**Ad dendum C. - Final HCPCS Codes Payable Under the 2012 OPPS by A** **PC**

**AP C**  **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 101400007 20103

0007 26011 0007 28001 0007 38300 0007 55100 0007 57022 0008 Level III Incision and Drainage 0008 10180 0008 19020 0008 21501 0008 23030 0008 23031 0008 23930 0008 23931 0008 27301 0008 27603 0008 38305 0008 51080 0008 54015 0008 54115 0008 57023 0008 69005 0012 Level I Debridem ent & Destruction 0012 11719 0012 11740 0012 17003 0012 17999 0012 96999 0012 G0127 0013 Level II Debridem ent & Destruction 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 117210013 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 0183T 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 364690015 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 Debridem ent & 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 0017 Level V Debridem ent & Destruction 0017 46910 0017 46917 0017 46922 0017 46924 0017 54055 0017 54057 0017 54060 0017 540650017 56501

0017 56515 0019 Level I Excision/ Biopsy 0019 11010 0019 11011 0019 11012 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 11047 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 11643 0020 20005 0020 20220 0020 21011 0020 210120020 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 11623 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 230770021 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 158300022 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 273240022 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 Smoking Cessation Services0031 99406

0031 99407 0031 G0436 0031 G0437 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 Im plantation of Neurostimulator Generator 0039 0268T 0039 61885 0039 63685 0039 64590 0040 Level I Im plantation/Revision/Replacem ent of Neurostimulator Electrodes 0040 0282T 0040 63650 0040 63663 0040 63664 0040 64553 0040 64555 0040 64561 0040 64565 0041 Level I Arthroscopy 0041 29800 0041 29804 0041 298050041 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 298200042 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 254470047 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 251150049 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 202500050 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 241010050 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 252100050 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 273850050 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 278940050 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 254910051 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 244980052 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 261050053 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 269510053 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 265480054 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 281080055 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 283100055 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 282980057 28299

0058 Level I Strapping and 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 29130 0058 29131 0058 29200 0058 29240 0058 29260 0058 29280 0058 29440 0058 29450 0058 29505 0058 29515 0058 29520 0058 29530 0058 29540 0058 29550 0058 29580 0058 29581 0058 29582 0058 29583 0058 29584 0058 29590 0058 29700 0058 29705 0058 29715 0058 29720 0058 29730 0058 29740 0058 29750 0058 29799 0060 Manipulation Therapy 0060 98925 0060 98926 0060 98927 0060 98928 0060 989290060 98940

0060 98941 0060 98942 0061 Level II Im plantation/Revision/Replacem ent 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 285050062 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 284450063 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 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 G03390069 Thoracoscopy

0069 32601 0069 32604 0069 32606 0069 32607 0069 32608 0069 32609 0069 39400 0070 Thoracentesis/Lavage Procedures 0070 32201 0070 32420 0070 32421 0070 32422 0070 32551 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 31240 0074 31510 0074 315120074 31515

0074 31525 0074 31526 0074 31528 0074 31529 0074 31530 0074 31531 0074 31535 0074 31536 0074 31540 0074 31541 0074 31570 0074 31576 0075 Level V Endoscopy Upper Airway 0075 31239 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 31545 0075 31546 0075 31560 0075 31561 0075 31571 0075 31578 0076 Level I Endoscopy Lower Airway 0076 0251T 0076 0252T 0076 31622 0076 31623 0076 31624 0076 31625 0076 31628 0076 31629 0076 31632 0076 31633 0076 316340076 31635

0076 31637 0076 31643 0076 31645 0076 31646 0076 31656 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 32552 0078 94060 0078 94642 0078 94660 0079 Ventilation Initiation and Managem ent 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 0234T0082 0236T

0082 0237T 0082 0238T 0082 37204 0082 61623 0082 61626 0082 92995 0082 92996 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 92982 0083 92984 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 936500086 Level III Electrophysiologic Procedures

0086 93651 0086 93652 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 33206 0089 33207 0090 Level I Insertion/Replacement of Permanent Pacemaker 0090 33212 0090 33227 0091 Level II Vascular Ligation 0091 364750091 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 929500094 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 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 37201 0103 372020103 92974

0103 93503 0103 93505 0104 Transcatheter Placement of Intracoronary Stents 0104 92980 0104 92981 0105 Repair/Revision/Removal of Pacemakers, AICDs, or Vascular Devices 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 33210 0106 33211 0106 33216 0106 33217 0107 Insertion of Cardioverter-Defibrillator Pulse Generator 0107 33230 0107 33231 0107 33240 0107 33262 0107 33263 0107 33264 0108 Insertion/Replacement/Repair of AICD Leads, Generator, and Pacing Electrodes 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 365120111 36513

0111 36514 0111 38206 0111 38242 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 494190121 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 0128 Echocardiogram with Contrast 0128 C8921 0128 C8922 0128 C8923 0128 C8924 0128 C8925 0128 C8926 0128 C8927 0128 C8928 0128 C8929 0128 C8930 0129 Level I Closed Treatment Fracture 0129 21800 0129 21820 0129 22305 0129 23500 0129 23540 0129 23570 0129 236000129 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 272000129 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 286000129 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 43770 0131 44180 0131 441860131 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 44206 0132 44207 0132 44208 0132 49652 0132 49653 0132 49654 0132 49655 0132 496560132 49657

0132 54692 0132 58541 0132 58542 0132 58543 0132 58544 0132 58550 0133 Level I Skin Repair 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 120450134 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 15115 0135 15221 0135 15273 0135 152770135 20926

0135 43887 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 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 23921 0136 25929 0136 33222 0136 33223 0137 Level V Skin Repair 0137 11960 0137 13160 0137 14301 0137 14302 0137 14350 0137 15100 0137 15101 0137 15120 0137 15121 0137 155700137 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 443120137 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 434530140 43456

0141 Level I Upper GI Procedures 0141 43200 0141 43202 0141 43204 0141 43234 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 Sm all 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 453860143 45391

0143 45392 0146 Level I Sigmoidoscopy and Anoscopy 0146 0227T 0146 45300 0146 45330 0146 45331 0146 45332 0146 45333 0146 45335 0146 45337 0146 45338 0146 45341 0146 46606 0146 46608 0146 46614 0147 Level II Sigmoidoscopy and Anoscopy 0147 45303 0147 45305 0147 45308 0147 45309 0147 45315 0147 45317 0147 45334 0147 45339 0147 45340 0147 45342 0147 46604 0147 46611 0148 Level I Anal/Rectal Procedures 0148 0288T 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 0184T 0149 45000 0149 45005 0149 45100 0149 451080149 45150

0149 45160 0149 45171 0149 45172 0149 45190 0149 45500 0149 45905 0149 45910 0149 45990 0149 46020 0149 46040 0149 46045 0149 46060 0149 46080 0149 46200 0149 46230 0149 46250 0149 46255 0149 46257 0149 46258 0149 46260 0149 46261 0149 46262 0149 46270 0149 46275 0149 46280 0149 46285 0149 46288 0149 46320 0149 46505 0149 46700 0149 46753 0149 46754 0149 46940 0149 46945 0149 46946 0149 49442 0150 Level IV Anal/Rectal Procedures 0150 45505 0150 45541 0150 45560 0150 46706 0150 46707 0150 46750 0150 46760 0150 46761 0150 467620150 46947

0150 C9716 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 Abdom inal 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 495530154 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 0249T 0155 45020 0155 45915 0155 46070 0155 46220 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 G01210159 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 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 509570162 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 524000162 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 532000166 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 0181 Level II Male Genital Procedures 0181 37790 0181 54110 0181 541110181 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 547000183 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 571560189 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 Fem ale 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 Fem ale Reproductive Proc 0193 56440 0193 56441 0193 56442 0193 56620 0193 56625 0193 56700 0193 567400193 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 598410193 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 573100202 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 645050204 64508

0204 64566 0204 64611 0204 64612 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 623100207 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 Lam inotom ies 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 62351 0208 63001 0208 63003 0208 63005 0208 63011 0208 63012 0208 63015 0208 63016 0208 63017 0208 63020 0208 63030 0208 63035 0208 630400208 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 93229 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 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 Tests 0215 0199T 0215 0278T 0215 95869 0215 95870 0215 958870215 95900

0215 95903 0215 95904 0215 95905 0215 95933 0215 95934 0215 95936 0215 95999 0216 Level III Nerve and Muscle Tests 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 Tests 0218 0272T 0218 0273T 0218 0285T 0218 90867 0218 90868 0218 90869 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 95921 0218 95922 0218 95923 0218 959280218 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 647740220 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 648930221 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 921400230 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 Segm ent 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 667000233 66710

0233 66720 0233 66840 0233 67880 0233 68130 0234 Level IV Anterior Segm ent Eye Procedures 0234 0099T 0234 0123T 0234 65272 0234 65275 0234 65426 0234 65805 0234 65810 0234 65815 0234 65820 0234 65850 0234 65870 0234 65875 0234 65920 0234 65930 0234 66130 0234 66150 0234 66155 0234 66160 0234 66165 0234 66170 0234 66172 0234 66185 0234 66600 0234 66605 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 672210235 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 678750239 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 688110240 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 673110243 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 210890250 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 426600251 42700

0251 69100 0251 69400 0251 69401 0251 69420 0251 92502 0252 Level III ENT Procedures 0252 20100 0252 20500 0252 21073 0252 21110 0252 21295 0252 21400 0252 21451 0252 21685 0252 30100 0252 30124 0252 30200 0252 30210 0252 30220 0252 30801 0252 31002 0252 31603 0252 31605 0252 31615 0252 40650 0252 40652 0252 40654 0252 40801 0252 40805 0252 40819 0252 40831 0252 41010 0252 41016 0252 41017 0252 41018 0252 41100 0252 41115 0252 41252 0252 41512 0252 41520 0252 41820 0252 41821 0252 42100 0252 42140 0252 42650 0252 428000252 42900

0252 43020 0252 60000 0252 69150 0252 69405 0252 69433 0252 C9727 0253 Level IV ENT Procedures 0253 21085 0253 21282 0253 21315 0253 21320 0253 21337 0253 21401 0253 21452 0253 21485 0253 21495 0253 21497 0253 30110 0253 30115 0253 30117 0253 30130 0253 30310 0253 30320 0253 30802 0253 30930 0253 40500 0253 40520 0253 40810 0253 40812 0253 40814 0253 40820 0253 41000 0253 41007 0253 41008 0253 41105 0253 41110 0253 41112 0253 41113 0253 41116 0253 41510 0253 41806 0253 41822 0253 41825 0253 41828 0253 41830 0253 418500253 41872

0253 42104 0253 42106 0253 42160 0253 42235 0253 42281 0253 42300 0253 42305 0253 42330 0253 42335 0253 42340 0253 42408 0253 42409 0253 42600 0253 42720 0253 42802 0253 42804 0253 42972 0253 43030 0253 69105 0253 69222 0253 69421 0253 69424 0253 69436 0253 69540 0253 69801 0254 Level V ENT Procedures 0254 21010 0254 21030 0254 21031 0254 21032 0254 21040 0254 21076 0254 21120 0254 21121 0254 21122 0254 21123 0254 21125 0254 21137 0254 21181 0254 21235 0254 21296 0254 21325 0254 21330 0254 21335 0254 21338 0254 213390254 21345

0254 21346 0254 21356 0254 21360 0254 21421 0254 21440 0254 21445 0254 21454 0254 30118 0254 30120 0254 30140 0254 30430 0254 30520 0254 30630 0254 31020 0254 31040 0254 31070 0254 31300 0254 31600 0254 31601 0254 31610 0254 31611 0254 31612 0254 31613 0254 31785 0254 31820 0254 31825 0254 31830 0254 40510 0254 40525 0254 40527 0254 40530 0254 40816 0254 40840 0254 40842 0254 40843 0254 41006 0254 41019 0254 41114 0254 41120 0254 41500 0254 41530 0254 41805 0254 41823 0254 41826 0254 41827 0254 418700254 41874

0254 42107 0254 42145 0254 42260 0254 42405 0254 42450 0254 42500 0254 42665 0254 42806 0254 42808 0254 42810 0254 42820 0254 42821 0254 42825 0254 42826 0254 42830 0254 42831 0254 42835 0254 42836 0254 42842 0254 42860 0254 42870 0254 42950 0254 42955 0254 43420 0254 62000 0254 69120 0254 69140 0254 69300 0254 69440 0254 69502 0254 69610 0254 69620 0254 69650 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 21025 0256 21026 0256 21029 0256 210340256 21044

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 21127 0256 21138 0256 21139 0256 21150 0256 21172 0256 21175 0256 21193 0256 21195 0256 21198 0256 21199 0256 21206 0256 21208 0256 21209 0256 21210 0256 21215 0256 21230 0256 21240 0256 21242 0256 21243 0256 21244 0256 21245 0256 21246 0256 21248 0256 21249 0256 21256 0256 21260 0256 21261 0256 212630256 21267

0256 21270 0256 21275 0256 21280 0256 21340 0256 21355 0256 21365 0256 21385 0256 21386 0256 21387 0256 21390 0256 21395 0256 21406 0256 21407 0256 21408 0256 21453 0256 21461 0256 21462 0256 21465 0256 21470 0256 21490 0256 30125 0256 30150 0256 30160 0256 30400 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 31075 0256 31080 0256 31081 0256 31084 0256 31085 0256 310860256 31087

0256 31090 0256 31200 0256 31201 0256 31205 0256 31320 0256 31400 0256 31420 0256 31580 0256 31582 0256 31588 0256 31590 0256 31595 0256 31614 0256 31750 0256 31755 0256 40700 0256 40701 0256 40702 0256 40720 0256 40761 0256 40844 0256 40845 0256 42120 0256 42182 0256 42200 0256 42205 0256 42210 0256 42215 0256 42220 0256 42225 0256 42226 0256 42227 0256 42410 0256 42415 0256 42420 0256 42425 0256 42440 0256 42505 0256 42507 0256 42508 0256 42509 0256 42510 0256 42725 0256 42815 0256 42844 0256 428900256 42892

0256 42962 0256 43130 0256 60252 0256 60260 0256 60271 0256 60500 0256 60502 0256 60520 0256 61330 0256 61334 0256 69310 0256 69320 0256 69450 0256 69501 0256 69505 0256 69511 0256 69530 0256 69550 0256 69552 0256 69601 0256 69602 0256 69603 0256 69604 0256 69605 0256 69631 0256 69632 0256 69633 0256 69635 0256 69636 0256 69637 0256 69641 0256 69642 0256 69643 0256 69644 0256 69645 0256 69646 0256 69660 0256 69661 0256 69662 0256 69666 0256 69667 0256 69670 0256 69676 0256 69700 0256 69711 0256 697200256 69725

0256 69740 0256 69745 0256 69805 0256 69806 0256 69820 0256 69840 0256 69905 0256 69910 0256 69915 0256 69955 0256 69960 0256 69970 0259 Level VII ENT Procedures 0259 69930 0260 Level I Plain FilmExcept Teeth 0260 70030 0260 70100 0260 70110 0260 70120 0260 70130 0260 70140 0260 70150 0260 70160 0260 70190 0260 70200 0260 70210 0260 70220 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 71030 0260 71035 0260 71100 0260 71101 0260 71110 0260 71120 0260 711300260 72020

0260 72040 0260 72069 0260 72070 0260 72072 0260 72074 0260 72080 0260 72100 0260 72120 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 73520 0260 73540 0260 73550 0260 73560 0260 73562 0260 73564 0260 73565 0260 73590 0260 73592 0260 73600 0260 73610 0260 73620 0260 73630 0260 73650 0260 73660 0260 740000260 74010

0260 74020 0260 76010 0260 76499 0260 77071 0260 77072 0260 77073 0260 77077 0260 77082 0260 G0130 0261 Level II Plain FilmExcept Teeth Including Bone Density Measurement 0261 70134 0261 70260 0261 71111 0261 72010 0261 72050 0261 72052 0261 72090 0261 72110 0261 72114 0261 74022 0261 74710 0261 75809 0261 75898 0261 76100 0261 77074 0261 77075 0261 77076 0262 Plain Filmof Teeth 0262 70300 0262 70310 0262 70320 0262 70355 0263 Level I Miscellaneous Radiology Procedures 0263 70170 0263 70373 0263 70390 0263 71040 0263 71060 0263 74190 0263 74305 0263 74470 0263 74740 0263 76080 0263 76101 0263 76102 0263 770530263 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 768730266 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 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 W ithout Contrast 0269 93304 0269 93306 0269 93307 0269 93313 0269 93315 0269 93350 0270 Level III Echocardiogram W ithout Contrast 0270 93303 0270 93312 0270 93316 0270 93318 0270 93351 0272 Fluoroscopy 0272 43752 0272 43756 0272 43757 0272 70370 0272 703710272 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 74240 0276 74241 0276 74246 0276 74247 0276 74250 0276 74260 0276 74270 0276 74283 0276 74290 0276 74291 0277 Level II Digestive Radiology 0277 49465 0277 74245 0277 74249 0277 74251 0277 74280 0278 Diagnostic Urography 0278 74400 0278 74410 0278 74415 0278 74420 0278 74425 0278 744300278 74440

0278 74445 0278 74450 0278 74455 0278 74775 0279 Level II Angiography and Venography 0279 36251 0279 36252 0279 36253 0279 36254 0279 75600 0279 75605 0279 75625 0279 75630 0279 75658 0279 75665 0279 75676 0279 75680 0279 75685 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 75650 0280 75660 0280 75662 0280 75671 0282 Miscellaneous Computed Axial Tomography 0282 76380 0282 76497 0283 Computed Tomography with Contrast0283 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 Segm ent Eye Procedures 0293 65770 0299 Hyperthermia and Radiation Treatment Procedures 0299 77470 0299 77600 0299 77605 0299 776100299 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 784910308 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 Radioelem ent Applications 0312 77761 0312 77762 0312 77763 0312 77776 0312 77777 0312 77799 0313 Brachy therapy 0313 0182T 0313 77785 0313 77786 0313 77787 0315 Level II Im plantation of Neurostimulator Generator 0315 61886 0317 Level II Miscellaneous Radiology Procedures 0317 74320 0317 75801 0317 75803 0317 75805 0317 75807 0317 76098 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 90804 0322 908050322 90810

0322 90811 0322 90899 0322 G0397 0323 Extended Individual Psychotherapy 0323 90801 0323 90802 0323 90806 0323 90807 0323 90808 0323 90809 0323 90812 0323 90813 0323 90814 0323 90815 0323 90845 0323 90865 0323 90880 0324 Family Psychotherapy 0324 90846 0324 90847 0325 Group Psychotherapy 0325 90849 0325 90853 0325 90857 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 D42680330 D4270

0330 D4271 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 Contrast0333 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 C89350337 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 0299T 0340 0300T 0340 11980 0340 11981 0340 11982 0340 11983 0340 15852 0340 15860 0340 19295 0340 20665 0340 20979 0340 30300 0340 40804 0340 42809 0340 43753 0340 437540340 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 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 0279T 0342 0280T 0342 80500 0342 80502 0342 86077 0342 86079 0342 88177 0342 88187 0342 88199 0342 88299 0342 88300 0342 88311 0342 88332 0342 88363 0342 88399 0342 89049 0342 89240 0342 89398 0343 Level III Pathology0343 85097

0343 86078 0343 88112 0343 88162 0343 88173 0343 88182 0343 88188 0343 88189 0343 88304 0343 88305 0343 88323 0343 88331 0343 88342 0343 88346 0343 88347 0343 88355 0343 88358 0343 88360 0343 88367 0343 88385 0343 89230 0343 89257 0343 89260 0343 89261 0344 Level IV Pathology 0344 0058T 0344 0059T 0344 88120 0344 88121 0344 88307 0344 88309 0344 88325 0344 88356 0344 88361 0344 88362 0344 88365 0344 88368 0344 88386 0344 89250 0344 89251 0344 89253 0344 89254 0344 89255 0344 89258 0344 89264 0344 89268 0344 892720344 89280

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 86870 0346 86922 0346 86965 0346 86975 0346 86978 0347 Level III Transfusion Laboratory Procedures 0347 86890 0347 86930 0347 86931 0347 86932 0347 86977 0350 Adm inistration of flu and PPV vaccine0350 G0008

0350 G0009 0350 G9141 0360 Level I Alim entary Tests 0360 91037 0360 91040 0360 91065 0360 91132 0360 91133 0360 91299 0361 Level II Alim entary Tests 0361 0240T 0361 0241T 0361 0242T 0361 91010 0361 91013 0361 91020 0361 91022 0361 91030 0361 91034 0361 91035 0361 91038 0361 95075 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 Audiom etry 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 925830364 92596

0364 92700 0365 Level II Audiom etry 0365 0212T 0365 92553 0365 92557 0365 92561 0365 92570 0365 92579 0365 92582 0365 92620 0365 92625 0365 92640 0366 Level III Audiom etry 0366 92572 0366 92577 0366 92601 0366 92602 0366 92603 0366 92604 0366 92626 0367 Level I Pulmonary Test 0367 93740 0367 94010 0367 94011 0367 94012 0367 94014 0367 94015 0367 94150 0367 94200 0367 94250 0367 94375 0367 94400 0367 94453 0367 94690 0367 94726 0367 94727 0367 94728 0367 94750 0367 94799 0367 95012 0368 Level II Pulmonary Tests 0368 94450 0368 94452 0368 94620 0368 94680 0368 947290368 94770

0368 95071 0369 Level III Pulmonary Tests 0369 0244T 0369 94013 0369 94070 0369 94621 0369 94681 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 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 95010 0381 95015 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 0382 96120 0383 Cardiac Computed Tomographic Imaging 0383 75572 0383 75573 0383 755740384 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-im aging Nuclear Medicine 0389 78000 0389 78001 0389 78003 0389 78730 0389 78999 0390 Level I Endocrine Imaging 0390 78010 0390 78011 0390 78099 0391 Level II Endocrine Imaging 0391 78006 0391 78007 0391 78070 0392 Level II Non-imaging Nuclear Medicine 0392 38792 0392 781900392 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 Im aging 0396 78300 0396 78305 0396 783060396 78315

0396 78320 0396 78399 0397 Vascular Imaging 0397 78445 0397 78456 0397 78457 0397 78458 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 786990404 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 IMRT Treatment Delivery 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 0250T 0415 0276T0415 0277T

0415 31626 0415 31630 0415 31631 0415 31636 0415 31638 0415 31640 0415 31641 0419 Level II Upper GI Procedures 0419 43201 0419 43205 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 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 473820423 47556

0423 50592 0423 50593 0424 Level II Sm all 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 24361 0425 24363 0425 24366 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 475300427 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 Health and Behavior Services 0432 96150 0432 96151 0432 96152 0432 96153 0432 96154 0432 G0396 0432 G0451 0433 Level II Pathology 0433 88104 0433 88106 0433 88108 0433 88125 0433 88160 0433 88161 0433 88172 0433 88184 0433 88185 0433 88302 0433 88312 0433 88313 0433 88314 0433 88319 0433 88321 0433 883290433 88333

0433 88334 0433 88384 0433 89220 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 95165 0436 96361 0436 96379 0436 96549 0437 Level II Drug Administration 0437 90471 0437 95144 0437 95145 0437 95148 0437 95149 0437 95170 0437 96366 0437 96367 0437 96370 0437 96371 0437 96372 0437 96373 0437 96374 0437 96375 0437 96401 0437 96402 0437 96405 0437 96415 0437 G0010 0438 Level III Drug Administration 0438 95146 0438 95147 0438 96360 0438 96411 0438 96417 0438 96420 0438 96423 0438 965420439 Level IV Drug Adm inistration

0439 95990 0439 95991 0439 96365 0439 96369 0439 96406 0439 96409 0439 96440 0439 96446 0439 96521 0439 96522 0440 Level V Drug Adm inistration 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 G0379 0605 Level 2 Hospital Clinic Visits 0605 90862 0605 92012 0605 92014 0605 99202 0605 99212 0605 99213 0605 99460 0605 99463 0605 G0246 0606 Level 3 Hospital Clinic Visits 0606 92002 0606 92004 0606 99203 0606 99214 0606 G0402 0607 Level 4 Hospital Clinic Visits 0607 95250 0607 99204 0607 99215 0607 G01750607 G0248

0607 G0249 0607 M0064 0608 Level 5 Hospital Clinic Visits 0608 90945 0608 99205 0609 Level 1 Type A Em ergency Visits 0609 99281 0613 Level 2 Type A Em ergency Visits 0613 99282 0614 Level 3 Type A Em ergency Visits 0614 99283 0615 Level 4 Type A Em ergency Visits 0615 99284 0616 Level 5 Type A Em ergency 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 0622 Level II Vascular Access Procedures 0622 36557 0622 36558 0622 36570 0622 36571 0622 36578 0622 36581 0622 36585 0622 36595 0623 Level III Vascular Access Procedures 0623 36260 0623 36560 0623 36561 0623 36563 0623 36565 0623 365660623 36582

0623 36583 0623 36640 0623 37192 0623 37193 0623 37200 0623 37203 0623 37209 0624 Phlebotomy and Minor Vascular Access Device Procedures 0624 36591 0624 36592 0624 37799 0624 96523 0624 99195 0626 Level 1 Type B Em ergency Visits 0626 G0380 0627 Level 2 Type B Em ergency Visits 0627 G0381 0628 Level 3 Type B Em ergency Visits 0628 G0382 0629 Level 4 Type B Em ergency Visits 0629 G0383 0630 Level 5 Type B Em ergency 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 332280654 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 G0290 0656 G0291 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 88348 0661 88349 0661 G0416 0662 CT Angiography 0662 70496 0662 70498 0662 71275 0662 72191 0662 73206 0662 73706 0662 74175 0662 75635 0664 Level I Proton BeamRadiation Therapy 0664 77520 0664 77522 0665 Bone Density:AppendicularSkeleton 0665 77081 0667 Level II Proton BeamRadiation 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 758600668 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 Segm ent Eye Procedures 0673 0191T 0673 0192T 0673 0253T 0673 66174 0673 66175 0673 66180 0673 66225 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 332820683 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 61880 0687 63661 0687 63662 0687 64569 0687 64585 0688 Revision/Removal of Neurostimulator Pulse Generator Receiver 0688 0271T 0688 61888 0688 63688 0688 64595 0690 Level I Electronic Analysis of Devices 0690 0224T 0690 0225T 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 623670691 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 W ithout 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 & Treatments0699 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 Am pho b cholesteryl sulfate 0735 J0288 0736 Am photericin b liposome inj 0736 J0289 0738 Rasburicase 0738 J2783 0747 Chlorothiazide sodiuminj 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 injection0825 J9261

0827 Floxuridine injection 0827 J9200 0828 Gemcitabine hcl injection 0828 J9201 0830 Irinotecan injection 0830 J9206 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 0865 Interferon alfa-n3 inj 0865 J9215 0868 Oral aprepitant 0868 J8501 0873 Hyalgan/supartz inj per dose 0873 J7321 0874 Synvisc or synvisc-one 0874 J73250875 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 Lymphocy te im mu ne globulin 0890 J7504 0900 Alglucerase injection 0900 J0205 0901 Alpha 1 proteinase inhibitor 0901 J0256 0902 Injection,onabotulinumtoxinA 0902 J0585 0903 Cy

tomegalovirus 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 injection0946 J1571

0947 Flebogamma injection 0947 J1572 0948 Gamunex/gamunex c 0948 J1561 0949 Frozen plasm a, pooled, sd 0949 P9023 0950 Whole blood for transfusion 0950 P9010 0951 Reclast injection 0951 J3488 0952 Cryoprecipitate each unit 0952 P9012 0954 RBC leukocy tes 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 Album in (human),5%, 50ml 0961 P9041 0963 Album in (human), 5%, 250 ml 0963 P9045 0964 Album in (human), 25%, 20 ml 0964 P9046 0965 Album in (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 P90511011 Platelets, hla-m, l/r, unit

1011 P9052 1013 Platelets leukocy tes 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 Pralidoxim e chloride inj 1023 J2730 1052 Injection, voriconazole 1052 J3465 1064 I131 iodide cap, rx 1064 A9517 1083 Adalim um ab injection 1083 J0135 1084 Denileukin diftitox inj 1084 J9160 1086 Temozolom ide 1086 J8700 1138 Hepagam b intravenous, inj 1138 J1573 1139 Protein c concentrate 1139 J2724 1142 Supprelin LA im plant 1142 J9226 1150 I131 iodide sol, rx 1150 A9530 1166 Cy

tarabine liposome inj 1166 J9098 1167 Inj, epirubicin hcl 1167 J9178 1168 Inj, temsirolimus 1168 J9330 1178 Busulfan injection1178 J0594

1203 Verteporfin injection 1203 J3396 1207 Octreotide injection, depot 1207 J2353 1213 Antihemophilic viii/vwf com p 1213 J7186 1214 Inj IVIG privigen 500 mg 1214 J1459 1221 Dim ethyl sulfoxide 50% 1221 J1212 1222 Pentastarch 10% solution 1222 J2513 1226 Inj streptokinase /250000 IU 1226 J2995 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 BMW D skin sub 1243 Q4104 1244 Integra DRT skin sub 1244 Q4105 1245 Dermagraft skin sub 1245 Q4106 1246 Graftjacket skin sub 1246 Q4107 1247 Integra matrix skin sub 1247 Q4108 1248 Prim atrix skin sub 1248 Q4110 1249 Cymetra allograft 1249 Q41121250 Graftjacket express allograf

1250 Q4113 1251 Integra flowable wound m atri 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 Allodermskin sub 1270 Q4116 1272 Acetylcysteine injection 1272 J0132 1274 Edetate calcium disodium inj 1274 J0600 1275 Vivaglobin, inj 1275 J1562 1279 Factor VIII (porcine) 1279 J7191 1280 Corticotropin injection 1280 J0800 1281 Bevacizum ab injection 1281 C9257 1287 Alloskin skin sub 1287 Q4115 1289 AbobotulinumtoxinA 1289 J0586 1290 Human fibrinogen conc inj 1290 J1680 1291 Rilonacept injection 1291 J2793 1295 Sm153 lexidronam 1295 A9604 1296 Degarelix injection 1296 J9155 1297 Ferumoxy tol, non-esrd 1297 Q0138 1304 Perphenazine injeciton 1304 J3310 1306 Urea injection 1306 J3350 1307 Oral busulfan 1307 J8510 1308 Mecasermin injection1308 J2170

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 am inolevulinate, 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 Wi late injection 1352 J7183 1353 Belim um ab injection 1353 J0490 1354 Hydroxyprogesterone caproate 1354 J1725 1355 Itraconazole injection 1355 J1835 1357 Inj protirelin per 250 mcg 1357 J2725 1358 Phentolaine m esylate inj 1358 J27601359 Foscarnet sodium injection

1359 J1455 1360 Apomorphine hydrochloride 1360 J0364 1361 Enfuvirtide injection 1361 J1324 1362 Inj heparin sodium per 10 u 1362 J1642 1373 Inj heparin sodium per 1000u 1373 J1644 1374 Sum atriptan succinate / 6 MG 1374 J3030 1408 Cyclophosphamide 100 MG inj 1408 J9070 1412 Vinorelbine tartrate inj 1412 J9390 1413 Lum izym e injection 1413 J0221 1415 Glassia injection 1415 J0257 1416 Factor XIII anti-hem factor 1416 J7180 1417 Gel-one 1417 J7326 1418 Oral everolimus 1418 J8561 1419 Dermacell 1419 Q4122 1426 Eribulin m esylate injection 1426 J9179 1505 New Technology - Level V ($300 - $400) 1505 G0417 1506 New Technology - Level VI ($400 - $500) 1506 G0418 1508 New Technology - Level VIII ($600 - $700) 1508 G0419 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 Daclizum ab, parenteral 1612 J7513 1613 Trastuzumab injection1613 J9355

1630 Hep b ig, im 1630 90371 1631 Baclofen intrathecal trial 1631 J0476 1633 Alefacept 1633 J0215 1643 Y90 ibritumom ab, 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 Basilixim ab 1683 J0480 1684 Corticorelin ovine triflutal 1684 J0795 1685 Darbepoetin alfa, non-esrd 1685 J0881 1686 Epoetin alfa, non-esrd 1686 J0885 1687 Digoxin im mu ne fab (ovine) 1687 J1162 1688 Ethanolam ine 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 sodiuminjection 1697 J2503 1700 Inj secretin synthetic human 1700 J2850 1701 Treprostinil injection 1701 J32851704 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 Brachy tx, non-str, Gold-198 1716 C1716 1717 Brachy tx, non-str, HDR Ir-192 1717 C1717 1719 Brachy tx, NS, Non-HDRIr-192 1719 C1719 1738 Oxaliplatin 1738 J9263 1739 Pegadem ase bovine, 25 iu 1739 J2504 1741 Urofollitropin, 75 iu 1741 J3355 1749 Endo, colon, retro imaging 1749 C1749 1830 Power bone m arrow bx needle 1830 C1830 1840 Telescopic intraocular lens 1840 C1840 1886 Catheter, ablation 1886 C1886 2210 Methyldopate hcl injection 2210 J0210 2616 Brachy tx, non-str,Yttrium-90 2616 C2616 2632 Iodine I-125 sodium iodide 2632 A9527 2634 Brachy tx, non-str, HA, I-125 2634 C2634 2635 Brachy tx, non-str, HA, P-103 2635 C2635 2636 Brachy linear, non-str,P-103 2636 C2636 2638 Brachy tx, stranded, I-125 2638 C2638 2639 Brachy tx, non-stranded,I-1252639 C2639

2640 Brachy tx, stranded, P-103 2640 C2640 2641 Brachy tx, non-stranded,P-103 2641 C2641 2642 Brachy tx, stranded, C-131 2642 C2642 2643 Brachy tx, non-stranded,C-131 2643 C2643 2698 Brachy tx, stranded, NOS 2698 C2698 2699 Brachy tx, 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 Am ifostine 7000 J0207 7011 Oprelvekin injection 7011 J2355 7034 Som atropin 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 Doxorubicin hcl liposome inj 7046 J9001 7048 Alteplase recombinant 7048 J2997 7049 Filgrastim 480 mcg injection 7049 J14417051 Leuprolide acetate implant

7051 J9219 7308 Am inolevulinic acid hcl top 7308 J7308 9001 Linezolid injection 9001 J2020 9002 Tenecteplase injection 9002 J3101 9003 Palivizum ab 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 Am photericin 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 9046 Iron sucrose injection 9046 J1756 9104 Antithymocy te globuln rabbit 9104 J7511 9108 Thyrotropin injection 9108 J3240 9110 Alemtuzum ab injection 9110 J9010 9115 Zoledronic acid9115 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 Natalizum ab 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 Bortezom ib injection 9207 J9041 9208 Agalsidase beta injection 9208 J0180 9209 Laronidase injection 9209 J1931 9210 Palonosetron hcl 9210 J2469 9213 Pem etrexed injection 9213 J9305 9214 Bevacizum ab injection 9214 J9035 9215 Cetuximab injection 9215 J90559217 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 Ranibizum ab injection 9233 J2778 9234 Alglucosidase alfa injection 9234 J0220 9235 Panitum um ab injection 9235 J9303 9236 Eculizum ab injection 9236 J1300 9237 Inj, lanreotide acetate 9237 J1930 9240 Injection, ixabepilone 9240 J9207 9242 Injection, fosaprepitant 9242 J1453 9243 Bendam ustine injection 9243 J9033 9244 Regadenoson injection 9244 J2785 9245 Romiplostim injection 9245 J2796 9248 Inj, clevidipine butyrate 9248 C9248 9249 Certolizum ab pegol inj 9249 J0718 9250 Artiss fibrin sealant 9250 C9250 9251 C1 esterase inhibitor inj 9251 J0598 9252 Plerixafor injection9252 J2562

9253 Temozolom ide injection 9253 J9328 9254 Injection, lacosamide 9254 C9254 9255 Paliperidone palm itate 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 Tocilizum ab 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 Sipleucel-T auto CD54+ 9273 Q2043 9274 Crotalidae Poly Immune Fab 9274 J0840 9275 Hexaminolevulinate HCl 9275 C9275 9276 Cabazitaxel injection 9276 J9043 9278 Incobotulinumtoxin A 9278 J0588 9279 Injection, ibuprofen 9279 C9279 9281 Injection, pegloticaseáááá 9281 J25079282 Injection, ceftaroline fosamilááááá

9282 J0712 9283 Injection, acetaminophen 9283 J0131 9284 Ipilim um ab injection 9284 J9228 9285 Patch, lidocaine/tetracaine 9285 C9285 9286 Injection, belatacept 9286 C9286 9287 Inj, brentuximab vedotin 9287 C9287 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 m atrix 9365 Q4124 9366 EpiFix wound cover 9366 C9366 9367 Endoform Dermal Template 9367 C9367 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 Granulocy tes, pheresis unit 9506 P9050 9507 Platelets, pheresis 9507 P9034 9508 Plasma 1 donor frz w/in 8 hr 9508 P9017**Short Descriptor SI**  **Relative Weight**  **Payment**

**Rate National** 

**Unadjusted Copayment**  **Minimum**

**Unadjusted Copayment**  S 0.5043 $35.31

. $7.07 Ultraviolet light therapy Photochemotherapy

with UV-B Photochemotherapy

with UV-A T 1.6118 $112.85

. $22.57 Fna w/o im age Drain breast lesion add-on Insert needle bone cavity T 3.5548 $248.89

. $49.78 Bone m arrow aspiration Bone m arrow biopsy T 4.5721 $320.12

. $64.03 Fna w/im age 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 8.1596 $571.30

. $114.26 Bx breast percut w/image Needle biopsy

muscle Needle biopsy

lymph nodes Biopsy of salivary

gland T 1.4209 $99.49

. $19.90 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 lesion T 12.8082 $896.78

. $179.36 Drainage of pilonidal cyst Drainage of hematoma/fluidExplore wound extremity

Drainage of finger abscess Drainage of bursa of foot Drainage lymph node lesion Drainage of scrotum abscess I & d vaginal hematoma pp T 20.5510 $1,438.90

. $287.78 Complex drainage wound Incision of breast lesion Drain neck/chest lesion Drain shoulder lesion Drain shoulder bursa Drainage of arm lesion Drainage of arm bursa 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 Drain external ear lesion T 0.3878 $27.15

. $5.43 Trim nail(s) Drain blood from under nail Destruct premalg les 2-14 Skin tissue procedure Dermatological procedure Trim nail(s) T 0.8768 $61.39

. $12.28 Acne surgery Debride infected skin add-on Trim skin lesion Trim skin lesions 2 to 4 Biopsy skin add-on Removal of skin tags Remove skin tags add-on Shave skin lesion Shave skin lesion Shave skin lesion Shave skin lesion Shave skin lesion Shave skin lesion Shave skin lesion Shave skin lesion Debride nail 1-5 Debride nail 6 or moreRemoval of nail plate

Remove nail plate add-on Excision of nail fold toe Injection into skin lesions Added skin lesions injection Abrasion lesion single Abrasion lesions add-on Chemical peel face epiderm Chemical peel nonfacial Initial treatm ent 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 1.4966 $104.79

. $20.96 Wound ultrasound Trim skin lesions over 4 Biopsy skin lesion Shave skin lesion Shave skin lesion Shave skin lesion Shave skin lesion 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

electrolysis Injection(s) spider veinsInjection therapy of vein Injection therapy

of veins Treatment of rectal prolapse Cryosurgery

anal lesion(s) Destruction penis lesion(s) Photodynam ic tx skin Photodynm c tx 30 min add-on Photodynam ic 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 20 cm< Neg press wound tx > 50 cm T 2.7597 $193.22

. $38.65 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 Abrasion treatment of skin Removal of sutures Removal of sutures 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) T 21.6700 $1,517.25

. $303.45 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 compl T 4.3953 $307.74

. $61.55 Debride skin at fx site Debride skin musc at fx site Deb skin bone at fx site 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 cm Exc tr-ext mal+marg 0.6-1 cm Exc tr-ext mal+marg 1.1-2 cm 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 Removal of contraceptive cap Abrasion treatment of skin Abrasion treatment of skin Removal of tail bone ulcer Removal of pressure sore Removal of foreign body Removal of arm foreign body Biopsy of floor of mouth T 8.2918 $580.56

. $116.12 Deb bone 20 sq cm/< Deb bone add-on Exc tr-ext b9+marg 2.1-3 cm 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 cm Exc face-mm b9+marg 2.1-3 cm Exc face-mm b9+marg 3.1-4 cm Exc tr-ext mal+marg 0.5 < cm Exc tr-ext mal+marg 2.1-3 cm Exc tr-ext mal+marg 3.1-4 cm Exc h-f-nk-sp mal+marg 0.5 < Exc s/n/h/f/g mal+mrg 1.1-2 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 body Biopsy forearm soft tissues Biopsy of soft tissues Biopsy of soft tissues Remove hip foreign body Biopsy thigh soft tissues Biopsy lower leg soft tissue Removal of foot foreign body Removal of foot foreign body Remove pat-active ht record Repair blood vessel lesion T 16.9957 $1,189.97

. $238.00 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 2.1-3 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 tissue Excise excessive skin tissue Excise excessive skin tissue Excise excessive skin tissue Removal of chest wall lesion 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 cm Resect shoulder tum < 5 cmBiopsy

arm/elbow soft tissue Biopsy arm/elbow soft tissue Exc arm/elbow les sc < 3 cm Ex arm/elbow tum deep < 5 cm 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<3cm Exc hand les sc < 1.5 cm Exc hand tum deep < 1.5 cm Exc hand tum ra < 3 cm Removal of implant from hand Exc hip/pelvis les sc < 3 cm Exc hip/pelv tum deep < 5 cm Resect hip/pelv tum < 5 cm Exc thigh/knee tum deep <5cm Resect thigh/knee tum < 5 cm Resect leg/ankle tum < 5 cm Exc leg/ankle tum < 3 cm Exc leg/ankle tum deep <5 cm Exc foot/toe tum sc < 1.5 cm Exc foot/toe tum deep <1.5cm Resect foot/toe tumor < 3 cm Removal of foot foreign body Temporal artery

procedure Biopsy of penis Remove external ear partial Remove ear canal lesion(s) T 23.2636 $1,628.82 $350.74 $325.77 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 Removal of pilonidal lesion Removal of pilonidal lesion Removal of pilonidal lesion Remove tissue expander(s) Abrasion treatment of skin Exc skin abdExcise excessive skin tissue

Excise excessive skin tissue Excise excessive skin tissue Excise excessive skin tissue 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 body 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 tissuesExc thigh/knee les sc < 3 cm

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 tissue 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 25.5066 $1,785.87

. $357.18 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 33.3398 $2,334.32 $580.94 $466.87 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 implant T 45.0217 $3,152.24 $747.07 $630.45 P-mastectomy

w/ln removal Mast mod rad Reduction of large breast Enlarge breast Immediate breast prosthesis Revise breast reconstruction X 0.2988 $20.92

. $4.19Behav chng smoking 3-10 min

Behav chng smoking > 10 min Tobacco-use counsel 3-10 min $0.00 $0.00 Tobacco-use counsel>10min $0.00 $0.00 X 0.2673 $18.72

. $3.75 Audiom etry

air only Audiom etry

air & bone Speech audiometry

threshold Speech audiom thresh & recog Vein access cutdown < 1 yr Vein access cutdown > 1 yr Withdrawal of arterial blood Echo exam of eye thickness Remote dx retinal imaging Remote retinal imaging mgmt Rhy thm ecg tracing ECG/signal-averaged Icm device eval Noninvas vasc dx study proc T 15.3535 $1,074.99 $227.40 $215.00 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 216.9330 $15,188.78

. $3,037.76 Implt/rpl crtd sns dev gen Insrt/redo neurostim 1 array Insrt/redo spine n generator Insrt/redo pn/gastr stimul S 63.3729 $4,437.12

. $887.43 Periph field stimul trial Implant neuroelectrodes Revise spine eltrd perq aray Revise spine eltrd plate Implant neuroelectrodes Implant neuroelectrodes Implant neuroelectrodes Implant neuroelectrodes T 29.7721 $2,084.52

. $416.91 Jaw arthroscopy

/surgery Jaw arthroscopy

/surgery Shoulder arthroscopy

dxShoulder arthroscopy /surgery Shoulder arthroscopy

/surgery Shoulder arthroscopy

/surgery 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 57.0707 $3,995.86 $804.74 $799.18 Shoulder arthroscopy

/surgery Shoulder arthroscopy

/surgery Shoulder arthroscopy

/surgery Shoulder arthroscopy

/surgeryShoulder arthroscopy /surgery Shoulder arthroscopy

/surgery Shoulder arthroscopy

/surgery Arthroscop rotator cuff repr Arthroscopy

biceps tenodesis 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 15.4596 $1,082.42 $268.44 $216.49 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 41.2873 $2,890.77

. $578.16 Reconstruct elbow joint Reconstruct head of radius Revise wrist joint Repair wrist jointsRemove 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 60.9147 $4,265.00

. $853.00 Reconstruct elbow joint Reconstruct wrist joint Reconstruct wrist joint Reconstruct wrist joint Revise knuckle with implant Revise/im plant finger joint Revise kneecap with implant T 22.0797 $1,545.93

. $309.19 Application of pelvis brace Remove bone fixation device Musculoskeletal surgery Drain chest lesion Revision of neck muscle Revision of neck muscle Abdom en 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 Am putation follow-up surgery Incision of tendon sheath Incise flexor carpi radialis 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 lesion Remove wrist/forearm lesionRemove wrist/forearm lesion

Remove forearm foreign body Release wrist/forearm tendon Am putation follow-up surgery Am putation follow-up surgery Am putate hand at wrist Am putation follow-up surgery 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 & fascia 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 Am putation follow-up surgery 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 Am putation follow-up surgery Treatment of foot infection Treatment of foot infection T 32.4461 $2,271.75

. $454.35 Extracorp shockwv tx hi enrg Extracorp shockwv tx anesth Perq sacral augmt unilat inj Perq sacral augmt bilat inj Plmt post facet implt lumb Plmt post facet implt addl Open bone biopsyOpen bone biopsy

Place ndl m usc/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 fixation 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

lum b Percut vertebroplasty

addl Apply spine prosth device Spine surgery

procedure Release shoulder joint Exploratory

shoulder surgery Exploratory

shoulder surgery Shoulder joint surgery Remove shoulder joint lining Incision of collarbone joint Explore treat shoulder joint 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 lesion Remove humerus lesion Remove collar bone lesion Remove shoulder blade lesion 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 jointRemove 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 ligm nt w/tiss Repr elbw m ed ligm nt w/tissu 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 cartilage 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 boneRemoval of wrist bones

Partial removal of radius Partial removal of ulna Removal of wrist prosthesis Removal of wrist prosthesis Repair forearm tendon/muscle Repair forearm tendon/muscle Repair forearm tendon/muscle Repair forearm tendon/muscle Repair forearm tendon/muscle Repair forearm tendon/muscle Repair forearm tendon sheath 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 lesion 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/fixation Partial removal leg bone(s) Repair of kneecap tendon Repair/graft kneecap tendon Repair of thigh muscleRepair/graft of thigh muscle

Incision of thigh tendons Lengthening of thigh tendon Lengthening of thigh tendons Transplant of thigh tendon Repair of knee cartilage Lat retinacular release open 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 lesion Remove/graft leg bone lesion Remove/graft leg bone lesion 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 tendons Revision of lower leg tendon 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 Am putation of foot at ankle Decompression of leg Decompression of leg Decompression of legHigh energy eswt plantar f Pelvic ring fracture uni/bil T 47.5032 $3,325.98

. $665.20 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/arm Repair rotator cuff acute Repair rotator cuff chronic Release of shoulder ligament 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 Realignm ent 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 ulnaReinforce radius and ulna

Fusion of hand bones Exploration of hip joint Transfer of abdominal muscle Transfer of spinal muscle Transfer of iliopsoas muscle Transfer of iliopsoas muscle Lengthening of thigh tendons Transplants of thigh tendons Revise thigh muscles/tendons Repair of knee ligament Osteochondral knee autograft Repair degenerated kneecap Revision of unstable kneecap Revision of unstable kneecap 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 tendon Incision of tibia Repair of leg epiphyses T 88.8483 $6,220.80

. $1,244.16 Lum bar spine proces distract Lum bar spine process addl Percut kyphoplasty

thor Percut kyphoplasty

lum bar 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 ligmnt Reconstruct elbow med ligmnt Revision of humerus Repair of humerus Repair humerus with graft Reinforce humerusFusion/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 Autochondrocy

te im plant knee Osteochondral knee allograft Reconstruction knee Reconstruction knee Reconstruction knee Repair/graft achilles tendon Reinforce tibia Fusion of ankle joint open Fusion of tibiofibular joint Fusion of foot bones Knee arthroscopy

/surgery Knee arthroscopy

/surgery Ankle arthroscopy

/surgery T 17.1902 $1,203.59 $253.49 $240.72 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 liningBiopsy

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 bone 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 Realignm ent 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 graft Repair of web finger Repair hand deformity Reconstruct extra finger Repair finger deformity Release muscles of hand Excision constricting tissue Am putation of finger/thumbAm putation of finger/thumb T 28.8625 $2,020.84

. $404.17

Replantation digit com plete 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 tendon Release forearm/hand tendon Transplant hand tendon Transplant/graft hand tendon Transplant palm tendon Transplant/graft palm tendon 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 graft Reconstruct finger joint Repair nonunion hand Reconstruct finger jointConstruct 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 graft Fusion of finger joint Fusion of finger jnt add-on Fusion/graft of finger joint Fuse/graft added joint Am putate metacarpal bone Remove sympathetic nerves Remove sympathetic nerves Remove sympathetic nerves T 22.0963 $1,547.09 $353.25 $309.42 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 lining Removal of foot joint lining Removal of foot lesion Excise foot tendon sheath Excise foot tendon sheath Removal of foot lesion Removal of toe lesions Removal of ankle/heel lesion Removal of foot lesion Removal of toe lesionsPart 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 bone 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 bone Repair hallux rigidus Incision of ankle bone Incision of metatarsal Incision of metatarsal Incision of metatarsal Revision of big toeRevision 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 Am putation thru metatarsal Am putation toe & m etatarsal Am putation of toe Partial am putation of toe Scope plantar fasciotomy T 58.4586 $4,093.04

. $818.61 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 autogrft 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 32.7262 $2,291.36 $475.91 $458.28 Correction of bunion Correction of bunion Correction of bunion Correction of bunion Correction of bunion Correction of bunion Correction of bunionCorrection of bunion S 1.1255 $78.80

. $15.76

Application of body

cast Application of body

cast Application of body

cast Application of body

cast Application of figure eight Application of shoulder cast Apply hand/wrist cast Apply finger cast Apply long arm splint Apply forearm splint Apply forearm splint Application of finger splint Application of finger splint Strapping of chest Strapping of shoulder Strapping of elbow or wrist Strapping of hand or finger Addition of walker to cast Application of leg cast Application long leg splint Application lower leg splint Strapping of hip Strapping of knee Strapping of ankle and/or ft Strapping of toes Application of paste boot Apply multlay comprs lwr leg Apply multlay comprs upr leg Apply multlay comprs upr arm Appl m ultlay

comprs arm/hand Application of foot splint Removal/revision of cast Removal/revision of cast Removal/revision of cast Repair of body

cast Wi ndowing of cast Wedging of cast Wedging of clubfoot cast Casting/strapping procedure S 0.3428 $24.00

. $4.80 Osteopathic manipulation Osteopathic manipulation Osteopathic manipulation Osteopathic manipulation Osteopathic manipulationChiropractic manipulation

Chiropractic manipulation Chiropractic manipulation S 88.6050 $6,203.77

. $1,240.76 Lap im pl electrode antrum Implant neuroelectrodes Implant neuroelectrodes Implant neuroelectrodes Implant neuroelectrodes T 26.1202 $1,828.83 $372.85 $365.77 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 Treat nasal septal fracture 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 fractureTreat toe fracture

Treat sesamoid bone fracture 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 49.8979 $3,493.65

. $698.73 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 styloid 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 fracture 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 fractureTreat midfoot fracture each

Treat metatarsal fracture Repair foot dislocation Repair foot dislocation T 68.1203 $4,769.51

. $953.91 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 & ulna 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 12.8903 $902.53

. $180.51 Mw therapy

for breast tumor Meg evoked single Meg evoked each addl Linear acc based stero radio S 35.9961 $2,520.30

. $504.06 Meg spontaneous Robt lin-radsurg fractx 2-5 S 48.1833 $3,373.60

. $674.72 U/s leiomyom ata ablate <200 U/s leiomyom ata ablate >200 Linear acc stereo radsur com Robot lin-radsurg com, firstT 34.5272 $2,417.46 $591.64 $483.50

Thoracoscopy

diagnostic Thoracoscopy

wbx sac Thoracoscopy

w/bx med space Thoracoscopy

w/bx infiltrate Thoracoscopy

w/bx nodule Thoracoscopy

w/bx pleura Mediastinoscopy

incl biopsy T 5.5061 $385.52

. $77.11 Drain percut lung lesion Puncture/clear lung Thoracentesis for aspiration Thoracentesis w/tube insert Insertion of chest tube 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 sac Cardiac surgery

procedure Abd paracentesis Abd paracentesis w/imaging Peritoneal lavage T 1.0729 $75.12

. $15.03 Diagnostic laryngoscopy Nasopharyngoscopy T 1.8643 $130.53

. $26.11 Nasal endoscopy

dx Nasal/sinus endoscopy dx Remove foreign body

larynx Injection into vocal cord Dx laryngoscopy

newborn Diagnostic laryngoscopy T 4.4119 $308.90 $67.83 $61.78 Remove foreign body

larynx Diagnostic laryngoscopy Bronchial brush biopsy Intro windpipe wire/tube T 21.2774 $1,489.76

. $297.96 Nasal/sinus endoscopy dx Nasal/sinus endoscopy surg Nasal/sinus endoscopy surg Nasal/sinus endoscopy surg Laryngoscopy

with biopsy Removal of larynx lesionLaryngoscopy for aspiration Dx laryngoscopy

excl nb Dx laryngoscopy

w/oper scope Laryngoscopy

and dilation Laryngoscopy

and dilation Laryngoscopy

w/fb removal Laryngoscopy

w/fb & op scope Laryngoscopy

w/biopsy Laryngoscopy

w/bx & op scope Laryngoscopy

w/exc of tumor Larynscop w/tumr exc + scope Laryngoscope w/vc inj Laryngoscopy

with biopsy T 30.3487 $2,124.89 $444.55 $424.98 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 Remove vc lesion w/scope Remove vc lesion scope/graft Laryngoscop w/ary

tenoidectom Larynscop remve cart + scop Laryngoscop w/vc inj + scope Removal of larynx lesion T 10.4689 $732.99 $189.82 $146.60 Remov bronchial valve Remov bronch valve addl Dx bronchoscope/wash Dx bronchoscope/brush Dx bronchoscope/lavage Bronchoscopy

w/biopsy(s) Bronchoscopy

/lung bx each Bronchoscopy

/needle bx each Bronchoscopy

/lung bx addl Bronchoscopy

/needle bx addl Bronch w/balloon occlusionBronchoscopy w/fb removal Bronchoscopy

stent add-on Diag bronchoscope/catheter Bronchoscopy

clear airways Bronchoscopy

reclear airway Bronchoscopy

inj for x-ray Airways surgical procedure S 0.4237 $29.67 $7.74 $5.94 Clearance of airways Surfactant admin thru tube Airway inhalation treatm ent Evaluate pt use of inhaler Chest wall m anipulation Chest wall m anipulation Therapeutic procd strg endur Oth resp proc, indiv Oth resp proc, group S 1.4089 $98.65

. $19.73 Intm msr bronchodil wheeze Change of windpipe airway Remove lung catheter Evaluation of wheezing Aerosol inhalation treatment Pos airway

pressure cpap S 3.1979 $223.90

. $44.78 Vent mgmt inpat init day Vent mgmt inpat subq day Neg press ventilation cnp T 38.8523 $2,720.28 $836.90 $544.06 Right heart cath Left hrt cath w/ventrclgrphy R&l hrt cath w/ventriclgrphy 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 angio 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 105.0651 $7,356.24

. $1,471.25 Trluml perip athrc renal artTrluml perip athrc abd aorta

Trluml perip athrc brchiocph Trluml perip athrc iliac art Transcatheter occlusion Endovasc tempory

vessel occl Transcath occlusion non-cns Coronary

atherectomy Coronary

atherectomy

add-on T 65.8519 $4,610.69

. $922.14 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 stent Tib/per revasc stnt & ather Repair arterial blockage Repair arterial blockage Coronary

artery dilation Coronary

artery dilation Revision of aortic valve Revision of mitral valve Revision of pulmonary

valve Pul art balloon repr percut Pul art balloon repr percut S 9.9330 $695.47

. $139.10 Bundle of His recording Intra-atrial recording Right ventricular recording Intra-atrial pacing Intraventricular pacing Esophageal recording Esophageal recording Heart rhy

thm pacing Electrophysiology

evaluation T 53.2719 $3,729.89

. $745.98 Electrophysiology

evaluation Electrophysiology

evaluation Electrophysiologic study Ablate heart dysrhy

thm focusT 121.8174 $8,529.17

. $1,705.84

Ablate heart dysrhy

thm focus Ablate heart dysrhy

thm focus T 41.0387 $2,873.37 $655.18 $574.68 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 graft 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 Primart mech thrombectomy Primart m-thrombect add-on Sec art m-thrombect add-on Venous mech thrombectomy Venous m-thrombectomy add-on Percut coronary

thrombectomy T 112.1218 $7,850.32 $1,643.98 $1,570.07 Insert heart pm atrial Insert heart pm ventricular T 94.2220 $6,597.05 $1,593.50 $1,319.41 Insert pulse gen sngl lead Remove&replace pm gen singl T 44.2272 $3,096.61

. $619.33 Endovenous rf 1st veinIns 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 26.8120 $1,877.27

. $375.46 Ligation nasal sinus artery Ligation upper jaw artery Endovenous rf vein add-on Endovenous laser 1st vein Endovenous laser vein addon Vascular endoscopy

procedure 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 31.1505 $2,181.03

. $436.21 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 patency Exploration of artery

/vein Explore limb vessels Excision graft extremity Ligation of neck vein Ligation of neck artery Repair venous blockage S 2.2326 $156.32 $43.83 $31.27 Insert emergency

airway Heart/lung resuscitation cprTemporary external pacing Nb resuscitation S 0.9930 $69.53

. $13.91 Cardiac rehab Cardiac rehab/monitor Intens cardiac rehab w/exerc Intens cardiac rehab no exer S 1.5248 $106.76 $36.86 $21.36 Echo guide for artery

repair Upr/lxtr art stdy

3+ lvls Lwr xtr vasc stdy

bilat Extremity

study S 0.9350 $65.46

. $13.10 Bioim pedance spectroscopy Ext ecg recording Ext ecg scan w/report Dx gastr intub w/asp specs Ecg monit/reprt up to 48 hrs Ecg monit/reprt up to 48 hrs Remote 30 day

ecg rev/report Am bulatory

BP recording Am bulatory

BP analysis Cardiovascular procedure Upr/l xtremity

art 2 levels Aneurysm pressure sens study Measure blood oxygen level Ped hom e apnea rec hk-up Ped hom e apnea rec downld S 0.3817 $26.73

. $5.35 Acoustic ecg w/i&r Electrocardiogram tracing Bioim pedance cv analysis EKG tracing for initial prev X 2.5439 $178.11 $41.37 $35.63 64 lead ecg w/tracing Cardiovascular stress test Cardiac drug stress test Microvolt t-wave assess Cardiokymography S 4.2669 $298.75 $100.24 $59.75 Tilt table evaluation S 0.5346 $37.43

. $7.49 Pulmonary

rehab w exer T 16.3852 $1,147.23

. $229.45 Harvest vein for bypass Transcatheter therapy

infuse Transcatheter therapy

infuseCath place cardio brachy tx Insert/place heart catheter Biopsy of heart lining T 81.1503 $5,681.82

. $1,136.37 Insert intracoronary

stent Insert intracoronary

stent T 21.7420 $1,522.29

. $304.46 Reposition pacing-defib lead 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 47.1769 $3,303.14

. $660.63 Insert electrd/pm cath sngl Insert card electrodes dual Insert 1 electrode pm-defib Insert 2 electrode pm-defib T 341.5859 $23,916.48

. $4,783.30 Insrt pulse gen w/dual leads Insrt pulse gen w/mult leads Insrt pulse gen w/singl lead Remv&replc cvd gen sing lead Remv&replc cvd gen dual lead Remv&replc cvd gen mult lead T 426.1201 $29,835.22

. $5,967.05 Nsert pace-defib w/lead S 3.4217 $239.57

. $47.92 Blood transfusion service Bl push transfuse 2 yr or < Bl exchange/transfuse nb Bl exchange/transfuse non-nb Transfusion service fetal Cryopreserve stem cells Thaw preserved stem cells Wash harvest stem cells Blood/lymph system procedure S 11.6629 $816.59 $189.89 $163.32 Apheresis wbc Apheresis rbcApheresis platelets

Apheresis plasma Harvest auto stem cells Lymphocy

te infuse transplant S 35.6252 $2,494.33

. $498.87 Im B1 mrw cel ther cmpl Im B1 mrw cel ther xcl hrvst Im B1 mrw cel ther hrvst onl Apheresis adsorp/reinfuse Apheresis selective Photopheresis Bone m arrow harvest allogen Bone m arrow harvest autolog Bn m arrow/stm transplt allo Bn m arrow/stm transplt auto T 25.2738 $1,769.57

. $353.92 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 51.2792 $3,590.36

. $718.08 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 37.4593 $2,622.75

. $524.55 Insertion of cannula Insertion of cannula Insertion of cannula Artery to vein shunt Cannula declotting Insert tun ip cath w/portT 6.2123 $434.96

. $87.00

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 1.1095 $77.68 $16.21 $15.54 Instll rx agnt into rnal tub Measure ureter pressure Drain bladder by

trocar/cath 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 106.5454 $7,459.88

. $1,491.98 Srs multisource S 7.9593 $557.28 $166.16 $111.46 TTE w or w/o fol w/cont, com TTE w or w/o fol w/cont, f/u 2D TTE w or w/o fol w/con,co 2D TTE w or w/o fol w/con,fu 2D TEE w or w/o fol w/con,in TEE w or w/o fol w/cont,cong TEE w or w/o fol w/cont, mon TTE w or w/o fol w/con,stres TTE w or wo fol wcon,Doppler TTE w or w/o contr, cont ECG T 1.5020 $105.16

. $21.04 Treatment of rib fracture Treat sternum fracture Treat spine process fracture Treat clavicle fracture Treat clavicle dislocation Treat shoulder blade fx Treat humerus fractureTreat 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 & ulna 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 fractureTreat 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 fracture 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 fracture Treat foot dislocation Treat foot dislocation Treat foot dislocationTreat foot dislocation

Treat toe dislocation Treat toe dislocation Foot/toes surgery

procedure T 38.9223 $2,725.18 $659.53 $545.04 Laparoscope proc spleen Laparoscope proc lymphatic Laparoscope proc esoph Lap revise/remv eltrd antrum 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/om entopexy

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 myom ectomy Laparo proc uterus Laparo proc oviduct-ovary Laparo proc ob care/deliver Laparo proc endocrine T 47.9394 $3,356.53 $1,001.89 $671.31 Laparoscopy

splenectomy Laparoscopy

lymph node biop Laparoscopy

lymphadenectomy Laparoscopy

gastrostomy Lap place gastr adj device Lap enterolysis Lap jejunostomyLaparoscopy appendectomy Laparoscopic cholecystectomy Laparo cholecystectomy /graph Laparo cholecystectomy /explr Lap ing hernia repair init Lap ing hernia repair recur Laparo partial nephrectomy Laparoscopy

pyeloplasty Laparoscopy

ureterolithotomy Laparo new ureter/bladder Laparo new ureter/bladder Laparo urethral suspension Laparo sling operation Laparoscopy

orchiectomy Laparo ligate spermatic vein Laparoscopy

surg colpopexy Laparo-myom ectomy

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 71.5658 $5,010.75 $1,236.99 $1,002.15 Laparoscopy

lymphadenectomy Laparoscopy

fundoplasty Lap paraesophag hern repair Laparoscopy

vagus nerve Laparoscopy

vagus nerve 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 recurLap 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 g Laparo-asst vag hysterectomy T 1.1922 $83.47 $23.34 $16.70 Repair of nail bed Therapy for contour defects Repair superficial wound(s) Repair superficial wound(s) Repair superficial wound(s) Repair superficial wound(s) Repair superficial wound(s) Repair superficial wound(s) Repair superficial wound(s) Repair superficial wound(s) Repair superficial wound(s) Repair superficial wound(s) Repair superficial wound(s) Repair superficial wound(s) Intmd wnd repair n-hf/genit Intmd wnd repair face/mm Repair wound/lesion add-on Skin sub graft t/a/l add-on Skin sub graft f/n/hf/g addl Hair transplant punch grafts Hair transplant punch grafts T 3.2354 $226.53

. $45.31 Correct skin color defects Correct skin color defects Correct skin color defects Therapy for contour defects Therapy for contour defects Therapy for contour defects Repair superficial wound(s) Closure of split wound Intmd wnd repair s/a/t/ext Intmd wnd repair s/a/t/ext Intmd wnd repair s/tr/ext Intmd wnd repair s/a/t/ext Intmd wnd repair s/a/t/ext Intmd wnd repair s/tr/ext Intmd wnd repair n-hf/genit Intmd wnd repair n-hf/genit Intmd wnd repair n-hf/genitIntmd wnd repair n-hf/genit

Intmd wnd repair n-hf/genit Intmd wnd repair face/mm Intmd wnd repair face/mm Intmd wnd repair face/mm Intmd wnd repair face/mm Intmd wnd repair face/mm Intmd wnd repair face/mm Repair wound/lesion add-on Repair of wound or lesion Repair of wound or lesion Repair of wound or lesion Repair wound/lesion add-on Repair wound/lesion add-on Wound prep f/n/hf/g Harvest cultured skin graft Skin pinch graft Epidrma-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 add Skin sub graft face/nk/hf/g Skn sub grft f/n/hf/g ch add Plastic surgery

neck T 4.9271 $344.98

. $69.00 Closure of split wound Repair of wound or lesion Repair of wound or lesion Repair of wound or lesion Repair of wound or lesion Repair of wound or lesion Repair of wound or lesion Wound prep trk/arm/leg Wound prep addl 100 cm Wnd prep f/n/hf/g addl cm Epidrmautogrft trnk/arm/leg Epidrmautogrft t/a/l add-on Epidrma-grft face/nck/hf/g Skin full graft add-on Skin sub grft t/arm/lg child Skn sub grft f/n/hf/g childRemoval of tissue for graft

Remove gastric port open Dermal filler inj px/suppl T 16.7703 $1,174.19

. $234.84 Reconstruction of nail bed Skin tissue rearrangement Skin tissue rearrangement Skin tissue rearrangement Skin tissue rearrangement Skin tissue rearrangement Skin tissue rearrangement Skin tissue rearrangement Skin tissue rearrangement Derm autograft trnk/arm/leg Derm autograft t/a/l add-on Derm autograft face/nck/hf/g Derm autograft f/n/hf/g add Skin full graft trunk Skin full graft trunk add-on Skin full graft sclp/arm/leg Skin full grft face/genit/hf 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 Am putation follow-up surgery Am putation follow-up surgery Revise pocket pacemaker Revise pocket for defib T 21.4409 $1,501.21

. $300.25 Insert tissue expander(s) Late closure of wound Skin tissue rearrangement Skin tissue rearrange add-on Skin tissue rearrangement Skin splt grft trnk/arm/leg Skin splt grft t/a/l add-on Skn splt a-grft fac/nck/hf/g Skn splt a-grft f/n/hf/g add Form skin pedicle flapForm skin pedicle flap

Form skin pedicle flap Form skin pedicle flap Skin graft Skin graft Skin graft Skin graft Transfer skin pedicle flap Forehead flap w/vasc pedicle Muscle-skin graft head/neck Muscle-skin graft trunk Muscle-skin graft arm Muscle-skin graft leg Neurovascular pedicle graft 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 wrinkles Removal of neck wrinkles Removal of brow wrinkles Removal of face wrinkles Removal of skin wrinkles Graft for face nerve palsy Graft for face nerve palsy Flap for face nerve palsy Skin and muscle repair face Suction assisted lipectomy Suction assisted lipectomy Suction assisted lipectomy Suction assisted lipectomy 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 abdom en Remove cartilage for graft Remove cartilage for graft Revise gastric port open Change gastric port open Revision of ileostomyRevision of colostomy T 5.0454 $353.26

. $70.66

Apply rem fixation device Treat spine fracture 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 & ulna Treat fracture radius/ulna Treat wrist bone fracture Manipulate finger w/anesth Manipulat palmcord post inj Treat thumb fracture Treat thigh fracture Treat thigh fracture Treatment of thigh fracture Treatment of thigh fracture Treatment of ankle fracture T 18.9489 $1,326.73

. $265.35 Comp ext fixate strut change Treat spine fracture 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 fracture Treat lower leg fracture Treat lower leg dislocation Treatment of heel fracture Treat foot dislocation T 6.5866 $461.17

. $92.24 Dilate esophagus Dilate esophagusDilate esophagus T 8.4511 $591.71 $138.69 $118.35

Esophagus endoscopy Esophagus endoscopy biopsy Esoph scope w/sclerosis inj Upper gi endoscopy

exam Uppr gi endoscopy

diagnosis Uppr gi scope w/submuc inj Upper gi endoscopy

biopsy Upper GI endoscopy

with tube Upper gi endoscopy

& inject Operative upper GI endoscopy Uppr gi endoscopy

/guide wire Esophagus surgery

procedure Surgical opening of stomach Reposition gastrostomy tube Place gastrostomy

tube Stom ach surgery

procedure T 10.4394 $730.93 $152.78 $146.19 Sm all bowel endoscopy Sm all bowel endoscopy /biopsy Sm all bowel endoscopy Sm all bowel endoscopy Sm all bowel endoscopy /biopsy Sm all bowel endoscopy Sm all bowel endoscopy Gi tract capsule endoscopy T 9.3693 $656.00 $186.06 $131.20 Endoscopy

of bowel pouch Endoscopy

bowel pouch/biop Colonoscopy Colonoscopy

with biopsy Colonoscopy

for foreign body 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 bleeding Lesion removal colonoscopy Lesion remove colonoscopy Lesion removal colonoscopy Colonoscopy

dilate strictureColonoscopy w/endoscope us Colonoscopy

w/endoscopic fnb T 6.2205 $435.53

. $87.11 Anoscopy

hra w/biopsy Proctosigmoidoscopy

dx Diagnostic sigmoidoscopy Sigmoidoscopy

and biopsy Sigmoidoscopy

w/fb removal Sigmoidoscopy

& polypectomy Sigmoidoscopy

w/subm uc inj Sigmoidoscopy

& decompress Sigmoidoscopy

w/tum r remove Sigmoidoscopy

w/ultrasound Anoscopy

and biopsy Anoscopy

remove for body Anoscopy

control bleeding T 11.0417 $773.10

. $154.62 Proctosigmoidoscopy

dilate Proctosigmoidoscopy

w/bx Proctosigmoidoscopy

removal Proctosigmoidoscopy

removal Proctosigmoidoscopy

removal Proctosigmoidoscopy

bleed Sigmoidoscopy

for bleeding Sigmoidoscopy

w/ablate tum r Sig w/balloon dilation Sigmoidoscopy

w/us guide bx Anoscopy

and dilation Anoscopy T 5.5158 $386.19

. $77.24 Anoscopy

w/rf delivery Reduction of rectal prolapse Rectum surgery

procedure Removal of rectal marker Incision of anal abscess Ligation of hemorrhoid(s) Injection into hemorrhoid(s) Destroy internal hemorrhoids Treatment of anal fissure Anus surgery

procedure Place endorectal app T 24.4382 $1,711.07

. $342.22 Exc rectal tumor endoscopic Drainage of pelvic abscess Drainage of rectal abscess Biopsy of rectum Removal of anorectal lesionExcision of rectal stricture

Excision of rectal lesion Exc rect tum transanal part Exc rect tum transanal full Destruction rectal tumor Repair of rectum Dilation of anal sphincter Dilation of rectal narrowing Surg dx exam anorectal Placement of seton Incision of rectal abscess Incision of rectal abscess Incision of rectal abscess Incision of anal sphincter Removal of anal fissure Removal of anal tags Remove ext hem groups 2+ Remove int/ext hem 1 group Remove in/ex hem grp & fiss Remove in/ex hem grp w/fistu Remove in/ex hem groups 2+ Remove in/ex hem grps & fiss Remove in/ex hem grps w/fist Remove anal fist subq Remove anal fist inter Remove anal fist complex Remove anal fist 2 stage Repair anal fistula Removal of hemorrhoid clot Chemodenervation anal musc Repair of anal stricture Reconstruction of anus Removal of suture from anus Treatment of anal fissure Remove by

ligat int hemgrp Remove by

ligat int hemgrps Place cecostomy

tube perc T 32.9805 $2,309.16

. $461.84 Repair of rectum Correct rectal prolapse Repair of rectocele Repr of anal fistula w/glue Repair anorectal fist w/plug Repair of anal sphincter Repair of anal sphincter Repair of anal sphincter Implant artificial sphincterHemorrhoidopexy by stapling Radiofrequency

energy to anu T 24.6966 $1,729.16

. $345.84 Endo cholangiopancreatograph Endo cholangiopancreatograph Endo cholangiopancreatograph Endo cholangiopancreatograph Endo cholangiopancreatograph Endo cholangiopancreatograph Endo cholangiopancreatograph Endo cholangiopancreatograph Endo cholangiopancreatograph Endoscopic pancreatoscopy T 29.1415 $2,040.37

. $408.08 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

procedure T 27.2798 $1,910.02

. $382.01 Unlisted procedure intestine Appendectomy Appendectomy

add-on Excision of umbilicus Remove foreign body

adbomen Revise abdomen-venous shunt Abdom en surgery

procedure Place needles pelvic for rt T 32.9294 $2,305.58 $464.85 $461.12 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 blockedRerepair 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 15.4175 $1,079.47

. $215.90 Ligation hemorrhoid w/us Drainage of rectal abscess Remove rectal obstruction Incision of anal septum Excise anal ext tag/papilla T 3.1886 $223.25

. $44.65 Treatment of bladder lesion Sim ple 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 2.7510 $192.61

. $38.53 Colon CA screen;barium enema Colon ca scrn; barium enema T 8.3164 $582.28 $0.00 $0.00 Colorectal scrn; hi risk ind $0.00 $0.00 Colon ca scrn not hi rsk ind $0.00 $0.00S 5.3772 $376.49 $0.00 $0.00

CA screen;flexi sigmoidscope $0.00 $0.00 T 6.7736 $474.26

. $94.86 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 17.4715 $1,223.28

. $244.66 Remove ureter stent percut Insert kidney

drain Kidney endoscopy

& treatment Kidney endoscopy

& treatment Ureter endoscopy

& biopsy Ureter endoscopy

& treatment Cystoscopy

removal of clots Cystoscopy

and treatment Cystoscopy

& revise urethra Cystoscopy

and treatment Cystoscopy

and treatment Cystoscopy

and treatment Dilate urethra stricture X-ray control cath insert X-ray control cath insert X-ray guide gu dilation T 26.2973 $1,841.23

. $368.25 Renal abscess open drain Change ureter stent percut Change stent via transureth Insert ureteral tube Create passage to kidney Kidney endoscopy Kidney endoscopy

& treatment Kidney endoscopy

& treatment Ureter endoscopy

& biopsy Ureter endoscopy

& treatmentUreter endoscopy & treatment Ureter endoscopy

& treatment 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 catheter 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 stricture Cystouretero w/renal strict Cystouretero & or pyeloscope Cystouretero w/stone remove Cystouretero w/biopsy Cystouretero w/excise tumor Cystouretero w/congen reprCystourethro cut ejacul duct

Incision of prostate Revision of bladder neck Relieve bladder contracture Drainage of prostate abscess Drainage of prostate abscess Drainage of prostate abscess T 37.0730 $2,595.70

. $519.14 Kidney endoscopy Removal of ureter stone Cystoscopy

im plant stent Cystoscopy

inject material Cystouretero w/lithotripsy Prostatectomy

(TURP) Remove prostate regrowth Transperi needle place pros T 1.9499 $136.52

. $27.31 Incise external hemorrhoid Measure kidney

pressure Drain bladder by

needle Irrigation of bladder Change of bladder tube Anal/urinary

muscle study Intraabdominal pressure test Dilate urethra stricture Insert prost urethral stent Treatment of penis lesion Treatment of penis lesion Penile injection Penis study T 20.4158 $1,429.43

. $285.89 Revise ureter Drain bl w/cath insertion Dilate urethra stricture Transurethral rf treatment Dynam ic cavernosometry Surgical exposure prostate T 21.0031 $1,470.55

. $294.11 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 urethraRemoval 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 32.3061 $2,261.94

. $452.39 Endoscopic injection/implant 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 52.0882 $3,647.01 $997.74 $729.41 Fragmenting of kidney

stone S 6.2419 $437.03

. $87.41 Hemodialysis one evaluation Unsched dialysis ESRD pt hos T 111.6495 $7,817.25 $2,055.58 $1,563.45 Laparo ablate liver tumor rf Laparo ablate liver cryosurg Laparo ablate renal mass T 34.6069 $2,423.04 $607.60 $484.61 Penile venous occlusion Treatment of penis lesion Treat penis lesion graftTreat 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 pros Remove self-contd penis pros Revision of penis Revision of penis Repair of penis Extensive testis surgery T 23.5454 $1,648.55

. $329.71 Circumcision w/regionl block 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 scrotumRemove 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 lesion Revise spermatic cord veins Incise sperm duct pouch Remove sperm pouch lesion T 13.7727 $964.31

. $192.87 Biopsy of prostate Biopsy of prostate Prostate saturation sampling T 1.5841 $110.91

. $22.19 I & D of vulva/perineum Drainage of gland abscess Biopsy of vulva/perineum Exam of vulva w/scope Exam/biopsy

of vulva w/scope 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 3.4818 $243.78

. $48.76 Electroejaculation Biopsy of vulva/perineum Ins vag brachy

tx deviceExam 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 oocy

te Transfer of embryo Transfer of embryo Am niocentesis diagnostic Fetal cord puncture prenatal Chorion biopsy Fetal scalp blood sample Umbilical cord occlud w/us Fetal fluid drainage w/us Fetal shunt placement w/us Abortion (mpr) T 23.0098 $1,611.05 $424.28 $322.21 Hysteroscopy

dx sep proc Hysteroscopy

biopsy Hysteroscopy

lysis Hysteroscopy

remove fb Hysteroscope procedure T 0.1337 $9.36 $1.95 $1.88 Fitting of diaphragm/cap Genital surgery

procedure Fetal invas px w/us Maternity care procedure Anogenital examchild Obtaining screen pap smear $0.00 $0.00 T 6.6979 $468.96

. $93.80 Drainage of pelvic fluid Biopsy of vagina Insert uteri tandems/ovoids Biopsy of cervix Endocervical curettage Am niocentesis therapeutic T 20.6493 $1,445.78

. $289.16 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 lesionRepair 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 repair Revision of cervix Obstetrical care Antepartum manipulation Deliver placenta Vbac delivery

only Treatment of miscarriage Care of miscarriage Treatment of miscarriage Abortion AbortionEvacuate mole of uterus

Remove cerclage suture T 35.9087 $2,514.18

. $502.84 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 addon Repair of bowel bulge Revise/remove sling repair Repair bladder & vagina Construction of vagina Construct vagina with graft Repair rectum-vagina fistula Repair bladder-vagina lesion Repair bladder-vagina lesion Repair vagina Removal of cervix Removal of residual cervix Remove cervix/repair vagina Myom ectomy

vag m ethod Vaginal hysterectomy Vag hyst including t/o Vag hyst w/t/o & vag repair Vag hyst w/enterocele repair Reopen fallopian tube Endom etr 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 45.9895 $3,220.00 $981.50 $644.00 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 lesionRepair 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 Endom etrial cryoablation Hysteroscopy

sterilization T 12.7996 $896.18

. $179.24 Treat trigeminal tract Epidural lysis mult sessions Epidural lysis on single day Treat spinal cord lesion Treat spinal canal lesion Inject spine w/cath l/s (cd) Remove spinal canal catheter Removal of spinal shunt Injection treatment of nerve Injection treatment of nerve Destroy lum b/sac facet jnt Injection treatment of nerve Injection treatment of nerve T 2.6055 $182.43

. $36.49 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 dupuy tren 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 lev Inj paravert f jnt c/t 3 lev Inj paravert f jnt l/s 2 lev Inj paravert f jnt l/s 3 lev N block spenopalatine ganglN block carotid sinus s/p

Neuroeltrd stim post tibial Chemodenerv saliv glands Destroy nerve face muscle N block inj common digit Destroy c/th facet jnt addl Chemodenerv eccrine glands Chemodenerv eccrine glands Nervous system surgery T 3.8754 $271.34

. $54.27 Njx tfrml eprl w/us cer/thor Njx tfrml eprl w/us lumb/sac 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 7.4537 $521.88

. $104.38 Njx paravert w/us cer/thor Njx paravert w/us lumb/sac Njx tfrml eprl w/us cer/thor Njx tfrml eprl w/us lumb/sac 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 artery Inject spine c/tInject spine l/s (cd)

Inject spine w/cath c/t 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 lev Inj paravert f jnt l/s 1 lev N block stellate ganglion N block inj hypogas plxs N block lumbar/thoracic N block inj celiac pelus Injection treatment of nerve Destroy cerv/thor facet jnt Destroy l/s facet jnt addl Injection treatment of nerve Inj for sacroiliac jt anesth T 50.7343 $3,552.21

. $710.45 Perq lamot/lam crv/thrc Perq lamot/lam lumbar Remove part of neck vertebra Remove part thorax vertebra Remove part lumbar vertebra Remove extra spine segment Revision of thorax spine Neck spine fuse&remov bel c2 Neck spine fusion Lum bar spine fusion Spine fusion extra segment Implant spinal canal cath Removal of spinal lamina Removal of spinal lamina Removal of spinal lamina Removal of spinal lamina Removal of spinal lamina Removal of spinal lamina Removal of spinal lamina Removal of spinal lamina Neck spine disk surgery Low back disk surgery Spinal disk surgery

add-on Lam inotomy single cervicalLam inotomy single lum bar

Removal of spinal lamina Removal of spinal lamina Removal of spinal lamina Remove spinal lamina add-on Decompress spinal cord Decompress spinal cord Decompress spine cord add-on Decompress spinal cord Decompress spine cord add-on Neck spine disk surgery Neck spine disk surgery S 11.3569 $795.16 $268.73 $159.04 Remote 30 day

ecg tech supp Multiple sleep latency

test Sleep study

attended Polysomnography

1-3 Polysomnography

4 or more Polysomnography

w/cpap Am bulatory

eeg monitoring EEG monitoring/videorecord EEG monitoring/computer Eeg monitor technol attended Pre-op service LVRS complete Pre-op service LVRS 10-15dos S 2.4298 $170.12 $53.58 $34.03 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 test Pre-op service LVRS 1-9 dos Post op service LVRS min 6 Home sleep test/type 2 Porta Home sleep test/type 3 Porta Home sleep test/type 4 Porta S 0.6335 $44.36

. $8.88 Physiologic tremor record Tempr Muscle test thor paraspinal Muscle test nonparaspinal Musc tst done w/n tst nonextMotor nerve conduction test

Motor nerve conduction test Sense nerve conduction test Motor/sens nrve conduct test Blink reflex test H-reflex test H-reflex test Neurological procedure S 2.6488 $185.46

. $37.10 Electrocochleography Auditor evoke potent compre Eeg cerebral death only Som atosensory

testing Som atosensory

testing Som atosensory

testing Visual evoked potential test Som atosensory

testing Electrode stimulation brain Electrode stim brain add-on Motion analysis video/3d Motion test w/ft press meas S 1.2025 $84.19

. $16.84 Interrogate crtd sns dev Interrogate crtd sns w/pgrmg Periph field stimul analys Tcranial magn stim tx plan Tcranial magn stim tx deli Tcran magn stim redetemine 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 unilat Muscle test cran nerve bilat Muscle test one fiber Lim b exercise test Musc tst done w/nerv tst lim Musc test done w/n test comp Autonom ic nerv function test Autonom ic nerv function test Autonom ic nerv function test C motor evoked uppr limbsC motor evoked lwr limbs

Neuromuscular junction test C motor evoked upr&lwr limbs EEG monitoring/giving drugs Analy ze neurostimno prog Analy ze neurostimcomplex Cranial neurostim complex Io anal gast n-stim subsq Dynam ic surface emg Dynam ic fine wire emg T 18.8921 $1,322.75

. $264.55 Neurectomy

hamstring Neurectomy

popliteal Decompression of tibia nerve Neurectomy

foot Treat trigeminal nerve Remove spinal cord lesion Stim ulation of spinal cord Remove lesion of spinal cord Injection treatment of nerve Injection treatment of nerve 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 lesionRemove digit nerve lesion

Digit nerve surgery

add-on Remove limb nerve lesion Lim b nerve surgery

add-on Remove nerve lesion Implant nerve end Remove skin nerve lesion Removal of nerve lesion Biopsy of nerve Remove sympathetic nerves Remove sympathetic nerves Remove sympathetic nerves T 36.1290 $2,529.61

. $505.93 Rev/remvl crtd sns dev total Incise skull/brain surgery Incise skull for treatment Percutaneous diskectomy Remove spine infusion device 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 nerve Repair of hand or foot nerve Repair of hand or foot nerve 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 nerve Subsequent repair of nerve Repair & revise nerve add-on Repair nerve/shorten bone Nerve graft head or neck Nerve graft head or neck Nerve graft hand or foot Nerve graft hand or foot Nerve graft arm or leg Nerve graft arm or legNerve graft hand or foot

Nerve graft hand or foot Nerve graft arm or leg Nerve graft arm or leg Nerve graft add-on Nerve graft add-on Nerve pedicle transfer Nerve pedicle transfer Nerve repair w/allograft Neurorraphy

w/vein autograft T 41.5547 $2,909.49

. $581.90 Insert brain-fluid device Replace/revise brain shunt Implant spinal canal cath Insert spine infusion device Install spinal shunt Revision of spinal shunt T 192.7379 $13,494.74

. $2,698.95 Implant spine infusion pump Implant spine infusion pump T 115.5014 $8,086.95

. $1,617.39 Remove hepatic shunt (tips) Transcath iv stent percut Transcath iv stent/perc addl Transcath iv stent open Transcath iv stent/open addl Em bolization uterine fibroid 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-on S 0.6424 $44.98

. $9.00 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 segmt Cmptr ophth img optic nerve Cptr ophth dx img post segmt Glaucoma provocative testsSpecial eye exam initial

Special eye exam subsequent Eye exam with photos Ophthalmoscopy

/dynamom etry Eye muscle evaluation Electro-oculography Color vision examination Dark adaptation eye exam Eye photography Contact lens fitting Prescription of contact lens Replacement of contact lens Special spectacles fitting Special spectacles fitting Eye prosthesis service Eye service or procedure Glaucoma scrn hgh risk direc S 2.0294 $142.09

. $28.42 Treatment of corneal lesion Inject/treat eye socket Remove eyelid foreign body Explore/irrigate tear ducts Eye exam with photos Icg angiography Electroretinography T 2.8247 $197.77 $42.27 $39.56 Conjunctival drug placement Remove eye lesion Incision of iris Eye surgery

procedure Ophth us b & quant a T 16.6214 $1,163.76

. $232.76 Remove foreign body

from eye Removal of eye lesion Biopsy of cornea Removal of eye lesion Curette/treat cornea Correction of astigmatism Correction of astigmatism Cover eye w/m em brane Cover eye w/m em brane suture Incise inner eye adhesions Incise inner eye adhesions Injection treatment of eye Injection treatment of eye Follow-up surgery

of eye Destruction ciliary

bodyCiliary

transsleral therapy Destruction ciliary

body Removal of lens material Revision of eyelid Remove eyelid lining lesion T 23.2851 $1,630.33 $347.90 $326.07 Implant corneal ring Scleral fistulization Repair of eye wound Repair of eye wound Removal of eye lesion Drainage of eye 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 blood clot from eye Remove eye lesion Glaucoma surgery Glaucoma surgery Glaucoma surgery Glaucoma surgery Glaucoma surgery Incision of eye Revise eye shunt Remove iris and lesion Removal of iris 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 4.8135 $337.02

. $67.41 Remove foreign body

from eye Treatment of retina Treatment of retinal lesion Treatment of choroid lesion Ocular photodynam ic therEye photodynam ic ther add-on

Eye surgery

procedure Dstry eye lesn,fdr vssl tech T 21.5368 $1,507.92

. $301.59 Suprachoroidal drug delivery Place intraoc radiation src Remove foreign body

from eye Repair of eye wound Partial removal of eye fluid Incise inner eye strands Repair detached retina Repair detached retina Release encircling material Remove eye im plant m aterial Treatment of retinal lesion Treatment of retinal lesion Reinforce/graft eye wall T 3.1036 $217.30

. $43.46 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 of eyelid 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 7.6566 $536.08

. $107.22 Curette/treat cornea Incision of eyelid Remove eyelid lesions Revise eyelashes Remove eyelid lesion Treat eyelid lesion Closure of eyelid by

sutureBiopsy

of eyelid lining Remove eyelid lining lesion T 19.7786 $1,384.82 $296.20 $276.97 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/im plant 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 ductProbe nasolacrimal duct

Probe nl duct w/balloon T 27.3416 $1,914.35 $383.45 $382.87 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 40.4039 $2,828.92 $597.36 $565.79 Revise eye Revise eye with im plant 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 24.8671 $1,741.09 $411.91 $348.22 Repair of eye socket wound Revise eye muscleRevise 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-on 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

procedure T 37.8979 $2,653.46 $794.94 $530.70 Corneal transplant Corneal transplant Corneal transplant Corneal transplant Corneal trnspl endothelial Ocular reconst transplant Ocular reconst transplant Ocular reconst transplant T 23.8810 $1,672.05 $490.37 $334.41 Cataract surgery

complex Cataract surg w/iol 1 stage Cataract surg w/iol 1 stage Insert lens prosthesis Exchange lens prosthesis T 5.4120 $378.93 $102.28 $75.79 Laser surgery

of eye Incise inner eye adhesions Revision of iris Revision of iris Removal of inner eye lesion After cataract laser surgery Laser surgery

eye strands Repair detached retina Treatment of retina Treatment of retinal lesion Treatment of retinal lesion Tr retinal les preterm inf T 30.9855 $2,169.48 $516.99 $433.90 Removal of lens material Removal of lens material Extraction of lens Extraction of lens T 1.0709 $74.98 $24.12 $15.00 Prepare face/oral prosthesisCranio/maxillofacial surgery

Treatment of nose fracture Reset dislocated jaw Head surgery

procedure Neck/chest surgery

procedure 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 bleeding Throat surgery

procedure Outer ear surgery

procedure Middle ear surgery

procedure Inner ear surgery

procedure Temporal bone surgery T 3.1150 $218.10

. $43.62 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 graft 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

ductDrainage of tonsil abscess

Biopsy of external ear Inflate middle ear canal Inflate middle ear canal Incision of eardrum Ear and throat examination T 7.4614 $522.42 $104.55 $104.49 Explore wound neck Injection of sinus tract Mnpj of tmj w/anesth Interdental fixation Revision of jaw muscle/bone Treat eye socket fracture Treat lower jaw fracture Hyoid myotomy

& suspension Intranasal biopsy Removal of nose lesion Injection treatment of nose Nasal sinus therapy Insert nasal septal button Ablate inf turbinate superf Irrigation sphenoid sinus Incision of windpipe Incision of windpipe Visualization of windpipe Repair lip Repair lip Repair lip Drainage of mouth lesion Removal foreign body

mouth Excise lip or cheek fold Repair mouth laceration Incision of tongue fold Drainage of mouth lesion Drainage of mouth lesion Drainage of mouth lesion Biopsy of tongue Excision of tongue fold Repair tongue laceration Tongue suspension Reconstruction tongue fold Excision gum each quadrant Excision of gum flap Biopsy roof of mouth Excision of uvula Dilation of salivary

duct Biopsy of throatRepair throat wound

Incision of esophagus Drain thyroid/tongue cyst Extensive ear canal surgery Catheterize m iddle ear canal Create eardrum opening Insert palate implants T 16.8699 $1,181.16 $279.20 $236.24 Prepare face/oral prosthesis Revision of eyelid Treatment of nose fracture Treatment of nose fracture Treat nasal septal fracture Treat eye socket fracture Treat lower jaw fracture Reset dislocated jaw Treat hyoid bone fracture Interdental wiring Removal of nose polyp(s) Removal of nose polyp(s) Removal of intranasal lesion Excise inferior turbinate Remove nasal foreign body Remove nasal foreign body Ablate inf turbinate submuc Ther fx nasal inf turbinate Partial excision of lip Partial excision of lip Excision of mouth lesion Excise/repair mouth lesion Excise/repair mouth lesion Treatment of mouth lesion Drainage 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 Excision of mouth lesion Tongue to lip surgery Removal foreign body

jawbone Excision of gum lesion Excision of gum lesion Excision of gum lesion Removal of gum tissue Treatment of gum lesionRepair gum

Excision lesion mouth roof Excision lesion mouth roof Treatment mouth roof lesion Repair palate Insertion palate prosthesis Drainage of salivary

gland Drainage of salivary

gland Removal of salivary

stone Removal of salivary

stone Removal of salivary

stone Excision of salivary

cyst Drainage of salivary

cyst Closure of salivary

fistula Drainage of throat abscess Biopsy of throat Biopsy of upper nose/throat Control nose/throat bleeding Throat muscle surgery Biopsy of external ear canal Clean out mastoid cavity Incision of eardrum Remove ventilating tube Create eardrum opening Remove ear lesion Incise inner ear T 24.8895 $1,742.66

. $348.54 Incision of jaw joint Excise max/zygom a b9 tumor Remove exostosis mandible Remove exostosis maxilla Excise mandible lesion Prepare face/oral prosthesis Reconstruction of chin Reconstruction of chin Reconstruction of chin Reconstruction of chin Augm entation lower jaw bone Reduction of forehead Contour cranial bone lesion Ear cartilage graft Revision of jaw muscle/bone Treatment of nose fracture Treatment of nose fracture Treatment of nose fracture Treat nasoethmoid fracture Treat nasoethmoid fractureTreat nose/jaw fracture

Treat nose/jaw fracture Treat cheek bone fracture Treat cheek bone fracture Treat mouth roof fracture Treat dental ridge fracture Treat dental ridge fracture Treat lower jaw fracture Removal of intranasal lesion Revision of nose Resect inferior turbinate Revision of nose Repair of nasal septum Repair nasal septum defect Exploration maxillary

sinus Exploration behind upper jaw Exploration of frontal sinus Removal of larynx lesion Incision of windpipe Incision of windpipe Incision of windpipe Surgery /speech prosthesis Puncture/clear windpipe 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 Reconstruct lip with flap Partial removal of lip Excision of mouth lesion Reconstruction of mouth Reconstruction of mouth Reconstruction of mouth Drainage of mouth lesion Place needles h&n for rt Excision of tongue lesion Partial removal of tongue Fixation of tongue Tongue base vol reduction Removal foreign body

gum Excision of gum lesion Excision of gum lesion Excision of gum lesion Gum graftRepair tooth socket

Excision lesion mouth roof Repair palate pharynx/uvula Repair nose to lip fistula Biopsy of salivary

gland Excise sublingual gland Repair salivary

duct Ligation of salivary

duct 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 tonsils Removal of adenoids Removal of adenoids Removal of adenoids Removal of adenoids Extensive surgery

of throat Excision of tonsil tags Excision of lingual tonsil Reconstruction of throat Surgical opening of throat Repair esophagus opening Treat skull fracture Removal of external ear Remove ear canal lesion(s) Revise external ear Exploration of middle ear Mastoidectomy Repair of eardrum Repair of eardrum Release middle ear bone T 7.2190 $505.45 $101.81 $101.09 Repair of eye wound Drainage of eye Incision of iris Removal of iris Incision secondary

cataract Removal of lens lesion Extraction of lens T 45.0377 $3,153.36

. $630.68 Excision of bone lower jaw Excision of facial bone(s) Contour of face bone lesion Excise max/zygom a mal tumorRemoval of jaw bone lesion

Remove mandible cyst complex Excise lwr jaw cyst w/repair Remove maxilla cyst complex Excis uppr jaw cyst w/repair Removal of jaw joint Remove jaw joint cartilage Remove coronoid process Prepare face/oral prosthesis Prepare face/oral prosthesis Prepare face/oral prosthesis Prepare face/oral prosthesis Prepare face/oral prosthesis Prepare face/oral prosthesis Prepare face/oral prosthesis Prepare face/oral prosthesis Prepare face/oral prosthesis Prepare face/oral prosthesis Maxillofacial fixation Augm entation lower jaw bone Reduction of forehead Reduction of forehead Reconstruct midface lefort Reconstruct orbit/forehead Reconstruct orbit/forehead Reconst lwr jaw w/o graft Reconst lwr jaw w/o fixation Reconstr lwr jaw segment Reconstr lwr jaw w/advance Reconstruct upper jaw bone Augm entation of facial bones Reduction of facial bones Face bone graft Lower jaw bone graft Rib cartilage 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 socketsRevise eye sockets

Augm entation cheek bone Revision orbitofacial bones Revision of eyelid Treatment of nose fracture Treat cheek bone fracture Treat cheek bone fracture Treat eye socket fracture Treat eye socket fracture Treat eye socket fracture Treat eye socket fracture Treat eye socket fracture Treat eye socket fracture Treat eye socket fracture Treat eye socket 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 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 sinus Removal of frontal sinus Removal of frontal sinus Removal of frontal sinus Removal of frontal sinus Removal of frontal sinusRemoval of frontal sinus

Exploration of sinuses Removal of ethmoid sinus Removal of ethmoid sinus Removal of ethmoid sinus Diagnostic incision larynx Revision of larynx Removal of epiglottis Revision of larynx Revision of larynx Revision of larynx Reinnervate larynx Larynx nerve surgery Repair windpipe opening Repair of windpipe Repair of windpipe 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 Remove palate/lesion Repair palate Reconstruct cleft palate 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 Repair salivary

duct Parotid duct diversion Parotid duct diversion Parotid duct diversion Parotid duct diversion Drainage of throat abscess Excision of neck cyst Extensive surgery

of throat Partial removal of pharynxRevision of pharyngeal walls

Control throat bleeding Removal of esophagus pouch Removal of thyroid Repeat thyroid surgery Removal of thyroid Explore parathyroid glands Re-explore parathyroids Removal of thymus gland Decompress eye socket Explore orbit/remove object Rebuild outer ear canal Rebuild outer ear canal Eardrum revision 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 Revise middle ear bone Revise middle ear bone Revise middle ear bone Repair middle ear structures Repair middle ear structures Remove mastoid air cells Remove middle ear nerve Close mastoid fistula Remove/repair hearing aid Release facial nerveRelease 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 412.7299 $28,897.70 $7,948.75 $5,779.54 Implant cochlear device X 0.6409 $44.87

. $8.98 X-ray eye for foreign body X-ray exam of jaw X-ray exam of jaw X-ray exam of mastoids X-ray exam of mastoids X-ray exam of facial bones X-ray exam of facial bones X-ray exam of nasal bones X-ray exam of eye sockets X-ray exam of eye sockets X-ray exam of sinuses 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

gland Chest x-ray Chest x-ray Chest x-ray Chest x-ray Chest x-ray Chest x-ray Chest x-ray X-ray exam of ribs X-ray exam of ribs/chest X-ray exam of ribs X-ray exam of breastbone X-ray exam of breastboneX-ray

exam of spine X-ray exam of neck spine X-ray exam of trunk spine X-ray exam of thoracic spine X-ray exam of thoracic spine X-ray exam of thoracic spine X-ray exam of trunk spine X-ray exam of lower spine X-ray exam of lower spine X-ray exam of pelvis X-ray exam of pelvis X-ray exam sacroiliac joints X-ray exam sacroiliac joints X-ray exam of tailbone X-ray exam of collar bone X-ray exam of shoulder blade 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 hips 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 knee 4 or more 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 abdomenX-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 X-rays bone length studies Joint survey

single view Dxa bone density

vert fx Single energy

x-ray study $0.00 $0.00 X 1.0790 $75.55

. $15.11 X-ray exam of middle ear X-ray exam of skull X-ray exam of ribs/chest X-ray exam of spine X-ray exam of neck spine X-ray exam of neck spine X-ray exam of trunk spine X-ray exam of lower spine X-ray exam of lower spine X-ray exam series abdomen X-ray measurement of pelvis Nonvascular shunt x-ray Follow-up angiography X-ray exam of body

section X-rays bone survey

lim ited X-rays bone survey

complete X-rays bone survey

infant X 0.4640 $32.49

. $6.50 X-ray exam of teeth X-ray exam of teeth Full mouth x-ray

of teeth Panoramic x-ray

of jaws X 3.3643 $235.55

. $47.11 X-ray exam of tear duct Contrast x-ray

of larynx X-ray exam of salivary

duct Contrast x-ray

of bronchi Contrast x-ray

of bronchi 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

ductX-ray

of mammary

ducts S 0.8990 $62.94 $22.26 $12.59 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 dynam ic Us exam infant hips static Ultrasound exam follow-up Echo examination procedure Intracranial study S 1.3781 $96.49 $37.23 $19.30 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 nst Transvaginal us non-ob Us exam pelvic complete Us exam scrotum Us transrectal Echograp trans r pros studyUs 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 $0.00 S 2.1681 $151.80 $59.37 $30.36 Pseudoaneurysm injection trt Intravascular us Ob us detailed sngl fetus Echo exam uterus GI endoscopic ultrasound Extracranial study Extracranial study Intracranial 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 5.6156 $393.18

. $78.64 Echo transthoracic Tte w/doppler complete Tte w/o doppler complete Echo transesophageal Echo transesophageal Stress tte only S 8.2952 $580.80 $133.61 $116.16 Echo transthoracic Echo transesophageal Echo transesophageal Echo transesophageal intraop Stress tte complete X 1.2171 $85.22 $30.47 $17.05 Nasal/orogastric w/stent Dx duod intub w/asp spec Dx duod intub w/asp specs Throat x-ray

& fluoroscopy Speech evaluation complexChest x-ray and fluoroscopy Chest x-ray

and fluoroscopy Fluoroscope examination Cine/video x-rays Fluoroscopic procedure S 7.0678 $494.86

. $98.98 Contrast x-ray

of brain Contrast x-ray

of brain Contrast x-ray

of neck spine Contrast x-ray

thorax spine Contrast x-ray

lower spine Contrast x-ray

spine S 4.0104 $280.79 $68.90 $56.16 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 joint Contrast x-ray

of ankle S 1.2186 $85.32 $33.87 $17.07 Contrst x-ray

exam of throat Contrast x-ray

esophagus Cine/vid x-ray

throat/esoph X-ray exam upper gi tract X-ray exam upper gi tract Contrst x-ray

uppr gi tract Contrst x-ray

uppr gi tract X-ray exam of small bowel X-ray exam of small bowel Contrast x-ray

exam of colon Contrast x-ray

exam of colon Contrast x-ray

gallbladder Contrast x-rays gallbladder S 2.0340 $142.41 $53.90 $28.49 Fluoro exam of g/colon tube X-ray exam upper gi tract Contrst x-ray

uppr gi tract X-ray exam of small bowel Contrast x-ray

exam of colon S 2.6196 $183.41 $58.44 $36.69 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

bladderX-ray

male genital tract X-ray exam of penis X-ray urethra/bladder X-ray urethra/bladder X-ray exam of perineum S 29.7209 $2,080.94

. $416.19 Ins cath ren art 1st unilat Ins cath ren art 1st bilat Ins cath ren art 2nd+ unilat Ins cath ren art 2nd+ bilat Contrast x-ray

exam of aorta Contrast x-ray

exam of aorta Contrast x-ray

exam of aorta X-ray aorta leg arteries Artery x-rays arm Artery x-rays head & neck Artery x-rays neck Artery x-rays neck Artery x-rays spine 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 Vein x-ray

liver Vein x-ray

liver Venous sampling by

catheter S 49.6878 $3,478.94

. $695.79 Artery x-rays head & neck Artery x-rays head & neck Artery x-rays head & neck Artery x-rays head & neck S 1.5251 $106.78 $35.57 $21.36 CAT scan follow-up study Ct procedure S 4.2929 $300.57 $96.62 $60.12Ct 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 S 6.2343 $436.50 $146.69 $87.30 Mri orbit/face/neck w/dye Mr angiography

head w/dye Mr angiography

neck w/dye Mri brain w/dye Mri brain w/dye Mri chest w/dye Mri neck spine w/dye Mri chest spine w/dye Mri lum bar 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 1.0218 $71.54 $0.00 $0.00 Ct bone density

axial $0.00 $0.00 Dxa bone density

axial $0.00 $0.00 T 117.1298 $8,200.96

. $1,640.20 Revise cornea with implant S 5.6386 $394.79

. $78.96 Special radiation treatment Hyperthermia treatment Hyperthermia treatment Hyperthermia treatmentHyperthermia treatment

Hyperthermia treatment S 1.4252 $99.79

. $19.96 Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Apply surface radiation S 2.4149 $169.08

. $33.82 Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Neutron beam tx simple Neutron beam tx complex Infuse radioactive materials X 2.8573 $200.06 $66.95 $40.02 Radiation treatment aid(s) Radiation treatment aid(s) Radiation treatment aid(s) X 1.5329 $107.33 $34.63 $21.47 Set radiation therapy

field Radiation therapy

planning Radiation therapy

dose plan Teletx isodose plan simple Teletx isodose plan intermed Brachy tx isodose calc simp Special radiation dosimetry Radiation physics consult Radiation physics consult External radiation dosimetry X 3.7681 $263.83 $88.76 $52.77 Set radiation therapy

field Set radiation therapy

field Teletx isodose plan complex Special teletx port plan Brachy tx isodose calc interm Brachy tx isodose plan compl Design mlc device for imrt S 14.8260 $1,038.06

. $207.62 Heart muscle imaging (PET) Heart image (pet) singleHeart image (pet) multiple

Brain im aging (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 13.6332 $954.54 $325.27 $190.91 Ins mark thor for rt perq Ins mark abd/pel for rt perq Place rt device/marker pros Set radiation therapy

field Radiotherapy

dose plan imrt Place device/marker, non pro S 5.4044 $378.39

. $75.68 Apply intrcav radiat simple Apply intrcav radiat interm Apply intrcav radiat compl Apply interstit radiat simpl Apply interstit radiat inter Radium/radioisotope therapy S 9.9687 $697.97 $263.92 $139.60 Hdr elect brachy

therapy Hdr brachy

tx 1 channel Hdr brachy

tx 2-12 channel Hdr brachy

tx over 12 chan S 285.5893 $19,995.82

. $3,999.17 Implant neurostim arrays X 5.7208 $400.55

. $80.11 Contrast x-ray

of bile ducts Lymph vessel x-ray

arm/leg Lymph vessel x-ray

arms/legs Lymph vessel x-ray

trunk Lymph vessel x-ray

trunk X-ray exam breast specimen S 346.4693 $24,258.39 $9,121.76 $4,851.68 Periph field stimul perm Inc for vagus n elect impl T 203.0553 $14,217.12 $5,559.48 $2,843.43 Fem/popl revasc stnt & ather Tib/per revasc stent & ather S 5.9715 $418.10

. $83.62 Electroconvulsive therapy S 1.1395 $79.78

. $15.96 Psy tx office 20-30 min Psy tx off 20-30 min w/e&mIntac psy

tx off 20-30 min Intac psy tx 20-30 w/e&m Psychiatric service/therapy Alcohol/subs interv >30 min S 1.5910 $111.40

. $22.28 Psy dx interview Intac psy dx interview Psy tx off 45-50 min Psy tx off 45-50 min w/e&m Psy tx office 75-80 min Psy tx off 75-80 w/e&m Intac psy tx off 45-50 min Intac psy tx 45-50 min w/e&m Intac psy tx off 75-80 min Intac psy tx 75-80 w/e&m Psychoanalysis Narcosynthesis Hypnotherapy S 1.8190 $127.36

. $25.48 Family psy tx w/o patient Family psy tx w/patient S 0.8088 $56.63 $11.70 $11.33 Multiple family

group psy

tx Group psychotherapy Intac group psy

tx S 8.2687 $578.94

. $115.79 Comprehensve oral evaluation Intraoral occlusal film Extraoral first film Extraoral ea additional film Dental bitewing single film Dental bitewings two films Dental bitewings four films Vert bitewings-sev to eight Pulp vitality

test Space maintainer fxd unilat Fixed bilat space maintainer Remove unilat space maintain Remove bilat space maintain Recement space maintainer Dental unspec restorative pr Endodontic endosseous implan Endodontic procedure Osseous surgery

per quadrant Bone replce graft first site Bone replce graft each add Surgical revision procedurePedicle soft tissue graft pr

Free soft tissue graft proc Subepithelial tissue graft Full mouth debridement Localized delivery

antim icro Facial moulage sectional Facial moulage complete Radiation applicator Radiation shield Radiation cone locator Commissure splint Dental connector bar Extraction coronal remnants Extraction erupted tooth/exr Rem imp tooth w mucoper flp Impact tooth remov soft tiss Impact tooth remov part bony Impact tooth remov comp bony Impact tooth rem bony

w/comp Tooth root removal Oral antral fistula closure Prim ary closure sinus perf Transseptal fiberotomy Reshaping bone orthognathic Other drugs/medicaments Treatment of complications Dental occlusal guard Occlusion analysis Lim ited occlusal adjustment Complete occlusal adjustment S 5.7930 $405.60 $156.82 $81.12 Ct abd & pelvis S 2.7436 $192.10 $74.27 $38.42 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 4.7767 $334.45 $116.13 $66.89Ct head/brain w/o & w/dye

Ct orbit/ear/fossa w/o&w/dye Ct maxillofacial w/o & w/dye 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 8.2987 $581.04 $187.25 $116.21 Ct angio abd&pelv w/o&w/dye Ct abd & pelv w/contrast Ct abd & pelv 1/> regns Magnetic Resonance Imaging and Magnetic Resonance Angiography without Contrast S 4.8381 $338.74 $133.48 $67.75

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 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 lum bar spine w/o dye Mri pelvis w/o dye Mri upper extremity

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

w/o dye Mri jnt of lwr extre w/o dye 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 extrMagnetic Resonance Imaging and Magnetic Resonance Angiography without Contrast f S 7.6347 $534.55 $197.64 $106.91

Mri orbt/fac/nck w/o & w/dye Mr angiograph head w/o&w/dye Mr angiograph neck w/o&w/dye Mri brain 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 lum bar spine w/o & w/dye Mri pelvis w/o & w/dye Mri uppr extremity

w/o&w/dye Mri joint upr extr w/o&w/dye Mri lwr extremity

w/o&w/dye Mri joint lwr extr w/o&w/dye 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, un 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 canal MRA, w/o&w/dye, upper extr X 0.6499 $45.50

. $9.10 Chd risk imt study Remote algorithm analys ecg Anoscopy

hra w/spec collect Njx platelet plasma Esw wound healing init wound Esw wound healing addl wound Implant hormone pellet(s) Insert drug implant device Remove drug implant device Remove/insert drug implant Dressing change not for burn Test for blood flow in graft 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 specDiagnostic 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 $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 trial Non-cov proc, clinical trial Bone m arrow aspirate &biopsy X 0.0806 $5.64 $2.09 $1.13 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 test Histoplasmosis skin test TB intradermal test X 0.1601 $11.21

. $2.25 Ctc test Ctc test w/i & r Lab pathology

consultation Lab pathology

consultation Physician blood bank service Physician blood bank service Cy tp fna eval ea addl Flowcy tometry /read 2-8 Cy topathology

procedure Cy togenetic study Surgical path gross Decalcify tissue Path consult intraop addl Xm archive tissue molec anal Surgical pathology

procedure Chct for mal hyperthermia Pathology

lab procedure Unlisted reprod med lab proc X 0.5259 $36.82 $10.84 $7.37Bone m arrow interpretation

Physician blood bank service Cy topath cell enhance tech Cy topath smear other source Cy topath eval fna report Cell m arker study Flowcy tometry /read 9-15 Flowcy tometry /read 16 & > Tissue exam by

pathologist Tissue exam by

pathologist Microslide consultation Path consult intraop 1 bloc Immunohistochemistry Immunofluorescent study Immunofluorescent study Analysis skeletal muscle Analysis tumor Tumor immunohistochem/manual Insitu hybridization auto Eval molecul probes 51-250 Collect sweat for test Sperm identification Sperm isolation simple Sperm isolation complex X 0.8180 $57.27 $15.56 $11.46 Cryopreservation ovary tiss Cryopreservation oocy

te Cy tp urne 3-5 probes ea spec Cy tp urine 3-5 probes cmptr Tissue exam by

pathologist Tissue exam by

pathologist Comprehensive review of data Analysis nerve Tumor immunohistochem/comput Nerve teasing preparations Insitu hybridization (fish) Insitu hybridization m anual Eval molecul probes 251-500 Cultr oocy

te/embryo <4 days Cultr oocy

te/embryo <4 days Em bryo hatching Oocy te identification Prepare embryo for transfer Cryopreservation embryo(s) Identify sperm tissue Insemination of oocy

tes Extended culture of oocy tesAssist oocy te fertilization Assist oocy

te fertilization Biopsy oocy te polar body Biopsy oocy te polar body Cryopreserve testicular tiss Storage/year embryo(s) Storage/year sperm/semen Storage/year reprod tissue Storage/year oocy

te(s) Thawing cryopresrved embryo Thawing cryopresrved sperm Thaw cryoprsvrd reprod tiss Thawing cryopresrved oocy te X 0.2135 $14.95

. $2.99 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 Leukacy te transfusion Vol reduction of blood/prod RBC pretreatment RBC pretreatment RBC pretreatment Rbc pretreatment serum Split blood or products Transfusion procedure X 0.3538 $24.77

. $4.96 RBC antibody

elution RBC antibody

identification Compatibility

test antiglob Pooling blood platelets Rbc pretreatment serum Rbc pretreatment serum X 0.6730 $47.12

. $9.43 Autologous blood process Frozen blood prep Frozen blood thaw Frozen blood freeze/thaw Rbc pretreatment serum S 0.3545 $24.82 $0.00 $0.00Adm in influenza virus vac $0.00 $0.00

Adm in pneumococcal vaccine $0.00 $0.00 Influenza A H1N1,adm in w cou $0.00 $0.00 X 1.7152 $120.09 $33.87 $24.02 Esoph imped function test Esoph balloon distension tst Breath hydrogen test Electrogastrography Electrogastrography

w/test Gastroenterology

procedure X 4.0827 $285.85 $83.23 $57.17 Esoph motility

3d topography Esoph motility

w/stim/perf Gi tract transit & pres meas Esophagus motility

study Esophgl motil w/stim/perfus Gastric motility

studies Duodenal motility

study Acid perfusion of esophagus Gastroesophageal reflux test G-esoph reflx tst w/electrod Esoph imped funct test > 1h Ingestion challenge test X 0.9638 $67.48 $17.10 $13.50 Nasal function studies Facial nerve function test Spontaneous nystagmus test Positional nystagmus test Optokinetic nystagmus test Oscillating tracking test Evoked auditory

test limited Evoked auditory

tst complete X 0.4911 $34.38 $7.06 $6.88 Tympanom etry

& reflex thresh Pure tone audiometry

air Speech threshold audiometry Speech audiometry

complete Loudness balance test Tone decay

hearing test Sisi hearing test Stenger test pure tone Tympanom etry Acoustic refl threshold tst Filtered speech hearing test Sensorineural acuity

test Synthetic sentence test Select picture audiometryEar protector evaluation

Ent procedure/service X 1.2175 $85.24 $18.05 $17.05 Compre audiometry

evaluation Audiom etry

air & bone Comprehensive hearing test Bekesy audiom etry

diagnosis Acoustic immitance testing Visual audiom etry

(vra) Conditioning play

audiom etry Auditory function 60 min Tinnitus assessment Aud brainstem implt programg X 1.6864 $118.07 $23.65 $23.62 Staggered spondaic word test 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 0.7420 $51.95 $13.76 $10.39 Temperature gradient studies Breathing capacity

test Spirom etry

up to 2 yrs old Spirmtry w/brnchdil inf-2 yr Patient recorded spirometry Patient recorded spirometry Vital capacity

test Lung function test (MBC/MVV) Expired gas collection Respiratory

flow volum e loop CO2 breathing response curve Hast w/oxygen titrate Exhaled air analysis Pulmfunct tst plethysmograp Pulmfunction test by

gas Pulmfunct test oscillometry Pulmonary

compliance study Pulmonary

service/procedure Exhaled nitric oxide meas X 0.8906 $62.36 $20.93 $12.48 Hypoxia response curve Hast w/report Pulmonary

stress test/simple Exhaled air analysis o2 C02/membane diffuse capacityExhaled carbon dioxide test

Bronchial allergy

tests X 2.6868 $188.12 $38.23 $37.63 Cont msr bronchodil wheeze Meas lung vol thru 2 yrs Evaluation of wheezing Pulmstress test/complex Exhaled air analysis o2/co2 Breath recording infant Bronchial allergy

tests X 1.1369 $79.60

. $15.92 Photosensitivity

tests Eye allergy

tests Rapid desensitization X 1.3842 $96.92

. $19.39 Psycho testing by

technician Psycho testing admin by comp Developm ental test extend S 9.6018 $672.28

. $134.46 Ht muscle image spect sing Ht muscle image spect mult Ht muscle image planar sing Ht musc image planar mult S 4.5192 $316.42 $126.56 $63.29 Lung ventilat&perfus imaging Lung perf&ventilat diferentl X 0.4426 $30.99

. $6.20 Percut allergy

skin tests Percut allergy

titrate test Id allergy titrate-drug/bug Id allergy test drug/bug Id allergy titrate-airborne Id allergy test-delayed type Allergy patch tests Photo patch test Nose allergy

test Allergy im mu nology

services X 2.5717 $180.06

. $36.02 Psycho testing by

psych/phys Neurobehavioral status exam Neuropsych tst by

psych/phys Neuropsych testing by

tec Neuropsych tst admin w/comp S 3.7417 $261.98

. $52.40 Ct hrt w/3d image Ct hrt w/3d image congen Ct angio hrt w/3d imageT 29.2172 $2,045.67

. $409.14

Esophagus endoscopy Uppr gi endoscopy

w/stent Endo cholangiopancreatograph Endo cholangiopancreatograph Sm all bowel endoscopy /stent S bowel endoscope w/stent Ileoscopy

w/stent Colonoscopy

w/stent Proctosigmoidoscopy

w/stent Sigmoidoscopy

w/stent Colonoscopy

w/stent S 104.8530 $7,341.39

. $1,468.28 Male sling procedure Insert tandem cuff Insert semi-rigid prosthesis S 169.3017 $11,853.83

. $2,370.77 Insert uro/ves nck sphincter Remove/replace ur sphincter Insert self-contd prosthesis Insert multi-comp penis pros Remove/replace penis prosth Remv/repl penis contain pros T 38.3457 $2,684.81 $655.55 $536.97 Hysteroscopy

resect septum Hysteroscopy

remove myom a Hysteroscopy

ablation S 22.7689 $1,594.19

. $318.84 X-ray c/t spine disk X-ray of lower spine disk S 1.5569 $109.01 $26.88 $21.81 Thyroid single uptake Thyroid multiple uptakes Thyroid suppress/stimul Urinary bladder retention Nuclear diagnostic exam S 1.8944 $132.64 $47.64 $26.53 Thyroid im aging Thyroid im aging with flow Endocrine nuclear procedure S 3.1610 $221.32 $65.46 $44.27 Thyroid im aging with uptake Thyroid im age mult uptakes Parathyroid nuclear imaging S 2.2892 $160.28 $39.07 $32.06 Ra tracer id of sentinl node Platelet survival kineticsPlatelet 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 6.9196 $484.48

. $96.90 T-cell depletion of harvest Tumor cell deplete of harvst Rbc depletion of harvest Platelet deplete of harvest Volum e deplete of harvest Harvest stem cell concentrte Plasma volume single Plasma volume multiple Red cell mass single Red cell mass multiple Blood volum e Red cell survival study Red cell survival kinetics Red cell sequestration S 4.1909 $293.43 $90.78 $58.69 Liver im aging Liver im aging with flow Liver im aging (3D) Liver im age (3d) with flow Liver and spleen imaging Liver & spleen im age/flow Hepatobiliary

system imaging Hepatobil syst image w/drug S 3.4841 $243.94 $87.01 $48.79 Salivary gland im aging Serial salivary

im aging Salivary gland function exam Esophageal motility

study Gastric mucosa imaging Gastroesophageal reflux exam Gastric emptying study Acute GI blood loss imaging GI protein loss exam Meckels divert exam Leveen/shunt patency

exam GI nuclear procedure S 3.5304 $247.18 $94.20 $49.44 Bone im aging lim ited area Bone im aging m ultiple areas Bone im aging whole bodyBone im aging 3 phase

Bone im aging (3D) Musculoskeletal nuclear exam S 2.0980 $146.89 $33.94 $29.38 Vascular flow imaging Acute venous thrombus image Venous thrombosis imaging Ven thrombosis images bilat S 4.2548 $297.90 $93.33 $59.58 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 3.6580 $256.12 $90.92 $51.23 Bone m arrow im aging ltd Bone m arrow im aging m ult Bone m arrow im aging body Spleen im aging Lymph system imaging Blood/lymph nuclear exam S 2.8915 $202.45 $71.16 $40.49 Lung ventilation im aging Lung perfusion imaging Lung perfusion differential Respiratory

nuclear exam S 8.6793 $607.69

. $121.54 Brain im age w/flow < 4 views Brain im age w/flow 4 + views Brain im aging (3D) Cerebrospinal fluid scan CSF ventriculography Cerebrospinal fluid scan CSF leakage imaging S 3.4408 $240.91 $72.42 $48.19 Brain im age < 4 views Brain im age 4+ views Brain flow im aging only CSF shunt evaluation Nuclear exam of tear flow Nervous system nuclear examS 4.5536 $318.82 $81.52 $63.77

Kidney im aging morphol Kidney im aging with flow K flow/funct image w/o drug K flow/funct image w/drug K flow/funct image multiple Kidney im aging (3D) Ureteral reflux study Testicular imaging w/flow Genitourinary

nuclear exam S 4.0053 $280.44 $85.08 $56.09 Thyroid met imaging Thyroid met imaging/studies Thyroid met imaging body Tumor imaging limited area S 3.2941 $230.64 $78.13 $46.13 Nuclear rx oral admin Nuclear rx iv admin Nuclr rx interstit colloid Nuclear rx intra-arterial Nuclear medicine therapy S 13.6750 $957.47

. $191.50 Adrenal nuclear imaging Tumor imaging whole body X 0.1101 $7.71 $2.17 $1.55 Coombs test direct Coombs test indirect qual Coombs test indirect titer Blood typing abo Blood typing rh (d) S 6.5452 $458.27

. $91.66 Delivery comp imrt Radiation tx delivery

im rt S 4.0373 $282.68

. $56.54 Nuclear rx intracav admin Hematopoietic nuclear tx Nuclear rx intra-articular S 7.0664 $494.76

. $98.96 Tumor imaging mult areas Tumor imaging whole body Tumor imaging (3D) Abscess imaging ltd area Abscess imaging whole body Nuclear localization/abscess T 28.9051 $2,023.82 $459.92 $404.77 Insert bronchial valve Bronch thermoplasty

1 lobeBronch thermoplasty lobes Bronchoscopy

w/m arkers Bronchoscopy

dilate/fx repr Bronchoscopy

dilate w/stent Bronchoscopy

bronch stents Bronchoscopy

revise stent Bronchoscopy

w/tumor excise Bronchoscopy

treat blockage T 12.6671 $886.90 $207.88 $177.38 Esoph scope w/submucous inj Esophagus endoscopy /ligation 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 bx Esoph endoscope w/drain cyst Uppr gi endoscopy

w/us fn bx Upper GI endoscopy

/ligation Uppr gi scope dilate strictr Place gastrostomy

tube Esoph endoscopy

dilation Upper GI endoscopy

/tumor Operative upper GI endoscopy Operative upper GI endoscopy Operative upper GI endoscopy 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 endoscopy T 25.9792 $1,818.96

. $363.80 Esophagus endoscopy /lesion Esoph endoscopy

ablation Uppr gi scope w/thrml txmnt Place gastrostomy

tube Repair stomach opening EPS gast cardia plic T 58.4890 $4,095.17

. $819.04 Perq rf ablate tx pul tumor Percut ablate liver rfBiliary

endoscopy

thru skin Perc rf ablate renal tumor Perc cryo ablate renal tum T 15.7819 $1,104.99 $240.64 $221.00 Sm all bowel endoscopy Sm all bowel endoscopy Sm all bowel endoscopy Sm all bowel endoscopy Sm all bowel endoscopy Sm all bowel endoscopy Sm all bowel endoscopy T 132.5319 $9,279.35

. $1,855.87 Reconstruct shoulder joint Reconstruct elbow joint Replace elbow joint Reconstruct head of radius Reconstruct wrist joint Reconstruct wrist joint Wrist replacement Revision of knee joint Implant temple bone w/stimul Temple bne implnt w/stimulat Temple bone implant revision Revise temple bone implant S 2.5699 $179.93

. $35.99 Application of body

cast Application of body

cast Application of body

cast Application of body

cast Application of body

cast Application of shoulder cast Application of long arm cast Application of forearm cast Application of hip cast Application of hip casts Application of long leg cast Application of long leg cast Apply long leg cast brace Application of long leg cast Apply short leg cast Apply short leg cast Apply short leg cast Apply rigid leg cast Removal/revision of cast T 16.2412 $1,137.14

. $227.43 Change bile duct catheter Revise/reinsert bile tubeExchange drainage catheter

Insert subq exten to ip cath Em bedded ip cath exit-site Change ext/int ureter stent Change kidney

tube Change of ureter tube/stent Replace/irrigate catheter T 23.9777 $1,678.82

. $335.77 Proctosigmoidoscopy

fb Proctosigmoidoscopy

ablate Proctosigmoidoscopy

volvul Anoscopy

remove lesion Anoscopy

remove lesions Anoscopy T 45.7676 $3,204.46

. $640.90 Removal of kidney

stone Removal of kidney

stone Laser surgery

of prostate Laser surgery

of prostate Prostate laser enucleation Prostatic microwave thermotx Prostatic rf thermotx S 0.5154 $36.09

. $7.22 Assess hlth/behave init Assess hlth/behave subseq Intervene hlth/behave indiv Intervene hlth/behave group Interv hlth/behav fam w/pt Alcohol/subs interv 15-30mn Devlopm ent test interpt&rep X 0.2434 $17.04 $5.06 $3.41 Cy topath fl nongyn smears Cy topath fl nongyn filter Cy topath concentrate tech Forensic cy

topathology Cy topath smear other source Cy topath smear other source Cy tp dx eval fna 1st ea site Flowcy tometry / tc 1 marker Flowcy tometry /tc add-on Tissue exam by

pathologist Special stains group 1 Special stains group 2 Histochemical stains add-on Enzym e histochemistry Microslide consultation Path consult intropIntraop cy

to path consult 1 Intraop cy

to path consult 2 Eval molecular probes 11-50 Sputumspecimen collection Cryopreservation sperm T 171.3141 $11,994.73

. $2,398.95 Transcath closure of asd Transcath closure of vsd S 0.3545 $24.82

. $4.97 Immunization admin each add Immune admin oral/nasal Immune admin oral/nasal addl Immunotherapy

one injection Immunotherapy

injections Antigen therapy

services Hydrate iv infusion add-on Ther/prop/diag inj/inf proc Chemotherapy

unspecified S 0.4972 $34.81

. $6.97 Immunization admin Antigen therapy

services Antigen therapy

services Antigen therapy

services Antigen therapy

services Antigen therapy

services Ther/proph/diag iv inf addon 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 addon Chemo anti-neopl sq/im Chemo hormon antineopl sq/im Chemo intralesional up to 7 Chemo iv infusion addl hr Adm in hepatitis b vaccine $0.00 $0.00 S 1.0388 $72.73

. $14.55 Antigen therapy

services Antigen therapy

services Hydration iv infusion init Chemo iv push addl drug Chemo iv infus each addl seq Chemo ia push tecnique Chemo ia infuse each addl hr Chemotherapy

injectionS 1.8098 $126.71

. $25.35

Spin/brain pum p refil & main Spin/brain pum p refil & main 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 syst S 2.9679 $207.80

. $41.56 Chemo iv infusion 1 hr Chemo prolong infuse w/pump Chemo ia infusion up to 1 hr Chemotherapy

infusion method Chemotherapy

into cns Prolonged IV inf, req pump S 21.9850 $1,539.30

. $307.86 Adm in + supply, tositumomab V 0.7689 $53.84

. $10.77 Office/outpatient visit new Office/outpatient visit est CA screen;pelvic/breast exam $0.00 $0.00 Initial foot exam pt lops Direct refer hospital observ V 1.0311 $72.19

. $14.44 Medication management Eye exam established pat Eye exam & treatment Office/outpatient visit new Office/outpatient visit est Office/outpatient visit est Init nb emper day

hosp Sam e day

nb discharge Followup eval of foot pt lop V 1.3588 $95.14

. $19.03 Eye exam new patient Eye exam new patient Office/outpatient visit new Office/outpatient visit est Initial preventive exam $0.00 $0.00 V 1.8647 $130.56

. $26.12 Glucose monitoring cont Office/outpatient visit new Office/outpatient visit est OPPS Service,sched team confDemonstrate use home inr mon

Provide INR test mater/equip Visit for drug monitoring V 2.5237 $176.70

. $35.34 Dialysis one evaluation Office/outpatient visit new V 0.7181 $50.28 $12.04 $10.06 Em ergency

dept visit V 1.2356 $86.51 $20.79 $17.31 Em ergency

dept visit V 1.9447 $136.16 $33.59 $27.24 Em ergency

dept visit V 3.1277 $218.99 $47.70 $43.80 Em ergency

dept visit V 4.6152 $323.14 $71.44 $64.63 Em ergency

dept visit S 6.6453 $465.28 $104.95 $93.06 Critical care first hour S 11.2658 $788.79

. $157.76 Trauma Respons w/hosp criti T 11.0639 $774.65

. $154.93 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 T 25.2672 $1,769.11

. $353.83 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 T 30.3507 $2,125.03

. $425.01 Insertion of infusion pump Insert tunneled cv cath Insert tunneled cv cath Insert tunneled cv cath Insert tunneled cv cath Insert tunneled cv cathReplace tunneled cv cath

Replace tunneled cv cath Insertion catheter artery Redo endovas vena cava filtr Rem endovas vena cava filter Transcatheter biopsy Transcatheter retrieval Change iv cath at thromb tx X 0.6068 $42.49 $12.33 $8.50 Draw blood off venous device Collect blood from picc Vascular surgery

procedure Irrig drug delivery

device Phlebotomy V 0.5627 $39.40

. $7.88 Lev 1 hosp type B ED visit V 0.7972 $55.82

. $11.17 Lev 2 hosp type B ED visit V 1.3178 $92.27

. $18.46 Lev 3 hosp type B ED visit V 1.9503 $136.55

. $27.31 Lev 4 hosp type B ED visit V 3.7639 $263.53

. $52.71 Lev 5 hosp type B ED visit T 62.4125 $4,369.87

. $873.98 Place po breast cath for rad Place breast cath for rad Place breast rad tube/caths Enlarge breast with implant Delayed breast prosthesis Breast reconstruction S 11.9274 $835.11

. $167.03 Apply interstit radiat compl T 30.8430 $2,159.50

. $431.90 Insert pleural cath Insert tun ip cath perc Ins tun ip cath for dial opn T 43.8023 $3,066.86

. $613.38 Repair defect of artery Repair blood vessel lesion Repair blood vessel lesion Repair blood vessel lesion Percut thrombect av fistula T 103.3418 $7,235.58

. $1,447.12 Insert pulse gen dual leads Insert pulse gen mult leads Remv&replc pm gen dual leadRemv&replc pm gen mult leads Insertion/Replacement/Conversion of a Permanent Dual Chamber Pacemaker or Pacing T 137.6558 $9,638.11

. $1,927.63 Insrt heart pm atrial & vent Upgrade of pacemaker system Insert pacing lead & connect L ventric pacing lead add-on T 105.6644 $7,398.20

. $1,479.64 Drug-eluting stents, single Drug-eluting stents,each add S 1.4941 $104.61

. $20.93 HYPERBARIC Oxygen X 1.8189 $127.35 $27.10 $25.47 Laryngeal function studies Basic vestibular evaluation Caloric vestibular test Sinusoidal rotational test Posturography X 2.3496 $164.51

. $32.91 Electron microscopy Scanning electron microscopy Sat biopsy

prostate 1-20 spc S 4.8375 $338.70 $114.37 $67.74 Ct angiography

head Ct angiography

neck Ct angiography

chest Ct angiograph pelv w/o&w/dye Ct angio upr extrm w/o&w/dye Ct angio lwr extr w/o&w/dye Ct angio abdom w/o & w/dye Ct angio abdominal arteries S 16.9101 $1,183.98

. $236.80 Proton trmt simple w/o comp Proton trmt simple w/comp S 0.4865 $34.06 $0.00 $0.00 Dxa bone density

/peripheral $0.00 $0.00 S 22.1209 $1,548.82

. $309.77 Proton trmt intermediate Proton treatment complex T 9.4045 $658.47

. $131.70 Access av dial grft for eval 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

neckVein x-ray

skull Vein x-ray

skull Vein x-ray

eye socket Vein x-ray

liver T 41.0159 $2,871.77

. $574.36 Prosth retina receive&gen Repair of eye wound Repair eye lesion Partial removal of eye fluid 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 im plant m aterial T 41.5778 $2,911.11 $634.95 $582.23 Insert ant segment drain int Insert ant segment drain ext Insert aqueous drain device Translum dil eye canal Trnslum dil eye canal w/stnt Implant eye shunt Repair/graft eye lesion T 113.8112 $7,968.60

. $1,593.72 Cryoablate prostate T 2.3021 $161.18

. $32.24 Declot vascular device Inj w/fluor eval cv device External cannula declotting Thromboly

tic therapy

stroke Change gastrostomy

tube Dissolve clot heart vessel T 1.3360 $93.54

. $18.71 Extrnl counterpulse, per tx S 5.3254 $372.86 $95.30 $74.58 Cardioversion electric ext Cardioversion electric int S 80.3579 $5,626.34

. $1,125.27 Implant pat-active ht recordS 3.0368 $212.62

. $42.53

Photochemotherapy

uv-a or b T 9.6713 $677.15

. $135.43 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 20.7198 $1,450.72 $385.30 $290.15 Implt/rpl crtd sns dev lead Rev/remvl crtd sns dev lead Periph field stimul revise Revise/remove neuroelectrode Remove spine eltrd perq aray Remove spine eltrd plate Revise/repl vagus n eltrd Revise/remove neuroelectrode T 31.1002 $2,177.51 $768.94 $435.51 Rev/remvl crtd sns dev gen Revise/remove neuroreceiver Revise/remove neuroreceiver Revise/rmv pn/gastr stimul S 0.4928 $34.50

. $6.90 Acoustic ecg 1+ analysis Acoustic ecg analy

& reprog Pmdevice progr eval sngl Pmdevice progr eval dual Pmdevice progr eval multi Icd device prog eval 1 sngl Icd device progr eval dual Icd device progr eval mult Ilr device eval progr Pmdevice eval in person Icd device interrogate Ilr device interrogate Wcd device interrogate Pmphone r-strip device eval Pm/icd remote tech serv Icm/ilr remote tech serv Analy ze pacem aker system Set-up cardiovert-defibrill S 2.3930 $167.55

. $33.51 Csf shunt reprogram Analy ze spine infus pumpAnaly

ze sp inf pump w/reprog Anal sp inf pmp w/reprg&fill Anl sp inf pmp w/mdreprg&fil S 1.5944 $111.63

. $22.33 Ecg/monitoring and analysis Interrogation vad in person Analy ze neurostimsimple Analy ze neurostimcomplex Cranial neurostim complex Analy ze neurostimbrain/1h Analy z neurostimbrain addon Io ga n-stim subsq w/reprog T 5.0714 $355.08 $88.08 $71.02 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 3.1615 $221.36

. $44.28 Echo exam of fetal heart Echo exam of fetal heart Tte f-up or lmtd S 1.0589 $74.14

. $14.83 Ocular blood flow measure Remove foreign body

from eye Remove foreign body

from eye Remove foreign body

from eye Remove foreign body

from eye 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 Prescription of contact lens Prescription of contact lens Modification of contact lens Special spectacles fitting Special spectacles fitting Repair & adjust spectacles Glaucoma scrn hgh risk direc T 15.4248 $1,079.98

. $216.00Biopsy

eye muscle Remove eyelid lining lesion New eye exam & treatment Eye exam & treatment K $954.77

. $190.96 Sr89 strontium K $207.92

. $41.59 Dexrazoxane HCl injection K $246.80

. $49.36 Filgrastim 300 mcg injection K $24.22

. $4.85 Sargramostim injection K $14.56

. $2.92 Am pho b cholesteryl sulfate K $14.25

. $2.85 Am photericin b liposome inj K $188.98

. $37.80 Rasburicase K $269.86

. $53.98 Chlorothiazide sodiuminj K $154.88

. $30.98 Mechlorethamine hcl inj K $567.28

. $113.46 Dactinomycin injection K $2.78

. $0.56 Naltrexone, depot form K $590.71

. $118.15 Leuprolide acetate /3.75 MG K $37.54

. $7.51 Etoposide oral 50 MG K $969.60

. $193.92 Aldesleukin injection K $117.34

. $23.47 Bcg live intravesical vac K $186.43

. $37.29 Goserelin acetate implant K $172.53

. $34.51 Carmustine injection K $62.08

. $12.42 Asparaginase injection K $15.60

. $3.12 Daunorubicin injection K $56.58

. $11.32 Daunorubicin citrate inj K $15.75

. $3.15 Docetaxel injection K $113.99

. $22.80Nelarabine injection K $60.82

. $12.17

Floxuridine injection K $89.64

. $17.93 Gemcitabine hcl injection K $6.42

. $1.29 Irinotecan injection K $32.03

. $6.41 Ifosfamide injection K $58.32

. $11.67 Idarubicin hcl injection K $99.76

. $19.96 Cosyntropin injection NOS K $16.82

. $3.37 Interferon alfa-2b inj K $582.59

. $116.52 Interferon gamma 1-b inj K $1,512.71

. $302.55 Inj melphalan hydrochl 50 MG K $101.84

. $20.37 Fludarabine phosphate inj K $2,675.40

. $535.08 Pegaspargase injection K $1,084.10

. $216.82 Pentostatin injection K $615.22

. $123.05 Rituximab injection K $265.69

. $53.14 Streptozocin injection K $131.18

. $26.24 Thiotepa injection K $19,348.11

. $3,869.63 Porfimer sodium injection K $23.94

. $4.79 Inj cladribine per 1 MG K $4.42

. $0.89 Leuprolide acetate injeciton K $37.36

. $7.48 Mitoxantrone hydrochl / 5 MG K $31.20

. $6.24 Interferon alfa-n3 inj K $6.06

. $1.22 Oral aprepitant K $88.00

. $17.60 Hyalgan/supartz inj per dose K $11.93

. $2.39 Synvisc or Synvisc-OneK $146.10

. $29.22

Euflexxa inj per dose K $166.14

. $33.23 Orthovisc inj per dose K $82.14

. $16.43 Rho d immune globulin inj K $122.53

. $24.51 Azathioprine parenteral K $556.51

. $111.31 Lymphocy

te im mu ne globulin K $41.24

. $8.25 Alglucerase injection K $3.83

. $0.77 Alpha 1 proteinase inhibitor K $5.38

. $1.08 Injection,onabotulinumtoxinA K $947.86

. $189.58 Cy tomegalovirus imm IV /vial K $211.59

. $42.32 Interferon beta-1b / .25 MG K $16,640.00

. $3,328.00 Ganciclovir long act implant K $94.42

. $18.89 Adenosine injection K $0.85

. $0.17 Factor viii K $1.09

. $0.22 Factor viii recombinant NOS K $0.91

. $0.19 Factor ix complex K $1.60

. $0.32 Anti-inhibitor K $0.89

. $0.18 Factor IX non-recombinant K $1.14

. $0.23 Factor IX recombinant K $206.16

. $41.24 Gamma globulin > 10 CC inj K $24.63

. $4.93 Capecitabine, oral, 500 mg K $55.80

. $11.16 Octagam injection K $37.08

. $7.42 Gammagard liquid injection K $5.09

. $1.02 Rhophylac injection K $52.11

. $10.43Hepagam b im injection G $35.15

. $6.90

Flebogamma injection K $36.78

. $7.36 Gamunex/gamunex c R 0.9547 $66.84

. $13.37 Frozen plasm a, pooled, sd R 2.7245 $190.76

. $38.16 Whole blood for transfusion K $218.44

. $43.69 Reclast injection R 1.1823 $82.78

. $16.56 Cryoprecipitate each unit R 2.8408 $198.90

. $39.78 RBC leukocy

tes reduced R 1.0400 $72.82

. $14.57 Plasma, frz between 8-24hour R 0.2574 $18.02

. $3.61 Plasma protein fract,5%,50ml R 1.2822 $89.77

. $17.96 Platelets, each unit R 2.0257 $141.83

. $28.37 Plaelet rich plasma unit R 2.1303 $149.16

. $29.84 Red blood cells unit R 4.1045 $287.38

. $57.48 Washed red blood cells unit K $21.32

. $4.27 Album in (human),5%, 50ml K $61.94

. $12.39 Album in (human), 5%, 250 ml K $26.84

. $5.37 Album in (human), 25%, 20 ml K $68.03

. $13.61 Album in (human), 25%, 50ml R 1.0362 $72.55

. $14.51 Plasmaprotein fract,5%,250ml R 1.6761 $117.35

. $23.47 Blood split unit R 1.9996 $140.00

. $28.00 Platelets leukoreduced irrad R 3.7309 $261.22

. $52.25 RBC leukoreduced irradiated R 1.0622 $74.37

. $14.88 Cryoprecipitatereducedplasma R 2.6930 $188.55

. $37.71 Blood, l/r, cmv-negR 11.4695 $803.05

. $160.61

Platelets, hla-m, l/r, unit R 1.8720 $131.07

. $26.22 Platelets leukocy

tes reduced K $109.30

. $21.86 Injection glatiramer acetate R 1.4989 $104.95

. $20.99 Blood, l/r, froz/degly

/wash R 5.4802 $383.70

. $76.74 Plt, aph/pher, l/r, cmv-neg R 2.0966 $146.80

. $29.36 Blood, l/r, irradiated R 9.8804 $691.79

. $138.36 Plate pheres leukoredu irrad R 8.7936 $615.69

. $123.14 Plt, pher, l/r cmv-neg, irr R 6.4103 $448.82

. $89.77 RBC, frz/deg/wsh, l/r, irrad R 4.3700 $305.97

. $61.20 RBC, l/r, cmv-neg, irrad K $88.51

. $17.71 Pralidoxim e chloride inj K $6.07

. $1.22 Injection, voriconazole K $17.26

. $3.46 I131 iodide cap, rx K $410.95

. $82.19 Adalim um ab injection K $1,603.01

. $320.61 Denileukin diftitox inj K $9.48

. $1.90 Temozolom ide K $52.11

. $10.43 Hepagam b intravenous, inj K $12.90

. $2.58 Protein c concentrate K $15,418.48

. $3,083.70 Supprelin LA im plant K $10.49

. $2.10 I131 iodide sol, rx K $503.48

. $100.70 Cy tarabine liposome inj K $1.87

. $0.38 Inj, epirubicin hcl, 2 mg K $50.57

. $10.12 Temsirolimus injection K $18.72

. $3.75Busulfan injection K $9.76

. $1.96

Verteporfin injection K $117.11

. $23.43 Octreotide injection, depot K $0.90

. $0.18 Antihemophilic viii/vwf com p K $34.42

. $6.89 Inj IVIG privigen 500 mg K $94.38

. $18.88 Dim ethyl sulfoxide 50% 50 ML K $13.23

. $2.65 Pentastarch 10% solution K $19.78

. $3.96 Inj streptokinase /250000 IU K $19.55

. $3.91 Mitomycin 5 MG inj K $959.07

. $191.82 Valrubicin injection K $1.58

. $0.32 Levoleucovorin injection K $11.53

. $2.31 Inj iron dextran K $77.92

. $15.59 Topotecan oral K $106.60

. $21.32 Rotavirus vacc 2 dose oral K $35.88

. $7.18 Apligraf K $5.74

. $1.15 Oasis wound matrix K $5.74

. $1.15 Oasis burn matrix K $16.26

. $3.26 Integra BMW D K $9.62

. $1.93 Integra DRT K $40.51

. $8.11 Dermagraft K $94.95

. $18.99 Graftjacket K $21.73

. $4.35 Integra matrix K $31.42

. $6.29 Prim atrix K $332.25

. $66.45 Cymetra injectableK $332.25

. $66.45

Graftjacket xpress K $1,019.89

. $203.98 Integra flowable wound m atri K $6.78

. $1.36 Gammagraft K $3.41

. $0.69 Triamcinolone A inj PRS-free K $2.71

. $0.55 Antithrombin iii injection K $1.07

. $0.22 Xyntha inj K $31.72

. $6.35 Alloderm K $2.74

. $0.55 Acetylcysteine injection K $189.47

. $37.90 Edetate calcium disodium inj K $12.48

. $2.50 Vivaglobin, inj K $9.12

. $1.83 Factor VIII (porcine) K $2,516.22

. $503.25 Corticotropin injection K $1.50

. $0.30 Bevacizum ab injection K $8.26

. $1.66 Alloskin K $7.29

. $1.46 AbobotulinumtoxinA K $71.57

. $14.32 Human fibrinogen conc inj K $23.64

. $4.73 Rilonacept injection K $7,592.00

. $1,518.40 Sm153 lexidronam K $2.71

. $0.55 Degarelix injection K $0.65

. $0.13 Ferumoxy

tol, non-esrd K $19.54

. $3.91 Perphenazine injeciton K $72.00

. $14.40 Urea injection K $3.77

. $0.76 Oral busulfan K $25.65

. $5.13Mecasermin injection G $88.97

. $17.46

Canakinumab injection K $7.15

. $1.43 Hizentra injection K $41.20

. $8.24 Imuglucerase injection K $2.70

. $0.54 Olanzapine long-acting inj K $101.40

. $20.28 Antithrombin recombinant K $74.52

. $14.91 Methyl am inolevulinate, top G $77.93

. $15.30 Oral fludarabine phosphate G $37.51

. $7.36 Collagenase, clost hist inj K $113.08

. $22.62 Amobarbital 125 MG inj K $2.94

. $0.59 Matristem micromatrix K $66.58

. $13.32 Ganciclovir sodium injection K $167.25

. $33.45 Gonadorelin hydroch/ 100 mcg K $32.84

. $6.57 Theraskin K $2.51

. $0.51 Oxacillin sodium injeciton K $1.20

. $0.24 Anidulafungin injection K $9.85

. $1.97 Topotecan injection K $4.52

. $0.91 Matristem wound matrix G $0.87

. $0.17 Wi late injection G $38.61

. $7.58 Belim um ab injection K $2.52

. $0.51 Hydroxyprogesterone caproate K $372.55

. $74.51 Itraconazole injection K $27.03

. $5.41 Inj protirelin per 250 mcg K $53.76

. $10.76 Phentolaine m esylate injK $14.37

. $2.88

Foscarnet sodium injection K $5.12

. $1.03 Apomorphine hydrochloride K $0.51

. $0.11 Enfuvirtide injection K $0.18

. $0.04 Inj heparin sodium per 10 u K $0.27

. $0.06 Inj heparin sodium per 1000u K $76.71

. $15.35 Sum atriptan succinate / 6 MG K $13.43

. $2.69 Cyclophosphamide 100 MG inj K $17.45

. $3.49 Vinorelbine tartrate inj G $148.30

. $29.10 Lum izym e injection K $3.81

. $0.77 Glassia injection G $8.44

. $1.66 Factor XIII anti-hem factor K $1,014.00

. $202.80 Gel-one K $5.68

. $1.14 Oral everolimus K $31.52

. $6.31 Dermacell G $90.06

. $17.68 Eribulin m esylate injection S $350.00

. $70.00 Sat biopsy

prostate 21-40 S $450.00

. $90.00 Sat biopsy

prostate 41-60 S $650.00

. $130.00 Sat biopsy

prostate: >60 K $548.95

. $109.79 Abciximab injection K $22.02

. $4.41 Eptifibatide injection K $204.31

. $40.87 Etanercept injection K $17.21

. $3.45 Rho(D) immune globulin h, sd K $516.41

. $103.29 Daclizum ab, parenteral K $71.08

. $14.22Trastuzumab injection K $113.50

. $22.70

Hep b ig im K $76.39

. $15.28 Baclofen intrathecal trial K $38.72

. $7.75 Alefacept K $36,100.41

. $7,220.09 Y90 ibritumom ab, rx K $29,618.96

. $5,923.80 I131 tositumomab, rx K $245.02

. $49.01 Tetanus immune globulin inj K $126.14

. $25.23 P32 Na phosphate K $579.98

. $116.00 P32 chromic phosphate K $2,190.58

. $438.12 Basilixim ab K $5.58

. $1.12 Corticorelin ovine triflutal K $3.14

. $0.63 Darbepoetin alfa, non-esrd K $9.70

. $1.94 Epoetin alfa, non-esrd K $626.71

. $125.35 Digoxin im mu ne fab (ovine) K $294.28

. $58.86 Ethanolam ine oleate 100 mg K $6.91

. $1.39 Fomepizole, 15 mg K $10.41

. $2.09 Hemin, 1 mg K $346.19

. $69.24 Lepirudin K $6.48

. $1.30 Ziconotide injection K $46.36

. $9.28 Nesiritide injection K $11.45

. $2.29 Palifermin injection K $1,001.34

. $200.27 Pegaptanib sodiuminjection K $26.98

. $5.40 Inj secretin synthetic human K $60.08

. $12.02 Treprostinil injectionK $0.88

. $0.18

Humate-P, inj K $1.52

. $0.31 Factor viia K $5.15

. $1.03 Azacitidine injection K $119.68

. $23.94 Clofarabine injection K $3,816.98

. $763.40 Vantas implant K $9.33

. $1.87 Paclitaxel protein bound U 0.5004 $35.04

. $7.01 Brachy tx, non-str, Gold-198 U 3.3224 $232.62

. $46.53 Brachy tx, non-str,HDR Ir-192 U 0.4544 $31.82

. $6.37 Brachy tx, NS, Non-HDRIr-192 K $9.96

. $2.00 Oxaliplatin K $248.56

. $49.72 Pegadem ase bovine, 25 iu K $65.66

. $13.14 Urofollitropin, 75 iu H Endo, colon, retro imaging H Power bone m arrow bx needle H Telescopic intraocular lens H Catheter, ablation K $39.16

. $7.84 Methyldopate hcl injection U 224.7054 $15,732.97

. $3,146.60 Brachy tx, non-str,Yttrium-90 U 0.2404 $16.83

. $3.37 Iodine I-125 sodium iodide U 0.8944 $62.62

. $12.53 Brachy tx, non-str, HA, I-125 U 0.3855 $26.99

. $5.40 Brachy tx, non-str, HA, P-103 U 0.5294 $37.07

. $7.42 Brachy linear, non-str,P-103 U 0.6498 $45.50

. $9.10 Brachy tx, stranded, I-125 U 0.5078 $35.55

. $7.11Brachy

tx, non-stranded,I-125 U 1.1433 $80.05

. $16.01 Brachy tx, stranded, P-103 U 0.9180 $64.27

. $12.86 Brachy tx, non-stranded,P-103 U 1.7379 $121.68

. $24.34 Brachy tx, stranded, C-131 U 1.1044 $77.33

. $15.47 Brachy tx, non-stranded,C-131 U 0.6498 $45.50

. $9.10 Brachy tx, stranded, NOS U 0.3855 $26.99

. $5.40 Brachy tx, non-stranded, NOS K $30.46

. $6.10 Immune globulin, powder K $171.48

. $34.30 Quinupristin/dalfopristin K $2.71

. $0.55 Bivalirudin K $20.62

. $4.13 Gamma globulin 1 CC inj K $1.77

. $0.36 Sermorelin acetate injection K $315.94

. $63.19 Am ifostine K $239.90

. $47.98 Oprelvekin injection K $61.81

. $12.37 Som atropin injection K $316.31

. $63.27 Teniposide, 50 mg K $449.09

. $89.82 Urokinase 250,000 IU inj K $1,111.59

. $222.32 Monoclonal antibodies K $8.92

. $1.79 Tirofiban HCl K $7.32

. $1.47 Capecitabine, oral, 150 mg K $62.01

. $12.41 Infliximab injection K $525.35

. $105.07 Doxorubicin hcl liposome inj K $42.24

. $8.45 Alteplase recombinant K $390.07

. $78.02 Filgrastim 480 mcg injectionK $4,728.88

. $945.78

Leuprolide acetate implant K $147.80

. $29.56 Am inolevulinic acid hcl top K $34.48

. $6.90 Linezolid injection K $57.15

. $11.43 Tenecteplase injection K $1,158.85

. $231.77 Rsv mab im 50mg K $2,690.84

. $538.17 Gemtuzumab ozogamicin inj K $1,623.59

. $324.72 Reteplase injection K $136.86

. $27.38 Tacrolimus injection K $40.10

. $8.02 Arsenic trioxide injection K $10.78

. $2.16 Inj, rimabotulinumtoxinB K $13.32

. $2.67 Caspofungin acetate K $238.30

. $47.66 IM inj interferon beta 1-a K $21.52

. $4.31 Rho d immune globulin 50 mcg K $8.42

. $1.69 Am photericin b lipid complex K $187.46

. $37.50 Baclofen 10 MG injection K $742.66

. $148.54 Cidofovir injection K $103.54

. $20.71 Inj estrogen conjugate 25 MG K $101.30

. $20.26 Glucagon hydrochloride/1 MG K $133.80

. $26.76 Ibutilide fumarate injection K $0.32

. $0.07 Iron sucrose injection K $432.20

. $86.44 Antithymocy

te globuln rabbit K $1,032.25

. $206.45 Thyrotropin injection K $575.18

. $115.04 Alemtuzum ab injection K $220.30

. $44.06Zoledronic acid K $2,676.49

. $535.30

Injection, pegfilgrastim 6mg K $83.63

. $16.73 Injection, Fulvestrant K $20.16

. $4.04 Injection, argatroban K $176.18

. $35.24 Triptorelin pamoate K $0.48

. $0.10 Daptomycin injection K $5.07

. $1.02 Risperidone, long acting K $10.32

. $2.07 Natalizum ab injection K $185.74

. $37.15 Rabies ig im/sc K $177.81

. $35.57 Rabies ig heat treated K $94.28

. $18.86 Varicella-zoster ig im K $112.23

. $22.45 Bcg vaccine percut K $205.48

. $41.10 Rabies vaccine im K $139.69

. $27.94 Rabies vaccine id K $110.75

. $22.15 Meningococcal vaccine sc K $100.15

. $20.03 Encephalitis vaccine sc K $92.92

. $18.59 Meningococcal vaccine im K $40.67

. $8.14 Bortezom ib injection K $138.53

. $27.71 Agalsidase beta injection K $26.33

. $5.27 Laronidase injection K $18.83

. $3.77 Palonosetron hcl K $52.76

. $10.56 Pem etrexed injection K $59.98

. $12.00 Bevacizum ab injection K $49.53

. $9.91 Cetuximab injectionK $216.90

. $43.38

Leuprolide acetate suspnsion K $341.40

. $68.28 Galsulfase injection K $18,980.00

. $3,796.00 Fluocinolone acetonide implt K $0.98

. $0.20 Micafungin sodium injection K $1.30

. $0.26 Tigecycline injection K $148.02

. $29.61 Ibandronate sodium injection K $20.72

. $4.15 Abatacept injection K $31.94

. $6.39 Decitabine injection K $446.44

. $89.29 Idursulfase injection K $395.53

. $79.11 Ranibizum ab injection K $155.84

. $31.17 Alglucosidase alfa injection K $85.59

. $17.12 Panitum um ab injection K $186.37

. $37.28 Eculizum ab injection K $30.98

. $6.20 Lanreotide injection K $63.47

. $12.70 Ixabepilone injection K $1.69

. $0.34 Fosaprepitant injection K $18.47

. $3.70 Bendam ustine injection K $51.22

. $10.25 Regadenoson injection K $45.87

. $9.18 Romiplostim injection K $2.66

. $0.54 Inj, clevidipine butyrate K $4.12

. $0.83 Certolizum ab pegol inj K $129.72

. $25.95 Artiss fibrin sealant K $43.37

. $8.68 C-1 esterase, cinryze K $275.80

. $55.16Plerixafor injection K $4.75

. $0.95

Temozolom ide injection K $0.15

. $0.03 Injection, lacosamide K $6.56

. $1.32 Paliperidone palm itate inj K $192.26

. $38.46 Dexamethasone intra implant G $2.10

. $0.42 Telavancin injection G $165.63

. $32.50 Pralatrexate injection G $45.41

. $8.91 Ofatumumab injection G $117.56

. $23.07 Ustekinumab injection G $289.07

. $56.73 Ecallantide injection G $3.47

. $0.68 Tocilizum ab injection G $224.79

. $44.11 Romidepsin injection G $25.55

. $5.02 Capsaicin 8% patch G $30.23

. $5.94 C-1 esterase, berinert G $37.29

. $7.32 Gammaplex injection G $349.51

. $68.59 Velaglucerase alfa G $14.47

. $2.84 Denosumab injection G $32,860.00

. $6,448.00 Sipuleucel-T auto CD54+ G $2,111.36

. $414.31 Crotalidae poly

im mu ne fab G $623.28 $0.00 $0.00 Hexaminolevulinate HCl $0.00 $0.00 G $135.57

. $26.61 Cabazitaxel injection G $5.53

. $1.08 Incobotulinumtoxin a G $1.62

. $0.32 Injection, ibuprofen G $301.75

. $59.22 Pegloticase injectionG $0.74

. $0.14

Ceftaroline fosamil inj G $0.11

. $0.03 Acetaminophen injection G $127.20

. $24.96 Ipilim um ab injection G $13.57

. $2.67 Patch, lidocaine/tetracaine G $3.91

. $0.77 Injection, belatacept G $95.40

. $18.72 Inj, brentuximab vedotin K $21.34

. $4.27 Omalizumab injection K $10.91

. $2.19 SurgiMend, fetal K $11.23

. $2.25 SurgiMend, neonatal K $20.60

. $4.12 Integra Meshed Bil Wound Mat G $10.39

. $2.04 Oasis tri-layer wound m atrix G $177.77

. $34.89 EpiFix wound cover G $4.35

. $0.86 Endoform Dermal Template G $1,908.00 $0.00 $0.00 Iodine i-123 ioflupane $0.00 $0.00 R 1.8342 $128.42

. $25.69 Platelets, irradiated R 7.6960 $538.84

. $107.77 Platelet pheres leukoreduced R 7.9257 $554.93

. $110.99 Platelet pheresis irradiated R 1.1562 $80.95

. $16.19 Fr frz plasma donor retested R 3.4084 $238.64

. $47.73 RBC deglycerolized R 2.8419 $198.98

. $39.80 RBC irradiated R 19.1478 $1,340.65

. $268.13 Granulocy

tes, pheresis unit R 6.3148 $442.14

. $88.43 Platelets, pheresis R 1.1408 $79.87

. $15.98 Plasma 1 donor frz w/in 8 hr