| Application Cast Hand & Lower Forearm Gauntlet (29085) |
$57 |
$114 |
0.4× |
| Application finger splint static (29130) |
$47.50 |
$95 |
0.4× |
| Application long arm splint shoulder hand (29105) |
$82.50 |
$165 |
0.5× |
| Application long leg splint thigh ankle/toes (29505) |
$115 |
$230 |
0.7× |
| Application Short Arm Splint Dynamic (29126) |
$70 |
$140 |
0.6× |
| Application short arm splint forearm-hand static (29125) |
$150.50 |
$301 |
1.2× |
| Application short leg splint calf foot (29515) |
$82.50 |
$165 |
0.5× |
| Apply short leg cast (29405) |
$135.50 |
$271 |
0.5× |
| Arterial puncture (36600) |
$179.50 |
$359 |
1.4× |
| Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) |
$160 |
$320 |
0.5× |
| Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) |
$160 |
$320 |
0.5× |
| Avulsion nail plate partial/complete simple 1 (11730) |
$111.50 |
$223 |
0.6× |
| Bladder Irrigation Simple (51700) |
$90 |
$180 |
0.4× |
| Bladder Scan (51798) |
$33.50 |
$67 |
0.6× |
| Blood transfusion service (36430) |
$515 |
$1,030 |
1.2× |
| Canthotomy Separate Procedure (67715) |
$2,916.50 |
$5,833 |
1.3× |
| Catheter Aspiration Nasotracheal Spx (31720) |
$216 |
$432 |
1.0× |
| Change Cystostomy Tube Simple (51705) |
$291 |
$582 |
1.2× |
| Chest tube placement (32551) |
$993 |
$1,986 |
0.7× |
| Chg Collect Blood From Catheter Venous Nos (36592) |
$150.50 |
$301 |
1.2× |
| Closed Rx Humer Epicondylr Fx,Manip (24565) |
$2,001 |
$4,002 |
1.3× |
| Closed Rx Med Malleolus Fx (27760) |
$277.50 |
$555 |
1.2× |
| Closed Rx Shldr Disloc,Gr Tub Fx (23665) |
$1,815.50 |
$3,631 |
1.2× |
| Closed Rx Tibia Shaft Fx (27750) |
$266.50 |
$533 |
1.1× |
| Closed Rx Tibial Plateau Fx (27530) |
$266.50 |
$533 |
1.1× |
| Closed Treat Vert Body Fract (22310) |
$277.50 |
$555 |
1.2× |
| Closed Treatment Of Distal Radioulnar Dislocation With Manipulation (25675) |
$266.50 |
$533 |
1.1× |
| Closed Treatment Pst Malleolus Fracture W/O Manj (27767) |
$277.50 |
$555 |
1.2× |
| Closed tx ankle dislocation w/o anesthesia (27840) |
$266.50 |
$533 |
1.1× |
| Closed tx calcaneal fracture w/o manipulation (28400) |
$277.50 |
$555 |
1.2× |
| Closed tx metatarsal fracture w/o manipulation (28470) |
$277.50 |
$555 |
1.2× |
| Closed tx patellar fracture w/o manipulation (27520) |
$19.50 |
$39 |
0.1× |
| Closed tx radial head/neck fx w/manipulation (24655) |
$2,001 |
$4,002 |
1.3× |
| Closed tx scapular fracture w/o manipulation (23570) |
$277.50 |
$555 |
1.2× |
| Closure of laceration, vestibule of mouth; 2.5 cm or less (40830) |
$287.50 |
$575 |
1.3× |
| Clsd tx clavicular fracture w/o manipulation (23500) |
$277.50 |
$555 |
1.2× |
| Clsd tx pelvic ring fx w/o manipulation (27197) |
$277.50 |
$555 |
1.2× |
| Clsd tx shoulder dislc w/manipulation w/o anes (23650) |
$154 |
$308 |
0.7× |
| Cltx dstl fibular fx lat malls w/o manj (27786) |
$277.50 |
$555 |
1.2× |
| Cltx Dstl Phlngl Fx Fngr/Thmb W/O Manj Ea (26750) |
$277.50 |
$555 |
1.2× |
| Cltx dstl radial fx/epiphysl sep w/o manj (25600) |
$277.50 |
$555 |
1.2× |
| Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) |
$826 |
$1,652 |
0.5× |
| Cltx fx grt toe phlx/phlg w/o manj (28490) |
$266.50 |
$533 |
1.1× |
| Cltx fx phlx/phlg oth/thn grt toe w/o manj (28510) |
$277.50 |
$555 |
1.2× |
| Cltx fx w8 brg artclr prtn dstl tib w/skel tracj (27825) |
$1,782 |
$3,564 |
1.2× |
| Cltx metacarpal fx w/o manipulation each bone (26600) |
$266.50 |
$533 |
1.1× |
| Cltx metacarpophalangeal dislc w/manj w/o anes (26700) |
$266.50 |
$533 |
1.1× |
| Cltx phlngl fx prox/middle px/f/t w/o manj ea (26720) |
$266.50 |
$533 |
1.1× |
| Control Nasal Hemorrhage Anterior Complex (30903) |
$67 |
$134 |
0.5× |
| Control Nasal Hemorrhage Anterior Simple (30901) |
$67 |
$134 |
0.5× |
| Debridement subcutaneous tissue 20 sq cm/< (11042) |
$469 |
$938 |
1.2× |
| Declot vascular device (36593) |
$383 |
$766 |
1.2× |
| Diagnostic sigmoidoscopy (45330) |
$1,074 |
$2,148 |
1.2× |
| Drainage Finger Abscess Simple (26010) |
$235.50 |
$471 |
1.2× |
| Drainage of hematoma/fluid (10140) |
$1,905 |
$3,810 |
1.2× |
| Draw blood off venous device (36591) |
$157.50 |
$315 |
1.2× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) |
$236 |
$472 |
1.2× |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) |
$236 |
$472 |
1.2× |
| Evacuation of subungual hematoma (11740) |
$144.50 |
$289 |
1.1× |
| Gastric Intubation/Aspiration, Therapeutic (43753) |
$154.50 |
$309 |
0.7× |
| I&d abscess simple (10060) |
$278.50 |
$557 |
1.5× |
| I&d perianal abscess superficial (46050) |
$899.50 |
$1,799 |
1.0× |
| I&d pilonidal cyst simple (10080) |
$372 |
$744 |
0.5× |
| Incision & drainage abscess complicated/multiple (10061) |
$512.50 |
$1,025 |
1.3× |
| Incision & removal foreign body subq tiss simple (10120) |
$195 |
$390 |
0.5× |
| Incision and drainage of vulva or perineal abscess (56405) |
$209.50 |
$419 |
0.7× |
| Incision thrombosed hemorrhoid external (46083) |
$279.50 |
$559 |
1.2× |
| Initial tx 1st degree burn local tx (16000) |
$235.50 |
$471 |
1.2× |
| Injection anes other peripheral nerve/branch (64450) |
$781.50 |
$1,563 |
1.2× |
| Injection single/mlt trigger point 1/2 muscles (20552) |
$334.50 |
$669 |
1.1× |
| Injection single/mlt trigger point 3/> muscles (20553) |
$351 |
$702 |
1.2× |
| Insert Bladder Cath Complex (51703) |
$184 |
$368 |
1.5× |
| Insert non-tunnel cv cath (36556) |
$2,363.50 |
$4,727 |
0.8× |
| Insert Temp Bladder Cath (51702) |
$179.50 |
$359 |
1.4× |
| Insert,Non-Indwelling Bladder Catheter (51701) |
$119.50 |
$239 |
0.9× |
| Intraoral i&d tongue/floor masticator space (41009) |
$646.50 |
$1,293 |
1.3× |
| Intraoral i&d tongue/floor submental space (41007) |
$1,792 |
$3,584 |
1.2× |
| Intubation endotracheal emergency procedure (31500) |
$350.50 |
$701 |
1.5× |
| Irrigate corpora cavernosa for priapism (54220) |
$304.50 |
$609 |
1.3× |
| Nasal/Sinus Endoscopy,W/Control Nasal Hem (31238) |
$2,050.50 |
$4,101 |
1.2× |
| Njx c/p/a cavernosa w/pharmacologic agt (54235) |
$289.50 |
$579 |
1.2× |
| Perq Drainage Pleura Insert Cath W/O Imaging (32556) |
$1,112.50 |
$2,225 |
0.6× |
| Perq replacement gtube not req revj gstrst trc (43762) |
$281 |
$562 |
1.2× |
| Placement of needle for intraosseous infusion (36680) |
$450.50 |
$901 |
1.1× |
| Preputial Stretching (54450) |
$291 |
$582 |
1.2× |
| Punch biopsy skin single lesion (11104) |
$317 |
$634 |
0.8× |
| Puncture Aspiration (10160) |
$455 |
$910 |
1.2× |
| Rbc DNA gntyp 12 bld grp gen (0282U) |
$1,498 |
$2,996 |
2.1× |
| Removal fb intranasal (30300) |
$67 |
$134 |
0.5× |
| Removal foreign body foot subcutaneous (28190) |
$827 |
$1,654 |
1.2× |
| Removal impacted cerumen irrigation/lvg unilat (69209) |
$97.50 |
$195 |
1.7× |
| Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) |
$69.50 |
$139 |
1.2× |
| Remove drug implant device (11982) |
$474.50 |
$949 |
1.1× |
| Remv Ext Canal Foreign Body (69200) |
$152 |
$304 |
1.2× |
| Remv F.B.,Eye,Superf Conjunc (65205) |
$150.50 |
$301 |
1.2× |
| Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) |
$738 |
$1,476 |
1.9× |
| Repair complex scalp/arm/leg 2.6-7.5 cm (13121) |
$828 |
$1,656 |
2.1× |
| Repair extensor tendon finger w/o graft each (26418) |
$1,888.50 |
$3,777 |
1.2× |
| Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) |
$469 |
$938 |
1.2× |
| Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) |
$469 |
$938 |
1.2× |
| Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) |
$469 |
$938 |
1.2× |
| Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) |
$469 |
$938 |
1.2× |
| Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) |
$758.50 |
$1,517 |
1.1× |
| Repair intermediate s/a/t/e 12.6-20.0cm (12035) |
$469 |
$938 |
1.2× |
| Repair intermediate s/a/t/e 2.5 cm/< (12031) |
$450.50 |
$901 |
1.2× |
| Repair intermediate s/a/t/e 2.6-7.5 cm (12032) |
$487 |
$974 |
1.3× |
| Repair intermediate s/a/t/e 7.6-12.5 cm (12034) |
$469 |
$938 |
1.2× |
| Repair of nail bed (11760) |
$709.50 |
$1,419 |
1.0× |
| Repair Tongue Laceration (41250) |
$468 |
$936 |
1.1× |
| Rmvl fb xtrnl eye corneal w/o slit lamp (65220) |
$450.50 |
$901 |
1.1× |
| Rmvl w/rinsj non-biodegradable drug dlvr implt (11983) |
$5 |
$10 |
0.0× |
| Rpr lac tongue floor mouth > 2.6 cm/cplx (41252) |
$287.50 |
$575 |
1.3× |
| Simple repair f/e/e/n/l/m 2.5cm/< (12011) |
$199 |
$398 |
1.0× |
| Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) |
$199 |
$398 |
1.0× |
| Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) |
$236.50 |
$473 |
1.2× |
| Simple repair f/e/e/n/l/m 7.6cm-12.5 cm (12015) |
$236.50 |
$473 |
1.2× |
| Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) |
$199 |
$398 |
1.0× |
| Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) |
$199 |
$398 |
1.0× |
| Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) |
$166 |
$332 |
0.9× |
| Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) |
$469 |
$938 |
1.2× |
| Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) |
$469 |
$938 |
1.2× |
| Spinal puncture lumbar diagnostic (62270) |
$796.50 |
$1,593 |
1.2× |
| Thrombolytic Therapy, Stroke (37195) |
$194.50 |
$389 |
0.6× |
| Trach Tube Change (31502) |
$262 |
$524 |
1.2× |
| Treat Fracture Radius & Ulna (25560) |
$283 |
$566 |
1.2× |
| Treat humerus fracture (24500) |
$277.50 |
$555 |
1.2× |
| Treat humerus fracture (23600) |
$277.50 |
$555 |
1.2× |
| Treat Wrist Bone Fracture (25630) |
$285.50 |
$571 |
1.2× |
| Treatment closed elbow dislocation w/o anes (24600) |
$277.50 |
$555 |
1.2× |
| Tx Superficial Wound Dehiscence Simple Closure (12020) |
$738 |
$1,476 |
1.0× |
| Tx superficial wound dehiscence w/packing (12021) |
$450.50 |
$901 |
1.2× |
| Vaginal delivery only (59409) |
$3,673 |
$7,346 |
1.2× |
| Venipuncture (36415) |
$5 |
$10 |
0.5× |