| Abd paracentesis (49082) |
— |
$4,247.75 |
— |
| Abd paracentesis w/imaging (49083) |
— |
$4,879.70 |
— |
| Ablation 1/> liver tumor perq cryoablation (47383) |
— |
$35,503.50 |
— |
| Ablation bone tumor rf perq w/img gdn when done (20982) |
— |
$44,102.30 |
— |
| Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when… (32998) |
— |
$11,335.30 |
— |
| Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when… (32994) |
— |
$22,379.90 |
— |
| Ablation, renal tumor(s), unilateral, percutaneous, cryotherapy (50593) |
— |
$27,846.40 |
— |
| Ablatj bone tumor cryo perq w/img gdn when prfmd (20983) |
— |
$44,102.30 |
— |
| Amniocentesis diagnostic (59000) |
— |
$4,674.30 |
— |
| Amniocentesis therapeutic (59001) |
— |
$998.30 |
— |
| Amnioinfusion (59070) |
— |
$1,001.95 |
— |
| Anchoring of extending tendon of fingers to wrist bone (25301) |
— |
$8,441.45 |
— |
| Anoscopy diagnostic (46600) |
— |
$383.40 |
— |
| Anoscopy remove for body (46608) |
— |
$2,743.05 |
— |
| Application cast finger (29086) |
— |
$472.90 |
— |
| Application Finger Splint Dynamic (29131) |
— |
$183.60 |
— |
| Application finger splint static (29130) |
— |
$383.40 |
— |
| Application of cranial tongs, caliper, or stereotactic frame, including removal (separate procedure) (20660) |
— |
$4,823.70 |
— |
| Application of long leg cast (thigh to toes); (29345) |
— |
$806 |
— |
| Application of long leg splint (thigh to ankle or toes) (29505) |
— |
$472.90 |
— |
| Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic… (20697) |
— |
$12,832.35 |
— |
| Application of short arm splint (forearm to hand); static (29125) |
— |
$383.40 |
— |
| Application of short leg cast (below knee to toes); (29405) |
— |
$806 |
— |
| Application of short leg cast (below knee to toes); walking or ambulatory type (29425) |
— |
$806 |
— |
| Application of short leg splint (calf to foot) (29515) |
— |
$472.90 |
— |
| Application of walking cast covering thigh to toe|SERV DELIV PERSONALLY BY PT OR UNDER AN OP PLAN OF CARE (29355) |
— |
$1,108.28 |
— |
| Application, cast; shoulder to hand (long arm) (29065) |
— |
$806 |
— |
| Apply hand/wrist cast (29085) |
— |
$472.90 |
— |
| Apply long arm splint (29105) |
— |
$472.90 |
— |
| Apply splint short arm dynamic (29126) |
— |
$383.40 |
— |
| Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) |
— |
$1,397.32 |
— |
| Arthrocentesis aspir&/inj interm jt/burs w/us (20606) |
— |
$2,678.60 |
— |
| Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) |
— |
$1,459.38 |
— |
| Arthrocentesis aspir&/inj major jt/bursa w/us (20611) |
— |
$1,545.52 |
— |
| Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) |
— |
$1,502.42 |
— |
| Arthrocnt aspir&/inj small jt/bursaw/us rec rprt (20604) |
— |
$1,674.95 |
— |
| Aspirate pleura w/o imaging (32554) |
— |
$3,422.80 |
— |
| Aspiration and/or injection of ganglion cyst(s) any location (20612) |
— |
$1,922.40 |
— |
| Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous Age Under 21 (50390) |
— |
$3,904.12 |
— |
| Aspiration and/or injection thyroid cyst (60300) |
— |
$3,490.75 |
— |
| Aspiration bladder insert suprapubic catheter (51102) |
— |
$4,605.75 |
— |
| Aspiration bladder needle (51100) |
— |
$440.60 |
— |
| Aspiration of fluid from cyst of spinal cord or fluid-filled cavity (62268) |
— |
$2,472.05 |
— |
| Avulsion of nail plate, partial or complete, simple; single (11730) |
— |
$600.85 |
— |
| Biliary endo prq t-tube dx w/collect spec brush (47552) |
— |
$11,139.15 |
— |
| Biliary endoscopy, percutaneous via T-tube or other tract; with dilation of biliary duct stricture(s) with stent Age… (47556) |
— |
$16,298.70 |
— |
| Biliary endoscopy, percutaneous via T-tube or other tract; with removal of calculus/calculi Age Under 21 (47554) |
— |
$32,795.35 |
— |
| Biliary ndsc prq t-tube w/dil duct w/o stent (47555) |
— |
$11,139.15 |
— |
| Biopsy bone trocar/needle deep (20225) |
— |
$6,743.50 |
— |
| Biopsy liver needle percutaneous (47000) |
— |
$5,147.20 |
— |
| Biopsy lymph node (38505) |
— |
$7,340.95 |
— |
| Biopsy muscle percutaneous needle (20206) |
— |
$6,826.60 |
— |
| Biopsy of salivary gland; needle (42400) |
— |
$2,327.15 |
— |
| Biopsy pleura percutaneous needle (32400) |
— |
$4,310.05 |
— |
| Biopsy soft tissue neck/thorax (21550) |
— |
$4,706.15 |
— |
| Biopsy thyroid percutaneous core needle (60100) |
— |
$3,490.75 |
— |
| Biopsy, abdominal or retroperitoneal mass, percutaneous needle Age Under 21 (49180) |
— |
$7,012.90 |
— |
| Biopsy, bone, trocar, or needle; superficial (eg, ilium, sternum, spinous process, ribs) Age Under 21 (20220) |
— |
$6,366.95 |
— |
| Biopsy, soft tissue of pelvis and hip area; deep, subfascial or intramuscular Age Under 21 (27041) |
— |
$10,588.85 |
— |
| Bladder irrigation (51700) |
— |
$661.30 |
— |
| Blepharotomy, drainage of abscess, eyelid Age Under 21 (67700) |
— |
$1,202.18 |
— |
| Brnchsc ebus guided sampl 1/2 node station/strux (31652) |
— |
$6,051.40 |
— |
| Brnchsc ebus guided sampl 3/> node station/strux (31653) |
— |
$7,560.90 |
— |
| Bronch foreign body removal (31635) |
— |
$5,094 |
— |
| Bx breast 1st lesion mr imag (19085) |
— |
$7,073.75 |
— |
| Bx breast 1st lesion strtctc (19081) |
— |
$5,704 |
— |
| Bx breast 1st lesion us imag (19083) |
— |
$5,704 |
— |
| Bx pancreas ndl perc (48102) |
— |
$3,478.45 |
— |
| Cast short arm (29075) |
— |
$806 |
— |
| Cessation thrombolytic thrpy w/catheter removal (37214) |
— |
$9,576.55 |
— |
| Change Cystostomy Tube Simple (51705) |
— |
$658.90 |
— |
| Change g-tube to g-j perc (49446) |
— |
$11,414.70 |
— |
| Change of cystostomy tube; complicated Age Under 21 (51710) |
— |
$1,205.40 |
— |
| Change of windpipe airway (31502) |
— |
$852.55 |
— |
| Chemical cauterization of granulation tissue (17250) |
— |
$745.15 |
— |
| Chemodenervation muscle neck unilat for dystonia (64616) |
— |
$861.86 |
— |
| Chest tube placement (32551) |
— |
$2,014.05 |
— |
| Chng urtrost tube/xtrnlly accessible stent ileal (50688) |
— |
$6,231.30 |
— |
| Cholecystostomy, percutaneous, complete procedure, including imaging guidance, catheter placement, cholecystogram when… (47490) |
— |
$11,139.15 |
— |
| Circumcision, Newborn (54150) |
— |
$562.50 |
— |
| Cisternal/lateral c1-c2 puncture w/injection (61055) |
— |
$1,875.75 |
— |
| Closed rx acetabular fx (27220) |
— |
$973.18 |
— |
| Closed rx humer epicondylr fx,manip (24565) |
— |
$6,632.58 |
— |
| Closed rx radial shaft fx w/dislocation (25520) |
— |
$6,632.58 |
— |
| Closed rx ulna shaft fx,manipulatn (25535) |
— |
$973.18 |
— |
| Closed treatment of acromioclavicular dislocation; without manipulation (23540) |
— |
$707.75 |
— |
| Closed treatment of ankle dislocation; requiring anesthesia, with or without percutaneous skeletal fixation Age Under 21 (27842) |
— |
$6,632.58 |
— |
| Closed treatment of articular fx,metacarpophalangeal or interphalangeal joint; w/o manip, each (26740) |
— |
$707.75 |
— |
| Closed treatment of calcaneal fracture; without manipulation (28400) |
— |
$707.75 |
— |
| Closed treatment of carpal bone fracture; without manipulation (25630) |
— |
$707.75 |
— |
| Closed treatment of carpal scaphoid (navicular) fracture; without manipulation (25622) |
— |
$707.75 |
— |
| Closed treatment of clavicular fracture; with manipulation (23505) |
— |
$6,632.58 |
— |
| Closed treatment of clavicular fracture; without manipulation (23500) |
— |
$707.75 |
— |
| Closed treatment of dislocated joint between collar and chest bone with manipulation (23525) |
— |
$973.18 |
— |
| Closed treatment of distal femoral epiphyseal separation; with manipulation, with or without skin or skeletal traction… (27517) |
— |
$6,632.58 |
— |
| Closed treatment of distal fibular fracture (lateral malleolus); with manipulation (27788) |
— |
$707.75 |
— |
| Closed treatment of distal fibular fracture (lateral malleolus); without manipulation (27786) |
— |
$707.75 |
— |
| Closed treatment of distal phalangeal fracture, finger or thumb; without manipulation, each (26750) |
— |
$707.75 |
— |
| Closed treatment of femoral fracture, distal end, medial or lateral condyle, with manipulation Age Under 21 (27510) |
— |
$6,632.58 |
— |
| Closed treatment of femoral fracture, proximal end, neck; without manipulation Age Under 21 (27230) |
— |
$973.18 |
— |
| Closed treatment of femoral shaft fracture, with manipulation, with or without skin or skeletal traction Age Under 21 (27502) |
— |
$6,632.58 |
— |
| Closed treatment of fracture of orbit, except blowout; without manipulation Age Under 21 (21400) |
— |
$1,651.30 |
— |
| Closed treatment of greater trochanteric fracture, without manipulation Age Under 21 (27246) |
— |
$707.75 |
— |
| Closed treatment of hip dislocation, traumatic; requiring anesthesia (27252) |
— |
$6,632.58 |
— |
| Closed treatment of humeral shaft fracture; without manipulation (24500) |
— |
$707.75 |
— |
| Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with manipulation, with… (27240) |
— |
$13,265.15 |
— |
| Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; without manipulation Age… (27238) |
— |
$6,632.58 |
— |
| Closed treatment of knee dislocation; requiring anesthesia Age Under 21 (27552) |
— |
$6,632.58 |
— |
| Closed treatment of knee dislocation; without anesthesia (27550) |
— |
$973.18 |
— |
| Closed treatment of medial malleolus fracture; with manipulation, with or without skin or skeletal traction Age Under 21 (27762) |
— |
$6,632.58 |
— |
| Closed treatment of medial malleolus fracture; without manipulation (27760) |
— |
$707.75 |
— |
| Closed treatment of metacarpal fracture, single; with manipulation, each bone (26605) |
— |
$707.75 |
— |
| Closed treatment of metacarpal fracture, single; without manipulation, each bone (26600) |
— |
$707.75 |
— |
| Closed treatment of Monteggia type of fracture dislocation at elbow (fracture proximal end of ulna with dislocation of… (24620) |
— |
$6,632.58 |
— |
| Closed treatment of patellar fracture, without manipulation (27520) |
— |
$707.75 |
— |
| Closed treatment of phalangeal shaft fx, proximal/middle phalanx w/o manipulation, each (26720) |
— |
$707.75 |
— |
| Closed treatment of post hip arthroplasty dislocation; requiring general anesthesia (27266) |
— |
$6,632.58 |
— |
| Closed treatment of proximal fibula or shaft fracture; with manipulation (27781) |
— |
$6,632.58 |
— |
| Closed treatment of proximal fibula or shaft fracture; without manipulation (27780) |
— |
$707.75 |
— |
| Closed treatment of proximal humeral (surgical or anatomical neck) fracture; with manipulation, with or without… (23605) |
— |
$6,632.58 |
— |
| Closed treatment of proximal humeral fracture; without manipulation (23600) |
— |
$707.75 |
— |
| Closed treatment of proximal tibiofibular joint dislocation; requiring anesthesia Age Under 21 (27831) |
— |
$13,357.70 |
— |
| Closed treatment of radial and ulnar shaft fractures; without manipulation (25560) |
— |
$707.75 |
— |
| Closed treatment of radial head or neck fracture; without manipulation (24650) |
— |
$707.75 |
— |
| Closed treatment of radial shaft fracture; without manipulation (25500) |
— |
$707.75 |
— |
| Closed treatment of radiocarpal or intercarpal dislocation, 1 or more bones, with manipulation (25660) |
— |
$973.18 |
— |
| Closed treatment of shoulder dislocation, with fracture of greater humeral tuberosity, with manipulation Age Under 21 (23665) |
— |
$6,632.58 |
— |
| Closed treatment of shoulder dislocation, with manipulation; without anesthesia (23650) |
— |
$973.18 |
— |
| Closed treatment of sternoclavicular dislocation; without manipulation Age Under 21 (23520) |
— |
$6,632.58 |
— |
| Closed treatment of sternum fracture Age Under 21 (21820) |
— |
$707.75 |
— |
| Closed treatment of supracondylar or transcondylar femoral fracture with or without intercondylar extension, with… (27503) |
— |
$6,632.58 |
— |
| Closed treatment of talotarsal joint dislocation; requiring anesthesia Age Under 21 (28575) |
— |
$13,357.70 |
— |
| Closed treatment of talus fracture; with manipulation Age Under 21 (28435) |
— |
$6,632.58 |
— |
| Closed treatment of talus fracture; without manipulation (28430) |
— |
$973.18 |
— |
| Closed treatment of tibial fracture, proximal (plateau); without manipulation (27530) |
— |
$707.75 |
— |
| Closed treatment of trans-scaphoperilunar type of fracture dislocation, with manipulation (25680) |
— |
$973.18 |
— |
| Closed treatment of ulnar fracture, proximal end; without manipulation (24670) |
— |
$707.75 |
— |
| Closed treatment of ulnar shaft fracture; without manipulation (25530) |
— |
$707.75 |
— |
| Closed treatment of ulnar styloid fracture (25650) |
— |
$707.75 |
— |
| Closed tx ankle dislocation w/o anesthesia (27840) |
— |
$707.75 |
— |
| Closed tx bimalleolar ankle fracture w/manj (27810) |
— |
$4,823.70 |
— |
| Closed tx bimalleolar ankle fracture w/o manip (27808) |
— |
$707.75 |
— |
| Closed tx femoral fracture prox head w/manj (27268) |
— |
$13,357.70 |
— |
| Closed tx femoral fracture prox head w/o manj (27267) |
— |
$13,357.70 |
— |
| Closed tx femoral shaft fx w/o manipulation (27500) |
— |
$707.75 |
— |
| Closed tx mandibular fracture w/manipulation (21451) |
— |
$4,577.10 |
— |
| Closed tx mandibular fracture w/o manipulation (21450) |
— |
$1,651.30 |
— |
| Closed tx mandibular fx w/interdental fixation (21453) |
— |
$17,576.10 |
— |
| Closed tx metatarsal fracture w/o manipulation (28470) |
— |
$707.75 |
— |
| Closed tx nose/jaw fx (21345) |
— |
$4,577.10 |
— |
| Closed tx patellar dislocation w/anesthesia (27562) |
— |
$973.18 |
— |
| Closed tx patellar dislocation w/o anesthesia (27560) |
— |
$707.75 |
— |
| Closed tx radial shaft fracture w/manipulation (25505) |
— |
$4,823.70 |
— |
| CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ TechFee (25565) |
— |
$4,823.70 |
— |
| Closed tx scapular fracture w/o manipulation (23570) |
— |
$707.75 |
— |
| Closed tx septal&nose fx (21337) |
— |
$9,663 |
— |
| Closed tx supra/transcondylar humeral fx, w/wo intercondylar extension; w/o manip (24530) |
— |
$707.75 |
— |
| Closed tx talotarsal joint dislc w/o anes (28570) |
— |
$973.18 |
— |
| Closed tx tarsometatarsal dislocation w/anes (28605) |
— |
$707.75 |
— |
| Closed tx tarsometatarsal dislocation w/o anes (28600) |
— |
$707.75 |
— |
| Closed tx temporomandibular dislc comp 1st/sbsq (21485) |
— |
$6,293.52 |
— |
| Closed tx vert fx w/manj (22315) |
— |
$9,714.70 |
— |
| Closure of laceration, vestibule of mouth; 2.5 cm or less (40830) |
— |
$733.10 |
— |
| Closure of laceration, vestibule of mouth; over 2.5 cm or complex (40831) |
— |
$1,651.30 |
— |
| Clsd tx acromioclavicular dislc w/manipulation (23545) |
— |
$973.18 |
— |
| Clsd tx nsl fx mnpj wo stblj (21315) |
— |
$4,577.10 |
— |
| Clsd tx nsl fx w/mnpj&stablj (21320) |
— |
$9,663 |
— |
| Clsd tx pelvic ring fx (27197) |
— |
$707.75 |
— |
| Clsd tx pelvic ring fx w/manipulation w/anes (27198) |
— |
$707.75 |
— |
| Clsd tx shoulder dislc w/manipulation req anes (23655) |
— |
$6,632.58 |
— |
| Cltx artclr fx invg mtcarphlngl/iphal jt w/manj (26742) |
— |
$4,823.70 |
— |
| Cltx carpo/metacarpal dislocation thumb w/manj (26641) |
— |
$707.75 |
— |
| Cltx distal femoral epiphysl separation w/o manj (27516) |
— |
$707.75 |
— |
| CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA TechFee (26755) |
— |
$707.75 |
— |
| Cltx dstl radial fx/epiphysl sep w/o manj (25600) |
— |
$707.75 |
— |
| Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) |
— |
$4,823.70 |
— |
| Cltx fem fx dstl end medial/lat condyle w/o manj (27508) |
— |
$707.75 |
— |
| Cltx fem fx prox end nck w/manj w/wo skel tracj (27232) |
— |
$1,946.38 |
— |
| Cltx fx w8 brg artclr prtn dstl tibia w/o manj (27824) |
— |
$707.75 |
— |
| Cltx greater humeral tuberosity fx w/o mnpj (23620) |
— |
$707.75 |
— |
| Cltx grter humeral tuberosity fx w/manipulation (23625) |
— |
$6,632.58 |
— |
| Cltx hip dislocation traumatic w/o anesthesia (27250) |
— |
$973.18 |
— |
| Cltx humeral condylar fx medial/lat w/o manj (24576) |
— |
$707.75 |
— |
| Cltx humeral epicondylar fx medial/lat w/o manj (24560) |
— |
$707.75 |
— |
| CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ TechFee (24505) |
— |
$4,823.70 |
— |
| Cltx intercondylar spi&/tubrst fx kne w/wo man (27538) |
— |
$707.75 |
— |
| Cltx interphalangeal joint dislocation req anes (28665) |
— |
$806 |
— |
| Cltx interphalangeal joint dislocation w/o anes (28660) |
— |
$707.75 |
— |
| CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES TechFee (26700) |
— |
$707.75 |
— |
| Cltx metar fx w/manj (28475) |
— |
$707.75 |
— |
| Cltx metatarsophlngl jt dislc req anes (28635) |
— |
$4,823.70 |
— |
| Cltx post ankle fx (27767) |
— |
$707.75 |
— |
| Cltx prox tibfib jt dislc w/o anes (27830) |
— |
$973.18 |
— |
| Cltx scapular fx w/mnpj w/wo skeletal traction (23575) |
— |
$6,632.58 |
— |
| Cltx sprcndylr/transcndylr humeral fx w/manj (24535) |
— |
$6,632.58 |
— |
| Cltx sprcndylr/trnscndylr fem fx w/o manj (27501) |
— |
$707.75 |
— |
| Cltx tarsal dislc oth/thn talotarsal w/o anes (28540) |
— |
$973.18 |
— |
| CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ TechFee (27752) |
— |
$4,823.70 |
— |
| Cltx tibial shaft fx w/o manipulation (27750) |
— |
$707.75 |
— |
| Cltx trimalleolar ankle fx w/manipulation (27818) |
— |
$8,441.45 |
— |
| Cltx trimalleolar ankle fx w/o manipulation (27816) |
— |
$707.75 |
— |
| Collect blood from implant venous access device (36591) |
— |
$464.75 |
— |
| Complete replacement picc rs&i (36584) |
— |
$3,101.70 |
— |
| Complex cystometrogram voiding pressure studies (51728) |
— |
$2,002.40 |
— |
| Contrast injection perq radiologic eval gi tube (49465) |
— |
$2,088.85 |
— |
| Contrast injection(s) for radiologic evaluation of existing central venous access device, including fluoroscopy, image… (36598) |
— |
$887.70 |
— |
| Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method (30901) |
— |
$383.40 |
— |
| Conv ext bil drg cath to int-ext bil drg cath (47535) |
— |
$11,139.15 |
— |
| Convert nephrostomy cath to nephrourtrl cath prq (50434) |
— |
$3,976.55 |
— |
| Core needle bx lung/mediastinum perq w/img (32408) |
— |
$7,373.30 |
— |
| Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) |
— |
$383.40 |
— |
| Ctrl nsl hemrrg pst nasal packs&/cautery subsq (30906) |
— |
$733.10 |
— |
| Curettage postpartum (59160) |
— |
$9,383.10 |
— |
| Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus Age Under 21 (52320) |
— |
$9,687.30 |
— |
| Debridement of extensive eczematous or infected skin; up to 10% of body surface (11000) |
— |
$1,264.65 |
— |
| DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/< TechFee (11042) |
— |
$2,337.85 |
— |
| Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm… (11044) |
— |
$4,865.95 |
— |
| Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm… (11043) |
— |
$1,884.95 |
— |
| Declot vascular device (36593) |
— |
$819.25 |
— |
| Delivery of placenta (59414) |
— |
$8,626.20 |
— |
| Destruction by neurolytic agent, with or without radiologic monitoring; celiac plexus Age Under 21 (64680) |
— |
$4,043.60 |
— |
| Diagnostic bone marrow aspirations (38220) |
— |
$10,272.80 |
— |
| Diagnostic bone marrow biopsies (38221) |
— |
$11,004.75 |
— |
| Diagnostic bone marrow biopsies & aspirations (38222) |
— |
$7,738.90 |
— |
| Diagnostic lumbar spinal puncture w/fluor or CT (62328) |
— |
$3,242.05 |
— |
| Dilation of esophagus, by unguided sound or bougie, single or multiple passes Age Under 21 (43450) |
— |
$2,720.60 |
— |
| Drain bladder by trocar/cath (51101) |
— |
$3,137.95 |
— |
| Drain lower leg lesion (27603) |
— |
$8,528.15 |
— |
| Drain neck/chest lesion (21501) |
— |
$8,116.10 |
— |
| Drain shoulder lesion (23030) |
— |
$8,528.15 |
— |
| Drainage abscess or hematoma, nasal, internal approach (30000) |
— |
$733.10 |
— |
| Drainage external auditory canal, abscess (69020) |
— |
$2,111.65 |
— |
| Drainage external ear, abscess or hematoma; complicated Age Under 21 (69005) |
— |
$4,865.95 |
— |
| Drainage external ear, abscess or hematoma; simple (69000) |
— |
$2,111.65 |
— |
| Drainage finger abscess simple (26010) |
— |
$600.85 |
— |
| Drainage of abscess of palate, uvula (42000) |
— |
$733.10 |
— |
| Drainage of abscess, cyst, hematoma, vestibule of mouth; complicated (40801) |
— |
$1,651.30 |
— |
| Drainage of abscess, cyst, hematoma, vestibule of mouth; simple (40800) |
— |
$2,111.65 |
— |
| Drainage of finger abscess; complicated (eg, felon) (26011) |
— |
$4,865.95 |
— |
| Drainage of nose lesion (30020) |
— |
$1,651.30 |
— |
| Drainage of scrotal wall abscess (55100) |
— |
$4,865.95 |
— |
| Drainage of scrotum (54700) |
— |
$6,113.10 |
— |
| Drainage of tonsil abscess (42700) |
— |
$733.10 |
— |
| Dry needling (20999) |
— |
$1,869.40 |
— |
| Ed proc insert intraosseous IV (36680) |
— |
$1,197.05 |
— |
| Ed proc insj temp ndwellg bladder catheter complicated (51703) |
— |
$706.90 |
— |
| Ed proc remve fb nasal- hospital (30300) |
— |
$383.40 |
— |
| Ed prof artl pnxr w/drawal bld dx (36600) |
— |
$281.15 |
— |
| Ed prof burn - large - hospital (16030) |
— |
$1,196.75 |
— |
| Ed prof burn medium - hospital (16025) |
— |
$600.85 |
— |
| Ed prof burn small - hospital (16020) |
— |
$600.85 |
— |
| Ed prof catheterization/straight (51701) |
— |
$383.40 |
— |
| Ed prof closed tx post hip arthroplasty (27265) |
— |
$973.18 |
— |
| Ed prof closed tx pst malleolus fx w/manipulation (27768) |
— |
$4,823.70 |
— |
| Ed prof closed tx radial head/neck fx w/manipulation (24655) |
— |
$6,632.58 |
— |
| Ed prof drain dental abscess-hospital (41800) |
— |
$383.40 |
— |
| Ed prof insert foley cath simple (51702) |
— |
$512.75 |
— |
| Ed prof insert non tunnel cv cath >5 (36556) |
— |
$3,890.85 |
— |
| Ed prof insertion of heart electr (33210) |
— |
$12,938.55 |
— |
| Ed prof int lac 12.6-20cm bd - hospital (12035) |
— |
$1,196.75 |
— |
| Ed prof int lac 7.6-12.5cm bd - hospital (12034) |
— |
$1,196.75 |
— |
| Ed prof interphalangeal dislocation- hospital (26770) |
— |
$707.75 |
— |
| Ed prof naso/oro-gastric tube plmt req phys&fluor gdn (43752) |
— |
$2,334.80 |
— |
| Egd percutaneous placement gastrostomy tube (43246) |
— |
$9,170.15 |
— |
| Egd us exam duodenum/jejunum (43259) |
— |
$7,361.55 |
— |
| Embolectomy or thrombectomy, with or without catheter; femoropopliteal, aortoiliac artery, by leg incision (34201) |
— |
$14,913.65 |
— |
| Endovascular temporary balloon arterial occlusion, head or neck (extracranial/intracranial) including selective… (61623) |
— |
$19,079.40 |
— |
| Endovenous rf 1st vein (36475) |
— |
$15,964.50 |
— |
| Er inj anesthetic agent, peripheral nerve or branch (64450) |
— |
$2,203.10 |
— |
| Escharotomy 1st incision (16035) |
— |
$1,196.75 |
— |
| Evac subungual hematoma (11740) |
— |
$383.40 |
— |
| Exc h-f-nk-sp b9+marg 0.5/< (11420) |
— |
$4,865.95 |
— |
| Exc tr-ext b9+marg 1.1-2 cm (11402) |
— |
$1,234.95 |
— |
| Exchange biliary drg catheter prq w/img gid rs&i (47536) |
— |
$9,478.30 |
— |
| Exchange nephrostomy catheter prq w/img gid rs&i (50435) |
— |
$4,303.75 |
— |
| Exchng absc/cst drg cath rad gid spx (49423) |
— |
$6,644.65 |
— |
| Excision of superficial tracheostomy lesions and/or granulation tissue (31899) |
— |
$582.45 |
— |
| Excision of thrombosed hemorrhoid, external (46320) |
— |
$3,541.75 |
— |
| Exploration with removal of deep foreign body, forearm or wrist (25248) |
— |
$6,632.58 |
— |
| External cannula declotting (36860) |
— |
$3,101.70 |
— |
| External cannula declotting (separate procedure); with balloon catheter Age Under 21 (36861) |
— |
$17,324.75 |
— |
| Fine needle aspiration bx w/CT gdn 1st lesion (10009) |
— |
$4,722.75 |
— |
| Fine needle aspiration bx w/fluor gdn 1st lesion (10007) |
— |
$4,722.75 |
— |
| Fine needle aspiration bx w/us gdn 1st lesion (10005) |
— |
$3,761.70 |
— |
| Ganglion impar nerve block (64999) |
— |
$1,959.70 |
— |
| Gastric lavage (43753) |
— |
$1,477.90 |
— |
| Guide cathet fluid drainage (10030) |
— |
$4,722.60 |
— |
| I&d abscess simple/single (10060) |
— |
$1,476.55 |
— |
| I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION TechFee (27301) |
— |
$8,528.15 |
— |
| I&d hematoma/seroma/fluid (10140) |
— |
$10,588.45 |
— |
| I&d pilonidal cyst simple (10080) |
— |
$1,211.20 |
— |
| I&d upper arm/elbow deep abscess/hematoma (23930) |
— |
$11,726.20 |
— |
| Image fluid collxn drainag cath transrec/vaginal (49407) |
— |
$10,588.85 |
— |
| Image-guide fluid collxn drainage cath visc perq (49405) |
— |
$10,588.85 |
— |
| Img-guide fluid collxn drainag cath periton perq (49406) |
— |
$10,588.85 |
— |
| Incise external hemorrhoid (46083) |
— |
$359 |
— |
| Incise/drain eyelid lining (68020) |
— |
$4,178.10 |
— |
| INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE TechFee (10061) |
— |
$2,957.10 |
— |
| Incision and drainage of Bartholin's gland abscess (56420) |
— |
$598.05 |
— |
| Incision and drainage of pilonidal cyst; complicated (10081) |
— |
$7,358.05 |
— |
| Incision and drainage of submucosal abscess, rectum (45005) |
— |
$3,541.75 |
— |
| Incision and drainage of vulva or perineal abscess (56405) |
— |
$1,091.40 |
— |
| Incision and drainage, complex, postoperative wound infection Age Under 21 (10180) |
— |
$18,071.75 |
— |
| Incision and drainage, forearm and/or wrist; bursa Age Under 21 (25031) |
— |
$6,632.58 |
— |
| Incision and drainage, forearm and/or wrist; deep abscess or hematoma Age Under 21 (25028) |
— |
$13,357.70 |
— |
| Incision and drainage, pelvis or hip joint area; deep abscess or hematoma Age Under 21 (26990) |
— |
$20,695.20 |
— |
| Incision and drainage, perianal abscess, superficial (46050) |
— |
$2,344 |
— |
| Incision and drainage, upper arm or elbow area; bursa Age Under 21 (23931) |
— |
$6,690.70 |
— |
| Incision and removal of foreign body, subcutaneous tissues; complicated (10121) |
— |
$9,287.10 |
— |
| Incision and removal of foreign body, subcutaneous tissues; simple (10120) |
— |
$2,517.20 |
— |
| Incision of rectal abscess (46040) |
— |
$5,298.25 |
— |
| Incision&drainage bursa foot (28001) |
— |
$4,865.95 |
— |
| Incisional biopsy skin single lesion (11106) |
— |
$1,404.20 |
— |
| Infectious disease (Bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 22… (0202U) |
— |
$1,522.18 |
— |
| Infusion of drug to dissolve blood clot in brain (37195) |
— |
$1,325.25 |
— |
| Initial treatment, first degree burn, when no more than local treatment is required (16000) |
— |
$600.85 |
— |
| Inj epidural blood or clot patch (62273) |
— |
$1,205.75 |
— |
| Inj paravert f jnt c/t 1 lev (64490) |
— |
$2,735.60 |
— |
| Inj paravert f jnt l/s 1 lev (64493) |
— |
$2,735.60 |
— |
| Inj,Anes Agent,Femoral Nerve,Single (64447) |
— |
$1,697.75 |
— |
| Injctn, abdmnl abscss/fstla, w sft tsse sub (amnfx) w/wo img gdnc/cntrst (49999) |
— |
$6,074.15 |
— |
| Injection aa&/strd axillary nerve w/img gdn (64417) |
— |
$2,735.60 |
— |
| Injection aa&/strd brachial plexus w/img gdn (64415) |
— |
$2,735.60 |
— |
| Injection aa&/strd greater occipital nerve (64405) |
— |
$1,222.30 |
— |
| Injection aa&/strd ilioinguinal ih nerves (64425) |
— |
$1,602.25 |
— |
| Injection aa&/strd intercostal nrv single lvl (64420) |
— |
$1,997.60 |
— |
| Injection aa&/strd pudendal nerve (64430) |
— |
$2,735.60 |
— |
| Injection aa&/strd sciatic nerve w/img gdn (64445) |
— |
$2,075.55 |
— |
| Injection aa&/strd suprascapular nerve (64418) |
— |
$2,075.55 |
— |
| Injection aa&/strd trigeminal nerve each branch (64400) |
— |
$888.95 |
— |
| Injection aa&/strd vagus nerve (64408) |
— |
$888.95 |
— |
| Injection eye drug (67028) |
— |
$1,044.85 |
— |
| Injection for identification of sentinel node (38792) |
— |
$2,299.15 |
— |
| Injection of sinus tract; therapeutic (separate procedure) Age Under 21 (20500) |
— |
$5,631.35 |
— |
| Injection px prq tx extremity pseudoaneurysm (36002) |
— |
$3,852.45 |
— |
| Injection(s), anesthetic agent(s) and/or steroid; paracervical (uterine) nerve Age Under 21 (64435) |
— |
$2,853.88 |
— |
| Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s) (20552) |
— |
$1,111.70 |
— |
| Injection(s); single or multiple trigger point(s), 3 or more muscle(s) (20553) |
— |
$1,122.15 |
— |
| Injection, anesthetic agent; celiac plexus, with or without radiologic monitoring Age Under 21 (64530) |
— |
$2,494.40 |
— |
| Ins cath ren art 1st bilat (36252) |
— |
$13,484.80 |
— |
| Ins cath ren art 1st unilat (36251) |
— |
$9,022.65 |
— |
| Ins cath ren art 2nd+ bilat (36254) |
— |
$22,351.90 |
— |
| Ins cath ren art 2nd+ unilat (36253) |
— |
$14,934.10 |
— |
| Ins intrvas vc filtr w/wo vas acs vsl selxn rs&i (37191) |
— |
$17,324.75 |
— |
| Ins vag brachytx device (57156) |
— |
$1,532 |
— |
| Ins/rplcmnt perm subq impltbl dfb w/subq eltrd (33270) |
— |
$47,152.20 |
— |
| Insert and remove bone pin (20650) |
— |
$9,714.70 |
— |
| Insert cervical dilator (59200) |
— |
$962.85 |
— |
| Insert gastrostomy tube percutaneous (49440) |
— |
$6,777.50 |
— |
| Insert heart pm atrial (33206) |
— |
$13,564.80 |
— |
| Insert non-tunnel cv cath < 5 y/o (36555) |
— |
$11,970.70 |
— |
| Insert pulse gen mult leads (33221) |
— |
$22,596.05 |
— |
| Insert tunneled cvc w/o subq port/pmp age <5 yr (36557) |
— |
$14,934.10 |
— |
| Insertion indwelling tunneled pleural catheter (32550) |
— |
$10,665.40 |
— |
| Insertion of implantable defibrillator pulse generator only; with existing single lead Age Under 21 (33240) |
— |
$33,542.95 |
— |
| Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); ventricular Age Under 21 (33207) |
— |
$13,564.80 |
— |
| Insertion of pacemaker pulse generator only; with existing dual leads Age Under 21 (33213) |
— |
$11,929.75 |
— |
| Insertion of pacemaker pulse generator only; with existing single lead Age Under 21 (33212) |
— |
$10,409.10 |
— |
| Insertion of peripherally inserted central venous access device, with subcutaneous port; younger than 5 years of age… (36570) |
— |
$10,460.70 |
— |
| Insertion of transvenous intrahepatic portosystemic shunt(s) (tips) (includes venous access, hepatic and portal vein… (37182) |
— |
$22,858.30 |
— |
| Insertion of tube into airway for aspiration of secretions (31720) |
— |
$1,135.20 |
— |
| Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; age 5 years or older Age… (36561) |
— |
$10,988.75 |
— |
| Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; age 5 years or… (36558) |
— |
$7,436.35 |
— |
| Insertion picc w/o img gdn 5 yr/> (36569) |
— |
$3,013.10 |
— |
| Insertion picc w/rs&i 5 yr/> (36573) |
— |
$3,013.10 |
— |
| Insertion subq cardiac rhythm monitor w/prgrmg (33285) |
— |
$18,069.60 |
— |
| Insertion tunnel intraperitoneal cath dial open (49421) |
— |
$6,680.90 |
— |
| Insj 1 transvns eltrd perm pacemaker/impltbl dfb (33216) |
— |
$23,384.20 |
— |
| Insj 2 transvns eltrd perm pacemaker/impltbl dfb (33217) |
— |
$19,274.25 |
— |
| Insj eltrd car ven sys attch prev pm/dfb pls gen (33224) |
— |
$13,315 |
— |
| Insj intraperitoneal catheter w/img guid (49418) |
— |
$23,051.20 |
— |
| Insj of subq implantable defibrillator electrode (33271) |
— |
$19,274.25 |
— |
| Insj prph ctr vad w/subq port age 5 yr/> (36571) |
— |
$10,460.70 |
— |
| Insj tun vad req 2 cath 2 sits w/o subq port/pmp (36565) |
— |
$10,460.70 |
— |
| Insj tunneled ctr vad w/subq port under 5 yr (36560) |
— |
$10,460.70 |
— |
| Insj Tunneled Ctr Vad W/Subq Pump (36563) |
— |
$17,324.75 |
— |
| Insj/rplcmt perm dfb w/trnsvns lds 1/dual chmbr (33249) |
— |
$56,293.50 |
— |
| Insrt heart pm atrial & vent (33208) |
— |
$37,942.15 |
— |
| Insrt pulse gen w/dual leads (33230) |
— |
$33,542.95 |
— |
| Insrt pulse gen w/mult leads (33231) |
— |
$47,152.20 |
— |
| Intraoral i&d tongue/floor lingual (41000) |
— |
$1,651.30 |
— |
| Intraoral i&d tongue/floor masticator space (41009) |
— |
$1,651.30 |
— |
| Intraoral i&d tongue/floor sublngl supfc (41005) |
— |
$733.10 |
— |
| Intraoral i&d tongue/floor submental space (41007) |
— |
$4,577.10 |
— |
| Intraoral i&d tongue/floor submndblr space (41008) |
— |
$9,663 |
— |
| Intro cath dialysis circuit dx angrph fluor s&i (36901) |
— |
$3,816.75 |
— |
| Intro cath dialysis circuit w/tcat plmt IV stent (36903) |
— |
$43,841.05 |
— |
| Intro cath dialysis circuit w/trluml balo angiop (36902) |
— |
$15,237.20 |
— |
| Intubation endotracheal (31500) |
— |
$1,311.60 |
— |
| Laryngoscopy flex diagnostic (31575) |
— |
$977.05 |
— |
| Laryngoscopy flx rmvl foreign body(s) (31577) |
— |
$1,225.50 |
— |
| Laryngoscopy w stroboscopy (31579) |
— |
$1,106.20 |
— |
| Laryngoscopy w/foreign body removal (31530) |
— |
$5,094 |
— |
| Long gi tube placement (44500) |
— |
$4,049.45 |
— |
| Lumbar puncture (62270) |
— |
$1,480 |
— |
| Manometric studies through ureterostomy or indwelling ureteral catheter Age Under 21 (50686) |
— |
$373.40 |
— |
| Marsupialization bartholin's gland cyst (56440) |
— |
$9,383.15 |
— |
| Mastotomy expl drg absc dp (19020) |
— |
$4,865.95 |
— |
| Meas post-voiding residual urine&/bladder cap (51798) |
— |
$186.40 |
— |
| Mechanical removal obstructive material from nonvascular catheter/device (32999) |
— |
$3,745.85 |
— |
| Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen… (36596) |
— |
$3,101.70 |
— |
| Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate… (36595) |
— |
$10,460.70 |
— |
| Medial canthopexy (21280) |
— |
$707.75 |
— |
| Myelography via lumbar inject rs&i lumbosacral (62304) |
— |
$3,080.85 |
— |
| Myelography via lumbar injection rs&i 2+ regions (62305) |
— |
$3,080.85 |
— |
| Myelography via lumbar injection rs&i cervical (62302) |
— |
$3,087.50 |
— |
| Myelography via lumbar injection rs&i thoracic (62303) |
— |
$3,087.50 |
— |
| Needle measurement and recording of electrical activity of muscles at bladder and bowel openings (51785) |
— |
$742.50 |
— |
| Nfct ds DNA untrgt ngnrj seq (0152U) |
— |
$6,378.60 |
— |
| Njx aa&/strd tfrm epi c/t 1 (64479) |
— |
$2,735.60 |
— |
| Njx cholangio prq w/img gid rs&i existing access (47531) |
— |
$10,582.20 |
— |
| Njx cholangio prq w/img gid rs&i new access (47532) |
— |
$11,381.30 |
— |
| Njx dx/ther sbst intrlmnr lmbr/sac w/img gdn (62323) |
— |
$2,181.45 |
— |
| Njx dx/ther sbst intrlmnr lmbr/sac w/img gdn (62327) |
— |
$2,735.60 |
— |
| Njx px antegrde nfrosgrm &/urtrgrm exstng acess (50431) |
— |
$3,471.25 |
— |
| Njx px antegrde nfrosgrm &/urtrgrm new access (50430) |
— |
$3,531.35 |
— |
| Non stress test (59025) |
— |
$1,044.50 |
— |
| Nonslctv cath thor aorta angio intr/xtrcranl art (36221) |
— |
$13,484.80 |
— |
| Onc Pan-Tumor DNA & RNA Next-Generation Sequencing Other Outpatient (0211U) |
— |
$25,365 |
— |
| Open/perq placement intravascular stent initial (37236) |
— |
$36,967.15 |
— |
| Open/perq placement intravascular stent same 1st (37238) |
— |
$36,967.15 |
— |
| Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion (11055) |
— |
$599.20 |
— |
| Pelvis/hip joint surgery unlisted (27299) |
— |
$1,869.40 |
— |
| Perc rf ablate renal tumor (50592) |
— |
$29,554.85 |
— |
| Percut ablate liver rf (47382) |
— |
$28,825.40 |
— |
| Percutaneous aspiration within the nucleus pulposus, intervertebral disc, or paravertebral tissue for diagnostic… (62267) |
— |
$2,099 |
— |
| Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent… (50080) |
— |
$12,071.80 |
— |
| Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic… (37188) |
— |
$13,051.28 |
— |
| Pericardiocentesis w/img guidance when performed (33016) |
— |
$2,010.50 |
— |
| Perq breast loc device placemt 1st lesio mr guid (19287) |
— |
$4,107.95 |
— |
| Perq dev breast 1st strtctc (19283) |
— |
$4,107.95 |
— |
| Perq dev breast 1st us imag (19285) |
— |
$3,927.20 |
— |
| Perq device breast 1st imag (19281) |
— |
$3,829.45 |
— |
| Perq dilation xst trc endourologic px w/img (50436) |
— |
$11,744.30 |
— |
| Perq dilation xst trc new access renal coltj sys (50437) |
— |
$12,005.28 |
— |
| Perq drainage pleura insert cath w/imaging (32557) |
— |
$4,652.52 |
— |
| Perq drainage pleura insert cath w/o imaging (32556) |
— |
$4,380.62 |
— |
| Perq replacement gtube not req revj gstrst trc (43762) |
— |
$1,974.85 |
— |
| Perq thrmbc/nfs dial circuit tcat plmt IV stent (36906) |
— |
$64,986.85 |
— |
| Perq thrmbc/nfs dial circuit trluml balo angiop (36905) |
— |
$42,908.25 |
— |
| Perq thrmbc/nfs dialysis circuit img dx angrph (36904) |
— |
$21,279.50 |
— |
| Perq vert agmntj cavity crtj uni/bi cannulation (22513) |
— |
$14,487.70 |
— |
| Perq vert agmntj cavity crtj uni/bi cannulj lmbr (22514) |
— |
$14,487.70 |
— |
| Perq vertebroplasty uni/bi injection lumbosacral (22511) |
— |
$6,798.40 |
— |
| Perq vertebroplasty uni/bi injx cervicothoracic (22510) |
— |
$6,798.40 |
— |
| Place duod/jej tube perc (49441) |
— |
$9,430.90 |
— |
| Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous,… (49411) |
— |
$8,792.95 |
— |
| Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), prostate (via… (55876) |
— |
$2,278.85 |
— |
| Plmt access thru biliary tree into small bwl new (47541) |
— |
$11,139.15 |
— |
| Plmt bile duct stent prq existing access (47538) |
— |
$14,881.45 |
— |
| Plmt bile duct stent prq new access w/o sep cath (47539) |
— |
$15,590.05 |
— |
| Plmt bile duct stent prq new access w/sep cath (47540) |
— |
$16,298.70 |
— |
| Plmt nephrostomy cath prq new access rs&i (50432) |
— |
$8,707.05 |
— |
| Plmt nephroureteral cath prq new access rs&i (50433) |
— |
$10,052.55 |
— |
| Plmt sft tiss loclzj dev perq 1st lesion (10035) |
— |
$4,486.45 |
— |
| Plmt urtrl stent prq new access w/sep nfros cath (50695) |
— |
$11,963.32 |
— |
| Plmt urtrl stent prq pre-existing nfros tract (50693) |
— |
$8,928 |
— |
| Plmt urtrl stnt prq new acess w/o sep nfros cath (50694) |
— |
$11,703.25 |
— |
| Pr closed treatment sesamoid fracture (28530) |
— |
$973.18 |
— |
| Prim prq trluml mchnl thrmbc n-cor n-icra 1st (37184) |
— |
$43,902.32 |
— |
| Proctosigmoidoscopy fb (45307) |
— |
$8,427 |
— |
| Prq plmt biliary drg cath w/img gid rs&i externl (47533) |
— |
$11,139.15 |
— |
| Prq plmt biliary drg cath w/img gid rs&i int-ext (47534) |
— |
$11,139.15 |
— |
| Prq transcatheter rtrvl intrvas fb with imaging (37197) |
— |
$10,460.70 |
— |
| Prq transluminal mechanical thrombectomy vein (37187) |
— |
$20,982.85 |
— |
| Puncture aspiration of abscess, hematoma, bulla, or cyst (10160) |
— |
$1,863.40 |
— |
| Puncture aspiration of cyst of breast (19000) |
— |
$2,110.90 |
— |
| Pvb thoracic single injection site w/img gid (64461) |
— |
$1,997.60 |
— |
| Radiant-neck/chest procedure unlisted (21899) |
— |
$745.80 |
— |
| Relocate skin pocket implantable defibrillator (33223) |
— |
$3,944.50 |
— |
| Relocation of skin pocket for pacemaker (33222) |
— |
$3,944.50 |
— |
| Removal (via snare/capture) and replacement of internally dwelling ureteral stent via percutaneous approach, including… (50382) |
— |
$11,652.18 |
— |
| Removal biliary drg catheter req fluor gid rs&i (47537) |
— |
$2,788.45 |
— |
| Removal foreign body foot complicated (28193) |
— |
$6,690.70 |
— |
| REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS TechFee (28190) |
— |
$2,111.65 |
— |
| Removal foreign body mouth (40804) |
— |
$2,720.60 |
— |
| Removal foreign body shoulder subcutaneous (23330) |
— |
$6,690.70 |
— |
| Removal foreign body upper arm/elbow deep (24201) |
— |
$11,726.20 |
— |
| Removal impacted cerumen irrigation/lvg unilat (69209) |
— |
$179.38 |
— |
| Removal impacted cerumen requiring instrumentation, unilateral (69210) |
— |
$282.78 |
— |
| Removal implantable defib pulse generator only (33241) |
— |
$8,839.20 |
— |
| Removal of cerclage suture under anesthesia (other than local) Age Under 21 (59871) |
— |
$9,383.10 |
— |
| Removal of fecal impaction or foreign body (separate procedure) under anesthesia (45915) |
— |
$1,790.30 |
— |
| Removal of foreign body in muscle or tendon sheath; simple (20520) |
— |
$4,865.95 |
— |
| Removal of foreign body in scrotum (55120) |
— |
$6,113.10 |
— |
| Removal of foreign body in voice box using an endoscope with mirror (31511) |
— |
$594.50 |
— |
| Removal of foreign body of upper arm or elbow area, accessed beneath the skin (24200) |
— |
$4,865.95 |
— |
| Removal of foreign body, external eye; conjunctival superficial (65205) |
— |
$383.40 |
— |
| Removal of foreign body, external eye; corneal, without slit lamp (65220) |
— |
$1,195.85 |
— |
| Removal of foreign body, foot; deep (28192) |
— |
$4,865.95 |
— |
| Removal of foreign body, pelvis or hip; deep (subfascial or intramuscular) Age Under 21 (27087) |
— |
$13,357.70 |
— |
| Removal of foreign body, shoulder; deep (subfascial or intramuscular) Age Under 21 (23333) |
— |
$11,726.20 |
— |
| Removal of iud (58301) |
— |
$962.85 |
— |
| Removal of nail bed (11750) |
— |
$1,196.75 |
— |
| Removal of pm generator (33233) |
— |
$9,361 |
— |
| Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions (11200) |
— |
$593.50 |
— |
| Removal of transvenous pacemaker electrode(s); dual lead system Age Under 21 (33235) |
— |
$6,982.25 |
— |
| Removal of transvenous pacemaker electrode(s); single lead system, atrial or ventricular Age Under 21 (33234) |
— |
$6,863.40 |
— |
| Removal of tunneled intraperitoneal catheter (49422) |
— |
$9,962.15 |
— |
| Removal subcutaneous cardiac rhythm monitor (33286) |
— |
$3,193.50 |
— |
| Removal tunneled cv cath (36590) |
— |
$3,270.20 |
— |
| Removal, non-biodegradable drug delivery implant (11982) |
— |
$1,195.85 |
— |
| Remove eyelid foreign body (67938) |
— |
$1,202.18 |
— |
| Remove foreign body from eye (65210) |
— |
$1,644.28 |
— |
| Remove hip foreign body (27086) |
— |
$11,726.20 |
— |
| Remove lung catheter (32552) |
— |
$3,745.85 |
— |
| Remove pharynx foreign body (42809) |
— |
$1,195.85 |
— |
| Remove ureter stent percut (50384) |
— |
$11,652.18 |
— |
| Remove vaginal foreign body (57415) |
— |
$9,383.15 |
— |
| Remvl perm pm pls gen w/repl plse gen 2 lead sys (33228) |
— |
$14,186.65 |
— |
| Remvl perm pm pls gen w/repl plse gen mult lead (33229) |
— |
$21,566.15 |
— |
| Remvl perm pm plse gen w/repl plse gen sngl lead (33227) |
— |
$12,603.75 |
— |
| Renal biopsy; percutaneous, by trocar or needle Age Under 21 (50200) |
— |
$4,485.25 |
— |
| Repair blood vessel lesion (35226) |
— |
$2,731.95 |
— |
| Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) |
— |
$1,196.75 |
— |
| REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM TechFee (13132) |
— |
$2,085.20 |
— |
| Repair complex scalp/arm/leg 2.6-7.5 cm (13121) |
— |
$2,085.20 |
— |
| Repair complex trunk 2.6-7.5 cm (13101) |
— |
$2,085.20 |
— |
| Repair eyelid wound (67930) |
— |
$9,643.42 |
— |
| Repair finger tendon (26418) |
— |
$4,823.70 |
— |
| Repair forearm tendon/muscle (25260) |
— |
$9,714.70 |
— |
| REPAIR INTERMEDIATE F/E/E/N/L and /MUC 2.5 CM/< (12051) |
— |
$1,196.75 |
— |
| REPAIR INTERMEDIATE F/E/E/N/L and /MUC 2.6-5.0 CM (12052) |
— |
$1,196.75 |
— |
| REPAIR INTERMEDIATE F/E/E/N/L and /MUC 7.6-12.5 CM (12054) |
— |
$1,196.75 |
— |
| Repair intermediate f/e/e/n/l&/muc 12.6-20.0cm (12055) |
— |
$1,196.75 |
— |
| Repair intermediate n/h/f/xtrnl gent 12.6-20 cm (12045) |
— |
$2,085.20 |
— |
| Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) |
— |
$1,196.75 |
— |
| Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) |
— |
$1,196.75 |
— |
| Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) |
— |
$2,085.20 |
— |
| REPAIR INTERMEDIATE S/A/T/E 2.5 CM/< TechFee (12031) |
— |
$1,196.75 |
— |
| REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM TechFee (12032) |
— |
$1,196.75 |
— |
| REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM TechFee (12036) |
— |
$2,085.20 |
— |
| Repair Intermediate Wound Face,e/e/n/ L/ Mucous Membranes 5.1cm To 7.5cm (12053) |
— |
$1,196.75 |
— |
| Repair Intermediate Wound Face,e/e/n/ L/ Mucous Membranes20.1cm To 30.0cm (12056) |
— |
$1,196.75 |
— |
| Repair Intermediate Wound Face,ears,eyelids,nose, Lips And Or Mucous Membranes Over 30.0cm (12057) |
— |
$1,196.75 |
— |
| Repair Intermediate Wounds Of Scalp, Underarms, Truck And/or Extremities Over 30.0cm (12037) |
— |
$5,473.20 |
— |
| Repair lac palate<2 cm (42180) |
— |
$1,651.30 |
— |
| Repair lead pace-defib one (33218) |
— |
$11,798.40 |
— |
| Repair lip full thickness vermillion only - lac - lip rn (40650) |
— |
$1,651.30 |
— |
| Repair lip, full thickness; up to half vertical height Age Under 21 (40652) |
— |
$1,651.30 |
— |
| Repair of laceration 2.5 cm or less; floor of mouth and/or anterior two-thirds of tongue (41250) |
— |
$1,195.85 |
— |
| Repair of laceration of tongue, floor of mouth, over 2.6 cm or complex (41252) |
— |
$733.10 |
— |
| Repair of nail bed (11760) |
— |
$1,884.95 |
— |
| Repair of tunneled or non-tunneled central venous access catheter, without subcutaneous port or pump, central or… (36575) |
— |
$2,971.20 |
— |
| Repair palate (42182) |
— |
$17,576.10 |
— |
| Repair tongue lacer,post 1/3 (41251) |
— |
$733.10 |
— |
| Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm (13151) |
— |
$2,085.20 |
— |
| Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm (13152) |
— |
$2,085.20 |
— |
| Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm (13120) |
— |
$2,085.20 |
— |
| Repair, complex, trunk; 1.1 cm to 2.5 cm (13100) |
— |
$2,085.20 |
— |
| Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; over 30.0 cm (12047) |
— |
$5,473.20 |
— |
| Repair, tendon or muscle, upper arm or elbow, each tendon or muscle, primary or secondary (excludes rotator cuff) Age… (24341) |
— |
$29,523.22 |
— |
| Replace duodenostomy/jejunostomy tube perq (49451) |
— |
$6,074.15 |
— |
| Replace gastrostomy/cecostomy tube percutaneous (49450) |
— |
$2,640.95 |
— |
| Replace picvad cath (36585) |
— |
$10,460.70 |
— |
| Replace tunneled cv cath (36582) |
— |
$10,460.70 |
— |
| Replacement gastro-jejunostomy tube percutaneous (49452) |
— |
$6,074.15 |
— |
| Repos previously implanted subq implantable dfb (33273) |
— |
$7,071.35 |
— |
| Reposition l ventric lead (33226) |
— |
$6,521.65 |
— |
| Reposition venous catheter (36597) |
— |
$3,101.70 |
— |
| Repositioning of a naso- or oro-gastric feeding tube, through the duodenum for enteric nutrition Age Under 21 (43761) |
— |
$1,946.50 |
— |
| Repositioning of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and… (37192) |
— |
$10,460.70 |
— |
| Reset dislocated jaw (21480) |
— |
$973.18 |
— |
| Revision, open, arteriovenous fistula; without thrombectomy, autogenous or nonautogenous dialysis graft (separate… (36832) |
— |
$17,614.55 |
— |
| Revj transvns intrhptc portosystemic shnt (tips) (37183) |
— |
$25,019.40 |
— |
| Rmvl & rplcmt xtrnl accessible nephrourtrl cath (50387) |
— |
$8,707.05 |
— |
| Rmvl embedded fb from dentalvlr struxs soft tiss (41805) |
— |
$4,577.10 |
— |
| Rmvl embedded fb vestibule mouth comp (40805) |
— |
$1,651.30 |
— |
| RMVL FB XTRNL AUDITORY CANAL W/O ANES TechFee (69200) |
— |
$383.40 |
— |
| RMVL FB XTRNL EYE CORNEAL W/SLIT LAMP TechFee (65222) |
— |
$383.40 |
— |
| Rmvl foreign body muscle/tendon sheath deep/comp (20525) |
— |
$8,528.15 |
— |
| Rmvl impltbl dfb pls gen w/rplcmt pls gen mlt ld (33264) |
— |
$58,940.25 |
— |
| Rmvl impltbl dfb plse gen w/repl plse gen 1 lead (33262) |
— |
$23,959.25 |
— |
| Rmvl impltbl dfb plse gen w/rplcmt plse gen 2 ld (33263) |
— |
$23,959.25 |
— |
| Rmvl nfros tube req fluoro guidance (50389) |
— |
$3,976.55 |
— |
| Rmvl of access device (36589) |
— |
$2,721.45 |
— |
| Rmvl of subq implantable defibrillator electrode (33272) |
— |
$7,071.35 |
— |
| Rmvl1/dual chmbr impltbl dfb eltrd transvns xtrj (33244) |
— |
$7,071.35 |
— |
| Rplc gtube revj gstrst trc (43763) |
— |
$2,056.35 |
— |
| Rplcmt compl non-tun cvc w/o subq port/pmp (36580) |
— |
$3,101.70 |
— |
| Rplcmt compl tun cvc w/o subq port/pmp (36581) |
— |
$8,350.60 |
— |
| Rpr blvsl w/grf other/than vein lower extremity (35286) |
— |
$21,532.75 |
— |
| Rpr ctr vad w/subq port/pmp ctr/prph insj sit (36576) |
— |
$3,101.70 |
— |
| Rpr intermediate n/h/f/xtrnl gent 20.1-30.0 cm (12046) |
— |
$2,085.20 |
— |
| Rpr lip fth>1half ver ht/cpx (40654) |
— |
$4,577.10 |
— |
| Rpr tdn/musc xtnsr f/arm&/wrist prim 1 ea tdn (25270) |
— |
$9,714.70 |
— |
| Rpsg prev implted pm/dfb r atr/r ventr electrode (33215) |
— |
$6,521.65 |
— |
| Rtrvl intrvas vc filtr w/wo acs vsl selxn rs&i (37193) |
— |
$12,767.05 |
— |
| Sclerotherapy fluid collection prq w/img gid (49185) |
— |
$4,722.75 |
— |
| Sgl bloon entrscpy ercp w bloon dilation and stone removal (alt anatomy) (47999) |
— |
$2,788.45 |
— |
| Sigmoidoscopy w/fb removal (45332) |
— |
$3,541.75 |
— |
| SIMPLE REPAIR F/E/E/N/L/M 2.5CM/< TechFee (12011) |
— |
$600.85 |
— |
| SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM TechFee (12013) |
— |
$600.85 |
— |
| SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM TechFee (12014) |
— |
$600.85 |
— |
| SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5 CM TechFee (12015) |
— |
$600.85 |
— |
| Simple repair f/e/e/n/l/m >30.0 cm (12018) |
— |
$600.85 |
— |
| SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/< TechFee (12001) |
— |
$860.50 |
— |
| SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK >30.0CM TechFee (12007) |
— |
$600.85 |
— |
| Simple Repair Superficial Wound F/e/,eyelids,n/l/ And Or Mucous Membranes 20.1cm To 30.0cm (12017) |
— |
$1,196.75 |
— |
| Simple Repair Superficial Wound F/e/eyelids,n/l/ And Or Mucous Membranes 12.6cm To 20.0cm (12016) |
— |
$1,196.75 |
— |
| Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) |
— |
$1,179.30 |
— |
| Skin tissue procedure unlisted (17999) |
— |
$777.70 |
— |
| Slctv cath carotid/innom art angio intrcranl art (36223) |
— |
$24,442.45 |
— |
| Slctv cath carotid/innom art angio xtrcranl art (36222) |
— |
$12,369.28 |
— |
| Slctv cath intrnl carotid art angio intrcrnl art (36224) |
— |
$22,960.98 |
— |
| Slctv cath subclavian art angio vertebral artery (36225) |
— |
$11,253.72 |
— |
| Slctv cath vertebral art angio vertebral artery (36226) |
— |
$24,091.60 |
— |
| SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM TechFee (12002) |
— |
$904.95 |
— |
| SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM TechFee (12005) |
— |
$1,196.75 |
— |
| Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) |
— |
$1,196.75 |
— |
| Strapping ankle (29540) |
— |
$472.90 |
— |
| Strapping elbow or wrist (29260) |
— |
$183.60 |
— |
| Strapping hand/finger (29280) |
— |
$183.60 |
— |
| Strapping hip (29520) |
— |
$527.18 |
— |
| Strapping of knee (29530) |
— |
$383.40 |
— |
| Strapping of shoulder (29240) |
— |
$383.40 |
— |
| Strapping of toes (29550) |
— |
$183.60 |
— |
| Strapping unna boot (29580) |
— |
$827.60 |
— |
| Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; full… (67935) |
— |
$9,643.42 |
— |
| Tcat insj/rpl perm leadless pacemaker rv w/img (33274) |
— |
$21,904.20 |
— |
| Therapeutic apheresis platelet (36513) |
— |
$7,040.40 |
— |
| Therapeutic apheresis; for plasma pheresis Age Under 21 (36514) |
— |
$9,115.55 |
— |
| Therapeutic apheresis; for red blood cells Age Under 21 (36512) |
— |
$8,455.10 |
— |
| Therapeutic apheresis; for white blood cells Age Under 21 (36511) |
— |
$7,039.30 |
— |
| Therapeutic spinal pnxr drainage csf w/fluor/CT (62329) |
— |
$1,480 |
— |
| Therapeutic spinal puncture drainage csf (62272) |
— |
$1,480 |
— |
| Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance (32555) |
— |
$3,980.90 |
— |
| Thrombectomy of arterial or venous graft (other than hemodialysis graft or fistula); Age Under 21 (35875) |
— |
$17,324.75 |
— |
| Thrombolysis art/venous infsn w/image subsq tx (37213) |
— |
$9,576.55 |
— |
| Thrombolysis arterial infusion icra rs&i init tx (37211) |
— |
$15,577.38 |
— |
| Thrombolysis venous infusion w/imaging init tx (37212) |
— |
$13,051.28 |
— |
| Tr retinal les preterm inf (67229) |
— |
$1,728.10 |
— |
| Transcatheter biopsy (37200) |
— |
$12,317.35 |
— |
| Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a… (61626) |
— |
$23,849.30 |
— |
| Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a… (61624) |
— |
$30,518.20 |
— |
| Transcervical introduction of fallopian tube catheter for diagnosis and/or re-establishing patency (any method), with… (58345) |
— |
$16,508.48 |
— |
| Transfer of tendon to restore intrinsic function; ring and small finger Age Under 21 (26497) |
— |
$193,816.50 |
— |
| Transfusion, blood or blood components (36430) |
— |
$1,207.15 |
— |
| Transperineal plmt biodegradable matrl 1/mlt njx (55874) |
— |
$7,686.90 |
— |
| Transtracheal (percutaneous) introduction of needle wire dilator/stent or indwelling tube for oxygen therapy Age Under… (31730) |
— |
$3,804.20 |
— |
| Transurethral destruction of prostate tissue; by radiofrequency thermotherapy Age Under 21 (53852) |
— |
$5,581.60 |
— |
| Treat craniofacial fracture (21431) |
— |
$9,663 |
— |
| Treat dental ridge fracture (21440) |
— |
$9,663 |
— |
| Treat foot dislocation (28545) |
— |
$13,357.70 |
— |
| Treat hip socket fracture (27222) |
— |
$1,946.38 |
— |
| Treat humerus fracture (24577) |
— |
$6,632.58 |
— |
| Treat knee fracture (27532) |
— |
$13,357.70 |
— |
| Treat lower leg fracture (27825) |
— |
$6,632.58 |
— |
| Treat mouth roof fracture (21421) |
— |
$9,663 |
— |
| Treat pleurodesis w/agent (32560) |
— |
$3,745.85 |
— |
| Treat tail bone fracture (27200) |
— |
$707.75 |
— |
| Treat thumb fracture (26645) |
— |
$6,632.58 |
— |
| Treat toe dislocation (28630) |
— |
$707.75 |
— |
| Treat ulnar fracture (24675) |
— |
$6,632.58 |
— |
| Treat wrist bone fracture (25635) |
— |
$6,632.58 |
— |
| Treat wrist bone fracture (25624) |
— |
$6,632.58 |
— |
| Treat wrist dislocation (25690) |
— |
$6,632.58 |
— |
| Treat wrist dislocation (25675) |
— |
$973.18 |
— |
| TREATMENT CLOSED ELBOW DISLOCATION REQ ANES TechFee (24605) |
— |
$6,632.58 |
— |
| Treatment of closed elbow dislocation; without anesthesia (24600) |
— |
$707.75 |
— |
| Treatment of heel fracture (28405) |
— |
$973.18 |
— |
| Treatment of tarsal bone fracture (except talus and calcaneus); without manipulation, each (28450) |
— |
$707.75 |
— |
| Trimming of nondystrophic nails, any number (11719) |
— |
$183.60 |
— |
| Trlml balo angiop open/perq img s&i 1st art (37246) |
— |
$21,279.50 |
— |
| Trlml balo angiop open/perq w/img s&i 1st vein (37248) |
— |
$21,279.50 |
— |
| Tx superficial wound dehiscence simple closure (12020) |
— |
$2,085.20 |
— |
| Tx superficial wound dehiscence w/packing (12021) |
— |
$1,196.75 |
— |
| Tx tarsal bone fx xcp talus&calcn w/manj (28455) |
— |
$4,823.70 |
— |
| Unlisted procedure rectum (45999) |
— |
$1,452.45 |
— |
| Unlisted procedure, liver (47399) |
— |
$4,722.75 |
— |
| Upgrade of pacemaker system (33214) |
— |
$14,164.50 |
— |
| Vaginal delivery (59409) |
— |
$11,008.60 |
— |
| Vasc embolize/occlude bleed (37244) |
— |
$26,599.35 |
— |
| Vascular embolization or occlusion arterial rs&i (37242) |
— |
$114,964.55 |
— |
| Vascular embolization or occlusion venous rs&i (37241) |
— |
$139,007.60 |
— |
| Vascular embolize/occlude organ tumor infarct (37243) |
— |
$22,824.90 |
— |
| Vascular surgery procedure (37799) |
— |
$7,310.65 |
— |
| Venipuncture (36415) |
— |
$88.50 |
— |
| Version cephalic external (59412) |
— |
$3,968.80 |
— |
| Wedge excision skin nail fold (11765) |
— |
$1,196.75 |
— |