| Abd paracentesis w/imaging (49083) |
— |
$1,927.45 |
— |
| Apply Body Cast,Risser Jacket (29010) |
— |
$3,122.50 |
— |
| Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) |
— |
$574.20 |
— |
| Arthrocentesis aspir&/inj interm jt/burs w/us (20606) |
— |
$1,684.85 |
— |
| Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) |
— |
$1,736.42 |
— |
| Arthrocentesis aspir&/inj major jt/bursa w/us (20611) |
— |
$1,869.55 |
— |
| Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) |
— |
$1,275.70 |
— |
| Arthrodesis ant interbody inc discectomy, cervical below c2 (22551) |
— |
$13,312.70 |
— |
| Arthrodesis, posterior or posterolateral technique, single level ; lumbar (with lateral transverse technique, when… (22612) |
— |
$29,519.45 |
— |
| Arthroplasty glenohumeral joint total shoulder (23472) |
— |
$29,519.45 |
— |
| Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty) (29877) |
— |
$8,942.65 |
— |
| Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral) including chondroplasty (29880) |
— |
$8,942.65 |
— |
| Avulsion nail plate partial/complete simple 1 (11730) |
— |
$1,056.95 |
— |
| Biopsy muscle percutaneous needle (20206) |
— |
$2,373.10 |
— |
| Biopsy soft tissue neck/thorax (21550) |
— |
$2,930.95 |
— |
| Blood patch (62273) |
— |
$1,852.20 |
— |
| Blood transfusion service (36430) |
— |
$1,212 |
— |
| Bx abdl/retroperitoneal mass prq needle (49180) |
— |
$2,011 |
— |
| Bx breast 1st lesion us imag (19083) |
— |
$3,215.30 |
— |
| Bx/exc lymph node needle superficial (38505) |
— |
$2,373.10 |
— |
| Cerv artific diskectomy (22856) |
— |
$17,943.20 |
— |
| Chg Collect Blood From Catheter Venous Nos (36592) |
— |
$231.50 |
— |
| Colonoscopy flex w/rem forcep (45384) |
— |
$2,373.10 |
— |
| Colonoscopy w/endoscopic fnb (45392) |
— |
$2,373.10 |
— |
| Colonoscopy w/fb removal (45379) |
— |
$2,373.10 |
— |
| Colsc Flexible W/Control Bleeding Any Method - Colonoscopy (45382) |
— |
$2,373.10 |
— |
| Colsc Flexible W/Transendoscopic Balloon Dilat - Colonoscopy (45386) |
— |
$2,373.10 |
— |
| Colsc flx with directed submucosal njx any sbst (45381) |
— |
$2,373.10 |
— |
| Control Oropharyngeal Hemorrhage Simple (42960) |
— |
$708.50 |
— |
| Debride nail 1-5 (11720) |
— |
$840 |
— |
| Destroy cerv/thor facet jnt (64633) |
— |
$6,361.40 |
— |
| Destroy lumb/sac facet jnt (64635) |
— |
$5,239.08 |
— |
| Diagnostic lumbar spinal puncture w/fluor or CT (62328) |
— |
$1,734.60 |
— |
| Egd Balloon Dil Esoph30 Mm/> (43233) |
— |
$4,341.05 |
— |
| Egd balloon dilation esophagus <30 mm diam (43249) |
— |
$4,341.05 |
— |
| Egd Dilation Gastric/Duodenal Stricture - Egd (43245) |
— |
$4,341.05 |
— |
| Egd Endo Mucosal Resection (43254) |
— |
$2,373.10 |
— |
| Egd flexible foreign body removal (43247) |
— |
$2,373.10 |
— |
| Egd guide wire insertion (43248) |
— |
$2,373.10 |
— |
| Egd injection varices (43243) |
— |
$2,373.10 |
— |
| Egd intrmural us needle aspirate/biopsy esophags (43238) |
— |
$4,341.05 |
— |
| Egd place gastrostomy tube (43246) |
— |
$4,341.05 |
— |
| Egd rem tumr/polyp forcep (43250) |
— |
$4,341.05 |
— |
| Egd remove lesion snare (43251) |
— |
$4,341.05 |
— |
| Egd Transoral Control Bleeding Any Method - Egd (43255) |
— |
$4,341.05 |
— |
| Egd tube/cath insertion (43241) |
— |
$2,373.10 |
— |
| Egd us fine needle bx/aspir (43242) |
— |
$4,341.05 |
— |
| Egd us transmural injxn/mark (43253) |
— |
$4,341.05 |
— |
| Egd Varices Ligation (43244) |
— |
$4,341.05 |
— |
| Egd w/transmural drain cyst (43240) |
— |
$4,341.05 |
— |
| Endoscopic us exam esoph (43237) |
— |
$4,341.05 |
— |
| Fine needle aspiration bx w/us gdn 1st lesion (10005) |
— |
$2,011.95 |
— |
| Guide Cathet Fluid Drainage (10030) |
— |
$1,736.45 |
— |
| I&d abscess simple (10060) |
— |
$607.75 |
— |
| Incise finger tendon sheath (26055) |
— |
$3,270.75 |
— |
| Inj paravert f jnt c/t 1 lev (64490) |
— |
$3,149.90 |
— |
| Inj tendon sheath/ligament (20550) |
— |
$911.75 |
— |
| Inject Anes/Steroid Foramen Cerv/Thoracic W Img Guide ,1 Level (64479) |
— |
$2,306.55 |
— |
| Inject Nerv Blck,Ilioingu/Iliohyp (64425) |
— |
$2,373.10 |
— |
| Injection anes other peripheral nerve/branch (64450) |
— |
$1,210.10 |
— |
| Injection single/mlt trigger point 1/2 muscles (20552) |
— |
$629.75 |
— |
| Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or… (62325) |
— |
$1,202.75 |
— |
| Insert picc cath (36569) |
— |
$2,351.65 |
— |
| Insert Temp Bladder Cath (51702) |
— |
$422.50 |
— |
| Insertion Picc W/Rs&I 5 Yr/> (36573) |
— |
$3,057.35 |
— |
| Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina… (63047) |
— |
$13,312.70 |
— |
| Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or… (63030) |
— |
$13,312.70 |
— |
| Laparoscopy appendectomy (44970) |
— |
$13,312.70 |
— |
| Ligation of hemorrhoid(s) (46221) |
— |
$2,373.10 |
— |
| Liver Biopsy (47000) |
— |
$2,373.10 |
— |
| Musculoskeletal surgery (20999) |
— |
$2,193.60 |
— |
| Myelography Lumbar Injection (62305) |
— |
$2,865.15 |
— |
| Myelography Lumbar Injection (62304) |
— |
$2,865.15 |
— |
| Myelography Via Lumbar Injection Rs&I Cervical (62302) |
— |
$2,865.15 |
— |
| Nasal/sinus endoscopy, surgical, with maxillary antrostomy (31256) |
— |
$8,942.65 |
— |
| Nasal/sinus ndsc total with sphenoidotomy (31257) |
— |
$13,312.70 |
— |
| Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level (64493) |
— |
$3,265.08 |
— |
| Njx dx/ther sbst intrlmnr crv/thrc w/img gdn (62321) |
— |
$2,324.58 |
— |
| Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/O Img Gdn (62320) |
— |
$1,328.60 |
— |
| Njx dx/ther sbst intrlmnr crv/thrc w/o img gdn (62324) |
— |
$1,416.15 |
— |
| Njx dx/ther sbst intrlmnr lmbr/sac w/img gdn (62327) |
— |
$1,579.30 |
— |
| Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn (62323) |
— |
$1,529.20 |
— |
| Njx dx/ther sbst intrlmnr lmbr/sac w/o img gdn (62326) |
— |
$2,135.20 |
— |
| Perq dev breast 1st strtctc (19283) |
— |
$4,746.25 |
— |
| Perq dev breast 1st us imag (19285) |
— |
$2,406.70 |
— |
| Perq device breast 1st imag (19281) |
— |
$2,373.10 |
— |
| Punch biopsy skin single lesion (11104) |
— |
$2,373.10 |
— |
| Puncture Aspiration (10160) |
— |
$747.80 |
— |
| Puncture Aspiration Cyst Breast (19000) |
— |
$7,140.50 |
— |
| Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions (11200) |
— |
$1,590.60 |
— |
| Remove wrist tendon lesion (25111) |
— |
$5,964 |
— |
| Repair elbow perc (24357) |
— |
$9,550.40 |
— |
| Revise median n/carpal tunnel surg (64721) |
— |
$9,550.40 |
— |
| Rmvl tun ctr vad w/subq port/pmp ctr/prph insj (36590) |
— |
$2,022.35 |
— |
| Rmvl Tun Cvc W/O Subq Port/Pmp (36589) |
— |
$1,978.15 |
— |
| Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) |
— |
$568.35 |
— |
| Spinal puncture lumbar diagnostic (62270) |
— |
$1,376.40 |
— |
| Tangential biopsy skin single lesion (11102) |
— |
$1,438.90 |
— |
| Thermal dstrj intraosseous bvn 1st 2 lmbr/sac (64628) |
— |
$11,500 |
— |
| Thoracentesis Needle/Cath Pleura W/Imaging (32555) |
— |
$1,873.35 |
— |
| Tonsillectomy and adenoidectomy; age 12 or over (42821) |
— |
$8,942.65 |
— |
| Total knee arthroplasty (27447) |
— |
$41,095.70 |
— |
| Unlisted procedure humerus/elbow (24999) |
— |
$6,366.95 |
— |
| Unlisted Procedure Nervous System (64999) |
— |
$6,366.95 |
— |
| Upper Gastrointestinal Endoscopy Including Esophagus, Stomach, And Either The Duodenum And/Or Jejunum As Appropriate;… (43257) |
— |
$8,942.65 |
— |
| Uppr gi opticl endomicrscopy (43252) |
— |
$4,341.05 |
— |
| Venipuncture (36415) |
— |
$40.88 |
— |