Procedures & surgery prices at Hiram W. Davis Medical Center

Petersburg, VA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abd paracentesis w/imaging (49083) $422
Abltj Soft Tis Inferior Turbinates Uni/Bi Supfc (30801) $312
Abrasion single lesion (15786) $324
Acne surgery (10040) $163
Acromioplasty or acromionectomy, partial, with or without coracoacromial ligament release Facility (23130) $864
Adjnt tis trnsfr/reargmt any area 30.1-60 sq cm (14301) $1,504
Amputation toe metatarsophalangeal joint (28820) $419
Amputation, leg, through tibia and fibula; (27880) $1,244
Appl Mltlayr Compres Leg Below Knee W/Ankle Foot (29581) $126
Application Cast Finger (29086) $105
Application Finger Splint Dynamic (29131) $73
Application finger splint static (29130) $57
Application long arm splint shoulder hand (29105) $112
Application of long leg cast (29345) $186
Application Short Arm Splint Dynamic (29126) $106
Application short arm splint forearm-hand static (29125) $90
Apply long leg splint (29505) $120
Apply short leg splint (29515) $98
Arterial puncture (36600) $40
Arteriovenous Anastomosis Open Direct (36821) $905
Arthrd Ant Min Discect Interbody Cerv Below C2 (22554) $1,737
Arthrd midtarsl/tarsometatarsal mult/transvrs (28730) $1,014
Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) $76
Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) $90
Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) $74
Arthrodesis interphalangeal jt w/wo int fixj (26860) $871
Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than… (22630) $2,180
Arthrodesis, posterior or posterolateral technique, single interspace; lumbar (with lateral transverse technique, when… (22612) $2,189
Arthroplasty interphalangeal joint each (26535) $610
Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, extensive Facility (29898) $779
Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, limited Facility (29897) $683
Arthroscopy, elbow, surgical; with removal of loose body or foreign body Facility (29834) $686
Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion with internal fixation Facility (29887) $1,046
Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving) including… (29880) $782
Arthroscopy, shoulder, surgical; capsulorrhaphy (29806) $1,468
Arthroscopy, shoulder, surgical; with rotator cuff repair (29827) $1,481
Arthrotomy ankle w/expl drainage/removal fb (27610) $900
Av fistula revision (36833) $1,105
Av fusion/forearm vein (36820) $982
Avulsion nail plate partial/complete simple 1 (11730) $162
Biopsy external ear (69100) $136
Biopsy muscle deep (20205) $431
Biopsy of breast; open, incisional (19101) $468
Biopsy or excision of lymph node(s); open, superficial (38500) $474
Bladder instillation anticarcinogenic agent (51720) $122
Bladder Irrigation Simple (51700) $108
Blood transfusion service (36430) $54
Bone Marrow Biopsy (38221) $228
Brnchsc W/Dstrj Tum Relief Stenosis Oth/Thn Exc (31641) $350
Brnchsc W/Tracheal/Bronchial Dilat/Clsd Rdctj Fx (31630) $272
Brnchsc W/Transbrncl Lung Bx 1 Lobe (31628) $532
Bronch ebus samplng 1/2 node (31652) $1,857
Bronchoscopy,Diagnostic W Lavage (31624) $361
Bx abdl/retroperitoneal mass prq needle (49180) $246
Bx/exc lymph node needle superficial (38505) $251
Capsulorrhaphy, glenohumeral joint, any type multidirectional instability Facility (23466) $1,553
Cartilage graft; nasal septum Facility (20912) $668
Cataract surgery complex (66982) $1,013
Catheter Aspiration Nasotracheal Spx (31720) $82
Chemical cautery tissue (17250) $126
Circum 28 days or older (54161) $271
Claviculectomy partial (23120) $819
Close Rx Prox/Mid Fing Shft Fx (26720) $282
Closed Rx Gr Tuberosity Hum Fx (23620) $382
Closed Treat Vert Body Fract (22310) $433
Closed treatment of calcaneal fracture; without manipulation (28400) $347
Closed tx nasal fracture w/o stabilization (21315) $212
Closed tx temporomandibular dislocation 1st/sbsq (21480) $199
Cltx dstl fibular fx lat malls w/manj (27788) $598
Cltx dstl radial fx/epiphysl sep w/o manj (25600) $478
Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) $759
Cltx fx w8 brg artclr prtn dstl tibia w/o mnpj (27824) $448
Cltx hip dislocation traumatic w/o anesthesia (27250) $248
Cltx Interphalangeal Joint Dislocation W/O Anes (28660) $171
Cltx metacarpal fx w/manipulation each bone (26605) $468
Cltx metacarpal fx w/o manipulation each bone (26600) $425
Cltx phlngl fx prox/middle px/f/t w/manj ea (26725) $483
Cltx tibial shaft fx w/manj w/wo skel tracj (27752) $751
Colonoscopy flex w/rem forcep (45384) $703
Colonoscopy w/band ligation (45398) $1,209
Complex Uroflowmetry (51741) $20
Contrast Inj Cent Ven Cath, Inc Flouro (36598) $174
Control Nasal Hemorrhage Anterior Complex (30903) $350
Control Nasal Hemorrhage Anterior Simple (30901) $224
Convert gastrostomy-gastro-jejunostomy tube percutaneous (49446) $1,163
Correction of bunion (28299) $1,403
Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); nonautogenous… (36830) $911
Cysto Bladder W/Ureteral Catheterization (52005) $433
Cysto calibration dilat urtl strix/stenosis (52281) $465
Cysto w fulg of minor lesions <0.5cm (52224) $1,129
Cysto w/insert ureteral stent (52332) $575
Cysto/Uretero/Pyeloscopy W/Lithotripsy (52353) $532
Cystometrogram W/Vp&Up (51729) $550
Cystouretero & or pyeloscope (52351) $411
Cystourethroscopy (52000) $344
Cystourethroscopy w/dest &/rmvl med bladder tum (52235) $391
Cystourethroscopy with biopsy (52204) $542
Cystourethroscopy, with internal urethrotomy; male Facility (52275) $771
Debride nail 1-5 (11720) $46
Debride nail 6 or more (11721) $62
Debridement Mastoidectomy Cavity Simple (69220) $108
Debridement subcutaneous tissue 20 sq cm/< (11042) $182
Destroy internal hemorrhoids (46930) $308
Destruc,Ciliary Body,Cyclophotocoag (66710) $607
Destruction Benign Lesions Up To 14 (17110) $159
Destruction mal lesion f/e/e/n/l/m 0.6-1.0cm (17281) $251
Destruction mal lesion f/e/e/n/l/m 1.1-2.0cm (17282) $286
Destruction mal lesion f/e/e/n/l/m 2.1-3.0cm (17283) $337
Destruction mal lesion f/e/e/n/l/m 3.1-4.0cm (17284) $384
Destruction mal lesion trunk/arm/leg 0.6-1.0 cm (17261) $206
Destruction mal lesion trunk/arm/leg 1.1-2.0cm (17262) $249
Destruction mal lesion trunk/arm/leg 2.1-3.0cm (17263) $269
Destruction mal lesion trunk/arm/leg 3.1-4.0cm (17264) $288
Destruction malignant lesion f/e/e/n/l/m 0.5cm/< (17280) $195
Destruction malignant lesion s/n/h/f/g 0.6-1.0cm (17271) $231
Destruction malignant lesion s/n/h/f/g 1.1-2.0cm (17272) $263
Destruction malignant lesion s/n/h/f/g 2.1-3.0cm (17273) $291
Destruction malignant lesion s/n/h/f/g 3.1-4.0cm (17274) $340
Destruction malignant lesion t/a/l 0.5 cm/< (17260) $139
Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg,… (54065) $308
Destruction Premalignant Lesion 15/> (17004) $235
Destruction premalignant lesion 1st (17000) $94
Diagnostic sigmoidoscopy (45330) $267
Dilation esoph unguided sound/bougie 1/mult pass (43450) $269
Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical,… (63075) $1,875
Drain Ext Ear Absc/Blood,Complic (69005) $308
Drainage external auditory canal abscess (69020) $333
Drainage External Ear Abscess/Hematoma Simple (69000) $263
Drainage Finger Abscess Simple (26010) $496
Drainage of gum lesion (41800) $412
Drainage of hematoma/fluid (10140) $238
Draw blood off venous device (36591) $38
Drs&/dbrdmt prtl-thkns burns 1st/sbsq small (16020) $118
Dx bone marrow bx & aspir (38222) $246
Ear Cartilage Graft (21235) $1,019
Egd Ablate Tumor Polyp/Lesion W/Dilation& Wire (43270) $1,067
Egd balloon dilation esophagus <30 mm diam (43249) $1,604
Egd control bleeding any (43255) $915
Egd dilate stricture (43245) $869
Egd flex removal lesion(s) by hot biopsy forceps (43250) $656
Egd flexible foreign body removal (43247) $552
Egd guide wire insertion (43248) $597
Egd place gastrostomy tube (43246) $275
Egd remove lesion snare (43251) $719
Endocervical Curettage (57505) $221
Endometrial Biopsy (58100) $144
Endovenous laser, 1st vein (36478) $1,428
Endovenous rf 1st vein (36475) $1,566
Enterorrhaphy single perforation (44602) $1,947
Ercp Duct Stent Placement (43274) $634
Ercp remove forgn body duct (43275) $516
Escharotomy initial incision (16035) $264
Esophagoscopy flexible guide wire dilation (43226) $557
Esophagoscopy, flexible, transoral; with removal of foreign body(s) (43215) $570
Evacuation of subungual hematoma (11740) $80
Ex tum/vasc malf sft tiss hand/fngr subq 1.5cm/> (26111) $578
Exc b9 les mrgn xcp sk tg t/a/l 0.5 cm/< (11400) $180
Exc B9 Lesion Mrgn Xcp Sk Tg S/N/H/F/G 0.5 Cm/< (11420) $179
Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 2.1-3.0cm (11423) $287
Exc b9 lesion mrgn xcp sk tg s/n/h/f/g 3.1-4.0cm (11424) $328
Exc b9 lesion mrgn xcp sk tg t/a/l 1.1-2.0 cm (11402) $242
Exc Face-Mm B9+Marg 0.5 Cm/< (11440) $201
Exc Face-Mm B9+Marg 2.1-3 Cm (11443) $319
Exc hydrocele sprmatic cord uni spx (55500) $543
Exc Skin Benig 0.6-1 Cm Remaindr Body (11421) $224
Exc Skin Benig 0.6-1 Cm Trunk,Arm,Leg (11401) $220
Exc Skin Benig 2.1-3 Cm Trunk,Arm,Leg (11403) $277
Exc Skin Benig 3.1- 4 Cm Face,Facial (11444) $396
Exc Skin Benig >4 Cm Remaindr Body (11426) $465
Exc Skin Malig >4 Cm Face,Facial (11646) $703
Exc Skin Malig >4 Cm Remaindr Body (11626) $567
Exc Skin Malig >4 Cm Trunk,Arm,Leg (11606) $622
Exc thigh/knee les sc 3 cm/> (27337) $584
Exc thigh/knee tum dep 5cm/> (27339) $1,049
Exc Tr-Ext B9+Marg 3.1-4 Cm (11404) $314
Exc tumor soft tissue abdominal wall subq <3cm (22902) $668
Exc tumor soft tissue leg/ankle subq <3cm (27618) $692
Exc tumor soft tissue neck/ant thorax subq <3cm (21555) $613
Excision Breast Lesion (19125) $800
Excision external ear partial simple repair (69110) $665
Excision H/P/P/U Simple/Intermediate Repair (11470) $644
Excision hydrocele bilateral (55041) $704
Excision Mal Lesion Trunk/Arm/Leg 0.5 Cm/< (11600) $278
Excision Mal Lesion Trunk/Arm/Leg 0.6-1.0 Cm (11601) $320
Excision mal lesion trunk/arm/leg 1.1-2.0 cm (11602) $341
Excision Mal Lesion Trunk/Arm/Leg 2.1-3.0 Cm (11603) $388
Excision Mal Lesion Trunk/Arm/Leg 3.1-4.0 Cm (11604) $432
Excision malignant lesion f/e/e/n/l 0.5 cm/< (11640) $285
Excision malignant lesion f/e/e/n/l 0.6-1.0 cm (11641) $331
Excision malignant lesion f/e/e/n/l 1.1-2.0 cm (11642) $374
Excision Malignant Lesion F/E/E/N/L 2.1-3.0 Cm (11643) $439
Excision Malignant Lesion F/E/E/N/L 3.1-4.0 Cm (11644) $541
Excision Malignant Lesion S/N/H/F/G 0.5 Cm/< (11620) $279
Excision Malignant Lesion S/N/H/F/G 0.6-1.0 Cm (11621) $321
Excision malignant lesion s/n/h/f/g 1.1-2.0 cm (11622) $352
Excision Malignant Lesion S/N/H/F/G 2.1-3.0 Cm (11623) $413
Excision Malignant Lesion S/N/H/F/G 3.1-4.0 Cm (11624) $470
Excision Multiple External Papillae/Tags Anus (46230) $442
Excision of benign lesion other than skin tag 0.6-1.0 cm (11441) $244
Excision of benign lesion other than skin tag 1.1-2.0 cm (11442) $271
Excision of infected graft; extremity Facility (35903) $776
Excision of lesion of spermatic cord (separate procedure) (55520) $639
Excision of lesion other than skin tag 1.1-2.0 cm (11422) $251
Excision of parotid tumor or parotid gland; lateral lobe, with dissection and preservation of facial nerve Facility (42415) $1,465
Excision of pilonidal cyst or sinus; simple (11770) $512
Excision of spermatocele, with or without epididymectomy Facility (54840) $444
Excision of varicocele or ligation of spermatic veins for varicocele; (separate procedure) Facility (55530) $487
Excision of varicocele or ligation of spermatic veins for varicocele; with hernia repair Facility (55540) $774
Excision olecranon bursa (24105) $503
Excision tumor soft tis back/flank subq 3 cm/> (21931) $654
Excision, tumor, soft tissue of abdominal wall, subcutaneous; 3 cm or greater (22903) $613
Excision/curettage cyst/tumor metacarpal (26200) $627
Explore & Treat Metacarpo-Phal Jt (26075) $472
Explore limb vessels (35860) $1,147
Explore Parathyroid Glands (60500) $1,345
Extraction of lens (66940) $1,067
Fasciectomy Plantar Fascia Partial Spx (28060) $723
Fasciotomy foot and/or toe (28008) $595
Fine needle aspiration bx w/us gdn 1st lesion (10005) $193
Fine needle aspiration without imaging guidance (10021) $142
Fit/Insert Intravag Support Device (57160) $105
Fixation of shoulder (23700) $273
Fluoro exam of g/colon tube (49465) $207
Fracture nasal inferior turbinate(s), therapeutic (30930) $164
Fth/Gft Fr W/Dir Clsr F/C/C/M/N/Ax/G/H/F 20 Cm/< (15240) $1,285
Fth/Gft Free W/Direct Closure N/E/E/L 20 Sq Cm/< (15260) $1,377
Gastrocnemius recession (27687) $630
Hallux rigidus w/cheilectomy 1st mp jt w/o implt (28289) $955
I&d abscess simple (10060) $174
I&d epididymis tstis&/scrotal space (54700) $293
Incise finger tendon sheath (26055) $843
Incision & drainage abscess complicated/multiple (10061) $297
Incision & removal foreign body subq tiss compl (10121) $370
Incision & removal foreign body subq tiss simple (10120) $210
Incision and drainage, complex, postoperative wound infection (10180) $369
Incision of eardrum (69420) $269
Incision of rectal abscess (46040) $786
Incision of urethra (53020) $132
Incision, flexor tendon sheath, wrist (eg, flexor carpi radialis) Facility (25001) $484
Incisional biopsy skin single lesion (11106) $221
Initial tx 1st degree burn local tx (16000) $106
Injection Aa&/Strd Other Peripheral Nerve/Branch (64450) $107
Injection anesthetic agent suprascapular nerve (64418) $123
Injection for identification of sentinel node (38792) $116
Injection into skin lesions (11900) $79
Injection Sclerosant Single Incmptnt Vein (36470) $162
Injection single/mlt trigger point 1/2 muscles (20552) $75
Injection Turbinate Therapeutic (30200) $156
Injection, Intralesional; More Than 7 Lesions (11901) $99
Ins cath ren art 2nd+ unilat (36253) $2,928
Ins endovas vena cava filtr (37191) $2,987
Ins/Rep Subq Defibrillator (33270) $777
Insert cath pleura w/o image (32556) $1,082
Insert gastrostomy tube percutaneous (49440) $1,210
Insert non-tunnel cv cath (36556) $306
Insert Temp Bladder Cath (51702) $87
Insert tunneled cv cath (36561) $1,439
Insert,Non-Indwelling Bladder Catheter (51701) $63
Insj picc rs&i 5 yr+ (36573) $577
Insj prph ctr vad w/subq port age 5 yr/> (36571) $1,871
Insj tunneled cvc w/o subq port/pmp age 5 yr/> (36558) $1,213
Intubation endotracheal emergency procedure (31500) $194
Irrigation maxillary sinus (31000) $260
Knee Arthroscopy/Surgery (29879) $919
Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina… (63047) $1,527
Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina… (63045) $1,777
Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or… (63020) $1,601
Lap ing hernia repair init (49650) $604
Laparoscopy w/rmvl adnexal structures (58661) $906
Laparoscopy, surgical; ablation of renal cysts Facility (50541) $1,254
Laparoscopy, surgical; cholecystectomy with cholangiography (47563) $1,001
Laparoscopy, surgical; partial nephrectomy (50543) $2,037
Laparoscopy, surgical; repair recurrent inguinal hernia (49651) $788
Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy Facility (38571) $909
Laps abd prtm&omentum dx w/wo spec br/wa spx (49320) $457
Laryngoscopy flexible diagnostic (31575) $181
Laser surgery of eye (65855) $338
Lithotripsy (50590) $1,031
Male sling procedure (53440) $1,032
Mastectomy for gynecomastia (19300) $822
Mastoidectomy; modified radical Facility (69505) $1,735
Mediastinoscpy w/lmph nod bx (39402) $550
Mohs 1 stage h/n/hf/g (17311) $934
Muscle-skin graft trunk (15734) $2,076
Myelography Lumbar Injection (62304) $365
Nasal endoscopy dx (31231) $266
Nasal/Sinus Ndsc Surg W/Bx Polypc/Dbrdmt Spx (31237) $358
Naso/oro-gastric tube plmt req phys&fluor gdnce (43752) $56
Njx aa&/strd sciatic nerve (64445) $177
Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level (64493) $246
Njx dx/ther sbst intrlmnr crv/thrc w/o img gdn (62324) $194
Open treatment of acromioclavicular dislocation, acute or chronic; with fascial graft (includes obtaining graft)… (23552) $912
Open treatment of mandibular fracture; with interdental fixation Facility (21462) $2,852
Open treatment tarsometatarsal joint dislocation (28615) $1,149
Open tx carpal scaphoid navicular fracture (25628) $1,002
Open Tx Distal Tibiofibular Joint Disruption (27829) $990
Open Tx Metacarpal Fracture Single Ea Bone (26615) $802
Open tx trimalleolar ankle fx w/o fixj pst lip (27822) $1,224
Open/Perq Place Stent Same (37238) $5,053
Optx dstl radl x-artic fx/epiphysl sep (25607) $1,028
Optx fem fx prox end nck int fixj/prostc rplcmt (27236) $1,651
Ostectomy, partial excision, fifth metatarsal head (bunionette) (separate procedure) (28110) $639
Osteot w/wo lngth shrt/corrj 1st metar (28306) $841
Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; thoracic Facility (22222) $2,422
Osteotomy, proximal tibia, including fibular excision or osteotomy (includes correction of genu varus ºbowleg» or genu… (27457) $1,333
Palatopharyngoplasty (42145) $957
Part Remv Femur/Prox Tib/Fib (27360) $1,264
Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing);… (28120) $936
Partial excision bone tibia (27640) $1,155
Partial excision of lip (40520) $706
Partical Excision Bone Phalanx Toe (28124) $660
Perq replacement gtube not req revj gstrst trc (43762) $330
Picc line placement (36569) $129
Placement of needle for intraosseous infusion (36680) $82
Plmt interstitial dev radiat tx prostate 1/mult (55876) $211
Proctosgmdsc rgd dx w/wo collj spec br/wa spx (45300) $183
Punch biopsy skin single lesion (11104) $178
Puncture aspiration of abscess hematoma bulla or cyst (10160) $181
Quadricepsplasty (eg, Bennett or Thompson type) Facility (27430) $1,033
Rad exc bursa synva wrst/f/arm tdn shths xtnsrs (25116) $840
Rad resect elbow caps/sr bone w rels (24149) $1,632
Radical resection of tumor (eg, sarcoma), soft tissue of foot or toe; less than 3 cm Facility (28046) $982
Reinsertion of ruptured biceps or triceps tendon, distal, with or without tendon graft Facility (24342) $1,078
Rem Endovas Vena Cava Filter (37193) $2,173
Removal foreign body intranasal (30300) $298
Removal foreign body muscle/tendon sheath simple (20520) $305
Removal foreign body pharynx (42809) $285
Removal Impacted Cerumen Requiring Instrumentation, Unilateral (69210) $66
Removal of arm foreign body (24200) $309
Removal of heel spur (28119) $730
Removal Of Knee Prosthesis (27488) $1,660
Removal of nail bed (11750) $224
Removal of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid) with corneo-scleral… (66830) $965
Removal skn tags mlt fibrq tags any area upw/15 (11200) $126
Remove anal fist subq (46270) $759
Remove eye/attach implant (65105) $1,330
Remv Ext Canal Foreign Body (69200) $112
Remv F.B.,Eye,Superf Conjunc (65205) $40
Repair complex f/c/c/m/n/ax/g/h/f 2.6-7.5 cm (13132) $661
Repair complex scalp/arm/leg 2.6-7.5 cm (13121) $597
Repair inguinal hernia, sliding, any age (49525) $800
Repair initial femoral hernia, any age; incarcerated or strangulated (49553) $883
Repair intermediate f/e/e/n/l&/muc 2.5 cm/< (12051) $399
Repair intermediate f/e/e/n/l&/muc 2.6-5.0 cm (12052) $443
Repair intermediate f/e/e/n/l&/muc 5.1-7.5 cm (12053) $512
Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) $373
Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) $436
Repair intermediate s/a/t/e 2.5 cm/< (12031) $371
Repair intermediate s/a/t/e 2.6-7.5 cm (12032) $424
Repair Nasal Stenosis (30465) $1,449
Repair of leg tendon each (27658) $512
Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; chronic Facility (23412) $1,183
Repair recurrent inguinal hernia, any age; reducible (49520) $883
Repair Tongue Laceration (41250) $400
Repair tooth socket (41874) $543
Repair, primary, disrupted ligament, ankle; collateral (27695) $667
Repair, secondary, disrupted ligament, ankle, collateral (eg, Watson-Jones procedure) Facility (27698) $884
Repair, tendon or muscle, flexor, forearm and/or wrist; secondary, single, each tendon or muscle Facility (25263) $885
Reposition gastric feeding tube thru duodenum (43761) $173
Revise knuckle joint (26530) $755
Revise knuckle with implant (26531) $879
Revise ulnar nerve at elbow (64718) $835
Revision of ileostomy; complicated (reconstruction in-depth) (separate procedure) Facility (44314) $1,391
Revision of iris (66761) $413
Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component Facility (27487) $2,419
Rhinoplasty, primary; lateral and alar cartilages and/or elevation of nasal tip Facility (30400) $1,744
Rmvl Fb Xtrnl Eye Embed Scjncl/Scleral Nonperfor (65210) $54
Rmvl Lens Material Phacofragmentation Aspir (66850) $1,071
Rmvl Tun Cvc W/O Subq Port/Pmp (36589) $232
Rmvl Vitreous Ant Appr Partial Removal (67005) $645
Rplc gtube revj gstrst trc (43763) $497
Rplcmt compl non-tun cvc w/o subq port/pmp (36580) $274
Rplcmt compl tun ctr vad w/subq port (36582) $1,289
Rplcmt compl tun cvc w/o subq port/pmp (36581) $1,141
Rpr Lip Full Thickness Vermilion Only (40650) $676
Rpr Retinal Dtchmnt W/Vitrectomy Any Meth (67108) $1,615
Scrotal exploration (55110) $536
Shave skin lesion 0.5 cm/< (11300) $144
Shave skin lesion 0.5 cm/< (11305) $151
Shaving Skin Lesion 1 F/E/E/N/L/M Diam 0.5 Cm/< (11310) $164
Shaving Skin Lesion 1 F/E/E/N/L/M Diam >2.0 Cm (11313) $255
Shaving Skin Lesion 1 S/N/H/F/G Diam 0.6-1.0 Cm (11306) $173
Shaving Skin Lesion 1 S/N/H/F/G Diam 1.1-2.0 Cm (11307) $198
Shaving Skin Lesion 1 S/N/H/F/G Diam >2.0 Cm (11308) $210
Shoulder Arthroscopy/Surgery (29825) $817
Shvg Skin Lesion 1 F/E/E/N/L/M Diam 0.6-1.0 Cm (11311) $194
Shvg Skin Lesion 1 F/E/E/N/L/M Diam 1.1-2.0 Cm (11312) $219
Shvg Skin Lesion 1 Trunk/Arm/Leg Diam 0.6-1.0 Cm (11301) $172
Shvg Skin Lesion 1 Trunk/Arm/Leg Diam >2.0 Cm (11303) $215
Shvg Skn Lesion 1 Trunk/Arm/Leg Diam 1.1-2.0 Cm (11302) $195
Sigmoidoscopy Flx Ndsc Us Xm (45341) $171
Sigmoidoscopy Flx With With Band Ligation(S) (45350) $989
Sigmoidoscopy w/biopsy (45331) $416
Simple repair f/e/e/n/l/m 2.5cm/< (12011) $157
Simple repair f/e/e/n/l/m 2.6cm-5.0 cm (12013) $164
Simple repair f/e/e/n/l/m 5.1cm-7.5 cm (12014) $201
Simple repair scalp/neck/ax/genit/trunk 2.5cm/< (12001) $132
Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) $183
Skin sub graft trnk/arm/leg (15271) $217
Skin tissue rearrangement (14040) $1,048
Slctv Cath Carotid/Innom Art Angio Xtrcranl Art (36222) $1,739
Slitting of prepuce (54001) $276
Smpl repair scalp/neck/ax/genit/trunk 2.6-7.5cm (12002) $158
Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) $289
Spinal puncture lumbar diagnostic (62270) $177
Spinal Puncture Therapeutic (62272) $241
Strabismus Recession/Rescj 1 Hrzntl Musc (67311) $657
Strapping ankle (29540) $39
Strapping knee (29530) $42
Strapping shoulder (29240) $42
Strapping toes (29550) $27
Strapping unna boot (29580) $90
Submucous Rescj Inferior Turbinate Prtl/Compl (30140) $417
Surgical arthroscopy shoulder lmtd dbrdmt 1/2 (29822) $754
Surgical closure tracheostomy or fistula; without plastic repair (31820) $626
Suture of quadriceps or hamstring muscle rupture; secondary reconstruction, including fascial or tendon graft Facility (27386) $1,199
Tangential biopsy skin single lesion (11102) $144
Tenodesis long tendon biceps (23430) $1,036
Ther Apheresis,Plasma Pheresis (36514) $807
Thyroid biopsy (60100) $153
Tnot elbow lateral/medial debride open tdn rpr (24359) $922
Total hip arthroplasty (27130) $1,774
Tracheobrnchsc Thru Est Trachs Inc (31615) $242
Tracheostoma Revj Smpl W/O Flap Rotation (31613) $599
Tracheotomy tube change (31502) $49
Transcatheter biopsy (37200) $292
Transur electr resection of prostate (52601) $998
Treat humerus fracture (23600) $471
Treat Thigh Fracture (27245) $1,697
Trim skin lesion (11055) $102
Trim skin lesions 2 to 4 (11056) $117
Trim skin lesions over 4 (11057) $128
Trimming Of Nondystrophic Nails, Any Number (11719) $20
Tube thoracostomy includes water seal (32551) $215
Tx Superficial Wound Dehiscence Simple Closure (12020) $421
Tx superficial wound dehiscence w/packing (12021) $248
Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or… (69645) $2,090
Tympanostomy (69433) $284
Us urine capacity measure (51798) $15
Uvulectomy excision of uvula (42140) $223
Vaginal delivery only (59409) $1,102
Vasc embolize/occlude organ (37243) $12,664
Vasc embolize/occlude venous (37241) $6,864
Venipuncture, cutdown; age 1 or over (36425) $56
Vitrectomy mechanical pars plana (67036) $1,218
Wedge excision skin nail fold (11765) $233