Procedures & surgery prices at Antelope Memorial Hospital

Neligh, NE · every code in this section with a posted price and a Medicare benchmark.

505 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
Abd paracentesis w/imaging (49083) $620
Abdom Paracentesis Dx/Ther W/O Imaging Guidance (49082) $792
Acne Surgery (10040) $249 $249 1.2×
Acromioplasty or acromionectomy, partial, with or without coracoacromial ligament release (23130) $1,315
Adding Walker Previously Applied Cast (29440) $94
Amniocentesis diagnostic (59000) $242
Anoscopy diagnostic (46600) $239
Anoscopy W/Rmvl Foreign Body (46608) $608
Anoscopy; with biopsy, single or multiple (46606) $593
Application cast elbow finger short arm (29075) $187
Application cast shoulder hand long arm (29065) $195
Application finger splint static (29130) $261.50
Application long arm splint shoulder hand (29105) $177
Application long leg splint thigh ankle/toes (29505) $194
Application of a uniplane (pins or wires in 1 plane), unilateral, external fixation system (20690) $1,258
Application of long leg cast (29345) $489
Application short arm splint forearm-hand static (29125) $271.50
Application short leg splint calf foot (29515) $156
Apply short leg cast (29405) $149
Arterial puncture (36600) $140
Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) $438
Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) $533
Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) $123
Arthroplasty knee condyle and plateau medial or lateral compartment (sso) (27446) $2,405
Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction (29888) $2,056
Arthroscopy knee w/lysis adhesions w/wo manj spx (29884) $1,313
Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure) (29870) $867
Arthroscopy, knee, surgical; abrasion arthroplasty or multiple drilling or microfracture (29879) $1,400
Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty) (29877) $1,316
Arthroscopy, knee, surgical; for removal of loose body or foreign body (29874) $1,138
Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (29875) $1,054
Arthroscopy, knee, surgical; with lateral release (29873) $1,143
Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral) including chondroplasty (29880) $1,193
Arthroscopy, knee, surgical; with meniscus repair (medial or lateral) (29882) $1,458
Arthroscopy, shoulder, surgical; capsulorrhaphy (29806) $2,228
Arthroscopy, shoulder, surgical; debridement, extensive (29823) $1,258
Arthroscopy, shoulder, surgical; debridement, limited (29822) $1,150
Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (29824) $1,436
Arthroscopy, shoulder, surgical; repair of slap lesion (29807) $2,180
Arthroscopy, shoulder, surgical; with rotator cuff repair (29827) $2,250
Aspirat/Injection Ganglion Cyst(S) (20612) $139
Avulsion nail plate partial/complete simple 1 (11730) $205
Banding of hemorrhoids using a flexible endoscope (sigmoidoscope) (45350) $1,415
Biopsy Cervix Single/Mult/Excision Of Lesion Spx (57500) $326
Biopsy external ear (69100) $204
Biopsy muscle deep (20205) $609
Biopsy Muscle Superficial (20200) $440
Biopsy of nail unit (11755) $263
Biopsy of prostate (55705) $1,573.50
Biopsy of uterus lining (58100) $215
Biopsy or excision of lymph node(s); open, superficial (38500) $701
Biopsy soft tissue of back (21920) $526
Bladder Instillation Anticarcinogenic Agent (51720) $1,017
Bladder Irrigation Simple (51700) $478
Bladder Scan (51798) $159
Blood patch (62273) $624
Blood transfusion service (36430) $1,521
Bone marrow aspiration only (38220) $480.50
Bone Marrow Biopsy (38221) $349
Bx breast 1st lesion us imag (19083) $3,333
Bx breast needle core w/o imaging guidance spx (19100) $311
Bx prst8 trct us guided (55707) $1,823
Bx/exc lymph node needle superficial (38505) $2,555
Change Cystostomy Tube Simple (51705) $631
Chemical Cautery Tissue (17250) $185
Chest tube placement (32551) $1,974.50
Chg Collect Blood From Catheter Venous Nos (36592) $144
Circum 28 days or older (54161) $422
Circumcision (54150) $294.50
Circumcision Neonate (54160) $473
Claviculectomy; partial (23120) $1,250
Closed Rx Gr Tuberosity Hum Fx (23620) $595
Closed Rx Humeral Supracondylar Fx (24530) $839
Closed Rx Med Malleolus Fx (27760) $1,012
Closed Rx Rad/Ulna Shaft Fx,Manip (25565) $1,123
Closed Rx Radial Shaft Fx (25500) $628
Closed Rx Radial Shaft Fx W/Dislocation (25520) $1,244
Closed Rx Spontaneous Hip Disloc (27256) $748
Closed Rx Tibia Shaft Fx (27750) $761
Closed Rx Tibial Plateau Fx (27530) $676
Closed Rx Trimalleolar Fx (27816) $727
Closed Treatment Coccygeal Fracture (27200) $413
Closed Treatment Of Distal Radioulnar Dislocation With Manipulation (25675) $748
Closed treatment of humeral condylar fracture, medial or lateral; without manipulation (24576) $774
Closed treatment of humeral epicondylar fracture, medial or lateral; without manipulation (24560) $730
Closed treatment of talus fracture; without manipulation (28430) $526
Closed treatment of ulnar shaft fracture; with manipulation (25535) $1,075
Closed Treatment Pst Malleolus Fracture W/O Manj (27767) $637
Closed Treatment Ulnar Styloid Fracture (25650) $723
Closed tx ankle dislocation w/o anesthesia (27840) $835
Closed Tx Bimalleolar Ankle Fracture W/O Manip (27808) $748
Closed tx calcaneal fracture w/o manipulation (28400) $543
Closed tx knee dislocation w/o anesthesia (27550) $924.50
Closed tx metatarsal fracture w/o manipulation (28470) $613.50
Closed tx patellar dislocation w/o anesthesia (27560) $748
Closed tx patellar fracture w/o manipulation (27520) $714
Closed tx radial head/neck fx w/o manipulation (24650) $582
Closed Tx Talotarsal Joint Dislocation W/Anes (28575) $901.50
Closed tx temporomandibular dislocation 1st/sbsq (21480) $299
Closed tx ulnar fracture prox end w/o manipulate (24670) $643
Closed tx ulnar shaft fracture w/o manipulation (25530) $585
Clsd Tx Acromioclavicular Dislc W/O Manipulation (23540) $523
Clsd tx clavicular fracture w/manipulation (23505) $2,571
Clsd tx clavicular fracture w/o manipulation (23500) $491
Clsd tx shoulder dislc w/manipulation req anes (23655) $1,005.50
Clsd tx shoulder dislc w/manipulation w/o anes (23650) $726
Cltx ankle dislc req anes w/wo prq skel fixj (27842) $942.50
Cltx Artclr Fx Invg Mtcrphlngl/Iphal Jt W/O Manj (26740) $515
Cltx Carpo/Metacarpal Dislocation Thumb W/Manj (26641) $913
Cltx dstl fibular fx lat malls w/o manj (27786) $688
Cltx Dstl Phlngl Fx Fngr/Thmb W/O Manj Ea (26750) $415
Cltx dstl radial fx/epiphysl sep w/o manj (25600) $746
Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) $1,166
Cltx fx grt toe phlx/phlg w/o manj (28490) $312
Cltx fx phlx/phlg oth/thn grt toe w/manj (28515) $363
Cltx fx phlx/phlg oth/thn grt toe w/o manj (28510) $267
Cltx fx w8 brg artclr prtn dstl tibia w/o manj (27824) $690
Cltx hip dislocation traumatic w/o anesthesia (27250) $557.50
Cltx Interphalangeal Joint Dislocation W/O Anes (28660) $270
Cltx iphal jt dislc w/manj w/o anes (26770) $691
Cltx metacarpal fx w/manipulation each bone (26605) $724
Cltx metacarpal fx w/o manipulation each bone (26600) $664
Cltx metacarpophalangeal dislc w/manj w/o anes (26700) $745
Cltx metatarsophlngl jt dislc w/o anes (28630) $316
Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) $748
Cltx phlngl fx prox/middle px/f/t w/o manj ea (26720) $444
Cltx Post Hip Arthrp Dislc Req Anes (27266) $1,241
Cltx post hip arthrp dislc w/o anes (27265) $895
Cltx prox fibula/shft fx w/manj (27781) $1,036.50
Cltx prox fibula/shft fx w/o manj (27780) $679
Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) $488
Cltx trimalleolar ankle fx w/manipulation (27818) $907
Cmbnd anterpost colporraphy w/cysto w/ntrcl rpr (57265) $1,839
Colonoscopy stoma w/biopsy (44389) $874
Colonoscopy thru stoma (44388) $1,586
Colonoscopy w/band ligation (45398) $2,717
Colposc,Cervix W/Adj Vag,W/Bx & Curretag (57454) $461
Colsc flx with directed submucosal njx any sbst (45381) $2,192
Control Nasal Hemorrhage Anterior Complex (30903) $516
Control Nasal Hemorrhage Anterior Simple (30901) $422
Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft (27132) $3,488
Cryotherapy of skin (17340) $113
Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) $740
Ctrl Nsl Hemrrg Pst Nasal Packs&/Cautery Subsq (30906) $796
Cysto w fulgertn lg bladder tumor(s) (52240) $823
Cysto w/dilat rx balo cath urtl strix/sten male (52284) $5,688
Cysto w/removal of tumors small (52234) $517
Cysto W/Simple Removal Stone & Stent (52310) $2,840
Cystoscopy w/biopsy (52204) $6,000
Cystourethroscopy (52000) $1,505
Cystourethroscopy Inj Chemodenervation Bladder (52287) $3,545.50
Cystourethroscopy,Fulgur 2-5 Cm Lesn (52235) $607
Dbrdmt extensv eczema/infect skn up 10% bdy surf (11000) $128
Dbrdmt Fx&/Dislc Subq T/M/F Bone (11012) $1,315
Debride nail 1-5 (11720) $156
Debride nail 6 or more (11721) $168
Debridement subcutaneous tissue 20 sq cm/< (11042) $221.50
Debridement, Skin, Sub-Q Tissue,Muscle,Bone,=<20 Sq Cm (11044) $657
Declot vascular device (36593) $869
Destroy cerv/thor facet jnt (64633) $2,213.50
Destroy lumb/sac facet jnt (64635) $3,142
Destruc Benign/Premal,15+ Lesions (17004) $359
Destruction benign lesions 15 or more (17111) $286
Destruction Benign Lesions Up To 14 (17110) $206
Destruction by neurolytic agent; other peripheral nerve or branch (64640) $1,589
Destruction mal lesion f/e/e/n/l/m 0.6-1.0cm (17281) $387
Destruction mal lesion f/e/e/n/l/m >4.0 cm (17286) $762
Destruction malignant lesion f/e/e/n/l/m 0.5cm/< (17280) $303
Destruction premalignant lesion 1st (17000) $146
Diagnostic sigmoidoscopy (45330) $1,356
Dilation esoph unguided sound/bougie 1/mult pass (43450) $399
Drain Mouth Absc/Cyst/Hematoma,Simpl (40800) $432
Drainage External Ear Abscess/Hematoma Simple (69000) $397
Drainage Finger Abscess Complicated (26011) $1,010
Drainage Finger Abscess Simple (26010) $731
Drainage of hematoma/fluid (10140) $363
Draw blood off venous device (36591) $200
Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) $414
Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) $333
Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) $182
Dry Needling 3+ Muscles (20561) $49
Dstrj les/scar vestibule mouth physical meths (40820) $554
Dstrj lesion anus simple surg excision (46922) $2,154
Egd Balloon Dil Esoph30 Mm/> (43233) $1,337
Egd balloon dilation esophagus <30 mm diam (43249) $3,690
Egd Dilation Gastric/Duodenal Stricture - Egd (43245) $1,409
Egd flexible foreign body removal (43247) $2,300
Egd place gastrostomy tube (43246) $416
Egd remove lesion snare (43251) $2,330
Esophagoscopy flexible removal foreign body (43215) $830
Esophagoscopy flexible transoral diagnostic (43200) $558
Evacuation of subungual hematoma (11740) $239
Exc abd les sc 3 cm/> (22903) $913
Exc arm/elbow les sc < 3 cm (24075) $1,084
Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 2.1-3.0cm (11423) $440
Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 3.1-4.0cm (11424) $507
Exc back les sc < 3 cm (21930) $1,059
Exc Face-Mm B9+Marg 0.5 Cm/< (11440) $308
Exc Face-Mm B9+Marg 2.1-3 Cm (11443) $487
Exc shoulder les sc 3 cm/> (23071) $876
Exc skin abd (15830) $2,442
Exc Skin Benig 0.6-1 Cm Remaindr Body (11421) $343
Exc Skin Benig 0.6-1 Cm Trunk,Arm,Leg (11401) $334
Exc Skin Benig 1.1-2 Cm Trunk,Arm,Leg (11402) $368
Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg (11403) $423
Exc Skin Benig 3.1- 4 Cm Face,Facial (11444) $605
Exc Skin Benig 3.1-4 Cm Trunk,Arm,Leg (11404) $476
Exc Skin Benig >4 Cm Remaindr Body (11426) $697
Exc Skin Benig >4 Cm Trunk,Arm,Leg (11406) $673
Exc Skin Malig 2.1-3 Cm Face,Facial (11643) $672
Exc Skin Malig >4 Cm Face,Facial (11646) $1,068
Exc Skin Malig >4 Cm Remaindr Body (11626) $858
Exc Skin Malig >4 Cm Trunk,Arm,Leg (11606) $949.50
Exc thigh/knee les sc 3 cm/> (27337) $875
Exc thigh/knee tum dep 5cm/> (27339) $1,572
Exc Thrombosed Hemorrhoid Xtrnl (46320) $174
Exc tr-ext b9+marg 0.5 cm or less (11400) $274
Exc tumor soft tiss shoulder subfasc <5cm (23076) $1,088
Excision Breast Lesion (19125) $1,190
Excision mal lesion trunk/arm/leg 0.5 cm/< (11600) $421
Excision Mal Lesion Trunk/Arm/Leg 0.6-1.0 Cm (11601) $489
Excision mal lesion trunk/arm/leg 1.1-2.0 cm (11602) $525
Excision Mal Lesion Trunk/Arm/Leg 2.1-3.0 Cm (11603) $596
Excision Mal Lesion Trunk/Arm/Leg 3.1-4.0 Cm (11604) $663
Excision malignant lesion f/e/e/n/l 0.5 cm/< (11640) $435
Excision malignant lesion f/e/e/n/l 0.6-1.0 cm (11641) $507
Excision malignant lesion f/e/e/n/l 1.1-2.0 cm (11642) $573
Excision Malignant Lesion F/E/E/N/L 3.1-4.0 Cm (11644) $827
Excision Malignant Lesion S/N/H/F/G 0.5 Cm/< (11620) $423
Excision malignant lesion s/n/h/f/g 0.6-1.0 cm (11621) $490
Excision malignant lesion s/n/h/f/g 1.1-2.0 cm (11622) $542
Excision Malignant Lesion S/N/H/F/G 2.1-3.0 Cm (11623) $632
Excision Malignant Lesion S/N/H/F/G 3.1-4.0 Cm (11624) $718
Excision of benign lesion other than skin tag 0.6-1.0 cm (11441) $373
Excision of benign lesion other than skin tag 1.1-2.0 cm (11442) $414
Excision of lesion other than skin tag 1.1-2.0 cm (11422) $384
Excision of lesion other than skin tag </= 0.5 cm (11420) $272
Excision of nail fold toe (11765) $699.50
Excision of pilonidal cyst or sinus; simple (11770) $745
Excision of single external papilla or tag, anus (46220) $514
Excision olecranon bursa (24105) $774
Excision Prepatellar Bursa (27340) $802
Excision tumor soft tissue thigh/knee subq <3cm (27327) $1,056
Excision, tumor, soft tissue of face or scalp, subcutaneous; less than 2 cm (21011) $7.62
Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm (23075) $660
Fetal non-stress test (59025) $243.50
Fixation of knee joint (27570) $327
Fixation of shoulder (23700) $416
Fth/Gft Fr W/Dir Clsr F/C/C/M/N/Ax/G/H/F 20 Cm/< (15240) $1,983
Gastric Intubation/Aspiration, Therapeutic (43753) $440
Hemorrhoidectomy external complete (46250) $1,009
I&d abscess simple (10060) $273 $273 1.3×
I&d perianal abscess superficial (46050) $1,486.50
I&d pilonidal cyst simple (10080) $532
Incise finger tendon sheath (26055) $1,276
Incision & drainage abscess complicated/multiple (10061) $459
Incision & removal foreign body subq tiss compl (10121) $563
Incision & removal foreign body subq tiss simple (10120) $684
Incision and drainage of bartholin's gland abscess (56420) $552
Incision and drainage of vulva or perineal abscess (56405) $906
Incision extensor tendon sheath wrist (25000) $746
Incision of lingual frenum (41010) $352
Incision of rectal abscess (46040) $2,207.50
Incision thrombosed hemorrhoid external (46083) $386
Incisional biopsy skin single lesion (11106) $331
Initial tx 1st degree burn local tx (16000) $159
Inj paravert f jnt c/t 1 lev (64490) $1,295
Inj tendon sheath/ligament (20550) $123
Inj,Anes Agent,Brachial Plexus,Single (64415) $2,063
Inj,Anes Agent,Femoral Nerve,Cont Inf (64448) $2,117
Inj,Anes Agent,Femoral Nerve,Single (64447) $250
Inject Anes/Steroid Plantar Common Digital Nerve (64455) $287
Inject Nerv Blck,Intercost,Multpl (64421) $677
Inject Nerv Blck,Intercostal,One (64420) $1,543
Inject scleros soln in hemorrhoids (46500) $663
Inject Tendon Origin/Insert (20551) $205
Injection aa&/strd genicular nrv branches w/img (64454) $168
Injection aa&/strd sciatic nerve w/img gdn (64445) $2,063
Injection aa&/strd trigeminal nerve each branch (64400) $454
Injection anes other peripheral nerve/branch (64450) $711
Injection single/mlt trigger point 1/2 muscles (20552) $112
Injection single/mlt trigger point 3/> muscles (20553) $129
Injection therapeutic carpal tunnel (20526) $280
Injection, intralesional; up to and including 7 lesions (11900) $123
Insert Bladder Cath Complex (51703) $333
Insert Drug Implant Device (11981) $212
Insert non-tunnel cv cath (36556) $827
Insert Non-Tunnel Cv Cath < 5 Y/O (36555) $4,337
Insert pessary/other device (57160) $158
Insert picc cath (36569) $2,253
Insert Temp Bladder Cath (51702) $307
Insert tun ip cath perc (49418) $2,037
Insert tunneled cv cath (36561) $2,027
Insert,Non-Indwelling Bladder Catheter (51701) $308
Insj tun vad req 2 cath 2 sits w/subq port (36566) $706
Insrt/redo spine n generator (63685) $720
Intubation endotracheal emergency procedure (31500) $1,063
Irrigate corpora cavernosa for priapism (54220) $472
Knee arthroscopy/surgery (29887) $1,592
Knee arthroscopy/surgery (29883) $1,779
Knee arthroscopy/surgery (29885) $1,598
Knee arthroscopy/surgery (29886) $1,347
Laparoscopy appendectomy (44970) $1,238
Laparoscopy tubal block (58671) $787
Laparoscopy Tubal Cautery (58670) $787
Laparoscopy, surgical; cholecystectomy with cholangiography (47563) $1,470
Laparoscopy, surgical; cholecystectomy with exploration of common duct (47564) $2,283
Laryngoscopy Flexible Diagnostic (31575) $240.50
Late closure of wound (13160) $1,671
Ligation of hemorrhoid(s) (46221) $1,378.50
Mastectomy simple complete (19303) $1,963
Nasal Endoscopy Diagnostic Uni/Bi Spx (31231) $153
Naso/oro-gastric tube plmt req phys&fluor gdnce (43752) $84
Needle insertion w/o injection 1 or 2 muscles (20560) $49
Nfct ds bct/vir respir DNA/RNA 22 trgt sarscov2 (0202U) $638
Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level (64493) $1,223
Njx dx/ther sbst intrlmnr crv/thrc w/img gdn (62321) $1,264
Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn (62323) $1,139
Open rx distal radius fx, intra-articular, 2 frag (25608) $1,757
Open Treatment Bimalleolar Ankle Fracture (27814) $1,620
Open Treatment Medial Malleolus Fracture (27766) $1,292
Open treatment of acromioclavicular dislocation, acute or chronic; (23550) $1,220
Open treatment of femoral fracture, proximal end, neck, internal fixation or prosthetic replacement (27236) $2,502
Open treatment of patellar fracture, with internal fixation and/or patellectomy (27524) $1,594
Open treatment of trimalleolar ankle fracture; with fixation of posterior lip (27823) $2,087
Open Tx Distal Phalangeal Fracture Each (26765) $1,081
Open Tx Humeral Epicondylar Fracture (24575) $1,555
Open tx of distal tibiofibular joint disruption, includes internal fixation, when performed (27829) $1,509
Open tx proximal humeral fx, incl int fixation, includes repair of tuberosity (23615) $1,866
Optx fem shft fx w/insj imed implt w/wo screw (27506) $2,805
Pelvic exam under anesthesia (57410) $223
Percutaneous skeletal fixation of femoral fracture, proximal end, neck (27235) $1,908
Perq Drainage Pleura Insert Cath W/O Imaging (32556) $1,564
Placement of needle for intraosseous infusion (36680) $594
Preputial Stretching (54450) $147
Prostatectomy (turp) (52601) $1,547
Prq impltj neurostim eltrd sacral nrve w/imaging (64561) $6,066
Punch biopsy skin single lesion (11104) $269
Puncture Aspiration (10160) $403.50
Puncture Aspiration Cyst Breast (19000) $592
Radiofrequency abltj nrv nrvtg si jt w/img gdn (64625) $2,262
Reconstr disloc patella w mscl adv (27422) $1,571
Removal fb intranasal (30300) $401
Removal foreign body pharynx (42809) $1,155
Removal impacted cerumen irrigation/lvg unilat (69209) $34
Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) $168
Removal Implant Deep (20680) $889
Removal of intrauterine device (iud) (58301) $234
Removal of knee prosthesis, including total knee prosthesis, methylmethacrylate with or without insertion of spacer,… (27488) $2,517
Removal of nail bed (11750) $310
Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions (11200) $199
Removal/bivalving full arm/full leg cast (29705) $439
Removal/bivalving gauntlet boot/body cast (29700) $137
Remove anal fist subq (46270) $1,126
Remove drug implant device (11982) $234
Remove foreign body from eye (65210) $1,155
Remove in/ex hem groups 2+ (46260) $1,011
Remove wrist tendon lesion (25111) $699
Remv Ext Canal Foreign Body (69200) $171
Remv F.B.,Eye,Superf Conjunc (65205) $208
Repair complex eyelid/nose/ear/lip 1.1-2.5 cm (13151) $1,602
Repair complex eyelid/nose/ear/lip 2.6-7.5 cm (13152) $1,058
Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) $1,042
Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) $1,005
Repair complex scalp/arm/leg 1.1-2.5 cm (13120) $757
Repair complex scalp/arm/leg 2.6-7.5 cm (13121) $1,254.50
Repair complex trunk 1.1-2.5 cm (13100) $1,602
Repair complex trunk 2.6-7.5 cm (13101) $1,602
Repair elbow deb/attch open (24359) $1,410
Repair elbow perc (24357) $908
Repair incomplete circumcision (54163) $471
Repair initial femoral hernia, any age; incarcerated or strangulated (49553) $1,299
Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated (49507) $1,209
Repair intermediate f/e/e/n/l&/muc 12.6-20.0cm (12055) $1,062
Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) $604
Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) $858
Repair intermediate f/e/e/n/l&/muc 20.1-30.0cm (12056) $1,221
Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) $776
Repair intermediate f/e/e/n/l&/muc 7.6-12.5 cm (12054) $813
Repair intermediate f/e/e/n/l&/muc >30.0 cm (12057) $1,042
Repair intermediate n/h/f/xtrnl gent 12.6-20 cm (12045) $1,602
Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) $802.50
Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) $663
Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) $1,208
Repair intermediate n/h/f/xtrnl gent >30.0 cm (12047) $5,139
Repair intermediate s/a/t/e 12.6-20.0cm (12035) $831
Repair intermediate s/a/t/e 2.5 cm/< (12031) $561
Repair intermediate s/a/t/e 2.6-7.5 cm (12032) $846
Repair intermediate s/a/t/e 20.1-30.0 cm (12036) $1,256
Repair intermediate s/a/t/e 7.6-12.5 cm (12034) $592
Repair intermediate s/a/t/e >30.0 cm (12037) $1,020
Repair kneecap tendon (27380) $1,321
Repair of leg tendon each (27664) $779
Repair of nail bed (11760) $395
Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; chronic (23412) $1,800
Repair of shoulder (23420) $2,054
Repair of thigh musc (27385) $1,298
Repair of vagina (57260) $1,646
Repair rotator cuff acute (23410) $1,734
Repair Tongue Laceration (41250) $354
Rerepair ing hernia reduce (49520) $1,300
Revise median n/carpal tunnel surg (64721) $947
Revise ulnar nerve at elbow (64718) $1,281
Revision of penis (54420) $472
Revision of total hip arthroplasty; acetabular component only with or without autograft or allograft (27137) $3,058
Revision of total hip arthroplasty; both components, with or without autograft or allograft (27134) $3,058
Revision of total hip arthroplasty; femoral component only with or without autograft or allograft (27138) $3,175
Revision of total knee arthroplasty with or without allograft; femoral and entire tibial component (27487) $3,657
Revision of total knee arthroplasty, with or without allograft; one component (27486) $2,937
Rmvl fb xtrnl eye corneal w/o slit lamp (65220) $1,155
Rmvl fb xtrnl eye corneal w/slit lamp (65222) $354
Rmvl tun ctr vad w/subq port/pmp ctr/prph insj (36590) $2,615.50
Rmvl Tun Cvc W/O Subq Port/Pmp (36589) $346
Rmvl w/rinsj non-biodegradable drug dlvr implt (11983) $299
Rpr 1st ingun hrna age 6 mo-5 yrs reducible (49500) $861
Rpr aa hernia 1st 3-10 cm ncrc8/strangulated (49594) $1,507
Rpr aa hernia 1st 3-10 cm reducible (49593) $1,159
Rpr aa hernia 1st < 3 cm ncrc8/strangulated (49592) $962
Rpr aa hernia 1st < 3 cm reducible (49591) $694
Rpr Aa Hernia Recr < 3 Cm Ncrc8/Strangulated (49614) $1,157
Rpr intermediate n/h/f/xtrnl gent 20.1-30.0 cm (12046) $1,602
Rpr Lip Full Thickness Half/< Vertical Height (40652) $1,617
Rpr Lip Full Thkns >One-Half Vert Height/Comple (40654) $4,245
Sgmdsc flx rmvl tum polyp/oth les snare tq (45338) $3,173
Shaving Skin Lesion 1 F/E/E/N/L/M Diam 0.5 Cm/< (11310) $247
Shaving Skin Lesion 1 F/E/E/N/L/M Diam >2.0 Cm (11313) $387
Shaving Skin Lesion 1 S/N/H/F/G Diam 0.5 Cm/< (11305) $226
Shaving Skin Lesion 1 S/N/H/F/G Diam 0.6-1.0 Cm (11306) $263
Shaving Skin Lesion 1 S/N/H/F/G Diam 1.1-2.0 Cm (11307) $297
Shaving Skin Lesion 1 S/N/H/F/G Diam >2.0 Cm (11308) $313
Shaving skin lesion 1 trunk/arm/leg diam 0.5cm/< (11300) $214
Shldr arthroscop,lyse adhesns (29825) $1,245
Shvg Skin Lesion 1 F/E/E/N/L/M Diam 0.6-1.0 Cm (11311) $292
Shvg Skin Lesion 1 F/E/E/N/L/M Diam 1.1-2.0 Cm (11312) $333
Shvg Skin Lesion 1 Trunk/Arm/Leg Diam 0.6-1.0 Cm (11301) $260
Shvg Skin Lesion 1 Trunk/Arm/Leg Diam >2.0 Cm (11303) $324
Shvg Skn Lesion 1 Trunk/Arm/Leg Diam 1.1-2.0 Cm (11302) $293
Sigmoidoscopy flx w/biopsy single/multiple (45331) $1,870.50
Sigmoidoscopy flx w/rmvl tumor by hot bx forceps (45333) $676
Simple repair f/e/e/n/l/m 12.6cm-20.0 cm (12016) $750
Simple repair f/e/e/n/l/m 2.5cm/< (12011) $398.50
Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) $422.50
Simple repair f/e/e/n/l/m 20.1cm-30.0 cm (12017) $678
Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) $442.50
Simple repair f/e/e/n/l/m 7.6cm-12.5 cm (12015) $473.50
Simple repair f/e/e/n/l/m >30.0 cm (12018) $354
Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) $199
Simple repair scalp/neck/ax/genit/trunk >30.0cm (12007) $536
Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) $405
Skin splt grft trnk/arm/leg (15100) $1,751
Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) $376
Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) $467.50
Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) $429
Spinal puncture lumbar diagnostic (62270) $1,601
Strapping ankle (29540) $223
Strapping elbow/wrist (29260) $84.50
Strapping knee (29530) $236
Strapping shoulder (29240) $471
Strapping toes (29550) $186
Strapping unna boot (29580) $136
Subcutaneous Hormone Pellet Implantation (11980) $334
Suspension of testis (54640) $916
Tangential biopsy skin single lesion (11102) $751
Tenodesis long tendon biceps (23430) $1,577
Tenotomy elbow lateral/medial debride open (24358) $1,131
Thoracentesis Needle/Cath Pleura W/Imaging (32555) $1,467.50
Thoracentesis needle/cath pleura w/o imaging (32554) $1,409
Total hip arthroplasty (27130) $2,685
Total knee arthroplasty (27447) $2,683
Trach Tube Change (31502) $685
Tracheostomy emergency cricothyroid membrane (31605) $685
Tracheostomy Emergency Procedure Transtracheal (31603) $4,245
Transabdominal Amnioinfusion W/Ultrsnd Guidance (59070) $810
Treat ankle dislocation (27846) $1,536
Treat finger dislocation (26775) $865
Treat Fracture Radius & Ulna (25560) $639
Treat fx distal radial (25606) $1,424
Treat fx rad extra-articul (25607) $1,575
Treat humerus fracture (24500) $795
Treat humerus fracture (23600) $731
Treat Metatarsal Fracture (28475) $571
Treat wrist bone fracture (25622) $678
Treat Wrist Bone Fracture (25630) $671
Treatment closed elbow dislocation w/o anes (24600) $783.50
Treatment of ankle fracture (27822) $1,859
Treatment of ankle fracture (27792) $1,339.50
Treatment of intertrochanteric or subtrochanteric femoral fracture; w intramedullary implant (27245) $2,570
Treatment of intertrochanteric, pertrochanteric, or subtrochanteric femoral fracture; with plate/screw type implant,… (27244) $2,573
Treatment of tarsal bone fracture (except talus and calcaneus); without manipulation, each (28450) $465
Treatment of tibia fracture (27759) $2,097
Trim skin lesion (11055) $160
Trim skin lesions 2 to 4 (11056) $172.50
Trim skin lesions over 4 (11057) $181
Trimming Of Nondystrophic Nails, Any Number (11719) $99.50
Tx Superficial Wound Dehiscence Simple Closure (12020) $1,119.50
Tx superficial wound dehiscence w/packing (12021) $1,042
Unlisted procedure pelvis/hip joint (27299) $1,298
Vag hyst complex (58290) $2,421
Vaginal delivery only (59409) $4,721
Vaginal hysterectomy (58260) $1,771
Vaginal hysterectomy; with removal of tube(s), and/or ovary(s) (58262) $1,957
Vasectomy (55250) $742
Vasotomy cannulization w/wo vas inc uni/bi spx (55200) $820
Vbac delivery only (59612) $1,798
Venipuncture (36415) $33