Procedures & surgery prices at Evans Memorial Hospital

Claxton, GA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abd paracentesis w/imaging (49083) $3,337.50
Abdom Paracentesis Dx/Ther W/O Imaging Guidance (49082) $3,200
Acne Surgery (10040) $505
Adjnt tis trnsfr/reargmt any area 30.1-60 sq cm (14301) $14,935
Adjt tis reargmt eye/nose/ear/lip 10.1-30.0 sqcm (14061) $8,370
Adjt/Reargmt F/C/C/M/N/Ax/G/H/F 10.1-30.0 Sq Cm (14041) $8,370
Adjt/rearrgmt scalp/arm/leg 10.1-30.0 sq cm (14021) $7,000
Amp leg thru tibia&fibula sec closure/scar rev (27884) $12,500
Amputation metatarsal with toe single (28810) $12,400
Amputation toe interphalangeal joint (28825) $13,000
Amputation Toe Metatarsophalangeal Joint (28820) $12,500
Amputation, foot; transmetatarsal (28805) $11,925
Anoscopy control bleeding (46614) $4,500
Anoscopy diagnostic (46600) $2,500
Anoscopy W/Rmvl Foreign Body (46608) $3,200
Anoscopy; with biopsy, single or multiple (46606) $5,000
Anrct xm surg req anes general spi/edrl dx (45990) $10,275
Appendectomy (44950) $13,390
Application cast elbow finger short arm (29075) $410
Application Cast Hand & Lower Forearm Gauntlet (29085) $775
Application cast shoulder hand long arm (29065) $560
Application Finger Splint Dynamic (29131) $170
Application finger splint static (29130) $245
Application long arm splint shoulder hand (29105) $410
Application long leg splint thigh ankle/toes (29505) $410
Application of long leg cast (29345) $890
Application Short Arm Splint Dynamic (29126) $170
Application short arm splint forearm-hand static (29125) $290
Application short leg splint calf foot (29515) $410
Apply short leg cast (29405) $560
Arterial puncture (36600) $105
Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) $725
Arthrocentesis aspir&/inj interm jt/burs w/us (20606) $1,975
Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) $1,000
Arthrocentesis aspir&/inj major jt/bursa w/us (20611) $1,175
Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) $640
Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (29875) $11,925
Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral) including chondroplasty (29880) $21,245
Arthroscopy, knee, surgical; with meniscus repair (medial or lateral) (29882) $11,925
Arthroscopy, shoulder, surgical; biceps tenodesis (29828) $20,085
Arthroscopy, shoulder, surgical; capsulorrhaphy (29806) $28,585
Arthroscopy, shoulder, surgical; debridement, extensive (29823) $13,500
Arthroscopy, shoulder, surgical; debridement, limited (29822) $15,710
Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (29824) $17,770
Arthroscopy, shoulder, surgical; with rotator cuff repair (29827) $2,785
Aspirat/Injection Ganglion Cyst(S) (20612) $1,100
Avulsion nail plate partial/complete simple 1 (11730) $645
Axillary lymphadenectomy; complete (38745) $21,890
Banding of hemorrhoids using a flexible endoscope (sigmoidoscope) (45350) $4,500
Biopsy Breast Open Incisional (19101) $14,230
Biopsy of uterus lining (58100) $800
Biopsy or excision of lymph node(s); open, internal mammary node(s) (38530) $14,225
Biopsy or excision of lymph node(s); open, superficial (38500) $14,230
Biopsy soft tissue neck/thorax (21550) $5,475
Biopsy/removal lymph nodes (38525) $13,845
Biopsy/removal lymph nodes (38510) $13,750
Bladder Irrigation Simple (51700) $450
Bladder Scan (51798) $350
Blood patch (62273) $3,350
Blood transfusion service (36430) $1,765
Breast augmentation with implant (19325) $35,250
Bx anorectal wall anal approach (45100) $9,805
Bx breast 1st lesion strtctc (19081) $670
Bx breast 1st lesion us imag (19083) $4,690
Bx breast needle core w/o imaging guidance spx (19100) $1,465
Bx/exc lymph node needle superficial (38505) $6,460
Canthotomy Separate Procedure (67715) $7,955
Catheter Aspiration Nasotracheal Spx (31720) $90
Change Cystostomy Tube Complicated (51710) $2,400
Change Cystostomy Tube Simple (51705) $775
Chemical Cautery Tissue (17250) $750
Chemodenervation internal anal sphincter (46505) $6,000
Chest tube placement (32551) $4,657.50
Chng urtrost tube/xtrnlly accessible stent ileal (50688) $5,115
Circumcision (54150) $680
Circumcision Neonate (54160) $815
Claviculectomy; partial (23120) $12,500
Close Rx Fingr Articular Fx,Manip (26742) $5,970
Closed Rx Humeral Supracondylar Fx (24530) $650
Closed Rx Med Malleolus Fx (27760) $650
Closed Rx Med Malleolus Fx,Manip (27762) $4,600
Closed Rx Mid Humerus Fx,Manipulatn (24505) $6,000
Closed Rx Rad/Ulna Shaft Fx,Manip (25565) $710
Closed Rx Radial Shaft Fx (25500) $710
Closed Rx Spontaneous Hip Disloc (27256) $650
Closed Rx Tibia Shaft Fx (27750) $650
Closed Rx Trauma Hip Disloc,Anesth (27252) $6,250
Closed treatment of humeral epicondylar fracture, medial or lateral; without manipulation (24560) $1,000
Closed treatment of ulnar shaft fracture; with manipulation (25535) $1,020
Closed treatment pst malleolus fracture w/manj (27768) $4,600
Closed Treatment Pst Malleolus Fracture W/O Manj (27767) $650
Closed Treatment Ulnar Styloid Fracture (25650) $675
Closed tx ankle dislocation w/o anesthesia (27840) $475
Closed Tx Bimalleolar Ankle Fracture W Manip (27810) $710
Closed Tx Bimalleolar Ankle Fracture W/O Manip (27808) $650
Closed tx calcaneal fracture w/o manipulation (28400) $410
Closed Tx Femoral Shaft Fx W/O Manipulation (27500) $650
Closed tx knee dislocation w/anesthesia (27552) $4,600
Closed tx knee dislocation w/o anesthesia (27550) $710
Closed tx metatarsal fracture w/o manipulation (28470) $650
Closed tx patellar dislocation w/anesthesia (27562) $2,990
Closed tx patellar dislocation w/o anesthesia (27560) $710
Closed tx radial head/neck fx w/manipulation (24655) $710
Closed tx radial head/neck fx w/o manipulation (24650) $650
Closed tx radial shaft fracture w/manipulation (25505) $4,860
Closed tx septal&nose fx (21337) $5,540
Closed tx temporomandibular dislocation 1st/sbsq (21480) $660
Closed Tx Ulnar Fracture Prox End W Manipulation (24675) $4,860
Closed tx ulnar fracture prox end w/o manipulate (24670) $650
Closed tx ulnar shaft fracture w/o manipulation (25530) $710
Clsd tx acromioclavicular dislc w/manipulation (23545) $710
Clsd tx clavicular fracture w/manipulation (23505) $5,000
Clsd tx clavicular fracture w/o manipulation (23500) $675
Clsd tx pelvic ring fx w/o manipulation (27197) $650
Clsd tx shoulder dislc w/manipulation req anes (23655) $4,960
Clsd tx shoulder dislc w/manipulation w/o anes (23650) $710
Cltx ankle dislc req anes w/wo prq skel fixj (27842) $6,820
Cltx Carpo/Metacarpal Dislocation Thumb W/Manj (26641) $710
Cltx dstl fibular fx lat malls w/manj (27788) $650
Cltx dstl fibular fx lat malls w/o manj (27786) $650
Cltx dstl phlngl fx fngr/thmb w/manj ea (26755) $410
Cltx Dstl Phlngl Fx Fngr/Thmb W/O Manj Ea (26750) $675
Cltx dstl radial fx/epiphysl sep w/o manj (25600) $675
Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) $3,910
Cltx fem fx dstl end medial/lat condyle w/manj (27510) $3,910
Cltx fem fx dstl end medial/lat condyle w/o manj (27508) $650
Cltx fem shft fx w/manj w/wo skin/skeletal tracj (27502) $4,600
Cltx fx grt toe phlx/phlg w/manj (28495) $650
Cltx fx grt toe phlx/phlg w/o manj (28490) $410
Cltx fx phlx/phlg oth/thn grt toe w/manj (28515) $1,135
Cltx fx phlx/phlg oth/thn grt toe w/o manj (28510) $410
Cltx fx w8 brg artclr prtn dstl tib w/skel tracj (27825) $4,060
Cltx fx w8 brg artclr prtn dstl tibia w/o manj (27824) $650
Cltx hip dislocation traumatic w/o anesthesia (27250) $1,420
Cltx Interphalangeal Joint Dislocation Req Anes (28665) $410
Cltx Interphalangeal Joint Dislocation W/O Anes (28660) $650
Cltx iphal jt dislc w/manj w/o anes (26770) $710
Cltx metacarpal fx w/manipulation each bone (26605) $710
Cltx metacarpal fx w/o manipulation each bone (26600) $810
Cltx metacarpophalangeal dislc w/manj w/anes (26705) $4,600
Cltx metacarpophalangeal dislc w/manj w/o anes (26700) $4,600
Cltx Metatarsophlngl Jt Dislc Req Anes (28635) $6,000
Cltx metatarsophlngl jt dislc w/o anes (28630) $650
Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) $410
Cltx phlngl fx prox/middle px/f/t w/o manj ea (26720) $675
Cltx Post Hip Arthrp Dislc Req Anes (27266) $4,600
Cltx post hip arthrp dislc w/o anes (27265) $1,075
Cltx prox fibula/shft fx w/manj (27781) $4,600
Cltx prox fibula/shft fx w/o manj (27780) $630
Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) $710
Cltx sprcndylr/transcndylr humeral fx w/manj (24535) $4,600
Cltx sprcndylr/trnscndylr fem fx w/manj (27503) $4,600
Cltx Sprcndylr/Trnscndylr Fem Fx W/O Manj (27501) $650
Cltx tibial shaft fx w/manj w/wo skel tracj (27752) $710
Cltx trimalleolar ankle fx w/manipulation (27818) $3,075
Colonoscopy stoma w/biopsy (44389) $6,120
Colonoscopy thru stoma (44388) $4,735
Colonoscopy w/fb removal (45379) $6,120
Colonoscopy w/resection (45390) $11,015
Colonoscopy w/stent plcmt (45389) $16,225
Colporrhaphy suture injury vagina (57200) $7,250
Colsc flx with directed submucosal njx any sbst (45381) $4,480
Control Nasal Hemorrhage Anterior Complex (30903) $450
Control Nasal Hemorrhage Anterior Simple (30901) $570
Correction hammertoe (28285) $13,200
Correction of bunion (28292) $17,065
Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) $490
Curette/treat cornea (65435) $3,000
Cysto W/Simple Removal Stone & Stent (52310) $4,750
Dbrdmt extensv eczema/infect skn up 10% bdy surf (11000) $2,500
Debride nail 1-5 (11720) $455
Debridement subcutaneous tissue 20 sq cm/< (11042) $1,247.50
Debridement, Skin, Sub-Q Tissue,Muscle,=<20 Sq Cm (11043) $2,205
Debridement, Skin, Sub-Q Tissue,Muscle,Bone,=<20 Sq Cm (11044) $6,000
Declot vascular device (36593) $1,275
Decompression; plantar digital nerve (64726) $7,440
Delay flap f/c/c/n/ax/g/h/f (15620) $7,500
Delivery placenta separate procedure (59414) $9,000
Destroy internal hemorrhoids (46930) $5,410
Destruction Benign Lesions Up To 14 (17110) $515
Destruction premalignant lesion 1st (17000) $700
Diagnostic sigmoidoscopy (45330) $3,605
Drain/inj small joint/bursa w/us (20604) $850
Drainage External Ear Abscess/Hematoma Simple (69000) $1,805
Drainage Finger Abscess Complicated (26011) $2,990
Drainage Finger Abscess Simple (26010) $775
Drainage mouth roof lesion (42000) $835
Drainage of eyelid abscess (67700) $1,075
Drainage of gum lesion (41800) $735
Drainage of hematoma/fluid (10140) $4,547.50
Drainage of scrotal wall abscess (55100) $3,415
Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) $545
Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) $505
Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) $450
Dstrj lesion anus simple surg excision (46922) $9,805
Dstrj lesion anus smpl eltrdsiccation (46910) $9,530
Egd Ablate Tumor Polyp/Lesion W/Dilation& Wire - Egd (43270) $6,430
Egd Balloon Dil Esoph30 Mm/> (43233) $7,500
Egd Dilation Gastric/Duodenal Stricture - Egd (43245) $6,430
Egd endoscopic stent place (43266) $17,375
Egd flexible foreign body removal (43247) $4,495
Egd guide wire insertion (43248) $4,030
Egd injection varices (43243) $6,430
Egd place gastrostomy tube (43246) $6,027.50
Egd Varices Ligation (43244) $6,430
Endometrial abltj thermal w/o hysteroscopic guid (58353) $19,000
Endoscopy Upper Small Intestine - Enteroscopy (44360) $6,765
Enterorrhaphy single perforation (44602) $10,000
Episiotomy or vaginal repair (59300) $3,300
Ercp Duct Stent Placement (43274) $16,225
Ercp Dx Collection Specimen Brushing/Washing - Ercp (43260) $11,165
Ercp ea duct/ampulla dilate (43277) $10,485
Ercp Remove Calculi/Debris Biliary/Pancreas Duct - Ercp (43264) $10,485
Ercp Stent Exchange W/Dilate (43276) $16,225
Ercp W/Biopsy Single/Multiple (43261) $10,145
Ercp w/sphincterotomy/papillotomy (43262) $10,485
Esophagogastroduodenoscopy submucosal injection (43236) $4,060
Esophagoscopy flex biopsy (43202) $4,835
Esophagoscopy flexible removal foreign body (43215) $7,590
Esophagoscopy lesion ablate (43229) $10,655
Esphgsc rgd/flx w/balo dilat < 30 mm diam (43220) $6,430
Evacuation of subungual hematoma (11740) $255
Ex tum/vasc mal sft tis hand/fngr subfsc 1.5+cm (26113) $6,250
Exc abd les sc 3 cm/> (22903) $10,045
Exc arm/elbow les sc 3 cm/> (24071) $10,350
Exc arm/elbow les sc < 3 cm (24075) $5,115
Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 2.1-3.0cm (11423) $6,500
Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 3.1-4.0cm (11424) $6,000
Exc back les sc < 3 cm (21930) $6,000
Exc back tum deep < 5 cm (21932) $10,850
Exc face les sbq 2 cm/> (21012) $6,500
Exc Face-Mm B9+Marg 0.5 Cm/< (11440) $2,605
Exc Face-Mm B9+Marg 2.1-3 Cm (11443) $6,250
Exc foot/toe tum sc < 1.5 cm (28043) $6,000
Exc forearm les sc 3 cm/> (25071) $6,250
Exc neck tum deep < 5 cm (21556) $10,850
Exc parotid tumor or gland lateral lobe w/dissec. preserve facial nerve 42415 (42415) $21,375
Exc rect tum transanal part (45171) $10,275
Exc shoulder les sc 3 cm/> (23071) $7,500
Exc shoulder tum deep 5 cm/> (23073) $10,350
Exc Skin Benig 0.6-1 Cm Trunk,Arm,Leg (11401) $1,625
Exc Skin Benig 1.1-2 Cm Trunk,Arm,Leg (11402) $2,100
Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg (11403) $3,840
Exc Skin Benig 3.1-4 Cm Trunk,Arm,Leg (11404) $6,000
Exc Skin Benig >4 Cm Face,Facial (11446) $10,850
Exc Skin Benig >4 Cm Remaindr Body (11426) $10,500
Exc Skin Benig >4 Cm Trunk,Arm,Leg (11406) $6,000
Exc Skin Malig >4 Cm Remaindr Body (11626) $10,500
Exc Skin Malig >4 Cm Trunk,Arm,Leg (11606) $5,925
Exc Sweat Gland Lesn Perineal,Complx (11471) $9,980
Exc thigh/knee les sc 3 cm/> (27337) $10,350
Exc Thrombosed Hemorrhoid Xtrnl (46320) $3,865
Exc tr-ext b9+marg 0.5 cm or less (11400) $2,050
Exc tumor soft tiss back/flank subfascial 5 cm/> (21933) $10,350
Exc tumor soft tiss shoulder subfasc <5cm (23076) $10,350
Exc tumor soft tissue abdl wall subfascial <5cm (22900) $10,850
Exc tumor soft tissue abdominal wall subq <3cm (22902) $6,000
Exc tumor soft tissue foot/toe subfasc 1.5+cm (28041) $10,350
Exc tumor soft tissue leg/ankle subq <3cm (27618) $7,500
Exc Tumor Soft Tissue Neck/Ant Thorax Subfascial 5+Cm (21554) $10,850
Exc Tumor Soft Tissue Neck/Ant Thorax Subq 3+Cm (21552) $10,625
Exc tumor soft tissue neck/ant thorax subq <3cm (21555) $5,985
Exc tumor soft tissue pelvis & hip subq <3cm (27047) $10,350
Exc tumor soft tissue thigh/knee subfasc <5cm (27328) $11,500
Excise parotid gland/lesion (42410) $21,400
Excise/repair mouth lesion (40812) $1,285
Excision Breast Lesion (19125) $11,305
Excision h/p/p/u simple/intermediate repair (11470) $10,850
Excision hidradenitis inguinal smpl/intrm rpr (11462) $10,625
Excision hydrocele bilateral (55041) $11,590
Excision mal lesion trunk/arm/leg 1.1-2.0 cm (11602) $1,500
Excision Mal Lesion Trunk/Arm/Leg 3.1-4.0 Cm (11604) $2,500
Excision malignant lesion f/e/e/n/l 0.6-1.0 cm (11641) $3,500
Excision of benign lesion other than skin tag 0.6-1.0 cm (11441) $3,500
Excision of benign lesion other than skin tag 1.1-2.0 cm (11442) $2,750
Excision of hydrocele; unilateral (55040) $13,185
Excision of lesion other than skin tag 1.1-2.0 cm (11422) $6,500
Excision of lesion other than skin tag </= 0.5 cm (11420) $3,415
Excision of lesion, tendon, tendon sheath, or capsule (including synovectomy) (eg, cys (28090) $5,750
Excision of nail fold toe (11765) $735
Excision of neuroma; hand or foot, except digital nerve (64782) $7,500
Excision of pilonidal cyst or sinus; simple (11770) $10,350
Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with complex repair (11463) $11,500
Excision of skin/subcutaneous tissue for hidradenitis, axillary; w/ simple or interm repair (11450) $10,850
Excision of submandibular (submaxillary) gland (42440) $23,820
Excision olecranon bursa (24105) $12,000
Excision pilonidal cyst/sinus complicated (11772) $9,250
Excision tumor soft tis back/flank subq 3 cm/> (21931) $6,000
Excision tumor soft tissue thigh/knee subq <3cm (27327) $6,250
Excision, tumor, soft tissue of abdominal wall, subfascial (eg, intramuscular); 5 cm or greater (22901) $10,350
Excision, tumor, soft tissue of face and scalp, subfascial (eg, subgaleal, intramuscular); 2 cm or greater (21014) $11,500
Excision, tumor, soft tissue of forearm and/or wrist area, subfa scial (eg, intramuscular); 3 cm or greater (25073) $11,500
Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; 3 cm or greater (27043) $10,500
Excision, tumor, soft tissue of upper arm or elbow area, subfasc ial (eg, intramuscular); 5 cm or greater (24073) $10,850
Excision,ben tumor,mandible,intra-oral (21046) $21,500
Explo/Drain Breast Abscess (19020) $7,725
Exploration penetrating wound spx extremity (20103) $465
Explore parathyroid glands (60500) $21,375
Fasciotomy foot and/or toe (28008) $17,065
Fasct prtl palmar 1 dgt prox iphal jt w/wo rpr (26123) $12,105
Fetal Contraction Stress Test (59020) $170
Fetal non-stress test (59025) $150
Fine needle aspiration bx w/us gdn 1st lesion (10005) $1,675
Fine needle aspiration without imaging guidance (10021) $1,032.50
Fluoro exam of g/colon tube (49465) $845
Fth/Gft Fr W/Dir Clsr F/C/C/M/N/Ax/G/H/F 20 Cm/< (15240) $7,000
Gastric Intubation/Aspiration, Therapeutic (43753) $360
Grafting of autologous fat by lipo 50 cc or less (15771) $14,820
Guide Cathet Fluid Drainage (10030) $2,500
Hemorrhoidectomy (46255) $10,580
Hemorrhoidectomy external complete (46250) $9,985
Hemorrhoidopexy (eg, for prolapsing internal hemorrhoids) by stapling (46947) $10,580
I&D Abscess Peritonsillar (42700) $750
I&d abscess simple (10060) $1,500
I&d epididymis tstis&/scrotal space (54700) $6,630
I&D Pelvis/Hip Jt Area Deep Abscess/Hematoma (26990) $13,000
I&d perianal abscess superficial (46050) $3,212.50
I&d pilonidal cyst simple (10080) $720
I&D Rectal Abscess + Fistulectomy (46060) $10,800
Immediate breast prosthesis (19340) $24,980
Incision & drainage abscess complicated/multiple (10061) $1,500
Incision & drainage pilonidal cyst complicated (10081) $2,025
Incision & removal foreign body subq tiss compl (10121) $6,000
Incision & removal foreign body subq tiss simple (10120) $1,075
Incision and drainage of bartholin's gland abscess (56420) $775
Incision and drainage of vulva or perineal abscess (56405) $605
Incision of rectal abscess (46045) $10,275
Incision of rectal abscess (46040) $2,855
Incision thrombosed hemorrhoid external (46083) $950
Incisional biopsy skin single lesion (11106) $2,575
Initial tx 1st degree burn local tx (16000) $450
Inj paravert f jnt c/t 1 lev (64490) $2,400
Inj,Anes Agent,Brachial Plexus,Single (64415) $3,505
Inject Anes/Steroid Plantar Common Digital Nerve (64455) $945
Inject Nerv Blck,Ilioingu/Iliohyp (64425) $2,750
Inject Nerv Blck,Intercostal,One (64420) $1,985
Inject Nerv Blck,Paravert Sympath (64520) $955
Inject scleros soln in hemorrhoids (46500) $2,215
Inject Tendon Origin/Insert (20551) $640
Injection aa&/strd trigeminal nerve each branch (64400) $810
Injection anes other peripheral nerve/branch (64450) $1,655
Injection for identification of sentinel node (38792) $2,575
Injection single/mlt trigger point 1/2 muscles (20552) $275
Injection single/mlt trigger point 3/> muscles (20553) $850
Injection, anesthetic agent; greater occipital nerve (64405) $1,000
Injection, intralesional; up to and including 7 lesions (11900) $887.50
Insert Bladder Cath Complex (51703) $565
Insert Drug Implant Device (11981) $750
Insert non-tunnel cv cath (36556) $3,000
Insert Non-Tunnel Cv Cath < 5 Y/O (36555) $5,177.50
Insert picc cath (36569) $5,962.50
Insert Picc W/O Sub-Q Port <5 Y/O (36568) $6,000
Insert Temp Bladder Cath (51702) $587.50
Insert,Non-Indwelling Bladder Catheter (51701) $632.50
Insertion Picc W/Rs&I 5 Yr/> (36573) $5,255
Insertion picc w/rs&i < 5 yr (36572) $1,800
Insj prph ctr vad w/subq port age 5 yr/> (36571) $7,675
Insj tunneled cvc w/o subq port/pmp age 5 yr/> (36558) $12,050
Insj/rplcmt breast implant sep day mastectomy (19342) $37,520
Insj/rplcmt temp transvns 1chmbr eltrd/pm cath (33210) $24,250
Insj/rplcmt temp transvns 2chmbr pacg eltrds spx (33211) $24,250
Intubation endotracheal emergency procedure (31500) $1,055
Irrigate corpora cavernosa for priapism (54220) $750
Knee arthroscopy/surgery (29883) $22,170
Lap ing hernia repair init (49650) $22,535
Laparoscopy appendectomy (44970) $22,535
Laparoscopy Remove Adnexa (58661) $18,025
Laparoscopy w/lysis of adhesions (58660) $22,535
Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of spec (49320) $22,535
Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure) (44180) $20,600
Laparoscopy, surgical, esophagogastric fundoplasty (eg, nissen, toupet procedures) (43280) $37,985
Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; with implantation of mesh (43282) $36,375
Laparoscopy, surgical; cholecystectomy with cholangiography (47563) $21,890
Laparoscopy, surgical; repair recurrent inguinal hernia (49651) $21,830
Laps fulg/exc ovary viscera/peritoneal surface (58662) $20,600
Laps Surg W/Aspir Cavity/Cyst Single/Multiple (49322) $22,535
Late closure of wound (13160) $7,000
Ligation or biopsy temporal artery (37609) $6,000
Lithotripsy (50590) $26,210
Mast mod rad (19307) $23,630
Mastectomy gynecomastia (19300) $10,815
Mastectomy partial (19301) $13,845
Mastectomy partial w/axillary lymphadenectomy (19302) $24,920
Mastectomy simple complete (19303) $24,980
Mastopexy (19316) $22,895
Musc myocutaneous/fasciocutaneous flap lxtr (15738) $13,025
Muscle-skin graft trunk (15734) $13,520
Naso/oro-gastric tube plmt req phys&fluor gdnce (43752) $410
Neuroplasty; nerve of hand or foot (64704) $7,500
Nipple exploration (19110) $11,305
Nipple/areola reconstruction (19350) $13,750
Njx c/p/a cavernosa w/pharmacologic agt (54235) $1,235
Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level (64493) $2,400
Open biopsy/excision inguinofemoral nodes (38531) $14,500
Open rx distal radius fx, intra-articular, 2 frag (25608) $28,500
Open Treatment Bimalleolar Ankle Fracture (27814) $27,500
Open tx of distal tibiofibular joint disruption, includes internal fixation, when performed (27829) $26,360
Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head (28288) $11,925
Partial excision bone talus/calcaneus (28120) $7,500
Partial excision of bone; tarsal or metatarsal bone, except talus or calcaneus (28122) $11,925
Partial removal of thyroid (60220) $22,860
Partial thyroid lobectomy, unilateral; with or without isthmusectomy (60210) $18,540
Partical Excision Bone Phalanx Toe (28124) $17,065
Penile Plethysmography (54240) $980
Percutaneous Skeletal Fixation Of Metacarpal Fracture, Each Bone (26608) $13,000
Peri-implant capsulectomy breast complete (19371) $13,845
Pericardiocentesis W/Imaging (33016) $4,575
Peritoneal Lavage (49084) $3,402.50
Perq dev breast 1st us imag (19285) $1,935
Perq Drainage Pleura Insert Cath W/O Imaging (32556) $6,835
Perq replacement gtube not req revj gstrst trc (43762) $767.50
Perq sft tiss loc device plmt 1st les w/gdnce (10035) $2,245
Placement of needle for intraosseous infusion (36680) $1,200
Pr unlisted px laparoscopic robotic closure of enterovesical fistula:w/intestine and/or bladder resection (44238) $21,300
Preputial Stretching (54450) $750
Prtl Thyr Lobec Uni W/Clat Stot Lobec (60212) $19,055
Punch biopsy skin single lesion (11104) $1,500
Puncture Aspiration (10160) $1,003.50
Puncture Aspiration Cyst Breast (19000) $4,277.50
Rad resect tumor soft tiss neck/ant thorax 5cm/> (21558) $10,465
Radical resection of tumor (eg, sarcoma), soft tissue of back or flank; 5 cm or greater (21936) $10,850
Reduction of Large Breast (19318) $23,820
Reforearm tend/musc,exten,second (25272) $11,925
Removal fb intranasal (30300) $670
Removal Foreign Body Foot Complicated (28193) $6,000
Removal foreign body foot deep (28192) $6,000
Removal foreign body foot subcutaneous (28190) $815
Removal Foreign Body Muscle/Tendon Sheath Simple (20520) $1,025
Removal Foreign Body Pelvis/Hip Deep (27087) $9,250
Removal foreign body pharynx (42809) $1,200
Removal foreign body upper arm/elbow deep (24201) $8,125
Removal impacted cerumen irrigation/lvg unilat (69209) $325
Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) $270
Removal Intact Mammary Implant (19328) $13,845
Removal of anal fissure (46200) $11,000
Removal of arm foreign body (24200) $4,650
Removal of nail bed (11750) $1,025
Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions (11200) $632.50
Removal of sperm cord lesion (55520) $12,875
Removal shoulder foreign body deep subfascial/im (23333) $8,125
Removal subq cardiac rhythm monitor (33286) $2,900
Removal/bivalving full arm/full leg cast (29705) $45
Removal/bivalving gauntlet boot/body cast (29700) $775
Remove by ligat int hem grp (46945) $11,500
Remove by ligat int hem grps (46946) $11,035
Remove elbow lesion (24120) $12,500
Remove Eyelid Foreign Body (67938) $1,285
Remove foreign body from eye (65210) $1,200
Remove in/ex hem groups 2+ (46260) $9,530
Remove Pilonidal Cyst Exten (11771) $10,850
Remove shoulder foreign body (23330) $4,500
Remove vagina tissue part (57107) $11,925
Remove wrist tendon lesion (25111) $6,500
Remv Ext Canal Foreign Body (69200) $375
Remv F.B.,Eye,Superf Conjunc (65205) $670
Repair arm tendon/muscle (24341) $26,500
Repair complex eyelid/nose/ear/lip 1.1-2.5 cm (13151) $2,050
Repair complex eyelid/nose/ear/lip 2.6-7.5 cm (13152) $2,050
Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) $870
Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) $1,647.50
Repair complex scalp/arm/leg 1.1-2.5 cm (13120) $1,795
Repair complex scalp/arm/leg 2.6-7.5 cm (13121) $1,610
Repair complex trunk 1.1-2.5 cm (13100) $1,795
Repair complex trunk 2.6-7.5 cm (13101) $2,632.50
Repair extensor tendon finger w/o graft each (26418) $7,375
Repair finger/hand tendon (26370) $12,975
Repair hallux rigidus (28289) $11,495
Repair hand tendon (26410) $4,600
Repair initial femoral hernia, any age; incarcerated or strangulated (49553) $14,370
Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated (49507) $13,225
Repair intermediate f/e/e/n/l&/muc 12.6-20.0cm (12055) $1,140
Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) $680
Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) $735
Repair intermediate f/e/e/n/l&/muc 20.1-30.0cm (12056) $1,140
Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) $680
Repair intermediate f/e/e/n/l&/muc 7.6-12.5 cm (12054) $895
Repair intermediate f/e/e/n/l&/muc >30.0 cm (12057) $1,140
Repair intermediate n/h/f/xtrnl gent 12.6-20 cm (12045) $1,800
Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) $630
Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) $655
Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) $1,800
Repair intermediate n/h/f/xtrnl gent >30.0 cm (12047) $5,215
Repair intermediate s/a/t/e 12.6-20.0cm (12035) $785
Repair intermediate s/a/t/e 2.5 cm/< (12031) $570
Repair intermediate s/a/t/e 2.6-7.5 cm (12032) $655
Repair intermediate s/a/t/e 20.1-30.0 cm (12036) $995
Repair intermediate s/a/t/e 7.6-12.5 cm (12034) $1,037.50
Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie,… (49595) $14,490
Repair of nail bed (11760) $275
Repair Tongue Laceration (41250) $890
Repair/revise wrist joint (25320) $26,450
Replace g/c tube perc (49450) $3,405
Replace Tissue Expander (11970) $26,355
Rerepair ing hernia blocked (49521) $14,175
Rerepair ing hernia reduce (49520) $14,175
Revise median n/carpal tunnel surg (64721) $7,358.52
Revise ulnar nerve at wrist (64719) $7,358.52
Revision of reconstructed breast (19380) $23,820
Revision peri-implant capsule breast (19370) $16,000
Rmvl embedded fb vestibule mouth comp (40805) $1,600
Rmvl Embedded Fb Vestibule Mouth Smpl (40804) $245
Rmvl fb xtrnl eye corneal w/o slit lamp (65220) $1,155
Rmvl fb xtrnl eye corneal w/slit lamp (65222) $435
Rmvl foreign body pelvis/hip subcutaneous tiss (27086) $3,840
Rmvl ruptured breast implant w/implant contents (19330) $12,900
Rmvl tun ctr vad w/subq port/pmp ctr/prph insj (36590) $4,502.50
Rplcmt compl tun ctr vad w/subq port (36582) $12,105
Rpr aa hernia 1st 3-10 cm ncrc8/strangulated (49594) $20,850
Rpr aa hernia 1st 3-10 cm reducible (49593) $14,500
Rpr aa hernia 1st < 3 cm ncrc8/strangulated (49592) $21,000
Rpr aa hernia 1st < 3 cm reducible (49591) $14,175
Rpr Aa Hernia Recr < 3 Cm Ncrc8/Strangulated (49614) $20,850
Rpr Aa Hernia Recr < 3 Cm Reducible (49613) $13,200
Rpr blood vessel direct lower extremity (35226) $4,265
Rpr intermediate n/h/f/xtrnl gent 20.1-30.0 cm (12046) $1,800
Rpr Lac 2.5 Cm/< Pst One-Third Tongue (41251) $450
Rpr lac tongue floor mouth > 2.6 cm/cplx (41252) $2,135
Rpr/advmnt flxr tdn zone 2 w/o fr grft ea tendon (26356) $12,975
Secondary repair of tendon or muscle of palm side of forearm or wrist (25263) $26,458.52
Sgmdsc flx dired sbmcsl njx any sbst (45335) $4,840
Sgmdsc flx rmvl tum polyp/oth les snare tq (45338) $3,685
Shaving Skin Lesion 1 S/N/H/F/G Diam 0.5 Cm/< (11305) $455
Shldr arthroscop,lyse adhesns (29825) $18,390
Sigmoidoscopy Flx Ablation Tumor Polyp/Oth Les - Endoscopy Sigmoid (45346) $4,330
Sigmoidoscopy flx w/biopsy single/multiple (45331) $3,685
Simple repair f/e/e/n/l/m 12.6cm-20.0 cm (12016) $995
Simple repair f/e/e/n/l/m 2.5cm/< (12011) $615
Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) $685
Simple repair f/e/e/n/l/m 20.1cm-30.0 cm (12017) $1,150
Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) $655
Simple repair f/e/e/n/l/m 7.6cm-12.5 cm (12015) $725
Simple repair f/e/e/n/l/m >30.0 cm (12018) $575
Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) $1,112.50
Simple repair scalp/neck/ax/genit/trunk >30.0cm (12007) $950
Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) $725
Skin splt grft trnk/arm/leg (15100) $7,210
Skn splt a-grft fac/nck/hf/g (15120) $14,935
Small bowel endoscopy (44366) $7,105
Small bowel endoscopy (44376) $4,870
Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) $685
Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) $815
Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) $1,020
Spinal puncture lumbar diagnostic (62270) $785
Strapping ankle (29540) $435
Strapping elbow/wrist (29260) $212.50
Strapping hand/finger (29280) $212.50
Strapping Hip (29520) $450
Strapping knee (29530) $255
Strapping shoulder (29240) $290
Strapping thorax (29200) $310
Strapping toes (29550) $255
Strapping unna boot (29580) $430
Suction assisted lipectomy; trunk (15877) $14,935
Suture Digital Nerve Hand/Foot 1 Nerve (64831) $7,800
Thoracentesis Needle/Cath Pleura W/Imaging (32555) $725
Thoracentesis needle/cath pleura w/o imaging (32554) $1,800
Thrombolytic Therapy, Stroke (37195) $1,200
Thyroid biopsy (60100) $2,447.50
Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a portion of thyroid (60260) $21,500
Thyroidectomy, total or complete (60240) $22,535
Thyroidectomy, total or subtotal for malignancy; with limited neck dissection (60252) $21,375
Tis trnfr trunk 10 sq cm/< (14000) $6,925
Tis trnfr trunk 10.1-30sqcm (14001) $6,925
Tissue expander placement breast reconstruction (19357) $67,405
Total thyroid lobectomy unilateral (60225) $22,860
Trach Tube Change (31502) $795
Tracheostomy emergency cricothyroid membrane (31605) $750
Tracheostomy Emergency Procedure Transtracheal (31603) $3,120
Transection or avulsion of other spinal nerve, extradural (64772) $7,725
Treat finger dislocation (26775) $775
Treat Fracture Radius & Ulna (25560) $710
Treat humerus fracture (24500) $710
Treat humerus fracture (23600) $675
Treat Metatarsal Fracture (28475) $650
Treatment closed elbow dislocation req anes (24605) $5,115
Treatment closed elbow dislocation w/o anes (24600) $710
Treatment of ankle fracture (27792) $26,360
Tx Spon Hip Dislc Abdct Splnt/Trcj W/Manj Anes (27257) $6,000
Unlisted laparoscopy procedure, esophagus (43289) $22,535
Unlisted laparoscopy px abd pertoneum & omentum (49329) $22,825
Unlisted procedure anus (46999) $3,605
Unlisted Procedure Breast (19499) $13,290
Unlisted Procedure Casting/Strapping (29799) $290
Unlisted Procedure External Ear (69399) $775
Unlisted Procedure Nervous System (64999) $310
Vaginal delivery only (59409) $9,000
Vasc Embolize/Occlude Bleed (37244) $32,000
Venipuncture (36415) $45
Venipuncture Cutdown Younger Than 1 Year (36420) $450
Venipuncture, cutdown; age 1 or over (36425) $1,100
Vulvectomy simple partial (56620) $11,925
Wound Prep F/N/Hf/G (15004) $2,500
Wound prep trk/arm/leg 1st 100 sq cm (15002) $7,316