Abd paracentesis w/imaging (49083)
range across 2 matching MRF lines |
— |
$3,200–$3,475 |
— |
| Abdom Paracentesis Dx/Ther W/O Imaging Guidance (49082) |
— |
$3,200 |
— |
| Acne surgery (10040) |
— |
$505 |
— |
| Adjacent Tissue Transfer/Reargmt Trunk 10 Sqcm/< (14000) |
— |
$6,925 |
— |
| Adjnt tis transfr/rearrange trunk 10.1-30.0 sqcm (14001) |
— |
$6,925 |
— |
| 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 |
— |
| Amputation foot transmetarsal (28805) |
— |
$11,925 |
— |
| Amputation metatarsal with toe single (28810) |
— |
$12,400 |
— |
| Amputation toe interphalangeal joint (28825) |
— |
$13,000 |
— |
| Amputation toe metatarsophalangeal joint (28820) |
— |
$12,500 |
— |
| Amputation, leg, through tibia and fibula; secondary closure or scar revision (27884) |
— |
$12,500 |
— |
| Anoscopy Control Bleeding (46614) |
— |
$4,500 |
— |
Anoscopy diagnostic (46600)
range across 3 matching MRF lines |
— |
$450–$3,350 |
— |
| 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 Finger Splint Dynamic (29131) |
— |
$170 |
— |
Application finger splint static (29130)
range across 2 matching MRF lines |
— |
$170–$320 |
— |
| Application long arm splint shoulder hand (29105) |
— |
$410 |
— |
| Application Long Leg Splint (29505) |
— |
$410 |
— |
| Application of long leg cast (29345) |
— |
$890 |
— |
| Application Short Arm Splint Dynamic (29126) |
— |
$170 |
— |
Application short arm splint forearm-hand static (29125)
range across 2 matching MRF lines |
— |
$170–$410 |
— |
| Application short leg splint calf foot (29515) |
— |
$410 |
— |
| Apply hand/wrist cast (29085) |
— |
$775 |
— |
| Apply long arm cast (29065) |
— |
$560 |
— |
| 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)
range across 4 matching MRF lines |
— |
$810–$1,200 |
— |
Arthrocentesis aspir&/inj major jt/bursa w/us (20611)
range across 2 matching MRF lines |
— |
$850–$1,500 |
— |
| Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) |
— |
$640 |
— |
| Arthroscopy knee synovectomy limited spx (29875) |
— |
$11,925 |
— |
| Arthroscopy shoulder distal claviculectomy (29824) |
— |
$17,770 |
— |
| Arthroscopy shoulder surgical capsulorrhaphy (29806) |
— |
$28,585 |
— |
| Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral) Facility (29883) |
— |
$22,170 |
— |
| Arthroscopy, knee, surgical; with meniscus repair (medial or lateral) (29882) |
— |
$11,925 |
— |
| Arthroscopy, shoulder, surgical; biceps tenodesis (29828) |
— |
$20,085 |
— |
| Arthroscopy, shoulder, surgical; debridement, extensive (29823) |
— |
$13,500 |
— |
| Arthroscopy, shoulder, surgical; debridement, limited (29822) |
— |
$15,710 |
— |
Arthroscopy, shoulder, surgical; with rotator cuff repair (29827)
range across 3 matching MRF lines |
— |
$1,755–$32,960 |
— |
| Arthrs Knee W/Meniscectomy Med&Lat W/Shaving (29880) |
— |
$21,245 |
— |
Aspirate pleura w/ imaging (32555)
range across 3 matching MRF lines |
— |
$725–$1,800 |
— |
| Aspirate Pleura W/O Imaging (32554) |
— |
$1,800 |
— |
| Aspirate/Inj Ganglion Cyst (20612) |
— |
$1,100 |
— |
| Avulsion nail plate partial/complete simple 1 (11730) |
— |
$645 |
— |
| Axillary lymphadenectomy; complete (38745) |
— |
$21,890 |
— |
| Biopsy of breast; open, incisional (19101) |
— |
$14,230 |
— |
| Biopsy of rectum (45100) |
— |
$9,805 |
— |
| Biopsy or excision of lymph node(s); open, internal mammary node(s) Facility (38530) |
— |
$14,225 |
— |
| Biopsy soft tissue neck/thorax (21550) |
— |
$5,475 |
— |
| Biopsy/removal lymph nodes (38510) |
— |
$13,750 |
— |
| Bladder Irrigation (51700) |
— |
$450 |
— |
| Bladder Scan (51798) |
— |
$350 |
— |
| Blepharotomy drainage abscess eyelid (67700) |
— |
$1,075 |
— |
| Blood Transfusion Service (36430) |
— |
$1,765 |
— |
| Breast augmentation with implant (19325) |
— |
$35,250 |
— |
| Breast Reduction (19318) |
— |
$23,820 |
— |
| Bx breast 1st lesion strtctc (19081) |
— |
$670 |
— |
Bx breast 1st lesion us imag (19083)
range across 2 matching MRF lines |
— |
$4,095–$5,285 |
— |
| Bx breast needle core w/o imaging guidance spx (19100) |
— |
$1,465 |
— |
| Bx/exc lymph node open deep axillary node (38525) |
— |
$13,845 |
— |
| Bx/exc lymph node open superficial (38500) |
— |
$14,230 |
— |
| Canthotomy Separate Procedure (67715) |
— |
$7,955 |
— |
| Carpal Tunnel Surgery (64721) |
— |
$7,358.52 |
— |
| Catheter aspiration nasotracheal spx (31720) |
— |
$90 |
— |
| Change Cystostomy Tube Complicated (51710) |
— |
$2,400 |
— |
| Change Cystostomy Tube Simple (51705) |
— |
$775 |
— |
| Change of Windpipe Airway (31502) |
— |
$795 |
— |
| Chemical Cautery Tissue (17250) |
— |
$750 |
— |
| Chemodenervation of internal anal sphincter (46505) |
— |
$6,000 |
— |
Chest tube placement (32551)
range across 2 matching MRF lines |
— |
$3,315–$6,000 |
— |
| Chng Urtrost Tube/Xtrnlly Accessible Stent Ileal (50688) |
— |
$5,115 |
— |
| Circumcision Neonate (54160) |
— |
$815 |
— |
| Circumcision w/clamp/oth dev w/block (54150) |
— |
$680 |
— |
| Cl Tx Tib Shft Fx W Manip (27752) |
— |
$710 |
— |
| Claviculectomy partial (23120) |
— |
$12,500 |
— |
| Clear outer ear canal (69200) |
— |
$375 |
— |
| Closed Rx Metacarpal Fx,Percut (26608) |
— |
$13,000 |
— |
| Closed Rx Spontaneous Hip Disloc (27256) |
— |
$650 |
— |
| Closed treatment of posterior malleolus fracture; with manipulation (27768) |
— |
$4,600 |
— |
| Closed treatment of ulnar shaft fracture; with manipulation (25535) |
— |
$1,020 |
— |
| 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 Radial Shaft Fracture W/O Manipulation (25500) |
— |
$710 |
— |
| Closed Tx Radial&Ulnar Shaft Fractures W/Manj (25565) |
— |
$710 |
— |
| Closed tx radial&ulnar shaft fractures w/o man (25560) |
— |
$710 |
— |
| 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 artclr fx invg mtcarphlngl/iphal jt w/manj (26742) |
— |
$5,970 |
— |
| 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 req anesthesia (27252) |
— |
$6,250 |
— |
| Cltx hip dislocation traumatic w/o anesthesia (27250) |
— |
$1,420 |
— |
| Cltx Humeral Epicondylar Fx Medial/Lat W/O Manj (24560) |
— |
$1,000 |
— |
| Cltx Interphalangeal Joint Dislocation Req Anes (28665) |
— |
$410 |
— |
| Cltx Interphalangeal Joint Dislocation W/O Anes (28660) |
— |
$650 |
— |
| Cltx Iphal Jt Dislc W/Manj Req Anes (26775) |
— |
$775 |
— |
| Cltx iphal jt dislc w/manj w/o anes (26770) |
— |
$710 |
— |
| Cltx Med Ankle Fx W/Mnpj (27762) |
— |
$4,600 |
— |
| Cltx Medial Ankle Fx (27760) |
— |
$650 |
— |
| 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 Metatarsophlngl Jt Dislc Req Anes (28635) |
— |
$6,000 |
— |
| 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/Transcndylr Humeral Fx W/WO Manj (24530) |
— |
$650 |
— |
| 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/o manipulation (27750) |
— |
$650 |
— |
| Cltx trimalleolar ankle fx w/manipulation (27818) |
— |
$3,075 |
— |
| Collection of venous blood by venipuncture (36415) |
— |
$45 |
— |
| Colonoscopy through stoma; with biopsy, single or multiple (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 |
— |
| Colonoscopy w/submucosal inj (45381) |
— |
$4,480 |
— |
| Colporrhaphy (57200) |
— |
$7,250 |
— |
| Control Nasal Hemorrhage Anterior Complex (30903) |
— |
$450 |
— |
| Control Nasal Hemorrhage Anterior Simple (30901) |
— |
$570 |
— |
| Correction hammertoe (28285) |
— |
$13,200 |
— |
| Corrj Hlx Vlgs Bncty Sesmdc Rescj Prox Phlx Base (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 |
— |
Deb Musc/Fascia 20 Sq Cm/< (11043)
range across 2 matching MRF lines |
— |
$2,060–$2,350 |
— |
| Debride nail 1-5 (11720) |
— |
$455 |
— |
| Debridement Bone Muscle &/Fascia 20 Sq Cm/< (11044) |
— |
$6,000 |
— |
Debridement subcutaneous tissue 20 sq cm/< (11042)
range across 2 matching MRF lines |
— |
$950–$1,545 |
— |
Declot vascular device (36593)
range across 2 matching MRF lines |
— |
$1,200–$1,350 |
— |
| Delay flap/sectioning flap f/c/c/n/ax/g/h/f (15620) |
— |
$7,500 |
— |
| Delivery of placenta (59414) |
— |
$9,000 |
— |
| Destruct B9 Lesion 1-14 (17110) |
— |
$515 |
— |
| Destruction Internal Hemorrhoid Thermal Energy (46930) |
— |
$5,410 |
— |
| 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 Mouth Roof Lesion (42000) |
— |
$835 |
— |
| Drainage of finger abscess simple (26010) |
— |
$775 |
— |
| Drainage of gum lesion (41800) |
— |
$735 |
— |
Drainage of hematoma/fluid (10140)
range across 4 matching MRF lines |
— |
$950–$6,500 |
— |
| Drainage of scrotal wall abscess (55100) |
— |
$3,415 |
— |
| Drainage of scrotum (54700) |
— |
$6,630 |
— |
| 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)
range across 2 matching MRF lines |
— |
$425–$475 |
— |
| Dstrj lesion anus simple surg excision (46922) |
— |
$9,805 |
— |
| Dstrj Lesion Anus Smpl Eltrdsiccation (46910) |
— |
$9,530 |
— |
| Egd Balloon Dil Esoph30 Mm/> (43233) |
— |
$7,500 |
— |
| Egd dilation gastric/duodenal stricture (43245) |
— |
$6,430 |
— |
| Egd Endoscopic Stent Place (43266) |
— |
$17,375 |
— |
| Egd Flexible Foreign Body Removal (43247) |
— |
$4,495 |
— |
Egd guide wire insertion (43248)
range across 3 matching MRF lines |
— |
$3,685–$4,840 |
— |
| Egd Injection Sclerosis Esophgl/Gastric Varices (43243) |
— |
$6,430 |
— |
| Egd lesion ablation (43270) |
— |
$6,430 |
— |
Egd place gastrostomy tube (43246)
range across 2 matching MRF lines |
— |
$3,685–$8,370 |
— |
| Egd Varices Ligation (43244) |
— |
$6,430 |
— |
| Endometrial ablation, thermal, without hysteroscopic guidance (58353) |
— |
$19,000 |
— |
| Endometrial Biopsy (58100) |
— |
$800 |
— |
| Endoscopy Upper Small Intestine (44360) |
— |
$6,765 |
— |
| Enterorrhaphy single perforation (44602) |
— |
$10,000 |
— |
| Enterosc >2nd prtn w/ileum w/wo collj spec spx (44376) |
— |
$4,870 |
— |
| Epidural Blood Patch (62273) |
— |
$3,350 |
— |
| Episiotomy or vaginal repair (59300) |
— |
$3,300 |
— |
| Ercp duct stent placement (43274) |
— |
$16,225 |
— |
| Ercp Dx Collection Specimen Brushing/Washing (43260) |
— |
$11,165 |
— |
| Ercp ea duct/ampulla dilate (43277) |
— |
$10,485 |
— |
| Ercp remove calculi/debris biliary/pancreas duct (43264) |
— |
$10,485 |
— |
| Ercp Stent Exchange W/Dilate (43276) |
— |
$16,225 |
— |
| Ercp W/Biopsy Single/Multiple (43261) |
— |
$10,145 |
— |
| Ercp,Sphincterotomy (43262) |
— |
$10,485 |
— |
| Esophagogastroduodenoscopy Submucosal Injection (43236) |
— |
$4,060 |
— |
| Esophagoscopy Flex Balloon Dilat <30 Mm Diam (43220) |
— |
$6,430 |
— |
| Esophagoscopy Flex Transoral Lesion Ablation (43229) |
— |
$10,655 |
— |
| Esophagoscopy, flexible, transoral; with biopsy, single or multiple (43202) |
— |
$4,835 |
— |
| Esophagoscopy, flexible, transoral; with removal of foreign body(s) (43215) |
— |
$7,590 |
— |
| Evacuation of subungual hematoma (11740) |
— |
$255 |
— |
| Ex Tum/Vasc Mal Sft Tis Hand/Fngr Subfsc 1.5cm/> (26113) |
— |
$6,250 |
— |
| Exc abdl tum deep 5 cm/> (22901) |
— |
$10,350 |
— |
| Exc arm/elbow les sc < 3 cm (24075) |
— |
$5,115 |
— |
| Exc b9 les mrgn xcp sk tg t/a/l 0.5 cm/< (11400) |
— |
$2,050 |
— |
| Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 2.1-3.0cm (11423) |
— |
$6,500 |
— |
| Exc Back Les Sc < 3 Cm (21930) |
— |
$6,000 |
— |
| Exc Back Tum Deep 5 Cm/> (21933) |
— |
$10,350 |
— |
| Exc back tum deep < 5 cm (21932) |
— |
$10,850 |
— |
| Exc Benign Tumor/Cyst Mndbl Intra-Oral Osteot (21046) |
— |
$21,500 |
— |
| Exc Breast Les Preop Plmt Rad Marker Open 1 Les (19125) |
— |
$11,305 |
— |
| Exc F/E/E/N/L Mal+Mrg 0.6-1 (11641) |
— |
$3,500 |
— |
| 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 0.6-1 Cm (11441) |
— |
$3,500 |
— |
| Exc Face-Mm B9+Marg 1.1-2 Cm (11442) |
— |
$2,750 |
— |
| Exc Face-Mm B9+Marg 2.1-3 Cm (11443) |
— |
$6,250 |
— |
| Exc Forearm Les Sc 3 Cm/> (25071) |
— |
$6,250 |
— |
| Exc Forearm Tum Deep 3 Cm/> (25073) |
— |
$11,500 |
— |
| Exc H-F-Nk-Sp B9+Marg 0.5/< (11420) |
— |
$3,415 |
— |
| Exc H-F-Nk-Sp B9+Marg 1.1-2 (11422) |
— |
$6,500 |
— |
| Exc Lesion Tendon Sheath/Capsule W/Synvct Foot (28090) |
— |
$5,750 |
— |
| Exc neuroma hand/foot xcp digital nerve (64782) |
— |
$7,500 |
— |
| Exc Prtd Tum/Prtd Glnd Lat Lobe W/O Nrv Dsj (42410) |
— |
$21,400 |
— |
| Exc Rct Tum Not Incl Muscularis Propria (45171) |
— |
$10,275 |
— |
| Exc Shoulder Tum Deep 5 Cm/> (23073) |
— |
$10,350 |
— |
| Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg (11403) |
— |
$3,840 |
— |
| Exc Skin Benig 3.1-4 Cm Remaindr Body (11424) |
— |
$6,000 |
— |
| Exc Skin Benig >4 Cm Remaindr Body (11426) |
— |
$10,500 |
— |
| Exc Skin Benig >4 Cm Trunk,Arm,Leg (11406) |
— |
$6,000 |
— |
| Exc Skin Benig >4cm Face,Facial (11446) |
— |
$10,850 |
— |
| Exc Skin Malig >4 Cm Remaindr Body (11626) |
— |
$10,500 |
— |
| Exc Skin Malig >4 Cm Trunk,Arm,Leg (11606) |
— |
$5,925 |
— |
| Exc thigh/knee les sc 3 cm/> (27337) |
— |
$10,350 |
— |
Exc Thrombosed Hemorrhoid Xtrnl (46320)
range across 3 matching MRF lines |
— |
$3,300–$7,670 |
— |
Exc Tr-Ext B9+Marg 0.6-1 Cm (11401)
range across 2 matching MRF lines |
— |
$1,200–$2,050 |
— |
Exc Tr-Ext B9+Marg 1.1-2 Cm (11402)
range across 2 matching MRF lines |
— |
$1,880–$2,320 |
— |
| Exc Tr-Ext B9+Marg 3.1-4 Cm (11404) |
— |
$6,000 |
— |
| Exc tumor soft tis neck/ant thorax subq 3 cm/> (21552) |
— |
$10,625 |
— |
| Exc Tumor Soft Tiss Face&Scalp Subfascial 2+Cm (21014) |
— |
$11,500 |
— |
| Exc tumor soft tiss neck/thorax subfascial <5cm (21556) |
— |
$10,850 |
— |
| Exc tumor soft tiss shoulder subfasc <5cm (23076) |
— |
$10,350 |
— |
| Exc tumor soft tiss upper arm/elbw subfasc 5+cm (24073) |
— |
$10,850 |
— |
| 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 <3cm (21555)
range across 2 matching MRF lines |
— |
$5,970–$6,000 |
— |
| Exc tumor soft tissue pelvis & hip subq <3cm (27047) |
— |
$10,350 |
— |
| Exc tumor soft tissue thigh/knee subfasc <5cm (27328) |
— |
$11,500 |
— |
| Exc Tumor Soft Tissue Upper Arm/Elbow Subq 3+Cm (24071) |
— |
$10,350 |
— |
| Excis Mouth Mucosa/Sub,Simpl Repair (40812) |
— |
$1,285 |
— |
| Excision H/P/P/U Complex Repair (11471) |
— |
$9,980 |
— |
| Excision H/P/P/U Simple/Intermediate Repair (11470) |
— |
$10,850 |
— |
| Excision Hidradenitis Inguinal Complex Repair (11463) |
— |
$11,500 |
— |
| Excision Hidradenitis Inguinal Smpl/Intrm Rpr (11462) |
— |
$10,625 |
— |
| 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 of ganglion, wrist (dorsal or volar); primary (25111) |
— |
$6,500 |
— |
| Excision of hydrocele; bilateral (55041) |
— |
$11,590 |
— |
| Excision of hydrocele; unilateral (55040) |
— |
$13,185 |
— |
| Excision of parotid tumor or parotid gland; lateral lobe, with dissection and preservation of facial nerve Facility (42415) |
— |
$21,375 |
— |
| Excision of pilonidal cyst or sinus; simple (11770) |
— |
$10,350 |
— |
| Excision of submandibular (submaxillary) gland (42440) |
— |
$23,820 |
— |
| Excision olecranon bursa (24105) |
— |
$12,000 |
— |
| Excision Pilonidal Cyst/Sinus Complicated (11772) |
— |
$9,250 |
— |
| Excision Pilonidal Cyst/Sinus Extensive (11771) |
— |
$10,850 |
— |
| Excision tumor soft tis back/flank subq 3 cm/> (21931) |
— |
$6,000 |
— |
| Excision tumor soft tissue foot/toe subq <1.5cm (28043) |
— |
$6,000 |
— |
| Excision tumor soft tissue shoulder subq 3 cm/> (23071) |
— |
$7,500 |
— |
| Excision Tumor Soft Tissue Thigh/Knee Subq <3Cm (27327) |
— |
$6,250 |
— |
| Excision, tumor, soft tissue of abdominal wall, subcutaneous; 3 cm or greater (22903) |
— |
$10,045 |
— |
| Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; 3 cm or greater (27043) |
— |
$10,500 |
— |
| Explo/Drain Breast Abscess (19020) |
— |
$7,725 |
— |
| Exploration penetrating wound spx extremity (20103) |
— |
$465 |
— |
| 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 without imaging guidance (10021)
range across 2 matching MRF lines |
— |
$735–$1,330 |
— |
| Fluoro exam of g/colon tube (49465) |
— |
$845 |
— |
Fna bx w/us gdn 1st les (10005)
range across 2 matching MRF lines |
— |
$775–$2,575 |
— |
| Foreskin manipulation (54450) |
— |
$750 |
— |
| Grafting of autologous fat by lipo 50 cc or less (15771) |
— |
$14,820 |
— |
| Guide Cathet Fluid Drainage (10030) |
— |
$2,500 |
— |
| Hemorrhoidectomy Ntrnl & Xtrnl 1 Column/Group (46255) |
— |
$10,580 |
— |
| Hemorrhoidectomy, external, 2 or more columns/groups (46250) |
— |
$9,985 |
— |
| Hemorrhoidectomy, internal and external, 2 or more columns/groups; (46260) |
— |
$9,530 |
— |
| Hemorrhoidopexy by stapling (46947) |
— |
$10,580 |
— |
| I&d abscess peritonsillar (42700) |
— |
$750 |
— |
I&d abscess simple (10060)
range across 3 matching MRF lines |
— |
$720–$1,750 |
— |
| I&D Intramural Im/Absc Transanal Anes (46045) |
— |
$10,275 |
— |
| I&D Ischiorct/Intramural Absc W/WO Seton (46060) |
— |
$10,800 |
— |
| I&d pelvis/hip jt area deep abscess/hematoma (26990) |
— |
$13,000 |
— |
I&d perianal abscess superficial (46050)
range across 2 matching MRF lines |
— |
$2,560–$3,865 |
— |
| I&d pilonidal cyst complicated (10081) |
— |
$2,025 |
— |
| I&d pilonidal cyst simple (10080) |
— |
$720 |
— |
| Immediate breast prosthesis (19340) |
— |
$24,980 |
— |
| Incise external hemorrhoid (46083) |
— |
$950 |
— |
Incision & drainage abscess complicated/multiple (10061)
range across 2 matching MRF lines |
— |
$1,455–$1,545 |
— |
| 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 (46040)
range across 2 matching MRF lines |
— |
$710–$5,000 |
— |
| Incisional biopsy skin single lesion (11106) |
— |
$2,575 |
— |
| Initial Tx 1st Degree Burn Local Tx (16000) |
— |
$450 |
— |
| Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Cerv/Thorac, 1st Level (64490) |
— |
$2,400 |
— |
| Injection for identification of sentinel node (38792) |
— |
$2,575 |
— |
| Injection of sclerosing solution, hemorrhoids (46500) |
— |
$2,215 |
— |
| Injection single tendon origin/insertion (20551) |
— |
$640 |
— |
| Injection single/mlt trigger point 1/2 muscles (20552) |
— |
$275 |
— |
| Injection single/mlt trigger point 3/> muscles (20553) |
— |
$850 |
— |
| Injection, anesthetic agent; brachial plexus, single (64415) |
— |
$3,505 |
— |
Injection, anesthetic agent; other peripheral nerve or branch (64450)
range across 2 matching MRF lines |
— |
$810–$2,500 |
— |
Injection, intralesional; up to and including 7 lesions (11900)
range across 2 matching MRF lines |
— |
$775–$1,000 |
— |
| Insert Bladder Cath Complex (51703) |
— |
$565 |
— |
| Insert cath pleura w/o image (32556) |
— |
$6,835 |
— |
| Insert Drug Implant Device (11981) |
— |
$750 |
— |
Insert non-tunnel cv cath (36556)
range across 3 matching MRF lines |
— |
$2,030–$12,000 |
— |
| Insert Picc W/O Sub-Q Port <5 Y/O (36568) |
— |
$6,000 |
— |
Insert Temp Bladder Cath (51702)
range across 4 matching MRF lines |
— |
$335–$880 |
— |
Insert,Non-Indwelling Bladder Catheter (51701)
range across 2 matching MRF lines |
— |
$425–$840 |
— |
Insertion Picc W/Rs&I 5 Yr/> (36573)
range across 2 matching MRF lines |
— |
$4,510–$6,000 |
— |
Insj Non-Tunneled Central Venous Cath Age < 5 Y (36555)
range across 2 matching MRF lines |
— |
$1,355–$9,000 |
— |
| Insj Picc Rs&I <5 Yr (36572) |
— |
$1,800 |
— |
| Insj prph ctr vad w/subq port age 5 yr/> (36571) |
— |
$7,675 |
— |
Insj prph cvc w/o subq port/pmp age 5 yr/> (36569)
range across 2 matching MRF lines |
— |
$5,925–$6,000 |
— |
| 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 |
— |
| Int hrhc by ligation single hroid w/o img gdn (46945) |
— |
$11,500 |
— |
| Intmd Rpr Face/Mm 12.6-20 Cm (12055) |
— |
$1,140 |
— |
| Intmd Rpr Face/Mm 20.1-30.0 (12056) |
— |
$1,140 |
— |
Intubation endotracheal emergency procedure (31500)
range across 4 matching MRF lines |
— |
$950–$2,680 |
— |
| Irrigation of corpora cavernosa for priapism (54220) |
— |
$750 |
— |
| Lap paraesoph her rpr w/mesh (43282) |
— |
$36,375 |
— |
| Laparoscopy aspiration (49322) |
— |
$22,535 |
— |
| Laparoscopy Enterolysis Separate Procedure (44180) |
— |
$20,600 |
— |
| Laparoscopy Surg Rpr Initial Inguinal Hernia (49650) |
— |
$22,535 |
— |
| Laparoscopy W/Lysis Of Adhesions (58660) |
— |
$22,535 |
— |
| Laparoscopy w/rmvl adnexal structures (58661) |
— |
$18,025 |
— |
| Laparoscopy, surgical, appendectomy (44970) |
— |
$22,535 |
— |
| Laparoscopy, surgical, esophagogastric fundoplasty (eg, nissen, toupet procedures) (43280) |
— |
$37,985 |
— |
| Laparoscopy, surgical; cholecystectomy with cholangiography (47563) |
— |
$21,890 |
— |
| Laparoscopy, surgical; repair recurrent inguinal hernia (49651) |
— |
$21,830 |
— |
| Laps abd prtm&omentum dx w/wo spec br/wa spx (49320) |
— |
$22,535 |
— |
| Laps fulg/exc ovary viscera/peritoneal surface (58662) |
— |
$20,600 |
— |
| Late closure of wound (13160) |
— |
$7,000 |
— |
| Ligation of hemorrhoids (46946) |
— |
$11,035 |
— |
| Ligation or biopsy temporal artery (37609) |
— |
$6,000 |
— |
| Lithotripsy, extracorporeal shock wave (50590) |
— |
$26,210 |
— |
| Mast mod rad (19307) |
— |
$23,630 |
— |
| Mastectomy for 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 |
— |
| Muscle, myocutaneous, or fasciocutaneous flap; lower extremity (15738) |
— |
$13,025 |
— |
| Muscle-skin graft trunk (15734) |
— |
$13,520 |
— |
| N Block Inj Ilio-Ing/Hypogi (64425) |
— |
$2,750 |
— |
| N block inj intercost sng (64420) |
— |
$1,985 |
— |
| N Block Inj Plantar Digit (64455) |
— |
$945 |
— |
| N Block Lumbar/Thoracic (64520) |
— |
$955 |
— |
Nasal/Orogastric W/Tube Plmt (43752)
range across 3 matching MRF lines |
— |
$360–$1,600 |
— |
Needle Biopsy Lymph Nodes (38505)
range across 2 matching MRF lines |
— |
$5,920–$7,000 |
— |
| Nipple Exploration (19110) |
— |
$11,305 |
— |
| Nipple/areola reconstruction (19350) |
— |
$13,750 |
— |
| Njx Anes Trigeminal Nrv Any Div/Branch (64400) |
— |
$810 |
— |
| Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level (64493) |
— |
$2,400 |
— |
| Occipital Nerve Block (64405) |
— |
$1,000 |
— |
| Open biopsy/excision inguinofemoral nodes (38531) |
— |
$14,500 |
— |
| Open Treatment Bimalleolar Ankle Fracture (27814) |
— |
$27,500 |
— |
| Open Tx Distal Fibular Fracture Lat Malleolus (27792) |
— |
$26,360 |
— |
| Open Tx Distal Tibiofibular Joint Disruption (27829) |
— |
$26,360 |
— |
| Optx dstl radl i-artic fx/epiphysl sep 2 frag (25608) |
— |
$28,500 |
— |
| Ostc prtl exostc/condylc metar head (28288) |
— |
$11,925 |
— |
| Parathyroidectomy or exploration of parathyroid(s); (60500) |
— |
$21,375 |
— |
| Part remv talus or calcaneus (28120) |
— |
$7,500 |
— |
| Partial removal of thyroid (60220) |
— |
$22,860 |
— |
| Partial thyroid excision (60212) |
— |
$19,055 |
— |
| Partial thyroid lobectomy, unilateral; with or without isthmusectomy (60210) |
— |
$18,540 |
— |
| Partical Excision Bone Phalanx Toe (28124) |
— |
$17,065 |
— |
| Penile Injection (54235) |
— |
$1,235 |
— |
| Penile Plethysmography (54240) |
— |
$980 |
— |
| Peri-Implant Capsulectomy Breast Complete (19371) |
— |
$13,845 |
— |
| Pericardiocentesis W/Imaging (33016) |
— |
$4,575 |
— |
Peritoneal Lavage (49084)
range across 2 matching MRF lines |
— |
$3,200–$3,605 |
— |
| Perq dev breast 1st us imag (19285) |
— |
$1,935 |
— |
| Perq sft tiss loc device plmt 1st les w/gdnce (10035) |
— |
$2,245 |
— |
| Placement of needle for intraosseous infusion (36680) |
— |
$1,200 |
— |
| Prtl exc b1 tarsal/metar b1 xcp talus/calcaneus (28122) |
— |
$11,925 |
— |
Punch biopsy skin single lesion (11104)
range across 3 matching MRF lines |
— |
$1,400–$1,600 |
— |
Puncture aspiration abscess hematoma bulla/cyst (10160)
range across 2 matching MRF lines |
— |
$515–$1,492 |
— |
Puncture Aspiration Cyst Breast (19000)
range across 2 matching MRF lines |
— |
$1,055–$7,500 |
— |
| 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 Facility (21936) |
— |
$10,850 |
— |
| Release foot/toe nerve (64726) |
— |
$7,440 |
— |
| Removal Embedded Foreign Body Eyelid (67938) |
— |
$1,285 |
— |
| 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 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 breast implant (19328) |
— |
$13,845 |
— |
| Removal of anal fissure (46200) |
— |
$11,000 |
— |
| Removal of foreign body from pharynx (42809) |
— |
$1,200 |
— |
| Removal of mammary implant material (19330) |
— |
$12,900 |
— |
| Removal of nail bed (11750) |
— |
$1,025 |
— |
| Removal of sperm cord lesion (55520) |
— |
$12,875 |
— |
| Removal or bivalving full arm or full leg cast (29705) |
— |
$45 |
— |
| Removal shoulder foreign body deep subfascial/im (23333) |
— |
$8,125 |
— |
Removal skn tags mlt fibrq tags any area upw/15 (11200)
range across 2 matching MRF lines |
— |
$515–$750 |
— |
| Removal subcutaneous cardiac rhythm monitor (33286) |
— |
$2,900 |
— |
| Removal sweat gland lesion (11450) |
— |
$10,850 |
— |
| Removal/bivalving gauntlet boot/body cast (29700) |
— |
$775 |
— |
| Remove elbow lesion (24120) |
— |
$12,500 |
— |
| Remove foreign body from eye (65205) |
— |
$670 |
— |
| Remove Nasal Foreign Body (30300) |
— |
$670 |
— |
| Remove Shoulder Foreign Body (23330) |
— |
$4,500 |
— |
| 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)
range across 2 matching MRF lines |
— |
$895–$2,400 |
— |
| Repair complex scalp/arm/leg 1.1-2.5 cm (13120) |
— |
$1,795 |
— |
Repair complex scalp/arm/leg 2.6-7.5 cm (13121)
range across 2 matching MRF lines |
— |
$895–$2,325 |
— |
| Repair complex trunk 1.1-2.5 cm (13100) |
— |
$1,795 |
— |
Repair complex trunk 2.6-7.5 cm (13101)
range across 2 matching MRF lines |
— |
$1,850–$3,415 |
— |
| Repair extensor tendon finger w/o graft each (26418) |
— |
$7,375 |
— |
| 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 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 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)
range across 2 matching MRF lines |
— |
$680–$1,395 |
— |
| Repair of nail bed (11760) |
— |
$275 |
— |
| Repair recurrent inguinal hernia, any age; incarcerated or strangulated (49521) |
— |
$14,175 |
— |
| Repair Tendon/Muscle Upper Arm/Elbow Ea (24341) |
— |
$26,500 |
— |
| Repair tongue laceration (41252) |
— |
$2,135 |
— |
| Repair tongue laceration (41250) |
— |
$890 |
— |
| Repair, tendon or muscle, extensor, forearm and/or wrist; secondary, single, each tendon or muscle Facility (25272) |
— |
$11,925 |
— |
| Repair, tendon or muscle, flexor, forearm and/or wrist; secondary, single, each tendon or muscle Facility (25263) |
— |
$26,458.52 |
— |
| Repair/Revise Wrist Joint (25320) |
— |
$26,450 |
— |
| Replace g/c tube perc (49450) |
— |
$3,405 |
— |
| Replacement Tissue Expander W/Permanent Implant (11970) |
— |
$26,355 |
— |
| Rerepair ing hernia reduce (49520) |
— |
$14,175 |
— |
| Revise Hand/Foot Nerve (64704) |
— |
$7,500 |
— |
| 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 fb xtrnl eye embed scjncl/scleral nonperfor (65210) |
— |
$1,200 |
— |
| Rmvl foreign body pelvis/hip subcutaneous tiss (27086) |
— |
$3,840 |
— |
| Rmvl Foreign Body Upper Arm/Elbow Subcutaneous (24200) |
— |
$4,650 |
— |
Rmvl tun ctr vad w/subq port/pmp ctr/prph insj (36590)
range across 2 matching MRF lines |
— |
$3,890–$5,115 |
— |
Rplc Gtube No Revj Trc (43762)
range across 2 matching MRF lines |
— |
$700–$835 |
— |
| 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 Cm Reducible (49591) |
— |
$14,175 |
— |
| Rpr Aa Hernia 1st > 10 Cm Reducible (49595) |
— |
$14,490 |
— |
| Rpr Aa Hernia Recr < 3 Cm Ncrc8/Strangulated (49614) |
— |
$20,850 |
— |
| Rpr Aa Hernia Recr < 3 Cm Reducible (49613) |
— |
$13,200 |
— |
| Rpr aa hrn 1st 3-10 rdc (49593) |
— |
$14,500 |
— |
| Rpr aa hrn 1st < 3 ncr/strn (49592) |
— |
$21,000 |
— |
| Rpr blood vessel direct lower extremity (35226) |
— |
$4,265 |
— |
| Rpr F/E/E/N/L/M 7.6-12.5 Cm (12015) |
— |
$725 |
— |
| 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/advmnt flxr tdn zone 2 w/o fr grft ea tendon (26356) |
— |
$12,975 |
— |
| Rpr/advmnt tdn w/ntc supfcis tdn prim ea tdn (26370) |
— |
$12,975 |
— |
| 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 |
— |
| Shoulder Arthroscopy/Surgery (29825) |
— |
$18,390 |
— |
| Sigmoidoscopy Flx Ablation Tumor Polyp/Oth Les (45346) |
— |
$4,330 |
— |
| Sigmoidoscopy Flx With With Band Ligation(S) (45350) |
— |
$4,500 |
— |
| Sigmoidoscopy, flexible; with biopsy, single or 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 >30.0 Cm (12018) |
— |
$575 |
— |
Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001)
range across 2 matching MRF lines |
— |
$615–$1,610 |
— |
| 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 Full Grft Face/Genit/Hf (15240) |
— |
$7,000 |
— |
| Small bowel endoscopy (44366) |
— |
$7,105 |
— |
| 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 |
— |
| Split Agrft F/S/N/H/F/G/M/D Gt 1st 100 Cm/</1 % (15120) |
— |
$14,935 |
— |
| Split Agrft T/a/L 1st 100 Cm/&/1% Bdy Inft/Chld (15100) |
— |
$7,210 |
— |
| Strapping ankle (29540) |
— |
$435 |
— |
Strapping elbow or wrist (29260)
range across 2 matching MRF lines |
— |
$170–$255 |
— |
Strapping hand/finger (29280)
range across 2 matching MRF lines |
— |
$170–$255 |
— |
| Strapping Hip (29520) |
— |
$450 |
— |
| Strapping knee (29530) |
— |
$255 |
— |
Strapping shoulder (29240)
range across 2 matching MRF lines |
— |
$170–$410 |
— |
Strapping thorax (29200)
range across 2 matching MRF lines |
— |
$170–$450 |
— |
| Strapping toes (29550) |
— |
$255 |
— |
Strapping Unna Boot (29580)
range across 2 matching MRF lines |
— |
$410–$450 |
— |
| Suction assisted lipectomy; trunk (15877) |
— |
$14,935 |
— |
| Suture digital nerve hand/foot 1 nerve (64831) |
— |
$7,800 |
— |
| Thrombolytic Therapy Stroke (37195) |
— |
$1,200 |
— |
Thyroid biopsy (60100)
range across 2 matching MRF lines |
— |
$2,320–$2,575 |
— |
| Thyroidectomy Post Prev Thyr Surg (60260) |
— |
$21,500 |
— |
| Thyroidectomy, total or complete (60240) |
— |
$22,535 |
— |
| Thyroidectomy, total or subtotal for malignancy; with limited neck dissection (60252) |
— |
$21,375 |
— |
| Tissue Expander Placement Breast Reconstruction (19357) |
— |
$67,405 |
— |
| Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy Facility (60225) |
— |
$22,860 |
— |
| Tracheostomy Emergency Cricothyroid Membrane (31605) |
— |
$750 |
— |
| Tracheostomy Emergency Procedure Transtracheal (31603) |
— |
$3,120 |
— |
| Transection/Avulsion Oth Spinal Nrv Xdrl (64772) |
— |
$7,725 |
— |
| Treat humerus fracture (24500) |
— |
$710 |
— |
| Treat Humerus Fracture (24505) |
— |
$6,000 |
— |
| Treat humerus fracture (23600) |
— |
$675 |
— |
| Treat Knuckle Dislocation (26700) |
— |
$4,600 |
— |
| Treat Metatarsal Fracture (28475) |
— |
$650 |
— |
| Treat Thumb Dislocation (26641) |
— |
$710 |
— |
| Treat toe dislocation (28630) |
— |
$650 |
— |
| Treatment Closed Elbow Dislocation Req Anes (24605) |
— |
$5,115 |
— |
| Treatment closed elbow dislocation w/o anes (24600) |
— |
$710 |
— |
| Tx Gastro Intub W/Asp (43753) |
— |
$360 |
— |
| Tx Spon Hip Dislc Abdct Splnt/Trcj W/Manj Anes (27257) |
— |
$6,000 |
— |
| Unlisted laparoscopy procedure, abdomen, peritoneum and omentum (49329) |
— |
$22,825 |
— |
| Unlisted laparoscopy procedure, esophagus (43289) |
— |
$22,535 |
— |
| Unlisted laparoscopy procedure, intestine (except rectum) (44238) |
— |
$21,300 |
— |
| Unlisted procedure anus (46999) |
— |
$3,605 |
— |
| Unlisted procedure breast (19499) |
— |
$13,290 |
— |
Unlisted Procedure Casting/Strapping (29799)
range across 2 matching MRF lines |
— |
$170–$410 |
— |
| Unlisted Procedure External Ear (69399) |
— |
$775 |
— |
| Unlisted procedure nervous system (64999) |
— |
$310 |
— |
| Vaginal delivery only (59409) |
— |
$9,000 |
— |
| Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) Facility (57107) |
— |
$11,925 |
— |
| Vasc Embolize/Occlude Bleed (37244) |
— |
$32,000 |
— |
| Vein Access Cutdown < 1 Yr (36420) |
— |
$450 |
— |
| Venous Cutdown >1 Y/O (36425) |
— |
$1,100 |
— |
| Vulvectomy simple partial (56620) |
— |
$11,925 |
— |
| Wedge excision skin nail fold (11765) |
— |
$735 |
— |
| Wound Prep F/N/Hf/G (15004) |
— |
$2,500 |
— |
| Wound Prep Trk/Arm/Leg (15002) |
— |
$7,316 |
— |