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 Department of Health and Human Services Centers for Medicare & Medicaid Services 42 CFR Parts 419 and 485
[CMS–1501–CN]
RIN 0938–AN46
 AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
 ACTION: Proposed rule; correction.
 SUMMARY: This document corrects technical errors that appeared in the proposed rule published in the 
                            **Federal Register**
                             on July 25, 2005 entitled “Medicare Program; Proposed Changes to the Hospital Outpatient Prospective Payment System and Calendar Year 2006 Payment Rates; Proposed Rule.”
 FOR FURTHER INFORMATION CONTACT: Rebecca Kane, (410) 786–0378.


SUPPLEMENTARY INFORMATION:  I. Background FR Doc. 05–14448 contains our proposed rule to update the Medicare Outpatient Prospective Payment System for calendar year (CY) 2006. We have identified a number of technical errors in the “Summary of Errors” section and are correcting them in the “Correction of Errors” section below. II. Summary of Errors A. Corrections Related to the Rural Adjustment Calculation The calendar year (CY) 2006 Outpatient Prospective Payment System (OPPS) proposed rule that we published in the 
                        **Federal Register**
                         on July 25, 2005 included a proposed 6.6 percent adjustment for rural sole community hospitals. The calculations used to develop the conversion factor and budget neutrality scalar inadvertently incorporated this adjustment as 6.4 percent. The rural adjustment is used in calculations that determine the scalar and conversion factor, and therefore affects the payment rates and copayment amounts published in the proposed rule. The corrected scalar is 1.003753831, and the corrected conversion factor is $59.343. The various changes to the preamble are specified under section III. of this correction notice. In addition to preamble text changes, we are correcting specific tables and addenda which also reflected the inadvertent use of a 6.4 percent rural adjustment factor, which we have described below. On page 42709, we published Table 11. We are correcting the last column of this table to present the corrected proposed CY 2006 payment amounts. In section III. of this notice, we republish Table 11 as corrected. On pages 42761–42762, we published Table 33. In section III. of this notice, we republish Table 33 as corrected. On pages 42764–42775, we published Addendum A, which provides the payment rates and copayment amounts for Ambulatory Payment Classification (APC) groups used for payment purposes under the OPPS. A corrected Addendum A is posted on the OPPS Web site at 
                        *http://www.cms.hhs.gov/​providers/​hopps/​2006p/​1501p.asp.* On pages 42776–42965, we published Addendum B, which provides the payment rates and copayment amounts for services payable under OPPS. A corrected Addendum B, including additional technical errors affecting HCPCS codes 78814, 78815, 78816, 91035, and 95950 is posted on the OPPS Web site at 
                        *http://www.cms.hhs.gov/​providers/​hopps/​2006p/​1501p.asp.* We are posting the corrected Addendum A and Addendum B on our Web site rather than publishing them in this notice because of the large volume of data included in these addenda. Hard copies of these tables are available by contacting the CMS staff member identified above. We note that as soon as we discovered these inadvertent errors that affected the payment rates noted in the proposed rule, we posted the corrections on the CMS Web site at: 
                        *http://www.cms.hhs.gov/​providers/​hopps/​2006p/​1501p.asp.* B. Other Corrections We also noted other typographical, formatting, and other technical errors in the proposed rule. On page 42714, we published Table 15. The proposed “unadjusted” and “adjusted” CY 2006 APC median cost for APC 0085 Level II Electrophysiologic Evaluation contained a typographical error and should read $2,123.38. We are correcting this under section III. of this notice. On page 42761, column 2 includes a comparison that discusses the differences in copayments from CY 2005 to CY 2006. While the analysis of this example is correct, the example incorrectly identifies the comparison as being the “minimum unadjusted copayment” rather than the “national unadjusted copayment”. We are making this correction under section III. of this notice to refer to the “national unadjusted copayment”. On page 42737, we published Table 26, which inadvertently excluded C2636 (Brachytherapy linear source, Palladium –103, per 1 mm) which was accurately described in the text of page 42736 as a proposed separately payable brachytherapy source. In section III. of the notice we append the excluded row to correct table 26 as published. The other technical, typographical, formatting, and other errors that appeared on various other pages of the 
                        **Federal Register**
                         are corrected as noted in section III. of this notice. III. Correction of Errors In FR Doc. 05–14448 of July 25, 2005 (70 FR 42674), make the following corrections: 1. On page 42690, in column 3, in the last paragraph, in line 20, the figure “0.999207669” is corrected to read “1.003753831”. 2. On page 42691, in column 1, in the second full paragraph, line 8, the year “2006” is corrected to read “2007”. 3. On page 42694, a. In column 1, in the second full paragraph, in line 8, the figure “$240.51” is corrected to read “$241.57”. b. In column 1, in the second full paragraph, in line 8, the figure “$48.10” is corrected to read “$48.31”. c. In column 3, in the third full paragraph, in line 8, the figure “1.002015212” is corrected to read “1.002023412”. d. In column 3, in the third full paragraph, in line 18, the figure “0.99652023” is corrected to read “0.99639633”. e. In column 3, in the last partial paragraph, in line 5, the figure “1.002015212” is corrected to read “1.002023412”. 4. On page 42695, a. In column 1, in the first partial paragraph, in line 5, the figure “0.99652023” is corrected to read “0.99639633”. b. In column 1, in the first partial paragraph, in line 7, the figure “$59.350” is corrected to read “$59.343”. 5. On page 42703, a. In column 1, in the second full paragraph, in line 5, the figure “$9.95” is corrected to read “$7.00”. b. In column 1, in the second full paragraph, in line 5, the figure “40” is corrected to read “28”. c. In column 1, in the second full paragraph, in line 6, the figure “$24.89” is corrected to read “$25.00”. 6. On page 42709,
                        ( print page 50681) a. In column 1, in the first full paragraph, in line 22, the figure “$1,297” is corrected to read “$1,274”. b. In column 1, in the first full paragraph, in line 23, the figure “$1,366” is corrected to read “$1,244”. c. In column 1, in the first full paragraph, in line 25, the figure “$1,100” is corrected to read “$1,025”. d. Table 11 is corrected to read as follows: Table 11.—Proposed APC Reassignment of New Technology Procedures Into Clinical APCs for CY 2006
HCPCS
Descriptor
CY 2005 APC
CY 2005 status 
                                 indicator
Proposed CY 2006 APC
Proposed CY 2006 status 
                                 indicator
CY 2005 payment amount
Proposed CY 2006 payment amount0027T
Endoscopic epidural lysis
1547
T
0220
T
$850
$1,030.1133225
L ventric pacing lead add-on
1525
S
0418
T
3,750
6,486.4561623
Endovasc tempory vessel occl
1555
T
0081
T
1,650
2,044.2192974
Cath place, cardio brachytx
1559
T
0103
T
2,250
873.1893580
Transcath closure of asd
1559
T
0434
T
2,250
5,387.6193581
Transcath closure of vsd
1559
T
0434
T
2,250
5,387.6195965
Meg, spontaneous
1528
S
0430
T
5,250
676.7595966
Meg, evoked, single
1516
S
0430
T
1,450
676.7595967
Meg, evoked, each add'l
1511
S
0430
T
950
676.75C9713
Non-contact laser vap prosta
1525
S
0429
T
3,750
2,511.08
 7. On page 42710, in column 2, in the first full paragraph, in line 19, the figure “$93.71” is corrected to read “$93.37”. 8. On page 42714, Table 15, APC 0085, in columns 5 and 7, in row 7, both occurrences of the figure “$2,123.46” are corrected to read “$2,123.38”. 9. On page 42737, Table 26, “Proposed Separately payable Brachytherapy Sources for CY 2006” is appended with the following row: HCPCS
Long descriptor
APC
APC title
New status indicatorC2636
Brachytherapy linear source, Palladium–103, per 1mm
2636
Brachytx linear source, P–103
H
 10. On page 42756, in column 1, in the first partial paragraph, in line 5, the figure “1.8” is corrected to read “1.7”. 11. On page 42758, in column 2, in the third full paragraph, in line 13, the figure “$59.35” is corrected to read “$59.34”. 12. On page 42759, a. In column 1, in the first partial paragraph, in line 21, the figure “5.8” is corrected to read “5.6”. b. In column 1, in the first partial paragraph, in line 31, the figure “1.2” is corrected to read “1.3”. c. In column 1, in the first partial paragraph, in line 31, the figure “1.8” is corrected to read “1.7”. d. In column 1, in the first partial paragraph, in line 36, the figure “2.6” is corrected to read “2.5”. e. In column 1, in the second partial paragraph, in line 22, the figure “2.9” is corrected to read “2.7”. f. In column 1, in the second partial paragraph, in line 25, the figure “0.7” is corrected to read “0.6”. g. In column 1, in the second partial paragraph, in line 30, the text “West South Central” is corrected to read “New England”. h. In column 2, in the first partial paragraph, in line 2, the figure “1.9” is corrected to read “1.7”. i. In column 2, in the first partial paragraph, in line 2, the figure “1.8” is corrected to read “1.6”. j. In column 2, in the first full paragraph, in line 4, the figure “0.4” is corrected to read “0.3”. k. In column 2, in the first full paragraph, in line 5, the figure “0.5” is corrected to read “0.3”. l. In column 2, in the first full paragraph, in line 9, the figure “0.9” is corrected to read “1.6”. m. In column 2, in the first full paragraph, in line 10, the figure “1.4” is corrected to read “2.2”. n. In column 2, in the first full paragraph, in line 21, the sentence portion “1.3 percent and voluntary and government hospitals will gain at least 0.1 percent.” is corrected to read “1.1 percent, voluntary hospitals would gain 0.2 percent, and government hospitals will see no changes as a result of changes to APC structure.” o. In column 3, in the second full paragraph, in line 7, the figure “0.997” is corrected to read “0.996”. p. In column 3, in the second full paragraph, in line 10, the figure “0.3” is corrected to read “0.4”. q. In column 3, in the second full paragraph, in line 13, the figure “5.2” is corrected to read “5.4”. 13. On page 42760, a. In column 1, in the first partial paragraph, in line 6, the figure “0.3” is corrected to read “0.4”. b. In column 1, in the first full paragraph, in line 19, the figure “5.8” is corrected to read “5.6”. c. In column 1, in the first full paragraph, in line 24, the figure “–2.8” is corrected to read “–2.4”. d. In column 1, in the first full paragraph, in line 32, the figure “1.2” is corrected to read “1.3”. e. In column 1, in the first full paragraph, in line 35, the figure “0.3” is corrected to read “0.4”. f. In column 1, in the first full paragraph, in line 37, the figure “1.5” is corrected to read “1.4”. g. In column 1, in the last paragraph, in line 7, the figure “8.6” is corrected to read “8.7”. h. In column 1, in the third partial paragraph, in line 12, the figure “5.0” is corrected to read “4.7”. i. In column 3, in the first partial paragraph, in line 6, the figure “2.6” is corrected to read “2.5”. j. In column 3, in the first partial paragraph, in line 12, the figure “2.1” is corrected to read “1.8”. k. In column 3, in the first partial paragraph, in line 32, the figure “3.7” is corrected to read “3.6”.
                        ( print page 50682) l. In column 3, in the first full paragraph, in line 11, the figure “3.4” is corrected to read “3.5”. m. In column 3, in the first full paragraph, in line 13, the figure “6.4” is corrected to read “6.5”. n. In column 3, in the first full paragraph, in line 30, the text “greater than” is corrected to read “of at least”. o. In column 3, in the first full paragraph, in lines 33 and 34, the figure “only 1.0” is corrected to read “1.4” and the text “and 0.8 percent, respectively.” is appended to the end of the sentence. 14. On page 42761 a. In column 1, in the first partial paragraph, in line 3, the figure “1.9” is corrected to read “2.6”. b. In column 1, in the first partial paragraph, in line 6, the figure “2.6” is corrected to read “3.4”. c. In column 1, in the first partial paragraph, in line 11, the figure “0.8” is corrected to read “0.6”. d. In column 1, in line 12, the designation for the heading “Estimated Impacts of This Proposed Rule on Beneficiaries” is corrected from “G” to read “F”. e. In column 1, in the second partial paragraph, in line 12, the figure “$11.86” is corrected to read “$11.91”. f. In column 2, in the first partial paragraph, in lines 4 and 6, the term “minimum” is corrected to read “national”. g. In column 2, in the first partial paragraph, in line 8, the figure “$223.91” is corrected to read “$224.91”. h. Table 33 is corrected to read as follows: Table 33.—Impact of Proposed Changes for CY 2006 Hospital Outpatient Prospective Payment System
Hospital category
Number of 
                                 hospitals
APC changes
New wage index
New adj for rural sole community hospitals
Cumulative (Cols 2,3,4) with market basket update
All changes(1)
(2)
(3)
(4)
(5)
(6)ALL HOSPITALS
4212
0.0
0.0
0.0
3.2
1.9URBAN HOSPITALS
2949
0.0
0.0
−0.4
2.8
1.6LARGE URBAN
1624
−0.8
0.0
−0.4
2.0
0.8OTHER URBAN
1325
1.0
0.0
−0.4
3.8
2.5RURAL HOSPITALS
1263
−0.1
0.1
1.8
5.0
3.5SOLE COMMUNITY
478
−0.1
0.0
5.4
8.7
6.5OTHER RURAL
785
−0.1
0.1
−0.4
2.8
1.6BEDS (URBAN):0–99 BEDS
917
0.0
0.2
−0.4
3.0
2.1100–199 BEDS
964
−0.4
0.0
−0.4
2.5
1.5200–299 BEDS
503
0.2
0.1
−0.4
3.2
2.4300–499 BEDS
402
−0.1
−0.1
−0.4
2.6
1.5500 + BEDS
163
0.3
0.0
−0.4
3.1
1.0BEDS (RURAL):0–49 BEDS
551
−0.9
0.2
2.1
4.6
3.150–100 BEDS
419
−0.8
0.2
2.3
4.8
3.0101–149 BEDS
180
1.4
0.0
1.1
5.8
4.7150–199 BEDS
62
−0.2
−0.2
1.8
4.7
3.7200 + BEDS
51
0.1
0.0
1.7
5.1
3.1VOLUME (URBAN):LT 5,000 claim lines
600
−5.6
0.5
−0.4
−2.4
−1.85,000–10,999
180
−2.4
0.2
−0.4
0.5
0.611,000–20,999
299
−0.6
0.2
−0.4
2.4
2.521,000–42,999
575
−0.6
0.1
−0.4
2.3
1.9GT 42,999
1295
0.2
0.0
−0.4
3.0
1.6VOLUME (RURAL):LT 5,000 claim lines
119
−2.7
0.0
1.4
1.7
1.45,000–10,999
195
−1.9
0.0
2.1
3.4
2.411,000–20,999
325
−0.9
−0.1
2.0
4.3
3.421,000–42,999
364
−0.9
0.2
1.9
4.5
3.0GT 42,999
260
0.6
0.0
1.7
5.7
3.8REGION (URBAN):NEW ENGLAND
166
−1.3
−0.1
−0.4
1.4
−0.2MIDDLE ATLANTIC
393
0.6
−0.1
−0.4
3.4
2.1SOUTH ATLANTIC
453
−0.4
−0.4
−0.4
2.0
1.0EAST NORTH CENT
466
0.4
−0.1
−0.4
3.2
1.7EAST SOUTH CENT
197
1.5
0.0
−0.4
4.4
3.4WEST NORTH CENT
184
2.5
−0.3
−0.4
5.1
3.6WEST SOUTH CENT
445
−0.3
−0.1
−0.4
2.5
1.3MOUNTAIN
163
−0.1
−0.2
−0.4
2.5
1.3PACIFIC
431
−1.7
1.1
−0.4
2.2
1.4PUERTO RICO
51
0.4
−0.3
−0.4
2.9
2.2REGION (RURAL):NEW ENGLAND
37
−1.1
0.9
1.2
4.2
0.8MIDDLE ATLANTIC
78
1.7
−0.4
1.4
6.0
4.1SOUTH ATLANTIC
189
−0.4
−0.2
1.7
4.4
3.3EAST NORTH CENT
171
−0.6
0.1
1.4
4.1
2.2EAST SOUTH CENT
202
−0.7
0.5
0.5
3.5
3.0WEST NORTH CENT
188
1.6
−0.3
2.6
7.2
4.7( print page 50683)WEST SOUTH CENT
242
−0.9
−0.2
2.2
4.4
3.7MOUNTAIN
95
−1.0
0.1
4.6
7.0
5.2PACIFIC
61
−0.7
1.8
2.7
7.2
5.3TEACHING STATUS:NON-TEACHING
3115
−0.3
0.1
0.3
3.2
2.3MINOR
769
0.3
0.0
−0.2
3.3
2.3MAJOR
328
0.3
−0.2
−0.3
3.0
0.6DSH PATIENT PERCENT:0
16
0.3
0.0
−0.4
3.1
3.1GT 0–0.10
386
0.1
−0.2
−0.3
2.8
1.70.10–0.16
555
0.0
0.1
0.2
3.5
2.40.16–0.23
802
0.1
0.0
0.1
3.5
2.30.23–0.35
977
0.1
−0.1
0.0
3.2
1.9GE 0.35
792
−0.3
0.1
−0.1
3.0
1.8TEFRA: DSH NOT AVAIL 1
684
−1.6
0.0
−0.4
1.2
−2.6URBAN TEACHING/DSH:TEACHING & DSH
944
0.4
−0.1
−0.4
3.1
1.7NO TEACHING/DSH
1401
−0.3
0.1
−0.4
2.5
1.8NO TEACHING/NO DSH
16
0.3
0.0
−0.4
3.1
3.1TEFRA: DSH NOT AVAIL 1
588
−2.2
0.1
−0.4
0.7
−3.4TYPE OF OWNERSHIP:VOLUNTARY
2397
0.2
0.0
0.0
3.3
2.0PROPRIETARY
1091
−1.1
0.0
0.0
2.1
1.6GOVERNMENT
724
0.0
0.1
0.2
3.6
1.7Col (1) Total Hospitals in 2006.Col (2) This column shows the impact of changes resulting from the reclassification of HCPCS codes among APC groups and from the addition of multiple procedure discounting for radiology procedures (budget neutral overall).Col (3) This column shows the adjustment for updating the wage index (budget neutral overall).Col (4) This column shows the adjustment for rural sole community hospitals (budget neutral overall).Col (5) This column shows the cumulative impact of cols 2 through 4 and the addition of the market basket update.Col (6) The column shows the impact of the change in MMA dollars in 2006 (drugs and 508) and outlier changes.1
                             Complete DSH numbers are not available for hospitals that are not paid under IPPS.
 15. On pages 42764–42775, Addendum A is corrected to read as follows: 
 
 Addendum A.—List of Ambulatory Payment Classifications (APCs) with Status Indicators, Relative Weights, Payment Rates, and Copayment Amounts Calendar Year 2006
APC
Group title
SI
Relative weight
Payment rate
National unadjusted copayment
Minimum unadjusted copayment0001
Level I Photochemotherapy
S
0.4213
$25.00
$7.00
$5.000002
Level I Fine Needle Biopsy/Aspiration
T
0.9559
$56.73

$11.350003
Bone Marrow Biopsy/Aspiration
T
2.6530
$157.44

$31.490004
Level I Needle Biopsy/ Aspiration Except Bone Marrow
T
1.7646
$104.72
$22.36
$20.940005
Level II Needle Biopsy/Aspiration Except Bone Marrow
T
3.5994
$213.60
$71.59
$42.720006
Level I Incision & Drainage
T
1.5500
$91.98
$22.28
$18.400007
Level II Incision & Drainage
T
11.4501
$679.48

$135.900008
Level III Incision and Drainage
T
16.4989
$979.09

$195.820009
Nail Procedures
T
0.6680
$39.64
$8.34
$7.930010
Level I Destruction of Lesion
T
0.5719
$33.94
$9.65
$6.790011
Level II Destruction of Lesion
T
2.0839
$123.66
$25.17
$24.730012
Level I Debridement & Destruction
T
0.8497
$50.42
$11.18
$10.080013
Level II Debridement & Destruction
T
1.1078
$65.74
$14.20
$13.150015
Level III Debridement & Destruction
T
1.6514
$98.00
$20.29
$19.600016
Level IV Debridement & Destruction
T
2.5834
$153.31
$33.57
$30.660017
Level VI Debridement & Destruction
T
18.4211
$1,093.16
$227.84
$218.630018
Biopsy of Skin/Puncture of Lesion
T
1.1726
$69.59
$16.04
$13.920019
Level I Excision/ Biopsy
T
4.0547
$240.62
$71.87
$48.120020
Level II Excision/ Biopsy
T
6.9433
$412.04
$107.40
$82.410021
Level III Excision/ Biopsy
T
14.9776
$888.82
$219.48
$177.760022
Level IV Excision/ Biopsy
T
19.6472
$1,165.92
$354.45
$233.180023
Exploration Penetrating Wound
T
4.7775
$283.51

$56.700024
Level I Skin Repair
T
1.6084
$95.45
$31.25
$19.090025
Level II Skin Repair
T
5.4938
$326.02
$101.85
$65.200027
Level IV Skin Repair
T
18.4182
$1,092.99
$329.72
$218.600028
Level I Breast Surgery
T
19.5801
$1,161.94
$303.74
$232.390029
Level II Breast Surgery
T
32.0476
$1,901.80
$632.64
$380.360030
Level III Breast Surgery
T
40.0825
$2,378.62
$763.55
$475.720033
Partial Hospitalization
P
4.0708
$241.57

$48.310035
Venous Cutdown
T
0.7158
$42.48

$8.500036
Level II Fine Needle Biopsy/Aspiration
T
2.1773
$129.21

$25.840037
Level IV Needle Biopsy/Aspiration Except Bone Marrow
T
9.4751
$562.28
$224.91
$112.460039
Level I Implantation of Neurostimulator
S
181.4000
$10,764.82

$2,152.960040
Level I Implantation of Neurostimulator Electrodes
S
55.3297
$3,283.43

$656.690041
Level I Arthroscopy
T
28.1318
$1,669.43

$333.890042
Level II Arthroscopy
T
43.9753
$2,609.63
$804.74
$521.930043
Closed Treatment Fracture Finger/Toe/Trunk
T
1.7694
$105.00

$21.000045
Bone/Joint Manipulation Under Anesthesia
T
14.4945
$860.15
$268.47
$172.030046
Open/Percutaneous Treatment Fracture or Dislocation
T
37.7023
$2,237.37
$535.76
$447.470047
Arthroplasty without Prosthesis
T
31.6107
$1,875.87
$537.03
$375.170048
Level I Arthroplasty with Prosthesis
T
43.1288
$2,559.39
$570.30
$511.880049
Level I Musculoskeletal Procedures Except Hand and Foot
T
20.3707
$1,208.86

$241.770050
Level II Musculoskeletal Procedures Except Hand and Foot
T
23.9081
$1,418.78

$283.760051
Level III Musculoskeletal Procedures Except Hand and Foot
T
36.5271
$2,167.63

$433.530052
Level IV Musculoskeletal Procedures Except Hand and Foot
T
43.9378
$2,607.40

$521.480053
Level I Hand Musculoskeletal Procedures
T
15.6795
$930.47
$253.49
$186.090054
Level II Hand Musculoskeletal Procedures
T
25.3711
$1,505.60

$301.120055
Level I Foot Musculoskeletal Procedures
T
20.0692
$1,190.97
$355.34
$238.190056
Level II Foot Musculoskeletal Procedures
T
40.2957
$2,391.27

$478.250057
Bunion Procedures
T
27.5493
$1,634.86
$475.91
$326.970058
Level I Strapping and Cast Application
S
1.0934
$64.89

$12.980060
Manipulation Therapy
S
0.4935
$29.29

$5.860068
CPAP Initiation
S
1.2293
$72.95
$29.18
$14.590069
Thoracoscopy
T
30.6775
$1,820.49
$591.64
$364.100070
Thoracentesis/Lavage Procedures
T
3.2101
$190.50

$38.100071
Level I Endoscopy Upper Airway
T
0.7915
$46.97
$11.31
$9.390072
Level II Endoscopy Upper Airway
T
1.4361
$85.22
$21.27
$17.040074
Level IV Endoscopy Upper Airway
T
15.7757
$936.18
$295.70
$187.240075
Level V Endoscopy Upper Airway
T
21.3426
$1,266.53
$445.92
$253.310076
Level I Endoscopy Lower Airway
T
9.4592
$561.34
$189.82
$112.270077
Level I Pulmonary Treatment
S
0.3444
$20.44
$7.74
$4.090078
Level II Pulmonary Treatment
S
1.0236
$60.74
$14.55
$12.150079
Ventilation Initiation and Management
S
2.3482
$139.35

$27.870080
Diagnostic Cardiac Catheterization
T
37.1361
$2,203.77
$838.92
$440.750081
Non-Coronary Angioplasty or Atherectomy
T
34.4473
$2,044.21

$408.840082
Coronary Atherectomy
T
85.0126
$5,044.90
$1,085.20
$1,008.980083
Coronary Angioplasty and Percutaneous Valvuloplasty
T
50.8925
$3,020.11

$604.020084
Level I Electrophysiologic Evaluation
S
10.0205
$594.65

$118.930085
Level II Electrophysiologic Evaluation
T
35.1882
$2,088.17
$426.25
$417.63( print page 50685)0086
Ablate Heart Dysrhythm Focus
T
44.2596
$2,626.50
$833.33
$525.300087
Cardiac Electrophysiologic Recording/Mapping
T
30.7101
$1,822.43

$364.490088
Thrombectomy
T
36.5617
$2,169.68
$655.22
$433.940089
Insertion/Replacement of Permanent Pacemaker and Electrodes
T
105.6143
$6,267.47
$1,682.28
$1,253.490090
Insertion/Replacement of Pacemaker Pulse Generator
T
89.1574
$5,290.87
$1,612.80
$1,058.170091
Level II Vascular Ligation
T
28.9999
$1,720.94
$348.23
$344.190092
Level I Vascular Ligation
T
23.4516
$1,391.69

$278.340093
Vascular Reconstruction/Fistula Repair without Device0094
Level I Resuscitation and Cardioversion
S
2.5363
$150.51
$47.62
$30.100095
Cardiac Rehabilitation
S
0.5885
$34.92
$13.96
$6.980096
Non-Invasive Vascular Studies
S
1.6307
$96.77
$38.70
$19.350097
Cardiac and Ambulatory Blood Pressure Monitoring
X
1.0223
$60.67
$23.79
$12.130098
Injection of Sclerosing Solution
T
1.1346
$67.33

$13.470099
Electrocardiograms
S
0.3821
$22.67

$4.530100
Cardiac Stress Tests
X
2.4968
$148.17
$41.44
$29.630101
Tilt Table Evaluation
S
4.2787
$253.91
$101.56
$50.780103
Miscellaneous Vascular Procedures
T
14.7142
$873.18
$223.63
$174.640104
Transcatheter Placement of Intracoronary Stents
T
79.0094
$4,688.65

$937.730105
Revision/Removal of Pacemakers, AICD, or Vascular
T
22.3685
$1,327.41
$370.40
$265.480106
Insertion/Replacement/Repair of Pacemaker and/or Electrodes
T
45.4851
$2,699.22

$539.840107
Insertion of Cardioverter-Defibrillator
T
260.0295
$15,430.93
$3,103.22
$3,086.190108
Insertion/Replacement/Repair of Cardioverter-Defibrillator Leads
T
349.1681
$20,720.68

$4,144.140109
Removal of Implanted Devices
T
11.0433
$655.34
$131.49
$131.070110
Transfusion
S
3.6594
$217.16

$43.430111
Blood Product Exchange
S
12.3956
$735.59
$200.18
$147.120112
Apheresis, Photopheresis, and Plasmapheresis
S
26.7948
$1,590.08
$438.94
$318.020113
Excision Lymphatic System
T
21.4653
$1,273.82

$254.760114
Thyroid/Lymphadenectomy Procedures
T
40.7652
$2,419.13
$485.91
$483.830115
Cannula/Access Device Procedures
T
31.4727
$1,867.68
$459.35
$373.540116
Chemotherapy Administration by Other Technique Except Infusion
S
1.1453
$67.97

$13.590117
Chemotherapy Administration by Infusion Only
S
3.2378
$192.14
$42.54
$38.430120
Infusion Therapy Except Chemotherapy
S
2.0193
$119.83
$28.21
$23.970121
Level I Tube changes and Repositioning
T
2.2766
$135.10
$43.80
$27.020122
Level II Tube changes and Repositioning
T
6.9721
$413.75
$84.85
$82.750123
Bone Marrow Harvesting and Bone Marrow/Stem Cell Transplant
S
22.9902
$1,364.31

$272.860125
Refilling of Infusion Pump
T
1.9331
$114.72

$22.940130
Level I Laparoscopy
T
31.9271
$1,894.65
$659.53
$378.930131
Level II Laparoscopy
T
43.3389
$2,571.86
$1,001.89
$514.370132
Level III Laparoscopy
T
62.9914
$3,738.10
$1,239.22
$747.620140
Esophageal Dilation without Endoscopy
T
5.4737
$324.83
$94.18
$64.970141
Level I Upper GI Procedures
T
8.1835
$485.63
$143.38
$97.130142
Small Intestine Endoscopy
T
9.3487
$554.78
$152.78
$110.960143
Lower GI Endoscopy
T
8.6869
$515.51
$186.06
$103.100146
Level I Sigmoidoscopy and Anoscopy
T
4.6374
$275.20
$64.40
$55.040147
Level II Sigmoidoscopy and Anoscopy
T
7.9679
$472.84

$94.570148
Level I Anal/Rectal Procedures
T
3.7383
$221.84
$57.21
$44.370149
Level III Anal/Rectal Procedures
T
18.0726
$1,072.48
$293.06
$214.500150
Level IV Anal/Rectal Procedures
T
23.8654
$1,416.24
$437.12
$283.250151
Endoscopic Retrograde Cholangio-Pancreatography (ERCP)
T
18.7338
$1,111.72
$245.46
$222.340152
Level I Percutaneous Abdominal and Biliary Procedures
T
12.2833
$728.93

$145.790153
Peritoneal and Abdominal Procedures
T
21.6961
$1,287.51
$382.75
$257.500154
Hernia/Hydrocele Procedures
T
28.7847
$1,708.17
$464.85
$341.630155
Level II Anal/Rectal Procedures
T
16.2546
$964.60

$192.920156
Level II Urinary and Anal Procedures
T
2.5751
$152.81
$40.52
$30.560157
Colorectal Cancer Screening: Barium Enema
S
2.2904
$135.92

$27.180158
Colorectal Cancer Screening: Colonoscopy
T
7.6588
$454.50

$113.630159
Colorectal Cancer Screening: Flexible Sigmoidoscopy
S
3.1455
$186.66

$46.670160
Level I Cystourethroscopy and other Genitourinary Procedures
T
6.6753
$396.13
$105.06
$79.230161
Level II Cystourethroscopy and other Genitourinary Procedures
T
18.5576
$1,101.26
$249.36
$220.250162
Level III Cystourethroscopy and other Genitourinary Procedures
T
23.3918
$1,388.14

$277.630163
Level IV Cystourethroscopy and other Genitourinary Procedures
T
33.7354
$2,001.96

$400.390164
Level I Urinary and Anal Procedures
T
1.1855
$70.35
$17.29
$14.07( print page 50686)0165
Level III Urinary and Anal Procedures
T
16.6689
$989.18

$197.840166
Level I Urethral Procedures
T
17.6743
$1,048.85
$218.73
$209.770168
Level II Urethral Procedures
T
28.2685
$1,677.54
$388.03
$335.510169
Lithotripsy
T
43.0133
$2,552.54
$1,021.01
$510.510170
Dialysis
S
5.8994
$350.09

$70.020180
Circumcision
T
19.8827
$1,179.90
$304.87
$235.980181
Penile Procedures
T
30.8663
$1,831.70
$621.82
$366.340183
Testes/Epididymis Procedures
T
23.6415
$1,402.96

$280.590184
Prostate Biopsy
T
4.3566
$258.53
$96.27
$51.710188
Level II Female Reproductive Proc
T
1.1400
$67.65

$13.530189
Level III Female Reproductive Proc
T
2.3710
$140.70

$28.140190
Level I Hysteroscopy
T
21.0653
$1,250.08
$424.28
$250.020191
Level I Female Reproductive Proc
T
0.1670
$9.91
$2.78
$1.980192
Level IV Female Reproductive Proc
T
4.3082
$255.66

$51.130193
Level V Female Reproductive Proc
T
14.5843
$865.48

$173.100194
Level VIII Female Reproductive Proc
T
20.7525
$1,231.52
$397.84
$246.300195
Level IX Female Reproductive Proc
T
26.6791
$1,583.22
$483.80
$316.640196
Dilation and Curettage
T
17.0974
$1,014.61
$338.23
$202.920197
Infertility Procedures
T
2.3572
$139.88

$27.980198
Pregnancy and Neonatal Care Procedures
T
1.3683
$81.20
$32.19
$16.240200
Level VII Female Reproductive Proc
T
17.8728
$1,060.63
$263.69
$212.130201
Level VI Female Reproductive Proc
T
17.6047
$1,044.72
$329.65
$208.940202
Level X Female Reproductive Proc
T
40.3866
$2,396.66
$958.66
$479.330203
Level IV Nerve Injections
T
10.4015
$617.26
$246.90
$123.450204
Level I Nerve Injections
T
2.1910
$130.02
$40.13
$26.000206
Level II Nerve Injections
T
5.4920
$325.91
$75.55
$65.180207
Level III Nerve Injections
T
6.0109
$356.70
$86.92
$71.340208
Laminotomies and Laminectomies
T
42.3409
$2,512.64

$502.530209
Extended EEG Studies and Sleep Studies, Level II
S
11.5713
$686.68
$274.67
$137.340212
Nervous System Injections
T
2.9740
$176.49
$70.59
$35.300213
Extended EEG Studies and Sleep Studies, Level I
S
2.2932
$136.09
$54.43
$27.220214
Electroencephalogram
S
1.1353
$67.37
$26.94
$13.470215
Level I Nerve and Muscle Tests
S
0.6115
$36.29
$14.51
$7.260216
Level III Nerve and Muscle Tests
S
2.6720
$158.56

$31.710218
Level II Nerve and Muscle Tests
S
1.1408
$67.70

$13.540220
Level I Nerve Procedures
T
17.3586
$1,030.11

$206.020221
Level II Nerve Procedures
T
29.9209
$1,775.60
$463.62
$355.120222
Implantation of Neurological Device
T
179.0982
$10,628.22

$2,125.640223
Implantation or Revision of Pain Management Catheter
T
28.1230
$1,668.90

$333.780224
Implantation of Reservoir/Pump/Shunt
T
40.6455
$2,412.03

$482.410225
Level II Implantation of Neurostimulator Electrodes
S
234.6925
$13,927.36

$2,785.470226
Implantation of Drug Infusion Reservoir
T
138.8695
$8,240.93

$1,648.190227
Implantation of Drug Infusion Device
T
136.4922
$8,099.86

$1,619.970228
Creation of Lumbar Subarachnoid Shunt
T
51.7258
$3,069.56

$613.910229
Transcatherter Placement of Intravascular Shunts
T
64.4545
$3,824.92
$771.23
$764.980230
Level I Eye Tests & Treatments
S
0.7858
$46.63
$14.97
$9.330231
Level III Eye Tests & Treatments
S
1.9278
$114.40
$44.61
$22.880232
Level I Anterior Segment Eye Procedures
T
6.6732
$396.01
$103.17
$79.200233
Level II Anterior Segment Eye Procedures
T
14.9673
$888.20
$266.33
$177.640234
Level III Anterior Segment Eye Procedures
T
21.9741
$1,304.01
$511.31
$260.800235
Level I Posterior Segment Eye Procedures
T
4.6593
$276.50
$67.40
$55.300236
Level II Posterior Segment Eye Procedures
T
17.0229
$1,010.19

$202.040237
Level III Posterior Segment Eye Procedures
T
28.9401
$1,717.39

$343.480238
Level I Repair and Plastic Eye Procedures
T
2.5933
$153.89

$30.780239
Level II Repair and Plastic Eye Procedures
T
6.9097
$410.04

$82.010240
Level III Repair and Plastic Eye Procedures
T
18.1508
$1,077.12
$315.31
$215.420241
Level IV Repair and Plastic Eye Procedures
T
23.3036
$1,382.91
$384.47
$276.580242
Level V Repair and Plastic Eye Procedures
T
30.5464
$1,812.72
$597.36
$362.540243
Strabismus/Muscle Procedures
T
22.1671
$1,315.46
$431.39
$263.090244
Corneal Transplant
T
38.3723
$2,277.13
$803.26
$455.430245
Level I Cataract Procedures without IOL Insert
T
13.3625
$792.97
$221.89
$158.590246
Cataract Procedures with IOL Insert
T
23.4597
$1,392.17
$495.96
$278.430247
Laser Eye Procedures Except Retinal
T
5.0330
$298.67
$104.31
$59.730248
Laser Retinal Procedures
T
4.6769
$277.54
$93.98
$55.510249
Level II Cataract Procedures without IOL Insert
T
27.9369
$1,657.86
$524.67
$331.570250
Nasal Cauterization/Packing
T
1.2896
$76.53
$26.79
$15.310251
Level I ENT Procedures
T
2.0101
$119.29

$23.860252
Level II ENT Procedures
T
7.8673
$466.87
$113.41
$93.370253
Level III ENT Procedures
T
16.1357
$957.54
$282.29
$191.51( print page 50687)0254
Level IV ENT Procedures
T
23.4040
$1,388.86
$321.35
$277.770256
Level V ENT Procedures
T
37.3204
$2,214.70

$442.940258
Tonsil and Adenoid Procedures
T
22.2466
$1,320.18
$437.25
$264.040259
Level VI ENT Procedures
T
366.3317
$21,739.22
$8,070.21
$4,347.840260
Level I Plain Film Except Teeth
X
0.7555
$44.83
$17.93
$8.970261
Level II Plain Film Except Teeth Including Bone Density Measurement
X
1.2901
$76.56

$15.310262
Plain Film of Teeth
X
0.9228
$54.76

$10.950263
Level I Miscellaneous Radiology Procedures
X
1.7476
$103.71
$24.40
$20.740264
Level II Miscellaneous Radiology Procedures
X
3.5240
$209.12
$79.41
$41.820265
Level I Diagnostic Ultrasound
S
1.0213
$60.61
$24.24
$12.120266
Level II Diagnostic Ultrasound
S
1.6393
$97.28
$38.91
$19.460267
Level III Diagnostic Ultrasound
S
2.6327
$156.23
$62.18
$31.250268
Ultrasound Guidance Procedures
S
1.0610
$62.96

$12.590269
Level III Echocardiogram Except Transesophageal
S
3.2437
$192.49
$76.99
$38.500270
Transesophageal Echocardiogram
S
6.0192
$357.20
$142.88
$71.440272
Level I Fluoroscopy
X
1.3801
$81.90
$32.76
$16.380274
Myelography
S
3.0413
$180.48
$72.19
$36.100275
Arthrography
S
3.5779
$212.32
$69.09
$42.460276
Level I Digestive Radiology
S
1.5319
$90.91
$36.36
$18.180277
Level II Digestive Radiology
S
2.3852
$141.54
$56.61
$28.310278
Diagnostic Urography
S
2.6434
$156.87
$62.74
$31.370279
Level II Angiography and Venography except Extremity
S
8.9319
$530.05
$150.03
$106.010280
Level III Angiography and Venography except Extremity
S
20.7902
$1,233.75
$353.85
$246.750282
Miscellaneous Computerized Axial Tomography
S
1.6542
$98.17
$39.26
$19.630283
Computerized Axial Tomography with Contrast Material
S
4.4253
$262.61
$105.04
$52.520284
Magnetic Resonance Imaging and Magnetic Resonance Angiography with Contras
S
6.4201
$380.99
$152.39
$76.200285
Myocardial Positron Emission Tomography (PET)
S
17.1798
$1,019.50
$318.72
$203.900288
Bone Density: Axial Skeleton
S
1.2568
$74.58

$14.920296
Level I Therapeutic Radiologic Procedures
S
2.2452
$133.24
$53.29
$26.650297
Level II Therapeutic Radiologic Procedures
S
5.2530
$311.73
$122.13
$62.350299
Miscellaneous Radiation Treatment
S
5.8482
$347.05

$69.410300
Level I Radiation Therapy
S
1.5198
$90.19

$18.040301
Level II Radiation Therapy
S
2.2195
$131.71

$26.340302
Level III Radiation Therapy
S
4.6145
$273.84
$103.74
$54.770303
Treatment Device Construction
X
2.8356
$168.27
$66.95
$33.650304
Level I Therapeutic Radiation Treatment Preparation
X
1.7738
$105.26
$41.52
$21.050305
Level II Therapeutic Radiation Treatment Preparation
X
4.0036
$237.59
$91.38
$47.520310
Level III Therapeutic Radiation Treatment Preparation
X
13.9490
$827.78
$325.27
$165.560312
Radioelement Applications
S
5.0032
$296.90

$59.380313
Brachytherapy
S
12.8655
$763.48

$152.700314
Hyperthermic Therapies
S
5.9945
$355.73
$98.36
$71.150315
Level II Implantation of Neurostimulator
T
290.6470
$17,247.86

$3,449.570320
Electroconvulsive Therapy
S
5.3765
$319.06
$80.06
$63.810321
Biofeedback and Other Training
S
1.3579
$80.58
$21.71
$16.120322
Brief Individual Psychotherapy
S
1.2319
$73.10

$14.620323
Extended Individual Psychotherapy
S
1.6227
$96.30
$20.08
$19.260324
Family Psychotherapy
S
2.0997
$124.60

$24.920325
Group Psychotherapy
S
1.3189
$78.27
$17.10
$15.650330
Dental Procedures
S
7.1756
$425.82

$85.160332
Computerized Axial Tomography and Computerized Angiography without Contras
S
3.2694
$194.02
$77.60
$38.800333
Computerized Axial Tomography and Computerized Angio w/o Contrast Material
S
5.2836
$313.54
$125.41
$62.710335
Magnetic Resonance Imaging, Miscellaneous
S
5.1581
$306.10
$122.43
$61.220336
Magnetic Resonance Imaging and Magnetic Resonance Angiography without Cont
S
6.0742
$360.46
$144.18
$72.090337
MRI and Magnetic Resonance Angiography without Contrast Material followed
S
8.7945
$521.89
$208.75
$104.380339
Observation
S
7.1403
$423.73

$84.750340
Minor Ancillary Procedures
X
0.6384
$37.88

$7.580341
Skin Tests
X
0.1112
$6.60
$2.62
$1.320342
Level I Pathology
X
0.1560
$9.26
$3.70
$1.850343
Level III Pathology
X
0.4786
$28.40
$11.10
$5.680344
Level IV Pathology
X
0.7996
$47.45
$15.66
$9.490345
Level I Transfusion Laboratory Procedures
X
0.2277
$13.51
$3.01
$2.700346
Level II Transfusion Laboratory Procedures
X
0.3434
$20.38
$4.54
$4.080347
Level III Transfusion Laboratory Procedures
X
0.8434
$50.05
$12.35
$10.01( print page 50688)0348
Fertility Laboratory Procedures
X
0.7927
$47.04

$9.410350
Administration of flu and PPV vaccines
X
0.3954
$23.46
$0.00
$0.000352
Level I Injections
X
0.1413
$8.39

$1.680353
Level II Injections
X
0.3954
$23.46

$4.690359
Level III Injections
X
0.8312
$49.33

$9.870360
Level I Alimentary Tests
X
1.4739
$87.47
$34.98
$17.490361
Level II Alimentary Tests
X
3.6216
$214.92
$83.23
$42.980362
Contact Lens and Spectacle Services
X
2.6607
$157.89

$31.580363
Level I Otorhinolaryngologic Function Tests
X
0.9128
$54.17
$17.44
$10.830364
Level I Audiometry
X
0.4708
$27.94
$9.06
$5.590365
Level II Audiometry
X
1.2356
$73.32
$18.95
$14.660366
Level III Audiometry
X
1.7743
$105.29
$30.04
$21.060367
Level I Pulmonary Test
X
0.6659
$39.52
$14.80
$7.900368
Level II Pulmonary Tests
X
0.9761
$57.92
$23.16
$11.580369
Level III Pulmonary Tests
X
2.7519
$163.31
$44.18
$32.660370
Allergy Tests
X
1.1232
$66.65

$13.330372
Therapeutic Phlebotomy
X
0.5700
$33.83
$10.09
$6.770373
Neuropsychological Testing
X
2.1926
$130.12

$26.020374
Monitoring Psychiatric Drugs
X
1.0414
$61.80

$12.360375
Ancillary Outpatient Services When Patient Expires
T
42.5900
$2,527.42

$505.480376
Level II Cardiac Imaging
S
5.1975
$308.44
$121.42
$61.690377
Level III Cardiac Imaging
S
6.8344
$405.57
$162.22
$81.110378
Level II Pulmonary Imaging
S
5.4997
$326.37
$130.54
$65.270379
Injection adenosine
K

$33.45

$6.690381
Single Allergy Tests
X
0.1884
$11.18
$2.35
$2.240384
GI Procedures with Stents
T
22.3392
$1,325.68
$287.93
$265.140385
Level I Prosthetic Urological Procedures
S
75.6446
$4,488.98

$897.800386
Level II Prosthetic Urological Procedures
S
120.1694
$7,131.21

$1,426.240387
Level II Hysteroscopy
T
32.5445
$1,931.29
$655.55
$386.260388
Discography
S
12.3294
$731.66
$292.66
$146.330389
Non-imaging Nuclear Medicine
S
1.4976
$88.87
$35.54
$17.770390
Level I Endocrine Imaging
S
2.5562
$151.69
$60.67
$30.340391
Level II Endocrine Imaging
S
2.8774
$170.75
$68.30
$34.150393
Red Cell/Plasma Studies
S
3.4438
$204.37
$81.74
$40.870394
Hepatobiliary Imaging
S
4.4630
$264.85
$105.93
$52.970395
GI Tract Imaging
S
3.8699
$229.65
$91.86
$45.930396
Bone Imaging
S
4.1426
$245.83
$98.33
$49.170397
Vascular Imaging
S
2.2646
$134.39
$53.75
$26.880398
Level I Cardiac Imaging
S
4.3093
$255.73
$102.29
$51.150399
Nuclear Medicine Add-on Imaging
S
1.5192
$90.15
$36.06
$18.030400
Hematopoietic Imaging
S
4.1335
$245.29
$98.11
$49.060401
Level I Pulmonary Imaging
S
3.4150
$202.66
$81.06
$40.530402
Brain Imaging
S
5.1847
$307.68
$123.07
$61.540403
CSF Imaging
S
3.6138
$214.45
$85.78
$42.890404
Renal and Genitourinary Studies Level I
S
3.8559
$228.82
$91.52
$45.760405
Renal and Genitourinary Studies Level II
S
4.2674
$253.24
$101.29
$50.650406
Tumor/Infection Imaging
S
4.3035
$255.38
$102.15
$51.080407
Radionuclide Therapy
S
3.9839
$236.42
$94.56
$47.280409
Red Blood Cell Tests
X
0.1258
$7.47
$2.22
$1.490411
Respiratory Procedures
S
0.3869
$22.96

$4.590412
IMRT Treatment Delivery
S
5.3643
$318.33

$63.670415
Level II Endoscopy Lower Airway
T
22.0955
$1,311.21
$459.92
$262.240416
Level I Intravascular and Intracardiac Ultrasound and Flow Reserve
S
19.5542
$1,160.40

$232.080417
Computerized Reconstruction
S
4.0750
$241.82

$48.360418
Insertion of Left Ventricular Pacing Elect
T
109.3043
$6,486.45

$1,297.290421
Prolonged Physiologic Monitoring
X
1.6600
$98.51

$19.700422
Level II Upper GI Procedures
T
22.9647
$1,362.79
$448.81
$272.560423
Level II Percutaneous Abdominal and Biliary Procedures
T
40.2866
$2,390.73

$478.150425
Level II Arthroplasty with Prosthesis
T
100.2058
$5,946.51
$1,378.01
$1,189.300426
Level II Strapping and Cast Application
S
2.1243
$126.06

$25.210427
Level III Tube Changes and Repositioning
T
10.1977
$605.16
$124.11
$121.030428
Level III Sigmoidoscopy and Anoscopy
T
19.9022
$1,181.06

$236.210429
Level V Cystourethroscopy and other Genitourinary Procedures
T
42.3147
$2,511.08

$502.220430
Level IV Nerve and Muscle Tests
T
11.4040
$676.75

$135.350432
Health and Behavior Services
S
0.6949
$41.24

$8.250433
Level II Pathology
X
0.2581
$15.32
$6.12
$3.060434
Cardiac Defect Repair
T
90.7877
$5,387.61

$1,077.52( print page 50689)0600
Low Level Clinic Visits
V
0.8688
$51.56

$10.310601
Mid Level Clinic Visits
V
1.0038
$59.57

$11.910602
High Level Clinic Visits
V
1.4284
$84.77

$16.950610
Low Level Emergency Visits
V
1.2947
$76.83
$19.48
$15.370611
Mid Level Emergency Visits
V
2.2718
$134.82
$35.76
$26.960612
High Level Emergency Visits
V
3.9853
$236.50
$54.12
$47.300620
Critical Care
S
8.2996
$492.52
$135.68
$98.500621
Level I Vascular Access Procedures
T
8.2986
$492.46

$98.490622
Level II Vascular Access Procedures
T
21.2671
$1,262.05

$252.410623
Level III Vascular Access Procedures
T
27.1105
$1,608.82

$321.760648
Breast Reconstruction with Prosthesis
T
50.4459
$2,993.61

$598.720651
Complex Interstitial Radiation Source Application
S
12.1448
$720.71

$144.140652
Insertion of Intraperitoneal Catheters
T
28.8948
$1,714.70

$342.940653
Vascular Reconstruction/Fistula Repair with Device
T
30.5339
$1,811.97

$362.390654
Insertion/Replacement of a permanent dual chamber pacemaker
T
100.9294
$5,989.45

$1,197.890655
Insertion/Replacement/Conversion of a permanent dual chamber pacemaker
T
133.7768
$7,938.72

$1,587.740656
Transcatheter Placement of Intracoronary Drug-Eluting Stents
T
109.9237
$6,523.20

$1,304.640657
Placement of Tissue Clips
S
1.7092
$101.43

$20.290658
Percutaneous Breast Biopsies
T
6.1049
$362.28

$72.460659
Hyperbaric Oxygen
S
1.5473
$91.82

$18.360660
Level II Otorhinolaryngologic Function Tests
X
1.6419
$97.44
$30.66
$19.490661
Level V Pathology
X
3.3775
$200.43
$80.17
$40.090662
CT Angiography
S
5.1621
$306.33
$122.53
$61.270664
Level I Proton Beam Radiation Therapy
S
12.9439
$768.13

$153.630665
Bone Density: AppendicularSkeleton
S
0.6464
$38.36

$7.670667
Level II Proton Beam Radiation Therapy
S
15.4857
$918.97

$183.790668
Level I Angiography and Venography except Extremity
S
6.5024
$385.87
$114.67
$77.170670
Level II Intravascular and Intracardiac Ultrasound and Flow Reserve
S
25.4131
$1,508.09
$472.46
$301.620671
Level II Echocardiogram Except Transesophageal
S
1.7028
$101.05
$40.42
$20.210672
Level IV Posterior Segment Eye Procedures
T
36.9284
$2,191.44

$438.290673
Level IV Anterior Segment Eye Procedures
T
29.2582
$1,736.27
$649.56
$347.250674
Prostate Cryoablation
T
95.7856
$5,684.20

$1,136.840675
Prostatic Thermotherapy
T
43.7329
$2,595.24

$519.050676
Thrombolysis and Thrombectomy
T
2.4105
$143.05

$28.610678
External Counterpulsation
T
1.7276
$102.52

$20.500679
Level II Resuscitation and Cardioversion
S
5.5774
$330.98
$95.30
$66.200680
Insertion of Patient Activated Event Recorders
S
62.9082
$3,733.16

$746.630681
Knee Arthroplasty
T
137.1630
$8,139.66
$2,081.48
$1,627.930682
Level V Debridement & Destruction
T
6.9107
$410.10
$162.42
$82.020683
Level II Photochemotherapy
S
1.9006
$112.79
$25.34
$22.560685
Level III Needle Biopsy/Aspiration Except Bone Marrow
T
6.0174
$357.09
$115.47
$71.420686
Level III Skin Repair
T
13.8287
$820.64

$164.130687
Revision/Removal of Neurostimulator Electrodes
T
19.2347
$1,141.44
$456.57
$228.290688
Revision/Removal of Neurostimulator Pulse Generator Receiver
T
43.0444
$2,554.38
$1,021.75
$510.880689
Electronic Analysis of Cardioverter-defibrillators
S
0.5735
$34.03

$6.810690
Electronic Analysis of Pacemakers and other Cardiac Devices
S
0.3755
$22.28
$8.91
$4.460691
Electronic Analysis of Programmable Shunts/Pumps
S
2.5252
$149.85
$59.94
$29.970692
Electronic Analysis of Neurostimulator Pulse Generators
S
2.0111
$119.34
$30.16
$23.870693
Level II Breast Reconstruction
T
42.2254
$2,505.78
$798.17
$501.160694
Mohs Surgery
T
3.8452
$228.19
$61.86
$45.640695
Level VII Debridement & Destruction
T
20.3164
$1,205.64
$266.59
$241.130697
Level I Echocardiogram Except Transesophageal
S
1.5357
$91.13
$36.45
$18.230698
Level II Eye Tests & Treatments
S
1.2438
$73.81
$16.55
$14.760699
Level IV Eye Tests & Treatments
T
10.0177
$594.48

$118.900700
Antepartum Manipulation
T
5.3614
$318.16

$63.630701
SR 89 chloride, per mCi
H0702
SM 153 lexidronam
H0704
IN 111 Satumomab pendetide per dose
H0705
Technetium TC99M tetrofosmin
H0726
Dexrazoxane hcl injection
K

$216.39

$43.280728
Filgrastim injection
K

$178.39

$35.680730
Pamidronate disodium
K

$58.42

$11.680731
Sargramostim injection
K

$21.11

$4.220732
Mesna injection
K

$13.68

$2.740733
Non esrd epoetin alpha inj
K

$9.99

$2.00( print page 50690)0734
Injection, darbepoetin alfa (for non-ESRD)
K

$3.28

$0.660735
Ampho b cholesteryl sulfate
K

$12.24

$2.450736
Amphotericin b liposome inj
K

$21.91

$4.380737
Ammonia N-13, per dose
H0738
Rasburicase
G

$109.18

$21.840750
Dolasetron mesylate
K

$6.55

$1.310763
Dolasetron mesylate oral
K

$48.54

$9.710764
Granisetron HCl injection
K

$7.24

$1.450765
Granisetron HCl oral
K

$33.51

$6.700768
Ondansetron hcl injection
K

$3.80

$0.760769
Ondansetron hcl oral
K

$32.02

$6.400800
Leuprolide acetate
K

$441.78

$88.360802
Etoposide oral
K

$41.12

$8.220807
Aldesleukin/single use vial
K

$701.76

$140.350809
Bcg live intravesical vac
K

$121.74

$24.350810
Goserelin acetate implant
K

$196.25

$39.250811
Carboplatin injection
K

$77.16

$15.430812
Carmus bischl nitro inj
K

$141.29

$28.260814
Asparaginase injection
K

$55.42

$11.080819
Dacarbazine inj
K

$6.20

$1.240820
Daunorubicin
K

$35.28

$7.060821
Daunorubicin citrate liposom
K

$57.56

$11.510823
Docetaxel
K

$301.17

$60.230827
Floxuridine injection
K

$60.17

$12.030828
Gemcitabine HCL
K

$117.45

$23.490830
Irinotecan injection
K

$129.08

$25.820831
Ifosfomide injection
K

$53.54

$10.710832
Idarubicin hcl injection
K

$314.00

$62.800834
Interferon alfa-2a inj
K

$31.75

$6.350835
Inj cosyntropin
K

$69.27

$13.850836
Interferon alfa-2b inj recombinant, 1 million
K

$13.22

$2.640838
Interferon gamma 1-b inj
K

$277.79

$55.560840
Melphalan hydrochl
K

$523.22

$104.640842
Fludarabine phosphate inj
K

$262.41

$52.480843
Pegaspargase
K

$1,528.80

$305.760844
Pentostatin injection
K

$1,868.91

$373.780849
Rituximab
K

$447.97

$89.590850
Streptozocin injection
K

$153.33

$30.670851
Thiotepa injection
K

$44.55

$8.910852
Topotecan
K

$755.51

$151.100855
Vinorelbine tartrate
K

$62.85

$12.570856
Porfimer sodium
K

$2,457.97

$491.590857
Bleomycin sulfate injection
K

$54.18

$10.840858
Cladribine
K

$39.37

$7.870860
Plicamycin (mithramycin) inj
K

$80.54

$16.110861
Leuprolide acetate injection
K

$10.96

$2.190862
Mitomycin
K

$26.36

$5.270863
Paclitaxel injection
K

$19.11

$3.820864
Mitoxantrone hcl
K

$329.69

$65.940865
Interferon alfa-n3 inj, human leukocyte derived, 2
K

$8.77

$1.750868
Oral aprepitant
G

$4.75

$0.950869
IVIG lyophil 1g
K

$39.46

$7.890870
IVIG lyophil 10 mg
K

$0.40

$0.080871
IVIG non-lyophil 1g
K

$57.26

$11.450872
IVIG non-lyophil 10 mg
K

$0.57

$0.110876
Caffeine citrate injection
K

$3.34

$0.670880
Penicillin g benzathine inj
K

$72.26

$14.450884
Rho d immune globulin inj
K

$113.91

$22.780887
Azathioprine parenteral
K

$47.40

$9.480888
Cyclosporine oral
K

$3.94

$0.790890
Lymphocyte immune globulin
K

$290.30

$58.060891
Tacrolimus oral
K

$3.37

$0.670892
Edetate calcium disodium inj
K

$40.34

$8.070893
Calcitonin salmon injection
K

$35.68

$7.140895
Deferoxamine mesylate inj
K

$14.91

$2.980900
Alglucerase injection
K

$39.94

$7.990901
Alpha 1 proteinase inhibitor
K

$3.30

$0.660902
Botulinum toxin a, per unit
K

$4.80

$0.960903
Cytomegalovirus imm IV/vial
K

$683.07

$136.61( print page 50691)0906
RSV-ivig
K

$15.56

$3.110910
Interferon beta-1b
K

$81.95

$16.390911
Streptokinase
K

$83.36

$16.670912
Interferon alfacon-1
K

$3.91

$0.780913
Ganciclovir long act implant
K

$4,318.68

$863.740916
Injection imiglucerase /unit
K

$3.98

$0.800917
Adenosine injection
K

$71.53

$14.310925
Factor viii
K

$0.51

$0.100926
Factor VIII (porcine)
K

$1.75

$0.350927
Factor viii recombinant
K

$0.94

$0.190928
Factor ix complex
K

$0.52

$0.100929
Anti-inhibitor per iu
K

$1.12

$0.220931
Factor IX non-recombinant
K

$0.75

$0.150932
Factor IX recombinant
K

$0.86

$0.170935
Clonidine hydrochloride
K

$57.47

$11.490949
Plasma, Pooled Multiple Donor, Solvent/Detergent T
K
1.1956
$70.95

$14.190950
Blood (Whole) For Transfusion
K
2.0123
$119.42

$23.880952
Cryoprecipitate
K
0.7395
$43.88

$8.780954
RBC leukocytes reduced
K
2.7370
$162.42

$32.480955
Plasma, Fresh Frozen
K
1.2934
$76.75

$15.350956
Plasma Protein Fraction
K
1.1226
$66.62

$13.320957
Platelet Concentrate
K
0.8317
$49.36

$9.870958
Platelet Rich Plasma
K
5.1815
$307.49

$61.500959
Red Blood Cells
K
2.0301
$120.47

$24.090960
Washed Red Blood Cells
K
2.9707
$176.29

$35.260961
Infusion, Albumin (Human) 5%, 50 ml
K
0.5119
$30.38

$6.080963
Albumin (human), 5%
K
1.3869
$82.30

$16.460964
Albumin (human), 25%
K
0.4878
$28.95

$5.790965
Albumin (human), 25%
K
1.1117
$65.97

$13.190966
Plasmaprotein fract, 5%
K
4.9564
$294.13

$58.830967
Split unit of blood
K
1.2698
$75.35

$15.070968
Platelets leukocyte reduced irradiated
K
2.3639
$140.28

$28.060969
Red blood cell leukocyte reduced irradiated
K
3.6451
$216.31

$43.261009
Cryoprecip reduced plasma
K
1.3062
$77.51

$15.501010
Blood, L/R, CMV-neg
K
2.9692
$176.20

$35.241011
Platelets, HLA-m, L/R, unit
K
10.9690
$650.93

$130.191013
Platelet concentrate, L/R, unit
K
1.6023
$95.09

$19.021016
Blood, L/R, froz/deglycerol/washed
K
5.2631
$312.33

$62.471017
Platelets, aph/pher, L/R, CMV-neg, unit
K
8.5998
$510.34

$102.071018
Blood, L/R, irradiated
K
2.8004
$166.18

$33.241019
Platelets, aph/pher, L/R, irradiated, unit
K
9.5131
$564.54

$112.911020
Pit, pher, L/R, CMV, irrad
K
10.1551
$602.63

$120.531021
RBC, frz/deg/wsh, L/R, irrad
K
4.8787
$289.52

$57.901022
RBC, L/R, CMV neg, irrad
K
4.2901
$254.59

$50.921045
Iobenguane sulfate I-131
H1052
Injection, Voriconazole
K

$4.63

$0.931064
I–131 sodium iodide capsule
H1065
I–131 sodium iodide solution
H1080
I–131 tositumomab, dx
H1081
I–131 tositumomab, tx
H1082
Treprostinil
K

$55.02

$11.001083
Injection, Adalimumab
K

$300.10

$60.021084
Denileukin diftitox
K

$1,235.33

$247.071085
Injection, Gallium Nitrate
K

$1.30

$0.261086
Temozolomide,oral
K

$7.28

$1.461088
Dx I131 so iodide cap millic
H1091
IN 111 Oxyquinoline
H1092
IN 111 Pentetate
H1093
TC99M fanolesomab
H1096
TC 99M Exametazime, per dose
H1150
Th I131 so iodide sol millic
H1166
Cytarabine liposome
K

$366.43

$73.291167
Epirubicin hcl
K

$25.15

$5.031178
Busulfan IV
K
0.2851
$16.92

$3.381201
TC 99M SUCCIMER, PER Vial
H1203
Verteporfin for injection
K

$9.16

$1.831207
Octreotide injection, depot
K

$87.40

$17.481210
Inj dihydroergotamine mesylt
K

$27.82

$5.561280
Corticotropin injection
K

$95.44

$19.09( print page 50692)1305
Apligraf
K
12.9222
$766.84

$153.371330
Ergonovine maleate injection
K
0.5263
$31.23

$6.251409
Factor viia recombinant
K

$1,080.11

$216.021436
Etidronate disodium inj
K

$68.69

$13.741491
New Technology—Level I ($0–$10)
S

$5.00

$1.001492
New Technology—Level I ($10–$20)
S

$15.00

$3.001493
New Technology—Level I ($20–$30)
S

$25.00

$5.001494
New Technology—Level I ($30–$40)
S

$35.00

$7.001495
New Technology—Level I ($40–$50)
S

$45.00

$9.001496
New Technology—Level I ($0–$10)
T

$5.00

$1.001497
New Technology—Level I ($10–$20)
T

$15.00

$3.001498
New Technology—Level I ($20–$30)
T

$25.00

$5.001499
New Technology—Level I ($30–$40)
T

$35.00

$7.001500
New Technology—Level I ($40–$50)
T

$45.00

$9.001502
New Technology—Level II ($50–$100)
S

$75.00

$15.001503
New Technology—Level III ($100–$200)
S

$150.00

$30.001504
New Technology—Level IV ($200–$300)
S

$250.00

$50.001505
New Technology—Level V ($300–$400)
S

$350.00

$70.001506
New Technology—Level VI ($400–$500)
S

$450.00

$90.001507
New Technology—Level VII ($500–$600)
S

$550.00

$110.001508
New Technology—Level VIII ($600–$700)
S

$650.00

$130.001509
New Technology—Level IX ($700–$800)
S

$750.00

$150.001510
New Technology—Level X ($800–$900)
S

$850.00

$170.001511
New Technology—Level XI ($900–$1000)
S

$950.00

$190.001512
New Technology—Level XII ($1000–$1100)
S

$1,050.00

$210.001513
New Technology—Level XIII ($1100–$1200)
S

$1,150.00

$230.001514
New Technology—Level XIV ($1200–$1300)
S

$1,250.00

$250.001515
New Technology—Level XV ($1300–$1400)
S

$1,350.00

$270.001516
New Technology—Level XVI ($1400–$1500)
S

$1,450.00

$290.001517
New Technology—Level XVII ($1500–$1600)
S

$1,550.00

$310.001518
New Technology—Level XVIII ($1600–$1700)
S

$1,650.00

$330.001519
New Technology—Level IXX ($1700–$1800)
S

$1,750.00

$350.001520
New Technology—Level XX ($1800–$1900)
S

$1,850.00

$370.001521
New Technology—Level XXI ($1900–$2000)
S

$1,950.00

$390.001522
New Technology—Level XXII ($2000–$2500)
S

$2,250.00

$450.001523
New Technology—Level XXIII ($2500–$3000)
S

$2,750.00

$550.001524
New Technology—Level XIV ($3000–$3500)
S

$3,250.00

$650.001525
New Technology—Level XXV ($3500–$4000)
S

$3,750.00

$750.001526
New Technology—Level XXVI ($4000–$4500)
S

$4,250.00

$850.001527
New Technology—Level XXVII ($4500–$5000)
S

$4,750.00

$950.001528
New Technology—Level XXVIII ($5000–$5500)
S

$5,250.00

$1,050.001529
New Technology—Level XXIX ($5500–$6000)
S

$5,750.00

$1,150.001530
New Technology—Level XXX ($6000–$6500)
S

$6,250.00

$1,250.001531
New Technology—Level XXXI ($6500–$7000)
S

$6,750.00

$1,350.001532
New Technology—Level XXXII ($7000–$7500)
S

$7,250.00

$1,450.001533
New Technology—Level XXXIII ($7500–$8000)
S

$7,750.00

$1,550.001534
New Technology—Level XXXIV ($8000–$8500)
S

$8,250.00

$1,650.001535
New Technology—Level XXXV ($8500–$9000)
S

$8,750.00

$1,750.001536
New Technology—Level XXXVI ($9000–$9500)
S

$9,250.00

$1,850.001537
New Technology—Level XXXVII ($9500–$10000)
S

$9,750.00

$1,950.001539
New Technology—Level II ($50–$100)
T

$75.00

$15.001540
New Technology—Level III ($100–$200)
T

$150.00

$30.001541
New Technology—Level IV ($200–$300)
T

$250.00

$50.001542
New Technology—Level V ($300–$400)
T

$350.00

$70.001543
New Technology—Level VI ($400–$500)
T

$450.00

$90.001544
New Technology—Level VII ($500–$600)
T

$550.00

$110.001545
New Technology—Level VIII ($600–$700)
T

$650.00

$130.001546
New Technology—Level IX ($700–$800)
T

$750.00

$150.001547
New Technology—Level X ($800–$900)
T

$850.00

$170.001548
New Technology—Level XI ($900–$1000)
T

$950.00

$190.001549
New Technology—Level XII ($1000–$1100)
T

$1,050.00

$210.001550
New Technology—Level XIII ($1100–$1200)
T

$1,150.00

$230.001551
New Technology—Level XIV ($1200- $1300)
T

$1,250.00

$250.001552
New Technology—Level XV ($1300–$1400)
T

$1,350.00

$270.001553
New Technology—Level XVI ($1400–$1500)
T

$1,450.00

$290.001554
New Technology—Level XVII ($1500-$1600)
T

$1,550.00

$310.001555
New Technology—Level XVIII ($1600-$1700)
T

$1,650.00

$330.001556
New Technology—Level XIX ($1700-$1800)
T

$1,750.00

$350.001557
New Technology—Level XX ($1800-$1900)
T

$1,850.00

$370.00( print page 50693)1558
New Technology—Level XXI ($1900-$2000)
T

$1,950.00

$390.001559
New Technology—Level XXII ($2000-$2500)
T

$2,250.00

$450.001560
New Technology—Level XXIII ($2500-$3000)
T

$2,750.00

$550.001561
New Technology—Level XXIV ($3000-$3500)
T

$3,250.00

$650.001562
New Technology—Level XXV ($3500-$4000)
T

$3,750.00

$750.001563
New Technology—Level XXVI ($4000-$4500)
T

$4,250.00

$850.001564
New Technology—Level XXVII ($4500-$5000)
T

$4,750.00

$950.001565
New Technology—Level XXVIII ($5000-$5500)
T

$5,250.00

$1,050.001566
New Technology—Level XXIX ($5500-$6000)
T

$5,750.00

$1,150.001567
New Technology—Level XXX ($6000-$6500)
T

$6,250.00

$1,250.001568
New Technology—Level XXXI ($6500-$7000)
T

$6,750.00

$1,350.001569
New Technology—Level XXXII ($7000-$7500)
T

$7,250.00

$1,450.001570
New Technology—Level XXXIII ($7500-$8000)
T

$7,750.00

$1,550.001571
New Technology—Level XXXIV ($8000-$8500)
T

$8,250.00

$1,650.001572
New Technology—Level XXXV ($8500-$9000)
T

$8,750.00

$1,750.001573
New Technology—Level XXXVI ($9000-$9500)
T

$9,250.00

$1,850.001574
New Technology—Level XXXVII ($9500-$10000)
T

$9,750.00

$1,950.001600
Technetium TC 99m sestamibi
H1603
Thallous chloride TL 201
H1604
IN 111 capromab pendetide, per dose
H1605
Abciximab injection
K

$450.60

$90.121607
Eptifibatide injection
K

$12.73

$2.551608
Etanercept injection
K

$152.11

$30.421609
Rho(D) immune globulin h, sd
K

$12.04

$2.411611
Hylan G–F 20 injection
K

$203.15

$40.631612
Daclizumab, parenteral
K

$381.48

$76.301613
Trastuzumab
K

$53.98

$10.801615
Basiliximab
K

$1,473.57

$294.711618
Vonwillebrandfactrcmplx, per iu
K

$0.74

$0.151619
Gallium ga 67
H1620
Technetium tc99m bicisate
H1622
Technetium tc99m mertiatide
H1624
Sodium phosphate p32
H1625
Indium 111-in pentetreotide
H1628
Chromic phosphate p32
H1655
Tinzaparin sodium injection
K

$2.53

$0.511670
Tetanus immune globulin inj
K

$76.90

$15.381716
Brachytx source, Gold 198
H1717
Brachytx source, HDR Ir–192
H1718
Brachytx source, Iodine 125
H1719
Brachytx sour, Non-HDR Ir–192
H1720
Brachytx sour, Palladium 103
H1740
Diazoxide injection
K

$113.86

$22.771775
FDG, per dose (4–40 mCi/ml)
H2210
Methyldopate hcl injection
K

$9.58

$1.922616
Brachytx source, Yttrium-90
H2632
Brachytx sol, I–125, per mCi
H2633
Brachytx source, Cesium-131
H2634
Brachytx source, HA, I–125
H2635
Brachytx source, HA, P–103
H2636
Brachytx linear source, P–103
H2730
Pralidoxime chloride inj
K

$76.68

$15.342770
Quinupristin/dalfopristin
K

$105.48

$21.102940
Somatrem injection
K

$43.14

$8.633030
Sumatriptan succinate
K

$51.03

$10.217000
Amifostine
K

$436.01

$87.207005
Gonadorelin hydroch
K

$173.44

$34.697011
Oprelvekin injection
K

$249.06

$49.817015
Busulfan, oral
K

$1.98

$0.407019
Aprotinin
K

$2.20

$0.447024
Corticorelin ovine triflutat
K

$386.53

$77.317025
Digoxin immune FAB (ovine)
K

$552.18

$110.447026
Ethanolamine oleate
K

$64.53

$12.917027
Fomepizole
K

$12.31

$2.467028
Fosphenytoin
K

$5.19

$1.047030
Hemin
K

$6.51

$1.307034
Somatropin injection
K

$42.93

$8.597035
Teniposide
K

$266.23

$53.257036
Urokinase inj
K

$415.69

$83.14( print page 50694)7037
Urofollitropin
K

$44.74

$8.957038
Monoclonal antibodies
K

$885.36

$177.077040
Pentastarch 10% solution
K

$12.45

$2.497041
Tirofiban hcl
K

$7.89

$1.587042
Capecitabine, oral
K

$3.30

$0.667043
Infliximab injection
K

$54.20

$10.847045
Trimetrexate glucoronate
K

$139.85

$27.977046
Doxorubicin hcl liposome inj
K

$365.64

$73.137048
Alteplase recombinant
K

$30.65

$6.137049
Filgrastim injection
K

$282.29

$56.467051
Leuprolide acetate implant
K

$2,262.19

$452.447308
Aminolevulinic acid hcl top
K

$96.79

$19.367316
Sodium hyaluronate injection
K

$110.65

$22.137515
Cyclosporine oral
K

$1.00

$0.209001
Linezolid injection
K

$24.15

$4.839002
Tenecteplase
K

$2,052.77

$410.559003
Palivizumab
K
4.1491
$246.22

$49.249004
Gemtuzumab ozogamicin
K

$2,245.04

$449.019005
Reteplase injection
K

$898.81

$179.769006
Tacrolimus injection
K

$126.61

$25.329008
Baclofen Refill Kit-500mcg
K
0.2447
$14.52

$2.909009
Baclofen refill kit—per 2000 mcg
K
0.7209
$42.78

$8.569012
Arsenic Trioxide
K

$33.76

$6.759015
Mycophenolate mofetil oral
K

$2.50

$0.509018
Botulinum toxin B
K

$7.89

$1.589019
Caspofungin acetate
K

$32.35

$6.479020
Sirolimus tablet
K

$6.85

$1.379022
IM inj interferon beta 1–a
K

$89.10

$17.829023
Rho d immune globulin
K

$25.08

$5.029024
Amphotericin b lipid complex
K

$11.95

$2.399025
Rubidium-Rb-82
H9030
Amphotericin B
K

$30.70

$6.149031
Arbutamine HCl injection
K

$163.15

$32.639032
Baclofen 10 MG injection
K

$188.01

$37.609033
Cidofovir injection
K

$782.98

$156.609038
Inj estrogen conjugate
K

$57.77

$11.559040
Intraocular Fomivirsen na
K

$203.93

$40.799042
Glucagon hydrochloride
K

$62.16

$12.439044
Ibutilide fumarate injection
K

$243.34

$48.679045
Iron dextran
K

$11.43

$2.299046
Iron sucrose injection
K

$0.38

$0.089047
Itraconazole injection
K

$36.93

$7.399051
Urea injection
K
1.0454
$62.04

$12.419054
Metabolically active tissue
K

$15.69

$3.149055
Injectable human tissue
K

$3.54

$0.719057
Lepirudin
K

$128.17

$25.639100
Iodinated I-131 serumalbumin, per 5uci
H9104
Anti-thymocycte globulin rabbit
K

$299.47

$59.899105
Hep B imm glob
K
1.8813
$111.64

$22.339108
Thyrotropin alfa
K

$712.58

$142.529110
Alemtuzumab injection
K

$516.87

$103.379112
Inj Perflutren lipid micros, ml
K

$63.51

$12.709114
Nesiritide
K

$75.19

$15.049115
Inj, zoledronic acid
K

$202.41

$40.489117
Yttrium 90 ibritumomab tiuxetan
H9118
In-111 ibritumomab tiuxetan
H9119
Pegfilgrastim
K

$2,178.28

$435.669120
Inj, Fulvestrant
K

$82.90

$16.589121
Inj, Argatroban
K
0.1897
$11.26

$2.259122
Triptorelin pamoate
K

$369.98

$74.009123
Transcyte
K

$719.41

$143.889124
Injection, daptomycin
G

$0.30

$0.069125
Risperidone, long acting
G

$4.71

$0.949126
Injection, natalizumab
G

$6.51

$1.309127
Paclitaxel protein pr
K

$8.59

$1.729128
Inj pegaptanib sodium
K

$1,074.27

$214.859130
Na chromateCr51, per 0.25mCi
H9132
51 Na Chromate, 50mCi
H9133
Rabies ig, im/sc
K

$64.56

$12.91( print page 50695)9134
Rabies ig, heat treated
K

$69.79

$13.969135
Varicella-zoster ig, im
K

$96.58

$19.329136
Adenovirus vaccine, type 4
K
0.9499
$56.37

$11.279137
Bcg vaccine, percut
K

$124.54

$24.919138
Hep a/hep b vacc, adult im
K
0.9674
$57.41

$11.489139
Rabies vaccine, im
K

$128.04

$25.619140
Rabies vaccine, id
K
1.4959
$88.77

$17.759141
Measles-rubella vaccine, sc
K
0.9467
$56.18

$11.249142
Chicken pox vaccine, sc
K

$64.29

$12.869143
Meningococcal vaccine, sc
K

$56.75

$11.359144
Encephalitis vaccine, sc
K

$67.73

$13.559145
Meningococcal vaccine, im
K
0.8948
$53.10

$10.629146
Technetium TC99m Disofenin
H9147
Technetium TC 99M Depreotide
H9148
I–123 sodium iodide capsule
H9149
Dx I131 so iodide microcurie
H9150
I–125 serum albumin micro
H9151
Tc 99M ARCITUMOMAB PER VIAL
H9152
Baclofen Intrathecal kit-1am
K
0.8562
$50.81

$10.169153
Na Iothalamate I–125, 10 uCi
H9154
Technetium tc99m glucepatate
H9155
Technetium tc99mlabeledrbcs
H9156
Nonmetabolic active tissue
K

$53.76

$10.759157
LOCM <=149 mg/ml iodine
K

$0.51

$0.109158
LOCM 150-199mg/ml iodine
K

$2.00

$0.409159
LOCM 200–249mg/ml iodine
K

$0.78

$0.169160
LOCM 250–299mg/ml iodine
K

$0.66

$0.139161
LOCM 300–349mg/ml iodine
K

$0.41

$0.089162
LOCM 350–399mg/ml iodine
K

$0.27

$0.059163
LOCM >= 400 mg/ml iodine
K

$0.20

$0.049164
Inj Gad-base MR contrast
K

$3.01

$0.609165
Oral MR contrast
K

$9.01

$1.809166
Dyphylline injection
K

$7.74

$1.559167
Valrubicin
K

$376.87

$75.379168
Pegademase bovine
K

$161.16

$32.239169
Anthrax vaccine, sc
K

$128.95

$25.799200
Orcel
K
2.6893
$159.59

$31.929201
Dermagraft
K
6.2066
$368.32

$73.669202
Inj Octafluoropropane mic,ml
K

$41.42

$8.289203
Inj Perflexane lipid micros, ml
K

$13.49

$2.709205
Oxaliplatin
K

$84.06

$16.819206
Integra
K

$9.23

$1.859207
Injection, bortezomib
K

$28.90

$5.789208
Injection, agalsidase beta
K

$123.35

$24.679209
Injection, laronidase
K

$23.16

$4.639210
Injection, palonosetron HCL
K

18.42

$3.689211
Inj, alefacept, IV
K

$571.01

$114.209212
Inj, alefacept, IM
K

$402.00

$80.409213
Injection, Pemetrexed
G

$41.29

$8.269214
Injection, Bevacizumab
G

$58.17

$11.639215
Injection, Cetuximab
G

$50.59

$10.129216
Abarelix Injection
G

$66.96

$13.399217
Leuprolide acetate suspnsion
K

$230.87

$46.179218
Injection, Azacitidine
K

$4.03

$0.819219
Mycophenolic Acid
G

$2.47

$0.499220
Sodium hyaluronate
G

$203.84

$40.779221
Graftjacket Reg Matrix
G

$1,234.36

$246.879222
Graftjacket SftTis
G

$890.74

$178.159300
Injection, Omalizumab
G

$15.98

$3.209500
Platelets, irradiated
K
1.3589
$80.64

$16.139501
Platelets, pheresis, leukocytes reduced
K
8.1495
$483.62

$96.729502
Platelet pheresis irradiated
K
5.1895
$307.96

$61.599503
Fresh frozen plasma, ea unit
K
1.6241
$96.38

$19.289504
RBC deglycerolized
K
6.4314
$381.66

$76.339505
RBC irradiated
K
2.3876
$141.69

$28.349506
Granulocytes, pheresis
K
15.6155
$926.67

$185.339507
Platelets, pheresis
K
6.8988
$409.40

$81.889508
Plasma, frozen w/in 8 hours
K
1.2038
$71.44

$14.29
 
 
 6. On pages 42776–42965, Addendum B is corrected to read as follows:       Addendum B.—Payment Status by HCPCS Code and Related Information Calendar Year 2006
CPT/HCPCS
SI
CI
Description
APC
Relative weight
Payment rate
National unadjusted copayment
Minimum unadjusted copayment0003T
S

Cervicography
1492

$15.00

$3.000008T
T

Upper gi endoscopy w/suture
0422
22.9647
$1,362.79
$448.81
$272.5600100
N

Anesth, salivary gland00102
N

Anesth, repair of cleft lip00103
N

Anesth, blepharoplasty00104
N

Anesth, electroshock0010T
A

Tb test, gamma interferon00120
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, vitreoretinal surg00147
N

Anesth, iridectomy00148
N

Anesth, eye exam00160
N

Anesth, nose/sinus surgery00162
N

Anesth, nose/sinus surgery00164
N

Anesth, biopsy of nose0016T
T

Thermotx choroid vasc lesion
0235
4.6593
$276.50
$67.40
$55.3000170
N

Anesth, procedure on mouth00172
N

Anesth, cleft palate repair00174
N

Anesth, pharyngeal surgery00176
C

Anesth, pharyngeal surgery0017T
E

Photocoagulat macular drusen0018T
S

Transcranial magnetic stimul
0215
0.6115
$36.29
$14.51
$7.2600190
N

Anesth, face/skull bone surg00192
C

Anesth, facial bone surgery0019T
E

Extracorp shock wave tx, ms0020T
B

Extracorp shock wave tx, ft00210
N

Anesth, open head surgery00212
N

Anesth, skull drainage00214
C

Anesth, skull drainage00215
C

Anesth, skull repair/fract00216
N

Anesth, head vessel surgery00218
N

Anesth, special head surgery0021T
C

Fetal oximetry, trnsvag/cerv00220
N

Anesth, intrcrn nerve00222
N

Anesth, head nerve surgery0023T
A

Phenotype drug test, hiv 10024T
C

Transcath cardiac reduction0026T
A

Measure remnant lipoproteins0027T
T

Endoscopic epidural lysis
0220
17.3586
$1,030.11

$206.020028T
N

Dexa body composition study0029T
A

Magnetic tx for incontinence00300
N

Anesth, head/neck/ptrunk0030T
A

Antiprothrombin antibody0031T
N

Speculoscopy00320
N

Anesth, neck organ, 1 & over00322
N

Anesth, biopsy of thyroid00326
N

Anesth, larynx/trach, < 1 yr0032T
N

Speculoscopy w/direct sample0033T
C

Endovasc taa repr incl subcl0034T
C

Endovasc taa repr w/o subcl00350
N

Anesth, neck vessel surgery00352
N

Anesth, neck vessel surgery0035T
C

Insert endovasc prosth, taa0036T
C

Endovasc prosth, taa, add-on0037T
C

Artery transpose/endovas taa0038T
C

Rad endovasc taa rpr w/cover0039T
C

Rad s/i, endovasc taa repair00400
N

Anesth, skin, ext/per/atrunk( print page 50697)00402
N

Anesth, surgery of breast00404
C

Anesth, surgery of breast00406
C

Anesth, surgery of breast0040T
C

Rad s/i, endovasc taa prosth00410
N

Anesth, correct heart rhythm0041T
A

Detect ur infect agnt w/cpas0042T
N

Ct perfusion w/contrast, cbf0043T
A

Co expired gas analysis0044T
N

Whole body photography00450
N

Anesth, surgery of shoulder00452
C

Anesth, surgery of shoulder00454
N

Anesth, collar bone biopsy0045T
N

Whole body photography0046T
T

Cath lavage, mammary duct(s)
0021
14.9776
$888.82
$219.48
$177.7600470
N

Anesth, removal of rib00472
N

Anesth, chest wall repair00474
C

Anesth, surgery of rib(s)0047T
T

Cath lavage, mammary duct(s)
0021
14.9776
$888.82
$219.48
$177.760048T
C

Implant ventricular device0049T
C

External circulation assist00500
N

Anesth, esophageal surgery0050T
C

Removal circulation assist0051T
C

Implant total heart system00520
N

Anesth, chest procedure00522
N

Anesth, chest lining biopsy00524
C

Anesth, chest drainage00528
N

Anesth, chest partition view00529
N

Anesth, chest partition view0052T
C

Replace component heart syst00530
N

Anesth, pacemaker insertion00532
N

Anesth, vascular access00534
N

Anesth, cardioverter/defib00537
N

Anesth, cardiac electrophys00539
N

Anesth, trach-bronch reconst0053T
C

Replace component heart syst00540
C

Anesth, chest surgery00541
N

Anesth, one lung ventilation00542
C

Anesth, release of lung00546
C

Anesth, lung,chest wall surg00548
N

Anesth, trachea,bronchi surg0054T
B

Bone surgery using computer00550
N

Anesth, sternal debridement0055T
B

Bone surgery using computer00560
C

Anesth, open heart surgery00561
C

Anesth, heart surg < age 100562
C

Anesth, open heart surgery00563
N

Anesth, heart proc w/pump00566
N

Anesth, cabg w/o pump0056T
B

Bone surgery using computer00580
C

Anesth, heart/lung transplnt0058T
X

Cryopreservation, ovary tiss
0348
0.7927
$47.04

$9.410059T
X

Cryopreservation, oocyte
0348
0.7927
$47.04

$9.4100600
N

Anesth, spine, cord surgery00604
C

Anesth, sitting procedure0060T
B

Electrical impedance scan0061T
B

Destruction of tumor, breast00620
N

Anesth, spine, cord surgery00622
C

Anesth, removal of nerves0062T
T

Rep intradisc annulus1 lev
0203
10.4015
$617.26
$246.90
$123.4500630
N

Anesth, spine, cord surgery00632
C

Anesth, removal of nerves00634
N

Anesth for chemonucleolysis00635
N

Anesth, lumbar puncture0063T
T

Rep intradisc annulus>1lev
0203
10.4015
$617.26
$246.90
$123.4500640
N

Anesth, spine manipulation0064T
A

Spectroscop eval expired gas( print page 50698)0065T
A

Ocular photoscreen bilat0066T
E

Ct colonography screen00670
C

Anesth, spine, cord surgery0067T*
S

Ct colonography dx
0333
5.2836
$313.54
$125.41
$62.710068T
B

Interp/rept heart sound0069T
N

Analysis only heart sound00700
N

Anesth, abdominal wall surg00702
N

Anesth, for liver biopsy0070T
N

Interp only heart sound0071T
T

U/s leiomyomata ablate <200
0193
14.5843
$865.48

$173.100072T
T

U/s leiomyomata ablate >200
0193
14.5843
$865.48

$173.1000730
N

Anesth, abdominal wall surg0073T
S

Delivery, comp imrt
0412
5.3643
$318.33

$63.6700740
N

Anesth, upper gi visualize0074T
E

Online physician e/m00750
N

Anesth, repair of hernia00752
N

Anesth, repair of hernia00754
N

Anesth, repair of hernia00756
N

Anesth, repair of hernia0075T
C

Perq stent/chest vert art0076T
C

S&i stent/chest vert art00770
N

Anesth, blood vessel repair0077T
C

Cereb therm perfusion probe0078T
C

Endovasc aort repr w/device00790
N

Anesth, surg upper abdomen00792
C

Anesth, hemorr/excise liver00794
C

Anesth, pancreas removal00796
C

Anesth, for liver transplant00797
N

Anesth, surgery for obesity0079T
C

Endovasc visc extnsn repr00800
N

Anesth, abdominal wall surg00802
C

Anesth, fat layer removal0080T
C

Endovasc aort repr rad s&i00810
N

Anesth, low intestine scope0081T
C

Endovasc visc extnsn s&i00820
N

Anesth, abdominal wall surg0082T
B

Stereotactic rad delivery00830
N

Anesth, repair of hernia00832
N

Anesth, repair of hernia00834
N

Anesth, hernia repair< 1 yr00836
N

Anesth hernia repair preemie0083T
N

Stereotactic rad tx mngmt00840
N

Anesth, surg lower abdomen00842
N

Anesth, amniocentesis00844
C

Anesth, pelvis surgery00846
C

Anesth, hysterectomy00848
C

Anesth, pelvic organ surg0084T
T

Temp prostate urethral stent
0164
1.1855
$70.35
$17.29
$14.0700851
N

Anesth, tubal ligation0085T
X

Breath test heart reject
0340
0.6384
$37.88

$7.5800860
N

Anesth, surgery of abdomen00862
N

Anesth, kidney/ureter surg00864
C

Anesth, removal of bladder00865
C

Anesth, removal of prostate00866
C

Anesth, removal of adrenal00868
C

Anesth, kidney transplant0086T
N

L ventricle fill pressure00870
N

Anesth, bladder stone surg00872
N

Anesth kidney stone destruct00873
N

Anesth kidney stone destruct0087T
X

Sperm eval hyaluronan
0348
0.7927
$47.04

$9.4100880
N

Anesth, abdomen vessel surg00882
C

Anesth, major vein ligation0088T
T

Rf tongue base vol reduxn
0253
16.1357
$957.54
$282.29
$191.5100902
N

Anesth, anorectal surgery00904
C

Anesth, perineal surgery( print page 50699)00906
N

Anesth, removal of vulva00908
C

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 surgery00921
N

Anesth, vasectomy00922
N

Anesth, sperm duct surgery00924
N

Anesth, testis exploration00926
N

Anesth, removal of testis00928
N

Anesth, removal of testis00930
N

Anesth, testis suspension00932
C

Anesth, amputation of penis00934
C

Anesth, penis, nodes removal00936
C

Anesth, penis, nodes removal00938
N

Anesth, insert penis device00940
N

Anesth, vaginal procedures00942
N

Anesth, surg on vag/urethral00944
C

Anesth, vaginal hysterectomy00948
N

Anesth, repair of cervix00950
N

Anesth, vaginal endoscopy00952
N

Anesth, hysteroscope/graph01112
N

Anesth, bone aspirate/bx01120
N

Anesth, pelvis surgery01130
N

Anesth, body cast procedure01140
C

Anesth, amputation at pelvis01150
C

Anesth, pelvic tumor surgery01160
N

Anesth, pelvis procedure01170
N

Anesth, pelvis surgery01173
N

Anesth, fx repair, pelvis01180
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
C

Anesth, hip disarticulation01214
C

Anesth, hip arthroplasty01215
N

Anesth, revise hip repair01220
N

Anesth, procedure on femur01230
N

Anesth, surgery of femur01232
C

Anesth, amputation of femur01234
C

Anesth, radical femur surg01250
N

Anesth, upper leg surgery01260
N

Anesth, upper leg veins surg01270
N

Anesth, thigh arteries surg01272
C

Anesth, femoral artery surg01274
C

Anesth, femoral embolectomy01320
N

Anesth, knee area surgery01340
N

Anesth, knee area procedure01360
N

Anesth, knee area surgery01380
N

Anesth, knee joint procedure01382
N

Anesth, dx knee arthroscopy01390
N

Anesth, knee area procedure01392
N

Anesth, knee area surgery01400
N

Anesth, knee joint surgery01402
C

Anesth, knee arthroplasty01404
C

Anesth, amputation at knee01420
N

Anesth, knee joint casting01430
N

Anesth, knee veins surgery01432
N

Anesth, knee vessel surg01440
N

Anesth, knee arteries surg01442
C

Anesth, knee artery surg01444
C

Anesth, knee artery repair01462
N

Anesth, lower leg procedure( print page 50700)01464
N

Anesth, ankle/ft 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
C

Anesth, ankle replacement01490
N

Anesth, lower leg casting01500
N

Anesth, leg arteries surg01502
C

Anesth, lwr leg embolectomy01520
N

Anesth, lower leg vein surg01522
N

Anesth, lower leg vein surg01610
N

Anesth, surgery of shoulder01620
N

Anesth, shoulder procedure01622
N

Anes dx shoulder arthroscopy01630
N

Anesth, surgery of shoulder01632
C

Anesth, surgery of shoulder01634
C

Anesth, shoulder joint amput01636
C

Anesth, forequarter amput01638
C

Anesth, shoulder replacement01650
N

Anesth, shoulder artery surg01652
C

Anesth, shoulder vessel surg01654
C

Anesth, shoulder vessel surg01656
C

Anesth, arm-leg vessel surg01670
N

Anesth, shoulder vein surg01680
N

Anesth, shoulder casting01682
N

Anesth, airplane cast01710
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, dx elbow arthroscopy01740
N

Anesth, upper arm surgery01742
N

Anesth, humerus surgery01744
N

Anesth, humerus repair01756
C

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 repair01810
N

Anesth, lower arm surgery01820
N

Anesth, lower arm procedure01829
N

Anesth, dx wrist arthroscopy01830
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 casting01905
N

Anes, spine inject, x-ray/re01916
N

Anesth, dx arteriography01920
N

Anesth, catheterize heart01922
N

Anesth, cat or MRI scan01924
N

Anes, ther interven rad, art01925
N

Anes, ther interven rad, car01926
N

Anes, tx interv rad hrt/cran01930
N

Anes, ther interven rad, vei01931
N

Anes, ther interven rad, tip01932
N

Anes, tx interv rad, th vein01933
N

Anes, tx interv rad, cran v( print page 50701)01951
N

Anesth, burn, less 4 percent01952
N

Anesth, burn, 4-9 percent01953
N

Anesth, burn, each 9 percent01958
N

Anesth, antepartum manipul01960
N

Anesth, vaginal delivery01961
N

Anesth, cs delivery01962
N

Anesth, emer hysterectomy01963
N

Anesth, cs hysterectomy01964
N

Anesth, abortion procedures01967
N

Anesth/analg, vag delivery01968
N

Anes/analg cs deliver add-on01969
N

Anesth/analg cs hyst add-on01990
C

Support for organ donor01991
N

Anesth, nerve block/inj01992
N

Anesth, n block/inj, prone01995
N

Regional anesthesia limb01996
N

Hosp manage cont drug admin01999
N

Unlisted anesth procedure0500F
E

Initial prenatal care visit0501F
E

Prenatal flow sheet0502F
E

Subsequent prenatal care0503F
E

Postpartum care visit1000F
E

Tobacco use, smoking, assess1001F
E

Tobacco use, non-smoking10021
T

Fna w/o image
0002
0.9559
$56.73

$11.3510022
T

Fna w/image
0036
2.1773
$129.21

$25.841002F
E

Assess anginal symptom/level10040
T

Acne surgery
0010
0.5719
$33.94
$9.65
$6.7910060
T

Drainage of skin abscess
0006
1.55
$91.98
$22.28
$18.4010061
T

Drainage of skin abscess
0006
1.55
$91.98
$22.28
$18.4010080
T

Drainage of pilonidal cyst
0006
1.55
$91.98
$22.28
$18.4010081
T

Drainage of pilonidal cyst
0007
11.4501
$679.48

$135.9010120
T

Remove foreign body
0006
1.55
$91.98
$22.28
$18.4010121
T

Remove foreign body
0021
14.9776
$888.82
$219.48
$177.7610140
T

Drainage of hematoma/fluid
0007
11.4501
$679.48

$135.9010160
T

Puncture drainage of lesion
0018
1.1726
$69.59
$16.04
$13.9210180
T

Complex drainage, wound
0008
16.4989
$979.09

$195.8211000
T

Debride infected skin
0015
1.6514
$98.00
$20.29
$19.6011001
T

Debride infected skin add-on
0012
0.8497
$50.42
$11.18
$10.0811004
C

Debride genitalia & perineum11005
C

Debride abdom wall11006
C

Debride genit/per/abdom wall11008
C

Remove mesh from abd wall11010
T

Debride skin, fx
0019
4.0547
$240.62
$71.87
$48.1211011
T

Debride skin/muscle, fx
0019
4.0547
$240.62
$71.87
$48.1211012
T

Debride skin/muscle/bone, fx
0019
4.0547
$240.62
$71.87
$48.1211040
T

Debride skin, partial
0015
1.6514
$98.00
$20.29
$19.6011041
T

Debride skin, full
0015
1.6514
$98.00
$20.29
$19.6011042
T

Debride skin/tissue
0016
2.5834
$153.31
$33.57
$30.6611043
T

Debride tissue/muscle
0016
2.5834
$153.31
$33.57
$30.6611044
T

Debride tissue/muscle/bone
0682
6.9107
$410.10
$162.42
$82.0211055
T

Trim skin lesion
0012
0.8497
$50.42
$11.18
$10.0811056
T

Trim skin lesions, 2 to 4
0012
0.8497
$50.42
$11.18
$10.0811057
T

Trim skin lesions, over 4
0013
1.1078
$65.74
$14.20
$13.1511100
T

Biopsy, skin lesion
0018
1.1726
$69.59
$16.04
$13.9211101
T

Biopsy, skin add-on
0018
1.1726
$69.59
$16.04
$13.9211200
T

Removal of skin tags
0013
1.1078
$65.74
$14.20
$13.1511201
T

Remove skin tags add-on
0015
1.6514
$98.00
$20.29
$19.6011300
T

Shave skin lesion
0012
0.8497
$50.42
$11.18
$10.0811301
T

Shave skin lesion
0012
0.8497
$50.42
$11.18
$10.0811302
T

Shave skin lesion
0013
1.1078
$65.74
$14.20
$13.1511303
T

Shave skin lesion
0015
1.6514
$98.00
$20.29
$19.6011305
T

Shave skin lesion
0013
1.1078
$65.74
$14.20
$13.1511306
T

Shave skin lesion
0013
1.1078
$65.74
$14.20
$13.1511307
T

Shave skin lesion
0013
1.1078
$65.74
$14.20
$13.1511308
T

Shave skin lesion
0013
1.1078
$65.74
$14.20
$13.15( print page 50702)11310
T

Shave skin lesion
0013
1.1078
$65.74
$14.20
$13.1511311
T

Shave skin lesion
0013
1.1078
$65.74
$14.20
$13.1511312
T

Shave skin lesion
0013
1.1078
$65.74
$14.20
$13.1511313
T

Shave skin lesion
0016
2.5834
$153.31
$33.57
$30.6611400
T

Removal of skin lesion
0019
4.0547
$240.62
$71.87
$48.1211401
T

Removal of skin lesion
0019
4.0547
$240.62
$71.87
$48.1211402
T

Removal of skin lesion
0019
4.0547
$240.62
$71.87
$48.1211403
T

Removal of skin lesion
0020
6.9433
$412.04
$107.40
$82.4111404
T

Removal of skin lesion
0021
14.9776
$888.82
$219.48
$177.7611406
T

Removal of skin lesion
0021
14.9776
$888.82
$219.48
$177.7611420
T

Removal of skin lesion
0020
6.9433
$412.04
$107.40
$82.4111421
T

Removal of skin lesion
0020
6.9433
$412.04
$107.40
$82.4111422
T

Removal of skin lesion
0020
6.9433
$412.04
$107.40
$82.4111423
T

Removal of skin lesion
0021
14.9776
$888.82
$219.48
$177.7611424
T

Removal of skin lesion
0021
14.9776
$888.82
$219.48
$177.7611426
T

Removal of skin lesion
0022
19.6472
$1,165.92
$354.45
$233.1811440
T

Removal of skin lesion
0019
4.0547
$240.62
$71.87
$48.1211441
T

Removal of skin lesion
0019
4.0547
$240.62
$71.87
$48.1211442
T

Removal of skin lesion
0020
6.9433
$412.04
$107.40
$82.4111443
T

Removal of skin lesion
0020
6.9433
$412.04
$107.40
$82.4111444
T

Removal of skin lesion
0020
6.9433
$412.04
$107.40
$82.4111446
T

Removal of skin lesion
0022
19.6472
$1,165.92
$354.45
$233.1811450
T

Removal, sweat gland lesion
0022
19.6472
$1,165.92
$354.45
$233.1811451
T

Removal, sweat gland lesion
0022
19.6472
$1,165.92
$354.45
$233.1811462
T

Removal, sweat gland lesion
0022
19.6472
$1,165.92
$354.45
$233.1811463
T

Removal, sweat gland lesion
0022
19.6472
$1,165.92
$354.45
$233.1811470
T

Removal, sweat gland lesion
0022
19.6472
$1,165.92
$354.45
$233.1811471
T

Removal, sweat gland lesion
0022
19.6472
$1,165.92
$354.45
$233.1811600
T

Removal of skin lesion
0019
4.0547
$240.62
$71.87
$48.1211601
T

Removal of skin lesion
0019
4.0547
$240.62
$71.87
$48.1211602
T

Removal of skin lesion
0019
4.0547
$240.62
$71.87
$48.1211603
T

Removal of skin lesion
0020
6.9433
$412.04
$107.40
$82.4111604
T

Removal of skin lesion
0020
6.9433
$412.04
$107.40
$82.4111606
T

Removal of skin lesion
0021
14.9776
$888.82
$219.48
$177.7611620
T

Removal of skin lesion
0020
6.9433
$412.04
$107.40
$82.4111621
T

Removal of skin lesion
0019
4.0547
$240.62
$71.87
$48.1211622
T

Removal of skin lesion
0020
6.9433
$412.04
$107.40
$82.4111623
T

Removal of skin lesion
0021
14.9776
$888.82
$219.48
$177.7611624
T

Removal of skin lesion
0021
14.9776
$888.82
$219.48
$177.7611626
T

Removal of skin lesion
0022
19.6472
$1,165.92
$354.45
$233.1811640
T

Removal of skin lesion
0020
6.9433
$412.04
$107.40
$82.4111641
T

Removal of skin lesion
0020
6.9433
$412.04
$107.40
$82.4111642
T

Removal of skin lesion
0020
6.9433
$412.04
$107.40
$82.4111643
T

Removal of skin lesion
0020
6.9433
$412.04
$107.40
$82.4111644
T

Removal of skin lesion
0021
14.9776
$888.82
$219.48
$177.7611646
T

Removal of skin lesion
0022
19.6472
$1,165.92
$354.45
$233.1811719
T

Trim nail(s)
0009
0.668
$39.64
$8.34
$7.9311720
T

Debride nail, 1-5
0009
0.668
$39.64
$8.34
$7.9311721
T

Debride nail, 6 or more
0009
0.668
$39.64
$8.34
$7.9311730
T

Removal of nail plate
0013
1.1078
$65.74
$14.20
$13.1511732
T

Remove nail plate, add-on
0012
0.8497
$50.42
$11.18
$10.0811740
T

Drain blood from under nail
0009
0.668
$39.64
$8.34
$7.9311750
T

Removal of nail bed
0019
4.0547
$240.62
$71.87
$48.1211752
T

Remove nail bed/finger tip
0022
19.6472
$1,165.92
$354.45
$233.1811755
T

Biopsy, nail unit
0019
4.0547
$240.62
$71.87
$48.1211760
T

Repair of nail bed
0024
1.6084
$95.45
$31.25
$19.0911762
T

Reconstruction of nail bed
0024
1.6084
$95.45
$31.25
$19.0911765
T

Excision of nail fold, toe
0015
1.6514
$98.00
$20.29
$19.6011770
T

Removal of pilonidal lesion
0022
19.6472
$1,165.92
$354.45
$233.1811771
T

Removal of pilonidal lesion
0022
19.6472
$1,165.92
$354.45
$233.1811772
T

Removal of pilonidal lesion
0022
19.6472
$1,165.92
$354.45
$233.1811900
T

Injection into skin lesions
0012
0.8497
$50.42
$11.18
$10.0811901
T

Added skin lesions injection
0012
0.8497
$50.42
$11.18
$10.0811920
T

Correct skin color defects
0024
1.6084
$95.45
$31.25
$19.0911921
T

Correct skin color defects
0024
1.6084
$95.45
$31.25
$19.0911922
T

Correct skin color defects
0024
1.6084
$95.45
$31.25
$19.09( print page 50703)11950
T

Therapy for contour defects
0024
1.6084
$95.45
$31.25
$19.0911951
T

Therapy for contour defects
0024
1.6084
$95.45
$31.25
$19.0911952
T

Therapy for contour defects
0024
1.6084
$95.45
$31.25
$19.0911954
T

Therapy for contour defects
0024
1.6084
$95.45
$31.25
$19.0911960
T

Insert tissue expander(s)
0027
18.4182
$1,092.99
$329.72
$218.6011970
T

Replace tissue expander
0027
18.4182
$1,092.99
$329.72
$218.6011971
T

Remove tissue expander(s)
0022
19.6472
$1,165.92
$354.45
$233.1811975
E

Insert contraceptive cap11976
T

Removal of contraceptive cap
0019
4.0547
$240.62
$71.87
$48.1211977
E

Removal/reinsert contra cap11980
X

Implant hormone pellet(s)
0340
0.6384
$37.88

$7.5811981
X

Insert drug implant device
0340
0.6384
$37.88

$7.5811982
X

Remove drug implant device
0340
0.6384
$37.88

$7.5811983
X

Remove/insert drug implant
0340
0.6384
$37.88

$7.5812001
T

Repair superficial wound(s)
0024
1.6084
$95.45
$31.25
$19.0912002
T

Repair superficial wound(s)
0024
1.6084
$95.45
$31.25
$19.0912004
T

Repair superficial wound(s)
0024
1.6084
$95.45
$31.25
$19.0912005
T

Repair superficial wound(s)
0024
1.6084
$95.45
$31.25
$19.0912006
T

Repair superficial wound(s)
0024
1.6084
$95.45
$31.25
$19.0912007
T

Repair superficial wound(s)
0024
1.6084
$95.45
$31.25
$19.0912011
T

Repair superficial wound(s)
0024
1.6084
$95.45
$31.25
$19.0912013
T

Repair superficial wound(s)
0024
1.6084
$95.45
$31.25
$19.0912014
T

Repair superficial wound(s)
0024
1.6084
$95.45
$31.25
$19.0912015
T

Repair superficial wound(s)
0024
1.6084
$95.45
$31.25
$19.0912016
T

Repair superficial wound(s)
0024
1.6084
$95.45
$31.25
$19.0912017
T

Repair superficial wound(s)
0024
1.6084
$95.45
$31.25
$19.0912018
T

Repair superficial wound(s)
0024
1.6084
$95.45
$31.25
$19.0912020
T

Closure of split wound
0024
1.6084
$95.45
$31.25
$19.0912021
T

Closure of split wound
0024
1.6084
$95.45
$31.25
$19.0912031
T

Layer closure of wound(s)
0024
1.6084
$95.45
$31.25
$19.0912032
T

Layer closure of wound(s)
0024
1.6084
$95.45
$31.25
$19.0912034
T

Layer closure of wound(s)
0024
1.6084
$95.45
$31.25
$19.0912035
T

Layer closure of wound(s)
0024
1.6084
$95.45
$31.25
$19.0912036
T

Layer closure of wound(s)
0024
1.6084
$95.45
$31.25
$19.0912037
T

Layer closure of wound(s)
0025
5.4938
$326.02
$101.85
$65.2012041
T

Layer closure of wound(s)
0024
1.6084
$95.45
$31.25
$19.0912042
T

Layer closure of wound(s)
0024
1.6084
$95.45
$31.25
$19.0912044
T

Layer closure of wound(s)
0024
1.6084
$95.45
$31.25
$19.0912045
T

Layer closure of wound(s)
0024
1.6084
$95.45
$31.25
$19.0912046
T

Layer closure of wound(s)
0024
1.6084
$95.45
$31.25
$19.0912047
T

Layer closure of wound(s)
0025
5.4938
$326.02
$101.85
$65.2012051
T

Layer closure of wound(s)
0024
1.6084
$95.45
$31.25
$19.0912052
T

Layer closure of wound(s)
0024
1.6084
$95.45
$31.25
$19.0912053
T

Layer closure of wound(s)
0024
1.6084
$95.45
$31.25
$19.0912054
T

Layer closure of wound(s)
0024
1.6084
$95.45
$31.25
$19.0912055
T

Layer closure of wound(s)
0024
1.6084
$95.45
$31.25
$19.0912056
T

Layer closure of wound(s)
0024
1.6084
$95.45
$31.25
$19.0912057
T

Layer closure of wound(s)
0025
5.4938
$326.02
$101.85
$65.2013100
T

Repair of wound or lesion
0025
5.4938
$326.02
$101.85
$65.2013101
T

Repair of wound or lesion
0025
5.4938
$326.02
$101.85
$65.2013102
T

Repair wound/lesion add-on
0024
1.6084
$95.45
$31.25
$19.0913120
T

Repair of wound or lesion
0024
1.6084
$95.45
$31.25
$19.0913121
T

Repair of wound or lesion
0024
1.6084
$95.45
$31.25
$19.0913122
T

Repair wound/lesion add-on
0024
1.6084
$95.45
$31.25
$19.0913131
T

Repair of wound or lesion
0024
1.6084
$95.45
$31.25
$19.0913132
T

Repair of wound or lesion
0024
1.6084
$95.45
$31.25
$19.0913133
T

Repair wound/lesion add-on
0024
1.6084
$95.45
$31.25
$19.0913150
T

Repair of wound or lesion
0025
5.4938
$326.02
$101.85
$65.2013151
T

Repair of wound or lesion
0024
1.6084
$95.45
$31.25
$19.0913152
T

Repair of wound or lesion
0025
5.4938
$326.02
$101.85
$65.2013153
T

Repair wound/lesion add-on
0024
1.6084
$95.45
$31.25
$19.0913160
T

Late closure of wound
0027
18.4182
$1,092.99
$329.72
$218.6014000
T

Skin tissue rearrangement
0686
13.8287
$820.64

$164.1314001
T

Skin tissue rearrangement
0027
18.4182
$1,092.99
$329.72
$218.6014020
T

Skin tissue rearrangement
0686
13.8287
$820.64

$164.1314021
T

Skin tissue rearrangement
0027
18.4182
$1,092.99
$329.72
$218.60( print page 50704)14040
T

Skin tissue rearrangement
0686
13.8287
$820.64

$164.1314041
T

Skin tissue rearrangement
0027
18.4182
$1,092.99
$329.72
$218.6014060
T

Skin tissue rearrangement
0027
18.4182
$1,092.99
$329.72
$218.6014061
T

Skin tissue rearrangement
0686
13.8287
$820.64

$164.1314300
T

Skin tissue rearrangement
0027
18.4182
$1,092.99
$329.72
$218.6014350
T

Skin tissue rearrangement
0027
18.4182
$1,092.99
$329.72
$218.6015000
T

Skin graft
0025
5.4938
$326.02
$101.85
$65.2015001
T

Skin graft add-on
0025
5.4938
$326.02
$101.85
$65.2015050
T

Skin pinch graft
0025
5.4938
$326.02
$101.85
$65.2015100
T

Skin split graft
0027
18.4182
$1,092.99
$329.72
$218.6015101
T

Skin split graft add-on
0027
18.4182
$1,092.99
$329.72
$218.6015120
T

Skin split graft
0027
18.4182
$1,092.99
$329.72
$218.6015121
T

Skin split graft add-on
0027
18.4182
$1,092.99
$329.72
$218.6015200
T

Skin full graft
0027
18.4182
$1,092.99
$329.72
$218.6015201
T

Skin full graft add-on
0025
5.4938
$326.02
$101.85
$65.2015220
T

Skin full graft
0027
18.4182
$1,092.99
$329.72
$218.6015221
T

Skin full graft add-on
0025
5.4938
$326.02
$101.85
$65.2015240
T

Skin full graft
0686
13.8287
$820.64

$164.1315241
T

Skin full graft add-on
0025
5.4938
$326.02
$101.85
$65.2015260
T

Skin full graft
0686
13.8287
$820.64

$164.1315261
T

Skin full graft add-on
0025
5.4938
$326.02
$101.85
$65.2015342
T

Cultured skin graft, 25 cm
0024
1.6084
$95.45
$31.25
$19.0915343
T

Culture skn graft addl 25 cm
0024
1.6084
$95.45
$31.25
$19.0915350
T

Skin homograft
0686
13.8287
$820.64

$164.1315351
T

Skin homograft add-on
0686
13.8287
$820.64

$164.1315400
T

Skin heterograft
0025
5.4938
$326.02
$101.85
$65.2015401
T

Skin heterograft add-on
0025
5.4938
$326.02
$101.85
$65.2015570
T

Form skin pedicle flap
0027
18.4182
$1,092.99
$329.72
$218.6015572
T

Form skin pedicle flap
0027
18.4182
$1,092.99
$329.72
$218.6015574
T

Form skin pedicle flap
0027
18.4182
$1,092.99
$329.72
$218.6015576
T

Form skin pedicle flap
0686
13.8287
$820.64

$164.1315600
T

Skin graft
0027
18.4182
$1,092.99
$329.72
$218.6015610
T

Skin graft
0027
18.4182
$1,092.99
$329.72
$218.6015620
T

Skin graft
0027
18.4182
$1,092.99
$329.72
$218.6015630
T

Skin graft
0027
18.4182
$1,092.99
$329.72
$218.6015650
T

Transfer skin pedicle flap
0027
18.4182
$1,092.99
$329.72
$218.6015732
T

Muscle-skin graft, head/neck
0027
18.4182
$1,092.99
$329.72
$218.6015734
T

Muscle-skin graft, trunk
0027
18.4182
$1,092.99
$329.72
$218.6015736
T

Muscle-skin graft, arm
0027
18.4182
$1,092.99
$329.72
$218.6015738
T

Muscle-skin graft, leg
0027
18.4182
$1,092.99
$329.72
$218.6015740
T

Island pedicle flap graft
0686
13.8287
$820.64

$164.1315750
T

Neurovascular pedicle graft
0027
18.4182
$1,092.99
$329.72
$218.6015756
C

Free muscle flap, microvasc15757
C

Free skin flap, microvasc15758
C

Free fascial flap, microvasc15760
T

Composite skin graft
0027
18.4182
$1,092.99
$329.72
$218.6015770
T

Derma-fat-fascia graft
0027
18.4182
$1,092.99
$329.72
$218.6015775
T

Hair transplant punch grafts
0025
5.4938
$326.02
$101.85
$65.2015776
T

Hair transplant punch grafts
0025
5.4938
$326.02
$101.85
$65.2015780
T

Abrasion treatment of skin
0022
19.6472
$1,165.92
$354.45
$233.1815781
T

Abrasion treatment of skin
0019
4.0547
$240.62
$71.87
$48.1215782
T

Dressing change not for burn
0019
4.0547
$240.62
$71.87
$48.1215783
T

Abrasion treatment of skin
0016
2.5834
$153.31
$33.57
$30.6615786
T

Abrasion, lesion, single
0013
1.1078
$65.74
$14.20
$13.1515787
T

Abrasion, lesions, add-on
0013
1.1078
$65.74
$14.20
$13.1515788
T

Chemical peel, face, epiderm
0012
0.8497
$50.42
$11.18
$10.0815789
T

Chemical peel, face, dermal
0015
1.6514
$98.00
$20.29
$19.6015792
T

Chemical peel, nonfacial
0013
1.1078
$65.74
$14.20
$13.1515793
T

Chemical peel, nonfacial
0012
0.8497
$50.42
$11.18
$10.0815810
T

Salabrasion
0016
2.5834
$153.31
$33.57
$30.6615811
T

Salabrasion
0016
2.5834
$153.31
$33.57
$30.6615819
T

Plastic surgery, neck
0025
5.4938
$326.02
$101.85
$65.2015820
T

Revision of lower eyelid
0027
18.4182
$1,092.99
$329.72
$218.6015821
T

Revision of lower eyelid
0027
18.4182
$1,092.99
$329.72
$218.6015822
T

Revision of upper eyelid
0027
18.4182
$1,092.99
$329.72
$218.6015823
T

Revision of upper eyelid
0027
18.4182
$1,092.99
$329.72
$218.60( print page 50705)15824
T

Removal of forehead wrinkles
0027
18.4182
$1,092.99
$329.72
$218.6015825
T

Removal of neck wrinkles
0027
18.4182
$1,092.99
$329.72
$218.6015826
T

Removal of brow wrinkles
0027
18.4182
$1,092.99
$329.72
$218.6015828
T

Removal of face wrinkles
0027
18.4182
$1,092.99
$329.72
$218.6015829
T

Removal of skin wrinkles
0027
18.4182
$1,092.99
$329.72
$218.6015831
T

Excise excessive skin tissue
0022
19.6472
$1,165.92
$354.45
$233.1815832
T

Excise excessive skin tissue
0022
19.6472
$1,165.92
$354.45
$233.1815833
T

Excise excessive skin tissue
0022
19.6472
$1,165.92
$354.45
$233.1815834
T

Excise excessive skin tissue
0022
19.6472
$1,165.92
$354.45
$233.1815835
T

Excise excessive skin tissue
0025
5.4938
$326.02
$101.85
$65.2015836
T

Excise excessive skin tissue
0021
14.9776
$888.82
$219.48
$177.7615837
T

Excise excessive skin tissue
0021
14.9776
$888.82
$219.48
$177.7615838
T

Excise excessive skin tissue
0021
14.9776
$888.82
$219.48
$177.7615839
T

Excise excessive skin tissue
0021
14.9776
$888.82
$219.48
$177.7615840
T

Graft for face nerve palsy
0027
18.4182
$1,092.99
$329.72
$218.6015841
T

Graft for face nerve palsy
0027
18.4182
$1,092.99
$329.72
$218.6015842
T

Flap for face nerve palsy
0027
18.4182
$1,092.99
$329.72
$218.6015845
T

Skin and muscle repair, face
0027
18.4182
$1,092.99
$329.72
$218.6015850
T

Removal of sutures
0016
2.5834
$153.31
$33.57
$30.6615851
T

Removal of sutures
0016
2.5834
$153.31
$33.57
$30.6615852
X

Dressing change not for burn
0340
0.6384
$37.88

$7.5815860
X

Test for blood flow in graft
0359
0.8312
$49.33

$9.8715876
T

Suction assisted lipectomy
0027
18.4182
$1,092.99
$329.72
$218.6015877
T

Suction assisted lipectomy
0027
18.4182
$1,092.99
$329.72
$218.6015878
T

Suction assisted lipectomy
0686
13.8287
$820.64

$164.1315879
T

Suction assisted lipectomy
0027
18.4182
$1,092.99
$329.72
$218.6015920
T

Removal of tail bone ulcer
0019
4.0547
$240.62
$71.87
$48.1215922
T

Removal of tail bone ulcer
0027
18.4182
$1,092.99
$329.72
$218.6015931
T

Remove sacrum pressure sore
0022
19.6472
$1,165.92
$354.45
$233.1815933
T

Remove sacrum pressure sore
0022
19.6472
$1,165.92
$354.45
$233.1815934
T

Remove sacrum pressure sore
0027
18.4182
$1,092.99
$329.72
$218.6015935
T

Remove sacrum pressure sore
0027
18.4182
$1,092.99
$329.72
$218.6015936
T

Remove sacrum pressure sore
0027
18.4182
$1,092.99
$329.72
$218.6015937
T

Remove sacrum pressure sore
0027
18.4182
$1,092.99
$329.72
$218.6015940
T

Remove hip pressure sore
0022
19.6472
$1,165.92
$354.45
$233.1815941
T

Remove hip pressure sore
0022
19.6472
$1,165.92
$354.45
$233.1815944
T

Remove hip pressure sore
0027
18.4182
$1,092.99
$329.72
$218.6015945
T

Remove hip pressure sore
0027
18.4182
$1,092.99
$329.72
$218.6015946
T

Remove hip pressure sore
0027
18.4182
$1,092.99
$329.72
$218.6015950
T

Remove thigh pressure sore
0022
19.6472
$1,165.92
$354.45
$233.1815951
T

Remove thigh pressure sore
0022
19.6472
$1,165.92
$354.45
$233.1815952
T

Remove thigh pressure sore
0027
18.4182
$1,092.99
$329.72
$218.6015953
T

Remove thigh pressure sore
0027
18.4182
$1,092.99
$329.72
$218.6015956
T

Remove thigh pressure sore
0027
18.4182
$1,092.99
$329.72
$218.6015958
T

Remove thigh pressure sore
0027
18.4182
$1,092.99
$329.72
$218.6015999
T

Removal of pressure sore
0019
4.0547
$240.62
$71.87
$48.1216000
T

Initial treatment of burn(s)
0012
0.8497
$50.42
$11.18
$10.0816010
T

Treatment of burn(s)
0016
2.5834
$153.31
$33.57
$30.6616015
T

Treatment of burn(s)
0017
18.4211
$1,093.16
$227.84
$218.6316020
T

Treatment of burn(s)
0013
1.1078
$65.74
$14.20
$13.1516025
T

Treatment of burn(s)
0013
1.1078
$65.74
$14.20
$13.1516030
T

Treatment of burn(s)
0015
1.6514
$98.00
$20.29
$19.6016035
C

Incision of burn scab, initi16036
C

Escharotomy addl incision17000
T

Destroy benign/premlg lesion
0010
0.5719
$33.94
$9.65
$6.7917003
T

Destroy lesions, 2-14
0010
0.5719
$33.94
$9.65
$6.7917004
T

Destroy lesions, 15 or more
0011
2.0839
$123.66
$25.17
$24.7317106
T

Destruction of skin lesions
0011
2.0839
$123.66
$25.17
$24.7317107
T

Destruction of skin lesions
0011
2.0839
$123.66
$25.17
$24.7317108
T

Destruction of skin lesions
0011
2.0839
$123.66
$25.17
$24.7317110
T

Destruct lesion, 1-14
0010
0.5719
$33.94
$9.65
$6.7917111
T

Destruct lesion, 15 or more
0010
0.5719
$33.94
$9.65
$6.7917250
T

Chemical cautery, tissue
0013
1.1078
$65.74
$14.20
$13.1517260
T

Destruction of skin lesions
0015
1.6514
$98.00
$20.29
$19.6017261
T

Destruction of skin lesions
0015
1.6514
$98.00
$20.29
$19.6017262
T

Destruction of skin lesions
0015
1.6514
$98.00
$20.29
$19.60( print page 50706)17263
T

Destruction of skin lesions
0015
1.6514
$98.00
$20.29
$19.6017264
T

Destruction of skin lesions
0015
1.6514
$98.00
$20.29
$19.6017266
T

Destruction of skin lesions
0016
2.5834
$153.31
$33.57
$30.6617270
T

Destruction of skin lesions
0015
1.6514
$98.00
$20.29
$19.6017271
T

Destruction of skin lesions
0013
1.1078
$65.74
$14.20
$13.1517272
T

Destruction of skin lesions
0015
1.6514
$98.00
$20.29
$19.6017273
T

Destruction of skin lesions
0015
1.6514
$98.00
$20.29
$19.6017274
T

Destruction of skin lesions
0016
2.5834
$153.31
$33.57
$30.6617276
T

Destruction of skin lesions
0016
2.5834
$153.31
$33.57
$30.6617280
T

Destruction of skin lesions
0015
1.6514
$98.00
$20.29
$19.6017281
T

Destruction of skin lesions
0015
1.6514
$98.00
$20.29
$19.6017282
T

Destruction of skin lesions
0015
1.6514
$98.00
$20.29
$19.6017283
T

Destruction of skin lesions
0015
1.6514
$98.00
$20.29
$19.6017284
T

Destruction of skin lesions
0016
2.5834
$153.31
$33.57
$30.6617286
T

Destruction of skin lesions
0015
1.6514
$98.00
$20.29
$19.6017304
T

Chemosurgery of skin lesion
0694
3.8452
$228.19
$61.86
$45.6417305
T

2 stage mohs, up to 5 spec
0694
3.8452
$228.19
$61.86
$45.6417306
T

3 stage mohs, up to 5 spec
0694
3.8452
$228.19
$61.86
$45.6417307
T

Mohs addl stage up to 5 spec
0694
3.8452
$228.19
$61.86
$45.6417310
T

Extensive skin chemosurgery
0694
3.8452
$228.19
$61.86
$45.6417340
T

Cryotherapy of skin
0012
0.8497
$50.42
$11.18
$10.0817360
T

Skin peel therapy
0013
1.1078
$65.74
$14.20
$13.1517380
T

Hair removal by electrolysis
0013
1.1078
$65.74
$14.20
$13.1517999
T

Skin tissue procedure
0006
1.55
$91.98
$22.28
$18.4019000
T

Drainage of breast lesion
0004
1.7646
$104.72
$22.36
$20.9419001
T

Drain breast lesion add-on
0004
1.7646
$104.72
$22.36
$20.9419020
T

Incision of breast lesion
0008
16.4989
$979.09

$195.8219030
N

Injection for breast x-ray19100
T

Bx breast percut w/o image
0005
3.5994
$213.60
$71.59
$42.7219101
T

Biopsy of breast, open
0028
19.5801
$1,161.94
$303.74
$232.3919102
T

Bx breast percut w/image
0005
3.5994
$213.60
$71.59
$42.7219103
T

Bx breast percut w/device
0658
6.1049
$362.28

$72.4619110
T

nipple exploration
0028
19.5801
$1,161.94
$303.74
$232.3919112
T

Excise breast duct fistula
0028
19.5801
$1,161.94
$303.74
$232.3919120
T

Removal of breast lesion
0028
19.5801
$1,161.94
$303.74
$232.3919125
T

Excision, breast lesion
0028
19.5801
$1,161.94
$303.74
$232.3919126
T

Excision, addl breast lesion
0028
19.5801
$1,161.94
$303.74
$232.3919140
T

Removal of breast tissue
0028
19.5801
$1,161.94
$303.74
$232.3919160
T

Removal of breast tissue
0028
19.5801
$1,161.94
$303.74
$232.3919162
T

Remove breast tissue, nodes
0693
42.2254
$2,505.78
$798.17
$501.1619180
T

Removal of breast
0029
32.0476
$1,901.80
$632.64
$380.3619182
T

Removal of breast
0029
32.0476
$1,901.80
$632.64
$380.3619200
C

Removal of breast19220
C

Removal of breast19240
T

Removal of breast
0030
40.0825
$2,378.62
$763.55
$475.7219260
T

Removal of chest wall lesion
0021
14.9776
$888.82
$219.48
$177.7619271
C

Revision of chest wall19272
C

Extensive chest wall surgery19290
N

Place needle wire, breast19291
N

Place needle wire, breast19295
S

Place breast clip, percut
0657
1.7092
$101.43

$20.2919296
S

Place po breast cath for rad
1524

$3,250.00

$650.0019297
S

Place breast cath for rad
1523

$2,750.00

$550.0019298
S

Place breast rad tube/caths
1524

$3,250.00

$650.0019316
T

Suspension of breast
0029
32.0476
$1,901.80
$632.64
$380.3619318
T

Reduction of large breast
0693
42.2254
$2,505.78
$798.17
$501.1619324
T

Enlarge breast
0693
42.2254
$2,505.78
$798.17
$501.1619325
T

Enlarge breast with implant
0648
50.4459
$2,993.61

$598.7219328
T

Removal of breast implant
0029
32.0476
$1,901.80
$632.64
$380.3619330
T

Removal of implant material
0029
32.0476
$1,901.80
$632.64
$380.3619340
T

Immediate breast prosthesis
0030
40.0825
$2,378.62
$763.55
$475.7219342
T

Delayed breast prosthesis
0648
50.4459
$2,993.61

$598.7219350
T

Breast reconstruction
0028
19.5801
$1,161.94
$303.74
$232.3919355
T

Correct inverted nipple(s)
0029
32.0476
$1,901.80
$632.64
$380.3619357
T

Breast reconstruction
0648
50.4459
$2,993.61

$598.7219361
C

Breast reconstruction( print page 50707)19364
C

Breast reconstruction19366
T

Breast reconstruction
0029
32.0476
$1,901.80
$632.64
$380.3619367
C

Breast reconstruction19368
C

Breast reconstruction19369
C

Breast reconstruction19370
T

Surgery of breast capsule
0029
32.0476
$1,901.80
$632.64
$380.3619371
T

Removal of breast capsule
0029
32.0476
$1,901.80
$632.64
$380.3619380
T

Revise breast reconstruction
0030
40.0825
$2,378.62
$763.55
$475.7219396
T

Design custom breast implant
0029
32.0476
$1,901.80
$632.64
$380.3619499
T

Breast surgery procedure
0028
19.5801
$1,161.94
$303.74
$232.3920000
T

Incision of abscess
0006
1.55
$91.98
$22.28
$18.4020005
T

Incision of deep abscess
0049
20.3707
$1,208.86

$241.772000F
E

Blood pressure, measured20100
T

Explore wound, neck
0023
4.7775
$283.51

$56.7020101
T

Explore wound, chest
0027
18.4182
$1,092.99
$329.72
$218.6020102
T

Explore wound, abdomen
0027
18.4182
$1,092.99
$329.72
$218.6020103
T

Explore wound, extremity
0023
4.7775
$283.51

$56.7020150
T

Excise epiphyseal bar
0051
36.5271
$2,167.63

$433.5320200
T

Muscle biopsy
0021
14.9776
$888.82
$219.48
$177.7620205
T

Deep muscle biopsy
0021
14.9776
$888.82
$219.48
$177.7620206
T

Needle biopsy, muscle
0005
3.5994
$213.60
$71.59
$42.7220220
T

Bone biopsy, trocar/needle
0019
4.0547
$240.62
$71.87
$48.1220225
T

Bone biopsy, trocar/needle
0020
6.9433
$412.04
$107.40
$82.4120240
T

Bone biopsy, excisional
0022
19.6472
$1,165.92
$354.45
$233.1820245
T

Bone biopsy, excisional
0022
19.6472
$1,165.92
$354.45
$233.1820250
T

Open bone biopsy
0049
20.3707
$1,208.86

$241.7720251
T

Open bone biopsy
0049
20.3707
$1,208.86

$241.7720500
T

Injection of sinus tract
0251
2.0101
$119.29

$23.8620501
N

Inject sinus tract for x-ray20520
T

Removal of foreign body
0019
4.0547
$240.62
$71.87
$48.1220525
T

Removal of foreign body
0022
19.6472
$1,165.92
$354.45
$233.1820526
T

Ther injection, carp tunnel
0204
2.191
$130.02
$40.13
$26.0020550
T

Inject tendon/ligament/cyst
0204
2.191
$130.02
$40.13
$26.0020551
T

Inj tendon origin/insertion
0204
2.191
$130.02
$40.13
$26.0020552
T

Inj trigger point, 1/2 muscl
0204
2.191
$130.02
$40.13
$26.0020553
T

Inject trigger points, > 3
0204
2.191
$130.02
$40.13
$26.0020600
T

Drain/inject, joint/bursa
0204
2.191
$130.02
$40.13
$26.0020605
T

Drain/inject, joint/bursa
0204
2.191
$130.02
$40.13
$26.0020610
T

Drain/inject, joint/bursa
0204
2.191
$130.02
$40.13
$26.0020612
T

Aspirate/inj ganglion cyst
0204
2.191
$130.02
$40.13
$26.0020615
T

Treatment of bone cyst
0004
1.7646
$104.72
$22.36
$20.9420650
T

Insert and remove bone pin
0049
20.3707
$1,208.86

$241.7720660
C

Apply, rem fixation device20661
C

Application of head brace20662
T

Application of pelvis brace
0049
20.3707
$1,208.86

$241.7720663
T

Application of thigh brace
0049
20.3707
$1,208.86

$241.7720664
C

Halo brace application20665
X

Removal of fixation device
0340
0.6384
$37.88

$7.5820670
T

Removal of support implant
0021
14.9776
$888.82
$219.48
$177.7620680
T

Removal of support implant
0022
19.6472
$1,165.92
$354.45
$233.1820690
T

Apply bone fixation device
0050
23.9081
$1,418.78

$283.7620692
T

Apply bone fixation device
0050
23.9081
$1,418.78

$283.7620693
T

Adjust bone fixation device
0049
20.3707
$1,208.86

$241.7720694
T

Remove bone fixation device
0049
20.3707
$1,208.86

$241.7720802
C

Replantation, arm, complete20805
C

Replant forearm, complete20808
C

Replantation hand, complete20816
C

Replantation digit, complete20822
T

Replantation digit, complete
0054
25.3711
$1,505.60

$301.1220824
C

Replantation thumb, complete20827
C

Replantation thumb, complete20838
C

Replantation foot, complete20900
T

Removal of bone for graft
0050
23.9081
$1,418.78

$283.7620902
T

Removal of bone for graft
0050
23.9081
$1,418.78

$283.7620910
T

Remove cartilage for graft
0027
18.4182
$1,092.99
$329.72
$218.6020912
T

Remove cartilage for graft
0027
18.4182
$1,092.99
$329.72
$218.60( print page 50708)20920
T

Removal of fascia for graft
0686
13.8287
$820.64

$164.1320922
T

Removal of fascia for graft
0027
18.4182
$1,092.99
$329.72
$218.6020924
T

Removal of tendon for graft
0050
23.9081
$1,418.78

$283.7620926
T

Removal of tissue for graft
0686
13.8287
$820.64

$164.1320930
C

Spinal bone allograft20931
C

Spinal bone allograft20936
C

Spinal bone autograft20937
C

Spinal bone autograft20938
C

Spinal bone autograft20950
T

Fluid pressure, muscle
0006
1.55
$91.98
$22.28
$18.4020955
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
T

Bone/skin graft, metatarsal
0056
40.2957
$2,391.27

$478.2520973
T

Bone/skin graft, great toe
0056
40.2957
$2,391.27

$478.2520974
A

Electrical bone stimulation20975
X

Electrical bone stimulation
0340
0.6384
$37.88

$7.5820979
A

Us bone stimulation20982
T

Ablate, bone tumor(s) perq
1557

$1,850.00

$370.0020999
T

Musculoskeletal surgery
0049
20.3707
$1,208.86

$241.7721010
T

Incision of jaw joint
0254
23.404
$1,388.86
$321.35
$277.7721015
T

Resection of facial tumor
0253
16.1357
$957.54
$282.29
$191.5121025
T

Excision of bone, lower jaw
0256
37.3204
$2,214.70

$442.9421026
T

Excision of facial bone(s)
0256
37.3204
$2,214.70

$442.9421029
T

Contour of face bone lesion
0256
37.3204
$2,214.70

$442.9421030
T

Removal of face bone lesion
0254
23.404
$1,388.86
$321.35
$277.7721031
T

Remove exostosis, mandible
0254
23.404
$1,388.86
$321.35
$277.7721032
T

Remove exostosis, maxilla
0254
23.404
$1,388.86
$321.35
$277.7721034
T

Removal of face bone lesion
0256
37.3204
$2,214.70

$442.9421040
T

Removal of jaw bone lesion
0254
23.404
$1,388.86
$321.35
$277.7721044
T

Removal of jaw bone lesion
0256
37.3204
$2,214.70

$442.9421045
C

Extensive jaw surgery21046
T

Remove mandible cyst complex
0256
37.3204
$2,214.70

$442.9421047
T

Excise lwr jaw cyst w/repair
0256
37.3204
$2,214.70

$442.9421048
T

Remove maxilla cyst complex
0256
37.3204
$2,214.70

$442.9421049
T

Excis uppr jaw cyst w/repair
0256
37.3204
$2,214.70

$442.9421050
T

Removal of jaw joint
0256
37.3204
$2,214.70

$442.9421060
T

Remove jaw joint cartilage
0256
37.3204
$2,214.70

$442.9421070
T

Remove coronoid process
0256
37.3204
$2,214.70

$442.9421076
T

Prepare face/oral prosthesis
0254
23.404
$1,388.86
$321.35
$277.7721077
T

Prepare face/oral prosthesis
0256
37.3204
$2,214.70

$442.9421079
T

Prepare face/oral prosthesis
0256
37.3204
$2,214.70

$442.9421080
T

Prepare face/oral prosthesis
0256
37.3204
$2,214.70

$442.9421081
T

Prepare face/oral prosthesis
0256
37.3204
$2,214.70

$442.9421082
T

Prepare face/oral prosthesis
0256
37.3204
$2,214.70

$442.9421083
T

Prepare face/oral prosthesis
0256
37.3204
$2,214.70

$442.9421084
T

Prepare face/oral prosthesis
0256
37.3204
$2,214.70

$442.9421085
T

Prepare face/oral prosthesis
0253
16.1357
$957.54
$282.29
$191.5121086
T

Prepare face/oral prosthesis
0256
37.3204
$2,214.70

$442.9421087
T

Prepare face/oral prosthesis
0256
37.3204
$2,214.70

$442.9421088
T

Prepare face/oral prosthesis
0256
37.3204
$2,214.70

$442.9421089
T

Prepare face/oral prosthesis
0251
2.0101
$119.29

$23.8621100
T

Maxillofacial fixation
0256
37.3204
$2,214.70

$442.9421110
T

Interdental fixation
0252
7.8673
$466.87
$113.41
$93.3721116
N

Injection, jaw joint x-ray21120
T

Reconstruction of chin
0254
23.404
$1,388.86
$321.35
$277.7721121
T

Reconstruction of chin
0254
23.404
$1,388.86
$321.35
$277.7721122
T

Reconstruction of chin
0254
23.404
$1,388.86
$321.35
$277.7721123
T

Reconstruction of chin
0254
23.404
$1,388.86
$321.35
$277.7721125
T

Augmentation, lower jaw bone
0254
23.404
$1,388.86
$321.35
$277.7721127
T

Augmentation, lower jaw bone
0256
37.3204
$2,214.70

$442.9421137
T

Reduction of forehead
0254
23.404
$1,388.86
$321.35
$277.7721138
T

Reduction of forehead
0256
37.3204
$2,214.70

$442.94( print page 50709)21139
T

Reduction of forehead
0256
37.3204
$2,214.70

$442.9421141
C

Reconstruct midface, lefort21142
C

Reconstruct midface, lefort21143
C

Reconstruct midface, lefort21145
C

Reconstruct midface, lefort21146
C

Reconstruct midface, lefort21147
C

Reconstruct midface, lefort21150
T

Reconstruct midface, lefort
0256
37.3204
$2,214.70

$442.9421151
C

Reconstruct midface, lefort21154
C

Reconstruct midface, lefort21155
C

Reconstruct midface, lefort21159
C

Reconstruct midface, lefort21160
C

Reconstruct midface, lefort21172
C

Reconstruct orbit/forehead21175
T

Reconstruct orbit/forehead
0256
37.3204
$2,214.70

$442.9421179
C

Reconstruct entire forehead21180
C

Reconstruct entire forehead21181
T

Contour cranial bone lesion
0254
23.404
$1,388.86
$321.35
$277.7721182
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
T

Reconst lwr jaw w/o fixation
0256
37.3204
$2,214.70

$442.9421196
C

Reconst lwr jaw w/fixation21198
T

Reconstr lwr jaw segment
0256
37.3204
$2,214.70

$442.9421199
T

Reconstr lwr jaw w/advance
0256
37.3204
$2,214.70

$442.9421206
T

Reconstruct upper jaw bone
0256
37.3204
$2,214.70

$442.9421208
T

Augmentation of facial bones
0256
37.3204
$2,214.70

$442.9421209
T

Reduction of facial bones
0256
37.3204
$2,214.70

$442.9421210
T

Face bone graft
0256
37.3204
$2,214.70

$442.9421215
T

Lower jaw bone graft
0256
37.3204
$2,214.70

$442.9421230
T

Rib cartilage graft
0256
37.3204
$2,214.70

$442.9421235
T

Ear cartilage graft
0254
23.404
$1,388.86
$321.35
$277.7721240
T

Reconstruction of jaw joint
0256
37.3204
$2,214.70

$442.9421242
T

Reconstruction of jaw joint
0256
37.3204
$2,214.70

$442.9421243
T

Reconstruction of jaw joint
0256
37.3204
$2,214.70

$442.9421244
T

Reconstruction of lower jaw
0256
37.3204
$2,214.70

$442.9421245
T

Reconstruction of jaw
0256
37.3204
$2,214.70

$442.9421246
T

Reconstruction of jaw
0256
37.3204
$2,214.70

$442.9421247
C

Reconstruct lower jaw bone21248
T

Reconstruction of jaw
0256
37.3204
$2,214.70

$442.9421249
T

Reconstruction of jaw
0256
37.3204
$2,214.70

$442.9421255
C

Reconstruct lower jaw bone21256
C

Reconstruction of orbit21260
T

Revise eye sockets
0256
37.3204
$2,214.70

$442.9421261
T

Revise eye sockets
0256
37.3204
$2,214.70

$442.9421263
T

Revise eye sockets
0256
37.3204
$2,214.70

$442.9421267
T

Revise eye sockets
0256
37.3204
$2,214.70

$442.9421268
C

Revise eye sockets21270
T

Augmentation, cheek bone
0256
37.3204
$2,214.70

$442.9421275
T

Revision, orbitofacial bones
0256
37.3204
$2,214.70

$442.9421280
T

Revision of eyelid
0256
37.3204
$2,214.70

$442.9421282
T

Revision of eyelid
0253
16.1357
$957.54
$282.29
$191.5121295
T

Revision of jaw muscle/bone
0252
7.8673
$466.87
$113.41
$93.3721296
T

Revision of jaw muscle/bone
0254
23.404
$1,388.86
$321.35
$277.7721299
T

Cranio/maxillofacial surgery
0251
2.0101
$119.29

$23.8621300
T

Treatment of skull fracture
0253
16.1357
$957.54
$282.29
$191.5121310
T

Treatment of nose fracture
0251
2.0101
$119.29

$23.8621315
T

Treatment of nose fracture
0251
2.0101
$119.29

$23.8621320
T

Treatment of nose fracture
0252
7.8673
$466.87
$113.41
$93.3721325
T

Treatment of nose fracture
0254
23.404
$1,388.86
$321.35
$277.7721330
T

Treatment of nose fracture
0254
23.404
$1,388.86
$321.35
$277.7721335
T

Treatment of nose fracture
0254
23.404
$1,388.86
$321.35
$277.7721336
T

Treat nasal septal fracture
0046
37.7023
$2,237.37
$535.76
$447.47( print page 50710)21337
T

Treat nasal septal fracture
0253
16.1357
$957.54
$282.29
$191.5121338
T

Treat nasoethmoid fracture
0254
23.404
$1,388.86
$321.35
$277.7721339
T

Treat nasoethmoid fracture
0254
23.404
$1,388.86
$321.35
$277.7721340
T

Treatment of nose fracture
0256
37.3204
$2,214.70

$442.9421343
C

Treatment of sinus fracture21344
C

Treatment of sinus fracture21345
T

Treat nose/jaw fracture
0254
23.404
$1,388.86
$321.35
$277.7721346
C

Treat nose/jaw fracture21347
C

Treat nose/jaw fracture21348
C

Treat nose/jaw fracture21355
T

Treat cheek bone fracture
0256
37.3204
$2,214.70

$442.9421356
T

Treat cheek bone fracture
0254
23.404
$1,388.86
$321.35
$277.7721360
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
T

Treat eye socket fracture
0256
37.3204
$2,214.70

$442.9421395
C

Treat eye socket fracture21400
T

Treat eye socket fracture
0252
7.8673
$466.87
$113.41
$93.3721401
T

Treat eye socket fracture
0253
16.1357
$957.54
$282.29
$191.5121406
T

Treat eye socket fracture
0256
37.3204
$2,214.70

$442.9421407
T

Treat eye socket fracture
0256
37.3204
$2,214.70

$442.9421408
T

Treat eye socket fracture
0256
37.3204
$2,214.70

$442.9421421
T

Treat mouth roof fracture
0254
23.404
$1,388.86
$321.35
$277.7721422
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
0254
23.404
$1,388.86
$321.35
$277.7721445
T

Treat dental ridge fracture
0254
23.404
$1,388.86
$321.35
$277.7721450
T

Treat lower jaw fracture
0251
2.0101
$119.29

$23.8621451
T

Treat lower jaw fracture
0252
7.8673
$466.87
$113.41
$93.3721452
T

Treat lower jaw fracture
0253
16.1357
$957.54
$282.29
$191.5121453
T

Treat lower jaw fracture
0256
37.3204
$2,214.70

$442.9421454
T

Treat lower jaw fracture
0254
23.404
$1,388.86
$321.35
$277.7721461
T

Treat lower jaw fracture
0256
37.3204
$2,214.70

$442.9421462
T

Treat lower jaw fracture
0256
37.3204
$2,214.70

$442.9421465
T

Treat lower jaw fracture
0256
37.3204
$2,214.70

$442.9421470
T

Treat lower jaw fracture
0256
37.3204
$2,214.70

$442.9421480
T

Reset dislocated jaw
0251
2.0101
$119.29

$23.8621485
T

Reset dislocated jaw
0253
16.1357
$957.54
$282.29
$191.5121490
T

Repair dislocated jaw
0256
37.3204
$2,214.70

$442.9421493
T

Treat hyoid bone fracture
0252
7.8673
$466.87
$113.41
$93.3721494
T

Treat hyoid bone fracture
0252
7.8673
$466.87
$113.41
$93.3721495
T

Treat hyoid bone fracture
0253
16.1357
$957.54
$282.29
$191.5121497
T

Interdental wiring
0253
16.1357
$957.54
$282.29
$191.5121499
T

Head surgery procedure
0251
2.0101
$119.29

$23.8621501
T

Drain neck/chest lesion
0008
16.4989
$979.09

$195.8221502
T

Drain chest lesion
0049
20.3707
$1,208.86

$241.7721510
C

Drainage of bone lesion21550
T

Biopsy of neck/chest
0021
14.9776
$888.82
$219.48
$177.7621555
T

Remove lesion, neck/chest
0022
19.6472
$1,165.92
$354.45
$233.1821556
T

Remove lesion, neck/chest
0022
19.6472
$1,165.92
$354.45
$233.1821557
T

Remove tumor, neck/chest
0022
19.6472
$1,165.92
$354.45
$233.1821600
T

Partial removal of rib
0050
23.9081
$1,418.78

$283.7621610
T

Partial removal of rib
0050
23.9081
$1,418.78

$283.7621615
C

Removal of rib21616
C

Removal of rib and nerves21620
C

Partial removal of sternum21627
C

Sternal debridement21630
C

Extensive sternum surgery( print page 50711)21632
C

Extensive sternum surgery21685
T

Hyoid myotomy & suspension
0252
7.8673
$466.87
$113.41
$93.3721700
T

Revision of neck muscle
0049
20.3707
$1,208.86

$241.7721705
C

Revision of neck muscle/rib21720
T

Revision of neck muscle
0049
20.3707
$1,208.86

$241.7721725
T

Revision of neck muscle
0006
1.55
$91.98
$22.28
$18.4021740
C

Reconstruction of sternum21742
T

Repair stern/nuss w/o scope
0051
36.5271
$2,167.63

$433.5321743
T

Repair sternum/nuss w/scope
0051
36.5271
$2,167.63

$433.5321750
C

Repair of sternum separation21800
T

Treatment of rib fracture
0043
1.7694
$105.00

$21.0021805
T

Treatment of rib fracture
0046
37.7023
$2,237.37
$535.76
$447.4721810
C

Treatment of rib fracture(s)21820
T

Treat sternum fracture
0043
1.7694
$105.00

$21.0021825
C

Treat sternum fracture21899
T

Neck/chest surgery procedure
0251
2.0101
$119.29

$23.8621920
T

Biopsy soft tissue of back
0020
6.9433
$412.04
$107.40
$82.4121925
T

Biopsy soft tissue of back
0022
19.6472
$1,165.92
$354.45
$233.1821930
T

Remove lesion, back or flank
0022
19.6472
$1,165.92
$354.45
$233.1821935
T

Remove tumor, back
0022
19.6472
$1,165.92
$354.45
$233.1822100
T

Remove part of neck vertebra
0208
42.3409
$2,512.64

$502.5322101
T

Remove part, thorax vertebra
0208
42.3409
$2,512.64

$502.5322102
T

Remove part, lumbar vertebra
0208
42.3409
$2,512.64

$502.5322103
T

Remove extra spine segment
0208
42.3409
$2,512.64

$502.5322110
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
T

Revision of thorax spine
0208
42.3409
$2,512.64

$502.5322224
C

Revision of lumbar spine22226
C

Revise, extra spine segment22305
T

Treat spine process fracture
0043
1.7694
$105.00

$21.0022310
T

Treat spine fracture
0043
1.7694
$105.00

$21.0022315
T

Treat spine fracture
0043
1.7694
$105.00

$21.0022318
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
14.4945
$860.15
$268.47
$172.0322520
T

Percut vertebroplasty thor
0050
23.9081
$1,418.78

$283.7622521
T

Percut vertebroplasty lumb
0050
23.9081
$1,418.78

$283.7622522
T

Percut vertebroplasty add'l
0050
23.9081
$1,418.78

$283.7622532
C

Lat thorax spine fusion22533
C

Lat lumbar spine fusion22534
C

Lat thor/lumb, add'l seg22548
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
T

Lumbar spine fusion
0208
42.3409
$2,512.64

$502.5322614
T

Spine fusion, extra segment
0208
42.3409
$2,512.64

$502.5322630
C

Lumbar spine fusion22632
C

Spine fusion, extra segment22800
C

Fusion of spine( print page 50712)22802
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 device22899
T

Spine surgery procedure
0043
1.7694
$105.00

$21.0022900
T

Remove abdominal wall lesion
0022
19.6472
$1,165.92
$354.45
$233.1822999
T

Abdomen surgery procedure
0019
4.0547
$240.62
$71.87
$48.1223000
T

Removal of calcium deposits
0021
14.9776
$888.82
$219.48
$177.7623020
T

Release shoulder joint
0051
36.5271
$2,167.63

$433.5323030
T

Drain shoulder lesion
0008
16.4989
$979.09

$195.8223031
T

Drain shoulder bursa
0008
16.4989
$979.09

$195.8223035
T

Drain shoulder bone lesion
0049
20.3707
$1,208.86

$241.7723040
T

Exploratory shoulder surgery
0050
23.9081
$1,418.78

$283.7623044
T

Exploratory shoulder surgery
0050
23.9081
$1,418.78

$283.7623065
T

Biopsy shoulder tissues
0021
14.9776
$888.82
$219.48
$177.7623066
T

Biopsy shoulder tissues
0022
19.6472
$1,165.92
$354.45
$233.1823075
T

Removal of shoulder lesion
0021
14.9776
$888.82
$219.48
$177.7623076
T

Removal of shoulder lesion
0022
19.6472
$1,165.92
$354.45
$233.1823077
T

Remove tumor of shoulder
0022
19.6472
$1,165.92
$354.45
$233.1823100
T

Biopsy of shoulder joint
0049
20.3707
$1,208.86

$241.7723101
T

Shoulder joint surgery
0050
23.9081
$1,418.78

$283.7623105
T

Remove shoulder joint lining
0050
23.9081
$1,418.78

$283.7623106
T

Incision of collarbone joint
0050
23.9081
$1,418.78

$283.7623107
T

Explore treat shoulder joint
0050
23.9081
$1,418.78

$283.7623120
T

Partial removal, collar bone
0051
36.5271
$2,167.63

$433.5323125
T

Removal of collar bone
0051
36.5271
$2,167.63

$433.5323130
T

Remove shoulder bone, part
0051
36.5271
$2,167.63

$433.5323140
T

Removal of bone lesion
0049
20.3707
$1,208.86

$241.7723145
T

Removal of bone lesion
0050
23.9081
$1,418.78

$283.7623146
T

Removal of bone lesion
0050
23.9081
$1,418.78

$283.7623150
T

Removal of humerus lesion
0050
23.9081
$1,418.78

$283.7623155
T

Removal of humerus lesion
0050
23.9081
$1,418.78

$283.7623156
T

Removal of humerus lesion
0050
23.9081
$1,418.78

$283.7623170
T

Remove collar bone lesion
0050
23.9081
$1,418.78

$283.7623172
T

Remove shoulder blade lesion
0050
23.9081
$1,418.78

$283.7623174
T

Remove humerus lesion
0050
23.9081
$1,418.78

$283.7623180
T

Remove collar bone lesion
0050
23.9081
$1,418.78

$283.7623182
T

Remove shoulder blade lesion
0050
23.9081
$1,418.78

$283.7623184
T

Remove humerus lesion
0050
23.9081
$1,418.78

$283.7623190
T

Partial removal of scapula
0050
23.9081
$1,418.78

$283.7623195
T

Removal of head of humerus
0050
23.9081
$1,418.78

$283.7623200
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
0020
6.9433
$412.04
$107.40
$82.4123331
T

Remove shoulder foreign body
0022
19.6472
$1,165.92
$354.45
$233.18( print page 50713)23332
C

Remove shoulder foreign body23350
N

Injection for shoulder x-ray23395
T

Muscle transfer,shoulder/arm
0051
36.5271
$2,167.63

$433.5323397
T

Muscle transfers
0052
43.9378
$2,607.40

$521.4823400
T

Fixation of shoulder blade
0050
23.9081
$1,418.78

$283.7623405
T

Incision of tendon & muscle
0050
23.9081
$1,418.78

$283.7623406
T

Incise tendon(s) & muscle(s)
0050
23.9081
$1,418.78

$283.7623410
T

Repair of tendon(s)
0052
43.9378
$2,607.40

$521.4823412
T

Repair rotator cuff, chronic
0052
43.9378
$2,607.40

$521.4823415
T

Release of shoulder ligament
0051
36.5271
$2,167.63

$433.5323420
T

Repair of shoulder
0052
43.9378
$2,607.40

$521.4823430
T

Repair biceps tendon
0052
43.9378
$2,607.40

$521.4823440
T

Remove/transplant tendon
0052
43.9378
$2,607.40

$521.4823450
T

Repair shoulder capsule
0052
43.9378
$2,607.40

$521.4823455
T

Repair shoulder capsule
0052
43.9378
$2,607.40

$521.4823460
T

Repair shoulder capsule
0052
43.9378
$2,607.40

$521.4823462
T

Repair shoulder capsule
0052
43.9378
$2,607.40

$521.4823465
T

Repair shoulder capsule
0052
43.9378
$2,607.40

$521.4823466
T

Repair shoulder capsule
0052
43.9378
$2,607.40

$521.4823470
T

Reconstruct shoulder joint
0425
100.2058
$5,946.51
$1,378.01
$1,189.3023472
C

Reconstruct shoulder joint23480
T

Revision of collar bone
0051
36.5271
$2,167.63

$433.5323485
T

Revision of collar bone
0051
36.5271
$2,167.63

$433.5323490
T

Reinforce clavicle
0051
36.5271
$2,167.63

$433.5323491
T

Reinforce shoulder bones
0051
36.5271
$2,167.63

$433.5323500
T

Treat clavicle fracture
0043
1.7694
$105.00

$21.0023505
T

Treat clavicle fracture
0043
1.7694
$105.00

$21.0023515
T

Treat clavicle fracture
0046
37.7023
$2,237.37
$535.76
$447.4723520
T

Treat clavicle dislocation
0043
1.7694
$105.00

$21.0023525
T

Treat clavicle dislocation
0043
1.7694
$105.00

$21.0023530
T

Treat clavicle dislocation
0046
37.7023
$2,237.37
$535.76
$447.4723532
T

Treat clavicle dislocation
0046
37.7023
$2,237.37
$535.76
$447.4723540
T

Treat clavicle dislocation
0043
1.7694
$105.00

$21.0023545
T

Treat clavicle dislocation
0043
1.7694
$105.00

$21.0023550
T

Treat clavicle dislocation
0046
37.7023
$2,237.37
$535.76
$447.4723552
T

Treat clavicle dislocation
0046
37.7023
$2,237.37
$535.76
$447.4723570
T

Treat shoulder blade fx
0043
1.7694
$105.00

$21.0023575
T

Treat shoulder blade fx
0043
1.7694
$105.00

$21.0023585
T

Treat scapula fracture
0046
37.7023
$2,237.37
$535.76
$447.4723600
T

Treat humerus fracture
0043
1.7694
$105.00

$21.0023605
T

Treat humerus fracture
0043
1.7694
$105.00

$21.0023615
T

Treat humerus fracture
0046
37.7023
$2,237.37
$535.76
$447.4723616
T

Treat humerus fracture
0046
37.7023
$2,237.37
$535.76
$447.4723620
T

Treat humerus fracture
0043
1.7694
$105.00

$21.0023625
T

Treat humerus fracture
0043
1.7694
$105.00

$21.0023630
T

Treat humerus fracture
0046
37.7023
$2,237.37
$535.76
$447.4723650
T

Treat shoulder dislocation
0043
1.7694
$105.00

$21.0023655
T

Treat shoulder dislocation
0045
14.4945
$860.15
$268.47
$172.0323660
T

Treat shoulder dislocation
0046
37.7023
$2,237.37
$535.76
$447.4723665
T

Treat dislocation/fracture
0043
1.7694
$105.00

$21.0023670
T

Treat dislocation/fracture
0046
37.7023
$2,237.37
$535.76
$447.4723675
T

Treat dislocation/fracture
0043
1.7694
$105.00

$21.0023680
T

Treat dislocation/fracture
0046
37.7023
$2,237.37
$535.76
$447.4723700
T

Fixation of shoulder
0045
14.4945
$860.15
$268.47
$172.0323800
T

Fusion of shoulder joint
0051
36.5271
$2,167.63

$433.5323802
T

Fusion of shoulder joint
0051
36.5271
$2,167.63

$433.5323900
C

Amputation of arm & girdle23920
C

Amputation at shoulder joint23921
T

Amputation follow-up surgery
0025
5.4938
$326.02
$101.85
$65.2023929
T

Shoulder surgery procedure
0043
1.7694
$105.00

$21.0023930
T

Drainage of arm lesion
0008
16.4989
$979.09

$195.8223931
T

Drainage of arm bursa
0008
16.4989
$979.09

$195.8223935
T

Drain arm/elbow bone lesion
0049
20.3707
$1,208.86

$241.7724000
T

Exploratory elbow surgery
0050
23.9081
$1,418.78

$283.7624006
T

Release elbow joint
0050
23.9081
$1,418.78

$283.7624065
T

Biopsy arm/elbow soft tissue
0021
14.9776
$888.82
$219.48
$177.76( print page 50714)24066
T

Biopsy arm/elbow soft tissue
0021
14.9776
$888.82
$219.48
$177.7624075
T

Remove arm/elbow lesion
0021
14.9776
$888.82
$219.48
$177.7624076
T

Remove arm/elbow lesion
0022
19.6472
$1,165.92
$354.45
$233.1824077
T

Remove tumor of arm/elbow
0022
19.6472
$1,165.92
$354.45
$233.1824100
T

Biopsy elbow joint lining
0049
20.3707
$1,208.86

$241.7724101
T

Explore/treat elbow joint
0050
23.9081
$1,418.78

$283.7624102
T

Remove elbow joint lining
0050
23.9081
$1,418.78

$283.7624105
T

Removal of elbow bursa
0049
20.3707
$1,208.86

$241.7724110
T

Remove humerus lesion
0049
20.3707
$1,208.86

$241.7724115
T

Remove/graft bone lesion
0050
23.9081
$1,418.78

$283.7624116
T

Remove/graft bone lesion
0050
23.9081
$1,418.78

$283.7624120
T

Remove elbow lesion
0049
20.3707
$1,208.86

$241.7724125
T

Remove/graft bone lesion
0050
23.9081
$1,418.78

$283.7624126
T

Remove/graft bone lesion
0050
23.9081
$1,418.78

$283.7624130
T

Removal of head of radius
0050
23.9081
$1,418.78

$283.7624134
T

Removal of arm bone lesion
0050
23.9081
$1,418.78

$283.7624136
T

Remove radius bone lesion
0050
23.9081
$1,418.78

$283.7624138
T

Remove elbow bone lesion
0050
23.9081
$1,418.78

$283.7624140
T

Partial removal of arm bone
0050
23.9081
$1,418.78

$283.7624145
T

Partial removal of radius
0050
23.9081
$1,418.78

$283.7624147
T

Partial removal of elbow
0050
23.9081
$1,418.78

$283.7624149
T

Radical resection of elbow
0050
23.9081
$1,418.78

$283.7624150
T

Extensive humerus surgery
0052
43.9378
$2,607.40

$521.4824151
T

Extensive humerus surgery
0052
43.9378
$2,607.40

$521.4824152
T

Extensive radius surgery
0052
43.9378
$2,607.40

$521.4824153
T

Extensive radius surgery
0052
43.9378
$2,607.40

$521.4824155
T

Removal of elbow joint
0051
36.5271
$2,167.63

$433.5324160
T

Remove elbow joint implant
0050
23.9081
$1,418.78

$283.7624164
T

Remove radius head implant
0050
23.9081
$1,418.78

$283.7624200
T

Removal of arm foreign body
0019
4.0547
$240.62
$71.87
$48.1224201
T

Removal of arm foreign body
0021
14.9776
$888.82
$219.48
$177.7624220
N

Injection for elbow x-ray24300
T

Manipulate elbow w/anesth
0045
14.4945
$860.15
$268.47
$172.0324301
T

Muscle/tendon transfer
0050
23.9081
$1,418.78

$283.7624305
T

Arm tendon lengthening
0050
23.9081
$1,418.78

$283.7624310
T

Revision of arm tendon
0049
20.3707
$1,208.86

$241.7724320
T

Repair of arm tendon
0051
36.5271
$2,167.63

$433.5324330
T

Revision of arm muscles
0051
36.5271
$2,167.63

$433.5324331
T

Revision of arm muscles
0051
36.5271
$2,167.63

$433.5324332
T

Tenolysis, triceps
0049
20.3707
$1,208.86

$241.7724340
T

Repair of biceps tendon
0051
36.5271
$2,167.63

$433.5324341
T

Repair arm tendon/muscle
0051
36.5271
$2,167.63

$433.5324342
T

Repair of ruptured tendon
0051
36.5271
$2,167.63

$433.5324343
T

Repr elbow lat ligmnt w/tiss
0050
23.9081
$1,418.78

$283.7624344
T

Reconstruct elbow lat ligmnt
0051
36.5271
$2,167.63

$433.5324345
T

Repr elbw med ligmnt w/tissu
0050
23.9081
$1,418.78

$283.7624346
T

Reconstruct elbow med ligmnt
0051
36.5271
$2,167.63

$433.5324350
T

Repair of tennis elbow
0050
23.9081
$1,418.78

$283.7624351
T

Repair of tennis elbow
0050
23.9081
$1,418.78

$283.7624352
T

Repair of tennis elbow
0050
23.9081
$1,418.78

$283.7624354
T

Repair of tennis elbow
0050
23.9081
$1,418.78

$283.7624356
T

Revision of tennis elbow
0050
23.9081
$1,418.78

$283.7624360
T

Reconstruct elbow joint
0047
31.6107
$1,875.87
$537.03
$375.1724361
T

Reconstruct elbow joint
0425
100.2058
$5,946.51
$1,378.01
$1,189.3024362
T

Reconstruct elbow joint
0048
43.1288
$2,559.39
$570.30
$511.8824363
T

Replace elbow joint
0425
100.2058
$5,946.51
$1,378.01
$1,189.3024365
T

Reconstruct head of radius
0047
31.6107
$1,875.87
$537.03
$375.1724366
T

Reconstruct head of radius
0425
100.2058
$5,946.51
$1,378.01
$1,189.3024400
T

Revision of humerus
0050
23.9081
$1,418.78

$283.7624410
T

Revision of humerus
0050
23.9081
$1,418.78

$283.7624420
T

Revision of humerus
0051
36.5271
$2,167.63

$433.5324430
T

Repair of humerus
0051
36.5271
$2,167.63

$433.5324435
T

Repair humerus with graft
0051
36.5271
$2,167.63

$433.5324470
T

Revision of elbow joint
0051
36.5271
$2,167.63

$433.5324495
T

Decompression of forearm
0050
23.9081
$1,418.78

$283.7624498
T

Reinforce humerus
0051
36.5271
$2,167.63

$433.53( print page 50715)24500
T

Treat humerus fracture
0043
1.7694
$105.00

$21.0024505
T

Treat humerus fracture
0043
1.7694
$105.00

$21.0024515
T

Treat humerus fracture
0046
37.7023
$2,237.37
$535.76
$447.4724516
T

Treat humerus fracture
0046
37.7023
$2,237.37
$535.76
$447.4724530
T

Treat humerus fracture
0043
1.7694
$105.00

$21.0024535
T

Treat humerus fracture
0043
1.7694
$105.00

$21.0024538
T

Treat humerus fracture
0046
37.7023
$2,237.37
$535.76
$447.4724545
T

Treat humerus fracture
0046
37.7023
$2,237.37
$535.76
$447.4724546
T

Treat humerus fracture
0046
37.7023
$2,237.37
$535.76
$447.4724560
T

Treat humerus fracture
0043
1.7694
$105.00

$21.0024565
T

Treat humerus fracture
0043
1.7694
$105.00

$21.0024566
T

Treat humerus fracture
0046
37.7023
$2,237.37
$535.76
$447.4724575
T

Treat humerus fracture
0046
37.7023
$2,237.37
$535.76
$447.4724576
T

Treat humerus fracture
0043
1.7694
$105.00

$21.0024577
T

Treat humerus fracture
0043
1.7694
$105.00

$21.0024579
T

Treat humerus fracture
0046
37.7023
$2,237.37
$535.76
$447.4724582
T

Treat humerus fracture
0046
37.7023
$2,237.37
$535.76
$447.4724586
T

Treat elbow fracture
0046
37.7023
$2,237.37
$535.76
$447.4724587
T

Treat elbow fracture
0046
37.7023
$2,237.37
$535.76
$447.4724600
T

Treat elbow dislocation
0043
1.7694
$105.00

$21.0024605
T

Treat elbow dislocation
0045
14.4945
$860.15
$268.47
$172.0324615
T

Treat elbow dislocation
0046
37.7023
$2,237.37
$535.76
$447.4724620
T

Treat elbow fracture
0043
1.7694
$105.00

$21.0024635
T

Treat elbow fracture
0046
37.7023
$2,237.37
$535.76
$447.4724640
T

Treat elbow dislocation
0043
1.7694
$105.00

$21.0024650
T

Treat radius fracture
0043
1.7694
$105.00

$21.0024655
T

Treat radius fracture
0043
1.7694
$105.00

$21.0024665
T

Treat radius fracture
0046
37.7023
$2,237.37
$535.76
$447.4724666
T

Treat radius fracture
0046
37.7023
$2,237.37
$535.76
$447.4724670
T

Treat ulnar fracture
0043
1.7694
$105.00

$21.0024675
T

Treat ulnar fracture
0043
1.7694
$105.00

$21.0024685
T

Treat ulnar fracture
0046
37.7023
$2,237.37
$535.76
$447.4724800
T

Fusion of elbow joint
0051
36.5271
$2,167.63

$433.5324802
T

Fusion/graft of elbow joint
0051
36.5271
$2,167.63

$433.5324900
C

Amputation of upper arm24920
C

Amputation of upper arm24925
T

Amputation follow-up surgery
0049
20.3707
$1,208.86

$241.7724930
C

Amputation follow-up surgery24931
C

Amputate upper arm & implant24935
T

Revision of amputation
0052
43.9378
$2,607.40

$521.4824940
C

Revision of upper arm24999
T

Upper arm/elbow surgery
0043
1.7694
$105.00

$21.0025000
T

Incision of tendon sheath
0049
20.3707
$1,208.86

$241.7725001
T

Incise flexor carpi radialis
0049
20.3707
$1,208.86

$241.7725020
T

Decompress forearm 1 space
0049
20.3707
$1,208.86

$241.7725023
T

Decompress forearm 1 space
0050
23.9081
$1,418.78

$283.7625024
T

Decompress forearm 2 spaces
0050
23.9081
$1,418.78

$283.7625025
T

Decompress forearm 2 spaces
0050
23.9081
$1,418.78

$283.7625028
T

Drainage of forearm lesion
0049
20.3707
$1,208.86

$241.7725031
T

Drainage of forearm bursa
0049
20.3707
$1,208.86

$241.7725035
T

Treat forearm bone lesion
0049
20.3707
$1,208.86

$241.7725040
T

Explore/treat wrist joint
0050
23.9081
$1,418.78

$283.7625065
T

Biopsy forearm soft tissues
0021
14.9776
$888.82
$219.48
$177.7625066
T

Biopsy forearm soft tissues
0022
19.6472
$1,165.92
$354.45
$233.1825075
T

Removel forearm lesion subcu
0021
14.9776
$888.82
$219.48
$177.7625076
T

Removel forearm lesion deep
0022
19.6472
$1,165.92
$354.45
$233.1825077
T

Remove tumor, forearm/wrist
0022
19.6472
$1,165.92
$354.45
$233.1825085
T

Incision of wrist capsule
0049
20.3707
$1,208.86

$241.7725100
T

Biopsy of wrist joint
0049
20.3707
$1,208.86

$241.7725101
T

Explore/treat wrist joint
0050
23.9081
$1,418.78

$283.7625105
T

Remove wrist joint lining
0050
23.9081
$1,418.78

$283.7625107
T

Remove wrist joint cartilage
0050
23.9081
$1,418.78

$283.7625110
T

Remove wrist tendon lesion
0049
20.3707
$1,208.86

$241.7725111
T

Remove wrist tendon lesion
0053
15.6795
$930.47
$253.49
$186.0925112
T

Reremove wrist tendon lesion
0053
15.6795
$930.47
$253.49
$186.0925115
T

Remove wrist/forearm lesion
0049
20.3707
$1,208.86

$241.77( print page 50716)25116
T

Remove wrist/forearm lesion
0049
20.3707
$1,208.86

$241.7725118
T

Excise wrist tendon sheath
0050
23.9081
$1,418.78

$283.7625119
T

Partial removal of ulna
0050
23.9081
$1,418.78

$283.7625120
T

Removal of forearm lesion
0050
23.9081
$1,418.78

$283.7625125
T

Remove/graft forearm lesion
0050
23.9081
$1,418.78

$283.7625126
T

Remove/graft forearm lesion
0050
23.9081
$1,418.78

$283.7625130
T

Removal of wrist lesion
0050
23.9081
$1,418.78

$283.7625135
T

Remove & graft wrist lesion
0050
23.9081
$1,418.78

$283.7625136
T

Remove & graft wrist lesion
0050
23.9081
$1,418.78

$283.7625145
T

Remove forearm bone lesion
0050
23.9081
$1,418.78

$283.7625150
T

Partial removal of ulna
0050
23.9081
$1,418.78

$283.7625151
T

Partial removal of radius
0050
23.9081
$1,418.78

$283.7625170
T

Extensive forearm surgery
0052
43.9378
$2,607.40

$521.4825210
T

Removal of wrist bone
0054
25.3711
$1,505.60

$301.1225215
T

Removal of wrist bones
0054
25.3711
$1,505.60

$301.1225230
T

Partial removal of radius
0050
23.9081
$1,418.78

$283.7625240
T

Partial removal of ulna
0050
23.9081
$1,418.78

$283.7625246
N

Injection for wrist x-ray25248
T

Remove forearm foreign body
0049
20.3707
$1,208.86

$241.7725250
T

Removal of wrist prosthesis
0050
23.9081
$1,418.78

$283.7625251
T

Removal of wrist prosthesis
0050
23.9081
$1,418.78

$283.7625259
T

Manipulate wrist w/anesthes
0043
1.7694
$105.00

$21.0025260
T

Repair forearm tendon/muscle
0050
23.9081
$1,418.78

$283.7625263
T

Repair forearm tendon/muscle
0050
23.9081
$1,418.78

$283.7625265
T

Repair forearm tendon/muscle
0050
23.9081
$1,418.78

$283.7625270
T

Repair forearm tendon/muscle
0050
23.9081
$1,418.78

$283.7625272
T

Repair forearm tendon/muscle
0050
23.9081
$1,418.78

$283.7625274
T

Repair forearm tendon/muscle
0050
23.9081
$1,418.78

$283.7625275
T

Repair forearm tendon sheath
0050
23.9081
$1,418.78

$283.7625280
T

Revise wrist/forearm tendon
0050
23.9081
$1,418.78

$283.7625290
T

Incise wrist/forearm tendon
0050
23.9081
$1,418.78

$283.7625295
T

Release wrist/forearm tendon
0049
20.3707
$1,208.86

$241.7725300
T

Fusion of tendons at wrist
0050
23.9081
$1,418.78

$283.7625301
T

Fusion of tendons at wrist
0050
23.9081
$1,418.78

$283.7625310
T

Transplant forearm tendon
0051
36.5271
$2,167.63

$433.5325312
T

Transplant forearm tendon
0051
36.5271
$2,167.63

$433.5325315
T

Revise palsy hand tendon(s)
0051
36.5271
$2,167.63

$433.5325316
T

Revise palsy hand tendon(s)
0051
36.5271
$2,167.63

$433.5325320
T

Repair/revise wrist joint
0051
36.5271
$2,167.63

$433.5325332
T

Revise wrist joint
0047
31.6107
$1,875.87
$537.03
$375.1725335
T

Realignment of hand
0051
36.5271
$2,167.63

$433.5325337
T

Reconstruct ulna/radioulnar
0051
36.5271
$2,167.63

$433.5325350
T

Revision of radius
0051
36.5271
$2,167.63

$433.5325355
T

Revision of radius
0051
36.5271
$2,167.63

$433.5325360
T

Revision of ulna
0050
23.9081
$1,418.78

$283.7625365
T

Revise radius & ulna
0050
23.9081
$1,418.78

$283.7625370
T

Revise radius or ulna
0051
36.5271
$2,167.63

$433.5325375
T

Revise radius & ulna
0051
36.5271
$2,167.63

$433.5325390
T

Shorten radius or ulna
0050
23.9081
$1,418.78

$283.7625391
T

Lengthen radius or ulna
0051
36.5271
$2,167.63

$433.5325392
T

Shorten radius & ulna
0050
23.9081
$1,418.78

$283.7625393
T

Lengthen radius & ulna
0051
36.5271
$2,167.63

$433.5325394
T

Repair carpal bone, shorten
0053
15.6795
$930.47
$253.49
$186.0925400
T

Repair radius or ulna
0050
23.9081
$1,418.78

$283.7625405
T

Repair/graft radius or ulna
0050
23.9081
$1,418.78

$283.7625415
T

Repair radius & ulna
0050
23.9081
$1,418.78

$283.7625420
T

Repair/graft radius & ulna
0051
36.5271
$2,167.63

$433.5325425
T

Repair/graft radius or ulna
0051
36.5271
$2,167.63

$433.5325426
T

Repair/graft radius & ulna
0051
36.5271
$2,167.63

$433.5325430
T

Vasc graft into carpal bone
0054
25.3711
$1,505.60

$301.1225431
T

Repair nonunion carpal bone
0054
25.3711
$1,505.60

$301.1225440
T

Repair/graft wrist bone
0051
36.5271
$2,167.63

$433.5325441
T

Reconstruct wrist joint
0425
100.2058
$5,946.51
$1,378.01
$1,189.3025442
T

Reconstruct wrist joint
0425
100.2058
$5,946.51
$1,378.01
$1,189.3025443
T

Reconstruct wrist joint
0048
43.1288
$2,559.39
$570.30
$511.8825444
T

Reconstruct wrist joint
0048
43.1288
$2,559.39
$570.30
$511.88( print page 50717)25445
T

Reconstruct wrist joint
0048
43.1288
$2,559.39
$570.30
$511.8825446
T

Wrist replacement
0425
100.2058
$5,946.51
$1,378.01
$1,189.3025447
T

Repair wrist joint(s)
0047
31.6107
$1,875.87
$537.03
$375.1725449
T

Remove wrist joint implant
0047
31.6107
$1,875.87
$537.03
$375.1725450
T

Revision of wrist joint
0051
36.5271
$2,167.63

$433.5325455
T

Revision of wrist joint
0051
36.5271
$2,167.63

$433.5325490
T

Reinforce radius
0051
36.5271
$2,167.63

$433.5325491
T

Reinforce ulna
0051
36.5271
$2,167.63

$433.5325492
T

Reinforce radius and ulna
0051
36.5271
$2,167.63

$433.5325500
T

Treat fracture of radius
0043
1.7694
$105.00

$21.0025505
T

Treat fracture of radius
0043
1.7694
$105.00

$21.0025515
T

Treat fracture of radius
0046
37.7023
$2,237.37
$535.76
$447.4725520
T

Treat fracture of radius
0043
1.7694
$105.00

$21.0025525
T

Treat fracture of radius
0046
37.7023
$2,237.37
$535.76
$447.4725526
T

Treat fracture of radius
0046
37.7023
$2,237.37
$535.76
$447.4725530
T

Treat fracture of ulna
0043
1.7694
$105.00

$21.0025535
T

Treat fracture of ulna
0043
1.7694
$105.00

$21.0025545
T

Treat fracture of ulna
0046
37.7023
$2,237.37
$535.76
$447.4725560
T

Treat fracture radius & ulna
0043
1.7694
$105.00

$21.0025565
T

Treat fracture radius & ulna
0043
1.7694
$105.00

$21.0025574
T

Treat fracture radius & ulna
0046
37.7023
$2,237.37
$535.76
$447.4725575
T

Treat fracture radius/ulna
0046
37.7023
$2,237.37
$535.76
$447.4725600
T

Treat fracture radius/ulna
0043
1.7694
$105.00

$21.0025605
T

Treat fracture radius/ulna
0043
1.7694
$105.00

$21.0025611
T

Treat fracture radius/ulna
0046
37.7023
$2,237.37
$535.76
$447.4725620
T

Treat fracture radius/ulna
0046
37.7023
$2,237.37
$535.76
$447.4725622
T

Treat wrist bone fracture
0043
1.7694
$105.00

$21.0025624
T

Treat wrist bone fracture
0043
1.7694
$105.00

$21.0025628
T

Treat wrist bone fracture
0046
37.7023
$2,237.37
$535.76
$447.4725630
T

Treat wrist bone fracture
0043
1.7694
$105.00

$21.0025635
T

Treat wrist bone fracture
0043
1.7694
$105.00

$21.0025645
T

Treat wrist bone fracture
0046
37.7023
$2,237.37
$535.76
$447.4725650
T

Treat wrist bone fracture
0043
1.7694
$105.00

$21.0025651
T

Pin ulnar styloid fracture
0046
37.7023
$2,237.37
$535.76
$447.4725652
T

Treat fracture ulnar styloid
0046
37.7023
$2,237.37
$535.76
$447.4725660
T

Treat wrist dislocation
0043
1.7694
$105.00

$21.0025670
T

Treat wrist dislocation
0046
37.7023
$2,237.37
$535.76
$447.4725671
T

Pin radioulnar dislocation
0046
37.7023
$2,237.37
$535.76
$447.4725675
T

Treat wrist dislocation
0043
1.7694
$105.00

$21.0025676
T

Treat wrist dislocation
0046
37.7023
$2,237.37
$535.76
$447.4725680
T

Treat wrist fracture
0043
1.7694
$105.00

$21.0025685
T

Treat wrist fracture
0046
37.7023
$2,237.37
$535.76
$447.4725690
T

Treat wrist dislocation
0043
1.7694
$105.00

$21.0025695
T

Treat wrist dislocation
0046
37.7023
$2,237.37
$535.76
$447.4725800
T

Fusion of wrist joint
0051
36.5271
$2,167.63

$433.5325805
T

Fusion/graft of wrist joint
0051
36.5271
$2,167.63

$433.5325810
T

Fusion/graft of wrist joint
0051
36.5271
$2,167.63

$433.5325820
T

Fusion of hand bones
0053
15.6795
$930.47
$253.49
$186.0925825
T

Fuse hand bones with graft
0054
25.3711
$1,505.60

$301.1225830
T

Fusion, radioulnar jnt/ulna
0051
36.5271
$2,167.63

$433.5325900
C

Amputation of forearm25905
C

Amputation of forearm25907
T

Amputation follow-up surgery
0049
20.3707
$1,208.86

$241.7725909
C

Amputation follow-up surgery25915
C

Amputation of forearm25920
C

Amputate hand at wrist25922
T

Amputate hand at wrist
0049
20.3707
$1,208.86

$241.7725924
C

Amputation follow-up surgery25927
C

Amputation of hand25929
T

Amputation follow-up surgery
0686
13.8287
$820.64

$164.1325931
C

Amputation follow-up surgery25999
T

Forearm or wrist surgery
0043
1.7694
$105.00

$21.0026010
T

Drainage of finger abscess
0006
1.55
$91.98
$22.28
$18.4026011
T

Drainage of finger abscess
0007
11.4501
$679.48

$135.9026020
T

Drain hand tendon sheath
0053
15.6795
$930.47
$253.49
$186.0926025
T

Drainage of palm bursa
0053
15.6795
$930.47
$253.49
$186.09( print page 50718)26030
T

Drainage of palm bursa(s)
0053
15.6795
$930.47
$253.49
$186.0926034
T

Treat hand bone lesion
0053
15.6795
$930.47
$253.49
$186.0926035
T

Decompress fingers/hand
0053
15.6795
$930.47
$253.49
$186.0926037
T

Decompress fingers/hand
0053
15.6795
$930.47
$253.49
$186.0926040
T

Release palm contracture
0054
25.3711
$1,505.60

$301.1226045
T

Release palm contracture
0054
25.3711
$1,505.60

$301.1226055
T

Incise finger tendon sheath
0053
15.6795
$930.47
$253.49
$186.0926060
T

Incision of finger tendon
0053
15.6795
$930.47
$253.49
$186.0926070
T

Explore/treat hand joint
0053
15.6795
$930.47
$253.49
$186.0926075
T

Explore/treat finger joint
0053
15.6795
$930.47
$253.49
$186.0926080
T

Explore/treat finger joint
0053
15.6795
$930.47
$253.49
$186.0926100
T

Biopsy hand joint lining
0053
15.6795
$930.47
$253.49
$186.0926105
T

Biopsy finger joint lining
0053
15.6795
$930.47
$253.49
$186.0926110
T

Biopsy finger joint lining
0053
15.6795
$930.47
$253.49
$186.0926115
T

Removel hand lesion subcut
0022
19.6472
$1,165.92
$354.45
$233.1826116
T

Removel hand lesion, deep
0022
19.6472
$1,165.92
$354.45
$233.1826117
T

Remove tumor, hand/finger
0022
19.6472
$1,165.92
$354.45
$233.1826121
T

Release palm contracture
0054
25.3711
$1,505.60

$301.1226123
T

Release palm contracture
0054
25.3711
$1,505.60

$301.1226125
T

Release palm contracture
0053
15.6795
$930.47
$253.49
$186.0926130
T

Remove wrist joint lining
0053
15.6795
$930.47
$253.49
$186.0926135
T

Revise finger joint, each
0054
25.3711
$1,505.60

$301.1226140
T

Revise finger joint, each
0053
15.6795
$930.47
$253.49
$186.0926145
T

Tendon excision, palm/finger
0053
15.6795
$930.47
$253.49
$186.0926160
T

Remove tendon sheath lesion
0053
15.6795
$930.47
$253.49
$186.0926170
T

Removal of palm tendon, each
0053
15.6795
$930.47
$253.49
$186.0926180
T

Removal of finger tendon
0053
15.6795
$930.47
$253.49
$186.0926185
T

Remove finger bone
0053
15.6795
$930.47
$253.49
$186.0926200
T

Remove hand bone lesion
0053
15.6795
$930.47
$253.49
$186.0926205
T

Remove/graft bone lesion
0054
25.3711
$1,505.60

$301.1226210
T

Removal of finger lesion
0053
15.6795
$930.47
$253.49
$186.0926215
T

Remove/graft finger lesion
0053
15.6795
$930.47
$253.49
$186.0926230
T

Partial removal of hand bone
0053
15.6795
$930.47
$253.49
$186.0926235
T

Partial removal, finger bone
0053
15.6795
$930.47
$253.49
$186.0926236
T

Partial removal, finger bone
0053
15.6795
$930.47
$253.49
$186.0926250
T

Extensive hand surgery
0053
15.6795
$930.47
$253.49
$186.0926255
T

Extensive hand surgery
0054
25.3711
$1,505.60

$301.1226260
T

Extensive finger surgery
0053
15.6795
$930.47
$253.49
$186.0926261
T

Extensive finger surgery
0053
15.6795
$930.47
$253.49
$186.0926262
T

Partial removal of finger
0053
15.6795
$930.47
$253.49
$186.0926320
T

Removal of implant from hand
0021
14.9776
$888.82
$219.48
$177.7626340
T

Manipulate finger w/anesth
0043
1.7694
$105.00

$21.0026350
T

Repair finger/hand tendon
0054
25.3711
$1,505.60

$301.1226352
T

Repair/graft hand tendon
0054
25.3711
$1,505.60

$301.1226356
T

Repair finger/hand tendon
0054
25.3711
$1,505.60

$301.1226357
T

Repair finger/hand tendon
0054
25.3711
$1,505.60

$301.1226358
T

Repair/graft hand tendon
0054
25.3711
$1,505.60

$301.1226370
T

Repair finger/hand tendon
0054
25.3711
$1,505.60

$301.1226372
T

Repair/graft hand tendon
0054
25.3711
$1,505.60

$301.1226373
T

Repair finger/hand tendon
0054
25.3711
$1,505.60

$301.1226390
T

Revise hand/finger tendon
0054
25.3711
$1,505.60

$301.1226392
T

Repair/graft hand tendon
0054
25.3711
$1,505.60

$301.1226410
T

Repair hand tendon
0053
15.6795
$930.47
$253.49
$186.0926412
T

Repair/graft hand tendon
0054
25.3711
$1,505.60

$301.1226415
T

Excision, hand/finger tendon
0054
25.3711
$1,505.60

$301.1226416
T

Graft hand or finger tendon
0054
25.3711
$1,505.60

$301.1226418
T

Repair finger tendon
0053
15.6795
$930.47
$253.49
$186.0926420
T

Repair/graft finger tendon
0054
25.3711
$1,505.60

$301.1226426
T

Repair finger/hand tendon
0054
25.3711
$1,505.60

$301.1226428
T

Repair/graft finger tendon
0054
25.3711
$1,505.60

$301.1226432
T

Repair finger tendon
0053
15.6795
$930.47
$253.49
$186.0926433
T

Repair finger tendon
0053
15.6795
$930.47
$253.49
$186.0926434
T

Repair/graft finger tendon
0054
25.3711
$1,505.60

$301.1226437
T

Realignment of tendons
0053
15.6795
$930.47
$253.49
$186.0926440
T

Release palm/finger tendon
0053
15.6795
$930.47
$253.49
$186.0926442
T

Release palm & finger tendon
0054
25.3711
$1,505.60

$301.12( print page 50719)26445
T

Release hand/finger tendon
0053
15.6795
$930.47
$253.49
$186.0926449
T

Release forearm/hand tendon
0054
25.3711
$1,505.60

$301.1226450
T

Incision of palm tendon
0053
15.6795
$930.47
$253.49
$186.0926455
T

Incision of finger tendon
0053
15.6795
$930.47
$253.49
$186.0926460
T

Incise hand/finger tendon
0053
15.6795
$930.47
$253.49
$186.0926471
T

Fusion of finger tendons
0053
15.6795
$930.47
$253.49
$186.0926474
T

Fusion of finger tendons
0053
15.6795
$930.47
$253.49
$186.0926476
T

Tendon lengthening
0053
15.6795
$930.47
$253.49
$186.0926477
T

Tendon shortening
0053
15.6795
$930.47
$253.49
$186.0926478
T

Lengthening of hand tendon
0053
15.6795
$930.47
$253.49
$186.0926479
T

Shortening of hand tendon
0053
15.6795
$930.47
$253.49
$186.0926480
T

Transplant hand tendon
0054
25.3711
$1,505.60

$301.1226483
T

Transplant/graft hand tendon
0054
25.3711
$1,505.60

$301.1226485
T

Transplant palm tendon
0054
25.3711
$1,505.60

$301.1226489
T

Transplant/graft palm tendon
0054
25.3711
$1,505.60

$301.1226490
T

Revise thumb tendon
0054
25.3711
$1,505.60

$301.1226492
T

Tendon transfer with graft
0054
25.3711
$1,505.60

$301.1226494
T

Hand tendon/muscle transfer
0054
25.3711
$1,505.60

$301.1226496
T

Revise thumb tendon
0054
25.3711
$1,505.60

$301.1226497
T

Finger tendon transfer
0054
25.3711
$1,505.60

$301.1226498
T

Finger tendon transfer
0054
25.3711
$1,505.60

$301.1226499
T

Revision of finger
0054
25.3711
$1,505.60

$301.1226500
T

Hand tendon reconstruction
0053
15.6795
$930.47
$253.49
$186.0926502
T

Hand tendon reconstruction
0054
25.3711
$1,505.60

$301.1226504
T

Hand tendon reconstruction
0054
25.3711
$1,505.60

$301.1226508
T

Release thumb contracture
0053
15.6795
$930.47
$253.49
$186.0926510
T

Thumb tendon transfer
0054
25.3711
$1,505.60

$301.1226516
T

Fusion of knuckle joint
0054
25.3711
$1,505.60

$301.1226517
T

Fusion of knuckle joints
0054
25.3711
$1,505.60

$301.1226518
T

Fusion of knuckle joints
0054
25.3711
$1,505.60

$301.1226520
T

Release knuckle contracture
0053
15.6795
$930.47
$253.49
$186.0926525
T

Release finger contracture
0053
15.6795
$930.47
$253.49
$186.0926530
T

Revise knuckle joint
0047
31.6107
$1,875.87
$537.03
$375.1726531
T

Revise knuckle with implant
0048
43.1288
$2,559.39
$570.30
$511.8826535
T

Revise finger joint
0047
31.6107
$1,875.87
$537.03
$375.1726536
T

Revise/implant finger joint
0048
43.1288
$2,559.39
$570.30
$511.8826540
T

Repair hand joint
0053
15.6795
$930.47
$253.49
$186.0926541
T

Repair hand joint with graft
0054
25.3711
$1,505.60

$301.1226542
T

Repair hand joint with graft
0053
15.6795
$930.47
$253.49
$186.0926545
T

Reconstruct finger joint
0054
25.3711
$1,505.60

$301.1226546
T

Repair nonunion hand
0054
25.3711
$1,505.60

$301.1226548
T

Reconstruct finger joint
0054
25.3711
$1,505.60

$301.1226550
T

Construct thumb replacement
0054
25.3711
$1,505.60

$301.1226551
C

Great toe-hand transfer26553
C

Single transfer, toe-hand26554
C

Double transfer, toe-hand26555
T

Positional change of finger
0054
25.3711
$1,505.60

$301.1226556
C

Toe joint transfer26560
T

Repair of web finger
0053
15.6795
$930.47
$253.49
$186.0926561
T

Repair of web finger
0054
25.3711
$1,505.60

$301.1226562
T

Repair of web finger
0054
25.3711
$1,505.60

$301.1226565
T

Correct metacarpal flaw
0054
25.3711
$1,505.60

$301.1226567
T

Correct finger deformity
0054
25.3711
$1,505.60

$301.1226568
T

Lengthen metacarpal/finger
0054
25.3711
$1,505.60

$301.1226580
T

Repair hand deformity
0053
15.6795
$930.47
$253.49
$186.0926587
T

Reconstruct extra finger
0053
15.6795
$930.47
$253.49
$186.0926590
T

Repair finger deformity
0053
15.6795
$930.47
$253.49
$186.0926591
T

Repair muscles of hand
0054
25.3711
$1,505.60

$301.1226593
T

Release muscles of hand
0053
15.6795
$930.47
$253.49
$186.0926596
T

Excision constricting tissue
0053
15.6795
$930.47
$253.49
$186.0926600
T

Treat metacarpal fracture
0043
1.7694
$105.00

$21.0026605
T

Treat metacarpal fracture
0043
1.7694
$105.00

$21.0026607
T

Treat metacarpal fracture
0043
1.7694
$105.00

$21.0026608
T

Treat metacarpal fracture
0046
37.7023
$2,237.37
$535.76
$447.4726615
T

Treat metacarpal fracture
0046
37.7023
$2,237.37
$535.76
$447.4726641
T

Treat thumb dislocation
0043
1.7694
$105.00

$21.00( print page 50720)26645
T

Treat thumb fracture
0043
1.7694
$105.00

$21.0026650
T

Treat thumb fracture
0046
37.7023
$2,237.37
$535.76
$447.4726665
T

Treat thumb fracture
0046
37.7023
$2,237.37
$535.76
$447.4726670
T

Treat hand dislocation
0043
1.7694
$105.00

$21.0026675
T

Treat hand dislocation
0043
1.7694
$105.00

$21.0026676
T

Pin hand dislocation
0046
37.7023
$2,237.37
$535.76
$447.4726685
T

Treat hand dislocation
0046
37.7023
$2,237.37
$535.76
$447.4726686
T

Treat hand dislocation
0046
37.7023
$2,237.37
$535.76
$447.4726700
T

Treat knuckle dislocation
0043
1.7694
$105.00

$21.0026705
T

Treat knuckle dislocation
0043
1.7694
$105.00

$21.0026706
T

Pin knuckle dislocation
0043
1.7694
$105.00

$21.0026715
T

Treat knuckle dislocation
0046
37.7023
$2,237.37
$535.76
$447.4726720
T

Treat finger fracture, each
0043
1.7694
$105.00

$21.0026725
T

Treat finger fracture, each
0043
1.7694
$105.00

$21.0026727
T

Treat finger fracture, each
0046
37.7023
$2,237.37
$535.76
$447.4726735
T

Treat finger fracture, each
0046
37.7023
$2,237.37
$535.76
$447.4726740
T

Treat finger fracture, each
0043
1.7694
$105.00

$21.0026742
T

Treat finger fracture, each
0043
1.7694
$105.00

$21.0026746
T

Treat finger fracture, each
0046
37.7023
$2,237.37
$535.76
$447.4726750
T

Treat finger fracture, each
0043
1.7694
$105.00

$21.0026755
T

Treat finger fracture, each
0043
1.7694
$105.00

$21.0026756
T

Pin finger fracture, each
0046
37.7023
$2,237.37
$535.76
$447.4726765
T

Treat finger fracture, each
0046
37.7023
$2,237.37
$535.76
$447.4726770
T

Treat finger dislocation
0043
1.7694
$105.00

$21.0026775
T

Treat finger dislocation
0045
14.4945
$860.15
$268.47
$172.0326776
T

Pin finger dislocation
0046
37.7023
$2,237.37
$535.76
$447.4726785
T

Treat finger dislocation
0046
37.7023
$2,237.37
$535.76
$447.4726820
T

Thumb fusion with graft
0054
25.3711
$1,505.60

$301.1226841
T

Fusion of thumb
0054
25.3711
$1,505.60

$301.1226842
T

Thumb fusion with graft
0054
25.3711
$1,505.60

$301.1226843
T

Fusion of hand joint
0054
25.3711
$1,505.60

$301.1226844
T

Fusion/graft of hand joint
0054
25.3711
$1,505.60

$301.1226850
T

Fusion of knuckle
0054
25.3711
$1,505.60

$301.1226852
T

Fusion of knuckle with graft
0054
25.3711
$1,505.60

$301.1226860
T

Fusion of finger joint
0054
25.3711
$1,505.60

$301.1226861
T

Fusion of finger jnt, add-on
0054
25.3711
$1,505.60

$301.1226862
T

Fusion/graft of finger joint
0054
25.3711
$1,505.60

$301.1226863
T

Fuse/graft added joint
0054
25.3711
$1,505.60

$301.1226910
T

Amputate metacarpal bone
0054
25.3711
$1,505.60

$301.1226951
T

Amputation of finger/thumb
0053
15.6795
$930.47
$253.49
$186.0926952
T

Amputation of finger/thumb
0053
15.6795
$930.47
$253.49
$186.0926989
T

Hand/finger surgery
0043
1.7694
$105.00

$21.0026990
T

Drainage of pelvis lesion
0049
20.3707
$1,208.86

$241.7726991
T

Drainage of pelvis bursa
0049
20.3707
$1,208.86

$241.7726992
C

Drainage of bone lesion27000
T

Incision of hip tendon
0049
20.3707
$1,208.86

$241.7727001
T

Incision of hip tendon
0050
23.9081
$1,418.78

$283.7627003
T

Incision of hip tendon
0050
23.9081
$1,418.78

$283.7627005
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
36.5271
$2,167.63

$433.5327035
T

Denervation of hip joint
0052
43.9378
$2,607.40

$521.4827036
C

Excision of hip joint/muscle27040
T

Biopsy of soft tissues
0020
6.9433
$412.04
$107.40
$82.4127041
T

Biopsy of soft tissues
0020
6.9433
$412.04
$107.40
$82.4127047
T

Remove hip/pelvis lesion
0022
19.6472
$1,165.92
$354.45
$233.1827048
T

Remove hip/pelvis lesion
0022
19.6472
$1,165.92
$354.45
$233.1827049
T

Remove tumor, hip/pelvis
0022
19.6472
$1,165.92
$354.45
$233.1827050
T

Biopsy of sacroiliac joint
0049
20.3707
$1,208.86

$241.7727052
T

Biopsy of hip joint
0049
20.3707
$1,208.86

$241.7727054
C

Removal of hip joint lining27060
T

Removal of ischial bursa
0049
20.3707
$1,208.86

$241.7727062
T

Remove femur lesion/bursa
0049
20.3707
$1,208.86

$241.7727065
T

Removal of hip bone lesion
0049
20.3707
$1,208.86

$241.77( print page 50721)27066
T

Removal of hip bone lesion
0050
23.9081
$1,418.78

$283.7627067
T

Remove/graft hip bone lesion
0050
23.9081
$1,418.78

$283.7627070
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
23.9081
$1,418.78

$283.7627086
T

Remove hip foreign body
0020
6.9433
$412.04
$107.40
$82.4127087
T

Remove hip foreign body
0049
20.3707
$1,208.86

$241.7727090
C

Removal of hip prosthesis27091
C

Removal of hip prosthesis27093
N

Injection for hip x-ray27095
N

Injection for hip x-ray27096
B

Inject sacroiliac joint27097
T

Revision of hip tendon
0050
23.9081
$1,418.78

$283.7627098
T

Transfer tendon to pelvis
0050
23.9081
$1,418.78

$283.7627100
T

Transfer of abdominal muscle
0051
36.5271
$2,167.63

$433.5327105
T

Transfer of spinal muscle
0051
36.5271
$2,167.63

$433.5327110
T

Transfer of iliopsoas muscle
0051
36.5271
$2,167.63

$433.5327111
T

Transfer of iliopsoas muscle
0051
36.5271
$2,167.63

$433.5327120
C

Reconstruction of hip socket27122
C

Reconstruction of hip socket27125
C

Partial hip replacement27130
C

Total hip arthroplasty27132
C

Total hip arthroplasty27134
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
0043
1.7694
$105.00

$21.0027194
T

Treat pelvic ring fracture
0045
14.4945
$860.15
$268.47
$172.0327200
T

Treat tail bone fracture
0043
1.7694
$105.00

$21.0027202
T

Treat tail bone fracture
0046
37.7023
$2,237.37
$535.76
$447.4727215
C

Treat pelvic fracture(s)27216
T

Treat pelvic ring fracture
0050
23.9081
$1,418.78

$283.7627217
C

Treat pelvic ring fracture27218
C

Treat pelvic ring fracture27220
T

Treat hip socket fracture
0043
1.7694
$105.00

$21.0027222
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
0043
1.7694
$105.00

$21.0027232
C

Treat thigh fracture27235
T

Treat thigh fracture
0050
23.9081
$1,418.78

$283.7627236
C

Treat thigh fracture27238
T

Treat thigh fracture
0043
1.7694
$105.00

$21.00( print page 50722)27240
C

Treat thigh fracture27244
C

Treat thigh fracture27245
C

Treat thigh fracture27246
T

Treat thigh fracture
0043
1.7694
$105.00

$21.0027248
C

Treat thigh fracture27250
T

Treat hip dislocation
0043
1.7694
$105.00

$21.0027252
T

Treat hip dislocation
0045
14.4945
$860.15
$268.47
$172.0327253
C

Treat hip dislocation27254
C

Treat hip dislocation27256
T

Treat hip dislocation
0043
1.7694
$105.00

$21.0027257
T

Treat hip dislocation
0045
14.4945
$860.15
$268.47
$172.0327258
C

Treat hip dislocation27259
C

Treat hip dislocation27265
T

Treat hip dislocation
0043
1.7694
$105.00

$21.0027266
T

Treat hip dislocation
0045
14.4945
$860.15
$268.47
$172.0327275
T

Manipulation of hip joint
0045
14.4945
$860.15
$268.47
$172.0327280
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
1.7694
$105.00

$21.0027301
T

Drain thigh/knee lesion
0008
16.4989
$979.09

$195.8227303
C

Drainage of bone lesion27305
T

Incise thigh tendon & fascia
0049
20.3707
$1,208.86

$241.7727306
T

Incision of thigh tendon
0049
20.3707
$1,208.86

$241.7727307
T

Incision of thigh tendons
0049
20.3707
$1,208.86

$241.7727310
T

Exploration of knee joint
0050
23.9081
$1,418.78

$283.7627315
T

Partial removal, thigh nerve
0220
17.3586
$1,030.11

$206.0227320
T

Partial removal, thigh nerve
0220
17.3586
$1,030.11

$206.0227323
T

Biopsy, thigh soft tissues
0021
14.9776
$888.82
$219.48
$177.7627324
T

Biopsy, thigh soft tissues
0022
19.6472
$1,165.92
$354.45
$233.1827327
T

Removal of thigh lesion
0022
19.6472
$1,165.92
$354.45
$233.1827328
T

Removal of thigh lesion
0022
19.6472
$1,165.92
$354.45
$233.1827329
T

Remove tumor, thigh/knee
0022
19.6472
$1,165.92
$354.45
$233.1827330
T

Biopsy, knee joint lining
0050
23.9081
$1,418.78

$283.7627331
T

Explore/treat knee joint
0050
23.9081
$1,418.78

$283.7627332
T

Removal of knee cartilage
0050
23.9081
$1,418.78

$283.7627333
T

Removal of knee cartilage
0050
23.9081
$1,418.78

$283.7627334
T

Remove knee joint lining
0050
23.9081
$1,418.78

$283.7627335
T

Remove knee joint lining
0050
23.9081
$1,418.78

$283.7627340
T

Removal of kneecap bursa
0049
20.3707
$1,208.86

$241.7727345
T

Removal of knee cyst
0049
20.3707
$1,208.86

$241.7727347
T

Remove knee cyst
0049
20.3707
$1,208.86

$241.7727350
T

Removal of kneecap
0050
23.9081
$1,418.78

$283.7627355
T

Remove femur lesion
0050
23.9081
$1,418.78

$283.7627356
T

Remove femur lesion/graft
0050
23.9081
$1,418.78

$283.7627357
T

Remove femur lesion/graft
0050
23.9081
$1,418.78

$283.7627358
T

Remove femur lesion/fixation
0050
23.9081
$1,418.78

$283.7627360
T

Partial removal, leg bone(s)
0050
23.9081
$1,418.78

$283.7627365
C

Extensive leg surgery27370
N

Injection for knee x-ray27372
T

Removal of foreign body
0022
19.6472
$1,165.92
$354.45
$233.1827380
T

Repair of kneecap tendon
0049
20.3707
$1,208.86

$241.7727381
T

Repair/graft kneecap tendon
0049
20.3707
$1,208.86

$241.7727385
T

Repair of thigh muscle
0049
20.3707
$1,208.86

$241.7727386
T

Repair/graft of thigh muscle
0049
20.3707
$1,208.86

$241.7727390
T

Incision of thigh tendon
0049
20.3707
$1,208.86

$241.7727391
T

Incision of thigh tendons
0049
20.3707
$1,208.86

$241.7727392
T

Incision of thigh tendons
0049
20.3707
$1,208.86

$241.7727393
T

Lengthening of thigh tendon
0050
23.9081
$1,418.78

$283.7627394
T

Lengthening of thigh tendons
0050
23.9081
$1,418.78

$283.7627395
T

Lengthening of thigh tendons
0051
36.5271
$2,167.63

$433.5327396
T

Transplant of thigh tendon
0050
23.9081
$1,418.78

$283.7627397
T

Transplants of thigh tendons
0051
36.5271
$2,167.63

$433.53( print page 50723)27400
T

Revise thigh muscles/tendons
0051
36.5271
$2,167.63

$433.5327403
T

Repair of knee cartilage
0050
23.9081
$1,418.78

$283.7627405
T

Repair of knee ligament
0051
36.5271
$2,167.63

$433.5327407
T

Repair of knee ligament
0051
36.5271
$2,167.63

$433.5327409
T

Repair of knee ligaments
0051
36.5271
$2,167.63

$433.5327412
T

Autochondrocyte implant knee
0042
43.9753
$2,609.63
$804.74
$521.9327415
T

Osteochondral knee allograft
0042
43.9753
$2,609.63
$804.74
$521.9327418
T

Repair degenerated kneecap
0051
36.5271
$2,167.63

$433.5327420
T

Revision of unstable kneecap
0051
36.5271
$2,167.63

$433.5327422
T

Revision of unstable kneecap
0051
36.5271
$2,167.63

$433.5327424
T

Revision/removal of kneecap
0051
36.5271
$2,167.63

$433.5327425
T

Lateral retinacular release
0050
23.9081
$1,418.78

$283.7627427
T

Reconstruction, knee
0052
43.9378
$2,607.40

$521.4827428
T

Reconstruction, knee
0052
43.9378
$2,607.40

$521.4827429
T

Reconstruction, knee
0052
43.9378
$2,607.40

$521.4827430
T

Revision of thigh muscles
0051
36.5271
$2,167.63

$433.5327435
T

Incision of knee joint
0051
36.5271
$2,167.63

$433.5327437
T

Revise kneecap
0047
31.6107
$1,875.87
$537.03
$375.1727438
T

Revise kneecap with implant
0048
43.1288
$2,559.39
$570.30
$511.8827440
T

Revision of knee joint
0047
31.6107
$1,875.87
$537.03
$375.1727441
T

Revision of knee joint
0047
31.6107
$1,875.87
$537.03
$375.1727442
T

Revision of knee joint
0047
31.6107
$1,875.87
$537.03
$375.1727443
T

Revision of knee joint
0047
31.6107
$1,875.87
$537.03
$375.1727445
C

Revision of knee joint27446
T

Revision of knee joint
0681
137.163
$8,139.66
$2,081.48
$1,627.9327447
C

Total knee arthroplasty27448
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
T

Surgery to stop leg growth
0050
23.9081
$1,418.78

$283.7627477
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
20.3707
$1,208.86

$241.7727497
T

Decompression of thigh/knee
0049
20.3707
$1,208.86

$241.7727498
T

Decompression of thigh/knee
0049
20.3707
$1,208.86

$241.7727499
T

Decompression of thigh/knee
0049
20.3707
$1,208.86

$241.7727500
T

Treatment of thigh fracture
0043
1.7694
$105.00

$21.0027501
T

Treatment of thigh fracture
0043
1.7694
$105.00

$21.0027502
T

Treatment of thigh fracture
0043
1.7694
$105.00

$21.0027503
T

Treatment of thigh fracture
0043
1.7694
$105.00

$21.0027506
C

Treatment of thigh fracture27507
C

Treatment of thigh fracture27508
T

Treatment of thigh fracture
0043
1.7694
$105.00

$21.0027509
T

Treatment of thigh fracture
0046
37.7023
$2,237.37
$535.76
$447.4727510
T

Treatment of thigh fracture
0043
1.7694
$105.00

$21.0027511
C

Treatment of thigh fracture27513
C

Treatment of thigh fracture27514
C

Treatment of thigh fracture27516
T

Treat thigh fx growth plate
0043
1.7694
$105.00

$21.0027517
T

Treat thigh fx growth plate
0043
1.7694
$105.00

$21.0027519
C

Treat thigh fx growth plate27520
T

Treat kneecap fracture
0043
1.7694
$105.00

$21.0027524
T

Treat kneecap fracture
0046
37.7023
$2,237.37
$535.76
$447.4727530
T

Treat knee fracture
0043
1.7694
$105.00

$21.00( print page 50724)27532
T

Treat knee fracture
0043
1.7694
$105.00

$21.0027535
C

Treat knee fracture27536
C

Treat knee fracture27538
T

Treat knee fracture(s)
0043
1.7694
$105.00

$21.0027540
C

Treat knee fracture27550
T

Treat knee dislocation
0043
1.7694
$105.00

$21.0027552
T

Treat knee dislocation
0045
14.4945
$860.15
$268.47
$172.0327556
C

Treat knee dislocation27557
C

Treat knee dislocation27558
C

Treat knee dislocation27560
T

Treat kneecap dislocation
0043
1.7694
$105.00

$21.0027562
T

Treat kneecap dislocation
0045
14.4945
$860.15
$268.47
$172.0327566
T

Treat kneecap dislocation
0046
37.7023
$2,237.37
$535.76
$447.4727570
T

Fixation of knee joint
0045
14.4945
$860.15
$268.47
$172.0327580
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
20.3707
$1,208.86

$241.7727596
C

Amputation follow-up surgery27598
C

Amputate lower leg at knee27599
T

Leg surgery procedure
0043
1.7694
$105.00

$21.0027600
T

Decompression of lower leg
0049
20.3707
$1,208.86

$241.7727601
T

Decompression of lower leg
0049
20.3707
$1,208.86

$241.7727602
T

Decompression of lower leg
0049
20.3707
$1,208.86

$241.7727603
T

Drain lower leg lesion
0008
16.4989
$979.09

$195.8227604
T

Drain lower leg bursa
0049
20.3707
$1,208.86

$241.7727605
T

Incision of achilles tendon
0055
20.0692
$1,190.97
$355.34
$238.1927606
T

Incision of achilles tendon
0049
20.3707
$1,208.86

$241.7727607
T

Treat lower leg bone lesion
0049
20.3707
$1,208.86

$241.7727610
T

Explore/treat ankle joint
0050
23.9081
$1,418.78

$283.7627612
T

Exploration of ankle joint
0050
23.9081
$1,418.78

$283.7627613
T

Biopsy lower leg soft tissue
0020
6.9433
$412.04
$107.40
$82.4127614
T

Biopsy lower leg soft tissue
0022
19.6472
$1,165.92
$354.45
$233.1827615
T

Remove tumor, lower leg
0046
37.7023
$2,237.37
$535.76
$447.4727618
T

Remove lower leg lesion
0021
14.9776
$888.82
$219.48
$177.7627619
T

Remove lower leg lesion
0022
19.6472
$1,165.92
$354.45
$233.1827620
T

Explore/treat ankle joint
0050
23.9081
$1,418.78

$283.7627625
T

Remove ankle joint lining
0050
23.9081
$1,418.78

$283.7627626
T

Remove ankle joint lining
0050
23.9081
$1,418.78

$283.7627630
T

Removal of tendon lesion
0049
20.3707
$1,208.86

$241.7727635
T

Remove lower leg bone lesion
0050
23.9081
$1,418.78

$283.7627637
T

Remove/graft leg bone lesion
0050
23.9081
$1,418.78

$283.7627638
T

Remove/graft leg bone lesion
0050
23.9081
$1,418.78

$283.7627640
T

Partial removal of tibia
0051
36.5271
$2,167.63

$433.5327641
T

Partial removal of fibula
0050
23.9081
$1,418.78

$283.7627645
C

Extensive lower leg surgery27646
C

Extensive lower leg surgery27647
T

Extensive ankle/heel surgery
0051
36.5271
$2,167.63

$433.5327648
N

Injection for ankle x-ray27650
T

Repair achilles tendon
0051
36.5271
$2,167.63

$433.5327652
T

Repair/graft achilles tendon
0051
36.5271
$2,167.63

$433.5327654
T

Repair of achilles tendon
0051
36.5271
$2,167.63

$433.5327656
T

Repair leg fascia defect
0049
20.3707
$1,208.86

$241.7727658
T

Repair of leg tendon, each
0049
20.3707
$1,208.86

$241.7727659
T

Repair of leg tendon, each
0049
20.3707
$1,208.86

$241.7727664
T

Repair of leg tendon, each
0049
20.3707
$1,208.86

$241.7727665
T

Repair of leg tendon, each
0050
23.9081
$1,418.78

$283.7627675
T

Repair lower leg tendons
0049
20.3707
$1,208.86

$241.7727676
T

Repair lower leg tendons
0050
23.9081
$1,418.78

$283.7627680
T

Release of lower leg tendon
0050
23.9081
$1,418.78

$283.7627681
T

Release of lower leg tendons
0050
23.9081
$1,418.78

$283.7627685
T

Revision of lower leg tendon
0050
23.9081
$1,418.78

$283.7627686
T

Revise lower leg tendons
0050
23.9081
$1,418.78

$283.7627687
T

Revision of calf tendon
0050
23.9081
$1,418.78

$283.7627690
T

Revise lower leg tendon
0051
36.5271
$2,167.63

$433.53( print page 50725)27691
T

Revise lower leg tendon
0051
36.5271
$2,167.63

$433.5327692
T

Revise additional leg tendon
0051
36.5271
$2,167.63

$433.5327695
T

Repair of ankle ligament
0050
23.9081
$1,418.78

$283.7627696
T

Repair of ankle ligaments
0050
23.9081
$1,418.78

$283.7627698
T

Repair of ankle ligament
0050
23.9081
$1,418.78

$283.7627700
T

Revision of ankle joint
0047
31.6107
$1,875.87
$537.03
$375.1727702
C

Reconstruct ankle joint27703
C

Reconstruction, ankle joint27704
T

Removal of ankle implant
0049
20.3707
$1,208.86

$241.7727705
T

Incision of tibia
0051
36.5271
$2,167.63

$433.5327707
T

Incision of fibula
0049
20.3707
$1,208.86

$241.7727709
T

Incision of tibia & fibula
0050
23.9081
$1,418.78

$283.7627712
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
23.9081
$1,418.78

$283.7627732
T

Repair of fibula epiphysis
0050
23.9081
$1,418.78

$283.7627734
T

Repair lower leg epiphyses
0050
23.9081
$1,418.78

$283.7627740
T

Repair of leg epiphyses
0050
23.9081
$1,418.78

$283.7627742
T

Repair of leg epiphyses
0051
36.5271
$2,167.63

$433.5327745
T

Reinforce tibia
0051
36.5271
$2,167.63

$433.5327750
T

Treatment of tibia fracture
0043
1.7694
$105.00

$21.0027752
T

Treatment of tibia fracture
0043
1.7694
$105.00

$21.0027756
T

Treatment of tibia fracture
0046
37.7023
$2,237.37
$535.76
$447.4727758
T

Treatment of tibia fracture
0046
37.7023
$2,237.37
$535.76
$447.4727759
T

Treatment of tibia fracture
0046
37.7023
$2,237.37
$535.76
$447.4727760
T

Treatment of ankle fracture
0043
1.7694
$105.00

$21.0027762
T

Treatment of ankle fracture
0043
1.7694
$105.00

$21.0027766
T

Treatment of ankle fracture
0046
37.7023
$2,237.37
$535.76
$447.4727780
T

Treatment of fibula fracture
0043
1.7694
$105.00

$21.0027781
T

Treatment of fibula fracture
0043
1.7694
$105.00

$21.0027784
T

Treatment of fibula fracture
0046
37.7023
$2,237.37
$535.76
$447.4727786
T

Treatment of ankle fracture
0043
1.7694
$105.00

$21.0027788
T

Treatment of ankle fracture
0043
1.7694
$105.00

$21.0027792
T

Treatment of ankle fracture
0046
37.7023
$2,237.37
$535.76
$447.4727808
T

Treatment of ankle fracture
0043
1.7694
$105.00

$21.0027810
T

Treatment of ankle fracture
0043
1.7694
$105.00

$21.0027814
T

Treatment of ankle fracture
0046
37.7023
$2,237.37
$535.76
$447.4727816
T

Treatment of ankle fracture
0043
1.7694
$105.00

$21.0027818
T

Treatment of ankle fracture
0043
1.7694
$105.00

$21.0027822
T

Treatment of ankle fracture
0046
37.7023
$2,237.37
$535.76
$447.4727823
T

Treatment of ankle fracture
0046
37.7023
$2,237.37
$535.76
$447.4727824
T

Treat lower leg fracture
0043
1.7694
$105.00

$21.0027825
T

Treat lower leg fracture
0043
1.7694
$105.00

$21.0027826
T

Treat lower leg fracture
0046
37.7023
$2,237.37
$535.76
$447.4727827
T

Treat lower leg fracture
0046
37.7023
$2,237.37
$535.76
$447.4727828
T

Treat lower leg fracture
0046
37.7023
$2,237.37
$535.76
$447.4727829
T

Treat lower leg joint
0046
37.7023
$2,237.37
$535.76
$447.4727830
T

Treat lower leg dislocation
0043
1.7694
$105.00

$21.0027831
T

Treat lower leg dislocation
0043
1.7694
$105.00

$21.0027832
T

Treat lower leg dislocation
0046
37.7023
$2,237.37
$535.76
$447.4727840
T

Treat ankle dislocation
0043
1.7694
$105.00

$21.0027842
T

Treat ankle dislocation
0045
14.4945
$860.15
$268.47
$172.0327846
T

Treat ankle dislocation
0046
37.7023
$2,237.37
$535.76
$447.4727848
T

Treat ankle dislocation
0046
37.7023
$2,237.37
$535.76
$447.4727860
T

Fixation of ankle joint
0045
14.4945
$860.15
$268.47
$172.0327870
T

Fusion of ankle joint
0051
36.5271
$2,167.63

$433.5327871
T

Fusion of tibiofibular joint
0051
36.5271
$2,167.63

$433.5327880
C

Amputation of lower leg27881
C

Amputation of lower leg27882
C

Amputation of lower leg27884
T

Amputation follow-up surgery
0049
20.3707
$1,208.86

$241.77( print page 50726)27886
C

Amputation follow-up surgery27888
C

Amputation of foot at ankle27889
T

Amputation of foot at ankle
0050
23.9081
$1,418.78

$283.7627892
T

Decompression of leg
0049
20.3707
$1,208.86

$241.7727893
T

Decompression of leg
0049
20.3707
$1,208.86

$241.7727894
T

Decompression of leg
0049
20.3707
$1,208.86

$241.7727899
T

Leg/ankle surgery procedure
0043
1.7694
$105.00

$21.0028001
T

Drainage of bursa of foot
0007
11.4501
$679.48

$135.9028002
T

Treatment of foot infection
0049
20.3707
$1,208.86

$241.7728003
T

Treatment of foot infection
0049
20.3707
$1,208.86

$241.7728005
T

Treat foot bone lesion
0055
20.0692
$1,190.97
$355.34
$238.1928008
T

Incision of foot fascia
0055
20.0692
$1,190.97
$355.34
$238.1928010
T

Incision of toe tendon
0055
20.0692
$1,190.97
$355.34
$238.1928011
T

Incision of toe tendons
0055
20.0692
$1,190.97
$355.34
$238.1928020
T

Exploration of foot joint
0055
20.0692
$1,190.97
$355.34
$238.1928022
T

Exploration of foot joint
0055
20.0692
$1,190.97
$355.34
$238.1928024
T

Exploration of toe joint
0055
20.0692
$1,190.97
$355.34
$238.1928030
T

Removal of foot nerve
0220
17.3586
$1,030.11

$206.0228035
T

Decompression of tibia nerve
0220
17.3586
$1,030.11

$206.0228043
T

Excision of foot lesion
0021
14.9776
$888.82
$219.48
$177.7628045
T

Excision of foot lesion
0055
20.0692
$1,190.97
$355.34
$238.1928046
T

Resection of tumor, foot
0055
20.0692
$1,190.97
$355.34
$238.1928050
T

Biopsy of foot joint lining
0055
20.0692
$1,190.97
$355.34
$238.1928052
T

Biopsy of foot joint lining
0055
20.0692
$1,190.97
$355.34
$238.1928054
T

Biopsy of toe joint lining
0055
20.0692
$1,190.97
$355.34
$238.1928060
T

Partial removal, foot fascia
0055
20.0692
$1,190.97
$355.34
$238.1928062
T

Removal of foot fascia
0055
20.0692
$1,190.97
$355.34
$238.1928070
T

Removal of foot joint lining
0055
20.0692
$1,190.97
$355.34
$238.1928072
T

Removal of foot joint lining
0055
20.0692
$1,190.97
$355.34
$238.1928080
T

Removal of foot lesion
0055
20.0692
$1,190.97
$355.34
$238.1928086
T

Excise foot tendon sheath
0055
20.0692
$1,190.97
$355.34
$238.1928088
T

Excise foot tendon sheath
0055
20.0692
$1,190.97
$355.34
$238.1928090
T

Removal of foot lesion
0055
20.0692
$1,190.97
$355.34
$238.1928092
T

Removal of toe lesions
0055
20.0692
$1,190.97
$355.34
$238.1928100
T

Removal of ankle/heel lesion
0055
20.0692
$1,190.97
$355.34
$238.1928102
T

Remove/graft foot lesion
0056
40.2957
$2,391.27

$478.2528103
T

Remove/graft foot lesion
0056
40.2957
$2,391.27

$478.2528104
T

Removal of foot lesion
0055
20.0692
$1,190.97
$355.34
$238.1928106
T

Remove/graft foot lesion
0056
40.2957
$2,391.27

$478.2528107
T

Remove/graft foot lesion
0056
40.2957
$2,391.27

$478.2528108
T

Removal of toe lesions
0055
20.0692
$1,190.97
$355.34
$238.1928110
T

Part removal of metatarsal
0055
20.0692
$1,190.97
$355.34
$238.1928111
T

Part removal of metatarsal
0055
20.0692
$1,190.97
$355.34
$238.1928112
T

Part removal of metatarsal
0055
20.0692
$1,190.97
$355.34
$238.1928113
T

Part removal of metatarsal
0055
20.0692
$1,190.97
$355.34
$238.1928114
T

Removal of metatarsal heads
0055
20.0692
$1,190.97
$355.34
$238.1928116
T

Revision of foot
0055
20.0692
$1,190.97
$355.34
$238.1928118
T

Removal of heel bone
0055
20.0692
$1,190.97
$355.34
$238.1928119
T

Removal of heel spur
0055
20.0692
$1,190.97
$355.34
$238.1928120
T

Part removal of ankle/heel
0055
20.0692
$1,190.97
$355.34
$238.1928122
T

Partial removal of foot bone
0055
20.0692
$1,190.97
$355.34
$238.1928124
T

Partial removal of toe
0055
20.0692
$1,190.97
$355.34
$238.1928126
T

Partial removal of toe
0055
20.0692
$1,190.97
$355.34
$238.1928130
T

Removal of ankle bone
0055
20.0692
$1,190.97
$355.34
$238.1928140
T

Removal of metatarsal
0055
20.0692
$1,190.97
$355.34
$238.1928150
T

Removal of toe
0055
20.0692
$1,190.97
$355.34
$238.1928153
T

Partial removal of toe
0055
20.0692
$1,190.97
$355.34
$238.1928160
T

Partial removal of toe
0055
20.0692
$1,190.97
$355.34
$238.1928171
T

Extensive foot surgery
0055
20.0692
$1,190.97
$355.34
$238.1928173
T

Extensive foot surgery
0055
20.0692
$1,190.97
$355.34
$238.1928175
T

Extensive foot surgery
0055
20.0692
$1,190.97
$355.34
$238.1928190
T

Removal of foot foreign body
0019
4.0547
$240.62
$71.87
$48.1228192
T

Removal of foot foreign body
0021
14.9776
$888.82
$219.48
$177.7628193
T

Removal of foot foreign body
0020
6.9433
$412.04
$107.40
$82.4128200
T

Repair of foot tendon
0055
20.0692
$1,190.97
$355.34
$238.1928202
T

Repair/graft of foot tendon
0055
20.0692
$1,190.97
$355.34
$238.19( print page 50727)28208
T

Repair of foot tendon
0055
20.0692
$1,190.97
$355.34
$238.1928210
T

Repair/graft of foot tendon
0056
40.2957
$2,391.27

$478.2528220
T

Release of foot tendon
0055
20.0692
$1,190.97
$355.34
$238.1928222
T

Release of foot tendons
0055
20.0692
$1,190.97
$355.34
$238.1928225
T

Release of foot tendon
0055
20.0692
$1,190.97
$355.34
$238.1928226
T

Release of foot tendons
0055
20.0692
$1,190.97
$355.34
$238.1928230
T

Incision of foot tendon(s)
0055
20.0692
$1,190.97
$355.34
$238.1928232
T

Incision of toe tendon
0055
20.0692
$1,190.97
$355.34
$238.1928234
T

Incision of foot tendon
0055
20.0692
$1,190.97
$355.34
$238.1928238
T

Revision of foot tendon
0056
40.2957
$2,391.27

$478.2528240
T

Release of big toe
0055
20.0692
$1,190.97
$355.34
$238.1928250
T

Revision of foot fascia
0055
20.0692
$1,190.97
$355.34
$238.1928260
T

Release of midfoot joint
0055
20.0692
$1,190.97
$355.34
$238.1928261
T

Revision of foot tendon
0055
20.0692
$1,190.97
$355.34
$238.1928262
T

Revision of foot and ankle
0055
20.0692
$1,190.97
$355.34
$238.1928264
T

Release of midfoot joint
0056
40.2957
$2,391.27

$478.2528270
T

Release of foot contracture
0055
20.0692
$1,190.97
$355.34
$238.1928272
T

Release of toe joint, each
0055
20.0692
$1,190.97
$355.34
$238.1928280
T

Fusion of toes
0055
20.0692
$1,190.97
$355.34
$238.1928285
T

Repair of hammertoe
0055
20.0692
$1,190.97
$355.34
$238.1928286
T

Repair of hammertoe
0055
20.0692
$1,190.97
$355.34
$238.1928288
T

Partial removal of foot bone
0055
20.0692
$1,190.97
$355.34
$238.1928289
T

Repair hallux rigidus
0055
20.0692
$1,190.97
$355.34
$238.1928290
T

Correction of bunion
0057
27.5493
$1,634.86
$475.91
$326.9728292
T

Correction of bunion
0057
27.5493
$1,634.86
$475.91
$326.9728293
T

Correction of bunion
0057
27.5493
$1,634.86
$475.91
$326.9728294
T

Correction of bunion
0057
27.5493
$1,634.86
$475.91
$326.9728296
T

Correction of bunion
0057
27.5493
$1,634.86
$475.91
$326.9728297
T

Correction of bunion
0057
27.5493
$1,634.86
$475.91
$326.9728298
T

Correction of bunion
0057
27.5493
$1,634.86
$475.91
$326.9728299
T

Correction of bunion
0057
27.5493
$1,634.86
$475.91
$326.9728300
T

Incision of heel bone
0056
40.2957
$2,391.27

$478.2528302
T

Incision of ankle bone
0055
20.0692
$1,190.97
$355.34
$238.1928304
T

Incision of midfoot bones
0056
40.2957
$2,391.27

$478.2528305
T

Incise/graft midfoot bones
0056
40.2957
$2,391.27

$478.2528306
T

Incision of metatarsal
0055
20.0692
$1,190.97
$355.34
$238.1928307
T

Incision of metatarsal
0055
20.0692
$1,190.97
$355.34
$238.1928308
T

Incision of metatarsal
0055
20.0692
$1,190.97
$355.34
$238.1928309
T

Incision of metatarsals
0056
40.2957
$2,391.27

$478.2528310
T

Revision of big toe
0055
20.0692
$1,190.97
$355.34
$238.1928312
T

Revision of toe
0055
20.0692
$1,190.97
$355.34
$238.1928313
T

Repair deformity of toe
0055
20.0692
$1,190.97
$355.34
$238.1928315
T

Removal of sesamoid bone
0055
20.0692
$1,190.97
$355.34
$238.1928320
T

Repair of foot bones
0056
40.2957
$2,391.27

$478.2528322
T

Repair of metatarsals
0056
40.2957
$2,391.27

$478.2528340
T

Resect enlarged toe tissue
0055
20.0692
$1,190.97
$355.34
$238.1928341
T

Resect enlarged toe
0055
20.0692
$1,190.97
$355.34
$238.1928344
T

Repair extra toe(s)
0055
20.0692
$1,190.97
$355.34
$238.1928345
T

Repair webbed toe(s)
0055
20.0692
$1,190.97
$355.34
$238.1928360
T

Reconstruct cleft foot
0056
40.2957
$2,391.27

$478.2528400
T

Treatment of heel fracture
0043
1.7694
$105.00

$21.0028405
T

Treatment of heel fracture
0043
1.7694
$105.00

$21.0028406
T

Treatment of heel fracture
0046
37.7023
$2,237.37
$535.76
$447.4728415
T

Treat heel fracture
0046
37.7023
$2,237.37
$535.76
$447.4728420
T

Treat/graft heel fracture
0046
37.7023
$2,237.37
$535.76
$447.4728430
T

Treatment of ankle fracture
0043
1.7694
$105.00

$21.0028435
T

Treatment of ankle fracture
0043
1.7694
$105.00

$21.0028436
T

Treatment of ankle fracture
0046
37.7023
$2,237.37
$535.76
$447.4728445
T

Treat ankle fracture
0046
37.7023
$2,237.37
$535.76
$447.4728450
T

Treat midfoot fracture, each
0043
1.7694
$105.00

$21.0028455
T

Treat midfoot fracture, each
0043
1.7694
$105.00

$21.0028456
T

Treat midfoot fracture
0046
37.7023
$2,237.37
$535.76
$447.4728465
T

Treat midfoot fracture, each
0046
37.7023
$2,237.37
$535.76
$447.4728470
T

Treat metatarsal fracture
0043
1.7694
$105.00

$21.0028475
T

Treat metatarsal fracture
0043
1.7694
$105.00

$21.0028476
T

Treat metatarsal fracture
0046
37.7023
$2,237.37
$535.76
$447.47( print page 50728)28485
T

Treat metatarsal fracture
0046
37.7023
$2,237.37
$535.76
$447.4728490
T

Treat big toe fracture
0043
1.7694
$105.00

$21.0028495
T

Treat big toe fracture
0043
1.7694
$105.00

$21.0028496
T

Treat big toe fracture
0046
37.7023
$2,237.37
$535.76
$447.4728505
T

Treat big toe fracture
0046
37.7023
$2,237.37
$535.76
$447.4728510
T

Treatment of toe fracture
0043
1.7694
$105.00

$21.0028515
T

Treatment of toe fracture
0043
1.7694
$105.00

$21.0028525
T

Treat toe fracture
0046
37.7023
$2,237.37
$535.76
$447.4728530
T

Treat sesamoid bone fracture
0043
1.7694
$105.00

$21.0028531
T

Treat sesamoid bone fracture
0046
37.7023
$2,237.37
$535.76
$447.4728540
T

Treat foot dislocation
0043
1.7694
$105.00

$21.0028545
T

Treat foot dislocation
0045
14.4945
$860.15
$268.47
$172.0328546
T

Treat foot dislocation
0046
37.7023
$2,237.37
$535.76
$447.4728555
T

Repair foot dislocation
0046
37.7023
$2,237.37
$535.76
$447.4728570
T

Treat foot dislocation
0043
1.7694
$105.00

$21.0028575
T

Treat foot dislocation
0043
1.7694
$105.00

$21.0028576
T

Treat foot dislocation
0046
37.7023
$2,237.37
$535.76
$447.4728585
T

Repair foot dislocation
0046
37.7023
$2,237.37
$535.76
$447.4728600
T

Treat foot dislocation
0043
1.7694
$105.00

$21.0028605
T

Treat foot dislocation
0043
1.7694
$105.00

$21.0028606
T

Treat foot dislocation
0046
37.7023
$2,237.37
$535.76
$447.4728615
T

Repair foot dislocation
0046
37.7023
$2,237.37
$535.76
$447.4728630
T

Treat toe dislocation
0043
1.7694
$105.00

$21.0028635
T

Treat toe dislocation
0045
14.4945
$860.15
$268.47
$172.0328636
T

Treat toe dislocation
0046
37.7023
$2,237.37
$535.76
$447.4728645
T

Repair toe dislocation
0046
37.7023
$2,237.37
$535.76
$447.4728660
T

Treat toe dislocation
0043
1.7694
$105.00

$21.0028665
T

Treat toe dislocation
0045
14.4945
$860.15
$268.47
$172.0328666
T

Treat toe dislocation
0046
37.7023
$2,237.37
$535.76
$447.4728675
T

Repair of toe dislocation
0046
37.7023
$2,237.37
$535.76
$447.4728705
T

Fusion of foot bones
0056
40.2957
$2,391.27

$478.2528715
T

Fusion of foot bones
0056
40.2957
$2,391.27

$478.2528725
T

Fusion of foot bones
0056
40.2957
$2,391.27

$478.2528730
T

Fusion of foot bones
0056
40.2957
$2,391.27

$478.2528735
T

Fusion of foot bones
0056
40.2957
$2,391.27

$478.2528737
T

Revision of foot bones
0056
40.2957
$2,391.27

$478.2528740
T

Fusion of foot bones
0056
40.2957
$2,391.27

$478.2528750
T

Fusion of big toe joint
0056
40.2957
$2,391.27

$478.2528755
T

Fusion of big toe joint
0055
20.0692
$1,190.97
$355.34
$238.1928760
T

Fusion of big toe joint
0056
40.2957
$2,391.27

$478.2528800
C

Amputation of midfoot28805
C

Amputation thru metatarsal28810
T

Amputation toe & metatarsal
0055
20.0692
$1,190.97
$355.34
$238.1928820
T

Amputation of toe
0055
20.0692
$1,190.97
$355.34
$238.1928825
T

Partial amputation of toe
0055
20.0692
$1,190.97
$355.34
$238.1928899
T

Foot/toes surgery procedure
0043
1.7694
$105.00

$21.0029000
S

Application of body cast
0058
1.0934
$64.89

$12.9829010
S

Application of body cast
0426
2.1243
$126.06

$25.2129015
S

Application of body cast
0426
2.1243
$126.06

$25.2129020
S

Application of body cast
0058
1.0934
$64.89

$12.9829025
S

Application of body cast
0058
1.0934
$64.89

$12.9829035
S

Application of body cast
0426
2.1243
$126.06

$25.2129040
S

Application of body cast
0058
1.0934
$64.89

$12.9829044
S

Application of body cast
0426
2.1243
$126.06

$25.2129046
S

Application of body cast
0426
2.1243
$126.06

$25.2129049
S

Application of figure eight
0058
1.0934
$64.89

$12.9829055
S

Application of shoulder cast
0426
2.1243
$126.06

$25.2129058
S

Application of shoulder cast
0058
1.0934
$64.89

$12.9829065
S

Application of long arm cast
0426
2.1243
$126.06

$25.2129075
S

Application of forearm cast
0426
2.1243
$126.06

$25.2129085
S

Apply hand/wrist cast
0058
1.0934
$64.89

$12.9829086
S

Apply finger cast
0058
1.0934
$64.89

$12.9829105
S

Apply long arm splint
0058
1.0934
$64.89

$12.9829125
S

Apply forearm splint
0058
1.0934
$64.89

$12.9829126
S

Apply forearm splint
0058
1.0934
$64.89

$12.9829130
S

Application of finger splint
0058
1.0934
$64.89

$12.98( print page 50729)29131
S

Application of finger splint
0058
1.0934
$64.89

$12.9829200
S

Strapping of chest
0058
1.0934
$64.89

$12.9829220
S

Strapping of low back
0058
1.0934
$64.89

$12.9829240
S

Strapping of shoulder
0058
1.0934
$64.89

$12.9829260
S

Strapping of elbow or wrist
0058
1.0934
$64.89

$12.9829280
S

Strapping of hand or finger
0058
1.0934
$64.89

$12.9829305
S

Application of hip cast
0426
2.1243
$126.06

$25.2129325
S

Application of hip casts
0426
2.1243
$126.06

$25.2129345
S

Application of long leg cast
0426
2.1243
$126.06

$25.2129355
S

Application of long leg cast
0426
2.1243
$126.06

$25.2129358
S

Apply long leg cast brace
0426
2.1243
$126.06

$25.2129365
S

Application of long leg cast
0426
2.1243
$126.06

$25.2129405
S

Apply short leg cast
0426
2.1243
$126.06

$25.2129425
S

Apply short leg cast
0426
2.1243
$126.06

$25.2129435
S

Apply short leg cast
0426
2.1243
$126.06

$25.2129440
S

Addition of walker to cast
0058
1.0934
$64.89

$12.9829445
S

Apply rigid leg cast
0426
2.1243
$126.06

$25.2129450
S

Application of leg cast
0058
1.0934
$64.89

$12.9829505
S

Application, long leg splint
0058
1.0934
$64.89

$12.9829515
S

Application lower leg splint
0058
1.0934
$64.89

$12.9829520
S

Strapping of hip
0058
1.0934
$64.89

$12.9829530
S

Strapping of knee
0058
1.0934
$64.89

$12.9829540
S

Strapping of ankle
0058
1.0934
$64.89

$12.9829550
S

Strapping of toes
0058
1.0934
$64.89

$12.9829580
S

Application of paste boot
0058
1.0934
$64.89

$12.9829590
S

Application of foot splint
0058
1.0934
$64.89

$12.9829700
S

Removal/revision of cast
0058
1.0934
$64.89

$12.9829705
S

Removal/revision of cast
0058
1.0934
$64.89

$12.9829710
S

Removal/revision of cast
0426
2.1243
$126.06

$25.2129715
S

Removal/revision of cast
0058
1.0934
$64.89

$12.9829720
S

Repair of body cast
0058
1.0934
$64.89

$12.9829730
S

Windowing of cast
0058
1.0934
$64.89

$12.9829740
S

Wedging of cast
0058
1.0934
$64.89

$12.9829750
S

Wedging of clubfoot cast
0058
1.0934
$64.89

$12.9829799
S

Casting/strapping procedure
0058
1.0934
$64.89

$12.9829800
T

Jaw arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929804
T

Jaw arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929805
T

Shoulder arthroscopy, dx
0041
28.1318
$1,669.43

$333.8929806
T

Shoulder arthroscopy/surgery
0042
43.9753
$2,609.63
$804.74
$521.9329807
T

Shoulder arthroscopy/surgery
0042
43.9753
$2,609.63
$804.74
$521.9329819
T

Shoulder arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929820
T

Shoulder arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929821
T

Shoulder arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929822
T

Shoulder arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929823
T

Shoulder arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929824
T

Shoulder arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929825
T

Shoulder arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929826
T

Shoulder arthroscopy/surgery
0042
43.9753
$2,609.63
$804.74
$521.9329827
T

Arthroscop rotator cuff repr
0042
43.9753
$2,609.63
$804.74
$521.9329830
T

Elbow arthroscopy
0041
28.1318
$1,669.43

$333.8929834
T

Elbow arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929835
T

Elbow arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929836
T

Elbow arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929837
T

Elbow arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929838
T

Elbow arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929840
T

Wrist arthroscopy
0041
28.1318
$1,669.43

$333.8929843
T

Wrist arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929844
T

Wrist arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929845
T

Wrist arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929846
T

Wrist arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929847
T

Wrist arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929848
T

Wrist endoscopy/surgery
0041
28.1318
$1,669.43

$333.8929850
T

Knee arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929851
T

Knee arthroscopy/surgery
0042
43.9753
$2,609.63
$804.74
$521.9329855
T

Tibial arthroscopy/surgery
0042
43.9753
$2,609.63
$804.74
$521.9329856
T

Tibial arthroscopy/surgery
0041
28.1318
$1,669.43

$333.89( print page 50730)29860
T

Hip arthroscopy, dx
0041
28.1318
$1,669.43

$333.8929861
T

Hip arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929862
T

Hip arthroscopy/surgery
0042
43.9753
$2,609.63
$804.74
$521.9329863
T

Hip arthroscopy/surgery
0042
43.9753
$2,609.63
$804.74
$521.9329866
T

Autgrft implnt, knee w/scope
0042
43.9753
$2,609.63
$804.74
$521.9329867
T

Allgrft implnt, knee w/scope
0042
43.9753
$2,609.63
$804.74
$521.9329868
T

Meniscal trnspl, knee w/scpe
0042
43.9753
$2,609.63
$804.74
$521.9329870
T

Knee arthroscopy, dx
0041
28.1318
$1,669.43

$333.8929871
T

Knee arthroscopy/drainage
0041
28.1318
$1,669.43

$333.8929873
T

Knee arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929874
T

Knee arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929875
T

Knee arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929876
T

Knee arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929877
T

Knee arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929879
T

Knee arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929880
T

Knee arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929881
T

Knee arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929882
T

Knee arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929883
T

Knee arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929884
T

Knee arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929885
T

Knee arthroscopy/surgery
0042
43.9753
$2,609.63
$804.74
$521.9329886
T

Knee arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929887
T

Knee arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929888
T

Knee arthroscopy/surgery
0042
43.9753
$2,609.63
$804.74
$521.9329889
T

Knee arthroscopy/surgery
0042
43.9753
$2,609.63
$804.74
$521.9329891
T

Ankle arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929892
T

Ankle arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929893
T

Scope, plantar fasciotomy
0055
20.0692
$1,190.97
$355.34
$238.1929894
T

Ankle arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929895
T

Ankle arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929897
T

Ankle arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929898
T

Ankle arthroscopy/surgery
0041
28.1318
$1,669.43

$333.8929899
T

Ankle arthroscopy/surgery
0042
43.9753
$2,609.63
$804.74
$521.9329900
T

Mcp joint arthroscopy, dx
0053
15.6795
$930.47
$253.49
$186.0929901
T

Mcp joint arthroscopy, surg
0053
15.6795
$930.47
$253.49
$186.0929902
T

Mcp joint arthroscopy, surg
0053
15.6795
$930.47
$253.49
$186.0929999
T

Arthroscopy of joint
0041
28.1318
$1,669.43

$333.8930000
T

Drainage of nose lesion
0251
2.0101
$119.29

$23.8630020
T

Drainage of nose lesion
0251
2.0101
$119.29

$23.8630100
T

Intranasal biopsy
0252
7.8673
$466.87
$113.41
$93.3730110
T

Removal of nose polyp(s)
0253
16.1357
$957.54
$282.29
$191.5130115
T

Removal of nose polyp(s)
0253
16.1357
$957.54
$282.29
$191.5130117
T

Removal of intranasal lesion
0253
16.1357
$957.54
$282.29
$191.5130118
T

Removal of intranasal lesion
0254
23.404
$1,388.86
$321.35
$277.7730120
T

Revision of nose
0253
16.1357
$957.54
$282.29
$191.5130124
T

Removal of nose lesion
0252
7.8673
$466.87
$113.41
$93.3730125
T

Removal of nose lesion
0256
37.3204
$2,214.70

$442.9430130
T

Removal of turbinate bones
0253
16.1357
$957.54
$282.29
$191.5130140
T

Removal of turbinate bones
0254
23.404
$1,388.86
$321.35
$277.7730150
T

Partial removal of nose
0256
37.3204
$2,214.70

$442.9430160
T

Removal of nose
0256
37.3204
$2,214.70

$442.9430200
T

Injection treatment of nose
0252
7.8673
$466.87
$113.41
$93.3730210
T

Nasal sinus therapy
0252
7.8673
$466.87
$113.41
$93.3730220
T

Insert nasal septal button
0252
7.8673
$466.87
$113.41
$93.3730300
X

Remove nasal foreign body
0340
0.6384
$37.88

$7.5830310
T

Remove nasal foreign body
0253
16.1357
$957.54
$282.29
$191.5130320
T

Remove nasal foreign body
0253
16.1357
$957.54
$282.29
$191.5130400
T

Reconstruction of nose
0256
37.3204
$2,214.70

$442.9430410
T

Reconstruction of nose
0256
37.3204
$2,214.70

$442.9430420
T

Reconstruction of nose
0256
37.3204
$2,214.70

$442.9430430
T

Revision of nose
0254
23.404
$1,388.86
$321.35
$277.7730435
T

Revision of nose
0256
37.3204
$2,214.70

$442.9430450
T

Revision of nose
0256
37.3204
$2,214.70

$442.9430460
T

Revision of nose
0256
37.3204
$2,214.70

$442.9430462
T

Revision of nose
0256
37.3204
$2,214.70

$442.9430465
T

Repair nasal stenosis
0256
37.3204
$2,214.70

$442.94( print page 50731)30520
T

Repair of nasal septum
0254
23.404
$1,388.86
$321.35
$277.7730540
T

Repair nasal defect
0256
37.3204
$2,214.70

$442.9430545
T

Repair nasal defect
0256
37.3204
$2,214.70

$442.9430560
T

Release of nasal adhesions
0251
2.0101
$119.29

$23.8630580
T

Repair upper jaw fistula
0256
37.3204
$2,214.70

$442.9430600
T

Repair mouth/nose fistula
0256
37.3204
$2,214.70

$442.9430620
T

Intranasal reconstruction
0256
37.3204
$2,214.70

$442.9430630
T

Repair nasal septum defect
0254
23.404
$1,388.86
$321.35
$277.7730801
T

Cauterization, inner nose
0252
7.8673
$466.87
$113.41
$93.3730802
T

Cauterization, inner nose
0252
7.8673
$466.87
$113.41
$93.3730901
T

Control of nosebleed
0250
1.2896
$76.53
$26.79
$15.3130903
T

Control of nosebleed
0250
1.2896
$76.53
$26.79
$15.3130905
T

Control of nosebleed
0250
1.2896
$76.53
$26.79
$15.3130906
T

Repeat control of nosebleed
0250
1.2896
$76.53
$26.79
$15.3130915
T

Ligation, nasal sinus artery
0091
28.9999
$1,720.94
$348.23
$344.1930920
T

Ligation, upper jaw artery
0092
26.482
$1,571.52
$505.37
$314.3030930
T

Therapy, fracture of nose
0253
16.1357
$957.54
$282.29
$191.5130999
T

Nasal surgery procedure
0251
2.0101
$119.29

$23.8631000
T

Irrigation, maxillary sinus
0251
2.0101
$119.29

$23.8631002
T

Irrigation, sphenoid sinus
0252
7.8673
$466.87
$113.41
$93.3731020
T

Exploration, maxillary sinus
0254
23.404
$1,388.86
$321.35
$277.7731030
T

Exploration, maxillary sinus
0256
37.3204
$2,214.70

$442.9431032
T

Explore sinus, remove polyps
0256
37.3204
$2,214.70

$442.9431040
T

Exploration behind upper jaw
0254
23.404
$1,388.86
$321.35
$277.7731050
T

Exploration, sphenoid sinus
0256
37.3204
$2,214.70

$442.9431051
T

Sphenoid sinus surgery
0256
37.3204
$2,214.70

$442.9431070
T

Exploration of frontal sinus
0254
23.404
$1,388.86
$321.35
$277.7731075
T

Exploration of frontal sinus
0256
37.3204
$2,214.70

$442.9431080
T

Removal of frontal sinus
0256
37.3204
$2,214.70

$442.9431081
T

Removal of frontal sinus
0256
37.3204
$2,214.70

$442.9431084
T

Removal of frontal sinus
0256
37.3204
$2,214.70

$442.9431085
T

Removal of frontal sinus
0256
37.3204
$2,214.70

$442.9431086
T

Removal of frontal sinus
0256
37.3204
$2,214.70

$442.9431087
T

Removal of frontal sinus
0256
37.3204
$2,214.70

$442.9431090
T

Exploration of sinuses
0256
37.3204
$2,214.70

$442.9431200
T

Removal of ethmoid sinus
0256
37.3204
$2,214.70

$442.9431201
T

Removal of ethmoid sinus
0256
37.3204
$2,214.70

$442.9431205
T

Removal of ethmoid sinus
0256
37.3204
$2,214.70

$442.9431225
C

Removal of upper jaw31230
C

Removal of upper jaw31231
T

Nasal endoscopy, dx
0072
1.4361
$85.22
$21.27
$17.0431233
T

Nasal/sinus endoscopy, dx
0072
1.4361
$85.22
$21.27
$17.0431235
T

Nasal/sinus endoscopy, dx
0074
15.7757
$936.18
$295.70
$187.2431237
T

Nasal/sinus endoscopy, surg
0075
21.3426
$1,266.53
$445.92
$253.3131238
T

Nasal/sinus endoscopy, surg
0074
15.7757
$936.18
$295.70
$187.2431239
T

Nasal/sinus endoscopy, surg
0075
21.3426
$1,266.53
$445.92
$253.3131240
T

Nasal/sinus endoscopy, surg
0074
15.7757
$936.18
$295.70
$187.2431254
T

Revision of ethmoid sinus
0075
21.3426
$1,266.53
$445.92
$253.3131255
T

Removal of ethmoid sinus
0075
21.3426
$1,266.53
$445.92
$253.3131256
T

Exploration maxillary sinus
0075
21.3426
$1,266.53
$445.92
$253.3131267
T

Endoscopy, maxillary sinus
0075
21.3426
$1,266.53
$445.92
$253.3131276
T

Sinus endoscopy, surgical
0075
21.3426
$1,266.53
$445.92
$253.3131287
T

Nasal/sinus endoscopy, surg
0075
21.3426
$1,266.53
$445.92
$253.3131288
T

Nasal/sinus endoscopy, surg
0075
21.3426
$1,266.53
$445.92
$253.3131290
C

Nasal/sinus endoscopy, surg31291
C

Nasal/sinus endoscopy, surg31292
T

Nasal/sinus endoscopy, surg
0075
21.3426
$1,266.53
$445.92
$253.3131293
T

Nasal/sinus endoscopy, surg
0075
21.3426
$1,266.53
$445.92
$253.3131294
T

Nasal/sinus endoscopy, surg
0075
21.3426
$1,266.53
$445.92
$253.3131299
T

Sinus surgery procedure
0251
2.0101
$119.29

$23.8631300
T

Removal of larynx lesion
0254
23.404
$1,388.86
$321.35
$277.7731320
T

Diagnostic incision, larynx
0256
37.3204
$2,214.70

$442.9431360
C

Removal of larynx31365
C

Removal of larynx31367
C

Partial removal of larynx31368
C

Partial removal of larynx( print page 50732)31370
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
37.3204
$2,214.70

$442.9431420
T

Removal of epiglottis
0256
37.3204
$2,214.70

$442.9431500
S

Insert emergency airway
0094
2.5363
$150.51
$47.62
$30.1031502
T

Change of windpipe airway
0121
2.2766
$135.10
$43.80
$27.0231505
T

Diagnostic laryngoscopy
0071
0.7915
$46.97
$11.31
$9.3931510
T

Laryngoscopy with biopsy
0074
15.7757
$936.18
$295.70
$187.2431511
T

Remove foreign body, larynx
0072
1.4361
$85.22
$21.27
$17.0431512
T

Removal of larynx lesion
0074
15.7757
$936.18
$295.70
$187.2431513
T

Injection into vocal cord
0072
1.4361
$85.22
$21.27
$17.0431515
T

Laryngoscopy for aspiration
0074
15.7757
$936.18
$295.70
$187.2431520
T

Diagnostic laryngoscopy
0072
1.4361
$85.22
$21.27
$17.0431525
T

Diagnostic laryngoscopy
0074
15.7757
$936.18
$295.70
$187.2431526
T

Diagnostic laryngoscopy
0075
21.3426
$1,266.53
$445.92
$253.3131527
T

Laryngoscopy for treatment
0075
21.3426
$1,266.53
$445.92
$253.3131528
T

Laryngoscopy and dilation
0074
15.7757
$936.18
$295.70
$187.2431529
T

Laryngoscopy and dilation
0074
15.7757
$936.18
$295.70
$187.2431530
T

Operative laryngoscopy
0075
21.3426
$1,266.53
$445.92
$253.3131531
T

Operative laryngoscopy
0075
21.3426
$1,266.53
$445.92
$253.3131535
T

Operative laryngoscopy
0075
21.3426
$1,266.53
$445.92
$253.3131536
T

Operative laryngoscopy
0075
21.3426
$1,266.53
$445.92
$253.3131540
T

Operative laryngoscopy
0075
21.3426
$1,266.53
$445.92
$253.3131541
T

Operative laryngoscopy
0075
21.3426
$1,266.53
$445.92
$253.3131545
T

Remove vc lesion w/scope
0075
21.3426
$1,266.53
$445.92
$253.3131546
T

Remove vc lesion scope/graft
0075
21.3426
$1,266.53
$445.92
$253.3131560
T

Operative laryngoscopy
0075
21.3426
$1,266.53
$445.92
$253.3131561
T

Operative laryngoscopy
0075
21.3426
$1,266.53
$445.92
$253.3131570
T

Laryngoscopy with injection
0074
15.7757
$936.18
$295.70
$187.2431571
T

Laryngoscopy with injection
0075
21.3426
$1,266.53
$445.92
$253.3131575
T

Diagnostic laryngoscopy
0072
1.4361
$85.22
$21.27
$17.0431576
T

Laryngoscopy with biopsy
0075
21.3426
$1,266.53
$445.92
$253.3131577
T

Remove foreign body, larynx
0073
4.1609
$246.92
$73.38
$49.3831578
T

Removal of larynx lesion
0075
21.3426
$1,266.53
$445.92
$253.3131579
T

Diagnostic laryngoscopy
0073
4.1609
$246.92
$73.38
$49.3831580
T

Revision of larynx
0256
37.3204
$2,214.70

$442.9431582
T

Revision of larynx
0256
37.3204
$2,214.70

$442.9431584
C

Treat larynx fracture31585
T

Treat larynx fracture
0253
16.1357
$957.54
$282.29
$191.5131586
T

Treat larynx fracture
0256
37.3204
$2,214.70

$442.9431587
C

Revision of larynx31588
T

Revision of larynx
0256
37.3204
$2,214.70

$442.9431590
T

Reinnervate larynx
0256
37.3204
$2,214.70

$442.9431595
T

Larynx nerve surgery
0256
37.3204
$2,214.70

$442.9431599
T

Larynx surgery procedure
0251
2.0101
$119.29

$23.8631600
T

Incision of windpipe
0254
23.404
$1,388.86
$321.35
$277.7731601
T

Incision of windpipe
0254
23.404
$1,388.86
$321.35
$277.7731603
T

Incision of windpipe
0252
7.8673
$466.87
$113.41
$93.3731605
T

Incision of windpipe
0252
7.8673
$466.87
$113.41
$93.3731610
T

Incision of windpipe
0254
23.404
$1,388.86
$321.35
$277.7731611
T

Surgery/speech prosthesis
0254
23.404
$1,388.86
$321.35
$277.7731612
T

Puncture/clear windpipe
0254
23.404
$1,388.86
$321.35
$277.7731613
T

Repair windpipe opening
0254
23.404
$1,388.86
$321.35
$277.7731614
T

Repair windpipe opening
0256
37.3204
$2,214.70

$442.9431615
T

Visualization of windpipe
0076
9.4592
$561.34
$189.82
$112.2731620
S

Endobronchial us add-on
0670
25.4131
$1,508.09
$472.46
$301.6231622
T

Dx bronchoscope/wash
0076
9.4592
$561.34
$189.82
$112.2731623
T

Dx bronchoscope/brush
0076
9.4592
$561.34
$189.82
$112.2731624
T

Dx bronchoscope/lavage
0076
9.4592
$561.34
$189.82
$112.2731625
T

Bronchoscopy w/biopsy(s)
0076
9.4592
$561.34
$189.82
$112.2731628
T

Bronchoscopy/lung bx, each
0076
9.4592
$561.34
$189.82
$112.2731629
T

Bronchoscopy/needle bx, each
0076
9.4592
$561.34
$189.82
$112.27( print page 50733)31630
T

Bronchoscopy dilate/fx repr
0415
22.0955
$1,311.21
$459.92
$262.2431631
T

Bronchoscopy, dilate w/stent
0415
22.0955
$1,311.21
$459.92
$262.2431632
T

Bronchoscopy/lung bx, add'l
0076
9.4592
$561.34
$189.82
$112.2731633
T

Bronchoscopy/needle bx add'l
0076
9.4592
$561.34
$189.82
$112.2731635
T

Bronchoscopy w/fb removal
0076
9.4592
$561.34
$189.82
$112.2731636
T

Bronchoscopy, bronch stents
0415
22.0955
$1,311.21
$459.92
$262.2431637
T

Bronchoscopy, stent add-on
0076
9.4592
$561.34
$189.82
$112.2731638
T

Bronchoscopy, revise stent
0415
22.0955
$1,311.21
$459.92
$262.2431640
T

Bronchoscopy w/tumor excise
0415
22.0955
$1,311.21
$459.92
$262.2431641
T

Bronchoscopy, treat blockage
0415
22.0955
$1,311.21
$459.92
$262.2431643
T

Diag bronchoscope/catheter
0076
9.4592
$561.34
$189.82
$112.2731645
T

Bronchoscopy, clear airways
0076
9.4592
$561.34
$189.82
$112.2731646
T

Bronchoscopy, reclear airway
0076
9.4592
$561.34
$189.82
$112.2731656
T

Bronchoscopy, inj for x-ray
0076
9.4592
$561.34
$189.82
$112.2731700
T

Insertion of airway catheter
0072
1.4361
$85.22
$21.27
$17.0431708
N

Instill airway contrast dye31710
N

Insertion of airway catheter31715
N

Injection for bronchus x-ray31717
T

Bronchial brush biopsy
0073
4.1609
$246.92
$73.38
$49.3831720
T

Clearance of airways
0071
0.7915
$46.97
$11.31
$9.3931725
C

Clearance of airways31730
T

Intro, windpipe wire/tube
0073
4.1609
$246.92
$73.38
$49.3831750
T

Repair of windpipe
0256
37.3204
$2,214.70

$442.9431755
T

Repair of windpipe
0256
37.3204
$2,214.70

$442.9431760
C

Repair of windpipe31766
C

Reconstruction of windpipe31770
C

Repair/graft of bronchus31775
C

Reconstruct bronchus31780
C

Reconstruct windpipe31781
C

Reconstruct windpipe31785
T

Remove windpipe lesion
0254
23.404
$1,388.86
$321.35
$277.7731786
C

Remove windpipe lesion31800
C

Repair of windpipe injury31805
C

Repair of windpipe injury31820
T

Closure of windpipe lesion
0253
16.1357
$957.54
$282.29
$191.5131825
T

Repair of windpipe defect
0254
23.404
$1,388.86
$321.35
$277.7731830
T

Revise windpipe scar
0254
23.404
$1,388.86
$321.35
$277.7731899
T

Airways surgical procedure
0076
9.4592
$561.34
$189.82
$112.2732000
T

Drainage of chest
0070
3.2101
$190.50

$38.1032002
T

Treatment of collapsed lung
0070
3.2101
$190.50

$38.1032005
T

Treat lung lining chemically
0070
3.2101
$190.50

$38.1032019
T

Insert pleural catheter
0070
3.2101
$190.50

$38.1032020
T

Insertion of chest tube
0070
3.2101
$190.50

$38.1032035
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
T

Drain, percut, lung lesion
0070
3.2101
$190.50

$38.1032215
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
0685
6.0174
$357.09
$115.47
$71.4232402
C

Open biopsy chest lining32405
T

Biopsy, lung or mediastinum
0685
6.0174
$357.09
$115.47
$71.4232420
T

Puncture/clear lung
0070
3.2101
$190.50

$38.10( print page 50734)32440
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 lesion32601
T

Thoracoscopy, diagnostic
0069
30.6775
$1,820.49
$591.64
$364.1032602
T

Thoracoscopy, diagnostic
0069
30.6775
$1,820.49
$591.64
$364.1032603
T

Thoracoscopy, diagnostic
0069
30.6775
$1,820.49
$591.64
$364.1032604
T

Thoracoscopy, diagnostic
0069
30.6775
$1,820.49
$591.64
$364.1032605
T

Thoracoscopy, diagnostic
0069
30.6775
$1,820.49
$591.64
$364.1032606
T

Thoracoscopy, diagnostic
0069
30.6775
$1,820.49
$591.64
$364.1032650
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 bypass32855
C

Prepare donor lung, single32856
C

Prepare donor lung, double32900
C

Removal of rib(s)32905
C

Revise & repair chest wall32906
C

Revise & repair chest wall32940
C

Revision of lung32960
T

Therapeutic pneumothorax
0070
3.2101
$190.50

$38.1032997
C

Total lung lavage32999
T

Chest surgery procedure
0070
3.2101
$190.50

$38.1033010
T

Drainage of heart sac
0070
3.2101
$190.50

$38.1033011
T

Repeat drainage of heart sac
0070
3.2101
$190.50

$38.1033015
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)( print page 50735)33141
C

Heart tmr w/other procedure33200
C

Insertion of heart pacemaker33201
C

Insertion of heart pacemaker33206
T

Insertion of heart pacemaker
0089
105.6143
$6,267.47
$1,682.28
$1,253.4933207
T

Insertion of heart pacemaker
0089
105.6143
$6,267.47
$1,682.28
$1,253.4933208
T

Insertion of heart pacemaker
0655
133.7768
$7,938.72

$1,587.7433210
T

Insertion of heart electrode
0106
45.4851
$2,699.22

$539.8433211
T

Insertion of heart electrode
0106
45.4851
$2,699.22

$539.8433212
T

Insertion of pulse generator
0090
89.1574
$5,290.87
$1,612.80
$1,058.1733213
T

Insertion of pulse generator
0654
100.9294
$5,989.45

$1,197.8933214
T

Upgrade of pacemaker system
0655
133.7768
$7,938.72

$1,587.7433215
T

Reposition pacing-defib lead
0105
22.3685
$1,327.41
$370.40
$265.4833216
T

Revise eltrd pacing-defib
0106
45.4851
$2,699.22

$539.8433217
T

Insert lead pace-defib, dual
0106
45.4851
$2,699.22

$539.8433218
T

Repair lead pace-defib, one
0106
45.4851
$2,699.22

$539.8433220
T

Repair lead pace-defib, dual
0106
45.4851
$2,699.22

$539.8433222
T

Revise pocket, acemaker
0027
18.4182
$1,092.99
$329.72
$218.6033223
T

Revise pocket, pacing-defib
0027
18.4182
$1,092.99
$329.72
$218.6033224
T

Insert pacing lead & connect
0418
109.3043
$6,486.45

$1,297.2933225
T

L ventric pacing lead add-on
0418
109.3043
$6,486.45

$1,297.2933226
T

Reposition l ventric lead
0105
22.3685
$1,327.41
$370.40
$265.4833233
T

Removal of pacemaker system
0105
22.3685
$1,327.41
$370.40
$265.4833234
T

Removal of pacemaker system
0105
22.3685
$1,327.41
$370.40
$265.4833235
T

Removal pacemaker electrode
0105
22.3685
$1,327.41
$370.40
$265.4833236
C

Remove electrode/thoracotomy33237
C

Remove electrode/thoracotomy33238
C

Remove electrode/thoracotomy33240
B

Insert pulse generator33241
T

Remove pulse generator
0105
22.3685
$1,327.41
$370.40
$265.4833243
C

Remove eltrd/thoracotomy33244
T

Remove eltrd, transven
0105
22.3685
$1,327.41
$370.40
$265.4833245
C

Insert epic eltrd pace-defib33246
C

Insert epic eltrd/generator33249
B

Eltrd/insert pace-defib33250
C

Ablate heart dysrhythm focus33251
C

Ablate heart dysrhythm focus33253
C

Reconstruct atria33261
C

Ablate heart dysrhythm focus33282
S

Implant pat-active ht record
0680
62.9082
$3,733.16

$746.6333284
T

Remove pat-active ht record
0109
11.0433
$655.34
$131.49
$131.0733300
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 valve( print page 50736)33425
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, translocation33508
N

Endoscopic vein harvest33510
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, modified fontan33617
C

Repair single ventricle33619
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 defects( print page 50737)33694
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/lung33933
C

Prepare donor heart/lung33935
C

Transplantation, heart/lung33940
C

Removal of donor heart33944
C

Prepare donor heart33945
C

Transplantation of heart33960
C

External circulation assist33961
C

External circulation assist33967
C

Insert ia percut device( print page 50738)33968
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 device33979
C

Insert intracorporeal device33980
C

Remove intracorporeal device33999
T

Cardiac surgery procedure
0070
3.2101
$190.50

$38.1034001
C

Removal of artery clot34051
C

Removal of artery clot34101
T

Removal of artery clot
0088
36.5617
$2,169.68
$655.22
$433.9434111
T

Removal of arm artery clot
0088
36.5617
$2,169.68
$655.22
$433.9434151
C

Removal of artery clot34201
T

Removal of artery clot
0088
36.5617
$2,169.68
$655.22
$433.9434203
T

Removal of leg artery clot
0088
36.5617
$2,169.68
$655.22
$433.9434401
C

Removal of vein clot34421
T

Removal of vein clot
0088
36.5617
$2,169.68
$655.22
$433.9434451
C

Removal of vein clot34471
T

Removal of vein clot
0088
36.5617
$2,169.68
$655.22
$433.9434490
T

Removal of vein clot
0088
36.5617
$2,169.68
$655.22
$433.9434501
T

Repair valve, femoral vein
0088
36.5617
$2,169.68
$655.22
$433.9434502
C

Reconstruct vena cava34510
T

Transposition of vein valve
0088
36.5617
$2,169.68
$655.22
$433.9434520
T

Cross-over vein graft
0088
36.5617
$2,169.68
$655.22
$433.9434530
T

Leg vein fusion
0088
36.5617
$2,169.68
$655.22
$433.9434800
C

Endovasc abdo repair w/tube34802
C

Endovasc abdo repr w/device34803
C

Endovas aaa repr w/3-p part34804
C

Endovasc abdo repr w/device34805
C

Endovasc abdo repair w/pros34808
C

Endovasc abdo occlud device34812
C

Xpose for endoprosth, aortic34813
C

Femoral endovas graft add-on34820
C

Xpose for endoprosth, iliac34825
C

Endovasc extend prosth, init34826
C

Endovasc exten prosth, add'l34830
C

Open aortic tube prosth repr34831
C

Open aortoiliac prosth repr34832
C

Open aortofemor prosth repr34833
C

Xpose for endoprosth, iliac34834
C

Xpose, endoprosth, brachial34900
C

Endovasc iliac repr w/graft35001
C

Repair defect of artery35002
C

Repair artery rupture, neck35005
C

Repair defect of artery35011
T

Repair defect of artery
0653
30.5339
$1,811.97

$362.3935013
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, groin( print page 50739)35141
C

Repair defect of artery35142
C

Repair artery rupture, thigh35151
C

Repair defect of artery35152
C

Repair artery rupture, knee35180
T

Repair blood vessel lesion
0093
23.4516
$1,391.69

$278.3435182
C

Repair blood vessel lesion35184
T

Repair blood vessel lesion
0093
23.4516
$1,391.69

$278.3435188
T

Repair blood vessel lesion
0088
36.5617
$2,169.68
$655.22
$433.9435189
C

Repair blood vessel lesion35190
T

Repair blood vessel lesion
0093
23.4516
$1,391.69

$278.3435201
T

Repair blood vessel lesion
0093
23.4516
$1,391.69

$278.3435206
T

Repair blood vessel lesion
0093
23.4516
$1,391.69

$278.3435207
T

Repair blood vessel lesion
0088
36.5617
$2,169.68
$655.22
$433.9435211
C

Repair blood vessel lesion35216
C

Repair blood vessel lesion35221
C

Repair blood vessel lesion35226
T

Repair blood vessel lesion
0093
23.4516
$1,391.69

$278.3435231
T

Repair blood vessel lesion
0093
23.4516
$1,391.69

$278.3435236
T

Repair blood vessel lesion
0093
23.4516
$1,391.69

$278.3435241
C

Repair blood vessel lesion35246
C

Repair blood vessel lesion35251
C

Repair blood vessel lesion35256
T

Repair blood vessel lesion
0093
23.4516
$1,391.69

$278.3435261
T

Repair blood vessel lesion
0653
30.5339
$1,811.97

$362.3935266
T

Repair blood vessel lesion
0653
30.5339
$1,811.97

$362.3935271
C

Repair blood vessel lesion35276
C

Repair blood vessel lesion35281
C

Repair blood vessel lesion35286
T

Repair blood vessel lesion
0653
30.5339
$1,811.97

$362.3935301
C

Rechanneling of artery35311
C

Rechanneling of artery35321
T

Rechanneling of artery
0093
23.4516
$1,391.69

$278.3435331
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
34.4473
$2,044.21

$408.8435459
T

Repair arterial blockage
0081
34.4473
$2,044.21

$408.8435460
T

Repair venous blockage
0081
34.4473
$2,044.21

$408.8435470
T

Repair arterial blockage
0081
34.4473
$2,044.21

$408.8435471
T

Repair arterial blockage
0081
34.4473
$2,044.21

$408.8435472
T

Repair arterial blockage
0081
34.4473
$2,044.21

$408.8435473
T

Repair arterial blockage
0081
34.4473
$2,044.21

$408.8435474
T

Repair arterial blockage
0081
34.4473
$2,044.21

$408.8435475
T

Repair arterial blockage
0081
34.4473
$2,044.21

$408.8435476
T

Repair venous blockage
0081
34.4473
$2,044.21

$408.8435480
C

Atherectomy, open35481
C

Atherectomy, open35482
C

Atherectomy, open35483
C

Atherectomy, open35484
T

Atherectomy, open
0081
34.4473
$2,044.21

$408.8435485
T

Atherectomy, open
0081
34.4473
$2,044.21

$408.8435490
T

Atherectomy, percutaneous
0081
34.4473
$2,044.21

$408.8435491
T

Atherectomy, percutaneous
0081
34.4473
$2,044.21

$408.8435492
T

Atherectomy, percutaneous
0081
34.4473
$2,044.21

$408.84( print page 50740)35493
T

Atherectomy, percutaneous
0081
34.4473
$2,044.21

$408.8435494
T

Atherectomy, percutaneous
0081
34.4473
$2,044.21

$408.8435495
T

Atherectomy, percutaneous
0081
34.4473
$2,044.21

$408.8435500
T

Harvest vein for bypass
0081
34.4473
$2,044.21

$408.8435501
C

Artery bypass graft35506
C

Artery bypass graft35507
C

Artery bypass graft35508
C

Artery bypass graft35509
C

Artery bypass graft35510
C

Artery bypass graft35511
C

Artery bypass graft35512
C

Artery bypass graft35515
C

Artery bypass graft35516
C

Artery bypass graft35518
C

Artery bypass graft35521
C

Artery bypass graft35522
C

Artery bypass graft35525
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 graft35572
N

Harvest femoropopliteal vein35583
C

Vein bypass graft35585
C

Vein bypass graft35587
C

Vein bypass graft35600
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 graft35647
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 graft35685
T

Bypass graft patency/patch
0093
23.4516
$1,391.69

$278.34( print page 50741)35686
T

Bypass graft/av fist patency
0093
23.4516
$1,391.69

$278.3435691
C

Arterial transposition35693
C

Arterial transposition35694
C

Arterial transposition35695
C

Arterial transposition35697
C

Reimplant artery each35700
C

Reoperation, bypass graft35701
C

Exploration, carotid artery35721
C

Exploration, femoral artery35741
C

Exploration popliteal artery35761
T

Exploration of artery/vein
0115
31.4727
$1,867.68
$459.35
$373.5435800
C

Explore neck vessels35820
C

Explore chest vessels35840
C

Explore abdominal vessels35860
T

Explore limb vessels
0093
23.4516
$1,391.69

$278.3435870
C

Repair vessel graft defect35875
T

Removal of clot in graft
0088
36.5617
$2,169.68
$655.22
$433.9435876
T

Removal of clot in graft
0088
36.5617
$2,169.68
$655.22
$433.9435879
T

Revise graft w/vein
0088
36.5617
$2,169.68
$655.22
$433.9435881
T

Revise graft w/vein
0088
36.5617
$2,169.68
$655.22
$433.9435901
C

Excision, graft, neck35903
T

Excision, graft, extremity
0115
31.4727
$1,867.68
$459.35
$373.5435905
C

Excision, graft, thorax35907
C

Excision, graft, abdomen36000
N

Place needle in vein36002
S

Pseudoaneurysm injection trt
0267
2.6327
$156.23
$62.18
$31.2536005
N

Injection ext 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
0623
27.1105
$1,608.82

$321.7636261
T

Revision of infusion pump
0623
27.1105
$1,608.82

$321.7636262
T

Removal of infusion pump
0622
21.2671
$1,262.05

$252.4136299
N

Vessel injection procedure36400
N

Bl draw < 3 yrs fem/jugular36405
N

Bl draw < 3 yrs scalp vein36406
N

Bl draw < 3 yrs other vein36410
N

Non-routine bl draw > 3 yrs36415
A

Drawing blood36416
N

Capillary blood draw36420
T

Vein access cutdown < 1 yr
0035
0.7158
$42.48

$8.5036425
T

Vein access cutdown > 1 yr
0035
0.7158
$42.48

$8.5036430
S

Blood transfusion service
0110
3.6594
$217.16

$43.4336440
S

Bl push transfuse, 2 yr or <
0110
3.6594
$217.16

$43.4336450
S

Bl exchange/transfuse, nb
0110
3.6594
$217.16

$43.4336455
S

Bl exchange/transfuse non-nb
0110
3.6594
$217.16

$43.4336460
S

Transfusion service, fetal
0110
3.6594
$217.16

$43.4336468
T

Injection(s), spider veins
0098
1.1346
$67.33

$13.4736469
T

Injection(s), spider veins
0098
1.1346
$67.33

$13.47( print page 50742)36470
T

Injection therapy of vein
0098
1.1346
$67.33

$13.4736471
T

Injection therapy of veins
0098
1.1346
$67.33

$13.4736475
T

Endovenous rf, 1st vein
0092
26.482
$1,571.52
$505.37
$314.3036476
T

Endovenous rf, vein add-on
0092
26.482
$1,571.52
$505.37
$314.3036478
T

Endovenous laser, 1st vein
0092
26.482
$1,571.52
$505.37
$314.3036479
T

Endovenous laser vein addon
0092
26.482
$1,571.52
$505.37
$314.3036481
N

Insertion of catheter, vein36500
N

Insertion of catheter, vein36510
N

Insertion of catheter, vein36511
S

Apheresis wbc
0111
12.3956
$735.59
$200.18
$147.1236512
S

Apheresis rbc
0111
12.3956
$735.59
$200.18
$147.1236513
S

Apheresis platelets
0111
12.3956
$735.59
$200.18
$147.1236514
S

Apheresis plasma
0111
12.3956
$735.59
$200.18
$147.1236515
S

Apheresis, adsorp/reinfuse
0112
26.7948
$1,590.08
$438.94
$318.0236516
S

Apheresis, selective
0112
26.7948
$1,590.08
$438.94
$318.0236522
S

Photopheresis
0112
26.7948
$1,590.08
$438.94
$318.0236540
N

Collect blood venous device36550
T

Declot vascular device
0676
2.4105
$143.05

$28.6136555
T

Insert non-tunnel cv cath
0621
8.2986
$492.46

$98.4936556
T

Insert non-tunnel cv cath
0621
8.2986
$492.46

$98.4936557
T

Insert tunneled cv cath
0622
21.2671
$1,262.05

$252.4136558
T

Insert tunneled cv cath
0622
21.2671
$1,262.05

$252.4136560
T

Insert tunneled cv cath
0623
27.1105
$1,608.82

$321.7636561
T

Insert tunneled cv cath
0623
27.1105
$1,608.82

$321.7636563
T

Insert tunneled cv cath
0623
27.1105
$1,608.82

$321.7636565
T

Insert tunneled cv cath
0623
27.1105
$1,608.82

$321.7636566
T

Insert tunneled cv cath
1564

$4,750.00

$950.0036568
T

Insert tunneled cv cath
0621
8.2986
$492.46

$98.4936569
T

Insert tunneled cv cath
0621
8.2986
$492.46

$98.4936570
T

Insert tunneled cv cath
0622
21.2671
$1,262.05

$252.4136571
T

Insert tunneled cv cath
0622
21.2671
$1,262.05

$252.4136575
T

Repair tunneled cv cath
0621
8.2986
$492.46

$98.4936576
T

Repair tunneled cv cath
0621
8.2986
$492.46

$98.4936578
T

Replace tunneled cv cath
0622
21.2671
$1,262.05

$252.4136580
T

Replace tunneled cv cath
0621
8.2986
$492.46

$98.4936581
T

Replace tunneled cv cath
0622
21.2671
$1,262.05

$252.4136582
T

Replace tunneled cv cath
0623
27.1105
$1,608.82

$321.7636583
T

Replace tunneled cv cath
0623
27.1105
$1,608.82

$321.7636584
T

Replace tunneled cv cath
0621
8.2986
$492.46

$98.4936585
T

Replace tunneled cv cath
0622
21.2671
$1,262.05

$252.4136589
T

Removal tunneled cv cath
0621
8.2986
$492.46

$98.4936590
T

Removal tunneled cv cath
0621
8.2986
$492.46

$98.4936595
T

Mech remov tunneled cv cath
0622
21.2671
$1,262.05

$252.4136596
T

Mech remov tunneled cv cath
0621
8.2986
$492.46

$98.4936597
T

Reposition venous catheter
0621
8.2986
$492.46

$98.4936600
N

Withdrawal of arterial blood36620
N

Insertion catheter, artery36625
N

Insertion catheter, artery36640
T

Insertion catheter, artery
0623
27.1105
$1,608.82

$321.7636660
C

Insertion catheter, artery36680
T

Insert needle, bone cavity
0002
0.9559
$56.73

$11.3536800
T

Insertion of cannula
0115
31.4727
$1,867.68
$459.35
$373.5436810
T

Insertion of cannula
0115
31.4727
$1,867.68
$459.35
$373.5436815
T

Insertion of cannula
0115
31.4727
$1,867.68
$459.35
$373.5436818
T

Av fuse, uppr arm, cephalic
0088
36.5617
$2,169.68
$655.22
$433.9436819
T

Av fusion/uppr arm vein
0088
36.5617
$2,169.68
$655.22
$433.9436820
T

Av fusion/forearm vein
0088
36.5617
$2,169.68
$655.22
$433.9436821
T

Av fusion direct any site
0088
36.5617
$2,169.68
$655.22
$433.9436822
C

Insertion of cannula(s)36823
C

Insertion of cannula(s)36825
T

Artery-vein autograft
0088
36.5617
$2,169.68
$655.22
$433.9436830
T

Artery-vein graft
0088
36.5617
$2,169.68
$655.22
$433.9436831
T

Open thrombect av fistula
0088
36.5617
$2,169.68
$655.22
$433.9436832
T

Av fistula revision, open
0088
36.5617
$2,169.68
$655.22
$433.9436833
T

Av fistula revision
0088
36.5617
$2,169.68
$655.22
$433.9436834
T

Repair A-V aneurysm
0088
36.5617
$2,169.68
$655.22
$433.94( print page 50743)36835
T

Artery to vein shunt
0115
31.4727
$1,867.68
$459.35
$373.5436838
T

Dist revas ligation, hemo
0088
36.5617
$2,169.68
$655.22
$433.9436860
T

External cannula declotting
0676
2.4105
$143.05

$28.6136861
T

Cannula declotting
0115
31.4727
$1,867.68
$459.35
$373.5436870
T

Percut thrombect av fistula
0653
30.5339
$1,811.97

$362.3937140
C

Revision of circulation37145
C

Revision of circulation37160
C

Revision of circulation37180
C

Revision of circulation37181
C

Splice spleen/kidney veins37182
C

Insert hepatic shunt (tips)37183
T

Remove hepatic shunt (tips)
0229
64.4545
$3,824.92
$771.23
$764.9837195
T

Thrombolytic therapy, stroke
0676
2.4105
$143.05

$28.6137200
T

Transcatheter biopsy
0685
6.0174
$357.09
$115.47
$71.4237201
T

Transcatheter therapy infuse
0676
2.4105
$143.05

$28.6137202
T

Transcatheter therapy infuse
0676
2.4105
$143.05

$28.6137203
T

Transcatheter retrieval
0103
14.7142
$873.18
$223.63
$174.6437204
T

Transcatheter occlusion
0115
31.4727
$1,867.68
$459.35
$373.5437205
T

Transcatheter stent
0229
64.4545
$3,824.92
$771.23
$764.9837206
T

Transcatheter stent add-on
0229
64.4545
$3,824.92
$771.23
$764.9837207
T

Transcatheter stent
0229
64.4545
$3,824.92
$771.23
$764.9837208
T

Transcatheter stent add-on
0229
64.4545
$3,824.92
$771.23
$764.9837209
T

Exchange arterial catheter
0103
14.7142
$873.18
$223.63
$174.6437215
C

Transcath stent, cca w/eps37216
C

Transcath stent, cca w/o eps37250
S

Iv us first vessel add-on
0416
19.5542
$1,160.40

$232.0837251
S

Iv us each add vessel add-on
0416
19.5542
$1,160.40

$232.0837500
T

Endoscopy ligate perf veins
0092
26.482
$1,571.52
$505.37
$314.3037501
T

Vascular endoscopy procedure
0092
26.482
$1,571.52
$505.37
$314.3037565
T

Ligation of neck vein
0093
23.4516
$1,391.69

$278.3437600
T

Ligation of neck artery
0093
23.4516
$1,391.69

$278.3437605
T

Ligation of neck artery
0091
28.9999
$1,720.94
$348.23
$344.1937606
T

Ligation of neck artery
0091
28.9999
$1,720.94
$348.23
$344.1937607
T

Ligation of a-v fistula
0092
26.482
$1,571.52
$505.37
$314.3037609
T

Temporal artery procedure
0021
14.9776
$888.82
$219.48
$177.7637615
T

Ligation of neck artery
0091
28.9999
$1,720.94
$348.23
$344.1937616
C

Ligation of chest artery37617
C

Ligation of abdomen artery37618
C

Ligation of extremity artery37620
T

Revision of major vein
0091
28.9999
$1,720.94
$348.23
$344.1937650
T

Revision of major vein
0091
28.9999
$1,720.94
$348.23
$344.1937660
C

Revision of major vein37700
T

Revise leg vein
0091
28.9999
$1,720.94
$348.23
$344.1937720
T

Removal of leg vein
0092
26.482
$1,571.52
$505.37
$314.3037730
T

Removal of leg veins
0092
26.482
$1,571.52
$505.37
$314.3037735
T

Removal of leg veins/lesion
0092
26.482
$1,571.52
$505.37
$314.3037760
T

Revision of leg veins
0091
28.9999
$1,720.94
$348.23
$344.1937765
T

Phleb veins - extrem - to 20
0091
28.9999
$1,720.94
$348.23
$344.1937766
T

Phleb veins - extrem 20+
0091
28.9999
$1,720.94
$348.23
$344.1937780
T

Revision of leg vein
0091
28.9999
$1,720.94
$348.23
$344.1937785
T

Ligate/divide/excise vein
0091
28.9999
$1,720.94
$348.23
$344.1937788
C

Revascularization, penis37790
T

Penile venous occlusion
0181
30.8663
$1,831.70
$621.82
$366.3437799
T

Vascular surgery procedure
0103
14.7142
$873.18
$223.63
$174.6438100
C

Removal of spleen, total38101
C

Removal of spleen, partial38102
C

Removal of spleen, total38115
C

Repair of ruptured spleen38120
T

Laparoscopy, splenectomy
0131
43.3389
$2,571.86
$1,001.89
$514.3738129
T

Laparoscope proc, spleen
0130
31.9271
$1,894.65
$659.53
$378.9338200
N

Injection for spleen x-ray38204
E

Bl donor search management38205
S

Harvest allogenic stem cells
0111
12.3956
$735.59
$200.18
$147.1238206
S

Harvest auto stem cells
0111
12.3956
$735.59
$200.18
$147.1238207
E

Cryopreserve stem cells38208
E

Thaw preserved stem cells( print page 50744)38209
E

Wash harvest stem cells38210
E

T-cell depletion of harvest38211
E

Tumor cell deplete of harvst38212
E

Rbc depletion of harvest38213
E

Platelet deplete of harvest38214
E

Volume deplete of harvest38215
E

Harvest stem cell concentrte38220
T

Bone marrow aspiration
0003
2.653
$157.44

$31.4938221
T

Bone marrow biopsy
0003
2.653
$157.44

$31.4938230
S

Bone marrow collection
0111
12.3956
$735.59
$200.18
$147.1238240
S

Bone marrow/stem transplant
0123
22.9902
$1,364.31

$272.8638241
S

Bone marrow/stem transplant
0123
22.9902
$1,364.31

$272.8638242
S

Lymphocyte infuse transplant
0111
12.3956
$735.59
$200.18
$147.1238300
T

Drainage, lymph node lesion
0007
11.4501
$679.48

$135.9038305
T

Drainage, lymph node lesion
0008
16.4989
$979.09

$195.8238308
T

Incision of lymph channels
0113
21.4653
$1,273.82

$254.7638380
C

Thoracic duct procedure38381
C

Thoracic duct procedure38382
C

Thoracic duct procedure38500
T

Biopsy/removal, lymph nodes
0113
21.4653
$1,273.82

$254.7638505
T

Needle biopsy, lymph nodes
0005
3.5994
$213.60
$71.59
$42.7238510
T

Biopsy/removal, lymph nodes
0113
21.4653
$1,273.82

$254.7638520
T

Biopsy/removal, lymph nodes
0113
21.4653
$1,273.82

$254.7638525
T

Biopsy/removal, lymph nodes
0113
21.4653
$1,273.82

$254.7638530
T

Biopsy/removal, lymph nodes
0113
21.4653
$1,273.82

$254.7638542
T

Explore deep node(s), neck
0114
40.7652
$2,419.13
$485.91
$483.8338550
T

Removal, neck/armpit lesion
0113
21.4653
$1,273.82

$254.7638555
T

Removal, neck/armpit lesion
0113
21.4653
$1,273.82

$254.7638562
C

Removal, pelvic lymph nodes38564
C

Removal, abdomen lymph nodes38570
T

Laparoscopy, lymph node biop
0131
43.3389
$2,571.86
$1,001.89
$514.3738571
T

Laparoscopy, lymphadenectomy
0132
62.9914
$3,738.10
$1,239.22
$747.6238572
T

Laparoscopy, lymphadenectomy
0131
43.3389
$2,571.86
$1,001.89
$514.3738589
T

Laparoscope proc, lymphatic
0130
31.9271
$1,894.65
$659.53
$378.9338700
T

Removal of lymph nodes, neck
0113
21.4653
$1,273.82

$254.7638720
T

Removal of lymph nodes, neck
0113
21.4653
$1,273.82

$254.7638724
C

Removal of lymph nodes, neck38740
T

Remove armpit lymph nodes
0114
40.7652
$2,419.13
$485.91
$483.8338745
T

Remove armpit lymph nodes
0114
40.7652
$2,419.13
$485.91
$483.8338746
C

Remove thoracic lymph nodes38747
C

Remove abdominal lymph nodes38760
T

Remove groin lymph nodes
0113
21.4653
$1,273.82

$254.7638765
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
S

Blood/lymph system procedure
0110
3.6594
$217.16

$43.4339000
C

Exploration of chest39010
C

Exploration of chest39200
C

Removal chest lesion39220
C

Removal chest lesion39400
T

Visualization of chest
0069
30.6775
$1,820.49
$591.64
$364.1039499
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, complex( print page 50745)39599
C

Diaphragm surgery procedure4000F
E

Tobacco use txmnt counseling4001F
E

Tobacco use txmnt, pharmacol4002F
E

Statin therapy, rx4006F
E

Beta-blocker therapy, rx4009F
E

Ace inhibitor therapy, rx4011F
E

Oral antiplatelet tx, rx40490
T

Biopsy of lip
0251
2.0101
$119.29

$23.8640500
T

Partial excision of lip
0253
16.1357
$957.54
$282.29
$191.5140510
T

Partial excision of lip
0254
23.404
$1,388.86
$321.35
$277.7740520
T

Partial excision of lip
0253
16.1357
$957.54
$282.29
$191.5140525
T

Reconstruct lip with flap
0254
23.404
$1,388.86
$321.35
$277.7740527
T

Reconstruct lip with flap
0254
23.404
$1,388.86
$321.35
$277.7740530
T

Partial removal of lip
0254
23.404
$1,388.86
$321.35
$277.7740650
T

Repair lip
0252
7.8673
$466.87
$113.41
$93.3740652
T

Repair lip
0252
7.8673
$466.87
$113.41
$93.3740654
T

Repair lip
0252
7.8673
$466.87
$113.41
$93.3740700
T

Repair cleft lip/nasal
0256
37.3204
$2,214.70

$442.9440701
T

Repair cleft lip/nasal
0256
37.3204
$2,214.70

$442.9440702
T

Repair cleft lip/nasal
0256
37.3204
$2,214.70

$442.9440720
T

Repair cleft lip/nasal
0256
37.3204
$2,214.70

$442.9440761
T

Repair cleft lip/nasal
0256
37.3204
$2,214.70

$442.9440799
T

Lip surgery procedure
0251
2.0101
$119.29

$23.8640800
T

Drainage of mouth lesion
0251
2.0101
$119.29

$23.8640801
T

Drainage of mouth lesion
0252
7.8673
$466.87
$113.41
$93.3740804
X

Removal, foreign body, mouth
0340
0.6384
$37.88

$7.5840805
T

Removal, foreign body, mouth
0252
7.8673
$466.87
$113.41
$93.3740806
T

Incision of lip fold
0251
2.0101
$119.29

$23.8640808
T

Biopsy of mouth lesion
0251
2.0101
$119.29

$23.8640810
T

Excision of mouth lesion
0253
16.1357
$957.54
$282.29
$191.5140812
T

Excise/repair mouth lesion
0253
16.1357
$957.54
$282.29
$191.5140814
T

Excise/repair mouth lesion
0253
16.1357
$957.54
$282.29
$191.5140816
T

Excision of mouth lesion
0254
23.404
$1,388.86
$321.35
$277.7740818
T

Excise oral mucosa for graft
0251
2.0101
$119.29

$23.8640819
T

Excise lip or cheek fold
0252
7.8673
$466.87
$113.41
$93.3740820
T

Treatment of mouth lesion
0253
16.1357
$957.54
$282.29
$191.5140830
T

Repair mouth laceration
0251
2.0101
$119.29

$23.8640831
T

Repair mouth laceration
0252
7.8673
$466.87
$113.41
$93.3740840
T

Reconstruction of mouth
0254
23.404
$1,388.86
$321.35
$277.7740842
T

Reconstruction of mouth
0254
23.404
$1,388.86
$321.35
$277.7740843
T

Reconstruction of mouth
0254
23.404
$1,388.86
$321.35
$277.7740844
T

Reconstruction of mouth
0256
37.3204
$2,214.70

$442.9440845
T

Reconstruction of mouth
0256
37.3204
$2,214.70

$442.9440899
T

Mouth surgery procedure
0251
2.0101
$119.29

$23.8641000
T

Drainage of mouth lesion
0253
16.1357
$957.54
$282.29
$191.5141005
T

Drainage of mouth lesion
0251
2.0101
$119.29

$23.8641006
T

Drainage of mouth lesion
0254
23.404
$1,388.86
$321.35
$277.7741007
T

Drainage of mouth lesion
0253
16.1357
$957.54
$282.29
$191.5141008
T

Drainage of mouth lesion
0253
16.1357
$957.54
$282.29
$191.5141009
T

Drainage of mouth lesion
0251
2.0101
$119.29

$23.8641010
T

Incision of tongue fold
0252
7.8673
$466.87
$113.41
$93.3741015
T

Drainage of mouth lesion
0251
2.0101
$119.29

$23.8641016
T

Drainage of mouth lesion
0252
7.8673
$466.87
$113.41
$93.3741017
T

Drainage of mouth lesion
0252
7.8673
$466.87
$113.41
$93.3741018
T

Drainage of mouth lesion
0252
7.8673
$466.87
$113.41
$93.3741100
T

Biopsy of tongue
0252
7.8673
$466.87
$113.41
$93.3741105
T

Biopsy of tongue
0253
16.1357
$957.54
$282.29
$191.5141108
T

Biopsy of floor of mouth
0252
7.8673
$466.87
$113.41
$93.3741110
T

Excision of tongue lesion
0253
16.1357
$957.54
$282.29
$191.5141112
T

Excision of tongue lesion
0253
16.1357
$957.54
$282.29
$191.5141113
T

Excision of tongue lesion
0253
16.1357
$957.54
$282.29
$191.5141114
T

Excision of tongue lesion
0254
23.404
$1,388.86
$321.35
$277.7741115
T

Excision of tongue fold
0252
7.8673
$466.87
$113.41
$93.3741116
T

Excision of mouth lesion
0253
16.1357
$957.54
$282.29
$191.5141120
T

Partial removal of tongue
0254
23.404
$1,388.86
$321.35
$277.7741130
C

Partial removal of tongue( print page 50746)41135
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
2.0101
$119.29

$23.8641251
T

Repair tongue laceration
0251
2.0101
$119.29

$23.8641252
T

Repair tongue laceration
0252
7.8673
$466.87
$113.41
$93.3741500
T

Fixation of tongue
0254
23.404
$1,388.86
$321.35
$277.7741510
T

Tongue to lip surgery
0253
16.1357
$957.54
$282.29
$191.5141520
T

Reconstruction, tongue fold
0252
7.8673
$466.87
$113.41
$93.3741599
T

Tongue and mouth surgery
0251
2.0101
$119.29

$23.8641800
T

Drainage of gum lesion
0251
2.0101
$119.29

$23.8641805
T

Removal foreign body, gum
0254
23.404
$1,388.86
$321.35
$277.7741806
T

Removal foreign body,jawbone
0253
16.1357
$957.54
$282.29
$191.5141820
T

Excision, gum, each quadrant
0252
7.8673
$466.87
$113.41
$93.3741821
T

Excision of gum flap
0252
7.8673
$466.87
$113.41
$93.3741822
T

Excision of gum lesion
0253
16.1357
$957.54
$282.29
$191.5141823
T

Excision of gum lesion
0254
23.404
$1,388.86
$321.35
$277.7741825
T

Excision of gum lesion
0253
16.1357
$957.54
$282.29
$191.5141826
T

Excision of gum lesion
0253
16.1357
$957.54
$282.29
$191.5141827
T

Excision of gum lesion
0254
23.404
$1,388.86
$321.35
$277.7741828
T

Excision of gum lesion
0253
16.1357
$957.54
$282.29
$191.5141830
T

Removal of gum tissue
0253
16.1357
$957.54
$282.29
$191.5141850
T

Treatment of gum lesion
0253
16.1357
$957.54
$282.29
$191.5141870
T

Gum graft
0254
23.404
$1,388.86
$321.35
$277.7741872
T

Repair gum
0253
16.1357
$957.54
$282.29
$191.5141874
T

Repair tooth socket
0254
23.404
$1,388.86
$321.35
$277.7741899
T

Dental surgery procedure
0251
2.0101
$119.29

$23.8642000
T

Drainage mouth roof lesion
0251
2.0101
$119.29

$23.8642100
T

Biopsy roof of mouth
0252
7.8673
$466.87
$113.41
$93.3742104
T

Excision lesion, mouth roof
0253
16.1357
$957.54
$282.29
$191.5142106
T

Excision lesion, mouth roof
0253
16.1357
$957.54
$282.29
$191.5142107
T

Excision lesion, mouth roof
0254
23.404
$1,388.86
$321.35
$277.7742120
T

Remove palate/lesion
0256
37.3204
$2,214.70

$442.9442140
T

Excision of uvula
0252
7.8673
$466.87
$113.41
$93.3742145
T

Repair palate, pharynx/uvula
0254
23.404
$1,388.86
$321.35
$277.7742160
T

Treatment mouth roof lesion
0253
16.1357
$957.54
$282.29
$191.5142180
T

Repair palate
0251
2.0101
$119.29

$23.8642182
T

Repair palate
0256
37.3204
$2,214.70

$442.9442200
T

Reconstruct cleft palate
0256
37.3204
$2,214.70

$442.9442205
T

Reconstruct cleft palate
0256
37.3204
$2,214.70

$442.9442210
T

Reconstruct cleft palate
0256
37.3204
$2,214.70

$442.9442215
T

Reconstruct cleft palate
0256
37.3204
$2,214.70

$442.9442220
T

Reconstruct cleft palate
0256
37.3204
$2,214.70

$442.9442225
T

Reconstruct cleft palate
0256
37.3204
$2,214.70

$442.9442226
T

Lengthening of palate
0256
37.3204
$2,214.70

$442.9442227
T

Lengthening of palate
0256
37.3204
$2,214.70

$442.9442235
T

Repair palate
0253
16.1357
$957.54
$282.29
$191.5142260
T

Repair nose to lip fistula
0254
23.404
$1,388.86
$321.35
$277.7742280
T

Preparation, palate mold
0251
2.0101
$119.29

$23.8642281
T

Insertion, palate prosthesis
0253
16.1357
$957.54
$282.29
$191.5142299
T

Palate/uvula surgery
0251
2.0101
$119.29

$23.8642300
T

Drainage of salivary gland
0253
16.1357
$957.54
$282.29
$191.5142305
T

Drainage of salivary gland
0253
16.1357
$957.54
$282.29
$191.5142310
T

Drainage of salivary gland
0251
2.0101
$119.29

$23.8642320
T

Drainage of salivary gland
0251
2.0101
$119.29

$23.8642325
T

Create salivary cyst drain
0251
2.0101
$119.29

$23.8642326
T

Create salivary cyst drain
0252
7.8673
$466.87
$113.41
$93.3742330
T

Removal of salivary stone
0253
16.1357
$957.54
$282.29
$191.5142335
T

Removal of salivary stone
0253
16.1357
$957.54
$282.29
$191.5142340
T

Removal of salivary stone
0253
16.1357
$957.54
$282.29
$191.5142400
T

Biopsy of salivary gland
0005
3.5994
$213.60
$71.59
$42.7242405
T

Biopsy of salivary gland
0253
16.1357
$957.54
$282.29
$191.5142408
T

Excision of salivary cyst
0253
16.1357
$957.54
$282.29
$191.51( print page 50747)42409
T

Drainage of salivary cyst
0253
16.1357
$957.54
$282.29
$191.5142410
T

Excise parotid gland/lesion
0256
37.3204
$2,214.70

$442.9442415
T

Excise parotid gland/lesion
0256
37.3204
$2,214.70

$442.9442420
T

Excise parotid gland/lesion
0256
37.3204
$2,214.70

$442.9442425
T

Excise parotid gland/lesion
0256
37.3204
$2,214.70

$442.9442426
C

Excise parotid gland/lesion42440
T

Excise submaxillary gland
0256
37.3204
$2,214.70

$442.9442450
T

Excise sublingual gland
0254
23.404
$1,388.86
$321.35
$277.7742500
T

Repair salivary duct
0254
23.404
$1,388.86
$321.35
$277.7742505
T

Repair salivary duct
0256
37.3204
$2,214.70

$442.9442507
T

Parotid duct diversion
0256
37.3204
$2,214.70

$442.9442508
T

Parotid duct diversion
0256
37.3204
$2,214.70

$442.9442509
T

Parotid duct diversion
0256
37.3204
$2,214.70

$442.9442510
T

Parotid duct diversion
0256
37.3204
$2,214.70

$442.9442550
N

Injection for salivary x-ray42600
T

Closure of salivary fistula
0253
16.1357
$957.54
$282.29
$191.5142650
T

Dilation of salivary duct
0252
7.8673
$466.87
$113.41
$93.3742660
T

Dilation of salivary duct
0251
2.0101
$119.29

$23.8642665
T

Ligation of salivary duct
0254
23.404
$1,388.86
$321.35
$277.7742699
T

Salivary surgery procedure
0251
2.0101
$119.29

$23.8642700
T

Drainage of tonsil abscess
0251
2.0101
$119.29

$23.8642720
T

Drainage of throat abscess
0253
16.1357
$957.54
$282.29
$191.5142725
T

Drainage of throat abscess
0256
37.3204
$2,214.70

$442.9442800
T

Biopsy of throat
0253
16.1357
$957.54
$282.29
$191.5142802
T

Biopsy of throat
0253
16.1357
$957.54
$282.29
$191.5142804
T

Biopsy of upper nose/throat
0253
16.1357
$957.54
$282.29
$191.5142806
T

Biopsy of upper nose/throat
0254
23.404
$1,388.86
$321.35
$277.7742808
T

Excise pharynx lesion
0253
16.1357
$957.54
$282.29
$191.5142809
X

Remove pharynx foreign body
0340
0.6384
$37.88

$7.5842810
T

Excision of neck cyst
0254
23.404
$1,388.86
$321.35
$277.7742815
T

Excision of neck cyst
0256
37.3204
$2,214.70

$442.9442820
T

Remove tonsils and adenoids
0258
22.2466
$1,320.18
$437.25
$264.0442821
T

Remove tonsils and adenoids
0258
22.2466
$1,320.18
$437.25
$264.0442825
T

Removal of tonsils
0258
22.2466
$1,320.18
$437.25
$264.0442826
T

Removal of tonsils
0258
22.2466
$1,320.18
$437.25
$264.0442830
T

Removal of adenoids
0258
22.2466
$1,320.18
$437.25
$264.0442831
T

Removal of adenoids
0258
22.2466
$1,320.18
$437.25
$264.0442835
T

Removal of adenoids
0258
22.2466
$1,320.18
$437.25
$264.0442836
T

Removal of adenoids
0258
22.2466
$1,320.18
$437.25
$264.0442842
T

Extensive surgery of throat
0254
23.404
$1,388.86
$321.35
$277.7742844
T

Extensive surgery of throat
0256
37.3204
$2,214.70

$442.9442845
C

Extensive surgery of throat42860
T

Excision of tonsil tags
0258
22.2466
$1,320.18
$437.25
$264.0442870
T

Excision of lingual tonsil
0258
22.2466
$1,320.18
$437.25
$264.0442890
T

Partial removal of pharynx
0256
37.3204
$2,214.70

$442.9442892
T

Revision of pharyngeal walls
0256
37.3204
$2,214.70

$442.9442894
C

Revision of pharyngeal walls42900
T

Repair throat wound
0252
7.8673
$466.87
$113.41
$93.3742950
T

Reconstruction of throat
0254
23.404
$1,388.86
$321.35
$277.7742953
C

Repair throat, esophagus42955
T

Surgical opening of throat
0254
23.404
$1,388.86
$321.35
$277.7742960
T

Control throat bleeding
0250
1.2896
$76.53
$26.79
$15.3142961
C

Control throat bleeding42962
T

Control throat bleeding
0256
37.3204
$2,214.70

$442.9442970
T

Control nose/throat bleeding
0250
1.2896
$76.53
$26.79
$15.3142971
C

Control nose/throat bleeding42972
T

Control nose/throat bleeding
0253
16.1357
$957.54
$282.29
$191.5142999
T

Throat surgery procedure
0251
2.0101
$119.29

$23.8643020
T

Incision of esophagus
0252
7.8673
$466.87
$113.41
$93.3743030
T

Throat muscle surgery
0253
16.1357
$957.54
$282.29
$191.5143045
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 esophagus( print page 50748)43113
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

Partial removal of esophagus43123
C

Partial removal of esophagus43124
C

Removal of esophagus43130
T

Removal of esophagus pouch
0254
23.404
$1,388.86
$321.35
$277.7743135
C

Removal of esophagus pouch43200
T

Esophagus endoscopy
0141
8.1835
$485.63
$143.38
$97.1343201
T

Esoph scope w/submucous inj
0141
8.1835
$485.63
$143.38
$97.1343202
T

Esophagus endoscopy, biopsy
0141
8.1835
$485.63
$143.38
$97.1343204
T

Esoph scope w/sclerosis inj
0141
8.1835
$485.63
$143.38
$97.1343205
T

Esophagus endoscopy/ligation
0141
8.1835
$485.63
$143.38
$97.1343215
T

Esophagus endoscopy
0141
8.1835
$485.63
$143.38
$97.1343216
T

Esophagus endoscopy/lesion
0141
8.1835
$485.63
$143.38
$97.1343217
T

Esophagus endoscopy
0141
8.1835
$485.63
$143.38
$97.1343219
T

Esophagus endoscopy
0384
22.3392
$1,325.68
$287.93
$265.1443220
T

Esoph endoscopy, dilation
0141
8.1835
$485.63
$143.38
$97.1343226
T

Esoph endoscopy, dilation
0141
8.1835
$485.63
$143.38
$97.1343227
T

Esoph endoscopy, repair
0141
8.1835
$485.63
$143.38
$97.1343228
T

Esoph endoscopy, ablation
0422
22.9647
$1,362.79
$448.81
$272.5643231
T

Esoph endoscopy w/us exam
0141
8.1835
$485.63
$143.38
$97.1343232
T

Esoph endoscopy w/us fn bx
0141
8.1835
$485.63
$143.38
$97.1343234
T

Upper GI endoscopy, exam
0141
8.1835
$485.63
$143.38
$97.1343235
T

Uppr gi endoscopy, diagnosis
0141
8.1835
$485.63
$143.38
$97.1343236
T

Uppr gi scope w/submuc inj
0141
8.1835
$485.63
$143.38
$97.1343237
T

Endoscopic us exam, esoph
0141
8.1835
$485.63
$143.38
$97.1343238
T

Uppr gi endoscopy w/us fn bx
0141
8.1835
$485.63
$143.38
$97.1343239
T

Upper GI endoscopy, biopsy
0141
8.1835
$485.63
$143.38
$97.1343240
T

Esoph endoscope w/drain cyst
0141
8.1835
$485.63
$143.38
$97.1343241
T

Upper GI endoscopy with tube
0141
8.1835
$485.63
$143.38
$97.1343242
T

Uppr gi endoscopy w/us fn bx
0141
8.1835
$485.63
$143.38
$97.1343243
T

Upper gi endoscopy & inject
0141
8.1835
$485.63
$143.38
$97.1343244
T

Upper GI endoscopy/ligation
0141
8.1835
$485.63
$143.38
$97.1343245
T

Uppr gi scope dilate strictr
0141
8.1835
$485.63
$143.38
$97.1343246
T

Place gastrostomy tube
0141
8.1835
$485.63
$143.38
$97.1343247
T

Operative upper GI endoscopy
0141
8.1835
$485.63
$143.38
$97.1343248
T

Uppr gi endoscopy/guide wire
0141
8.1835
$485.63
$143.38
$97.1343249
T

Esoph endoscopy, dilation
0141
8.1835
$485.63
$143.38
$97.1343250
T

Upper GI endoscopy/tumor
0141
8.1835
$485.63
$143.38
$97.1343251
T

Operative upper GI endoscopy
0141
8.1835
$485.63
$143.38
$97.1343255
T

Operative upper GI endoscopy
0141
8.1835
$485.63
$143.38
$97.1343256
T

Uppr gi endoscopy w stent
0384
22.3392
$1,325.68
$287.93
$265.1443257
T

Uppr gi scope w/thrml txmnt
0422
22.9647
$1,362.79
$448.81
$272.5643258
T

Operative upper GI endoscopy
0141
8.1835
$485.63
$143.38
$97.1343259
T

Endoscopic ultrasound exam
0141
8.1835
$485.63
$143.38
$97.1343260
T

Endo cholangiopancreatograph
0151
18.7338
$1,111.72
$245.46
$222.3443261
T

Endo cholangiopancreatograph
0151
18.7338
$1,111.72
$245.46
$222.3443262
T

Endo cholangiopancreatograph
0151
18.7338
$1,111.72
$245.46
$222.3443263
T

Endo cholangiopancreatograph
0151
18.7338
$1,111.72
$245.46
$222.3443264
T

Endo cholangiopancreatograph
0151
18.7338
$1,111.72
$245.46
$222.3443265
T

Endo cholangiopancreatograph
0151
18.7338
$1,111.72
$245.46
$222.3443267
T

Endo cholangiopancreatograph
0151
18.7338
$1,111.72
$245.46
$222.3443268
T

Endo cholangiopancreatograph
0384
22.3392
$1,325.68
$287.93
$265.1443269
T

Endo cholangiopancreatograph
0384
22.3392
$1,325.68
$287.93
$265.1443271
T

Endo cholangiopancreatograph
0151
18.7338
$1,111.72
$245.46
$222.3443272
T

Endo cholangiopancreatograph
0151
18.7338
$1,111.72
$245.46
$222.3443280
T

Laparoscopy, fundoplasty
0132
62.9914
$3,738.10
$1,239.22
$747.6243289
T

Laparoscope proc, esoph
0130
31.9271
$1,894.65
$659.53
$378.9343300
C

Repair of esophagus43305
C

Repair esophagus and fistula43310
C

Repair of esophagus43312
C

Repair esophagus and fistula43313
C

Esophagoplasty congenital( print page 50749)43314
C

Tracheo-esophagoplasty cong43320
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 opening43450
T

Dilate esophagus
0140
5.4737
$324.83
$94.18
$64.9743453
T

Dilate esophagus
0140
5.4737
$324.83
$94.18
$64.9743456
T

Dilate esophagus
0140
5.4737
$324.83
$94.18
$64.9743458
T

Dilate esophagus
0140
5.4737
$324.83
$94.18
$64.9743460
C

Pressure treatment esophagus43496
C

Free jejunum flap, microvasc43499
T

Esophagus surgery procedure
0141
8.1835
$485.63
$143.38
$97.1343500
C

Surgical opening of stomach43501
C

Surgical repair of stomach43502
C

Surgical repair of stomach43510
T

Surgical opening of stomach
0141
8.1835
$485.63
$143.38
$97.1343520
C

Incision of pyloric muscle43600
T

Biopsy of stomach
0141
8.1835
$485.63
$143.38
$97.1343605
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 repair43644
C

Lap gastric bypass/roux-en-y43645
C

Lap gastr bypass incl smll i43651
T

Laparoscopy, vagus nerve
0132
62.9914
$3,738.10
$1,239.22
$747.6243652
T

Laparoscopy, vagus nerve
0132
62.9914
$3,738.10
$1,239.22
$747.6243653
T

Laparoscopy, gastrostomy
0131
43.3389
$2,571.86
$1,001.89
$514.3743659
T

Laparoscope proc, stom
0130
31.9271
$1,894.65
$659.53
$378.9343750
T

Place gastrostomy tube
0141
8.1835
$485.63
$143.38
$97.1343752
X

Nasal/orogastric w/stent
0272
1.3801
$81.90
$32.76
$16.3843760
T

Change gastrostomy tube
0121
2.2766
$135.10
$43.80
$27.0243761
T

Reposition gastrostomy tube
0122
6.9721
$413.75
$84.85
$82.7543800
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
0422
22.9647
$1,362.79
$448.81
$272.5643831
T

Place gastrostomy tube
0141
8.1835
$485.63
$143.38
$97.1343832
C

Place gastrostomy tube( print page 50750)43840
C

Repair of stomach lesion43842
C

Gastroplasty for obesity43843
C

Gastroplasty for obesity43845
C

Gastroplasty duodenal switch43846
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
0141
8.1835
$485.63
$143.38
$97.1343880
C

Repair stomach-bowel fistula43999
T

Stomach surgery procedure
0141
8.1835
$485.63
$143.38
$97.1344005
C

Freeing of bowel adhesion44010
C

Incision of small bowel44015
C

Insert needle cath bowel44020
C

Explore small intestine44021
C

Decompress small bowel44025
C

Incision of large bowel44050
C

Reduce bowel obstruction44055
C

Correct malrotation of bowel44100
T

Biopsy of bowel
0141
8.1835
$485.63
$143.38
$97.1344110
C

Excise intestine lesion(s)44111
C

Excision of bowel lesion(s)44120
C

Removal of small intestine44121
C

Removal of small intestine44125
C

Removal of small intestine44126
C

Enterectomy w/o taper, cong44127
C

Enterectomy w/taper, cong44128
C

Enterectomy cong, add-on44130
C

Bowel to bowel fusion44132
C

Enterectomy, cadaver donor44133
C

Enterectomy, live donor44135
C

Intestine transplnt, cadaver44136
C

Intestine transplant, live44137
C

Remove intestinal allograft44139
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
43.3389
$2,571.86
$1,001.89
$514.3744201
T

Laparoscopy, jejunostomy
0131
43.3389
$2,571.86
$1,001.89
$514.3744202
C

Lap resect s/intestine singl44203
C

Lap resect s/intestine, addl44204
C

Laparo partial colectomy44205
C

Lap colectomy part w/ileum44206
T

Lap part colectomy w/stoma
0132
62.9914
$3,738.10
$1,239.22
$747.6244207
T

L colectomy/coloproctostomy
0132
62.9914
$3,738.10
$1,239.22
$747.6244208
T

L colectomy/coloproctostomy
0132
62.9914
$3,738.10
$1,239.22
$747.6244210
C

Laparo total proctocolectomy44211
C

Laparo total proctocolectomy44212
C

Laparo total proctocolectomy44238
T

Laparoscope proc, intestine
0130
31.9271
$1,894.65
$659.53
$378.9344239
T

Laparoscope proc, rectum
0130
31.9271
$1,894.65
$659.53
$378.93( print page 50751)44300
C

Open bowel to skin44310
C

Ileostomy/jejunostomy44312
T

Revision of ileostomy
0027
18.4182
$1,092.99
$329.72
$218.6044314
C

Revision of ileostomy44316
C

Devise bowel pouch44320
C

Colostomy44322
C

Colostomy with biopsies44340
T

Revision of colostomy
0027
18.4182
$1,092.99
$329.72
$218.6044345
C

Revision of colostomy44346
C

Revision of colostomy44360
T

Small bowel endoscopy
0142
9.3487
$554.78
$152.78
$110.9644361
T

Small bowel endoscopy/biopsy
0142
9.3487
$554.78
$152.78
$110.9644363
T

Small bowel endoscopy
0142
9.3487
$554.78
$152.78
$110.9644364
T

Small bowel endoscopy
0142
9.3487
$554.78
$152.78
$110.9644365
T

Small bowel endoscopy
0142
9.3487
$554.78
$152.78
$110.9644366
T

Small bowel endoscopy
0142
9.3487
$554.78
$152.78
$110.9644369
T

Small bowel endoscopy
0142
9.3487
$554.78
$152.78
$110.9644370
T

Small bowel endoscopy/stent
0384
22.3392
$1,325.68
$287.93
$265.1444372
T

Small bowel endoscopy
0142
9.3487
$554.78
$152.78
$110.9644373
T

Small bowel endoscopy
0142
9.3487
$554.78
$152.78
$110.9644376
T

Small bowel endoscopy
0142
9.3487
$554.78
$152.78
$110.9644377
T

Small bowel endoscopy/biopsy
0142
9.3487
$554.78
$152.78
$110.9644378
T

Small bowel endoscopy
0142
9.3487
$554.78
$152.78
$110.9644379
T

S bowel endoscope w/stent
0384
22.3392
$1,325.68
$287.93
$265.1444380
T

Small bowel endoscopy
0142
9.3487
$554.78
$152.78
$110.9644382
T

Small bowel endoscopy
0142
9.3487
$554.78
$152.78
$110.9644383
T

Ileoscopy w/stent
0384
22.3392
$1,325.68
$287.93
$265.1444385
T

Endoscopy of bowel pouch
0143
8.6869
$515.51
$186.06
$103.1044386
T

Endoscopy, bowel pouch/biop
0143
8.6869
$515.51
$186.06
$103.1044388
T

Colonoscopy
0143
8.6869
$515.51
$186.06
$103.1044389
T

Colonoscopy with biopsy
0143
8.6869
$515.51
$186.06
$103.1044390
T

Colonoscopy for foreign body
0143
8.6869
$515.51
$186.06
$103.1044391
T

Colonoscopy for bleeding
0143
8.6869
$515.51
$186.06
$103.1044392
T

Colonoscopy & polypectomy
0143
8.6869
$515.51
$186.06
$103.1044393
T

Colonoscopy, lesion removal
0143
8.6869
$515.51
$186.06
$103.1044394
T

Colonoscopy w/snare
0143
8.6869
$515.51
$186.06
$103.1044397
T

Colonoscopy w/stent
0384
22.3392
$1,325.68
$287.93
$265.1444500
T

Intro, gastrointestinal tube
0121
2.2766
$135.10
$43.80
$27.0244602
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/prosthesis44701
N

Intraop colon lavage add-on44715
C

Prepare donor intestine44720
C

Prep donor intestine/venous44721
C

Prep donor intestine/artery44799
T

Unlisted procedure intestine
0142
9.3487
$554.78
$152.78
$110.9644800
C

Excision of bowel pouch44820
C

Excision of mesentery lesion44850
C

Repair of mesentery44899
C

Bowel surgery procedure44900
C

Drain app abscess, open44901
T

Drain app abscess, percut
0037
9.4751
$562.28
$224.91
$112.4644950
C

Appendectomy44955
C

Appendectomy add-on44960
C

Appendectomy( print page 50752)44970
T

Laparoscopy, appendectomy
0131
43.3389
$2,571.86
$1,001.89
$514.3744979
T

Laparoscope proc, app
0130
31.9271
$1,894.65
$659.53
$378.9345000
T

Drainage of pelvic abscess
0148
3.7383
$221.84
$57.21
$44.3745005
T

Drainage of rectal abscess
0155
16.2546
$964.60

$192.9245020
T

Drainage of rectal abscess
0155
16.2546
$964.60

$192.9245100
T

Biopsy of rectum
0149
18.0726
$1,072.48
$293.06
$214.5045108
T

Removal of anorectal lesion
0150
23.8654
$1,416.24
$437.12
$283.2545110
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 prolapse45136
C

Excise ileoanal reservior45150
T

Excision of rectal stricture
0149
18.0726
$1,072.48
$293.06
$214.5045160
T

Excision of rectal lesion
0150
23.8654
$1,416.24
$437.12
$283.2545170
T

Excision of rectal lesion
0150
23.8654
$1,416.24
$437.12
$283.2545190
T

Destruction, rectal tumor
0150
23.8654
$1,416.24
$437.12
$283.2545300
T

Proctosigmoidoscopy dx
0146
4.6374
$275.20
$64.40
$55.0445303
T

Proctosigmoidoscopy dilate
0147
7.9679
$472.84

$94.5745305
T

Proctosigmoidoscopy w/bx
0147
7.9679
$472.84

$94.5745307
T

Proctosigmoidoscopy fb
0428
19.9022
$1,181.06

$236.2145308
T

Proctosigmoidoscopy removal
0147
7.9679
$472.84

$94.5745309
T

Proctosigmoidoscopy removal
0147
7.9679
$472.84

$94.5745315
T

Proctosigmoidoscopy removal
0147
7.9679
$472.84

$94.5745317
T

Proctosigmoidoscopy bleed
0147
7.9679
$472.84

$94.5745320
T

Proctosigmoidoscopy ablate
0428
19.9022
$1,181.06

$236.2145321
T

Proctosigmoidoscopy volvul
0428
19.9022
$1,181.06

$236.2145327
T

Proctosigmoidoscopy w/stent
0384
22.3392
$1,325.68
$287.93
$265.1445330
T

Diagnostic sigmoidoscopy
0146
4.6374
$275.20
$64.40
$55.0445331
T

Sigmoidoscopy and biopsy
0146
4.6374
$275.20
$64.40
$55.0445332
T

Sigmoidoscopy w/fb removal
0146
4.6374
$275.20
$64.40
$55.0445333
T

Sigmoidoscopy & polypectomy
0147
7.9679
$472.84

$94.5745334
T

Sigmoidoscopy for bleeding
0147
7.9679
$472.84

$94.5745335
T

Sigmoidoscopy w/submuc inj
0146
4.6374
$275.20
$64.40
$55.0445337
T

Sigmoidoscopy & decompress
0146
4.6374
$275.20
$64.40
$55.0445338
T

Sigmoidoscopy w/tumr remove
0147
7.9679
$472.84

$94.5745339
T

Sigmoidoscopy w/ablate tumr
0147
7.9679
$472.84

$94.5745340
T

Sig w/balloon dilation
0147
7.9679
$472.84

$94.5745341
T

Sigmoidoscopy w/ultrasound
0147
7.9679
$472.84

$94.5745342
T

Sigmoidoscopy w/us guide bx
0147
7.9679
$472.84

$94.5745345
T

Sigmoidoscopy w/stent
0384
22.3392
$1,325.68
$287.93
$265.1445355
T

Surgical colonoscopy
0143
8.6869
$515.51
$186.06
$103.1045378
T

Diagnostic colonoscopy
0143
8.6869
$515.51
$186.06
$103.1045379
T

Colonoscopy w/fb removal
0143
8.6869
$515.51
$186.06
$103.1045380
T

Colonoscopy and biopsy
0143
8.6869
$515.51
$186.06
$103.1045381
T

Colonoscopy, submucous inj
0143
8.6869
$515.51
$186.06
$103.1045382
T

Colonoscopy/control bleeding
0143
8.6869
$515.51
$186.06
$103.1045383
T

Lesion removal colonoscopy
0143
8.6869
$515.51
$186.06
$103.1045384
T

Lesion remove colonoscopy
0143
8.6869
$515.51
$186.06
$103.1045385
T

Lesion removal colonoscopy
0143
8.6869
$515.51
$186.06
$103.1045386
T

Colonoscopy dilate stricture
0143
8.6869
$515.51
$186.06
$103.1045387
T

Colonoscopy w/stent
0384
22.3392
$1,325.68
$287.93
$265.1445391
T

Colonoscopy w/endoscope us
0143
8.6869
$515.51
$186.06
$103.1045392
T

Colonoscopy w/endoscopic fnb
0143
8.6869
$515.51
$186.06
$103.1045500
T

Repair of rectum
0149
18.0726
$1,072.48
$293.06
$214.5045505
T

Repair of rectum
0150
23.8654
$1,416.24
$437.12
$283.2545520
T

Treatment of rectal prolapse
0098
1.1346
$67.33

$13.4745540
C

Correct rectal prolapse( print page 50753)45541
T

Correct rectal prolapse
0150
23.8654
$1,416.24
$437.12
$283.2545550
C

Repair rectum/remove sigmoid45560
T

Repair of rectocele
0150
23.8654
$1,416.24
$437.12
$283.2545562
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
3.7383
$221.84
$57.21
$44.3745905
T

Dilation of anal sphincter
0149
18.0726
$1,072.48
$293.06
$214.5045910
T

Dilation of rectal narrowing
0149
18.0726
$1,072.48
$293.06
$214.5045915
T

Remove rectal obstruction
0148
3.7383
$221.84
$57.21
$44.3745999
T

Rectum surgery procedure
0148
3.7383
$221.84
$57.21
$44.3746020
T

Placement of seton
0150
23.8654
$1,416.24
$437.12
$283.2546030
T

Removal of rectal marker
0148
3.7383
$221.84
$57.21
$44.3746040
T

Incision of rectal abscess
0149
18.0726
$1,072.48
$293.06
$214.5046045
T

Incision of rectal abscess
0150
23.8654
$1,416.24
$437.12
$283.2546050
T

Incision of anal abscess
0148
3.7383
$221.84
$57.21
$44.3746060
T

Incision of rectal abscess
0150
23.8654
$1,416.24
$437.12
$283.2546070
T

Incision of anal septum
0155
16.2546
$964.60

$192.9246080
T

Incision of anal sphincter
0149
18.0726
$1,072.48
$293.06
$214.5046083
T

Incise external hemorrhoid
0148
3.7383
$221.84
$57.21
$44.3746200
T

Removal of anal fissure
0150
23.8654
$1,416.24
$437.12
$283.2546210
T

Removal of anal crypt
0149
18.0726
$1,072.48
$293.06
$214.5046211
T

Removal of anal crypts
0150
23.8654
$1,416.24
$437.12
$283.2546220
T

Removal of anal tag
0149
18.0726
$1,072.48
$293.06
$214.5046221
T

Ligation of hemorrhoid(s)
0148
3.7383
$221.84
$57.21
$44.3746230
T

Removal of anal tags
0149
18.0726
$1,072.48
$293.06
$214.5046250
T

Hemorrhoidectomy
0150
23.8654
$1,416.24
$437.12
$283.2546255
T

Hemorrhoidectomy
0150
23.8654
$1,416.24
$437.12
$283.2546257
T

Remove hemorrhoids & fissure
0150
23.8654
$1,416.24
$437.12
$283.2546258
T

Remove hemorrhoids & fistula
0150
23.8654
$1,416.24
$437.12
$283.2546260
T

Hemorrhoidectomy
0150
23.8654
$1,416.24
$437.12
$283.2546261
T

Remove hemorrhoids & fissure
0150
23.8654
$1,416.24
$437.12
$283.2546262
T

Remove hemorrhoids & fistula
0150
23.8654
$1,416.24
$437.12
$283.2546270
T

Removal of anal fistula
0150
23.8654
$1,416.24
$437.12
$283.2546275
T

Removal of anal fistula
0150
23.8654
$1,416.24
$437.12
$283.2546280
T

Removal of anal fistula
0150
23.8654
$1,416.24
$437.12
$283.2546285
T

Removal of anal fistula
0150
23.8654
$1,416.24
$437.12
$283.2546288
T

Repair anal fistula
0150
23.8654
$1,416.24
$437.12
$283.2546320
T

Removal of hemorrhoid clot
0148
3.7383
$221.84
$57.21
$44.3746500
T

Injection into hemorrhoid(s)
0155
16.2546
$964.60

$192.9246600
X

Diagnostic anoscopy
0340
0.6384
$37.88

$7.5846604
T

Anoscopy and dilation
0147
7.9679
$472.84

$94.5746606
T

Anoscopy and biopsy
0146
4.6374
$275.20
$64.40
$55.0446608
T

Anoscopy, remove for body
0147
7.9679
$472.84

$94.5746610
T

Anoscopy, remove lesion
0428
19.9022
$1,181.06

$236.2146611
T

Anoscopy
0147
7.9679
$472.84

$94.5746612
T

Anoscopy, remove lesions
0428
19.9022
$1,181.06

$236.2146614
T

Anoscopy, control bleeding
0146
4.6374
$275.20
$64.40
$55.0446615
T

Anoscopy
0428
19.9022
$1,181.06

$236.2146700
T

Repair of anal stricture
0150
23.8654
$1,416.24
$437.12
$283.2546705
C

Repair of anal stricture46706
T

Repr of anal fistula w/glue
0150
23.8654
$1,416.24
$437.12
$283.2546715
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 anomaly46750
T

Repair of anal sphincter
0150
23.8654
$1,416.24
$437.12
$283.2546751
C

Repair of anal sphincter( print page 50754)46753
T

Reconstruction of anus
0150
23.8654
$1,416.24
$437.12
$283.2546754
T

Removal of suture from anus
0149
18.0726
$1,072.48
$293.06
$214.5046760
T

Repair of anal sphincter
0150
23.8654
$1,416.24
$437.12
$283.2546761
T

Repair of anal sphincter
0150
23.8654
$1,416.24
$437.12
$283.2546762
T

Implant artificial sphincter
0150
23.8654
$1,416.24
$437.12
$283.2546900
T

Destruction, anal lesion(s)
0016
2.5834
$153.31
$33.57
$30.6646910
T

Destruction, anal lesion(s)
0017
18.4211
$1,093.16
$227.84
$218.6346916
T

Cryosurgery, anal lesion(s)
0013
1.1078
$65.74
$14.20
$13.1546917
T

Laser surgery, anal lesions
0695
20.3164
$1,205.64
$266.59
$241.1346922
T

Excision of anal lesion(s)
0695
20.3164
$1,205.64
$266.59
$241.1346924
T

Destruction, anal lesion(s)
0695
20.3164
$1,205.64
$266.59
$241.1346934
T

Destruction of hemorrhoids
0155
16.2546
$964.60

$192.9246935
T

Destruction of hemorrhoids
0155
16.2546
$964.60

$192.9246936
T

Destruction of hemorrhoids
0149
18.0726
$1,072.48
$293.06
$214.5046937
T

Cryotherapy of rectal lesion
0149
18.0726
$1,072.48
$293.06
$214.5046938
T

Cryotherapy of rectal lesion
0150
23.8654
$1,416.24
$437.12
$283.2546940
T

Treatment of anal fissure
0149
18.0726
$1,072.48
$293.06
$214.5046942
T

Treatment of anal fissure
0148
3.7383
$221.84
$57.21
$44.3746945
T

Ligation of hemorrhoids
0155
16.2546
$964.60

$192.9246946
T

Ligation of hemorrhoids
0155
16.2546
$964.60

$192.9246947
T

Hemorrhoidopexy by stapling
0150
23.8654
$1,416.24
$437.12
$283.2546999
T

Anus surgery procedure
0148
3.7383
$221.84
$57.21
$44.3747000
T

Needle biopsy of liver
0685
6.0174
$357.09
$115.47
$71.4247001
N

Needle biopsy, liver add-on47010
C

Open drainage, liver lesion47011
T

Percut drain, liver lesion
0037
9.4751
$562.28
$224.91
$112.4647015
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 liver47135
C

Transplantation of liver47136
C

Transplantation of liver47140
C

Partial removal, donor liver47141
C

Partial removal, donor liver47142
C

Partial removal, donor liver47143
C

Prep donor liver, whole47144
C

Prep donor liver, 3-segment47145
C

Prep donor liver, lobe split47146
C

Prep donor liver/venous47147
C

Prep donor liver/arterial47300
C

Surgery for liver lesion47350
C

Repair liver wound47360
C

Repair liver wound47361
C

Repair liver wound47362
C

Repair liver wound47370
T

Laparo ablate liver tumor rf
0131
43.3389
$2,571.86
$1,001.89
$514.3747371
T

Laparo ablate liver cryosurg
0131
43.3389
$2,571.86
$1,001.89
$514.3747379
T

Laparoscope procedure, liver
0130
31.9271
$1,894.65
$659.53
$378.9347380
C

Open ablate liver tumor rf47381
C

Open ablate liver tumor cryo47382
T

Percut ablate liver rf
0423
40.2866
$2,390.73

$478.1547399
T

Liver surgery procedure
0002
0.9559
$56.73

$11.3547400
C

Incision of liver duct47420
C

Incision of bile duct47425
C

Incision of bile duct47460
C

Incise bile duct sphincter47480
C

Incision of gallbladder47490
T

Incision of gallbladder
0152
12.2833
$728.93

$145.7947500
N

Injection for liver x-rays47505
N

Injection for liver x-rays47510
T

Insert catheter, bile duct
0152
12.2833
$728.93

$145.7947511
T

Insert bile duct drain
0152
12.2833
$728.93

$145.7947525
T

Change bile duct catheter
0427
10.1977
$605.16
$124.11
$121.03( print page 50755)47530
T

Revise/reinsert bile tube
0427
10.1977
$605.16
$124.11
$121.0347550
C

Bile duct endoscopy add-on47552
T

Biliary endoscopy thru skin
0152
12.2833
$728.93

$145.7947553
T

Biliary endoscopy thru skin
0152
12.2833
$728.93

$145.7947554
T

Biliary endoscopy thru skin
0152
12.2833
$728.93

$145.7947555
T

Biliary endoscopy thru skin
0152
12.2833
$728.93

$145.7947556
T

Biliary endoscopy thru skin
0152
12.2833
$728.93

$145.7947560
T

Laparoscopy w/cholangio
0130
31.9271
$1,894.65
$659.53
$378.9347561
T

Laparo w/cholangio/biopsy
0130
31.9271
$1,894.65
$659.53
$378.9347562
T

Laparoscopic cholecystectomy
0131
43.3389
$2,571.86
$1,001.89
$514.3747563
T

Laparo cholecystectomy/graph
0131
43.3389
$2,571.86
$1,001.89
$514.3747564
T

Laparo cholecystectomy/explr
0131
43.3389
$2,571.86
$1,001.89
$514.3747570
C

Laparo cholecystoenterostomy47579
T

Laparoscope proc, biliary
0130
31.9271
$1,894.65
$659.53
$378.9347600
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
12.2833
$728.93

$145.7947700
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
0152
12.2833
$728.93

$145.7948000
C

Drainage of abdomen48001
C

Placement of drain, pancreas48005
C

Resect/debride pancreas48020
C

Removal of pancreatic stone48100
C

Biopsy of pancreas, open48102
T

Needle biopsy, pancreas
0685
6.0174
$357.09
$115.47
$71.4248120
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 pancreatic cyst48510
C

Drain pancreatic pseudocyst48511
T

Drain pancreatic pseudocyst
0037
9.4751
$562.28
$224.91
$112.4648520
C

Fuse pancreas cyst and bowel48540
C

Fuse pancreas cyst and bowel48545
C

Pancreatorrhaphy48547
C

Duodenal exclusion48550
E

Donor pancreatectomy( print page 50756)48551
C

Prep donor pancreas48552
C

Prep donor pancreas/venous48554
E

Transpl allograft pancreas48556
C

Removal, allograft pancreas48999
T

Pancreas surgery procedure
0004
1.7646
$104.72
$22.36
$20.9449000
C

Exploration of abdomen49002
C

Reopening of abdomen49010
C

Exploration behind abdomen49020
C

Drain abdominal abscess49021
T

Drain abdominal abscess
0037
9.4751
$562.28
$224.91
$112.4649040
C

Drain, open, abdom abscess49041
T

Drain, percut, abdom abscess
0037
9.4751
$562.28
$224.91
$112.4649060
C

Drain, open, retrop abscess49061
T

Drain, percut, retroper absc
0037
9.4751
$562.28
$224.91
$112.4649062
C

Drain to peritoneal cavity49080
T

Puncture, peritoneal cavity
0070
3.2101
$190.50

$38.1049081
T

Removal of abdominal fluid
0070
3.2101
$190.50

$38.1049085
T

Remove abdomen foreign body
0153
21.6961
$1,287.51
$382.75
$257.5049180
T

Biopsy, abdominal mass
0685
6.0174
$357.09
$115.47
$71.4249200
T

Removal of abdominal lesion
0130
31.9271
$1,894.65
$659.53
$378.9349201
C

Remove abdom lesion, complex49215
C

Excise sacral spine tumor49220
C

Multiple surgery, abdomen49250
T

Excision of umbilicus
0153
21.6961
$1,287.51
$382.75
$257.5049255
C

Removal of omentum49320
T

Diag laparo separate proc
0130
31.9271
$1,894.65
$659.53
$378.9349321
T

Laparoscopy, biopsy
0130
31.9271
$1,894.65
$659.53
$378.9349322
T

Laparoscopy, aspiration
0130
31.9271
$1,894.65
$659.53
$378.9349323
T

Laparo drain lymphocele
0130
31.9271
$1,894.65
$659.53
$378.9349329
T

Laparo proc, abdm/per/oment
0130
31.9271
$1,894.65
$659.53
$378.9349400
N

Air injection into abdomen49419
T

Insrt abdom cath for chemotx
0115
31.4727
$1,867.68
$459.35
$373.5449420
T

Insert abdom drain, temp
0652
28.8948
$1,714.70

$342.9449421
T

Insert abdom drain, perm
0652
28.8948
$1,714.70

$342.9449422
T

Remove perm cannula/catheter
0105
22.3685
$1,327.41
$370.40
$265.4849423
T

Exchange drainage catheter
0152
12.2833
$728.93

$145.7949424
N

Assess cyst, contrast inject49425
C

Insert abdomen-venous drain49426
T

Revise abdomen-venous shunt
0153
21.6961
$1,287.51
$382.75
$257.5049427
N

Injection, abdominal shunt49428
C

Ligation of shunt49429
T

Removal of shunt
0105
22.3685
$1,327.41
$370.40
$265.4849491
T

Rpr hern preemie reduc
0154
28.7847
$1,708.17
$464.85
$341.6349492
T

Rpr ing hern premie, blocked
0154
28.7847
$1,708.17
$464.85
$341.6349495
T

Rpr ing hernia baby, reduc
0154
28.7847
$1,708.17
$464.85
$341.6349496
T

Rpr ing hernia baby, blocked
0154
28.7847
$1,708.17
$464.85
$341.6349500
T

Rpr ing hernia, init, reduce
0154
28.7847
$1,708.17
$464.85
$341.6349501
T

Rpr ing hernia, init blocked
0154
28.7847
$1,708.17
$464.85
$341.6349505
T

Prp i/hern init reduc>5 yr
0154
28.7847
$1,708.17
$464.85
$341.6349507
T

Prp i/hern init block>5 yr
0154
28.7847
$1,708.17
$464.85
$341.6349520
T

Rerepair ing hernia, reduce
0154
28.7847
$1,708.17
$464.85
$341.6349521
T

Rerepair ing hernia, blocked
0154
28.7847
$1,708.17
$464.85
$341.6349525
T

Repair ing hernia, sliding
0154
28.7847
$1,708.17
$464.85
$341.6349540
T

Repair lumbar hernia
0154
28.7847
$1,708.17
$464.85
$341.6349550
T

Rpr rem hernia, init, reduce
0154
28.7847
$1,708.17
$464.85
$341.6349553
T

Rpr fem hernia, init blocked
0154
28.7847
$1,708.17
$464.85
$341.6349555
T

Rerepair fem hernia, reduce
0154
28.7847
$1,708.17
$464.85
$341.6349557
T

Rerepair fem hernia, blocked
0154
28.7847
$1,708.17
$464.85
$341.6349560
T

Rpr ventral hern init, reduc
0154
28.7847
$1,708.17
$464.85
$341.6349561
T

Rpr ventral hern init, block
0154
28.7847
$1,708.17
$464.85
$341.6349565
T

Rerepair ventrl hern, reduce
0154
28.7847
$1,708.17
$464.85
$341.6349566
T

Rerepair ventrl hern, block
0154
28.7847
$1,708.17
$464.85
$341.6349568
T

Hernia repair w/mesh
0154
28.7847
$1,708.17
$464.85
$341.6349570
T

Rpr epigastric hern, reduce
0154
28.7847
$1,708.17
$464.85
$341.6349572
T

Rpr epigastric hern, blocked
0154
28.7847
$1,708.17
$464.85
$341.6349580
T

Rpr umbil hern, reduc < 5 yr
0154
28.7847
$1,708.17
$464.85
$341.63( print page 50757)49582
T

Rpr umbil hern, block < 5 yr
0154
28.7847
$1,708.17
$464.85
$341.6349585
T

Rpr umbil hern, reduc > 5 yr
0154
28.7847
$1,708.17
$464.85
$341.6349587
T

Rpr umbil hern, block > 5 yr
0154
28.7847
$1,708.17
$464.85
$341.6349590
T

Repair spigilian hernia
0154
28.7847
$1,708.17
$464.85
$341.6349600
T

Repair umbilical lesion
0154
28.7847
$1,708.17
$464.85
$341.6349605
C

Repair umbilical lesion49606
C

Repair umbilical lesion49610
C

Repair umbilical lesion49611
C

Repair umbilical lesion49650
T

Laparo hernia repair initial
0131
43.3389
$2,571.86
$1,001.89
$514.3749651
T

Laparo hernia repair recur
0131
43.3389
$2,571.86
$1,001.89
$514.3749659
T

Laparo proc, hernia repair
0130
31.9271
$1,894.65
$659.53
$378.9349900
C

Repair of abdominal wall49904
C

Omental flap, extra-abdom49905
C

Omental flap49906
C

Free omental flap, microvasc49999
T

Abdomen surgery procedure
0153
21.6961
$1,287.51
$382.75
$257.5050010
C

Exploration of kidney50020
T

Renal abscess, open drain
0162
23.3918
$1,388.14

$277.6350021
T

Renal abscess, percut drain
0037
9.4751
$562.28
$224.91
$112.4650040
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
0429
42.3147
$2,511.08

$502.2250081
T

Removal of kidney stone
0429
42.3147
$2,511.08

$502.2250100
C

Revise kidney blood vessels50120
C

Exploration of kidney50125
C

Explore and drain kidney50130
C

Removal of kidney stone50135
C

Exploration of kidney50200
T

Biopsy of kidney
0685
6.0174
$357.09
$115.47
$71.4250205
C

Biopsy of kidney50220
C

Remove kidney, open50225
C

Removal kidney open, complex50230
C

Removal kidney open, radical50234
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 kidney50323
C

Prep cadaver renal allograft50325
C

Prep donor renal graft50327
C

Prep renal graft/venous50328
C

Prep renal graft/arterial50329
C

Prep renal graft/ureteral50340
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
0685
6.0174
$357.09
$115.47
$71.4250391
T

Instll rx agnt into rnal tub
0156
2.5751
$152.81
$40.52
$30.5650392
T

Insert kidney drain
0161
18.5576
$1,101.26
$249.36
$220.2550393
T

Insert ureteral tube
0161
18.5576
$1,101.26
$249.36
$220.2550394
N

Injection for kidney x-ray50395
T

Create passage to kidney
0161
18.5576
$1,101.26
$249.36
$220.2550396
T

Measure kidney pressure
0164
1.1855
$70.35
$17.29
$14.0750398
T

Change kidney tube
0122
6.9721
$413.75
$84.85
$82.7550400
C

Revision of kidney/ureter50405
C

Revision of kidney/ureter50500
C

Repair of kidney wound( print page 50758)50520
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
0130
31.9271
$1,894.65
$659.53
$378.9350542
T

Laparo ablate renal mass
0131
43.3389
$2,571.86
$1,001.89
$514.3750543
T

Laparo partial nephrectomy
0131
43.3389
$2,571.86
$1,001.89
$514.3750544
T

Laparoscopy, pyeloplasty
0130
31.9271
$1,894.65
$659.53
$378.9350545
C

Laparo radical nephrectomy50546
C

Laparoscopic nephrectomy50547
C

Laparo removal donor kidney50548
C

Laparo remove w/ ureter50549
T

Laparoscope proc, renal
0130
31.9271
$1,894.65
$659.53
$378.9350551
T

Kidney endoscopy
0160
6.6753
$396.13
$105.06
$79.2350553
T

Kidney endoscopy
0161
18.5576
$1,101.26
$249.36
$220.2550555
T

Kidney endoscopy & biopsy
0160
6.6753
$396.13
$105.06
$79.2350557
T

Kidney endoscopy & treatment
0162
23.3918
$1,388.14

$277.6350561
T

Kidney endoscopy & treatment
0161
18.5576
$1,101.26
$249.36
$220.2550562
T

Renal scope w/tumor resect
0160
6.6753
$396.13
$105.06
$79.2350570
T

Kidney endoscopy
0160
6.6753
$396.13
$105.06
$79.2350572
T

Kidney endoscopy
0160
6.6753
$396.13
$105.06
$79.2350574
T

Kidney endoscopy & biopsy
0160
6.6753
$396.13
$105.06
$79.2350575
T

Kidney endoscopy
0163
33.7354
$2,001.96

$400.3950576
T

Kidney endoscopy & treatment
0161
18.5576
$1,101.26
$249.36
$220.2550580
C

Kidney endoscopy & treatment50590
T

Fragmenting of kidney stone
0169
43.0133
$2,552.54
$1,021.01
$510.5150600
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
0164
1.1855
$70.35
$17.29
$14.0750688
T

Change of ureter tube
0122
6.9721
$413.75
$84.85
$82.7550690
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 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 intestine50820
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
43.3389
$2,571.86
$1,001.89
$514.3750947
T

Laparo new ureter/bladder
0131
43.3389
$2,571.86
$1,001.89
$514.37( print page 50759)50948
T

Laparo new ureter/bladder
0131
43.3389
$2,571.86
$1,001.89
$514.3750949
T

Laparoscope proc, ureter
0130
31.9271
$1,894.65
$659.53
$378.9350951
T

Endoscopy of ureter
0160
6.6753
$396.13
$105.06
$79.2350953
T

Endoscopy of ureter
0160
6.6753
$396.13
$105.06
$79.2350955
T

Ureter endoscopy & biopsy
0161
18.5576
$1,101.26
$249.36
$220.2550957
T

Ureter endoscopy & treatment
0161
18.5576
$1,101.26
$249.36
$220.2550961
T

Ureter endoscopy & treatment
0161
18.5576
$1,101.26
$249.36
$220.2550970
T

Ureter endoscopy
0160
6.6753
$396.13
$105.06
$79.2350972
T

Ureter endoscopy & catheter
0160
6.6753
$396.13
$105.06
$79.2350974
T

Ureter endoscopy & biopsy
0161
18.5576
$1,101.26
$249.36
$220.2550976
T

Ureter endoscopy & treatment
0161
18.5576
$1,101.26
$249.36
$220.2550980
T

Ureter endoscopy & treatment
0161
18.5576
$1,101.26
$249.36
$220.2551000
T

Drainage of bladder
0164
1.1855
$70.35
$17.29
$14.0751005
T

Drainage of bladder
0164
1.1855
$70.35
$17.29
$14.0751010
T

Drainage of bladder
0165
16.6689
$989.18

$197.8451020
T

Incise & treat bladder
0162
23.3918
$1,388.14

$277.6351030
T

Incise & treat bladder
0162
23.3918
$1,388.14

$277.6351040
T

Incise & drain bladder
0162
23.3918
$1,388.14

$277.6351045
T

Incise bladder/drain ureter
0160
6.6753
$396.13
$105.06
$79.2351050
T

Removal of bladder stone
0162
23.3918
$1,388.14

$277.6351060
C

Removal of ureter stone51065
T

Remove ureter calculus
0162
23.3918
$1,388.14

$277.6351080
T

Drainage of bladder abscess
0008
16.4989
$979.09

$195.8251500
T

Removal of bladder cyst
0154
28.7847
$1,708.17
$464.85
$341.6351520
T

Removal of bladder lesion
0162
23.3918
$1,388.14

$277.6351525
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
1.1855
$70.35
$17.29
$14.0751701
X

Insert bladder catheter
0340
0.6384
$37.88

$7.5851702
X

Insert temp bladder cath
0340
0.6384
$37.88

$7.5851703
T

Insert bladder cath, complex
0164
1.1855
$70.35
$17.29
$14.0751705
T

Change of bladder tube
0121
2.2766
$135.10
$43.80
$27.0251710
T

Change of bladder tube
0122
6.9721
$413.75
$84.85
$82.7551715
T

Endoscopic injection/implant
0168
28.2685
$1,677.54
$388.03
$335.5151720
T

Treatment of bladder lesion
0156
2.5751
$152.81
$40.52
$30.5651725
T

Simple cystometrogram
0156
2.5751
$152.81
$40.52
$30.5651726
T

Complex cystometrogram
0156
2.5751
$152.81
$40.52
$30.5651736
T

Urine flow measurement
0164
1.1855
$70.35
$17.29
$14.0751741
T

Electro-uroflowmetry, first
0164
1.1855
$70.35
$17.29
$14.0751772
T

Urethra pressure profile
0156
2.5751
$152.81
$40.52
$30.5651784
T

Anal/urinary muscle study
0164
1.1855
$70.35
$17.29
$14.0751785
T

Anal/urinary muscle study
0164
1.1855
$70.35
$17.29
$14.0751792
T

Urinary reflex study
0164
1.1855
$70.35
$17.29
$14.0751795
T

Urine voiding pressure study
0164
1.1855
$70.35
$17.29
$14.0751797
T

Intraabdominal pressure test
0164
1.1855
$70.35
$17.29
$14.0751798
X

Us urine capacity measure
0340
0.6384
$37.88

$7.5851800
C

Revision of bladder/urethra51820
C

Revision of urinary tract51840
C

Attach bladder/urethra51841
C

Attach bladder/urethra51845
C

Repair bladder neck( print page 50760)51860
C

Repair of bladder wound51865
C

Repair of bladder wound51880
T

Repair of bladder opening
0162
23.3918
$1,388.14

$277.6351900
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
43.3389
$2,571.86
$1,001.89
$514.3751992
T

Laparo sling operation
0132
62.9914
$3,738.10
$1,239.22
$747.6252000
T

Cystoscopy
0160
6.6753
$396.13
$105.06
$79.2352001
T

Cystoscopy, removal of clots
0160
6.6753
$396.13
$105.06
$79.2352005
T

Cystoscopy & ureter catheter
0161
18.5576
$1,101.26
$249.36
$220.2552007
T

Cystoscopy and biopsy
0161
18.5576
$1,101.26
$249.36
$220.2552010
T

Cystoscopy & duct catheter
0160
6.6753
$396.13
$105.06
$79.2352204
T

Cystoscopy
0161
18.5576
$1,101.26
$249.36
$220.2552214
T

Cystoscopy and treatment
0162
23.3918
$1,388.14

$277.6352224
T

Cystoscopy and treatment
0162
23.3918
$1,388.14

$277.6352234
T

Cystoscopy and treatment
0162
23.3918
$1,388.14

$277.6352235
T

Cystoscopy and treatment
0162
23.3918
$1,388.14

$277.6352240
T

Cystoscopy and treatment
0162
23.3918
$1,388.14

$277.6352250
T

Cystoscopy and radiotracer
0162
23.3918
$1,388.14

$277.6352260
T

Cystoscopy and treatment
0161
18.5576
$1,101.26
$249.36
$220.2552265
T

Cystoscopy and treatment
0160
6.6753
$396.13
$105.06
$79.2352270
T

Cystoscopy & revise urethra
0161
18.5576
$1,101.26
$249.36
$220.2552275
T

Cystoscopy & revise urethra
0161
18.5576
$1,101.26
$249.36
$220.2552276
T

Cystoscopy and treatment
0161
18.5576
$1,101.26
$249.36
$220.2552277
T

Cystoscopy and treatment
0162
23.3918
$1,388.14

$277.6352281
T

Cystoscopy and treatment
0161
18.5576
$1,101.26
$249.36
$220.2552282
T

Cystoscopy, implant stent
0163
33.7354
$2,001.96

$400.3952283
T

Cystoscopy and treatment
0161
18.5576
$1,101.26
$249.36
$220.2552285
T

Cystoscopy and treatment
0161
18.5576
$1,101.26
$249.36
$220.2552290
T

Cystoscopy and treatment
0161
18.5576
$1,101.26
$249.36
$220.2552300
T

Cystoscopy and treatment
0161
18.5576
$1,101.26
$249.36
$220.2552301
T

Cystoscopy and treatment
0161
18.5576
$1,101.26
$249.36
$220.2552305
T

Cystoscopy and treatment
0161
18.5576
$1,101.26
$249.36
$220.2552310
T

Cystoscopy and treatment
0160
6.6753
$396.13
$105.06
$79.2352315
T

Cystoscopy and treatment
0161
18.5576
$1,101.26
$249.36
$220.2552317
T

Remove bladder stone
0162
23.3918
$1,388.14

$277.6352318
T

Remove bladder stone
0162
23.3918
$1,388.14

$277.6352320
T

Cystoscopy and treatment
0162
23.3918
$1,388.14

$277.6352325
T

Cystoscopy, stone removal
0162
23.3918
$1,388.14

$277.6352327
T

Cystoscopy, inject material
0162
23.3918
$1,388.14

$277.6352330
T

Cystoscopy and treatment
0162
23.3918
$1,388.14

$277.6352332
T

Cystoscopy and treatment
0162
23.3918
$1,388.14

$277.6352334
T

Create passage to kidney
0162
23.3918
$1,388.14

$277.6352341
T

Cysto w/ureter stricture tx
0162
23.3918
$1,388.14

$277.6352342
T

Cysto w/up stricture tx
0162
23.3918
$1,388.14

$277.6352343
T

Cysto w/renal stricture tx
0162
23.3918
$1,388.14

$277.6352344
T

Cysto/uretero, stone remove
0162
23.3918
$1,388.14

$277.6352345
T

Cysto/uretero w/up stricture
0162
23.3918
$1,388.14

$277.6352346
T

Cystouretero w/renal strict
0162
23.3918
$1,388.14

$277.6352351
T

Cystouretero & or pyeloscope
0161
18.5576
$1,101.26
$249.36
$220.2552352
T

Cystouretero w/stone remove
0162
23.3918
$1,388.14

$277.6352353
T

Cystouretero w/lithotripsy
0163
33.7354
$2,001.96

$400.3952354
T

Cystouretero w/biopsy
0162
23.3918
$1,388.14

$277.6352355
T

Cystouretero w/excise tumor
0162
23.3918
$1,388.14

$277.6352400
T

Cystouretero w/congen repr
0162
23.3918
$1,388.14

$277.6352402
T

Cystourethro cut ejacul duct
0162
23.3918
$1,388.14

$277.6352450
T

Incision of prostate
0162
23.3918
$1,388.14

$277.6352500
T

Revision of bladder neck
0162
23.3918
$1,388.14

$277.6352510
T

Dilation prostatic urethra
0161
18.5576
$1,101.26
$249.36
$220.2552601
T

Prostatectomy (TURP)
0163
33.7354
$2,001.96

$400.3952606
T

Control postop bleeding
0162
23.3918
$1,388.14

$277.6352612
T

Prostatectomy, first stage
0163
33.7354
$2,001.96

$400.39( print page 50761)52614
T

Prostatectomy, second stage
0163
33.7354
$2,001.96

$400.3952620
T

Remove residual prostate
0163
33.7354
$2,001.96

$400.3952630
T

Remove prostate regrowth
0163
33.7354
$2,001.96

$400.3952640
T

Relieve bladder contracture
0162
23.3918
$1,388.14

$277.6352647
T

Laser surgery of prostate
0429
42.3147
$2,511.08

$502.2252648
T

Laser surgery of prostate
0429
42.3147
$2,511.08

$502.2252700
T

Drainage of prostate abscess
0162
23.3918
$1,388.14

$277.6353000
T

Incision of urethra
0166
17.6743
$1,048.85
$218.73
$209.7753010
T

Incision of urethra
0166
17.6743
$1,048.85
$218.73
$209.7753020
T

Incision of urethra
0166
17.6743
$1,048.85
$218.73
$209.7753025
T

Incision of urethra
0166
17.6743
$1,048.85
$218.73
$209.7753040
T

Drainage of urethra abscess
0166
17.6743
$1,048.85
$218.73
$209.7753060
T

Drainage of urethra abscess
0166
17.6743
$1,048.85
$218.73
$209.7753080
T

Drainage of urinary leakage
0166
17.6743
$1,048.85
$218.73
$209.7753085
T

Drainage of urinary leakage
0166
17.6743
$1,048.85
$218.73
$209.7753200
T

Biopsy of urethra
0166
17.6743
$1,048.85
$218.73
$209.7753210
T

Removal of urethra
0168
28.2685
$1,677.54
$388.03
$335.5153215
T

Removal of urethra
0166
17.6743
$1,048.85
$218.73
$209.7753220
T

Treatment of urethra lesion
0168
28.2685
$1,677.54
$388.03
$335.5153230
T

Removal of urethra lesion
0168
28.2685
$1,677.54
$388.03
$335.5153235
T

Removal of urethra lesion
0166
17.6743
$1,048.85
$218.73
$209.7753240
T

Surgery for urethra pouch
0168
28.2685
$1,677.54
$388.03
$335.5153250
T

Removal of urethra gland
0166
17.6743
$1,048.85
$218.73
$209.7753260
T

Treatment of urethra lesion
0166
17.6743
$1,048.85
$218.73
$209.7753265
T

Treatment of urethra lesion
0166
17.6743
$1,048.85
$218.73
$209.7753270
T

Removal of urethra gland
0166
17.6743
$1,048.85
$218.73
$209.7753275
T

Repair of urethra defect
0166
17.6743
$1,048.85
$218.73
$209.7753400
T

Revise urethra, stage 1
0168
28.2685
$1,677.54
$388.03
$335.5153405
T

Revise urethra, stage 2
0168
128.2685
$1,677.54
$388.03
$335.5153410
T

Reconstruction of urethra
0168
28.2685
$1,677.54
$388.03
$335.5153415
C

Reconstruction of urethra53420
T

Reconstruct urethra, stage 1
0168
28.2685
$1,677.54
$388.03
$335.5153425
T

Reconstruct urethra, stage 2
0168
28.2685
$1,677.54
$388.03
$335.5153430
T

Reconstruction of urethra
0168
28.2685
$1,677.54
$388.03
$335.5153431
T

Reconstruct urethra/bladder
0168
28.2685
$1,677.54
$388.03
$335.5153440
S

Correct bladder function
0385
75.6446
$4,488.98

$897.8053442
T

Remove perineal prosthesis
0168
28.2685
$1,677.54
$388.03
$335.5153444
S

Insert tandem cuff
0385
75.6446
$4,488.98

$897.8053445
S

Insert uro/ves nck sphincter
0386
120.1694
$7,131.21

$1,426.2453446
T

Remove uro sphincter
0168
28.2685
$1,677.54
$388.03
$335.5153447
S

Remove/replace ur sphincter
0386
120.1694
$7,131.21

$1,426.2453448
C

Remov/replc ur sphinctr comp53449
T

Repair uro sphincter
0168
28.2685
$1,677.54
$388.03
$335.5153450
T

Revision of urethra
0168
28.2685
$1,677.54
$388.03
$335.5153460
T

Revision of urethra
0166
17.6743
$1,048.85
$218.73
$209.7753500
T

Urethrlys, transvag w/ scope
0168
28.2685
$1,677.54
$388.03
$335.5153502
T

Repair of urethra injury
0166
17.6743
$1,048.85
$218.73
$209.7753505
T

Repair of urethra injury
0168
28.2685
$1,677.54
$388.03
$335.5153510
T

Repair of urethra injury
0166
17.6743
$1,048.85
$218.73
$209.7753515
T

Repair of urethra injury
0168
28.2685
$1,677.54
$388.03
$335.5153520
T

Repair of urethra defect
0168
28.2685
$1,677.54
$388.03
$335.5153600
T

Dilate urethra stricture
0156
2.5751
$152.81
$40.52
$30.5653601
T

Dilate urethra stricture
0164
1.1855
$70.35
$17.29
$14.0753605
T

Dilate urethra stricture
0161
18.5576
$1,101.26
$249.36
$220.2553620
T

Dilate urethra stricture
0165
16.6689
$989.18

$197.8453621
T

Dilate urethra stricture
0164
1.1855
$70.35
$17.29
$14.0753660
T

Dilation of urethra
0164
1.1855
$70.35
$17.29
$14.0753661
T

Dilation of urethra
0164
1.1855
$70.35
$17.29
$14.0753665
T

Dilation of urethra
0166
17.6743
$1,048.85
$218.73
$209.7753850
T

Prostatic microwave thermotx
0675
43.7329
$2,595.24

$519.0553852
T

Prostatic rf thermotx
0675
43.7329
$2,595.24

$519.0553853
T

Prostatic water thermother
0162
23.3918
$1,388.14

$277.6353899
T

Urology surgery procedure
0164
1.1855
$70.35
$17.29
$14.0754000
T

Slitting of prepuce
0166
17.6743
$1,048.85
$218.73
$209.7754001
T

Slitting of prepuce
0166
17.6743
$1,048.85
$218.73
$209.7754015
T

Drain penis lesion
0008
16.4989
$979.09

$195.82( print page 50762)54050
T

Destruction, penis lesion(s)
0013
1.1078
$65.74
$14.20
$13.1554055
T

Destruction, penis lesion(s)
0017
18.4211
$1,093.16
$227.84
$218.6354056
T

Cryosurgery, penis lesion(s)
0012
0.8497
$50.42
$11.18
$10.0854057
T

Laser surg, penis lesion(s)
0017
18.4211
$1,093.16
$227.84
$218.6354060
T

Excision of penis lesion(s)
0017
18.4211
$1,093.16
$227.84
$218.6354065
T

Destruction, penis lesion(s)
0695
20.3164
$1,205.64
$266.59
$241.1354100
T

Biopsy of penis
0021
14.9776
$888.82
$219.48
$177.7654105
T

Biopsy of penis
0022
19.6472
$1,165.92
$354.45
$233.1854110
T

Treatment of penis lesion
0181
30.8663
$1,831.70
$621.82
$366.3454111
T

Treat penis lesion, graft
0181
30.8663
$1,831.70
$621.82
$366.3454112
T

Treat penis lesion, graft
0181
30.8663
$1,831.70
$621.82
$366.3454115
T

Treatment of penis lesion
0008
16.4989
$979.09

$195.8254120
T

Partial removal of penis
0181
30.8663
$1,831.70
$621.82
$366.3454125
C

Removal of penis54130
C

Remove penis & nodes54135
C

Remove penis & nodes54150
T

Circumcision
0180
19.8827
$1,179.90
$304.87
$235.9854152
T

Circumcision
0180
19.8827
$1,179.90
$304.87
$235.9854160
T

Circumcision
0180
19.8827
$1,179.90
$304.87
$235.9854161
T

Circumcision
0180
19.8827
$1,179.90
$304.87
$235.9854162
T

Lysis penil circumic lesion
0180
19.8827
$1,179.90
$304.87
$235.9854163
T

Repair of circumcision
0180
19.8827
$1,179.90
$304.87
$235.9854164
T

Frenulotomy of penis
0180
19.8827
$1,179.90
$304.87
$235.9854200
T

Treatment of penis lesion
0156
2.5751
$152.81
$40.52
$30.5654205
T

Treatment of penis lesion
0181
30.8663
$1,831.70
$621.82
$366.3454220
T

Treatment of penis lesion
0156
2.5751
$152.81
$40.52
$30.5654230
N

Prepare penis study54231
T

Dynamic cavernosometry
0165
16.6689
$989.18

$197.8454235
T

Penile injection
0164
1.1855
$70.35
$17.29
$14.0754240
T

Penis study
0164
1.1855
$70.35
$17.29
$14.0754250
T

Penis study
0164
1.1855
$70.35
$17.29
$14.0754300
T

Revision of penis
0181
30.8663
$1,831.70
$621.82
$366.3454304
T

Revision of penis
0181
30.8663
$1,831.70
$621.82
$366.3454308
T

Reconstruction of urethra
0181
30.8663
$1,831.70
$621.82
$366.3454312
T

Reconstruction of urethra
0181
30.8663
$1,831.70
$621.82
$366.3454316
T

Reconstruction of urethra
0181
30.8663
$1,831.70
$621.82
$366.3454318
T

Reconstruction of urethra
0181
30.8663
$1,831.70
$621.82
$366.3454322
T

Reconstruction of urethra
0181
30.8663
$1,831.70
$621.82
$366.3454324
T

Reconstruction of urethra
0181
30.8663
$1,831.70
$621.82
$366.3454326
T

Reconstruction of urethra
0181
30.8663
$1,831.70
$621.82
$366.3454328
T

Revise penis/urethra
0181
30.8663
$1,831.70
$621.82
$366.3454332
C

Revise penis/urethra54336
C

Revise penis/urethra54340
T

Secondary urethral surgery
0181
30.8663
$1,831.70
$621.82
$366.3454344
T

Secondary urethral surgery
0181
30.8663
$1,831.70
$621.82
$366.3454348
T

Secondary urethral surgery
0181
30.8663
$1,831.70
$621.82
$366.3454352
T

Reconstruct urethra/penis
0181
30.8663
$1,831.70
$621.82
$366.3454360
T

Penis plastic surgery
0181
30.8663
$1,831.70
$621.82
$366.3454380
T

Repair penis
0181
30.8663
$1,831.70
$621.82
$366.3454385
T

Repair penis
0181
30.8663
$1,831.70
$621.82
$366.3454390
C

Repair penis and bladder54400
S

Insert semi-rigid prosthesis
0385
75.6446
$4,488.98

$897.8054401
S

Insert self-contd prosthesis
0386
120.1694
$7,131.21

$1,426.2454405
S

Insert multi-comp penis pros
0386
120.1694
$7,131.21

$1,426.2454406
T

Remove muti-comp penis pros
0181
30.8663
$1,831.70
$621.82
$366.3454408
T

Repair multi-comp penis pros
0181
30.8663
$1,831.70
$621.82
$366.3454410
S

Remove/replace penis prosth
0386
120.1694
$7,131.21

$1,426.2454411
C

Remov/replc penis pros, comp54415
T

Remove self-contd penis pros
0181
30.8663
$1,831.70
$621.82
$366.3454416
S

Remv/repl penis contain pros
0386
120.1694
$7,131.21

$1,426.2454417
C

Remv/replc penis pros, compl54420
T

Revision of penis
0181
30.8663
$1,831.70
$621.82
$366.3454430
C

Revision of penis54435
T

Revision of penis
0181
30.8663
$1,831.70
$621.82
$366.3454440
T

Repair of penis
0181
30.8663
$1,831.70
$621.82
$366.3454450
T

Preputial stretching
0156
2.5751
$152.81
$40.52
$30.56( print page 50763)54500
T

Biopsy of testis
0037
9.4751
$562.28
$224.91
$112.4654505
T

Biopsy of testis
0183
23.6415
$1,402.96

$280.5954512
T

Excise lesion testis
0183
23.6415
$1,402.96

$280.5954520
T

Removal of testis
0183
23.6415
$1,402.96

$280.5954522
T

Orchiectomy, partial
0183
23.6415
$1,402.96

$280.5954530
T

Removal of testis
0154
28.7847
$1,708.17
$464.85
$341.6354535
C

Extensive testis surgery54550
T

Exploration for testis
0154
28.7847
$1,708.17
$464.85
$341.6354560
T

Exploration for testis
0183
23.6415
$1,402.96

$280.5954600
T

Reduce testis torsion
0183
23.6415
$1,402.96

$280.5954620
T

Suspension of testis
0183
23.6415
$1,402.96

$280.5954640
T

Suspension of testis
0154
28.7847
$1,708.17
$464.85
$341.6354650
C

Orchiopexy (Fowler-Stephens)54660
T

Revision of testis
0183
23.6415
$1,402.96

$280.5954670
T

Repair testis injury
0183
23.6415
$1,402.96

$280.5954680
T

Relocation of testis(es)
0183
23.6415
$1,402.96

$280.5954690
T

Laparoscopy, orchiectomy
0131
43.3389
$2,571.86
$1,001.89
$514.3754692
T

Laparoscopy, orchiopexy
0132
62.9914
$3,738.10
$1,239.22
$747.6254699
T

Laparoscope proc, testis
0130
31.9271
$1,894.65
$659.53
$378.9354700
T

Drainage of scrotum
0183
23.6415
$1,402.96

$280.5954800
T

Biopsy of epididymis
0004
1.7646
$104.72
$22.36
$20.9454820
T

Exploration of epididymis
0183
23.6415
$1,402.96

$280.5954830
T

Remove epididymis lesion
0183
23.6415
$1,402.96

$280.5954840
T

Remove epididymis lesion
0183
23.6415
$1,402.96

$280.5954860
T

Removal of epididymis
0183
23.6415
$1,402.96

$280.5954861
T

Removal of epididymis
0183
23.6415
$1,402.96

$280.5954900
T

Fusion of spermatic ducts
0183
23.6415
$1,402.96

$280.5954901
T

Fusion of spermatic ducts
0183
23.6415
$1,402.96

$280.5955000
T

Drainage of hydrocele
0004
1.7646
$104.72
$22.36
$20.9455040
T

Removal of hydrocele
0154
28.7847
$1,708.17
$464.85
$341.6355041
T

Removal of hydroceles
0154
28.7847
$1,708.17
$464.85
$341.6355060
T

Repair of hydrocele
0183
23.6415
$1,402.96

$280.5955100
T

Drainage of scrotum abscess
0008
16.4989
$979.09

$195.8255110
T

Explore scrotum
0183
23.6415
$1,402.96

$280.5955120
T

Removal of scrotum lesion
0183
23.6415
$1,402.96

$280.5955150
T

Removal of scrotum
0183
23.6415
$1,402.96

$280.5955175
T

Revision of scrotum
0183
23.6415
$1,402.96

$280.5955180
T

Revision of scrotum
0183
23.6415
$1,402.96

$280.5955200
T

Incision of sperm duct
0183
23.6415
$1,402.96

$280.5955250
T

Removal of sperm duct(s)
0183
23.6415
$1,402.96

$280.5955300
N

Prepare, sperm duct x-ray55400
T

Repair of sperm duct
0183
23.6415
$1,402.96

$280.5955450
T

Ligation of sperm duct
0183
23.6415
$1,402.96

$280.5955500
T

Removal of hydrocele
0183
23.6415
$1,402.96

$280.5955520
T

Removal of sperm cord lesion
0183
23.6415
$1,402.96

$280.5955530
T

Revise spermatic cord veins
0183
23.6415
$1,402.96

$280.5955535
T

Revise spermatic cord veins
0154
28.7847
$1,708.17
$464.85
$341.6355540
T

Revise hernia & sperm veins
0154
28.7847
$1,708.17
$464.85
$341.6355550
T

Laparo ligate spermatic vein
0131
43.3389
$2,571.86
$1,001.89
$514.3755559
T

Laparo proc, spermatic cord
0130
31.9271
$1,894.65
$659.53
$378.9355600
T

Incise sperm duct pouch
0183
23.6415
$1,402.96

$280.5955605
C

Incise sperm duct pouch55650
C

Remove sperm duct pouch55680
T

Remove sperm pouch lesion
0183
23.6415
$1,402.96

$280.5955700
T

Biopsy of prostate
0184
4.3566
$258.53
$96.27
$51.7155705
T

Biopsy of prostate
0184
4.3566
$258.53
$96.27
$51.7155720
T

Drainage of prostate abscess
0162
23.3918
$1,388.14

$277.6355725
T

Drainage of prostate abscess
0162
23.3918
$1,388.14

$277.6355801
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 surgery( print page 50764)55845
C

Extensive prostate surgery55859
T

Percut/needle insert, pros
0163
33.7354
$2,001.96

$400.3955860
T

Surgical exposure, prostate
0165
16.6689
$989.18

$197.8455862
C

Extensive prostate surgery55865
C

Extensive prostate surgery55866
C

Laparo radical prostatectomy55870
T

Electroejaculation
0197
2.3572
$139.88

$27.9855873
T

Cryoablate prostate
0674
95.7856
$5,684.20

$1,136.8455899
T

Genital surgery procedure
0164
1.1855
$70.35
$17.29
$14.0755970
E

Sex transformation, M to F55980
E

Sex transformation, F to M56405
T

I & D of vulva/perineum
0189
2.371
$140.70

$28.1456420
T

Drainage of gland abscess
0189
2.371
$140.70

$28.1456440
T

Surgery for vulva lesion
0194
20.7525
$1,231.52
$397.84
$246.3056441
T

Lysis of labial lesion(s)
0193
14.5843
$865.48

$173.1056501
T

Destroy, vulva lesions, sim
0017
18.4211
$1,093.16
$227.84
$218.6356515
T

Destroy vulva lesion/s compl
0695
20.3164
$1,205.64
$266.59
$241.1356605
T

Biopsy of vulva/perineum
0019
4.0547
$240.62
$71.87
$48.1256606
T

Biopsy of vulva/perineum
0019
4.0547
$240.62
$71.87
$48.1256620
T

Partial removal of vulva
0195
26.6791
$1,583.22
$483.80
$316.6456625
T

Complete removal of vulva
0195
26.6791
$1,583.22
$483.80
$316.6456630
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
20.7525
$1,231.52
$397.84
$246.3056720
T

Incision of hymen
0193
14.5843
$865.48

$173.1056740
T

Remove vagina gland lesion
0194
20.7525
$1,231.52
$397.84
$246.3056800
T

Repair of vagina
0194
20.7525
$1,231.52
$397.84
$246.3056805
T

Repair clitoris
0193
14.5843
$865.48

$173.1056810
T

Repair of perineum
0194
20.7525
$1,231.52
$397.84
$246.3056820
T

Exam of vulva w/scope
0188
1.14
$67.65

$13.5356821
T

Exam/biopsy of vulva w/scope
0189
2.371
$140.70

$28.1457000
T

Exploration of vagina
0193
14.5843
$865.48

$173.1057010
T

Drainage of pelvic abscess
0193
14.5843
$865.48

$173.1057020
T

Drainage of pelvic fluid
0192
4.3082
$255.66

$51.1357022
T

I & d vaginal hematoma, pp
0007
11.4501
$679.48

$135.9057023
T

I & d vag hematoma, non-ob
0008
16.4989
$979.09

$195.8257061
T

Destroy vag lesions, simple
0194
20.7525
$1,231.52
$397.84
$246.3057065
T

Destroy vag lesions, complex
0194
20.7525
$1,231.52
$397.84
$246.3057100
T

Biopsy of vagina
0192
4.3082
$255.66

$51.1357105
T

Biopsy of vagina
0194
20.7525
$1,231.52
$397.84
$246.3057106
T

Remove vagina wall, partial
0194
20.7525
$1,231.52
$397.84
$246.3057107
T

Remove vagina tissue, part
0195
26.6791
$1,583.22
$483.80
$316.6457109
T

Vaginectomy partial w/nodes
0195
26.6791
$1,583.22
$483.80
$316.6457110
C

Remove vagina wall, complete57111
C

Remove vagina tissue, compl57112
C

Vaginectomy w/nodes, compl57120
T

Closure of vagina
0195
26.6791
$1,583.22
$483.80
$316.6457130
T

Remove vagina lesion
0194
20.7525
$1,231.52
$397.84
$246.3057135
T

Remove vagina lesion
0194
20.7525
$1,231.52
$397.84
$246.3057150
T

Treat vagina infection
0191
0.167
$9.91
$2.78
$1.9857155
T

Insert uteri tandems/ovoids
0192
4.3082
$255.66

$51.1357160
T

Insert pessary/other device
0188
1.14
$67.65

$13.5357170
T

Fitting of diaphragm/cap
0191
0.167
$9.91
$2.78
$1.9857180
T

Treat vaginal bleeding
0189
2.371
$140.70

$28.1457200
T

Repair of vagina
0194
20.7525
$1,231.52
$397.84
$246.3057210
T

Repair vagina/perineum
0194
20.7525
$1,231.52
$397.84
$246.3057220
T

Revision of urethra
0202
40.3866
$2,396.66
$958.66
$479.3357230
T

Repair of urethral lesion
0195
26.6791
$1,583.22
$483.80
$316.6457240
T

Repair bladder & vagina
0195
26.6791
$1,583.22
$483.80
$316.6457250
T

Repair rectum & vagina
0195
26.6791
$1,583.22
$483.80
$316.6457260
T

Repair of vagina
0195
26.6791
$1,583.22
$483.80
$316.64( print page 50765)57265
T

Extensive repair of vagina
0202
40.3866
$2,396.66
$958.66
$479.3357267
T

Insert mesh/pelvic flr addon
0154
28.7847
$1,708.17
$464.85
$341.6357268
T

Repair of bowel bulge
0195
26.6791
$1,583.22
$483.80
$316.6457270
C

Repair of bowel pouch57280
C

Suspension of vagina57282
C

Repair of vaginal prolapse57283
C

Colpopexy, intraperitoneal57284
T

Repair paravaginal defect
0202
40.3866
$2,396.66
$958.66
$479.3357287
T

Revise/remove sling repair
0202
40.3866
$2,396.66
$958.66
$479.3357288
T

Repair bladder defect
0202
40.3866
$2,396.66
$958.66
$479.3357289
T

Repair bladder & vagina
0195
26.6791
$1,583.22
$483.80
$316.6457291
T

Construction of vagina
0195
26.6791
$1,583.22
$483.80
$316.6457292
C

Construct vagina with graft57300
T

Repair rectum-vagina fistula
0195
26.6791
$1,583.22
$483.80
$316.6457305
C

Repair rectum-vagina fistula57307
C

Fistula repair & colostomy57308
C

Fistula repair, transperine57310
T

Repair urethrovaginal lesion
0202
40.3866
$2,396.66
$958.66
$479.3357311
C

Repair urethrovaginal lesion57320
T

Repair bladder-vagina lesion
0195
26.6791
$1,583.22
$483.80
$316.6457330
T

Repair bladder-vagina lesion
0195
26.6791
$1,583.22
$483.80
$316.6457335
C

Repair vagina57400
T

Dilation of vagina
0194
20.7525
$1,231.52
$397.84
$246.3057410
T

Pelvic examination
0193
14.5843
$865.48

$173.1057415
T

Remove vaginal foreign body
0194
20.7525
$1,231.52
$397.84
$246.3057420
T

Exam of vagina w/scope
0189
2.371
$140.70

$28.1457421
T

Exam/biopsy of vag w/scope
0189
2.371
$140.70

$28.1457425
T

Laparoscopy, surg, colpopexy
0130
31.9271
$1,894.65
$659.53
$378.9357452
T

Examination of vagina
0189
2.371
$140.70

$28.1457454
T

Vagina examination & biopsy
0189
2.371
$140.70

$28.1457455
T

Biopsy of cervix w/scope
0189
2.371
$140.70

$28.1457456
T

Endocerv curettage w/scope
0189
2.371
$140.70

$28.1457460
T

Cervix excision
0193
14.5843
$865.48

$173.1057461
T

Conz of cervix w/scope, leep
0194
20.7525
$1,231.52
$397.84
$246.3057500
T

Biopsy of cervix
0192
4.3082
$255.66

$51.1357505
T

Endocervical curettage
0189
2.371
$140.70

$28.1457510
T

Cauterization of cervix
0193
14.5843
$865.48

$173.1057511
T

Cryocautery of cervix
0189
2.371
$140.70

$28.1457513
T

Laser surgery of cervix
0193
14.5843
$865.48

$173.1057520
T

Conization of cervix
0194
20.7525
$1,231.52
$397.84
$246.3057522
T

Conization of cervix
0195
26.6791
$1,583.22
$483.80
$316.6457530
T

Removal of cervix
0195
26.6791
$1,583.22
$483.80
$316.6457531
C

Removal of cervix, radical57540
C

Removal of residual cervix57545
C

Remove cervix/repair pelvis57550
T

Removal of residual cervix
0195
26.6791
$1,583.22
$483.80
$316.6457555
T

Remove cervix/repair vagina
0195
26.6791
$1,583.22
$483.80
$316.6457556
T

Remove cervix, repair bowel
0202
40.3866
$2,396.66
$958.66
$479.3357700
T

Revision of cervix
0194
20.7525
$1,231.52
$397.84
$246.3057720
T

Revision of cervix
0194
20.7525
$1,231.52
$397.84
$246.3057800
T

Dilation of cervical canal
0193
14.5843
$865.48

$173.1057820
T

D & c of residual cervix
0196
17.0974
$1,014.61
$338.23
$202.9258100
T

Biopsy of uterus lining
0188
1.14
$67.65

$13.5358120
T

Dilation and curettage
0196
17.0974
$1,014.61
$338.23
$202.9258140
C

Removal of uterus lesion58145
T

Myomectomy vag method
0195
26.6791
$1,583.22
$483.80
$316.6458146
C

Myomectomy abdom complex58150
C

Total hysterectomy58152
C

Total hysterectomy58180
C

Partial hysterectomy58200
C

Extensive hysterectomy58210
C

Extensive hysterectomy58240
C

Removal of pelvis contents58260
C

Vaginal hysterectomy58262
C

Vag hyst including t/o58263
C

Vag hyst w/t/o & vag repair( print page 50766)58267
C

Vag hyst w/urinary repair58270
C

Vag hyst w/enterocele repair58275
C

Hysterectomy/revise vagina58280
C

Hysterectomy/revise vagina58285
C

Extensive hysterectomy58290
C

Vag hyst complex58291
C

Vag hyst incl t/o, complex58292
C

Vag hyst t/o & repair, compl58293
C

Vag hyst w/uro repair, compl58294
C

Vag hyst w/enterocele, compl58300
E

Insert intrauterine device58301
T

Remove intrauterine device
0189
2.371
$140.70

$28.1458321
T

Artificial insemination
0197
2.3572
$139.88

$27.9858322
T

Artificial insemination
0197
2.3572
$139.88

$27.9858323
T

Sperm washing
0197
2.3572
$139.88

$27.9858340
N

Catheter for hysterography58345
T

Reopen fallopian tube
0193
14.5843
$865.48

$173.1058346
T

Insert heyman uteri capsule
0193
14.5843
$865.48

$173.1058350
T

Reopen fallopian tube
0195
26.6791
$1,583.22
$483.80
$316.6458353
T

Endometr ablate, thermal
0195
26.6791
$1,583.22
$483.80
$316.6458356
T

Endometrial cryoablation
0202
40.3866
$2,396.66
$958.66
$479.3358400
C

Suspension of uterus58410
C

Suspension of uterus58520
C

Repair of ruptured uterus58540
C

Revision of uterus58545
T

Laparoscopic myomectomy
0130
31.9271
$1,894.65
$659.53
$378.9358546
T

Laparo-myomectomy, complex
0131
43.3389
$2,571.86
$1,001.89
$514.3758550
T

Laparo-asst vag hysterectomy
0132
62.9914
$3,738.10
$1,239.22
$747.6258552
T

Laparo-vag hyst incl t/o
0131
43.3389
$2,571.86
$1,001.89
$514.3758553
T

Laparo-vag hyst, complex
0131
43.3389
$2,571.86
$1,001.89
$514.3758554
T

Laparo-vag hyst w/t/o, compl
0131
43.3389
$2,571.86
$1,001.89
$514.3758555
T

Hysteroscopy, dx, sep proc
0190
21.0653
$1,250.08
$424.28
$250.0258558
T

Hysteroscopy, biopsy
0190
21.0653
$1,250.08
$424.28
$250.0258559
T

Hysteroscopy, lysis
0190
21.0653
$1,250.08
$424.28
$250.0258560
T

Hysteroscopy, resect septum
0387
32.5445
$1,931.29
$655.55
$386.2658561
T

Hysteroscopy, remove myoma
0387
32.5445
$1,931.29
$655.55
$386.2658562
T

Hysteroscopy, remove fb
0190
21.0653
$1,250.08
$424.28
$250.0258563
T

Hysteroscopy, ablation
0387
32.5445
$1,931.29
$655.55
$386.2658565
T

Hysteroscopy, sterilization
0202
40.3866
$2,396.66
$958.66
$479.3358578
T

Laparo proc, uterus
0130
31.9271
$1,894.65
$659.53
$378.9358579
T

Hysteroscope procedure
0190
21.0653
$1,250.08
$424.28
$250.0258600
T

Division of fallopian tube
0195
26.6791
$1,583.22
$483.80
$316.6458605
C

Division of fallopian tube58611
C

Ligate oviduct(s) add-on58615
T

Occlude fallopian tube(s)
0194
20.7525
$1,231.52
$397.84
$246.3058660
T

Laparoscopy, lysis
0131
43.3389
$2,571.86
$1,001.89
$514.3758661
T

Laparoscopy, remove adnexa
0131
43.3389
$2,571.86
$1,001.89
$514.3758662
T

Laparoscopy, excise lesions
0131
43.3389
$2,571.86
$1,001.89
$514.3758670
T

Laparoscopy, tubal cautery
0131
43.3389
$2,571.86
$1,001.89
$514.3758671
T

Laparoscopy, tubal block
0131
43.3389
$2,571.86
$1,001.89
$514.3758672
T

Laparoscopy, fimbrioplasty
0131
43.3389
$2,571.86
$1,001.89
$514.3758673
T

Laparoscopy, salpingostomy
0131
43.3389
$2,571.86
$1,001.89
$514.3758679
T

Laparo proc, oviduct-ovary
0130
31.9271
$1,894.65
$659.53
$378.9358700
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
T

Create new tubal opening
0195
26.6791
$1,583.22
$483.80
$316.6458800
T

Drainage of ovarian cyst(s)
0193
14.5843
$865.48

$173.1058805
C

Drainage of ovarian cyst(s)58820
T

Drain ovary abscess, open
0195
26.6791
$1,583.22
$483.80
$316.6458822
C

Drain ovary abscess, percut58823
T

Drain pelvic abscess, percut
0193
14.5843
$865.48

$173.1058825
C

Transposition, ovary(s)( print page 50767)58900
T

Biopsy of ovary(s)
0193
14.5843
$865.48

$173.1058920
T

Partial removal of ovary(s)
0195
26.6791
$1,583.22
$483.80
$316.6458925
T

Removal of ovarian cyst(s)
0195
26.6791
$1,583.22
$483.80
$316.6458940
C

Removal of ovary(s)58943
C

Removal of ovary(s)58950
C

Resect ovarian malignancy58951
C

Resect ovarian malignancy58952
C

Resect ovarian malignancy58953
C

Tah, rad dissect for debulk58954
C

Tah rad debulk/lymph remove58956
C

Bso, omentectomy w/tah58960
C

Exploration of abdomen58970
T

Retrieval of oocyte
0197
2.3572
$139.88

$27.9858974
T

Transfer of embryo
0197
2.3572
$139.88

$27.9858976
T

Transfer of embryo
0197
2.3572
$139.88

$27.9858999
T

Genital surgery procedure
0191
0.167
$9.91
$2.78
$1.9859000
T

Amniocentesis, diagnostic
0198
1.3683
$81.20
$32.19
$16.2459001
T

Amniocentesis, therapeutic
0192
4.3082
$255.66

$51.1359012
T

Fetal cord puncture,prenatal
0198
1.3683
$81.20
$32.19
$16.2459015
T

Chorion biopsy
0198
1.3683
$81.20
$32.19
$16.2459020
T

Fetal contract stress test
0192
4.3082
$255.66

$51.1359025
T

Fetal non-stress test
0198
1.3683
$81.20
$32.19
$16.2459030
T

Fetal scalp blood sample
0198
1.3683
$81.20
$32.19
$16.2459050
E

Fetal monitor w/report59051
B

Fetal monitor/interpret only59070
T

Transabdom amnioinfus w/ us
0198
1.3683
$81.20
$32.19
$16.2459072
T

Umbilical cord occlud w/ us
0198
1.3683
$81.20
$32.19
$16.2459074
T

Fetal fluid drainage w/ us
0198
1.3683
$81.20
$32.19
$16.2459076
T

Fetal shunt placement, w/ us
0198
1.3683
$81.20
$32.19
$16.2459100
T

Remove uterus lesion
0195
26.6791
$1,583.22
$483.80
$316.6459120
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
43.3389
$2,571.86
$1,001.89
$514.3759151
T

Treat ectopic pregnancy
0131
43.3389
$2,571.86
$1,001.89
$514.3759160
T

D & c after delivery
0196
17.0974
$1,014.61
$338.23
$202.9259200
T

Insert cervical dilator
0189
2.371
$140.70

$28.1459300
T

Episiotomy or vaginal repair
0193
14.5843
$865.48

$173.1059320
T

Revision of cervix
0194
20.7525
$1,231.52
$397.84
$246.3059325
C

Revision of cervix59350
C

Repair of uterus59400
B

Obstetrical care59409
T

Obstetrical care
0194
20.7525
$1,231.52
$397.84
$246.3059410
B

Obstetrical care59412
T

Antepartum manipulation
0700
5.3614
$318.16

$63.6359414
T

Deliver placenta
0193
14.5843
$865.48

$173.1059425
B

Antepartum care only59426
B

Antepartum care only59430
B

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
0194
20.7525
$1,231.52
$397.84
$246.3059614
E

Vbac care after delivery59618
E

Attempted vbac delivery59620
C

Attempted vbac delivery only59622
E

Attempted vbac after care59812
T

Treatment of miscarriage
0201
17.6047
$1,044.72
$329.65
$208.9459820
T

Care of miscarriage
0201
17.6047
$1,044.72
$329.65
$208.9459821
T

Treatment of miscarriage
0201
17.6047
$1,044.72
$329.65
$208.9459830
C

Treat uterus infection( print page 50768)59840
T

Abortion
0200
17.8728
$1,060.63
$263.69
$212.1359841
T

Abortion
0200
17.8728
$1,060.63
$263.69
$212.1359850
C

Abortion59851
C

Abortion59852
C

Abortion59855
C

Abortion59856
C

Abortion59857
C

Abortion59866
T

Abortion (mpr)
0198
1.3683
$81.20
$32.19
$16.2459870
T

Evacuate mole of uterus
0201
17.6047
$1,044.72
$329.65
$208.9459871
T

Remove cerclage suture
0194
20.7525
$1,231.52
$397.84
$246.3059897
T

Fetal invas px w/ us
0198
1.3683
$81.20
$32.19
$16.2459898
T

Laparo proc, ob care/deliver
0130
31.9271
$1,894.65
$659.53
$378.9359899
T

Maternity care procedure
0198
1.3683
$81.20
$32.19
$16.2460000
T

Drain thyroid/tongue cyst
0252
7.8673
$466.87
$113.41
$93.3760001
T

Aspirate/inject thyriod cyst
0004
1.7646
$104.72
$22.36
$20.9460100
T

Biopsy of thyroid
0004
1.7646
$104.72
$22.36
$20.9460200
T

Remove thyroid lesion
0114
40.7652
$2,419.13
$485.91
$483.8360210
T

Partial thyroid excision
0114
40.7652
$2,419.13
$485.91
$483.8360212
T

Partial thyroid excision
0114
40.7652
$2,419.13
$485.91
$483.8360220
T

Partial removal of thyroid
0114
40.7652
$2,419.13
$485.91
$483.8360225
T

Partial removal of thyroid
0114
40.7652
$2,419.13
$485.91
$483.8360240
T

Removal of thyroid
0114
40.7652
$2,419.13
$485.91
$483.8360252
T

Removal of thyroid
0256
37.3204
$2,214.70

$442.9460254
C

Extensive thyroid surgery60260
T

Repeat thyroid surgery
0256
37.3204
$2,214.70

$442.9460270
C

Removal of thyroid60271
C

Removal of thyroid60280
T

Remove thyroid duct lesion
0114
40.7652
$2,419.13
$485.91
$483.8360281
T

Remove thyroid duct lesion
0114
40.7652
$2,419.13
$485.91
$483.8360500
T

Explore parathyroid glands
0256
37.3204
$2,214.70

$442.9460502
C

Re-explore parathyroids60505
C

Explore parathyroid glands60512
T

Autotransplant parathyroid
0022
19.6472
$1,165.92
$354.45
$233.1860520
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
31.9271
$1,894.65
$659.53
$378.9360699
T

Endocrine surgery procedure
0114
40.7652
$2,419.13
$485.91
$483.8361000
T

Remove cranial cavity fluid
0212
2.974
$176.49
$70.59
$35.3061001
T

Remove cranial cavity fluid
0212
2.974
$176.49
$70.59
$35.3061020
T

Remove brain cavity fluid
0212
2.974
$176.49
$70.59
$35.3061026
T

Injection into brain canal
0212
2.974
$176.49
$70.59
$35.3061050
T

Remove brain canal fluid
0212
2.974
$176.49
$70.59
$35.3061055
T

Injection into brain canal
0212
2.974
$176.49
$70.59
$35.3061070
T

Brain canal shunt procedure
0212
2.974
$176.49
$70.59
$35.3061105
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
40.6455
$2,412.03

$482.4161250
C

Pierce skull & explore61253
C

Pierce skull & explore61304
C

Open skull for exploration61305
C

Open skull for exploration( print page 50769)61312
C

Open skull for drainage61313
C

Open skull for drainage61314
C

Open skull for drainage61315
C

Open skull for drainage61316
C

Implt cran bone flap to abdo61320
C

Open skull for drainage61321
C

Open skull for drainage61322
C

Decompressive craniotomy61323
C

Decompressive lobectomy61330
T

Decompress eye socket
0256
37.3204
$2,214.70

$442.9461332
C

Explore/biopsy eye socket61333
C

Explore orbit/remove lesion61334
T

Explore orbit/remove object
0256
37.3204
$2,214.70

$442.9461340
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 lesion61517
C

Implt brain chemotx add-on61518
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 lesion61537
C

Removal of brain tissue61538
C

Removal of brain tissue61539
C

Removal of brain tissue61540
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 tumor61566
C

Removal of brain tissue61567
C

Incision of brain tissue61570
C

Remove foreign body, brain61571
C

Incise skull for brain wound( print page 50770)61575
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 dura61623
T

Endovasc tempory vessel occl
0081
34.4473
$2,044.21

$408.8461624
C

Occlusion/embolization cath61626
T

Transcath occlusion, non-cns
0081
34.4473
$2,044.21

$408.8461680
C

Intracranial vessel surgery61682
C

Intracranial vessel surgery61684
C

Intracranial vessel surgery61686
C

Intracranial vessel surgery61690
C

Intracranial vessel surgery61692
C

Intracranial vessel surgery61697
C

Brain aneurysm repr, complx61698
C

Brain aneurysm repr, complx61700
C

Brain aneurysm repr, simple61702
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 treatment61790
T

Treat trigeminal nerve
0220
17.3586
$1,030.11

$206.0261791
T

Treat trigeminal tract
0206
5.492
$325.91
$75.55
$65.1861793
E

Focus radiation beam61795
S

Brain surgery using computer
0302
4.6145
$273.84
$103.74
$54.7761850
C

Implant neuroelectrodes61860
C

Implant neuroelectrodes61863
C

Implant neuroelectrode61864
C

Implant neuroelectrde, add'l61867
C

Implant neuroelectrode61868
C

Implant neuroelectrde, add'l61870
C

Implant neuroelectrodes( print page 50771)61875
C

Implant neuroelectrodes61880
T

Revise/remove neuroelectrode
0687
19.2347
$1,141.44
$456.57
$228.2961885
S

Implant neurostim one array
0039
181.4
$10,764.82

$2,152.9661886
T

Implant neurostim arrays
0315
290.647
$17,247.86

$3,449.5761888
T

Revise/remove neuroreceiver
0688
43.0444
$2,554.38
$1,021.75
$510.8862000
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 graft62148
C

Retr bone flap to fix skull62160
T

Neuroendoscopy add-on
0122
6.9721
$413.75
$84.85
$82.7562161
C

Dissect brain w/scope62162
C

Remove colloid cyst w/scope62163
C

Neuroendoscopy w/fb removal62164
C

Remove brain tumor w/scope62165
C

Remove pituit tumor w/scope62180
C

Establish brain cavity shunt62190
C

Establish brain cavity shunt62192
C

Establish brain cavity shunt62194
T

Replace/irrigate catheter
0427
10.1977
$605.16
$124.11
$121.0362200
C

Establish brain cavity shunt62201
C

Establish brain cavity shunt62220
C

Establish brain cavity shunt62223
C

Establish brain cavity shunt62225
T

Replace/irrigate catheter
0427
10.1977
$605.16
$124.11
$121.0362230
T

Replace/revise brain shunt
0224
40.6455
$2,412.03

$482.4162252
S

Csf shunt reprogram
0691
2.5252
$149.85
$59.94
$29.9762256
C

Remove brain cavity shunt62258
C

Replace brain cavity shunt62263
T

Lysis epidural adhesions
0203
10.4015
$617.26
$246.90
$123.4562264
T

Epidural lysis on single day
0203
10.4015
$617.26
$246.90
$123.4562268
T

Drain spinal cord cyst
0212
2.974
$176.49
$70.59
$35.3062269
T

Needle biopsy, spinal cord
0685
6.0174
$357.09
$115.47
$71.4262270
T

Spinal fluid tap, diagnostic
0204
2.191
$130.02
$40.13
$26.0062272
T

Drain cerebro spinal fluid
0204
2.191
$130.02
$40.13
$26.0062273
T

Treat epidural spine lesion
0206
5.492
$325.91
$75.55
$65.1862280
T

Treat spinal cord lesion
0207
6.0109
$356.70
$86.92
$71.3462281
T

Treat spinal cord lesion
0207
6.0109
$356.70
$86.92
$71.3462282
T

Treat spinal canal lesion
0207
6.0109
$356.70
$86.92
$71.3462284
N

Injection for myelogram62287
T

Percutaneous diskectomy
0221
29.9209
$1,775.60
$463.62
$355.1262290
N

Inject for spine disk x-ray62291
N

Inject for spine disk x-ray62292
T

Injection into disk lesion
0212
2.974
$176.49
$70.59
$35.3062294
T

Injection into spinal artery
0212
2.974
$176.49
$70.59
$35.3062310
T

Inject spine c/t
0207
6.0109
$356.70
$86.92
$71.3462311
T

Inject spine l/s (cd)
0207
6.0109
$356.70
$86.92
$71.3462318
T

Inject spine w/cath, c/t
0207
6.0109
$356.70
$86.92
$71.3462319
T

Inject spine w/cath l/s (cd)
0207
6.0109
$356.70
$86.92
$71.3462350
T

Implant spinal canal cath
0223
28.123
$1,668.90

$333.7862351
T

Implant spinal canal cath
0208
42.3409
$2,512.64

$502.5362355
T

Remove spinal canal catheter
0203
10.4015
$617.26
$246.90
$123.4562360
T

Insert spine infusion device
0226
138.8695
$8,240.93

$1,648.1962361
T

Implant spine infusion pump
0227
136.4922
$8,099.86

$1,619.97( print page 50772)62362
T

Implant spine infusion pump
0227
136.4922
$8,099.86

$1,619.9762365
T

Remove spine infusion device
0221
29.9209
$1,775.60
$463.62
$355.1262367
S

Analyze spine infusion pump
0691
2.5252
$149.85
$59.94
$29.9762368
S

Analyze spine infusion pump
0691
2.5252
$149.85
$59.94
$29.9763001
T

Removal of spinal lamina
0208
42.3409
$2,512.64

$502.5363003
T

Removal of spinal lamina
0208
42.3409
$2,512.64

$502.5363005
T

Removal of spinal lamina
0208
42.3409
$2,512.64

$502.5363011
T

Removal of spinal lamina
0208
42.3409
$2,512.64

$502.5363012
T

Removal of spinal lamina
0208
42.3409
$2,512.64

$502.5363015
T

Removal of spinal lamina
0208
42.3409
$2,512.64

$502.5363016
T

Removal of spinal lamina
0208
42.3409
$2,512.64

$502.5363017
T

Removal of spinal lamina
0208
42.3409
$2,512.64

$502.5363020
T

Neck spine disk surgery
0208
42.3409
$2,512.64

$502.5363030
T

Low back disk surgery
0208
42.3409
$2,512.64

$502.5363035
T

Spinal disk surgery add-on
0208
42.3409
$2,512.64

$502.5363040
T

Laminotomy, single cervical
0208
42.3409
$2,512.64

$502.5363042
T

Laminotomy, single lumbar
0208
42.3409
$2,512.64

$502.5363043
C

Laminotomy, add'l cervical63044
C

Laminotomy, add'l lumbar63045
T

Removal of spinal lamina
0208
42.3409
$2,512.64

$502.5363046
T

Removal of spinal lamina
0208
42.3409
$2,512.64

$502.5363047
T

Removal of spinal lamina
0208
42.3409
$2,512.64

$502.5363048
T

Remove spinal lamina add-on
0208
42.3409
$2,512.64

$502.5363050
C

Cervical laminoplasty63051
C

C-laminoplasty w/graft/plate63055
T

Decompress spinal cord
0208
42.3409
$2,512.64

$502.5363056
T

Decompress spinal cord
0208
42.3409
$2,512.64

$502.5363057
T

Decompress spine cord add-on
0208
42.3409
$2,512.64

$502.5363064
T

Decompress spinal cord
0208
42.3409
$2,512.64

$502.5363066
T

Decompress spine cord add-on
0208
42.3409
$2,512.64

$502.5363075
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-on63101
C

Removal of vertebral body63102
C

Removal of vertebral body63103
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 lesion( print page 50773)63268
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 tumor63295
C

Repair of laminectomy defect63300
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
17.3586
$1,030.11

$206.0263610
T

Stimulation of spinal cord
0220
17.3586
$1,030.11

$206.0263615
T

Remove lesion of spinal cord
0220
17.3586
$1,030.11

$206.0263650
S

Implant neuroelectrodes
0040
55.3297
$3,283.43

$656.6963655
S

Implant neuroelectrodes
0040
55.3297
$3,283.43

$656.6963660
T

Revise/remove neuroelectrode
0687
19.2347
$1,141.44
$456.57
$228.2963685
T

Implant neuroreceiver
0222
179.0982
$10,628.22

$2,125.6463688
T

Revise/remove neuroreceiver
0688
43.0444
$2,554.38
$1,021.75
$510.8863700
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
51.7258
$3,069.56

$613.9163744
T

Revision of spinal shunt
0228
51.7258
$3,069.56

$613.9163746
T

Removal of spinal shunt
0109
11.0433
$655.34
$131.49
$131.0764400
T

N block inj, trigeminal
0204
2.191
$130.02
$40.13
$26.0064402
T

N block inj, facial
0204
2.191
$130.02
$40.13
$26.0064405
T

N block inj, occipital
0204
2.191
$130.02
$40.13
$26.0064408
T

N block inj, vagus
0204
2.191
$130.02
$40.13
$26.0064410
T

N block inj, phrenic
0206
5.492
$325.91
$75.55
$65.1864412
T

N block inj, spinal accessor
0206
5.492
$325.91
$75.55
$65.1864413
T

N block inj, cervical plexus
0204
2.191
$130.02
$40.13
$26.0064415
T

Injection for nerve block
0204
2.191
$130.02
$40.13
$26.0064416
T

N block cont infuse, b plex
0204
2.191
$130.02
$40.13
$26.0064417
T

N block inj, axillary
0204
2.191
$130.02
$40.13
$26.0064418
T

N block inj, suprascapular
0204
2.191
$130.02
$40.13
$26.0064420
T

N block inj, intercost, sng
0204
2.191
$130.02
$40.13
$26.0064421
T

N block inj, intercost, mlt
0206
5.492
$325.91
$75.55
$65.1864425
T

N block inj ilio-ing/hypogi
0204
2.191
$130.02
$40.13
$26.0064430
T

N block inj, pudendal
0204
2.191
$130.02
$40.13
$26.0064435
T

N block inj, paracervical
0204
2.191
$130.02
$40.13
$26.0064445
T

Injection for nerve block
0204
2.191
$130.02
$40.13
$26.0064446
T

N blk inj, sciatic, cont inf
0206
5.492
$325.91
$75.55
$65.1864447
T

N block inj fem, single
0204
2.191
$130.02
$40.13
$26.0064448
T

N block inj fem, cont inf
0204
2.191
$130.02
$40.13
$26.00( print page 50774)64449
T

N block inj, lumbar plexus
0204
2.191
$130.02
$40.13
$26.0064450
T

N block, other peripheral
0204
2.191
$130.02
$40.13
$26.0064470
T

Inj paravertebral c/t
0207
6.0109
$356.70
$86.92
$71.3464472
T

Inj paravertebral c/t add-on
0206
5.492
$325.91
$75.55
$65.1864475
T

Inj paravertebral l/s
0207
6.0109
$356.70
$86.92
$71.3464476
T

Inj paravertebral l/s add-on
0206
5.492
$325.91
$75.55
$65.1864479
T

Inj foramen epidural c/t
0207
6.0109
$356.70
$86.92
$71.3464480
T

Inj foramen epidural add-on
0207
6.0109
$356.70
$86.92
$71.3464483
T

Inj foramen epidural l/s
0207
6.0109
$356.70
$86.92
$71.3464484
T

Inj foramen epidural add-on
0207
6.0109
$356.70
$86.92
$71.3464505
T

N block, spenopalatine gangl
0204
2.191
$130.02
$40.13
$26.0064508
T

N block, carotid sinus s/p
0204
2.191
$130.02
$40.13
$26.0064510
T

N block, stellate ganglion
0207
6.0109
$356.70
$86.92
$71.3464517
T

N block inj, hypogas plxs
0204
2.191
$130.02
$40.13
$26.0064520
T

N block, lumbar/thoracic
0207
6.0109
$356.70
$86.92
$71.3464530
T

N block inj, celiac pelus
0207
6.0109
$356.70
$86.92
$71.3464550
A

Apply neurostimulator64553
S

Implant neuroelectrodes
0225
234.6925
$13,927.36

$2,785.4764555
S

Implant neuroelectrodes
0040
55.3297
$3,283.43

$656.6964560
S

Implant neuroelectrodes
0040
55.3297
$3,283.43

$656.6964561
S

Implant neuroelectrodes
0040
55.3297
$3,283.43

$656.6964565
S

Implant neuroelectrodes
0040
55.3297
$3,283.43

$656.6964573
S

Implant neuroelectrodes
0225
234.6925
$13,927.36

$2,785.4764575
S

Implant neuroelectrodes
0040
55.3297
$3,283.43

$656.6964577
S

Implant neuroelectrodes
0225
234.6925
$13,927.36

$2,785.4764580
S

Implant neuroelectrodes
0040
55.3297
$3,283.43

$656.6964581
S

Implant neuroelectrodes
0040
55.3297
$3,283.43

$656.6964585
T

Revise/remove neuroelectrode
0687
19.2347
$1,141.44
$456.57
$228.2964590
T

Implant neuroreceiver
0222
179.0982
$10,628.22

$2,125.6464595
T

Revise/remove neuroreceiver
0688
43.0444
$2,554.38
$1,021.75
$510.8864600
T

Injection treatment of nerve
0203
10.4015
$617.26
$246.90
$123.4564605
T

Injection treatment of nerve
0203
10.4015
$617.26
$246.90
$123.4564610
T

Injection treatment of nerve
0203
10.4015
$617.26
$246.90
$123.4564612
T

Destroy nerve, face muscle
0204
2.191
$130.02
$40.13
$26.0064613
T

Destroy nerve, spine muscle
0204
2.191
$130.02
$40.13
$26.0064614
T

Destroy nerve, extrem musc
0204
2.191
$130.02
$40.13
$26.0064620
T

Injection treatment of nerve
0203
10.4015
$617.26
$246.90
$123.4564622
T

Destr paravertebrl nerve l/s
0203
10.4015
$617.26
$246.90
$123.4564623
T

Destr paravertebral n add-on
0207
6.0109
$356.70
$86.92
$71.3464626
T

Destr paravertebrl nerve c/t
0203
10.4015
$617.26
$246.90
$123.4564627
T

Destr paravertebral n add-on
0207
6.0109
$356.70
$86.92
$71.3464630
T

Injection treatment of nerve
0206
5.492
$325.91
$75.55
$65.1864640
T

Injection treatment of nerve
0206
5.492
$325.91
$75.55
$65.1864680
T

Injection treatment of nerve
0207
6.0109
$356.70
$86.92
$71.3464681
T

Injection treatment of nerve
0203
10.4015
$617.26
$246.90
$123.4564702
T

Revise finger/toe nerve
0220
17.3586
$1,030.11

$206.0264704
T

Revise hand/foot nerve
0220
17.3586
$1,030.11

$206.0264708
T

Revise arm/leg nerve
0220
17.3586
$1,030.11

$206.0264712
T

Revision of sciatic nerve
0220
17.3586
$1,030.11

$206.0264713
T

Revision of arm nerve(s)
0220
17.3586
$1,030.11

$206.0264714
T

Revise low back nerve(s)
0220
17.3586
$1,030.11

$206.0264716
T

Revision of cranial nerve
0220
17.3586
$1,030.11

$206.0264718
T

Revise ulnar nerve at elbow
0220
17.3586
$1,030.11

$206.0264719
T

Revise ulnar nerve at wrist
0220
17.3586
$1,030.11

$206.0264721
T

Carpal tunnel surgery
0220
17.3586
$1,030.11

$206.0264722
T

Relieve pressure on nerve(s)
0220
17.3586
$1,030.11

$206.0264726
T

Release foot/toe nerve
0220
17.3586
$1,030.11

$206.0264727
T

Internal nerve revision
0220
17.3586
$1,030.11

$206.0264732
T

Incision of brow nerve
0220
17.3586
$1,030.11

$206.0264734
T

Incision of cheek nerve
0220
17.3586
$1,030.11

$206.0264736
T

Incision of chin nerve
0220
17.3586
$1,030.11

$206.0264738
T

Incision of jaw nerve
0220
17.3586
$1,030.11

$206.0264740
T

Incision of tongue nerve
0220
17.3586
$1,030.11

$206.0264742
T

Incision of facial nerve
0220
17.3586
$1,030.11

$206.0264744
T

Incise nerve, back of head
0220
17.3586
$1,030.11

$206.0264746
T

Incise diaphragm nerve
0220
17.3586
$1,030.11

$206.02( print page 50775)64752
C

Incision of vagus nerve64755
C

Incision of stomach nerves64760
C

Incision of vagus nerve64761
T

Incision of pelvis nerve
0220
17.3586
$1,030.11

$206.0264763
T

Incise hip/thigh nerve
0220
17.3586
$1,030.11

$206.0264766
T

Incise hip/thigh nerve
0221
29.9209
$1,775.60
$463.62
$355.1264771
T

Sever cranial nerve
0220
17.3586
$1,030.11

$206.0264772
T

Incision of spinal nerve
0220
17.3586
$1,030.11

$206.0264774
T

Remove skin nerve lesion
0220
17.3586
$1,030.11

$206.0264776
T

Remove digit nerve lesion
0220
17.3586
$1,030.11

$206.0264778
T

Digit nerve surgery add-on
0220
17.3586
$1,030.11

$206.0264782
T

Remove limb nerve lesion
0220
17.3586
$1,030.11

$206.0264783
T

Limb nerve surgery add-on
0220
17.3586
$1,030.11

$206.0264784
T

Remove nerve lesion
0220
17.3586
$1,030.11

$206.0264786
T

Remove sciatic nerve lesion
0221
29.9209
$1,775.60
$463.62
$355.1264787
T

Implant nerve end
0220
17.3586
$1,030.11

$206.0264788
T

Remove skin nerve lesion
0220
17.3586
$1,030.11

$206.0264790
T

Removal of nerve lesion
0220
17.3586
$1,030.11

$206.0264792
T

Removal of nerve lesion
0221
29.9209
$1,775.60
$463.62
$355.1264795
T

Biopsy of nerve
0220
17.3586
$1,030.11

$206.0264802
T

Remove sympathetic nerves
0220
17.3586
$1,030.11

$206.0264804
C

Remove sympathetic nerves64809
C

Remove sympathetic nerves64818
C

Remove sympathetic nerves64820
T

Remove sympathetic nerves
0220
17.3586
$1,030.11

$206.0264821
T

Remove sympathetic nerves
0054
25.3711
$1,505.60

$301.1264822
T

Remove sympathetic nerves
0054
25.3711
$1,505.60

$301.1264823
T

Remove sympathetic nerves
0054
25.3711
$1,505.60

$301.1264831
T

Repair of digit nerve
0221
29.9209
$1,775.60
$463.62
$355.1264832
T

Repair nerve add-on
0221
29.9209
$1,775.60
$463.62
$355.1264834
T

Repair of hand or foot nerve
0221
29.9209
$1,775.60
$463.62
$355.1264835
T

Repair of hand or foot nerve
0221
29.9209
$1,775.60
$463.62
$355.1264836
T

Repair of hand or foot nerve
0221
29.9209
$1,775.60
$463.62
$355.1264837
T

Repair nerve add-on
0221
29.9209
$1,775.60
$463.62
$355.1264840
T

Repair of leg nerve
0221
29.9209
$1,775.60
$463.62
$355.1264856
T

Repair/transpose nerve
0221
29.9209
$1,775.60
$463.62
$355.1264857
T

Repair arm/leg nerve
0221
29.9209
$1,775.60
$463.62
$355.1264858
T

Repair sciatic nerve
0221
29.9209
$1,775.60
$463.62
$355.1264859
T

Nerve surgery
0221
29.9209
$1,775.60
$463.62
$355.1264861
T

Repair of arm nerves
0221
29.9209
$1,775.60
$463.62
$355.1264862
T

Repair of low back nerves
0221
29.9209
$1,775.60
$463.62
$355.1264864
T

Repair of facial nerve
0221
29.9209
$1,775.60
$463.62
$355.1264865
T

Repair of facial nerve
0221
29.9209
$1,775.60
$463.62
$355.1264866
C

Fusion of facial/other nerve64868
C

Fusion of facial/other nerve64870
T

Fusion of facial/other nerve
0221
29.9209
$1,775.60
$463.62
$355.1264872
T

Subsequent repair of nerve
0221
29.9209
$1,775.60
$463.62
$355.1264874
T

Repair & revise nerve add-on
0221
29.9209
$1,775.60
$463.62
$355.1264876
T

Repair nerve/shorten bone
0221
29.9209
$1,775.60
$463.62
$355.1264885
T

Nerve graft, head or neck
0221
29.9209
$1,775.60
$463.62
$355.1264886
T

Nerve graft, head or neck
0221
29.9209
$1,775.60
$463.62
$355.1264890
T

Nerve graft, hand or foot
0221
29.9209
$1,775.60
$463.62
$355.1264891
T

Nerve graft, hand or foot
0221
29.9209
$1,775.60
$463.62
$355.1264892
T

Nerve graft, arm or leg
0221
29.9209
$1,775.60
$463.62
$355.1264893
T

Nerve graft, arm or leg
0221
29.9209
$1,775.60
$463.62
$355.1264895
T

Nerve graft, hand or foot
0221
29.9209
$1,775.60
$463.62
$355.1264896
T

Nerve graft, hand or foot
0221
29.9209
$1,775.60
$463.62
$355.1264897
T

Nerve graft, arm or leg
0221
29.9209
$1,775.60
$463.62
$355.1264898
T

Nerve graft, arm or leg
0221
29.9209
$1,775.60
$463.62
$355.1264901
T

Nerve graft add-on
0221
29.9209
$1,775.60
$463.62
$355.1264902
T

Nerve graft add-on
0221
29.9209
$1,775.60
$463.62
$355.1264905
T

Nerve pedicle transfer
0221
29.9209
$1,775.60
$463.62
$355.1264907
T

Nerve pedicle transfer
0221
29.9209
$1,775.60
$463.62
$355.1264999
T

Nervous system surgery
0204
2.191
$130.02
$40.13
$26.0065091
T

Revise eye
0242
30.5464
$1,812.72
$597.36
$362.5465093
T

Revise eye with implant
0241
23.3036
$1,382.91
$384.47
$276.58( print page 50776)65101
T

Removal of eye
0242
30.5464
$1,812.72
$597.36
$362.5465103
T

Remove eye/insert implant
0242
30.5464
$1,812.72
$597.36
$362.5465105
T

Remove eye/attach implant
0242
30.5464
$1,812.72
$597.36
$362.5465110
T

Removal of eye
0242
30.5464
$1,812.72
$597.36
$362.5465112
T

Remove eye/revise socket
0242
30.5464
$1,812.72
$597.36
$362.5465114
T

Remove eye/revise socket
0242
30.5464
$1,812.72
$597.36
$362.5465125
T

Revise ocular implant
0240
18.1508
$1,077.12
$315.31
$215.4265130
T

Insert ocular implant
0241
23.3036
$1,382.91
$384.47
$276.5865135
T

Insert ocular implant
0241
23.3036
$1,382.91
$384.47
$276.5865140
T

Attach ocular implant
0242
30.5464
$1,812.72
$597.36
$362.5465150
T

Revise ocular implant
0241
23.3036
$1,382.91
$384.47
$276.5865155
T

Reinsert ocular implant
0242
30.5464
$1,812.72
$597.36
$362.5465175
T

Removal of ocular implant
0240
18.1508
$1,077.12
$315.31
$215.4265205
S

Remove foreign body from eye
0698
1.2438
$73.81
$16.55
$14.7665210
S

Remove foreign body from eye
0698
1.2438
$73.81
$16.55
$14.7665220
S

Remove foreign body from eye
0698
1.2438
$73.81
$16.55
$14.7665222
S

Remove foreign body from eye
0698
1.2438
$73.81
$16.55
$14.7665235
T

Remove foreign body from eye
0233
14.9673
$888.20
$266.33
$177.6465260
T

Remove foreign body from eye
0236
17.0229
$1,010.19

$202.0465265
T

Remove foreign body from eye
0237
28.9401
$1,717.39

$343.4865270
T

Repair of eye wound
0240
18.1508
$1,077.12
$315.31
$215.4265272
T

Repair of eye wound
0234
21.9741
$1,304.01
$511.31
$260.8065273
C

Repair of eye wound65275
T

Repair of eye wound
0234
21.9741
$1,304.01
$511.31
$260.8065280
T

Repair of eye wound
0236
17.0229
$1,010.19

$202.0465285
T

Repair of eye wound
0672
36.9284
$2,191.44

$438.2965286
T

Repair of eye wound
0232
6.6732
$396.01
$103.17
$79.2065290
T

Repair of eye socket wound
0243
22.1671
$1,315.46
$431.39
$263.0965400
T

Removal of eye lesion
0233
14.9673
$888.20
$266.33
$177.6465410
T

Biopsy of cornea
0233
14.9673
$888.20
$266.33
$177.6465420
T

Removal of eye lesion
0233
14.9673
$888.20
$266.33
$177.6465426
T

Removal of eye lesion
0234
21.9741
$1,304.01
$511.31
$260.8065430
S

Corneal smear
0698
1.2438
$73.81
$16.55
$14.7665435
T

Curette/treat cornea
0239
6.9097
$410.04

$82.0165436
T

Curette/treat cornea
0233
14.9673
$888.20
$266.33
$177.6465450
S

Treatment of corneal lesion
0231
1.9278
$114.40
$44.61
$22.8865600
T

Revision of cornea
0240
18.1508
$1,077.12
$315.31
$215.4265710
T

Corneal transplant
0244
38.3723
$2,277.13
$803.26
$455.4365730
T

Corneal transplant
0244
38.3723
$2,277.13
$803.26
$455.4365750
T

Corneal transplant
0244
38.3723
$2,277.13
$803.26
$455.4365755
T

Corneal transplant
0244
38.3723
$2,277.13
$803.26
$455.4365760
E

Revision of cornea65765
E

Revision of cornea65767
E

Corneal tissue transplant65770
T

Revise cornea with implant
0244
38.3723
$2,277.13
$803.26
$455.4365771
E

Radial keratotomy65772
T

Correction of astigmatism
0233
14.9673
$888.20
$266.33
$177.6465775
T

Correction of astigmatism
0233
14.9673
$888.20
$266.33
$177.6465780
T

Ocular reconst, transplant
0244
38.3723
$2,277.13
$803.26
$455.4365781
T

Ocular reconst, transplant
0244
38.3723
$2,277.13
$803.26
$455.4365782
T

Ocular reconst, transplant
0244
38.3723
$2,277.13
$803.26
$455.4365800
T

Drainage of eye
0233
14.9673
$888.20
$266.33
$177.6465805
T

Drainage of eye
0233
14.9673
$888.20
$266.33
$177.6465810
T

Drainage of eye
0234
21.9741
$1,304.01
$511.31
$260.8065815
T

Drainage of eye
0234
21.9741
$1,304.01
$511.31
$260.8065820
T

Relieve inner eye pressure
0232
6.6732
$396.01
$103.17
$79.2065850
T

Incision of eye
0234
21.9741
$1,304.01
$511.31
$260.8065855
T

Laser surgery of eye
0247
5.033
$298.67
$104.31
$59.7365860
T

Incise inner eye adhesions
0247
5.033
$298.67
$104.31
$59.7365865
T

Incise inner eye adhesions
0233
14.9673
$888.20
$266.33
$177.6465870
T

Incise inner eye adhesions
0234
21.9741
$1,304.01
$511.31
$260.8065875
T

Incise inner eye adhesions
0234
21.9741
$1,304.01
$511.31
$260.8065880
T

Incise inner eye adhesions
0233
14.9673
$888.20
$266.33
$177.6465900
T

Remove eye lesion
0233
14.9673
$888.20
$266.33
$177.6465920
T

Remove implant of eye
0234
21.9741
$1,304.01
$511.31
$260.8065930
T

Remove blood clot from eye
0234
21.9741
$1,304.01
$511.31
$260.80( print page 50777)66020
T

Injection treatment of eye
0233
14.9673
$888.20
$266.33
$177.6466030
T

Injection treatment of eye
0232
6.6732
$396.01
$103.17
$79.2066130
T

Remove eye lesion
0234
21.9741
$1,304.01
$511.31
$260.8066150
T

Glaucoma surgery
0234
21.9741
$1,304.01
$511.31
$260.8066155
T

Glaucoma surgery
0234
21.9741
$1,304.01
$511.31
$260.8066160
T

Glaucoma surgery
0234
21.9741
$1,304.01
$511.31
$260.8066165
T

Glaucoma surgery
0234
21.9741
$1,304.01
$511.31
$260.8066170
T

Glaucoma surgery
0234
21.9741
$1,304.01
$511.31
$260.8066172
T

Incision of eye
0673
29.2582
$1,736.27
$649.56
$347.2566180
T

Implant eye shunt
0673
29.2582
$1,736.27
$649.56
$347.2566185
T

Revise eye shunt
0673
29.2582
$1,736.27
$649.56
$347.2566220
T

Repair eye lesion
0672
36.9284
$2,191.44

$438.2966225
T

Repair/graft eye lesion
0673
29.2582
$1,736.27
$649.56
$347.2566250
T

Follow-up surgery of eye
0233
14.9673
$888.20
$266.33
$177.6466500
T

Incision of iris
0232
6.6732
$396.01
$103.17
$79.2066505
T

Incision of iris
0232
6.6732
$396.01
$103.17
$79.2066600
T

Remove iris and lesion
0234
21.9741
$1,304.01
$511.31
$260.8066605
T

Removal of iris
0234
21.9741
$1,304.01
$511.31
$260.8066625
T

Removal of iris
0232
6.6732
$396.01
$103.17
$79.2066630
T

Removal of iris
0234
21.9741
$1,304.01
$511.31
$260.8066635
T

Removal of iris
0234
21.9741
$1,304.01
$511.31
$260.8066680
T

Repair iris & ciliary body
0234
21.9741
$1,304.01
$511.31
$260.8066682
T

Repair iris & ciliary body
0234
21.9741
$1,304.01
$511.31
$260.8066700
T

Destruction, ciliary body
0233
14.9673
$888.20
$266.33
$177.6466710
T

Destruction, ciliary body
0233
14.9673
$888.20
$266.33
$177.6466711
T

Ciliary endoscopic ablation
0233
14.9673
$888.20
$266.33
$177.6466720
T

Destruction, ciliary body
0233
14.9673
$888.20
$266.33
$177.6466740
T

Destruction, ciliary body
0234
21.9741
$1,304.01
$511.31
$260.8066761
T

Revision of iris
0247
5.033
$298.67
$104.31
$59.7366762
T

Revision of iris
0247
5.033
$298.67
$104.31
$59.7366770
T

Removal of inner eye lesion
0247
5.033
$298.67
$104.31
$59.7366820
T

Incision, secondary cataract
0232
6.6732
$396.01
$103.17
$79.2066821
T

After cataract laser surgery
0247
5.033
$298.67
$104.31
$59.7366825
T

Reposition intraocular lens
0234
21.9741
$1,304.01
$511.31
$260.8066830
T

Removal of lens lesion
0232
6.6732
$396.01
$103.17
$79.2066840
T

Removal of lens material
0245
13.3625
$792.97
$221.89
$158.5966850
T

Removal of lens material
0249
27.9369
$1,657.86
$524.67
$331.5766852
T

Removal of lens material
0249
27.9369
$1,657.86
$524.67
$331.5766920
T

Extraction of lens
0249
27.9369
$1,657.86
$524.67
$331.5766930
T

Extraction of lens
0249
27.9369
$1,657.86
$524.67
$331.5766940
T

Extraction of lens
0245
13.3625
$792.97
$221.89
$158.5966982
T

Cataract surgery, complex
0246
23.4597
$1,392.17
$495.96
$278.4366983
T

Cataract surg w/iol, 1 stage
0246
23.4597
$1,392.17
$495.96
$278.4366984
T

Cataract surg w/iol, 1 stage
0246
23.4597
$1,392.17
$495.96
$278.4366985
T

Insert lens prosthesis
0246
23.4597
$1,392.17
$495.96
$278.4366986
T

Exchange lens prosthesis
0246
23.4597
$1,392.17
$495.96
$278.4366990
N

Ophthalmic endoscope add-on66999
T

Eye surgery procedure
0232
6.6732
$396.01
$103.17
$79.2067005
T

Partial removal of eye fluid
0237
28.9401
$1,717.39

$343.4867010
T

Partial removal of eye fluid
0237
28.9401
$1,717.39

$343.4867015
T

Release of eye fluid
0237
28.9401
$1,717.39

$343.4867025
T

Replace eye fluid
0237
28.9401
$1,717.39

$343.4867027
T

Implant eye drug system
0672
36.9284
$2,191.44

$438.2967028
T

Injection eye drug
0235
4.6593
$276.50
$67.40
$55.3067030
T

Incise inner eye strands
0236
17.0229
$1,010.19

$202.0467031
T

Laser surgery, eye strands
0247
5.033
$298.67
$104.31
$59.7367036
T

Removal of inner eye fluid
0672
36.9284
$2,191.44

$438.2967038
T

Strip retinal membrane
0672
36.9284
$2,191.44

$438.2967039
T

Laser treatment of retina
0672
36.9284
$2,191.44

$438.2967040
T

Laser treatment of retina
0672
36.9284
$2,191.44

$438.2967101
T

Repair detached retina
0236
17.0229
$1,010.19

$202.0467105
T

Repair detached retina
0248
4.6769
$277.54
$93.98
$55.5167107
T

Repair detached retina
0672
36.9284
$2,191.44

$438.2967108
T

Repair detached retina
0672
36.9284
$2,191.44

$438.2967110
T

Repair detached retina
0236
17.0229
$1,010.19

$202.0467112
T

Rerepair detached retina
0672
36.9284
$2,191.44

$438.29( print page 50778)67115
T

Release encircling material
0236
17.0229
$1,010.19

$202.0467120
T

Remove eye implant material
0236
17.0229
$1,010.19

$202.0467121
T

Remove eye implant material
0237
28.9401
$1,717.39

$343.4867141
T

Treatment of retina
0235
4.6593
$276.50
$67.40
$55.3067145
T

Treatment of retina
0248
4.6769
$277.54
$93.98
$55.5167208
T

Treatment of retinal lesion
0236
17.0229
$1,010.19

$202.0467210
T

Treatment of retinal lesion
0248
4.6769
$277.54
$93.98
$55.5167218
T

Treatment of retinal lesion
0236
17.0229
$1,010.19

$202.0467220
T

Treatment of choroid lesion
0235
4.6593
$276.50
$67.40
$55.3067221
T

Ocular photodynamic ther
0235
4.6593
$276.50
$67.40
$55.3067225
T

Eye photodynamic ther add-on
0235
4.6593
$276.50
$67.40
$55.3067227
T

Treatment of retinal lesion
0236
17.0229
$1,010.19

$202.0467228
T

Treatment of retinal lesion
0248
4.6769
$277.54
$93.98
$55.5167250
T

Reinforce eye wall
0240
18.1508
$1,077.12
$315.31
$215.4267255
T

Reinforce/graft eye wall
0237
28.9401
$1,717.39

$343.4867299
T

Eye surgery procedure
0235
4.6593
$276.50
$67.40
$55.3067311
T

Revise eye muscle
0243
22.1671
$1,315.46
$431.39
$263.0967312
T

Revise two eye muscles
0243
22.1671
$1,315.46
$431.39
$263.0967314
T

Revise eye muscle
0243
22.1671
$1,315.46
$431.39
$263.0967316
T

Revise two eye muscles
0243
22.1671
$1,315.46
$431.39
$263.0967318
T

Revise eye muscle(s)
0243
22.1671
$1,315.46
$431.39
$263.0967320
T

Revise eye muscle(s) add-on
0243
22.1671
$1,315.46
$431.39
$263.0967331
T

Eye surgery follow-up add-on
0243
22.1671
$1,315.46
$431.39
$263.0967332
T

Rerevise eye muscles add-on
0243
22.1671
$1,315.46
$431.39
$263.0967334
T

Revise eye muscle w/suture
0243
22.1671
$1,315.46
$431.39
$263.0967335
T

Eye suture during surgery
0243
22.1671
$1,315.46
$431.39
$263.0967340
T

Revise eye muscle add-on
0243
22.1671
$1,315.46
$431.39
$263.0967343
T

Release eye tissue
0243
22.1671
$1,315.46
$431.39
$263.0967345
T

Destroy nerve of eye muscle
0238
2.5933
$153.89

$30.7867350
T

Biopsy eye muscle
0699
10.0177
$594.48

$118.9067399
T

Eye muscle surgery procedure
0243
22.1671
$1,315.46
$431.39
$263.0967400
T

Explore/biopsy eye socket
0241
23.3036
$1,382.91
$384.47
$276.5867405
T

Explore/drain eye socket
0241
23.3036
$1,382.91
$384.47
$276.5867412
T

Explore/treat eye socket
0241
23.3036
$1,382.91
$384.47
$276.5867413
T

Explore/treat eye socket
0241
23.3036
$1,382.91
$384.47
$276.5867414
T

Explr/decompress eye socket
0242
30.5464
$1,812.72
$597.36
$362.5467415
T

Aspiration, orbital contents
0240
18.1508
$1,077.12
$315.31
$215.4267420
T

Explore/treat eye socket
0242
30.5464
$1,812.72
$597.36
$362.5467430
T

Explore/treat eye socket
0242
30.5464
$1,812.72
$597.36
$362.5467440
T

Explore/drain eye socket
0242
30.5464
$1,812.72
$597.36
$362.5467445
T

Explr/decompress eye socket
0242
30.5464
$1,812.72
$597.36
$362.5467450
T

Explore/biopsy eye socket
0242
30.5464
$1,812.72
$597.36
$362.5467500
S

Inject/treat eye socket
0231
1.9278
$114.40
$44.61
$22.8867505
T

Inject/treat eye socket
0238
2.5933
$153.89

$30.7867515
T

Inject/treat eye socket
0238
2.5933
$153.89

$30.7867550
T

Insert eye socket implant
0242
30.5464
$1,812.72
$597.36
$362.5467560
T

Revise eye socket implant
0241
23.3036
$1,382.91
$384.47
$276.5867570
T

Decompress optic nerve
0242
30.5464
$1,812.72
$597.36
$362.5467599
T

Orbit surgery procedure
0238
2.5933
$153.89

$30.7867700
T

Drainage of eyelid abscess
0238
2.5933
$153.89

$30.7867710
T

Incision of eyelid
0239
6.9097
$410.04

$82.0167715
T

Incision of eyelid fold
0240
18.1508
$1,077.12
$315.31
$215.4267800
T

Remove eyelid lesion
0238
2.5933
$153.89

$30.7867801
T

Remove eyelid lesions
0239
6.9097
$410.04

$82.0167805
T

Remove eyelid lesions
0238
2.5933
$153.89

$30.7867808
T

Remove eyelid lesion(s)
0240
18.1508
$1,077.12
$315.31
$215.4267810
T

Biopsy of eyelid
0238
2.5933
$153.89

$30.7867820
S

Revise eyelashes
0698
1.2438
$73.81
$16.55
$14.7667825
T

Revise eyelashes
0238
2.5933
$153.89

$30.7867830
T

Revise eyelashes
0239
6.9097
$410.04

$82.0167835
T

Revise eyelashes
0240
18.1508
$1,077.12
$315.31
$215.4267840
T

Remove eyelid lesion
0239
6.9097
$410.04

$82.0167850
T

Treat eyelid lesion
0239
6.9097
$410.04

$82.0167875
T

Closure of eyelid by suture
0239
6.9097
$410.04

$82.0167880
T

Revision of eyelid
0233
14.9673
$888.20
$266.33
$177.6467882
T

Revision of eyelid
0240
18.1508
$1,077.12
$315.31
$215.42( print page 50779)67900
T

Repair brow defect
0240
18.1508
$1,077.12
$315.31
$215.4267901
T

Repair eyelid defect
0240
18.1508
$1,077.12
$315.31
$215.4267902
T

Repair eyelid defect
0240
18.1508
$1,077.12
$315.31
$215.4267903
T

Repair eyelid defect
0240
18.1508
$1,077.12
$315.31
$215.4267904
T

Repair eyelid defect
0240
18.1508
$1,077.12
$315.31
$215.4267906
T

Repair eyelid defect
0240
18.1508
$1,077.12
$315.31
$215.4267908
T

Repair eyelid defect
0240
18.1508
$1,077.12
$315.31
$215.4267909
T

Revise eyelid defect
0240
18.1508
$1,077.12
$315.31
$215.4267911
T

Revise eyelid defect
0240
18.1508
$1,077.12
$315.31
$215.4267912
T

Correction eyelid w/ implant
0240
18.1508
$1,077.12
$315.31
$215.4267914
T

Repair eyelid defect
0240
18.1508
$1,077.12
$315.31
$215.4267915
T

Repair eyelid defect
0240
18.1508
$1,077.12
$315.31
$215.4267916
T

Repair eyelid defect
0240
18.1508
$1,077.12
$315.31
$215.4267917
T

Repair eyelid defect
0240
18.1508
$1,077.12
$315.31
$215.4267921
T

Repair eyelid defect
0240
18.1508
$1,077.12
$315.31
$215.4267922
T

Repair eyelid defect
0240
18.1508
$1,077.12
$315.31
$215.4267923
T

Repair eyelid defect
0240
18.1508
$1,077.12
$315.31
$215.4267924
T

Repair eyelid defect
0240
18.1508
$1,077.12
$315.31
$215.4267930
T

Repair eyelid wound
0240
18.1508
$1,077.12
$315.31
$215.4267935
T

Repair eyelid wound
0240
18.1508
$1,077.12
$315.31
$215.4267938
S

Remove eyelid foreign body
0698
1.2438
$73.81
$16.55
$14.7667950
T

Revision of eyelid
0240
18.1508
$1,077.12
$315.31
$215.4267961
T

Revision of eyelid
0240
18.1508
$1,077.12
$315.31
$215.4267966
T

Revision of eyelid
0240
18.1508
$1,077.12
$315.31
$215.4267971
T

Reconstruction of eyelid
0241
23.3036
$1,382.91
$384.47
$276.5867973
T

Reconstruction of eyelid
0241
23.3036
$1,382.91
$384.47
$276.5867974
T

Reconstruction of eyelid
0241
23.3036
$1,382.91
$384.47
$276.5867975
T

Reconstruction of eyelid
0240
18.1508
$1,077.12
$315.31
$215.4267999
T

Revision of eyelid
0238
2.5933
$153.89

$30.7868020
T

Incise/drain eyelid lining
0240
18.1508
$1,077.12
$315.31
$215.4268040
S

Treatment of eyelid lesions
0698
1.2438
$73.81
$16.55
$14.7668100
T

Biopsy of eyelid lining
0232
6.6732
$396.01
$103.17
$79.2068110
T

Remove eyelid lining lesion
0699
10.0177
$594.48

$118.9068115
T

Remove eyelid lining lesion
0240
18.1508
$1,077.12
$315.31
$215.4268130
T

Remove eyelid lining lesion
0233
14.9673
$888.20
$266.33
$177.6468135
T

Remove eyelid lining lesion
0239
6.9097
$410.04

$82.0168200
S

Treat eyelid by injection
0230
0.7858
$46.63
$14.97
$9.3368320
T

Revise/graft eyelid lining
0240
18.1508
$1,077.12
$315.31
$215.4268325
T

Revise/graft eyelid lining
0242
30.5464
$1,812.72
$597.36
$362.5468326
T

Revise/graft eyelid lining
0241
23.3036
$1,382.91
$384.47
$276.5868328
T

Revise/graft eyelid lining
0241
23.3036
$1,382.91
$384.47
$276.5868330
T

Revise eyelid lining
0234
21.9741
$1,304.01
$511.31
$260.8068335
T

Revise/graft eyelid lining
0241
23.3036
$1,382.91
$384.47
$276.5868340
T

Separate eyelid adhesions
0240
18.1508
$1,077.12
$315.31
$215.4268360
T

Revise eyelid lining
0234
21.9741
$1,304.01
$511.31
$260.8068362
T

Revise eyelid lining
0234
21.9741
$1,304.01
$511.31
$260.8068371
T

Harvest eye tissue, alograft
0233
14.9673
$888.20
$266.33
$177.6468399
T

Eyelid lining surgery
0238
2.5933
$153.89

$30.7868400
T

Incise/drain tear gland
0238
2.5933
$153.89

$30.7868420
T

Incise/drain tear sac
0240
18.1508
$1,077.12
$315.31
$215.4268440
T

Incise tear duct opening
0238
2.5933
$153.89

$30.7868500
T

Removal of tear gland
0241
23.3036
$1,382.91
$384.47
$276.5868505
T

Partial removal, tear gland
0241
23.3036
$1,382.91
$384.47
$276.5868510
T

Biopsy of tear gland
0240
18.1508
$1,077.12
$315.31
$215.4268520
T

Removal of tear sac
0241
23.3036
$1,382.91
$384.47
$276.5868525
T

Biopsy of tear sac
0240
18.1508
$1,077.12
$315.31
$215.4268530
T

Clearance of tear duct
0240
18.1508
$1,077.12
$315.31
$215.4268540
T

Remove tear gland lesion
0241
23.3036
$1,382.91
$384.47
$276.5868550
T

Remove tear gland lesion
0242
30.5464
$1,812.72
$597.36
$362.5468700
T

Repair tear ducts
0241
23.3036
$1,382.91
$384.47
$276.5868705
T

Revise tear duct opening
0238
2.5933
$153.89

$30.7868720
T

Create tear sac drain
0242
30.5464
$1,812.72
$597.36
$362.5468745
T

Create tear duct drain
0241
23.3036
$1,382.91
$384.47
$276.5868750
T

Create tear duct drain
0242
30.5464
$1,812.72
$597.36
$362.5468760
S

Close tear duct opening
0698
1.2438
$73.81
$16.55
$14.7668761
S

Close tear duct opening
0231
1.9278
$114.40
$44.61
$22.88( print page 50780)68770
T

Close tear system fistula
0240
18.1508
$1,077.12
$315.31
$215.4268801
S

Dilate tear duct opening
0698
1.2438
$73.81
$16.55
$14.7668810
S

Probe nasolacrimal duct
0231
1.9278
$114.40
$44.61
$22.8868811
T

Probe nasolacrimal duct
0240
18.1508
$1,077.12
$315.31
$215.4268815
T

Probe nasolacrimal duct
0240
18.1508
$1,077.12
$315.31
$215.4268840
S

Explore/irrigate tear ducts
0231
1.9278
$114.40
$44.61
$22.8868850
N

Injection for tear sac x-ray68899
S

Tear duct system surgery
0230
0.7858
$46.63
$14.97
$9.3369000
T

Drain external ear lesion
0006
1.55
$91.98
$22.28
$18.4069005
T

Drain external ear lesion
0008
16.4989
$979.09

$195.8269020
T

Drain outer ear canal lesion
0006
1.55
$91.98
$22.28
$18.4069090
E

Pierce earlobes69100
T

Biopsy of external ear
0019
4.0547
$240.62
$71.87
$48.1269105
T

Biopsy of external ear canal
0253
16.1357
$957.54
$282.29
$191.5169110
T

Remove external ear, partial
0021
14.9776
$888.82
$219.48
$177.7669120
T

Removal of external ear
0254
23.404
$1,388.86
$321.35
$277.7769140
T

Remove ear canal lesion(s)
0254
23.404
$1,388.86
$321.35
$277.7769145
T

Remove ear canal lesion(s)
0021
14.9776
$888.82
$219.48
$177.7669150
T

Extensive ear canal surgery
0252
7.8673
$466.87
$113.41
$93.3769155
C

Extensive ear/neck surgery69200
X

Clear outer ear canal
0340
0.6384
$37.88

$7.5869205
T

Clear outer ear canal
0022
19.6472
$1,165.92
$354.45
$233.1869210
X

Remove impacted ear wax
0340
0.6384
$37.88

$7.5869220
T

Clean out mastoid cavity
0012
0.8497
$50.42
$11.18
$10.0869222
T

Clean out mastoid cavity
0253
16.1357
$957.54
$282.29
$191.5169300
T

Revise external ear
0254
23.404
$1,388.86
$321.35
$277.7769310
T

Rebuild outer ear canal
0256
37.3204
$2,214.70

$442.9469320
T

Rebuild outer ear canal
0256
37.3204
$2,214.70

$442.9469399
T

Outer ear surgery procedure
0251
2.0101
$119.29

$23.8669400
T

Inflate middle ear canal
0251
2.0101
$119.29

$23.8669401
T

Inflate middle ear canal
0251
2.0101
$119.29

$23.8669405
T

Catheterize middle ear canal
0252
7.8673
$466.87
$113.41
$93.3769410
T

Inset middle ear (baffle)
0251
2.0101
$119.29

$23.8669420
T

Incision of eardrum
0251
2.0101
$119.29

$23.8669421
T

Incision of eardrum
0253
16.1357
$957.54
$282.29
$191.5169424
T

Remove ventilating tube
0252
7.8673
$466.87
$113.41
$93.3769433
T

Create eardrum opening
0252
7.8673
$466.87
$113.41
$93.3769436
T

Create eardrum opening
0253
16.1357
$957.54
$282.29
$191.5169440
T

Exploration of middle ear
0254
23.404
$1,388.86
$321.35
$277.7769450
T

Eardrum revision
0256
37.3204
$2,214.70

$442.9469501
T

Mastoidectomy
0256
37.3204
$2,214.70

$442.9469502
T

Mastoidectomy
0254
23.404
$1,388.86
$321.35
$277.7769505
T

Remove mastoid structures
0256
37.3204
$2,214.70

$442.9469511
T

Extensive mastoid surgery
0256
37.3204
$2,214.70

$442.9469530
T

Extensive mastoid surgery
0256
37.3204
$2,214.70

$442.9469535
C

Remove part of temporal bone69540
T

Remove ear lesion
0253
16.1357
$957.54
$282.29
$191.5169550
T

Remove ear lesion
0256
37.3204
$2,214.70

$442.9469552
T

Remove ear lesion
0256
37.3204
$2,214.70

$442.9469554
C

Remove ear lesion69601
T

Mastoid surgery revision
0256
37.3204
$2,214.70

$442.9469602
T

Mastoid surgery revision
0256
37.3204
$2,214.70

$442.9469603
T

Mastoid surgery revision
0256
37.3204
$2,214.70

$442.9469604
T

Mastoid surgery revision
0256
37.3204
$2,214.70

$442.9469605
T

Mastoid surgery revision
0256
37.3204
$2,214.70

$442.9469610
T

Repair of eardrum
0254
23.404
$1,388.86
$321.35
$277.7769620
T

Repair of eardrum
0254
23.404
$1,388.86
$321.35
$277.7769631
T

Repair eardrum structures
0256
37.3204
$2,214.70

$442.9469632
T

Rebuild eardrum structures
0256
37.3204
$2,214.70

$442.9469633
T

Rebuild eardrum structures
0256
37.3204
$2,214.70

$442.9469635
T

Repair eardrum structures
0256
37.3204
$2,214.70

$442.9469636
T

Rebuild eardrum structures
0256
37.3204
$2,214.70

$442.9469637
T

Rebuild eardrum structures
0256
37.3204
$2,214.70

$442.9469641
T

Revise middle ear & mastoid
0256
37.3204
$2,214.70

$442.9469642
T

Revise middle ear & mastoid
0256
37.3204
$2,214.70

$442.9469643
T

Revise middle ear & mastoid
0256
37.3204
$2,214.70

$442.94( print page 50781)69644
T

Revise middle ear & mastoid
0256
37.3204
$2,214.70

$442.9469645
T

Revise middle ear & mastoid
0256
37.3204
$2,214.70

$442.9469646
T

Revise middle ear & mastoid
0256
37.3204
$2,214.70

$442.9469650
T

Release middle ear bone
0254
23.404
$1,388.86
$321.35
$277.7769660
T

Revise middle ear bone
0256
37.3204
$2,214.70

$442.9469661
T

Revise middle ear bone
0256
37.3204
$2,214.70

$442.9469662
T

Revise middle ear bone
0256
37.3204
$2,214.70

$442.9469666
T

Repair middle ear structures
0256
37.3204
$2,214.70

$442.9469667
T

Repair middle ear structures
0256
37.3204
$2,214.70

$442.9469670
T

Remove mastoid air cells
0256
37.3204
$2,214.70

$442.9469676
T

Remove middle ear nerve
0256
37.3204
$2,214.70

$442.9469700
T

Close mastoid fistula
0256
37.3204
$2,214.70

$442.9469710
E

Implant/replace hearing aid69711
T

Remove/repair hearing aid
0256
37.3204
$2,214.70

$442.9469714
T

Implant temple bone w/stimul
0256
37.3204
$2,214.70

$442.9469715
T

Temple bne implnt w/stimulat
0256
37.3204
$2,214.70

$442.9469717
T

Temple bone implant revision
0256
37.3204
$2,214.70

$442.9469718
T

Revise temple bone implant
0256
37.3204
$2,214.70

$442.9469720
T

Release facial nerve
0256
37.3204
$2,214.70

$442.9469725
T

Release facial nerve
0256
37.3204
$2,214.70

$442.9469740
T

Repair facial nerve
0256
37.3204
$2,214.70

$442.9469745
T

Repair facial nerve
0256
37.3204
$2,214.70

$442.9469799
T

Middle ear surgery procedure
0251
2.0101
$119.29

$23.8669801
T

Incise inner ear
0256
37.3204
$2,214.70

$442.9469802
T

Incise inner ear
0256
37.3204
$2,214.70

$442.9469805
T

Explore inner ear
0256
37.3204
$2,214.70

$442.9469806
T

Explore inner ear
0256
37.3204
$2,214.70

$442.9469820
T

Establish inner ear window
0256
37.3204
$2,214.70

$442.9469840
T

Revise inner ear window
0256
37.3204
$2,214.70

$442.9469905
T

Remove inner ear
0256
37.3204
$2,214.70

$442.9469910
T

Remove inner ear & mastoid
0256
37.3204
$2,214.70

$442.9469915
T

Incise inner ear nerve
0256
37.3204
$2,214.70

$442.9469930
T

Implant cochlear device
0259
366.3317
$21,739.22
$8,070.21
$4,347.8469949
T

Inner ear surgery procedure
0251
2.0101
$119.29

$23.8669950
C

Incise inner ear nerve69955
T

Release facial nerve
0256
37.3204
$2,214.70

$442.9469960
T

Release inner ear canal
0256
37.3204
$2,214.70

$442.9469970
C

Remove inner ear lesion69979
T

Temporal bone surgery
0251
2.0101
$119.29

$23.8669990
N

Microsurgery add-on70010
S

Contrast x-ray of brain
0274
3.0413
$180.48
$72.19
$36.1070015
S

Contrast x-ray of brain
0274
3.0413
$180.48
$72.19
$36.1070030
X

X-ray eye for foreign body
0260
0.7555
$44.83
$17.93
$8.9770100
X

X-ray exam of jaw
0260
0.7555
$44.83
$17.93
$8.9770110
X

X-ray exam of jaw
0260
0.7555
$44.83
$17.93
$8.9770120
X

X-ray exam of mastoids
0260
0.7555
$44.83
$17.93
$8.9770130
X

X-ray exam of mastoids
0260
0.7555
$44.83
$17.93
$8.9770134
X

X-ray exam of middle ear
0261
1.2901
$76.56

$15.3170140
X

X-ray exam of facial bones
0260
0.7555
$44.83
$17.93
$8.9770150
X

X-ray exam of facial bones
0260
0.7555
$44.83
$17.93
$8.9770160
X

X-ray exam of nasal bones
0260
0.7555
$44.83
$17.93
$8.9770170
X

X-ray exam of tear duct
0264
3.524
$209.12
$79.41
$41.8270190
X

X-ray exam of eye sockets
0260
0.7555
$44.83
$17.93
$8.9770200
X

X-ray exam of eye sockets
0260
0.7555
$44.83
$17.93
$8.9770210
X

X-ray exam of sinuses
0260
0.7555
$44.83
$17.93
$8.9770220
X

X-ray exam of sinuses
0260
0.7555
$44.83
$17.93
$8.9770240
X

X-ray exam, pituitary saddle
0260
0.7555
$44.83
$17.93
$8.9770250
X

X-ray exam of skull
0260
0.7555
$44.83
$17.93
$8.9770260
X

X-ray exam of skull
0261
1.2901
$76.56

$15.3170300
X

X-ray exam of teeth
0262
0.9228
$54.76

$10.9570310
X

X-ray exam of teeth
0262
0.9228
$54.76

$10.9570320
X

Full mouth x-ray of teeth
0262
0.9228
$54.76

$10.9570328
X

X-ray exam of jaw joint
0260
0.7555
$44.83
$17.93
$8.9770330
X

X-ray exam of jaw joints
0260
0.7555
$44.83
$17.93
$8.9770332
S

X-ray exam of jaw joint
0275
3.5779
$212.32
$69.09
$42.4670336
S

Magnetic image, jaw joint
0335
5.1581
$306.10
$122.43
$61.22( print page 50782)70350
X

X-ray head for orthodontia
0260
0.7555
$44.83
$17.93
$8.9770355
X

Panoramic x-ray of jaws
0260
0.7555
$44.83
$17.93
$8.9770360
X

X-ray exam of neck
0260
0.7555
$44.83
$17.93
$8.9770370
X

Throat x-ray & fluoroscopy
0272
1.3801
$81.90
$32.76
$16.3870371
X

Speech evaluation, complex
0272
1.3801
$81.90
$32.76
$16.3870373
X

Contrast x-ray of larynx
0263
1.7476
$103.71
$24.40
$20.7470380
X

X-ray exam of salivary gland
0260
0.7555
$44.83
$17.93
$8.9770390
X

X-ray exam of salivary duct
0263
1.7476
$103.71
$24.40
$20.7470450*
S

Ct head/brain w/o dye
0332
3.2694
$194.02
$77.60
$38.8070460*
S

Ct head/brain w/dye
0283
4.4253
$262.61
$105.04
$52.5270470*
S

Ct head/brain w/o & w/ dye
0333
5.2836
$313.54
$125.41
$62.7170480*
S

Ct orbit/ear/fossa w/o dye
0332
3.2694
$194.02
$77.60
$38.8070481*
S

Ct orbit/ear/fossa w/dye
0283
4.4253
$262.61
$105.04
$52.5270482*
S

Ct orbit/ear/fossa w/o&w dye
0333
5.2836
$313.54
$125.41
$62.7170486*
S

Ct maxillofacial w/o dye
0332
3.2694
$194.02
$77.60
$38.8070487*
S

Ct maxillofacial w/dye
0283
4.4253
$262.61
$105.04
$52.5270488*
S

Ct maxillofacial w/o & w dye
0333
5.2836
$313.54
$125.41
$62.7170490*
S

Ct soft tissue neck w/o dye
0332
3.2694
$194.02
$77.60
$38.8070491*
S

Ct soft tissue neck w/dye
0283
4.4253
$262.61
$105.04
$52.5270492*
S

Ct sft tsue nck w/o & w/dye
0333
5.2836
$313.54
$125.41
$62.7170496*
S

Ct angiography, head
0662
5.1621
$306.33
$122.53
$61.2770498*
S

Ct angiography, neck
0662
5.1621
$306.33
$122.53
$61.2770540*
S

Mri orbit/face/neck w/o dye
0336
6.0742
$360.46
$144.18
$72.0970542*
S

Mri orbit/face/neck w/dye
0284
6.4201
$380.99
$152.39
$76.2070543*
S

Mri orbt/fac/nck w/o & w dye
0337
8.7945
$521.89
$208.75
$104.3870544*
S

Mr angiography head w/o dye
0336
6.0742
$360.46
$144.18
$72.0970545*
S

Mr angiography head w/dye
0284
6.4201
$380.99
$152.39
$76.2070546*
S

Mr angiograph head w/o&w dye
0337
8.7945
$521.89
$208.75
$104.3870547*
S

Mr angiography neck w/o dye
0336
6.0742
$360.46
$144.18
$72.0970548*
S

Mr angiography neck w/dye
0284
6.4201
$380.99
$152.39
$76.2070549*
S

Mr angiograph neck w/o&w dye
0337
8.7945
$521.89
$208.75
$104.3870551*
S

Mri brain w/o dye
0336
6.0742
$360.46
$144.18
$72.0970552*
S

Mri brain w/ dye
0284
6.4201
$380.99
$152.39
$76.2070553*
S

Mri brain w/o & w/ dye
0337
8.7945
$521.89
$208.75
$104.3870557
S

Mri brain w/o dye
0336
6.0742
$360.46
$144.18
$72.0970558
S

Mri brain w/ dye
0284
6.4201
$380.99
$152.39
$76.2070559
S

Mri brain w/o & w/ dye
0337
8.7945
$521.89
$208.75
$104.3871010
X

Chest x-ray
0260
0.7555
$44.83
$17.93
$8.9771015
X

Chest x-ray
0260
0.7555
$44.83
$17.93
$8.9771020
X

Chest x-ray
0260
0.7555
$44.83
$17.93
$8.9771021
X

Chest x-ray
0260
0.7555
$44.83
$17.93
$8.9771022
X

Chest x-ray
0260
0.7555
$44.83
$17.93
$8.9771023
X

Chest x-ray and fluoroscopy
0272
1.3801
$81.90
$32.76
$16.3871030
X

Chest x-ray
0260
0.7555
$44.83
$17.93
$8.9771034
X

Chest x-ray and fluoroscopy
0272
1.3801
$81.90
$32.76
$16.3871035
X

Chest x-ray
0260
0.7555
$44.83
$17.93
$8.9771040
X

Contrast x-ray of bronchi
0263
1.7476
$103.71
$24.40
$20.7471060
X

Contrast x-ray of bronchi
0263
1.7476
$103.71
$24.40
$20.7471090
X

X-ray & pacemaker insertion
0272
1.3801
$81.90
$32.76
$16.3871100
X

X-ray exam of ribs
0260
0.7555
$44.83
$17.93
$8.9771101
X

X-ray exam of ribs/chest
0260
0.7555
$44.83
$17.93
$8.9771110
X

X-ray exam of ribs
0260
0.7555
$44.83
$17.93
$8.9771111
X

X-ray exam of ribs/ chest
0261
1.2901
$76.56

$15.3171120
X

X-ray exam of breastbone
0260
0.7555
$44.83
$17.93
$8.9771130
X

X-ray exam of breastbone
0260
0.7555
$44.83
$17.93
$8.9771250*
S

Ct thorax w/o dye
0332
3.2694
$194.02
$77.60
$38.8071260*
S

Ct thorax w/dye
0283
4.4253
$262.61
$105.04
$52.5271270*
S

Ct thorax w/o & w/ dye
0333
5.2836
$313.54
$125.41
$62.7171275*
S

Ct angiography, chest
0662
5.1621
$306.33
$122.53
$61.2771550*
S

Mri chest w/o dye
0336
6.0742
$360.46
$144.18
$72.0971551*
S

Mri chest w/dye
0284
6.4201
$380.99
$152.39
$76.2071552*
S

Mri chest w/o & w/dye
0337
8.7945
$521.89
$208.75
$104.3871555
B

Mri angio chest w or w/o dye72010
X

X-ray exam of spine
0260
0.7555
$44.83
$17.93
$8.9772020
X

X-ray exam of spine
0260
0.7555
$44.83
$17.93
$8.9772040
X

X-ray exam of neck spine
0260
0.7555
$44.83
$17.93
$8.97( print page 50783)72050
X

X-ray exam of neck spine
0261
1.2901
$76.56

$15.3172052
X

X-ray exam of neck spine
0261
1.2901
$76.56

$15.3172069
X

X-ray exam of trunk spine
0260
0.7555
$44.83
$17.93
$8.9772070
X

X-ray exam of thoracic spine
0260
0.7555
$44.83
$17.93
$8.9772072
X

X-ray exam of thoracic spine
0260
0.7555
$44.83
$17.93
$8.9772074
X

X-ray exam of thoracic spine
0260
0.7555
$44.83
$17.93
$8.9772080
X

X-ray exam of trunk spine
0260
0.7555
$44.83
$17.93
$8.9772090
X

X-ray exam of trunk spine
0261
1.2901
$76.56

$15.3172100
X

X-ray exam of lower spine
0260
0.7555
$44.83
$17.93
$8.9772110
X

X-ray exam of lower spine
0261
1.2901
$76.56

$15.3172114
X

X-ray exam of lower spine
0261
1.2901
$76.56

$15.3172120
X

X-ray exam of lower spine
0261
1.2901
$76.56

$15.3172125*
S

Ct neck spine w/o dye
0332
3.2694
$194.02
$77.60
$38.8072126*
S

Ct neck spine w/dye
0283
4.4253
$262.61
$105.04
$52.5272127*
S

Ct neck spine w/o & w/dye
0333
5.2836
$313.54
$125.41
$62.7172128*
S

Ct chest spine w/o dye
0332
3.2694
$194.02
$77.60
$38.8072129*
S

Ct chest spine w/dye
0283
4.4253
$262.61
$105.04
$52.5272130*
S

Ct chest spine w/o & w/dye
0333
5.2836
$313.54
$125.41
$62.7172131*
S

Ct lumbar spine w/o dye
0332
3.2694
$194.02
$77.60
$38.8072132*
S

Ct lumbar spine w/dye
0283
4.4253
$262.61
$105.04
$52.5272133*
S

Ct lumbar spine w/o & w/dye
0333
5.2836
$313.54
$125.41
$62.7172141*
S

Mri neck spine w/o dye
0336
6.0742
$360.46
$144.18
$72.0972142*
S

Mri neck spine w/dye
0284
6.4201
$380.99
$152.39
$76.2072146*
S

Mri chest spine w/o dye
0336
6.0742
$360.46
$144.18
$72.0972147*
S

Mri chest spine w/dye
0284
6.4201
$380.99
$152.39
$76.2072148*
S

Mri lumbar spine w/o dye
0336
6.0742
$360.46
$144.18
$72.0972149*
S

Mri lumbar spine w/dye
0284
6.4201
$380.99
$152.39
$76.2072156*
S

Mri neck spine w/o & w/dye
0337
8.7945
$521.89
$208.75
$104.3872157*
S

Mri chest spine w/o & w/dye
0337
8.7945
$521.89
$208.75
$104.3872158*
S

Mri lumbar spine w/o & w/dye
0337
8.7945
$521.89
$208.75
$104.3872159
E

Mr angio spine w/o&w/dye72170
X

X-ray exam of pelvis
0260
0.7555
$44.83
$17.93
$8.9772190
X

X-ray exam of pelvis
0260
0.7555
$44.83
$17.93
$8.9772191*
S

Ct angiograph pelv w/o&w/dye
0662
5.1621
$306.33
$122.53
$61.2772192*
S

Ct pelvis w/o dye
0332
3.2694
$194.02
$77.60
$38.8072193*
S

Ct pelvis w/dye
0283
4.4253
$262.61
$105.04
$52.5272194*
S

Ct pelvis w/o & w/dye
0333
5.2836
$313.54
$125.41
$62.7172195*
S

Mri pelvis w/o dye
0336
6.0742
$360.46
$144.18
$72.0972196*
S

Mri pelvis w/dye
0284
6.4201
$380.99
$152.39
$76.2072197*
S

Mri pelvis w/o & w/dye
0337
8.7945
$521.89
$208.75
$104.3872198
B

Mr angio pelvis w/o & w/dye72200
X

X-ray exam sacroiliac joints
0260
0.7555
$44.83
$17.93
$8.9772202
X

X-ray exam sacroiliac joints
0260
0.7555
$44.83
$17.93
$8.9772220
X

X-ray exam of tailbone
0260
0.7555
$44.83
$17.93
$8.9772240
S

Contrast x-ray of neck spine
0274
3.0413
$180.48
$72.19
$36.1072255
S

Contrast x-ray, thorax spine
0274
3.0413
$180.48
$72.19
$36.1072265
S

Contrast x-ray, lower spine
0274
3.0413
$180.48
$72.19
$36.1072270
S

Contrast x-ray, spine
0274
3.0413
$180.48
$72.19
$36.1072275
S

Epidurography
0274
3.0413
$180.48
$72.19
$36.1072285
S

X-ray c/t spine disk
0388
12.3294
$731.66
$292.66
$146.3372295
S

X-ray of lower spine disk
0388
12.3294
$731.66
$292.66
$146.3373000
X

X-ray exam of collar bone
0260
0.7555
$44.83
$17.93
$8.9773010
X

X-ray exam of shoulder blade
0260
0.7555
$44.83
$17.93
$8.9773020
X

X-ray exam of shoulder
0260
0.7555
$44.83
$17.93
$8.9773030
X

X-ray exam of shoulder
0260
0.7555
$44.83
$17.93
$8.9773040
S

Contrast x-ray of shoulder
0275
3.5779
$212.32
$69.09
$42.4673050
X

X-ray exam of shoulders
0260
0.7555
$44.83
$17.93
$8.9773060
X

X-ray exam of humerus
0260
0.7555
$44.83
$17.93
$8.9773070
X

X-ray exam of elbow
0260
0.7555
$44.83
$17.93
$8.9773080
X

X-ray exam of elbow
0260
0.7555
$44.83
$17.93
$8.9773085
S

Contrast x-ray of elbow
0275
3.5779
$212.32
$69.09
$42.4673090
X

X-ray exam of forearm
0260
0.7555
$44.83
$17.93
$8.9773092
X

X-ray exam of arm, infant
0260
0.7555
$44.83
$17.93
$8.9773100
X

X-ray exam of wrist
0260
0.7555
$44.83
$17.93
$8.9773110
X

X-ray exam of wrist
0260
0.7555
$44.83
$17.93
$8.9773115
S

Contrast x-ray of wrist
0275
3.5779
$212.32
$69.09
$42.46( print page 50784)73120
X

X-ray exam of hand
0260
0.7555
$44.83
$17.93
$8.9773130
X

X-ray exam of hand
0260
0.7555
$44.83
$17.93
$8.9773140
X

X-ray exam of finger(s)
0260
0.7555
$44.83
$17.93
$8.9773200*
S

Ct upper extremity w/o dye
0332
3.2694
$194.02
$77.60
$38.8073201*
S

Ct upper extremity w/dye
0283
4.4253
$262.61
$105.04
$52.5273202*
S

Ct uppr extremity w/o&w/dye
0333
5.2836
$313.54
$125.41
$62.7173206*
S

Ct angio upr extrm w/o&w/dye
0662
5.1621
$306.33
$122.53
$61.2773218*
S

Mri upper extremity w/o dye
0336
6.0742
$360.46
$144.18
$72.0973219*
S

Mri upper extremity w/dye
0284
6.4201
$380.99
$152.39
$76.2073220*
S

Mri uppr extremity w/o&w/dye
0337
8.7945
$521.89
$208.75
$104.3873221*
S

Mri joint upr extrem w/o dye
0336
6.0742
$360.46
$144.18
$72.0973222*
S

Mri joint upr extrem w/dye
0284
6.4201
$380.99
$152.39
$76.2073223*
S

Mri joint upr extr w/o&w/dye
0337
8.7945
$521.89
$208.75
$104.3873225
E

Mr angio upr extr w/o&w/dye73500
X

X-ray exam of hip
0260
0.7555
$44.83
$17.93
$8.9773510
X

X-ray exam of hip
0260
0.7555
$44.83
$17.93
$8.9773520
X

X-ray exam of hips
0261
1.2901
$76.56

$15.3173525
S

Contrast x-ray of hip
0275
3.5779
$212.32
$69.09
$42.4673530
X

X-ray exam of hip
0261
1.2901
$76.56

$15.3173540
X

X-ray exam of pelvis & hips
0260
0.7555
$44.83
$17.93
$8.9773542
S

X-ray exam, sacroiliac joint
0275
3.5779
$212.32
$69.09
$42.4673550
X

X-ray exam of thigh
0260
0.7555
$44.83
$17.93
$8.9773560
X

X-ray exam of knee, 1 or 2
0260
0.7555
$44.83
$17.93
$8.9773562
X

X-ray exam of knee, 3
0260
0.7555
$44.83
$17.93
$8.9773564
X

X-ray exam, knee, 4 or more
0260
0.7555
$44.83
$17.93
$8.9773565
X

X-ray exam of knees
0260
0.7555
$44.83
$17.93
$8.9773580
S

Contrast x-ray of knee joint
0275
3.5779
$212.32
$69.09
$42.4673590
X

X-ray exam of lower leg
0260
0.7555
$44.83
$17.93
$8.9773592
X

X-ray exam of leg, infant
0260
0.7555
$44.83
$17.93
$8.9773600
X

X-ray exam of ankle
0260
0.7555
$44.83
$17.93
$8.9773610
X

X-ray exam of ankle
0260
0.7555
$44.83
$17.93
$8.9773615
S

Contrast x-ray of ankle
0275
3.5779
$212.32
$69.09
$42.4673620
X

X-ray exam of foot
0260
0.7555
$44.83
$17.93
$8.9773630
X

X-ray exam of foot
0260
0.7555
$44.83
$17.93
$8.9773650
X

X-ray exam of heel
0260
0.7555
$44.83
$17.93
$8.9773660
X

X-ray exam of toe(s)
0260
0.7555
$44.83
$17.93
$8.9773700*
S

Ct lower extremity w/o dye
0332
3.2694
$194.02
$77.60
$38.8073701*
S

Ct lower extremity w/dye
0283
4.4253
$262.61
$105.04
$52.5273702*
S

Ct lwr extremity w/o&w/dye
0333
5.2836
$313.54
$125.41
$62.7173706*
S

Ct angio lwr extr w/o&w/dye
0662
5.1621
$306.33
$122.53
$61.2773718*
S

Mri lower extremity w/o dye
0336
6.0742
$360.46
$144.18
$72.0973719*
S

Mri lower extremity w/dye
0284
6.4201
$380.99
$152.39
$76.2073720*
S

Mri lwr extremity w/o&w/dye
0337
8.7945
$521.89
$208.75
$104.3873721*
S

Mri jnt of lwr extre w/o dye
0336
6.0742
$360.46
$144.18
$72.0973722*
S

Mri joint of lwr extr w/dye
0284
6.4201
$380.99
$152.39
$76.2073723*
S

Mri joint lwr extr w/o&w/dye
0337
8.7945
$521.89
$208.75
$104.3873725
B

Mr ang lwr ext w or w/o dye74000
X

X-ray exam of abdomen
0260
0.7555
$44.83
$17.93
$8.9774010
X

X-ray exam of abdomen
0260
0.7555
$44.83
$17.93
$8.9774020
X

X-ray exam of abdomen
0260
0.7555
$44.83
$17.93
$8.9774022
X

X-ray exam series, abdomen
0261
1.2901
$76.56

$15.3174150*
S

Ct abdomen w/o dye
0332
3.2694
$194.02
$77.60
$38.8074160*
S

Ct abdomen w/dye
0283
4.4253
$262.61
$105.04
$52.5274170*
S

Ct abdomen w/o &w /dye
0333
5.2836
$313.54
$125.41
$62.7174175*
S

Ct angio abdom w/o & w/dye
0662
5.1621
$306.33
$122.53
$61.2774181*
S

Mri abdomen w/o dye
0336
6.0742
$360.46
$144.18
$72.0974182*
S

Mri abdomen w/dye
0284
6.4201
$380.99
$152.39
$76.2074183*
S

Mri abdomen w/o & w/dye
0337
8.7945
$521.89
$208.75
$104.3874185
B

Mri angio, abdom w orw/o dye74190
X

X-ray exam of peritoneum
0264
3.524
$209.12
$79.41
$41.8274210
S

Contrst x-ray exam of throat
0276
1.5319
$90.91
$36.36
$18.1874220
S

Contrast x-ray, esophagus
0276
1.5319
$90.91
$36.36
$18.1874230
S

Cine/vid x-ray, throat/esoph
0276
1.5319
$90.91
$36.36
$18.1874235
S

Remove esophagus obstruction
0296
2.2452
$133.24
$53.29
$26.6574240
S

X-ray exam, upper gi tract
0276
1.5319
$90.91
$36.36
$18.1874241
S

X-ray exam, upper gi tract
0276
1.5319
$90.91
$36.36
$18.18( print page 50785)74245
S

X-ray exam, upper gi tract
0277
2.3852
$141.54
$56.61
$28.3174246
S

Contrst x-ray uppr gi tract
0276
1.5319
$90.91
$36.36
$18.1874247
S

Contrst x-ray uppr gi tract
0276
1.5319
$90.91
$36.36
$18.1874249
S

Contrst x-ray uppr gi tract
0277
2.3852
$141.54
$56.61
$28.3174250
S

X-ray exam of small bowel
0276
1.5319
$90.91
$36.36
$18.1874251
S

X-ray exam of small bowel
0277
2.3852
$141.54
$56.61
$28.3174260
S

X-ray exam of small bowel
0277
2.3852
$141.54
$56.61
$28.3174270
S

Contrast x-ray exam of colon
0276
1.5319
$90.91
$36.36
$18.1874280
S

Contrast x-ray exam of colon
0277
2.3852
$141.54
$56.61
$28.3174283
S

Contrast x-ray exam of colon
0276
1.5319
$90.91
$36.36
$18.1874290
S

Contrast x-ray, gallbladder
0276
1.5319
$90.91
$36.36
$18.1874291
S

Contrast x-rays, gallbladder
0276
1.5319
$90.91
$36.36
$18.1874300
X

X-ray bile ducts/pancreas
0263
1.7476
$103.71
$24.40
$20.7474301
X

X-rays at surgery add-on
0263
1.7476
$103.71
$24.40
$20.7474305
X

X-ray bile ducts/pancreas
0263
1.7476
$103.71
$24.40
$20.7474320
X

Contrast x-ray of bile ducts
0264
3.524
$209.12
$79.41
$41.8274327
S

X-ray bile stone removal
0296
2.2452
$133.24
$53.29
$26.6574328
N

X-ray bile duct endoscopy74329
N

X-ray for pancreas endoscopy74330
N

X-ray bile/panc endoscopy74340
X

X-ray guide for GI tube
0272
1.3801
$81.90
$32.76
$16.3874350
X

X-ray guide, stomach tube
0263
1.7476
$103.71
$24.40
$20.7474355
X

X-ray guide, intestinal tube
0263
1.7476
$103.71
$24.40
$20.7474360
S

X-ray guide, GI dilation
0296
2.2452
$133.24
$53.29
$26.6574363
S

X-ray, bile duct dilation
0297
5.253
$311.73
$122.13
$62.3574400
S

Contrst x-ray, urinary tract
0278
2.6434
$156.87
$62.74
$31.3774410
S

Contrst x-ray, urinary tract
0278
2.6434
$156.87
$62.74
$31.3774415
S

Contrst x-ray, urinary tract
0278
2.6434
$156.87
$62.74
$31.3774420
S

Contrst x-ray, urinary tract
0278
2.6434
$156.87
$62.74
$31.3774425
S

Contrst x-ray, urinary tract
0278
2.6434
$156.87
$62.74
$31.3774430
S

Contrast x-ray, bladder
0278
2.6434
$156.87
$62.74
$31.3774440
S

X-ray, male genital tract
0278
2.6434
$156.87
$62.74
$31.3774445
S

X-ray exam of penis
0278
2.6434
$156.87
$62.74
$31.3774450
S

X-ray, urethra/bladder
0278
2.6434
$156.87
$62.74
$31.3774455
S

X-ray, urethra/bladder
0278
2.6434
$156.87
$62.74
$31.3774470
X

X-ray exam of kidney lesion
0263
1.7476
$103.71
$24.40
$20.7474475
S

X-ray control, cath insert
0297
5.253
$311.73
$122.13
$62.3574480
S

X-ray control, cath insert
0296
2.2452
$133.24
$53.29
$26.6574485
S

X-ray guide, GU dilation
0296
2.2452
$133.24
$53.29
$26.6574710
X

X-ray measurement of pelvis
0261
1.2901
$76.56

$15.3174740
X

X-ray, female genital tract
0264
3.524
$209.12
$79.41
$41.8274742
X

X-ray, fallopian tube
0264
3.524
$209.12
$79.41
$41.8274775
S

X-ray exam of perineum
0278
2.6434
$156.87
$62.74
$31.3775552
S

Heart mri for morph w/o dye
0336
6.0742
$360.46
$144.18
$72.0975553
S

Heart mri for morph w/dye
0284
6.4201
$380.99
$152.39
$76.2075554
S

Cardiac MRI/function
0336
6.0742
$360.46
$144.18
$72.0975555
S

Cardiac MRI/limited study
0336
6.0742
$360.46
$144.18
$72.0975556
E

Cardiac MRI/flow mapping75600
S

Contrast x-ray exam of aorta
0280
20.7902
$1,233.75
$353.85
$246.7575605
S

Contrast x-ray exam of aorta
0280
20.7902
$1,233.75
$353.85
$246.7575625
S

Contrast x-ray exam of aorta
0280
20.7902
$1,233.75
$353.85
$246.7575630
S

X-ray aorta, leg arteries
0280
20.7902
$1,233.75
$353.85
$246.7575635*
S

Ct angio abdominal arteries
0662
5.1621
$306.33
$122.53
$61.2775650
S

Artery x-rays, head & neck
0280
20.7902
$1,233.75
$353.85
$246.7575658
S

Artery x-rays, arm
0279
8.9319
$530.05
$150.03
$106.0175660
S

Artery x-rays, head & neck
0668
6.5024
$385.87
$114.67
$77.1775662
S

Artery x-rays, head & neck
0280
20.7902
$1,233.75
$353.85
$246.7575665
S

Artery x-rays, head & neck
0280
20.7902
$1,233.75
$353.85
$246.7575671
S

Artery x-rays, head & neck
0280
20.7902
$1,233.75
$353.85
$246.7575676
S

Artery x-rays, neck
0280
20.7902
$1,233.75
$353.85
$246.7575680
S

Artery x-rays, neck
0280
20.7902
$1,233.75
$353.85
$246.7575685
S

Artery x-rays, spine
0280
20.7902
$1,233.75
$353.85
$246.7575705
S

Artery x-rays, spine
0668
6.5024
$385.87
$114.67
$77.1775710
S

Artery x-rays, arm/leg
0280
20.7902
$1,233.75
$353.85
$246.7575716
S

Artery x-rays, arms/legs
0280
20.7902
$1,233.75
$353.85
$246.7575722
S

Artery x-rays, kidney
0280
20.7902
$1,233.75
$353.85
$246.75( print page 50786)75724
S

Artery x-rays, kidneys
0280
20.7902
$1,233.75
$353.85
$246.7575726
S

Artery x-rays, abdomen
0280
20.7902
$1,233.75
$353.85
$246.7575731
S

Artery x-rays, adrenal gland
0280
20.7902
$1,233.75
$353.85
$246.7575733
S

Artery x-rays, adrenals
0668
6.5024
$385.87
$114.67
$77.1775736
S

Artery x-rays, pelvis
0280
20.7902
$1,233.75
$353.85
$246.7575741
S

Artery x-rays, lung
0279
8.9319
$530.05
$150.03
$106.0175743
S

Artery x-rays, lungs
0280
20.7902
$1,233.75
$353.85
$246.7575746
S

Artery x-rays, lung
0279
8.9319
$530.05
$150.03
$106.0175756
S

Artery x-rays, chest
0279
8.9319
$530.05
$150.03
$106.0175774
S

Artery x-ray, each vessel
0279
8.9319
$530.05
$150.03
$106.0175790
S

Visualize A-V shunt
0279
8.9319
$530.05
$150.03
$106.0175801
X

Lymph vessel x-ray, arm/leg
0264
3.524
$209.12
$79.41
$41.8275803
X

Lymph vessel x-ray,arms/legs
0264
3.524
$209.12
$79.41
$41.8275805
X

Lymph vessel x-ray, trunk
0264
3.524
$209.12
$79.41
$41.8275807
X

Lymph vessel x-ray, trunk
0264
3.524
$209.12
$79.41
$41.8275809
X

Nonvascular shunt, x-ray
0263
1.7476
$103.71
$24.40
$20.7475810
S

Vein x-ray, spleen/liver
0279
8.9319
$530.05
$150.03
$106.0175820
S

Vein x-ray, arm/leg
0668
6.5024
$385.87
$114.67
$77.1775822
S

Vein x-ray, arms/legs
0668
6.5024
$385.87
$114.67
$77.1775825
S

Vein x-ray, trunk
0279
8.9319
$530.05
$150.03
$106.0175827
S

Vein x-ray, chest
0279
8.9319
$530.05
$150.03
$106.0175831
S

Vein x-ray, kidney
0279
8.9319
$530.05
$150.03
$106.0175833
S

Vein x-ray, kidneys
0279
8.9319
$530.05
$150.03
$106.0175840
S

Vein x-ray, adrenal gland
0280
20.7902
$1,233.75
$353.85
$246.7575842
S

Vein x-ray, adrenal glands
0280
20.7902
$1,233.75
$353.85
$246.7575860
S

Vein x-ray, neck
0668
6.5024
$385.87
$114.67
$77.1775870
S

Vein x-ray, skull
0668
6.5024
$385.87
$114.67
$77.1775872
S

Vein x-ray, skull
0279
8.9319
$530.05
$150.03
$106.0175880
S

Vein x-ray, eye socket
0668
6.5024
$385.87
$114.67
$77.1775885
S

Vein x-ray, liver
0280
20.7902
$1,233.75
$353.85
$246.7575887
S

Vein x-ray, liver
0279
8.9319
$530.05
$150.03
$106.0175889
S

Vein x-ray, liver
0280
20.7902
$1,233.75
$353.85
$246.7575891
S

Vein x-ray, liver
0279
8.9319
$530.05
$150.03
$106.0175893
N

Venous sampling by catheter75894
S

X-rays, transcath therapy
0297
5.253
$311.73
$122.13
$62.3575896
S

X-rays, transcath therapy
0297
5.253
$311.73
$122.13
$62.3575898
X

Follow-up angiography
0263
1.7476
$103.71
$24.40
$20.7475900
C

Arterial catheter exchange75901
X

Remove cva device obstruct
0263
1.7476
$103.71
$24.40
$20.7475902
X

Remove cva lumen obstruct
0263
1.7476
$103.71
$24.40
$20.7475940
S

X-ray placement, vein filter
0297
5.253
$311.73
$122.13
$62.3575945
S

Intravascular us
0267
2.6327
$156.23
$62.18
$31.2575946
S

Intravascular us add-on
0266
1.6393
$97.28
$38.91
$19.4675952
C

Endovasc repair abdom aorta75953
C

Abdom aneurysm endovas rpr75954
C

Iliac aneurysm endovas rpr75960
S

Transcatheter intro, stent
0668
6.5024
$385.87
$114.67
$77.1775961
S

Retrieval, broken catheter
0668
6.5024
$385.87
$114.67
$77.1775962
S

Repair arterial blockage
0668
6.5024
$385.87
$114.67
$77.1775964
S

Repair artery blockage, each
0668
6.5024
$385.87
$114.67
$77.1775966
S

Repair arterial blockage
0668
6.5024
$385.87
$114.67
$77.1775968
S

Repair artery blockage, each
0668
6.5024
$385.87
$114.67
$77.1775970
S

Vascular biopsy
0668
6.5024
$385.87
$114.67
$77.1775978
S

Repair venous blockage
0668
6.5024
$385.87
$114.67
$77.1775980
S

Contrast xray exam bile duct
0297
5.253
$311.73
$122.13
$62.3575982
S

Contrast xray exam bile duct
0297
5.253
$311.73
$122.13
$62.3575984
X

Xray control catheter change
0263
1.7476
$103.71
$24.40
$20.7475989
N

Abscess drainage under x-ray75992
S

Atherectomy, x-ray exam
0279
8.9319
$530.05
$150.03
$106.0175993
S

Atherectomy, x-ray exam
0279
8.9319
$530.05
$150.03
$106.0175994
S

Atherectomy, x-ray exam
0279
8.9319
$530.05
$150.03
$106.0175995
S

Atherectomy, x-ray exam
0279
8.9319
$530.05
$150.03
$106.0175996
S

Atherectomy, x-ray exam
0279
8.9319
$530.05
$150.03
$106.0175998
N

Fluoroguide for vein device76000
X

Fluoroscope examination
0272
1.3801
$81.90
$32.76
$16.3876001
N

Fluoroscope exam, extensive( print page 50787)76003
N

Needle localization by x-ray76005
N

Fluoroguide for spine inject76006
X

X-ray stress view
0260
0.7555
$44.83
$17.93
$8.9776010
X

X-ray, nose to rectum
0260
0.7555
$44.83
$17.93
$8.9776012
S

Percut vertebroplasty fluor
0274
3.0413
$180.48
$72.19
$36.1076013
S

Percut vertebroplasty, ct
0274
3.0413
$180.48
$72.19
$36.1076020
X

X-rays for bone age
0260
0.7555
$44.83
$17.93
$8.9776040
X

X-rays, bone evaluation
0261
1.2901
$76.56

$15.3176061
X

X-rays, bone survey
0261
1.2901
$76.56

$15.3176062
X

X-rays, bone survey
0261
1.2901
$76.56

$15.3176065
X

X-rays, bone evaluation
0261
1.2901
$76.56

$15.3176066
X

Joint survey, single view
0260
0.7555
$44.83
$17.93
$8.9776070
S

CT scan, bone density study
0288
1.2568
$74.58

$14.9276071
S

Ct bone density, peripheral
0282
1.6542
$98.17
$39.26
$19.6376075
S

Dexa, axial skeleton study
0288
1.2568
$74.58

$14.9276076
S

Dexa, peripheral study
0665
0.6464
$38.36

$7.6776077
X

Dxa bone density/v-fracture
0260
0.7555
$44.83
$17.93
$8.9776078
X

Radiographic absorptiometry
0260
0.7555
$44.83
$17.93
$8.9776080
X

X-ray exam of fistula
0263
1.7476
$103.71
$24.40
$20.7476082
A

Computer mammogram add-on76083
A

Computer mammogram add-on76086
X

X-ray of mammary duct
0263
1.7476
$103.71
$24.40
$20.7476088
X

X-ray of mammary ducts
0263
1.7476
$103.71
$24.40
$20.7476090
A

Mammogram, one breast76091
A

Mammogram, both breasts76092
A

Mammogram, screening76093
E

Magnetic image, breast76094
E

Magnetic image, both breasts76095
X

Stereotactic breast biopsy
0264
3.524
$209.12
$79.41
$41.8276096
X

X-ray of needle wire, breast
0263
1.7476
$103.71
$24.40
$20.7476098
X

X-ray exam, breast specimen
0260
0.7555
$44.83
$17.93
$8.9776100
X

X-ray exam of body section
0261
1.2901
$76.56

$15.3176101
X

Complex body section x-ray
0263
1.7476
$103.71
$24.40
$20.7476102
X

Complex body section x-rays
0264
3.524
$209.12
$79.41
$41.8276120
X

Cine/video x-rays
0272
1.3801
$81.90
$32.76
$16.3876125
X

Cine/video x-rays add-on
0260
0.7555
$44.83
$17.93
$8.9776140
E

X-ray consultation76150
X

X-ray exam, dry process
0260
0.7555
$44.83
$17.93
$8.9776350
N

Special x-ray contrast study76355
S

Ct scan for localization
0283
4.4253
$262.61
$105.04
$52.5276360
S

Ct scan for needle biopsy
0283
4.4253
$262.61
$105.04
$52.5276362
S

Ct guide for tissue ablation
0332
3.2694
$194.02
$77.60
$38.8076370
S

Ct scan for therapy guide
0282
1.6542
$98.17
$39.26
$19.6376375
S

3d/holograph reconstr add-on
0282
1.6542
$98.17
$39.26
$19.6376380
S

CAT scan follow-up study
0282
1.6542
$98.17
$39.26
$19.6376390
E

Mr spectroscopy76393
S

Mr guidance for needle place
0335
5.1581
$306.10
$122.43
$61.2276394
S

Mri for tissue ablation
0335
5.1581
$306.10
$122.43
$61.2276400
S

Magnetic image, bone marrow
0335
5.1581
$306.10
$122.43
$61.2276496
X

Fluoroscopic procedure
0272
1.3801
$81.90
$32.76
$16.3876497
S

Ct procedure
0282
1.6542
$98.17
$39.26
$19.6376498
S

Mri procedure
0335
5.1581
$306.10
$122.43
$61.2276499
X

Radiographic procedure
0260
0.7555
$44.83
$17.93
$8.9776506
S

Echo exam of head
0265
1.0213
$60.61
$24.24
$12.1276510
S

Ophth us, b & quant a
0266
1.6393
$97.28
$38.91
$19.4676511
S

Echo exam of eye
0266
1.6393
$97.28
$38.91
$19.4676512
S

Echo exam of eye
0266
1.6393
$97.28
$38.91
$19.4676513
S

Echo exam of eye, water bath
0266
1.6393
$97.28
$38.91
$19.4676514
X

Echo exam of eye, thickness
0340
0.6384
$37.88

$7.5876516
S

Echo exam of eye
0265
1.0213
$60.61
$24.24
$12.1276519
S

Echo exam of eye
0266
1.6393
$97.28
$38.91
$19.4676529
S

Echo exam of eye
0265
1.0213
$60.61
$24.24
$12.1276536
S

Us exam of head and neck
0266
1.6393
$97.28
$38.91
$19.4676604*
S

Us exam, chest, b-scan
0266
1.6393
$97.28
$38.91
$19.4676645*
S

Us exam, breast(s)
0265
1.0213
$60.61
$24.24
$12.1276700*
S

Us exam, abdom, complete
0266
1.6393
$97.28
$38.91
$19.46( print page 50788)76705*
S

Echo exam of abdomen
0266
1.6393
$97.28
$38.91
$19.4676770*
S

Us exam abdo back wall, comp
0266
1.6393
$97.28
$38.91
$19.4676775*
S

Us exam abdo back wall, lim
0266
1.6393
$97.28
$38.91
$19.4676778*
S

Us exam kidney transplant
0266
1.6393
$97.28
$38.91
$19.4676800
S

Us exam, spinal canal
0266
1.6393
$97.28
$38.91
$19.4676801
S

Ob us < 14 wks, single fetus
0266
1.6393
$97.28
$38.91
$19.4676802
S

Ob us < 14 wks, add'l fetus
0265
1.0213
$60.61
$24.24
$12.1276805
S

Us exam, pg uterus, compl
0266
1.6393
$97.28
$38.91
$19.4676810
S

Us exam, pg uterus, mult
0266
1.6393
$97.28
$38.91
$19.4676811
S

Ob us, detailed, sngl fetus
0267
2.6327
$156.23
$62.18
$31.2576812
S

Ob us, detailed, addl fetus
0266
1.6393
$97.28
$38.91
$19.4676815
S

Us exam, pg uterus limit
0265
1.0213
$60.61
$24.24
$12.1276816
S

Us exam pg uterus repeat
0265
1.0213
$60.61
$24.24
$12.1276817
S

Transvaginal us, obstetric
0266
1.6393
$97.28
$38.91
$19.4676818
S

Fetal biophys profile w/nst
0266
1.6393
$97.28
$38.91
$19.4676819
S

Fetal biophys profil w/o nst
0266
1.6393
$97.28
$38.91
$19.4676820
S

Umbilical artery echo
0096
1.6307
$96.77
$38.70
$19.3576821
S

Middle cerebral artery echo
0096
1.6307
$96.77
$38.70
$19.3576825
S

Echo exam of fetal heart
0671
1.7028
$101.05
$40.42
$20.2176826
S

Echo exam of fetal heart
0697
1.5357
$91.13
$36.45
$18.2376827
S

Echo exam of fetal heart
0671
1.7028
$101.05
$40.42
$20.2176828
S

Echo exam of fetal heart
0697
1.5357
$91.13
$36.45
$18.2376830*
S

Transvaginal us, non-ob
0266
1.6393
$97.28
$38.91
$19.4676831*
S

Echo exam, uterus
0267
2.6327
$156.23
$62.18
$31.2576856*
S

Us exam, pelvic, complete
0266
1.6393
$97.28
$38.91
$19.4676857*
S

Us exam, pelvic, limited
0265
1.0213
$60.61
$24.24
$12.1276870
S

Us exam, scrotum
0266
1.6393
$97.28
$38.91
$19.4676872
S

Us, transrectal
0266
1.6393
$97.28
$38.91
$19.4676873
S

Echograp trans r, pros study
0266
1.6393
$97.28
$38.91
$19.4676880
S

Us exam, extremity
0266
1.6393
$97.28
$38.91
$19.4676885
S

Us exam infant hips, dynamic
0265
1.0213
$60.61
$24.24
$12.1276886
S

Us exam infant hips, static
0266
1.6393
$97.28
$38.91
$19.4676930
S

Echo guide, cardiocentesis
0268
1.061
$62.96

$12.5976932
S

Echo guide for heart biopsy
0268
1.061
$62.96

$12.5976936
S

Echo guide for artery repair
0268
1.061
$62.96

$12.5976937
N

Us guide, vascular access76940
S

Us guide, tissue ablation
0268
1.061
$62.96

$12.5976941
S

Echo guide for transfusion
0268
1.061
$62.96

$12.5976942
S

Echo guide for biopsy
0268
1.061
$62.96

$12.5976945
S

Echo guide, villus sampling
0268
1.061
$62.96

$12.5976946
S

Echo guide for amniocentesis
0268
1.061
$62.96

$12.5976948
S

Echo guide, ova aspiration
0268
1.061
$62.96

$12.5976950
S

Echo guidance radiotherapy
0268
1.061
$62.96

$12.5976965
S

Echo guidance radiotherapy
0268
1.061
$62.96

$12.5976970
S

Ultrasound exam follow-up
0265
1.0213
$60.61
$24.24
$12.1276975
S

GI endoscopic ultrasound
0266
1.6393
$97.28
$38.91
$19.4676977
X

Us bone density measure
0340
0.6384
$37.88

$7.5876986
S

Ultrasound guide intraoper
0266
1.6393
$97.28
$38.91
$19.4676999
S

Echo examination procedure
0265
1.0213
$60.61
$24.24
$12.1277261
E

Radiation therapy planning77262
E

Radiation therapy planning77263
E

Radiation therapy planning77280
X

Set radiation therapy field
0304
1.7738
$105.26
$41.52
$21.0577285
X

Set radiation therapy field
0305
4.0036
$237.59
$91.38
$47.5277290
X

Set radiation therapy field
0305
4.0036
$237.59
$91.38
$47.5277295
X

Set radiation therapy field
0310
13.949
$827.78
$325.27
$165.5677299
E

Radiation therapy planning77300
X

Radiation therapy dose plan
0304
1.7738
$105.26
$41.52
$21.0577301
X

Radiotherapy dose plan, imrt
0310
13.949
$827.78
$325.27
$165.5677305
X

Teletx isodose plan simple
0304
1.7738
$105.26
$41.52
$21.0577310
X

Teletx isodose plan intermed
0305
4.0036
$237.59
$91.38
$47.5277315
X

Teletx isodose plan complex
0305
4.0036
$237.59
$91.38
$47.5277321
X

Special teletx port plan
0305
4.0036
$237.59
$91.38
$47.5277326
X

Radiation therapy dose plan
0304
1.7738
$105.26
$41.52
$21.0577327
X

Brachytx isodose calc interm
0305
4.0036
$237.59
$91.38
$47.5277328
X

Brachytx isodose plan compl
0305
4.0036
$237.59
$91.38
$47.52( print page 50789)77331
X

Special radiation dosimetry
0304
1.7738
$105.26
$41.52
$21.0577332
X

Radiation treatment aid(s)
0303
2.8356
$168.27
$66.95
$33.6577333
X

Radiation treatment aid(s)
0303
2.8356
$168.27
$66.95
$33.6577334
X

Radiation treatment aid(s)
0303
2.8356
$168.27
$66.95
$33.6577336
X

Radiation physics consult
0304
1.7738
$105.26
$41.52
$21.0577370
X

Radiation physics consult
0304
1.7738
$105.26
$41.52
$21.0577399
X

External radiation dosimetry
0304
1.7738
$105.26
$41.52
$21.0577401
S

Radiation treatment delivery
0300
1.5198
$90.19

$18.0477402
S

Radiation treatment delivery
0300
1.5198
$90.19

$18.0477403
S

Radiation treatment delivery
0300
1.5198
$90.19

$18.0477404
S

Radiation treatment delivery
0300
1.5198
$90.19

$18.0477406
S

Radiation treatment delivery
0300
1.5198
$90.19

$18.0477407
S

Radiation treatment delivery
0300
1.5198
$90.19

$18.0477408
S

Radiation treatment delivery
0300
1.5198
$90.19

$18.0477409
S

Radiation treatment delivery
0300
1.5198
$90.19

$18.0477411
S

Radiation treatment delivery
0301
2.2195
$131.71

$26.3477412
S

Radiation treatment delivery
0301
2.2195
$131.71

$26.3477413
S

Radiation treatment delivery
0301
2.2195
$131.71

$26.3477414
S

Radiation treatment delivery
0301
2.2195
$131.71

$26.3477416
S

Radiation treatment delivery
0301
2.2195
$131.71

$26.3477417
X

Radiology port film(s)
0260
0.7555
$44.83
$17.93
$8.9777418
S

Radiation tx delivery, imrt
0412
5.3643
$318.33

$63.6777427
E

Radiation tx management, x577431
E

Radiation therapy management77432
E

Stereotactic radiation trmt77470
S

Special radiation treatment
0299
5.8482
$347.05

$69.4177499
E

Radiation therapy management77520
S

Proton trmt, simple w/o comp
0664
12.9439
$768.13

$153.6377522
S

Proton trmt, simple w/comp
0664
12.9439
$768.13

$153.6377523
S

Proton trmt, intermediate
0667
15.4857
$918.97

$183.7977525
S

Proton treatment, complex
0667
15.4857
$918.97

$183.7977600
S

Hyperthermia treatment
0314
5.9945
$355.73
$98.36
$71.1577605
S

Hyperthermia treatment
0314
5.9945
$355.73
$98.36
$71.1577610
S

Hyperthermia treatment
0314
5.9945
$355.73
$98.36
$71.1577615
S

Hyperthermia treatment
0314
5.9945
$355.73
$98.36
$71.1577620
S

Hyperthermia treatment
0314
5.9945
$355.73
$98.36
$71.1577750
S

Infuse radioactive materials
0301
2.2195
$131.71

$26.3477761
S

Apply intrcav radiat simple
0312
5.0032
$296.90

$59.3877762
S

Apply intrcav radiat interm
0312
5.0032
$296.90

$59.3877763
S

Apply intrcav radiat compl
0312
5.0032
$296.90

$59.3877776
S

Apply interstit radiat simpl
0312
5.0032
$296.90

$59.3877777
S

Apply interstit radiat inter
0312
5.0032
$296.90

$59.3877778
S

Apply interstit radiat compl
0651
12.1448
$720.71

$144.1477781
S

High intensity brachytherapy
0313
12.8655
$763.48

$152.7077782
S

High intensity brachytherapy
0313
12.8655
$763.48

$152.7077783
S

High intensity brachytherapy
0313
12.8655
$763.48

$152.7077784
S

High intensity brachytherapy
0313
12.8655
$763.48

$152.7077789
S

Apply surface radiation
0300
1.5198
$90.19

$18.0477790
N

Radiation handling77799
S

Radium/radioisotope therapy
0313
12.8655
$763.48

$152.7078000
S

Thyroid, single uptake
0389
1.4976
$88.87
$35.54
$17.7778001
S

Thyroid, multiple uptakes
0389
1.4976
$88.87
$35.54
$17.7778003
S

Thyroid suppress/stimul
0389
1.4976
$88.87
$35.54
$17.7778006
S

Thyroid imaging with uptake
0390
2.5562
$151.69
$60.67
$30.3478007
S

Thyroid image, mult uptakes
0391
2.8774
$170.75
$68.30
$34.1578010
S

Thyroid imaging
0390
2.5562
$151.69
$60.67
$30.3478011
S

Thyroid imaging with flow
0390
2.5562
$151.69
$60.67
$30.3478015
S

Thyroid met imaging
0406
4.3035
$255.38
$102.15
$51.0878016
S

Thyroid met imaging/studies
0406
4.3035
$255.38
$102.15
$51.0878018
S

Thyroid met imaging, body
0406
4.3035
$255.38
$102.15
$51.0878020
S

Thyroid met uptake
0399
1.5192
$90.15
$36.06
$18.0378070
S

Parathyroid nuclear imaging
0391
2.8774
$170.75
$68.30
$34.1578075
S

Adrenal nuclear imaging
0391
2.8774
$170.75
$68.30
$34.1578099
S

Endocrine nuclear procedure
0390
2.5562
$151.69
$60.67
$30.3478102
S

Bone marrow imaging, ltd
0400
4.1335
$245.29
$98.11
$49.0678103
S

Bone marrow imaging, mult
0400
4.1335
$245.29
$98.11
$49.06( print page 50790)78104
S

Bone marrow imaging, body
0400
4.1335
$245.29
$98.11
$49.0678110
S

Plasma volume, single
0393
3.4438
$204.37
$81.74
$40.8778111
S

Plasma volume, multiple
0393
3.4438
$204.37
$81.74
$40.8778120
S

Red cell mass, single
0393
3.4438
$204.37
$81.74
$40.8778121
S

Red cell mass, multiple
0393
3.4438
$204.37
$81.74
$40.8778122
S

Blood volume
0393
3.4438
$204.37
$81.74
$40.8778130
S

Red cell survival study
0393
3.4438
$204.37
$81.74
$40.8778135
S

Red cell survival kinetics
0393
3.4438
$204.37
$81.74
$40.8778140
S

Red cell sequestration
0393
3.4438
$204.37
$81.74
$40.8778160
S

Plasma iron turnover
0393
3.4438
$204.37
$81.74
$40.8778162
S

Radioiron absorption exam
0393
3.4438
$204.37
$81.74
$40.8778170
S

Red cell iron utilization
0393
3.4438
$204.37
$81.74
$40.8778172
S

Total body iron estimation
0393
3.4438
$204.37
$81.74
$40.8778185
S

Spleen imaging
0400
4.1335
$245.29
$98.11
$49.0678190
S

Platelet survival, kinetics
0389
1.4976
$88.87
$35.54
$17.7778191
S

Platelet survival
0389
1.4976
$88.87
$35.54
$17.7778195
S

Lymph system imaging
0400
4.1335
$245.29
$98.11
$49.0678199
S

Blood/lymph nuclear exam
0400
4.1335
$245.29
$98.11
$49.0678201
S

Liver imaging
0394
4.463
$264.85
$105.93
$52.9778202
S

Liver imaging with flow
0394
4.463
$264.85
$105.93
$52.9778205
S

Liver imaging (3D)
0394
4.463
$264.85
$105.93
$52.9778206
S

Liver image (3d) with flow
0394
4.463
$264.85
$105.93
$52.9778215
S

Liver and spleen imaging
0394
4.463
$264.85
$105.93
$52.9778216
S

Liver & spleen image/flow
0394
4.463
$264.85
$105.93
$52.9778220
S

Liver function study
0394
4.463
$264.85
$105.93
$52.9778223
S

Hepatobiliary imaging
0394
4.463
$264.85
$105.93
$52.9778230
S

Salivary gland imaging
0395
3.8699
$229.65
$91.86
$45.9378231
S

Serial salivary imaging
0395
3.8699
$229.65
$91.86
$45.9378232
S

Salivary gland function exam
0395
3.8699
$229.65
$91.86
$45.9378258
S

Esophageal motility study
0395
3.8699
$229.65
$91.86
$45.9378261
S

Gastric mucosa imaging
0395
3.8699
$229.65
$91.86
$45.9378262
S

Gastroesophageal reflux exam
0395
3.8699
$229.65
$91.86
$45.9378264
S

Gastric emptying study
0395
3.8699
$229.65
$91.86
$45.9378267
A

Breath tst attain/anal c-1478268
A

Breath test analysis, c-1478270
S

Vit B-12 absorption exam
0389
1.4976
$88.87
$35.54
$17.7778271
S

Vit b-12 absrp exam, int fac
0389
1.4976
$88.87
$35.54
$17.7778272
S

Vit B-12 absorp, combined
0389
1.4976
$88.87
$35.54
$17.7778278
S

Acute GI blood loss imaging
0395
3.8699
$229.65
$91.86
$45.9378282
S

GI protein loss exam
0395
3.8699
$229.65
$91.86
$45.9378290
S

Meckel's divert exam
0395
3.8699
$229.65
$91.86
$45.9378291
S

Leveen/shunt patency exam
0395
3.8699
$229.65
$91.86
$45.9378299
S

GI nuclear procedure
0395
3.8699
$229.65
$91.86
$45.9378300
S

Bone imaging, limited area
0396
4.1426
$245.83
$98.33
$49.1778305
S

Bone imaging, multiple areas
0396
4.1426
$245.83
$98.33
$49.1778306
S

Bone imaging, whole body
0396
4.1426
$245.83
$98.33
$49.1778315
S

Bone imaging, 3 phase
0396
4.1426
$245.83
$98.33
$49.1778320
S

Bone imaging (3D)
0396
4.1426
$245.83
$98.33
$49.1778350
X

Bone mineral, single photon
0260
0.7555
$44.83
$17.93
$8.9778351
E

Bone mineral, dual photon78399
S

Musculoskeletal nuclear exam
0396
4.1426
$245.83
$98.33
$49.1778414
S

Non-imaging heart function
0398
4.3093
$255.73
$102.29
$51.1578428
S

Cardiac shunt imaging
0398
4.3093
$255.73
$102.29
$51.1578445
S

Vascular flow imaging
0397
2.2646
$134.39
$53.75
$26.8878455
S

Venous thrombosis study
0397
2.2646
$134.39
$53.75
$26.8878456
S

Acute venous thrombus image
0397
2.2646
$134.39
$53.75
$26.8878457
S

Venous thrombosis imaging
0397
2.2646
$134.39
$53.75
$26.8878458
S

Ven thrombosis images, bilat
0397
2.2646
$134.39
$53.75
$26.8878459
S

Heart muscle imaging (PET)
0285
17.1798
$1,019.50
$318.72
$203.9078460
S

Heart muscle blood, single
0398
4.3093
$255.73
$102.29
$51.1578461
S

Heart muscle blood, multiple
0377
6.8344
$405.57
$162.22
$81.1178464
S

Heart image (3d), single
0398
4.3093
$255.73
$102.29
$51.1578465
S

Heart image (3d), multiple
0377
6.8344
$405.57
$162.22
$81.1178466
S

Heart infarct image
0398
4.3093
$255.73
$102.29
$51.1578468
S

Heart infarct image (ef)
0398
4.3093
$255.73
$102.29
$51.1578469
S

Heart infarct image (3D)
0398
4.3093
$255.73
$102.29
$51.15( print page 50791)78472
S

Gated heart, planar, single
0398
4.3093
$255.73
$102.29
$51.1578473
S

Gated heart, multiple
0376
5.1975
$308.44
$121.42
$61.6978478
S

Heart wall motion add-on
0399
1.5192
$90.15
$36.06
$18.0378480
S

Heart function add-on
0399
1.5192
$90.15
$36.06
$18.0378481
S

Heart first pass, single
0398
4.3093
$255.73
$102.29
$51.1578483
S

Heart first pass, multiple
0376
5.1975
$308.44
$121.42
$61.6978491
S

Heart image (pet), single
0285
17.1798
$1,019.50
$318.72
$203.9078492
S

Heart image (pet), multiple
0285
17.1798
$1,019.50
$318.72
$203.9078494
S

Heart image, spect
0398
4.3093
$255.73
$102.29
$51.1578496
S

Heart first pass add-on
0399
1.5192
$90.15
$36.06
$18.0378499
S

Cardiovascular nuclear exam
0398
4.3093
$255.73
$102.29
$51.1578580
S

Lung perfusion imaging
0401
3.415
$202.66
$81.06
$40.5378584
S

Lung V/Q image single breath
0378
5.4997
$326.37
$130.54
$65.2778585
S

Lung V/Q imaging
0378
5.4997
$326.37
$130.54
$65.2778586
S

Aerosol lung image, single
0401
3.415
$202.66
$81.06
$40.5378587
S

Aerosol lung image, multiple
0401
3.415
$202.66
$81.06
$40.5378588
S

Perfusion lung image
0378
5.4997
$326.37
$130.54
$65.2778591
S

Vent image, 1 breath, 1 proj
0401
3.415
$202.66
$81.06
$40.5378593
S

Vent image, 1 proj, gas
0401
3.415
$202.66
$81.06
$40.5378594
S

Vent image, mult proj, gas
0401
3.415
$202.66
$81.06
$40.5378596
S

Lung differential function
0378
5.4997
$326.37
$130.54
$65.2778599
S

Respiratory nuclear exam
0401
3.415
$202.66
$81.06
$40.5378600
S

Brain imaging, ltd static
0402
5.1847
$307.68
$123.07
$61.5478601
S

Brain imaging, ltd w/flow
0402
5.1847
$307.68
$123.07
$61.5478605
S

Brain imaging, complete
0402
5.1847
$307.68
$123.07
$61.5478606
S

Brain imaging, compl w/flow
0402
5.1847
$307.68
$123.07
$61.5478607
S

Brain imaging (3D)
0402
5.1847
$307.68
$123.07
$61.5478608
S

Brain imaging (PET)
1513

$1,150.00

$230.0078609
S

Brain imaging (PET)
1513

$1,150.00

$230.0078610
S

Brain flow imaging only
0402
5.1847
$307.68
$123.07
$61.5478615
S

Cerebral vascular flow image
0402
5.1847
$307.68
$123.07
$61.5478630
S

Cerebrospinal fluid scan
0403
3.6138
$214.45
$85.78
$42.8978635
S

CSF ventriculography
0403
3.6138
$214.45
$85.78
$42.8978645
S

CSF shunt evaluation
0403
3.6138
$214.45
$85.78
$42.8978647
S

Cerebrospinal fluid scan
0403
3.6138
$214.45
$85.78
$42.8978650
S

CSF leakage imaging
0403
3.6138
$214.45
$85.78
$42.8978660
S

Nuclear exam of tear flow
0403
3.6138
$214.45
$85.78
$42.8978699
S

Nervous system nuclear exam
0402
5.1847
$307.68
$123.07
$61.5478700
S

Kidney imaging, static
0267
2.6327
$156.23
$62.18
$31.2578701
S

Kidney imaging with flow
0404
3.8559
$228.82
$91.52
$45.7678704
S

Imaging renogram
0404
3.8559
$228.82
$91.52
$45.7678707
S

Kidney flow/function image
0404
3.8559
$228.82
$91.52
$45.7678708
S

Kidney flow/function image
0405
4.2674
$253.24
$101.29
$50.6578709
S

Kidney flow/function image
0405
4.2674
$253.24
$101.29
$50.6578710
S

Kidney imaging (3D)
0404
3.8559
$228.82
$91.52
$45.7678715
S

Renal vascular flow exam
0404
3.8559
$228.82
$91.52
$45.7678725
S

Kidney function study
0389
1.4976
$88.87
$35.54
$17.7778730
X

Urinary bladder retention
0340
0.6384
$37.88

$7.5878740
S

Ureteral reflux study
0404
3.8559
$228.82
$91.52
$45.7678760
S

Testicular imaging
0404
3.8559
$228.82
$91.52
$45.7678761
S

Testicular imaging/flow
0404
3.8559
$228.82
$91.52
$45.7678799
S

Genitourinary nuclear exam
0404
3.8559
$228.82
$91.52
$45.7678800
S

Tumor imaging, limited area
0406
4.3035
$255.38
$102.15
$51.0878801
S

Tumor imaging, mult areas
0406
4.3035
$255.38
$102.15
$51.0878802
S

Tumor imaging, whole body
0406
4.3035
$255.38
$102.15
$51.0878803
S

Tumor imaging (3D)
0406
4.3035
$255.38
$102.15
$51.0878804
S

Tumor imaging, whole body
1508

$650.00

$130.0078805
S

Abscess imaging, ltd area
0406
4.3035
$255.38
$102.15
$51.0878806
S

Abscess imaging, whole body
0406
4.3035
$255.38
$102.15
$51.0878807
S

Nuclear localization/abscess
0406
4.3035
$255.38
$102.15
$51.0878811
S

Tumor imaging (pet), limited
1513

$1,150.00

$230.0078812
S

Tumor image (pet)/skul-thigh
1513

$1,150.00

$230.0078813
S

Tumor image (pet) full body
1513

$1,150.00

$230.0078814
S

Tumor image pet/ct, limited
1514

$1,250.00

$250.0078815
S

Tumorimage pet/ct skul-thigh
1514

$1,250.00

$250.0078816
S

Tumor image pet/ct full body
1514

$1,250.00

$250.00( print page 50792)78890
N

Nuclear medicine data proc78891
N

Nuclear med data proc78999
S

Nuclear diagnostic exam
0389
1.4976
$88.87
$35.54
$17.7779005
S

Nuclear rx, oral admin
0407
3.9839
$236.42
$94.56
$47.2879101
S

Nuclear rx, iv admin
0407
3.9839
$236.42
$94.56
$47.2879200
S

Intracavitary nuclear trmt
0407
3.9839
$236.42
$94.56
$47.2879300
S

Interstitial nuclear therapy
0407
3.9839
$236.42
$94.56
$47.2879403
S

Hematopoetic nuclear therapy
1507

$550.00

$110.0079440
S

Nuclear joint therapy
0407
3.9839
$236.42
$94.56
$47.2879445
S

Nuclear rx, intra-arterial
0407
3.9839
$236.42
$94.56
$47.2879999
S

Nuclear medicine therapy
0407
3.9839
$236.42
$94.56
$47.2880048
A

Basic metabolic panel80050
E

General health panel80051
A

Electrolyte panel80053
A

Comprehen metabolic panel80055
E

Obstetric panel80061
A

Lipid panel80069
A

Renal function panel80074
A

Acute hepatitis panel80076
A

Hepatic function panel80100
A

Drug screen, qualitate/multi80101
A

Drug screen, single80102
A

Drug confirmation80103
N

Drug analysis, tissue prep80150
A

Assay of amikacin80152
A

Assay of amitriptyline80154
A

Assay of benzodiazepines80156
A

Assay, carbamazepine, total80157
A

Assay, 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 gold80173
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 panel80406
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 panel( print page 50793)80418
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
0433
0.2581
$15.32
$6.12
$3.0680502
X

Lab pathology consultation
0342
0.156
$9.26
$3.70
$1.8581000
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
A

Urinalysis test procedure82000
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, semiquant82045
A

Albumin, ischemia modified82055
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 II( print page 50794)82164
A

Angiotensin I enzyme test82172
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, direct82252
A

Fecal bilirubin test82261
A

Assay of biotinidase82270
A

Test for blood, feces82273
A

Test for blood, other source82274
A

Assay test for blood, fecal82286
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 analysis, qual82360
A

Calculus assay, quant82365
A

Calculus spectroscopy82370
A

X-ray assay, calculus82373
A

Assay, c-d transfer measure82374
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, bld/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 creatine( print page 50795)82541
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 creatinine82570
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 dimethadione82656
A

Pancreatic elastase, fecal82657
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 or 4, each82800
A

Blood pH82803
A

Blood gases pH, pO2 & pCO282805
A

Blood gases W/02 saturation82810
A

Blood gases, O2 sat only82820
A

Hemoglobin-oxygen affinity82926
A

Assay of gastric acid( print page 50796)82928
A

Assay of gastric acid82938
A

Gastrin test82941
A

Assay of gastrin82943
A

Assay of glucagon82945
A

Glucose other fluid82946
A

Glucagon tolerance test82947
A

Assay, glucose, blood 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 glutamine82977
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 guanosine83009
A

H pylori (c-13), blood83010
A

Assay of haptoglobin, quant83012
A

Assay of haptoglobins83013
A

H pylori 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, chemical83033
A

Fetal hemoglobin assay, qual83036
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 histamine83090
A

Assay of 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 insulin( print page 50797)83528
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 enzymes83630
A

Lactoferrin, fecal (qual)83632
A

Placental lactogen83633
A

Test urine for lactose83634
A

Assay of urine for lactose83655
A

Assay of lead83661
A

L/s ratio, fetal lung83662
A

Foam stability, fetal lung83663
A

Fluoro polarize, fetal lung83664
A

Lamellar bdy, fetal lung83670
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 magnesium83775
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 myoglobin83880
A

Natriuretic peptide83883
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

Organic acids, total, quant83919
A

Organic acids, qual, each( print page 50798)83921
A

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 oxalate83950
A

Oncoprotein, her-2/neu83970
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 progesterone84146
A

Assay of prolactin84150
A

Assay of prostaglandin84152
A

Assay of psa, complexed84153
A

Assay of psa, total84154
A

Assay of psa, free84155
A

Assay of protein, serum84156
A

Assay of protein, urine84157
A

Assay of protein, other84160
A

Assay of protein, any source84163
A

Pappa, serum84165
A

Electrophoreisis of proteins84166
A

Protein e-phoresis/urine/csf84181
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 selenium( print page 50799)84260
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 sodium84302
A

Assay of sweat 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/urobilinogen84578
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 a84591
A

Assay of nos vitamin84597
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 assay( print page 50800)84830
A

Ovulation tests84999
A

Clinical chemistry test85002
A

Bleeding time test85004
A

Automated diff wbc count85007
A

Differential WBC count85008
A

Nondifferential WBC count85009
A

Differential WBC count85013
A

Spun microhematocrit85014
A

Hematocrit85018
A

Hemoglobin85025
A

Automated hemogram85027
A

Automated hemogram85032
A

Manual cell count, each85041
A

Red blood cell (RBC) count85044
A

Reticulocyte count85045
A

Reticulocyte count85046
A

Reticyte/hgb concentrate85048
A

White blood cell (WBC) count85049
A

Automated platelet count85055
A

Reticulated platelet assay85060
B

Blood smear interpretation85097
X

Bone marrow interpretation
0343
0.4786
$28.40
$11.10
$5.6885130
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 test85307
A

Assay activated protein c85335
A

Factor inhibitor test85337
A

Thrombomodulin85345
A

Coagulation time85347
A

Coagulation time85348
A

Coagulation time85360
A

Euglobulin lysis85362
A

Fibrin degradation products85366
A

Fibrinogen test85370
A

Fibrinogen test85378
A

Fibrin degradation85379
A

Fibrin degradation, quant85380
A

Fibrin degradation, vte85384
A

Fibrinogen85385
A

Fibrinogen85390
A

Fibrinolysins screen85396
N

Clotting assay, whole blood85400
A

Fibrinolytic plasmin85410
A

Fibrinolytic antiplasmin( print page 50801)85415
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

Heparin neutralization85530
A

Heparin-protamine tolerance85536
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 aggregation85597
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
A

Hematology procedure86000
A

Agglutinins, febrile86001
A

Allergen specific igg86003
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, screen86064
A

B cells, total count86077
X

Physician blood bank service
0433
0.2581
$15.32
$6.12
$3.0686078
X

Physician blood bank service
0343
0.4786
$28.40
$11.10
$5.6886079
X

Physician blood bank service
0433
0.2581
$15.32
$6.12
$3.0686140
A

C-reactive protein86141
A

C-reactive protein, hs86146
A

Glycoprotein 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 antibody86226
A

DNA antibody, single strand86235
A

Nuclear antigen antibody( print page 50802)86243
A

Fc receptor86255
A

Fluorescent antibody, screen86256
A

Fluorescent antibody, titer86277
A

Growth hormone antibody86280
A

Hemagglutination inhibition86294
A

Immunoassay, tumor, qual86300
A

Immunoassay, tumor, ca 15-386301
A

Immunoassay, tumor, ca 19-986304
A

Immunoassay, tumor, ca 12586308
A

Heterophile antibodies86309
A

Heterophile antibodies86310
A

Heterophile antibodies86316
A

Immunoassay, tumor other86317
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 procedure86335
A

Immunfix e-phorsis/urine/csf86336
A

Inhibin A86337
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 factor86379
A

Nk cells, total count86382
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
0.1112
$6.60
$2.62
$1.3286490
X

Coccidioidomycosis skin test
0341
0.1112
$6.60
$2.62
$1.3286510
X

Histoplasmosis skin test
0341
0.1112
$6.60
$2.62
$1.3286580
X

TB intradermal test
0341
0.1112
$6.60
$2.62
$1.3286585
X

TB tine test
0341
0.1112
$6.60
$2.62
$1.3286586
X

Skin test, unlisted
0341
0.1112
$6.60
$2.62
$1.3286587
A

Stem cells, total count86590
A

Streptokinase, antibody86592
A

Blood serology, qualitative86593
A

Blood serology, quantitative86602
A

Antinomyces antibody86603
A

Adenovirus antibody86606
A

Aspergillus antibody86609
A

Bacterium antibody86611
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 antibody( print page 50803)86632
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 antibody86654
A

Encephalitis antibody86658
A

Enterovirus antibody86663
A

Epstein-barr antibody86664
A

Epstein-barr antibody86665
A

Epstein-barr antibody86666
A

Ehrlichia antibody86668
A

Francisella tularensis86671
A

Fungus antibody86674
A

Giardia lamblia antibody86677
A

Helicobacter pylori86682
A

Helminth antibody86684
A

Hemophilus influenza86687
A

Htlv-i antibody86688
A

Htlv-ii antibody86689
A

HTLV/HIV confirmatory test86692
A

Hepatitis, delta agent86694
A

Herpes simplex test86695
A

Herpes simplex test86696
A

Herpes simplex type 286698
A

Histoplasma86701
A

HIV-186702
A

HIV-286703
A

HIV-1/HIV-2, single assay86704
A

Hep b core antibody, total86705
A

Hep b core antibody, igm86706
A

Hep b surface antibody86707
A

Hep be antibody86708
A

Hep a antibody, total86709
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 antibody86757
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 antibody( print page 50804)86787
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
A

Immunology procedure86850
X

RBC antibody screen
0345
0.2277
$13.51
$3.01
$2.7086860
X

RBC antibody elution
0346
0.3434
$20.38
$4.54
$4.0886870
X

RBC antibody identification
0346
0.3434
$20.38
$4.54
$4.0886880
X

Coombs test, direct
0409
0.1258
$7.47
$2.22
$1.4986885
X

Coombs test, indirect, qual
0409
0.1258
$7.47
$2.22
$1.4986886
X

Coombs test, indirect, titer
0409
0.1258
$7.47
$2.22
$1.4986890
X

Autologous blood process
0347
0.8434
$50.05
$12.35
$10.0186891
X

Autologous blood, op salvage
0346
0.3434
$20.38
$4.54
$4.0886900
X

Blood typing, ABO
0409
0.1258
$7.47
$2.22
$1.4986901
X

Blood typing, Rh (D)
0409
0.1258
$7.47
$2.22
$1.4986903
X

Blood typing, antigen screen
0345
0.2277
$13.51
$3.01
$2.7086904
X

Blood typing, patient serum
0346
0.3434
$20.38
$4.54
$4.0886905
X

Blood typing, RBC antigens
0345
0.2277
$13.51
$3.01
$2.7086906
X

Blood typing, Rh phenotype
0345
0.2277
$13.51
$3.01
$2.7086910
E

Blood typing, paternity test86911
E

Blood typing, antigen system86920
X

Compatibility test
0346
0.3434
$20.38
$4.54
$4.0886921
X

Compatibility test
0345
0.2277
$13.51
$3.01
$2.7086922
X

Compatibility test
0346
0.3434
$20.38
$4.54
$4.0886927
X

Plasma, fresh frozen
0345
0.2277
$13.51
$3.01
$2.7086930
X

Frozen blood prep
0347
0.8434
$50.05
$12.35
$10.0186931
X

Frozen blood thaw
0347
0.8434
$50.05
$12.35
$10.0186932
X

Frozen blood freeze/thaw
0347
0.8434
$50.05
$12.35
$10.0186940
A

Hemolysins/agglutinins, auto86941
A

Hemolysins/agglutinins86945
X

Blood product/irradiation
0345
0.2277
$13.51
$3.01
$2.7086950
X

Leukacyte transfusion
0345
0.2277
$13.51
$3.01
$2.7086965
X

Pooling blood platelets
0345
0.2277
$13.51
$3.01
$2.7086970
X

RBC pretreatment
0345
0.2277
$13.51
$3.01
$2.7086971
X

RBC pretreatment
0345
0.2277
$13.51
$3.01
$2.7086972
X

RBC pretreatment
0346
0.3434
$20.38
$4.54
$4.0886975
X

RBC pretreatment, serum
0345
0.2277
$13.51
$3.01
$2.7086976
X

RBC pretreatment, serum
0345
0.2277
$13.51
$3.01
$2.7086977
X

RBC pretreatment, serum
0345
0.2277
$13.51
$3.01
$2.7086978
X

RBC pretreatment, serum
0345
0.2277
$13.51
$3.01
$2.7086985
X

Split blood or products
0345
0.2277
$13.51
$3.01
$2.7086999
X

Transfusion procedure
0345
0.2277
$13.51
$3.01
$2.7087001
A

Small animal inoculation87003
A

Small animal inoculation87015
A

Specimen concentration87040
A

Blood culture for bacteria87045
A

Feces culture, bacteria87046
A

Stool cultr, bacteria, each87070
A

Culture, bacteria, other87071
A

Culture bacteri aerobic othr87073
A

Culture bacteria anaerobic87075
A

Cultr bacteria, except blood87076
A

Culture anaerobe ident, each87077
A

Culture aerobic identify( print page 50805)87081
A

Culture screen only87084
A

Culture of specimen by kit87086
A

Urine culture/colony count87088
A

Urine bacteria culture87101
A

Skin fungi culture87102
A

Fungus isolation culture87103
A

Blood fungus culture87106
A

Fungi identification, yeast87107
A

Fungi identification, mold87109
A

Mycoplasma87110
A

Chlamydia culture87116
A

Mycobacteria culture87118
A

Mycobacteric identification87140
A

Culture type immunofluoresc87143
A

Culture typing, glc/hplc87147
A

Culture type, immunologic87149
A

Culture type, nucleic acid87152
A

Culture type pulse field gel87158
A

Culture typing, added method87164
A

Dark field examination87166
A

Dark field examination87168
A

Macroscopic exam arthropod87169
A

Macroscopic exam parasite87172
A

Pinworm exam87176
A

Tissue homogenization, cultr87177
A

Ova and parasites smears87181
A

Microbe susceptible, diffuse87184
A

Microbe susceptible, disk87185
A

Microbe susceptible, enzyme87186
A

Microbe susceptible, mic87187
A

Microbe susceptible, mlc87188
A

Microbe suscept, macrobroth87190
A

Microbe suscept, mycobacteri87197
A

Bactericidal level, serum87205
A

Smear, gram stain87206
A

Smear, fluorescent/acid stai87207
A

Smear, special stain87210
A

Smear, wet mount, saline/ink87220
A

Tissue exam for fungi87230
A

Assay, toxin or antitoxin87250
A

Virus inoculate, eggs/animal87252
A

Virus inoculation, tissue87253
A

Virus inoculate tissue, addl87254
A

Virus inoculation, shell via87255
A

Genet virus isolate, hsv87260
A

Adenovirus ag, if87265
A

Pertussis ag, if87267
A

Enterovirus antibody, dfa87269
A

Giardia ag, if87270
A

Chlamydia trachomatis ag, if87271
A

Cryptosporidum/gardia ag, if87272
A

Cryptosporidium ag, if87273
A

Herpes simplex 2, ag, if87274
A

Herpes simplex 1, ag, if87275
A

Influenza b, ag, if87276
A

Influenza a, ag, if87277
A

Legionella micdadei, ag, if87278
A

Legion pneumophilia ag, if87279
A

Parainfluenza, ag, if87280
A

Respiratory syncytial ag, if87281
A

Pneumocystis carinii, ag, if87283
A

Rubeola, ag, if87285
A

Treponema pallidum, ag, if87290
A

Varicella zoster, ag, if87299
A

Antibody detection, nos, if87300
A

Ag detection, polyval, if( print page 50806)87301
A

Adenovirus ag, eia87320
A

Chylmd trach ag, eia87324
A

Clostridium ag, eia87327
A

Cryptococcus neoform ag, eia87328
A

Cryptosporidium ag, eia87329
A

Giardia ag, eia87332
A

Cytomegalovirus ag, eia87335
A

E coli 0157 ag, eia87336
A

Entamoeb hist dispr, ag, eia87337
A

Entamoeb hist group, ag, eia87338
A

Hpylori, stool, eia87339
A

H pylori ag, eia87340
A

Hepatitis b surface ag, eia87341
A

Hepatitis b surface, ag, eia87350
A

Hepatitis be ag, eia87380
A

Hepatitis delta ag, eia87385
A

Histoplasma capsul ag, eia87390
A

Hiv-1 ag, eia87391
A

Hiv-2 ag, eia87400
A

Influenza a/b, ag, eia87420
A

Resp syncytial ag, eia87425
A

Rotavirus ag, eia87427
A

Shiga-like toxin ag, eia87430
A

Strep a ag, eia87449
A

Ag detect nos, eia, mult87450
A

Ag detect nos, eia, single87451
A

Ag detect polyval, eia, mult87470
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, quant( print page 50807)87537
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, quant87660
A

Trichomonas vagin, dir probe87797
A

Detect agent nos, dna, dir87798
A

Detect agent nos, dna, amp87799
A

Detect agent nos, dna, quant87800
A

Detect agnt mult, dna, direc87801
A

Detect agnt mult, dna, ampli87802
A

Strep b assay w/optic87803
A

Clostridium toxin a w/optic87804
A

Influenza assay w/optic87807
A

Rsv assay w/optic87810
A

Chylmd trach assay w/optic87850
A

N. gonorrhoeae assay w/optic87880
A

Strep a assay w/optic87899
A

Agent nos assay w/optic87901
A

Genotype, dna, hiv reverse t87902
A

Genotype, dna, hepatitis C87903
A

Phenotype, dna hiv w/culture87904
A

Phenotype, dna hiv w/clt add87999
A

Microbiology procedure88000
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
0433
0.2581
$15.32
$6.12
$3.0688106
X

Cytopathology, fluids
0433
0.2581
$15.32
$6.12
$3.0688107
X

Cytopathology, fluids
0433
0.2581
$15.32
$6.12
$3.0688108
X

Cytopath, concentrate tech
0433
0.2581
$15.32
$6.12
$3.06( print page 50808)88112
X

Cytopath, cell enhance tech
0343
0.4786
$28.40
$11.10
$5.6888125
X

Forensic cytopathology
0342
0.156
$9.26
$3.70
$1.8588130
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 redo88147
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
0433
0.2581
$15.32
$6.12
$3.0688161
X

Cytopath smear, other source
0433
0.2581
$15.32
$6.12
$3.0688162
X

Cytopath smear, other source
0433
0.2581
$15.32
$6.12
$3.0688164
A

Cytopath tbs, c/v, manual88165
A

Cytopath tbs, c/v, redo88166
A

Cytopath tbs, c/v, auto redo88167
A

Cytopath tbs, c/v, select88172
X

Cytopathology eval of fna
0343
0.4786
$28.40
$11.10
$5.6888173
X

Cytopath eval, fna, report
0343
0.4786
$28.40
$11.10
$5.6888174
A

Cytopath, c/v auto, in fluid88175
A

Cytopath c/v auto fluid redo88182
X

Cell marker study
0344
0.7996
$47.45
$15.66
$9.4988184
X

Flowcytometry/ tc, 1 marker
0344
0.7996
$47.45
$15.66
$9.4988185
X

Flowcytometry/tc, add-on
0343
0.4786
$28.40
$11.10
$5.6888187
X

Flowcytometry/read, 2-8
0433
0.2581
$15.32
$6.12
$3.0688188
X

Flowcytometry/read, 9-15
0433
0.2581
$15.32
$6.12
$3.0688189
X

Flowcytometry/read, 16 & >
0343
0.4786
$28.40
$11.10
$5.6888199
A

Cytopathology procedure88230
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, 20-2588267
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
0.156
$9.26
$3.70
$1.8588300
X

Surgical path, gross
0433
0.2581
$15.32
$6.12
$3.0688302
X

Tissue exam by pathologist
0433
0.2581
$15.32
$6.12
$3.0688304
X

Tissue exam by pathologist
0343
0.4786
$28.40
$11.10
$5.6888305
X

Tissue exam by pathologist
0343
0.4786
$28.40
$11.10
$5.6888307
X

Tissue exam by pathologist
0344
0.7996
$47.45
$15.66
$9.4988309
X

Tissue exam by pathologist
0344
0.7996
$47.45
$15.66
$9.4988311
X

Decalcify tissue
0342
0.156
$9.26
$3.70
$1.85( print page 50809)88312
X

Special stains
0433
0.2581
$15.32
$6.12
$3.0688313
X

Special stains
0433
0.2581
$15.32
$6.12
$3.0688314
X

Histochemical stain
0342
0.156
$9.26
$3.70
$1.8588318
X

Chemical histochemistry
0433
0.2581
$15.32
$6.12
$3.0688319
X

Enzyme histochemistry
0343
0.4786
$28.40
$11.10
$5.6888321
X

Microslide consultation
0433
0.2581
$15.32
$6.12
$3.0688323
X

Microslide consultation
0343
0.4786
$28.40
$11.10
$5.6888325
X

Comprehensive review of data
0344
0.7996
$47.45
$15.66
$9.4988329
X

Path consult introp
0433
0.2581
$15.32
$6.12
$3.0688331
X

Path consult intraop, 1 bloc
0343
0.4786
$28.40
$11.10
$5.6888332
X

Path consult intraop, add'l
0433
0.2581
$15.32
$6.12
$3.0688342
X

Immunohistochemistry
0343
0.4786
$28.40
$11.10
$5.6888346
X

Immunofluorescent study
0343
0.4786
$28.40
$11.10
$5.6888347
X

Immunofluorescent study
0343
0.4786
$28.40
$11.10
$5.6888348
X

Electron microscopy
0661
3.3775
$200.43
$80.17
$40.0988349
X

Scanning electron microscopy
0661
3.3775
$200.43
$80.17
$40.0988355
X

Analysis, skeletal muscle
0343
0.4786
$28.40
$11.10
$5.6888356
X

Analysis, nerve
0344
0.7996
$47.45
$15.66
$9.4988358
X

Analysis, tumor
0344
0.7996
$47.45
$15.66
$9.4988360
X

Tumor immunohistochem/manual
0344
0.7996
$47.45
$15.66
$9.4988361
X

Immunohistochemistry, tumor
0344
0.7996
$47.45
$15.66
$9.4988362
X

Nerve teasing preparations
0344
0.7996
$47.45
$15.66
$9.4988365
X

Tissue hybridization
0344
0.7996
$47.45
$15.66
$9.4988367
X

Insitu hybridization, auto
0344
0.7996
$47.45
$15.66
$9.4988368
X

Insitu hybridization, manual
0344
0.7996
$47.45
$15.66
$9.4988371
A

Protein, western blot tissue88372
A

Protein analysis w/probe88380
A

Microdissection88399
A

Surgical pathology procedure88400
A

Bilirubin total transcut89050
A

Body fluid cell count89051
A

Body fluid cell count89055
A

Leukocyte assessment, fecal89060
A

Exam,synovial fluid crystals89100
X

Sample intestinal contents
0360
1.4739
$87.47
$34.98
$17.4989105
X

Sample intestinal contents
0360
1.4739
$87.47
$34.98
$17.4989125
A

Specimen fat stain89130
X

Sample stomach contents
0360
1.4739
$87.47
$34.98
$17.4989132
X

Sample stomach contents
0360
1.4739
$87.47
$34.98
$17.4989135
X

Sample stomach contents
0360
1.4739
$87.47
$34.98
$17.4989136
X

Sample stomach contents
0360
1.4739
$87.47
$34.98
$17.4989140
X

Sample stomach contents
0360
1.4739
$87.47
$34.98
$17.4989141
X

Sample stomach contents
0360
1.4739
$87.47
$34.98
$17.4989160
A

Exam feces for meat fibers89190
A

Nasal smear for eosinophils89220
X

Sputum specimen collection
0343
0.4786
$28.40
$11.10
$5.6889225
A

Starch granules, feces89230
X

Collect sweat for test
0433
0.2581
$15.32
$6.12
$3.0689235
A

Water load test89240
A

Pathology lab procedure89250
X

Cultr oocyte/embryo <4 days
0348
0.7927
$47.04

$9.4189251
X

Cultr oocyte/embryo <4 days
0348
0.7927
$47.04

$9.4189253
X

Embryo hatching
0348
0.7927
$47.04

$9.4189254
X

Oocyte identification
0348
0.7927
$47.04

$9.4189255
X

Prepare embryo for transfer
0348
0.7927
$47.04

$9.4189257
X

Sperm identification
0348
0.7927
$47.04

$9.4189258
X

Cryopreservation embryo(s)
0348
0.7927
$47.04

$9.4189259
X

Cryopreservation, sperm
0348
0.7927
$47.04

$9.4189260
X

Sperm isolation, simple
0348
0.7927
$47.04

$9.4189261
X

Sperm isolation, complex
0348
0.7927
$47.04

$9.4189264
X

Identify sperm tissue
0348
0.7927
$47.04

$9.4189268
X

Insemination of oocytes
0348
0.7927
$47.04

$9.4189272
X

Extended culture of oocytes
0348
0.7927
$47.04

$9.4189280
X

Assist oocyte fertilization
0348
0.7927
$47.04

$9.4189281
X

Assist oocyte fertilization
0348
0.7927
$47.04

$9.4189290
X

Biopsy, oocyte polar body
0348
0.7927
$47.04

$9.41( print page 50810)89291
X

Biopsy, oocyte polar body
0348
0.7927
$47.04

$9.4189300
A

Semen analysis w/huhner89310
A

Semen analysis89320
A

Semen analysis, complete89321
A

Semen analysis & motility89325
A

Sperm antibody test89329
A

Sperm evaluation test89330
A

Evaluation, cervical mucus89335
X

Cryopreserve testicular tiss
0348
0.7927
$47.04

$9.4189342
X

Storage/year embryo(s)
0348
0.7927
$47.04

$9.4189343
X

Storage/year sperm/semen
0348
0.7927
$47.04

$9.4189344
X

Storage/year reprod tissue
0348
0.7927
$47.04

$9.4189346
X

Storage/year oocyte
0348
0.7927
$47.04

$9.4189352
X

Thawing cryopresrved embryo
0348
0.7927
$47.04

$9.4189353
X

Thawing cryopresrved sperm
0348
0.7927
$47.04

$9.4189354
X

Thaw cryoprsvrd reprod tiss
0348
0.7927
$47.04

$9.4189356
X

Thawing cryopresrved oocyte
0348
0.7927
$47.04

$9.4190281
E

Human ig, im90283
E

Human ig, iv90287
E

Botulinum antitoxin90288
E

Botulism ig, iv90291
E

Cmv ig, iv90296
N

Diphtheria antitoxin90371
E

Hep b ig, im90375
K

Rabies ig, im/sc
9133

$64.56

$12.9190376
K

Rabies ig, heat treated
9134

$69.79

$13.9690378
E

Rsv ig, im, 50mg90379
E

Rsv ig, iv90384
E

Rh ig, full-dose, im90385
N

Rh ig, minidose, im90386
E

Rh ig, iv90389
E

Tetanus ig, im90393
N

Vaccina ig, im90396
K

Varicella-zoster ig, im
9135

$96.58

$19.3290399
E

Immune globulin90465
B

Immune admin 1 inj, < 8 yrs90466
B

Immune admin addl inj, < 8 y90467
B

Immune admin o or n, < 8 yrs90468
B

Immune admin o/n, addl < 8 y90471
X

Immunization admin
0353
0.3954
$23.46

$4.6990472
X

Immunization admin, each add
0353
0.3954
$23.46

$4.6990473
S

Immune admin oral/nasal
1491

$5.00

$1.0090474
S

Immune admin oral/nasal addl
1491

$5.00

$1.0090476
K

Adenovirus vaccine, type 4
9136
0.9499
$56.37

$11.2790477
N

Adenovirus vaccine, type 790581
K

Anthrax vaccine, sc
9169

$128.95

$25.7990585
K

Bcg vaccine, percut
9137

$124.54

$24.9190586
B

Bcg vaccine, intravesical90632
N

Hep a vaccine, adult im90633
N

Hep a vacc, ped/adol, 2 dose90634
N

Hep a vacc, ped/adol, 3 dose90636
K

Hep a/hep b vacc, adult im
9138
0.9674
$57.41

$11.4890645
N

Hib vaccine, hboc, im90646
N

Hib vaccine, prp-d, im90647
N

Hib vaccine, prp-omp, im90648
N

Hib vaccine, prp-t, im90655
L

Flu vaccine, 6-35 mo, im90656
L

Flu vaccine no preserv 3 & >90657
L

Flu vaccine, 6-35 mo, im90658
L

Flu vaccine, 3 yrs, im90660
E

Flu vaccine, nasal90665
N

Lyme disease vaccine, im90669
E

Pneumococcal vacc, ped <590675
K

Rabies vaccine, im
9139

$128.04

$25.6190676
K

Rabies vaccine, id
9140
1.4959
$88.77

$17.7590680
N

Rotovirus vaccine, oral( print page 50811)90690
N

Typhoid vaccine, oral90691
N

Typhoid vaccine, im90692
N

Typhoid vaccine, h-p, sc/id90693
N

Typhoid vaccine, akd, sc90698
N

Dtap-hib-ip vaccine, im90700
N

Dtap vaccine, im90701
N

Dtp vaccine, im90702
N

Dt vaccine < 7, im90703
N

Tetanus vaccine, im90704
N

Mumps vaccine, sc90705
N

Measles vaccine, sc90706
N

Rubella vaccine, sc90707
N

Mmr vaccine, sc90708
K

Measles-rubella vaccine, sc
9141
0.9467
$56.18

$11.2490710
N

Mmrv vaccine, sc90712
N

Oral poliovirus vaccine90713
N

Poliovirus, ipv, sc90715
N

Tdap vaccine >7 im90716
K

Chicken pox vaccine, sc
9142

$64.29

$12.8690717
N

Yellow fever vaccine, sc90718
N

Td vaccine > 7, im90719
N

Diphtheria vaccine, im90720
N

Dtp/hib vaccine, im90721
N

Dtap/hib vaccine, im90723
E

Dtap-hep b-ipv vaccine, im90725
N

Cholera vaccine, injectable90727
N

Plague vaccine, im90732
L

Pneumococcal vaccine90733
K

Meningococcal vaccine, sc
9143

$56.75

$11.3590734
K

Meningococcal vaccine, im
9145
0.8948
$53.10

$10.6290735
K

Encephalitis vaccine, sc
9144

$67.73

$13.5590740
F

Hepb vacc, ill pat 3 dose im90743
F

Hep b vacc, adol, 2 dose, im90744
F

Hepb vacc ped/adol 3 dose im90746
F

Hep b vaccine, adult, im90747
F

Hepb vacc, ill pat 4 dose im90748
E

Hep b/hib vaccine, im90749
N

Vaccine toxoid90780
S

IV infusion therapy, 1 hour
0120
2.0193
$119.83
$28.21
$23.9790781
N

IV infusion, additional hour90782
X

Injection, sc/im
0353
0.3954
$23.46

$4.6990783
X

Injection, ia
0359
0.8312
$49.33

$9.8790784
X

Injection, iv
0359
0.8312
$49.33

$9.8790788
X

Injection of antibiotic
0359
0.8312
$49.33

$9.8790799
X

Ther/prophylactic/dx inject
0352
0.1413
$8.39

$1.6890801
S

Psy dx interview
0323
1.6227
$96.30
$20.08
$19.2690802
S

Intac psy dx interview
0323
1.6227
$96.30
$20.08
$19.2690804
S

Psytx, office, 20-30 min
0322
1.2319
$73.10

$14.6290805
S

Psytx, off, 20-30 min w/e&m
0322
1.2319
$73.10

$14.6290806
S

Psytx, off, 45-50 min
0323
1.6227
$96.30
$20.08
$19.2690807
S

Psytx, off, 45-50 min w/e&m
0323
1.6227
$96.30
$20.08
$19.2690808
S

Psytx, office, 75-80 min
0323
1.6227
$96.30
$20.08
$19.2690809
S

Psytx, off, 75-80, w/e&m
0323
1.6227
$96.30
$20.08
$19.2690810
S

Intac psytx, off, 20-30 min
0322
1.2319
$73.10

$14.6290811
S

Intac psytx, 20-30, w/e&m
0322
1.2319
$73.10

$14.6290812
S

Intac psytx, off, 45-50 min
0323
1.6227
$96.30
$20.08
$19.2690813
S

Intac psytx, 45-50 min w/e&m
0323
1.6227
$96.30
$20.08
$19.2690814
S

Intac psytx, off, 75-80 min
0323
1.6227
$96.30
$20.08
$19.2690815
S

Intac psytx, 75-80 w/e&m
0323
1.6227
$96.30
$20.08
$19.2690816
S

Psytx, hosp, 20-30 min
0322
1.2319
$73.10

$14.6290817
S

Psytx, hosp, 20-30 min w/e&m
0322
1.2319
$73.10

$14.6290818
S

Psytx, hosp, 45-50 min
0323
1.6227
$96.30
$20.08
$19.2690819
S

Psytx, hosp, 45-50 min w/e&m
0323
1.6227
$96.30
$20.08
$19.2690821
S

Psytx, hosp, 75-80 min
0323
1.6227
$96.30
$20.08
$19.2690822
S

Psytx, hosp, 75-80 min w/e&m
0323
1.6227
$96.30
$20.08
$19.2690823
S

Intac psytx, hosp, 20-30 min
0322
1.2319
$73.10

$14.62( print page 50812)90824
S

Intac psytx, hsp 20-30 w/e&m
0322
1.2319
$73.10

$14.6290826
S

Intac psytx, hosp, 45-50 min
0323
1.6227
$96.30
$20.08
$19.2690827
S

Intac psytx, hsp 45-50 w/e&m
0323
1.6227
$96.30
$20.08
$19.2690828
S

Intac psytx, hosp, 75-80 min
0323
1.6227
$96.30
$20.08
$19.2690829
S

Intac psytx, hsp 75-80 w/e&m
0323
1.6227
$96.30
$20.08
$19.2690845
S

Psychoanalysis
0323
1.6227
$96.30
$20.08
$19.2690846
S

Family psytx w/o patient
0324
2.0997
$124.60

$24.9290847
S

Family psytx w/patient
0324
2.0997
$124.60

$24.9290849
S

Multiple family group psytx
0325
1.3189
$78.27
$17.10
$15.6590853
S

Group psychotherapy
0325
1.3189
$78.27
$17.10
$15.6590857
S

Intac group psytx
0325
1.3189
$78.27
$17.10
$15.6590862
X

Medication management
0374
1.0414
$61.80

$12.3690865
S

Narcosynthesis
0323
1.6227
$96.30
$20.08
$19.2690870
S

Electroconvulsive therapy
0320
5.3765
$319.06
$80.06
$63.8190871
E

Electroconvulsive therapy90875
E

Psychophysiological therapy90876
E

Psychophysiological therapy90880
S

Hypnotherapy
0323
1.6227
$96.30
$20.08
$19.2690882
E

Environmental manipulation90885
N

Psy evaluation of records90887
N

Consultation with family90889
N

Preparation of report90899
S

Psychiatric service/therapy
0322
1.2319
$73.10

$14.6290901
A

Biofeedback train, any meth90911
S

Biofeedback peri/uro/rectal
0321
1.3579
$80.58
$21.71
$16.1290918
E

ESRD related services, month90919
E

ESRD related services, month90920
E

ESRD related services, month90921
E

ESRD related services, month90922
E

ESRD related services, day90923
E

Esrd related services, day90924
E

Esrd related services, day90925
E

Esrd related services, day90935
S

Hemodialysis, one evaluation
0170
5.8994
$350.09

$70.0290937
E

Hemodialysis, repeated eval90939
N

Hemodialysis study, transcut90940
N

Hemodialysis access study90945
S

Dialysis, one evaluation
0170
5.8994
$350.09

$70.0290947
E

Dialysis, repeated eval90989
B

Dialysis training, complete90993
B

Dialysis training, incompl90997
E

Hemoperfusion90999
B

Dialysis procedure91000
X

Esophageal intubation
0361
3.6216
$214.92
$83.23
$42.9891010
X

Esophagus motility study
0361
3.6216
$214.92
$83.23
$42.9891011
X

Esophagus motility study
0361
3.6216
$214.92
$83.23
$42.9891012
X

Esophagus motility study
0361
3.6216
$214.92
$83.23
$42.9891020
X

Gastric motility
0361
3.6216
$214.92
$83.23
$42.9891030
X

Acid perfusion of esophagus
0361
3.6216
$214.92
$83.23
$42.9891034
X

Gastroesophageal reflux test
0361
3.6216
$214.92
$83.23
$42.9891035
S

G-esoph reflx tst w/electrod
1506

$450.00

$90.0091037
X

Esoph imped function test
0361
3.6216
$214.92
$83.23
$42.9891038
X

Esoph imped funct test > 1h
0361
3.6216
$214.92
$83.23
$42.9891040
X

Esoph balloon distension tst
0360
1.4739
$87.47
$34.98
$17.4991052
X

Gastric analysis test
0361
3.6216
$214.92
$83.23
$42.9891055
X

Gastric intubation for smear
0360
1.4739
$87.47
$34.98
$17.4991060
X

Gastric saline load test
0360
1.4739
$87.47
$34.98
$17.4991065
X

Breath hydrogen test
0360
1.4739
$87.47
$34.98
$17.4991100
X

Pass intestine bleeding tube
0360
1.4739
$87.47
$34.98
$17.4991105
X

Gastric intubation treatment
0360
1.4739
$87.47
$34.98
$17.4991110
T

Gi tract capsule endoscopy
0142
9.3487
$554.78
$152.78
$110.9691120
T

Rectal sensation test
0156
2.5751
$152.81
$40.52
$30.5691122
T

Anal pressure record
0156
2.5751
$152.81
$40.52
$30.5691123
N

Irrigate fecal impaction91132
X

Electrogastrography
0360
1.4739
$87.47
$34.98
$17.4991133
X

Electrogastrography w/test
0360
1.4739
$87.47
$34.98
$17.49( print page 50813)91299
X

Gastroenterology procedure
0360
1.4739
$87.47
$34.98
$17.4992002
V

Eye exam, new patient
0601
1.0038
$59.57

$11.9192004
V

Eye exam, new patient
0601
1.0038
$59.57

$11.9192012
V

Eye exam established pat
0600
0.8688
$51.56

$10.3192014
V

Eye exam & treatment
0601
1.0038
$59.57

$11.9192015
E

Refraction92018
T

New eye exam & treatment
0699
10.0177
$594.48

$118.9092019
T

Eye exam & treatment
0699
10.0177
$594.48

$118.9092020
S

Special eye evaluation
0230
0.7858
$46.63
$14.97
$9.3392060
S

Special eye evaluation
0230
0.7858
$46.63
$14.97
$9.3392065
S

Orthoptic/pleoptic training
0698
1.2438
$73.81
$16.55
$14.7692070
N

Fitting of contact lens92081
S

Visual field examination(s)
0230
0.7858
$46.63
$14.97
$9.3392082
S

Visual field examination(s)
0230
0.7858
$46.63
$14.97
$9.3392083
S

Visual field examination(s)
0230
0.7858
$46.63
$14.97
$9.3392100
N

Serial tonometry exam(s)92120
S

Tonography & eye evaluation
0230
0.7858
$46.63
$14.97
$9.3392130
S

Water provocation tonography
0230
0.7858
$46.63
$14.97
$9.3392135
S

Opthalmic dx imaging
0230
0.7858
$46.63
$14.97
$9.3392136
S

Ophthalmic biometry
0698
1.2438
$73.81
$16.55
$14.7692140
S

Glaucoma provocative tests
0698
1.2438
$73.81
$16.55
$14.7692225
S

Special eye exam, initial
0230
0.7858
$46.63
$14.97
$9.3392226
S

Special eye exam, subsequent
0230
0.7858
$46.63
$14.97
$9.3392230
T

Eye exam with photos
0699
10.0177
$594.48

$118.9092235
S

Eye exam with photos
0231
1.9278
$114.40
$44.61
$22.8892240
S

Icg angiography
0231
1.9278
$114.40
$44.61
$22.8892250
S

Eye exam with photos
0230
0.7858
$46.63
$14.97
$9.3392260
S

Ophthalmoscopy/dynamometry
0698
1.2438
$73.81
$16.55
$14.7692265
S

Eye muscle evaluation
0230
0.7858
$46.63
$14.97
$9.3392270
S

Electro-oculography
0230
0.7858
$46.63
$14.97
$9.3392275
S

Electroretinography
0231
1.9278
$114.40
$44.61
$22.8892283
S

Color vision examination
0230
0.7858
$46.63
$14.97
$9.3392284
S

Dark adaptation eye exam
0698
1.2438
$73.81
$16.55
$14.7692285
S

Eye photography
0230
0.7858
$46.63
$14.97
$9.3392286
S

Internal eye photography
0698
1.2438
$73.81
$16.55
$14.7692287
S

Internal eye photography
0698
1.2438
$73.81
$16.55
$14.7692310
E

Contact lens fitting92311
X

Contact lens fitting
0362
2.6607
$157.89

$31.5892312
X

Contact lens fitting
0362
2.6607
$157.89

$31.5892313
X

Contact lens fitting
0362
2.6607
$157.89

$31.5892314
E

Prescription of contact lens92315
X

Prescription of contact lens
0362
2.6607
$157.89

$31.5892316
X

Prescription of contact lens
0362
2.6607
$157.89

$31.5892317
X

Prescription of contact lens
0362
2.6607
$157.89

$31.5892325
X

Modification of contact lens
0362
2.6607
$157.89

$31.5892326
X

Replacement of contact lens
0362
2.6607
$157.89

$31.5892330
S

Fitting of artificial eye
0230
0.7858
$46.63
$14.97
$9.3392335
N

Fitting of artificial eye92340
E

Fitting of spectacles92341
E

Fitting of spectacles92342
E

Fitting of spectacles92352
X

Special spectacles fitting
0362
2.6607
$157.89

$31.5892353
X

Special spectacles fitting
0362
2.6607
$157.89

$31.5892354
X

Special spectacles fitting
0362
2.6607
$157.89

$31.5892355
X

Special spectacles fitting
0362
2.6607
$157.89

$31.5892358
X

Eye prosthesis service
0362
2.6607
$157.89

$31.5892370
E

Repair & adjust spectacles92371
X

Repair & adjust spectacles
0362
2.6607
$157.89

$31.5892390
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
0.7858
$46.63
$14.97
$9.3392502
T

Ear and throat examination
0251
2.0101
$119.29

$23.86( print page 50814)92504
N

Ear microscopy examination92506
A

Speech/hearing evaluation92507
A

Speech/hearing therapy92508
A

Speech/hearing therapy92510
E

Rehab for ear implant92511
T

Nasopharyngoscopy
0071
0.7915
$46.97
$11.31
$9.3992512
X

Nasal function studies
0363
0.9128
$54.17
$17.44
$10.8392516
X

Facial nerve function test
0660
1.6419
$97.44
$30.66
$19.4992520
X

Laryngeal function studies
0660
1.6419
$97.44
$30.66
$19.4992526
A

Oral function therapy92531
N

Spontaneous nystagmus study92532
N

Positional nystagmus test92533
N

Caloric vestibular test92534
N

Optokinetic nystagmus test92541
X

Spontaneous nystagmus test
0363
0.9128
$54.17
$17.44
$10.8392542
X

Positional nystagmus test
0363
0.9128
$54.17
$17.44
$10.8392543
X

Caloric vestibular test
0660
1.6419
$97.44
$30.66
$19.4992544
X

Optokinetic nystagmus test
0363
0.9128
$54.17
$17.44
$10.8392545
X

Oscillating tracking test
0363
0.9128
$54.17
$17.44
$10.8392546
X

Sinusoidal rotational test
0660
1.6419
$97.44
$30.66
$19.4992547
X

Supplemental electrical test
0363
0.9128
$54.17
$17.44
$10.8392548
X

Posturography
0660
1.6419
$97.44
$30.66
$19.4992551
E

Pure tone hearing test, air92552
X

Pure tone audiometry, air
0364
0.4708
$27.94
$9.06
$5.5992553
X

Audiometry, air & bone
0365
1.2356
$73.32
$18.95
$14.6692555
X

Speech threshold audiometry
0364
0.4708
$27.94
$9.06
$5.5992556
X

Speech audiometry, complete
0364
0.4708
$27.94
$9.06
$5.5992557
X

Comprehensive hearing test
0365
1.2356
$73.32
$18.95
$14.6692559
E

Group audiometric testing92560
E

Bekesy audiometry, screen92561
X

Bekesy audiometry, diagnosis
0364
0.4708
$27.94
$9.06
$5.5992562
X

Loudness balance test
0364
0.4708
$27.94
$9.06
$5.5992563
X

Tone decay hearing test
0364
0.4708
$27.94
$9.06
$5.5992564
X

Sisi hearing test
0364
0.4708
$27.94
$9.06
$5.5992565
X

Stenger test, pure tone
0364
0.4708
$27.94
$9.06
$5.5992567
X

Tympanometry
0364
0.4708
$27.94
$9.06
$5.5992568
X

Acoustic reflex testing
0364
0.4708
$27.94
$9.06
$5.5992569
X

Acoustic reflex decay test
0364
0.4708
$27.94
$9.06
$5.5992571
X

Filtered speech hearing test
0364
0.4708
$27.94
$9.06
$5.5992572
X

Staggered spondaic word test
0365
1.2356
$73.32
$18.95
$14.6692573
X

Lombard test
0364
0.4708
$27.94
$9.06
$5.5992575
X

Sensorineural acuity test
0364
0.4708
$27.94
$9.06
$5.5992576
X

Synthetic sentence test
0364
0.4708
$27.94
$9.06
$5.5992577
X

Stenger test, speech
0366
1.7743
$105.29
$30.04
$21.0692579
X

Visual audiometry (vra)
0365
1.2356
$73.32
$18.95
$14.6692582
X

Conditioning play audiometry
0365
1.2356
$73.32
$18.95
$14.6692583
X

Select picture audiometry
0364
0.4708
$27.94
$9.06
$5.5992584
X

Electrocochleography
0660
1.6419
$97.44
$30.66
$19.4992585
S

Auditor evoke potent, compre
0216
2.672
$158.56

$31.7192586
S

Auditor evoke potent, limit
0218
1.1408
$67.70

$13.5492587
X

Evoked auditory test
0363
0.9128
$54.17
$17.44
$10.8392588
X

Evoked auditory test
0363
0.9128
$54.17
$17.44
$10.8392590
E

Hearing aid exam, one ear92591
E

Hearing aid exam, both ears92592
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
0364
0.4708
$27.94
$9.06
$5.5992597
A

Voice Prosthetic Evaluation92601
X

Cochlear implt f/up exam < 7
0366
1.7743
$105.29
$30.04
$21.0692602
X

Reprogram cochlear implt < 7
0366
1.7743
$105.29
$30.04
$21.0692603
X

Cochlear implt f/up exam 7 >
0366
1.7743
$105.29
$30.04
$21.0692604
X

Reprogram cochlear implt 7 >
0366
1.7743
$105.29
$30.04
$21.0692605
A

Eval for nonspeech device rx92606
A

Non-speech device service( print page 50815)92607
A

Ex for speech device rx, 1hr92608
A

Ex for speech device rx addl92609
A

Use of speech device service92610
A

Evaluate swallowing function92611
A

Motion fluoroscopy/swallow92612
A

Endoscopy swallow tst (fees)92613
E

Endoscopy swallow tst (fees)92614
A

Laryngoscopic sensory test92615
E

Eval laryngoscopy sense tst92616
A

Fees w/laryngeal sense test92617
E

Interprt fees/laryngeal test92620
X

Auditory function, 60 min
0364
0.4708
$27.94
$9.06
$5.5992621
N

Auditory function, + 15 min92625
X

Tinnitus assessment
0364
0.4708
$27.94
$9.06
$5.5992700
X

Ent procedure/service
0364
0.4708
$27.94
$9.06
$5.5992950
S

Heart/lung resuscitation cpr
0094
2.5363
$150.51
$47.62
$30.1092953
S

Temporary external pacing
0094
2.5363
$150.51
$47.62
$30.1092960
S

Cardioversion electric, ext
0679
5.5774
$330.98
$95.30
$66.2092961
S

Cardioversion, electric, int
0679
5.5774
$330.98
$95.30
$66.2092970
C

Cardioassist, internal92971
C

Cardioassist, external92973
T

Percut coronary thrombectomy
0676
2.4105
$143.05

$28.6192974
T

Cath place, cardio brachytx
0103
14.7142
$873.18
$223.63
$174.6492975
C

Dissolve clot, heart vessel92977
T

Dissolve clot, heart vessel
0676
2.4105
$143.05

$28.6192978
S

Intravasc us, heart add-on
0670
25.4131
$1,508.09
$472.46
$301.6292979
S

Intravasc us, heart add-on
0416
19.5542
$1,160.40

$232.0892980
T

Insert intracoronary stent
0104
79.0094
$4,688.65

$937.7392981
T

Insert intracoronary stent
0104
79.0094
$4,688.65

$937.7392982
T

Coronary artery dilation
0083
50.8925
$3,020.11

$604.0292984
T

Coronary artery dilation
0083
50.8925
$3,020.11

$604.0292986
T

Revision of aortic valve
0083
50.8925
$3,020.11

$604.0292987
T

Revision of mitral valve
0083
50.8925
$3,020.11

$604.0292990
T

Revision of pulmonary valve
0083
50.8925
$3,020.11

$604.0292992
C

Revision of heart chamber92993
C

Revision of heart chamber92995
T

Coronary atherectomy
0082
85.0126
$5,044.90
$1,085.20
$1,008.9892996
T

Coronary atherectomy add-on
0082
85.0126
$5,044.90
$1,085.20
$1,008.9892997
T

Pul art balloon repr, percut
0081
34.4473
$2,044.21

$408.8492998
T

Pul art balloon repr, percut
0081
34.4473
$2,044.21

$408.8493000
B

Electrocardiogram, complete93005
S

Electrocardiogram, tracing
0099
0.3821
$22.67

$4.5393010
A

Electrocardiogram report93012
N

Transmission of ecg93014
B

Report on transmitted ecg93015
B

Cardiovascular stress test93016
B

Cardiovascular stress test93017
X

Cardiovascular stress test
0100
2.4968
$148.17
$41.44
$29.6393018
B

Cardiovascular stress test93024
X

Cardiac drug stress test
0100
2.4968
$148.17
$41.44
$29.6393025
X

Microvolt t-wave assess
0100
2.4968
$148.17
$41.44
$29.6393040
B

Rhythm ECG with report93041
S

Rhythm ECG, tracing
0099
0.3821
$22.67

$4.5393042
B

Rhythm ECG, report93224
B

ECG monitor/report, 24 hrs93225
X

ECG monitor/record, 24 hrs
0097
1.0223
$60.67
$23.79
$12.1393226
X

ECG monitor/report, 24 hrs
0097
1.0223
$60.67
$23.79
$12.1393227
B

ECG monitor/review, 24 hrs93230
B

ECG monitor/report, 24 hrs93231
X

Ecg monitor/record, 24 hrs
0097
1.0223
$60.67
$23.79
$12.1393232
X

ECG monitor/report, 24 hrs
0097
1.0223
$60.67
$23.79
$12.1393233
B

ECG monitor/review, 24 hrs93235
B

ECG monitor/report, 24 hrs93236
X

ECG monitor/report, 24 hrs
0097
1.0223
$60.67
$23.79
$12.1393237
B

ECG monitor/review, 24 hrs93268
B

ECG record/review( print page 50816)93270
X

ECG recording
0097
1.0223
$60.67
$23.79
$12.1393271
X

Ecg/monitoring and analysis
0097
1.0223
$60.67
$23.79
$12.1393272
B

Ecg/review, interpret only93278
S

ECG/signal-averaged
0099
0.3821
$22.67

$4.5393303
S

Echo transthoracic
0269
3.2437
$192.49
$76.99
$38.5093304
S

Echo transthoracic
0697
1.5357
$91.13
$36.45
$18.2393307
S

Echo exam of heart
0269
3.2437
$192.49
$76.99
$38.5093308
S

Echo exam of heart
0697
1.5357
$91.13
$36.45
$18.2393312
S

Echo transesophageal
0270
6.0192
$357.20
$142.88
$71.4493313
S

Echo transesophageal
0270
6.0192
$357.20
$142.88
$71.4493314
N

Echo transesophageal93315
S

Echo transesophageal
0270
6.0192
$357.20
$142.88
$71.4493316
S

Echo transesophageal
0270
6.0192
$357.20
$142.88
$71.4493317
N

Echo transesophageal93318
S

Echo transesophageal intraop
0270
6.0192
$357.20
$142.88
$71.4493320
S

Doppler echo exam, heart
0671
1.7028
$101.05
$40.42
$20.2193321
S

Doppler echo exam, heart
0697
1.5357
$91.13
$36.45
$18.2393325
S

Doppler color flow add-on
0697
1.5357
$91.13
$36.45
$18.2393350
S

Echo transthoracic
0269
3.2437
$192.49
$76.99
$38.5093501
T

Right heart catheterization
0080
37.1361
$2,203.77
$838.92
$440.7593503
T

Insert/place heart catheter
0103
14.7142
$873.18
$223.63
$174.6493505
T

Biopsy of heart lining
0103
14.7142
$873.18
$223.63
$174.6493508
T

Cath placement, angiography
0080
37.1361
$2,203.77
$838.92
$440.7593510
T

Left heart catheterization
000
37.1361
$2,203.77
$838.92
$440.7593511
T

Left heart catheterization
0080
37.1361
$2,203.77
$838.92
$440.7593514
T

Left heart catheterization
0080
37.1361
$2,203.77
$838.92
$440.7593524
T

Left heart catheterization
0080
37.1361
$2,203.77
$838.92
$440.7593526
T

Rt & Lt heart catheters
0080
37.1361
$2,203.77
$838.92
$440.7593527
T

Rt & Lt heart catheters
0080
37.1361
$2,203.77
$838.92
$440.7593528
T

Rt & Lt heart catheters
0080
37.1361
$2,203.77
$838.92
$440.7593529
T

Rt, lt heart catheterization
0080
37.1361
$2,203.77
$838.92
$440.7593530
T

Rt heart cath, congenital
0080
37.1361
$2,203.77
$838.92
$440.7593531
T

R & l heart cath, congenital
0080
37.1361
$2,203.77
$838.92
$440.7593532
T

R & l heart cath, congenital
0080
37.1361
$2,203.77
$838.92
$440.7593533
T

R & l heart cath, congenital
0080
37.1361
$2,203.77
$838.92
$440.7593539
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
S

Heart flow reserve measure
0670
25.4131
$1,508.09
$472.46
$301.6293572
S

Heart flow reserve measure
0416
19.5542
$1,160.40

$232.0893580
T

Transcath closure of asd
0434
90.7877
$5,387.61

$1,077.5293581
T

Transcath closure of vsd
0434
90.7877
$5,387.61

$1,077.5293600
T

Bundle of His recording
0087
30.7101
$1,822.43

$364.4993602
T

Intra-atrial recording
0087
30.7101
$1,822.43

$364.4993603
T

Right ventricular recording
0087
30.7101
$1,822.43

$364.4993609
T

Map tachycardia, add-on
0087
30.7101
$1,822.43

$364.4993610
T

Intra-atrial pacing
0087
30.7101
$1,822.43

$364.4993612
T

Intraventricular pacing
0087
30.7101
$1,822.43

$364.4993613
T

Electrophys map 3d, add-on
0087
30.7101
$1,822.43

$364.4993615
T

Esophageal recording
0087
30.7101
$1,822.43

$364.4993616
T

Esophageal recording
0087
30.7101
$1,822.43

$364.4993618
T

Heart rhythm pacing
0087
30.7101
$1,822.43

$364.4993619
T

Electrophysiology evaluation
0085
35.1882
$2,088.17
$426.25
$417.6393620
T

Electrophysiology evaluation
0085
35.1882
$2,088.17
$426.25
$417.6393621
T

Electrophysiology evaluation
0085
35.1882
$2,088.17
$426.25
$417.6393622
T

Electrophysiology evaluation
0085
35.1882
$2,088.17
$426.25
$417.6393623
T

Stimulation, pacing heart
0087
30.7101
$1,822.43

$364.4993624
T

Electrophysiologic study
0085
35.1882
$2,088.17
$426.25
$417.63( print page 50817)93631
T

Heart pacing, mapping
0087
30.7101
$1,822.43

$364.4993640
S

Evaluation heart device
0084
10.0205
$594.65

$118.9393641
S

Electrophysiology evaluation
0084
10.0205
$594.65

$118.9393642
S

Electrophysiology evaluation
0084
10.0205
$594.65

$118.9393650
T

Ablate heart dysrhythm focus
0086
44.2596
$2,626.50
$833.33
$525.3093651
T

Ablate heart dysrhythm focus
0086
44.2596
$2,626.50
$833.33
$525.3093652
T

Ablate heart dysrhythm focus
0086
44.2596
$2,626.50
$833.33
$525.3093660
S

Tilt table evaluation
0101
4.2787
$253.91
$101.56
$50.7893662
S

Intracardiac ecg (ice)
0670
25.4131
$1,508.09
$472.46
$301.6293668
E

Peripheral vascular rehab93701
S

Bioimpedance, thoracic
0099
0.3821
$22.67

$4.5393720
B

Total body plethysmography93721
X

Plethysmography tracing
0368
0.9761
$57.92
$23.16
$11.5893722
B

Plethysmography report93724
S

Analyze pacemaker system
0690
0.3755
$22.28
$8.91
$4.4693727
S

Analyze ilr system
0690
0.3755
$22.28
$8.91
$4.4693731
S

Analyze pacemaker system
0690
0.3755
$22.28
$8.91
$4.4693732
S

Analyze pacemaker system
0690
0.3755
$22.28
$8.91
$4.4693733
S

Telephone analy, pacemaker
0690
0.3755
$22.28
$8.91
$4.4693734
S

Analyze pacemaker system
0690
0.3755
$22.28
$8.91
$4.4693735
S

Analyze pacemaker system
0690
0.3755
$22.28
$8.91
$4.4693736
S

Telephonic analy, pacemaker
0690
0.3755
$22.28
$8.91
$4.4693740
X

Temperature gradient studies
0368
0.9761
$57.92
$23.16
$11.5893741
S

Analyze ht pace device sngl
0689
0.5735
$34.03

$6.8193742
S

Analyze ht pace device sngl
0689
0.5735
$34.03

$6.8193743
S

Analyze ht pace device dual
0689
0.5735
$34.03

$6.8193744
S

Analyze ht pace device dual
0689
0.5735
$34.03

$6.8193745
S

Set-up cardiovert-defibrill
0689
0.5735
$34.03

$6.8193760
E

Cephalic thermogram93762
E

Peripheral thermogram93770
N

Measure venous pressure93784
E

Ambulatory BP monitoring93786
X

Ambulatory BP recording
0097
1.0223
$60.67
$23.79
$12.1393788
X

Ambulatory BP analysis
0097
1.0223
$60.67
$23.79
$12.1393790
B

Review/report BP recording93797
S

Cardiac rehab
0095
0.5885
$34.92
$13.96
$6.9893798
S

Cardiac rehab/monitor
0095
0.5885
$34.92
$13.96
$6.9893799
S

Cardiovascular procedure
0096
1.6307
$96.77
$38.70
$19.3593875
S

Extracranial study
0096
1.6307
$96.77
$38.70
$19.3593880
S

Extracranial study
0267
2.6327
$156.23
$62.18
$31.2593882
S

Extracranial study
0267
2.6327
$156.23
$62.18
$31.2593886
S

Intracranial study
0267
2.6327
$156.23
$62.18
$31.2593888
S

Intracranial study
0266
1.6393
$97.28
$38.91
$19.4693890
S

Tcd, vasoreactivity study
0266
1.6393
$97.28
$38.91
$19.4693892
S

Tcd, emboli detect w/o inj
0266
1.6393
$97.28
$38.91
$19.4693893
S

Tcd, emboli detect w/inj
0266
1.6393
$97.28
$38.91
$19.4693922
S

Extremity study
0096
1.6307
$96.77
$38.70
$19.3593923
S

Extremity study
0096
1.6307
$96.77
$38.70
$19.3593924
S

Extremity study
0096
1.6307
$96.77
$38.70
$19.3593925
S

Lower extremity study
0267
2.6327
$156.23
$62.18
$31.2593926
S

Lower extremity study
0266
1.6393
$97.28
$38.91
$19.4693930
S

Upper extremity study
0267
2.6327
$156.23
$62.18
$31.2593931
S

Upper extremity study
0266
1.6393
$97.28
$38.91
$19.4693965
S

Extremity study
0096
1.6307
$96.77
$38.70
$19.3593970
S

Extremity study
0267
2.6327
$156.23
$62.18
$31.2593971
S

Extremity study
0266
1.6393
$97.28
$38.91
$19.4693975
S

Vascular study
0267
2.6327
$156.23
$62.18
$31.2593976
S

Vascular study
0267
2.6327
$156.23
$62.18
$31.2593978
S

Vascular study
0266
1.6393
$97.28
$38.91
$19.4693979
S

Vascular study
0266
1.6393
$97.28
$38.91
$19.4693980
S

Penile vascular study
0267
2.6327
$156.23
$62.18
$31.2593981
S

Penile vascular study
0266
1.6393
$97.28
$38.91
$19.4693990
S

Doppler flow testing
0266
1.6393
$97.28
$38.91
$19.4694010
X

Breathing capacity test
0368
0.9761
$57.92
$23.16
$11.5894014
X

Patient recorded spirometry
0367
0.6659
$39.52
$14.80
$7.9094015
X

Patient recorded spirometry
0367
0.6659
$39.52
$14.80
$7.90( print page 50818)94016
A

Review patient spirometry94060
X

Evaluation of wheezing
0368
0.9761
$57.92
$23.16
$11.5894070
X

Evaluation of wheezing
0369
2.7519
$163.31
$44.18
$32.6694150
X

Vital capacity test
0367
0.6659
$39.52
$14.80
$7.9094200
X

Lung function test (MBC/MVV)
0367
0.6659
$39.52
$14.80
$7.9094240
X

Residual lung capacity
0368
0.9761
$57.92
$23.16
$11.5894250
X

Expired gas collection
0367
0.6659
$39.52
$14.80
$7.9094260
X

Thoracic gas volume
0367
0.6659
$39.52
$14.80
$7.9094350
X

Lung nitrogen washout curve
0367
0.6659
$39.52
$14.80
$7.9094360
X

Measure airflow resistance
0367
0.6659
$39.52
$14.80
$7.9094370
X

Breath airway closing volume
0367
0.6659
$39.52
$14.80
$7.9094375
X

Respiratory flow volume loop
0367
0.6659
$39.52
$14.80
$7.9094400
X

CO2 breathing response curve
0367
0.6659
$39.52
$14.80
$7.9094450
X

Hypoxia response curve
0368
0.9761
$57.92
$23.16
$11.5894452
X

Hast w/report
0368
0.9761
$57.92
$23.16
$11.5894453
X

Hast w/oxygen titrate
0368
0.9761
$57.92
$23.16
$11.5894620
X

Pulmonary stress test/simple
0368
0.9761
$57.92
$23.16
$11.5894621
X

Pulm stress test/complex
0369
2.7519
$163.31
$44.18
$32.6694640
S

Airway inhalation treatment
0077
0.3444
$20.44
$7.74
$4.0994642
S

Aerosol inhalation treatment
0078
1.0236
$60.74
$14.55
$12.1594656
S

Initial ventilator mgmt
0079
2.3482
$139.35

$27.8794657
S

Continued ventilator mgmt
0079
2.3482
$139.35

$27.8794660
S

Pos airway pressure, CPAP
0068
1.2293
$72.95
$29.18
$14.5994662
S

Neg press ventilation, cnp
0079
2.3482
$139.35

$27.8794664
S

Aerosol or vapor inhalations
0077
0.3444
$20.44
$7.74
$4.0994667
S

Chest wall manipulation
0077
0.3444
$20.44
$7.74
$4.0994668
S

Chest wall manipulation
0077
0.3444
$20.44
$7.74
$4.0994680
X

Exhaled air analysis, o2
0367
0.6659
$39.52
$14.80
$7.9094681
X

Exhaled air analysis, o2/co2
0368
0.9761
$57.92
$23.16
$11.5894690
X

Exhaled air analysis
0368
0.9761
$57.92
$23.16
$11.5894720
X

Monoxide diffusing capacity
0368
0.9761
$57.92
$23.16
$11.5894725
X

Membrane diffusion capacity
0368
0.9761
$57.92
$23.16
$11.5894750
X

Pulmonary compliance study
0368
0.9761
$57.92
$23.16
$11.5894760
N

Measure blood oxygen level94761
N

Measure blood oxygen level94762
N

Measure blood oxygen level94770
X

Exhaled carbon dioxide test
0367
0.6659
$39.52
$14.80
$7.9094772
X

Breath recording, infant
0369
2.7519
$163.31
$44.18
$32.6694799
X

Pulmonary service/procedure
0367
0.6659
$39.52
$14.80
$7.9095004
X

Percut allergy skin tests
0381
0.1884
$11.18
$2.35
$2.2495010
X

Percut allergy titrate test
0381
0.1884
$11.18
$2.35
$2.2495015
X

Id allergy titrate-drug/bug
0381
0.1884
$11.18
$2.35
$2.2495024
X

Id allergy test, drug/bug
0381
0.1884
$11.18
$2.35
$2.2495027
X

Skin end point titration
0381
0.1884
$11.18
$2.35
$2.2495028
X

Id allergy test-delayed type
0381
0.1884
$11.18
$2.35
$2.2495044
X

Allergy patch tests
0381
0.1884
$11.18
$2.35
$2.2495052
X

Photo patch test
0381
0.1884
$11.18
$2.35
$2.2495056
X

Photosensitivity tests
0370
1.1232
$66.65

$13.3395060
X

Eye allergy tests
0370
1.1232
$66.65

$13.3395065
X

Nose allergy test
0381
0.1884
$11.18
$2.35
$2.2495070
X

Bronchial allergy tests
0369
2.7519
$163.31
$44.18
$32.6695071
X

Bronchial allergy tests
0369
2.7519
$163.31
$44.18
$32.6695075
X

Ingestion challenge test
0361
3.6216
$214.92
$83.23
$42.9895078
X

Provocative testing
0370
1.1232
$66.65

$13.3395115
X

Immunotherapy, one injection
0352
0.1413
$8.39

$1.6895117
X

Immunotherapy injections
0353
0.3954
$23.46

$4.6995120
B

Immunotherapy, one injection95125
B

Immunotherapy, many antigens95130
B

Immunotherapy, insect venom95131
B

Immunotherapy, insect venoms95132
B

Immunotherapy, insect venoms95133
B

Immunotherapy, insect venoms95134
B

Immunotherapy, insect venoms95144
X

Antigen therapy services
0353
0.3954
$23.46

$4.6995145
X

Antigen therapy services
0353
0.3954
$23.46

$4.6995146
X

Antigen therapy services
0359
0.8312
$49.33

$9.87( print page 50819)95147
X

Antigen therapy services
0359
0.8312
$49.33

$9.8795148
X

Antigen therapy services
0353
0.3954
$23.46

$4.6995149
X

Antigen therapy services
0352
0.1413
$8.39

$1.6895165
X

Antigen therapy services
0353
0.3954
$23.46

$4.6995170
X

Antigen therapy services
0352
0.1413
$8.39

$1.6895180
X

Rapid desensitization
0370
1.1232
$66.65

$13.3395199
X

Allergy immunology services
0370
1.1232
$66.65

$13.3395250
X

Glucose monitoring, cont
0421
1.66
$98.51

$19.7095805
S

Multiple sleep latency test
0209
11.5713
$686.68
$274.67
$137.3495806
S

Sleep study, unattended
0213
2.2932
$136.09
$54.43
$27.2295807
S

Sleep study, attended
0209
11.5713
$686.68
$274.67
$137.3495808
S

Polysomnography, 1-3
0209
11.5713
$686.68
$274.67
$137.3495810
S

Polysomnography, 4 or more
0209
11.5713
$686.68
$274.67
$137.3495811
S

Polysomnography w/cpap
0209
11.5713
$686.68
$274.67
$137.3495812
S

Electroencephalogram (EEG)
0213
2.2932
$136.09
$54.43
$27.2295813
S

Eeg, over 1 hour
0213
2.2932
$136.09
$54.43
$27.2295816
S

Electroencephalogram (EEG)
0213
2.2932
$136.09
$54.43
$27.2295819
S

Electroencephalogram (EEG)
0213
2.2932
$136.09
$54.43
$27.2295822
S

Sleep electroencephalogram
0213
2.2932
$136.09
$54.43
$27.2295824
S

Eeg, cerebral death only
0214
1.1353
$67.37
$26.94
$13.4795827
S

night electroencephalogram
0213
2.2932
$136.09
$54.43
$27.2295829
S

Surgery electrocorticogram
0214
1.1353
$67.37
$26.94
$13.4795830
B

Insert electrodes for EEG95831
A

Limb muscle testing, manual95832
A

Hand muscle testing, manual95833
A

Body muscle testing, manual95834
A

Body muscle testing, manual95851
A

Range of motion measurements95852
A

Range of motion measurements95857
S

Tensilon test
0218
1.1408
$67.70

$13.5495858
S

Tensilon test & myogram
0215
0.6115
$36.29
$14.51
$7.2695860
S

Muscle test, one limb
0218
1.1408
$67.70

$13.5495861
S

Muscle test, 2 limbs
0218
1.1408
$67.70

$13.5495863
S

Muscle test, 3 limbs
0218
1.1408
$67.70

$13.5495864
S

Muscle test, 4 limbs
0218
1.1408
$67.70

$13.5495867
S

Muscle test, head or neck
0218
1.1408
$67.70

$13.5495868
S

Muscle test cran nerve bilat
0218
1.1408
$67.70

$13.5495869
S

Muscle test, thor paraspinal
0215
0.6115
$36.29
$14.51
$7.2695870
S

Muscle test, nonparaspinal
0215
0.6115
$36.29
$14.51
$7.2695872
S

Muscle test, one fiber
0218
1.1408
$67.70

$13.5495875
S

Limb exercise test
0215
0.6115
$36.29
$14.51
$7.2695900
S

Motor nerve conduction test
0215
0.6115
$36.29
$14.51
$7.2695903
S

Motor nerve conduction test
0215
0.6115
$36.29
$14.51
$7.2695904
S

Sense nerve conduction test
0215
0.6115
$36.29
$14.51
$7.2695920
S

Intraop nerve test add-on
0216
2.672
$158.56

$31.7195921
S

Autonomic nerv function test
0218
1.1408
$67.70

$13.5495922
S

Autonomic nerv function test
0218
1.1408
$67.70

$13.5495923
S

Autonomic nerv function test
0218
1.1408
$67.70

$13.5495925
S

Somatosensory testing
0216
2.672
$158.56

$31.7195926
S

Somatosensory testing
0216
2.672
$158.56

$31.7195927
S

Somatosensory testing
0216
2.672
$158.56

$31.7195928
S

C motor evoked, uppr limbs
0218
1.1408
$67.70

$13.5495929
S

C motor evoked, lwr limbs
0218
1.1408
$67.70

$13.5495930
S

Visual evoked potential test
0216
2.672
$158.56

$31.7195933
S

Blink reflex test
0215
0.6115
$36.29
$14.51
$7.2695934
S

H-reflex test
0215
0.6115
$36.29
$14.51
$7.2695936
S

H-reflex test
0215
0.6115
$36.29
$14.51
$7.2695937
S

Neuromuscular junction test
0218
1.1408
$67.70

$13.5495950
S

Ambulatory eeg monitoring
0209
11.5713
$686.68
$274.67
$137.3495951
S

EEG monitoring/videorecord
0209
11.5713
$686.68
$274.67
$137.3495953
S

EEG monitoring/computer
0209
11.5713
$686.68
$274.67
$137.3495954
S

EEG monitoring/giving drugs
0214
1.1353
$67.37
$26.94
$13.4795955
S

EEG during surgery
0213
2.2932
$136.09
$54.43
$27.2295956
S

Eeg monitoring, cable/radio
0209
11.5713
$686.68
$274.67
$137.3495957
S

EEG digital analysis
0214
1.1353
$67.37
$26.94
$13.4795958
S

EEG monitoring/function test
0213
2.2932
$136.09
$54.43
$27.22( print page 50820)95961
S

Electrode stimulation, brain
0216
2.672
$158.56

$31.7195962
S

Electrode stim, brain add-on
0216
2.672
$158.56

$31.7195965
T

Meg, spontaneous
0430
11.404
$676.75

$135.3595966
T

Meg, evoked, single
0430
11.404
$676.75

$135.3595967
T

Meg, evoked, each add'l
0430
11.404
$676.75

$135.3595970
S

Analyze neurostim, no prog
0218
1.1408
$67.70

$13.5495971
S

Analyze neurostim, simple
0692
2.0111
$119.34
$30.16
$23.8795972
S

Analyze neurostim, complex
0692
2.0111
$119.34
$30.16
$23.8795973
S

Analyze neurostim, complex
0692
2.0111
$119.34
$30.16
$23.8795974
S

Cranial neurostim, complex
0692
2.0111
$119.34
$30.16
$23.8795975
S

Cranial neurostim, complex
0692
2.0111
$119.34
$30.16
$23.8795978
S

Analyze neurostim brain/1h
0692
2.0111
$119.34
$30.16
$23.8795979
S

Analyz neurostim brain addon
0692
2.0111
$119.34
$30.16
$23.8795990
T

Spin/brain pump refil & main
0125
1.9331
$114.72

$22.9495991
T

Spin/brain pump refil & main
0125
1.9331
$114.72

$22.9495999
S

Neurological procedure
0215
0.6115
$36.29
$14.51
$7.2696000
S

Motion analysis, video/3d
0216
2.672
$158.56

$31.7196001
S

Motion test w/ft press meas
0216
2.672
$158.56

$31.7196002
S

Dynamic surface emg
0218
1.1408
$67.70

$13.5496003
S

Dynamic fine wire emg
0215
0.6115
$36.29
$14.51
$7.2696004
E

Phys review of motion tests96100
X

Psychological testing
0373
2.1926
$130.12

$26.0296105
A

Assessment of aphasia96110
X

Developmental test, lim
0373
2.1926
$130.12

$26.0296111
X

Developmental test, extend
0373
2.1926
$130.12

$26.0296115
X

Neurobehavior status exam
0373
2.1926
$130.12

$26.0296117
X

Neuropsych test battery
0373
2.1926
$130.12

$26.0296150
S

Assess lth/behave, init
0432
0.6949
$41.24

$8.2596151
S

Assess hlth/behave, subseq
0432
0.6949
$41.24

$8.2596152
S

Intervene hlth/behave, indiv
0432
0.6949
$41.24

$8.2596153
S

Intervene hlth/behave, group
0432
0.6949
$41.24

$8.2596154
S

Interv hlth/behav, fam w/pt
0432
0.6949
$41.24

$8.2596155
E

Interv hlth/behav fam no pt96400
S

Chemotherapy, sc/im
0116
1.1453
$67.97

$13.5996405
S

Intralesional chemo admin
0116
1.1453
$67.97

$13.5996406
S

Intralesional chemo admin
0116
1.1453
$67.97

$13.5996408
S

Chemotherapy, push technique
0116
1.1453
$67.97

$13.5996410
S

Chemotherapy,infusion method
0117
3.2378
$192.14
$42.54
$38.4396412
N

Chemo, infuse method add-on96414
S

Chemo, infuse method add-on
0117
3.2378
$192.14
$42.54
$38.4396420
S

Chemotherapy, push technique
0116
1.1453
$67.97

$13.5996422
S

Chemotherapy,infusion method
0117
3.2378
$192.14
$42.54
$38.4396423
N

Chemo, infuse method add-on96425
S

Chemotherapy,infusion method
0117
3.2378
$192.14
$42.54
$38.4396440
S

Chemotherapy, intracavitary
0116
1.1453
$67.97

$13.5996445
S

Chemotherapy, intracavitary
0116
1.1453
$67.97

$13.5996450
S

Chemotherapy, into CNS
0116
1.1453
$67.97

$13.5996520
T

Port pump refill & main
0125
1.9331
$114.72

$22.9496530
T

Pump refilling, maintenance
0125
1.9331
$114.72

$22.9496542
S

Chemotherapy injection
0116
1.1453
$67.97

$13.5996545
N

Provide chemotherapy agent96549
S

Chemotherapy, unspecified
0116
1.1453
$67.97

$13.5996567
T

Photodynamic tx, skin
0016
2.5834
$153.31
$33.57
$30.6696570
T

Photodynamic tx, 30 min
0015
1.6514
$98.00
$20.29
$19.6096571
T

Photodynamic tx, addl 15 min
0015
1.6514
$98.00
$20.29
$19.6096900
S

Ultraviolet light therapy
0001
0.4213
$25.00
$7.00
$5.0096902
N

Trichogram96910
S

Photochemotherapy with UV-B
0001
0.4213
$25.00
$7.00
$5.0096912
S

Photochemotherapy with UV-A
0001
0.4213
$25.00
$7.00
$5.0096913
S

Photochemotherapy, UV-A or B
0683
1.9006
$112.79
$25.34
$22.5696920
T

Laser tx, skin < 250 sq cm
0013
1.1078
$65.74
$14.20
$13.1596921
T

Laser tx, skin 250-500 sq cm
0013
1.1078
$65.74
$14.20
$13.1596922
T

Laser tx, skin > 500 sq cm
0013
1.1078
$65.74
$14.20
$13.1596999
T

Dermatological procedure
0010
0.5719
$33.94
$9.65
$6.7997001
A

Pt evaluation97002
A

Pt re-evaluation( print page 50821)97003
A

Ot evaluation97004
A

Ot re-evaluation97005
E

Athletic train eval97006
E

Athletic train reeval97010
A

Hot or cold packs therapy97012
A

Mechanical traction therapy97014
E

Electric stimulation therapy97016
A

Vasopneumatic device therapy97018
A

Paraffin bath therapy97020
A

Microwave therapy97022
A

Whirlpool therapy97024
A

Diathermy treatment97026
A

Infrared therapy97028
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 activities97532
A

Cognitive skills development97533
A

Sensory integration97535
A

Self care mngment training97537
A

Community/work reintegration97542
A

Wheelchair mngment training97545
A

Work hardening97546
A

Work hardening add-on97597
A

Active wound care/20 cm or <97598
A

Active wound care > 20 cm97602
A

Wound(s) care non-selective97605
A

Neg press wound tx, < 50 cm97606
A

Neg press wound tx, > 50 cm97703
A

Prosthetic checkout97750
A

Physical performance test97755
A

Assistive technology assess97799
A

Physical medicine procedure97802
A

Medical nutrition, indiv, in97803
A

Med nutrition, indiv, subseq97804
A

Medical nutrition, group97810
E

Acupunct w/o stimul 15 min97811
E

Acupunct w/o stimul addl 15m97813
E

Acupunct w/stimul 15 min97814
E

Acupunct w/stimul addl 15m98925
S

Osteopathic manipulation
0060
0.4935
$29.29

$5.8698926
S

Osteopathic manipulation
0060
0.4935
$29.29

$5.8698927
S

Osteopathic manipulation
0060
0.4935
$29.29

$5.8698928
S

Osteopathic manipulation
0060
0.4935
$29.29

$5.8698929
S

Osteopathic manipulation
0060
0.4935
$29.29

$5.8698940
S

Chiropractic manipulation
0060
0.4935
$29.29

$5.8698941
S

Chiropractic manipulation
0060
0.4935
$29.29

$5.8698942
S

Chiropractic manipulation
0060
0.4935
$29.29

$5.8698943
E

Chiropractic manipulation99000
B

Specimen handling99001
B

Specimen handling99002
B

Device handling( print page 50822)99024
B

Postop follow-up visit99026
E

In-hospital on call service99027
E

Out-of-hosp on call service99050
B

Medical services after hrs99052
B

Medical services at night99054
B

Medical servcs, unusual hrs99056
B

Non-office medical services99058
B

Office emergency care99070
B

Special supplies99071
B

Patient education materials99075
E

Medical testimony99078
N

Group health education99080
B

Special reports or forms99082
B

Unusual physician travel99090
B

Computer data analysis99091
E

Collect/review data from pt99100
B

Special anesthesia service99116
B

Anesthesia with hypothermia99135
B

Special anesthesia procedure99140
B

Emergency anesthesia99141
N

Sedation, iv/im or inhalant99142
N

Sedation, oral/rectal/nasal99170
T

Anogenital exam, child
0191
0.167
$9.91
$2.78
$1.9899172
E

Ocular function screen99173
E

Visual acuity screen99175
N

Induction of vomiting99183
B

Hyperbaric oxygen therapy99185
N

Regional hypothermia99186
N

Total body hypothermia99190
C

Special pump services99191
C

Special pump services99192
C

Special pump services99195
X

Phlebotomy
0372
0.57
$33.83
$10.09
$6.7799199
B

Special service/proc/report99201
V

Office/outpatient visit, new
0600
0.8688
$51.56

$10.3199202
V

Office/outpatient visit, new
0600
0.8688
$51.56

$10.3199203
V

Office/outpatient visit, new
0601
1.0038
$59.57

$11.9199204
V

Office/outpatient visit, new
0602
1.4284
$84.77

$16.9599205
V

Office/outpatient visit, new
0602
1.4284
$84.77

$16.9599211
V

Office/outpatient visit, est
0600
0.8688
$51.56

$10.3199212
V

Office/outpatient visit, est
0600
0.8688
$51.56

$10.3199213
V

Office/outpatient visit, est
0601
1.0038
$59.57

$11.9199214
V

Office/outpatient visit, est
0602
1.4284
$84.77

$16.9599215
V

Office/outpatient visit, est
0602
1.4284
$84.77

$16.9599217
B

Observation care discharge99218
B

Observation care99219
B

Observation care99220
B

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
B

Observ/hosp same date99235
B

Observ/hosp same date99236
B

Observ/hosp same date99238
E

Hospital discharge day99239
E

Hospital discharge day99241
V

Office consultation
0600
0.8688
$51.56

$10.3199242
V

Office consultation
0600
0.8688
$51.56

$10.3199243
V

Office consultation
0601
1.0038
$59.57

$11.9199244
V

Office consultation
0602
1.4284
$84.77

$16.9599245
V

Office consultation
0602
1.4284
$84.77

$16.9599251
C

Initial inpatient consult99252
C

Initial inpatient consult( print page 50823)99253
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
0.8688
$51.56

$10.3199272
V

Confirmatory consultation
0600
0.8688
$51.56

$10.3199273
V

Confirmatory consultation
0601
1.0038
$59.57

$11.9199274
V

Confirmatory consultation
0602
1.4284
$84.77

$16.9599275
V

Confirmatory consultation
0602
1.4284
$84.77

$16.9599281
V

Emergency dept visit
0610
1.2947
$76.83
$19.48
$15.3799282
V

Emergency dept visit
0610
1.2947
$76.83
$19.48
$15.3799283
V

Emergency dept visit
0611
2.2718
$134.82
$35.76
$26.9699284
V

Emergency dept visit
0612
3.9853
$236.50
$54.12
$47.3099285
V

Emergency dept visit
0612
3.9853
$236.50
$54.12
$47.3099288
B

Direct advanced life support99289
N

Pt transport, 30-74 min99290
N

Pt transport, addl 30 min99291
S

Critical care, first hour
0620
8.2996
$492.52
$135.68
$98.5099292
N

Critical care, add=l 30 min99293
C

Ped critical care, initial99294
C

Ped critical care, subseq99295
C

Neonatal critical care99296
C

Neonatal critical care99298
C

Neonatal critical care99299
C

Ic, lbw infant 1500-2500 gm99301
B

Nursing facility care99302
B

Nursing facility care99303
B

Nursing facility care99311
B

Nursing fac care, subseq99312
B

Nursing fac care, subseq99313
B

Nursing fac care, subseq99315
B

Nursing fac discharge day99316
B

Nursing fac discharge day99321
B

Rest home visit, new patient99322
B

Rest home visit, new patient99323
B

Rest home visit, new patient99331
B

Rest home visit, est pat99332
B

Rest home visit, est pat99333
B

Rest home visit, est pat99341
B

Home visit, new patient99342
B

Home visit, new patient99343
B

Home visit, new patient99344
B

Home visit, new patient99345
B

Home visit, new patient99347
B

Home visit, est patient99348
B

Home visit, est patient99349
B

Home visit, est patient99350
B

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
B

Physician standby services99361
E

Physician/team conference99362
E

Physician/team conference99371
B

Physician phone consultation99372
B

Physician phone consultation99373
B

Physician phone consultation99374
B

Home health care supervision99375
E

Home health care supervision99377
B

Hospice care supervision99378
E

Hospice care supervision( print page 50824)99379
B

Nursing fac care supervision99380
B

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
V

Initial care, normal newborn
0600
0.8688
$51.56

$10.3199432
N

Newborn care, not in hosp99433
C

Normal newborn care/hospital99435
E

Newborn discharge day hosp99436
N

Attendance, birth99440
S

Newborn resuscitation
0094
2.5363
$150.51
$47.62
$30.1099450
E

Life/disability evaluation99455
B

Disability examination99456
B

Disability examination99499
B

Unlisted e&m service99500
E

Home visit, prenatal99501
E

Home visit, postnatal99502
E

Home visit, nb care99503
E

Home visit, resp therapy99504
E

Home visit mech ventilator99505
E

Home visit, stoma care99506
E

Home visit, im injection99507
E

Home visit, cath maintain99509
E

Home visit day life activity99510
E

Home visit, sing/m/fam couns99511
E

Home visit, fecal/enema mgmt99512
E

Home visit for hemodialysis99600
E

Home visit nos99601
E

Home infusion/visit, 2 hrs99602
E

Home infusion, each addtl hrA0021
E

Outside state ambulance servA0080
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 recipA0190
E

Noner transport meals recipA0200
E

Noner transport lodgng escrtA0210
E

Noner transport meals escortA0225
A

Neonatal emergency transportA0380
A

Basic life support mileageA0382
A

Basic support routine suppls( print page 50825)A0384
A

Bls defibrillation suppliesA0390
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 02 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 mileageA0800
B

Amb trans 7pm-7amA0888
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
B

Supp for self-adm injectionsA4212
B

Non coring needle or styletA4213
E

20+ CC syringe onlyA4215
E

Sterile needleA4216
A

Sterile water/saline, 10 mlA4217
A

Sterile water/saline, 500 mlA4220
N

Infusion pump refill kitA4221
Y

Maint drug infus cath per wkA4222
Y

Drug infusion pump suppliesA4223
E

Infusion supplies w/o pumpA4230
Y

Infus insulin pump non needlA4231
Y

Infusion insulin pump needleA4232
Y

Syringe w/needle insulin 3ccA4244
E

Alcohol or peroxide per pintA4245
E

Alcohol wipes per boxA4246
E

Betadine/phisohex solutionA4247
E

Betadine/iodine swabs/wipesA4248
N

Chlorhexidine antiseptA4250
E

Urine reagent strips/tabletsA4253
Y

Blood glucose/reagent stripsA4254
Y

Battery for glucose monitorA4255
Y

Glucose monitor platformsA4256
Y

Calibrator solution/chipsA4257
Y

Replace Lensshield CartridgeA4258
Y

Lancet device eachA4259
Y

Lancets per boxA4260
E

Levonorgestrel implantA4261
E

Cervical cap contraceptiveA4262
N

Temporary tear duct plugA4263
N

Permanent tear duct plugA4265
Y

ParaffinA4266
E

DiaphragmA4267
E

Male condomA4268
E

Female condomA4269
E

SpermicideA4270
A

Disposable endoscope sheathA4280
A

Brst prsths adhsv attchmnt( print page 50826)A4281
E

Replacement breastpump tubeA4282
E

Replacement breastpump adptA4283
E

Replacement breastpump capA4284
E

Replcmnt breast pump shieldA4285
E

Replcmnt breast pump bottleA4286
E

Replcmnt breastpump lok ringA4290
B

Sacral nerve stim test leadA4300
N

Cath impl vasc access portalA4301
N

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-wayA4320
A

Irrigation trayA4321
A

Cath therapeutic irrig agentA4322
A

Irrigation syringeA4326
A

Male external catheterA4327
A

Fem urinary collect dev cupA4328
A

Fem urinary collect pouchA4330
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 wayA4348
A

Male ext cath extended wearA4349
A

Disposable male external catA4351
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 or abdomen bagA4359
A

Urinary suspensory w/o leg bA4361
A

Ostomy face plateA4362
A

Solid skin barrierA4364
A

Adhesive, liquid or equalA4365
A

Adhesive remover wipesA4366
A

Ostomy ventA4367
A

Ostomy beltA4368
A

Ostomy filterA4369
A

Skin barrier liquid per ozA4371
A

Skin barrier powder per ozA4372
A

Skin barrier solid 4x4 equivA4373
A

Skin barrier with flangeA4375
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 fcplA4380
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 ring( print page 50827)A4385
A

Ost skn barrier sld ext wearA4387
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 eachA4405
A

Nonpectin based ostomy pasteA4406
A

Pectin based ostomy pasteA4407
A

Ext wear ost skn barr <=4sq÷A4408
A

Ext wear ost skn barr >4sq÷A4409
A

Ost skn barr w flng <=4 sq÷A4410
A

Ost skn barr w flng >4sq÷A4413
A

2 pc drainable ost pouchA4414
A

Ostomy sknbarr w flng <=4sq÷A4415
A

Ostomy skn barr w flng >4sq÷A4416
A

Ost pch clsd w barrier/filtrA4417
A

Ost pch w bar/bltinconv/fltrA4418
A

Ost pch clsd w/o bar w filtrA4419
A

Ost pch for bar w flange/fltA4420
A

Ost pch clsd for bar w lk flA4421
E

Ostomy supply miscA4422
A

Ost pouch absorbent materialA4423
A

Ost pch for bar w lk fl/fltrA4424
A

Ost pch drain w bar & filterA4425
A

Ost pch drain for barrier flA4426
A

Ost pch drain 2 piece systemA4427
A

Ost pch drain/barr lk flng/fA4428
A

Urine ost pouch w faucet/tapA4429
A

Urine ost pch bar w lock flnA4430
A

Ost pch urine w lock flng/ftA4431
A

Urine ost pch bar w lock flnA4432
A

Ost pch urine w lock flng/ftA4433
A

Urine ost pch bar w lock flnA4434
A

Ost pch urine w lock flng/ftA4450
A

Non-waterproof tapeA4452
A

Waterproof tapeA4455
A

Adhesive remover per ounceA4458
E

Reusable enema bagA4462
A

Abdmnl drssng holder/binderA4465
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 stockingA4520
E

Incontinence garment anytypeA4550
B

Surgical traysA4554
E

Disposable underpadsA4555
E

Disposable underpad smallA4556
Y

Electrodes, pairA4557
Y

Lead wires, pairA4558
Y

Conductive paste or gel( print page 50828)A4561
N

Pessary rubber, any typeA4562
N

Pessary, non rubber,any typeA4565
A

SlingsA4570
E

SplintA4575
E

Hyperbaric o2 chamber dispsA4580
E

Cast supplies (plaster)A4590
E

Special casting materialA4595
Y

TENS suppl 2 lead per monthA4605
Y

Trach suction cath close sysA4606
A

Oxygen probe used w oximeterA4608
Y

Transtracheal oxygen cathA4611
Y

Heavy duty batteryA4612
Y

Battery cablesA4613
Y

Battery chargerA4614
A

Hand-held PEFR meterA4615
Y

Cannula nasalA4616
Y

Tubing (oxygen) per footA4617
Y

Mouth pieceA4618
Y

Breathing circuitsA4619
Y

Face tentA4620
Y

Variable concentration maskA4623
A

Tracheostomy inner cannulaA4624
Y

Tracheal suction tubeA4625
A

Trach care kit for new trachA4626
A

Tracheostomy cleaning brushA4627
E

Spacer bag/reservoirA4628
Y

Oropharyngeal suction cathA4629
A

Tracheostomy care kitA4630
Y

Repl bat t.e.n.s. own by ptA4632
Y

Infus pump rplcemnt batteryA4633
Y

Uvl replacement bulbA4634
A

Replacement bulb th lightboxA4635
Y

Underarm crutch padA4636
Y

Handgrip for cane etcA4637
Y

Repl tip cane/crutch/walkerA4638
Y

Repl batt pulse gen sysA4639
Y

Infrared ht sys replcmnt padA4640
Y

Alternating pressure padA4641
N

Diagnostic imaging agentA4642
H

Satumomab pendetide per dose
0704A4643
B

High dose contrast MRIA4644
B

Contrast 100-199 MGs iodineA4645
B

Contrast 200-299 MGs iodineA4646
B

Contrast 300-399 MGs iodineA4647
B

Supp- paramagnetic contr matA4649
A

Surgical suppliesA4651
A

Calibrated microcap tubeA4652
A

Microcapillary tube sealantA4653
A

PD catheter anchor beltA4656
A

Dialysis needleA4657
A

Dialysis syringe w/wo needleA4660
A

Sphyg/bp app w cuff and stetA4663
A

Dialysis blood pressure cuffA4670
E

Automatic bp monitor, dialA4671
B

Disposable cycler setA4672
B

Drainage ext line, dialysisA4673
B

Ext line w easy lock connectA4674
B

Chem/antisept solution, 8ozA4680
A

Activated carbon filter, eaA4690
A

Dialyzer, eachA4706
A

Bicarbonate conc sol per galA4707
A

Bicarbonate conc pow per pacA4708
A

Acetate conc sol per gallonA4709
A

Acid conc sol per gallonA4714
A

Treated water per gallonA4719
A

÷Y set÷ tubing( print page 50829)A4720
A

Dialysat sol fld vol > 249ccA4721
A

Dialysat sol fld vol > 999ccA4722
A

Dialys sol fld vol > 1999ccA4723
A

Dialys sol fld vol > 2999ccA4724
A

Dialys sol fld vol > 3999ccA4725
A

Dialys sol fld vol > 4999ccA4726
A

Dialys sol fld vol > 5999ccA4728
B

Dialysate solution, non-dexA4730
A

Fistula cannulation set, eaA4736
A

Topical anesthetic, per gramA4737
A

Inj anesthetic per 10 mlA4740
A

Shunt accessoryA4750
A

Art or venous blood tubingA4755
A

Comb art/venous blood tubingA4760
A

Dialysate sol test kit, eachA4765
A

Dialysate conc pow per packA4766
A

Dialysate conc sol add 10 mlA4770
A

Blood collection tube/vacuumA4771
A

Serum clotting time tubeA4772
A

Blood glucose test stripsA4773
A

Occult blood test stripsA4774
A

Ammonia test stripsA4802
A

Protamine sulfate per 50 mgA4860
A

Disposable catheter tipsA4870
A

Plumb/elec wk hm hemo equipA4890
A

Repair/maint cont hemo equipA4911
A

Drain bag/bottleA4913
A

Misc dialysis supplies nocA4918
A

Venous pressure clampA4927
A

Non-sterile glovesA4928
A

Surgical maskA4929
A

Tourniquet for dialysis, eaA4930
A

Sterile, gloves per pairA4931
A

Reusable oral thermometerA4932
E

Reusable rectal thermometerA5051
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/flangeA5071
A

Urinary pouch w/barrierA5072
A

Urinary pouch w/o barrierA5073
A

Urinary pouch on barr w/flngA5081
A

Continent stoma plugA5082
A

Continent stoma catheterA5093
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 8x8A5126
A

Disk/foam pad +or- adhesiveA5131
A

Appliance cleanerA5200
A

Percutaneous catheter anchorA5500
Y

Diab shoe for density insertA5501
Y

Diabetic custom molded shoeA5503
Y

Diabetic shoe w/roller/rockrA5504
Y

Diabetic shoe with wedgeA5505
Y

Diab shoe w/metatarsal barA5506
Y

Diabetic shoe w/off set heel( print page 50830)A5507
Y

Modification diabetic shoeA5508
Y

Diabetic deluxe shoeA5509
E

Direct heat form shoe insertA5510
E

Compression form shoe insertA5511
E

Custom fab molded shoe inserA6000
E

Wound warming wound coverA6010
A

Collagen based wound fillerA6011
A

Collagen gel/paste wound filA6021
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 bdrA6243
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 b( print page 50831)A6252
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 / gramA6266
A

Impreg gauze no h20/sal/yardA6402
A

Sterile gauze <= 16 sq inA6403
A

Sterile gauze>16 <= 48 sq inA6404
A

Sterile gauze > 48 sq inA6407
A

Packing strips, non-impregA6410
A

Sterile eye padA6411
A

Non-sterile eye padA6412
E

Occlusive eye patchA6441
A

Pad band w>=3÷ <5÷/ydA6442
A

Conform band n/s w<3÷/ydA6443
A

Conform band n/s w>=3÷<5÷/ydA6444
A

Conform band n/s w>=5÷/ydA6445
A

Conform band s w <3÷/ydA6446
A

Conform band s w>=3÷ <5÷/ydA6447
A

Conform band s w >=5÷/ydA6448
A

Lt compres band <3÷/ydA6449
A

Lt compres band >=3÷ <5÷/ydA6450
A

Lt compres band >=5÷/ydA6451
A

Mod compres band w>=3÷<5÷/ydA6452
A

High compres band w>=3÷<5÷ydA6453
A

Self-adher band w <3÷/ydA6454
A

Self-adher band w>=3÷ <5÷/ydA6455
A

Self-adher band >=5÷/ydA6456
A

Zinc paste band w >=3÷<5÷/ydA6501
A

Compres burngarment bodysuitA6502
A

Compres burngarment chinstrpA6503
A

Compres burngarment facehoodA6504
A

Cmprsburngarment glove-wristA6505
A

Cmprsburngarment glove-elbowA6506
A

Cmprsburngrmnt glove-axillaA6507
A

Cmprs burngarment foot-kneeA6508
A

Cmprs burngarment foot-thighA6509
A

Compres burn garment jacketA6510
A

Compres burn garment leotardA6511
A

Compres burn garment pantyA6512
A

Compres burn garment, nocA6550
Y

Neg pres wound ther drsg setA6551
Y

Neg press wound ther canistrA7000
Y

Disposable canister for pumpA7001
Y

Nondisposable pump canisterA7002
Y

Tubing used w suction pumpA7003
Y

Nebulizer administration setA7004
Y

Disposable nebulizer sml volA7005
Y

Nondisposable nebulizer setA7006
Y

Filtered nebulizer admin setA7007
Y

Lg vol nebulizer disposableA7008
Y

Disposable nebulizer prefillA7009
Y

Nebulizer reservoir bottleA7010
Y

Disposable corrugated tubingA7011
Y

Nondispos corrugated tubingA7012
Y

Nebulizer water collec devicA7013
Y

Disposable compressor filterA7014
Y

Compressor nondispos filterA7015
Y

Aerosol mask used w nebulizeA7016
Y

Nebulizer dome & mouthpiece( print page 50832)A7017
Y

Nebulizer not used w oxygenA7018
Y

Water distilled w/nebulizerA7025
Y

Replace chest compress vestA7026
Y

Replace chst cmprss sys hoseA7030
Y

CPAP full face maskA7031
Y

Replacement facemask interfaA7032
Y

Replacement nasal cushionA7033
Y

Replacement nasal pillowsA7034
Y

Nasal application deviceA7035
Y

Pos airway press headgearA7036
Y

Pos airway press chinstrapA7037
Y

Pos airway pressure tubingA7038
Y

Pos airway pressure filterA7039
Y

Filter, non disposable w papA7040
A

One way chest drain valveA7041
A

Water seal drain containerA7042
A

Implanted pleural catheterA7043
A

Vacuum drainagebottle/tubingA7044
Y

PAP oral interfaceA7045
Y

Repl exhalation port for PAPA7046
Y

Repl water chamber, PAP devA7501
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 sysA7520
A

Trach/laryn tube non-cuffedA7521
A

Trach/laryn tube cuffedA7522
A

Trach/laryn tube stainlessA7523
A

Tracheostomy shower protectA7524
A

Tracheostoma stent/stud/bttnA7525
A

Tracheostomy maskA7526
A

Tracheostomy tube collarA7527
A

Trach/laryn tube plug/stopA9150
B

Misc/exper non-prescript druA9152
E

Single vitamin nosA9153
E

Multi-vitamin nosA9180
E

Lice treatment, topicalA9270
E

Non-covered item or serviceA9280
E

Alert device, nocA9300
E

Exercise equipmentA9500
H

Technetium TC 99m sestamibi
1600A9502
H

Technetium TC99M tetrofosmin
0705A9503
N

Technetium TC 99m medronateA9504
N

Technetium tc 99m apcitideA9505
H

Thallous chloride TL 201/mci
1603A9507
H

Indium/111 capromab pendetid
1604A9508
H

Iobenguane sulfate I-131, pe
1045A9510
H

Technetium TC99m Disofenin
9146A9511
H

Technetium TC 99m depreotide
9147A9512
N

Technetium tc99m pertechnetateA9513
N

Technetium tc-99m mebrofeninA9514
N

Technetium tc99m pyrophosphateA9515
N

Technetium tc-99m pentetateA9516
H

I-123 sodium iodide capsule
9148A9517
H

Th I131 so iodide cap millic
1064A9519
N

Technetium tc-99m macroag albuA9520
N

Technetium tc-99m sulfur clldA9521
H

Technetium tc-99m exametazine
1096A9522
B

Indium 111i britumomabtiuxetanA9523
B

Yttrium 90i britumomabtiuxetanA9524
H

Iodinated I-131 serumalbumin
9100( print page 50833)A9525
E

Low/iso-osmolar contrast matA9526
H

Ammonia N-13, per dose
0737A9528
H

Dx I131 so iodide cap millic
1088A9529
H

Dx I131 so iodide sol millic
1065A9530
H

Th I131 so iodide sol millic
1150A9531
H

Dx I131 so iodide microcurie
9149A9532
H

I-125 serum albumin micro
9150A9533
B

I-131 tositumomab diagnosticA9534
B

I-131 tositumomab therapeutA9600
H

Strontium-89 chloride
0701A9605
H

Samarium sm153 lexidronamm
0702A9699
N

Noc therapeutic radiopharmA9700
B

Echocardiography ContrastA9900
A

Supply/accessory/serviceA9901
A

Delivery/set up/dispensingA9999
Y

DME supply or accessory, nosB4034
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 levineB4086
A

Gastrostomy/jejunostomy tubeB4100
E

Food thickener oralB4102
Y

EF adult fluids and electroB4103
Y

EF ped fluid and electrolyteB4104
E

Additive for enteral formulaB4149
Y

EF blenderized foodsB4150
A

Enteral formulae category iB4152
A

Enteral formulae category iiB4153
A

Enteral formulae category IIIB4154
A

Enteral formulae category IVB4155
A

Enteral formulae category vB4157
Y

EF special metabolic inheritB4158
Y

EF ped complete intact nutB4159
Y

EF ped complete soy basedB4160
Y

EF ped calorie dense > / =0.7kcB4161
Y

EF ped hydrolyzed/amino acidB4162
Y

EF ped specmetabolic inheritB4164
A

Parenteral 50% dextrose soluB4168
A

Parenteral sol amino acid 3B4172
A

Parenteral sol amino acid 5B4176
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 cC1079
N

CO 57/58 per 0.5 uCiC1080
H

I-131 tositumomab, dx
1080( print page 50834)C1081
H

I-131 tositumomab, tx
1081C1082
H

In-111 ibritumomab tiuxetan
9118C1083
H

Yttrium 90 ibritumomab tiuxe
9117C1091
H

IN111 oxyquinoline,per 0.5 mCi
1091C1092
H

IN 111 pentetate per 0.5 mCi
1092C1093
H

TC99M fanolesomab
1093C1122
H

Tc 99M ARCITUMOMAB PER VIAL
9151C1178
K

BUSULFAN IV, 6 Mg
1178
0.2851
$16.92

$3.38C1200
N

TC 99M Sodium GlucoheptonatC1201
H

TC 99M SUCCIMER, PER Vial
1201C1300
S

HYPERBARIC Oxygen
0659
1.5473
$91.82

$18.36C1305
K

Apligraf, 44cm2
1305
12.9222
$766.84

$153.37C1713
N

Anchor/screw bn/bn,tis/bnC1714
N

Cath, trans atherectomy, dirC1715
N

Brachytherapy needleC1716
H

Brachytx source, Gold 198
1716C1717
H

Brachytx source, HDR Ir-192
1717C1718
H

Brachytx source, Iodine 125
1718C1719
H

Brachytx sour,Non-HDR Ir-192
1719C1720
H

Brachytx sour, Palladium 103
1720C1721
N

AICD, dual chamberC1722
N

AICD, single chamberC1724
N

Cath, trans atherec,rotationC1725
N

Cath, translumin non-laserC1726
N

Cath, bal dil, non-vascularC1727
N

Cath, bal tis dis, non-vasC1728
N

Cath, brachytx seed admC1729
N

Cath, drainageC1730
N

Cath, EP, 19 or few electC1731
N

Cath, EP, 20 or more elecC1732
N

Cath, EP, diag/abl, 3D/vectC1733
N

Cath, EP, othr than cool-tipC1750
N

Cath, hemodialysis,long-termC1751
N

Cath, inf, per/cent/midlineC1752
N

Cath,hemodialysis,short-termC1753
N

Cath, intravas ultrasoundC1754
N

Catheter, intradiscalC1755
N

Catheter, intraspinalC1756
N

Cath, pacing, transesophC1757
N

Cath, thrombectomy/embolectC1758
N

Catheter, ureteralC1759
N

Cath, intra echocardiographyC1760
N

Closure dev, vascC1762
N

Conn tiss, human(inc fascia)C1763
N

Conn tiss, non-humanC1764
N

Event recorder, cardiacC1765
N

Adhesion barrierC1766
N

Intro/sheath,strble,non-peelC1767
N

Generator, neurostim, impC1768
N

Graft, vascularC1769
N

Guide wireC1770
N

Imaging coil, MR, insertableC1771
N

Rep dev, urinary, w/slingC1772
N

Infusion pump, programmableC1773
N

Ret dev, insertableC1775
H

FDG, per dose (4-40 mCi/ml)
1775C1776
N

Joint device (implantable)C1777
N

Lead, AICD, endo single coilC1778
N

Lead, neurostimulatorC1779
N

Lead, pmkr, transvenous VDDC1780
N

Lens, intraocular (new tech)C1781
N

Mesh (implantable)C1782
N

MorcellatorC1783
N

Ocular imp, aqueous drain deC1784
N

Ocular dev, intraop, det retC1785
N

Pmkr, dual, rate-resp( print page 50835)C1786
N

Pmkr, single, rate-respC1787
N

Patient progr, neurostimC1788
N

Port, indwelling, impC1789
N

Prosthesis, breast, impC1813
N

Prosthesis, penile, inflatabC1814
N

Retinal tamp, silicone oilC1815
N

Pros, urinary sph, impC1816
N

Receiver/transmitter, neuroC1817
N

Septal defect imp sysC1818
N

Integrated keratoprosthesisC1819
N

Tissue local excisionC1874
N

Stent, coated/cov w/del sysC1875
N

Stent, coated/cov w/o del syC1876
N

Stent, non-coa/non-cov w/delC1877
N

Stent, non-coat/cov w/o delC1878
N

Matrl for vocal cordC1879
N

Tissue marker, implantableC1880
N

Vena cava filterC1881
N

Dialysis access systemC1882
N

AICD, other than sing/dualC1883
N

Adapt/ext, pacing/neuro leadC1884
N

Embolization Protect systC1885
N

Cath, translumin angio laserC1887
N

Catheter, guidingC1888
N

Endovas non-cardiac abl cathC1891
N

Infusion pump,non-prog, permC1892
N

Intro/sheath,fixed,peel-awayC1893
N

Intro/sheath, fixed,non-peelC1894
N

Intro/sheath, non-laserC1895
N

Lead, AICD, endo dual coilC1896
N

Lead, AICD, non sing/dualC1897
N

Lead, neurostim test kitC1898
N

Lead, pmkr, other than transC1899
N

Lead, pmkr/AICD combinationC1900
N

Lead coronary venousC2614
N

Probe, perc lumb discC2615
N

Sealant, pulmonary, liquidC2616
H

Brachytx source, Yttrium-90
2616C2617
N

Stent, non-cor, tem w/o delC2618
N

Probe, cryoablationC2619
N

Pmkr, dual, non rate-respC2620
N

Pmkr, single, non rate-respC2621
N

Pmkr, other than sing/dualC2622
N

Prosthesis, penile, non-infC2625
N

Stent, non-cor, tem w/del syC2626
N

Infusion pump, non-prog,tempC2627
N

Cath, suprapubic/cystoscopicC2628
N

Catheter, occlusionC2629
N

Intro/sheath, laserC2630
N

Cath, EP, cool-tipC2631
N

Rep dev, urinary, w/o slingC2632
H

Brachytx sol, I-125, per mCi
2632C2633
H

Brachytx source, Cesium-131
2633C2634
H

Brachytx source, HA, I-125
2634C2635
H

Brachytx source, HA, P-103
2635C2636
H

Brachytx linear source, P-10
2636C8900*
S

MRA w/cont, abd
0284
6.4201
$380.99
$152.39
$76.20C8901*
S

MRA w/o cont, abd
0336
6.0742
$360.46
$144.18
$72.09C8902*
S

MRA w/o fol w/cont, abd
0337
8.7945
$521.89
$208.75
$104.38C8903*
S

MRI w/cont, breast, uni
0284
6.4201
$380.99
$152.39
$76.20C8904*
S

MRI w/o cont, breast, uni
0336
6.0742
$360.46
$144.18
$72.09C8905*
S

MRI w/o fol w/cont, brst, un
0337
8.7945
$521.89
$208.75
$104.38C8906*
S

MRI w/cont, breast, bi
0284
6.4201
$380.99
$152.39
$76.20C8907*
S

MRI w/o cont, breast, bi
0336
6.0742
$360.46
$144.18
$72.09C8908*
S

MRI w/o fol w/cont, breast,
0337
8.7945
$521.89
$208.75
$104.38C8909*
S

MRA w/cont, chest
0284
6.4201
$380.99
$152.39
$76.20( print page 50836)C8910*
S

MRA w/o cont, chest
0336
6.0742
$360.46
$144.18
$72.09C8911*
S

MRA w/o fol w/cont, chest
0337
8.7945
$521.89
$208.75
$104.38C8912*
S

MRA w/cont, lwr ext
0284
6.4201
$380.99
$152.39
$76.20C8913*
S

MRA w/o cont, lwr ext
0336
6.0742
$360.46
$144.18
$72.09C8914*
S

MRA w/o fol w/cont, lwr ext
0337
8.7945
$521.89
$208.75
$104.38C8918*
S

MRA w/cont, pelvis
0284
6.4201
$380.99
$152.39
$76.20C8919*
S

MRA w/o cont, pelvis
0336
6.0742
$360.46
$144.18
$72.09C8920*
S

MRA w/o fol w/cont, pelvis
0337
8.7945
$521.89
$208.75
$104.38C9000
H

Na chromateCr51, per 0.25mCi
9130C9003
K

Palivizumab, per 50 mg
9003
4.1491
$246.22

$49.24C9007
K

Baclofen Intrathecal kit-1am
9152
0.8562
$50.81

$10.16C9008
K

Baclofen Refill Kit-500mcg
9008
0.2447
$14.52

$2.90C9009
K

Baclofen Refill Kit-2000mcg
9009
0.7209
$42.78

$8.56C9013
N

Co 57 cobaltous chlorideC9102
H

51 Na Chromate, 50mCi
9132C9103
H

Na Iothalamate I-125, 10 uCi
9153C9105
K

Hep B imm glob, per 1 ml
9105
1.8813
$111.64

$22.33C9112
D

Perflutren lipid micro, 2mlC9113
N

Inj pantoprazole sodium, viaC9121
K

Injection, argatroban
9121
0.1897
$11.26

$2.25C9123
K

Transcyte, 247cm2
9123

$719.41

$143.88C9127
K

Paclitaxel protein pr
9127

$8.59

$1.72C9128
K

Inj pegaptanib sodium
9128

$1,074.27

$214.85C9200
K

Orcel, 36 cm2
9200
2.6893
$159.59

$31.92C9201
K

Dermagraft, 37.5cm2
9201
6.2066
$368.32

$73.66C9202
D

OctafluoropropaneC9203
D

Perflexane lipid microC9205
K

Oxaliplatin
9205

$84.06

$16.81C9206
K

Integra, per cm2
9206

$9.23

$1.85C9211
K

Inj, alefacept, IV
9211

$571.01

$114.20C9212
K

Inj, alefacept, IM
9212

$402.00

$80.40C9218
K

Injection, Azacitidine
9218

$4.03

$0.81C9220
G

Sodium hyaluronate
9220

$203.84

$40.77C9221
G

Graftjacket Reg Matrix
9221

$1,234.36

$246.87C9222
G

Graftjacket SftTis
9222

$890.74

$178.15C9223
D

Inj adenosine, tx dxC9399
A

Unclass drugs/biologicalsC9400
D

Thallous chloride, brandC9401
D

Strontium-89 chloride, brandC9402
D

Th I131 so iodide cap, brandC9403
D

Dx I131 so iodide cap, brandC9404
D

Dx I131 so iodide sol, brandC9405
D

Th I131 so iodide sol, brandC9410
D

Dexrazoxane HCl inj, brandC9411
D

Pamidronate disodium, brandC9413
D

Na hyaluronate branC9414
D

Etoposide oral, brandC9415
D

Doxorubic hcl chemo, brandC9417
D

Bleomycin sulfate inj, brandC9418
D

Cisplatin inj, brandC9419
D

Inj cladribine, brandC9420
D

Cyclophosphamide inj, brandC9421
D

Cyclophosphamide lyo, brandC9422
D

Cytarabine hcl inj, brandC9423
D

Dacarbazine inj, brandC9424
D

Daunorubicin, brandC9425
D

Etoposide inj, brandC9426
D

Floxuridine inj, brandC9427
D

Ifosfomide inj, brandC9428
D

Mesna injection, brandC9429
D

Idarubicin hcl inj, brandC9430
D

Leuprolide acetate branC9431
D

Paclitaxel inj, brandC9432
D

Mitomycin inj, brandC9433
D

Thiotepa inj, brandC9435
D

Gonadorelin hydroch, brand( print page 50837)C9436
D

Azathioprine parenteral,brndC9437
D

Carmus bischl nitro injC9438
D

Cyclosporine oral, brandC9439
D

Diethylstilbestrol injectionC9440
D

Vinorelbine tar,brandC9704
T

Inj inert subs upper GI
1556

$1,750.00

$350.00C9713
T

Non-contact laser vap prosta
0429
42.3147
$2,511.08

$502.22C9716
S

RF Energy to Anus
1519

$1,750.00

$350.00C9718
T

Kyphoplasty, first vertebra
0051
36.5271
$2,167.63

$433.53C9719
T

Kyphoplasty, each addl
0051
36.5271
$2,167.63

$433.53C9720
T

HE ESW tx, tennis elbow
1547

$850.00

$170.00C9721
T

HE ESW tx, plantar fasciitis
1547

$850.00

$170.00C9722
S

KV imaging w/IR tracking
1502

$75.00

$15.00C9723
S

Dyn IR Perf Img
1502

$75.00

$15.00C9724
T

EPS gast cardia plic
0422
22.9647
$1,362.79
$448.81
$272.56D0120
E

Periodic oral evaluationD0140
E

Limit oral eval problm focusD0150
S

Comprehensve oral evaluation
0330
7.1756
$425.82

$85.16D0160
E

Extensv oral eval prob focusD0170
E

Re-eval,est pt,problem focusD0180
E

Comp periodontal evaluationD0210
E

Intraor complete film seriesD0220
E

Intraoral periapical first fD0230
E

Intraoral periapical ea addD0240
S

Intraoral occlusal film
0330
7.1756
$425.82

$85.16D0250
S

Extraoral first film
0330
7.1756
$425.82

$85.16D0260
S

Extraoral ea additional film
0330
7.1756
$425.82

$85.16D0270
S

Dental bitewing single film
0330
7.1756
$425.82

$85.16D0272
S

Dental bitewings two films
0330
7.1756
$425.82

$85.16D0274
S

Dental bitewings four films
0330
7.1756
$425.82

$85.16D0277
S

Vert bitewings-sev to eight
0330
7.1756
$425.82

$85.16D0290
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 studyD0416
B

Viral cultureD0421
B

Gen tst suscept oral diseaseD0425
E

Caries susceptibility testD0431
B

Diag tst detect mucos abnormD0460
S

Pulp vitality test
0330
7.1756
$425.82

$85.16D0470
E

Diagnostic castsD0472
B

Gross exam, prep & reportD0473
B

Micro exam, prep & reportD0474
B

Micro w exam of surg marginsD0475
B

Decalcification procedureD0476
B

Spec stains for microorganisD0477
B

Spec stains not for microorgD0478
B

Immunohistochemical stainsD0479
B

Tissue in-situ hybridizationD0480
B

Cytopath smear prep & reportD0481
B

Electron microscopy diagnostD0482
B

Direct immunofluorescenceD0483
B

Indirect immunofluorescenceD0484
B

Consult slides prep elsewherD0485
B

Consult inc prep of slidesD0502
B

Other oral pathology proceduD0999
B

Unspecified diagnostic proceD1110
E

Dental prophylaxis adultD1120
E

Dental prophylaxis childD1201
E

Topical fluor w prophy childD1203
E

Topical fluor w/o prophy chi( print page 50838)D1204
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
7.1756
$425.82

$85.16D1515
S

Fixed bilat space maintainer
0330
7.1756
$425.82

$85.16D1520
S

Remove unilat space maintain
0330
7.1756
$425.82

$85.16D1525
S

Remove bilat space maintain
0330
7.1756
$425.82

$85.16D1550
S

Recement space maintainer
0330
7.1756
$425.82

$85.16D2140
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 anD2390
E

Ant resin-based cmpst crownD2391
E

Post 1 srfc resinbased cmpstD2392
E

Post 2 srfc resinbased cmpstD2393
E

Post 3 srfc resinbased cmpstD2394
E

Post >=4srfc resinbase cmpstD2410
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 laboratoryD2712
E

Crown 3/4 resin-based composD2720
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 metalD2794
E

Crown-titaniumD2799
E

Provisional crownD2910
E

Dental recement inlayD2915
E

Recement cast or prefab postD2920
E

Dental recement crown( print page 50839)D2930
E

Prefab stnlss steel crwn priD2931
E

Prefab stnlss steel crown peD2932
E

Prefabricated resin crownD2933
E

Prefab stainless steel crownD2934
E

Prefab steel crown primaryD2940
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 porcelainD2971
E

Add proc construct new crownD2975
E

CopingD2980
E

Crown repairD2999
S

Dental unspec restorative pr
0330
7.1756
$425.82

$85.16D3110
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
7.1756
$425.82

$85.16D3470
E

Intentional replantationD3910
E

Isolation- tooth w rubb damD3920
E

Tooth splittingD3950
E

Canal prep/fitting of dowelD3999
S

Endodontic procedure
0330
7.1756
$425.82

$85.16D4210
E

Gingivectomy/plasty per quadD4211
E

Gingivectomy/plasty per tootD4240
E

Gingival flap proc w/ planinD4241
E

Gngvl flap w rootplan 1-3 thD4245
E

Apically positioned flapD4249
E

Crown lengthen hard tissueD4260
S

Osseous surgery per quadrant
0330
7.1756
$425.82

$85.16D4261
E

Osseous surgl-3teethperquadD4263
S

Bone replce graft first site
0330
7.1756
$425.82

$85.16D4264
S

Bone replce graft each add
0330
7.1756
$425.82

$85.16D4265
E

Bio mtrls to aid soft/os regD4266
E

Guided tiss regen resorbleD4267
E

Guided tiss regen nonresorbD4268
S

Surgical revision procedure
0330
7.1756
$425.82

$85.16D4270
S

Pedicle soft tissue graft pr
0330
7.1756
$425.82

$85.16D4271
S

Free soft tissue graft proc
0330
7.1756
$425.82

$85.16( print page 50840)D4273
S

Subepithelial tissue graft
0330
7.1756
$425.82

$85.16D4274
E

Distal/proximal wedge procD4275
E

Soft tissue allograftD4276
E

Con tissue w dble ped graftD4320
E

Provision splnt intracoronalD4321
E

Provisional splint extracoroD4341
E

Periodontal scaling & rootD4342
E

Periodontal scaling 1-3teethD4355
S

Full mouth debridement
0330
7.1756
$425.82

$85.16D4381
S

Localized chemo delivery
0330
7.1756
$425.82

$85.16D4910
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 metalD5225
E

Maxillary part denture flexD5226
E

Mandibular part denture flexD5281
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 claspD5640
E

Replace part denture teethD5650
E

Add tooth to partial dentureD5660
E

Add clasp to partial dentureD5670
E

Replc tth&acrlc on mtl frmwkD5671
E

Replc tth&acrlc mandibularD5710
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
7.1756
$425.82

$85.16D5912
S

Facial moulage complete
0330
7.1756
$425.82

$85.16D5913
E

Nasal prosthesisD5914
E

Auricular prosthesis( print page 50841)D5915
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
7.1756
$425.82

$85.16D5984
S

Radiation shield
0330
7.1756
$425.82

$85.16D5985
S

Radiation cone locator
0330
7.1756
$425.82

$85.16D5986
E

Fluoride applicatorD5987
S

Commissure splint
0330
7.1756
$425.82

$85.16D5988
E

Surgical splintD5999
E

Maxillofacial prosthesisD6010
E

Odontics endosteal implantD6040
E

Odontics eposteal implantD6050
E

Odontics transosteal implntD6053
E

Implnt/abtmnt spprt remv dntD6054
E

Implnt/abtmnt spprt remvprtlD6055
E

Implant connecting barD6056
E

Prefabricated abutmentD6057
E

Custom abutmentD6058
E

Abutment supported crownD6059
E

Abutment supported mtl crownD6060
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 implant( print page 50842)D6094
E

Abut support crown titaniumD6095
E

Odontics repr abutmentD6100
E

Removal of implantD6190
E

Radio/surgical implant indexD6194
E

Abut support retainer titaniD6199
E

Implant procedureD6205
E

Pontic-indirect resin basedD6210
E

Prosthodont high noble metalD6211
E

Bridge base metal castD6212
E

Bridge noble metal castD6214
E

Pontic titaniumD6240
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 metalD6253
E

Provisional ponticD6545
E

Dental retainr cast metlD6548
E

Porcelain/ceramic retainerD6600
E

Porcelain/ceramic inlay 2srfD6601
E

Porc/ceram inlay >= 3 surfacD6602
E

Cst hgh nble mtl inlay 2 srfD6603
E

Cst hgh nble mtl inlay >=3srD6604
E

Cst bse mtl inlay 2 surfacesD6605
E

Cst bse mtl inlay >= 3 surfaD6606
E

Cast noble metal inlay 2 surD6607
E

Cst noble mtl inlay >=3 surfD6608
E

Onlay porc/crmc 2 surfacesD6609
E

Onlay porc/crmc >=3 surfacesD6610
E

Onlay cst hgh nbl mtl 2 srfcD6611
E

Onlay cst hgh nbl mtl >=3srfD6612
E

Onlay cst base mtl 2 surfaceD6613
E

Onlay cst base mtl >=3 surfaD6614
E

Onlay cst nbl mtl 2 surfacesD6615
E

Onlay cst nbl mtl >=3 surfacD6624
E

Inlay titaniumD6634
E

Onlay titaniumD6710
E

Crown-indirect resin basedD6720
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 castD6793
E

Provisional retainer crownD6794
E

Crown titaniumD6920
S

Dental connector bar
0330
7.1756
$425.82

$85.16D6930
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 post( print page 50843)D6977
E

Each addtl prefab postD6980
E

Bridge repairD6985
E

Pediatric partial denture fxD6999
E

Fixed prosthodontic procD7111
S

Coronal remnants deciduous t
0330
7.1756
$425.82

$85.16D7140
S

Extraction erupted tooth/exr
0330
7.1756
$425.82

$85.16D7210
S

Rem imp tooth w mucoper flp
0330
7.1756
$425.82

$85.16D7220
S

Impact tooth remov soft tiss
0330
7.1756
$425.82

$85.16D7230
S

Impact tooth remov part bony
0330
7.1756
$425.82

$85.16D7240
S

Impact tooth remov comp bony
0330
7.1756
$425.82

$85.16D7241
S

Impact tooth rem bony w/comp
0330
7.1756
$425.82

$85.16D7250
S

Tooth root removal
0330
7.1756
$425.82

$85.16D7260
S

Oral antral fistula closure
0330
7.1756
$425.82

$85.16D7261
S

Primary closure sinus perf
0330
7.1756
$425.82

$85.16D7270
E

Tooth reimplantationD7272
E

Tooth transplantationD7280
E

Exposure impact tooth orthodD7282
E

Mobilize erupted/malpos tootD7283
B

Place device impacted toothD7285
E

Biopsy of oral tissue hardD7286
E

Biopsy of oral tissue softD7287
E

Cytology sample collectionD7288
B

Brush biopsyD7290
E

Repositioning of teethD7291
S

Transseptal fiberotomy
0330
7.1756
$425.82

$85.16D7310
E

Alveoplasty w/ extractionD7311
E

Alveoloplasty w/extract 1-3D7320
E

Alveoplasty w/o extractionD7321
B

Alveoloplasty not w/extractsD7340
E

Vestibuloplasty ridge extensD7350
E

Vestibuloplasty exten graftD7410
E

Rad exc lesion up to 1.25 cmD7411
E

Excision benign lesion>1.25cD7412
E

Excision benign lesion complD7413
E

Excision malig lesion < =1.25cD7414
E

Excision malig lesion > 1.25cmD7415
E

Excision malig les complicatD7440
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 siteD7472
E

Removal of torus palatinusD7473
E

Remove torus mandibularisD7485
E

Surg reduct osseoustuberositD7490
E

Mandible resectionD7510
E

I&d absc intraoral soft tissD7511
B

Incision/drain abscess intraD7520
E

I&d abscess extraoralD7521
B

Incision/drain abscess extraD7530
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 alveolusD7671
E

Alveolus open reductionD7680
E

Reduct simple facial bone fx( print page 50844)D7710
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 fxD7771
E

Alveolus clsd reduc stblz teD7780
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 therapyD7910
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
7.1756
$425.82

$85.16D7941
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 graftD7953
E

Bone replacement graftD7955
E

Repair maxillofacial defectsD7960
E

Frenulectomy/frenulotomyD7963
E

FrenuloplastyD7970
E

Excision hyperplastic tissueD7971
E

Excision pericoronal gingivaD7972
E

Surg redct fibrous tuberositD7980
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 primary( print page 50845)D8060
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 hoursD9450
E

Case presentation tx planD9610
E

Dent therapeutic drug injectD9630
S

Other drugs/medicaments
0330
7.1756
$425.82

$85.16D9910
E

Dent appl desensitizing medD9911
E

Appl desensitizing resinD9920
E

Behavior managementD9930
S

Treatment of complications
0330
7.1756
$425.82

$85.16D9940
S

Dental occlusal guard
0330
7.1756
$425.82

$85.16D9941
E

Fabrication athletic guardD9942
E

Repair/reline occlusal guardD9950
S

Occlusion analysis
0330
7.1756
$425.82

$85.16D9951
S

Limited occlusal adjustment
0330
7.1756
$425.82

$85.16D9952
S

Complete occlusal adjustment
0330
7.1756
$425.82

$85.16D9970
E

Enamel microabrasionD9971
E

Odontoplasty 1-2 teethD9972
E

Extrnl bleaching per archD9973
E

Extrnl bleaching per toothD9974
E

Intrnl bleaching per toothD9999
E

Adjunctive procedureE0100
Y

Cane adjust/fixed with tipE0105
Y

Cane adjust/fixed quad/3 proE0110
Y

Crutch forearm pairE0111
Y

Crutch forearm eachE0112
Y

Crutch underarm pair woodE0113
Y

Crutch underarm each woodE0114
Y

Crutch underarm pair no woodE0116
Y

Crutch underarm each no woodE0117
Y

Underarm springassist crutchE0118
E

Crutch substituteE0130
Y

Walker rigid adjust/fixed htE0135
Y

Walker folding adjust/fixedE0140
Y

Walker w trunk supportE0141
Y

Rigid wheeled walker adj/fixE0143
Y

Walker folding wheeled w/o sE0144
Y

Enclosed walker w rear seatE0147
Y

Walker variable wheel resistE0148
Y

Heavyduty walker no wheels( print page 50846)E0149
Y

Heavy duty wheeled walkerE0153
Y

Forearm crutch platform attaE0154
Y

Walker platform attachmentE0155
Y

Walker wheel attachment,pairE0156
Y

Walker seat attachmentE0157
Y

Walker crutch attachmentE0158
Y

Walker leg extenders set of4E0159
Y

Brake for wheeled walkerE0160
Y

Sitz type bath or equipmentE0161
Y

Sitz bath/equipment w/faucetE0162
Y

Sitz bath chairE0163
Y

Commode chair stationry fxdE0164
Y

Commode chair mobile fixed aE0166
Y

Commode chair mobile detachE0167
Y

Commode chair pail or panE0168
Y

Heavyduty/wide commode chairE0169
Y

Seatlift incorp commodechairE0175
Y

Commode chair foot restE0180
Y

Press pad alternating w pumpE0181
Y

Press pad alternating w/ pumE0182
Y

Pressure pad alternating pumE0184
Y

Dry pressure mattressE0185
Y

Gel pressure mattress padE0186
Y

Air pressure mattressE0187
Y

Water pressure mattressE0188
Y

Synthetic sheepskin padE0189
Y

Lambswool sheepskin padE0190
E

Positioning cushionE0191
Y

Protector heel or elbowE0193
Y

Powered air flotation bedE0194
Y

Air fluidized bedE0196
Y

Gel pressure mattressE0197
Y

Air pressure pad for mattresE0198
Y

Water pressure pad for mattrE0199
Y

Dry pressure pad for mattresE0200
Y

Heat lamp without standE0202
Y

Phototherapy light w/ photomE0203
E

Therapeutic lightbox tabletpE0205
Y

Heat lamp with standE0210
Y

Electric heat pad standardE0215
Y

Electric heat pad moistE0217
Y

Water circ heat pad w pumpE0218
Y

Water circ cold pad w pumpE0220
Y

Hot water bottleE0221
E

Infrared heating pad systemE0225
Y

Hydrocollator unitE0230
Y

Ice cap or collarE0231
E

Wound warming deviceE0232
E

Warming card for NWTE0235
Y

Paraffin bath unit portableE0236
Y

Pump for water circulating pE0238
Y

Heat pad non-electric moistE0239
Y

Hydrocollator unit portableE0240
E

Bath/shower chairE0241
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 attachmentE0247
E

Trans bench w/wo comm openE0248
E

HDtrans bench w/wo comm openE0249
Y

Pad water circulating heat uE0250
Y

Hosp bed fixed ht w/ mattresE0251
Y

Hosp bed fixd ht w/o mattresE0255
Y

Hospital bed var ht w/ mattr( print page 50847)E0256
Y

Hospital bed var ht w/o mattE0260
Y

Hosp bed semi-electr w/ mattE0261
Y

Hosp bed semi-electr w/o matE0265
Y

Hosp bed total electr w/ matE0266
Y

Hosp bed total elec w/o mattE0270
E

Hospital bed institutional tE0271
Y

Mattress innerspringE0272
Y

Mattress foam rubberE0273
E

Bed boardE0274
E

Over-bed tableE0275
Y

Bed pan standardE0276
Y

Bed pan fractureE0277
Y

Powered pres-redu air mattrsE0280
Y

Bed cradleE0290
Y

Hosp bed fx ht w/o rails w/mE0291
Y

Hosp bed fx ht w/o rail w/oE0292
Y

Hosp bed var ht w/o rail w/oE0293
Y

Hosp bed var ht w/o rail w/E0294
Y

Hosp bed semi-elect w/ mattrE0295
Y

Hosp bed semi-elect w/o mattE0296
Y

Hosp bed total elect w/ mattE0297
Y

Hosp bed total elect w/o matE0300
Y

Enclosed ped crib hosp gradeE0301
Y

HD hosp bed, 350-600 lbsE0302
Y

Ex hd hosp bed > 600 lbsE0303
Y

Hosp bed hvy dty xtra wideE0304
Y

Hosp bed xtra hvy dty × wideE0305
Y

Rails bed side half lengthE0310
Y

Rails bed side full lengthE0315
E

Bed accessory brd/tbl/supprtE0316
Y

Bed safety enclosureE0325
Y

Urinal male jug-typeE0326
Y

Urinal female jug-typeE0350
E

Control unit bowel systemE0352
E

Disposable pack w/bowel systE0370
E

Air elevator for heelE0371
Y

Nonpower mattress overlayE0372
Y

Powered air mattress overlayE0373
Y

Nonpowered pressure mattressE0424
Y

Stationary compressed gas 02E0425
E

Gas system stationary compreE0430
E

Oxygen system gas portableE0431
Y

Portable gaseous 02E0434
Y

Portable liquid 02E0435
E

Oxygen system liquid portablE0439
Y

Stationary liquid 02E0440
E

Oxygen system liquid stationE0441
Y

Oxygen contents, gaseousE0442
Y

Oxygen contents, liquidE0443
Y

Portable 02 contents, gasE0444
Y

Portable 02 contents, liquidE0445
A

Oximeter non-invasiveE0450
Y

Volume vent stationary/portaE0455
Y

Oxygen tent excl croup/ped tE0457
Y

Chest shellE0459
Y

Chest wrapE0460
Y

Neg press vent portabl/statnE0461
Y

Vol vent noninvasive interfaE0462
Y

Rocking bed w/ or w/o side rE0463
Y

Press supp vent invasive intE0464
Y

Press supp vent noninv intE0470
Y

RAD w/o backup non-inv intfcE0471
Y

RAD w/backup non inv intrfcE0472
Y

RAD w backup invasive intrfcE0480
Y

Percussor elect/pneum home mE0481
E

Intrpulmnry percuss vent sys( print page 50848)E0482
Y

Cough stimulating deviceE0483
Y

Chest compression gen systemE0484
Y

Non-elec oscillatory pep dvcE0500
Y

Ippb all typesE0550
Y

Humidif extens supple w ippbE0555
Y

Humidifier for use w/ regulaE0560
Y

Humidifier supplemental w/ iE0561
Y

Humidifier nonheated w PAPE0562
Y

Humidifier heated used w PAPE0565
Y

Compressor air power sourceE0570
Y

Nebulizer with compressionE0571
Y

Aerosol compressor for svnebE0572
Y

Aerosol compressor adjust prE0574
Y

Ultrasonic generator w svnebE0575
Y

Nebulizer ultrasonicE0580
Y

Nebulizer for use w/ regulatE0585
Y

Nebulizer w/ compressor & heE0590
Y

Dispensing fee dme neb drugE0600
Y

Suction pump portab hom modlE0601
Y

Cont airway pressure deviceE0602
Y

Manual breast pumpE0603
A

Electric breast pumpE0604
A

Hosp grade elec breast pumpE0605
Y

Vaporizer room typeE0606
Y

Drainage board posturalE0607
Y

Blood glucose monitor homeE0610
Y

Pacemaker monitr audible/visE0615
Y

Pacemaker monitr digital/visE0616
N

Cardiac event recorderE0617
Y

Automatic ext defibrillatorE0618
A

Apnea monitorE0619
A

Apnea monitor w recorderE0620
Y

Cap bld skin piercing laserE0621
Y

Patient lift sling or seatE0625
E

Patient lift bathroom or toiE0627
Y

Seat lift incorp lift-chairE0628
Y

Seat lift for pt furn-electrE0629
Y

Seat lift for pt furn-non-elE0630
Y

Patient lift hydraulicE0635
Y

Patient lift electricE0636
Y

PT support & positioning sysE0637
E

Sit-stand w seatlift wheeledE0638
E

Standing frame sys wheeledE0639
E

Moveable patient lift systemE0640
E

Fixed patient lift systemE0650
Y

Pneuma compresor non-segmentE0651
Y

Pneum compressor segmentalE0652
Y

Pneum compres w/cal pressureE0655
Y

Pneumatic appliance half armE0660
Y

Pneumatic appliance full legE0665
Y

Pneumatic appliance full armE0666
Y

Pneumatic appliance half legE0667
Y

Seg pneumatic appl full legE0668
Y

Seg pneumatic appl full armE0669
Y

Seg pneumatic appli half legE0671
Y

Pressure pneum appl full legE0672
Y

Pressure pneum appl full armE0673
Y

Pressure pneum appl half legE0675
Y

Pneumatic compression deviceE0691
Y

Uvl pnl 2 sq ft or lessE0692
Y

Uvl sys panel 4 ftE0693
Y

Uvl sys panel 6 ftE0694
Y

Uvl md cabinet sys 6 ftE0700
E

Safety equipmentE0701
Y

Helmet w face guard prefabE0710
E

Restraints any type( print page 50849)E0720
Y

Tens two leadE0730
Y

Tens four leadE0731
Y

Conductive garment for tens/E0740
Y

Incontinence treatment systmE0744
Y

Neuromuscular stim for scoliE0745
Y

Neuromuscular stim for shockE0746
E

Electromyograph biofeedbackE0747
Y

Elec osteogen stim not spineE0748
Y

Elec osteogen stim spinalE0749
N

Elec osteogen stim implantedE0752
B

Neurostimulator electrodeE0754
A

Pulsegenerator pt programmerE0755
E

Electronic salivary reflex sE0756
B

Implantable pulse generatorE0757
N

Implantable RF receiverE0758
A

External RF transmitterE0759
A

Replace rdfrquncy transmittrE0760
Y

Osteogen ultrasound stimltorE0761
E

Nontherm electromgntc deviceE0765
Y

Nerve stimulator for tx n&vE0769
B

Electric wound treatment devE0776
Y

Iv poleE0779
Y

Amb infusion pump mechanicalE0780
Y

Mech amb infusion pump <8hrsE0781
Y

External ambulatory infus puE0782
N

Non-programble infusion pumpE0783
N

Programmable infusion pumpE0784
Y

Ext amb infusn pump insulinE0785
N

Replacement impl pump cathetE0786
N

Implantable pump replacementE0791
Y

Parenteral infusion pump staE0830
N

Ambulatory traction deviceE0840
Y

Tract frame attach headboardE0849
Y

Cervical pneum trac equipE0850
Y

Traction stand free standingE0855
Y

Cervical traction equipmentE0860
Y

Tract equip cervical tractE0870
Y

Tract frame attach footboardE0880
Y

Trac stand free stand extremE0890
Y

Traction frame attach pelvicE0900
Y

Trac stand free stand pelvicE0910
Y

Trapeze bar attached to bedE0920
Y

Fracture frame attached to bE0930
Y

Fracture frame free standingE0935
Y

Exercise device passive motiE0940
Y

Trapeze bar free standingE0941
Y

Gravity assisted traction deE0942
Y

Cervical head harness/halterE0944
Y

Pelvic belt/harness/bootE0945
Y

Belt/harness extremityE0946
Y

Fracture frame dual w crossE0947
Y

Fracture frame attachmnts peE0948
Y

Fracture frame attachmnts ceE0950
E

TrayE0951
E

Loop heelE0952
E

Toe loop/holder, eachE0953
E

Pneumatic tireE0954
E

Wheelchair semi-pneumatic caE0955
Y

Cushioned headrestE0956
Y

W/c lateral trunk/hip supporE0957
Y

W/c medial thigh supportE0958
A

Whlchr att- conv 1 arm driveE0959
B

Amputee adapterE0960
Y

W/c shoulder harness/strapsE0961
B

Wheelchair brake extensionE0966
B

Wheelchair head rest extensi( print page 50850)E0967
Y

Wheelchair hand rimsE0968
Y

Wheelchair commode seatE0969
Y

Wheelchair narrowing deviceE0970
B

Wheelchair no. 2 footplatesE0971
B

Wheelchair anti-tipping deviE0972
A

Transfer board or deviceE0973
B

W/Ch access det adj armrestE0974
B

W/Ch access anti-rollbackE0977
Y

Wheelchair wedge cushionE0978
B

W/C acc,saf belt pelv strapE0980
Y

Wheelchair safety vestE0981
Y

Seat upholstery, replacementE0982
Y

Back upholstery, replacementE0983
Y

Add pwr joystickE0984
Y

Add pwr tillerE0985
Y

W/c seat lift mechanismE0986
Y

Man w/c push-rim pow assistE0990
B

Whellchair elevating leg resE0992
B

Wheelchair solid seat insertE0994
Y

Wheelchair arm restE0995
B

Wheelchair calf restE0996
B

Wheelchair tire solidE0997
Y

Wheelchair caster w/ a forkE0998
Y

Wheelchair caster w/o a forkE0999
Y

Wheelchr pneumatic tire w/whE1000
B

Wheelchair tire pneumatic caE1001
Y

Wheelchair wheelE1002
Y

Pwr seat tiltE1003
Y

Pwr seat reclineE1004
Y

Pwr seat recline mechE1005
Y

Pwr seat recline pwrE1006
Y

Pwr seat combo w/o shearE1007
Y

Pwr seat combo w/shearE1008
Y

Pwr seat combo pwr shearE1009
Y

Add mech leg elevationE1010
Y

Add pwr leg elevationE1011
Y

Ped wc modify width adjustmE1014
Y

Reclining back add ped w/cE1015
Y

Shock absorber for man w/cE1016
Y

Shock absorber for power w/cE1017
Y

HD shck absrbr for hd man wcE1018
Y

HD shck absrber for hd powwcE1019
E

HD feature power seatE1020
Y

Residual limb support systemE1021
E

Ex hd feature power seatE1025
E

Pedwc lat/thor sup nocontourE1026
E

Pedwc contoured lat/thor supE1027
E

Ped wc lat/ant supportE1028
Y

W/c manual swingawayE1029
Y

W/c vent tray fixedE1030
Y

W/c vent tray gimbaledE1031
Y

Rollabout chair with castersE1035
Y

Patient transfer systemE1037
Y

Transport chair, ped sizeE1038
Y

Transport chair, adult sizeE1039
Y

Transport chair pt wt>=250lbE1050
A

Whelchr fxd full length armsE1060
A

Wheelchair detachable armsE1070
A

Wheelchair detachable foot rE1083
A

Hemi-wheelchair fixed armsE1084
A

Hemi-wheelchair detachable aE1085
A

Hemi-wheelchair fixed armsE1086
A

Hemi-wheelchair detachable aE1087
A

Wheelchair lightwt fixed armE1088
A

Wheelchair lightweight det aE1089
A

Wheelchair lightwt fixed arm( print page 50851)E1090
A

Wheelchair lightweight det aE1092
A

Wheelchair wide w/ leg restsE1093
A

Wheelchair wide w/ foot restE1100
A

Whchr s-recl fxd arm leg resE1110
A

Wheelchair semi-recl detachE1130
A

Whlchr stand fxd arm ft restE1140
A

Wheelchair standard detach aE1150
Y

Wheelchair standard w/ leg rE1160
A

Wheelchair fixed armsE1161
A

Manual adult wc w tiltinspacE1170
A

Whlchr ampu fxd arm leg restE1171
A

Wheelchair amputee w/o leg rE1172
A

Wheelchair amputee detach arE1180
A

Wheelchair amputee w/ foot rE1190
A

Wheelchair amputee w/ leg reE1195
A

Wheelchair amputee heavy dutE1200
A

Wheelchair amputee fixed armE1210
Y

Whlchr moto ful arm leg restE1211
Y

Wheelchair motorized w/ detE1212
A

Wheelchair motorized w fullE1213
A

Wheelchair motorized w/ detE1220
A

Whlchr special size/constrcE1221
A

Wheelchair spec size w footE1222
A

Wheelchair spec size w/ legE1223
A

Wheelchair spec size w footE1224
A

Wheelchair spec size w/ legE1225
Y

Wheelchair spec sz semi-reclE1226
B

W/C access fully reclinebackE1227
Y

Wheelchair spec sz spec ht aE1228
Y

Wheelchair spec sz spec ht bE1229
Y

Pediatric wheelchair NOSE1230
Y

Power operated vehicleE1231
Y

Rigid ped w/c tilt-in-spaceE1232
Y

Folding ped wc tilt-in-spaceE1233
Y

Rig ped wc tltnspc w/o seatE1234
Y

Fld ped wc tltnspc w/o seatE1235
Y

Rigid ped wc adjustableE1236
Y

Folding ped wc adjustableE1237
Y

Rgd ped wc adjstabl w/o seatE1238
Y

Fld ped wc adjstabl w/o seatE1239
Y

Ped power wheelchair NOSE1240
A

Whchr litwt det arm leg restE1250
A

Wheelchair lightwt fixed armE1260
A

Wheelchair lightwt foot restE1270
A

Wheelchair lightweight leg rE1280
A

Whchr h-duty det arm leg resE1285
A

Wheelchair heavy duty fixedE1290
A

Wheelchair hvy duty detach aE1295
A

Wheelchair heavy duty fixedE1296
Y

Wheelchair special seat heigE1297
Y

Wheelchair special seat deptE1298
Y

Wheelchair spec seat depth/wE1300
E

Whirlpool portableE1310
Y

Whirlpool non-portableE1340
Y

Repair for DME, per 15 minE1353
Y

Oxygen supplies regulatorE1355
Y

Oxygen supplies stand/rackE1372
Y

Oxy suppl heater for nebulizE1390
Y

Oxygen concentratorE1391
Y

Oxygen concentrator, dualE1399
N

Durable medical equipment miE1405
Y

O2/water vapor enrich w/heatE1406
Y

O2/water vapor enrich w/o heE1500
A

CentrifugeE1510
A

Kidney dialysate delivry sysE1520
A

Heparin infusion pump( print page 50852)E1530
A

Replacement air bubble detecE1540
A

Replacement pressure alarmE1550
A

Bath conductivity meterE1560
A

Replace blood leak detectorE1570
A

Adjustable chair for esrd ptE1575
A

Transducer protect/fld barE1580
A

Unipuncture control systemE1590
A

Hemodialysis machineE1592
A

Auto interm peritoneal dialyE1594
A

Cycler dialysis machineE1600
A

Deli/install chrg hemo equipE1610
A

Reverse osmosis h2o puri sysE1615
A

Deionizer H2O puri systemE1620
A

Replacement blood pumpE1625
A

Water softening systemE1630
A

Reciprocating peritoneal diaE1632
A

Wearable artificial kidneyE1634
B

Peritoneal dialysis clampE1635
A

Compact travel hemodialyzerE1636
A

Sorbent cartridges per 10E1637
A

Hemostats for dialysis, eachE1639
A

Dialysis scaleE1699
A

Dialysis equipment nocE1700
Y

Jaw motion rehab systemE1701
Y

Repl cushions for jaw motionE1702
Y

Repl measr scales jaw motionE1800
Y

Adjust elbow ext/flex deviceE1801
Y

SPS elbow deviceE1802
Y

Adjst forearm pro/sup deviceE1805
Y

Adjust wrist ext/flex deviceE1806
Y

SPS wrist deviceE1810
Y

Adjust knee ext/flex deviceE1811
Y

SPS knee deviceE1815
Y

Adjust ankle ext/flex deviceE1816
Y

SPS ankle deviceE1818
Y

SPS forearm deviceE1820
Y

Soft interface materialE1821
Y

Replacement interface SPSDE1825
Y

Adjust finger ext/flex devcE1830
Y

Adjust toe ext/flex deviceE1840
Y

Adj shoulder ext/flex deviceE1841
Y

Static str shldr dev rom adjE1902
A

AAC non-electronic boardE2000
Y

Gastric suction pump hme mdlE2100
Y

Bld glucose monitor w voiceE2101
Y

Bld glucose monitor w lanceE2120
Y

Pulse gen sys tx endolymp flE2201
Y

Man w/ch acc seat w>=20÷<24÷E2202
Y

Seat width 24-27 inE2203
Y

Frame depth less than 22 inE2204
Y

Frame depth 22 to 25 inE2205
Y

Manual wc accessory, handrimE2206
Y

Complete wheel lock assemblyE2291
E

Planar back for ped size wcE2292
E

Planar seat for ped size wcE2293
E

Contour back for ped size wcE2294
E

Contour seat for ped size wcE2300
Y

Pwr seat elevation sysE2301
Y

Pwr standingE2310
Y

Electro connect btw controlE2311
Y

Electro connect btw 2 sysE2320
Y

Hand chin controlE2321
Y

Hand interface joystickE2322
Y

Mult mech switchesE2323
Y

Special joystick handleE2324
Y

Chin cup interface( print page 50853)E2325
Y

Sip and puff interfaceE2326
Y

Breath tube kitE2327
Y

Head control interface mechE2328
Y

Head/extremity control interE2329
Y

Head control nonproportionalE2330
Y

Head control proximity switcE2331
Y

Attendant controlE2340
Y

W/c wdth 20-23 in seat frameE2341
Y

W/c wdth 24-27 in seat frameE2342
Y

W/c dpth 20-21 in seat frameE2343
Y

W/c dpth 22-25 in seat frameE2351
Y

Electronic SGD interfaceE2360
Y

22nf nonsealed leadacidE2361
Y

22nf sealed leadacid batteryE2362
Y

Gr24 nonsealed leadacidE2363
Y

Gr24 sealed leadacid batteryE2364
Y

U1nonsealed leadacid batteryE2365
Y

U1 sealed leadacid batteryE2366
Y

Battery charger, single modeE2367
Y

Battery charger, dual modeE2368
Y

Power wc motor replacementE2369
Y

Pwr wc gear box replacementE2370
Y

Pwr wc motor/gear box comboE2399
Y

Noc interfaceE2402
Y

Neg press wound therapy pumpE2500
Y

SGD digitized pre-rec <=8minE2502
Y

SGD prerec msg >8min <=20minE2504
Y

SGD prerec msg>20min <=40minE2506
Y

SGD prerec msg > 40 minE2508
Y

SGD spelling phys contactE2510
Y

SGD w multi methods msg/accsE2511
Y

SGD sftwre prgrm for PC/PDAE2512
Y

SGD accessory, mounting sysE2599
Y

SGD accessory nocE2601
Y

Gen w/c cushion wdth < 22 inE2602
Y

Gen w/c cushion wdth >=22 inE2603
Y

Skin protect wc cus wd <22inE2604
Y

Skin protect wc cus wd>=22inE2605
Y

Position wc cush wdth <22 inE2606
Y

Position wc cush wdth>=22 inE2607
Y

Skin pro/pos wc cus wd <22inE2608
Y

Skin pro/pos wc cus wd>=22inE2609
Y

Custom fabricate w/c cushionE2610
B

Powered w/c cushionE2611
Y

Gen use back cush wdth <22inE2612
Y

Gen use back cush wdth>=22inE2613
Y

Position back cush wd <22inE2614
Y

Position back cush wd>=22inE2615
Y

Pos back post/lat wdth <22inE2616
Y

Pos back post/lat wdth>=22inE2617
Y

Custom fab w/c back cushionE2618
Y

Wc acc solid seat supp baseE2619
Y

Replace cover w/c seat cushE2620
Y

WC planar back cush wd <22inE2621
Y

WC planar back cush wd>=22inE8000
E

Posterior gait trainerE8001
E

Upright gait trainerE8002
E

Anterior gait trainerG0008
X

Admin influenza virus vac
0350
0.3954
$23.46
$0.00
$0.00G0009
X

Admin pneumococcal vaccine
0350
0.3954
$23.46
$0.00
$0.00G0010
B

Admin hepatitis b vaccineG0027
A

Semen analysisG0101
V

CA screen pelvic/breast exam
0600
0.8688
$51.56

$10.31G0102
N

Prostate ca screening dreG0103
A

Psa, total screeningG0104
S

CA screen flexi sigmoidscope
0159
3.1455
$186.66

$46.67( print page 50854)G0105
T

Colorectal scrn hi risk ind
0158
7.6588
$454.50

$113.63G0106
S

Colon CA screen barium enema
0157
2.2904
$135.92

$27.18G0107
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 counselG0117
S

Glaucoma scrn hgh risk direc
0230
0.7858
$46.63
$14.97
$9.33G0118
S

Glaucoma scrn hgh risk direc
0230
0.7858
$46.63
$14.97
$9.33G0120
S

Colon ca scrn barium enema
0157
2.2904
$135.92

$27.18G0121
T

Colon ca scrn not hi rsk ind
0158
7.6588
$454.50

$113.63G0122
E

Colon ca scrn barium enemaG0123
A

Screen cerv/vag thin layerG0124
A

Screen c/v thin layer by MDG0127
T

Trim nail(s)
0009
0.668
$39.64
$8.34
$7.93G0128
B

CORF skilled nursing serviceG0129
P

Partial hosp prog service
0033
4.0708
$241.57

$48.31G0130
X

Single energy x-ray study
0260
0.7555
$44.83
$17.93
$8.97G0141
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
B

HHCP-serv of pt,ea 15 minG0152
B

HHCP-serv of ot,ea 15 minG0153
B

HHCP-svs of s/l path,ea 15mnG0154
B

HHCP-svs of rn,ea 15 minG0155
B

HHCP-svs of csw,ea 15 minG0156
B

HHCP-svs of aide,ea 15 minG0166
T

Extrnl counterpulse, per tx
0678
1.7276
$102.52

$20.50G0168
N

Wound closure by adhesiveG0173
S

Linear acc stereo radsur com
1528

$5,250.00

$1,050.00G0175
V

OPPS Service,sched team conf
0602
1.4284
$84.77

$16.95G0176
P

OPPS/PHP activity therapy
0033
4.0708
$241.57

$48.31G0177
P

OPPS/PHP train & educ serv
0033
4.0708
$241.57

$48.31G0179
E

MD recertification HHA PTG0180
E

MD certification HHA patientG0181
E

Home health care supervisionG0182
E

Hospice care supervisionG0186
T

Dstry eye lesn,fdr vssl tech
0235
4.6593
$276.50
$67.40
$55.30G0202
A

ScreeningmammographydigitalG0204
A

DiagnosticmammographydigitalG0206
A

DiagnosticmammographydigitalG0219
E

PET img whbd ring noncov indG0235
E

PET not otherwise specifiedG0237
S

Therapeutic procd strg endur
0411
0.3869
$22.96

$4.59G0238
S

Oth resp proc, indiv
0411
0.3869
$22.96

$4.59G0239
S

Oth resp proc, group
0411
0.3869
$22.96

$4.59G0243
S

Multisour photon stero treat
1528

$5,250.00

$1,050.00G0244
B

Observ care by facility toptG0245
V

Initial Foot Exam PTLOPS
0600
0.8688
$51.56

$10.31G0246
V

Followup eval of foot pt lop
0600
0.8688
$51.56

$10.31G0247
T

Routine footcare pt w lops
0009
0.668
$39.64
$8.34
$7.93G0248
S

Demonstrate use home inr mon
1503

$150.00

$30.00G0249
S

Provide test material,equipm
1503

$150.00

$30.00G0250
E

MD review interpret of testG0251
S

Linear acc based stero radio
1513

$1,150.00

$230.00G0252
E

PET imaging initial dxG0255
E

Current percep threshold tstG0257
S

Unsched dialysis ESRD pt hos
0170
5.8994
$350.09

$70.02( print page 50855)G0258
X

IV infusion during obs stay
0340
0.6384
$37.88

$7.58G0259
N

Inject for sacroiliac jointG0260
T

Inj for sacroiliac jt anesth
0206
5.492
$325.91
$75.55
$65.18G0263
B

Adm with CHF, CP, asthmaG0264
B

Assmt otr CHF, CP, asthmaG0265
A

Cryopresevation Freeze+storaG0266
A

Thawing + expansion froz celG0267
S

Bone marrow or psc harvest
0110
3.6594
$217.16

$43.43G0268
X

Removal of impacted wax md
0340
0.6384
$37.88

$7.58G0269
N

Occlusive device in vein artG0270
A

MNT subs tx for change dxG0271
A

Group MNT 2 or more 30 minsG0275
N

Renal angio, cardiac cathG0278
N

Iliac art angio,cardiac cathG0279
A

Excorp shock tx, elbow epiG0280
A

Excorp shock tx other thanG0281
A

Elec stim unattend for pressG0282
E

Elect stim wound care not pdG0283
A

Elec stim other than woundG0288
S

Recon, CTA for pre & post su
0417
4.075
$241.82

$48.36G0289
N

Arthro, loose body + chondroG0290
T

Drug-eluting stents, single
0656
109.9237
$6,523.20

$1,304.64G0291
T

Drug-eluting stents,each add
0656
109.9237
$6,523.20

$1,304.64G0293
S

Non-cov surg proc,clin trial
1505

$350.00

$70.00G0294
S

Non-cov proc, clinical trial
1502

$75.00

$15.00G0295
E

Electromagnetic therapy oncG0297
T

Insert single chamber/cd
0107
260.0295
$15,430.93
$3,103.22
$3,086.19G0298
T

Insert dual chamber/cd
0107
260.0295
$15,430.93
$3,103.22
$3,086.19G0299
T

Inser/repos single icd+leads
0108
349.1681
$20,720.68

$4,144.14G0300
T

Insert reposit lead dual+gen
0108
349.1681
$20,720.68

$4,144.14G0302
S

Pre-op service LVRS complete
1509

$750.00

$150.00G0303
S

Pre-op service LVRS 10-15dos
507

$550.00

$110.00G0304
S

Pre-op service LVRS 1-9 dos
1504

$250.00

$50.00G0305
S

Post op service LVRS min 6
1504

$250.00

$50.00G0306
A

CBC/diffwbc w/o plateletG0307
A

CBC without plateletG0308
A

ESRD related svc 4+mo<2yrsG0309
A

ESRD related svc 2-3mo<2yrsG0310
A

ESRD related svc 1vst<2yrG0311
A

ESRD related svs 4+mo 2-11yrG0312
A

ESRD relate svs 2-3 mo 2-11yG0313
A

ESRD related svs 1 mon 2-11yG0314
A

ESRD relate svs 4+mo 12-19G0315
A

ESRD related svs 2-3 mo 12-1G0316
A

ESRD related svs 1 vis/12-19G0317
A

ESRD related svs 4+mo 20+yrsG0318
A

ESRD related svs 2-3 mo 20+yG0319
A

ESRD related svs 1visit 20+yG0320
A

ESRD related svs home underG0321
A

ESRDrelatedsvs home mo 2-11yG0322
A

ESRD related svs home mo 12-1G0323
A

ESRD related svs home mo 20+G0324
A

ESRD related svs home/dy/2yG0325
A

ESRD relate home/dy 2-11yrG0326
A

ESRD relate home/dy 12-19yG0327
A

ESRD relate home/dy 20+yrsG0328
A

Fecal blood scrn immunoassayG0329
A

Electromagntic tx for ulcersG0337
A

Hospice evaluation preelectiG0339
S

Robot lin-radsurg com, first
1528

$5,250.00

$1,050.00G0340
S

Robt lin-radsurg fractx 2-5
1525

$3,750.00

$750.00G0341
C

Percutaneous islet celltransG0342
C

Laparoscopy Islet cell TransG0343
C

Laparotomy Islet cell tranpG0344
V

Initial preventive exam
0601
1.0038
$59.57

$11.91G0345
M

IV infuse hydration initial( print page 50856)G0346
M

Each additional infuse hoursG0347
M

IV infusion therapy/diagnostG0348
M

each additional hr up to 8hrG0349
M

additional sequential infuseG0350
M

concurrent infusionG0351
M

therapeutic/diagnostic injecG0353
M

IV push,single orinitial druG0354
M

each addition sequential IVG0355
M

chemo administrate subcut/IMG0356
M

hormonal anti-neoplasticG0357
M

IV push single/initial substG0358
M

IV push each additional drugG0359
M

chemotherapy IV one hr initiG0360
M

each additional hr 1-8 hrsG0361
M

prolong chemo Infuse>8hrs puG0362
M

each add sequential infusionG0363
M

irrigate implanted venous deG0364
X

Bone marrow aspirate & biops
0342
0.156
$9.26
$3.70
$1.85G0365
S

Vessel mapping hemo access
0267
2.6327
$156.23
$62.18
$31.25G0366
B

EKG for initial prevent examG0367
S

EKG tracing for initial prev
0099
0.3821
$22.67

$4.53G0368
M

EKG interpret & report preveG0369
M

Pharm fee 1st month transplaG0370
M

Pharmacy fee oral cancer etcG0371
M

Pharm dispense inhalation 30G0374
M

Pharm dispense inhalation 90G0375
S

Smoke/Tobacco counseling 3-1
1491

$5.00

$1.00G0376
S

Smoke/Tobacco counseling >10
1491

$5.00

$1.00G3001
S

Admin + supply, tositumomab
1522

$2,250.00

$450.00G9001
B

MCCD, initial rateG9002
B

MCCD,maintenance rateG9003
B

MCCD, risk adj hi, initialG9004
B

MCCD, risk adj lo, initialG9005
B

MCCD, risk adj, maintenanceG9006
B

MCCD, Home monitoringG9007
B

MCCD, sch team confG9008
B

Mccd,phys coor-care ovrsghtG9009
E

MCCD, risk adj, level 3G9010
E

MCCD, risk adj, level 4G9011
E

MCCD, risk adj, level 5G9012
E

Other Specified Case MgmtG9013
E

ESRD demo bundle level IG9014
E

ESRD demo bundle-level IIG9016
E

Demo-smoking cessation counG9017
A

Amantadine HCL,oralG9018
A

Zanamivir, inh pwdrG9019
A

Oseltamivir phospG9020
A

Rimantadine HCLG9021
M

Chemo assess nausea vomit L1G9022
M

Chemo assess nausea vomit L2G9023
M

Chemo assess nausea vomit L3G9024
M

Chemo assess nausea vomit L4G9025
M

Chemo assessment pain level1G9026
M

Chemo assessment pain level2G9027
M

Chemo assessment pain level3G9028
M

Chemo assessment pain level4G9029
M

Chemo assess for fatigue L1G9030
M

Chemo assess for fatigue L2G9031
M

Chemo assess for fatigue L3G9032
M

Chemo assess for fatigue L4G9033
A

Amantadine HCL, oral, brandG9034
A

Zanamivir, inh pwdr, brandG9035
A

Oseltamivir phosp, brandG9036
A

Rimantadine HCL, brandG9041
A

Low vision serv occupationalG9042
A

Low vision orient/mobility( print page 50857)G9043
A

Low vision rehab therapistG9044
A

Low vision rehab teacherJ0120
N

Tetracyclin injectionJ0128
G

Abarelix injection
9216

$66.96

$13.39J0130
K

Abciximab injection
1605

$450.60

$90.12J0135
K

Adalimumab injection
1083

$300.10

$60.02J0150
K

Injection adenosine 6 MG
0379

$33.45

$6.69J0152
K

Adenosine injection
0917

$71.53

$14.31J0170
N

Adrenalin epinephrin injectJ0180
K

Agalsidase beta injection
9208

$123.35

$24.67J0190
N

Inj biperiden lactate/5 mgJ0200
N

Alatrofloxacin mesylateJ0205
K

Alglucerase injection
0900

$39.94

$7.99J0207
K

Amifostine
7000

$436.01

$87.20J0210
K

Methyldopate hcl injection
2210

$9.58

$1.92J0215
B

AlefaceptJ0256
K

Alpha 1 proteinase inhibitor
0901

$3.30

$0.66J0270
B

Alprostadil for injectionJ0275
B

Alprostadil urethral supposJ0280
N

Aminophyllin 250 MG injJ0282
N

Amiodarone HClJ0285
K

Amphotericin B
9030

$30.70

$6.14J0287
K

Amphotericin b lipid complex
9024

$11.95

$2.39J0288
K

Ampho b cholesteryl sulfate
0735

$12.24

$2.45J0289
K

Amphotericin b liposome inj
0736

$21.91

$4.38J0290
N

Ampicillin 500 MG injJ0295
N

Ampicillin sodium per 1.5 gmJ0300
N

Amobarbital 125 MG injJ0330
N

Succinycholine chloride injJ0350
N

Injection anistreplase 30 uJ0360
N

Hydralazine hcl injectionJ0380
N

Inj metaraminol bitartrateJ0390
N

Chloroquine injectionJ0395
K

Arbutamine HCl injection
9031

$163.15

$32.63J0456
N

AzithromycinJ0460
N

Atropine sulfate injectionJ0470
N

Dimecaprol injectionJ0475
K

Baclofen 10 MG injection
9032

$188.01

$37.60J0476
B

Baclofen intrathecal trialJ0500
N

Dicyclomine 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
K

Penicillin g benzathine inj
0880

$72.26

$14.45J0583
N

BivalirudinJ0585
K

Botulinum toxin a per unit
0902

$4.80

$0.96J0587
K

Botulinum toxin type B
9018

$7.89

$1.58J0592
N

Buprenorphine hydrochlorideJ0595
N

Butorphanol tartrate 1 mgJ0600
K

Edetate calcium disodium inj
0892

$40.34

$8.07J0610
N

Calcium gluconate injectionJ0620
N

Calcium glycer & lact/10 MLJ0630
K

Calcitonin salmon injection
0893

$35.68

$7.14J0636
N

Inj calcitriol per 0.1 mcgJ0637
K

Caspofungin acetate
9019

$32.35

$6.47J0640
N

Leucovorin calcium injectionJ0670
N

Inj mepivacaine HCL/10 mlJ0690
N

Cefazolin sodium injectionJ0692
N

Cefepime HCl for injectionJ0694
N

Cefoxitin sodium injectionJ0696
N

Ceftriaxone sodium injectionJ0697
N

Sterile cefuroxime injection( print page 50858)J0698
N

Cefotaxime sodium injectionJ0702
N

Betamethasone acet&sod phospJ0704
N

Betamethasone sod phosp/4 MGJ0706
K

Caffeine citrate injection
0876

$3.34

$0.67J0710
N

Cephapirin sodium injectionJ0713
N

Inj ceftazidime per 500 mgJ0715
N

Ceftizoxime sodium / 500 MGJ0720
N

Chloramphenicol sodium injecJ0725
N

Chorionic gonadotropin/1000uJ0735
K

Clonidine hydrochloride
0935

$57.47

$11.49J0740
K

Cidofovir injection
9033

$782.98

$156.60J0743
N

Cilastatin sodium injectionJ0744
N

Ciprofloxacin ivJ0745
N

Inj codeine phosphate /30 MGJ0760
N

Colchicine injectionJ0770
N

Colistimethate sodium injJ0780
N

Prochlorperazine injectionJ0800
K

Corticotropin injection
1280

$95.44

$19.09J0835
K

Inj cosyntropin per 0.25 MG
0835

$69.27

$13.85J0850
K

Cytomegalovirus imm IV /vial
0903

$683.07

$136.61J0878
G

Daptomycin injection
9124

$0.30

$0.06J0880
E

Darbepoetin alfa injectionJ0895
K

Deferoxamine mesylate inj
0895

$14.91

$2.98J0900
N

Testosterone enanthate injJ0945
N

Brompheniramine maleate injJ0970
N

Estradiol valerate injectionJ1000
N

Depo-estradiol cypionate injJ1020
N

Methylprednisolone 20 MG injJ1030
N

Methylprednisolone 40 MG injJ1040
N

Methylprednisolone 80 MG injJ1051
N

Medroxyprogesterone injJ1055
E

Medrxyprogester acetate injJ1056
E

MA/EC contraceptiveinjectionJ1060
N

Testosterone cypionate 1 MLJ1070
N

Testosterone cypionat 100 MGJ1080
N

Testosterone cypionat 200 MGJ1094
N

Inj dexamethasone acetateJ1100
N

Dexamethasone sodium phosJ1110
K

Inj dihydroergotamine mesylt
1210

$27.82

$5.56J1120
N

Acetazolamid sodium injectioJ1160
N

Digoxin injectionJ1165
N

Phenytoin sodium injectionJ1170
N

Hydromorphone injectionJ1180
K

Dyphylline injection
9166

$7.74

$1.55J1190
K

Dexrazoxane HCl injection
0726

$216.39

$43.28J1200
N

Diphenhydramine hcl injectioJ1205
N

Chlorothiazide sodium injJ1212
N

Dimethyl sulfoxide 50% 50 MLJ1230
N

Methadone injectionJ1240
N

Dimenhydrinate injectionJ1245
N

Dipyridamole injectionJ1250
N

Inj dobutamine HCL/250 mgJ1260
K

Dolasetron mesylate
0750

$6.55

$1.31J1270
N

Injection, doxercalciferolJ1320
N

Amitriptyline injectionJ1325
N

Epoprostenol injectionJ1327
K

Eptifibatide injection
1607

$12.73

$2.55J1330
K

Ergonovine maleate injection
1330
0.5263
$31.23

$6.25J1335
N

Ertapenem injectionJ1364
N

Erythro lactobionate /500 MGJ1380
N

Estradiol valerate 10 MG injJ1390
N

Estradiol valerate 20 MG injJ1410
K

Inj estrogen conjugate 25 MG
9038

$57.77

$11.55J1435
N

Injection estrone per 1 MGJ1436
K

Etidronate disodium inj
1436

$68.69

$13.74J1438
K

Etanercept injection
1608

$152.11

$30.42( print page 50859)J1440
K

Filgrastim 300 mcg injection
0728

$178.39

$35.68J1441
K

Filgrastim 480 mcg injection
7049

$282.29

$56.46J1450
N

FluconazoleJ1452
K

Intraocular Fomivirsen na
9040

$203.93

$40.79J1455
N

Foscarnet sodium injectionJ1457
K

Gallium nitrate injection
1085

$1.30

$0.26J1460
N

Gamma globulin 1 CC injJ1470
B

Gamma globulin 2 CC injJ1480
B

Gamma globulin 3 CC injJ1490
B

Gamma globulin 4 CC injJ1500
B

Gamma globulin 5 CC injJ1510
B

Gamma globulin 6 CC injJ1520
B

Gamma globulin 7 CC injJ1530
B

Gamma globulin 8 CC injJ1540
B

Gamma globulin 9 CC injJ1550
B

Gamma globulin 10 CC injJ1560
B

Gamma globulin > 10 CC injJ1563
E

IV immune globulinJ1564
E

Immune globulin 10 mgJ1565
K

RSV-ivig
0906

$15.56

$3.11J1570
N

Ganciclovir sodium injectionJ1580
N

Garamycin gentamicin injJ1590
N

Gatifloxacin injectionJ1595
N

Injection glatiramer acetateJ1600
N

Gold sodium thiomaleate injJ1610
K

Glucagon hydrochloride/1 MG
9042

$62.16

$12.43J1620
K

Gonadorelin hydroch/ 100 mcg
7005

$173.44

$34.69J1626
K

Granisetron HCl injection
0764

$7.24

$1.45J1630
N

Haloperidol injectionJ1631
N

Haloperidol decanoate injJ1642
N

Inj heparin sodium per 10 uJ1644
N

Inj heparin sodium per 1000uJ1645
N

Dalteparin sodiumJ1650
N

Inj enoxaparin sodiumJ1652
N

Fondaparinux sodiumJ1655
K

Tinzaparin sodium injection
1655

$2.53

$0.51J1670
K

Tetanus immune globulin inj
1670

$76.90

$15.38J1700
N

Hydrocortisone acetate injJ1710
N

Hydrocortisone sodium ph injJ1720
N

Hydrocortisone sodium succ iJ1730
K

Diazoxide injection
1740

$113.86

$22.77J1742
K

Ibutilide fumarate injection
9044

$243.34

$48.67J1745
K

Infliximab injection
7043

$54.20

$10.84J1750
K

Iron dextran
9045

$11.43

$2.29J1756
K

Iron sucrose injection
9046

$0.38

$0.08J1785
K

Injection imiglucerase /unit
0916

$3.98

$0.80J1790
N

Droperidol injectionJ1800
N

Propranolol injectionJ1810
E

Droperidol/fentanyl injJ1815
N

Insulin injectionJ1817
N

Insulin for insulin pump useJ1825
E

Interferon beta-1aJ1830
K

Interferon beta-1b / .25 MG
0910

$81.95

$16.39J1835
K

Itraconazole injection
9047

$36.93

$7.39J1840
N

Kanamycin sulfate 500 MG injJ1850
N

Kanamycin sulfate 75 MG injJ1885
N

Ketorolac tromethamine injJ1890
N

Cephalothin sodium injectionJ1931
K

Laronidase injection
9209

$23.16

$4.63J1940
N

Furosemide injectionJ1950
K

Leuprolide acetate /3.75 MG
0800

$441.78

$88.36J1955
B

Inj levocarnitine per 1 gmJ1956
N

Levofloxacin injectionJ1960
N

Levorphanol tartrate injJ1980
N

Hyoscyamine sulfate injJ1990
N

Chlordiazepoxide injection( print page 50860)J2001
N

Lidocaine injectionJ2010
N

Lincomycin injectionJ2020
K

Linezolid injection
9001

$24.15

$4.83J2060
N

Lorazepam injectionJ2150
N

Mannitol injectionJ2175
N

Meperidine hydrochl /100 MGJ2180
N

Meperidine/promethazine injJ2185
N

MeropenemJ2210
N

Methylergonovin maleate injJ2250
N

Inj midazolam hydrochlorideJ2260
N

Inj milrinone lactate / 5 MGJ2270
N

Morphine sulfate injectionJ2271
N

Morphine so4 injection 100mgJ2275
N

Morphine sulfate injectionJ2280
N

Inj, moxifloxacin 100 mgJ2300
N

Inj nalbuphine hydrochlorideJ2310
N

Inj naloxone hydrochlorideJ2320
N

Nandrolone decanoate 50 MGJ2321
N

Nandrolone decanoate 100 MGJ2322
N

Nandrolone decanoate 200 MGJ2324
K

Nesiritide
9114

$75.19

$15.04J2353
K

Octreotide injection, depot
1207

$87.40

$17.48J2354
N

Octreotide inj, non-depotJ2355
K

Oprelvekin injection
7011

$249.06

$49.81J2357
G

Omalizumab injection
9300

$15.98

$3.20J2360
N

Orphenadrine injectionJ2370
N

Phenylephrine hcl injectionJ2400
N

Chloroprocaine hcl injectionJ2405
K

Ondansetron hcl injection
0768

$3.80

$0.76J2410
N

Oxymorphone hcl injectionJ2430
K

Pamidronate disodium /30 MG
0730

$58.42

$11.68J2440
N

Papaverin hcl injectionJ2460
N

Oxytetracycline injectionJ2469
K

Palonosetron HCl
9210

$18.42

$3.68J2501
N

ParicalcitolJ2505
K

Injection, pegfilgrastim 6mg
9119

$2,178.28

$435.66J2510
N

Penicillin g procaine injJ2515
N

Pentobarbital sodium injJ2540
N

Penicillin g potassium injJ2543
N

Piperacillin/tazobactamJ2545
Y

Pentamidine isethionte/300mgJ2550
N

Promethazine hcl injectionJ2560
N

Phenobarbital sodium injJ2590
N

Oxytocin injectionJ2597
N

Inj desmopressin acetateJ2650
N

Prednisolone acetate injJ2670
N

Totazoline hcl injectionJ2675
N

Inj progesterone per 50 MGJ2680
N

Fluphenazine decanoate 25 MGJ2690
N

Procainamide hcl injectionJ2700
N

Oxacillin sodium injecitonJ2710
N

Neostigmine methylslfte injJ2720
N

Inj protamine sulfate/10 MGJ2725
N

Inj protirelin per 250 mcgJ2730
K

Pralidoxime chloride inj
2730

$76.68

$15.34J2760
N

Phentolaine mesylate injJ2765
N

Metoclopramide hcl injectionJ2770
K

Quinupristin/dalfopristin
2770

$105.48

$21.10J2780
N

Ranitidine hydrochloride injJ2783
G

Rasburicase
0738

$109.18

$21.84J2788
K

Rho d immune globulin 50 mcg
9023

$25.08

$5.02J2790
K

Rho d immune globulin inj
0884

$113.91

$22.78J2792
K

Rho(D) immune globulin h, sd
1609

$12.04

$2.41J2794
G

Risperidone, long acting
9125

$4.71

$0.94J2795
N

Ropivacaine HCl injectionJ2800
N

Methocarbamol injection( print page 50861)J2810
N

Inj theophylline per 40 MGJ2820
K

Sargramostim injection
0731

$21.11

$4.22J2910
N

Aurothioglucose injecitonJ2912
N

Sodium chloride injectionJ2916
N

Na ferric gluconate complexJ2920
N

Methylprednisolone injectionJ2930
N

Methylprednisolone injectionJ2940
K

Somatrem injection
2940

$43.14

$8.63J2941
K

Somatropin injection
7034

$42.93

$8.59J2950
N

Promazine hcl injectionJ2993
K

Reteplase injection
9005

$898.81

$179.76J2995
K

Inj streptokinase /250000 IU
0911

$83.36

$16.67J2997
K

Alteplase recombinant
7048

$30.65

$6.13J3000
N

Streptomycin injectionJ3010
N

Fentanyl citrate injecitonJ3030
K

Sumatriptan succinate / 6 MG
3030

$51.03

$10.21J3070
N

Pentazocine hcl injectionJ3100
K

Tenecteplase injection
9002

$2,052.77

$410.55J3105
N

Terbutaline sulfate injJ3110
B

Teriparatide injectionJ3120
N

Testosterone enanthate injJ3130
N

Testosterone enanthate injJ3140
N

Testosterone suspension injJ3150
N

Testosteron propionate injJ3230
N

Chlorpromazine hcl injectionJ3240
K

Thyrotropin injection
9108

$712.58

$142.52J3246
K

Tirofiban HCl
7041

$7.89

$1.58J3250
N

Trimethobenzamide hcl injJ3260
N

Tobramycin sulfate injectionJ3265
N

Injection torsemide 10 mg/mlJ3280
N

Thiethylperazine maleate injJ3301
N

Triamcinolone acetonide injJ3302
N

Triamcinolone diacetate injJ3303
N

Triamcinolone hexacetonl injJ3305
K

Inj trimetrexate glucoronate
7045

$139.85

$27.97J3310
N

Perphenazine injecitonJ3315
K

Triptorelin pamoate
9122

$369.98

$74.00J3320
N

Spectinomycn di-hcl injJ3350
K

Urea injection
9051
1.0454
$62.04

$12.41J3360
N

Diazepam injectionJ3364
N

Urokinase 5000 IU injectionJ3365
K

Urokinase 250,000 IU inj
7036

$415.69

$83.14J3370
N

Vancomycin hcl injectionJ3396
K

Verteporfin injection
1203

$9.16

$1.83J3400
N

Triflupromazine hcl injJ3410
N

Hydroxyzine hcl injectionJ3411
N

Thiamine hcl 100 mgJ3415
N

Pyridoxine hcl 100 mgJ3420
N

Vitamin b12 injectionJ3430
N

Vitamin k phytonadione injJ3465
K

Injection, voriconazole
1052

$4.63

$0.93J3470
N

Hyaluronidase injectionJ3475
N

Inj magnesium sulfateJ3480
N

Inj potassium chlorideJ3485
N

ZidovudineJ3486
N

Ziprasidone mesylateJ3487
K

Zoledronic acid
9115

$202.41

$40.48J3490
N

Drugs unclassified injectionJ3520
E

Edetate disodium per 150 mgJ3530
N

Nasal vaccine inhalationJ3535
E

Metered dose inhaler drugJ3570
E

Laetrile amygdalin vit B17J3590
N

Unclassified biologicsJ7030
N

Normal saline solution infusJ7040
N

Normal saline solution infusJ7042
N

5% dextrose/normal saline( print page 50862)J7050
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
K

Factor viii
0925

$0.51

$0.10J7191
K

Factor VIII (porcine)
0926

$1.75

$0.35J7192
K

Factor viii recombinant
0927

$0.94

$0.19J7193
K

Factor IX non-recombinant
0931

$0.75

$0.15J7194
K

Factor ix complex
0928

$0.52

$0.10J7195
K

Factor IX recombinant
0932

$0.86

$0.17J7197
N

Antithrombin iii injectionJ7198
K

Anti-inhibitor
0929

$1.12

$0.22J7199
B

Hemophilia clot factor nocJ7300
E

Intraut copper contraceptiveJ7302
E

Levonorgestrel iu contraceptJ7303
E

Contraceptive vaginal ringJ7304
E

Contraceptive hormone patchJ7308
K

Aminolevulinic acid hcl top
7308

$96.79

$19.36J7310
K

Ganciclovir long act implant
0913

$4,318.68

$863.74J7317
K

Sodium hyaluronate injection
7316

$110.65

$22.13J7320
K

Hylan G-F 20 injection
1611

$203.15

$40.63J7330
B

Cultured chondrocytes implntJ7340
E

Metabolic active D/E tissueJ7342
K

Metabolically active tissue
9054

$15.69

$3.14J7343
B

Nonmetabolic act d/e tissueJ7344
K

Nonmetabolic active tissue
9156

$53.76

$10.75J7350
K

Injectable human tissue
9055

$3.54

$0.71J7500
N

Azathioprine oral 50mgJ7501
K

Azathioprine parenteral
0887

$47.40

$9.48J7502
K

Cyclosporine oral 100 mg
0888

$3.94

$0.79J7504
K

Lymphocyte immune globulin
0890

$290.30

$58.06J7505
K

Monoclonal antibodies
7038

$885.36

77.07J7506
N

Prednisone oralJ7507
K

Tacrolimus oral per 1 MG
0891

$3.37

$0.67J7509
N

Methylprednisolone oralJ7510
N

Prednisolone oral per 5 mgJ7511
K

Antithymocyte globuln rabbit
9104

$299.47

$59.89J7513
K

Daclizumab, parenteral
1612

$381.48

$76.30J7515
K

Cyclosporine oral 25 mg
7515

$1.00

$0.20J7516
N

Cyclosporin parenteral 250mgJ7517
K

Mycophenolate mofetil oral
9015

$2.50

$0.50J7518
G

Mycophenolic acid
9219

$2.47

$0.49J7520
K

Sirolimus, oral
9020

$6.85

$1.37J7525
K

Tacrolimus injection
9006

$126.61

$25.32J7599
N

Immunosuppressive drug nocJ7608
Y

Acetylcysteine inh sol u dJ7611
Y

Albuterol concentrated formJ7612
Y

Levalbuterol concentratedJ7613
Y

Albuterol unit doseJ7614
Y

Levalbuterol unit doseJ7616
Y

Albuterol compound solutionJ7617
Y

Levalbuterol compounded solJ7622
A

Beclomethasone inhalatn solJ7624
A

Betamethasone inhalation solJ7626
A

Budesonide inhalation solJ7628
Y

Bitolterol mes inhal sol conJ7629
Y

Bitolterol mes inh sol u dJ7631
Y

Cromolyn sodium inh sol u dJ7633
N

Budesonide concentrated solJ7635
Y

Atropine inhal sol conJ7636
Y

Atropine inhal sol unit doseJ7637
Y

Dexamethasone inhal sol con( print page 50863)J7638
Y

Dexamethasone inhal sol u dJ7639
Y

Dornase alpha inhal sol u dJ7641
A

Flunisolide, inhalation solJ7642
Y

Glycopyrrolate inhal sol conJ7643
Y

Glycopyrrolate inhal sol u dJ7644
Y

Ipratropium brom inh sol u dJ7648
Y

Isoetharine hcl inh sol conJ7649
Y

Isoetharine hcl inh sol u dJ7658
Y

Isoproterenolhcl inh sol conJ7659
Y

Isoproterenol hcl inh sol udJ7668
Y

Metaproterenol inh sol conJ7669
Y

Metaproterenol inh sol u dJ7674
N

Methacholine chloride, nebJ7680
Y

Terbutaline so4 inh sol conJ7681
Y

Terbutaline so4 inh sol u dJ7682
Y

Tobramycin inhalation solJ7683
Y

Triamcinolone inh sol conJ7684
Y

Triamcinolone inh sol u dJ7699
Y

Inhalation solution for DMEJ7799
Y

Non-inhalation drug for DMEJ8499
E

Oral prescrip drug non chemoJ8501
G

Oral aprepitant
0868

$4.75

$0.95J8510
K

Oral busulfan
7015

$1.98

$0.40J8520
K

Capecitabine, oral, 150 mg
7042

$3.30

$0.66J8521
E

Capecitabine, oral, 500 mgJ8530
N

Cyclophosphamide oral 25 MGJ8560
K

Etoposide oral 50 MG
0802

$41.12

$8.22J8565
E

Gefitinib oralJ8600
N

Melphalan oral 2 MGJ8610
N

Methotrexate oral 2.5 MGJ8700
K

Temozolomide
1086

$7.28

$1.46J8999
B

Oral prescription drug chemoJ9000
N

Doxorubic hcl 10 MG vl chemoJ9001
K

Doxorubicin hcl liposome inj
7046

$365.64

$73.13J9010
K

Alemtuzumab injection
9110

$516.87

$103.37J9015
K

Aldesleukin/single use vial
0807

$701.76

$140.35J9017
K

Arsenic trioxide
9012

$33.76

$6.75J9020
K

Asparaginase injection
0814

$55.42

$11.08J9031
K

Bcg live intravesical vac
0809

$121.74

$24.35J9035
G

Bevacizumab injection
9214

$58.17

$11.63J9040
K

Bleomycin sulfate injection
0857

$54.18

$10.84J9041
K

Bortezomib injection
9207

$28.90

$5.78J9045
K

Carboplatin injection
0811

$77.16

$15.43J9050
K

Carmus bischl nitro inj
0812

$141.29

$28.26J9055
G

Cetuximab injection
9215

$50.59

$10.12J9060
N

Cisplatin 10 MG injectionJ9062
B

Cisplatin 50 MG injectionJ9065
K

Inj cladribine per 1 MG
0858

$39.37

$7.87J9070
N

Cyclophosphamide 100 MG injJ9080
B

Cyclophosphamide 200 MG injJ9090
B

Cyclophosphamide 500 MG injJ9091
B

Cyclophosphamide 1.0 grm injJ9092
B

Cyclophosphamide 2.0 grm injJ9093
N

Cyclophosphamide lyophilizedJ9094
B

Cyclophosphamide lyophilizedJ9095
B

Cyclophosphamide lyophilizedJ9096
B

Cyclophosphamide lyophilizedJ9097
B

Cyclophosphamide lyophilizedJ9098
K

Cytarabine liposome
1166

$366.43

$73.29J9100
N

Cytarabine hcl 100 MG injJ9110
B

Cytarabine hcl 500 MG injJ9120
N

Dactinomycin actinomycin dJ9130
K

Dacarbazine 100 mg inj
0819

$6.20

$1.24J9140
B

Dacarbazine 200 MG injJ9150
K

Daunorubicin
0820

$35.28

$7.06J9151
K

Daunorubicin citrate liposom
0821

$57.56

$11.51( print page 50864)J9160
K

Denileukin diftitox, 300 mcg
1084

$1,235.33

$247.07J9165
N

Diethylstilbestrol injectionJ9170
K

Docetaxel
0823

$301.17

$60.23J9178
K

Inj, epirubicin hcl, 2 mg
1167

$25.15

$5.03J9181
N

Etoposide 10 MG injJ9182
B

Etoposide 100 MG injJ9185
K

Fludarabine phosphate inj
0842

$262.41

$52.48J9190
N

Fluorouracil injectionJ9200
K

Floxuridine injection
0827

$60.17

$12.03J9201
K

Gemcitabine HCl
0828

$117.45

$23.49J9202
K

Goserelin acetate implant
0810

$196.25

$39.25J9206
K

Irinotecan injection
0830

$129.08

$25.82J9208
K

Ifosfomide injection
0831

$53.54

$10.71J9209
K

Mesna injection
0732

$13.68

$2.74J9211
K

Idarubicin hcl injection
0832

$314.00

$62.80J9212
K

Interferon alfacon-1
0912

$3.91

$0.78J9213
K

Interferon alfa-2a inj
0834

$31.75

$6.35J9214
K

Interferon alfa-2b inj
0836

$13.22

$2.64J9215
K

Interferon alfa-n3 inj
0865

$8.77

$1.75J9216
K

Interferon gamma 1-b inj
0838

$277.79

$55.56J9217
K

Leuprolide acetate suspnsion
9217

$230.87

$46.17J9218
K

Leuprolide acetate injeciton
0861

$10.96

$2.19J9219
K

Leuprolide acetate implant
7051

$2,262.19

$452.44J9230
N

Mechlorethamine hcl injJ9245
K

Inj melphalan hydrochl 50 MG
0840

$523.22

$104.64J9250
N

Methotrexate sodium injJ9260
B

Methotrexate sodium injJ9263
B

OxaliplatinJ9265
K

Paclitaxel injection
0863

$19.11

$3.82J9266
K

Pegaspargase/singl dose vial
0843

$1,528.80

$305.76J9268
K

Pentostatin injection
0844

$1,868.91

$373.78J9270
K

Plicamycin (mithramycin) inj
0860

$80.54

$16.11J9280
K

Mitomycin 5 MG inj
0862

$26.36

$5.27J9290
B

Mitomycin 20 MG injJ9291
B

Mitomycin 40 MG injJ9293
K

Mitoxantrone hydrochl / 5 MG
0864

$329.69

$65.94J9300
K

Gemtuzumab ozogamicin
9004

$2,245.04

$449.01J9305
G

Pemetrexed injection
9213

$41.29

$8.26J9310
K

Rituximab cancer treatment
0849

$447.97

$89.59J9320
K

Streptozocin injection
0850

$153.33

$30.67J9340
K

Thiotepa injection
0851

$44.55

$8.91J9350
K

Topotecan
0852

$755.51

$151.10J9355
K

Trastuzumab
1613

$53.98

$10.80J9357
K

Valrubicin, 200 mg
9167

$376.87

$75.37J9360
N

Vinblastine sulfate injJ9370
N

Vincristine sulfate 1 MG injJ9375
B

Vincristine sulfate 2 MG injJ9380
B

Vincristine sulfate 5 MG injJ9390
K

Vinorelbine tartrate/10 mg
0855

$62.85

$12.57J9395
K

Injection, Fulvestrant
9120

$82.90

$16.58J9600
K

Porfimer sodium
0856

$2,457.97

$491.59J9999
N

Chemotherapy drugK0001
Y

Standard wheelchairK0002
Y

Stnd hemi (low seat) whlchrK0003
Y

Lightweight wheelchairK0004
Y

High strength ltwt whlchrK0005
Y

Ultralightweight wheelchairK0006
Y

Heavy duty wheelchairK0007
Y

Extra heavy duty wheelchairK0009
Y

Other manual wheelchair/baseK0010
Y

Stnd wt frame power whlchrK0011
Y

Stnd wt pwr whlchr w controlK0012
Y

Ltwt portbl power whlchrK0014
Y

Other power whlchr baseK0015
Y

Detach non-adjus hght armrstK0017
Y

Detach adjust armrest base( print page 50865)K0018
Y

Detach adjust armrst upperK0019
Y

Arm pad eachK0020
Y

Fixed adjust armrest pairK0037
Y

High mount flip-up footrestK0038
Y

Leg strap eachK0039
Y

Leg strap h style eachK0040
Y

Adjustable angle footplateK0041
Y

Large size footplate eachK0042
Y

Standard size footplate eachK0043
Y

Ftrst lower extension tubeK0044
Y

Ftrst upper hanger bracketK0045
Y

Footrest complete assemblyK0046
Y

Elevat legrst low extensionK0047
Y

Elevat legrst up hangr brackK0050
Y

Ratchet assemblyK0051
Y

Cam relese assem ftrst/lgrstK0052
Y

Swingaway detach footrestK0053
Y

Elevate footrest articulateK0056
Y

Seat ht <17 or >=21 ltwt wcK0064
Y

Zero pressure tube flat freeK0065
Y

Spoke protectorsK0066
Y

Solid tire any size eachK0067
Y

Pneumatic tire any size eachK0068
Y

Pneumatic tire tube eachK0069
Y

Rear whl complete solid tireK0070
Y

Rear whl compl pneum tireK0071
Y

Front castr compl pneum tireK0072
Y

Frnt cstr cmpl sem-pneum tirK0073
Y

Caster pin lock eachK0074
Y

Pneumatic caster tire eachK0075
Y

Semi-pneumatic caster tireK0076
Y

Solid caster tire eachK0077
Y

Front caster assem completeK0078
Y

Pneumatic caster tire tubeK0090
Y

Rear tire power wheelchairK0091
Y

Rear tire tube power whlchrK0092
Y

Rear assem cmplt powr whlchrK0093
Y

Rear zero pressure tire tubeK0094
Y

Wheel tire for power baseK0095
Y

Wheel tire tube each baseK0096
Y

Wheel assem powr base compltK0097
Y

Wheel zero presure tire tubeK0098
Y

Drive belt power wheelchairK0099
Y

Pwr wheelchair front casterK0102
Y

Crutch and cane holderK0104
Y

Cylinder tank carrierK0105
Y

Iv hangerK0106
Y

Arm trough eachK0108
Y

W/c component-accessory NOSK0195
Y

Elevating whlchair leg restsK0415
B

RX antiemetic drg, oral NOSK0416
B

Rx antiemetic drg,rectal NOSK0452
Y

Wheelchair bearingsK0455
Y

Pump uninterrupted infusionK0462
Y

Temporary replacement eqpmntK0552
Y

Supply/Ext inf pump syr typeK0600
Y

Functional neuromuscularstimK0601
Y

Repl batt silver oxide 1.5 vK0602
Y

Repl batt silver oxide 3 vK0603
Y

Repl batt alkaline 1.5 vK0604
Y

Repl batt lithium 3.6 vK0605
Y

Repl batt lithium 4.5 vK0606
Y

AED garment w/elec analysisK0607
Y

Repl batt for AEDK0608
Y

Repl garment for AEDK0609
Y

Repl electrode for AED( print page 50866)K0618
A

TLSO 2 piece rigid shellK0619
A

TLSO 3 piece rigid shellK0620
A

Tubular elastic dressingK0628
Y

Mult dens insert direct formK0629
Y

Mult dens insert custom moldK0630
Y

SIO flex pelvisacral prefabK0631
Y

SIO flex pelvisacral customK0632
Y

SIO panel prefabK0633
Y

SIO panel customK0634
Y

LO flexibl L1 - below L5 preK0635
Y

LO sag stays/panels pre-fabK0636
Y

LO sagitt rigid panel prefabK0637
Y

LO flex w/o rigid stays preK0638
Y

LSO flex w/rigid stays custK0639
Y

LSO post rigid panel preK0640
Y

LSO sag-coro rigid frame preK0641
Y

LSO sag-cor rigid frame custK0642
Y

LSO flexion control prefabK0643
Y

LSO flexion control customK0644
Y

LSO sagit rigid panel prefabK0645
Y

LSO sagittal rigid panel cusK0646
Y

LSO sag-coronal panel prefabK0647
Y

LSO sag-coronal panel customK0648
Y

LSO s/c shell/panel prefabK0649
Y

LSO s/c shell/panel customK0669
Y

W/c seat/back no CVR SADMERCK0670
A

Stance phase onlyK0671
Y

Portable oxygen concentratorL0100
A

Cranial orthosis/helmet moldL0110
A

Cranial orthosis/helmet nonmL0112
A

Cranial cervical orthosisL0120
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 fabricaL0430
A

Dewall posture protectorL0450
A

TLSO flex prefab thoracicL0452
A

tlso flex custom fab thoraciL0454
A

TLSO flex prefab sacrococ-T9L0456
A

TLSO flex prefabL0458
A

TLSO 2Mod symphis-xipho preL0460
A

TLSO2Mod symphysis-stern preL0462
A

TLSO 3Mod sacro-scap preL0464
A

TLSO 4Mod sacro-scap preL0466
A

TLSO rigid frame pre soft apL0468
A

TLSO rigid frame prefab pelvL0470
A

TLSO rigid frame pre subclavL0472
A

TLSO rigid frame hyperex preL0480
A

TLSO rigid plastic custom faL0482
A

TLSO rigid lined custom fabL0484
A

TLSO rigid plastic cust fabL0486
A

TLSO rigidlined cust fab twoL0488
A

TLSO rigid lined pre one pieL0490
A

TLSO rigid plastic pre oneL0700
A

Ctlso a-p-l control moldedL0710
A

Ctlso a-p-l control w/ interL0810
A

Halo cervical into jckt vest( print page 50867)L0820
A

Halo cervical into body jackL0830
A

Halo cerv into milwaukee typL0860
A

Magnetic resonanc image compL0861
A

Halo repl liner/interfaceL0960
E

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 modelL1005
A

Tension based scoliosis orthL1010
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-flexL1640
A

Pelv band/spread bar thigh cL1650
A

HO abduction hip adjustableL1652
A

HO bi thighcuffs w sprdr barL1660
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 joints( print page 50868)L1815
A

Elastic with condylar padsL1820
A

Ko elas w/ condyle pads & joL1825
A

Ko elastic knee capL1830
A

Ko immobilizer canvas longitL1831
A

Knee orth pos locking jointL1832
A

KO adj jnt pos rigid supportL1834
A

Ko w/0 joint rigid molded toL1836
A

Rigid KO wo jointsL1840
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/lacersL1900
A

Afo sprng wir drsflx calf bdL1901
A

Prefab ankle orthosisL1902
A

Afo ankle gauntletL1904
A

Afo molded ankle gauntletL1906
A

Afo multiligamentus ankle suL1907
A

AFO supramalleolar customL1910
A

Afo sing bar clasp attach shL1920
A

Afo sing upright w/ adjust sL1930
A

Afo plasticL1932
A

Afo rig ant tib prefab TCF/=L1940
A

Afo molded to patient plastiL1945
A

Afo molded plas rig ant tibL1950
A

Afo spiral molded to pt plasL1951
A

AFO spiral prefabricatedL1960
A

Afo pos solid ank plastic moL1970
A

Afo plastic molded w/ankle jL1971
A

AFO w/ankle joint, prefabL1980
A

Afo sing solid stirrup calfL1990
A

Afo doub solid stirrup calfL2000
A

Kafo sing fre stirr thi/calfL2005
A

KAFO sng/dbl mechanical actL2010
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 brL2106
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 rigidL2126
A

Kafo fem fx cast thermoplasL2128
A

Kafo fem fx cast molded to pL2132
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 joint( print page 50869)L2182
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 & pL2232
A

Rocker bottom, contact AFOL2240
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 jntL2492
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 perL2768
A

Ortho sidebar disconnectL2770
A

Low ext orthosis per bar/jnt( print page 50870)L2780
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 padL2820
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
B

Ft insert ucb berkeley shellL3001
B

Foot insert remov molded speL3002
B

Foot insert plastazote or eqL3003
B

Foot insert silicone gel eacL3010
B

Foot longitudinal arch suppoL3020
B

Foot longitud/metatarsal supL3030
B

Foot arch support remov premL3031
E

Foot lamin/prepreg compositeL3040
B

Ft arch suprt premold longitL3050
B

Foot arch supp premold metatL3060
B

Foot arch supp longitud/metaL3070
B

Arch suprt att to sho longitL3080
B

Arch supp att to shoe metataL3090
B

Arch supp att to shoe long/mL3100
B

Hallus-valgus nght dynamic sL3140
B

Abduction rotation bar shoeL3150
B

Abduct rotation bar w/o shoeL3160
B

Shoe styled positioning devL3170
B

Foot plastic heel stabilizerL3201
B

Oxford w supinat/pronat infL3202
B

Oxford w/ supinat/pronator cL3203
B

Oxford w/ supinator/pronatorL3204
B

Hightop w/ supp/pronator infL3206
B

Hightop w/ supp/pronator chiL3207
B

Hightop w/ supp/pronator junL3208
B

Surgical boot each infantL3209
B

Surgical boot each childL3211
B

Surgical boot each juniorL3212
B

Benesch boot pair infantL3213
B

Benesch boot pair childL3214
B

Benesch boot pair juniorL3215
B

Orthopedic ftwear ladies oxfL3216
B

Orthoped ladies shoes dpth iL3217
B

Ladies shoes hightop depth iL3219
B

Orthopedic mens shoes oxfordL3221
B

Orthopedic mens shoes dpth iL3222
B

Mens shoes hightop depth inlL3224
A

Womans shoe oxford braceL3225
A

Mans shoe oxford braceL3230
B

Custom shoes depth inlayL3250
B

Custom mold shoe remov prostL3251
B

Shoe molded to pt silicone sL3252
B

Shoe molded plastazote custL3253
B

Shoe molded plastazote custL3254
B

Orth foot non-stndard size/wL3255
B

Orth foot non-standard size/L3257
B

Orth foot add charge split sL3260
B

Ambulatory surgical boot eacL3265
B

Plastazote sandal eachL3300
B

Sho lift taper to metatarsalL3310
B

Shoe lift elev heel/sole neoL3320
B

Shoe lift elev heel/sole corL3330
B

Lifts elevation metal extensL3332
B

Shoe lifts tapered to one-haL3334
B

Shoe lifts elevation heel /i( print page 50871)L3340
B

Shoe wedge sachL3350
B

Shoe heel wedgeL3360
B

Shoe sole wedge outside soleL3370
B

Shoe sole wedge between soleL3380
B

Shoe clubfoot wedgeL3390
B

Shoe outflare wedgeL3400
B

Shoe metatarsal bar wedge roL3410
B

Shoe metatarsal bar betweenL3420
B

Full sole/heel wedge btweenL3430
B

Sho heel count plast reinforL3440
B

Heel leather reinforcedL3450
B

Shoe heel sach cushion typeL3455
B

Shoe heel new leather standaL3460
B

Shoe heel new rubber standarL3465
B

Shoe heel thomas with wedgeL3470
B

Shoe heel thomas extend to bL3480
B

Shoe heel pad & depress forL3485
B

Shoe heel pad removable forL3500
B

Ortho shoe add leather insolL3510
B

Orthopedic shoe add rub inslL3520
B

O shoe add felt w leath inslL3530
B

Ortho shoe add half soleL3540
B

Ortho shoe add full soleL3550
B

O shoe add standard toe tapL3560
B

O shoe add horseshoe toe tapL3570
B

O shoe add instep extensionL3580
B

O shoe add instep velcro cloL3590
B

O shoe convert to sof counteL3595
B

Ortho shoe add march barL3600
B

Trans shoe calip plate existL3610
B

Trans shoe caliper plate newL3620
B

Trans shoe solid stirrup exiL3630
B

Trans shoe solid stirrup newL3640
B

Shoe dennis browne splint boL3649
B

Orthopedic shoe modifica NOSL3650
A

Shlder fig 8 abduct restrainL3651
A

Prefab shoulder orthosisL3652
A

Prefab dbl shoulder orthosisL3660
A

Abduct restrainer canvas&webL3670
A

Acromio/clavicular canvas&weL3675
A

Canvas vest SOL3677
E

SO hard plastic stabilizerL3700
A

Elbow orthoses elas w staysL3701
A

Prefab elbow orthosisL3710
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, PrefabricatedL3762
A

Rigid EO wo jointsL3800
A

Whfo short opponen no attachL3805
A

Whfo long opponens no attachL3807
A

WHFO,no joint, prefabricatedL3810
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 & iL3890
B

Torsion mechanism wrist/elboL3900
A

Hinge extension/flex wrist/f( print page 50872)L3901
A

Hinge ext/flex wrist fingerL3902
E

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-moldedL3909
A

Prefab wrist orthosisL3910
A

Whfo swanson designL3911
A

Prefab hand finger orthosisL3912
A

Flex glove w/elastic fingerL3914
A

WHO wrist extension cock-upL3916
A

Whfo wrist extens w/ outriggL3917
A

Prefab metacarpl fx orthosisL3918
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/ outrL3946
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
Y

Seo mobile arm sup att to wcL3965
Y

Arm supp att to wc rancho tyL3966
Y

Mobile arm supports reclininL3968
Y

Friction dampening arm suppL3969
Y

Monosuspension arm/hand suppL3970
Y

Elevat proximal arm supportL3972
Y

Offset/lat rocker arm w/ elaL3974
Y

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 orthL4002
A

Replace strap, any orthosisL4010
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 th( print page 50873)L4110
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

Ankle control orthosi prefabL4360
A

Pneumati walking boot prefabL4370
A

Pneumatic full leg splintL4380
A

Pneumatic knee splintL4386
A

Non-pneum walk boot prefabL4392
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 axisL5301
A

BK mold socket SACH ft endoL5311
A

Knee disart, SACH ft, endoL5321
A

AK open end SACHL5331
A

Hip disart canadian SACH ftL5341
A

Hemipelvectomy canadian SACHL5400
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 chL5450
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 hemipelvectomy( print page 50874)L5629
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

Bk flex inner socket ext fraL5646
A

Below knee cushion socketL5647
A

Below knee suction socketL5648
A

Above knee cushion socketL5649
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 kneeL5661
A

Multi-durometer symesL5665
A

Multi-durometer below kneeL5666
A

Below knee cuff suspensionL5668
A

Socket insert w/o lock lowerL5670
A

Bk molded supracondylar suspL5671
A

BK/AK locking mechanismL5672
A

Bk removable medial brim susL5673
A

Socket insert w lock mechL5676
A

Bk knee joints single axis pL5677
A

Bk knee joints polycentric pL5678
A

Bk joint covers pairL5679
A

Socket insert w/o lock mechL5680
A

Bk thigh lacer non-moldedL5681
A

Intl custm cong/latyp insertL5682
A

Bk thigh lacer glut/ischia mL5683
A

Initial custom socket insertL5684
A

Bk fork strapL5685
A

Below knee sus/seal sleeveL5686
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 cover BKL5705
A

Custom shape cover AKL5706
A

Custom shape cvr knee disartL5707
A

Custom shape cvr 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 ph( print page 50875)L5718
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 pneumL5781
A

Lower limb pros vacuum pumpL5782
A

HD low limb pros vacuum pumpL5785
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 flexionL5848
A

Knee-shin sys hydraul stanceL5850
A

Endo ak/hip knee extens assiL5855
A

Mech hip extension assistL5856
A

Elec knee-shin swing/stanceL5857
A

Elec knee-shin swing onlyL5910
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 pyloL5990
A

User adjustable heel heightL5995
A

Lower ext pros heavyduty feaL5999
A

Lowr extremity prosthes NOSL6000
A

Par hand robin-aids thum remL6010
A

Hand robin-aids little/ringL6020
A

Part hand robin-aids no fingL6025
A

Part hand disart myoelectricL6050
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 t( print page 50876)L6120
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/extension 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 lockL6638
A

Elec lock on manual pw elbowL6640
A

Shoulder abduction joint paiL6641
A

Excursion amplifier pulley tL6642
A

Excursion amplifier lever tyL6645
A

Shoulder flexion-abduction jL6646
A

Multipo locking shoulder jntL6647
A

Shoulder lock actuatorL6648
A

Ext pwrd shlder lock/unlockL6650
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 each( print page 50877)L6692
A

Silicone gel insert or equalL6693
A

Lockingelbow forearm cntrbalL6694
A

Elbow socket ins use w/lockL6695
A

Elbow socket ins use w/o lckL6696
A

Cus elbo skt in for con/atypL6697
A

Cus elbo skt in not con/atypL6698
A

Below/above elbow lock mechL6700
A

Terminal device model #3L6705
A

Terminal device model #5L6710
A

Terminal device model #5xL6715
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 voL6881
A

Autograsp feature ul term dvL6882
A

Microprocessor control uplmbL6890
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 myoelectronic( print page 50878)L6970
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 myoeleL7181
A

Electronic elbo simultaneousL7185
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 equaL7274
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/eL7367
A

Replacemnt lithium ionbatterL7368
A

Lithium ion battery chargerL7499
A

Upper extremity prosthes NOSL7500
A

Prosthetic dvc repair hourlyL7510
A

Prosthetic device repair repL7520
A

Repair prosthesis per 15 minL7900
A

Male vacuum erection systemL8000
A

Mastectomy braL8001
A

Breast prosthesis bra & formL8002
A

Brst prsth bra & bilat formL8010
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
A

Compression stocking BK30-40L8120
A

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 lymphedema( print page 50879)L8230
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 lL8499
A

Unlisted misc prosthetic serL8500
A

Artificial larynxL8501
A

Tracheostomy speaking valveL8505
A

Artificial larynx, accessoryL8507
A

Trach-esoph voice pros pt inL8509
A

Trach-esoph voice pros md inL8510
A

Voice amplifierL8511
A

Indwelling trach insertL8512
A

Gel cap for trach voice prosL8513
A

Trach pros cleaning deviceL8514
A

Repl trach puncture dilatorL8515
A

Gel cap app device for trachL8600
N

Implant breast silicone/eqL8603
N

Collagen imp urinary 2.5 mlL8606
N

Synthetic implnt urinary 1mlL8610
N

Ocular implantL8612
N

Aqueous shunt prosthesisL8613
N

Ossicular implantL8614
N

Cochlear device/systemL8615
A

Coch implant headset replaceL8616
A

Coch implant microphone replL8617
A

Coch implant trans coil replL8618
A

Coch implant tran cable replL8619
A

Replace cochlear processorL8620
A

Repl lithium ion batteryL8621
A

Repl zinc air batteryL8622
A

Repl alkaline batteryL8630
N

Metacarpophalangeal implantL8631
N

MCP joint repl 2 pc or moreL8641
N

Metatarsal joint implantL8642
N

Hallux implantL8658
N

Interphalangeal joint spacerL8659
N

Interphalangeal joint replL8670
N

Vascular graft, syntheticL8699
N

Prosthetic implant NOSL9900
A

O&P supply/accessory/serviceM0064
X

Visit for drug monitoring
0374
1.0414
$61.80

$12.36M0075
E

Cellular therapyM0076
E

ProlotherapyM0100
E

Intragastric hypothermiaM0300
E

IV chelationtherapyM0301
E

Fabric wrapping of aneurysmP2028
A

Cephalin floculation testP2029
A

Congo red blood testP2031
E

Hair analysisP2033
A

Blood thymol turbidityP2038
A

Blood mucoprotein( print page 50880)P3000
A

Screen pap by tech w md supvP3001
B

Screening pap smear by physP7001
E

Culture bacterial urineP9010
K

Whole blood for transfusion
0950
2.0123
$119.42

$23.88P9011
K

Blood split unit
0967
1.2698
$75.35

$15.07P9012
K

Cryoprecipitate each unit
0952
0.7395
$43.88

$8.78P9016
K

RBC leukocytes reduced
0954
2.7370
$162.42

$32.48P9017
K

Plasma 1 donor frz w/in 8 hr
9508
1.2038
$71.44

$14.29P9019
K

Platelets, each unit
0957
0.8317
$49.36

$9.87P9020
K

Plaelet rich plasma unit
0958
5.1815
$307.49

$61.50P9021
K

Red blood cells unit
0959
2.0301
$120.47

$24.09P9022
K

Washed red blood cells unit
0960
2.9707
$176.29

$35.26P9023
K

Frozen plasma, pooled, sd
0949
1.1956
$70.95

$14.19P9031
K

Platelets leukocytes reduced
1013
1.6023
$95.09

$19.02P9032
K

Platelets, irradiated
9500
1.3589
$80.64

$16.13P9033
K

Platelets leukoreduced irrad
0968
2.3639
$140.28

$28.06P9034
K

Platelets, pheresis
9507
6.8988
$409.40

$81.88P9035
K

Platelet pheres leukoreduced
9501
8.1495
$483.62

$96.72P9036
K

Platelet pheresis irradiated
9502
5.1895
$307.96

$61.59P9037
K

Plate pheres leukoredu irrad
1019
9.5131
$564.54

$112.91P9038
K

RBC irradiated
9505
2.3876
$141.69

$28.34P9039
K

RBC deglycerolized
9504
6.4314
$381.66

$76.33P9040
K

RBC leukoreduced irradiated
0969
3.6451
$216.31

$43.26P9041
K

Albumin (human),5%, 50ml
0961
0.5119
$30.38

$6.08P9043
K

Plasma protein fract,5%,50ml
0956
1.1226
$66.62

$13.32P9044
K

Cryoprecipitatereducedplasma
1009
1.3062
$77.51

$15.50P9045
K

Albumin (human), 5%, 250 ml
0963
1.3869
$82.30

$16.46P9046
K

Albumin (human), 25%, 20 ml
0964
0.4878
$28.95

$5.79P9047
K

Albumin (human), 25%, 50ml
0965
1.1117
$65.97

$13.19P9048
K

Plasmaprotein fract,5%,250ml
0966
4.9564
$294.13

$58.83P9050
K

Granulocytes, pheresis unit
9506
15.6155
$926.67

$185.33P9051
K

Blood, l/r, cmv-neg
1010
2.9692
$176.20

$35.24P9052
K

Platelets, hla-m, l/r, unit
1011
10.9690
$650.93

$130.19P9053
K

Plt, pher, l/r cmv-neg, irr
1020
10.1551
$602.63

$120.53P9054
K

Blood, l/r, froz/degly/wash
1016
5.2631
$312.33

$62.47P9055
K

Plt, aph/pher, l/r, cmv-neg
1017
8.5998
$510.34

$102.07P9056
K

Blood, l/r, irradiated
1018
2.8004
$166.18

$33.24P9057
K

RBC, frz/deg/wsh, l/r, irrad
1021
4.8787
$289.52

$57.90P9058
K

RBC, l/r, cmv-neg, irrad
1022
4.2901
$254.59

$50.92P9059
K

Plasma, frz between 8-24hour
0955
1.2934
$76.75

$15.35P9060
K

Fr frz plasma donor retested
9503
1.6241
$96.38

$19.28P9603
A

One-way allow prorated milesP9604
A

One-way allow prorated tripP9612
N

Catheterize for urine specP9615
N

Urine specimen collect multQ0035
X

Cardiokymography
0100
2.4968
$148.17
$41.44
$29.63Q0081
B

Infusion ther other than cheQ0083
B

Chemo by other than infusionQ0084
B

Chemotherapy by infusionQ0085
B

Chemo by both infusion and oQ0091
T

Obtaining screen pap smear
0191
0.167
$9.91
$2.78
$1.98Q0092
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
K

Non esrd epoetin alpha inj
0733

$9.99

$2.00Q0137
K

Darbepoetin alfa, non esrd
0734

$3.28

$0.66Q0144
E

Azithromycin dihydrate, oralQ0163
N

Diphenhydramine HCl 50mgQ0164
N

Prochlorperazine maleate 5mgQ0165
B

Prochlorperazine maleate10mgQ0166
K

Granisetron HCl 1 mg oral
0765

$33.51

$6.70Q0167
N

Dronabinol 2.5mg oralQ0168
B

Dronabinol 5mg oral( print page 50881)Q0169
N

Promethazine HCl 12.5mg oralQ0170
B

Promethazine HCl 25 mg oralQ0171
N a

Chlorpromazine HCl 10mg oralQ0172
B

Chlorpromazine HCl 25mg oralQ0173
N

Trimethobenzamide HCl 250mgQ0174
N

Thiethylperazine maleate10mgQ0175
N

Perphenazine 4mg oralQ0176
B

Perphenazine 8mg oralQ0177
N

Hydroxyzine pamoate 25mgQ0178
B

Hydroxyzine pamoate 50mgQ0179
K

Ondansetron HCl 8mg oral
0769

$32.02

$6.40Q0180
K

Dolasetron mesylate oral
0763

$48.54

$9.71Q0181
E

Unspecified oral anti-emeticQ0187
K

Factor viia recombinant
1409

$1,080.11

$216.02Q1001
N

Ntiol category 1Q1002
N

Ntiol category 2Q1003
N

Ntiol category 3Q1004
N

Ntiol category 4Q1005
N

Ntiol category 5Q2001
E

Oral cabergoline 0.5 mgQ2002
N

Elliotts b solution per mlQ2003
K

Aprotinin, 10,000 kiu
7019

$2.20

$0.44Q2004
N

Bladder calculi irrig solQ2005
K

Corticorelin ovine triflutat
7024

$386.53

$77.31Q2006
K

Digoxin immune fab (ovine)
7025

$552.18

$110.44Q2007
K

Ethanolamine oleate 100 mg
7026

$64.53

$12.91Q2008
K

Fomepizole, 15 mg
7027

$12.31

$2.46Q2009
K

Fosphenytoin, 50 mg
7028

$5.19

$1.04Q2011
K

Hemin, per 1 mg
7030

$6.51

$1.30Q2012
K

Pegademase bovine, 25 iu
9168

$161.16

$32.23Q2013
K

Pentastarch 10% solution
7040

$12.45

$2.49Q2014
N

Sermorelin acetate, 0.5 mgQ2017
K

Teniposide, 50 mg
7035

$266.23

$53.25Q2018
K

Urofollitropin, 75 iu
7037

$44.74

$8.95Q2019
K

Basiliximab
1615

$1,473.57

$294.71Q2020
E

Histrelin acetateQ2021
K

Lepirudin
9057

$128.17

$25.63Q2022
K

VonWillebrandFactrCmplxperIU
1618

$0.74

$0.15Q3000
H

Rubidium-Rb-82
9025Q3001
B

Brachytherapy RadioelementsQ3002
H

Gallium ga 67
1619Q3003
H

Technetium tc99m bicisate
1620Q3004
N

Xenon xe 133Q3005
H

Technetium tc99m mertiatide
1622Q3006
H

Technetium tc99m glucepatate
9154Q3007
H

Sodium phosphate p32
1624Q3008
H

Indium 111-in pentetreotide
1625Q3009
N

Technetium tc99m oxidronateQ3010
H

Technetium tc99m labeledrbcs
9155Q3011
H

Chromic phosphate p32
1628Q3012
N

Cyanocobalamin cobalt co57Q3014
A

Telehealth facility feeQ3019
A

ALS emer trans no ALS servQ3020
A

ALS nonemer trans no ALS seQ3025
K

IM inj interferon beta 1-a
9022

$89.10

$17.82Q3026
E

Subc inj interferon beta-1aQ3031
N

Collagen skin testQ4001
B

Cast sup body cast plasterQ4002
B

Cast sup body cast fiberglasQ4003
B

Cast sup shoulder cast plstrQ4004
B

Cast sup shoulder cast fbrglQ4005
B

Cast sup long arm adult plstQ4006
B

Cast sup long arm adult fbrgQ4007
B

Cast sup long arm ped plsterQ4008
B

Cast sup long arm ped fbrglsQ4009
B

Cast sup sht arm adult plstr( print page 50882)Q4010
B

Cast sup sht arm adult fbrglQ4011
B

Cast sup sht arm ped plaster012
B

Cast sup sht arm ped fbrglasQ4013
B

Cast sup gauntlet plasterQ4014
B

Cast sup gauntlet fiberglassQ4015
B

Cast sup gauntlet ped plsterQ4016
B

Cast sup gauntlet ped fbrglsQ4017
B

Cast sup lng arm splint plstQ4018
B

Cast sup lng arm splint fbrgQ4019
B

Cast sup lng arm splnt ped pQ4020
B

Cast sup lng arm splnt ped fQ4021
B

Cast sup sht arm splint plstQ4022
B

Cast sup sht arm splint fbrgQ4023
B

Cast sup sht arm splnt ped pQ4024
B

Cast sup sht arm splnt ped fQ4025
B

Cast sup hip spica plasterQ4026
B

Cast sup hip spica fiberglasQ4027
B

Cast sup hip spica ped plstrQ4028
B

Cast sup hip spica ped fbrglQ4029
B

Cast sup long leg plasterQ4030
B

Cast sup long leg fiberglassQ4031
B

Cast sup lng leg ped plasterQ4032
B

Cast sup lng leg ped fbrglsQ4033
B

Cast sup lng leg cylinder plQ4034
B

Cast sup lng leg cylinder fbQ4035
B

Cast sup lngleg cylndr ped pQ4036
B

Cast sup lngleg cylndr ped fQ4037
B

Cast sup shrt leg plasterQ4038
B

Cast sup shrt leg fiberglassQ4039
B

Cast sup shrt leg ped plsterQ4040
B

Cast sup shrt leg ped fbrglsQ4041
B

Cast sup lng leg splnt plstrQ4042
B

Cast sup lng leg splnt fbrglQ4043
B

Cast sup lng leg splnt ped pQ4044
B

Cast sup lng leg splnt ped fQ4045
B

Cast sup sht leg splnt plstrQ4046
B

Cast sup sht leg splnt fbrglQ4047
B

Cast sup sht leg splnt ped pQ4048
B

Cast sup sht leg splnt ped fQ4049
B

Finger splint, staticQ4050
B

Cast supplies unlistedQ4051
B

Splint supplies miscQ4054
A

Darbepoetin alfa, esrd useQ4055
A

Epoetin alfa, esrd useQ4075
N

Acyclovir, 5 mgQ4076
N

Dopamine hcl, 40 mgQ4077
K

Treprostinil, 1 mg
1082

$55.02

$11.00Q4079
G

Injection, natalizumab
9126

$6.51

$1.30Q9941
K

IVIG lyophil 1g
0869

$39.46

$7.89Q9942
K

IVIG lyophil 10 mg
0870

$0.40

$0.08Q9943
K

IVIG non-lyophil 1g
0871

$57.26

$11.45Q9944
K

IVIG non-lyophil 10 mg
0872

$0.57

$0.11Q9945
K

LOCM <=149 mg/ml iodine, 1ml
9157

$0.51

$0.10Q9946
K

LOCM 150-199mg/ml iodine,1ml
9158

$2.00

$0.40Q9947
K

LOCM 200-249mg/ml iodine,1ml
9159

$0.78

$0.16Q9948
K

LOCM 250-299mg/ml iodine,1ml
9160

$0.66

$0.13Q9949
K

LOCM 300-349mg/ml iodine,1ml
9161

$0.41

$0.08Q9950
K

LOCM 350-399mg/ml iodine,1ml
9162

$0.27

$0.05Q9951
K

LOCM >= 400 mg/ml iodine,1ml
19163

$0.20

$0.04Q9952
K

Inj Gad-base MR contrast, ml
9164

$3.01

$0.60Q9953
N

Inj Fe-based MR contrast, mlQ9954
K

Oral MR contrast, 100 ml
9165

$9.01

$1.80Q9955
K

Inj perflexane lip micros, m
9203

$13.49

$2.70Q9956
K

Inj octafluoropropane mic,ml
9202

$41.42

$8.28Q9957
K

Inj perflutren lip micros, m
9112

$63.51

$12.70R0070
N

Transport portable x-ray( print page 50883)R0075
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 bifocalV2118
A

Lens aniseikonic singleV2121
A

Lenticular lens, 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 7.12-20V2203
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 4.25-7/2V2209
A

Lens sphcy bifocal 4.25-7/4V2210
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 12V2215
A

Lens lenticular bifocalV2218
A

Lens aniseikonic bifocalV2219
A

Lens bifocal seg width overV2220
A

Lens bifocal add over 3.25dV2221
A

Lenticular lens, bifocalV2299
A

Lens bifocal specialityV2300
A

Lens sphere trifocal 4.00dV2301
A

Lens sphere trifocal 4.12-7V2302
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 4.25-7/2V2309
A

Lens sphc trifocal 4.25-7/4V2310
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 trifocalV2318
A

Lens aniseikonic trifocalV2319
A

Lens trifocal seg width > 28V2320
A

Lens trifocal add over 3.25dV2321
A

Lenticular lens, trifocalV2399
A

Lens trifocal specialityV2410
A

Lens variab asphericity sing( print page 50884)V2430
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 lensV2702
E

Deluxe lens featureV2710
A

Glass/plastic slab off prismV2715
A

Prism lens/esV2718
A

Fresnell prism press-on lensV2730
A

Special base curveV2744
A

Tint photochromatic lens/esV2745
A

Tint, any color/solid/gradV2750
A

Anti-reflective coatingV2755
A

UV lens/esV2756
E

Eye glass caseV2760
A

Scratch resistant coatingV2761
B

Mirror coatingV2762
A

Polarization, any lensV2770
A

Occluder lens/esV2780
A

Oversize lens/esV2781
B

Progressive lens per lensV2782
A

Lens, 1.54-1.65 p/1.60-1.79gV2783
A

Lens, >= 1.66 p/>=1.80 gV2784
A

Lens polycarb or equalV2785
F

Corneal tissue processingV2786
A

Occupational multifocal lensV2790
N

Amniotic membraneV2797
A

Vis item/svc in other codeV2799
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

Hearing aid monaural in earV5060
E

Behind ear hearing aidV5070
E

Glasses air conductionV5080
E

Glasses bone conduction( print page 50885)V5090
E

Hearing aid dispensing feeV5095
E

Implant mid ear hearing prosV5100
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 aidV5200
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 bicrosV5241
E

Dispensing fee, monauralV5242
E

Hearing aid, monaural, cicV5243
E

Hearing aid, monaural, itcV5244
E

Hearing aid, prog, mon, cicV5245
E

Hearing aid, prog, mon, itcV5246
E

Hearing aid, prog, mon, iteV5247
E

Hearing aid, prog, mon, bteV5248
E

Hearing aid, binaural, cicV5249
E

Hearing aid, binaural, itcV5250
E

Hearing aid, prog, bin, cicV5251
E

Hearing aid, prog, bin, itcV5252
E

Hearing aid, prog, bin, iteV5253
E

Hearing aid, prog, bin, bteV5254
E

Hearing id, digit, mon, cicV5255
E

Hearing aid, digit, mon, itcV5256
E

Hearing aid, digit, mon, iteV5257
E

Hearing aid, digit, mon, bteV5258
E

Hearing aid, digit, bin, cicV5259
E

Hearing aid, digit, bin, itcV5260
E

Hearing aid, digit, bin, iteV5261
E

Hearing aid, digit, bin, bteV5262
E

Hearing aid, disp, monauralV5263
E

Hearing aid, disp, binauralV5264
E

Ear mold/insertV5265
E

Ear mold/insert, dispV5266
E

Battery for hearing deviceV5267
E

Hearing aid supply/accessoryV5268
E

ALD Telephone AmplifierV5269
E

Alerting device, any typeV5270
E

ALD, TV amplifier, any typeV5271
E

ALD, TV caption decoderV5272
E

TddV5273
E

ALD for cochlear implantV5274
E

ALD unspecifiedV5275
E

Ear impressionV5298
E

Hearing aid nocV5299
B

Hearing serviceV5336
E

Repair communication deviceV5362
E

Speech screeningV5363
E

Language screeningV5364
E

Dysphagia screening* Code is subject to contiguous body area imaging discount policy discussed in Section XIV of this proposed rule.CPT codes and descriptions only are copyright American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.Copyright American Dental Association. All Rights Reserved.
 
 
  (Catalog of Federal Domestic Assistance Program No. 93.773, Medicare_Hospital Insurance; and Program No. 93.774, Medicare_Supplementary Medical Insurance Program) Dated: August 17, 2005 Ann C. Agnew, Executive Secretary to the Department


[FR Doc. 05–16699 Filed 8–18–05; 2:44 pm] BILLING CODE 4120–01–P