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 Department of Health and Human Services Centers for Medicare & Medicaid Services 42 CFR Parts 410, 411, 412, 413, 414, 416, 419, 482, and 485
[(CMS-1392-CN), (CMS-1533-CN), and (CMS-1531-CN)]
RIN 0938-AO71, RIN 0938-AO70, and RIN 0938-AO35
 AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
 ACTION: Correction of final rule with comment period.
 SUMMARY: This document corrects technical errors that appeared in the final rule with comment period published in the 
                            **Federal Register**
                             (FR) on November 27, 2007, entitled “Changes to the Hospital Outpatient Prospective Payment System and CY 2008 Payment Rates, the Ambulatory Surgical Center Payment System and CY 2008 Payment Rates, the Hospital Inpatient Prospective Payment System and FY 2008 Payment Rates; and Payments for Graduate Medical Education for Affiliated Teaching Hospitals in Certain Emergency Situations Medicare and Medicaid Programs: Hospital Conditions of Participation; Necessary Provider Designations of Critical Access Hospitals.”
 DATES: *Effective Date:*
                             January 1, 2008 except that the correction to §485.610(e) is effective February 22, 2008.
 FOR FURTHER INFORMATION CONTACT: Alberta Dwivedi, (410) 786-0378.


SUPPLEMENTARY INFORMATION:  I. Background In FR Doc. 07-5507 of November 27, 2007 (72 FR 66579), we have identified a number of technical and typographical errors that we describe in the “Summary of Errors” section and correct in the “Correction of Errors” section below. The provisions in this correction notice are effective as if they had been included in the document published on November 27, 2007. Accordingly, the corrections are effective January 1, 2008. II. Summary of Errors On November 27, 2007, we published a final rule with comment period entitled, “Changes to the Hospital Outpatient Prospective Payment System and CY 2008 Payment Rates, the Ambulatory Surgical Center Payment System and CY 2008 Payment Rates, the Hospital Inpatient Prospective Payment System and FY 2008 Payment Rates; and Payments for Graduate Medical Education for Affiliated Teaching Hospitals in Certain Emergency Situations Medicare and Medicaid Programs: Hospital Conditions of Participation; Necessary Provider Designations of Critical Access Hospitals,” (hereinafter referred to as the OPPS/ASC final rule with comment period). Included in that document were technical and typographical errors. We incorrectly stated that the application deadline for submitting applications for a new class of new technology intraocular lenses in the “Dates” section under 
                        *Application Deadline—New Class of New Technology Intraocular Lens*
                         was April 1, 2008. In the preamble to the OPPS/ASC final rule with comment period (72 FR 66855), we stated the correct application deadline date as March 14, 2008. We are changing the application deadline in the “Dates” section to reflect the correct date of March 14, 2008. We also stated that approximately 131 million final action claims were used for hospital outpatient department services furnished on or after January 1, 2006 and before January 1, 2007 for the purpose of recalibrating the OPPS relative weights for CY 2008. The actual number of final action claims used was 141 million. In addition, we stated that we would provide further instructions about reporting echocardiography procedures with and without contrast in the January 2007 OPPS update. The correct reference should have been to the January 2008 OPPS update and we are correcting the statement. Furthermore, we are correcting the typographical errors that mistakenly reversed the listings for the composite APC procedure codes for APC 8001 and APC 8000. We also inadvertently failed to address in the OPPS/ASC final rule with comment period two timely public comments. This document includes summaries of those public comments and our responses. The OPPS/ASC final rule with comment period included several addenda. We are adding three HCPCS codes (CPT codes 90650, 90681, and 90696) to Addendum B because they are new active CPT codes for CY 2008 that we omitted from the CY 2008 OPPS/ASC final rule with comment period. In publishing Addenda A and B, we inadvertently published incorrect minimum unadjusted copayment rates for several pass-through drugs and biologicals. Additionally, for several HCPCS codes where payment is based on mean costs from hospital claims, we inadvertently published CY 2007 payment rates instead of CY 2008 payment rates. In addition, in Addendum B, we inadvertently assigned status indicator “L” to new CPT codes 90661, 90662, and 90663 that indicated these codes would be paid in CY 2008. These three CPT codes actually describe vaccines where there are currently no FDA-approved products and, therefore, these codes are noncovered by Medicare as of January 2008. We are changing the status indicator to “E”, to reflect the correct status. Furthermore, we inadvertently assigned a payable status indicator to HCPCS code G0377. We note that this is a noncovered service under Medicare Part B in accordance with the statute as of January 1, 2008. Also, in Addendum B, we incorrectly assigned status indicator “M”, indicating services not billable to the fiscal intermediary, to new CY 2008 HCPCS code G9140, when this service may be paid off another fee schedule by fiscal intermediaries. In addition, we are republishing Addenda AA and BB to take into account updated Medicare Physician Fee Schedule (MPFS) CY 2008 information. As required at 42 CFR § 416.171(d), the revised ASC payment system limits payment for office-based procedures and covered ancillary radiology services to the lesser of the ASC rate or the amount calculated by multiplying the nonfacility practice expense (PE) relative value units (RVUs) for the service by the conversion factor under the MPFS. However, the PE RVUs listed for many CPT codes in Addendum B of the CY 2008 MPFS final rule (72 FR 66222) were incorrect due to a methodological error and consequently, have been corrected in a correction notice to that final rule (73 FR 2568). Since the ASC payment amounts for office-based procedures and covered ancillary services are determined using the amounts in the MPFS final rule, we must correct the CY 2008 payment amounts for ASC procedures and services using the 
                        ( print page 9861)
                        corrected MPFS amounts. The corrected payment amounts are reflected in Addenda AA and BB to this correction notice. Lastly, we inadvertently labeled two Addendum as Addendum DD2 and are correcting “Addendum DD2-OPPS Comment Indicators” to read “Addendum D2-OPPS Comment Indicators.” In Addendum M, we inadvertently assigned incorrect APCs to HCPCS codes 90862, 96102, and M0064. The APC assignments of these individual services were correct in Addendum B to the CY 2008 OPPS/ASC final rule with comment period (72 FR 67096, 67103, and 67160) that identified OPPS payment by HCPCS code. Therefore, we are correcting their assignments in Addendum M that identified HCPCS codes that may be paid through composite APCs to reflect their correct OPPS treatment if they are paid through a single code APC. III. Correction of Errors In FR Doc. 07-5507 (72 FR 66579), we are making the following corrections: 1. On page 66580, in the second column, line 6 of the paragraph entitled, “Application Deadline—New Class of New Technology Intraocular Lens:” in the “Dates” section, the application deadline date “April 1, 2008” is corrected to read “March 14, 2008”. 2. On page 66589, in the first column, in line 15, the number “131 million” is corrected to read “141 million.” 3. On page 66644, in the third column, in lines 12 and 13, the date “January 2007” is corrected to read “January 2008.” 4. On page 66669, in the third column, fourth full paragraph, the paragraph is deleted and replaced in its entirety to read as follows: We received one comment related to our proposal. *Comment:*
                         A commenter disagreed with the statement in the CY 2008 OPPS/ASC proposed rule that the circumstances in which total body hypothermia would be provided to a Medicare beneficiary would be extremely rare. The commenter stated that approximately 72 percent of all U.S. hospitals do not have cardiac catheterization or open heart surgery capabilities. The commenter also stated that it would be common for many post-cardiac arrest patients who are treated in these hospitals to be transferred to another facility that can provide the necessary services. The commenter also disagreed that low-cost methods to induce hypothermia, such as applying ice packs to the patient, are viable alternatives to technologically advanced methods of inducing hypothermia, specifically because the low-cost methods are ineffective and inconvenient. According to the commenter, the small number of claims (39 in CY 2006) and low median cost ($35) for CPT code 99816 (Hypothermia; total body) mean that a hospital receives no additional payment when providing hypothermia. The commenter recommended that CMS create a Level II HCPCS G-code for technologically advanced methods of inducing hypothermia, and that CMS pay separately for this new code. *Response:*
                         We proposed to package payment for CPT code 99816 for CY 2008. We continue to believe that when a patient presents to one hospital and then is cooled and transported to another hospital without admission to the first hospital, payment for the hypothermia service would be most appropriately packaged into payment for the many other separately payable services that it most likely accompanied and that would be paid to the first hospital under the OPPS. To the extent that technologically advanced methods to induce hypothermia may become an adopted standard of care by more hospitals over time based on the evolution of clinical practice, the median cost for CPT code 99186 may change to reflect contemporary utilization patterns. In general, if a service is described by an existing CPT code, we do not create an additional Level II HCPCS code for payment. Instead, the commenter may wish to discuss the hypothermia service with the AMA's CPT Editorial Panel in order to assess the need for any changes to CPT codes. Therefore, we are finalizing our proposal to maintain the packaged status of CPT code 99186 for CY 2008. 5. On page 66726, in the second column, first full paragraph, under the heading “b. Endovenous Ablation (APC 0092)”, the paragraph is deleted and replaced in its entirety to read as follows: “For CY 2008, we proposed to pay approximately $1,684 for CPT codes 36476 (Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites) and 36478 (Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; first vein treated) through their proposed assignment to APC 0092 (Level I Vascular Ligation). In CY 2007, CPT code 36476 is assigned to APC 0091 (Level II Vascular Ligation), which has a proposed CY 2008 payment rate of $2,781. The proposed APC assignment for CPT code 36478 is the same as its CY 2007 APC assignment. 6. On page 66726, in the second column, second full paragraph, under the heading “b. Endovenous Ablation (APC 0092)”, the paragraph is deleted and replaced in its entirety to read as follows: ``We received several public comments on the proposed CY 2008 payment for CPT codes 36476 and 36478. A summary of the public comments and our response follow.'' *Comment:*
                         A commenter disagreed with our proposed reassignment of add-on CPT code 36476 (Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; second and subsequent veins treated in a single extremity, each through separate access sites) from APC 0091 (Level II Vascular Ligation), with a proposed CY 2008 payment of approximately $2,781, to APC 0092 (Level I Vascular Ligation), with a proposed CY 2008 payment of approximately $1,684. According to the commenter, CPT code 36476 should remain in APC 0091, the same APC to which its associated primary CPT code, 36475 (Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated), was proposed for assignment in CY 2008. The commenter asserted that the procedures described by CPT codes 36475 and 36476 are clinically similar and use comparable resources, and that the application of the multiple procedure reduction to lower-paying APC 0092 would result in inaccurate payment for the CPT code 36476 add-on procedure, which always must be performed in conjunction with the primary procedure. *Response:*
                         We proposed to reassign 36476 from APC 0091 to APC 0092 because proposed rule claims data indicated that the costs associated with CPT code 36476 are more similar to the costs of other procedures assigned to APC 0092, taking into account the multiple surgical procedure 50 percent payment reduction that would be applied in the typical cases where CPT code 36476 was reported in conjunction with CPT code 36475. Final rule claims data support this reassignment; the median cost for CPT code 36476 is approximately $971, while the CY 2008 payment rate for APC 0092 is approximately $1,646, and the payment rate for APC 0091 is approximately $2,714. The median cost for the first vessel CPT code 36475 is much higher than that of CPT code 36476, at approximately $2,396, which we believe 
                        ( print page 9862)
                        to be a reflection of the significantly higher relative cost of furnishing the initial service described by CPT code 36475 compared to the additional service described by CPT code 36476, likely due in part to the radiofrequency catheter cost that is associated with the initial service. We disagree with the commenter that CPT codes 36475 and 36476 are similar in terms of resource utilization based on this cost data. The application of the multiple procedure reduction of 50 percent to APC 0092 when CPT code 36476 is billed with another procedure with status indicator ``T,'' such as CPT code 36475, would result in a payment of approximately $823, a sum that is only slightly less than the approximate $971 median cost of CPT code 36476. In contrast, if CPT code 36476 were assigned to APC 0091, the payment with the multiple procedure reduction would be approximately $1,357, a substantial overpayment. Therefore, we disagree with the commenter that assignment of CPT code 36476 to APC 0092 would result in inaccurate payment, even with application of the multiple procedure reduction. While it is true that the procedure described by CPT code 36476 is clinically similar to the procedure described by CPT code 36475 which is assigned to APC 0091 as the commenter asserts, it also is clinically similar to other procedures in APC 0092, which includes a variety of surgical procedures involving veins. In summary, we continue to believe that the procedure described by CPT code 36476 is similar both clinically and in terms of resource utilization to other procedures assigned to APC 0092, even with application of the multiple procedure reduction. Therefore, after review of the public comment received, we are finalizing our proposal, without modification, to reassign CPT code 36476 to APC 0092 for CY 2008. 7. On page 66726, in the third column, the third full paragraph, the paragraph is deleted and replaced in its entirety to read as follows: ``After consideration of the public comments received, we are finalizing our CY 2008 proposal, without modification, to assign CPT codes 36476 and 36478 to APC 0092, with a median cost of about $1,626''. 8. On page 66906, in the third column, in the first full paragraph— A. In line 16, the APC code “8000” is corrected to read “8001.” B. In line 24, the APC code, “8001” is corrected to read “8000.” Correction to Regulations Text On page 66934, the introductory text of § 485.610(e) is revised to read as follows: § 485.610
  
 *(e) Standard: Off-campus and co-location requirements for CAHs.*
                                 A CAH may continue to meet the location requirements of paragraph (c) of this section only if the CAH meets the following: 
 Corrections to Addenda Addendum A.—OPPS APCS for CY 2008
 1.On page 66939, for APC 0825, in line 74, in column 7, the minimum unadjusted copayment “$17.37” is corrected to read “$17.20.” 2.On page 66940, for APC 0911, in line 43— A. In column 5, the payment rate “$129.75” is corrected to read “$20.89.” B. In column 7, the minimum unadjusted copayment “25.95” is corrected to read “$4.18.” 3.On page 66940, for APC 0951, in line 7 from the bottom of the page, in column 7, the minimum unadjusted copayment “$44.16” is corrected to read “$43.74.” 4.On page 66941, for APC 0998, in line 11— A. In column 5, the payment rate “$88.15” is corrected to read “$12.24.” B. In column 7, the minimum unadjusted copayment “$17.63” is corrected to read “$2.45.” 5.On page 66941, for APC 1041, in line 27— A. In column 5, the payment rate “$172.41” is corrected to read “$19.81.” B. In column 7, the minimum unadjusted copayment “$34.48” is corrected to read “$3.96.” 6.On page 66941, for APC 1141, in line 36— A. In column 5, the payment rate “$67.96” is corrected to read “$42.24.” B. In column 7, the minimum unadjusted copayment “$13.59” is corrected to read “$8.37.” 7.On page 66941, for APC 1168, in line 42, in column 7, the minimum unadjusted copayment “$9.68” is corrected to read “$9.59.” 8.On page 66941, for APC 1169, in line 43— A. In column 5, the payment rate “$482.56” is corrected to read “$407.56.” B. In column 7, the minimum unadjusted copayment “$96.51” is corrected to read “$80.74.” 9.On page 66942, for APC 1606, in line 52— A. In column 5, the payment rate “$2,693.80” is corrected to read “$1,706.04.” B. In column 7, the minimum unadjusted copayment “$538.76” is corrected to read “$341.21.” 10.On page 66943, for APC 2940, in line 37— A. In column 5, the payment rate “$168.90” is corrected to read “$42.69.” B. In column 7, the minimum unadjusted copayment “$33.78” is corrected to read “$8.54.” 11.On page 66944, for APC 9051, in line 5— A. In column 5, the payment rate “$74.16” is corrected to read “$23.23.” B. In column 7, the minimum unadjusted copayment “$14.83” is corrected to read “$4.65.” 12.On page 66944, for APC 9126, in line 17, in column 7, the minimum unadjusted copayment “$1.50” is corrected to read “$1.49.” 13.On page 66944, for APC 9140, in line 23— A. In column 5, the payment rate “$119.86” is corrected to read “$118.82.” B. In column 7, the minimum unadjusted copayment “$23.97” is corrected to read “$23.76.” 14.On page 66944, for APC 9141, in line 24— A. In column 5, the payment rate “$45.53” is corrected to read “$66.38.” B. In column 7, the minimum unadjusted copayment “$9.11” is corrected to read “$13.28.” 15.On page 66944, for APC 9167, in line 29— A. In column 5, the payment rate “$77.96” is corrected to read “$219.39.” B. In column 7, the minimum unadjusted copayment “$15.59” is corrected to read “$43.88.” 16.On page 66944— A. For APC 9227, in line 43, in column 7, the minimum unadjusted copayment “$0.29” is corrected to read “$0.28.” B. For APC 9229, in line 45, in column 7, the minimum unadjusted copayment “$27.79” is corrected to read “$27.53.” C. For APC 9230, in line 46, in column 7, the minimum unadjusted copayment “$3.74” is corrected to read “$3.70.” D. For APC 9232, in line 48, in column 7, the minimum unadjusted copayment “$91.01” is corrected to read “$90.15.” 
                            ( print page 9863) E. For APC 9233, in line 49, in column 7, the minimum unadjusted copayment “$406.05” is corrected to read “$402.22.” F. For APC 9235, in line 51, in column 7, the minimum unadjusted copayment “$16.63” is corrected to read “$16.47.” G. For APC 9236, in line 52, in column 7, the minimum unadjusted copayment “$35.28” is corrected to read “$34.94.” 17.On page 66944, for APC 9350, in line 55— A. In column 5, the payment rate “$482.56” is corrected to read “$496.87.” B. In column 7, the minimum unadjusted copayment “$96.51” is corrected to read “$98.44.” 18.On page 66944, for APC 9351, in line 56— A. In column 5, the payment rate “$67.96” is corrected to read “$95.32.” B. In column 7, the minimum unadjusted copayment “$13.59” is corrected to read “$18.88.” ADDENDUM AA.—ASC COVERED SURGICAL PROCEDURES FOR CY 2008 We are republishing Addendum AA in its entirety. See attached chart. ADDENDUM B.—OPPS PAYMENT BY HCPCS CODE FOR CY 2008 1.On page 67095, the chart for HCPCS codes starting with HCPCS code 90649 through HCPCS code 90708 should read as follows: HCPCS code
Short descriptor
CI
SI
APC
Relative weight
Payment rate
National unadjusted copayment
Minimum unadjusted copayment90650
Hpv typ bival 3 dose, im
NI
E90655
Flu vaccine no preserv 6-35m

L90656
Flu vaccine no preserv 3 & >

L90657
Flu vaccine, 3 yrs, im

L90658
Flu vaccine, 3 yrs & >, im

L90660
Flu vaccine, nasal

L90661
Flu vacc cell cult prsv free
NI
E90662
Flu vacc prsv free inc antig
NI
E90663
Flu vacc pandemic
NI
E90665
Lyme disease vaccine, im

N90669
Pneumococcal vacc, ped <5
CH
L90675
Rabies vaccine, im

K
9139

$150.80

$30.1690676
Rabies vaccine, id

K
9140

$118.82

$23.7690680
Rotavirus vacc 3 dose, oral

N90681
Rotavirus vacc 2 dose, oral
NI
E90690
Typhoid vaccine, oral

N90691
Typhoid vaccine, im

N90692
Typhoid vaccine, h-p, sc/id

N90693
Typhoid vaccine, akd, sc

B90696
Dtap-ipv vacc 4-6 yr, im
NI
E90698
Dtap-hib-ip vaccine, im

N90700
Dtap vaccine, < 7 yrs, im

N90701
Dtp vaccine, im

N90702
Dt vaccine < 7, im

N90703
Tetanus vaccine, im

N90704
Mumps vaccine, sc

N90705
Measles vaccine, sc

N90706
Rubella vaccine, sc

N90707
Mmr vaccine, sc

N90708
Measles-rubella vaccine, sc

K
9141

$66.38

$13.28
 2.On page 67118, for HCPCS code C9239, in line 25, in column 9, the minimum unadjusted copayment “$9.68” is corrected to read “$9.59.” 3.On page 67118, for HCPCS code C9352, in line 28— A. In column 7, the payment rate “$482.56” is corrected to read “$496.87.” B. In column 9, the minimum unadjusted copayment “$96.51” is corrected to read “$98.44.” 4.On page 67118, for HCPCS code C9353, in line 29— A. In column 7, the payment rate “$482.56” is corrected to read “$407.56.” B. In column 9, the minimum unadjusted copayment “$96.51” is corrected to read “$80.74.” 5.On page 67134, for HCPCS code G0377, in line 47— A. In column 4, the SI code “S” is corrected to read “E.” B. In column 5, the APC code “0437” is removed. C. In column 6, the relative weight number “0.3945” is removed. D. In column 7, the payment rate “$25.13” is removed. E. In column 9, the minimum unadjusted copayment “$5.03” is removed. 6.On page 67139, for HCPCS code G9140, in line 40, in column 4, the SI code “M” is corrected to read “A”. 7.On page 67139, for HCPCS code J0129, in line 43, in column 9, the minimum unadjusted copayment “$3.74” is corrected to read “$3.70.” 8.On page 67139, for HCPCS code J0190, in line 52— A. In column 7, the payment rate “$88.15” is corrected to read “$12.24.” B. In column 9, the minimum unadjusted copayment “$17.63” is corrected to read “$2.45.” 9.On page 67139, for HCPCS code J0350, in line 74— A. In column 7, the payment rate “$2,693.80” is corrected to read “$1,706.04.” B. In column 9, the minimum unadjusted copayment “$538.76” is corrected to read “$341.21.” 10.On page 67141, for HCPCS code J1300, in line 17, in column 9, the minimum unadjusted copayment “$35.28” is corrected to read “$34.94.” 11.On page 67142— A. For HCPCS code J1740, in line 4, in column 9, the minimum unadjusted copayment “$27.79” is corrected to read “$27.53.” B. For HCPCS code J1743, in line 6, in column 9, the minimum unadjusted copayment “$91.01” is corrected to read “$90.15.” C. For HCPCS code J2248, in line 43, in column 9, the minimum unadjusted copayment “$0.29” is corrected to read “$0.28.” D. For HCPCS code J2323, in line 57, in column 9, the minimum unadjusted 
                            ( print page 9864)
                            copayment “$1.50” is corrected to read “$1.49.” 12.On page 67143 for HCPCS code J2778, in line 21, in column 9, the minimum unadjusted copayment “$406.05” is corrected to read “$402.22.” 13.On page 67143, for HCPCS code J2940, in line 39— A. In column 7, the payment rate “$168.90” is corrected to read “$42.69.” B. In column 9, the minimum unadjusted copayment “$33.78” is corrected to read “$8.54.” 14.On page 67143, for HCPCS code J2995, in line 43— A. In column 7, the payment rate “$129.75” is corrected to read “$20.89.” B. In column 9, the minimum unadjusted copayment “$25.95” is corrected to read “$4.18.” 15.On page 67143, for HCPCS code J3350, in line 72— A. In column 7, the payment rate “$74.16” is corrected to read “$23.23.” B. In column 9, the minimum unadjusted copayment “$14.83” is corrected to read “$4.65.” 16.On page 67144, for HCPCS code J3488, in line 15, in column 9, the minimum unadjusted copayment “$44.16” is corrected to read “$43.74.” 17.On page 67144, for HCPCS code J7348, in line 65— A. In column 7, the payment rate “$67.96” is corrected to read “$95.32,” B. In column 9, the minimum unadjusted copayment “$13.59” is corrected to read “$18.88.” 18.On page 67144, for HCPCS code J7349, in line 66— A. In column 7, the payment rate “$67.96” is corrected to read “$42.24,” B. In column 9, the minimum unadjusted copayment “$13.59” is corrected to read “$8.37.” 19.On page 67146, for HCPCS code J9261, in line 65, in column 9, the minimum unadjusted copayment “$17.37” is corrected to read “$17.20.” 20.On page 67146, for HCPCS code J9270, in line 71— A. In column 7, the payment rate “$172.41” is corrected to read “$19.81.” B. In column 9, the minimum unadjusted copayment “$34.48” is corrected to read “$3.96.” 21.On page 67146, for HCPCS code J9303, in line 77, in column 9, the minimum unadjusted copayment “$16.63” is corrected to read “$16.47.” 22.On page 67147, for HCPCS code J9357, in line 4— A. In column 7, the payment rate “$77.96” is corrected to read “$219.39.” B. In column 9, the minimum unadjusted copayment “$15.59” is corrected to read “$43.88.” ADDENDUM BB.—ASC COVERED ANCILLARY SERVICES INTEGRAL TO COVERED SURGICAL PROCEDURES FOR CY 2008 We are republishing Addendum BB in its entirety, see attached chart. ADDENDUM DD2.—OPPS COMMENT INDICATORS On page 67190, in line 1, the header “ADDENDUM DD2—OPPS COMMENT INDICATORS” is corrected to read “ADDENDUM D2—OPPS COMMENT INDICATORS.” ADDENDUM M.—HCPCS CODES FOR ASSIGNMENT TO COMPOSITE APCS FOR CY 2008 On page 67225— A. For HCPCS code 90862, in line 19, in column 5, the single code APC assignment number “0605” is corrected to read “0606.” B. For HCPCS code 96102, in line 24, in column 5, the single code APC assignment number “0373” is corrected to read “0382.” C. For HCPCS code M0064, in line 37, in column 5, the single code APC assignment number “0605” is corrected to read “0606.” IV. Waiver of Proposed Rulemaking and Delay in Effective Date We ordinarily publish a notice of proposed rulemaking in the 
                        **Federal Register**
                         to provide a period for public comment before the provisions of a notice such as this takes effect in accordance with section 553(b) of the Administrative Procedure Act (APA) (5 U.S.C. 553(b)). We also ordinarily provide a 30-day delay in the effective date of the provisions of a notice in accordance with section 553(d) of the APA (5 U.S.C. 553(d)). However, we can waive both the notice and comment procedure and the 30-day delay in effective date if the Secretary finds, for good cause, that it is impracticable, unnecessary or contrary to the public interest, and incorporates a statement of the finding and the reasons therefore in the notice. The policies and payment methodology finalized in the CY 2008 OPPS/ASC final rule with comment period have previously been subjected to notice and comment procedures. This correction notice merely provides technical corrections to the CY 2008 OPPS/ASC final rule with comment period that was promulgated through notice and comment rulemaking, and does not make substantive changes to the policies or payment methodologies that were finalized in the final rule with comment period. For example, in order to conform the document to the final policies of the CY 2008 OPPS/ASC final rule with comment period, this notice corrects typographical errors, makes clarifications to the preamble text, and revises inaccurate tabular data. Therefore, we find it unnecessary to undertake further notice and comment procedures with respect to this correction notice. For the reasons stated above, we find that both notice and comment and the 30-day delay in effective date for this correction notice are unnecessary. Therefore, we find there is good cause to waive notice and comment procedures and the 30-day delay in effective date for this correction notice. (Catalog of Federal Domestic Assistance Program No. 93.774, Medicare—Supplementary Medical Insurance Program) Dated: February 5, 2008. Ann Agnew, Executive Secretary to the Department.
 
 
 Addendum AA.—ASC Covered Surgical Procedures for CY 2008
[Including Surgical Procedures for Which Payment Is Packaged]
HCPCS code
Short descriptor
Subject to multiple procedure discounting
Comment indicator
Payment indicator
CY 2007 ASC payment rate
CY 2008 fully implemented payment weight
CY 2008 fully implemented payment
CY 2008 first transition year payment0016T
Thermotx choroid vasc lesion
Y

R2

4.1331
$171.11
$171.110017T
Photocoagulat macular drusen
Y

R2

4.1331
$171.11
$171.110027T
Endoscopic epidural lysis
Y

G2

18.0518
$747.36
$747.360031T
Speculoscopy
N

N10032T
Speculoscopy w/direct sample
N

N10046T
Cath lavage, mammary duct(s)
Y

R2

16.1001
$666.56
$666.560047T
Cath lavage, mammary duct(s)
Y

R2

16.1001
$666.56
$666.560062T
Rep intradisc annulus;1 lev
Y

G2

29.19
$1,208.50
$1,208.500063T
Rep intradisc annulus; >1 lev
Y

G2

29.19
$1,208.50
$1,208.500084T
Temp prostate urethral stent
Y

G2

2.0077
$83.12
$83.120088T
Rf tongue base vol reduxn
Y
CH
G2

16.3288
$676.03
$676.030099T *
Implant corneal ring
Y

R2

16.171
$669.50
$669.500100T
Prosth retina receive & gen
Y

G2

37.2078
$1,540.44
$1,540.440101T
Extracorp shockwv tx,hi enrg
Y

G2

29.19
$1,208.50
$1,208.500102T
Extracorp shockwv tx,anesth
Y

G2

29.19
$1,208.50
$1,208.500123T
Scleral fistulization
Y

G2

23.1758
$959.50
$959.500124T *
Conjunctival drug placement
Y

R2

5.1169
$211.84
$211.840137T
Prostate saturation sampling
Y
CH
G2

11.0338
$456.81
$456.810170T
Anorectal fistula plug rpr
Y
CH
G2

30.1606
$1,248.68
$1,248.680176T
Aqu canal dilat w/o retent
Y

A2
$1,339.00
39.7101
$1,644.04
$1,415.260177T
Aqu canal dilat w retent
Y

A2
$1,339.00
39.7101
$1,644.04
$1,415.260186T
Suprachoroidal drug delivery
Y
NI
G2

18.235
$754.95
$754.9510021
Fna w/o image
Y

P2

1.1097
$45.94
$45.9410022
Fna w/image
Y

G2

4.327
$179.14
$179.1410040
Acne surgery
Y

P2

0.793
$32.83
$32.8310060
Drainage of skin abscess
Y

P3

1.1191
$46.33
$46.3310061
Drainage of skin abscess
Y

P2

1.4066
$58.23
$58.2310080
Drainage of pilonidal cyst
Y

P2

1.4066
$58.23
$58.2310081
Drainage of pilonidal cyst
Y

P3

3.1106
$128.78
$128.7810120
Remove foreign body
Y

P2

1.4066
$58.23
$58.2310121
Remove foreign body
Y

A2
$446.00
16.1001
$666.56
$501.1410140
Drainage of hematoma/fluid
Y

P3

1.6623
$68.82
$68.8210160
Puncture drainage of lesion
Y

P2

1.4066
$58.23
$58.2310180
Complex drainage, wound
Y

A2
$446.00
18.3197
$758.45
$524.1111000
Debride infected skin
Y

P3

0.5348
$22.14
$22.1411001
Debride infected skin add-on
Y

P3

0.1894
$7.84
$7.8411010
Debride skin, fx
Y

A2
$251.52
4.3039
$178.19
$233.1911011
Debride skin/muscle, fx
Y

A2
$251.52
4.3039
$178.19
$233.1911012
Debride skin/muscle/bone, fx
Y

A2
$251.52
4.3039
$178.19
$233.1911040
Debride skin, partial
Y

P3

0.4937
$20.44
$20.4411041
Debride skin, full
Y

P3

0.5679
$23.51
$23.5111042
Debride skin/tissue
Y

A2
$164.42
2.6604
$110.14
$150.8511043
Debride tissue/muscle
Y

A2
$164.42
2.6604
$110.14
$150.8511044
Debride tissue/muscle/bone
Y

A2
$423.10
6.8816
$284.91
$388.5511055
Trim skin lesion
Y

P3

0.5596
$23.17
$23.1711056
Trim skin lesions, 2 to 4
Y

P3

0.6253
$25.89
$25.8911057
Trim skin lesions, over 4
Y

P3

0.7077
$29.30
$29.3011100
Biopsy, skin lesion
Y

P2

0.793
$32.83
$32.8311101
Biopsy, skin add-on
Y

P3

0.3046
$12.61
$12.6111200
Removal of skin tags
Y
CH
P2

0.793
$32.83
$32.8311201
Remove skin tags add-on
Y

P3

0.1316
$5.45
$5.4511300
Shave skin lesion
Y

P2

0.793
$32.83
$32.8311301
Shave skin lesion
Y

P2

0.793
$32.83
$32.8311302
Shave skin lesion
Y

P2

0.793
$32.83
$32.8311303
Shave skin lesion
Y

P2

1.4595
$60.42
$60.4211305
Shave skin lesion
Y

P3

0.7901
$32.71
$32.7111306
Shave skin lesion
Y
CH
P2

0.793
$32.83
$32.8311307
Shave skin lesion
Y

P2

0.793
$32.83
$32.8311308
Shave skin lesion
Y

P2

0.793
$32.83
$32.8311310
Shave skin lesion
Y
CH
P2

0.793
$32.83
$32.8311311
Shave skin lesion
Y

P2

0.793
$32.83
$32.8311312
Shave skin lesion
Y

P2

0.793
$32.83
$32.8311313
Shave skin lesion
Y
CH
P2

0.793
$32.83
$32.8311400
Exc tr-ext b9+marg 0.5 < cm
Y

P3

1.5963
$66.09
$66.0911401
Exc tr-ext b9+marg 0.6-1 cm
Y

P3

1.7444
$72.22
$72.2211402
Exc tr-ext b9+marg 1.1-2 cm
Y

P3

1.9009
$78.70
$78.7011403
Exc tr-ext b9+marg 2.1-3 cm
Y

P3

2.0408
$84.49
$84.4911404
Exc tr-ext b9+marg 3.1-4 cm
Y

A2
$333.00
16.1001
$666.56
$416.3911406
Exc tr-ext b9+marg > 4.0 cm
Y

A2
$446.00
16.1001
$666.56
$501.1411420
Exc h-f-nk-sp b9+marg 0.5 <
Y

P3

1.4811
$61.32
$61.3211421
Exc h-f-nk-sp b9+marg 0.6-1
Y

P3

1.7611
$72.91
$72.9111422
Exc h-f-nk-sp b9+marg 1.1-2
Y

P3

1.9338
$80.06
$80.0611423
Exc h-f-nk-sp b9+marg 2.1-3
Y

P3

2.1642
$89.60
$89.6011424
Exc h-f-nk-sp b9+marg 3.1-4
Y

A2
$446.00
16.1001
$666.56
$501.1411426
Exc h-f-nk-sp b9+marg > 4 cm
Y

A2
$446.00
21.1098
$873.97
$552.9911440
Exc face-mm b9+marg 0.5 < cm
Y

P3

1.728
$71.54
$71.5411441
Exc face-mm b9+marg 0.6-1 cm
Y

P3

1.942
$80.40
$80.40( print page 9866)11442
Exc face-mm b9+marg 1.1-2 cm
Y

P3

2.1313
$88.24
$88.2411443
Exc face-mm b9+marg 2.1-3 cm
Y

P3

2.3864
$98.80
$98.8011444
Exc face-mm b9+marg 3.1-4 cm
Y

A2
$333.00
8.685
$359.57
$339.6411446
Exc face-mm b9+marg > 4 cm
Y

A2
$446.00
21.1098
$873.97
$552.9911450
Removal, sweat gland lesion
Y

A2
$446.00
21.1098
$873.97
$552.9911451
Removal, sweat gland lesion
Y

A2
$446.00
21.1098
$873.97
$552.9911462
Removal, sweat gland lesion
Y

A2
$446.00
21.1098
$873.97
$552.9911463
Removal, sweat gland lesion
Y

A2
$446.00
21.1098
$873.97
$552.9911470
Removal, sweat gland lesion
Y

A2
$446.00
21.1098
$873.97
$552.9911471
Removal, sweat gland lesion
Y

A2
$446.00
21.1098
$873.97
$552.9911600
Exc tr-ext mlg+marg 0.5 < cm
Y

P3

2.2135
$91.64
$91.6411601
Exc tr-ext mlg+marg 0.6-1 cm
Y

P3

2.5263
$104.59
$104.5911602
Exc tr-ext mlg+marg 1.1-2 cm
Y

P3

2.7485
$113.79
$113.7911603
Exc tr-ext mlg+marg 2.1-3 cm
Y

P3

2.9294
$121.28
$121.2811604
Exc tr-ext mlg+marg 3.1-4 cm
Y

A2
$418.49
8.685
$359.57
$403.7611606
Exc tr-ext mlg+marg > 4 cm
Y

A2
$446.00
16.1001
$666.56
$501.1411620
Exc h-f-nk-sp mlg+marg 0.5 <
Y

P3

2.2384
$92.67
$92.6711621
Exc h-f-nk-sp mlg+marg 0.6-1
Y

P3

2.5509
$105.61
$105.6111622
Exc h-f-nk-sp mlg+marg 1.1-2
Y

P3

2.8224
$116.85
$116.8511623
Exc h-f-nk-sp mlg+marg 2.1-3
Y

P3

3.0692
$127.07
$127.0711624
Exc h-f-nk-sp mlg+marg 3.1-4
Y

A2
$446.00
16.1001
$666.56
$501.1411626
Exc h-f-nk-sp mlg+mar > 4 cm
Y

A2
$446.00
21.1098
$873.97
$552.9911640
Exc face-mm malig+marg 0.5 <
Y

P3

2.3536
$97.44
$97.4411641
Exc face-mm malig+marg 0.6-1
Y

P3

2.7403
$113.45
$113.4511642
Exc face-mm malig+marg 1.1-2
Y

P3

3.061
$126.73
$126.7311643
Exc face-mm malig+marg 2.1-3
Y

P3

3.3246
$137.64
$137.6411644
Exc face-mm malig+marg 3.1-4
Y

A2
$446.00
16.1001
$666.56
$501.1411646
Exc face-mm mlg+marg > 4 cm
Y

A2
$446.00
21.1098
$873.97
$552.9911719
Trim nail(s)
Y

P3

0.2551
$10.56
$10.5611720
Debride nail, 1-5
Y

P3

0.3292
$13.63
$13.6311721
Debride nail, 6 or more
Y

P3

0.4031
$16.69
$16.6911730
Removal of nail plate
Y
CH
P2

0.793
$32.83
$32.8311732
Remove nail plate, add-on
Y

P3

0.4031
$16.69
$16.6911740
Drain blood from under nail
Y
CH
P2

0.2963
$12.27
$12.2711750
Removal of nail bed
Y

P3

2.1065
$87.21
$87.2111752
Remove nail bed/finger tip
Y

P3

2.9048
$120.26
$120.2611755
Biopsy, nail unit
Y

P3

1.4811
$61.32
$61.3211760
Repair of nail bed
Y

G2

2.1051
$87.15
$87.1511762
Reconstruction of nail bed
Y
CH
P3

2.7072
$112.08
$112.0811765
Excision of nail fold, toe
Y

P2

1.4595
$60.42
$60.4211770
Removal of pilonidal lesion
Y

A2
$510.00
21.1098
$873.97
$600.9911771
Removal of pilonidal lesion
Y

A2
$510.00
21.1098
$873.97
$600.9911772
Removal of pilonidal lesion
Y

A2
$510.00
21.1098
$873.97
$600.9911900
Injection into skin lesions
Y

P3

0.6418
$26.57
$26.5711901
Added skin lesions injection
Y

P3

0.6831
$28.28
$28.2811920
Correct skin color defects
Y

P2

2.1051
$87.15
$87.1511921
Correct skin color defects
Y

P2

2.1051
$87.15
$87.1511922
Correct skin color defects
Y

P3

0.8476
$35.09
$35.0911950
Therapy for contour defects
Y

P3

0.8311
$34.41
$34.4111951
Therapy for contour defects
Y

P3

0.9874
$40.88
$40.8811952
Therapy for contour defects
Y
CH
P2

1.2792
$52.96
$52.9611954
Therapy for contour defects
Y

P2

1.2792
$52.96
$52.9611960
Insert tissue expander(s)
Y

A2
$446.00
20.2069
$836.59
$543.6511970
Replace tissue expander
Y

A2
$510.00
42.985
$1,779.62
$827.4111971
Remove tissue expander(s)
Y

A2
$333.00
21.1098
$873.97
$468.2411976
Removal of contraceptive cap
Y

P3

1.4154
$58.60
$58.6011980
Implant hormone pellet(s)
N

P2

0.631
$26.12
$26.1211981
Insert drug implant device
N

P2

0.631
$26.12
$26.1211982
Remove drug implant device
N

P2

0.631
$26.12
$26.1211983
Remove/insert drug implant
N

P2

0.631
$26.12
$26.1212001
Repair superficial wound(s)
Y

P2

1.2792
$52.96
$52.9612002
Repair superficial wound(s)
Y

P2

1.2792
$52.96
$52.9612004
Repair superficial wound(s)
Y

P2

1.2792
$52.96
$52.9612005
Repair superficial wound(s)
Y

A2
$91.24
1.2792
$52.96
$81.6712006
Repair superficial wound(s)
Y

A2
$91.24
1.2792
$52.96
$81.6712007
Repair superficial wound(s)
Y

A2
$91.24
1.2792
$52.96
$81.6712011
Repair superficial wound(s)
Y

P2

1.2792
$52.96
$52.9612013
Repair superficial wound(s)
Y

P2

1.2792
$52.96
$52.9612014
Repair superficial wound(s)
Y

P2

1.2792
$52.96
$52.9612015
Repair superficial wound(s)
Y

G2

1.2792
$52.96
$52.9612016
Repair superficial wound(s)
Y

A2
$91.24
1.2792
$52.96
$81.6712017
Repair superficial wound(s)
Y

A2
$91.24
1.2792
$52.96
$81.6712018
Repair superficial wound(s)
Y

A2
$91.24
1.2792
$52.96
$81.6712020
Closure of split wound
Y

A2
$91.24
4.5263
$187.39
$115.2812021
Closure of split wound
Y

A2
$91.24
4.5263
$187.39
$115.2812031
Layer closure of wound(s)
Y

P2

2.1051
$87.15
$87.1512032
Layer closure of wound(s)
Y

P2

2.1051
$87.15
$87.15( print page 9867)12034
Layer closure of wound(s)
Y

A2
$91.24
2.1051
$87.15
$90.2212035
Layer closure of wound(s)
Y

A2
$91.24
2.1051
$87.15
$90.2212036
Layer closure of wound(s)
Y

A2
$91.24
2.1051
$87.15
$90.2212037
Layer closure of wound(s)
Y

A2
$323.28
2.1051
$87.15
$264.2512041
Layer closure of wound(s)
Y

P2

2.1051
$87.15
$87.1512042
Layer closure of wound(s)
Y

P2

2.1051
$87.15
$87.1512044
Layer closure of wound(s)
Y

A2
$91.24
2.1051
$87.15
$90.2212045
Layer closure of wound(s)
Y

A2
$91.24
2.1051
$87.15
$90.2212046
Layer closure of wound(s)
Y

A2
$91.24
2.1051
$87.15
$90.2212047
Layer closure of wound(s)
Y

A2
$323.28
2.1051
$87.15
$264.2512051
Layer closure of wound(s)
Y

P2

2.1051
$87.15
$87.1512052
Layer closure of wound(s)
Y

P2

2.1051
$87.15
$87.1512053
Layer closure of wound(s)
Y

P2

2.1051
$87.15
$87.1512054
Layer closure of wound(s)
Y

A2
$91.24
2.1051
$87.15
$90.2212055
Layer closure of wound(s)
Y

A2
$91.24
2.1051
$87.15
$90.2212056
Layer closure of wound(s)
Y

A2
$91.24
2.1051
$87.15
$90.2212057
Layer closure of wound(s)
Y

A2
$323.28
2.1051
$87.15
$264.2513100
Repair of wound or lesion
Y

A2
$323.28
4.5263
$187.39
$289.3113101
Repair of wound or lesion
Y

A2
$323.28
4.5263
$187.39
$289.3113102
Repair wound/lesion add-on
Y

A2
$91.24
4.5263
$187.39
$115.2813120
Repair of wound or lesion
Y

A2
$91.24
2.1051
$87.15
$90.2213121
Repair of wound or lesion
Y

A2
$91.24
4.5263
$187.39
$115.2813122
Repair wound/lesion add-on
Y

A2
$91.24
2.1051
$87.15
$90.2213131
Repair of wound or lesion
Y

A2
$91.24
4.5263
$187.39
$115.2813132
Repair of wound or lesion
Y

A2
$91.24
4.5263
$187.39
$115.2813133
Repair wound/lesion add-on
Y

A2
$91.24
4.5263
$187.39
$115.2813150
Repair of wound or lesion
Y

A2
$323.28
4.5263
$187.39
$289.3113151
Repair of wound or lesion
Y

A2
$323.28
4.5263
$187.39
$289.3113152
Repair of wound or lesion
Y

A2
$323.28
4.5263
$187.39
$289.3113153
Repair wound/lesion add-on
Y

A2
$91.24
2.1051
$87.15
$90.2213160
Late closure of wound
Y

A2
$446.00
20.2069
$836.59
$543.6514000
Skin tissue rearrangement
Y

A2
$446.00
15.0458
$622.91
$490.2314001
Skin tissue rearrangement
Y

A2
$510.00
15.0458
$622.91
$538.2314020
Skin tissue rearrangement
Y

A2
$510.00
15.0458
$622.91
$538.2314021
Skin tissue rearrangement
Y

A2
$510.00
15.0458
$622.91
$538.2314040
Skin tissue rearrangement
Y

A2
$446.00
15.0458
$622.91
$490.2314041
Skin tissue rearrangement
Y

A2
$510.00
15.0458
$622.91
$538.2314060
Skin tissue rearrangement
Y

A2
$510.00
15.0458
$622.91
$538.2314061
Skin tissue rearrangement
Y

A2
$510.00
15.0458
$622.91
$538.2314300
Skin tissue rearrangement
Y

A2
$630.00
20.2069
$836.59
$681.6514350
Skin tissue rearrangement
Y

A2
$510.00
20.2069
$836.59
$591.6515002
Wnd prep, ch/inf, trk/arm/lg
Y

A2
$323.28
4.5263
$187.39
$289.3115003
Wnd prep, ch/inf addl 100 cm
Y

A2
$323.28
4.5263
$187.39
$289.3115004
Wnd prep ch/inf, f/n/hf/g
Y

A2
$323.28
4.5263
$187.39
$289.3115005
Wnd prep, f/n/hf/g, addl cm
Y

A2
$323.28
4.5263
$187.39
$289.3115040
Harvest cultured skin graft
Y

A2
$91.24
2.1051
$87.15
$90.2215050
Skin pinch graft
Y

A2
$323.28
4.5263
$187.39
$289.3115100
Skin splt grft, trnk/arm/leg
Y

A2
$446.00
20.2069
$836.59
$543.6515101
Skin splt grft t/a/l, add-on
Y

A2
$510.00
20.2069
$836.59
$591.6515110
Epidrm autogrft trnk/arm/leg
Y

A2
$446.00
4.5263
$187.39
$381.3515111
Epidrm autogrft t/a/l add-on
Y

A2
$333.00
4.5263
$187.39
$296.6015115
Epidrm a-grft face/nck/hf/g
Y

A2
$446.00
4.5263
$187.39
$381.3515116
Epidrm a-grft f/n/hf/g addl
Y

A2
$333.00
4.5263
$187.39
$296.6015120
Skn splt a-grft fac/nck/hf/g
Y

A2
$446.00
20.2069
$836.59
$543.6515121
Skn splt a-grft f/n/hf/g add
Y

A2
$510.00
20.2069
$836.59
$591.6515130
Derm autograft, trnk/arm/leg
Y

A2
$446.00
15.0458
$622.91
$490.2315131
Derm autograft t/a/l add-on
Y

A2
$333.00
15.0458
$622.91
$405.4815135
Derm autograft face/nck/hf/g
Y

A2
$446.00
15.0458
$622.91
$490.2315136
Derm autograft, f/n/hf/g add
Y

A2
$333.00
15.0458
$622.91
$405.4815150
Cult epiderm grft t/arm/leg
Y

A2
$446.00
4.5263
$187.39
$381.3515151
Cult epiderm grft t/a/l addl
Y

A2
$333.00
4.5263
$187.39
$296.6015152
Cult epiderm graft t/a/l +%
Y

A2
$333.00
4.5263
$187.39
$296.6015155
Cult epiderm graft, f/n/hf/g
Y

A2
$446.00
4.5263
$187.39
$381.3515156
Cult epidrm grft f/n/hfg add
Y

A2
$333.00
4.5263
$187.39
$296.6015157
Cult epiderm grft f/n/hfg +%
Y

A2
$333.00
4.5263
$187.39
$296.6015200
Skin full graft, trunk
Y

A2
$510.00
15.0458
$622.91
$538.2315201
Skin full graft trunk add-on
Y

A2
$323.28
15.0458
$622.91
$398.1915220
Skin full graft sclp/arm/leg
Y

A2
$446.00
15.0458
$622.91
$490.2315221
Skin full graft add-on
Y

A2
$323.28
4.5263
$187.39
$289.3115240
Skin full grft face/genit/hf
Y

A2
$510.00
15.0458
$622.91
$538.2315241
Skin full graft add-on
Y

A2
$323.28
4.5263
$187.39
$289.3115260
Skin full graft een & lips
Y

A2
$446.00
15.0458
$622.91
$490.2315261
Skin full graft add-on
Y

A2
$323.28
15.0458
$622.91
$398.1915300
Apply skinallogrft, t/arm/lg
Y

A2
$323.28
4.5263
$187.39
$289.3115301
Apply sknallogrft t/a/l addl
Y

A2
$323.28
4.5263
$187.39
$289.3115320
Apply skin allogrft f/n/hf/g
Y

A2
$323.28
4.5263
$187.39
$289.3115321
Aply sknallogrft f/n/hfg add
Y

A2
$323.28
4.5263
$187.39
$289.31( print page 9868)15330
Aply acell alogrft t/arm/leg
Y

A2
$323.28
4.5263
$187.39
$289.3115331
Aply acell grft t/a/l add-on
Y

A2
$323.28
4.5263
$187.39
$289.3115335
Apply acell graft, f/n/hf/g
Y

A2
$323.28
4.5263
$187.39
$289.3115336
Aply acell grft f/n/hf/g add
Y

A2
$323.28
4.5263
$187.39
$289.3115340
Apply cult skin substitute
Y
CH
G2

2.1051
$87.15
$87.1515341
Apply cult skin sub add-on
Y

G2

2.1051
$87.15
$87.1515360
Apply cult derm sub, t/a/l
Y

G2

2.1051
$87.15
$87.1515361
Aply cult derm sub t/a/l add
Y

G2

2.1051
$87.15
$87.1515365
Apply cult derm sub f/n/hf/g
Y

G2

2.1051
$87.15
$87.1515366
Apply cult derm f/hf/g add
Y

G2

2.1051
$87.15
$87.1515400
Apply skin xenograft, t/a/l
Y

A2
$323.28
4.5263
$187.39
$289.3115401
Apply skn xenogrft t/a/l add
Y

A2
$323.28
4.5263
$187.39
$289.3115420
Apply skin xgraft, f/n/hf/g
Y

A2
$323.28
4.5263
$187.39
$289.3115421
Apply skn xgrft f/n/hf/g add
Y

A2
$323.28
4.5263
$187.39
$289.3115430
Apply acellular xenograft
Y

A2
$323.28
4.5263
$187.39
$289.3115431
Apply acellular xgraft add
Y

A2
$323.28
4.5263
$187.39
$289.3115570
Form skin pedicle flap
Y

A2
$510.00
20.2069
$836.59
$591.6515572
Form skin pedicle flap
Y

A2
$510.00
20.2069
$836.59
$591.6515574
Form skin pedicle flap
Y

A2
$510.00
20.2069
$836.59
$591.6515576
Form skin pedicle flap
Y

A2
$510.00
20.2069
$836.59
$591.6515600
Skin graft
Y

A2
$510.00
20.2069
$836.59
$591.6515610
Skin graft
Y

A2
$510.00
20.2069
$836.59
$591.6515620
Skin graft
Y

A2
$630.00
20.2069
$836.59
$681.6515630
Skin graft
Y

A2
$510.00
20.2069
$836.59
$591.6515650
Transfer skin pedicle flap
Y

A2
$717.00
20.2069
$836.59
$746.9015731
Forehead flap w/vasc pedicle
Y

A2
$510.00
20.2069
$836.59
$591.6515732
Muscle-skin graft, head/neck
Y

A2
$510.00
20.2069
$836.59
$591.6515734
Muscle-skin graft, trunk
Y

A2
$510.00
20.2069
$836.59
$591.6515736
Muscle-skin graft, arm
Y

A2
$510.00
20.2069
$836.59
$591.6515738
Muscle-skin graft, leg
Y

A2
$510.00
20.2069
$836.59
$591.6515740
Island pedicle flap graft
Y

A2
$446.00
15.0458
$622.91
$490.2315750
Neurovascular pedicle graft
Y

A2
$446.00
20.2069
$836.59
$543.6515760
Composite skin graft
Y

A2
$446.00
20.2069
$836.59
$543.6515770
Derma-fat-fascia graft
Y

A2
$510.00
20.2069
$836.59
$591.6515775
Hair transplant punch grafts
Y

A2
$323.28
1.2792
$52.96
$255.7015776
Hair transplant punch grafts
Y

A2
$323.28
1.2792
$52.96
$255.7015780
Abrasion treatment of skin
Y

P3

9.3645
$387.70
$387.7015781
Abrasion treatment of skin
Y

P2

4.3039
$178.19
$178.1915782
Abrasion treatment of skin
Y

P2

4.3039
$178.19
$178.1915783
Abrasion treatment of skin
Y

P2

2.6604
$110.14
$110.1415786
Abrasion, lesion, single
Y

P2

0.793
$32.83
$32.8315787
Abrasion, lesions, add-on
Y

P3

0.7901
$32.71
$32.7115788
Chemical peel, face, epiderm
Y

P2

0.793
$32.83
$32.8315789
Chemical peel, face, dermal
Y

P2

1.4595
$60.42
$60.4215792
Chemical peel, nonfacial
Y

P2

1.4595
$60.42
$60.4215793
Chemical peel, nonfacial
Y

P2

0.793
$32.83
$32.8315819
Plastic surgery, neck
Y

G2

2.1051
$87.15
$87.1515820
Revision of lower eyelid
Y

A2
$510.00
20.2069
$836.59
$591.6515821
Revision of lower eyelid
Y

A2
$510.00
20.2069
$836.59
$591.6515822
Revision of upper eyelid
Y

A2
$510.00
20.2069
$836.59
$591.6515823
Revision of upper eyelid
Y

A2
$717.00
20.2069
$836.59
$746.9015824
Removal of forehead wrinkles
Y

A2
$510.00
20.2069
$836.59
$591.6515825
Removal of neck wrinkles
Y

A2
$510.00
20.2069
$836.59
$591.6515826
Removal of brow wrinkles
Y

A2
$510.00
20.2069
$836.59
$591.6515828
Removal of face wrinkles
Y

A2
$510.00
20.2069
$836.59
$591.6515829
Removal of skin wrinkles
Y

A2
$717.00
20.2069
$836.59
$746.9015830
Exc skin abd
Y

A2
$510.00
21.1098
$873.97
$600.9915832
Excise excessive skin tissue
Y

A2
$510.00
21.1098
$873.97
$600.9915833
Excise excessive skin tissue
Y

A2
$510.00
21.1098
$873.97
$600.9915834
Excise excessive skin tissue
Y

A2
$510.00
21.1098
$873.97
$600.9915835
Excise excessive skin tissue
Y

A2
$323.28
21.1098
$873.97
$460.9515836
Excise excessive skin tissue
Y

A2
$510.00
16.1001
$666.56
$549.1415837
Excise excessive skin tissue
Y

G2

16.1001
$666.56
$666.5615838
Excise excessive skin tissue
Y

G2

16.1001
$666.56
$666.5615839
Excise excessive skin tissue
Y

A2
$510.00
16.1001
$666.56
$549.1415840
Graft for face nerve palsy
Y

A2
$630.00
20.2069
$836.59
$681.6515841
Graft for face nerve palsy
Y

A2
$630.00
20.2069
$836.59
$681.6515842
Flap for face nerve palsy
Y

G2

20.2069
$836.59
$836.5915845
Skin and muscle repair, face
Y

A2
$630.00
20.2069
$836.59
$681.6515847
Exc skin abd add-on
Y

A2
$510.00
21.1098
$873.97
$600.9915850
Removal of sutures
Y

G2

2.6604
$110.14
$110.1415851
Removal of sutures
Y

P3

1.2425
$51.44
$51.4415852
Dressing change not for burn
N

G2

0.631
$26.12
$26.1215860
Test for blood flow in graft
N

G2

0.631
$26.12
$26.1215876
Suction assisted lipectomy
Y

A2
$510.00
20.2069
$836.59
$591.6515877
Suction assisted lipectomy
Y

A2
$510.00
20.2069
$836.59
$591.6515878
Suction assisted lipectomy
Y

A2
$510.00
20.2069
$836.59
$591.65( print page 9869)15879
Suction assisted lipectomy
Y

A2
$510.00
20.2069
$836.59
$591.6515920
Removal of tail bone ulcer
Y

A2
$251.52
4.3039
$178.19
$233.1915922
Removal of tail bone ulcer
Y

A2
$630.00
20.2069
$836.59
$681.6515931
Remove sacrum pressure sore
Y

A2
$510.00
21.1098
$873.97
$600.9915933
Remove sacrum pressure sore
Y

A2
$510.00
21.1098
$873.97
$600.9915934
Remove sacrum pressure sore
Y

A2
$510.00
20.2069
$836.59
$591.6515935
Remove sacrum pressure sore
Y

A2
$630.00
20.2069
$836.59
$681.6515936
Remove sacrum pressure sore
Y

A2
$630.00
15.0458
$622.91
$628.2315937
Remove sacrum pressure sore
Y

A2
$630.00
20.2069
$836.59
$681.6515940
Remove hip pressure sore
Y

A2
$510.00
21.1098
$873.97
$600.9915941
Remove hip pressure sore
Y

A2
$510.00
21.1098
$873.97
$600.9915944
Remove hip pressure sore
Y

A2
$510.00
20.2069
$836.59
$591.6515945
Remove hip pressure sore
Y

A2
$630.00
20.2069
$836.59
$681.6515946
Remove hip pressure sore
Y

A2
$630.00
20.2069
$836.59
$681.6515950
Remove thigh pressure sore
Y

A2
$510.00
21.1098
$873.97
$600.9915951
Remove thigh pressure sore
Y

A2
$630.00
21.1098
$873.97
$690.9915952
Remove thigh pressure sore
Y

A2
$510.00
15.0458
$622.91
$538.2315953
Remove thigh pressure sore
Y

A2
$630.00
15.0458
$622.91
$628.2315956
Remove thigh pressure sore
Y

A2
$510.00
15.0458
$622.91
$538.2315958
Remove thigh pressure sore
Y

A2
$630.00
15.0458
$622.91
$628.2316000
Initial treatment of burn(s)
Y

P3

0.65
$26.91
$26.9116020
Dress/debrid p-thick burn, s
Y

P3

0.9874
$40.88
$40.8816025
Dress/debrid p-thick burn, m
Y

A2
$67.11
2.6604
$110.14
$77.8716030
Dress/debrid p-thick burn, l
Y

A2
$99.83
2.6604
$110.14
$102.4116035
Incision of burn scab, initi
Y

G2

2.6604
$110.14
$110.1417000
Destruct premalg lesion
Y

P2

0.793
$32.83
$32.8317003
Destruct premalg les, 2-14
Y

P3

0.0906
$3.75
$3.7517004
Destroy premlg lesions 15+
Y

P3

1.9502
$80.74
$80.7417106
Destruction of skin lesions
Y

P2

2.6604
$110.14
$110.1417107
Destruction of skin lesions
Y

P2

2.6604
$110.14
$110.1417108
Destruction of skin lesions
Y

P2

2.6604
$110.14
$110.1417110
Destruct b9 lesion, 1-14
Y

P2

0.793
$32.83
$32.8317111
Destruct lesion, 15 or more
Y

P2

1.4595
$60.42
$60.4217250
Chemical cautery, tissue
Y

P3

1.0451
$43.27
$43.2717260
Destruction of skin lesions
Y

P3

1.1026
$45.65
$45.6517261
Destruction of skin lesions
Y

P2

1.4595
$60.42
$60.4217262
Destruction of skin lesions
Y

P2

1.4595
$60.42
$60.4217263
Destruction of skin lesions
Y

P2

1.4595
$60.42
$60.4217264
Destruction of skin lesions
Y

P2

1.4595
$60.42
$60.4217266
Destruction of skin lesions
Y

P3

2.4685
$102.20
$102.2017270
Destruction of skin lesions
Y

P2

1.4595
$60.42
$60.4217271
Destruction of skin lesions
Y

P2

1.4595
$60.42
$60.4217272
Destruction of skin lesions
Y

P2

1.4595
$60.42
$60.4217273
Destruction of skin lesions
Y
CH
P3

2.2299
$92.32
$92.3217274
Destruction of skin lesions
Y

P3

2.5427
$105.27
$105.2717276
Destruction of skin lesions
Y

P2

2.6604
$110.14
$110.1417280
Destruction of skin lesions
Y
CH
P2

1.4595
$60.42
$60.4217281
Destruction of skin lesions
Y
CH
P3

1.9091
$79.04
$79.0417282
Destruction of skin lesions
Y
CH
P3

2.1806
$90.28
$90.2817283
Destruction of skin lesions
Y
CH
P3

2.5098
$103.91
$103.9117284
Destruction of skin lesions
Y

P2

2.6604
$110.14
$110.1417286
Destruction of skin lesions
Y

P2

2.6604
$110.14
$110.1417311
Mohs, 1 stage, h/n/hf/g
Y

P2

3.6321
$150.37
$150.3717312
Mohs addl stage
Y

P2

3.6321
$150.37
$150.3717313
Mohs, 1 stage, t/a/l
Y

P2

3.6321
$150.37
$150.3717314
Mohs, addl stage, t/a/l
Y

P2

3.6321
$150.37
$150.3717315
Mohs surg, addl block
Y

P3

0.9381
$38.84
$38.8417340
Cryotherapy of skin
Y

P3

0.2961
$12.26
$12.2617360
Skin peel therapy
Y

P2

0.793
$32.83
$32.8317380
Hair removal by electrolysis
Y

R2

0.793
$32.83
$32.8319000
Drainage of breast lesion
Y

P3

1.6046
$66.43
$66.4319001
Drain breast lesion add-on
Y

P3

0.2058
$8.52
$8.5219020
Incision of breast lesion
Y

A2
$446.00
18.3197
$758.45
$524.1119030
Injection for breast x-ray
N

N119100
Bx breast percut w/o image
Y

A2
$240.00
4.327
$179.14
$224.7919101
Biopsy of breast, open
Y

A2
$446.00
20.6417
$854.59
$548.1519102
Bx breast percut w/image
Y

A2
$240.00
7.1147
$294.56
$253.6419103
Bx breast percut w/device
Y

A2
$395.77
13.5764
$562.08
$437.3519105
Cryosurg ablate fa, each
Y

G2

31.7134
$1,312.97
$1,312.9719110
Nipple exploration
Y

A2
$446.00
20.6417
$854.59
$548.1519112
Excise breast duct fistula
Y

A2
$510.00
20.6417
$854.59
$596.1519120
Removal of breast lesion
Y

A2
$510.00
20.6417
$854.59
$596.1519125
Excision, breast lesion
Y

A2
$510.00
20.6417
$854.59
$596.1519126
Excision, addl breast lesion
Y

A2
$510.00
20.6417
$854.59
$596.1519290
Place needle wire, breast
N

N119291
Place needle wire, breast
N

N119295
Place breast clip, percut
N
CH
N1( print page 9870)19296
Place po breast cath for rad
Y

A2
$1,339.00
56.5774
$2,342.36
$1,589.8419297
Place breast cath for rad
Y

A2
$1,339.00
56.5774
$2,342.36
$1,589.8419298
Place breast rad tube/caths
Y

A2
$1,339.00
56.5774
$2,342.36
$1,589.8419300
Removal of breast tissue
Y

A2
$630.00
20.6417
$854.59
$686.1519301
Partical mastectomy
Y

A2
$510.00
20.6417
$854.59
$596.1519302
P-mastectomy w/ln removal
Y

A2
$995.00
39.8191
$1,648.55
$1,158.3919303
Mast, simple, complete
Y

A2
$630.00
31.7134
$1,312.97
$800.7419304
Mast, subq
Y

A2
$630.00
31.7134
$1,312.97
$800.7419316
Suspension of breast
Y

A2
$630.00
31.7134
$1,312.97
$800.7419318
Reduction of large breast
Y

A2
$630.00
39.8191
$1,648.55
$884.6419324
Enlarge breast
Y

A2
$630.00
39.8191
$1,648.55
$884.6419325
Enlarge breast with implant
Y

A2
$1,339.00
56.5774
$2,342.36
$1,589.8419328
Removal of breast implant
Y

A2
$333.00
31.7134
$1,312.97
$577.9919330
Removal of implant material
Y

A2
$333.00
31.7134
$1,312.97
$577.9919340
Immediate breast prosthesis
Y

A2
$446.00
39.8191
$1,648.55
$746.6419342
Delayed breast prosthesis
Y

A2
$510.00
56.5774
$2,342.36
$968.0919350
Breast reconstruction
Y

A2
$630.00
20.6417
$854.59
$686.1519355
Correct inverted nipple(s)
Y

A2
$630.00
31.7134
$1,312.97
$800.7419357
Breast reconstruction
Y

A2
$717.00
56.5774
$2,342.36
$1,123.3419366
Breast reconstruction
Y

A2
$717.00
31.7134
$1,312.97
$865.9919370
Surgery of breast capsule
Y

A2
$630.00
31.7134
$1,312.97
$800.7419371
Removal of breast capsule
Y

A2
$630.00
31.7134
$1,312.97
$800.7419380
Revise breast reconstruction
Y

A2
$717.00
39.8191
$1,648.55
$949.8919396
Design custom breast implant
Y

G2

31.7134
$1,312.97
$1,312.9720000
Incision of abscess
Y

P2

1.4066
$58.23
$58.2320005
Incision of deep abscess
Y

A2
$446.00
21.2689
$880.55
$554.6420103
Explore wound, extremity
Y

G2

9.6341
$398.86
$398.8620150
Excise epiphyseal bar
Y

G2

42.985
$1,779.62
$1,779.6220200
Muscle biopsy
Y

A2
$446.00
16.1001
$666.56
$501.1420205
Deep muscle biopsy
Y

A2
$510.00
16.1001
$666.56
$549.1420206
Needle biopsy, muscle
Y

A2
$240.00
7.1147
$294.56
$253.6420220
Bone biopsy, trocar/needle
Y

A2
$251.52
8.685
$359.57
$278.5320225
Bone biopsy, trocar/needle
Y

A2
$418.49
8.685
$359.57
$403.7620240
Bone biopsy, excisional
Y

A2
$446.00
21.1098
$873.97
$552.9920245
Bone biopsy, excisional
Y

A2
$510.00
21.1098
$873.97
$600.9920250
Open bone biopsy
Y

A2
$510.00
21.2689
$880.55
$602.6420251
Open bone biopsy
Y

A2
$510.00
21.2689
$880.55
$602.6420500
Injection of sinus tract
Y

P3

1.4811
$61.32
$61.3220501
Inject sinus tract for x-ray
N

N120520
Removal of foreign body
Y

P3

2.2712
$94.03
$94.0320525
Removal of foreign body
Y

A2
$510.00
21.1098
$873.97
$600.9920526
Ther injection, carp tunnel
Y

P3

0.7323
$30.32
$30.3220550
Inj tendon sheath/ligament
Y

P3

0.5514
$22.83
$22.8320551
Inj tendon origin/insertion
Y

P3

0.5432
$22.49
$22.4920552
Inj trigger point, 1/2 muscl
Y

P3

0.5348
$22.14
$22.1420553
Inject trigger points, =/> 3
Y

P3

0.6007
$24.87
$24.8720555
Place ndl musc/tis for rt
Y
NI
G2

29.19
$1,208.50
$1,208.5020600
Drain/inject, joint/bursa
Y

P3

0.5432
$22.49
$22.4920605
Drain/inject, joint/bursa
Y

P3

0.6171
$25.55
$25.5520610
Drain/inject, joint/bursa
Y

P3

0.8311
$34.41
$34.4120612
Aspirate/inj ganglion cyst
Y

P3

0.5761
$23.85
$23.8520615
Treatment of bone cyst
Y
CH
P3

2.5591
$105.95
$105.9520650
Insert and remove bone pin
Y

A2
$510.00
21.2689
$880.55
$602.6420662
Application of pelvis brace
Y

R2

21.2689
$880.55
$880.5520663
Application of thigh brace
Y

R2

21.2689
$880.55
$880.5520665
Removal of fixation device
N

G2

0.631
$26.12
$26.1220670
Removal of support implant
Y

A2
$333.00
16.1001
$666.56
$416.3920680
Removal of support implant
Y

A2
$510.00
21.1098
$873.97
$600.9920690
Apply bone fixation device
Y

A2
$446.00
29.19
$1,208.50
$636.6320692
Apply bone fixation device
Y

A2
$510.00
29.19
$1,208.50
$684.6320693
Adjust bone fixation device
Y

A2
$510.00
21.2689
$880.55
$602.6420694
Remove bone fixation device
Y

A2
$333.00
21.2689
$880.55
$469.8920822
Replantation digit, complete
Y

G2

26.3105
$1,089.28
$1,089.2820900
Removal of bone for graft
Y

A2
$510.00
29.19
$1,208.50
$684.6320902
Removal of bone for graft
Y

A2
$630.00
29.19
$1,208.50
$774.6320910
Remove cartilage for graft
Y

A2
$510.00
20.2069
$836.59
$591.6520912
Remove cartilage for graft
Y

A2
$510.00
20.2069
$836.59
$591.6520920
Removal of fascia for graft
Y

A2
$630.00
15.0458
$622.91
$628.2320922
Removal of fascia for graft
Y

A2
$510.00
15.0458
$622.91
$538.2320924
Removal of tendon for graft
Y

A2
$630.00
29.19
$1,208.50
$774.6320926
Removal of tissue for graft
Y

A2
$630.00
4.5263
$187.39
$519.3520950
Fluid pressure, muscle
Y

G2

1.4066
$58.23
$58.2320972
Bone/skin graft, metatarsal
Y

G2

44.2687
$1,832.77
$1,832.7720973
Bone/skin graft, great toe
Y

R2

44.2687
$1,832.77
$1,832.7720975
Electrical bone stimulation
N
CH
N120979
Us bone stimulation
N

P3

0.5843
$24.19
$24.1920982
Ablate, bone tumor(s) perq
Y

G2

42.985
$1,779.62
$1,779.62( print page 9871)20985
Cptr-asst dir ms px
N
NI
N120986
Cptr-asst dir ms px io img
N
NI
N120987
Cptr-asst dir ms px  pre img
N
NI
N121010
Incision of jaw joint
Y

A2
$446.00
23.9765
$992.65
$582.6621015
Resection of facial tumor
Y

A2
$510.00
16.3288
$676.03
$551.5121025
Excision of bone, lower jaw
Y

A2
$446.00
39.8776
$1,650.97
$747.2421026
Excision of facial bone(s)
Y

A2
$446.00
39.8776
$1,650.97
$747.2421029
Contour of face bone lesion
Y

A2
$446.00
39.8776
$1,650.97
$747.2421030
Excise max/zygoma b9 tumor
Y

P3

5.5627
$230.30
$230.3021031
Remove exostosis, mandible
Y

P3

4.5588
$188.74
$188.7421032
Remove exostosis, maxilla
Y

P3

4.6905
$194.19
$194.1921034
Excise max/zygoma mlg tumor
Y

A2
$510.00
39.8776
$1,650.97
$795.2421040
Excise mandible lesion
Y

A2
$446.00
23.9765
$992.65
$582.6621044
Removal of jaw bone lesion
Y

A2
$446.00
39.8776
$1,650.97
$747.2421046
Remove mandible cyst complex
Y

A2
$446.00
39.8776
$1,650.97
$747.2421047
Excise lwr jaw cyst w/repair
Y

A2
$446.00
39.8776
$1,650.97
$747.2421048
Remove maxilla cyst complex
Y

R2

39.8776
$1,650.97
$1,650.9721050
Removal of jaw joint
Y

A2
$510.00
39.8776
$1,650.97
$795.2421060
Remove jaw joint cartilage
Y

A2
$446.00
39.8776
$1,650.97
$747.2421070
Remove coronoid process
Y

A2
$510.00
39.8776
$1,650.97
$795.2421073 *
Mnpj of tmj w/anesth
Y
NI
P3

4.526
$187.38
$187.3821076
Prepare face/oral prosthesis
Y

P3

8.3851
$347.15
$347.1521077
Prepare face/oral prosthesis
Y

P3

20.4816
$847.96
$847.9621079
Prepare face/oral prosthesis
Y

P3

14.598
$604.37
$604.3721080
Prepare face/oral prosthesis
Y

P3

16.7293
$692.61
$692.6121081
Prepare face/oral prosthesis
Y

P3

15.3632
$636.05
$636.0521082
Prepare face/oral prosthesis
Y

P3

14.096
$583.59
$583.5921083
Prepare face/oral prosthesis
Y

P3

13.8738
$574.39
$574.3921084
Prepare face/oral prosthesis
Y

P3

16.1697
$669.44
$669.4421085
Prepare face/oral prosthesis
Y

P3

6.2622
$259.26
$259.2621086
Prepare face/oral prosthesis
Y

P3

15.0917
$624.81
$624.8121087
Prepare face/oral prosthesis
Y

P3

14.9518
$619.02
$619.0221088
Prepare face/oral prosthesis
Y

R2

39.8776
$1,650.97
$1,650.9721100
Maxillofacial fixation
Y

A2
$446.00
39.8776
$1,650.97
$747.2421110
Interdental fixation
Y

P2

7.4474
$308.33
$308.3321116
Injection, jaw joint x-ray
N

N121120
Reconstruction of chin
Y

A2
$995.00
23.9765
$992.65
$994.4121121
Reconstruction of chin
Y

A2
$995.00
23.9765
$992.65
$994.4121122
Reconstruction of chin
Y

A2
$995.00
23.9765
$992.65
$994.4121123
Reconstruction of chin
Y

A2
$995.00
23.9765
$992.65
$994.4121125
Augmentation, lower jaw bone
Y

A2
$995.00
23.9765
$992.65
$994.4121127
Augmentation, lower jaw bone
Y

A2
$1,339.00
39.8776
$1,650.97
$1,416.9921137
Reduction of forehead
Y

G2

23.9765
$992.65
$992.6521138
Reduction of forehead
Y

G2

39.8776
$1,650.97
$1,650.9721139
Reduction of forehead
Y

G2

39.8776
$1,650.97
$1,650.9721150
Reconstruct midface, lefort
Y

G2

39.8776
$1,650.97
$1,650.9721181
Contour cranial bone lesion
Y

A2
$995.00
23.9765
$992.65
$994.4121198
Reconstr lwr jaw segment
Y

G2

39.8776
$1,650.97
$1,650.9721199
Reconstr lwr jaw w/advance
Y

G2

39.8776
$1,650.97
$1,650.9721206
Reconstruct upper jaw bone
Y

A2
$717.00
39.8776
$1,650.97
$950.4921208
Augmentation of facial bones
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9921209
Reduction of facial bones
Y

A2
$717.00
39.8776
$1,650.97
$950.4921210
Face bone graft
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9921215
Lower jaw bone graft
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9921230
Rib cartilage graft
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9921235
Ear cartilage graft
Y

A2
$995.00
23.9765
$992.65
$994.4121240
Reconstruction of jaw joint
Y

A2
$630.00
39.8776
$1,650.97
$885.2421242
Reconstruction of jaw joint
Y

A2
$717.00
39.8776
$1,650.97
$950.4921243
Reconstruction of jaw joint
Y

A2
$717.00
39.8776
$1,650.97
$950.4921244
Reconstruction of lower jaw
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9921245
Reconstruction of jaw
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9921246
Reconstruction of jaw
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9921248
Reconstruction of jaw
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9921249
Reconstruction of jaw
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9921260
Revise eye sockets
Y

G2

39.8776
$1,650.97
$1,650.9721267
Revise eye sockets
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9921270
Augmentation, cheek bone
Y

A2
$717.00
39.8776
$1,650.97
$950.4921275
Revision, orbitofacial bones
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9921280
Revision of eyelid
Y

A2
$717.00
39.8776
$1,650.97
$950.4921282
Revision of eyelid
Y

A2
$717.00
16.3288
$676.03
$706.7621295
Revision of jaw muscle/bone
Y

A2
$333.00
7.4474
$308.33
$326.8321296
Revision of jaw muscle/bone
Y

A2
$333.00
23.9765
$992.65
$497.9121310
Treatment of nose fracture
Y

A2
$150.72
2.5002
$103.51
$138.9221315
Treatment of nose fracture
Y

A2
$150.72
2.5002
$103.51
$138.9221320
Treatment of nose fracture
Y

A2
$446.00
16.3288
$676.03
$503.5121325
Treatment of nose fracture
Y

A2
$630.00
23.9765
$992.65
$720.6621330
Treatment of nose fracture
Y

A2
$717.00
23.9765
$992.65
$785.91( print page 9872)21335
Treatment of nose fracture
Y

A2
$995.00
23.9765
$992.65
$994.4121336
Treat nasal septal fracture
Y

A2
$630.00
26.1592
$1,083.02
$743.2621337
Treat nasal septal fracture
Y

A2
$446.00
16.3288
$676.03
$503.5121338
Treat nasoethmoid fracture
Y

A2
$630.00
23.9765
$992.65
$720.6621339
Treat nasoethmoid fracture
Y

A2
$717.00
23.9765
$992.65
$785.9121340
Treatment of nose fracture
Y

A2
$630.00
39.8776
$1,650.97
$885.2421345
Treat nose/jaw fracture
Y

A2
$995.00
23.9765
$992.65
$994.4121355
Treat cheek bone fracture
Y

A2
$510.00
39.8776
$1,650.97
$795.2421356
Treat cheek bone fracture
Y

A2
$510.00
23.9765
$992.65
$630.6621360
Treat cheek bone fracture
Y
CH
G2

23.9765
$992.65
$992.6521390
Treat eye socket fracture
Y

G2

39.8776
$1,650.97
$1,650.9721400
Treat eye socket fracture
Y

A2
$446.00
7.4474
$308.33
$411.5821401
Treat eye socket fracture
Y

A2
$510.00
16.3288
$676.03
$551.5121406
Treat eye socket fracture
Y

G2

39.8776
$1,650.97
$1,650.9721407
Treat eye socket fracture
Y

G2

39.8776
$1,650.97
$1,650.9721421
Treat mouth roof fracture
Y

A2
$630.00
23.9765
$992.65
$720.6621440
Treat dental ridge fracture
Y

P3

7.0687
$292.65
$292.6521445
Treat dental ridge fracture
Y

A2
$630.00
23.9765
$992.65
$720.6621450
Treat lower jaw fracture
Y

A2
$150.72
2.5002
$103.51
$138.9221451
Treat lower jaw fracture
Y

A2
$464.15
7.4474
$308.33
$425.2021452
Treat lower jaw fracture
Y

A2
$446.00
16.3288
$676.03
$503.5121453
Treat lower jaw fracture
Y

A2
$510.00
39.8776
$1,650.97
$795.2421454
Treat lower jaw fracture
Y

A2
$717.00
23.9765
$992.65
$785.9121461
Treat lower jaw fracture
Y

A2
$630.00
39.8776
$1,650.97
$885.2421462
Treat lower jaw fracture
Y

A2
$717.00
39.8776
$1,650.97
$950.4921465
Treat lower jaw fracture
Y

A2
$630.00
39.8776
$1,650.97
$885.2421480
Reset dislocated jaw
Y

A2
$150.72
2.5002
$103.51
$138.9221485
Reset dislocated jaw
Y

A2
$446.00
16.3288
$676.03
$503.5121490
Repair dislocated jaw
Y

A2
$510.00
39.8776
$1,650.97
$795.2421495
Treat hyoid bone fracture
Y

G2

16.3288
$676.03
$676.0321497
Interdental wiring
Y

A2
$446.00
16.3288
$676.03
$503.5121501
Drain neck/chest lesion
Y

A2
$446.00
18.3197
$758.45
$524.1121502
Drain chest lesion
Y

A2
$446.00
21.2689
$880.55
$554.6421550
Biopsy of neck/chest
Y

G2

8.685
$359.57
$359.5721555
Remove lesion, neck/chest
Y

A2
$446.00
21.1098
$873.97
$552.9921556
Remove lesion, neck/chest
Y

A2
$446.00
21.1098
$873.97
$552.9921557
Remove tumor, neck/chest
Y

G2

21.1098
$873.97
$873.9721600
Partial removal of rib
Y

A2
$446.00
29.19
$1,208.50
$636.6321610
Partial removal of rib
Y

A2
$446.00
29.19
$1,208.50
$636.6321685
Hyoid myotomy & suspension
Y

G2

7.4474
$308.33
$308.3321700
Revision of neck muscle
Y

A2
$446.00
21.2689
$880.55
$554.6421720
Revision of neck muscle
Y

A2
$510.00
21.2689
$880.55
$602.6421725
Revision of neck muscle
Y

A2
$88.46
1.4066
$58.23
$80.9021800
Treatment of rib fracture
Y

A2
$103.62
1.7682
$73.21
$96.0221805
Treatment of rib fracture
Y

A2
$446.00
26.1592
$1,083.02
$605.2621820
Treat sternum fracture
Y

A2
$103.62
1.7682
$73.21
$96.0221920
Biopsy soft tissue of back
Y

P3

3.1763
$131.50
$131.5021925
Biopsy soft tissue of back
Y

A2
$446.00
21.1098
$873.97
$552.9921930
Remove lesion, back or flank
Y

A2
$446.00
21.1098
$873.97
$552.9921935
Remove tumor, back
Y

A2
$510.00
21.1098
$873.97
$600.9922102
Remove part, lumbar vertebra
Y

G2

46.7724
$1,936.42
$1,936.4222103
Remove extra spine segment
Y

G2

46.7724
$1,936.42
$1,936.4222305
Treat spine process fracture
Y

A2
$103.62
1.7682
$73.21
$96.0222310
Treat spine fracture
Y

A2
$103.62
1.7682
$73.21
$96.0222315
Treat spine fracture
Y

A2
$103.62
1.7682
$73.21
$96.0222505
Manipulation of spine
Y

A2
$446.00
14.7658
$611.32
$487.3322520
Percut vertebroplasty thor
Y

A2
$1,339.00
29.19
$1,208.50
$1,306.3822521
Percut vertebroplasty lumb
Y

A2
$1,339.00
29.19
$1,208.50
$1,306.3822522
Percut vertebroplasty add?l
Y

A2
$1,339.00
29.19
$1,208.50
$1,306.3822523
Percut kyphoplasty, thor
Y

G2

79.4244
$3,288.25
$3,288.2522524
Percut kyphoplasty, lumbar
Y

G2

79.4244
$3,288.25
$3,288.2522525
Percut kyphoplasty, add-on
Y

G2

79.4244
$3,288.25
$3,288.2522526
Idet, single level
Y
CH
G2

29.19
$1,208.50
$1,208.5022527
Idet, 1 or more levels
Y
CH
G2

29.19
$1,208.50
$1,208.5022900
Remove abdominal wall lesion
Y

A2
$630.00
21.1098
$873.97
$690.9923000
Removal of calcium deposits
Y

A2
$446.00
16.1001
$666.56
$501.1423020
Release shoulder joint
Y

A2
$446.00
42.985
$1,779.62
$779.4123030
Drain shoulder lesion
Y

A2
$333.00
18.3197
$758.45
$439.3623031
Drain shoulder bursa
Y

A2
$510.00
18.3197
$758.45
$572.1123035
Drain shoulder bone lesion
Y

A2
$510.00
21.2689
$880.55
$602.6423040
Exploratory shoulder surgery
Y

A2
$510.00
29.19
$1,208.50
$684.6323044
Exploratory shoulder surgery
Y

A2
$630.00
29.19
$1,208.50
$774.6323065
Biopsy shoulder tissues
Y

P3

2.2384
$92.67
$92.6723066
Biopsy shoulder tissues
Y

A2
$446.00
21.1098
$873.97
$552.9923075
Removal of shoulder lesion
Y

A2
$446.00
16.1001
$666.56
$501.1423076
Removal of shoulder lesion
Y

A2
$446.00
21.1098
$873.97
$552.9923077
Remove tumor of shoulder
Y

A2
$510.00
21.1098
$873.97
$600.99( print page 9873)23100
Biopsy of shoulder joint
Y

A2
$446.00
21.2689
$880.55
$554.6423101
Shoulder joint surgery
Y

A2
$995.00
29.19
$1,208.50
$1,048.3823105
Remove shoulder joint lining
Y

A2
$630.00
29.19
$1,208.50
$774.6323106
Incision of collarbone joint
Y

A2
$630.00
29.19
$1,208.50
$774.6323107
Explore treat shoulder joint
Y

A2
$630.00
29.19
$1,208.50
$774.6323120
Partial removal, collar bone
Y

A2
$717.00
29.19
$1,208.50
$839.8823125
Removal of collar bone
Y

A2
$717.00
29.19
$1,208.50
$839.8823130
Remove shoulder bone, part
Y

A2
$717.00
42.985
$1,779.62
$982.6623140
Removal of bone lesion
Y

A2
$630.00
21.2689
$880.55
$692.6423145
Removal of bone lesion
Y

A2
$717.00
29.19
$1,208.50
$839.8823146
Removal of bone lesion
Y

A2
$717.00
29.19
$1,208.50
$839.8823150
Removal of humerus lesion
Y

A2
$630.00
29.19
$1,208.50
$774.6323155
Removal of humerus lesion
Y

A2
$717.00
29.19
$1,208.50
$839.8823156
Removal of humerus lesion
Y

A2
$717.00
29.19
$1,208.50
$839.8823170
Remove collar bone lesion
Y

A2
$446.00
29.19
$1,208.50
$636.6323172
Remove shoulder blade lesion
Y

A2
$446.00
29.19
$1,208.50
$636.6323174
Remove humerus lesion
Y

A2
$446.00
29.19
$1,208.50
$636.6323180
Remove collar bone lesion
Y

A2
$630.00
29.19
$1,208.50
$774.6323182
Remove shoulder blade lesion
Y

A2
$630.00
29.19
$1,208.50
$774.6323184
Remove humerus lesion
Y

A2
$630.00
29.19
$1,208.50
$774.6323190
Partial removal of scapula
Y

A2
$630.00
29.19
$1,208.50
$774.6323195
Removal of head of humerus
Y

A2
$717.00
29.19
$1,208.50
$839.8823330
Remove shoulder foreign body
Y

A2
$333.00
8.685
$359.57
$339.6423331
Remove shoulder foreign body
Y

A2
$333.00
21.1098
$873.97
$468.2423350
Injection for shoulder x-ray
N

N123395
Muscle transfer,shoulder/arm
Y

A2
$717.00
42.985
$1,779.62
$982.6623397
Muscle transfers
Y

A2
$995.00
79.4244
$3,288.25
$1,568.3123400
Fixation of shoulder blade
Y

A2
$995.00
29.19
$1,208.50
$1,048.3823405
Incision of tendon & muscle
Y

A2
$446.00
29.19
$1,208.50
$636.6323406
Incise tendon(s) & muscle(s)
Y

A2
$446.00
29.19
$1,208.50
$636.6323410
Repair rotator cuff, acute
Y

A2
$717.00
42.985
$1,779.62
$982.6623412
Repair rotator cuff, chronic
Y

A2
$995.00
42.985
$1,779.62
$1,191.1623415
Release of shoulder ligament
Y

A2
$717.00
42.985
$1,779.62
$982.6623420
Repair of shoulder
Y

A2
$995.00
42.985
$1,779.62
$1,191.1623430
Repair biceps tendon
Y

A2
$630.00
42.985
$1,779.62
$917.4123440
Remove/transplant tendon
Y

A2
$630.00
42.985
$1,779.62
$917.4123450
Repair shoulder capsule
Y

A2
$717.00
79.4244
$3,288.25
$1,359.8123455
Repair shoulder capsule
Y

A2
$995.00
79.4244
$3,288.25
$1,568.3123460
Repair shoulder capsule
Y

A2
$717.00
79.4244
$3,288.25
$1,359.8123462
Repair shoulder capsule
Y

A2
$995.00
42.985
$1,779.62
$1,191.1623465
Repair shoulder capsule
Y

A2
$717.00
79.4244
$3,288.25
$1,359.8123466
Repair shoulder capsule
Y

A2
$995.00
42.985
$1,779.62
$1,191.1623480
Revision of collar bone
Y

A2
$630.00
42.985
$1,779.62
$917.4123485
Revision of collar bone
Y

A2
$995.00
79.4244
$3,288.25
$1,568.3123490
Reinforce clavicle
Y

A2
$510.00
42.985
$1,779.62
$827.4123491
Reinforce shoulder bones
Y

A2
$510.00
79.4244
$3,288.25
$1,204.5623500
Treat clavicle fracture
Y

A2
$103.62
1.7682
$73.21
$96.0223505
Treat clavicle fracture
Y

A2
$103.62
1.7682
$73.21
$96.0223515
Treat clavicle fracture
Y

A2
$510.00
59.2233
$2,451.90
$995.4823520
Treat clavicle dislocation
Y

A2
$103.62
1.7682
$73.21
$96.0223525
Treat clavicle dislocation
Y

A2
$103.62
1.7682
$73.21
$96.0223530
Treat clavicle dislocation
Y

A2
$510.00
41.1091
$1,701.96
$807.9923532
Treat clavicle dislocation
Y

A2
$630.00
26.1592
$1,083.02
$743.2623540
Treat clavicle dislocation
Y

A2
$103.62
1.7682
$73.21
$96.0223545
Treat clavicle dislocation
Y

A2
$103.62
1.7682
$73.21
$96.0223550
Treat clavicle dislocation
Y

A2
$510.00
41.1091
$1,701.96
$807.9923552
Treat clavicle dislocation
Y

A2
$630.00
41.1091
$1,701.96
$897.9923570
Treat shoulder blade fx
Y

A2
$103.62
1.7682
$73.21
$96.0223575
Treat shoulder blade fx
Y

A2
$103.62
1.7682
$73.21
$96.0223585
Treat scapula fracture
Y

A2
$510.00
59.2233
$2,451.90
$995.4823600
Treat humerus fracture
Y

P2

1.7682
$73.21
$73.2123605
Treat humerus fracture
Y

A2
$103.62
1.7682
$73.21
$96.0223615
Treat humerus fracture
Y

A2
$630.00
59.2233
$2,451.90
$1,085.4823616
Treat humerus fracture
Y

A2
$630.00
59.2233
$2,451.90
$1,085.4823620
Treat humerus fracture
Y

P2

1.7682
$73.21
$73.2123625
Treat humerus fracture
Y

A2
$103.62
1.7682
$73.21
$96.0223630
Treat humerus fracture
Y

A2
$717.00
59.2233
$2,451.90
$1,150.7323650
Treat shoulder dislocation
Y

A2
$103.62
1.7682
$73.21
$96.0223655
Treat shoulder dislocation
Y

A2
$333.00
14.7658
$611.32
$402.5823660
Treat shoulder dislocation
Y

A2
$510.00
41.1091
$1,701.96
$807.9923665
Treat dislocation/fracture
Y

A2
$103.62
1.7682
$73.21
$96.0223670
Treat dislocation/fracture
Y

A2
$510.00
59.2233
$2,451.90
$995.4823675
Treat dislocation/fracture
Y

A2
$103.62
1.7682
$73.21
$96.0223680
Treat dislocation/fracture
Y

A2
$510.00
41.1091
$1,701.96
$807.9923700
Fixation of shoulder
Y

A2
$333.00
14.7658
$611.32
$402.5823800
Fusion of shoulder joint
Y

A2
$630.00
79.4244
$3,288.25
$1,294.5623802
Fusion of shoulder joint
Y

A2
$995.00
42.985
$1,779.62
$1,191.16( print page 9874)23921
Amputation follow-up surgery
Y

A2
$323.28
15.0458
$622.91
$398.1923930
Drainage of arm lesion
Y

A2
$333.00
18.3197
$758.45
$439.3623931
Drainage of arm bursa
Y

A2
$446.00
18.3197
$758.45
$524.1123935
Drain arm/elbow bone lesion
Y

A2
$446.00
21.2689
$880.55
$554.6424000
Exploratory elbow surgery
Y

A2
$630.00
29.19
$1,208.50
$774.6324006
Release elbow joint
Y

A2
$630.00
29.19
$1,208.50
$774.6324065
Biopsy arm/elbow soft tissue
Y

P3

3.0282
$125.37
$125.3724066
Biopsy arm/elbow soft tissue
Y

A2
$446.00
16.1001
$666.56
$501.1424075
Remove arm/elbow lesion
Y

A2
$446.00
16.1001
$666.56
$501.1424076
Remove arm/elbow lesion
Y

A2
$446.00
21.1098
$873.97
$552.9924077
Remove tumor of arm/elbow
Y

A2
$510.00
21.1098
$873.97
$600.9924100
Biopsy elbow joint lining
Y

A2
$333.00
21.2689
$880.55
$469.8924101
Explore/treat elbow joint
Y

A2
$630.00
29.19
$1,208.50
$774.6324102
Remove elbow joint lining
Y

A2
$630.00
29.19
$1,208.50
$774.6324105
Removal of elbow bursa
Y

A2
$510.00
21.2689
$880.55
$602.6424110
Remove humerus lesion
Y

A2
$446.00
21.2689
$880.55
$554.6424115
Remove/graft bone lesion
Y

A2
$510.00
29.19
$1,208.50
$684.6324116
Remove/graft bone lesion
Y

A2
$510.00
29.19
$1,208.50
$684.6324120
Remove elbow lesion
Y

A2
$510.00
21.2689
$880.55
$602.6424125
Remove/graft bone lesion
Y

A2
$510.00
29.19
$1,208.50
$684.6324126
Remove/graft bone lesion
Y

A2
$510.00
29.19
$1,208.50
$684.6324130
Removal of head of radius
Y

A2
$510.00
29.19
$1,208.50
$684.6324134
Removal of arm bone lesion
Y

A2
$446.00
29.19
$1,208.50
$636.6324136
Remove radius bone lesion
Y

A2
$446.00
29.19
$1,208.50
$636.6324138
Remove elbow bone lesion
Y

A2
$446.00
29.19
$1,208.50
$636.6324140
Partial removal of arm bone
Y

A2
$510.00
29.19
$1,208.50
$684.6324145
Partial removal of radius
Y

A2
$510.00
29.19
$1,208.50
$684.6324147
Partial removal of elbow
Y

A2
$446.00
29.19
$1,208.50
$636.6324149
Radical resection of elbow
Y

G2

29.19
$1,208.50
$1,208.5024152
Extensive radius surgery
Y

G2

42.985
$1,779.62
$1,779.6224153
Extensive radius surgery
Y

G2

79.4244
$3,288.25
$3,288.2524155
Removal of elbow joint
Y

A2
$510.00
42.985
$1,779.62
$827.4124160
Remove elbow joint implant
Y

A2
$446.00
29.19
$1,208.50
$636.6324164
Remove radius head implant
Y

A2
$510.00
29.19
$1,208.50
$684.6324200
Removal of arm foreign body
Y

P3

2.5345
$104.93
$104.9324201
Removal of arm foreign body
Y

A2
$446.00
16.1001
$666.56
$501.1424220
Injection for elbow x-ray
N

N124300
Manipulate elbow w/anesth
Y

G2

14.7658
$611.32
$611.3224301
Muscle/tendon transfer
Y

A2
$630.00
29.19
$1,208.50
$774.6324305
Arm tendon lengthening
Y

A2
$630.00
29.19
$1,208.50
$774.6324310
Revision of arm tendon
Y

A2
$510.00
21.2689
$880.55
$602.6424320
Repair of arm tendon
Y

A2
$510.00
42.985
$1,779.62
$827.4124330
Revision of arm muscles
Y

A2
$510.00
79.4244
$3,288.25
$1,204.5624331
Revision of arm muscles
Y

A2
$510.00
42.985
$1,779.62
$827.4124332
Tenolysis, triceps
Y

G2

21.2689
$880.55
$880.5524340
Repair of biceps tendon
Y

A2
$510.00
42.985
$1,779.62
$827.4124341
Repair arm tendon/muscle
Y

A2
$510.00
42.985
$1,779.62
$827.4124342
Repair of ruptured tendon
Y

A2
$510.00
42.985
$1,779.62
$827.4124343
Repr elbow lat ligmnt w/tiss
Y

G2

29.19
$1,208.50
$1,208.5024344
Reconstruct elbow lat ligmnt
Y

G2

79.4244
$3,288.25
$3,288.2524345
Repr elbw med ligmnt w/tissu
Y

A2
$446.00
29.19
$1,208.50
$636.6324346
Reconstruct elbow med ligmnt
Y

G2

42.985
$1,779.62
$1,779.6224350
Repair of tennis elbow
N
CH
D524351
Repair of tennis elbow
N
CH
D524352
Repair of tennis elbow
N
CH
D524354
Repair of tennis elbow
N
CH
D524356
Revision of tennis elbow
N
CH
D524357
Repair elbow, perc
Y
NI
G2

29.19
$1,208.50
$1,208.5024358
Repair elbow w/deb, open
Y
NI
G2

29.19
$1,208.50
$1,208.5024359
Repair elbow deb/attch open
Y
NI
G2

29.19
$1,208.50
$1,208.5024360
Reconstruct elbow joint
Y

A2
$717.00
35.904
$1,486.46
$909.3724361
Reconstruct elbow joint
Y

A2
$717.00
122.2057
$5,059.44
$1,802.6124362
Reconstruct elbow joint
Y

A2
$717.00
50.8876
$2,106.80
$1,064.4524363
Replace elbow joint
Y

A2
$995.00
122.2057
$5,059.44
$2,011.1124365
Reconstruct head of radius
Y

A2
$717.00
35.904
$1,486.46
$909.3724366
Reconstruct head of radius
Y

A2
$717.00
122.2057
$5,059.44
$1,802.6124400
Revision of humerus
Y

A2
$630.00
29.19
$1,208.50
$774.6324410
Revision of humerus
Y

A2
$630.00
29.19
$1,208.50
$774.6324420
Revision of humerus
Y

A2
$510.00
42.985
$1,779.62
$827.4124430
Repair of humerus
Y

A2
$510.00
79.4244
$3,288.25
$1,204.5624435
Repair humerus with graft
Y

A2
$630.00
79.4244
$3,288.25
$1,294.5624470
Revision of elbow joint
Y

A2
$510.00
42.985
$1,779.62
$827.4124495
Decompression of forearm
Y

A2
$446.00
29.19
$1,208.50
$636.6324498
Reinforce humerus
Y

A2
$510.00
79.4244
$3,288.25
$1,204.5624500
Treat humerus fracture
Y

A2
$103.62
1.7682
$73.21
$96.0224505
Treat humerus fracture
Y

A2
$103.62
1.7682
$73.21
$96.0224515
Treat humerus fracture
Y

A2
$630.00
59.2233
$2,451.90
$1,085.48( print page 9875)24516
Treat humerus fracture
Y

A2
$630.00
59.2233
$2,451.90
$1,085.4824530
Treat humerus fracture
Y

A2
$103.62
1.7682
$73.21
$96.0224535
Treat humerus fracture
Y

A2
$103.62
1.7682
$73.21
$96.0224538
Treat humerus fracture
Y

A2
$446.00
26.1592
$1,083.02
$605.2624545
Treat humerus fracture
Y

A2
$630.00
59.2233
$2,451.90
$1,085.4824546
Treat humerus fracture
Y

A2
$717.00
59.2233
$2,451.90
$1,150.7324560
Treat humerus fracture
Y

A2
$103.62
1.7682
$73.21
$96.0224565
Treat humerus fracture
Y

A2
$103.62
1.7682
$73.21
$96.0224566
Treat humerus fracture
Y

A2
$446.00
26.1592
$1,083.02
$605.2624575
Treat humerus fracture
Y

A2
$510.00
59.2233
$2,451.90
$995.4824576
Treat humerus fracture
Y

A2
$103.62
1.7682
$73.21
$96.0224577
Treat humerus fracture
Y

A2
$103.62
1.7682
$73.21
$96.0224579
Treat humerus fracture
Y

A2
$510.00
59.2233
$2,451.90
$995.4824582
Treat humerus fracture
Y

A2
$446.00
26.1592
$1,083.02
$605.2624586
Treat elbow fracture
Y

A2
$630.00
59.2233
$2,451.90
$1,085.4824587
Treat elbow fracture
Y

A2
$717.00
59.2233
$2,451.90
$1,150.7324600
Treat elbow dislocation
Y

A2
$103.62
1.7682
$73.21
$96.0224605
Treat elbow dislocation
Y

A2
$446.00
14.7658
$611.32
$487.3324615
Treat elbow dislocation
Y

A2
$510.00
59.2233
$2,451.90
$995.4824620
Treat elbow fracture
Y

A2
$103.62
1.7682
$73.21
$96.0224635
Treat elbow fracture
Y

A2
$510.00
59.2233
$2,451.90
$995.4824640
Treat elbow dislocation
Y
CH
P3

1.3908
$57.58
$57.5824650
Treat radius fracture
Y

P2

1.7682
$73.21
$73.2124655
Treat radius fracture
Y

A2
$103.62
1.7682
$73.21
$96.0224665
Treat radius fracture
Y

A2
$630.00
41.1091
$1,701.96
$897.9924666
Treat radius fracture
Y

A2
$630.00
59.2233
$2,451.90
$1,085.4824670
Treat ulnar fracture
Y

A2
$103.62
1.7682
$73.21
$96.0224675
Treat ulnar fracture
Y

A2
$103.62
1.7682
$73.21
$96.0224685
Treat ulnar fracture
Y

A2
$510.00
41.1091
$1,701.96
$807.9924800
Fusion of elbow joint
Y

A2
$630.00
42.985
$1,779.62
$917.4124802
Fusion/graft of elbow joint
Y

A2
$717.00
42.985
$1,779.62
$982.6624925
Amputation follow-up surgery
Y

A2
$510.00
21.2689
$880.55
$602.6425000
Incision of tendon sheath
Y

A2
$510.00
21.2689
$880.55
$602.6425001
Incise flexor carpi radialis
Y

G2

21.2689
$880.55
$880.5525020
Decompress forearm 1 space
Y

A2
$510.00
21.2689
$880.55
$602.6425023
Decompress forearm 1 space
Y

A2
$510.00
29.19
$1,208.50
$684.6325024
Decompress forearm 2 spaces
Y

A2
$510.00
29.19
$1,208.50
$684.6325025
Decompress forearm 2 spaces
Y

A2
$510.00
29.19
$1,208.50
$684.6325028
Drainage of forearm lesion
Y

A2
$333.00
21.2689
$880.55
$469.8925031
Drainage of forearm bursa
Y

A2
$446.00
21.2689
$880.55
$554.6425035
Treat forearm bone lesion
Y

A2
$446.00
21.2689
$880.55
$554.6425040
Explore/treat wrist joint
Y

A2
$717.00
29.19
$1,208.50
$839.8825065
Biopsy forearm soft tissues
Y

P3

3.1106
$128.78
$128.7825066
Biopsy forearm soft tissues
Y

A2
$446.00
21.1098
$873.97
$552.9925075
Removal forearm lesion subcu
Y

A2
$446.00
16.1001
$666.56
$501.1425076
Removal forearm lesion deep
Y

A2
$510.00
21.1098
$873.97
$600.9925077
Remove tumor, forearm/wrist
Y

A2
$510.00
21.1098
$873.97
$600.9925085
Incision of wrist capsule
Y

A2
$510.00
21.2689
$880.55
$602.6425100
Biopsy of wrist joint
Y

A2
$446.00
21.2689
$880.55
$554.6425101
Explore/treat wrist joint
Y

A2
$510.00
29.19
$1,208.50
$684.6325105
Remove wrist joint lining
Y

A2
$630.00
29.19
$1,208.50
$774.6325107
Remove wrist joint cartilage
Y

A2
$510.00
29.19
$1,208.50
$684.6325109
Excise tendon forearm/wrist
Y

G2

21.2689
$880.55
$880.5525110
Remove wrist tendon lesion
Y

A2
$510.00
21.2689
$880.55
$602.6425111
Remove wrist tendon lesion
Y

A2
$510.00
16.4637
$681.61
$552.9025112
Reremove wrist tendon lesion
Y

A2
$630.00
16.4637
$681.61
$642.9025115
Remove wrist/forearm lesion
Y

A2
$630.00
21.2689
$880.55
$692.6425116
Remove wrist/forearm lesion
Y

A2
$630.00
21.2689
$880.55
$692.6425118
Excise wrist tendon sheath
Y

A2
$446.00
29.19
$1,208.50
$636.6325119
Partial removal of ulna
Y

A2
$510.00
29.19
$1,208.50
$684.6325120
Removal of forearm lesion
Y

A2
$510.00
29.19
$1,208.50
$684.6325125
Remove/graft forearm lesion
Y

A2
$510.00
29.19
$1,208.50
$684.6325126
Remove/graft forearm lesion
Y

A2
$510.00
29.19
$1,208.50
$684.6325130
Removal of wrist lesion
Y

A2
$510.00
29.19
$1,208.50
$684.6325135
Remove & graft wrist lesion
Y

A2
$510.00
29.19
$1,208.50
$684.6325136
Remove & graft wrist lesion
Y

A2
$510.00
29.19
$1,208.50
$684.6325145
Remove forearm bone lesion
Y

A2
$446.00
29.19
$1,208.50
$636.6325150
Partial removal of ulna
Y

A2
$446.00
29.19
$1,208.50
$636.6325151
Partial removal of radius
Y

A2
$446.00
29.19
$1,208.50
$636.6325210
Removal of wrist bone
Y

A2
$510.00
26.3105
$1,089.28
$654.8225215
Removal of wrist bones
Y

A2
$630.00
26.3105
$1,089.28
$744.8225230
Partial removal of radius
Y

A2
$630.00
29.19
$1,208.50
$774.6325240
Partial removal of ulna
Y

A2
$630.00
29.19
$1,208.50
$774.6325246
Injection for wrist x-ray
N

N125248
Remove forearm foreign body
Y

A2
$446.00
21.2689
$880.55
$554.6425250
Removal of wrist prosthesis
Y

A2
$333.00
29.19
$1,208.50
$551.8825251
Removal of wrist prosthesis
Y

A2
$333.00
29.19
$1,208.50
$551.88( print page 9876)25259
Manipulate wrist w/anesthes
Y

G2

1.7682
$73.21
$73.2125260
Repair forearm tendon/muscle
Y

A2
$630.00
29.19
$1,208.50
$774.6325263
Repair forearm tendon/muscle
Y

A2
$446.00
29.19
$1,208.50
$636.6325265
Repair forearm tendon/muscle
Y

A2
$510.00
29.19
$1,208.50
$684.6325270
Repair forearm tendon/muscle
Y

A2
$630.00
29.19
$1,208.50
$774.6325272
Repair forearm tendon/muscle
Y

A2
$510.00
29.19
$1,208.50
$684.6325274
Repair forearm tendon/muscle
Y

A2
$630.00
29.19
$1,208.50
$774.6325275
Repair forearm tendon sheath
Y

A2
$630.00
29.19
$1,208.50
$774.6325280
Revise wrist/forearm tendon
Y

A2
$630.00
29.19
$1,208.50
$774.6325290
Incise wrist/forearm tendon
Y

A2
$510.00
29.19
$1,208.50
$684.6325295
Release wrist/forearm tendon
Y

A2
$510.00
21.2689
$880.55
$602.6425300
Fusion of tendons at wrist
Y

A2
$510.00
29.19
$1,208.50
$684.6325301
Fusion of tendons at wrist
Y

A2
$510.00
29.19
$1,208.50
$684.6325310
Transplant forearm tendon
Y

A2
$510.00
42.985
$1,779.62
$827.4125312
Transplant forearm tendon
Y

A2
$630.00
42.985
$1,779.62
$917.4125315
Revise palsy hand tendon(s)
Y

A2
$510.00
42.985
$1,779.62
$827.4125316
Revise palsy hand tendon(s)
Y

A2
$510.00
79.4244
$3,288.25
$1,204.5625320
Repair/revise wrist joint
Y

A2
$510.00
42.985
$1,779.62
$827.4125332
Revise wrist joint
Y

A2
$717.00
35.904
$1,486.46
$909.3725335
Realignment of hand
Y

A2
$510.00
42.985
$1,779.62
$827.4125337
Reconstruct ulna/radioulnar
Y

A2
$717.00
42.985
$1,779.62
$982.6625350
Revision of radius
Y

A2
$510.00
79.4244
$3,288.25
$1,204.5625355
Revision of radius
Y

A2
$510.00
42.985
$1,779.62
$827.4125360
Revision of ulna
Y

A2
$510.00
29.19
$1,208.50
$684.6325365
Revise radius & ulna
Y

A2
$510.00
29.19
$1,208.50
$684.6325370
Revise radius or ulna
Y

A2
$510.00
42.985
$1,779.62
$827.4125375
Revise radius & ulna
Y

A2
$630.00
42.985
$1,779.62
$917.4125390
Shorten radius or ulna
Y

A2
$510.00
29.19
$1,208.50
$684.6325391
Lengthen radius or ulna
Y

A2
$630.00
42.985
$1,779.62
$917.4125392
Shorten radius & ulna
Y

A2
$510.00
29.19
$1,208.50
$684.6325393
Lengthen radius & ulna
Y

A2
$630.00
42.985
$1,779.62
$917.4125394
Repair carpal bone, shorten
Y

G2

16.4637
$681.61
$681.6125400
Repair radius or ulna
Y

A2
$510.00
79.4244
$3,288.25
$1,204.5625405
Repair/graft radius or ulna
Y

A2
$630.00
79.4244
$3,288.25
$1,294.5625415
Repair radius & ulna
Y

A2
$510.00
79.4244
$3,288.25
$1,204.5625420
Repair/graft radius & ulna
Y

A2
$630.00
79.4244
$3,288.25
$1,294.5625425
Repair/graft radius or ulna
Y

A2
$510.00
42.985
$1,779.62
$827.4125426
Repair/graft radius & ulna
Y

A2
$630.00
42.985
$1,779.62
$917.4125430
Vasc graft into carpal bone
Y

G2

26.3105
$1,089.28
$1,089.2825431
Repair nonunion carpal bone
Y

G2

26.3105
$1,089.28
$1,089.2825440
Repair/graft wrist bone
Y

A2
$630.00
79.4244
$3,288.25
$1,294.5625441
Reconstruct wrist joint
Y

A2
$717.00
122.2057
$5,059.44
$1,802.6125442
Reconstruct wrist joint
Y

A2
$717.00
122.2057
$5,059.44
$1,802.6125443
Reconstruct wrist joint
Y

A2
$717.00
50.8876
$2,106.80
$1,064.4525444
Reconstruct wrist joint
Y

A2
$717.00
50.8876
$2,106.80
$1,064.4525445
Reconstruct wrist joint
Y

A2
$717.00
50.8876
$2,106.80
$1,064.4525446
Wrist replacement
Y

A2
$995.00
122.2057
$5,059.44
$2,011.1125447
Repair wrist joint(s)
Y

A2
$717.00
35.904
$1,486.46
$909.3725449
Remove wrist joint implant
Y

A2
$717.00
35.904
$1,486.46
$909.3725450
Revision of wrist joint
Y

A2
$510.00
42.985
$1,779.62
$827.4125455
Revision of wrist joint
Y

A2
$510.00
42.985
$1,779.62
$827.4125490
Reinforce radius
Y

A2
$510.00
42.985
$1,779.62
$827.4125491
Reinforce ulna
Y

A2
$510.00
42.985
$1,779.62
$827.4125492
Reinforce radius and ulna
Y

A2
$510.00
42.985
$1,779.62
$827.4125500
Treat fracture of radius
Y

P2

1.7682
$73.21
$73.2125505
Treat fracture of radius
Y

A2
$103.62
1.7682
$73.21
$96.0225515
Treat fracture of radius
Y

A2
$510.00
41.1091
$1,701.96
$807.9925520
Treat fracture of radius
Y

A2
$103.62
1.7682
$73.21
$96.0225525
Treat fracture of radius
Y

A2
$630.00
41.1091
$1,701.96
$897.9925526
Treat fracture of radius
Y

A2
$717.00
41.1091
$1,701.96
$963.2425530
Treat fracture of ulna
Y

P2

1.7682
$73.21
$73.2125535
Treat fracture of ulna
Y

A2
$103.62
1.7682
$73.21
$96.0225545
Treat fracture of ulna
Y

A2
$510.00
41.1091
$1,701.96
$807.9925560
Treat fracture radius & ulna
Y

P2

1.7682
$73.21
$73.2125565
Treat fracture radius & ulna
Y

A2
$103.62
1.7682
$73.21
$96.0225574
Treat fracture radius & ulna
Y

A2
$510.00
59.2233
$2,451.90
$995.4825575
Treat fracture radius/ulna
Y

A2
$510.00
59.2233
$2,451.90
$995.4825600
Treat fracture radius/ulna
Y

P2

1.7682
$73.21
$73.2125605
Treat fracture radius/ulna
Y

A2
$103.62
1.7682
$73.21
$96.0225606
Treat fx distal radial
Y

A2
$510.00
26.1592
$1,083.02
$653.2625607
Treat fx rad extra-articul
Y

A2
$717.00
59.2233
$2,451.90
$1,150.7325608
Treat fx rad intra-articul
Y

A2
$717.00
59.2233
$2,451.90
$1,150.7325609
Treat fx radial 3+ frag
Y

A2
$717.00
59.2233
$2,451.90
$1,150.7325622
Treat wrist bone fracture
Y

P2

1.7682
$73.21
$73.2125624
Treat wrist bone fracture
Y

A2
$103.62
1.7682
$73.21
$96.0225628
Treat wrist bone fracture
Y

A2
$510.00
41.1091
$1,701.96
$807.9925630
Treat wrist bone fracture
Y

P2

1.7682
$73.21
$73.21( print page 9877)25635
Treat wrist bone fracture
Y

A2
$103.62
1.7682
$73.21
$96.0225645
Treat wrist bone fracture
Y

A2
$510.00
41.1091
$1,701.96
$807.9925650
Treat wrist bone fracture
Y

P2

1.7682
$73.21
$73.2125651
Pin ulnar styloid fracture
Y

G2

26.1592
$1,083.02
$1,083.0225652
Treat fracture ulnar styloid
Y

G2

41.1091
$1,701.96
$1,701.9625660
Treat wrist dislocation
Y

A2
$103.62
1.7682
$73.21
$96.0225670
Treat wrist dislocation
Y

A2
$510.00
26.1592
$1,083.02
$653.2625671
Pin radioulnar dislocation
Y

A2
$333.00
26.1592
$1,083.02
$520.5125675
Treat wrist dislocation
Y

A2
$103.62
1.7682
$73.21
$96.0225676
Treat wrist dislocation
Y

A2
$446.00
26.1592
$1,083.02
$605.2625680
Treat wrist fracture
Y

A2
$103.62
1.7682
$73.21
$96.0225685
Treat wrist fracture
Y

A2
$510.00
26.1592
$1,083.02
$653.2625690
Treat wrist dislocation
Y

A2
$103.62
1.7682
$73.21
$96.0225695
Treat wrist dislocation
Y

A2
$446.00
26.1592
$1,083.02
$605.2625800
Fusion of wrist joint
Y

A2
$630.00
79.4244
$3,288.25
$1,294.5625805
Fusion/graft of wrist joint
Y

A2
$717.00
42.985
$1,779.62
$982.6625810
Fusion/graft of wrist joint
Y

A2
$717.00
79.4244
$3,288.25
$1,359.8125820
Fusion of hand bones
Y

A2
$630.00
16.4637
$681.61
$642.9025825
Fuse hand bones with graft
Y

A2
$717.00
79.4244
$3,288.25
$1,359.8125830
Fusion, radioulnar jnt/ulna
Y

A2
$717.00
79.4244
$3,288.25
$1,359.8125907
Amputation follow-up surgery
Y

A2
$510.00
21.2689
$880.55
$602.6425922
Amputate hand at wrist
Y

A2
$510.00
21.2689
$880.55
$602.6425929
Amputation follow-up surgery
Y

A2
$510.00
15.0458
$622.91
$538.2325931
Amputation follow-up surgery
Y
CH
G2

21.2689
$880.55
$880.5526010
Drainage of finger abscess
Y

P2

1.4066
$58.23
$58.2326011
Drainage of finger abscess
Y

A2
$333.00
11.5594
$478.57
$369.3926020
Drain hand tendon sheath
Y

A2
$446.00
16.4637
$681.61
$504.9026025
Drainage of palm bursa
Y

A2
$333.00
16.4637
$681.61
$420.1526030
Drainage of palm bursa(s)
Y

A2
$446.00
16.4637
$681.61
$504.9026034
Treat hand bone lesion
Y

A2
$446.00
16.4637
$681.61
$504.9026035
Decompress fingers/hand
Y

G2

16.4637
$681.61
$681.6126040
Release palm contracture
Y

A2
$630.00
26.3105
$1,089.28
$744.8226045
Release palm contracture
Y

A2
$510.00
26.3105
$1,089.28
$654.8226055
Incise finger tendon sheath
Y

A2
$446.00
16.4637
$681.61
$504.9026060
Incision of finger tendon
Y

A2
$446.00
16.4637
$681.61
$504.9026070
Explore/treat hand joint
Y

A2
$446.00
16.4637
$681.61
$504.9026075
Explore/treat finger joint
Y

A2
$630.00
16.4637
$681.61
$642.9026080
Explore/treat finger joint
Y

A2
$630.00
16.4637
$681.61
$642.9026100
Biopsy hand joint lining
Y

A2
$446.00
16.4637
$681.61
$504.9026105
Biopsy finger joint lining
Y

A2
$333.00
16.4637
$681.61
$420.1526110
Biopsy finger joint lining
Y

A2
$333.00
16.4637
$681.61
$420.1526115
Removal hand lesion subcut
Y

A2
$446.00
21.1098
$873.97
$552.9926116
Removal hand lesion, deep
Y

A2
$446.00
21.1098
$873.97
$552.9926117
Remove tumor, hand/finger
Y

A2
$510.00
21.1098
$873.97
$600.9926121
Release palm contracture
Y

A2
$630.00
26.3105
$1,089.28
$744.8226123
Release palm contracture
Y

A2
$630.00
26.3105
$1,089.28
$744.8226125
Release palm contracture
Y

A2
$630.00
16.4637
$681.61
$642.9026130
Remove wrist joint lining
Y

A2
$510.00
16.4637
$681.61
$552.9026135
Revise finger joint, each
Y

A2
$630.00
26.3105
$1,089.28
$744.8226140
Revise finger joint, each
Y

A2
$446.00
16.4637
$681.61
$504.9026145
Tendon excision, palm/finger
Y

A2
$510.00
16.4637
$681.61
$552.9026160
Remove tendon sheath lesion
Y

A2
$510.00
16.4637
$681.61
$552.9026170
Removal of palm tendon, each
Y

A2
$510.00
16.4637
$681.61
$552.9026180
Removal of finger tendon
Y

A2
$510.00
16.4637
$681.61
$552.9026185
Remove finger bone
Y

A2
$630.00
16.4637
$681.61
$642.9026200
Remove hand bone lesion
Y

A2
$446.00
16.4637
$681.61
$504.9026205
Remove/graft bone lesion
Y

A2
$510.00
26.3105
$1,089.28
$654.8226210
Removal of finger lesion
Y

A2
$446.00
16.4637
$681.61
$504.9026215
Remove/graft finger lesion
Y

A2
$510.00
16.4637
$681.61
$552.9026230
Partial removal of hand bone
Y

A2
$992.95
16.4637
$681.61
$915.1226235
Partial removal, finger bone
Y

A2
$510.00
16.4637
$681.61
$552.9026236
Partial removal, finger bone
Y

A2
$510.00
16.4637
$681.61
$552.9026250
Extensive hand surgery
Y

A2
$510.00
16.4637
$681.61
$552.9026255
Extensive hand surgery
Y

A2
$510.00
26.3105
$1,089.28
$654.8226260
Extensive finger surgery
Y

A2
$510.00
16.4637
$681.61
$552.9026261
Extensive finger surgery
Y

A2
$510.00
16.4637
$681.61
$552.9026262
Partial removal of finger
Y

A2
$446.00
16.4637
$681.61
$504.9026320
Removal of implant from hand
Y

A2
$446.00
16.1001
$666.56
$501.1426340
Manipulate finger w/anesth
Y

G2

1.7682
$73.21
$73.2126350
Repair finger/hand tendon
Y

A2
$333.00
26.3105
$1,089.28
$522.0726352
Repair/graft hand tendon
Y

A2
$630.00
26.3105
$1,089.28
$744.8226356
Repair finger/hand tendon
Y

A2
$630.00
26.3105
$1,089.28
$744.8226357
Repair finger/hand tendon
Y

A2
$630.00
26.3105
$1,089.28
$744.8226358
Repair/graft hand tendon
Y

A2
$630.00
26.3105
$1,089.28
$744.8226370
Repair finger/hand tendon
Y

A2
$630.00
26.3105
$1,089.28
$744.8226372
Repair/graft hand tendon
Y

A2
$630.00
26.3105
$1,089.28
$744.8226373
Repair finger/hand tendon
Y

A2
$510.00
26.3105
$1,089.28
$654.82( print page 9878)26390
Revise hand/finger tendon
Y

A2
$630.00
26.3105
$1,089.28
$744.8226392
Repair/graft hand tendon
Y

A2
$510.00
26.3105
$1,089.28
$654.8226410
Repair hand tendon
Y

A2
$510.00
16.4637
$681.61
$552.9026412
Repair/graft hand tendon
Y

A2
$510.00
26.3105
$1,089.28
$654.8226415
Excision, hand/finger tendon
Y

A2
$630.00
26.3105
$1,089.28
$744.8226416
Graft hand or finger tendon
Y

A2
$510.00
26.3105
$1,089.28
$654.8226418
Repair finger tendon
Y

A2
$630.00
16.4637
$681.61
$642.9026420
Repair/graft finger tendon
Y

A2
$630.00
26.3105
$1,089.28
$744.8226426
Repair finger/hand tendon
Y

A2
$510.00
26.3105
$1,089.28
$654.8226428
Repair/graft finger tendon
Y

A2
$510.00
26.3105
$1,089.28
$654.8226432
Repair finger tendon
Y

A2
$510.00
16.4637
$681.61
$552.9026433
Repair finger tendon
Y

A2
$510.00
16.4637
$681.61
$552.9026434
Repair/graft finger tendon
Y

A2
$510.00
26.3105
$1,089.28
$654.8226437
Realignment of tendons
Y

A2
$510.00
16.4637
$681.61
$552.9026440
Release palm/finger tendon
Y

A2
$510.00
16.4637
$681.61
$552.9026442
Release palm & finger tendon
Y

A2
$510.00
26.3105
$1,089.28
$654.8226445
Release hand/finger tendon
Y

A2
$510.00
16.4637
$681.61
$552.9026449
Release forearm/hand tendon
Y

A2
$510.00
26.3105
$1,089.28
$654.8226450
Incision of palm tendon
Y

A2
$510.00
16.4637
$681.61
$552.9026455
Incision of finger tendon
Y

A2
$510.00
16.4637
$681.61
$552.9026460
Incise hand/finger tendon
Y

A2
$510.00
16.4637
$681.61
$552.9026471
Fusion of finger tendons
Y

A2
$446.00
16.4637
$681.61
$504.9026474
Fusion of finger tendons
Y

A2
$446.00
16.4637
$681.61
$504.9026476
Tendon lengthening
Y

A2
$333.00
16.4637
$681.61
$420.1526477
Tendon shortening
Y

A2
$333.00
16.4637
$681.61
$420.1526478
Lengthening of hand tendon
Y

A2
$333.00
16.4637
$681.61
$420.1526479
Shortening of hand tendon
Y

A2
$333.00
16.4637
$681.61
$420.1526480
Transplant hand tendon
Y

A2
$510.00
26.3105
$1,089.28
$654.8226483
Transplant/graft hand tendon
Y

A2
$510.00
26.3105
$1,089.28
$654.8226485
Transplant palm tendon
Y

A2
$446.00
26.3105
$1,089.28
$606.8226489
Transplant/graft palm tendon
Y

A2
$510.00
26.3105
$1,089.28
$654.8226490
Revise thumb tendon
Y

A2
$510.00
26.3105
$1,089.28
$654.8226492
Tendon transfer with graft
Y

A2
$510.00
26.3105
$1,089.28
$654.8226494
Hand tendon/muscle transfer
Y

A2
$510.00
26.3105
$1,089.28
$654.8226496
Revise thumb tendon
Y

A2
$510.00
26.3105
$1,089.28
$654.8226497
Finger tendon transfer
Y

A2
$510.00
26.3105
$1,089.28
$654.8226498
Finger tendon transfer
Y

A2
$630.00
26.3105
$1,089.28
$744.8226499
Revision of finger
Y

A2
$510.00
26.3105
$1,089.28
$654.8226500
Hand tendon reconstruction
Y

A2
$630.00
16.4637
$681.61
$642.9026502
Hand tendon reconstruction
Y

A2
$630.00
26.3105
$1,089.28
$744.8226508
Release thumb contracture
Y

A2
$510.00
16.4637
$681.61
$552.9026510
Thumb tendon transfer
Y

A2
$510.00
26.3105
$1,089.28
$654.8226516
Fusion of knuckle joint
Y

A2
$333.00
26.3105
$1,089.28
$522.0726517
Fusion of knuckle joints
Y

A2
$510.00
26.3105
$1,089.28
$654.8226518
Fusion of knuckle joints
Y

A2
$510.00
26.3105
$1,089.28
$654.8226520
Release knuckle contracture
Y

A2
$510.00
16.4637
$681.61
$552.9026525
Release finger contracture
Y

A2
$510.00
16.4637
$681.61
$552.9026530
Revise knuckle joint
Y

A2
$510.00
35.904
$1,486.46
$754.1226531
Revise knuckle with implant
Y

A2
$995.00
50.8876
$2,106.80
$1,272.9526535
Revise finger joint
Y

A2
$717.00
35.904
$1,486.46
$909.3726536
Revise/implant finger joint
Y

A2
$717.00
50.8876
$2,106.80
$1,064.4526540
Repair hand joint
Y

A2
$630.00
16.4637
$681.61
$642.9026541
Repair hand joint with graft
Y

A2
$995.00
26.3105
$1,089.28
$1,018.5726542
Repair hand joint with graft
Y

A2
$630.00
16.4637
$681.61
$642.9026545
Reconstruct finger joint
Y

A2
$630.00
26.3105
$1,089.28
$744.8226546
Repair nonunion hand
Y

A2
$630.00
26.3105
$1,089.28
$744.8226548
Reconstruct finger joint
Y

A2
$630.00
26.3105
$1,089.28
$744.8226550
Construct thumb replacement
Y

A2
$446.00
26.3105
$1,089.28
$606.8226555
Positional change of finger
Y

A2
$510.00
26.3105
$1,089.28
$654.8226560
Repair of web finger
Y

A2
$446.00
16.4637
$681.61
$504.9026561
Repair of web finger
Y

A2
$510.00
26.3105
$1,089.28
$654.8226562
Repair of web finger
Y

A2
$630.00
26.3105
$1,089.28
$744.8226565
Correct metacarpal flaw
Y

A2
$717.00
26.3105
$1,089.28
$810.0726567
Correct finger deformity
Y

A2
$717.00
26.3105
$1,089.28
$810.0726568
Lengthen metacarpal/finger
Y

A2
$510.00
26.3105
$1,089.28
$654.8226580
Repair hand deformity
Y

A2
$717.00
16.4637
$681.61
$708.1526587
Reconstruct extra finger
Y

A2
$717.00
16.4637
$681.61
$708.1526590
Repair finger deformity
Y

A2
$717.00
16.4637
$681.61
$708.1526591
Repair muscles of hand
Y

A2
$510.00
26.3105
$1,089.28
$654.8226593
Release muscles of hand
Y

A2
$510.00
16.4637
$681.61
$552.9026596
Excision constricting tissue
Y

A2
$446.00
16.4637
$681.61
$504.9026600
Treat metacarpal fracture
Y

P2

1.7682
$73.21
$73.2126605
Treat metacarpal fracture
Y

A2
$103.62
1.7682
$73.21
$96.0226607
Treat metacarpal fracture
Y

A2
$103.62
1.7682
$73.21
$96.0226608
Treat metacarpal fracture
Y

A2
$630.00
26.1592
$1,083.02
$743.2626615
Treat metacarpal fracture
Y

A2
$630.00
41.1091
$1,701.96
$897.9926641
Treat thumb dislocation
Y
CH
P2

1.7682
$73.21
$73.21( print page 9879)26645
Treat thumb fracture
Y

A2
$103.62
1.7682
$73.21
$96.0226650
Treat thumb fracture
Y

A2
$446.00
26.1592
$1,083.02
$605.2626665
Treat thumb fracture
Y

A2
$630.00
41.1091
$1,701.96
$897.9926670
Treat hand dislocation
Y
CH
P2

1.7682
$73.21
$73.2126675
Treat hand dislocation
Y

A2
$103.62
1.7682
$73.21
$96.0226676
Pin hand dislocation
Y

A2
$446.00
26.1592
$1,083.02
$605.2626685
Treat hand dislocation
Y

A2
$510.00
26.1592
$1,083.02
$653.2626686
Treat hand dislocation
Y

A2
$510.00
59.2233
$2,451.90
$995.4826700
Treat knuckle dislocation
Y
CH
P2

1.7682
$73.21
$73.2126705
Treat knuckle dislocation
Y

A2
$103.62
1.7682
$73.21
$96.0226706
Pin knuckle dislocation
Y

A2
$103.62
1.7682
$73.21
$96.0226715
Treat knuckle dislocation
Y

A2
$630.00
26.1592
$1,083.02
$743.2626720
Treat finger fracture, each
Y

P2

1.7682
$73.21
$73.2126725
Treat finger fracture, each
Y

P2

1.7682
$73.21
$73.2126727
Treat finger fracture, each
Y

A2
$995.00
26.1592
$1,083.02
$1,017.0126735
Treat finger fracture, each
Y

A2
$630.00
26.1592
$1,083.02
$743.2626740
Treat finger fracture, each
Y

P2

1.7682
$73.21
$73.2126742
Treat finger fracture, each
Y

A2
$103.62
1.7682
$73.21
$96.0226746
Treat finger fracture, each
Y

A2
$717.00
26.1592
$1,083.02
$808.5126750
Treat finger fracture, each
Y

P2

1.7682
$73.21
$73.2126755
Treat finger fracture, each
Y

G2

1.7682
$73.21
$73.2126756
Pin finger fracture, each
Y

A2
$446.00
26.1592
$1,083.02
$605.2626765
Treat finger fracture, each
Y

A2
$630.00
26.1592
$1,083.02
$743.2626770
Treat finger dislocation
Y

G2

1.7682
$73.21
$73.2126775
Treat finger dislocation
Y
CH
P3

4.0402
$167.27
$167.2726776
Pin finger dislocation
Y

A2
$446.00
26.1592
$1,083.02
$605.2626785
Treat finger dislocation
Y

A2
$446.00
26.1592
$1,083.02
$605.2626820
Thumb fusion with graft
Y

A2
$717.00
26.3105
$1,089.28
$810.0726841
Fusion of thumb
Y

A2
$630.00
26.3105
$1,089.28
$744.8226842
Thumb fusion with graft
Y

A2
$630.00
26.3105
$1,089.28
$744.8226843
Fusion of hand joint
Y

A2
$510.00
26.3105
$1,089.28
$654.8226844
Fusion/graft of hand joint
Y

A2
$510.00
26.3105
$1,089.28
$654.8226850
Fusion of knuckle
Y

A2
$630.00
26.3105
$1,089.28
$744.8226852
Fusion of knuckle with graft
Y

A2
$630.00
26.3105
$1,089.28
$744.8226860
Fusion of finger joint
Y

A2
$510.00
26.3105
$1,089.28
$654.8226861
Fusion of finger jnt, add-on
Y

A2
$446.00
26.3105
$1,089.28
$606.8226862
Fusion/graft of finger joint
Y

A2
$630.00
26.3105
$1,089.28
$744.8226863
Fuse/graft added joint
Y

A2
$510.00
26.3105
$1,089.28
$654.8226910
Amputate metacarpal bone
Y

A2
$510.00
26.3105
$1,089.28
$654.8226951
Amputation of finger/thumb
Y

A2
$446.00
16.4637
$681.61
$504.9026952
Amputation of finger/thumb
Y

A2
$630.00
16.4637
$681.61
$642.9026990
Drainage of pelvis lesion
Y

A2
$333.00
21.2689
$880.55
$469.8926991
Drainage of pelvis bursa
Y

A2
$333.00
21.2689
$880.55
$469.8927000
Incision of hip tendon
Y

A2
$446.00
21.2689
$880.55
$554.6427001
Incision of hip tendon
Y

A2
$510.00
29.19
$1,208.50
$684.6327003
Incision of hip tendon
Y

A2
$510.00
29.19
$1,208.50
$684.6327033
Exploration of hip joint
Y

A2
$510.00
42.985
$1,779.62
$827.4127035
Denervation of hip joint
Y

A2
$630.00
42.985
$1,779.62
$917.4127040
Biopsy of soft tissues
Y

A2
$333.00
8.685
$359.57
$339.6427041
Biopsy of soft tissues
Y

A2
$418.49
8.685
$359.57
$403.7627047
Remove hip/pelvis lesion
Y

A2
$446.00
21.1098
$873.97
$552.9927048
Remove hip/pelvis lesion
Y

A2
$510.00
21.1098
$873.97
$600.9927049
Remove tumor, hip/pelvis
Y

A2
$510.00
21.1098
$873.97
$600.9927050
Biopsy of sacroiliac joint
Y

A2
$510.00
21.2689
$880.55
$602.6427052
Biopsy of hip joint
Y

A2
$510.00
21.2689
$880.55
$602.6427060
Removal of ischial bursa
Y

A2
$717.00
21.2689
$880.55
$757.8927062
Remove femur lesion/bursa
Y

A2
$717.00
21.2689
$880.55
$757.8927065
Removal of hip bone lesion
Y

A2
$717.00
21.2689
$880.55
$757.8927066
Removal of hip bone lesion
Y

A2
$717.00
29.19
$1,208.50
$839.8827067
Remove/graft hip bone lesion
Y

A2
$717.00
29.19
$1,208.50
$839.8827080
Removal of tail bone
Y

A2
$446.00
29.19
$1,208.50
$636.6327086
Remove hip foreign body
Y

A2
$333.00
8.685
$359.57
$339.6427087
Remove hip foreign body
Y

A2
$510.00
21.2689
$880.55
$602.6427093
Injection for hip x-ray
N

N127095
Injection for hip x-ray
N

N127097
Revision of hip tendon
Y

A2
$510.00
29.19
$1,208.50
$684.6327098
Transfer tendon to pelvis
Y

A2
$510.00
29.19
$1,208.50
$684.6327100
Transfer of abdominal muscle
Y

A2
$630.00
42.985
$1,779.62
$917.4127105
Transfer of spinal muscle
Y

A2
$630.00
42.985
$1,779.62
$917.4127110
Transfer of iliopsoas muscle
Y

A2
$630.00
42.985
$1,779.62
$917.4127111
Transfer of iliopsoas muscle
Y

A2
$630.00
42.985
$1,779.62
$917.4127193
Treat pelvic ring fracture
Y

A2
$103.62
1.7682
$73.21
$96.0227194
Treat pelvic ring fracture
Y

A2
$446.00
14.7658
$611.32
$487.3327200
Treat tail bone fracture
Y

P2

1.7682
$73.21
$73.2127202
Treat tail bone fracture
Y

A2
$446.00
41.1091
$1,701.96
$759.9927220
Treat hip socket fracture
Y

G2

1.7682
$73.21
$73.2127230
Treat thigh fracture
Y

A2
$103.62
1.7682
$73.21
$96.02( print page 9880)27238
Treat thigh fracture
Y

A2
$103.62
1.7682
$73.21
$96.0227246
Treat thigh fracture
Y

A2
$103.62
1.7682
$73.21
$96.0227250
Treat hip dislocation
Y

A2
$103.62
1.7682
$73.21
$96.0227252
Treat hip dislocation
Y

A2
$446.00
14.7658
$611.32
$487.3327256
Treat hip dislocation
Y

G2

1.7682
$73.21
$73.2127257
Treat hip dislocation
Y

A2
$510.00
14.7658
$611.32
$535.3327265
Treat hip dislocation
Y

A2
$103.62
1.7682
$73.21
$96.0227266
Treat hip dislocation
Y

A2
$446.00
14.7658
$611.32
$487.3327267
Cltx thigh fx
Y
NI
G2

1.7682
$73.21
$73.2127275
Manipulation of hip joint
Y

A2
$446.00
14.7658
$611.32
$487.3327301
Drain thigh/knee lesion
Y

A2
$510.00
18.3197
$758.45
$572.1127305
Incise thigh tendon & fascia
Y

A2
$446.00
21.2689
$880.55
$554.6427306
Incision of thigh tendon
Y

A2
$510.00
21.2689
$880.55
$602.6427307
Incision of thigh tendons
Y

A2
$510.00
21.2689
$880.55
$602.6427310
Exploration of knee joint
Y

A2
$630.00
29.19
$1,208.50
$774.6327323
Biopsy, thigh soft tissues
Y

A2
$333.00
8.685
$359.57
$339.6427324
Biopsy, thigh soft tissues
Y

A2
$333.00
21.1098
$873.97
$468.2427325
Neurectomy, hamstring
Y

A2
$446.00
18.0518
$747.36
$521.3427326
Neurectomy, popliteal
Y

A2
$446.00
18.0518
$747.36
$521.3427327
Removal of thigh lesion
Y

A2
$446.00
21.1098
$873.97
$552.9927328
Removal of thigh lesion
Y

A2
$510.00
21.1098
$873.97
$600.9927329
Remove tumor, thigh/knee
Y

A2
$630.00
21.1098
$873.97
$690.9927330
Biopsy, knee joint lining
Y

A2
$630.00
29.19
$1,208.50
$774.6327331
Explore/treat knee joint
Y

A2
$630.00
29.19
$1,208.50
$774.6327332
Removal of knee cartilage
Y

A2
$630.00
29.19
$1,208.50
$774.6327333
Removal of knee cartilage
Y

A2
$630.00
29.19
$1,208.50
$774.6327334
Remove knee joint lining
Y

A2
$630.00
29.19
$1,208.50
$774.6327335
Remove knee joint lining
Y

A2
$630.00
29.19
$1,208.50
$774.6327340
Removal of kneecap bursa
Y

A2
$510.00
21.2689
$880.55
$602.6427345
Removal of knee cyst
Y

A2
$630.00
21.2689
$880.55
$692.6427347
Remove knee cyst
Y

A2
$630.00
21.2689
$880.55
$692.6427350
Removal of kneecap
Y

A2
$630.00
29.19
$1,208.50
$774.6327355
Remove femur lesion
Y

A2
$510.00
29.19
$1,208.50
$684.6327356
Remove femur lesion/graft
Y

A2
$630.00
29.19
$1,208.50
$774.6327357
Remove femur lesion/graft
Y

A2
$717.00
29.19
$1,208.50
$839.8827358
Remove femur lesion/fixation
Y

A2
$717.00
29.19
$1,208.50
$839.8827360
Partial removal, leg bone(s)
Y

A2
$717.00
29.19
$1,208.50
$839.8827370
Injection for knee x-ray
N

N127372
Removal of foreign body
Y

A2
$995.00
21.1098
$873.97
$964.7427380
Repair of kneecap tendon
Y

A2
$333.00
21.2689
$880.55
$469.8927381
Repair/graft kneecap tendon
Y

A2
$510.00
21.2689
$880.55
$602.6427385
Repair of thigh muscle
Y

A2
$510.00
21.2689
$880.55
$602.6427386
Repair/graft of thigh muscle
Y

A2
$510.00
21.2689
$880.55
$602.6427390
Incision of thigh tendon
Y

A2
$333.00
21.2689
$880.55
$469.8927391
Incision of thigh tendons
Y

A2
$446.00
21.2689
$880.55
$554.6427392
Incision of thigh tendons
Y

A2
$510.00
21.2689
$880.55
$602.6427393
Lengthening of thigh tendon
Y

A2
$446.00
29.19
$1,208.50
$636.6327394
Lengthening of thigh tendons
Y

A2
$510.00
29.19
$1,208.50
$684.6327395
Lengthening of thigh tendons
Y

A2
$510.00
42.985
$1,779.62
$827.4127396
Transplant of thigh tendon
Y

A2
$510.00
29.19
$1,208.50
$684.6327397
Transplants of thigh tendons
Y

A2
$510.00
42.985
$1,779.62
$827.4127400
Revise thigh muscles/tendons
Y

A2
$510.00
42.985
$1,779.62
$827.4127403
Repair of knee cartilage
Y

A2
$630.00
29.19
$1,208.50
$774.6327405
Repair of knee ligament
Y

A2
$630.00
42.985
$1,779.62
$917.4127407
Repair of knee ligament
Y

A2
$630.00
79.4244
$3,288.25
$1,294.5627409
Repair of knee ligaments
Y

A2
$630.00
42.985
$1,779.62
$917.4127416
Osteochondral knee autograft
Y
NI
G2

42.985
$1,779.62
$1,779.6227418
Repair degenerated kneecap
Y

A2
$510.00
42.985
$1,779.62
$827.4127420
Revision of unstable kneecap
Y

A2
$510.00
42.985
$1,779.62
$827.4127422
Revision of unstable kneecap
Y

A2
$995.00
42.985
$1,779.62
$1,191.1627424
Revision/removal of kneecap
Y

A2
$510.00
42.985
$1,779.62
$827.4127425
Lat retinacular release open
Y

A2
$995.00
29.19
$1,208.50
$1,048.3827427
Reconstruction, knee
Y

A2
$510.00
42.985
$1,779.62
$827.4127428
Reconstruction, knee
Y

A2
$630.00
79.4244
$3,288.25
$1,294.5627429
Reconstruction, knee
Y

A2
$630.00
79.4244
$3,288.25
$1,294.5627430
Revision of thigh muscles
Y

A2
$630.00
42.985
$1,779.62
$917.4127435
Incision of knee joint
Y

A2
$630.00
42.985
$1,779.62
$917.4127437
Revise kneecap
Y

A2
$630.00
35.904
$1,486.46
$844.1227438
Revise kneecap with implant
Y

A2
$717.00
50.8876
$2,106.80
$1,064.4527440
Revision of knee joint
Y

G2

35.904
$1,486.46
$1,486.4627441
Revision of knee joint
Y

A2
$717.00
35.904
$1,486.46
$909.3727442
Revision of knee joint
Y

A2
$717.00
35.904
$1,486.46
$909.3727443
Revision of knee joint
Y

A2
$717.00
35.904
$1,486.46
$909.3727446
Revision of knee joint
Y

G2

274.6715
$11,371.67
$11,371.6727496
Decompression of thigh/knee
Y

A2
$717.00
21.2689
$880.55
$757.8927497
Decompression of thigh/knee
Y

A2
$510.00
21.2689
$880.55
$602.6427498
Decompression of thigh/knee
Y

A2
$510.00
21.2689
$880.55
$602.64( print page 9881)27499
Decompression of thigh/knee
Y

A2
$510.00
21.2689
$880.55
$602.6427500
Treatment of thigh fracture
Y

A2
$103.62
1.7682
$73.21
$96.0227501
Treatment of thigh fracture
Y

A2
$103.62
1.7682
$73.21
$96.0227502
Treatment of thigh fracture
Y

A2
$103.62
1.7682
$73.21
$96.0227503
Treatment of thigh fracture
Y

A2
$103.62
1.7682
$73.21
$96.0227508
Treatment of thigh fracture
Y

A2
$103.62
1.7682
$73.21
$96.0227509
Treatment of thigh fracture
Y

A2
$510.00
26.1592
$1,083.02
$653.2627510
Treatment of thigh fracture
Y

A2
$103.62
1.7682
$73.21
$96.0227516
Treat thigh fx growth plate
Y

A2
$103.62
1.7682
$73.21
$96.0227517
Treat thigh fx growth plate
Y

A2
$103.62
1.7682
$73.21
$96.0227520
Treat kneecap fracture
Y

A2
$103.62
1.7682
$73.21
$96.0227530
Treat knee fracture
Y

A2
$103.62
1.7682
$73.21
$96.0227532
Treat knee fracture
Y

A2
$103.62
1.7682
$73.21
$96.0227538
Treat knee fracture(s)
Y

A2
$103.62
1.7682
$73.21
$96.0227550
Treat knee dislocation
Y

A2
$103.62
1.7682
$73.21
$96.0227552
Treat knee dislocation
Y

A2
$333.00
14.7658
$611.32
$402.5827560
Treat kneecap dislocation
Y

A2
$103.62
1.7682
$73.21
$96.0227562
Treat kneecap dislocation
Y

A2
$333.00
14.7658
$611.32
$402.5827566
Treat kneecap dislocation
Y

A2
$446.00
41.1091
$1,701.96
$759.9927570
Fixation of knee joint
Y

A2
$333.00
14.7658
$611.32
$402.5827594
Amputation follow-up surgery
Y

A2
$510.00
21.2689
$880.55
$602.6427600
Decompression of lower leg
Y

A2
$510.00
21.2689
$880.55
$602.6427601
Decompression of lower leg
Y

A2
$510.00
21.2689
$880.55
$602.6427602
Decompression of lower leg
Y

A2
$510.00
21.2689
$880.55
$602.6427603
Drain lower leg lesion
Y

A2
$446.00
18.3197
$758.45
$524.1127604
Drain lower leg bursa
Y

A2
$446.00
21.2689
$880.55
$554.6427605
Incision of achilles tendon
Y

A2
$333.00
20.8284
$862.32
$465.3327606
Incision of achilles tendon
Y

A2
$333.00
21.2689
$880.55
$469.8927607
Treat lower leg bone lesion
Y

A2
$446.00
21.2689
$880.55
$554.6427610
Explore/treat ankle joint
Y

A2
$446.00
29.19
$1,208.50
$636.6327612
Exploration of ankle joint
Y

A2
$510.00
29.19
$1,208.50
$684.6327613
Biopsy lower leg soft tissue
Y

P3

2.9376
$121.62
$121.6227614
Biopsy lower leg soft tissue
Y

A2
$446.00
21.1098
$873.97
$552.9927615
Remove tumor, lower leg
Y

A2
$510.00
29.19
$1,208.50
$684.6327618
Remove lower leg lesion
Y

A2
$446.00
16.1001
$666.56
$501.1427619
Remove lower leg lesion
Y

A2
$510.00
21.1098
$873.97
$600.9927620
Explore/treat ankle joint
Y

A2
$630.00
29.19
$1,208.50
$774.6327625
Remove ankle joint lining
Y

A2
$630.00
29.19
$1,208.50
$774.6327626
Remove ankle joint lining
Y

A2
$630.00
29.19
$1,208.50
$774.6327630
Removal of tendon lesion
Y

A2
$510.00
21.2689
$880.55
$602.6427635
Remove lower leg bone lesion
Y

A2
$510.00
29.19
$1,208.50
$684.6327637
Remove/graft leg bone lesion
Y

A2
$510.00
29.19
$1,208.50
$684.6327638
Remove/graft leg bone lesion
Y

A2
$510.00
29.19
$1,208.50
$684.6327640
Partial removal of tibia
Y

A2
$446.00
42.985
$1,779.62
$779.4127641
Partial removal of fibula
Y

A2
$446.00
29.19
$1,208.50
$636.6327647
Extensive ankle/heel surgery
Y

A2
$510.00
42.985
$1,779.62
$827.4127648
Injection for ankle x-ray
N

N127650
Repair achilles tendon
Y

A2
$510.00
42.985
$1,779.62
$827.4127652
Repair/graft achilles tendon
Y

A2
$510.00
79.4244
$3,288.25
$1,204.5627654
Repair of achilles tendon
Y

A2
$510.00
42.985
$1,779.62
$827.4127656
Repair leg fascia defect
Y

A2
$446.00
21.2689
$880.55
$554.6427658
Repair of leg tendon, each
Y

A2
$333.00
21.2689
$880.55
$469.8927659
Repair of leg tendon, each
Y

A2
$446.00
21.2689
$880.55
$554.6427664
Repair of leg tendon, each
Y

A2
$446.00
21.2689
$880.55
$554.6427665
Repair of leg tendon, each
Y

A2
$446.00
29.19
$1,208.50
$636.6327675
Repair lower leg tendons
Y

A2
$446.00
21.2689
$880.55
$554.6427676
Repair lower leg tendons
Y

A2
$510.00
29.19
$1,208.50
$684.6327680
Release of lower leg tendon
Y

A2
$510.00
29.19
$1,208.50
$684.6327681
Release of lower leg tendons
Y

A2
$446.00
29.19
$1,208.50
$636.6327685
Revision of lower leg tendon
Y

A2
$510.00
29.19
$1,208.50
$684.6327686
Revise lower leg tendons
Y

A2
$510.00
29.19
$1,208.50
$684.6327687
Revision of calf tendon
Y

A2
$510.00
29.19
$1,208.50
$684.6327690
Revise lower leg tendon
Y

A2
$630.00
42.985
$1,779.62
$917.4127691
Revise lower leg tendon
Y

A2
$630.00
42.985
$1,779.62
$917.4127692
Revise additional leg tendon
Y

A2
$510.00
42.985
$1,779.62
$827.4127695
Repair of ankle ligament
Y

A2
$446.00
29.19
$1,208.50
$636.6327696
Repair of ankle ligaments
Y

A2
$446.00
29.19
$1,208.50
$636.6327698
Repair of ankle ligament
Y

A2
$446.00
29.19
$1,208.50
$636.6327700
Revision of ankle joint
Y

A2
$717.00
35.904
$1,486.46
$909.3727704
Removal of ankle implant
Y

A2
$446.00
21.2689
$880.55
$554.6427705
Incision of tibia
Y

A2
$446.00
42.985
$1,779.62
$779.4127707
Incision of fibula
Y

A2
$446.00
21.2689
$880.55
$554.6427709
Incision of tibia & fibula
Y

A2
$446.00
29.19
$1,208.50
$636.6327726
Repair fibula nonunion
Y
NI
G2

26.1592
$1,083.02
$1,083.0227730
Repair of tibia epiphysis
Y

A2
$446.00
29.19
$1,208.50
$636.6327732
Repair of fibula epiphysis
Y

A2
$446.00
29.19
$1,208.50
$636.6327734
Repair lower leg epiphyses
Y

A2
$446.00
29.19
$1,208.50
$636.63( print page 9882)27740
Repair of leg epiphyses
Y

A2
$446.00
29.19
$1,208.50
$636.6327742
Repair of leg epiphyses
Y

A2
$446.00
42.985
$1,779.62
$779.4127745
Reinforce tibia
Y

A2
$510.00
79.4244
$3,288.25
$1,204.5627750
Treatment of tibia fracture
Y

A2
$103.62
1.7682
$73.21
$96.0227752
Treatment of tibia fracture
Y

A2
$103.62
1.7682
$73.21
$96.0227756
Treatment of tibia fracture
Y

A2
$510.00
26.1592
$1,083.02
$653.2627758
Treatment of tibia fracture
Y

A2
$630.00
41.1091
$1,701.96
$897.9927759
Treatment of tibia fracture
Y

A2
$630.00
59.2233
$2,451.90
$1,085.4827760
Cltx medial ankle fx
Y

A2
$103.62
1.7682
$73.21
$96.0227762
Cltx med ankle fx w/mnpj
Y

A2
$103.62
1.7682
$73.21
$96.0227766
Optx medial ankle fx
Y

A2
$510.00
41.1091
$1,701.96
$807.9927767
Cltx post ankle fx
Y
NI
G2

1.7682
$73.21
$73.2127768
Cltx post ankle fx w/mnpj
Y
NI
G2

1.7682
$73.21
$73.2127769
Optx post ankle fx
Y
NI
G2

41.1091
$1,701.96
$1,701.9627780
Treatment of fibula fracture
Y

A2
$103.62
1.7682
$73.21
$96.0227781
Treatment of fibula fracture
Y

A2
$103.62
1.7682
$73.21
$96.0227784
Treatment of fibula fracture
Y

A2
$510.00
41.1091
$1,701.96
$807.9927786
Treatment of ankle fracture
Y

A2
$103.62
1.7682
$73.21
$96.0227788
Treatment of ankle fracture
Y

A2
$103.62
1.7682
$73.21
$96.0227792
Treatment of ankle fracture
Y

A2
$510.00
41.1091
$1,701.96
$807.9927808
Treatment of ankle fracture
Y

A2
$103.62
1.7682
$73.21
$96.0227810
Treatment of ankle fracture
Y

A2
$103.62
1.7682
$73.21
$96.0227814
Treatment of ankle fracture
Y

A2
$510.00
41.1091
$1,701.96
$807.9927816
Treatment of ankle fracture
Y

A2
$103.62
1.7682
$73.21
$96.0227818
Treatment of ankle fracture
Y

A2
$103.62
1.7682
$73.21
$96.0227822
Treatment of ankle fracture
Y

A2
$510.00
41.1091
$1,701.96
$807.9927823
Treatment of ankle fracture
Y

A2
$510.00
59.2233
$2,451.90
$995.4827824
Treat lower leg fracture
Y

A2
$103.62
1.7682
$73.21
$96.0227825
Treat lower leg fracture
Y

A2
$103.62
1.7682
$73.21
$96.0227826
Treat lower leg fracture
Y

A2
$510.00
41.1091
$1,701.96
$807.9927827
Treat lower leg fracture
Y

A2
$510.00
59.2233
$2,451.90
$995.4827828
Treat lower leg fracture
Y

A2
$630.00
59.2233
$2,451.90
$1,085.4827829
Treat lower leg joint
Y

A2
$446.00
41.1091
$1,701.96
$759.9927830
Treat lower leg dislocation
Y

A2
$103.62
1.7682
$73.21
$96.0227831
Treat lower leg dislocation
Y

A2
$103.62
1.7682
$73.21
$96.0227832
Treat lower leg dislocation
Y

A2
$446.00
41.1091
$1,701.96
$759.9927840
Treat ankle dislocation
Y

A2
$103.62
1.7682
$73.21
$96.0227842
Treat ankle dislocation
Y

A2
$333.00
14.7658
$611.32
$402.5827846
Treat ankle dislocation
Y

A2
$510.00
41.1091
$1,701.96
$807.9927848
Treat ankle dislocation
Y

A2
$510.00
41.1091
$1,701.96
$807.9927860
Fixation of ankle joint
Y

A2
$333.00
14.7658
$611.32
$402.5827870
Fusion of ankle joint, open
Y

A2
$630.00
79.4244
$3,288.25
$1,294.5627871
Fusion of tibiofibular joint
Y

A2
$630.00
79.4244
$3,288.25
$1,294.5627884
Amputation follow-up surgery
Y

A2
$510.00
21.2689
$880.55
$602.6427889
Amputation of foot at ankle
Y

A2
$510.00
29.19
$1,208.50
$684.6327892
Decompression of leg
Y

A2
$510.00
21.2689
$880.55
$602.6427893
Decompression of leg
Y

A2
$510.00
21.2689
$880.55
$602.6427894
Decompression of leg
Y

A2
$510.00
21.2689
$880.55
$602.6428001
Drainage of bursa of foot
Y

P3

2.8719
$118.90
$118.9028002
Treatment of foot infection
Y

A2
$510.00
21.2689
$880.55
$602.6428003
Treatment of foot infection
Y

A2
$510.00
21.2689
$880.55
$602.6428005
Treat foot bone lesion
Y

A2
$510.00
20.8284
$862.32
$598.0828008
Incision of foot fascia
Y

A2
$510.00
20.8284
$862.32
$598.0828010
Incision of toe tendon
Y

P3

2.156
$89.26
$89.2628011
Incision of toe tendons
Y

A2
$510.00
20.8284
$862.32
$598.0828020
Exploration of foot joint
Y

A2
$446.00
20.8284
$862.32
$550.0828022
Exploration of foot joint
Y

A2
$446.00
20.8284
$862.32
$550.0828024
Exploration of toe joint
Y

A2
$446.00
20.8284
$862.32
$550.0828035
Decompression of tibia nerve
Y

A2
$630.00
18.0518
$747.36
$659.3428043
Excision of foot lesion
Y

A2
$446.00
21.1098
$873.97
$552.9928045
Excision of foot lesion
Y

A2
$510.00
20.8284
$862.32
$598.0828046
Resection of tumor, foot
Y

A2
$510.00
20.8284
$862.32
$598.0828050
Biopsy of foot joint lining
Y

A2
$446.00
20.8284
$862.32
$550.0828052
Biopsy of foot joint lining
Y

A2
$446.00
20.8284
$862.32
$550.0828054
Biopsy of toe joint lining
Y

A2
$446.00
20.8284
$862.32
$550.0828055
Neurectomy, foot
Y

A2
$630.00
18.0518
$747.36
$659.3428060
Partial removal, foot fascia
Y

A2
$446.00
20.8284
$862.32
$550.0828062
Removal of foot fascia
Y

A2
$510.00
20.8284
$862.32
$598.0828070
Removal of foot joint lining
Y

A2
$510.00
20.8284
$862.32
$598.0828072
Removal of foot joint lining
Y

A2
$510.00
20.8284
$862.32
$598.0828080
Removal of foot lesion
Y

A2
$510.00
20.8284
$862.32
$598.0828086
Excise foot tendon sheath
Y

A2
$446.00
20.8284
$862.32
$550.0828088
Excise foot tendon sheath
Y

A2
$446.00
20.8284
$862.32
$550.0828090
Removal of foot lesion
Y

A2
$510.00
20.8284
$862.32
$598.0828092
Removal of toe lesions
Y

A2
$510.00
20.8284
$862.32
$598.0828100
Removal of ankle/heel lesion
Y

A2
$446.00
20.8284
$862.32
$550.0828102
Remove/graft foot lesion
Y

A2
$510.00
44.2687
$1,832.77
$840.69( print page 9883)28103
Remove/graft foot lesion
Y

A2
$510.00
44.2687
$1,832.77
$840.6928104
Removal of foot lesion
Y

A2
$446.00
20.8284
$862.32
$550.0828106
Remove/graft foot lesion
Y

A2
$510.00
44.2687
$1,832.77
$840.6928107
Remove/graft foot lesion
Y

A2
$510.00
44.2687
$1,832.77
$840.6928108
Removal of toe lesions
Y

A2
$446.00
20.8284
$862.32
$550.0828110
Part removal of metatarsal
Y

A2
$510.00
20.8284
$862.32
$598.0828111
Part removal of metatarsal
Y

A2
$510.00
20.8284
$862.32
$598.0828112
Part removal of metatarsal
Y

A2
$510.00
20.8284
$862.32
$598.0828113
Part removal of metatarsal
Y

A2
$510.00
20.8284
$862.32
$598.0828114
Removal of metatarsal heads
Y

A2
$510.00
20.8284
$862.32
$598.0828116
Revision of foot
Y

A2
$510.00
20.8284
$862.32
$598.0828118
Removal of heel bone
Y

A2
$630.00
20.8284
$862.32
$688.0828119
Removal of heel spur
Y

A2
$630.00
20.8284
$862.32
$688.0828120
Part removal of ankle/heel
Y

A2
$995.00
20.8284
$862.32
$961.8328122
Partial removal of foot bone
Y

A2
$510.00
20.8284
$862.32
$598.0828124
Partial removal of toe
Y

P3

4.8385
$200.32
$200.3228126
Partial removal of toe
Y

A2
$510.00
20.8284
$862.32
$598.0828130
Removal of ankle bone
Y

A2
$510.00
20.8284
$862.32
$598.0828140
Removal of metatarsal
Y

A2
$510.00
20.8284
$862.32
$598.0828150
Removal of toe
Y

A2
$510.00
20.8284
$862.32
$598.0828153
Partial removal of toe
Y

A2
$510.00
20.8284
$862.32
$598.0828160
Partial removal of toe
Y

A2
$510.00
20.8284
$862.32
$598.0828171
Extensive foot surgery
Y

A2
$510.00
20.8284
$862.32
$598.0828173
Extensive foot surgery
Y

A2
$510.00
20.8284
$862.32
$598.0828175
Extensive foot surgery
Y

A2
$510.00
20.8284
$862.32
$598.0828190
Removal of foot foreign body
Y

P3

3.0446
$126.05
$126.0528192
Removal of foot foreign body
Y

A2
$446.00
16.1001
$666.56
$501.1428193
Removal of foot foreign body
Y

A2
$418.49
8.685
$359.57
$403.7628200
Repair of foot tendon
Y

A2
$510.00
20.8284
$862.32
$598.0828202
Repair/graft of foot tendon
Y

A2
$510.00
20.8284
$862.32
$598.0828208
Repair of foot tendon
Y

A2
$510.00
20.8284
$862.32
$598.0828210
Repair/graft of foot tendon
Y

A2
$510.00
44.2687
$1,832.77
$840.6928220
Release of foot tendon
Y

P3

4.5588
$188.74
$188.7428222
Release of foot tendons
Y

A2
$333.00
20.8284
$862.32
$465.3328225
Release of foot tendon
Y

A2
$333.00
20.8284
$862.32
$465.3328226
Release of foot tendons
Y

A2
$333.00
20.8284
$862.32
$465.3328230
Incision of foot tendon(s)
Y

P3

4.5011
$186.35
$186.3528232
Incision of toe tendon
Y

P3

4.3038
$178.18
$178.1828234
Incision of foot tendon
Y

A2
$446.00
20.8284
$862.32
$550.0828238
Revision of foot tendon
Y

A2
$510.00
44.2687
$1,832.77
$840.6928240
Release of big toe
Y

A2
$446.00
20.8284
$862.32
$550.0828250
Revision of foot fascia
Y

A2
$510.00
20.8284
$862.32
$598.0828260
Release of midfoot joint
Y

A2
$510.00
20.8284
$862.32
$598.0828261
Revision of foot tendon
Y

A2
$510.00
20.8284
$862.32
$598.0828262
Revision of foot and ankle
Y

A2
$630.00
20.8284
$862.32
$688.0828264
Release of midfoot joint
Y

A2
$333.00
44.2687
$1,832.77
$707.9428270
Release of foot contracture
Y

A2
$510.00
20.8284
$862.32
$598.0828272
Release of toe joint, each
Y

P3

4.1226
$170.68
$170.6828280
Fusion of toes
Y

A2
$446.00
20.8284
$862.32
$550.0828285
Repair of hammertoe
Y

A2
$510.00
20.8284
$862.32
$598.0828286
Repair of hammertoe
Y

A2
$630.00
20.8284
$862.32
$688.0828288
Partial removal of foot bone
Y

A2
$510.00
20.8284
$862.32
$598.0828289
Repair hallux rigidus
Y

A2
$510.00
20.8284
$862.32
$598.0828290
Correction of bunion
Y

A2
$446.00
29.4167
$1,217.88
$638.9728292
Correction of bunion
Y

A2
$446.00
29.4167
$1,217.88
$638.9728293
Correction of bunion
Y

A2
$510.00
29.4167
$1,217.88
$686.9728294
Correction of bunion
Y

A2
$510.00
29.4167
$1,217.88
$686.9728296
Correction of bunion
Y

A2
$510.00
29.4167
$1,217.88
$686.9728297
Correction of bunion
Y

A2
$510.00
29.4167
$1,217.88
$686.9728298
Correction of bunion
Y

A2
$510.00
29.4167
$1,217.88
$686.9728299
Correction of bunion
Y

A2
$717.00
29.4167
$1,217.88
$842.2228300
Incision of heel bone
Y

A2
$446.00
44.2687
$1,832.77
$792.6928302
Incision of ankle bone
Y

A2
$446.00
20.8284
$862.32
$550.0828304
Incision of midfoot bones
Y

A2
$446.00
44.2687
$1,832.77
$792.6928305
Incise/graft midfoot bones
Y

A2
$510.00
44.2687
$1,832.77
$840.6928306
Incision of metatarsal
Y

A2
$630.00
20.8284
$862.32
$688.0828307
Incision of metatarsal
Y

A2
$630.00
20.8284
$862.32
$688.0828308
Incision of metatarsal
Y

A2
$446.00
20.8284
$862.32
$550.0828309
Incision of metatarsals
Y

A2
$630.00
44.2687
$1,832.77
$930.6928310
Revision of big toe
Y

A2
$510.00
20.8284
$862.32
$598.0828312
Revision of toe
Y

A2
$510.00
20.8284
$862.32
$598.0828313
Repair deformity of toe
Y

A2
$446.00
20.8284
$862.32
$550.0828315
Removal of sesamoid bone
Y

A2
$630.00
20.8284
$862.32
$688.0828320
Repair of foot bones
Y

A2
$630.00
44.2687
$1,832.77
$930.6928322
Repair of metatarsals
Y

A2
$630.00
44.2687
$1,832.77
$930.6928340
Resect enlarged toe tissue
Y

A2
$630.00
20.8284
$862.32
$688.0828341
Resect enlarged toe
Y

A2
$630.00
20.8284
$862.32
$688.08( print page 9884)28344
Repair extra toe(s)
Y

A2
$630.00
20.8284
$862.32
$688.0828345
Repair webbed toe(s)
Y

A2
$630.00
20.8284
$862.32
$688.0828400
Treatment of heel fracture
Y

A2
$103.62
1.7682
$73.21
$96.0228405
Treatment of heel fracture
Y

A2
$103.62
1.7682
$73.21
$96.0228406
Treatment of heel fracture
Y

A2
$446.00
26.1592
$1,083.02
$605.2628415
Treat heel fracture
Y

A2
$510.00
59.2233
$2,451.90
$995.4828420
Treat/graft heel fracture
Y

A2
$630.00
41.1091
$1,701.96
$897.9928430
Treatment of ankle fracture
Y

P2

1.7682
$73.21
$73.2128435
Treatment of ankle fracture
Y

A2
$103.62
1.7682
$73.21
$96.0228436
Treatment of ankle fracture
Y

A2
$446.00
26.1592
$1,083.02
$605.2628445
Treat ankle fracture
Y

A2
$510.00
41.1091
$1,701.96
$807.9928446
Osteochondral talus autogrft
Y
NI
G2

44.2687
$1,832.77
$1,832.7728450
Treat midfoot fracture, each
Y

P2

1.7682
$73.21
$73.2128455
Treat midfoot fracture, each
Y

P2

1.7682
$73.21
$73.2128456
Treat midfoot fracture
Y

A2
$446.00
26.1592
$1,083.02
$605.2628465
Treat midfoot fracture, each
Y

A2
$510.00
41.1091
$1,701.96
$807.9928470
Treat metatarsal fracture
Y

P2

1.7682
$73.21
$73.2128475
Treat metatarsal fracture
Y

P2

1.7682
$73.21
$73.2128476
Treat metatarsal fracture
Y

A2
$446.00
26.1592
$1,083.02
$605.2628485
Treat metatarsal fracture
Y

A2
$630.00
41.1091
$1,701.96
$897.9928490
Treat big toe fracture
Y

P3

1.6869
$69.84
$69.8428495
Treat big toe fracture
Y

P2

1.7682
$73.21
$73.2128496
Treat big toe fracture
Y

A2
$446.00
26.1592
$1,083.02
$605.2628505
Treat big toe fracture
Y

A2
$510.00
26.1592
$1,083.02
$653.2628510
Treatment of toe fracture
Y

P3

1.3248
$54.85
$54.8528515
Treatment of toe fracture
Y

P3

1.6951
$70.18
$70.1828525
Treat toe fracture
Y

A2
$510.00
26.1592
$1,083.02
$653.2628530
Treat sesamoid bone fracture
Y

P3

1.2589
$52.12
$52.1228531
Treat sesamoid bone fracture
Y

A2
$510.00
26.1592
$1,083.02
$653.2628540
Treat foot dislocation
Y

P2

1.7682
$73.21
$73.2128545
Treat foot dislocation
Y

A2
$333.00
26.1592
$1,083.02
$520.5128546
Treat foot dislocation
Y

A2
$446.00
26.1592
$1,083.02
$605.2628555
Repair foot dislocation
Y

A2
$446.00
41.1091
$1,701.96
$759.9928570
Treat foot dislocation
Y

P2

1.7682
$73.21
$73.2128575
Treat foot dislocation
Y

A2
$103.62
1.7682
$73.21
$96.0228576
Treat foot dislocation
Y

A2
$510.00
26.1592
$1,083.02
$653.2628585
Repair foot dislocation
Y

A2
$510.00
26.1592
$1,083.02
$653.2628600
Treat foot dislocation
Y

P2

1.7682
$73.21
$73.2128605
Treat foot dislocation
Y

A2
$103.62
1.7682
$73.21
$96.0228606
Treat foot dislocation
Y

A2
$446.00
26.1592
$1,083.02
$605.2628615
Repair foot dislocation
Y

A2
$510.00
41.1091
$1,701.96
$807.9928630
Treat toe dislocation
Y
CH
P3

1.4072
$58.26
$58.2628635
Treat toe dislocation
Y

A2
$333.00
14.7658
$611.32
$402.5828636
Treat toe dislocation
Y

A2
$510.00
26.1592
$1,083.02
$653.2628645
Repair toe dislocation
Y

A2
$510.00
26.1592
$1,083.02
$653.2628660
Treat toe dislocation
Y
CH
P3

1.0534
$43.61
$43.6128665
Treat toe dislocation
Y

A2
$333.00
14.7658
$611.32
$402.5828666
Treat toe dislocation
Y

A2
$510.00
26.1592
$1,083.02
$653.2628675
Repair of toe dislocation
Y

A2
$510.00
26.1592
$1,083.02
$653.2628705
Fusion of foot bones
Y

A2
$630.00
44.2687
$1,832.77
$930.6928715
Fusion of foot bones
Y

A2
$630.00
79.4244
$3,288.25
$1,294.5628725
Fusion of foot bones
Y

A2
$630.00
44.2687
$1,832.77
$930.6928730
Fusion of foot bones
Y

A2
$630.00
44.2687
$1,832.77
$930.6928735
Fusion of foot bones
Y

A2
$630.00
44.2687
$1,832.77
$930.6928737
Revision of foot bones
Y

A2
$717.00
44.2687
$1,832.77
$995.9428740
Fusion of foot bones
Y

A2
$630.00
44.2687
$1,832.77
$930.6928750
Fusion of big toe joint
Y

A2
$630.00
44.2687
$1,832.77
$930.6928755
Fusion of big toe joint
Y

A2
$630.00
20.8284
$862.32
$688.0828760
Fusion of big toe joint
Y

A2
$630.00
44.2687
$1,832.77
$930.6928810
Amputation toe & metatarsal
Y

A2
$446.00
20.8284
$862.32
$550.0828820
Amputation of toe
Y

A2
$446.00
20.8284
$862.32
$550.0828825
Partial amputation of toe
Y

A2
$446.00
20.8284
$862.32
$550.0828890 *
High energy eswt, plantar f
Y
CH
P3

4.2296
$175.11
$175.1129000
Application of body cast
N

G2

1.0931
$45.26
$45.2629010
Application of body cast
N

P2

2.291
$94.85
$94.8529015
Application of body cast
N

P2

2.291
$94.85
$94.8529020
Application of body cast
N

G2

1.0931
$45.26
$45.2629025
Application of body cast
N

P2

1.0931
$45.26
$45.2629035
Application of body cast
N
CH
P2

2.291
$94.85
$94.8529040
Application of body cast
N

G2

1.0931
$45.26
$45.2629044
Application of body cast
N

P2

2.291
$94.85
$94.8529046
Application of body cast
N

G2

2.291
$94.85
$94.8529049
Application of figure eight
N

P3

0.9956
$41.22
$41.2229055
Application of shoulder cast
N

P2

2.291
$94.85
$94.8529058
Application of shoulder cast
N

P2

1.0931
$45.26
$45.2629065
Application of long arm cast
N

P3

1.0698
$44.29
$44.2929075
Application of forearm cast
N

P3

1.0287
$42.59
$42.59( print page 9885)29085
Apply hand/wrist cast
N

P3

1.0451
$43.27
$43.2729086
Apply finger cast
N

P3

0.8394
$34.75
$34.7529105
Apply long arm splint
N

P3

0.9546
$39.52
$39.5229125
Apply forearm splint
N

P3

0.8147
$33.73
$33.7329126
Apply forearm splint
N

P3

0.9135
$37.82
$37.8229130
Application of finger splint
N

P3

0.3703
$15.33
$15.3329131
Application of finger splint
N

P3

0.5432
$22.49
$22.4929200
Strapping of chest
N

P3

0.5432
$22.49
$22.4929220
Strapping of low back
N

P3

0.5679
$23.51
$23.5129240
Strapping of shoulder
N

P3

0.6253
$25.89
$25.8929260
Strapping of elbow or wrist
N

P3

0.5843
$24.19
$24.1929280
Strapping of hand or finger
N

P3

0.6007
$24.87
$24.8729305
Application of hip cast
N
CH
P2

2.291
$94.85
$94.8529325
Application of hip casts
N
CH
P2

2.291
$94.85
$94.8529345
Application of long leg cast
N

P3

1.4154
$58.60
$58.6029355
Application of long leg cast
N

P3

1.3659
$56.55
$56.5529358
Apply long leg cast brace
N

P3

1.6787
$69.50
$69.5029365
Application of long leg cast
N

P3

1.3331
$55.19
$55.1929405
Apply short leg cast
N

P3

0.9956
$41.22
$41.2229425
Apply short leg cast
N

P3

1.0121
$41.90
$41.9029435
Apply short leg cast
N

P3

1.2674
$52.47
$52.4729440
Addition of walker to cast
N

P3

0.5514
$22.83
$22.8329445
Apply rigid leg cast
N

P3

1.3823
$57.23
$57.2329450
Application of leg cast
N

P2

1.0931
$45.26
$45.2629505
Application, long leg splint
N
CH
P3

0.9299
$38.50
$38.5029515
Application lower leg splint
N
CH
P3

0.7488
$31.00
$31.0029520
Strapping of hip
N

P3

0.6171
$25.55
$25.5529530
Strapping of knee
N

P3

0.5925
$24.53
$24.5329540
Strapping of ankle and/or ft
N

P3

0.3949
$16.35
$16.3529550
Strapping of toes
N

P3

0.4031
$16.69
$16.6929580
Application of paste boot
N

P3

0.5596
$23.17
$23.1729590
Application of foot splint
N

P3

0.4526
$18.74
$18.7429700
Removal/revision of cast
N

P3

0.757
$31.34
$31.3429705
Removal/revision of cast
N

P3

0.65
$26.91
$26.9129710
Removal/revision of cast
N

P3

1.1768
$48.72
$48.7229715
Removal/revision of cast
N

P3

0.9792
$40.54
$40.5429720
Repair of body cast
N

P3

0.9546
$39.52
$39.5229730
Windowing of cast
N

P3

0.6336
$26.23
$26.2329740
Wedging of cast
N

P3

0.8968
$37.13
$37.1329750
Wedging of clubfoot cast
N

P3

0.8722
$36.11
$36.1129800
Jaw arthroscopy/surgery
Y

A2
$510.00
28.7803
$1,191.53
$680.3829804
Jaw arthroscopy/surgery
Y

A2
$510.00
28.7803
$1,191.53
$680.3829805
Shoulder arthroscopy, dx
Y

A2
$510.00
28.7803
$1,191.53
$680.3829806
Shoulder arthroscopy/surgery
Y

A2
$510.00
45.7072
$1,892.32
$855.5829807
Shoulder arthroscopy/surgery
Y

A2
$510.00
45.7072
$1,892.32
$855.5829819
Shoulder arthroscopy/surgery
Y

A2
$510.00
45.7072
$1,892.32
$855.5829820
Shoulder arthroscopy/surgery
Y

A2
$510.00
45.7072
$1,892.32
$855.5829821
Shoulder arthroscopy/surgery
Y

A2
$510.00
45.7072
$1,892.32
$855.5829822
Shoulder arthroscopy/surgery
Y

A2
$510.00
28.7803
$1,191.53
$680.3829823
Shoulder arthroscopy/surgery
Y

A2
$510.00
45.7072
$1,892.32
$855.5829824
Shoulder arthroscopy/surgery
Y

A2
$717.00
28.7803
$1,191.53
$835.6329825
Shoulder arthroscopy/surgery
Y

A2
$510.00
45.7072
$1,892.32
$855.5829826
Shoulder arthroscopy/surgery
Y

A2
$510.00
45.7072
$1,892.32
$855.5829827
Arthroscop rotator cuff repr
Y

A2
$717.00
45.7072
$1,892.32
$1,010.8329828
Arthroscopy biceps tenodesis
Y
NI
G2

45.7072
$1,892.32
$1,892.3229830
Elbow arthroscopy
Y

A2
$510.00
28.7803
$1,191.53
$680.3829834
Elbow arthroscopy/surgery
Y

A2
$510.00
28.7803
$1,191.53
$680.3829835
Elbow arthroscopy/surgery
Y

A2
$510.00
28.7803
$1,191.53
$680.3829836
Elbow arthroscopy/surgery
Y

A2
$510.00
28.7803
$1,191.53
$680.3829837
Elbow arthroscopy/surgery
Y

A2
$510.00
28.7803
$1,191.53
$680.3829838
Elbow arthroscopy/surgery
Y

A2
$510.00
28.7803
$1,191.53
$680.3829840
Wrist arthroscopy
Y

A2
$510.00
28.7803
$1,191.53
$680.3829843
Wrist arthroscopy/surgery
Y

A2
$510.00
28.7803
$1,191.53
$680.3829844
Wrist arthroscopy/surgery
Y

A2
$510.00
28.7803
$1,191.53
$680.3829845
Wrist arthroscopy/surgery
Y

A2
$510.00
28.7803
$1,191.53
$680.3829846
Wrist arthroscopy/surgery
Y

A2
$510.00
28.7803
$1,191.53
$680.3829847
Wrist arthroscopy/surgery
Y

A2
$510.00
45.7072
$1,892.32
$855.5829848
Wrist endoscopy/surgery
Y

A2
$1,339.00
28.7803
$1,191.53
$1,302.1329850
Knee arthroscopy/surgery
Y

A2
$630.00
28.7803
$1,191.53
$770.3829851
Knee arthroscopy/surgery
Y

A2
$630.00
45.7072
$1,892.32
$945.5829855
Tibial arthroscopy/surgery
Y

A2
$630.00
45.7072
$1,892.32
$945.5829856
Tibial arthroscopy/surgery
Y

A2
$630.00
45.7072
$1,892.32
$945.5829860
Hip arthroscopy, dx
Y

A2
$630.00
45.7072
$1,892.32
$945.5829861
Hip arthroscopy/surgery
Y

A2
$630.00
45.7072
$1,892.32
$945.5829862
Hip arthroscopy/surgery
Y

A2
$1,339.00
45.7072
$1,892.32
$1,477.3329863
Hip arthroscopy/surgery
Y

A2
$630.00
45.7072
$1,892.32
$945.5829866
Autgrft implnt, knee w/scope
Y
CH
G2

45.7072
$1,892.32
$1,892.32( print page 9886)29870
Knee arthroscopy, dx
Y

A2
$510.00
28.7803
$1,191.53
$680.3829871
Knee arthroscopy/drainage
Y

A2
$510.00
28.7803
$1,191.53
$680.3829873
Knee arthroscopy/surgery
Y

A2
$510.00
28.7803
$1,191.53
$680.3829874
Knee arthroscopy/surgery
Y

A2
$510.00
28.7803
$1,191.53
$680.3829875
Knee arthroscopy/surgery
Y

A2
$630.00
28.7803
$1,191.53
$770.3829876
Knee arthroscopy/surgery
Y

A2
$630.00
28.7803
$1,191.53
$770.3829877
Knee arthroscopy/surgery
Y

A2
$630.00
28.7803
$1,191.53
$770.3829879
Knee arthroscopy/surgery
Y

A2
$510.00
28.7803
$1,191.53
$680.3829880
Knee arthroscopy/surgery
Y

A2
$630.00
28.7803
$1,191.53
$770.3829881
Knee arthroscopy/surgery
Y

A2
$630.00
28.7803
$1,191.53
$770.3829882
Knee arthroscopy/surgery
Y

A2
$510.00
28.7803
$1,191.53
$680.3829883
Knee arthroscopy/surgery
Y

A2
$510.00
28.7803
$1,191.53
$680.3829884
Knee arthroscopy/surgery
Y

A2
$510.00
28.7803
$1,191.53
$680.3829885
Knee arthroscopy/surgery
Y

A2
$510.00
45.7072
$1,892.32
$855.5829886
Knee arthroscopy/surgery
Y

A2
$510.00
28.7803
$1,191.53
$680.3829887
Knee arthroscopy/surgery
Y

A2
$510.00
28.7803
$1,191.53
$680.3829888
Knee arthroscopy/surgery
Y

A2
$510.00
45.7072
$1,892.32
$855.5829889
Knee arthroscopy/surgery
Y

A2
$510.00
45.7072
$1,892.32
$855.5829891
Ankle arthroscopy/surgery
Y

A2
$510.00
45.7072
$1,892.32
$855.5829892
Ankle arthroscopy/surgery
Y

A2
$510.00
45.7072
$1,892.32
$855.5829893
Scope, plantar fasciotomy
Y

A2
$1,255.56
20.8284
$862.32
$1,157.2529894
Ankle arthroscopy/surgery
Y

A2
$510.00
28.7803
$1,191.53
$680.3829895
Ankle arthroscopy/surgery
Y

A2
$510.00
28.7803
$1,191.53
$680.3829897
Ankle arthroscopy/surgery
Y

A2
$510.00
28.7803
$1,191.53
$680.3829898
Ankle arthroscopy/surgery
Y

A2
$510.00
28.7803
$1,191.53
$680.3829899
Ankle arthroscopy/surgery
Y

A2
$510.00
45.7072
$1,892.32
$855.5829900
Mcp joint arthroscopy, dx
Y

A2
$510.00
28.7803
$1,191.53
$680.3829901
Mcp joint arthroscopy, surg
Y

A2
$510.00
28.7803
$1,191.53
$680.3829902
Mcp joint arthroscopy, surg
Y

A2
$510.00
28.7803
$1,191.53
$680.3829904
Subtalar arthro w/fb rmvl
Y
NI
G2

28.7803
$1,191.53
$1,191.5329905
Subtalar arthro w/exc
Y
NI
G2

28.7803
$1,191.53
$1,191.5329906
Subtalar arthro w/deb
Y
NI
G2

28.7803
$1,191.53
$1,191.5329907
Subtalar arthro w/fusion
Y
NI
G2

45.7072
$1,892.32
$1,892.3230000
Drainage of nose lesion
Y

P2

2.5002
$103.51
$103.5130020
Drainage of nose lesion
Y

P2

2.5002
$103.51
$103.5130100
Intranasal biopsy
Y

P3

1.8763
$77.68
$77.6830110
Removal of nose polyp(s)
Y

P3

2.9376
$121.62
$121.6230115
Removal of nose polyp(s)
Y

A2
$446.00
16.3288
$676.03
$503.5130117
Removal of intranasal lesion
Y

A2
$510.00
16.3288
$676.03
$551.5130118
Removal of intranasal lesion
Y

A2
$510.00
23.9765
$992.65
$630.6630120
Revision of nose
Y

A2
$333.00
16.3288
$676.03
$418.7630124
Removal of nose lesion
Y

R2

7.4474
$308.33
$308.3330125
Removal of nose lesion
Y

A2
$446.00
39.8776
$1,650.97
$747.2430130
Excise inferior turbinate
Y

A2
$510.00
16.3288
$676.03
$551.5130140
Resect inferior turbinate
Y

A2
$446.00
23.9765
$992.65
$582.6630150
Partial removal of nose
Y

A2
$510.00
39.8776
$1,650.97
$795.2430160
Removal of nose
Y

A2
$630.00
39.8776
$1,650.97
$885.2430200
Injection treatment of nose
Y

P3

1.4975
$62.00
$62.0030210
Nasal sinus therapy
Y

P3

1.9009
$78.70
$78.7030220
Insert nasal septal button
Y

A2
$464.15
7.4474
$308.33
$425.2030300
Remove nasal foreign body
N

P2

0.631
$26.12
$26.1230310
Remove nasal foreign body
Y

A2
$333.00
16.3288
$676.03
$418.7630320
Remove nasal foreign body
Y

A2
$446.00
16.3288
$676.03
$503.5130400
Reconstruction of nose
Y

A2
$630.00
39.8776
$1,650.97
$885.2430410
Reconstruction of nose
Y

A2
$717.00
39.8776
$1,650.97
$950.4930420
Reconstruction of nose
Y

A2
$717.00
39.8776
$1,650.97
$950.4930430
Revision of nose
Y

A2
$510.00
23.9765
$992.65
$630.6630435
Revision of nose
Y

A2
$717.00
39.8776
$1,650.97
$950.4930450
Revision of nose
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9930460
Revision of nose
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9930462
Revision of nose
Y

A2
$1,339.00
39.8776
$1,650.97
$1,416.9930465
Repair nasal stenosis
Y

A2
$1,339.00
39.8776
$1,650.97
$1,416.9930520
Repair of nasal septum
Y

A2
$630.00
23.9765
$992.65
$720.6630540
Repair nasal defect
Y

A2
$717.00
39.8776
$1,650.97
$950.4930545
Repair nasal defect
Y

A2
$717.00
39.8776
$1,650.97
$950.4930560
Release of nasal adhesions
Y

A2
$150.72
2.5002
$103.51
$138.9230580
Repair upper jaw fistula
Y

A2
$630.00
39.8776
$1,650.97
$885.2430600
Repair mouth/nose fistula
Y

A2
$630.00
39.8776
$1,650.97
$885.2430620
Intranasal reconstruction
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9930630
Repair nasal septum defect
Y

A2
$995.00
23.9765
$992.65
$994.4130801
Ablate inf turbinate, superf
Y

A2
$333.00
7.4474
$308.33
$326.8330802
Cauterization, inner nose
Y

A2
$333.00
7.4474
$308.33
$326.8330901
Control of nosebleed
Y

P3

1.0862
$44.97
$44.9730903
Control of nosebleed
Y

A2
$72.48
1.1251
$46.58
$66.0130905
Control of nosebleed
Y

A2
$72.48
1.1251
$46.58
$66.0130906
Repeat control of nosebleed
Y

A2
$72.48
1.1251
$46.58
$66.0130915
Ligation, nasal sinus artery
Y

A2
$446.00
25.841
$1,069.84
$601.96( print page 9887)30920
Ligation, upper jaw artery
Y

A2
$510.00
25.841
$1,069.84
$649.9630930
Ther fx, nasal inf turbinate
Y

A2
$630.00
16.3288
$676.03
$641.5131000
Irrigation, maxillary sinus
Y

P3

2.4934
$103.23
$103.2331002
Irrigation, sphenoid sinus
Y

R2

7.4474
$308.33
$308.3331020
Exploration, maxillary sinus
Y

A2
$446.00
23.9765
$992.65
$582.6631030
Exploration, maxillary sinus
Y

A2
$510.00
39.8776
$1,650.97
$795.2431032
Explore sinus, remove polyps
Y

A2
$630.00
39.8776
$1,650.97
$885.2431040
Exploration behind upper jaw
Y

R2

23.9765
$992.65
$992.6531050
Exploration, sphenoid sinus
Y

A2
$446.00
39.8776
$1,650.97
$747.2431051
Sphenoid sinus surgery
Y

A2
$630.00
39.8776
$1,650.97
$885.2431070
Exploration of frontal sinus
Y

A2
$446.00
23.9765
$992.65
$582.6631075
Exploration of frontal sinus
Y

A2
$630.00
39.8776
$1,650.97
$885.2431080
Removal of frontal sinus
Y

A2
$630.00
39.8776
$1,650.97
$885.2431081
Removal of frontal sinus
Y

A2
$630.00
39.8776
$1,650.97
$885.2431084
Removal of frontal sinus
Y

A2
$630.00
39.8776
$1,650.97
$885.2431085
Removal of frontal sinus
Y

A2
$630.00
39.8776
$1,650.97
$885.2431086
Removal of frontal sinus
Y

A2
$630.00
39.8776
$1,650.97
$885.2431087
Removal of frontal sinus
Y

A2
$630.00
39.8776
$1,650.97
$885.2431090
Exploration of sinuses
Y

A2
$717.00
39.8776
$1,650.97
$950.4931200
Removal of ethmoid sinus
Y

A2
$446.00
39.8776
$1,650.97
$747.2431201
Removal of ethmoid sinus
Y

A2
$717.00
39.8776
$1,650.97
$950.4931205
Removal of ethmoid sinus
Y

A2
$510.00
39.8776
$1,650.97
$795.2431231
Nasal endoscopy, dx
Y

P2

1.6115
$66.72
$66.7231233
Nasal/sinus endoscopy, dx
Y

A2
$86.39
1.6115
$66.72
$81.4731235
Nasal/sinus endoscopy, dx
Y

A2
$333.00
17.016
$704.48
$425.8731237
Nasal/sinus endoscopy, surg
Y

A2
$446.00
17.016
$704.48
$510.6231238
Nasal/sinus endoscopy, surg
Y

A2
$333.00
17.016
$704.48
$425.8731239
Nasal/sinus endoscopy, surg
Y

A2
$630.00
22.7191
$940.59
$707.6531240
Nasal/sinus endoscopy, surg
Y

A2
$446.00
17.016
$704.48
$510.6231254
Revision of ethmoid sinus
Y

A2
$510.00
22.7191
$940.59
$617.6531255
Removal of ethmoid sinus
Y

A2
$717.00
22.7191
$940.59
$772.9031256
Exploration maxillary sinus
Y

A2
$510.00
22.7191
$940.59
$617.6531267
Endoscopy, maxillary sinus
Y

A2
$510.00
22.7191
$940.59
$617.6531276
Sinus endoscopy, surgical
Y

A2
$510.00
22.7191
$940.59
$617.6531287
Nasal/sinus endoscopy, surg
Y

A2
$510.00
22.7191
$940.59
$617.6531288
Nasal/sinus endoscopy, surg
Y

A2
$510.00
22.7191
$940.59
$617.6531300
Removal of larynx lesion
Y

A2
$717.00
23.9765
$992.65
$785.9131320
Diagnostic incision, larynx
Y

A2
$446.00
39.8776
$1,650.97
$747.2431400
Revision of larynx
Y

A2
$446.00
39.8776
$1,650.97
$747.2431420
Removal of epiglottis
Y

A2
$446.00
39.8776
$1,650.97
$747.2431500
Insert emergency airway
N

G2

2.459
$101.81
$101.8131502
Change of windpipe airway
N

G2

1.3362
$55.32
$55.3231505
Diagnostic laryngoscopy
Y

P2

0.8224
$34.05
$34.0531510
Laryngoscopy with biopsy
Y

A2
$446.00
17.016
$704.48
$510.6231511
Remove foreign body, larynx
Y

A2
$86.39
1.6115
$66.72
$81.4731512
Removal of larynx lesion
Y

A2
$446.00
17.016
$704.48
$510.6231513
Injection into vocal cord
Y

A2
$86.39
1.6115
$66.72
$81.4731515
Laryngoscopy for aspiration
Y

A2
$333.00
17.016
$704.48
$425.8731520
Dx laryngoscopy, newborn
Y

G2

1.6115
$66.72
$66.7231525
Dx laryngoscopy excl nb
Y

A2
$333.00
17.016
$704.48
$425.8731526
Dx laryngoscopy w/oper scope
Y

A2
$446.00
22.7191
$940.59
$569.6531527
Laryngoscopy for treatment
Y

A2
$333.00
22.7191
$940.59
$484.9031528
Laryngoscopy and dilation
Y

A2
$446.00
17.016
$704.48
$510.6231529
Laryngoscopy and dilation
Y

A2
$446.00
17.016
$704.48
$510.6231530
Laryngoscopy w/fb removal
Y

A2
$446.00
22.7191
$940.59
$569.6531531
Laryngoscopy w/fb & op scope
Y

A2
$510.00
22.7191
$940.59
$617.6531535
Laryngoscopy w/biopsy
Y

A2
$446.00
22.7191
$940.59
$569.6531536
Laryngoscopy w/bx & op scope
Y

A2
$510.00
22.7191
$940.59
$617.6531540
Laryngoscopy w/exc of tumor
Y

A2
$510.00
22.7191
$940.59
$617.6531541
Larynscop w/tumr exc + scope
Y

A2
$630.00
22.7191
$940.59
$707.6531545
Remove vc lesion w/scope
Y

A2
$630.00
22.7191
$940.59
$707.6531546
Remove vc lesion scope/graft
Y

A2
$630.00
22.7191
$940.59
$707.6531560
Laryngoscop w/arytenoidectom
Y

A2
$717.00
22.7191
$940.59
$772.9031561
Larynscop, remve cart + scop
Y

A2
$717.00
22.7191
$940.59
$772.9031570
Laryngoscope w/vc inj
Y

A2
$446.00
17.016
$704.48
$510.6231571
Laryngoscop w/vc inj + scope
Y

A2
$446.00
22.7191
$940.59
$569.6531575
Diagnostic laryngoscopy
Y

P3

1.4811
$61.32
$61.3231576
Laryngoscopy with biopsy
Y

A2
$446.00
22.7191
$940.59
$569.6531577
Remove foreign body, larynx
Y

A2
$236.42
3.994
$165.36
$218.6631578
Removal of larynx lesion
Y

A2
$446.00
22.7191
$940.59
$569.6531579
Diagnostic laryngoscopy
Y

P3

2.7321
$113.11
$113.1131580
Revision of larynx
Y

A2
$717.00
39.8776
$1,650.97
$950.4931582
Revision of larynx
Y

A2
$717.00
39.8776
$1,650.97
$950.4931588
Revision of larynx
Y

A2
$717.00
39.8776
$1,650.97
$950.4931590
Reinnervate larynx
Y

A2
$717.00
39.8776
$1,650.97
$950.4931595
Larynx nerve surgery
Y

A2
$446.00
39.8776
$1,650.97
$747.2431603
Incision of windpipe
Y

A2
$333.00
7.4474
$308.33
$326.83( print page 9888)31605
Incision of windpipe
Y

G2

7.4474
$308.33
$308.3331611
Surgery/speech prosthesis
Y

A2
$510.00
23.9765
$992.65
$630.6631612
Puncture/clear windpipe
Y

A2
$333.00
23.9765
$992.65
$497.9131613
Repair windpipe opening
Y

A2
$446.00
23.9765
$992.65
$582.6631614
Repair windpipe opening
Y

A2
$446.00
39.8776
$1,650.97
$747.2431615
Visualization of windpipe
Y

A2
$333.00
9.9575
$412.25
$352.8131620
Endobronchial us add-on
N
CH
N131622
Dx bronchoscope/wash
Y

A2
$333.00
9.9575
$412.25
$352.8131623
Dx bronchoscope/brush
Y

A2
$446.00
9.9575
$412.25
$437.5631624
Dx bronchoscope/lavage
Y

A2
$446.00
9.9575
$412.25
$437.5631625
Bronchoscopy w/biopsy(s)
Y

A2
$446.00
9.9575
$412.25
$437.5631628
Bronchoscopy/lung bx, each
Y

A2
$446.00
9.9575
$412.25
$437.5631629
Bronchoscopy/needle bx, each
Y

A2
$446.00
9.9575
$412.25
$437.5631630
Bronchoscopy dilate/fx repr
Y

A2
$446.00
24.0654
$996.33
$583.5831631
Bronchoscopy, dilate w/stent
Y

A2
$446.00
24.0654
$996.33
$583.5831632
Bronchoscopy/lung bx, add?l
Y

G2

9.9575
$412.25
$412.2531633
Bronchoscopy/needle bx add?l
Y

G2

9.9575
$412.25
$412.2531635
Bronchoscopy w/fb removal
Y

A2
$446.00
9.9575
$412.25
$437.5631636
Bronchoscopy, bronch stents
Y

A2
$446.00
24.0654
$996.33
$583.5831637
Bronchoscopy, stent add-on
Y

A2
$333.00
9.9575
$412.25
$352.8131638
Bronchoscopy, revise stent
Y

A2
$446.00
24.0654
$996.33
$583.5831640
Bronchoscopy w/tumor excise
Y

A2
$446.00
24.0654
$996.33
$583.5831641
Bronchoscopy, treat blockage
Y

A2
$446.00
24.0654
$996.33
$583.5831643
Diag bronchoscope/catheter
Y

A2
$446.00
9.9575
$412.25
$437.5631645
Bronchoscopy, clear airways
Y

A2
$333.00
9.9575
$412.25
$352.8131646
Bronchoscopy, reclear airway
Y

A2
$333.00
9.9575
$412.25
$352.8131656
Bronchoscopy, inj for x-ray
Y

A2
$333.00
9.9575
$412.25
$352.8131715
Injection for bronchus x-ray
N

N131717
Bronchial brush biopsy
Y

A2
$236.42
3.994
$165.36
$218.6631720
Clearance of airways
N

A2
$47.32
0.3877
$16.05
$39.5031730
Intro, windpipe wire/tube
Y

A2
$236.42
3.994
$165.36
$218.6631750
Repair of windpipe
Y

A2
$717.00
39.8776
$1,650.97
$950.4931755
Repair of windpipe
Y

A2
$446.00
39.8776
$1,650.97
$747.2431820
Closure of windpipe lesion
Y

A2
$333.00
16.3288
$676.03
$418.7631825
Repair of windpipe defect
Y

A2
$446.00
23.9765
$992.65
$582.6631830
Revise windpipe scar
Y

A2
$446.00
23.9765
$992.65
$582.6632000
Drainage of chest
N
CH
D532002
Treatment of collapsed lung
N
CH
D532019
Insert pleural catheter
N
CH
D532400
Needle biopsy chest lining
Y

A2
$333.00
9.3354
$386.49
$346.3732405
Biopsy, lung or mediastinum
Y

A2
$333.00
9.3354
$386.49
$346.3732420
Puncture/clear lung
Y

A2
$222.78
5.2024
$215.38
$220.9332421
Thoracentesis for aspiration
Y
NI
A2
$222.78
5.2024
$215.38
$220.9332422
Thoracentesis w/tube insert
Y
NI
G2

5.2024
$215.38
$215.3832550
Insert pleural cath
Y
NI
G2

30.7096
$1,271.41
$1,271.4132960
Therapeutic pneumothorax
Y

G2

5.2024
$215.38
$215.3832998
Perq rf ablate tx, pul tumor
Y
CH
G2

42.998
$1,780.16
$1,780.1633010
Drainage of heart sac
Y

A2
$222.78
5.2024
$215.38
$220.9333011
Repeat drainage of heart sac
Y

A2
$222.78
5.2024
$215.38
$220.9333206
Insertion of heart pacemaker
Y

J8

169.4628
$7,015.93
$7,015.9333207
Insertion of heart pacemaker
Y

J8

169.4628
$7,015.93
$7,015.9333208
Insertion of heart pacemaker
Y

J8

196.2967
$8,126.88
$8,126.8833210
Insertion of heart electrode
Y
CH
J8

90.579
$3,750.06
$3,750.0633211
Insertion of heart electrode
Y
CH
J8

90.579
$3,750.06
$3,750.0633212
Insertion of pulse generator
Y

H8
$510.00
142.1043
$5,883.26
$5,514.6433213
Insertion of pulse generator
Y

H8
$510.00
154.6733
$6,403.63
$6,010.0633214
Upgrade of pacemaker system
Y

J8

196.2967
$8,126.88
$8,126.8833215
Reposition pacing-defib lead
Y

G2

23.9802
$992.80
$992.8033216
Insert lead pace-defib, one
Y
CH
J8

90.579
$3,750.06
$3,750.0633217
Insert lead pace-defib, dual
Y
CH
J8

90.579
$3,750.06
$3,750.0633218
Repair lead pace-defib, one
Y

G2

23.9802
$992.80
$992.8033220
Repair lead pace-defib, dual
Y

G2

23.9802
$992.80
$992.8033222
Revise pocket, pacemaker
Y

A2
$446.00
15.0458
$622.91
$490.2333223
Revise pocket, pacing-defib
Y

A2
$446.00
15.0458
$622.91
$490.2333224
Insert pacing lead & connect
Y

J8

375.1658
$15,532.24
$15,532.2433225
L ventric pacing lead add-on
Y

J8

375.1658
$15,532.24
$15,532.2433226
Reposition l ventric lead
Y

G2

23.9802
$992.80
$992.8033233
Removal of pacemaker system
Y

A2
$446.00
23.9802
$992.80
$582.7033234
Removal of pacemaker system
Y

G2

23.9802
$992.80
$992.8033235
Removal pacemaker electrode
Y

G2

23.9802
$992.80
$992.8033240
Insert pulse generator
Y
CH
J8

493.9803
$20,451.28
$20,451.2833241
Remove pulse generator
Y

G2

23.9802
$992.80
$992.8033249
Eltrd/insert pace-defib
Y
CH
J8

599.3974
$24,815.65
$24,815.6533282
Implant pat-active ht record
N

J8

98.4186
$4,074.63
$4,074.6333284
Remove pat-active ht record
Y

G2

8.685
$359.57
$359.5733508
Endoscopic vein harvest
N

N135188
Repair blood vessel lesion
Y

A2
$630.00
38.7673
$1,605.00
$873.75( print page 9889)35207
Repair blood vessel lesion
Y

A2
$630.00
38.7673
$1,605.00
$873.7535473
Repair arterial blockage
Y

G2

45.3845
$1,878.96
$1,878.9635476
Repair venous blockage
Y

G2

45.3845
$1,878.96
$1,878.9635492
Atherectomy, percutaneous
Y

G2

87.5137
$3,623.15
$3,623.1535572
Harvest femoropopliteal vein
N

N135761
Exploration of artery/vein
Y

G2

29.6965
$1,229.46
$1,229.4635875
Removal of clot in graft
Y

A2
$1,339.00
38.7673
$1,605.00
$1,405.5035876
Removal of clot in graft
Y

A2
$1,339.00
38.7673
$1,605.00
$1,405.5036000
Place needle in vein
N

N136002
Pseudoaneurysm injection trt
N

G2

2.3792
$98.50
$98.5036005
Injection ext venography
N

N136010
Place catheter in vein
N

N136011
Place catheter in vein
N

N136012
Place catheter in vein
N

N136013
Place catheter in artery
N

N136014
Place catheter in artery
N

N136015
Place catheter in artery
N

N136100
Establish access to artery
N

N136120
Establish access to artery
N

N136140
Establish access to artery
N

N136145
Artery to vein shunt
N

N136160
Establish access to aorta
N

N136200
Place catheter in aorta
N

N136215
Place catheter in artery
N

N136216
Place catheter in artery
N

N136217
Place catheter in artery
N

N136218
Place catheter in artery
N

N136245
Place catheter in artery
N

N136246
Place catheter in artery
N

N136247
Place catheter in artery
N

N136248
Place catheter in artery
N

N136260
Insertion of infusion pump
Y

A2
$510.00
28.8743
$1,195.42
$681.3636261
Revision of infusion pump
Y

A2
$446.00
23.9802
$992.80
$582.7036262
Removal of infusion pump
Y

A2
$333.00
23.9802
$992.80
$497.9536400
Bl draw < 3 yrs fem/jugular
N

N136405
Bl draw < 3 yrs scalp vein
N

N136406
Bl draw < 3 yrs other vein
N

N136410
Non-routine bl draw > 3 yrs
N

N136416
Capillary blood draw
N

N136420
Vein access cutdown < 1 yr
Y

G2

0.2143
$8.87
$8.8736425
Vein access cutdown > 1 yr
Y

R2

0.2143
$8.87
$8.8736430
Blood transfusion service
N

P3

0.7983
$33.05
$33.0536440
Bl push transfuse, 2 yr or <
N

R2

3.3967
$140.63
$140.6336450
Bl exchange/transfuse, nb
N

R2

3.3967
$140.63
$140.6336468
Injection(s), spider veins
Y

R2

0.793
$32.83
$32.8336469
Injection(s), spider veins
Y
CH
R2

0.793
$32.83
$32.8336470
Injection therapy of vein
Y

P2

0.793
$32.83
$32.8336471
Injection therapy of veins
Y

P2

0.793
$32.83
$32.8336475
Endovenous rf, 1st vein
Y

A2
$1,339.00
42.6114
$1,764.15
$1,445.2936476
Endovenous rf, vein add-on
Y

A2
$1,339.00
25.841
$1,069.84
$1,271.7136478
Endovenous laser, 1st vein
Y

A2
$1,339.00
25.841
$1,069.84
$1,271.7136479
Endovenous laser vein addon
Y

A2
$1,339.00
25.841
$1,069.84
$1,271.7136481
Insertion of catheter, vein
N

N136500
Insertion of catheter, vein
N

N136510
Insertion of catheter, vein
N

N136511
Apheresis wbc
N

G2

11.5058
$476.35
$476.3536512
Apheresis rbc
N

G2

11.5058
$476.35
$476.3536513
Apheresis platelets
N

G2

11.5058
$476.35
$476.3536514
Apheresis plasma
N

G2

11.5058
$476.35
$476.3536515
Apheresis, adsorp/reinfuse
N

G2

30.6035
$1,267.02
$1,267.0236516
Apheresis, selective
N

G2

30.6035
$1,267.02
$1,267.0236522
Photopheresis
N

G2

30.6035
$1,267.02
$1,267.0236540
Collect blood venous device
N
CH
D536550
Declot vascular device
N
CH
D536555
Insert non-tunnel cv cath
Y

A2
$333.00
10.9092
$451.65
$362.6636556
Insert non-tunnel cv cath
Y

A2
$333.00
10.9092
$451.65
$362.6636557
Insert tunneled cv cath
Y

A2
$446.00
24.1069
$998.05
$584.0136558
Insert tunneled cv cath
Y

A2
$446.00
24.1069
$998.05
$584.0136560
Insert tunneled cv cath
Y

A2
$510.00
28.8743
$1,195.42
$681.3636561
Insert tunneled cv cath
Y

A2
$510.00
28.8743
$1,195.42
$681.3636563
Insert tunneled cv cath
Y

A2
$510.00
28.8743
$1,195.42
$681.3636565
Insert tunneled cv cath
Y

A2
$510.00
28.8743
$1,195.42
$681.3636566
Insert tunneled cv cath
Y

H8
$510.00
107.6665
$4,457.50
$3,796.2336568
Insert picc cath
Y

A2
$333.00
10.9092
$451.65
$362.6636569
Insert picc cath
Y

A2
$333.00
10.9092
$451.65
$362.6636570
Insert picvad cath
Y

A2
$510.00
24.1069
$998.05
$632.0136571
Insert picvad cath
Y

A2
$510.00
24.1069
$998.05
$632.01( print page 9890)36575
Repair tunneled cv cath
Y

A2
$446.00
5.6614
$234.39
$393.1036576
Repair tunneled cv cath
Y

A2
$446.00
10.9092
$451.65
$447.4136578
Replace tunneled cv cath
Y

A2
$446.00
24.1069
$998.05
$584.0136580
Replace cvad cath
Y

A2
$333.00
10.9092
$451.65
$362.6636581
Replace tunneled cv cath
Y

A2
$446.00
24.1069
$998.05
$584.0136582
Replace tunneled cv cath
Y

A2
$510.00
28.8743
$1,195.42
$681.3636583
Replace tunneled cv cath
Y

A2
$510.00
28.8743
$1,195.42
$681.3636584
Replace picc cath
Y

A2
$333.00
10.9092
$451.65
$362.6636585
Replace picvad cath
Y

A2
$510.00
24.1069
$998.05
$632.0136589
Removal tunneled cv cath
Y

A2
$333.00
5.6614
$234.39
$308.3536590
Removal tunneled cv cath
Y

A2
$333.00
10.9092
$451.65
$362.6636591
Draw blood off venous device
N
NI
N136592
Collect blood from picc
N
NI
N136593
Declot vascular device
Y
NI
P3

0.4937
$20.44
$20.4436595
Mech remov tunneled cv cath
Y

G2

24.1069
$998.05
$998.0536596
Mech remov tunneled cv cath
Y

G2

10.9092
$451.65
$451.6536597
Reposition venous catheter
Y

G2

10.9092
$451.65
$451.6536598
Inj w/fluor, eval cv device
Y
CH
P3

1.9997
$82.79
$82.7936600
Withdrawal of arterial blood
N

N136620
Insertion catheter, artery
N

N136625
Insertion catheter, artery
N

N136640
Insertion catheter, artery
Y

A2
$333.00
28.8743
$1,195.42
$548.6136680
Insert needle, bone cavity
Y

G2

1.1097
$45.94
$45.9436800
Insertion of cannula
Y

A2
$510.00
29.6965
$1,229.46
$689.8736810
Insertion of cannula
Y

A2
$510.00
29.6965
$1,229.46
$689.8736815
Insertion of cannula
Y

A2
$510.00
29.6965
$1,229.46
$689.8736818
Av fuse, uppr arm, cephalic
Y

A2
$510.00
38.7673
$1,605.00
$783.7536819
Av fuse, uppr arm, basilic
Y

A2
$510.00
38.7673
$1,605.00
$783.7536820
Av fusion/forearm vein
Y

A2
$510.00
38.7673
$1,605.00
$783.7536821
Av fusion direct any site
Y

A2
$510.00
38.7673
$1,605.00
$783.7536825
Artery-vein autograft
Y

A2
$630.00
38.7673
$1,605.00
$873.7536830
Artery-vein nonautograft
Y

A2
$630.00
38.7673
$1,605.00
$873.7536831
Open thrombect av fistula
Y

A2
$1,339.00
38.7673
$1,605.00
$1,405.5036832
Av fistula revision, open
Y

A2
$630.00
38.7673
$1,605.00
$873.7536833
Av fistula revision
Y

A2
$630.00
38.7673
$1,605.00
$873.7536834
Repair a-v aneurysm
Y

A2
$510.00
38.7673
$1,605.00
$783.7536835
Artery to vein shunt
Y

A2
$630.00
29.6965
$1,229.46
$779.8736860
External cannula declotting
Y

A2
$127.40
2.4824
$102.77
$121.2436861
Cannula declotting
Y

A2
$510.00
29.6965
$1,229.46
$689.8736870
Percut thrombect av fistula
Y

A2
$1,339.00
40.4667
$1,675.36
$1,423.0937184
Prim art mech thrombectomy
Y

G2

38.7673
$1,605.00
$1,605.0037185
Prim art m-thrombect add-on
Y

G2

38.7673
$1,605.00
$1,605.0037186
Sec art m-thrombect add-on
Y

G2

38.7673
$1,605.00
$1,605.0037187
Venous mech thrombectomy
Y

G2

38.7673
$1,605.00
$1,605.0037188
Venous m-thrombectomy add-on
Y

G2

38.7673
$1,605.00
$1,605.0037200
Transcatheter biopsy
Y

G2

28.8743
$1,195.42
$1,195.4237203
Transcatheter retrieval
Y

G2

28.8743
$1,195.42
$1,195.4237250
Iv us first vessel add-on
N
CH
N137251
Iv us each add vessel add-on
N
CH
N137500
Endoscopy ligate perf veins
Y

A2
$510.00
42.6114
$1,764.15
$823.5437607
Ligation of a-v fistula
Y

A2
$510.00
25.841
$1,069.84
$649.9637609
Temporal artery procedure
Y

A2
$446.00
16.1001
$666.56
$501.1437650
Revision of major vein
Y

A2
$446.00
25.841
$1,069.84
$601.9637700
Revise leg vein
Y

A2
$446.00
25.841
$1,069.84
$601.9637718
Ligate/strip short leg vein
Y

A2
$510.00
25.841
$1,069.84
$649.9637722
Ligate/strip long leg vein
Y

A2
$510.00
42.6114
$1,764.15
$823.5437735
Removal of leg veins/lesion
Y

A2
$510.00
42.6114
$1,764.15
$823.5437760
Ligation, leg veins, open
Y

A2
$510.00
25.841
$1,069.84
$649.9637765
Phleb veins extrem 10-20
Y

R2

25.841
$1,069.84
$1,069.8437766
Phleb veins extrem 20+
Y

R2

25.841
$1,069.84
$1,069.8437780
Revision of leg vein
Y

A2
$510.00
25.841
$1,069.84
$649.9637785
Ligate/divide/excise vein
Y

A2
$510.00
25.841
$1,069.84
$649.9637790
Penile venous occlusion
Y

A2
$510.00
33.9306
$1,404.76
$733.6938200
Injection for spleen x-ray
N

N138204
Bl donor search management
N

N138205
Harvest allogenic stem cells
N

G2

11.5058
$476.35
$476.3538206
Harvest auto stem cells
N

G2

11.5058
$476.35
$476.3538220
Bone marrow aspiration
Y
CH
P3

2.6333
$109.02
$109.0238221
Bone marrow biopsy
Y
CH
P3

2.7649
$114.47
$114.4738230
Bone marrow collection
N

G2

30.6035
$1,267.02
$1,267.0238241
Bone marrow/stem transplant
N

G2

30.6035
$1,267.02
$1,267.0238242
Lymphocyte infuse transplant
N

R2

11.5058
$476.35
$476.3538300
Drainage, lymph node lesion
Y

A2
$333.00
11.5594
$478.57
$369.3938305
Drainage, lymph node lesion
Y

A2
$446.00
18.3197
$758.45
$524.1138308
Incision of lymph channels
Y

A2
$446.00
22.9584
$950.50
$572.1338500
Biopsy/removal, lymph nodes
Y

A2
$446.00
22.9584
$950.50
$572.1338505
Needle biopsy, lymph nodes
Y

A2
$240.00
7.1147
$294.56
$253.64( print page 9891)38510
Biopsy/removal, lymph nodes
Y

A2
$446.00
22.9584
$950.50
$572.1338520
Biopsy/removal, lymph nodes
Y

A2
$446.00
22.9584
$950.50
$572.1338525
Biopsy/removal, lymph nodes
Y

A2
$446.00
22.9584
$950.50
$572.1338530
Biopsy/removal, lymph nodes
Y

A2
$446.00
22.9584
$950.50
$572.1338542
Explore deep node(s), neck
Y

A2
$446.00
44.324
$1,835.06
$793.2738550
Removal, neck/armpit lesion
Y

A2
$510.00
22.9584
$950.50
$620.1338555
Removal, neck/armpit lesion
Y

A2
$630.00
22.9584
$950.50
$710.1338570
Laparoscopy, lymph node biop
Y

A2
$1,339.00
45.5317
$1,885.06
$1,475.5238571
Laparoscopy, lymphadenectomy
Y

A2
$1,339.00
69.6652
$2,884.21
$1,725.3038572
Laparoscopy, lymphadenectomy
Y

A2
$1,339.00
45.5317
$1,885.06
$1,475.5238700
Removal of lymph nodes, neck
Y

G2

22.9584
$950.50
$950.5038740
Remove armpit lymph nodes
Y

A2
$446.00
44.324
$1,835.06
$793.2738745
Remove armpit lymph nodes
Y

A2
$630.00
44.324
$1,835.06
$931.2738760
Remove groin lymph nodes
Y

A2
$446.00
22.9584
$950.50
$572.1338790
Inject for lymphatic x-ray
N

N138792
Identify sentinel node
N

N138794
Access thoracic lymph duct
N

N140490
Biopsy of lip
Y

P3

1.5224
$63.03
$63.0340500
Partial excision of lip
Y

A2
$446.00
16.3288
$676.03
$503.5140510
Partial excision of lip
Y

A2
$446.00
23.9765
$992.65
$582.6640520
Partial excision of lip
Y

A2
$446.00
16.3288
$676.03
$503.5140525
Reconstruct lip with flap
Y

A2
$446.00
23.9765
$992.65
$582.6640527
Reconstruct lip with flap
Y

A2
$446.00
23.9765
$992.65
$582.6640530
Partial removal of lip
Y

A2
$446.00
23.9765
$992.65
$582.6640650
Repair lip
Y

A2
$464.15
7.4474
$308.33
$425.2040652
Repair lip
Y

A2
$464.15
7.4474
$308.33
$425.2040654
Repair lip
Y

A2
$464.15
7.4474
$308.33
$425.2040700
Repair cleft lip/nasal
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9940701
Repair cleft lip/nasal
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9940702
Repair cleft lip/nasal
Y

R2

39.8776
$1,650.97
$1,650.9740720
Repair cleft lip/nasal
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9940761
Repair cleft lip/nasal
Y

A2
$510.00
39.8776
$1,650.97
$795.2440800
Drainage of mouth lesion
Y

P2

1.4066
$58.23
$58.2340801
Drainage of mouth lesion
Y

A2
$446.00
7.4474
$308.33
$411.5840804
Removal, foreign body, mouth
N

P2

0.631
$26.12
$26.1240805
Removal, foreign body, mouth
Y

P3

3.9581
$163.87
$163.8740806
Incision of lip fold
Y

P3

1.7529
$72.57
$72.5740808
Biopsy of mouth lesion
Y

P2

2.5002
$103.51
$103.5140810
Excision of mouth lesion
Y

P3

2.7072
$112.08
$112.0840812
Excise/repair mouth lesion
Y

P3

3.3985
$140.70
$140.7040814
Excise/repair mouth lesion
Y

A2
$446.00
16.3288
$676.03
$503.5140816
Excision of mouth lesion
Y

A2
$446.00
23.9765
$992.65
$582.6640818
Excise oral mucosa for graft
Y

A2
$150.72
2.5002
$103.51
$138.9240819
Excise lip or cheek fold
Y

A2
$333.00
7.4474
$308.33
$326.8340820
Treatment of mouth lesion
Y

P3

3.8018
$157.40
$157.4040830
Repair mouth laceration
Y

G2

2.5002
$103.51
$103.5140831
Repair mouth laceration
Y

A2
$333.00
7.4474
$308.33
$326.8340840
Reconstruction of mouth
Y

A2
$446.00
23.9765
$992.65
$582.6640842
Reconstruction of mouth
Y

A2
$510.00
23.9765
$992.65
$630.6640843
Reconstruction of mouth
Y

A2
$510.00
23.9765
$992.65
$630.6640844
Reconstruction of mouth
Y

A2
$717.00
39.8776
$1,650.97
$950.4940845
Reconstruction of mouth
Y

A2
$717.00
39.8776
$1,650.97
$950.4941000
Drainage of mouth lesion
Y

P3

2.0079
$83.13
$83.1341005
Drainage of mouth lesion
Y

A2
$150.72
2.5002
$103.51
$138.9241006
Drainage of mouth lesion
Y

A2
$333.00
23.9765
$992.65
$497.9141007
Drainage of mouth lesion
Y

A2
$333.00
16.3288
$676.03
$418.7641008
Drainage of mouth lesion
Y

A2
$333.00
16.3288
$676.03
$418.7641009
Drainage of mouth lesion
Y

A2
$150.72
2.5002
$103.51
$138.9241010
Incision of tongue fold
Y

A2
$333.00
7.4474
$308.33
$326.8341015
Drainage of mouth lesion
Y

A2
$150.72
2.5002
$103.51
$138.9241016
Drainage of mouth lesion
Y

A2
$333.00
7.4474
$308.33
$326.8341017
Drainage of mouth lesion
Y

A2
$333.00
7.4474
$308.33
$326.8341018
Drainage of mouth lesion
Y

A2
$333.00
7.4474
$308.33
$326.8341019
Place needles h&n for rt
Y
NI
G2

23.9765
$992.65
$992.6541100
Biopsy of tongue
Y

P3

2.0983
$86.87
$86.8741105
Biopsy of tongue
Y

P3

2.049
$84.83
$84.8341108
Biopsy of floor of mouth
Y

P3

1.8927
$78.36
$78.3641110
Excision of tongue lesion
Y

P3

2.7321
$113.11
$113.1141112
Excision of tongue lesion
Y

A2
$446.00
16.3288
$676.03
$503.5141113
Excision of tongue lesion
Y

A2
$446.00
16.3288
$676.03
$503.5141114
Excision of tongue lesion
Y

A2
$446.00
23.9765
$992.65
$582.6641115
Excision of tongue fold
Y

P3

3.0777
$127.42
$127.4241116
Excision of mouth lesion
Y

A2
$333.00
16.3288
$676.03
$418.7641120
Partial removal of tongue
Y

A2
$717.00
23.9765
$992.65
$785.9141250
Repair tongue laceration
Y

A2
$150.72
2.5002
$103.51
$138.9241251
Repair tongue laceration
Y

A2
$150.72
2.5002
$103.51
$138.9241252
Repair tongue laceration
Y

A2
$446.00
7.4474
$308.33
$411.58( print page 9892)41500
Fixation of tongue
Y

A2
$333.00
23.9765
$992.65
$497.9141510
Tongue to lip surgery
Y

A2
$333.00
16.3288
$676.03
$418.7641520
Reconstruction, tongue fold
Y

A2
$446.00
7.4474
$308.33
$411.5841800
Drainage of gum lesion
Y

A2
$88.46
1.4066
$58.23
$80.9041805
Removal foreign body, gum
Y

P3

3.0118
$124.69
$124.6941806
Removal foreign body,jawbone
Y

P3

3.8758
$160.46
$160.4641820
Excision, gum, each quadrant
Y

R2

7.4474
$308.33
$308.3341821
Excision of gum flap
Y

G2

7.4474
$308.33
$308.3341822
Excision of gum lesion
Y

P3

3.5796
$148.20
$148.2041823
Excision of gum lesion
Y

P3

4.9455
$204.75
$204.7541825
Excision of gum lesion
Y

P3

2.7813
$115.15
$115.1541826
Excision of gum lesion
Y

P3

3.0941
$128.10
$128.1041827
Excision of gum lesion
Y

A2
$446.00
23.9765
$992.65
$582.6641828
Excision of gum lesion
Y

P3

3.2504
$134.57
$134.5741830
Removal of gum tissue
Y

P3

4.5011
$186.35
$186.3541850
Treatment of gum lesion
Y

R2

16.3288
$676.03
$676.0341870
Gum graft
Y

G2

23.9765
$992.65
$992.6541872
Repair gum
Y

P3

4.5506
$188.40
$188.4041874
Repair tooth socket
Y

P3

4.3202
$178.86
$178.8642000
Drainage mouth roof lesion
Y

A2
$150.72
2.5002
$103.51
$138.9242100
Biopsy roof of mouth
Y

P3

1.7939
$74.27
$74.2742104
Excision lesion, mouth roof
Y

P3

2.5181
$104.25
$104.2542106
Excision lesion, mouth roof
Y

P3

3.1598
$130.82
$130.8242107
Excision lesion, mouth roof
Y

A2
$446.00
23.9765
$992.65
$582.6642120
Remove palate/lesion
Y

A2
$630.00
39.8776
$1,650.97
$885.2442140
Excision of uvula
Y

A2
$446.00
7.4474
$308.33
$411.5842145
Repair palate, pharynx/uvula
Y

A2
$717.00
23.9765
$992.65
$785.9142160
Treatment mouth roof lesion
Y

P3

3.2997
$136.61
$136.6142180
Repair palate
Y

A2
$150.72
2.5002
$103.51
$138.9242182
Repair palate
Y

A2
$446.00
39.8776
$1,650.97
$747.2442200
Reconstruct cleft palate
Y

A2
$717.00
39.8776
$1,650.97
$950.4942205
Reconstruct cleft palate
Y

A2
$717.00
39.8776
$1,650.97
$950.4942210
Reconstruct cleft palate
Y

A2
$717.00
39.8776
$1,650.97
$950.4942215
Reconstruct cleft palate
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9942220
Reconstruct cleft palate
Y

A2
$717.00
39.8776
$1,650.97
$950.4942226
Lengthening of palate
Y

A2
$717.00
39.8776
$1,650.97
$950.4942235
Repair palate
Y

A2
$717.00
16.3288
$676.03
$706.7642260
Repair nose to lip fistula
Y

A2
$630.00
23.9765
$992.65
$720.6642280
Preparation, palate mold
Y

P3

1.728
$71.54
$71.5442281
Insertion, palate prosthesis
Y

G2

16.3288
$676.03
$676.0342300
Drainage of salivary gland
Y

A2
$333.00
16.3288
$676.03
$418.7642305
Drainage of salivary gland
Y

A2
$446.00
16.3288
$676.03
$503.5142310
Drainage of salivary gland
Y

A2
$150.72
2.5002
$103.51
$138.9242320
Drainage of salivary gland
Y

A2
$150.72
2.5002
$103.51
$138.9242330
Removal of salivary stone
Y

P3

2.699
$111.74
$111.7442335
Removal of salivary stone
Y

P3

4.3941
$181.92
$181.9242340
Removal of salivary stone
Y

A2
$446.00
16.3288
$676.03
$503.5142400
Biopsy of salivary gland
Y

P3

1.4975
$62.00
$62.0042405
Biopsy of salivary gland
Y

A2
$446.00
16.3288
$676.03
$503.5142408
Excision of salivary cyst
Y

A2
$510.00
16.3288
$676.03
$551.5142409
Drainage of salivary cyst
Y

A2
$510.00
16.3288
$676.03
$551.5142410
Excise parotid gland/lesion
Y

A2
$510.00
39.8776
$1,650.97
$795.2442415
Excise parotid gland/lesion
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9942420
Excise parotid gland/lesion
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9942425
Excise parotid gland/lesion
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9942440
Excise submaxillary gland
Y

A2
$510.00
39.8776
$1,650.97
$795.2442450
Excise sublingual gland
Y

A2
$446.00
23.9765
$992.65
$582.6642500
Repair salivary duct
Y

A2
$510.00
23.9765
$992.65
$630.6642505
Repair salivary duct
Y

A2
$630.00
39.8776
$1,650.97
$885.2442507
Parotid duct diversion
Y

A2
$510.00
39.8776
$1,650.97
$795.2442508
Parotid duct diversion
Y

A2
$630.00
39.8776
$1,650.97
$885.2442509
Parotid duct diversion
Y

A2
$630.00
39.8776
$1,650.97
$885.2442510
Parotid duct diversion
Y

A2
$630.00
39.8776
$1,650.97
$885.2442550
Injection for salivary x-ray
N

N142600
Closure of salivary fistula
Y

A2
$333.00
16.3288
$676.03
$418.7642650
Dilation of salivary duct
Y

P3

0.9792
$40.54
$40.5442660
Dilation of salivary duct
Y

P3

1.1521
$47.70
$47.7042665
Ligation of salivary duct
Y

A2
$995.00
23.9765
$992.65
$994.4142700
Drainage of tonsil abscess
Y

A2
$150.72
2.5002
$103.51
$138.9242720
Drainage of throat abscess
Y

A2
$333.00
16.3288
$676.03
$418.7642725
Drainage of throat abscess
Y

A2
$446.00
39.8776
$1,650.97
$747.2442800
Biopsy of throat
Y

P3

1.9173
$79.38
$79.3842802
Biopsy of throat
Y

A2
$333.00
16.3288
$676.03
$418.7642804
Biopsy of upper nose/throat
Y

A2
$333.00
16.3288
$676.03
$418.7642806
Biopsy of upper nose/throat
Y

A2
$446.00
23.9765
$992.65
$582.6642808
Excise pharynx lesion
Y

A2
$446.00
16.3288
$676.03
$503.5142809
Remove pharynx foreign body
N

G2

0.631
$26.12
$26.12( print page 9893)42810
Excision of neck cyst
Y

A2
$510.00
23.9765
$992.65
$630.6642815
Excision of neck cyst
Y

A2
$717.00
39.8776
$1,650.97
$950.4942820
Remove tonsils and adenoids
Y

A2
$510.00
22.2557
$921.41
$612.8542821
Remove tonsils and adenoids
Y

A2
$717.00
22.2557
$921.41
$768.1042825
Removal of tonsils
Y

A2
$630.00
22.2557
$921.41
$702.8542826
Removal of tonsils
Y

A2
$630.00
22.2557
$921.41
$702.8542830
Removal of adenoids
Y

A2
$630.00
22.2557
$921.41
$702.8542831
Removal of adenoids
Y

A2
$630.00
22.2557
$921.41
$702.8542835
Removal of adenoids
Y

A2
$630.00
22.2557
$921.41
$702.8542836
Removal of adenoids
Y

A2
$630.00
22.2557
$921.41
$702.8542860
Excision of tonsil tags
Y

A2
$510.00
22.2557
$921.41
$612.8542870
Excision of lingual tonsil
Y

A2
$510.00
22.2557
$921.41
$612.8542890
Partial removal of pharynx
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9942892
Revision of pharyngeal walls
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9942900
Repair throat wound
Y

A2
$333.00
7.4474
$308.33
$326.8342950
Reconstruction of throat
Y

A2
$446.00
23.9765
$992.65
$582.6642955
Surgical opening of throat
Y

A2
$446.00
23.9765
$992.65
$582.6642960
Control throat bleeding
Y

A2
$72.48
1.1251
$46.58
$66.0142962
Control throat bleeding
Y

A2
$446.00
39.8776
$1,650.97
$747.2442970
Control nose/throat bleeding
Y

R2

1.1251
$46.58
$46.5842972
Control nose/throat bleeding
Y

A2
$510.00
16.3288
$676.03
$551.5143030
Throat muscle surgery
Y

G2

16.3288
$676.03
$676.0343200
Esophagus endoscopy
Y

A2
$333.00
8.503
$352.03
$337.7643201
Esoph scope w/submucous inj
Y

A2
$333.00
8.503
$352.03
$337.7643202
Esophagus endoscopy, biopsy
Y

A2
$333.00
8.503
$352.03
$337.7643204
Esoph scope w/sclerosis inj
Y

A2
$333.00
8.503
$352.03
$337.7643205
Esophagus endoscopy/ligation
Y

A2
$333.00
8.503
$352.03
$337.7643215
Esophagus endoscopy
Y

A2
$333.00
8.503
$352.03
$337.7643216
Esophagus endoscopy/lesion
Y

A2
$333.00
8.503
$352.03
$337.7643217
Esophagus endoscopy
Y

A2
$333.00
8.503
$352.03
$337.7643219
Esophagus endoscopy
Y

A2
$333.00
24.9814
$1,034.25
$508.3143220
Esoph endoscopy, dilation
Y

A2
$333.00
8.503
$352.03
$337.7643226
Esoph endoscopy, dilation
Y

A2
$333.00
8.503
$352.03
$337.7643227
Esoph endoscopy, repair
Y

A2
$446.00
8.503
$352.03
$422.5143228
Esoph endoscopy, ablation
Y

A2
$446.00
25.3233
$1,048.41
$596.6043231
Esoph endoscopy w/us exam
Y

A2
$446.00
8.503
$352.03
$422.5143232
Esoph endoscopy w/us fn bx
Y

A2
$446.00
8.503
$352.03
$422.5143234
Upper gi endoscopy, exam
Y

A2
$333.00
8.503
$352.03
$337.7643235
Uppr gi endoscopy, diagnosis
Y

A2
$333.00
8.503
$352.03
$337.7643236
Uppr gi scope w/submuc inj
Y

A2
$446.00
8.503
$352.03
$422.5143237
Endoscopic us exam, esoph
Y

A2
$446.00
8.503
$352.03
$422.5143238
Uppr gi endoscopy w/us fn bx
Y

A2
$446.00
8.503
$352.03
$422.5143239
Upper gi endoscopy, biopsy
Y

A2
$446.00
8.503
$352.03
$422.5143240
Esoph endoscope w/drain cyst
Y

A2
$446.00
8.503
$352.03
$422.5143241
Upper gi endoscopy with tube
Y

A2
$446.00
8.503
$352.03
$422.5143242
Uppr gi endoscopy w/us fn bx
Y

A2
$446.00
8.503
$352.03
$422.5143243
Upper gi endoscopy & inject
Y

A2
$446.00
8.503
$352.03
$422.5143244
Upper gi endoscopy/ligation
Y

A2
$446.00
8.503
$352.03
$422.5143245
Uppr gi scope dilate strictr
Y

A2
$446.00
8.503
$352.03
$422.5143246
Place gastrostomy tube
Y

A2
$446.00
8.503
$352.03
$422.5143247
Operative upper gi endoscopy
Y

A2
$446.00
8.503
$352.03
$422.5143248
Uppr gi endoscopy/guide wire
Y

A2
$446.00
8.503
$352.03
$422.5143249
Esoph endoscopy, dilation
Y

A2
$446.00
8.503
$352.03
$422.5143250
Upper gi endoscopy/tumor
Y

A2
$446.00
8.503
$352.03
$422.5143251
Operative upper gi endoscopy
Y

A2
$446.00
8.503
$352.03
$422.5143255
Operative upper gi endoscopy
Y

A2
$446.00
8.503
$352.03
$422.5143256
Uppr gi endoscopy w/stent
Y

A2
$510.00
24.9814
$1,034.25
$641.0643257
Uppr gi scope w/thrml txmnt
Y

A2
$510.00
25.3233
$1,048.41
$644.6043258
Operative upper gi endoscopy
Y

A2
$510.00
8.503
$352.03
$470.5143259
Endoscopic ultrasound exam
Y

A2
$510.00
8.503
$352.03
$470.5143260
Endo cholangiopancreatograph
Y

A2
$446.00
20.951
$867.39
$551.3543261
Endo cholangiopancreatograph
Y

A2
$446.00
20.951
$867.39
$551.3543262
Endo cholangiopancreatograph
Y

A2
$446.00
20.951
$867.39
$551.3543263
Endo cholangiopancreatograph
Y

A2
$446.00
20.951
$867.39
$551.3543264
Endo cholangiopancreatograph
Y

A2
$446.00
20.951
$867.39
$551.3543265
Endo cholangiopancreatograph
Y

A2
$446.00
20.951
$867.39
$551.3543267
Endo cholangiopancreatograph
Y

A2
$446.00
20.951
$867.39
$551.3543268
Endo cholangiopancreatograph
Y

A2
$446.00
24.9814
$1,034.25
$593.0643269
Endo cholangiopancreatograph
Y

A2
$446.00
24.9814
$1,034.25
$593.0643271
Endo cholangiopancreatograph
Y

A2
$446.00
20.951
$867.39
$551.3543272
Endo cholangiopancreatograph
Y

A2
$446.00
20.951
$867.39
$551.3543450
Dilate esophagus
Y

A2
$333.00
5.8431
$241.91
$310.2343453
Dilate esophagus
Y

A2
$333.00
5.8431
$241.91
$310.2343456
Dilate esophagus
Y

A2
$335.41
5.8431
$241.91
$312.0443458
Dilate esophagus
Y

A2
$335.41
8.503
$352.03
$339.5743600
Biopsy of stomach
Y

A2
$333.00
8.503
$352.03
$337.7643653
Laparoscopy, gastrostomy
Y

A2
$1,339.00
45.5317
$1,885.06
$1,475.52( print page 9894)43750
Place gastrostomy tube
N
CH
D543760
Change gastrostomy tube
Y

A2
$144.98
3.2383
$134.07
$142.2543761
Reposition gastrostomy tube
Y

A2
$333.00
8.503
$352.03
$337.7643870
Repair stomach opening
Y

A2
$333.00
8.503
$352.03
$337.7643886
Revise gastric port, open
Y

G2

20.2069
$836.59
$836.5943887
Remove gastric port, open
Y

G2

4.5263
$187.39
$187.3943888
Change gastric port, open
Y

G2

20.2069
$836.59
$836.5944100
Biopsy of bowel
Y

A2
$333.00
8.503
$352.03
$337.7644312
Revision of ileostomy
Y

A2
$333.00
20.2069
$836.59
$458.9044340
Revision of colostomy
Y

A2
$510.00
20.2069
$836.59
$591.6544360
Small bowel endoscopy
Y

A2
$446.00
9.5292
$394.52
$433.1344361
Small bowel endoscopy/biopsy
Y

A2
$446.00
9.5292
$394.52
$433.1344363
Small bowel endoscopy
Y

A2
$446.00
9.5292
$394.52
$433.1344364
Small bowel endoscopy
Y

A2
$446.00
9.5292
$394.52
$433.1344365
Small bowel endoscopy
Y

A2
$446.00
9.5292
$394.52
$433.1344366
Small bowel endoscopy
Y

A2
$446.00
9.5292
$394.52
$433.1344369
Small bowel endoscopy
Y

A2
$446.00
9.5292
$394.52
$433.1344370
Small bowel endoscopy/stent
Y

A2
$1,339.00
24.9814
$1,034.25
$1,262.8144372
Small bowel endoscopy
Y

A2
$446.00
9.5292
$394.52
$433.1344373
Small bowel endoscopy
Y

A2
$446.00
9.5292
$394.52
$433.1344376
Small bowel endoscopy
Y

A2
$446.00
9.5292
$394.52
$433.1344377
Small bowel endoscopy/biopsy
Y

A2
$446.00
9.5292
$394.52
$433.1344378
Small bowel endoscopy
Y

A2
$446.00
9.5292
$394.52
$433.1344379
S bowel endoscope w/stent
Y

A2
$1,339.00
24.9814
$1,034.25
$1,262.8144380
Small bowel endoscopy
Y

A2
$333.00
9.5292
$394.52
$348.3844382
Small bowel endoscopy
Y

A2
$333.00
9.5292
$394.52
$348.3844383
Ileoscopy w/stent
Y

A2
$1,339.00
24.9814
$1,034.25
$1,262.8144385
Endoscopy of bowel pouch
Y

A2
$333.00
8.8486
$366.34
$341.3444386
Endoscopy, bowel pouch/biop
Y

A2
$333.00
8.8486
$366.34
$341.3444388
Colonoscopy
Y

A2
$333.00
8.8486
$366.34
$341.3444389
Colonoscopy with biopsy
Y

A2
$333.00
8.8486
$366.34
$341.3444390
Colonoscopy for foreign body
Y

A2
$333.00
8.8486
$366.34
$341.3444391
Colonoscopy for bleeding
Y

A2
$333.00
8.8486
$366.34
$341.3444392
Colonoscopy & polypectomy
Y

A2
$333.00
8.8486
$366.34
$341.3444393
Colonoscopy, lesion removal
Y

A2
$333.00
8.8486
$366.34
$341.3444394
Colonoscopy w/snare
Y

A2
$333.00
8.8486
$366.34
$341.3444397
Colonoscopy w/stent
Y

A2
$333.00
24.9814
$1,034.25
$508.3144500
Intro, gastrointestinal tube
Y
CH
G2

3.2383
$134.07
$134.0744701
Intraop colon lavage add-on
N

N145000
Drainage of pelvic abscess
Y

A2
$312.07
10.9132
$451.82
$347.0145005
Drainage of rectal abscess
Y

A2
$446.00
10.9132
$451.82
$447.4645020
Drainage of rectal abscess
Y

A2
$446.00
10.9132
$451.82
$447.4645100
Biopsy of rectum
Y

A2
$333.00
22.7451
$941.67
$485.1745108
Removal of anorectal lesion
Y

A2
$446.00
22.7451
$941.67
$569.9245150
Excision of rectal stricture
Y

A2
$446.00
22.7451
$941.67
$569.9245160
Excision of rectal lesion
Y

A2
$446.00
22.7451
$941.67
$569.9245170
Excision of rectal lesion
Y

A2
$446.00
22.7451
$941.67
$569.9245190
Destruction, rectal tumor
Y

A2
$1,339.00
22.7451
$941.67
$1,239.6745300
Proctosigmoidoscopy dx
Y

P3

1.4318
$59.28
$59.2845303
Proctosigmoidoscopy dilate
Y

P2

8.7031
$360.32
$360.3245305
Proctosigmoidoscopy w/bx
Y

A2
$333.00
8.7031
$360.32
$339.8345307
Proctosigmoidoscopy fb
Y

A2
$333.00
21.4632
$888.60
$471.9045308
Proctosigmoidoscopy removal
Y

A2
$333.00
8.7031
$360.32
$339.8345309
Proctosigmoidoscopy removal
Y

A2
$333.00
8.7031
$360.32
$339.8345315
Proctosigmoidoscopy removal
Y

A2
$333.00
8.7031
$360.32
$339.8345317
Proctosigmoidoscopy bleed
Y

A2
$333.00
8.7031
$360.32
$339.8345320
Proctosigmoidoscopy ablate
Y

A2
$333.00
21.4632
$888.60
$471.9045321
Proctosigmoidoscopy volvul
Y

A2
$333.00
21.4632
$888.60
$471.9045327
Proctosigmoidoscopy w/stent
Y

A2
$333.00
24.9814
$1,034.25
$508.3145330
Diagnostic sigmoidoscopy
Y

P3

1.9748
$81.76
$81.7645331
Sigmoidoscopy and biopsy
Y

A2
$299.24
5.0972
$211.03
$277.1945332
Sigmoidoscopy w/fb removal
Y

A2
$299.24
5.0972
$211.03
$277.1945333
Sigmoidoscopy & polypectomy
Y

A2
$333.00
8.7031
$360.32
$339.8345334
Sigmoidoscopy for bleeding
Y

A2
$333.00
8.7031
$360.32
$339.8345335
Sigmoidoscopy w/submuc inj
Y

A2
$299.24
5.0972
$211.03
$277.1945337
Sigmoidoscopy & decompress
Y

A2
$299.24
5.0972
$211.03
$277.1945338
Sigmoidoscopy w/tumr remove
Y

A2
$333.00
8.7031
$360.32
$339.8345339
Sigmoidoscopy w/ablate tumr
Y

A2
$333.00
8.7031
$360.32
$339.8345340
Sig w/balloon dilation
Y

A2
$333.00
8.7031
$360.32
$339.8345341
Sigmoidoscopy w/ultrasound
Y

A2
$333.00
8.7031
$360.32
$339.8345342
Sigmoidoscopy w/us guide bx
Y

A2
$333.00
8.7031
$360.32
$339.8345345
Sigmoidoscopy w/stent
Y

A2
$333.00
24.9814
$1,034.25
$508.3145355
Surgical colonoscopy
Y

A2
$333.00
8.8486
$366.34
$341.3445378
Diagnostic colonoscopy
Y

A2
$446.00
8.8486
$366.34
$426.0945379
Colonoscopy w/fb removal
Y

A2
$446.00
8.8486
$366.34
$426.0945380
Colonoscopy and biopsy
Y

A2
$446.00
8.8486
$366.34
$426.0945381
Colonoscopy, submucous inj
Y

A2
$446.00
8.8486
$366.34
$426.09( print page 9895)45382
Colonoscopy/control bleeding
Y

A2
$446.00
8.8486
$366.34
$426.0945383
Lesion removal colonoscopy
Y

A2
$446.00
8.8486
$366.34
$426.0945384
Lesion remove colonoscopy
Y

A2
$446.00
8.8486
$366.34
$426.0945385
Lesion removal colonoscopy
Y

A2
$446.00
8.8486
$366.34
$426.0945386
Colonoscopy dilate stricture
Y

A2
$446.00
8.8486
$366.34
$426.0945387
Colonoscopy w/stent
Y

A2
$333.00
24.9814
$1,034.25
$508.3145391
Colonoscopy w/endoscope us
Y

A2
$446.00
8.8486
$366.34
$426.0945392
Colonoscopy w/endoscopic fnb
Y

A2
$446.00
8.8486
$366.34
$426.0945500
Repair of rectum
Y

A2
$446.00
22.7451
$941.67
$569.9245505
Repair of rectum
Y

A2
$446.00
30.1606
$1,248.68
$646.6745520
Treatment of rectal prolapse
Y

P2

0.793
$32.83
$32.8345560
Repair of rectocele
Y

A2
$446.00
30.1606
$1,248.68
$646.6745900
Reduction of rectal prolapse
Y

A2
$312.07
4.7935
$198.46
$283.6745905
Dilation of anal sphincter
Y

A2
$333.00
22.7451
$941.67
$485.1745910
Dilation of rectal narrowing
Y

A2
$333.00
22.7451
$941.67
$485.1745915
Remove rectal obstruction
Y

A2
$312.07
10.9132
$451.82
$347.0145990
Surg dx exam, anorectal
Y

A2
$312.07
22.7451
$941.67
$469.4746020
Placement of seton
Y

A2
$510.00
22.7451
$941.67
$617.9246030
Removal of rectal marker
Y

A2
$312.07
4.7935
$198.46
$283.6746040
Incision of rectal abscess
Y

A2
$510.00
22.7451
$941.67
$617.9246045
Incision of rectal abscess
Y

A2
$446.00
22.7451
$941.67
$569.9246050
Incision of anal abscess
Y

A2
$312.07
10.9132
$451.82
$347.0146060
Incision of rectal abscess
Y

A2
$446.00
22.7451
$941.67
$569.9246070
Incision of anal septum
Y

G2

10.9132
$451.82
$451.8246080
Incision of anal sphincter
Y

A2
$510.00
22.7451
$941.67
$617.9246083
Incise external hemorrhoid
Y

P2

2.0077
$83.12
$83.1246200
Removal of anal fissure
Y

A2
$446.00
22.7451
$941.67
$569.9246210
Removal of anal crypt
Y

A2
$446.00
22.7451
$941.67
$569.9246211
Removal of anal crypts
Y

A2
$446.00
22.7451
$941.67
$569.9246220
Removal of anal tag
Y

A2
$333.00
22.7451
$941.67
$485.1746221
Ligation of hemorrhoid(s)
Y

P3

2.6251
$108.68
$108.6846230
Removal of anal tags
Y

A2
$333.00
22.7451
$941.67
$485.1746250
Hemorrhoidectomy
Y

A2
$510.00
22.7451
$941.67
$617.9246255
Hemorrhoidectomy
Y

A2
$510.00
22.7451
$941.67
$617.9246257
Remove hemorrhoids & fissure
Y

A2
$510.00
22.7451
$941.67
$617.9246258
Remove hemorrhoids & fistula
Y

A2
$510.00
22.7451
$941.67
$617.9246260
Hemorrhoidectomy
Y

A2
$510.00
22.7451
$941.67
$617.9246261
Remove hemorrhoids & fissure
Y

A2
$630.00
22.7451
$941.67
$707.9246262
Remove hemorrhoids & fistula
Y

A2
$630.00
22.7451
$941.67
$707.9246270
Removal of anal fistula
Y

A2
$510.00
22.7451
$941.67
$617.9246275
Removal of anal fistula
Y

A2
$510.00
22.7451
$941.67
$617.9246280
Removal of anal fistula
Y

A2
$630.00
22.7451
$941.67
$707.9246285
Removal of anal fistula
Y

A2
$333.00
22.7451
$941.67
$485.1746288
Repair anal fistula
Y

A2
$630.00
22.7451
$941.67
$707.9246320
Removal of hemorrhoid clot
Y

P3

1.8678
$77.33
$77.3346500
Injection into hemorrhoid(s)
Y

P3

2.3536
$97.44
$97.4446505
Chemodenervation anal musc
Y

G2

4.7935
$198.46
$198.4646600
Diagnostic anoscopy
N

P2

0.631
$26.12
$26.1246604
Anoscopy and dilation
Y

P2

8.7031
$360.32
$360.3246606
Anoscopy and biopsy
Y

P3

3.1516
$130.48
$130.4846608
Anoscopy, remove for body
Y

A2
$333.00
8.7031
$360.32
$339.8346610
Anoscopy, remove lesion
Y

A2
$333.00
21.4632
$888.60
$471.9046611
Anoscopy
Y

A2
$333.00
8.7031
$360.32
$339.8346612
Anoscopy, remove lesions
Y

A2
$333.00
21.4632
$888.60
$471.9046614
Anoscopy, control bleeding
Y

P3

1.7529
$72.57
$72.5746615
Anoscopy
Y

A2
$446.00
21.4632
$888.60
$556.6546700
Repair of anal stricture
Y

A2
$510.00
22.7451
$941.67
$617.9246706
Repr of anal fistula w/glue
Y

A2
$333.00
30.1606
$1,248.68
$561.9246750
Repair of anal sphincter
Y

A2
$510.00
30.1606
$1,248.68
$694.6746753
Reconstruction of anus
Y

A2
$510.00
22.7451
$941.67
$617.9246754
Removal of suture from anus
Y

A2
$446.00
22.7451
$941.67
$569.9246760
Repair of anal sphincter
Y

A2
$446.00
30.1606
$1,248.68
$646.6746761
Repair of anal sphincter
Y

A2
$510.00
30.1606
$1,248.68
$694.6746762
Implant artificial sphincter
Y

A2
$995.00
30.1606
$1,248.68
$1,058.4246900
Destruction, anal lesion(s)
Y

P3

2.5673
$106.29
$106.2946910
Destruction, anal lesion(s)
Y

P3

2.7895
$115.49
$115.4946916
Cryosurgery, anal lesion(s)
Y

P2

1.4595
$60.42
$60.4246917
Laser surgery, anal lesions
Y

A2
$333.00
19.9041
$824.05
$455.7646922
Excision of anal lesion(s)
Y

A2
$333.00
19.9041
$824.05
$455.7646924
Destruction, anal lesion(s)
Y

A2
$333.00
19.9041
$824.05
$455.7646934
Destruction of hemorrhoids
Y

P3

4.3777
$181.24
$181.2446935
Destruction of hemorrhoids
Y

P3

3.0118
$124.69
$124.6946936
Destruction of hemorrhoids
Y

P3

4.5753
$189.42
$189.4246937
Cryotherapy of rectal lesion
Y

A2
$446.00
22.7451
$941.67
$569.9246938
Cryotherapy of rectal lesion
Y

A2
$446.00
30.1606
$1,248.68
$646.6746940
Treatment of anal fissure
Y

P3

1.9915
$82.45
$82.4546942
Treatment of anal fissure
Y

P3

1.9091
$79.04
$79.04( print page 9896)46945
Ligation of hemorrhoids
Y

P3

3.3161
$137.29
$137.2946946
Ligation of hemorrhoids
Y

A2
$333.00
10.9132
$451.82
$362.7146947
Hemorrhoidopexy by stapling
Y

A2
$995.00
30.1606
$1,248.68
$1,058.4247000
Needle biopsy of liver
Y

A2
$333.00
9.3354
$386.49
$346.3747001
Needle biopsy, liver add-on
N

N147382
Percut ablate liver rf
Y

G2

42.998
$1,780.16
$1,780.1647500
Injection for liver x-rays
N

N147505
Injection for liver x-rays
N

N147510
Insert catheter, bile duct
Y

A2
$446.00
28.6884
$1,187.73
$631.4347511
Insert bile duct drain
Y

A2
$1,245.85
28.6884
$1,187.73
$1,231.3247525
Change bile duct catheter
Y

A2
$333.00
15.3545
$635.69
$408.6747530
Revise/reinsert bile tube
Y

A2
$333.00
15.3545
$635.69
$408.6747552
Biliary endoscopy thru skin
Y

A2
$446.00
28.6884
$1,187.73
$631.4347553
Biliary endoscopy thru skin
Y

A2
$510.00
28.6884
$1,187.73
$679.4347554
Biliary endoscopy thru skin
Y

A2
$510.00
28.6884
$1,187.73
$679.4347555
Biliary endoscopy thru skin
Y

A2
$510.00
28.6884
$1,187.73
$679.4347556
Biliary endoscopy thru skin
Y

A2
$1,245.85
28.6884
$1,187.73
$1,231.3247560
Laparoscopy w/cholangio
Y

A2
$510.00
34.3958
$1,424.02
$738.5147561
Laparo w/cholangio/biopsy
Y

A2
$510.00
34.3958
$1,424.02
$738.5147562
Laparoscopic cholecystectomy
Y

G2

45.5317
$1,885.06
$1,885.0647563
Laparo cholecystectomy/graph
Y

G2

45.5317
$1,885.06
$1,885.0647564
Laparo cholecystectomy/explr
Y

G2

45.5317
$1,885.06
$1,885.0647630
Remove bile duct stone
Y

A2
$510.00
28.6884
$1,187.73
$679.4348102
Needle biopsy, pancreas
Y

A2
$333.00
9.3354
$386.49
$346.3749080
Puncture, peritoneal cavity
Y

A2
$222.78
5.2024
$215.38
$220.9349081
Removal of abdominal fluid
Y

A2
$222.78
5.2024
$215.38
$220.9349180
Biopsy, abdominal mass
Y

A2
$333.00
9.3354
$386.49
$346.3749250
Excision of umbilicus
Y

A2
$630.00
25.6947
$1,063.79
$738.4549320
Diag laparo separate proc
Y

A2
$510.00
34.3958
$1,424.02
$738.5149321
Laparoscopy, biopsy
Y

A2
$630.00
34.3958
$1,424.02
$828.5149322
Laparoscopy, aspiration
Y

A2
$630.00
34.3958
$1,424.02
$828.5149400
Air injection into abdomen
N

N149402
Remove foreign body, adbomen
Y

A2
$446.00
25.6947
$1,063.79
$600.4549419
Insrt abdom cath for chemotx
Y

A2
$333.00
29.6965
$1,229.46
$557.1249420
Insert abdom drain, temp
Y

A2
$333.00
30.7096
$1,271.41
$567.6049421
Insert abdom drain, perm
Y

A2
$333.00
30.7096
$1,271.41
$567.6049422
Remove perm cannula/catheter
Y

A2
$333.00
23.9802
$992.80
$497.9549423
Exchange drainage catheter
Y

G2

15.3545
$635.69
$635.6949424
Assess cyst, contrast inject
N

N149426
Revise abdomen-venous shunt
Y

A2
$446.00
25.6947
$1,063.79
$600.4549427
Injection, abdominal shunt
N

N149429
Removal of shunt
Y

G2

23.9802
$992.80
$992.8049440
Place gastrostomy tube perc
Y
NI
G2

8.503
$352.03
$352.0349441
Place duod/jej tube perc
Y
NI
G2

8.503
$352.03
$352.0349446
Change g-tube to g-j perc
Y
NI
G2

8.503
$352.03
$352.0349450
Replace g/c tube perc
Y
NI
G2

3.2383
$134.07
$134.0749451
Replace duod/jej tube perc
Y
NI
G2

3.2383
$134.07
$134.0749452
Replace g-j tube perc
Y
NI
G2

3.2383
$134.07
$134.0749460
Fix g/colon tube w/device
Y
NI
G2

3.2383
$134.07
$134.0749465
Fluoro exam of g/colon tube
N
NI
N149495
Rpr ing hernia baby, reduc
Y

A2
$630.00
30.6788
$1,270.13
$790.0349496
Rpr ing hernia baby, blocked
Y

A2
$630.00
30.6788
$1,270.13
$790.0349500
Rpr ing hernia, init, reduce
Y

A2
$630.00
30.6788
$1,270.13
$790.0349501
Rpr ing hernia, init blocked
Y

A2
$1,339.00
30.6788
$1,270.13
$1,321.7849505
Prp i/hern init reduc >5 yr
Y

A2
$630.00
30.6788
$1,270.13
$790.0349507
Prp i/hern init block >5 yr
Y

A2
$1,339.00
30.6788
$1,270.13
$1,321.7849520
Rerepair ing hernia, reduce
Y

A2
$995.00
30.6788
$1,270.13
$1,063.7849521
Rerepair ing hernia, blocked
Y

A2
$1,339.00
30.6788
$1,270.13
$1,321.7849525
Repair ing hernia, sliding
Y

A2
$630.00
30.6788
$1,270.13
$790.0349540
Repair lumbar hernia
Y

A2
$446.00
30.6788
$1,270.13
$652.0349550
Rpr rem hernia, init, reduce
Y

A2
$717.00
30.6788
$1,270.13
$855.2849553
Rpr fem hernia, init blocked
Y

A2
$1,339.00
30.6788
$1,270.13
$1,321.7849555
Rerepair fem hernia, reduce
Y

A2
$717.00
30.6788
$1,270.13
$855.2849557
Rerepair fem hernia, blocked
Y

A2
$1,339.00
30.6788
$1,270.13
$1,321.7849560
Rpr ventral hern init, reduc
Y

A2
$630.00
30.6788
$1,270.13
$790.0349561
Rpr ventral hern init, block
Y

A2
$1,339.00
30.6788
$1,270.13
$1,321.7849565
Rerepair ventrl hern, reduce
Y

A2
$630.00
30.6788
$1,270.13
$790.0349566
Rerepair ventrl hern, block
Y

A2
$1,339.00
30.6788
$1,270.13
$1,321.7849568
Hernia repair w/mesh
Y

A2
$995.00
30.6788
$1,270.13
$1,063.7849570
Rpr epigastric hern, reduce
Y

A2
$630.00
30.6788
$1,270.13
$790.0349572
Rpr epigastric hern, blocked
Y

A2
$1,339.00
30.6788
$1,270.13
$1,321.7849580
Rpr umbil hern, reduc < 5 yr
Y

A2
$630.00
30.6788
$1,270.13
$790.0349582
Rpr umbil hern, block < 5 yr
Y

A2
$1,339.00
30.6788
$1,270.13
$1,321.7849585
Rpr umbil hern, reduc > 5 yr
Y

A2
$630.00
30.6788
$1,270.13
$790.0349587
Rpr umbil hern, block > 5 yr
Y

A2
$1,339.00
30.6788
$1,270.13
$1,321.7849590
Repair spigelian hernia
Y

A2
$510.00
30.6788
$1,270.13
$700.0349600
Repair umbilical lesion
Y

A2
$630.00
30.6788
$1,270.13
$790.03( print page 9897)49650
Laparo hernia repair initial
Y

A2
$630.00
45.5317
$1,885.06
$943.7749651
Laparo hernia repair recur
Y

A2
$995.00
45.5317
$1,885.06
$1,217.5250200
Biopsy of kidney
Y

A2
$333.00
9.3354
$386.49
$346.3750382
Change ureter stent, percut
Y

G2

24.7749
$1,025.71
$1,025.7150384
Remove ureter stent, percut
Y

G2

17.942
$742.82
$742.8250385
Change stent via transureth
Y
NI
G2

17.942
$742.82
$742.8250386
Remove stent via transureth
Y
NI
G2

5.9735
$247.31
$247.3150387
Change ext/int ureter stent
Y

G2

15.3545
$635.69
$635.6950389
Remove renal tube w/fluoro
Y

G2

5.9735
$247.31
$247.3150390
Drainage of kidney lesion
Y

A2
$333.00
9.3354
$386.49
$346.3750391
Instll rx agnt into rnal tub
Y

P2

1.0356
$42.87
$42.8750392
Insert kidney drain
Y

A2
$333.00
17.942
$742.82
$435.4650393
Insert ureteral tube
Y

A2
$333.00
24.7749
$1,025.71
$506.1850394
Injection for kidney x-ray
N

N150395
Create passage to kidney
Y

A2
$333.00
17.942
$742.82
$435.4650396
Measure kidney pressure
Y

A2
$131.50
2.0077
$83.12
$119.4150398
Change kidney tube
Y

A2
$333.00
15.3545
$635.69
$408.6750551
Kidney endoscopy
Y

A2
$333.00
5.9735
$247.31
$311.5850553
Kidney endoscopy
Y

A2
$333.00
24.7749
$1,025.71
$506.1850555
Kidney endoscopy & biopsy
Y

A2
$333.00
5.9735
$247.31
$311.5850557
Kidney endoscopy & treatment
Y

A2
$333.00
24.7749
$1,025.71
$506.1850561
Kidney endoscopy & treatment
Y

A2
$333.00
24.7749
$1,025.71
$506.1850562
Renal scope w/tumor resect
Y

G2

5.9735
$247.31
$247.3150570
Kidney endoscopy
Y

G2

5.9735
$247.31
$247.3150572
Kidney endoscopy
Y

G2

5.9735
$247.31
$247.3150574
Kidney endoscopy & biopsy
Y

G2

5.9735
$247.31
$247.3150575
Kidney endoscopy
Y

G2

36.0774
$1,493.64
$1,493.6450576
Kidney endoscopy & treatment
Y

G2

17.942
$742.82
$742.8250580
Kidney endoscopy & treatment
Y
CH
G2

17.942
$742.82
$742.8250590
Fragmenting of kidney stone
Y

G2

41.5299
$1,719.38
$1,719.3850592
Perc rf ablate renal tumor
Y

G2

42.998
$1,780.16
$1,780.1650684
Injection for ureter x-ray
N

N150686
Measure ureter pressure
Y

P2

1.0356
$42.87
$42.8750688
Change of ureter tube/stent
Y

A2
$333.00
15.3545
$635.69
$408.6750690
Injection for ureter x-ray
N

N150947
Laparo new ureter/bladder
Y

A2
$1,339.00
45.5317
$1,885.06
$1,475.5250948
Laparo new ureter/bladder
Y

A2
$1,339.00
45.5317
$1,885.06
$1,475.5250951
Endoscopy of ureter
Y

A2
$333.00
5.9735
$247.31
$311.5850953
Endoscopy of ureter
Y

A2
$333.00
5.9735
$247.31
$311.5850955
Ureter endoscopy & biopsy
Y

A2
$333.00
24.7749
$1,025.71
$506.1850957
Ureter endoscopy & treatment
Y

A2
$333.00
24.7749
$1,025.71
$506.1850961
Ureter endoscopy & treatment
Y

A2
$333.00
24.7749
$1,025.71
$506.1850970
Ureter endoscopy
Y

A2
$333.00
5.9735
$247.31
$311.5850972
Ureter endoscopy & catheter
Y

A2
$333.00
5.9735
$247.31
$311.5850974
Ureter endoscopy & biopsy
Y

A2
$333.00
17.942
$742.82
$435.4650976
Ureter endoscopy & treatment
Y

A2
$333.00
17.942
$742.82
$435.4650980
Ureter endoscopy & treatment
Y

A2
$333.00
24.7749
$1,025.71
$506.1851000
Drainage of bladder
N
CH
D551005
Drainage of bladder
N
CH
D551010
Drainage of bladder
N
CH
D551020
Incise & treat bladder
Y

A2
$630.00
24.7749
$1,025.71
$728.9351030
Incise & treat bladder
Y

A2
$630.00
24.7749
$1,025.71
$728.9351040
Incise & drain bladder
Y

A2
$630.00
24.7749
$1,025.71
$728.9351045
Incise bladder/drain ureter
Y

A2
$399.24
5.9735
$247.31
$361.2651050
Removal of bladder stone
Y

A2
$630.00
24.7749
$1,025.71
$728.9351065
Remove ureter calculus
Y

A2
$630.00
24.7749
$1,025.71
$728.9351080
Drainage of bladder abscess
Y

A2
$333.00
18.3197
$758.45
$439.3651100
Drain bladder by needle
Y
NI
P3

0.757
$31.34
$31.3451101
Drain bladder by trocar/cath
Y
NI
P2

1.0356
$42.87
$42.8751102
Drain bl w/cath insertion
Y
NI
A2
$333.00
19.3414
$800.75
$449.9451500
Removal of bladder cyst
Y

A2
$630.00
30.6788
$1,270.13
$790.0351520
Removal of bladder lesion
Y

A2
$630.00
24.7749
$1,025.71
$728.9351600
Injection for bladder x-ray
N

N151605
Preparation for bladder xray
N

N151610
Injection for bladder x-ray
N

N151700
Irrigation of bladder
Y

P3

1.2756
$52.81
$52.8151701
Insert bladder catheter
N

P2

0.631
$26.12
$26.1251702
Insert temp bladder cath
N

P2

0.631
$26.12
$26.1251703
Insert bladder cath, complex
Y

P2

1.0356
$42.87
$42.8751705
Change of bladder tube
Y

P3

1.7693
$73.25
$73.2551710
Change of bladder tube
Y

A2
$333.00
15.3545
$635.69
$408.6751715
Endoscopic injection/implant
Y

A2
$510.00
29.7864
$1,233.19
$690.8051720
Treatment of bladder lesion
Y

P3

1.3823
$57.23
$57.2351725
Simple cystometrogram
Y

P2

3.0469
$126.14
$126.1451726
Complex cystometrogram
Y

A2
$209.48
3.0469
$126.14
$188.6551736
Urine flow measurement
Y

P3

0.4444
$18.40
$18.4051741
Electro-uroflowmetry, first
Y

P3

0.5101
$21.12
$21.12( print page 9898)51772
Urethra pressure profile
Y

A2
$131.50
2.0077
$83.12
$119.4151784
Anal/urinary muscle study
Y

P2

1.0356
$42.87
$42.8751785
Anal/urinary muscle study
Y

A2
$66.92
2.0077
$83.12
$70.9751792
Urinary reflex study
Y

P2

1.0356
$42.87
$42.8751795
Urine voiding pressure study
Y

P2

2.0077
$83.12
$83.1251797
Intraabdominal pressure test
Y

P2

2.0077
$83.12
$83.1251798
Us urine capacity measure
N

P3

0.3867
$16.01
$16.0151880
Repair of bladder opening
Y

A2
$333.00
24.7749
$1,025.71
$506.1851992
Laparo sling operation
Y

A2
$717.00
45.5317
$1,885.06
$1,009.0252000
Cystoscopy
Y

A2
$333.00
5.9735
$247.31
$311.5852001
Cystoscopy, removal of clots
Y

A2
$399.24
17.942
$742.82
$485.1452005
Cystoscopy & ureter catheter
Y

A2
$446.00
17.942
$742.82
$520.2152007
Cystoscopy and biopsy
Y

A2
$446.00
24.7749
$1,025.71
$590.9352010
Cystoscopy & duct catheter
Y

A2
$399.24
5.9735
$247.31
$361.2652204
Cystoscopy w/biopsy(s)
Y

A2
$446.00
17.942
$742.82
$520.2152214
Cystoscopy and treatment
Y

A2
$446.00
24.7749
$1,025.71
$590.9352224
Cystoscopy and treatment
Y

A2
$446.00
24.7749
$1,025.71
$590.9352234
Cystoscopy and treatment
Y

A2
$446.00
24.7749
$1,025.71
$590.9352235
Cystoscopy and treatment
Y

A2
$510.00
24.7749
$1,025.71
$638.9352240
Cystoscopy and treatment
Y

A2
$510.00
24.7749
$1,025.71
$638.9352250
Cystoscopy and radiotracer
Y

A2
$630.00
24.7749
$1,025.71
$728.9352260
Cystoscopy and treatment
Y

A2
$446.00
17.942
$742.82
$520.2152265
Cystoscopy and treatment
Y

P2

5.9735
$247.31
$247.3152270
Cystoscopy & revise urethra
Y

A2
$446.00
17.942
$742.82
$520.2152275
Cystoscopy & revise urethra
Y

A2
$446.00
24.7749
$1,025.71
$590.9352276
Cystoscopy and treatment
Y

A2
$510.00
24.7749
$1,025.71
$638.9352277
Cystoscopy and treatment
Y

A2
$446.00
24.7749
$1,025.71
$590.9352281
Cystoscopy and treatment
Y

A2
$446.00
17.942
$742.82
$520.2152282
Cystoscopy, implant stent
Y

A2
$1,339.00
36.0774
$1,493.64
$1,377.6652283
Cystoscopy and treatment
Y

A2
$446.00
24.7749
$1,025.71
$590.9352285
Cystoscopy and treatment
Y

A2
$446.00
17.942
$742.82
$520.2152290
Cystoscopy and treatment
Y

A2
$446.00
17.942
$742.82
$520.2152300
Cystoscopy and treatment
Y

A2
$446.00
24.7749
$1,025.71
$590.9352301
Cystoscopy and treatment
Y

A2
$510.00
24.7749
$1,025.71
$638.9352305
Cystoscopy and treatment
Y

A2
$446.00
24.7749
$1,025.71
$590.9352310
Cystoscopy and treatment
Y

A2
$399.24
17.942
$742.82
$485.1452315
Cystoscopy and treatment
Y

A2
$446.00
24.7749
$1,025.71
$590.9352317
Remove bladder stone
Y

A2
$333.00
24.7749
$1,025.71
$506.1852318
Remove bladder stone
Y

A2
$446.00
24.7749
$1,025.71
$590.9352320
Cystoscopy and treatment
Y

A2
$717.00
24.7749
$1,025.71
$794.1852325
Cystoscopy, stone removal
Y

A2
$630.00
24.7749
$1,025.71
$728.9352327
Cystoscopy, inject material
Y

A2
$446.00
24.7749
$1,025.71
$590.9352330
Cystoscopy and treatment
Y

A2
$446.00
24.7749
$1,025.71
$590.9352332
Cystoscopy and treatment
Y

A2
$446.00
24.7749
$1,025.71
$590.9352334
Create passage to kidney
Y

A2
$510.00
24.7749
$1,025.71
$638.9352341
Cysto w/ureter stricture tx
Y

A2
$510.00
24.7749
$1,025.71
$638.9352342
Cysto w/up stricture tx
Y

A2
$510.00
24.7749
$1,025.71
$638.9352343
Cysto w/renal stricture tx
Y

A2
$510.00
24.7749
$1,025.71
$638.9352344
Cysto/uretero, stricture tx
Y

A2
$510.00
24.7749
$1,025.71
$638.9352345
Cysto/uretero w/up stricture
Y

A2
$510.00
24.7749
$1,025.71
$638.9352346
Cystouretero w/renal strict
Y

A2
$510.00
24.7749
$1,025.71
$638.9352351
Cystouretero & or pyeloscope
Y

A2
$510.00
24.7749
$1,025.71
$638.9352352
Cystouretero w/stone remove
Y

A2
$630.00
24.7749
$1,025.71
$728.9352353
Cystouretero w/lithotripsy
Y

A2
$630.00
36.0774
$1,493.64
$845.9152354
Cystouretero w/biopsy
Y

A2
$630.00
24.7749
$1,025.71
$728.9352355
Cystouretero w/excise tumor
Y

A2
$630.00
24.7749
$1,025.71
$728.9352400
Cystouretero w/congen repr
Y

A2
$510.00
24.7749
$1,025.71
$638.9352402
Cystourethro cut ejacul duct
Y

A2
$510.00
24.7749
$1,025.71
$638.9352450
Incision of prostate
Y

A2
$510.00
24.7749
$1,025.71
$638.9352500
Revision of bladder neck
Y

A2
$510.00
24.7749
$1,025.71
$638.9352510
Dilation prostatic urethra
N
CH
D552601
Prostatectomy (turp)
Y

A2
$630.00
36.0774
$1,493.64
$845.9152606
Control postop bleeding
Y

A2
$333.00
24.7749
$1,025.71
$506.1852612
Prostatectomy, first stage
Y

A2
$446.00
36.0774
$1,493.64
$707.9152614
Prostatectomy, second stage
Y

A2
$333.00
36.0774
$1,493.64
$623.1652620
Remove residual prostate
Y

A2
$333.00
36.0774
$1,493.64
$623.1652630
Remove prostate regrowth
Y

A2
$446.00
36.0774
$1,493.64
$707.9152640
Relieve bladder contracture
Y

A2
$446.00
24.7749
$1,025.71
$590.9352647
Laser surgery of prostate
Y

A2
$1,339.00
45.2042
$1,871.50
$1,472.1352648
Laser surgery of prostate
Y

A2
$1,339.00
45.2042
$1,871.50
$1,472.1352700
Drainage of prostate abscess
Y

A2
$446.00
24.7749
$1,025.71
$590.9353000
Incision of urethra
Y

A2
$333.00
19.1505
$792.85
$447.9653010
Incision of urethra
Y

A2
$333.00
19.1505
$792.85
$447.9653020
Incision of urethra
Y

A2
$333.00
19.1505
$792.85
$447.9653025
Incision of urethra
Y

R2

19.1505
$792.85
$792.8553040
Drainage of urethra abscess
Y

A2
$446.00
19.1505
$792.85
$532.7153060
Drainage of urethra abscess
Y

P3

1.7198
$71.20
$71.20( print page 9899)53080
Drainage of urinary leakage
Y

A2
$510.00
19.1505
$792.85
$580.7153085
Drainage of urinary leakage
Y

G2

19.1505
$792.85
$792.8553200
Biopsy of urethra
Y

A2
$333.00
19.1505
$792.85
$447.9653210
Removal of urethra
Y

A2
$717.00
29.7864
$1,233.19
$846.0553215
Removal of urethra
Y

A2
$717.00
19.1505
$792.85
$735.9653220
Treatment of urethra lesion
Y

A2
$446.00
29.7864
$1,233.19
$642.8053230
Removal of urethra lesion
Y

A2
$446.00
29.7864
$1,233.19
$642.8053235
Removal of urethra lesion
Y

A2
$510.00
19.1505
$792.85
$580.7153240
Surgery for urethra pouch
Y

A2
$446.00
29.7864
$1,233.19
$642.8053250
Removal of urethra gland
Y

A2
$446.00
19.1505
$792.85
$532.7153260
Treatment of urethra lesion
Y

A2
$446.00
19.1505
$792.85
$532.7153265
Treatment of urethra lesion
Y

A2
$446.00
19.1505
$792.85
$532.7153270
Removal of urethra gland
Y

A2
$446.00
19.1505
$792.85
$532.7153275
Repair of urethra defect
Y

A2
$446.00
19.1505
$792.85
$532.7153400
Revise urethra, stage 1
Y

A2
$510.00
29.7864
$1,233.19
$690.8053405
Revise urethra, stage 2
Y

A2
$446.00
29.7864
$1,233.19
$642.8053410
Reconstruction of urethra
Y

A2
$446.00
29.7864
$1,233.19
$642.8053420
Reconstruct urethra, stage 1
Y

A2
$510.00
29.7864
$1,233.19
$690.8053425
Reconstruct urethra, stage 2
Y

A2
$446.00
29.7864
$1,233.19
$642.8053430
Reconstruction of urethra
Y

A2
$446.00
29.7864
$1,233.19
$642.8053431
Reconstruct urethra/bladder
Y

A2
$446.00
29.7864
$1,233.19
$642.8053440
Male sling procedure
N
CH
H8
$446.00
106.8568
$4,423.98
$3,500.5053442
Remove/revise male sling
Y

A2
$333.00
29.7864
$1,233.19
$558.0553444
Insert tandem cuff
N
CH
H8
$446.00
106.8568
$4,423.98
$3,500.5053445
Insert uro/ves nck sphincter
N

H8
$333.00
193.4277
$8,008.10
$6,625.7553446
Remove uro sphincter
Y

A2
$333.00
29.7864
$1,233.19
$558.0553447
Remove/replace ur sphincter
N

H8
$333.00
193.4277
$8,008.10
$6,625.7553449
Repair uro sphincter
Y

A2
$333.00
29.7864
$1,233.19
$558.0553450
Revision of urethra
Y

A2
$333.00
29.7864
$1,233.19
$558.0553460
Revision of urethra
Y

A2
$333.00
19.1505
$792.85
$447.9653502
Repair of urethra injury
Y

A2
$446.00
19.1505
$792.85
$532.7153505
Repair of urethra injury
Y

A2
$446.00
29.7864
$1,233.19
$642.8053510
Repair of urethra injury
Y

A2
$446.00
19.1505
$792.85
$532.7153515
Repair of urethra injury
Y

A2
$446.00
29.7864
$1,233.19
$642.8053520
Repair of urethra defect
Y

A2
$446.00
29.7864
$1,233.19
$642.8053600
Dilate urethra stricture
Y

P3

0.9381
$38.84
$38.8453601
Dilate urethra stricture
Y
CH
P2

1.0356
$42.87
$42.8753605
Dilate urethra stricture
Y

A2
$446.00
17.942
$742.82
$520.2153620
Dilate urethra stricture
Y

P3

1.5224
$63.03
$63.0353621
Dilate urethra stricture
Y

P3

1.5963
$66.09
$66.0953660
Dilation of urethra
Y
CH
P2

1.0356
$42.87
$42.8753661
Dilation of urethra
Y
CH
P2

1.0356
$42.87
$42.8753665
Dilation of urethra
Y

A2
$333.00
19.1505
$792.85
$447.9653850
Prostatic microwave thermotx
Y

P2

45.2042
$1,871.50
$1,871.5053852
Prostatic rf thermotx
Y

P2

45.2042
$1,871.50
$1,871.5053853
Prostatic water thermother
Y

P2

24.7749
$1,025.71
$1,025.7154000
Slitting of prepuce
Y

A2
$446.00
19.1505
$792.85
$532.7154001
Slitting of prepuce
Y

A2
$446.00
19.1505
$792.85
$532.7154015
Drain penis lesion
Y

A2
$630.00
18.3197
$758.45
$662.1154050
Destruction, penis lesion(s)
Y

P2

1.4595
$60.42
$60.4254055
Destruction, penis lesion(s)
Y

P3

1.4565
$60.30
$60.3054056
Cryosurgery, penis lesion(s)
Y

P2

0.793
$32.83
$32.8354057
Laser surg, penis lesion(s)
Y

A2
$333.00
19.9041
$824.05
$455.7654060
Excision of penis lesion(s)
Y

A2
$333.00
19.9041
$824.05
$455.7654065
Destruction, penis lesion(s)
Y

A2
$333.00
19.9041
$824.05
$455.7654100
Biopsy of penis
Y

A2
$333.00
16.1001
$666.56
$416.3954105
Biopsy of penis
Y

A2
$333.00
21.1098
$873.97
$468.2454110
Treatment of penis lesion
Y

A2
$446.00
33.9306
$1,404.76
$685.6954111
Treat penis lesion, graft
Y

A2
$446.00
33.9306
$1,404.76
$685.6954112
Treat penis lesion, graft
Y

A2
$446.00
33.9306
$1,404.76
$685.6954115
Treatment of penis lesion
Y

A2
$333.00
18.3197
$758.45
$439.3654120
Partial removal of penis
Y

A2
$446.00
33.9306
$1,404.76
$685.6954150
Circumcision w/regionl block
Y

A2
$333.00
22.3251
$924.28
$480.8254160
Circumcision, neonate
Y

A2
$446.00
22.3251
$924.28
$565.5754161
Circum 28 days or older
Y

A2
$446.00
22.3251
$924.28
$565.5754162
Lysis penil circumic lesion
Y

A2
$446.00
22.3251
$924.28
$565.5754163
Repair of circumcision
Y

A2
$446.00
22.3251
$924.28
$565.5754164
Frenulotomy of penis
Y

A2
$446.00
22.3251
$924.28
$565.5754200
Treatment of penis lesion
Y

P3

1.5717
$65.07
$65.0754205
Treatment of penis lesion
Y

A2
$630.00
33.9306
$1,404.76
$823.6954220
Treatment of penis lesion
Y

A2
$131.50
2.0077
$83.12
$119.4154230
Prepare penis study
N

N154231
Dynamic cavernosometry
Y

P3

1.3741
$56.89
$56.8954235
Penile injection
Y

P3

0.9628
$39.86
$39.8654240
Penis study
Y

P3

0.6667
$27.60
$27.6054250
Penis study
Y

P3

0.2304
$9.54
$9.5454300
Revision of penis
Y

A2
$510.00
33.9306
$1,404.76
$733.69( print page 9900)54304
Revision of penis
Y

A2
$510.00
33.9306
$1,404.76
$733.6954308
Reconstruction of urethra
Y

A2
$510.00
33.9306
$1,404.76
$733.6954312
Reconstruction of urethra
Y

A2
$510.00
33.9306
$1,404.76
$733.6954316
Reconstruction of urethra
Y

A2
$510.00
33.9306
$1,404.76
$733.6954318
Reconstruction of urethra
Y

A2
$510.00
33.9306
$1,404.76
$733.6954322
Reconstruction of urethra
Y

A2
$510.00
33.9306
$1,404.76
$733.6954324
Reconstruction of urethra
Y

A2
$510.00
33.9306
$1,404.76
$733.6954326
Reconstruction of urethra
Y

A2
$510.00
33.9306
$1,404.76
$733.6954328
Revise penis/urethra
Y

A2
$510.00
33.9306
$1,404.76
$733.6954340
Secondary urethral surgery
Y

A2
$510.00
33.9306
$1,404.76
$733.6954344
Secondary urethral surgery
Y

A2
$510.00
33.9306
$1,404.76
$733.6954348
Secondary urethral surgery
Y

A2
$510.00
33.9306
$1,404.76
$733.6954352
Reconstruct urethra/penis
Y

A2
$510.00
33.9306
$1,404.76
$733.6954360
Penis plastic surgery
Y

A2
$510.00
33.9306
$1,404.76
$733.6954380
Repair penis
Y

A2
$510.00
33.9306
$1,404.76
$733.6954385
Repair penis
Y

A2
$510.00
33.9306
$1,404.76
$733.6954400
Insert semi-rigid prosthesis
N
CH
H8
$510.00
106.8568
$4,423.98
$3,548.5054401
Insert self-contd prosthesis
N

H8
$510.00
193.4277
$8,008.10
$6,758.5054405
Insert multi-comp penis pros
N

H8
$510.00
193.4277
$8,008.10
$6,758.5054406
Remove muti-comp penis pros
Y

A2
$510.00
33.9306
$1,404.76
$733.6954408
Repair multi-comp penis pros
Y

A2
$510.00
33.9306
$1,404.76
$733.6954410
Remove/replace penis prosth
N

H8
$510.00
193.4277
$8,008.10
$6,758.5054415
Remove self-contd penis pros
Y

A2
$510.00
33.9306
$1,404.76
$733.6954416
Remv/repl penis contain pros
N

H8
$510.00
193.4277
$8,008.10
$6,758.5054420
Revision of penis
Y

A2
$630.00
33.9306
$1,404.76
$823.6954435
Revision of penis
Y

A2
$630.00
33.9306
$1,404.76
$823.6954440
Repair of penis
Y

A2
$630.00
33.9306
$1,404.76
$823.6954450
Preputial stretching
Y

A2
$209.48
3.0469
$126.14
$188.6554500
Biopsy of testis
Y

A2
$333.00
13.5764
$562.08
$390.2754505
Biopsy of testis
Y

A2
$333.00
22.3251
$924.28
$480.8254512
Excise lesion testis
Y

A2
$446.00
22.3251
$924.28
$565.5754520
Removal of testis
Y

A2
$510.00
22.3251
$924.28
$613.5754522
Orchiectomy, partial
Y

A2
$510.00
22.3251
$924.28
$613.5754530
Removal of testis
Y

A2
$630.00
30.6788
$1,270.13
$790.0354550
Exploration for testis
Y

A2
$630.00
30.6788
$1,270.13
$790.0354560
Exploration for testis
Y

G2

22.3251
$924.28
$924.2854600
Reduce testis torsion
Y

A2
$630.00
22.3251
$924.28
$703.5754620
Suspension of testis
Y

A2
$510.00
22.3251
$924.28
$613.5754640
Suspension of testis
Y

A2
$630.00
30.6788
$1,270.13
$790.0354660
Revision of testis
Y

A2
$446.00
22.3251
$924.28
$565.5754670
Repair testis injury
Y

A2
$510.00
22.3251
$924.28
$613.5754680
Relocation of testis(es)
Y

A2
$510.00
22.3251
$924.28
$613.5754690
Laparoscopy, orchiectomy
Y

A2
$1,339.00
45.5317
$1,885.06
$1,475.5254692
Laparoscopy, orchiopexy
Y

G2

69.6652
$2,884.21
$2,884.2154700
Drainage of scrotum
Y

A2
$446.00
22.3251
$924.28
$565.5754800
Biopsy of epididymis
Y

A2
$127.16
4.327
$179.14
$140.1654830
Remove epididymis lesion
Y

A2
$510.00
22.3251
$924.28
$613.5754840
Remove epididymis lesion
Y

A2
$630.00
22.3251
$924.28
$703.5754860
Removal of epididymis
Y

A2
$510.00
22.3251
$924.28
$613.5754861
Removal of epididymis
Y

A2
$630.00
22.3251
$924.28
$703.5754865
Explore epididymis
Y

A2
$333.00
22.3251
$924.28
$480.8254900
Fusion of spermatic ducts
Y

A2
$630.00
22.3251
$924.28
$703.5754901
Fusion of spermatic ducts
Y

A2
$630.00
22.3251
$924.28
$703.5755000
Drainage of hydrocele
Y

P3

1.6128
$66.77
$66.7755040
Removal of hydrocele
Y

A2
$510.00
30.6788
$1,270.13
$700.0355041
Removal of hydroceles
Y

A2
$717.00
30.6788
$1,270.13
$855.2855060
Repair of hydrocele
Y

A2
$630.00
22.3251
$924.28
$703.5755100
Drainage of scrotum abscess
Y

A2
$333.00
11.5594
$478.57
$369.3955110
Explore scrotum
Y

A2
$446.00
22.3251
$924.28
$565.5755120
Removal of scrotum lesion
Y

A2
$446.00
22.3251
$924.28
$565.5755150
Removal of scrotum
Y

A2
$333.00
22.3251
$924.28
$480.8255175
Revision of scrotum
Y

A2
$333.00
22.3251
$924.28
$480.8255180
Revision of scrotum
Y

A2
$446.00
22.3251
$924.28
$565.5755200
Incision of sperm duct
Y

A2
$446.00
22.3251
$924.28
$565.5755250
Removal of sperm duct(s)
Y

A2
$446.00
22.3251
$924.28
$565.5755300
Prepare, sperm duct x-ray
N

N155400
Repair of sperm duct
Y

A2
$333.00
22.3251
$924.28
$480.8255450
Ligation of sperm duct
Y

P3

5.1264
$212.24
$212.2455500
Removal of hydrocele
Y

A2
$510.00
22.3251
$924.28
$613.5755520
Removal of sperm cord lesion
Y

A2
$630.00
22.3251
$924.28
$703.5755530
Revise spermatic cord veins
Y

A2
$630.00
22.3251
$924.28
$703.5755535
Revise spermatic cord veins
Y

A2
$630.00
30.6788
$1,270.13
$790.0355540
Revise hernia & sperm veins
Y

A2
$717.00
30.6788
$1,270.13
$855.2855550
Laparo ligate spermatic vein
Y

A2
$1,339.00
45.5317
$1,885.06
$1,475.5255600
Incise sperm duct pouch
Y

R2

22.3251
$924.28
$924.2855680
Remove sperm pouch lesion
Y

A2
$333.00
22.3251
$924.28
$480.8255700
Biopsy of prostate
Y

A2
$345.83
11.0338
$456.81
$373.58( print page 9901)55705
Biopsy of prostate
Y

A2
$345.83
11.0338
$456.81
$373.5855720
Drainage of prostate abscess
Y

A2
$333.00
24.7749
$1,025.71
$506.1855725
Drainage of prostate abscess
Y

A2
$446.00
24.7749
$1,025.71
$590.9355860
Surgical exposure, prostate
Y

G2

19.3414
$800.75
$800.7555870
Electroejaculation
Y

P3

1.6541
$68.48
$68.4855873
Cryoablate prostate
Y

H8
$1,339.00
162.5379
$6,729.23
$6,219.6355875
Transperi needle place, pros
N

A2
$1,339.00
36.0774
$1,493.64
$1,377.6655876 *
Place rt device/marker, pros
Y

P3

1.7033
$70.52
$70.5255920
Place needles pelvic for rt
Y
NI
G2

25.6947
$1,063.79
$1,063.7956405
I & d of vulva/perineum
Y

P3

1.0287
$42.59
$42.5956420
Drainage of gland abscess
Y

P2

1.352
$55.97
$55.9756440
Surgery for vulva lesion
Y

A2
$446.00
19.0203
$787.46
$531.3756441
Lysis of labial lesion(s)
Y

A2
$333.00
19.0203
$787.46
$446.6256442
Hymenotomy
Y

A2
$333.00
19.0203
$787.46
$446.6256501
Destroy, vulva lesions, sim
Y

P3

1.4072
$58.26
$58.2656515
Destroy vulva lesion/s compl
Y

A2
$510.00
19.9041
$824.05
$588.5156605
Biopsy of vulva/perineum
Y

P3

0.8229
$34.07
$34.0756606
Biopsy of vulva/perineum
Y

P3

0.3539
$14.65
$14.6556620
Partial removal of vulva
Y

A2
$717.00
19.0203
$787.46
$734.6256625
Complete removal of vulva
Y

A2
$995.00
19.0203
$787.46
$943.1256700
Partial removal of hymen
Y

A2
$333.00
19.0203
$787.46
$446.6256740
Remove vagina gland lesion
Y

A2
$510.00
19.0203
$787.46
$579.3756800
Repair of vagina
Y

A2
$510.00
19.0203
$787.46
$579.3756805
Repair clitoris
Y

G2

19.0203
$787.46
$787.4656810
Repair of perineum
Y

A2
$717.00
19.0203
$787.46
$734.6256820
Exam of vulva w/scope
Y

P3

1.0287
$42.59
$42.5956821
Exam/biopsy of vulva w/scope
Y

P2

1.352
$55.97
$55.9757000
Exploration of vagina
Y

A2
$333.00
19.0203
$787.46
$446.6257010
Drainage of pelvic abscess
Y

A2
$446.00
19.0203
$787.46
$531.3757020
Drainage of pelvic fluid
Y

A2
$409.33
6.0783
$251.65
$369.9157022
I & d vaginal hematoma, pp
Y

G2

11.5594
$478.57
$478.5757023
I & d vag hematoma, non-ob
Y

A2
$333.00
18.3197
$758.45
$439.3657061
Destroy vag lesions, simple
Y

P3

1.3084
$54.17
$54.1757065
Destroy vag lesions, complex
Y

A2
$333.00
19.0203
$787.46
$446.6257100
Biopsy of vagina
Y

P3

0.8394
$34.75
$34.7557105
Biopsy of vagina
Y

A2
$446.00
19.0203
$787.46
$531.3757130
Remove vagina lesion
Y

A2
$446.00
19.0203
$787.46
$531.3757135
Remove vagina lesion
Y

A2
$446.00
19.0203
$787.46
$531.3757150
Treat vagina infection
Y
CH
P3

0.6913
$28.62
$28.6257155
Insert uteri tandems/ovoids
Y

A2
$409.33
6.0783
$251.65
$369.9157160
Insert pessary/other device
Y

P3

0.8476
$35.09
$35.0957170
Fitting of diaphragm/cap
Y

P2

0.1309
$5.42
$5.4257180
Treat vaginal bleeding
Y

A2
$178.05
1.352
$55.97
$147.5357200
Repair of vagina
Y

A2
$333.00
19.0203
$787.46
$446.6257210
Repair vagina/perineum
Y

A2
$446.00
19.0203
$787.46
$531.3757220
Revision of urethra
Y

A2
$510.00
42.7099
$1,768.23
$824.5657230
Repair of urethral lesion
Y

A2
$510.00
32.4237
$1,342.37
$718.0957240
Repair bladder & vagina
Y

A2
$717.00
32.4237
$1,342.37
$873.3457250
Repair rectum & vagina
Y

A2
$717.00
32.4237
$1,342.37
$873.3457260
Repair of vagina
Y

A2
$717.00
32.4237
$1,342.37
$873.3457265
Extensive repair of vagina
Y

A2
$995.00
42.7099
$1,768.23
$1,188.3157267
Insert mesh/pelvic flr addon
Y

A2
$995.00
32.4237
$1,342.37
$1,081.8457268
Repair of bowel bulge
Y

A2
$510.00
32.4237
$1,342.37
$718.0957287
Revise/remove sling repair
Y

G2

32.4237
$1,342.37
$1,342.3757288
Repair bladder defect
Y

A2
$717.00
42.7099
$1,768.23
$979.8157289
Repair bladder & vagina
Y

A2
$717.00
32.4237
$1,342.37
$873.3457291
Construction of vagina
Y

A2
$717.00
32.4237
$1,342.37
$873.3457300
Repair rectum-vagina fistula
Y

A2
$510.00
32.4237
$1,342.37
$718.0957320
Repair bladder-vagina lesion
Y

G2

32.4237
$1,342.37
$1,342.3757400
Dilation of vagina
Y

A2
$446.00
19.0203
$787.46
$531.3757410
Pelvic examination
Y

A2
$446.00
19.0203
$787.46
$531.3757415
Remove vaginal foreign body
Y

A2
$446.00
19.0203
$787.46
$531.3757420
Exam of vagina w/scope
Y

P3

1.0616
$43.95
$43.9557421
Exam/biopsy of vag w/scope
Y

P3

1.4154
$58.60
$58.6057452
Exam of cervix w/scope
Y

P3

1.0121
$41.90
$41.9057454
Bx/curett of cervix w/scope
Y

P3

1.2507
$51.78
$51.7857455
Biopsy of cervix w/scope
Y

P3

1.3248
$54.85
$54.8557456
Endocerv curettage w/scope
Y

P3

1.2756
$52.81
$52.8157460
Bx of cervix w/scope, leep
Y

P3

4.1639
$172.39
$172.3957461
Conz of cervix w/scope, leep
Y

P3

4.3941
$181.92
$181.9257500
Biopsy of cervix
Y

P3

1.8763
$77.68
$77.6857505
Endocervical curettage
Y

P3

1.1437
$47.35
$47.3557510
Cauterization of cervix
Y

P3

1.1768
$48.72
$48.7257511
Cryocautery of cervix
Y

P2

1.352
$55.97
$55.9757513
Laser surgery of cervix
Y

A2
$446.00
19.0203
$787.46
$531.3757520
Conization of cervix
Y

A2
$446.00
19.0203
$787.46
$531.3757522
Conization of cervix
Y

A2
$446.00
19.0203
$787.46
$531.37( print page 9902)57530
Removal of cervix
Y

A2
$510.00
32.4237
$1,342.37
$718.0957550
Removal of residual cervix
Y

A2
$510.00
32.4237
$1,342.37
$718.0957556
Remove cervix, repair bowel
Y

A2
$717.00
42.7099
$1,768.23
$979.8157558
D&c of cervical stump
Y

A2
$510.00
19.0203
$787.46
$579.3757700
Revision of cervix
Y

A2
$333.00
19.0203
$787.46
$446.6257720
Revision of cervix
Y

A2
$510.00
19.0203
$787.46
$579.3757800
Dilation of cervical canal
Y

P3

0.6089
$25.21
$25.2158100
Biopsy of uterus lining
Y

P3

1.0121
$41.90
$41.9058110
Bx done w/colposcopy add-on
N
CH
N158120
Dilation and curettage
Y

A2
$446.00
19.0203
$787.46
$531.3758145
Myomectomy vag method
Y

A2
$717.00
32.4237
$1,342.37
$873.3458301
Remove intrauterine device
Y

P3

0.971
$40.20
$40.2058321
Artificial insemination
Y

P3

0.8558
$35.43
$35.4358322
Artificial insemination
Y

P3

0.9217
$38.16
$38.1658323
Sperm washing
Y

P3

0.2797
$11.58
$11.5858340
Catheter for hysterography
N

N158345
Reopen fallopian tube
Y

R2

19.0203
$787.46
$787.4658346
Insert heyman uteri capsule
Y

A2
$446.00
19.0203
$787.46
$531.3758350
Reopen fallopian tube
Y

A2
$510.00
32.4237
$1,342.37
$718.0958353
Endometr ablate, thermal
Y

A2
$995.00
32.4237
$1,342.37
$1,081.8458356
Endometrial cryoablation
Y

P2

42.7099
$1,768.23
$1,768.2358545
Laparoscopic myomectomy
Y

A2
$1,339.00
34.3958
$1,424.02
$1,360.2658546
Laparo-myomectomy, complex
Y

A2
$1,339.00
45.5317
$1,885.06
$1,475.5258550
Laparo-asst vag hysterectomy
Y

A2
$1,339.00
69.6652
$2,884.21
$1,725.3058552
Laparo-vag hyst incl t/o
Y

G2

45.5317
$1,885.06
$1,885.0658555
Hysteroscopy, dx, sep proc
Y

A2
$333.00
21.6576
$896.65
$473.9158558
Hysteroscopy, biopsy
Y

A2
$510.00
21.6576
$896.65
$606.6658559
Hysteroscopy, lysis
Y

A2
$446.00
21.6576
$896.65
$558.6658560
Hysteroscopy, resect septum
Y

A2
$510.00
34.2048
$1,416.11
$736.5358561
Hysteroscopy, remove myoma
Y

A2
$510.00
34.2048
$1,416.11
$736.5358562
Hysteroscopy, remove fb
Y

A2
$510.00
21.6576
$896.65
$606.6658563
Hysteroscopy, ablation
Y

A2
$1,339.00
34.2048
$1,416.11
$1,358.2858565
Hysteroscopy, sterilization
Y

A2
$1,339.00
42.7099
$1,768.23
$1,446.3158600
Division of fallopian tube
Y

G2

32.4237
$1,342.37
$1,342.3758615
Occlude fallopian tube(s)
Y

G2

19.0203
$787.46
$787.4658660
Laparoscopy, lysis
Y

A2
$717.00
45.5317
$1,885.06
$1,009.0258661
Laparoscopy, remove adnexa
Y

A2
$717.00
45.5317
$1,885.06
$1,009.0258662
Laparoscopy, excise lesions
Y

A2
$717.00
45.5317
$1,885.06
$1,009.0258670
Laparoscopy, tubal cautery
Y

A2
$510.00
45.5317
$1,885.06
$853.7758671
Laparoscopy, tubal block
Y

A2
$510.00
45.5317
$1,885.06
$853.7758672
Laparoscopy, fimbrioplasty
Y

A2
$717.00
45.5317
$1,885.06
$1,009.0258673
Laparoscopy, salpingostomy
Y

A2
$717.00
45.5317
$1,885.06
$1,009.0258800
Drainage of ovarian cyst(s)
Y

A2
$510.00
19.0203
$787.46
$579.3758805
Drainage of ovarian cyst(s)
Y
CH
G2

32.4237
$1,342.37
$1,342.3758820
Drain ovary abscess, open
Y

A2
$510.00
32.4237
$1,342.37
$718.0958900
Biopsy of ovary(s)
Y

A2
$510.00
19.0203
$787.46
$579.3758970
Retrieval of oocyte
Y

A2
$245.92
2.7584
$114.20
$212.9958974
Transfer of embryo
Y

A2
$245.92
2.7584
$114.20
$212.9958976
Transfer of embryo
Y

A2
$245.92
2.7584
$114.20
$212.9959000
Amniocentesis, diagnostic
Y
CH
P3

1.5717
$65.07
$65.0759001
Amniocentesis, therapeutic
Y

R2

6.0783
$251.65
$251.6559012
Fetal cord puncture, prenatal
Y

G2

2.7584
$114.20
$114.2059015
Chorion biopsy
Y

P3

1.2178
$50.42
$50.4259020
Fetal contract stress test
Y

P3

0.5761
$23.85
$23.8559025
Fetal non-stress test
Y

P3

0.2961
$12.26
$12.2659070
Transabdom amnioinfus w/us
Y

G2

2.7584
$114.20
$114.2059072
Umbilical cord occlud w/us
Y

G2

2.7584
$114.20
$114.2059076
Fetal shunt placement, w/us
Y

G2

2.7584
$114.20
$114.2059100
Remove uterus lesion
Y

R2

32.4237
$1,342.37
$1,342.3759150
Treat ectopic pregnancy
Y

G2

45.5317
$1,885.06
$1,885.0659151
Treat ectopic pregnancy
Y

G2

45.5317
$1,885.06
$1,885.0659160
D & c after delivery
Y

A2
$510.00
19.0203
$787.46
$579.3759200
Insert cervical dilator
Y

P3

0.8722
$36.11
$36.1159300
Episiotomy or vaginal repair
Y

P3

1.7939
$74.27
$74.2759320
Revision of cervix
Y

A2
$333.00
19.0203
$787.46
$446.6259412
Antepartum manipulation
Y

G2

19.0203
$787.46
$787.4659414
Deliver placenta
Y

G2

19.0203
$787.46
$787.4659812
Treatment of miscarriage
Y

A2
$717.00
19.0203
$787.46
$734.6259820
Care of miscarriage
Y

A2
$717.00
19.0203
$787.46
$734.6259821
Treatment of miscarriage
Y

A2
$717.00
19.0203
$787.46
$734.6259840
Abortion
Y

A2
$717.00
19.0203
$787.46
$734.6259841
Abortion
Y

A2
$717.00
19.0203
$787.46
$734.6259866
Abortion (mpr)
Y

G2

2.7584
$114.20
$114.2059870
Evacuate mole of uterus
Y

A2
$717.00
19.0203
$787.46
$734.6259871
Remove cerclage suture
Y

A2
$717.00
19.0203
$787.46
$734.6260000
Drain thyroid/tongue cyst
Y

A2
$333.00
7.4474
$308.33
$326.8360001
Aspirate/inject thyriod cyst
N
CH
D5( print page 9903)60100
Biopsy of thyroid
Y

P3

1.1191
$46.33
$46.3360200
Remove thyroid lesion
Y

A2
$446.00
44.324
$1,835.06
$793.2760280
Remove thyroid duct lesion
Y

A2
$630.00
44.324
$1,835.06
$931.2760281
Remove thyroid duct lesion
Y

A2
$630.00
44.324
$1,835.06
$931.2760300
Aspir/inj thyroid cyst
Y
NI
P3

1.3741
$56.89
$56.8961000
Remove cranial cavity fluid
Y

R2

8.5263
$353.00
$353.0061001
Remove cranial cavity fluid
Y

R2

8.5263
$353.00
$353.0061020
Remove brain cavity fluid
Y

A2
$183.83
8.5263
$353.00
$226.1261026
Injection into brain canal
Y

A2
$183.83
8.5263
$353.00
$226.1261050
Remove brain canal fluid
Y

A2
$183.83
8.5263
$353.00
$226.1261055
Injection into brain canal
Y

A2
$183.83
8.5263
$353.00
$226.1261070
Brain canal shunt procedure
Y

A2
$183.83
3.2383
$134.07
$171.3961215
Insert brain-fluid device
Y

A2
$510.00
36.2768
$1,501.90
$757.9861330
Decompress eye socket
Y

G2

39.8776
$1,650.97
$1,650.9761334
Explore orbit/remove object
Y

G2

39.8776
$1,650.97
$1,650.9761790
Treat trigeminal nerve
Y

A2
$510.00
18.0518
$747.36
$569.3461791
Treat trigeminal tract
Y

A2
$351.92
14.4879
$599.81
$413.8961795
Brain surgery using computer
N
CH
N161880
Revise/remove neuroelectrode
Y

G2

22.4734
$930.42
$930.4261885
Insrt/redo neurostim 1 array
N

H8
$446.00
269.543
$11,159.35
$10,493.8961886
Implant neurostim arrays
N

H8
$510.00
395.2777
$16,364.89
$15,586.1661888
Revise/remove neuroreceiver
Y

A2
$333.00
34.4166
$1,424.88
$605.9762194
Replace/irrigate catheter
Y

A2
$333.00
8.5263
$353.00
$338.0062225
Replace/irrigate catheter
Y

A2
$333.00
15.3545
$635.69
$408.6762230
Replace/revise brain shunt
Y

A2
$446.00
36.2768
$1,501.90
$709.9862252
Csf shunt reprogram
N

P3

1.0698
$44.29
$44.2962263
Epidural lysis mult sessions
Y

A2
$333.00
14.4879
$599.81
$399.7062264
Epidural lysis on single day
Y

A2
$333.00
14.4879
$599.81
$399.7062268
Drain spinal cord cyst
Y

A2
$183.83
8.5263
$353.00
$226.1262269
Needle biopsy, spinal cord
Y

A2
$333.00
9.3354
$386.49
$346.3762270
Spinal fluid tap, diagnostic
Y

A2
$139.00
4.0964
$169.60
$146.6562272
Drain cerebro spinal fluid
Y

A2
$139.00
4.0964
$169.60
$146.6562273
Inject epidural patch
Y

A2
$333.00
4.0964
$169.60
$292.1562280
Treat spinal cord lesion
Y

A2
$333.00
7.0546
$292.07
$322.7762281
Treat spinal cord lesion
Y

A2
$333.00
7.0546
$292.07
$322.7762282
Treat spinal canal lesion
Y

A2
$333.00
7.0546
$292.07
$322.7762284
Injection for myelogram
N

N162287
Percutaneous diskectomy
Y

A2
$1,339.00
33.2707
$1,377.44
$1,348.6162290
Inject for spine disk x-ray
N

N162291
Inject for spine disk x-ray
N

N162292
Injection into disk lesion
Y
CH
R2

8.5263
$353.00
$353.0062294
Injection into spinal artery
Y

A2
$183.83
8.5263
$353.00
$226.1262310
Inject spine c/t
Y

A2
$333.00
7.0546
$292.07
$322.7762311
Inject spine l/s (cd)
Y

A2
$333.00
7.0546
$292.07
$322.7762318
Inject spine w/cath, c/t
Y

A2
$333.00
7.0546
$292.07
$322.7762319
Inject spine w/cath l/s (cd)
Y

A2
$333.00
7.0546
$292.07
$322.7762350
Implant spinal canal cath
Y

A2
$446.00
36.2768
$1,501.90
$709.9862355
Remove spinal canal catheter
Y

A2
$446.00
14.4879
$599.81
$484.4562360
Insert spine infusion device
Y

A2
$446.00
36.2768
$1,501.90
$709.9862361
Implant spine infusion pump
Y

H8
$446.00
263.8315
$10,922.89
$10,157.0762362
Implant spine infusion pump
Y

H8
$446.00
263.8315
$10,922.89
$10,157.0762365
Remove spine infusion device
Y

A2
$446.00
33.2707
$1,377.44
$678.8662367
Analyze spine infusion pump
N

P3

0.428
$17.72
$17.7262368
Analyze spine infusion pump
N

P3

0.5183
$21.46
$21.4663600
Remove spinal cord lesion
Y

A2
$446.00
18.0518
$747.36
$521.3463610
Stimulation of spinal cord
Y

A2
$333.00
18.0518
$747.36
$436.5963615
Remove lesion of spinal cord
Y

R2

18.0518
$747.36
$747.3663650
Implant neuroelectrodes
N

H8
$446.00
83.1135
$3,440.98
$2,909.3663655
Implant neuroelectrodes
N

J8

109.8976
$4,549.87
$4,549.8763660
Revise/remove neuroelectrode
Y

A2
$333.00
22.4734
$930.42
$482.3663685
Insrt/redo spine n generator
N

H8
$446.00
350.8302
$14,524.72
$13,727.2063688
Revise/remove neuroreceiver
Y

A2
$333.00
34.4166
$1,424.88
$605.9763744
Revision of spinal shunt
Y

A2
$510.00
36.2768
$1,501.90
$757.9863746
Removal of spinal shunt
Y

A2
$446.00
5.6614
$234.39
$393.1064400
N block inj, trigeminal
Y

P3

1.3659
$56.55
$56.5564402
N block inj, facial
Y

P3

1.2425
$51.44
$51.4464405
N block inj, occipital
Y

P3

1.078
$44.63
$44.6364408
N block inj, vagus
Y

P3

1.2425
$51.44
$51.4464410
N block inj, phrenic
Y

A2
$333.00
7.0546
$292.07
$322.7764412
N block inj, spinal accessor
Y

P3

1.9666
$81.42
$81.4264413
N block inj, cervical plexus
Y

P3

1.3002
$53.83
$53.8364415
N block inj, brachial plexus
Y

A2
$139.00
4.0964
$169.60
$146.6564416
N block cont infuse, b plex
Y

G2

7.0546
$292.07
$292.0764417
N block inj, axillary
Y

A2
$139.00
4.0964
$169.60
$146.6564418
N block inj, suprascapular
Y

P3

1.8596
$76.99
$76.9964420
N block inj, intercost, sng
Y

A2
$139.00
4.0964
$169.60
$146.6564421
N block inj, intercost, mlt
Y

A2
$333.00
4.0964
$169.60
$292.15( print page 9904)64425
N block inj, ilio-ing/hypogi
Y

P3

1.2096
$50.08
$50.0864430
N block inj, pudendal
Y

A2
$139.00
7.0546
$292.07
$177.2764435
N block inj, paracervical
Y

P3

1.8596
$76.99
$76.9964445
N block inj, sciatic, sng
Y

P3

1.7693
$73.25
$73.2564446
N blk inj, sciatic, cont inf
Y

G2

14.4879
$599.81
$599.8164447
N block inj fem, single
Y
CH
R2

4.0964
$169.60
$169.6064450
N block, other peripheral
Y

P3

1.0369
$42.93
$42.9364470
Inj paravertebral c/t
Y

A2
$333.00
7.0546
$292.07
$322.7764472
Inj paravertebral c/t add-on
Y

A2
$333.00
4.0964
$169.60
$292.1564475
Inj paravertebral l/s
Y

A2
$333.00
7.0546
$292.07
$322.7764476
Inj paravertebral l/s add-on
Y

A2
$333.00
2.3213
$96.10
$273.7864479
Inj foramen epidural c/t
Y

A2
$333.00
7.0546
$292.07
$322.7764480
Inj foramen epidural add-on
Y

A2
$333.00
4.0964
$169.60
$292.1564483
Inj foramen epidural l/s
Y

A2
$333.00
7.0546
$292.07
$322.7764484
Inj foramen epidural add-on
Y

A2
$333.00
4.0964
$169.60
$292.1564505
N block, spenopalatine gangl
Y

P3

0.971
$40.20
$40.2064508
N block, carotid sinus s/p
Y

P3

2.2053
$91.30
$91.3064510
N block, stellate ganglion
Y

A2
$333.00
7.0546
$292.07
$322.7764517
N block inj, hypogas plxs
Y

A2
$139.00
7.0546
$292.07
$177.2764520
N block, lumbar/thoracic
Y

A2
$333.00
7.0546
$292.07
$322.7764530
N block inj, celiac pelus
Y

A2
$333.00
7.0546
$292.07
$322.7764553
Implant neuroelectrodes
N

H8
$333.00
316.5407
$13,105.10
$12,022.9564555
Implant neuroelectrodes
N

J8

83.1135
$3,440.98
$3,440.9864560
Implant neuroelectrodes
N

J8

83.1135
$3,440.98
$3,440.9864561
Implant neuroelectrodes
N

H8
$510.00
83.1135
$3,440.98
$2,957.3664565
Implant neuroelectrodes
N

J8

83.1135
$3,440.98
$3,440.9864573
Implant neuroelectrodes
N

H8
$333.00
316.5407
$13,105.10
$12,022.9564575
Implant neuroelectrodes
N

H8
$333.00
109.8976
$4,549.87
$3,785.9264577
Implant neuroelectrodes
N

H8
$333.00
109.8976
$4,549.87
$3,785.9264580
Implant neuroelectrodes
N

H8
$333.00
109.8976
$4,549.87
$3,785.9264581
Implant neuroelectrodes
N

H8
$510.00
109.8976
$4,549.87
$3,918.6764585
Revise/remove neuroelectrode
Y

A2
$333.00
22.4734
$930.42
$482.3664590
Insrt/redo pn/gastr stimul
N

H8
$446.00
269.543
$11,159.35
$10,493.8964595
Revise/rmv pn/gastr stimul
Y

A2
$333.00
34.4166
$1,424.88
$605.9764600
Injection treatment of nerve
Y

A2
$333.00
14.4879
$599.81
$399.7064605
Injection treatment of nerve
Y

A2
$333.00
14.4879
$599.81
$399.7064610
Injection treatment of nerve
Y

A2
$333.00
14.4879
$599.81
$399.7064612
Destroy nerve, face muscle
Y

P3

1.6705
$69.16
$69.1664613
Destroy nerve, neck muscle
Y

P3

1.7693
$73.25
$73.2564614
Destroy nerve, extrem musc
Y

P3

1.9915
$82.45
$82.4564620
Injection treatment of nerve
Y

A2
$333.00
7.0546
$292.07
$322.7764622
Destr paravertebrl nerve l/s
Y

A2
$333.00
14.4879
$599.81
$399.7064623
Destr paravertebral n add-on
Y

A2
$333.00
7.0546
$292.07
$322.7764626
Destr paravertebrl nerve c/t
Y

A2
$333.00
14.4879
$599.81
$399.7064627
Destr paravertebral n add-on
Y

A2
$333.00
2.3213
$96.10
$273.7864630
Injection treatment of nerve
Y

A2
$351.92
7.0546
$292.07
$336.9664640
Injection treatment of nerve
Y

P3

2.7156
$112.43
$112.4364650
Chemodenerv eccrine glands
Y
CH
P3

0.65
$26.91
$26.9164653
Chemodenerv eccrine glands
Y
CH
P3

0.6831
$28.28
$28.2864680
Injection treatment of nerve
Y

A2
$390.95
14.4879
$599.81
$443.1764681
Injection treatment of nerve
Y

A2
$446.00
14.4879
$599.81
$484.4564702
Revise finger/toe nerve
Y

A2
$333.00
18.0518
$747.36
$436.5964704
Revise hand/foot nerve
Y

A2
$333.00
18.0518
$747.36
$436.5964708
Revise arm/leg nerve
Y

A2
$446.00
18.0518
$747.36
$521.3464712
Revision of sciatic nerve
Y

A2
$446.00
18.0518
$747.36
$521.3464713
Revision of arm nerve(s)
Y

A2
$446.00
18.0518
$747.36
$521.3464714
Revise low back nerve(s)
Y

A2
$446.00
18.0518
$747.36
$521.3464716
Revision of cranial nerve
Y

A2
$510.00
18.0518
$747.36
$569.3464718
Revise ulnar nerve at elbow
Y

A2
$446.00
18.0518
$747.36
$521.3464719
Revise ulnar nerve at wrist
Y

A2
$446.00
18.0518
$747.36
$521.3464721
Carpal tunnel surgery
Y

A2
$446.00
18.0518
$747.36
$521.3464722
Relieve pressure on nerve(s)
Y

A2
$333.00
18.0518
$747.36
$436.5964726
Release foot/toe nerve
Y

A2
$333.00
18.0518
$747.36
$436.5964727
Internal nerve revision
Y

A2
$333.00
18.0518
$747.36
$436.5964732
Incision of brow nerve
Y

A2
$446.00
18.0518
$747.36
$521.3464734
Incision of cheek nerve
Y

A2
$446.00
18.0518
$747.36
$521.3464736
Incision of chin nerve
Y

A2
$446.00
18.0518
$747.36
$521.3464738
Incision of jaw nerve
Y

A2
$446.00
18.0518
$747.36
$521.3464740
Incision of tongue nerve
Y

A2
$446.00
18.0518
$747.36
$521.3464742
Incision of facial nerve
Y

A2
$446.00
18.0518
$747.36
$521.3464744
Incise nerve, back of head
Y

A2
$446.00
18.0518
$747.36
$521.3464746
Incise diaphragm nerve
Y

A2
$446.00
18.0518
$747.36
$521.3464761
Incision of pelvis nerve
Y

G2

18.0518
$747.36
$747.3664763
Incise hip/thigh nerve
Y

G2

18.0518
$747.36
$747.3664766
Incise hip/thigh nerve
Y

G2

33.2707
$1,377.44
$1,377.4464771
Sever cranial nerve
Y

A2
$446.00
18.0518
$747.36
$521.3464772
Incision of spinal nerve
Y

A2
$446.00
18.0518
$747.36
$521.34( print page 9905)64774
Remove skin nerve lesion
Y

A2
$446.00
18.0518
$747.36
$521.3464776
Remove digit nerve lesion
Y

A2
$510.00
18.0518
$747.36
$569.3464778
Digit nerve surgery add-on
Y

A2
$446.00
18.0518
$747.36
$521.3464782
Remove limb nerve lesion
Y

A2
$510.00
18.0518
$747.36
$569.3464783
Limb nerve surgery add-on
Y

A2
$446.00
18.0518
$747.36
$521.3464784
Remove nerve lesion
Y

A2
$510.00
18.0518
$747.36
$569.3464786
Remove sciatic nerve lesion
Y

A2
$510.00
33.2707
$1,377.44
$726.8664787
Implant nerve end
Y

A2
$446.00
18.0518
$747.36
$521.3464788
Remove skin nerve lesion
Y

A2
$510.00
18.0518
$747.36
$569.3464790
Removal of nerve lesion
Y

A2
$510.00
18.0518
$747.36
$569.3464792
Removal of nerve lesion
Y

A2
$510.00
33.2707
$1,377.44
$726.8664795
Biopsy of nerve
Y

A2
$446.00
18.0518
$747.36
$521.3464802
Remove sympathetic nerves
Y

A2
$446.00
18.0518
$747.36
$521.3464820
Remove sympathetic nerves
Y

G2

18.0518
$747.36
$747.3664821
Remove sympathetic nerves
Y

A2
$630.00
26.3105
$1,089.28
$744.8264822
Remove sympathetic nerves
Y

G2

26.3105
$1,089.28
$1,089.2864823
Remove sympathetic nerves
Y

G2

26.3105
$1,089.28
$1,089.2864831
Repair of digit nerve
Y

A2
$630.00
33.2707
$1,377.44
$816.8664832
Repair nerve add-on
Y

A2
$333.00
33.2707
$1,377.44
$594.1164834
Repair of hand or foot nerve
Y

A2
$446.00
33.2707
$1,377.44
$678.8664835
Repair of hand or foot nerve
Y

A2
$510.00
33.2707
$1,377.44
$726.8664836
Repair of hand or foot nerve
Y

A2
$510.00
33.2707
$1,377.44
$726.8664837
Repair nerve add-on
Y

A2
$333.00
33.2707
$1,377.44
$594.1164840
Repair of leg nerve
Y

A2
$446.00
33.2707
$1,377.44
$678.8664856
Repair/transpose nerve
Y

A2
$446.00
33.2707
$1,377.44
$678.8664857
Repair arm/leg nerve
Y

A2
$446.00
33.2707
$1,377.44
$678.8664858
Repair sciatic nerve
Y

A2
$446.00
33.2707
$1,377.44
$678.8664859
Nerve surgery
Y

A2
$333.00
33.2707
$1,377.44
$594.1164861
Repair of arm nerves
Y

A2
$510.00
33.2707
$1,377.44
$726.8664862
Repair of low back nerves
Y

A2
$510.00
33.2707
$1,377.44
$726.8664864
Repair of facial nerve
Y

A2
$510.00
33.2707
$1,377.44
$726.8664865
Repair of facial nerve
Y

A2
$630.00
33.2707
$1,377.44
$816.8664870
Fusion of facial/other nerve
Y

A2
$630.00
33.2707
$1,377.44
$816.8664872
Subsequent repair of nerve
Y

A2
$446.00
33.2707
$1,377.44
$678.8664874
Repair & revise nerve add-on
Y

A2
$510.00
33.2707
$1,377.44
$726.8664876
Repair nerve/shorten bone
Y

A2
$510.00
33.2707
$1,377.44
$726.8664885
Nerve graft, head or neck
Y

A2
$446.00
33.2707
$1,377.44
$678.8664886
Nerve graft, head or neck
Y

A2
$446.00
33.2707
$1,377.44
$678.8664890
Nerve graft, hand or foot
Y

A2
$446.00
33.2707
$1,377.44
$678.8664891
Nerve graft, hand or foot
Y

A2
$446.00
33.2707
$1,377.44
$678.8664892
Nerve graft, arm or leg
Y

A2
$446.00
33.2707
$1,377.44
$678.8664893
Nerve graft, arm or leg
Y

A2
$446.00
33.2707
$1,377.44
$678.8664895
Nerve graft, hand or foot
Y

A2
$510.00
33.2707
$1,377.44
$726.8664896
Nerve graft, hand or foot
Y

A2
$510.00
33.2707
$1,377.44
$726.8664897
Nerve graft, arm or leg
Y

A2
$510.00
33.2707
$1,377.44
$726.8664898
Nerve graft, arm or leg
Y

A2
$510.00
33.2707
$1,377.44
$726.8664901
Nerve graft add-on
Y

A2
$446.00
33.2707
$1,377.44
$678.8664902
Nerve graft add-on
Y

A2
$446.00
33.2707
$1,377.44
$678.8664905
Nerve pedicle transfer
Y

A2
$446.00
33.2707
$1,377.44
$678.8664907
Nerve pedicle transfer
Y

A2
$333.00
33.2707
$1,377.44
$594.1164910
Nerve repair w/allograft
Y
CH
G2

18.0518
$747.36
$747.3665091
Revise eye
Y

A2
$510.00
37.7243
$1,561.82
$772.9665093
Revise eye with implant
Y

A2
$510.00
37.7243
$1,561.82
$772.9665101
Removal of eye
Y

A2
$510.00
37.7243
$1,561.82
$772.9665103
Remove eye/insert implant
Y

A2
$510.00
37.7243
$1,561.82
$772.9665105
Remove eye/attach implant
Y

A2
$630.00
37.7243
$1,561.82
$862.9665110
Removal of eye
Y

A2
$717.00
37.7243
$1,561.82
$928.2165112
Remove eye/revise socket
Y

A2
$995.00
37.7243
$1,561.82
$1,136.7165114
Remove eye/revise socket
Y

A2
$995.00
37.7243
$1,561.82
$1,136.7165125
Revise ocular implant
Y

G2

18.7307
$775.47
$775.4765130
Insert ocular implant
Y

A2
$510.00
24.3077
$1,006.36
$634.0965135
Insert ocular implant
Y

A2
$446.00
24.3077
$1,006.36
$586.0965140
Attach ocular implant
Y

A2
$510.00
37.7243
$1,561.82
$772.9665150
Revise ocular implant
Y

A2
$446.00
24.3077
$1,006.36
$586.0965155
Reinsert ocular implant
Y

A2
$510.00
37.7243
$1,561.82
$772.9665175
Removal of ocular implant
Y

A2
$333.00
18.7307
$775.47
$443.6265205
Remove foreign body from eye
N

P3

0.4937
$20.44
$20.4465210
Remove foreign body from eye
N

P3

0.6253
$25.89
$25.8965220
Remove foreign body from eye
N

G2

0.8696
$36.00
$36.0065222
Remove foreign body from eye
N

P3

0.6831
$28.28
$28.2865235
Remove foreign body from eye
Y

A2
$446.00
16.171
$669.50
$501.8865260
Remove foreign body from eye
Y

A2
$510.00
18.235
$754.95
$571.2465265
Remove foreign body from eye
Y

A2
$630.00
27.845
$1,152.81
$760.7065270
Repair of eye wound
Y

A2
$446.00
18.7307
$775.47
$528.3765272
Repair of eye wound
Y

A2
$446.00
23.1758
$959.50
$574.3865275
Repair of eye wound
Y

A2
$630.00
23.1758
$959.50
$712.3865280
Repair of eye wound
Y

A2
$630.00
18.235
$754.95
$661.24( print page 9906)65285
Repair of eye wound
Y

A2
$630.00
37.2078
$1,540.44
$857.6165286
Repair of eye wound
Y

P2

5.1169
$211.84
$211.8465290
Repair of eye socket wound
Y

A2
$510.00
24.1291
$998.97
$632.2465400
Removal of eye lesion
Y

A2
$333.00
16.171
$669.50
$417.1365410
Biopsy of cornea
Y

A2
$446.00
16.171
$669.50
$501.8865420
Removal of eye lesion
Y

A2
$446.00
16.171
$669.50
$501.8865426
Removal of eye lesion
Y

A2
$717.00
23.1758
$959.50
$777.6365430
Corneal smear
N
CH
P2

0.8696
$36.00
$36.0065435
Curette/treat cornea
Y

P3

0.7652
$31.68
$31.6865436
Curette/treat cornea
Y

G2

16.171
$669.50
$669.5065450
Treatment of corneal lesion
N

G2

2.179
$90.21
$90.2165600
Revision of cornea
Y

P3

3.884
$160.80
$160.8065710
Corneal transplant
Y

A2
$995.00
37.4896
$1,552.11
$1,134.2865730
Corneal transplant
Y

A2
$995.00
37.4896
$1,552.11
$1,134.2865750
Corneal transplant
Y

A2
$995.00
37.4896
$1,552.11
$1,134.2865755
Corneal transplant
Y

A2
$995.00
37.4896
$1,552.11
$1,134.2865770
Revise cornea with implant
Y

A2
$995.00
84.8039
$3,510.97
$1,623.9965772
Correction of astigmatism
Y

A2
$630.00
16.171
$669.50
$639.8865775
Correction of astigmatism
Y

A2
$630.00
16.171
$669.50
$639.8865780
Ocular reconst, transplant
Y

A2
$717.00
37.4896
$1,552.11
$925.7865781
Ocular reconst, transplant
Y

A2
$717.00
37.4896
$1,552.11
$925.7865782
Ocular reconst, transplant
Y

A2
$717.00
37.4896
$1,552.11
$925.7865800
Drainage of eye
Y

A2
$333.00
16.171
$669.50
$417.1365805
Drainage of eye
Y

A2
$333.00
16.171
$669.50
$417.1365810
Drainage of eye
Y

A2
$510.00
23.1758
$959.50
$622.3865815
Drainage of eye
Y

A2
$446.00
23.1758
$959.50
$574.3865820
Relieve inner eye pressure
Y

A2
$333.00
5.1169
$211.84
$302.7165850
Incision of eye
Y

A2
$630.00
23.1758
$959.50
$712.3865855
Laser surgery of eye
Y

P3

3.2093
$132.87
$132.8765860
Incise inner eye adhesions
Y

P3

3.0036
$124.35
$124.3565865
Incise inner eye adhesions
Y

A2
$333.00
16.171
$669.50
$417.1365870
Incise inner eye adhesions
Y

A2
$630.00
23.1758
$959.50
$712.3865875
Incise inner eye adhesions
Y

A2
$630.00
23.1758
$959.50
$712.3865880
Incise inner eye adhesions
Y

A2
$630.00
16.171
$669.50
$639.8865900
Remove eye lesion
Y

A2
$717.00
16.171
$669.50
$705.1365920
Remove implant of eye
Y

A2
$995.00
23.1758
$959.50
$986.1365930
Remove blood clot from eye
Y

A2
$717.00
23.1758
$959.50
$777.6366020
Injection treatment of eye
Y

A2
$333.00
16.171
$669.50
$417.1366030
Injection treatment of eye
Y

A2
$333.00
5.1169
$211.84
$302.7166130
Remove eye lesion
Y

A2
$995.00
23.1758
$959.50
$986.1366150
Glaucoma surgery
Y

A2
$630.00
23.1758
$959.50
$712.3866155
Glaucoma surgery
Y

A2
$630.00
23.1758
$959.50
$712.3866160
Glaucoma surgery
Y

A2
$446.00
23.1758
$959.50
$574.3866165
Glaucoma surgery
Y

A2
$630.00
23.1758
$959.50
$712.3866170
Glaucoma surgery
Y

A2
$630.00
23.1758
$959.50
$712.3866172
Incision of eye
Y

A2
$630.00
23.1758
$959.50
$712.3866180
Implant eye shunt
Y

A2
$717.00
39.7101
$1,644.04
$948.7666185
Revise eye shunt
Y

A2
$446.00
39.7101
$1,644.04
$745.5166220
Repair eye lesion
Y

A2
$510.00
37.2078
$1,540.44
$767.6166225
Repair/graft eye lesion
Y

A2
$630.00
39.7101
$1,644.04
$883.5166250
Follow-up surgery of eye
Y

A2
$446.00
16.171
$669.50
$501.8866500
Incision of iris
Y

A2
$333.00
5.1169
$211.84
$302.7166505
Incision of iris
Y

A2
$333.00
5.1169
$211.84
$302.7166600
Remove iris and lesion
Y

A2
$510.00
23.1758
$959.50
$622.3866605
Removal of iris
Y

A2
$510.00
23.1758
$959.50
$622.3866625
Removal of iris
Y

A2
$372.94
5.1169
$211.84
$332.6766630
Removal of iris
Y

A2
$510.00
23.1758
$959.50
$622.3866635
Removal of iris
Y

A2
$510.00
23.1758
$959.50
$622.3866680
Repair iris & ciliary body
Y

A2
$510.00
23.1758
$959.50
$622.3866682
Repair iris & ciliary body
Y

A2
$446.00
23.1758
$959.50
$574.3866700
Destruction, ciliary body
Y

A2
$446.00
16.171
$669.50
$501.8866710
Ciliary transsleral therapy
Y

A2
$446.00
16.171
$669.50
$501.8866711
Ciliary endoscopic ablation
Y

A2
$446.00
16.171
$669.50
$501.8866720
Destruction, ciliary body
Y

A2
$446.00
16.171
$669.50
$501.8866740
Destruction, ciliary body
Y

A2
$446.00
23.1758
$959.50
$574.3866761
Revision of iris
Y

P3

4.3695
$180.90
$180.9066762
Revision of iris
Y

P3

4.4272
$183.29
$183.2966770
Removal of inner eye lesion
Y

P3

4.781
$197.94
$197.9466820
Incision, secondary cataract
Y

G2

5.1169
$211.84
$211.8466821
After cataract laser surgery
Y

A2
$312.50
5.2001
$215.29
$288.2066825
Reposition intraocular lens
Y

A2
$630.00
23.1758
$959.50
$712.3866830
Removal of lens lesion
Y

A2
$372.94
5.1169
$211.84
$332.6766840
Removal of lens material
Y

A2
$630.00
14.9171
$617.58
$626.9066850
Removal of lens material
Y

A2
$995.00
28.7035
$1,188.35
$1,043.3466852
Removal of lens material
Y

A2
$630.00
28.7035
$1,188.35
$769.5966920
Extraction of lens
Y

A2
$630.00
28.7035
$1,188.35
$769.5966930
Extraction of lens
Y

A2
$717.00
28.7035
$1,188.35
$834.84( print page 9907)66940
Extraction of lens
Y

A2
$717.00
14.9171
$617.58
$692.1566982
Cataract surgery, complex
Y

A2
$973.00
23.8649
$988.03
$976.7666983
Cataract surg w/iol, 1 stage
Y

A2
$973.00
23.8649
$988.03
$976.7666984
Cataract surg w/iol, 1 stage
Y

A2
$973.00
23.8649
$988.03
$976.7666985
Insert lens prosthesis
Y

A2
$826.00
23.8649
$988.03
$866.5166986
Exchange lens prosthesis
Y

A2
$826.00
23.8649
$988.03
$866.5166990
Ophthalmic endoscope add-on
N

N167005
Partial removal of eye fluid
Y

A2
$630.00
27.845
$1,152.81
$760.7067010
Partial removal of eye fluid
Y

A2
$630.00
27.845
$1,152.81
$760.7067015
Release of eye fluid
Y

A2
$333.00
27.845
$1,152.81
$537.9567025
Replace eye fluid
Y

A2
$333.00
27.845
$1,152.81
$537.9567027
Implant eye drug system
Y

A2
$630.00
37.2078
$1,540.44
$857.6167028
Injection eye drug
N

P3

1.9997
$82.79
$82.7967030
Incise inner eye strands
Y

A2
$333.00
18.235
$754.95
$438.4967031
Laser surgery, eye strands
Y

A2
$312.50
5.2001
$215.29
$288.2067036
Removal of inner eye fluid
Y

A2
$630.00
37.2078
$1,540.44
$857.6167038
Strip retinal membrane
N
CH
D567039
Laser treatment of retina
Y

A2
$995.00
37.2078
$1,540.44
$1,131.3667040
Laser treatment of retina
Y

A2
$995.00
37.2078
$1,540.44
$1,131.3667041
Vit for macular pucker
Y
NI
G2

37.2078
$1,540.44
$1,540.4467042
Vit for macular hole
Y
NI
G2

37.2078
$1,540.44
$1,540.4467043
Vit for membrane dissect
Y
NI
G2

37.2078
$1,540.44
$1,540.4467101
Repair detached retina
Y

P3

7.2496
$300.14
$300.1467105
Repair detached retina
Y

P2

5.2001
$215.29
$215.2967107
Repair detached retina
Y

A2
$717.00
37.2078
$1,540.44
$922.8667108
Repair detached retina
Y

A2
$995.00
37.2078
$1,540.44
$1,131.3667110
Repair detached retina
Y

P3

7.8831
$326.37
$326.3767112
Rerepair detached retina
Y

A2
$995.00
37.2078
$1,540.44
$1,131.3667113
Repair retinal detach, cplx
Y
NI
G2

37.2078
$1,540.44
$1,540.4467115
Release encircling material
Y

A2
$446.00
18.235
$754.95
$523.2467120
Remove eye implant material
Y

A2
$446.00
18.235
$754.95
$523.2467121
Remove eye implant material
Y

A2
$446.00
27.845
$1,152.81
$622.7067141
Treatment of retina
Y

A2
$241.77
4.1331
$171.11
$224.1167145
Treatment of retina
Y

P3

4.5506
$188.40
$188.4067208
Treatment of retinal lesion
Y

P3

4.8467
$200.66
$200.6667210
Treatment of retinal lesion
Y
CH
P3

5.1349
$212.59
$212.5967218
Treatment of retinal lesion
Y

A2
$717.00
18.235
$754.95
$726.4967220
Treatment of choroid lesion
Y

P2

4.1331
$171.11
$171.1167221
Ocular photodynamic ther
Y

P3

2.9789
$123.33
$123.3367225
Eye photodynamic ther add-on
Y

P3

0.1976
$8.18
$8.1867227
Treatment of retinal lesion
Y

A2
$333.00
27.845
$1,152.81
$537.9567228
Treatment of retinal lesion
Y

P2

5.2001
$215.29
$215.2967229 *
Tr retinal les preterm inf
Y
NI
R2

5.2001
$215.29
$215.2967250
Reinforce eye wall
Y

A2
$510.00
18.7307
$775.47
$576.3767255
Reinforce/graft eye wall
Y

A2
$510.00
27.845
$1,152.81
$670.7067311
Revise eye muscle
Y

A2
$510.00
24.1291
$998.97
$632.2467312
Revise two eye muscles
Y

A2
$630.00
24.1291
$998.97
$722.2467314
Revise eye muscle
Y

A2
$630.00
24.1291
$998.97
$722.2467316
Revise two eye muscles
Y

A2
$630.00
24.1291
$998.97
$722.2467318
Revise eye muscle(s)
Y

A2
$630.00
24.1291
$998.97
$722.2467320
Revise eye muscle(s) add-on
Y

A2
$630.00
24.1291
$998.97
$722.2467331
Eye surgery follow-up add-on
Y

A2
$630.00
24.1291
$998.97
$722.2467332
Rerevise eye muscles add-on
Y

A2
$630.00
24.1291
$998.97
$722.2467334
Revise eye muscle w/suture
Y

A2
$630.00
24.1291
$998.97
$722.2467335
Eye suture during surgery
Y

A2
$630.00
24.1291
$998.97
$722.2467340
Revise eye muscle add-on
Y

A2
$630.00
24.1291
$998.97
$722.2467343
Release eye tissue
Y

A2
$995.00
24.1291
$998.97
$995.9967345
Destroy nerve of eye muscle
Y

P3

1.9584
$81.08
$81.0867346
Biopsy, eye muscle
Y

A2
$333.00
13.7453
$569.07
$392.0267400
Explore/biopsy eye socket
Y

A2
$510.00
24.3077
$1,006.36
$634.0967405
Explore/drain eye socket
Y

A2
$630.00
24.3077
$1,006.36
$724.0967412
Explore/treat eye socket
Y

A2
$717.00
24.3077
$1,006.36
$789.3467413
Explore/treat eye socket
Y

A2
$717.00
24.3077
$1,006.36
$789.3467414
Explr/decompress eye socket
Y

G2

37.7243
$1,561.82
$1,561.8267415
Aspiration, orbital contents
Y

A2
$333.00
18.7307
$775.47
$443.6267420
Explore/treat eye socket
Y

A2
$717.00
37.7243
$1,561.82
$928.2167430
Explore/treat eye socket
Y

A2
$717.00
37.7243
$1,561.82
$928.2167440
Explore/drain eye socket
Y

A2
$717.00
37.7243
$1,561.82
$928.2167445
Explr/decompress eye socket
Y

A2
$717.00
37.7243
$1,561.82
$928.2167450
Explore/biopsy eye socket
Y

A2
$717.00
37.7243
$1,561.82
$928.2167500
Inject/treat eye socket
N

G2

2.179
$90.21
$90.2167505
Inject/treat eye socket
Y

G2

2.9022
$120.15
$120.1567515
Inject/treat eye socket
Y

P3

0.5596
$23.17
$23.1767550
Insert eye socket implant
Y

A2
$630.00
37.7243
$1,561.82
$862.9667560
Revise eye socket implant
Y

A2
$446.00
24.3077
$1,006.36
$586.0967570
Decompress optic nerve
Y

A2
$630.00
37.7243
$1,561.82
$862.9667700
Drainage of eyelid abscess
Y

P2

2.9022
$120.15
$120.15( print page 9908)67710
Incision of eyelid
Y

P3

3.7359
$154.67
$154.6767715
Incision of eyelid fold
Y

A2
$333.00
18.7307
$775.47
$443.6267800
Remove eyelid lesion
Y

P3

1.2343
$51.10
$51.1067801
Remove eyelid lesions
Y

P3

1.4975
$62.00
$62.0067805
Remove eyelid lesions
Y

P3

1.9338
$80.06
$80.0667808
Remove eyelid lesion(s)
Y

A2
$446.00
18.7307
$775.47
$528.3767810
Biopsy of eyelid
Y

P2

2.9022
$120.15
$120.1567820
Revise eyelashes
N

P3

0.428
$17.72
$17.7267825
Revise eyelashes
Y

P3

1.292
$53.49
$53.4967830
Revise eyelashes
Y

A2
$446.00
7.2847
$301.59
$409.9067835
Revise eyelashes
Y

A2
$446.00
18.7307
$775.47
$528.3767840
Remove eyelid lesion
Y

P3

3.8593
$159.78
$159.7867850
Treat eyelid lesion
Y

P3

2.7403
$113.45
$113.4567875
Closure of eyelid by suture
Y

G2

7.2847
$301.59
$301.5967880
Revision of eyelid
Y

A2
$510.00
16.171
$669.50
$549.8867882
Revision of eyelid
Y

A2
$510.00
18.7307
$775.47
$576.3767900
Repair brow defect
Y

A2
$630.00
18.7307
$775.47
$666.3767901
Repair eyelid defect
Y

A2
$717.00
18.7307
$775.47
$731.6267902
Repair eyelid defect
Y

A2
$717.00
18.7307
$775.47
$731.6267903
Repair eyelid defect
Y

A2
$630.00
18.7307
$775.47
$666.3767904
Repair eyelid defect
Y

A2
$630.00
18.7307
$775.47
$666.3767906
Repair eyelid defect
Y

A2
$717.00
18.7307
$775.47
$731.6267908
Repair eyelid defect
Y

A2
$630.00
18.7307
$775.47
$666.3767909
Revise eyelid defect
Y

A2
$630.00
18.7307
$775.47
$666.3767911
Revise eyelid defect
Y

A2
$510.00
18.7307
$775.47
$576.3767912
Correction eyelid w/implant
Y

A2
$510.00
18.7307
$775.47
$576.3767914
Repair eyelid defect
Y

A2
$510.00
18.7307
$775.47
$576.3767915
Repair eyelid defect
Y

P3

4.2378
$175.45
$175.4567916
Repair eyelid defect
Y

A2
$630.00
18.7307
$775.47
$666.3767917
Repair eyelid defect
Y

A2
$630.00
18.7307
$775.47
$666.3767921
Repair eyelid defect
Y

A2
$510.00
18.7307
$775.47
$576.3767922
Repair eyelid defect
Y

P3

4.1472
$171.70
$171.7067923
Repair eyelid defect
Y

A2
$630.00
18.7307
$775.47
$666.3767924
Repair eyelid defect
Y

A2
$630.00
18.7307
$775.47
$666.3767930
Repair eyelid wound
Y

P3

4.1472
$171.70
$171.7067935
Repair eyelid wound
Y

A2
$446.00
18.7307
$775.47
$528.3767938
Remove eyelid foreign body
N

P2

2.179
$90.21
$90.2167950
Revision of eyelid
Y

A2
$446.00
18.7307
$775.47
$528.3767961
Revision of eyelid
Y

A2
$510.00
18.7307
$775.47
$576.3767966
Revision of eyelid
Y

A2
$510.00
18.7307
$775.47
$576.3767971
Reconstruction of eyelid
Y

A2
$510.00
24.3077
$1,006.36
$634.0967973
Reconstruction of eyelid
Y

A2
$510.00
24.3077
$1,006.36
$634.0967974
Reconstruction of eyelid
Y

A2
$510.00
24.3077
$1,006.36
$634.0967975
Reconstruction of eyelid
Y

A2
$510.00
18.7307
$775.47
$576.3768020
Incise/drain eyelid lining
Y

P3

1.0862
$44.97
$44.9768040
Treatment of eyelid lesions
N

P3

0.5432
$22.49
$22.4968100
Biopsy of eyelid lining
Y

P3

2.3123
$95.73
$95.7368110
Remove eyelid lining lesion
Y

P3

2.954
$122.30
$122.3068115
Remove eyelid lining lesion
Y

A2
$446.00
18.7307
$775.47
$528.3768130
Remove eyelid lining lesion
Y

A2
$446.00
16.171
$669.50
$501.8868135
Remove eyelid lining lesion
Y

P3

1.399
$57.92
$57.9268200
Treat eyelid by injection
N

P3

0.4031
$16.69
$16.6968320
Revise/graft eyelid lining
Y

A2
$630.00
18.7307
$775.47
$666.3768325
Revise/graft eyelid lining
Y

A2
$630.00
24.3077
$1,006.36
$724.0968326
Revise/graft eyelid lining
Y

A2
$630.00
24.3077
$1,006.36
$724.0968328
Revise/graft eyelid lining
Y

A2
$630.00
24.3077
$1,006.36
$724.0968330
Revise eyelid lining
Y

A2
$630.00
23.1758
$959.50
$712.3868335
Revise/graft eyelid lining
Y

A2
$630.00
24.3077
$1,006.36
$724.0968340
Separate eyelid adhesions
Y

A2
$630.00
18.7307
$775.47
$666.3768360
Revise eyelid lining
Y

A2
$446.00
23.1758
$959.50
$574.3868362
Revise eyelid lining
Y

A2
$446.00
23.1758
$959.50
$574.3868371
Harvest eye tissue, alograft
Y

A2
$446.00
16.171
$669.50
$501.8868400
Incise/drain tear gland
Y

P2

2.9022
$120.15
$120.1568420
Incise/drain tear sac
Y

P3

4.4354
$183.63
$183.6368440
Incise tear duct opening
Y

P3

1.3741
$56.89
$56.8968500
Removal of tear gland
Y

A2
$510.00
24.3077
$1,006.36
$634.0968505
Partial removal, tear gland
Y

A2
$510.00
24.3077
$1,006.36
$634.0968510
Biopsy of tear gland
Y

A2
$333.00
18.7307
$775.47
$443.6268520
Removal of tear sac
Y

A2
$510.00
24.3077
$1,006.36
$634.0968525
Biopsy of tear sac
Y

A2
$333.00
18.7307
$775.47
$443.6268530
Clearance of tear duct
Y

P3

5.6697
$234.73
$234.7368540
Remove tear gland lesion
Y

A2
$510.00
24.3077
$1,006.36
$634.0968550
Remove tear gland lesion
Y

A2
$510.00
24.3077
$1,006.36
$634.0968700
Repair tear ducts
Y

A2
$446.00
24.3077
$1,006.36
$586.0968705
Revise tear duct opening
Y

P2

2.9022
$120.15
$120.1568720
Create tear sac drain
Y

A2
$630.00
24.3077
$1,006.36
$724.0968745
Create tear duct drain
Y

A2
$630.00
24.3077
$1,006.36
$724.09( print page 9909)68750
Create tear duct drain
Y

A2
$630.00
24.3077
$1,006.36
$724.0968760
Close tear duct opening
N

P2

2.179
$90.21
$90.2168761
Close tear duct opening
N

P3

1.6869
$69.84
$69.8468770
Close tear system fistula
Y

A2
$630.00
18.7307
$775.47
$666.3768801
Dilate tear duct opening
N

P2

0.8696
$36.00
$36.0068810
Probe nasolacrimal duct
N

A2
$131.86
2.179
$90.21
$121.4568811
Probe nasolacrimal duct
Y

A2
$446.00
18.7307
$775.47
$528.3768815
Probe nasolacrimal duct
Y

A2
$446.00
18.7307
$775.47
$528.3768816 *
Probe nl duct w/balloon
Y
NI
P3

10.4918
$434.37
$434.3768840
Explore/irrigate tear ducts
N
CH
P3

1.2756
$52.81
$52.8168850
Injection for tear sac x-ray
N

N169000
Drain external ear lesion
Y

P2

1.4066
$58.23
$58.2369005
Drain external ear lesion
Y

P3

2.4357
$100.84
$100.8469020
Drain outer ear canal lesion
Y

P2

1.4066
$58.23
$58.2369100
Biopsy of external ear
Y

P3

1.4647
$60.64
$60.6469105
Biopsy of external ear canal
Y

P3

2.049
$84.83
$84.8369110
Remove external ear, partial
Y

A2
$333.00
16.1001
$666.56
$416.3969120
Removal of external ear
Y

A2
$446.00
23.9765
$992.65
$582.6669140
Remove ear canal lesion(s)
Y

A2
$446.00
23.9765
$992.65
$582.6669145
Remove ear canal lesion(s)
Y

A2
$446.00
16.1001
$666.56
$501.1469150
Extensive ear canal surgery
Y

A2
$464.15
7.4474
$308.33
$425.2069200
Clear outer ear canal
N

P2

0.631
$26.12
$26.1269205
Clear outer ear canal
Y

A2
$333.00
21.1098
$873.97
$468.2469210
Remove impacted ear wax
N

P3

0.4937
$20.44
$20.4469220
Clean out mastoid cavity
Y

P2

0.793
$32.83
$32.8369222
Clean out mastoid cavity
Y

P3

3.2176
$133.21
$133.2169300
Revise external ear
Y

A2
$510.00
23.9765
$992.65
$630.6669310
Rebuild outer ear canal
Y

A2
$510.00
39.8776
$1,650.97
$795.2469320
Rebuild outer ear canal
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9969400
Inflate middle ear canal
Y

P3

2.049
$84.83
$84.8369401
Inflate middle ear canal
Y

P3

1.1355
$47.01
$47.0169405
Catheterize middle ear canal
Y

P3

2.9458
$121.96
$121.9669420
Incision of eardrum
Y

P2

2.5002
$103.51
$103.5169421
Incision of eardrum
Y

A2
$510.00
16.3288
$676.03
$551.5169424
Remove ventilating tube
Y

P3

1.8596
$76.99
$76.9969433
Create eardrum opening
Y

P3

2.6415
$109.36
$109.3669436
Create eardrum opening
Y

A2
$510.00
16.3288
$676.03
$551.5169440
Exploration of middle ear
Y

A2
$510.00
23.9765
$992.65
$630.6669450
Eardrum revision
Y

A2
$333.00
39.8776
$1,650.97
$662.4969501
Mastoidectomy
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9969502
Mastoidectomy
Y

A2
$995.00
23.9765
$992.65
$994.4169505
Remove mastoid structures
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9969511
Extensive mastoid surgery
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9969530
Extensive mastoid surgery
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9969540
Remove ear lesion
Y

P3

3.1434
$130.14
$130.1469550
Remove ear lesion
Y

A2
$717.00
39.8776
$1,650.97
$950.4969552
Remove ear lesion
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9969601
Mastoid surgery revision
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9969602
Mastoid surgery revision
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9969603
Mastoid surgery revision
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9969604
Mastoid surgery revision
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9969605
Mastoid surgery revision
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9969610
Repair of eardrum
Y

P3

4.312
$178.52
$178.5269620
Repair of eardrum
Y

A2
$446.00
23.9765
$992.65
$582.6669631
Repair eardrum structures
Y

A2
$717.00
39.8776
$1,650.97
$950.4969632
Rebuild eardrum structures
Y

A2
$717.00
39.8776
$1,650.97
$950.4969633
Rebuild eardrum structures
Y

A2
$717.00
39.8776
$1,650.97
$950.4969635
Repair eardrum structures
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9969636
Rebuild eardrum structures
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9969637
Rebuild eardrum structures
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9969641
Revise middle ear & mastoid
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9969642
Revise middle ear & mastoid
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9969643
Revise middle ear & mastoid
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9969644
Revise middle ear & mastoid
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9969645
Revise middle ear & mastoid
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9969646
Revise middle ear & mastoid
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9969650
Release middle ear bone
Y

A2
$995.00
23.9765
$992.65
$994.4169660
Revise middle ear bone
Y

A2
$717.00
39.8776
$1,650.97
$950.4969661
Revise middle ear bone
Y

A2
$717.00
39.8776
$1,650.97
$950.4969662
Revise middle ear bone
Y

A2
$717.00
39.8776
$1,650.97
$950.4969666
Repair middle ear structures
Y

A2
$630.00
39.8776
$1,650.97
$885.2469667
Repair middle ear structures
Y

A2
$630.00
39.8776
$1,650.97
$885.2469670
Remove mastoid air cells
Y

A2
$510.00
39.8776
$1,650.97
$795.2469676
Remove middle ear nerve
Y

A2
$510.00
39.8776
$1,650.97
$795.2469700
Close mastoid fistula
Y

A2
$510.00
39.8776
$1,650.97
$795.2469711
Remove/repair hearing aid
Y

A2
$333.00
39.8776
$1,650.97
$662.4969714
Implant temple bone w/stimul
Y

A2
$1,339.00
39.8776
$1,650.97
$1,416.99( print page 9910)69715
Temple bne implnt w/stimulat
Y

A2
$1,339.00
39.8776
$1,650.97
$1,416.9969717
Temple bone implant revision
Y

A2
$1,339.00
39.8776
$1,650.97
$1,416.9969718
Revise temple bone implant
Y

A2
$1,339.00
39.8776
$1,650.97
$1,416.9969720
Release facial nerve
Y

A2
$717.00
39.8776
$1,650.97
$950.4969740
Repair facial nerve
Y

A2
$717.00
39.8776
$1,650.97
$950.4969745
Repair facial nerve
Y

A2
$717.00
39.8776
$1,650.97
$950.4969801
Incise inner ear
Y

A2
$717.00
39.8776
$1,650.97
$950.4969802
Incise inner ear
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9969805
Explore inner ear
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9969806
Explore inner ear
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9969820
Establish inner ear window
Y

A2
$717.00
39.8776
$1,650.97
$950.4969840
Revise inner ear window
Y

A2
$717.00
39.8776
$1,650.97
$950.4969905
Remove inner ear
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9969910
Remove inner ear & mastoid
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9969915
Incise inner ear nerve
Y

A2
$995.00
39.8776
$1,650.97
$1,158.9969930
Implant cochlear device
Y

H8
$995.00
568.8394
$23,550.52
$22,213.7669990
Microsurgery add-on
N

N1C9716
Radiofrequency energy to anu
Y

G2

30.1606
$1,248.68
$1,248.68C9724
EPS gast cardia plic
Y

G2

25.3233
$1,048.41
$1,048.41C9725
Place endorectal app
N

G2

8.6351
$357.50
$357.50C9726
Rxt breast appl place/remov
N

G2

10.2051
$422.50
$422.50C9727
Insert palate implants
N

G2

13.3451
$552.50
$552.50C9728
Place device/marker, non pro
Y
CH
R2

3.0469
$126.14
$126.14G0104
CA screen;flexi sigmoidscope
N

P3

1.9748
$81.76
$81.76G0105
Colorectal scrn; hi risk ind
Y

A2
$446.00
7.8504
$325.01
$415.75G0121
Colon ca scrn not hi rsk ind
Y

A2
$446.00
7.8504
$325.01
$415.75G0127
Trim nail(s)
Y

P3

0.2633
$10.90
$10.90G0186
Dstry eye lesn,fdr vssl tech
Y

R2

4.1331
$171.11
$171.11G0247
Routine footcare pt w lops
Y

P3

0.4937
$20.44
$20.44G0259
Inject for sacroiliac joint
N

N1G0260
Inj for sacroiliac jt anesth
Y

A2
$333.00
7.0546
$292.07
$322.77G0268
Removal of impacted wax md
N
CH
N1G0269
Occlusive device in vein art
N

N1G0289
Arthro, loose body + chondro
N

N1G0364
Bone marrow aspirate & biopsy
Y

P3

0.1234
$5.11
$5.11G0392
AV fistula or graft arterial
Y

A2
$1,339.00
45.3845
$1,878.96
$1,473.99G0393
AV fistula or graft venous
Y

A2
$1,339.00
45.3845
$1,878.96
$1,473.99**Note:**
                             The Medicare program payment is 80 percent of the total payment amount and beneficiary coinsurance is 20 percent of the total payment amount, except for screening flexible sigmoidoscopies and screening colonoscopies for which the program payment is 75 percent and the beneficiary coinsurance is 25 percent.* Refers to codes designated as “office-based,”  whose designation as office-based is temporary because we have insufficient claims data.  We will reconsider this designation when new claims data become available.
 
 
 Addendum BB.—ASC Covered Ancillary Services Integral to Covered Surgical Procedures for CY 2008
[Including Ancillary Services for Which Payment Is Packaged]
HCPCS code
Short descriptor
Comment indicator
Payment indicator
CY 2008 payment weight
CY 2008 payment0028T
Dexa body composition study

N10042T
Ct perfusion w/contrast, cbf

N10054T
Bone surgery using computer
CH
D50055T
Bone surgery using computer
CH
D50056T
Bone surgery using computer
CH
D50067T
Ct colonography;dx

Z2
3.0109
$124.650071T
U/s leiomyomata ablate <200

Z2
61.6965
$2,554.300072T
U/s leiomyomata ablate >200

Z2
61.6965
$2,554.300073T
Delivery, comp imrt

Z2
5.4582
$225.970126T
Chd risk imt study

N10144T
Ct heart wo dye; qual calc

Z2
1.5839
$65.580145T
Ct heart w/wo dye funct

Z2
4.7005
$194.610146T
Ccta w/wo dye

Z2
4.7005
$194.610147T
Ccta w/wo, quan calcium

Z2
4.7005
$194.610148T
Ccta w/wo, strxr

Z2
4.7005
$194.610149T
Ccta w/wo, strxr quan calc

Z2
4.7005
$194.610150T
Ccta w/wo, disease strxr

Z2
4.7005
$194.610151T
Ct heart funct add-on

Z2
1.5839
$65.580159T
Cad breast mri

N10174T
Cad cxr with interp

N10175T
Cad cxr remote

N10182T
Hdr elect brachytherapy
CH
Z2
27.4752
$1,137.500185T
Comptr probability analysis
NI
N170010
Contrast x-ray of brain
CH
N170015
Contrast x-ray of brain
CH
N170030
X-ray eye for foreign body

Z3
0.3949
$16.3570100
X-ray exam of jaw

Z3
0.4526
$18.7470110
X-ray exam of jaw

Z3
0.5514
$22.8370120
X-ray exam of mastoids

Z3
0.5183
$21.4670130
X-ray exam of mastoids

Z2
0.6954
$28.7970134
X-ray exam of middle ear

Z3
0.6253
$25.8970140
X-ray exam of facial bones

Z3
0.4609
$19.0870150
X-ray exam of facial bones

Z3
0.6336
$26.2370160
X-ray exam of nasal bones

Z3
0.4773
$19.7670170
X-ray exam of tear duct
CH
N170190
X-ray exam of eye sockets

Z3
0.5266
$21.8070200
X-ray exam of eye sockets

Z3
0.6418
$26.5770210
X-ray exam of sinuses

Z3
0.4691
$19.4270220
X-ray exam of sinuses

Z3
0.5925
$24.5370240
X-ray exam, pituitary saddle

Z3
0.3949
$16.3570250
X-ray exam of skull

Z3
0.5101
$21.1270260
X-ray exam of skull

Z3
0.6831
$28.2870300
X-ray exam of teeth

Z3
0.1894
$7.8470310
X-ray exam of teeth

Z3
0.4855
$20.1070320
Full mouth x-ray of teeth

Z2
0.5749
$23.8070328
X-ray exam of jaw joint

Z3
0.4362
$18.0670330
X-ray exam of jaw joints
CH
Z2
0.6954
$28.7970332
X-ray exam of jaw joint
CH
N170336
Magnetic image, jaw joint

Z2
4.883
$202.1670350
X-ray head for orthodontia

Z3
0.2715
$11.2470355
Panoramic x-ray of jaws

Z3
0.3292
$13.6370360
X-ray exam of neck

Z3
0.3785
$15.6770370
Throat x-ray  &  fluoroscopy

Z3
1.1768
$48.7270371
Speech evaluation, complex

Z2
1.3271
$54.9470373
Contrast x-ray of larynx
CH
N170380
X-ray exam of salivary gland

Z3
0.5925
$24.5370390
X-ray exam of salivary duct
CH
N170450
Ct head/brain w/o dye

Z2
3.0109
$124.6570460
Ct head/brain w/dye

Z2
4.3564
$180.3670470
Ct head/brain w/o  &  w/dye

Z2
5.1125
$211.6670480
Ct orbit/ear/fossa w/o dye

Z2
3.0109
$124.6570481
Ct orbit/ear/fossa w/dye

Z2
4.3564
$180.3670482
Ct orbit/ear/fossa w/o & w/dye

Z2
5.1125
$211.6670486
Ct maxillofacial w/o dye

Z2
3.0109
$124.6570487
Ct maxillofacial w/dye

Z2
4.3564
$180.3670488
Ct maxillofacial w/o  &  w/dye

Z2
5.1125
$211.6670490
Ct soft tissue neck w/o dye

Z2
3.0109
$124.6570491
Ct soft tissue neck w/dye

Z2
4.3564
$180.3670492
Ct sft tsue nck w/o  &  w/dye

Z2
5.1125
$211.66( print page 9912)70496
Ct angiography, head

Z2
5.1641
$213.8070498
Ct angiography, neck

Z2
5.1641
$213.8070540
Mri orbit/face/neck w/o dye

Z2
5.3933
$223.2970542
Mri orbit/face/neck w/dye

Z2
6.235
$258.1470543
Mri orbt/fac/nck w/o  &  w/dye

Z2
8.2463
$341.4170544
Mr angiography head w/o dye

Z2
5.3933
$223.2970545
Mr angiography head w/dye

Z2
6.235
$258.1470546
Mr angiograph head w/o & w/dye

Z2
8.2463
$341.4170547
Mr angiography neck w/o dye

Z2
5.3933
$223.2970548
Mr angiography neck w/dye

Z2
6.235
$258.1470549
Mr angiograph neck w/o & w/dye

Z2
8.2463
$341.4170551
Mri brain w/o dye

Z2
5.3933
$223.2970552
Mri brain w/dye

Z2
6.235
$258.1470553
Mri brain w/o  &  w/dye

Z2
8.2463
$341.4170554
Fmri brain by tech

Z2
5.3933
$223.2970555
Fmri brain by phys/psych

Z2
5.3933
$223.2970557
Mri brain w/o dye

Z2
5.3933
$223.2970558
Mri brain w/dye

Z2
6.235
$258.1470559
Mri brain w/o  &  w/dye

Z2
8.2463
$341.4171010
Chest x-ray

Z3
0.3456
$14.3171015
Chest x-ray

Z3
0.4196
$17.3771020
Chest x-ray

Z3
0.4609
$19.0871021
Chest x-ray

Z3
0.5596
$23.1771022
Chest x-ray

Z3
0.6253
$25.8971023
Chest x-ray and fluoroscopy

Z3
0.8968
$37.1371030
Chest x-ray

Z3
0.6582
$27.2571034
Chest x-ray and fluoroscopy

Z2
1.3271
$54.9471035
Chest x-ray

Z3
0.5101
$21.1271040
Contrast x-ray of bronchi
CH
N171060
Contrast x-ray of bronchi
CH
N171090
X-ray  &  pacemaker insertion
CH
N171100
X-ray exam of ribs

Z3
0.4609
$19.0871101
X-ray exam of ribs/chest

Z3
0.5514
$22.8371110
X-ray exam of ribs

Z3
0.6007
$24.8771111
X-ray exam of ribs/chest

Z3
0.7652
$31.6871120
X-ray exam of breastbone

Z3
0.5019
$20.7871130
X-ray exam of breastbone

Z3
0.5679
$23.5171250
Ct thorax w/o dye

Z2
3.0109
$124.6571260
Ct thorax w/dye

Z2
4.3564
$180.3671270
Ct thorax w/o  &  w/dye

Z2
5.1125
$211.6671275
Ct angiography, chest

Z2
5.1641
$213.8071550
Mri chest w/o dye

Z2
5.3933
$223.2971551
Mri chest w/dye

Z2
6.235
$258.1471552
Mri chest w/o  &  w/dye

Z2
8.2463
$341.4172010
X-ray exam of spine

Z2
0.6954
$28.7972020
X-ray exam of spine

Z3
0.3456
$14.3172040
X-ray exam of neck spine

Z3
0.5348
$22.1472050
X-ray exam of neck spine

Z3
0.7652
$31.6872052
X-ray exam of neck spine

Z3
0.9874
$40.8872069
X-ray exam of trunk spine

Z3
0.4773
$19.7672070
X-ray exam of thoracic spine

Z3
0.5019
$20.7872072
X-ray exam of thoracic spine

Z3
0.5843
$24.1972074
X-ray exam of thoracic spine
CH
Z2
0.6954
$28.7972080
X-ray exam of trunk spine

Z3
0.5266
$21.8072090
X-ray exam of trunk spine

Z3
0.65
$26.9172100
X-ray exam of lower spine

Z3
0.5761
$23.8572110
X-ray exam of lower spine

Z3
0.7983
$33.0572114
X-ray exam of lower spine

Z3
1.078
$44.6372120
X-ray exam of lower spine

Z3
0.7734
$32.0272125
Ct neck spine w/o dye

Z2
3.0109
$124.6572126
Ct neck spine w/dye

Z2
4.3564
$180.3672127
Ct neck spine w/o  &  w/dye

Z2
5.1125
$211.6672128
Ct chest spine w/o dye

Z2
3.0109
$124.6572129
Ct chest spine w/dye

Z2
4.3564
$180.3672130
Ct chest spine w/o  &  w/dye

Z2
5.1125
$211.6672131
Ct lumbar spine w/o dye

Z2
3.0109
$124.6572132
Ct lumbar spine w/dye

Z2
4.3564
$180.3672133
Ct lumbar spine w/o  &  w/dye

Z2
5.1125
$211.66( print page 9913)72141
Mri neck spine w/o dye

Z2
5.3933
$223.2972142
Mri neck spine w/dye

Z2
6.235
$258.1472146
Mri chest spine w/o dye

Z2
5.3933
$223.2972147
Mri chest spine w/dye

Z2
6.235
$258.1472148
Mri lumbar spine w/o dye

Z2
5.3933
$223.2972149
Mri lumbar spine w/dye

Z2
6.235
$258.1472156
Mri neck spine w/o  &  w/dye

Z2
8.2463
$341.4172157
Mri chest spine w/o  &  w/dye

Z2
8.2463
$341.4172158
Mri lumbar spine w/o  &  w/dye

Z2
8.2463
$341.4172170
X-ray exam of pelvis

Z3
0.3949
$16.3572190
X-ray exam of pelvis

Z3
0.5925
$24.5372191
Ct angiograph pelv w/o & w/dye

Z2
5.1641
$213.8072192
Ct pelvis w/o dye

Z2
3.0109
$124.6572193
Ct pelvis w/dye

Z2
4.3564
$180.3672194
Ct pelvis w/o  &  w/dye

Z2
5.1125
$211.6672195
Mri pelvis w/o dye

Z2
5.3933
$223.2972196
Mri pelvis w/dye

Z2
6.235
$258.1472197
Mri pelvis w/o  &  w/dye

Z2
8.2463
$341.4172200
X-ray exam sacroiliac joints

Z3
0.4362
$18.0672202
X-ray exam sacroiliac joints

Z3
0.5348
$22.1472220
X-ray exam of tailbone

Z3
0.4526
$18.7472240
Contrast x-ray of neck spine
CH
N172255
Contrast x-ray, thorax spine
CH
N172265
Contrast x-ray, lower spine
CH
N172270
Contrast x-ray, spine
CH
N172275
Epidurography
CH
N172285
X-ray c/t spine disk
CH
N172291
Perq vertebroplasty, fluor
CH
N172292
Perq vertebroplasty, ct
CH
N172295
X-ray of lower spine disk
CH
N173000
X-ray exam of collar bone

Z3
0.4196
$17.3773010
X-ray exam of shoulder blade

Z3
0.428
$17.7273020
X-ray exam of shoulder

Z3
0.3539
$14.6573030
X-ray exam of shoulder

Z3
0.4444
$18.4073040
Contrast x-ray of shoulder
CH
N173050
X-ray exam of shoulders

Z3
0.5432
$22.4973060
X-ray exam of humerus

Z3
0.4444
$18.4073070
X-ray exam of elbow

Z3
0.4196
$17.3773080
X-ray exam of elbow

Z3
0.5183
$21.4673085
Contrast x-ray of elbow
CH
N173090
X-ray exam of forearm

Z3
0.4196
$17.3773092
X-ray exam of arm, infant

Z3
0.4196
$17.3773100
X-ray exam of wrist

Z3
0.428
$17.7273110
X-ray exam of wrist

Z3
0.5101
$21.1273115
Contrast x-ray of wrist
CH
N173120
X-ray exam of hand

Z3
0.4113
$17.0373130
X-ray exam of hand

Z3
0.4691
$19.4273140
X-ray exam of finger(s)

Z3
0.4362
$18.0673200
Ct upper extremity w/o dye

Z2
3.0109
$124.6573201
Ct upper extremity w/dye

Z2
4.3564
$180.3673202
Ct uppr extremity w/o & w/dye

Z2
5.1125
$211.6673206
Ct angio upr extrm w/o & w/dye

Z2
5.1641
$213.8073218
Mri upper extremity w/o dye

Z2
5.3933
$223.2973219
Mri upper extremity w/dye

Z2
6.235
$258.1473220
Mri uppr extremity w/o & w/dye

Z2
8.2463
$341.4173221
Mri joint upr extrem w/o dye

Z2
5.3933
$223.2973222
Mri joint upr extrem w/dye

Z2
6.235
$258.1473223
Mri joint upr extr w/o & w/dye

Z2
8.2463
$341.4173500
X-ray exam of hip

Z3
0.3703
$15.3373510
X-ray exam of hip

Z3
0.5266
$21.8073520
X-ray exam of hips

Z3
0.5596
$23.1773525
Contrast x-ray of hip
CH
N173530
X-ray exam of hip
CH
N173540
X-ray exam of pelvis  &  hips

Z3
0.5348
$22.1473542
X-ray exam, sacroiliac joint
CH
N173550
X-ray exam of thigh

Z3
0.4362
$18.0673560
X-ray exam of knee, 1 or 2

Z3
0.428
$17.7273562
X-ray exam of knee, 3

Z3
0.5101
$21.12( print page 9914)73564
X-ray exam, knee, 4 or more

Z3
0.5761
$23.8573565
X-ray exam of knees

Z3
0.4444
$18.4073580
Contrast x-ray of knee joint
CH
N173590
X-ray exam of lower leg

Z3
0.4113
$17.0373592
X-ray exam of leg, infant

Z3
0.4196
$17.3773600
X-ray exam of ankle

Z3
0.4113
$17.0373610
X-ray exam of ankle

Z3
0.4691
$19.4273615
Contrast x-ray of ankle
CH
N173620
X-ray exam of foot

Z3
0.4031
$16.6973630
X-ray exam of foot

Z3
0.4691
$19.4273650
X-ray exam of heel

Z3
0.3949
$16.3573660
X-ray exam of toe(s)

Z3
0.4196
$17.3773700
Ct lower extremity w/o dye

Z2
3.0109
$124.6573701
Ct lower extremity w/dye

Z2
4.3564
$180.3673702
Ct lwr extremity w/o & w/dye

Z2
5.1125
$211.6673706
Ct angio lwr extr w/o & w/dye

Z2
5.1641
$213.8073718
Mri lower extremity w/o dye

Z2
5.3933
$223.2973719
Mri lower extremity w/dye

Z2
6.235
$258.1473720
Mri lwr extremity w/o & w/dye

Z2
8.2463
$341.4173721
Mri jnt of lwr extre w/o dye

Z2
5.3933
$223.2973722
Mri joint of lwr extr w/dye

Z2
6.235
$258.1473723
Mri joint lwr extr w/o & w/dye

Z2
8.2463
$341.4174000
X-ray exam of abdomen

Z3
0.3785
$15.6774010
X-ray exam of abdomen

Z3
0.5266
$21.8074020
X-ray exam of abdomen

Z3
0.5514
$22.8374022
X-ray exam series, abdomen

Z3
0.6582
$27.2574150
Ct abdomen w/o dye

Z2
3.0109
$124.6574160
Ct abdomen w/dye

Z2
4.3564
$180.3674170
Ct abdomen w/o  &  w/dye

Z2
5.1125
$211.6674175
Ct angio abdom w/o  &  w/dye

Z2
5.1641
$213.8074181
Mri abdomen w/o dye

Z2
5.3933
$223.2974182
Mri abdomen w/dye

Z2
6.235
$258.1474183
Mri abdomen w/o  &  w/dye

Z2
8.2463
$341.4174190
X-ray exam of peritoneum
CH
N174210
Contrst x-ray exam of throat

Z3
1.1686
$48.3874220
Contrast x-ray, esophagus

Z3
1.2507
$51.7874230
Cine/vid x-ray, throat/esoph

Z3
1.2674
$52.4774235
Remove esophagus obstruction
CH
N174240
X-ray exam, upper gi tract
CH
Z2
1.3834
$57.2774241
X-ray exam, upper gi tract

Z2
1.3834
$57.2774245
X-ray exam, upper gi tract

Z2
2.2222
$92.0074246
Contrst x-ray uppr gi tract

Z2
1.3834
$57.2774247
Contrst x-ray uppr gi tract

Z2
1.3834
$57.2774249
Contrst x-ray uppr gi tract

Z2
2.2222
$92.0074250
X-ray exam of small bowel
CH
Z2
1.3834
$57.2774251
X-ray exam of small bowel

Z2
2.2222
$92.0074260
X-ray exam of small bowel

Z2
1.3834
$57.2774270
Contrast x-ray exam of colon

Z2
1.3834
$57.2774280
Contrast x-ray exam of colon

Z2
2.2222
$92.0074283
Contrast x-ray exam of colon

Z2
1.3834
$57.2774290
Contrast x-ray, gallbladder

Z3
0.9053
$37.4874291
Contrast x-rays, gallbladder

Z3
0.7816
$32.3674300
X-ray bile ducts/pancreas
CH
N174301
X-rays at surgery add-on
CH
N174305
X-ray bile ducts/pancreas
CH
N174320
Contrast x-ray of bile ducts
CH
N174327
X-ray bile stone removal
CH
N174328
X-ray bile duct endoscopy

N174329
X-ray for pancreas endoscopy

N174330
X-ray bile/panc endoscopy

N174340
X-ray guide for gi tube
CH
N174350
X-ray guide, stomach tube
CH
D574355
X-ray guide, intestinal tube
CH
N174360
X-ray guide, gi dilation
CH
N174363
X-ray, bile duct dilation
CH
N174400
Contrst x-ray, urinary tract

Z3
1.6869
$69.8474410
Contrst x-ray, urinary tract

Z3
1.835
$75.9774415
Contrst x-ray, urinary tract

Z3
2.1478
$88.92( print page 9915)74420
Contrst x-ray, urinary tract

Z2
2.6121
$108.1474425
Contrst x-ray, urinary tract
CH
N174430
Contrast x-ray, bladder
CH
N174440
X-ray, male genital tract
CH
N174445
X-ray exam of penis
CH
N174450
X-ray, urethra/bladder
CH
N174455
X-ray, urethra/bladder
CH
N174470
X-ray exam of kidney lesion
CH
N174475
X-ray control, cath insert
CH
N174480
X-ray control, cath insert
CH
N174485
X-ray guide, gu dilation
CH
N174710
X-ray measurement of pelvis

Z3
0.65
$26.9174740
X-ray, female genital tract
CH
N174742
X-ray, fallopian tube
CH
N174775
X-ray exam of perineum

Z2
2.6121
$108.1475552
Heart mri for morph w/o dye
CH
D575553
Heart mri for morph w/dye
CH
D575554
Cardiac MRI/function
CH
D575555
Cardiac MRI/limited study
CH
D575557
Cardiac mri for morph
NI
Z2
5.3933
$223.2975559
Cardiac mri w/stress img
NI
Z2
5.3933
$223.2975561
Cardiac mri for morph w/dye
NI
Z2
8.2463
$341.4175563
Card mri w/stress img  &  dye
NI
Z2
8.2463
$341.4175600
Contrast x-ray exam of aorta
CH
N175605
Contrast x-ray exam of aorta
CH
N175625
Contrast x-ray exam of aorta
CH
N175630
X-ray aorta, leg arteries
CH
N175635
Ct angio abdominal arteries
CH
N175650
Artery x-rays, head  &  neck
CH
N175658
Artery x-rays, arm
CH
N175660
Artery x-rays, head  &  neck
CH
N175662
Artery x-rays, head  &  neck
CH
N175665
Artery x-rays, head  &  neck
CH
N175671
Artery x-rays, head  &  neck
CH
N175676
Artery x-rays, neck
CH
N175680
Artery x-rays, neck
CH
N175685
Artery x-rays, spine
CH
N175705
Artery x-rays, spine
CH
N175710
Artery x-rays, arm/leg
CH
N175716
Artery x-rays, arms/legs
CH
N175722
Artery x-rays, kidney
CH
N175724
Artery x-rays, kidneys
CH
N175726
Artery x-rays, abdomen
CH
N175731
Artery x-rays, adrenal gland
CH
N175733
Artery x-rays, adrenals
CH
N175736
Artery x-rays, pelvis
CH
N175741
Artery x-rays, lung
CH
N175743
Artery x-rays, lungs
CH
N175746
Artery x-rays, lung
CH
N175756
Artery x-rays, chest
CH
N175774
Artery x-ray, each vessel
CH
N175790
Visualize a-v shunt
CH
N175801
Lymph vessel x-ray, arm/leg
CH
N175803
Lymph vessel x-ray,arms/legs
CH
N175805
Lymph vessel x-ray, trunk
CH
N175807
Lymph vessel x-ray, trunk
CH
N175809
Nonvascular shunt, x-ray
CH
N175810
Vein x-ray, spleen/liver
CH
N175820
Vein x-ray, arm/leg
CH
N175822
Vein x-ray, arms/legs
CH
N175825
Vein x-ray, trunk
CH
N175827
Vein x-ray, chest
CH
N175831
Vein x-ray, kidney
CH
N175833
Vein x-ray, kidneys
CH
N175840
Vein x-ray, adrenal gland
CH
N175842
Vein x-ray, adrenal glands
CH
N175860
Vein x-ray, neck
CH
N175870
Vein x-ray, skull
CH
N1( print page 9916)75872
Vein x-ray, skull
CH
N175880
Vein x-ray, eye socket
CH
N175885
Vein x-ray, liver
CH
N175887
Vein x-ray, liver
CH
N175889
Vein x-ray, liver
CH
N175891
Vein x-ray, liver
CH
N175893
Venous sampling by catheter

N175894
X-rays, transcath therapy
CH
N175896
X-rays, transcath therapy
CH
N175898
Follow-up angiography
CH
N175901
Remove cva device obstruct
CH
N175902
Remove cva lumen obstruct
CH
N175940
X-ray placement, vein filter
CH
N175945
Intravascular us
CH
N175946
Intravascular us add-on
CH
N175960
Transcath iv stent rs & i
CH
N175961
Retrieval, broken catheter
CH
N175962
Repair arterial blockage
CH
N175964
Repair artery blockage, each
CH
N175966
Repair arterial blockage
CH
N175968
Repair artery blockage, each
CH
N175970
Vascular biopsy
CH
N175978
Repair venous blockage
CH
N175980
Contrast xray exam bile duct
CH
N175982
Contrast xray exam bile duct
CH
N175984
Xray control catheter change
CH
N175989
Abscess drainage under x-ray

N175992
Atherectomy, x-ray exam
CH
N175993
Atherectomy, x-ray exam
CH
N175994
Atherectomy, x-ray exam
CH
N175995
Atherectomy, x-ray exam
CH
N175996
Atherectomy, x-ray exam
CH
N176000
Fluoroscope examination
CH
N176001
Fluoroscope exam, extensive

N176010
X-ray, nose to rectum

Z3
0.4113
$17.0376080
X-ray exam of fistula
CH
N176098
X-ray exam, breast specimen

Z3
0.2797
$11.5876100
X-ray exam of body section

Z2
1.157
$47.9076101
Complex body section x-ray

Z2
2.6838
$111.1176102
Complex body section x-rays

Z2
2.6838
$111.1176120
Cine/video x-rays

Z3
1.1521
$47.7076125
Cine/video x-rays add-on
CH
N176150
X-ray exam, dry process

Z3
0.4526
$18.7476350
Special x-ray contrast study

N176376
3d render w/o postprocess
CH
N176377
3d rendering w/postprocess
CH
N176380
Cat scan follow-up study

Z2
1.5839
$65.5876496
Fluoroscopic procedure

Z2
1.3271
$54.9476497
Ct procedure

Z2
1.5839
$65.5876498
Mri procedure

Z2
4.883
$202.1676499
Radiographic procedure

Z2
0.6954
$28.7976506
Echo exam of head

Z2
0.957
$39.6276510
Ophth us, b  &  quant a
CH
Z3
1.5963
$66.0976511
Ophth us, quant a only

Z3
1.2589
$52.1276512
Ophth us, b w/non-quant a

Z3
1.0862
$44.9776513
Echo exam of eye, water bath

Z3
1.1604
$48.0476514
Echo exam of eye, thickness

Z3
0.0659
$2.7376516
Echo exam of eye

Z3
0.9053
$37.4876519
Echo exam of eye

Z3
0.9874
$40.8876529
Echo exam of eye

Z3
0.8558
$35.4376536
Us exam of head and neck
CH
Z2
1.5094
$62.4976604
Us exam, chest

Z2
0.957
$39.6276645
Us exam, breast(s)

Z2
0.957
$39.6276700
Us exam, abdom, complete

Z2
1.5094
$62.4976705
Echo exam of abdomen

Z3
1.4647
$60.6476770
Us exam abdo back wall, comp

Z2
1.5094
$62.4976775
Us exam abdo back wall, lim

Z3
1.4893
$61.6676776
Us exam k transpl w/doppler

Z2
1.5094
$62.49( print page 9917)76800
Us exam, spinal canal

Z3
1.4154
$58.6076801
Ob us < 14 wks, single fetus

Z2
1.5094
$62.4976802
Ob us < 14 wks, add?l fetus

Z3
0.7241
$29.9876805
Ob us >/= 14 wks, sngl fetus

Z2
1.5094
$62.4976810
Ob us >/= 14 wks, addl fetus

Z3
0.9874
$40.8876811
Ob us, detailed, sngl fetus
CH
Z2
2.3792
$98.5076812
Ob us, detailed, addl fetus

Z2
0.957
$39.6276813
Ob us nuchal meas, 1 gest

Z3
1.4893
$61.6676814
Ob us nuchal meas, add-on

Z3
0.7077
$29.3076815
Ob us, limited, fetus(s)

Z2
0.957
$39.6276816
Ob us, follow-up, per fetus

Z2
0.957
$39.6276817
Transvaginal us, obstetric

Z2
0.957
$39.6276818
Fetal biophys profile w/nst

Z3
1.4483
$59.9676819
Fetal biophys profil w/o nst

Z3
1.2343
$51.1076820
Umbilical artery echo

Z3
0.8311
$34.4176821
Middle cerebral artery echo

Z3
1.3495
$55.8776825
Echo exam of fetal heart

Z2
1.5094
$62.4976826
Echo exam of fetal heart
CH
Z2
0.957
$39.6276827
Echo exam of fetal heart
CH
Z2
0.957
$39.6276828
Echo exam of fetal heart

Z3
0.65
$26.9176830
Transvaginal us, non-ob

Z2
1.5094
$62.4976831
Echo exam, uterus

Z3
1.6623
$68.8276856
Us exam, pelvic, complete

Z2
1.5094
$62.4976857
Us exam, pelvic, limited

Z2
0.957
$39.6276870
Us exam, scrotum

Z2
1.5094
$62.4976872
Us, transrectal

Z2
1.5094
$62.4976873
Echograp trans r, pros study

Z2
1.5094
$62.4976880
Us exam, extremity

Z2
1.5094
$62.4976885
Us exam infant hips, dynamic

Z2
0.957
$39.6276886
Us exam infant hips, static

Z2
0.957
$39.6276930
Echo guide, cardiocentesis
CH
N176932
Echo guide for heart biopsy
CH
N176936
Echo guide for artery repair
CH
N176937
Us guide, vascular access

N176940
Us guide, tissue ablation
CH
N176941
Echo guide for transfusion
CH
N176942
Echo guide for biopsy
CH
N176945
Echo guide, villus sampling
CH
N176946
Echo guide for amniocentesis
CH
N176948
Echo guide, ova aspiration
CH
N176950
Echo guidance radiotherapy
CH
N176965
Echo guidance radiotherapy
CH
N176970
Ultrasound exam follow-up

Z2
0.957
$39.6276975
Gi endoscopic ultrasound
CH
N176977
Us bone density measure

Z3
0.3785
$15.6776998
Us guide, intraop
CH
N176999
Echo examination procedure

Z2
0.957
$39.6277001
Fluoroguide for vein device

N177002
Needle localization by xray

N177003
Fluoroguide for spine inject

N177011
Ct scan for localization
CH
N177012
Ct scan for needle biopsy
CH
N177013
Ct guide for tissue ablation
CH
N177014
Ct scan for therapy guide
CH
N177021
Mr guidance for needle place
CH
N177022
Mri for tissue ablation
CH
N177031
Stereotact guide for brst bx
CH
N177032
Guidance for needle, breast
CH
N177053
X-ray of mammary duct
CH
N177054
X-ray of mammary ducts
CH
N177071
X-ray stress view

Z3
0.3949
$16.3577072
X-rays for bone age

Z3
0.2961
$12.2677073
X-rays, bone length studies

Z3
0.5596
$23.1777074
X-rays, bone survey, limited

Z3
0.9381
$38.8477075
X-rays, bone survey complete

Z2
1.157
$47.9077076
X-rays, bone survey, infant

Z2
0.6954
$28.7977077
Joint survey, single view

Z3
0.6831
$28.2877078
Ct bone density, axial

Z2
1.1384
$47.13( print page 9918)77079
Ct bone density, peripheral

Z3
1.5224
$63.0377080
Dxa bone density, axial

Z2
1.1384
$47.1377081
Dxa bone density/peripheral
CH
Z3
0.4773
$19.7677082
Dxa bone density, vert fx

Z3
0.5019
$20.7877083
Radiographic absorptiometry

Z3
0.4362
$18.0677084
Magnetic image, bone marrow

Z2
4.883
$202.1677280
Set radiation therapy field

Z2
1.5576
$64.4977285
Set radiation therapy field

Z2
3.9276
$162.6177290
Set radiation therapy field

Z2
3.9276
$162.6177295
Set radiation therapy field
CH
Z2
13.5621
$561.4877299
Radiation therapy planning

Z2
1.5576
$64.4977300
Radiation therapy dose plan

Z3
0.9546
$39.5277301
Radiotherapy dose plan, imrt

Z2
13.5621
$561.4877305
Teletx isodose plan simple

Z3
1.0451
$43.2777310
Teletx isodose plan intermed

Z3
1.3331
$55.1977315
Teletx isodose plan complex

Z3
1.7444
$72.2277321
Special teletx port plan

Z3
2.156
$89.2677326
Brachytx isodose calc simp

Z2
1.5576
$64.4977327
Brachytx isodose calc interm

Z3
2.9294
$121.2877328
Brachytx isodose plan compl

Z3
3.9168
$162.1677331
Special radiation dosimetry

Z3
0.4196
$17.3777332
Radiation treatment aid(s)

Z3
1.1191
$46.3377333
Radiation treatment aid(s)

Z3
0.8804
$36.4577334
Radiation treatment aid(s)

Z3
2.2876
$94.7177336
Radiation physics consult

Z2
1.5576
$64.4977370
Radiation physics consult

Z2
1.5576
$64.4977371
Srs, multisource

Z3
24.7769
$1,025.7977399
External radiation dosimetry

Z2
1.5576
$64.4977401
Radiation treatment delivery

Z3
0.9217
$38.1677402
Radiation treatment delivery

Z2
1.4229
$58.9177403
Radiation treatment delivery

Z2
1.4229
$58.9177404
Radiation treatment delivery

Z2
1.4229
$58.9177406
Radiation treatment delivery

Z2
1.4229
$58.9177407
Radiation treatment delivery

Z2
1.4229
$58.9177408
Radiation treatment delivery

Z2
1.4229
$58.9177409
Radiation treatment delivery

Z2
1.4229
$58.9177411
Radiation treatment delivery

Z2
2.2167
$91.7777412
Radiation treatment delivery

Z2
2.2167
$91.7777413
Radiation treatment delivery

Z2
2.2167
$91.7777414
Radiation treatment delivery

Z2
2.2167
$91.7777416
Radiation treatment delivery

Z2
2.2167
$91.7777417
Radiology port film(s)
CH
N177418
Radiation tx delivery, imrt

Z2
5.4582
$225.9777421
Stereoscopic x-ray guidance
CH
N177422
Neutron beam tx, simple

Z2
2.2167
$91.7777423
Neutron beam tx, complex

Z2
2.2167
$91.7777435
Sbrt management

N177470
Special radiation treatment

Z3
5.1018
$211.2277520
Proton trmt, simple w/o comp

Z2
12.8205
$530.7877522
Proton trmt, simple w/comp

Z2
12.8205
$530.7877523
Proton trmt, intermediate

Z2
15.3404
$635.1177525
Proton treatment, complex

Z2
15.3404
$635.1177600
Hyperthermia treatment
CH
Z3
5.2665
$218.0477605
Hyperthermia treatment

Z2
5.7996
$240.1177610
Hyperthermia treatment

Z2
5.7996
$240.1177615
Hyperthermia treatment

Z2
5.7996
$240.1177620
Hyperthermia treatment
CH
Z3
5.4146
$224.1777750
Infuse radioactive materials

Z3
1.7529
$72.5777761
Apply intrcav radiat simple

Z3
3.127
$129.4677762
Apply intrcav radiat interm

Z3
3.8511
$159.4477763
Apply intrcav radiat compl

Z3
4.9455
$204.7577776
Apply interstit radiat simpl

Z3
3.2833
$135.9377777
Apply interstit radiat inter

Z3
3.991
$165.2377778
Apply interstit radiat compl

Z3
5.2501
$217.3677781
High intensity brachytherapy

Z3
10.0063
$414.2777782
High intensity brachytherapy

Z2
11.6779
$483.4877783
High intensity brachytherapy

Z2
11.6779
$483.4877784
High intensity brachytherapy

Z2
11.6779
$483.48( print page 9919)77789
Apply surface radiation

Z3
0.8558
$35.4377790
Radiation handling

N177799
Radium/radioisotope therapy

Z2
8.514
$352.4978000
Thyroid, single uptake

Z3
1.1355
$47.0178001
Thyroid, multiple uptakes

Z3
1.4483
$59.9678003
Thyroid suppress/stimul

Z3
1.1437
$47.3578006
Thyroid imaging with uptake

Z2
3.4513
$142.8978007
Thyroid image, mult uptakes

Z3
2.2466
$93.0178010
Thyroid imaging
CH
Z2
2.0471
$84.7578011
Thyroid imaging with flow

Z2
2.0471
$84.7578015
Thyroid met imaging

Z3
3.168
$131.1678016
Thyroid met imaging/studies
CH
Z3
4.8303
$199.9878018
Thyroid met imaging, body

Z2
5.0681
$209.8278020
Thyroid met uptake
CH
N178070
Parathyroid nuclear imaging
CH
Z3
3.0777
$127.4278075
Adrenal nuclear imaging
CH
Z3
6.9122
$286.1778099
Endocrine nuclear procedure

Z2
2.0471
$84.7578102
Bone marrow imaging, ltd

Z3
2.4852
$102.8978103
Bone marrow imaging, mult

Z3
3.4398
$142.4178104
Bone marrow imaging, body

Z2
3.9293
$162.6878110
Plasma volume, single

Z3
1.2425
$51.4478111
Plasma volume, multiple

Z3
1.9091
$79.0478120
Red cell mass, single

Z3
1.5471
$64.0578121
Red cell mass, multiple

Z3
2.0654
$85.5178122
Blood volume

Z3
2.7567
$114.1378130
Red cell survival study

Z3
2.5263
$104.5978135
Red cell survival kinetics
CH
Z3
5.4885
$227.2378140
Red cell sequestration

Z3
2.7403
$113.4578185
Spleen imaging

Z3
3.0528
$126.3978190
Platelet survival, kinetics

Z2
2.9022
$120.1578191
Platelet survival

Z2
2.9022
$120.1578195
Lymph system imaging

Z2
3.9293
$162.6878199
Blood/lymph nuclear exam

Z2
3.9293
$162.6878201
Liver imaging

Z3
2.8142
$116.5178202
Liver imaging with flow

Z3
3.3161
$137.2978205
Liver imaging (3d)
CH
Z2
4.4603
$184.6678206
Liver image (3d) with flow

Z2
4.4603
$184.6678215
Liver and spleen imaging

Z3
3.127
$129.4678216
Liver  &  spleen image/flow

Z3
2.5263
$104.5978220
Liver function study

Z3
2.7321
$113.1178223
Hepatobiliary imaging

Z2
4.4603
$184.6678230
Salivary gland imaging

Z3
2.5509
$105.6178231
Serial salivary imaging

Z3
2.3864
$98.8078232
Salivary gland function exam

Z3
2.5345
$104.9378258
Esophageal motility study

Z3
3.3492
$138.6678261
Gastric mucosa imaging

Z2
3.7911
$156.9678262
Gastroesophageal reflux exam

Z2
3.7911
$156.9678264
Gastric emptying study

Z2
3.7911
$156.9678270
Vit b-12 absorption exam

Z3
1.4072
$58.2678271
Vit b-12 absrp exam, int fac

Z3
1.4318
$59.2878272
Vit b-12 absorp, combined

Z3
1.7775
$73.5978278
Acute gi blood loss imaging

Z2
3.7911
$156.9678282
Gi protein loss exam

Z2
3.7911
$156.9678290
Meckel?s divert exam

Z2
3.7911
$156.9678291
Leveen/shunt patency exam

Z3
3.67
$151.9478299
Gi nuclear procedure

Z2
3.7911
$156.9678300
Bone imaging, limited area

Z3
2.6743
$110.7278305
Bone imaging, multiple areas

Z3
3.6453
$150.9278306
Bone imaging, whole body
CH
Z2
3.8039
$157.4978315
Bone imaging, 3 phase

Z2
3.8039
$157.4978320
Bone imaging (3d)

Z2
3.8039
$157.4978399
Musculoskeletal nuclear exam

Z2
3.8039
$157.4978414
Non-imaging heart function

Z2
4.862
$201.2978428
Cardiac shunt imaging

Z3
2.9458
$121.9678445
Vascular flow imaging
CH
Z3
2.5427
$105.2778456
Acute venous thrombus image

Z2
3.1433
$130.1478457
Venous thrombosis imaging
CH
Z3
2.913
$120.6078458
Ven thrombosis images, bilat

Z2
3.1433
$130.14( print page 9920)78459
Heart muscle imaging (pet)

Z2
21.9955
$910.6478460
Heart muscle blood, single

Z3
2.7567
$114.1378461
Heart muscle blood, multiple

Z3
3.4313
$142.0678464
Heart image (3d), single
CH
Z3
5.1182
$211.9078465
Heart image (3d), multiple
CH
Z3
9.2739
$383.9578466
Heart infarct image

Z3
2.8473
$117.8878468
Heart infarct image (ef)

Z3
3.7605
$155.6978469
Heart infarct image (3d)
CH
Z3
4.5588
$188.7478472
Gated heart, planar, single
CH
Z3
4.5835
$189.7678473
Gated heart, multiple

Z2
4.862
$201.2978478
Heart wall motion add-on
CH
N178480
Heart function add-on
CH
N178481
Heart first pass, single

Z3
4.032
$166.9378483
Heart first pass, multiple

Z2
4.862
$201.2978491
Heart image (pet), single

Z2
21.9955
$910.6478492
Heart image (pet), multiple

Z2
21.9955
$910.6478494
Heart image, spect

Z2
4.862
$201.2978496
Heart first pass add-on
CH
N178499
Cardiovascular nuclear exam

Z2
4.862
$201.2978580
Lung perfusion imaging

Z2
3.3954
$140.5778584
Lung v/q image single breath

Z3
2.4193
$100.1678585
Lung v/q imaging

Z2
4.9509
$204.9778586
Aerosol lung image, single

Z3
2.7238
$112.7778587
Aerosol lung image, multiple

Z3
3.3246
$137.6478588
Perfusion lung image

Z3
4.7233
$195.5578591
Vent image, 1 breath, 1 proj

Z3
2.8306
$117.1978593
Vent image, 1 proj, gas

Z3
3.3328
$137.9878594
Vent image, mult proj, gas

Z2
3.3954
$140.5778596
Lung differential function

Z2
4.9509
$204.9778599
Respiratory nuclear exam

Z2
3.3954
$140.5778600
Brain image < 4 views

Z3
2.9294
$121.2878601
Brain image w/flow < 4 views
CH
Z2
3.2295
$133.7078605
Brain image 4+ views
CH
Z2
3.2295
$133.7078606
Brain image w/flow 4 + views
CH
Z3
5.0197
$207.8278607
Brain imaging (3d)
CH
Z3
6.081
$251.7678608
Brain imaging (pet)

Z2
16.6001
$687.2678610
Brain flow imaging only

Z3
3.382
$140.0278615
Cerebral vascular flow image
CH
D578630
Cerebrospinal fluid scan
CH
Z3
5.538
$229.2878635
Csf ventriculography
CH
Z3
4.5835
$189.7678645
Csf shunt evaluation

Z2
3.2295
$133.7078647
Cerebrospinal fluid scan
CH
Z3
5.8259
$241.2078650
Csf leakage imaging
CH
Z3
5.3487
$221.4478660
Nuclear exam of tear flow

Z3
2.5509
$105.6178699
Nervous system nuclear exam

Z2
3.2295
$133.7078700
Kidney imaging, morphol

Z3
2.9953
$124.0178701
Kidney imaging with flow

Z3
3.6125
$149.5678707
K flow/funct image w/o drug
CH
Z3
3.9581
$163.8778708
K flow/funct image w/drug

Z3
3.0941
$128.1078709
K flow/funct image, multiple

Z2
5.0824
$210.4278710
Kidney imaging (3d)
CH
Z3
4.5175
$187.0378725
Kidney function study
CH
Z3
1.6541
$68.4878730
Urinary bladder retention
CH
Z3
1.3908
$57.5878740
Ureteral reflux study

Z3
3.1188
$129.1278761
Testicular imaging w/flow

Z3
3.2915
$136.2778799
Genitourinary nuclear exam

Z2
5.0824
$210.4278800
Tumor imaging, limited area

Z3
3.1023
$128.4478801
Tumor imaging, mult areas

Z3
4.1144
$170.3478802
Tumor imaging, whole body
CH
Z3
5.5052
$227.9278803
Tumor imaging (3d)
CH
Z3
6.0564
$250.7478804
Tumor imaging, whole body
CH
Z3
10.5082
$435.0578805
Abscess imaging, ltd area

Z3
3.0364
$125.7178806
Abscess imaging, whole body
CH
Z3
5.9658
$246.9978807
Nuclear localization/abscess
CH
Z3
6.0482
$250.4078811
Pet image, ltd area

Z2
16.6001
$687.2678812
Pet image, skull-thigh

Z2
16.6001
$687.2678813
Pet image, full body

Z2
16.6001
$687.2678814
Pet image w/ct, lmtd

Z2
16.6001
$687.26( print page 9921)78815
Pet image w/ct, skull-thigh

Z2
16.6001
$687.2678816
Pet image w/ct, full body

Z2
16.6001
$687.2678890
Nuclear medicine data proc

N178891
Nuclear med data proc

N178999
Nuclear diagnostic exam

Z2
1.819
$75.3179005
Nuclear rx, oral admin

Z3
1.6046
$66.4379101
Nuclear rx, iv admin

Z3
1.6705
$69.1679200
Nuclear rx, intracav admin

Z3
1.728
$71.5479300
Nuclr rx, interstit colloid

Z2
3.302
$136.7179403
Hematopoietic nuclear tx

Z3
2.6497
$109.7079440
Nuclear rx, intra-articular

Z3
1.5553
$64.3979445
Nuclear rx, intra-arterial

Z2
3.302
$136.7179999
Nuclear medicine therapy

Z2
3.302
$136.7190296
Diphtheria antitoxin
CH
N190371
Hep b ig, im

K2

$122.0290375
Rabies ig, im/sc

K2

$68.2290376
Rabies ig, heat treated

K2

$71.6990385
Rh ig, minidose, im
CH
N190393
Vaccina ig, im
CH
N190396
Varicella-zoster ig, im

K2

$122.7490476
Adenovirus vaccine, type 4
CH
N190477
Adenovirus vaccine, type 7
CH
N190581
Anthrax vaccine, sc
CH
N190585
Bcg vaccine, percut

K2

$118.9890632
Hep a vaccine, adult im
CH
N190633
Hep a vacc, ped/adol, 2 dose
CH
N190634
Hep a vacc, ped/adol, 3 dose
CH
N190636
Hep a/hep b vacc, adult im
CH
N190645
Hib vaccine, hboc, im
CH
N190646
Hib vaccine, prp-d, im
CH
N190647
Hib vaccine, prp-omp, im
CH
N190648
Hib vaccine, prp-t, im
CH
N190665
Lyme disease vaccine, im
CH
N190675
Rabies vaccine, im

K2

$150.8090676
Rabies vaccine, id

K2

$119.8690680
Rotovirus vacc 3 dose, oral
CH
N190690
Typhoid vaccine, oral
CH
N190691
Typhoid vaccine, im
CH
N190692
Typhoid vaccine, h-p, sc/id
CH
N190698
Dtap-hib-ip vaccine, im
CH
N190700
Dtap vaccine, < 7 yrs, im
CH
N190701
Dtp vaccine, im
CH
N190702
Dt vaccine < 7, im
CH
N190703
Tetanus vaccine, im
CH
N190704
Mumps vaccine, sc
CH
N190705
Measles vaccine, sc
CH
N190706
Rubella vaccine, sc
CH
N190707
Mmr vaccine, sc
CH
N190708
Measles-rubella vaccine, sc

K2

$45.5390710
Mmrv vaccine, sc
CH
N190712
Oral poliovirus vaccine
CH
N190713
Poliovirus, ipv, sc/im
CH
N190714
Td vaccine no prsrv >/= 7 im
CH
N190715
Tdap vaccine >7 im
CH
N190717
Yellow fever vaccine, sc
CH
N190718
Td vaccine > 7, im
CH
N190719
Diphtheria vaccine, im
CH
N190720
Dtp/hib vaccine, im
CH
N190721
Dtap/hib vaccine, im
CH
N190725
Cholera vaccine, injectable
CH
N190727
Plague vaccine, im
CH
N190733
Meningococcal vaccine, sc

K2

$85.2990734
Meningococcal vaccine, im

K2

$82.0090735
Encephalitis vaccine, sc

K2

$98.1790749
Vaccine toxoid
CH
N1A4218
Sterile saline or water

N1A4220
Infusion pump refill kit

N1A4248
Chlorhexidine antisept

N1( print page 9922)A4262
Temporary tear duct plug

N1A4263
Permanent tear duct plug

N1A4270
Disposable endoscope sheath

N1A4300
Cath impl vasc access portal

N1A4301
Implantable access syst perc

N1A4305
Drug delivery system >=50 ML

N1A4306
Drug delivery system <=50 ml

N1A4648
Implantable tissue marker
NI
N1A4650
Implant radiation dosimeter
NI
N1A9527
Iodine I-125 sodium iodide
CH
H2
0.4325
$27.55A9535
Injection, methylene blue
CH
N1A9576
Inj prohance multipack
NI
N1A9577
Inj multihance
NI
N1A9578
Inj multihance multipack
NI
N1A9579
Gad-base MR contrast NOS,1ml
NI
N1A9698
Non-rad contrast materialNOC

N1C1713
Anchor/screw bn/bn,tis/bn

N1C1714
Cath, trans atherectomy, dir

N1C1715
Brachytherapy needle

N1C1716
Brachytx, non-str, Gold-198
CH
H2
0.5228
$33.30C1717
Brachytx, non-str,HDR Ir-192
CH
H2
2.7505
$175.19C1719
Brachytx, NS, Non-HDRIr-192
CH
H2
1.0226
$65.13C1721
AICD, dual chamber

N1C1722
AICD, single chamber

N1C1724
Cath, trans atherec,rotation

N1C1725
Cath, translumin non-laser

N1C1726
Cath, bal dil, non-vascular

N1C1727
Cath, bal tis dis, non-vas

N1C1728
Cath, brachytx seed adm

N1C1729
Cath, drainage

N1C1730
Cath, EP, 19 or few elect

N1C1731
Cath, EP, 20 or more elec

N1C1732
Cath, EP, diag/abl, 3D/vect

N1C1733
Cath, EP, othr than cool-tip

N1C1750
Cath, hemodialysis,long-term

N1C1751
Cath, inf, per/cent/midline

N1C1752
Cath,hemodialysis,short-term

N1C1753
Cath, intravas ultrasound

N1C1754
Catheter, intradiscal

N1C1755
Catheter, intraspinal

N1C1756
Cath, pacing, transesoph

N1C1757
Cath, thrombectomy/embolect

N1C1758
Catheter, ureteral

N1C1759
Cath, intra echocardiography

N1C1760
Closure dev, vasc

N1C1762
Conn tiss, human(inc fascia)

N1C1763
Conn tiss, non-human

N1C1764
Event recorder, cardiac

N1C1765
Adhesion barrier

N1C1766
Intro/sheath,strble,non-peel

N1C1767
Generator, neuro non-recharg

N1C1768
Graft, vascular

N1C1769
Guide wire

N1C1770
Imaging coil, MR, insertable

N1C1771
Rep dev, urinary, w/sling

N1C1772
Infusion pump, programmable

N1C1773
Ret dev, insertable

N1C1776
Joint device (implantable)

N1C1777
Lead, AICD, endo single coil

N1C1778
Lead, neurostimulator

N1C1779
Lead, pmkr, transvenous VDD

N1C1780
Lens, intraocular (new tech)

N1C1781
Mesh (implantable)

N1C1782
Morcellator

N1C1783
Ocular imp, aqueous drain de

N1C1784
Ocular dev, intraop, det ret

N1C1785
Pmkr, dual, rate-resp

N1C1786
Pmkr, single, rate-resp

N1( print page 9923)C1787
Patient progr, neurostim

N1C1788
Port, indwelling, imp

N1C1789
Prosthesis, breast, imp

N1C1813
Prosthesis, penile, inflatab

N1C1814
Retinal tamp, silicone oil

N1C1815
Pros, urinary sph, imp

N1C1816
Receiver/transmitter, neuro

N1C1817
Septal defect imp sys

N1C1818
Integrated keratoprosthesis

N1C1819
Tissue localization-excision

N1C1820
Generator neuro rechg bat sy
CH
N1C1821
Interspinous implant

J7C1874
Stent, coated/cov w/del sys

N1C1875
Stent, coated/cov w/o del sy

N1C1876
Stent, non-coa/non-cov w/del

N1C1877
Stent, non-coat/cov w/o del

N1C1878
Matrl for vocal cord

N1C1879
Tissue marker, implantable

N1C1880
Vena cava filter

N1C1881
Dialysis access system

N1C1882
AICD, other than sing/dual

N1C1883
Adapt/ext, pacing/neuro lead

N1C1884
Embolization Protect syst

N1C1885
Cath, translumin angio laser

N1C1887
Catheter, guiding

N1C1888
Endovas non-cardiac abl cath

N1C1891
Infusion pump,non-prog, perm

N1C1892
Intro/sheath,fixed,peel-away

N1C1893
Intro/sheath, fixed,non-peel

N1C1894
Intro/sheath, non-laser

N1C1895
Lead, AICD, endo dual coil

N1C1896
Lead, AICD, non sing/dual

N1C1897
Lead, neurostim test kit

N1C1898
Lead, pmkr, other than trans

N1C1899
Lead, pmkr/AICD combination

N1C1900
Lead, coronary venous

N1C2614
Probe, perc lumb disc

N1C2615
Sealant, pulmonary, liquid

N1C2616
Brachytx, non-str,Yttrium-90
CH
H2
184.7105
$11,764.95C2617
Stent, non-cor, tem w/o del

N1C2618
Probe, cryoablation

N1C2619
Pmkr, dual, non rate-resp

N1C2620
Pmkr, single, non rate-resp

N1C2621
Pmkr, other than sing/dual

N1C2622
Prosthesis, penile, non-inf

N1C2625
Stent, non-cor, tem w/del sy

N1C2626
Infusion pump, non-prog,temp

N1C2627
Cath, suprapubic/cystoscopic

N1C2628
Catheter, occlusion

N1C2629
Intro/sheath, laser

N1C2630
Cath, EP, cool-tip

N1C2631
Rep dev, urinary, w/o sling

N1C2634
Brachytx, non-str, HA, I-125
CH
H2
0.4858
$30.94C2635
Brachytx, non-str, HA, P-103
CH
H2
0.7366
$46.92C2636
Brachy linear, non-str,P-103
CH
H2
0.66
$42.04C2638
Brachytx, stranded, I-125
CH
H2
0.7113
$45.31C2639
Brachytx, non-stranded,I-125
CH
H2
0.5039
$32.10C2640
Brachytx, stranded, P-103
CH
H2
1.0308
$65.66C2641
Brachytx, non-stranded,P-103
CH
H2
0.8077
$51.45C2642
Brachytx, stranded, C-131
CH
H2
1.5342
$97.72C2643
Brachytx, non-stranded,C-131
CH
H2
1.006
$64.08C2698
Brachytx, stranded, NOS
CH
H2
0.7113
$45.31C2699
Brachytx, non-stranded, NOS
CH
H2
0.4858
$30.94C8900
MRA w/cont, abd

Z2
6.235
$258.14C8901
MRA w/o cont, abd

Z2
5.3933
$223.29C8902
MRA w/o fol w/cont, abd

Z2
8.2463
$341.41C8903
MRI w/cont, breast, uni

Z2
6.235
$258.14C8904
MRI w/o cont, breast, uni

Z2
5.3933
$223.29( print page 9924)C8905
MRI w/o fol w/cont, brst, un

Z2
8.2463
$341.41C8906
MRI w/cont, breast, bi

Z2
6.235
$258.14C8907
MRI w/o cont, breast, bi

Z2
5.3933
$223.29C8908
MRI w/o fol w/cont, breast,

Z2
8.2463
$341.41C8909
MRA w/cont, chest

Z2
6.235
$258.14C8910
MRA w/o cont, chest

Z2
5.3933
$223.29C8911
MRA w/o fol w/cont, chest

Z2
8.2463
$341.41C8912
MRA w/cont, lwr ext

Z2
6.235
$258.14C8913
MRA w/o cont, lwr ext

Z2
5.3933
$223.29C8914
MRA w/o fol w/cont, lwr ext

Z2
8.2463
$341.41C8918
MRA w/cont, pelvis

Z2
6.235
$258.14C8919
MRA w/o cont, pelvis

Z2
5.3933
$223.29C8920
MRA w/o fol w/cont, pelvis

Z2
8.2463
$341.41C9003
Palivizumab, per 50 mg

K2

$810.67C9113
Inj pantoprazole sodium, via

N1C9121
Injection, argatroban

K2

$18.96C9232
Injection, idursulfase
CH
D5C9233
Injection, ranibizumab
CH
D5C9234
Inj, alglucosidase alfa
CH
D5C9235
Injection, panitumumab
CH
D5C9238
Inj, levetiracetam
NI
K2

$6.30C9239
Inj, temsirolimus
NI
K2

$48.41C9350
Porous collagen tube per cm
CH
D5C9351
Acellular derm tissue percm2
CH
D5C9352
Neuragen nerve guide, per cm
NI
K2

$482.56C9353
Neurawrap nerve protector,cm
NI
K2

$482.56C9399
Unclassified drugs or biolog

K7E0616
Cardiac event recorder

N1E0749
Elec osteogen stim implanted

N1E0782
Non-programble infusion pump

N1E0783
Programmable infusion pump

N1E0785
Replacement impl pump cathet

N1E0786
Implantable pump replacement

N1G0130
Single energy x-ray study

Z3
0.5348
$22.14G0173
Linear acc stereo radsur com

Z2
61.6965
$2,554.30G0251
Linear acc based stero radio

Z2
16.5911
$686.89G0288
Recon, CTA for surg plan
CH
N1G0339
Robot lin-radsurg com, first

Z2
61.6965
$2,554.30G0340
Robt lin-radsurg fractx 2-5

Z2
45.0693
$1,865.91J0120
Tetracyclin injection

N1J0128
Abarelix injection

K2

$67.97J0129
Abatacept injection

K2

$18.69J0130
Abciximab injection

K2

$420.17J0132
Acetylcysteine injection
CH
N1J0133
Acyclovir injection

N1J0135
Adalimumab injection

K2

$329.58J0150
Injection adenosine 6 MG

K2

$25.10J0152
Adenosine injection

K2

$67.89J0170
Adrenalin epinephrin inject

N1J0180
Agalsidase beta injection

K2

$126.00J0190
Inj biperiden lactate/5 mg

K2

$88.15J0200
Alatrofloxacin mesylate

N1J0205
Alglucerase injection

K2

$38.85J0207
Amifostine

K2

$490.93J0210
Methyldopate hcl injection

K2

$13.04J0215
Alefacept

K2

$26.47J0220
Aglucosidase alfa injection
NI
K2

$126.00J0256
Alpha 1 proteinase inhibitor

K2

$3.28J0278
Amikacin sulfate injection

N1J0280
Aminophyllin 250 MG inj

N1J0282
Amiodarone HCl

N1J0285
Amphotericin B

N1J0287
Amphotericin b lipid complex

K2

$10.40J0288
Ampho b cholesteryl sulfate

K2

$11.89J0289
Amphotericin b liposome inj

K2

$16.21J0290
Ampicillin 500 MG inj

N1J0295
Ampicillin sodium per 1.5 gm

N1J0300
Amobarbital 125 MG inj

N1( print page 9925)J0330
Succinycholine chloride inj

N1J0348
Anadulafungin injection

K2

$1.91J0350
Injection anistreplase 30 u

K2

$2,693.80J0360
Hydralazine hcl injection

N1J0364
Apomorphine hydrochloride
CH
N1J0365
Aprotonin, 10,000 kiu

K2

$2.66J0380
Inj metaraminol bitartrate
CH
N1J0390
Chloroquine injection

N1J0395
Arbutamine HCl injection
CH
N1J0400
Aripiprazole injection
NI
K2

$0.28J0456
Azithromycin

N1J0460
Atropine sulfate injection

N1J0470
Dimecaprol injection

N1J0475
Baclofen 10 MG injection

K2

$193.29J0476
Baclofen intrathecal trial

K2

$69.73J0480
Basiliximab

K2

$1,541.03J0500
Dicyclomine injection

N1J0515
Inj benztropine mesylate

N1J0520
Bethanechol chloride inject

N1J0530
Penicillin g benzathine inj

N1J0540
Penicillin g benzathine inj

N1J0550
Penicillin g benzathine inj

N1J0560
Penicillin g benzathine inj

N1J0570
Penicillin g benzathine inj

N1J0580
Penicillin g benzathine inj

N1J0583
Bivalirudin

K2

$1.84J0585
Botulinum toxin a per unit

K2

$5.21J0587
Botulinum toxin type B

K2

$8.63J0592
Buprenorphine hydrochloride

N1J0594
Busulfan injection

K2

$9.17J0595
Butorphanol tartrate 1 mg

N1J0600
Edetate calcium disodium inj

K2

$49.64J0610
Calcium gluconate injection

N1J0620
Calcium glycer  &  lact/10 ML

N1J0630
Calcitonin salmon injection

N1J0636
Inj calcitriol per 0.1 mcg

N1J0637
Caspofungin acetate

K2

$24.05J0640
Leucovorin calcium injection

N1J0670
Inj mepivacaine HCL/10 ml

N1J0690
Cefazolin sodium injection

N1J0692
Cefepime HCl for injection

N1J0694
Cefoxitin sodium injection

N1J0696
Ceftriaxone sodium injection

N1J0697
Sterile cefuroxime injection

N1J0698
Cefotaxime sodium injection

N1J0702
Betamethasone acet & sod phosp

N1J0704
Betamethasone sod phosp/4 MG

N1J0706
Caffeine citrate injection
CH
N1J0710
Cephapirin sodium injection

N1J0713
Inj ceftazidime per 500 mg

N1J0715
Ceftizoxime sodium/500 MG

N1J0720
Chloramphenicol sodium injec

N1J0725
Chorionic gonadotropin/1000u

N1J0735
Clonidine hydrochloride

K2

$62.78J0740
Cidofovir injection

K2

$754.39J0743
Cilastatin sodium injection

N1J0744
Ciprofloxacin iv

N1J0745
Inj codeine phosphate /30 MG

N1J0760
Colchicine injection

N1J0770
Colistimethate sodium inj

N1J0780
Prochlorperazine injection

N1J0795
Corticorelin ovine triflutal

K2

$4.43J0800
Corticotropin injection

K2

$169.77J0835
Inj cosyntropin per 0.25 MG

K2

$64.01J0850
Cytomegalovirus imm IV /vial

K2

$870.53J0878
Daptomycin injection

K2

$0.35J0881
Darbepoetin alfa, non-esrd

K2

$2.88J0885
Epoetin alfa, non-esrd

K2

$8.97( print page 9926)J0894
Decitabine injection

K2

$26.48J0895
Deferoxamine mesylate inj
CH
N1J0900
Testosterone enanthate inj

N1J0945
Brompheniramine maleate inj

N1J0970
Estradiol valerate injection

N1J1000
Depo-estradiol cypionate inj

N1J1020
Methylprednisolone 20 MG inj

N1J1030
Methylprednisolone 40 MG inj

N1J1040
Methylprednisolone 80 MG inj

N1J1051
Medroxyprogesterone inj

N1J1060
Testosterone cypionate 1 ML

N1J1070
Testosterone cypionat 100 MG

N1J1080
Testosterone cypionat 200 MG

N1J1094
Inj dexamethasone acetate

N1J1100
Dexamethasone sodium phos

N1J1110
Inj dihydroergotamine mesylt

N1J1120
Acetazolamid sodium injectio

N1J1160
Digoxin injection

N1J1162
Digoxin immune fab (ovine)

K2

$478.88J1165
Phenytoin sodium injection

N1J1170
Hydromorphone injection

N1J1180
Dyphylline injection

N1J1190
Dexrazoxane HCl injection

K2

$162.11J1200
Diphenhydramine hcl injectio

N1J1205
Chlorothiazide sodium inj

K2

$141.07J1212
Dimethyl sulfoxide 50% 50 ML

N1J1230
Methadone injection

N1J1240
Dimenhydrinate injection

N1J1245
Dipyridamole injection

N1J1250
Inj dobutamine HCL/250 mg

N1J1260
Dolasetron mesylate

K2

$4.66J1265
Dopamine injection

N1J1270
Injection, doxercalciferol

N1J1300
Eculizumab injection
NI
K2

$176.38J1320
Amitriptyline injection

N1J1324
Enfuvirtide injection

K2

$0.40J1325
Epoprostenol injection

N1J1327
Eptifibatide injection

K2

$17.67J1330
Ergonovine maleate injection
CH
N1J1335
Ertapenem injection

N1J1364
Erythro lactobionate /500 MG

N1J1380
Estradiol valerate 10 MG inj

N1J1390
Estradiol valerate 20 MG inj

N1J1410
Inj estrogen conjugate 25 MG

K2

$66.64J1430
Ethanolamine oleate 100 mg

K2

$79.23J1435
Injection estrone per 1 MG

N1J1436
Etidronate disodium inj

K2

$70.73J1438
Etanercept injection

K2

$167.12J1440
Filgrastim 300 mcg injection

K2

$193.79J1441
Filgrastim 480 mcg injection

K2

$298.39J1450
Fluconazole

N1J1451
Fomepizole, 15 mg

K2

$12.80J1452
Intraocular Fomivirsen na
CH
N1J1455
Foscarnet sodium injection
CH
N1J1457
Gallium nitrate injection
CH
K2

$1.61J1458
Galsulfase injection

K2

$306.88J1460
Gamma globulin 1 CC inj

K2

$11.91J1470
Gamma globulin 2 CC inj
CH
K2

$23.82J1480
Gamma globulin 3 CC inj
CH
K2

$35.72J1490
Gamma globulin 4 CC inj
CH
K2

$47.64J1500
Gamma globulin 5 CC inj
CH
K2

$59.54J1510
Gamma globulin 6 CC inj
CH
K2

$71.50J1520
Gamma globulin 7 CC inj
CH
K2

$83.30J1530
Gamma globulin 8 CC inj
CH
K2

$95.27J1540
Gamma globulin 9 CC inj
CH
K2

$107.25J1550
Gamma globulin 10 CC inj
CH
K2

$119.09J1560
Gamma globulin > 10 CC inj
CH
K2

$119.09J1561
Gamunex injection
NI
K2

$32.06( print page 9927)J1562
Vivaglobin, inj

K2

$7.01J1565
RSV-ivig

K2

$16.02J1566
Immune globulin, powder

K2

$26.89J1567
Immune globulin, liquid
CH
D5J1568
Octagam injection
NI
K2

$33.19J1569
Gammagard liquid injection
NI
K2

$31.06J1570
Ganciclovir sodium injection

N1J1571
Hepagam B IM injection
NI
K2

$63.51J1572
Flebogamma injection
NI
K2

$32.27J1573
Hepagam B intravenous, inj
NI
K2

$63.51J1580
Garamycin gentamicin inj

N1J1590
Gatifloxacin injection

N1J1595
Injection glatiramer acetate
CH
K2

$52.04J1600
Gold sodium thiomaleate inj

N1J1610
Glucagon hydrochloride/1 MG

K2

$68.84J1620
Gonadorelin hydroch/ 100 mcg

K2

$178.59J1626
Granisetron HCl injection

K2

$5.74J1630
Haloperidol injection

N1J1631
Haloperidol decanoate inj

N1J1640
Hemin, 1 mg

K2

$7.08J1642
Inj heparin sodium per 10 u

N1J1644
Inj heparin sodium per 1000u

N1J1645
Dalteparin sodium

N1J1650
Inj enoxaparin sodium

N1J1652
Fondaparinux sodium
CH
K2

$5.92J1655
Tinzaparin sodium injection
CH
N1J1670
Tetanus immune globulin inj

K2

$103.46J1700
Hydrocortisone acetate inj

N1J1710
Hydrocortisone sodium ph inj

N1J1720
Hydrocortisone sodium succ i

N1J1730
Diazoxide injection

K2

$113.24J1740
Ibandronate sodium injection

K2

$138.96J1742
Ibutilide fumarate injection

K2

$287.15J1743
Idursulfase injection
NI
K2

$455.03J1745
Infliximab injection

K2

$54.42J1751
Iron dextran 165 injection

K2

$11.82J1752
Iron dextran 267 injection

K2

$10.30J1756
Iron sucrose injection

K2

$0.36J1785
Injection imiglucerase /unit

K2

$3.89J1790
Droperidol injection

N1J1800
Propranolol injection

N1J1815
Insulin injection

N1J1817
Insulin for insulin pump use

N1J1830
Interferon beta-1b/.25 MG

K2

$106.57J1835
Itraconazole injection

K2

$39.68J1840
Kanamycin sulfate 500 MG inj

N1J1850
Kanamycin sulfate 75 MG inj

N1J1885
Ketorolac tromethamine inj

N1J1890
Cephalothin sodium injection

N1J1931
Laronidase injection

K2

$23.64J1940
Furosemide injection

N1J1945
Lepirudin

K2

$159.44J1950
Leuprolide acetate /3.75 MG

K2

$452.58J1956
Levofloxacin injection

N1J1960
Levorphanol tartrate inj

N1J1980
Hyoscyamine sulfate inj

N1J1990
Chlordiazepoxide injection

N1J2001
Lidocaine injection

N1J2010
Lincomycin injection

N1J2020
Linezolid injection

K2

$25.17J2060
Lorazepam injection

N1J2150
Mannitol injection

N1J2170
Mecasermin injection

K2

$15.62J2175
Meperidine hydrochl /100 MG

N1J2180
Meperidine/promethazine inj

N1J2185
Meropenem
CH
N1J2210
Methylergonovin maleate inj

N1J2248
Micafungin sodium injection

K2

$1.44( print page 9928)J2250
Inj midazolam hydrochloride

N1J2260
Inj milrinone lactate/5 MG

N1J2270
Morphine sulfate injection

N1J2271
Morphine so4 injection 100mg

N1J2275
Morphine sulfate injection

N1J2278
Ziconotide injection

K2

$6.46J2280
Inj, moxifloxacin 100 mg

N1J2300
Inj nalbuphine hydrochloride

N1J2310
Inj naloxone hydrochloride

N1J2315
Naltrexone, depot form

K2

$1.87J2320
Nandrolone decanoate 50 MG

N1J2321
Nandrolone decanoate 100 MG

N1J2322
Nandrolone decanoate 200 MG

N1J2323
Natalizumab injection
NI
K2

$7.51J2325
Nesiritide injection

K2

$32.95J2353
Octreotide injection, depot

K2

$99.04J2354
Octreotide inj, non-depot

N1J2355
Oprelvekin injection

K2

$247.02J2357
Omalizumab injection

K2

$17.12J2360
Orphenadrine injection

N1J2370
Phenylephrine hcl injection

N1J2400
Chloroprocaine hcl injection

N1J2405
Ondansetron hcl injection

K2

$0.26J2410
Oxymorphone hcl injection

N1J2425
Palifermin injection

K2

$11.24J2430
Pamidronate disodium /30 MG

K2

$28.31J2440
Papaverin hcl injection

N1J2460
Oxytetracycline injection

N1J2469
Palonosetron HCl

K2

$16.45J2501
Paricalcitol

N1J2503
Pegaptanib sodium injection

K2

$1,035.69J2504
Pegademase bovine, 25 iu

K2

$197.51J2505
Injection, pegfilgrastim 6mg

K2

$2,145.12J2510
Penicillin g procaine inj

N1J2513
Pentastarch 10% solution
CH
K2

$21.98J2515
Pentobarbital sodium inj

N1J2540
Penicillin g potassium inj

N1J2543
Piperacillin/tazobactam

N1J2550
Promethazine hcl injection

N1J2560
Phenobarbital sodium inj

N1J2590
Oxytocin injection

N1J2597
Inj desmopressin acetate

N1J2650
Prednisolone acetate inj

N1J2670
Totazoline hcl injection

N1J2675
Inj progesterone per 50 MG

N1J2680
Fluphenazine decanoate 25 MG

N1J2690
Procainamide hcl injection

N1J2700
Oxacillin sodium injeciton

N1J2710
Neostigmine methylslfte inj

N1J2720
Inj protamine sulfate/10 MG

N1J2724
Protein C concentrate
NI
K2

$12.08J2725
Inj protirelin per 250 mcg

N1J2730
Pralidoxime chloride inj
CH
K2

$35.20J2760
Phentolaine mesylate inj

N1J2765
Metoclopramide hcl injection

N1J2770
Quinupristin/dalfopristin

K2

$126.44J2778
Ranibizumab injection
NI
K2

$2,030.23J2780
Ranitidine hydrochloride inj

N1J2783
Rasburicase

K2

$144.43J2788
Rho d immune globulin 50 mcg

K2

$26.41J2790
Rho d immune globulin inj

K2

$80.79J2791
Rhophylac injection
NI
K2

$5.29J2792
Rho(D) immune globulin h, sd

K2

$15.62J2794
Risperidone, long acting

K2

$4.86J2795
Ropivacaine HCl injection

N1J2800
Methocarbamol injection

N1J2805
Sincalide injection

N1J2810
Inj theophylline per 40 MG

N1( print page 9929)J2820
Sargramostim injection

K2

$24.86J2850
Inj secretin synthetic human

K2

$20.12J2910
Aurothioglucose injeciton

N1J2916
Na ferric gluconate complex

N1J2920
Methylprednisolone injection

N1J2930
Methylprednisolone injection

N1J2940
Somatrem injection

K2

$168.90J2941
Somatropin injection

K2

$48.52J2950
Promazine hcl injection

N1J2993
Reteplase injection

K2

$841.28J2995
Inj streptokinase /250000 IU

K2

$129.75J2997
Alteplase recombinant

K2

$33.39J3000
Streptomycin injection

N1J3010
Fentanyl citrate injeciton

N1J3030
Sumatriptan succinate/6 MG

K2

$61.27J3070
Pentazocine injection

N1J3100
Tenecteplase injection

K2

$2,034.65J3105
Terbutaline sulfate inj

N1J3120
Testosterone enanthate inj

N1J3130
Testosterone enanthate inj

N1J3140
Testosterone suspension inj

N1J3150
Testosteron propionate inj

N1J3230
Chlorpromazine hcl injection

N1J3240
Thyrotropin injection

K2

$834.18J3243
Tigecycline injection

K2

$0.96J3246
Tirofiban HCl

K2

$7.56J3250
Trimethobenzamide hcl inj

N1J3260
Tobramycin sulfate injection

N1J3265
Injection torsemide 10 mg/ml

N1J3280
Thiethylperazine maleate inj

N1J3285
Treprostinil injection

K2

$55.36J3301
Triamcinolone acetonide inj

N1J3302
Triamcinolone diacetate inj

N1J3303
Triamcinolone hexacetonl inj

N1J3305
Inj trimetrexate glucoronate

K2

$148.30J3310
Perphenazine injeciton

N1J3315
Triptorelin pamoate

K2

$159.38J3320
Spectinomycn di-hcl inj
CH
N1J3350
Urea injection

K2

$74.16J3355
Urofollitropin, 75 iu

K2

$50.22J3360
Diazepam injection

N1J3364
Urokinase 5000 IU injection

N1J3365
Urokinase 250,000 IU inj

K2

$453.41J3370
Vancomycin hcl injection

N1J3396
Verteporfin injection

K2

$8.99J3400
Triflupromazine hcl inj

N1J3410
Hydroxyzine hcl injection

N1J3411
Thiamine hcl 100 mg

N1J3415
Pyridoxine hcl 100 mg

N1J3420
Vitamin b12 injection

N1J3430
Vitamin k phytonadione inj

N1J3465
Injection, voriconazole

K2

$4.93J3470
Hyaluronidase injection

N1J3471
Ovine, up to 999 USP units

N1J3472
Ovine, 1000 USP units

K2

$133.77J3473
Hyaluronidase recombinant

K2

$0.40J3475
Inj magnesium sulfate

N1J3480
Inj potassium chloride

N1J3485
Zidovudine

N1J3486
Ziprasidone mesylate

N1J3487
Zoledronic acid

K2

$205.76J3488
Reclast injection
NI
K2

$220.81J3490
Drugs unclassified injection

N1J3530
Nasal vaccine inhalation

N1J3590
Unclassified biologics

N1J7030
Normal saline solution infus

N1J7040
Normal saline solution infus

N1J7042
5% dextrose/normal saline

N1( print page 9930)J7050
Normal saline solution infus

N1J7060
5% dextrose/water

N1J7070
D5w infusion

N1J7100
Dextran 40 infusion

N1J7110
Dextran 75 infusion

N1J7120
Ringers lactate infusion

N1J7130
Hypertonic saline solution

N1J7187
Humate-P, inj

K2

$0.88J7189
Factor viia

K2

$1.15J7190
Factor viii

K2

$0.75J7191
Factor VIII (porcine)
CH
N1J7192
Factor viii recombinant

K2

$1.07J7193
Factor IX non-recombinant

K2

$0.89J7194
Factor ix complex

K2

$0.80J7195
Factor IX recombinant

K2

$0.99J7197
Antithrombin iii injection

K2

$1.82J7198
Anti-inhibitor

K2

$1.42J7308
Aminolevulinic acid hcl top

K2

$109.92J7310
Ganciclovir long act implant

K2

$4,707.90J7311
Fluocinolone acetonide implt

K2

$19,162.50J7321
Hyalgan/supartz inj per dose
NI
K2

$101.81J7322
Synvisc inj per dose
NI
K2

$178.11J7323
Euflexxa inj per dose
NI
K2

$110.95J7324
Orthovisc inj per dose
NI
K2

$174.50J7340
Metabolic active D/E tissue

K2

$28.45J7341
Non-human, metabolic tissue
CH
N1J7342
Metabolically active tissue

K2

$36.40J7343
Nonmetabolic act d/e tissue

K2

$20.22J7344
Nonmetabolic active tissue

K2

$94.53J7345
Non-human, non-metab tissue
CH
D5J7346
Injectable human tissue

K2

$774.46J7347
Integra matrix tissue
NI
K2

$33.14J7348
Tissuemend tissue
NI
K2

$67.96J7349
Primatrix tissue
NI
K2

$67.96J7500
Azathioprine oral 50mg

N1J7501
Azathioprine parenteral

K2

$47.88J7502
Cyclosporine oral 100 mg

K2

$3.52J7504
Lymphocyte immune globulin

K2

$336.10J7505
Monoclonal antibodies

K2

$977.75J7506
Prednisone oral

N1J7507
Tacrolimus oral per 1 MG

K2

$3.69J7509
Methylprednisolone oral

N1J7510
Prednisolone oral per 5 mg

N1J7511
Antithymocyte globuln rabbit

K2

$337.82J7513
Daclizumab, parenteral

K2

$322.28J7515
Cyclosporine oral 25 mg

N1J7516
Cyclosporin parenteral 250mg

N1J7517
Mycophenolate mofetil oral

K2

$2.66J7518
Mycophenolic acid

K2

$2.41J7520
Sirolimus, oral

K2

$7.50J7525
Tacrolimus injection

K2

$138.64J7599
Immunosuppressive drug noc

N1J7674
Methacholine chloride, neb

N1J7799
Non-inhalation drug for DME

N1J8501
Oral aprepitant

K2

$4.99J8510
Oral busulfan

K2

$2.26J8520
Capecitabine, oral, 150 mg

K2

$4.28J8521
Capecitabine, oral, 500 mg
CH
K2

$14.19J8530
Cyclophosphamide oral 25 MG

N1J8540
Oral dexamethasone

N1J8560
Etoposide oral 50 MG

K2

$29.46J8597
Antiemetic drug oral NOS

N1J8600
Melphalan oral 2 MG
CH
K2

$4.14J8610
Methotrexate oral 2.5 MG

N1J8650
Nabilone oral

K2

$16.80J8700
Temozolomide

K2

$7.49J9000
Doxorubic hcl 10 MG vl chemo
CH
N1J9001
Doxorubicin hcl liposome inj

K2

$396.15( print page 9931)J9010
Alemtuzumab injection

K2

$549.77J9015
Aldesleukin/single use vial

K2

$788.84J9017
Arsenic trioxide

K2

$34.44J9020
Asparaginase injection

K2

$54.26J9025
Azacitidine injection

K2

$4.35J9027
Clofarabine injection

K2

$114.41J9031
Bcg live intravesical vac

K2

$113.75J9035
Bevacizumab injection

K2

$56.93J9040
Bleomycin sulfate injection

K2

$42.93J9041
Bortezomib injection

K2

$33.20J9045
Carboplatin injection

K2

$7.44J9050
Carmus bischl nitro inj

K2

$152.24J9055
Cetuximab injection

K2

$49.43J9060
Cisplatin 10 MG injection

N1J9062
Cisplatin 50 MG injection
CH
N1J9065
Inj cladribine per 1 MG

K2

$32.04J9070
Cyclophosphamide 100 MG inj

N1J9080
Cyclophosphamide 200 MG inj
CH
N1J9090
Cyclophosphamide 500 MG inj
CH
N1J9091
Cyclophosphamide 1.0 grm inj
CH
N1J9092
Cyclophosphamide 2.0 grm inj
CH
N1J9093
Cyclophosphamide lyophilized
CH
N1J9094
Cyclophosphamide lyophilized
CH
N1J9095
Cyclophosphamide lyophilized
CH
N1J9096
Cyclophosphamide lyophilized
CH
N1J9097
Cyclophosphamide lyophilized
CH
N1J9098
Cytarabine liposome

K2

$412.21J9100
Cytarabine hcl 100 MG inj

N1J9110
Cytarabine hcl 500 MG inj
CH
N1J9120
Dactinomycin actinomycin d

K2

$488.78J9130
Dacarbazine 100 mg inj
CH
N1J9140
Dacarbazine 200 MG inj
CH
N1J9150
Daunorubicin

K2

$19.33J9151
Daunorubicin citrate liposom

K2

$55.23J9160
Denileukin diftitox, 300 mcg

K2

$1,386.59J9165
Diethylstilbestrol injection

N1J9170
Docetaxel

K2

$310.85J9175
Elliotts b solution per ml

N1J9178
Inj, epirubicin hcl, 2 mg

K2

$19.79J9181
Etoposide 10 MG inj

N1J9182
Etoposide 100 MG inj
CH
N1J9185
Fludarabine phosphate inj

K2

$226.67J9190
Fluorouracil injection

N1J9200
Floxuridine injection

K2

$54.63J9201
Gemcitabine HCl

K2

$127.31J9202
Goserelin acetate implant

K2

$192.29J9206
Irinotecan injection

K2

$124.61J9208
Ifosfomide injection

K2

$38.13J9209
Mesna injection

K2

$7.97J9211
Idarubicin hcl injection

K2

$302.42J9212
Interferon alfacon-1

K2

$4.62J9213
Interferon alfa-2a inj

K2

$41.37J9214
Interferon alfa-2b inj

K2

$13.92J9215
Interferon alfa-n3 inj

K2

$9.03J9216
Interferon gamma 1-b inj

K2

$306.66J9217
Leuprolide acetate suspnsion

K2

$236.06J9218
Leuprolide acetate injeciton

K2

$7.98J9219
Leuprolide acetate implant

K2

$1,648.41J9225
Vantas implant

K2

$1,412.46J9226
Supprelin LA implant
NI
K7J9230
Mechlorethamine hcl inj

K2

$143.08J9245
Inj melphalan hydrochl 50 MG

K2

$1,548.88J9250
Methotrexate sodium inj

N1J9260
Methotrexate sodium inj
CH
N1J9261
Nelarabine injection

K2

$86.84J9263
Oxaliplatin

K2

$9.15J9264
Paclitaxel protein bound

K2

$8.79J9265
Paclitaxel injection

K2

$14.57( print page 9932)J9266
Pegaspargase/singl dose vial

K2

$2,080.19J9268
Pentostatin injection

K2

$2,051.68J9270
Plicamycin (mithramycin) inj

K2

$172.41J9280
Mitomycin 5 MG inj

K2

$14.39J9290
Mitomycin 20 MG inj
CH
K2

$57.56J9291
Mitomycin 40 MG inj
CH
K2

$115.11J9293
Mitoxantrone hydrochl/5 MG

K2

$107.96J9300
Gemtuzumab ozogamicin

K2

$2,411.98J9303
Panitumumab injection
NI
K2

$83.15J9305
Pemetrexed injection

K2

$44.49J9310
Rituximab cancer treatment

K2

$504.40J9320
Streptozocin injection

K2

$146.93J9340
Thiotepa injection

K2

$41.12J9350
Topotecan

K2

$859.62J9355
Trastuzumab

K2

$58.51J9357
Valrubicin, 200 mg

K2

$77.96J9360
Vinblastine sulfate inj

N1J9370
Vincristine sulfate 1 MG inj

N1J9375
Vincristine sulfate 2 MG inj
CH
N1J9380
Vincristine sulfate 5 MG inj
CH
N1J9390
Vinorelbine tartrate/10 mg

K2

$21.41J9395
Injection, Fulvestrant

K2

$80.60J9600
Porfimer sodium

K2

$2,532.53J9999
Chemotherapy drug

N1L8600
Implant breast silicone/eq

N1L8603
Collagen imp urinary 2.5 ml

N1L8606
Synthetic implnt urinary 1ml

N1L8609
Artificial cornea

N1L8610
Ocular implant

N1L8612
Aqueous shunt prosthesis

N1L8613
Ossicular implant

N1L8614
Cochlear device

N1L8630
Metacarpophalangeal implant

N1L8631
MCP joint repl 2 pc or more

N1L8641
Metatarsal joint implant

N1L8642
Hallux implant

N1L8658
Interphalangeal joint spacer

N1L8659
Interphalangeal joint repl

N1L8670
Vascular graft, synthetic

N1L8682
Implt neurostim radiofq rec

N1L8690
Aud osseo dev, int/ext comp

J7L8699
Prosthetic implant NOS

N1P9041
Albumin (human),5%, 50ml
CH
K2
0.3413
$21.74P9045
Albumin (human), 5%, 250 ml
CH
K2
1.0987
$69.98P9046
Albumin (human), 25%, 20 ml
CH
K2
0.4118
$26.23P9047
Albumin (human), 25%, 50ml
CH
K2
1.1362
$72.37Q0163
Diphenhydramine HCl 50mg

N1Q0164
Prochlorperazine maleate 5mg

N1Q0166
Granisetron HCl 1 mg oral

K2

$49.96Q0167
Dronabinol 2.5mg oral

N1Q0169
Promethazine HCl 12.5mg oral

N1Q0171
Chlorpromazine HCl 10mg oral

N1Q0173
Trimethobenzamide HCl 250mg

N1Q0174
Thiethylperazine maleate 10mg

N1Q0175
Perphenazine 4mg oral

N1Q0177
Hydroxyzine pamoate 25mg

N1Q0179
Ondansetron HCl 8mg oral

K2

$18.37Q0180
Dolasetron mesylate oral

K2

$43.77Q0515
Sermorelin acetate injection

K2

$1.74Q1003
Ntiol category 3

L6

$50.00Q2004
Bladder calculi irrig sol

N1Q2009
Fosphenytoin, 50 mg

K2

$5.76Q2017
Teniposide, 50 mg

K2

$280.26Q3025
IM inj interferon beta 1-a

K2

$118.84Q4079
Natalizumab injection
CH
D5Q4083
Hyalgan/supartz inj per dose
CH
D5Q4084
Synvisc inj per dose
CH
D5Q4085
Euflexxa inj per dose
CH
D5( print page 9933)Q4086
Orthovisc inj per dose
CH
D5Q4087
Octagam injection
CH
D5Q4088
Gammagard liquid injection
CH
D5Q4089
Rhophylac injection
CH
D5Q4090
Hepagam B IM injection
CH
D5Q4091
Flebogamma injection
CH
D5Q4092
Gamunex injection
CH
D5Q4095
Reclast injection
CH
D5Q9945
LOCM <=149 mg/ml iodine, 1ml
CH
D5Q9946
LOCM 150-199mg/ml iodine,1ml
CH
D5Q9947
LOCM 200-249mg/ml iodine,1ml
CH
D5Q9948
LOCM 250-299mg/ml iodine,1ml
CH
D5Q9949
LOCM 300-349mg/ml iodine,1ml
CH
D5Q9950
LOCM 350-399mg/ml iodine,1ml
CH
D5Q9951
LOCM >= 400 mg/ml iodine,1ml
CH
N1Q9952
Inj Gad-base MR contrast,1ml
CH
D5Q9953
Inj Fe-based MR contrast,1ml
CH
N1Q9954
Oral MR contrast, 100 ml
CH
N1Q9955
Inj perflexane lip micros,ml
CH
N1Q9956
Inj octafluoropropane mic,ml
CH
N1Q9957
Inj perflutren lip micros,ml
CH
N1Q9958
HOCM <=149 mg/ml iodine, 1ml

N1Q9959
HOCM 150-199mg/ml iodine,1ml

N1Q9960
HOCM 200-249mg/ml iodine,1ml

N1Q9961
HOCM 250-299mg/ml iodine,1ml

N1Q9962
HOCM 300-349mg/ml iodine,1ml

N1Q9963
HOCM 350-399mg/ml iodine,1ml

N1Q9964
HOCM>= 400mg/ml iodine, 1ml

N1Q9965
LOCM 100-199mg/ml iodine,1ml
NI
N1Q9966
LOCM 200-299mg/ml iodine,1ml
NI
N1Q9967
LOCM 300-399mg/ml iodine,1ml
NI
N1V2630
Anter chamber intraocul lens

N1V2631
Iris support intraoclr lens

N1V2632
Post chmbr intraocular lens

N1V2785
Corneal tissue processing

F4V2790
Amniotic membrane

N1**Note:**
                             The Medicare program payment is 80 percent of the total payment amount and beneficiary coinsurance is 20 percent of the total payment amount, except for screening flexible sigmoidoscopies and screening colonoscopies for which the program payment is 75 percent and the beneficiary coinsurance is 25 percent.


[FR Doc. 08-671 Filed 2-19-08; 8:45 am] BILLING CODE 4120-01-P