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 Department of Health and Human Services Health Care Financing Administration 42 CFR Part 419
[HCFA-1005-IFC]
RIN 0938-A156
 AGENCY: Health Care Financing Administration (HCFA), HHS.
 ACTION: Interim final rule with comment period.
 SUMMARY: This interim final rule with comment period provides for the annual update to the Medicare hospital outpatient prospective payment system conversion factor that is used to calculate the payment amount for each payment group, effective January 1, 2001. It also updates the wage index values and incorporates the year 2001 changes in the procedure codes that are used to make payments under this system. In this rule, we are also responding to public comments received on those portions of the April 7, 2000 final rule with comment period (which established the hospital outpatient prospective payment system) that implemented related provisions of the Balanced Budget Refinement Act (BBRA) of 1999. In addition, we are responding to public comments on the August 3, 2000 interim final rule with comment period that modified the April 7, 2000 final rule with comment period by revising the criteria used to define new or innovative medical devices, drugs, and biologicals eligible for transitional pass-through payments and correcting the criteria for grandfathering provider-based Federally Qualified Health Centers (FQHC) into the prospective payment system.
 DATES:  *Effective Date:*
                             These regulations are effective on January 1, 2001. *Comment Period:*
                             We will consider comments if we receive them at the appropriate address, as provided below, no later than 5 p.m. on January 12, 2001.
 ADDRESSES: Mail written comments (1 original and 3 copies) to the following address: Health Care Financing Administration, Department of Health and Human Services, Attention: HCFA-1005-IFC, P.O. Box 8013, Baltimore, MD 21244-8013. To ensure that mailed comments are received in time for us to consider them, please allow for possible delays in delivering them. If you prefer, you may deliver your written comments (1 original and 3 copies) to one of the following addresses: Room 443-G, Hubert H. Humphrey Building, 200 Independence Avenue, SW., Washington, DC 20201, or Room C5-14-03, 7500 Security Boulevard, Baltimore, MD 21244-1850. Comments mailed to the above addresses may be delayed and received too late for us to consider them. Because of staff and resource limitations, we cannot accept comments by facsimile (FAX) transmission. In commenting, please refer to file code HCFA-1005-IFC. of the received timely will be available for public inspection as they are received, generally beginning approximately 3 weeks after publication of a document, in Room 443-G of the Department's office at 200 Independence Avenue, SW., Washington, DC, on Monday through Friday of each week from 8:30 to 5 p.m. (phone: (202) 690-7890).
 FOR FURTHER INFORMATION CONTACT: Janet Wellham (410) 786-4510, Chuck Braver, (410) 786-6719, or Jana Petze (410) 786-9374, (for general information). Kity Ahern, (410) 786-4515 (for information related to ambulatory payment classification groups and transitional pass-through payments related to drugs and biologicals). Majorie Baldo, (410) 786-4617 or Barry Levi, (410) 786-4529 (for information related to transitional pass-through payments for medical devices). George Morey (410) 786-4653 (for information related to the criteria for grandfathering provider-based FQHCs into the prospective payment system).


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                         online database through GPO Access, a service of the U.S. Government Printing Office. The Website address is http://www.access.gpo.gov /nara/index.html. To assist readers in referencing sections contained in this document, we are providing the following table of contents: Table of Contents I. Background A. General Summary of April 7, 2000 Final Rule With Comment Period that Implemented Amendments Enacted by the Balanced Budget Act of 1997 and the Balanced Budget Refinement Act of 1999 B. June 30, 2000 Notice of Delay of Effective Date for the April 7, 2000 Final Rule with Comment Period C. August 3, 2000 Interim Final Rule with Comment Period D. Summary of This Interim Final Rule with Comment Period II. Analysis of, and Responses to, Public Comments on the BBRA 1999 Provisions and the August 3, 2000 Interim Final Rule with Comment Period A. April 7, 2000 BBRA 1999 Provisions 1. Outlier Adjustment 2. Transitional Pass-Through for Additional Costs of Innovative Medical Devices, Drugs, and Biologicals a. Definition of a device b. Eligibility criteria c. Investigational device exemption (IDE) device d. Removing cost of predicate item e. Excluded costs f. Effect on conversion factor g. Cost significance tests h. Brand-specific versus categorization approaches i. Issues pertaining to specific items j. Pass-through applications process k. Payment for pass-through items l. Focus medical review 3. Budget Neutrality Applied to New Adjustments 4. Limitation on Judicial Review 5. Inclusion in the Hospital Outpatient Prospective Payment System of Certain Implantable Items 6. Payment Weights Based on Median or Mean Hospital Costs 7. Limitation on Variation of Costs of Services Classified Within a Group 8. Annual Review of the Components of the Hospital Outpatient Prospective Payment System 9. Copayment Amounts Not Affected by Pass-Throughs 10. Extension of Cost Reductions 11. Clarification of Congressional Intent Regarding Base Amounts Used in Determining the Hospital Outpatient Prospective Payment System 
                            ( print page 67799) 12. Transitional Corridors for Application of Outpatient Prospective Payment System a. Interim payment versus final settlement b. Payment-to-cost ratios c. Cost-to-charge ratios d. Interim payments limited to 85 percent of the estimated transitional corridor payment e. Providers having more than one 1996 cost report f. Providers having no 1996 cost report g. Prospective payment system delay and transitional corridor payments h. Rural hold-harmless provision i. Covered charges j. Cancer hospitals and transitional corridor payments k. Teaching hospitals and transitional corridor payments 13. Limitation on Coinsurance for a Procedure 14. Reclassification of Certain Hospitals B. August 3, 2000 Interim Final Rule With Comment Period 1. Transitional Pass-Through Provisions a. “Not insignificant” cost criteria b. Definition of medical device 2. Revision to Grandfather Provision for Certain FQHCs and “Look-Alikes” 3. Clarification of Notice of Beneficiary Cost-Sharing Liability 4. Clarification of Protocols for Off-Campus Departments 5. Typographical Errors in the Provider-Based Regulations III. Provisions of This Interim Final Rule With Comment Period A. Changes Relating to the BBRA 1999 Public Comments B. Annual Updates to Components of the Hospital Outpatient Prospective Payment System 1. APC Groups a. New codes b. Deleted codes c. Revisions to correct errors or inconsistencies d. Device-related codes e. Inpatient codes moved to the outpatient setting f. “Two-times” rule g. Inpatient codes moved to outpatient and affected by device h. Newly covered codes i. Pass-through requests for drugs 2. Inpatient Procedures List Update 3. Wage Index Adjustment 4. Conversion Factor Update IV. Waiver of Notice of Proposed Rulemaking V. Collection of Information Requirements VI. Regulatory Impact A. General B. Analysis for Changes in this Interim Final Rule with Comment Period C. Federalism D. Executive Order 12866 and 5 U.S.C. 804(2) Regulation Text *Addenda* *Note to the Addenda* *Addendum A*
                            —List of Hospital Outpatient Ambulatory Payment Classifications with Status Indicators, Relative Weights, Payment Rates, and Coinsurance Amounts—Calendar Year 2001 *Addendum B*
                            —Hospital Outpatient Department (HOPD) Payment Status by HCPCS Code and Related Information—Calendar Year 2001 Addendum C—[Reserved] *Addendum D*
                            —Status Indicators: How Various Services Are Treated under the Hospital Outpatient Prospective Payment System *Addendum E*
                            —CPT Codes Which Will Be Paid Only As Inpatient Procedures—Calendar Year 2001 *Addendum F*
                            —Wage Index for Urban Areas *Addendum G*
                            —Wage Index for Rural Areas *Addendum H*
                            —Wage Index for Hospitals That Are Reclassified Alphabetical List of Acronyms Appearing in the Interim Final Rule With Comment Period APC Ambulatory payment classification APG Ambulatory patient group ASC Ambulatory surgical center AWP Average wholesale price BBA 1997 Balanced Budget Act of 1997 BBRA 1999 Balanced Budget Refinement Act of 1999 CAT Computerized axial tomography CCI [HCFA's] Correct Coding Initiative CCR Cost center specific cost-to-charge ratio CMHC Community mental health center CORF Comprehensive outpatient rehabilitation facility CPI Consumer Price Index CPT [Physicians'] Current Procedural Terminology, 4th Edition, 2000, copyrighted by the American Medical Association DME Durable medical equipment DMEPOS DME, prosthetics (which include prosthetic devices and implants) orthotics, and supplies DRG Diagnosis-related group FDA Food and Drug Administration FQHC Federally qualified health center HCPCS HCFA Common Procedure Coding System HHA Home health agency ICD-9-CM International Classification of Diseases, Ninth Edition, Clinical Modification IME Indirect medical education JCAHO Joint Commission on Accreditation of Healthcare Organizations MRI Magnetic resonance imaging MSA Metropolitan statistical area NECMA New England County Metropolitan Area PPS Prospective payment system RFA Regulatory Flexibility Act RHC Rural health clinic RRC Rural referral center SCH Sole community hospital SNF Skilled nursing facility I. Background A. General Summary of April 7, 2000 Final Rule With Comment Period That Implemented Amendments Enacted by the Balanced Budget Act of 1997 and the Balanced Budget Refinement Act of 1999 On April 7, 2000, we published in the 
                        **Federal Register**
                         (65 FR 18434) a final rule with comment period to implement a new prospective payment system for hospital outpatient services. This new system establishes prospective payment rates for covered outpatient hospital services using ambulatory payment classification (APC) groups. The April 7, 2000 final rule with comment period implemented section 4523 of the Balanced Budget Act of 1997 (the BBA 1997), Public Law 105-33, and related sections of the Balanced Budget Refinement Act of 1999 (the BBRA 1999), Public Law 106-113. Section 4523 of the BBA 1997 amended section 1833 of the Social Security Act (the Act) by adding subsection (t) to provide for implementation of a prospective payment system for hospital outpatient services furnished to Medicare beneficiaries. Section 1833(t) of the Act, as added by the BBA 1997— Authorizes the Secretary to designate the hospital outpatient services that would be paid under the prospective payment system and requires that the hospital outpatient prospective payment system include hospital inpatient services designated by the Secretary that are covered under Medicare Part B for beneficiaries who are entitled to Part A benefits but who have exhausted them or are otherwise entitled to them.
                    Sets forth certain requirements for the hospital outpatient prospective payment system, including the requirement that a classification system for covered outpatient services be developed that may consist of groups arranged so that the services within each group are comparable clinically and with respect to the use of resources.
                    Specifies data requirements for establishing relative payment weights. The weights are to be based on the median hospital costs determined by 1996 claims data and data from the most recent available cost reports. (This provision has subsequently been changed by the BBRA 1999, as discussed later in this preamble.)
                    Requires that the portion of the Medicare payment and the beneficiary coinsurance that are attributable to labor and labor-related costs be adjusted for geographic wage differences in a budget neutral manner.
                    Authorizes the Secretary under section 1833(t)(2)(E) of the Act to establish, in a budget neutral manner, other adjustments, such as outlier adjustments or adjustments for certain classes of hospitals, that the Secretary determines to be necessary to ensure equitable payments.
                    Requires the Secretary to develop a method for controlling unnecessary( print page 67800)
                        increases in the volume of covered outpatient services.
                    Specifies how beneficiary deductibles are to be treated when calculating the Medicare payment and beneficiary coinsurance amounts and requires that rules be established regarding determination of coinsurance amounts for covered services that were not furnished in 1996. The statute freezes beneficiary coinsurance at 20 percent of the national median charges for covered services (or a group of covered services) furnished during 1996 and updated to 1999 using the Secretary's estimated charge growth from 1996 to 1999.
                    Prescribes the formula for calculating the initial conversion factor used to determine 1999 Medicare payment amounts and the method for updating the conversion factor in subsequent years.
                    Describes the method for determining the Medicare payment amount and the beneficiary coinsurance amount for services covered under the outpatient prospective payment system. (This section was amended by the BBRA 1999, as discussed later in this preamble.)
                    Requires the Secretary to establish a procedure whereby hospitals may voluntarily elect to reduce beneficiary copayment for some or all covered services to an amount no less than 20 percent of the Medicare payment amount. Hospitals are further allowed to disseminate information on any such reductions of copayment amounts. Section 4451 of the BBA 1997 added section 1861(v)(1)(T) to the Act, which provides that any reduction in copayment, must not be treated as a bad debt.
                    Authorizes periodic review and revision of the payment groups, relative payment weights, wage index, and conversion factor. (This section was amended by the BBRA 1999, as discussed later in this preamble.)
                    Describes how payment is to be made for ambulance services, which are specifically excluded from the hospital outpatient prospective payment system under section 1833(t)(1)(B) of the Act.
                    Provides that the Secretary may establish a separate conversion factor for services furnished by cancer hospitals that are excluded from the hospital inpatient prospective payment system.
                    Prohibits administrative or judicial review of the hospital outpatient prospective payment system classification system, the payment groups, relative payment weights, wage adjustment factors, other adjustments, calculation of base amounts, periodic adjustments, and the establishment of a separate conversion factor for those cancer hospitals excluded from hospital inpatient prospective payment system. (This section was expanded by the BBRA 1999, as discussed later in this preamble.) Section 4523(d) of the BBA 1997 made a conforming amendment to section 1833(a)(2)(B) of the Act to provide for payment under the hospital outpatient prospective payment system for some services described in section 1832(a)(2) of the Act that are currently paid on a cost basis and furnished by providers of services, such as comprehensive outpatient rehabilitation facilities (CORFs), home health agencies (HHAs), hospices, and community mental health centers (CMHCs). This amendment provides that partial hospitalization services furnished by CMHCs be paid under the hospital outpatient prospective payment system. Before enactment of section 4521(b) of the BBA 1997, the blended payment formulas for ambulatory surgery centers (ASC) procedures, radiology, and other diagnostic services, the ASC or physician fee schedule portion were calculated as if the beneficiary paid 20 percent of the ASC rate or physician fee schedule amount instead of the actual amount paid, which was 20 percent of the hospital's billed charges. Section 4521(b) of the BBA 1997, which amended sections 1833(i)(3)(B)(i)(II) and 1833(n)(1)(B)(i) of the Act, corrected this anomaly by changing the blended calculations so that all amounts paid by the beneficiary are subtracted from the total payment in the calculation to determine the amount due from the program. Effective for services furnished on or after October 1, 1997, payment for ASC surgery, radiology, and other diagnostic services calculated by blended payment methods is now calculated by subtracting the full amount of coinsurance due from the beneficiary (based on 20 percent of the hospital's billed charges). Section 1861(v)(1)(S)(ii) of the Act was amended by section 4522 of the BBA 1997 to require that the amounts otherwise payable for hospital outpatient operating costs and capital costs be reduced by 5.8 percent and 10 percent, respectively, through December 31, 1999. (This section was further amended by the BBRA 1999.) (Refer to the April 7, 2000 hospital outpatient prospective payment system final rule with comment period for a more in-depth description of how the changes made by the BBA 1997 and the BBRA 1999 were implemented.) On November 29, 1999, after we had published a proposed rule to implement section 4253 of the BBA 1997, the BBRA 1999 was enacted. The BBRA 1999 made major changes that affected the hospital outpatient prospective payment system that was established by the BBA 1997 and implemented in the April 7, 2000 final rule with comment period. Therefore, in the April 7, 2000 final rule with comment period, we also implemented 14 provisions of the BBRA 1999 that affected the hospital outpatient prospective payment system and solicited public comments on those provisions. The BBRA 1999 provisions on which we solicited comments included the following: 1. Outlier Adjustment Section 201(a) of the BBRA 1999 amended section 1833(t) of the Act by adding a new paragraph (5) to provide that the Secretary must make payment adjustments (that is, an outlier payment) for covered services whose costs exceed a threshold determined by the Secretary. This section describes how the additional payments are to be calculated and caps the projected outlier payments at no more than 2.5 percent of the total projected payments (sum of both Medicare and beneficiary payments to the hospital) made under the hospital outpatient prospective payment system for years before 2004 and 3.0 percent of the total projected payments for 2004 and subsequent years. 2. Transitional Pass-Through for Additional Costs of Innovative Medical Devices, Drugs, and Biologicals Section 201(b) of the BBRA 1999 added new section 1833(t)(6) to the Act, establishing transitional pass-through payments for certain medical devices, drugs, and biologicals. This provision specifies the types of items for which additional payments must be made; describes the amount of the additional payments; limits these payments to at least 2, but not more than 3 years; and caps the projected payment adjustments annually at 2.5 percent of the total projected payments for hospital outpatient services each year before 2004 and no more than 2.0 percent in subsequent years. Under this provision, the Secretary must reduce pro rata the amount of the additional payments if, before the beginning of a year, he or she estimates that these payments would otherwise exceed the caps. 3. Budget Neutrality Applied to New Adjustments Section 201(c) of the BBRA 1999 amended section 1833(t)(2)(E) of the Act to require that the establishment of outlier and transitional pass-through payment adjustments be made in a budget neutral manner. 
                        ( print page 67801) 4. Limitation on Judicial Review Section 201(d) of the BBRA 1999 amended redesignated section 1833(t)(11) of the Act by extending the prohibition of administrative or judicial review to include the factors for determining outlier payments (that is, the fixed multiple, or a fixed dollar cutoff amount, the marginal cost of care, or applicable total payment percentage), and the determination of additional payments for certain medical devices, drugs, and biologicals, the insignificant cost determination for these items, the duration of the additional payment or portion of the prospective payment system payment amount associated with particular devices, drugs, or biologicals, and any pro rata reduction. 5. Inclusion in the Hospital Outpatient Prospective Payment System of Certain Implantable Items Section 201(e) of the BBRA 1999 amended section 1833(t)(1)(B) of the Act to include as covered hospital outpatient services implantable prosthetics, durable medical equipment (DME), diagnostic x-ray, laboratory, and other tests associated with those implantable items. 6. Payment Weights Based on Median or Mean Hospital Costs Section 201(f) of the BBRA 1999 amended section 1833(t)(2)(C) of the Act, which specifies data requirements for establishing relative payment weights, to allow the Secretary the discretion to base the weights on either the median or mean hospital costs determined by data from the most recent available cost reports. 7. Limitation on Variation of Costs of Services Classified Within a Group Section 201(g) of the BBRA 1999 amended section 1833(t)(2) of the Act to limit the variation of costs of services within each payment classification group by providing that the highest median cost (or mean cost, if elected by the Secretary) for an item or service within the group cannot be more than 2 times greater than the lowest median (or mean) cost for an item or service within the group. The provision allows the Secretary to make exceptions in unusual cases, such as for low volume items and services. 8. Annual Review of the Hospital Outpatient Prospective Payment System Components Section 201(h) of the BBRA 1999 amended redesignated section 1833(t)(8) of the Act to require at least an annual review of the payment groups, relative payment weights, and the wage and other adjustments made by the Secretary to take into account changes in medical practice, the addition of new services, new cost data, and other relevant information and factors. Section 201(h)(2) provides that the first annual review must be conducted in 2001 for application in 2002. The section was further amended to require the Secretary to consult with an expert outside advisory panel composed of an appropriate selection of provider representatives who will review the clinical integrity of the groups and weights and advise the Secretary accordingly. The panel may use data other than those collected or developed by the Department of Health and Human Services (HHS) for review and advisory purposes. 9. Coinsurance Not Affected by Pass-Throughs Section 201(i) of the BBRA 1999 amended redesignated section 1833(t)(7) of the Act to provide that the beneficiary coinsurance amount will be calculated as if the outlier and transitional pass-throughs had not occurred; that is, there will be no additional coinsurance collected from beneficiaries for the additional payments made to hospitals by Medicare for these adjustments. 10. Extension of Cost Reductions Section 201(k) of the BBRA 1999 amended section 1861(v)(1)(S)(ii) of the Act to extend, until the first date that the hospital outpatient prospective payment system is implemented, the 5.8 and 10 percent reductions for hospital operating and capital costs, respectively. 11. Clarification of Congressional Intent Regarding Base Amounts Used in Determining the Hospital Outpatient Prospective Payment System Section 201(l) of the BBRA 1999 provided that, “With respect to determining the amount of copayments described in paragraph (3)(A)(ii) of section 1833(t) of the Social Security Act, as added by section 4523(a) of BBA, Congress finds that such amount should be determined without regard to such section, in a budget neutral manner with respect to aggregate payments to hospitals, and that the Secretary of Health and Human Services has the authority to determine such amount without regard to such section.” 12. Transitional Corridors for Application of Outpatient Prospective Payment System Section 202 of the BBRA 1999 amended section 1833(t) of the Act by redesignating paragraphs (7) through (11) as paragraphs (8) through (12), respectively, and adding a new paragraph (7), which provides for a transitional adjustment to limit payment reductions under the hospital outpatient prospective payment system. More specifically, from the date the prospective payment system is implemented through 2003, a provider, including a CMHC, will receive an adjustment if its prospective payment system payments for outpatient services furnished during the year is less than a set percentage of its “pre-BBA” amount for that year. The pre-BBA amount is the product of the reasonable costs the hospital incurs for prospective payment system services during the year and the payment-to-cost ratio for covered prospective payment system services furnished during the cost report period ending during 1996. Two categories of hospitals, rural hospitals with 100 or fewer beds and cancer hospitals, will be held harmless under this provision. Small rural hospitals will be held harmless for services furnished before January 1, 2004. The hold-harmless provision applies permanently to cancer centers. Section 202 also requires the Secretary to make interim payments to affected hospitals subject to retrospective adjustments and requires that the provisions of this section do not affect beneficiary coinsurance. Finally, this provision is not subject to budget neutrality. 13. Limitation on Coinsurance for a Procedure Section 204 of the BBRA 1999 amended redesignated section 1833(t)(8) of the Act to provide that the copayment amount for a procedure performed in a year cannot exceed the hospital inpatient deductible for that year. 14. Reclassification of Certain Hospitals Section 401 of the BBRA 1999 added section 1886(d)(8)(E) to the Act to permit reclassification of certain urban hospitals as rural hospitals for purposes of section 1886(d) of the Act. Section 401 added section 1833(t)(13) to the Act to provide that a hospital being treated as a rural hospital under section 1886(d)(8)(E) is also to be treated as a rural hospital under the hospital outpatient prospective payment system. A discussion of how each of these BBRA 1999 provisions was implemented in the April 7, 2000 final rule with comment period appears in section II of this preamble preceding our summary of the public comments received and our responses to those comments. 
                        ( print page 67802) B. June 30, 2000 Notice of Delay of Effective Date for the April 7, 2000 Final Rule With Comment Period On June 30, 2000, we published a notice in the 
                        **Federal Register**
                         (65 FR 40535) announcing a delay in the effective date of the April 7, 2000 hospital outpatient prospective payment system final rule with comment period from July 1, 2000 to August 1, 2000. This delay was based on our determination that the appropriate claims processing changes could not feasibly be made to our computer systems and properly tested in time to ensure that proper payments would be made for Medicare hospital outpatient services under the new prospective payment system by the original July 1, 2000 effective date. C. August 3, 2000 Interim Final Rule With Comment Period On August 3, 2000, we published an interim final rule with comment period in the 
                        **Federal Register**
                         (65 FR 47670) that changed one criterion and postponed the effective date for two other criteria that a new device, drug, or biological must meet in order for its cost to be considered “not insignificant” for purposes of determining its eligibility for transitional pass-through payments from the hospital outpatient prospective payment system. It also changed the transitional pass-through payment policy to include new single use medical devices that come in contact with human tissue and are surgically implanted or inserted into patients, whether or not the devices remain with the patients following their release. These policies were a departure from those presented in the April 7, 2000 final rule with comment period. The August 3, 2000 rule also corrected a trigger date for grandfathering of provider-based FQHCs to conform with the intent not to disrupt existing FQHCs with longstanding provider-based treatment that we discussed in the April 7, 2000 rule. Under the criteria in the April 7, 2000 final rule with comment period, FQHCs would have been treated as departments of a provider without regard to the criteria for provider-based status if they continued to qualify as FQHCs and were designated as FQHCs before 1995. In accordance with the August 3, 2000 interim final rule with comment period and this interim final rule with comment period, facilities that continue to qualify as FQHCs and were designated as FQHCs or “look-alikes” on or before April 7, 2000 would continue to be treated as provider-based facilities. In addition, we clarified how the requirement for prior notices to beneficiaries is to be applied in emergency situations. We also clarified the protocols for off-campus departments in emergency situations. D. Summary of This Interim Final Rule With Comment Period In section II of this preamble, we— Respond to public comments received timely on the 14 BBRA 1999 provisions that were included in the April 7, 2000 final rule with comment period. (We received numerous public comments on other aspects of the April 7, 2000 final rule with comment period that were not open for comment. We will not address those comments in this rule.)
                    Respond to public comments on the August 3, 2000 interim final rule with comment period that revised the criteria for defining new or innovative medical devices, drugs, and biologicals eligible for pass-through payments and corrected the criteria for the grandfathering provision for certain FQHCs as provider-based. In section III of this preamble, we are updating, for services furnished during calendar year 2001, the wage index values and the conversion factor, and revising the APCs to reflect new codes for 2001 effective January 1, 2001. As required under section 1833(t)(8)(A) of the Act, in 2001, we will begin our annual review process of the APC groups, relative weights, and the wage and other adjustments for the prospective payment systems payments that will become effective on January 1, 2002. The statute requires the Secretary to consult with an expert outside advisory panel composed of an appropriate selection of representatives of providers to review (and advise the Secretary concerning) the clinical integrity of the groups and weights. This provision allows these experts to use data other than those collected or developed by us during our review of the APC groups and weights. II. Analysis of, and Responses to, Public Comments on the BBRA 1999 Provisions and the August 3, 2000 Interim Final Rule With Comment Period We received a total of 747 pieces of timely correspondence containing public comments on the April 7, 2000 final rule with comment period. In addition to receiving comments from various organizations throughout the hospital industry, we also received comments from beneficiaries and their families, physicians, health care workers, individual hospitals, professional associations and societies, legal and nonlegal representatives and spokespersons for beneficiaries and hospitals, members of the Congress, and other interested citizens. The majority of the comments addressed the BBRA 1999 provisions relating to the limitation on variation of costs of services classified within a group, the transitional pass-through provision for devices, drugs, and biologicals, and the inclusion of implantable items. We received 13 comments in response to the August 3, 2000 interim final rule with comment period. These comments were submitted by major associations, drug and device manufacturers, providers, a private citizen, and a law firm. More than half of the comments addressed issues for which we did not solicit comments in the August 3, 2000 interim final rule with comment period. Those comments specifically addressed payment policy and typographical errors present in the April 7, 2000 final rule with comment period. The remaining commenters addressed the revisions to the criteria to define new or innovative medical devices, drugs, and biologicals eligible for pass-through payments and corrections to the criteria for the grandfathering provision for certain FQHCs. These commenters took issue with some of the provisions and raised additional concerns regarding our actions. A summary of the public comments and our responses to them appears following the discussion of the April 7, 2000 final rule with comment period. We have carefully reviewed and considered all comments received timely. The modifications that we are making in response to commenters' suggestions and recommendations are summarized in section III.A of this preamble and, as appropriate, reflected in the regulation text. A. April 7, 2000 BBRA 1999 Provisions Below we discuss the implementation of the BBRA 1999 provisions addressed in the April 7, 2000 final rule with comment period and modified in the August 3, 2000 interim final rule with comment period, the public comments received on each provision, and our response to those comments. 1. Outlier Adjustment Section 1833(t)(5) of the Act, as added by section 201(a) of the BBRA 1999, required that the Secretary make an additional payment (that is, an outlier adjustment) for outpatient services for which a hospital's charges, adjusted to cost, exceed a fixed multiple of the sum of the outpatient prospective payment system payment and the transitional pass-through payments. The Secretary is 
                        ( print page 67803)
                        authorized to determine the amount of this fixed multiple and the percent of costs above the threshold that is to be paid under this outlier provision. Under the statute, projected outlier payments may not exceed an “applicable percentage” of projected total program payments. The applicable percentage means a percentage specified by the Secretary (projected percentage of outlier payments relative to total payments), subject to the following limits: For years before 2004, the projected percentage that the Secretary specifies cannot exceed 2.5 percent; for 2004 and later, the projected percentage cannot exceed 3.0 percent. Section 1833(t)(2)(E) of the Act requires that these payments be budget neutral. Section 1833(t)(5)(D) of the Act grants the Secretary authority until 2002 to identify outliers on a bill basis rather than on a specific service basis and to use an overall hospital cost-to-charge ratio (CCR) to calculate costs on the bill rather than using department-specific CCRs for each hospital. In the April 7, 2000 final rule with comment period, in accordance with the statute, we presented how the additional outlier payments are to be calculated. To set the threshold or fixed multiple and the payment percentage of costs above that multiple for which an outlier payment would be made, we first had to determine what specified percentage of total program payment, up to 2.5 percent, we should select. We decided to set the outlier target at 2.0 percent. In order to set the fixed multiple outlier threshold and payment percentage, we simulated the prospective payment system payments. We calibrated the threshold and the payment percentage applying an iterative process so that the simulated outlier payments were 2.5 percent of simulated total payments. For purposes of the simulation, we set a “target” of 2.5 percent (rather than 2.0 percent), because we believed that a given set of numerical criteria would result in a higher percentage of outlier payments under the simulation using 1996 data than under the prospective payment system. This is because we believe that the 1996 data reflects undercoding of services, which means simulated total payments would likely be understated and, in turn, the percentage of outlier payments would be overstated. In addition, we were not able to fully estimate the amount and distribution of pass-through payments using the 1996 data. Our inability to make these estimates further understated the total payments under the simulation. We believe that a set of numerical criteria that results in simulated outlier payments of 2.5 percent using the 1996 data would result in outlier payments of 2.0 percent under the prospective payment system. The difference arises from the effect of undercoding in the historical data and the payment of pass-throughs under prospective payment system. We set the outlier threshold at 2.5 times the prospective payment system payments. *Comment:*
                         Several commenters asked us to clarify how series bills for services such as chemotherapy that are billed monthly for multiple sessions are treated in determining outlier payments. They also asked that we clarify how bills for multiple clinic visits on the same day are treated in calculating the outlier payment. *Response:*
                         In accordance with section 1833(t)(5)(D) of the Act, until 2002, outliers will be determined on a bill basis rather than on a specific service basis. Therefore, the charges (converted to costs) associated with all services under the hospital outpatient prospective payment system reported on series bills or all payable multiple clinic visits billed on a single claim would be used to determine whether the outlier threshold is exceeded and to calculate the outlier payment. *Comment:*
                         One commenter suggested that we prospectively adjust the conversion factor if we determine that the actual outlier expenditures are less than estimated in a given year. *Response:*
                         Consistent with our outlier policies in other prospective payment systems, we will not adjust the conversion factor for a given year to account for an underestimation (or overestimation) of outlier payments in a previous year. The statute does not provide for such an adjustment to the conversion factor. We set outlier policies prospectively, using the best available data. Outlier payments, like many aspects of a prospective payment system, reflect estimates, and we believe it would be inappropriate to adjust the conversion factor (upward or downward) for a given year simply because an estimate for a previous year ultimately turned out to be inaccurate. If we underestimate or overestimate the percentage of outlier payments, the divergence of our estimate from actual experience might provide information that might help us improve estimates in the future, but it would have no direct effect on the conversion factor for any following year. *Comment:*
                         One commenter urged us to provide additional information about the cost-to-charge ratios that will be used to determine whether a claim exceeds the outlier threshold for payment. The commenter stated that the preamble language on page 18498 of our April 7, 2000 final rule with comment period conflicts with statements contained in Program Memorandum Transmittal No. A-00-23 regarding which cost-to-charge ratio would be used to determine whether a claim meets the outlier threshold requirements for payment. According to the commenter, we stated in the final rule with comment period that we will use a hospital's overall cost-to-charge ratio to make this determination, but stated in the program memorandum that we will use an outpatient cost-to-charge ratio. The commenter asked us to clarify the conflicting statements. *Response:*
                         On September 8, 2000, we issued Program Memorandum Transmittal No. A-00-63, titled “Cost-to-Charge Ratios (CCRs) for Calculating Certain Payments Under the Hospital Outpatient Prospective Payment System” which describes how we calculated the cost-to-charge ratios that are used to determine payments for outliers, interim transitional corridors, and device pass-throughs for calendar year 2000. That program memorandum defined the cost-to-charge ratio that is used to calculate these payments as the overall hospital outpatient cost-to-charge ratio. This is consistent with what we stated in our April 7, 2000 final rule with comment period. The September program memorandum contains the latest and most complete information available on cost-to-charge ratio calculation for the hospital outpatient prospective payment system. *Comment:*
                         One commenter assumed that we will use department level cost-to-charge ratios after 2002 to determine if a particular outpatient service qualifies for outlier payment. The commenter asked if we will use a “national cost-to-charge mapping procedure” to determine the appropriate department cost-to-charge ratios to use. The commenter expressed concern about the appropriateness of that approach because of the variability among providers in assigning costs to departments. For this reason, the commenter recommended, if we use a national cost-to-charge mapping procedure, we permit providers to request outlier payments if they can demonstrate that the actual department cost-to-charge ratio to which they assign costs for a service results in a cost calculation that meets the outlier threshold. *Response:*
                         We plan to address this issue and seek comments on it in the rulemaking process for the annual update for 2002. *Comment:*
                         One commenter urged us to publish annually the “cost reporting 
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                        year” used to determine the cost-to-charge ratios that will be used in determining outlier payments. The commenter also asked that we explain how we computed cost-to-charge ratios for hospitals that have merged or been acquired. *Response:*
                         On September 8, 2000, we issued Program Memorandum Transmittal No. A-00-63 that describes the specific criteria we used and provides detailed instructions for calculating the cost-to-charge ratios for hospitals that have merged or been acquired. It also identifies the specific cost reporting year end that was used to calculate each provider's cost-to-charge ratio. *Comment:*
                         One commenter asked that we lower the outlier threshold from 2.5 to 2.0. The commenter strongly recommended that we permanently retain the lowered threshold to ensure appropriate patient care and adequate provider reimbursement. *Response:*
                         We oppose lowering the outlier threshold to 2.0. As discussed in our April 7, 2000 final rule with comment period, we set the outlier threshold at 2.5 by simulating total prospective payment system payments (using 1996 hospital outpatient data) and using an iterative process to calculate a threshold under which outlier payments are projected to equal 2.0 percent of total payments. If we lowered the threshold as the commenter suggests, then the projected percentage of outlier payments would increase and we would have to reduce the conversion factor correspondingly (thus reducing the payment for all non-outlier cases.) 2. Transitional Pass-Through for Additional Costs of Innovative Medical Devices, Drugs, and Biologicals Section 1833(t)(6) of the Act, as added by section 201(b) of the BBRA 1999, requires the Secretary to make additional payments to hospitals, outside the hospital outpatient prospective payment system for a period of 2 to 3 years for specific items. The items designated by the law are the following: Current orphan drugs, as designated under section 526 of the Federal Food, Drug, and Cosmetic Act; current drugs, biologic agents, and brachytherapy devices used for treatment of cancer; current radiopharmaceutical drugs and biological products; and new medical devices, drugs, and biologic agents, in instances where the item was not being paid as a hospital outpatient service as of December 31, 1996, and where the cost of the item is “not insignificant” in relation to the hospital outpatient prospective payment system payment amount. In this context, “current” refers to those items for which hospital outpatient payment is being made on the first date the new prospective payment system is implemented. Section 1833(t)(6)(C)(i) of the Act sets the additional payment amounts for the drugs and biologicals as the amount by which the amount determined under section 1842(o) of the Act (95 percent of the average wholesale price (AWP)) exceeds the portion of the otherwise applicable hospital outpatient department fee schedule amount that the Secretary determines to be associated with the drug or biological. Section 1833(t)(6)(C)(ii) of the Act provides that the additional payment for medical devices be the amount by which the hospital's charges for the device, adjusted to cost, exceed the portion of the otherwise applicable hospital outpatient department fee schedule amount determined by the Secretary to be associated with the device. Under section 1833(t)(6)(D), the total amount of pass-through payments for a given year cannot be projected to exceed an “applicable percentage” of total payments. For a year (or a portion of a year) before 2004, the applicable percentage is 2.5 percent; for 2004 and subsequent years, the applicable percentage is 2.0 percent. If the Secretary estimates that total pass-through payments would exceed the caps, the statute requires the Secretary to reduce the additional payments uniformly to ensure the ceiling is not exceeded. These pass-through payments must be made in a budget neutral manner. In addition, these additional payments do not affect the computation of the beneficiary coinsurance amount. In the April 7, 2000 final rule with comment period, we specified the types of items for which additional payments would be made; described the amount of the additional payments; announced that these payments would be limited to at least 2 years but not more than 3 years; and announced a cap of the projected payment adjustments annually at 2.5 percent of the total projected payments for hospital outpatient services each year before 2004 and no more than 2.0 percent in subsequent years. a. Definition of a Device *Comment:*
                         Some commenters argued that we have adopted a very narrow definition of a device that restricts pass-through payments to prosthetic devices and excludes valuable new nonprosthetics from pass-through consideration. They asserted that the definition of a device should mirror the definition set forth in the Federal Food, Drug, and Cosmetic Act. They agreed that such a definition should exclude capital equipment, reusable items, and incidental supplies. However, they argued that we should clarify and revise our definition of devices to those that are “implanted or inserted” and “remain with the patient after the patient is released from the hospital outpatient department.” *Response:*
                         The definition of a device under the Food, Drug, and Cosmetic Act is extremely broad. In summary, it refers to a device as an instrument, apparatus, implement, machine, contrivance, implant, 
                        *in vitro*
                         reagent, or other similar or related article, including any component, part, or accessory, which is— Recognized in the official national formulary, or the U.S. Pharmacopeia, or any supplement to them;
                    Intended for the use of the diagnosis of conditions other than diseases such as pregnancy;
                    Intended to affect the structure or any function of the body of man or other animals; or
                    Considered an*in vitro*
                         diagnostic product, including those previously regulated as drugs, and which does not achieve any of its principal intended purposes through chemical action within or on the body of man or other animals and which is not dependent upon being metabolized for the achievement of any of its principal intended purposes. This definition is inappropriate for use in the context of the transitional pass-through payments for several reasons: It would include (as the commenters noted) items that are treated as supplies, reusable items, or capital equipment by Medicare payment systems, including the outpatient prospective payment system. It has a number of inappropriate elements, including reference to pharmaceuticals and to use in animals. Further, it is insufficiently specific for Medicare purposes, as it does not mention medical necessity or the test of whether the cost of a device is “not insignificant” relative to the associated APC. We have instead provided a definition of a device specific to the purposes of the transitional pass-through provision. This definition was presented in the preamble to the April 7, 2000 final rule with comment period and revised in the August 3, 2000 interim final rule with comment period, which added § 413.43(e)(4). In the August 3, 2000 interim final rule with comment period, we revised the criteria that we had set forth in the 
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                        April 7, 2000 final rule with comment period to define a device. Among the changes included is a revision of the criterion relating to whether a device must remain with the patient. The new criterion (§ 419.43(e)(4)(iv)) includes devices that are surgically implanted or inserted in a patient “whether or not they remain with the patient when the patient is released from the hospital outpatient department.” This change allows pass-through payments for devices that are surgically implanted or inserted even temporarily in a patient providing the devices meet all other requirements for pass-through payments. As a result, nonprosthetic devices, such as cardiac catheters, guidewires, or stents that commenters noted would be excluded, may be eligible for pass-through status. In § 419.43(e)(4)(iv), we have retained the limitation to devices that are surgically implanted or inserted because we believe this offers the best interpretation of section 201(e) of the BBRA 1999, which indicates that implantable devices are to be included in the APCs. To further clarify how we interpret § 419.43(e)(4)(iv), we consider that a device is surgically implanted or inserted if it is introduced into the human body through a surgically created incision. We do not consider an item used to cut or otherwise create a surgical opening to be a device that is surgically implanted or inserted. We consider items used to create incisions, such as scalpels, electrocautery units, biopsy apparatuses, or other commonly used operating room instruments, to be supplies or capital equipment, and hence, in accordance with § 419.43(e)(4)(vi) or (vii), we consider these items not eligible for transitional pass-through payments. We believe the function of these items is different and distinct from that of devices that are used for surgical implantation or insertion. Generally, we would expect that surgical implantation or insertion of a device occurs after the surgeon uses certain primary tools, supplies, or instruments to create the surgical path or site for implanting the device. We have discovered some items that do not meet the requirement of being surgically implanted or inserted were erroneously approved for pass-through payments. Consequently, we will eliminate these items from the list of items eligible for pass-through payments, effective January 1, 2001. *Comment:*
                         One commenter claimed that it was inappropriate for us to change the definition of devices through letters to manufacturers. The commenter believed that this was done outside the rulemaking process. *Response:*
                         We did not make a change to our policy through a letter. As we began to evaluate the hundreds of applications for approval of numerous devices, it was apparent that our definition for new medical devices as published in our April 7, 2000 final rule with comment period would have resulted in denials for items that we believe might warrant pass-through payments. Examples of such potential denials are many types of general and specialty catheters. Based on our experience in reviewing these applications, we decided to change three of the eight specific criteria that a new device must meet in order to be eligible for pass-through payments. We published these changes in our August 3, 2000 interim final rule with comment period. b. Eligibility Criteria *Comment:*
                         Some commenters believed that we should accept and process applications for items while they are undergoing the FDA review process. *Response:*
                         We have accepted and begun processing all applications, including those for which items are pending FDA approval or clearance. However, in those instances where the FDA approval or clearance documentation is missing, the application is considered incomplete. In order for an item to be eligible for transitional pass-through payments, it must have been approved or cleared by the FDA for marketing. We will not make a final determination on any applications that are pending FDA approval or clearance until all the required documentation is submitted. Resources permitting, we will commence preliminary processing of the applications when received. The applying party is responsible for providing us with proper evidence of FDA approval or clearance for any item, once approval or clearance has been obtained. Once we receive documentation of FDA approval or clearance and determine the item is determined to be eligible for transitional pass-through payments, payment for the item will commence at the start of the next quarterly update of pass-through items. *Comment:*
                         Some commenters asked that we clarify that items must meet Medicare coverage requirements in order to qualify for pass-through status. *Response:*
                         As stated in both our April 7, 2000 final rule with comment period and our August 3, 2000 interim final rule with comment, items that qualify for pass-through payments must be covered by Medicare. They must have been determined to be reasonable and necessary for the diagnosis or treatment of an illness or injury or to improve the functioning of a malformed body part, as required by section 1862(a)(1)(A) of the Act. (See § 419.43(e)(4)(iii).) c. Investigational Device Exemption (IDE) Devices *Comment:*
                         Some commenters recommended that we automatically define as “new” any device that receives an investigational device exemption (IDE) from the FDA, with a Category B designation. They believed that we should pay for IDE devices through the pass-through payment methodology rather than limit the payment to no more than what is currently paid for an equivalent device. *Response:*
                         As stated in our August 3, 2000 interim final rule with comment period, we have changed the payment methodology for eligible IDE Category B devices so that they will be paid using the transitional pass-through methodology. Since these noninvestigational devices are required to meet the same eligibility criteria as other devices, we determined that they should be paid in a similar manner. However, we do not accept the commenter's recommendation that all IDE Category B devices “automatically” be considered as new. The statute defines “new” medical device on the basis of a date certain (that is, payment for the device was not being made as an hospital outpatient service as of December 31, 1996) rather than based on a class of devices (such as IDEs). d. Removing Cost of Predicate Item *Comment:*
                         Some commenters stated that we did not have adequate data to ensure appropriate removal of the costs for predecessor items (particularly radiopharmaceuticals and devices) from their relevant APCs. They advocated that we reevaluate this provision as soon as possible after implementation of our new system and make necessary changes. *Response:*
                         We will be continuously evaluating our data to remove the costs of predecessor items from the pass-through payments. As of January 1, 2001, a specific dollar amount will be deducted from selected devices (see explanation below). Over time, such deductions will be made, as we are able to make appropriate estimates from the data. e. Excluded Costs *Comment:*
                         A number of commenters stated that the APC construction excluded costs for implantable devices billed with revenue codes 274, 275 and 278. The commenters recommended 
                        ( print page 67806)
                        that implantable devices associated with these revenue codes be included on the pass-through list until data is collected to adequately reflect the cost of such devices. In addition to claims that revenue codes 274, 275 and 278 were not represented in the data, some commenters alleged that implant procedures were infrequently performed on an outpatient basis prior to 1997 and therefore the costs associated with them were not represented in the data used to develop the APC rates. Some commenters recommended, on that basis, that all implantable devices be included for pass-through payment regardless of FDA approval dates. *Response:*
                         Following enactment of the BBRA of 1999, we did not have sufficient time to re-run our data to package the costs of implantable device revenue centers into the APC weights and still be able to publish a final rule in time to implement the prospective payment system by July 1, 2000. As of January 1, 2001, the APC rates will reflect the inclusion of revenue codes 274, 275 and 278. While the aggregate amount of these revenue centers is small (0.3 percent of total charges in 1996), the costs of certain procedures such as implantation of cardiac pacemakers did increase substantially. As detailed in section III.B.1 of this interim final rule, some APC groups were modified because of the inclusion of these revenue centers, and rates for some procedures will increase to reflect these costs. A reduction in an amount equal to the increase in the APC rates will be deducted from the relevant devices that are either eligible for pass-through payments or that can be billed for additional payment through the new technology APCs. f. Effect on Conversion Factor *Comment:*
                         Some commenters believed that lowering the outpatient prospective payment system conversion factor to reflect the 2.5 percent transitional pass-through adjustment could affect hospitals' financial health. They asserted that any risks to the financial health of hospitals resulting from reducing the conversion factor should be balanced against any benefits that would be gained from higher payments for new drugs and devices. Another commenter advocated that we increase the conversion factor if we find that the transitional pass-through payments do not comprise 2.5 percent of the total outpatient prospective payment system payments. *Response:*
                         Section 1833(t)(2)(E), as amended by section 201(c) of the BBRA 1999, requires that transitional pass-through payments be implemented in a budget neutral manner. We set prospective payment system rates prospectively and, consistent with our policies in other aspects of the prospective payment system, we will not adjust (upward or downward) the conversion factor for a given year to account for the difference between 2.5 percent and the actual percentage of pass-through payments in a previous year. g. Cost Significance Tests *Comment:*
                         Some commenters asserted that we could preclude some worthwhile technologies from achieving pass-through status if we set the “not insignificant” cost threshold at 25 percent of the APC payment rate for the relevant procedure with which it is used. They contend that technologies associated with higher payment APCs would be more likely to be disqualified. *Response:*
                         We have lowered the cost threshold from 25 percent to 10 percent of the applicable fee schedule amount for the service associated with the item. This change is effective for services furnished on or after August 1, 2000. *Comment:*
                         A hospital association asked that we clarify how the “not insignificant” criteria will be applied when a new device, drug, or biological is associated with more than one APC. The commenter stated that, under the current provisions of the rule, an item could be determined to be eligible for pass-through payment when used in performing a procedure in one APC, but not another. The commenter suggested that an item that meets the criteria for one APC be treated as a pass-through item for all APCs in which it is used. *Response:*
                         We agree with the stated approach. This has been the policy that we have applied in processing applications. *Comment:*
                         One manufacturer stated that we did not make information available on the “not insignificant” rule in sufficient time for applicants to take the criteria into account in preparing applications for payment effective August 1, 2000. The commenter alleged that the term “not insignificant” can be interpreted widely and caused manufacturers not to apply for all potentially eligible pass-through items. The commenter recommended that we review applications submitted for the following HCPCS codes to be certain that they meet the published cost criteria and remove them from the pass-through list if they do not. The commenter also advocated that we allow other manufacturers to submit applications retroactive to July 1, 2000, to assure that we are not promoting a competitive disadvantage for some companies. HCPCS Codes C1029 C1034 C1061 C1072 C1073 C1074 C1100 C1101 C1155 *Response:*
                         In order for a device to be included on the pass-through list, it must meet the criteria for transitional pass-through payments. These criteria include a test of whether the cost of a device is “not insignificant” relative to the payment for the associated APC. This test was first put forth in the April 7, 2000 final rule with comment period, and subsequently revised in the August 3, 2000 interim final rule with comment period. All the devices denoted by the HCPCS codes listed above were tested and met the 10-percent “not insignificant” test as well as the other applicable criteria. The “not insignificant” test was applied uniformly to all applications that had been received timely. We believe that permitting retroactive applications is unwarranted (and would be inconsistent with principles of prospectivity); moreover, resource and systems constraints would make it infeasible to give retroactive effect to determinations of eligibility for pass-through payments. h. Brand-Specific Versus Categorization Approaches *Comment:*
                         Many commenters criticized us for implementing a brand-specific approach to items on the pass-through list. Device manufacturers in particular recommended a category scheme to classify pass-through devices. Representatives of the device industry also offered to assist us in creating the categories. They argued that a category system would allow devices to be added immediately upon FDA approval. They stated that under a category approach manufacturers would only approach us to obtain new pass-through categories and codes when items reflect a technological advance and are significantly more costly than existing payment amounts. *Response:*
                         We adopted a trade-name specific approach for several reasons. First, such an approach provides better information. Codes that are largely item-specific allow us to track what procedures the items are used with and costs of the items. When the pass-through payments for an item ends, we would expect to have good information 
                        ( print page 67807)
                        for assigning it to relevant APCs and ensuring appropriate payment for these APCs. Adopting a scheme with a significant degree of categorization would require use of averages in making assignments and setting payment rates. Decisions based on these more limited data would be likely to lead to intensified concerns about the appropriateness of APC assignment and payment. Second, this approach permits finer discrimination in eligibility decisions. An item-by-item approach allows us to be sure individual items in fact meet the criteria for eligibility. Of major concern in this instance is whether a device is “new” using the standard of the statute. Section 1833(t)(6)(A) of the Act limits transitional pass-through payment to those devices for which “* * * payment for the device * * * as an outpatient hospital service under this part was not being made as of December 31, 1996.” Adopting categories would in some cases mix “old” and “new” devices. In these instances, either some old devices would get special treatment that they would not be eligible for if they were examined on an item-specific basis, or an entire category could be considered old, thus depriving some new devices from special treatment they would be eligible for if they were examined on an item-specific basis. Third, an item-specific scheme avoids issues associated with the design of categories needed for purposes of transitional pass-through payments. It largely avoids concerns about what items should be in what category or whether new categories should be created to accommodate items that may appear to be little different from those in existing categories. Fourth, an item-specific approach allows us to assure that a newly arriving device can obtain the full period of pass-through status it is arguably eligible for under the statute. A categorization approach would likely lead to latecomers being eligible for pass-through payments for a shorter period. Insofar as revision to APC payment rates reflected the costs of items in the category by the time the category was terminated, the shorter period would be of little consequence. However, if the costs of the late-coming item were significantly higher, this procedure could appear objectionable. A solution in this case would be to create a new code, which could be specific to that item, thus departing from a categorization approach. We recognize that a category approach would lessen concerns about competitive disadvantages that may have been inadvertently created by an item specific approach and about access to specific items by hospitals and their patients. However, we found no satisfactory way of establishing categories that would not run into difficulty regarding the test of whether a device is “new” as described above. Consequently, we are making no change in our approach. *Comment:*
                         Many commenters argued that competitive advantages have resulted and will continue to result from using a brand-specific approach to implementing transitional pass-through payments for devices. Some commenters alleged that our use of the FDA approval date as a proxy for determining payment in concert with the brand-specific approach causes further competitive disadvantages. Some hospitals claimed that the brand-specific approach would create winners and losers if a device that one hospital uses obtains pass-through status, but one that another hospital uses does not. A number of commenters asserted that a category approach would decrease the administrative burden on hospitals, manufacturers, and us that a brand-specific approach for application and approval of new devices now incurs. *Response:*
                         It was never our intent to competitively disadvantage anyone or any product. To the maximum extent possible, given the limitations under the BBRA 1999 and our resource constraints, we have worked closely with the pharmaceutical and medical device industries to identify and resolve such issues. By October 1, 2000, we had determined that more than 700 devices are eligible for pass-through payments. Therefore, we believe that hospitals will receive additional payments for many of the devices they use. i. Issues Pertaining to Specific Items *Comment:*
                         A medical association advocated pass-through status for the following devices: new pacemakers, implantable cardioverter defibrillators, insertable loop recorders, electrophysiology catheters (ablation and diagnostic), intracardiac echocardiography ultrasound catheters, and advanced three-dimensional mapping system catheters. *Response:*
                         All of these items are already on the pass-through list. For a complete list of items approved on the pass-through list, refer to Addendum B of this rule for short descriptions of the items. Refer to Program Memoranda Transmittals Nos. A-00-42, A-00-61 and A-00-72 for the long descriptors for each of the C-codes listed in Addendum B. We are developing an additional program memorandum that we expect to issue shortly. This additional program memorandum will contain a list of additional devices, drugs, and new technology services that will be effective January 1, 2001. *Comment:*
                         Several device manufacturers alleged that the following devices were not included on the pass-through list: PALMAZ Balloon-Expandable Stent Corinthian IQ Biliary Stent SMART Cordis Nitinol Stent CARTO EP Navigation System Catheters HYDROLYSER Catheter Indigo Prostate Seeding Needle Lioresal Intrathecal SynchroMed and SynchroMed EL infusion pumps *Response:*
                         All of these devices have been approved for pass-through payments and assigned C-codes. They have been assigned the following codes: the PALMAZ Balloon-Expandable Stent, C8522; Corinthian IQ Biliary Stent, C5004; SMART Cordis Nitinol Stent, C1372; CARTO EP Navigation System Catheters, C1047; HYDROLYSER Catheter, C1054; Indigo Prostate Seeding Needle, C1706; Lioresal Intrathecal, C9007, C9008, C9009, and C9010; SynchroMed and SynchroMed EL infusion pumps, C8505 and C3800, respectively. *Comment:*
                         Another device manufacturer claimed that the following devices were not included on the pass-through list: Mitek Bone Anchors Innovasive Bone Anchors VAPR and VAPR Thermal T Electrode Gynecare TVT Tension-Free Support for Incontinence System (TVT) Gynecare Thermachoice Uterine Balloon Therapy System *Response:*
                         Many of the items above have been approved for pass-through status and assigned C-codes. The Mitek and Innovasive Bone Anchors have been assigned to C1109; VAPR and VAPR Thermal T Electrode, to C1323; TVT Single-Use Tension-Free Vaginal Tape, to C1370; and the Gynecare Thermachoice II Catheter, to C1056. However, some of the items included in the Gynecare TVT Tension-Free Support for Incontinence System and the Gynecare Thermachoice Uterine Balloon Therapy System did not meet the criteria for pass-through status and, therefore, are ineligible for additional payments. The eligible pass-through items are listed in Addendum B. *Comment:*
                         A device manufacturer believed that we should have approved the Targis System, which provides prostatic microwave thermotherapy, for pass-through payments. *Response:*
                         We assigned the prostatic microwave thermotherapy procedure to 
                        ( print page 67808)
                        a new technology APC, that is, APC 0980. In making this assignment, we took into account the costs associated with performing this procedure, including the cost of the Targis system. Therefore, we would not also make a pass-through payment for the system. *Comment:*
                         A number of commenters contended that only 39 of the more than 70 eligible radiopharmaceuticals have been given pass-through status. They recommended that we approve the following radiopharmaceuticals for pass-through payments: Strontium Sr 82 Rubidium Rb 82 Generator Sodium Chromate Cr-51 Co 57 Cobaltous Chloride Co 57 Cyanocobalamin Ferrous Citrate Fe59 Fludeoxyglucose F 18 Intrinsic Factor Concentrate Capsules In 111 Imciromab (Myoscint) In 111 Labeled WBCs, Platelets I 123 and I 131 Hippurate Iodinated I 131 Albumin (I 131 Albumin) Iodinated I 125 Albumin (I 125 Albumin) Iothalamate Sodium I 125 Albumin (I125 Iothalamate) Technetium Tc 99m Pertechnetate Technetium Tc 99m Albumin Colloid Technetium Tc 99m Lidofenin Technetium Tc 99m Tebroxime Technetium Tc 99m Nofetumomab (Verluma) Technetium Tc 99m HMPAO labeled WBCs Technetium Tc 99m Human Serum Albumin Technetium Tc 99m Serum Albumin (Tc 99m HSA kit) Xenon XE 127 Gas *Response:*
                         While a number of radiopharmaceuticals are already on the pass-through list, we are unable to add some of the ones listed above because we do not have AWPs for them. The AWPs are the basis for payment for these items and without the AWPs we cannot approve them for pass-through payments. As soon as the AWPs are made available to us, we will complete our review to determine their pass-through status. If eligible, they will be added to the pass-through list during the appropriate quarterly update cycle. *Comment:*
                         One commenter stated that our transitional pass-through policy for devices precludes pass-through eligibility for capital equipment and therefore does not provide a mechanism under our new system for recognizing the incremental costs associated with capital equipment. The commenter recommended that we recognize capital-equipment costs through our new technology APCs. *Response:*
                         Under our new outpatient prospective payment system, capital costs are not paid separately. Payment for these costs are included in the total APC payment amount for each procedure or medical visit and will be updated through our annual updating process. Therefore, the new technology APCs will not be used to make separate payments for capital related costs. *Comment:*
                         A number of commenters claimed that we denied pass-through status for the contrast agents. *Response:*
                         As clarified in our August 3, 2000 interim final rule with comment, contrast agents other than radiopharmaceuticals are considered supplies and are not eligible for pass-through payments. (See § 419.43(e)(4)(vii).) *Comment:*
                         A medical association claimed that we denied pass-through status requests for high dose rate brachytherapy. Another industry group alleged that many brachytherapy related items that manufacturers applied for were excluded from the pass-through list. *Response:*
                         Since publishing our initial list of potentially eligible pass-through items to our website on March 9, 2000, we have added 38 brachytherapy items to our pass-through list. High-dose rate brachytherapy will be eligible for pass-through payment effective for services furnished on or after January 1, 2001. j. Pass-Through Applications Process *Comment:*
                         Some commenters urged that we process transitional pass-through applications in a more timely manner. A few other commenters believed that we should have chosen a date later than July 14, 2000 as the application deadline for the October 1, 2000 quarterly update for pass-through items. *Response:*
                         We have committed considerable resources to process pass-through applications in a timely manner. Since publication of our preliminary list of 149 potentially eligible pass-through items on our website on March 9, 2000, we have approved nearly 1000 additional items for pass-through payments. We have instituted a coding strategy that allows us to assign a temporary HCPCS code immediately to an eligible pass-through item if a national HCPCS code has not been assigned. We have committed to making quarterly updates to the pass-through list, a commitment that is unprecedented in Medicare's history. We have reviewed all applications timely submitted for each update cycle. Unfortunately, however, we have had to defer items with significantly unclear applications or for which sufficient information was not included to determine that the item meets the statutory criteria. We have endeavored to work closely with the applicants to obtain this information and respond timely to their questions. Regarding objections to setting a July 14, 2000 deadline for receipt of pass-through applications for the October 1 update, this deadline was established in order to evaluate the applications and make the necessary systems modifications in time for the October release to our fiscal intermediaries and standard systems maintainers. *Comment:*
                         One commenter believed that we should update our transitional pass-through list more frequently than quarterly. Some other commenters were concerned that the quarterly updating process could potentially create systems problems for both HCFA and hospitals that would delay payments. They believed that such a delay would, in turn, create cash flow difficulties for hospitals. They urged that we develop contingency plans to address cash flow problems resulting from the transitional pass-through process. *Response:*
                         Because of the complexity of our new system, we cannot institute systems changes more frequently than quarterly for pass-through payments. While we believe that making quarterly updates to the pass-through list will present challenges both for HCFA and the hospital industry, we have not been advised that any hospital is experiencing cash flow problems attributable to the transitional pass-through process. *Comment:*
                         One commenter urged us to issue guidelines that detail the planned methodologies, data sources, and associated timelines for updating the pass-through list. *Response:*
                         Since March 10, 2000, we have published information on our website which provides detailed instructions and deadlines for submitting transitional pass-through applications. These instructions have been revised as needed in order to clarify and update information and may be found on the following HCFA website: http://www.hcfa.gov /medlearn/refopps.htm. *Comment:*
                         One commenter claimed that our method and timing of assigning HCPCS codes to eligible transitional pass-through items would preclude Medicare beneficiaries from receiving appropriate treatment. The commenter also alleged that hospitals will not always be adequately reimbursed for their costs for such items and that they will have an incentive to switch to more invasive treatment options with higher costs. 
                        ( print page 67809) *Response:*
                         We have expedited the process of assigning HCPCS codes to pass-through items. When an item is determined eligible for pass-through status, a temporary HCPCS code is assigned immediately in order that hospitals may begin billing the item as soon as it is effective for payment. In addition, section 1833(t)(6)(C)(i) of the Act requires that the hospital's additional payment for drugs and biologicals be determined as the difference between the amount determined under section 1842(o) of the Act (95 percent of AWP) and the portion of the hospital outpatient department fee schedule amount determined by the Secretary to be associated with those items. For devices, the additional payment is the difference between the hospitals' charges adjusted to costs and the portion of the applicable hospital outpatient department fee schedule amount associated with the device. We believe that this payment method will appropriately reimburse hospitals for eligible pass-through items and that hospitals will act in a prudent manner and not compromise their patients' safety and care. k. Payment for Pass-Through Items *Comment:*
                         Several commenters questioned how payment would be made when a pass-through item is included on an outpatient claim. Another commenter stated that our April 7, 2000 final rule with comment period does not state the actual payment amount that will be made for each pass-through item, or provide a good reason for not updating drug and biological average wholesale prices quarterly, or pledge timely correction of payment amount errors. The latter commenter believed that we should make available the actual APC payment rates for pass-through items and institute quarterly pricing-updates for drug and biological APCs. *Response:*
                         Transitional pass-through payments for devices are established by taking the hospital charges for each billed item (on an item-by-item basis), reducing them to cost by use of the hospital's cost-to-charge ratio, and subtracting an amount representing the device cost contained in the APC payments for procedures involving that device. Note that for services furnished prior to January 1, 2001, we have not subtracted an amount for the predicate device that is packaged in the relevant APC. However, we will implement this policy beginning with services furnished on or after January 1, 2001. These calculations are all done in the outpatient prospective payment system pricer. Because there are no predetermined APC payment rates for eligible pass-through devices, we cannot publish them in the same manner as we publish the APC payment rates for other services. For drugs and biologicals, pass-through payments are determined based on 95 percent of the AWP for the eligible drug or biological. We described in our April 7, 2000 final rule (65 FR 18481) the process we used to subtract the cost of the eligible drug or biological contained in the APC payments for procedures involving that drug, radiopharmaceutical or biological. The year 2000 AWPs for pass-through drugs and biologicals on which payments are currently based will be updated annually at the beginning of the next quarter following publication of the updated values. Due to the complexity of our new system, we cannot update AWPs quarterly as requested. *Comment:*
                         A number of commenters stated that the codes for drugs in Addendum K of our April 2000 final rule are specific to the dosage amount dispensed and asked what happens if the dosage dispensed to a patient is not equal to the amount associated with the eligible codes. The commenters requested additional information about how providers should account for these situations. They asked if we would allow providers to bill for the product amount associated with the container opened to treat the patient and round up to the nearest whole billing unit. *Response:*
                         The APC payment amount for drugs and biologicals is established at the lowest dosage level for the specific drug or biological. If the dosage required in treating the patient exceeds the lowest level specified in the HCPCS code descriptor for the drug or biological, providers may bill the number of units necessary to treat the patient and round them up to the nearest unit. To determine the payment for the drug or biological, multiply the number of billed units by the APC payment amount. *Comment:*
                         One commenter stated that the APC payment amount for Eptifibatide, a drug on the pass-through list, does not equal 95 percent of the average wholesale price ($6.28 per 5-mg. service unit). The commenter claimed that the APC payment is 42 percent lower than 95 percent of the AWP. The commenter asked that we correct the payment immediately. *Response:*
                         The correct APC payment amount for Eptifibatide injection, 5 mg. is $12.57, of which $1.68 is the minimum unadjusted coinsurance. *Comment:*
                         One commenter stated that the APC payment amount for Quadramet, a pass-through drug, is incorrect. The commenter claimed the AWP for this drug is $2,975 rather than $2,875, which the commenter believed is the basis for our APC payment amount. The commenter stated that the pass-through payment should be $942.08 instead of $910.42. *Response:*
                         The correct APC payment amount for Quadramet is $942.09. Of this amount, $134.87 is the minimum unadjusted coinsurance. *Comment:*
                         A commenter stated that the APC payment amount for Thyrogen, a pass-through drug, should be $494.00 rather than $404.18 per vial. *Response:*
                         The APC payment amount of $404.18 is for 0.9 mg. units of Thyrogen rather than 1.1 mg., which appears to be the standard vial dosage. However, because Thyrogen is not available in a vial dosage less than 1.1 mg., we are eliminating the APC payment for 0.9 mg. units (HCPCS code J3240) effective for outpatient prospective payment system services furnished on or after January 1, 2001. We have established a new code, C9108, for Thyrogen, 1.1 mg. with an APC payment amount of $494.00. This new code is effective for outpatient prospective payment system services furnished on or after January 1, 2001. *Comment:*
                         A medical association acknowledged our short lead-time for implementing the transitional pass-through provision and urged that we hold a series of face-to-face meetings with physicians and suppliers to clarify and revise our pass-through policies. *Response:*
                         Since publishing our April 7, 2000 final rule with comment period, we have met on numerous occasions with physicians and representatives of hospitals, pharmaceutical companies and device manufacturers. During these meetings, we have discussed our transitional pass-through policies and clarified information regarding the pass-through applications process. *Comment:*
                         One commenter stated that the April 7, 2000 final rule with comment period requiring the submittal of applications for national HCPCS codes to bill eligible transitional pass-through was published after the application deadline had passed. The commenter alleged that some manufacturers obtained information about the pass-through provisions prior to publication of the final rule, submitted their applications timely, and thus dominated the hospital outpatient market. *Response:*
                         On March 9, 2000, we posted information on our website similar to that contained in the April 7, 2000 final rule with comment period about applying for national HCPCS codes for pass-through items. We also 
                        ( print page 67810)
                        discussed the coding deadline with representatives of the pharmaceutical and device manufacturers associations as well as with hospital industry representatives through conference calls, meetings, and e-mails. We note that the instructions and deadline for submitting applications for a national HCPCS code are well established and were published on HCFA's website (http://www.hcfa.gov /medicare/hcpcs.htm) more than a year prior to publication of our April 7, 2000 final rule with comment period. Subsequent to these publications, we adopted a new system for assigning codes exclusively for pass-through items to expedite their availability to the hospital industry and Medicare beneficiaries. Therefore, interested parties applying for pass-through status for items have not been required to obtain national HCPCS codes for these items unless they want to bill other payment systems in addition to the hospital outpatient prospective payment system. l. Focus Medical Review *Comment:*
                         One commenter asked that we clarify why we intend to conduct focused medical review of pass-through eligible drugs, biologicals and medical devices. *Response:*
                         Our goal is to identify inappropriate billing for these services and to ensure that payment is not made for noncovered services. 3. Budget Neutrality Applied to New Adjustments In the April 7, 2000 final rule with comment period, in accordance with section 1833(t)(2)(E) of the Act, as amended by section 201(c) of the BBRA 1999, we made the outlier and transitional pass-through payment adjustments under section 1833(t)(5) and section 1833(t)(6) of the Act, respectively, budget neutral. We did not receive any public comments on this provision. 4. Limitation on Judicial Review In the April 7, 2000 final rule with comment period (65 FR 18503-18504), in accordance with section 1833(t)(12) of the Act (as amended by section 201(d) of the BBRA 1999 and redesignated by section 202(a) of the BBRA 1999), we implemented the extension of the prohibition of administrative or judicial review to include the factors for determining outlier payments (that is, the fixed multiple, or a fixed dollar cutoff amount, the marginal cost of care, or applicable total payment percentage), and the factors used to determine additional payments for certain medical devices, drugs, and biologicals, the insignificant cost determination for these items, the duration of the additional payment or portion of the prospective payment system payment amount associated with particular devices, drugs, or biologicals, and any pro rata reduction. We did not receive any public comments on this provision. 5. Inclusion in the Hospital Outpatient Prospective Payment System of Certain Implantable Items In the April 7, 2000 final rule with comment period, we specified that section 1833(t)(1)(B) of the Act, as amended by section 201(e) of the BBRA 1999, provides that “covered OPD services” include implantable items described in section 1861(s)(3), (6), or (8) of the Act. The conference report accompanying the BBRA 1999, H.R. Rept. No. 479, 106th Cong., 1st Sess. at 869-870, (1999), expresses the belief of the conferees that the current DMEPOS fee schedule is not appropriate for certain implantable medical items such as pacemakers, defibrillators, cardiac sensors, venous grafts, drug pumps, stents, neurostimulators, and orthopedic implants as well as items that come into contact with internal human tissue during invasive medical procedures, but are not permanently implanted. In the conference report agreement, the conferees state their intention that payment for these items be made through the hospital outpatient prospective payment system, regardless of how they might be classified on current HCFA fee schedules. In the April 7, 2000 final rule with comment period, we included the following in the list of items and services whose costs are included in hospital outpatient prospective payment rates: Prosthetic implants (other than dental) that replace all or part of an internal body organ (including colostomy bags and supplies directly related to colostomy care), and including replacement of these devices; implantable DME; and implantable items used in performing diagnostic x-rays, diagnostic laboratory tests, and other diagnostic tests. In accordance with the BBRA 1999 provision, we require that an implantable item be classified to the group that includes the service to which the item relates. We indicated that we would continue to review the impact of packaging implantables in future updates. For more detailed information on this provision, refer to the April 7, 2000 final rule with comment period (65 FR 18443-18444). *Comment:*
                         Two commenters (hospitals) expressed concern that the APC for the Cyberonics-NeuroCybernetic Prosthesis (NCP) System, an implantable device used to treat epilepsy patients with partial-onset seizures, will not adequately reimburse hospitals for the cost of the device and the implantation procedure cost. The hospitals recommended that HCFA create a separate APC group for the NCP System implantation. *Response:*
                         The NCP System was approved for pass-through status effective for services furnished on or after August 1, 2000 (see Program Memorandum Transmittal No. A-00-42 issued on July 26, 2000). The two components of this system, the NeuroCybernetic Prosthesis Generator and the NeuroCybernetic Prosthesis Lead, will be paid based on the hospital's charges that are converted to cost using the hospital's assigned cost-to-charge ratio. These devices have been assigned to two separate pass-through APCs (1048 and 1306, respectively) and should be billed using HCPCS code C1048 for the generator and C1306 for each lead. *Comment:*
                         Several commenters from physician practices and a device manufacturer raised concerns that the APC payment level for the Contigen Implant procedure is inadequate to cover the facility costs and the Contigen Implant supplies. According to the commenters, the APC reimbursement amount only covers the 2-3 Contigen Implant syringes used per procedure. The commenters recommended that we map the Contigen Implant procedure and the collagen skin test to higher paying completely new APCs, to more adequately reflect reasonable costs for syringes and skin tests used in the procedure, in addition to appropriate facility fees. Other commenters raised concerns that the separate APC reimbursement for the pre-Contigen Implant procedure testing is inadequate to reimburse for the reasonable cost of the supply. They recommended that we allow payment of Contigen Implant syringes according to the DMEPOS fee schedule. One commenter recommended that we create a special ancillary APC to cover Contigen Implant syringes and the collagen skin test. *Response:*
                         While we understand the commenters' concerns, Contigen Implant syringes do not qualify for transitional pass-through status because they do not meet all of the device criteria set forth in § 419.43(e)(4). Specifically, they are not items that are surgically implanted or inserted in a patient. However, both collagen implant 
                        ( print page 67811)
                        material and the collagen skin test are paid as APCs (that is, APCs 6012 through 6016 and 343, respectively). We will examine data after the first year of billing under the prospective payment system to determine if we are adequately capturing the cost of performing these procedures. As stated in our April 7, 2000 final rule with comment period, we will initiate the annual review process for the various components of our system, including the APC groupings, in calendar year 2001 for services furnished on or after January 1, 2002. We expect to publish our proposed rule for 2002 in the spring of 2001. *Comment:*
                         A device manufacturer inquired as to what will happen when devices are taken off the transitional pass-through list after 2 to 3 years. The commenter stated that the additional expense of these implantable devices will require that HCFA reassign these CPT codes to an APC that is comparable clinically and in terms of resources used at the close of the transition period. If this does not occur, the commenter indicated that hospitals would be seriously underpaid for the use of these technologies and other technologies in similar circumstances. *Response:*
                         As stated above, the BBRA 1999 allows for 2 to 3 years of transitional pass-through payments to be made for new devices, drugs, and biologicals. After the temporary payment period expires for any item, its cost will be packaged with the relative procedure code or medical visit and assigned to the APC group that is clinically related and comparable in resources used. Thus, the APC groupings, weights, and payments will be updated in a subsequent year to include costs associated with former pass-through items. *Comment:*
                         A coalition of health care providers and insurers indicated that providers should be allowed to report all DME, orthotics, and prosthetic devices, both implantable and nonimplantable, on the UB-92 to the fiscal intermediary. The fiscal intermediary should be able to either pay for the item via the DMEPOS fee schedule or through the APC. This also would allow a tracking system for future ratesetting, and consolidate the billing into one claim. This would consolidate all charges on one bill per encounter, which simplifies processing and is consistent with other third party payer claims processing as well as Medicare inpatient claims processing. *Response:*
                         Section 201(e) of the BBRA 1999 amended section 1833(t)(1)(B) of the Act to require that covered outpatient prospective payment system services include implantable medical items, described in section 1861(s)(3), (6), or (8) of the Act. These items were formerly paid under the DMEPOS fee schedule. The statute is explicit in defining which DME items are payable under the hospital outpatient prospective payment system. Also, we cannot adopt the suggested billing changes for DME as the commenter suggested. All services that are billed through the fiscal intermediaries, whether they are paid under the hospital outpatient prospective payment system or DMEPOS, may be submitted on the UB-92 (or the equivalent electronic transaction). However, there are numerous, very exacting, specific criteria and rules that govern Medicare coverage and payment for nonimplantable DME and oxygen. The DME regional carriers are exclusively qualified to deal with these issues. Therefore, claims for nonimplantable DME and oxygen cannot be billed to the fiscal intermediaries. Instead, providers must continue to submit claims for nonimplantable DME and oxygen to the DME regional carriers using form HCFA-1500 (or the equivalent electronic transaction). It should be noted that if a health care provider submits an electronic claim for these services, the transaction must comply with the standards adopted by the Secretary in the August 17, 2000 final rule (65 FR 50312) Standards for Electronic Transactions. The compliance date of that rule is October 16, 2002. *Comment:*
                         A device manufacturer expressed concern about how the new system will change the payment mechanism for cochlear implants. Under the DMEPOS fee schedule, payments were fixed and unrelated to hospital charges. Now, under the new system, hospitals must properly establish charges that, when multiplied by the ratio of cost to charges, provide an accurate reflection of cost. This manufacturer was concerned that they will have to collect data to determine the charges hospitals have set for these devices and the applicable ratio of cost to charges. They believe the charges may not have been set appropriately to be consistent with the ratio of cost to charges. If not, pass-through payments might be substantially less than the actual cost for these medical devices. This manufacturer indicated that it is working to obtain the required charge and cost report data from providers of cochlear implant procedures and will report back to us once it has these data. The manufacturer requested that we agree to work with them in setting any future update to the payment allowance recognizing the short timeframe available to collect the data. *Response:*
                         We appreciate the commenter's offer to assist us in collecting cost and charge data on cochlear implants billed by hospitals. However, for purposes of making transitional pass-through payments for new medical devices such as cochlear implants, it is not necessary for manufacturers to obtain cost report data from hospitals to assist us in developing hospital-specific, cost-to-charge ratios to calculate these payments. We have already calculated these ratios and assigned them to providers. Each provider is responsible for accurately reporting its charges in order that we may calculate the appropriate payment for the pass-through device. 6. Payment Weights Based on Median or Mean Hospital Costs Section 1833(t)(2)(C) of the Act requires the Secretary to establish relative payment weights for covered hospital outpatient services. This section requires that the weights be developed using data on claims from 1996 and data from the most recent available hospital cost reports. As specified in the April 7, 2000 final rule with comment period (65 FR 18482), section 201(f) of the BBRA 1999 amended section 1833(t)(2)(C) of the Act to authorize the Secretary to base the relative payments weights on median or mean hospital costs. In implementing the BBRA 1999 provision, we decided to adopt as final our previously proposed policy to base the relative payment weights on median (as opposed to mean) costs. We had already used median costs to reconstruct our database for the outpatient prospective payment system group weights and conversion factors in a proposed rule and we believe that this method is still valid, especially considering the time constraints for implementation of the BBRA 1999 provision. We indicated that, among other things, reconstructing our database to evaluate the impact of using mean costs after the BBRA 1999 was enacted would have delayed implementation of the hospital outpatient prospective payment system rule. *Comment:*
                         A group of hospitals urged us to adopt a mean-based APC relative weight system to implement section 201(f) of the BBRA 1999, which authorizes, but does not require, the Secretary to use mean (rather than median) costs in determining the APC payment weights. The commenters contend that use of the geometric mean is standard in the industry as the basis 
                        ( print page 67812)
                        for calculating payment weights for prospective payment systems. They pointed out that the geometric mean is used because costs are not distributed “normally” (that is, there are no negative costs) and that for APCs that include low volume, high costs procedures, the geometric mean is preferable for adequately accounting for these costs. The commenters believed that our use of median costs also forced us to select an arbitrary value for relative weight 1.0, because finding the median of medians is meaningless. The commenters believed that, given the Congress' clarification in section 201(f) of the BBRA 1999, we should at least evaluate the impact of a mean-based system in our system review for 2001. *Response:*
                         We plan to further evaluate the feasibility of using mean rather than median costs for calculating APC payment weights in future updates. In order to make a decision about whether we should change the basis we are using for determining payment weights, we have to analyze and rerun claims data and conduct extensive impact analyses to assess the impact such a change would have on different types of providers and different types of services. 7. Limitation on Variation of Costs of Services Classified Within a Group Section 1833(t)(2) of the Act was amended by section 201(g) of the BBRA 1999 to limit the variation in resource use among the procedures or services within an APC group. Specifically, section 1833(t)(2) of the Act provides that the items and services within a group cannot be considered comparable with respect to the use of resources if the highest cost item or service within a group is more than 2 times greater than the lowest cost item or service within the same group. The Secretary is to use either the mean or median cost of the item or service. Section 1833(t)(2) of the Act, as amended, also allows the Secretary to make exceptions to this limit on the variation of costs within each group in unusual cases such as low volume items and services, although we may not make such an exception in the case of a drug or biological that has been designated as an orphan drug under section 526 of the Federal Food, Drug, and Cosmetic Act. In the April 7, 2000 final rule with comment period, we elected to use the median cost because we have continued to set the relative payment weights for each APC based on median hospital costs. We modified the composition of the APC groups and then made additional changes to the APC in response to public comments on individual or serial APCs. In determining whether or not to accept changes recommended by commenters, we focused on five criteria that are fundamental to the definition of a group within the APC system. The decision to accept or decline a modification to an APC group was determined based on whether the change enhanced, detracted from, or had no effect on the integrity of an APC group within the context of the following five criteria: Resource homogeneity;
                    Clinical homogeneity;
                    Provider concentration;
                    Frequency of services; and
                    Minimal opportunity for upcoding and code fragmentation. For a full explanation of these criteria, refer to the April 7, 2000 final rule with comment period (65 FR 18457). After we modified the composition of the APC groups based on the recommendations of commenters, we applied the median cost variation limit required by section 201(g) of the BBRA 1999 to the revised APC groups. As a result of our analysis of the array of median costs within the revised APC groups, we had to split some otherwise clinically homogeneous APC groups into smaller groups. We listed the APC groups that we had designated as exceptions to the “two times” requirement and our reasons for granting the exception. We based the exceptions on factors such as low procedure volume, suspect or incomplete cost data, concerns about inaccurate or incorrect coding, or compelling clinical arguments. We indicated that we would be examining the extent to which the APC reorganization due to the “two times” rule results in upcoding (refer to the April 7, 2000 final rule with comment period (65 FR 18458-18475)). *Comment:*
                         We received requests to examine 51 APCs that commenters alleged violated the “two times” rule. *Response:*
                         We reevaluated the APCs listed below, upon which we received comments, and found that most of them did not warrant revision. We received no new information about these APC groups that would alter our previous decision. These APCs are identified below under numbers 1 and 2. Our review also revealed that a few APC groups did warrant revision and we have reconfigured these APCs accordingly. We have listed these APCs under number 3. In addition, our review identified some APCs that are additional exceptions to the “two times” requirement. These APC groups and our reasons for the exception are listed below under number 4. In reviewing the APC groups for conformance to the “two times” requirement, we exempted from the analysis codes for unlisted services and procedures and those codes that represent less than 2 percent of the claims in the APC (our test for low volume). 1. Taking into account the exemptions mentioned above, the following APC groups that we reviewed based on comments have not been reconfigured: 0005 Level II Needle Biopsy/Aspiration Except Bone Marrow 0076 Endoscopy Lower Airway 0088 Thrombectomy 0090 Level II Implantation/Removal/Revision of Pacemaker, AICD or Vascular Device 0111 Blood Product Exchange 0112 Extracorporeal Photopheresis 0121 Level I Tube changes and Repositioning 0143 Lower GI Endoscopy 0146 Level I Sigmoidoscopy 0149 Level II Anal/Rectal Procedure 0150 Level III Anal/Rectal Procedure 0151 Endoscopic Retrograde Cholangio-Pancreatography (ERCP) 0162 Level III Cystourethroscopy and other Genitourinary Procedures 0260 Level I Plain Film Except Teeth 0262 Plain Film of Teeth 0265 Level I Diagnostic Ultrasound Except Vascular 0268 Guidance Under Ultrasound 0269 Echocardiogram Except Transesophageal 0278 Diagnostic Urography 0280 Level II Diagnostic Angiography and Venography Except Extremity 0282 Level I Computerized Axial Tomography 0283 Level II Computerized Axial Tomography 0284 Magnetic Resonance Imaging 0286 Myocardial Scans 0290 Standard Non-Imaging Nuclear Medicine 0291 Level I Diagnostic Nuclear Medicine Excluding Myocardial Scans 0292 Level II Diagnostic Nuclear Medicine Excluding Myocardial Scans 0294 Level I Therapeutic Nuclear Medicine 0297 Level II Therapeutic Radiologic Procedures 0301 Level II Radiation Therapy 0303 Treatment Device Construction 0304 Level I Therapeutic Radiation Treatment Preparation 0305 Level II Therapeutic Radiation Treatment Preparation 2. The following APC groups were listed in the April 7, 2000 final rule 
                        ( print page 67813)
                        with comment period as exceptions to the “two times” rule and our review found no factual basis for modifying our decision: 0030 Breast Reconstruction/Mastectomy 0264 Level II Miscellaneous Radiology Procedures 0274 Myelography 0279 Level I Diagnostic Angiography and Venography Except Extremity 0311 Radiation Physics Services 0371 Allergy Injections 3. We have reconstructed the four APCs shown below as a result of adding the cost of certain devices used in performing procedures included in these APCs. We discuss this change in section III.B. of this preamble. 0080 Diagnostic Cardiac Catheterization 0081 Non-Coronary Angioplasty or Atherectomy 0082 Coronary Atherectomy 0083 Athrectomy 4. Following are additional exceptions to the “two times” rule and our reasons for the exceptions. We are excepting these APCs from the “two times limit” on an interim basis, until we can review data from the first year of billing under the hospital outpatient prospective payment system. 0142 Small Intestine Endoscopy: The codes in APC 0142 are clinically similar and should show a relative progression of cost with slight increases in complexity. This effect does not occur, presumably due to low volume (although exceeding our low volume threshold) or inconsistent coding. Splitting this APC into two, based on current data, would be unjustified. 0145 Therapeutic Anoscopy: The costs of the codes in this APC are aberrant, with several of them exceeding the costs of more extensive procedures such as sigmoidoscopy and colonoscopy. 0152 Percutaneous Biliary Endoscopic Procedures: The codes in this APC have so few occurrences that we cannot justify splitting the group. Several of the codes call for the use of devices such as stents that may be paid for separately. 0161 Level II Cystourethroscopy and other Genitourinary Procedures: The costs of the codes in this APC are aberrant, with more comprehensive codes costing less than the base codes. 0195 Level V Female Reproductive Procedures: This is a low volume APC, with aberrant cost data. In several instances, codes that are more comprehensive cost less than the related, simpler code. 0296 Level I Therapeutic Radiologic Procedures: We believe the codes at the lower end of the median cost in this APC would be underpaid if we were to move them to a lower-paying APC. 0300 Level I Radiation Therapy: We believe we would underpay codes at the lower end of median cost in this APC if we were to move them to a lower-paying APC. 0312 Radioelement Applications: We believe the costs in this very low volume APC are aberrant. However, the group is completely coherent clinically. The radioactive elements related to these codes would receive separate payment. 0313 Brachytherapy: We believe the costs in this very low volume APC are aberrant. The group is coherent clinically. The radioactive elements related to these codes would receive separate payment. 0314 Hyperthermic Therapies: This APC has an extremely low volume, with aberrant costs. 8. Annual Review of the Components of the Hospital Outpatient Prospective Payment System In the April 7, 2000 final rule with comment period (65 FR 18501-18502), we indicated that, in accordance with section 1833(t)(9) (as redesignated and revised by sections 201(h) and 202(a) of the BBRA 1999), we would review and update annually, for implementation effective January 1 of each year, the APC groups, the relative payment weights, and the wage and other adjustments that are components of the hospital outpatient prospective payment system. In accordance with section 201(h)(2) of the BBRA 1999, an annual review process will begin in calendar year 2001 for the hospital outpatient prospective payments that would take effect for services furnished on or after January 1, 2002. This review process will involve consultation with an expert advisory panel. We will provide notice of the formation of the expert advisory panel in the 
                        **Federal Register**
                        . The expert outside advisory panel will review and make recommendations to us on the clinical integrity of the groups and weights and may use data other than those collected or developed by us for their review and advisory functions. We note that in section III of this preamble, we are updating the wage index values and the conversion factor under the hospital outpatient prospective payment system effective for calendar year 2001. We also are making appropriate changes to the APC groups to reflect additions and deletions of CPT codes and changes to a limited number of APCs to incorporate the cost of certain devices used in performing those procedures that were excluded from our initial ratesetting methodology. *Comment:*
                         One commenter stated that the wage index for the Hattiesburg, Mississippi Metropolitan Statistical Area (MSA), .7306, was printed incorrectly in our April 7, 2000 final rule with comment period. The commenter stated that use of this value would result in an underpayment for that area. The commenter further stated that, “the appropriate wage index for the Hattiesburg, Mississippi MSA for the fiscal year 2000 is .7634.” The commenter was concerned that we had previously acknowledged this error and promised to correct it via a program memorandum to fiscal intermediaries dated April 2000 (Transmittal Number A-00-17), but had failed to do so in our April 7, 2000 final rule with comment period. *Response:*
                         We apologize for the confusion. The fiscal year 2000 hospital inpatient prospective payment system wage index value for the Hattiesburg, Mississippi (MSA) was changed from .7306 to .7634 in accordance with section 153 of the BBRA 1999 that required us to include wage data from Wesley Medical Center in calculating the wage index for this MSA. On August 1, 2000, we published in the 
                        **Federal Register**
                         an interim final rule with comment period (65 FR 47026) that included Hattiesburg's new hospital inpatient prospective payment system wage index. For services paid under the hospital outpatient prospective payment system, the new wage index value is effective for services furnished on or after August 1, 2000. 9. Copayment Amounts Not Affected by Pass-Throughs Section 1833(t) of the Act, as established by the BBA of 1997, includes a mechanism designed to achieve a beneficiary coinsurance level equal to 20 percent of the prospectively determined payment rate established for the service. In the April 7, 2000 final rule with comment period, we specified how a copayment amount is calculated annually for each APC group under the hospital outpatient prospective payment system. We also explained that sections 201(a) and (b) of the BBRA 1999 amended section 1833(t) of the Act to provide for additional payments to hospitals for outlier cases and for certain medical devices, drugs, and biologicals and that these additional payments to hospitals will not affect copayment amounts. Redesignated section 1833(t)(8)(D) of the Act, as amended by section 201(i) of the BBRA 1999, provides that the copayment amount is to be computed as 
                        ( print page 67814)
                        if outlier adjustments, adjustments for certain medical devices, drugs, and biologicals, as well as any other adjustments we may establish under section 1833(t)(2)(E) of the Act, had not occurred. In addition, we specified that section 202 of the BBRA 1999 added a new section 1833(t)(7) to the Act to provide transitional corridor payments to certain hospitals through calendar year 2003 and indefinitely for certain cancer centers. Section 1833(t)(7)(H) of the Act provides that the transitional corridor payment provisions will have no effect on determining copayment amounts. We specified that copayment from beneficiaries will not be collected for the additional payments made to hospitals (outlier and transitional pass-throughs) by Medicare. Beneficiary copayment amounts will be calculated as if the outlier and transitional pass-throughs had not occurred (65 FR 18487-18488). When a drug or device pass-through payment is reduced by the otherwise applicable APC payment amount that is associated with the drug or device, it is only the portion of the payment that represents an additional pass-through payment that is not subject to copayment. The portion that does not represent an additional pass-through payment will be subject to copayment. We did not receive any public comments on this provision. 10. Extension of Cost Reductions In the April 7, 2000 final rule with comment period (65 FR 18439), we announced that, in accordance with section 1861(v)(1)(S)(ii) of the Act (as amended by section 201(k) of the BBRA 1999), the 5.8 and 10 percent reductions for hospital operating and capital costs, respectively, would extend until the first date that the hospital outpatient prospective payment system is implemented (which was August 1, 2000). We did not receive any public comments on this provision. 11. Clarification of Congressional Intent Regarding Base Amounts Used in Determining the Hospital Outpatient Prospective Payment System Section 201(l) of the BBRA 1999 provided that, “With respect to determining the amount of copayments described in paragraph (3)(A)(ii) of section 1833(t) of the Act, as added by section 4523(a) of BBA, Congress finds that such amount should be determined without regard to such section, in a budget neutral manner with respect to aggregate payments to hospitals, and that the Secretary of Health and Human Services has the authority to determine such amount without regard to such section.” In accordance with this provision, in the April 7, 2000 final rule with comment period (65 FR 18482-18493), we explained how we determined APC group weights, calculated an outpatient prospective payment system conversion factor, and determined national prospective payment rates, standardized for area wage variations, for the APC groups. We then explained how we calculated the aggregate hospital outpatient prospective payment to hospitals in a budget neutral manner and how we calculated beneficiary coinsurance amounts for each APC group. We did not receive any public comments on this provision. 12. Transitional Corridors for Application of Outpatient Prospective Payment System Section 1833(t)(7) of the Act, as added by section 202(a)(3) of the BBRA 1999, provides for payment adjustments during a transition period to limit the decline in payments under the outpatient prospective payment system for hospitals. These additional payments are to be implemented without regard to budget neutrality and are in effect through 2003. In the April 7, 2000 final rule with comment period (65 FR 18499-18500), we specified that, from the date the prospective payment system is implemented through 2003, a provider, including a CMHC, will receive an adjustment if its prospective payment system payments for outpatient services furnished during the year is less than a set percentage of its pre-BBA amount for that year. The pre-BBA amount is the product of the reasonable cost the hospital incurs for prospective payment system services furnished during the year and the payment-to-cost ratio for covered prospective payment system services furnished during the cost reporting period ending in calendar year 1996. Additionally, we provided that small rural hospitals with 100 or fewer beds and cancer hospitals will be held harmless under this provision. Small rural hospitals will be held harmless for services furnished before January 1, 2004. The hold-harmless provision applies permanently to cancer centers. We announced that we will make interim payments to the affected hospitals subject to retrospective adjustments and that these provisions do not affect beneficiary coinsurance. Finally, we specified that this provision is not subject to budget neutrality. a. Interim Payment Versus Final Settlement *Comment:*
                         One commenter recommended that we make retroactive payments to hospitals in those “situations where underpayments have been made between the prospective payment system payments as compared to the pre-prospective payment system amounts.” Another commenter asked that we set forth the process that would be used to determine retroactive payment adjustments if the hospital's interim payments are higher or lower than its actual experience. The commenter further asks that we state whether the interim payments will be compared to outpatient payments shown on settled or audited cost reports. *Response:*
                         Final transitional corridor payments are determined based on a provider's settled cost report. At the time the cost report is settled, the reasonable costs incurred by the provider to furnish outpatient prospective payment system services during the calendar year are known and that amount is then multiplied by the provider's 1996 payment-to-cost ratio to calculate the pre-BBA amount. The pre-BBA amount for a calendar year is compared to the actual prospective payment system payments the provider received to determine whether the provider may be entitled to a transitional corridor payment. Although the final transitional corridor payment is based on a settled cost report, beginning in October 2000, we have been making monthly interim payments to providers based on estimates of what their transitional corridor payments should be based on the monthly bills the provider submits. The monthly payments are designed to maintain some additional cash flow to providers that may otherwise realize significant losses on services that are being paid under the prospective payment system. b. Payment-to-Cost Ratios *Comment:*
                         One commenter argued that our formula for calculating the base payment-to-cost ratio for the transitional corridor payments does not comport with the statutory requirements. The commenter stated that we define the denominator of the base payment-to-cost ratio to be “[the] reasonable cost of these services for the period, without applying the cost reductions under section 1861(v)(1)(S) of the Act.” The commenter contends that the phrase “without applying the cost reductions under section 1861(v)(1)(S) of the Act” is not included in section 1833(t)(7)(F)(ii)(II) of the Act, as 
                        ( print page 67815)
                        amended by section 212 of the BBRA 1999. The commenter claimed that by defining the denominator in this manner, the payment-to-cost ratio is understated and transitional corridors payments to hospitals would be reduced. The commenter stated that such a reduction is contrary to Congressional intent and urged us to modify our base payment-to-cost denominator set forth in § 419.70(f)(2)(ii) to exclude the phrase “without applying the cost reduction under section 1861(v)(1)(S) of the Act.” *Response:*
                         The phrase “without applying the cost reductions under section 1861(v)(1)(S) of the Act” was intended to make clear that a hospital's 1996 “reasonable costs” do not include the effects of the reductions in section 1861(v)(1)(S) of the Act. We did not mean to suggest that we were taking the hospital's 1996 “reasonable costs” and then adding back the reductions for purposes of determining the denominator of the base payment-to-cost ratio. We view the hospital's 1996 reasonable costs as the unreduced amount; thus, the denominator of the hospital's base payment-to-cost ratio (1996 reasonable costs) does not reflect the reductions. We believe that our policy is consistent with the purpose of the transitional corridor provision. Under this policy, if a hospital incurs the same amount of costs during the transitional corridor as in 1996, then its pre-BBA amount (the amount that estimates what the hospital would have received in the current year if payments were calculated under the pre-prospective payment system) would be the same as the payments the hospital received in 1996. Under the methodology suggested by the commenter, if a hospital incurs the same amount of costs during the transitional corridor as in 1996, then its pre-BBA amount would be 
                        *higher*
                         than the payments the hospital received in 1996. The language in § 419.70(f)(2)(ii) as set forth in the April 7, 2000 final rule with comment period was intended to clarify, not revise, the definition of 1996 reasonable costs, but we recognize that the phrase at issue may have inadvertently caused confusion to the extent it is redundant; accordingly, we are revising that section to remove the phrase. *Comment:*
                         One commenter asked us to clarify the term “payment-to-cost ratio” and the data that will be used to compute the ratio. Several commenters asked why we did not give the 1996 outpatient prospective payment system-specific amounts required to compute the payment-to-cost ratio and the methodology for calculating it. *Response:*
                         The statutory definition of base “payment-to-cost ratio” is fairly straightforward. Under section 1833(t)(7)(F) of the Act, the base payment-to-cost ratio for a given hospital is the ratio of (1) the hospital's Medicare Part B reimbursement for covered OPD services for the cost reporting period ending during 1996, to (2) the hospital's reasonable costs for that period. We are in the process of developing program instructions for fiscal intermediaries (for notification to providers) to provide detailed information on how payment-to-cost ratios are calculated. These instructions will be made available as soon as possible. *Comment:*
                         One hospital association recommended that we revise our regulations to explicitly state that we will adjust the provider's 1996 payment-to-cost ratio “whenever subsequent developments occur that affect the data used in the calculation.” The commenter cited final audit adjustments and appeal determinations as examples of adjustments that would warrant changing the 1996 cost data used to calculate the provider's payment-to-cost ratio. The commenter stated that this policy is consistent with similar adjustments made under the prospective payment systems for both inpatient operating and capital-related costs. *Response:*
                         We agree with the commenter. In the event final audit adjustments or appeals result in a change in outpatient costs or payments for the provider's 1996 cost report, the provider's payment-to-cost ratio would be recalculated. *Comment:*
                         One commenter asked for clarification on the treatment of direct graduate medical education costs and education costs for nursing and allied health programs in calculating the payment-to-cost ratio. The commenter assumed that such costs are excluded from the pre-BBA amount because they will continue to be paid on a cost pass-through basis. *Response:*
                         The commenter is correct that direct graduate medical education costs and certain costs of nursing and allied health programs are paid on a cost pass-through basis and will not be included in calculating a provider's pre-BBA amount. *Comment:*
                         One commenter asked that we explain our reasons for basing the transitional corridor interim payments on a 0.8 payment-to-cost ratio. The commenter suggested that a provider be allowed to modify its interim transitional corridor payment if it can show that its payment-to-cost ratio is higher or lower than the 0.8 level. Several commenters questioned why we chose to use a standard 0.8 payment-to-cost ratio for all providers in calculating the interim payment if provider-specific payment-to-cost ratios were available. They stated that 9 of the 10 cancer centers have payment-to-cost ratios that exceed 0.8. *Response:*
                         The standard payment-to-cost ratio of 80 percent is an average value that we calculated for payment-to-cost ratios across all hospitals. We decided to use 80 percent for all providers to permit us to make interim payments as soon as possible following the implementation of the outpatient prospective payment system. If we had attempted to calculate individual payment-to-cost ratios for all providers, it would have delayed, perhaps for several months, the introduction of interim payments. Final transitional corridor payments will be calculated using each provider's payment-to-cost ratio for the relevant year at the time of settlement of the cost report. In the future, as we gain more experience with interim payments, we will consider permitting modification of payment-to-cost ratios to reflect particular circumstances. c. Cost-to-Charge Ratios *Comment:*
                         One commenter stated that the April 7, 2000 final rule with comment period did not explain how the transitional corridor payments would be implemented for the 10 cancer hospitals. The commenter noted that while Program Memorandum Transmittal No. A-00-23 issued by us on April 7, 2000, does describe how these payments are to be calculated it does not clarify how we derived the hospital-specific cost-to-charge ratios used to compute the transitional corridor payments. Several commenters representing the 10 cancer centers stated that the cost-to-charge ratios for their centers that will be used in calculating their transitional corridor, outlier, and transitional pass-through payments are significantly lower than their estimates. They requested that we explain how we determined their ratios and comment on the appropriateness of our methodology. They also asked that we respond to a number of specific questions to allow hospitals to determine whether the cost-to-charge ratios accurately reflect the hospital's cost and provide a fair base for calculating their transitional corridor payments. *Response:*
                         On September 8, 2000, we issued a Program Memorandum Transmittal No. A-00-63, which provides a detailed explanation of how hospital cost-to-charge ratios were 
                        ( print page 67816)
                        calculated. This program memorandum is available on HCFA's internet website at www.hcfa.gov/​Medicare. d. Interim Payments Limited to 85 Percent of the Estimated Transitional Corridor Payment *Comment:*
                         One commenter asked why we will only pay 85 percent of the estimated transitional corridor payment as an interim payment. Another commenter recommended that we reconsider our policy to pay providers only 85 percent of their transitional corridor payments on the interim basis. The commenter stated that our policy to withhold 15 percent of each provider's payment until the fiscal intermediary finalizes the provider's cost report is contrary to Congressional intent to preserve hospitals' cash flow and ensure them of an ability to provide outpatient services to beneficiaries, especially those in rural areas. Another commenter stated that retaining 15 percent of each provider's estimated transitional corridor payments until the provider's cost report is settled is contrary to Congressional intent and defers relief provided by statute for several years. *Response:*
                         We limited the interim payment to less than 100 percent of the estimated payment in order to minimize the risk of overpayment. If interim payments exceed the final settled amounts, we would need to initiate recoupment procedures that place additional burden both on the agency and on providers. Eighty-five percent was chosen as a reasonable percentage that prudently balances the cash flow needs of some providers with concerns regarding possible difficulties in the recovery of overpayments. We have used comparable figures in other situations in which we make interim or advance payments. One example where we specified 85 percent for advance payments is in the contingency plan that we published to address the possibility that either our contractors or individual providers would be unable to process claims at the initiation of the outpatient prospective payment system. In the future, as cost reports are settled and we are able to determine how well interim transitional corridor payments relate to final transitional corridor payments, we will reevaluate this aspect of our interim payment policy. e. Providers Having More Than One 1996 Cost Report *Comment:*
                         Several commenters stated that we did not discuss in our final rule how we would calculate the 1996 payment-to-cost ratio in cases where a provider has more than one cost report that is less than 12 full months during the fiscal year ending in 1996. The commenters asked which would be the appropriate cost report to use in calculating the transitional corridor payments. One commenter explained that this situation may occur if ownership changed during the provider's fiscal year ending in 1996. *Response:*
                         The 1996 cost report that will be used to calculate a payment-to-cost ratio is the cost report period that ends in calendar year 1996. If a provider has two cost reports that end in 1996, we will make a decision about which cost report to use on a case-by-case basis, depending on which appeared to be the most representative of the provider's experience in 1996. For example, if one cost report covers a longer period, we would likely use that one. f. Providers Having No 1996 Cost Report *Comment:*
                         One commenter expressed concern about insufficient guidance from us about how transitional corridor payments would be determined for providers that did not file cost reports during 1996. The commenter believed that because the statute is silent on this issue, we have the discretion to develop such policy. The commenter strongly opposed any decisions by us to preclude providers without 1996 cost reports from being eligible to receive transitional corridor payments. Another commenter requested that we treat new hospitals that did not file a 1996 cost report the same as rural hospitals. The commenter contended that the pre-BBA payment level for these hospitals should be based on the hospital's first full cost reporting period, and would be guaranteed at that level through December 31, 2003. Another commenter suggested as an option that we assign a regional average payment-to-cost ratio for existing providers to providers without a 1996 cost report. *Response:*
                         Under the statute, the amount of transitional payments to providers depends on the provider's reimbursement for the 1996 cost reporting period. We intend to monitor the adequacy of payments to providers not having a 1996 cost report, but we believe that a statutory change is required in order to provide transitional payments to providers that did not have a 1996 cost report. g. Prospective Payment System Delay and Transitional Corridor Payments *Comment:*
                         One commenter expressed concern about the potential effect of delaying implementation of the hospital outpatient prospective payment system on the duration of the transitional corridor payments as provided by law. The commenter stated that our decision to delay implementation of the prospective payment system for 1 month, from July 1, 2000 to August 1, 2000, should not result in a 1-month loss of transitional corridor payments for providers. The commenter believed that the 3
                        1/2
                         years of corridor payments required by law for non-cancer hospitals paid under the outpatient prospective payment system should not be reduced due to delayed implementation of the prospective payment system. The commenter urged us to seek a legislative change if we determine the 3
                        1/2
                         year period for transitional corridor payments must coincide with the first 3
                        1/2
                         years of actual prospective payment system implementation. *Response:*
                         For hospitals that do not qualify for the permanent hold-harmless provision applicable to cancer hospitals, the statute provides for transitional corridor payments through the end of calendar year 2003. We will monitor and evaluate prospective payment system payments and will consider whether it would be appropriate to recommend that Congress legislate an extension of transitional corridor payments. h. Rural Hold-Harmless Provision *Comment:*
                         One commenter suggested that we reevaluate the definition of rural outpatient hospitals eligible for the hold-harmless provision and consider including rural hospitals that have 100 to 200 beds, “but whose outpatient volumes are not sufficient to maintain the facilities' finances.” *Response:*
                         The bed size for hospitals to qualify for the rural hospital hold-harmless provision is limited by statute, under section 1833(t)(7)(D)(i) of the Act, to hospitals that have no more than 100 beds. *Comment:*
                         One commenter stated that on page 18501 of the April 7, 2000 final rule with comment period, we state that bed size under the rural hospital hold-harmless provision will be determined in the same manner as it is for the hospital inpatient prospective payment system indirect medical education adjustment. The commenter contended that we have not provided these instructions to fiscal intermediaries. The commenter questioned whether the fiscal intermediaries are using the number of beds reported on the hospital cost reports to determine the bed size. Still another commenter stated that we failed to specify how beds are to be counted under the hospital outpatient prospective payment system. The commenter further stated that our impact analysis published in the April 7, 2000 final rule with comment period 
                        ( print page 67817)
                        suggests that available bed counts shown on the HCFA-2552 cost report S-3 Worksheet are used to determine if a hospital has 100 or fewer beds to qualify for the rural hold-harmless transitional corridor payment provision. The commenter urged us to clarify this issue. *Response:*
                         In Program Memorandum Transmittal No. A-00-23, later revised in June 2000 as Program Memorandum Transmittal No. A-00-36, we provided instructions to fiscal intermediaries concerning how to calculate interim transitional corridor payments. As indicated in the April 7, 2000 final rule with comment period, the bed size used for transitional corridor payments will be the same bed size defined in and used to calculate indirect medical education costs and disproportionate share adjustments under the hospital inpatient prospective payment system. Fiscal intermediaries are instructed to obtain certain provider-specific information needed to make the calculation from the outpatient provider-specific file that they maintain. Certain items on the outpatient provider-specific file, including bed size, are taken directly from the provider file used in processing inpatient claims. *Comment:*
                         One commenter urged that we revise policy for determining bed size for purposes of defining rural providers eligible for the hold-harmless provision. The commenter advocated that we adjust a provider's count of acute inpatient days to account for observation patients occupying acute inpatient beds. *Response:*
                         The commenter did not provide a rationale for their recommendation. We believe that it is appropriate to adopt a policy for purposes of the outpatient prospective payment system that is consistent with the policy for purposes of the inpatient prospective payment system; therefore, we are not making a change at this time. *Comment:*
                         A commenter specifically asked that, for purposes of determining bed size for rural providers, we clarify what year is used to determine bed size. The commenter also asked what our policy is regarding providers that changed their inpatient capacity prior to July 1, 2000, and those that may change this capacity during the 3
                        1/2
                         year transition period. The commenter suggested that we permit hospitals to downsize capacity without affecting their eligibility for hold-harmless status. *Response:*
                         Under § 412.105(b), to determine bed size for the rural hold-harmless provision, we calculated bed size on the basis of the provider's cost reporting period. A rural hospital's bed size and, therefore, its eligibility for hold-harmless treatment may change from one cost reporting period to the next. *Comment:*
                         Several commenters asked us to clarify whether a hospital's reclassification for either the wage index area or standardized amount affects its eligibility for the rural hold-harmless payment. The commenter believed that, because the BBRA 1999 statutory provision relevant to the rural hold-harmless provision refers to providers “located in a rural area” rather than the provider's payment status, a provider's geographic reclassification for wages or standardized amount has no bearing on its rural hold-harmless status. A few commenters argued that a geographic reclassification under inpatient prospective payment system for the wage index or the standardized amount is not relevant for purposes of the hold-harmless rural payment provision and that these reclassified hospitals should be included in the rural hold-harmless payment. *Response:*
                         If a hospital is located in a rural area, it will not lose its eligibility for hold-harmless payments if it obtains a geographic reclassification under the inpatient prospective payment system for purposes of determining its wage index or standardized amount. *Comment:*
                         A number of commenters expressed concern about the various aspects of the hold-harmless provision, referring to sections 1886(d)(8)(E) and 1833(t)(13) under section 401 of the BBRA 1999, and asked about a hospital's eligibility for the rural hold-harmless provision. *Response:*
                         Under section 1886(d)(8)(E) of the Act, as added by section 401 of the BBRA 1999, if a hospital submits an application and meets certain criteria, the Secretary treats the hospital as being located in a rural area for purposes of section 1886(d) of the Act. Under section 1833(t)(13) of the Act, as added by section 401(b) of the BBRA 1999, if a hospital is treated as being located in a rural area under section 1886(d)(8)(E) of the Act, then the Secretary shall treat the hospital as being located in a rural area for purposes of the outpatient prospective payment system. Therefore, if a hospital is treated as being located in a rural area under section 1886(d)(8)(E) of the Act, then the hospital is treated as a rural hospital for purposes of the hold-harmless provision. *Comment:*
                         One commenter stated that the 2-month waiting period for interim transitional payments may adversely affect a large number of small rural hospitals. The commenter also believed these hospitals will require a higher interim payment than planned. The commenter asked that we use a hospital-specific impact analyses to create a process for interim payments for these small rural hospitals that would begin concurrently with the start of the prospective payment system. *Response:*
                         In order to calculate interim transitional corridor payments for any hospital, we needed to have some amount of claims that had been processed under the prospective payment system. For this reason, we were not able to begin transitional corridor payments concurrently with the implementation of the prospective payment system. Because of our concerns discussed earlier about having to initiate recoupment procedures in cases of overpayments, we are not increasing interim payments at this time. However, as cost reports are settled and we are able to determine how well interim payments predict final transitional corridor payments, we will be able to reevaluate this policy. i. Covered Charges *Comment:*
                         Several commenters asked that we clarify the definition of “covered charges” used to compute the rural hold-harmless transitional corridor payment. One commenter stated that total procedures and thus the hold-harmless payment will be understated should we eliminate from these calculations the charges for incidental procedures or procedures that the Outpatient Code Editor consolidates into the main procedures. *Response:*
                         In the preamble and the regulation text of the April 7, 2000 final rule with comment period, we refer to “covered hospital outpatient services” to describe the services that are paid under the prospective payment system and, therefore, subject to the transitional corridor provision. To determine a provider's costs for purposes of calculating the pre-BBA amount for both interim payments and for final cost report settlement, we will take into account all costs encompassed under the prospective payment system, including the cost of incidental services that are packaged into the APC rate. These services are identified as those having HCPCS codes with a status indicator of “N” (as listed in Addendum B) and incidental services that may not be billed with HCPCS codes, but which are billed under revenue codes that indicate a packaged service such as observation services, recovery room, supplies and many drugs. *Comment:*
                         One commenter asked us to clarify how charges for packaged services, for example observation services, should be billed when they are 
                        ( print page 67818)
                        the only service provided. The commenter stated that inclusion of charges for these packaged services in the total bill charges are necessary to calculate the proper transitional corridor payment. *Response:*
                         Packaged services will not be the only items that appear on a bill. Packaged services will appear on a bill with the service to which they are incidental. For example, observation services are properly billed with the clinic visit, emergency room visit, surgery, etc., that results in the need for the incidental observation service. j. Cancer Hospitals and Transitional Corridor Payments *Comment:*
                         Several commenters believed that the process described in Program Memorandum Transmittal No. A-00-23 for calculating the hold-harmless transitional corridor payments should be revised because it does not reflect Congressional intent and will not provide the relief to the 10 cancer centers that the Congress intended. These commenters contended that the method described in the program memorandum for calculating the transitional corridor payments will result in a 22 percent loss in outpatient patient revenues for the cancer centers compared to those received in 1998. The commenters further claimed that their revenue losses under the new outpatient prospective payment system may increase an additional 2 percent, or 24 percent in total, because we will not pay claims for any medical visits that are billed in conjunction with related significant procedures. In addition, these commenters urged us to: Establish an appeal process for providers with cash flow problems that would permit fiscal intermediaries to adjust a provider's cost-to-charge ratio “to rectify ongoing OPPS losses prior to reconciliation.”
                    Reduce interim payments to the 10 cancer centers by only 5 percent rather than 15 percent. (The commenters contended that this approach would be consistent with the method currently used to determine their inpatient interim payments under the TEFRA cost limits system.)
                    Pay the 10 cancer centers the balance of the hold-harmless payments due at the time the cost report is subjected to desk review rather than at the time it is settled. (The commenters stated that settlement of the centers' cost reports is completed within 2 to 4 years after a completed cost report is filed, whereas the cost report desk review is generally completed 90 days after it is filed.) *Response:*
                         Medical visits may be billed with significant procedures as long as the medical visit is a separate and distinct service from the significant procedure, even though the significant procedure is related to the medical visit. For example, as a result of an examination performed as part of a clinic or emergency room visit, a patient is determined to need a CT scan or MRI, or as a result of a dermatology examination performed as a clinic visit, a patient also has a surgical procedure to remove a mole. In these types of situations, payment will be made for both a medical visit and a significant procedure. Program Memorandum Transmittal No. A-00-63 provides for adjustment of a provider's cost-to-charge ratio in certain specific situations. In the future, in order to reflect changes in hospital costs and charges, we will allow fiscal intermediaries to make additional updates of a provider's cost-to-charge ratio to ensure that interim payments accurately reflect our best estimates of final transitional corridor payments. Although we limited the interim payment to 85 percent of the estimated payment in order to minimize the risk of overpayment, in the future, as cost reports are settled and we are able to determine how well interim payments predict final transitional corridor payments, we will be able to reevaluate this aspect of our interim payment policy and we will consider permitting modification of payment-to-cost ratios to reflect particular circumstances. The statute indicates that interim payments are made subject to retrospective adjustments based on settled cost reports. However, it is current practice that, depending on the provider's specific situation, a fiscal intermediary may make additional payments as part of a tentative settlement action prior to final settlement of the cost report. k. Teaching Hospitals and Transitional Corridor Payments *Comment:*
                         One commenter urged that we retain the transitional corridor payments permanently for major teaching hospitals. *Response:*
                         Section 1833(t)(7) of the Act provides permanent transitional corridor payments only for cancer hospitals described in section 1886(d)(1)(B)(v) of the Act. As indicated earlier, we will monitor and evaluate the prospective payment system payments and will consider whether it would be appropriate to recommend that Congress extend transitional corridor payments. *Comment:*
                         One commenter stated that while the transitional corridor payments will mitigate some of the losses to teaching hospitals under the prospective payment system compared to the former cost-based payment system, these payments are temporary. The commenter believed that we underestimated the losses that some teaching hospitals will experience. Another commenter urged us to monitor closely the impact of the prospective payment system on major teaching hospitals during the 3
                        1/2
                         year transitional corridor payments. The commenter believed that these hospitals will require a payment adjustment after the transitional corridor payment period expires to mitigate their potential financial losses under the prospective payment system. *Response:*
                         As we stated in the preamble of the April 7, 2000 final rule with comment period, we will perform further comprehensive analyses of cost and payment differences between different classes of hospitals as soon as there is a sufficient amount of claims data submitted under the prospective payment system. We will use data from the initial years of the prospective payment system to conduct regression and simulation analyses. In addition, we will carefully track and analyze the additional payments made to hospitals under the transitional corridor provision. These analyses will be used to consider and possibly propose adjustments in the system, particularly beginning in 2004 when the transitional corridor provisions expire. 13. Limitation on Coinsurance for a Procedure In the April 7, 2000 final rule with comment period (65 FR 18488), we specified that, in accordance with section 1833(t)(8) of the Act (as amended by section 204(a) of the BBRA 1999), the coinsurance amount for a procedure performed in a year cannot exceed the hospital inpatient deductible for that year. We specified that we would apply the limitation to the wage-adjusted coinsurance amount (not the unadjusted coinsurance amount) after any Part B deductible amounts are taken into account. Therefore, although the unadjusted coinsurance amount for any APC may be higher or lower than the inpatient hospital deductible, the actual coinsurance amount for an APC, determined after any deductible amounts and adjustments for variations in geographic areas are taken into account, will be limited to the Medicare inpatient hospital deductible. Any reduction in coinsurance that occurs in applying the limitation will be paid to 
                        ( print page 67819)
                        hospitals as additional program payments. *Comment:*
                         One commenter disagreed with our interpretation of the BBRA 1999 provision that amended section 1833(t)(8) of the Act to limit the coinsurance amount for a procedure to the amount of the inpatient hospital deductible. The commenter believed that our interpretation that applies the limitation to coinsurance on an APC by the APC basis is too narrow. The commenter concluded that, at a minimum, the limitation should be more broadly interpreted to apply to the total coinsurance incurred by a beneficiary in connection with an outpatient visit, that is, from the time the beneficiary walks into an outpatient department until he or she is released. However, to implement the provision as envisioned by the Congress, the commenter suggested that we also consider developing a service period unit for outpatient procedures that is similar to the “spell of illness” concept used to define the set of services to which a single inpatient hospital deductible applies. Therefore, when a patient comes to an outpatient department for treatment of a particular condition, his or her coinsurance liability for all the services required for that condition should not exceed the inpatient hospital deductible. The commenter recommended that we apply the limitation regardless of how many or which APCs are billed or the number of visits required for such treatment. *Response:*
                         APCs are based on CPT codes. We believe that the most plausible meaning for “procedure” in this context is a CPT code or, by extension, an APC. Thus we interpret the limitation of coinsurance for a procedure in section 1833(t)(8)(C) of the Act as added by section 204 of the BBRA 1999 to apply in general to APCs. We do not believe that it was the intent of the Congress to apply the coinsurance limitation to the beneficiary's aggregate coinsurance amounts for all outpatient services received during the entire service period for a specific condition or even to the services a beneficiary receives in one day. During the Congressional committee deliberations on this provision before it was enacted, we held technical discussions with committee staff. At their request, we identified the specific 10 APCs in the September 1998 proposed rule that would be likely to have a coinsurance that exceeded the inpatient hospital deductible. The Congressional Budget Office also used that information to project the cost of this statutory provision. Therefore, we believe that our interpretation in the April 7, 2000 final rule with comment period of how the coinsurance limitation is to be applied is consistent with the intent of Congress. *Comment:*
                         Several commenters pointed out that because APCs for drugs and biologicals are defined based on HCPCS codes for the lowest unit of the drug or biological, if we intend to apply the inpatient deductible limit at the APC level, we might disadvantage beneficiaries who receive multiple units. For example, the coinsurance for a specific drug APC may not exceed the inpatient deductible amount. However, if multiple units of the same drug are administered, the coinsurance based on the multiple APCs may, in fact, exceed the inpatient deductible. The commenters believed that the total coinsurance amount for a drug or biological based on the amount administered should be subjected to the inpatient deductible limit. The commenters believed that constructing APCs for drugs based on the lowest unit of the drug is solely a payment convention and does not mean that each dose is a separate “procedure.” Therefore, the commenters contended, a better reading of the statute is that the administration of a drug or biological, regardless of the dose, is one procedure for purposes of applying the hospital outpatient prospective payment system and it would be inappropriate to compare the inpatient deductible limit to anything but the total coinsurance amounts. *Response:*
                         In the case of services that involve the administration of drugs and biologicals in separate APCs, we have concluded that we should apply the limitation on coinsurance to include both the drug or biological (in whatever units it is administered) and the service that leads to its administration. We constructed separate APCs for drugs and biologicals, and established pricing on the basis of the lowest dose, not to reflect CPT codes, but solely as a matter of convenience in administering the payment system. Consequently, we think that the interpretation with the most clinical relevance in this instance is to treat a drug or biological and the service that leads to its administration as a single procedure. We had not proposed separate APCs for drugs and biologicals in the proposed rule for the outpatient prospective payment system and the Congress did not know we would segment APCs at the time it passed the BBRA 1997. Effective for drugs and biologicals furnished on or after January 1, 2001, when multiple units of a drug or biological are furnished to a beneficiary during one day, resulting in multiple APC payments for the same drug, we will aggregate the total coinsurance applicable to the drug or biological, and the aggregated amount cannot exceed the inpatient hospital deductible for the calendar year. In order to accomplish this change in our bill processing systems, we are assigning a new status indicator designated as “K” to APCs for nonpass-through drugs and biologicals (as reflected in Addendum D of this interim final rule with comment period). Effective for services furnished on or after July 1, 2001, in the same circumstances, we will aggregate the total coinsurance applicable to the drug or biological and to the service that resulted in the administration of the drug, and the aggregated amount cannot exceed the inpatient hospital deductible for the calendar year. We are unable to make the latter provision effective earlier because of systems constraints. *Comment:*
                         One commenter stated that the BBRA 1999 requirement that coinsurance for a procedure cannot exceed the inpatient hospital deductible for that year adds confusion to an already complicated formula for determining coinsurance. The commenter stated that the monitoring of coinsurance needed to ensure the limitation is being applied on a procedure basis will add undue burden and increase a provider's costs. To make the hospital outpatient prospective payment system less complicated, the commenter believed that we should consider eliminating the threshold. *Response:*
                         The coinsurance limitation is required by statute. Therefore, a statutory change would be required to eliminate this provision. 14. Reclassification of Certain Hospitals In the August 1, 2000 
                        **Federal Register**
                         (65 FR 47029), we implemented section 401 of the BBRA 1999 for the hospital inpatient prospective payment system. Section 401(a) of the BBRA 1999, which amended section 1886(d)(8) of the Act by adding a new paragraph (E), directs the Secretary to treat any subsection (d) hospital located in an urban area as being located in the rural area of the State in which the hospital is located if the hospital files an application (in the form and manner determined by the Secretary) and meets certain statutorily specified criteria. Additionally, section 401(a) of the BBRA 1999 includes hospitals “* * * located in an area designated by any law or regulation of such State as a rural area (or is designated by such State as a rural hospital).” A hospital also may seek to qualify for reclassification premised on the fact that, had it been located in a 
                        ( print page 67820)
                        rural area, it would have qualified as a rural referral center or as a sole community hospital. Section 401(b) of the BBRA 1999 made a conforming change to section 1833(t) of the Act. Specifically, section 401(b) added section 1833(t)(13) to the Act which provides that if a hospital is being treated as being located in a rural area under section 1886(d)(8)(E) of the Act (for purposes of section 1886(d) of the Act), the hospital will also be treated under section 1833(t)(13) of the Act as being located in a rural area. In the April 7, 2000 final rule with comment period, we explained that we use the same yearly version of the hospital inpatient prospective payment system wage index (which takes effect each October 1) to adjust the portion of the outpatient prospective payment system payment rate and the coinsurance amount that is attributable to labor-related costs for relative differences in labor and labor-related costs across geographic areas (and that will be applied effective each January 1). This wage index reflects the effects of hospital designations under section 1886(d)(8)(B) of the Act and hospital reclassifications under section 1886(d)(10) of the Act. We did not receive any comments on this conforming change. B. August 3, 2000 Interim Final Rule With Comment Period Following are the issues addressed in the August 3, 2000 interim final rule with comment period, the public comments received on each issue, and our response to those comments. In that interim final rule, we— Revised the regulation at § 419.43(e)(1)(iv) to change one criterion and postpone the effective date for two other criteria that a new device, drug, or biological must meet in order for its cost to be considered “not insignificant” for purposes of determining its eligibility for transitional pass-through payments;
                    Changed our interpretation for three of the eight criteria set forth in the April 7, 2000 final rule with comment period for defining a new medical device that would be eligible for transitional pass-through payments and amended § 419.43 by adding new paragraph (e)(4) to include all eight criteria;
                    Clarified the assignment of “C” codes to eligible pass-through items;
                    Corrected a trigger date for grandfathering of provider-based FQHCs; and
                    Clarified our intent regarding prior notice of beneficiary cost-sharing liability in emergency situations. 1. Transitional Pass-Through Provisions a. “Not Insignificant” Cost Criteria Section 1833(t)(6) of the Act, as added by section 201(b) of the BBRA 1999, requires the Secretary to make transitional pass-through payments for post-1996 new drugs, biologicals, and devices for at least 2 but no more than 3 years when the cost of the item is “not insignificant” in relation to the hospital outpatient prospective payment system payment amount. In the April 7, 2000 final rule with comment period, we established three criteria that a new device, drug, or biological must meet to determine whether its costs are not insignificant relative to the APC payment with which the item is associated (65 FR 18480-81). We stated that all of the following cost criteria must be satisfied in order for a new device, drug, or biological to be eligible for transitional pass-through payments: Its expected reasonable cost exceeds the applicable fee schedule amount determined to be associated with the drug, biological, or device by 25 percent.
                    The expected reasonable cost of the new drug, biological, or device exceeds the portion of the fee schedule amount determined to be associated with the drug, biological, or device by 25 percent.
                    The difference between the expected, reasonable cost of the item and the portion of the hospital outpatient department fee schedule amount determined to be associated with the item exceeds 10 percent of the applicable hospital outpatient fee schedule amount. After we published the April 7, 2000 final rule with comment period, we gained considerable experience from reviewing applications for transitional pass-through payments. Based on that experience, we concluded that the 25-percent limitation was too restrictive and could result in limiting Medicare beneficiaries' access to new products. Therefore, in the August 3, 2000 interim final rule with comment period, we changed that criterion to ensure that Medicare beneficiaries would continue to have access to the latest technologies. We now require that the expected reasonable cost of a new drug, biological, or device must exceed 10 percent of the applicable fee schedule amount for the associated service. In addition, we also postponed the effective date of the other two criteria applying to a new device, biologicals, or drugs for which a transitional pass-through payment is first made to on or after January 1, 2003. As stated in the August 3, 2000 interim final rule with comment period, the delay in the effective date for these two criteria is necessary so that we will have sufficient time to gather and analyze data needed to determine the current portion of the fee schedule amounts associated with a device, drug, or biological, which is an essential factor in applying these criteria. *Comment:*
                         Several commenters commended us for revising the one “not insignificant” criterion and postponing the other two criteria until after December 31, 2002. However, some argued that we created an uneven playing field by changing our policies after we published our April 7, 2000 final rule and announced pass-through application deadlines. They claimed that our untimely lowering of the cost threshold from 25 percent to 10 percent unfairly disadvantaged companies that did not submit pass-through applications by the deadline for our August 1, 2000 payments because they believed that their products would not qualify for payment. One commenter recommended that we rapidly process applications submitted for our January 1, 2001 update and change the effective date of that update to November 1, 2000. Another commenter advocated that we apply the 10-percent cost threshold retroactively to all device pass-through applications to ensure equitable treatment for all manufacturers. *Response:*
                         Based on our review of transitional pass-through applications, we believe that we have not applied our policy change inconsistently to applications that we received. The change to the lower cost threshold is effective for services furnished on or after August 1, 2000. If an applicant's product was denied pass-through status because its cost was considered to be “not insignificant” and that applicant can show that our decision was not based on the 10-percent criterion, the applicant may request that we reevaluate the application. In addition, we encourage other interested parties who withheld applications because they believed that their products would not qualify for pass-through status to submit them. Further, we cannot update the pass-through payments effective November 1, 2000 as requested. Adding new pass-through items to our outpatient prospective payment system requires changes to our complex Medicare computerized claims processing systems that we can make only at the beginning of a calendar quarter. *Comment:*
                         One commenter believed that reducing the cost threshold to 10 percent for new devices may be too low. The commenter stated that the lower 
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                        cost threshold would expose hospitals to financial risk created by the use of new and expensive technology furnished in providing patient care. The commenter advocated that we consider as an option “establishing * * * a floor—or a variable percentage that is higher for low-cost cases and lower for high-cost cases.” *Response:*
                         We believe that this option will require time to evaluate its merits, assess its impact on our systems and determine systems changes that would be required to implement it. Therefore, we will consider this request for possible inclusion in our future proposed rule for outpatient prospective payment system updating that we expect to publish in the spring of 2001. *Comment:*
                         One commenter urged that we grant the public another opportunity to evaluate and comment on all three “not insignificant” cost criteria before implementing them. *Response:*
                         Before we implement all three of these criteria, we plan to provide notice and opportunity for public comment. Since we do not expect to implement two of these criteria before January 1, 2003, we would not expect to publish a proposed rulemaking until the spring of 2002. *Comment:*
                         One commenter asked how we would apply the three “not insignificant” cost criteria in instances when multiple units of a new device are used in performing a procedure. The commenter recommended that we use the “weighted average cost of the product, based on the average number of unit used in a procedure.” *Response:*
                         We plan to fully describe our approach to implementing these three criteria in a future proposed rule. As previously stated, we will not implement two of these criteria before January 1, 2003. Therefore, we do not expect to publish a proposed rulemaking until the spring of 2002. *Comment:*
                         One commenter asked that we clarify how transitional pass-through payments will be incorporated into the APC payments at the end of the 2- to 3-year transitional period for a given device. The commenter also asked how we would prevent the cost for the pass-through items from being diluted significantly by the median cost of other procedures grouped in the same APC. *Response:*
                         We plan to use a methodology similar to that currently used to construct the APC groups to incorporate payment for pass-through items into the APC payments once their pass-through status expires. That is, we have assigned a unique HCPCS code to each eligible pass-through item that will allow us to track its payments and utilization over the 2 to 3 years that it is eligible for pass-through status. The codes will allow us to match the pass-through items to the specific procedures or medical visits with which they are used. After we gain appropriate information about the actual costs a hospital incurs to provide a pass-through item, we will package the cost for the pass-through with that for the relevant procedure or medical visit with which it is used and assign the packaged service to a clinically related APC group with comparable resources. We will limit the cost variation within each group as required by section 1833(t)(2) of the Act, as amended by section 201(g) of the BBRA 1999. In accordance with this provision, the items and services within a group cannot be considered comparable with respect to the use of resources if the highest median cost item or service within a group is more than two times greater than the lowest median cost item or service within the same group. By law, the Secretary is allowed certain exceptions to this requirement, that is, for low volume items and services. *Comment:*
                         One commenter asked if we would provide adequate recognition for multiple devices used in a procedure “if multiple procedure discounting is allowed to cut the pass-through generated recognition of these costs in half.” *Response:*
                         Under the hospital outpatient prospective payment system, devices eligible for pass-through payments are paid separately and not subject to the multiple procedure discounting policy. This policy applies only to the actual surgical procedure that is performed to implant the pass-through device. These procedures are denoted by a status indicator “T” and listed in Addendum B of this rule. *Comment:*
                         One commenter urged us to correct erroneous APC groupings more frequently than during our scheduled quarterly or annual update cycles until we stabilize the hospital outpatient prospective payment system. *Response:*
                         We understand the importance of paying appropriately for services billed under our new outpatient system and are committed to resolving problems that would preclude us from making appropriate payments in a timely manner. However, because of the complexity of our system we cannot commit to making changes other than during the scheduled updating cycles. b. Definition of Medical Device In the April 7, 2000 final rule with comment period, we established eight specific criteria that new or innovative medical devices must meet to be considered eligible for pass-through payments under section 1833(t)(6) of the Act. We stated in that rule that new or innovative medical devices must meet all of the following criteria to be considered eligible for transitional pass-through payments: (1) They were not recognized for payment as a hospital outpatient service prior to 1997. (2) They have been approved or cleared for use by the FDA. (3) They are determined to be reasonable and necessary for the diagnosis or treatment of an illness or injury or to improve the functioning of a malformed body part, as required by section 1862(a)(1)(A) of the Act. We recognize that some investigational devices are refinements of existing technologies or replications of existing technologies and may be considered reasonable and necessary. Therefore, we indicated that we will consider devices for coverage under the hospital outpatient prospective payment system if they have received an FDA investigational device exemption (IDE) and are classified by the FDA as Category B devices. However, in accordance with regulations at § 405.209, payment for a nonexperimental investigation device is based on, and may not exceed, the amount that would have been paid for a currently used device serving the same medical purpose that has been approved or cleared for marketing by the FDA. (4) They are an integral and subordinate part of the procedure performed, are used for one patient only, are surgically implanted or inserted, and remain with that patient after the patient is released from the hospital outpatient department. (5) The associated cost is not insignificant in relation to the APC payment for the service in which the innovative medical equipment is packaged. (6) They are not equipment, instruments, apparatuses, implements, or items for which depreciation and financing expenses are recovered as depreciable assets as defined in Chapter 1 of the Medicare Provider Reimbursement Manual (HCFA Pub. 15-1). (7) They are not materials and supplies such as sutures, clips, or customized surgical kits furnished incident to a service or procedure. (8) They are not materials such as biologicals or synthetics that may be used to replace human skin. In the August 3, 2000 rule, we revised criteria (3), (4), and (7) and amended § 419.43(e)(4) to include all eight criteria. We stated in that rule that our change in policies reflects experience 
                        ( print page 67822)
                        gained in reviewing and processing transitional pass-through applications for devices since publishing our April 7, 2000 final rule with comment period. With regard to criteria (3), we revised it by removing the cost limitation provision for IDE Category B devices that qualify for transitional pass-through payments. We explained in the August 3, 2000 interim final rule that on review of our policy for such new devices, we believed that it would be more appropriate to remove the cost limitation because they are subjected to the same eligibility requirements as any other device applying for pass-through status and because pass-through payments for a specific device are temporary. For criteria (4), we modified our interpretation of which devices are eligible for transition pass-through payments to include new medical devices that are used for one patient only, are single use, come in contact with human tissue, and are surgically implanted or inserted in a patient during a procedure but may also be removed during that procedure so that the patient leaves the hospital without the device. Our revised interpretation also includes clips that are used as radiological site or tissue markers. As explained in the August 3, 2000 interim final rule, it became apparent, based on experience gained in processing a large number of applications for new medical device pass-through status, that our attempt to distinguish implantable devices using the criteria we had outlined in our April 7, 2000 final rule with comment period had some practical limitations. We also explained that, in some instances, the new medical device is implanted temporarily rather than permanently as indicated in our original policy published in the April 7, 2000 final rule with comment period. However, we did not intend for our policy to exclude new medical devices that are implanted or inserted during a procedure but also may be removed during that procedure so that the patient leaves the hospital without the device. Rather, we believed that these devices should be considered for pass-through payments because they also are implantables. We further stated in the August 3, 2000 interim final rule with comment period that it had become apparent that some implantable clips are expensive and function other than as tools or supplies necessary for a surgeon to perform a surgical procedure. We did not intend to exclude such clips from consideration for pass-through payments. Therefore, we revised our interpretation of which devices are eligible for transitional pass-through status to include also new single use medical devices that may be temporarily implanted or inserted in a patient. Finally, in criterion (7), we became aware of the need, based on our review of pass-through applications, to clarify that supplies include pharmacological imaging and stressing agents, including contrast media but excluding radiopharmaceuticals (for which payment under the transitional pass-through provision is established by section 1833(t)(6)(A) of the Act). *Comment:*
                         One commenter urged that we issue detailed guidelines that clarify whether an IDE Category B device with pass-through status will be assigned only one “C-code” for both its clinical investigation and commercialization. *Response:*
                         Our general policy is to assign only one code to an eligible pass-through item. *Comment:*
                         One commenter asked how we would reconcile differences in pass-through payment differences (over 2 to 3 years) that are made for an eligible IDE Category B device during its clinical investigation phase versus those paid once the device is commercialized. *Response:*
                         Policy decisions regarding the analytical treatment of costs associated with specific items that will be included in our database for constructing APCs will be made in the context of the methodology that we use to derive updated APC weights and payments. This methodology will be fully described in a subsequent proposed rule prior to incorporating the cost for pass-through devices such as eligible IDE Category B devices into our APC payments. *Comment:*
                         One commenter asked that we clarify when the definition of a device includes or excludes all of a device's components. The commenter also asked whether we assigned separate codes for the device's components. *Response:*
                         If a device can be separated into distinct components and such components are considered integral to the functioning of that device, we evaluate the device and all its component parts to determine whether any or all would qualify for transitional pass-through payment. For example, we have approved several implantable neurostimulator systems for pass-through payment. These systems usually include at least two or three separate components such as a generator, leads, and receiver/transmitter. In this case, we have assigned separate HCPCS codes to each of the eligible components. However, if an eligible pass-through item is considered a component of a non-eligible item, such as a piece of capital equipment, only the eligible item will receive a HCPCS code to bill for pass-through payments. *Comment:*
                         One commenter warned us about medical devices that we have approved for pass-through payments such as electrophysiology catheters that the commenter alleges are not single use items. The commenter stated that hospitals use them more than once. The commenter advocated that we advise hospitals not to request additional payments for any approved pass-through item if they reprocess or reuse them. *Response:*
                         In the August 3, 2000 interim final rule with comment period, we revised criterion “d” of the eight medical device eligibility criteria to explicitly preclude pass-through payments for new medical devices other than those that are single use. Therefore, additional payments will not be made for devices that are reprocessed or reused. Hospitals that bill these devices might be considered to be engaging in fraudulent billing practices. *Comment:*
                         A number of the commenters urged that we abandon the use of an individual or brand-specific approach to approving devices for transitional pass-through payments and adopt an approach that distinguishes devices based on categories. The commenters argued that a category approach is more appropriate and more efficient to implement than an individual, item-specific approach. They alleged that the latter approach creates winners and losers and delays timely approval of new technologies. *Response:*
                         As previously stated, we adopted a trade-name specific approach for several reasons. First, such an approach provides better information. Codes that are largely item-specific allow us to track what procedures the items are used with and costs of the items. When the pass-through payments for an item ends, we would expect to have good information for assigning it to relevant APCs and ensuring appropriate payment for these APCs. Adopting a scheme with a significant degree of categorization would require use of averages in making assignments and setting payment rates. Decisions based on these more limited data would likely lead to intensified concerns about the appropriateness of APC assignment and payment. Second, this approach permits finer discrimination in eligibility decisions. An item-by-item approach allows us to be sure individual items in fact meet the criteria for eligibility. Of major concern in this instance is whether a device is “new” using the standard of the statute. Section 1833(t)(6)(A) of the Act limits 
                        ( print page 67823)
                        transitional pass-through payment to those devices for which “ * * * payment for the device * * * as an outpatient hospital service under this part was not being made as of December 31, 1996.” Adopting categories would in some cases mix “old” and “new” devices. In these instances, either some old devices would get special treatment that they would not be eligible for if they were examined on an item-specific basis, or an entire category could be considered old, thus depriving some new devices from special treatment they would be eligible for if they were examined on an item-specific basis. Third, an item-specific scheme avoids issues associated with the design of categories needed for purposes of transitional pass-through payments. It largely avoids concerns about what items should be in what category or whether new categories should be created to accommodate items that may appear to be little different from those in existing categories. Fourth, an item-specific approach allows us to assure that a newly arriving device can obtain the full period of pass-through status it is arguably eligible for under the statute. A categorization approach would likely lead to latecomers being eligible for pass-through payments only for a shorter period. Insofar as revision to APC payment rates reflected the costs of items in the category by the time the category was terminated, the shorter period would be of little consequence. However, if the costs of the late-coming item were significantly higher, this procedure could appear objectionable. A solution in this case would be to create a new code, which could be specific to that item, thus departing from a categorization approach. We recognize that a category approach would lessen concerns about competitive disadvantages that may have been inadvertently created by an item specific approach and about access to specific items by hospitals and their patients. However, we found no satisfactory way of establishing categories that would not run into difficulty regarding the test of whether a device is “new” as described above. Consequently, we are making no change in our approach in response to comments. 2. Revision to Grandfather Provision for Certain FQHCs and “Look-Alikes” In the April 7, 2000 final rule with comment period, which discussed the provider-based status criteria and requirements, we grandfathered FQHCs or “look-alikes” that were designated as such before 1995 in order to assure the continuity of care and access to care for patients of some of these facilities. To meet our original policy intent of helping to ensure that the new criteria do not disrupt the delivery of services to patients of these facilities, in the August 3, 2000 interim final rule with comment period (65 FR 47674), we corrected § 413.65(m) to state that a facility that has since April 7, 1995 furnished only services that were billed as if they had been furnished by a department of a provider will continue to be considered as a department of a provider, without regard to compliance with the provider-based criteria, if the facility— (1) Received a grant on or before April 7, 2000 under section 330 of the Public Health Service Act and continues to receive funding under such a grant, or is receiving funding from a grant made on or before April 7, 2000 under section 330 of the Public Health Service Act under a contract with recipient of such a grant, and continues to meet the requirements to receive a grant under section 330 of the Public Health Service Act; or (2) Based on the recommendation of the Public Health Service, was determined by HCFA on or before April 7, 2000 to meet the requirements for receiving a grant under section 330 of the Public Health Service Act, and continues to meet such requirements. We made this change to clarify that grandfathering under § 413.65 is based on continued status as a section 330 of the Public Health Service Act grantee or a “look-alike” facility. We received no comments on this change. 3. Clarification of Notice of Beneficiary Cost-Sharing Liability In the August 3, 2000 interim final rule with comment, we also addressed whether hospitals could reasonably be expected to furnish an exact statement of the patient's financial liability, since the exact scope of services needed may not be known at the time notice must be given. Specifically, we stated that when the extent of care needed is not known before the patient is admitted, the hospital may furnish a written notice to the patient that explains the general fact that the beneficiary will incur a coinsurance liability to the hospital that he or she would not incur if the facility were not provider based. Furthermore, we clarified that the estimate of “potential financial liability” in this written notice may be based on typical or average charges for visits to the facility or organization, while stating that the patient's actual liability will depend upon the actual services furnished by the hospital. *Comment:*
                         One commenter stated that our clarification regarding the notice of beneficiary cost sharing liability was helpful, but recommended that we amend or modify the regulations at § 413.65(g)(7) to reflect such clarification since the wording of the existing regulations states twice that the notice must be given “prior to the delivery of services” without an exclusion for emergency medical conditions. In addition, the regulation states that the hospital has an obligation to notify the beneficiary of the “potential financial liability” not just to provide the beneficiary with “an estimate based upon typical or average charges” in the event that the exact type and extent of care is not known. The commenter also recommended that we require hospitals to only notify the beneficiary of the fact that the beneficiary will incur a coinsurance liability for hospital outpatient services without giving a dollar amount of beneficiary copayment. Such a notice could include a statement that the copayment liability will be determined by us and the beneficiary will be notified of the exact amount once the hospital is notified of the amount determined by us. The commenter believes that an estimate based on charges would “miss the point” of this provision since beneficiary copayment amounts are now determined by HCFA using an APC grouper, not charges. *Response:*
                         We appreciate the commenter's concerns and agree that a change in the regulations is needed to reflect the clarification provided in the August 3, 2000 interim final rule with comment period in a future proposed rule. As we stated in the August 3, 2000 interim final rule with comment period (65 FR 47675), we are developing a proposed rule that will further revise and clarify the notice requirements. We are doing this to allow the public a full opportunity to comment on the changes and to ensure that we have the benefit of all relevant comments. We disagree with the commenter's statement that an estimate based on charges would “miss the point” of this provision since such a notice is required only to give the beneficiary an idea or an example of their “potential financial liability”. As stated in the August 3, 2000 interim final rule with comment period (65 FR 47675), the estimate should state that the beneficiary's “actual liability will depend upon actual services furnished by the hospital.” Also, with the delay in the effective date of the provider-based status regulations until January 10, 2001, hospitals will have at least five months of experience with APC 
                        ( print page 67824)
                        payments under outpatient prospective payment system and should be able to develop an appropriate estimate of a copayment amount based on APCs rather than charges. 4. Clarification of Protocols for Off-Campus Departments In the April 7, 2000 final rule, under new § 489.24(i)(2) we require hospitals to establish protocols for handling individuals with potential emergency conditions who arrive at hospital off-campus departments. Section 489.24(i)(2)(ii) further requires that if the off-campus department is a physical therapy, radiology, or other facility not routinely staffed with physicians, RNs, or LPNs, the department personnel must be given protocols that direct them to contact emergency personnel at the main hospital campus. In the August 3, 2000 interim final rule with comment period, we clarified that § 489.24(i)(2) does not require a delay of an appropriate transfer when the main hospital campus does not have the specialized capability or facilities required by the individual or when the individual's condition is deteriorating so rapidly that the time needed to move the individual to the main hospital campus would significantly jeopardize the individual's life or health. We also stated that the contact with emergency personnel at the main hospital campus should be made either after, or concurrently with, the actions needed to arrange an appropriate transfer under § 489.24(i)(3)(ii), if doing otherwise would significantly jeopardize the individual's life or health. We noted that this clarification does not relieve the off-site department of the responsibility for making this contact, but only clarifies that the contact may be delayed in specific cases when doing otherwise would endanger a patient subject to EMTALA protection. We received no comments on this clarification. 5. Typographical Errors in the Provider-Based Regulations *Comment:*
                         One commenter questioned whether the provider-based regulations in §§ 413.65 and 489.24, as they appeared in the April 7, 2000 final rule with comment period (65 FR 18538), contained typographical errors. *Response:*
                         We are aware of typographical errors in the provider-based regulations as published in the April 7, 2000 final rule with comment period (65 FR 18538) and will be publishing a correction notice (HCFA-1005-CN) to make these corrections. III. Provisions of This Interim Final Rule With Comment Period A. Changes Relating to the BBRA 1999 Public Comments Except for the changes discussed in the preamble, we are adopting the BBRA 1999 provisions implemented in the April 7, 2000 final rule with comment period and the August 3, 2000 interim final rule with comment period, described in section II of this preamble, as final without modification. We are making the following changes to the regulation text as a result of the public comments received: We are revising § 419.41(c)(4)(i) to provide that, effective January 1, 2001, when multiple APCs for a single drug or biological are furnished to a beneficiary on the same day, the inpatient hospital deductible limitation on coinsurance will be applied to the aggregate coinsurance for the drug or biological. The section is further revised to provide that, effective July 1, 2001, the coinsurance amount for the procedure or service that resulted in the administration of the drug or biological will be aggregated with the coinsurance for the drug or biological in applying the limit. We are revising § 419.70(f)(2)(ii) to remove the phrase “without applying the cost reductions under section 1861(v)(1)(S) of the Act”. We recognize that the phase may have inadvertently caused confusion to the extent it is redundant, as pointed out by a commenter. B. Annual Updates to Components of the Hospital Outpatient Prospective Payment System In this interim final rule with comment period, for calendar year 2001, we are updating the wage index and the conversion factor adjustment for covered hospital outpatient services furnished beginning January 1, 2001. We also are updating the existing APC groups to reflect new codes that have been assigned. In accordance with section 1833(t)(9)(A) of the Act and section 201(h)(2) of the BBRA 1999, we will undertake a complete system update in 2001 for hospital outpatient prospective payments. That update will take effect on January 1, 2002. We will consult with an expert outside advisory panel composed of appropriate representatives of providers. This panel will review and advise us concerning the clinical integrity of the APC groups and relative weights. The panel will be allowed to use data other than those we have collected or developed during our review of the APC groups and relative weights. 1. APC Groups We are updating the existing APC groups effective January 1, 2001 to reflect the addition of new CPT and alpha-numeric codes, the deletion of invalid codes, changes to the list of procedures we pay for only in an inpatient setting (the “inpatient list”), the creation of a new status indicator, newly covered procedures, reconfigurations due to the inclusion of device costs, and revisions to correct errors and provide consistency in the placement of codes. a. New Codes There are 936 new codes, 645 of which are “C” codes. “New” in this context means new since the April 7, 2000 final rule with comment period was published. Many of the “C” codes were published in program memoranda over the intervening months. New codes are shown in Addendum B with an asterisk in the column preceding the code. b. Deleted Codes With the exception of “C” codes, codes deleted effective January 1 of each year are given a 3-month grace period in which they will still be recognized. “C” codes are temporary codes used exclusively to bill pass-through items and new technology services and items paid under the hospital prospective payment system. We will retire these codes prospectively at the start of a new calendar quarter based on specific service dates and are not extending the same 3-month grace period to them. We will drop all non “C” codes from APCs effective April l. Deleted codes are shown in Addendum B. They are followed by the letter D. The AMA's CPT books also list deleted codes. c. Revisions to Correct Errors or Inconsistencies We are revising the APCs in order to correct errors and to provide greater consistency in the placement of codes. For example, we had assigned various types of cardiovascular diagnostic tests to four APCs, with rates based on data that, on subsequent review, appeared limited. We are recategorizing these APCs. This recategorization results in three APCs with greater clinical coherence. Medicare covers influenza, pneumococcal, and hepatitis B immunizations routinely, with no copayment or deductible due for flu and pneumonia vaccines or their administration. Other vaccines may be covered in certain circumstances, but are, in fact, given so infrequently that our cost data are limited. We are 
                        ( print page 67825)
                        rearranging the preventive vaccines and assigning the less frequently furnished vaccines based on their reported costs, but within a smaller range. We expect very few immunizations other than influenza and pneumonia to be billed, but if they are billed, we will update our data. We also are changing the APCs to which bone density studies are assigned. The codes used in 1996 captured both central and peripheral bone density studies. Coding changes since that time have separated the two types of studies, but this distinction was not reflected in the 1996 data. In order to better reflect these differences, we are separating the various codes and assigning central dual energy x-ray absorptiometry (DEXA) bone density studies to a new technology APC. We did not include the codes for transfusion laboratory services (for example, typing and crossmatching) in APCs in the April 7, 2000 final rule with comment period. We are now creating three APCs to capture these codes, and an additional APC to capture fertility procedures. d. Device-Related Codes As described in the April 7, 2000 final rule with comment period, revenue centers 274, 275, and 278 were not included for purposes of calculating the APC rates because prior to the BBRA 1999, we anticipated paying for durable medical equipment and prosthetics (including implantable devices) outside of the outpatient prospective payment system and it was unfeasible to revise our database to reflect the revenue centers in time to publish a final rule and implement the prospective payment system by July 1, 2000. To reflect the inclusion of implantable devices as required under the BBRA 1999, we have recalculated APC rates with these revenue centers included. As a result, the median cost for certain procedures such as inserting pacemakers, replacing leads, and providing neurostimulators increased significantly. In order to recognize these cost increases, which are attributable to the devices, and to aid in the assignment of devices to APCs at the end of the pass-through period, we are reconfiguring certain APCs. That is, we are creating APC groups for the insertion of pacemakers, the replacement of pacemaker electrodes, the implantation of a pacemaker and electrodes, and the removal of a pacemaker. These changes reflect our basic criteria that procedures within an APC group be clinically similar and comparable in terms of resources, with the highest cost item or service within a group being no more than 2 times greater than the lowest cost item or service within the same group. e. Inpatient Codes Moved to the Outpatient Setting In response to numerous requests, we reviewed the composition of the inpatient list. While we continue to believe that we have the majority of the codes assigned properly, for the reasons discussed in section III.B.2. we are persuaded to move a number of codes to the outpatient setting. We are able to place most codes into closely related APCs. f. “Two-times” Rule The BBRA 1999 required us to ensure that no APC contains codes such that the highest median cost in the APC exceed twice the lowest median cost. We undertook an analysis of APCs in relation to this requirement as part of the 2001 update. (Note that the law provides for exceptions based on low volume and other reasons. We consider a code that captures fewer than 2 percent of the services within an APC to be low volume, and we disregard codes for unlisted services or procedures, since we do not know what service or procedure was billed.) For example, moving a radical mastectomy code from the inpatient list to a breast procedure APC caused the group to fail the two-times test. In another instance, as described above, we packaged costs associated with implantable devices into the relevant procedure codes. This change would also cause device-related APCs to fail the two-times test. For these situations and others that failed the two-times test, we are reconfiguring the APCs appropriately. g. Inpatient Codes Moved to Outpatient and Affected by Device Seven codes related to vascular and neurological procedures were moved from the inpatient list into APCs, that were then split according to device use, in response to comments. h. Newly Covered Codes The updated APCs reflect recent HCFA decisions to provide Medicare coverage for an electrical bioimpedance procedure and three magnetic resonance angiography services. The codes for these newly covered services are M0302 and 71555, 73725, and 74185, respectively. i. Pass-Through Requests for Drugs Since publication of the April 7, 2000 final rule with comment period, we have received additional requests for pass-through status for a number of drugs. The codes for the additional eligible pass-through drugs are shown in Addendum B. The following table contains a listing of the changes in the APC groups discussed above. Summary of Changes to APCs
New Codes
Changes to APC Placement of Existing CodesRevisions or corrections of errors
Device-related codes
Inpatient moved to outpatient
“Two-times” rule
Inpatient codes moved to outpatient and affected by device
Newly covered codes
Pass-through requests for drugs936 codes added, 645 of which are “C”
111 codes changed
87 codes changed
56 codes changed (12 as of 8/1/2000)
25 codes changed
7 codes changed
4 codes changed
4 codes changed( print page 67826)Denoted by asterisk in Addendum B
APCs—0004, 0087, 0099, 0100, 0102, 0123, 0282, 0340, 0342, 0346, 0347, 0348, 0349, 0354, 0356, 0602, 0761, 0970, 0971, 0974, 0976, 1044, 1401, 1402, 1403, 1404, 1405, 1406, 1407, and 1409
APCs—0082, 0083, 0089, 0091, 0093, 0103, 0104, 0105, 0106, 0107, 0108, 0109, 0115, 0119, 0124, 0185, 0224, 0225, 0226, 0227, 0228, 0229, 0256, and 1002
APCs—0005, 0020, 0021, 0029, 0046, 0050, 0081, 0114, 0115, 0120, 0121, 0162, 0165, 0194, 0195, 0198 , 0216, 0254, 0256, 0263, 0264, 0279, 0280, 0970, 0974, and 0981.
APCs—0028 and 0029
HCPCS—37620, 35011, 36834, 61880, 61888, 33284, 63741
HCPCS—71555, 73725, 74185, M0302
HCPCS—J1650, J2770, J1810, J7315
 Addenda A and B reflect changes to the APC groups, effective January 1, 2001. Addendum C, entitled “Hospital Outpatient Department (HOPD) Payment for Procedures by APC, Calendar Year 2001,” is not published in this interim final rule with comment period, but will be posted on our website at http://www.hcfa.gov /medlearn/refopps.htm. Addendum C will display data similar to those contained in Addenda A and B, but sorted by APCs with each procedure code listed that is assigned to the APC. 2. Inpatient Procedures List Update In the preamble to the April 7, 2000 final rule with comment period, we indicated that, as part of our annual update process, we would update the procedures on the inpatient list. The first annual revision of this list is effective on January 1, 2001. We are removing 44 procedures from the list and placing them in APCs. (Several procedures that were inadvertently left on the inpatient list in the April 7, 2000 final rule with comment period were removed from the list and placed in APCs in August 2000.) The revised list is included in Addendum E. We have attempted to limit the inpatient only list to those procedures that, in current medical practice as understood by our clinical staff, require inpatient care, such as those that are highly invasive, result in major blood loss or temporary deficits of organ systems (such as neurological impairment or respiratory insufficiency), or otherwise require intensive or extensive postoperative care. Insofar as advances in medical practice mitigate concerns about these procedures being performed on an outpatient basis, we will be prepared to remove them from the inpatient list and provide for payment under the hospital outpatient prospective payment system. Since the April 7, 2000 final rule with comment period was published, we have received requests to move a number of procedures from the inpatient list because, based on medical evidence, the procedures can be performed safely in a hospital outpatient setting. These included breast and other cancer procedures, repairs of facial trauma, many orthopedic procedures, several vascular procedures, and some genito-urinary procedures. Among the procedures we are removing from the inpatient list and placing in APCs as a result of these requests are excision of chest wall tumors, several orthopedic repairs, vascular procedures, and ureteral endoscopies. We are moving overnight pulse oximetry from the inpatient list to packaged status. We also are moving several comparable procedures, for example, related ureteral endoscopies. At this time, we are not removing from the inpatient list various spinal procedures, including osteotomies and laminectomies. We also are not removing several open abdominal and retroperitoneal procedures from the inpatient list because many of these procedures involve prolonged invasion of the thoracic cavity, the peritoneum, or the retroperitoneal space. Patients undergoing these procedures typically require prolonged postoperative monitoring. Moreover, the information provided to us by requesters did not provide convincing evidence that these procedures are currently being performed or can be safely performed in an outpatient setting. However, we are aware that, with advances in technology and surgical techniques, many of these procedures may eventually be performed safely in a hospital outpatient setting. We will continue to review all the procedures on the inpatient list and will consider additional requests to move specific procedures to the outpatient setting. We ask that these requests contain detailed rationale along with medical evidence that the procedure may be performed safely in an outpatient setting. We note that, in some instances, requests for removing a particular procedure from the inpatient list may have resulted from a misunderstanding about appropriate coding. Less invasive versions of the procedure on the inpatient list may be in an APC. The presence of certain thoracoscopies on the inpatient list, for example, does not mean that no thoracoscopy will be paid under the outpatient prospective payment system. We also were asked to move several procedures from APCs to the inpatient list. Because of the rapid advance in technology and surgical techniques mentioned above, we believe that if procedures have been assigned APCs, we should not reverse that status unless it becomes obvious that we have made an error. Thus, we are moving to the inpatient setting only one of the codes for which we received a request (open treatment of a knee dislocation, which requires more than outpatient 
                        ( print page 67827)
                        postoperative monitoring), and two other codes (for nephrectomy with total ureterectomy and for escharotomy) that had been assigned APCs in error. Beginning in April 2001, we will, if warranted, revise the inpatient list at least quarterly to better reflect changes in medical practice that permit procedures that were previously performed only in an inpatient setting to be safely and effectively performed in an outpatient setting. In the April 7, 2000 final rule with comment period, we discussed our intent to revise the list as part of the annual update of APCs and asked that interested parties advise us of procedures that can be performed in an outpatient setting. Since we will be making quarterly updates to the outpatient prospective payment system for other purposes, we will also change the inpatient list quarterly, if warranted. Generally, because of systems limitations, 3 months or more are required after a decision is made before we can implement a change. The inpatient list was not a result of a provision of the BBRA 1999; it was included in the September 1998 proposed rule and we responded to comments and made the provision final in the April 7, 2000 final rule with comment. Accordingly, we did not request comments on our policy on the establishment of the inpatient list at that time. Nonetheless, we received a number of comments concerning the existence of this list, the provisions for updating it, and its implications for other Medicare payment systems. We will consider these comments and expect to discuss the matter further in the proposed rule updating the hospital outpatient prospective payment system for 2002, which we will publish in the spring of 2001. 3. Wage Index Adjustment Under section 1833(t)(2)(D) of the Act, we are required to determine a wage adjustment factor to adjust, in a budget neutral manner, the portion of the payment rate and the coinsurance amount that is attributable to labor-related costs for relative differences in labor and labor-related costs across geographic regions under the hospital outpatient prospective payment system. In the April 7, 2000 final rule with comment period, we specified, in regulations at § 419.43(c), that each year we use the hospital inpatient prospective payment system wage index established in accordance with 42 CFR Part 412 to make a wage adjustment for relative differences in labor and labor-related costs across geographic areas under the hospital outpatient prospective payment system. We note that, by statute, we implement the annual update of the hospital inpatient prospective payment system on a fiscal year basis. However, we update the hospital outpatient prospective payment system on a calendar year basis. Therefore, the hospital inpatient prospective payment system wage index values established for urban and rural areas and for reclassified hospitals published in the 
                        **Federal Register**
                         on August 1, 2000 (65 FR 47149 through 47157) are being applied for wage adjustments under the hospital outpatient prospective payment system, effective January 1, 2001. The fiscal year 2001 hospital inpatient wage index reflects the effects of hospitals redesignated under section 1886(d)(8)(B) of the Act and hospital reclassifications under section 1886(d)(10) of the Act. After publication of the hospital inpatient wage index values for fiscal year 2001 on August 1, 2000, we discovered several errors in the values for several geographic areas. The correct wage index values for all areas are republished in Addenda F, G, and H of this interim final rule with comment period. In this interim final rule with comment period, we are establishing the methodology that we will use in making adjustments for area wage differences for services furnished in the Virgin Islands. We note that a hospital inpatient prospective payment system wage index value is not calculated for the Virgin Islands because there are no hospitals located in that area that are paid under the inpatient hospital prospective payment system. Because the wage index that we adopted in our April 7, 2000 final rule with comment period does not include a value for adjusting wage differences for the Virgin Islands, we will use the wage index for the Virgin Islands as calculated for the skilled nursing facilities prospective payment system to make this adjustment. The skilled nursing facilities prospective payment system uses the inpatient hospital wage index data to adjust its prospective payment rates for the same fiscal year (that is effective October 1, 2000) as covered by the hospital inpatient prospective payment system wage index values. As stated in the July 31, 2000 skilled nursing facilities prospective payment system final rule (65 FR 46770), “The computation of the wage index * * * incorporate[s] the latest data and methodology used to construct the hospital wage index. For these reasons, the wage index adjustment that we will apply to the Virgin Islands for services furnished on or after January 1, 2001 is 0.6306. Although the wage index for skilled nursing facilities is based on a fiscal year beginning October 1, we will apply the wage index factor for the Virgin Islands that goes into effect on October 1 of each year to the hospital outpatient prospective payment system services furnished during the following calendar year. This is consistent with how we apply the hospital inpatient prospective payment system wage index values to the hospital outpatient prospective payment system services. Consistent with the methodology applicable for services furnished in 2000 (on or after August 1, 2000), in making adjustments for area wage differences for services furnished in 2001, we will recognize 60 percent of the hospital's costs as labor-related costs that are standardized for geographic wage differences. 4. Conversion Factor Update Section 1833(t)(3)(C)(ii) of the Act requires us to update annually the conversion factor used to determine APC payment rates. Section 1833(t)(3)(C)(iii) of the Act provides that the update be equal to the hospital inpatient market basket percentage increase applicable to hospital discharges under section 1886(b)(3)(B)(iii) of the Act, reduced by one percentage point for the years 2000, 2001, and 2002. Thus, the update to the outpatient hospital prospective payment system conversion factor for 2001 is 2.4 percent (3.4 percent minus 1 percent). In accordance with section 1833(t)(9)(B) of the Act, the conversion factor for 2001 also has been adjusted to ensure that the revisions we made to update the wage index are made on a budget-neutral basis. A budget neutrality factor of .9989 was calculated for wage index changes by comparing total payments from our simulation model using the wage index values that will be effective January 1, 2001. The market basket increase of 2.4 percent for 2001 and the required budget neutrality adjustment calculated to be .9989 result in a conversion factor for 2001 of $49.596. IV. Waiver of Notice of Proposed Rulemaking We ordinarily publish a notice of proposed rulemaking in the 
                        **Federal Register**
                         and invite public comments on the proposed rule. The notice of proposed rulemaking includes a reference to the legal authority under which the rule is proposed, and the terms and substance of the proposed rule or a description of the subjects and 
                        ( print page 67828)
                        issues involved. This procedure can be waived, however, if an agency finds good cause that a notice-and-comment procedure is impracticable, unnecessary, or contrary to the public interest, and incorporates a statement of the finding and its reasons in the rule. For the reasons set forth below, we find that the circumstances surrounding this interim final rule with comment period make it either unnecessary or impracticable to pursue a notice-and-comment procedure before the provisions of this interim final rule with comment period take effect. As discussed earlier in this interim final rule with comment period, we implemented the hospital outpatient prospective payment system on August 1, 2000 in accordance with the methodology that we set forth in the April 7, 2000 final rule with comment period (65 FR 18434). In section III.I. of the April 7, 2000 final rule with comment period (65 FR 18501), we discuss how we will update the outpatient prospective payment system on an annual basis. We are required under section 1833(t)(3)(C)(ii) of the Act to update annually the conversion factor used to determine the APC payment rates. Under the regulations, 42 CFR 419.43, the wage adjustment under outpatient prospective payment system is based on the hospital inpatient wage index, and we updated the hospital inpatient wage index after the publication of the April 7, 2000 final rule with comment period. Accordingly, in this interim final rule with comment period, we are updating the conversion factor and the wage index adjustment for covered hospital outpatient services furnished beginning January 1, 2001, using the methodology published in the April 7, 2000 final rule with comment period, for which we had previously received comments. We also are updating the existing APC groups to reflect new and deleted CPT codes for 2001 and reconfiguring certain APC groups using more recent data to ensure clinical integrity and consideration of resource use as required by section 1833(t)(8)(A) of the Act and as described in the April 7, 2000 final rule with comment period (65 FR 18456 and 18501). Because these various adjustments are being made in accordance with existing methodology as set forth in the April 7, 2000 final rule with comment period, we believe it is unnecessary to address them further through the notice-and-comment procedure. In addition, we find good cause to waive prior notice-and-comment procedures with respect to the Virgin Islands wage index methodology because it would have been impracticable to undertake and complete notice-and-comment procedures on this issue in time for the Virgin Islands outpatient prospective payment system wage index value to be effective at the same time as the updated outpatient prospective payment system wage index values for all other areas. Accordingly, we find good cause to waive the notice-and-comment procedure with respect to the annual update of the wage index values, conversion factor, and the APC groups. However, we are providing for a 60-day comment period as specified in the “Dates” section of this preamble. II. Collection of Information Requirements This document does not impose information collection and recordkeeping requirements. Consequently, it need not be reviewed by the Office of Management and Budget under the authority of the Paperwork Reduction Act of 1995. VI. Regulatory Impact A. General We have examined the impacts of this interim final with comment period rule as required by Executive Order 12866, the Unfunded Mandates Reform Act of 1965, and the Regulatory Flexibility Act (RFA) (Public Law 96-354). Executive Order 12866 directs agencies to assess all costs and benefits of available regulatory alternatives and, if regulation is necessary, to select regulatory approaches that maximize net benefits (including potential economic, environmental, public health and safety effects, distributive impacts, and equity). A regulatory impact analysis (RIA) must be prepared for major rules with economically significant effects ($100 million or more annually). Section 202 of the Unfunded Mandates Reform Act of 1995 also requires that agencies assess anticipated costs and benefits before issuing any rule that may result in an expenditure in any one year by State, local, or tribal governments, in the aggregate, or by the private sector, of $100 million. This final rule does not mandate any requirements for State, local, or tribal governments. The RFA requires agencies to analyze options for regulatory relief of small businesses. For purposes of the RFA, small entities include small businesses, nonprofit organizations and government agencies. For purposes of the RFA, we consider all hospitals to be small entities. Individuals and States are not included in the definition of a small entity. In addition, section 1102(b) of the Act requires us to prepare a regulatory impact analysis if a rule may have a significant impact on the operations of a substantial number of small rural hospitals. This analysis must conform to the provisions of section 604 of the RFA. With the exception of hospitals located in certain New England counties, for purposes of section 1102(b) of the Act, we define a small rural hospital as a hospital that is located outside of a Metropolitan Statistical Area (MSA) or New England County Metropolitan Area (NECMA). Section 601(g) of the Social Security Amendments of 1983 (Public Law 98-21) designated hospitals in certain New England counties as belonging to the adjacent NECMA. Thus, for purposes of the hospital outpatient prospective payment system, we classify these hospitals as urban hospitals. B. Analysis for Changes in this Interim Final Rule with Comment Period We implemented the outpatient prospective payment system on August 1, 2000 in accordance with the methodology published in the April 7, 2000 final rule with comment period. In section III.I. of the April 7, 2000 final rule with comment period (65 FR 18501), we discuss how we will update the outpatient prospective payment system on an annual basis. We are required under section 1833(t)(3)(C)(ii) of the Act to update annually the conversion factor used to determine the APC payment rates. We are required under section 1833(t)(8)(A) of the Act to revise not less often than annually the wage and other adjustments. Accordingly, in this interim final rule with comment period, we are updating the conversion factor and the wage index adjustment for covered hospital outpatient services furnished beginning January 1, 2001, using the methodology published in the April 7, 2000 final rule with comment period, for which we had previously received comments. In section IX.B. of the preamble of the April 7, 2000 final rule with comment period, we gave our Office of the Actuary's projection of the additional benefit expenditures from the Medicare Part B Trust Fund resulting from implementation of the hospital outpatient prospective payment system and the hospital outpatient provisions enacted by the BBRA 1999. The impact of implementing the hospital outpatient prospective payment system on the Medicare program is reflected in the table below, which is republished from the April 7, 2000 final rule with 
                        ( print page 67829)
                        comment period (65 FR 18530). The calendar year 2001 increase in total payments to hospitals, which results primarily from the updated conversion factor, is already included as part of HCFA's current law baseline expenditures for hospital outpatient services under the outpatient prospective payment system. Fiscal year
Impact (in 
                                 millions)2001
$3,0302002
3,5202003
4,2302004
4,670
 We also are updating the existing APC groups to reflect new and deleted CPT codes for 2001 and adjusting the groups to reflect more recent data as we described in the April 7, 2000 final rule with comment period. The provisions of this interim final rule with comment period do not measurably alter the effect of the outpatient prospective payment system on the groups of hospitals or geographic areas as projected in Table 2 of the April 7, 2000 final rule with comment period (65 FR 18533-18534). C. Federalism We have examined this interim rule with comment period in accordance with Executive Order 13132, Federalism, and have determined that it will not have any negative impact on the rights, roles, and responsibilities of State, local or Tribal governments. D. Executive Order 12866 and 5 U.S.C. 804(2) The statutory effects of the provisions that are being implemented by this interim final rule with comment period result in expenditures exceeding $100 million per year. Therefore, this interim final rule with comment period is an economically significant rule under Executive Order 12866, and a major rule under 5 U.S.C. 804(2). In accordance with the provisions of Executive Order 12866, this interim final rule with comment period was reviewed by the Office of Management and Budget. List of Subjects in 42 CFR Part 419 Health facilities
Hospitals
Medicare
 For the reasons set forth in the preamble, 42 CFR Part 419 is amended as set forth below: PART 419—PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES
 1.The authority citation for Part 419 continues to read as follows: Authority:
                            Secs. 1102, 1833(t), and 187l of the Social Security Act (42 U.S.C. 1302, 1395l(t), and 1395hh). 2.Section 419.41 is amended by revising paragraph (c)(4)(i) to read as follows: § 419.41
  
 (c) * * * (4) * * * (i) The coinsurance amount for an APC cannot exceed the amount of the inpatient hospital deductible, established in accordance with § 409.82 of this chapter, for that year. For purposes of this paragraph (c)— (A) Effective for drugs and biologicals furnished on or after January 1, 2001, the coinsurance amount for multiple APCs for a single drug or biological furnished on the same day will be aggregated and treated as the coinsurance amount for one APC. (B) Effective for drugs and biologicals furnished on or after July 1, 2001, the coinsurance amount for the APC or APCs for a drug or biological furnished on the same day will be aggregated with the coinsurance amount for the APC that reflects the administration of the drug or biological furnished on that day and treated as the coinsurance amount for one APC.
 3.Section 419.70 is amended by revising paragraph (f)(2)(ii) to read as follows: § 419.70
  
 (f) * * * (2) * * * (ii) The reasonable cost of these services for this period.
 (Catalog of Federal Domestic Assistance Program No. 93.774,  Medicare'Supplementary Medical Insurance Program) Dated: November 1, 2000. Michael M. Hash, Acting Administrator, Health Care Financing Administration. Approved: November 1, 2000. Donna E. Shalala, Secretary.
 Note to the Addenda: The following Addenda A through H will not appear in the Code of Federal Regulations. Addenda A through H provide various data pertaining to the Medicare hospital outpatient prospective payment system. Addendum A contains the APCs with title, status indicators, relative weight, payment rate, national unadjusted coinsurance, and minimum unadjusted coinsurance. Addendum B differs from Addendum A in that the APC titles are not listed and both HCPCS codes and descriptions appear. Addendum C, entitled “Hospital Outpatient Department (HOPD) Payment for Procedures by APC, Calendar Year 2001,” is not published in this interim final rule with comment period, but will be posted on our website at (http://www.hcfa.gov /medlearn/refopps.htm). Addendum C will display data similar to those contained in Addenda A and B, but sorted by APCs with each procedure code listed that is assigned to the APC. Addendum D lists the status indicators for how various services are treated under the hospital outpatient prospective payment system. Addendum E lists the procedures that we pay for only in an inpatient setting. Addendum F lists the wage index for urban areas, Addendum G lists the wage index for rural areas, and Addendum H lists the wage index for hospitals that are reclassified. Addendum A.—List of Hospital Outpatient Ambulatory Payment Classification Groups with Status Indicators, Relative Weights, Payment Rates, and Coinsurance Amounts The payment rate (once wage adjusted) is the total payment to the hospital. The coinsurance amount is part of the total payment rate. Those APCs with status indicators “G” or “J” denote the inclusion of drugs that are eligible for pass-through payments. The relative weight column for these drug APCs is empty since payment for pass-through drugs/biologicals is calculated using the average wholesale price for the drug/biological rather than the relative weight. Note also that the only coinsurance column that has been filled is the minimum unadjusted coinsurance column. The coinsurance is applied to the nonpass-through portion of the payment rate for the drug/biological. Those APCs with status indicator “H” denote the inclusion of devices that are eligible for pass-through payments. The relative weight, payment rate, and coinsurance columns are not filled for these APCs. The relative weight and payment rate columns are empty because payment for pass-through devices is determined based on the hospital's submitted charges adjusted to cost using the hospital's cost-to-charge ratio. This calculation is done in the PRICER. The coinsurance columns for these APCs are not filled since the coinsurance is applied to the APC that contains the procedure with which the pass-through device is used rather than to the device APC. Addendum B.—Hospital Outpatient Department (HOPD) Payment Status by HCPCS Code and Related Information The codes listed in this addendum include the 2001 CPT codes as published in CPT 2001 by the American Medical Association. Also listed are the codes that have been deleted for 2001. These codes are denoted in the CPT column with the subscript letter “D”. These codes are billable through March 31, 2001 for services occurring before January 1, 2001. Deleted codes billed after March 31, 
                            ( print page 67830)
                            2001 will be rejected. CPT codes appearing for the first time in 2001 are denoted in the CPT column with bolded print. These codes are new for 2001 and are billable effective January 1, 2001. All CPT codes that are paid only as inpatient procedures are denoted by the status indicator “C”. A number of procedures that appeared on the inpatient list in the April 7, 2000 final rule with comment period are now payable under the hospital outpatient prospective payment system. The status indicators for these codes have been updated to reflect their current payment status. Addendum A.—List of Hospital Outpatient Ambulatory Payment Classifications With Status Indicators, Relative Weights, Payment Rates, and Coinsurance Amounts, Calendar Year 2001
APC
Group title
Status 
                                 indicator
Relative 
                                 weight
Payment 
                                 rate
National 
                                 unadjusted  
                                 coinsurance
Minimum 
                                 unadjusted  
                                 coinsurance0001
Photochemotherapy
S
0.47
$23.31
$8.49
$4.660002
Fine needle Biopsy/Aspiration
T
0.62
$30.75
$17.66
$6.150003
Bone Marrow Biopsy/Aspiration
T
0.98
$48.61
$27.99
$9.720004
Level I Needle Biopsy/ Aspiration Except Bone Marrow
T
1.84
$91.26
$32.57
$18.250005
Level II Needle Biopsy /Aspiration Except Bone Marrow
T
5.41
$268.32
$119.75
$53.660006
Level I Incision & Drainage
T
2.00
$99.19
$33.95
$19.840007
Level II Incision & Drainage
T
3.68
$182.51
$72.03
$36.500008
Level III Incision & Drainage
T
6.15
$305.02
$113.67
$61.000009
Nail Procedures
T
0.74
$36.70
$9.63
$7.340010
Level I Destruction of Lesion
T
0.55
$27.28
$9.86
$5.460011
Level II Destruction of Lesion
T
2.72
$134.90
$50.01
$26.980012
Level I Debridement & Destruction
T
0.53
$26.29
$9.18
$5.260013
Level II Debridement & Destruction
T
0.91
$45.13
$17.66
$9.030014
Level III Debridement & Destruction
T
1.50
$74.39
$24.55
$14.880015
Level IV Debridement & Destruction
T
1.77
$87.78
$31.20
$17.560016
Level V Debridement & Destruction
T
3.53
$175.07
$74.67
$35.010017
Level VI Debridement & Destruction
T
12.45
$617.47
$289.16
$123.490018
Biopsy Skin, Subcutaneous Tissue or Mucous Membrane
T
0.94
$46.62
$17.66
$9.320019
Level I Excision/ Biopsy
T
4.00
$198.39
$78.91
$39.680020
Level II Excision/ Biopsy
T
6.51
$322.87
$130.53
$64.570021
Level III Excision/ Biopsy
T
10.49
$520.26
$236.51
$104.050022
Level IV Excision/ Biopsy
T
12.49
$619.45
$292.94
$123.890023
Exploration Penetrating Wound
T
1.98
$98.20
$40.37
$19.640024
Level I Skin Repair
T
2.43
$120.51
$44.50
$24.100025
Level II Skin Repair
T
3.74
$185.49
$70.66
$37.100026
Level III Skin Repair
T
12.11
$600.61
$277.92
$120.120027
Level IV Skin Repair
T
15.80
$783.62
$383.10
$156.720028
Level I Incision/Excision Breast
T
12.37
$613.52
$303.74
$122.700029
Level II Incision/Excision Breast
T
31.39
$1,557.05
$820.79
$311.410030
Breast Reconstruction
T
31.11
$1,543.16
$763.55
$308.630032
Placement Transvenous Catheters/Arterial Cutdown
T
5.40
$267.82
$119.52
$53.560033
Partial Hospitalization
P
4.17
$206.82
$48.17
$41.360040
Arthrocentesis & Ligament/Tendon Injection
T
2.11
$104.65
$40.60
$20.930041
Arthroscopy
T
24.57
$1,218.58
$592.08
$243.720042
Arthroscopically-Aided Procedures
T
29.22
$1,449.19
$804.74
$289.840043
Closed Treatment Fracture Finger/Toe/Trunk
T
1.64
$81.34
$25.46
$16.270044
Closed Treatment Fracture/Dislocation Except Finger/Toe/Trunk
T
2.17
$107.63
$38.08
$21.530045
Bone/Joint Manipulation Under Anesthesia
T
11.02
$546.55
$277.12
$109.310046
Open/Percutaneous Treatment Fracture or Dislocation
T
22.29
$1,105.50
$535.76
$221.100047
Arthroplasty without Prosthesis
T
22.09
$1,095.58
$537.03
$219.120048
Arthroplasty with Prosthesis
T
29.06
$1,441.26
$725.94
$288.250049
Level I Musculoskeletal Procedures Except Hand and Foot
T
15.04
$745.93
$356.95
$149.190050
Level II Musculoskeletal Procedures Except Hand and Foot
T
21.13
$1,047.96
$513.86
$209.590051
Level III Musculoskeletal Procedures Except Hand and Foot
T
27.76
$1,376.79
$675.24
$275.360052
Level IV Musculoskeletal Procedures Except Hand and Foot
T
36.16
$1,793.39
$930.91
$358.680053
Level I Hand Musculoskeletal Procedures
T
11.32
$561.42
$253.49
$112.280054
Level II Hand Musculoskeletal Procedures
T
19.66
$975.06
$472.33
$195.010055
Level I Foot Musculoskeletal Procedures
T
15.47
$767.26
$355.34
$153.450056
Level II Foot Musculoskeletal Procedures
T
17.30
$858.02
$405.81
$171.600057
Bunion Procedures
T
21.00
$1,041.52
$496.65
$208.300058
Level I Strapping and Cast Application
S
1.09
$54.06
$19.27
$10.810059
Level II Strapping and Cast Application
S
1.74
$86.30
$29.59
$17.260060
Manipulation Therapy
S
0.77
$38.19
$7.80
$7.640070
Thoracentesis/Lavage Procedures
T
3.64
$180.53
$79.60
$36.110071
Level I Endoscopy Upper Airway
T
0.55
$27.28
$14.22
$5.460072
Level II Endoscopy Upper Airway
T
1.26
$62.49
$41.52
$12.500073
Level III Endoscopy Upper Airway
T
4.11
$203.84
$91.07
$40.770074
Level IV Endoscopy Upper Airway
T
13.61
$675.00
$347.54
$135.000075
Level V Endoscopy Upper Airway
T
18.55
$920.01
$467.29
$184.000076
Endoscopy Lower Airway
T
8.06
$399.75
$197.05
$79.950077
Level I Pulmonary Treatment
S
0.43
$21.33
$12.62
$4.270078
Level II Pulmonary Treatment
S
1.34
$66.46
$29.13
$13.290079
Ventilation Initiation and Management
S
3.18
$157.72
$107.70
$31.540080
Diagnostic Cardiac Catheterization
T
31.55
$1,564.75
$838.92
$312.950081
Non-Coronary Angioplasty or Atherectomy
T
28.81
$1,428.86
$710.91
$285.770082
Coronary Atherectomy
T
51.01
$2,529.89
$1,351.74
$505.980083
Coronary Angioplasty
T
29.70
$1,473.00
$794.30
$294.600084
Level I Electrophysiologic Evaluation
S
10.70
$530.68
$177.79
$106.140085
Level II Electrophysiologic Evaluation
S
27.06
$1,342.07
$654.48
$268.410086
Ablate Heart Dysrhythm Focus
S
47.62
$2,361.76
$1,265.37
$472.350087
Cardiac Electrophysiologic Recording/Mapping
S
9.53
$472.65
$214.72
$94.530088
Thrombectomy
T
26.49
$1,313.80
$678.68
$262.76( print page 67831)0089
Insertion/Replacement of Permanent Pacemaker and Electrodes
T
78.45
$3,890.81
$2,275.19
$778.160090
Insertion/Replacement of Pacemaker Pulse Generator
T
78.28
$3,882.37
$2,133.88
$776.470091
Level I Vascular Ligation
T
14.79
$733.52
$348.23
$146.700092
Level II Vascular Ligation
T
20.21
$1,002.34
$505.37
$200.470093
Vascular Repair/Fistula Construction
T
12.82
$635.82
$277.34
$127.160094
Resuscitation and Cardioversion
S
4.51
$223.68
$105.29
$44.740095
Cardiac Rehabilitation
S
0.64
$31.74
$16.98
$6.350096
Non-Invasive Vascular Studies
S
2.06
$102.16
$61.48
$20.430097
Cardiac Monitoring for 30 days
X
1.62
$80.35
$62.40
$16.070098
Injection of Sclerosing Solution
T
1.19
$59.02
$20.88
$11.800099
Electrocardiograms
S
0.38
$18.85
$14.68
$3.770100
Stress Tests and Continuous ECG
X
1.70
$84.32
$71.57
$16.860101
Tilt Table Evaluation
S
4.47
$221.70
$128.84
$44.340102
Electronic Analysis of Pacemakers/other Devices
S
0.45
$22.32
$12.62
$4.460103
Miscellaneous Vascular Procedures
T
13.09
$649.21
$295.70
$129.840104
Transcatheter Placement of Intracoronary Stents
T
14.94
$740.96
$339.51
$148.190105
Revision/Removal of Pacemakers, AICD, or Vascular Device
T
15.06
$746.92
$372.32
$149.380106
Insertion/Replacement/Repair of Pacemaker Electrodes
T
18.96
$940.34
$503.07
$188.070107
Insertion of Cardioverter-Defibrillator
T
147.51
$7,315.91
$5,086.37
$1,463.180108
Insertion/Replacement/Repair of Cardioverter-Defibrillator Leads
T
210.84
$10,456.84
$5,484.72
$2,091.370109
Removal of Implanted Devices
T
6.53
$323.86
$133.51
$64.770110
Transfusion
S
5.83
$289.15
$122.73
$57.830111
Blood Product Exchange
S
14.17
$702.77
$300.74
$140.550112
Extracorporeal Photopheresis
S
39.60
$1,964.01
$663.65
$392.800113
Excision Lymphatic System
T
13.89
$688.89
$326.55
$137.780114
Thyroid/Lymphadenectomy Procedures
T
19.56
$970.10
$493.78
$194.020115
Cannula/Access Device Procedures
T
19.34
$959.19
$506.74
$191.840116
Chemotherapy Administration by Other Technique Except Infusion
S
2.34
$116.06
$23.21
$23.210117
Chemotherapy Administration by Infusion Only
S
1.84
$91.26
$71.80
$18.250118
Chemotherapy Administration by Both Infusion and Other Technique
S
2.90
$143.83
$72.03
$28.770119
Implantation of Devices
T
9.87
$489.59
$161.50
$97.920120
Infusion Therapy Except Chemotherapy
T
1.66
$82.33
$42.67
$16.470121
Level I Tube changes and Repositioning
T
2.36
$117.05
$52.53
$23.410122
Level II Tube changes and Repositioning
T
5.04
$249.96
$114.93
$49.990123
Bone Marrow Harvesting and Bone Marrow/Stem Cell Transplant
S
4.13
$204.83
$40.97
$40.970124
Revision of Implanted Infusion Pump
T
2.55
$126.64
$81.36
$25.330130
Level I Laparoscopy
T
25.36
$1,257.75
$659.53
$251.550131
Level II Laparoscopy
T
41.81
$2,073.61
$1,089.88
$414.720132
Level III Laparoscopy
T
48.91
$2,425.74
$1,239.22
$485.150140
Esophageal Dilation without Endoscopy
T
4.74
$235.09
$107.24
$47.020141
Upper GI Procedures
T
7.15
$354.61
$184.67
$70.920142
Small Intestine Endoscopy
T
7.45
$369.49
$162.42
$73.900143
Lower GI Endoscopy
T
7.98
$395.78
$199.12
$79.160144
Diagnostic Anoscopy
T
2.23
$110.60
$49.32
$22.120145
Therapeutic Anoscopy
T
7.46
$369.98
$179.39
$74.000146
Level I Sigmoidoscopy
T
2.83
$140.36
$65.15
$28.070147
Level II Sigmoidoscopy
T
6.26
$310.47
$149.11
$62.090148
Level I Anal/Rectal Procedure
T
2.34
$116.06
$43.59
$23.210149
Level II Anal/Rectal Procedure
T
12.86
$637.80
$293.06
$127.560150
Level III Anal/Rectal Procedure
T
17.68
$876.86
$437.12
$175.370151
Endoscopic Retrograde Cholangio-Pancreatography (ERCP)
T
10.53
$522.25
$245.46
$104.450152
Percutaneous Biliary Endoscopic Procedures
T
8.22
$407.68
$207.38
$81.540153
Peritoneal and Abdominal Procedures
T
19.62
$973.08
$496.31
$194.620154
Hernia/Hydrocele Procedures
T
22.43
$1,112.45
$556.98
$222.490157
Colorectal Cancer Screening: Barium Enema
S
1.79
$88.78

$22.190158
Colorectal Cancer Screening: Colonoscopy
S
7.98
$395.78

$98.940159
Colorectal Cancer Screening: Flexible Sigmoidoscopy
S
2.83
$140.36

$35.090160
Level I Cystourethroscopy and other Genitourinary Procedures
T
5.43
$269.30
$110.11
$53.860161
Level II Cystourethroscopy and other Genitourinary Procedures
T
10.94
$542.58
$249.36
$108.520162
Level III Cystourethroscopy and other Genitourinary Procedures
T
17.49
$867.44
$427.49
$173.490163
Level IV Cystourethroscopy and other Genitourinary Procedures
T
28.98
$1,437.30
$792.58
$287.460164
Level I Urinary and Anal Procedures
T
2.17
$107.64
$33.03
$21.530165
Level II Urinary and Anal Procedures
T
3.89
$192.92
$91.76
$38.580166
Level I Urethral Procedures
T
10.17
$504.39
$218.73
$100.880167
Level II Urethral Procedures
T
21.06
$1,044.50
$555.84
$208.900168
Level III Urethral Procedures
T
24.94
$1,236.93
$536.11
$247.390169
Lithotripsy
T
46.72
$2,317.13
$1,384.20
$463.430170
Dialysis for Other Than ESRD Patients
S
6.68
$331.30
$72.26
$66.260180
Circumcision
T
13.62
$675.49
$304.87
$135.100181
Penile Procedures
T
32.37
$1,605.43
$906.36
$321.090182
Insertion of Penile Prosthesis
T
52.11
$2,584.45
$1,525.05
$516.890183
Testes/Epididymis Procedures
T
18.26
$905.62
$448.94
$181.120184
Prostate Biopsy
T
4.94
$245.01
$122.96
$49.000185
Removal or Repair of Penile Prosthesis
T
32.37
$1,605.43
$906.36
$321.090190
Surgical Hysteroscopy
T
17.85
$885.29
$443.89
$177.060191
Level I Female Reproductive Procedures
T
1.19
$59.02
$17.43
$11.800192
Level II Female Reproductive Procedures
T
2.38
$118.04
$35.33
$23.610193
Level III Female Reproductive Procedures
T
8.93
$442.89
$171.13
$88.58( print page 67832)0194
Level IV Female Reproductive Procedures
T
16.21
$803.96
$395.94
$160.790195
Level V Female Reproductive Procedures
T
18.68
$926.46
$483.80
$185.290196
Dilatation & Curettage
T
14.47
$717.66
$357.98
$143.530197
Infertility Procedures
T
2.40
$119.03
$49.55
$23.810198
Pregnancy and Neonatal Care Procedures
T
1.34
$66.46
$33.03
$13.290199
Vaginal Delivery
T
11.20
$555.48
$157.83
$111.100200
Therapeutic Abortion
T
13.89
$688.89
$373.23
$137.780201
Spontaneous Abortion
T
13.00
$644.75
$329.65
$128.950210
Spinal Tap
T
3.00
$148.79
$62.40
$29.760211
Level I Nervous System Injections
T
3.32
$164.66
$74.78
$32.930212
Level II Nervous System Injections
T
3.64
$180.53
$88.78
$36.110213
Extended EEG Studies and Sleep Studies
S
11.15
$553.00
$290.42
$110.600214
Electroencephalogram
S
2.32
$115.06
$58.50
$23.010215
Level I Nerve and Muscle Tests
S
1.15
$57.04
$30.05
$11.410216
Level II Nerve and Muscle Tests
S
2.87
$142.34
$64.69
$28.470217
Level III Nerve and Muscle Tests
S
5.87
$291.13
$156.68
$58.230220
Level I Nerve Procedures
T
13.96
$692.36
$326.21
$138.470221
Level II Nerve Procedures
T
18.36
$910.58
$463.62
$182.120222
Implantation of Neurological Device
T
124.43
$6,171.23
$2,955.13
$1,234.250223
Implantation of Pain Management Device
T
7.05
$349.65
$154.27
$69.930224
Implantation of Reservoir/Pump/Shunt
T
17.89
$887.27
$453.41
$177.450225
Implantation of Neurostimulator Electrodes
T
17.72
$878.84
$408.33
$175.770226
Implantation of Drug Infusion Reservoir
T
5.62
$278.73
$109.42
$55.750227
Implantation of Drug Infusion Device
T
11.17
$553.99
$330.11
$110.800228
Creation of Lumbar Subarachnoid Shunt
T
25.06
$1,242.88
$696.46
$248.580229
Transcatherter Placement of Intravascular Shunts
T
34.81
$1,726.44
$1,030.12
$345.290230
Level I Eye Tests
S
0.98
$48.61
$22.48
$9.720231
Level II Eye Tests
S
2.64
$130.94
$59.87
$26.190232
Level I Anterior Segment Eye
T
6.04
$299.56
$134.66
$59.910233
Level II Anterior Segment Eye
T
13.79
$683.93
$331.60
$136.790234
Level III Anterior Segment Eye Procedures
T
20.64
$1,023.66
$502.16
$204.730235
Level I Posterior Segment Eye Procedures
T
2.94
$145.81
$78.91
$29.160236
Level II Posterior Segment Eye Procedures
T
6.70
$332.29
$147.96
$66.460237
Level III Posterior Segment Eye Procedures
T
33.96
$1,684.28
$852.68
$336.860238
Level I Repair and Plastic Eye Procedures
T
2.80
$138.87
$58.96
$27.770239
Level II Repair and Plastic Eye Procedures
T
6.26
$310.47
$123.42
$62.090240
Level III Repair and Plastic Eye Procedures
T
13.47
$668.06
$315.31
$133.610241
Level IV Repair and Plastic Eye Procedures
T
16.60
$823.30
$384.47
$164.660242
Level V Repair and Plastic Eye Procedures
T
23.70
$1,175.42
$597.36
$235.080243
Strabismus/Muscle Procedures
T
17.99
$892.23
$431.39
$178.450244
Corneal Transplant
T
32.88
$1,630.72
$851.42
$326.140245
Cataract Procedures without IOL Insert
T
26.55
$1,316.77
$623.85
$263.350246
Cataract Procedures with IOL Insert
T
26.55
$1,316.77
$623.85
$263.350247
Laser Eye Procedures Except Retinal
T
4.89
$242.52
$112.86
$48.500248
Laser Retinal Procedures
T
4.19
$207.81
$94.05
$41.560250
Nasal Cauterization/Packing
T
2.21
$109.61
$38.54
$21.920251
Level I ENT Procedures
T
1.68
$83.32
$27.99
$16.660252
Level II ENT Procedures
T
5.18
$256.90
$114.24
$51.380253
Level III ENT Procedures
T
12.02
$596.14
$284.00
$119.230254
Level IV ENT Procedures
T
12.45
$617.47
$272.41
$123.490256
Level V ENT Procedures
T
25.40
$1,259.74
$623.05
$251.950258
Tonsil and Adenoid Procedures
T
18.62
$923.48
$462.81
$184.700260
Level I Plain Film Except Teeth
X
0.79
$39.18
$22.02
$7.840261
Level II Plain Film Except Teeth Including Bone Density Measurement
X
1.38
$68.44
$38.77
$13.690262
Plain Film of Teeth
X
0.40
$19.83
$10.90
$3.970263
Level I Miscellaneous Radiology Procedures
X
1.68
$83.32
$45.88
$16.660264
Level II Miscellaneous Radiology Procedures
X
3.83
$189.96
$108.97
$37.990265
Level I Diagnostic Ultrasound Except Vascular
S
1.17
$58.03
$38.08
$11.610266
Level II Diagnostic Ultrasound Except Vascular
S
1.79
$88.78
$57.35
$17.760267
Vascular Ultrasound
S
2.72
$134.90
$80.06
$26.980268
Guidance Under Ultrasound
X
2.23
$110.60
$69.51
$22.120269
Echocardiogram Except Transesophageal
S
4.40
$218.22
$114.01
$43.640270
Transesophageal Echocardiogram
S
5.55
$275.25
$150.26
$55.050271
Mammography
S
0.70
$34.72
$19.50
$6.940272
Level I Fluoroscopy
X
1.40
$69.43
$39.00
$13.890273
Level II Fluoroscopy
X
2.49
$123.49
$61.02
$24.700274
Myelography
S
4.83
$239.55
$128.12
$47.910275
Arthrography
S
2.74
$135.89
$72.26
$27.180276
Level I Digestive Radiology
S
1.79
$88.78
$49.78
$17.760277
Level II Digestive Radiology
S
2.47
$122.50
$69.28
$24.500278
Diagnostic Urography
S
2.85
$141.35
$81.67
$28.270279
Level I Angiography and Venography except Extremity
S
6.30
$312.46
$174.57
$62.490280
Level II Angiography and Venography except Extremity
S
14.98
$742.95
$380.12
$148.590281
Venography of Extremity
S
4.40
$218.22
$115.16
$43.640282
Level I Computerized Axial Tomography
S
2.38
$118.04
$94.51
$23.610283
Level II Computerized Axial Tomography
S
4.89
$242.52
$179.39
$48.500284
Magnetic Resonance Imaging
S
8.02
$397.76
$257.39
$79.550285
Positron Emission Tomography (PET)
S
15.06
$746.92
$415.21
$149.38( print page 67833)0286
Myocardial Scans
S
7.28
$361.06
$200.04
$72.210290
Standard Non-Imaging Nuclear Medicine
S
1.94
$96.21
$55.51
$19.240291
Level I Diagnostic Nuclear Medicine Excluding Myocardial Scans
S
3.15
$156.22
$93.14
$31.240292
Level II Diagnostic Nuclear Medicine Excluding Myocardial Scans
S
4.36
$216.24
$126.63
$43.250294
Level I Therapeutic Nuclear Medicine
S
5.13
$254.43
$144.06
$50.890295
Level II Therapeutic Nuclear Medicine
S
19.85
$984.48
$609.17
$196.900296
Level I Therapeutic Radiologic Procedures
S
3.57
$177.06
$100.25
$35.410297
Level II Therapeutic Radiologic Procedures
S
6.13
$304.03
$172.51
$60.810300
Level I Radiation Therapy
S
1.98
$98.20
$47.72
$19.640301
Level II Radiation Therapy
S
2.21
$109.61
$52.53
$21.920302
Level III Radiation Therapy
S
8.21
$407.18
$216.55
$81.440303
Treatment Device Construction
X
2.83
$140.36
$69.28
$28.070304
Level I Therapeutic Radiation Treatment Preparation
X
1.49
$73.90
$41.52
$14.780305
Level II Therapeutic Radiation Treatment Preparation
X
4.06
$201.36
$97.50
$40.270310
Level III Therapeutic Radiation Treatment Preparation
X
13.98
$693.35
$339.05
$138.670311
Radiation Physics Services
X
1.32
$65.46
$31.66
$13.090312
Radioelement Applications
S
4.09
$202.85
$109.65
$40.570313
Brachytherapy
S
7.89
$391.31
$164.02
$78.260314
Hyperthermic Therapies
S
5.88
$291.62
$150.95
$58.320320
Electroconvulsive Therapy
S
3.68
$182.51
$80.06
$36.500321
Biofeedback and Other Training
S
1.26
$62.49
$29.25
$12.500322
Brief Individual Psychotherapy
S
1.32
$65.46
$14.22
$13.090323
Extended Individual Psychotherapy
S
1.85
$91.75
$22.48
$18.350324
Family Psychotherapy
S
1.87
$92.74
$20.19
$18.550325
Group Psychotherapy
S
1.55
$76.88
$19.96
$15.380330
Dental Procedures
S
1.51
$74.89
$14.98
$14.980340
Minor Ancillary Procedures
X
1.04
$51.58
$12.85
$10.320341
Immunology Tests
X
0.13
$6.44
$3.67
$1.290342
Level I Pathology
X
0.26
$12.90
$8.03
$2.580343
Level II Pathology
X
0.45
$22.32
$12.16
$4.460344
Level III Pathology
X
0.79
$39.18
$23.63
$7.840345
Transfusion Laboratory Procedures Level I
X
0.22
$10.92
$5.37
$2.180346
Transfusion Laboratory Procedures Level II
X
0.51
$25.49
$12.03
$5.100347
Transfusion Laboratory Procedures Level III
X
0.84
$41.90
$20.13
$8.380348
Fertility Laboratory Procedures
X
0.52
$25.57
$5.11
$5.110349
Miscellaneous Laboratory Procedures
X
0.48
$23.65
$4.73
$4.730354
Administration of Influenza/Pneumonia Vaccine
K
0.13
$6.330355
Level I Immunizations
K
0.19
$9.42
$5.05
$1.880356
Level II Immunizations
K
0.36
$17.86
$4.82
$3.570359
Injections
X
0.96
$47.61
$9.52
$9.520360
Level I Alimentary Tests
X
1.38
$68.44
$34.75
$13.690361
Level II Alimentary Tests
X
3.53
$175.07
$88.09
$35.010362
Fitting of Vision Aids
X
0.51
$25.30
$9.63
$5.060363
Otorhinolaryngologic Function Tests
X
2.83
$140.36
$53.22
$28.070364
Level I Audiometry
X
0.68
$33.72
$13.31
$6.740365
Level II Audiometry
X
1.47
$72.91
$22.48
$14.580367
Level I Pulmonary Test
X
0.83
$41.16
$20.65
$8.230368
Level II Pulmonary Tests
X
1.66
$82.33
$42.44
$16.470369
Level III Pulmonary Tests
X
2.34
$116.06
$58.50
$23.210370
Allergy Tests
X
0.57
$28.27
$11.81
$5.650371
Allergy Injections
X
0.32
$15.87
$3.67
$3.170372
Therapeutic Phlebotomy
X
0.43
$21.33
$10.09
$4.270373
Neuropsychological Testing
X
3.21
$159.20
$44.96
$31.840374
Monitoring Psychiatric Drugs
X
1.17
$58.03
$13.08
$11.610600
Low Level Clinic Visits
V
0.98
$48.61
$9.72
$9.720601
Mid Level Clinic Visits
V
1.00
$49.60
$9.92
$9.920602
High Level Clinic Visits
V
1.66
$82.33
$16.47
$16.470610
Low Level Emergency Visits
V
1.34
$66.46
$20.65
$13.290611
Mid Level Emergency Visits
V
2.11
$104.65
$36.47
$20.930612
High Level Emergency Visits
V
3.19
$158.21
$54.14
$31.640620
Critical Care
S
8.60
$426.53
$152.78
$85.310701
SR 89 chloride, per mCi
G

$783.75

$95.620702
SM 153 lexidronam, 50 mCi
G

$942.09

$134.870704
IN 111 Satumomab pendetide per dose
G

$712.50

$86.930705
TC 99M tetrofosmin, per dose
G

$136.80

$16.690725
Leucovorin calcium inj, 50 mg
G

$49.73

$6.660726
Dexrazoxane hcl injection, 250 mg
G

$161.11

$21.590727
Etidronate disodium inj 300 mg
G

$63.65

$8.530728
Filgrastim 300 mcg injection
G

$171.38

$22.960730
Pamidronate disodium, 30 mg
G

$232.51

$31.160731
Sargramostim injection 50 mcg
G

$27.42

$3.670732
Mesna injection 200 mg
G

$36.51

$4.890733
Non esrd epoetin alpha inj, 1000 u
G

$11.40

$1.530750
Dolasetron mesylate, 10 mg
G

$14.81

$1.980754
Metoclopramide hcl injection up to 10 mg
G

$2.00

$0.270755
Thiethylperazine maleate inj up to 10 mg
G

$5.02

$0.670761
Unspecified oral anti-emetic
G

$0.60

$0.080762
Dronabinol 2.5mg oral
G

$3.20

$0.48( print page 67834)0763
Dolasetron mesylate oral, 100 mg
G

$65.21

$8.740764
Granisetron hcl injection 100 mcg
G

$1.85

$0.250765
Granisetron hcl 1 mg oral
G

$44.70

$5.990768
Ondansetron hcl injection 1 mg
G

$6.09

$0.820769
Ondansetron hcl 8mg oral
G

$25.15

$3.370800
Leuprolide acetate, 3.75 mg
G

$492.71

$63.270801
Cyclophosphamide oral 25 mg
G

$2.12

$0.280802
Etoposide oral 50 mg
G

$45.95

$6.160803
Melphalan oral 2 mg
G

$2.07

$0.280807
Aldesleukin/single use vial
G

$569.76

$76.350809
Bcg live intravesical vac
G

$159.39

$19.450810
Goserelin acetate implant 3.6 mg
G

$446.49

$59.830811
Carboplatin injection 50 mg
G

$98.90

$13.250812
Carmus bischl nitro inj 100 mg
G

$103.27

$13.840813
Cisplatin 10 mg injection
G

$42.18

$5.650814
Asparaginase injection 10,000 u
G

$57.41

$7.690815
Cyclophosphamide 100 mg inj
G

$6.13

$0.820816
Cyclophosphamide lyophilized 100 mg
G

$6.13

$0.820817
Cytarabine hcl 100 mg inj
G

$5.94

$0.800818
Dactinomycin 0.5 mg
G

$12.73

$1.710819
Dacarbazine 10 mg inj
G

$1.13

$0.150820
Daunorubicin 10 mg
G

$80.04

$10.730821
Daunorubicin citrate liposom 10 mg
G

$64.60

$8.660822
Diethylstilbestrol injection 250 mg
G

$4.20

$0.560823
Docetaxel, 20 mg
G

$283.65

$38.010824
Etoposide 10 mg inj
G

$4.06

$0.540826
Methotrexate Oral 2.5 mg
G

$2.92

$0.390827
Floxuridine injection 500 mg
G

$129.56

$17.360828
Gemcitabine HCL 200 mg
G

$88.46

$11.850830
Irinotecan injection 20 mg
G

$117.81

$15.790831
Ifosfomide injection 1 gm
G

$141.50

$18.960832
Idarubicin hcl injection 5 mg
G

$341.38

$45.750833
Interferon alfacon-1, 1 mcg
G

$3.91

$0.520834
Interferon alfa-2a inj recombinant 3 million u
G

$33.22

$4.450836
Interferon alfa-2b inj recombinant, 1 million
G

$11.28

$1.510838
Interferon gamma 1-b inj, 3 million u
G

$199.50

$26.730839
Mechlorethamine hcl inj 10 mg
G

$11.01

$1.480840
Melphalan hydrochl 50 mg
G

$363.48

$48.710841
Methotrexate sodium inj 5 mg
G

$0.45

$0.060842
Fludarabine phosphate inj 50 mg
G

$237.03

$31.760843
Pegaspargase, singl dose vial
G

$1,321.65

$177.100844
Pentostatin injection, 10 mg
G

$1,562.75

$209.410847
Doxorubicin hcl 10 mg vl chemo
G

$15.79

$2.120849
Rituximab, 100 mg
G

$420.29

$56.320850
Streptozocin injection, 1 gm
G

$65.79

$8.820851
Thiotepa injection, 15 mg
G

$100.30

$13.440852
Topotecan, 4 mg
G

$573.75

$76.880853
Vinblastine sulfate inj, 1 mg
G

$4.11

$0.550854
Vincristine sulfate 1 mg inj
G

$30.16

$4.040855
Vinorelbine tartrate, 10 mg
G

$75.51

$10.120856
Porfimer sodium, 75 mg
G

$2,603.67

$348.890857
Bleomycin sulfate injection 15 u
G

$294.48

$39.460858
Cladribine, 1mg
G

$53.47

$7.160859
Fluorouracil injection 500 mg
G

$2.75

$0.370860
Plicamycin (mithramycin) inj 2.5 mg
G

$93.80

$12.570861
Leuprolide acetate injection 1 mg
G

$22.90

$3.070862
Mitomycin 5 mg inj
G

$121.65

$16.300863
Paclitaxel injection, 30 mg
G

$173.50

$23.250864
Mitoxantrone hcl, 5 mg
G

$223.02

$29.880865
Interferon alfa-n3 inj, human leukocyte derived, 250,000 iu
G

$7.86

$1.050884
Rho d immune globulin inj, 1 dose pkg
G

$35.91

$4.380886
Azathioprine oral 50mg
G

$1.24

$0.170887
Azathioprine parenteral 100 mg
G

$67.88

$9.100888
Cyclosporine oral 100 mg
G

$5.80

$0.780889
Cyclosporin parenteral 250mg
G

$15.81

$2.120890
Lymphocyte immune globulin 250 mg
G

$249.13

$30.390891
Tacrolimus oral per 1 mg
G

$2.66

$0.360900
Alglucerase injection, per 10 u
G

$37.53

$5.030901
Alpha 1 proteinase inhibitor, 10 mg
G

$2.09

$0.280902
Botulinum toxin a, per unit
G

$4.39

$0.590903
Cytomegalovirus imm IV, vial
G

$370.50

$49.650905
Immune globulin 500 mg
G

$27.28

$3.330906
RSV-ivig, 50 mg
G

$427.73

$57.320907
Ganciclovir Sodium 500 mg injection
K
0.45
$22.26

$4.450908
Tetanus immune globulin inj up to 250 u
G

$102.60

$13.750909
Interferon beta-1a, 33 mcg
G

$204.73

$27.430910
Interferon beta-1b, .25 mg
G

$57.00

$7.640911
Streptokinase per 250,000 iu
K
1.76
$87.25

$17.45( print page 67835)0913
Ganciclovir long act implant 4.5 mg
G

$4,750.00

$636.500914
Reteplase, per 37.6mg
G

$2,612.50

$350.080915
Alteplase inj rec, per 10 mg
K
3.80
$188.46

$37.690916
Imiglucerase, unit
G

$3.75

$0.500917
Pharmacologic stressors
K
0.36
$17.86

$3.570918
Brachytherapy Seeds, Any type, Each
H0925
Factor viii per iu
G

$0.88

$0.120926
Factor VIII (porcine) per iu
G

$2.09

$0.280927
Factor viii recombinant per iu
G

$1.17

$0.160928
Factor ix complex per iu
G

$.71

$0.100929
Anti-inhibitor per iu
G

$1.43

$0.190930
Antithrombin iii injection per iu
G

$.82

$0.110931
Factor IX non-recombinant, per iu
G

$0.72

$0.100932
Factor IX recombinant, per iu
G

$1.12

$0.100949
Plasma, Pooled Multiple Donor, Solvent/Detergent Treated, Frozen
K
2.94
$145.76

$29.150950
Blood (Whole) For Transfusion
K
2.08
$103.33

$20.670952
Cryoprecipitate
K
0.70
$34.70

$6.940953
Fibrinogen Unit
K
0.48
$23.80

$4.760954
RBC Leukocytes Reduced
K
2.83
$140.35

$28.070955
Plasma, Fresh Frozen
K
2.26
$111.85

$22.370956
Plasma Protein Fraction
K
1.26
$62.49

$12.500957
Platelet Concentrate
K
0.98
$48.55

$9.710958
Platelet Rich Plasma
K
1.16
$57.54

$11.510959
Red Blood Cells
K
2.04
$101.31

$20.260960
Washed Red Blood Cells
K
3.81
$188.75

$37.750961
Infusion, Albumin (Human) 5%, 500 ml
K
2.77
$137.38

$27.480962
Infusion, Albumin (Human) 25%, 50 ml
K
1.38
$68.44

$13.690970
New Technology— I ($0-$50)
T
0.52
$25.79

$5.160971
New Technology— II ($50-$100)
S
1.55
$76.88

$15.380972
New Technology— III ($100-$200)
T
3.09
$153.26

$30.650973
New Technology— IV ($200-$300)
T
5.16
$255.91

$51.180974
New Technology— V ($300-$500)
S
8.25
$409.17

$81.830975
New Technology— VI ($500-$750)
T
12.90
$639.79

$127.960976
New Technology— VII ($750-$1000)
S
18.05
$895.21

$179.040977
New Technology— VIII ($1000-$1250)
T
23.20
$1,150.63

$230.130978
New Technology— IX ($1250-$1500)
T
28.36
$1,406.54

$281.310979
New Technology— X ($1500-$1750)
T
33.51
$1,661.96

$332.390980
New Technology— XI ($1750-$2000)
T
38.67
$1,917.89

$383.580981
New Technology— XII ($2000-$2500)
S
46.40
$2,301.26

$460.250982
New Technology— XIII ($2500-$3500)
T
61.87
$3,068.50

$613.700983
New Technology— XIV ($3500-$5000)
T
87.65
$4,347.09

$869.420984
New Technology— XV ($5000-$6000)
T
113.43
$5,625.67

$1,125.130987
New Device Technology— I ($0-$250)
X

$127.86

$25.570988
New Device Technology— II ($250-$500)
X

$383.58

$76.720989
New Device Technology— III ($500-$750)
X

$639.30

$127.860990
New Device Technology— IV ($750-$1000)
X

$895.01

$179.000991
New Device Technology— V ($1000-$1500)
X

$1,278.59

$255.720992
New Device Technology— VI ($1500-$2000)
X

$1,790.03

$358.010993
New Device Technology— VII ($2000-$3000)
X

$2,557.18

$511.440994
New Device Technology— VIII ($3000-$4000)
X

$3,580.05

$716.010995
New Device Technology— IX ($4000-$5000)
X

$4,602.92

$920.580996
New Device Technology— X ($5000-$7000)
X

$6,137.23

$1,227.450997
New Device Technology— XI ($7000-$9000)
X

$8,182.98

$1,636.601000
Perclose Closer Prostar Arterial Vascular Closure
H1001
AcuNav-diagnstic ultrsnd ca
H1002
Cochlear Implant System
H1003
Cath, ablation, Livewire TC
H1004
Fast-Cath,Swartz,SAFL,CSTA
H1006
ARRAY post chamb IOL
H1007
Ams 700 penile prosthesis
H1008
Urolume-implt urethral stent
H1009
Plasma, cryoprecipitate-reduced, unit
K
0.86
$42.76

$8.551010
Blood, L/R, CMV-neg
K
2.88
$142.84

$28.571011
Platelets, L/R, CMV-neg, unit
K
11.86
$588.15

$117.631012
Platelet concentrate, L/R, irradiated, unit
K
1.92
$95.23

$19.051013
Platelet concentrate, L/R, unit
K
1.18
$58.30

$11.661014
Platelets, aph/pher, L/R, unit
K
8.93
$443.11

$88.621016
Blood, L/R, froz/deglycerol/washed
K
7.15
$354.68

$70.941017
Platelets, aph/pher, L/R, CMV-neg, unit
K
9.33
$462.54

$92.511018
Blood, L/R, irradiated
K
3.13
$155.48

$31.101019
Platelets, aph/pher, L/R, irradiated, unit
K
9.64
$478.09

$95.621024
Quinupristin 150 mg/dalfopriston 350 mg
J

$102.05

$13.671025
Marinr CS catheter
H1026
RF Perfrmr cath 5F RF Marinr
H1027
Magic x/short, Radius14mm
H1028
Prcis Twst trnsvg anch sys
H1029
CRE guided balloon dil cath
H1030
Cthtr:Mrshal,Blu Max Utr Dmnd
H( print page 67836)1033
Sonicath mdl 37-410
H1034
SURPASS, Long30 SURPASS-cath
H1035
Cath, Ultra ICE
H1036
R port/reservoir impl dev
H1037
Vaxcelchronic dialysis cath
H1038
UltraCross Imaging Cath
H1039
Wallstent/RP: Trach
H1040
Wallstent/RP TIPS—20/40/60
H1042
Wallstent, UltraFlex: Bil
H1043
Atherectomy sys, coronary
H1045
I-131 MIBG (ioben-sulfate) O.5mCi
G

$1,140.00

$139.081047
Navi-Star, Noga-Star cath
H1048
NeuroCyberneticPros: gen
H1051
Oasis Thrombectomy Cath
H1053
EnSite 3000 catheter
H1054
Hydrolyser Thromb Cath 6/7F
H1055
Transesoph 210, 210-S Cath
H1056
Thermachoice II Cath
H1057
Micromark Tissue Marker
H1059
Carticel,auto cult-chndr cyte
G

$14,250.00

$2,010.001060
ACS multi-link tristor stent
H1061
ACS Viking Guiding cath
H1063
EndoTak Endurance EZ, RX leads
H1067
Megalink biliary stent
H1068
Pulsar DDD pmkr
H1069
Discovery DR, pmaker
H1071
Pulsar Max, Pulsar SR pmkr
H1072
Guidant: blln dil cath
H1073
Gynecare Morcellator
H1074
RX/OTW Viatrac-peri dil cath
H1075
Guidant: lead
H1076
Ventak mini sc defib
H1077
Ventak VR Prizm VR, sc defib
H1078
Ventak: Prizm, AVIIIDR defib
H1079
CO 57/58 0.5 mCi
G

$264.10

$32.221084
Denileukin diftitox, 300 mcg
G

$942.88

$126.351086
Temozolomide, 5 mg
G

$5.70

$0.761087
I-123 per uCi capsule
G

$0.84

$0.101089
CO 57, 0.5 mCi
G

$91.20

$11.131090
IN 111 Chloride, per mCi
G

$152.00

$18.541091
IN 111 Oxyquinoline, per 5 mCi
G

$508.25

$62.011092
IN 111 Pentetate, per 1.5 mCi
G

$769.50

$93.881094
TC 99M Albumin aggr, per vial
J

$34.20

$4.171095
TC 99M Depreotide, per vial
G

$760.00

$101.841096
TC 99M Exametazime, per dose
G

$445.31

$63.751097
TC 99M Mebrofenin, per vial
G

$46.76

$5.711098
TC 99M Pentetate, per vial
G

$22.80

$2.781099
TC 99M Pyrophosphate, per vial
J

$42.75

$5.221100
Medtronic AVE GT1 guidewire
H1101
Medtronic AVE, AVE Z2 cath
H1102
Synergy Neurostim Genrtr
H1103
Micro Jewel Defibrillator
H1104
RF Conductor Ablative Cath
H1105
Sigma 300VDD pacmker
H1106
SynergyEZ Pt Progrmr
H1107
Torqr, Solist cath
H1108
Reveal Cardiac Recorder
H1109
Implantable anchor: Ethicon
H1110
Stable Mapper, cath electrd
H1111
AneuRxAort-Uni-Ilicstnt&cath
H1112
AneuRx Stent graft/del.cath
H1113
Tlnt Endo Sprng Stnt Grft Sys
H1114
TalntSprgStnt+Graf endo pros
H1115
5038S,5038,5038L pace lead
H1116
CapSureSP pacing Lead
H1117
Ancure Endograft Del Sys
H1118
Sigma300DR LegIIDR,pacemkr
H1119
Sprint6932,6943 defib lead
H1120
Sprint6942,6945 defib lead
H1121
Gem defibrillator
H1122
TC 99M arcitumomab per dose
G

$926.25

$124.121123
Gem II VR defibrillator
H1124
InterStim Test Stim Kit
H1125
Kappa 400SR,Ttopaz II SR pmkr
H1126
Kappa 700 DR pacemakr
H1127
Kappa 700SR,pmkr sgl chamber
H1128
Kappa 700D,Ruby IID pmkr
H1129
Kappa 700VDD,pacmkr
H( print page 67837)1130
Sigma 200D,LGCY IID sc pmkr
H1131
Sigma 200DR, pmker
H1132
Sigma 200SR Leg II:sc pac
H1133
Sigma SR, Vita SR, pmaker
H1134
Sigma 300D pmker
H1135
Entity DR 5326L/R, DC, pmkr
H1136
Affinity DR 5330L/R, DC, pmkr
H1137
CardioSEAL implant syst
H1143
AddVent mod 2060BL,VDD
H1144
Afnty SP 5130,Integrity SR,pmkr
H1145
Angio-Seal 6fr, 8fr
H1147
AV Plus DX 1368: lead
H1148
Contour MD sc defib
H1149
Entity DC 5226R-pmker
H1151
Passiveplus DX lead, 10mdls
H1152
LifeSite Access System
H1153
Regency SC+ 2402L pmker
H1154
SPL:SPOI,02,04− defib lead
H1155
Repliform 8 sq cm
H1156
Tr 1102TrSR+ 2260L,2264L,5131
H1157
Trilogy DCT 23/8L pmkr
H1158
TVL lead SV01,SV02,SV04
H1159
TVL RV02,RV06,RV07: lead
H1160
TVL-ADX 1559: lead
H1161
Tendril DX, 1388 pacing lead
H1162
TempoDr, TrilogyDR+DC pmkr
H1163
Tendril SDX, 1488T pacing lead
H1164
Iodine-125 brachytx seed
H1166
Cytarabine liposomal, 10 mg
G

$371.45

$49.771167
Epirubicin hcl, 2 mg
J

$24.94

$3.341171
Autosuture site marker stple
H1172
Spacemaker dissect ballon
H1173
Cor stntS540,S670,o-wire stn
H1174
Bard brachytx needle
H1178
Busulfan IV, 6 mg
G

$26.48

$3.551180
Vigor SR, SC, pmkr
H1181
Meridian SSI, SC, pmkr
H1182
Pulsar SSI, SC, pmkr
H1183
Jade IIS, Sigma 300S,SC, pmkr
H1184
Sigma 200S, SC, pmkr
H1188
I 131, per mCi
G

$5.86

$0.751200
TC 99M Sodium Glucoheptonate, per vial
G

$113.05

$13.791201
TC 99M succimer, per vial
G

$135.66

$16.551202
TC 99M Sulfur Colloid, per dose
G

$38.00

$4.641203
Verteporfin for Injection
G

$1,458.25

$195.411205
TC 99M Disofenin, per vial
G

$427.50

$57.291207
Octreotide acetate depot 1mg
G

$135.10

$16.481302
SQ01: lead
H1303
CapSure Fix 6940/4068-110, lead
H1304
Sonicath mdl 37-416,-418
H1305
Apligraf
G

$1,157.81

$163.311306
NeuroCyberneticPros: lead
H1311
Trilogy DR+/DAO pmkr
H1312
Magic WALLSTENT stent-Mini
H1313
Magic medium, Radius 31mm
H1314
Magic WALLSTENT stent-Long
H1315
Vigor DR, Meridian DR pmkr
H1316
Meridian DDD pmkr
H1317
Discovery SR, pmkr
H1318
Meridian SR pmakr
H1319
Wallstent/RP Enteral--60mm
H1320
Wallstent/RP Iliac Del Sys
H1325
Pallidium −103 seed
H1326
Angio-jet rheolytic thromb cath
H1328
ANS Renew NS trnsmtr
H1333
PALMZA Corinthian bill stent
H1334
Crown,Mini-crown,CrossLC
H1335
Mesh, Prolene
H1336
Constant Flow Imp Pump
H1337
IsoMed 8472-20/35/60
H1348
I 131 per mCi solution
G

$146.57

$17.881350
Prosta/OncoSeed, RAPID strand, I-125
H1351
CapSure(Fix)pacing lead
H1352
Gem II defib
H1353
Itrel Interstm neurostim+ext
H1354
Kappa 400DR,Diamond II 820DR
H1355
Kappa 600DR, Vita DR
H1356
Profile MD V-186HV3 sc defib
H( print page 67838)1357
Angstrom MD V-190HV3 sc defib
H1358
Affinity DC 5230R-Pacemaker
H1359
Pulsar,Pulsar Max DR,pmkr
H1363
Gem DR, DC, defib
H1364
Photon DR V-230HV3 DC defib
H1365
Guidewire, Hi-Torque14/18/35
H1366
Guidewire,PTCA, Hi-Torque
H1367
Guidewire, Hi-Torque CrossIt
H1369
ANS Renew Stim Sys recvr
H1370
Tension-Free Vaginal Tape
H1371
Symp Nitinol Transhep Bil Sys
H1372
Cordis Nitinol bil stent
H1375
Stent, coronary, NIR
H1376
ANS Renew Stim Sys lead
H1377
Specify 3988 neuro lead
H1378
InterStim Tx 3080/3886 lead
H1379
Pisces-Quad 3887 lead
H1400
Diphenhydramine hcl 50mg
G

$1.18

$.161401
Prochlorperazine maleate 5mg
G

$1.31

$.181402
Promethazine hcl 12.5mg oral
G

$.03

$.001403
Chlorpromazine hcl 10mg oral
G

$.55

$.071404
Trimethobenzamide hcl 250mg
G

$.36

$.051405
Thiethylperazine maleate10mg
G

$.69

$.091406
Perphenazine 4mg oral
G

$.71

$.101407
Hydroxyzine pamoate 25mg
G

$.20

$.031409
Factor viia recombinant, per 1.2 mg
G

$1,596.00

$213.861410
Prosorba column
H1411
Herculink,OTW SDS bil stent
H1420
StapleTac2 Bone w/Dermis
H1421
StapleTac2 Bone wo Dermis
H1450
Orthosphere Arthroplasty
H1451
Orthosphere Arthroplasty Kit
H1500
Atherectomy sys, peripheral
H1600
TC 99M sestamibi, per syringe
G

$109.25

$13.331601
TC 99M medronate, per dose
G

$38.38

$4.681602
TC 99M apcitide, per vial
G

$47.50

$5.801603
TL 201, mCi
G

$28.50

$3.481604
IN 111 capromab pendetide, per dose
G

$1,008.90

$135.191605
Abciximab injection, 10 mg
G

$513.02

$68.741606
Anistreplase, 30 u
G

$2,693.80

$360.971607
Eptifibatide injection, 5 mg
G

$12.57

$1.681608
Etanercept injection, 25 mg
G

$134.42

$18.011609
Rho(D) immune globulin h, sd, 100 iu
G

$20.55

$2.511611
Hylan G-F 20 injection, 16 mg
G

$204.87

$27.451612
Daclizumab, parenteral, 25 mg
G

$397.29

$53.241613
Trastuzumab, 10 mg
G

$48.85

$6.551614
Valrubicin, 200 mg
G

$423.23

$56.711615
Basiliximab, 20 mg
G

$1,250.01

$167.501616
Histrelin Acetate, 0.5 mg
G

$14.91

$2.001617
Lepirdin, 50 mg
G

$124.49

$16.681618
Von Willebrand factor, per iu
G

$.95

$.131619
Ga 67, per mCi
G

$25.97

$3.171620
TC 99M Bicisate, per vial
G

$417.53

$55.951621
Xe 133, per mCi
G

$28.50

$3.661622
TC 99M Mertiatide, per vial
G

$185.82

$24.901623
TC 99M Gluceptate
G

$22.61

$2.761624
P32 sodium, per mCi
G

$74.10

$9.041625
IN 111 Pentetreotide, per mCi
G

$283.42

$37.981626
TC 99M Oxidronate, per vial
G

$38.38

$4.681627
TC-99 labeled red blood cell, per test
G

$38.95

$4.751628
P32 phosphate chromic, per mCi
G

$137.12

$16.731700
Authen Mick TP brachy needle
H1701
Medtec MT-BT-5201-25 ndl
H1702
WWMT brachytx needle
H1703
Mentor Prostate Brachy
H1704
MT-BT-5001-25/5051-25
H1705
Best Flexi Brachy Needle
H1706
Indigo Prostate Seeding Ndl
H1707
Varisource Implt Ndl
H1708
UroMed Prostate Seed Ndl
H1709
Remington Brachytx Needle
H1710
US Biopsy Prostate Needle
H1711
MD Tech brachytx needle
H1712
Imagyn brachytx needle
H1790
Iridium 192 HDR
H1791
OncoSeed, Rapid Strand I-125
H1792
UroMed I-125 Brachy seed
H1793
Bard InterSource P-103 seed
H( print page 67839)1794
Bard IsoSeed P-103 seed
H1795
Bard BrachySource I-125
H1796
SourceTech Med I-125
H1797
Draximage I-125 seed
H1798
Syncor I-125 PharmaSeed
H1799
I-Plant I-125 Brachytx seed
H1800
Pd-103 brachytx seed
H1801
IoGold I-125 brachytx seed
H1802
Iridium 192 brachytx seeds
H1803
Best Iodine 125 brachytx sds
H1804
Best Palladium 103 seeds
H1805
IsoStar Iodine-125 seeds
H1806
Gold 198
H1810
D114S Dilatation Cath
H1811
Surgical Dynamics Anchors
H1812
OBL Anchors
H1850
Repliform 14/21 sq cm
H1851
Repliform 24/28 sq cm
H1852
TransCyte, per 247 sq cm
H1853
Suspend, per 8/14 sq cm
H1854
Suspend, per 24/28 sq cm
H1855
Suspend, per 36 sq cm
H1856
Suspend, per 48 sq cm
H1857
Suspend, per 84 sq cm
H1858
DuraDerm, per 8/14 sq cm
H1859
DuraDerm, per 21/24/28 sq cm
H1860
DuraDerm, per 48 sq cm
H1861
DuraDerm, per 36 sq cm
H1862
DuraDerm, per 72 sq cm
H1863
DuraDerm, per 84 sq cm
H1864
SpermaTex, per 13.44 sq cm
H1865
FasLata, per 8/14 sq cm
H1866
FasLata, per 24/28 sq cm
H1867
FasLata, per 36/48 sq cm
H1868
FasLata, per 96 sq cm
H1869
Gore Thyroplasty Dev
H1870
DermMatrix, per 16 sq cm
H1871
DermMatrix, 32 or 64 sq cm
H1872
Dermagraft, per 37.5 sq cm
H1873
Bard 3DMax Mesh
H1929
Maverick PTCA Cath
H1930
Coyote Dil Cath, 20/30/40mm
H1931
Talon Dil Cath
H1932
Scimed Remedy Dil Cath
H1933
Opti-Plast XL/Centurion Cath
H1934
Ultraverse 3.5F Bal Dil Cath
H1935
Workhorse PTA Bal Cath
H1936
Uromax Ultra Bal Dil Cath
H1937
Synergy Balloon Dil Cath
H1938
UroForce Bal Dil Cath
H1939
Raptur, Ninja PTCA Dil Cath
H1940
PowerFlex,OPTA 5/LP Bal Cath
H1941
Jupiter PTA Dil Cath
H1942
Cordis Maxi LD PTA Bal Cath
H1943
RXCrossSail OTW OpenSail
H1944
Rapid Exchange Bil Dil Cath
H1945
Savvy PTA Dil Cath
H1946
R1s Rapid Dil Cath
H1947
Gazelle Bal Dil Cath
H1948
Pursuit Balloon Cath
H1949
Oracle Megasonics Cath
H1979
Visions PV/Avanar US Cath
H1980
Atlantis SR Coronary Cath
H1981
PTCA Catheters
H2000
Orbiter ST Steerable Cath
H2001
Constellation Diag Cath
H2002
Irvine 5F Inquiry Diag EP Cath
H2003
Irvine 6F Inquiry Diag EP Cath
H2004
Biosense EP Cath—Octapolar
H2005
Biosense EP Cath—Hexapolar
H2006
Biosense EP Cath—Decapolar
H2007
Irvine 6F Luma-Cath EP Cath
H2008
7F Luma-Cath EP Cath 81910-15
H2009
Irvine 7F Luma-Cath EP Cath
H2010
Fixed Curve EP Cath
H2011
Deflectable Tip Cath—Quad
H2012
Celsius Abln Cath
H2013
Celsius Large Abln Cath
H( print page 67840)2014
Celsius II Asym Abln Cath
H2015
Celsius II Sym Abln Cath
H2016
Navi-Star DS, Navi-Star Ther
H2017
Navi-Star Abln Cath
H2018
Polaris T Ablation Cath
H2019
EP Deflectable Cath
H2020
Blazer II XP Abln Cath
H2021
SilverFlex EP Cath
H2022
CP Chilli Cooled Abln Cath
H2023
Chilli Cld AblnCath-std, lg
H2100
CP CS Reference Cath
H2101
CP RV Reference Cath
H2102
CP Radii 7F EP Cath
H2103
CP Radii 7F EP Cath w/Track
H2104
Lasso Deflectable Cath
H2151
Veripath Guiding Cath
H2152
Cordis Vista Brite Tip Cath
H2153
Bard Viking Cath
H2200
Arrow-Trerotola PTD Cath
H2300
Varisource Stnd Catheters
H2597
CliniCath/kit 16/18 sgl/dbl
H2598
CliniCath 18/20/24G-single
H2599
CliniCath 16/18G-double
H2601
Bard DL Ureteral Cath
H2602
Vitesse Laser Cath 1.4/1.7mm
H2603
Vitesse Laser Cath 2.0mm
H2604
Vitesse E Laser Cath 2.0mm
H2605
Extreme Laser Catheter
H2606
SpineCath XL Catheter
H2607
SpineCath Intradiscal Cath
H2608
Scimed 6F Wiseguide Cath
H2609
Flexima Bil Drainage Cath
H2610
FlexTipPlus Intraspinal Cath
H2611
AlgoLine Intraspinal Cath
H2612
InDura Catheter
H2700
MycroPhylax Plus SC defib
H2701
Phylax XM SC defib
H2702
Ventak Prizm 2 VR Defib
H2703
Ventak Prizm VR HE Defib
H2704
Ventak Mini IV+ Defib
H2801
Defender IV DR 612 DC defib
H2802
Phylax AV DC defib
H2803
Ventak Prizm DR HE Defib
H2804
Ventak Prizm 2 DR Defib
H2805
Jewel AF 7250 Defib
H2806
GEM VR 7227 Defib
H2807
Contak CD 1823
H2808
Contak TR 1241
H3002
EasyTrak Defib Lead
H3001
Kainox SL/RV defib lead
H3003
Endotak SQ Array XP lead
H3004
Intervene Defib Lead
H3400
Siltex Spectrum, Contour Prof
H3401
Saline-Filled Spectrum
H3500
Mentor Alpha I Inf Penile Pros
H3510
AMS 800 Urinary Pros
H3551
Choice/PT Graphix/Luge/Trooper
H3552
Hi-Torque Whisper
H3553
Cordis guidewires
H3554
Jindo guidewire
H3555
Wholey Hi-Torque Plus GW
H3556
Wave/FlowWire Guidewire
H3557
HyTek guidewire
H3800
SynchroMed EL infusion pump
H3801
Arrow/MicroJect PCA Sys
H3851
Elastic UV IOL AA-4203T/TF/TL
H4000
Opus G 4621, 4624 SC pmkr
H4001
Opus S 4121/4124 SC pmkr
H4002
Talent 113 SC pmkr
H4003
Kairos SR SC pmkr
H4004
Actros SR, Actros SLR SC pmkr
H4005
Philos SR/SR-B SC pmkr
H4006
Pulsar Max II SR pmkr
H4007
Marathon SR pmkr
H4008
Discovery II SSI pmkr
H4009
Discovery II SR pmkr
H4300
Integrity AFx DR 5342 pmkr
H4301
Integrity AFx DR 5346 pmkr
H( print page 67841)4302
Affinity VDR 5430 pmkr
H4303
Brio 112 DC pmkr
H4304
Brio 212, Talent 213/223 DC pmkr
H4305
Brio 222 DC pmkr
H4306
Brio 220 DC pmkr
H4307
Kairos DR DC pmkr
H4308
Inos2, Inos2+ DC pmkr
H4309
Actros DR,D,DR-A,SLR DC pmkr
H4310
Actros DR-B DC pmkr
H4311
Philos DR/DR-B/SLR DC pmkr
H4312
Pulsar Max II DR pmkr
H4313
Marathon DR pmkr
H4314
Momentum DR pmkr
H4315
Selection AFm pmkr
H4316
Discovery II DR
H4317
Discovery II DDD
H4600
Snynox,Polyrox,Elox,Retrox
H4602
Tendril SDX, 1488K pmkr lead
H4603
Oscor/Flexion pmkr lead
H4604
CrystallineActFix,CapsureFix
H4605
CapSure Epi pmkr lead
H4606
Flextend pmkr lead
H4607
FinelineII/EZ, ThinlineII/EZ
H5000
BX Velocity w/Hepacoat
H5001
Memotherm Bil Stent, sm, med
H5002
Memotherm Bil Stent, large
H5003
Memotherm Bil Stent, x-large
H5004
PalmazCorinthian IQ Bil Stent
H5005
PalmazCorinthian IQ Trans/Bil
H5006
PalmazTrans Bil Stent Sys-Med
H5007
PalmazTrans XL Bil Stent--40mm
H5008
PalmazTrans XL Bil Stent--50mm
H5009
VistaFlex Biliary Stent
H5010
Rapid Exchange Bil Stent Sys
H5011
IntraStent, IntraStent LP
H5012
IntraStent DoubleStrut LD
H5013
IntraStent DoubleStrut, XS
H5014
AVE Bridge Stent Sys-10/17/28
H5015
AVE/X3 Bridge Sys, 40-100
H5016
Biliary stent single use cov
H5017
WallstentRP Bil--20/40/60/68mm
H5018
WallstentRP Bil--80/94mm
H5019
Flexima Bil Stent Sys
H5020
Smart Nitinol Stent--20mm
H5021
Smart Nitinol Stent--40/60mm
H5022
Smart Nitinol Stent--80mm
H5023
BX Velocity Stent--8/13mm
H5024
BX Velocity Stent--18mm
H5025
BX Velocity Stent--23mm
H5026
BX Velocity Stent--28/33mm
H5027
BX Velocity w/Hep--8/13mm
H5028
BX Velocity w/Hep--18mm
H5029
BX Velocity w/Hep--23mm
H5030
Stent, coronary, S660 9/12mm
H5031
Stent,coronary, S660 15/18mm
H5032
Stent,coronary, S660 24/30mm
H5033
Niroyal Stent Sys, 9mm
H5034
Niroyal Stent Sys, 12/15mm
H5035
Niroyal Stent Sys, 18mm
H5036
Niroyal Stent Sys, 25mm
H5037
Niroyal Stent Sys, 31mm
H5038
BX Velocity Stent w/Raptor
H5039
IntraCoil Periph Stent--40mm
H5040
IntraCoil Periph Stent--60mm
H5041
BeStent Over-the-Wire 24/30mm
H5042
BeStent Over-the-Wire 18mm
H5043
BeStent Over-the-Wire 15mm
H5044
BeStent Over-the-Wire 9/12mm
H5045
Multilink Tetra Cor Stent Sys
H5046
Radius 20mm cor stent
H5047
Niroyal Elite Cor Stent Sys
H5048
GR II Coronary Stent
H5130
Wilson-Cook Colonic Z-Stent
H5131
Bard Colorectal Stent-60mm
H5132
Bard Colorectal Stent-80mm
H5133
Bard Colorectal Stent-100mm
H5134
Enteral Wallstent—90mm
H5279
Contour/Percuflex Stent
H( print page 67842)5280
Inlay Dbl Ureteral Stent
H5281
Wallgraft Trach Sys 70mm
H5282
Wallgraft Trach Sys 20/30/50
H5283
Wallstent/RP TIPS—80mm
H5284
Wallstent TrachUltraFlex
H5600
Closure dev, VasoSeal ES
H5601
VasoSeal Model 1000
H6001
Composix Mesh 8/21 in
H6002
Composix Mesh 32 in
H6003
Composix Mesh 48 in
H6004
Composix Mesh 80 in
H6005
Composix Mesh 140 in
H6006
Composix Mesh 144 in
H6012
Pelvicol Collagen 8/14 sq cm
H6013
Pelvicol Collagen 21/24/28 sq cm
H6014
Pelvicol Collagen 36 sq cm
H6015
Pelvicol Collagen 48 sq cm
H6016
Pelvicol Collagen 96 sq cm
H6017
Gore-Tex DualMesh 75/96 sq cm
H6018
Gore-Tex DualMesh 150 sq cm
H6019
Gore-Tex DualMesh 285 sq cm
H6020
Gore-Tex DualMesh 432 sq cm
H6021
Gore-Tex DualMesh 600 sq cm
H6022
Gore-Tex DualMesh 884 sq cm
H6023
Gore-TexPlus 1mm, 75/96sq cm
H6024
Gore-TexPlus 1mm, 150sq cm
H6025
Gore-TexPlus 1mm, 285sq cm
H6026
Gore-TexPlus 1mm, 432sq cm
H6027
Gore-TexPlus 1mm, 600sq cm
H6028
Gore-TexPlus 1mm, 884 sq cm
H6029
Gore-TexPlus 2mm, 150 sq cm
H6030
Gore-TexPlus 2mm, 285 sq cm
H6031
Gore-TexPlus 2mm, 432 sq cm
H6032
Gore-TexPlus 2mm, 600 sq cm
H6033
Gore-TexPlus 2mm, 884 sq cm
H6034
Bard ePTFE: 150 sq cm--2mm
H6035
Bard ePTFE 150 sqcm-1mm,75-2mm
H6036
Bard ePTFE: 50/75 sqcm-1,2mm
H6037
Bard ePTFE: 300 sq cm-1,2mm
H6038
Bard ePTFE: 600 sq cm-1mm
H6039
Bard ePTFE: 884 sq cm-1mm
H6040
Bard ePTFE: 600 sq cm-2mm
H6041
Bard ePTFE: 884 sq cm-2mm
H6050
Female Sling Sys w/wo Matrl
H6051
Stratasis Sling, 20/40 cm
H6052
Stratasis Sling, 60 cm
H6053
Surgisis Soft Graft
H6054
Surgisis Enhanced Graft
H6055
Surgisis Enhanced Tissue
H6056
Surgisis Soft Tissue Graft
H6057
Surgisis Hernia Graft
H6058
SurgiPro Hernia Plug, med/lg
H6080
Male Sling Sys w/wo Matrl
H6200
Exxcel Sft ePTFE vas graft
H6201
Impra Venaflo--10/20cm
H6202
Impra Venaflo-30/40cm
H6203
Impra Venaflo-50cm,vt45
H6204
Impra Venaflo-stepped
H6205
Impra Carboflo—10cm
H6206
Impra Carboflo—20cm
H6207
Impra Carboflo—30/35/40cm
H6208
Impra Carboflo—40/50cm
H6209
Impra Carboflo—ctrflex
H6210
Exxcel ePTFE vas graft
H6300
Vanguard III Endovas Graft
H6500
Preface Guiding Sheath
H6501
Soft Tip Sheaths
H6502
Perry Exchange Dilator
H6525
Spectranetics Laser Sheath
H6600
Micro Litho Flex Probes
H6650
Fast-Cath Guiding Introducer
H6651
Seal-AwayGuiding Introducer
H6652
Bard Excalibur Introducer
H6700
Focal Seal-L
H7000
Amifostine, 500 mg
G

$350.31

$46.947001
Amphotericin B lipid complex, 50 mg
G

$95.00

$12.737003
Epoprostenol injection 0.5 mg
G

$16.53

$2.227004
Immune globulin 5 gms
G

$272.80

$33.28( print page 67843)7005
Gonadorelin hydroch, 100 mcg
G

$14.80

$1.987007
Milrinone lactate, per 5 ml, inj
K
0.47
$23.31

$4.667010
Morphine sulfate (preservative free) 10 mg
G

$7.41

$.997011
Oprelvekin injection, 5 mg
G

$236.31

$31.677014
Fentanyl citrate inj up 2 ml
G

$0.98

$0.137015
Busulfan, oral, 2 mg
G

$1.73

$0.237019
Aprotinin, 10,000 kiu
G

$196.35

$26.317022
Elliot's B solution, per ml
G

$14.25

$1.917023
Treatment for bladder calculi, per 500 ml
G

$23.54

$3.157024
Corticorelin ovine triflutate, per 0.1 mg
G

$353.88

$45.777025
Digoxin immune FAB (Ovine), 40 mg vial
G

$530.44

$64.717026
Ethanolamine oleate, 100 mg
G

$27.21

$3.657027
Fomepizole, 1.5 mg
G

$728.33

$97.607028
Fosphenytoin, 50 mg
G

$8.55

$1.157029
Glatiramer acetate, 20 mg
G

$27.40

$3.677030
Hemin, 1 mg
G

$0.90

$0.127031
Octreotide acetate injection 1mg
G

$115.34

$15.467032
Sermorelin acetate, 0.5 mg
G

$15.78

$2.117033
Somatrem, 5 mg
G

$199.50

$26.737034
Somatropin, 1 mg (any derivation)
G

$39.90

$5.357035
Teniposide, 50 mg
G

$195.28

$26.177036
Urokinase, inj, IV, 250,000 I.U.
K
6.78
$336.29

$67.267037
Urofollitropin, 75 I.U.
G

$69.73

$9.347038
Muromonab-CD3, 5 mg
G

$741.00

$99.297039
Pegademase bovine inj 25 I.U
G

$139.33

$18.677040
Pentastarch 10% inj, 100 ml
G

$15.11

$2.047041
Tirofiban hydrochloride 12.5 mg
G

$399.00

$53.477042
Capecitabine, oral, 150 mg
G

$1.94

$0.267043
Infliximab injection 10 mg
G

$58.08

$7.787045
Trimetrexate glucoronate 25 mg
G

$69.83

$9.367046
Doxorubicin hcl liposome inj 10 mg
G

$311.72

$41.777047
Droperidol/fentanyl inj
G

$7.02

$0.907048
Alteplase, 1 mg
K
0.38
$18.70

$3.747049
Filgrastim 480 mcg injection
G

$273.03

$35.067315
Sodium hyaluronate, 20 mg
G

$125.59

$16.838099
Spectranetics Lead Lock Dev
H8100
Adhesion barrier, ADCON-L
H8102
SurgiVision Esoph Coil
H9000
Na chromate Cr51, per 0.25mCi
G

$259.36

$34.759001
Linezolid inj, 200mg
J

$34.14

$4.579002
Tenecteplase, 50mg/vial
J

$2,612.50

$350.089003
Palivizumab, per 50mg
J

$664.49

$89.049004
Gemtuzumab ozogamicin inj,5mg
J

$1,929.69

$258.589005
Reteplase inj, half-kit, 18.8 mg/vial
G

$1,306.25

$175.049006
Tacrolimus inj, per 5mg (1 amp)
J

$109.83

$14.729007
Baclofen Intrathecal kit-1amp
G

$79.80

$10.699008
Baclofen Refill Kit—500mcg
G

$222.30

$29.799009
Baclofen Refill Kit—2000mcg
G

$467.40

$62.639010
Baclofen Refill Kit—4000mcg
G

$820.80

$109.999011
Caffeine Citrate, inj, 1ml
G

$12.22

$1.579100
Iodinated I-131 Albumin
G

$246.05

$30.029102
51 Na chromate, 50mCi
G

$216.60

$26.439103
Na Iothalamate I-125, 10uCi
G

$12.27

$1.509104
Anti-thymocyte globulin,25mg
G

$251.75

$33.739105
Hep B imm glob, per 1 ml
G

$152.00

$20.379106
Sirolimus 1mg/ml
J

$6.51

$.879107
Tinzaparin sodium, 2ml vial
J

$159.60

$20.509108
Thyrotropin Alfa,1.1 mg
G

$494.00

$70.729109
Tirofiban hydrochloride 6.25 mg
G

$199.50

$28.569217
Leuprolide acetate for depot suspension, 7.5 mg
G

$592.60

$79.409500
Platelets, irrad, ea unit
K
1.77
$87.97

$17.599501
Platelets, pheresis, ea unit
K
9.69
$480.75

$96.159502
Platelets, pher/irrad, ea unit
K
10.52
$521.66

$104.339503
Fresh frozen plasma, ea unit
K
1.65
$81.83

$16.379504
RBC, deglycerolized, ea unit
K
4.35
$215.83

$43.17( print page 67844)9505
RBC, irradiated, ea unit
K
2.58
$127.86

$25.579998
Enoxaparin
G

$5.53

$0.79
 
 
 Addendum B.—Hospital Outpatient Department (HOPD) Payment Status by HCPCS Code and Related Information
CPT/
                                 HCPCS
HOPD 
                                 Status  
                                 Indicator
Description
APC
Relative 
                                 Weight
Payment 
                                 Rate
National 
                                 Unadjusted  
                                 Coinsurance
Minimum 
                                 Unadjusted  
                                 Coinsurance00100
N
Anesth, salivary gland00102
N
Anesth, repair of cleft lip00103
N
Anesth, blepharoplasty00104
N
Anesth, electroshock00120
N
Anesth, ear surgery00124
N
Anesth, ear exam00126
N
Anesth, tympanotomy00140
N
Anesth, procedures on eye00142
N
Anesth, lens surgery00144
N
Anesth, corneal transplant00145
N
Anesth, vitrectomy00147
N
Anesth, iridectomy00148
N
Anesth, eye exam00160
N
Anesth, nose/sinus surgery00162
N
Anesth, nose/sinus surgery00164
N
Anesth, biopsy of nose00170
N
Anesth, procedure on mouth00172
N
Anesth, cleft palate repair00174
N
Anesth, pharyngeal surgery00176
N
Anesth, pharyngeal surgery00190
N
Anesth, facial bone surgery00192
N
Anesth, facial bone surgery00210
N
Anesth, open head surgery00212
N
Anesth, skull drainage00214
N
Anesth, skull drainage00215
N
Anesth, skull fracture00216
N
Anesth, head vessel surgery00218
N
Anesth, special head surgery00220
N
Anesth, spinal fluid shunt00222
N
Anesth, head nerve surgery00300
N
Anesth, head/neck/ptrunk00320
N
Anesth, neck organ surgery00322
N
Anesth, biopsy of thyroid00350
N
Anesth, neck vessel surgery00352
N
Anesth, neck vessel surgery00400
N
Anesth, skin, ext/per/atrunk00402
N
Anesth, surgery of breast00404
N
Anesth, surgery of breast00406
N
Anesth, surgery of breast00410
N
Anesth, correct heart rhythm00420
N
Anesth, skin surgery, back00450
N
Anesth, surgery of shoulder00452
N
Anesth, surgery of shoulder00454
N
Anesth, collar bone biopsy00470
N
Anesth, removal of rib00472
N
Anesth, chest wall repair00474
N
Anesth, surgery of rib(s)00500
N
Anesth, esophageal surgery00520
N
Anesth, chest procedure00522
N
Anesth, chest lining biopsy00524
N
Anesth, chest drainage00528
N
Anesth, chest partition view00530
N
Anesth, pacemaker insertion00532
N
Anesth, vascular access00534
N
Anesth, cardioverter/defib*00537
N
Anesth, cardiac electrophys00540
N
Anesth, chest surgery00542
N
Anesth, release of lung00544
N
Anesth, chest lining removal00546
N
Anesth, lung,chest wall surg00548
N
Anesth, trachea,bronchi surg*00550
N
Anesth, sternal debridement00560
N
Anesth, open heart surgery00562
N
Anesth, open heart surgery( print page 67845)*00563
N
Anesth, openproc w/pump*00566
N
Anesth CABG w/o pump00580
N
Anesth heart/lung transplant00600
N
Anesth, spine, cord surgery00604
N
Anesth, surgery of vertebra00620
N
Anesth, spine, cord surgery00622
N
Anesth, removal of nerves00630
N
Anesth, spine, cord surgery00632
N
Anesth, removal of nerves00634
N
Anesth for chemonucleolysis*00635
N
Anesth, lumbar puncture00670
N
Anesth, spine, cord surgery00700
N
Anesth, abdominal wall surg00702
N
Anesth, for liver biopsy00730
N
Anesth, abdominal wall surg00740
N
Anesth, upper gi visualize00750
N
Anesth, repair of hernia00752
N
Anesth, repair of hernia00754
N
Anesth, repair of hernia00756
N
Anesth, repair of hernia00770
N
Anesth, blood vessel repair00790
N
Anesth, surg upper abdomen00792
N
Anesth, part liver removal00794
N
Anesth, pancreas removal00796
N
Anesth, for liver transplant00800
N
Anesth, abdominal wall surg00802
N
Anesth, fat layer removal00810
N
Anesth, low intestine scope00820
N
Anesth, abdominal wall surg00830
N
Anesth, repair of hernia00832
N
Anesth, repair of hernia00840
N
Anesth, surg lower abdomen00842
N
Anesth, amniocentesis00844
N
Anesth, pelvis surgery00846
N
Anesth, hysterectomy00848
N
Anesth, pelvic organ surg00850
N
Anesth, cesarean section00855
N
Anesth, hysterectomy00857
N
Analgesia, labor & c-section00860
N
Anesth, surgery of abdomen00862
N
Anesth, kidney/ureter surg00864
N
Anesth, removal of bladder00865
N
Anesth, removal of prostate00866
N
Anesth, removal of adrenal00868
N
Anesth, kidney transplant00870
N
Anesth, bladder stone surg00872
N
Anesth kidney stone destruct00873
N
Anesth kidney stone destruct00880
N
Anesth, abdomen vessel surg00882
N
Anesth, major vein ligation00884
N
Anesth, major vein revision00900D
N
Anesth, perineal procedure00902
N
Anesth, anorectal surgery00904
N
Anesth, perineal surgery00906
N
Anesth, removal of vulva00908
N
Anesth, removal of prostate00910
N
Anesth, bladder surgery00912
N
Anesth, bladder tumor surg00914
N
Anesth, removal of prostate00916
N
Anesth, bleeding control00918
N
Anesth, stone removal00920
N
Anesth, genitalia surgery00922
N
Anesth, sperm duct surgery27280
C
Fusion of sacroiliac joint27282
C
Fusion of pubic bones27284
C
Fusion of hip joint27286
C
Fusion of hip joint27290
C
Amputation of leg at hip27295
C
Amputation of leg at hip27299
T
Pelvis/hip joint surgery
0043
1.64
$81.34
$25.46
$16.2727301
T
Drain thigh/knee lesion
0008
6.15
$305.02
$113.67
$61.0027303
C
Drainage of bone lesion27305
T
Incise thigh tendon & fascia
0049
15.04
$745.93
$356.95
$149.1927306
T
Incision of thigh tendon
0049
15.04
$745.93
$356.95
$149.19( print page 67846)27307
T
Incision of thigh tendons
0049
15.04
$745.93
$356.95
$149.1927310
T
Exploration of knee joint
0050
21.13
$1,047.96
$513.86
$209.5927315
T
Partial removal, thigh nerve
0220
13.96
$692.36
$326.21
$138.4727320
T
Partial removal, thigh nerve
0220
13.96
$692.36
$326.21
$138.4727323
T
Biopsy, thigh soft tissues
0021
10.49
$520.26
$236.51
$104.0527324
T
Biopsy, thigh soft tissues
0022
12.49
$619.45
$292.94
$123.8927327
T
Removal of thigh lesion
0022
12.49
$619.45
$292.94
$123.8927328
T
Removal of thigh lesion
0022
12.49
$619.45
$292.94
$123.8927329
T
Remove tumor, thigh/knee
0022
12.49
$619.45
$292.94
$123.8927330
T
Biopsy, knee joint lining
0050
21.13
$1,047.96
$513.86
$209.5927331
T
Explore/treat knee joint
0050
21.13
$1,047.96
$513.86
$209.5927332
T
Removal of knee cartilage
0050
21.13
$1,047.96
$513.86
$209.5927333
T
Removal of knee cartilage
0050
21.13
$1,047.96
$513.86
$209.5927334
T
Remove knee joint lining
0050
21.13
$1,047.96
$513.86
$209.5927335
T
Remove knee joint lining
0050
21.13
$1,047.96
$513.86
$209.5927340
T
Removal of kneecap bursa
0049
15.04
$745.93
$356.95
$149.1927345
T
Removal of knee cyst
0049
15.04
$745.93
$356.95
$149.1927347
T
Remove knee cyst
0049
15.04
$745.93
$356.95
$149.1927350
T
Removal of kneecap
0050
21.13
$1,047.96
$513.86
$209.5927355
T
Remove femur lesion
0050
21.13
$1,047.96
$513.86
$209.5927356
T
Remove femur lesion/graft
0050
21.13
$1,047.96
$513.86
$209.5927357
T
Remove femur lesion/graft
0050
21.13
$1,047.96
$513.86
$209.5927358
T
Remove femur lesion/fixation
0050
21.13
$1,047.96
$513.86
$209.5927360
T
Partial removal, leg bone(s)
0050
21.13
$1,047.96
$513.86
$209.5927365
C
Extensive leg surgery27370
N
Injection for knee x-ray27372
T
Removal of foreign body
0022
12.49
$619.45
$292.94
$123.8927380
T
Repair of kneecap tendon
0049
15.04
$745.93
$356.95
$149.1927381
T
Repair/graft kneecap tendon
0049
15.04
$745.93
$356.95
$149.1927385
T
Repair of thigh muscle
0049
15.04
$745.93
$356.95
$149.1927386
T
Repair/graft of thigh muscle
0049
15.04
$745.93
$356.95
$149.1927390
T
Incision of thigh tendon
0049
15.04
$745.93
$356.95
$149.1927391
T
Incision of thigh tendons
0049
15.04
$745.93
$356.95
$149.1927392
T
Incision of thigh tendons
0049
15.04
$745.93
$356.95
$149.1927393
T
Lengthening of thigh tendon
0050
21.13
$1,047.96
$513.86
$209.5927394
T
Lengthening of thigh tendons
0050
21.13
$1,047.96
$513.86
$209.5927395
T
Lengthening of thigh tendons
0051
27.76
$1,376.79
$675.24
$275.3627396
T
Transplant of thigh tendon
0050
21.13
$1,047.96
$513.86
$209.5927397
T
Transplants of thigh tendons
0051
27.76
$1,376.79
$675.24
$275.3627400
T
Revise thigh muscles/tendons
0051
27.76
$1,376.79
$675.24
$275.3627403
T
Repair of knee cartilage
0050
21.13
$1,047.96
$513.86
$209.5927405
T
Repair of knee ligament
0051
27.76
$1,376.79
$675.24
$275.3627407
T
Repair of knee ligament
0051
27.76
$1,376.79
$675.24
$275.3627409
T
Repair of knee ligaments
0051
27.76
$1,376.79
$675.24
$275.3627418
T
Repair degenerated kneecap
0051
27.76
$1,376.79
$675.24
$275.3627420
T
Revision of unstable kneecap
0051
27.76
$1,376.79
$675.24
$275.3627422
T
Revision of unstable kneecap
0051
27.76
$1,376.79
$675.24
$275.3627424
T
Revision/removal of kneecap
0051
27.76
$1,376.79
$675.24
$275.3627425
T
Lateral retinacular release
0050
21.13
$1,047.96
$513.86
$209.5927427
T
Reconstruction, knee
0052
36.16
$1,793.39
$930.91
$358.6827428
T
Reconstruction, knee
0052
36.16
$1,793.39
$930.91
$358.6827429
T
Reconstruction, knee
0052
36.16
$1,793.39
$930.91
$358.6827430
T
Revision of thigh muscles
0051
27.76
$1,376.79
$675.24
$275.3627435
T
Incision of knee joint
0051
27.76
$1,376.79
$675.24
$275.3627437
T
Revise kneecap
0047
22.09
$1,095.58
$537.03
$219.1227438
T
Revise kneecap with implant
0048
29.06
$1,441.26
$725.94
$288.2527440
T
Revision of knee joint
0047
22.09
$1,095.58
$537.03
$219.1227441
T
Revision of knee joint
0047
22.09
$1,095.58
$537.03
$219.1227442
T
Revision of knee joint
0047
22.09
$1,095.58
$537.03
$219.1227443
T
Revision of knee joint
0047
22.09
$1,095.58
$537.03
$219.1227445
C
Revision of knee joint27446
C
Revision of knee joint27447
C
Total knee replacement27448
C
Incision of thigh27450
C
Incision of thigh27454
C
Realignment of thigh bone27455
C
Realignment of knee27457
C
Realignment of knee27465
C
Shortening of thigh bone27466
C
Lengthening of thigh bone27468
C
Shorten/lengthen thighs27470
C
Repair of thigh27472
C
Repair/graft of thigh27475
C
Surgery to stop leg growth( print page 67847)27477
C
Surgery to stop leg growth27479
C
Surgery to stop leg growth27485
C
Surgery to stop leg growth27486
C
Revise/replace knee joint27487
C
Revise/replace knee joint27488
C
Removal of knee prosthesis27495
C
Reinforce thigh27496
T
Decompression of thigh/knee
0049
15.04
$745.93
$356.95
$149.1927497
T
Decompression of thigh/knee
0049
15.04
$745.93
$356.95
$149.1927498
T
Decompression of thigh/knee
0049
15.04
$745.93
$356.95
$149.1927499
T
Decompression of thigh/knee
0049
15.04
$745.93
$356.95
$149.1927500
T
Treatment of thigh fracture
0044
2.17
$107.63
$38.08
$21.5327501
T
Treatment of thigh fracture
0044
2.17
$107.63
$38.08
$21.5327502
T
Treatment of thigh fracture
0044
2.17
$107.63
$38.08
$21.5327503
T
Treatment of thigh fracture
0044
2.17
$107.63
$38.08
$21.5327506
C
Treatment of thigh fracture27507
C
Treatment of thigh fracture27508
T
Treatment of thigh fracture
0044
2.17
$107.63
$38.08
$21.5327509
T
Treatment of thigh fracture
0046
22.29
$1,105.50
$535.76
$221.1027510
T
Treatment of thigh fracture
0044
2.17
$107.63
$38.08
$21.5327511
C
Treatment of thigh fracture27513
C
Treatment of thigh fracture27514
C
Treatment of thigh fracture27516
T
Treat thigh fx growth plate
0044
2.17
$107.63
$38.08
$21.5327517
T
Treat thigh fx growth plate
0044
2.17
$107.63
$38.08
$21.5327519
C
Treat thigh fx growth plate27520
T
Treat kneecap fracture
0044
2.17
$107.63
$38.08
$21.5327524
T
Treat kneecap fracture
0046
22.29
$1,105.50
$535.76
$221.1027530
T
Treat knee fracture
0044
2.17
$107.63
$38.08
$21.5327532
T
Treat knee fracture
0044
2.17
$107.63
$38.08
$21.5327535
C
Treat knee fracture27536
C
Treat knee fracture27538
T
Treat knee fracture(s)
0044
2.17
$107.63
$38.08
$21.5327540
C
Treat knee fracture27550
T
Treat knee dislocation
0044
2.17
$107.63
$38.08
$21.5327552
T
Treat knee dislocation
0045
11.02
$546.55
$277.12
$109.3127556
C
Treat knee dislocation27557
C
Treat knee dislocation27558
C
Treat knee dislocation27560
T
Treat kneecap dislocation
0044
2.17
$107.63
$38.08
$21.5327562
T
Treat kneecap dislocation
0045
11.02
$546.55
$277.12
$109.3127566
T
Treat kneecap dislocation
0046
22.29
$1,105.50
$535.76
$221.1027570
T
Fixation of knee joint
0045
11.02
$546.55
$277.12
$109.3127580
C
Fusion of knee27590
C
Amputate leg at thigh27591
C
Amputate leg at thigh27592
C
Amputate leg at thigh27594
T
Amputation follow-up surgery
0049
15.04
$745.93
$356.95
$149.1927596
C
Amputation follow-up surgery27598
C
Amputate lower leg at knee27599
T
Leg surgery procedure
0044
2.17
$107.63
$38.08
$21.5327600
T
Decompression of lower leg
0049
15.04
$745.93
$356.95
$149.1927601
T
Decompression of lower leg
0049
15.04
$745.93
$356.95
$149.1927602
T
Decompression of lower leg
0049
15.04
$745.93
$356.95
$149.1927603
T
Drain lower leg lesion
0008
6.15
$305.02
$113.67
$61.0027604
T
Drain lower leg bursa
0049
15.04
$745.93
$356.95
$149.1927605
T
Incision of achilles tendon
0055
15.47
$767.26
$355.34
$153.4500924
N
Anesth, testis exploration00926
N
Anesth, removal of testis00928
N
Anesth, removal of testis00930
N
Anesth, testis suspension00932
N
Anesth, amputation of penis00934
N
Anesth, penis, nodes removal00936
N
Anesth, penis, nodes removal00938
N
Anesth, insert penis device00940
N
Anesth, vaginal procedures00942
N
Anesth, surgery on vagina00944
N
Anesth, vaginal hysterectomy00946
N
Anesth, vaginal delivery00948
N
Anesth, repair of cervix00950
N
Anesth, vaginal endoscopy00952
N
Anesth, hysteroscope/graph00955
N
Analgesia, vaginal delivery01000
N
Anesth, skin surgery, pelvis( print page 67848)01110
N
Anesth, skin surgery, pelvis*01112
N
Anesth, bone aspirate/bx01120
N
Anesth, pelvis surgery01130
N
Anesth, body cast procedure01140
N
Anesth, amputation at pelvis01150
N
Anesth, pelvic tumor surgery01160
N
Anesth, pelvis procedure01170
N
Anesth, pelvis surgery01180
N
Anesth, pelvis nerve removal01190
N
Anesth, pelvis nerve removal01200
N
Anesth, hip joint procedure01202
N
Anesth, arthroscopy of hip01210
N
Anesth, hip joint surgery01212
N
Anesth, hip disarticulation01214
N
Anesth, replacement of hip*01215
N
Anesth, revise hip repair01220
N
Anesth, procedure on femur01230
N
Anesth, surgery of femur01232
N
Anesth, amputation of femur01234
N
Anesth, radical femur surg01240
N
Anesth, upper leg skin surg01250
N
Anesth, upper leg surgery01260
N
Anesth, upper leg veins surg01270
N
Anesth, thigh arteries surg01272
N
Anesth, femoral artery surg01274
N
Anesth, femoral embolectomy01300
N
Anesth, skin surgery, knee01320
N
Anesth, knee area surgery01340
N
Anesth, knee area procedure01360
N
Anesth, knee area surgery01380
N
Anesth, knee joint procedure01382
N
Anesth, knee arthroscopy01390
N
Anesth, knee area procedure01392
N
Anesth, knee area surgery01400
N
Anesth, knee joint surgery01402
N
Anesth, replacement of knee01404
N
Anesth, amputation at knee01420
N
Anesth, knee joint casting01430
N
Anesth, knee veins surgery01432
N
Anesth, knee vessel surg01440
N
Anesth, knee arteries surg01442
N
Anesth, knee artery surg01444
N
Anesth, knee artery repair01460
N
Anesth, lower leg skin surg01462
N
Anesth, lower leg procedure01464
N
Anesth, ankle arthroscopy01470
N
Anesth, lower leg surgery01472
N
Anesth, achilles tendon surg01474
N
Anesth, lower leg surgery01480
N
Anesth, lower leg bone surg01482
N
Anesth, radical leg surgery01484
N
Anesth, lower leg revision01486
N
Anesth, ankle replacement01490
N
Anesth, lower leg casting01500
N
Anesth, leg arteries surg01502
N
Anesth, lwr leg embolectomy01520
N
Anesth, lower leg vein surg01522
N
Anesth, lower leg vein surg01600
N
Anesth, shoulder skin surg01610
N
Anesth, surgery of shoulder01620
N
Anesth, shoulder procedure01622
N
Anesth, shoulder arthroscopy01630
N
Anesth, surgery of shoulder01632
N
Anesth, surgery of shoulder01634
N
Anesth, shoulder joint amput01636
N
Anesth, forequarter amput01638
N
Anesth, shoulder replacement01650
N
Anesth, shoulder artery surg01652
N
Anesth, shoulder vessel surg01654
N
Anesth, shoulder vessel surg01656
N
Anesth, arm-leg vessel surg01670
N
Anesth, shoulder vein surg01680
N
Anesth, shoulder casting01682
N
Anesth, airplane cast( print page 67849)01700
N
Anesth, elbow area skin surg01710
N
Anesth, elbow area surgery01712
N
Anesth, uppr arm tendon surg01714
N
Anesth, uppr arm tendon surg01716
N
Anesth, biceps tendon repair01730
N
Anesth, uppr arm procedure01732
N
Anesth, elbow arthroscopy01740
N
Anesth, upper arm surgery01742
N
Anesth, humerus surgery01744
N
Anesth, humerus repair01756
N
Anesth, radical humerus surg01758
N
Anesth, humeral lesion surg01760
N
Anesth, elbow replacement01770
N
Anesth, uppr arm artery surg01772
N
Anesth, uppr arm embolectomy01780
N
Anesth, upper arm vein surg01782
N
Anesth, uppr arm vein repair01784D
N
Anesth, av fistula repair01800
N
Anesth, lower arm skin surg01810
N
Anesth, lower arm surgery01820
N
Anesth, lower arm procedure01830
N
Anesth, lower arm surgery01832
N
Anesth, wrist replacement01840
N
Anesth, lwr arm artery surg01842
N
Anesth, lwr arm embolectomy01844
N
Anesth, vascular shunt surg01850
N
Anesth, lower arm vein surg01852
N
Anesth, lwr arm vein repair01860
N
Anesth, lower arm casting01900
N
Anesth, uterus/tube inject01902
N
Anesth, burr holes, skull01904
N
Anesth, skull x-ray inject01906
N
Anesth, lumbar myelography01908
N
Anesth, cervical myelography01910
N
Anesth, skull myelography01912
N
Anesth, lumbar diskography01914
N
Anesth, cervical diskography01916
N
Anesth, head arteriogram01918
N
Anesth, limb arteriogram01920
N
Anesth, catheterize heart01921
N
Anesth, vessel surgery01922
N
Anesth, cat or MRI scan*01951
N
Anesth, burn, less 1 percent*01952
N
Anesth, burn, 1-9 percent*01953
N
Anesth, burn, each 9 percent01990
N
Support for organ donor01995
N
Regional anesthesia, limb01996
N
Manage daily drug therapy01999
N
Unlisted anesth procedure10040
T
Acne surgery of skin abscess
0006
2.00
$99.19
$33.95
$19.8410060
T
Drainage of skin abscess
0006
2.00
$99.19
$33.95
$19.8410061
T
Drainage of skin abscess
0006
2.00
$99.19
$33.95
$19.8410080
T
Drainage of pilonidal cyst
0006
2.00
$99.19
$33.95
$19.8410081
T
Drainage of pilonidal cyst
0007
3.68
$182.51
$72.03
$36.5010120
T
Remove foreign body
0006
2.00
$99.19
$33.95
$19.8410121
T
Remove foreign body
0020
6.51
$322.87
$130.53
$64.5710140
T
Drainage of hematoma/fluid
0007
3.68
$182.51
$72.03
$36.5010160
T
Puncture drainage of lesion
0006
2.00
$99.19
$33.95
$19.8410180
T
Complex drainage, wound
0007
3.68
$182.51
$72.03
$36.5011000
T
Debride infected skin
0015
1.77
$87.78
$31.20
$17.5611001
T
Debride infected skin add-on
0015
1.77
$87.78
$31.20
$17.5611010
T
Debride skin, fx
0022
12.49
$619.45
$292.94
$123.8911011
T
Debride skin/muscle, fx
0022
12.49
$619.45
$292.94
$123.8911012
T
Debride skin/muscle/bone, fx
0022
12.49
$619.45
$292.94
$123.8911040
T
Debride skin, partial
0015
1.77
$87.78
$31.20
$17.5611041
T
Debride skin, full
0015
1.77
$87.78
$31.20
$17.5611042
T
Debride skin/tissue
0016
3.53
$175.07
$74.67
$35.0111043
T
Debride tissue/muscle
0016
3.53
$175.07
$74.67
$35.0111044
T
Debride tissue/muscle/bone
0017
12.45
$617.47
$289.16
$123.4911055
T
Trim skin lesion
0015
1.77
$87.78
$31.20
$17.5611056
T
Trim skin lesions, 2 to 4
0015
1.77
$87.78
$31.20
$17.5611057
T
Trim skin lesions, over 4
0015
1.77
$87.78
$31.20
$17.5611100
T
Biopsy of skin lesion
0018
0.94
$46.62
$17.66
$9.3211101
T
Biopsy, skin add-on
0018
0.94
$46.62
$17.66
$9.32( print page 67850)11200
T
Removal of skin tags
0015
1.77
$87.78
$31.20
$17.5611201
T
Remove skin tags add-on
0015
1.77
$87.78
$31.20
$17.5611300
T
Shave skin lesion
0013
0.91
$45.13
$17.66
$9.0311301
T
Shave skin lesion
0013
0.91
$45.13
$17.66
$9.0311302
T
Shave skin lesion
0014
1.50
$74.39
$24.55
$14.8811303
T
Shave skin lesion
0015
1.77
$87.78
$31.20
$17.5611305
T
Shave skin lesion
0013
0.91
$45.13
$17.66
$9.0311306
T
Shave skin lesion
0013
0.91
$45.13
$17.66
$9.0311307
T
Shave skin lesion
0014
1.50
$74.39
$24.55
$14.8811308
T
Shave skin lesion
0015
1.77
$87.78
$31.20
$17.5611310
T
Shave skin lesion
0013
0.91
$45.13
$17.66
$9.0311311
T
Shave skin lesion
0013
0.91
$45.13
$17.66
$9.0311312
T
Shave skin lesion
0015
1.77
$87.78
$31.20
$17.5611313
T
Shave skin lesion
0016
3.53
$175.07
$74.67
$35.0111400
T
Removal of skin lesion
0019
4.00
$198.39
$78.91
$39.6811401
T
Removal of skin lesion
0019
4.00
$198.39
$78.91
$39.6811402
T
Removal of skin lesion
0019
4.00
$198.39
$78.91
$39.6811403
T
Removal of skin lesion
0020
6.51
$322.87
$130.53
$64.5711404
T
Removal of skin lesion
0020
6.51
$322.87
$130.53
$64.5711406
T
Removal of skin lesion
0020
6.51
$322.87
$130.53
$64.5711420
T
Removal of skin lesion
0019
4.00
$198.39
$78.91
$39.6811421
T
Removal of skin lesion
0019
4.00
$198.39
$78.91
$39.6811422
T
Removal of skin lesion
0019
4.00
$198.39
$78.91
$39.6811423
T
Removal of skin lesion
0020
6.51
$322.87
$130.53
$64.5711424
T
Removal of skin lesion
0020
6.51
$322.87
$130.53
$64.5711426
T
Removal of skin lesion
0022
12.49
$619.45
$292.94
$123.8911440
T
Removal of skin lesion
0019
4.00
$198.39
$78.91
$39.6811441
T
Removal of skin lesion
0019
4.00
$198.39
$78.91
$39.6811442
T
Removal of skin lesion
0019
4.00
$198.39
$78.91
$39.6811443
T
Removal of skin lesion
0020
6.51
$322.87
$130.53
$64.5711444
T
Removal of skin lesion
0020
6.51
$322.87
$130.53
$64.5711446
T
Removal of skin lesion
0022
12.49
$619.45
$292.94
$123.8911450
T
Removal, sweat gland lesion
0022
12.49
$619.45
$292.94
$123.8911451
T
Removal, sweat gland lesion
0022
12.49
$619.45
$292.94
$123.8911462
T
Removal, sweat gland lesion
0022
12.49
$619.45
$292.94
$123.8911463
T
Removal, sweat gland lesion
0022
12.49
$619.45
$292.94
$123.8911470
T
Removal, sweat gland lesion
0022
12.49
$619.45
$292.94
$123.8911471
T
Removal, sweat gland lesion
0022
12.49
$619.45
$292.94
$123.8911600
T
Removal of skin lesion
0019
4.00
$198.39
$78.91
$39.6811601
T
Removal of skin lesion
0019
4.00
$198.39
$78.91
$39.6811602
T
Removal of skin lesion
0019
4.00
$198.39
$78.91
$39.6811603
T
Removal of skin lesion
0020
6.51
$322.87
$130.53
$64.5711604
T
Removal of skin lesion
0020
6.51
$322.87
$130.53
$64.5711606
T
Removal of skin lesion
0021
10.49
$520.26
$236.51
$104.0511620
T
Removal of skin lesion
0019
4.00
$198.39
$78.91
$39.6811621
T
Removal of skin lesion
0019
4.00
$198.39
$78.91
$39.6811622
T
Removal of skin lesion
0019
4.00
$198.39
$78.91
$39.6811623
T
Removal of skin lesion
0020
6.51
$322.87
$130.53
$64.5711624
T
Removal of skin lesion
0020
6.51
$322.87
$130.53
$64.5711626
T
Removal of skin lesion
0022
12.49
$619.45
$292.94
$123.8911640
T
Removal of skin lesion
0019
4.00
$198.39
$78.91
$39.6811641
T
Removal of skin lesion
0019
4.00
$198.39
$78.91
$39.6811642
T
Removal of skin lesion
0019
4.00
$198.39
$78.91
$39.6811643
T
Removal of skin lesion
0020
6.51
$322.87
$130.53
$64.5711644
T
Removal of skin lesion
0020
6.51
$322.87
$130.53
$64.5711646
T
Removal of skin lesion
0022
12.49
$619.45
$292.94
$123.8911719
T
Trim nail(s)
0009
0.74
$36.70
$9.63
$7.3411720
T
Debride nail, 1-5
0009
0.74
$36.70
$9.63
$7.3411721
T
Debride nail, 6 or more
0009
0.74
$36.70
$9.63
$7.3411730
T
Removal of nail plate
0013
0.91
$45.13
$17.66
$9.0311732
T
Remove nail plate, add-on
0012
0.53
$26.29
$9.18
$5.2611740
T
Drain blood from under nail
0009
0.74
$36.70
$9.63
$7.3411750
T
Removal of nail bed
0019
4.00
$198.39
$78.91
$39.6811752
T
Remove nail bed/finger tip
0022
12.49
$619.45
$292.94
$123.8911755
T
Biopsy, nail unit
0019
4.00
$198.39
$78.91
$39.6811760
T
Repair of nail bed
0024
2.43
$120.51
$44.50
$24.1011762
T
Reconstruction of nail bed
0024
2.43
$120.51
$44.50
$24.1011765
T
Excision of nail fold, toe
0015
1.77
$87.78
$31.20
$17.5611770
T
Removal of pilonidal lesion
0021
10.49
$520.26
$236.51
$104.0511771
T
Removal of pilonidal lesion
0022
12.49
$619.45
$292.94
$123.8911772
T
Removal of pilonidal lesion
0022
12.49
$619.45
$292.94
$123.8911900
T
Injection into skin lesions
0012
0.53
$26.29
$9.18
$5.2611901
T
Added skin lesions injection
0013
0.91
$45.13
$17.66
$9.0311920
T
Correct skin color defects
0024
2.43
$120.51
$44.50
$24.10( print page 67851)11921
T
Correct skin color defects
0024
2.43
$120.51
$44.50
$24.1011922
T
Correct skin color defects
0024
2.43
$120.51
$44.50
$24.1011950
T
Therapy for contour defects
0024
2.43
$120.51
$44.50
$24.1011951
T
Therapy for contour defects
0024
2.43
$120.51
$44.50
$24.1011952
T
Therapy for contour defects
0024
2.43
$120.51
$44.50
$24.1011954
T
Therapy for contour defects
0024
2.43
$120.51
$44.50
$24.1011960
T
Insert tissue expander(s)
0026
12.11
$600.61
$277.92
$120.1211970
T
Replace tissue expander
0026
12.11
$600.61
$277.92
$120.1211971
T
Remove tissue expander(s)
0022
12.49
$619.45
$292.94
$123.8911975
E
Insert contraceptive cap11976
T
Removal of contraceptive cap
0019
4.00
$198.39
$78.91
$39.6811977
E
Removal/reinsert contra cap11980
X
Implant hormone pellet(s)
0340
1.04
$51.58
$12.85
$10.3212001
T
Repair superficial wound(s)
0024
2.43
$120.51
$44.50
$24.1012002
T
Repair superficial wound(s)
0024
2.43
$120.51
$44.50
$24.1012004
T
Repair superficial wound(s)
0024
2.43
$120.51
$44.50
$24.1012005
T
Repair superficial wound(s)
0024
2.43
$120.51
$44.50
$24.1012006
T
Repair superficial wound(s)
0024
2.43
$120.51
$44.50
$24.1012007
T
Repair superficial wound(s)
0024
2.43
$120.51
$44.50
$24.1012011
T
Repair superficial wound(s)
0024
2.43
$120.51
$44.50
$24.1012013
T
Repair superficial wound(s)
0024
2.43
$120.51
$44.50
$24.1012014
T
Repair superficial wound(s)
0024
2.43
$120.51
$44.50
$24.1012015
T
Repair superficial wound(s)
0024
2.43
$120.51
$44.50
$24.1012016
T
Repair superficial wound(s)
0024
2.43
$120.51
$44.50
$24.1012017
T
Repair superficial wound(s)
0024
2.43
$120.51
$44.50
$24.1012018
T
Repair superficial wound(s)
0024
2.43
$120.51
$44.50
$24.1012020
T
Closure of split wound
0024
2.43
$120.51
$44.50
$24.1012021
T
Closure of split wound
0024
2.43
$120.51
$44.50
$24.1012031
T
Layer closure of wound(s)
0024
2.43
$120.51
$44.50
$24.1012032
T
Layer closure of wound(s)
0024
2.43
$120.51
$44.50
$24.1012034
T
Layer closure of wound(s)
0024
2.43
$120.51
$44.50
$24.1012035
T
Layer closure of wound(s)
0024
2.43
$120.51
$44.50
$24.1012036
T
Layer closure of wound(s)
0024
2.43
$120.51
$44.50
$24.1012037
T
Layer closure of wound(s)
0026
12.11
$600.61
$277.92
$120.1212041
T
Layer closure of wound(s)
0024
2.43
$120.51
$44.50
$24.1012042
T
Layer closure of wound(s)
0024
2.43
$120.51
$44.50
$24.1012044
T
Layer closure of wound(s)
0024
2.43
$120.51
$44.50
$24.1012045
T
Layer closure of wound(s)
0024
2.43
$120.51
$44.50
$24.1012046
T
Layer closure of wound(s)
0024
2.43
$120.51
$44.50
$24.1012047
T
Layer closure of wound(s)
0026
12.11
$600.61
$277.92
$120.1212051
T
Layer closure of wound(s)
0024
2.43
$120.51
$44.50
$24.1012052
T
Layer closure of wound(s)
0024
2.43
$120.51
$44.50
$24.1012053
T
Layer closure of wound(s)
0024
2.43
$120.51
$44.50
$24.1012054
T
Layer closure of wound(s)
0024
2.43
$120.51
$44.50
$24.1012055
T
Layer closure of wound(s)
0024
2.43
$120.51
$44.50
$24.1012056
T
Layer closure of wound(s)
0024
2.43
$120.51
$44.50
$24.1012057
T
Layer closure of wound(s)
0026
12.11
$600.61
$277.92
$120.1213100
T
Repair of wound or lesion
0025
3.74
$185.49
$70.66
$37.1013101
T
Repair of wound or lesion
0025
3.74
$185.49
$70.66
$37.1013102
T
Repair wound/lesion add-on
0025
3.74
$185.49
$70.66
$37.1013120
T
Repair of wound or lesion
0025
3.74
$185.49
$70.66
$37.1013121
T
Repair of wound or lesion
0025
3.74
$185.49
$70.66
$37.1013122
T
Repair wound/lesion add-on
0025
3.74
$185.49
$70.66
$37.1013131
T
Repair of wound or lesion
0025
3.74
$185.49
$70.66
$37.1013132
T
Repair of wound or lesion
0025
3.74
$185.49
$70.66
$37.1013133
T
Repair wound/lesion add-on
0025
3.74
$185.49
$70.66
$37.1013150
T
Repair of wound or lesion
0026
12.11
$600.61
$277.92
$120.1213151
T
Repair of wound or lesion
0025
3.74
$185.49
$70.66
$37.1013152
T
Repair of wound or lesion
0025
3.74
$185.49
$70.66
$37.1013153
T
Repair wound/lesion add-on
0025
3.74
$185.49
$70.66
$37.1013160
T
Late closure of wound
0026
12.11
$600.61
$277.92
$120.1214000
T
Skin tissue rearrangement
0026
12.11
$600.61
$277.92
$120.1214001
T
Skin tissue rearrangement
0026
12.11
$600.61
$277.92
$120.1214020
T
Skin tissue rearrangement
0026
12.11
$600.61
$277.92
$120.1214021
T
Skin tissue rearrangement
0026
12.11
$600.61
$277.92
$120.1214040
T
Skin tissue rearrangement
0026
12.11
$600.61
$277.92
$120.1214041
T
Skin tissue rearrangement
0026
12.11
$600.61
$277.92
$120.1214060
T
Skin tissue rearrangement
0026
12.11
$600.61
$277.92
$120.1214061
T
Skin tissue rearrangement
0026
12.11
$600.61
$277.92
$120.1214300
T
Skin tissue rearrangement
0026
12.11
$600.61
$277.92
$120.1214350
T
Skin tissue rearrangement
0026
12.11
$600.61
$277.92
$120.1215000
T
Skin graft
0026
12.11
$600.61
$277.92
$120.1215001
T
Skin graft add-on
0026
12.11
$600.61
$277.92
$120.1215050
T
Skin pinch graft
0026
12.11
$600.61
$277.92
$120.12( print page 67852)15100
T
Skin split graft
0026
12.11
$600.61
$277.92
$120.1215101
T
Skin split graft add-on
0026
12.11
$600.61
$277.92
$120.1215120
T
Skin split graft
0026
12.11
$600.61
$277.92
$120.1215121
T
Skin split graft add-on
0026
12.11
$600.61
$277.92
$120.1215200
T
Skin full graft
0026
12.11
$600.61
$277.92
$120.1215201
T
Skin full graft add-on
0026
12.11
$600.61
$277.92
$120.1215220
T
Skin full graft
0026
12.11
$600.61
$277.92
$120.1215221
T
Skin full graft add-on
0026
12.11
$600.61
$277.92
$120.1215240
T
Skin full graft
0026
12.11
$600.61
$277.92
$120.1215241
T
Skin full graft add-on
0026
12.11
$600.61
$277.92
$120.1215260
T
Skin full graft
0026
12.11
$600.61
$277.92
$120.1215261
T
Skin full graft add-on
0026
12.11
$600.61
$277.92
$120.12*15342
T
Cultured skin graft, 25 cm
0025
3.74
$185.49
$70.66
$37.10*15343
T
Culture skin graft addl 25 cm
0025
3.74
$185.49
$70.66
$37.1015350
T
Skin homograft
0026
12.11
$600.61
$277.92
$120.1215351
T
Skin homograft add-on
0026
12.11
$600.61
$277.92
$120.1215400
T
Skin heterograft
0026
12.11
$600.61
$277.92
$120.1215401
T
Skin heterograft add-on
0026
12.11
$600.61
$277.92
$120.1215570
T
Form skin pedicle flap
0026
12.11
$600.61
$277.92
$120.1215572
T
Form skin pedicle flap
0026
12.11
$600.61
$277.92
$120.1215574
T
Form skin pedicle flap
0026
12.11
$600.61
$277.92
$120.1215576
T
Form skin pedicle flap
0026
12.11
$600.61
$277.92
$120.1215600
T
Skin graft
0026
12.11
$600.61
$277.92
$120.1215610
T
Skin graft
0026
12.11
$600.61
$277.92
$120.1215620
T
Skin graft
0026
12.11
$600.61
$277.92
$120.1215630
T
Skin graft
0026
12.11
$600.61
$277.92
$120.1215650
T
Transfer skin pedicle flap
0026
12.11
$600.61
$277.92
$120.1215732
T
Muscle-skin graft, head/neck
0027
15.80
$783.62
$383.10
$156.7215734
T
Muscle-skin graft, trunk
0027
15.80
$783.62
$383.10
$156.7215736
T
Muscle-skin graft, arm
0027
15.80
$783.62
$383.10
$156.7215738
T
Muscle-skin graft, leg
0027
15.80
$783.62
$383.10
$156.7215740
T
Island pedicle flap graft
0027
15.80
$783.62
$383.10
$156.7215750
T
Neurovascular pedicle graft
0027
15.80
$783.62
$383.10
$156.7215756
C
Free muscle flap, microvasc15757
C
Free skin flap, microvasc15758
C
Free fascial flap, microvasc15760
T
Composite skin graft
0027
15.80
$783.62
$383.10
$156.7215770
T
Derma-fat-fascia graft
0027
15.80
$783.62
$383.10
$156.7215775
T
Hair transplant punch grafts
0026
12.11
$600.61
$277.92
$120.1215776
T
Hair transplant punch grafts
0026
12.11
$600.61
$277.92
$120.1215780
T
Abrasion treatment of skin
0022
12.49
$619.45
$292.94
$123.8915781
T
Abrasion treatment of skin
0022
12.49
$619.45
$292.94
$123.8915782
T
Abrasion treatment of skin
0022
12.49
$619.45
$292.94
$123.8915783
T
Abrasion treatment of skin
0015
1.77
$87.78
$31.20
$17.5615786
T
Abrasion, lesion, single
0013
0.91
$45.13
$17.66
$9.0315787
T
Abrasion, lesions, add-on
0016
3.53
$175.07
$74.67
$35.0115788
T
Chemical peel, face, epiderm
0013
0.91
$45.13
$17.66
$9.0315789
T
Chemical peel, face, dermal
0015
1.77
$87.78
$31.20
$17.5615792
T
Chemical peel, nonfacial
0016
3.53
$175.07
$74.67
$35.0115793
T
Chemical peel, nonfacial
0016
3.53
$175.07
$74.67
$35.0115810
T
Salabrasion
0016
3.53
$175.07
$74.67
$35.0115811
T
Salabrasion
0022
12.49
$619.45
$292.94
$123.8915819
T
Plastic surgery, neck
0026
12.11
$600.61
$277.92
$120.1215820
T
Revision of lower eyelid
0026
12.11
$600.61
$277.92
$120.1215821
T
Revision of lower eyelid
0026
12.11
$600.61
$277.92
$120.1215822
T
Revision of upper eyelid
0026
12.11
$600.61
$277.92
$120.1215823
T
Revision of upper eyelid
0026
12.11
$600.61
$277.92
$120.1215824
T
Removal of forehead wrinkles
0027
15.80
$783.62
$383.10
$156.7215825
T
Removal of neck wrinkles
0026
12.11
$600.61
$277.92
$120.1215826
T
Removal of brow wrinkles
0027
15.80
$783.62
$383.10
$156.7215828
T
Removal of face wrinkles
0027
15.80
$783.62
$383.10
$156.7215829
T
Removal of skin wrinkles
0026
12.11
$600.61
$277.92
$120.1215831
T
Excise excessive skin tissue
0027
15.80
$783.62
$383.10
$156.7215832
T
Excise excessive skin tissue
0027
15.80
$783.62
$383.10
$156.7215833
T
Excise excessive skin tissue
0027
15.80
$783.62
$383.10
$156.7215834
T
Excise excessive skin tissue
0027
15.80
$783.62
$383.10
$156.7215835
T
Excise excessive skin tissue
0026
12.11
$600.61
$277.92
$120.1215836
T
Excise excessive skin tissue
0027
15.80
$783.62
$383.10
$156.7215837
T
Excise excessive skin tissue
0027
15.80
$783.62
$383.10
$156.7215838
T
Excise excessive skin tissue
0022
12.49
$619.45
$292.94
$123.8915839
T
Excise excessive skin tissue
0027
15.80
$783.62
$383.10
$156.7215840
T
Graft for face nerve palsy
0027
15.80
$783.62
$383.10
$156.7215841
T
Graft for face nerve palsy
0027
15.80
$783.62
$383.10
$156.7215842
T
Graft for face nerve palsy
0027
15.80
$783.62
$383.10
$156.72( print page 67853)15845
T
Skin and muscle repair, face
0027
15.80
$783.62
$383.10
$156.7215850
T
Removal of sutures
0013
0.91
$45.13
$17.66
$9.0315851
T
Removal of sutures
0013
0.91
$45.13
$17.66
$9.0315852
T
Dressing change,not for burn
0012
0.53
$26.29
$9.18
$5.2615860
N
Test for blood flow in graft15876
T
Suction assisted lipectomy
0027
15.80
$783.62
$383.10
$156.7215877
T
Suction assisted lipectomy
0027
15.80
$783.62
$383.10
$156.7215878
T
Suction assisted lipectomy
0027
15.80
$783.62
$383.10
$156.7215879
T
Suction assisted lipectomy
0027
15.80
$783.62
$383.10
$156.7215920
T
Removal of tail bone ulcer
0022
12.49
$619.45
$292.94
$123.8915922
T
Removal of tail bone ulcer
0027
15.80
$783.62
$383.10
$156.7215931
T
Remove sacrum pressure sore
0022
12.49
$619.45
$292.94
$123.8915933
T
Remove sacrum pressure sore
0022
12.49
$619.45
$292.94
$123.8915934
T
Remove sacrum pressure sore
0027
15.80
$783.62
$383.10
$156.7215935
T
Remove sacrum pressure sore
0027
15.80
$783.62
$383.10
$156.7215936
T
Remove sacrum pressure sore
0027
15.80
$783.62
$383.10
$156.7215937
T
Remove sacrum pressure sore
0027
15.80
$783.62
$383.10
$156.7215940
T
Remove hip pressure sore
0022
12.49
$619.45
$292.94
$123.8915941
T
Remove hip pressure sore
0022
12.49
$619.45
$292.94
$123.8915944
T
Remove hip pressure sore
0027
15.80
$783.62
$383.10
$156.7215945
T
Remove hip pressure sore
0027
15.80
$783.62
$383.10
$156.7215946
T
Remove hip pressure sore
0027
15.80
$783.62
$383.10
$156.7215950
T
Remove thigh pressure sore
0022
12.49
$619.45
$292.94
$123.8915951
T
Remove thigh pressure sore
0022
12.49
$619.45
$292.94
$123.8915952
T
Remove thigh pressure sore
0027
15.80
$783.62
$383.10
$156.7215953
T
Remove thigh pressure sore
0027
15.80
$783.62
$383.10
$156.7215956
T
Remove thigh pressure sore
0027
15.80
$783.62
$383.10
$156.7215958
T
Remove thigh pressure sore
0027
15.80
$783.62
$383.10
$156.7215999
T
Removal of pressure sore
0022
12.49
$619.45
$292.94
$123.8916000
T
Initial treatment of burn(s)
0015
1.77
$87.78
$31.20
$17.5616010
T
Treatment of burn(s)
0015
1.77
$87.78
$31.20
$17.5616015
T
Treatment of burn(s)
0017
12.45
$617.47
$289.16
$123.4916020
T
Treatment of burn(s)
0015
1.77
$87.78
$31.20
$17.5616025
T
Treatment of burn(s)
0014
1.50
$74.39
$24.55
$14.8816030
T
Treatment of burn(s)
0015
1.77
$87.78
$31.20
$17.5616035
C
Incision of burn scab, initl*16036
C
Incise burn scab, addl incis17000
T
Destroy benign/premal lesion
0010
0.55
$27.28
$9.86
$5.4617003
T
Destroy lesions, 2-14
0010
0.55
$27.28
$9.86
$5.4617004
T
Destroy lesions, 15 or more
0011
2.72
$134.90
$50.01
$26.9817106
T
Destruction of skin lesions
0011
2.72
$134.90
$50.01
$26.9817107
T
Destruction of skin lesions
0011
2.72
$134.90
$50.01
$26.9817108
T
Destruction of skin lesions
0011
2.72
$134.90
$50.01
$26.9817110
T
Destruct lesion, 1-14
0010
0.55
$27.28
$9.86
$5.4617111
T
Destruct lesion, 15 or more
0011
2.72
$134.90
$50.01
$26.9817250
T
Chemical cautery, tissue
0014
1.50
$74.39
$24.55
$14.8817260
T
Destruction of skin lesions
0013
0.91
$45.13
$17.66
$9.0317261
T
Destruction of skin lesions
0013
0.91
$45.13
$17.66
$9.0317262
T
Destruction of skin lesions
0013
0.91
$45.13
$17.66
$9.0317263
T
Destruction of skin lesions
0013
0.91
$45.13
$17.66
$9.0317264
T
Destruction of skin lesions
0015
1.77
$87.78
$31.20
$17.5617266
T
Destruction of skin lesions
0016
3.53
$175.07
$74.67
$35.0117270
T
Destruction of skin lesions
0015
1.77
$87.78
$31.20
$17.5617271
T
Destruction of skin lesions
0013
0.91
$45.13
$17.66
$9.0317272
T
Destruction of skin lesions
0013
0.91
$45.13
$17.66
$9.0317273
T
Destruction of skin lesions
0015
1.77
$87.78
$31.20
$17.5617274
T
Destruction of skin lesions
0015
1.77
$87.78
$31.20
$17.5617276
T
Destruction of skin lesions
0015
1.77
$87.78
$31.20
$17.5617280
T
Destruction of skin lesions
0015
1.77
$87.78
$31.20
$17.5617281
T
Destruction of skin lesions
0015
1.77
$87.78
$31.20
$17.5617282
T
Destruction of skin lesions
0015
1.77
$87.78
$31.20
$17.5617283
T
Destruction of skin lesions
0015
1.77
$87.78
$31.20
$17.5617284
T
Destruction of skin lesions
0016
3.53
$175.07
$74.67
$35.0117286
T
Destruction of skin lesions
0016
3.53
$175.07
$74.67
$35.0117304
T
Chemosurgery of skin lesion
0020
6.51
$322.87
$130.53
$64.5717305
T
2nd stage chemosurgery
0020
6.51
$322.87
$130.53
$64.5717306
T
3rd stage chemosurgery
0020
6.51
$322.87
$130.53
$64.5717307
T
Followup skin lesion therapy
0020
6.51
$322.87
$130.53
$64.5717310
T
Extensive skin chemosurgery
0020
6.51
$322.87
$130.53
$64.5717340
T
Cryotherapy of skin
0012
0.53
$26.29
$9.18
$5.2617360
T
Skin peel therapy
0016
3.53
$175.07
$74.67
$35.0117380
T
Hair removal by electrolysis
0016
3.53
$175.07
$74.67
$35.0117999
T
Skin tissue procedure
0004
1.84
$91.26
$32.57
$18.2519000
T
Drainage of breast lesion
0004
1.84
$91.26
$32.57
$18.25( print page 67854)19001
T
Drain breast lesion add-on
0004
1.84
$91.26
$32.57
$18.2519020
T
Incision of breast lesion
0008
6.15
$305.02
$113.67
$61.0019030
N
Injection for breast x-ray19100
T
Bx breast percut w/o image
0005
5.41
$268.32
$119.75
$53.6619101
T
Biopsy of breast, open
0028
12.37
$613.52
$303.74
$122.70*19102
T
Bx breast percut w/ image
0005
5.41
$268.32
$119.75
$53.66*19103
S
Bx breast percut w/device
0974
8.25
$409.17

$81.8319110
T
Nipple exploration
0028
12.37
$613.52
$303.74
$122.7019112
T
Excise breast duct fistula
0028
12.37
$613.52
$303.74
$122.7019120
T
Removal of breast lesion
0028
12.37
$613.52
$303.74
$122.7019125
T
Excision, breast lesion
0028
12.37
$613.52
$303.74
$122.7019126
T
Excision, addl breast lesion
0028
12.37
$613.52
$303.74
$122.7019140
T
Removal of breast tissue
0028
12.37
$613.52
$303.74
$122.7019160
T
Removal of breast tissue
0028
12.37
$613.52
$303.74
$122.7019162
T
Remove breast tissue, nodes
0029
31.39
$1,557.05
$820.79
$311.4119180
T
Removal of breast
0029
31.39
$1,557.05
$820.79
$311.4119182
T
Removal of breast
0028
12.37
$613.52
$303.74
$122.7019200
C
Removal of breast19220
C
Removal of breast19240
T
Removal of breast
0029
31.39
$1,557.05
$820.79
$311.4119260
T
Removal of chest wall lesion
0021
10.49
$520.26
$236.51
$104.0519271
C
Revision of chest wall19272
C
Extensive chest wall surgery19290
T
Place needle wire, breast
0028
12.37
$613.52
$303.74
$122.7019291
T
Place needle wire, breast
0028
12.37
$613.52
$303.74
$122.70*19295
S
Place breast clip, percut
0971
1.55
$76.88

$15.3819316
T
Suspension of breast
0029
31.39
$1,557.05
$820.79
$311.4119318
T
Reduction of large breast
0029
31.39
$1,557.05
$820.79
$311.4119324
T
Enlarge breast
0029
31.39
$1,557.05
$820.79
$311.4119325
T
Enlarge breast with implant
0030
31.11
$1,543.16
$763.55
$308.6319328
T
Removal of breast implant
0028
12.37
$613.52
$303.74
$122.7019330
T
Removal of implant material
0028
12.37
$613.52
$303.74
$122.7019340
T
Immediate breast prosthesis
0030
31.11
$1,543.16
$763.55
$308.6319342
T
Delayed breast prosthesis
0030
31.11
$1,543.16
$763.55
$308.6319350
T
Breast reconstruction
0028
12.37
$613.52
$303.74
$122.7019355
T
Correct inverted nipple(s)
0028
12.37
$613.52
$303.74
$122.7019357
T
Breast reconstruction
0030
31.11
$1,543.16
$763.55
$308.6319361
C
Breast reconstruction19364
C
Breast reconstruction19366
T
Breast reconstruction
0029
31.39
$1,557.05
$820.79
$311.4119367
C
Breast reconstruction19368
C
Breast reconstruction19369
C
Breast reconstruction19370
T
Surgery of breast capsule
0028
12.37
$613.52
$303.74
$122.7019371
T
Removal of breast capsule
0029
31.39
$1,557.05
$820.79
$311.4119380
T
Revise breast reconstruction
0029
31.39
$1,557.05
$820.79
$311.4119396
T
Design custom breast implant
0028
12.37
$613.52
$303.74
$122.7019499
T
Breast surgery procedure
0004
1.84
$91.26
$32.57
$18.2520000
T
Incision of abscess
0006
2.00
$99.19
$33.95
$19.8420005
T
Incision of deep abscess
0049
15.04
$745.93
$356.95
$149.1920100
T
Explore wound, neck
0023
1.98
$98.20
$40.37
$19.6420101
T
Explore wound, chest
0026
12.11
$600.61
$277.92
$120.1220102
T
Explore wound, abdomen
0026
12.11
$600.61
$277.92
$120.1220103
T
Explore wound, extremity
0023
1.98
$98.20
$40.37
$19.6420150
T
Excise epiphyseal bar
0051
27.76
$1,376.79
$675.24
$275.3620200
T
Muscle biopsy
0020
6.51
$322.87
$130.53
$64.5720205
T
Deep muscle biopsy
0021
10.49
$520.26
$236.51
$104.0520206
T
Needle biopsy, muscle
0005
5.41
$268.32
$119.75
$53.6620220
T
Bone biopsy, trocar/needle
0019
4.00
$198.39
$78.91
$39.6820225
T
Bone biopsy, trocar/needle
0020
6.51
$322.87
$130.53
$64.5720240
T
Bone biopsy, excisional
0022
12.49
$619.45
$292.94
$123.8920245
T
Bone biopsy, excisional
0022
12.49
$619.45
$292.94
$123.8920250
T
Open bone biopsy
0049
15.04
$745.93
$356.95
$149.1920251
T
Open bone biopsy
0049
15.04
$745.93
$356.95
$149.1920500
T
Injection of sinus tract
0252
5.18
$256.90
$114.24
$51.3820501
N
Inject sinus tract for x-ray20520
T
Removal of foreign body
0019
4.00
$198.39
$78.91
$39.6820525
T
Removal of foreign body
0022
12.49
$619.45
$292.94
$123.8920550
T
Inject tendon/ligament/cyst
0040
2.11
$104.65
$40.60
$20.9320600
T
Drain/inject, joint/bursa
0040
2.11
$104.65
$40.60
$20.9320605
T
Drain/inject, joint/bursa
0040
2.11
$104.65
$40.60
$20.9320610
T
Drain/inject, joint/bursa
0040
2.11
$104.65
$40.60
$20.9320615
T
Treatment of bone cyst
0004
1.84
$91.26
$32.57
$18.2520650
T
Insert and remove bone pin
0049
15.04
$745.93
$356.95
$149.19( print page 67855)20660
C
Apply,remove fixation device20661
C
Application of head brace20662
C
Application of pelvis brace20663
C
Application of thigh brace20664
C
Halo brace application20665
N
Removal of fixation device20670
T
Removal of support implant
0021
10.49
$520.26
$236.51
$104.0520680
T
Removal of support implant
0022
12.49
$619.45
$292.94
$123.8920690
T
Apply bone fixation device
0050
21.13
$1,047.96
$513.86
$209.5920692
T
Apply bone fixation device
0050
21.13
$1,047.96
$513.86
$209.5920693
T
Adjust bone fixation device
0049
15.04
$745.93
$356.95
$149.1920694
T
Remove bone fixation device
0049
15.04
$745.93
$356.95
$149.1920802
C
Replantation, arm, complete20805
C
Replant, forearm, complete20808
C
Replantation hand, complete20816
C
Replantation digit, complete20822
C
Replantation digit, complete20824
C
Replantation thumb, complete20827
C
Replantation thumb, complete20838
C
Replantation foot, complete20900
T
Removal of bone for graft
0050
21.13
$1,047.96
$513.86
$209.5920902
T
Removal of bone for graft
0050
21.13
$1,047.96
$513.86
$209.5920910
T
Remove cartilage for graft
0026
12.11
$600.61
$277.92
$120.1220912
T
Remove cartilage for graft
0026
12.11
$600.61
$277.92
$120.1220920
T
Removal of fascia for graft
0026
12.11
$600.61
$277.92
$120.1220922
T
Removal of fascia for graft
0026
12.11
$600.61
$277.92
$120.1220924
T
Removal of tendon for graft
0050
21.13
$1,047.96
$513.86
$209.5920926
T
Removal of tissue for graft
0026
12.11
$600.61
$277.92
$120.1220930
C
Spinal bone allograft20931
C
Spinal bone allograft20936
C
Spinal bone autograft20937
C
Spinal bone autograft20938
C
Spinal bone autograft20950
T
Fluid pressure, muscle
0008
6.15
$305.02
$113.67
$61.0020955
C
Fibula bone graft, microvasc20956
C
Iliac bone graft, microvasc20957
C
Mt bone graft, microvasc20962
C
Other bone graft, microvasc20969
C
Bone/skin graft, microvasc20970
C
Bone/skin graft, iliac crest20972
C
Bone/skin graft, metatarsal20973
C
Bone/skin graft, great toe20974
A
Electrical bone stimulation20975
T
Electrical bone stimulation
0049
15.04
$745.93
$356.95
$149.1920979
E
Us bone stimulation20999
N
Musculoskeletal surgery21010
T
Incision of jaw joint
0254
12.45
$617.47
$272.41
$123.4921015
T
Resection of facial tumor
0254
12.45
$617.47
$272.41
$123.4921025
T
Excision of bone, lower jaw
0256
25.40
$1,259.74
$623.05
$251.9521026
T
Excision of facial bone(s)
0256
25.40
$1,259.74
$623.05
$251.9521029
T
Contour of face bone lesion
0256
25.40
$1,259.74
$623.05
$251.9521030
T
Removal of face bone lesion
0254
12.45
$617.47
$272.41
$123.4921031
T
Remove exostosis, mandible
0253
12.02
$596.14
$284.00
$119.2321032
T
Remove exostosis, maxilla
0253
12.02
$596.14
$284.00
$119.2321034
T
Removal of face bone lesion
0256
25.40
$1,259.74
$623.05
$251.9521040
T
Removal of jaw bone lesion
0253
12.02
$596.14
$284.00
$119.2321041
T
Removal of jaw bone lesion
0256
25.40
$1,259.74
$623.05
$251.9521044
T
Removal of jaw bone lesion
0256
25.40
$1,259.74
$623.05
$251.9521045
C
Extensive jaw surgery21050
T
Removal of jaw joint
0256
25.40
$1,259.74
$623.05
$251.9521060
T
Remove jaw joint cartilage
0256
25.40
$1,259.74
$623.05
$251.9521070
T
Remove coronoid process
0256
25.40
$1,259.74
$623.05
$251.9521076
T
Prepare face/oral prosthesis
0254
12.45
$617.47
$272.41
$123.4921077
T
Prepare face/oral prosthesis
0256
25.40
$1,259.74
$623.05
$251.9521079
T
Prepare face/oral prosthesis
0256
25.40
$1,259.74
$623.05
$251.9521080
T
Prepare face/oral prosthesis
0256
25.40
$1,259.74
$623.05
$251.9521081
T
Prepare face/oral prosthesis
0256
25.40
$1,259.74
$623.05
$251.9521082
T
Prepare face/oral prosthesis
0256
25.40
$1,259.74
$623.05
$251.9521083
T
Prepare face/oral prosthesis
0256
25.40
$1,259.74
$623.05
$251.9521084
T
Prepare face/oral prosthesis
0256
25.40
$1,259.74
$623.05
$251.9521085
T
Prepare face/oral prosthesis
0253
12.02
$596.14
$284.00
$119.2321086
T
Prepare face/oral prosthesis
0256
25.40
$1,259.74
$623.05
$251.9521087
T
Prepare face/oral prosthesis
0256
25.40
$1,259.74
$623.05
$251.9521088
T
Prepare face/oral prosthesis
0256
25.40
$1,259.74
$623.05
$251.95( print page 67856)21089
T
Prepare face/oral prosthesis
0253
12.02
$596.14
$284.00
$119.2321100
T
Maxillofacial fixation
0256
25.40
$1,259.74
$623.05
$251.9521110
T
Interdental fixation
0254
12.45
$617.47
$272.41
$123.4921116
N
Injection, jaw joint x-ray21120
T
Reconstruction of chin
0254
12.45
$617.47
$272.41
$123.4921121
T
Reconstruction of chin
0254
12.45
$617.47
$272.41
$123.4921122
T
Reconstruction of chin
0254
12.45
$617.47
$272.41
$123.4921123
T
Reconstruction of chin
0254
12.45
$617.47
$272.41
$123.4921125
T
Augmentation, lower jaw bone
0254
12.45
$617.47
$272.41
$123.4921127
T
Augmentation, lower jaw bone
0256
25.40
$1,259.74
$623.05
$251.9521137
T
Reduction of forehead
0254
12.45
$617.47
$272.41
$123.4921138
T
Reduction of forehead
0256
25.40
$1,259.74
$623.05
$251.9521139
T
Reduction of forehead
0256
25.40
$1,259.74
$623.05
$251.9521141
C
Reconstruct midface, lefort21142
C
Reconstruct midface, lefort21143
C
Reconstruct midface, lefort21145
C
Reconstruct midface, lefort21146
C
Reconstruct midface, lefort21147
C
Reconstruct midface, lefort21150
C
Reconstruct midface, lefort21151
C
Reconstruct midface, lefort21154
C
Reconstruct midface, lefort21155
C
Reconstruct midface, lefort21159
C
Reconstruct midface, lefort21160
C
Reconstruct midface, lefort21172
C
Reconstruct orbit/forehead21175
C
Reconstruct orbit/forehead21179
C
Reconstruct entire forehead21180
C
Reconstruct entire forehead21181
T
Contour cranial bone lesion
0254
12.45
$617.47
$272.41
$123.4921182
C
Reconstruct cranial bone21183
C
Reconstruct cranial bone21184
C
Reconstruct cranial bone21188
C
Reconstruction of midface21193
C
Reconst lwr jaw w/o graft21194
C
Reconst lwr jaw w/ graft21195
C
Reconst lwr jaw w/o fixation21196
C
Reconst lwr jaw w/fixation21198
T
Reconst lwr jaw segment
0256
25.40
$1,259.74
$623.05
$251.95*21199
T
Reconst lwr jaw w/advance
0256
25.40
$1,259.74
$623.05
$251.9521206
T
Reconstruct upper jaw bone
0256
25.40
$1,259.74
$623.05
$251.9521208
T
Augmentation of facial bones
0256
25.40
$1,259.74
$623.05
$251.9521209
T
Reduction of facial bones
0256
25.40
$1,259.74
$623.05
$251.9521210
T
Face bone graft
0256
25.40
$1,259.74
$623.05
$251.9521215
T
Lower jaw bone graft
0256
25.40
$1,259.74
$623.05
$251.9521230
T
Rib cartilage graft
0256
25.40
$1,259.74
$623.05
$251.9521235
T
Ear cartilage graft
0254
12.45
$617.47
$272.41
$123.4921240
T
Reconstruction of jaw joint
0256
25.40
$1,259.74
$623.05
$251.9521242
T
Reconstruction of jaw joint
0256
25.40
$1,259.74
$623.05
$251.9521243
T
Reconstruction of jaw joint
0256
25.40
$1,259.74
$623.05
$251.9521244
T
Reconstruction of lower jaw
0256
25.40
$1,259.74
$623.05
$251.9521245
T
Reconstruction of jaw
0256
25.40
$1,259.74
$623.05
$251.9521246
T
Reconstruction of jaw
0256
25.40
$1,259.74
$623.05
$251.9521247
C
Reconstruct lower jaw bone21248
T
Reconstruction of jaw
0256
25.40
$1,259.74
$623.05
$251.9521249
T
Reconstruction of jaw
0256
25.40
$1,259.74
$623.05
$251.9521255
C
Reconstruct lower jaw bone21256
C
Reconstruction of orbit21260
T
Revise eye sockets
0256
25.40
$1,259.74
$623.05
$251.9521261
T
Revise eye sockets
0256
25.40
$1,259.74
$623.05
$251.9521263
T
Revise eye sockets
0256
25.40
$1,259.74
$623.05
$251.9521267
T
Revise eye sockets
0256
25.40
$1,259.74
$623.05
$251.9521268
C
Revise eye sockets21270
T
Augmentation, cheek bone
0256
25.40
$1,259.74
$623.05
$251.9521275
T
Revision, orbitofacial bones
0256
25.40
$1,259.74
$623.05
$251.9521280
T
Revision of eyelid
0256
25.40
$1,259.74
$623.05
$251.9521282
T
Revision of eyelid
0253
12.02
$596.14
$284.00
$119.2321295
T
Revision of jaw muscle/bone
0253
12.02
$596.14
$284.00
$119.2321296
T
Revision of jaw muscle/bone
0254
12.45
$617.47
$272.41
$123.4921299
T
Cranio/maxillofacial surgery
0253
12.02
$596.14
$284.00
$119.2321300
T
Treatment of skull fracture
0253
12.02
$596.14
$284.00
$119.2321310
T
Treatment of nose fracture
0253
12.02
$596.14
$284.00
$119.2321315
T
Treatment of nose fracture
0253
12.02
$596.14
$284.00
$119.2321320
T
Treatment of nose fracture
0253
12.02
$596.14
$284.00
$119.23( print page 67857)21325
T
Treatment of nose fracture
0253
12.02
$596.14
$284.00
$119.2321330
T
Treatment of nose fracture
0254
12.45
$617.47
$272.41
$123.4921335
T
Treatment of nose fracture
0254
12.45
$617.47
$272.41
$123.4921336
T
Treat nasal septal fracture
0046
22.29
$1,105.50
$535.76
$221.1021337
T
Treat nasal septal fracture
0253
12.02
$596.14
$284.00
$119.2321338
T
Treat nasoethmoid fracture
0254
12.45
$617.47
$272.41
$123.4921339
T
Treat nasoethmoid fracture
0254
12.45
$617.47
$272.41
$123.4921340
T
Treatment of nose fracture
0256
25.40
$1,259.74
$623.05
$251.9521343
C
Treatment of sinus fracture21344
C
Treatment of sinus fracture21345
T
Treat nose/jaw fracture
0254
12.45
$617.47
$272.41
$123.4921346
C
Treat nose/jaw fracture21347
C
Treat nose/jaw fracture21348
C
Treat nose/jaw fracture21355
T
Treat cheek bone fracture
0256
25.40
$1,259.74
$623.05
$251.9521356
C
Treat cheek bone fracture21360
C
Treat cheek bone fracture21365
C
Treat cheek bone fracture21366
C
Treat cheek bone fracture21385
C
Treat eye socket fracture21386
C
Treat eye socket fracture21387
C
Treat eye socket fracture21390
C
Treat eye socket fracture21395
C
Treat eye socket fracture21400
T
Treat eye socket fracture
0252
5.18
$256.90
$114.24
$51.3821401
T
Treat eye socket fracture
0253
12.02
$596.14
$284.00
$119.2321406
T
Treat eye socket fracture
0256
25.40
$1,259.74
$623.05
$251.9521407
T
Treat eye socket fracture
0256
25.40
$1,259.74
$623.05
$251.9521408
C
Treat eye socket fracture21421
T
Treat mouth roof fracture
0254
12.45
$617.47
$272.41
$123.4921422
C
Treat mouth roof fracture21423
C
Treat mouth roof fracture21431
C
Treat craniofacial fracture21432
C
Treat craniofacial fracture21433
C
Treat craniofacial fracture21435
C
Treat craniofacial fracture21436
C
Treat craniofacial fracture21440
T
Treat dental ridge fracture
0253
12.02
$596.14
$284.00
$119.2321445
T
Treat dental ridge fracture
0254
12.45
$617.47
$272.41
$123.4921450
T
Treat lower jaw fracture
0251
1.68
$83.32
$27.99
$16.6621451
T
Treat lower jaw fracture
0254
12.45
$617.47
$272.41
$123.4921452
T
Treat lower jaw fracture
0253
12.02
$596.14
$284.00
$119.2321453
T
Treat lower jaw fracture
0256
25.40
$1,259.74
$623.05
$251.9521454
T
Treat lower jaw fracture
0254
12.45
$617.47
$272.41
$123.4921461
T
Treat lower jaw fracture
0256
25.40
$1,259.74
$623.05
$251.9521462
T
Treat lower jaw fracture
0256
25.40
$1,259.74
$623.05
$251.9521465
T
Treat lower jaw fracture
0256
25.40
$1,259.74
$623.05
$251.9521470
T
Treat lower jaw fracture
0256
25.40
$1,259.74
$623.05
$251.9521480
T
Reset dislocated jaw
0251
1.68
$83.32
$27.99
$16.6621485
T
Reset dislocated jaw
0253
12.02
$596.14
$284.00
$119.2321490
T
Repair dislocated jaw
0256
25.40
$1,259.74
$623.05
$251.9521493
T
Treat hyoid bone fracture
0252
5.18
$256.90
$114.24
$51.3821494
T
Treat hyoid bone fracture
0252
5.18
$256.90
$114.24
$51.3821495
C
Treat hyoid bone fracture21497
T
Interdental wiring
0253
12.02
$596.14
$284.00
$119.2321499
T
Head surgery procedure
0253
12.02
$596.14
$284.00
$119.2321501
T
Drain neck/chest lesion
0008
6.15
$305.02
$113.67
$61.0021502
T
Drain chest lesion
0050
21.13
$1,047.96
$513.86
$209.5921510
C
Drainage of bone lesion21550
T
Biopsy of neck/chest
0019
4.00
$198.39
$78.91
$39.6821555
T
Remove lesion, neck/chest
0022
12.49
$619.45
$292.94
$123.8921556
T
Remove lesion, neck/chest
0022
12.49
$619.45
$292.94
$123.8921557
C
Remove tumor, neck/chest21600
T
Partial removal of rib
0050
21.13
$1,047.96
$513.86
$209.5921610
T
Partial removal of rib
0050
21.13
$1,047.96
$513.86
$209.5921615
C
Removal of rib21616
C
Removal of rib and nerves21620
C
Partial removal of sternum21627
C
Sternal debridement21630
C
Extensive sternum surgery21632
C
Extensive sternum surgery21700
T
Revision of neck muscle
0008
6.15
$305.02
$113.67
$61.0021705
C
Revision of neck muscle/rib21720
T
Revision of neck muscle
0008
6.15
$305.02
$113.67
$61.00( print page 67858)21725
T
Revision of neck muscle
0008
6.15
$305.02
$113.67
$61.0021740
C
Reconstruction of sternum21750
C
Repair of sternum separation21800
T
Treatment of rib fracture
0043
1.64
$81.34
$25.46
$16.2721805
T
Treatment of rib fracture
0046
22.29
$1,105.50
$535.76
$221.1021810
C
Treatment of rib fracture(s)21820
T
Treat sternum fracture
0043
1.64
$81.34
$25.46
$16.2721825
C
Treat sternum fracture21899
T
Neck/chest surgery procedure
0252
5.18
$256.90
$114.24
$51.3821920
T
Biopsy soft tissue of back
0020
6.51
$322.87
$130.53
$64.5721925
T
Biopsy soft tissue of back
0022
12.49
$619.45
$292.94
$123.8921930
T
Remove lesion, back or flank
0022
12.49
$619.45
$292.94
$123.8921935
T
Remove tumor, back
0022
12.49
$619.45
$292.94
$123.8922100
C
Remove part of neck vertebra22101
C
Remove part, thorax vertebra22102
C
Remove part, lumbar vertebra22103
C
Remove extra spine segment22110
C
Remove part of neck vertebra22112
C
Remove part, thorax vertebra22114
C
Remove part, lumbar vertebra22116
C
Remove extra spine segment22210
C
Revision of neck spine22212
C
Revision of thorax spine22214
C
Revision of lumbar spine22216
C
Revise, extra spine segment22220
C
Revision of neck spine22222
C
Revision of thorax spine22224
C
Revision of lumbar spine22226
C
Revise, extra spine segment22305
T
Treat spine process fracture
0043
1.64
$81.34
$25.46
$16.2722310
T
Treat spine fracture
0043
1.64
$81.34
$25.46
$16.2722315
T
Treat spine fracture
0043
1.64
$81.34
$25.46
$16.2722318
C
Treat odontoid fx w/o graft22319
C
Treat odontoid fx w/graft22325
C
Treat spine fracture22326
C
Treat neck spine fracture22327
C
Treat thorax spine fracture22328
C
Treat each add spine fx22505
T
Manipulation of spine
0045
11.02
$546.55
$277.12
$109.31*22520
T
Percut vertebroplasty thor
0049
15.04
$745.93
$356.95
$149.19*22521
T
Percut vertebroplasty lumb
0049
15.04
$745.93
$356.95
$149.19*22522
T
Percut vertebroplasty addl
0049
15.04
$745.93
$356.95
$149.1922548
C
Neck spine fusion22554
C
Neck spine fusion22556
C
Thorax spine fusion22558
C
Lumbar spine fusion22585
C
Additional spinal fusion22590
C
Spine & skull spinal fusion22595
C
Neck spinal fusion22600
C
Neck spine fusion22610
C
Thorax spine fusion22612
C
Lumbar spine fusion22614
C
Spine fusion, extra segment22630
C
Lumbar spine fusion22632
C
Spine fusion, extra segment22800
C
Fusion of spine22802
C
Fusion of spine22804
C
Fusion of spine22808
C
Fusion of spine22810
C
Fusion of spine22812
C
Fusion of spine22818
C
Kyphectomy, 1-2 segments22819
C
Kyphectomy, 3 or more22830
C
Exploration of spinal fusion22840
C
Insert spine fixation device22841
C
Insert spine fixation device22842
C
Insert spine fixation device22843
C
Insert spine fixation device22844
C
Insert spine fixation device22845
C
Insert spine fixation device22846
C
Insert spine fixation device22847
C
Insert spine fixation device22848
C
Insert pelv fixation device22849
C
Reinsert spinal fixation( print page 67859)22850
C
Remove spine fixation device22851
C
Apply spine prosth device22852
C
Remove spine fixation device22855
C
Remove spine fixation device22899
T
Spine surgery procedure
0043
1.64
$81.34
$25.46
$16.2722900
T
Remove abdominal wall lesion
0022
12.49
$619.45
$292.94
$123.8922999
T
Abdomen surgery procedure
0022
12.49
$619.45
$292.94
$123.8923000
T
Removal of calcium deposits
0021
10.49
$520.26
$236.51
$104.0523020
T
Release shoulder joint
0051
27.76
$1,376.79
$675.24
$275.3623030
T
Drain shoulder lesion
0008
6.15
$305.02
$113.67
$61.0023031
T
Drain shoulder bursa
0008
6.15
$305.02
$113.67
$61.0023035
C
Drain shoulder bone lesion23040
T
Exploratory shoulder surgery
0050
21.13
$1,047.96
$513.86
$209.5923044
T
Exploratory shoulder surgery
0050
21.13
$1,047.96
$513.86
$209.5923065
T
Biopsy shoulder tissues
0021
10.49
$520.26
$236.51
$104.0523066
T
Biopsy shoulder tissues
0022
12.49
$619.45
$292.94
$123.8923075
T
Removal of shoulder lesion
0021
10.49
$520.26
$236.51
$104.0523076
T
Removal of shoulder lesion
0022
12.49
$619.45
$292.94
$123.8923077
T
Remove tumor of shoulder
0022
12.49
$619.45
$292.94
$123.8923100
T
Biopsy of shoulder joint
0049
15.04
$745.93
$356.95
$149.1923101
T
Shoulder joint surgery
0050
21.13
$1,047.96
$513.86
$209.5923105
T
Remove shoulder joint lining
0050
21.13
$1,047.96
$513.86
$209.5923106
T
Incision of collarbone joint
0050
21.13
$1,047.96
$513.86
$209.5923107
T
Explore treat shoulder joint
0050
21.13
$1,047.96
$513.86
$209.5923120
T
Partial removal, collar bone
0051
27.76
$1,376.79
$675.24
$275.3623125
C
Removal of collar bone23130
T
Remove shoulder bone, part
0051
27.76
$1,376.79
$675.24
$275.3623140
T
Removal of bone lesion
0049
15.04
$745.93
$356.95
$149.1923145
T
Removal of bone lesion
0050
21.13
$1,047.96
$513.86
$209.5923146
T
Removal of bone lesion
0050
21.13
$1,047.96
$513.86
$209.5923150
T
Removal of humerus lesion
0050
21.13
$1,047.96
$513.86
$209.5923155
T
Removal of humerus lesion
0050
21.13
$1,047.96
$513.86
$209.5923156
T
Removal of humerus lesion
0050
21.13
$1,047.96
$513.86
$209.5923170
T
Remove collar bone lesion
0050
21.13
$1,047.96
$513.86
$209.5923172
T
Remove shoulder blade lesion
0050
21.13
$1,047.96
$513.86
$209.5923174
T
Remove humerus lesion
0050
21.13
$1,047.96
$513.86
$209.5923180
T
Remove collar bone lesion
0050
21.13
$1,047.96
$513.86
$209.5923182
T
Remove shoulder blade lesion
0050
21.13
$1,047.96
$513.86
$209.5923184
T
Remove humerus lesion
0050
21.13
$1,047.96
$513.86
$209.5923190
T
Partial removal of scapula
0050
21.13
$1,047.96
$513.86
$209.5923195
C
Removal of head of humerus23200
C
Removal of collar bone23210
C
Removal of shoulder blade23220
C
Partial removal of humerus23221
C
Partial removal of humerus23222
C
Partial removal of humerus23330
T
Remove shoulder foreign body
0019
4.00
$198.39
$78.91
$39.6823331
T
Remove shoulder foreign body
0022
12.49
$619.45
$292.94
$123.8923332
C
Remove shoulder foreign body23350
N
Injection for shoulder x-ray23395
C
Muscle transfer,shoulder/arm23397
C
Muscle transfers23400
C
Fixation of shoulder blade23405
T
Incision of tendon & muscle
0050
21.13
$1,047.96
$513.86
$209.5923406
T
Incise tendon(s) & muscle(s)
0050
21.13
$1,047.96
$513.86
$209.5923410
T
Repair of tendon(s)
0052
36.16
$1,793.39
$930.91
$358.6823412
T
Repair of tendon(s)
0052
36.16
$1,793.39
$930.91
$358.6823415
T
Release of shoulder ligament
0051
27.76
$1,376.79
$675.24
$275.3623420
T
Repair of shoulder
0052
36.16
$1,793.39
$930.91
$358.6823430
T
Repair biceps tendon
0052
36.16
$1,793.39
$930.91
$358.6823440
C
Remove/transplant tendon23450
T
Repair shoulder capsule
0052
36.16
$1,793.39
$930.91
$358.6823455
T
Repair shoulder capsule
0052
36.16
$1,793.39
$930.91
$358.6823460
T
Repair shoulder capsule
0052
36.16
$1,793.39
$930.91
$358.6823462
T
Repair shoulder capsule
0052
36.16
$1,793.39
$930.91
$358.6823465
T
Repair shoulder capsule
0052
36.16
$1,793.39
$930.91
$358.6823466
T
Repair shoulder capsule
0052
36.16
$1,793.39
$930.91
$358.6823470
C
Reconstruct shoulder joint23472
C
Reconstruct shoulder joint23480
T
Revision of collar bone
0051
27.76
$1,376.79
$675.24
$275.3623485
T
Revision of collar bone
0051
27.76
$1,376.79
$675.24
$275.3623490
T
Reinforce clavicle
0051
27.76
$1,376.79
$675.24
$275.3623491
T
Reinforce shoulder bones
0051
27.76
$1,376.79
$675.24
$275.3623500
T
Treat clavicle fracture
0043
1.64
$81.34
$25.46
$16.27( print page 67860)23505
T
Treat clavicle fracture
0043
1.64
$81.34
$25.46
$16.2723515
T
Treat clavicle fracture
0046
22.29
$1,105.50
$535.76
$221.1023520
T
Treat clavicle dislocation
0043
1.64
$81.34
$25.46
$16.2723525
T
Treat clavicle dislocation
0043
1.64
$81.34
$25.46
$16.2723530
T
Treat clavicle dislocation
0046
22.29
$1,105.50
$535.76
$221.1023532
T
Treat clavicle dislocation
0046
22.29
$1,105.50
$535.76
$221.1023540
T
Treat clavicle dislocation
0043
1.64
$81.34
$25.46
$16.2723545
T
Treat clavicle dislocation
0043
1.64
$81.34
$25.46
$16.2723550
T
Treat clavicle dislocation
0046
22.29
$1,105.50
$535.76
$221.1023552
T
Treat clavicle dislocation
0046
22.29
$1,105.50
$535.76
$221.1023570
T
Treat shoulder blade fx
0043
1.64
$81.34
$25.46
$16.2723575
T
Treat shoulder blade fx
0043
1.64
$81.34
$25.46
$16.2723585
T
Treat scapula fracture
0046
22.29
$1,105.50
$535.76
$221.1023600
T
Treat humerus fracture
0044
2.17
$107.63
$38.08
$21.5323605
T
Treat humerus fracture
0044
2.17
$107.63
$38.08
$21.5323615
T
Treat humerus fracture
0046
22.29
$1,105.50
$535.76
$221.1023616
T
Treat humerus fracture
0046
22.29
$1,105.50
$535.76
$221.1023620
T
Treat humerus fracture
0044
2.17
$107.63
$38.08
$21.5323625
T
Treat humerus fracture
0044
2.17
$107.63
$38.08
$21.5323630
T
Treat humerus fracture
0046
22.29
$1,105.50
$535.76
$221.1023650
T
Treat shoulder dislocation
0043
1.64
$81.34
$25.46
$16.2723655
T
Treat shoulder dislocation
0045
11.02
$546.55
$277.12
$109.3123660
T
Treat shoulder dislocation
0046
22.29
$1,105.50
$535.76
$221.1023665
T
Treat dislocation/fracture
0044
2.17
$107.63
$38.08
$21.5323670
T
Treat dislocation/fracture
0046
22.29
$1,105.50
$535.76
$221.1023675
T
Treat dislocation/fracture
0044
2.17
$107.63
$38.08
$21.5323680
T
Treat dislocation/fracture
0046
22.29
$1,105.50
$535.76
$221.1023700
T
Fixation of shoulder
0045
11.02
$546.55
$277.12
$109.3123800
T
Fusion of shoulder joint
0051
27.76
$1,376.79
$675.24
$275.3623802
T
Fusion of shoulder joint
0051
27.76
$1,376.79
$675.24
$275.3623900
C
Amputation of arm & girdle23920
C
Amputation at shoulder joint23921
T
Amputation follow-up surgery
0026
12.11
$600.61
$277.92
$120.1223929
T
Shoulder surgery procedure
0043
1.64
$81.34
$25.46
$16.2723930
T
Drainage of arm lesion
0008
6.15
$305.02
$113.67
$61.0023931
T
Drainage of arm bursa
0008
6.15
$305.02
$113.67
$61.0023935
T
Drain arm/elbow bone lesion
0049
15.04
$745.93
$356.95
$149.1924000
T
Exploratory elbow surgery
0050
21.13
$1,047.96
$513.86
$209.5924006
T
Release elbow joint
0050
21.13
$1,047.96
$513.86
$209.5924065
T
Biopsy arm/elbow soft tissue
0020
6.51
$322.87
$130.53
$64.5724066
T
Biopsy arm/elbow soft tissue
0020
6.51
$322.87
$130.53
$64.5724075
T
Remove arm/elbow lesion
0021
10.49
$520.26
$236.51
$104.0524076
T
Remove arm/elbow lesion
0022
12.49
$619.45
$292.94
$123.8924077
T
Remove tumor of arm/elbow
0022
12.49
$619.45
$292.94
$123.8924100
T
Biopsy elbow joint lining
0049
15.04
$745.93
$356.95
$149.1924101
T
Explore/treat elbow joint
0050
21.13
$1,047.96
$513.86
$209.5924102
T
Remove elbow joint lining
0050
21.13
$1,047.96
$513.86
$209.5924105
T
Removal of elbow bursa
0049
15.04
$745.93
$356.95
$149.1924110
T
Remove humerus lesion
0049
15.04
$745.93
$356.95
$149.1924115
T
Remove/graft bone lesion
0050
21.13
$1,047.96
$513.86
$209.5924116
T
Remove/graft bone lesion
0050
21.13
$1,047.96
$513.86
$209.5924120
T
Remove elbow lesion
0049
15.04
$745.93
$356.95
$149.1924125
T
Remove/graft bone lesion
0050
21.13
$1,047.96
$513.86
$209.5924126
T
Remove/graft bone lesion
0050
21.13
$1,047.96
$513.86
$209.5924130
T
Removal of head of radius
0050
21.13
$1,047.96
$513.86
$209.5924134
T
Removal of arm bone lesion
0050
21.13
$1,047.96
$513.86
$209.5924136
T
Remove radius bone lesion
0050
21.13
$1,047.96
$513.86
$209.5924138
T
Remove elbow bone lesion
0050
21.13
$1,047.96
$513.86
$209.5924140
T
Partial removal of arm bone
0050
21.13
$1,047.96
$513.86
$209.5924145
T
Partial removal of radius
0050
21.13
$1,047.96
$513.86
$209.5924147
T
Partial removal of elbow
0050
21.13
$1,047.96
$513.86
$209.5924149
C
Radical resection of elbow24150
C
Extensive humerus surgery24151
C
Extensive humerus surgery24152
C
Extensive radius surgery24153
C
Extensive radius surgery24155
T
Removal of elbow joint
0051
27.76
$1,376.79
$675.24
$275.3624160
T
Remove elbow joint implant
0050
21.13
$1,047.96
$513.86
$209.5924164
T
Remove radius head implant
0050
21.13
$1,047.96
$513.86
$209.5924200
T
Removal of arm foreign body
0019
4.00
$198.39
$78.91
$39.6824201
T
Removal of arm foreign body
0021
10.49
$520.26
$236.51
$104.0524220
N
Injection for elbow x-ray24301
T
Muscle/tendon transfer
0050
21.13
$1,047.96
$513.86
$209.5924305
T
Arm tendon lengthening
0050
21.13
$1,047.96
$513.86
$209.59( print page 67861)24310
T
Revision of arm tendon
0049
15.04
$745.93
$356.95
$149.1924320
T
Repair of arm tendon
0051
27.76
$1,376.79
$675.24
$275.3624330
T
Revision of arm muscles
0051
27.76
$1,376.79
$675.24
$275.3624331
T
Revision of arm muscles
0051
27.76
$1,376.79
$675.24
$275.3624340
T
Repair of biceps tendon
0051
27.76
$1,376.79
$675.24
$275.3624341
T
Repair arm tendon/muscle
0051
27.76
$1,376.79
$675.24
$275.3624342
T
Repair of ruptured tendon
0051
27.76
$1,376.79
$675.24
$275.3624350
T
Repair of tennis elbow
0050
21.13
$1,047.96
$513.86
$209.5924351
T
Repair of tennis elbow
0050
21.13
$1,047.96
$513.86
$209.5924352
T
Repair of tennis elbow
0050
21.13
$1,047.96
$513.86
$209.5924354
T
Repair of tennis elbow
0050
21.13
$1,047.96
$513.86
$209.5924356
T
Revision of tennis elbow
0050
21.13
$1,047.96
$513.86
$209.5924360
T
Reconstruct elbow joint
0047
22.09
$1,095.58
$537.03
$219.1224361
T
Reconstruct elbow joint
0048
29.06
$1,441.26
$725.94
$288.2524362
T
Reconstruct elbow joint
0048
29.06
$1,441.26
$725.94
$288.2524363
T
Replace elbow joint
0048
29.06
$1,441.26
$725.94
$288.2524365
T
Reconstruct head of radius
0047
22.09
$1,095.58
$537.03
$219.1224366
T
Reconstruct head of radius
0048
29.06
$1,441.26
$725.94
$288.2524400
T
Revision of humerus
0050
21.13
$1,047.96
$513.86
$209.5924410
T
Revision of humerus
0050
21.13
$1,047.96
$513.86
$209.5924420
T
Revision of humerus
0051
27.76
$1,376.79
$675.24
$275.3624430
T
Repair of humerus
0051
27.76
$1,376.79
$675.24
$275.3624435
T
Repair humerus with graft
0051
27.76
$1,376.79
$675.24
$275.3624470
T
Revision of elbow joint
0051
27.76
$1,376.79
$675.24
$275.3624495
T
Decompression of forearm
0050
21.13
$1,047.96
$513.86
$209.5924498
T
Reinforce humerus
0051
27.76
$1,376.79
$675.24
$275.3624500
T
Treat humerus fracture
0044
2.17
$107.63
$38.08
$21.5324505
T
Treat humerus fracture
0044
2.17
$107.63
$38.08
$21.5324515
T
Treat humerus fracture
0046
22.29
$1,105.50
$535.76
$221.1024516
T
Treat humerus fracture
0046
22.29
$1,105.50
$535.76
$221.1024530
T
Treat humerus fracture
0044
2.17
$107.63
$38.08
$21.5324535
T
Treat humerus fracture
0044
2.17
$107.63
$38.08
$21.5324538
T
Treat humerus fracture
0046
22.29
$1,105.50
$535.76
$221.1024545
T
Treat humerus fracture
0046
22.29
$1,105.50
$535.76
$221.1024546
T
Treat humerus fracture
0046
22.29
$1,105.50
$535.76
$221.1024560
T
Treat humerus fracture
0044
2.17
$107.63
$38.08
$21.5324565
T
Treat humerus fracture
0044
2.17
$107.63
$38.08
$21.5324566
T
Treat humerus fracture
0046
22.29
$1,105.50
$535.76
$221.1024575
T
Treat humerus fracture
0046
22.29
$1,105.50
$535.76
$221.1024576
T
Treat humerus fracture
0044
2.17
$107.63
$38.08
$21.5324577
T
Treat humerus fracture
0044
2.17
$107.63
$38.08
$21.5324579
T
Treat humerus fracture
0046
22.29
$1,105.50
$535.76
$221.1024582
T
Treat humerus fracture
0046
22.29
$1,105.50
$535.76
$221.1024586
T
Treat elbow fracture
0046
22.29
$1,105.50
$535.76
$221.1024587
T
Treat elbow fracture
0046
22.29
$1,105.50
$535.76
$221.1024600
T
Treat elbow dislocation
0044
2.17
$107.63
$38.08
$21.5324605
T
Treat elbow dislocation
0045
11.02
$546.55
$277.12
$109.3124615
T
Treat elbow dislocation
0046
22.29
$1,105.50
$535.76
$221.1024620
T
Treat elbow fracture
0044
2.17
$107.63
$38.08
$21.5324635
T
Treat elbow fracture
0046
22.29
$1,105.50
$535.76
$221.1024640
T
Treat elbow dislocation
0044
2.17
$107.63
$38.08
$21.5324650
T
Treat radius fracture
0044
2.17
$107.63
$38.08
$21.5324655
T
Treat radius fracture
0044
2.17
$107.63
$38.08
$21.5324665
T
Treat radius fracture
0046
22.29
$1,105.50
$535.76
$221.1024666
T
Treat radius fracture
0046
22.29
$1,105.50
$535.76
$221.1024670
T
Treat ulnar fracture
0044
2.17
$107.63
$38.08
$21.5324675
T
Treat ulnar fracture
0044
2.17
$107.63
$38.08
$21.5324685
T
Treat ulnar fracture
0046
22.29
$1,105.50
$535.76
$221.1024800
T
Fusion of elbow joint
0051
27.76
$1,376.79
$675.24
$275.3624802
T
Fusion/graft of elbow joint
0051
27.76
$1,376.79
$675.24
$275.3624900
C
Amputation of upper arm24920
C
Amputation of upper arm24925
T
Amputation follow-up surgery
0049
15.04
$745.93
$356.95
$149.1924930
C
Amputation follow-up surgery24931
C
Amputate upper arm & implant24935
T
Revision of amputation
0052
36.16
$1,793.39
$930.91
$358.6824940
C
Revision of upper arm24999
T
Upper arm/elbow surgery
0044
2.17
$107.63
$38.08
$21.5325000
T
Incision of tendon sheath
0049
15.04
$745.93
$356.95
$149.1925020
T
Decompression of forearm
0049
15.04
$745.93
$356.95
$149.1925023
T
Decompression of forearm
0050
21.13
$1,047.96
$513.86
$209.5925028
T
Drainage of forearm lesion
0049
15.04
$745.93
$356.95
$149.1925031
T
Drainage of forearm bursa
0049
15.04
$745.93
$356.95
$149.1925035
T
Treat forearm bone lesion
0049
15.04
$745.93
$356.95
$149.19( print page 67862)25040
T
Explore/treat wrist joint
0050
21.13
$1,047.96
$513.86
$209.5925065
T
Biopsy forearm soft tissues
0020
6.51
$322.87
$130.53
$64.5725066
T
Biopsy forearm soft tissues
0022
12.49
$619.45
$292.94
$123.8925075
T
Removal of forearm lesion
0020
6.51
$322.87
$130.53
$64.5725076
T
Removal of forearm lesion
0022
12.49
$619.45
$292.94
$123.8925077
T
Remove tumor, forearm/wrist
0022
12.49
$619.45
$292.94
$123.8925085
T
Incision of wrist capsule
0049
15.04
$745.93
$356.95
$149.1925100
T
Biopsy of wrist joint
0049
15.04
$745.93
$356.95
$149.1925101
T
Explore/treat wrist joint
0050
21.13
$1,047.96
$513.86
$209.5925105
T
Remove wrist joint lining
0050
21.13
$1,047.96
$513.86
$209.5925107
T
Remove wrist joint cartilage
0050
21.13
$1,047.96
$513.86
$209.5925110
T
Remove wrist tendon lesion
0049
15.04
$745.93
$356.95
$149.1925111
T
Remove wrist tendon lesion
0053
11.32
$561.42
$253.49
$112.2825112
T
Reremove wrist tendon lesion
0053
11.32
$561.42
$253.49
$112.2825115
T
Remove wrist/forearm lesion
0049
15.04
$745.93
$356.95
$149.1925116
T
Remove wrist/forearm lesion
0049
15.04
$745.93
$356.95
$149.1925118
T
Excise wrist tendon sheath
0050
21.13
$1,047.96
$513.86
$209.5925119
T
Partial removal of ulna
0050
21.13
$1,047.96
$513.86
$209.5925120
T
Removal of forearm lesion
0050
21.13
$1,047.96
$513.86
$209.5925125
T
Remove/graft forearm lesion
0050
21.13
$1,047.96
$513.86
$209.5925126
T
Remove/graft forearm lesion
0050
21.13
$1,047.96
$513.86
$209.5925130
T
Removal of wrist lesion
0050
21.13
$1,047.96
$513.86
$209.5925135
T
Remove & graft wrist lesion
0050
21.13
$1,047.96
$513.86
$209.5925136
T
Remove & graft wrist lesion
0050
21.13
$1,047.96
$513.86
$209.5925145
T
Remove forearm bone lesion
0050
21.13
$1,047.96
$513.86
$209.5925150
T
Partial removal of ulna
0050
21.13
$1,047.96
$513.86
$209.5925151
T
Partial removal of radius
0050
21.13
$1,047.96
$513.86
$209.5925170
C
Extensive forearm surgery25210
T
Removal of wrist bone
0054
19.66
$975.06
$472.33
$195.0125215
T
Removal of wrist bones
0054
19.66
$975.06
$472.33
$195.0125230
T
Partial removal of radius
0050
21.13
$1,047.96
$513.86
$209.5925240
T
Partial removal of ulna
0050
21.13
$1,047.96
$513.86
$209.5925246
N
Injection for wrist x-ray25248
T
Remove forearm foreign body
0049
15.04
$745.93
$356.95
$149.1925250
T
Removal of wrist prosthesis
0050
21.13
$1,047.96
$513.86
$209.5925251
T
Removal of wrist prosthesis
0050
21.13
$1,047.96
$513.86
$209.5925260
T
Repair forearm tendon/muscle
0050
21.13
$1,047.96
$513.86
$209.5925263
T
Repair forearm tendon/muscle
0050
21.13
$1,047.96
$513.86
$209.5925265
T
Repair forearm tendon/muscle
0050
21.13
$1,047.96
$513.86
$209.5925270
T
Repair forearm tendon/muscle
0050
21.13
$1,047.96
$513.86
$209.5925272
T
Repair forearm tendon/muscle
0050
21.13
$1,047.96
$513.86
$209.5925274
T
Repair forearm tendon/muscle
0050
21.13
$1,047.96
$513.86
$209.5925280
T
Revise wrist/forearm tendon
0050
21.13
$1,047.96
$513.86
$209.5925290
T
Incise wrist/forearm tendon
0050
21.13
$1,047.96
$513.86
$209.5925295
T
Release wrist/forearm tendon
0049
15.04
$745.93
$356.95
$149.1925300
T
Fusion of tendons at wrist
0050
21.13
$1,047.96
$513.86
$209.5925301
T
Fusion of tendons at wrist
0050
21.13
$1,047.96
$513.86
$209.5927606
T
Incision of achilles tendon
0049
15.04
$745.93
$356.95
$149.1927607
T
Treat lower leg bone lesion
0049
15.04
$745.93
$356.95
$149.1927610
T
Explore/treat ankle joint
0050
21.13
$1,047.96
$513.86
$209.5927612
T
Exploration of ankle joint
0050
21.13
$1,047.96
$513.86
$209.5927613
T
Biopsy lower leg soft tissue
0020
6.51
$322.87
$130.53
$64.5727614
T
Biopsy lower leg soft tissue
0022
12.49
$619.45
$292.94
$123.8927615
T
Remove tumor, lower leg
0046
22.29
$1,105.50
$535.76
$221.1027618
T
Remove lower leg lesion
0021
10.49
$520.26
$236.51
$104.0527619
T
Remove lower leg lesion
0022
12.49
$619.45
$292.94
$123.8927620
T
Explore/treat ankle joint
0050
21.13
$1,047.96
$513.86
$209.5927625
T
Remove ankle joint lining
0050
21.13
$1,047.96
$513.86
$209.5927626
T
Remove ankle joint lining
0050
21.13
$1,047.96
$513.86
$209.5927630
T
Removal of tendon lesion
0049
15.04
$745.93
$356.95
$149.1927635
T
Remove lower leg bone lesion
0050
21.13
$1,047.96
$513.86
$209.5927637
T
Remove/graft leg bone lesion
0050
21.13
$1,047.96
$513.86
$209.5927638
T
Remove/graft leg bone lesion
0050
21.13
$1,047.96
$513.86
$209.5927640
T
Partial removal of tibia
0051
27.76
$1,376.79
$675.24
$275.3627641
T
Partial removal of fibula
0050
21.13
$1,047.96
$513.86
$209.5927645
C
Extensive lower leg surgery27646
C
Extensive lower leg surgery27647
T
Extensive ankle/heel surgery
0051
27.76
$1,376.79
$675.24
$275.3627648
N
Injection for ankle x-ray27650
T
Repair achilles tendon
0051
27.76
$1,376.79
$675.24
$275.3627652
T
Repair/graft achilles tendon
0051
27.76
$1,376.79
$675.24
$275.3627654
T
Repair of achilles tendon
0051
27.76
$1,376.79
$675.24
$275.3627656
T
Repair leg fascia defect
0049
15.04
$745.93
$356.95
$149.1927658
T
Repair of leg tendon, each
0049
15.04
$745.93
$356.95
$149.19( print page 67863)27659
T
Repair of leg tendon, each
0049
15.04
$745.93
$356.95
$149.1927664
T
Repair of leg tendon, each
0049
15.04
$745.93
$356.95
$149.1927665
T
Repair of leg tendon, each
0050
21.13
$1,047.96
$513.86
$209.5927675
T
Repair lower leg tendons
0049
15.04
$745.93
$356.95
$149.1927676
T
Repair lower leg tendons
0050
21.13
$1,047.96
$513.86
$209.5927680
T
Release of lower leg tendon
0050
21.13
$1,047.96
$513.86
$209.5927681
T
Release of lower leg tendons
0050
21.13
$1,047.96
$513.86
$209.5927685
T
Revision of lower leg tendon
0050
21.13
$1,047.96
$513.86
$209.5927686
T
Revise lower leg tendons
0050
21.13
$1,047.96
$513.86
$209.5927687
T
Revision of calf tendon
0050
21.13
$1,047.96
$513.86
$209.5927690
T
Revise lower leg tendon
0051
27.76
$1,376.79
$675.24
$275.3627691
T
Revise lower leg tendon
0051
27.76
$1,376.79
$675.24
$275.3627692
T
Revise additional leg tendon
0051
27.76
$1,376.79
$675.24
$275.3627695
T
Repair of ankle ligament
0050
21.13
$1,047.96
$513.86
$209.5927696
T
Repair of ankle ligaments
0050
21.13
$1,047.96
$513.86
$209.5927698
T
Repair of ankle ligament
0050
21.13
$1,047.96
$513.86
$209.5927700
T
Revision of ankle joint
0047
22.09
$1,095.58
$537.03
$219.1227702
C
Reconstruct ankle joint27703
C
Reconstruction, ankle joint27704
T
Removal of ankle implant
0049
15.04
$745.93
$356.95
$149.1927705
T
Incision of tibia
0051
27.76
$1,376.79
$675.24
$275.3627707
T
Incision of fibula
0049
15.04
$745.93
$356.95
$149.1927709
T
Incision of tibia & fibula
0050
21.13
$1,047.96
$513.86
$209.5927712
C
Realignment of lower leg27715
C
Revision of lower leg27720
C
Repair of tibia27722
C
Repair/graft of tibia27724
C
Repair/graft of tibia27725
C
Repair of lower leg27727
C
Repair of lower leg27730
T
Repair of tibia epiphysis
0050
21.13
$1,047.96
$513.86
$209.5927732
T
Repair of fibula epiphysis
0050
21.13
$1,047.96
$513.86
$209.5927734
T
Repair lower leg epiphyses
0050
21.13
$1,047.96
$513.86
$209.5927740
T
Repair of leg epiphyses
0050
21.13
$1,047.96
$513.86
$209.5927742
T
Repair of leg epiphyses
0051
27.76
$1,376.79
$675.24
$275.3627745
T
Reinforce tibia
0051
27.76
$1,376.79
$675.24
$275.3627750
T
Treatment of tibia fracture
0044
2.17
$107.63
$38.08
$21.5327752
T
Treatment of tibia fracture
0044
2.17
$107.63
$38.08
$21.5327756
T
Treatment of tibia fracture
0046
22.29
$1,105.50
$535.76
$221.1027758
T
Treatment of tibia fracture
0046
22.29
$1,105.50
$535.76
$221.1027759
T
Treatment of tibia fracture
0046
22.29
$1,105.50
$535.76
$221.1027760
T
Treatment of ankle fracture
0044
2.17
$107.63
$38.08
$21.5327762
T
Treatment of ankle fracture
0044
2.17
$107.63
$38.08
$21.5327766
T
Treatment of ankle fracture
0046
22.29
$1,105.50
$535.76
$221.1027780
T
Treatment of fibula fracture
0044
2.17
$107.63
$38.08
$21.5327781
T
Treatment of fibula fracture
0044
2.17
$107.63
$38.08
$21.5327784
T
Treatment of fibula fracture
0046
22.29
$1,105.50
$535.76
$221.1027786
T
Treatment of ankle fracture
0044
2.17
$107.63
$38.08
$21.5327788
T
Treatment of ankle fracture
0044
2.17
$107.63
$38.08
$21.5327792
T
Treatment of ankle fracture
0046
22.29
$1,105.50
$535.76
$221.1027808
T
Treatment of ankle fracture
0044
2.17
$107.63
$38.08
$21.5327810
T
Treatment of ankle fracture
0044
2.17
$107.63
$38.08
$21.5327814
T
Treatment of ankle fracture
0046
22.29
$1,105.50
$535.76
$221.1027816
T
Treatment of ankle fracture
0044
2.17
$107.63
$38.08
$21.5327818
T
Treatment of ankle fracture
0044
2.17
$107.63
$38.08
$21.5327822
T
Treatment of ankle fracture
0046
22.29
$1,105.50
$535.76
$221.1027823
T
Treatment of ankle fracture
0046
22.29
$1,105.50
$535.76
$221.1027824
T
Treat lower leg fracture
0044
2.17
$107.63
$38.08
$21.5327825
T
Treat lower leg fracture
0044
2.17
$107.63
$38.08
$21.5327826
T
Treat lower leg fracture
0046
22.29
$1,105.50
$535.76
$221.1027827
T
Treat lower leg fracture
0046
22.29
$1,105.50
$535.76
$221.1027828
T
Treat lower leg fracture
0046
22.29
$1,105.50
$535.76
$221.1027829
T
Treat lower leg joint
0046
22.29
$1,105.50
$535.76
$221.1027830
T
Treat lower leg dislocation
0044
2.17
$107.63
$38.08
$21.5327831
T
Treat lower leg dislocation
0045
11.02
$546.55
$277.12
$109.3127832
T
Treat lower leg dislocation
0046
22.29
$1,105.50
$535.76
$221.1027840
T
Treat ankle dislocation
0044
2.17
$107.63
$38.08
$21.5327842
T
Treat ankle dislocation
0045
11.02
$546.55
$277.12
$109.3127846
T
Treat ankle dislocation
0046
22.29
$1,105.50
$535.76
$221.1027848
T
Treat ankle dislocation
0046
22.29
$1,105.50
$535.76
$221.1027860
T
Fixation of ankle joint
0045
11.02
$546.55
$277.12
$109.3127870
T
Fusion of ankle joint
0051
27.76
$1,376.79
$675.24
$275.3627871
T
Fusion of tibiofibular joint
0051
27.76
$1,376.79
$675.24
$275.3627880
C
Amputation of lower leg( print page 67864)27881
C
Amputation of lower leg27882
C
Amputation of lower leg27884
T
Amputation follow-up surgery
0049
15.04
$745.93
$356.95
$149.1927886
C
Amputation follow-up surgery27888
C
Amputation of foot at ankle27889
T
Amputation of foot at ankle
0050
21.13
$1,047.96
$513.86
$209.5927892
T
Decompression of leg
0049
15.04
$745.93
$356.95
$149.1927893
T
Decompression of leg
0049
15.04
$745.93
$356.95
$149.1927894
T
Decompression of leg
0049
15.04
$745.93
$356.95
$149.1927899
T
Leg/ankle surgery procedure
0044
2.17
$107.63
$38.08
$21.5328001
T
Drainage of bursa of foot
0008
6.15
$305.02
$113.67
$61.0028002
T
Treatment of foot infection
0049
15.04
$745.93
$356.95
$149.1928003
T
Treatment of foot infection
0049
15.04
$745.93
$356.95
$149.1928005
T
Treat foot bone lesion
0055
15.47
$767.26
$355.34
$153.4528008
T
Incision of foot fascia
0055
15.47
$767.26
$355.34
$153.4528010
T
Incision of toe tendon
0055
15.47
$767.26
$355.34
$153.4528011
T
Incision of toe tendons
0055
15.47
$767.26
$355.34
$153.4528020
T
Exploration of foot joint
0055
15.47
$767.26
$355.34
$153.4528022
T
Exploration of foot joint
0055
15.47
$767.26
$355.34
$153.4528024
T
Exploration of toe joint
0055
15.47
$767.26
$355.34
$153.4528030
T
Removal of foot nerve
0220
13.96
$692.36
$326.21
$138.4728035
T
Decompression of tibia nerve
0220
13.96
$692.36
$326.21
$138.4728043
T
Excision of foot lesion
0021
10.49
$520.26
$236.51
$104.0528045
T
Excision of foot lesion
0055
15.47
$767.26
$355.34
$153.4528046
T
Resection of tumor, foot
0055
15.47
$767.26
$355.34
$153.4528050
T
Biopsy of foot joint lining
0055
15.47
$767.26
$355.34
$153.4528052
T
Biopsy of foot joint lining
0055
15.47
$767.26
$355.34
$153.4528054
T
Biopsy of toe joint lining
0055
15.47
$767.26
$355.34
$153.4528060
T
Partial removal, foot fascia
0056
17.30
$858.02
$405.81
$171.6028062
T
Removal of foot fascia
0056
17.30
$858.02
$405.81
$171.6028070
T
Removal of foot joint lining
0056
17.30
$858.02
$405.81
$171.6028072
T
Removal of foot joint lining
0056
17.30
$858.02
$405.81
$171.6028080
T
Removal of foot lesion
0055
15.47
$767.26
$355.34
$153.4528086
T
Excise foot tendon sheath
0055
15.47
$767.26
$355.34
$153.4528088
T
Excise foot tendon sheath
0055
15.47
$767.26
$355.34
$153.4528090
T
Removal of foot lesion
0055
15.47
$767.26
$355.34
$153.4528092
T
Removal of toe lesions
0055
15.47
$767.26
$355.34
$153.4528100
T
Removal of ankle/heel lesion
0055
15.47
$767.26
$355.34
$153.4528102
T
Remove/graft foot lesion
0056
17.30
$858.02
$405.81
$171.6028103
T
Remove/graft foot lesion
0056
17.30
$858.02
$405.81
$171.6028104
T
Removal of foot lesion
0055
15.47
$767.26
$355.34
$153.4528106
T
Remove/graft foot lesion
0056
17.30
$858.02
$405.81
$171.6028107
T
Remove/graft foot lesion
0056
17.30
$858.02
$405.81
$171.6028108
T
Removal of toe lesions
0055
15.47
$767.26
$355.34
$153.4528110
T
Part removal of metatarsal
0057
21.00
$1,041.52
$496.65
$208.3028111
T
Part removal of metatarsal
0055
15.47
$767.26
$355.34
$153.4528112
T
Part removal of metatarsal
0055
15.47
$767.26
$355.34
$153.4528113
T
Part removal of metatarsal
0055
15.47
$767.26
$355.34
$153.4528114
T
Removal of metatarsal heads
0055
15.47
$767.26
$355.34
$153.4528116
T
Revision of foot
0055
15.47
$767.26
$355.34
$153.4528118
T
Removal of heel bone
0055
15.47
$767.26
$355.34
$153.4528119
T
Removal of heel spur
0055
15.47
$767.26
$355.34
$153.4528120
T
Part removal of ankle/heel
0055
15.47
$767.26
$355.34
$153.4528122
T
Partial removal of foot bone
0055
15.47
$767.26
$355.34
$153.4528124
T
Partial removal of toe
0055
15.47
$767.26
$355.34
$153.4528126
T
Partial removal of toe
0055
15.47
$767.26
$355.34
$153.4528130
T
Removal of ankle bone
0055
15.47
$767.26
$355.34
$153.4528140
T
Removal of metatarsal
0055
15.47
$767.26
$355.34
$153.4528150
T
Removal of toe
0055
15.47
$767.26
$355.34
$153.4528153
T
Partial removal of toe
0055
15.47
$767.26
$355.34
$153.4528160
T
Partial removal of toe
0055
15.47
$767.26
$355.34
$153.4528171
T
Extensive foot surgery
0055
15.47
$767.26
$355.34
$153.4528173
T
Extensive foot surgery
0055
15.47
$767.26
$355.34
$153.4528175
T
Extensive foot surgery
0055
15.47
$767.26
$355.34
$153.4528190
T
Removal of foot foreign body
0019
4.00
$198.39
$78.91
$39.6828192
T
Removal of foot foreign body
0021
10.49
$520.26
$236.51
$104.0528193
T
Removal of foot foreign body
0020
6.51
$322.87
$130.53
$64.5728200
T
Repair of foot tendon
0055
15.47
$767.26
$355.34
$153.4528202
T
Repair/graft of foot tendon
0056
17.30
$858.02
$405.81
$171.6028208
T
Repair of foot tendon
0055
15.47
$767.26
$355.34
$153.4528210
T
Repair/graft of foot tendon
0055
15.47
$767.26
$355.34
$153.4528220
T
Release of foot tendon
0055
15.47
$767.26
$355.34
$153.4528222
T
Release of foot tendons
0055
15.47
$767.26
$355.34
$153.4528225
T
Release of foot tendon
0055
15.47
$767.26
$355.34
$153.45( print page 67865)28226
T
Release of foot tendons
0055
15.47
$767.26
$355.34
$153.4528230
T
Incision of foot tendon(s)
0055
15.47
$767.26
$355.34
$153.4528232
T
Incision of toe tendon
0055
15.47
$767.26
$355.34
$153.4528234
T
Incision of foot tendon
0055
15.47
$767.26
$355.34
$153.4528238
T
Revision of foot tendon
0056
17.30
$858.02
$405.81
$171.6028240
T
Release of big toe
0055
15.47
$767.26
$355.34
$153.4528250
T
Revision of foot fascia
0056
17.30
$858.02
$405.81
$171.6028260
T
Release of midfoot joint
0056
17.30
$858.02
$405.81
$171.6028261
T
Revision of foot tendon
0056
17.30
$858.02
$405.81
$171.6028262
T
Revision of foot and ankle
0056
17.30
$858.02
$405.81
$171.6028264
T
Release of midfoot joint
0056
17.30
$858.02
$405.81
$171.6028270
T
Release of foot contracture
0055
15.47
$767.26
$355.34
$153.4528272
T
Release of toe joint, each
0055
15.47
$767.26
$355.34
$153.4528280
T
Fusion of toes
0055
15.47
$767.26
$355.34
$153.4528285
T
Repair of hammertoe
0055
15.47
$767.26
$355.34
$153.4528286
T
Repair of hammertoe
0055
15.47
$767.26
$355.34
$153.4528288
T
Partial removal of foot bone
0056
17.30
$858.02
$405.81
$171.6028289
T
Repair hallux rigidus
0056
17.30
$858.02
$405.81
$171.6028290
T
Correction of bunion
0057
21.00
$1,041.52
$496.65
$208.3028292
T
Correction of bunion
0057
21.00
$1,041.52
$496.65
$208.3028293
T
Correction of bunion
0057
21.00
$1,041.52
$496.65
$208.3028294
T
Correction of bunion
0057
21.00
$1,041.52
$496.65
$208.3028296
T
Correction of bunion
0057
21.00
$1,041.52
$496.65
$208.3028297
T
Correction of bunion
0057
21.00
$1,041.52
$496.65
$208.3028298
T
Correction of bunion
0057
21.00
$1,041.52
$496.65
$208.3028299
T
Correction of bunion
0057
21.00
$1,041.52
$496.65
$208.3028300
T
Incision of heel bone
0056
17.30
$858.02
$405.81
$171.6028302
T
Incision of ankle bone
0056
17.30
$858.02
$405.81
$171.6028304
T
Incision of midfoot bones
0056
17.30
$858.02
$405.81
$171.6028305
T
Incise/graft midfoot bones
0056
17.30
$858.02
$405.81
$171.6028306
T
Incision of metatarsal
0056
17.30
$858.02
$405.81
$171.6028307
T
Incision of metatarsal
0056
17.30
$858.02
$405.81
$171.6028308
T
Incision of metatarsal
0056
17.30
$858.02
$405.81
$171.6028309
T
Incision of metatarsals
0056
17.30
$858.02
$405.81
$171.6028310
T
Revision of big toe
0055
15.47
$767.26
$355.34
$153.4528312
T
Revision of toe
0055
15.47
$767.26
$355.34
$153.4528313
T
Repair deformity of toe
0055
15.47
$767.26
$355.34
$153.4528315
T
Removal of sesamoid bone
0055
15.47
$767.26
$355.34
$153.4528320
T
Repair of foot bones
0056
17.30
$858.02
$405.81
$171.6028322
T
Repair of metatarsals
0056
17.30
$858.02
$405.81
$171.6028340
T
Resect enlarged toe tissue
0055
15.47
$767.26
$355.34
$153.4528341
T
Resect enlarged toe
0055
15.47
$767.26
$355.34
$153.4528344
T
Repair extra toe(s)
0056
17.30
$858.02
$405.81
$171.6028345
T
Repair webbed toe(s)
0056
17.30
$858.02
$405.81
$171.6028360
T
Reconstruct cleft foot
0056
17.30
$858.02
$405.81
$171.6028400
T
Treatment of heel fracture
0044
2.17
$107.63
$38.08
$21.5328405
T
Treatment of heel fracture
0044
2.17
$107.63
$38.08
$21.5328406
T
Treatment of heel fracture
0046
22.29
$1,105.50
$535.76
$221.1028415
T
Treat heel fracture
0046
22.29
$1,105.50
$535.76
$221.1028420
T
Treat/graft heel fracture
0046
22.29
$1,105.50
$535.76
$221.1028430
T
Treatment of ankle fracture
0044
2.17
$107.63
$38.08
$21.5328435
T
Treatment of ankle fracture
0044
2.17
$107.63
$38.08
$21.5328436
T
Treatment of ankle fracture
0046
22.29
$1,105.50
$535.76
$221.1028445
T
Treat ankle fracture
0046
22.29
$1,105.50
$535.76
$221.1028450
T
Treat midfoot fracture, each
0044
2.17
$107.63
$38.08
$21.5328455
T
Treat midfoot fracture, each
0044
2.17
$107.63
$38.08
$21.5328456
T
Treat midfoot fracture
0046
22.29
$1,105.50
$535.76
$221.1028465
T
Treat midfoot fracture, each
0046
22.29
$1,105.50
$535.76
$221.1028470
T
Treat metatarsal fracture
0044
2.17
$107.63
$38.08
$21.5328475
T
Treat metatarsal fracture
0044
2.17
$107.63
$38.08
$21.5328476
T
Treat metatarsal fracture
0046
22.29
$1,105.50
$535.76
$221.1028485
T
Treat metatarsal fracture
0046
22.29
$1,105.50
$535.76
$221.1028490
T
Treat big toe fracture
0043
1.64
$81.34
$25.46
$16.2728495
T
Treat big toe fracture
0043
1.64
$81.34
$25.46
$16.2728496
T
Treat big toe fracture
0046
22.29
$1,105.50
$535.76
$221.1028505
T
Treat big toe fracture
0046
22.29
$1,105.50
$535.76
$221.1028510
T
Treatment of toe fracture
0043
1.64
$81.34
$25.46
$16.2728515
T
Treatment of toe fracture
0043
1.64
$81.34
$25.46
$16.2728525
T
Treat toe fracture
0046
22.29
$1,105.50
$535.76
$221.1028530
T
Treat sesamoid bone fracture
0044
2.17
$107.63
$38.08
$21.5328531
T
Treat sesamoid bone fracture
0046
22.29
$1,105.50
$535.76
$221.1028540
T
Treat foot dislocation
0044
2.17
$107.63
$38.08
$21.5328545
T
Treat foot dislocation
0045
11.02
$546.55
$277.12
$109.3128546
T
Treat foot dislocation
0046
22.29
$1,105.50
$535.76
$221.10( print page 67866)28555
T
Repair foot dislocation
0046
22.29
$1,105.50
$535.76
$221.1028570
T
Treat foot dislocation
0044
2.17
$107.63
$38.08
$21.5328575
T
Treat foot dislocation
0045
11.02
$546.55
$277.12
$109.3128576
T
Treat foot dislocation
0046
22.29
$1,105.50
$535.76
$221.1028585
T
Repair foot dislocation
0046
22.29
$1,105.50
$535.76
$221.1028600
T
Treat foot dislocation
0044
2.17
$107.63
$38.08
$21.5328605
T
Treat foot dislocation
0045
11.02
$546.55
$277.12
$109.3128606
T
Treat foot dislocation
0046
22.29
$1,105.50
$535.76
$221.1028615
T
Repair foot dislocation
0046
22.29
$1,105.50
$535.76
$221.1028630
T
Treat toe dislocation
0043
1.64
$81.34
$25.46
$16.2728635
T
Treat toe dislocation
0045
11.02
$546.55
$277.12
$109.3128636
T
Treat toe dislocation
0046
22.29
$1,105.50
$535.76
$221.1028645
T
Repair toe dislocation
0046
22.29
$1,105.50
$535.76
$221.1028660
T
Treat toe dislocation
0043
1.64
$81.34
$25.46
$16.2728665
T
Treat toe dislocation
0045
11.02
$546.55
$277.12
$109.3128666
T
Treat toe dislocation
0046
22.29
$1,105.50
$535.76
$221.1028675
T
Repair of toe dislocation
0046
22.29
$1,105.50
$535.76
$221.1028705
T
Fusion of foot bones
0056
17.30
$858.02
$405.81
$171.6028715
T
Fusion of foot bones
0056
17.30
$858.02
$405.81
$171.6028725
T
Fusion of foot bones
0056
17.30
$858.02
$405.81
$171.6028730
T
Fusion of foot bones
0056
17.30
$858.02
$405.81
$171.6028735
T
Fusion of foot bones
0056
17.30
$858.02
$405.81
$171.6028737
T
Revision of foot bones
0055
15.47
$767.26
$355.34
$153.4528740
T
Fusion of foot bones
0056
17.30
$858.02
$405.81
$171.6028750
T
Fusion of big toe joint
0055
15.47
$767.26
$355.34
$153.4528755
T
Fusion of big toe joint
0055
15.47
$767.26
$355.34
$153.4528760
T
Fusion of big toe joint
0056
17.30
$858.02
$405.81
$171.6028800
C
Amputation of midfoot28805
C
Amputation thru metatarsal28810
T
Amputation toe & metatarsal
0055
15.47
$767.26
$355.34
$153.4528820
T
Amputation of toe
0055
15.47
$767.26
$355.34
$153.4528825
T
Partial amputation of toe
0055
15.47
$767.26
$355.34
$153.4528899
T
Foot/toes surgery procedure
0043
1.64
$81.34
$25.46
$16.2729000
S
Application of body cast
0059
1.74
$86.30
$29.59
$17.2629010
S
Application of body cast
0059
1.74
$86.30
$29.59
$17.2629015
S
Application of body cast
0059
1.74
$86.30
$29.59
$17.2629020
S
Application of body cast
0059
1.74
$86.30
$29.59
$17.2629025
S
Application of body cast
0059
1.74
$86.30
$29.59
$17.2629035
S
Application of body cast
0059
1.74
$86.30
$29.59
$17.2629040
S
Application of body cast
0059
1.74
$86.30
$29.59
$17.2629044
S
Application of body cast
0059
1.74
$86.30
$29.59
$17.2629046
S
Application of body cast
0059
1.74
$86.30
$29.59
$17.2629049
S
Application of figure eight
0059
1.74
$86.30
$29.59
$17.2629055
S
Application of shoulder cast
0059
1.74
$86.30
$29.59
$17.2629058
S
Application of shoulder cast
0059
1.74
$86.30
$29.59
$17.2629065
S
Application of long arm cast
0059
1.74
$86.30
$29.59
$17.2629075
S
Application of forearm cast
0059
1.74
$86.30
$29.59
$17.2629085
S
Apply hand/wrist cast
0059
1.74
$86.30
$29.59
$17.2629105
S
Apply long arm splint
0059
1.74
$86.30
$29.59
$17.2629125
S
Apply forearm splint
0059
1.74
$86.30
$29.59
$17.2629126
S
Apply forearm splint
0059
1.74
$86.30
$29.59
$17.2629130
S
Application of finger splint
0059
1.74
$86.30
$29.59
$17.2629131
S
Application of finger splint
0059
1.74
$86.30
$29.59
$17.2629200
S
Strapping of chest
0059
1.74
$86.30
$29.59
$17.2629220
S
Strapping of low back
0059
1.74
$86.30
$29.59
$17.2629240
S
Strapping of shoulder
0059
1.74
$86.30
$29.59
$17.2629260
S
Strapping of elbow or wrist
0059
1.74
$86.30
$29.59
$17.2629280
S
Strapping of hand or finger
0059
1.74
$86.30
$29.59
$17.2629305
S
Application of hip cast
0059
1.74
$86.30
$29.59
$17.2629325
S
Application of hip casts
0059
1.74
$86.30
$29.59
$17.2629345
S
Application of long leg cast
0059
1.74
$86.30
$29.59
$17.2629355
S
Application of long leg cast
0059
1.74
$86.30
$29.59
$17.2629358
S
Apply long leg cast brace
0059
1.74
$86.30
$29.59
$17.2629365
S
Application of long leg cast
0059
1.74
$86.30
$29.59
$17.2629405
S
Apply short leg cast
0059
1.74
$86.30
$29.59
$17.2629425
S
Apply short leg cast
0059
1.74
$86.30
$29.59
$17.2629435
S
Apply short leg cast
0059
1.74
$86.30
$29.59
$17.2629440
S
Addition of walker to cast
0059
1.74
$86.30
$29.59
$17.2629445
S
Apply rigid leg cast
0059
1.74
$86.30
$29.59
$17.2629450
S
Application of leg cast
0059
1.74
$86.30
$29.59
$17.2629505
S
Application, long leg splint
0058
1.09
$54.06
$19.27
$10.8129515
S
Application lower leg splint
0058
1.09
$54.06
$19.27
$10.8129520
S
Strapping of hip
0058
1.09
$54.06
$19.27
$10.8129530
S
Strapping of knee
0058
1.09
$54.06
$19.27
$10.81( print page 67867)29540
S
Strapping of ankle
0058
1.09
$54.06
$19.27
$10.8129550
S
Strapping of toes
0058
1.09
$54.06
$19.27
$10.8129580
S
Application of paste boot
0058
1.09
$54.06
$19.27
$10.8129590
S
Application of foot splint
0058
1.09
$54.06
$19.27
$10.8129700
S
Removal/revision of cast
0058
1.09
$54.06
$19.27
$10.8129705
S
Removal/revision of cast
0058
1.09
$54.06
$19.27
$10.8129710
S
Removal/revision of cast
0058
1.09
$54.06
$19.27
$10.8129715
S
Removal/revision of cast
0058
1.09
$54.06
$19.27
$10.8129720
S
Repair of body cast
0058
1.09
$54.06
$19.27
$10.8129730
S
Windowing of cast
0058
1.09
$54.06
$19.27
$10.8129740
S
Wedging of cast
0058
1.09
$54.06
$19.27
$10.8129750
S
Wedging of clubfoot cast
0058
1.09
$54.06
$19.27
$10.8129799
S
Casting/strapping procedure
0058
1.09
$54.06
$19.27
$10.8129800
T
Jaw arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229804
T
Jaw arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229815
T
Shoulder arthroscopy
0041
24.57
$1,218.58
$592.08
$243.7229819
T
Shoulder arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229820
T
Shoulder arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229821
T
Shoulder arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229822
T
Shoulder arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229823
T
Shoulder arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229825
T
Shoulder arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229826
T
Shoulder arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229830
T
Elbow arthroscopy
0041
24.57
$1,218.58
$592.08
$243.7229834
T
Elbow arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229835
T
Elbow arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229836
T
Elbow arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229837
T
Elbow arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229838
T
Elbow arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229840
T
Wrist arthroscopy
0041
24.57
$1,218.58
$592.08
$243.7229843
T
Wrist arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229844
T
Wrist arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229845
T
Wrist arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229846
T
Wrist arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229847
T
Wrist arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229848
T
Wrist endoscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229850
T
Knee arthroscopy/surgery
0042
29.22
$1,449.19
$804.74
$289.8429851
T
Knee arthroscopy/surgery
0042
29.22
$1,449.19
$804.74
$289.8429855
T
Tibial arthroscopy/surgery
0042
29.22
$1,449.19
$804.74
$289.8429856
T
Tibial arthroscopy/surgery
0042
29.22
$1,449.19
$804.74
$289.8429860
T
Hip arthroscopy, dx
0041
24.57
$1,218.58
$592.08
$243.7229861
T
Hip arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229862
T
Hip arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229863
T
Hip arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229870
T
Knee arthroscopy, dx
0041
24.57
$1,218.58
$592.08
$243.7229871
T
Knee arthroscopy/drainage
0041
24.57
$1,218.58
$592.08
$243.7229874
T
Knee arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229875
T
Knee arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229876
T
Knee arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229877
T
Knee arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229879
T
Knee arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229880
T
Knee arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229881
T
Knee arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229882
T
Knee arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229883
T
Knee arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229884
T
Knee arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229885
T
Knee arthroscopy/surgery
0042
29.22
$1,449.19
$804.74
$289.8429886
T
Knee arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229887
T
Knee arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229888
T
Knee arthroscopy/surgery
0042
29.22
$1,449.19
$804.74
$289.8429889
T
Knee arthroscopy/surgery
0042
29.22
$1,449.19
$804.74
$289.8429891
T
Ankle arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229892
T
Ankle arthroscopy/surgery
0042
29.22
$1,449.19
$804.74
$289.8429893
T
Scope, plantar fasciotomy
0055
15.47
$767.26
$355.34
$153.4529894
T
Ankle arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229895
T
Ankle arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229897
T
Ankle arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229898
T
Ankle arthroscopy/surgery
0041
24.57
$1,218.58
$592.08
$243.7229909
T
Arthroscopy of joint
0041
24.57
$1,218.58
$592.08
$243.7230000
T
Drainage of nose lesion
0251
1.68
$83.32
$27.99
$16.6630020
T
Drainage of nose lesion
0251
1.68
$83.32
$27.99
$16.6630100
T
Intranasal biopsy
0252
5.18
$256.90
$114.24
$51.3830110
T
Removal of nose polyp(s)
0253
12.02
$596.14
$284.00
$119.2330115
T
Removal of nose polyp(s)
0253
12.02
$596.14
$284.00
$119.23( print page 67868)30117
T
Removal of intranasal lesion
0253
12.02
$596.14
$284.00
$119.2330118
T
Removal of intranasal lesion
0254
12.45
$617.47
$272.41
$123.4930120
T
Revision of nose
0253
12.02
$596.14
$284.00
$119.2330124
T
Removal of nose lesion
0252
5.18
$256.90
$114.24
$51.3830125
T
Removal of nose lesion
0256
25.40
$1,259.74
$623.05
$251.9530130
T
Removal of turbinate bones
0253
12.02
$596.14
$284.00
$119.2330140
T
Removal of turbinate bones
0253
12.02
$596.14
$284.00
$119.2330150
T
Partial removal of nose
0256
25.40
$1,259.74
$623.05
$251.9530160
T
Removal of nose
0256
25.40
$1,259.74
$623.05
$251.9530200
T
Injection treatment of nose
0253
12.02
$596.14
$284.00
$119.2330210
T
Nasal sinus therapy
0252
5.18
$256.90
$114.24
$51.3830220
T
Insert nasal septal button
0252
5.18
$256.90
$114.24
$51.3830300
T
Remove nasal foreign body
0251
1.68
$83.32
$27.99
$16.6630310
T
Remove nasal foreign body
0253
12.02
$596.14
$284.00
$119.2330320
T
Remove nasal foreign body
0253
12.02
$596.14
$284.00
$119.2330400
T
Reconstruction of nose
0256
25.40
$1,259.74
$623.05
$251.9530410
T
Reconstruction of nose
0256
25.40
$1,259.74
$623.05
$251.9530420
T
Reconstruction of nose
0256
25.40
$1,259.74
$623.05
$251.9530430
T
Revision of nose
0254
12.45
$617.47
$272.41
$123.4930435
T
Revision of nose
0256
25.40
$1,259.74
$623.05
$251.9530450
T
Revision of nose
0256
25.40
$1,259.74
$623.05
$251.9530460
T
Revision of nose
0256
25.40
$1,259.74
$623.05
$251.9530462
T
Revision of nose
0256
25.40
$1,259.74
$623.05
$251.95*30465
T
Repair nasal stenosis
0256
25.40
$1,259.74
$623.05
$251.9530520
T
Repair of nasal septum
0256
25.40
$1,259.74
$623.05
$251.9530540
T
Repair nasal defect
0256
25.40
$1,259.74
$623.05
$251.9530545
T
Repair nasal defect
0256
25.40
$1,259.74
$623.05
$251.9530560
T
Release of nasal adhesions
0251
1.68
$83.32
$27.99
$16.6630580
T
Repair upper jaw fistula
0256
25.40
$1,259.74
$623.05
$251.9530600
T
Repair mouth/nose fistula
0256
25.40
$1,259.74
$623.05
$251.9530620
T
Intranasal reconstruction
0256
25.40
$1,259.74
$623.05
$251.9530630
T
Repair nasal septum defect
0254
12.45
$617.47
$272.41
$123.4930801
T
Cauterization, inner nose
0252
5.18
$256.90
$114.24
$51.3830802
T
Cauterization, inner nose
0253
12.02
$596.14
$284.00
$119.2330901
T
Control of nosebleed
0250
2.21
$109.61
$38.54
$21.9230903
T
Control of nosebleed
0250
2.21
$109.61
$38.54
$21.9230905
T
Control of nosebleed
0250
2.21
$109.61
$38.54
$21.9230906
T
Repeat control of nosebleed
0250
2.21
$109.61
$38.54
$21.9230915
T
Ligation, nasal sinus artery
0091
14.79
$733.52
$348.23
$146.7030920
T
Ligation, upper jaw artery
0092
20.21
$1,002.34
$505.37
$200.4730930
T
Therapy, fracture of nose
0253
12.02
$596.14
$284.00
$119.2330999
T
Nasal surgery procedure
0251
1.68
$83.32
$27.99
$16.6631000
T
Irrigation, maxillary sinus
0251
1.68
$83.32
$27.99
$16.6631002
T
Irrigation, sphenoid sinus
0252
5.18
$256.90
$114.24
$51.3831020
T
Exploration, maxillary sinus
0253
12.02
$596.14
$284.00
$119.2331030
T
Exploration, maxillary sinus
0256
25.40
$1,259.74
$623.05
$251.9531032
T
Explore sinus,remove polyps
0256
25.40
$1,259.74
$623.05
$251.9531040
T
Exploration behind upper jaw
0254
12.45
$617.47
$272.41
$123.4931050
T
Exploration, sphenoid sinus
0256
25.40
$1,259.74
$623.05
$251.9531051
T
Sphenoid sinus surgery
0256
25.40
$1,259.74
$623.05
$251.9531070
T
Exploration of frontal sinus
0254
12.45
$617.47
$272.41
$123.4931075
T
Exploration of frontal sinus
0256
25.40
$1,259.74
$623.05
$251.9531080
T
Removal of frontal sinus
0256
25.40
$1,259.74
$623.05
$251.9531081
T
Removal of frontal sinus
0256
25.40
$1,259.74
$623.05
$251.9531084
T
Removal of frontal sinus
0256
25.40
$1,259.74
$623.05
$251.9531085
T
Removal of frontal sinus
0256
25.40
$1,259.74
$623.05
$251.9531086
T
Removal of frontal sinus
0256
25.40
$1,259.74
$623.05
$251.9531087
T
Removal of frontal sinus
0256
25.40
$1,259.74
$623.05
$251.9531090
T
Exploration of sinuses
0256
25.40
$1,259.74
$623.05
$251.9531200
T
Removal of ethmoid sinus
0256
25.40
$1,259.74
$623.05
$251.9531201
T
Removal of ethmoid sinus
0256
25.40
$1,259.74
$623.05
$251.9531205
T
Removal of ethmoid sinus
0256
25.40
$1,259.74
$623.05
$251.9531225
C
Removal of upper jaw31230
C
Removal of upper jaw31231
T
Nasal endoscopy, dx
0071
0.55
$27.28
$14.22
$5.4631233
T
Nasal/sinus endoscopy, dx
0072
1.26
$62.49
$41.52
$12.5031235
T
Nasal/sinus endoscopy, dx
0074
13.61
$675.00
$347.54
$135.0031237
T
Nasal/sinus endoscopy, surg
0074
13.61
$675.00
$347.54
$135.0031238
T
Nasal/sinus endoscopy, surg
0074
13.61
$675.00
$347.54
$135.0031239
T
Nasal/sinus endoscopy, surg
0075
18.55
$920.01
$467.29
$184.0031240
T
Nasal/sinus endoscopy, surg
0074
13.61
$675.00
$347.54
$135.0031254
T
Revision of ethmoid sinus
0075
18.55
$920.01
$467.29
$184.0031255
T
Removal of ethmoid sinus
0075
18.55
$920.01
$467.29
$184.0031256
T
Exploration maxillary sinus
0075
18.55
$920.01
$467.29
$184.00( print page 67869)31267
T
Endoscopy, maxillary sinus
0075
18.55
$920.01
$467.29
$184.0031276
T
Sinus endoscopy, surgical
0075
18.55
$920.01
$467.29
$184.0031287
T
Nasal/sinus endoscopy, surg
0075
18.55
$920.01
$467.29
$184.0031288
T
Nasal/sinus endoscopy, surg
0075
18.55
$920.01
$467.29
$184.0031290
C
Nasal/sinus endoscopy, surg31291
C
Nasal/sinus endoscopy, surg31292
C
Nasal/sinus endoscopy, surg31293
C
Nasal/sinus endoscopy, surg31294
C
Nasal/sinus endoscopy, surg31299
T
Sinus surgery procedure
0252
5.18
$256.90
$114.24
$51.3831300
T
Removal of larynx lesion
0256
25.40
$1,259.74
$623.05
$251.9531320
T
Diagnostic incision, larynx
0256
25.40
$1,259.74
$623.05
$251.9531360
C
Removal of larynx31365
C
Removal of larynx31367
C
Partial removal of larynx31368
C
Partial removal of larynx31370
C
Partial removal of larynx31375
C
Partial removal of larynx31380
C
Partial removal of larynx31382
C
Partial removal of larynx31390
C
Removal of larynx & pharynx31395
C
Reconstruct larynx & pharynx31400
T
Revision of larynx
0256
25.40
$1,259.74
$623.05
$251.9531420
T
Removal of epiglottis
0256
25.40
$1,259.74
$623.05
$251.9531500
S
Insert emergency airway
0094
4.51
$223.68
$105.29
$44.7431502
T
Change of windpipe airway
0121
2.36
$117.05
$52.53
$23.4131505
T
Diagnostic laryngoscopy
0072
1.26
$62.49
$41.52
$12.5031510
T
Laryngoscopy with biopsy
0074
13.61
$675.00
$347.54
$135.0031511
T
Remove foreign body, larynx
0072
1.26
$62.49
$41.52
$12.5031512
T
Removal of larynx lesion
0074
13.61
$675.00
$347.54
$135.0031513
T
Injection into vocal cord
0073
4.11
$203.84
$91.07
$40.7731515
T
Laryngoscopy for aspiration
0074
13.61
$675.00
$347.54
$135.0031520
T
Diagnostic laryngoscopy
0072
1.26
$62.49
$41.52
$12.5031525
T
Diagnostic laryngoscopy
0074
13.61
$675.00
$347.54
$135.0031526
T
Diagnostic laryngoscopy
0074
13.61
$675.00
$347.54
$135.0031527
T
Laryngoscopy for treatment
0075
18.55
$920.01
$467.29
$184.0031528
T
Laryngoscopy and dilatation
0074
13.61
$675.00
$347.54
$135.0031529
T
Laryngoscopy and dilatation
0074
13.61
$675.00
$347.54
$135.0031530
T
Operative laryngoscopy
0075
18.55
$920.01
$467.29
$184.0031531
T
Operative laryngoscopy
0075
18.55
$920.01
$467.29
$184.0031535
T
Operative laryngoscopy
0075
18.55
$920.01
$467.29
$184.0031536
T
Operative laryngoscopy
0075
18.55
$920.01
$467.29
$184.0031540
T
Operative laryngoscopy
0075
18.55
$920.01
$467.29
$184.0031541
T
Operative laryngoscopy
0075
18.55
$920.01
$467.29
$184.0031560
T
Operative laryngoscopy
0075
18.55
$920.01
$467.29
$184.0031561
T
Operative laryngoscopy
0075
18.55
$920.01
$467.29
$184.0031570
T
Laryngoscopy with injection
0075
18.55
$920.01
$467.29
$184.0031571
T
Laryngoscopy with injection
0075
18.55
$920.01
$467.29
$184.0031575
T
Diagnostic laryngoscopy
0071
0.55
$27.28
$14.22
$5.4631576
T
Laryngoscopy with biopsy
0074
13.61
$675.00
$347.54
$135.0031577
T
Remove foreign body, larynx
0073
4.11
$203.84
$91.07
$40.7731578
T
Removal of larynx lesion
0074
13.61
$675.00
$347.54
$135.0031579
T
Diagnostic laryngoscopy
0073
4.11
$203.84
$91.07
$40.7731580
T
Revision of larynx
0256
25.40
$1,259.74
$623.05
$251.9531582
C
Revision of larynx31584
C
Treat larynx fracture31585
T
Treat larynx fracture
0253
12.02
$596.14
$284.00
$119.2331586
T
Treat larynx fracture
0256
25.40
$1,259.74
$623.05
$251.9531587
C
Revision of larynx31588
T
Revision of larynx
0256
25.40
$1,259.74
$623.05
$251.9531590
T
Reinnervate larynx
0256
25.40
$1,259.74
$623.05
$251.9531595
T
Larynx nerve surgery
0256
25.40
$1,259.74
$623.05
$251.9531599
T
Larynx surgery procedure
0253
12.02
$596.14
$284.00
$119.2331600
T
Incision of windpipe
0254
12.45
$617.47
$272.41
$123.4931601
T
Incision of windpipe
0254
12.45
$617.47
$272.41
$123.4931603
T
Incision of windpipe
0254
12.45
$617.47
$272.41
$123.4931605
T
Incision of windpipe
0254
12.45
$617.47
$272.41
$123.4931610
T
Incision of windpipe
0254
12.45
$617.47
$272.41
$123.4931611
T
Surgery/speech prosthesis
0254
12.45
$617.47
$272.41
$123.4931612
T
Puncture/clear windpipe
0253
12.02
$596.14
$284.00
$119.2331613
T
Repair windpipe opening
0254
12.45
$617.47
$272.41
$123.4931614
T
Repair windpipe opening
0256
25.40
$1,259.74
$623.05
$251.9531615
T
Visualization of windpipe
0076
8.06
$399.75
$197.05
$79.9531622
T
Dx bronchoscope/wash
0076
8.06
$399.75
$197.05
$79.95( print page 67870)31623
T
Dx bronchoscope/brush
0076
8.06
$399.75
$197.05
$79.9531624
T
Dx bronchoscope/lavage
0076
8.06
$399.75
$197.05
$79.9531625
T
Bronchoscopy with biopsy
0076
8.06
$399.75
$197.05
$79.9531628
T
Bronchoscopy with biopsy
0076
8.06
$399.75
$197.05
$79.9531629
T
Bronchoscopy with biopsy
0076
8.06
$399.75
$197.05
$79.9531630
T
Bronchoscopy with repair
0076
8.06
$399.75
$197.05
$79.9531631
T
Bronchoscopy with dilation
0076
8.06
$399.75
$197.05
$79.9531635
T
Remove foreign body, airway
0076
8.06
$399.75
$197.05
$79.9531640
T
Bronchoscopy & remove lesion
0076
8.06
$399.75
$197.05
$79.9531641
T
Bronchoscopy, treat blockage
0076
8.06
$399.75
$197.05
$79.9531643
T
Diag bronchoscope/catheter
0076
8.06
$399.75
$197.05
$79.9531645
T
Bronchoscopy, clear airways
0076
8.06
$399.75
$197.05
$79.9531646
T
Bronchoscopy, reclear airway
0076
8.06
$399.75
$197.05
$79.9531656
T
Bronchoscopy, inj for xray
0076
8.06
$399.75
$197.05
$79.9531700
T
Insertion of airway catheter
0072
1.26
$62.49
$41.52
$12.5031708
N
Instill airway contrast dye31710
N
Insertion of airway catheter31715
N
Injection for bronchus x-ray31717
T
Bronchial brush biopsy
0073
4.11
$203.84
$91.07
$40.7731720
T
Clearance of airways
0072
1.26
$62.49
$41.52
$12.5031725
C
Clearance of airways31730
T
Intro, windpipe wire/tube
0073
4.11
$203.84
$91.07
$40.7731750
T
Repair of windpipe
0256
25.40
$1,259.74
$623.05
$251.9531755
T
Repair of windpipe
0256
25.40
$1,259.74
$623.05
$251.9531760
C
Repair of windpipe31766
C
Reconstruction of windpipe31770
C
Repair/graft of bronchus31775
C
Reconstruct bronchus31780
C
Reconstruct windpipe31781
C
Reconstruct windpipe31785
C
Remove windpipe lesion31786
C
Remove windpipe lesion31800
C
Repair of windpipe injury31805
C
Repair of windpipe injury31820
T
Closure of windpipe lesion
0253
12.02
$596.14
$284.00
$119.2331825
T
Repair of windpipe defect
0254
12.45
$617.47
$272.41
$123.4931830
T
Revise windpipe scar
0254
12.45
$617.47
$272.41
$123.4931899
T
Airways surgical procedure
0076
8.06
$399.75
$197.05
$79.9532000
T
Drainage of chest
0070
3.64
$180.53
$79.60
$36.1132002
T
Treatment of collapsed lung
0070
3.64
$180.53
$79.60
$36.1132005
T
Treat lung lining chemically
0070
3.64
$180.53
$79.60
$36.1132020
T
Insertion of chest tube
0070
3.64
$180.53
$79.60
$36.1132035
C
Exploration of chest32036
C
Exploration of chest32095
C
Biopsy through chest wall32100
C
Exploration/biopsy of chest32110
C
Explore/repair chest32120
C
Re-exploration of chest32124
C
Explore chest free adhesions32140
C
Removal of lung lesion(s)32141
C
Remove/treat lung lesions32150
C
Removal of lung lesion(s)32151
C
Remove lung foreign body32160
C
Open chest heart massage32200
C
Drain, open, lung lesion32201
C
Drain, percut, lung lesion32215
C
Treat chest lining32220
C
Release of lung32225
C
Partial release of lung32310
C
Removal of chest lining32320
C
Free/remove chest lining32400
T
Needle biopsy chest lining
0005
5.41
$268.32
$119.75
$53.6632402
C
Open biopsy chest lining32405
T
Biopsy, lung or mediastinum
0005
5.41
$268.32
$119.75
$53.6632420
T
Puncture/clear lung
0070
3.64
$180.53
$79.60
$36.1132440
C
Removal of lung32442
C
Sleeve pneumonectomy32445
C
Removal of lung32480
C
Partial removal of lung32482
C
Bilobectomy32484
C
Segmentectomy32486
C
Sleeve lobectomy32488
C
Completion pneumonectomy32491
C
Lung volume reduction( print page 67871)32500
C
Partial removal of lung32501
C
Repair bronchus add-on32520
C
Remove lung & revise chest32522
C
Remove lung & revise chest32525
C
Remove lung & revise chest32540
C
Removal of lung lesion32601
T
Thoracoscopy, diagnostic
0076
8.06
$399.75
$197.05
$79.9532602
T
Thoracoscopy, diagnostic
0076
8.06
$399.75
$197.05
$79.9532603
T
Thoracoscopy, diagnostic
0076
8.06
$399.75
$197.05
$79.9532604
T
Thoracoscopy, diagnostic
0076
8.06
$399.75
$197.05
$79.9532605
T
Thoracoscopy, diagnostic
0076
8.06
$399.75
$197.05
$79.9532606
T
Thoracoscopy, diagnostic
0076
8.06
$399.75
$197.05
$79.9532650
C
Thoracoscopy, surgical32651
C
Thoracoscopy, surgical32652
C
Thoracoscopy, surgical32653
C
Thoracoscopy, surgical32654
C
Thoracoscopy, surgical32655
C
Thoracoscopy, surgical32656
C
Thoracoscopy, surgical32657
C
Thoracoscopy, surgical32658
C
Thoracoscopy, surgical32659
C
Thoracoscopy, surgical32660
C
Thoracoscopy, surgical32661
C
Thoracoscopy, surgical32662
C
Thoracoscopy, surgical32663
C
Thoracoscopy, surgical32664
C
Thoracoscopy, surgical32665
C
Thoracoscopy, surgical32800
C
Repair lung hernia32810
C
Close chest after drainage32815
C
Close bronchial fistula32820
C
Reconstruct injured chest32850
C
Donor pneumonectomy32851
C
Lung transplant, single32852
C
Lung transplant with bypass32853
C
Lung transplant, double32854
C
Lung transplant with bypass32900
C
Removal of rib(s)32905
C
Revise & repair chest wall32906
C
Revise & repair chest wall32940
C
Revision of lung32960
T
Therapeutic pneumothorax
0070
3.64
$180.53
$79.60
$36.1132997
C
Total lung lavage32999
T
Chest surgery procedure
0070
3.64
$180.53
$79.60
$36.1133010
T
Drainage of heart sac
0070
3.64
$180.53
$79.60
$36.1133011
T
Repeat drainage of heart sac
0070
3.64
$180.53
$79.60
$36.1133015
C
Incision of heart sac33020
C
Incision of heart sac33025
C
Incision of heart sac33030
C
Partial removal of heart sac33031
C
Partial removal of heart sac33050
C
Removal of heart sac lesion33120
C
Removal of heart lesion33130
C
Removal of heart lesion33140
C
Heart revascularize (tmr)*33141
C
Heart TMR w/ other procedure33200
C
Insertion of heart pacemaker33201
C
Insertion of heart pacemaker33206
T
Insertion of heart pacemaker
0089
78.45
$3,890.81
$2,275.19
$778.1633207
T
Insertion of heart pacemaker
0089
78.45
$3,890.81
$2,275.19
$778.1633208
T
Insertion of heart pacemaker
0089
78.45
$3,890.81
$2,275.19
$778.1633210
T
Insertion of heart electrode
0106
18.96
$940.34
$503.07
$188.0733211
T
Insertion of heart electrode
0106
18.96
$940.34
$503.07
$188.0733212
T
Insertion of pulse generator
0090
78.28
$3,882.37
$2,133.88
$776.4733213
T
Insertion of pulse generator
0090
78.28
$3,882.37
$2,133.88
$776.4733214
T
Upgrade of pacemaker system
0089
78.45
$3,890.81
$2,275.19
$778.1633216
T
Revise eltrd pacing-defib
0106
18.96
$940.34
$503.07
$188.0733217
T
Revise eltrd pacing-defib
0106
18.96
$940.34
$503.07
$188.0733218
T
Revise eltrd pacing-defib
0106
18.96
$940.34
$503.07
$188.0733220
T
Revise eltrd pacing-defib
0106
18.96
$940.34
$503.07
$188.0733222
T
Revise pocket, pacemaker
0026
12.11
$600.61
$277.92
$120.1233223
T
Revise pocket, pacing-defib
0026
12.11
$600.61
$277.92
$120.1233233
T
Removal of pacemaker system
0105
15.06
$746.92
$372.32
$149.3833234
T
Removal of pacemaker system
0105
15.06
$746.92
$372.32
$149.38( print page 67872)33235
T
Removal pacemaker electrode
0105
15.06
$746.92
$372.32
$149.3833236
C
Remove electrode/thoracotomy33237
C
Remove electrode/thoracotomy33238
C
Remove electrode/thoracotomy33240
T
Insert pulse generator
0107
147.51
$7,315.91
$5,086.37
$1,463.1833241
T
Remove pulse generator
0105
15.06
$746.92
$372.32
$149.3833243
C
Remove eltrd/thoracotomy33244
T
Remove eltrd, transven
0105
15.06
$746.92
$372.32
$149.3833245
C
Insert epic eltrd pace-defib33246
C
Insert epic eltrd/generator33249
T
Eltrd/insert pace-defib
0108
210.84
$10,456.84
$5,484.72
$2,091.3733250
C
Ablate heart dysrhythm focus33251
C
Ablate heart dysrhythm focus33253
C
Reconstruct atria33261
C
Ablate heart dysrhythm focus33282
S
Implant pat-active ht record
0974
8.25
$409.17

$81.8333284
T
Remove pat-active ht record
0109
6.53
$323.86
$133.51
$64.7733300
C
Repair of heart wound33305
C
Repair of heart wound33310
C
Exploratory heart surgery33315
C
Exploratory heart surgery33320
C
Repair major blood vessel(s)33321
C
Repair major vessel33322
C
Repair major blood vessel(s)33330
C
Insert major vessel graft33332
C
Insert major vessel graft33335
C
Insert major vessel graft33400
C
Repair of aortic valve33401
C
Valvuloplasty, open33403
C
Valvuloplasty, w/cp bypass33404
C
Prepare heart-aorta conduit33405
C
Replacement of aortic valve33406
C
Replacement of aortic valve33410
C
Replacement of aortic valve33411
C
Replacement of aortic valve33412
C
Replacement of aortic valve33413
C
Replacement of aortic valve33414
C
Repair of aortic valve33415
C
Revision, subvalvular tissue33416
C
Revise ventricle muscle33417
C
Repair of aortic valve33420
C
Revision of mitral valve33422
C
Revision of mitral valve33425
C
Repair of mitral valve33426
C
Repair of mitral valve33427
C
Repair of mitral valve33430
C
Replacement of mitral valve33460
C
Revision of tricuspid valve33463
C
Valvuloplasty, tricuspid33464
C
Valvuloplasty, tricuspid33465
C
Replace tricuspid valve33468
C
Revision of tricuspid valve33470
C
Revision of pulmonary valve33471
C
Valvotomy, pulmonary valve33472
C
Revision of pulmonary valve33474
C
Revision of pulmonary valve33475
C
Replacement, pulmonary valve33476
C
Revision of heart chamber33478
C
Revision of heart chamber33496
C
Repair, prosth valve clot33500
C
Repair heart vessel fistula33501
C
Repair heart vessel fistula33502
C
Coronary artery correction33503
C
Coronary artery graft33504
C
Coronary artery graft33505
C
Repair artery w/tunnel33506
C
Repair artery, translocation33510
C
CABG, vein, single33511
C
CABG, vein, two33512
C
CABG, vein, three33513
C
CABG, vein, four33514
C
CABG, vein, five33516
C
Cabg, vein, six or more33517
C
CABG, artery-vein, single( print page 67873)33518
C
CABG, artery-vein, two33519
C
CABG, artery-vein, three33521
C
CABG, artery-vein, four33522
C
CABG, artery-vein, five33523
C
Cabg, art-vein, six or more33530
C
Coronary artery, bypass/reop33533
C
CABG, arterial, single33534
C
CABG, arterial, two33535
C
CABG, arterial, three33536
C
Cabg, arterial, four or more33542
C
Removal of heart lesion33545
C
Repair of heart damage33572
C
Open coronary endarterectomy33600
C
Closure of valve33602
C
Closure of valve33606
C
Anastomosis/artery-aorta33608
C
Repair anomaly w/conduit33610
C
Repair by enlargement33611
C
Repair double ventricle33612
C
Repair double ventricle33615
C
Repair, simple fontan33617
C
Repair, modified fontan33619
C
Repair single ventricle33641
C
Repair heart septum defect33645
C
Revision of heart veins33647
C
Repair heart septum defects33660
C
Repair of heart defects33665
C
Repair of heart defects33670
C
Repair of heart chambers33681
C
Repair heart septum defect33684
C
Repair heart septum defect33688
C
Repair heart septum defect33690
C
Reinforce pulmonary artery33692
C
Repair of heart defects33694
C
Repair of heart defects33697
C
Repair of heart defects33702
C
Repair of heart defects33710
C
Repair of heart defects33720
C
Repair of heart defect33722
C
Repair of heart defect33730
C
Repair heart-vein defect(s)33732
C
Repair heart-vein defect33735
C
Revision of heart chamber33736
C
Revision of heart chamber33737
C
Revision of heart chamber33750
C
Major vessel shunt33755
C
Major vessel shunt33762
C
Major vessel shunt33764
C
Major vessel shunt & graft33766
C
Major vessel shunt33767
C
Major vessel shunt33770
C
Repair great vessels defect33771
C
Repair great vessels defect33774
C
Repair great vessels defect33775
C
Repair great vessels defect33776
C
Repair great vessels defect33777
C
Repair great vessels defect33778
C
Repair great vessels defect33779
C
Repair great vessels defect33780
C
Repair great vessels defect33781
C
Repair great vessels defect33786
C
Repair arterial trunk33788
C
Revision of pulmonary artery33800
C
Aortic suspension33802
C
Repair vessel defect33803
C
Repair vessel defect33813
C
Repair septal defect33814
C
Repair septal defect33820
C
Revise major vessel33822
C
Revise major vessel33824
C
Revise major vessel33840
C
Remove aorta constriction33845
C
Remove aorta constriction33851
C
Remove aorta constriction( print page 67874)33852
C
Repair septal defect33853
C
Repair septal defect33860
C
Ascending aortic graft33861
C
Ascending aortic graft33863
C
Ascending aortic graft33870
C
Transverse aortic arch graft33875
C
Thoracic aortic graft33877
C
Thoracoabdominal graft33910
C
Remove lung artery emboli33915
C
Remove lung artery emboli33916
C
Surgery of great vessel33917
C
Repair pulmonary artery33918
C
Repair pulmonary atresia33919
C
Repair pulmonary atresia33920
C
Repair pulmonary atresia33922
C
Transect pulmonary artery33924
C
Remove pulmonary shunt33930
C
Removal of donor heart/lung33935
C
Transplantation, heart/lung33940
C
Removal of donor heart33945
C
Transplantation of heart33960
C
External circulation assist33961
C
External circulation assist33968
C
Remove aortic assist device33970
C
Aortic circulation assist33971
C
Aortic circulation assist33973
C
Insert balloon device33974
C
Remove intra-aortic balloon33975
C
Implant ventricular device33976
C
Implant ventricular device33977
C
Remove ventricular device33978
C
Remove ventricular device33999
T
Cardiac surgery procedure
0070
3.64
$180.53
$79.60
$36.1134001
C
Removal of artery clot34051
C
Removal of artery clot34101
T
Removal of artery clot
0088
26.49
$1,313.80
$678.68
$262.7634111
T
Removal of arm artery clot
0088
26.49
$1,313.80
$678.68
$262.7634151
C
Removal of artery clot34201
T
Removal of artery clot
0088
26.49
$1,313.80
$678.68
$262.7634203
T
Removal of leg artery clot
0088
26.49
$1,313.80
$678.68
$262.7634401
C
Removal of vein clot34421
T
Removal of vein clot
0088
26.49
$1,313.80
$678.68
$262.7634451
C
Removal of vein clot34471
T
Removal of vein clot
0088
26.49
$1,313.80
$678.68
$262.7634490
T
Removal of vein clot
0088
26.49
$1,313.80
$678.68
$262.7634501
T
Repair valve, femoral vein
0088
26.49
$1,313.80
$678.68
$262.7634502
C
Reconstruct vena cava34510
T
Transposition of vein valve
0088
26.49
$1,313.80
$678.68
$262.7634520
T
Cross-over vein graft
0088
26.49
$1,313.80
$678.68
$262.7634530
T
Leg vein fusion
0088
26.49
$1,313.80
$678.68
$262.76*34800
C
Endovasc abdo repair w/tube*34802
C
Endovasc abdo repr w/device*34804
C
Endovasc abdo repr w/device*34808
C
Endovasc abdo occlud device*34812
C
xpose for endoprosth, aortic*34813
C
xpose for endoprosth, femoral*34820
C
xpose for endoprosth, iliac*34825
C
endovasc extend prosth, init*34826
C
endovasc extend prosth,addl*34830
C
open aortic tube prosth repr*34831
C
open aortoiliac prosth repr*34832
C
open aortofemor prosth repr35001
C
Repair defect of artery35002
C
Repair artery rupture, neck35005
C
Repair defect of artery35011
T
Repair defect of artery
0093
12.82
$635.82
$277.34
$127.1635013
C
Repair artery rupture, arm35021
C
Repair defect of artery35022
C
Repair artery rupture, chest35045
C
Repair defect of arm artery35081
C
Repair defect of artery35082
C
Repair artery rupture, aorta35091
C
Repair defect of artery35092
C
Repair artery rupture, aorta( print page 67875)35102
C
Repair defect of artery35103
C
Repair artery rupture, groin35111
C
Repair defect of artery35112
C
Repair artery rupture,spleen35121
C
Repair defect of artery35122
C
Repair artery rupture, belly35131
C
Repair defect of artery35132
C
Repair artery rupture, groin35141
C
Repair defect of artery35142
C
Repair artery rupture, thigh35151
C
Repair defect of artery35152
C
Repair artery rupture, knee35161
C
Repair defect of artery35162
C
Repair artery rupture35180
T
Repair blood vessel lesion
0093
12.82
$635.82
$277.34
$127.1635182
C
Repair blood vessel lesion35184
T
Repair blood vessel lesion
0093
12.82
$635.82
$277.34
$127.1635188
T
Repair blood vessel lesion
0088
26.49
$1,313.80
$678.68
$262.7635189
C
Repair blood vessel lesion35190
T
Repair blood vessel lesion
0093
12.82
$635.82
$277.34
$127.1635201
T
Repair blood vessel lesion
0093
12.82
$635.82
$277.34
$127.1635206
T
Repair blood vessel lesion
0093
12.82
$635.82
$277.34
$127.1635207
T
Repair blood vessel lesion
0088
26.49
$1,313.80
$678.68
$262.7635211
C
Repair blood vessel lesion35216
C
Repair blood vessel lesion35221
C
Repair blood vessel lesion35226
T
Repair blood vessel lesion
0093
12.82
$635.82
$277.34
$127.1635231
T
Repair blood vessel lesion
0093
12.82
$635.82
$277.34
$127.1635236
T
Repair blood vessel lesion
0093
12.82
$635.82
$277.34
$127.1635241
C
Repair blood vessel lesion35246
C
Repair blood vessel lesion35251
C
Repair blood vessel lesion35256
T
Repair blood vessel lesion
0093
12.82
$635.82
$277.34
$127.1635261
T
Repair blood vessel lesion
0093
12.82
$635.82
$277.34
$127.1635266
T
Repair blood vessel lesion
0093
12.82
$635.82
$277.34
$127.1635271
C
Repair blood vessel lesion35276
C
Repair blood vessel lesion35281
C
Repair blood vessel lesion35286
T
Repair blood vessel lesion
0093
12.82
$635.82
$277.34
$127.1635301
C
Rechanneling of artery35311
C
Rechanneling of artery35321
T
Rechanneling of artery
0093
12.82
$635.82
$277.34
$127.1635331
C
Rechanneling of artery35341
C
Rechanneling of artery35351
C
Rechanneling of artery35355
C
Rechanneling of artery35361
C
Rechanneling of artery35363
C
Rechanneling of artery35371
C
Rechanneling of artery35372
C
Rechanneling of artery35381
C
Rechanneling of artery35390
C
Reoperation, carotid add-on35400
C
Angioscopy35450
C
Repair arterial blockage35452
C
Repair arterial blockage35454
C
Repair arterial blockage35456
C
Repair arterial blockage35458
T
Repair arterial blockage
0081
28.81
$1,428.86
$710.91
$285.7735459
T
Repair arterial blockage
0081
28.81
$1,428.86
$710.91
$285.7735460
T
Repair venous blockage
0081
28.81
$1,428.86
$710.91
$285.7735470
T
Repair arterial blockage
0081
28.81
$1,428.86
$710.91
$285.7735471
T
Repair arterial blockage
0081
28.81
$1,428.86
$710.91
$285.7735472
T
Repair arterial blockage
0081
28.81
$1,428.86
$710.91
$285.7735473
T
Repair arterial blockage
0081
28.81
$1,428.86
$710.91
$285.7735474
T
Repair arterial blockage
0081
28.81
$1,428.86
$710.91
$285.7735475
T
Repair arterial blockage
0081
28.81
$1,428.86
$710.91
$285.7735476
T
Repair venous blockage
0081
28.81
$1,428.86
$710.91
$285.7735480
C
Atherectomy, open35481
T
Atherectomy, open
0081
28.81
$1,428.86
$710.91
$285.7735482
C
Atherectomy, open35483
C
Atherectomy, open35484
T
Atherectomy, open
0081
28.81
$1,428.86
$710.91
$285.7735485
T
Atherectomy, open
0081
28.81
$1,428.86
$710.91
$285.7735490
T
Atherectomy, percutaneous
0081
28.81
$1,428.86
$710.91
$285.77( print page 67876)35491
T
Atherectomy, percutaneous
0081
28.81
$1,428.86
$710.91
$285.7735492
T
Atherectomy, percutaneous
0081
28.81
$1,428.86
$710.91
$285.7735493
T
Atherectomy, percutaneous
0081
28.81
$1,428.86
$710.91
$285.7735494
T
Atherectomy, percutaneous
0081
28.81
$1,428.86
$710.91
$285.7735495
T
Atherectomy, percutaneous
0081
28.81
$1,428.86
$710.91
$285.7735500
T
Harvest vein for bypass
0091
14.79
$733.52
$348.23
$146.7035501
C
Artery bypass graft35506
C
Artery bypass graft35507
C
Artery bypass graft35508
C
Artery bypass graft35509
C
Artery bypass graft35511
C
Artery bypass graft35515
C
Artery bypass graft35516
C
Artery bypass graft35518
C
Artery bypass graft35521
C
Artery bypass graft35526
C
Artery bypass graft35531
C
Artery bypass graft35533
C
Artery bypass graft35536
C
Artery bypass graft35541
C
Artery bypass graft35546
C
Artery bypass graft35548
C
Artery bypass graft35549
C
Artery bypass graft35551
C
Artery bypass graft35556
C
Artery bypass graft35558
C
Artery bypass graft35560
C
Artery bypass graft35563
C
Artery bypass graft35565
C
Artery bypass graft35566
C
Artery bypass graft35571
C
Artery bypass graft35582
C
Vein bypass graft35583
C
Vein bypass graft35585
C
Vein bypass graft35587
C
Vein bypass graft*35600
C
Harvest artery for CABG35601
C
Artery bypass graft35606
C
Artery bypass graft35612
C
Artery bypass graft35616
C
Artery bypass graft35621
C
Artery bypass graft35623
C
Bypass graft, not vein35626
C
Artery bypass graft35631
C
Artery bypass graft35636
C
Artery bypass graft35641
C
Artery bypass graft35642
C
Artery bypass graft35645
C
Artery bypass graft35646
C
Artery bypass graft35650
C
Artery bypass graft35651
C
Artery bypass graft35654
C
Artery bypass graft35656
C
Artery bypass graft35661
C
Artery bypass graft35663
C
Artery bypass graft35665
C
Artery bypass graft35666
C
Artery bypass graft35671
C
Artery bypass graft35681
C
Composite bypass graft35682
C
Composite bypass graft35683
C
Composite bypass graft35691
C
Arterial transposition35693
C
Arterial transposition35694
C
Arterial transposition35695
C
Arterial transposition35700
C
Reoperation, bypass graft35701
C
Exploration, carotid artery35721
C
Exploration, femoral artery35741
C
Exploration popliteal artery35761
T
Exploration of artery/vein
0115
19.34
$959.19
$506.74
$191.8435800
C
Explore neck vessels35820
C
Explore chest vessels35840
C
Explore abdominal vessels( print page 67877)35860
T
Explore limb vessels
0115
19.34
$959.19
$506.74
$191.8435870
C
Repair vessel graft defect35875
T
Removal of clot in graft
0088
26.49
$1,313.80
$678.68
$262.7635876
T
Removal of clot in graft
0088
26.49
$1,313.80
$678.68
$262.7635879
T
Revise graft w/vein
0088
26.49
$1,313.80
$678.68
$262.7635881
T
Revise graft w/vein
0088
26.49
$1,313.80
$678.68
$262.7635901
C
Excision, graft, neck35903
T
Excision, graft, extremity
0115
19.34
$959.19
$506.74
$191.8435905
C
Excision, graft, thorax35907
C
Excision, graft, abdomen36000
N
Place needle in vein36005
N
Injection, venography36010
N
Place catheter in vein36011
N
Place catheter in vein36012
N
Place catheter in vein36013
N
Place catheter in artery36014
N
Place catheter in artery36015
N
Place catheter in artery36100
N
Establish access to artery36120
N
Establish access to artery36140
N
Establish access to artery36145
N
Artery to vein shunt36160
N
Establish access to aorta36200
N
Place catheter in aorta36215
N
Place catheter in artery36216
N
Place catheter in artery36217
N
Place catheter in artery36218
N
Place catheter in artery36245
N
Place catheter in artery36246
N
Place catheter in artery36247
N
Place catheter in artery36248
N
Place catheter in artery36260
T
Insertion of infusion pump
0119
9.87
$489.59
$161.50
$97.9236261
T
Revision of infusion pump
0124
2.55
$126.64
$81.36
$25.3336262
T
Removal of infusion pump
0109
6.53
$323.86
$133.51
$64.7736299
T
Vessel injection procedure
0089
78.45
$3,890.81
$2,275.19
$778.1636400
N
Drawing blood36405
N
Drawing blood36406
N
Drawing blood36410
N
Drawing blood36415
E
Drawing blood36420
T
Establish access to vein
0032
5.40
$267.82
$119.52
$53.5636425
T
Establish access to vein
0032
5.40
$267.82
$119.52
$53.5636430
S
Blood transfusion service
0110
5.83
$289.15
$122.73
$57.8336440
S
Blood transfusion service
0110
5.83
$289.15
$122.73
$57.8336450
S
Exchange transfusion service
0110
5.83
$289.15
$122.73
$57.8336455
S
Exchange transfusion service
0110
5.83
$289.15
$122.73
$57.8336460
S
Transfusion service, fetal
0110
5.83
$289.15
$122.73
$57.8336468
T
Injection(s), spider veins
0098
1.19
$59.02
$20.88
$11.8036469
T
Injection(s), spider veins
0098
1.19
$59.02
$20.88
$11.8036470
T
Injection therapy of vein
0098
1.19
$59.02
$20.88
$11.8036471
T
Injection therapy of veins
0098
1.19
$59.02
$20.88
$11.8036481
N
Insertion of catheter, vein36488
T
Insertion of catheter, vein
0032
5.40
$267.82
$119.52
$53.5636489
T
Insertion of catheter, vein
0032
5.40
$267.82
$119.52
$53.5636490
T
Insertion of catheter, vein
0032
5.40
$267.82
$119.52
$53.5636491
T
Insertion of catheter, vein
0032
5.40
$267.82
$119.52
$53.5636493
T
Repositioning of cvc
0032
5.40
$267.82
$119.52
$53.5636500
N
Insertion of catheter, vein36510
C
Insertion of catheter, vein36520
S
Plasma and/or cell exchange
0111
14.17
$702.77
$300.74
$140.5536521
S
Apheresis w/ adsorp/reinfuse
0111
14.17
$702.77
$300.74
$140.5536522
S
Photopheresis
0112
39.60
$1,964.01
$663.65
$392.8036530
T
Insertion of infusion pump
0119
9.87
$489.59
$161.50
$97.9236531
T
Revision of infusion pump
0124
2.55
$126.64
$81.36
$25.3336532
T
Removal of infusion pump
0109
6.53
$323.86
$133.51
$64.7736533
T
Insertion of access device
0115
19.34
$959.19
$506.74
$191.8436534
T
Revision of access device
0103
13.09
$649.21
$295.70
$129.8436535
T
Removal of access device
0109
6.53
$323.86
$133.51
$64.77*36540
N
Collect blood venous device36550
T
Declot vascular device
0970
0.52
$25.79

$5.1636600
N
Withdrawal of arterial blood36620
N
Insertion catheter, artery36625
N
Insertion catheter, artery( print page 67878)36640
T
Insertion catheter, artery
0032
5.40
$267.82
$119.52
$53.5636660
C
Insertion catheter, artery36680
T
Insert needle, bone cavity
0120
1.66
$82.33
$42.67
$16.4736800
T
Insertion of cannula
0115
19.34
$959.19
$506.74
$191.8436810
T
Insertion of cannula
0115
19.34
$959.19
$506.74
$191.8436815
T
Insertion of cannula
0115
19.34
$959.19
$506.74
$191.8436819
T
Av fusion by basilic vein
0093
12.82
$635.82
$277.34
$127.1636821
T
Av fusion direct any site
0088
26.49
$1,313.80
$678.68
$262.7636822
C
Insertion of cannula(s)36823
C
Insertion of cannula(s)36825
T
Artery-vein graft
0088
26.49
$1,313.80
$678.68
$262.7636830
T
Artery-vein graft
0088
26.49
$1,313.80
$678.68
$262.7636831
T
Av fistula excision
0088
26.49
$1,313.80
$678.68
$262.7636832
T
Av fistula revision
0088
26.49
$1,313.80
$678.68
$262.7636833
T
Av fistula revision
0088
26.49
$1,313.80
$678.68
$262.7636834
T
Repair A-V aneurysm
0093
12.82
$635.82
$277.34
$127.1636835
T
Artery to vein shunt
0115
19.34
$959.19
$506.74
$191.8436860
T
External cannula declotting
0115
19.34
$959.19
$506.74
$191.8436861
T
Cannula declotting
0115
19.34
$959.19
$506.74
$191.84*36870
T
AV fistula revision, open
0093
12.82
$635.82
$277.34
$127.1637140
C
Revision of circulation37145
C
Revision of circulation37160
C
Revision of circulation37180
C
Revision of circulation37181
C
Splice spleen/kidney veins37195
C
Thrombolytic therapy, stroke37200
T
Transcatheter biopsy
0005
5.41
$268.32
$119.75
$53.6637201
T
Transcatheter therapy infuse
0120
1.66
$82.33
$42.67
$16.4737202
T
Transcatheter therapy infuse
0120
1.66
$82.33
$42.67
$16.4737203
T
Transcatheter retrieval
0103
13.09
$649.21
$295.70
$129.8437204
T
Transcatheter occlusion
0103
13.09
$649.21
$295.70
$129.8437205
T
Transcatheter stent
0229
34.81
$1,726.44
$1,030.12
$345.2937206
T
Transcatheter stent add-on
0229
34.81
$1,726.44
$1,030.12
$345.2937207
T
Transcatheter stent
0229
34.81
$1,726.44
$1,030.12
$345.2937208
T
Transcatheter stent add-on
0229
34.81
$1,726.44
$1,030.12
$345.2937209
T
Exchange arterial catheter
0103
13.09
$649.21
$295.70
$129.8437250
T
Iv us first vessel add-on
0103
13.09
$649.21
$295.70
$129.8437251
T
Iv us each add vessel add-on
0103
13.09
$649.21
$295.70
$129.8437565
T
Ligation of neck vein
0093
12.82
$635.82
$277.34
$127.1637600
T
Ligation of neck artery
0093
12.82
$635.82
$277.34
$127.1637605
T
Ligation of neck artery
0091
14.79
$733.52
$348.23
$146.7037606
T
Ligation of neck artery
0091
14.79
$733.52
$348.23
$146.7037607
T
Ligation of a-v fistula
0092
20.21
$1,002.34
$505.37
$200.4737609
T
Temporal artery procedure
0020
6.51
$322.87
$130.53
$64.5737615
T
Ligation of neck artery
0091
14.79
$733.52
$348.23
$146.7037616
C
Ligation of chest artery37617
C
Ligation of abdomen artery37618
C
Ligation of extremity artery37620
T
Revision of major vein
0091
14.79
$733.52
$348.23
$146.7037650
T
Revision of major vein
0091
14.79
$733.52
$348.23
$146.7037660
C
Revision of major vein37700
T
Revise leg vein
0091
14.79
$733.52
$348.23
$146.7037720
T
Removal of leg vein
0092
20.21
$1,002.34
$505.37
$200.4737730
T
Removal of leg veins
0092
20.21
$1,002.34
$505.37
$200.4737735
T
Removal of leg veins/lesion
0092
20.21
$1,002.34
$505.37
$200.4737760
T
Revision of leg veins
0091
14.79
$733.52
$348.23
$146.7037780
T
Revision of leg vein
0091
14.79
$733.52
$348.23
$146.7037785
T
Revise secondary varicosity
0091
14.79
$733.52
$348.23
$146.7037788
C
Revascularization, penis37790
T
Penile venous occlusion
0181
32.37
$1,605.43
$906.36
$321.0937799
T
Vascular surgery procedure
0020
6.51
$322.87
$130.53
$64.5738100
C
Removal of spleen, total38101
C
Removal of spleen, partial38102
C
Removal of spleen, total38115
C
Repair of ruptured spleen38120
T
Laparoscopy, splenectomy
0131
41.81
$2,073.61
$1,089.88
$414.7238129
T
Laparoscope proc, spleen
0130
25.36
$1,257.75
$659.53
$251.5538200
N
Injection for spleen x-ray38230
S
Bone marrow collection
0123
4.13
$204.83
$40.97
$40.9738231
S
Stem cell collection
0111
14.17
$702.77
$300.74
$140.5538240
S
Bone marrow/stem transplant
0123
4.13
$204.83
$40.97
$40.9738241
S
Bone marrow/stem transplant
0123
4.13
$204.83
$40.97
$40.9738300
T
Drainage, lymph node lesion
0008
6.15
$305.02
$113.67
$61.0038305
T
Drainage, lymph node lesion
0008
6.15
$305.02
$113.67
$61.00( print page 67879)38308
T
Incision of lymph channels
0113
13.89
$688.89
$326.55
$137.7838380
C
Thoracic duct procedure38381
C
Thoracic duct procedure38382
C
Thoracic duct procedure38500
T
Biopsy/removal, lymph nodes
0113
13.89
$688.89
$326.55
$137.7838505
T
Needle biopsy, lymph nodes
0005
5.41
$268.32
$119.75
$53.6638510
T
Biopsy/removal, lymph nodes
0113
13.89
$688.89
$326.55
$137.7838520
T
Biopsy/removal, lymph nodes
0113
13.89
$688.89
$326.55
$137.7838525
T
Biopsy/removal, lymph nodes
0113
13.89
$688.89
$326.55
$137.7838530
T
Biopsy/removal, lymph nodes
0113
13.89
$688.89
$326.55
$137.7838542
T
Explore deep node(s), neck
0114
19.56
$970.10
$493.78
$194.0238550
T
Removal, neck/armpit lesion
0113
13.89
$688.89
$326.55
$137.7838555
T
Removal, neck/armpit lesion
0114
19.56
$970.10
$493.78
$194.0238562
C
Removal, pelvic lymph nodes38564
C
Removal, abdomen lymph nodes38570
T
Laparoscopy, lymph node biop
0131
41.81
$2,073.61
$1,089.88
$414.7238571
T
Laparoscopy, lymphadenectomy
0132
48.91
$2,425.74
$1,239.22
$485.1538572
T
Laparoscopy, lymphadenectomy
0131
41.81
$2,073.61
$1,089.88
$414.7238589
T
Laparoscope proc, lymphatic
0130
25.36
$1,257.75
$659.53
$251.5538700
C
Removal of lymph nodes, neck38720
T
Removal of lymph nodes, neck
0114
19.56
$970.10
$493.78
$194.0238724
C
Removal of lymph nodes, neck38740
T
Remove armpit lymph nodes
0114
19.56
$970.10
$493.78
$194.0238745
T
Remove armpit lymph nodes
0114
19.56
$970.10
$493.78
$194.0238746
C
Remove thoracic lymph nodes38747
C
Remove abdominal lymph nodes38760
T
Remove groin lymph nodes
0114
19.56
$970.10
$493.78
$194.0238765
C
Remove groin lymph nodes38770
C
Remove pelvis lymph nodes38780
C
Remove abdomen lymph nodes38790
N
Inject for lymphatic x-ray38792
N
Identify sentinel node38794
N
Access thoracic lymph duct38999
T
Blood/lymph system procedure
0008
6.15
$305.02
$113.67
$61.0039000
C
Exploration of chest39010
C
Exploration of chest39200
C
Removal chest lesion39220
C
Removal chest lesion39400
T
Visualization of chest
0076
8.06
$399.75
$197.05
$79.9539499
C
Chest procedure39501
C
Repair diaphragm laceration39502
C
Repair paraesophageal hernia39503
C
Repair of diaphragm hernia39520
C
Repair of diaphragm hernia39530
C
Repair of diaphragm hernia39531
C
Repair of diaphragm hernia39540
C
Repair of diaphragm hernia39541
C
Repair of diaphragm hernia39545
C
Revision of diaphragm39560
C
Resect diaphragm, simple39561
C
Resect diaphragm, complex39599
C
Diaphragm surgery procedure40490
T
Biopsy of lip
0252
5.18
$256.90
$114.24
$51.3840500
T
Partial excision of lip
0253
12.02
$596.14
$284.00
$119.2340510
T
Partial excision of lip
0254
12.45
$617.47
$272.41
$123.4940520
T
Partial excision of lip
0253
12.02
$596.14
$284.00
$119.2340525
T
Reconstruct lip with flap
0254
12.45
$617.47
$272.41
$123.4940527
T
Reconstruct lip with flap
0254
12.45
$617.47
$272.41
$123.4940530
T
Partial removal of lip
0254
12.45
$617.47
$272.41
$123.4940650
T
Repair lip
0253
12.02
$596.14
$284.00
$119.2340652
T
Repair lip
0253
12.02
$596.14
$284.00
$119.2340654
T
Repair lip
0254
12.45
$617.47
$272.41
$123.4940700
T
Repair cleft lip/nasal
0256
25.40
$1,259.74
$623.05
$251.9540701
T
Repair cleft lip/nasal
0256
25.40
$1,259.74
$623.05
$251.9540702
T
Repair cleft lip/nasal
0256
25.40
$1,259.74
$623.05
$251.9540720
T
Repair cleft lip/nasal
0256
25.40
$1,259.74
$623.05
$251.9540761
T
Repair cleft lip/nasal
0256
25.40
$1,259.74
$623.05
$251.9540799
T
Lip surgery procedure
0253
12.02
$596.14
$284.00
$119.2340800
T
Drainage of mouth lesion
0251
1.68
$83.32
$27.99
$16.6640801
T
Drainage of mouth lesion
0252
5.18
$256.90
$114.24
$51.3840804
T
Removal, foreign body, mouth
0251
1.68
$83.32
$27.99
$16.6640805
T
Removal, foreign body, mouth
0252
5.18
$256.90
$114.24
$51.3840806
T
Incision of lip fold
0251
1.68
$83.32
$27.99
$16.6640808
T
Biopsy of mouth lesion
0251
1.68
$83.32
$27.99
$16.66( print page 67880)40810
T
Excision of mouth lesion
0253
12.02
$596.14
$284.00
$119.2340812
T
Excise/repair mouth lesion
0252
5.18
$256.90
$114.24
$51.3840814
T
Excise/repair mouth lesion
0253
12.02
$596.14
$284.00
$119.2340816
T
Excision of mouth lesion
0253
12.02
$596.14
$284.00
$119.2340818
T
Excise oral mucosa for graft
0251
1.68
$83.32
$27.99
$16.6640819
T
Excise lip or cheek fold
0252
5.18
$256.90
$114.24
$51.3840820
T
Treatment of mouth lesion
0253
12.02
$596.14
$284.00
$119.2340830
T
Repair mouth laceration
0251
1.68
$83.32
$27.99
$16.6640831
T
Repair mouth laceration
0253
12.02
$596.14
$284.00
$119.2340840
T
Reconstruction of mouth
0254
12.45
$617.47
$272.41
$123.4940842
T
Reconstruction of mouth
0254
12.45
$617.47
$272.41
$123.4940843
T
Reconstruction of mouth
0254
12.45
$617.47
$272.41
$123.4940844
T
Reconstruction of mouth
0256
25.40
$1,259.74
$623.05
$251.9540845
T
Reconstruction of mouth
0256
25.40
$1,259.74
$623.05
$251.9540899
T
Mouth surgery procedure
0252
5.18
$256.90
$114.24
$51.3841000
T
Drainage of mouth lesion
0253
12.02
$596.14
$284.00
$119.2341005
T
Drainage of mouth lesion
0251
1.68
$83.32
$27.99
$16.6641006
T
Drainage of mouth lesion
0253
12.02
$596.14
$284.00
$119.2341007
T
Drainage of mouth lesion
0253
12.02
$596.14
$284.00
$119.2341008
T
Drainage of mouth lesion
0253
12.02
$596.14
$284.00
$119.2341009
T
Drainage of mouth lesion
0251
1.68
$83.32
$27.99
$16.6641010
T
Incision of tongue fold
0253
12.02
$596.14
$284.00
$119.2341015
T
Drainage of mouth lesion
0252
5.18
$256.90
$114.24
$51.3841016
T
Drainage of mouth lesion
0253
12.02
$596.14
$284.00
$119.2341017
T
Drainage of mouth lesion
0253
12.02
$596.14
$284.00
$119.2341018
T
Drainage of mouth lesion
0253
12.02
$596.14
$284.00
$119.2341100
T
Biopsy of tongue
0252
5.18
$256.90
$114.24
$51.3841105
T
Biopsy of tongue
0253
12.02
$596.14
$284.00
$119.2341108
T
Biopsy of floor of mouth
0252
5.18
$256.90
$114.24
$51.3841110
T
Excision of tongue lesion
0253
12.02
$596.14
$284.00
$119.2341112
T
Excision of tongue lesion
0253
12.02
$596.14
$284.00
$119.2341113
T
Excision of tongue lesion
0253
12.02
$596.14
$284.00
$119.2341114
T
Excision of tongue lesion
0254
12.45
$617.47
$272.41
$123.4941115
T
Excision of tongue fold
0253
12.02
$596.14
$284.00
$119.2341116
T
Excision of mouth lesion
0253
12.02
$596.14
$284.00
$119.2341120
T
Partial removal of tongue
0256
25.40
$1,259.74
$623.05
$251.9541130
C
Partial removal of tongue41135
C
Tongue and neck surgery41140
C
Removal of tongue41145
C
Tongue removal, neck surgery41150
C
Tongue, mouth, jaw surgery41153
C
Tongue, mouth, neck surgery41155
C
Tongue, jaw, & neck surgery41250
T
Repair tongue laceration
0251
1.68
$83.32
$27.99
$16.6641251
T
Repair tongue laceration
0253
12.02
$596.14
$284.00
$119.2341252
T
Repair tongue laceration
0253
12.02
$596.14
$284.00
$119.2341500
T
Fixation of tongue
0253
12.02
$596.14
$284.00
$119.2341510
T
Tongue to lip surgery
0253
12.02
$596.14
$284.00
$119.2341520
T
Reconstruction, tongue fold
0253
12.02
$596.14
$284.00
$119.2341599
T
Tongue and mouth surgery
0251
1.68
$83.32
$27.99
$16.6641800
T
Drainage of gum lesion
0251
1.68
$83.32
$27.99
$16.6641805
T
Removal foreign body, gum
0253
12.02
$596.14
$284.00
$119.2341806
T
Removal foreign body,jawbone
0253
12.02
$596.14
$284.00
$119.2341820
T
Excision, gum, each quadrant
0252
5.18
$256.90
$114.24
$51.3841821
T
Excision of gum flap
0252
5.18
$256.90
$114.24
$51.3841822
T
Excision of gum lesion
0253
12.02
$596.14
$284.00
$119.2341823
T
Excision of gum lesion
0253
12.02
$596.14
$284.00
$119.2341825
T
Excision of gum lesion
0253
12.02
$596.14
$284.00
$119.2341826
T
Excision of gum lesion
0253
12.02
$596.14
$284.00
$119.2341827
T
Excision of gum lesion
0253
12.02
$596.14
$284.00
$119.2341828
T
Excision of gum lesion
0253
12.02
$596.14
$284.00
$119.2341830
T
Removal of gum tissue
0253
12.02
$596.14
$284.00
$119.2341850
T
Treatment of gum lesion
0253
12.02
$596.14
$284.00
$119.2341870
T
Gum graft
0253
12.02
$596.14
$284.00
$119.2341872
T
Repair gum
0253
12.02
$596.14
$284.00
$119.2341874
T
Repair tooth socket
0253
12.02
$596.14
$284.00
$119.2341899
T
Dental surgery procedure
0253
12.02
$596.14
$284.00
$119.2342000
T
Drainage mouth roof lesion
0251
1.68
$83.32
$27.99
$16.6642100
T
Biopsy roof of mouth
0252
5.18
$256.90
$114.24
$51.3842104
T
Excision lesion, mouth roof
0253
12.02
$596.14
$284.00
$119.2342106
T
Excision lesion, mouth roof
0253
12.02
$596.14
$284.00
$119.2342107
T
Excision lesion, mouth roof
0254
12.45
$617.47
$272.41
$123.4942120
T
Remove palate/lesion
0256
25.40
$1,259.74
$623.05
$251.9542140
T
Excision of uvula
0252
5.18
$256.90
$114.24
$51.38( print page 67881)42145
T
Repair palate, pharynx/uvula
0254
12.45
$617.47
$272.41
$123.4942160
T
Treatment mouth roof lesion
0253
12.02
$596.14
$284.00
$119.2342180
T
Repair palate
0251
1.68
$83.32
$27.99
$16.6642182
T
Repair palate
0256
25.40
$1,259.74
$623.05
$251.9542200
T
Reconstruct cleft palate
0256
25.40
$1,259.74
$623.05
$251.9542205
T
Reconstruct cleft palate
0256
25.40
$1,259.74
$623.05
$251.9542210
T
Reconstruct cleft palate
0256
25.40
$1,259.74
$623.05
$251.9542215
T
Reconstruct cleft palate
0256
25.40
$1,259.74
$623.05
$251.9542220
T
Reconstruct cleft palate
0256
25.40
$1,259.74
$623.05
$251.9542225
T
Reconstruct cleft palate
0256
25.40
$1,259.74
$623.05
$251.9542226
T
Lengthening of palate
0256
25.40
$1,259.74
$623.05
$251.9542227
T
Lengthening of palate
0256
25.40
$1,259.74
$623.05
$251.9542235
T
Repair palate
0254
12.45
$617.47
$272.41
$123.4942260
T
Repair nose to lip fistula
0253
12.02
$596.14
$284.00
$119.2342280
T
Preparation, palate mold
0251
1.68
$83.32
$27.99
$16.6642281
T
Insertion, palate prosthesis
0253
12.02
$596.14
$284.00
$119.2342299
T
Palate/uvula surgery
0251
1.68
$83.32
$27.99
$16.6642300
T
Drainage of salivary gland
0253
12.02
$596.14
$284.00
$119.2342305
T
Drainage of salivary gland
0253
12.02
$596.14
$284.00
$119.2342310
T
Drainage of salivary gland
0251
1.68
$83.32
$27.99
$16.6642320
T
Drainage of salivary gland
0251
1.68
$83.32
$27.99
$16.6642325
T
Create salivary cyst drain
0252
5.18
$256.90
$114.24
$51.3842326
T
Create salivary cyst drain
0252
5.18
$256.90
$114.24
$51.3842330
T
Removal of salivary stone
0252
5.18
$256.90
$114.24
$51.3842335
T
Removal of salivary stone
0253
12.02
$596.14
$284.00
$119.2342340
T
Removal of salivary stone
0253
12.02
$596.14
$284.00
$119.2342400
T
Biopsy of salivary gland
0004
1.84
$91.26
$32.57
$18.2542405
T
Biopsy of salivary gland
0253
12.02
$596.14
$284.00
$119.2342408
T
Excision of salivary cyst
0253
12.02
$596.14
$284.00
$119.2342409
T
Drainage of salivary cyst
0253
12.02
$596.14
$284.00
$119.2342410
T
Excise parotid gland/lesion
0256
25.40
$1,259.74
$623.05
$251.9542415
T
Excise parotid gland/lesion
0256
25.40
$1,259.74
$623.05
$251.9542420
T
Excise parotid gland/lesion
0256
25.40
$1,259.74
$623.05
$251.9542425
T
Excise parotid gland/lesion
0256
25.40
$1,259.74
$623.05
$251.9542426
C
Excise parotid gland/lesion42440
T
Excise submaxillary gland
0256
25.40
$1,259.74
$623.05
$251.9542450
T
Excise sublingual gland
0253
12.02
$596.14
$284.00
$119.2342500
T
Repair salivary duct
0254
12.45
$617.47
$272.41
$123.4942505
T
Repair salivary duct
0256
25.40
$1,259.74
$623.05
$251.9542507
T
Parotid duct diversion
0256
25.40
$1,259.74
$623.05
$251.9542508
T
Parotid duct diversion
0256
25.40
$1,259.74
$623.05
$251.9542509
T
Parotid duct diversion
0256
25.40
$1,259.74
$623.05
$251.9542510
T
Parotid duct diversion
0256
25.40
$1,259.74
$623.05
$251.9542550
N
Injection for salivary x-ray42600
T
Closure of salivary fistula
0253
12.02
$596.14
$284.00
$119.2342650
T
Dilation of salivary duct
0252
5.18
$256.90
$114.24
$51.3842660
T
Dilation of salivary duct
0252
5.18
$256.90
$114.24
$51.3842665
T
Ligation of salivary duct
0253
12.02
$596.14
$284.00
$119.2342699
T
Salivary surgery procedure
0253
12.02
$596.14
$284.00
$119.2342700
T
Drainage of tonsil abscess
0251
1.68
$83.32
$27.99
$16.6642720
T
Drainage of throat abscess
0253
12.02
$596.14
$284.00
$119.2342725
T
Drainage of throat abscess
0256
25.40
$1,259.74
$623.05
$251.9542800
T
Biopsy of throat
0252
5.18
$256.90
$114.24
$51.3842802
T
Biopsy of throat
0253
12.02
$596.14
$284.00
$119.2342804
T
Biopsy of upper nose/throat
0253
12.02
$596.14
$284.00
$119.2342806
T
Biopsy of upper nose/throat
0253
12.02
$596.14
$284.00
$119.2342808
T
Excise pharynx lesion
0253
12.02
$596.14
$284.00
$119.2342809
T
Remove pharynx foreign body
0251
1.68
$83.32
$27.99
$16.6642810
T
Excision of neck cyst
0253
12.02
$596.14
$284.00
$119.2342815
T
Excision of neck cyst
0256
25.40
$1,259.74
$623.05
$251.9542820
T
Remove tonsils and adenoids
0258
18.62
$923.48
$462.81
$184.7042821
T
Remove tonsils and adenoids
0258
18.62
$923.48
$462.81
$184.7042825
T
Removal of tonsils
0258
18.62
$923.48
$462.81
$184.7042826
T
Removal of tonsils
0258
18.62
$923.48
$462.81
$184.7042830
T
Removal of adenoids
0258
18.62
$923.48
$462.81
$184.7042831
T
Removal of adenoids
0258
18.62
$923.48
$462.81
$184.7042835
T
Removal of adenoids
0258
18.62
$923.48
$462.81
$184.7042836
T
Removal of adenoids
0258
18.62
$923.48
$462.81
$184.7042842
C
Extensive surgery of throat42844
T
Extensive surgery of throat
0256
25.40
$1,259.74
$623.05
$251.9542845
C
Extensive surgery of throat42860
T
Excision of tonsil tags
0258
18.62
$923.48
$462.81
$184.7042870
T
Excision of lingual tonsil
0258
18.62
$923.48
$462.81
$184.7042890
T
Partial removal of pharynx
0256
25.40
$1,259.74
$623.05
$251.95( print page 67882)42892
T
Revision of pharyngeal walls
0256
25.40
$1,259.74
$623.05
$251.9542894
C
Revision of pharyngeal walls42900
T
Repair throat wound
0253
12.02
$596.14
$284.00
$119.2342950
T
Reconstruction of throat
0254
12.45
$617.47
$272.41
$123.4942953
C
Repair throat, esophagus42955
T
Surgical opening of throat
0254
12.45
$617.47
$272.41
$123.4942960
T
Control throat bleeding
0250
2.21
$109.61
$38.54
$21.9242961
C
Control throat bleeding42962
T
Control throat bleeding
0256
25.40
$1,259.74
$623.05
$251.9542970
T
Control nose/throat bleeding
0250
2.21
$109.61
$38.54
$21.9242971
C
Control nose/throat bleeding42972
T
Control nose/throat bleeding
0253
12.02
$596.14
$284.00
$119.2342999
T
Throat surgery procedure
0252
5.18
$256.90
$114.24
$51.3843020
T
Incision of esophagus
0254
12.45
$617.47
$272.41
$123.4943030
C
Throat muscle surgery43045
C
Incision of esophagus43100
C
Excision of esophagus lesion43101
C
Excision of esophagus lesion43107
C
Removal of esophagus43108
C
Removal of esophagus43112
C
Removal of esophagus43113
C
Removal of esophagus43116
C
Partial removal of esophagus43117
C
Partial removal of esophagus43118
C
Partial removal of esophagus43121
C
Partial removal of esophagus43122
C
Parital removal of esophagus43123
C
Partial removal of esophagus43124
C
Removal of esophagus43130
T
Removal of esophagus pouch
0254
12.45
$617.47
$272.41
$123.4943135
C
Removal of esophagus pouch43200
T
Esophagus endoscopy
0141
7.15
$354.61
$184.67
$70.9243202
T
Esophagus endoscopy, biopsy
0141
7.15
$354.61
$184.67
$70.9243204
T
Esophagus endoscopy & inject
0141
7.15
$354.61
$184.67
$70.9243205
T
Esophagus endoscopy/ligation
0141
7.15
$354.61
$184.67
$70.9243215
T
Esophagus endoscopy
0141
7.15
$354.61
$184.67
$70.9243216
T
Esophagus endoscopy/lesion
0141
7.15
$354.61
$184.67
$70.9243217
T
Esophagus endoscopy
0141
7.15
$354.61
$184.67
$70.9243219
T
Esophagus endoscopy
0141
7.15
$354.61
$184.67
$70.9243220
T
Esoph endoscopy, dilation
0141
7.15
$354.61
$184.67
$70.9243226
T
Esoph endoscopy, dilation
0141
7.15
$354.61
$184.67
$70.9243227
T
Esoph endoscopy, repair
0141
7.15
$354.61
$184.67
$70.9243228
T
Esoph endoscopy, ablation
0141
7.15
$354.61
$184.67
$70.92*43231
T
Esoph endoscopy w/ US exam
0141
7.15
$354.61
$184.67
$70.92*43232
T
Esoph endoscopy w/ US fn bx
0141
7.15
$354.61
$184.67
$70.9243234
T
Upper GI endoscopy, exam
0141
7.15
$354.61
$184.67
$70.9243235
T
Uppr gi endoscopy, diagnosis
0141
7.15
$354.61
$184.67
$70.9243239
T
Upper GI endoscopy, biopsy
0141
7.15
$354.61
$184.67
$70.92*43240
T
Esoph endoscopy w/ drain cyst
0141
7.15
$354.61
$184.67
$70.9243241
T
Upper GI endoscopy with tube
0141
7.15
$354.61
$184.67
$70.92*43242
T
Uppr GI endoscopy w/ US fn bx
0141
7.15
$354.61
$184.67
$70.9243243
T
Upper GI endoscopy & inject
0141
7.15
$354.61
$184.67
$70.9243244
T
Upper GI endoscopy/ligation
0141
7.15
$354.61
$184.67
$70.9243245
T
Operative upper GI endoscopy
0141
7.15
$354.61
$184.67
$70.9243246
T
Place gastrostomy tube
0141
7.15
$354.61
$184.67
$70.9243247
T
Operative upper GI endoscopy
0141
7.15
$354.61
$184.67
$70.9243248
T
Uppr gi endoscopy/guide wire
0141
7.15
$354.61
$184.67
$70.9243249
T
Esoph endoscopy, dilation
0141
7.15
$354.61
$184.67
$70.9243250
T
Upper GI endoscopy/tumor
0141
7.15
$354.61
$184.67
$70.9243251
T
Operative upper GI endoscopy
0141
7.15
$354.61
$184.67
$70.9243255
T
Operative upper GI endoscopy
0141
7.15
$354.61
$184.67
$70.92*43256
T
Uppr GI endoscopy w/ stent
0141
7.15
$354.61
$184.67
$70.9243258
T
Operative upper GI endoscopy
0141
7.15
$354.61
$184.67
$70.9243259
T
Endoscopic ultrasound exam
0141
7.15
$354.61
$184.67
$70.9243260
T
Endo cholangiopancreatograph
0151
10.53
$522.25
$245.46
$104.4543261
T
Endo cholangiopancreatograph
0151
10.53
$522.25
$245.46
$104.4543262
T
Endo cholangiopancreatograph
0151
10.53
$522.25
$245.46
$104.4543263
T
Endo cholangiopancreatograph
0151
10.53
$522.25
$245.46
$104.4543264
T
Endo cholangiopancreatograph
0151
10.53
$522.25
$245.46
$104.4543265
T
Endo cholangiopancreatograph
0151
10.53
$522.25
$245.46
$104.4543267
T
Endo cholangiopancreatograph
0151
10.53
$522.25
$245.46
$104.4543268
T
Endo cholangiopancreatograph
0151
10.53
$522.25
$245.46
$104.4543269
T
Endo cholangiopancreatograph
0151
10.53
$522.25
$245.46
$104.4543271
T
Endo cholangiopancreatograph
0151
10.53
$522.25
$245.46
$104.45( print page 67883)43272
T
Endo cholangiopancreatograph
0151
10.53
$522.25
$245.46
$104.4543280
T
Laparoscopy, fundoplasty
0132
48.91
$2,425.74
$1,239.22
$485.1543289
T
Laparoscope proc, esoph
0130
25.36
$1,257.75
$659.53
$251.5543300
C
Repair of esophagus43305
C
Repair esophagus and fistula43310
C
Repair of esophagus43312
C
Repair esophagus and fistula43320
C
Fuse esophagus & stomach43324
C
Revise esophagus & stomach43325
C
Revise esophagus & stomach43326
C
Revise esophagus & stomach43330
C
Repair of esophagus43331
C
Repair of esophagus43340
C
Fuse esophagus & intestine43341
C
Fuse esophagus & intestine43350
C
Surgical opening, esophagus43351
C
Surgical opening, esophagus43352
C
Surgical opening, esophagus43360
C
Gastrointestinal repair43361
C
Gastrointestinal repair*44383
T
Ileoscopy through stoma w/stent
0142
7.45
$369.49
$162.42
$73.9043400
C
Ligate esophagus veins43401
C
Esophagus surgery for veins43405
C
Ligate/staple esophagus43410
C
Repair esophagus wound43415
C
Repair esophagus wound43420
C
Repair esophagus opening43425
C
Repair esophagus opening43450
T
Dilate esophagus
0140
4.74
$235.09
$107.24
$47.0243453
T
Dilate esophagus
0140
4.74
$235.09
$107.24
$47.0243456
T
Dilate esophagus
0140
4.74
$235.09
$107.24
$47.0243458
T
Dilate esophagus
0140
4.74
$235.09
$107.24
$47.0243460
C
Pressure treatment esophagus43496
C
Free jejunum flap, microvasc43499
T
Esophagus surgery procedure
0140
4.74
$235.09
$107.24
$47.0243500
C
Surgical opening of stomach43501
C
Surgical repair of stomach43502
C
Surgical repair of stomach43510
C
Surgical opening of stomach43520
C
Incision of pyloric muscle43600
T
Biopsy of stomach
0141
7.15
$354.61
$184.67
$70.9243605
C
Biopsy of stomach43610
C
Excision of stomach lesion43611
C
Excision of stomach lesion43620
C
Removal of stomach43621
C
Removal of stomach43622
C
Removal of stomach43631
C
Removal of stomach, partial43632
C
Removal of stomach, partial43633
C
Removal of stomach, partial43634
C
Removal of stomach, partial43635
C
Removal of stomach, partial43638
C
Removal of stomach, partial43639
C
Removal of stomach, partial43640
C
Vagotomy & pylorus repair43641
C
Vagotomy & pylorus repair43651
T
Laparoscopy, vagus nerve
0132
48.91
$2,425.74
$1,239.22
$485.1543652
T
Laparoscopy, vagus nerve
0132
48.91
$2,425.74
$1,239.22
$485.1543653
T
Laparoscopy, gastrostomy
0131
41.81
$2,073.61
$1,089.88
$414.7243659
T
Laparoscope proc, stom
0130
25.36
$1,257.75
$659.53
$251.55*43752
E
Nasal/orogastric w/stent43750
T
Place gastrostomy tube
0141
7.15
$354.61
$184.67
$70.9243760
T
Change gastrostomy tube
0121
2.36
$117.05
$52.53
$23.4143761
T
Reposition gastrostomy tube
0121
2.36
$117.05
$52.53
$23.4143800
C
Reconstruction of pylorus43810
C
Fusion of stomach and bowel43820
C
Fusion of stomach and bowel43825
C
Fusion of stomach and bowel43830
T
Place gastrostomy tube
0141
7.15
$354.61
$184.67
$70.9243831
T
Place gastrostomy tube
0141
7.15
$354.61
$184.67
$70.9243832
C
Place gastrostomy tube43840
C
Repair of stomach lesion43842
C
Gastroplasty for obesity43843
C
Gastroplasty for obesity( print page 67884)43846
C
Gastric bypass for obesity43847
C
Gastric bypass for obesity43848
C
Revision gastroplasty43850
C
Revise stomach-bowel fusion43855
C
Revise stomach-bowel fusion43860
C
Revise stomach-bowel fusion43865
C
Revise stomach-bowel fusion43870
T
Repair stomach opening
0025
3.74
$185.49
$70.66
$37.1043880
C
Repair stomach-bowel fistula43999
T
Stomach surgery procedure
0121
2.36
$117.05
$52.53
$23.4144005
C
Freeing of bowel adhesion44010
C
Incision of small bowel44015
C
Insert needle cath bowel44020
C
Exploration of small bowel44021
C
Decompress small bowel44025
C
Incision of large bowel44050
C
Reduce bowel obstruction44055
C
Correct malrotation of bowel44100
T
Biopsy of bowel
0141
7.15
$354.61
$184.67
$70.9244110
C
Excision of bowel lesion(s)44111
C
Excision of bowel lesion(s)44120
C
Removal of small intestine44121
C
Removal of small intestine44125
C
Removal of small intestine44130
C
Bowel to bowel fusion*44132
C
Enterectomy, cadaver donor*44133
C
Enterectomy, live donor*44135
C
Intestine transplnt, cadaver*44136
C
Intestine transplnt, live44139
C
Mobilization of colon44140
C
Partial removal of colon44141
C
Partial removal of colon44143
C
Partial removal of colon44144
C
Partial removal of colon44145
C
Partial removal of colon44146
C
Partial removal of colon44147
C
Partial removal of colon44150
C
Removal of colon44151
C
Removal of colon/ileostomy44152
C
Removal of colon/ileostomy44153
C
Removal of colon/ileostomy44155
C
Removal of colon/ileostomy44156
C
Removal of colon/ileostomy44160
C
Removal of colon44200
T
Laparoscopy, enterolysis
0131
41.81
$2,073.61
$1,089.88
$414.7244201
T
Laparoscopy, jejunostomy
0131
41.81
$2,073.61
$1,089.88
$414.7244202
C
Laparo, resect intestine44209
T
Laparoscope proc, intestine
0130
25.36
$1,257.75
$659.53
$251.5544300
C
Open bowel to skin44310
C
Ileostomy/jejunostomy44312
T
Revision of ileostomy
0026
12.11
$600.61
$277.92
$120.1244314
C
Revision of ileostomy44316
C
Devise bowel pouch44320
C
Colostomy44322
C
Colostomy with biopsies44340
T
Revision of colostomy
0026
12.11
$600.61
$277.92
$120.1244345
C
Revision of colostomy44346
C
Revision of colostomy44360
T
Small bowel endoscopy
0142
7.45
$369.49
$162.42
$73.9044361
T
Small bowel endoscopy/biopsy
0142
7.45
$369.49
$162.42
$73.9044363
T
Small bowel endoscopy
0142
7.45
$369.49
$162.42
$73.9044364
T
Small bowel endoscopy
0142
7.45
$369.49
$162.42
$73.9044365
T
Small bowel endoscopy
0142
7.45
$369.49
$162.42
$73.9044366
T
Small bowel endoscopy
0142
7.45
$369.49
$162.42
$73.9044369
T
Small bowel endoscopy
0142
7.45
$369.49
$162.42
$73.90*44370
T
Small bowel endoscopy/stent
0142
7.45
$369.49
$162.42
$73.9044372
T
Small bowel endoscopy
0142
7.45
$369.49
$162.42
$73.9044373
T
Small bowel endoscopy
0142
7.45
$369.49
$162.42
$73.9044376
T
Small bowel endoscopy
0142
7.45
$369.49
$162.42
$73.9044377
T
Small bowel endoscopy/biopsy
0142
7.45
$369.49
$162.42
$73.9044378
T
Small bowel endoscopy
0142
7.45
$369.49
$162.42
$73.90*44379
T
Small bowel endoscopy/stent
0142
7.45
$369.49
$162.42
$73.9044380
T
Small bowel endoscopy
0142
7.45
$369.49
$162.42
$73.9044382
T
Small bowel endoscopy
0142
7.45
$369.49
$162.42
$73.90( print page 67885)44385
T
Endoscopy of bowel pouch
0143
7.98
$395.78
$199.12
$79.1644386
T
Endoscopy, bowel pouch/biop
0143
7.98
$395.78
$199.12
$79.1644388
T
Colon endoscopy
0143
7.98
$395.78
$199.12
$79.1644389
T
Colonoscopy with biopsy
0143
7.98
$395.78
$199.12
$79.1644390
T
Colonoscopy for foreign body
0143
7.98
$395.78
$199.12
$79.1644391
T
Colonoscopy for bleeding
0143
7.98
$395.78
$199.12
$79.1644392
T
Colonoscopy & polypectomy
0143
7.98
$395.78
$199.12
$79.1644393
T
Colonoscopy, lesion removal
0143
7.98
$395.78
$199.12
$79.1644394
T
Colonoscopy w/snare
0143
7.98
$395.78
$199.12
$79.16*44397
T
Colonoscopy w/stent
0143
7.98
$395.78
$199.12
$79.1644500
T
Intro, gastrointestinal tube
0121
2.36
$117.05
$52.53
$23.4144602
C
Suture, small intestine44603
C
Suture, small intestine44604
C
Suture, large intestine44605
C
Repair of bowel lesion44615
C
Intestinal stricturoplasty44620
C
Repair bowel opening44625
C
Repair bowel opening44626
C
Repair bowel opening44640
C
Repair bowel-skin fistula44650
C
Repair bowel fistula44660
C
Repair bowel-bladder fistula44661
C
Repair bowel-bladder fistula44680
C
Surgical revision, intestine44700
C
Suspend bowel w/prosthesis44799
T
Intestine surgery procedure
0142
7.45
$369.49
$162.42
$73.9044800
C
Excision of bowel pouch44820
C
Excision of mesentery lesion44850
C
Repair of mesentery44899
C
Bowel surgery procedure44900
C
Drain app abscess, open44901
C
Drain app abscess, percut44950
C
Appendectomy44955
C
Appendectomy add-on44960
C
Appendectomy44970
T
Laparoscopy, appendectomy
0130
25.36
$1,257.75
$659.53
$251.5544979
T
Laparoscope proc, app
0130
25.36
$1,257.75
$659.53
$251.5545000
T
Drainage of pelvic abscess
0149
12.86
$637.80
$293.06
$127.5645005
T
Drainage of rectal abscess
0148
2.34
$116.06
$43.59
$23.2145020
T
Drainage of rectal abscess
0149
12.86
$637.80
$293.06
$127.5645100
T
Biopsy of rectum
0149
12.86
$637.80
$293.06
$127.5645108
T
Removal of anorectal lesion
0150
17.68
$876.86
$437.12
$175.3745110
C
Removal of rectum45111
C
Partial removal of rectum45112
C
Removal of rectum45113
C
Partial proctectomy45114
C
Partial removal of rectum45116
C
Partial removal of rectum45119
C
Remove rectum w/reservoir45120
C
Removal of rectum45121
C
Removal of rectum and colon45123
C
Partial proctectomy45126
C
Pelvic exenteration45130
C
Excision of rectal prolapse45135
C
Excision of rectal prolapse45150
T
Excision of rectal stricture
0150
17.68
$876.86
$437.12
$175.3745160
T
Excision of rectal lesion
0150
17.68
$876.86
$437.12
$175.3745170
T
Excision of rectal lesion
0150
17.68
$876.86
$437.12
$175.3745190
T
Destruction, rectal tumor
0150
17.68
$876.86
$437.12
$175.3745300
T
Proctosigmoidoscopy
0146
2.83
$140.36
$65.15
$28.0745303
T
Proctosigmoidoscopy
0146
2.83
$140.36
$65.15
$28.0745305
T
Proctosigmoidoscopy & biopsy
0146
2.83
$140.36
$65.15
$28.0745307
T
Proctosigmoidoscopy
0146
2.83
$140.36
$65.15
$28.0745308
T
Proctosigmoidoscopy
0147
6.26
$310.47
$149.11
$62.0945309
T
Proctosigmoidoscopy
0147
6.26
$310.47
$149.11
$62.0945315
T
Proctosigmoidoscopy
0147
6.26
$310.47
$149.11
$62.0945317
T
Proctosigmoidoscopy
0146
2.83
$140.36
$65.15
$28.0745320
T
Proctosigmoidoscopy
0147
6.26
$310.47
$149.11
$62.0945321
T
Proctosigmoidoscopy
0147
6.26
$310.47
$149.11
$62.09*45327
T
Proctosigmoidoscopy w/stent
0147
6.26
$310.47
$149.11
$62.0945330
T
Diagnostic sigmoidoscopy
0146
2.83
$140.36
$65.15
$28.0745331
T
Sigmoidoscopy and biopsy
0146
2.83
$140.36
$65.15
$28.0745332
T
Sigmoidoscopy w/fb removal
0146
2.83
$140.36
$65.15
$28.0745333
T
Sigmoidoscopy & polypectomy
0147
6.26
$310.47
$149.11
$62.09( print page 67886)45334
T
Sigmoidoscopy for bleeding
0147
6.26
$310.47
$149.11
$62.0945337
T
Sigmoidoscopy & decompress
0147
6.26
$310.47
$149.11
$62.0945338
T
Sigmoidoscopy w/tumr remove
0147
6.26
$310.47
$149.11
$62.0945339
T
Sigmoidoscopy w/ablate tumr
0147
6.26
$310.47
$149.11
$62.09*45341
T
Sigmoidoscopy w/ultrasound
0147
6.26
$310.47
$149.11
$62.09*45342
T
Sigmoidoscopy w/ US guide bx
0147
6.26
$310.47
$149.11
$62.09*45345
T
Sigmoidoscopy w/stent
0147
6.26
$310.47
$149.11
$62.0945355
T
Surgical colonoscopy
0143
7.98
$395.78
$199.12
$79.1645378
T
Diagnostic colonoscopy
0143
7.98
$395.78
$199.12
$79.1645379
T
Colonoscopy
0143
7.98
$395.78
$199.12
$79.1645380
T
Colonoscopy and biopsy
0143
7.98
$395.78
$199.12
$79.1645382
T
Colonoscopy/control bleeding
0143
7.98
$395.78
$199.12
$79.1645383
T
Lesion removal colonoscopy
0143
7.98
$395.78
$199.12
$79.1645384
T
Colonoscopy
0143
7.98
$395.78
$199.12
$79.1645385
T
Lesion removal colonoscopy
0143
7.98
$395.78
$199.12
$79.16*45387
T
Colonoscopy w/stent
0143
7.98
$395.78
$199.12
$79.1645500
T
Repair of rectum
0150
17.68
$876.86
$437.12
$175.3745505
T
Repair of rectum
0150
17.68
$876.86
$437.12
$175.3745520
T
Treatment of rectal prolapse
0098
1.19
$59.02
$20.88
$11.8045540
C
Correct rectal prolapse45541
C
Correct rectal prolapse45550
C
Repair rectum/remove sigmoid45560
T
Repair of rectocele
0150
17.68
$876.86
$437.12
$175.3745562
C
Exploration/repair of rectum45563
C
Exploration/repair of rectum45800
C
Repair rect/bladder fistula45805
C
Repair fistula w/colostomy45820
C
Repair rectourethral fistula45825
C
Repair fistula w/colostomy45900
T
Reduction of rectal prolapse
0148
2.34
$116.06
$43.59
$23.2145905
T
Dilation of anal sphincter
0149
12.86
$637.80
$293.06
$127.5645910
T
Dilation of rectal narrowing
0149
12.86
$637.80
$293.06
$127.5645915
T
Remove rectal obstruction
0148
2.34
$116.06
$43.59
$23.2145999
T
Rectum surgery procedure
0148
2.34
$116.06
$43.59
$23.2146030
T
Removal of rectal marker
0149
12.86
$637.80
$293.06
$127.5646040
T
Incision of rectal abscess
0148
2.34
$116.06
$43.59
$23.2146045
T
Incision of rectal abscess
0150
17.68
$876.86
$437.12
$175.3746050
T
Incision of anal abscess
0148
2.34
$116.06
$43.59
$23.2146060
T
Incision of rectal abscess
0150
17.68
$876.86
$437.12
$175.3746070
T
Incision of anal septum
0148
2.34
$116.06
$43.59
$23.2146080
T
Incision of anal sphincter
0149
12.86
$637.80
$293.06
$127.5646083
T
Incise external hemorrhoid
0148
2.34
$116.06
$43.59
$23.2146200
T
Removal of anal fissure
0150
17.68
$876.86
$437.12
$175.3746210
T
Removal of anal crypt
0149
12.86
$637.80
$293.06
$127.5646211
T
Removal of anal crypts
0150
17.68
$876.86
$437.12
$175.3746220
T
Removal of anal tab
0149
12.86
$637.80
$293.06
$127.5646221
T
Ligation of hemorrhoid(s)
0148
2.34
$116.06
$43.59
$23.2146230
T
Removal of anal tabs
0149
12.86
$637.80
$293.06
$127.5646250
T
Hemorrhoidectomy
0150
17.68
$876.86
$437.12
$175.3746255
T
Hemorrhoidectomy
0150
17.68
$876.86
$437.12
$175.3746257
T
Remove hemorrhoids & fissure
0150
17.68
$876.86
$437.12
$175.3746258
T
Remove hemorrhoids & fistula
0150
17.68
$876.86
$437.12
$175.3746260
T
Hemorrhoidectomy
0150
17.68
$876.86
$437.12
$175.3746261
T
Remove hemorrhoids & fissure
0150
17.68
$876.86
$437.12
$175.3746262
T
Remove hemorrhoids & fistula
0150
17.68
$876.86
$437.12
$175.3746270
T
Removal of anal fistula
0150
17.68
$876.86
$437.12
$175.3746275
T
Removal of anal fistula
0150
17.68
$876.86
$437.12
$175.3746280
T
Removal of anal fistula
0150
17.68
$876.86
$437.12
$175.3746285
T
Removal of anal fistula
0150
17.68
$876.86
$437.12
$175.3746288
T
Repair anal fistula
0150
17.68
$876.86
$437.12
$175.3746320
T
Removal of hemorrhoid clot
0148
2.34
$116.06
$43.59
$23.2146500
T
Injection into hemorrhoids
0148
2.34
$116.06
$43.59
$23.2146600
N
Diagnostic anoscopy46604
T
Anoscopy and dilation
0144
2.23
$110.60
$49.32
$22.1246606
T
Anoscopy and biopsy
0145
7.46
$369.98
$179.39
$74.0046608
T
Anoscopy/ remove for body
0144
2.23
$110.60
$49.32
$22.1246610
T
Anoscopy/remove lesion
0145
7.46
$369.98
$179.39
$74.0046611
T
Anoscopy
0145
7.46
$369.98
$179.39
$74.0046612
T
Anoscopy/ remove lesions
0145
7.46
$369.98
$179.39
$74.0046614
T
Anoscopy/control bleeding
0145
7.46
$369.98
$179.39
$74.0046615
T
Anoscopy
0145
7.46
$369.98
$179.39
$74.0046700
T
Repair of anal stricture
0150
17.68
$876.86
$437.12
$175.3746705
C
Repair of anal stricture46715
C
Repair of anovaginal fistula( print page 67887)46716
C
Repair of anovaginal fistula46730
C
Construction of absent anus46735
C
Construction of absent anus46740
C
Construction of absent anus46742
C
Repair of imperforated anus46744
C
Repair of cloacal anomaly46746
C
Repair of cloacal anomaly46748
C
Repair of cloacal anomaly46750
T
Repair of anal sphincter
0150
17.68
$876.86
$437.12
$175.3746751
C
Repair of anal sphincter46753
T
Reconstruction of anus
0150
17.68
$876.86
$437.12
$175.3746754
T
Removal of suture from anus
0149
12.86
$637.80
$293.06
$127.5646760
T
Repair of anal sphincter
0150
17.68
$876.86
$437.12
$175.3746761
T
Repair of anal sphincter
0150
17.68
$876.86
$437.12
$175.3746762
T
Implant artificial sphincter
0150
17.68
$876.86
$437.12
$175.3746900
T
Destruction, anal lesion(s)
0016
3.53
$175.07
$74.67
$35.0146910
T
Destruction, anal lesion(s)
0016
3.53
$175.07
$74.67
$35.0146916
T
Cryosurgery, anal lesion(s)
0016
3.53
$175.07
$74.67
$35.0146917
T
Laser surgery, anal lesions
0014
1.50
$74.39
$24.55
$14.8846922
T
Excision of anal lesion(s)
0017
12.45
$617.47
$289.16
$123.4946924
T
Destruction, anal lesion(s)
0017
12.45
$617.47
$289.16
$123.4946934
T
Destruction of hemorrhoids
0148
2.34
$116.06
$43.59
$23.2146935
T
Destruction of hemorrhoids
0148
2.34
$116.06
$43.59
$23.2146936
T
Destruction of hemorrhoids
0149
12.86
$637.80
$293.06
$127.5646937
T
Cryotherapy of rectal lesion
0150
17.68
$876.86
$437.12
$175.3746938
T
Cryotherapy of rectal lesion
0150
17.68
$876.86
$437.12
$175.3746940
T
Treatment of anal fissure
0149
12.86
$637.80
$293.06
$127.5646942
T
Treatment of anal fissure
0149
12.86
$637.80
$293.06
$127.5646945
T
Ligation of hemorrhoids
0148
2.34
$116.06
$43.59
$23.2146946
T
Ligation of hemorrhoids
0148
2.34
$116.06
$43.59
$23.2146999
T
Anus surgery procedure
0149
12.86
$637.80
$293.06
$127.5647000
T
Needle biopsy of liver
0005
5.41
$268.32
$119.75
$53.6647001
C
Needle biopsy, liver add-on47010
C
Open drainage, liver lesion47011
C
Percut drain, liver lesion47015
C
Inject/aspirate liver cyst47100
C
Wedge biopsy of liver47120
C
Partial removal of liver47122
C
Extensive removal of liver47125
C
Partial removal of liver47130
C
Partial removal of liver47133
C
Removal of donor liver47134
C
Partial removal, donor liver47135
C
Transplantation of liver47136
C
Transplantation of liver47300
C
Surgery for liver lesion47350
C
Repair liver wound47360
C
Repair liver wound47361
C
Repair liver wound47362
C
Repair liver wound*47379
T
Laparoscope procedure, liver
0130
25.36
$1,257.75
$659.53
$251.5547399
T
Liver surgery procedure
0005
5.41
$268.32
$119.75
$53.6647400
C
Incision of liver duct47420
C
Incision of bile duct47425
C
Incision of bile duct47460
C
Incise bile duct sphincter47480
C
Incision of gallbladder47490
C
Incision of gallbladder47500
N
Injection for liver x-rays47505
N
Injection for liver x-rays47510
T
Insert catheter, bile duct
0152
8.22
$407.68
$207.38
$81.5447511
T
Insert bile duct drain
0152
8.22
$407.68
$207.38
$81.5447525
T
Change bile duct catheter
0122
5.04
$249.96
$114.93
$49.9947530
T
Revise/reinsert bile tube
0121
2.36
$117.05
$52.53
$23.4147550
C
Bile duct endoscopy add-on47552
T
Biliary endoscopy thru skin
0152
8.22
$407.68
$207.38
$81.5447553
T
Biliary endoscopy thru skin
0152
8.22
$407.68
$207.38
$81.5447554
T
Biliary endoscopy thru skin
0152
8.22
$407.68
$207.38
$81.5447555
T
Biliary endoscopy thru skin
0152
8.22
$407.68
$207.38
$81.5447556
T
Biliary endoscopy thru skin
0152
8.22
$407.68
$207.38
$81.5447560
T
Laparoscopy w/cholangio
0130
25.36
$1,257.75
$659.53
$251.5547561
T
Laparo w/cholangio/biopsy
0130
25.36
$1,257.75
$659.53
$251.5547562
T
Laparoscopic cholecystectomy
0131
41.81
$2,073.61
$1,089.88
$414.7247563
T
Laparo cholecystectomy/graph
0131
41.81
$2,073.61
$1,089.88
$414.72( print page 67888)47564
T
Laparo cholecystectomy/explr
0131
41.81
$2,073.61
$1,089.88
$414.7247570
C
Laparo cholecystoenterostomy47579
T
Laparoscope proc, biliary
0130
25.36
$1,257.75
$659.53
$251.5547600
C
Removal of gallbladder47605
C
Removal of gallbladder47610
C
Removal of gallbladder47612
C
Removal of gallbladder47620
C
Removal of gallbladder47630
T
Remove bile duct stone
0152
8.22
$407.68
$207.38
$81.5447700
C
Exploration of bile ducts47701
C
Bile duct revision47711
C
Excision of bile duct tumor47712
C
Excision of bile duct tumor47715
C
Excision of bile duct cyst47716
C
Fusion of bile duct cyst47720
C
Fuse gallbladder & bowel47721
C
Fuse upper gi structures47740
C
Fuse gallbladder & bowel47741
C
Fuse gallbladder & bowel47760
C
Fuse bile ducts and bowel47765
C
Fuse liver ducts & bowel47780
C
Fuse bile ducts and bowel47785
C
Fuse bile ducts and bowel47800
C
Reconstruction of bile ducts47801
C
Placement, bile duct support47802
C
Fuse liver duct & intestine47900
C
Suture bile duct injury47999
T
Bile tract surgery procedure
0121
2.36
$117.05
$52.53
$23.4148000
C
Drainage of abdomen48001
C
Placement of drain, pancreas48005
C
Resect/debride pancreas48020
C
Removal of pancreatic stone48100
C
Biopsy of pancreas48102
T
Needle biopsy, pancreas
0005
5.41
$268.32
$119.75
$53.6648120
C
Removal of pancreas lesion48140
C
Partial removal of pancreas48145
C
Partial removal of pancreas48146
C
Pancreatectomy48148
C
Removal of pancreatic duct48150
C
Partial removal of pancreas48152
C
Pancreatectomy48153
C
Pancreatectomy48154
C
Pancreatectomy48155
C
Removal of pancreas48160
E
Pancreas removal/transplant48180
C
Fuse pancreas and bowel48400
C
Injection, intraop add-on48500
C
Surgery of pancreas cyst48510
C
Drain pancreatic pseudocyst48511
C
Drain pancreatic pseudocyst48520
C
Fuse pancreas cyst and bowel48540
C
Fuse pancreas cyst and bowel48545
C
Pancreatorrhaphy48547
C
Duodenal exclusion48550
E
Donor pancreatectomy48554
E
Transpl allograft pancreas48556
C
Removal, allograft pancreas48999
T
Pancreas surgery procedure
0005
5.41
$268.32
$119.75
$53.6649000
C
Exploration of abdomen49002
C
Reopening of abdomen49010
C
Exploration behind abdomen49020
C
Drain abdominal abscess49021
C
Drain abdominal abscess49040
C
Drain, open, abdom abscess49041
C
Drain, percut, abdom abscess49060
C
Drain, open, retrop abscess49061
C
Drain, percut, retroper absc49062
C
Drain to peritoneal cavity49080
T
Puncture, peritoneal cavity
0070
3.64
$180.53
$79.60
$36.1149081
T
Removal of abdominal fluid
0070
3.64
$180.53
$79.60
$36.1149085
T
Remove abdomen foreign body
0153
19.62
$973.08
$496.31
$194.6249180
T
Biopsy, abdominal mass
0005
5.41
$268.32
$119.75
$53.6649200
C
Removal of abdominal lesion49201
C
Removal of abdominal lesion( print page 67889)49215
C
Excise sacral spine tumor49220
C
Multiple surgery, abdomen49250
T
Excision of umbilicus
0153
19.62
$973.08
$496.31
$194.6249255
C
Removal of omentum49320
T
Diag laparo separate proc
0130
25.36
$1,257.75
$659.53
$251.5549321
T
Laparoscopy, biopsy
0130
25.36
$1,257.75
$659.53
$251.5549322
T
Laparoscopy, aspiration
0130
25.36
$1,257.75
$659.53
$251.5549323
T
Laparo drain lymphocele
0130
25.36
$1,257.75
$659.53
$251.5549329
T
Laparo proc, abdm/per/oment
0130
25.36
$1,257.75
$659.53
$251.5549400
N
Air injection into abdomen49420
T
Insert abdominal drain
0153
19.62
$973.08
$496.31
$194.6249421
T
Insert abdominal drain
0153
19.62
$973.08
$496.31
$194.6249422
T
Remove perm cannula/catheter
0105
15.06
$746.92
$372.32
$149.3849423
T
Exchange drainage catheter
0153
19.62
$973.08
$496.31
$194.6249424
N
Assess cyst, contrast inject49425
C
Insert abdomen-venous drain49426
T
Revise abdomen-venous shunt
0153
19.62
$973.08
$496.31
$194.6249427
N
Injection, abdominal shunt49428
C
Ligation of shunt49429
T
Removal of shunt
0105
15.06
$746.92
$372.32
$149.3849495
T
Repair inguinal hernia, init
0154
22.43
$1,112.45
$556.98
$222.4949496
T
Repair inguinal hernia, init
0154
22.43
$1,112.45
$556.98
$222.4949500
T
Repair inguinal hernia
0154
22.43
$1,112.45
$556.98
$222.4949501
T
Repair inguinal hernia, init
0154
22.43
$1,112.45
$556.98
$222.4949505
T
Repair inguinal hernia
0154
22.43
$1,112.45
$556.98
$222.4949507
T
Repair inguinal hernia
0154
22.43
$1,112.45
$556.98
$222.4949520
T
Rerepair inguinal hernia
0154
22.43
$1,112.45
$556.98
$222.4949521
T
Repair inguinal hernia, rec
0154
22.43
$1,112.45
$556.98
$222.4949525
T
Repair inguinal hernia
0154
22.43
$1,112.45
$556.98
$222.4949540
T
Repair lumbar hernia
0154
22.43
$1,112.45
$556.98
$222.4949550
T
Repair femoral hernia
0154
22.43
$1,112.45
$556.98
$222.4949553
T
Repair femoral hernia, init
0154
22.43
$1,112.45
$556.98
$222.4949555
T
Repair femoral hernia
0154
22.43
$1,112.45
$556.98
$222.4949557
T
Repair femoral hernia, recur
0154
22.43
$1,112.45
$556.98
$222.4949560
T
Repair abdominal hernia
0154
22.43
$1,112.45
$556.98
$222.4949561
T
Repair incisional hernia
0154
22.43
$1,112.45
$556.98
$222.4949565
T
Rerepair abdominal hernia
0154
22.43
$1,112.45
$556.98
$222.4949566
T
Repair incisional hernia
0154
22.43
$1,112.45
$556.98
$222.4949568
T
Hernia repair w/mesh
0154
22.43
$1,112.45
$556.98
$222.4949570
T
Repair epigastric hernia
0154
22.43
$1,112.45
$556.98
$222.4949572
T
Repair epigastric hernia
0154
22.43
$1,112.45
$556.98
$222.4949580
T
Repair umbilical hernia
0154
22.43
$1,112.45
$556.98
$222.4949582
T
Repair umbilical hernia
0154
22.43
$1,112.45
$556.98
$222.4949585
T
Repair umbilical hernia
0154
22.43
$1,112.45
$556.98
$222.4949587
T
Repair umbilical hernia
0154
22.43
$1,112.45
$556.98
$222.4949590
T
Repair abdominal hernia
0154
22.43
$1,112.45
$556.98
$222.4949600
T
Repair umbilical lesion
0154
22.43
$1,112.45
$556.98
$222.4949605
C
Repair umbilical lesion49606
C
Repair umbilical lesion49610
C
Repair umbilical lesion49611
C
Repair umbilical lesion49650
T
Laparo hernia repair initial
0131
41.81
$2,073.61
$1,089.88
$414.7249651
T
Laparo hernia repair recur
0131
41.81
$2,073.61
$1,089.88
$414.7249659
T
Laparo proc, hernia repair
0131
41.81
$2,073.61
$1,089.88
$414.7249900
C
Repair of abdominal wall49905
C
Omental flap49906
C
Free omental flap, microvasc49999
T
Abdomen surgery procedure
0121
2.36
$117.05
$52.53
$23.4150010
C
Exploration of kidney50020
C
Renal abscess, open drain50021
C
Renal abscess, percut drain50040
C
Drainage of kidney50045
C
Exploration of kidney50060
C
Removal of kidney stone50065
C
Incision of kidney50070
C
Incision of kidney50075
C
Removal of kidney stone50080
T
Removal of kidney stone
0163
28.98
$1,437.30
$792.58
$287.4650081
T
Removal of kidney stone
0163
28.98
$1,437.30
$792.58
$287.4650100
C
Revise kidney blood vessels50120
C
Exploration of kidney50125
C
Explore and drain kidney50130
C
Removal of kidney stone50135
C
Exploration of kidney( print page 67890)50200
T
Biopsy of kidney
0005
5.41
$268.32
$119.75
$53.6650205
C
Biopsy of kidney50220
C
Removal of kidney50225
C
Removal of kidney50230
C
Removal of kidney50234
C
Removal of kidney & ureter50236
C
Removal of kidney & ureter50240
C
Partial removal of kidney50280
C
Removal of kidney lesion50290
C
Removal of kidney lesion50300
C
Removal of donor kidney50320
C
Removal of donor kidney50340
C
Removal of kidney50360
C
Transplantation of kidney50365
C
Transplantation of kidney50370
C
Remove transplanted kidney50380
C
Reimplantation of kidney50390
T
Drainage of kidney lesion
0005
5.41
$268.32
$119.75
$53.6650392
T
Insert kidney drain
0160
5.43
$269.30
$110.11
$53.8650393
T
Insert ureteral tube
0160
5.43
$269.30
$110.11
$53.8650394
N
Injection for kidney x-ray50395
T
Create passage to kidney
0160
5.43
$269.30
$110.11
$53.8650396
T
Measure kidney pressure
0165
3.89
$192.92
$91.76
$38.5850398
T
Change kidney tube
0122
5.04
$249.96
$114.93
$49.9950400
C
Revision of kidney/ureter50405
C
Revision of kidney/ureter50500
C
Repair of kidney wound50520
C
Close kidney-skin fistula50525
C
Repair renal-abdomen fistula50526
C
Repair renal-abdomen fistula50540
C
Revision of horseshoe kidney50541
T
Laparo ablate renal cyst
0131
41.81
$2,073.61
$1,089.88
$414.7250544
T
Laparoscopy, pyeloplasty
0131
41.81
$2,073.61
$1,089.88
$414.72*50545
C
Laparo radical nephrectomy50546
C
Laparoscopic nephrectomy50547
C
Laparo removal donor kidney50548
C
Laparo-asst remove k/ureter50549
T
Laparoscope proc, renal
0130
25.36
$1,257.75
$659.53
$251.5550551
T
Kidney endoscopy
0161
10.94
$542.58
$249.36
$108.5250553
T
Kidney endoscopy
0161
10.94
$542.58
$249.36
$108.5250555
T
Kidney endoscopy & biopsy
0161
10.94
$542.58
$249.36
$108.5250557
T
Kidney endoscopy & treatment
0161
10.94
$542.58
$249.36
$108.5250559
T
Renal endoscopy/radiotracer
0161
10.94
$542.58
$249.36
$108.5250561
T
Kidney endoscopy & treatment
0161
10.94
$542.58
$249.36
$108.5250570
C
Kidney endoscopy50572
C
Kidney endoscopy50574
C
Kidney endoscopy & biopsy50575
C
Kidney endoscopy50576
C
Kidney endoscopy & treatment50578
C
Renal endoscopy/radiotracer50580
C
Kidney endoscopy & treatment50590
T
Fragmenting of kidney stone
0169
46.72
$2,317.13
$1,384.20
$463.4350600
C
Exploration of ureter50605
C
Insert ureteral support50610
C
Removal of ureter stone50620
C
Removal of ureter stone50630
C
Removal of ureter stone50650
C
Removal of ureter50660
C
Removal of ureter50684
N
Injection for ureter x-ray50686
T
Measure ureter pressure
0165
3.89
$192.92
$91.76
$38.5850688
T
Change of ureter tube
0121
2.36
$117.05
$52.53
$23.4150690
N
Injection for ureter x-ray50700
C
Revision of ureter50715
C
Release of ureter50722
C
Release of ureter50725
C
Release/revise ureter50727
C
Revise ureter50728
C
Revise ureter50740
C
Fusion of ureter & kidney50750
C
Fusion of ureter & kidney50760
C
Fusion of ureters50770
C
Splicing of ureters50780
C
Reimplant ureter in bladder( print page 67891)50782
C
Reimplant ureter in bladder50783
C
Reimplant ureter in bladder50785
C
Reimplant ureter in bladder50800
C
Implant ureter in bowel50810
C
Fusion of ureter & bowel50815
C
Urine shunt to bowel50820
C
Construct bowel bladder50825
C
Construct bowel bladder50830
C
Revise urine flow50840
C
Replace ureter by bowel50845
C
Appendico-vesicostomy50860
C
Transplant ureter to skin50900
C
Repair of ureter50920
C
Closure ureter/skin fistula50930
C
Closure ureter/bowel fistula50940
C
Release of ureter50945
T
Laparoscopy ureterolithotomy
0131
41.81
$2,073.61
$1,089.88
$414.72*50947
T
Laparoscopy new ureter/bladder
0130
25.36
$1,257.75
$659.53
$251.55*50948
T
Laparoscopy new ureter/bladder
0130
25.36
$1,257.75
$659.53
$251.55*50949
T
Laparoscope proc, ureter
0130
25.36
$1,257.75
$659.53
$251.5550951
T
Endoscopy of ureter
0162
17.49
$867.44
$427.49
$173.4950953
T
Endoscopy of ureter
0162
17.49
$867.44
$427.49
$173.4950955
T
Ureter endoscopy & biopsy
0162
17.49
$867.44
$427.49
$173.4950957
T
Ureter endoscopy & treatment
0162
17.49
$867.44
$427.49
$173.4950959
T
Ureter endoscopy & tracer
0162
17.49
$867.44
$427.49
$173.4950961
T
Ureter endoscopy & treatment
0162
17.49
$867.44
$427.49
$173.4950970
T
Ureter endoscopy
0162
17.49
$867.44
$427.49
$173.4950972
T
Ureter endoscopy & catheter
0162
17.49
$867.44
$427.49
$173.4950974
T
Ureter endoscopy & biopsy
0162
17.49
$867.44
$427.49
$173.4950976
T
Ureter endoscopy & treatment
0162
17.49
$867.44
$427.49
$173.4950978
T
Ureter endoscopy & tracer
0162
17.49
$867.44
$427.49
$173.4950980
T
Ureter endoscopy & treatment
0162
17.49
$867.44
$427.49
$173.4951000
T
Drainage of bladder
0165
3.89
$192.92
$91.76
$38.5851005
T
Drainage of bladder
0164
2.17
$107.64
$33.03
$21.5351010
T
Drainage of bladder
0165
3.89
$192.92
$91.76
$38.5851020
T
Incise & treat bladder
0162
17.49
$867.44
$427.49
$173.4951030
T
Incise & treat bladder
0162
17.49
$867.44
$427.49
$173.4951040
T
Incise & drain bladder
0162
17.49
$867.44
$427.49
$173.4951045
T
Incise bladder/drain ureter
0162
17.49
$867.44
$427.49
$173.4951050
T
Removal of bladder stone
0162
17.49
$867.44
$427.49
$173.4951060
C
Removal of ureter stone51065
T
Removal of ureter stone
0162
17.49
$867.44
$427.49
$173.4951080
T
Drainage of bladder abscess
0008
6.15
$305.02
$113.67
$61.0051500
T
Removal of bladder cyst
0154
22.43
$1,112.45
$556.98
$222.4951520
T
Removal of bladder lesion
0162
17.49
$867.44
$427.49
$173.4951525
C
Removal of bladder lesion51530
C
Removal of bladder lesion51535
C
Repair of ureter lesion51550
C
Partial removal of bladder51555
C
Partial removal of bladder51565
C
Revise bladder & ureter(s)51570
C
Removal of bladder51575
C
Removal of bladder & nodes51580
C
Remove bladder/revise tract51585
C
Removal of bladder & nodes51590
C
Remove bladder/revise tract51595
C
Remove bladder/revise tract51596
C
Remove bladder/create pouch51597
C
Removal of pelvic structures51600
N
Injection for bladder x-ray51605
N
Preparation for bladder xray51610
N
Injection for bladder x-ray51700
T
Irrigation of bladder
0164
2.17
$107.64
$33.03
$21.5351705
T
Change of bladder tube
0121
2.36
$117.05
$52.53
$23.4151710
T
Change of bladder tube
0121
2.36
$117.05
$52.53
$23.4151715
T
Endoscopic injection/implant
0167
21.06
$1,044.50
$555.84
$208.9051720
T
Treatment of bladder lesion
0165
3.89
$192.92
$91.76
$38.5851725
T
Simple cystometrogram
0165
3.89
$192.92
$91.76
$38.5851726
T
Complex cystometrogram
0165
3.89
$192.92
$91.76
$38.5851736
T
Urine flow measurement
0164
2.17
$107.64
$33.03
$21.5351741
T
Electro-uroflowmetry, first
0164
2.17
$107.64
$33.03
$21.5351772
T
Urethra pressure profile
0165
3.89
$192.92
$91.76
$38.5851784
T
Anal/urinary muscle study
0164
2.17
$107.64
$33.03
$21.5351785
T
Anal/urinary muscle study
0164
2.17
$107.64
$33.03
$21.53( print page 67892)51792
T
Urinary reflex study
0165
3.89
$192.92
$91.76
$38.5851795
T
Urine voiding pressure study
0164
2.17
$107.64
$33.03
$21.5351797
T
Intraabdominal pressure test
0164
2.17
$107.64
$33.03
$21.5351800
C
Revision of bladder/urethra51820
C
Revision of urinary tract51840
C
Attach bladder/urethra51841
C
Attach bladder/urethra51845
C
Repair bladder neck51860
C
Repair of bladder wound51865
C
Repair of bladder wound51880
T
Repair of bladder opening
0162
17.49
$867.44
$427.49
$173.4951900
C
Repair bladder/vagina lesion51920
C
Close bladder-uterus fistula51925
C
Hysterectomy/bladder repair51940
C
Correction of bladder defect51960
C
Revision of bladder & bowel51980
C
Construct bladder opening51990
T
Laparo urethral suspension
0131
41.81
$2,073.61
$1,089.88
$414.7251992
T
Laparo sling operation
0132
48.91
$2,425.74
$1,239.22
$485.1552000
T
Cystoscopy
0160
5.43
$269.30
$110.11
$53.8652005
T
Cystoscopy & ureter catheter
0161
10.94
$542.58
$249.36
$108.5252007
T
Cystoscopy and biopsy
0161
10.94
$542.58
$249.36
$108.5252010
T
Cystoscopy & duct catheter
0161
10.94
$542.58
$249.36
$108.5252204
T
Cystoscopy
0161
10.94
$542.58
$249.36
$108.5252214
T
Cystoscopy and treatment
0161
10.94
$542.58
$249.36
$108.5252224
T
Cystoscopy and treatment
0161
10.94
$542.58
$249.36
$108.5252234
T
Cystoscopy and treatment
0162
17.49
$867.44
$427.49
$173.4952235
T
Cystoscopy and treatment
0162
17.49
$867.44
$427.49
$173.4952240
T
Cystoscopy and treatment
0163
28.98
$1,437.30
$792.58
$287.4652250
T
Cystoscopy and radiotracer
0162
17.49
$867.44
$427.49
$173.4952260
T
Cystoscopy and treatment
0161
10.94
$542.58
$249.36
$108.5252265
T
Cystoscopy and treatment
0160
5.43
$269.30
$110.11
$53.8652270
T
Cystoscopy & revise urethra
0161
10.94
$542.58
$249.36
$108.5252275
T
Cystoscopy & revise urethra
0161
10.94
$542.58
$249.36
$108.5252276
T
Cystoscopy and treatment
0161
10.94
$542.58
$249.36
$108.5252277
T
Cystoscopy and treatment
0162
17.49
$867.44
$427.49
$173.4952281
T
Cystoscopy and treatment
0161
10.94
$542.58
$249.36
$108.5252282
T
Cystoscopy, implant stent
0162
17.49
$867.44
$427.49
$173.4952283
T
Cystoscopy and treatment
0161
10.94
$542.58
$249.36
$108.5252285
T
Cystoscopy and treatment
0161
10.94
$542.58
$249.36
$108.5252290
T
Cystoscopy and treatment
0161
10.94
$542.58
$249.36
$108.5252300
T
Cystoscopy and treatment
0161
10.94
$542.58
$249.36
$108.5252301
T
Cystoscopy and treatment
0161
10.94
$542.58
$249.36
$108.5252305
T
Cystoscopy and treatment
0161
10.94
$542.58
$249.36
$108.5252310
T
Cystoscopy and treatment
0161
10.94
$542.58
$249.36
$108.5252315
T
Cystoscopy and treatment
0161
10.94
$542.58
$249.36
$108.5252317
T
Remove bladder stone
0162
17.49
$867.44
$427.49
$173.4952318
T
Remove bladder stone
0162
17.49
$867.44
$427.49
$173.4952320
T
Cystoscopy and treatment
0162
17.49
$867.44
$427.49
$173.4952325
T
Cystoscopy, stone removal
0162
17.49
$867.44
$427.49
$173.4952327
T
Cystoscopy, inject material
0161
10.94
$542.58
$249.36
$108.5252330
T
Cystoscopy and treatment
0162
17.49
$867.44
$427.49
$173.4952332
T
Cystoscopy and treatment
0162
17.49
$867.44
$427.49
$173.4952334
T
Create passage to kidney
0162
17.49
$867.44
$427.49
$173.4952335D
T
Endoscopy of urinary tract
0162
17.49
$867.44
$427.49
$173.4952336D
T
Cystoscopy, stone removal
0162
17.49
$867.44
$427.49
$173.4952337D
T
Cystoscopy, stone removal
0162
17.49
$867.44
$427.49
$173.4952338D
T
Cystoscopy and treatment
0162
17.49
$867.44
$427.49
$173.4952339D
T
Cystoscopy and treatment
0162
17.49
$867.44
$427.49
$173.4952340D
T
Cystoscopy and treatment
0162
17.49
$867.44
$427.49
$173.49*52341
T
Cysto w/ureter stricture treatment
0162
17.49
$867.44
$427.49
$173.49*52342
T
Cysto w/up stricture treatment
0162
17.49
$867.44
$427.49
$173.49*52343
T
Cysto w/renal stricture treatment
0162
17.49
$867.44
$427.49
$173.49*52344
T
Cysto/uretero, stone removal
0162
17.49
$867.44
$427.49
$173.49*52345
T
Cysto/uretero w/up stricture
0162
17.49
$867.44
$427.49
$173.49*52346
T
Cystouretero w/renal strict
0162
17.49
$867.44
$427.49
$173.49*52351
T
Cystouretero &/or pyeloscope
0161
10.94
$542.58
$249.36
$108.52*52352
T
Cystouretero w/stone removal
0162
17.49
$867.44
$427.49
$173.49*52353
T
Cystouretero w/lithotripsy
0162
17.49
$867.44
$427.49
$173.49*52354
T
Cystouretero w/biopsy
0162
17.49
$867.44
$427.49
$173.49*52355
T
Cystouretero w/excise tumor
0162
17.49
$867.44
$427.49
$173.49*52400
T
Cystouretero w/congen repr
0162
17.49
$867.44
$427.49
$173.4952450
T
Incision of prostate
0162
17.49
$867.44
$427.49
$173.4952500
T
Revision of bladder neck
0162
17.49
$867.44
$427.49
$173.49( print page 67893)52510
T
Dilation prostatic urethra
0161
10.94
$542.58
$249.36
$108.5252601
T
Prostatectomy (TURP)
0163
28.98
$1,437.30
$792.58
$287.4652606
T
Control postop bleeding
0162
17.49
$867.44
$427.49
$173.4952612
T
Prostatectomy, first stage
0163
28.98
$1,437.30
$792.58
$287.4652614
T
Prostatectomy, second stage
0163
28.98
$1,437.30
$792.58
$287.4652620
T
Remove residual prostate
0163
28.98
$1,437.30
$792.58
$287.4652630
T
Remove prostate regrowth
0163
28.98
$1,437.30
$792.58
$287.4652640
T
Relieve bladder contracture
0162
17.49
$867.44
$427.49
$173.4952647
T
Laser surgery of prostate
0163
28.98
$1,437.30
$792.58
$287.4652648
T
Laser surgery of prostate
0163
28.98
$1,437.30
$792.58
$287.4652700
T
Drainage of prostate abscess
0162
17.49
$867.44
$427.49
$173.4953000
T
Incision of urethra
0166
10.17
$504.39
$218.73
$100.8853010
T
Incision of urethra
0166
10.17
$504.39
$218.73
$100.8853020
T
Incision of urethra
0166
10.17
$504.39
$218.73
$100.8853025
T
Incision of urethra
0166
10.17
$504.39
$218.73
$100.8853040
T
Drainage of urethra abscess
0166
10.17
$504.39
$218.73
$100.8853060
T
Drainage of urethra abscess
0166
10.17
$504.39
$218.73
$100.8853080
T
Drainage of urinary leakage
0166
10.17
$504.39
$218.73
$100.8853085
C
Drainage of urinary leakage53200
T
Biopsy of urethra
0166
10.17
$504.39
$218.73
$100.8853210
T
Removal of urethra
0168
24.94
$1,236.93
$536.11
$247.3953215
T
Removal of urethra
0168
24.94
$1,236.93
$536.11
$247.3953220
T
Treatment of urethra lesion
0168
24.94
$1,236.93
$536.11
$247.3953230
T
Removal of urethra lesion
0168
24.94
$1,236.93
$536.11
$247.3953235
T
Removal of urethra lesion
0168
24.94
$1,236.93
$536.11
$247.3953240
T
Surgery for urethra pouch
0168
24.94
$1,236.93
$536.11
$247.3953250
T
Removal of urethra gland
0166
10.17
$504.39
$218.73
$100.8853260
T
Treatment of urethra lesion
0166
10.17
$504.39
$218.73
$100.8853265
T
Treatment of urethra lesion
0166
10.17
$504.39
$218.73
$100.8853270
T
Removal of urethra gland
0167
21.06
$1,044.50
$555.84
$208.9053275
T
Repair of urethra defect
0166
10.17
$504.39
$218.73
$100.8853400
T
Revise urethra, stage 1
0168
24.94
$1,236.93
$536.11
$247.3953405
T
Revise urethra, stage 2
0168
24.94
$1,236.93
$536.11
$247.3953410
T
Reconstruction of urethra
0168
24.94
$1,236.93
$536.11
$247.3953415
C
Reconstruction of urethra53420
T
Reconstruct urethra, stage 1
0168
24.94
$1,236.93
$536.11
$247.3953425
T
Reconstruct urethra, stage 2
0168
24.94
$1,236.93
$536.11
$247.3953430
T
Reconstruction of urethra
0168
24.94
$1,236.93
$536.11
$247.3953440
T
Correct bladder function
0182
52.11
$2,584.45
$1,525.05
$516.8953442
T
Remove perineal prosthesis
0166
10.17
$504.39
$218.73
$100.8853443
C
Reconstruction of urethra53445
T
Correct urine flow control
0182
52.11
$2,584.45
$1,525.05
$516.8953447
T
Remove artificial sphincter
0168
24.94
$1,236.93
$536.11
$247.3953449
T
Correct artificial sphincter
0168
24.94
$1,236.93
$536.11
$247.3953450
T
Revision of urethra
0168
24.94
$1,236.93
$536.11
$247.3953460
T
Revision of urethra
0168
24.94
$1,236.93
$536.11
$247.3953502
T
Repair of urethra injury
0166
10.17
$504.39
$218.73
$100.8853505
T
Repair of urethra injury
0167
21.06
$1,044.50
$555.84
$208.9053510
T
Repair of urethra injury
0166
10.17
$504.39
$218.73
$100.8853515
T
Repair of urethra injury
0168
24.94
$1,236.93
$536.11
$247.3953520
T
Repair of urethra defect
0168
24.94
$1,236.93
$536.11
$247.3953600
T
Dilate urethra stricture
0164
2.17
$107.64
$33.03
$21.5353601
T
Dilate urethra stricture
0164
2.17
$107.64
$33.03
$21.5353605
T
Dilate urethra stricture
0161
10.94
$542.58
$249.36
$108.5253620
T
Dilate urethra stricture
0165
3.89
$192.92
$91.76
$38.5853621
T
Dilate urethra stricture
0164
2.17
$107.64
$33.03
$21.5353660
T
Dilation of urethra
0164
2.17
$107.64
$33.03
$21.5353661
T
Dilation of urethra
0164
2.17
$107.64
$33.03
$21.5353665
T
Dilation of urethra
0166
10.17
$504.39
$218.73
$100.8853670
N
Insert urinary catheter53675
T
Insert urinary catheter
0164
2.17
$107.64
$33.03
$21.5353850
T
Prostatic microwave thermotx
0980
38.67
$1,917.89

$383.5853852
T
Prostatic rf thermotx
0980
38.67
$1,917.89

$383.5853899
T
Urology surgery procedure
0165
3.89
$192.92
$91.76
$38.5854000
T
Slitting of prepuce
0166
10.17
$504.39
$218.73
$100.8854001
T
Slitting of prepuce
0166
10.17
$504.39
$218.73
$100.8854015
T
Drain penis lesion
0008
6.15
$305.02
$113.67
$61.0054050
T
Destruction, penis lesion(s)
0013
0.91
$45.13
$17.66
$9.0354055
T
Destruction, penis lesion(s)
0016
3.53
$175.07
$74.67
$35.0154056
T
Cryosurgery, penis lesion(s)
0013
0.91
$45.13
$17.66
$9.0354057
T
Laser surg, penis lesion(s)
0017
12.45
$617.47
$289.16
$123.4954060
T
Excision of penis lesion(s)
0017
12.45
$617.47
$289.16
$123.4954065
T
Destruction, penis lesion(s)
0017
12.45
$617.47
$289.16
$123.4954100
T
Biopsy of penis
0020
6.51
$322.87
$130.53
$64.57( print page 67894)54105
T
Biopsy of penis
0021
10.49
$520.26
$236.51
$104.0554110
T
Treatment of penis lesion
0181
32.37
$1,605.43
$906.36
$321.0954111
T
Treat penis lesion, graft
0181
32.37
$1,605.43
$906.36
$321.0954112
T
Treat penis lesion, graft
0181
32.37
$1,605.43
$906.36
$321.0954115
T
Treatment of penis lesion
0008
6.15
$305.02
$113.67
$61.0054120
T
Partial removal of penis
0181
32.37
$1,605.43
$906.36
$321.0954125
C
Removal of penis54130
C
Remove penis & nodes54135
C
Remove penis & nodes54150
T
Circumcision
0180
13.62
$675.49
$304.87
$135.1054152
T
Circumcision
0180
13.62
$675.49
$304.87
$135.1054160
T
Circumcision
0180
13.62
$675.49
$304.87
$135.1054161
T
Circumcision
0180
13.62
$675.49
$304.87
$135.1054200
T
Treatment of penis lesion
0165
3.89
$192.92
$91.76
$38.5854205
T
Treatment of penis lesion
0181
32.37
$1,605.43
$906.36
$321.0954220
T
Treatment of penis lesion
0165
3.89
$192.92
$91.76
$38.5854230
N
Prepare penis study54231
T
Dynamic cavernosometry
0165
3.89
$192.92
$91.76
$38.5854235
T
Penile injection
0164
2.17
$107.64
$33.03
$21.5354240
T
Penis study
0164
2.17
$107.64
$33.03
$21.5354250
T
Penis study
0165
3.89
$192.92
$91.76
$38.5854300
T
Revision of penis
0181
32.37
$1,605.43
$906.36
$321.0954304
T
Revision of penis
0181
32.37
$1,605.43
$906.36
$321.0954308
T
Reconstruction of urethra
0181
32.37
$1,605.43
$906.36
$321.0954312
T
Reconstruction of urethra
0181
32.37
$1,605.43
$906.36
$321.0954316
T
Reconstruction of urethra
0181
32.37
$1,605.43
$906.36
$321.0954318
T
Reconstruction of urethra
0181
32.37
$1,605.43
$906.36
$321.0954322
T
Reconstruction of urethra
0181
32.37
$1,605.43
$906.36
$321.0954324
T
Reconstruction of urethra
0181
32.37
$1,605.43
$906.36
$321.0954326
T
Reconstruction of urethra
0181
32.37
$1,605.43
$906.36
$321.0954328
T
Revise penis/urethra
0181
32.37
$1,605.43
$906.36
$321.0954332
C
Revise penis/urethra54336
C
Revise penis/urethra54340
T
Secondary urethral surgery
0181
32.37
$1,605.43
$906.36
$321.0954344
T
Secondary urethral surgery
0181
32.37
$1,605.43
$906.36
$321.0954348
T
Secondary urethral surgery
0181
32.37
$1,605.43
$906.36
$321.0954352
T
Reconstruct urethra/penis
0181
32.37
$1,605.43
$906.36
$321.0954360
T
Penis plastic surgery
0181
32.37
$1,605.43
$906.36
$321.0954380
T
Repair penis
0181
32.37
$1,605.43
$906.36
$321.0954385
T
Repair penis
0181
32.37
$1,605.43
$906.36
$321.0954390
C
Repair penis and bladder54400
T
Insert semi-rigid prosthesis
0182
52.11
$2,584.45
$1,525.05
$516.8954401
T
Insert self-contd prosthesis
0182
52.11
$2,584.45
$1,525.05
$516.8954402
T
Remove penis prosthesis
0185
32.37
$1,605.43
$906.36
$321.0954405
T
Insert multi-comp prosthesis
0182
52.11
$2,584.45
$1,525.05
$516.8954407
T
Remove multi-comp prosthesis
0185
32.37
$1,605.43
$906.36
$321.0954409
T
Revise penis prosthesis
0185
32.37
$1,605.43
$906.36
$321.0954420
T
Revision of penis
0181
32.37
$1,605.43
$906.36
$321.0954430
C
Revision of penis54435
T
Revision of penis
0181
32.37
$1,605.43
$906.36
$321.0954440
T
Repair of penis
0181
32.37
$1,605.43
$906.36
$321.0954450
T
Preputial stretching
0165
3.89
$192.92
$91.76
$38.5854500
T
Biopsy of testis
0005
5.41
$268.32
$119.75
$53.6654505
T
Biopsy of testis
0183
18.26
$905.62
$448.94
$181.1254510
T
Removal of testis lesion
0183
18.26
$905.62
$448.94
$181.12*54512
T
Excise lesion testis
0183
18.26
$905.62
$448.94
$181.1254520
T
Removal of testis
0183
18.26
$905.62
$448.94
$181.12*54522
T
Orchiectomy, partial
0183
18.26
$905.62
$448.94
$181.1254530
T
Removal of testis
0154
22.43
$1,112.45
$556.98
$222.4954535
C
Extensive testis surgery54550
T
Exploration for testis
0154
22.43
$1,112.45
$556.98
$222.4954560
C
Exploration for testis54600
T
Reduce testis torsion
0183
18.26
$905.62
$448.94
$181.1254620
T
Suspension of testis
0183
18.26
$905.62
$448.94
$181.1254640
T
Suspension of testis
0154
22.43
$1,112.45
$556.98
$222.4954650
C
Orchiopexy (Fowler-Stephens)54660
T
Revision of testis
0183
18.26
$905.62
$448.94
$181.1254670
T
Repair testis injury
0183
18.26
$905.62
$448.94
$181.1254680
T
Relocation of testis(es)
0183
18.26
$905.62
$448.94
$181.1254690
T
Laparoscopy, orchiectomy
0131
41.81
$2,073.61
$1,089.88
$414.7254692
T
Laparoscopy, orchiopexy
0132
48.91
$2,425.74
$1,239.22
$485.1554699
T
Laparoscope proc, testis
0130
25.36
$1,257.75
$659.53
$251.5554700
T
Drainage of scrotum
0183
18.26
$905.62
$448.94
$181.1254800
T
Biopsy of epididymis
0004
1.84
$91.26
$32.57
$18.25( print page 67895)54820
T
Exploration of epididymis
0183
18.26
$905.62
$448.94
$181.1254830
T
Remove epididymis lesion
0183
18.26
$905.62
$448.94
$181.1254840
T
Remove epididymis lesion
0183
18.26
$905.62
$448.94
$181.1254860
T
Removal of epididymis
0183
18.26
$905.62
$448.94
$181.1254861
T
Removal of epididymis
0183
18.26
$905.62
$448.94
$181.1254900
T
Fusion of spermatic ducts
0183
18.26
$905.62
$448.94
$181.1254901
T
Fusion of spermatic ducts
0183
18.26
$905.62
$448.94
$181.1255000
T
Drainage of hydrocele
0004
1.84
$91.26
$32.57
$18.2555040
T
Removal of hydrocele
0154
22.43
$1,112.45
$556.98
$222.4955041
T
Removal of hydroceles
0154
22.43
$1,112.45
$556.98
$222.4955060
T
Repair of hydrocele
0183
18.26
$905.62
$448.94
$181.1255100
T
Drainage of scrotum abscess
0008
6.15
$305.02
$113.67
$61.0055110
T
Explore scrotum
0183
18.26
$905.62
$448.94
$181.1255120
T
Removal of scrotum lesion
0183
18.26
$905.62
$448.94
$181.1255150
T
Removal of scrotum
0183
18.26
$905.62
$448.94
$181.1255175
T
Revision of scrotum
0183
18.26
$905.62
$448.94
$181.1255180
T
Revision of scrotum
0183
18.26
$905.62
$448.94
$181.1255200
T
Incision of sperm duct
0183
18.26
$905.62
$448.94
$181.1255250
T
Removal of sperm duct(s)
0183
18.26
$905.62
$448.94
$181.1255300
N
Prepare, sperm duct x-ray55400
T
Repair of sperm duct
0183
18.26
$905.62
$448.94
$181.1255450
T
Ligation of sperm duct
0183
18.26
$905.62
$448.94
$181.1255500
T
Removal of hydrocele
0183
18.26
$905.62
$448.94
$181.1255520
T
Removal of sperm cord lesion
0183
18.26
$905.62
$448.94
$181.1255530
T
Revise spermatic cord veins
0183
18.26
$905.62
$448.94
$181.1255535
T
Revise spermatic cord veins
0154
22.43
$1,112.45
$556.98
$222.4955540
T
Revise hernia & sperm veins
0154
22.43
$1,112.45
$556.98
$222.4955550
T
Laparo ligate spermatic vein
0131
41.81
$2,073.61
$1,089.88
$414.7255559
T
Laparo proc, spermatic cord
0130
25.36
$1,257.75
$659.53
$251.5555600
C
Incise sperm duct pouch55605
C
Incise sperm duct pouch55650
C
Remove sperm duct pouch55680
T
Remove sperm pouch lesion
0183
18.26
$905.62
$448.94
$181.1255700
T
Biopsy of prostate
0184
4.94
$245.01
$122.96
$49.0055705
T
Biopsy of prostate
0184
4.94
$245.01
$122.96
$49.0055720
T
Drainage of prostate abscess
0162
17.49
$867.44
$427.49
$173.4955725
T
Drainage of prostate abscess
0162
17.49
$867.44
$427.49
$173.4955801
C
Removal of prostate55810
C
Extensive prostate surgery55812
C
Extensive prostate surgery55815
C
Extensive prostate surgery55821
C
Removal of prostate55831
C
Removal of prostate55840
C
Extensive prostate surgery55842
C
Extensive prostate surgery55845
C
Extensive prostate surgery55859
T
Percut/needle insert, pros
0162
17.49
$867.44
$427.49
$173.4955860
T
Surgical exposure, prostate
0165
3.89
$192.92
$91.76
$38.5855862
C
Extensive prostate surgery55865
C
Extensive prostate surgery55870
T
Electroejaculation
0197
2.40
$119.03
$49.55
$23.81*55873
T
Cryoablate prostate
0980
38.67
$1,917.89

$383.5855899
T
Genital surgery procedure
0164
2.17
$107.64
$33.03
$21.5355970
E
Sex transformation, M to F55980
E
Sex transformation, F to M56405
T
I & D of vulva/perineum
0192
2.38
$118.04
$35.33
$23.6156420
T
Drainage of gland abscess
0192
2.38
$118.04
$35.33
$23.6156440
T
Surgery for vulva lesion
0194
16.21
$803.96
$395.94
$160.7956441
T
Lysis of labial lesion(s)
0193
8.93
$442.89
$171.13
$88.5856501
T
Destruction, vulva lesion(s)
0016
3.53
$175.07
$74.67
$35.0156515
T
Destruction, vulva lesion(s)
0017
12.45
$617.47
$289.16
$123.4956605
T
Biopsy of vulva/perineum
0019
4.00
$198.39
$78.91
$39.6856606
T
Biopsy of vulva/perineum
0019
4.00
$198.39
$78.91
$39.6856620
T
Partial removal of vulva
0195
18.68
$926.46
$483.80
$185.2956625
T
Complete removal of vulva
0195
18.68
$926.46
$483.80
$185.2956630
C
Extensive vulva surgery56631
C
Extensive vulva surgery56632
C
Extensive vulva surgery56633
C
Extensive vulva surgery56634
C
Extensive vulva surgery56637
C
Extensive vulva surgery56640
C
Extensive vulva surgery56700
T
Partial removal of hymen
0194
16.21
$803.96
$395.94
$160.7956720
T
Incision of hymen
0193
8.93
$442.89
$171.13
$88.58( print page 67896)56740
T
Remove vagina gland lesion
0194
16.21
$803.96
$395.94
$160.7956800
T
Repair of vagina
0194
16.21
$803.96
$395.94
$160.7956805
T
Repair clitoris
0194
16.21
$803.96
$395.94
$160.7956810
T
Repair of perineum
0194
16.21
$803.96
$395.94
$160.7957000
T
Exploration of vagina
0194
16.21
$803.96
$395.94
$160.7957010
T
Drainage of pelvic abscess
0194
16.21
$803.96
$395.94
$160.7957020
T
Drainage of pelvic fluid
0193
8.93
$442.89
$171.13
$88.58*57022
T
I & D vaginal hematoma, OB
0007
3.68
$182.51
$72.03
$36.50*57023
T
I & D vaginal hematoma, trauma
0007
3.68
$182.51
$72.03
$36.5057061
T
Destruction vagina lesion(s)
0194
16.21
$803.96
$395.94
$160.7957065
T
Destruction vagina lesion(s)
0194
16.21
$803.96
$395.94
$160.7957100
T
Biopsy of vagina
0192
2.38
$118.04
$35.33
$23.6157105
T
Biopsy of vagina
0194
16.21
$803.96
$395.94
$160.7957106
T
Remove vagina wall, partial
0194
16.21
$803.96
$395.94
$160.7957107
T
Remove vagina tissue, part
0194
16.21
$803.96
$395.94
$160.7957109
T
Vaginectomy partial w/nodes
0194
16.21
$803.96
$395.94
$160.7957110
C
Remove vagina wall, complete57111
C
Remove vagina tissue, compl57112
C
Vaginectomy w/nodes, compl57120
T
Closure of vagina
0194
16.21
$803.96
$395.94
$160.7957130
T
Remove vagina lesion
0194
16.21
$803.96
$395.94
$160.7957135
T
Remove vagina lesion
0194
16.21
$803.96
$395.94
$160.7957150
T
Treat vagina infection
0192
2.38
$118.04
$35.33
$23.6157160
T
Insert pessary/other device
0191
1.19
$59.02
$17.43
$11.8057170
T
Fitting of diaphragm/cap
0191
1.19
$59.02
$17.43
$11.8057180
T
Treat vaginal bleeding
0192
2.38
$118.04
$35.33
$23.6157200
T
Repair of vagina
0194
16.21
$803.96
$395.94
$160.7957210
T
Repair vagina/perineum
0194
16.21
$803.96
$395.94
$160.7957220
T
Revision of urethra
0195
18.68
$926.46
$483.80
$185.2957230
T
Repair of urethral lesion
0194
16.21
$803.96
$395.94
$160.7957240
T
Repair bladder & vagina
0195
18.68
$926.46
$483.80
$185.2957250
T
Repair rectum & vagina
0195
18.68
$926.46
$483.80
$185.2957260
T
Repair of vagina
0195
18.68
$926.46
$483.80
$185.2957265
T
Extensive repair of vagina
0195
18.68
$926.46
$483.80
$185.2957268
T
Repair of bowel bulge
0195
18.68
$926.46
$483.80
$185.2957270
C
Repair of bowel pouch57280
C
Suspension of vagina57282
C
Repair of vaginal prolapse57284
T
Repair paravaginal defect
0195
18.68
$926.46
$483.80
$185.29*57287
T
Revise/remove sling repair
0195
18.68
$926.46
$483.80
$185.2957288
T
Repair bladder defect
0195
18.68
$926.46
$483.80
$185.2957289
T
Repair bladder & vagina
0195
18.68
$926.46
$483.80
$185.2957291
T
Construction of vagina
0195
18.68
$926.46
$483.80
$185.2957292
C
Construct vagina with graft57300
T
Repair rectum-vagina fistula
0195
18.68
$926.46
$483.80
$185.2957305
C
Repair rectum-vagina fistula57307
C
Fistula repair & colostomy57308
C
Fistula repair, transperine57310
T
Repair urethrovaginal lesion
0195
18.68
$926.46
$483.80
$185.2957311
C
Repair urethrovaginal lesion57320
T
Repair bladder-vagina lesion
0195
18.68
$926.46
$483.80
$185.2957330
T
Repair bladder-vagina lesion
0195
18.68
$926.46
$483.80
$185.2957335
C
Repair vagina57400
T
Dilation of vagina
0194
16.21
$803.96
$395.94
$160.7957410
T
Pelvic examination
0194
16.21
$803.96
$395.94
$160.7957415
T
Remove vaginal foreign body
0194
16.21
$803.96
$395.94
$160.7957452
T
Examination of vagina
0191
1.19
$59.02
$17.43
$11.8057454
T
Vagina examination & biopsy
0192
2.38
$118.04
$35.33
$23.6157460
T
Cervix excision
0193
8.93
$442.89
$171.13
$88.5857500
T
Biopsy of cervix
0193
8.93
$442.89
$171.13
$88.5857505
T
Endocervical curettage
0192
2.38
$118.04
$35.33
$23.6157510
T
Cauterization of cervix
0193
8.93
$442.89
$171.13
$88.5857511
T
Cryocautery of cervix
0192
2.38
$118.04
$35.33
$23.6157513
T
Laser surgery of cervix
0193
8.93
$442.89
$171.13
$88.5857520
T
Conization of cervix
0194
16.21
$803.96
$395.94
$160.7957522
T
Conization of cervix
0195
18.68
$926.46
$483.80
$185.2957530
T
Removal of cervix
0195
18.68
$926.46
$483.80
$185.2957531
C
Removal of cervix, radical57540
C
Removal of residual cervix57545
C
Remove cervix/repair pelvis57550
T
Removal of residual cervix
0195
18.68
$926.46
$483.80
$185.2957555
T
Remove cervix/repair vagina
0195
18.68
$926.46
$483.80
$185.2957556
T
Remove cervix, repair bowel
0195
18.68
$926.46
$483.80
$185.2957700
T
Revision of cervix
0194
16.21
$803.96
$395.94
$160.79( print page 67897)57720
T
Revision of cervix
0194
16.21
$803.96
$395.94
$160.7957800
T
Dilation of cervical canal
0193
8.93
$442.89
$171.13
$88.5857820
T
D & c of residual cervix
0196
14.47
$717.66
$357.98
$143.5358100
T
Biopsy of uterus lining
0191
1.19
$59.02
$17.43
$11.8058120
T
Dilation and curettage
0196
14.47
$717.66
$357.98
$143.5358140
C
Removal of uterus lesion58145
T
Removal of uterus lesion
0195
18.68
$926.46
$483.80
$185.2958150
C
Total hysterectomy58152
C
Total hysterectomy58180
C
Partial hysterectomy58200
C
Extensive hysterectomy58210
C
Extensive hysterectomy58240
C
Removal of pelvis contents58260
C
Vaginal hysterectomy58262
C
Vaginal hysterectomy58263
C
Vaginal hysterectomy58267
C
Hysterectomy & vagina repair58270
C
Hysterectomy & vagina repair58275
C
Hysterectomy/revise vagina58280
C
Hysterectomy/revise vagina58285
C
Extensive hysterectomy58300
E
Insert intrauterine device58301
T
Remove intrauterine device
0191
1.19
$59.02
$17.43
$11.8058321
T
Artificial insemination
0197
2.40
$119.03
$49.55
$23.8158322
T
Artificial insemination
0197
2.40
$119.03
$49.55
$23.8158323
T
Sperm washing
0197
2.40
$119.03
$49.55
$23.8158340
N
Catheter for hysterography58345
T
Reopen fallopian tube
0194
16.21
$803.96
$395.94
$160.7958350
T
Reopen fallopian tube
0194
16.21
$803.96
$395.94
$160.79*58353
T
Endometr ablate, thermal
0193
8.93
$442.89
$171.13
$88.5858400
C
Suspension of uterus58410
C
Suspension of uterus58520
C
Repair of ruptured uterus58540
C
Revision of uterus58550
T
Laparo-asst vag hysterectomy
0132
48.91
$2,425.74
$1,239.22
$485.1558551
T
Laparoscopy, remove myoma
0131
41.81
$2,073.61
$1,089.88
$414.7258555
T
Hysteroscopy, dx, sep proc
0191
1.19
$59.02
$17.43
$11.8058558
T
Hysteroscopy, biopsy
0190
17.85
$885.29
$443.89
$177.0658559
T
Hysteroscopy, lysis
0190
17.85
$885.29
$443.89
$177.0658560
T
Hysteroscopy, resect septum
0190
17.85
$885.29
$443.89
$177.0658561
T
Hysteroscopy, remove myoma
0190
17.85
$885.29
$443.89
$177.0658562
T
Hysteroscopy, remove fb
0190
17.85
$885.29
$443.89
$177.0658563
T
Hysteroscopy, ablation
0190
17.85
$885.29
$443.89
$177.0658578
T
Laparo proc, uterus
0190
17.85
$885.29
$443.89
$177.0658579
T
Hysteroscope procedure
0190
17.85
$885.29
$443.89
$177.0658600
T
Division of fallopian tube
0194
16.21
$803.96
$395.94
$160.7958605
C
Division of fallopian tube58611
C
Ligate oviduct(s) add-on58615
T
Occlude fallopian tube(s)
0194
16.21
$803.96
$395.94
$160.7958660
T
Laparoscopy, lysis
0131
41.81
$2,073.61
$1,089.88
$414.7258661
T
Laparoscopy, remove adnexa
0131
41.81
$2,073.61
$1,089.88
$414.7258662
T
Laparoscopy, excise lesions
0131
41.81
$2,073.61
$1,089.88
$414.7258670
T
Laparoscopy, tubal cautery
0131
41.81
$2,073.61
$1,089.88
$414.7258671
T
Laparoscopy, tubal block
0131
41.81
$2,073.61
$1,089.88
$414.7258672
T
Laparoscopy, fimbrioplasty
0131
41.81
$2,073.61
$1,089.88
$414.7258673
T
Laparoscopy, salpingostomy
0131
41.81
$2,073.61
$1,089.88
$414.7258679
T
Laparo proc, oviduct-ovary
0130
25.36
$1,257.75
$659.53
$251.5558700
C
Removal of fallopian tube58720
C
Removal of ovary/tube(s)58740
C
Revise fallopian tube(s)58750
C
Repair oviduct58752
C
Revise ovarian tube(s)58760
C
Remove tubal obstruction58770
C
Create new tubal opening58800
T
Drainage of ovarian cyst(s)
0195
18.68
$926.46
$483.80
$185.2958805
C
Drainage of ovarian cyst(s)58820
T
Drain ovary abscess, open
0195
18.68
$926.46
$483.80
$185.2958822
C
Drain ovary abscess, percut58823
C
Drain pelvic abscess, percut58825
C
Transposition, ovary(s)58900
T
Biopsy of ovary(s)
0195
18.68
$926.46
$483.80
$185.2958920
T
Partial removal of ovary(s)
0195
18.68
$926.46
$483.80
$185.2958925
T
Removal of ovarian cyst(s)
0195
18.68
$926.46
$483.80
$185.2958940
C
Removal of ovary(s)( print page 67898)58943
C
Removal of ovary(s)58950
C
Resect ovarian malignancy58951
C
Resect ovarian malignancy58952
C
Resect ovarian malignancy58960
C
Exploration of abdomen58970
T
Retrieval of oocyte
0194
16.21
$803.96
$395.94
$160.7958974
T
Transfer of embryo
0197
2.40
$119.03
$49.55
$23.8158976
T
Transfer of embryo
0197
2.40
$119.03
$49.55
$23.8158999
T
Genital surgery procedure
0019
4.00
$198.39
$78.91
$39.6859000
T
Amniocentesis
0198
1.34
$66.46
$33.03
$13.2959012
T
Fetal cord puncture,prenatal
0198
1.34
$66.46
$33.03
$13.2959015
T
Chorion biopsy
0198
1.34
$66.46
$33.03
$13.2959020
T
Fetal contract stress test
0198
1.34
$66.46
$33.03
$13.2959025
T
Fetal non-stress test
0198
1.34
$66.46
$33.03
$13.2959030
T
Fetal scalp blood sample
0198
1.34
$66.46
$33.03
$13.2959050
T
Fetal monitor w/report
0198
1.34
$66.46
$33.03
$13.2959051
E
Fetal monitor/interpret only59100
C
Remove uterus lesion59120
C
Treat ectopic pregnancy59121
C
Treat ectopic pregnancy59130
C
Treat ectopic pregnancy59135
C
Treat ectopic pregnancy59136
C
Treat ectopic pregnancy59140
C
Treat ectopic pregnancy59150
T
Treat ectopic pregnancy
0131
41.81
$2,073.61
$1,089.88
$414.7259151
T
Treat ectopic pregnancy
0131
41.81
$2,073.61
$1,089.88
$414.7259160
T
D & c after delivery
0196
14.47
$717.66
$357.98
$143.5359200
T
Insert cervical dilator
0191
1.19
$59.02
$17.43
$11.8059300
T
Episiotomy or vaginal repair
0194
16.21
$803.96
$395.94
$160.7959320
T
Revision of cervix
0194
16.21
$803.96
$395.94
$160.7959325
C
Revision of cervix59350
C
Repair of uterus59400
E
Obstetrical care59409
T
Obstetrical care
0199
11.20
$555.48
$157.83
$111.1059410
E
Obstetrical care59412
T
Antepartum manipulation
0199
11.20
$555.48
$157.83
$111.1059414
T
Deliver placenta
0199
11.20
$555.48
$157.83
$111.1059425
E
Antepartum care only59426
E
Antepartum care only59430
E
Care after delivery59510
E
Cesarean delivery59514
C
Cesarean delivery only59515
E
Cesarean delivery59525
C
Remove uterus after cesarean59610
E
Vbac delivery59612
T
Vbac delivery only
0199
11.20
$555.48
$157.83
$111.1059614
E
Vbac care after delivery59618
E
Attempted vbac delivery59620
C
Attempted vbac delivery only59622
E
Attempted vbac after care59812
T
Treatment of miscarriage
0201
13.00
$644.75
$329.65
$128.9559820
T
Care of miscarriage
0201
13.00
$644.75
$329.65
$128.9559821
T
Treatment of miscarriage
0201
13.00
$644.75
$329.65
$128.9559830
C
Treat uterus infection59840
T
Abortion
0200
13.89
$688.89
$373.23
$137.7859841
T
Abortion
0200
13.89
$688.89
$373.23
$137.7859850
C
Abortion59851
C
Abortion59852
C
Abortion59855
C
Abortion59856
C
Abortion59857
C
Abortion59866
T
Abortion (mpr)
0198
1.34
$66.46
$33.03
$13.2959870
T
Evacuate mole of uterus
0201
13.00
$644.75
$329.65
$128.9559871
T
Remove cerclage suture
0194
16.21
$803.96
$395.94
$160.7959898
T
Laparo proc, ob care/deliver
0130
25.36
$1,257.75
$659.53
$251.5559899
T
Maternity care procedure
0198
1.34
$66.46
$33.03
$13.2960000
T
Drain thyroid/tongue cyst
0253
12.02
$596.14
$284.00
$119.2360001
T
Aspirate/inject thyriod cyst
0002
0.62
$30.75
$17.66
$6.1560100
T
Biopsy of thyroid
0004
1.84
$91.26
$32.57
$18.2560200
T
Remove thyroid lesion
0114
19.56
$970.10
$493.78
$194.0260210
T
Partial thyroid excision
0114
19.56
$970.10
$493.78
$194.0260212
T
Parital thyroid excision
0114
19.56
$970.10
$493.78
$194.0260220
T
Partial removal of thyroid
0114
19.56
$970.10
$493.78
$194.02( print page 67899)60225
T
Partial removal of thyroid
0114
19.56
$970.10
$493.78
$194.0260240
T
Removal of thyroid
0114
19.56
$970.10
$493.78
$194.0260252
T
Removal of thyroid
0256
25.40
$1,259.74
$623.05
$251.9560254
C
Extensive thyroid surgery60260
T
Repeat thyroid surgery
0256
25.40
$1,259.74
$623.05
$251.9560270
C
Removal of thyroid60271
C
Removal of thyroid60280
T
Remove thyroid duct lesion
0114
19.56
$970.10
$493.78
$194.0260281
T
Remove thyroid duct lesion
0114
19.56
$970.10
$493.78
$194.0260500
T
Explore parathyroid glands
0256
25.40
$1,259.74
$623.05
$251.9560502
C
Re-explore parathyroids60505
C
Explore parathyroid glands60512
T
Autotransplant parathyroid
0020
6.51
$322.87
$130.53
$64.5760520
C
Removal of thymus gland60521
C
Removal of thymus gland60522
C
Removal of thymus gland60540
C
Explore adrenal gland60545
C
Explore adrenal gland60600
C
Remove carotid body lesion60605
C
Remove carotid body lesion60650
C
Laparoscopy adrenalectomy60659
T
Laparo proc, endocrine
0130
25.36
$1,257.75
$659.53
$251.5560699
T
Endocrine surgery procedure
0004
1.84
$91.26
$32.57
$18.2561000
T
Remove cranial cavity fluid
0212
3.64
$180.53
$88.78
$36.1161001
T
Remove cranial cavity fluid
0212
3.64
$180.53
$88.78
$36.1161020
T
Remove brain cavity fluid
0212
3.64
$180.53
$88.78
$36.1161026
T
Injection into brain canal
0212
3.64
$180.53
$88.78
$36.1161050
T
Remove brain canal fluid
0212
3.64
$180.53
$88.78
$36.1161055
T
Injection into brain canal
0212
3.64
$180.53
$88.78
$36.1161070
T
Brain canal shunt procedure
0212
3.64
$180.53
$88.78
$36.1161105
C
Twist drill hole61107
C
Drill skull for implantation61108
C
Drill skull for drainage61120
C
Burr hole for puncture61140
C
Pierce skull for biopsy61150
C
Pierce skull for drainage61151
C
Pierce skull for drainage61154
C
Pierce skull & remove clot61156
C
Pierce skull for drainage61210
C
Pierce skull, implant device61215
T
Insert brain-fluid device
0224
17.89
$887.27
$453.41
$177.4561250
C
Pierce skull & explore61253
C
Pierce skull & explore61304
C
Open skull for exploration61305
C
Open skull for exploration61312
C
Open skull for drainage61313
C
Open skull for drainage61314
C
Open skull for drainage61315
C
Open skull for drainage61320
C
Open skull for drainage61321
C
Open skull for drainage61330
T
Decompress eye socket
0256
25.40
$1,259.74
$623.05
$251.9561332
C
Explore/biopsy eye socket61333
C
Explore orbit/remove lesion61334
C
Explore orbit/remove object61340
C
Relieve cranial pressure61343
C
Incise skull (press relief)61345
C
Relieve cranial pressure61440
C
Incise skull for surgery61450
C
Incise skull for surgery61458
C
Incise skull for brain wound61460
C
Incise skull for surgery61470
C
Incise skull for surgery61480
C
Incise skull for surgery61490
C
Incise skull for surgery61500
C
Removal of skull lesion61501
C
Remove infected skull bone61510
C
Removal of brain lesion61512
C
Remove brain lining lesion61514
C
Removal of brain abscess61516
C
Removal of brain lesion61518
C
Removal of brain lesion61519
C
Remove brain lining lesion61520
C
Removal of brain lesion( print page 67900)61521
C
Removal of brain lesion61522
C
Removal of brain abscess61524
C
Removal of brain lesion61526
C
Removal of brain lesion61530
C
Removal of brain lesion61531
C
Implant brain electrodes61533
C
Implant brain electrodes61534
C
Removal of brain lesion61535
C
Remove brain electrodes61536
C
Removal of brain lesion61538
C
Removal of brain tissue61539
C
Removal of brain tissue61541
C
Incision of brain tissue61542
C
Removal of brain tissue61543
C
Removal of brain tissue61544
C
Remove & treat brain lesion61545
C
Excision of brain tumor61546
C
Removal of pituitary gland61548
C
Removal of pituitary gland61550
C
Release of skull seams61552
C
Release of skull seams61556
C
Incise skull/sutures61557
C
Incise skull/sutures61558
C
Excision of skull/sutures61559
C
Excision of skull/sutures61563
C
Excision of skull tumor61564
C
Excision of skull tumor61570
C
Remove foreign body, brain61571
C
Incise skull for brain wound61575
C
Skull base/brainstem surgery61576
C
Skull base/brainstem surgery61580
C
Craniofacial approach, skull61581
C
Craniofacial approach, skull61582
C
Craniofacial approach, skull61583
C
Craniofacial approach, skull61584
C
Orbitocranial approach/skull61585
C
Orbitocranial approach/skull61586
C
Resect nasopharynx, skull61590
C
Infratemporal approach/skull61591
C
Infratemporal approach/skull61592
C
Orbitocranial approach/skull61595
C
Transtemporal approach/skull61596
C
Transcochlear approach/skull61597
C
Transcondylar approach/skull61598
C
Transpetrosal approach/skull61600
C
Resect/excise cranial lesion61601
C
Resect/excise cranial lesion61605
C
Resect/excise cranial lesion61606
C
Resect/excise cranial lesion61607
C
Resect/excise cranial lesion61608
C
Resect/excise cranial lesion61609
C
Transect artery, sinus61610
C
Transect artery, sinus61611
C
Transect artery, sinus61612
C
Transect artery, sinus61613
C
Remove aneurysm, sinus61615
C
Resect/excise lesion, skull61616
C
Resect/excise lesion, skull61618
C
Repair dura61619
C
Repair dura61624
C
Occlusion/embolization cath61626
C
Occlusion/embolization cath61680
C
Intracranial vessel surgery61682
C
Intracranial vessel surgery61684
C
Intracranial vessel surgery61686
C
Intracranial vessel surgery61690
C
Intracranial vessel surgery61692
C
Intracranial vessel surgery*61697
C
Brain aneurysm repair, complex*61698
C
Brain aneurysm repair, complex61700
C
Inner skull vessel surgery61702
C
Inner skull vessel surgery61703
C
Clamp neck artery61705
C
Revise circulation to head( print page 67901)61708
C
Revise circulation to head61710
C
Revise circulation to head61711
C
Fusion of skull arteries61720
C
Incise skull/brain surgery61735
C
Incise skull/brain surgery61750
C
Incise skull/brain biopsy61751
C
Brain biopsy w/ ct/mr guide61760
C
Implant brain electrodes61770
C
Incise skull for treatment61790
T
Treat trigeminal nerve
0220
13.96
$692.36
$326.21
$138.4761791
C
Treat trigeminal tract61793
E
Focus radiation beam61795
S
Brain surgery using computer
0302
8.21
$407.18
$216.55
$81.4461850
C
Implant neuroelectrodes61860
C
Implant neuroelectrodes61862
C
Implant neurostimul, subcort61870
C
Implant neuroelectrodes61875
C
Implant neuroelectrodes61880
T
Revise/remove neuroelectrode
0105
15.06
$746.92
$372.32
$149.3861885
T
Implant neurostim one array
0222
124.43
$6,171.23
$2,955.13
$1,234.2561886
T
Implant neurostim arrays
0222
124.43
$6,171.23
$2,955.13
$1,234.2561888
T
Revise/remove neuroreceiver
0105
15.06
$746.92
$372.32
$149.3862000
C
Treat skull fracture62005
C
Treat skull fracture62010
C
Treatment of head injury62100
C
Repair brain fluid leakage62115
C
Reduction of skull defect62116
C
Reduction of skull defect62117
C
Reduction of skull defect62120
C
Repair skull cavity lesion62121
C
Incise skull repair62140
C
Repair of skull defect62141
C
Repair of skull defect62142
C
Remove skull plate/flap62143
C
Replace skull plate/flap62145
C
Repair of skull & brain62146
C
Repair of skull with graft62147
C
Repair of skull with graft62180
C
Establish brain cavity shunt62190
C
Establish brain cavity shunt62192
C
Establish brain cavity shunt62194
T
Replace/irrigate catheter
0121
2.36
$117.05
$52.53
$23.4162200
C
Establish brain cavity shunt62201
C
Establish brain cavity shunt62220
C
Establish brain cavity shunt62223
C
Establish brain cavity shunt62225
T
Replace/irrigate catheter
0121
2.36
$117.05
$52.53
$23.4162230
T
Replace/revise brain shunt
0224
17.89
$887.27
$453.41
$177.45*62252
S
CSF shunt reprogram
0102
0.45
$22.32
$12.62
$4.4662256
C
Remove brain cavity shunt62258
C
Replace brain cavity shunt62263
T
Lysis epidural adhesions
0212
3.64
$180.53
$88.78
$36.1162268
T
Drain spinal cord cyst
0212
3.64
$180.53
$88.78
$36.1162269
T
Needle biopsy, spinal cord
0005
5.41
$268.32
$119.75
$53.6662270
T
Spinal fluid tap, diagnostic
0210
3.00
$148.79
$62.40
$29.7662272
T
Drain spinal fluid
0210
3.00
$148.79
$62.40
$29.7662273
T
Treat epidural spine lesion
0212
3.64
$180.53
$88.78
$36.1162280
T
Treat spinal cord lesion
0212
3.64
$180.53
$88.78
$36.1162281
T
Treat spinal cord lesion
0212
3.64
$180.53
$88.78
$36.1162282
T
Treat spinal canal lesion
0212
3.64
$180.53
$88.78
$36.1162284
N
Injection for myelogram62287
T
Percutaneous diskectomy
0220
13.96
$692.36
$326.21
$138.4762290
N
Inject for spine disk x-ray62291
N
Inject for spine disk x-ray62292
T
Injection into disk lesion
0212
3.64
$180.53
$88.78
$36.1162294
T
Injection into spinal artery
0212
3.64
$180.53
$88.78
$36.1162310
T
Inject spine c/t
0212
3.64
$180.53
$88.78
$36.1162311
T
Inject spine l/s (cd)
0212
3.64
$180.53
$88.78
$36.1162318
T
Inject spine w/cath, c/t
0212
3.64
$180.53
$88.78
$36.1162319
T
Inject spine w/cath l/s (cd)
0212
3.64
$180.53
$88.78
$36.1162350
T
Implant spinal canal cath
0223
7.05
$349.65
$154.27
$69.9362351
C
Implant spinal canal cath62355
T
Remove spinal canal catheter
0105
15.06
$746.92
$372.32
$149.3862360
T
Insert spine infusion device
0226
5.62
$278.73
$109.42
$55.75( print page 67902)62361
T
Implant spine infusion pump
0227
11.17
$553.99
$330.11
$110.8062362
T
Implant spine infusion pump
0227
11.17
$553.99
$330.11
$110.8062365
T
Remove spine infusion device
0105
15.06
$746.92
$372.32
$149.3862367
S
Analyze spine infusion pump
0102
0.45
$22.32
$12.62
$4.4662368
S
Analyze spine infusion pump
0102
0.45
$22.32
$12.62
$4.4663001
C
Removal of spinal lamina63003
C
Removal of spinal lamina63005
C
Removal of spinal lamina63011
C
Removal of spinal lamina63012
C
Removal of spinal lamina63015
C
Removal of spinal lamina63016
C
Removal of spinal lamina63017
C
Removal of spinal lamina63020
C
Neck spine disk surgery63030
C
Low back disk surgery63035
C
Spinal disk surgery add-on63040
C
Neck spine disk surgery63042
C
Low back disk surgery*63043
C
Laminotomy, addl cervical*63044
C
Laminotomy, addl lumbar63045
C
Removal of spinal lamina63046
C
Removal of spinal lamina63047
C
Removal of spinal lamina63048
C
Remove spinal lamina add-on63055
C
Decompress spinal cord63056
C
Decompress spinal cord63057
C
Decompress spine cord add-on63064
C
Decompress spinal cord63066
C
Decompress spine cord add-on63075
C
Neck spine disk surgery63076
C
Neck spine disk surgery63077
C
Spine disk surgery, thorax63078
C
Spine disk surgery, thorax63081
C
Removal of vertebral body63082
C
Remove vertebral body add-on63085
C
Removal of vertebral body63086
C
Remove vertebral body add-on63087
C
Removal of vertebral body63088
C
Remove vertebral body add-on63090
C
Removal of vertebral body63091
C
Remove vertebral body add-on63170
C
Incise spinal cord tract(s)63172
C
Drainage of spinal cyst63173
C
Drainage of spinal cyst63180
C
Revise spinal cord ligaments63182
C
Revise spinal cord ligaments63185
C
Incise spinal column/nerves63190
C
Incise spinal column/nerves63191
C
Incise spinal column/nerves63194
C
Incise spinal column & cord63195
C
Incise spinal column & cord63196
C
Incise spinal column & cord63197
C
Incise spinal column & cord63198
C
Incise spinal column & cord63199
C
Incise spinal column & cord63200
C
Release of spinal cord63250
C
Revise spinal cord vessels63251
C
Revise spinal cord vessels63252
C
Revise spinal cord vessels63265
C
Excise intraspinal lesion63266
C
Excise intraspinal lesion63267
C
Excise intraspinal lesion63268
C
Excise intraspinal lesion63270
C
Excise intraspinal lesion63271
C
Excise intraspinal lesion63272
C
Excise intraspinal lesion63273
C
Excise intraspinal lesion63275
C
Biopsy/excise spinal tumor63276
C
Biopsy/excise spinal tumor63277
C
Biopsy/excise spinal tumor63278
C
Biopsy/excise spinal tumor63280
C
Biopsy/excise spinal tumor63281
C
Biopsy/excise spinal tumor63282
C
Biopsy/excise spinal tumor( print page 67903)63283
C
Biopsy/excise spinal tumor63285
C
Biopsy/excise spinal tumor63286
C
Biopsy/excise spinal tumor63287
C
Biopsy/excise spinal tumor63290
C
Biopsy/excise spinal tumor63300
C
Removal of vertebral body63301
C
Removal of vertebral body63302
C
Removal of vertebral body63303
C
Removal of vertebral body63304
C
Removal of vertebral body63305
C
Removal of vertebral body63306
C
Removal of vertebral body63307
C
Removal of vertebral body63308
C
Remove vertebral body add-on63600
T
Remove spinal cord lesion
0220
13.96
$692.36
$326.21
$138.4763610
T
Stimulation of spinal cord
0220
13.96
$692.36
$326.21
$138.4763615
T
Remove lesion of spinal cord
0220
13.96
$692.36
$326.21
$138.4763650
T
Implant neuroelectrodes
0225
17.72
$878.84
$408.33
$175.7763655
C
Implant neuroelectrodes63660
T
Revise/remove neuroelectrode
0105
15.06
$746.92
$372.32
$149.3863685
T
Implant neuroreceiver
0222
124.43
$6,171.23
$2,955.13
$1,234.2563688
T
Revise/remove neuroreceiver
0105
15.06
$746.92
$372.32
$149.3863700
C
Repair of spinal herniation63702
C
Repair of spinal herniation63704
C
Repair of spinal herniation63706
C
Repair of spinal herniation63707
C
Repair spinal fluid leakage63709
C
Repair spinal fluid leakage63710
C
Graft repair of spine defect63740
C
Install spinal shunt63741
T
Install spinal shunt
0228
25.06
$1,242.88
$696.46
$248.5863744
T
Revision of spinal shunt
0228
25.06
$1,242.88
$696.46
$248.5863746
T
Removal of spinal shunt
0109
6.53
$323.86
$133.51
$64.7764400
T
Injection for nerve block
0211
3.32
$164.66
$74.78
$32.9364402
T
Injection for nerve block
0211
3.32
$164.66
$74.78
$32.9364405
T
Injection for nerve block
0211
3.32
$164.66
$74.78
$32.9364408
T
Injection for nerve block
0211
3.32
$164.66
$74.78
$32.9364410
T
Injection for nerve block
0211
3.32
$164.66
$74.78
$32.9364412
T
Injection for nerve block
0211
3.32
$164.66
$74.78
$32.9364413
T
Injection for nerve block
0211
3.32
$164.66
$74.78
$32.9364415
T
Injection for nerve block
0211
3.32
$164.66
$74.78
$32.9364417
T
Injection for nerve block
0211
3.32
$164.66
$74.78
$32.9364418
T
Injection for nerve block
0211
3.32
$164.66
$74.78
$32.9364420
T
Injection for nerve block
0211
3.32
$164.66
$74.78
$32.9364421
T
Injection for nerve block
0211
3.32
$164.66
$74.78
$32.9364425
T
Injection for nerve block
0211
3.32
$164.66
$74.78
$32.9364430
T
Injection for nerve block
0211
3.32
$164.66
$74.78
$32.9364435
T
Injection for nerve block
0211
3.32
$164.66
$74.78
$32.9364445
T
Injection for nerve block
0211
3.32
$164.66
$74.78
$32.9364450
T
Injection for nerve block
0211
3.32
$164.66
$74.78
$32.9364470
T
Inj paravertebral c/t
0211
3.32
$164.66
$74.78
$32.9364472
T
Inj paravertebral c/t add-on
0211
3.32
$164.66
$74.78
$32.9364475
T
Inj paravertebral l/s
0211
3.32
$164.66
$74.78
$32.9364476
T
Inj paravertebral l/s add-on
0211
3.32
$164.66
$74.78
$32.9364479
T
Inj foramen epidural c/t
0211
3.32
$164.66
$74.78
$32.9364480
T
Inj foramen epidural add-on
0211
3.32
$164.66
$74.78
$32.9364483
T
Inj foramen epidural l/s
0211
3.32
$164.66
$74.78
$32.9364484
T
Inj foramen epidural add-on
0211
3.32
$164.66
$74.78
$32.9364505
T
Injection for nerve block
0211
3.32
$164.66
$74.78
$32.9364508
T
Injection for nerve block
0211
3.32
$164.66
$74.78
$32.9364510
T
Injection for nerve block
0211
3.32
$164.66
$74.78
$32.9364520
T
Injection for nerve block
0211
3.32
$164.66
$74.78
$32.9364530
T
Injection for nerve block
0211
3.32
$164.66
$74.78
$32.9364550
A
Apply neurostimulator64553
T
Implant neuroelectrodes
0225
17.72
$878.84
$408.33
$175.7764555
T
Implant neuroelectrodes
0225
17.72
$878.84
$408.33
$175.7764560
T
Implant neuroelectrodes
0225
17.72
$878.84
$408.33
$175.7764565
T
Implant neuroelectrodes
0225
17.72
$878.84
$408.33
$175.7764573
T
Implant neuroelectrodes
0225
17.72
$878.84
$408.33
$175.7764575
T
Implant neuroelectrodes
0225
17.72
$878.84
$408.33
$175.7764577
T
Implant neuroelectrodes
0225
17.72
$878.84
$408.33
$175.7764580
T
Implant neuroelectrodes
0225
17.72
$878.84
$408.33
$175.7764585
T
Revise/remove neuroelectrode
0105
15.06
$746.92
$372.32
$149.3864590
T
Implant neuroreceiver
0222
124.43
$6,171.23
$2,955.13
$1,234.25( print page 67904)64595
T
Revise/remove neuroreceiver
0105
15.06
$746.92
$372.32
$149.3864600
T
Injection treatment of nerve
0211
3.32
$164.66
$74.78
$32.9364605
T
Injection treatment of nerve
0211
3.32
$164.66
$74.78
$32.9364610
T
Injection treatment of nerve
0211
3.32
$164.66
$74.78
$32.9364612
T
Destroy nerve, face muscle
0211
3.32
$164.66
$74.78
$32.9364613
T
Destroy nerve, spine muscle
0211
3.32
$164.66
$74.78
$32.93*64614
S
Desrtoy nerve, extrem musc
0971
1.55
$76.88

$15.3864620
T
Injection treatment of nerve
0211
3.32
$164.66
$74.78
$32.9364622
T
Destr paravertebrl nerve l/s
0211
3.32
$164.66
$74.78
$32.9364623
T
Destr paravertebral n add-on
0211
3.32
$164.66
$74.78
$32.9364626
T
Destr paravertebrl nerve c/t
0211
3.32
$164.66
$74.78
$32.9364627
T
Destr paravertebral n add-on
0211
3.32
$164.66
$74.78
$32.9364630
T
Injection treatment of nerve
0211
3.32
$164.66
$74.78
$32.9364640
T
Injection treatment of nerve
0211
3.32
$164.66
$74.78
$32.9364680
T
Injection treatment of nerve
0211
3.32
$164.66
$74.78
$32.9364702
T
Revise finger/toe nerve
0220
13.96
$692.36
$326.21
$138.4764704
T
Revise hand/foot nerve
0220
13.96
$692.36
$326.21
$138.4764708
T
Revise arm/leg nerve
0220
13.96
$692.36
$326.21
$138.4764712
T
Revision of sciatic nerve
0220
13.96
$692.36
$326.21
$138.4764713
T
Revision of arm nerve(s)
0220
13.96
$692.36
$326.21
$138.4764714
T
Revise low back nerve(s)
0220
13.96
$692.36
$326.21
$138.4764716
T
Revision of cranial nerve
0220
13.96
$692.36
$326.21
$138.4764718
T
Revise ulnar nerve at elbow
0220
13.96
$692.36
$326.21
$138.4764719
T
Revise ulnar nerve at wrist
0220
13.96
$692.36
$326.21
$138.4764721
T
Carpal tunnel surgery
0220
13.96
$692.36
$326.21
$138.4764722
T
Relieve pressure on nerve(s)
0220
13.96
$692.36
$326.21
$138.4764726
T
Release foot/toe nerve
0220
13.96
$692.36
$326.21
$138.4764727
T
Internal nerve revision
0220
13.96
$692.36
$326.21
$138.4764732
T
Incision of brow nerve
0220
13.96
$692.36
$326.21
$138.4764734
T
Incision of cheek nerve
0220
13.96
$692.36
$326.21
$138.4764736
T
Incision of chin nerve
0220
13.96
$692.36
$326.21
$138.4764738
T
Incision of jaw nerve
0220
13.96
$692.36
$326.21
$138.4764740
T
Incision of tongue nerve
0220
13.96
$692.36
$326.21
$138.4764742
T
Incision of facial nerve
0220
13.96
$692.36
$326.21
$138.4764744
T
Incise nerve, back of head
0220
13.96
$692.36
$326.21
$138.4764746
T
Incise diaphragm nerve
0220
13.96
$692.36
$326.21
$138.4764752
C
Incision of vagus nerve64755
C
Incision of stomach nerves64760
C
Incision of vagus nerve64761
T
Incision of pelvis nerve
0220
13.96
$692.36
$326.21
$138.4764763
C
Incise hip/thigh nerve64766
C
Incise hip/thigh nerve64771
T
Sever cranial nerve
0220
13.96
$692.36
$326.21
$138.4764772
T
Incision of spinal nerve
0220
13.96
$692.36
$326.21
$138.4764774
T
Remove skin nerve lesion
0220
13.96
$692.36
$326.21
$138.4764776
T
Remove digit nerve lesion
0220
13.96
$692.36
$326.21
$138.4764778
T
Digit nerve surgery add-on
0220
13.96
$692.36
$326.21
$138.4764782
T
Remove limb nerve lesion
0220
13.96
$692.36
$326.21
$138.4764783
T
Limb nerve surgery add-on
0220
13.96
$692.36
$326.21
$138.4764784
T
Remove nerve lesion
0220
13.96
$692.36
$326.21
$138.4764786
T
Remove sciatic nerve lesion
0221
18.36
$910.58
$463.62
$182.1264787
T
Implant nerve end
0220
13.96
$692.36
$326.21
$138.4764788
T
Remove skin nerve lesion
0220
13.96
$692.36
$326.21
$138.4764790
T
Removal of nerve lesion
0220
13.96
$692.36
$326.21
$138.4764792
T
Removal of nerve lesion
0221
18.36
$910.58
$463.62
$182.1264795
T
Biopsy of nerve
0220
13.96
$692.36
$326.21
$138.4764802
C
Remove sympathetic nerves64804
C
Remove sympathetic nerves64809
C
Remove sympathetic nerves64818
C
Remove sympathetic nerves64820
C
Remove sympathetic nerves64831
T
Repair of digit nerve
0221
18.36
$910.58
$463.62
$182.1264832
T
Repair nerve add-on
0221
18.36
$910.58
$463.62
$182.1264834
T
Repair of hand or foot nerve
0221
18.36
$910.58
$463.62
$182.1264835
T
Repair of hand or foot nerve
0221
18.36
$910.58
$463.62
$182.1264836
T
Repair of hand or foot nerve
0221
18.36
$910.58
$463.62
$182.1264837
T
Repair nerve add-on
0221
18.36
$910.58
$463.62
$182.1264840
T
Repair of leg nerve
0221
18.36
$910.58
$463.62
$182.1264856
T
Repair/transpose nerve
0221
18.36
$910.58
$463.62
$182.1264857
T
Repair arm/leg nerve
0221
18.36
$910.58
$463.62
$182.1264858
T
Repair sciatic nerve
0221
18.36
$910.58
$463.62
$182.1264859
T
Nerve surgery
0221
18.36
$910.58
$463.62
$182.1264861
T
Repair of arm nerves
0221
18.36
$910.58
$463.62
$182.1264862
T
Repair of low back nerves
0221
18.36
$910.58
$463.62
$182.12( print page 67905)64864
T
Repair of facial nerve
0221
18.36
$910.58
$463.62
$182.1264865
T
Repair of facial nerve
0221
18.36
$910.58
$463.62
$182.1264866
C
Fusion of facial/other nerve64868
C
Fusion of facial/other nerve64870
T
Fusion of facial/other nerve
0221
18.36
$910.58
$463.62
$182.1264872
T
Subsequent repair of nerve
0221
18.36
$910.58
$463.62
$182.1264874
T
Repair & revise nerve add-on
0221
18.36
$910.58
$463.62
$182.1264876
T
Repair nerve/shorten bone
0221
18.36
$910.58
$463.62
$182.1264885
T
Nerve graft, head or neck
0221
18.36
$910.58
$463.62
$182.1264886
T
Nerve graft, head or neck
0221
18.36
$910.58
$463.62
$182.1264890
T
Nerve graft, hand or foot
0221
18.36
$910.58
$463.62
$182.1264891
T
Nerve graft, hand or foot
0221
18.36
$910.58
$463.62
$182.1264892
T
Nerve graft, arm or leg
0221
18.36
$910.58
$463.62
$182.1264893
T
Nerve graft, arm or leg
0221
18.36
$910.58
$463.62
$182.1264895
T
Nerve graft, hand or foot
0221
18.36
$910.58
$463.62
$182.1264896
T
Nerve graft, hand or foot
0221
18.36
$910.58
$463.62
$182.1264897
T
Nerve graft, arm or leg
0221
18.36
$910.58
$463.62
$182.1264898
T
Nerve graft, arm or leg
0221
18.36
$910.58
$463.62
$182.1264901
T
Nerve graft add-on
0221
18.36
$910.58
$463.62
$182.1264902
T
Nerve graft add-on
0221
18.36
$910.58
$463.62
$182.1264905
T
Nerve pedicle transfer
0221
18.36
$910.58
$463.62
$182.1264907
T
Nerve pedicle transfer
0221
18.36
$910.58
$463.62
$182.1264999
T
Nervous system surgery
0211
3.32
$164.66
$74.78
$32.9365091
T
Revise eye
0242
23.70
$1,175.42
$597.36
$235.0865093
T
Revise eye with implant
0241
16.60
$823.30
$384.47
$164.6665101
T
Removal of eye
0242
23.70
$1,175.42
$597.36
$235.0865103
T
Remove eye/insert implant
0242
23.70
$1,175.42
$597.36
$235.0865105
T
Remove eye/attach implant
0242
23.70
$1,175.42
$597.36
$235.0865110
T
Removal of eye
0242
23.70
$1,175.42
$597.36
$235.0865112
T
Remove eye/revise socket
0242
23.70
$1,175.42
$597.36
$235.0865114
T
Remove eye/revise socket
0242
23.70
$1,175.42
$597.36
$235.0865125
T
Revise ocular implant
0240
13.47
$668.06
$315.31
$133.6165130
T
Insert ocular implant
0241
16.60
$823.30
$384.47
$164.6665135
T
Insert ocular implant
0241
16.60
$823.30
$384.47
$164.6665140
T
Attach ocular implant
0242
23.70
$1,175.42
$597.36
$235.0865150
T
Revise ocular implant
0241
16.60
$823.30
$384.47
$164.6665155
T
Reinsert ocular implant
0242
23.70
$1,175.42
$597.36
$235.0865175
T
Removal of ocular implant
0240
13.47
$668.06
$315.31
$133.6165205
S
Remove foreign body from eye
0231
2.64
$130.94
$59.87
$26.1965210
S
Remove foreign body from eye
0231
2.64
$130.94
$59.87
$26.1965220
S
Remove foreign body from eye
0231
2.64
$130.94
$59.87
$26.1965222
S
Remove foreign body from eye
0231
2.64
$130.94
$59.87
$26.1965235
T
Remove foreign body from eye
0232
6.04
$299.56
$134.66
$59.9165260
T
Remove foreign body from eye
0237
33.96
$1,684.28
$852.68
$336.8665265
T
Remove foreign body from eye
0237
33.96
$1,684.28
$852.68
$336.8665270
T
Repair of eye wound
0240
13.47
$668.06
$315.31
$133.6165272
T
Repair of eye wound
0232
6.04
$299.56
$134.66
$59.9165273
C
Repair of eye wound65275
T
Repair of eye wound
0233
13.79
$683.93
$331.60
$136.7965280
T
Repair of eye wound
0233
13.79
$683.93
$331.60
$136.7965285
T
Repair of eye wound
0234
20.64
$1,023.66
$502.16
$204.7365286
T
Repair of eye wound
0232
6.04
$299.56
$134.66
$59.9165290
T
Repair of eye socket wound
0243
17.99
$892.23
$431.39
$178.4565400
T
Removal of eye lesion
0232
6.04
$299.56
$134.66
$59.9165410
T
Biopsy of cornea
0233
13.79
$683.93
$331.60
$136.7965420
T
Removal of eye lesion
0233
13.79
$683.93
$331.60
$136.7965426
T
Removal of eye lesion
0233
13.79
$683.93
$331.60
$136.7965430
S
Corneal smear
0231
2.64
$130.94
$59.87
$26.1965435
T
Curette/treat cornea
0239
6.26
$310.47
$123.42
$62.0965436
T
Curette/treat cornea
0232
6.04
$299.56
$134.66
$59.9165450
T
Treatment of corneal lesion
0232
6.04
$299.56
$134.66
$59.9165600
T
Revision of cornea
0240
13.47
$668.06
$315.31
$133.6165710
T
Corneal transplant
0244
32.88
$1,630.72
$851.42
$326.1465730
T
Corneal transplant
0244
32.88
$1,630.72
$851.42
$326.1465750
T
Corneal transplant
0244
32.88
$1,630.72
$851.42
$326.1465755
T
Corneal transplant
0244
32.88
$1,630.72
$851.42
$326.1465760
E
Revision of cornea65765
E
Revision of cornea65767
E
Corneal tissue transplant65770
T
Revise cornea with implant
0244
32.88
$1,630.72
$851.42
$326.1465771
E
Radial keratotomy65772
T
Correction of astigmatism
0232
6.04
$299.56
$134.66
$59.9165775
T
Correction of astigmatism
0233
13.79
$683.93
$331.60
$136.7965800
T
Drainage of eye
0232
6.04
$299.56
$134.66
$59.91( print page 67906)65805
T
Drainage of eye
0233
13.79
$683.93
$331.60
$136.7965810
T
Drainage of eye
0233
13.79
$683.93
$331.60
$136.7965815
T
Drainage of eye
0233
13.79
$683.93
$331.60
$136.7965820
T
Relieve inner eye pressure
0232
6.04
$299.56
$134.66
$59.9165850
T
Incision of eye
0234
20.64
$1,023.66
$502.16
$204.7365855
T
Laser surgery of eye
0247
4.89
$242.52
$112.86
$48.5065860
T
Incise inner eye adhesions
0247
4.89
$242.52
$112.86
$48.5065865
T
Incise inner eye adhesions
0233
13.79
$683.93
$331.60
$136.7965870
T
Incise inner eye adhesions
0233
13.79
$683.93
$331.60
$136.7965875
T
Incise inner eye adhesions
0233
13.79
$683.93
$331.60
$136.7965880
T
Incise inner eye adhesions
0232
6.04
$299.56
$134.66
$59.9165900
T
Remove eye lesion
0232
6.04
$299.56
$134.66
$59.9165920
T
Remove implant from eye
0233
13.79
$683.93
$331.60
$136.7965930
T
Remove blood clot from eye
0233
13.79
$683.93
$331.60
$136.7966020
T
Injection treatment of eye
0232
6.04
$299.56
$134.66
$59.9166030
T
Injection treatment of eye
0232
6.04
$299.56
$134.66
$59.9166130
T
Remove eye lesion
0233
13.79
$683.93
$331.60
$136.7966150
T
Glaucoma surgery
0233
13.79
$683.93
$331.60
$136.7966155
T
Glaucoma surgery
0234
20.64
$1,023.66
$502.16
$204.7366160
T
Glaucoma surgery
0234
20.64
$1,023.66
$502.16
$204.7366165
T
Glaucoma surgery
0234
20.64
$1,023.66
$502.16
$204.7366170
T
Glaucoma surgery
0234
20.64
$1,023.66
$502.16
$204.7366172
T
Incision of eye
0234
20.64
$1,023.66
$502.16
$204.7366180
T
Implant eye shunt
0234
20.64
$1,023.66
$502.16
$204.7366185
T
Revise eye shunt
0234
20.64
$1,023.66
$502.16
$204.7366220
T
Repair eye lesion
0236
6.70
$332.29
$147.96
$66.4666225
T
Repair/graft eye lesion
0234
20.64
$1,023.66
$502.16
$204.7366250
T
Follow-up surgery of eye
0233
13.79
$683.93
$331.60
$136.7966500
T
Incision of iris
0232
6.04
$299.56
$134.66
$59.9166505
T
Incision of iris
0232
6.04
$299.56
$134.66
$59.9166600
T
Remove iris and lesion
0233
13.79
$683.93
$331.60
$136.7966605
T
Removal of iris
0233
13.79
$683.93
$331.60
$136.7966625
T
Removal of iris
0232
6.04
$299.56
$134.66
$59.9166630
T
Removal of iris
0233
13.79
$683.93
$331.60
$136.7966635
T
Removal of iris
0233
13.79
$683.93
$331.60
$136.7966680
T
Repair iris & ciliary body
0233
13.79
$683.93
$331.60
$136.7966682
T
Repair iris & ciliary body
0233
13.79
$683.93
$331.60
$136.7966700
T
Destruction, ciliary body
0232
6.04
$299.56
$134.66
$59.9166710
T
Destruction, ciliary body
0232
6.04
$299.56
$134.66
$59.9166720
T
Destruction, ciliary body
0232
6.04
$299.56
$134.66
$59.9166740
T
Destruction, ciliary body
0233
13.79
$683.93
$331.60
$136.7966761
T
Revision of iris
0247
4.89
$242.52
$112.86
$48.5066762
T
Revision of iris
0247
4.89
$242.52
$112.86
$48.5066770
T
Removal of inner eye lesion
0247
4.89
$242.52
$112.86
$48.5066820
T
Incision, secondary cataract
0232
6.04
$299.56
$134.66
$59.9166821
T
After cataract laser surgery
0247
4.89
$242.52
$112.86
$48.5066825
T
Reposition intraocular lens
0233
13.79
$683.93
$331.60
$136.7966830
T
Removal of lens lesion
0232
6.04
$299.56
$134.66
$59.9166840
T
Removal of lens material
0245
26.55
$1,316.77
$623.85
$263.3566850
T
Removal of lens material
0245
26.55
$1,316.77
$623.85
$263.3566852
T
Removal of lens material
0245
26.55
$1,316.77
$623.85
$263.3566920
T
Extraction of lens
0245
26.55
$1,316.77
$623.85
$263.3566930
T
Extraction of lens
0245
26.55
$1,316.77
$623.85
$263.3566940
T
Extraction of lens
0245
26.55
$1,316.77
$623.85
$263.35*66982
T
Cataract surgery, complex
0246
26.55
$1,316.77
$623.85
$263.3566983
T
Remove cataract/insert lens
0246
26.55
$1,316.77
$623.85
$263.3566984
T
Remove cataract/insert lens
0246
26.55
$1,316.77
$623.85
$263.3566985
T
Insert lens prosthesis
0246
26.55
$1,316.77
$623.85
$263.3566986
T
Exchange lens prosthesis
0246
26.55
$1,316.77
$623.85
$263.3566999
T
Eye surgery procedure
0247
4.89
$242.52
$112.86
$48.5067005
T
Partial removal of eye fluid
0237
33.96
$1,684.28
$852.68
$336.8667010
T
Partial removal of eye fluid
0237
33.96
$1,684.28
$852.68
$336.8667015
T
Release of eye fluid
0237
33.96
$1,684.28
$852.68
$336.8667025
T
Replace eye fluid
0237
33.96
$1,684.28
$852.68
$336.8667027
T
Implant eye drug system
0237
33.96
$1,684.28
$852.68
$336.8667028
T
Injection eye drug
0236
6.70
$332.29
$147.96
$66.4667030
T
Incise inner eye strands
0236
6.70
$332.29
$147.96
$66.4667031
T
Laser surgery, eye strands
0247
4.89
$242.52
$112.86
$48.5067036
T
Removal of inner eye fluid
0237
33.96
$1,684.28
$852.68
$336.8667038
T
Strip retinal membrane
0237
33.96
$1,684.28
$852.68
$336.8667039
T
Laser treatment of retina
0237
33.96
$1,684.28
$852.68
$336.8667040
T
Laser treatment of retina
0237
33.96
$1,684.28
$852.68
$336.8667101
T
Repair detached retina
0236
6.70
$332.29
$147.96
$66.4667105
T
Repair detached retina
0248
4.19
$207.81
$94.05
$41.56( print page 67907)67107
T
Repair detached retina
0237
33.96
$1,684.28
$852.68
$336.8667108
T
Repair detached retina
0237
33.96
$1,684.28
$852.68
$336.8667110
T
Repair detached retina
0236
6.70
$332.29
$147.96
$66.4667112
T
Rerepair detached retina
0237
33.96
$1,684.28
$852.68
$336.8667115
T
Release encircling material
0236
6.70
$332.29
$147.96
$66.4667120
T
Remove eye implant material
0236
6.70
$332.29
$147.96
$66.4667121
T
Remove eye implant material
0237
33.96
$1,684.28
$852.68
$336.8667141
T
Treatment of retina
0235
2.94
$145.81
$78.91
$29.1667145
T
Treatment of retina
0248
4.19
$207.81
$94.05
$41.5667208
T
Treatment of retinal lesion
0235
2.94
$145.81
$78.91
$29.1667210
T
Treatment of retinal lesion
0248
4.19
$207.81
$94.05
$41.5667218
T
Treatment of retinal lesion
0237
33.96
$1,684.28
$852.68
$336.8667220
T
Treatment of choroid lesion
0237
33.96
$1,684.28
$852.68
$336.86*67221
T
Treatment of choroid lesion
0235
2.94
$145.81
$78.91
$29.1667227
T
Treatment of retinal lesion
0235
2.94
$145.81
$78.91
$29.1667228
T
Treatment of retinal lesion
0248
4.19
$207.81
$94.05
$41.5667250
T
Reinforce eye wall
0240
13.47
$668.06
$315.31
$133.6167255
T
Reinforce/graft eye wall
0237
33.96
$1,684.28
$852.68
$336.8667299
T
Eye surgery procedure
0248
4.19
$207.81
$94.05
$41.5667311
T
Revise eye muscle
0243
17.99
$892.23
$431.39
$178.4567312
T
Revise two eye muscles
0243
17.99
$892.23
$431.39
$178.4567314
T
Revise eye muscle
0243
17.99
$892.23
$431.39
$178.4567316
T
Revise two eye muscles
0243
17.99
$892.23
$431.39
$178.4567318
T
Revise eye muscle(s)
0243
17.99
$892.23
$431.39
$178.4567320
T
Revise eye muscle(s) add-on
0243
17.99
$892.23
$431.39
$178.4567331
T
Eye surgery follow-up add-on
0243
17.99
$892.23
$431.39
$178.4567332
T
Rerevise eye muscles add-on
0243
17.99
$892.23
$431.39
$178.4567334
T
Revise eye muscle w/suture
0243
17.99
$892.23
$431.39
$178.4567335
T
Eye suture during surgery
0243
17.99
$892.23
$431.39
$178.4567340
T
Revise eye muscle add-on
0243
17.99
$892.23
$431.39
$178.4567343
T
Release eye tissue
0243
17.99
$892.23
$431.39
$178.4567345
T
Destroy nerve of eye muscle
0238
2.80
$138.87
$58.96
$27.7767350
S
Biopsy eye muscle
0231
2.64
$130.94
$59.87
$26.1967399
T
Eye muscle surgery procedure
0243
17.99
$892.23
$431.39
$178.4567400
T
Explore/biopsy eye socket
0241
16.60
$823.30
$384.47
$164.6667405
T
Explore/drain eye socket
0241
16.60
$823.30
$384.47
$164.6667412
T
Explore/treat eye socket
0241
16.60
$823.30
$384.47
$164.6667413
T
Explore/treat eye socket
0241
16.60
$823.30
$384.47
$164.6667414
T
Explr/decompress eye socket
0242
23.70
$1,175.42
$597.36
$235.0867415
T
Aspiration, orbital contents
0239
6.26
$310.47
$123.42
$62.0967420
T
Explore/treat eye socket
0242
23.70
$1,175.42
$597.36
$235.0867430
T
Explore/treat eye socket
0242
23.70
$1,175.42
$597.36
$235.0867440
T
Explore/drain eye socket
0242
23.70
$1,175.42
$597.36
$235.0867445
T
Explr/decompress eye socket
0242
23.70
$1,175.42
$597.36
$235.0867450
T
Explore/biopsy eye socket
0242
23.70
$1,175.42
$597.36
$235.0867500
S
Inject/treat eye socket
0231
2.64
$130.94
$59.87
$26.1967505
T
Inject/treat eye socket
0238
2.80
$138.87
$58.96
$27.7767515
T
Inject/treat eye socket
0239
6.26
$310.47
$123.42
$62.0967550
T
Insert eye socket implant
0242
23.70
$1,175.42
$597.36
$235.0867560
T
Revise eye socket implant
0241
16.60
$823.30
$384.47
$164.6667570
T
Decompress optic nerve
0242
23.70
$1,175.42
$597.36
$235.0867599
T
Orbit surgery procedure
0239
6.26
$310.47
$123.42
$62.0967700
T
Drainage of eyelid abscess
0238
2.80
$138.87
$58.96
$27.7767710
T
Incision of eyelid
0239
6.26
$310.47
$123.42
$62.0967715
T
Incision of eyelid fold
0240
13.47
$668.06
$315.31
$133.6167800
T
Remove eyelid lesion
0238
2.80
$138.87
$58.96
$27.7767801
T
Remove eyelid lesions
0239
6.26
$310.47
$123.42
$62.0967805
T
Remove eyelid lesions
0238
2.80
$138.87
$58.96
$27.7767808
T
Remove eyelid lesion(s)
0240
13.47
$668.06
$315.31
$133.6167810
T
Biopsy of eyelid
0238
2.80
$138.87
$58.96
$27.7767820
T
Revise eyelashes
0238
2.80
$138.87
$58.96
$27.7767825
T
Revise eyelashes
0238
2.80
$138.87
$58.96
$27.7767830
T
Revise eyelashes
0239
6.26
$310.47
$123.42
$62.0967835
T
Revise eyelashes
0240
13.47
$668.06
$315.31
$133.6167840
T
Remove eyelid lesion
0239
6.26
$310.47
$123.42
$62.0967850
T
Treat eyelid lesion
0239
6.26
$310.47
$123.42
$62.0967875
T
Closure of eyelid by suture
0239
6.26
$310.47
$123.42
$62.0967880
T
Revision of eyelid
0232
6.04
$299.56
$134.66
$59.9167882
T
Revision of eyelid
0240
13.47
$668.06
$315.31
$133.6167900
T
Repair brow defect
0240
13.47
$668.06
$315.31
$133.6167901
T
Repair eyelid defect
0240
13.47
$668.06
$315.31
$133.6167902
T
Repair eyelid defect
0240
13.47
$668.06
$315.31
$133.6167903
T
Repair eyelid defect
0240
13.47
$668.06
$315.31
$133.6167904
T
Repair eyelid defect
0240
13.47
$668.06
$315.31
$133.61( print page 67908)67906
T
Repair eyelid defect
0240
13.47
$668.06
$315.31
$133.6167908
T
Repair eyelid defect
0240
13.47
$668.06
$315.31
$133.6167909
T
Revise eyelid defect
0240
13.47
$668.06
$315.31
$133.6167911
T
Revise eyelid defect
0240
13.47
$668.06
$315.31
$133.6167914
T
Repair eyelid defect
0240
13.47
$668.06
$315.31
$133.6167915
T
Repair eyelid defect
0239
6.26
$310.47
$123.42
$62.0967916
T
Repair eyelid defect
0240
13.47
$668.06
$315.31
$133.6167917
T
Repair eyelid defect
0240
13.47
$668.06
$315.31
$133.6167921
T
Repair eyelid defect
0240
13.47
$668.06
$315.31
$133.6167922
T
Repair eyelid defect
0239
6.26
$310.47
$123.42
$62.0967923
T
Repair eyelid defect
0240
13.47
$668.06
$315.31
$133.6167924
T
Repair eyelid defect
0240
13.47
$668.06
$315.31
$133.6167930
T
Repair eyelid wound
0240
13.47
$668.06
$315.31
$133.6167935
T
Repair eyelid wound
0240
13.47
$668.06
$315.31
$133.6167938
T
Remove eyelid foreign body
0238
2.80
$138.87
$58.96
$27.7767950
T
Revision of eyelid
0240
13.47
$668.06
$315.31
$133.6167961
T
Revision of eyelid
0240
13.47
$668.06
$315.31
$133.6167966
T
Revision of eyelid
0240
13.47
$668.06
$315.31
$133.6167971
T
Reconstruction of eyelid
0241
16.60
$823.30
$384.47
$164.6667973
T
Reconstruction of eyelid
0241
16.60
$823.30
$384.47
$164.6667974
T
Reconstruction of eyelid
0241
16.60
$823.30
$384.47
$164.6667975
T
Reconstruction of eyelid
0240
13.47
$668.06
$315.31
$133.6167999
T
Revision of eyelid
0240
13.47
$668.06
$315.31
$133.6168020
T
Incise/drain eyelid lining
0240
13.47
$668.06
$315.31
$133.6168040
T
Treatment of eyelid lesions
0239
6.26
$310.47
$123.42
$62.0968100
T
Biopsy of eyelid lining
0232
6.04
$299.56
$134.66
$59.9168110
S
Remove eyelid lining lesion
0231
2.64
$130.94
$59.87
$26.1968115
T
Remove eyelid lining lesion
0239
6.26
$310.47
$123.42
$62.0968130
T
Remove eyelid lining lesion
0233
13.79
$683.93
$331.60
$136.7968135
T
Remove eyelid lining lesion
0239
6.26
$310.47
$123.42
$62.0968200
S
Treat eyelid by injection
0230
0.98
$48.61
$22.48
$9.7268320
T
Revise/graft eyelid lining
0240
13.47
$668.06
$315.31
$133.6168325
T
Revise/graft eyelid lining
0242
23.70
$1,175.42
$597.36
$235.0868326
T
Revise/graft eyelid lining
0241
16.60
$823.30
$384.47
$164.6668328
T
Revise/graft eyelid lining
0241
16.60
$823.30
$384.47
$164.6668330
T
Revise eyelid lining
0233
13.79
$683.93
$331.60
$136.7968335
T
Revise/graft eyelid lining
0241
16.60
$823.30
$384.47
$164.6668340
T
Separate eyelid adhesions
0240
13.47
$668.06
$315.31
$133.6168360
T
Revise eyelid lining
0234
20.64
$1,023.66
$502.16
$204.7368362
T
Revise eyelid lining
0234
20.64
$1,023.66
$502.16
$204.7368399
T
Eyelid lining surgery
0239
6.26
$310.47
$123.42
$62.0968400
T
Incise/drain tear gland
0238
2.80
$138.87
$58.96
$27.7768420
T
Incise/drain tear sac
0240
13.47
$668.06
$315.31
$133.6168440
T
Incise tear duct opening
0238
2.80
$138.87
$58.96
$27.7768500
T
Removal of tear gland
0241
16.60
$823.30
$384.47
$164.6668505
T
Partial removal, tear gland
0241
16.60
$823.30
$384.47
$164.6668510
T
Biopsy of tear gland
0240
13.47
$668.06
$315.31
$133.6168520
T
Removal of tear sac
0241
16.60
$823.30
$384.47
$164.6668525
T
Biopsy of tear sac
0240
13.47
$668.06
$315.31
$133.6168530
T
Clearance of tear duct
0240
13.47
$668.06
$315.31
$133.6168540
T
Remove tear gland lesion
0241
16.60
$823.30
$384.47
$164.6668550
T
Remove tear gland lesion
0242
23.70
$1,175.42
$597.36
$235.0868700
T
Repair tear ducts
0241
16.60
$823.30
$384.47
$164.6668705
T
Revise tear duct opening
0238
2.80
$138.87
$58.96
$27.7768720
T
Create tear sac drain
0242
23.70
$1,175.42
$597.36
$235.0868745
T
Create tear duct drain
0241
16.60
$823.30
$384.47
$164.6668750
T
Create tear duct drain
0242
23.70
$1,175.42
$597.36
$235.0868760
T
Close tear duct opening
0238
2.80
$138.87
$58.96
$27.7768761
S
Close tear duct opening
0231
2.64
$130.94
$59.87
$26.1968770
T
Close tear system fistula
0240
13.47
$668.06
$315.31
$133.6168801
S
Dilate tear duct opening
0231
2.64
$130.94
$59.87
$26.1968810
S
Probe nasolacrimal duct
0231
2.64
$130.94
$59.87
$26.1968811
T
Probe nasolacrimal duct
0240
13.47
$668.06
$315.31
$133.6168815
T
Probe nasolacrimal duct
0240
13.47
$668.06
$315.31
$133.6168840
S
Explore/irrigate tear ducts
0231
2.64
$130.94
$59.87
$26.1968850
N
Injection for tear sac x-ray68899
S
Tear duct system surgery
0231
2.64
$130.94
$59.87
$26.1969000
T
Drain external ear lesion
0006
2.00
$99.19
$33.95
$19.8469005
T
Drain external ear lesion
0007
3.68
$182.51
$72.03
$36.5069020
T
Drain outer ear canal lesion
0006
2.00
$99.19
$33.95
$19.8469090
E
Pierce earlobes69100
T
Biopsy of external ear
0019
4.00
$198.39
$78.91
$39.6869105
T
Biopsy of external ear canal
0253
12.02
$596.14
$284.00
$119.2369110
T
Remove external ear, partial
0020
6.51
$322.87
$130.53
$64.57( print page 67909)69120
T
Removal of external ear
0253
12.02
$596.14
$284.00
$119.2369140
T
Remove ear canal lesion(s)
0254
12.45
$617.47
$272.41
$123.4969145
T
Remove ear canal lesion(s)
0020
6.51
$322.87
$130.53
$64.5769150
C
Extensive ear canal surgery69155
C
Extensive ear/neck surgery69200
X
Clear outer ear canal
0340
1.04
$51.58
$12.85
$10.3269205
T
Clear outer ear canal
0022
12.49
$619.45
$292.94
$123.8969210
X
Remove impacted ear wax
0340
1.04
$51.58
$12.85
$10.3269220
T
Clean out mastoid cavity
0012
0.53
$26.29
$9.18
$5.2669222
T
Clean out mastoid cavity
0253
12.02
$596.14
$284.00
$119.2369300
T
Revise external ear
0254
12.45
$617.47
$272.41
$123.4969310
T
Rebuild outer ear canal
0256
25.40
$1,259.74
$623.05
$251.9569320
T
Rebuild outer ear canal
0256
25.40
$1,259.74
$623.05
$251.9569399
T
Outer ear surgery procedure
0252
5.18
$256.90
$114.24
$51.3869400
T
Inflate middle ear canal
0251
1.68
$83.32
$27.99
$16.6669401
N
Inflate middle ear canal69405
T
Catheterize middle ear canal
0252
5.18
$256.90
$114.24
$51.3869410
T
Inset middle ear (baffle)
0252
5.18
$256.90
$114.24
$51.3869420
T
Incision of eardrum
0252
5.18
$256.90
$114.24
$51.3869421
T
Incision of eardrum
0253
12.02
$596.14
$284.00
$119.2369424
T
Remove ventilating tube
0252
5.18
$256.90
$114.24
$51.3869433
T
Create eardrum opening
0252
5.18
$256.90
$114.24
$51.3869436
T
Create eardrum opening
0253
12.02
$596.14
$284.00
$119.2369440
T
Exploration of middle ear
0253
12.02
$596.14
$284.00
$119.2369450
T
Eardrum revision
0256
25.40
$1,259.74
$623.05
$251.9569501
T
Mastoidectomy
0256
25.40
$1,259.74
$623.05
$251.9569502
C
Mastoidectomy69505
T
Remove mastoid structures
0256
25.40
$1,259.74
$623.05
$251.9569511
T
Extensive mastoid surgery
0256
25.40
$1,259.74
$623.05
$251.9569530
T
Extensive mastoid surgery
0256
25.40
$1,259.74
$623.05
$251.9569535
C
Remove part of temporal bone69540
T
Remove ear lesion
0253
12.02
$596.14
$284.00
$119.2369550
T
Remove ear lesion
0256
25.40
$1,259.74
$623.05
$251.9569552
T
Remove ear lesion
0256
25.40
$1,259.74
$623.05
$251.9569554
C
Remove ear lesion69601
T
Mastoid surgery revision
0256
25.40
$1,259.74
$623.05
$251.9569602
T
Mastoid surgery revision
0256
25.40
$1,259.74
$623.05
$251.9569603
T
Mastoid surgery revision
0256
25.40
$1,259.74
$623.05
$251.9569604
T
Mastoid surgery revision
0256
25.40
$1,259.74
$623.05
$251.9569605
T
Mastoid surgery revision
0256
25.40
$1,259.74
$623.05
$251.9569610
T
Repair of eardrum
0253
12.02
$596.14
$284.00
$119.2369620
T
Repair of eardrum
0253
12.02
$596.14
$284.00
$119.2369631
T
Repair eardrum structures
0256
25.40
$1,259.74
$623.05
$251.9569632
T
Rebuild eardrum structures
0256
25.40
$1,259.74
$623.05
$251.9569633
T
Rebuild eardrum structures
0256
25.40
$1,259.74
$623.05
$251.9569635
T
Repair eardrum structures
0256
25.40
$1,259.74
$623.05
$251.9569636
T
Rebuild eardrum structures
0256
25.40
$1,259.74
$623.05
$251.9569637
T
Rebuild eardrum structures
0256
25.40
$1,259.74
$623.05
$251.9569641
T
Revise middle ear & mastoid
0256
25.40
$1,259.74
$623.05
$251.9569642
T
Revise middle ear & mastoid
0256
25.40
$1,259.74
$623.05
$251.9569643
T
Revise middle ear & mastoid
0256
25.40
$1,259.74
$623.05
$251.9569644
T
Revise middle ear & mastoid
0256
25.40
$1,259.74
$623.05
$251.9569645
T
Revise middle ear & mastoid
0256
25.40
$1,259.74
$623.05
$251.9569646
T
Revise middle ear & mastoid
0256
25.40
$1,259.74
$623.05
$251.9569650
T
Release middle ear bone
0254
12.45
$617.47
$272.41
$123.4969660
T
Revise middle ear bone
0256
25.40
$1,259.74
$623.05
$251.9569661
T
Revise middle ear bone
0256
25.40
$1,259.74
$623.05
$251.9569662
T
Revise middle ear bone
0256
25.40
$1,259.74
$623.05
$251.9569666
T
Repair middle ear structures
0256
25.40
$1,259.74
$623.05
$251.9569667
T
Repair middle ear structures
0256
25.40
$1,259.74
$623.05
$251.9569670
T
Remove mastoid air cells
0256
25.40
$1,259.74
$623.05
$251.9569676
T
Remove middle ear nerve
0256
25.40
$1,259.74
$623.05
$251.9569700
T
Close mastoid fistula
0256
25.40
$1,259.74
$623.05
$251.9569710
E
Implant/replace hearing aid69711
T
Remove/repair hearing aid
0256
25.40
$1,259.74
$623.05
$251.95*69714
T
Implant temple bone w/stimul
0256
25.40
$1,259.74
$623.05
$251.95*69715
T
Temple bne implnt w/stimulat
0256
25.40
$1,259.74
$623.05
$251.95*69717
T
Temple bone implant revision
0256
25.40
$1,259.74
$623.05
$251.95*69718
T
Revise temple bone implant
0256
25.40
$1,259.74
$623.05
$251.9569720
T
Release facial nerve
0256
25.40
$1,259.74
$623.05
$251.9569725
T
Release facial nerve
0256
25.40
$1,259.74
$623.05
$251.9569740
T
Repair facial nerve
0256
25.40
$1,259.74
$623.05
$251.9569745
T
Repair facial nerve
0256
25.40
$1,259.74
$623.05
$251.9569799
T
Middle ear surgery procedure
0253
12.02
$596.14
$284.00
$119.23( print page 67910)69801
T
Incise inner ear
0256
25.40
$1,259.74
$623.05
$251.9569802
T
Incise inner ear
0256
25.40
$1,259.74
$623.05
$251.9569805
T
Explore inner ear
0256
25.40
$1,259.74
$623.05
$251.9569806
T
Explore inner ear
0256
25.40
$1,259.74
$623.05
$251.9569820
T
Establish inner ear window
0256
25.40
$1,259.74
$623.05
$251.9569840
T
Revise inner ear window
0256
25.40
$1,259.74
$623.05
$251.9569905
T
Remove inner ear
0256
25.40
$1,259.74
$623.05
$251.9569910
T
Remove inner ear & mastoid
0256
25.40
$1,259.74
$623.05
$251.9569915
T
Incise inner ear nerve
0256
25.40
$1,259.74
$623.05
$251.9569930
T
Implant cochlear device
0256
25.40
$1,259.74
$623.05
$251.9569949
T
Inner ear surgery procedure
0253
12.02
$596.14
$284.00
$119.2369950
C
Incise inner ear nerve69955
T
Release facial nerve
0256
25.40
$1,259.74
$623.05
$251.9569960
T
Release inner ear canal
0256
25.40
$1,259.74
$623.05
$251.9569970
C
Remove inner ear lesion69979
T
Temporal bone surgery
0252
5.18
$256.90
$114.24
$51.3869990
N
Microsurgery add-on70010
S
Contrast x-ray of brain
0274
4.83
$239.55
$128.12
$47.9170015
S
Contrast x-ray of brain
0274
4.83
$239.55
$128.12
$47.9170030
X
X-ray eye for foreign body
0260
0.79
$39.18
$22.02
$7.8470100
X
X-ray exam of jaw
0260
0.79
$39.18
$22.02
$7.8470110
X
X-ray exam of jaw
0260
0.79
$39.18
$22.02
$7.8470120
X
X-ray exam of mastoids
0260
0.79
$39.18
$22.02
$7.8470130
X
X-ray exam of mastoids
0260
0.79
$39.18
$22.02
$7.8470134
X
X-ray exam of middle ear
0261
1.38
$68.44
$38.77
$13.6970140
X
X-ray exam of facial bones
0260
0.79
$39.18
$22.02
$7.8470150
X
X-ray exam of facial bones
0260
0.79
$39.18
$22.02
$7.8470160
X
X-ray exam of nasal bones
0260
0.79
$39.18
$22.02
$7.8470170
X
X-ray exam of tear duct
0263
1.68
$83.32
$45.88
$16.6670190
X
X-ray exam of eye sockets
0260
0.79
$39.18
$22.02
$7.8470200
X
X-ray exam of eye sockets
0260
0.79
$39.18
$22.02
$7.8470210
X
X-ray exam of sinuses
0260
0.79
$39.18
$22.02
$7.8470220
X
X-ray exam of sinuses
0260
0.79
$39.18
$22.02
$7.8470240
X
X-ray exam, pituitary saddle
0260
0.79
$39.18
$22.02
$7.8470250
X
X-ray exam of skull
0260
0.79
$39.18
$22.02
$7.8470260
X
X-ray exam of skull
0261
1.38
$68.44
$38.77
$13.6970300
X
X-ray exam of teeth
0262
0.40
$19.83
$10.90
$3.9770310
X
X-ray exam of teeth
0262
0.40
$19.83
$10.90
$3.9770320
X
Full mouth x-ray of teeth
0262
0.40
$19.83
$10.90
$3.9770328
X
X-ray exam of jaw joint
0260
0.79
$39.18
$22.02
$7.8470330
X
X-ray exam of jaw joints
0260
0.79
$39.18
$22.02
$7.8470332
S
X-ray exam of jaw joint
0275
2.74
$135.89
$72.26
$27.1870336
S
Magnetic image, jaw joint
0284
8.02
$397.76
$257.39
$79.5570350
X
X-ray head for orthodontia
0260
0.79
$39.18
$22.02
$7.8470355
X
Panoramic x-ray of jaws
0260
0.79
$39.18
$22.02
$7.8470360
X
X-ray exam of neck
0260
0.79
$39.18
$22.02
$7.8470370
X
Throat x-ray & fluoroscopy
0273
2.49
$123.49
$61.02
$24.7070371
X
Speech evaluation, complex
0272
1.40
$69.43
$39.00
$13.8970373
X
Contrast x-ray of larynx
0263
1.68
$83.32
$45.88
$16.6670380
X
X-ray exam of salivary gland
0260
0.79
$39.18
$22.02
$7.8470390
X
X-ray exam of salivary duct
0263
1.68
$83.32
$45.88
$16.6670450
S
CAT scan of head or brain
0283
4.89
$242.52
$179.39
$48.5070460
S
Contrast CAT scan of head
0283
4.89
$242.52
$179.39
$48.5070470
S
Contrast CAT scans of head
0283
4.89
$242.52
$179.39
$48.5070480
S
CAT scan of skull
0283
4.89
$242.52
$179.39
$48.5070481
S
Contrast CAT scan of skull
0283
4.89
$242.52
$179.39
$48.5070482
S
Contrast CAT scans of skull
0283
4.89
$242.52
$179.39
$48.5070486
S
Cat scan of face/jaw
0282
2.38
$118.04
$94.51
$23.6170487
S
Contrast CAT scan, face/jaw
0283
4.89
$242.52
$179.39
$48.5070488
S
Contrast cat scans, face/jaw
0283
4.89
$242.52
$179.39
$48.5070490
S
CAT scan of neck tissue
0283
4.89
$242.52
$179.39
$48.5070491
S
Contrast CAT of neck tissue
0283
4.89
$242.52
$179.39
$48.5070492
S
Contrast CAT of neck tissue
0283
4.89
$242.52
$179.39
$48.50*70496
S
Ct angiography, head
0283
4.89
$242.52
$179.39
$48.50*70498
S
Ct angiography, neck
0283
4.89
$242.52
$179.39
$48.5070540
S
Magnetic image, face/neck
0284
8.02
$397.76
$257.39
$79.5570541D
S
MR angiography
0284
8.02
$397.76
$257.39
$79.55*70542
S
MR (eg, proton) imaging
0284
8.02
$397.76
$257.39
$79.55*70543
S
MR (eg, proton) imaging
0284
8.02
$397.76
$257.39
$79.55*70544
S
MR angiography
0284
8.02
$397.76
$257.39
$79.55*70545
S
MR angiography
0284
8.02
$397.76
$257.39
$79.55*70546
S
MR angiography
0284
8.02
$397.76
$257.39
$79.55*70547
S
MR angiography
0284
8.02
$397.76
$257.39
$79.55*70548
S
MR angiography
0284
8.02
$397.76
$257.39
$79.55( print page 67911)*70549
S
MR angiography
0284
8.02
$397.76
$257.39
$79.5570551
S
Magnetic image, brain (MRI)
0284
8.02
$397.76
$257.39
$79.5570552
S
Magnetic image, brain (MRI)
0284
8.02
$397.76
$257.39
$79.5570553
S
Magnetic image, brain (mri)
0284
8.02
$397.76
$257.39
$79.5571010
X
Chest x-ray
0260
0.79
$39.18
$22.02
$7.8471015
X
Chest x-ray
0260
0.79
$39.18
$22.02
$7.8471020
X
Chest x-ray
0260
0.79
$39.18
$22.02
$7.8471021
X
Chest x-ray
0260
0.79
$39.18
$22.02
$7.8471022
X
Chest x-ray
0260
0.79
$39.18
$22.02
$7.8471023
X
Chest x-ray and fluoroscopy
0272
1.40
$69.43
$39.00
$13.8971030
X
Chest x-ray
0260
0.79
$39.18
$22.02
$7.8471034
X
Chest x-ray and fluoroscopy
0272
1.40
$69.43
$39.00
$13.8971035
X
Chest x-ray
0260
0.79
$39.18
$22.02
$7.8471036D
X
X-ray guidance for biopsy
0273
2.49
$123.49
$61.02
$24.7071040
X
Contrast x-ray of bronchi
0263
1.68
$83.32
$45.88
$16.6671060
X
Contrast x-ray of bronchi
0263
1.68
$83.32
$45.88
$16.6671090
X
X-ray & pacemaker insertion
0273
2.49
$123.49
$61.02
$24.7071100
X
X-ray exam of ribs
0260
0.79
$39.18
$22.02
$7.8471101
X
X-ray exam of ribs/chest
0260
0.79
$39.18
$22.02
$7.8471110
X
X-ray exam of ribs
0260
0.79
$39.18
$22.02
$7.8471111
X
X-ray exam of ribs/ chest
0261
1.38
$68.44
$38.77
$13.6971120
X
X-ray exam of breastbone
0260
0.79
$39.18
$22.02
$7.8471130
X
X-ray exam of breastbone
0260
0.79
$39.18
$22.02
$7.8471250
S
Cat scan of chest
0283
4.89
$242.52
$179.39
$48.5071260
S
Contrast CAT scan of chest
0283
4.89
$242.52
$179.39
$48.5071270
S
Contrast CAT scans of chest
0283
4.89
$242.52
$179.39
$48.50*71275
S
CT angiography, chest
0283
4.89
$242.52
$179.39
$48.5071550
S
Magnetic image, chest (mri)
0284
8.02
$397.76
$257.39
$79.55*71551
S
MRI chest w/ dye
0284
8.02
$397.76
$257.39
$79.55*71552
S
MRI chest w/o dye
0284
8.02
$397.76
$257.39
$79.5571555
S
Magnetic image, chest (mra)
0284
8.02
$397.76
$257.39
$79.5572010
X
X-ray exam of spine
0261
1.38
$68.44
$38.77
$13.6972020
X
X-ray exam of spine
0260
0.79
$39.18
$22.02
$7.8472040
X
X-ray exam of neck spine
0260
0.79
$39.18
$22.02
$7.8472050
X
X-ray exam of neck spine
0261
1.38
$68.44
$38.77
$13.6972052
X
X-ray exam of neck spine
0261
1.38
$68.44
$38.77
$13.6972069
X
X-ray exam of trunk spine
0260
0.79
$39.18
$22.02
$7.8472070
X
X-ray exam of thoracic spine
0260
0.79
$39.18
$22.02
$7.8472072
X
X-ray exam of thoracic spine
0260
0.79
$39.18
$22.02
$7.8472074
X
X-ray exam of thoracic spine
0260
0.79
$39.18
$22.02
$7.8472080
X
X-ray exam of trunk spine
0260
0.79
$39.18
$22.02
$7.8472090
X
X-ray exam of trunk spine
0260
0.79
$39.18
$22.02
$7.8472100
X
X-ray exam of lower spine
0260
0.79
$39.18
$22.02
$7.8472110
X
X-ray exam of lower spine
0261
1.38
$68.44
$38.77
$13.6972114
X
X-ray exam of lower spine
0261
1.38
$68.44
$38.77
$13.6972120
X
X-ray exam of lower spine
0260
0.79
$39.18
$22.02
$7.8472125
S
CAT scan of neck spine
0283
4.89
$242.52
$179.39
$48.5072126
S
Contrast CAT scan of neck
0283
4.89
$242.52
$179.39
$48.5072127
S
Contrast CAT scans of neck
0283
4.89
$242.52
$179.39
$48.5072128
S
CAT scan of thorax spine
0283
4.89
$242.52
$179.39
$48.5072129
S
Contrast CAT scan of thorax
0283
4.89
$242.52
$179.39
$48.5072130
S
Contrast CAT scans of thorax
0283
4.89
$242.52
$179.39
$48.5072131
S
CAT scan of lower spine
0283
4.89
$242.52
$179.39
$48.5072132
S
Contrast CAT of lower spine
0283
4.89
$242.52
$179.39
$48.5072133
S
Contrst cat scans, low spine
0283
4.89
$242.52
$179.39
$48.5072141
S
Magnetic image, neck spine
0284
8.02
$397.76
$257.39
$79.5572142
S
Magnetic image, neck spine
0284
8.02
$397.76
$257.39
$79.5572146
S
Magnetic image, chest spine
0284
8.02
$397.76
$257.39
$79.5572147
S
Magnetic image, chest spine
0284
8.02
$397.76
$257.39
$79.5572148
S
Magnetic image, lumbar spine
0284
8.02
$397.76
$257.39
$79.5572149
S
Magnetic image, lumbar spine
0284
8.02
$397.76
$257.39
$79.5572156
S
Magnetic image, neck spine
0284
8.02
$397.76
$257.39
$79.5572157
S
Magnetic image, chest spine
0284
8.02
$397.76
$257.39
$79.5572158
S
Magnetic image, lumbar spine
0284
8.02
$397.76
$257.39
$79.5572159
E
Magnetic image, spine (mra)72170
X
X-ray exam of pelvis
0260
0.79
$39.18
$22.02
$7.8472190
X
X-ray exam of pelvis
0260
0.79
$39.18
$22.02
$7.84*72191
S
CT angiograph pelv w/o & w/ dye
0283
4.89
$242.52
$179.39
$48.5072192
S
CAT scan of pelvis
0283
4.89
$242.52
$179.39
$48.5072193
S
Contrast CAT scan of pelvis
0283
4.89
$242.52
$179.39
$48.5072194
S
Contrast CAT scans of pelvis
0283
4.89
$242.52
$179.39
$48.50*72195
S
MRI pelvis w/o dye
0284
8.02
$397.76
$257.39
$79.5572196
S
Magnetic image, pelvis
0284
8.02
$397.76
$257.39
$79.55*72197
S
MRI pelvis w/o & w/ dye
0284
8.02
$397.76
$257.39
$79.55( print page 67912)72198
E
Magnetic image, pelvis (mra)72200
X
X-ray exam sacroiliac joints
0260
0.79
$39.18
$22.02
$7.8472202
X
X-ray exam sacroiliac joints
0260
0.79
$39.18
$22.02
$7.8472220
X
X-ray exam of tailbone
0260
0.79
$39.18
$22.02
$7.8472240
S
Contrast x-ray of neck spine
0274
4.83
$239.55
$128.12
$47.9172255
S
Contrast x-ray, thorax spine
0274
4.83
$239.55
$128.12
$47.9172265
S
Contrast x-ray, lower spine
0274
4.83
$239.55
$128.12
$47.9172270
S
Contrast x-ray of spine
0274
4.83
$239.55
$128.12
$47.9172275
S
Epidurography
0274
4.83
$239.55
$128.12
$47.9172285
S
X-ray c/t spine disk
0274
4.83
$239.55
$128.12
$47.9172295
S
X-ray of lower spine disk
0274
4.83
$239.55
$128.12
$47.9173000
X
X-ray exam of collar bone
0260
0.79
$39.18
$22.02
$7.8473010
X
X-ray exam of shoulder blade
0260
0.79
$39.18
$22.02
$7.8473020
X
X-ray exam of shoulder
0260
0.79
$39.18
$22.02
$7.8473030
X
X-ray exam of shoulder
0260
0.79
$39.18
$22.02
$7.8473040
S
Contrast x-ray of shoulder
0275
2.74
$135.89
$72.26
$27.1873050
X
X-ray exam of shoulders
0260
0.79
$39.18
$22.02
$7.8473060
X
X-ray exam of humerus
0260
0.79
$39.18
$22.02
$7.8473070
X
X-ray exam of elbow
0260
0.79
$39.18
$22.02
$7.8473080
X
X-ray exam of elbow
0260
0.79
$39.18
$22.02
$7.8473085
S
Contrast x-ray of elbow
0275
2.74
$135.89
$72.26
$27.1873090
X
X-ray exam of forearm
0260
0.79
$39.18
$22.02
$7.8473092
X
X-ray exam of arm, infant
0260
0.79
$39.18
$22.02
$7.8473100
X
X-ray exam of wrist
0260
0.79
$39.18
$22.02
$7.8473110
X
X-ray exam of wrist
0260
0.79
$39.18
$22.02
$7.8473115
S
Contrast x-ray of wrist
0275
2.74
$135.89
$72.26
$27.1873120
X
X-ray exam of hand
0260
0.79
$39.18
$22.02
$7.8473130
X
X-ray exam of hand
0260
0.79
$39.18
$22.02
$7.8473140
X
X-ray exam of finger(s)
0260
0.79
$39.18
$22.02
$7.8473200
S
CAT scan of arm
0283
4.89
$242.52
$179.39
$48.5073201
S
Contrast CAT scan of arm
0283
4.89
$242.52
$179.39
$48.5073202
S
Contrast CAT scans of arm
0283
4.89
$242.52
$179.39
$48.50*73206
S
CT angio upr extrm w/o & w/ dye
0283
4.89
$242.52
$179.39
$48.50*73218
S
MRI upper extrm w/o dye
0284
8.02
$397.76
$257.39
$79.55*73219
S
MRI upper extrm w/ dye
0284
8.02
$397.76
$257.39
$79.5573220
S
Magnetic image, arm/hand
0284
8.02
$397.76
$257.39
$79.5573221
S
Magnetic image, joint of arm
0284
8.02
$397.76
$257.39
$79.55*73222
S
MRI joint upr extrm w/ dye
0284
8.02
$397.76
$257.39
$79.55*73223
S
MRI joint upr extrm w/o & w/ dye
0284
8.02
$397.76
$257.39
$79.5573225
E
Magnetic image, upper (mra)73500
X
X-ray exam of hip
0260
0.79
$39.18
$22.02
$7.8473510
X
X-ray exam of hip
0260
0.79
$39.18
$22.02
$7.8473520
X
X-ray exam of hips
0260
0.79
$39.18
$22.02
$7.8473525
S
Contrast x-ray of hip
0275
2.74
$135.89
$72.26
$27.1873530
X
X-ray exam of hip
0261
1.38
$68.44
$38.77
$13.6973540
X
X-ray exam of pelvis & hips
0260
0.79
$39.18
$22.02
$7.8473542
S
X-ray exam, sacroiliac joint
0275
2.74
$135.89
$72.26
$27.1873550
X
X-ray exam of thigh
0260
0.79
$39.18
$22.02
$7.8473560
X
X-ray exam of knee, 1 or 2
0260
0.79
$39.18
$22.02
$7.8473562
X
X-ray exam of knee, 3
0260
0.79
$39.18
$22.02
$7.8473564
X
X-ray exam, knee, 4 or more
0260
0.79
$39.18
$22.02
$7.8473565
X
X-ray exam of knees
0260
0.79
$39.18
$22.02
$7.8473580
S
Contrast x-ray of knee joint
0275
2.74
$135.89
$72.26
$27.1873590
X
X-ray exam of lower leg
0260
0.79
$39.18
$22.02
$7.8473592
X
X-ray exam of leg, infant
0261
1.38
$68.44
$38.77
$13.6973600
X
X-ray exam of ankle
0260
0.79
$39.18
$22.02
$7.8473610
X
X-ray exam of ankle
0260
0.79
$39.18
$22.02
$7.8473615
S
Contrast x-ray of ankle
0275
2.74
$135.89
$72.26
$27.1873620
X
X-ray exam of foot
0260
0.79
$39.18
$22.02
$7.8473630
X
X-ray exam of foot
0260
0.79
$39.18
$22.02
$7.8473650
X
X-ray exam of heel
0260
0.79
$39.18
$22.02
$7.8473660
X
X-ray exam of toe(s)
0260
0.79
$39.18
$22.02
$7.8473700
S
CAT scan of leg
0283
4.89
$242.52
$179.39
$48.5073701
S
Contrast CAT scan of leg
0283
4.89
$242.52
$179.39
$48.5073702
S
Contrast CAT scans of leg
0283
4.89
$242.52
$179.39
$48.50*73706
S
CT angio lwr extr w/o & w/ dye
0283
4.89
$242.52
$179.39
$48.50*73718
S
MRI lower extrem w/o dye
0284
8.02
$397.76
$257.39
$79.55*73719
S
MRI lower extrem w/ dye
0284
8.02
$397.76
$257.39
$79.5573720
S
Magnetic image, leg/foot
0284
8.02
$397.76
$257.39
$79.5573721
S
Magnetic image, joint of leg
0284
8.02
$397.76
$257.39
$79.55*73722
S
MRI joint lwr extrm w/ dye
0284
8.02
$397.76
$257.39
$79.55*73723
S
MRI joint lwr extrm w/o & w/ dye
0284
8.02
$397.76
$257.39
$79.5573725
S
Magnetic image/lower (mra)
0284
8.02
$397.76
$257.39
$79.5574000
X
X-ray exam of abdomen
0260
0.79
$39.18
$22.02
$7.84( print page 67913)74010
X
X-ray exam of abdomen
0260
0.79
$39.18
$22.02
$7.8474020
X
X-ray exam of abdomen
0260
0.79
$39.18
$22.02
$7.8474022
X
X-ray exam series, abdomen
0261
1.38
$68.44
$38.77
$13.6974150
S
CAT scan of abdomen
0283
4.89
$242.52
$179.39
$48.5074160
S
Contrast CAT scan of abdomen
0283
4.89
$242.52
$179.39
$48.5074170
S
Contrast CAT scans, abdomen
0283
4.89
$242.52
$179.39
$48.50*74175
S
CT angio abdom w/o & w/ dye
0283
4.89
$242.52
$179.39
$48.5074181
S
Magnetic image/abdomen (mri)
0284
8.02
$397.76
$257.39
$79.55*74182
S
MRI abdomen w/ dye
0284
8.02
$397.76
$257.39
$79.55*74183
S
MRI abdomen w/o & w/ dye
0284
8.02
$397.76
$257.39
$79.5574185
S
Magnetic image/abdomen (MRA)
0284
8.02
$397.76
$257.39
$79.5574190
X
X-ray exam of peritoneum
0263
1.68
$83.32
$45.88
$16.6674210
S
Contrst x-ray exam of throat
0276
1.79
$88.78
$49.78
$17.7674220
S
Contrast x-ray, esophagus
0276
1.79
$88.78
$49.78
$17.7674230
S
Cinema x-ray, throat/esoph
0276
1.79
$88.78
$49.78
$17.7674235
S
Remove esophagus obstruction
0296
3.57
$177.06
$100.25
$35.4174240
S
X-ray exam, upper gi tract
0276
1.79
$88.78
$49.78
$17.7674241
S
X-ray exam, upper gi tract
0276
1.79
$88.78
$49.78
$17.7674245
S
X-ray exam, upper gi tract
0277
2.47
$122.50
$69.28
$24.5074246
S
Contrst x-ray uppr gi tract
0276
1.79
$88.78
$49.78
$17.7674247
S
Contrst x-ray uppr gi tract
0276
1.79
$88.78
$49.78
$17.7674249
S
Contrst x-ray uppr gi tract
0277
2.47
$122.50
$69.28
$24.5074250
S
X-ray exam of small bowel
0276
1.79
$88.78
$49.78
$17.7674251
S
X-ray exam of small bowel
0277
2.47
$122.50
$69.28
$24.5074260
S
X-ray exam of small bowel
0277
2.47
$122.50
$69.28
$24.5074270
S
Contrast x-ray exam of colon
0276
1.79
$88.78
$49.78
$17.7674280
S
Contrast x-ray exam of colon
0277
2.47
$122.50
$69.28
$24.5074283
S
Contrast x-ray exam of colon
0276
1.79
$88.78
$49.78
$17.7674290
S
Contrast x-ray, gallbladder
0276
1.79
$88.78
$49.78
$17.7674291
S
Contrast x-rays, gallbladder
0276
1.79
$88.78
$49.78
$17.7674300
X
X-ray bile ducts/pancreas
0263
1.68
$83.32
$45.88
$16.6674301
X
X-rays at surgery add-on
0263
1.68
$83.32
$45.88
$16.6674305
X
X-ray bile ducts/pancreas
0263
1.68
$83.32
$45.88
$16.6674320
X
Contrast x-ray of bile ducts
0264
3.83
$189.96
$108.97
$37.9974327
S
X-ray bile stone removal
0296
3.57
$177.06
$100.25
$35.4174328
X
Xray bile duct endoscopy
0264
3.83
$189.96
$108.97
$37.9974329
X
X-ray for pancreas endoscopy
0264
3.83
$189.96
$108.97
$37.9974330
X
X-ray bile/panc endoscopy
0264
3.83
$189.96
$108.97
$37.9974340
X
X-ray guide for GI tube
0272
1.40
$69.43
$39.00
$13.8974350
X
X-ray guide, stomach tube
0264
3.83
$189.96
$108.97
$37.9974355
X
X-ray guide, intestinal tube
0264
3.83
$189.96
$108.97
$37.9974360
S
X-ray guide, GI dilation
0296
3.57
$177.06
$100.25
$35.4174363
S
X-ray, bile duct dilation
0297
6.13
$304.03
$172.51
$60.8174400
S
Contrst x-ray, urinary tract
0278
2.85
$141.35
$81.67
$28.2774410
S
Contrst x-ray, urinary tract
0278
2.85
$141.35
$81.67
$28.2774415
S
Contrst x-ray, urinary tract
0278
2.85
$141.35
$81.67
$28.2774420
S
Contrst x-ray, urinary tract
0278
2.85
$141.35
$81.67
$28.2774425
S
Contrst x-ray, urinary tract
0278
2.85
$141.35
$81.67
$28.2774430
S
Contrast x-ray, bladder
0278
2.85
$141.35
$81.67
$28.2774440
S
X-ray, male genital tract
0278
2.85
$141.35
$81.67
$28.2774445
S
X-ray exam of penis
0278
2.85
$141.35
$81.67
$28.2774450
S
X-ray, urethra/bladder
0278
2.85
$141.35
$81.67
$28.2774455
S
X-ray, urethra/bladder
0278
2.85
$141.35
$81.67
$28.2774470
X
X-ray exam of kidney lesion
0264
3.83
$189.96
$108.97
$37.9974475
S
X-ray control, cath insert
0297
6.13
$304.03
$172.51
$60.8174480
S
X-ray control, cath insert
0297
6.13
$304.03
$172.51
$60.8174485
S
X-ray guide, GU dilation
0296
3.57
$177.06
$100.25
$35.4174710
X
X-ray measurement of pelvis
0260
0.79
$39.18
$22.02
$7.8474740
X
X-ray, female genital tract
0264
3.83
$189.96
$108.97
$37.9974742
X
X-ray, fallopian tube
0264
3.83
$189.96
$108.97
$37.9974775
S
X-ray exam of perineum
0278
2.85
$141.35
$81.67
$28.2775552
S
Magnetic image, myocardium
0284
8.02
$397.76
$257.39
$79.5575553
S
Magnetic image, myocardium
0284
8.02
$397.76
$257.39
$79.5575554
S
Cardiac MRI/function
0284
8.02
$397.76
$257.39
$79.5575555
S
Cardiac MRI/limited study
0284
8.02
$397.76
$257.39
$79.5575556
E
Cardiac MRI/flow mapping75600
S
Contrast x-ray exam of aorta
0280
14.98
$742.95
$380.12
$148.5975605
S
Contrast x-ray exam of aorta
0280
14.98
$742.95
$380.12
$148.5975625
S
Contrast x-ray exam of aorta
0280
14.98
$742.95
$380.12
$148.5975630
S
X-ray aorta, leg arteries
0280
14.98
$742.95
$380.12
$148.59*75635
S
CT angio abdominal arteries
0283
4.89
$242.52
$179.39
$48.5075650
S
Artery x-rays, head & neck
0280
14.98
$742.95
$380.12
$148.5975658
S
Artery x-rays, arm
0280
14.98
$742.95
$380.12
$148.5975660
S
Artery x-rays, head & neck
0279
6.30
$312.46
$174.57
$62.49( print page 67914)75662
S
Artery x-rays, head & neck
0279
6.30
$312.46
$174.57
$62.4975665
S
Artery x-rays, head & neck
0280
14.98
$742.95
$380.12
$148.5975671
S
Artery x-rays, head & neck
0280
14.98
$742.95
$380.12
$148.5975676
S
Artery x-rays, neck
0280
14.98
$742.95
$380.12
$148.5975680
S
Artery x-rays, neck
0280
14.98
$742.95
$380.12
$148.5975685
S
Artery x-rays, spine
0279
6.30
$312.46
$174.57
$62.4975705
S
Artery x-rays, spine
0279
6.30
$312.46
$174.57
$62.4975710
S
Artery x-rays, arm/leg
0280
14.98
$742.95
$380.12
$148.5975716
S
Artery x-rays, arms/legs
0280
14.98
$742.95
$380.12
$148.5975722
S
Artery x-rays, kidney
0280
14.98
$742.95
$380.12
$148.5975724
S
Artery x-rays, kidneys
0280
14.98
$742.95
$380.12
$148.5975726
S
Artery x-rays, abdomen
0280
14.98
$742.95
$380.12
$148.5975731
S
Artery x-rays, adrenal gland
0280
14.98
$742.95
$380.12
$148.5975733
S
Artery x-rays, adrenals
0280
14.98
$742.95
$380.12
$148.5975736
S
Artery x-rays, pelvis
0280
14.98
$742.95
$380.12
$148.5975741
S
Artery x-rays, lung
0279
6.30
$312.46
$174.57
$62.4975743
S
Artery x-rays, lungs
0280
14.98
$742.95
$380.12
$148.5975746
S
Artery x-rays, lung
0279
6.30
$312.46
$174.57
$62.4975756
S
Artery x-rays, chest
0279
6.30
$312.46
$174.57
$62.4975774
S
Artery x-ray, each vessel
0280
14.98
$742.95
$380.12
$148.5975790
S
Visualize A-V shunt
0281
4.40
$218.22
$115.16
$43.6475801
X
Lymph vessel x-ray, arm/leg
0264
3.83
$189.96
$108.97
$37.9975803
X
Lymph vessel x-ray,arms/legs
0264
3.83
$189.96
$108.97
$37.9975805
X
Lymph vessel x-ray, trunk
0264
3.83
$189.96
$108.97
$37.9975807
X
Lymph vessel x-ray, trunk
0264
3.83
$189.96
$108.97
$37.9975809
X
Nonvascular shunt, x-ray
0264
3.83
$189.96
$108.97
$37.9975810
S
Vein x-ray, spleen/liver
0279
6.30
$312.46
$174.57
$62.4975820
S
Vein x-ray, arm/leg
0281
4.40
$218.22
$115.16
$43.6475822
S
Vein x-ray, arms/legs
0281
4.40
$218.22
$115.16
$43.6475825
S
Vein x-ray, trunk
0279
6.30
$312.46
$174.57
$62.4975827
S
Vein x-ray, chest
0279
6.30
$312.46
$174.57
$62.4975831
S
Vein x-ray, kidney
0279
6.30
$312.46
$174.57
$62.4975833
S
Vein x-ray, kidneys
0279
6.30
$312.46
$174.57
$62.4975840
S
Vein x-ray, adrenal gland
0279
6.30
$312.46
$174.57
$62.4975842
S
Vein x-ray, adrenal glands
0279
6.30
$312.46
$174.57
$62.4975860
S
Vein x-ray, neck
0279
6.30
$312.46
$174.57
$62.4975870
S
Vein x-ray, skull
0279
6.30
$312.46
$174.57
$62.4975872
S
Vein x-ray, skull
0279
6.30
$312.46
$174.57
$62.4975880
S
Vein x-ray, eye socket
0279
6.30
$312.46
$174.57
$62.4975885
S
Vein x-ray, liver
0279
6.30
$312.46
$174.57
$62.4975887
S
Vein x-ray, liver
0280
14.98
$742.95
$380.12
$148.5975889
S
Vein x-ray, liver
0279
6.30
$312.46
$174.57
$62.4975891
S
Vein x-ray, liver
0279
6.30
$312.46
$174.57
$62.4975893
N
Venous sampling by catheter75894
S
X-rays, transcath therapy
0297
6.13
$304.03
$172.51
$60.8175896
S
X-rays, transcath therapy
0297
6.13
$304.03
$172.51
$60.8175898
X
Follow-up angiogram
0264
3.83
$189.96
$108.97
$37.9975900
C
Arterial catheter exchange75940
X
X-ray placement, vein filter
0264
3.83
$189.96
$108.97
$37.9975945
S
Intravascular us
0267
2.72
$134.90
$80.06
$26.9875946
S
Intravascular us add-on
0267
2.72
$134.90
$80.06
$26.98*75952
C
Abdom aneurysm endovas repr*75953
C
Abdom aneurysm endovas repr75960
S
Transcatheter intro, stent
0279
6.30
$312.46
$174.57
$62.4975961
S
Retrieval, broken catheter
0279
6.30
$312.46
$174.57
$62.4975962
S
Repair arterial blockage
0280
14.98
$742.95
$380.12
$148.5975964
S
Repair artery blockage, each
0279
6.30
$312.46
$174.57
$62.4975966
S
Repair arterial blockage
0280
14.98
$742.95
$380.12
$148.5975968
S
Repair artery blockage, each
0279
6.30
$312.46
$174.57
$62.4975970
S
Vascular biopsy
0279
6.30
$312.46
$174.57
$62.4975978
S
Repair venous blockage
0279
6.30
$312.46
$174.57
$62.4975980
S
Contrast xray exam bile duct
0297
6.13
$304.03
$172.51
$60.8175982
S
Contrast xray exam bile duct
0297
6.13
$304.03
$172.51
$60.8175984
S
Xray control catheter change
0296
3.57
$177.06
$100.25
$35.4175989
X
Abscess drainage under x-ray
0273
2.49
$123.49
$61.02
$24.7075992
S
Atherectomy, x-ray exam
0279
6.30
$312.46
$174.57
$62.4975993
T
Atherectomy, x-ray exam
0081
28.81
$1,428.86
$710.91
$285.7775994
T
Atherectomy, x-ray exam
0081
28.81
$1,428.86
$710.91
$285.7775995
S
Atherectomy, x-ray exam
0279
6.30
$312.46
$174.57
$62.4975996
T
Atherectomy, x-ray exam
0081
28.81
$1,428.86
$710.91
$285.7776000
X
Fluoroscope examination
0272
1.40
$69.43
$39.00
$13.8976001
X
Fluoroscope exam, extensive
0273
2.49
$123.49
$61.02
$24.7076003
X
Needle localization by x-ray
0272
1.40
$69.43
$39.00
$13.8976005
X
Fluoroguide for spine inject
0273
2.49
$123.49
$61.02
$24.70( print page 67915)76006
X
X-ray stress view
0261
1.38
$68.44
$38.77
$13.6976010
X
X-ray, nose to rectum
0260
0.79
$39.18
$22.02
$7.84*76012
S
Percut vertebroplasty fluor
0274
4.83
$239.55
$128.12
$47.91*76013
S
Percut vertebroplasty CT
0274
4.83
$239.55
$128.12
$47.9176020
X
X-rays for bone age
0261
1.38
$68.44
$38.77
$13.6976040
X
X-rays, bone evaluation
0260
0.79
$39.18
$22.02
$7.8476061
X
X-rays, bone survey
0261
1.38
$68.44
$38.77
$13.6976062
X
X-rays, bone survey
0261
1.38
$68.44
$38.77
$13.6976065
X
X-rays, bone evaluation
0261
1.38
$68.44
$38.77
$13.6976066
X
Joint(s) survey, single film
0260
0.79
$39.18
$22.02
$7.8476070
E
CT scan, bone density study76075
S
Dual energy x-ray study
0971
1.55
$76.88

$15.3876076
T
Dual energy x-ray study
0970
0.52
$25.79

$5.1676078
X
Photodensitometry
0261
1.38
$68.44
$38.77
$13.6976080
X
X-ray exam of fistula
0263
1.68
$83.32
$45.88
$16.6676086
X
X-ray of mammary duct
0263
1.68
$83.32
$45.88
$16.6676088
X
X-ray of mammary ducts
0263
1.68
$83.32
$45.88
$16.6676090
S
Mammogram, one breast
0271
0.70
$34.72
$19.50
$6.9476091
S
Mammogram, both breasts
0271
0.70
$34.72
$19.50
$6.9476092
A
Mammogram, screening76093
S
Magnetic image, breast
0284
8.02
$397.76
$257.39
$79.5576094
S
Magnetic image, both breasts
0284
8.02
$397.76
$257.39
$79.5576095
X
Stereotactic breast biopsy
0264
3.83
$189.96
$108.97
$37.9976096
X
X-ray of needle wire, breast
0263
1.68
$83.32
$45.88
$16.6676098
X
X-ray exam, breast specimen
0260
0.79
$39.18
$22.02
$7.8476100
X
X-ray exam of body section
0261
1.38
$68.44
$38.77
$13.6976101
X
Complex body section x-ray
0263
1.68
$83.32
$45.88
$16.6676102
X
Complex body section x-rays
0264
3.83
$189.96
$108.97
$37.9976120
X
Cinematic x-rays
0261
1.38
$68.44
$38.77
$13.6976125
X
Cinematic x-rays add-on
0261
1.38
$68.44
$38.77
$13.6976140
E
X-ray consultation76150
X
X-ray exam, dry process
0260
0.79
$39.18
$22.02
$7.8476350
N
Special x-ray contrast study76355
S
CAT scan for localization
0283
4.89
$242.52
$179.39
$48.5076360
S
CAT scan for needle biopsy
0283
4.89
$242.52
$179.39
$48.5076365D
S
CAT scan for cyst aspiration
0283
4.89
$242.52
$179.39
$48.5076370
S
CAT scan for therapy guide
0282
2.38
$118.04
$94.51
$23.6176375
S
3d/holograph reconstr add-on
0282
2.38
$118.04
$94.51
$23.6176380
S
CAT scan follow-up study
0282
2.38
$118.04
$94.51
$23.6176390
S
Mr spectroscopy
0284
8.02
$397.76
$257.39
$79.55*76393
X
MR guidance for needle place
0273
2.49
$123.49
$61.02
$24.7076400
S
Magnetic image, bone marrow
0284
8.02
$397.76
$257.39
$79.5576499
X
Radiographic procedure
0260
0.79
$39.18
$22.02
$7.8476506
S
Echo exam of head
0266
1.79
$88.78
$57.35
$17.7676511
S
Echo exam of eye
0266
1.79
$88.78
$57.35
$17.7676512
S
Echo exam of eye
0266
1.79
$88.78
$57.35
$17.7676513
S
Echo exam of eye, water bath
0265
1.17
$58.03
$38.08
$11.6176516
S
Echo exam of eye
0266
1.79
$88.78
$57.35
$17.7676519
S
Echo exam of eye
0266
1.79
$88.78
$57.35
$17.7676529
S
Echo exam of eye
0265
1.17
$58.03
$38.08
$11.6176536
S
Echo exam of head and neck
0265
1.17
$58.03
$38.08
$11.6176604
S
Echo exam of chest
0266
1.79
$88.78
$57.35
$17.7676645
S
Echo exam of breast(s)
0265
1.17
$58.03
$38.08
$11.6176700
S
Echo exam of abdomen
0266
1.79
$88.78
$57.35
$17.7676705
S
Echo exam of abdomen
0266
1.79
$88.78
$57.35
$17.7676770
S
Echo exam abdomen back wall
0266
1.79
$88.78
$57.35
$17.7676775
S
Echo exam abdomen back wall
0266
1.79
$88.78
$57.35
$17.7676778
S
Echo exam kidney transplant
0266
1.79
$88.78
$57.35
$17.7676800
S
Echo exam spinal canal
0266
1.79
$88.78
$57.35
$17.7676805
S
Echo exam of pregnant uterus
0266
1.79
$88.78
$57.35
$17.7676810
S
Echo exam of pregnant uterus
0265
1.17
$58.03
$38.08
$11.6176815
S
Echo exam of pregnant uterus
0265
1.17
$58.03
$38.08
$11.6176816
S
Echo exam follow-up/repeat
0265
1.17
$58.03
$38.08
$11.6176818
S
Fetal biophysical profile
0266
1.79
$88.78
$57.35
$17.76*76819
S
Fetl biophys profil w/o stress
0266
1.79
$88.78
$57.35
$17.7676825
S
Echo exam of fetal heart
0269
4.40
$218.22
$114.01
$43.6476826
S
Echo exam of fetal heart
0269
4.40
$218.22
$114.01
$43.6476827
S
Echo exam of fetal heart
0269
4.40
$218.22
$114.01
$43.6476828
S
Echo exam of fetal heart
0269
4.40
$218.22
$114.01
$43.6476830
S
Echo exam, transvaginal
0266
1.79
$88.78
$57.35
$17.7676831
S
Echo exam, uterus
0266
1.79
$88.78
$57.35
$17.7676856
S
Echo exam of pelvis
0266
1.79
$88.78
$57.35
$17.7676857
S
Echo exam of pelvis
0265
1.17
$58.03
$38.08
$11.6176870
S
Echo exam of scrotum
0266
1.79
$88.78
$57.35
$17.76( print page 67916)76872
S
Echo exam, transrectal
0266
1.79
$88.78
$57.35
$17.7676873
S
Echograp trans r, pros study
0266
1.79
$88.78
$57.35
$17.7676880
S
Echo exam of extremity
0266
1.79
$88.78
$57.35
$17.7676885
S
Echo exam, infant hips
0266
1.79
$88.78
$57.35
$17.7676886
S
Echo exam, infant hips
0266
1.79
$88.78
$57.35
$17.7676930
X
Echo guide for heart sac tap
0268
2.23
$110.60
$69.51
$22.1276932
X
Echo guide for heart biopsy
0268
2.23
$110.60
$69.51
$22.1276934D
X
Echo guide for chest tap
0268
2.23
$110.60
$69.51
$22.1276936
X
Echo guide for artery repair
0268
2.23
$110.60
$69.51
$22.1276938D
X
Echo exam for drainage
0268
2.23
$110.60
$69.51
$22.1276941
X
Echo guide for transfusion
0268
2.23
$110.60
$69.51
$22.1276942
X
Echo guide for biopsy
0268
2.23
$110.60
$69.51
$22.1276945
X
Echo guide, villus sampling
0268
2.23
$110.60
$69.51
$22.1276946
X
Echo guide for amniocentesis
0268
2.23
$110.60
$69.51
$22.1276948
X
Echo guide, ova aspiration
0268
2.23
$110.60
$69.51
$22.1276950
X
Echo guidance radiotherapy
0268
2.23
$110.60
$69.51
$22.1276960D
X
Echo guidance radiotherapy
0268
2.23
$110.60
$69.51
$22.1276965
X
Echo guidance radiotherapy
0268
2.23
$110.60
$69.51
$22.1276970
S
Ultrasound exam follow-up
0265
1.17
$58.03
$38.08
$11.6176975
S
GI endoscopic ultrasound
0266
1.79
$88.78
$57.35
$17.7676977
S
Us bone density measure
0265
1.17
$58.03
$38.08
$11.6176986
S
Echo exam at surgery
0266
1.79
$88.78
$57.35
$17.7676999
S
Echo examination procedure
0266
1.79
$88.78
$57.35
$17.7677261
E
Radiation therapy planning77262
E
Radiation therapy planning77263
E
Radiation therapy planning77280
X
Set radiation therapy field
0304
1.49
$73.90
$41.52
$14.7877285
X
Set radiation therapy field
0305
4.06
$201.36
$97.50
$40.2777290
X
Set radiation therapy field
0305
4.06
$201.36
$97.50
$40.2777295
X
Set radiation therapy field
0310
13.98
$693.35
$339.05
$138.6777299
E
Radiation therapy planning77300
X
Radiation therapy dose plan
0304
1.49
$73.90
$41.52
$14.7877305
X
Radiation therapy dose plan
0304
1.49
$73.90
$41.52
$14.7877310
X
Radiation therapy dose plan
0304
1.49
$73.90
$41.52
$14.7877315
X
Radiation therapy dose plan
0305
4.06
$201.36
$97.50
$40.2777321
X
Radiation therapy port plan
0305
4.06
$201.36
$97.50
$40.2777326
X
Radiation therapy dose plan
0305
4.06
$201.36
$97.50
$40.2777327
X
Radiation therapy dose plan
0305
4.06
$201.36
$97.50
$40.2777328
X
Radiation therapy dose plan
0305
4.06
$201.36
$97.50
$40.2777331
X
Special radiation dosimetry
0304
1.49
$73.90
$41.52
$14.7877332
X
Radiation treatment aid(s)
0303
2.83
$140.36
$69.28
$28.0777333
X
Radiation treatment aid(s)
0303
2.83
$140.36
$69.28
$28.0777334
X
Radiation treatment aid(s)
0303
2.83
$140.36
$69.28
$28.0777336
X
Radiation physics consult
0311
1.32
$65.46
$31.66
$13.0977370
X
Radiation physics consult
0311
1.32
$65.46
$31.66
$13.0977399
X
External radiation dosimetry
0311
1.32
$65.46
$31.66
$13.0977401
S
Radiation treatment delivery
0300
1.98
$98.20
$47.72
$19.6477402
S
Radiation treatment delivery
0300
1.98
$98.20
$47.72
$19.6477403
S
Radiation treatment delivery
0300
1.98
$98.20
$47.72
$19.6477404
S
Radiation treatment delivery
0300
1.98
$98.20
$47.72
$19.6477406
S
Radiation treatment delivery
0300
1.98
$98.20
$47.72
$19.6477407
S
Radiation treatment delivery
0300
1.98
$98.20
$47.72
$19.6477408
S
Radiation treatment delivery
0300
1.98
$98.20
$47.72
$19.6477409
S
Radiation treatment delivery
0300
1.98
$98.20
$47.72
$19.6477411
S
Radiation treatment delivery
0301
2.21
$109.61
$52.53
$21.9277412
S
Radiation treatment delivery
0301
2.21
$109.61
$52.53
$21.9277413
S
Radiation treatment delivery
0301
2.21
$109.61
$52.53
$21.9277414
S
Radiation treatment delivery
0300
1.98
$98.20
$47.72
$19.6477416
S
Radiation treatment delivery
0301
2.21
$109.61
$52.53
$21.9277417
X
Radiology port film(s)
0260
0.79
$39.18
$22.02
$7.8477427
E
Radiation tx management, x577431
E
Radiation therapy management77432
E
Stereotactic radiation trmt77470
S
Special radiation treatment
0302
8.21
$407.18
$216.55
$81.4477499
E
Radiation therapy management77520
S
Proton beam delivery
0974
8.25
$409.17

$81.83*77522
S
Proton trmt, simple w/ comp
0974
8.25
$409.17

$81.8377523
S
Proton beam delivery
0976
18.05
$895.21

$179.04*77525
S
Proton treatment, complex
0976
18.05
$895.21

$179.0477600
S
Hyperthermia treatment
0314
5.88
$291.62
$150.95
$58.3277605
S
Hyperthermia treatment
0314
5.88
$291.62
$150.95
$58.3277610
S
Hyperthermia treatment
0314
5.88
$291.62
$150.95
$58.3277615
S
Hyperthermia treatment
0314
5.88
$291.62
$150.95
$58.3277620
S
Hyperthermia treatment
0314
5.88
$291.62
$150.95
$58.32( print page 67917)77750
S
Infuse radioactive materials
0301
2.21
$109.61
$52.53
$21.9277761
S
Radioelement application
0312
4.09
$202.85
$109.65
$40.5777762
S
Radioelement application
0312
4.09
$202.85
$109.65
$40.5777763
S
Radioelement application
0312
4.09
$202.85
$109.65
$40.5777776
S
Radioelement application
0312
4.09
$202.85
$109.65
$40.5777777
S
Radioelement application
0312
4.09
$202.85
$109.65
$40.5777778
S
Radioelement application
0312
4.09
$202.85
$109.65
$40.5777781
S
High intensity brachytherapy
0313
7.89
$391.31
$164.02
$78.2677782
S
High intensity brachytherapy
0313
7.89
$391.31
$164.02
$78.2677783
S
High intensity brachytherapy
0313
7.89
$391.31
$164.02
$78.2677784
S
High intensity brachytherapy
0313
7.89
$391.31
$164.02
$78.2677789
S
Radioelement application
0300
1.98
$98.20
$47.72
$19.6477790
N
Radioelement handling77799
S
Radium/radioisotope therapy
0313
7.89
$391.31
$164.02
$78.2678000
S
Thyroid, single uptake
0290
1.94
$96.21
$55.51
$19.2478001
S
Thyroid, multiple uptakes
0290
1.94
$96.21
$55.51
$19.2478003
S
Thyroid suppress/stimul
0290
1.94
$96.21
$55.51
$19.2478006
S
Thyroid imaging with uptake
0291
3.15
$156.22
$93.14
$31.2478007
S
Thyroid image, mult uptakes
0291
3.15
$156.22
$93.14
$31.2478010
S
Thyroid imaging
0290
1.94
$96.21
$55.51
$19.2478011
S
Thyroid imaging with flow
0290
1.94
$96.21
$55.51
$19.2478015
S
Thyroid met imaging
0291
3.15
$156.22
$93.14
$31.2478016
S
Thyroid met imaging/studies
0292
4.36
$216.24
$126.63
$43.2578018
S
Thyroid met imaging, body
0292
4.36
$216.24
$126.63
$43.2578020
S
Thyroid met uptake
0292
4.36
$216.24
$126.63
$43.2578070
S
Parathyroid nuclear imaging
0292
4.36
$216.24
$126.63
$43.2578075
S
Adrenal nuclear imaging
0292
4.36
$216.24
$126.63
$43.2578099
S
Endocrine nuclear procedure
0290
1.94
$96.21
$55.51
$19.2478102
S
Bone marrow imaging, ltd
0291
3.15
$156.22
$93.14
$31.2478103
S
Bone marrow imaging, mult
0292
4.36
$216.24
$126.63
$43.2578104
S
Bone marrow imaging, body
0292
4.36
$216.24
$126.63
$43.2578110
S
Plasma volume, single
0291
3.15
$156.22
$93.14
$31.2478111
S
Plasma volume, multiple
0291
3.15
$156.22
$93.14
$31.2478120
S
Red cell mass, single
0291
3.15
$156.22
$93.14
$31.2478121
S
Red cell mass, multiple
0291
3.15
$156.22
$93.14
$31.2478122
S
Blood volume
0292
4.36
$216.24
$126.63
$43.2578130
S
Red cell survival study
0292
4.36
$216.24
$126.63
$43.2578135
S
Red cell survival kinetics
0292
4.36
$216.24
$126.63
$43.2578140
S
Red cell sequestration
0292
4.36
$216.24
$126.63
$43.2578160
S
Plasma iron turnover
0292
4.36
$216.24
$126.63
$43.2578162
S
Iron absorption exam
0292
4.36
$216.24
$126.63
$43.2578170
S
Red cell iron utilization
0292
4.36
$216.24
$126.63
$43.2578172
S
Total body iron estimation
0292
4.36
$216.24
$126.63
$43.2578185
S
Spleen imaging
0291
3.15
$156.22
$93.14
$31.2478190
S
Platelet survival, kinetics
0291
3.15
$156.22
$93.14
$31.2478191
S
Platelet survival
0291
3.15
$156.22
$93.14
$31.2478195
S
Lymph system imaging
0292
4.36
$216.24
$126.63
$43.2578199
S
Blood/lymph nuclear exam
0290
1.94
$96.21
$55.51
$19.2478201
S
Liver imaging
0291
3.15
$156.22
$93.14
$31.2478202
S
Liver imaging with flow
0291
3.15
$156.22
$93.14
$31.2478205
S
Liver imaging (3D)
0292
4.36
$216.24
$126.63
$43.2578206
S
Liver image (3d) w/flow
0292
4.36
$216.24
$126.63
$43.2578215
S
Liver and spleen imaging
0291
3.15
$156.22
$93.14
$31.2478216
S
Liver & spleen image/flow
0291
3.15
$156.22
$93.14
$31.2478220
S
Liver function study
0292
4.36
$216.24
$126.63
$43.2578223
S
Hepatobiliary imaging
0292
4.36
$216.24
$126.63
$43.2578230
S
Salivary gland imaging
0291
3.15
$156.22
$93.14
$31.2478231
S
Serial salivary imaging
0291
3.15
$156.22
$93.14
$31.2478232
S
Salivary gland function exam
0291
3.15
$156.22
$93.14
$31.2478258
S
Esophageal motility study
0291
3.15
$156.22
$93.14
$31.2478261
S
Gastric mucosa imaging
0291
3.15
$156.22
$93.14
$31.2478262
S
Gastroesophageal reflux exam
0291
3.15
$156.22
$93.14
$31.2478264
S
Gastric emptying study
0292
4.36
$216.24
$126.63
$43.2578267
A
Breath tst attain/anal c-1478268
A
Breath test analysis, c-1478270
S
Vit B-12 absorption exam
0290
1.94
$96.21
$55.51
$19.2478271
S
Vit B-12 absorp exam, IF
0290
1.94
$96.21
$55.51
$19.2478272
S
Vit B-12 absorp, combined
0291
3.15
$156.22
$93.14
$31.2478278
S
Acute GI blood loss imaging
0292
4.36
$216.24
$126.63
$43.2578282
S
GI protein loss exam
0290
1.94
$96.21
$55.51
$19.2478290
S
Meckel's divert exam
0291
3.15
$156.22
$93.14
$31.2478291
S
Leveen/shunt patency exam
0292
4.36
$216.24
$126.63
$43.2578299
S
GI nuclear procedure
0290
1.94
$96.21
$55.51
$19.2478300
S
Bone imaging, limited area
0291
3.15
$156.22
$93.14
$31.24( print page 67918)78305
S
Bone imaging, multiple areas
0292
4.36
$216.24
$126.63
$43.2578306
S
Bone imaging, whole body
0292
4.36
$216.24
$126.63
$43.2578315
S
Bone imaging, 3 phase
0292
4.36
$216.24
$126.63
$43.2578320
S
Bone imaging (3D)
0292
4.36
$216.24
$126.63
$43.2578350
X
Bone mineral, single photon
0261
1.38
$68.44
$38.77
$13.6978351
E
Bone mineral, dual photon78399
S
Musculoskeletal nuclear exam
0290
1.94
$96.21
$55.51
$19.2478414
S
Non-imaging heart function
0292
4.36
$216.24
$126.63
$43.2578428
S
Cardiac shunt imaging
0292
4.36
$216.24
$126.63
$43.2578445
S
Vascular flow imaging
0291
3.15
$156.22
$93.14
$31.2478455
S
Venous thrombosis study
0291
3.15
$156.22
$93.14
$31.2478456
S
Acute venous thrombus image
0291
3.15
$156.22
$93.14
$31.2478457
S
Venous thrombosis imaging
0291
3.15
$156.22
$93.14
$31.2478458
S
Ven thrombosis images, bilat
0291
3.15
$156.22
$93.14
$31.2478459
E
Heart muscle imaging (PET)78460
S
Heart muscle blood, single
0286
7.28
$361.06
$200.04
$72.2178461
S
Heart muscle blood, multiple
0286
7.28
$361.06
$200.04
$72.2178464
S
Heart image (3d), single
0286
7.28
$361.06
$200.04
$72.2178465
S
Heart image (3d), multiple
0286
7.28
$361.06
$200.04
$72.2178466
S
Heart infarct image
0292
4.36
$216.24
$126.63
$43.2578468
S
Heart infarct image (ef)
0292
4.36
$216.24
$126.63
$43.2578469
S
Heart infarct image (3D)
0292
4.36
$216.24
$126.63
$43.2578472
S
Gated heart, planar, single
0286
7.28
$361.06
$200.04
$72.2178473
S
Gated heart, multiple
0286
7.28
$361.06
$200.04
$72.2178478
S
Heart wall motion add-on
0286
7.28
$361.06
$200.04
$72.2178480
S
Heart function add-on
0286
7.28
$361.06
$200.04
$72.2178481
S
Heart first pass, single
0286
7.28
$361.06
$200.04
$72.2178483
S
Heart first pass, multiple
0286
7.28
$361.06
$200.04
$72.2178491
E
Heart image (pet), single78492
E
Heart image (pet), multiple78494
S
Heart image, spect
0296
3.57
$177.06
$100.25
$35.4178496
S
Heart first pass add-on
0296
3.57
$177.06
$100.25
$35.4178499
S
Cardiovascular nuclear exam
0292
4.36
$216.24
$126.63
$43.2578580
S
Lung perfusion imaging
0291
3.15
$156.22
$93.14
$31.2478584
S
Lung V/Q image single breath
0292
4.36
$216.24
$126.63
$43.2578585
S
Lung V/Q imaging
0292
4.36
$216.24
$126.63
$43.2578586
S
Aerosol lung image, single
0292
4.36
$216.24
$126.63
$43.2578587
S
Aerosol lung image, multiple
0292
4.36
$216.24
$126.63
$43.2578588
S
Perfusion lung image
0292
4.36
$216.24
$126.63
$43.2578591
S
Vent image, 1 breath, 1 proj
0291
3.15
$156.22
$93.14
$31.2478593
S
Vent image, 1 proj, gas
0292
4.36
$216.24
$126.63
$43.2578594
S
Vent image, mult proj, gas
0292
4.36
$216.24
$126.63
$43.2578596
S
Lung differential function
0292
4.36
$216.24
$126.63
$43.2578599
S
Respiratory nuclear exam
0291
3.15
$156.22
$93.14
$31.2478600
S
Brain imaging, ltd static
0292
4.36
$216.24
$126.63
$43.2578601
S
Brain imaging, ltd w/ flow
0292
4.36
$216.24
$126.63
$43.2578605
S
Brain imaging, complete
0291
3.15
$156.22
$93.14
$31.2478606
S
Brain imaging, compl w/flow
0292
4.36
$216.24
$126.63
$43.2578607
S
Brain imaging (3D)
0292
4.36
$216.24
$126.63
$43.2578608
E
Brain imaging (PET)78609
E
Brain imaging (PET)78610
S
Brain flow imaging only
0291
3.15
$156.22
$93.14
$31.2478615
S
Cerebral blood flow imaging
0292
4.36
$216.24
$126.63
$43.2578630
S
Cerebrospinal fluid scan
0292
4.36
$216.24
$126.63
$43.2578635
S
CSF ventriculography
0292
4.36
$216.24
$126.63
$43.2578645
S
CSF shunt evaluation
0292
4.36
$216.24
$126.63
$43.2578647
S
Cerebrospinal fluid scan
0292
4.36
$216.24
$126.63
$43.2578650
S
CSF leakage imaging
0292
4.36
$216.24
$126.63
$43.2578660
S
Nuclear exam of tear flow
0291
3.15
$156.22
$93.14
$31.2478699
S
Nervous system nuclear exam
0292
4.36
$216.24
$126.63
$43.2578700
S
Kidney imaging, static
0291
3.15
$156.22
$93.14
$31.2478701
S
Kidney imaging with flow
0291
3.15
$156.22
$93.14
$31.2478704
S
Imaging renogram
0292
4.36
$216.24
$126.63
$43.2578707
S
Kidney flow/function image
0292
4.36
$216.24
$126.63
$43.2578708
S
Kidney flow/function image
0292
4.36
$216.24
$126.63
$43.2578709
S
Kidney flow/function image
0292
4.36
$216.24
$126.63
$43.2578710
S
Kidney imaging (3D)
0292
4.36
$216.24
$126.63
$43.2578715
S
Renal vascular flow exam
0291
3.15
$156.22
$93.14
$31.2478725
S
Kidney function study
0291
3.15
$156.22
$93.14
$31.2478730
S
Urinary bladder retention
0291
3.15
$156.22
$93.14
$31.2478740
S
Ureteral reflux study
0291
3.15
$156.22
$93.14
$31.2478760
S
Testicular imaging
0291
3.15
$156.22
$93.14
$31.2478761
S
Testicular imaging/flow
0291
3.15
$156.22
$93.14
$31.2478799
S
Genitourinary nuclear exam
0292
4.36
$216.24
$126.63
$43.25( print page 67919)78800
S
Tumor imaging, limited area
0292
4.36
$216.24
$126.63
$43.2578801
S
Tumor imaging, mult areas
0292
4.36
$216.24
$126.63
$43.2578802
S
Tumor imaging, whole body
0292
4.36
$216.24
$126.63
$43.2578803
S
Tumor imaging (3D)
0292
4.36
$216.24
$126.63
$43.2578805
S
Abscess imaging, ltd area
0292
4.36
$216.24
$126.63
$43.2578806
S
Abscess imaging, whole body
0292
4.36
$216.24
$126.63
$43.2578807
S
Nuclear localization/abscess
0292
4.36
$216.24
$126.63
$43.2578810
E
Tumor imaging (PET)78890
N
Nuclear medicine data proc78891
N
Nuclear med data proc78990
N
Provide diag radionuclide(s)78999
S
Nuclear diagnostic exam
0291
3.15
$156.22
$93.14
$31.2479000
S
Init hyperthyroid therapy
0294
5.13
$254.43
$144.06
$50.8979001
S
Repeat hyperthyroid therapy
0294
5.13
$254.43
$144.06
$50.8979020
S
Thyroid ablation
0294
5.13
$254.43
$144.06
$50.8979030
S
Thyroid ablation, carcinoma
0294
5.13
$254.43
$144.06
$50.8979035
S
Thyroid metastatic therapy
0294
5.13
$254.43
$144.06
$50.8979100
S
Hematopoetic nuclear therapy
0294
5.13
$254.43
$144.06
$50.8979200
S
Intracavitary nuclear trmt
0295
19.85
$984.48
$609.17
$196.9079300
S
Interstitial nuclear therapy
0294
5.13
$254.43
$144.06
$50.8979400
S
Nonhemato nuclear therapy
0295
19.85
$984.48
$609.17
$196.9079420
S
Intravascular nuclear ther
0295
19.85
$984.48
$609.17
$196.9079440
S
Nuclear joint therapy
0294
5.13
$254.43
$144.06
$50.8979900
N
Provide ther radiopharm(s)79999
S
Nuclear medicine therapy
0294
5.13
$254.43
$144.06
$50.8980048
A
Basic metabolic panel80050
A
General health panel80051
A
Electrolyte panel80053
A
Comprehen metabolic panel80055
A
Obstetric panel80061
A
Lipid panel80069
A
Renal function panel80072
A
Arthritis panel80074
A
Acute hepatitis panel80076
A
Hepatic function panel80090
A
Torch antibody panel80100
A
Drug screen80101
A
Drug screen80102
A
Drug confirmation80103
N
Drug analysis, tissue prep80150
A
Assay of amikacin80152
A
Assay of amitriptyline80154
A
Assay of benzodiazepines80156
A
Assay of carbamazepine*80157
A
Assay of carbamazepine, free80158
A
Assay of cyclosporine80160
A
Assay of desipramine80162
A
Assay of digoxin80164
A
Assay, dipropylacetic acid80166
A
Assay of doxepin80168
A
Assay of ethosuximide80170
A
Assay of gentamicin80172
A
Assay of gold*80173
A
Assay of haloperidol80174
A
Assay of imipramine80176
A
Assay of lidocaine80178
A
Assay of lithium80182
A
Assay of nortriptyline80184
A
Assay of phenobarbital80185
A
Assay of phenytoin, total80186
A
Assay of phenytoin, free80188
A
Assay of primidone80190
A
Assay of procainamide80192
A
Assay of procainamide80194
A
Assay of quinidine80196
A
Assay of salicylate80197
A
Assay of tacrolimus80198
A
Assay of theophylline80200
A
Assay of tobramycin80201
A
Assay of topiramate80202
A
Assay of vancomycin80299
A
Quantitative assay, drug80400
A
Acth stimulation panel80402
A
Acth stimulation panel( print page 67920)80406
A
Acth stimulation panel80408
A
Aldosterone suppression eval80410
A
Calcitonin stimul panel80412
A
CRH stimulation panel80414
A
Testosterone response80415
A
Estradiol response panel80416
A
Renin stimulation panel80417
A
Renin stimulation panel80418
A
Pituitary evaluation panel80420
A
Dexamethasone panel80422
A
Glucagon tolerance panel80424
A
Glucagon tolerance panel80426
A
Gonadotropin hormone panel80428
A
Growth hormone panel80430
A
Growth hormone panel80432
A
Insulin suppression panel80434
A
Insulin tolerance panel80435
A
Insulin tolerance panel80436
A
Metyrapone panel80438
A
TRH stimulation panel80439
A
TRH stimulation panel80440
A
TRH stimulation panel80500
X
Lab pathology consultation
0343
0.45
$22.32
$12.16
$4.4680502
X
Lab pathology consultation
0343
0.45
$22.32
$12.16
$4.4681000
A
Urinalysis, nonauto w/scope81001
A
Urinalysis, auto w/scope81002
A
Urinalysis nonauto w/o scope81003
A
Urinalysis, auto, w/o scope81005
A
Urinalysis81007
A
Urine screen for bacteria81015
A
Microscopic exam of urine81020
A
Urinalysis, glass test81025
A
Urine pregnancy test81050
A
Urinalysis, volume measure81099
X
Urinalysis test procedure
0349
0.48
$23.65
$4.73
$4.7382000
A
Assay of blood acetaldehyde82003
A
Assay of acetaminophen82009
A
Test for acetone/ketones82010
A
Acetone assay82013
A
Acetylcholinesterase assay82016
A
Acylcarnitines, qual82017
A
Acylcarnitines, quant82024
A
Assay of acth82030
A
Assay of adp & amp82040
A
Assay of serum albumin82042
A
Assay of urine albumin82043
A
Microalbumin, quantitative82044
A
Microalbumin, semiquant82055
A
Assay of ethanol82075
A
Assay of breath ethanol82085
A
Assay of aldolase82088
A
Assay of aldosterone82101
A
Assay of urine alkaloids82103
A
Alpha-1-antitrypsin, total82104
A
Alpha-1-antitrypsin, pheno82105
A
Alpha-fetoprotein, serum82106
A
Alpha-fetoprotein, amniotic82108
A
Assay of aluminum82120
A
Amines, vaginal fluid qual82127
A
Amino acid, single qual82128
A
Amino acids, mult qual82131
A
Amino acids, single quant82135
A
Assay, aminolevulinic acid82136
A
Amino acids, quant, 2-582139
A
Amino acids, quan, 6 or more82140
A
Assay of ammonia82143
A
Amniotic fluid scan82145
A
Assay of amphetamines82150
A
Assay of amylase82154
A
Androstanediol glucuronide82157
A
Assay of androstenedione82160
A
Assay of androsterone82163
A
Assay of angiotensin II82164
A
Angiotensin I enzyme test( print page 67921)82172
A
Assay of apolipoprotein82175
A
Assay of arsenic82180
A
Assay of ascorbic acid82190
A
Atomic absorption82205
A
Assay of barbiturates82232
A
Assay of beta-2 protein82239
A
Bile acids, total82240
A
Bile acids, cholylglycine82247
A
Bilirubin, total82248
A
Bilirubin, direct82251D
A
Assay of bilirubin82252
A
Fecal bilirubin test82261
A
Assay of biotinidase82270
A
Test for blood, feces82273
A
Test for blood, other source82286
A
Assay of bradykinin82300
A
Assay of cadmium82306
A
Assay of vitamin D82307
A
Assay of vitamin D82308
A
Assay of calcitonin82310
A
Assay of calcium82330
A
Assay of calcium82331
A
Calcium infusion test82340
A
Assay of calcium in urine82355
A
Calculus (stone) analysis82360
A
Calculus (stone) assay82365
A
Calculus (stone) assay82370
A
X-ray assay, calculus*82373
A
Carb deficient transferrin82374
A
Assay, blood carbon dioxide82375
A
Assay, blood carbon monoxide82376
A
Test for carbon monoxide82378
A
Carcinoembryonic antigen82379
A
Assay of carnitine82380
A
Assay of carotene82382
A
Assay, urine catecholamines82383
A
Assay, blood catecholamines82384
A
Assay, three catecholamines82387
A
Assay of cathepsin-d82390
A
Assay of ceruloplasmin82397
A
Chemiluminescent assay82415
A
Assay of chloramphenicol82435
A
Assay of blood chloride82436
A
Assay of urine chloride82438
A
Assay, other fluid chlorides82441
A
Test for chlorohydrocarbons82465
A
Assay of serum cholesterol82480
A
Assay, serum cholinesterase82482
A
Assay, rbc cholinesterase82485
A
Assay, chondroitin sulfate82486
A
Gas/liquid chromatography82487
A
Paper chromatography82488
A
Paper chromatography82489
A
Thin layer chromatography82491
A
Chromotography, quant, sing82492
A
Chromotography, quant, mult82495
A
Assay of chromium82507
A
Assay of citrate82520
A
Assay of cocaine82523
A
Collagen crosslinks82525
A
Assay of copper82528
A
Assay of corticosterone82530
A
Cortisol, free82533
A
Total cortisol82540
A
Assay of creatine82541
A
Column chromotography, qual82542
A
Column chromotography, quant82543
A
Column chromotograph/isotope82544
A
Column chromotograph/isotope82550
A
Assay of ck (cpk)82552
A
Assay of cpk in blood82553
A
Creatine, MB fraction82554
A
Creatine, isoforms82565
A
Assay of creatinine( print page 67922)82570
A
Assay of urine creatinine82575
A
Creatinine clearance test82585
A
Assay of cryofibrinogen82595
A
Assay of cryoglobulin82600
A
Assay of cyanide82607
A
Vitamin B-1282608
A
B-12 binding capacity82615
A
Test for urine cystines82626
A
Dehydroepiandrosterone82627
A
Dehydroepiandrosterone82633
A
Desoxycorticosterone82634
A
Deoxycortisol82638
A
Assay of dibucaine number82646
A
Assay of dihydrocodeinone82649
A
Assay of dihydromorphinone82651
A
Assay of dihydrotestosterone82652
A
Assay of dihydroxyvitamin d82654
A
Assay of dimethadione82657
A
Enzyme cell activity82658
A
Enzyme cell activity, ra82664
A
Electrophoretic test82666
A
Assay of epiandrosterone82668
A
Assay of erythropoietin82670
A
Assay of estradiol82671
A
Assay of estrogens82672
A
Assay of estrogen82677
A
Assay of estriol82679
A
Assay of estrone82690
A
Assay of ethchlorvynol82693
A
Assay of ethylene glycol82696
A
Assay of etiocholanolone82705
A
Fats/lipids, feces, qual82710
A
Fats/lipids, feces, quant82715
A
Assay of fecal fat82725
A
Assay of blood fatty acids82726
A
Long chain fatty acids82728
A
Assay of ferritin82731
A
Assay of fetal fibronectin82735
A
Assay of fluoride82742
A
Assay of flurazepam82746
A
Blood folic acid serum82747
A
Assay of folic acid, rbc82757
A
Assay of semen fructose82759
A
Assay of rbc galactokinase82760
A
Assay of galactose82775
A
Assay galactose transferase82776
A
Galactose transferase test82784
A
Assay of gammaglobulin igm82785
A
Assay of gammaglobulin ige82787
A
Igg 1, 2, 3 and 482800
A
Blood pH82803
A
Blood gases: pH, pO2 & pCO282805
A
Blood gases W/O2 saturation82810
A
Blood gases, O2 sat only82820
A
Hemoglobin-oxygen affinity82926
A
Assay of gastric acid82928
A
Assay of gastric acid82938
A
Gastrin test82941
A
Assay of gastrin82943
A
Assay of glucagon*82945
A
Glucose, body fluid other than blood82946
A
Glucagon tolerance test82947
A
Assay of glucose, quant82948
A
Reagent strip/blood glucose82950
A
Glucose test82951
A
Glucose tolerance test (GTT)82952
A
GTT-added samples82953
A
Glucose-tolbutamide test82955
A
Assay of g6pd enzyme82960
A
Test for G6PD enzyme82962
A
Glucose blood test82963
A
Assay of glucosidase82965
A
Assay of gdh enzyme82975
A
Assay of glutamine( print page 67923)82977
A
Assay of GGT82978
A
Assay of glutathione82979
A
Assay, rbc glutathione82980
A
Assay of glutethimide82985
A
Glycated protein83001
A
Gonadotropin (FSH)83002
A
Gonadotropin (LH)83003
A
Assay, growth hormone (hgh)83008
A
Assay of guanosine83010
A
Assay of haptoglobin, quant83012
A
Assay of haptoglobins83013
A
H pylori breath tst analysis83014
A
H pylori drug admin/collect83015
A
Heavy metal screen83018
A
Quantitative screen, metals83020
A
Hemoglobin electrophoresis83021
A
Hemoglobin chromotography83026
A
Hemoglobin, copper sulfate83030
A
Fetal hemoglobin assay83033
A
Fetal fecal hemoglobin assay83036
A
Glycated hemoglobin test83045
A
Blood methemoglobin test83050
A
Blood methemoglobin assay83051
A
Assay of plasma hemoglobin83055
A
Blood sulfhemoglobin test83060
A
Blood sulfhemoglobin assay83065
A
Assay of hemoglobin heat83068
A
Hemoglobin stability screen83069
A
Assay of urine hemoglobin83070
A
Assay of hemosiderin, qual83071
A
Assay of hemosiderin, quant83080
A
Assay of b hexosaminidase83088
A
Assay of histamine*83090
A
Homocystine83150
A
Assay of for hva83491
A
Assay of corticosteroids83497
A
Assay of 5-hiaa83498
A
Assay of progesterone83499
A
Assay of progesterone83500
A
Assay, free hydroxyproline83505
A
Assay, total hydroxyproline83516
A
Immunoassay, nonantibody83518
A
Immunoassay, dipstick83519
A
Immunoassay, nonantibody83520
A
Immunoassay, RIA83525
A
Assay of insulin83527
A
Assay of insulin83528
A
Assay of intrinsic factor83540
A
Assay of iron83550
A
Iron binding test83570
A
Assay of idh enzyme83582
A
Assay of ketogenic steroids83586
A
Assay 17- ketosteroids83593
A
Fractionation, ketosteroids83605
A
Assay of lactic acid83615
A
Lactate (LD) (LDH) enzyme83625
A
Assay of ldh enzymes83632
A
Placental lactogen83633
A
Test urine for lactose83634
A
Assay of urine for lactose83655
A
Assay of lead83661
A
Assay of l/s ratio83662
A
L/S ratio, foam stability*83663
A
Fetal lung maturity, fluor polar*83664
A
Fetal lung maturity, lam body dens83670
A
Assay of lap enzyme83690
A
Assay of lipase83715
A
Assay of blood lipoproteins83716
A
Assay of blood lipoproteins83718
A
Assay of lipoprotein83719
A
Assay of blood lipoprotein83721
A
Assay of blood lipoprotein83727
A
Assay of lrh hormone83735
A
Assay of magnesium( print page 67924)83775
A
Assay of md enzyme83785
A
Assay of manganese83788
A
Mass spectrometry qual83789
A
Mass spectrometry quant83805
A
Assay of meprobamate83825
A
Assay of mercury83835
A
Assay of metanephrines83840
A
Assay of methadone83857
A
Assay of methemalbumin83858
A
Assay of methsuximide83864
A
Mucopolysaccharides83866
A
Mucopolysaccharides screen83872
A
Assay synovial fluid mucin83873
A
Assay of csf protein83874
A
Assay of myoglobin83883
A
Assay, nephelometry not spec83885
A
Assay of nickel83887
A
Assay of nicotine83890
A
Molecule isolate83891
A
Molecule isolate nucleic83892
A
Molecular diagnostics83893
A
Molecule dot/slot/blot83894
A
Molecule gel electrophor83896
A
Molecular diagnostics83897
A
Molecule nucleic transfer83898
A
Molecule nucleic ampli83901
A
Molecule nucleic ampli83902
A
Molecular diagnostics83903
A
Molecule mutation scan83904
A
Molecule mutation identify83905
A
Molecule mutation identify83906
A
Molecule mutation identify83912
A
Genetic examination83915
A
Assay of nucleotidase83916
A
Oligoclonal bands83918
A
Assay, organic acids quant83919
A
Assay, organic acids qual*83921
A
Assay, organic acid, single, quant83925
A
Assay of opiates83930
A
Assay of blood osmolality83935
A
Assay of urine osmolality83937
A
Assay of osteocalcin83945
A
Assay of oxalate83970
A
Assay of parathormone83986
A
Assay of body fluid acidity83992
A
Assay for phencyclidine84022
A
Assay of phenothiazine84030
A
Assay of blood pku84035
A
Assay of phenylketones84060
A
Assay acid phosphatase84061
A
Phosphatase, forensic exam84066
A
Assay prostate phosphatase84075
A
Assay alkaline phosphatase84078
A
Assay alkaline phosphatase84080
A
Assay alkaline phosphatases84081
A
Amniotic fluid enzyme test84085
A
Assay of rbc pg6d enzyme84087
A
Assay phosphohexose enzymes84100
A
Assay of phosphorus84105
A
Assay of urine phosphorus84106
A
Test for porphobilinogen84110
A
Assay of porphobilinogen84119
A
Test urine for porphyrins84120
A
Assay of urine porphyrins84126
A
Assay of feces porphyrins84127
A
Assay of feces porphyrins84132
A
Assay of serum potassium84133
A
Assay of urine potassium84134
A
Assay of prealbumin84135
A
Assay of pregnanediol84138
A
Assay of pregnanetriol84140
A
Assay of pregnenolone84143
A
Assay of 17-hydroxypregneno84144
A
Assay of progesterone( print page 67925)84146
A
Assay of prolactin84150
A
Assay of prostaglandin*84152
A
PSA, complexed84153
A
Assay of psa, total84154
A
Assay of psa, free84155
A
Assay of protein84160
A
Assay of serum protein84165
A
Assay of serum proteins84181
A
Western blot test84182
A
Protein, western blot test84202
A
Assay RBC protoporphyrin84203
A
Test RBC protoporphyrin84206
A
Assay of proinsulin84207
A
Assay of vitamin b-684210
A
Assay of pyruvate84220
A
Assay of pyruvate kinase84228
A
Assay of quinine84233
A
Assay of estrogen84234
A
Assay of progesterone84235
A
Assay of endocrine hormone84238
A
Assay, nonendocrine receptor84244
A
Assay of renin84252
A
Assay of vitamin b-284255
A
Assay of selenium84260
A
Assay of serotonin84270
A
Assay of sex hormone globul84275
A
Assay of sialic acid84285
A
Assay of silica84295
A
Assay of serum sodium84300
A
Assay of urine sodium84305
A
Assay of somatomedin84307
A
Assay of somatostatin84311
A
Spectrophotometry84315
A
Body fluid specific gravity84375
A
Chromatogram assay, sugars84376
A
Sugars, single, qual84377
A
Sugars, multiple, qual84378
A
Sugars single quant84379
A
Sugars multiple quant84392
A
Assay of urine sulfate84402
A
Assay of testosterone84403
A
Assay of total testosterone84425
A
Assay of vitamin b-184430
A
Assay of thiocyanate84432
A
Assay of thyroglobulin84436
A
Assay of total thyroxine84437
A
Assay of neonatal thyroxine84439
A
Assay of free thyroxine84442
A
Assay of thyroid activity84443
A
Assay thyroid stim hormone84445
A
Assay of tsi84446
A
Assay of vitamin e84449
A
Assay of transcortin84450
A
Transferase (AST) (SGOT)84460
A
Alanine amino (ALT) (SGPT)84466
A
Assay of transferrin84478
A
Assay of triglycerides84479
A
Assay of thyroid (t3 or t4)84480
A
Assay, triiodothyronine (t3)84481
A
Free assay (FT-3)84482
A
T3 reverse84484
A
Assay of troponin, quant84485
A
Assay duodenal fluid trypsin84488
A
Test feces for trypsin84490
A
Assay of feces for trypsin84510
A
Assay of tyrosine84512
A
Assay of troponin, qual84520
A
Assay of urea nitrogen84525
A
Urea nitrogen semi-quant84540
A
Assay of urine/urea-n84545
A
Urea-N clearance test84550
A
Assay of blood/uric acid84560
A
Assay of urine/uric acid84577
A
Assay of feces/urobilinogen( print page 67926)84578
A
Test urine urobilinogen84580
A
Assay of urine urobilinogen84583
A
Assay of urine urobilinogen84585
A
Assay of urine vma84586
A
Assay of vip84588
A
Assay of vasopressin84590
A
Assay of vitamin a*84591
A
Vitamin, NOS84597
A
Assay of vitamin k84600
A
Assay of volatiles84620
A
Xylose tolerance test84630
A
Assay of zinc84681
A
Assay of c-peptide84702
A
Chorionic gonadotropin test84703
A
Chorionic gonadotropin assay84830
A
Ovulation tests84999
X
Clinical chemistry test
0349
0.48
$23.65
$4.73
$4.7385002
A
Bleeding time test85007
A
Differential WBC count85008
A
Nondifferential WBC count85009
A
Differential WBC count85013
A
Hematocrit85014
A
Hematocrit85018
A
Hemoglobin85021
A
Automated hemogram85022
A
Automated hemogram85023
A
Automated hemogram85024
A
Automated hemogram85025
A
Automated hemogram85027
A
Automated hemogram85031
A
Manual hemogram, cbc85041
A
Red blood cell (RBC) count85044
A
Reticulocyte count85045
A
Reticulocyte count85046
A
Reticyte/hgb concentrate85048
A
White blood cell (WBC) count85060
X
Blood smear interpretation
0342
0.26
$12.90
$8.03
$2.5885095
T
Bone marrow aspiration
0003
0.98
$48.61
$27.99
$9.7285097
X
Bone marrow interpretation
0344
0.79
$39.18
$23.63
$7.8485102
T
Bone marrow biopsy
0003
0.98
$48.61
$27.99
$9.7285130
A
Chromogenic substrate assay85170
A
Blood clot retraction85175
A
Blood clot lysis time85210
A
Blood clot factor II test85220
A
Blood clot factor V test85230
A
Blood clot factor VII test85240
A
Blood clot factor VIII test85244
A
Blood clot factor VIII test85245
A
Blood clot factor VIII test85246
A
Blood clot factor VIII test85247
A
Blood clot factor VIII test85250
A
Blood clot factor IX test85260
A
Blood clot factor X test85270
A
Blood clot factor XI test85280
A
Blood clot factor XII test85290
A
Blood clot factor XIII test85291
A
Blood clot factor XIII test85292
A
Blood clot factor assay85293
A
Blood clot factor assay85300
A
Antithrombin III test85301
A
Antithrombin III test85302
A
Blood clot inhibitor antigen85303
A
Blood clot inhibitor test85305
A
Blood clot inhibitor assay85306
A
Blood clot inhibitor test*85307
A
Activated protein C resistance85335
A
Factor inhibitor test85337
A
Thrombomodulin85345
A
Coagulation time85347
A
Coagulation time85348
A
Coagulation time85360
A
Euglobulin lysis85362
A
Fibrin degradation products85366
A
Fibrinogen test( print page 67927)85370
A
Fibrinogen test85378
A
Fibrin degradation85379
A
Fibrin degradation85384
A
Fibrinogen85385
A
Fibrinogen85390
A
Fibrinolysins screen85400
A
Fibrinolytic plasmin85410
A
Fibrinolytic antiplasmin85415
A
Fibrinolytic plasminogen85420
A
Fibrinolytic plasminogen85421
A
Fibrinolytic plasminogen85441
A
Heinz bodies, direct85445
A
Heinz bodies, induced85460
A
Hemoglobin, fetal85461
A
Hemoglobin, fetal85475
A
Hemolysin85520
A
Heparin assay85525
A
Heparin85530
A
Heparin-protamine tolerance85535
A
Iron stain, blood cells*85536
A
Iron stain, peripheral blood85540
A
Wbc alkaline phosphatase85547
A
RBC mechanical fragility85549
A
Muramidase85555
A
RBC osmotic fragility85557
A
RBC osmotic fragility85576
A
Blood platelet aggregation85585
A
Blood platelet estimation85590
A
Platelet count, manual85595
A
Platelet count, automated85597
A
Platelet neutralization85610
A
Prothrombin time85611
A
Prothrombin test85612
A
Viper venom prothrombin time85613
A
Russell viper venom, diluted85635
A
Reptilase test85651
A
Rbc sed rate, nonautomated85652
A
Rbc sed rate, automated85660
A
RBC sickle cell test85670
A
Thrombin time, plasma85675
A
Thrombin time, titer85705
A
Thromboplastin inhibition85730
A
Thromboplastin time, partial85732
A
Thromboplastin time, partial85810
A
Blood viscosity examination85999
X
Hematology procedure
0349
0.48
$23.65
$4.73
$4.7386000
A
Agglutinins, febrile*86001
A
Allergen specific IgE, quant/semiquant86003
A
Allergen specific IgE86005
A
Allergen specific IgE86021
A
WBC antibody identification86022
A
Platelet antibodies86023
A
Immunoglobulin assay86038
A
Antinuclear antibodies86039
A
Antinuclear antibodies (ANA)86060
A
Antistreptolysin o, titer86063
A
Antistreptolysin o, screen86077
X
Physician blood bank service
0343
0.45
$22.32
$12.16
$4.4686078
X
Physician blood bank service
0344
0.79
$39.18
$23.63
$7.8486079
X
Physician blood bank service
0344
0.79
$39.18
$23.63
$7.8486140
A
C-reactive protein*86146
A
Beta 2 glycoprotein I antibody86147
A
Cardiolipin antibody86148
A
Phospholipid antibody86155
A
Chemotaxis assay86156
A
Cold agglutinin, screen86157
A
Cold agglutinin, titer86160
A
Complement, antigen86161
A
Complement/function activity86162
A
Complement, total (CH50)86171
A
Complement fixation, each86185
A
Counterimmunoelectrophoresis86215
A
Deoxyribonuclease, antibody86225
A
DNA antibody( print page 67928)86226
A
DNA antibody, single strand86235
A
Nuclear antigen antibody86243
A
Fc receptor86255
A
Fluorescent antibody, screen86256
A
Fluorescent antibody, titer86277
A
Growth hormone antibody86280
A
Hemagglutination inhibition*86294
A
Tumor antigen, qual or semiquant*86300
A
Tumor antigen, quant; CA 15-3*86301
A
Tumor antigen, quant; CA 19-9*86304
A
Tumor antigen, quant; CA 12586308
A
Heterophile antibodies86309
A
Heterophile antibodies86310
A
Heterophile antibodies86316
A
Immunoassay, tumor antigen86317
A
Immunoassay,infectious agent86318
A
Immunoassay,infectious agent86320
A
Serum immunoelectrophoresis86325
A
Other immunoelectrophoresis86327
A
Immunoelectrophoresis assay86329
A
Immunodiffusion86331
A
Immunodiffusion ouchterlony86332
A
Immune complex assay86334
A
Immunofixation procedure86337
A
Insulin antibodies86340
A
Intrinsic factor antibody86341
A
Islet cell antibody86343
A
Leukocyte histamine release86344
A
Leukocyte phagocytosis86353
A
Lymphocyte transformation86359
A
T cells, total count86360
A
T cell, absolute count/ratio86361
A
T cell, absolute count86376
A
Microsomal antibody86378
A
Migration inhibitory factor86382
A
Neutralization test, viral86384
A
Nitroblue tetrazolium dye86403
A
Particle agglutination test86406
A
Particle agglutination test86430
A
Rheumatoid factor test86431
A
Rheumatoid factor, quant86485
X
Skin test, candida
0341
0.13
$6.44
$3.67
$1.2986490
X
Coccidioidomycosis skin test
0341
0.13
$6.44
$3.67
$1.2986510
X
Histoplasmosis skin test
0341
0.13
$6.44
$3.67
$1.2986580
X
TB intradermal test
0341
0.13
$6.44
$3.67
$1.2986585
X
TB tine test
0341
0.13
$6.44
$3.67
$1.2986586
X
Skin test, unlisted
0341
0.13
$6.44
$3.67
$1.2986590
A
Streptokinase, antibody86592
A
Blood serology, qualitative86593
A
Blood serology, quantitative86602
A
Antinomyces antibody86603
A
Adenovirus antibody86606
A
Aspergillus antibody86609
A
Bacterium antibody*86611
A
Bartonella antibody86612
A
Blastomyces antibody86615
A
Bordetella antibody86617
A
Lyme disease antibody86618
A
Lyme disease antibody86619
A
Borrelia antibody86622
A
Brucella antibody86625
A
Campylobacter antibody86628
A
Candida antibody86631
A
Chlamydia antibody86632
A
Chlamydia igm antibody86635
A
Coccidioides antibody86638
A
Q fever antibody86641
A
Cryptococcus antibody86644
A
CMV antibody86645
A
CMV antibody, IgM86648
A
Diphtheria antibody86651
A
Encephalitis antibody86652
A
Encephalitis antibody86653
A
Encephalitis antibody( print page 67929)86654
A
Encephalitis antibody86658
A
Enterovirus antibody86663
A
Epstein-barr antibody86664
A
Epstein-barr antibody86665
A
Epstein-barr antibody*86666
A
Erlichia antibody86668
A
Francisella tularensis86671
A
Fungus antibody86674
A
Giardia lamblia antibody86677
A
Helicobacter pylori86682
A
Helminth antibody*86683
A
Fecal hgb antibody86684
A
Hemophilus influenza86687
A
Htlv-i antibody86688
A
Htlv-ii antibody86689
A
HTLV/HIV confirmatory test86692
A
Hepatitis, delta agent*86696
A
Herpes simplex type 2 antibody86694
A
Herpes simplex test86695
A
Herpes simplex test86698
A
Histoplasma86701
A
HIV-186702
A
HIV-286703
A
HIV-1/HIV-2, single assay86704
A
Hep b core antibody, igg/igm86705
A
Hep b core antibody, igm86706
A
Hep b surface antibody86707
A
Hep be antibody86708
A
Hep a antibody, igg/igm86709
A
Hep a antibody, igm86710
A
Influenza virus antibody86713
A
Legionella antibody86717
A
Leishmania antibody86720
A
Leptospira antibody86723
A
Listeria monocytogenes ab86727
A
Lymph choriomeningitis ab86729
A
Lympho venereum antibody86732
A
Mucormycosis antibody86735
A
Mumps antibody86738
A
Mycoplasma antibody86741
A
Neisseria meningitidis86744
A
Nocardia antibody86747
A
Parvovirus antibody86750
A
Malaria antibody86753
A
Protozoa antibody nos86756
A
Respiratory virus antibody*86757
A
Rickettsia antibody86759
A
Rotavirus antibody86762
A
Rubella antibody86765
A
Rubeola antibody86768
A
Salmonella antibody86771
A
Shigella antibody86774
A
Tetanus antibody86777
A
Toxoplasma antibody86778
A
Toxoplasma antibody, igm86781
A
Treponema pallidum, confirm86784
A
Trichinella antibody86787
A
Varicella-zoster antibody86790
A
Virus antibody nos86793
A
Yersinia antibody86800
A
Thyroglobulin antibody86803
A
Hepatitis c ab test86804
A
Hep c ab test, confirm86805
A
Lymphocytotoxicity assay86806
A
Lymphocytotoxicity assay86807
A
Cytotoxic antibody screening86808
A
Cytotoxic antibody screening86812
A
HLA typing, A, B, or C86813
A
HLA typing, A, B, or C86816
A
HLA typing, DR/DQ86817
A
HLA typing, DR/DQ86821
A
Lymphocyte culture, mixed86822
A
Lymphocyte culture, primed86849
X
Immunology procedure
0349
0.48
$23.65
$4.73
$4.73( print page 67930)86850
X
RBC antibody screen
0346
0.51
$25.49
$12.03
$5.1086860
X
RBC antibody elution
0345
0.22
$10.92
$5.37
$2.1886870
X
RBC antibody identification
0347
0.84
$41.90
$20.13
$8.3886880
A
Coombs test86885
A
Coombs test86886
A
Coombs test86890
X
Autologous blood process
0347
0.84
$41.90
$20.13
$8.3886891
X
Autologous blood, op salvage
0345
0.22
$10.92
$5.37
$2.1886900
A
Blood typing, ABO86901
X
Blood typing, Rh (D)
0345
0.22
$10.92
$5.37
$2.1886903
A
Blood typing, antigen screen86904
A
Blood typing, patient serum86905
A
Blood typing, RBC antigens86906
A
Blood typing, Rh phenotype86910
E
Blood typing, paternity test86911
E
Blood typing, antigen system86915
X
Bone marrow/stem cell prep
0347
0.84
$41.90
$20.13
$8.3886920
X
Compatibility test
0346
0.51
$25.49
$12.03
$5.1086921
X
Compatibility test
0346
0.51
$25.49
$12.03
$5.1086922
X
Compatibility test
0346
0.51
$25.49
$12.03
$5.1086927
X
Plasma, fresh frozen
0347
0.84
$41.90
$20.13
$8.3886930
X
Frozen blood prep
0347
0.84
$41.90
$20.13
$8.3886931
X
Frozen blood thaw
0347
0.84
$41.90
$20.13
$8.3886932
X
Frozen blood freeze/thaw
0347
0.84
$41.90
$20.13
$8.3886940
A
Hemolysins/agglutinins, auto86941
A
Hemolysins/agglutinins86945
X
Blood product/irradiation
0346
0.51
$25.49
$12.03
$5.1086950
X
Leukacyte transfusion
0347
0.84
$41.90
$20.13
$8.3886965
X
Pooling blood platelets
0346
0.51
$25.49
$12.03
$5.1086970
X
RBC pretreatment
0345
0.22
$10.92
$5.37
$2.1886971
X
RBC pretreatment
0346
0.51
$25.49
$12.03
$5.1086972
X
RBC pretreatment
0345
0.22
$10.92
$5.37
$2.1886975
X
RBC pretreatment, serum
0346
0.51
$25.49
$12.03
$5.1086976
X
RBC pretreatment, serum
0347
0.84
$41.90
$20.13
$8.3886977
X
RBC pretreatment, serum
0346
0.51
$25.49
$12.03
$5.1086978
X
RBC pretreatment, serum
0345
0.22
$10.92
$5.37
$2.1886985
X
Split blood or products
0347
0.84
$41.90
$20.13
$8.3886999
X
Transfusion procedure
0346
0.51
$25.49
$12.03
$5.1087001
A
Small animal inoculation87003
A
Small animal inoculation87015
A
Specimen concentration87040
A
Blood culture for bacteria87045
A
Stool culture for bacteria*87046
A
Stool culture for bacteria87060D
A
Nose/throat culture, bact87070
A
Culture specimen, bacteria*87071
A
Culture specimen, bacteria87072D
A
Culture of specimen by kit*87073
A
Culture specimen, bacteria87075
A
Culture specimen, bacteria87076
A
Bacteria identification*87077
A
Culture specimen, bacteria87081
A
Bacteria culture screen87082
A
Culture of specimen by kit87083D
A
Culture of specimen by kit87084
A
Culture of specimen by kit87085D
A
Culture of specimen by kit87086
A
Urine culture/colony count87087D
A
Urine bacteria culture87088
A
Urine bacteria culture87101
A
Skin fungus culture87102
A
Fungus isolation culture87103
A
Blood fungus culture87106
A
Fungus identification*87107
A
Culture specimen, fungi87109
A
Mycoplasma culture87110
A
Culture, chlamydia87116
A
Mycobacteria culture87117D
A
Mycobacteria culture87118
A
Mycobacteria identification87140
A
Culture typing, fluorescent87143
A
Culture typing, GLC method87145D
A
Culture typing, phage method87147
A
Culture typing, serologic( print page 67931)*87149
A
Culture typing87151D
A
Culture typing, serologic*87152
A
Culture typing87155D
A
Culture typing, precipitin87158
A
Culture typing, added method87163D
A
Special microbiology culture87164
A
Dark field examination87166
A
Dark field examination*87168
A
Macroscopic exam, arthropod*87169
A
Macroscopic exam, arthropod*87172
A
Pinworm exam87174D
A
Endotoxin, bacterial87175D
A
Assay, endotoxin, bacterial87176
A
Endotoxin, bacterial87177
A
Ova and parasites smears87181
A
Antibiotic sensitivity, each87184
A
Antibiotic sensitivity, each*87185
A
Susceptibility study87186
A
Antibiotic sensitivity, MIC87187
A
Antibiotic sensitivity, MBC87188
A
Antibiotic sensitivity, each87190
A
TB antibiotic sensitivity87192D
A
Antibiotic sensitivity, each87197
A
Bactericidal level, serum87205
A
Smear, stain & interpret87206
A
Smear, stain & interpret87207
A
Smear, stain & interpret87208D
A
Smear, stain & interpret87210
A
Smear, stain & interpret87211D
A
Smear, stain & interpret87220
A
Tissue exam for fungi87230
A
Assay, toxin or antitoxin87250
A
Virus inoculation for test87252
A
Virus inoculation for test87253
A
Virus inoculation for test*87254
A
Virus isolation87260
A
Adenovirus ag, dfa87265
A
Pertussis ag, dfa87270
A
Chylmd trach ag, dfa87272
A
Cryptosporidum ag, dfa*87273
A
Identify infectious agent87274
A
Herpes simplex ag, dfa*87275
A
Identify infectious agent87276
A
Influenza ag, dfa*87277
A
Identify infectious agent87278
A
Legion pneumo ag, dfa*87279
A
Identify infectious agent87280
A
Resp syncytial ag, dfa*87281
A
Identify infectious agent*87283
A
Identify infectious agent87285
A
Trepon pallidum ag, dfa87290
A
Varicella ag, dfa87299
A
Ag detection nos, dfa*87300
A
Identify infectious agent87301
A
Adenovirus ag, eia87320
A
Chylmd trach ag, eia87324
A
Clostridium ag, eia*87327
A
Identify infectious agent87328
A
Cryptospor ag, eia87332
A
Cytomegalovirus ag, eia87335
A
E coli 0157 ag, eia*87336
A
Identify infectious agent*87337
A
Identify infectious agent87338
A
Hpylori, stool, eia*87339
A
Identify infectious agent87340
A
Hepatitis b surface ag, eia*87341
A
Identify infectious agent87350
A
Hepatitis be ag, eia87380
A
Hepatitis delta ag, eia87385
A
Histoplasma capsul ag, eia87390
A
Hiv-1 ag, eia87391
A
Hiv-2 ag, eia*87400
A
Identify infectious agent87420
A
Resp syncytial ag, eia( print page 67932)87425
A
Rotavirus ag, eia*87427
A
Identify infectious agent87430
A
Strep a ag, eia87449
A
Ag detect nos, eia, mult87450
A
Ag detect nos, eia, single*87451
A
Identify infectious agent87470
A
Bartonella, dna, dir probe87471
A
Bartonella, dna, amp probe87472
A
Bartonella, dna, quant87475
A
Lyme dis, dna, dir probe87476
A
Lyme dis, dna, amp probe87477
A
Lyme dis, dna, quant87480
A
Candida, dna, dir probe87481
A
Candida, dna, amp probe87482
A
Candida, dna, quant87485
A
Chylmd pneum, dna, dir probe87486
A
Chylmd pneum, dna, amp probe87487
A
Chylmd pneum, dna, quant87490
A
Chylmd trach, dna, dir probe87491
A
Chylmd trach, dna, amp probe87492
A
Chylmd trach, dna, quant87495
A
Cytomeg, dna, dir probe87496
A
Cytomeg, dna, amp probe87497
A
Cytomeg, dna, quant87510
A
Gardner vag, dna, dir probe87511
A
Gardner vag, dna, amp probe87512
A
Gardner vag, dna, quant87515
A
Hepatitis b, dna, dir probe87516
A
Hepatitis b , dna, amp probe87517
A
Hepatitis b , dna, quant87520
A
Hepatitis c , rna, dir probe87521
A
Hepatitis c , rna, amp probe87522
A
Hepatitis c, rna, quant87525
A
Hepatitis g , dna, dir probe87526
A
Hepatitis g, dna, amp probe87527
A
Hepatitis g, dna, quant87528
A
Hsv, dna, dir probe87529
A
Hsv, dna, amp probe87530
A
Hsv, dna, quant87531
A
Hhv-6, dna, dir probe87532
A
Hhv-6, dna, amp probe87533
A
Hhv-6, dna, quant87534
A
Hiv-1, dna, dir probe87535
A
Hiv-1, dna, amp probe87536
A
Hiv-1, dna, quant87537
A
Hiv-2, dna, dir probe87538
A
Hiv-2, dna, amp probe87539
A
Hiv-2, dna, quant87540
A
Legion pneumo, dna, dir prob87541
A
Legion pneumo, dna, amp prob87542
A
Legion pneumo, dna, quant87550
A
Mycobacteria, dna, dir probe87551
A
Mycobacteria, dna, amp probe87552
A
Mycobacteria, dna, quant87555
A
M.tuberculo, dna, dir probe87556
A
M.tuberculo, dna, amp probe87557
A
M.tuberculo, dna, quant87560
A
M.avium-intra, dna, dir prob87561
A
M.avium-intra, dna, amp prob87562
A
M.avium-intra, dna, quant87580
A
M.pneumon, dna, dir probe87581
A
M.pneumon, dna, amp probe87582
A
M.pneumon, dna, quant87590
A
N.gonorrhoeae, dna, dir prob87591
A
N.gonorrhoeae, dna, amp prob87592
A
N.gonorrhoeae, dna, quant87620
A
Hpv, dna, dir probe87621
A
Hpv, dna, amp probe87622
A
Hpv, dna, quant87650
A
Strep a, dna, dir probe87651
A
Strep a, dna, amp probe87652
A
Strep a, dna, quant87797
A
Detect agent nos, dna, dir87798
A
Detect agent nos, dna, amp( print page 67933)87799
A
Detect agent nos, dna, quant*87800
A
Identify infectious agent*87801
A
Identify infectious agent87810
A
Chylmd trach assay w/optic87850
A
N. gonorrhoeae assay w/optic87880
A
Strep a assay w/optic87899
A
Agent nos assay w/optic*87901
A
Infectious agent genotype*87903
A
Infectious agent phenotype*87904
A
Infectious agent phenotype87999
X
Microbiology procedure
0349
0.48
$23.65
$4.73
$4.7388000
E
Autopsy (necropsy), gross88005
E
Autopsy (necropsy), gross88007
E
Autopsy (necropsy), gross88012
E
Autopsy (necropsy), gross88014
E
Autopsy (necropsy), gross88016
E
Autopsy (necropsy), gross88020
E
Autopsy (necropsy), complete88025
E
Autopsy (necropsy), complete88027
E
Autopsy (necropsy), complete88028
E
Autopsy (necropsy), complete88029
E
Autopsy (necropsy), complete88036
E
Limited autopsy88037
E
Limited autopsy88040
E
Forensic autopsy (necropsy)88045
E
Coroner's autopsy (necropsy)88099
E
Necropsy (autopsy) procedure88104
X
Cytopathology, fluids
0343
0.45
$22.32
$12.16
$4.4688106
X
Cytopathology, fluids
0343
0.45
$22.32
$12.16
$4.4688107
X
Cytopathology, fluids
0343
0.45
$22.32
$12.16
$4.4688108
X
Cytopath, concentrate tech
0343
0.45
$22.32
$12.16
$4.4688125
X
Forensic cytopathology
0343
0.45
$22.32
$12.16
$4.4688130
A
Sex chromatin identification88140
A
Sex chromatin identification88141
N
Cytopath, c/v, interpret88142
A
Cytopath, c/v, thin layer88143
A
Cytopath c/v thin layer redo88144
A
Cytopath, c/v thin lyr redo88145
A
Cytopath, c/v thin lyr sel88147
A
Cytopath, c/v, automated88148
A
Cytopath, c/v, auto rescreen88150
A
Cytopath, c/v, manual88152
A
Cytopath, c/v, auto redo88153
A
Cytopath, c/v, redo88154
A
Cytopath, c/v, select88155
A
Cytopath, c/v, index add-on88160
X
Cytopath smear, other source
0342
0.26
$12.90
$8.03
$2.5888161
X
Cytopath smear, other source
0343
0.45
$22.32
$12.16
$4.4688162
X
Cytopath smear, other source
0343
0.45
$22.32
$12.16
$4.4688164
A
Cytopath tbs, c/v, manual88165
A
Cytopath tbs, c/v, redo88166
A
Cytopath tbs, c/v, auto redo88167
A
Cytopath tbs, c/v, select88170
T
Fine needle aspiration
0002
0.62
$30.75
$17.66
$6.1588171
T
Fine needle aspiration
0002
0.62
$30.75
$17.66
$6.1588172
X
Evaluation of smear
0343
0.45
$22.32
$12.16
$4.4688173
X
Interpretation of smear
0343
0.45
$22.32
$12.16
$4.4688180
X
Cell marker study
0344
0.79
$39.18
$23.63
$7.8488182
X
Cell marker study
0344
0.79
$39.18
$23.63
$7.8488199
X
Cytopathology procedure
0349
0.48
$23.65
$4.73
$4.7388230
A
Tissue culture, lymphocyte88233
A
Tissue culture, skin/biopsy88235
A
Tissue culture, placenta88237
A
Tissue culture, bone marrow88239
A
Tissue culture, tumor88240
A
Cell cryopreserve/storage88241
A
Frozen cell preparation88245
A
Chromosome analysis, 20-2588248
A
Chromosome analysis, 50-10088249
A
Chromosome analysis, 10088261
A
Chromosome analysis, 588262
A
Chromosome analysis, 15-2088263
A
Chromosome analysis, 4588264
A
Chromosome analysis, 20-25( print page 67934)88267
A
Chromosome analys, placenta88269
A
Chromosome analys, amniotic88271
A
Cytogenetics, dna probe88272
A
Cytogenetics, 3-588273
A
Cytogenetics, 10-3088274
A
Cytogenetics, 25-9988275
A
Cytogenetics, 100-30088280
A
Chromosome karyotype study88283
A
Chromosome banding study88285
A
Chromosome count, additional88289
A
Chromosome study, additional88291
A
Cyto/molecular report88299
X
Cytogenetic study
0342
0.26
$12.90
$8.03
$2.5888300
X
Surgical path, gross
0342
0.26
$12.90
$8.03
$2.5888302
X
Tissue exam by pathologist
0342
0.26
$12.90
$8.03
$2.5888304
X
Tissue exam by pathologist
0343
0.45
$22.32
$12.16
$4.4688305
X
Tissue exam by pathologist
0343
0.45
$22.32
$12.16
$4.4688307
X
Tissue exam by pathologist
0344
0.79
$39.18
$23.63
$7.8488309
X
Tissue exam by pathologist
0344
0.79
$39.18
$23.63
$7.8488311
X
Decalcify tissue
0342
0.26
$12.90
$8.03
$2.5888312
X
Special stains
0343
0.45
$22.32
$12.16
$4.4688313
X
Special stains
0342
0.26
$12.90
$8.03
$2.5888314
X
Histochemical stain
0343
0.45
$22.32
$12.16
$4.4688318
X
Chemical histochemistry
0343
0.45
$22.32
$12.16
$4.4688319
X
Enzyme histochemistry
0342
0.26
$12.90
$8.03
$2.5888321
X
Microslide consultation
0342
0.26
$12.90
$8.03
$2.5888323
X
Microslide consultation
0343
0.45
$22.32
$12.16
$4.4688325
X
Comprehensive review of data
0343
0.45
$22.32
$12.16
$4.4688329
X
Pathology consult in surgery
0343
0.45
$22.32
$12.16
$4.4688331
X
Pathology consult in surgery
0343
0.45
$22.32
$12.16
$4.4688332
X
Pathology consult in surgery
0343
0.45
$22.32
$12.16
$4.4688342
X
Immunocytochemistry
0344
0.79
$39.18
$23.63
$7.8488346
X
Immunofluorescent study
0343
0.45
$22.32
$12.16
$4.4688347
X
Immunofluorescent study
0344
0.79
$39.18
$23.63
$7.8488348
X
Electron microscopy
0344
0.79
$39.18
$23.63
$7.8488349
X
Scanning electron microscopy
0344
0.79
$39.18
$23.63
$7.8488355
X
Analysis, skeletal muscle
0344
0.79
$39.18
$23.63
$7.8488356
X
Analysis, nerve
0344
0.79
$39.18
$23.63
$7.8488358
X
Analysis, tumor
0344
0.79
$39.18
$23.63
$7.8488362
X
Nerve teasing preparations
0343
0.45
$22.32
$12.16
$4.4688365
X
Tissue hybridization
0344
0.79
$39.18
$23.63
$7.8488371
A
Protein, western blot tissue88372
A
Protein analysis w/probe88399
X
Surgical pathology procedure
0349
0.48
$23.65
$4.73
$4.73*88400
A
Bilirubin total, trascutaneous89050
A
Body fluid cell count89051
A
Body fluid cell count89060
A
Exam,synovial fluid crystals89100
X
Sample intestinal contents
0361
3.53
$175.07
$88.09
$35.0189105
X
Sample intestinal contents
0360
1.38
$68.44
$34.75
$13.6989125
A
Specimen fat stain89130
X
Sample stomach contents
0360
1.38
$68.44
$34.75
$13.6989132
X
Sample stomach contents
0360
1.38
$68.44
$34.75
$13.6989135
X
Sample stomach contents
0360
1.38
$68.44
$34.75
$13.6989136
X
Sample stomach contents
0360
1.38
$68.44
$34.75
$13.6989140
X
Sample stomach contents
0360
1.38
$68.44
$34.75
$13.6989141
X
Sample stomach contents
0361
3.53
$175.07
$88.09
$35.0189160
A
Exam feces for meat fibers89190
A
Nasal smear for eosinophils89250
X
Fertilization of oocyte
0348
0.52
$25.57
$5.11
$5.1189251
X
Culture oocyte w/embryos
0348
0.52
$25.57
$5.11
$5.1189252
X
Assist oocyte fertilization
0348
0.52
$25.57
$5.11
$5.1189253
X
Embryo hatching
0348
0.52
$25.57
$5.11
$5.1189254
X
Oocyte identification
0348
0.52
$25.57
$5.11
$5.1189255
X
Prepare embryo for transfer
0348
0.52
$25.57
$5.11
$5.1189256
X
Prepare cryopreserved embryo
0348
0.52
$25.57
$5.11
$5.1189257
X
Sperm identification
0348
0.52
$25.57
$5.11
$5.1189258
X
Cryopreservation, embryo
0348
0.52
$25.57
$5.11
$5.1189259
X
Cryopreservation, sperm
0348
0.52
$25.57
$5.11
$5.1189260
X
Sperm isolation, simple
0348
0.52
$25.57
$5.11
$5.1189261
X
Sperm isolation, complex
0348
0.52
$25.57
$5.11
$5.1189264
X
Identify sperm tissue
0348
0.52
$25.57
$5.11
$5.1189300
A
Semen analysis89310
A
Semen analysis( print page 67935)89320
A
Semen analysis*89321
A
Semen analysis89325
A
Sperm antibody test89329
A
Sperm evaluation test89330
A
Evaluation, cervical mucus89350
X
Sputum specimen collection
0344
0.79
$39.18
$23.63
$7.8489355
A
Exam feces for starch89360
X
Collect sweat for test
0344
0.79
$39.18
$23.63
$7.8489365
A
Water load test89399
X
Pathology lab procedure
0349
0.48
$23.65
$4.73
$4.7390281
E
Human ig, im90283
E
Human ig, iv90287
E
Botulinum antitoxin90288
E
Botulism ig, iv90291
E
Cmv ig, iv90296
K
Diphtheria antitoxin
0356
0.36
$17.86
$4.82
$3.5790371
K
Hep b ig, im
0356
0.36
$17.86
$4.82
$3.5790375
K
Rabies ig, im/sc
0356
0.36
$17.86
$4.82
$3.5790376
K
Rabies ig, heat treated
0356
0.36
$17.86
$4.82
$3.5790378
K
Rsv ig, im
0356
0.36
$17.86
$4.82
$3.5790379
K
Rsv ig, iv
0356
0.36
$17.86
$4.82
$3.5790384
E
Rh ig, full-dose, im90385
K
Rh ig, minidose, im
0356
0.36
$17.86
$4.82
$3.5790386
E
Rh ig, iv90389
K
Tetanus ig, im
0356
0.36
$17.86
$4.82
$3.5790393
K
Vaccina ig, im
0356
0.36
$17.86
$4.82
$3.5790396
K
Varicella-zoster ig, im
0356
0.36
$17.86
$4.82
$3.5790399
E
Immune globulin90471
N
Immunization admin90472
N
Immunization admin, each add90476
K
Adenovirus vaccine, type 4
0356
0.36
$17.86
$4.82
$3.5790477
K
Adenovirus vaccine, type 7
0356
0.36
$17.86
$4.82
$3.5790581
K
Anthrax vaccine, sc
0356
0.36
$17.86
$4.82
$3.5790585
K
Bcg vaccine, percut
0356
0.36
$17.86
$4.82
$3.5790586
K
Bcg vaccine, intravesical
0356
0.36
$17.86
$4.82
$3.5790632
K
Hep a vaccine, adult im
0356
0.36
$17.86
$4.82
$3.5790633
K
Hep a vacc, ped/adol, 2 dose
0356
0.36
$17.86
$4.82
$3.5790634
K
Hep a vacc, ped/adol, 3 dose
0356
0.36
$17.86
$4.82
$3.5790636
K
Hep a/hep b vacc, adult im
0356
0.36
$17.86
$4.82
$3.5790645
K
Hib vaccine, hboc, im
0355
0.19
$9.42
$5.05
$1.8890646
K
Hib vaccine, prp-d, im
0355
0.19
$9.42
$5.05
$1.8890647
K
Hib vaccine, prp-omp, im
0355
0.19
$9.42
$5.05
$1.8890648
K
Hib vaccine, prp-t, im
0355
0.19
$9.42
$5.05
$1.8890657
K
Flu vaccine, 6-35 mo, im
0354
0.13
$6.3390658
K
Flu vaccine, 3 yrs, im
0354
0.13
$6.3390659
K
Flu vaccine, whole, im
0354
0.13
$6.3390660
K
Flu vaccine, nasal
0354
0.13
$6.3390665
K
Lyme disease vaccine, im
0356
0.36
$17.86
$4.82
$3.5790669
K
Pneumococcal vaccine, ped
0356
0.36
$17.86
$4.82
$3.5790675
K
Rabies vaccine, im
0356
0.36
$17.86
$4.82
$3.5790676
K
Rabies vaccine, id
0356
0.36
$17.86
$4.82
$3.5790680
K
Rotovirus vaccine, oral
0356
0.36
$17.86
$4.82
$3.5790690
K
Typhoid vaccine, oral
0356
0.36
$17.86
$4.82
$3.5790691
K
Typhoid vaccine, im
0356
0.36
$17.86
$4.82
$3.5790692
K
Typhoid vaccine, h-p, sc/id
0356
0.36
$17.86
$4.82
$3.5790693
K
Typhoid vaccine, akd, sc
0356
0.36
$17.86
$4.82
$3.5790700
K
Dtap vaccine, im
0355
0.19
$9.42
$5.05
$1.8890701
K
Dtp vaccine, im
0356
0.36
$17.86
$4.82
$3.5790702
K
Dt vaccine, im
0355
0.19
$9.42
$5.05
$1.8890703
K
Tetanus vaccine, im
0356
0.36
$17.86
$4.82
$3.5790704
K
Mumps vaccine, sc
0355
0.19
$9.42
$5.05
$1.8890705
K
Measles vaccine, sc
0356
0.36
$17.86
$4.82
$3.5790706
K
Rubella vaccine, sc
0356
0.36
$17.86
$4.82
$3.5790707
K
Mmr vaccine, sc
0356
0.36
$17.86
$4.82
$3.5790708
K
Measles-rubella vaccine, sc
0356
0.36
$17.86
$4.82
$3.5790709
K
Rubella & mumps vaccine, sc
0356
0.36
$17.86
$4.82
$3.5790710
K
Mmrv vaccine, sc
0356
0.36
$17.86
$4.82
$3.5790712
K
Oral poliovirus vaccine
0356
0.36
$17.86
$4.82
$3.5790713
K
Poliovirus, ipv, sc
0355
0.19
$9.42
$5.05
$1.8890716
K
Chicken pox vaccine, sc
0355
0.19
$9.42
$5.05
$1.8890717
K
Yellow fever vaccine, sc
0356
0.36
$17.86
$4.82
$3.5790718
K
Td vaccine, im
0356
0.36
$17.86
$4.82
$3.5790719
K
Diphtheria vaccine, im
0356
0.36
$17.86
$4.82
$3.5790720
K
Dtp/hib vaccine, im
0355
0.19
$9.42
$5.05
$1.88( print page 67936)90721
K
Dtap/hib vaccine, im
0355
0.19
$9.42
$5.05
$1.88*90723
K
DTAP-HepB-IPV vaccine
0356
0.36
$17.86
$4.82
$3.5790725
K
Cholera vaccine, injectable
0356
0.36
$17.86
$4.82
$3.5790727
K
Plague vaccine, im
0355
0.19
$9.42
$5.05
$1.8890732
K
Pneumococcal vaccine, adult
0354
0.13
$6.3390733
K
Meningococcal vaccine, sc
0356
0.36
$17.86
$4.82
$3.5790735
K
Encephalitis vaccine, sc
0356
0.36
$17.86
$4.82
$3.57*90740
K
Hep B vaccine, 3 dose sched
0356
0.36
$17.86
$4.82
$3.57*90743
K
Hep B vaccine, 2 dose sched
0356
0.36
$17.86
$4.82
$3.5790744
K
Hep b vaccine, ped/adol, im
0356
0.36
$17.86
$4.82
$3.5790746
K
Hep b vaccine, adult, im
0356
0.36
$17.86
$4.82
$3.5790747
K
Hep b vaccine, ill pat, im
0356
0.36
$17.86
$4.82
$3.5790748
K
Hep b/hib vaccine, im
0356
0.36
$17.86
$4.82
$3.5790749
K
Vaccine toxoid
0355
0.19
$9.42
$5.05
$1.8890780
E
IV infusion therapy, 1 hour90781
E
IV infusion, additional hour90782
X
Injection, sc/im
0359
0.96
$47.61
$9.52
$9.5290783
X
Injection, ia
0359
0.96
$47.61
$9.52
$9.5290784
X
Injection, iv
0359
0.96
$47.61
$9.52
$9.5290788
X
Injection of antibiotic
0359
0.96
$47.61
$9.52
$9.5290799
X
Ther/prophylactic/dx inject
0359
0.96
$47.61
$9.52
$9.5290801
S
Psy dx interview
0323
1.85
$91.75
$22.48
$18.3590802
S
Intac psy dx interview
0323
1.85
$91.75
$22.48
$18.3590804
S
Psytx, office, 20-30 min
0322
1.32
$65.46
$14.22
$13.0990805
S
Psytx, off, 20-30 min w/e&m
0322
1.32
$65.46
$14.22
$13.0990806
S
Psytx, off, 45-50 min
0323
1.85
$91.75
$22.48
$18.3590807
S
Psytx, off, 45-50 min w/e&m
0323
1.85
$91.75
$22.48
$18.3590808
S
Psytx, office, 75-80 min
0323
1.85
$91.75
$22.48
$18.3590809
S
Psytx, off, 75-80, w/e&m
0323
1.85
$91.75
$22.48
$18.3590810
S
Intac psytx, off, 20-30 min
0322
1.32
$65.46
$14.22
$13.0990811
S
Intac psytx, 20-30, w/e&m
0322
1.32
$65.46
$14.22
$13.0990812
S
Intac psytx, off, 45-50 min
0323
1.85
$91.75
$22.48
$18.3590813
S
Intac psytx, 45-50 min w/e&m
0323
1.85
$91.75
$22.48
$18.3590814
S
Intac psytx, off, 75-80 min
0323
1.85
$91.75
$22.48
$18.3590815
S
Intac psytx, 75-80 w/e&m
0323
1.85
$91.75
$22.48
$18.3590816
S
Psytx, hosp, 20-30 min
0322
1.32
$65.46
$14.22
$13.0990817
S
Psytx, hosp, 20-30 min w/e&m
0322
1.32
$65.46
$14.22
$13.0990818
S
Psytx, hosp, 45-50 min
0323
1.85
$91.75
$22.48
$18.3590819
S
Psytx, hosp, 45-50 min w/e&m
0323
1.85
$91.75
$22.48
$18.3590821
S
Psytx, hosp, 75-80 min
0323
1.85
$91.75
$22.48
$18.3590822
S
Psytx, hosp, 75-80 min w/e&m
0323
1.85
$91.75
$22.48
$18.3590823
S
Intac psytx, hosp, 20-30 min
0322
1.32
$65.46
$14.22
$13.0990824
S
Intac psytx, hsp 20-30 w/e&m
0322
1.32
$65.46
$14.22
$13.0990826
S
Intac psytx, hosp, 45-50 min
0323
1.85
$91.75
$22.48
$18.3590827
S
Intac psytx, hsp 45-50 w/e&m
0323
1.85
$91.75
$22.48
$18.3590828
S
Intac psytx, hosp, 75-80 min
0323
1.85
$91.75
$22.48
$18.3590829
S
Intac psytx, hsp 75-80 w/e&m
0323
1.85
$91.75
$22.48
$18.3590845
S
Psychoanalysis
0323
1.85
$91.75
$22.48
$18.3590846
S
Family psytx w/o patient
0324
1.87
$92.74
$20.19
$18.5590847
S
Family psytx w/patient
0324
1.87
$92.74
$20.19
$18.5590849
S
Multiple family group psytx
0325
1.55
$76.88
$19.96
$15.3890853
S
Group psychotherapy
0325
1.55
$76.88
$19.96
$15.3890857
S
Intac group psytx
0325
1.55
$76.88
$19.96
$15.3890862
X
Medication management
0374
1.17
$58.03
$13.08
$11.6190865
S
Narcosynthesis
0323
1.85
$91.75
$22.48
$18.3590870
S
Electroconvulsive therapy
0320
3.68
$182.51
$80.06
$36.5090871
S
Electroconvulsive therapy
0320
3.68
$182.51
$80.06
$36.5090875
E
Psychophysiological therapy90876
E
Psychophysiological therapy90880
S
Hypnotherapy
0323
1.85
$91.75
$22.48
$18.3590882
E
Environmental manipulation90885
N
Psy evaluation of records90887
N
Consultation with family90889
N
Preparation of report90899
S
Psychiatric service/therapy
0322
1.32
$65.46
$14.22
$13.0990901
S
Biofeedback train, any meth
0321
1.26
$62.49
$29.25
$12.5090911
S
Biofeedback peri/uro/rectal
0321
1.26
$62.49
$29.25
$12.5090918
A
ESRD related services, month90919
A
ESRD related services, month90920
A
ESRD related services, month90921
A
ESRD related services, month90922
A
ESRD related services, day90923
A
Esrd related services, day90924
A
Esrd related services, day( print page 67937)90925
A
Esrd related services, day90935
S
Hemodialysis, one evaluation
0170
6.68
$331.30
$72.26
$66.2690937
E
Hemodialysis, repeated eval*90940
N
Hemodyalysis access study90945
S
Dialysis, one evaluation
0170
6.68
$331.30
$72.26
$66.2690947
E
Dialysis, repeated eval90989
E
Dialysis training, complete90993
E
Dialysis training, incompl90997
E
Hemoperfusion90999
E
Dialysis procedure91000
X
Esophageal intubation
0361
3.53
$175.07
$88.09
$35.0191010
X
Esophagus motility study
0361
3.53
$175.07
$88.09
$35.0191011
X
Esophagus motility study
0361
3.53
$175.07
$88.09
$35.0191012
X
Esophagus motility study
0361
3.53
$175.07
$88.09
$35.0191020
X
Gastric motility
0361
3.53
$175.07
$88.09
$35.0191030
X
Acid perfusion of esophagus
0360
1.38
$68.44
$34.75
$13.6991032
X
Esophagus, acid reflux test
0361
3.53
$175.07
$88.09
$35.0191033
X
Prolonged acid reflux test
0361
3.53
$175.07
$88.09
$35.0191052
X
Gastric analysis test
0361
3.53
$175.07
$88.09
$35.0191055
X
Gastric intubation for smear
0360
1.38
$68.44
$34.75
$13.6991060
X
Gastric saline load test
0361
3.53
$175.07
$88.09
$35.0191065
X
Breath hydrogen test
0360
1.38
$68.44
$34.75
$13.6991100
X
Pass intestine bleeding tube
0360
1.38
$68.44
$34.75
$13.6991105
X
Gastric intubation treatment
0360
1.38
$68.44
$34.75
$13.6991122
T
Anal pressure record
0165
3.89
$192.92
$91.76
$38.58*91132
X
Electrogastrography
0360
1.38
$68.44
$34.75
$13.69*91133
X
Electrogastrography
0360
1.38
$68.44
$34.75
$13.6991299
X
Gastroenterology procedure
0360
1.38
$68.44
$34.75
$13.6992002
V
Eye exam, new patient
0601
1.00
$49.60
$9.92
$9.9292004
V
Eye exam, new patient
0602
1.66
$82.33
$16.47
$16.4792012
V
Eye exam established pat
0601
1.00
$49.60
$9.92
$9.9292014
V
Eye exam & treatment
0602
1.66
$82.33
$16.47
$16.4792015
E
Refraction92018
S
New eye exam & treatment
0231
2.64
$130.94
$59.87
$26.1992019
S
Eye exam & treatment
0231
2.64
$130.94
$59.87
$26.1992020
S
Special eye evaluation
0230
0.98
$48.61
$22.48
$9.7292060
S
Special eye evaluation
0230
0.98
$48.61
$22.48
$9.7292065
S
Orthoptic/pleoptic training
0230
0.98
$48.61
$22.48
$9.7292070
N
Fitting of contact lens92081
S
Visual field examination(s)
0230
0.98
$48.61
$22.48
$9.7292082
S
Visual field examination(s)
0230
0.98
$48.61
$22.48
$9.7292083
S
Visual field examination(s)
0230
0.98
$48.61
$22.48
$9.7292100
N
Serial tonometry exam(s)92120
S
Tonography & eye evaluation
0230
0.98
$48.61
$22.48
$9.7292130
S
Water provocation tonography
0230
0.98
$48.61
$22.48
$9.7292135
S
Opthalmic dx imaging
0231
2.64
$130.94
$59.87
$26.1992140
S
Glaucoma provocative tests
0231
2.64
$130.94
$59.87
$26.1992225
S
Special eye exam, initial
0230
0.98
$48.61
$22.48
$9.7292226
S
Special eye exam, subsequent
0231
2.64
$130.94
$59.87
$26.1992230
S
Eye exam with photos
0231
2.64
$130.94
$59.87
$26.1992235
S
Eye exam with photos
0231
2.64
$130.94
$59.87
$26.1992240
S
Icg angiography
0231
2.64
$130.94
$59.87
$26.1992250
S
Eye exam with photos
0230
0.98
$48.61
$22.48
$9.7292260
S
Ophthalmoscopy/dynamometry
0230
0.98
$48.61
$22.48
$9.7292265
S
Eye muscle evaluation
0230
0.98
$48.61
$22.48
$9.7292270
S
Electro-oculography
0230
0.98
$48.61
$22.48
$9.7292275
S
Electroretinography
0216
2.87
$142.34
$64.69
$28.4792283
S
Color vision examination
0230
0.98
$48.61
$22.48
$9.7292284
S
Dark adaptation eye exam
0231
2.64
$130.94
$59.87
$26.1992285
S
Eye photography
0230
0.98
$48.61
$22.48
$9.7292286
S
Internal eye photography
0231
2.64
$130.94
$59.87
$26.1992287
S
Internal eye photography
0231
2.64
$130.94
$59.87
$26.1992310
E
Contact lens fitting92311
X
Contact lens fitting
0362
0.51
$25.30
$9.63
$5.0692312
X
Contact lens fitting
0362
0.51
$25.30
$9.63
$5.0692313
X
Contact lens fitting
0362
0.51
$25.30
$9.63
$5.0692314
E
Prescription of contact lens92315
X
Prescription of contact lens
0362
0.51
$25.30
$9.63
$5.0692316
X
Prescription of contact lens
0362
0.51
$25.30
$9.63
$5.0692317
X
Prescription of contact lens
0362
0.51
$25.30
$9.63
$5.0692325
X
Modification of contact lens
0362
0.51
$25.30
$9.63
$5.0692326
X
Replacement of contact lens
0362
0.51
$25.30
$9.63
$5.0692330
S
Fitting of artificial eye
0230
0.98
$48.61
$22.48
$9.7292335
N
Fitting of artificial eye( print page 67938)92340
E
Fitting of spectacles92341
E
Fitting of spectacles92342
E
Fitting of spectacles92352
X
Special spectacles fitting
0362
0.51
$25.30
$9.63
$5.0692353
X
Special spectacles fitting
0362
0.51
$25.30
$9.63
$5.0692354
X
Special spectacles fitting
0362
0.51
$25.30
$9.63
$5.0692355
X
Special spectacles fitting
0362
0.51
$25.30
$9.63
$5.0692358
X
Eye prosthesis service
0362
0.51
$25.30
$9.63
$5.0692370
E
Repair & adjust spectacles92371
X
Repair & adjust spectacles
0362
0.51
$25.30
$9.63
$5.0692390
E
Supply of spectacles92391
E
Supply of contact lenses92392
E
Supply of low vision aids92393
E
Supply of artificial eye92395
E
Supply of spectacles92396
E
Supply of contact lenses92499
S
Eye service or procedure
0230
0.98
$48.61
$22.48
$9.7292502
T
Ear and throat examination
0251
1.68
$83.32
$27.99
$16.6692504
N
Ear microscopy examination92506
A
Speech/hearing evaluation92507
A
Speech/hearing therapy92508
A
Speech/hearing therapy92510
A
Rehab for ear implant92511
T
Nasopharyngoscopy
0071
0.55
$27.28
$14.22
$5.4692512
X
Nasal function studies
0363
2.83
$140.36
$53.22
$28.0792516
X
Facial nerve function test
0363
2.83
$140.36
$53.22
$28.0792520
X
Laryngeal function studies
0363
2.83
$140.36
$53.22
$28.0792525
E
Oral function evaluation92526
A
Oral function therapy92531
N
Spontaneous nystagmus study92532
N
Positional nystagmus study92533
N
Caloric vestibular test92534
N
Optokinetic nystagmus92541
X
Spontaneous nystagmus test
0363
2.83
$140.36
$53.22
$28.0792542
X
Positional nystagmus test
0363
2.83
$140.36
$53.22
$28.0792543
X
Caloric vestibular test
0363
2.83
$140.36
$53.22
$28.0792544
X
Optokinetic nystagmus test
0363
2.83
$140.36
$53.22
$28.0792545
X
Oscillating tracking test
0363
2.83
$140.36
$53.22
$28.0792546
X
Sinusoidal rotational test
0363
2.83
$140.36
$53.22
$28.0792547
X
Supplemental electrical test
0363
2.83
$140.36
$53.22
$28.0792548
X
Posturography
0363
2.83
$140.36
$53.22
$28.0792551
E
Pure tone hearing test, air92552
X
Pure tone audiometry, air
0364
0.68
$33.72
$13.31
$6.7492553
X
Audiometry, air & bone
0364
0.68
$33.72
$13.31
$6.7492555
X
Speech threshold audiometry
0364
0.68
$33.72
$13.31
$6.7492556
X
Speech audiometry, complete
0364
0.68
$33.72
$13.31
$6.7492557
X
Comprehensive hearing test
0365
1.47
$72.91
$22.48
$14.5892559
E
Group audiometric testing92560
E
Bekesy audiometry, screen92561
X
Bekesy audiometry, diagnosis
0365
1.47
$72.91
$22.48
$14.5892562
X
Loudness balance test
0365
1.47
$72.91
$22.48
$14.5892563
X
Tone decay hearing test
0365
1.47
$72.91
$22.48
$14.5892564
X
Sisi hearing test
0365
1.47
$72.91
$22.48
$14.5892565
X
Stenger test, pure tone
0365
1.47
$72.91
$22.48
$14.5892567
X
Tympanometry
0364
0.68
$33.72
$13.31
$6.7492568
X
Acoustic reflex testing
0365
1.47
$72.91
$22.48
$14.5892569
X
Acoustic reflex decay test
0365
1.47
$72.91
$22.48
$14.5892571
X
Filtered speech hearing test
0365
1.47
$72.91
$22.48
$14.5892572
X
Staggered spondaic word test
0365
1.47
$72.91
$22.48
$14.5892573
X
Lombard test
0365
1.47
$72.91
$22.48
$14.5892575
X
Sensorineural acuity test
0365
1.47
$72.91
$22.48
$14.5892576
X
Synthetic sentence test
0365
1.47
$72.91
$22.48
$14.5892577
X
Stenger test, speech
0365
1.47
$72.91
$22.48
$14.5892579
X
Visual audiometry (vra)
0365
1.47
$72.91
$22.48
$14.5892582
X
Conditioning play audiometry
0365
1.47
$72.91
$22.48
$14.5892583
X
Select picture audiometry
0365
1.47
$72.91
$22.48
$14.5892584
X
Electrocochleography
0363
2.83
$140.36
$53.22
$28.0792585
S
Auditory evoked potential
0216
2.87
$142.34
$64.69
$28.47*92586
S
Auditory evoked potentials, ltd
0971
1.55
$76.88

$15.3892587
X
Evoked auditory test
0363
2.83
$140.36
$53.22
$28.0792588
X
Evoked auditory test
0363
2.83
$140.36
$53.22
$28.0792589
X
Auditory function test(s)
0365
1.47
$72.91
$22.48
$14.5892590
E
Hearing aid exam, one ear92591
E
Hearing aid exam, both ears( print page 67939)92592
E
Hearing aid check, one ear92593
E
Hearing aid check, both ears92594
E
Electro hearng aid test, one92595
E
Electro hearng aid tst, both92596
X
Ear protector evaluation
0365
1.47
$72.91
$22.48
$14.5892597D
E
Voice prosthetic evaluation92598D
E
Voice prosthetic modification92599
X
ENT procedure/service
0364
0.68
$33.72
$13.31
$6.7492950
S
Heart/lung resuscitation cpr
0094
4.51
$223.68
$105.29
$44.7492953
S
Temporary external pacing
0094
4.51
$223.68
$105.29
$44.7492960
S
Cardioversion electric, ext
0094
4.51
$223.68
$105.29
$44.7492961
S
Cardioversion, electric, int
0094
4.51
$223.68
$105.29
$44.7492970
C
Cardioassist, internal92971
C
Cardioassist, external92975
C
Dissolve clot, heart vessel92977
T
Dissolve clot, heart vessel
0120
1.66
$82.33
$42.67
$16.4792978
S
Intravasc us, heart add-on
0267
2.72
$134.90
$80.06
$26.9892979
S
Intravasc us, heart add-on
0267
2.72
$134.90
$80.06
$26.9892980
T
Insert intracoronary stent
0104
14.94
$740.96
$339.51
$148.1992981
T
Insert intracoronary stent
0104
14.94
$740.96
$339.51
$148.1992982
T
Coronary artery dilation
0082
51.01
$2,529.89
$1,351.74
$505.9892984
T
Coronary artery dilation
0082
51.01
$2,529.89
$1,351.74
$505.9892986
C
Revision of aortic valve92987
C
Revision of mitral valve92990
C
Revision of pulmonary valve92992
C
Revision of heart chamber92993
C
Revision of heart chamber92995
T
Coronary atherectomy
0083
29.70
$1,473.00
$794.30
$294.6092996
T
Coronary atherectomy add-on
0083
29.70
$1,473.00
$794.30
$294.6092997
C
Pul art balloon repr, percut92998
C
Pul art balloon repr, percut93000
E
Electrocardiogram, complete93005
X
Electrocardiogram, tracing
0099
0.38
$18.85
$14.68
$3.7793010
E
Electrocardiogram report93012
X
Transmission of ecg
0097
1.62
$80.35
$62.40
$16.0793014
E
Report on transmitted ecg93015
E
Cardiovascular stress test93016
E
Cardiovascular stress test93017
X
Cardiovascular stress test
0100
1.70
$84.32
$71.57
$16.8693018
E
Cardiovascular stress test93024
X
Cardiac drug stress test
0100
1.70
$84.32
$71.57
$16.8693040
E
Rhythm ECG with report93041
X
Rhythm ECG, tracing
0099
0.38
$18.85
$14.68
$3.7793042
E
Rhythm ECG, report93224
E
ECG monitor/report, 24 hrs93225
X
ECG monitor/record, 24 hrs
0100
1.70
$84.32
$71.57
$16.8693226
X
ECG monitor/report, 24 hrs
0100
1.70
$84.32
$71.57
$16.8693227
E
ECG monitor/review, 24 hrs93230
E
ECG monitor/report, 24 hrs93231
X
Ecg monitor/record, 24 hrs
0100
1.70
$84.32
$71.57
$16.8693232
X
ECG monitor/report, 24 hrs
0100
1.70
$84.32
$71.57
$16.8693233
E
ECG monitor/review, 24 hrs93235
E
ECG monitor/report, 24 hrs93236
X
ECG monitor/report, 24 hrs
0100
1.70
$84.32
$71.57
$16.8693237
E
ECG monitor/review, 24 hrs93268
E
ECG record/review93270
X
ECG recording
0097
1.62
$80.35
$62.40
$16.0793271
X
Ecg/monitoring and analysis
0097
1.62
$80.35
$62.40
$16.0793272
E
Ecg/review,interpret only93278
X
ECG/signal-averaged
0099
0.38
$18.85
$14.68
$3.7793303
S
Echo transthoracic
0269
4.40
$218.22
$114.01
$43.6493304
S
Echo transthoracic
0269
4.40
$218.22
$114.01
$43.6493307
S
Echo exam of heart
0269
4.40
$218.22
$114.01
$43.6493308
S
Echo exam of heart
0269
4.40
$218.22
$114.01
$43.6493312
S
Echo transesophageal
0270
5.55
$275.25
$150.26
$55.0593313
S
Echo transesophageal
0270
5.55
$275.25
$150.26
$55.0593314
N
Echo transesophageal93315
S
Echo transesophageal
0270
5.55
$275.25
$150.26
$55.0593316
S
Echo transesophageal
0270
5.55
$275.25
$150.26
$55.0593317
N
Echo transesophageal*93318
S
Echo transesophageal
0270
5.55
$275.25
$150.26
$55.0593320
S
Doppler echo exam, heart
0269
4.40
$218.22
$114.01
$43.6493321
S
Doppler echo exam, heart
0269
4.40
$218.22
$114.01
$43.6493325
S
Doppler color flow add-on
0269
4.40
$218.22
$114.01
$43.64( print page 67940)93350
S
Echo transthoracic
0269
4.40
$218.22
$114.01
$43.6493501
T
Right heart catheterization
0080
31.55
$1,564.75
$838.92
$312.9593503
T
Insert/place heart catheter
0103
13.09
$649.21
$295.70
$129.8493505
T
Biopsy of heart lining
0103
13.09
$649.21
$295.70
$129.8493508
N
Cath placement, angiography93510
T
Left heart catheterization
0080
31.55
$1,564.75
$838.92
$312.9593511
T
Left heart catheterization
0080
31.55
$1,564.75
$838.92
$312.9593514
T
Left heart catheterization
0080
31.55
$1,564.75
$838.92
$312.9593524
T
Left heart catheterization
0080
31.55
$1,564.75
$838.92
$312.9593526
T
Rt & Lt heart catheters
0080
31.55
$1,564.75
$838.92
$312.9593527
T
Rt & Lt heart catheters
0080
31.55
$1,564.75
$838.92
$312.9593528
T
Rt & Lt heart catheters
0080
31.55
$1,564.75
$838.92
$312.9593529
T
Rt, Lt heart catheterization
0080
31.55
$1,564.75
$838.92
$312.9593530
T
Rt heart cath, congenital
0080
31.55
$1,564.75
$838.92
$312.9593531
T
R & l heart cath, congenital
0080
31.55
$1,564.75
$838.92
$312.9593532
T
R & l heart cath, congenital
0080
31.55
$1,564.75
$838.92
$312.9593533
T
R & l heart cath, congenital
0080
31.55
$1,564.75
$838.92
$312.9593536
T
Insert circulation assi
0103
13.09
$649.21
$295.70
$129.8493539
N
Injection, cardiac cath93540
N
Injection, cardiac cath93541
N
Injection for lung angiogram93542
N
Injection for heart x-rays93543
N
Injection for heart x-rays93544
N
Injection for aortography93545
N
Inject for coronary x-rays93555
N
Imaging, cardiac cath93556
N
Imaging, cardiac cath93561
N
Cardiac output measurement93562
N
Cardiac output measurement93571
N
Heart flow reserve measure93572
N
Heart flow reserve measure93600
S
Bundle of His recording
0087
9.53
$472.65
$214.72
$94.5393602
S
Intra-atrial recording
0087
9.53
$472.65
$214.72
$94.5393603
S
Right ventricular recording
0087
9.53
$472.65
$214.72
$94.5393607
S
Left ventricular recording
0087
9.53
$472.65
$214.72
$94.5393609
S
Mapping of tachycardia
0087
9.53
$472.65
$214.72
$94.5393610
S
Intra-atrial pacing
0087
9.53
$472.65
$214.72
$94.5393612
S
Intraventricular pacing
0087
9.53
$472.65
$214.72
$94.5393615
S
Esophageal recording
0087
9.53
$472.65
$214.72
$94.5393616
S
Esophageal recording
0087
9.53
$472.65
$214.72
$94.5393618
S
Heart rhythm pacing
0087
9.53
$472.65
$214.72
$94.5393619
S
Electrophysiology evaluation
0085
27.06
$1,342.07
$654.48
$268.4193620
S
Electrophysiology evaluation
0085
27.06
$1,342.07
$654.48
$268.4193621
S
Electrophysiology evaluation
0085
27.06
$1,342.07
$654.48
$268.4193622
S
Electrophysiology evaluation
0085
27.06
$1,342.07
$654.48
$268.4193623
S
Stimulation, pacing heart
0087
9.53
$472.65
$214.72
$94.5393624
S
Electrophysiologic study
0087
9.53
$472.65
$214.72
$94.5393631
S
Heart pacing, mapping
0087
9.53
$472.65
$214.72
$94.5393640
S
Evaluation heart device
0084
10.70
$530.68
$177.79
$106.1493641
S
Electrophysiology evaluation
0084
10.70
$530.68
$177.79
$106.1493642
S
Electrophysiology evaluation
0084
10.70
$530.68
$177.79
$106.1493650
S
Ablate heart dysrhythm focus
0086
47.62
$2,361.76
$1,265.37
$472.3593651
S
Ablate heart dysrhythm focus
0086
47.62
$2,361.76
$1,265.37
$472.3593652
S
Ablate heart dysrhythm focus
0086
47.62
$2,361.76
$1,265.37
$472.3593660
S
Tilt table evaluation
0101
4.47
$221.70
$128.84
$44.34*93662
S
Intracardiac ECG
0270
5.55
$275.25
$150.26
$55.05*93668
E
Peripheral vascular rehab93720
E
Total body plethysmography93721
S
Plethysmography tracing
0096
2.06
$102.16
$61.48
$20.4393722
E
Plethysmography report93724
S
Analyze pacemaker system
0102
0.45
$22.32
$12.62
$4.4693727
S
Analyze ilr system
0102
0.45
$22.32
$12.62
$4.4693731
S
Analyze pacemaker system
0102
0.45
$22.32
$12.62
$4.4693732
S
Analyze pacemaker system
0102
0.45
$22.32
$12.62
$4.4693733
S
Telephone analy, pacemaker
0102
0.45
$22.32
$12.62
$4.4693734
S
Analyze pacemaker system
0102
0.45
$22.32
$12.62
$4.4693735
S
Analyze pacemaker system
0102
0.45
$22.32
$12.62
$4.4693736
S
Telephone analy, pacemaker
0102
0.45
$22.32
$12.62
$4.4693737
S
Analyze cardio/defibrillator
0102
0.45
$22.32
$12.62
$4.4693738
S
Analyze cardio/defibrillator
0102
0.45
$22.32
$12.62
$4.4693740
S
Temperature gradient studies
0096
2.06
$102.16
$61.48
$20.4393741
S
Analyze ht pace device sngl
0102
0.45
$22.32
$12.62
$4.4693742
S
Analyze ht pace device sngl
0102
0.45
$22.32
$12.62
$4.4693743
S
Analyze ht pace device dual
0102
0.45
$22.32
$12.62
$4.46( print page 67941)93744
S
Analyze ht pace device dual
0102
0.45
$22.32
$12.62
$4.4693760
E
Cephalic thermogram93762
E
Peripheral thermogram93770
N
Measure venous pressure93784
E
Ambulatory BP monitoring93786
E
Ambulatory BP recording93788
E
Ambulatory BP analysis93790
E
Review/report BP recording93797
S
Cardiac rehab
0095
0.64
$31.74
$16.98
$6.3593798
S
Cardiac rehab/monitor
0095
0.64
$31.74
$16.98
$6.3593799
S
Cardiovascular procedure
0096
2.06
$102.16
$61.48
$20.4393875
S
Extracranial study
0096
2.06
$102.16
$61.48
$20.4393880
S
Extracranial study
0267
2.72
$134.90
$80.06
$26.9893882
S
Extracranial study
0267
2.72
$134.90
$80.06
$26.9893886
S
Intracranial study
0267
2.72
$134.90
$80.06
$26.9893888
S
Intracranial study
0267
2.72
$134.90
$80.06
$26.9893922
S
Extremity study
0096
2.06
$102.16
$61.48
$20.4393923
S
Extremity study
0096
2.06
$102.16
$61.48
$20.4393924
S
Extremity study
0096
2.06
$102.16
$61.48
$20.4393925
S
Lower extremity study
0267
2.72
$134.90
$80.06
$26.9893926
S
Lower extremity study
0267
2.72
$134.90
$80.06
$26.9893930
S
Upper extremity study
0267
2.72
$134.90
$80.06
$26.9893931
S
Upper extremity study
0267
2.72
$134.90
$80.06
$26.9893965
S
Extremity study
0096
2.06
$102.16
$61.48
$20.4393970
S
Extremity study
0267
2.72
$134.90
$80.06
$26.9893971
S
Extremity study
0267
2.72
$134.90
$80.06
$26.9893975
S
Vascular study
0267
2.72
$134.90
$80.06
$26.9893976
S
Vascular study
0267
2.72
$134.90
$80.06
$26.9893978
S
Vascular study
0267
2.72
$134.90
$80.06
$26.9893979
S
Vascular study
0267
2.72
$134.90
$80.06
$26.9893980
S
Penile vascular study
0267
2.72
$134.90
$80.06
$26.9893981
S
Penile vascular study
0267
2.72
$134.90
$80.06
$26.9893990
S
Doppler flow testing
0267
2.72
$134.90
$80.06
$26.9894010
X
Breathing capacity test
0367
0.83
$41.16
$20.65
$8.2394014
X
Patient recorded spirometry
0369
2.34
$116.06
$58.50
$23.2194015
X
Patient recorded spirometry
0369
2.34
$116.06
$58.50
$23.2194016
X
Review patient spirometry
0369
2.34
$116.06
$58.50
$23.2194060
X
Evaluation of wheezing
0368
1.66
$82.33
$42.44
$16.4794070
X
Evaluation of wheezing
0369
2.34
$116.06
$58.50
$23.2194150
N
Vital capacity test94200
X
Lung function test (MBC/MVV)
0367
0.83
$41.16
$20.65
$8.2394240
X
Residual lung capacity
0368
1.66
$82.33
$42.44
$16.4794250
X
Expired gas collection
0367
0.83
$41.16
$20.65
$8.2394260
X
Thoracic gas volume
0368
1.66
$82.33
$42.44
$16.4794350
X
Lung nitrogen washout curve
0368
1.66
$82.33
$42.44
$16.4794360
X
Measure airflow resistance
0368
1.66
$82.33
$42.44
$16.4794370
X
Breath airway closing volume
0368
1.66
$82.33
$42.44
$16.4794375
X
Respiratory flow volume loop
0367
0.83
$41.16
$20.65
$8.2394400
X
CO2 breathing response curve
0367
0.83
$41.16
$20.65
$8.2394450
X
Hypoxia response curve
0367
0.83
$41.16
$20.65
$8.2394620
X
Pulmonary stress test/simple
0368
1.66
$82.33
$42.44
$16.4794621
X
Pulm stress test/complex
0369
2.34
$116.06
$58.50
$23.2194640
S
Airway inhalation treatment
0077
0.43
$21.33
$12.62
$4.2794642
S
Aerosol inhalation treatment
0078
1.34
$66.46
$29.13
$13.2994650
S
Pressure breathing (IPPB)
0077
0.43
$21.33
$12.62
$4.2794651
S
Pressure breathing (IPPB)
0077
0.43
$21.33
$12.62
$4.2794652
C
Pressure breathing (IPPB)94656
S
Initial ventilator mgmt
0079
3.18
$157.72
$107.70
$31.5494657
S
Continued ventilator mgmt
0079
3.18
$157.72
$107.70
$31.5494660
S
Pos airway pressure, CPAP
0079
3.18
$157.72
$107.70
$31.5494662
S
Neg press ventilation, cnp
0079
3.18
$157.72
$107.70
$31.5494664
S
Aerosol or vapor inhalations
0077
0.43
$21.33
$12.62
$4.2794665
S
Aerosol or vapor inhalations
0077
0.43
$21.33
$12.62
$4.2794667
S
Chest wall manipulation
0077
0.43
$21.33
$12.62
$4.2794668
S
Chest wall manipulation
0077
0.43
$21.33
$12.62
$4.2794680
X
Exhaled air analysis, o2
0367
0.83
$41.16
$20.65
$8.2394681
X
Exhaled air analysis, o2/co2
0368
1.66
$82.33
$42.44
$16.4794690
X
Exhaled air analysis
0367
0.83
$41.16
$20.65
$8.2394720
X
Monoxide diffusing capacity
0367
0.83
$41.16
$20.65
$8.2394725
X
Membrane diffusion capacity
0368
1.66
$82.33
$42.44
$16.4794750
X
Pulmonary compliance study
0368
1.66
$82.33
$42.44
$16.4794760
N
Measure blood oxygen level94761
N
Measure blood oxygen level94762
N
Measure blood oxygen level( print page 67942)94770
X
Exhaled carbon dioxide test
0367
0.83
$41.16
$20.65
$8.2394772
X
Breath recording, infant
0369
2.34
$116.06
$58.50
$23.2194799
X
Pulmonary service/procedure
0367
0.83
$41.16
$20.65
$8.2395004
X
Allergy skin tests
0370
0.57
$28.27
$11.81
$5.6595010
X
Sensitivity skin tests
0370
0.57
$28.27
$11.81
$5.6595015
X
Sensitivity skin tests
0370
0.57
$28.27
$11.81
$5.6595024
X
Allergy skin tests
0370
0.57
$28.27
$11.81
$5.6595027
X
Skin end point titration
0370
0.57
$28.27
$11.81
$5.6595028
X
Allergy skin tests
0370
0.57
$28.27
$11.81
$5.6595044
X
Allergy patch tests
0370
0.57
$28.27
$11.81
$5.6595052
X
Photo patch test
0370
0.57
$28.27
$11.81
$5.6595056
X
Photosensitivity tests
0370
0.57
$28.27
$11.81
$5.6595060
X
Eye allergy tests
0370
0.57
$28.27
$11.81
$5.6595065
X
Nose allergy test
0370
0.57
$28.27
$11.81
$5.6595070
X
Bronchial allergy tests
0369
2.34
$116.06
$58.50
$23.2195071
X
Bronchial allergy tests
0369
2.34
$116.06
$58.50
$23.2195075
X
Ingestion challenge test
0361
3.53
$175.07
$88.09
$35.0195078
X
Provocative testing
0370
0.57
$28.27
$11.81
$5.6595115
X
Immunotherapy, one injection
0371
0.32
$15.87
$3.67
$3.1795117
X
Immunotherapy injections
0371
0.32
$15.87
$3.67
$3.1795120
E
Immunotherapy, one injection95125
E
Immunotherapy, many antigens95130
E
Immunotherapy, insect venom95131
E
Immunotherapy, insect venoms95132
E
Immunotherapy, insect venoms95133
E
Immunotherapy, insect venoms95134
E
Immunotherapy, insect venoms95144
X
Antigen therapy services
0371
0.32
$15.87
$3.67
$3.1795145
X
Antigen therapy services
0371
0.32
$15.87
$3.67
$3.1795146
X
Antigen therapy services
0371
0.32
$15.87
$3.67
$3.1795147
X
Antigen therapy services
0371
0.32
$15.87
$3.67
$3.1795148
X
Antigen therapy services
0371
0.32
$15.87
$3.67
$3.1795149
X
Antigen therapy services
0371
0.32
$15.87
$3.67
$3.1795165
X
Antigen therapy services
0371
0.32
$15.87
$3.67
$3.1795170
X
Antigen therapy services
0371
0.32
$15.87
$3.67
$3.1795180
X
Rapid desensitization
0370
0.57
$28.27
$11.81
$5.6595199
X
Allergy immunology services
0370
0.57
$28.27
$11.81
$5.6595805
S
Multiple sleep latency test
0213
11.15
$553.00
$290.42
$110.6095806
S
Sleep study, unattended
0213
11.15
$553.00
$290.42
$110.6095807
S
Sleep study, attended
0213
11.15
$553.00
$290.42
$110.6095808
S
Polysomnography, 1-3
0213
11.15
$553.00
$290.42
$110.6095810
S
Polysomnography, 4 or more
0213
11.15
$553.00
$290.42
$110.6095811
S
Polysomnography w/cpap
0213
11.15
$553.00
$290.42
$110.6095812
S
Electroencephalogram (EEG)
0213
11.15
$553.00
$290.42
$110.6095813
S
Electroencephalogram (EEG)
0213
11.15
$553.00
$290.42
$110.6095816
S
Electroencephalogram (EEG)
0214
2.32
$115.06
$58.50
$23.0195819
S
Electroencephalogram (EEG)
0214
2.32
$115.06
$58.50
$23.0195822
S
Sleep electroencephalogram
0214
2.32
$115.06
$58.50
$23.0195824
S
Electroencephalography
0214
2.32
$115.06
$58.50
$23.0195827
S
Night electroencephalogram
0213
11.15
$553.00
$290.42
$110.6095829
S
Surgery electrocorticogram
0214
2.32
$115.06
$58.50
$23.0195830
E
Insert electrodes for EEG95831
N
Limb muscle testing, manual95832
N
Hand muscle testing, manual95833
N
Body muscle testing, manual95834
N
Body muscle testing, manual95851
N
Range of motion measurements95852
N
Range of motion measurements95857
S
Tensilon test
0215
1.15
$57.04
$30.05
$11.4195858
S
Tensilon test & myogram
0215
1.15
$57.04
$30.05
$11.4195860
S
Muscle test, one limb
0215
1.15
$57.04
$30.05
$11.4195861
S
Muscle test, two limbs
0215
1.15
$57.04
$30.05
$11.4195863
S
Muscle test, 3 limbs
0216
2.87
$142.34
$64.69
$28.4795864
S
Muscle test, 4 limbs
0215
1.15
$57.04
$30.05
$11.4195867
S
Muscle test, head or neck
0216
2.87
$142.34
$64.69
$28.4795868
S
Muscle test, head or neck
0216
2.87
$142.34
$64.69
$28.4795869
S
Muscle test, thor paraspinal
0215
1.15
$57.04
$30.05
$11.4195870
S
Muscle test, nonparaspinal
0215
1.15
$57.04
$30.05
$11.4195872
S
Muscle test, one fiber
0215
1.15
$57.04
$30.05
$11.4195875
S
Limb exercise test
0217
5.87
$291.13
$156.68
$58.2395900
S
Motor nerve conduction test
0215
1.15
$57.04
$30.05
$11.4195903
S
Motor nerve conduction test
0215
1.15
$57.04
$30.05
$11.4195904
S
Sense/mixed n conduction tst
0215
1.15
$57.04
$30.05
$11.4195920
S
Intraop nerve test add-on
0216
2.87
$142.34
$64.69
$28.47( print page 67943)95921
S
Autonomic nerv function test
0216
2.87
$142.34
$64.69
$28.4795922
S
Autonomic nerv function test
0216
2.87
$142.34
$64.69
$28.4795923
S
Autonomic nerv function test
0216
2.87
$142.34
$64.69
$28.4795925
S
Somatosensory testing
0216
2.87
$142.34
$64.69
$28.4795926
S
Somatosensory testing
0216
2.87
$142.34
$64.69
$28.4795927
S
Somatosensory testing
0216
2.87
$142.34
$64.69
$28.4795930
S
Visual evoked potential test
0216
2.87
$142.34
$64.69
$28.4795933
S
Blink reflex test
0215
1.15
$57.04
$30.05
$11.4195934
S
H-reflex test
0215
1.15
$57.04
$30.05
$11.4195936
S
H-reflex test
0216
2.87
$142.34
$64.69
$28.4795937
S
Neuromuscular junction test
0215
1.15
$57.04
$30.05
$11.4195950
S
Ambulatory eeg monitoring
0217
5.87
$291.13
$156.68
$58.2395951
S
EEG monitoring/videorecord
0213
11.15
$553.00
$290.42
$110.6095953
S
EEG monitoring/computer
0213
11.15
$553.00
$290.42
$110.6095954
S
EEG monitoring/giving drugs
0213
11.15
$553.00
$290.42
$110.6095955
S
EEG during surgery
0214
2.32
$115.06
$58.50
$23.0195956
N
Eeg monitoring, cable/radio95957
N
EEG digital analysis95958
S
EEG monitoring/function test
0213
11.15
$553.00
$290.42
$110.6095961
S
Electrode stimulation, brain
0216
2.87
$142.34
$64.69
$28.4795962
S
Electrode stim, brain add-on
0216
2.87
$142.34
$64.69
$28.4795970
S
Analyze neurostim, no prog
0102
0.45
$22.32
$12.62
$4.4695971
S
Analyze neurostim, simple
0102
0.45
$22.32
$12.62
$4.4695972
S
Analyze neurostim, complex
0102
0.45
$22.32
$12.62
$4.4695973
S
Analyze neurostim, complex
0102
0.45
$22.32
$12.62
$4.4695974
S
Cranial neurostim, complex
0102
0.45
$22.32
$12.62
$4.4695975
S
Cranial neurostim, complex
0102
0.45
$22.32
$12.62
$4.4695999
N
Neurological procedure96100
X
Psychological testing
0373
3.21
$159.20
$44.96
$31.8496105
X
Assessment of aphasia
0373
3.21
$159.20
$44.96
$31.8496110
X
Developmental test, lim
0373
3.21
$159.20
$44.96
$31.8496111
X
Developmental test, extend
0373
3.21
$159.20
$44.96
$31.8496115
X
Neurobehavior status exam
0373
3.21
$159.20
$44.96
$31.8496117
X
Neuropsych test battery
0373
3.21
$159.20
$44.96
$31.8496400
E
Chemotherapy, sc/im96405
E
Intralesional chemo admin96406
E
Intralesional chemo admin96408
E
Chemotherapy, push technique96410
E
Chemotherapy,infusion method96412
E
Chemo, infuse method add-on96414
E
Chemo, infuse method add-on96420
E
Chemotherapy, push technique96422
E
Chemotherapy,infusion method96423
E
Chemo, infuse method add-on96425
E
Chemotherapy,infusion method96440
E
Chemotherapy, intracavitary96445
E
Chemotherapy, intracavitary96450
E
Chemotherapy, into CNS96520
E
Pump refilling, maintenance96530
E
Pump refilling, maintenance96542
E
Chemotherapy injection96545
E
Provide chemotherapy agent96549
E
Chemotherapy, unspecified96570
T
Photodynamic tx, 30 min
0973
5.16
$255.91

$51.1896571
T
Photodynamic tx, addl 15 min
0973
5.16
$255.91

$51.1896900
S
Ultraviolet light therapy
0001
0.47
$23.31
$8.49
$4.6696902
N
Trichogram96910
S
Photochemotherapy with UV-B
0001
0.47
$23.31
$8.49
$4.6696912
S
Photochemotherapy with UV-A
0001
0.47
$23.31
$8.49
$4.6696913
S
Photochemotherapy, UV-A or B
0001
0.47
$23.31
$8.49
$4.6696999
S
Dermatological procedure
0001
0.47
$23.31
$8.49
$4.6697001
A
Pt evaluation97002
A
Pt re-evaluation97003
A
Ot evaluation97004
A
Ot re-evaluation97010
A
Hot or cold packs therapy97012
A
Mechanical traction therapy97014
A
Electric stimulation therapy97016
A
Vasopneumatic device therapy97018
A
Paraffin bath therapy97020
A
Microwave therapy97022
A
Whirlpool therapy97024
A
Diathermy treatment97026
A
Infrared therapy( print page 67944)97028
A
Ultraviolet therapy97032
A
Electrical stimulation97033
A
Electric current therapy97034
A
Contrast bath therapy97035
A
Ultrasound therapy97036
A
Hydrotherapy97039
A
Physical therapy treatment97110
A
Therapeutic exercises97112
A
Neuromuscular reeducation97113
A
Aquatic therapy/exercises97116
A
Gait training therapy97124
A
Massage therapy97139
A
Physical medicine procedure97140
A
Manual therapy97150
A
Group therapeutic procedures97504
A
Orthotic training97520
A
Prosthetic training97530
A
Therapeutic activities*97532
A
Cognitive skills development*97533
A
Sensory integration97535
A
Self care mngment training97537
A
Community/work reintegration97542
A
Wheelchair mngment training97545
A
Work hardening97546
A
Work hardening add-on*97601
A
Wound care selective*97602
N
Wound care non-selective97703
A
Prosthetic checkout97750
A
Physical performance test97770D
A
Cognitive skills development97780
E
Acupuncture w/o stimul97781
E
Acupuncture w/stimul97799
A
Physical medicine procedure*97802
E
Medical nutrition*97803
E
Medical nutrition*97804
E
Medical nutrition98925
S
Osteopathic manipulation
0060
0.77
$38.19
$7.80
$7.6498926
S
Osteopathic manipulation
0060
0.77
$38.19
$7.80
$7.6498927
S
Osteopathic manipulation
0060
0.77
$38.19
$7.80
$7.6498928
S
Osteopathic manipulation
0060
0.77
$38.19
$7.80
$7.6498929
S
Osteopathic manipulation
0060
0.77
$38.19
$7.80
$7.6498940
S
Chiropractic manipulation
0060
0.77
$38.19
$7.80
$7.6498941
S
Chiropractic manipulation
0060
0.77
$38.19
$7.80
$7.6498942
S
Chiropractic manipulation
0060
0.77
$38.19
$7.80
$7.6498943
E
Chiropractic manipulation99000
E
Specimen handling99001
E
Specimen handling99002
E
Device handling99024
E
Postop follow-up visit99025
E
Initial surgical evaluation99050
E
Medical services after hrs99052
E
Medical services at night99054
E
Medical servcs, unusual hrs99056
E
Non-office medical services99058
E
Office emergency care99070
E
Special supplies99071
E
Patient education materials99075
E
Medical testimony99078
E
Group health education99080
E
Special reports or forms99082
E
Unusual physician travel99090
E
Computer data analysis99100
E
Special anesthesia service99116
E
Anesthesia with hypothermia99135
E
Special anesthesia procedure99140
E
Emergency anesthesia99141
N
Sedation, iv/im or inhalant99142
N
Sedation, oral/rectal/nasal99170
T
Anogenital exam, child
0192
2.38
$118.04
$35.33
$23.61*99172
E
Visual function screening99173
E
Visual screening test99175
N
Induction of vomiting99183
E
Hyperbaric oxygen therapy99185
N
Regional hypothermia( print page 67945)99186
N
Total body hypothermia99190
C
Special pump services99191
C
Special pump services99192
C
Special pump services99195
X
Phlebotomy
0372
0.43
$21.33
$10.09
$4.2799199
E
Special service/proc/report99201
V
Office/outpatient visit, new
0600
0.98
$48.61
$9.72
$9.7299202
V
Office/outpatient visit, new
0600
0.98
$48.61
$9.72
$9.7299203
V
Office/outpatient visit, new
0601
1.00
$49.60
$9.92
$9.9299204
V
Office/outpatient visit, new
0602
1.66
$82.33
$16.47
$16.4799205
V
Office/outpatient visit, new
0602
1.66
$82.33
$16.47
$16.4799211
V
Office/outpatient visit, est
0600
0.98
$48.61
$9.72
$9.7299212
V
Office/outpatient visit, est
0600
0.98
$48.61
$9.72
$9.7299213
V
Office/outpatient visit, est
0601
1.00
$49.60
$9.92
$9.9299214
V
Office/outpatient visit, est
0602
1.66
$82.33
$16.47
$16.4799215
V
Office/outpatient visit, est
0602
1.66
$82.33
$16.47
$16.4799217
N
Observation care discharge99218
N
Observation care99219
N
Observation care99220
N
Observation care99221
E
Initial hospital care99222
E
Initial hospital care99223
E
Initial hospital care99231
E
Subsequent hospital care99232
E
Subsequent hospital care99233
E
Subsequent hospital care99234
N
Observ/hosp same date99235
N
Observ/hosp same date99236
N
Observ/hosp same date99238
E
Hospital discharge day99239
E
Hospital discharge day99241
V
Office consultation
0600
0.98
$48.61
$9.72
$9.7299242
V
Office consultation
0600
0.98
$48.61
$9.72
$9.7299243
V
Office consultation
0601
1.00
$49.60
$9.92
$9.9299244
V
Office consultation
0602
1.66
$82.33
$16.47
$16.4799245
V
Office consultation
0602
1.66
$82.33
$16.47
$16.4799251
C
Initial inpatient consult99252
C
Initial inpatient consult99253
C
Initial inpatient consult99254
C
Initial inpatient consult99255
C
Initial inpatient consult99261
C
Follow-up inpatient consult99262
C
Follow-up inpatient consult99263
C
Follow-up inpatient consult99271
V
Confirmatory consultation
0600
0.98
$48.61
$9.72
$9.7299272
V
Confirmatory consultation
0600
0.98
$48.61
$9.72
$9.7299273
V
Confirmatory consultation
0601
1.00
$49.60
$9.92
$9.9299274
V
Confirmatory consultation
0602
1.66
$82.33
$16.47
$16.4799275
V
Confirmatory consultation
0602
1.66
$82.33
$16.47
$16.4799281
V
Emergency dept visit
0610
1.34
$66.46
$20.65
$13.2999282
V
Emergency dept visit
0610
1.34
$66.46
$20.65
$13.2999283
V
Emergency dept visit
0611
2.11
$104.65
$36.47
$20.9399284
V
Emergency dept visit
0612
3.19
$158.21
$54.14
$31.6499285
V
Emergency dept visit
0612
3.19
$158.21
$54.14
$31.6499288
E
Direct advanced life support99291
S
Critical care, first hour
0620
8.60
$426.53
$152.78
$85.3199292
N
Critical care, addl 30 min99295
C
Neonatal critical care99296
C
Neonatal critical care99297
C
Neonatal critical care99298
C
Neonatal critical care99301
E
Nursing facility care99302
E
Nursing facility care99303
E
Nursing facility care99311
E
Nursing fac care, subseq99312
E
Nursing fac care, subseq99313
E
Nursing fac care, subseq99315
E
Nursing fac discharge day99316
E
Nursing fac discharge day99321
E
Rest home visit, new patient99322
E
Rest home visit, new patient99323
E
Rest home visit, new patient99331
E
Rest home visit, est pat99332
E
Rest home visit, est pat( print page 67946)99333
E
Rest home visit, est pat99341
E
Home visit, new patient99342
E
Home visit, new patient99343
E
Home visit, new patient99344
E
Home visit, new patient99345
E
Home visit, new patient99347
E
Home visit, est patient99348
E
Home visit, est patient99349
E
Home visit, est patient99350
E
Home visit, est patient99354
N
Prolonged service, office99355
N
Prolonged service, office99356
C
Prolonged service, inpatient99357
C
Prolonged service, inpatient99358
N
Prolonged serv, w/o contact99359
N
Prolonged serv, w/o contact99360
E
Physician standby services99361
E
Physician/team conference99362
E
Physician/team conference99371
E
Physician phone consultation99372
E
Physician phone consultation99373
E
Physician phone consultation99374
E
Home health care supervision99375D
E
Home health care supervision99377
E
Hospice care supervision99378D
E
Hospice care supervision99379
E
Nursing fac care supervision99380
E
Nursing fac care supervision99381
E
Prev visit, new, infant99382
E
Prev visit, new, age 1-499383
E
Prev visit, new, age 5-1199384
E
Prev visit, new, age 12-1799385
E
Prev visit, new, age 18-3999386
E
Prev visit, new, age 40-6499387
E
Prev visit, new, 65 & over99391
E
Prev visit, est, infant99392
E
Prev visit, est, age 1-499393
E
Prev visit, est, age 5-1199394
E
Prev visit, est, age 12-1799395
E
Prev visit, est, age 18-3999396
E
Prev visit, est, age 40-6499397
E
Prev visit, est, 65 & over99401
E
Preventive counseling, indiv99402
E
Preventive counseling, indiv99403
E
Preventive counseling, indiv99404
E
Preventive counseling, indiv99411
E
Preventive counseling, group99412
E
Preventive counseling, group99420
E
Health risk assessment test99429
E
Unlisted preventive service99431
N
Initial care, normal newborn99432
N
Newborn care, not in hosp99433
C
Normal newborn care/hospital99435
E
Newborn discharge day hosp99436
N
Attendance, birth99440
S
Newborn resuscitation
0094
4.51
$223.68
$105.29
$44.7499450
E
Life/disability evaluation99455
E
Disability examination99456
E
Disability examination99499
E
Unlisted e&m serviceA0021
E
Outside state ambulance servA0030D
A
Air ambulance serviceA0040D
A
Helicopter ambulance serviceA0050D
A
Water amb service emergencyA0080
E
Noninterest escort in non erA0090
E
Interest escort in non erA0100
E
Nonemergency transport taxiA0110
E
Nonemergency transport busA0120
E
Noner transport mini-busA0130
E
Noner transport wheelch vanA0140
E
Nonemergency transport airA0160
E
Noner transport case workerA0170
E
Noner transport parking feesA0180
E
Noner transport lodgng recip( print page 67947)A0190
E
Noner transport meals recipA0200
E
Noner transport lodgng escrtA0210
E
Noner transport meals escortA0225
A
Neonatal emergency transportA0300D
A
Ambulance basic non-emer allA0302D
A
Ambulance basic emergeny allA0304D
A
Amb adv non-er no serv allA0306D
A
Amb adv non-er spec serv allA0308D
A
Amb adv er no spec serv allA0310D
A
Amb adv er spec serv allA0320D
A
Amb basic non-er + suppliesA0322D
A
Amb basic emerg + suppliesA0324D
A
Adv non-er serv sep mileageA0326D
A
Adv non-er no serv sep mileA0328D
A
Adv er no serv sep mileageA0330D
A
Adv er spec serv sep mileA0340D
A
Amb basic non-er + mileageA0342D
A
Ambul basic emer + mileageA0344D
A
Amb adv non-er no serv +mileA0346D
A
Amb adv non-er serv + mileA0348D
A
Adv emer no spec serv + mileA0350D
A
Adv emer spec serv + mileageA0360D
A
Basic non-er sep mile & suppA0362D
A
Basic emer sep mile & supplyA0364D
A
Adv non-er no serv sep mi&suA0366D
A
Adv non-er serv sep mil&suppA0368
A
Adv er no serv sep mile&suppA0370D
A
Adv er spec serv sep mi&suppA0380D
A
Basic life support mileageA0382
A
Basic support routine supplsA0384
A
Bls defibrillation suppliesA0390D
A
Advanced life support mileagA0392
A
Als defibrillation suppliesA0394
A
Als IV drug therapy suppliesA0396
A
Als esophageal intub supplsA0398
A
Als routine disposble supplsA0420
A
Ambulance waiting 1/2 hrA0422
A
Ambulance O2 life sustainingA0424
A
Extra ambulance attendantA0425
A
Ground mileageA0426
A
Als 1A0427
A
ALS1-emergencyA0428
A
blsA0429
A
BLS-emergencyA0430
A
Fixed wing air transportA0431
A
Rotary wing air transportA0432
A
PI volunteer ambulance coA0433
A
als 2A0434
A
Specialty care transportA0435
A
Fixed wing air mileageA0436
A
Rotary wing air mileageA0888
E
Noncovered ambulance mileageA0999
A
Unlisted ambulance serviceA4206
E
1 CC sterile syringe&needleA4207
E
2 CC sterile syringe&needleA4208
E
3 CC sterile syringe&needleA4209
E
5+ CC sterile syringe&needleA4210
E
Nonneedle injection deviceA4211
E
Supp for self-adm injectionsA4212
E
Non coring needle or styletA4213
E
20+ CC syringe onlyA4214
A
30 CC sterile water/salineA4215
E
Sterile needleA4220
E
Infusion pump refill kitA4221
A
Maint drug infus cath per wkA4222
A
Drug infusion pump suppliesA4230
A
Infus insulin pump non needlA4231
A
Infusion insulin pump needleA4232
A
Syringe w/needle insulin 3ccA4244
E
Alcohol or peroxide per pintA4245
E
Alcohol wipes per boxA4246
E
Betadine/phisohex solutionA4247
E
Betadine/iodine swabs/wipesA4250
E
Urine reagent strips/tablets( print page 67948)A4253
A
Blood glucose/reagent stripsA4254
A
Battery for glucose monitorA4255
A
Glucose monitor platformsA4256
A
Calibrator solution/chipsA4258
A
Lancet device eachA4259
A
Lancets per boxA4260
E
Levonorgestrel implantA4261
E
Cervical cap contraceptiveA4262
N
Temporary tear duct plugA4263
N
Permanent tear duct plugA4265
A
ParaffinA4270
A
Disposable endoscope sheathA4280
A
Brst prsths adhsv attchmntA4290
N
Sacral nerve stim test leadA4300
A
Cath impl vasc access portalA4301
A
Implantable access syst percA4305
A
Drug delivery system >=50 MLA4306
A
Drug delivery system <=5 MLA4310
A
Insert tray w/o bag/cathA4311
A
Catheter w/o bag 2-way latexA4312
A
Cath w/o bag 2-way siliconeA4313
A
Catheter w/bag 3-wayA4314
A
Cath w/drainage 2-way latexA4315
A
Cath w/drainage 2-way silcneA4316
A
Cath w/drainage 3-wayA4319
A
Sterile H2O irrigation solutA4320
A
Irrigation trayA4321
A
Cath therapeutic irrig agentA4322
A
Irrigation syringeA4323
A
Saline irrigation solutionA4324
A
Male ext cath w/adh coatingA4325
A
Male ext cath w/adh stripA4326
A
Male external catheterA4327
A
Fem urinary collect dev cupA4328
A
Fem urinary collect pouchA4329
A
External catheter start setA4330
A
Stool collection pouchA4331
A
Extension drainage tubingA4332
A
Lubricant for cath insertionA4333
A
Urinary cath anchor deviceA4334
A
Urinary cath leg strapA4335
A
Incontinence supplyA4338
A
Indwelling catheter latexA4340
A
Indwelling catheter specialA4344
A
Cath indw foley 2 way silicnA4346
A
Cath indw foley 3 wayA4347
A
Male external catheterA4348
A
Male ext cath extended wearA4351
A
Straight tip urine catheterA4352
A
Coude tip urinary catheterA4353
A
Intermittent urinary cathA4354
A
Cath insertion tray w/bagA4355
A
Bladder irrigation tubingA4356
A
Ext ureth clmp or compr dvcA4357
A
Bedside drainage bagA4358
A
Urinary leg bagA4359
A
Urinary suspensory w/o leg bA4361
A
Ostomy face plateA4362
A
Solid skin barrierA4364
A
Ostomy/cath adhesiveA4365
A
Ostomy adhesive remover wipeA4367
A
Ostomy beltA4368
A
Ostomy filterA4369
A
Skin barrier liquid per ozA4370
A
Skin barrier paste per ozA4371
A
Skin barrier powder per ozA4372
A
Skin barrier solid 4x4 equivA4373
A
Skin barrier with flangeA4374
A
Skin barrier extended wearA4375
A
Drainable plastic pch w fcplA4376
A
Drainable rubber pch w fcpltA4377
A
Drainable plstic pch w/o fpA4378
A
Drainable rubber pch w/o fpA4379
A
Urinary plastic pouch w fcpl( print page 67949)A4380
A
Urinary rubber pouch w fcpltA4381
A
Urinary plastic pouch w/o fpA4382
A
Urinary hvy plstc pch w/o fpA4383
A
Urinary rubber pouch w/o fpA4384
A
Ostomy faceplt/silicone ringA4385
A
Ost skn barrier sld ext wearA4386
A
Ost skn barrier w flng ex wrA4387
A
Ost clsd pouch w att st barrA4388
A
Drainable pch w ex wear barrA4389
A
Drainable pch w st wear barrA4390
A
Drainable pch ex wear convexA4391
A
Urinary pouch w ex wear barrA4392
A
Urinary pouch w st wear barrA4393
A
Urine pch w ex wear bar convA4394
A
Ostomy pouch liq deodorantA4395
A
Ostomy pouch solid deodorantA4396
A
Peristomal hernia supprt bltA4397
A
Irrigation supply sleeveA4398
A
Ostomy irrigation bagA4399
A
Ostomy irrig cone/cath w brsA4400
A
Ostomy irrigation setA4402
A
Lubricant per ounceA4404
A
Ostomy ring eachA4421
A
Ostomy supply miscA4454
A
Tape all types all sizesA4455
A
Adhesive remover per ounceA4460
A
Elastic compression bandageA4462
A
Abdmnl drssng holder/binderA4464
A
Joint support device/garmentA4465
A
Non-elastic extremity binderA4470
A
Gravlee jet washerA4480
A
Vabra aspiratorA4481
A
Tracheostoma filterA4483
A
Moisture exchangerA4490
E
Above knee surgical stockingA4495
E
Thigh length surg stockingA4500
E
Below knee surgical stockingA4510
E
Full length surg stockingA4550
E
Surgical traysA4554
E
Disposable underpadsA4556
A
Electrodes, pairA4557
A
Lead wires, pairA4558
A
Conductive paste or gelA4560D
A
PessaryA4561
N
Pessary rubber, any typeA4562
N
Pessary, non rubber,any typeA4565
A
SlingsA4570
N
SplintA4572
A
Rib beltA4575
E
Hyperbaric o2 chamber dispsA4580
N
Cast supplies (plaster)A4590
N
Special casting materialA4595
A
TENS suppl 2 lead per monthA4608
A
Transtracheal oxygen cathA4611
A
Heavy duty batteryA4612
A
Battery cablesA4613
A
Battery chargerA4614
A
Hand-held PEFR meterA4615
A
Cannula nasalA4616
A
Tubing (oxygen) per footA4617
A
Mouth pieceA4618
A
Breathing circuitsA4619
A
Face tentA4620
A
Variable concentration maskA4621
A
Tracheotomy mask or collarA4622
A
Tracheostomy or larngectomyA4623
A
Tracheostomy inner cannulaA4624
A
Tracheal suction tubeA4625
A
Trach care kit for new trachA4626
A
Tracheostomy cleaning brushA4627
E
Spacer bag/reservoirA4628
A
Oropharyngeal suction cathA4629
A
Tracheostomy care kitA4630
A
Repl bat t.e.n.s. own by pt( print page 67950)A4631
A
Wheelchair batteryA4635
A
Underarm crutch padA4636
A
Handgrip for cane etcA4637
A
Repl tip cane/crutch/walkerA4640
A
Alternating pressure padA4641
N
Diagnostic imaging agentA4642
G
Satumomab pendetide per dose
0704

$712.50

$86.93A4643
N
High dose contrast MRIA4644
N
Contrast 100-199 MGs iodineA4645
N
Contrast 200-299 MGs iodineA4646
N
Contrast 300-399 MGs iodineA4647
N
Supp- paramagnetic contr matA4649
A
Surgical suppliesA4650
A
Supp esrd centrifugeA4655
A
Esrd syringe/needleA4660
A
Esrd blood pressure deviceA4663
A
Esrd blood pressure cuffA4670
E
Auto blood pressure monitorA4680
A
Activated carbon filtersA4690
A
DialyzersA4700
A
Standard dialysate solutionA4705
A
Bicarb dialysate solutionA4712
A
Sterile waterA4714
A
Treated water for dialysisA4730
A
Fistula cannulation set dialA4735
A
Local/topical anestheticsA4740
A
Esrd shunt accessoryA4750
A
Arterial or venous tubingA4755
A
Arterial and venous tubingA4760
A
Standard testing solutionA4765
A
Dialysate concentrateA4770
A
Blood testing suppliesA4771
A
Blood clotting time tubeA4772
A
Dextrostick/glucose stripsA4773
A
HemostixA4774
A
Ammonia test paperA4780
A
Esrd sterilizing agentA4790
A
Esrd cleansing agentsA4800
A
Heparin/antidote dialysisA4820
A
Supplies hemodialysis kitA4850
A
Rubber tipped hemostatsA4860
A
Disposable catheter capsA4870
A
Plumbing/electrical workA4880
A
Water storage tanksA4890
A
Contracts/repair/maintenanceA4900
A
Capd supply kitA4901
A
Ccpd supply kitA4905
A
Ipd supply kitA4910
A
Esrd nonmedical suppliesA4912
A
Gomco drain bottleA4913
A
Esrd supplyA4914
A
Preparation kitA4918
A
Venous pressure clampA4919
A
Supp dialysis dialyzer holdeA4920
A
Harvard pressure clampA4921
A
Measuring cylinderA4927
A
GlovesA5051
A
Pouch clsd w barr attachedA5052
A
Clsd ostomy pouch w/o barrA5053
A
Clsd ostomy pouch faceplateA5054
A
Clsd ostomy pouch w/flangeA5055
A
Stoma capA5061
A
Pouch drainable w barrier atA5062
A
Drnble ostomy pouch w/o barrA5063
A
Drain ostomy pouch w/flangeA5064
E
Drain ostomy pouch w/fceplteA5065D
E
Drain ostomy pouch w/fceplteA5071
A
Urinary pouch w/barrierA5072
A
Urinary pouch w/o barrierA5073
A
Urinary pouch on barr w/flngA5074
E
Urinary pouch w/faceplateA5075
E
Urinary pouch on faceplateA5081
A
Continent stoma plugA5082
A
Continent stoma catheter( print page 67951)A5093
A
Ostomy accessory convex inseA5102
A
Bedside drain btl w/wo tubeA5105
A
Urinary suspensoryA5112
A
Urinary leg bagA5113
A
Latex leg strapA5114
A
Foam/fabric leg strapA5119
A
Skin barrier wipes box pr 50A5121
A
Solid skin barrier 6x6A5122
A
Solid skin barrier 8x8A5123
A
Skin barrier with flangeA5126
A
Disk/foam pad +or- adhesiveA5131
A
Appliance cleanerA5149D
A
Incontinence/ostomy supplyA5200
A
Percutaneous catheter anchorA5500
A
Diab shoe for density insertA5501
A
Diabetic custom molded shoeA5502
A
Diabetic shoe density insertA5503
A
Diabetic shoe w/roller/rockrA5504
A
Diabetic shoe with wedgeA5505
A
Diab shoe w/metatarsal barA5506
A
Diabetic shoe w/off set heelA5507
A
Modification diabetic shoeA5508
A
Diabetic deluxe shoeA6020
A
Collagen wound dressingA6021
A
Collagen dressing <=16 sq inA6022
A
Collagen drsg>6<=48 sq inA6023
A
Collagen dressing >48 sq inA6024
A
Collagen dsg wound fillerA6025
E
Silicone gel sheet, eachA6154
A
Wound pouch eachA6196
A
Alginate dressing <=16 sq inA6197
A
Alginate drsg >16 <=48 sq inA6198
A
alginate dressing > 48 sq inA6199
A
Alginate drsg wound fillerA6200
A
Compos drsg <=16 no borderA6201
A
Compos drsg >16<=48 no bdrA6202
A
Compos drsg >48 no borderA6203
A
Composite drsg <= 16 sq inA6204
A
Composite drsg >16<=48 sq inA6205
A
Composite drsg > 48 sq inA6206
A
Contact layer <= 16 sq inA6207
A
Contact layer >16<= 48 sq inA6208
A
Contact layer > 48 sq inA6209
A
Foam drsg <=16 sq in w/o bdrA6210
A
Foam drg >16<=48 sq in w/o bA6211
A
Foam drg > 48 sq in w/o brdrA6212
A
Foam drg <=16 sq in w/borderA6213
A
Foam drg >16<=48 sq in w/bdrA6214
A
Foam drg > 48 sq in w/borderA6215
A
Foam dressing wound fillerA6216
A
Non-sterile gauze<=16 sq inA6217
A
Non-sterile gauze>16<=48 sqA6218
A
Non-sterile gauze > 48 sq inA6219
A
Gauze <= 16 sq in w/borderA6220
A
Gauze >16 <=48 sq in w/bordrA6221
A
Gauze > 48 sq in w/borderA6222
A
Gauze <=16 in no w/sal w/o bA6223
A
Gauze >16<=48 no w/sal w/o bA6224
A
Gauze > 48 in no w/sal w/o bA6228
A
Gauze <= 16 sq in water/salA6229
A
Gauze >16<=48 sq in watr/salA6230
A
Gauze > 48 sq in water/salneA6231
A
Hydrogel dsg<=16 sq inA6232
A
Hydrogel dsg>16<=48 sq inA6233
A
Hydrogel dressing >48 sq inA6234
A
Hydrocolld drg <=16 w/o bdrA6235
A
Hydrocolld drg >16<=48 w/o bA6236
A
Hydrocolld drg > 48 in w/o bA6237
A
Hydrocolld drg <=16 in w/bdrA6238
A
Hydrocolld drg >16<=48 w/bdrA6239
A
Hydrocolld drg > 48 in w/bdrA6240
A
Hydrocolld drg filler pasteA6241
A
Hydrocolloid drg filler dryA6242
A
Hydrogel drg <=16 in w/o bdr( print page 67952)A6243
A
Hydrogel drg >16<=48 w/o bdrA6244
A
Hydrogel drg >48 in w/o bdrA6245
A
Hydrogel drg <= 16 in w/bdrA6246
A
Hydrogel drg >16<=48 in w/bA6247
A
Hydrogel drg > 48 sq in w/bA6248
A
Hydrogel drsg gel fillerA6250
A
Skin seal protect moisturizrA6251
A
Absorpt drg <=16 sq in w/o bA6252
A
Absorpt drg >16 <=48 w/o bdrA6253
A
Absorpt drg > 48 sq in w/o bA6254
A
Absorpt drg <=16 sq in w/bdrA6255
A
Absorpt drg >16<=48 in w/bdrA6256
A
Absorpt drg > 48 sq in w/bdrA6257
A
Transparent film <= 16 sq inA6258
A
Transparent film >16<=48 inA6259
A
Transparent film > 48 sq inA6260
A
Wound cleanser any type/sizeA6261
A
Wound filler gel/paste /ozA6262
A
Wound filler dry form / gramA6263
A
Non-sterile elastic gauze/ydA6264
A
Non-sterile no elastic gauzeA6265
A
Tape per 18 sq inchesA6266
A
Impreg gauze no h2O/sal/yardA6402
A
Sterile gauze <= 16 sq inA6403
A
Sterile gauze>16 <= 48 sq inA6404
A
Sterile gauze > 48 sq inA6405
A
Sterile elastic gauze /ydA6406
A
Sterile non-elastic gauze/ydA7000
A
Disposable canister for pumpA7001
A
Nondisposable pump canisterA7002
A
Tubing used w suction pumpA7003
A
Nebulizer administration setA7004
A
Disposable nebulizer sml volA7005
A
Nondisposable nebulizer setA7006
A
Filtered nebulizer admin setA7007
A
Lg vol nebulizer disposableA7008
A
Disposable nebulizer prefillA7009
A
Nebulizer reservoir bottleA7010
A
Disposable corrugated tubingA7011
A
Nondispos corrugated tubingA7012
A
Nebulizer water collec devicA7013
A
Disposable compressor filterA7014
A
Compressor nondispos filterA7015
A
Aerosol mask used w nebulizeA7016
A
Nebulizer dome & mouthpieceA7017
A
Nebulizer not used w oxygenA7018
A
Water distilled w/nebulizerA7019
A
Saline solution dispenserA7020
A
Sterile H2O or NSS w lgv nebA7501
A
Tracheostoma valve w diaphraA7502
A
Replacement diaphragm/fplateA7503
A
HMES filter holder or capA7504
A
Tracheostoma HMES filterA7505
A
HMES or trach valve housingA7506
A
HMES/trachvalve adhesivediskA7507
A
Integrated filter & holderA7508
A
Housing & Integrated AdhesivA7509
A
Heat & moisture exchange sysA9150
E
Misc/exper non-prescript druA9160
E
Podiatrist non-covered serviA9170
E
Chiropractor non-covered serA9190
E
Misc/expe personal comfort iA9270
E
Non-covered item or serviceA9300
E
Exercise equipment*A9500
G
Technetium TC 99m sestamibi
1600

$109.25

$13.33A9502
G
Technetium TC99M tetrofosmin
0705

$136.80

$16.69*A9503
G
Technetium TC 99m medronate
1601

$38.38

$4.68*A9504
G
Technetium tc 99m apcitide
1602

$47.50

$5.80*A9505
G
Thallous chloride TL 201/mci
1603

$28.50

$3.48*A9507
G
Indium/111 capromab pendetid
1604

$1,008.90

$135.19A9508
G
Iobenguane sulfate I-131
1045

$1,140.00

$139.08A9510
G
Technetium TC99m Disofenin
1205

$427.50

$57.29A9600
G
Strontium-89 chloride
0701

$783.75

$95.62A9605
G
Samarium sm153 lexidronamm
0702

$942.09

$134.87( print page 67953)A9700
N
Echocardiography ContrastA9900
E
Supply/accessory/serviceA9901
E
Delivery/set up/dispensingB4034
A
Enter feed supkit syr by dayB4035
A
Enteral feed supp pump per dB4036
A
Enteral feed sup kit grav byB4081
A
Enteral ng tubing w/ styletB4082
A
Enteral ng tubing w/o styletB4083
A
Enteral stomach tube levineB4084
A
Gastrostomy/jejunostomy tubiB4085
A
Gastrostomy tube w/ring eachB4150
A
Enteral formulae category iB4151
A
Enteral formulae category i-B4152
A
Enteral formulae category iiB4153
A
Enteral formulae category iiB4154
A
Enteral formulae category IVB4155
A
Enteral formulae category vB4156
A
Enteral formulae category viB4164
A
Parenteral 50% dextrose soluB4168
A
Parenteral sol amino acid 3.B4172
A
Parenteral sol amino acid 5.B4176
A
Parenteral sol amino acid 7-B4178
A
Parenteral sol amino acid >B4180
A
Parenteral sol carb > 50%B4184
A
Parenteral sol lipids 10%B4186
A
Parenteral sol lipids 20%B4189
A
Parenteral sol amino acid &B4193
A
Parenteral sol 52-73 gm protB4197
A
Parenteral sol 74-100 gm proB4199
A
Parenteral sol > 100gm proteB4216
A
Parenteral nutrition additivB4220
A
Parenteral supply kit premixB4222
A
Parenteral supply kit homemiB4224
A
Parenteral administration kiB5000
A
Parenteral sol renal-amirosyB5100
A
Parenteral sol hepatic-freamB5200
A
Parenteral sol stres-brnch cB9000
A
Enter infusion pump w/o alrmB9002
A
Enteral infusion pump w/ alaB9004
A
Parenteral infus pump portabB9006
A
Parenteral infus pump statioB9998
A
Enteral supp not otherwise cB9999
A
Parenteral supp not othrws cC1000
H
PerclosClosr ProstarArt Vas
1000C1001
H
AcuNav-diagnstic ultrsnd ca
1001C1003
H
Cath, ablation, Livewire TC
1003C1004
H
Fast-Cath,Swartz,SAFL,CSTA
1004C1005D
E
Sensar IOLC1006
H
ARRAY post chamb IOL
1006C1007
H
Ams 700 penile prosthesis
1007C1008
H
Urolume-implt uretheral stent
1008C1009
K
Plasma, cryoprecipitate-reduced, unit
1009
0.86
$42.76

$8.55C1010
K
Blood, L/R, CMV-neg
1010
2.88
$142.84

$28.57C1011
K
Platelets, L/R, CMV-neg, unit
1011
11.86
$588.15

$117.63C1012
K
Platelet concentrate, L/R, irradiated, unit
1012
1.92
$95.23

$19.05C1013
K
Platelet concentrate, L/R, unit
1013
1.18
$58.30

$11.66C1014
K
Platelets, aph/pher, L/R, unit
1014
8.93
$443.11

$88.62C1016
K
Blood, L/R, froz/deglycerol/washed
1016
7.15
$354.68

$70.94C1017
K
Platelets, aph/pher, L/R, CMV-neg, unit
1017
9.33
$462.54

$92.51C1018
K
Blood, L/R, irradiated
1018
3.13
$155.48

$31.10C1019
K
Platelets, aph/pher, L/R, irradiated, unit
1019
9.64
$478.09

$95.62C1024
J
Quinupristin 150 mg/dalfopriston 350 mg
1024

$159.60

$20.50C1025
H
Marinr CS Cath
1025C1026
H
RF Perfrmr cath 5F RF Marinr
1026C1027
H
Magic x/short, Radius14mm
1027C1028
H
Prcis Twst trnsvg anch sys
1028C1029
H
CRE guided balloon dil cath
1029C1030
H
Cthtr:Mrshal,Blu Max Utr Dmnd
1030C1031D
E
MR Comp/mod LeVeen ned electC1033
H
Sonicath mdl 37-410
1033C1034
H
SURPASS, Long30 SURPASS-cath
1034C1035
H
Cath, Ultra ICE
1035C1036
H
R port/reservoir impl dev
1036C1037
H
Vaxcelchronic dialysis cath
1037( print page 67954)C1038
H
UltraCross Imaging Cath
1038C1039
H
Wallstent, tracheobronchial
1039C1040
H
WALLSTENT: TIPS (shunt)
1040C1042
H
Wallstent, biliary
1042C1043
H
Atherectomy sys, coronary
1043C1045
G
I-131 MIBG (ioben-sulfate) O.5mCi
1045

$1,140.00

$139.08C1047
H
Noga/Navi-Star cath
1047C1048
H
NeuroCyberneticPros: gen
1048C1050
H
Prosorba column
1410C1051
H
Oasis Thrombectomy Cath
1051C1053
H
EnSite 3000 catheter
1053C1054
H
Hydrolyser Thromb Cath 6/7F
1054C1055
H
Transesoph 210, 210-S Cath
1055C1056
H
Thermachoice II Cath
1056C1057
H
Micromark Tissue Marker
1057C1059
G
Carticel,auto cult-chndr cyte
1059

$14,250.00

$2,010.00C1060
H
ACS multi-link tristor/ultra
1060*C1061
H
ACS Viking Guiding cath
1061*C1063
H
EndoTak Endurance EZ, RX lead
1063*C1067
H
Megalink biliary stent
1067*C1068
H
Pulsar DDD pmkr
1068*C1069
H
Discovery DR, pmaker
1069*C1071
H
Pulsar Max, Pulsar SR pmkr
1071*C1072
H
Guidant: blln dil cath
1072*C1073
H
Morcellator
1073*C1074
H
RX/OTW Viatrac-peri dil cath
1074*C1075
H
Guidant: lead
1075*C1076
H
Ventak mini sc defib
1076*C1077
H
Ventak VR Prizm VR, sc defib
1077*C1078
H
Ventak: Prizm, AVIIIDR defib
1078*C1079
G
CO 57/58 0.5 mCi
1079

$264.10

$32.22*C1084
G
Denileukin diftitox, 300 mcg
1084

$942.88

$126.35*C1086
G
Temozolomide, 5 mg
1086

$5.70

$.76*C1087
G
I-123 per uCi capsule
1087

$.84

$.10*C1088
T
LaserOptic tx sys
0980
38.67
$1,917.89

$383.58*C1089
G
CO 57, 0.5 mCi
1089

$91.20

$11.13*C1090
G
IN 111 Chloride, per mCi
1090

$152.00

$18.54*C1091
G
IN 111 Oxyquinoline, per 5 mCi
1091

$508.25

$62.01*C1092
G
IN 111 Pentetate, per 1.5 mCi
1092

$769.50

$93.88*C1094
J
TC 99M Albumin aggr, per vial
1094

$102.05

$13.67*C1095
G
TC 99M Depreotide, per vial
1095

$760.00

$101.84*C1096
G
TC 99M Exametazime, per dose
1096

$34.20

$4.17*C1097
G
TC 99M Mebrofenin, per vial
1097

$445.31

$63.75*C1098
G
TC 99M Pentetate, per vial
1098

$46.76

$5.71*C1099
J
TC 99M Pyrophosphate, per vial
1099

$42.75

$5.22*C1100
H
Medtronic AVE GT1 guidewire
1100*C1101
H
MedtronicAVE Zuma guidecath
1101*C1102
H
Syngergy Neurostim Genrtr
1102*C1103
H
Micro Jewel Defibrillator
1103*C1104
H
RF Conductor Ablative Cath
1104*C1105
H
Sigma 300VDD pacmker
1105*C1106
H
SynergyEZ Pt Progrmr
1106*C1107
H
Torqr, Solist cath
1107*C1109
H
Implantable anchor: Ethicon
1109*C1110
H
Stable Mapper, cath electrd
1110*C1111
H
AneuRxAort-Uni-Ilicstnt&cath
1111*C1112
H
AneuRx Stent graft/del.cath
1112*C1113
H
Tlnt Endo Sprng Stnt Grft Sys
1113*C1114
H
TalntSprgStnt+Graf endo pros
1114*C1115
H
5038S,5038,5038L pace lead
1115*C1116
H
CapSureSP pacing Lead
1116*C1117
H
Ancure Endograft Del Sys
1117*C1118
H
Sigma300DR LegIIDR,pacemkr
1118*C1119
H
Sprint6932,6943 defib lead
1119*C1120
H
Sprint6942,6945 defib lead
1120*C1121
H
Gem defibrillator
1121*C1122
G
TC 99M arcitumomab per dose
1122

$22.80

$2.78*C1123
H
Gem II VR defibrillator
1123*C1124
H
InterStim Test Stim Kit
1124*C1125
H
Kappa 400SR,Ttopaz II SR pmkr
1125*C1126
H
Kappa 700 DR pacemakr
1126*C1127
H
Kappa 700SR,pmkr sgl chamber
1127*C1128
H
Kappa 700D,Ruby IID pmkr
1128*C1129
H
Kappa 700VDD,pacmkr
1129( print page 67955)*C1130
H
Sigm200D,LGCY IID sc pmkr
1130*C1131
H
Sigma 200DR, pmker
1131*C1132
H
Sigma300,200SR Leg II:sc pac
1132*C1133
H
Sigma SR, Vita SR, pmaker
1133*C1134
H
Sigma 300D pmker
1134*C1135
H
Entity DR 5326L/R
1135*C1136
H
Affinity DR 5330L/R
1136*C1137
H
CardioSEAL implant syst
1137*C1143
H
AddVent mod 2060BL,VDD
1143*C1144
H
Afnty SR 5130,Integrity SR,pmkr
1144*C1145
H
Angio-Seal 6fr, 8fr
1145C1146D
E
VETT tube*C1147
H
AV Plus DX 1368: lead
1147*C1148
H
Contour MD sc defib
1148*C1149
H
Entity DC 5226R, 5226 pmkr
1149*C1151
H
Passiveplus DX lead, 10mdls
1151*C1152
H
LifeSite Access System
1152*C1153
H
Regency SC+ 2402L pmker
1153*C1154
H
SPL:SPOI,02,04- defib lead
1154*C1155
H
Repliform 8 sq cm
1155*C1156
H
Tr 1102TrSR+ 2260L,2264L,5131
1156*C1157
H
Trilogy DCT 2318L pmkr
1157*C1158
H
TVL lead SV01,SV02,SV04
1158*C1159
H
TVL RV02,RV06,RV07: lead
1159*C1160
H
TVL-ADX 1559: lead
1160*C1161
H
Tendril DX, 1388 pacing lead
1161*C1162
H
TempoDr, TrilogyDR+DC pmkr
1162*C1163
H
Tendril SDX, 1488T pacing lead
1163*C1164
H
Iodine-125 brachytx seed
1164*C1166
G
Cytarabine liposomal, 10 mg
1166

$371.45

$49.77*C1167
J
Epirubicin hcl, 2 mg
1167

$24.94

$3.34C1170D
E
ABBI disp biopsy device*C1171
H
Autosuture site marker stple
1171*C1172
H
Spacemaker dissect ballon
1172*C1173
H
Cor stnt S540, S670, o-wire stn
1173*C1174
H
Bard brachytx needle
1174C1175D
E
Biopsy device, MIBB DeviceC1176D
E
Mammotome HH Probe w/Vac SysC1177D
E
11-G Mammotome Probe*C1178
G
Busulfan IV, 6 mg
1178

$26.48

$3.55C1179D
E
14-G Mammotome Probe*C1180
H
Vigor SR, SC, pmkr
1180*C1181
H
Meridian SSI, SC, pmkr
1181*C1182
H
Pulsar SSI, SC, pmkr
1182*C1183
H
Jade IIS, Sigma 300S,SC, pmkr
1183*C1184
H
Sigma 200S, SC, pmkr
1184*C1188
G
I 131, per mCi
1188

$5.86

$.75*C1200
G
TC 99M Sodium Glucoheptonate, per vial
1200

$113.05

$13.79*C1201
G
TC 99M succimer, per vial
1201

$135.66

$16.55*C1202
G
TC 99M Sulfur Colloid, per dose
1202

$38.00

$4.64*C1203
G
Verteporfin for Injection
1203

$1,458.25

$195.41*C1205
G
TC 99M Disofenin, per vial
1205

$427.50

$57.29*C1207
G
Octreotide acetate depot 1mg
1207

$135.10

$16.48*C1300
S
Hyperbaric O2 per 30 min under pressure
0971
1.55
$76.88

$15.38*C1302
H
Lead, defibrillator, TVL SQ01
1302*C1303
H
CapSure Fix 6940/4068-110, lead
1303*C1304
H
Sonicath mdl 37-416,-418
1304*C1305
G
Apligraf
1305

$1,157.81

$163.31*C1306
H
NeuroCyberneticPros: lead
1306*C1311
H
Trilogy DR+/DAO pmkr
1311*C1312
H
Magic WALLSTENTstent-Mini
1312*C1313
H
Magic medium, Radius 31mm
1313*C1314
H
Magic WALLSTENT stent-Long
1314*C1315
H
Vigor DR, Meridian DR pmkr
1315*C1316
H
Meridian DDD pmkr
1316*C1317
H
Discovery SR, pmkr
1317*C1318
H
Meridian SR pmakr
1318*C1319
H
WALLSTENT: enteral
1319*C1320
H
WALLSTENT:iliac
1320C1321D
E
Palate/Base of Tongue electrC1322D
E
Turbinate Somnoplasty electrC1323D
E
VAPR/T disp electrodeC1324D
E
Ligasure disposable electrode*C1325
H
Pallidium -103 seed
1325( print page 67956)*C1326
H
Angio-jet rheolytic thromb cath
1326*C1328
H
ANS Renew NS trnsmtr
1328C1329D
E
Versapoint disp electrode*C1333
H
PALMAZ Corinthian bill stent
1333*C1334
H
Crown,Mini-crown,CrossLC
1334*C1335
H
Mesh, Prolene
1335*C1336
H
Constant Flow Imp Pump
1336*C1337
H
IsoMed 8472-20/35/60
1337*C1348
G
I 131 per mCi solution
1348

$146.57

$17.88*C1350
H
ProstaSeed, I125, per source
1350*C1351
H
CapSure Fix lead
1351*C1352
H
Gem II defib
1352*C1353
H
Itrel Interstm neurostim+ext
1353*C1354
H
Kappa 400DR,Diamond II 820DR
1354*C1355
H
Kappa 600DR, Vita DR
1355*C1356
H
Profile MD V-186HV3 sc defib
1356*C1357
H
Angstrom MD V-190HV3 sc defib
1357*C1358
H
Affinity DC 5230R, 5230 pmkr
1358*C1359
H
Pulsar,Pulsar Max DR,pmkr
1359*C1360D
T
Ocular photodynamic therapy
0235
2.94
$145.81
$78.91
$29.16*C1361
H
Reveal Cardiac Recorder
1108*C1362
H
Herculink,OTW SDS bil stent
1411*C1363
H
Gem DR, DC, defib
1363*C1364
H
Photon DR V-230HV3 DC defib
1364*C1365
H
Guidewire, Hi-Torque14/18/35
1365*C1366
H
Guidewire,PTCA, Hi-Torque
1366*C1367
H
Guidewire, Hi-Torque CrossIt
1367C1368D
E
On-Q Pain Mgt Sys*C1369
H
ANS Renew Stim Sys recvr
1369*C1370
H
Tension-Free Vaginal Tape
1370*C1371
H
Symp Nitinol Transhep Bil Sys
1371*C1372
H
Cordis Nitinol bil stent
1372*C1375
H
Stent, coronary, NIR
1375*C1376
H
ANS Renew Stim Sys lead/ex
1376*C1377
H
Specify 3988 neuro lead
1377*C1378
H
InterStim Tx 3080/3886 lead
1378*C1379
H
Pisces-Quad 3887 lead
1379*C1420
H
StapleTac2 Bone w/Dermis
1420*C1421
H
StapleTac2 Bone wo Dermis
1421*C1450
H
Orthosphere Arthroplasty
1450*C1451
H
Orthosphere Arthroplasty Kit
1451*C1500
H
Atherectomy sys, peripheral
1500*C1700
H
Authen Mick TP brachy needle
1700*C1701
H
Medtec MT-BT-5201 -25 ndl
1701*C1702
H
WWMT brachytx needle
1702*C1703
H
Mentor Prostate Brachy
1703*C1704
H
MT-BT-5001-25/5051-25
1704*C1705
H
Best Flexi Brachy Needle
1705*C1706
H
Indigo Prostate Seeding Ndl
1706*C1707
H
Varisource Implt Ndl
1707*C1708
H
UroMed Prostate Seed Ndl
1708*C1709
H
Remington Brachytx Needle
1709*C1710
H
US Biopsy Prostate Needle
1710*C1711
H
MD Tech brachytx needle
1711*C1712
H
Imagyn brachytx needle
1712*C1790
H
Iridium 192 HDR
1790*C1791
H
OncoSeed, Rapid Strand I-125
1791*C1792
H
UroMed I-125 Brachy seed
1792*C1793
H
Bard InterSource P-103 seed
1793*C1794
H
Bard IsoSeed P-103 seed
1794*C1795
H
Bard BrachySource I-125
1795*C1796
H
SourceTech Med I-125
1796*C1797
H
Draximage I-125 seed
1797*C1798
H
Syncor I-125 PharmaSeed
1798*C1799
H
I-Plant I-125 Brachytx seed
1799*C1800
H
Pd-103 brachytx seed
1800*C1801
H
IoGold I-125 brachytx seed
1801*C1802
H
Brachytherapy seed, Iridium 192
1802*C1803
H
Best Iodine 125 brachytx sds
1803*C1804
H
Best Palladium 103 seeds
1804*C1805
H
IsoStar Iodine-125 seeds
1805*C1806
H
Gold 198 brachy seeds
1806*C1810
H
D114S Dilatation Cath
1810*C1811
H
Surgical Dynamics Anchors
1811( print page 67957)*C1812
H
OBL Anchors
1812*C1850
H
Repliform 14/21 sq cm
1850*C1851
H
Repliform 24/28 sq cm
1851*C1852
H
TransCyte, per 247 sq cm
1852*C1853
H
Suspend, per 8/14 sq cm
1853*C1854
H
Suspend, per 24/28 sq cm
1854*C1855
H
Suspend, per 36 sq cm
1855*C1856
H
Suspend, per 48 sq cm
1856*C1857
H
Suspend, per 84 sq cm
1857*C1858
H
DuraDerm, per 8/14 sq cm
1858*C1859
H
DuraDerm, per 21/24/28 sq cm
1859*C1860
H
DuraDerm, per 48 sq cm
1860*C1861
H
DuraDerm, per 36 sq cm
1861*C1862
H
DuraDerm, per 72 sq cm
1862*C1863
H
DuraDerm, per 84 sq cm
1863*C1864
H
SpermaTex,per 13.44 sq cm
1864*C1865
H
FasLata, per 8/14 sq cm
1865*C1866
H
FasLata, per 24/28 sq cm
1866*C1867
H
FasLata, per 36/48 sq cm
1867*C1868
H
FasLata, per 96 sq cm
1868*C1869
H
Gore Thyroplasty Dev
1869*C1870
H
DermMatrix, per 16 sq cm
1870*C1871
H
DermMatrix, 32 or 64 sq cm
1871*C1872
H
Dermagraft, per 37.5 sq cm
1872*C1873
H
Bard 3DMax Mesh
1873*C1929
H
Maverick PTCA Cath
1929*C1930
H
Coyote Dil Cath,20/30/40mm
1930*C1931
H
Talon Dil Cath
1931*C1932
H
Scimed Remedy Dil Cath
1932*C1933
H
Opti-Plast XL/Centurion Cath
1933*C1934
H
Ultraverse 3.5F Bal Dil Cath
1934*C1935
H
Workhorse PTA Bal Cath
1935*C1936
H
Uromax Ultra Bal Dil Cath
1936*C1937
H
Synergy Balloon Dil Cath
1937*C1938
H
UroForce Bal Dil Cath
1938*C1939
H
Raptor, Ninja PTCA Dil Cath
1939*C1940
H
PowerFlex,OPTA 5/LP Bal Cath
1940*C1941
H
Jupiter PTA Dil Cath
1941*C1942
H
Cordis Maxi LD PTA Bal Cath
1942*C1943
H
RXCrossSail OTW OpenSail
1943*C1944
H
Rapid Exchange Bil Dil Cath
1944*C1945
H
Savvy PTA Dil Cath
1945*C1946
H
R1s Rapid Dil Cath
1946*C1947
H
Gazelle Bal Dil Cath
1947*C1948
H
Pursuit Balloon Cath
1948*C1949
H
Oracle Megasonics Cath
1949*C1979
H
Visions PV/Avanar US Cath
1979*C1980
H
Atlantis SR Coronary Cath
1980*C1981
H
PTCA Catheters
1981*C2000
H
Orbiter ST Steerable Cath
2000*C2001
H
Constellation Diag Cath
2001*C2002
H
Irvine 5F Inquiry Diag EP Cath
2002*C2003
H
Irvine 6F Inquiry Diag EP Cath
2003*C2004
H
Biosense EP Cath--Octapolar
2004*C2005
H
Biosense EP Cath--Hexapolar
2005*C2006
H
Biosense EP Cath--Decapolar
2006*C2007
H
Irvine 6F Luma-Cath EP Cath
2007*C2008
H
Luma-Cath EP Cath 81910-15
2008*C2009
H
Irvine 7F Luma-Cath EP Cath
2009*C2010
H
Fixed Curve EP Cath
2010*C2011
H
Deflectable Tip Cath--Quad
2011*C2012
H
Celsius Abln Cath
2012*C2013
H
Celsius Large Abln Cath
2013*C2014
H
Celsius II Asym Abln Cath
2014*C2015
H
Celsius II Sym Abln Cath
2015*C2016
H
Navi-Star DS, Navi-Star Ther
2016*C2017
H
Navi-Star Abln Cath
2017*C2018
H
Polaris T Ablation Cath
2018*C2019
H
EP Deflectable Cath
2019*C2020
H
Catheter, ablation, Blazer II XP
2020*C2021
H
SilverFlex EP Cath
2021*C2022
H
CP Chilli Cooled Abln Cath
2022*C2023
H
Chilli Cld AblnCath-std, lg
2023*C2100
H
CP CS Reference Cath
2100( print page 67958)*C2101
H
CP RV Reference Cath
2101*C2102
H
CP Radii 7F EP Cath
2102*C2103
H
CP Radii 7F EP Cath w/Track
2103*C2104
H
Lasso Deflectable Cath
2104*C2151
H
Veripath Guiding Cath
2151*C2152
H
Cordis Vista Brite Tip Cath
2152*C2153
H
Bard Viking Cath
2153*C2200
H
Arrow-Trerotola PTD Cath
2200*C2300
H
Varisource Stnd Catheters
2300*C2597
H
CliniCath/kit 16/18 sgl/dbl
2597*C2598
H
CliniCath 18/20/24G-single
2598*C2599
H
CliniCath 16/18G-double
2599C2600D
E
Gold Probe Catheter*C2601
H
Bard DL Ureteral Cath
2601*C2602
H
Vitesse Laser Cath 1.4/1.7mm
2602*C2603
H
Vitesse Laser Cath 2.0mm
2603*C2604
H
Vitesse E Laser Cath 2.0mm
2604*C2605
H
Extreme Laser Catheter
2605*C2606
H
SpineCath XL Catheter
2606*C2607
H
SpineCath Intradiscal Cath
2607*C2608
H
Scimed 6F Wiseguide Cath
2608*C2609
H
Flexima Bil Drainage Cath
2609*C2610
H
FlexTipPlus Intraspinal Cath
2610*C2611
H
AlgoLine Intraspinal Cath
2611*C2612
H
InDura Catheter
2612*C2676
E
Response CV Catheter*C2700
H
MycroPhylax Plus SC defib
2700*C2701
H
Phylax XM SC defib
2701*C2702
H
Ventak Prizm 2 VR Defib
2702*C2703
H
Ventak Prizm VR HE Defib
2703*C2704
H
Ventak Mini IV+ Defib
2704*C2801
H
Defender IV DR 612 DC defib
2801*C2802
H
Phylax AV DC defib
2802*C2803
H
Ventak Prizm DR HE Defib
2803*C2804
H
Ventak Prizm 2 DR Defib
2804*C2805
H
Jewel AF 7250 Defib
2805*C2806
H
GEM VR 7227 Defib
2806*C2807
H
Contak CD 1823
2807*C2808
H
Contak TR 1241
2808*C3001
H
Kainox SL/RV defib lead
3001*C3002
H
EasyTrak Defib Lead
3002*C3003
H
Endotak SQ Array XP lead
3003*C3004
H
Intervene Defib Lead
3004*C3400
H
Siltex Spectrum,Contour Prof
3400*C3401
H
Saline-Filled Spectrum
3401*C3500
H
Mentor Alpha I Inf Penile Pros
3500*C3510
H
AMS 800 Urinary Pros
3510*C3551
H
Choice/PT Graphix/Luge/Trooper
3551*C3552
H
Hi-Torque Whisper
3552*C3553
H
Cordis guidewires
3553*C3554
H
Jindo guidewire
3554*C3555
H
Wholey Hi-Torque Plus GW
3555*C3556
H
Wave/FlowWire Guidewire
3556*C3557
H
HyTek guidewire
3557*C3800
H
SynchroMed EL infusion pump
3800*C3801
H
Arrow/MicroJect PCA Sys
3801*C3851
H
Elastic UV IOL AA-4203T/TF/TL
3851*C4000
H
Opus G 4621, 4624 SC pmkr
4000*C4001
H
Opus S 4121/4124 SC pmkr
4001*C4002
H
Talent 113 SC pmkr
4002*C4003
H
Kairos SR SC pmkr
4003*C4004
H
Actros SR, Actros SLR SC pmkr
4004*C4005
H
Philos SR/SR-B SC pmkr
4005*C4006
H
Pulsar Max II SR pmkr
4006*C4007
H
Marathon SR pmkr
4007*C4008
H
Discovery II SSI pmkr
4008*C4009
H
Discovery II SR pmkr
4009*C4300
H
Integrity AFx DR 5342 pmkr
4300*C4301
H
Integrity AFx DR 5346 pmkr
4301*C4302
H
Affinity VDR 5430 pmkr
4302*C4303
H
Brio 112 DC pmkr
4303*C4304
H
Brio 212, Talent 213/223 DC pmkr
4304*C4305
H
Brio 222 DC pmkr
4305*C4306
H
Brio 220 DC pmkr
4306( print page 67959)*C4307
H
Kairos DR DC pmkr
4307*C4308
H
Inos2, Inos2+ DC pmkr
4308*C4309
H
Actros DR,D,DR-A,SLR DC pmkr
4309*C4310
H
Actros DR-B DC pmkr
4310*C4311
H
Philos DR/DR-B/SLR DC pmkr
4311*C4312
H
Pulsar Max II DR pmkr
4312*C4313
H
Marathon DR pmkr
4313*C4314
H
Momentum DR pmkr
4314*C4315
H
Selection AFm pmkr
4315*C4316
H
Discovery II DR
4316*C4317
H
Discovery II DDD
4317*C4600
H
Snynox,Polyrox,Elox,Retrox
4600*C4601
E
Aescula LV pmkr lead*C4602
H
Tendril SDX, 1488K pmkr lead
4602*C4603
H
Oscor/Flexion pmkr lead
4603*C4604
H
CrystallineActFix,CapsureFix
4604*C4605
H
CapSure Epi pmkr lead
4605*C4606
H
Flextend pmkr lead
4606*C4607
H
FinelineII/EZ, ThinlineII/EZ
4607*C5000
H
BX Velocity w/Hepacoat
5000*C5001
H
Memotherm Bil Stent, sm, med
5001*C5002
H
Memotherm Bil Stent, large
5002*C5003
H
Memotherm Bil Stent, x-large
5003*C5004
H
PalmazCorinthian IQ Bil Stent
5004*C5005
H
PalmazCorinthian IQ Trans/Bil
5005*C5006
H
PalmazTrans Bil Stent Sys-Med
5006*C5007
H
PalmazTrans XL Bil Stent--40mm
5007*C5008
H
PalmazTrans XL Bil Stent--50mm
5008*C5009
H
Stent, biliary, Biliary VistaFlex Stent
5009*C5010
H
Rapid Exchange Bil Stent Sys
5010*C5011
H
Stent, biliary, IntraStent, IntraStent LP
5011*C5012
H
Stent, biliary, IntraStent DoubleStrut LD
5012*C5013
H
IntraStent DoubleStrut, XS
5013*C5014
H
AVE Bridge Stent Sys-10/17/28
5014*C5015
H
AVE/X3 Bridge Sys, 40-100
5015*C5016
H
Biliary stent single use cov
5016*C5017
H
WallstentRP Bil--20/40/60/68mm
5017*C5018
H
WallstentRP Bil--80/94mm
5018*C5019
H
Flexima Bil Stent Sys
5019*C5020
H
Smart Nitinol Stent--20mm
5020*C5021
H
Smart Nitinol Stent--40/60mm
5021*C5022
H
Smart Nitinol Stent--80mm
5022*C5023
H
BX Velocity Stent--8/13mm
5023*C5024
H
BX Velocity Stent--18mm
5024*C5025
H
BX Velocity Stent--23mm
5025*C5026
H
BX Velocity Stent--28/33mm
5026*C5027
H
BX Velocity w/Hep--8/13mm
5027*C5028
H
BX Velocity w/Hep--18mm
5028*C5029
H
BX Velocity w/Hep--23mm
5029*C5030
H
Stent, coronary, S660 9/12mm
5030*C5031
H
Stent,coronary, S660 15/18mm
5031*C5032
H
Stent,coronary, S660 24/30mm
5032*C5033
H
Niroyal Stent Sys, 9mm
5033*C5034
H
Niroyal Stent Sys, 12/15mm
5034*C5035
H
Niroyal Stent Sys, 18mm
5035*C5036
H
Niroyal Stent Sys, 25mm
5036*C5037
H
Niroyal Stent Sys, 31mm
5037*C5038
H
BX Velocity Stent w/Raptor
5038*C5039
H
IntraCoil Periph Stent--40mm
5039*C5040
H
IntraCoil Periph Stent--60mm
5040*C5041
H
BeStent Over-the-Wire 24/30mm
5041*C5042
H
BeStent Over-the-Wire 18mm
5042*C5043
H
BeStent Over-the-Wire 15mm
5043*C5044
H
BeStent Over-the-Wire 9/12mm
5044*C5045
H
Multilink Tetra Cor Stent Sys
5045*C5046
H
Radius 20mm cor stent
5046*C5047
H
Niroyal Elite Cor Stent Sys
5047*C5048
H
GR II Coronary Stent
5048*C5130
H
Wilson-Cook Colonic Z-Stent
5130*C5131
H
Bard Colorectal Stent-60mm
5131*C5132
H
Bard Colorectal Stent-80mm
5132*C5133
H
Bard Colorectal Stent-100mm
5133*C5134
H
Enteral Wallstent--90mm
5134*C5279
H
Contour/Percuflex Stent
5279( print page 67960)*C5280
H
Inlay Dbl Ureteral Stent
5280*C5281
H
Wallgraft Trach Sys 70mm
5281*C5282
H
Wallgraft Trach Sys 20/30/50
5282*C5283
H
Wallstent/RP TIPS --80mm
5283*C5284
H
Wallstent TrachUltraFlex
5284*C5600
H
Closure dev, VasoSeal ES
5600*C5601
H
VasoSeal Model 1000
5601*C6001
H
Composix Mesh 8/21 in
6001*C6002
H
Composix Mesh 32 in
6002*C6003
H
Composix Mesh 48 in
6003*C6004
H
Composix Mesh 80 in
6004*C6005
H
Composix Mesh 140 in
6005*C6006
H
Composix Mesh 144 in
6006*C6012
H
Pelvicol Collagen 8/14 sq cm
6012*C6013
H
Pelvicol Collagen 21/24/28 sq cm
6013*C6014
H
Pelvicol Collagen 40sq cm
6014*C6015
H
Pelvicol Collagen 48 sq cm
6015*C6016
H
Pelvicol Collagen 96 sq cm
6016*C6017
H
Gore-Tex DualMesh 75/96 sq cm
6017*C6018
H
Gore-Tex DualMesh 150 sq cm
6018*C6019
H
Gore-Tex DualMesh 285 sq cm
6019*C6020
H
Gore-Tex DualMesh 432 sq cm
6020*C6021
H
Gore-Tex DualMesh 600 sq cm
6021*C6022
H
Gore-Tex DualMesh 884 sq cm
6022*C6023
H
Gore-TexPlus 1mm, 75/96sq cm
6023*C6024
H
Gore-TexPlus 1mm, 150sq cm
6024*C6025
H
Gore-TexPlus 1mm, 285sq cm
6025*C6026
H
Gore-TexPlus 1mm, 432sq cm
6026*C6027
H
Gore-TexPlus 1mm, 600sq cm
6027*C6028
H
Gore-TexPlus 1mm, 884 sq cm
6028*C6029
H
Gore-TexPlus 2mm, 150 sq cm
6029*C6030
H
Gore-TexPlus 2mm, 285 sq cm
6030*C6031
H
Gore-TexPlus 2mm, 432 sq cm
6031*C6032
H
Gore-TexPlus 2mm, 600 sq cm
6032*C6033
H
Gore-TexPlus 2mm, 884 sq cm
6033*C6034
H
Bard ePTFE: 15 sq cm--2mm
6034*C6035
H
Bard ePTFE150sqcm-1mm,75-2mm
6035*C6036
H
Bard ePTFE: 50/75sqcm-1,2mm
6036*C6037
H
Bard ePTFE: 300sq cm-1,2mm
6037*C6038
H
Bard ePTFE: 600sq cm-1mm
6038*C6039
H
Bard ePTFE: 884sq cm-1mm
6039*C6040
H
Bard ePTFE: 600sq cm-2mm
6040*C6041
H
Bard ePTFE: 884sq cm-2mm
6041*C6050
H
Female Sling Sys w/wo Matrl
6050*C6051
H
Stratasis Urethral Sling, 20/40 cm
6051*C6052
H
Stratasis Urethral Sling, 60 cm
6052*C6053
H
Surgisis Soft Graft
6053*C6054
H
Surgisis Enhanced Graft
6054*C6055
H
Surgisis Enhanced Tissue
6055*C6056
H
Surgisis Soft Tissue Graft
6056*C6057
H
Surgisis Hernia Graft
6057*C6058
H
SurgiPro Hernia Plug, med/lg
6058*C6080
H
Male Sling Sys w/wo Matrl
6080*C6200
H
Exxcel Sft ePTFE vas graft
6200*C6201
H
Impra Venaflo--10/20cm
6201*C6202
H
Impra Venaflo-30/40cm
6202*C6203
H
Impra Venaflo-50cm,vt45
6203*C6204
H
Impra Venaflo-stepped
6204*C6205
H
Impra Carboflo--10cm
6205*C6206
H
Impra Carboflo--20cm
6206*C6207
H
Impra Carboflo--30/35/40cm
6207*C6208
H
Impra Carboflo--40/50cm
6208*C6209
H
Impra Carboflo--ctrflex
6209*C6210
H
Exxcel ePTFE vas graft
6210*C6300
H
Vanguard III Endovas Graft
6300*C6500
H
Preface Guiding Sheath
6500*C6501
H
Sheath, Soft Tip Sheaths
6501*C6502
H
Perry Exchange Dilator
6502*C6525
H
Spectranetics Laser Sheath
6525*C6600
H
Micro Litho Flex Probes
6600*C6650
H
Fast-Cath Guiding Introducer
6650*C6651
H
Seal-AwayGuiding Introducer
6651*C6652
H
Bard Excalibur Introducer
6652*C6700
H
Focal Seal-L
6700( print page 67961)*C8099
H
Spectranetics Lead Lock Dev
8099C8100
H
Adhesion barrier, ADCON-L
8100*C8102
H
SurgiVision Esoph Coil
8102C8103D
E
Capio Capturing Dev*C8500
X
Atherocath-GTO
0991

$1,278.59

$255.72*C8501
X
Pacemaker, single chamber, Vigor SSI
0992

$1,790.03

$358.01*C8502
X
Livewire Steerable EP Cath
0988

$383.58

$76.72*C8503
X
SyncroMed Vas Cath
0988

$383.58

$76.72*C8504
X
VasoSeal Hemostasis Dev
0987

$127.86

$25.57*C8505
X
SynchroMed Infusion Pump
0997

$8,182.98

$1,636.60*C8506
X
Pmkr leads 4057M,4058M
0990

$895.01

$179.00*C8507
X
6721L/M/S,6939 lead
0990

$895.01

$179.00*C8508
X
Lead, defibrillator, CapSure 4965
0990

$895.01

$179.00*C8509
X
Transvene 6933/6937 lead
0990

$895.01

$179.00*C8510
X
Lead, defibrillator, DP-3238
0990

$895.01

$179.00*C8511
X
Lead, defibrillator, EndoTak DSP
0996

$6,137.23

$1,227.45*C8512
X
On-Point,Pisces-Quad lead
0990

$895.01

$179.00*C8513
X
Pisces,Resume II lead
0990

$895.01

$179.00*C8514
X
Dura II Penile Pros
0993

$2,557.18

$511.44*C8515D
X
Alpha 1 narrow base prosthesis
0995

$4,602.92

$920.58*C8516
X
Mentor Acu-Form/Mal Pros
0992

$1,790.03

$358.01*C8517D
X
Ambicor prosthesis
0994

$3,580.05

$716.01*C8518
X
Pacemaker, dual chamber, Vigor DDD
0994

$3,580.05

$716.01*C8519
X
Pacemaker, dual chamber, Vista DDD
0994

$3,580.05

$716.01*C8520
X
Pacemaker, single chamber, Legacy II S
0992

$1,790.03

$358.01*C8521
X
Medtronic Mattrix rcvr/trmr
0997

$8,182.98

$1,636.60*C8522
X
Palmaz Bal Stent
0990

$895.01

$179.00*C8523
X
Wallstent Trans Bil
0991

$1,278.59

$255.72*C8524
X
Wallstent Esop
0991

$1,278.59

$255.72*C8525
X
Esoph stent--double
0992

$1,790.03

$358.01*C8526
X
OptiPlast XT 5F PTA Cath
0987

$127.86

$25.57*C8528
X
MS Classique Balloon Dilation Catheter
0987

$127.86

$25.57*C8529
X
Crista Cath II Def 20-Pole
0990

$895.01

$179.00*C8530
X
Gel-Filled/Smooth Mammary Pros
0989

$639.30

$127.86*C8531
X
Wilson-Cook Esoph Z-Stent
0989

$639.30

$127.86*C8532
X
UltraFlex Esoph
0991

$1,278.59

$255.72*C8533
X
SynchroMed Vas Cath 8700A/V
0988

$383.58

$76.72*C8534
X
AMS Malleable 650 Penile Prosthesis
0992

$1,790.03

$358.01*C8535
X
Za/Spiral Z Bil Stent
0990

$895.01

$179.00*C8536
X
Esoph Z Metal Stent
0991

$1,278.59

$255.72*C8539
X
Quantum Dil Balloon
0987

$127.86

$25.57*C8540
X
Flex-EZ Bal Dilator
0988

$383.58

$76.72*C8541
X
Carson/Passprt Dil
0988

$383.58

$76.72*C8542
X
UrethraMax Dil Cath
0987

$127.86

$25.57*C8543
X
Amplatz Renal Dil
0987

$127.86

$25.57*C8550
X
Livewire 5F, 7F EP Cath
0989

$639.30

$127.86*C8551
X
Livewire 7F Duo-Decapolar
0990

$895.01

$179.00*C8552
X
Santuro Fixed Curve Cath
0989

$639.30

$127.86*C8597
X
Wisdom ST guidewire
0987

$127.86

$25.57*C8598
X
SV Guidewire-5/8/14cm
0987

$127.86

$25.57*C8599
X
Stabilizer XS guidewire
0987

$127.86

$25.57*C8600
X
Shinobi Plus guidewire
0987

$127.86

$25.57*C8650
X
XL Check-Flo Introducer
0987

$127.86

$25.57*C8724
X
Octad neuro lead
0991

$1,278.59

$255.72*C8725
X
SymMix neuro lead
0990

$895.01

$179.00*C8748
X
Endotak SQ Patch defib lead
0990

$895.01

$179.00*C8749
X
Endotak SQ Array defib lead
0993

$2,557.18

$511.44*C8750
X
Unity VDDR dc pmkr
0994

$3,580.05

$716.01*C8775
X
2188 Cor pmkr lead
0991

$1,278.59

$255.72*C8776
X
Innomedica pmkr lead
0990

$895.01

$179.00*C8777
X
Unipass pmkr lead
0991

$1,278.59

$255.72*C8800
X
Lg Palmaz Bil Stent
0990

$895.01

$179.00*C8801
X
Gianturco Bil Z Stent
0989

$639.30

$127.86*C8802
X
Oasis Stent Intro Sys
0987

$127.86

$25.57*C8830
X
Gianturco-Roubin Cor Snt
0991

$1,278.59

$255.72*C8890
X
Perfluoron, per 2ml
0987

$127.86

$25.57*C8891
X
Perfluoron, per 5/7ml
0988

$383.58

$76.72C9000
G
Na chromate Cr51, per 0.25mCi
9000

$259.36

$34.75C9001
J
Linezolid inj, 200mg
9001

$34.14

$4.57C9002
J
Tenecteplase, 50mg/vial
9002

$2,612.50

$350.08C9003
J
Palivizumab, per 50mg
9003

$664.49

$89.04C9004
J
Gemtuzumab ozogamicin inj,5mg
9004

$1,929.69

$258.58C9005
G
reteplase, 18.1 mg (one single-use vial)
9005

$1,306.25

$175.04C9006
J
Tacrolimus inj, per 5mg (1 amp)
9006

$109.83

$14.72( print page 67962)C9007
G
Baclofen Intrathecal kit-1amp
9007

$79.80

$10.69C9008
G
Baclofen Refill Kit--500mcg
9008

$222.30

$29.79C9009
G
Baclofen Refill Kit--2000mcg
9009

$467.40

$62.63C9010
G
Baclofen Refill Kit--4000mcg
9010

$820.80

$109.99C9011
G
Caffeine Citrate, inj, 1ml
9011

$12.22

$1.57*C9100
G
Iodinated I-131 Albumin
9100

$246.05

$30.02C9102
G
51 Na chromate, 50uCi
9102

$216.60

$26.43C9103
G
Na Iothalamate I-125, 10uCi
9103

$12.27

$1.50C9104
G
Anti-thymocyte globulin,25mg
9104

$251.75

$33.73C9105
G
Hep B imm glob, per 1 ml
9105

$152.00

$20.37C9106
J
Sirolimus 1mg/ml
9106

$6.51

$.87*C9107
J
Tinzaparin sodium, 2ml vial
9107

$159.60

$20.50C9108
G
Thyrotropin alfa, 1.1 mg
9108

$494.00

$70.72C9109
G
Tirofiban hcl, 6.25 mg
9109

$199.50

$28.56C9500
K
Platelets, irradiated, each unit
9500
1.77
$87.97

$17.59C9501
K
Platelets, pheresis, each unit
9501
9.69
$480.75

$96.15C9502
K
Platelets, pheresis, irradiated, each unit
9502
10.52
$521.66

$104.33C9503
K
Fresh frzn plasma, donor retested, unit
9503
1.65
$81.83

$16.37C9504
K
Red blood cells, deglycerolized, unit
9504
4.35
$215.83

$43.17C9505
K
Red blood cells, irradiated, each unit
9505
2.58
$127.86

$25.57*C9700
T
Water-induced thermotherapy
0977
23.20
$1,150.63

$230.13*C9701
S
Stretta Procedure
0976
18.05
$895.21

$179.04*C9702
S
Chkmate Intra Brachytx Sys
0981
46.40
$2,301.26

$460.25D0120
E
Periodic oral evaluationD0140
E
Limit oral eval problm focusD0150
S
Comprehensve oral evaluation
0330
1.51
$74.89
$14.98
$14.98D0160
E
Extensv oral eval prob focusD0170
E
Re-eval,est pt,problem focusD0210
E
Intraor complete film seriesD0220
E
Intraoral periapical first fD0230
E
Intraoral periapical ea addD0240
S
Intraoral occlusal film
0330
1.51
$74.89
$14.98
$14.98D0250
S
Extraoral first film
0330
1.51
$74.89
$14.98
$14.98D0260
S
Extraoral ea additional film
0330
1.51
$74.89
$14.98
$14.98D0270
S
Dental bitewing single film
0330
1.51
$74.89
$14.98
$14.98D0272
S
Dental bitewings two films
0330
1.51
$74.89
$14.98
$14.98D0274
S
Dental bitewings four films
0330
1.51
$74.89
$14.98
$14.98D0277
S
Vert bitewings-sev to eight
0330
1.51
$74.89
$14.98
$14.98D0290
E
Dental film skull/facial bonD0310
E
Dental saliographyD0320
E
Dental tmj arthrogram incl iD0321
E
Dental other tmj filmsD0322
E
Dental tomographic surveyD0330
E
Dental panoramic filmD0340
E
Dental cephalometric filmD0350
E
Oral/facial imagesD0415
E
Bacteriologic studyD0425
E
Caries susceptibility testD0460
S
Pulp vitality test
0330
1.51
$74.89
$14.98
$14.98D0470
E
Diagnostic castsD0472
S
Gross exam, prep & report
0330
1.51
$74.89
$14.98
$14.98D0473
S
Micro exam, prep & report
0330
1.51
$74.89
$14.98
$14.98D0474
S
Micro w exam of surg margins
0330
1.51
$74.89
$14.98
$14.98D0480
S
Cytopath smear prep & report
0330
1.51
$74.89
$14.98
$14.98D0501
S
Histopathologic examinations
0330
1.51
$74.89
$14.98
$14.98D0502
S
Other oral pathology procedu
0330
1.51
$74.89
$14.98
$14.98D0999
S
Unspecified diagnostic proce
0330
1.51
$74.89
$14.98
$14.98D1110
E
Dental prophylaxis adultD1120
E
Dental prophylaxis childD1201
E
Topical fluor w prophy childD1203
E
Topical fluor w/o prophy chiD1204
E
Topical fluor w/o prophy aduD1205
E
Topical fluoride w/ prophy aD1310
E
Nutri counsel-control cariesD1320
E
Tobacco counselingD1330
E
Oral hygiene instructionD1351
E
Dental sealant per toothD1510
S
Space maintainer fxd unilat
0330
1.51
$74.89
$14.98
$14.98D1515
S
Fixed bilat space maintainer
0330
1.51
$74.89
$14.98
$14.98D1520
S
Remove unilat space maintain
0330
1.51
$74.89
$14.98
$14.98D1525
S
Remove bilat space maintain
0330
1.51
$74.89
$14.98
$14.98D1550
S
Recement space maintainer
0330
1.51
$74.89
$14.98
$14.98D2110
E
Amalgam one surface primaryD2120
E
Amalgam two surfaces primary( print page 67963)D2130
E
Amalgam three surfaces primaD2131
E
Amalgam four/more surf primaD2140
E
Amalgam one surface permanenD2150
E
Amalgam two surfaces permaneD2160
E
Amalgam three surfaces permaD2161
E
Amalgam 4 or > surfaces permD2330
E
Resin one surface-anteriorD2331
E
Resin two surfaces-anteriorD2332
E
Resin three surfaces-anterioD2335
E
Resin 4/> surf or w incis anD2336
E
Composite resin crownD2337
E
Compo resin crown ant-permD2380
E
Resin one surf poster primarD2381
E
Resin two surf poster primarD2382
E
Resin three/more surf post pD2385
E
Resin one surf poster permanD2386
E
Resin two surf poster permanD2387
E
Resin three/more surf post pD2388
E
Resin four/more, post permD2410
E
Dental gold foil one surfaceD2420
E
Dental gold foil two surfaceD2430
E
Dental gold foil three surfaD2510
E
Dental inlay metalic 1 surfD2520
E
Dental inlay metallic 2 surfD2530
E
Dental inlay metl 3/more surD2542
E
Dental onlay metallic 2 surfD2543
E
Dental onlay metallic 3 surfD2544
E
Dental onlay metl 4/more surD2610
E
Inlay porcelain/ceramic 1 suD2620
E
Inlay porcelain/ceramic 2 suD2630
E
Dental onlay porc 3/more surD2642
E
Dental onlay porcelin 2 surfD2643
E
Dental onlay porcelin 3 surfD2644
E
Dental onlay porc 4/more surD2650
E
Inlay composite/resin one suD2651
E
Inlay composite/resin two suD2652
E
Dental inlay resin 3/mre surD2662
E
Dental onlay resin 2 surfaceD2663
E
Dental onlay resin 3 surfaceD2664
E
Dental onlay resin 4/mre surD2710
E
Crown resin laboratoryD2720
E
Crown resin w/ high noble meD2721
E
Crown resin w/ base metalD2722
E
Crown resin w/ noble metalD2740
E
Crown porcelain/ceramic subsD2750
E
Crown porcelain w/ h noble mD2751
E
Crown porcelain fused base mD2752
E
Crown porcelain w/ noble metD2780
E
Crown 3/4 cast hi noble metD2781
E
Crown 3/4 cast base metalD2782
E
Crown 3/4 cast noble metalD2783
E
Crown 3/4 porcelain/ceramicD2790
E
Crown full cast high noble mD2791
E
Crown full cast base metalD2792
E
Crown full cast noble metalD2799
E
Provisional crownD2910
E
Dental recement inlayD2920
E
Dental recement crownD2930
E
Prefab stnlss steel crwn priD2931
E
Prefab stnlss steel crown peD2932
E
Prefabricated resin crownD2933
E
Prefab stainless steel crownD2940
E
Dental sedative fillingD2950
E
Core build-up incl any pinsD2951
E
Tooth pin retentionD2952
E
Post and core cast + crownD2953
E
Each addtnl cast postD2954
E
Prefab post/core + crownD2955
E
Post removalD2957
E
Each addtnl prefab postD2960
E
Laminate labial veneerD2961
E
Lab labial veneer resinD2962
E
Lab labial veneer porcelainD2970
S
Temporary- fractured tooth
0330
1.51
$74.89
$14.98
$14.98( print page 67964)D2980
E
Crown repairD2999
S
Dental unspec restorative pr
0330
1.51
$74.89
$14.98
$14.98D3110
E
Pulp cap directD3120
E
Pulp cap indirectD3220
E
Therapeutic pulpotomyD3221
E
Gross pulpal debridementD3230
E
Pulpal therapy anterior primD3240
E
Pulpal therapy posterior priD3310
E
AnteriorD3320
E
Root canal therapy 2 canalsD3330
E
Root canal therapy 3 canalsD3331
E
Non-surg tx root canal obsD3332
E
Incomplete endodontic txD3333
E
Internal root repairD3346
E
Retreat root canal anteriorD3347
E
Retreat root canal bicuspidD3348
E
Retreat root canal molarD3351
E
Apexification/recalc initialD3352
E
Apexification/recalc interimD3353
E
Apexification/recalc finalD3410
E
Apicoect/perirad surg anterD3421
E
Root surgery bicuspidD3425
E
Root surgery molarD3426
E
Root surgery ea add rootD3430
E
Retrograde fillingD3450
E
Root amputationD3460
S
Endodontic endosseous implan
0330
1.51
$74.89
$14.98
$14.98D3470
E
Intentional replantationD3910
E
Isolation- tooth w rubb damD3920
E
Tooth splittingD3950
E
Canal prep/fitting of dowelD3999
S
Endodontic procedure
0330
1.51
$74.89
$14.98
$14.98D4210
E
Gingivectomy/plasty per quadD4211
E
Gingivectomy/plasty per tootD4220
E
Gingival curettage per quadrD4240
E
Gingival flap proc w/ planinD4245
E
Apically positioned flapD4249
E
Crown lengthen hard tissueD4260
S
Osseous surgery per quadrant
0330
1.51
$74.89
$14.98
$14.98D4263
S
Bone replce graft first site
0330
1.51
$74.89
$14.98
$14.98D4264
S
Bone replce graft each add
0330
1.51
$74.89
$14.98
$14.98D4266
E
Guided tiss regen resorbleD4267
E
Guided tiss regen nonresorbD4268
S
Surgical revision procedure
0330
1.51
$74.89
$14.98
$14.98D4270
S
Pedicle soft tissue graft pr
0330
1.51
$74.89
$14.98
$14.98D4271
S
Free soft tissue graft proc
0330
1.51
$74.89
$14.98
$14.98D4273
S
Subepithelial tissue graft
0330
1.51
$74.89
$14.98
$14.98D4274
E
Distal/proximal wedge procD4320
E
Provision splnt intracoronalD4321
E
Provisional splint extracoroD4341
E
Periodontal scaling & rootD4355
S
Full mouth debridement
0330
1.51
$74.89
$14.98
$14.98D4381
S
Localized chemo delivery
0330
1.51
$74.89
$14.98
$14.98D4910
E
Periodontal maint proceduresD4920
E
Unscheduled dressing changeD4999
E
Unspecified periodontal procD5110
E
Dentures complete maxillaryD5120
E
Dentures complete mandibleD5130
E
Dentures immediat maxillaryD5140
E
Dentures immediat mandibleD5211
E
Dentures maxill part resinD5212
E
Dentures mand part resinD5213
E
Dentures maxill part metalD5214
E
Dentures mandibl part metalD5281
E
Removable partial dentureD5410
E
Dentures adjust cmplt maxilD5411
E
Dentures adjust cmplt mandD5421
E
Dentures adjust part maxillD5422
E
Dentures adjust part mandblD5510
E
Dentur repr broken compl basD5520
E
Replace denture teeth compltD5610
E
Dentures repair resin baseD5620
E
Rep part denture cast frameD5630
E
Rep partial denture clasp( print page 67965)D5640
E
Replace part denture teethD5650
E
Add tooth to partial dentureD5660
E
Add clasp to partial dentureD5710
E
Dentures rebase cmplt maxilD5711
E
Dentures rebase cmplt mandD5720
E
Dentures rebase part maxillD5721
E
Dentures rebase part mandblD5730
E
Denture reln cmplt maxil chD5731
E
Denture reln cmplt mand chrD5740
E
Denture reln part maxil chrD5741
E
Denture reln part mand chrD5750
E
Denture reln cmplt max labD5751
E
Denture reln cmplt mand labD5760
E
Denture reln part maxil labD5761
E
Denture reln part mand labD5810
E
Denture interm cmplt maxillD5811
E
Denture interm cmplt mandblD5820
E
Denture interm part maxillD5821
E
Denture interm part mandblD5850
E
Denture tiss conditn maxillD5851
E
Denture tiss condtin mandblD5860
E
Overdenture completeD5861
E
Overdenture partialD5862
E
Precision attachmentD5867
E
Replacement of precision attD5875
E
Prosthesis modificationD5899
E
Removable prosthodontic procD5911
S
Facial moulage sectional
0330
1.51
$74.89
$14.98
$14.98D5912
S
Facial moulage complete
0330
1.51
$74.89
$14.98
$14.98D5913
E
Nasal prosthesisD5914
E
Auricular prosthesisD5915
E
Orbital prosthesisD5916
E
Ocular prosthesisD5919
E
Facial prosthesisD5922
E
Nasal septal prosthesisD5923
E
Ocular prosthesis interimD5924
E
Cranial prosthesisD5925
E
Facial augmentation implantD5926
E
Replacement nasal prosthesisD5927
E
Auricular replacementD5928
E
Orbital replacementD5929
E
Facial replacementD5931
E
Surgical obturatorD5932
E
Postsurgical obturatorD5933
E
Refitting of obturatorD5934
E
Mandibular flange prosthesisD5935
E
Mandibular denture prosthD5936
E
Temp obturator prosthesisD5937
E
Trismus applianceD5951
E
Feeding aidD5952
E
Pediatric speech aidD5953
E
Adult speech aidD5954
E
Superimposed prosthesisD5955
E
Palatal lift prosthesisD5958
E
Intraoral con def inter pltD5959
E
Intraoral con def mod palatD5960
E
Modify speech aid prosthesisD5982
E
Surgical stentD5983
S
Radiation applicator
0330
1.51
$74.89
$14.98
$14.98D5984
S
Radiation shield
0330
1.51
$74.89
$14.98
$14.98D5985
S
Radiation cone locator
0330
1.51
$74.89
$14.98
$14.98D5986
E
Fluoride applicatorD5987
S
Commissure splint
0330
1.51
$74.89
$14.98
$14.98D5988
E
Surgical splintD5999
E
Maxillofacial prosthesisD6010
E
Odontics endosteal implantD6020
E
Odontics abutment placementD6040
E
Odontics eposteal implantD6050
E
Odontics transosteal implntD6055
E
Implant connecting barD6056
E
Prefabricated abutmentD6057
E
Custom abutmentD6058
E
Abutment supported crownD6059
E
Abutment supported mtl crown( print page 67966)D6060
E
Abutment supported mtl crownD6061
E
Abutment supported mtl crownD6062
E
Abutment supported mtl crownD6063
E
Abutment supported mtl crownD6064
E
Abutment supported mtl crownD6065
E
Implant supported crownD6066
E
Implant supported mtl crownD6067
E
Implant supported mtl crownD6068
E
Abutment supported retainerD6069
E
Abutment supported retainerD6070
E
Abutment supported retainerD6071
E
Abutment supported retainerD6072
E
Abutment supported retainerD6073
E
Abutment supported retainerD6074
E
Abutment supported retainerD6075
E
Implant supported retainerD6076
E
Implant supported retainerD6077
E
Implant supported retainerD6078
E
Implnt/abut suprtd fixd dentD6079
E
Implnt/abut suprtd fixd dentD6080
E
Implant maintenanceD6090
E
Repair implantD6095
E
Odontics repr abutmentD6100
E
Removal of implantD6199
E
Implant procedureD6210
E
Prosthodont high noble metalD6211
E
Bridge base metal castD6212
E
Bridge noble metal castD6240
E
Bridge porcelain high nobleD6241
E
Bridge porcelain base metalD6242
E
Bridge porcelain nobel metalD6245
E
Bridge porcelain/ceramicD6250
E
Bridge resin w/high nobleD6251
E
Bridge resin base metalD6252
E
Bridge resin w/noble metalD6519
E
Inlay/onlay porce/ceramicD6520
E
Dental retainer two surfacesD6530
E
Retainer metallic 3+ surfaceD6543
E
Dental retainr onlay 3 surfD6544
E
Dental retainr onlay 4/moreD6545
E
Dental retainr cast metlD6548
E
Porcelain/ceramic retainerD6720
E
Retain crown resin w hi nbleD6721
E
Crown resin w/base metalD6722
E
Crown resin w/noble metalD6740
E
Crown porcelain/ceramicD6750
E
Crown porcelain high nobleD6751
E
Crown porcelain base metalD6752
E
Crown porcelain noble metalD6780
E
Crown 3/4 high noble metalD6781
E
Crown 3/4 cast based metalD6782
E
Crown 3/4 cast noble metalD6783
E
Crown 3/4 porcelain/ceramicD6790
E
Crown full high noble metalD6791
E
Crown full base metal castD6792
E
Crown full noble metal castD6920
S
Dental connector bar
0330
1.51
$74.89
$14.98
$14.98D6930
E
Dental recement bridgeD6940
E
Stress breakerD6950
E
Precision attachmentD6970
E
Post & core plus retainerD6971
E
Cast post bridge retainerD6972
E
Prefab post & core plus retaD6973
E
Core build up for retainerD6975
E
Coping metalD6976
E
Each addtnl cast postD6977
E
Each addtl prefab postD6980
E
Bridge repairD6999
E
Fixed prosthodontic procD7110
S
Oral surgery single tooth
0330
1.51
$74.89
$14.98
$14.98D7120
S
Each add tooth extraction
0330
1.51
$74.89
$14.98
$14.98D7130
S
Tooth root removal
0330
1.51
$74.89
$14.98
$14.98D7210
S
Rem imp tooth w mucoper flp
0330
1.51
$74.89
$14.98
$14.98D7220
S
Impact tooth remov soft tiss
0330
1.51
$74.89
$14.98
$14.98( print page 67967)D7230
S
Impact tooth remov part bony
0330
1.51
$74.89
$14.98
$14.98D7240
S
Impact tooth remov comp bony
0330
1.51
$74.89
$14.98
$14.98D7241
S
Impact tooth rem bony w/comp
0330
1.51
$74.89
$14.98
$14.98D7250
S
Tooth root removal
0330
1.51
$74.89
$14.98
$14.98D7260
S
Oral antral fistula closure
0330
1.51
$74.89
$14.98
$14.98D7270
E
Tooth reimplantationD7272
E
Tooth transplantationD7280
E
Exposure impact tooth orthodD7281
E
Exposure tooth aid eruptionD7285
E
Biopsy of oral tissue hardD7286
E
Biopsy of oral tissue softD7290
E
Repositioning of teethD7291
S
Transseptal fiberotomy
0330
1.51
$74.89
$14.98
$14.98D7310
E
Alveoplasty w/ extractionD7320
E
Alveoplasty w/o extractionD7340
E
Vestibuloplasty ridge extensD7350
E
Vestibuloplasty exten graftD7410
E
Rad exc lesion up to 1.25 cmD7420
E
Lesion > 1.25 cmD7430
E
Exc benign tumor to 1.25 cmD7431
E
Benign tumor exc > 1.25 cmD7440
E
Malig tumor exc to 1.25 cmD7441
E
Malig tumor > 1.25 cmD7450
E
Rem odontogen cyst to 1.25cmD7451
E
Rem odontogen cyst > 1.25 cmD7460
E
Rem nonodonto cyst to 1.25cmD7461
E
Rem nonodonto cyst > 1.25 cmD7465
E
Lesion destructionD7471
E
Rem exostosis any siteD7480
E
Partial ostectomyD7490
E
Mandible resectionD7510
E
I&d absc intraoral soft tissD7520
E
I&d abscess extraoralD7530
E
Removal fb skin/areolar tissD7540
E
Removal of fb reactionD7550
E
Removal of sloughed off boneD7560
E
Maxillary sinusotomyD7610
E
Maxilla open reduct simpleD7620
E
Clsd reduct simpl maxilla fxD7630
E
Open red simpl mandible fxD7640
E
Clsd red simpl mandible fxD7650
E
Open red simp malar/zygom fxD7660
E
Clsd red simp malar/zygom fxD7670
E
Closd rductn splint alveolusD7680
E
Reduct simple facial bone fxD7710
E
Maxilla open reduct compoundD7720
E
Clsd reduct compd maxilla fxD7730
E
Open reduct compd mandble fxD7740
E
Clsd reduct compd mandble fxD7750
E
Open red comp malar/zygma fxD7760
E
Clsd red comp malar/zygma fxD7770
E
Open reduc compd alveolus fxD7780
E
Reduct compnd facial bone fxD7810
E
Tmj open reduct-dislocationD7820
E
Closed tmp manipulationD7830
E
Tmj manipulation under anestD7840
E
Removal of tmj condyleD7850
E
Tmj meniscectomyD7852
E
Tmj repair of joint discD7854
E
Tmj excisn of joint membraneD7856
E
Tmj cutting of a muscleD7858
E
Tmj reconstructionD7860
E
Tmj cutting into jointD7865
E
Tmj reshaping componentsD7870
E
Tmj aspiration joint fluidD7871
E
Lysis + lavage w cathetersD7872
E
Tmj diagnostic arthroscopyD7873
E
Tmj arthroscopy lysis adhesnD7874
E
Tmj arthroscopy disc repositD7875
E
Tmj arthroscopy synovectomyD7876
E
Tmj arthroscopy discectomyD7877
E
Tmj arthroscopy debridementD7880
E
Occlusal orthotic applianceD7899
E
Tmj unspecified therapy( print page 67968)D7910
E
Dent sutur recent wnd to 5cmD7911
E
Dental suture wound to 5 cmD7912
E
Suture complicate wnd > 5 cmD7920
E
Dental skin graftD7940
S
Reshaping bone orthognathic
0330
1.51
$74.89
$14.98
$14.98D7941
E
Bone cutting ramus closedD7943
E
Cutting ramus open w/graftD7944
E
Bone cutting segmentedD7945
E
Bone cutting body mandibleD7946
E
Reconstruction maxilla totalD7947
E
Reconstruct maxilla segmentD7948
E
Reconstruct midface no graftD7949
E
Reconstruct midface w/graftD7950
E
Mandible graftD7955
E
Repair maxillofacial defectsD7960
E
Frenulectomy/frenulotomyD7970
E
Excision hyperplastic tissueD7971
E
Excision pericoronal gingivaD7980
E
SialolithotomyD7981
E
Excision of salivary glandD7982
E
SialodochoplastyD7983
E
Closure of salivary fistulaD7990
E
Emergency tracheotomyD7991
E
Dental coronoidectomyD7995
E
Synthetic graft facial bonesD7996
E
Implant mandible for augmentD7997
E
Appliance removalD7999
E
Oral surgery procedureD8010
E
Limited dental tx primaryD8020
E
Limited dental tx transitionD8030
E
Limited dental tx adolescentD8040
E
Limited dental tx adultD8050
E
Intercep dental tx primaryD8060
E
Intercep dental tx transitnD8070
E
Compre dental tx transitionD8080
E
Compre dental tx adolescentD8090
E
Compre dental tx adultD8210
E
Orthodontic rem appliance txD8220
E
Fixed appliance therapy habtD8660
E
Preorthodontic tx visitD8670
E
Periodic orthodontc tx visitD8680
E
Orthodontic retentionD8690
E
Orthodontic treatmentD8691
E
Repair ortho applianceD8692
E
Replacement retainerD8999
E
Orthodontic procedureD9110
N
Tx dental pain minor procD9210
E
Dent anesthesia w/o surgeryD9211
E
Regional block anesthesiaD9212
E
Trigeminal block anesthesiaD9215
E
Local anesthesiaD9220
E
General anesthesiaD9221
E
General anesthesia ea ad 15mD9230
N
AnalgesiaD9241
E
Intravenous sedationD9242
E
IV sedation ea ad 30 mD9248
N
Sedation (non-iv)D9310
E
Dental consultationD9410
E
Dental house callD9420
E
Hospital callD9430
E
Office visit during hoursD9440
E
Office visit after hoursD9610
E
Dent therapeutic drug injectD9630
S
Other drugs/medicaments
0330
1.51
$74.89
$14.98
$14.98D9910
E
Dent appl desensitizing medD9911
E
Appl desensitizing resinD9920
E
Behavior managementD9930
S
Treatment of complications
0330
1.51
$74.89
$14.98
$14.98D9940
S
Dental occlusal guard
0330
1.51
$74.89
$14.98
$14.98D9941
E
Fabrication athletic guardD9950
S
Occlusion analysis
0330
1.51
$74.89
$14.98
$14.98D9951
S
Limited occlusal adjustment
0330
1.51
$74.89
$14.98
$14.98D9952
S
Complete occlusal adjustment
0330
1.51
$74.89
$14.98
$14.98D9970
E
Enamel microabrasion( print page 67969)D9971
E
Odontoplasty 1-2 teethD9972
E
Extrnl bleaching per archD9973
E
Extrnl bleaching per toothD9974
E
Intrnl bleaching per toothD9999
E
Adjunctive procedureE0100
A
Cane adjust/fixed with tipE0105
A
Cane adjust/fixed quad/3 proE0110
A
Crutch forearm pairE0111
A
Crutch forearm eachE0112
A
Crutch underarm pair woodE0113
A
Crutch underarm each woodE0114
A
Crutch underarm pair no woodE0116
A
Crutch underarm each no woodE0130
A
Walker rigid adjust/fixed htE0135
A
Walker folding adjust/fixedE0141
A
Rigid walker wheeled wo seatE0142
A
Walker rigid wheeled with seE0143
A
Walker folding wheeled w/o sE0144
A
Enclosed walker w rear seatE0145
A
Walker whled seat/crutch attE0146
A
Folding walker wheels w seatE0147
A
Walker variable wheel resistE0148
A
Heavyduty walker no wheelsE0149
A
Heavy duty wheeled walkerE0153
A
Forearm crutch platform attaE0154
A
Walker platform attachmentE0155
A
Walker wheel attachment,pairE0156
A
Walker seat attachmentE0157
A
Walker crutch attachmentE0158
A
Walker leg extenders set of4E0159
A
Brake for wheeled walkerE0160
A
Sitz type bath or equipmentE0161
A
Sitz bath/equipment w/faucetE0162
A
Sitz bath chairE0163
A
Commode chair stationry fxdE0164
A
Commode chair mobile fixed aE0165
A
Commode chair stationry detE0166
A
Commode chair mobile detachE0167
A
Commode chair pail or panE0168
A
Heavyduty/wide commode chairE0175
A
Commode chair foot restE0176
A
Air pressre pad/cushion nonpE0177
A
Water press pad/cushion nonpE0178
A
Gel pressre pad/cushion nonpE0179
A
Dry pressre pad/cushion nonpE0180
A
Press pad alternating w pumpE0181
A
Press pad alternating w/ pumE0182
A
Pressure pad alternating pumE0184
A
Dry pressure mattressE0185
A
Gel pressure mattress padE0186
A
Air pressure mattressE0187
A
Water pressure mattressE0188
E
Synthetic sheepskin padE0189
E
Lambswool sheepskin padE0191
A
Protector heel or elbowE0192
A
Pad wheelchr low press/positE0193
A
Powered air flotation bedE0194
A
Air fluidized bedE0196
A
Gel pressure mattressE0197
A
Air pressure pad for mattresE0198
A
Water pressure pad for mattrE0199
A
Dry pressure pad for mattresE0200
A
Heat lamp without standE0202
A
Phototherapy light w/ photomE0205
A
Heat lamp with standE0210
A
Electric heat pad standardE0215
A
Electric heat pad moistE0217
A
Water circ heat pad w pumpE0218
E
Water circ cold pad w pumpE0220
A
Hot water bottleE0225
A
Hydrocollator unitE0230
A
Ice cap or collarE0235
A
Paraffin bath unit portableE0236
A
Pump for water circulating p( print page 67970)E0238
A
Heat pad non-electric moistE0239
A
Hydrocollator unit portableE0241
E
Bath tub wall railE0242
E
Bath tub rail floorE0243
E
Toilet railE0244
E
Toilet seat raisedE0245
E
Tub stool or benchE0246
E
Transfer tub rail attachmentE0249
A
Pad water circulating heat uE0250
A
Hosp bed fixed ht w/ mattresE0251
A
Hosp bed fixd ht w/o mattresE0255
A
Hospital bed var ht w/ mattrE0256
A
Hospital bed var ht w/o mattE0260
A
Hosp bed semi-electr w/ mattE0261
A
Hosp bed semi-electr w/o matE0265
A
Hosp bed total electr w/ matE0266
A
Hosp bed total elec w/o mattE0270
E
Hospital bed institutional tE0271
A
Mattress innerspringE0272
A
Mattress foam rubberE0273
E
Bed boardE0274
E
Over-bed tableE0275
A
Bed pan standardE0276
A
Bed pan fractureE0277
A
Powered pres-redu air mattrsE0280
A
Bed cradleE0290
A
Hosp bed fx ht w/o rails w/mE0291
A
Hosp bed fx ht w/o rail w/oE0292
A
Hosp bed var ht w/o rail w/oE0293
A
Hosp bed var ht w/o rail w/E0294
A
Hosp bed semi-elect w/ mattrE0295
A
Hosp bed semi-elect w/o mattE0296
A
Hosp bed total elect w/ mattE0297
A
Hosp bed total elect w/o matE0298
A
Heavyduty/xtra wide hosp bedE0305
A
Rails bed side half lengthE0310
A
Rails bed side full lengthE0315
E
Bed accessory brd/tbl/supprtE0325
A
Urinal male jug-typeE0326
A
Urinal female jug-typeE0350
E
Control unit bowel systemE0352
E
Disposable pack w/bowel systE0370
E
Air elevator for heelE0371
A
Nonpower mattress overlayE0372
A
Powered air mattress overlayE0373
A
Nonpowered pressure mattressE0424
A
Stationary compressed gas O2E0425
E
Gas system stationary compreE0430
E
Oxygen system gas portableE0431
A
Portable gaseous O2E0434
A
Portable liquid O2E0435
E
Oxygen system liquid portablE0439
A
Stationary liquid O2E0440
E
Oxygen system liquid stationE0441
A
Oxygen contents gas per/unitE0442
A
Oxygen contents liq per/unitE0443
A
Port O2 contents gas/unitE0444
A
Port O2 contents liq/unitE0450
A
Volume vent stationary/portaE0455
A
Oxygen tent excl croup/ped tE0457
A
Chest shellE0459
A
Chest wrapE0460
A
Neg press vent portabl/statnE0462
A
Rocking bed w/ or w/o side rE0480
A
Percussor elect/pneum home mE0500
A
Ippb all typesE0550
A
Humidif extens supple w ippbE0555
A
Humidifier for use w/ regulaE0560
A
Humidifier supplemental w/ iE0565
A
Compressor air power sourceE0570
A
Nebulizer with compressionE0571
A
Aerosol compressor for svnebE0572
A
Aerosol compressor adjust prE0574
A
Ultrasonic generator w svneb( print page 67971)E0575
A
Nebulizer ultrasonicE0580
A
Nebulizer for use w/ regulatE0585
A
Nebulizer w/ compressor & heE0590
A
Dispensing fee dme neb drugE0600
A
Suction pump portab hom modlE0601
A
Cont airway pressure deviceE0602
E
Breast pumpE0605
A
Vaporizer room typeE0606
A
Drainage board posturalE0607
A
Blood glucose monitor homeE0608
A
Apnea monitorE0609
A
Blood gluc mon w/special feaE0610
A
Pacemaker monitr audible/visE0615
A
Pacemaker monitr digital/visE0616
N
Cardiac event recorderE0617
A
Automatic ext defibrillatorE0621
A
Patient lift sling or seatE0625
E
Patient lift bathroom or toiE0627
A
Seat lift incorp lift-chairE0628
A
Seat lift for pt furn-electrE0629
A
Seat lift for pt furn-non-elE0630
A
Patient lift hydraulicE0635
A
Patient lift electricE0650
A
Pneuma compresor non-segmentE0651
A
Pneum compressor segmentalE0652
A
Pneum compres w/cal pressureE0655
A
Pneumatic appliance half armE0660
A
Pneumatic appliance full legE0665
A
Pneumatic appliance full armE0666
A
Pneumatic appliance half legE0667
A
Seg pneumatic appl full legE0668
A
Seg pneumatic appl full armE0669
A
Seg pneumatic appli half legE0671
A
Pressure pneum appl full legE0672
A
Pressure pneum appl full armE0673
A
Pressure pneum appl half legE0690
A
Ultraviolet cabinetE0700
E
Safety equipmentE0710
E
Restraints any typeE0720
A
Tens two leadE0730
A
Tens four leadE0731
A
Conductive garment for tens/E0740
E
Incontinence treatment systmE0744
A
Neuromuscular stim for scoliE0745
A
Neuromuscular stim for shockE0746
E
Electromyograph biofeedbackE0747
A
Elec osteogen stim not spineE0748
A
Elec osteogen stim spinalE0749
N
Elec osteogen stim implantedE0751D
N
Pulse generator or receiverE0753
N
Neurostimulator electrodesE0755
E
Electronic salivary reflex sE0756
N
Implantable pulse generatorE0757
N
Implantable RF receiverE0758
A
External RF transmitterE0760
E
Osteogen ultrasound stimltorE0765
A
Nerve stimulator for tx n&vE0776
A
Iv poleE0779
A
Amb infusion pump mechanicalE0780
A
Mech amb infusion pump <8hrsE0781
A
External ambulatory infus puE0782
N
Non-programble infusion pumpE0783
N
Programmable infusion pumpE0784
A
Ext amb infusn pump insulinE0785
N
Replacement impl pump cathetE0786
N
Implantable pump replacementE0791
A
Parenteral infusion pump staE0830
A
Ambulatory traction deviceE0840
A
Tract frame attach headboardE0850
A
Traction stand free standingE0855
A
Cervical traction equipmentE0860
A
Tract equip cervical tractE0870
A
Tract frame attach footboardE0880
A
Trac stand free stand extrem( print page 67972)E0890
A
Traction frame attach pelvicE0900
A
Trac stand free stand pelvicE0910
A
Trapeze bar attached to bedE0920
A
Fracture frame attached to bE0930
A
Fracture frame free standingE0935
A
Exercise device passive motiE0940
A
Trapeze bar free standingE0941
A
Gravity assisted traction deE0942
A
Cervical head harness/halterE0943
A
Cervical pillowE0944
A
Pelvic belt/harness/bootE0945
A
Belt/harness extremityE0946
A
Fracture frame dual w crossE0947
A
Fracture frame attachmnts peE0948
A
Fracture frame attachmnts ceE0950
E
TrayE0951
E
Loop heelE0952
E
Loop tieE0953
E
Pneumatic tireE0954
E
Wheelchair semi-pneumatic caE0958
E
Whlchr att- conv 1 arm driveE0959
E
Amputee adapterE0961
E
Wheelchair brake extensionE0962
A
Wheelchair 1 inch cushionE0963
A
Wheelchair 2 inch cushionE0964
A
Wheelchair 3 inch cushionE0965
A
Wheelchair 4 inch cushionE0966
E
Wheelchair head rest extensiE0967
E
Wheelchair hand rimsE0968
E
Wheelchair commode seatE0969
E
Wheelchair narrowing deviceE0970
E
Wheelchair no. 2 footplatesE0971
E
Wheelchair anti-tipping deviE0972
A
Transfer board or deviceE0973
E
Wheelchair adjustabl heightE0974
E
Wheelchair grade-aidE0975
E
Wheelchair reinforced seat uE0976
E
Wheelchair reinforced back uE0977
E
Wheelchair wedge cushionE0978
E
Wheelchair belt w/airplane bE0979
E
Wheelchair belt with velcroE0980
E
Wheelchair safety vestE0990
E
Whellchair elevating leg resE0991
E
Wheelchair upholstry seatE0992
E
Wheelchair solid seat insertE0993
E
Wheelchair back upholsteryE0994
E
Wheelchair arm restE0995
E
Wheelchair calf restE0996
E
Wheelchair tire solidE0997
E
Wheelchair caster w/ a forkE0998
E
Wheelchair caster w/o a forkE0999
E
Wheelchr pneumatic tire w/whE1000
E
Wheelchair tire pneumatic caE1001
E
Wheelchair wheelE1031
A
Rollabout chair with castersE1035
A
Patient transfer systemE1050
E
Whelchr fxd full length armsE1060
E
Wheelchair detachable armsE1065
E
Wheelchair power attachmentE1066
E
Wheelchair battery chargerE1069
E
Wheelchair deep cycle batterE1070
E
Wheelchair detachable foot rE1083
E
Hemi-wheelchair fixed armsE1084
E
Hemi-wheelchair detachable aE1085
E
Hemi-wheelchair fixed armsE1086
E
Hemi-wheelchair detachable aE1087
E
Wheelchair lightwt fixed armE1088
E
Wheelchair lightweight det aE1089
E
Wheelchair lightwt fixed armE1090
E
Wheelchair lightweight det aE1091
E
Wheelchair youthE1092
E
Wheelchair wide w/ leg restsE1093
E
Wheelchair wide w/ foot restE1100
E
Whchr s-recl fxd arm leg res( print page 67973)E1110
E
Wheelchair semi-recl detachE1130
E
Whlchr stand fxd arm ft restE1140
E
Wheelchair standard detach aE1150
E
Wheelchair standard w/ leg rE1160
E
Wheelchair fixed armsE1170
E
Whlchr ampu fxd arm leg restE1171
E
Wheelchair amputee w/o leg rE1172
E
Wheelchair amputee detach arE1180
E
Wheelchair amputee w/ foot rE1190
E
Wheelchair amputee w/ leg reE1195
E
Wheelchair amputee heavy dutE1200
E
Wheelchair amputee fixed armE1210
E
Whlchr moto ful arm leg restE1211
E
Wheelchair motorized w/ detE1212
E
Wheelchair motorized w fullE1213
E
Wheelchair motorized w/ detE1220
E
Whlchr special size/constrcE1221
E
Wheelchair spec size w footE1222
E
Wheelchair spec size w/ legE1223
E
Wheelchair spec size w footE1224
E
Wheelchair spec size w/ legE1225
E
Wheelchair spec sz semi-reclE1226
E
Wheelchair spec sz full-reclE1227
E
Wheelchair spec sz spec ht aE1228
E
Wheelchair spec sz spec ht bE1230
A
Power operated vehicleE1240
E
Whchr litwt det arm leg restE1250
E
Wheelchair lightwt fixed armE1260
E
Wheelchair lightwt foot restE1270
E
Wheelchair lightweight leg rE1280
E
Whchr h-duty det arm leg resE1285
E
Wheelchair heavy duty fixedE1290
E
Wheelchair hvy duty detach aE1295
E
Wheelchair heavy duty fixedE1296
E
Wheelchair special seat heigE1297
E
Wheelchair special seat deptE1298
E
Wheelchair spec seat depth/wE1300
E
Whirlpool portableE1310
A
Whirlpool non-portableE1340
A
Repair for DME, per 15 minE1353
A
Oxygen supplies regulatorE1355
A
Oxygen supplies stand/rackE1372
A
Oxy suppl heater for nebulizE1375D
A
Oxygen suppl nebulizer portaE1377D
E
Oxygen concentrator to 244 cE1378D
E
Oxygen concentrator to 488 cE1379D
E
Oxygen concentrator to 732 cE1380D
E
Oxygen concentrator to 976 cE1381D
E
Oxygen concentrat to 1220 cuE1382D
E
Oxygen concentrat to 1464 cuE1383D
E
Oxygen concentrat to 1708 cuE1384D
E
Oxygen concentrat to 1952 cuE1385D
E
Oxygen concentrator > 1952 cE1390
A
Oxygen concentratorE1399
A
Durable medical equipment miE1405
A
O2/water vapor enrich w/heatE1406
A
O2/water vapor enrich w/o heE1510
A
Kidney dialysate delivry sysE1520
A
Heparin infusion pump for diE1530
A
Air bubble detector for dialE1540
A
Pressure alarm for dialysisE1550
A
Bath conductivity meterE1560
A
Blood leak detector for dialE1570
A
Adjustable chair for esrd ptE1575
A
Transducer protector/fluid bE1580
A
Unipuncture control systemE1590
A
Hemodialysis machineE1592
A
Auto interm peritoneal dialyE1594
A
Cycler dialysis machineE1600
A
Deliv/install equip for dialE1610
A
Reverse osmosis water purifiE1615
A
Deionizer water purificationE1620
A
Blood pump for dialysisE1625
A
Water softening system( print page 67974)E1630
A
Reciprocating peritoneal diaE1632
A
Wearable artificial kidneyE1635
A
Compact travel hemodialyzerE1636
A
Sorbent cartridges for dialyE1640
A
Replacement components for dE1699
A
Dialysis equipment unspecifiE1700
A
Jaw motion rehab systemE1701
A
Repl cushions for jaw motionE1702
A
Repl measr scales jaw motionE1800
A
Adjust elbow ext/flex deviceE1805
A
Adjust wrist ext/flex deviceE1810
A
Adjust knee ext/flex deviceE1815
A
Adjust ankle ext/flex deviceE1820
A
Soft interface materialE1825
A
Adjust finger ext/flex devcE1830
A
Adjust toe ext/flex deviceE1900
A
Speech communication deviceG0001
A
Drawing blood for specimenG0002
N
Temporary urinary catheterG0004
E
ECG transm phys review & intG0005
X
ECG 24 hour recording
0097
1.62
$80.35
$62.40
$16.07G0006
X
ECG transmission & analysis
0097
1.62
$80.35
$62.40
$16.07G0007
N
ECG phy review & interpretG0008
K
Admin influenza virus vac
0354
0.13
$6.33G0009
K
Admin pneumococcal vaccine
0354
0.13
$6.33G0010
N
Admin hepatitis b vaccineG0015
X
Post symptom ECG tracing
0097
1.62
$80.35
$62.40
$16.07G0016
E
Post symptom ECG md reviewG0025
X
Collagen skin test kit
0343
0.45
$22.32
$12.16
$4.46G0026
A
Fecal leukocyte examinationG0027
A
Semen analysisG0030
S
PET imaging prev PET single
0285
15.06
$746.92
$415.21
$149.38G0031
S
PET imaging prev PET multple
0285
15.06
$746.92
$415.21
$149.38G0032
S
PET follow SPECT 78464 singl
0285
15.06
$746.92
$415.21
$149.38G0033
S
PET follow SPECT 78464 mult
0285
15.06
$746.92
$415.21
$149.38G0034
S
PET follow SPECT 76865 singl
0285
15.06
$746.92
$415.21
$149.38G0035
S
PET follow SPECT 78465 mult
0285
15.06
$746.92
$415.21
$149.38G0036
S
PET follow cornry angio sing
0285
15.06
$746.92
$415.21
$149.38G0037
S
PET follow cornry angio mult
0285
15.06
$746.92
$415.21
$149.38G0038
S
PET follow myocard perf sing
0285
15.06
$746.92
$415.21
$149.38G0039
S
PET follow myocard perf mult
0285
15.06
$746.92
$415.21
$149.38G0040
S
PET follow stress echo singl
0285
15.06
$746.92
$415.21
$149.38G0041
S
PET follow stress echo mult
0285
15.06
$746.92
$415.21
$149.38G0042
S
PET follow ventriculogm sing
0285
15.06
$746.92
$415.21
$149.38G0043
S
PET follow ventriculogm mult
0285
15.06
$746.92
$415.21
$149.38G0044
S
PET following rest ECG singl
0285
15.06
$746.92
$415.21
$149.38G0045
S
PET following rest ECG mult
0285
15.06
$746.92
$415.21
$149.38G0046
S
PET follow stress ECG singl
0285
15.06
$746.92
$415.21
$149.38G0047
S
PET follow stress ECG mult
0285
15.06
$746.92
$415.21
$149.38G0050
S
Residual urine by ultrasound
0265
1.17
$58.03
$38.08
$11.61G0101
V
CA screen;pelvic/breast exam
0601
1.00
$49.60
$9.92
$9.92G0102
N
Prostate ca screening; dreG0103
A
Psa, total screeningG0104
S
CA screen;flexi sigmoidscope
0159
2.83
$140.36

$35.09G0105
S
Colorectal scrn; hi risk ind
0158
7.98
$395.78

$98.94G0106
S
Colon CA screen;barium enema
0157
1.79
$88.78

$22.19G0107
A
CA screen; fecal blood testG0108
A
Diab manage trn per indivG0109
A
Diab manage trn ind/groupG0110
A
Nett pulm-rehab educ; indG0111
A
Nett pulm-rehab educ; groupG0112
A
Nett;nutrition guid, initialG0113
A
Nett;nutrition guid,subseqntG0114
A
Nett; psychosocial consultG0115
A
Nett; psychological testingG0116
A
Nett; psychosocial counselG0120
S
Colon ca scrn; barium enema
0157
1.79
$88.78

$22.19G0121
E
Colon ca scrn not hi rsk indG0122
S
Colon ca scrn; barium enema
0157
1.79
$88.78

$22.19G0123
A
Screen cerv/vag thin layerG0124
A
Screen c/v thin layer by MDG0125
S
Lung image (PET)
0981
46.40
$2,301.26

$460.25G0126
S
Lung image (PET) staging
0981
46.40
$2,301.26

$460.25G0127
T
Trim nail(s)
0009
0.74
$36.70
$9.63
$7.34( print page 67975)G0128
E
CORF skilled nursing serviceG0129
P
Partial hosp prog service
0033
4.17
$206.82
$48.17
$41.36G0130
X
Single energy x-ray study
0261
1.38
$68.44
$38.77
$13.69G0131
S
CT scan, bone density study
0282
2.38
$118.04
$94.51
$23.61G0132
S
CT scan, bone density study
0282
2.38
$118.04
$94.51
$23.61G0141
E
Scr c/v cyto,autosys and mdG0143
A
Scr c/v cyto,thinlayer,rescrG0144
A
Scr c/v cyto,thinlayer,rescrG0145
A
Scr c/v cyto,thinlayer,rescrG0147
A
Scr c/v cyto, automated sysG0148
A
Scr c/v cyto, autosys, rescrG0151
E
HHCP-serv of pt,ea 15 minG0152
E
HHCP-serv of ot,ea 15 minG0153
E
HHCP-svs of s/l path,ea 15mnG0154
E
HHCP-svs of rn,ea 15 minG0155
E
HHCP-svs of csw,ea 15 minG0156
E
HHCP-svs of aide,ea 15 minG0159D
T
Perc declot dialysis graft
0103
13.09
$649.21
$295.70
$129.84*G0160D
S
Cryo. ablation, prostate
0981
46.40
$2,301.26

$460.25G0161D
X
Echo guide for cryo probes
0268
2.23
$110.60
$69.51
$22.12G0163
S
Pet for rec of colorectal ca
0981
46.40
$2,301.26

$460.25G0164
S
Pet for lymphoma staging
0981
46.40
$2,301.26

$460.25G0165
S
Pet,rec of melanoma/met ca
0981
46.40
$2,301.26

$460.25G0166
T
Extrnl counterpulse, per tx
0972
3.09
$153.26

$30.65G0167
E
Hyperbaric oz tx;no md reqrdG0168
T
Wound closure by adhesive
0970
0.52
$25.79

$5.16G0169D
T
Removal tissue; no anesthsia
0013
0.91
$45.13
$17.66
$9.03G0170D
T
Skin biograft
0025
3.74
$185.49
$70.66
$37.10G0171D
T
Skin biograft add-on
0025
3.74
$185.49
$70.66
$37.10G0172D
P
Partial hosp prog service
0033
4.17
$206.82
$48.17
$41.36G0173
S
Stereotactic radiosurgery
0302
8.21
$407.18
$216.55
$81.44G0174
S
IMRT , per session
0302
8.21
$407.18
$216.55
$81.44G0175
V
Interdisciplinary team conf
0602
1.66
$82.33
$16.47
$16.47*G0176
P
OPPS/PHP;activity therapy
0033
4.17
$206.82
$48.17
$41.36*G0177
P
OPPS/PHP; train & educ serv
0033
4.17
$206.82
$48.17
$41.36*G0178
S
Intensity modulated radiation
0302
8.21
$407.18
$216.55
$81.44*G0179
E
Phys recertification, HHA pt*G0180
E
Phys certification, HHA pt*G0181
E
Home health care supervision*G0182
E
Hospice care supervision*G0183
T
Ocular photodynamic therapy
0235
2.94
$145.81
$78.91
$29.16*G0184
T
Ocular photocoagulation
0235
33.96
$1,684.28
$852.68
$336.86*G0185
T
Transpuppillary thermotx
0235
6.70
$332.29
$147.96
$66.46*G0186
T
Dstry eye lesn,fdr vssl tech
0235
6.70
$332.29
$147.96
$66.46*G0187
T
Dstry mclr drusen,photocoag
0235
33.96
$1,684.28
$852.68
$336.86*G0188
X
Xray lwr extrmty-full lngth

1.38
$68.44
$38.77
$13.69*G0190
N
Immunization administration*G0191
N
Immunization admin,each add*G0192
N
Immunization oral/intranasal*G0195
A
Clinical eval, swallowing*G0196
A
Radioisotope eval, swallowing*G0197
A
Eval, speech generating device*G0198
A
Trng, speech generating device*G0199
A
Re-evaluation, speech device*G0200
A
Eval, voice prosthetic*G0201
A
Trng, voice prosthetic*G9001
E
Coordinated care fee*G9002
E
Coordinated care fee*G9003
E
Coordinated care fee*G9004
E
Coordinated care fee*G9005
E
Coordinated care fee*G9006
E
Coordinated care fee*G9007
E
Coordinated care fee*G9008
E
Coordinated care fee*G9016
A
Demo-smoking cessation counJ0120
N
Tetracyclin injection*J0130
G
Abciximab injection
1605

$513.02

$68.74J0150
K
Injection adenosine 6 MG
0917
0.36
$17.86

$3.57J0151
E
Adenosine injectionJ0170
N
Adrenalin epinephrin injectJ0190
N
Inj biperiden lactate/5 mgJ0200
N
Alatrofloxacin mesylateJ0205
G
Alglucerase injection
0900

$37.53

$5.03J0207
G
Amifostine
7000

$350.31

$46.94( print page 67976)J0210
N
Methyldopate hcl injectionJ0256
G
Alpha 1 proteinase inhibitor
0901

$2.09

$.28J0270
E
Alprostadil for injectionJ0275
E
Alprostadil urethral supposJ0280
N
Aminophyllin 250 MG injJ0282
N
Amiodarone HClJ0285
N
Amphotericin BJ0286
G
Amphotericin B lipid complex
7001

$95.00

$12.73J0290
N
Ampicillin 500 MG injJ0295
N
Ampicillin sodium per 1.5 gmJ0300
N
Amobarbital 125 MG injJ0330
N
Succinycholine chloride injJ0340
N
Nandrolon phenpropionate inj*J0350
G
Injection anistreplase 30 u
1606

$2,693.80

$360.97J0360
N
Hydralazine hcl injectionJ0380
N
Inj metaraminol bitartrateJ0390
N
Chloroquine injectionJ0395
N
Arbutamine HCl injectionJ0400
N
Inj trimethaphan camsylateJ0456
N
AzithromycinJ0460
N
Atropine sulfate injectionJ0470
N
Dimecaprol injectionJ0475
N
Baclofen 10 MG injectionJ0476
E
Baclofen 50 mcg intrathecal trialJ0500
N
Dicyclomine injectionJ0510
N
Benzquinamide injectionJ0515
N
Inj benztropine mesylateJ0520
N
Bethanechol chloride injectJ0530
N
Penicillin g benzathine injJ0540
N
Penicillin g benzathine injJ0550
N
Penicillin g benzathine injJ0560
N
Penicillin g benzathine injJ0570
N
Penicillin g benzathine injJ0580
N
Penicillin g benzathine injJ0585
G
Botulinum toxin a per unit
0902

$4.39

$.59J0590
N
Ethylnorepinephrine hcl injJ0600
N
Edetate calcium disodium injJ0610
N
Calcium gluconate injectionJ0620
N
Calcium glycer & lact/10 MLJ0630
N
Calcitonin salmon injectionJ0635
N
Calcitriol injectionJ0640
G
Leucovorin calcium injection
0725

$49.73

$6.66J0670
N
Inj mepivacaine HCL/10 mlJ0690
N
Cefazolin sodium injectionJ0694
N
Cefoxitin sodium injectionJ0695
N
Cefonocid sodium injectionJ0696
N
Ceftriaxone sodium injectionJ0697
N
Sterile cefuroxime injectionJ0698
N
Cefotaxime sodium injectionJ0702
N
Betamethasone acet&sod phospJ0704
N
Betamethasone sod phosp/4 MGJ0710
N
Cephapirin sodium injectionJ0713
N
Inj ceftazidime per 500 mgJ0715
N
Ceftizoxime sodium / 500 MGJ0720
N
Chloramphenicol sodium injecJ0725
N
Chorionic gonadotropin/1000uJ0730
N
Chlorpheniramin maleate injJ0735
N
Clonidine hydrochlorideJ0740
N
Cidofovir injectionJ0743
N
Cilastatin sodium injectionJ0745
N
Inj codeine phosphate /30 MGJ0760
N
Colchicine injectionJ0770
N
Colistimethate sodium injJ0780
N
Prochlorperazine injectionJ0800
N
Corticotropin injectionJ0810
N
Cortisone injectionJ0835
N
Inj cosyntropin per 0.25 MGJ0850
G
Cytomegalovirus imm IV /vial
0903

$370.50

$49.65J0895
N
Deferoxamine mesylate injJ0900
N
Testosterone enanthate injJ0945
N
Brompheniramine maleate injJ0970
N
Estradiol valerate injectionJ1000
N
Depo-estradiol cypionate injJ1020
N
Methylprednisolone 20 MG inj( print page 67977)J1030
N
Methylprednisolone 40 MG injJ1040
N
Methylprednisolone 80 MG injJ1050
N
Medroxyprogesterone injJ1055
E
Medrxyprogester acetate injJ1060
N
Testosterone cypionate 1 MLJ1070
N
Testosterone cypionat 100 MGJ1080
N
Testosterone cypionat 200 MGJ1090
N
Testosterone cypionate 50 MGJ1095
N
Inj dexamethasone acetateJ1100
N
Dexamethasone sodium phosJ1110
N
Inj dihydroergotamine mesyltJ1120
N
Acetazolamid sodium injectioJ1160
N
Digoxin injectionJ1165
N
Phenytoin sodium injectionJ1170
N
Hydromorphone injectionJ1180
N
Dyphylline injectionJ1190
G
Dexrazoxane HCl injection
0726

$161.11

$21.59J1200
N
Diphenhydramine hcl injectioJ1205
N
Chlorothiazide sodium injJ1212
N
Dimethyl sulfoxide 50% 50 MLJ1230
N
Methadone injectionJ1240
N
Dimenhydrinate injectionJ1245
K
Dipyridamole injection
0917
0.36
$17.86

$3.57J1250
N
Inj dobutamine HCL/250 mgJ1260
G
Dolasetron mesylate
0750

$14.81

$1.98J1320
N
Amitriptyline injectionJ1325
G
Epoprostenol injection
7003

$16.53

$2.22*J1327
G
Eptifibatide injection
1607

$12.57

$1.68J1330
N
Ergonovine maleate injectionJ1362
N
Erythromycin glucep / 250 MGJ1364
N
Erythro lactobionate /500 MGJ1380
N
Estradiol valerate 10 MG injJ1390
N
Estradiol valerate 20 MG injJ1410
N
Inj estrogen conjugate 25 MGJ1435
N
Injection estrone per 1 MGJ1436
G
Etidronate disodium inj
0727

$63.65

$8.53*J1438
G
Etanercept injection
1608

$134.42

$18.01J1440
G
Filgrastim 300 mcg injection
0728

$171.38

$22.96J1441
G
Filgrastim 480 mcg injection
7049

$273.03

$35.06J1450
N
FluconazoleJ1452
N
Intraocular Fomivirsen na 1.65 MGJ1455
N
Foscarnet sodium injectionJ1460
N
Gamma globulin 1 CC injJ1470
E
Gamma globulin 2 CC injJ1480
E
Gamma globulin 3 CC injJ1490
E
Gamma globulin 4 CC injJ1500
E
Gamma globulin 5 CC injJ1510
E
Gamma globulin 6 CC injJ1520
E
Gamma globulin 7 CC injJ1530
E
Gamma globulin 8 CC injJ1540
E
Gamma globulin 9 CC injJ1550
E
Gamma globulin 10 CC injJ1560
E
Gamma globulin > 10 CC injJ1561
G
Immune globulin 500 mg
0905

$27.28

$3.33J1562D
G
Immune globulin 5 gms
7004

$272.80

$33.28J1563D
N
IV immune globulin 1 GMJ1565
G
RSV-ivig
0906

$427.73

$57.32J1570
K
Ganciclovir sodium injection
0907
0.45
$22.26

$4.45J1580
N
Garamycin gentamicin injJ1600
N
Gold sodium thiomaleate injJ1610
N
Glucagon hydrochloride/1 MGJ1620
G
Gonadorelin hydroch/ 100 mcg
7005

$14.80

$1.98J1626
G
Granisetron HCl injection
0764

$1.85

$.25J1630
N
Haloperidol injectionJ1631
N
Haloperidol decanoate injJ1642
N
Inj heparin sodium per 10 uJ1644
N
Inj heparin sodium per 1000uJ1645
N
Dalteparin sodiumJ1650
G
Enoxaparin sodium 10 mg
9998

$5.53

$.79J1670
G
Tetanus immune globulin inj
0908

$102.60

$13.75J1690
N
Prednisolone tebutate injJ1700
N
Hydrocortisone acetate injJ1710
N
Hydrocortisone sodium ph injJ1720
N
Hydrocortisone sodium succ i( print page 67978)J1730
N
Diazoxide injectionJ1739
N
Hydroxyprogesterone cap 125J1741
N
Hydroxyprogesterone cap 250J1742
N
Ibutilide fumarate injectionJ1745
G
Infliximab injection
7043

$58.08

$7.78J1750
N
Iron dextranJ1785
G
Injection imiglucerase /unit
0916

$3.75

$.50J1790
N
Droperidol injectionJ1800
N
Propranolol injectionJ1810
G
Droperidol/fentanyl inj
7047

$7.02

$.90J1820
N
Insulin injectionJ1825
G
Interferon beta-1a
0909

$204.73

$27.43J1830
G
Interferon beta-1b / .25 MG
0910

$57.00

$7.64J1840
N
Kanamycin sulfate 500 MG injJ1850
N
Kanamycin sulfate 75 MG injJ1885
N
Ketorolac tromethamine injJ1890
N
Cephalothin sodium injectionJ1910
N
Kutapressin injectionJ1930
N
Propiomazine injectionJ1940
N
Furosemide injectionJ1950
G
Leuprolide acetate /3.75 MG
0800

$492.71

$63.27J1955
N
Inj levocarnitine per 1 gmJ1956
N
Levofloxacin injectionJ1960
N
Levorphanol tartrate injJ1970
N
Methotrimeprazine injectionJ1980
N
Hyoscyamine sulfate injJ1990
N
Chlordiazepoxide injectionJ2000
N
Lidocaine injectionJ2010
N
Lincomycin injectionJ2060
N
Lorazepam injectionJ2150
N
Mannitol injectionJ2175
N
Meperidine hydrochl /100 MGJ2180
N
Meperidine/promethazine injJ2210
N
Methylergonovin maleate injJ2240
N
Metocurine iodide injectionJ2250
N
Inj midazolam hydrochlorideJ2260
K
Inj milrinone lactate / 5 ML
7007
0.47
$23.31

$4.66J2270
N
Morphine sulfate injectionJ2271
N
Morphine so4 injection 100mgJ2275
G
Morphine sulfate injection
7010

$7.41

$.99J2300
N
Inj nalbuphine hydrochlorideJ2310
N
Inj naloxone hydrochlorideJ2320
N
Nandrolone decanoate 50 MGJ2321
N
Nandrolone decanoate 100 MGJ2322
N
Nandrolone decanoate 200 MGJ2330
N
Thiothixene injectionJ2350
N
Niacinamide/niacin injectionJ2352
G
Octreotide acetate injection
7031

$115.34

$15.46J2355
G
Oprelvekin injection
7011

$236.31

$31.67J2360
N
Orphenadrine injectionJ2370
N
Phenylephrine hcl injectionJ2400
N
Chloroprocaine hcl injectionJ2405
G
Ondansetron hcl injection
0768

$6.09

$.82J2410
N
Oxymorphone hcl injectionJ2430
G
Pamidronate disodium /30 MG
0730

$232.51

$31.16J2440
N
Papaverin hcl injectionJ2460
N
Oxytetracycline injectionJ2480
N
Hydrochlorides of opium injJ2500
N
ParicalcitolJ2510
N
Penicillin g procaine injJ2512
N
Inj pentagastrin per 2 MLJ2515
N
Pentobarbital sodium injJ2540
N
Penicillin g potassium injJ2543
N
Piperacillin/tazobactamJ2545
A
Pentamidine isethionte/300mgJ2550
N
Promethazine hcl injectionJ2560
N
Phenobarbital sodium injJ2590
N
Oxytocin injectionJ2597
E
Inj desmopressin acetateJ2640
N
Prednisolone sodium ph injJ2650
N
Prednisolone acetate injJ2670
N
Totazoline hcl injectionJ2675
N
Inj progesterone per 50 MGJ2680
N
Fluphenazine decanoate 25 MG( print page 67979)J2690
N
Procainamide hcl injectionJ2700
N
Oxacillin sodium injectionJ2710
N
Neostigmine methylslfte injJ2720
N
Inj protamine sulfate/10 MGJ2725
N
Inj protirelin per 250 mcgJ2730
N
Pralidoxime chloride injJ2760
N
Phentolaine mesylate injJ2765
G
Metoclopramide hcl injection
0754

$2.00

$.27J2770
G
Quinupristin/dalfopristin
1024

$102.05

$13.67J2780
N
Ranitidine hydrochloride injJ2790
G
Rho d immune globulin inj
0884

$35.91

$4.38*J2792
G
Rho(D) immune globulin h, sd
1609

$20.55

$2.51J2795
N
Ropivacaine HCl injectionJ2800
N
Methocarbamol injectionJ2810
N
Inj theophylline per 40 MGJ2820
G
Sargramostim injection
0731

$27.42

$3.67J2860
N
Secobarbital sodium injJ2910
N
Aurothioglucose injectionJ2912
N
Sodium chloride injectionJ2915
N
NA Ferric Gluconate ComplexJ2920
N
Methylprednisolone injectionJ2930
N
Methylprednisolone injectionJ2950
N
Promazine hcl injectionJ2970
N
Methicillin sodium injectionJ2993
G
Reteplase injection
9005

$1,306.25

$175.04J2994D
G
Reteplase double bolus
0914

$2,612.50

$350.08J2995
K
Inj streptokinase /250000 IU
0911
1.76
$87.25

$17.45J2996D
K
Alteplase recombinant inj
0915
3.80
$188.46

$37.69J2997
G
Alteplase recombinant, 1 mg
7048
0.38
$18.70

$3.74J3000
N
Streptomycin injectionJ3010
G
Fentanyl citrate injection
7014

$.98

$.13J3030
N
Sumatriptan succinate / 6 MGJ3070
N
Pentazocine hcl injectionJ3080
N
Chlorprothixene injectionJ3105
N
Terbutaline sulfate injJ3120
N
Testosterone enanthate injJ3130
N
Testosterone enanthate injJ3140
N
Testosterone suspension injJ3150
N
Testosteron propionate injJ3230
N
Chlorpromazine hcl injection*J3240
E
Thyrotropin injectionJ3245
G
Tirofiban hydrochloride
7041

$399.00

$53.47J3250
N
Trimethobenzamide hcl injJ3260
N
Tobramycin sulfate injectionJ3265
N
Injection torsemide 10 mg/mlJ3270
N
Imipramine hcl injectionJ3280
G
Thiethylperazine maleate inj
0755

$5.02

$.67J3301
N
Triamcinolone acetonide injJ3302
N
Triamcinolone diacetate injJ3303
N
Triamcinolone hexacetonl injJ3305
G
Inj trimetrexate glucoronate
7045

$69.83

$9.36J3310
N
Perphenazine injectionJ3320
N
Spectinomycn di-hcl injJ3350
N
Urea injectionJ3360
N
Diazepam injectionJ3364
N
Urokinase 5000 IU injectionJ3365
K
Urokinase 250,000 IU inj
7036
6.78
$336.29

$67.26J3370
N
Vancomycin hcl injectionJ3390
N
Methoxamine injectionJ3400
N
Triflupromazine hcl injJ3410
N
Hydroxyzine hcl injectionJ3420
N
Vitamin b12 injectionJ3430
N
Vitamin k phytonadione injJ3450
N
Mephentermine sulfate injJ3470
N
Hyaluronidase injectionJ3475
N
Inj magnesium sulfateJ3480
N
Inj potassium chlorideJ3485
N
ZidovudineJ3490
N
Drugs unclassified injectionJ3520
E
Edetate disodium per 150 mgJ3530
N
Nasal vaccine inhalationJ3535
E
Metered dose inhaler drugJ3570
E
Laetrile amygdalin vit B17J7030
N
Normal saline solution infus( print page 67980)J7040
N
Normal saline solution infusJ7042
N
5% dextrose/normal salineJ7050
N
Normal saline solution infusJ7051
N
Sterile saline/waterJ7060
N
5% dextrose/waterJ7070
N
D5w infusionJ7100
N
Dextran 40 infusionJ7110
N
Dextran 75 infusionJ7120
N
Ringers lactate infusionJ7130
N
Hypertonic saline solutionJ7190
G
Factor viii
0925

$.88

$.12J7191
G
Factor VIII (porcine)
0926

$2.09

$.28J7192
G
Factor viii recombinant
0927

$1.17

$.16J7194
G
Factor ix complex
0928

$.71

$.10J7197
G
Antithrombin iii injection
0930

$.82

$.11J7198
G
Anti-inhibitor
0929

$1.43

$.19J7199
E
Hemophilia clot factor nocJ7300
E
Intraut copper contraceptiveJ7310
G
Ganciclovir long act implant
0913

$4,750.00

$636.50J7315
G
Sodium hyaluronate injection
7315

$125.59

$16.83*J7320
G
Hylan G-F 20 injection
1611

$204.87

$27.45J7330
G
Cultured chondrocytes implnt
1059

$14,250.00

$2,010.00J7500
G
Azathioprine oral 50mg
0886

$1.24

$.17J7501
G
Azathioprine parenteral
0887

$67.88

$9.10J7502
G
Cyclosporine oral 100 mg
0888

$5.80

$.78J7504
G
Lymphocyte immune globulin
0890

$249.13

$30.39J7505
G
Muromonab-CD3, 5 mg
7038

$741.00

$99.29J7506
N
Prednisone oralJ7507
G
Tacrolimus oral per 1 MG
0891

$2.66

$.36J7508
E
Tacrolimus oral per 5 MGJ7509
N
Methylprednisolone oralJ7510
N
Prednisolone oral per 5 mg*J7513
G
Daclizumab, parenteral
1612

$397.29

$53.24J7515
N
Cyclosporine oral 25 mgJ7516
G
Cyclosporin parenteral 250mg
0889

$15.81

$2.12J7517
N
Mycophenolate mofetil oralJ7520
G
Sirolimus, oral
9106

$6.51

$.87J7525
E
Tacrolimus injectionJ7599
E
Immunosuppressive drug nocJ7608
A
Acetylcysteine inh sol u dJ7610D
A
Acetylcysteine 10% injectionJ7615D
A
Acetylcysteine 20% injectionJ7618
A
Albuterol inh sol conJ7619
A
Albuterol inh sol u dJ7620D
A
Albuterol sulfate .083%/mlJ7625D
A
Albuterol sulfate .5% injJ7627D
A
Bitolterolmesylate inhal solJ7628
A
Bitolterol mes inhal sol conJ7629
A
Bitolterol mes inh sol u dJ7630D
A
Cromolyn sodium injectionJ7631
A
Cromolyn sodium inh sol u dJ7635
A
Atropine inhal sol conJ7636
A
Atropine inhal sol unit doseJ7637
A
Dexamethasone inhal sol conJ7638
A
Dexamethasone inhal sol u dJ7639
A
Dornase alpha inhal sol u dJ7640D
A
Epinephrine injectionJ7642
A
Glycopyrrolate inhal sol conJ7643
A
Glycopyrrolate inhal sol u dJ7644
A
Ipratropium brom inh sol u dJ7645D
A
Ipratropium bromide .02%/mlJ7648
A
Isoetharine hcl inh sol conJ7649
A
Isoetharine hcl inh sol u dJ7650D
A
Isoetharine hcl .1% injJ7651D
A
Isoetharine hcl .125% injJ7652D
A
Isoetharine hcl .167% injJ7653D
A
Isoetharine hcl .2%/ injJ7654D
A
Isoetharine hcl .25% injJ7655D
A
Isoetharine hcl 1% injJ7658
A
Isoproterenolhcl inh sol conJ7659
A
Isoproterenol hcl inh sol udJ7660D
A
Isoproterenol hcl .5% injJ7665D
A
Isoproterenol hcl 1% injJ7668
A
Metaproterenol inh sol con( print page 67981)J7669
A
Metaproterenol inh sol u dJ7670D
A
Metaproterenol sulfate .4%J7672D
A
Metaproterenol sulfate .6%J7675D
A
Metaproterenol sulfate 5%J7680
A
Terbutaline so4 inh sol conJ7681
A
Terbutaline so4 inh sol u dJ7682
A
Tobramycin inhalation solJ7683
A
Triamcinolone inh sol conJ7684
A
Triamcinolone inh sol u dJ7699
A
Inhalation solution for DMEJ7799
A
Non-inhalation drug for DMEJ8499
E
Oral prescrip drug non chemoJ8510
G
Oral busulfan
7015

$1.73

$.23J8520
G
Capecitabine, oral, 150 mg
7042

$1.94

$.26J8521
N
Capecitabine, oral, 500 mgJ8530
G
Cyclophosphamide oral 25 MG
0801

$2.12

$.28J8560
G
Etoposide oral 50 MG
0802

$45.95

$6.16J8600
G
Melphalan oral 2 MG
0803

$2.07

$.30J8610
G
Methotrexate oral 2.5 MG
0826

$2.92

$.39J8700
G
Temozolmide, oral 5 mg
1086

$5.70

$.76J8999
E
Oral prescription drug chemoJ9000
G
Doxorubic hcl 10 MG vl chemo
0847

$15.79

$2.12J9001
G
Doxorubicin hcl liposome inj
7046

$311.72

$41.77J9015
G
Aldesleukin/single use vial
0807

$569.76

$76.35J9020
G
Asparaginase injection
0814

$57.41

$7.69J9031
G
Bcg live intravesical vac
0809

$159.39

$19.45J9040
G
Bleomycin sulfate injection
0857

$294.48

$39.46J9045
G
Carboplatin injection
0811

$98.90

$13.25J9050
G
Carmus bischl nitro inj
0812

$103.27

$13.84J9060
G
Cisplatin 10 MG injection
0813

$42.18

$5.65J9062
E
Cisplatin 50 MG injectionJ9065
G
Inj cladribine per 1 MG
0858

$53.47

$7.16J9070
G
Cyclophosphamide 100 MG inj
0815

$6.13

$.82J9080
E
Cyclophosphamide 200 MG injJ9090
E
Cyclophosphamide 500 MG injJ9091
E
Cyclophosphamide 1.0 grm injJ9092
E
Cyclophosphamide 2.0 grm injJ9093
G
Cyclophosphamide lyophilized
0816

$6.13

$.82J9094
E
Cyclophosphamide lyophilizedJ9095
E
Cyclophosphamide lyophilizedJ9096
E
Cyclophosphamide lyophilizedJ9097
E
Cyclophosphamide lyophilizedJ9100
G
Cytarabine hcl 100 MG inj
0817

$5.94

$.80J9110
E
Cytarabine hcl 500 MG injJ9120
G
Dactinomycin actinomycin d
0818

$12.73

$1.71J9130
G
Dacarbazine 10 MG inj
0819

$1.13

$.15J9140
E
Dacarbazine 200 MG injJ9150
G
Daunorubicin
0820

$80.04

$10.73J9151
G
Daunorubicin citrate liposom
0821

$64.60

$8.66J9160
G
Denileukin diftitox, 300 mcg
1084

$942.88

$126.35J9165
G
Diethylstilbestrol injection
0822

$4.20

$.56J9170
G
Docetaxel
0823

$283.65

$38.01J9180
E
Epirubicin HCl injectionJ9181
G
Etoposide 10 MG inj
0824

$4.06

$.54J9182
E
Etoposide 100 MG injJ9185
G
Fludarabine phosphate inj
0842

$237.03

$31.76J9190
G
Fluorouracil injection
0859

$2.75

$.37J9200
G
Floxuridine injection
0827

$129.56

$17.36J9201
G
Gemcitabine HCl
0828

$88.46

$11.85J9202
G
Goserelin acetate implant
0810

$446.49

$59.83J9206
G
Irinotecan injection
0830

$117.81

$15.79J9208
G
Ifosfomide injection
0831

$141.50

$18.96J9209
G
Mesna injection
0732

$36.51

$4.89J9211
G
Idarubicin hcl injection
0832

$341.38

$45.75J9212
G
Interferon alfacon-1
0833

$3.91

$.52J9213
G
Interferon alfa-2a inj
0834

$33.22

$4.45J9214
G
Interferon alfa-2b inj
0836

$11.28

$1.51J9215
G
Interferon alfa-n3 inj
0865

$7.86

$1.05J9216
G
Interferon gamma 1-b inj
0838

$199.50

$26.73J9217
G
Leuprolide acetate suspnsion
9217

$592.60

$79.40J9218
G
Leuprolide acetate injection
0861

$22.90

$3.07J9219
N
Leuprolide acetate implantJ9230
G
Mechlorethamine hcl inj
0839

$11.01

$1.48J9245
G
Inj melphalan hydrochl 50 MG
0840

$363.48

$48.71( print page 67982)J9250
G
Methotrexate sodium inj
0841

$.45

$.06J9260
E
Methotrexate sodium injJ9265
G
Paclitaxel injection
0863

$173.50

$23.25J9266
G
Pegaspargase/singl dose vial
0843

$1,321.65

$177.10J9268
G
Pentostatin injection
0844

$1,562.75

$209.41J9270
G
Plicamycin (mithramycin) inj
0860

$93.80

$12.57J9280
G
Mitomycin 5 MG inj
0862

$121.65

$16.30J9290
E
Mitomycin 20 MG injJ9291
E
Mitomycin 40 MG injJ9293
G
Mitoxantrone hydrochl / 5 MG
0864

$223.02

$29.88J9310
G
Rituximab cancer treatment
0849

$420.29

$56.32J9320
G
Streptozocin injection
0850

$65.79

$8.82J9340
G
Thiotepa injection
0851

$100.30

$13.44J9350
G
Topotecan
0852

$573.75

$76.88*J9355
G
Trastuzumab
1613

$48.85

$6.55*J9357
G
Valrubicin, 200 mg
1614

$423.23

$56.71J9360
G
Vinblastine sulfate inj
0853

$4.11

$.55J9370
G
Vincristine sulfate 1 MG inj
0854

$30.16

$4.04J9375
E
Vincristine sulfate 2 MG injJ9380
E
Vincristine sulfate 5 MG injJ9390
G
Vinorelbine tartrate/10 mg
0855

$75.51

$10.12J9600
G
Porfimer sodium
0856

$2,603.67

$348.89J9999
E
Chemotherapy drugK0001
A
Standard wheelchairK0002
A
Stnd hemi (low seat) whlchrK0003
A
Lightweight wheelchairK0004
A
High strength ltwt whlchrK0005
A
Ultralightweight wheelchairK0006
A
Heavy duty wheelchairK0007
A
Extra heavy duty wheelchairK0008
A
Cstm manual wheelchair/baseK0009
A
Other manual wheelchair/baseK0010
A
Stnd wt frame power whlchrK0011
A
Stnd wt pwr whlchr w controlK0012
A
Ltwt portbl power whlchrK0013
A
Custom power whlchr baseK0014
A
Other power whlchr baseK0015
A
Detach non-adjus hght armrstK0016
A
Detach adjust armrst cmpleteK0017
A
Detach adjust armrest baseK0018
A
Detach adjust armrst upperK0019
A
Arm pad eachK0020
A
Fixed adjust armrest pairK0021
A
Anti-tipping device eachK0022
A
Reinforced back upholsteryK0023
A
Planr back insrt foam w/strpK0024
A
Plnr back insrt foam w/hrdwrK0025
A
Hook-on headrest extensionK0026
A
Back upholst lgtwt whlchrK0027
A
Back upholst other whlchrK0028
A
Manual fully reclining backK0029
A
Reinforced seat upholsteryK0030
A
Solid plnr seat sngl dnsfoamK0031
A
Safety belt/pelvic strapK0032
A
Seat uphols lgtwt whlchrK0033
A
Seat upholstery other whlchrK0034
A
Heel loop eachK0035
A
Heel loop with ankle strapK0036
A
Toe loop eachK0037
A
High mount flip-up footrestK0038
A
Leg strap eachK0039
A
Leg strap h style eachK0040
A
Adjustable angle footplateK0041
A
Large size footplate eachK0042
A
Standard size footplate eachK0043
A
Ftrst lower extension tubeK0044
A
Ftrst upper hanger bracketK0045
A
Footrest complete assemblyK0046
A
Elevat legrst low extensionK0047
A
Elevat legrst up hangr brackK0048
A
Elevate legrest completeK0049
A
Calf pad eachK0050
A
Ratchet assemblyK0051
A
Cam relese assem ftrst/lgrst( print page 67983)K0052
A
Swingaway detach footrestK0053
A
Elevate footrest articulateK0054
A
Seat wdth 10-12/15/17/20 wcK0055
A
Seat dpth 15/17/18 ltwt wcK0056
A
Seat ht <17 or >=21 ltwt wcK0057
A
Seat wdth 19/20 hvy dty wcK0058
A
Seat dpth 17/18 power wcK0059
A
Plastic coated handrim eachK0060
A
Steel handrim eachK0061
A
Aluminum handrim eachK0062
A
Handrim 8-10 vert/obliq projK0063
A
Hndrm 12-16 vert/obliq projK0064
A
Zero pressure tube flat freeK0065
A
Spoke protectorsK0066
A
Solid tire any size eachK0067
A
Pneumatic tire any size eachK0068
A
Pneumatic tire tube eachK0069
A
Rear whl complete solid tireK0070
A
Rear whl compl pneum tireK0071
A
Front castr compl pneum tireK0072
A
Frnt cstr cmpl sem-pneum tirK0073
A
Caster pin lock eachK0074
A
Pneumatic caster tire eachK0075
A
Semi-pneumatic caster tireK0076
A
Solid caster tire eachK0077
A
Front caster assem completeK0078
A
Pneumatic caster tire tubeK0079
A
Wheel lock extension pairK0080
A
Anti-rollback device pairK0081
A
Wheel lock assembly completeK0082
A
22 nf deep cycl acid batteryK0083
A
22 nf gel cell battery eachK0084
A
Grp 24 deep cycl acid battryK0085
A
Group 24 gel cell batteryK0086
A
U-1 lead acid battery eachK0087
A
U-1 gel cell battery eachK0088
A
Battry chrgr acid/gel cellK0089
A
Battery charger dual modeK0090
A
Rear tire power wheelchairK0091
A
Rear tire tube power whlchrK0092
A
Rear assem cmplt powr whlchrK0093
A
Rear zero pressure tire tubeK0094
A
Wheel tire for power baseK0095
A
Wheel tire tube each baseK0096
A
Wheel assem powr base compltK0097
A
Wheel zero presure tire tubeK0098
A
Drive belt power wheelchairK0099
A
Pwr wheelchair front casterK0100
A
Amputee adapter pairK0101
A
One-arm drive attachmentK0102
A
Crutch and cane holderK0103
A
Transfer board < 25′′K0104
A
Cylinder tank carrierK0105
A
Iv hangerK0106
A
Arm trough eachK0107
A
Wheelchair trayK0108
A
W/c component-accessory NOSK0112
A
Trunk vest supprt innr frameK0113
A
Trunk vest suprt w/o inr frmK0114
A
Whlchr back suprt inr frameK0115
A
Back module orthotic systemK0116
A
Back & seat modul orthot sysK0182D
A
Water distilled w/ nebulizerK0183
A
Nasal application deviceK0184
A
Nasal pillows/seals pairK0185
A
Pos airway pressure headgearK0186
A
Pos airway prssure chinstrapK0187
A
Pos airway pressure tubingK0188
A
Pos airway pressure filterK0189
A
Filter nondisposable w PAPK0195
A
Elevating whlchair leg restsK0268
A
Humidifier nonheated w PAPK0269D
A
Aerosol compressor cpap devK0270D
A
Ultrasonic generator w nebul( print page 67984)K0280D
A
Extension drainage tubingK0281D
A
Lubricant catheter insertionK0283D
A
Saline solution dispenserK0407D
A
Urinary cath skin attachmentK0408D
A
Urinary cath leg strapK0409D
A
Sterile H2O irrigation solutK0410D
A
Male ext cath w/adh coatingK0411D
A
Male ext cath w/adh stripK0415
E
RX antiemetic drg, oral NOSK0416
E
Rx antiemetic drg,rectal NOSK0440D
A
Nasal prosthesisK0441D
A
Midfacial prosthesisK0442D
A
Orbital prosthesisK0443D
A
Upper facial prosthesisK0444D
A
Hemi-facial prosthesisK0445D
A
Auricular prosthesisK0446D
A
Partial facial prosthesisK0447D
A
Nasal septal prosthesisK0448D
A
Unspec maxillofacial prosthK0449D
A
Repair maxillofacial prosthK0450D
A
Liq adhes for facial prosthK0451D
A
Adhesive remover wipesK0452
A
Wheelchair bearingsK0455
A
Pump uninterrupted infusionK0456D
A
Heavyduty/xtra wide hosp bedK0457D
A
Heavyduty/wide commode chairK0458D
A
Heavyduty walker no wheelsK0459D
A
Heavy duty wheeled walkerK0460
A
WC power add-on joystickK0461
A
WC power add-on tiller cntrlK0462
A
Temporary replacement eqpmntK0501D
A
Aerosol compressor for svnebK0529D
A
Sterile H20 or nss w lv nebK0531
A
Heated humidifier used w papK0532
A
Noninvasive assist wo backupK0533
A
Noninvasive assist w backupK0534
A
Invasive assist w backupK0535D
A
Gauze, impregnated hydrogelK0536D
A
Gauze, impregnated hydrogelK0537D
A
Gauze, impregnated hydrogelK0541
A
Speech generating deviceK0542
A
Speech generating deviceK0543
A
Speech generating deviceK0544
A
Speech generating deviceK0545
A
Speech generating softwareK0546
A
Accessory for sgd,mntng systK0547
A
Accessory for sgd,not clasfdL0100
A
Cerv craniosten helmet moldL0110
A
Cerv craniostenosis hel non-L0120
A
Cerv flexible non-adjustableL0130
A
Flex thermoplastic collar moL0140
A
Cervical semi-rigid adjustabL0150
A
Cerv semi-rig adj molded chnL0160
A
Cerv semi-rig wire occ/mandL0170
A
Cervical collar molded to ptL0172
A
Cerv col thermplas foam 2 piL0174
A
Cerv col foam 2 piece w thorL0180
A
Cer post col occ/man sup adjL0190
A
Cerv collar supp adj cerv baL0200
A
Cerv col supp adj bar & thorL0210
A
Thoracic rib beltL0220
A
Thor rib belt custom fabricaL0300
A
TLSO flex surgical supportL0310
A
Tlso flexible custom fabricaL0315
A
Tlso flex elas rigid post paL0317
A
Tlso flex hypext elas post pL0320
A
Tlso a-p contrl w apron frntL0330
A
Tlso ant-pos-lateral controlL0340
A
Tlso a-p-l-rotary with apronL0350
A
Tlso flex compress jacket cuL0360
A
Tlso flex compress jacket moL0370
A
Tlso a-p-l-rotary hyperextenL0380
A
Tlso a-p-l-rot w/ pos extensL0390
A
Tlso a-p-l control molded( print page 67985)L0400
A
Tlso a-p-l w interface materL0410
A
Tlso a-p-l two piece constrL0420
A
Tlso a-p-l 2 piece w interfaL0430
A
Tlso a-p-l w interface custmL0440
A
Tlso a-p-l overlap frnt custL0500
A
Lso flex surgical supportL0510
A
Lso flexible custom fabricatL0515
A
Lso flex elas w/ rig post paL0520
A
Lso a-p-l control with apronL0530
A
Lso ant-pos control w apronL0540
A
Lso lumbar flexion a-p-lL0550
A
Lso a-p-l control moldedL0560
A
Lso a-p-l w interfaceL0565
A
Lso a-p-l control customL0600
A
Sacroiliac flex surg supportL0610
A
Sacroiliac flexible custm faL0620
A
Sacroiliac semi-rig w apronL0700
A
Ctlso a-p-l control moldedL0710
A
Ctlso a-p-l control w/ interL0810
A
Halo cervical into jckt vestL0820
A
Halo cervical into body jackL0830
A
Halo cerv into milwaukee typL0860
A
Magnetic resonanc image compL0900
A
Torso/ptosis supportL0910
A
Torso & ptosis supp custm faL0920
A
Torso/pendulous abd supportL0930
A
Pendulous abdomen supp custmL0940
A
Torso/postsurgical supportL0950
A
Post surg support custom fabL0960
A
Post surgical support padsL0970
A
Tlso corset frontL0972
A
Lso corset frontL0974
A
Tlso full corsetL0976
A
Lso full corsetL0978
A
Axillary crutch extensionL0980
A
Peroneal straps pairL0982
A
Stocking supp grips set of fL0984
A
Protective body sock eachL0999
A
Add to spinal orthosis NOSL1000
A
Ctlso milwauke initial modelL1010
A
Ctlso axilla slingL1020
A
Kyphosis padL1025
A
Kyphosis pad floatingL1030
A
Lumbar bolster padL1040
A
Lumbar or lumbar rib padL1050
A
Sternal padL1060
A
Thoracic padL1070
A
Trapezius slingL1080
A
OutriggerL1085
A
Outrigger bil w/ vert extensL1090
A
Lumbar slingL1100
A
Ring flange plastic/leatherL1110
A
Ring flange plas/leather molL1120
A
Covers for upright eachL1200
A
Furnsh initial orthosis onlyL1210
A
Lateral thoracic extensionL1220
A
Anterior thoracic extensionL1230
A
Milwaukee type superstructurL1240
A
Lumbar derotation padL1250
A
Anterior asis padL1260
A
Anterior thoracic derotationL1270
A
Abdominal padL1280
A
Rib gusset (elastic) eachL1290
A
Lateral trochanteric padL1300
A
Body jacket mold to patientL1310
A
Post-operative body jacketL1499
A
Spinal orthosis NOSL1500
A
Thkao mobility frameL1510
A
Thkao standing frameL1520
A
Thkao swivel walkerL1600
A
Abduct hip flex frejka w cvrL1610
A
Abduct hip flex frejka covrL1620
A
Abduct hip flex pavlik harneL1630
A
Abduct control hip semi-flex( print page 67986)L1640
A
Pelv band/spread bar thigh cL1650
A
HO abduction hip adjustableL1660
A
HO abduction static plasticL1680
A
Pelvic & hip control thigh cL1685
A
Post-op hip abduct custom faL1686
A
HO post-op hip abductionL1690
A
Combination bilateral HOL1700
A
Leg perthes orth toronto typL1710
A
Legg perthes orth newingtonL1720
A
Legg perthes orthosis trilatL1730
A
Legg perthes orth scottish rL1750
A
Legg perthes slingL1755
A
Legg perthes patten bottom tL1800
A
Knee orthoses elas w staysL1810
A
Ko elastic with jointsL1815
A
Elastic with condylar padsL1820
A
Ko elas w/ condyle pads & joL1825
A
Ko elastic knee capL1830
A
Ko immobilizer canvas longitL1832
A
KO adj jnt pos rigid supportL1834
A
Ko w/0 joint rigid molded toL1840
A
Ko derot ant cruciate customL1843
A
KO single upright custom fitL1844
A
Ko w/adj jt rot cntrl moldedL1845
A
Ko w/ adj flex/ext rotat cusL1846
A
Ko w adj flex/ext rotat moldL1847
A
KO adjustable w air chambersL1850
A
Ko swedish typeL1855
A
Ko plas doub upright jnt molL1858
A
Ko polycentric pneumatic padL1860
A
Ko supracondylar socket moldL1870
A
Ko doub upright lacers moldeL1880
A
Ko doub upright cuffs/lacersL1885
A
Knee upright w/resistanceL1900
A
Afo sprng wir drsflx calf bdL1902
A
Afo ankle gauntletL1904
A
Afo molded ankle gauntletL1906
A
Afo multiligamentus ankle suL1910
A
Afo sing bar clasp attach shL1920
A
Afo sing upright w/ adjust sL1930
A
Afo plasticL1940
A
Afo molded to patient plastiL1945
A
Afo molded plas rig ant tibL1950
A
Afo spiral molded to pt plasL1960
A
Afo pos solid ank plastic moL1970
A
Afo plastic molded w/ankle jL1980
A
Afo sing solid stirrup calfL1990
A
Afo doub solid stirrup calfL2000
A
Kafo sing fre stirr thi/calfL2010
A
Kafo sng solid stirrup w/o jL2020
A
Kafo dbl solid stirrup band/L2030
A
Kafo dbl solid stirrup w/o jL2035
A
KAFO plastic pediatric sizeL2036
A
Kafo plas doub free knee molL2037
A
Kafo plas sing free knee molL2038
A
Kafo w/o joint multi-axis anL2039
A
KAFO,plstic,medlat rotat conL2040
A
Hkafo torsion bil rot strapsL2050
A
Hkafo torsion cable hip pelvL2060
A
Hkafo torsion ball bearing jL2070
A
Hkafo torsion unilat rot strL2080
A
Hkafo unilat torsion cableL2090
A
Hkafo unilat torsion ball brL2102
A
Afo tibial fx cast plstr molL2104
A
Afo tib fx cast synthetic moL2106
A
Afo tib fx cast plaster moldL2108
A
Afo tib fx cast molded to ptL2112
A
Afo tibial fracture softL2114
A
Afo tib fx semi-rigidL2116
A
Afo tibial fracture rigidL2122
A
Kafo fem fx cast plaster molL2124
A
Kafo fem fx cast synthet molL2126
A
Kafo fem fx cast thermoplasL2128
A
Kafo fem fx cast molded to p( print page 67987)L2132
A
Kafo femoral fx cast softL2134
A
Kafo fem fx cast semi-rigidL2136
A
Kafo femoral fx cast rigidL2180
A
Plas shoe insert w ank jointL2182
A
Drop lock kneeL2184
A
Limited motion knee jointL2186
A
Adj motion knee jnt lerman tL2188
A
Quadrilateral brimL2190
A
Waist beltL2192
A
Pelvic band & belt thigh flaL2200
A
Limited ankle motion ea jntL2210
A
Dorsiflexion assist each joiL2220
A
Dorsi & plantar flex ass/resL2230
A
Split flat caliper stirr & pL2240
A
Round caliper and plate attaL2250
A
Foot plate molded stirrup atL2260
A
Reinforced solid stirrupL2265
A
Long tongue stirrupL2270
A
Varus/valgus strap padded/liL2275
A
Plastic mod low ext pad/lineL2280
A
Molded inner bootL2300
A
Abduction bar jointed adjustL2310
A
Abduction bar-straightL2320
A
Non-molded lacerL2330
A
Lacer molded to patient modeL2335
A
Anterior swing bandL2340
A
Pre-tibial shell molded to pL2350
A
Prosthetic type socket moldeL2360
A
Extended steel shankL2370
A
Patten bottomL2375
A
Torsion ank & half solid stiL2380
A
Torsion straight knee jointL2385
A
Straight knee joint heavy duL2390
A
Offset knee joint eachL2395
A
Offset knee joint heavy dutyL2397
A
Suspension sleeve lower extL2405
A
Knee joint drop lock ea jntL2415
A
Knee joint cam lock each joiL2425
A
Knee disc/dial lock/adj flexL2430
A
Knee jnt ratchet lock ea jntL2435
A
Knee joint polycentric jointL2492
A
Knee lift loop drop lock rinL2500
A
Thi/glut/ischia wgt bearingL2510
A
Th/wght bear quad-lat brim mL2520
A
Th/wght bear quad-lat brim cL2525
A
Th/wght bear nar m-l brim moL2526
A
Th/wght bear nar m-l brim cuL2530
A
Thigh/wght bear lacer non-moL2540
A
Thigh/wght bear lacer moldedL2550
A
Thigh/wght bear high roll cuL2570
A
Hip clevis type 2 posit jntL2580
A
Pelvic control pelvic slingL2600
A
Hip clevis/thrust bearing frL2610
A
Hip clevis/thrust bearing loL2620
A
Pelvic control hip heavy dutL2622
A
Hip joint adjustable flexionL2624
A
Hip adj flex ext abduct contL2627
A
Plastic mold recipro hip & cL2628
A
Metal frame recipro hip & caL2630
A
Pelvic control band & belt uL2640
A
Pelvic control band & belt bL2650
A
Pelv & thor control glutealL2660
A
Thoracic control thoracic baL2670
A
Thorac cont paraspinal uprigL2680
A
Thorac cont lat support upriL2750
A
Plating chrome/nickel pr barL2755
A
Carbon graphite laminationL2760
A
Extension per extension perL2770
A
Low ext orthosis per bar/jntL2780
A
Non-corrosive finishL2785
A
Drop lock retainer eachL2795
A
Knee control full kneecapL2800
A
Knee cap medial or lateral pL2810
A
Knee control condylar pad( print page 67988)L2820
A
Soft interface below knee seL2830
A
Soft interface above knee seL2840
A
Tibial length sock fx or equL2850
A
Femoral lgth sock fx or equaL2860
A
Torsion mechanism knee/ankleL2999
A
Lower extremity orthosis NOSL3000
E
Ft insert ucb berkeley shellL3001
E
Foot insert remov molded speL3002
E
Foot insert plastazote or eqL3003
E
Foot insert silicone gel eacL3010
E
Foot longitudinal arch suppoL3020
E
Foot longitud/metatarsal supL3030
E
Foot arch support remov premL3040
E
Ft arch suprt premold longitL3050
E
Foot arch supp premold metatL3060
E
Foot arch supp longitud/metaL3070
E
Arch suprt att to sho longitL3080
E
Arch supp att to shoe metataL3090
E
Arch supp att to shoe long/mL3100
E
Hallus-valgus nght dynamic sL3140
E
Abduction rotation bar shoeL3150
E
Abduct rotation bar w/o shoeL3160
E
Shoe styled positioning devL3170
E
Foot plastic heel stabilizerL3201
E
Oxford w supinat/pronat infL3202
E
Oxford w/ supinat/pronator cL3203
E
Oxford w/ supinator/pronatorL3204
E
Hightop w/ supp/pronator infL3206
E
Hightop w/ supp/pronator chiL3207
E
Hightop w/ supp/pronator junL3208
E
Surgical boot each infantL3209
E
Surgical boot each childL3211
E
Surgical boot each juniorL3212
E
Benesch boot pair infantL3213
E
Benesch boot pair childL3214
E
Benesch boot pair juniorL3215
E
Orthopedic ftwear ladies oxfL3216
E
Orthoped ladies shoes dpth iL3217
E
Ladies shoes hightop depth iL3218
E
Ladies surgical boot eachL3219
E
Orthopedic mens shoes oxfordL3221
E
Orthopedic mens shoes dpth iL3222
E
Mens shoes hightop depth inlL3223
E
Mens surgical boot eachL3224
A
Woman's shoe oxford braceL3225
A
Man's shoe oxford braceL3230
E
Custom shoes depth inlayL3250
E
Custom mold shoe remov prostL3251
E
Shoe molded to pt silicone sL3252
E
Shoe molded plastazote custL3253
E
Shoe molded plastazote custL3254
E
Orth foot non-stndard size/wL3255
E
Orth foot non-standard size/L3257
E
Orth foot add charge split sL3260
E
Ambulatory surgical boot eacL3265
E
Plastazote sandal eachL3300
E
Sho lift taper to metatarsalL3310
E
Shoe lift elev heel/sole neoL3320
E
Shoe lift elev heel/sole corL3330
E
Lifts elevation metal extensL3332
E
Shoe lifts tapered to one-haL3334
E
Shoe lifts elevation heel /iL3340
E
Shoe wedge sachL3350
E
Shoe heel wedgeL3360
E
Shoe sole wedge outside soleL3370
E
Shoe sole wedge between soleL3380
E
Shoe clubfoot wedgeL3390
E
Shoe outflare wedgeL3400
E
Shoe metatarsal bar wedge roL3410
E
Shoe metatarsal bar betweenL3420
E
Full sole/heel wedge btweenL3430
E
Sho heel count plast reinforL3440
E
Heel leather reinforcedL3450
E
Shoe heel sach cushion type( print page 67989)L3455
E
Shoe heel new leather standaL3460
E
Shoe heel new rubber standarL3465
E
Shoe heel thomas with wedgeL3470
E
Shoe heel thomas extend to bL3480
E
Shoe heel pad & depress forL3485
E
Shoe heel pad removable forL3500
E
Ortho shoe add leather insolL3510
E
Orthopedic shoe add rub inslL3520
E
O shoe add felt w leath inslL3530
E
Ortho shoe add half soleL3540
E
Ortho shoe add full soleL3550
E
O shoe add standard toe tapL3560
E
O shoe add horseshoe toe tapL3570
E
O shoe add instep extensionL3580
E
O shoe add instep velcro cloL3590
E
O shoe convert to sof counteL3595
E
Ortho shoe add march barL3600
E
Trans shoe calip plate existL3610
E
Trans shoe caliper plate newL3620
E
Trans shoe solid stirrup exiL3630
E
Trans shoe solid stirrup newL3640
E
Shoe dennis browne splint boL3649
E
Orthopedic shoe modifica NOSL3650
A
Shlder fig 8 abduct restrainL3660
A
Abduct restrainer canvas&webL3670
A
Acromio/clavicular canvas&weL3675
A
Canvas vest SOL3700
A
Elbow orthoses elas w staysL3710
A
Elbow elastic with metal joiL3720
A
Forearm/arm cuffs free motioL3730
A
Forearm/arm cuffs ext/flex aL3740
A
Cuffs adj lock w/ active conL3760
A
EO withjoint, PrefabricatedL3800
A
Whfo short opponen no attachL3805
A
Whfo long opponens no attachL3807
A
Whfo w inflatable airchamberL3810
A
Whfo thumb abduction barL3815
A
Whfo second m.p. abduction aL3820
A
Whfo ip ext asst w/ mp ext sL3825
A
Whfo m.p. extension stopL3830
A
Whfo m.p. extension assistL3835
A
Whfo m.p. spring extension aL3840
A
Whfo spring swivel thumbL3845
A
Whfo thumb ip ext ass w/ mpL3850
A
Action wrist w/ dorsiflex asL3855
A
Whfo adj m.p. flexion controL3860
A
Whfo adj m.p. flex ctrl & i.L3890
E
Torsion mechanism wrist/elboL3900
A
Hinge extension/flex wrist/fL3901
A
Hinge ext/flex wrist fingerL3902
A
Whfo ext power compress gasL3904
A
Whfo electric custom fittedL3906
A
Wrist gauntlet molded to ptL3907
A
Whfo wrst gauntlt thmb spicaL3908
A
Wrist cock-up non-moldedL3910
A
Whfo swanson designL3912
A
Flex glove w/elastic fingerL3914
A
WHO wrist extension cock-upL3916
A
Whfo wrist extens w/ outriggL3918
A
HFO knuckle benderL3920
A
Knuckle bender with outriggeL3922
A
Knuckle bend 2 seg to flex jL3923
A
HFO, no joint, prefabricatedL3924
A
OppenheimerL3926
A
Thomas suspensionL3928
A
Finger extension w/ clock spL3930
A
Finger extension with wristL3932
A
Safety pin spring wireL3934
A
Safety pin modifiedL3936
A
PalmerL3938
A
Dorsal wristL3940
A
Dorsal wrist w/ outrigger atL3942
A
Reverse knuckle benderL3944
A
Reverse knuckle bend w/ outr( print page 67990)L3946
A
HFO composite elasticL3948
A
Finger knuckle benderL3950
A
Oppenheimer w/ knuckle bendL3952
A
Oppenheimer w/ rev knuckle 2L3954
A
Spreading handL3956
A
Add joint upper ext orthosisL3960
A
Sewho airplan desig abdu posL3962
A
Sewho erbs palsey design abdL3963
A
Molded w/ articulating elbowL3964
A
Seo mobile arm sup att to wcL3965
A
Arm supp att to wc rancho tyL3966
A
Mobile arm supports reclininL3968
A
Friction dampening arm suppL3969
A
Monosuspension arm/hand suppL3970
A
Elevat proximal arm supportL3972
A
Offset/lat rocker arm w/ elaL3974
A
Mobile arm support supinatorL3980
A
Upp ext fx orthosis humeralL3982
A
Upper ext fx orthosis rad/ulL3984
A
Upper ext fx orthosis wristL3985
A
Forearm hand fx orth w/ wr hL3986
A
Humeral rad/ulna wrist fx orL3995
A
Sock fracture or equal eachL3999
A
Upper limb orthosis NOSL4000
A
Repl girdle milwaukee orthL4010
A
Replace trilateral socket brL4020
A
Replace quadlat socket brimL4030
A
Replace socket brim cust fitL4040
A
Replace molded thigh lacerL4045
A
Replace non-molded thigh lacL4050
A
Replace molded calf lacerL4055
A
Replace non-molded calf laceL4060
A
Replace high roll cuffL4070
A
Replace prox & dist uprightL4080
A
Repl met band kafo-afo proxL4090
A
Repl met band kafo-afo calf/L4100
A
Repl leath cuff kafo prox thL4110
A
Repl leath cuff kafo-afo calL4130
A
Replace pretibial shellL4205
A
Ortho dvc repair per 15 minL4210
A
Orth dev repair/repl minor pL4350
A
Pneumatic ankle cntrl splintL4360
A
Pneumatic walking splintL4370
A
Pneumatic full leg splintL4380
A
Pneumatic knee splintL4392
A
Replace AFO soft interfaceL4394
A
Replace foot drop spintL4396
A
Static AFOL4398
A
Foot drop splint recumbentL5000
A
Sho insert w arch toe fillerL5010
A
Mold socket ank hgt w/ toe fL5020
A
Tibial tubercle hgt w/ toe fL5050
A
Ank symes mold sckt sach ftL5060
A
Symes met fr leath socket arL5100
A
Molded socket shin sach footL5105
A
Plast socket jts/thgh lacerL5150
A
Mold sckt ext knee shin sachL5160
A
Mold socket bent knee shin sL5200
A
Kne sing axis fric shin sachL5210
A
No knee/ankle joints w/ ft bL5220
A
No knee joint with artic aliL5230
A
Fem focal defic constant friL5250
A
Hip canad sing axi cons fricL5270
A
Tilt table locking hip singL5280
A
Hemipelvect canad sing axisL5300
A
Bk sach soft cover & finishL5310
A
Knee disart sach soft cv/finL5320
A
Ak open end sach soft cv/finL5330
A
Hip canadian sach sft cv/finL5340
A
Hemipelvectomy canad cv/finL5400
A
Postop dress & 1 cast chg bkL5410
A
Postop dsg bk ea add cast chL5420
A
Postop dsg & 1 cast chg ak/dL5430
A
Postop dsg ak ea add cast ch( print page 67991)L5450
A
Postop app non-wgt bear dsgL5460
A
Postop app non-wgt bear dsgL5500
A
Init bk ptb plaster directL5505
A
Init ak ischal plstr directL5510
A
Prep BK ptb plaster moldedL5520
A
Perp BK ptb thermopls directL5530
A
Prep BK ptb thermopls moldedL5535
A
Prep BK ptb open end socketL5540
A
Prep BK ptb laminated socketL5560
A
Prep AK ischial plast moldedL5570
A
Prep AK ischial direct formL5580
A
Prep AK ischial thermo moldL5585
A
Prep AK ischial open endL5590
A
Prep AK ischial laminatedL5595
A
Hip disartic sach thermoplsL5600
A
Hip disart sach laminat moldL5610
A
Above knee hydracadenceL5611
A
Ak 4 bar link w/fric swingL5613
A
Ak 4 bar ling w/hydraul swigL5614
A
4-bar link above knee w/swngL5616
A
Ak univ multiplex sys frictL5617
A
AK/BK self-aligning unit eaL5618
A
Test socket symesL5620
A
Test socket below kneeL5622
A
Test socket knee disarticulaL5624
A
Test socket above kneeL5626
A
Test socket hip disarticulatL5628
A
Test socket hemipelvectomyL5629
A
Below knee acrylic socketL5630
A
Syme typ expandabl wall scktL5631
A
Ak/knee disartic acrylic socL5632
A
Symes type ptb brim design sL5634
A
Symes type poster opening soL5636
A
Symes type medial opening soL5637
A
Below knee total contactL5638
A
Below knee leather socketL5639
A
Below knee wood socketL5640
A
Knee disarticulat leather soL5642
A
Above knee leather socketL5643
A
Hip flex inner socket ext frL5644
A
Above knee wood socketL5645
A
Ak flexibl inner socket extL5646
A
Below knee air cushion sockeL5647
A
Below knee suction socketL5648
A
Above knee air cushion sockeL5649
A
Isch containmt/narrow m-l soL5650
A
Tot contact ak/knee disart sL5651
A
Ak flex inner socket ext fraL5652
A
Suction susp ak/knee disartL5653
A
Knee disart expand wall sockL5654
A
Socket insert symesL5655
A
Socket insert below kneeL5656
A
Socket insert knee articulatL5658
A
Socket insert above kneeL5660
A
Sock insrt syme silicone gelL5661
A
Multi-durometer symesL5662
A
Socket insert bk silicone geL5663
A
Sock knee disartic siliconeL5664
A
Socket insert ak silicone geL5665
A
Multi-durometer below kneeL5666
A
Below knee cuff suspensionL5667
A
Socket insert w lock lowerL5668
A
Socket insert w/o lock lowerL5669
A
Below knee socket w/o lockL5670
A
Bk molded supracondylar suspL5672
A
Bk removable medial brim susL5674
A
Bk latex sleeve suspension/eL5675
A
Bk latex sleeve susp/eq hvyL5676
A
Bk knee joints single axis pL5677
A
Bk knee joints polycentric pL5678
A
Bk joint covers pairL5680
A
Bk thigh lacer non-moldedL5682
A
Bk thigh lacer glut/ischia mL5684
A
Bk fork strap( print page 67992)L5686
A
Bk back checkL5688
A
Bk waist belt webbingL5690
A
Bk waist belt padded and linL5692
A
Ak pelvic control belt lightL5694
A
Ak pelvic control belt pad/lL5695
A
Ak sleeve susp neoprene/equaL5696
A
Ak/knee disartic pelvic joinL5697
A
Ak/knee disartic pelvic bandL5698
A
Ak/knee disartic silesian baL5699
A
Shoulder harnessL5700
A
Replace socket below kneeL5701
A
Replace socket above kneeL5702
A
Replace socket hipL5704
A
Custom shape covr below kneeL5705
A
Custm shape cover above kneeL5706
A
Custm shape cvr knee disartL5707
A
Custm shape cover hip disartL5710
A
Kne-shin exo sng axi mnl locL5711
A
Knee-shin exo mnl lock ultraL5712
A
Knee-shin exo frict swg & stL5714
A
Knee-shin exo variable frictL5716
A
Knee-shin exo mech stance phL5718
A
Knee-shin exo frct swg & staL5722
A
Knee-shin pneum swg frct exoL5724
A
Knee-shin exo fluid swing phL5726
A
Knee-shin ext jnts fld swg eL5728
A
Knee-shin fluid swg & stanceL5780
A
Knee-shin pneum/hydra pneumL5785
A
Exoskeletal bk ultralt materL5790
A
Exoskeletal ak ultra-light mL5795
A
Exoskel hip ultra-light mateL5810
A
Endoskel knee-shin mnl lockL5811
A
Endo knee-shin mnl lck ultraL5812
A
Endo knee-shin frct swg & stL5814
A
Endo knee-shin hydral swg phL5816
A
Endo knee-shin polyc mch staL5818
A
Endo knee-shin frct swg & stL5822
A
Endo knee-shin pneum swg frcL5824
A
Endo knee-shin fluid swing pL5826
A
Miniature knee jointL5828
A
Endo knee-shin fluid swg/staL5830
A
Endo knee-shin pneum/swg phaL5840
A
Multi-axial knee/shin systemL5845
A
Knee-shin sys stance flexionL5846
A
Knee-shin sys microprocessorL5850
A
Endo ak/hip knee extens assiL5855
A
Mech hip extension assistL5910
A
Endo below knee alignable syL5920
A
Endo ak/hip alignable systemL5925
A
Above knee manual lockL5930
A
High activity knee frameL5940
A
Endo bk ultra-light materialL5950
A
Endo ak ultra-light materialL5960
A
Endo hip ultra-light materiaL5962
A
Below knee flex cover systemL5964
A
Above knee flex cover systemL5966
A
Hip flexible cover systemL5968
A
Multiaxial ankle w dorsiflexL5970
A
Foot external keel sach footL5972
A
Flexible keel footL5974
A
Foot single axis ankle/footL5975
A
Combo ankle/foot prosthesisL5976
A
Energy storing footL5978
A
Ft prosth multiaxial ankl/ftL5979
A
Multi-axial ankle/ft prosthL5980
A
Flex foot systemL5981
A
Flex-walk sys low ext prosthL5982
A
Exoskeletal axial rotation uL5984
A
Endoskeletal axial rotationL5985
A
Lwr ext dynamic prosth pylonL5986
A
Multi-axial rotation unitL5987
A
Shank ft w vert load pylonL5988
A
Vertical shock reducing pyloL5999
A
Lowr extremity prosthes NOS( print page 67993)L6000
A
Par hand robin-aids thum remL6010
A
Hand robin-aids little/ringL6020
A
Part hand robin-aids no fingL6050
A
Wrst MLd sck flx hng tri padL6055
A
Wrst mold sock w/exp interfaL6100
A
Elb mold sock flex hinge padL6110
A
Elbow mold sock suspension tL6120
A
Elbow mold doub splt soc steL6130
A
Elbow stump activated lock hL6200
A
Elbow mold outsid lock hingeL6205
A
Elbow molded w/ expand interL6250
A
Elbow inter loc elbow forarmL6300
A
Shlder disart int lock elbowL6310
A
Shoulder passive restor compL6320
A
Shoulder passive restor capL6350
A
Thoracic intern lock elbowL6360
A
Thoracic passive restor compL6370
A
Thoracic passive restor capL6380
A
Postop dsg cast chg wrst/elbL6382
A
Postop dsg cast chg elb dis/L6384
A
Postop dsg cast chg shlder/tL6386
A
Postop ea cast chg & realignL6388
A
Postop applicat rigid dsg onL6400
A
Below elbow prosth tiss shapL6450
A
Elb disart prosth tiss shapL6500
A
Above elbow prosth tiss shapL6550
A
Shldr disar prosth tiss shapL6570
A
Scap thorac prosth tiss shapL6580
A
Wrist/elbow bowden cable molL6582
A
Wrist/elbow bowden cbl dir fL6584
A
Elbow fair lead cable moldedL6586
A
Elbow fair lead cable dir foL6588
A
Shdr fair lead cable moldedL6590
A
Shdr fair lead cable directL6600
A
Polycentric hinge pairL6605
A
Single pivot hinge pairL6610
A
Flexible metal hinge pairL6615
A
Disconnect locking wrist uniL6616
A
Disconnect insert locking wrL6620
A
Flexion-friction wrist unitL6623
A
Spring-ass rot wrst w/ latchL6625
A
Rotation wrst w/ cable lockL6628
A
Quick disconn hook adapter oL6629
A
Lamination collar w/ couplinL6630
A
Stainless steel any wristL6632
A
Latex suspension sleeve eachL6635
A
Lift assist for elbowL6637
A
Nudge control elbow lockL6640
A
Shoulder abduction joint paiL6641
A
Excursion amplifier pulley tL6642
A
Excursion amplifier lever tyL6645
A
Shoulder flexion-abduction jL6650
A
Shoulder universal jointL6655
A
Standard control cable extraL6660
A
Heavy duty control cableL6665
A
Teflon or equal cable liningL6670
A
Hook to hand cable adapterL6672
A
Harness chest/shlder saddleL6675
A
Harness figure of 8 sing conL6676
A
Harness figure of 8 dual conL6680
A
Test sock wrist disart/bel eL6682
A
Test sock elbw disart/aboveL6684
A
Test socket shldr disart/thoL6686
A
Suction socketL6687
A
Frame typ socket bel elbow/wL6688
A
Frame typ sock above elb/disL6689
A
Frame typ socket shoulder diL6690
A
Frame typ sock interscap-thoL6691
A
Removable insert eachL6692
A
Silicone gel insert or equalL6693
A
Lockingelbow forearm cntrbalL6700
A
Terminal device model #3L6705
A
Terminal device model #5L6710
A
Terminal device model #5x( print page 67994)L6715
A
Terminal device model #5xaL6720
A
Terminal device model #6L6725
A
Terminal device model #7L6730
A
Terminal device model #7loL6735
A
Terminal device model #8L6740
A
Terminal device model #8xL6745
A
Terminal device model #88xL6750
A
Terminal device model #10pL6755
A
Terminal device model #10xL6765
A
Terminal device model #12pL6770
A
Terminal device model #99xL6775
A
Terminal device model #555L6780
A
Terminal device model #ss555L6790
A
Hooks-accu hook or equalL6795
A
Hooks-2 load or equalL6800
A
Hooks-aprl vc or equalL6805
A
Modifier wrist flexion unitL6806
A
Trs grip vc or equalL6807
A
Term device grip1/2 or equalL6808
A
Term device infant or childL6809
A
Trs super sport passiveL6810
A
Pincher tool otto bock or eqL6825
A
Hands dorrance voL6830
A
Hand aprl vcL6835
A
Hand sierra voL6840
A
Hand becker imperialL6845
A
Hand becker lock gripL6850
A
Term dvc-hand becker plyliteL6855
A
Hand robin-aids voL6860
A
Hand robin-aids vo softL6865
A
Hand passive handL6867
A
Hand detroit infant handL6868
A
Passive inf hand steeper/hosL6870
A
Hand child mittL6872
A
Hand nyu child handL6873
A
Hand mech inf steeper or equL6875
A
Hand bock vcL6880
A
Hand bock voL6890
A
Production gloveL6895
A
Custom gloveL6900
A
Hand restorat thumb/1 fingerL6905
A
Hand restoration multiple fiL6910
A
Hand restoration no fingersL6915
A
Hand restoration replacmnt gL6920
A
Wrist disarticul switch ctrlL6925
A
Wrist disart myoelectronic cL6930
A
Below elbow switch controlL6935
A
Below elbow myoelectronic ctL6940
A
Elbow disarticulation switchL6945
A
Elbow disart myoelectronic cL6950
A
Above elbow switch controlL6955
A
Above elbow myoelectronic ctL6960
A
Shldr disartic switch controL6965
A
Shldr disartic myoelectronicL6970
A
Interscapular-thor switch ctL6975
A
Interscap-thor myoelectronicL7010
A
Hand otto back steeper/eq swL7015
A
Hand sys teknik village switL7020
A
Electronic greifer switch ctL7025
A
Electron hand myoelectronicL7030
A
Hand sys teknik vill myoelecL7035
A
Electron greifer myoelectroL7040
A
Prehensile actuator hosmer sL7045
A
Electron hook child michiganL7170
A
Electronic elbow hosmer switL7180
A
Electronic elbow utah myoeleL7185
A
Electron elbow adolescent swL7186
A
Electron elbow child switchL7190
A
Elbow adolescent myoelectronL7191
A
Elbow child myoelectronic ctL7260
A
Electron wrist rotator ottoL7261
A
Electron wrist rotator utahL7266
A
Servo control steeper or equL7272
A
Analogue control unb or equa( print page 67995)L7274
A
Proportional ctl 12 volt utaL7360
A
Six volt bat otto bock/eq eaL7362
A
Battery chrgr six volt ottoL7364
A
Twelve volt battery utah/equL7366
A
Battery chrgr 12 volt utah/eL7499
A
Upper extremity prosthes NOSL7500
A
Prosthetic dvc repair hourlyL7510
A
Prosthetic device repair repL7520
A
Repair prosthesis per 15 minL7900
A
Vacuum erection systemL8000
A
Mastectomy braL8010
A
Mastectomy sleeveL8015
A
Ext breastprosthesis garmentL8020
A
Mastectomy formL8030
A
Breast prosthesis silicone/eL8035
A
Custom breast prosthesisL8039
A
Breast prosthesis NOSL8040
A
Nasal prosthesisL8041
A
Midfacial prosthesisL8042
A
Orbital prosthesisL8043
A
Upper facial prosthesisL8044
A
Hemi-facial prosthesisL8045
A
Auricular prosthesisL8046
A
Partial facial prosthesisL8047
A
Nasal septal prosthesisL8048
A
Unspec maxillofacial prosthL8049
A
Repair maxillofacial prosthL8100
E
Compression stocking BK18-30L8110
E
Compression stocking BK30-40L8120
E
Compression stocking BK40-50L8130
E
Gc stocking thighlngth 18-30L8140
E
Gc stocking thighlngth 30-40L8150
E
Gc stocking thighlngth 40-50L8160
E
Gc stocking full lngth 18-30L8170
E
Gc stocking full lngth 30-40L8180
E
Gc stocking full lngth 40-50L8190
E
Gc stocking waistlngth 18-30L8195
E
Gc stocking waistlngth 30-40L8200
E
Gc stocking waistlngth 40-50L8210
E
Gc stocking custom madeL8220
E
Gc stocking lymphedemaL8230
E
Gc stocking garter beltL8239
E
G compression stocking NOSL8300
A
Truss single w/ standard padL8310
A
Truss double w/ standard padL8320
A
Truss addition to std pad waL8330
A
Truss add to std pad scrotalL8400
A
Sheath below kneeL8410
A
Sheath above kneeL8415
A
Sheath upper limbL8417
A
Pros sheath/sock w gel cushnL8420
A
Prosthetic sock multi ply BKL8430
A
Prosthetic sock multi ply AKL8435
A
Pros sock multi ply upper lmL8440
A
Shrinker below kneeL8460
A
Shrinker above kneeL8465
A
Shrinker upper limbL8470
A
Pros sock single ply BKL8480
A
Pros sock single ply AKL8485
A
Pros sock single ply upper lL8490
A
Air seal suction reten systmL8499
A
Unlisted misc prosthetic serL8500
A
Artificial larynxL8501
A
Tracheostomy speaking valveL8600
N
Implant breast silicone/eqL8603
N
Collagen imp urinary 2.5 CCL8606
N
Synthetic implnt urinary 1mlL8610
N
Ocular implantL8612
N
Aqueous shunt prosthesisL8613
N
Ossicular implant*L8614
H
Cochlear device/system
1002L8619
A
Replace cochlear processorL8630
N
Metacarpophalangeal implantL8641
N
Metatarsal joint implant( print page 67996)L8642
N
Hallux implantL8658
N
Interphalangeal joint implntL8670
N
Vascular graft, syntheticL8699
N
Prosthetic implant NOSL9900
A
O&P supply/accessory/serviceM0064
X
Visit for drug monitoring
0374
1.17
$58.03
$13.08
$11.61M0075
E
Cellular therapyM0076
E
ProlotherapyM0100
E
Intragastric hypothermiaM0300
E
IV chelationtherapyM0301
E
Fabric wrapping of aneurysmM0302
T
Assessment of cardiac output
0970
0.52
$25.79

$5.16P2028
A
Cephalin floculation testP2029
A
Congo red blood testP2031
E
Hair analysisP2033
A
Blood thymol turbidityP2038
A
Blood mucoproteinP3000
A
Screen pap by tech w md supvP3001
E
Screening pap smear by physP7001
E
Culture bacterial urineP9010
K
Whole blood for transfusion
0950
2.08
$103.33

$20.67P9011
E
Blood split unitP9012
K
Cryoprecipitate each unit
0952
0.70
$34.70

$6.94P9013D
K
Unit/s blood fibrinogen
0953
0.48
$23.80

$4.76P9016
K
Leukocyte poor blood, unit
0954
2.83
$140.35

$28.07P9017
K
One donor fresh frozn plasma
0955
2.26
$111.85

$22.37P9018D
K
Plasma protein fract, unit
0956
1.26
$62.49

$12.50P9019
K
Platelet concentrate unit
0957
0.98
$48.55

$9.71P9020
K
Plaelet rich plasma unit
0958
1.16
$57.54

$11.51P9021
K
Red blood cells unit
0959
2.04
$101.31

$20.26P9022
K
Washed red blood cells unit
0960
3.81
$188.75

$37.75P9023
K
Frozen plasma, pooled, sd
0949
2.94
$145.76

$29.15P9031
K
Platelets leukocytes reduced
0954
2.83
$140.35

$28.07P9032
K
Platelets, irradiated
9500
1.77
$87.97

$17.59P9033
K
Platelets leukoreduced irrad
0954
2.83
$140.35

$28.07P9034
K
Platelets, pheresis
9501
9.69
$480.75

$96.15P9035
K
Platelet pheres leukoreduced
9501
9.69
$480.75

$96.15P9036
K
Platelet pheresis irradiated
9502
10.52
$521.66

$104.33P9037
K
Plate pheres leukoredu irrad
9501
9.69
$480.75

$96.15P9038
K
RBC irradiated
9505
2.58
$127.86

$25.57P9039
K
RBC deglycerolized
9504
4.35
$215.83

$43.17P9040
K
RBC leukoreduced irradiated
9504
4.35
$215.83

$43.17P9041
K
Albumin(human), 5%, 500 ML
0961
2.77
$137.38

$27.48P9042
K
Albumin (human), 25%, 50 ML
0962
1.38
$68.44

$13.69P9043
K
Plasma protein fraction
0956
1.26
$62.49

$12.50P9044
K
Cryoprecipitate reduced plasma
1009
0.86
$42.76

$8.55P9603
A
One-way allow prorated milesP9604
A
One-way allow prorated tripP9612
N
Catheterize for urine specP9615
N
Urine specimen collect multQ0034D
K
Admin of influenza vaccine
0354
0.13
$6.33Q0035
X
Cardiokymography
0100
1.70
$84.32
$71.57
$16.86Q0081
T
Infusion ther other than che
0120
1.66
$82.33
$42.67
$16.47Q0082D
P
Activity therapy w/partial h
0033
4.17
$206.82
$48.17
$41.36Q0083
S
Chemo by other than infusion
0116
2.34
$116.06
$23.21
$23.21Q0084
S
Chemotherapy by infusion
0117
1.84
$91.26
$71.80
$18.25Q0085
S
Chemo by both infusion and o
0118
2.90
$143.83
$72.03
$28.77Q0086
A
Physical therapy evaluation/Q0091
T
Obtaining screen pap smear
0191
1.19
$59.02
$17.43
$11.80Q0092
N
Set up port xray equipmentQ0111
A
Wet mounts/ w preparationsQ0112
A
Potassium hydroxide prepsQ0113
A
Pinworm examinationsQ0114
A
Fern testQ0115
A
Post-coital mucous examQ0136
G
Non esrd epoetin alpha inj
0733

$11.40

$1.53Q0144
E
Azithromycin dihydrate, oralQ0156D
K
Human albumin 5%
0961
2.77
$137.38

$27.48Q0157D
K
Human albumin 25%
0962
1.38
$68.44

$13.69Q0160
G
Factor IX non-recombinant
0931

$.72

$.10Q0161
G
Factor IX recombinant
0932

$1.12

$.10Q0163
G
Diphenhydramine HCl 50mg
1400

$1.18

$.16Q0164
G
Prochlorperazine maleate 5mg
1401

$1.31

$.18Q0165
E
Prochlorperazine maleate10mg( print page 67997)Q0166
G
Granisetron HCl 1 mg oral
0765

$44.70

$5.99Q0167
G
Dronabinol 2.5mg oral
0762

$3.20

$.48Q0168
E
Dronabinol 5mg oralQ0169
G
Promethazine HCl 12.5mg oral
1402

$.03Q0170
E
Promethazine HCl 25 mg oralQ0171
G
Chlorpromazine HCl 10mg oral
1403

$.55

$.07Q0172
E
Chlorpromazine HCl 25mg oralQ0173
G
Trimethobenzamide HCl 250mg
1404

$.36

$.05Q0174
G
Thiethylperazine maleate10mg
1405

$.69

$.09Q0175
G
Perphenazine 4mg oral
1406

$.71

$.10Q0176
E
Perphenazine 8mg oralQ0177
G
Hydroxyzine pamoate 25mg
1407

$.20

$.03Q0178
E
Hydroxyzine pamoate 50mgQ0179
G
Ondansetron HCl 8mg oral
0769

$25.15

$3.37Q0180
G
Dolasetron mesylate oral
0763

$65.21

$8.74Q0181
G
Unspecified oral anti-emetic
0761

$.60

$.08Q0183
N
Nonmetabolic active tissueQ0184
N
Metabolically active tissueQ0185
N
Metabolic active D/E tissueQ0186D
E
Paramedic intercept, ruralQ0187
G
Factor viia recombinant
1409

$1,596.00

$213.86Q0188D
N
Contrast mediumQ1001
E
Ntiol category 1Q1002
E
Ntiol category 2Q1003
E
Ntiol category 3Q1004
E
Ntiol category 4Q1005
E
Ntiol category 5Q2001
N
Cabergoline, 0.5 mg, oralQ2002
G
Elliot's B solution, per ml
7022

$14.25

$1.91Q2003
G
Aprotinin, 10,000 kiu
7019

$196.35

$26.31Q2004
G
Treatment for bladder calculi, per 500 ml
7023

$23.54

$3.15Q2005
G
Corticorelin ovine triflutate, per 0.1 mg
7024

$353.88

$45.77Q2006
G
Digoxin immune FAB (Ovine), 40 mg vial
7025

$530.44

$64.71Q2007
G
Ethanolamine oleate, 100 mg
7026

$27.21

$3.65Q2008
G
Fomepizole, 1.5 mg
7027

$728.33

$97.60Q2009
G
Fosphenytoin, 50 mg
7028

$8.55

$1.15Q2010
G
Glatiramer acetate, 20 mg
7029

$27.40

$3.67Q2011
G
Hemin, 1 mg
7030

$.90

$.12Q2012
G
Pegademase bovine inj 25 I.U
7039

$139.33

$18.67Q2013
G
Pentastarch 10% inj, 100 ml
7040

$15.11

$2.04Q2014
G
Sermorelin acetate, 0.5 mg
7032

$15.78

$2.11Q2015
G
Somatrem, 5 mg
7033

$199.50

$26.73Q2016
G
Somatropin, 1 mg (any derivation)
7034

$39.90

$5.35Q2017
G
Teniposide, 50 mg
7035

$195.28

$26.17Q2018
G
Urofollitropin, 75 I.U.
7037

$69.73

$9.34*Q2019
G
Basiliximab, 20 mg
1615

$1,250.01

$167.50*Q2020
G
Histrelin Acetate, 0.5 mg
1616

$14.91

$2.00*Q2021
G
Lepirdin, 50 mg
1617

$124.49

$16.68*Q2022
G
Von Willebrand factor, per iu
1618

$.95

$.13Q3001
H
Brachytherapy Seeds
0918*Q3002
G
Ga 67, per mCi
1619

$25.97

$3.17*Q3003
G
TC 99M Bicisate, per vial
1620

$417.53

$55.95*Q3004
G
Xe 133, per mCi
1621

$28.50

$3.66*Q3005
G
TC 99M Mertiatide, per vial
1622

$185.82

$24.90*Q3006
G
TC 99M Gluceptate
1623

$22.61

$2.76*Q3007
G
P32 sodium, per mCi
1624

$74.10

$9.04*Q3008
G
IN 111 Pentetreotide, per mCi
1625

$283.42

$37.98*Q3009
G
TC 99M Oxidronate, per vial
1626

$38.38

$4.68*Q3010
G
TC-99 labeled red blood cell, per test
1627

$38.95

$4.75*Q3011
G
P32 phosphate chromic, per mCi
1628

$137.12

$16.73Q9920
A
Epoetin with hct <= 20Q9921
A
Epoetin with hct = 21Q9922
A
Epoetin with hct = 22Q9923
A
Epoetin with hct = 23Q9924
A
Epoetin with hct = 24Q9925
A
Epoetin with hct = 25Q9926
A
Epoetin with hct = 26Q9927
A
Epoetin with hct = 27Q9928
A
Epoetin with hct = 28Q9929
A
Epoetin with hct = 29Q9930
A
Epoetin with hct = 30Q9931
A
Epoetin with hct = 31Q9932
A
Epoetin with hct = 32Q9933
A
Epoetin with hct = 33( print page 67998)Q9934
A
Epoetin with hct = 34Q9935
A
Epoetin with hct = 35Q9936
A
Epoetin with hct = 36Q9937
A
Epoetin with hct = 37Q9938
A
Epoetin with hct = 38Q9939
A
Epoetin with hct = 39Q9940
A
Epoetin with hct >= 40R0070
N
Transport portable x-rayR0075
N
Transport port x-ray multiplR0076
N
Transport portable EKGV2020
A
Vision svcs frames purchasesV2025
E
Eyeglasses delux framesV2100
A
Lens spher single plano 4.00V2101
A
Single visn sphere 4.12-7.00V2102
A
Singl visn sphere 7.12-20.00V2103
A
Spherocylindr 4.00d/12-2.00dV2104
A
Spherocylindr 4.00d/2.12-4dV2105
A
Spherocylinder 4.00d/4.25-6dV2106
A
Spherocylinder 4.00d/>6.00dV2107
A
Spherocylinder 4.25d/12-2dV2108
A
Spherocylinder 4.25d/2.12-4dV2109
A
Spherocylinder 4.25d/4.25-6dV2110
A
Spherocylinder 4.25d/over 6dV2111
A
Spherocylindr 7.25d/.25-2.25V2112
A
Spherocylindr 7.25d/2.25-4dV2113
A
Spherocylindr 7.25d/4.25-6dV2114
A
Spherocylinder over 12.00dV2115
A
Lens lenticular bifocalV2116
A
Nonaspheric lens bifocalV2117
A
Aspheric lens bifocalV2118
A
Lens aniseikonic singleV2199
A
Lens single vision not oth cV2200
A
Lens spher bifoc plano 4.00dV2201
A
Lens sphere bifocal 4.12-7.0V2202
A
Lens sphere bifocal 7.12-20.V2203
A
Lens sphcyl bifocal 4.00d/.1V2204
A
Lens sphcy bifocal 4.00d/2.1V2205
A
Lens sphcy bifocal 4.00d/4.2V2206
A
Lens sphcy bifocal 4.00d/oveV2207
A
Lens sphcy bifocal 4.25-7d/.V2208
A
Lens sphcy bifocal 4.25-7/2.V2209
A
Lens sphcy bifocal 4.25-7/4.V2210
A
Lens sphcy bifocal 4.25-7/ovV2211
A
Lens sphcy bifo 7.25-12/.25-V2212
A
Lens sphcyl bifo 7.25-12/2.2V2213
A
Lens sphcyl bifo 7.25-12/4.2V2214
A
Lens sphcyl bifocal over 12.V2215
A
Lens lenticular bifocalV2216
A
Lens lenticular nonasphericV2217
A
Lens lenticular aspheric bifV2218
A
Lens aniseikonic bifocalV2219
A
Lens bifocal seg width overV2220
A
Lens bifocal add over 3.25dV2299
A
Lens bifocal specialityV2300
A
Lens sphere trifocal 4.00dV2301
A
Lens sphere trifocal 4.12-7.V2302
A
Lens sphere trifocal 7.12-20V2303
A
Lens sphcy trifocal 4.0/.12-V2304
A
Lens sphcy trifocal 4.0/2.25V2305
A
Lens sphcy trifocal 4.0/4.25V2306
A
Lens sphcyl trifocal 4.00/>6V2307
A
Lens sphcy trifocal 4.25-7/.V2308
A
Lens sphc trifocal 4.25-7/2.V2309
A
Lens sphc trifocal 4.25-7/4.V2310
A
Lens sphc trifocal 4.25-7/>6V2311
A
Lens sphc trifo 7.25-12/.25-V2312
A
Lens sphc trifo 7.25-12/2.25V2313
A
Lens sphc trifo 7.25-12/4.25V2314
A
Lens sphcyl trifocal over 12V2315
A
Lens lenticular trifocalV2316
A
Lens lenticular nonasphericV2317
A
Lens lenticular aspheric triV2318
A
Lens aniseikonic trifocalV2319
A
Lens trifocal seg width > 28( print page 67999)V2320
A
Lens trifocal add over 3.25dV2399
A
Lens trifocal specialityV2410
A
Lens variab asphericity singV2430
A
Lens variable asphericity biV2499
A
Variable asphericity lensV2500
A
Contact lens pmma sphericalV2501
A
Cntct lens pmma-toric/prismV2502
A
Contact lens pmma bifocalV2503
A
Cntct lens pmma color visionV2510
A
Cntct gas permeable sphericlV2511
A
Cntct toric prism ballastV2512
A
Cntct lens gas permbl bifoclV2513
A
Contact lens extended wearV2520
A
Contact lens hydrophilicV2521
A
Cntct lens hydrophilic toricV2522
A
Cntct lens hydrophil bifoclV2523
A
Cntct lens hydrophil extendV2530
A
Contact lens gas impermeableV2531
A
Contact lens gas permeableV2599
A
Contact lens/es other typeV2600
A
Hand held low vision aidsV2610
A
Single lens spectacle mountV2615
A
Telescop/othr compound lensV2623
A
Plastic eye prosth customV2624
A
Polishing artifical eyeV2625
A
Enlargemnt of eye prosthesisV2626
A
Reduction of eye prosthesisV2627
A
Scleral cover shellV2628
A
Fabrication & fittingV2629
A
Prosthetic eye other typeV2630
N
Anter chamber intraocul lensV2631
N
Iris support intraoclr lensV2632
N
Post chmbr intraocular lensV2700
A
Balance lensV2710
A
Glass/plastic slab off prismV2715
A
Prism lens/esV2718
A
Fresnell prism press-on lensV2730
A
Special base curveV2740
A
Rose tint plasticV2741
A
Non-rose tint plasticV2742
A
Rose tint glassV2743
A
Non-rose tint glassV2744
A
Tint photochromatic lens/esV2750
A
Anti-reflective coatingV2755
A
UV lens/esV2760
A
Scratch resistant coatingV2770
A
Occluder lens/esV2780
A
Oversize lens/esV2781
E
Progressive lens per lensV2785
F
Corneal tissue processingV2790
N
Amniotic membraneV2799
A
Miscellaneous vision serviceV5008
E
Hearing screeningV5010
E
Assessment for hearing aidV5011
E
Hearing aid fitting/checkingV5014
E
Hearing aid repair/modifyingV5020
E
Conformity evaluationV5030
E
Body-worn hearing aid airV5040
E
Body-worn hearing aid boneV5050
E
Body-worn hearing aid in earV5060
E
Behind ear hearing aidV5070
E
Glasses air conductionV5080
E
Glasses bone conductionV5090
E
Hearing aid dispensing feeV5100
E
Body-worn bilat hearing aidV5110
E
Hearing aid dispensing feeV5120
E
Body-worn binaur hearing aidV5130
E
In ear binaural hearing aidV5140
E
Behind ear binaur hearing aiV5150
E
Glasses binaural hearing aidV5160
E
Dispensing fee binauralV5170
E
Within ear cros hearing aidV5180
E
Behind ear cros hearing aidV5190
E
Glasses cros hearing aid( print page 68000)V5200
E
Cros hearing aid dispens feeV5210
E
In ear bicros hearing aidV5220
E
Behind ear bicros hearing aiV5230
E
Glasses bicros hearing aidV5240
E
Dispensing fee bicrosV5299
E
Hearing serviceV5336
E
Repair communication deviceV5362
A
Speech screeningV5363
A
Language screeningV5364
A
Dysphagia screening25310
T
Transplant forearm tendon
0051
27.76
$1,376.79
$675.24
$275.3625312
T
Transplant forearm tendon
0051
27.76
$1,376.79
$675.24
$275.3625315
T
Revise palsy hand tendon(s)
0051
27.76
$1,376.79
$675.24
$275.3625316
T
Revise palsy hand tendon(s)
0051
27.76
$1,376.79
$675.24
$275.3625320
T
Repair/revise wrist joint
0051
27.76
$1,376.79
$675.24
$275.3625332
T
Revise wrist joint
0047
22.09
$1,095.58
$537.03
$219.1225335
T
Realignment of hand
0051
27.76
$1,376.79
$675.24
$275.3625337
T
Reconstruct ulna/radioulnar
0051
27.76
$1,376.79
$675.24
$275.3625350
T
Revision of radius
0051
27.76
$1,376.79
$675.24
$275.3625355
T
Revision of radius
0051
27.76
$1,376.79
$675.24
$275.3625360
T
Revision of ulna
0050
21.13
$1,047.96
$513.86
$209.5925365
T
Revise radius & ulna
0050
21.13
$1,047.96
$513.86
$209.5925370
T
Revise radius or ulna
0051
27.76
$1,376.79
$675.24
$275.3625375
T
Revise radius & ulna
0051
27.76
$1,376.79
$675.24
$275.3625390
C
Shorten radius or ulna25391
C
Lengthen radius or ulna25392
C
Shorten radius & ulna25393
C
Lengthen radius & ulna25400
T
Repair radius or ulna
0050
21.13
$1,047.96
$513.86
$209.5925405
T
Repair/graft radius or ulna
0050
21.13
$1,047.96
$513.86
$209.5925415
T
Repair radius & ulna
0050
21.13
$1,047.96
$513.86
$209.5925420
C
Repair/graft radius & ulna25425
T
Repair/graft radius or ulna
0051
27.76
$1,376.79
$675.24
$275.3625426
T
Repair/graft radius & ulna
0051
27.76
$1,376.79
$675.24
$275.3625440
T
Repair/graft wrist bone
0051
27.76
$1,376.79
$675.24
$275.3625441
T
Reconstruct wrist joint
0048
29.06
$1,441.26
$725.94
$288.2525442
T
Reconstruct wrist joint
0048
29.06
$1,441.26
$725.94
$288.2525443
T
Reconstruct wrist joint
0048
29.06
$1,441.26
$725.94
$288.2525444
T
Reconstruct wrist joint
0048
29.06
$1,441.26
$725.94
$288.2525445
T
Reconstruct wrist joint
0048
29.06
$1,441.26
$725.94
$288.2525446
T
Wrist replacement
0048
29.06
$1,441.26
$725.94
$288.2525447
T
Repair wrist joint(s)
0047
22.09
$1,095.58
$537.03
$219.1225449
T
Remove wrist joint implant
0047
22.09
$1,095.58
$537.03
$219.1225450
T
Revision of wrist joint
0051
27.76
$1,376.79
$675.24
$275.3625455
T
Revision of wrist joint
0051
27.76
$1,376.79
$675.24
$275.3625490
T
Reinforce radius
0051
27.76
$1,376.79
$675.24
$275.3625491
T
Reinforce ulna
0051
27.76
$1,376.79
$675.24
$275.3625492
T
Reinforce radius and ulna
0051
27.76
$1,376.79
$675.24
$275.3625500
T
Treat fracture of radius
0044
2.17
$107.63
$38.08
$21.5325505
T
Treat fracture of radius
0044
2.17
$107.63
$38.08
$21.5325515
T
Treat fracture of radius
0046
22.29
$1,105.50
$535.76
$221.1025520
T
Treat fracture of radius
0044
2.17
$107.63
$38.08
$21.5325525
T
Treat fracture of radius
0046
22.29
$1,105.50
$535.76
$221.1025526
T
Treat fracture of radius
0046
22.29
$1,105.50
$535.76
$221.1025530
T
Treat fracture of ulna
0044
2.17
$107.63
$38.08
$21.5325535
T
Treat fracture of ulna
0044
2.17
$107.63
$38.08
$21.5325545
T
Treat fracture of ulna
0046
22.29
$1,105.50
$535.76
$221.1025560
T
Treat fracture radius & ulna
0044
2.17
$107.63
$38.08
$21.5325565
T
Treat fracture radius & ulna
0044
2.17
$107.63
$38.08
$21.5325574
T
Treat fracture radius & ulna
0046
22.29
$1,105.50
$535.76
$221.1025575
T
Treat fracture radius/ulna
0046
22.29
$1,105.50
$535.76
$221.1025600
T
Treat fracture radius/ulna
0044
2.17
$107.63
$38.08
$21.5325605
T
Treat fracture radius/ulna
0044
2.17
$107.63
$38.08
$21.5325611
T
Treat fracture radius/ulna
0046
22.29
$1,105.50
$535.76
$221.1025620
T
Treat fracture radius/ulna
0046
22.29
$1,105.50
$535.76
$221.1025622
T
Treat wrist bone fracture
0044
2.17
$107.63
$38.08
$21.5325624
T
Treat wrist bone fracture
0044
2.17
$107.63
$38.08
$21.5325628
T
Treat wrist bone fracture
0046
22.29
$1,105.50
$535.76
$221.1025630
T
Treat wrist bone fracture
0044
2.17
$107.63
$38.08
$21.5325635
T
Treat wrist bone fracture
0044
2.17
$107.63
$38.08
$21.5325645
T
Treat wrist bone fracture
0046
22.29
$1,105.50
$535.76
$221.1025650
T
Treat wrist bone fracture
0044
2.17
$107.63
$38.08
$21.5325660
T
Treat wrist dislocation
0044
2.17
$107.63
$38.08
$21.5325670
T
Treat wrist dislocation
0046
22.29
$1,105.50
$535.76
$221.10( print page 68001)25675
T
Treat wrist dislocation
0044
2.17
$107.63
$38.08
$21.5325676
T
Treat wrist dislocation
0046
22.29
$1,105.50
$535.76
$221.1025680
T
Treat wrist fracture
0044
2.17
$107.63
$38.08
$21.5325685
T
Treat wrist fracture
0046
22.29
$1,105.50
$535.76
$221.1025690
T
Treat wrist dislocation
0044
2.17
$107.63
$38.08
$21.5325695
T
Treat wrist dislocation
0046
22.29
$1,105.50
$535.76
$221.1025800
T
Fusion of wrist joint
0051
27.76
$1,376.79
$675.24
$275.3625805
T
Fusion/graft of wrist joint
0051
27.76
$1,376.79
$675.24
$275.3625810
T
Fusion/graft of wrist joint
0051
27.76
$1,376.79
$675.24
$275.3625820
T
Fusion of hand bones
0053
11.32
$561.42
$253.49
$112.2825825
T
Fuse hand bones with graft
0054
19.66
$975.06
$472.33
$195.0125830
T
Fusion, radioulnar jnt/ulna
0051
27.76
$1,376.79
$675.24
$275.3625900
C
Amputation of forearm25905
C
Amputation of forearm25907
T
Amputation follow-up surgery
0049
15.04
$745.93
$356.95
$149.1925909
C
Amputation follow-up surgery25915
C
Amputation of forearm25920
C
Amputate hand at wrist25922
T
Amputate hand at wrist
0049
15.04
$745.93
$356.95
$149.1925924
C
Amputation follow-up surgery25927
C
Amputation of hand25929
T
Amputation follow-up surgery
0026
12.11
$600.61
$277.92
$120.1225931
C
Amputation follow-up surgery25999
T
Forearm or wrist surgery
0044
2.17
$107.63
$38.08
$21.5326010
T
Drainage of finger abscess
0006
2.00
$99.19
$33.95
$19.8426011
T
Drainage of finger abscess
0007
3.68
$182.51
$72.03
$36.5026020
T
Drain hand tendon sheath
0053
11.32
$561.42
$253.49
$112.2826025
T
Drainage of palm bursa
0053
11.32
$561.42
$253.49
$112.2826030
T
Drainage of palm bursa(s)
0053
11.32
$561.42
$253.49
$112.2826034
T
Treat hand bone lesion
0053
11.32
$561.42
$253.49
$112.2826035
T
Decompress fingers/hand
0053
11.32
$561.42
$253.49
$112.2826037
T
Decompress fingers/hand
0053
11.32
$561.42
$253.49
$112.2826040
T
Release palm contracture
0054
19.66
$975.06
$472.33
$195.0126045
T
Release palm contracture
0054
19.66
$975.06
$472.33
$195.0126055
T
Incise finger tendon sheath
0053
11.32
$561.42
$253.49
$112.2826060
T
Incision of finger tendon
0053
11.32
$561.42
$253.49
$112.2826070
T
Explore/treat hand joint
0053
11.32
$561.42
$253.49
$112.2826075
T
Explore/treat finger joint
0053
11.32
$561.42
$253.49
$112.2826080
T
Explore/treat finger joint
0053
11.32
$561.42
$253.49
$112.2826100
T
Biopsy hand joint lining
0053
11.32
$561.42
$253.49
$112.2826105
T
Biopsy finger joint lining
0053
11.32
$561.42
$253.49
$112.2826110
T
Biopsy finger joint lining
0053
11.32
$561.42
$253.49
$112.2826115
T
Removal of hand lesion
0022
12.49
$619.45
$292.94
$123.8926116
T
Removal of hand lesion
0022
12.49
$619.45
$292.94
$123.8926117
T
Remove tumor, hand/finger
0022
12.49
$619.45
$292.94
$123.8926121
T
Release palm contracture
0054
19.66
$975.06
$472.33
$195.0126123
T
Release palm contracture
0054
19.66
$975.06
$472.33
$195.0126125
T
Release palm contracture
0054
19.66
$975.06
$472.33
$195.0126130
T
Remove wrist joint lining
0053
11.32
$561.42
$253.49
$112.2826135
T
Revise finger joint, each
0054
19.66
$975.06
$472.33
$195.0126140
T
Revise finger joint, each
0053
11.32
$561.42
$253.49
$112.2826145
T
Tendon excision, palm/finger
0053
11.32
$561.42
$253.49
$112.2826160
T
Remove tendon sheath lesion
0053
11.32
$561.42
$253.49
$112.2826170
T
Removal of palm tendon, each
0053
11.32
$561.42
$253.49
$112.2826180
T
Removal of finger tendon
0053
11.32
$561.42
$253.49
$112.2826185
T
Remove finger bone
0053
11.32
$561.42
$253.49
$112.2826200
T
Remove hand bone lesion
0053
11.32
$561.42
$253.49
$112.2826205
T
Remove/graft bone lesion
0054
19.66
$975.06
$472.33
$195.0126210
T
Removal of finger lesion
0053
11.32
$561.42
$253.49
$112.2826215
T
Remove/graft finger lesion
0053
11.32
$561.42
$253.49
$112.2826230
T
Partial removal of hand bone
0053
11.32
$561.42
$253.49
$112.2826235
T
Partial removal, finger bone
0053
11.32
$561.42
$253.49
$112.2826236
T
Partial removal, finger bone
0053
11.32
$561.42
$253.49
$112.2826250
T
Extensive hand surgery
0053
11.32
$561.42
$253.49
$112.2826255
T
Extensive hand surgery
0054
19.66
$975.06
$472.33
$195.0126260
T
Extensive finger surgery
0053
11.32
$561.42
$253.49
$112.2826261
T
Extensive finger surgery
0053
11.32
$561.42
$253.49
$112.2826262
T
Partial removal of finger
0053
11.32
$561.42
$253.49
$112.2826320
T
Removal of implant from hand
0020
6.51
$322.87
$130.53
$64.5726350
T
Repair finger/hand tendon
0054
19.66
$975.06
$472.33
$195.0126352
T
Repair/graft hand tendon
0054
19.66
$975.06
$472.33
$195.0126356
T
Repair finger/hand tendon
0054
19.66
$975.06
$472.33
$195.0126357
T
Repair finger/hand tendon
0054
19.66
$975.06
$472.33
$195.0126358
T
Repair/graft hand tendon
0054
19.66
$975.06
$472.33
$195.01( print page 68002)26370
T
Repair finger/hand tendon
0054
19.66
$975.06
$472.33
$195.0126372
T
Repair/graft hand tendon
0054
19.66
$975.06
$472.33
$195.0126373
T
Repair finger/hand tendon
0054
19.66
$975.06
$472.33
$195.0126390
T
Revise hand/finger tendon
0054
19.66
$975.06
$472.33
$195.0126392
T
Repair/graft hand tendon
0054
19.66
$975.06
$472.33
$195.0126410
T
Repair hand tendon
0053
11.32
$561.42
$253.49
$112.2826412
T
Repair/graft hand tendon
0054
19.66
$975.06
$472.33
$195.0126415
T
Excision, hand/finger tendon
0054
19.66
$975.06
$472.33
$195.0126416
T
Graft hand or finger tendon
0054
19.66
$975.06
$472.33
$195.0126418
T
Repair finger tendon
0053
11.32
$561.42
$253.49
$112.2826420
T
Repair/graft finger tendon
0054
19.66
$975.06
$472.33
$195.0126426
T
Repair finger/hand tendon
0054
19.66
$975.06
$472.33
$195.0126428
T
Repair/graft finger tendon
0054
19.66
$975.06
$472.33
$195.0126432
T
Repair finger tendon
0053
11.32
$561.42
$253.49
$112.2826433
T
Repair finger tendon
0053
11.32
$561.42
$253.49
$112.2826434
T
Repair/graft finger tendon
0054
19.66
$975.06
$472.33
$195.0126437
T
Realignment of tendons
0053
11.32
$561.42
$253.49
$112.2826440
T
Release palm/finger tendon
0053
11.32
$561.42
$253.49
$112.2826442
T
Release palm & finger tendon
0054
19.66
$975.06
$472.33
$195.0126445
T
Release hand/finger tendon
0053
11.32
$561.42
$253.49
$112.2826449
T
Release forearm/hand tendon
0054
19.66
$975.06
$472.33
$195.0126450
T
Incision of palm tendon
0053
11.32
$561.42
$253.49
$112.2826455
T
Incision of finger tendon
0053
11.32
$561.42
$253.49
$112.2826460
T
Incise hand/finger tendon
0053
11.32
$561.42
$253.49
$112.2826471
T
Fusion of finger tendons
0053
11.32
$561.42
$253.49
$112.2826474
T
Fusion of finger tendons
0053
11.32
$561.42
$253.49
$112.2826476
T
Tendon lengthening
0053
11.32
$561.42
$253.49
$112.2826477
T
Tendon shortening
0053
11.32
$561.42
$253.49
$112.2826478
T
Lengthening of hand tendon
0053
11.32
$561.42
$253.49
$112.2826479
T
Shortening of hand tendon
0053
11.32
$561.42
$253.49
$112.2826480
T
Transplant hand tendon
0054
19.66
$975.06
$472.33
$195.0126483
T
Transplant/graft hand tendon
0054
19.66
$975.06
$472.33
$195.0126485
T
Transplant palm tendon
0054
19.66
$975.06
$472.33
$195.0126489
T
Transplant/graft palm tendon
0054
19.66
$975.06
$472.33
$195.0126490
T
Revise thumb tendon
0054
19.66
$975.06
$472.33
$195.0126492
T
Tendon transfer with graft
0054
19.66
$975.06
$472.33
$195.0126494
T
Hand tendon/muscle transfer
0054
19.66
$975.06
$472.33
$195.0126496
T
Revise thumb tendon
0054
19.66
$975.06
$472.33
$195.0126497
T
Finger tendon transfer
0054
19.66
$975.06
$472.33
$195.0126498
T
Finger tendon transfer
0054
19.66
$975.06
$472.33
$195.0126499
T
Revision of finger
0054
19.66
$975.06
$472.33
$195.0126500
T
Hand tendon reconstruction
0053
11.32
$561.42
$253.49
$112.2826502
T
Hand tendon reconstruction
0054
19.66
$975.06
$472.33
$195.0126504
T
Hand tendon reconstruction
0054
19.66
$975.06
$472.33
$195.0126508
T
Release thumb contracture
0053
11.32
$561.42
$253.49
$112.2826510
T
Thumb tendon transfer
0054
19.66
$975.06
$472.33
$195.0126516
T
Fusion of knuckle joint
0054
19.66
$975.06
$472.33
$195.0126517
T
Fusion of knuckle joints
0054
19.66
$975.06
$472.33
$195.0126518
T
Fusion of knuckle joints
0054
19.66
$975.06
$472.33
$195.0126520
T
Release knuckle contracture
0053
11.32
$561.42
$253.49
$112.2826525
T
Release finger contracture
0053
11.32
$561.42
$253.49
$112.2826530
T
Revise knuckle joint
0047
22.09
$1,095.58
$537.03
$219.1226531
T
Revise knuckle with implant
0048
29.06
$1,441.26
$725.94
$288.2526535
T
Revise finger joint
0047
22.09
$1,095.58
$537.03
$219.1226536
T
Revise/implant finger joint
0048
29.06
$1,441.26
$725.94
$288.2526540
T
Repair hand joint
0053
11.32
$561.42
$253.49
$112.2826541
T
Repair hand joint with graft
0054
19.66
$975.06
$472.33
$195.0126542
T
Repair hand joint with graft
0053
11.32
$561.42
$253.49
$112.2826545
T
Reconstruct finger joint
0054
19.66
$975.06
$472.33
$195.0126546
T
Repair nonunion hand
0054
19.66
$975.06
$472.33
$195.0126548
T
Reconstruct finger joint
0054
19.66
$975.06
$472.33
$195.0126550
T
Construct thumb replacement
0054
19.66
$975.06
$472.33
$195.0126551
C
Great toe-hand transfer26553
C
Single transfer, toe-hand26554
C
Double transfer, toe-hand26555
T
Positional change of finger
0054
19.66
$975.06
$472.33
$195.0126556
C
Toe joint transfer26560
T
Repair of web finger
0053
11.32
$561.42
$253.49
$112.2826561
T
Repair of web finger
0054
19.66
$975.06
$472.33
$195.0126562
T
Repair of web finger
0054
19.66
$975.06
$472.33
$195.0126565
T
Correct metacarpal flaw
0054
19.66
$975.06
$472.33
$195.0126567
T
Correct finger deformity
0054
19.66
$975.06
$472.33
$195.0126568
T
Lengthen metacarpal/finger
0054
19.66
$975.06
$472.33
$195.0126580
T
Repair hand deformity
0054
19.66
$975.06
$472.33
$195.01( print page 68003)26585
T
Repair finger deformity
0054
19.66
$975.06
$472.33
$195.0126587
T
Reconstruct extra finger
0053
11.32
$561.42
$253.49
$112.2826590
T
Repair finger deformity
0054
19.66
$975.06
$472.33
$195.0126591
T
Repair muscles of hand
0054
19.66
$975.06
$472.33
$195.0126593
T
Release muscles of hand
0053
11.32
$561.42
$253.49
$112.2826596
T
Excision constricting tissue
0054
19.66
$975.06
$472.33
$195.0126597
T
Release of scar contracture
0054
19.66
$975.06
$472.33
$195.0126600
T
Treat metacarpal fracture
0044
2.17
$107.63
$38.08
$21.5326605
T
Treat metacarpal fracture
0044
2.17
$107.63
$38.08
$21.5326607
T
Treat metacarpal fracture
0044
2.17
$107.63
$38.08
$21.5326608
T
Treat metacarpal fracture
0046
22.29
$1,105.50
$535.76
$221.1026615
T
Treat metacarpal fracture
0046
22.29
$1,105.50
$535.76
$221.1026641
T
Treat thumb dislocation
0044
2.17
$107.63
$38.08
$21.5326645
T
Treat thumb fracture
0044
2.17
$107.63
$38.08
$21.5326650
T
Treat thumb fracture
0046
22.29
$1,105.50
$535.76
$221.1026665
T
Treat thumb fracture
0046
22.29
$1,105.50
$535.76
$221.1026670
T
Treat hand dislocation
0044
2.17
$107.63
$38.08
$21.5326675
T
Treat hand dislocation
0045
11.02
$546.55
$277.12
$109.3126676
T
Pin hand dislocation
0046
22.29
$1,105.50
$535.76
$221.1026685
T
Treat hand dislocation
0046
22.29
$1,105.50
$535.76
$221.1026686
T
Treat hand dislocation
0046
22.29
$1,105.50
$535.76
$221.1026700
T
Treat knuckle dislocation
0043
1.64
$81.34
$25.46
$16.2726705
T
Treat knuckle dislocation
0045
11.02
$546.55
$277.12
$109.3126706
T
Pin knuckle dislocation
0044
2.17
$107.63
$38.08
$21.5326715
T
Treat knuckle dislocation
0046
22.29
$1,105.50
$535.76
$221.1026720
T
Treat finger fracture, each
0043
1.64
$81.34
$25.46
$16.2726725
T
Treat finger fracture, each
0043
1.64
$81.34
$25.46
$16.2726727
T
Treat finger fracture, each
0046
22.29
$1,105.50
$535.76
$221.1026735
T
Treat finger fracture, each
0046
22.29
$1,105.50
$535.76
$221.1026740
T
Treat finger fracture, each
0043
1.64
$81.34
$25.46
$16.2726742
T
Treat finger fracture, each
0044
2.17
$107.63
$38.08
$21.5326746
T
Treat finger fracture, each
0046
22.29
$1,105.50
$535.76
$221.1026750
T
Treat finger fracture, each
0043
1.64
$81.34
$25.46
$16.2726755
T
Treat finger fracture, each
0043
1.64
$81.34
$25.46
$16.2726756
T
Pin finger fracture, each
0046
22.29
$1,105.50
$535.76
$221.1026765
T
Treat finger fracture, each
0046
22.29
$1,105.50
$535.76
$221.1026770
T
Treat finger dislocation
0043
1.64
$81.34
$25.46
$16.2726775
T
Treat finger dislocation
0045
11.02
$546.55
$277.12
$109.3126776
T
Pin finger dislocation
0046
22.29
$1,105.50
$535.76
$221.1026785
T
Treat finger dislocation
0046
22.29
$1,105.50
$535.76
$221.1026820
T
Thumb fusion with graft
0054
19.66
$975.06
$472.33
$195.0126841
T
Fusion of thumb
0054
19.66
$975.06
$472.33
$195.0126842
T
Thumb fusion with graft
0054
19.66
$975.06
$472.33
$195.0126843
T
Fusion of hand joint
0054
19.66
$975.06
$472.33
$195.0126844
T
Fusion/graft of hand joint
0054
19.66
$975.06
$472.33
$195.0126850
T
Fusion of knuckle
0054
19.66
$975.06
$472.33
$195.0126852
T
Fusion of knuckle with graft
0054
19.66
$975.06
$472.33
$195.0126860
T
Fusion of finger joint
0054
19.66
$975.06
$472.33
$195.0126861
T
Fusion of finger jnt, add-on
0054
19.66
$975.06
$472.33
$195.0126862
T
Fusion/graft of finger joint
0054
19.66
$975.06
$472.33
$195.0126863
T
Fuse/graft added joint
0054
19.66
$975.06
$472.33
$195.0126910
T
Amputate metacarpal bone
0054
19.66
$975.06
$472.33
$195.0126951
T
Amputation of finger/thumb
0053
11.32
$561.42
$253.49
$112.2826952
T
Amputation of finger/thumb
0053
11.32
$561.42
$253.49
$112.2826989
T
Hand/finger surgery
0043
1.64
$81.34
$25.46
$16.2726990
T
Drainage of pelvis lesion
0049
15.04
$745.93
$356.95
$149.1926991
T
Drainage of pelvis bursa
0049
15.04
$745.93
$356.95
$149.1926992
C
Drainage of bone lesion27000
T
Incision of hip tendon
0049
15.04
$745.93
$356.95
$149.1927001
T
Incision of hip tendon
0050
21.13
$1,047.96
$513.86
$209.5927003
T
Incision of hip tendon
0050
21.13
$1,047.96
$513.86
$209.5927005
C
Incision of hip tendon27006
C
Incision of hip tendons27025
C
Incision of hip/thigh fascia27030
C
Drainage of hip joint27033
T
Exploration of hip joint
0051
27.76
$1,376.79
$675.24
$275.3627035
C
Denervation of hip joint27036
C
Excision of hip joint/muscle27040
T
Biopsy of soft tissues
0021
10.49
$520.26
$236.51
$104.0527041
T
Biopsy of soft tissues
0022
12.49
$619.45
$292.94
$123.8927047
T
Remove hip/pelvis lesion
0022
12.49
$619.45
$292.94
$123.8927048
T
Remove hip/pelvis lesion
0022
12.49
$619.45
$292.94
$123.8927049
T
Remove tumor, hip/pelvis
0022
12.49
$619.45
$292.94
$123.8927050
T
Biopsy of sacroiliac joint
0049
15.04
$745.93
$356.95
$149.19( print page 68004)27052
T
Biopsy of hip joint
0049
15.04
$745.93
$356.95
$149.1927054
C
Removal of hip joint lining27060
T
Removal of ischial bursa
0049
15.04
$745.93
$356.95
$149.1927062
T
Remove femur lesion/bursa
0049
15.04
$745.93
$356.95
$149.1927065
T
Removal of hip bone lesion
0049
15.04
$745.93
$356.95
$149.1927066
T
Removal of hip bone lesion
0050
21.13
$1,047.96
$513.86
$209.5927067
T
Remove/graft hip bone lesion
0050
21.13
$1,047.96
$513.86
$209.5927070
C
Partial removal of hip bone27071
C
Partial removal of hip bone27075
C
Extensive hip surgery27076
C
Extensive hip surgery27077
C
Extensive hip surgery27078
C
Extensive hip surgery27079
C
Extensive hip surgery27080
T
Removal of tail bone
0050
21.13
$1,047.96
$513.86
$209.5927086
T
Remove hip foreign body
0019
4.00
$198.39
$78.91
$39.6827087
T
Remove hip foreign body
0049
15.04
$745.93
$356.95
$149.1927090
C
Removal of hip prosthesis27091
C
Removal of hip prosthesis27093
N
Injection for hip x-ray27095
N
Injection for hip x-ray27096
N
Inject sacroiliac joint27097
T
Revision of hip tendon
0050
21.13
$1,047.96
$513.86
$209.5927098
T
Transfer tendon to pelvis
0050
21.13
$1,047.96
$513.86
$209.5927100
T
Transfer of abdominal muscle
0051
27.76
$1,376.79
$675.24
$275.3627105
T
Transfer of spinal muscle
0051
27.76
$1,376.79
$675.24
$275.3627110
T
Transfer of iliopsoas muscle
0051
27.76
$1,376.79
$675.24
$275.3627111
T
Transfer of iliopsoas muscle
0051
27.76
$1,376.79
$675.24
$275.3627120
C
Reconstruction of hip socket27122
C
Reconstruction of hip socket27125
C
Partial hip replacement27130
C
Total hip replacement27132
C
Total hip replacement27134
C
Revise hip joint replacement27137
C
Revise hip joint replacement27138
C
Revise hip joint replacement27140
C
Transplant femur ridge27146
C
Incision of hip bone27147
C
Revision of hip bone27151
C
Incision of hip bones27156
C
Revision of hip bones27158
C
Revision of pelvis27161
C
Incision of neck of femur27165
C
Incision/fixation of femur27170
C
Repair/graft femur head/neck27175
C
Treat slipped epiphysis27176
C
Treat slipped epiphysis27177
C
Treat slipped epiphysis27178
C
Treat slipped epiphysis27179
C
Revise head/neck of femur27181
C
Treat slipped epiphysis27185
C
Revision of femur epiphysis27187
C
Reinforce hip bones27193
T
Treat pelvic ring fracture
0044
2.17
$107.63
$38.08
$21.5327194
T
Treat pelvic ring fracture
0045
11.02
$546.55
$277.12
$109.3127200
T
Treat tail bone fracture
0043
1.64
$81.34
$25.46
$16.2727202
T
Treat tail bone fracture
0046
22.29
$1,105.50
$535.76
$221.1027215
C
Treat pelvic fracture(s)27216
C
Treat pelvic ring fracture27217
C
Treat pelvic ring fracture27218
C
Treat pelvic ring fracture27220
T
Treat hip socket fracture
0044
2.17
$107.63
$38.08
$21.5327222
C
Treat hip socket fracture27226
C
Treat hip wall fracture27227
C
Treat hip fracture(s)27228
C
Treat hip fracture(s)27230
T
Treat thigh fracture
0044
2.17
$107.63
$38.08
$21.5327232
C
Treat thigh fracture27235
C
Treat thigh fracture27236
C
Treat thigh fracture27238
T
Treat thigh fracture
0044
2.17
$107.63
$38.08
$21.5327240
C
Treat thigh fracture27244
C
Treat thigh fracture27245
C
Treat thigh fracture( print page 68005)27246
T
Treat thigh fracture
0044
2.17
$107.63
$38.08
$21.5327248
C
Treat thigh fracture27250
T
Treat hip dislocation
0044
2.17
$107.63
$38.08
$21.5327252
T
Treat hip dislocation
0045
11.02
$546.55
$277.12
$109.3127253
C
Treat hip dislocation27254
C
Treat hip dislocation27256
T
Treat hip dislocation
0044
2.17
$107.63
$38.08
$21.5327257
T
Treat hip dislocation
0045
11.02
$546.55
$277.12
$109.3127258
C
Treat hip dislocation27259
C
Treat hip dislocation27265
T
Treat hip dislocation
0044
2.17
$107.63
$38.08
$21.5327266
T
Treat hip dislocation
0047
22.09
$1,095.58
$537.03
$219.1227275
T
Manipulation of hip joint
0045
11.02
$546.55
$277.12
$109.31CPT codes and descriptions only are copyright American Medical Association.  All Rights Reserved. Applicable FARS/DFARS Apply.Copyright American Dental Association.  All rights reserved.* Code is new in 2001.
 
 
 Addendum C—[Reserved] Addendum D.—Status Indicators: How Various Services Are Treated Under the Hospital Outpatient Prospective Payment System
Indicator
Service
StatusA
Pulmonary Rehabilitation Clinical Trial
Not Paid Under Ourpatient PPS.C
Inpatient Procedures
Admit Patient; Bill as Inpatient.A
Durable Medical Equipment, Prosthetics and Orthotics
DMEPOS Fee Schedule.E
Non-Covered Items and Services
Not Paid Under Outpatient PPS.A
Physical, Occupational and Speech Therapy
Rehabilitation Fee Schedule.A
Ambulance
Ambulance Fee Schedule.A
EPO for ESRD Patients
National Rate.A
Clinical Diagnostic Laboratory Services
Laboratory Fee Schedule.A
Physician Services for ESRD Patients
Not Paid Under Outpatient PPS.A
Screening Mammography
Lower of Charges or National Rate.N
Incidental Services, packaged into APC Rate
Packaged.P
Partial Hospitalization
Paid Per Diem APC.S
Significant Procedure, Not Discounted When Multiple
Paid Under Outpatient PPS.T
Significant Procedure, Multiple Procedure Reduction Applies
Paid Under Outpatient PPS.V
Visit to Clinic or Emergency Department
Paid Under Outpatient PPS.X
Ancillary Service
Paid Under Outpatient PPS.F
Acquisition of Corneal Tissue
Paid at Reasonable Cost.G
Current Drug/Biological Pass-Through
Additional Payment.H
Device Pass-Through
Additional Payment.J
New Drug/Biological Pass-Through
Additional Payment.K
Non Pass-Through Drug/Biological
Paid Under Outpatient PPS.
 
 
 Addendum E.—CPT Codes Which Will Be Paid Only as Inpatient Procedures
[Calendar Year 2001]
CPT/
                                 HCPCS
HOPD 
                                 status  
                                 indicator
Description15756
C
Free muscle flap, microvasc15757
C
Free skin flap, microvasc15758
C
Free fascial flap, microvasc16035
C
Incision of burn scab*
                                 16036
C
Incision of burn scab19200
C
Removal of breast19220
C
Removal of breast19271
C
Revision of chest wall19272
C
Extensive chest wall surgery19361
C
Breast reconstruction19364
C
Breast reconstruction19367
C
Breast reconstruction19368
C
Breast reconstruction19369
C
Breast reconstruction20660
C
Apply, remove fixation device20661
C
Application of head brace20662
C
Application of pelvis brace20663
C
Application of thigh brace20664
C
Halo brace application20802
C
Replantation, arm, complete20805
C
Replant, forearm, complete20808
C
Replantation hand, complete20816
C
Replantation digit, complete20822
C
Replantation digit, complete20824
C
Replantation thumb, complete20827
C
Replantation thumb, complete20838
C
Replantation foot, complete20930
C
Spinal bone allograft20931
C
Spinal bone allograft20936
C
Spinal bone autograft20937
C
Spinal bone autograft20938
C
Spinal bone autograft20955
C
Fibula bone graft, microvasc20956
C
Iliac bone graft, microvasc20957
C
Mt bone graft, microvasc20962
C
Other bone graft, microvasc20969
C
Bone/skin graft, microvasc20970
C
Bone/skin graft, iliac crest20972
C
Bone/skin graft, metatarsal20973
C
Bone/skin graft, great toe21045
C
Extensive jaw surgery21141
C
Reconstruct midface, lefort21142
C
Reconstruct midface, lefort21143
C
Reconstruct midface, lefort21145
C
Reconstruct midface, lefort21146
C
Reconstruct midface, lefort21147
C
Reconstruct midface, lefort( print page 68006)21150
C
Reconstruct midface, lefort21151
C
Reconstruct midface, lefort21154
C
Reconstruct midface, lefort21155
C
Reconstruct midface, lefort21159
C
Reconstruct midface, lefort21160
C
Reconstruct midface, lefort21172
C
Reconstruct orbit/forehead21175
C
Reconstruct orbit/forehead21179
C
Reconstruct entire forehead21180
C
Reconstruct entire forehead21182
C
Reconstruct cranial bone21183
C
Reconstruct cranial bone21184
C
Reconstruct cranial bone21188
C
Reconstruction of midface21193
C
Reconstruct lower jaw bone21194
C
Reconstruct lower jaw bone21195
C
Reconstruct lower jaw bone21196
C
Reconstruct lower jaw bone21247
C
Reconstruct lower jaw bone21255
C
Reconstruct lower jaw bone21256
C
Reconstruction of orbit21268
C
Revise eye sockets21343
C
Treatment of sinus fracture21344
C
Treatment of sinus fracture21346
C
Treat nose/jaw fracture21347
C
Treat nose/jaw fracture21348
C
Treat nose/jaw fracture21356
C
Treat cheek bone fracture21360
C
Treat cheek bone fracture21365
C
Treat cheek bone fracture21366
C
Treat cheek bone fracture21385
C
Treat eye socket fracture21386
C
Treat eye socket fracture21387
C
Treat eye socket fracture21390
C
Treat eye socket fracture21395
C
Treat eye socket fracture21408
C
Treat eye socket fracture21422
C
Treat mouth roof fracture21423
C
Treat mouth roof fracture21431
C
Treat craniofacial fracture21432
C
Treat craniofacial fracture21433
C
Treat craniofacial fracture21435
C
Treat craniofacial fracture21436
C
Treat craniofacial fracture21495
C
Treat hyoid bone fracture21510
C
Drainage of bone lesion21557
C
Remove tumor, neck/chest21615
C
Removal of rib21616
C
Removal of rib and nerves21620
C
Partial removal of sternum21627
C
Sternal debridement21630
C
Extensive sternum surgery21632
C
Extensive sternum surgery21705
C
Revision of neck muscle/rib21740
C
Reconstruction of sternum21750
C
Repair of sternum separation21810
C
Treatment of rib fracture(s)21825
C
Treat sternum fracture22100
C
Remove part of neck vertebra22101
C
Remove part, thorax vertebra22102
C
Remove part, lumbar vertebra22103
C
Remove extra spine segment22110
C
Remove part of neck vertebra22112
C
Remove part, thorax vertebra22114
C
Remove part, lumbar vertebra22116
C
Remove extra spine segment22210
C
Revision of neck spine22212
C
Revision of thorax spine22214
C
Revision of lumbar spine22216
C
Revise, extra spine segment22220
C
Revision of neck spine22222
C
Revision of thorax spine22224
C
Revision of lumbar spine22226
C
Revise, extra spine segment22318
C
Treat odontoid fx w/o graft22319
C
Treat odontoid fx w/graft22325
C
Treat spine fracture22326
C
Treat neck spine fracture22327
C
Treat thorax spine fracture22328
C
Treat each add spine fx22548
C
Neck spine fusion22554
C
Neck spine fusion22556
C
Thorax spine fusion22558
C
Lumbar spine fusion22585
C
Additional spinal fusion22590
C
Spine & skull spinal fusion22595
C
Neck spinal fusion22600
C
Neck spine fusion22610
C
Thorax spine fusion22612
C
Lumbar spine fusion22614
C
Spine fusion, extra segment22630
C
Lumbar spine fusion22632
C
Spine fusion, extra segment22800
C
Fusion of spine22802
C
Fusion of spine22804
C
Fusion of spine22808
C
Fusion of spine22810
C
Fusion of spine22812
C
Fusion of spine22818
C
Kyphectomy, 1-2 segments22819
C
Kyphectomy, 3 or more22830
C
Exploration of spinal fusion22840
C
Insert spine fixation device22841
C
Insert spine fixation device22842
C
Insert spine fixation device22843
C
Insert spine fixation device22844
C
Insert spine fixation device22845
C
Insert spine fixation device22846
C
Insert spine fixation device22847
C
Insert spine fixation device22848
C
Insert pelv fixation device22849
C
Reinsert spinal fixation22850
C
Remove spine fixation device22851
C
Apply spine prosth device22852
C
Remove spine fixation device22855
C
Remove spine fixation device23035
C
Drain shoulder bone lesion23125
C
Removal of collar bone23195
C
Removal of head of humerus23200
C
Removal of collar bone23210
C
Removal of shoulder blade23220
C
Partial removal of humerus23221
C
Partial removal of humerus23222
C
Partial removal of humerus23332
C
Remove shoulder foreign body23395
C
Muscle transfer, shoulder/arm23397
C
Muscle transfers23400
C
Fixation of shoulder blade23440
C
Remove/transplant tendon23470
C
Reconstruct shoulder joint23472
C
Reconstruct shoulder joint23900
C
Amputation of arm & girdle23920
C
Amputation at shoulder joint24149
C
Radical resection of elbow24150
C
Extensive humerus surgery24151
C
Extensive humerus surgery24152
C
Extensive radius surgery24153
C
Extensive radius surgery24900
C
Amputation of upper arm24920
C
Amputation of upper arm24930
C
Amputation follow-up surgery24931
C
Amputate upper arm & implant24940
C
Revision of upper arm25170
C
Extensive forearm surgery25390
C
Shorten radius or ulna25391
C
Lengthen radius or ulna25392
C
Shorten radius & ulna25393
C
Lengthen radius & ulna25420
C
Repair/graft radius & ulna25900
C
Amputation of forearm25905
C
Amputation of forearm25909
C
Amputation follow-up surgery25915
C
Amputation of forearm25920
C
Amputate hand at wrist25924
C
Amputation follow-up surgery25927
C
Amputation of hand25931
C
Amputation follow-up surgery26551
C
Great toe-hand transfer26553
C
Single transfer, toe-hand26554
C
Double transfer, toe-hand26556
C
Toe joint transfer26992
C
Drainage of bone lesion27005
C
Incision of hip tendon27006
C
Incision of hip tendons27025
C
Incision of hip/thigh fascia27030
C
Drainage of hip joint27035
C
Denervation of hip joint27036
C
Excision of hip joint/muscle27054
C
Removal of hip joint lining27070
C
Partial removal of hip bone27071
C
Partial removal of hip bone27075
C
Extensive hip surgery27076
C
Extensive hip surgery27077
C
Extensive hip surgery27078
C
Extensive hip surgery27079
C
Extensive hip surgery27090
C
Removal of hip prosthesis27091
C
Removal of hip prosthesis27120
C
Reconstruction of hip socket27122
C
Reconstruction of hip socket27125
C
Partial hip replacement27130
C
Total hip replacement27132
C
Total hip replacement27134
C
Revise hip joint replacement27137
C
Revise hip joint replacement27138
C
Revise hip joint replacement27140
C
Transplant femur ridge27146
C
Incision of hip bone27147
C
Revision of hip bone27151
C
Incision of hip bones27156
C
Revision of hip bones27158
C
Revision of pelvis27161
C
Incision of neck of femur27165
C
Incision/fixation of femur27170
C
Repair/graft femur head/neck27175
C
Treat slipped epiphysis27176
C
Treat slipped epiphysis27177
C
Treat slipped epiphysis27178
C
Treat slipped epiphysis27179
C
Revise head/neck of femur27181
C
Treat slipped epiphysis27185
C
Revision of femur epiphysis27187
C
Reinforce hip bones27215
C
Treat pelvic fracture(s)27216
C
Treat pelvic ring fracture27217
C
Treat pelvic ring fracture27218
C
Treat pelvic ring fracture27222
C
Treat hip socket fracture27226
C
Treat hip wall fracture27227
C
Treat hip fracture(s)27228
C
Treat hip fracture(s)27232
C
Treat thigh fracture27235
C
Treat thigh fracture( print page 68007)27236
C
Treat thigh fracture27240
C
Treat thigh fracture27244
C
Treat thigh fracture27245
C
Treat thigh fracture27248
C
Treat thigh fracture27253
C
Treat hip dislocation27254
C
Treat hip dislocation27258
C
Treat hip dislocation27259
C
Treat hip dislocation27280
C
Fusion of sacroiliac joint27282
C
Fusion of pubic bones27284
C
Fusion of hip joint27286
C
Fusion of hip joint27290
C
Amputation of leg at hip27295
C
Amputation of leg at hip27303
C
Drainage of bone lesion27365
C
Extensive leg surgery27445
C
Revision of knee joint27446
C
Revision of knee joint27447
C
Total knee replacement27448
C
Incision of thigh27450
C
Incision of thigh27454
C
Realignment of thigh bone27455
C
Realignment of knee27457
C
Realignment of knee27465
C
Shortening of thigh bone27466
C
Lengthening of thigh bone27468
C
Shorten/lengthen thighs27470
C
Repair of thigh27472
C
Repair/graft of thigh27475
C
Surgery to stop leg growth27477
C
Surgery to stop leg growth27479
C
Surgery to stop leg growth27485
C
Surgery to stop leg growth27486
C
Revise/replace knee joint27487
C
Revise/replace knee joint27488
C
Removal of knee prosthesis27495
C
Reinforce thigh27506
C
Treatment of thigh fracture27507
C
Treatment of thigh fracture27511
C
Treatment of thigh fracture27513
C
Treatment of thigh fracture27514
C
Treatment of thigh fracture27519
C
Treat thigh fx growth plate27535
C
Treat knee fracture27536
C
Treat knee fracture27540
C
Treat knee fracture27556
C
Treat knee dislocation27557
C
Treat knee dislocation27558
C
Treat knee dislocation27580
C
Fusion of knee27590
C
Amputate leg at thigh27591
C
Amputate leg at thigh27592
C
Amputate leg at thigh27596
C
Amputation follow-up surgery27598
C
Amputate lower leg at knee27645
C
Extensive lower leg surgery27646
C
Extensive lower leg surgery27702
C
Reconstruct ankle joint27703
C
Reconstruction, ankle joint27712
C
Realignment of lower leg27715
C
Revision of lower leg27720
C
Repair of tibia27722
C
Repair/graft of tibia27724
C
Repair/graft of tibia27725
C
Repair of lower leg27727
C
Repair of lower leg27880
C
Amputation of lower leg27881
C
Amputation of lower leg27882
C
Amputation of lower leg27886
C
Amputation follow-up surgery27888
C
Amputation of foot at ankle28800
C
Amputation of midfoot28805
C
Amputation thru metatarsal31225
C
Removal of upper jaw31230
C
Removal of upper jaw31290
C
Nasal/sinus endoscopy, surg31291
C
Nasal/sinus endoscopy, surg31292
C
Nasal/sinus endoscopy, surg31293
C
Nasal/sinus endoscopy, surg31294
C
Nasal/sinus endoscopy, surg31360
C
Removal of larynx31365
C
Removal of larynx31367
C
Partial removal of larynx31368
C
Partial removal of larynx31370
C
Partial removal of larynx31375
C
Partial removal of larynx31380
C
Partial removal of larynx31382
C
Partial removal of larynx31390
C
Removal of larynx & pharynx31395
C
Reconstruct larynx & pharynx31582
C
Revision of larynx31584
C
Treat larynx fracture31587
C
Revision of larynx31725
C
Clearance of airways31760
C
Repair of windpipe31766
C
Reconstruction of windpipe31770
C
Repair/graft of bronchus31775
C
Reconstruct bronchus31780
C
Reconstruct windpipe31781
C
Reconstruct windpipe31785
C
Remove windpipe lesion31786
C
Remove windpipe lesion31800
C
Repair of windpipe injury31805
C
Repair of windpipe injury32035
C
Exploration of chest32036
C
Exploration of chest32095
C
Biopsy through chest wall32100
C
Exploration/biopsy of chest32110
C
Explore/repair chest32120
C
Re-exploration of chest32124
C
Explore chest free adhesions32140
C
Removal of lung lesion(s)32141
C
Remove/treat lung lesions32150
C
Removal of lung lesion(s)32151
C
Remove lung foreign body32160
C
Open chest heart massage32200
C
Drain, open, lung lesion32201
C
Drain, percut, lung lesion32215
C
Treat chest lining32220
C
Release of lung32225
C
Partial release of lung32310
C
Removal of chest lining32320
C
Free/remove chest lining32402
C
Open biopsy chest lining32440
C
Removal of lung32442
C
Sleeve pneumonectomy32445
C
Removal of lung32480
C
Partial removal of lung32482
C
Bilobectomy32484
C
Segmentectomy32486
C
Sleeve lobectomy32488
C
Completion pneumonectomy32491
C
Lung volume reduction32500
C
Partial removal of lung32501
C
Repair bronchus add-on32520
C
Remove lung & revise chest32522
C
Remove lung & revise chest32525
C
Remove lung & revise chest32540
C
Removal of lung lesion32650
C
Thoracoscopy, surgical32651
C
Thoracoscopy, surgical32652
C
Thoracoscopy, surgical32653
C
Thoracoscopy, surgical32654
C
Thoracoscopy, surgical32655
C
Thoracoscopy, surgical32656
C
Thoracoscopy, surgical32657
C
Thoracoscopy, surgical32658
C
Thoracoscopy, surgical32659
C
Thoracoscopy, surgical32660
C
Thoracoscopy, surgical32661
C
Thoracoscopy, surgical32662
C
Thoracoscopy, surgical32663
C
Thoracoscopy, surgical32664
C
Thoracoscopy, surgical32665
C
Thoracoscopy, surgical32800
C
Repair lung hernia32810
C
Close chest after drainage32815
C
Close bronchial fistula32820
C
Reconstruct injured chest32850
C
Donor pneumonectomy32851
C
Lung transplant, single32852
C
Lung transplant with bypass32853
C
Lung transplant, double32854
C
Lung transplant with bypass32900
C
Removal of rib(s)32905
C
Revise & repair chest wall32906
C
Revise & repair chest wall32940
C
Revision of lung32997
C
Total lung lavage33015
C
Incision of heart sac33020
C
Incision of heart sac33025
C
Incision of heart sac33030
C
Partial removal of heart sac33031
C
Partial removal of heart sac33050
C
Removal of heart sac lesion33120
C
Removal of heart lesion33130
C
Removal of heart lesion33140
C
Heart revascularize (tmr)*
                                 33141
C
Heart revascularize (tmr)33200
C
Insertion of heart pacemaker33201
C
Insertion of heart pacemaker33236
C
Remove electrode/thoracotomy33237
C
Remove electrode/thoracotomy33238
C
Remove electrode/thoracotomy33243
C
Remove eltrd/thoracotomy33245
C
Insert epic eltrd pace-defib33246
C
Insert epic eltrd/generator33250
C
Ablate heart dysrhythm focus33251
C
Ablate heart dysrhythm focus33253
C
Reconstruct atria33261
C
Ablate heart dysrhythm focus33300
C
Repair of heart wound33305
C
Repair of heart wound33310
C
Exploratory heart surgery33315
C
Exploratory heart surgery33320
C
Repair major blood vessel(s)33321
C
Repair major vessel33322
C
Repair major blood vessel(s)33330
C
Insert major vessel graft33332
C
Insert major vessel graft33335
C
Insert major vessel graft33400
C
Repair of aortic valve33401
C
Valvuloplasty, open33403
C
Valvuloplasty, w/cp bypass33404
C
Prepare heart-aorta conduit33405
C
Replacement of aortic valve33406
C
Replacement of aortic valve33410
C
Replacement of aortic valve33411
C
Replacement of aortic valve( print page 68008)33412
C
Replacement of aortic valve33413
C
Replacement of aortic valve33414
C
Repair of aortic valve33415
C
Revision, subvalvular tissue33416
C
Revise ventricle muscle33417
C
Repair of aortic valve33420
C
Revision of mitral valve33422
C
Revision of mitral valve33425
C
Repair of mitral valve33426
C
Repair of mitral valve33427
C
Repair of mitral valve33430
C
Replacement of mitral valve33460
C
Revision of tricuspid valve33463
C
Valvuloplasty, tricuspid33464
C
Valvuloplasty, tricuspid33465
C
Replace tricuspid valve33468
C
Revision of tricuspid valve33470
C
Revision of pulmonary valve33471
C
Valvotomy, pulmonary valve33472
C
Revision of pulmonary valve33474
C
Revision of pulmonary valve33475
C
Replacement, pulmonary valve33476
C
Revision of heart chamber33478
C
Revision of heart chamber33496
C
Repair, prosth valve clot33500
C
Repair heart vessel fistula33501
C
Repair heart vessel fistula33502
C
Coronary artery correction33503
C
Coronary artery graft33504
C
Coronary artery graft33505
C
Repair artery w/tunnel33506
C
Repair artery, translocation33510
C
CABG, vein, single33511
C
CABG, vein, two33512
C
CABG, vein, three33513
C
CABG, vein, four33514
C
CABG, vein, five33516
C
Cabg, vein, six or more33517
C
CABG, artery-vein, single33518
C
CABG, artery-vein, two33519
C
CABG, artery-vein, three33521
C
CABG, artery-vein, four33522
C
CABG, artery-vein, five33523
C
Cabg, art-vein, six or more33530
C
Coronary artery, bypass/reop33533
C
CABG, arterial, single33534
C
CABG, arterial, two33535
C
CABG, arterial, three33536
C
Cabg, arterial, four or more33542
C
Removal of heart lesion33545
C
Repair of heart damage33572
C
Open coronary endarterectomy33600
C
Closure of valve33602
C
Closure of valve33606
C
Anastomosis/artery-aorta33608
C
Repair anomaly w/conduit33610
C
Repair by enlargement33611
C
Repair double ventricle33612
C
Repair double ventricle33615
C
Repair, simple fontan33617
C
Repair, modified fontan33619
C
Repair single ventricle33641
C
Repair heart septum defect33645
C
Revision of heart veins33647
C
Repair heart septum defects33660
C
Repair of heart defects33665
C
Repair of heart defects33670
C
Repair of heart chambers33681
C
Repair heart septum defect33684
C
Repair heart septum defect33688
C
Repair heart septum defect33690
C
Reinforce pulmonary artery33692
C
Repair of heart defects33694
C
Repair of heart defects33697
C
Repair of heart defects33702
C
Repair of heart defects33710
C
Repair of heart defects33720
C
Repair of heart defect33722
C
Repair of heart defect33730
C
Repair heart-vein defect(s)33732
C
Repair heart-vein defect33735
C
Revision of heart chamber33736
C
Revision of heart chamber33737
C
Revision of heart chamber33750
C
Major vessel shunt33755
C
Major vessel shunt33762
C
Major vessel shunt33764
C
Major vessel shunt & graft33766
C
Major vessel shunt33767
C
Major vessel shunt33770
C
Repair great vessels defect33771
C
Repair great vessels defect33774
C
Repair great vessels defect33775
C
Repair great vessels defect33776
C
Repair great vessels defect33777
C
Repair great vessels defect33778
C
Repair great vessels defect33779
C
Repair great vessels defect33780
C
Repair great vessels defect33781
C
Repair great vessels defect33786
C
Repair arterial trunk33788
C
Revision of pulmonary artery33800
C
Aortic suspension33802
C
Repair vessel defect33803
C
Repair vessel defect33813
C
Repair septal defect33814
C
Repair septal defect33820
C
Revise major vessel33822
C
Revise major vessel33824
C
Revise major vessel33840
C
Remove aorta constriction33845
C
Remove aorta constriction33851
C
Remove aorta constriction33852
C
Repair septal defect33853
C
Repair septal defect33860
C
Ascending aortic graft33861
C
Ascending aortic graft33863
C
Ascending aortic graft33870
C
Transverse aortic arch graft33875
C
Thoracic aortic graft33877
C
Thoracoabdominal graft33910
C
Remove lung artery emboli33915
C
Remove lung artery emboli33916
C
Surgery of great vessel33917
C
Repair pulmonary artery33918
C
Repair pulmonary atresia33919
C
Repair pulmonary atresia33920
C
Repair pulmonary atresia33922
C
Transect pulmonary artery33924
C
Remove pulmonary shunt33930
C
Removal of donor heart/lung33935
C
Transplantation, heart/lung33940
C
Removal of donor heart33945
C
Transplantation of heart33960
C
External circulation assist33961
C
External circulation assist33968
C
Remove aortic assist device33970
C
Aortic circulation assist33971
C
Aortic circulation assist33973
C
Insert balloon device33974
C
Remove intra-aortic balloon33975
C
Implant ventricular device33976
C
Implant ventricular device33977
C
Remove ventricular device33978
C
Remove ventricular device34001
C
Removal of artery clot34051
C
Removal of artery clot34151
C
Removal of artery clot34401
C
Removal of vein clot34451
C
Removal of vein clot34502
C
Reconstruct vena cava*
                                 34800
C
Repair abdominal aortic aneurysm*
                                 34802
C
Repair abdominal aortic aneurysm*
                                 34804
C
Repair abdominal aortic aneurysm*
                                 34808
C
Repair abdominal aortic aneurysm*
                                 34812
C
Repair abdominal aortic aneurysm*
                                 34813
C
Repair abdominal aortic aneurysm*
                                 34820
C
Repair abdominal aortic aneurysm*
                                 34825
C
Repair abdominal aortic aneurysm*
                                 34826
C
Repair abdominal aortic aneurysm*
                                 34830
C
Repair abdominal aortic aneurysm*
                                 34831
C
Repair abdominal aortic aneurysm*
                                 34832
C
Repair abdominal aortic aneurysm35001
C
Repair defect of artery35002
C
Repair artery rupture, neck35005
C
Repair defect of artery35013
C
Repair artery rupture, arm35021
C
Repair defect of artery35022
C
Repair artery rupture, chest35045
C
Repair defect of arm artery35081
C
Repair defect of artery35082
C
Repair artery rupture, aorta35091
C
Repair defect of artery35092
C
Repair artery rupture, aorta35102
C
Repair defect of artery35103
C
Repair artery rupture, groin35111
C
Repair defect of artery35112
C
Repair artery rupture,spleen35121
C
Repair defect of artery35122
C
Repair artery rupture, belly35131
C
Repair defect of artery35132
C
Repair artery rupture, groin35141
C
Repair defect of artery35142
C
Repair artery rupture, thigh35151
C
Repair defect of artery35152
C
Repair artery rupture, knee35161
C
Repair defect of artery35162
C
Repair artery rupture35182
C
Repair blood vessel lesion35189
C
Repair blood vessel lesion35211
C
Repair blood vessel lesion35216
C
Repair blood vessel lesion35221
C
Repair blood vessel lesion35241
C
Repair blood vessel lesion35246
C
Repair blood vessel lesion35251
C
Repair blood vessel lesion35271
C
Repair blood vessel lesion35276
C
Repair blood vessel lesion35281
C
Repair blood vessel lesion( print page 68009)35301
C
Rechanneling of artery35311
C
Rechanneling of artery35331
C
Rechanneling of artery35341
C
Rechanneling of artery35351
C
Rechanneling of artery35355
C
Rechanneling of artery35361
C
Rechanneling of artery35363
C
Rechanneling of artery35371
C
Rechanneling of artery35372
C
Rechanneling of artery35381
C
Rechanneling of artery35390
C
Reoperation, carotid add-on35400
C
Angioscopy35450
C
Repair arterial blockage35452
C
Repair arterial blockage35454
C
Repair arterial blockage35456
C
Repair arterial blockage35480
C
Atherectomy, open35482
C
Atherectomy, open35483
C
Atherectomy, open35501
C
Artery bypass graft35506
C
Artery bypass graft35507
C
Artery bypass graft35508
C
Artery bypass graft35509
C
Artery bypass graft35511
C
Artery bypass graft35515
C
Artery bypass graft35516
C
Artery bypass graft35518
C
Artery bypass graft35521
C
Artery bypass graft35526
C
Artery bypass graft35531
C
Artery bypass graft35533
C
Artery bypass graft35536
C
Artery bypass graft35541
C
Artery bypass graft35546
C
Artery bypass graft35548
C
Artery bypass graft35549
C
Artery bypass graft35551
C
Artery bypass graft35556
C
Artery bypass graft35558
C
Artery bypass graft35560
C
Artery bypass graft35563
C
Artery bypass graft35565
C
Artery bypass graft35566
C
Artery bypass graft35571
C
Artery bypass graft35582
C
Vein bypass graft35583
C
Vein bypass graft35585
C
Vein bypass graft35587
C
Vein bypass graft*
                                 35600
C
Harvest artery graft35601
C
Artery bypass graft35606
C
Artery bypass graft35612
C
Artery bypass graft35616
C
Artery bypass graft35621
C
Artery bypass graft35623
C
Bypass graft, not vein35626
C
Artery bypass graft35631
C
Artery bypass graft35636
C
Artery bypass graft35641
C
Artery bypass graft35642
C
Artery bypass graft35645
C
Artery bypass graft35646
C
Artery bypass graft35650
C
Artery bypass graft35651
C
Artery bypass graft35654
C
Artery bypass graft35656
C
Artery bypass graft35661
C
Artery bypass graft35663
C
Artery bypass graft35665
C
Artery bypass graft35666
C
Artery bypass graft35671
C
Artery bypass graft35681
C
Composite bypass graft35682
C
Composite bypass graft35683
C
Composite bypass graft35691
C
Arterial transposition35693
C
Arterial transposition35694
C
Arterial transposition35695
C
Arterial transposition35700
C
Reoperation, bypass graft35701
C
Exploration, carotid artery35721
C
Exploration, femoral artery35741
C
Exploration popliteal artery35800
C
Explore neck vessels35820
C
Explore chest vessels35840
C
Explore abdominal vessels35870
C
Repair vessel graft defect35901
C
Excision, graft, neck35905
C
Excision, graft, thorax35907
C
Excision, graft, abdomen36510
C
Insertion of catheter, vein36660
C
Insertion catheter, artery36822
C
Insertion of cannula(s)36823
C
Insertion of cannula(s)37140
C
Revision of circulation37145
C
Revision of circulation37160
C
Revision of circulation37180
C
Revision of circulation37181
C
Splice spleen/kidney veins37195
C
Thrombolytic therapy, stroke37616
C
Ligation of chest artery37617
C
Ligation of abdomen artery37618
C
Ligation of extremity artery37660
C
Revision of major vein37788
C
Revascularization, penis38100
C
Removal of spleen, total38101
C
Removal of spleen, partial38102
C
Removal of spleen, total38115
C
Repair of ruptured spleen38380
C
Thoracic duct procedure38381
C
Thoracic duct procedure38382
C
Thoracic duct procedure38562
C
Removal, pelvic lymph nodes38564
C
Removal, abdomen lymph nodes38700
C
Removal of lymph nodes, neck38724
C
Removal of lymph nodes, neck38746
C
Remove thoracic lymph nodes38747
C
Remove abdominal lymph nodes38765
C
Remove groin lymph nodes38770
C
Remove pelvis lymph nodes38780
C
Remove abdomen lymph nodes39000
C
Exploration of chest39010
C
Exploration of chest39200
C
Removal chest lesion39220
C
Removal chest lesion39499
C
Chest procedure39501
C
Repair diaphragm laceration39502
C
Repair paraesophageal hernia39503
C
Repair of diaphragm hernia39520
C
Repair of diaphragm hernia39530
C
Repair of diaphragm hernia39531
C
Repair of diaphragm hernia39540
C
Repair of diaphragm hernia39541
C
Repair of diaphragm hernia39545
C
Revision of diaphragm39560
C
Resect diaphragm, simple39561
C
Resect diaphragm, complex39599
C
Diaphragm surgery procedure41130
C
Partial removal of tongue41135
C
Tongue and neck surgery41140
C
Removal of tongue41145
C
Tongue removal, neck surgery41150
C
Tongue, mouth, jaw surgery41153
C
Tongue, mouth, neck surgery41155
C
Tongue, jaw, & neck surgery42426
C
Excise parotid gland/lesion42842
C
Extensive surgery of throat42845
C
Extensive surgery of throat42894
C
Revision of pharyngeal walls42953
C
Repair throat, esophagus42961
C
Control throat bleeding42971
C
Control nose/throat bleeding43030
C
Throat muscle surgery43045
C
Incision of esophagus43100
C
Excision of esophagus lesion43101
C
Excision of esophagus lesion43107
C
Removal of esophagus43108
C
Removal of esophagus43112
C
Removal of esophagus43113
C
Removal of esophagus43116
C
Partial removal of esophagus43117
C
Partial removal of esophagus43118
C
Partial removal of esophagus43121
C
Partial removal of esophagus43122
C
Parital removal of esophagus43123
C
Partial removal of esophagus43124
C
Removal of esophagus43135
C
Removal of esophagus pouch43300
C
Repair of esophagus43305
C
Repair esophagus and fistula43310
C
Repair of esophagus43312
C
Repair esophagus and fistula43320
C
Fuse esophagus & stomach43324
C
Revise esophagus & stomach43325
C
Revise esophagus & stomach43326
C
Revise esophagus & stomach43330
C
Repair of esophagus43331
C
Repair of esophagus43340
C
Fuse esophagus & intestine43341
C
Fuse esophagus & intestine43350
C
Surgical opening, esophagus43351
C
Surgical opening, esophagus43352
C
Surgical opening, esophagus43360
C
Gastrointestinal repair43361
C
Gastrointestinal repair43400
C
Ligate esophagus veins43401
C
Esophagus surgery for veins43405
C
Ligate/staple esophagus43410
C
Repair esophagus wound43415
C
Repair esophagus wound43420
C
Repair esophagus opening43425
C
Repair esophagus opening43460
C
Pressure treatment esophagus43496
C
Free jejunum flap, microvasc43500
C
Surgical opening of stomach43501
C
Surgical repair of stomach43502
C
Surgical repair of stomach43510
C
Surgical opening of stomach43520
C
Incision of pyloric muscle43605
C
Biopsy of stomach43610
C
Excision of stomach lesion43611
C
Excision of stomach lesion43620
C
Removal of stomach43621
C
Removal of stomach43622
C
Removal of stomach43631
C
Removal of stomach, partial43632
C
Removal of stomach, partial( print page 68010)43633
C
Removal of stomach, partial43634
C
Removal of stomach, partial43635
C
Removal of stomach, partial43638
C
Removal of stomach, partial43639
C
Removal of stomach, partial43640
C
Vagotomy & pylorus repair43641
C
Vagotomy & pylorus repair43800
C
Reconstruction of pylorus43810
C
Fusion of stomach and bowel43820
C
Fusion of stomach and bowel43825
C
Fusion of stomach and bowel43832
C
Place gastrostomy tube43840
C
Repair of stomach lesion43842
C
Gastroplasty for obesity43843
C
Gastroplasty for obesity43846
C
Gastric bypass for obesity43847
C
Gastric bypass for obesity43848
C
Revision gastroplasty43850
C
Revise stomach-bowel fusion43855
C
Revise stomach-bowel fusion43860
C
Revise stomach-bowel fusion43865
C
Revise stomach-bowel fusion43880
C
Repair stomach-bowel fistula44005
C
Freeing of bowel adhesion44010
C
Incision of small bowel44015
C
Insert needle cath bowel44020
C
Exploration of small bowel44021
C
Decompress small bowel44025
C
Incision of large bowel44050
C
Reduce bowel obstruction44055
C
Correct malrotation of bowel44110
C
Excision of bowel lesion(s)44111
C
Excision of bowel lesion(s)44120
C
Removal of small intestine44121
C
Removal of small intestine44125
C
Removal of small intestine*
                                 44130
C
Bowel to bowel fusion*
                                 44132
C
Donor enterectomy*
                                 44133
C
Donor enterectomy*
                                 44135
C
Intestinal allotransplantation*
                                 44136
C
Intestinal allotransplantation44139
C
Mobilization of colon44140
C
Partial removal of colon44141
C
Partial removal of colon44143
C
Partial removal of colon44144
C
Partial removal of colon44145
C
Partial removal of colon44146
C
Partial removal of colon44147
C
Partial removal of colon44150
C
Removal of colon44151
C
Removal of colon/ileostomy44152
C
Removal of colon/ileostomy44153
C
Removal of colon/ileostomy44155
C
Removal of colon/ileostomy44156
C
Removal of colon/ileostomy44160
C
Removal of colon44202
C
Laparo, resect intestine44300
C
Open bowel to skin44310
C
Ileostomy/jejunostomy44314
C
Revision of ileostomy44316
C
Devise bowel pouch44320
C
Colostomy44322
C
Colostomy with biopsies44345
C
Revision of colostomy44346
C
Revision of colostomy44602
C
Suture, small intestine44603
C
Suture, small intestine44604
C
Suture, large intestine44605
C
Repair of bowel lesion44615
C
Intestinal stricturoplasty44620
C
Repair bowel opening44625
C
Repair bowel opening44626
C
Repair bowel opening44640
C
Repair bowel-skin fistula44650
C
Repair bowel fistula44660
C
Repair bowel-bladder fistula44661
C
Repair bowel-bladder fistula44680
C
Surgical revision, intestine44700
C
Suspend bowel w/prosthesis44800
C
Excision of bowel pouch44820
C
Excision of mesentery lesion44850
C
Repair of mesentery44899
C
Bowel surgery procedure44900
C
Drain app abscess, open44901
C
Drain app abscess, percut44950
C
Appendectomy44955
C
Appendectomy add-on44960
C
Appendectomy45110
C
Removal of rectum45111
C
Partial removal of rectum45112
C
Removal of rectum45113
C
Partial proctectomy45114
C
Partial removal of rectum45116
C
Partial removal of rectum45119
C
Remove rectum w/reservoir45120
C
Removal of rectum45121
C
Removal of rectum and colon45123
C
Partial proctectomy45126
C
Pelvic exenteration45130
C
Excision of rectal prolapse45135
C
Excision of rectal prolapse45540
C
Correct rectal prolapse45541
C
Correct rectal prolapse45550
C
Repair rectum/remove sigmoid45562
C
Exploration/repair of rectum45563
C
Exploration/repair of rectum45800
C
Repair rect/bladder fistula45805
C
Repair fistula w/colostomy45820
C
Repair rectourethral fistula45825
C
Repair fistula w/colostomy46705
C
Repair of anal stricture46715
C
Repair of anovaginal fistula46716
C
Repair of anovaginal fistula46730
C
Construction of absent anus46735
C
Construction of absent anus46740
C
Construction of absent anus46742
C
Repair of imperforated anus46744
C
Repair of cloacal anomaly46746
C
Repair of cloacal anomaly46748
C
Repair of cloacal anomaly46751
C
Repair of anal sphincter47001
C
Needle biopsy, liver add-on47010
C
Open drainage, liver lesion47011
C
Percut drain, liver lesion47015
C
Inject/aspirate liver cyst47100
C
Wedge biopsy of liver47120
C
Partial removal of liver47122
C
Extensive removal of liver47125
C
Partial removal of liver47130
C
Partial removal of liver47133
C
Removal of donor liver47134
C
Partial removal, donor liver47135
C
Transplantation of liver47136
C
Transplantation of liver47300
C
Surgery for liver lesion47350
C
Repair liver wound47360
C
Repair liver wound47361
C
Repair liver wound47362
C
Repair liver wound47400
C
Incision of liver duct47420
C
Incision of bile duct47425
C
Incision of bile duct47460
C
Incise bile duct sphincter47480
C
Incision of gallbladder47490
C
Incision of gallbladder47550
C
Bile duct endoscopy add-on47570
C
Laparo cholecystoenterostomy47600
C
Removal of gallbladder47605
C
Removal of gallbladder47610
C
Removal of gallbladder47612
C
Removal of gallbladder47620
C
Removal of gallbladder47700
C
Exploration of bile ducts47701
C
Bile duct revision47711
C
Excision of bile duct tumor47712
C
Excision of bile duct tumor47715
C
Excision of bile duct cyst47716
C
Fusion of bile duct cyst47720
C
Fuse gallbladder & bowel47721
C
Fuse upper gi structures47740
C
Fuse gallbladder & bowel47741
C
Fuse gallbladder & bowel47760
C
Fuse bile ducts and bowel47765
C
Fuse liver ducts & bowel47780
C
Fuse bile ducts and bowel47785
C
Fuse bile ducts and bowel47800
C
Reconstruction of bile ducts47801
C
Placement, bile duct support47802
C
Fuse liver duct & intestine47900
C
Suture bile duct injury48000
C
Drainage of abdomen48001
C
Placement of drain, pancreas48005
C
Resect/debride pancreas48020
C
Removal of pancreatic stone48100
C
Biopsy of pancreas48120
C
Removal of pancreas lesion48140
C
Partial removal of pancreas48145
C
Partial removal of pancreas48146
C
Pancreatectomy48148
C
Removal of pancreatic duct48150
C
Partial removal of pancreas48152
C
Pancreatectomy48153
C
Pancreatectomy48154
C
Pancreatectomy48155
C
Removal of pancreas48180
C
Fuse pancreas and bowel48400
C
Injection, intraop add-on48500
C
Surgery of pancreas cyst48510
C
Drain pancreatic pseudocyst48511
C
Drain pancreatic pseudocyst48520
C
Fuse pancreas cyst and bowel48540
C
Fuse pancreas cyst and bowel48545
C
Pancreatorrhaphy48547
C
Duodenal exclusion48556
C
Removal, allograft pancreas49000
C
Exploration of abdomen49002
C
Reopening of abdomen49010
C
Exploration behind abdomen49020
C
Drain abdominal abscess49021
C
Drain abdominal abscess49040
C
Drain, open, abdom abscess49041
C
Drain, percut, abdom abscess49060
C
Drain, open, retrop abscess49061
C
Drain, percut, retroper absc49062
C
Drain to peritoneal cavity49200
C
Removal of abdominal lesion49201
C
Removal of abdominal lesion49215
C
Excise sacral spine tumor49220
C
Multiple surgery, abdomen49255
C
Removal of omentum49425
C
Insert abdomen-venous drain49428
C
Ligation of shunt49605
C
Repair umbilical lesion( print page 68011)49606
C
Repair umbilical lesion49610
C
Repair umbilical lesion49611
C
Repair umbilical lesion49900
C
Repair of abdominal wall49905
C
Omental flap49906
C
Free omental flap, microvasc50010
C
Exploration of kidney50020
C
Renal abscess, open drain50021
C
Renal abscess, percut drain50040
C
Drainage of kidney50045
C
Exploration of kidney50060
C
Removal of kidney stone50065
C
Incision of kidney50070
C
Incision of kidney50075
C
Removal of kidney stone50100
C
Revise kidney blood vessels50120
C
Exploration of kidney50125
C
Explore and drain kidney50130
C
Removal of kidney stone50135
C
Exploration of kidney50205
C
Biopsy of kidney50220
C
Removal of kidney50225
C
Removal of kidney50230
C
Removal of kidney50234
C
Removal of kidney & ureter50236
C
Removal of kidney & ureter50240
C
Partial removal of kidney50280
C
Removal of kidney lesion50290
C
Removal of kidney lesion50300
C
Removal of donor kidney50320
C
Removal of donor kidney50340
C
Removal of kidney50360
C
Transplantation of kidney50365
C
Transplantation of kidney50370
C
Remove transplanted kidney50380
C
Reimplantation of kidney50400
C
Revision of kidney/ureter50405
C
Revision of kidney/ureter50500
C
Repair of kidney wound50520
C
Close kidney-skin fistula50525
C
Repair renal-abdomen fistula50526
C
Repair renal-abdomen fistula50540
C
Revision of horseshoe kidney*
                                 50545
C
Laparoscopic nephrectomy50546
C
Laparoscopic nephrectomy50547
C
Laparo removal donor kidney50548
C
Laparo-asst remove k/ureter50570
C
Kidney endoscopy50572
C
Kidney endoscopy50574
C
Kidney endoscopy & biopsy50575
C
Kidney endoscopy50576
C
Kidney endoscopy & treatment50578
C
Renal endoscopy/radiotracer50580
C
Kidney endoscopy & treatment50600
C
Exploration of ureter50605
C
Insert ureteral support50610
C
Removal of ureter stone50620
C
Removal of ureter stone50630
C
Removal of ureter stone50650
C
Removal of ureter50660
C
Removal of ureter50700
C
Revision of ureter50715
C
Release of ureter50722
C
Release of ureter50725
C
Release/revise ureter50727
C
Revise ureter50728
C
Revise ureter50740
C
Fusion of ureter & kidney50750
C
Fusion of ureter & kidney50760
C
Fusion of ureters50770
C
Splicing of ureters50780
C
Reimplant ureter in bladder50782
C
Reimplant ureter in bladder50783
C
Reimplant ureter in bladder50785
C
Reimplant ureter in bladder50800
C
Implant ureter in bowel50810
C
Fusion of ureter & bowel50815
C
Urine shunt to bowel50820
C
Construct bowel bladder50825
C
Construct bowel bladder50830
C
Revise urine flow50840
C
Replace ureter by bowel50845
C
Appendico-vesicostomy50860
C
Transplant ureter to skin50900
C
Repair of ureter50920
C
Closure ureter/skin fistula50930
C
Closure ureter/bowel fistula50940
C
Release of ureter51060
C
Removal of ureter stone51525
C
Removal of bladder lesion51530
C
Removal of bladder lesion51535
C
Repair of ureter lesion51550
C
Partial removal of bladder51555
C
Partial removal of bladder51565
C
Revise bladder & ureter(s)51570
C
Removal of bladder51575
C
Removal of bladder & nodes51580
C
Remove bladder/revise tract51585
C
Removal of bladder & nodes51590
C
Remove bladder/revise tract51595
C
Remove bladder/revise tract51596
C
Remove bladder/create pouch51597
C
Removal of pelvic structures51800
C
Revision of bladder/urethra51820
C
Revision of urinary tract51840
C
Attach bladder/urethra51841
C
Attach bladder/urethra51845
C
Repair bladder neck51860
C
Repair of bladder wound51865
C
Repair of bladder wound51900
C
Repair bladder/vagina lesion51920
C
Close bladder-uterus fistula51925
C
Hysterectomy/bladder repair51940
C
Correction of bladder defect51960
C
Revision of bladder & bowel51980
C
Construct bladder opening53085
C
Drainage of urinary leakage53415
C
Reconstruction of urethra53443
C
Reconstruction of urethra54125
C
Removal of penis54130
C
Remove penis & nodes54135
C
Remove penis & nodes54332
C
Revise penis/urethra54336
C
Revise penis/urethra54390
C
Repair penis and bladder54430
C
Revision of penis54535
C
Extensive testis surgery54560
C
Exploration for testis54650
C
Orchiopexy (Fowler-Stephens)55600
C
Incise sperm duct pouch55605
C
Incise sperm duct pouch55650
C
Remove sperm duct pouch55801
C
Removal of prostate55810
C
Extensive prostate surgery55812
C
Extensive prostate surgery55815
C
Extensive prostate surgery55821
C
Removal of prostate55831
C
Removal of prostate55840
C
Extensive prostate surgery55842
C
Extensive prostate surgery55845
C
Extensive prostate surgery55862
C
Extensive prostate surgery55865
C
Extensive prostate surgery56630
C
Extensive vulva surgery56631
C
Extensive vulva surgery56632
C
Extensive vulva surgery56633
C
Extensive vulva surgery56634
C
Extensive vulva surgery56637
C
Extensive vulva surgery56640
C
Extensive vulva surgery57110
C
Remove vagina wall, complete57111
C
Remove vagina tissue, compl57112
C
Vaginectomy w/nodes, compl57270
C
Repair of bowel pouch57280
C
Suspension of vagina57282
C
Repair of vaginal prolapse57292
C
Construct vagina with graft57305
C
Repair rectum-vagina fistula57307
C
Fistula repair & colostomy57308
C
Fistula repair, transperine57311
C
Repair urethrovaginal lesion57335
C
Repair vagina57531
C
Removal of cervix, radical57540
C
Removal of residual cervix57545
C
Remove cervix/repair pelvis58140
C
Removal of uterus lesion58150
C
Total hysterectomy58152
C
Total hysterectomy58180
C
Partial hysterectomy58200
C
Extensive hysterectomy58210
C
Extensive hysterectomy58240
C
Removal of pelvis contents58260
C
Vaginal hysterectomy58262
C
Vaginal hysterectomy58263
C
Vaginal hysterectomy58267
C
Hysterectomy & vagina repair58270
C
Hysterectomy & vagina repair58275
C
Hysterectomy/revise vagina58280
C
Hysterectomy/revise vagina58285
C
Extensive hysterectomy58400
C
Suspension of uterus58410
C
Suspension of uterus58520
C
Repair of ruptured uterus58540
C
Revision of uterus58605
C
Division of fallopian tube58611
C
Ligate oviduct(s) add-on58700
C
Removal of fallopian tube58720
C
Removal of ovary/tube(s)58740
C
Revise fallopian tube(s)58750
C
Repair oviduct58752
C
Revise ovarian tube(s)58760
C
Remove tubal obstruction58770
C
Create new tubal opening58805
C
Drainage of ovarian cyst(s)58822
C
Drain ovary abscess, percut58823
C
Drain pelvic abscess, percut58825
C
Transposition, ovary(s)58940
C
Removal of ovary(s)58943
C
Removal of ovary(s)58950
C
Resect ovarian malignancy58951
C
Resect ovarian malignancy58952
C
Resect ovarian malignancy58960
C
Exploration of abdomen59100
C
Remove uterus lesion59120
C
Treat ectopic pregnancy59121
C
Treat ectopic pregnancy59130
C
Treat ectopic pregnancy59135
C
Treat ectopic pregnancy59136
C
Treat ectopic pregnancy59140
C
Treat ectopic pregnancy59325
C
Revision of cervix59350
C
Repair of uterus59514
C
Cesarean delivery only 
                                ( print page 68012)59525
C
Remove uterus after cesarean59620
C
Attempted vbac delivery only59830
C
Treat uterus infection59850
C
Abortion59851
C
Abortion59852
C
Abortion59855
C
Abortion59856
C
Abortion59857
C
Abortion60254
C
Extensive thyroid surgery60270
C
Removal of thyroid60271
C
Removal of thyroid60502
C
Re-explore parathyroids60505
C
Explore parathyroid glands60520
C
Removal of thymus gland60521
C
Removal of thymus gland60522
C
Removal of thymus gland60540
C
Explore adrenal gland60545
C
Explore adrenal gland60600
C
Remove carotid body lesion60605
C
Remove carotid body lesion60650
C
Laparoscopy adrenalectomy61105
C
Twist drill hole61107
C
Drill skull for implantation61108
C
Drill skull for drainage61120
C
Burr hole for puncture61140
C
Pierce skull for biopsy61150
C
Pierce skull for drainage61151
C
Pierce skull for drainage61154
C
Pierce skull & remove clot61156
C
Pierce skull for drainage61210
C
Pierce skull, implant device61250
C
Pierce skull & explore61253
C
Pierce skull & explore61304
C
Open skull for exploration61305
C
Open skull for exploration61312
C
Open skull for drainage61313
C
Open skull for drainage61314
C
Open skull for drainage61315
C
Open skull for drainage61320
C
Open skull for drainage61321
C
Open skull for drainage61332
C
Explore/biopsy eye socket61333
C
Explore orbit/remove lesion61334
C
Explore orbit/remove object61340
C
Relieve cranial pressure61343
C
Incise skull (press relief)61345
C
Relieve cranial pressure61440
C
Incise skull for surgery61450
C
Incise skull for surgery61458
C
Incise skull for brain wound61460
C
Incise skull for surgery61470
C
Incise skull for surgery61480
C
Incise skull for surgery61490
C
Incise skull for surgery61500
C
Removal of skull lesion61501
C
Remove infected skull bone61510
C
Removal of brain lesion61512
C
Remove brain lining lesion61514
C
Removal of brain abscess61516
C
Removal of brain lesion61518
C
Removal of brain lesion61519
C
Remove brain lining lesion61520
C
Removal of brain lesion61521
C
Removal of brain lesion61522
C
Removal of brain abscess61524
C
Removal of brain lesion61526
C
Removal of brain lesion61530
C
Removal of brain lesion61531
C
Implant brain electrodes61533
C
Implant brain electrodes61534
C
Removal of brain lesion61535
C
Remove brain electrodes61536
C
Removal of brain lesion61538
C
Removal of brain tissue61539
C
Removal of brain tissue61541
C
Incision of brain tissue61542
C
Removal of brain tissue61543
C
Removal of brain tissue61544
C
Remove & treat brain lesion61545
C
Excision of brain tumor61546
C
Removal of pituitary gland61548
C
Removal of pituitary gland61550
C
Release of skull seams61552
C
Release of skull seams61556
C
Incise skull/sutures61557
C
Incise skull/sutures61558
C
Excision of skull/sutures61559
C
Excision of skull/sutures61563
C
Excision of skull tumor61564
C
Excision of skull tumor61570
C
Remove foreign body, brain61571
C
Incise skull for brain wound61575
C
Skull base/brainstem surgery61576
C
Skull base/brainstem surgery61580
C
Craniofacial approach, skull61581
C
Craniofacial approach, skull61582
C
Craniofacial approach, skull61583
C
Craniofacial approach, skull61584
C
Orbitocranial approach/skull61585
C
Orbitocranial approach/skull61586
C
Resect nasopharynx, skull61590
C
Infratemporal approach/skull61591
C
Infratemporal approach/skull61592
C
Orbitocranial approach/skull61595
C
Transtemporal approach/skull61596
C
Transcochlear approach/skull61597
C
Transcondylar approach/skull61598
C
Transpetrosal approach/skull61600
C
Resect/excise cranial lesion61601
C
Resect/excise cranial lesion61605
C
Resect/excise cranial lesion61606
C
Resect/excise cranial lesion61607
C
Resect/excise cranial lesion61608
C
Resect/excise cranial lesion61609
C
Transect artery, sinus61610
C
Transect artery, sinus61611
C
Transect artery, sinus61612
C
Transect artery, sinus61613
C
Remove aneurysm, sinus61615
C
Resect/excise lesion, skull61616
C
Resect/excise lesion, skull61618
C
Repair dura61619
C
Repair dura61624
C
Occlusion/embolization cath61626
C
Occlusion/embolization cath61680
C
Intracranial vessel surgery61682
C
Intracranial vessel surgery61684
C
Intracranial vessel surgery61686
C
Intracranial vessel surgery61690
C
Intracranial vessel surgery61692
C
Intracranial vessel surgery*
                                 61697
C
Intracranial aneurysm surgery*
                                 61698
C
Intracranial aneurysm surgery61700
C
Inner skull vessel surgery61702
C
Inner skull vessel surgery61703
C
Clamp neck artery61705
C
Revise circulation to head61708
C
Revise circulation to head61710
C
Revise circulation to head61711
C
Fusion of skull arteries61720
C
Incise skull/brain surgery61735
C
Incise skull/brain surgery61750
C
Incise skull/brain biopsy61751
C
Brain biopsy w/ ct/mr guide61760
C
Implant brain electrodes61770
C
Incise skull for treatment61791
C
Treat trigeminal tract61850
C
Implant neuroelectrodes61860
C
Implant neuroelectrodes61862
C
Implant neurostimul, subcort61870
C
Implant neuroelectrodes61875
C
Implant neuroelectrodes62000
C
Treat skull fracture62005
C
Treat skull fracture62010
C
Treatment of head injury62100
C
Repair brain fluid leakage62115
C
Reduction of skull defect62116
C
Reduction of skull defect62117
C
Reduction of skull defect62120
C
Repair skull cavity lesion62121
C
Incise skull repair62140
C
Repair of skull defect62141
C
Repair of skull defect62142
C
Remove skull plate/flap62143
C
Replace skull plate/flap62145
C
Repair of skull & brain62146
C
Repair of skull with graft62147
C
Repair of skull with graft62180
C
Establish brain cavity shunt62190
C
Establish brain cavity shunt62192
C
Establish brain cavity shunt62200
C
Establish brain cavity shunt62201
C
Establish brain cavity shunt62220
C
Establish brain cavity shunt62223
C
Establish brain cavity shunt62256
C
Remove brain cavity shunt62258
C
Replace brain cavity shunt62351
C
Implant spinal canal cath63001
C
Removal of spinal lamina63003
C
Removal of spinal lamina63005
C
Removal of spinal lamina63011
C
Removal of spinal lamina63012
C
Removal of spinal lamina63015
C
Removal of spinal lamina63016
C
Removal of spinal lamina63017
C
Removal of spinal lamina63020
C
Neck spine disk surgery63030
C
Low back disk surgery63035
C
Spinal disk surgery add-on63040
C
Neck spine disk surgery63042
C
Low back disk surgery*
                                 63043
C
Repair of skull*
                                 63044
C
Repair of skull63045
C
Removal of spinal lamina63046
C
Removal of spinal lamina63047
C
Removal of spinal lamina63048
C
Remove spinal lamina add-on63055
C
Decompress spinal cord63056
C
Decompress spinal cord63057
C
Decompress spine cord add-on63064
C
Decompress spinal cord63066
C
Decompress spine cord add-on63075
C
Neck spine disk surgery63076
C
Neck spine disk surgery63077
C
Spine disk surgery, thorax63078
C
Spine disk surgery, thorax63081
C
Removal of vertebral body63082
C
Remove vertebral body add-on63085
C
Removal of vertebral body( print page 68013)63086
C
Remove vertebral body add-on63087
C
Removal of vertebral body63088
C
Remove vertebral body add-on63090
C
Removal of vertebral body63091
C
Remove vertebral body add-on63170
C
Incise spinal cord tract(s)63172
C
Drainage of spinal cyst63173
C
Drainage of spinal cyst63180
C
Revise spinal cord ligaments63182
C
Revise spinal cord ligaments63185
C
Incise spinal column/nerves63190
C
Incise spinal column/nerves63191
C
Incise spinal column/nerves63194
C
Incise spinal column & cord63195
C
Incise spinal column & cord63196
C
Incise spinal column & cord63197
C
Incise spinal column & cord63198
C
Incise spinal column & cord63199
C
Incise spinal column & cord63200
C
Release of spinal cord63250
C
Revise spinal cord vessels63251
C
Revise spinal cord vessels63252
C
Revise spinal cord vessels63265
C
Excise intraspinal lesion63266
C
Excise intraspinal lesion63267
C
Excise intraspinal lesion63268
C
Excise intraspinal lesion63270
C
Excise intraspinal lesion63271
C
Excise intraspinal lesion63272
C
Excise intraspinal lesion63273
C
Excise intraspinal lesion63275
C
Biopsy/excise spinal tumor63276
C
Biopsy/excise spinal tumor63277
C
Biopsy/excise spinal tumor63278
C
Biopsy/excise spinal tumor63280
C
Biopsy/excise spinal tumor63281
C
Biopsy/excise spinal tumor63282
C
Biopsy/excise spinal tumor63283
C
Biopsy/excise spinal tumor63285
C
Biopsy/excise spinal tumor63286
C
Biopsy/excise spinal tumor63287
C
Biopsy/excise spinal tumor63290
C
Biopsy/excise spinal tumor63300
C
Removal of vertebral body63301
C
Removal of vertebral body63302
C
Removal of vertebral body63303
C
Removal of vertebral body63304
C
Removal of vertebral body63305
C
Removal of vertebral body63306
C
Removal of vertebral body63307
C
Removal of vertebral body63308
C
Remove vertebral body add-on63655
C
Implant neuroelectrodes63700
C
Repair of spinal herniation63702
C
Repair of spinal herniation63704
C
Repair of spinal herniation63706
C
Repair of spinal herniation63707
C
Repair spinal fluid leakage63709
C
Repair spinal fluid leakage63710
C
Graft repair of spine defect63740
C
Install spinal shunt64752
C
Incision of vagus nerve64755
C
Incision of stomach nerves64760
C
Incision of vagus nerve64763
C
Incise hip/thigh nerve64766
C
Incise hip/thigh nerve64802
C
Remove sympathetic nerves64804
C
Remove sympathetic nerves64809
C
Remove sympathetic nerves64818
C
Remove sympathetic nerves64820
C
Remove sympathetic nerves64866
C
Fusion of facial/other nerve64868
C
Fusion of facial/other nerve65273
C
Repair of eye wound69150
C
Extensive ear canal surgery69155
C
Extensive ear/neck surgery69502
C
Mastoidectomy69535
C
Remove part of temporal bone69554
C
Remove ear lesion69950
C
Incise inner ear nerve69970
C
Remove inner ear lesion75900
C
Arterial catheter exchange*
                                 75952
C
Abdominal aortic aneurysm repair*
                                 75953
C
Abdominal aortic aneurysm repair92970
C
Cardioassist, internal92971
C
Cardioassist, external92975
C
Dissolve clot, heart vessel92986
C
Revision of aortic valve92987
C
Revision of mitral valve92990
C
Revision of pulmonary valve92992
C
Revision of heart chamber92993
C
Revision of heart chamber92997
C
Pul art balloon repr, percut92998
C
Pul art balloon repr, percut94652
C
Pressure breathing (IPPB)99190
C
Special pump services99191
C
Special pump services99192
C
Special pump services99251
C
Initial inpatient consult99252
C
Initial inpatient consult99253
C
Initial inpatient consult99254
C
Initial inpatient consult99255
C
Initial inpatient consult99261
C
Follow-up inpatient consult99262
C
Follow-up inpatient consult99263
C
Follow-up inpatient consult99295
C
Neonatal critical care99296
C
Neonatal critical care99297
C
Neonatal critical care99298
C
Neonatal critical care99356
C
Prolonged service, inpatient99357
C
Prolonged service, inpatient99433
C
Normal newborn care/hospitalCPT codes and descriptions only are copyright American Medical Association.  All Rights Reserved. Applicable FARS/DFARS Apply.Copyright American Dental Association.  All rights reserved.* Code is new in 2001.
 Addendum F—Wage Index for Urban Areas
Urban Area 
                                 (Constituent Counties)
Wage 
                                 Index0040 Abilene, −+*
0.8240Taylor, TX0060 Aguadilla, PR
0.4391Aguada, PRAguadilla, PRMoca, PR0080 Akron, OH
0.9736Portage, OHSummit, OH0120 Albany, GA
0.9933Dougherty, GALee, GA0160 Albany-Schenectady-Troy, NY
0.8549Albany, NYMontgomery, NYRensselaer, NYSaratoga, NYSchenectady, NYSchoharie, NY0200 Albuquerque, NM
0.9136Bernalillo, NMSandoval, NMValencia, NM0220 Alexandria, LA
0.8170Rapides, LA0240 Allentown-Bethlehem-Easton, PA
0.9925Carbon, PALehigh, PANorthampton, PA0280 Altoona, PA
0.9346Blair, PA0320 Amarillo, TX Potter, TX
0.8715Randall, TX0380 Anchorage, AK
1.2865Anchorage, AK0440 Ann Arbor, MI
1.1254Lenawee, MILivingston, MIWashtenaw, MI0450 Anniston, AL
0.8284Calhoun, AL0460 Appleton-Oshkosh-Neenah, WI
0.9052Calumet, WIOutagamie, WIWinnebago, WI0470 Arecibo, PR
0.4525Arecibo, PRCamuy, PRHatillo, PR0480 Asheville, NC
0.9516Buncombe, NCMadison, NC0500 Athens, GA
0.9739Clarke, GAMadison, GAOconee, GA0520 Atlanta, GA 1
1.0096Barrow, GABartow, GACarroll, GACherokee, GAClayton, GACobb, GACoweta, GADeKalb, GADouglas, GAFayette, GAForsyth, GAFulton, GAGwinnett, GAHenry, GANewton, GAPaulding, GAPickens, GARockdale, GASpalding, GAWalton, GA0560 Atlantic-Cape May, NJ
1.1182Atlantic, NJ( print page 68014)Cape May, NJ0580 Auburn-Opelika, AL
0.8106Lee, AL0600 Augusta-Aiken, GA-SC
0.9160Columbia, GAMcDuffie, GARichmond, GAAiken, SCEdgefield, SC0640 Austin-San Marcos, TX 1
0.9577Bastrop, TXCaldwell, TXHays, TXTravis, TXWilliamson, TX0680 Bakersfield, CA 2
0.9861Kern, CA0720 Baltimore, MD 1
0.9365Anne Arundel, MDBaltimore County, MDBaltimore City, MDCarroll, MDHarford, MDHoward, MDQueen Anne's, MD0733 Bangor, ME
0.9561Penobscot, ME0743 Barnstable-Yarmouth, MA
1.3839Barnstable, MA0760 Baton Rouge, LA
0.8842Ascension, LAEast Baton Rouge, LALivingston, LAWest Baton Rouge, LA0840 Beaumont-Port Arthur, TX
0.8744Hardin, TXJefferson, TXOrange, TX0860 Bellingham, WA
1.1439Whatcom, WA0870 Benton Harbor, MI 2
0.9021Berrien, MI0875 Bergen-Passaic, NJ 1
1.1605Bergen, NJPassaic, NJ0880 Billings, MT
0.9591Yellowstone, MT0920 Biloxi-Gulfport-Pascagoula, MS
0.8236Hancock, MSHarrison, MSJackson, MS0960 Binghamton, NY
0.8690Broome, NYTioga, NY1000 Birmingham, AL
0.8477Blount, ALJefferson, ALSt. Clair, ALShelby, AL1010 Bismarck, ND
0.7897Burleigh, NDMorton, ND1020 Bloomington, IN
0.8733Monroe, IN1040 Bloomington-Normal, IL
0.9156McLean, IL1080 Boise City, ID
0.9042Ada, IDCanyon, ID1123 Boston-Worcester-Lawrence-Lowell-Brockton, MA-NH (MA Hospitals) 1
                                , 2
1.1204Bristol, MAEssex, MAMiddlesex, MANorfolk, MAPlymouth, MASuffolk, MAWorcester, MAHillsborough, NHMerrimack, NHRockingham, NHStrafford, NH1123 Boston-Worcester-Lawrence-Lowell-Brockton, MA-NH (NH Hospitals) 1
1.1160Bristol, MAEssex, MAMiddlesex, MANorfolk, MAPlymouth, MASuffolk, MAWorcester, MAHillsborough, NHMerrimack, NHRockingham, NHStrafford, NH1125 Boulder-Longmont, CO
0.9731Boulder, CO1145 Brazoria, TX
0.8658Brazoria, TX1150 Bremerton, WA
1.0975Kitsap, WA1240 Brownsville-Harlingen-San Benito, TX
0.8722Cameron, TX1260 Bryan-College Station, TX
0.8237Brazos, TX1280 Buffalo-Niagara Falls, NY 1
0.9580Erie, NYNiagara, NY1303 Burlington, VT
1.0735Chittenden, VTFranklin, VTGrand Isle, VT1310 Caguas, PR
0.4562Caguas, PRCayey, PRCidra, PRGurabo, PRSan Lorenzo, PR1320 Canton-Massillon, OH 2
0.8670Carroll, OHStark, OH1350 Casper, WY 2
0.8817Natrona, WY1360 Cedar Rapids, IA
0.8736Linn, IA1400 Champaign-Urbana, IL
0.9198Champaign, IL1440 Charleston-North Charleston, SC
0.9067Berkeley, SCCharleston, SCDorchester, SC1480 Charleston, WV
0.9240Kanawha, WVPutnam, WV1520 Charlotte-Gastonia-Rock Hill, NC-SC 1
0.9391Cabarrus, NCGaston, NCLincoln, NCMecklenburg, NCRowan, NCStanly, NCUnion, NCYork, SC1540 Charlottesville, VA
1.0789Albemarle, VACharlottesville City, VAFluvanna, VAGreene, VA1560 Chattanooga, TN-GA
0.9833Catoosa, GADade, GAWalker, GAHamilton, TNMarion, TN1580 Cheyenne, WY 2
0.8817Laramie, WY1600 Chicago, IL 1
1.1146Cook, ILDeKalb, ILDuPage, ILGrundy, ILKane, ILKendall, ILLake, ILMcHenry, ILWill, IL1620 Chico-Paradise, CA
0.9918Butte, CA1640 Cincinnati, OH-KY-IN 1
0.9415Dearborn, INOhio, INBoone, KYCampbell, KYGallatin, KYGrant, KYKenton, KYPendleton, KYBrown, OHClermont, OHHamilton, OHWarren, OH1660 Clarksville-Hopkinsville, TN-KY
0.8277Christian, KYMontgomery, TN1680 Cleveland-Lorain-Elyria, OH 1
0.9593Ashtabula, OHCuyahoga, OHGeauga, OHLake, OHLorain, OHMedina, OH1720 Colorado Springs, CO
0.9697El Paso, CO1740 Columbia, MO
0.8961Boone, MO1760 Columbia, SC
0.9554Lexington, SCRichland, SC1800 Columbus, GA-AL Russell, AL
0.8568Chattahoochee, GAHarris, GAMuscogee, GA1840 Columbus, OH 1
0.9619Delaware, OHFairfield, OHFranklin, OHLicking, OHMadison, OHPickaway, OH1880 Corpus Christi, TX
0.8726Nueces, TXSan Patricio, TX1890 Corvallis, OR
1.1326Benton, OR1900 Cumberland, MD-WV (MD Hospitals) 2
0.8651Allegany, MDMineral, WV1900 Cumberland, MD-WV (WV Hospital)
0.8369Allegany, MDMineral, WV1920 Dallas, TX 1
0.9913Collin, TXDallas, TXDenton, TXEllis, TXHenderson, TXHunt, TXKaufman, TXRockwall, TX1950 Danville, VA
0.8589Danville City, VAPittsylvania, VA1960 Davenport-Moline-Rock Island, IA-IL
0.8898( print page 68015)Scott, IAHenry, ILRock Island, IL2000 Dayton-Springfield, OH
0.9442Clark, OHGreene, OHMiami, OHMontgomery, OH2020 Daytona Beach, FL
0.9147Flagler, FLVolusia, FL2030 Decatur, AL
0.8534Lawrence, ALMorgan, AL2040 Decatur, IL 2
0.8160Macon, IL2080 Denver, CO 1
1.0181Adams, COArapahoe, CODenver, CODouglas, COJefferson, CO2120 Des Moines, IA
0.9118Dallas, IAPolk, IAWarren, IA2160 Detroit, MI 1
1.0510Lapeer, MIMacomb, MIMonroe, MIOakland, MISt. Clair, MIWayne, MI2180 Dothan, AL
0.8013Dale, ALHouston, AL2190 Dover, DE
1.0078Kent, DE2200 Dubuque, IA
0.8746Dubuque, IA2240 Duluth-Superior, MN-WI
1.0043St. Louis, MNDouglas, WI2281 Dutchess County, NY
0.9491Dutchess, NY2290 Eau Claire, WI 2
0.8880Chippewa, WIEau Claire, WI2320 El Paso, TX
0.9346El Paso, TX2330 Elkhart-Goshen, IN
0.9145Elkhart, IN2335 Elmira, NY
0.8546Chemung, NY2340 Enid, OK
0.8610Garfield, OK2360 Erie, PA
0.8985Erie, PA2400 Eugene-Springfield, OR
1.0965Lane, OR2440 Evansville-Henderson, IN-KY (IN Hospitals) 2
0.8602Posey, INVanderburgh, INWarrick, INHenderson, KY2440 Evansville-Henderson, IN-KY (KY Hospitals)
0.8173Posey, INVanderburgh, INWarrick, INHenderson, KY2520 Fargo-Moorhead, ND-MN
0.8749Clay, MNCass, ND2560 Fayetteville, NC
0.8655Cumberland, NC2580 Fayetteville-Springdale-Rogers, AR
0.7910Benton, ARWashington, AR2620 Flagstaff, AZ-UT
1.0686Coconino, AZKane, UT2640 Flint, MI
1.1205Genesee, MI2650 Florence, AL
0.7652Colbert, ALLauderdale, AL2655 Florence, SC
0.8777Florence, SC2670 Fort Collins-Loveland, CO
1.0647Larimer, CO2680 1
                                 Ft. Lauderdale, FL
1.0152Broward, FL2700 Fort Myers-Cape Coral, FL
0.9247Lee, FL2710 Fort Pierce-Port St. Lucie, FL
0.9622Martin, FLSt. Lucie, FL2720 Fort Smith, AR-OK
0.8052Crawford, ARSebastian, ARSequoyah, OK2750 Fort Walton Beach, FL
0.9607Okaloosa, FL2760 Fort Wayne, IN
0.8665Adams, INAllen, INDe Kalb, INHuntington, INWells, INWhitley, IN2800 Forth Worth-Arlington, TX 1
0.9527Hood, TXJohnson, TXParker, TXTarrant, TX2840 Fresno, CA
1.0104Fresno, CAMadera, CA2880 Gadsden, AL
0.8423Etowah, AL2900 Gainesville, FL
1.0074Alachua, FL2920 Galveston-Texas City, TX
0.9918Galveston, TX2960 Gary, IN
0.9454Lake, INPorter, IN2975 Glens Falls, NY 2
0.8499Warren, NYWashington, NY2980 Goldsboro, NC 2
0.8441Wayne, NC2985 Grand Forks, ND-MN
0.8954Polk, MNGrand Forks, ND2995 Grand Junction, CO
0.9471Mesa, CO3000 Grand Rapids-Muskegon-Holland, MI 1
1.0248Allegan, MIKent, MIMuskegon, MIOttawa, MI3040 Great Falls, MT
0.9330Cascade, MT3060 Greeley, CO
0.9814Weld, CO3080 Green Bay, WI
0.9308Brown, WI3120 Greensboro-Winston-Salem-High Point, NC 1
0.9124Alamance, NCDavidson, NCDavie, NCForsyth, NC Guilford, NCRandolph, NCStokes, NCYadkin, NC3150 Greenville, NC
0.9384Pitt, NC3160 Greenville-Spartanburg-Anderson, SC
0.9003Anderson, SCCherokee, SCGreenville, SCPickens, SCSpartanburg, SC3180 Hagerstown, MD
0.9409Washington, MD3200 Hamilton-Middletown, OH
0.9061Butler, OH3240 Harrisburg-Lebanon-Carlisle, PA
0.9386Cumberland, PADauphin, PALebanon, PAPerry, PA3283 Hartford, CT 1
                                , 2
1.1715Hartford, CTLitchfield, CTMiddlesex, CTTolland, CT3285 Hattiesburg, MS 2
0.7491Forrest, MSLamar, MS3290 Hickory-Morganton-Lenoir, NC
0.8755Alexander, NCBurke, NCCaldwell, NCCatawba, NC3320 Honolulu, HI
1.1866Honolulu, HI3350 Houma, LA
0.8086Lafourche, LATerrebonne, LA3360 Houston, TX 1
0.9732Chambers, TXFort Bend, TXHarris, TXLiberty, TXMontgomery, TXWaller, TX3400 Huntington-Ashland, WV-KY-OH
0.9876Boyd, KYCarter, KYGreenup, KYLawrence, OHCabell, WVWayne, WV3440 Huntsville, AL
0.8932Limestone, ALMadison, AL3480 Indianapolis, IN 1
0.9787Boone, INHamilton, INHancock, INHendricks, INJohnson, INMadison, INMarion, INMorgan, INShelby, IN3500 Iowa City, IA
0.9657Johnson, IA3520 Jackson, MI
0.9134Jackson, MI3560 Jackson, MS
0.8812Hinds, MSMadison, MSRankin, MS3580 Jackson, TN
0.8796Madison, TNChester, TN3600 Jacksonville, FL 1
0.9208Clay, FLDuval, FL( print page 68016)Nassau, FLSt. Johns, FL3605 Jacksonville, NC 2
0.8441Onslow, NC3610 Jamestown, NY 2
0.8499Chautauqua, NY3620 Janesville-Beloit, WI
0.9585Rock, WI3640 Jersey City, NJ
1.1573Hudson, NJ3660 Johnson City-Kingsport-Bristol, TN-VA
0.8328Carter, TNHawkins, TNSullivan, TNUnicoi, TNWashington, TNBristol City, VAScott, VAWashington, VA3680 Johnstown, PA
0.8578Cambria, PASomerset, PA3700 Jonesboro, AR
0.7832Craighead, AR3710 Joplin, MO
0.8148Jasper, MONewton, MO3720 Kalamazoo-Battlecreek, MI
1.0453Calhoun, MIKalamazoo, MIVan Buren, MI3740 Kankakee, IL
0.9902Kankakee, IL3760 Kansas City, KS-MO 1
0.9661Johnson, KSLeavenworth, KSMiami, KSWyandotte, KSCass, MOClay, MOClinton, MOJackson, MOLafayette, MOPlatte, MORay, MO3800 Kenosha, WI
0.9611Kenosha, WI3810 Killeen-Temple, TX
1.0119Bell, TXCoryell, TX3840 Knoxville, TN
0.8340Anderson, TNBlount, TNKnox, TNLoudon, TNSevier, TNUnion, TN3850 Kokomo, IN
0.9525Howard, INTipton, IN3870 La Crosse, WI-MN
0.9211Houston, MNLa Crosse, WI3880 Lafayette, LA
0.8490Acadia, LALafayette, LASt. Landry, LASt. Martin, LA3920 Lafayette, IN
0.8834Clinton, INTippecanoe, IN3960 Lake Charles, LA 2
0.7713Calcasieu, LA3980 Lakeland-Winter Haven, FL
0.8928Polk, FL4000 Lancaster, PA
0.9259Lancaster, PA4040 Lansing-East Lansing, MI
0.9934Clinton, MIEaton, MIIngham, MI4080 Laredo, TX
0.8168Webb, TX4100 Las Cruces, NM
0.8658Dona Ana, NM4120 Las Vegas, NV-AZ 1
1.0796Mohave, AZClark, NVNye, NV4150 Lawrence, KS
0.8190Douglas, KS4200 Lawton, OK
0.8996Comanche, OK4243 Lewiston-Auburn, ME
0.9036Androscoggin, ME4280 Lexington, KY
0.8866Bourbon, KYClark, KYFayette, KYJessamine, KYMadison, KYScott, KYWoodford, KY4320 Lima, OH
0.9320Allen, OHAuglaize, OH4360 Lincoln, NE
0.9666Lancaster, NE4400 Little Rock-North Little Rock, AR
0.8906Faulkner, ARLonoke, ARPulaski, ARSaline, AR4420 Longview-Marshall, TX
0.8922Gregg, TXHarrison, TXUpshur, TX4480 Los Angeles-Long Beach, CA 1
1.2033Los Angeles, CA4520 Louisville, KY-IN
0.9350Clark, INFloyd, INHarrison, INScott, INBullitt, KYJefferson, KYOldham, KY4600 Lubbock, TX
0.8838Lubbock, TX4640 Lynchburg, VA
0.8867Amherst, VABedford, VABedford City, VACampbell, VALynchburg City, VA4680 Macon, GA
0.8974Bibb, GAHouston, GAJones, GAPeach, GATwiggs, GA4720 Madison, WI
1.0271Dane, WI4800 Mansfield, OH
0.8690Crawford, OHRichland, OH4840 Mayaguez, PR
0.4589Anasco, PRCabo Rojo, PRHormigueros, PRMayaguez, PRSabana Grande, PRSan German, PR4880 McAllen-Edinburg-Mission, TX
0.8566Hidalgo, TX4890 Medford-Ashland, OR
1.0344Jackson, OR4900 Melbourne-Titusville-Palm Bay, FL
0.9688Brevard, Fl4920 Memphis, TN-AR-MS 1
0.8723Crittenden, ARDeSoto, MSFayette, TNShelby, TNTipton, TN4940 Merced, CA 2
0.9861Merced, CA5000 Miami, FL 1
1.0059Dade, FL5015 Middlesex-Somerset-Hunterdon, NJ 1
1.0333Hunterdon, NJMiddlesex, NJSomerset, NJ5080 Milwaukee-Waukesha, WI 1
0.9767Milwaukee, WIOzaukee, WIWashington, WIWaukesha, WI5120 Minneapolis-St. Paul, MN-WI 1
1.1017Anoka, MNCarver, MNChisago, MNDakota, MNHennepin, MNIsanti, MNRamsey, MNScott, MNSherburne, MNWashington, MNWright, MNPierce, WISt. Croix, WI5140 Missoula, MT
0.9332Missoula, MT5160 Mobile, AL
0.8163Baldwin, ALMobile, AL5170 Modesto, CA
1.0396Stanislaus, CA5190 Monmouth-Ocean, NJ 1
1.1283Monmouth, NJOcean, NJ5200 Monroe, LA
0.8396Ouachita, LA5240 Montgomery, AL
0.7653Autauga, ALElmore, ALMontgomery, AL5280 Muncie, IN
1.0969Delaware, IN5330 Myrtle Beach, SC
0.8440Horry, SC5345 Naples, FL
0.9661Collier, FL5360 Nashville, TN 1
0.9490Cheatham, TNDavidson, TNDickson, TNRobertson, TNRutherford, TNSumner, TNWilliamson, TNWilson, TN5380 Nassau-Suffolk, NY 1
1.3932Nassau, NYSuffolk, NY5483 New Haven-Bridgeport-Stamford-Waterbury-Danbury, CT 1
1.2034Fairfield, CTNew Haven, CT5523 New London-Norwich, CT
1.2063New London, CT5560 New Orleans, LA 1
0.9295Jefferson, LAOrleans, LA( print page 68017)Plaquemines, LASt. Bernard, LASt. Charles, LASt. James, LASt. John The Baptist, LASt. Tammany, LA5600 New York, NY 1
1.4651Bronx, NYKings, NYNew York, NYPutnam, NYQueens, NYRichmond, NYRockland, NYWestchester, NY5640 Newark, NJ 1
1.0757Essex, NJMorris, NJSussex, NJUnion, NJWarren, NJ5660 Newburgh, NY-PA
1.0847Orange, NYPike, PA5720 Norfolk-Virginia Beach-Newport News, VA-NC 1
0.8422Currituck, NCChesapeake City, VAGloucester, VAHampton City, VAIsle of Wight, VAJames City, VAMathews, VANewport News City, VANorfolk City, VAPoquoson City, VAPortsmouth City, VASuffolk City, VAVirginia Beach City VAWilliamsburg City, VAYork, VA5775 Oakland, CA 1
1.4983Alameda, CAContra Costa, CA5790 Ocala, FL
0.9243Marion, FL5800 Odessa-Midland, TX
0.9205Ector, TXMidland, TX5880 Oklahoma City, OK 1
0.8822Canadian, OKCleveland, OKLogan, OKMcClain, OKOklahoma, OKPottawatomie, OK5910 Olympia, WA
1.0677Thurston, WA5920 Omaha, NE-IA
0.9572Pottawattamie, IACass, NEDouglas, NESarpy, NEWashington, NE5945 Orange County, CA 1
1.1411Orange, CA5960 Orlando, FL 1
0.9610Lake, FLOrange, FLOsceola, FLSeminole, FL5990 Owensboro, KY
0.8159Daviess, KY6015 Panama City, FL
0.9010Bay, FL6020 Parkersburg-Marietta, WV-OH (WV Hospitals)
0.8274Washington, OHWood, WV6020 Parkersburg-Marietta, WV-OH (OH Hospitals) 2
0.8670Washington, OHWood, WV6080 Pensacola, FL 2
0.8928Escambia, FLSanta Rosa, FL6120 Peoria-Pekin, IL
0.8646Peoria, ILTazewell, ILWoodford, IL6160 Philadelphia, PA-NJ 1
1.0937Burlington, NJCamden, NJGloucester, NJSalem, NJBucks, PAChester, PADelaware, PAMontgomery, PAPhiladelphia, PA6200 Phoenix-Mesa, AZ 1
0.9669Maricopa, AZPinal, AZ6240 Pine Bluff, AR
0.7791Jefferson, AR6280 Pittsburgh, PA 1
0.9741Allegheny, PABeaver, PAButler, PAFayette, PAWashington, PAWestmoreland, PA6323 Pittsfield, MA 2
1.1204Berkshire, MA6340 Pocatello, ID
0.9076Bannock, ID6360 Ponce, PR
0.5006Guayanilla, PRJuana Diaz, PRPenuelas, PRPonce, PRVillalba, PRYauco, PR6403 Portland, ME
0.9748Cumberland, MESagadahoc, MEYork, ME6440 Portland-Vancouver, 1
                                 OR-WA
1.0910Clackamas, ORColumbia, ORMultnomah, ORWashington, ORYamhill, ORClark, WA6483 Providence-Warwick-Pawtucket, RI 1
1.0864Bristol, RIKent, RINewport, RIProvidence, RIWashington, RI6520 Provo-Orem, UT
1.0041Utah, UT6560 Pueblo, CO 2
0.8968Pueblo, CO6580 Punta Gorda, FL
0.9613Charlotte, FL6600 Racine, WI
0.9246Racine, WI6640 Raleigh-Durham-Chapel Hill, NC 1
0.9646Chatham, NCDurham, NCFranklin, NCJohnston, NCOrange, NCWake, NC6660 Rapid City, SD
0.8865Pennington, SD6680 Reading, PA
0.9152Berks, PA690  Redding, CA
1.1664Shasta, CA6720 Reno, NV
1.0550Washoe, NV6740 Richland-Kennewick-Pasco, WA
1.1460Benton, WAFranklin, WA6760 Richmond-Petersburg, VA
0.9617Charles City County, VAChesterfield, VAColonial Heights City, VADinwiddie, VAGoochland, VAHanover, VAHenrico, VAHopewell City, VANew Kent, VAPetersburg City, VAPowhatan, VAPrince George, VARichmond City, VA6780 Riverside-San Bernardino, CA 1
1.1115Riverside, CASan Bernardino, CA6800 Roanoke, VA
0.8782Botetourt, VARoanoke, VARoanoke City, VASalem City, VA6820 Rochester, MN
1.1315Olmsted, MN6840 Rochester, NY 1
0.9182Genesee, NYLivingston, NYMonroe, NYOntario, NYOrleans, NYWayne, NY6880 Rockford, IL
0.8819Boone, ILOgle, ILWinnebago, IL6895 Rocky Mount, NC
0.8849Edgecombe, NCNash, NC6920 Sacramento, CA 1
1.1957El Dorado, CAPlacer, CASacramento, CA6960 Saginaw-Bay City-Midland, MI
0.9575Bay, MIMidland, MISaginaw, MI6980 St. Cloud, MN
1.0016Benton, MNStearns, MN7000 St. Joseph, MO
0.9071Andrew, MOBuchanan, MO7040 St. Louis, MO-IL 1
0.9049Clinton, ILJersey, ILMadison, ILMonroe, ILSt. Clair, ILFranklin, MOJefferson, MOLincoln, MOSt. Charles, MOSt. Louis, MOSt. Louis City, MOWarren, MO7080 Salem, OR
1.0132Marion, ORPolk, OR7120 Salinas, CA
1.4502Monterey, CA7160 Salt Lake City-Ogden, UT 1
0.9811( print page 68018)Davis, UTSalt Lake, UTWeber, UT7200 San Angelo, TX
0.8083Tom Green, TX7240 San Antonio, TX 1
0.8580Bexar, TXComal, TXGuadalupe, TXWilson, TX7320 San Diego, CA 1
1.1784San Diego, CA7360 San Francisco, CA 1
1.4193Marin, CASan Francisco, CASan Mateo, CA7400 San Jose, CA 1
1.3564Santa Clara, CA7440 San Juan-Bayamon, PR 1
0.4690Aguas Buenas, PRBarceloneta, PRBayamon, PRCanovanas, PRCarolina, PRCatano, PRCeiba, PRComerio, PRCorozal, PRDorado, PRFajardo, PRFlorida, PRGuaynabo, PRHumacao, PRJuncos, PRLos Piedras, PRLoiza, PRLuguillo, PRManati, PRMorovis, PRNaguabo, PRNaranjito, PRRio Grande, PRSan Juan, PRToa Alta, PRToa Baja, PRTrujillo Alto, PRVega Alta, PRVega Baja, PRYabucoa, PR7460 San Luis Obispo-Atascadero-Paso Robles, CA
1.0673San Luis Obispo, CA7480 Santa Barbara-Santa Maria-Lompoc, CA
1.0597Santa Barbara, CA7485 Santa Cruz-Watsonville, CA
1.4095Santa Cruz, CA7490 Santa Fe, NM
1.0537Los Alamos, NMSanta Fe, NM7500 Santa Rosa, CA
1.2646Sonoma, CA7510 Sarasota-Bradenton, FL
0.9809Manatee, FLSarasota, FL7520 Savannah, GA
0.9697Bryan, GAChatham, GAEffingham, GA7560 Scranton-Wilkes-Barre-Hazleton, PA 2
0.8578Columbia, PALackawanna, PALuzerne, PAWyoming, PA7600 Seattle-Bellevue-Everett, WA 1
1.1016Island, WAKing, WASnohomish, WA7610 Sharon, PA 2
0.8578Mercer, PA7620 Sheboygan, WI 2
0.8880Sheboygan, WI7640 Sherman-Denison, TX
0.8795Grayson, TX7680 Shreveport-Bossier City, LA
0.8750Bossier, LACaddo, LAWebster, LA7720 Sioux City, IA-NE
0.8473Woodbury, IADakota, NE7760 Sioux Falls, SD
0.8790Lincoln, SDMinnehaha, SD7800 South Bend, IN
1.0029St. Joseph, IN7840 Spokane, WA
1.0513Spokane, WA7880 Springfield, IL
0.8685Menard, ILSangamon, IL7920 Springfield, MO
0.8488Christian, MOGreene, MOWebster, MO8003 Springfield, MA 2
1.1204Hampden, MAHampshire, MA8050 State College, PA
0.9038Centre, PA8080 Steubenville-Weirton, OH-WV 2
                                 (OH Hospitals)
0.8670Jefferson, OHBrooke, WVHancock, WV8080 Steubenville-Weirton, OH-WV (WV Hospitals)
0.8548Jefferson, OHBrooke, WVHancock, WV8120 Stockton-Lodi, CA
1.0629San Joaquin, CA8140 Sumter, SC 2
0.8370Sumter, SC8160 Syracuse, NY
0.9594Cayuga, NYMadison, NYOnondaga, NYOswego, NY8200 Tacoma, WA
1.1564Pierce, WA8240 Tallahassee, FL 2
0.8928Gadsden, FLLeon, FL8280 Tampa-St. Petersburg-Clearwater, FL 1
0.9099Hernando, FLHillsborough, FLPasco, FLPinellas, FL8320 Terre Haute, IN 2
0.8602Clay, INVermillion, INVigo, IN8360 Texarkana, AR-Texarkana, TX
0.8427Miller, ARBowie, TX8400 Toledo, OH
0.9664Fulton, OHLucas, OHWood, OH8440 Topeka, KS
0.9117Shawnee, KS8480 Trenton, NJ
1.0137Mercer, NJ8520 Tucson, AZ
0.8821Pima, AZ8560 Tulsa, OK
0.8454Creek, OKOsage, OKRogers, OKTulsa, OKWagoner, OK8600 Tuscaloosa, AL
0.8064Tuscaloosa, AL8640 Tyler, TX
0.9404Smith, TX8680 Utica-Rome, NY
0.8560Herkimer, NYOneida, NY8720 Vallejo-Fairfield-Napa, CA
1.2266Napa, CASolano, CA8735 Ventura, CA
1.0479Ventura, CA8750 Victoria, TX
0.8154Victoria, TX8760 Vineland-Millville-Bridgeton, NJ
1.0501Cumberland, NJ8780 Visalia-Tulare-Porterville, CA 2
0.9861Tulare, CA8800 Waco, TX
0.8314McLennan, TX8840 Washington, DC-MD-VA-WV 1
1.0755District of Columbia, DCCalvert, MDCharles, MDFrederick, MDMontgomery, MDPrince Georges, MDAlexandria City, VAArlington, VAClarke, VACulpeper, VAFairfax, VAFairfax City, VAFalls Church City, VAFauquier, VAFredericksburg City, VAKing George, VALoudoun, VAManassas City, VAManassas Park City, VAPrince William, VASpotsylvania, VAStafford, VAWarren, VABerkeley, WVJefferson, WV8920 Waterloo-Cedar Falls, IA
0.8802Black Hawk, IA8940 Wausau, WI
0.9426Marathon, WI8960 1
                                 West Palm Beach-Boca Raton, FL
0.9615Palm Beach, FL9000 Wheeling, WV-OH 2
                                 (WV Hospitals)
0.8231Belmont, OHMarshall, WVOhio, WV9000 Wheeling, WV-OH 2
                                 (OH Hospitals)
0.8670Belmont, OHMarshall, WVOhio, WV9040 Wichita, KS
0.9544Butler, KSHarvey, KSSedgwick, KS9080 Wichita Falls, TX
0.7668Archer, TXWichita, TX9140 Williamsport, PA 2
0.8578Lycoming, PA9160 Wilmington-Newark, DE-MD
1.1191New Castle, DECecil, MD9200 Wilmington, NC
0.9402( print page 68019)New Hanover, NCBrunswick, NC9260 Yakima, WA 2
1.0434Yakima, WA9270 Yolo, CA
1.0199Yolo, CA9280 York, PA
0.9264York, PA9320 Youngstown-Warren, OH
0.9543Columbiana, OHMahoning, OHTrumbull, OH9340 Yuba City, CA
1.0706Sutter, CAYuba, CA9360 Yuma, AZ
0.9529Yuma, AZ1
                             Large Urban Area2
                             Hospitals geographically located in the area are assigned the statewide rural wage index for FY 2001.
 Addendum G—Wage Index for Rural Areas
Nonurban area
DWage indexAlabama
0.7528Alaska
1.2392Arizona
0.8317Arkansas
0.7445California
0.9861Colorado
0.8968Connecticut
1.1715Delaware
0.9074Florida
0.8928Georgia
0.8329Hawaii
1.1059Idaho
0.8678Illinois
0.8160Indiana
0.8602Iowa
0.8030Kansas
0.7605Kentucky
0.7931Louisiana
0.7713Maine
0.8766Maryland
0.8651Massachusetts
1.1204Michigan
0.9021Minnesota
0.8881Mississippi
0.7491Missouri
0.7707Montana
0.8688Nebraska
0.8109Nevada
0.9232New Hampshire
0.9845New Jersey 1New Mexico
0.8497New York
0.8499North Carolina
0.8441North Dakota
0.7716Ohio
0.8670Oklahoma
0.7491Oregon
1.0132Pennsylvania
0.8578Puerto Rico
0.4264Rhode Island 1South Carolina
0.8370South Dakota
0.7570Tennessee
0.7838Texas
0.7507Utah
0.9037Vermont
0.9409Virginia
0.8189Washington
1.0434West Virginia
0.8231Wisconsin
0.8880Wyoming
0.88171
                             All counties within the State are classified as urban.
 Addendum H—Wage Index for Hospitals That Are Reclassified
Area
Wage 
                                 IndexAbilene, TX
0.8240Akron, OH
0.9736Alexandria, LA
0.8170Amarillo, TX
0.8715Anchorage, AK
1.2865Ann Arbor, MI
1.1064Atlanta, GA
1.0096Atlantic-Cape May, NJ
1.0822Augusta-Aiken, GA-SC
0.9160Barnstable-Yarmouth, MA
1.3583Baton Rouge, LA
0.8734Benton Harbor, MI
0.9021Bergen-Passaic, NJ
1.1605Billings, MT
0.9591Binghamton, NY
0.8690Birmingham, AL
0.8477Bismarck, ND
0.7897Bloomington-Normal, IL
0.9156Boise City, ID
0.9042Boston-Worcester-Lawrence-Lowell-Brockton, MA-NH (NH, RI, and VT Hospitals)
1.1160Burlington, VT
1.0236Casper, WY
0.8817Champaign-Urbana, IL
0.9084Charleston-North Charleston, SC
0.9067Charleston, WV
0.8904Charlotte-Gastonia-Rock Hill, NC-SC
0.9391Chattanooga, TN-GA
0.9624Chicago, IL
1.1015Cincinnati, OH-KY-IN
0.9415Clarksville-Hopkinsville, TN-KY
0.8277Cleveland-Lorain-Elyria, OH
0.9593Columbia, MO
0.8756Columbia, SC
0.9433Columbus, OH
0.9619Dallas, TX
0.9913Danville, VA
0.8212Davenport-Moline-Rock Island, IA-IL
0.8898Dayton-Springfield, OH
0.9442Denver, CO
1.0181Des Moines, IA
0.9011Dothan, AL
0.8013Dover, DE
0.9769Duluth-Superior, MN-WI
1.0043Eau Claire, WI
0.8880Erie, PA
0.8985Eugene-Springfield, OR
1.0965Fargo-Moorhead, ND-MN
0.8517Fayetteville, NC
0.8469Flagstaff, AZ-UT
1.0525Flint, MI
1.1058Florence, AL
0.7652Florence, SC
0.8777Fort Collins-Loveland, CO
1.0647Ft. Lauderdale, FL
1.0152Fort Pierce-Port St. Lucie, FL
0.9622Fort Smith, AR-OK
0.7947Fort Walton Beach, FL
0.9358Fort Wayne, IN
0.8665Forth Worth-Arlington, TX
0.9527Gadsden, AL
0.8423Grand Forks, ND-MN
0.8954Grand Junction, CO
0.9471Grand Rapids-Muskegon-Holland, MI
1.0248Great Falls, MT
0.9330Greeley, CO
0.9573Green Bay, WI
0.9308Greensboro-Winston-Salem-High Point, NC
0.9124Greenville, NC
0.9172Greenville-Spartanburg-Anderson, SC
0.9003Harrisburg-Lebanon-Carlisle, PA
0.9386Hartford, CT (MA Hospital)
1.1420Hattiesburg, MS
0.7491Hickory-Morganton-Lenoir, NC
0.8577Honolulu, HI
1.1866Houston, TX
0.9732Huntington-Ashland, WV-KY-OH
0.9605Huntsville, AL
0.8779Indianapolis, IN
0.9787Jackson, MS
0.8698Jackson, TN
0.8796Jacksonville, FL
0.9208Jersey City, NJ
1.1573Johnson City-Kingsport-Bristol, TN-VA
0.8328Joplin, MO
0.8148Kalamazoo-Battlecreek, MI
1.0291Kansas City, KS-MO
0.9509Knoxville, TN
0.8340Kokomo, IN
0.9525Lafayette, LA
0.8490Lansing-East Lansing, MI
0.9934Las Cruces, NM
0.8510Las Vegas, NV-AZ
1.0796Lexington, KY
0.8712Lima, OH
0.9320Lincoln, NE
0.9666Little Rock-North Little Rock, AR
0.8791Longview-Marshall, TX
0.8732Los Angeles-Long Beach, CA
1.2033Louisville, KY-IN
0.9350Lynchburg, VA
0.8749Macon, GA
0.8974Madison, WI
1.0271Mansfield, OH
0.8690Memphis, TN-AR-MS
0.8584Milwaukee-Waukesha, WI
0.9767Minneapolis-St. Paul, MN-WI
1.1017Missoula, MT
0.9332Mobile, AL
0.8163Monmouth-Ocean, NJ
1.1283Montgomery, AL
0.7653Myrtle Beach, SC (NC Hospital)
0.8441Nashville, TN
0.9301New Haven-Bridgeport-Stamford-Waterbury-Danbury, CT
1.2034New London-Norwich, CT
1.1926New Orleans, LA
0.9295New York, NY
1.4463Newburgh, NY-PA
1.0317Norfolk-Virginia Beach-Newport News, VA-NC
0.8441Oakland, CA
1.4983Ocala, FL
0.9243Odessa-Midland, TX
0.9074Oklahoma City, OK
0.8822Omaha, NE-IA
0.9572Orange County, CA
1.1411Orlando, FL
0.9610Peoria-Pekin, IL
0.8646Philadelphia, PA-NJ
1.0937Pine Bluff, AR
0.7680Pittsburgh, PA
0.9575Pittsfield, MA (VT Hospital)
0.9914Pocatello, ID
0.8715Portland, ME
0.9629Portland-Vancouver, OR-WA
1.0910Provo-Orem, UT
1.0041Raleigh-Durham-Chapel Hill, NC
0.9646Rapid City, SD
0.8865Redding, CA
1.1664Reno, NV
1.0438Richland-Kennewick-Pasco, WA
1.1147Roanoke, VA
0.8782Rochester, MN
1.1315Rockford, IL
0.8819Sacramento, CA
1.1957( print page 68020)Saginaw-Bay City-Midland, MI
0.9575St. Cloud, MN
1.0016St. Joseph, MO
0.8848St. Louis, MO-IL
0.9049Salinas, CA
1.4502Salt Lake City-Ogden, UT
0.9811San Diego, CA
1.1784Santa Cruz-Watsonville, CA
1.3897Santa Fe, NM
1.0000Santa Rosa, CA
1.2398Seattle-Bellevue-Everett, WA
1.1016Sherman-Denison, TX
0.8795Sioux City, IA-NE
0.8473South Bend, IN
1.0029Spokane, WA
1.0333Springfield, IL
0.8685Springfield, MO
0.8212Syracuse, NY
0.9594Tampa-St. Petersburg-Clearwater, FL
0.9099Texarkana, AR-Texarkana, TX
0.8427Toledo, OH
0.9664Topeka, KS
0.9117Tucson, AZ
0.8821Tulsa, OK
0.8454Tuscaloosa, AL
0.8064Tyler, TX
0.9141Victoria, TX
0.8154Washington, DC-MD-VA-WV
1.0755Waterloo-Cedar Falls, IA
0.8802Wausau, WI
0.9426Wichita, KS
0.9262Rural Alabama
0.7528Rural Florida
0.8928Rural Illinois
0.8160Rural Louisiana
0.7713Rural Michigan
0.9021Rural Minnesota
0.8881Rural Missouri
0.7707Rural Montana
0.8688Rural Oregon
1.0132Rural Texas
0.7507Rural Washington
1.0434Rural West Virginia
0.8231Rural Wisconsin
0.8880Rural Wyoming (NE Hospital)
0.8671


[FR Doc. 00-28475 Filed 11-2-00; 11:43 am] BILLING  CODE 4120-01-P