| Abd paracentesis w/imaging (49083) |
— |
$2,819 |
— |
| Abdom Paracentesis Dx/Ther W/O Imaging Guidance (49082) |
— |
$2,819 |
— |
| Abdomen Surgery Procedure (22999) |
— |
$877 |
— |
| Ablation Bone Tumor Rf Perq W/Img Gdn When Done (20982) |
— |
$33,155 |
— |
| Ablation ire prst8 1 or more tumors percutaneous (55877) |
— |
$39,000 |
— |
| Ablatj Bone Tumor Cryo Perq W/Img Gdn When Prfmd (20983) |
— |
$23,100 |
— |
| Abltj Soft Tis Inferior Turbinates Uni/Bi Supfc (30801) |
— |
$4,148 |
— |
| Adding Walker Previously Applied Cast (29440) |
— |
$499 |
— |
| Adjacent Tissue Transfer/Reargmt Trunk 10 Sqcm/< (14000) |
— |
$5,702 |
— |
| Adjnt tis transfr/rearrange trunk 10.1-30.0 sqcm (14001) |
— |
$5,702 |
— |
| Adjnt tis trnsfr/reargmt any area 30.1-60 sq cm (14301) |
— |
$10,003 |
— |
| Adjt Tis Reargmt Eye/Nose/Ear/Lip 10.1-30.0 Sqcm (14061) |
— |
$5,702 |
— |
Adjt tis trns/reargmt f/c/c/m/n/a/g/h/f 10sqcm/< (14040) range across 2 matching MRF lines |
— |
$5,895–$6,485 |
— |
| Adjt Tis Trnsfr/Reargmt Scalp/Arm/Leg 10 Sq Cm/< (14020) |
— |
$6,126 |
— |
| Adjt/Reargmt F/C/C/M/N/Ax/G/H/F 10.1-30.0 Sq Cm (14041) |
— |
$6,126 |
— |
| Adjt/Rearrgmt Scalp/Arm/Leg 10.1-30.0 Sq Cm (14021) |
— |
$6,126 |
— |
| Amniocentesis diagnostic (59000) |
— |
$3,495 |
— |
| Amniocentesis therapeutic (59001) |
— |
$2,660 |
— |
| Amp F/Th 1/2 Jt/Phalanx W/Neurect Local Flap (26952) |
— |
$8,154 |
— |
| Amp F/Th 1/2 Jt/Phalanx W/Neurect W/Dir Clsr (26951) |
— |
$8,154 |
— |
| Amputation toe interphalangeal joint (28825) |
— |
$11,330 |
— |
| Amputation toe metatarsophalangeal joint (28820) |
— |
$9,738 |
— |
| Anoscopy W/Rmvl Foreign Body (46608) |
— |
$2,666 |
— |
Apheresis Platelets (36513) range across 3 matching MRF lines |
— |
$3,960–$5,940 |
— |
Appl Clubfoot Cast Molding/Manj Long/Short Leg (29450) range across 2 matching MRF lines |
— |
$454–$499 |
— |
Appl Hip Spica Cast One&One-Half Spica/Both Legs (29325) range across 2 matching MRF lines |
— |
$892–$981 |
— |
Application cast elbow finger short arm (29075) range across 2 matching MRF lines |
— |
$948–$1,043 |
— |
| Application Cast Finger (29086) |
— |
$499 |
— |
| Application Cast Shoulder Spica (29055) |
— |
$882 |
— |
Application Finger Splint Dynamic (29131) range across 2 matching MRF lines |
— |
$296–$326 |
— |
| Application finger splint static (29130) |
— |
$322 |
— |
| Application Hip Spica Cast 1 Leg (29305) |
— |
$1,054 |
— |
Application long arm splint shoulder hand (29105) range across 3 matching MRF lines |
— |
$509–$560 |
— |
| Application Long Leg Cast Brace (29358) |
— |
$882 |
— |
| Application Long Leg Cast Walker/Ambulatory Type (29355) |
— |
$882 |
— |
Application Long Leg Splint (29505) range across 3 matching MRF lines |
— |
$478–$526 |
— |
| Application of cylinder cast (thigh to ankle) (29365) |
— |
$882 |
— |
| Application of long leg cast (29345) |
— |
$882 |
— |
| Application of rigid total contact leg cast (29445) |
— |
$1,177 |
— |
| Application Patellar Tendon Bearing Cast (29435) |
— |
$882 |
— |
| Application Short Arm Splint Dynamic (29126) |
— |
$448 |
— |
Application short arm splint forearm-hand static (29125) range across 2 matching MRF lines |
— |
$478–$526 |
— |
| Application short leg splint calf foot (29515) |
— |
$526 |
— |
| Application uniplane external fixation system (20690) |
— |
$18,022 |
— |
| Application, cast; figure-of-eight Facility (29049) |
— |
$882 |
— |
Apply hand/wrist cast (29085) range across 2 matching MRF lines |
— |
$454–$499 |
— |
Apply long arm cast (29065) range across 2 matching MRF lines |
— |
$674–$741 |
— |
| Apply Multlay Comprs Lwr Leg (29581) |
— |
$499 |
— |
| Apply Short Leg Cast (29405) |
— |
$882 |
— |
Apply short leg cast (29425) range across 2 matching MRF lines |
— |
$948–$1,043 |
— |
| Apply shoulder cast,plastr velpeau (29058) |
— |
$882 |
— |
Arterial puncture (36600) range across 2 matching MRF lines |
— |
$320–$352 |
— |
| Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) |
— |
$970 |
— |
| Arthrocentesis aspir&/inj interm jt/burs w/us (20606) |
— |
$2,860 |
— |
| Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) |
— |
$1,761 |
— |
| Arthrocentesis aspir&/inj major jt/bursa w/us (20611) |
— |
$1,761 |
— |
| Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) |
— |
$1,066 |
— |
| Arthroplasty interphalangeal joint each (26535) |
— |
$9,738 |
— |
| Arthrt expl drg/rmvl loose/fb iphal jt ea (26080) |
— |
$4,862 |
— |
| Arthrt expl drg/rmvl loose/fb mtcarphlngl jt ea (26075) |
— |
$9,738 |
— |
| Aspirate pleura w/ imaging (32555) |
— |
$2,732 |
— |
| Aspirate Pleura W/O Imaging (32554) |
— |
$2,732 |
— |
| Aspirate/Inj Ganglion Cyst (20612) |
— |
$1,066 |
— |
| Aspiration & Injection Treatment Bone Cyst (20615) |
— |
$2,310 |
— |
| Aspiration and/or injection thyroid cyst (60300) |
— |
$2,153 |
— |
| Aspiration bladder insert suprapubic catheter (51102) |
— |
$6,569 |
— |
| Aspiration Bladder Needle (51100) |
— |
$2,195 |
— |
| Avulsion nail plate partial/complete simple 1 (11730) |
— |
$850 |
— |
| Biliary Endo Prq T-Tube Dx W/Collect Spec Brush (47552) |
— |
$19,059 |
— |
| Biliary ndsc prq t-tube dilat strix w/stent (47556) |
— |
$25,931 |
— |
| Biliary ndsc prq t-tube w/dil duct w/o stent (47555) |
— |
$11,433 |
— |
| Biopsy Abdominal Mass (49180) |
— |
$6,883 |
— |
| Biopsy bone open superficial (20240) |
— |
$8,582 |
— |
| Biopsy bone trocar/needle deep (20225) |
— |
$4,939 |
— |
| Biopsy Bone Trocar/Needle Superficial (20220) |
— |
$4,939 |
— |
| Biopsy muscle percutaneous needle (20206) |
— |
$4,084 |
— |
| Biopsy of breast; open, incisional (19101) |
— |
$9,983 |
— |
| Biopsy of liver, needle; percutaneous (47000) |
— |
$6,883 |
— |
| Biopsy of penis (54100) |
— |
$6,128 |
— |
| Biopsy Oropharynx (42800) |
— |
$3,842 |
— |
| Biopsy Pleura Percutaneous Needle (32400) |
— |
$4,939 |
— |
| Biopsy Prostate Transrectal Ultrasound-Guided (55707) |
— |
$13,200 |
— |
| Biopsy Salivary Gland Needle (42400) |
— |
$2,356 |
— |
| Biopsy Soft Tissue Back/Flank Superficial (21920) |
— |
$4,939 |
— |
| Biopsy soft tissue forearm&/wrist superficial (25065) |
— |
$6,600 |
— |
| Biopsy soft tissue leg/ankle area superficial (27613) |
— |
$6,600 |
— |
| Biopsy soft tissue neck/thorax (21550) |
— |
$4,939 |
— |
| Biopsy Soft Tissue Pelvis&Hip Area Superficial (27040) |
— |
$4,939 |
— |
| Biopsy soft tissue pelvis&hip deep/subfscal/im (27041) |
— |
$4,939 |
— |
| Biopsy Soft Tissue Shoulder Deep (23066) |
— |
$11,220 |
— |
| Biopsy Soft Tissue Shoulder Superficial (23065) |
— |
$5,720 |
— |
| Biopsy soft tissue thigh/knee area superficial (27323) |
— |
$4,939 |
— |
| Biopsy Vulva/Perineum 1 Lesion Spx (56605) |
— |
$2,805 |
— |
| Biopsy/removal lymph nodes (38510) |
— |
$12,100 |
— |
| Bladder Irrigation (51700) |
— |
$862 |
— |
| Bladder Scan (51798) |
— |
$366 |
— |
| Blepharoplasty Lower Eyelid (15820) |
— |
$5,702 |
— |
| Blepharotomy drainage abscess eyelid (67700) |
— |
$1,073 |
— |
| Blood Transfusion Service (36430) |
— |
$3,700 |
— |
Bone Marrow Biopsy (38221) range across 2 matching MRF lines |
— |
$4,084–$5,488 |
— |
Bone Marrow; Aspiration Only (38220) range across 3 matching MRF lines |
— |
$4,084–$5,488 |
— |
| Brnchsc Brushing/Protected Brushings (31623) |
— |
$5,071 |
— |
| Bronchoscopy W/Biopsy(S) (31625) |
— |
$5,071 |
— |
| Bx breast 1st lesion mr imag (19085) |
— |
$5,002 |
— |
| Bx breast 1st lesion strtctc (19081) |
— |
$5,002 |
— |
| Bx breast 1st lesion us imag (19083) |
— |
$5,002 |
— |
| Bx breast needle core w/o imaging guidance spx (19100) |
— |
$4,939 |
— |
| Bx Cervix (57500) |
— |
$2,660 |
— |
| Bx prostate in-bore CT/MRI trgt les only 1st (55714) |
— |
$20,079 |
— |
| Bx prostate strtctc saturation sampling img gid (55706) |
— |
$12,100 |
— |
| Bx prostate tprnl MRI-us gid trgt les 1st (55712) |
— |
$13,200 |
— |
| Bx prostate transperineal ultrasound-guided (55709) |
— |
$13,200 |
— |
| Bx prostate transrectal MRI-us gid trgt les 1st (55711) |
— |
$13,200 |
— |
| Bx prst8 in-bore CT/MRI bx 1 (55713) |
— |
$20,079 |
— |
| Bx prst8 tprn us w/MRI fus 1 (55710) |
— |
$13,200 |
— |
| Bx prst8 trct us w/MRI fus 1 (55708) |
— |
$13,200 |
— |
| Canthoplasty (67950) |
— |
$6,796 |
— |
| Canthotomy Separate Procedure (67715) |
— |
$7,556 |
— |
| Capsulotomy Iphal Joint Each Joint Spx (28272) |
— |
$6,073 |
— |
| Carpal Tunnel Surgery (64721) |
— |
$6,820 |
— |
| Cerclage cervix pregnancy vaginal (59320) |
— |
$11,106 |
— |
Cessj Therapy Cath Removal (37214) range across 3 matching MRF lines |
— |
$12,075–$12,285 |
— |
| Change Cystostomy Tube Complicated (51710) |
— |
$2,195 |
— |
| Change Cystostomy Tube Simple (51705) |
— |
$862 |
— |
Change of Windpipe Airway (31502) range across 2 matching MRF lines |
— |
$806–$887 |
— |
| Change ureter stent percut (50382) |
— |
$7,593 |
— |
| Chemical Cautery Tissue (17250) |
— |
$624 |
— |
| Chemodenerv 1 extrem 5/> mus (64644) |
— |
$3,850 |
— |
| Chemodenerv 1 extremity 1-4 (64642) |
— |
$3,850 |
— |
| Chemodenerv Eccrine Glands (64650) |
— |
$923 |
— |
Chemodenerv Musc Migraine (64615) range across 2 matching MRF lines |
— |
$1,320–$1,658 |
— |
Chemodenerv musc neck dyston (64616) range across 2 matching MRF lines |
— |
$1,059–$2,119 |
— |
| Chemodenerv Parotid&Submandibl Salivary Glnds (64611) |
— |
$923 |
— |
| Chemodenerv trunk musc 1-5 (64646) |
— |
$3,850 |
— |
| Chemodenerv trunk musc 6/> (64647) |
— |
$3,850 |
— |
| Chemodenervation Muscle Larynx Unilat W/Emg (64617) |
— |
$2,119 |
— |
| Chemodnrvtj Musc Musc Innervated Facial Nrv Unil (64612) |
— |
$923 |
— |
| Chest tube placement (32551) |
— |
$4,035 |
— |
| Chng Urtrost Tube/Xtrnlly Accessible Stent Ileal (50688) |
— |
$6,569 |
— |
| Cholecystostomy Prq W/Imaging & Catheter Plmt (47490) |
— |
$12,682 |
— |
| Chorionic Villus Sampling (59015) |
— |
$2,025 |
— |
Circumcision w/clamp/oth dev w/block (54150) range across 2 matching MRF lines |
— |
$4,665–$5,132 |
— |
| Cl Tx Scapular Fx; W Manip (23575) |
— |
$4,049 |
— |
| Cl Tx Tib Shft Fx W Manip (27752) |
— |
$5,536 |
— |
| Clear outer ear canal (69200) |
— |
$399 |
— |
| Closed rx talotarsal disloc,anesth (28575) |
— |
$9,738 |
— |
| Closed Treat Vert Body Fract (22310) |
— |
$799 |
— |
| Closed Treatment Of Distal Radioulnar Dislocation With Manipulation (25675) |
— |
$799 |
— |
| Closed treatment of posterior malleolus fracture; with manipulation (27768) |
— |
$4,862 |
— |
| Closed treatment of ulnar shaft fracture; with manipulation (25535) |
— |
$799 |
— |
| Closed Treatment Sesamoid Fracture (28530) |
— |
$799 |
— |
| Closed Treatment Sternum Fracture (21820) |
— |
$799 |
— |
| Closed Treatment Ulnar Styloid Fracture (25650) |
— |
$799 |
— |
| Closed tx ankle dislocation w/o anesthesia (27840) |
— |
$799 |
— |
| Closed Tx Bimalleolar Ankle Fracture W Manip (27810) |
— |
$4,049 |
— |
| Closed Tx Bimalleolar Ankle Fracture W/O Manip (27808) |
— |
$799 |
— |
| Closed Tx Calcaneal Fracture W/Manipulation (28405) |
— |
$799 |
— |
| Closed Tx Calcaneal Fracture W/O Manipulation (28400) |
— |
$799 |
— |
| Closed tx carpal scaphoid fracture w/manj (25624) |
— |
$4,862 |
— |
| Closed Tx Carpal Scaphoid Fracture W/O Manj (25622) |
— |
$799 |
— |
| Closed tx femoral fracture prox head w/o manj (27267) |
— |
$9,738 |
— |
| Closed Tx Femoral Shaft Fx W/O Manipulation (27500) |
— |
$1,472 |
— |
| Closed Tx Knee Dislocation W/Anesthesia (27552) |
— |
$4,862 |
— |
| Closed tx knee dislocation w/o anesthesia (27550) |
— |
$799 |
— |
| Closed Tx Lunate Dislocation W/Manipulation (25690) |
— |
$5,536 |
— |
| Closed Tx Mandibular Fracture W/O Manipulation (21450) |
— |
$1,768 |
— |
| Closed Tx Mandibular Fx W/Interdental Fixation (21453) |
— |
$16,499 |
— |
Closed tx metatarsal fracture w/o manipulation (28470) range across 2 matching MRF lines |
— |
$726–$799 |
— |
| Closed Tx Monteggia Fx Dislocation Elbow W/Manj (24620) |
— |
$5,536 |
— |
| Closed Tx Nasal Bone Fx W/Mnpj W/O Stabilization (21315) |
— |
$6,391 |
— |
| Closed Tx Nasal Bone Fx W/Mnpj W/Stabilization (21320) |
— |
$8,110 |
— |
| Closed Tx Palatal/Maxillary Fx W/Fixation/Splint (21421) |
— |
$8,681 |
— |
| Closed tx patellar dislocation w/anesthesia (27562) |
— |
$3,317 |
— |
| Closed tx patellar dislocation w/o anesthesia (27560) |
— |
$799 |
— |
| Closed Tx Patellar Fracture W/O Manipulation (27520) |
— |
$799 |
— |
| Closed tx radial head/neck fx w/manipulation (24655) |
— |
$4,049 |
— |
| Closed tx radial head/neck fx w/o manipulation (24650) |
— |
$799 |
— |
| Closed tx radial shaft fracture w/manipulation (25505) |
— |
$4,049 |
— |
| Closed Tx Radial Shaft Fracture W/O Manipulation (25500) |
— |
$799 |
— |
| Closed Tx Radial&Ulnar Shaft Fractures W/Manj (25565) |
— |
$4,049 |
— |
Closed tx radial&ulnar shaft fractures w/o man (25560) range across 2 matching MRF lines |
— |
$726–$799 |
— |
| Closed Tx Scapular Fracture W/O Manipulation (23570) |
— |
$799 |
— |
| Closed tx septal&nose fx (21337) |
— |
$8,681 |
— |
| Closed tx talotarsal joint dislc w/o anes (28570) |
— |
$799 |
— |
| Closed Tx Talus Fracture W/Manipulation (28435) |
— |
$4,862 |
— |
| Closed tx talus fracture w/o manipulation (28430) |
— |
$799 |
— |
| Closed Tx Tarsometatarsal Dislocation W/Anes (28605) |
— |
$799 |
— |
| Closed tx tarsometatarsal dislocation w/o anes (28600) |
— |
$799 |
— |
| Closed tx temporomandibular dislc comp 1st/sbsq (21485) |
— |
$4,148 |
— |
| Closed tx temporomandibular dislocation 1st/sbsq (21480) |
— |
$799 |
— |
| Closed Tx Ulnar Fracture Prox End W Manipulation (24675) |
— |
$4,049 |
— |
| Closed Tx Ulnar Fracture Prox End W/O Manipulate (24670) |
— |
$799 |
— |
| Closed tx ulnar shaft fracture w/o manipulation (25530) |
— |
$799 |
— |
| Closure Laceration Vestibule Mouth 2.5 Cm/< (40830) |
— |
$707 |
— |
| Closure Laceration Vestibule Mouth > 2.5 Cm/Cpl (40831) |
— |
$1,894 |
— |
| Clsd tx acromioclavicular dislc w/manipulation (23545) |
— |
$799 |
— |
| Clsd Tx Acromioclavicular Dislc W/O Manipulation (23540) |
— |
$799 |
— |
| Clsd Tx Clavicular Fracture W/Manipulation (23505) |
— |
$5,536 |
— |
Clsd tx clavicular fracture w/o manipulation (23500) range across 2 matching MRF lines |
— |
$726–$799 |
— |
| Clsd tx fx orbit except blowout w/o manipulation (21400) |
— |
$3,513 |
— |
| Clsd tx shoulder dislc w/manipulation req anes (23655) |
— |
$5,787 |
— |
| Clsd tx shoulder dislc w/manipulation w/o anes (23650) |
— |
$799 |
— |
| Cltx Acetabulum Hip/Sockt Fx W/O Manj (27220) |
— |
$799 |
— |
| Cltx ankle dislc req anes w/wo prq skel fixj (27842) |
— |
$4,862 |
— |
| Cltx artclr fx invg mtcarphlngl/iphal jt w/manj (26742) |
— |
$4,049 |
— |
| Cltx Artclr Fx Invg Mtcrphlngl/Iphal Jt W/O Manj (26740) |
— |
$799 |
— |
| Cltx Carpal Bone Fx W/Manj Each Bone (25635) |
— |
$4,862 |
— |
| Cltx Carpal Bone Fx W/O Manj Each Bone (25630) |
— |
$799 |
— |
| Cltx carpo/metacarpl dislc thmb manj ea w/o anes (26670) |
— |
$799 |
— |
| Cltx Distal Femoral Epiphysl Separation W/O Manj (27516) |
— |
$799 |
— |
| Cltx dstl fibular fx lat malls w/manj (27788) |
— |
$799 |
— |
Cltx dstl fibular fx lat malls w/o manj (27786) range across 2 matching MRF lines |
— |
$726–$799 |
— |
| Cltx dstl phlngl fx fngr/thmb w/manj ea (26755) |
— |
$799 |
— |
| Cltx Dstl Phlngl Fx Fngr/Thmb W/O Manj Ea (26750) |
— |
$935 |
— |
Cltx dstl radial fx/epiphysl sep w/o manj (25600) range across 2 matching MRF lines |
— |
$726–$799 |
— |
| Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) |
— |
$5,280 |
— |
| Cltx dstl xtnsr tdn insj w/wo percutan pinning (26432) |
— |
$5,720 |
— |
| Cltx Fem Fx Dstl End Medial/Lat Condyle W/Manj (27510) |
— |
$4,862 |
— |
| Cltx fem fx dstl end medial/lat condyle w/o manj (27508) |
— |
$799 |
— |
| Cltx Fem Fx Prox End Nck W/O Manj (27230) |
— |
$799 |
— |
| Cltx fem shft fx w/manj w/wo skin/skeletal tracj (27502) |
— |
$4,862 |
— |
| Cltx fx grt toe phlx/phlg w/manj (28495) |
— |
$799 |
— |
| Cltx fx grt toe phlx/phlg w/o manj (28490) |
— |
$594 |
— |
| Cltx fx phlx/phlg oth/thn grt toe w/manj (28515) |
— |
$799 |
— |
| Cltx fx phlx/phlg oth/thn grt toe w/o manj (28510) |
— |
$799 |
— |
| Cltx fx w8 brg artclr prtn dstl tib w/skel tracj (27825) |
— |
$5,536 |
— |
| Cltx fx w8 brg artclr prtn dstl tibia w/o manj (27824) |
— |
$799 |
— |
| Cltx greater humeral tuberosity fx w/o manj (23620) |
— |
$799 |
— |
| Cltx Greater Trochanteric Fx W/O Manj (27246) |
— |
$799 |
— |
| Cltx Grter Humeral Tuberosity Fx W/Manipulation (23625) |
— |
$4,862 |
— |
| Cltx hip dislocation traumatic req anesthesia (27252) |
— |
$5,728 |
— |
| Cltx hip dislocation traumatic w/o anesthesia (27250) |
— |
$799 |
— |
| Cltx Humeral Condylar Fx Medial/Lat W/O Manj (24576) |
— |
$799 |
— |
| Cltx humeral condylar fx medial/lateral w/manj (24577) |
— |
$4,049 |
— |
| Cltx Humeral Epicondylar Fx Medial/Lat W/Manj (24565) |
— |
$4,049 |
— |
| Cltx Humeral Epicondylar Fx Medial/Lat W/O Manj (24560) |
— |
$799 |
— |
| Cltx inter/peri/subtrochanteric fem fx w/o manj (27238) |
— |
$4,862 |
— |
| Cltx Interphalangeal Joint Dislocation Req Anes (28665) |
— |
$3,427 |
— |
| Cltx Interphalangeal Joint Dislocation W/O Anes (28660) |
— |
$799 |
— |
| Cltx Iphal Jt Dislc W/Manj Req Anes (26775) |
— |
$3,647 |
— |
| Cltx iphal jt dislc w/manj w/o anes (26770) |
— |
$799 |
— |
| Cltx Med Ankle Fx W/Mnpj (27762) |
— |
$4,862 |
— |
| Cltx Medial Ankle Fx (27760) |
— |
$799 |
— |
| Cltx metacarpal fx w/manipulation each bone (26605) |
— |
$799 |
— |
Cltx metacarpal fx w/o manipulation each bone (26600) range across 2 matching MRF lines |
— |
$726–$799 |
— |
| Cltx metacarpophalangeal dislc w/manj w/anes (26705) |
— |
$4,049 |
— |
| Cltx Metatarsophlngl Jt Dislc Req Anes (28635) |
— |
$4,862 |
— |
| Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) |
— |
$799 |
— |
| Cltx phlngl fx prox/middle px/f/t w/o manj ea (26720) |
— |
$799 |
— |
| Cltx post hip arthrp dislc req anes (27266) |
— |
$6,214 |
— |
| Cltx post hip arthrp dislc w/o anes (27265) |
— |
$799 |
— |
| Cltx prox fibula/shft fx w/manj (27781) |
— |
$4,862 |
— |
| Cltx prox fibula/shft fx w/o manj (27780) |
— |
$799 |
— |
| Cltx prox humrl fx w/manj w/wo skeletal tracj (23605) |
— |
$5,536 |
— |
| Cltx prox tibfib jt dislc req anes (27831) |
— |
$9,738 |
— |
| Cltx prox tibfib jt dislc w/o anes (27830) |
— |
$799 |
— |
| Cltx Rdcrpl/Intercarpl Dislc 1/> Bones W/Manj (25660) |
— |
$799 |
— |
| Cltx rdl head sublxtj chld nursemaid elbw w/manj (24640) |
— |
$799 |
— |
| Cltx Rdl Shft Fx&Cltx Dislc Dstl Rad/Uln Jt (25520) |
— |
$4,862 |
— |
| Cltx shoulder dislc w/fx humeral tubrst w/manj (23665) |
— |
$4,049 |
— |
| Cltx Shoulder Dislc W/Surg/Antmcl Neck Fx W/Manj (23675) |
— |
$4,049 |
— |
| Cltx sprcndylr/transcndylr humeral fx w/manj (24535) |
— |
$4,049 |
— |
Cltx Sprcndylr/Transcndylr Humeral Fx W/WO Manj (24530) range across 2 matching MRF lines |
— |
$726–$799 |
— |
| Cltx Sprcndylr/Trnscndylr Fem Fx W/O Manj (27501) |
— |
$799 |
— |
| Cltx Tarsal Dislc Oth/Thn Talotarsal W/Anes (28545) |
— |
$9,738 |
— |
| Cltx tarsal dislc oth/thn talotarsal w/o anes (28540) |
— |
$799 |
— |
| Cltx tibial fx proximal w/o manipulation (27530) |
— |
$799 |
— |
Cltx tibial shaft fx w/o manipulation (27750) range across 2 matching MRF lines |
— |
$726–$799 |
— |
| Cltx trimalleolar ankle fx w/manipulation (27818) |
— |
$4,049 |
— |
| Cltx trimalleolar ankle fx w/o manipulation (27816) |
— |
$799 |
— |
| Collect Blood From Catheter Venous Nos (36592) |
— |
$495 |
— |
| Collection of venous blood by venipuncture (36415) |
— |
$111 |
— |
| Colporrhaphy (57200) |
— |
$8,329 |
— |
| Colposc,Cervix W/Adj Vag,W/Bx & Curretag (57454) |
— |
$1,214 |
— |
| Colposcopy Cervix Endocervical Curettage (57456) |
— |
$1,214 |
— |
Colposcopy cervix upper/adjacent vagina (57452) range across 2 matching MRF lines |
— |
$608–$756 |
— |
| Colposcopy Cervix Uppr/Adjcnt Vagina W/Cervix Bx (57455) |
— |
$1,214 |
— |
| Colposcopy cervix vag eltrd conization cervix (57461) |
— |
$11,814 |
— |
| Colposcopy Cervix Vag Loop Eltrd Bx Cervix (57460) |
— |
$11,814 |
— |
| Colposcopy entire vagina w/cervix if present (57420) |
— |
$1,214 |
— |
| Colposcopy of vulva (56820) |
— |
$756 |
— |
| Colposcopy Vulva W/Biopsy (56821) |
— |
$1,214 |
— |
| Colposcopy,Entire Vagina,W/Biopsy(S) (57421) |
— |
$3,039 |
— |
| Complex drainage wound (10180) |
— |
$7,802 |
— |
| Composite Skin Graft (15760) |
— |
$5,702 |
— |
| Control Nasal Hemorrhage Anterior Complex (30903) |
— |
$431 |
— |
| Control Nasal Hemorrhage Anterior Simple (30901) |
— |
$436 |
— |
| Control oropharyngeal hemorrhage simple (42960) |
— |
$1,386 |
— |
| Conversion ext bil drg cath (47535) |
— |
$11,433 |
— |
| Convert gastrostomy-gastro-jejunostomy tube percutaneous (49446) |
— |
$5,332 |
— |
| Convert Nephrostomy Catheter (50434) |
— |
$14,269 |
— |
| Core Needle Bx Lung/Mediastinum Perq W/Img (32408) |
— |
$7,983 |
— |
| Csf shunt reprogram (62252) |
— |
$990 |
— |
| Ctrl Nasopharyngeal Hemrrg Smpl W/Pst Nsl Packs (42970) |
— |
$707 |
— |
| Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) |
— |
$431 |
— |
| Ctrl Nsl Hemrrg Pst Nasal Packs&/Cautery Subsq (30906) |
— |
$707 |
— |
| Ctrl Oropharyngeal Hemorrhage W/Sec Surg Ivntj (42962) |
— |
$8,681 |
— |
| Curettage postpartum (59160) |
— |
$11,106 |
— |
| Cysto Bladder W/Ureteral Catheterization (52005) |
— |
$7,593 |
— |
| Cysto calibration dilat urtl strix/stenosis (52281) |
— |
$7,696 |
— |
| Cysto w/ureteroscopy w/lithotripsy (52353) |
— |
$18,120 |
— |
| Cysto/uretero w/lithotripsy (52356) |
— |
$18,120 |
— |
| Cystotomy, with insertion of ureteral catheter or stent (separate procedure) Facility (51045) |
— |
$6,569 |
— |
| Cystotomy; for simple excision of vesical neck (separate procedure) Facility (51520) |
— |
$8,782 |
— |
| Cystourethroscopy (52000) |
— |
$2,195 |
— |
| Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus Facility (52330) |
— |
$12,485 |
— |
| Cystourethroscopy; with ureteral meatotomy, unilateral or bilateral Facility (52290) |
— |
$6,569 |
— |
| Dbrdmt extensv eczema/infect skn up 10% bdy surf (11000) |
— |
$1,810 |
— |
Dbrdmt Fx&/Dislc Subq T/M/F Bone (11012) range across 2 matching MRF lines |
— |
$6,507–$7,158 |
— |
| Dbrdmt w/rmvl fm fx&/dislc skin&subq tissus (11010) |
— |
$2,153 |
— |
| Dbrdmt W/Rmvl Fm Fx&/Dislc Skn Subq T/M/F Musc (11011) |
— |
$2,153 |
— |
Deb Musc/Fascia 20 Sq Cm/< (11043) range across 2 matching MRF lines |
— |
$1,645–$1,810 |
— |
| Debride nail 1-5 (11720) |
— |
$259 |
— |
Debride nail 6 or more (11721) range across 3 matching MRF lines |
— |
$285–$314 |
— |
| Debridement Bone Muscle &/Fascia 20 Sq Cm/< (11044) |
— |
$6,668 |
— |
Debridement subcutaneous tissue 20 sq cm/< (11042) range across 2 matching MRF lines |
— |
$1,434–$1,577 |
— |
Declot vascular device (36593) range across 2 matching MRF lines |
— |
$1,210–$1,331 |
— |
| Deep Muscle Biopsy (20205) |
— |
$8,582 |
— |
| Delivery of placenta (59414) |
— |
$5,500 |
— |
| Destr W Neurolytic; Celiac Plexus (64680) |
— |
$2,750 |
— |
| Destruct B9 Lesion 1-14 (17110) |
— |
$612 |
— |
| Destruction of lesion of cornea by cryotherapy, photocoagulation or thermocauterization (65450) |
— |
$1,165 |
— |
| Diagnostic sigmoidoscopy (45330) |
— |
$2,666 |
— |
| Dilat Xst Trc New Access Rcs (50437) |
— |
$8,782 |
— |
| Dilate Urethra Stricture (53620) |
— |
$3,658 |
— |
| Dilate Urethra Stricture (53600) |
— |
$862 |
— |
Drain Cerebro Spinal Fluid (62272) range across 3 matching MRF lines |
— |
$2,558–$2,814 |
— |
| Drain Hand Tendon Sheath (26020) |
— |
$9,738 |
— |
| Drain/inj small joint/bursa w/us (20604) |
— |
$923 |
— |
| Drainage Abscess/Hematoma Nasal Septum (30020) |
— |
$1,768 |
— |
| Drainage external auditory canal abscess (69020) |
— |
$1,772 |
— |
| Drainage external ear abscess/hematoma cmplx (69005) |
— |
$5,610 |
— |
| Drainage External Ear Abscess/Hematoma Simple (69000) |
— |
$1,772 |
— |
| Drainage Finger Abscess Complicated (26011) |
— |
$4,939 |
— |
| Drainage Mouth Roof Lesion (42000) |
— |
$707 |
— |
| Drainage of finger abscess simple (26010) |
— |
$691 |
— |
| Drainage of gum lesion (41800) |
— |
$691 |
— |
| Drainage of hematoma/fluid (10140) |
— |
$5,500 |
— |
| Drainage of hydrocele (55000) |
— |
$2,153 |
— |
| Drainage of mouth lesion (41017) |
— |
$8,681 |
— |
| Drainage of nose lesion (30000) |
— |
$977 |
— |
| Drainage of palmar bursa; multiple bursa Facility (26030) |
— |
$12,238 |
— |
| Drainage of perirenal or renal abscess, open Facility (50020) |
— |
$10,155 |
— |
| Drainage of rectal abscess (45020) |
— |
$9,240 |
— |
| Drainage of rectal abscess (45005) |
— |
$3,505 |
— |
| Drainage of scrotal wall abscess (55100) |
— |
$4,939 |
— |
| Drainage of scrotum (54700) |
— |
$6,569 |
— |
| Drainage of skene's gland abscess or cyst (53060) |
— |
$6,569 |
— |
| Draw Blood Off Venous Device (36591) |
— |
$322 |
— |
| Drg Absc Cst Hmtma Vestibule Mouth Comp (40801) |
— |
$1,944 |
— |
| Drg Absc Cst Hmtma Vestibule Mouth Smpl (40800) |
— |
$1,772 |
— |
| Drg privesical/prevesical space absc (51080) |
— |
$8,582 |
— |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq large (16030) |
— |
$1,004 |
— |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq medium (16025) |
— |
$612 |
— |
| Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) |
— |
$624 |
— |
| Dstrj Neurolytic Agent Other Peripheral Nerve (64640) |
— |
$3,300 |
— |
| Dx Bone Marrow Bx & Aspir (38222) |
— |
$14,376 |
— |
| Dx Bronchoscope/Lavage (31624) |
— |
$4,276 |
— |
| Dx Bronchoscope/Wash (31622) |
— |
$5,071 |
— |
| Dx gastr intub w/asp spec (43754) |
— |
$927 |
— |
Dx Laryngoscopy Excl Nb (31525) range across 3 matching MRF lines |
— |
$4,610–$5,071 |
— |
Dx lmbr spi pnxr w/fluor/CT (62328) range across 2 matching MRF lines |
— |
$2,541–$2,640 |
— |
| Egd cautery tumor polyp (43250) |
— |
$4,794 |
— |
| Egd Flexible Foreign Body Removal (43247) |
— |
$3,435 |
— |
| Egd place gastrostomy tube (43246) |
— |
$4,794 |
— |
| Endometrial Biopsy (58100) |
— |
$608 |
— |
| Endovasc Temp Balloon Occlus,Head/Nck (61623) |
— |
$39,600 |
— |
Epidural Blood Patch (62273) range across 5 matching MRF lines |
— |
$2,864–$3,466 |
— |
Episiotomy or vaginal repair (59300) range across 2 matching MRF lines |
— |
$7,572–$8,329 |
— |
| Esophagoscopy Flexible Transnasal Diagnostic (43197) |
— |
$2,795 |
— |
| Esophagoscopy Flexible Transoral Diagnostic (43200) |
— |
$2,310 |
— |
| Esophagoscopy, flexible, transoral; with removal of foreign body(s) (43215) |
— |
$5,332 |
— |
| Evacuation of subungual hematoma (11740) |
— |
$449 |
— |
| Exc arm/elbow les sc < 3 cm (24075) |
— |
$5,632 |
— |
| Exc b9 les mrgn xcp sk tg t/a/l 0.5 cm/< (11400) |
— |
$2,492 |
— |
| Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 2.1-3.0cm (11423) |
— |
$4,939 |
— |
| Exc back tum deep < 5 cm (21932) |
— |
$9,273 |
— |
| Exc Face-Mm B9+Marg 1.1-2 Cm (11442) |
— |
$2,153 |
— |
| Exc Face-Mm B9+Marg 2.1-3 Cm (11443) |
— |
$4,939 |
— |
| Exc H-F-Nk-Sp B9+Marg 0.5/< (11420) |
— |
$4,939 |
— |
| Exc H-F-Nk-Sp B9+Marg 0.6-1 (11421) |
— |
$2,475 |
— |
| Exc H-F-Nk-Sp B9+Marg 1.1-2 (11422) |
— |
$4,939 |
— |
| Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg (11403) |
— |
$2,153 |
— |
| Exc Skin Benig 3.1-4 Cm Remaindr Body (11424) |
— |
$5,630 |
— |
| Exc Skin Benig >4 Cm Remaindr Body (11426) |
— |
$9,515 |
— |
| Exc Skin Benig >4 Cm Trunk,Arm,Leg (11406) |
— |
$5,573 |
— |
| Exc Thrombosed Hemorrhoid Xtrnl (46320) |
— |
$7,052 |
— |
| Exc Tr-Ext B9+Marg 0.6-1 Cm (11401) |
— |
$1,168 |
— |
| Exc Tr-Ext B9+Marg 1.1-2 Cm (11402) |
— |
$1,772 |
— |
| Exc Tr-Ext B9+Marg 3.1-4 Cm (11404) |
— |
$4,939 |
— |
| Exc tumor soft tiss face&scalp subfascial < 2cm (21013) |
— |
$5,940 |
— |
| Exchange Biliary Drg Catheter Prq W/Img Gid Rs&I (47536) |
— |
$11,433 |
— |
| Exchange Nephrostomy Catheter Prq W/Img Gid Rs&I (50435) |
— |
$13,955 |
— |
| Exchng Absc/Cst Drg Cath Rad Gid Spx (49423) |
— |
$5,332 |
— |
| Excision & Repair Eyelid < One-Fourth Lid Margin (67961) |
— |
$6,796 |
— |
| Excision Lesion Tongue W/O Closure (41110) |
— |
$8,681 |
— |
| Excision Mal Lesion Trunk/Arm/Leg 0.5 Cm/< (11600) |
— |
$2,487 |
— |
| Excision malignant lesion f/e/e/n/l 0.5 cm/< (11640) |
— |
$2,729 |
— |
| Excision Multiple External Papillae/Tags Anus (46230) |
— |
$8,657 |
— |
| Excision of ganglion, wrist (dorsal or volar); primary (25111) |
— |
$4,862 |
— |
| Excision of neuroma; digital nerve, 1 or both, same digit (64776) |
— |
$6,874 |
— |
| Excision of pilonidal cyst or sinus; simple (11770) |
— |
$8,582 |
— |
| Excision of submandibular (submaxillary) gland (42440) |
— |
$16,499 |
— |
| Excision tendon finger flexor/extensor each (26180) |
— |
$4,862 |
— |
| Expl penetrating wound spx abdomen/flank/back (20102) |
— |
$5,702 |
— |
| Explo/Drain Breast Abscess (19020) |
— |
$4,939 |
— |
| Exploration of knee joint (27310) |
— |
$11,264 |
— |
| Exploration penetrating wound spx chest (20101) |
— |
$6,897 |
— |
Exploration penetrating wound spx extremity (20103) range across 2 matching MRF lines |
— |
$3,713–$4,084 |
— |
| Exploration Penetrating Wound Spx Neck (20100) |
— |
$2,090 |
— |
| Exploratory elbow surgery (24000) |
— |
$9,738 |
— |
| Explore/Treat Hand Joint (26070) |
— |
$4,862 |
— |
| External cephalic version (59412) |
— |
$7,572 |
— |
| Eye Surg Ant Sgmt Proc Unlisted (66999) |
— |
$5,871 |
— |
| Fasciotomy, foot and/or toe (28008) |
— |
$11,319 |
— |
Fetal Contraction Stress Test (59020) range across 2 matching MRF lines |
— |
$1,040–$1,144 |
— |
Fetal non-stress test (59025) range across 2 matching MRF lines |
— |
$1,404–$1,544 |
— |
| Fetal Scalp Blood Sampling (59030) |
— |
$1,101 |
— |
| Filleted Finger/Toe Flap W/Prepj Recipient Site (14350) |
— |
$10,003 |
— |
| Fine needle aspiration bx w/CT gdn 1st lesion (10009) |
— |
$4,433 |
— |
| Fine needle aspiration bx w/mr gdn 1st lesion (10011) |
— |
$5,533 |
— |
| Fine needle aspiration without imaging guidance (10021) |
— |
$1,168 |
— |
| Fluid Pressure Muscle (20950) |
— |
$2,153 |
— |
| Fluoro exam of g/colon tube (49465) |
— |
$902 |
— |
| Fna Bx W/Fluor Gdn 1St Les (10007) |
— |
$3,333 |
— |
Fna bx w/us gdn 1st les (10005) range across 3 matching MRF lines |
— |
$3,333–$4,165 |
— |
| Forehead flap w/vasc pedicle (15731) |
— |
$10,560 |
— |
| Foreskin manipulation (54450) |
— |
$862 |
— |
| Frmj Dir/Tube Pedcl W/Wotr Fh/Ch/Ch/M/N/Ax/G/H/F (15574) |
— |
$5,702 |
— |
| Frmj Direct/Tubed Pedicle W/Wotr E/N/E/L/Ntroral (15576) |
— |
$7,145 |
— |
| Fth/Gft Free W/Direct Closure N/E/E/L 20 Sq Cm/< (15260) |
— |
$6,192 |
— |
| Fth/gft free w/direct closure s/a/l 20 cm/< (15220) |
— |
$5,702 |
— |
| Graft Ear Crtlg Autogenous Nose/Ear (21235) |
— |
$16,499 |
— |
| Guide Cathet Fluid Drainage (10030) |
— |
$3,803 |
— |
| Head Surgery Procedure (21499) |
— |
$1,910 |
— |
| Hemorrhoidectomy, external, 2 or more columns/groups (46250) |
— |
$8,657 |
— |
| I&d abscess peritonsillar (42700) |
— |
$1,266 |
— |
I&d abscess simple (10060) range across 3 matching MRF lines |
— |
$691–$1,210 |
— |
| I&d deep absc bursa/hematoma thigh/knee region (27301) |
— |
$8,582 |
— |
| I&D Deep Absc/Hematoma Neck/Chest (21501) |
— |
$8,582 |
— |
| I&D Forearm&/Wrist Deep Abscess/Hematoma (25028) |
— |
$9,738 |
— |
| I&d forearm/wrist bursa (25031) |
— |
$4,862 |
— |
I&d perianal abscess superficial (46050) range across 2 matching MRF lines |
— |
$2,424–$2,666 |
— |
| I&d pilonidal cyst complicated (10081) |
— |
$2,616 |
— |
| I&d pilonidal cyst simple (10080) |
— |
$1,772 |
— |
| I&d upper arm/elbow deep abscess/hematoma (23930) |
— |
$7,158 |
— |
| I&d vaginal hematoma obstetrical/postpartum (57022) |
— |
$11,177 |
— |
| Icd Pocket Revision (33223) |
— |
$5,702 |
— |
| Image Cath Fluid Colxn Visc (49405) |
— |
$5,885 |
— |
| Image Cath Fluid Peri/Retro (49406) |
— |
$5,885 |
— |
| Image Cath Fluid Trns/Vgnl (49407) |
— |
$4,939 |
— |
| Incise external hemorrhoid (46083) |
— |
$862 |
— |
| Incise finger tendon sheath (26055) |
— |
$4,862 |
— |
| Incision & drainage abscess complicated/multiple (10061) |
— |
$1,168 |
— |
| Incision & drainage leg/ankle abscess/hematoma (27603) |
— |
$8,582 |
— |
| Incision & removal foreign body subq tiss compl (10121) |
— |
$6,183 |
— |
| Incision & removal foreign body subq tiss simple (10120) |
— |
$1,168 |
— |
| Incision and drainage of bartholin's gland abscess (56420) |
— |
$660 |
— |
| Incision and drainage of vulva or perineal abscess (56405) |
— |
$1,101 |
— |
| Incision and drainage, open, of deep abscess (subfascial), posterior spine; lumbar, sacral, or lumbosacral Facility (22015) |
— |
$25,300 |
— |
| Incision extensor tendon sheath wrist (25000) |
— |
$4,862 |
— |
| Incision of eardrum (69420) |
— |
$707 |
— |
| Incision of Foot Tendon (28234) |
— |
$7,119 |
— |
| Incision of rectal abscess (46040) |
— |
$7,049 |
— |
| Incision of urethra (53020) |
— |
$7,999 |
— |
| Incision&drainage bursa foot (28001) |
— |
$4,939 |
— |
| Incision&Drainage Upper Arm/Elbow Bursa (23931) |
— |
$4,939 |
— |
| Incisional biopsy skin single lesion (11106) |
— |
$2,378 |
— |
| Initial Tx 1st Degree Burn Local Tx (16000) |
— |
$612 |
— |
| Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Cerv/Thorac, 1st Level (64490) |
— |
$3,033 |
— |
| Inj W/Fluor Eval Cv Device (36598) |
— |
$1,665 |
— |
| Inject Anes/Steroid Foramen Cerv/Thoracic W Img Guide ,1 Level (64479) |
— |
$2,552 |
— |
| Injection 1 tendon sheath/ligament aponeurosis (20550) |
— |
$2,640 |
— |
| Injection aa&/strd axillary nerve w/img gdn (64417) |
— |
$2,296 |
— |
| Injection aa&/strd intercostal nrv ea addl lvl (64421) |
— |
$2,552 |
— |
| Injection Aa&/Strd Sciatic Nerve W/Img Gdn (64445) |
— |
$2,614 |
— |
| Injection anesthetic agent suprascapular nerve (64418) |
— |
$2,026 |
— |
| Injection enzyme palmar fascial cord (20527) |
— |
$1,089 |
— |
| Injection for identification of sentinel node (38792) |
— |
$1,973 |
— |
| Injection Into Brain Canal (61055) |
— |
$2,159 |
— |
| Injection single tendon origin/insertion (20551) |
— |
$3,023 |
— |
Injection single/mlt trigger point 1/2 muscles (20552) range across 3 matching MRF lines |
— |
$3,080–$4,805 |
— |
Injection single/mlt trigger point 3/> muscles (20553) range across 3 matching MRF lines |
— |
$4,400–$7,417 |
— |
| Injection therapeutic carpal tunnel (20526) |
— |
$923 |
— |
| Injection, anesthetic agent; brachial plexus, single (64415) |
— |
$2,296 |
— |
| Injection, anesthetic agent; other peripheral nerve or branch (64450) |
— |
$2,026 |
— |
| Injection, Intralesional; More Than 7 Lesions (11901) |
— |
$1,540 |
— |
| Injection, intralesional; up to and including 7 lesions (11900) |
— |
$770 |
— |
| Ins cath ren art 1st bilat (36252) |
— |
$23,384 |
— |
| Ins cath ren art 1st unilat (36251) |
— |
$11,692 |
— |
| Ins cath ren art 2nd+ bilat (36254) |
— |
$11,692 |
— |
| Ins cath ren art 2nd+ unilat (36253) |
— |
$17,342 |
— |
| Ins endovas vena cava filtr (37191) |
— |
$15,674 |
— |
| Ins Vag Brachytx Device (57156) |
— |
$2,364 |
— |
| Ins/Rep Subq Defibrillator (33270) |
— |
$121,925 |
— |
| Insert 1 Electrode Pm-Defib (33216) |
— |
$27,864 |
— |
| Insert Bladder Cath Complex (51703) |
— |
$559 |
— |
| Insert cath pleura w/ image (32557) |
— |
$4,035 |
— |
Insert cath pleura w/o image (32556) range across 2 matching MRF lines |
— |
$2,484–$4,794 |
— |
| Insert cervical dilator (59200) |
— |
$1,040 |
— |
| Insert Gastrostomy Tube Percutaneous (49440) |
— |
$5,332 |
— |
| Insert Heart Pm Atrial (33206) |
— |
$37,598 |
— |
| Insert Heart Pm Ventricular (33207) |
— |
$37,598 |
— |
| Insert non-tunnel cv cath (36556) |
— |
$8,030 |
— |
| Insert Pacing Lead & Connect (33224) |
— |
$71,741 |
— |
| Insert pessary/other device (57160) |
— |
$608 |
— |
| Insert Picc W/O Sub-Q Port <5 Y/O (36568) |
— |
$5,642 |
— |
| Insert pulse gen mult leads (33221) |
— |
$73,755 |
— |
| Insert Temp Bladder Cath (51702) |
— |
$399 |
— |
| Insert tun ip cath perc (49418) |
— |
$11,433 |
— |
Insert tunneled cv cath (36561) range across 2 matching MRF lines |
— |
$12,279–$16,691 |
— |
| Insert tunneled cv cath (36563) |
— |
$15,674 |
— |
| Insert tunneled cvc w/o subq port/pmp age <5 yr (36557) |
— |
$15,674 |
— |
| Insert,Non-Indwelling Bladder Catheter (51701) |
— |
$399 |
— |
| Insertion indwelling tunneled pleural catheter (32550) |
— |
$11,433 |
— |
| Insertion phrenic nerve stimulator system (33276) |
— |
$178,530 |
— |
| Insertion Picc W/Rs&I 5 Yr/> (36573) |
— |
$5,642 |
— |
| Insertion subq cardiac rhythm monitor w/prgrmg (33285) |
— |
$36,977 |
— |
| Insertion Uterine Tandem&/Vaginal Ovoids (57155) |
— |
$12,530 |
— |
| Insj 2 Transvns Eltrd Perm Pacemaker/Impltbl Dfb (33217) |
— |
$32,340 |
— |
| Insj Non-Tunneled Central Venous Cath Age < 5 Y (36555) |
— |
$8,030 |
— |
| Insj Picc Rs&I <5 Yr (36572) |
— |
$5,642 |
— |
| Insj prph ctr vad w/subq port age 5 yr/> (36571) |
— |
$9,428 |
— |
| Insj Prph Ctr Vad W/Subq Port Under 5 Yr (36570) |
— |
$9,428 |
— |
Insj prph cvc w/o subq port/pmp age 5 yr/> (36569) range across 4 matching MRF lines |
— |
$5,129–$5,642 |
— |
| Insj tun vad req 2 cath 2 sits w/o subq port/pmp (36565) |
— |
$12,279 |
— |
| Insj Tun Vad Req 2 Cath 2 Sits W/Subq Port (36566) |
— |
$15,674 |
— |
| Insj Tunneled Ctr Vad W/Subq Port Under 5 Yr (36560) |
— |
$12,279 |
— |
| Insj tunneled cvc w/o subq port/pmp age 5 yr/> (36558) |
— |
$10,560 |
— |
| Insj/Rplcmt Defib W/Lead(S) (33249) |
— |
$138,359 |
— |
| Insj/rplcmt temp transvns 1chmbr eltrd/pm cath (33210) |
— |
$27,864 |
— |
| Insrt heart pm atrial & vent (33208) |
— |
$40,005 |
— |
| Int hrhc by ligation single hroid w/o img gdn (46945) |
— |
$8,657 |
— |
| Interdental fixation (21110) |
— |
$5,363 |
— |
| Intmd Rpr Face/Mm 12.6-20 Cm (12055) |
— |
$1,168 |
— |
| Intmd Rpr Face/Mm 20.1-30.0 (12056) |
— |
$1,168 |
— |
| Intro cath dialysis circuit (36901) |
— |
$7,488 |
— |
| Intro cath dialysis circuit w/tcat plmt IV stent (36903) |
— |
$38,951 |
— |
| Intro Cath Dialysis Circuit W/Trluml Balo Angiop (36902) |
— |
$25,957 |
— |
| Intro Gastrointestinal Tube (44500) |
— |
$2,795 |
— |
Intubation endotracheal emergency procedure (31500) range across 3 matching MRF lines |
— |
$806–$887 |
— |
| Irrigation of corpora cavernosa for priapism (54220) |
— |
$862 |
— |
| Laparo ablate liver tumor rf (47370) |
— |
$35,750 |
— |
| Laryngoscopy diagnostic (31505) |
— |
$584 |
— |
Laryngoscopy flexible diagnostic (31575) range across 2 matching MRF lines |
— |
$731–$804 |
— |
| Laryngoscopy Flx Rmvl Foreign Body(S) (31577) |
— |
$1,445 |
— |
| Laryngoscopy Foreign Body Rmvl Micro/Telescope (31531) |
— |
$9,711 |
— |
| Laryngoscopy Indirect W/Removal Foreign Body (31511) |
— |
$584 |
— |
| Laryngoscopy W/Foreign Body Removal (31530) |
— |
$5,071 |
— |
| Laryngoscopy w/wo tracheoscopy aspiration (31515) |
— |
$6,168 |
— |
| Laryngoscopy W/WO Tracheoscopy Dx Newborn (31520) |
— |
$935 |
— |
| Late closure of wound (13160) |
— |
$5,702 |
— |
| Lateral Canthopexy (21282) |
— |
$8,681 |
— |
| Ligation of a-v fistula (37607) |
— |
$9,428 |
— |
| Ligation or biopsy temporal artery (37609) |
— |
$5,685 |
— |
| Lip Surgery Procedure (40799) |
— |
$707 |
— |
| Lithotripsy, extracorporeal shock wave (50590) |
— |
$18,120 |
— |
| Lyse chest fibrin init day (32561) |
— |
$2,156 |
— |
| Lyse Chest Fibrin Subq Day (32562) |
— |
$2,156 |
— |
| Lysis Intranasal Synechia (30560) |
— |
$1,768 |
— |
| Maternity Care Procedure (59899) |
— |
$608 |
— |
| Mech Remov Intralum Obstr Cv Dev Thru Lumen (36596) |
— |
$4,035 |
— |
| Mech remov tunneled cv cath (36595) |
— |
$9,428 |
— |
| Musc myocutaneous/fasciocutaneous flap uxtr (15736) |
— |
$6,892 |
— |
| Musc myoq/fscq flap head&neck w/named vasc pedcl (15733) |
— |
$10,560 |
— |
| Muscle, myocutaneous, or fasciocutaneous flap; lower extremity (15738) |
— |
$10,003 |
— |
| Muscle-skin graft trunk (15734) |
— |
$10,003 |
— |
| Myelography Lumbar Injection (62305) |
— |
$4,860 |
— |
| Myelography Lumbar Injection (62304) |
— |
$2,430 |
— |
| Myelography via lumbar injection rs&i cervical (62302) |
— |
$2,430 |
— |
| Myelography Via Lumbar Injection Rs&I Thoracic (62303) |
— |
$2,430 |
— |
| N Block Inj Celiac Pelus (64530) |
— |
$3,366 |
— |
| N block inj intercost sng (64420) |
— |
$2,026 |
— |
| N Block Inj Plantar Digit (64455) |
— |
$1,551 |
— |
| N Block Inj Pudendal (64430) |
— |
$2,296 |
— |
| N Block Lumbar/Thoracic (64520) |
— |
$2,552 |
— |
Nasal Endoscopy Dx (31231) range across 2 matching MRF lines |
— |
$531–$584 |
— |
| Nasal surgery procedure (30999) |
— |
$707 |
— |
| Nasal/Orogastric W/Tube Plmt (43752) |
— |
$1,003 |
— |
| Nasal/Sinus Ndsc Surg W/Control Nasal Hemrrg (31238) |
— |
$5,071 |
— |
| Nasal/Sphenoid Sinus Endoscopy,Dx (31235) |
— |
$6,314 |
— |
| Needle Biopsy Lymph Nodes (38505) |
— |
$6,031 |
— |
| Needle Biopsy Pancreas (48102) |
— |
$5,347 |
— |
| Neuroplasty and/or transposition; cranial nerve (specify) Facility (64716) |
— |
$6,353 |
— |
| Neurp Major Prph Nrv Arm/Leg Opn Oth/Thn Spec (64708) |
— |
$6,875 |
— |
| Njx Anes Trigeminal Nrv Any Div/Branch (64400) |
— |
$923 |
— |
| Njx Cholangio Prq W/Img Gid Rs&I Existing Access (47531) |
— |
$8,715 |
— |
| Njx Cholangio Prq W/Img Gid Rs&I New Access (47532) |
— |
$8,715 |
— |
| Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level (64493) |
— |
$3,033 |
— |
| Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn (62325) |
— |
$2,860 |
— |
| Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn (62321) |
— |
$2,860 |
— |
| Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn (62327) |
— |
$2,860 |
— |
| Njx dx/ther sbst intrlmnr lmbr/sac w/img gdn (62323) |
— |
$2,860 |
— |
| Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/O Img Gdn (62326) |
— |
$3,150 |
— |
| Njx Px Antegrde Nfrosgrm &/Urtrgrm Exstng Acess (50431) |
— |
$2,860 |
— |
| Njx Px Antegrde Nfrosgrm &/Urtrgrm New Access (50430) |
— |
$1,720 |
— |
| Obstructive material removal from gi tube (49460) |
— |
$2,795 |
— |
| Occipital Nerve Block (64405) |
— |
$1,126 |
— |
| Open treatment of nasal fracture; uncomplicated Facility (21325) |
— |
$8,681 |
— |
| Open treatment of nasal fracture; with concomitant open treatment of fractured septum Facility (21335) |
— |
$8,681 |
— |
| Open treatment of nasal septal fracture, with or without stabilization Facility (21336) |
— |
$9,491 |
— |
| Open Treatment Radial Shaft Fracture (25515) |
— |
$22,605 |
— |
| Open Tx Articular Fracture Mcp/Ip Joint Ea (26746) |
— |
$9,738 |
— |
| Open Tx Distal Phalangeal Fracture Each (26765) |
— |
$10,522 |
— |
| Open Tx Humeral Epicondylar Fracture (24575) |
— |
$38,188 |
— |
| Open tx interphalangeal joint dislocation (26785) |
— |
$13,853 |
— |
| Open Tx Metacarpal Fracture Single Ea Bone (26615) |
— |
$12,232 |
— |
| Open Tx Phalangeal Shaft Fracture Prox/Middle Ea (26735) |
— |
$10,522 |
— |
| Open Tx Radial Head/Neck Fracture (24665) |
— |
$20,855 |
— |
| Open Tx Radial Head/Neck Fracture Prosth (24666) |
— |
$38,188 |
— |
| Open tx ulnar fx proximal end (24685) |
— |
$20,855 |
— |
| Open/Perq Place Stent 1St (37236) |
— |
$38,951 |
— |
| Open/Perq Place Stent Same (37238) |
— |
$38,951 |
— |
| Optx humeral shft fx w/plate/screws w/wocerclage (24515) |
— |
$38,188 |
— |
| Osteotomy Phalanx Finger Each (26567) |
— |
$9,738 |
— |
| Partial Excision Distal Phalanx Finger (26236) |
— |
$5,289 |
— |
| Partical Excision Bone Phalanx Toe (28124) |
— |
$11,765 |
— |
| Pelvic examination under anesthesia (other than local) (57410) |
— |
$8,329 |
— |
| Penile Injection (54235) |
— |
$964 |
— |
| Perc Cryo Ablate Renal Tum (50593) |
— |
$30,690 |
— |
| Perc Rf Ablate Renal Tumor (50592) |
— |
$19,957 |
— |
| Percut Ablate Liver Rf (47382) |
— |
$19,957 |
— |
| Percut Cath Occlusn Non Cns Lesn (61626) |
— |
$38,951 |
— |
| Percut Drain/Inject Renal Cyst (50390) |
— |
$3,974 |
— |
Percut Mech Thrombectomy, Venous, Repeat (37188) range across 3 matching MRF lines |
— |
$11,737–$12,296 |
— |
| Pericardiocentesis W/Imaging (33016) |
— |
$4,035 |
— |
| Peritoneal Lavage (49084) |
— |
$2,795 |
— |
| Perm Occlusion/Embolization,Percut,Cns (61624) |
— |
$38,951 |
— |
| Perq av fistula creation uxtr sep access sites (36837) |
— |
$44,174 |
— |
| Perq av fistula creation uxtr single access (36836) |
— |
$44,174 |
— |
| Perq Cervicothoracic Inject (22510) |
— |
$10,292 |
— |
| Perq dev breast 1st mr guide (19287) |
— |
$4,708 |
— |
| Perq dev breast 1st strtctc (19283) |
— |
$4,708 |
— |
| Perq dev breast 1st us imag (19285) |
— |
$4,708 |
— |
| Perq device breast 1st imag (19281) |
— |
$4,898 |
— |
| Perq dilation xst trc endourologic px w/img (50436) |
— |
$8,782 |
— |
| Perq Lumbosacral Injection (22511) |
— |
$8,154 |
— |
| Perq Radiofreq Ablation Tx, Pul Tumor (32998) |
— |
$19,957 |
— |
| Perq sft tiss loc device plmt 1st les w/gdnce (10035) |
— |
$4,036 |
— |
| Perq skel fixj distal radial fx/epiphysl sep (25606) |
— |
$9,900 |
— |
| Perq thrmbc/nfs dial circuit trluml balo angiop (36905) |
— |
$38,951 |
— |
| Perq thrmbc/nfs dialysis circuit img dx angrph (36904) |
— |
$25,957 |
— |
| Perq vert agmntj cavity crtj uni/bi cannulj lmbr (22514) |
— |
$28,393 |
— |
| Perq Vertebral Augmentation (22513) |
— |
$28,393 |
— |
| Pin knuckle dislocation (26706) |
— |
$9,738 |
— |
| Place Cath Subclavian Art (36225) |
— |
$14,353 |
— |
| Place Cath Thoracic Aorta (36221) |
— |
$14,353 |
— |
| Place Cath Vertebral Art (36226) |
— |
$19,061 |
— |
| Place Duod/Jej Tube Perc (49441) |
— |
$5,332 |
— |
| Place Rt Device/Marker Pros (55876) |
— |
$5,005 |
— |
| Placement of needle for intraosseous infusion (36680) |
— |
$1,053 |
— |
| Plmt Bile Duct Stent Prq Existing Access (47538) |
— |
$16,772 |
— |
| Plmt Bile Duct Stent Prq New Access W/O Sep Cath (47539) |
— |
$16,772 |
— |
| Plmt Bile Duct Stent Prq New Access W/Sep Cath (47540) |
— |
$16,772 |
— |
| Plmt Nephrostomy Cath Prq New Access Rs&I (50432) |
— |
$14,071 |
— |
| Plmt Nephroureteral Catheter (50433) |
— |
$14,071 |
— |
| Plmt Urtrl Stent Prq New Access W/Sep Nfros Cath (50695) |
— |
$14,224 |
— |
| Plmt Urtrl Stent Prq Pre-Existing Nfros Tract (50693) |
— |
$14,224 |
— |
| Plmt Urtrl Stnt Prq New Acess W/O Sep Nfros Cath (50694) |
— |
$14,224 |
— |
| Prim art mech thrombectomy (37184) |
— |
$44,174 |
— |
| Proctopexy Perineal Approach (45541) |
— |
$9,682 |
— |
| Proctosgmdsc rgd dx w/wo collj spec br/wa spx (45300) |
— |
$2,666 |
— |
| Prq Aspir Pulposus/Intervertebral Disc/Pvrt Tiss (62267) |
— |
$2,153 |
— |
| Prq Plmt Biliary Drg Cath W/Img Gid Rs&I Externl (47533) |
— |
$11,433 |
— |
| Prq Plmt Biliary Drg Cath W/Img Gid Rs&I Int-Ext (47534) |
— |
$11,433 |
— |
| Prq Skel Fixj Dstl Phlngl Fx Fngr/Thmb Ea (26756) |
— |
$9,738 |
— |
| Pseudoaneurysm Injection Trt (36002) |
— |
$1,583 |
— |
Punch biopsy skin single lesion (11104) range across 2 matching MRF lines |
— |
$1,485–$1,828 |
— |
| Puncture aspiration abscess hematoma bulla/cyst (10160) |
— |
$1,210 |
— |
| Puncture Aspiration Cyst Breast (19000) |
— |
$2,153 |
— |
| Puncture shunt tube/reservoir aspiration/inj px (61070) |
— |
$2,541 |
— |
| Reconstruction Nail Bed W/Graft (11762) |
— |
$5,702 |
— |
| Redo Endovas Vena Cava Filtr (37192) |
— |
$9,900 |
— |
| Relocation Pocket Pacemaker (33222) |
— |
$5,702 |
— |
| Rem Endovas Vena Cava Filter (37193) |
— |
$9,428 |
— |
| Removal Biliary Drg Catheter Req Fluor Gid Rs&I (47537) |
— |
$8,370 |
— |
| Removal Embedded Foreign Body Eyelid (67938) |
— |
$1,073 |
— |
| Removal Foreign Body Deep Thigh/Knee (27372) |
— |
$8,582 |
— |
| Removal Foreign Body Foot Complicated (28193) |
— |
$4,939 |
— |
| Removal foreign body foot deep (28192) |
— |
$5,632 |
— |
| Removal Foreign Body Foot Subcutaneous (28190) |
— |
$2,709 |
— |
| Removal Foreign Body Muscle/Tendon Sheath Simple (20520) |
— |
$4,084 |
— |
| Removal impacted cerumen irrigation/lvg unilat (69209) |
— |
$226 |
— |
| Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) |
— |
$273 |
— |
| Removal impacted vag fb spx w/anes oth/thn local (57415) |
— |
$8,329 |
— |
Removal Implant Deep (20680) range across 2 matching MRF lines |
— |
$7,158–$8,582 |
— |
| Removal Implant Superficial Separate Procedure (20670) |
— |
$4,939 |
— |
| Removal of foreign body from pharynx (42809) |
— |
$1,003 |
— |
| Removal of nail bed (11750) |
— |
$1,730 |
— |
| Removal of tunneled intraperitoneal catheter (49422) |
— |
$12,389 |
— |
Removal or bivalving full arm or full leg cast (29705) range across 2 matching MRF lines |
— |
$829–$912 |
— |
| Removal Pacemaker Electrode (33235) |
— |
$10,223 |
— |
| Removal phrenic nerve stimulator system (33278) |
— |
$12,870 |
— |
| Removal ppm generator only (33233) |
— |
$21,402 |
— |
| Removal skn tags mlt fibrq tags any area upw/15 (11200) |
— |
$612 |
— |
| Removal subcutaneous cardiac rhythm monitor (33286) |
— |
$5,885 |
— |
| Removal Sutures/Staples Requiring Anesthesia (15851) |
— |
$5,702 |
— |
| Removal, under anesthesia, of external fixation system (20694) |
— |
$4,862 |
— |
Removal/bivalving gauntlet boot/body cast (29700) range across 2 matching MRF lines |
— |
$802–$882 |
— |
| Remove Brain Cavity Fluid (61020) |
— |
$2,552 |
— |
| Remove cerclage suture (59871) |
— |
$8,329 |
— |
| Remove drug implant device (11982) |
— |
$1,730 |
— |
| Remove Elctrd Transvenously (33244) |
— |
$10,223 |
— |
| Remove Forearm Foreign Body (25248) |
— |
$9,738 |
— |
| Remove foreign body from eye (65205) |
— |
$414 |
— |
Remove Intrauterine Device (58301) range across 2 matching MRF lines |
— |
$735–$809 |
— |
| Remove intrvas foreign body (37197) |
— |
$13,605 |
— |
| Remove lung catheter (32552) |
— |
$2,732 |
— |
| Remove Nasal Foreign Body (30300) |
— |
$399 |
— |
| Remove Pulse Generator (33241) |
— |
$11,246 |
— |
| Remove renal tube w/fluoro (50389) |
— |
$2,926 |
— |
| Remove Shoulder Foreign Body (23330) |
— |
$4,084 |
— |
| Remove tissue expander (11971) |
— |
$8,582 |
— |
| Remove ureter stent percut (50384) |
— |
$5,132 |
— |
| Remove&replace pm gen singl (33227) |
— |
$27,864 |
— |
| Remv&replc cvd gen dual lead (33263) |
— |
$87,868 |
— |
| Remv&replc cvd gen mult lead (33264) |
— |
$121,925 |
— |
| Remv&replc cvd gen sing lead (33262) |
— |
$87,868 |
— |
| Remv&replc pm gen dual lead (33228) |
— |
$37,598 |
— |
| Remv&replc pm gen mult leads (33229) |
— |
$49,086 |
— |
| Renal Biopsy Perq (50200) |
— |
$5,629 |
— |
| Repair Achilles Tendon (27650) |
— |
$18,022 |
— |
| Repair Blood Vessel Direct Hand Finger (35207) |
— |
$9,428 |
— |
| Repair blood vessel direct neck (35201) |
— |
$18,883 |
— |
| Repair Blood Vessel Direct Upper Extremity (35206) |
— |
$9,428 |
— |
| Repair blood vessel lesion (35190) |
— |
$15,674 |
— |
| Repair complex eyelid/nose/ear/lip 1.1-2.5 cm (13151) |
— |
$2,168 |
— |
| Repair complex eyelid/nose/ear/lip 2.6-7.5 cm (13152) |
— |
$2,168 |
— |
| Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) |
— |
$1,386 |
— |
| Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) |
— |
$2,168 |
— |
| Repair complex scalp/arm/leg 1.1-2.5 cm (13120) |
— |
$1,810 |
— |
| Repair complex scalp/arm/leg 2.6-7.5 cm (13121) |
— |
$1,810 |
— |
| Repair complex trunk 1.1-2.5 cm (13100) |
— |
$1,810 |
— |
| Repair complex trunk 2.6-7.5 cm (13101) |
— |
$1,810 |
— |
| Repair Extensor Tendon Finger W/Graft Each (26420) |
— |
$9,738 |
— |
Repair extensor tendon finger w/o graft each (26418) range across 2 matching MRF lines |
— |
$4,926–$10,945 |
— |
| Repair Extensor Tendon Hand W/Graft Each (26412) |
— |
$9,738 |
— |
| Repair Eyelid Wound (67935) |
— |
$6,796 |
— |
| Repair Finger Tendon (26433) |
— |
$8,154 |
— |
| Repair Finger/Hand Tendon (26350) |
— |
$9,738 |
— |
| Repair Flexor Tendon Leg Primary W/O Graft Each (27658) |
— |
$9,900 |
— |
Repair Hand Joint (26540) range across 2 matching MRF lines |
— |
$8,154–$9,950 |
— |
| Repair Hand Tendon (26410) |
— |
$9,738 |
— |
| Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) |
— |
$1,386 |
— |
| Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) |
— |
$1,400 |
— |
| Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) |
— |
$1,400 |
— |
| Repair intermediate f/e/e/n/l&/muc 7.6-12.5 cm (12054) |
— |
$1,400 |
— |
| Repair intermediate f/e/e/n/l&/muc >30.0 cm (12057) |
— |
$1,004 |
— |
| Repair intermediate n/h/f/xtrnl gent 12.6-20 cm (12045) |
— |
$1,810 |
— |
| Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) |
— |
$1,210 |
— |
| Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) |
— |
$1,386 |
— |
| Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) |
— |
$1,582 |
— |
| Repair Intermediate N/H/F/Xtrnl Gent >30.0 Cm (12047) |
— |
$5,702 |
— |
| Repair intermediate s/a/t/e 12.6-20.0cm (12035) |
— |
$1,766 |
— |
| Repair intermediate s/a/t/e 2.5 cm/< (12031) |
— |
$1,386 |
— |
Repair intermediate s/a/t/e 2.6-7.5 cm (12032) range across 2 matching MRF lines |
— |
$1,386–$2,076 |
— |
| Repair intermediate s/a/t/e 20.1-30.0 cm (12036) |
— |
$1,810 |
— |
| Repair intermediate s/a/t/e 7.6-12.5 cm (12034) |
— |
$1,400 |
— |
| Repair intermediate s/a/t/e >30.0 cm (12037) |
— |
$6,669 |
— |
| Repair intrinsic muscles hand each muscle (26591) |
— |
$9,738 |
— |
| Repair Laceration Palate </2 Cm (42180) |
— |
$1,768 |
— |
| Repair Laceration Palate >2 Cm/Complex (42182) |
— |
$16,499 |
— |
| Repair Lead Pace-Defib One (33218) |
— |
$10,223 |
— |
| Repair of nail bed (11760) |
— |
$1,810 |
— |
| Repair of urethra injury (53502) |
— |
$10,155 |
— |
| Repair recurrent inguinal hernia, any age; incarcerated or strangulated (49521) |
— |
$19,059 |
— |
| Repair Spica/Body/Jacket Cast (29720) |
— |
$499 |
— |
| Repair Tendon Extensor Foot 1/2 Each Tendon (28208) |
— |
$9,738 |
— |
| Repair Tendon/Muscle Upper Arm/Elbow Ea (24341) |
— |
$18,022 |
— |
| Repair tongue laceration (41252) |
— |
$2,156 |
— |
| Repair tongue laceration (41250) |
— |
$1,003 |
— |
| Replace duodenostomy/jejunostomy tube perq (49451) |
— |
$2,795 |
— |
| Replace G-J Tube Perc (49452) |
— |
$2,795 |
— |
| Replace g/c tube perc (49450) |
— |
$2,795 |
— |
| Replantation digit complete (20822) |
— |
$9,738 |
— |
| Reposition Gastrostomy Tube (43761) |
— |
$862 |
— |
| Reposition L Ventric Lead (33226) |
— |
$9,428 |
— |
| Reposition Pacing-Defib Lead (33215) |
— |
$9,428 |
— |
| Reposition Venous Catheter (36597) |
— |
$7,582 |
— |
| Repositioning phrenic nrv stimulator transvns ld (33281) |
— |
$12,870 |
— |
| Rerepair ing hernia reduce (49520) |
— |
$11,433 |
— |
| Revise Hand/Foot Nerve (64704) |
— |
$6,245 |
— |
| Revise ulnar nerve at wrist (64719) |
— |
$6,600 |
— |
| Revise/Repair Finger/Toe Nerve (64702) |
— |
$6,245 |
— |
| Revj Colostomy Smpl Rls Supfc Scar Spx (44340) |
— |
$10,003 |
— |
| Revj Ileostomy Simple Rls Superficial Scar Spx (44312) |
— |
$10,003 |
— |
| Revsc evasc fpvt angiop uni cplx les 1st vsl (37265) |
— |
$17,520 |
— |
| Revsc evasc fpvt angiop uni sf les 1st vsl (37263) |
— |
$17,520 |
— |
| Revsc evasc fpvt athrc uni cplx les 1st vsl (37273) |
— |
$44,174 |
— |
| Revsc evasc fpvt athrc uni sf les 1st vsl (37271) |
— |
$44,174 |
— |
| Revsc evasc fpvt st athrc uni cplx les 1st vsl (37277) |
— |
$59,039 |
— |
| Revsc evasc fpvt st athrc uni sf les 1st vsl (37275) |
— |
$59,039 |
— |
| Revsc evasc fpvt st plmt uni cplx les 1st vsl (37269) |
— |
$38,951 |
— |
| Revsc evasc fpvt st plmt uni sf les 1st vsl (37267) |
— |
$38,951 |
— |
| Revsc evasc imvt angiop uni cplx les 1st vsl (37298) |
— |
$38,951 |
— |
| Revsc evasc imvt angiop uni sf les 1st vsl (37296) |
— |
$38,951 |
— |
| Revsc evasc ivt angiop uni cplx les 1st vsl (37256) |
— |
$18,337 |
— |
| Revsc evasc ivt angiop uni sf les 1st vsl (37254) |
— |
$18,337 |
— |
| Revsc evasc ivt st plmt uni cplx les 1st vsl (37260) |
— |
$38,951 |
— |
| Revsc evasc ivt st plmt uni sf les 1st vsl (37258) |
— |
$38,951 |
— |
| Revsc evasc tpvt angiop uni cplx les 1st vsl (37282) |
— |
$38,951 |
— |
| Revsc evasc tpvt angiop uni sf les 1st vsl (37280) |
— |
$38,951 |
— |
| Revsc evasc tpvt athrc uni cplx les 1st vsl (37290) |
— |
$59,039 |
— |
| Revsc evasc tpvt athrc uni sf les 1st vsl (37288) |
— |
$59,039 |
— |
| Revsc evasc tpvt st athrc uni cplx les 1st vsl (37294) |
— |
$59,039 |
— |
| Revsc evasc tpvt st athrc uni sf les 1st vsl (37292) |
— |
$59,039 |
— |
| Revsc evasc tpvt st plmt uni cplx les 1st vsl (37286) |
— |
$59,039 |
— |
| Revsc evasc tpvt st plmt uni sf les 1st vsl (37284) |
— |
$59,039 |
— |
| Rmvl & rplcmt xtrnl accessible nephrourtrl cath (50387) |
— |
$6,569 |
— |
| Rmvl embedded fb vestibule mouth comp (40805) |
— |
$1,768 |
— |
| Rmvl Embedded Fb Vestibule Mouth Smpl (40804) |
— |
$2,284 |
— |
| Rmvl FB Xtrnl Auditory Canal Anes (69205) |
— |
$4,939 |
— |
| Rmvl fb xtrnl eye corneal w/o slit lamp (65220) |
— |
$1,003 |
— |
| Rmvl fb xtrnl eye corneal w/slit lamp (65222) |
— |
$414 |
— |
| Rmvl fb xtrnl eye embed scjncl/scleral nonperfor (65210) |
— |
$1,053 |
— |
| Rmvl fecal impaction/fb spx under anes (45915) |
— |
$3,505 |
— |
| Rmvl Foreign Body Intranasal Lateral Rhinotomy (30320) |
— |
$4,876 |
— |
| Rmvl Foreign Body Muscle/Tendon Sheath Deep/Comp (20525) |
— |
$8,582 |
— |
| Rmvl foreign body pelvis/hip subcutaneous tiss (27086) |
— |
$7,158 |
— |
| Rmvl Foreign Body Upper Arm/Elbow Subcutaneous (24200) |
— |
$4,939 |
— |
| Rmvl of subq implantable defibrillator electrode (33272) |
— |
$10,223 |
— |
| Rmvl Phrenic Nrv Stimulator Pulse Generator Only (33280) |
— |
$13,200 |
— |
| Rmvl phrnc nrv stimulator transvns stimj/snsg ld (33279) |
— |
$13,200 |
— |
| Rmvl transvns pm eltrd 1 lead sys atr/ventr (33234) |
— |
$9,892 |
— |
| Rmvl tun ctr vad w/subq port/pmp ctr/prph insj (36590) |
— |
$7,582 |
— |
| Rmvl Tun Cvc W/O Subq Port/Pmp (36589) |
— |
$4,241 |
— |
| Rmvl&rplcmt phrenic nrv stimulator pls generator (33287) |
— |
$118,800 |
— |
| Rmvl&rplcmt phrnc nrv stim trnsvns stimj/snsg ld (33288) |
— |
$51,480 |
— |
| Rmvl/Bivalv Sho/Hip Spica Minerva/Risser Jacket (29710) |
— |
$882 |
— |
| Rplc Gtube No Revj Trc (43762) |
— |
$961 |
— |
| Rplc gtube revj gstrst trc (43763) |
— |
$1,071 |
— |
| Rplcmt cath ctr vad subq port/pmp (36578) |
— |
$9,428 |
— |
Rplcmt compl non-tun cvc w/o subq port/pmp (36580) range across 2 matching MRF lines |
— |
$4,035–$6,061 |
— |
| Rplcmt Compl Prph Ctr Vad W/Subq Port (36585) |
— |
$9,428 |
— |
| Rplcmt Compl Prph Cvc W/O Subq Port/Pmp (36584) |
— |
$9,428 |
— |
| Rplcmt compl tun ctr vad w/subq pmp (36583) |
— |
$15,674 |
— |
| Rplcmt compl tun ctr vad w/subq port (36582) |
— |
$12,298 |
— |
| Rplcmt compl tun cvc w/o subq port/pmp (36581) |
— |
$9,428 |
— |
| Rpr blood vessel direct lower extremity (35226) |
— |
$2,153 |
— |
| Rpr ctr vad w/subq port/pmp ctr/prph insj sit (36576) |
— |
$4,035 |
— |
| Rpr Extensor Tendon Leg Primary W/O Graft Each (27664) |
— |
$20,855 |
— |
| Rpr F/E/E/N/L/M 7.6-12.5 Cm (12015) |
— |
$612 |
— |
| Rpr Intermediate N/H/F/Xtrnl Gent 20.1-30.0 Cm (12046) |
— |
$1,582 |
— |
| Rpr Lac 2.5 Cm/< Pst One-Third Tongue (41251) |
— |
$901 |
— |
| Rpr Lip Full Thickness Half/< Vertical Height (40652) |
— |
$1,768 |
— |
| Rpr Lip Full Thickness Vermilion Only (40650) |
— |
$1,894 |
— |
| Rpr Lip Full Thkns >One-Half Vert Height/Comple (40654) |
— |
$4,148 |
— |
| Rpr Prim Disrupted Ligm Ankle Bth Coltrl Ligms (27696) |
— |
$23,672 |
— |
| Rpr Tdn Flxr Foot 1/2 W/O Free Grafg Each Tendon (28200) |
— |
$9,738 |
— |
| Rpr Tdn/Musc Flxr F/Arm&/Wrst Prim 1 Ea Tdn/Mu (25260) |
— |
$9,738 |
— |
| Rpr Tdn/Musc Xtnsr F/Arm&/Wrist Prim 1 Ea Tdn (25270) |
— |
$9,738 |
— |
| Rpr tun/non-tun ctr vad cath w/o subq port/pmp (36575) |
— |
$2,732 |
— |
| Rpr Wnd Extraocular Muscle Tendon&/Tenon Capsu (65290) |
— |
$11,790 |
— |
| Rpr xtnsr tdn cntrl slip tiss w/lat band ea fngr (26426) |
— |
$11,330 |
— |
| Rpr/advmnt flxr tdn zone 2 w/o fr grft ea tendon (26356) |
— |
$9,738 |
— |
| Rpr/advmnt flxr tdn zone 2 w/o fr grft ea tendon (26357) |
— |
$9,738 |
— |
Rpr/advmnt tdn w/ntc supfcis tdn prim ea tdn (26370) range across 2 matching MRF lines |
— |
$8,853–$9,738 |
— |
| Sclerotx Fluid Collection (49185) |
— |
$4,084 |
— |
| Sialot Submndblr Sublngl/Prtd Uncomp Intraoral (42330) |
— |
$8,681 |
— |
| Simple repair f/e/e/n/l/m 12.6cm-20.0 cm (12016) |
— |
$1,004 |
— |
| Simple repair f/e/e/n/l/m 2.5cm/< (12011) |
— |
$612 |
— |
| Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) |
— |
$612 |
— |
| Simple Repair F/E/E/N/L/M 20.1cm-30.0 Cm (12017) |
— |
$1,168 |
— |
| Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) |
— |
$612 |
— |
| Simple Repair F/E/E/N/L/M >30.0 Cm (12018) |
— |
$941 |
— |
| Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) |
— |
$612 |
— |
| Simple repair scalp/neck/ax/genit/trunk >30.0cm (12007) |
— |
$612 |
— |
| Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) |
— |
$612 |
— |
| Skin Full Grft Face/Genit/Hf (15240) |
— |
$6,126 |
— |
| Skin Pinch Graft (15050) |
— |
$3,154 |
— |
| Skin sub graft face/nk/hf/g (15275) |
— |
$6,036 |
— |
| Skin sub graft trnk/arm/leg (15271) |
— |
$5,798 |
— |
| Skin sub grft t/arm/lg child (15273) |
— |
$10,003 |
— |
| Skin Tissue Procedure (17999) |
— |
$624 |
— |
| Skn sub grft f/n/hf/g child (15277) |
— |
$5,798 |
— |
| Slctv Cath Carotid/Innom Art Angio Intrcranl Art (36223) |
— |
$15,674 |
— |
| Slctv cath carotid/innom art angio xtrcranl art (36222) |
— |
$14,353 |
— |
| Slctv Cath Intrnl Carotid Art Angio Intrcrnl Art (36224) |
— |
$19,061 |
— |
| Slitting of prepuce (54001) |
— |
$6,569 |
— |
| Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) |
— |
$612 |
— |
| Smpl rpr scalp/neck/ax/genit/trunk 12.6-20.0cm (12005) |
— |
$1,004 |
— |
| Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) |
— |
$1,004 |
— |
Spinal puncture lumbar diagnostic (62270) range across 4 matching MRF lines |
— |
$2,558–$2,814 |
— |
| Split Agrft F/S/N/H/F/G/M/D Gt 1st 100 Cm/</1 % (15120) |
— |
$10,003 |
— |
| Split Agrft T/a/L 1st 100 Cm/&/1% Bdy Inft/Chld (15100) |
— |
$5,702 |
— |
| Strapping ankle (29540) |
— |
$499 |
— |
| Strapping elbow or wrist (29260) |
— |
$298 |
— |
| Strapping hand/finger (29280) |
— |
$298 |
— |
| Strapping Hip (29520) |
— |
$322 |
— |
| Strapping knee (29530) |
— |
$326 |
— |
Strapping shoulder (29240) range across 2 matching MRF lines |
— |
$405–$446 |
— |
| Strapping thorax (29200) |
— |
$499 |
— |
| Strapping toes (29550) |
— |
$298 |
— |
| Strapping Unna Boot (29580) |
— |
$706 |
— |
| Subcutaneous Hormone Pellet Implantation (11980) |
— |
$1,430 |
— |
| Sutr Wnd Eyelid/Margin/Tarsus/Conjunc Prtl Thick (67930) |
— |
$7,755 |
— |
| Suture 1 nerve hand/foot common sensory nerve (64834) |
— |
$25,174 |
— |
| Suture digital nerve hand/foot 1 nerve (64831) |
— |
$16,583 |
— |
| Suture infrapatellar tendon primary (27380) |
— |
$24,860 |
— |
| Suture of facial nerve; extracranial Facility (64864) |
— |
$16,782 |
— |
| Suture pharynx for wound or injury (42900) |
— |
$4,148 |
— |
| Tangential biopsy skin single lesion (11102) |
— |
$1,168 |
— |
| Tcat Impl Wrls P-Art Prs Snr L-T Hemodyn Mntr (33289) |
— |
$73,218 |
— |
| Tcat Insj/Rpl Perm Ldls Pm (33274) |
— |
$60,845 |
— |
| Tcat Rmvl Perm Ldls Pm (33275) |
— |
$10,468 |
— |
| Tenolysis flexor tendon palm&finger each tendo (26442) |
— |
$12,671 |
— |
| Tenolysis flexor tendon palm/finger each tendon (26440) |
— |
$5,327 |
— |
| Tenolysis, extensor tendon, hand or finger, each tendon (26445) |
— |
$10,656 |
— |
| Tenotomy extensor hand/finger open each tendon (26460) |
— |
$5,355 |
— |
| Tenotomy Flexor Finger Open Each Tendon (26455) |
— |
$5,390 |
— |
| Tenotomy Percutaneous Toe Single Tendon (28010) |
— |
$7,119 |
— |
| Tenotomy, Percutaneous, Toe; Multiple Tendons (28011) |
— |
$5,665 |
— |
Ther Apheresis,Red Blood Cells (36512) range across 3 matching MRF lines |
— |
$3,960–$5,940 |
— |
| Ther Spi Pnxr Csf Fluor/Ct (62329) |
— |
$3,300 |
— |
Therapeutic Apheresis White Blood Cells (36511) range across 2 matching MRF lines |
— |
$4,620–$6,930 |
— |
Therapeutic plasma exchange (36514) range across 4 matching MRF lines |
— |
$3,960–$5,940 |
— |
| Thermal dstrj intraosseous bvn 1st 2 lmbr/sac (64628) |
— |
$49,500 |
— |
| Thrmbc/Nfs Dialysis Circuit (36906) |
— |
$44,174 |
— |
| Thromblytic art/ven therapy (37213) |
— |
$12,075 |
— |
| Thrombolytic Art Therapy (37211) |
— |
$15,674 |
— |
| Thrombolytic Therapy Stroke (37195) |
— |
$1,176 |
— |
| Thrombolytic Venous Therapy (37212) |
— |
$11,083 |
— |
| Thyroid biopsy (60100) |
— |
$3,333 |
— |
| Tis Trnfr E/N/E/L 10 Sq Cm/< (14060) |
— |
$6,126 |
— |
| Tooth extraction (41899) |
— |
$615 |
— |
| Tracheobrnchsc Thru Est Trachs Inc (31615) |
— |
$1,768 |
— |
| Tracheostomy Emergency Cricothyroid Membrane (31605) |
— |
$1,768 |
— |
| Tracheostomy Emergency Procedure Transtracheal (31603) |
— |
$4,148 |
— |
| Transcatheter biopsy (37200) |
— |
$15,674 |
— |
| Transcerv Fallopian Tube Cath W/WO Hystosalping (58345) |
— |
$8,329 |
— |
| Transfer skin pedicle flap (15650) |
— |
$5,702 |
— |
| Treat Big Toe Fracture (28505) |
— |
$9,738 |
— |
| Treat Dental Ridge Fracture (21440) |
— |
$8,681 |
— |
| Treat humerus fracture (24500) |
— |
$799 |
— |
| Treat Humerus Fracture (24505) |
— |
$4,049 |
— |
Treat humerus fracture (23600) range across 2 matching MRF lines |
— |
$726–$799 |
— |
| Treat knee fracture (27532) |
— |
$9,738 |
— |
| Treat Knee Fracture(S) (27538) |
— |
$799 |
— |
| Treat Knuckle Dislocation (26700) |
— |
$799 |
— |
| Treat Metatarsal Fracture (28475) |
— |
$799 |
— |
| Treat scapula fracture (23585) |
— |
$20,855 |
— |
| Treat Tail Bone Fracture (27200) |
— |
$799 |
— |
| Treat Thumb Dislocation (26641) |
— |
$799 |
— |
| Treat Thumb Fracture (26645) |
— |
$4,862 |
— |
| Treat toe dislocation (28630) |
— |
$799 |
— |
| Treat Vaginal Bleeding (57180) |
— |
$608 |
— |
| Treatment Closed Elbow Dislocation Req Anes (24605) |
— |
$6,214 |
— |
| Treatment closed elbow dislocation w/o anes (24600) |
— |
$799 |
— |
| Trim skin lesion (11055) |
— |
$504 |
— |
| Trim skin lesions 2 to 4 (11056) |
— |
$605 |
— |
| Trim skin lesions over 4 (11057) |
— |
$770 |
— |
| Trimming Nondystrophic Nails Any Number (11719) |
— |
$218 |
— |
| Trluml Balo Angiop 1St Art (37246) |
— |
$22,000 |
— |
| Trluml Balo Angiop 1St Vein (37248) |
— |
$22,000 |
— |
| Tx Gastro Intub W/Asp (43753) |
— |
$927 |
— |
| Tx Incomplete Abortion Any Trimester Surgical (59812) |
— |
$11,165 |
— |
| Tx Missed Abortion First Trimester Surgical (59820) |
— |
$8,329 |
— |
| Tx Missed Abortion Second Trimester Surgical (59821) |
— |
$11,106 |
— |
| Tx open tendon flexor toe 1 tendon spx (28232) |
— |
$7,119 |
— |
| Tx Spon Hip Dislc Abdct Splnt/Trcj W/Manj Anes (27257) |
— |
$4,049 |
— |
Tx Superficial Wound Dehiscence Simple Closure (12020) range across 2 matching MRF lines |
— |
$1,810–$2,075 |
— |
| Tx superficial wound dehiscence w/packing (12021) |
— |
$1,168 |
— |
| Tx Tarsal Bone Fx Xcp Talus&Calcn W/Manj (28455) |
— |
$9,738 |
— |
| Tx Tarsal Bone Fx Xcp Talus&Calcn W/O Manj (28450) |
— |
$799 |
— |
Unlisted Cardiac Surgery (33999) range across 3 matching MRF lines |
— |
$2,732–$11,000 |
— |
| Unlisted laparoscopy procedure stomach (43659) |
— |
$16,772 |
— |
| Unlisted procedure anus (46999) |
— |
$3,969 |
— |
| Unlisted Procedure Biliary Tract (47999) |
— |
$3,300 |
— |
Unlisted procedure breast (19499) range across 3 matching MRF lines |
— |
$9,602–$9,983 |
— |
| Unlisted Procedure Casting/Strapping (29799) |
— |
$499 |
— |
| Unlisted Procedure External Ear (69399) |
— |
$615 |
— |
| Unlisted procedure femur or knee (27599) |
— |
$891 |
— |
Unlisted procedure foot or toes (28899) range across 2 matching MRF lines |
— |
$924–$2,200 |
— |
| Unlisted procedure forearm or wrist (25999) |
— |
$880 |
— |
| Unlisted Procedure Hands/Fingers (26989) |
— |
$799 |
— |
| Unlisted procedure humerus/elbow (24999) |
— |
$892 |
— |
| Unlisted Procedure Intestine (44799) |
— |
$7,920 |
— |
| Unlisted procedure larynx (31599) |
— |
$707 |
— |
| Unlisted Procedure Leg/Ankle (27899) |
— |
$799 |
— |
| Unlisted procedure lungs and pleura (32999) |
— |
$2,750 |
— |
| Unlisted Procedure Male Genital System (55899) |
— |
$949 |
— |
| Unlisted Procedure Muscskeletal System General (20999) |
— |
$799 |
— |
| Unlisted procedure nervous system (64999) |
— |
$1,066 |
— |
| Unlisted Procedure Palate Uvula (42299) |
— |
$707 |
— |
| Unlisted Procedure Pharynx Adenoids/Tonsils (42999) |
— |
$707 |
— |
Unlisted Procedure Rectum (45999) range across 2 matching MRF lines |
— |
$2,302–$4,400 |
— |
| Unlisted procedure shoulder (23929) |
— |
$1,100 |
— |
Unlisted procedure stomach (43999) range across 4 matching MRF lines |
— |
$3,135–$4,633 |
— |
| Unlisted Procedure Tongue Floor Mouth (41599) |
— |
$707 |
— |
| Unlisted Procedure Trachea Bronchi (31899) |
— |
$6,820 |
— |
Unlisted Procedure Vascular Surgery (37799) range across 3 matching MRF lines |
— |
$3,791–$33,000 |
— |
Unlisted procedure, abdomen, peritoneum and omentum (49999) range across 2 matching MRF lines |
— |
$3,850–$10,501 |
— |
| Unlisted Procedure, Urinary System (53899) |
— |
$862 |
— |
| Unlisted px female genital system nonobstetrical (58999) |
— |
$608 |
— |
| Upgrade of pacemaker system (33214) |
— |
$40,005 |
— |
| Vaginal Delivery After Cesarean Delivery (59612) |
— |
$12,417 |
— |
| Vaginal delivery only (59409) |
— |
$8,329 |
— |
| Vasc embolize/occlude artery (37242) |
— |
$44,174 |
— |
| Vasc Embolize/Occlude Bleed (37244) |
— |
$38,951 |
— |
| Vasc Embolize/Occlude Organ (37243) |
— |
$38,951 |
— |
| Vasc embolize/occlude venous (37241) |
— |
$38,951 |
— |
| Vein Access Cutdown < 1 Yr (36420) |
— |
$322 |
— |
| Venous Cutdown >1 Y/O (36425) |
— |
$1,003 |
— |
| Venous Mech Thrombectomy (37187) |
— |
$27,713 |
— |
| Vestibuloplasty Anterior (40840) |
— |
$16,499 |
— |
| Vestibuloplasty Cplx W/Ridge Xtn Musc Rpsg (40845) |
— |
$16,499 |
— |
| Wedge excision skin nail fold (11765) |
— |
$1,004 |
— |
| Wedging of cast (29740) |
— |
$882 |
— |
| Wedging of clubfoot cast (29750) |
— |
$882 |
— |
| Windowing of cast (29730) |
— |
$499 |
— |
| Wound Prep F/N/Hf/G (15004) |
— |
$1,810 |
— |
| Wound Prep Trk/Arm/Leg (15002) |
— |
$5,702 |
— |