| Aerosol inhalation pentamidine (94642) |
$237 |
$237 |
1.0× |
| Airway inhalation treatment (94640) |
$188 |
$188 |
0.8× |
| Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours… (93788) |
$315 |
$315 |
2.2× |
| Ambulatory bp recording (93786) |
$352 |
$352 |
2.5× |
| Application of a modality to 1 or more areas; electrical stimulation (manual), each 15 minutes Other Outpatient (97032) |
$89.50 |
$89.50 |
— |
| Application of a modality to 1 or more areas; iontophoresis, each 15 minutes Other Outpatient (97033) |
$150.50 |
$150.50 |
— |
| Application of a modality to 1 or more areas; ultrasound, each 15 minutes Other Outpatient (97035) |
$71 |
$71 |
— |
| Basic vestibular evaluation (92540) |
$474 |
$474 |
2.1× |
| Behavioral & qualit analysis voice and resonance (92524) |
$361 |
$361 |
— |
| Bipap initial day (94660) |
$489 |
$489 |
2.1× |
| Breathing capacity test (94010) |
$146.50 |
$146.50 |
0.6× |
| Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration (94060) |
$338 |
$338 |
0.9× |
| Canalith repositioning (95992) |
$133 |
$133 |
— |
| Cardiovascular stress test (93017) |
$705 |
$705 |
3.1× |
| Cardioversion elective external (92960) |
$1,924 |
$1,924 |
2.8× |
| Chemo anti-neopl sq/im (96401) |
$172 |
$172 |
2.3× |
| Chemo hormon antineopl sq/im (96402) |
$172 |
$172 |
2.3× |
| Chemo IV infus each addl seq (96417) |
$544 |
$544 |
7.2× |
| Chemo IV infusion addl hr (96415) |
$320 |
$320 |
4.2× |
| Chemo IV push addl drug (96411) |
$354 |
$354 |
4.7× |
| Chemother prolong infuse w/pump (96416) |
$1,083 |
$1,083 |
3.1× |
| Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug (96413) |
$1,250 |
$1,250 |
3.6× |
| Chemotherapy administration; intravenous, push technique, single or initial substance/drug (96409) |
$363 |
$363 |
1.0× |
| Chest physiotherapy initial (94667) |
$305 |
$305 |
2.2× |
| Color/duplex Doppler, complete (93975) |
$1,212 |
$1,212 |
4.8× |
| Color/duplex Doppler, limited (93976) |
$1,140 |
$1,140 |
10.3× |
| Community/work reintegration training (eg, shopping, transportation, money management, avocational activities and/or… (97537) |
$139 |
$139 |
— |
| Cont gluc mntr physician/qhp provided equipment (95250) |
$330 |
$330 |
2.3× |
| Cont gluc mntr pt prov eqp (95249) |
$330 |
$330 |
5.3× |
| Continuous inhalation treatment with aerosol medication for acute airway obstruction; first hour (94644) |
$352 |
$352 |
2.5× |
| Cpr (92950) |
$1,403.50 |
$1,403.50 |
6.2× |
| Critical care ill/injured patient init 30-74 min (99291) |
$4,726.50 |
$4,726.50 |
5.4× |
| Debridement open wound 20 sq cm< (97597) |
$315.50 |
$315.50 |
1.5× |
| Delivery/birthing room resuscitation (99465) |
$849 |
$849 |
1.2× |
| Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study Age Under 21 (93978) |
$900 |
$900 |
3.6× |
| Duplex scan of extracranial arteries; complete bilateral study Age Under 21 (93880) |
$535 |
$535 |
2.1× |
| Duplex scan of extracranial arteries; unilateral or limited study Age Under 21 (93882) |
$255 |
$255 |
2.3× |
| Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study Age… (93970) |
$2,182 |
$2,182 |
8.7× |
| Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study Age… (93971) |
$1,172 |
$1,172 |
10.6× |
| Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study Age Under 21 (93925) |
$2,376 |
$2,376 |
9.4× |
| Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study Age Under 21 (93926) |
$1,145 |
$1,145 |
10.4× |
| Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study Age Under 21 (93930) |
$2,248 |
$2,248 |
8.9× |
| Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study Age Under 21 (93931) |
$1,135 |
$1,135 |
10.3× |
| Ear and throat examination (92502) |
$496 |
$496 |
0.9× |
| ECG monit/reprt up to 48 hrs (93226) |
$153 |
$153 |
2.5× |
| ECG/monitoring and analysis (93271) |
$750 |
$750 |
7.5× |
| Echo transesophageal (93312) |
$2,308 |
$2,308 |
4.0× |
| EEG 41-60 minutes (95812) |
$1,282 |
$1,282 |
5.6× |
| EEG awake & asleep (95819) |
$843 |
$843 |
3.7× |
| EEG awake/drowsy (95816) |
$810 |
$810 |
3.6× |
| EKG 12 lead tracing only (93005) |
$312 |
$312 |
5.0× |
| Emergency department visit high mdm (99285) |
$2,175.50 |
$2,175.50 |
3.5× |
| Emergency department visit low mdm (99283) |
$1,017.50 |
$1,017.50 |
3.5× |
| Emergency department visit may not req phys/qhp (99281) |
$489 |
$489 |
5.5× |
| Emergency department visit moderate mdm (99284) |
$1,643 |
$1,643 |
3.7× |
| Emergency department visit straightforward mdm (99282) |
$714.50 |
$714.50 |
4.4× |
| Esoph balloon distension tst (91040) |
$1,360 |
$1,360 |
3.5× |
| Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and… (91010) |
$680.50 |
$680.50 |
1.7× |
| Eval of Oral and Pharyngeal Swallowing - Eval of Oral and Pharyngeal Swallowing Fx Chg (92610) |
$422 |
$422 |
— |
| Evaluate pt use of inhaler (94664) |
$188 |
$188 |
0.8× |
| Evaluation of speech fluency (92521) |
$358 |
$358 |
— |
| Evaluation of speech sound production articulate (92522) |
$349 |
$349 |
— |
| Evoked auditory test limited (92587) |
$154 |
$154 |
0.7× |
| External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; recording (includes… (93225) |
$1,020 |
$1,020 |
7.3× |
| Flexible endoscopic evaluation, laryngeal sensory testing by cine or video recording; Other Outpatient (92614) |
$667 |
$667 |
— |
| Fluidotherapy (97022) |
$96 |
$96 |
— |
| Gas dilut/washout lung vol w/wo distrib vent&vol (94727) |
$231 |
$231 |
1.0× |
| Gastroesophag reflx test w/telemtry ph eltrd (91035) |
$1,260 |
$1,260 |
1.4× |
| Immunization administration (90471) |
$106 |
$106 |
1.4× |
| Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant (99460) |
$641 |
$641 |
4.6× |
| Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant admitted and… (99463) |
$850 |
$850 |
6.1× |
| Injection,Therap/Proph/Diagnost, IV Push, Ea Add, New Drug (96375) |
$147 |
$147 |
3.0× |
| Injection,Therap/Proph/Diagnost, IV Push, Initial Drug (96374) |
$146 |
$146 |
0.7× |
| Insertion and placement of flow directed catheter (eg, Swan-Ganz) for monitoring purposes with Cardiac Cath (93503) |
$2,097 |
$2,097 |
1.3× |
| Interrog dev eval pm/ldls pm phys/qhp in person (93288) |
$328 |
$328 |
8.3× |
| Interrog device eval heart (93289) |
$323 |
$323 |
8.2× |
| Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health… (93291) |
$107 |
$107 |
3.5× |
| Irrigaj implntd venous access drug delivery syst (96523) |
$165 |
$165 |
2.7× |
| IV infusion hydration each additional hour (96361) |
$172 |
$172 |
3.5× |
| IV infusion hydration initial 31 min-1 hour (96360) |
$261 |
$261 |
1.2× |
| IV infusion ther proph addl sequential to 1 hr (96367) |
$424.50 |
$424.50 |
5.6× |
| IV infusion therapy/prophylaxis /dx 1st to 1 hr (96365) |
$615.50 |
$615.50 |
2.7× |
| IV tx, each additional hour (96366) |
$343.50 |
$343.50 |
7.0× |
| Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; subsequent (94668) |
$209 |
$209 |
1.5× |
| Maximum voluntary ventilation (94200) |
$161 |
$161 |
2.6× |
| Mechanical traction therapy (97012) |
$87 |
$87 |
— |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) |
$84 |
$84 |
— |
| Medical nutrition group (97804) |
$74 |
$74 |
— |
| Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes… (97803) |
$82 |
$82 |
— |
| Motion fluoroscopic evaluation of swallowing function by cine or video recording Other Outpatient (92611) |
$847 |
$847 |
— |
| Nasopharyngoscopy (92511) |
$584 |
$584 |
2.8× |
| Neg pressure wound therapy non dme </= 50 sq cm (97607) |
$569 |
$569 |
1.3× |
| Neg pressure wound therapy non dme >50 sq cm (97608) |
$600 |
$600 |
1.4× |
| Negative pressure wound therapy dme </= 50 sq cm (97605) |
$513 |
$513 |
2.4× |
| Negative pressure wound therapy dme >50 sq cm (97606) |
$542 |
$542 |
1.3× |
| Non-invasive physiologic study extremity 3 levels (93923) |
$491 |
$491 |
2.2× |
| Noninvasive ear/pulse oximetry overnight monitor (94762) |
$404 |
$404 |
3.0× |
| Occupational therapy eval high complex 60 mins (97167) |
$319 |
$319 |
— |
| Occupational therapy eval low complex 30 mins (97165) |
$314 |
$314 |
— |
| Occupational therapy eval mod complex 45 mins (97166) |
$315 |
$315 |
— |
| Oral function therapy (92526) |
$420 |
$420 |
— |
| Orthc/prostc mgmt sbsq enc (97763) |
$158 |
$158 |
— |
| Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper… (97760) |
$154.50 |
$154.50 |
— |
| Ot manual therapy ea 15 min (97140) |
$152 |
$152 |
— |
| Ot neuromuscular re-education (97112) |
$140 |
$140 |
— |
| Ot paraffin bath (97018) |
$59.50 |
$59.50 |
— |
| Ot re-evaluation (97168) |
$209 |
$209 |
— |
| OT Therapeutic Activities Charges (97530) |
$105.50 |
$105.50 |
— |
| Outpatient cardiac rehab w/cont ECG monitoring (93798) |
$391 |
$391 |
2.9× |
| Peripheral vascular rehab (93668) |
$395 |
$395 |
6.3× |
| Phlebotomy therapeutic (99195) |
$207 |
$207 |
1.5× |
| Phy/qhp op pulm rhb w/o mntr (94625) |
$394 |
$394 |
6.3× |
| Physical therapy evaluation high complex 45 mins (97163) |
$321 |
$321 |
— |
| Physical therapy evaluation low complex 20 mins (97161) |
$306 |
$306 |
— |
| Physical therapy evaluation mod complex 30 mins (97162) |
$315 |
$315 |
— |
| Pm device progr eval multi (93281) |
$425 |
$425 |
10.8× |
| Polysom 6/>yrs sleep w/cpap 4/> addl param attnd (95811) |
$3,774 |
$3,774 |
4.2× |
| Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a… (95782) |
$3,162 |
$3,162 |
3.5× |
| Pr mchnl sclp cool cap sply head meas fitg&educaj (97007) |
$177 |
$177 |
0.1× |
| Prgrmg dev eval pm/ldls pm (93279) |
$342 |
$342 |
8.7× |
| Program eval implantable in persn dual ld pacer (93280) |
$393 |
$393 |
10.0× |
| Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of… (93282) |
$342 |
$342 |
8.7× |
| Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of… (93285) |
$127 |
$127 |
3.2× |
| Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of… (93284) |
$425 |
$425 |
10.8× |
| Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of… (93283) |
$391 |
$391 |
9.9× |
| Prosthetic(s) training, upper and/or lower extremity(ies), initial prosthetic(s) encounter, each 15 minutes Other… (97761) |
$101 |
$101 |
— |
| Psych diag eval w/med srvcs (90792) |
$603 |
$603 |
3.2× |
| Pt gait training 15 min (97116) |
$130 |
$130 |
— |
| Pt physical performance test (97750) |
$144 |
$144 |
— |
| Pt re-evaluation (97164) |
$210 |
$210 |
— |
| Pt Work Hardening/conditioningwork Reconditioning Initial Charge (97545) |
$314 |
$314 |
— |
| Pulm funct tst plethysmograp (94726) |
$274 |
$274 |
0.7× |
| Pulmonary stress testing (94618) |
$154 |
$154 |
1.1× |
| Refill/maint pump/resvr syst (96522) |
$892 |
$892 |
4.0× |
| Refilling and maintenance of portable pump (96521) |
$892 |
$892 |
4.0× |
| Remote 30 day ECG rev/report (93270) |
$573 |
$573 |
14.6× |
| Respiratory flow volume loop (94375) |
$278 |
$278 |
1.2× |
| Self-care/home management training (eg, activities of daily living (ADL) and compensatory training, meal preparation,… (97535) |
$139 |
$139 |
— |
| Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands,… (97533) |
$218 |
$218 |
— |
| Speech sound lang comprehen (92523) |
$367 |
$367 |
— |
| Temp transcutaneous pacing (92953) |
$2,330 |
$2,330 |
3.3× |
| Test for hearing various pitches using earphone (92552) |
$93 |
$93 |
0.7× |
| Ther ivntj cog funcj cntct 1st 15 minutes (97129) |
$150.50 |
$150.50 |
— |
| Ther ivntj cog funcj cntct ea addl 15 minutes (97130) |
$150.50 |
$150.50 |
— |
| Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with therapeutic exercises Other Outpatient (97113) |
$134 |
$134 |
— |
| Therapeutic prophylactic/dx injection subq/im (96372) |
$97.50 |
$97.50 |
1.3× |
| Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study Age Under 21 (93304) |
$461 |
$461 |
0.8× |
| Tte congenital complete (93303) |
$1,570 |
$1,570 |
2.7× |
| Tte f-up or lmtd (93308) |
$481 |
$481 |
1.9× |
| Tte w/doppler complete (93306) |
$1,365.50 |
$1,365.50 |
2.4× |
| Tx of Speech/Lang/Voice/Comm/Auditory Chg (92507) |
$328 |
$328 |
— |
| Tympanometry (92567) |
$83 |
$83 |
2.1× |
| Upr/l xtremity art 2 levels (93922) |
$479 |
$479 |
3.4× |
| Ventilation ip/obs initial day (94002) |
$640 |
$640 |
1.0× |
| Ventilator subsequent day (94003) |
$205 |
$205 |
0.3× |
| Work hardening/conditioning; each additional hour (List separately in addition to code for primary procedure) (97546) |
$157 |
$157 |
— |
| Wound(s) care non-selective (97602) |
$180 |
$180 |
0.9× |