray exam scloiosis erect

X-ray exam l-2 spine 4/>vws

X-ray exam l-s spine bendin

X-ray bend only l-s spine

X-ray exam of hips

X-ray exam knee 4 or more
X-ray exam series abdomen

X-ray measurement of pelvis

Nonvascular shunt x-ray

X-ray exam of body section

X-rays bone length studies

X-rays bone survey limited

X-rays bone survey complete

X-rays bone survey infant

Single energy x-ray study $0.00 X 0.5031 $35.88 .

X-ray exam of teeth

X-ray exam of teeth

Full mouth x-ray of teeth

Panoramic x-ray of jaws

X 3.5823 $255.46.

X-ray exam of tear duct

Contrast x-ray of larynx

X-ray exam of salivary duct

X-ray exam of peritoneum

X-ray bile ducts/pancreas

X-ray exam of kidney lesion

X-ray female genital tract

X-ray exam of fistula

Complex body section x-ray

Complex body section x-rays

X-ray of mammary duct

X-ray of mammary ducts

S 0.9054 $64.57 $22.26

Echo exam of head

Echo exam of eye

Echo exam of eye

Us exam chest

Us exam breast(s)

Ob us < 14 wks addl fetus

Ob us detailed addl fetus

Ob us nuchal meas 1 gest

Ob us nuchal meas add-on

Ob us limited fetus(s)

Ob us follow-up per fetus

Transvaginal us obstetric

Umbilical artery echo

Middle cerebral artery echo

Echo exam of fetal heart

Echo exam of fetal heart

Us exam pelvic limited

Us xtr non-vasc lmtd

Us exam infant hips dynamic
Us exam infant hips static

Ultrasound exam follow-up

Echo examination procedure

Intracranial limited study

S 1.3928 $99.32 $37.23

Ophth us quant a only

Ophth us b w/non-quant a

Echo exam of eye water bath

Echo exam of eye

Us exam of head and neck

Us exam abdom complete

Echo exam of abdomen

Us exam abdo back wall comp

Us exam abdo back wall lim

Us exam k transpl w/doppler

Us exam spinal canal

Ob us < 14 wks single fetus

Ob us >/= 14 wks sngl fetus

Ob us >/= 14 wks addl fetus

Fetal biophys profile w/nst

Fetal biophys profil w/o ns

Transvaginal us non-ob

Us exam pelvic complete

Us exam scrotum

Us transrectal

Us xtr non-vasc complete

Tcd vasoreactivity study

Tcd emboli detect w/o inj

Tcd emboli detect w/inj

Lower extremity study

Upper extremity study

Extremity study

Vascular study

Doppler flow testing

Ultrasound exam AAA screen $0.00 S 2.1699 $154.74 $59.55

Pseudoaneurysm injection tr

Intravascular us

Ob us detailed sngl fetus

Echo exam uterus

Echograp trans r pros study

GI endoscopic ultrasound

Extracranial bilat study

Extracranial uni/ltd study

Intracranial complete study

Lower extremity study

Upper extremity study
Extremity study

Vascular study

Vascular study

Vascular study

Penile vascular study

Penile vascular study

Vessel mapping hemo access

S 5.4757 $390.49.

Echo transthoracic

Tte w/doppler complete

Tte w/o doppler complete

Echo transesophageal

Echo transesophageal

Stress tte only

S 7.8339 $558.66 $128.73

Echo transthoracic

Echo transesophageal

Echo transesophageal

Echo transesophageal intrao

Stress tte complete

X 1.6023 $114.26 $30.47

Nasal/orogastric w/stent

Dx duod intub w/asp spec

Dx duod intub w/asp specs

Throat x-ray & fluoroscopy

Speech evaluation complex

Chest x-ray and fluoroscopy

Chest x-ray&fluoro 4/> view

Fluoroscope examination

Cine/video x-rays

Fluoroscopic procedure

S 7.1179 $507.60.

Contrast x-ray of brain

Contrast x-ray of brain

Myelography neck spine

Myelography thoracic spine

Myelography l-s spine

Myelogphy 2/> spine regions

S 4.1881 $298.67 $68.90

X-ray exam of jaw joint

Contrast x-ray of shoulder

Contrast x-ray of elbow

Contrast x-ray of wrist

Contrast x-ray of hip

Contrast x-ray of knee join

Contrast x-ray of ankle

S 1.1600 $82.72 $32.84
Contrst x-ray exam of throa

Contrast x-ray esophagus

Cine/vid x-ray throat/esoph

X-ray exam of small bowel

X-ray exam of small bowel

Contrast x-ray gallbladder

Contrast x-rays gallbladder

S 1.7222 $122.82 $46.51

Fluoro exam of g/colon tube

X-ray upper gi delay w/o ku

X-rayupper gi delay w/kub

X-ray upper gi&small intest

Contrst x-ray uppr gi tract

Contrst x-ray uppr gi tract

Contrst x-ray uppr gi tract

X-ray exam of small bowel

Contrast x-ray exam of colo

Contrast x-ray exam of colo

Contrast x-ray exam of colo

S 2.9385 $209.55 $58.44

Contrst x-ray urinary tract

Contrst x-ray urinary tract

Contrst x-ray urinary tract

Contrst x-ray urinary tract

Contrst x-ray urinary tract

Contrast x-ray bladder

X-ray male genital tract

X-ray exam of penis

X-ray urethra/bladder

X-ray urethra/bladder

X-ray exam of perineum

S 31.1279 $2,219.82.

Place cath thoracic aorta

Place cath carotid/inom art

Place cath carotid/inom art

Place cath subclavian art

Ins cath ren art 1st unilat

Ins cath ren art 1st bilat

Ins cath ren art 2nd+ unila

Ins cath ren art 2nd+ bilat

Contrast exam thoracic aort

Contrast exam thoracic aort

Contrast exam abdominl aort

X-ray aorta leg arteries

Artery x-rays arm

Artery x-rays spine

Artery x-rays arm/leg
Artery x-rays arms/legs

Artery x-rays abdomen

Artery x-rays adrenal gland

Artery x-rays adrenals

Artery x-rays pelvis

Artery x-rays lung

Artery x-rays lungs

Vein x-ray spleen/liver

Vein x-ray trunk

Vein x-ray kidney

Vein x-ray kidneys

Vein x-ray adrenal gland

Vein x-ray adrenal glands

Vein x-ray liver w/hemodyna

Vein x-ray liver w/hemodyna

Vein x-ray liver

Venous sampling by catheter

S 50.9080 $3,630.40.

Place cath carotd art

Place cath vertebral art

S 1.3864 $98.87 $32.94

CAT scan follow-up study

Ct procedure

S 4.1669 $297.15 $95.46

Ct head/brain w/dye

Ct orbit/ear/fossa w/dye

Ct maxillofacial w/dye

Ct soft tissue neck w/dye

Ct thorax w/dye

Ct neck spine w/dye

Ct chest spine w/dye

Ct lumbar spine w/dye

Ct pelvis w/dye

Ct upper extremity w/dye

Ct lower extremity w/dye

Ct abdomen w/dye

Ct colonography dx w/dye

ance Angiography with ContrastS 6.3741 $454.56 $146.59

Mri orbit/face/neck w/dye

Mr angiography head w/dye

Mr angiography neck w/dye

Mri brain stem w/dye

Mri brain w/dye

Mri chest w/dye

Mri neck spine w/dye

Mri chest spine w/dye

Mri lumbar spine w/dye
Mri pelvis w/dye

Mri upper extremity w/dye

Mri joint upr extrem w/dye

Mri lower extremity w/dye

Mri joint of lwr extr w/dye

Mri abdomen w/dye

MRA w/cont, abd

MRI w/cont, breast, uni

MRI w/cont, breast, bi

MRA w/cont, chest

MRA w/cont, lwr ext

MRA w/cont, pelvis

MRA, w/dye, spinal canal

MRA, w/dye, upper extremity

S 1.0359 $73.87 $0.00

Ct bone density axial $0.00

Dxa bone density axial $0.00 T 123.3630 $8,797.39 .

Revise cornea with implant

S 5.5027 $392.41.

Special radiation treatment

Hyperthermia treatment

Hyperthermia treatment

Hyperthermia treatment

Hyperthermia treatment

Hyperthermia treatment

S 1.3392 $95.50.

Radiation treatment deliver

Radiation treatment deliver

Radiation treatment deliver

Radiation treatment deliver

Radiation treatment deliver

Radiation treatment deliver

Apply surface radiation

S 2.5173 $179.52.

Radiation treatment deliver

Radiation treatment deliver

Radiation treatment deliver

Radiation treatment deliver

Radiation treatment deliver

Radiation treatment deliver

Radiation treatment deliver

Neutron beam tx simple

Neutron beam tx complex

Infuse radioactive material

X 2.8292 $201.76 $66.95

Radiation treatment aid(s)
Radiation treatment aid(s)

Radiation treatment aid(s)

X 1.5387 $109.73 $34.63

Set radiation therapy field

Radiation therapy planning

Radiation therapy dose plan

Teletx isodose plan simple

Teletx isodose plan interme

Brachytx isodose calc simp

Special radiation dosimetry

Radiation physics consult

Radiation physics consult

External radiation dosimetr

X 4.0804 $290.99 $88.78

Set radiation therapy field

Set radiation therapy field

Teletx isodose plan complex

Special teletx port plan

Brachytx isodose calc inter

Brachytx isodose plan compl

Design mlc device for imrt

S 14.8096 $1,056.12.

Heart muscle imaging (PET)

Heart image (pet) single

Heart image (pet) multiple

Brain imaging (PET)

Pet image ltd area

Pet image skull-thigh

Pet image full body

Pet image w/ct lmtd

Pet image w/ct skull-thigh

Pet image w/ct full body

X 13.8052 $984.49 $325.27

Ins mark thor for rt perq

Ins mark abd/pel for rt per

Place rt device/marker pros

Set radiation therapy field

Radiotherapy dose plan imrt

Place device/marker, non pr

S 5.7609 $410.83.

Apply intrcav radiat simple

Apply intrcav radiat interm

Apply intrcav radiat compl

Apply interstit radiat simp

Apply interstit radiat inte

Radium/radioisotope therapy

S 9.6431 $687.68 $259.86
Hdr elect brachytherapy

Hdr brachytx 1 channel

Hdr brachytx 2-12 channel

Hdr brachytx over 12 chan

S 288.8990 $20,602.25.

Implant neurostim arrays

X 4.5159 $322.04.

Contrast x-ray of bile duct

Lymph vessel x-ray arm/leg

Lymph vessel x-ray arms/leg

Lymph vessel x-ray trunk

Lymph vessel x-ray trunk

X-ray exam breast specimen

Parathyrd planar w/wo subtr

Parathyrd planar w/spect&ct

S 359.7987 $25,658.32 $9,121.76

Periph field stimul perm

Inc for vagus n elect impl

T 204.6785 $14,596.24 $5,559.48

Fem/popl revasc stnt & athe

Tib/per revasc stent & athe

S 6.1511 $438.65.

Electroconvulsive therapy

S 1.1619 $82.86.

Psytx pt&/family 30 minutes

Psychiatric service/therapy

S 1.5448 $110.16.

Psych diagnostic evaluation

Psych diag eval w/med srvcs

Psytx pt&/family 45 minutes

Psytx pt&/family 60 minutes

Psytx crisis initial 60 min

Psychoanalysis

Narcosynthesis

Hypnotherapy

S 1.7979 $128.21.

Family psytx w/o patient

Family psytx w/patient

S 0.8506 $60.66.

Multiple family group psytx

Group psychotherapy

S 7.5832 $540.78.

Comprehensve oral evaluatio

Intraoral occlusal film

Extraoral first film

Extraoral ea additional fil

Dental bitewing single imag
Dental bitewings two images

Bitewings four images

Vert bitewings 7 to 8 image

Pulp vitality test

Space maintainer fxd unilat

Fixed bilat space maintaine

Remove unilat space maintai

Remove bilat space maintain

Recement space maintainer

Dental unspec restorative p

Endodontic endosseous impla

Endodontic procedure

Osseous surgery 4 or more

Bone replce graft first sit

Bone replce graft each add

Surgical revision procedure

Pedicle soft tissue graft p

Subepithelial tissue graft

Full mouth debridement

Localized delivery antimicr

Facial moulage sectional

Facial moulage complete

Radiation applicator

Radiation shield

Radiation cone locator

Commissure splint

Dental connector bar

Extraction coronal remnants

Extraction erupted tooth/ex

Rem imp tooth w mucoper flp

Impact tooth remov soft tis

Impact tooth remov part bon

Impact tooth remov comp bon

Impact tooth rem bony w/com

Tooth root removal

Oral antral fistula closure

Primary closure sinus perf

Transseptal fiberotomy

Reshaping bone orthognathic

Other drugs/medicaments

Treatment of complications

Dental occlusal guard

Occlusion analysis

Limited occlusal adjustment

Complete occlusal adjustmen

S 4.2917 $306.05 $118.33

Ct abd & pelvis
S 2.4340 $173.58 $67.11

Ct head/brain w/o dye

Ct orbit/ear/fossa w/o dye

Ct maxillofacial w/o dye

Ct soft tissue neck w/o dye

Ct thorax w/o dye

Ct neck spine w/o dye

Ct chest spine w/o dye

Ct lumbar spine w/o dye

Ct pelvis w/o dye

Ct upper extremity w/o dye

Ct lower extremity w/o dye

Ct abdomen w/o dye

Ct colonography dx

S 4.6182 $329.34 $114.38

Ct head/brain w/o & w/dye

Ct orbit/ear/fossa w/o&w/dy

Ct maxillofacial w/o & w/dy

Ct sft tsue nck w/o & w/dye

Ct thorax w/o & w/dye

Ct neck spine w/o & w/dye

Ct chest spine w/o & w/dye

Ct lumbar spine w/o & w/dye

Ct pelvis w/o & w/dye

Ct uppr extremity w/o&w/dye

Ct lwr extremity w/o&w/dye

Ct abdomen w/o & w/dye

S 6.7671 $482.58 $155.52

Ct angio abd&pelv w/o&w/dye

Ct abd & pelv w/contrast

Ct abd & pelv 1/> regns

ance Angiography without ContrastS 4.7466 $338.49 $133.38

Magnetic image jaw joint

Mri orbit/face/neck w/o dye

Mr angiography head w/o dye

Mr angiography neck w/o dye

Mri brain stem w/o dye

Fmri brain by tech

Fmri brain by phys/psych

Mri brain w/o dye

Mri chest w/o dye

Mri neck spine w/o dye

Mri chest spine w/o dye

Mri lumbar spine w/o dye

Mri pelvis w/o dye

Mri upper extremity w/o dye

Mri joint upr extrem w/o dy
Mri lower extremity w/o dye

Mri jnt of lwr extre w/o dy

Mri abdomen w/o dye

Cardiac mri for morph

Cardiac mri w/stress img

Mri procedure

Magnetic image bone marrow

MRA w/o cont, abd

MRI w/o cont, breast, uni

MRI w/o cont, breast, bi

MRA w/o cont, chest

MRA w/o cont, lwr ext

MRA w/o cont, pelvis

MRA, w/o dye, spinal canal

MRA, w/o dye, upper extr

ance Angiography without Contrast fS 7.7051 $549.47 $197.64

Mri orbt/fac/nck w/o &w/dye

Mr angiograph head w/o&w/dy

Mr angiograph neck w/o&w/dy

Mri brain stem w/o & w/dye

Mri brain w/o & w/dye

Mri chest w/o & w/dye

Mri neck spine w/o & w/dye

Mri chest spine w/o & w/dye

Mri lumbar spine w/o & w/dy

Mri pelvis w/o & w/dye

Mri uppr extremity w/o&w/dy

Mri joint upr extr w/o&w/dy

Mri lwr extremity w/o&w/dye

Mri joint lwr extr w/o&w/dy

Mri abdomen w/o & w/dye

Cardiac mri for morph w/dye

Card mri w/stress img & dye

MRA w/o fol w/cont, abd

MRI w/o fol w/cont, brst, u

MRI w/o fol w/cont, breast,

MRA w/o fol w/cont, chest

MRA w/o fol w/cont, lwr ext

MRA w/o fol w/cont, pelvis

MRA, w/o&w/dye, spinal cana

MRA, w/o&w/dye, upper extr

X 0.6961 $49.64.

Chd risk imt study

Remote algorithm analys ecg

Anoscopy hra w/spec collect

Njx platelet plasma

Implant hormone pellet(s)
Insert drug implant device

Remove drug implant device

Remove/insert drug implant

Dressing change not for bur

Test for blood flow in graf

Place needle wire breast

Place breast clip percut

Removal of fixation device

Us bone stimulation

Remove nasal foreign body

Removal foreign body mouth

Remove pharynx foreign body

Tx gastro intub w/asp

Dx gastr intub w/asp spec

Diagnostic anoscopy

Insert bladder catheter

Insert temp bladder cath

Urine flow measurement

Us urine capacity measure

Clear outer ear canal

Remove impacted ear wax

Ct hrt w/o dye w/ca test

Us bone density measure $0.00

Cbt 1st hour

Cbt each addl hour

Car seat/bed test 60 min

Car seat/bed test + 30 min

Non-cov surg proc,clin tria

Non-cov proc, clinical tria

Bone marrow aspirate &biops

Fecal microbiota prep insti

X 0.0957 $6.82 $2.09

Touch quant sensory test

Vibrate quant sensory test

Cool quant sensory test

Heat quant sensory test

Nos quant sensory test

Skin test candida

Skin test nos antigen

Coccidioidomycosis skin tes

Histoplasmosis skin test

TB intradermal test

X 0.1782 $12.71.

Lab pathology consultation

Phys blood bank serv xmatch

Cell enumeration & id

Cell enumeration phys inter
Cytopath smear other source

Cytopath smear other source

Cytp fna eval ea addl

Flowcytometry/tc add-on

Cytopathology procedure

Cytogenetic study

Surgical path gross

Decalcify tissue

Microslide consultation

Path consult introp

Path consult intraop addl

Intraop cyto path consult 2

Xm archive tissue molec ana

Optical endomicroscpy inter

Surgical pathology procedur

Chct for mal hyperthermia

Pathology lab procedure

Unlisted reprod med lab pro

X 0.5342 $38.10 $10.84

Bone marrow interpretation

Cytopath eval fna report

Cell marker study

Tissue exam by pathologist

Microslide consultation

Immunohistochemistry

Immunofluorescent study

Analysis skeletal muscle

Analysis nerve

Analysis tumor

Tumor immunohistochem/manua

Tumor immunohistochem/compu

Insitu hybridization (fish)

Insitu hybridization auto

Collect sweat for test

Sperm isolation simple

Sperm isolation complex

Assist oocyte fertilization

X 0.8477 $60.45 $15.56

Cryopreservation ovary tiss

Cryopreservation oocyte

Tissue exam by pathologist

Comprehensive review of dat

Nerve teasing preparations

Insitu hybridization manual

Cultr oocyte/embryo <4 days

Cultr oocyte/embryo <4 days

Embryo hatching
Oocyte identification

Prepare embryo for transfer

Cryopreservation embryo(s)

Identify sperm tissue

Insemination of oocytes

Extended culture of oocytes

Assist oocyte fertilization

Biopsy oocyte polar body

Biopsy oocyte polar body

Cryopreserve testicular tis

Storage/year embryo(s)

Storage/year sperm/semen

Storage/year reprod tissue

Storage/year oocyte(s)

Thawing cryopresrved embryo

Thawing cryopresrved sperm

Thaw cryoprsvrd reprod tiss

Thawing cryopresrved oocyte

X 0.2519 $17.96.

RBC antibody screen

Autologous blood op salvage

Blood type antigen donor ea

Blood typing patient serum

Blood typing rbc antigens

Blood typing rh phenotype

Compatibility test spin

Compatibility test incubate

Compatibility test electric

Plasma fresh frozen

Blood product/irradiation

Leukacyte transfusion

Vol reduction of blood/prod

Rbc pretx incubatj w/chemic

Rbc pretx incubatj w/enzyme

Rbc pretx incubatj w/densit

Rbc serum pretx id dilution

Split blood or products

Transfusion procedure

X 0.3504 $24.99.

RBC antibody elution

Compatibility test antiglob

Pooling blood platelets

Rbc pretreatment serum

X 0.4810 $34.30.

RBC antibody identification

Autologous blood process

Frozen blood prep
Frozen blood thaw

Frozen blood freeze/thaw

Rbc serum pretx incubj drug

Rbc serum pretx incubj/inhi

S 0.3788 $27.01 $0.00

Admin influenza virus vac $0.00

Admin pneumococcal vaccine $0.00 X 1.9249 $137.27 $33.59

Esoph imped function test

Esoph balloon distension ts

Breath hydrogen test

Electrogastrography

Electrogastrography w/test

Gastroenterology procedure

Ingest challenge addl 60 mi

X 4.2433 $302.60 $83.23

Esoph motility 3d topograph

Esoph motility w/stim/perf

Esophagus motility study

Esophgl motil w/stim/perfus

Gastric motility studies

Duodenal motility study

Acid perfusion of esophagus

Gastroesophageal reflux tes

G-esoph reflx tst w/electro

Esoph imped funct test > 1h

Gi wireless capsule measure

Ingest challenge ini 120 mi

X 0.9156 $65.29 $16.12

Nasal function studies

Facial nerve function test

Spontaneous nystagmus test

Positional nystagmus test

Optokinetic nystagmus test

Oscillating tracking test

Evoked auditory test limite

Evoked auditory tst complet

X 0.5032 $35.88.

Tympanometry & reflex thres

Pure tone audiometry air

Speech threshold audiometry

Speech audiometry complete

Loudness balance test

Tone decay hearing test

Sisi hearing test

Stenger test pure tone

Tympanometry
Acoustic refl threshold tst

Filtered speech hearing tes

Sensorineural acuity test

Synthetic sentence test

Select picture audiometry

Ear protector evaluation

Ent procedure/service

X 1.2424 $88.60 $18.04

Compre audiometry evaluatio

Audiometry air & bone

Comprehensive hearing test

Bekesy audiometry diagnosis

Acoustic immitance testing

Visual audiometry (vra)

Conditioning play audiometr

Auditory function 60 min

Tinnitus assessment

Aud brainstem implt program

X 1.6401 $116.96 $23.43

Staggered spondaic word tes

Stenger test speech

Cochlear implt f/up exam <7

Reprogram cochlear implt 7/

Cochlear implt f/up exam 7/

Reprogram cochlear implt 7/

Eval aud rehab status

X 0.6318 $45.06 $11.97

Spirometry up to 2 yrs old

Spirmtry w/brnchdil inf-2 y

Vital capacity test

Lung function test (MBC/MVV

Expired gas collection

Respiratory flow volume loo

CO2 breathing response curv

Exhaled air analysis

Pulm funct tst plethysmogra

Pulm function test by gas

Pulm funct test oscillometr

Pulmonary compliance study

Pulmonary service/procedure

Exhaled nitric oxide meas

X 0.8816 $62.87 $20.93

Temperature gradient studie

Breathing capacity test

Patient recorded spirometry

Patient recorded spirometry

Hypoxia response curve
Hast w/report

Hast w/oxygen titrate

Pulmonary stress test/simpl

Co/membane diffuse capacity

Bronchial allergy tests

X 2.5221 $179.86 $36.55

Cont msr bronchodil wheeze

Meas lung vol thru 2 yrs

Evaluation of wheezing

Pulm stress test/complex

Exhaled air analysis o2

Exhaled air analysis o2/co2

Exhaled carbon dioxide test

Breath recording infant

Bronchial allergy tests

X 1.3347 $95.18.

Photosensitivity tests

Eye allergy tests

Rapid desensitization

X 1.2128 $86.49.

Psycho testing by technicia

Psycho testing admin by com

Developmental test extend

Neuropsych tst admin w/comp

S 9.5309 $679.68.

Ht muscle image spect sing

Ht muscle image spect mult

Ht muscle image planar sing

Ht musc image planar mult

S 4.7173 $336.40 $126.64

Lung ventilat&perfus imagin

Lung perf&ventilat diferent

X 0.3478 $24.80.

Percut allergy skin tests

Perq & icut allg test venom

Perq&ic allg test drugs/bio

Icut allergy test drug/bug

Icut allergy titrate-airbor

Icut allergy test-delayed

Allergy patch tests

Photo patch test

Nose allergy test

Allergy immunology services

X 2.4863 $177.31.

Psycho testing by psych/phy

Neurobehavioral status exam

Neuropsych tst by psych/phy
Neuropsych testing by tec

S 3.7468 $267.20.

Ct hrt w/3d image

Ct hrt w/3d image congen

Ct angio hrt w/3d image

T 29.6863 $2,117.02.

Esophagus endoscopy

Uppr gi endoscopy w/stent

Endo cholangiopancreatograp

Endo cholangiopancreatograp

Small bowel endoscopy/stent

S bowel endoscope w/stent

Ileoscopy w/stent

Colonoscopy w/stent

Proctosigmoidoscopy w/stent

Sigmoidoscopy w/stent

Colonoscopy w/stent

S 107.0677 $7,635.32.

Male sling procedure

Insert tandem cuff

Insert semi-rigid prosthesi

S 175.4934 $12,514.96.

Insert uro/ves nck sphincte

Remove/replace ur sphincter

Insert self-contd prosthesi

Insert multi-comp penis pro

Remove/replace penis prosth

Remv/repl penis contain pro

T 37.5259 $2,676.08 $654.35

Hysteroscopy resect septum

Hysteroscopy remove myoma

Hysteroscopy ablation

S 24.2728 $1,730.97.

Discography cerv/thor spine

X-ray of lower spine disk

S 1.5990 $114.03 $26.88

Thyroid uptake measurement

Urinary bladder retention

Nuclear diagnostic exam

S 2.1040 $150.04 $47.69

Thyroid imaging w/blood flo

Endocrine nuclear procedure

S 3.2664 $232.94 $65.46

Thyroid imaging w/blood flo

Parathyroid planar imaging

S 2.7567 $196.59.

Ra tracer id of sentinl nod
Platelet survival kinetics

Platelet survival

Vit B-12 absorption exam

Vit b-12 absrp exam int fac

Vit b-12 absorp combined

Kidney function study

Iv inj ra drug dx study

S 6.1109 $435.79.

T-cell depletion of harvest

Tumor cell deplete of harvs

Rbc depletion of harvest

Platelet deplete of harvest

Volume deplete of harvest

Harvest stem cell concentrt

Plasma volume single

Plasma volume multiple

Red cell mass single

Red cell mass multiple

Blood volume

Red cell survival study

Red cell survival kinetics

Red cell sequestration

S 4.4086 $314.39 $90.78

Liver imaging

Liver imaging with flow

Liver imaging (3D)

Liver image (3d) with flow

Liver and spleen imaging

Liver & spleen image/flow

Hepatobiliary system imagin

Hepatobil syst image w/drug

S 3.6004 $256.76 $87.01

Salivary gland imaging

Serial salivary imaging

Salivary gland function exa

Esophageal motility study

Gastric mucosa imaging

Gastroesophageal reflux exa

Gastric emptying study

Acute GI blood loss imaging

GI protein loss exam

Meckels divert exam

Leveen/shunt patency exam

GI nuclear procedure

S 3.6694 $261.68 $94.20

Bone imaging limited area

Bone imaging multiple areas
Bone imaging whole body

Bone imaging 3 phase

Bone imaging (3D)

Musculoskeletal nuclear exa

S 4.6411 $330.97.

Follow-up angiography

Vascular flow imaging

Acute venous thrombus image

Venous thrombosis imaging

Ven thrombosis images bilat

Non-ophthalmic FVA

S 4.3329 $308.99 $93.33

Non-imaging heart function

Cardiac shunt imaging

Heart infarct image

Heart infarct image (ef)

Heart infarct image (3D)

Gated heart planar single

Gated heart multiple

Heart first pass single

Heart first pass multiple

Heart image spect

Cardiovascular nuclear exam

S 3.9257 $279.95 $90.90

Bone marrow imaging ltd

Bone marrow imaging mult

Bone marrow imaging body

Spleen imaging

Lymph system imaging

Blood/lymph nuclear exam

S 3.0984 $220.96 $71.16

Lung ventilation imaging

Lung perfusion imaging

Lung perfusion differential

Respiratory nuclear exam

S 6.4272 $458.34.

Brain image w/flow < 4 view

Brain image w/flow 4 + view

Brain imaging (3D)

Cerebrospinal fluid scan

CSF ventriculography

Cerebrospinal fluid scan

CSF leakage imaging

S 3.7033 $264.09 $72.42

Brain image < 4 views

Brain image 4+ views

Brain flow imaging only
CSF shunt evaluation

Nuclear exam of tear flow

Nervous system nuclear exam

S 4.6683 $332.91 $81.55

Kidney imaging morphol

Kidney imaging with flow

K flow/funct image w/o drug

K flow/funct image w/drug

K flow/funct image multiple

Kidney imaging (3D)

Ureteral reflux study

Testicular imaging w/flow

Genitourinary nuclear exam

S 4.2080 $300.09 $85.06

Thyroid met imaging

Thyroid met imaging/studies

Thyroid met imaging body

Tumor imaging limited area

S 3.3193 $236.71 $78.13

Nuclear rx oral admin

Nuclear rx iv admin

Nuclr rx interstit colloid

Nuclear rx intra-arterial

Nuclear medicine therapy

S 13.4001 $955.60.

Adrenal cortex & medulla im

Tumor imaging whole body

X 0.1356 $9.67 $2.17

Coombs test direct

Coombs test indirect qual

Coombs test indirect titer

Blood typing abo

Blood typing rh (d)

S 6.7828 $483.70.

Delivery comp imrt

Radiation tx delivery imrt

S 4.2209 $301.01.

Nuclear rx intracav admin

Hematopoietic nuclear tx

Nuclear rx intra-articular

S 7.0469 $502.54.

Tumor imaging mult areas

Tumor imaging whole body

Tumor imaging (3D)

Abscess imaging ltd area

Abscess imaging whole body

Nuclear localization/absces
T 22.0465 $1,572.20 $357.09

Bronchoscopy w/markers

Bronchoscopy/needle bx each

Bronchoscopy dilate/fx repr

Bronchoscopy dilate w/stent

Bronch w/balloon occlusion

Bronchoscopy bronch stents

Bronchoscopy revise stent

Bronchoscopy w/tumor excise

Bronchoscopy treat blockage

Bronchial valve init insert

Bronchial valve addl insert

Bronchial valve remov addl

Bronch thermoplsty 1 lobe

Bronch thermoplsty 2/> lobe

T 12.9960 $926.78 $207.70

Esoph scope w/submucous inj

Esophagus endoscopy/ligatio

Esoph optical endomicroscop

Esophagus endoscopy

Esophagus endoscopy

Esoph endoscopy dilation

Esoph endoscopy dilation

Esoph endoscopy repair

Esoph endoscopy w/us exam

Esoph endoscopy w/us fn bx

Endoscopic us exam esoph

Uppr gi endoscopy w/us fn b

Esoph endoscope w/drain cys

Uppr gi endoscopy w/us fn b

Upper GI endoscopy/ligation

Uppr gi scope dilate strict

Place gastrostomy tube

Esoph endoscopy dilation

Upper GI endoscopy/tumor

Operative upper GI endoscop

Uppr gi opticl endomicrscop

Operative upper GI endoscop

Operative upper GI endoscop

Endoscopic ultrasound exam

Dilate esophagus

Biopsy of bowel

Place gastrostomy tube perc

Place duod/jej tube perc

Change g-tube to g-j perc

Esophageal capsule endoscop

T 26.1852 $1,867.35.
Esophagus endoscopy/lesion

Esoph endoscopy ablation

Uppr gi scope w/thrml txmnt

Place gastrostomy tube

Repair stomach opening

EPS stomach plic

T 56.7444 $4,046.61.

Perq rf ablate tx pul tumor

Percut ablate liver rf

Biliary endoscopy thru skin

Perc rf ablate renal tumor

Perc cryo ablate renal tum

T 15.5387 $1,108.11 $240.83

Small bowel endoscopy

Small bowel endoscopy

Small bowel endoscopy

Small bowel endoscopy

Small bowel endoscopy

Small bowel endoscopy

Small bowel endoscopy

T 134.6442 $9,601.88.

Reconstruct shoulder joint

Revis reconst shoulder join

Reconstruct elbow joint

Replace elbow joint

Reconstruct head of radius

Revise reconst elbow joint

Revise reconst elbow joint

Reconstruct wrist joint

Reconstruct wrist joint

Wrist replacement

Revision of knee joint

Implant temple bone w/stimu

Temple bne implnt w/stimula

Temple bone implant revisio

Revise temple bone implant

S 2.6522 $189.14.

Application of body cast

Application of body cast

Application of body cast

Application of body cast

Application of body cast

Application of shoulder cas

Application of long arm cas

Application of forearm cast

Application of hip cast

Application of hip casts
Application of long leg cas

Application of long leg cas

Apply long leg cast brace

Application of long leg cas

Apply short leg cast

Apply short leg cast

Apply short leg cast

Apply rigid leg cast

Removal/revision of cast

T 16.8497 $1,201.60.

Change bile duct catheter

Revise/reinsert bile tube

Exchange drainage catheter

Insert subq exten to ip cat

Embedded ip cath exit-site

Change ext/int ureter stent

Change kidney tube

Change of ureter tube/stent

Replace/irrigate catheter

T 21.4711 $1,531.17.

Proctosigmoidoscopy fb

Proctosigmoidoscopy ablate

Proctosigmoidoscopy volvul

Anoscopy remove lesion

Anoscopy remove lesions

Anoscopy

T 45.7285 $3,261.04.

Removal of kidney stone

Removal of kidney stone

Laser surgery of prostate

Laser surgery of prostate

Prostate laser enucleation

Prostatic microwave thermot

Prostatic rf thermotx

S 0.6290 $44.86.

Assess hlth/behave init

Assess hlth/behave subseq

Intervene hlth/behave indiv

Interv hlth/behav fam w/pt

Alcohol/subs interv 15-30mn

Alcohol/subs interv >30 min

Tobacco-use counsel>10min $0.00

Annual alcohol screen 15 mi $0.00

Brief alcohol misuse counse $0.00

Depression screen annual $0.00

High inten beh couns STD 30 $0.00

Intens behave ther cardio d $0.00
Behavior counsel obesity 15 $0.00

Devlopment test interpt&rep

X 0.3285 $23.43 $5.17

Lab pathology consultation

Phys blood bank serv reactj

Phys blood bank serv authrj

Cytopath fl nongyn smears

Cytopath fl nongyn filter

Cytopath concentrate tech

Cytopath cell enhance tech

Forensic cytopathology

Cytopath smear other source

Cytp dx eval fna 1st ea sit

Flowcytometry/ tc 1 marker

Flowcytometry/read 2-8

Flowcytometry/read 9-15

Flowcytometry/read 16 & >

Tissue exam by pathologist

Tissue exam by pathologist

Special stains group 1

Special stains group 2

Histochemical stains add-on

Enzyme histochemistry

Path consult intraop 1 bloc

Intraop cyto path consult 1

Immunofluorescent study

Sputum specimen collection

Sperm identification

Cryopreservation sperm

T 167.9170 $11,974.67.

Transcath closure of asd

Transcath closure of vsd

S 0.3788 $27.01.

Immunization admin each add

Immune admin oral/nasal

Immune admin oral/nasal add

Immunotherapy one injection

Immunotherapy injections

Antigen therapy services

Antigen therapy services

Hydrate iv infusion add-on

Ther/proph/diag iv inf addo

Ther/prop/diag inj/inf proc

Chemotherapy unspecified

Admin hepatitis b vaccine $0.00 S 0.5487 $39.13 .

Immunization admin
Antigen therapy services

Antigen therapy services

Antigen therapy services

Antigen therapy services

Tx/proph/dg addl seq iv inf

Sc ther infusion addl hr

Sc ther infusion reset pump

Ther/proph/diag inj sc/im

Ther/proph/diag inj ia

Ther/proph/diag inj iv push

Tx/pro/dx inj new drug addo

Chemo anti-neopl sq/im

Chemo hormon antineopl sq/i

Chemo intralesional up to 7

Chemo iv infusion addl hr

S 1.0473 $74.69.

Antigen therapy services

Antigen therapy services

Hydration iv infusion init

Chemo iv push addl drug

Chemo iv infus each addl se

Chemo ia push tecnique

Chemo ia infuse each addl h

Chemotherapy injection

S 2.0507 $146.24.

Spin/brain pump refil & mai

Spin/brain pump refil & mai

Ther/proph/diag iv inf init

Sc ther infusion up to 1 hr

Chemo intralesional over 7

Chemo iv push sngl drug

Chemotherapy intracavitary

Chemotx admn prtl cavity

Refill/maint portable pump

Refill/maint pump/resvr sys

S 3.2322 $230.50.

Chemo iv infusion 1 hr

Chemo prolong infuse w/pump

Chemo ia infusion up to 1 h

Chemotherapy infusion metho

Chemotherapy into cns

Prolonged IV inf, req pump

S 27.5195 $1,962.50.

Admin + supply, tositumomab

V 0.7960 $56.77.

Office/outpatient visit new

Office/outpatient visit est
CA screen;pelvic/breast exa $0.00

Initial foot exam pt lops

Followup eval of foot pt lo

V 1.0332 $73.68.

Eye exam establish patient

Eye exam&tx estab pt 1/>vst

Office/outpatient visit new

Office/outpatient visit est

Office/outpatient visit est

Init nb em per day hosp

Same day nb discharge

Trans care mgmt 14 day disc

V 1.3596 $96.96.

Eye exam new patient

Eye exam new patient

Glucose monitoring cont

Office/outpatient visit new

Office/outpatient visit est

Trans care mgmt 7 day disch

Initial preventive exam $0.00

Visit for drug monitoring

V 1.8017 $128.48.

Office/outpatient visit new

Office/outpatient visit est

Demonstrate use home inr mo

Provide INR test mater/equi

V 2.4650 $175.79.

Dialysis one evaluation

Office/outpatient visit new

OPPS Service,sched team con

Direct refer hospital obser

V 0.7266 $51.82 $12.04

Emergency dept visit

V 1.2923 $92.16 $20.80

Emergency dept visit

V 2.0103 $143.36 $33.60

Emergency dept visit

V 3.2164 $229.37 $47.70

Emergency dept visit

V 4.8338 $344.71 $71.54

Emergency dept visit

S 7.5142 $535.86.

Critical care first hour

S 12.8233 $914.47.

Trauma Respons w/hosp criti

T 11.0230 $786.08.

Insert non-tunnel cv cath
Insert non-tunnel cv cath

Insert picc cath

Insert picc cath

Repair tunneled cv cath

Replace cvad cath

Replace picc cath

Removal tunneled cv cath

Mech remov tunneled cv cath

Reposition venous catheter

Thrombolytic art therapy

Thrombolytic venous therapy

T 24.5972 $1,754.10.

Insert tunneled cv cath

Insert tunneled cv cath

Insert picvad cath

Insert picvad cath

Replace tunneled cv cath

Replace tunneled cv cath

Replace picvad cath

Mech remov tunneled cv cath

Thromblytic art/ven therapy

Cessj therapy cath removal

T 31.2425 $2,228.00.

Insertion of infusion pump

Insert tunneled cv cath

Insert tunneled cv cath

Insert tunneled cv cath

Insert tunneled cv cath

Insert tunneled cv cath

Replace tunneled cv cath

Replace tunneled cv cath

Insertion catheter artery

Redo endovas vena cava filt

Rem endovas vena cava filte

Remove intrvas foreign body

Transcatheter biopsy

X 0.6889 $49.13 $12.39

Draw blood off venous devic

Collect blood from picc

Vascular surgery procedure

Irrig drug delivery device

Phlebotomy

V 0.9504 $67.78.

Lev 1 hosp type B ED visit

V 0.7589 $54.12.

Lev 2 hosp type B ED visit

V 1.2605 $89.89.
Lev 3 hosp type B ED visit

V 1.9113 $136.30 .

Lev 4 hosp type B ED visit

V 2.9070 $207.31 .

Lev 5 hosp type B ED visit

T 63.9715 $4,562.00 .

Place po breast cath for ra

Place breast cath for rad

Place breast rad tube/caths

Enlarge breast with implant

Delayed breast prosthesis

Breast reconstruction

S 12.2772 $875.52 .

Apply interstit radiat comp

T 31.6784 $2,259.08 .

Insert pleural cath

Insert tun ip cath perc

Ins tun ip cath for dial op

T 37.4589 $2,671.31 .

Repair defect of artery

Repair blood vessel lesion

Repair blood vessel lesion

Repair blood vessel lesion

Percut thrombect av fistula

T 108.1809 $7,714.70 .

Insert pulse gen dual leads

Insert pulse gen mult leads

Remv&replc pm gen dual lead

Remv&replc pm gen mult lead

Dual Chamber Pacemaker or Pacing T 142.8432 $10,186.58 .

Insrt heart pm atrial & ven

Upgrade of pacemaker system

Insert pacing lead & connec

L ventric pacing lead add-o

T 108.8606 $7,763.18 .

Perc drug-el cor stent sing

Perc drug-el cor stent bran

Perc d-e cor stent ather s

Perc d-e cor stent ather br

Perc d-e cor revasc t cabg

Perc d-e cor revasc t cabg

Perc d-e cor revasc w AMI s

Perc d-e cor revasc chro si

Perc d-e cor revasc chro ad

S 1.5109 $107.75 .

HYPERBARIC Oxygen

X 1.8519 $132.06 $27.10
Laryngeal function studies

Basic vestibular evaluation

Caloric vestibular test

Sinusoidal rotational test

Posturography

X 2.2023 $157.05.

Cytp urne 3-5 probes ea spe

Cytp urine 3-5 probes cmptr

Tissue exam by pathologist

Electron microscopy

Scanning electron microscop

Sat biopsy 10-20

Sat biopsy prostate 21-40

Sat biopsy prostate 41-60

Sat biopsy prostate: >60

S 4.7570 $339.24 $114.37

Ct angiography head

Ct angiography neck

Ct angiography chest

Ct angiograph pelv w/o&w/dy

Ct angio upr extrm w/o&w/dy

Ct angio lwr extr w/o&w/dye

Ct angio abdom w/o & w/dye

Ct angio abdominal arteries

S 15.9383 $1,136.61.

Proton trmt simple w/o comp

Proton trmt simple w/comp

S 0.4941 $35.24 $0.00

Dxa bone density/peripheral $0.00 S 9.5685 $682.36 .

Proton trmt intermediate

Proton treatment complex

T 10.0404 $716.01.

Access av dial grft for eva

Artery x-rays lung

Artery x-rays chest

Av dialysis shunt imaging

Vein x-ray arm/leg

Vein x-ray arms/legs

Vein x-ray chest

Vein x-ray neck

Vein x-ray skull

Vein x-ray skull epidural

Vein x-ray eye socket

Vein x-ray liver w/o hemody

T 40.8587 $2,913.76.

Prosth retina receive&gen
Repair of eye wound

Repair eye lesion

Partial removal of eye flui

Release of eye fluid

Replace eye fluid

Implant eye drug system

Removal of inner eye fluid

Laser treatment of retina

Laser treatment of retina

Vit for macular pucker

Vit for macular hole

Vit for membrane dissect

Repair detached retina

Repair detached retina

Rerepair detached retina

Repair retinal detach cplx

Remove eye implant material

T 41.7586 $2,977.93 $635.64

Insert ant segment drain in

Insert ant segment drain ex

Insert aqueous drain device

Remove blood clot from eye

Glaucoma surgery

Translum dil eye canal

Trnslum dil eye canal w/stn

Implant eye shunt

Revise eye shunt

Repair/graft eye lesion

Removal of iris

T 109.7287 $7,825.08.

Cryoablate prostate

T 2.4212 $172.66.

Declot vascular device

Inj w/fluor eval cv device

External cannula declotting

Thrombolytic therapy stroke

Change gastrostomy tube

Dissolve clot heart vessel

T 1.3951 $99.49.

Extrnl counterpulse, per tx

S 5.6047 $399.69 $95.30

Cardioversion electric ext

Cardioversion electric int

S 82.6392 $5,893.25.

Implant pat-active ht recor

S 2.4161 $172.30.

Photochemotherapy uv-a or b
T 10.0060 $713.56

.

Needle biopsy chest lining

Percut bx lung/mediastinum

Needle biopsy of liver

Needle biopsy pancreas

Biopsy abdominal mass

Renal biopsy perq

Drainage of kidney lesion

Needle biopsy spinal cord

T 21.1894 $1,511.08 $389.48

Implt/rpl crtd sns dev lead

Rev/remvl crtd sns dev lead

Periph field stimul revise

Laps rmvl nstim array vagus

Revise/remove neuroelectrod

Remove spine eltrd perq ara

Remove spine eltrd plate

Revise/remove neuroelectrod

or ReceiverT 36.4346 $2,598.26 $768.94

Rev/remvl crtd sns dev gen

Laps rmvl vgl arry & pls ge

Rmvl vagus nerve pls gen

Revise/remove neuroreceiver

Revise/remove neuroreceiver

Revise/rmv pn/gastr stimul

S 0.4761 $33.95.

Acoustic ecg 1+ analysis

Acoustic ecg analy & reprog

Icar ischm mntrng prgrm eva

icar ischm mntr interr eval

Elec alys vagus nrv pls gen

Implt subq defib interogat

Implt subq defib sys dev ev

Pm device progr eval sngl

Pm device progr eval dual

Pm device progr eval multi

Icd device progr eval 1 sng

Icd device progr eval dual

Icd device progr eval mult

Ilr device eval progr

Pm device eval in person

Icd device interrogate

Ilr device interrogate

Wcd device interrogate

Pm phone r-strip device eva

Pm/icd remote tech serv

Icm/ilr remote tech serv
Analyze pacemaker system

Set-up cardiovert-defibrill

S 2.6879 $191.68.

Csf shunt reprogram

Analyze spine infus pump

Analyze sp inf pump w/repro

Anal sp inf pmp w/reprg&fil

Anl sp inf pmp w/mdreprg&fi

S 1.5631 $111.47.

Ecg/monitoring and analysis

Interrogation vad in person

Analyze neurostim simple

Analyze neurostim complex

Cranial neurostim complex

Analyze neurostim brain/1h

Analyz neurostim brain addo

Io ga n-stim subsq w/reprog

T 5.1585 $367.87 $88.07

Mohs 1 stage h/n/hf/g

Mohs addl stage

Mohs 1 stage t/a/l

Mohs addl stage t/a/l

Mohs surg addl block

S 2.9820 $212.66.

Echo exam of fetal heart

Echo exam of fetal heart

Tte f-up or lmtd

S 1.0386 $74.07.

Ocular blood flow measure

Remove foreign body from ey

Remove foreign body from ey

Remove foreign body from ey

Remove foreign body from ey

Corneal smear

Revise eyelashes

Treatment of eyelid lesions

Dilate tear duct opening

Visual field examination(s)

Ophthalmic biometry

Eye exam with photos

Internal eye photography

Internal eye photography

Contact lens fitting

Contact lens fitting

Rx cntact lens aphakia 1 ey

Rx cntact lens aphakia 2 ey

Modification of contact len
Fit aphakia spectcl monofoc

Fit aphakia spectcl multifo

Repair & adjust spectacles

Glaucoma scrn hgh risk dire

T 15.8683 $1,131.62.

Biopsy eye muscle

Remove eyelid lining lesion

New eye exam & treatment

Eye exam & treatment

K $1,071.86.

Sr89 strontium

K $159.00.

Dexrazoxane HCl injection

K $268.91.

Filgrastim 300 mcg injectio

K $31.59.

Sargramostim injection

K $14.84.

Ampho b cholesteryl sulfate

K $14.83.

Amphotericin b liposome inj

K $204.73.

Rasburicase

K $259.14.

Chlorothiazide sodium inj

K $157.86.

Mechlorethamine hcl inj

K $578.93.

Dactinomycin injection

K $2.85.

Naltrexone, depot form

K $663.95.

Leuprolide acetate /3.75 MG

K $52.17.

Etoposide oral 50 MG

K $1,246.98.

Aldesleukin injection

K $116.81.

Bcg live intravesical vac

K $166.01.

Goserelin acetate implant

K $175.76.

Carmustine injection

K $63.21.

Asparaginase, NOS

K $19.19.

Daunorubicin injection
K $243.80

.

Daunorubicin citrate inj

K $6.69.

Docetaxel injection

K $122.65.

Nelarabine injection

K $52.39.

Floxuridine injection

K $12.25.

Gemcitabine hcl injection

K $30.49.

Ifosfamide injection

K $100.00.

Idarubicin hcl injection

K $101.68.

Cosyntropin injection NOS

K $19.06.

Interferon alfa-2b inj

K $2,517.90.

Interferon gamma 1-b inj

K $1,312.54.

Inj melphalan hydrochl 50 M

K $84.88.

Fludarabine phosphate inj

K $5,890.00.

Pegaspargase injection

K $946.92.

Pentostatin injection

K $659.72.

Rituximab injection

K $274.16.

Streptozocin injection

K $175.30.

Thiotepa injection

K $19,325.78.

Porfimer sodium injection

K $28.24.

Inj cladribine per 1 MG

K $5.98.

Leuprolide acetate injecito

K $36.22.

Mitoxantrone hydrochl / 5 M

K $6.29.

Oral aprepitant

K $92.25.

Hyalgan/supartz inj per dos

K $12.22.
Synvisc or Synvisc-One

K $151.09.

Euflexxa inj per dose

K $169.91.

Orthovisc inj per dose

K $83.77.

Rho d immune globulin inj

K $144.62.

Azathioprine parenteral

K $646.10.

Lymphocyte immune globulin

K $41.99.

Alglucerase injection

K $3.97.

Alpha 1 proteinase inhibito

K $5.47.

Injection,onabotulinumtoxin

K $1,013.87.

Cytomegalovirus imm IV /via

K $243.35.

Interferon beta-1b / .25 MG

K $16,960.00.

Ganciclovir long act implan

K $109.40.

Adenosine injection

K $0.90.

Factor viii

K $1.11.

Factor viii recombinant NOS

K $1.03.

Factor ix complex

K $1.63.

Anti-inhibitor

K $0.94.

Factor IX non-recombinant

K $1.24.

Factor IX recombinant

K $233.37.

Gamma globulin > 10 CC inj

K $27.55.

Capecitabine, oral, 500 mg

K $33.21.

Octagam injection

K $37.62.

Gammagard liquid injection

K $5.19.

Rhophylac injection
K $52.14

.

Hepagam b im injection

G $34.43.

Flebogamma injection

K $38.28.

Gamunex-C/Gammaked

R 1.0129 $72.23.

Frozen plasma, pooled, sd

R 2.3815 $169.83.

Whole blood for transfusion

K $224.75.

Reclast injection

R 1.1028 $78.64.

Cryoprecipitate each unit

R 2.7097 $193.24.

RBC leukocytes reduced

R 1.0591 $75.53.

Plasma, frz between 8-24hou

R 0.2848 $20.31.

Plasma protein fract,5%,50m

R 1.2846 $91.61.

Platelets, each unit

R 2.4626 $175.62.

Plaelet rich plasma unit

R 2.1285 $151.79.

Red blood cells unit

R 4.1562 $296.39.

Washed red blood cells unit

K $22.63.

Albumin (human),5%, 50ml

K $60.67.

Albumin (human), 5%, 250 ml

K $30.24.

Albumin (human), 25%, 20 ml

K $69.20.

Albumin (human), 25%, 50ml

R 0.6613 $47.16.

Plasmaprotein fract,5%,250m

R 1.9121 $136.36.

Blood split unit

R 2.1939 $156.45.

Platelets leukoreduced irra

R 3.8309 $273.19.

RBC leukoreduced irradiated

R 0.9531 $67.97.

Cryoprecipitatereducedplasm

R 2.5982 $185.29.
Blood, l/r, cmv-neg

R 10.8739 $775.45.

Platelets, hla-m, l/r, unit

R 1.6595 $118.34.

Platelets leukocytes reduce

K $129.42.

Injection glatiramer acetat

R 1.7169 $122.44.

Blood, l/r, froz/degly/wash

R 4.7192 $336.54.

Plt, aph/pher, l/r, cmv-neg

R 2.4667 $175.91.

Blood, l/r, irradiated

R 9.4536 $674.16.

Plate pheres leukoredu irra

R 9.2615 $660.47.

Plt, pher, l/r cmv-neg, irr

R 5.1700 $368.69.

RBC, frz/deg/wsh, l/r, irra

R 4.0183 $286.56.

RBC, l/r, cmv-neg, irrad

K $88.60.

Pralidoxime chloride inj

K $6.63.

Injection, voriconazole

K $40.70.

I131 iodide cap, rx

K $456.38.

Adalimumab injection

K $1,646.18.

Denileukin diftitox inj

K $10.67.

Temozolomide

K $52.14.

Hepagam b intravenous, inj

K $13.59.

Protein c concentrate

K $16,172.58.

Supprelin LA implant

K $11.23.

I131 iodide sol, rx

K $523.87.

Cytarabine liposome inj

K $1.61.

Inj, epirubicin hcl, 2 mg

K $53.51.

Temsirolimus injection
K $21.90

.

Busulfan injection

K $10.16.

Verteporfin injection

K $127.00.

Octreotide injection, depot

K $0.93.

Antihemophilic viii/vwf com

K $35.14.

Inj IVIG privigen 500 mg

K $87.15.

Dimethyl sulfoxide 50% 50 M

K $22.90.

Mitomycin injection

K $1,006.27.

Valrubicin injection

K $1.91.

Levoleucovorin injection

K $12.00.

Inj iron dextran

K $83.93.

Topotecan oral

K $108.65.

Rotavirus vacc 2 dose oral

K $38.06.

Apligraf

K $7.78.

Oasis wound matrix

K $7.78.

Oasis burn matrix

K $20.97.

Integra BMWD

K $11.40.

Integra DRT

K $42.57.

Dermagraft

K $98.39.

Graftjacket

K $25.17.

Integra matrix

K $37.76.

Primatrix

K $442.20.

Cymetra injectable

K $442.20.

Graftjacket xpress

K $1,176.14.
Integra flowable wound matr

K $6.87.

Gammagraft

K $3.57.

Triamcinolone A inj PRS-fre

K $3.04.

Antithrombin iii injection

K $1.10.

Xyntha inj

K $32.21.

Alloderm

K $3.04.

Acetylcysteine injection

K $201.40.

Edetate calcium disodium in

K $12.72.

Vivaglobin, inj

K $2,948.92.

Corticotropin injection

K $1.56.

Bevacizumab injection

K $10.19.

Alloskin

K $6.95.

AbobotulinumtoxinA

K $24.09.

Rilonacept injection

K $7,919.26.

Sm 153 lexidronam

K $2.99.

Degarelix injection

K $0.64.

Ferumoxytol, non-esrd

K $5.31.

Oral busulfan

G $89.41.

Canakinumab injection

K $7.29.

Hizentra injection

K $41.74.

Imuglucerase injection

K $2.75.

Olanzapine long-acting inj

K $103.35.

Antithrombin recombinant

K $75.95.

Methyl aminolevulinate, top
K $81.77

.

Oral fludarabine phosphate

K $37.51.

Collagenase, clost hist inj

K $152.43.

Amobarbital 125 MG inj

K $2.87.

Matristem micromatrix

K $73.04.

Ganciclovir sodium injectio

K $6.06.

Gonadorelin hydroch/ 100 mc

K $22.29.

Theraskin

K $2.38.

Oxacillin sodium injeciton

K $1.25.

Anidulafungin injection

K $3.13.

Topotecan injection

K $4.40.

Matristem wound matrix

K $0.88.

Wilate injection

G $38.32.

Belimumab injection

K $2.70.

Hydroxyprogesterone caproat

K $88.27.

Itraconazole injection

K $29.74.

Inj protirelin per 250 mcg

K $0.53.

Enfuvirtide injection

K $23.48.

Cyclophosphamide 100 MG inj

K $153.61.

Lumizyme injection

K $0.91.

Human fibrinogen conc inj

K $3.92.

Glassia injection

G $6.41.

Factor XIII anti-hem factor

K $614.91.

Gel-one

K $86.61.
Dermacell

G $980.50.

Aflibercept injection

K $498.27.

Imported lipodox inj

K $112.86.

Anthrax vaccine sc or im

K $0.58.

Minocycline hydrochloride

K $25.78.

Nabilone oral

G $92.81.

Eribulin mesylate injection

K $13.37.

Alloskin

K $134.24.

Arthroflex

K $46.69.

Flexhd/Allopatchhd/matrixhd

K $31.26.

Unite biomatrix

G $3,635.80.

Centruroides immune f(ab)

K $86.37.

Arbutamine hcl injection

K $62.74.

Calcitonin salmon injection

K $33.36.

Testosterone enanthate inj

K $1.54.

Injection estrone per 1 MG

K $86.33.

Gatifloxacin injection

K $88.27.

Diazoxide injection

K $2.65.

Aprotonin, 10,000 kiu

K $6.12.

Inj desmopressin acetate

K $85.00.

Intraocular Fomivirsen na

K $10.00.

Non-HEU TC-99M add-on/dose

K $235.05.

Icatibant injection

K $6.18.

Oral everolimus
K $0.37

.

Methylnaltrexone injection

K $1.77.

Visualization adjunct

K $17.06.

Interferon alfacon-1 inj

K $575.03.

Abciximab injection

K $24.64.

Eptifibatide injection

K $231.10.

Etanercept injection

K $18.43.

Rho(D) immune globulin h, s

K $526.34.

Daclizumab, parenteral

K $76.40.

Trastuzumab injection

K $97.15.

Hep b ig im

K $76.47.

Baclofen intrathecal trial

K $41.64.

Alefacept

K $38,058.06.

Y90 ibritumomab, rx

K $30,188.56.

I131 tositumomab, rx

K $276.27.

Tetanus immune globulin inj

K $170.10.

P32 Na phosphate

K $114.95.

P32 chromic phosphate

K $2,324.18.

Basiliximab

K $5.82.

Corticorelin ovine trifluta

K $3.32.

Darbepoetin alfa, non-esrd

K $9.87.

Epoetin alfa, non-esrd

K $899.63.

Digoxin immune fab (ovine)

K $299.94.

Ethanolamine oleate 100 mg

K $6.51.
Fomepizole, 15 mg

K $13.26.

Hemin, 1 mg

K $551.76.

Lepirudin

K $6.61.

Ziconotide injection

K $51.81.

Nesiritide injection

K $12.12.

Palifermin injection

K $1,029.95.

Pegaptanib sodium injection

K $27.49.

Inj secretin synthetic huma

K $61.24.

Treprostinil injection

K $0.90.

Humate-P, inj

K $1.61.

Factor viia

K $5.52.

Azacitidine injection

K $125.76.

Clofarabine injection

K $3,016.50.

Vantas implant

K $9.59.

Paclitaxel protein bound

U 1.5340 $109.39.

Brachytx, non-str, Gold-198

U 3.4927 $249.07.

Brachytx, non-str,HDR Ir-19

U 0.5205 $37.12.

Brachytx, NS, Non-HDRIr-192

K $9.25.

Oxaliplatin

K $265.48.

Pegademase bovine, 25 iu

K $66.69.

Urofollitropin, 75 iu

H

Power bone marrow bx needle

H

Telescopic intraocular lens

H

Catheter, ablation
K $42.40

.

Methyldopate hcl injection

U 219.7241 $15,669.18.

Brachytx, non-str,Yttrium-9

U 0.2949 $21.03.

Iodine I-125 sodium iodide

U 0.9229 $65.81.

Brachytx, non-str, HA, I-12

U 0.4285 $30.56.

Brachytx, non-str, HA, P-10

U 0.4994 $35.61.

Brachy linear, non-str,P-10

U 0.6548 $46.70.

Brachytx, stranded, I-125

U 0.5005 $35.69.

Brachytx, non-stranded,I-12

U 1.0578 $75.43.

Brachytx, stranded, P-103

U 0.8481 $60.48.

Brachytx, non-stranded,P-10

U 1.5461 $110.26.

Brachytx, stranded, C-131

U 0.9259 $66.03.

Brachytx, non-stranded,C-13

U 0.6548 $46.70.

Brachytx, stranded, NOS

U 0.4285 $30.56.

Brachytx, non-stranded, NOS

K $32.21.

Immune globulin, powder

K $175.05.

Quinupristin/dalfopristin

K $2.98.

Bivalirudin

K $23.34.

Gamma globulin 1 CC inj

K $1.80.

Sermorelin acetate injectio

K $310.18.

Amifostine

K $244.00.

Oprelvekin injection

K $66.98.

Somatropin injection

K $321.83.

Teniposide, 50 mg

K $457.73.
Urokinase 250,000 IU inj

K $1,156.08.

Monoclonal antibodies

K $8.69.

Tirofiban HCl

K $8.28.

Capecitabine, oral, 150 mg

K $65.18.

Infliximab injection

K $532.03.

Doxil injection

K $49.22.

Alteplase recombinant

K $426.87.

Filgrastim 480 mcg injectio

K $4,819.82.

Leuprolide acetate implant

K $161.18.

Aminolevulinic acid hcl top

T 156.2930 $11,145.72 $4,458.28

Ep & ablate supravent arrhy

Ep & ablate ventric tachy

Tx atrial fib pulm vein iso

K $39.32.

Linezolid injection

K $66.50.

Tenecteplase injection

K $1,240.19.

Rsv mab im 50mg

K $2,742.59.

Gemtuzumab ozogamicin inj

K $2,301.90.

Reteplase injection

K $139.36.

Tacrolimus injection

K $44.99.

Arsenic trioxide injection

K $10.89.

Inj, rimabotulinumtoxinB

K $12.85.

Caspofungin acetate

K $287.09.

IM inj interferon beta 1-a

K $25.86.

Rho d immune globulin 50 mc

K $10.99.

Amphotericin b lipid comple
K $179.99

.

Baclofen 10 MG injection

K $757.02.

Cidofovir injection

K $125.45.

Inj estrogen conjugate 25 M

K $111.23.

Glucagon hydrochloride/1 MG

K $139.24.

Ibutilide fumarate injectio

K $465.73.

Antithymocyte globuln rabbi

K $1,053.79.

Thyrotropin injection

K $587.78.

Alemtuzumab injection

K $224.10.

Zoledronic acid

K $2,838.89.

Injection, pegfilgrastim 6m

K $87.04.

Injection, Fulvestrant

K $18.30.

Injection, argatroban

K $160.30.

Triptorelin pamoate

K $0.54.

Daptomycin injection

K $5.45.

Risperidone, long acting

K $11.59.

Natalizumab injection

K $207.35.

Rabies ig im/sc

K $194.67.

Rabies ig heat treated

K $79.88.

Varicella-zoster ig im

K $116.14.

Bcg vaccine percut

K $208.73.

Rabies vaccine im

K $155.64.

Rabies vaccine id

K $106.49.

Meningococcal vaccine sc

K $102.08.
Encephalitis vaccine sc

K $94.13.

Meningococcal vaccine im

K $43.47.

Bortezomib injection

K $140.30.

Agalsidase beta injection

K $26.67.

Laronidase injection

K $19.02.

Palonosetron hcl

K $56.51.

Pemetrexed injection

K $62.32.

Bevacizumab injection

K $51.09.

Cetuximab injection

K $217.02.

Leuprolide acetate suspnsio

K $354.35.

Galsulfase injection

K $19,345.00.

Fluocinolone acetonide impl

K $0.94.

Micafungin sodium injection

K $1.46.

Tigecycline injection

K $151.64.

Ibandronate sodium injectio

K $22.19.

Abatacept injection

K $33.40.

Decitabine injection

K $455.03.

Idursulfase injection

K $398.31.

Ranibizumab injection

K $204.42.

Alglucosidase alfa injectio

K $89.02.

Panitumumab injection

K $195.46.

Eculizumab injection

K $33.82.

Lanreotide injection

K $66.49.

Ixabepilone injection
K $1.72

.

Fosaprepitant injection

K $20.61.

Bendamustine injection

K $53.67.

Regadenoson injection

K $48.18.

Romiplostim injection

K $2.96.

Inj, clevidipine butyrate

K $4.91.

Certolizumab pegol inj

K $66.43.

Artiss fibrin sealant

K $45.70.

C-1 esterase, cinryze

K $287.45.

Plerixafor injection

K $4.82.

Temozolomide injection

K $7.02.

Paliperidone palmitate inj

K $195.76.

Dexamethasone intra implant

K $2.65.

Telavancin injection

K $173.94.

Pralatrexate injection

K $45.44.

Ofatumumab injection

K $130.53.

Ustekinumab injection

K $318.22.

Ecallantide injection

K $3.57.

Tocilizumab injection

K $233.16.

Romidepsin injection

K $25.55.

Capsaicin 8% patch

K $30.23.

C-1 esterase, berinert

K $37.25.

Gammaplex injection

K $349.31.

Velaglucerase alfa

K $14.32.
Denosumab injection

K $32,696.25.

Sipuleucel-T auto CD54+

K $2,216.80.

Crotalidae poly immune fab

K $136.07.

Cabazitaxel injection

K $4.46.

Incobotulinumtoxin a

G $320.77.

Pegloticase injection

G $0.78.

Ceftaroline fosamil inj

G $0.11.

Acetaminophen injection

G $125.16.

Ipilimumab injection

G $13.28 $0.00

Patch, lidocaine/tetracaine $0.00 G $3.80 .

Belatacept injection

G $95.40.

Brentuximab vedotin inj

G $334.32.

Erwinaze injection

G $1.14 $0.00

Inj, bupivacaine liposome $0.00 G $102.86 .

Injection, pertuzumab

G $233.73.

Injection, glucarpidase

G $31.54.

Inj, taliglucerase alfa

G $29.29.

Injection, carfilzomib

G $16.96.

Injection, ziv-aflibercept

K $23.53.

Omalizumab injection

K $12.03.

SurgiMend, fetal

K $11.80.

SurgiMend, neonatal

K $24.15.

Integra Meshed Bil Wound Ma

G $10.36.

Oasis tri-layer wound matri
G $129.38

.

Epifix

K $4.35.

Endoform Dermal Template

G $137.47.

Grafix core

G $109.40.

Grafix prime

G $1,974.93 $0.00

Iodine I-123 ioflupane $0.00 R 1.8822 $134.23 .

Platelets, irradiated

R 7.1694 $511.27.

Platelet pheres leukoreduce

R 9.4761 $675.77.

Platelet pheresis irradiate

R 0.7967 $56.82.

Fr frz plasma donor reteste

R 6.7273 $479.74.

RBC deglycerolized

R 2.8319 $201.95.

RBC irradiated

R 22.6900 $1,618.09.

Granulocytes, pheresis unit

R 6.0577 $431.99.

Platelets, pheresis

R 1.1037 $78.71.

Plasma 1 donor frz w/in 8 h
Minimum 

Unadjusted 

Copayment

$7.43

$24.53

$54.08

$69.11

$125.05

$25.09
$145.12

$263.83

$5.68

$14.31
$21.40
$41.93

$283.56
$67.28

$116.73
$224.35
$332.22

$372.56

$491.80

$647.20
$4.48

$0.00

$4.69

$223.71

$3,278.95

$879.96
$422.33
$776.05

$207.82
$573.61

$890.03

$311.07
$461.36




$687.52
$1,172.50
$237.09

$413.23
$316.79

$865.57

$491.09
$18.91

$10.79
$3.91

$1,358.41

$381.77
$752.79
$1,008.06

$195.65
$470.96

$660.13

$512.95

$82.48

$15.46

$28.58

$67.45
$270.41

$405.37

$152.78
$7.02

$20.19

$49.49

$529.91
$1,534.24

$804.61

$141.08
$784.47

$620.05

$1,646.03

$1,322.48
$604.93

$391.74

$429.86
$32.17

$15.99

$21.73

$13.31

$5.34

$35.37

$60.71
$7.87

$231.30

$1,222.09

$336.63

$753.21

$4,502.41
$6,136.01

$52.09

$190.13

$577.74

$364.00
$734.23

$535.95

$87.93

$16.40
$1,582.11

$26.73

$546.02
$697.43

$1,024.28
$17.15

$50.30
$78.68
$222.33
$302.02
$79.78

$167.09
$96.61

$124.69

$150.14

$138.27
$84.07

$143.12

$87.87
$365.89

$473.20
$345.46

$405.56

$370.52

$485.83
$255.77

$46.47
$36.85

$0.00

$0.00

$0.00

$0.00

$0.00

$101.96

$226.26
$381.78
$547.42

$30.55

$281.91
$308.03

$474.65

$567.66
$99.27

$1,816.13

$86.79

$115.68

$555.10
$339.37

$193.45
$23.72

$46.82

$336.42
$1.65

$0.00

$99.63

$290.91
$527.89
$681.11

$171.34

$36.53
$58.35
$113.15
$751.72

$161.23
$34.53

$8.63

$36.81
$15.97

$268.95
$496.32
$650.22
$2,822.25

$1,731.37

$9.69
$28.98

$28.96

$225.90

$335.33
$83.28

$288.43

$46.36
$123.14

$273.59
$380.82
$566.55

$359.54

$593.48
$346.10

$82.16

$419.09

$15.62
$45.97

$99.72
$229.48
$359.96


$132.57

$655.78



$6,065.38

$9.19

$14.17
$0.00

$7.18

$51.10

$12.92
$19.87

$0.00

$30.95
$78.10

$111.74

$22.86

$101.52

$59.74

$16.55
$24.57

$41.91

$443.97
$726.08

$19.78

$59.43

$90.92
$0.00

$0.00

$0.00

$1,759.48

$78.49

$19.10

$35.91

$40.36
$21.95

$58.20

$211.23

$196.90

$82.17

$137.54
$4,120.45

$64.41

$5,131.67

$2,919.25

$87.73

$16.58

$22.04

$25.65

$12.14

$108.16
$61.21
$34.72

$65.87

$96.52

$67.70
$109.90

$9.93
$0.00

$1.37

$2.55
$7.62

$12.09
$3.60

$5.00

$6.86
$0.00

$0.00

$0.00

$27.46

$60.52

$13.06

$7.18
$17.72

$23.40

$9.02

$12.58
$35.98

$19.04

$17.30

$135.94

$67.28

$4.96

$35.47
$53.44

$423.41

$1,527.07

$2,503.00

$535.22

$346.20

$22.81

$30.01

$46.59

$39.32
$87.16

$62.88

$51.36

$52.34
$66.20

$61.80

$55.99

$44.20

$91.67

$52.82
$66.59

$60.02

$47.35

$191.12

$1.94

$96.74

$60.21

$100.51
$314.44

$185.36

$373.47
$809.33

$221.63

$1,920.38

$37.83
$240.32

$306.24

$652.21

$8.98

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00
$0.00

$4.69

$2,394.94

$5.41

$0.00

$7.83
$14.94

$29.25

$46.10

$392.50

$11.36
$0.00

$14.74

$19.40

$0.00

$25.70

$35.16

$10.37

$18.44

$28.68

$45.88

$68.95

$107.18

$182.90

$157.22
$350.82

$445.60

$9.83

$13.56

$10.83

$17.98
$27.26

$41.47

$912.40

$175.11

$451.82

$534.27

$1,542.94

$2,037.32

$1,552.64

$21.55

$26.42
$31.41

$67.85

$227.33

$0.00

$0.00

$136.48

$143.21

$582.76
$595.59

$1,565.02

$34.54

$19.90

$79.94

$1,178.65

$34.46
$142.72

$302.22

$519.66

$6.79
$38.34

$22.30

$73.58

$42.54

$14.82
$226.33

$214.38

$31.80

$53.79

$6.32

$2.97

$2.97

$40.95

$51.83

$31.58

$115.79

$0.57

$132.79

$10.44

$249.40

$23.37

$33.21

$35.16

$12.65

$3.84
$48.76

$1.34

$24.53

$10.48

$2.45

$6.10

$20.00

$20.34

$3.82

$503.58

$262.51

$16.98

$1,178.00

$189.39

$131.95

$54.84

$35.06

$3,865.16

$5.65

$1.20

$7.25

$1.26

$18.45

$2.45
$30.22

$33.99

$16.76

$28.93

$129.22

$8.40

$0.80

$1.10

$202.78

$48.67

$3,392.00

$21.88

$0.18

$0.23

$0.21

$0.33

$0.19

$0.25

$46.68

$5.51

$6.65

$7.53

$1.04
$10.43

$6.89

$7.66

$14.45

$33.97

$44.95

$15.73

$38.65

$15.11

$4.07

$18.33

$35.13

$30.36

$59.28

$4.53

$12.14

$6.05

$13.84

$9.44

$27.28

$31.29

$54.64

$13.60

$37.06
$155.09

$23.67

$25.89

$24.49

$67.31

$35.19

$134.84

$132.10

$73.74

$57.32

$17.72

$1.33

$8.14

$91.28

$329.24

$2.14

$10.43

$2.72

$3,234.52

$2.25

$104.78

$0.33

$10.71
$4.38

$2.04

$25.40

$0.19

$7.03

$17.43

$4.58

$201.26

$0.39

$2.40

$16.79

$21.73

$7.62

$1.56

$1.56

$4.20

$2.28

$8.52

$19.68

$5.04

$7.56

$88.44

$88.44

$235.23
$1.38

$0.72

$0.61

$0.22

$6.45

$0.61

$40.28

$2.55

$589.79

$0.32

$2.04

$1.39

$4.82

$1,583.86

$0.60

$0.13

$1.07

$17.89

$1.46

$8.35

$0.55

$20.67

$15.19
$16.36

$7.51

$30.49

$0.58

$14.61

$1.22

$4.46

$0.48

$0.25

$0.63

$0.88

$0.18

$7.67

$0.54

$17.66

$5.95

$0.11

$4.70

$30.73

$0.19

$0.79

$1.29

$122.99

$17.33
$196.10

$99.66

$22.58

$0.12

$5.16

$18.57

$2.68

$26.85

$9.34

$6.26

$727.16

$17.28

$12.55

$6.68

$0.31

$17.27

$17.66

$0.53

$1.23

$17.00

$2.00

$47.01

$1.24
$0.08

$0.36

$3.42

$115.01

$4.93

$46.22

$3.69

$105.27

$15.28

$19.43

$15.30

$8.33

$7,611.62

$6,037.72

$55.26

$34.02

$22.99

$464.84

$1.17

$0.67

$1.98

$179.93

$59.99

$1.31
$2.66

$110.36

$1.33

$10.37

$2.43

$205.99

$5.50

$12.25

$0.18

$0.33

$1.11

$25.16

$603.30

$1.92

$21.88

$49.82

$7.43

$1.85

$53.10

$13.34
$8.48

$3,133.84

$4.21

$13.17

$6.12

$7.13

$9.34

$7.14

$15.09

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