| Acne surgery (10040) |
— |
$161 |
— |
| Amp F/Th 1/2 Jt/Phalanx W/Neurect W/Dir Clsr (26951) |
— |
$1,300 |
— |
| Amputate Metacarpal Bone (26910) |
— |
$1,100 |
— |
| Anoscopy diagnostic (46600) |
— |
$200 |
— |
| Application finger splint static (29130) |
— |
$262.35 |
— |
| Application long arm splint shoulder hand (29105) |
— |
$350 |
— |
| Application short arm splint forearm-hand static (29125) |
— |
$225 |
— |
| Application short leg splint calf foot (29515) |
— |
$295 |
— |
| Arterial puncture (36600) |
— |
$75 |
— |
Arthrocentesis aspir&/inj interm jt/burs w/o us (20605)
range across 2 matching MRF lines |
— |
$535–$780 |
— |
Arthrocentesis aspir&/inj major jt/bursa w/o us (20610)
range across 2 matching MRF lines |
— |
$480–$625 |
— |
Arthrocentesis aspir&/inj major jt/bursa w/us (20611)
range across 2 matching MRF lines |
— |
$570–$875 |
— |
Arthrocentesis aspir&/inj small jt/bursa w/o us (20600)
range across 2 matching MRF lines |
— |
$435–$475 |
— |
| Avulsion nail plate partial/complete simple 1 (11730) |
— |
$185 |
— |
| Biopsy External Auditory Canal (69105) |
— |
$150 |
— |
| Biopsy external ear (69100) |
— |
$143 |
— |
| Biopsy nail unit (11755) |
— |
$190 |
— |
| Biopsy Vulva/Perineum 1 Lesion Spx (56605) |
— |
$180 |
— |
| Bladder Scan (51798) |
— |
$105 |
— |
Blood Transfusion Service (36430)
range across 9 matching MRF lines |
— |
$50–$895 |
— |
| Chemodenerv 1 extrem 5/> mus (64644) |
— |
$845 |
— |
| Chemodenerv 1 extremity 1-4 (64642) |
— |
$735 |
— |
| Chemodnrvtj Musc Musc Innervated Facial Nrv Unil (64612) |
— |
$383 |
— |
| Clear outer ear canal (69200) |
— |
$250 |
— |
| Clsd tx shoulder dislc w/manipulation req anes (23655) |
— |
$600 |
— |
| Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) |
— |
$305 |
— |
Cltx iphal jt dislc w/manj w/o anes (26770)
range across 2 matching MRF lines |
— |
$263.23–$1,052 |
— |
| Cltx post hip arthrp dislc req anes (27266) |
— |
$750 |
— |
| Collect Blood From Catheter Venous Nos (36592) |
— |
$65 |
— |
| Collection of venous blood by venipuncture (36415) |
— |
$26 |
— |
| Colsc flx w/removal lesion by hot bx forceps (45384) |
— |
$1,000 |
— |
| Control Nasal Hemorrhage Anterior Complex (30903) |
— |
$690 |
— |
| Control Nasal Hemorrhage Anterior Simple (30901) |
— |
$485 |
— |
| Dbrdmt extensv eczema/infect skn up 10% bdy surf (11000) |
— |
$130 |
— |
| Debridement subcutaneous tissue 20 sq cm/< (11042) |
— |
$250 |
— |
Destroy cerv/thor facet jnt (64633)
range across 2 matching MRF lines |
— |
$3,825–$5,355 |
— |
Destroy lumb/sac facet jnt (64635)
range across 3 matching MRF lines |
— |
$1,575–$5,483 |
— |
Destruct B9 Lesion 1-14 (17110)
range across 2 matching MRF lines |
— |
$204–$205 |
— |
| Destruction Benign Lesions 15/> (17111) |
— |
$250 |
— |
| Destruction mal lesion trunk/arm/leg 0.6-1.0 cm (17261) |
— |
$336 |
— |
| Destruction mal lesion trunk/arm/leg 1.1-2.0cm (17262) |
— |
$418 |
— |
| Destruction malignant lesion f/e/e/n/l/m 0.5cm/< (17280) |
— |
$265 |
— |
| Destruction neurolytic agt genicular nerve w/img (64624) |
— |
$3,950 |
— |
Destruction Premalignant Lesion 15/> (17004)
range across 2 matching MRF lines |
— |
$250–$300 |
— |
| Destruction premalignant lesion 1st (17000) |
— |
$168 |
— |
| Diagnostic sigmoidoscopy (45330) |
— |
$925 |
— |
Drain Cerebro Spinal Fluid (62272)
range across 2 matching MRF lines |
— |
$910–$1,593 |
— |
Drain/inj small joint/bursa w/us (20604)
range across 2 matching MRF lines |
— |
$525–$695 |
— |
| Drainage of finger abscess simple (26010) |
— |
$225 |
— |
| Drainage of hematoma/fluid (10140) |
— |
$250 |
— |
| Draw Blood Off Venous Device (36591) |
— |
$35 |
— |
| Dstrj Neurlytic Trigem Nrv 2/3 Div Radio Monitor (64610) |
— |
$675 |
— |
| Dstrj Neurolytic Agent Other Peripheral Nerve (64640) |
— |
$852 |
— |
| Dx Laryngoscopy Excl Nb (31525) |
— |
$500 |
— |
Dx lmbr spi pnxr w/fluor/CT (62328)
range across 2 matching MRF lines |
— |
$748–$1,309 |
— |
| Egd Balloon Dilation Esophagus <30 Mm Diam (43249) |
— |
$1,750 |
— |
| Egd cautery tumor polyp (43250) |
— |
$1,100 |
— |
| Egd control bleeding any (43255) |
— |
$1,100 |
— |
| Egd Flexible Foreign Body Removal (43247) |
— |
$600 |
— |
| Egd remove lesion snare (43251) |
— |
$1,100 |
— |
Epidural Blood Patch (62273)
range across 2 matching MRF lines |
— |
$1,275–$2,231 |
— |
Exc b9 les mrgn xcp sk tg t/a/l 0.5 cm/< (11400)
range across 2 matching MRF lines |
— |
$200–$256 |
— |
| Exc Face-Mm B9+Marg 0.6-1 Cm (11441) |
— |
$405 |
— |
| Exc Face-Mm B9+Marg 1.1-2 Cm (11442) |
— |
$447 |
— |
| Exc H-F-Nk-Sp B9+Marg 0.6-1 (11421) |
— |
$336 |
— |
| Exc H-F-Nk-Sp B9+Marg 1.1-2 (11422) |
— |
$414 |
— |
| Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg (11403) |
— |
$453 |
— |
| Exc Skin Benig >4 Cm Trunk,Arm,Leg (11406) |
— |
$650 |
— |
| Exc Skin Malig 2.1-3 Cm Remaindr Body (11623) |
— |
$500 |
— |
| Exc Skin Malig >4 Cm Remaindr Body (11626) |
— |
$650 |
— |
| Exc Tr-Ext B9+Marg 0.6-1 Cm (11401) |
— |
$321 |
— |
| Exc Tr-Ext B9+Marg 1.1-2 Cm (11402) |
— |
$354 |
— |
| Excise, Malign Lesion w/Margins, Trunk, Arms, or Legs; Excised diam 2.1 to 3.0 cm Charge (11603) |
— |
$591 |
— |
| Excision mal lesion trunk/arm/leg 1.1-2.0 cm (11602) |
— |
$300 |
— |
Excision Mal Lesion Trunk/Arm/Leg 3.1-4.0 Cm (11604)
range across 2 matching MRF lines |
— |
$385–$651 |
— |
| Excision malignant lesion s/n/h/f/g 1.1-2.0 cm (11622) |
— |
$519 |
— |
| Fetal non-stress test (59025) |
— |
$231 |
— |
| I&d abscess simple (10060) |
— |
$321 |
— |
| Incision & drainage abscess complicated/multiple (10061) |
— |
$250 |
— |
| Incision & removal foreign body subq tiss simple (10120) |
— |
$175 |
— |
| Incisional biopsy eyelid skin & lid margin (67810) |
— |
$210 |
— |
| Incisional biopsy skin single lesion (11106) |
— |
$200 |
— |
Inj Dx/Ther Agnt Paravert Facet Joint,Img Guide,Cerv/Thorac, 1st Level (64490)
range across 2 matching MRF lines |
— |
$3,094–$5,423 |
— |
Injection 1 tendon sheath/ligament aponeurosis (20550)
range across 2 matching MRF lines |
— |
$435–$538 |
— |
Injection aa&/strd axillary nerve w/img gdn (64417)
range across 2 matching MRF lines |
— |
$595–$1,041 |
— |
Injection aa&/strd genicular nrv branches w/img (64454)
range across 2 matching MRF lines |
— |
$1,573–$2,753 |
— |
Injection aa&/strd intercostal nrv ea addl lvl (64421)
range across 2 matching MRF lines |
— |
$1,148–$2,009 |
— |
Injection Aa&/Strd Sciatic Nerve W/Img Gdn (64445)
range across 2 matching MRF lines |
— |
$808–$1,414 |
— |
Injection anesthetic agent suprascapular nerve (64418)
range across 2 matching MRF lines |
— |
$595–$1,041 |
— |
Injection single tendon origin/insertion (20551)
range across 2 matching MRF lines |
— |
$390–$625 |
— |
Injection single/mlt trigger point 1/2 muscles (20552)
range across 2 matching MRF lines |
— |
$390–$625 |
— |
Injection single/mlt trigger point 3/> muscles (20553)
range across 2 matching MRF lines |
— |
$435–$750 |
— |
Injection therapeutic carpal tunnel (20526)
range across 2 matching MRF lines |
— |
$435–$575 |
— |
Injection, anesthetic agent; brachial plexus, single (64415)
range across 2 matching MRF lines |
— |
$595–$1,041 |
— |
Injection, anesthetic agent; other peripheral nerve or branch (64450)
range across 2 matching MRF lines |
— |
$435–$575 |
— |
Injection, Intralesional; More Than 7 Lesions (11901)
range across 3 matching MRF lines |
— |
$142–$575 |
— |
| Injection, intralesional; up to and including 7 lesions (11900) |
— |
$198 |
— |
| Insert Bladder Cath Complex (51703) |
— |
$235 |
— |
| Insert cath pleura w/o image (32556) |
— |
$865 |
— |
| Insert Temp Bladder Cath (51702) |
— |
$125 |
— |
| Insert,Non-Indwelling Bladder Catheter (51701) |
— |
$65 |
— |
| Insertion Picc W/Rs&I 5 Yr/> (36573) |
— |
$633 |
— |
Insj prph cvc w/o subq port/pmp age 5 yr/> (36569)
range across 2 matching MRF lines |
— |
$1,400–$1,500 |
— |
| Intubation endotracheal emergency procedure (31500) |
— |
$335 |
— |
| Laparoscopy w/rmvl adnexal structures (58661) |
— |
$1,100 |
— |
| Laryngoscopy W/WO Tracheoscopy Dx Newborn (31520) |
— |
$600 |
— |
N block inj intercost sng (64420)
range across 2 matching MRF lines |
— |
$808–$1,414 |
— |
N Block Inj Pudendal (64430)
range across 2 matching MRF lines |
— |
$1,000–$2,558 |
— |
Njx Anes Trigeminal Nrv Any Div/Branch (64400)
range across 2 matching MRF lines |
— |
$1,700–$2,550 |
— |
Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level (64493)
range across 2 matching MRF lines |
— |
$1,795–$2,995 |
— |
Njx Dx/Ther Sbst Intrlmnr Crv/Thrc W/Img Gdn (62321)
range across 2 matching MRF lines |
— |
$1,275–$2,231 |
— |
Njx dx/ther sbst intrlmnr lmbr/sac w/img gdn (62323)
range across 2 matching MRF lines |
— |
$1,063–$1,860 |
— |
Occipital Nerve Block (64405)
range across 2 matching MRF lines |
— |
$595–$1,041 |
— |
| Placement of needle for intraosseous infusion (36680) |
— |
$250 |
— |
| Proctosgmdsc rigid w/dilation (45303) |
— |
$175 |
— |
| Punch biopsy skin single lesion (11104) |
— |
$165 |
— |
| Puncture aspiration abscess hematoma bulla/cyst (10160) |
— |
$200 |
— |
| Removal Foreign Body Foot Subcutaneous (28190) |
— |
$275 |
— |
| Removal skn tags mlt fibrq tags any area upw/15 (11200) |
— |
$232 |
— |
| Repair complex eyelid/nose/ear/lip 1.1-2.5 cm (13151) |
— |
$310 |
— |
| Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) |
— |
$600 |
— |
| Repair complex scalp/arm/leg 2.6-7.5 cm (13121) |
— |
$700 |
— |
Repair complex trunk 2.6-7.5 cm (13101)
range across 2 matching MRF lines |
— |
$478–$580 |
— |
| Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) |
— |
$340 |
— |
| Repair intermediate s/a/t/e 2.5 cm/< (12031) |
— |
$250 |
— |
| Repair intermediate s/a/t/e 2.6-7.5 cm (12032) |
— |
$650 |
— |
| Repair tongue laceration (41252) |
— |
$465.25 |
— |
| Shaving Skin Lesion 1 S/N/H/F/G Diam 0.5 Cm/< (11305) |
— |
$150 |
— |
| Shvg Skin Lesion 1 Trunk/Arm/Leg Diam >2.0 Cm (11303) |
— |
$175 |
— |
| Simple repair f/e/e/n/l/m 2.5cm/< (12011) |
— |
$225 |
— |
| Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) |
— |
$480 |
— |
| Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) |
— |
$650 |
— |
| Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) |
— |
$310 |
— |
| Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) |
— |
$625 |
— |
| Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) |
— |
$425 |
— |
Spinal puncture lumbar diagnostic (62270)
range across 2 matching MRF lines |
— |
$810–$1,418 |
— |
| Strapping Unna Boot (29580) |
— |
$83 |
— |
| Suture infrapatellar tendon primary (27380) |
— |
$600 |
— |
| Tangential biopsy skin single lesion (11102) |
— |
$200 |
— |
Ther Spi Pnxr Csf Fluor/Ct (62329)
range across 2 matching MRF lines |
— |
$850–$1,488 |
— |
| Treatment Closed Elbow Dislocation Req Anes (24605) |
— |
$950 |
— |
| Treatment closed elbow dislocation w/o anes (24600) |
— |
$450 |
— |
| Treatment of anal fissure (46940) |
— |
$300 |
— |
| Trim skin lesion (11055) |
— |
$150 |
— |
| Trim skin lesions 2 to 4 (11056) |
— |
$150 |
— |
Unlisted procedure nervous system (64999)
range across 2 matching MRF lines |
— |
$400–$675 |
— |
| Vaginal delivery only (59409) |
— |
$1,800 |
— |