| Advance care planning first 30 mins (99497) |
$117 |
$156 |
1.1× |
| Aerosol inhalation pentamidine (94642) |
$302.25 |
$403 |
1.4× |
| Airway inhalation treatment (94640) |
$141 |
$188 |
0.6× |
| Allergy injection single (95115) |
$26.25 |
$35 |
0.5× |
| Allergy testing, any combination of percutaneous (scratch, puncture, prick) and intracutaneous (intradermal),… (95018) |
$33 |
$44 |
0.9× |
| Anogenital examination, magnified, in childhood for suspected trauma, including image recording when performed (99170) |
$418.50 |
$558 |
2.0× |
| Behav assmt w/score & docd/stand instrument (96127) |
$54.75 |
$73 |
1.4× |
| Bipap initial day (94660) |
$819 |
$1,092 |
3.7× |
| Breathing capacity test (94010) |
$138.75 |
$185 |
0.6× |
| Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration (94060) |
$432 |
$576 |
1.1× |
| Canalith repositioning (95992) |
$100.50 |
$134 |
— |
| Car seat/bed test inft thru 12 mo 60 min (94780) |
$169.50 |
$226 |
4.4× |
| Cardioversion elective external (92960) |
$612.38 |
$816.50 |
0.9× |
| Cardioversion elective internal (92961) |
$801.38 |
$1,068.50 |
1.2× |
| Chemo anti-neopl sq/im (96401) |
$495.75 |
$661 |
6.7× |
| Chemo hormon antineopl sq/im (96402) |
$202.50 |
$270 |
2.8× |
| Chemo IV infus each addl seq (96417) |
$172.50 |
$230 |
2.3× |
| Chemo IV infusion addl hr (96415) |
$146.25 |
$195 |
2.0× |
| Chemo IV push addl drug (96411) |
$216.38 |
$288.50 |
2.9× |
| Chemother prolong infuse w/pump (96416) |
$528 |
$704 |
1.6× |
| Chemotherapy administration, intra-arterial; infusion technique, each additional hour (List separately in addition to… (96423) |
$61.50 |
$82 |
1.3× |
| Chemotherapy administration, intra-arterial; infusion technique, up to 1 hour (96422) |
$545.25 |
$727 |
1.6× |
| Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug (96413) |
$408 |
$544 |
1.2× |
| Chemotherapy administration; intravenous, push technique, single or initial substance/drug (96409) |
$291 |
$388 |
0.9× |
| Chest physiotherapy initial (94667) |
$93.75 |
$125 |
0.7× |
| Chron care mgmt srvc 20 min (99490) |
$175.50 |
$234 |
1.7× |
| Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time… (99487) |
$184.12 |
$245.50 |
1.0× |
| Continuous inhalation treatment with aerosol medication for acute airway obstruction; first hour (94644) |
$308.25 |
$411 |
2.3× |
| Cpr (92950) |
$824.25 |
$1,099 |
3.7× |
| Critical care ill/injured patient init 30-74 min (99291) |
$1,799.25 |
$2,399 |
2.1× |
| Debridement open wound 20 sq cm< (97597) |
$272.25 |
$363 |
1.3× |
| Delivery/birthing room resuscitation (99465) |
$514.50 |
$686 |
0.8× |
| Duplex scan of extracranial arteries; complete bilateral study Age Under 21 (93880) |
$1,147.12 |
$1,529.50 |
4.7× |
| Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study Age… (93970) |
$883.88 |
$1,178.50 |
3.6× |
| Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study Age… (93971) |
$612.75 |
$817 |
5.7× |
| Echo transesophageal (93312) |
$202.50 |
$270 |
0.4× |
| EKG 12 lead tracing only (93005) |
$221.62 |
$295.50 |
3.7× |
| Emergency department visit high mdm (99285) |
$348 |
$464 |
0.6× |
| Emergency department visit low mdm (99283) |
$141.75 |
$189 |
0.5× |
| Emergency department visit may not req phys/qhp (99281) |
$42.75 |
$57 |
0.5× |
| Emergency department visit moderate mdm (99284) |
$239.25 |
$319 |
0.6× |
| Emergency department visit straightforward mdm (99282) |
$83.25 |
$111 |
0.5× |
| Evaluate pt use of inhaler (94664) |
$163.50 |
$218 |
0.7× |
| External ECG rec>48hr<7d recording (93242) |
$63.75 |
$85 |
1.7× |
| External ECG rec>7d<15d recording (93246) |
$108 |
$144 |
2.8× |
| External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; recording (includes… (93225) |
$465 |
$620 |
3.4× |
| Im adm intransl/oral 1 vaccine (90473) |
$62.25 |
$83 |
0.8× |
| Immunization administration (90471) |
$88.50 |
$118 |
1.2× |
| Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant (99460) |
$249 |
$332 |
1.8× |
| Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant admitted and… (99463) |
$181.50 |
$242 |
1.3× |
| Injection,Therap/Proph/Diagnost, IV Push, Ea Add, New Drug (96375) |
$130.50 |
$174 |
2.7× |
| Injection,Therap/Proph/Diagnost, IV Push, Initial Drug (96374) |
$224.62 |
$299.50 |
1.0× |
| Insertion and placement of flow directed catheter (eg, Swan-Ganz) for monitoring purposes with Cardiac Cath (93503) |
$1,507.50 |
$2,010 |
0.9× |
| Intracutaneous (intradermal) tests with allergenic extracts, immediate type reaction, including test interpretation and… (95024) |
$12 |
$16 |
0.2× |
| Irrigaj implntd venous access drug delivery syst (96523) |
$112.50 |
$150 |
1.9× |
| IV infusion hydration each additional hour (96361) |
$129.75 |
$173 |
2.7× |
| IV infusion hydration initial 31 min-1 hour (96360) |
$309.75 |
$413 |
1.4× |
| IV infusion ther proph addl sequential to 1 hr (96367) |
$127.12 |
$169.50 |
1.7× |
| IV infusion therapy/prophylaxis /dx 1st to 1 hr (96365) |
$364.50 |
$486 |
1.7× |
| IV tx, each additional hour (96366) |
$135.75 |
$181 |
2.8× |
| Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; subsequent (94668) |
$121.50 |
$162 |
0.9× |
| Multiple sleep latency (95805) |
$1,989.75 |
$2,653 |
2.3× |
| Neg pressure wound therapy non dme </= 50 sq cm (97607) |
$546.38 |
$728.50 |
1.3× |
| Neg pressure wound therapy non dme >50 sq cm (97608) |
$409.50 |
$546 |
1.0× |
| Negative pressure wound therapy dme </= 50 sq cm (97605) |
$201.75 |
$269 |
1.0× |
| Negative pressure wound therapy dme >50 sq cm (97606) |
$184.50 |
$246 |
0.4× |
| Non-invasive physiologic study extremity 3 levels (93923) |
$174.75 |
$233 |
0.8× |
| Orthc/prostc mgmt sbsq enc (97763) |
$82.50 |
$110 |
— |
| Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper… (97760) |
$83.25 |
$111 |
— |
| Osteopath manj 1-2 regions (98925) |
$43.88 |
$58.50 |
2.0× |
| Osteopath manj 3-4 regions (98926) |
$61.88 |
$82.50 |
2.8× |
| Osteopath manj 9-10 regions (98929) |
$118.12 |
$157.50 |
5.4× |
| Osteopathic manipulative tx 5-6 body regions (98927) |
$81.38 |
$108.50 |
3.7× |
| Osteopathic manipulative tx 7-8 body regions (98928) |
$99.38 |
$132.50 |
4.5× |
| Ot manual therapy ea 15 min (97140) |
$102.75 |
$137 |
— |
| Ot neuromuscular re-education (97112) |
$103.50 |
$138 |
— |
| OT Therapeutic Activities Charges (97530) |
$91.50 |
$122 |
— |
| Ot wheelchair management (97542) |
$96.75 |
$129 |
— |
| Percutaneous tests w/allergenic extracts (95004) |
$12.75 |
$17 |
0.0× |
| Phlebotomy therapeutic (99195) |
$158.62 |
$211.50 |
1.2× |
| Physical therapy evaluation high complex 45 mins (97163) |
$260.25 |
$347 |
— |
| Physical therapy evaluation low complex 20 mins (97161) |
$178.50 |
$238 |
— |
| Physical therapy evaluation mod complex 30 mins (97162) |
$213 |
$284 |
— |
| Polysom 6/>yrs sleep w/cpap 4/> addl param attnd (95811) |
$2,439.75 |
$3,253 |
2.8× |
| Prepj& allergen immunotherapy 1/mlt antigen (95165) |
$21.75 |
$29 |
0.5× |
| Professional services for allergen immunotherapy; 2 or more injections (95117) |
$32.25 |
$43 |
0.7× |
| Prosthetic(s) training, upper and/or lower extremity(ies), initial prosthetic(s) encounter, each 15 minutes Other… (97761) |
$76.50 |
$102 |
— |
| Psych diag eval w/med srvcs (90792) |
$422.25 |
$563 |
2.3× |
| Pt gait training 15 min (97116) |
$79.50 |
$106 |
— |
| Pt re-evaluation (97164) |
$128.25 |
$171 |
— |
| Pulmonary stress testing (94618) |
$93 |
$124 |
0.7× |
| Self-care/home management training (eg, activities of daily living (ADL) and compensatory training, meal preparation,… (97535) |
$83.25 |
$111 |
— |
| Sleep study unattended (95806) |
$256.50 |
$342 |
1.2× |
| Temp transcutaneous pacing (92953) |
$396 |
$528 |
0.6× |
| Ther/proph/diag inj ia (96373) |
$225.75 |
$301 |
1.0× |
| Therapeutic prophylactic/dx injection subq/im (96372) |
$47.25 |
$63 |
0.6× |
| Tobacco use cessation intensive >10 minutes (99407) |
$48.75 |
$65 |
1.3× |
| Tobacco use cessation intermediate 3-10 minutes (99406) |
$32.62 |
$43.50 |
0.9× |
| Trans care mgmt 14 day disch (99495) |
$573 |
$764 |
4.2× |
| Trans care mgmt 7 day disch (99496) |
$772.50 |
$1,030 |
5.7× |
| Tte f-up or lmtd (93308) |
$430.50 |
$574 |
1.8× |
| Tte w/doppler complete (93306) |
$1,684.50 |
$2,246 |
3.0× |
| Unlisted special dermatological service or procedure (96999) |
$163.12 |
$217.50 |
0.8× |
| Upr/l xtremity art 2 levels (93922) |
$181.50 |
$242 |
1.3× |
| Ventilation ip/obs initial day (94002) |
$2,398.50 |
$3,198 |
3.8× |
| Ventilator subsequent day (94003) |
$1,727.25 |
$2,303 |
2.7× |
| Wound(s) care non-selective (97602) |
$154.50 |
$206 |
0.8× |