Procedures & surgery prices at Intermountain Health Platte Valley Hospital

Brighton, CO · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abd paracentesis (49082) $4,207.30
Abd paracentesis w/imaging (49083) $4,833.25
Ablation 1/> liver tumor perq cryoablation (47383) $35,165.40
Ablation bone tumor rf perq w/img gdn when done (20982) $43,682.30
Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when… (32994) $18,327.80
Ablation, renal tumor(s), unilateral, percutaneous, cryotherapy (50593) $23,834.05
Amnioinfusion (59070) $992.40
Anchoring of extending tendon of fingers to wrist bone (25301) $8,361.05
Anoscopy diagnostic (46600) $379.75
Anoscopy remove for body (46608) $2,716.95
App skn sub grft t/a/l area/<100scm /<1st 25 scm (15271) $4,550
App skn subgrft t/a/l area/100sq cm 1st 100sq cm (15273) $8,133.70
Application cast finger (29086) $468.40
Application Finger Splint Dynamic (29131) $181.85
Application finger splint static (29130) $379.75
Application of cranial tongs, caliper, or stereotactic frame, including removal (separate procedure) (20660) $4,777.75
Application of long leg cast (thigh to toes); (29345) $798.35
Application of long leg splint (thigh to ankle or toes) (29505) $468.40
Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic… (20697) $5,702.55
Application of short arm splint (forearm to hand); static (29125) $379.75
Application of short leg cast (below knee to toes); (29405) $798.35
Application of short leg cast (below knee to toes); walking or ambulatory type (29425) $798.35
Application of short leg splint (calf to foot) (29515) $468.40
Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or… (15277) $7,107.08
Application of vein wound compression bandages on lower leg ankle and foot|BILATERAL PROCEDURE |SERV DELIV PERSONALLY… (29581) $896.10
Application of walking cast covering thigh to toe|SERV DELIV PERSONALLY BY PT OR UNDER AN OP PLAN OF CARE (29355) $1,097.72
Application rigid total contact leg cast (29445) $1,810.75
Application, cast; shoulder to hand (long arm) (29065) $798.35
Apply hand/wrist cast (29085) $468.40
Apply long arm splint (29105) $468.40
Apply splint short arm dynamic (29126) $379.75
Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) $1,384
Arthrocentesis aspir&/inj interm jt/burs w/us (20606) $1,557.60
Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) $1,445.48
Arthrocentesis aspir&/inj major jt/bursa w/us (20611) $1,530.80
Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) $1,411.05
Arthrocnt aspir&/inj small jt/bursaw/us rec rprt (20604) $1,510.68
Aspirate pleura w/o imaging (32554) $3,390.20
Aspiration and/or injection of ganglion cyst(s) any location (20612) $1,904.10
Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous Age Under 21 (50390) $3,866.92
Aspiration bladder insert suprapubic catheter (51102) $4,561.85
Aspiration bladder needle (51100) $734.70
Aspiration of fluid from cyst of spinal cord or fluid-filled cavity (62268) $1,805.15
Avulsion of nail plate, partial or complete, simple; single (11730) $420
Biliary endoscopy, percutaneous via T-tube or other tract; with dilation of biliary duct stricture(s) with stent Age… (47556) $16,143.45
Biliary ndsc prq t-tube w/dil duct w/o stent (47555) $11,033.05
Biopsy bone trocar/needle deep (20225) $4,420.25
Biopsy liver needle percutaneous (47000) $4,191.45
Biopsy lymph node (38505) $2,947.30
Biopsy muscle percutaneous needle (20206) $2,874
Biopsy of salivary gland; needle (42400) $2,711.75
Biopsy pleura percutaneous needle (32400) $4,269
Biopsy soft tissue neck/thorax (21550) $2,391.25
Biopsy thyroid percutaneous core needle (60100) $2,029.25
Biopsy, abdominal or retroperitoneal mass, percutaneous needle Age Under 21 (49180) $3,059.95
Biopsy, bone, trocar, or needle; superficial (eg, ilium, sternum, spinous process, ribs) Age Under 21 (20220) $4,100.50
Biopsy, breast, w/wo placement of localization device(s), when performed (19499) $9,579.85
Bladder irrigation (51700) $595.85
Blepharotomy, drainage of abscess, eyelid Age Under 21 (67700) $1,190.75
Bronch foreign body removal (31635) $5,045.50
Bx breast 1st lesion mr imag (19085) $6,930.65
Bx breast 1st lesion strtctc (19081) $5,649.70
Bx breast 1st lesion us imag (19083) $5,649.70
Bx pancreas ndl perc (48102) $2,732.80
Cast short arm (29075) $798.35
Cessation thrombolytic thrpy w/catheter removal (37214) $3,407.95
Change Cystostomy Tube Simple (51705) $652.60
Change g-tube to g-j perc (49446) $8,746.65
Change of cystostomy tube; complicated Age Under 21 (51710) $1,193.95
Change of windpipe airway (31502) $789.60
Chemical cauterization of granulation tissue (17250) $738.10
Chest tube placement (32551) $1,994.85
Chng urtrost tube/xtrnlly accessible stent ileal (50688) $6,171.95
Cholecystostomy, percutaneous, complete procedure, including imaging guidance, catheter placement, cholecystogram when… (47490) $5,458.50
Circumcision, Newborn (54150) $562.50
Closed rx acetabular fx (27220) $963.92
Closed rx humer epicondylr fx,manip (24565) $6,569.40
Closed rx radial shaft fx w/dislocation (25520) $6,569.40
Closed rx ulna shaft fx,manipulatn (25535) $963.92
Closed treatment of acromioclavicular dislocation; without manipulation (23540) $701.05
Closed treatment of ankle dislocation; requiring anesthesia, with or without percutaneous skeletal fixation Age Under 21 (27842) $6,569.40
Closed treatment of articular fx,metacarpophalangeal or interphalangeal joint; w/o manip, each (26740) $701.05
Closed treatment of calcaneal fracture; without manipulation (28400) $701.05
Closed treatment of carpal bone fracture; without manipulation (25630) $701.05
Closed treatment of carpal scaphoid (navicular) fracture; without manipulation (25622) $701.05
Closed treatment of clavicular fracture; with manipulation (23505) $6,569.40
Closed treatment of clavicular fracture; without manipulation (23500) $701.05
Closed treatment of dislocated joint between collar and chest bone with manipulation (23525) $963.92
Closed treatment of distal femoral epiphyseal separation; with manipulation, with or without skin or skeletal traction… (27517) $6,569.40
Closed treatment of distal fibular fracture (lateral malleolus); with manipulation (27788) $701.05
Closed treatment of distal fibular fracture (lateral malleolus); without manipulation (27786) $701.05
Closed treatment of distal phalangeal fracture, finger or thumb; without manipulation, each (26750) $701.05
Closed treatment of femoral fracture, distal end, medial or lateral condyle, with manipulation Age Under 21 (27510) $6,569.40
Closed treatment of femoral fracture, proximal end, neck; without manipulation Age Under 21 (27230) $963.92
Closed treatment of femoral shaft fracture, with manipulation, with or without skin or skeletal traction Age Under 21 (27502) $6,569.40
Closed treatment of fracture of orbit, except blowout; without manipulation Age Under 21 (21400) $1,635.60
Closed treatment of greater trochanteric fracture, without manipulation Age Under 21 (27246) $701.05
Closed treatment of hip dislocation, traumatic; requiring anesthesia (27252) $6,569.40
Closed treatment of humeral shaft fracture; without manipulation (24500) $701.05
Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with manipulation, with… (27240) $13,138.82
Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; without manipulation Age… (27238) $6,569.40
Closed treatment of knee dislocation; requiring anesthesia Age Under 21 (27552) $6,569.40
Closed treatment of knee dislocation; without anesthesia (27550) $963.92
Closed treatment of medial malleolus fracture; with manipulation, with or without skin or skeletal traction Age Under 21 (27762) $6,569.40
Closed treatment of medial malleolus fracture; without manipulation (27760) $701.05
Closed treatment of metacarpal fracture, single; with manipulation, each bone (26605) $701.05
Closed treatment of metacarpal fracture, single; without manipulation, each bone (26600) $701.05
Closed treatment of Monteggia type of fracture dislocation at elbow (fracture proximal end of ulna with dislocation of… (24620) $6,569.40
Closed treatment of patellar fracture, without manipulation (27520) $701.05
Closed treatment of phalangeal shaft fx, proximal/middle phalanx w/o manipulation, each (26720) $701.05
Closed treatment of post hip arthroplasty dislocation; requiring general anesthesia (27266) $6,569.40
Closed treatment of proximal fibula or shaft fracture; with manipulation (27781) $6,569.40
Closed treatment of proximal fibula or shaft fracture; without manipulation (27780) $701.05
Closed treatment of proximal humeral (surgical or anatomical neck) fracture; with manipulation, with or without… (23605) $6,569.40
Closed treatment of proximal humeral fracture; without manipulation (23600) $701.05
Closed treatment of proximal tibiofibular joint dislocation; requiring anesthesia Age Under 21 (27831) $13,230.48
Closed treatment of radial and ulnar shaft fractures; without manipulation (25560) $701.05
Closed treatment of radial head or neck fracture; without manipulation (24650) $701.05
Closed treatment of radial shaft fracture; without manipulation (25500) $701.05
Closed treatment of radiocarpal or intercarpal dislocation, 1 or more bones, with manipulation (25660) $963.92
Closed treatment of shoulder dislocation, with fracture of greater humeral tuberosity, with manipulation Age Under 21 (23665) $6,569.40
Closed treatment of shoulder dislocation, with manipulation; without anesthesia (23650) $963.92
Closed treatment of sternoclavicular dislocation; without manipulation Age Under 21 (23520) $6,569.40
Closed treatment of sternum fracture Age Under 21 (21820) $701.05
Closed treatment of supracondylar or transcondylar femoral fracture with or without intercondylar extension, with… (27503) $6,569.40
Closed treatment of talotarsal joint dislocation; requiring anesthesia Age Under 21 (28575) $13,230.48
Closed treatment of talus fracture; with manipulation Age Under 21 (28435) $6,569.40
Closed treatment of talus fracture; without manipulation (28430) $963.92
Closed treatment of tibial fracture, proximal (plateau); without manipulation (27530) $701.05
Closed treatment of trans-scaphoperilunar type of fracture dislocation, with manipulation (25680) $963.92
Closed treatment of ulnar fracture, proximal end; without manipulation (24670) $701.05
Closed treatment of ulnar shaft fracture; without manipulation (25530) $701.05
Closed treatment of ulnar styloid fracture (25650) $701.05
Closed tx ankle dislocation w/o anesthesia (27840) $701.05
Closed tx bimalleolar ankle fracture w/manj (27810) $4,777.75
Closed tx bimalleolar ankle fracture w/o manip (27808) $701.05
Closed tx femoral fracture prox head w/manj (27268) $13,230.48
Closed tx femoral fracture prox head w/o manj (27267) $13,230.48
Closed tx femoral shaft fx w/o manipulation (27500) $701.05
Closed tx mandibular fracture w/manipulation (21451) $4,533.50
Closed tx mandibular fracture w/o manipulation (21450) $1,635.60
Closed tx mandibular fx w/interdental fixation (21453) $17,408.70
Closed tx metatarsal fracture w/o manipulation (28470) $701.05
Closed tx nose/jaw fx (21345) $4,533.50
Closed tx patellar dislocation w/anesthesia (27562) $963.92
Closed tx patellar dislocation w/o anesthesia (27560) $701.05
Closed tx radial shaft fracture w/manipulation (25505) $4,777.75
CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ TechFee (25565) $4,777.75
Closed tx scapular fracture w/o manipulation (23570) $701.05
Closed tx septal&nose fx (21337) $9,570.95
Closed tx supra/transcondylar humeral fx, w/wo intercondylar extension; w/o manip (24530) $701.05
Closed tx talotarsal joint dislc w/o anes (28570) $963.92
Closed tx tarsometatarsal dislocation w/anes (28605) $701.05
Closed tx tarsometatarsal dislocation w/o anes (28600) $701.05
Closed tx temporomandibular dislc comp 1st/sbsq (21485) $6,233.58
Closed tx vert fx w/manj (22315) $9,622.15
Closure of laceration, vestibule of mouth; 2.5 cm or less (40830) $726.10
Closure of laceration, vestibule of mouth; over 2.5 cm or complex (40831) $1,635.60
Clsd tx acromioclavicular dislc w/manipulation (23545) $963.92
Clsd tx nsl fx mnpj wo stblj (21315) $4,533.50
Clsd tx nsl fx w/mnpj&stablj (21320) $9,570.95
Clsd tx pelvic ring fx (27197) $701.05
Clsd tx pelvic ring fx w/manipulation w/anes (27198) $701.05
Clsd tx shoulder dislc w/manipulation req anes (23655) $6,569.40
Cltx artclr fx invg mtcarphlngl/iphal jt w/manj (26742) $4,777.75
Cltx carpo/metacarpal dislocation thumb w/manj (26641) $701.05
Cltx distal femoral epiphysl separation w/o manj (27516) $701.05
CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA TechFee (26755) $701.05
Cltx dstl radial fx/epiphysl sep w/o manj (25600) $701.05
Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) $4,777.75
Cltx fem fx dstl end medial/lat condyle w/o manj (27508) $701.05
Cltx fem fx prox end nck w/manj w/wo skel tracj (27232) $1,927.82
Cltx fx w8 brg artclr prtn dstl tibia w/o manj (27824) $701.05
Cltx greater humeral tuberosity fx w/o mnpj (23620) $701.05
Cltx grter humeral tuberosity fx w/manipulation (23625) $6,569.40
Cltx hip dislocation traumatic w/o anesthesia (27250) $963.92
Cltx humeral condylar fx medial/lat w/o manj (24576) $701.05
Cltx humeral epicondylar fx medial/lat w/o manj (24560) $701.05
CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ TechFee (24505) $4,777.75
Cltx intercondylar spi&/tubrst fx kne w/wo man (27538) $701.05
Cltx interphalangeal joint dislocation req anes (28665) $798.35
Cltx interphalangeal joint dislocation w/o anes (28660) $701.05
CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES TechFee (26700) $701.05
Cltx metar fx w/manj (28475) $701.05
Cltx metatarsophlngl jt dislc req anes (28635) $4,777.75
Cltx post ankle fx (27767) $701.05
Cltx prox tibfib jt dislc w/o anes (27830) $963.92
Cltx scapular fx w/mnpj w/wo skeletal traction (23575) $6,569.40
Cltx sprcndylr/transcndylr humeral fx w/manj (24535) $6,569.40
Cltx sprcndylr/trnscndylr fem fx w/o manj (27501) $701.05
Cltx tarsal dislc oth/thn talotarsal w/o anes (28540) $963.92
CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ TechFee (27752) $4,777.75
Cltx tibial shaft fx w/o manipulation (27750) $701.05
Cltx trimalleolar ankle fx w/manipulation (27818) $8,361.05
Cltx trimalleolar ankle fx w/o manipulation (27816) $701.05
Collect blood from catheter venous nos (36592) $145.35
Collect blood from implant venous access device (36591) $460.35
Complete replacement picc rs&i (36584) $1,967.15
Complex cystometrogram voiding pressure studies (51728) $2,002.40
Contrast injection perq radiologic eval gi tube (49465) $2,068.95
Contrast injection(s) for radiologic evaluation of existing central venous access device, including fluoroscopy, image… (36598) $879.25
Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method (30901) $379.75
Conv ext bil drg cath to int-ext bil drg cath (47535) $11,033.05
Convert nephrostomy cath to nephrourtrl cath prq (50434) $5,793.68
Core needle bx lung/mediastinum perq w/img (32408) $5,005.60
Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) $379.75
Ctrl nsl hemrrg pst nasal packs&/cautery subsq (30906) $726.10
Curettage postpartum (59160) $9,293.75
Debridement of extensive eczematous or infected skin; up to 10% of body surface (11000) $1,252.60
Debridement of nail(s) by any method(s); 1 to 5 (11720) $179.75
Debridement of nail(s) by any method(s); 6 or more (11721) $212.15
DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/< TechFee (11042) $1,626.75
Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm… (11044) $5,658.45
Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm… (11043) $2,575.60
Declot vascular device (36593) $608.55
Delivery of placenta (59414) $4,213.35
Diagnostic bone marrow aspirations (38220) $10,174.98
Diagnostic bone marrow biopsies (38221) $10,899.92
Diagnostic bone marrow biopsies & aspirations (38222) $7,665.18
Diagnostic lumbar spinal puncture w/fluor or CT (62328) $2,582
Dilation of esophagus, by unguided sound or bougie, single or multiple passes Age Under 21 (43450) $2,694.70
Drain bladder by trocar/cath (51101) $3,108.10
Drain lower leg lesion (27603) $8,446.95
Drain neck/chest lesion (21501) $8,038.80
Drain shoulder lesion (23030) $8,446.95
Drainage abscess or hematoma, nasal, internal approach (30000) $726.10
Drainage external auditory canal, abscess (69020) $2,091.50
Drainage external ear, abscess or hematoma; complicated Age Under 21 (69005) $4,819.60
Drainage external ear, abscess or hematoma; simple (69000) $2,091.50
Drainage finger abscess simple (26010) $595.15
Drainage of abscess of palate, uvula (42000) $726.10
Drainage of abscess, cyst, hematoma, vestibule of mouth; complicated (40801) $1,635.60
Drainage of abscess, cyst, hematoma, vestibule of mouth; simple (40800) $2,091.50
Drainage of finger abscess; complicated (eg, felon) (26011) $4,819.60
Drainage of nose lesion (30020) $1,635.60
Drainage of scrotal wall abscess (55100) $4,819.60
Drainage of scrotum (54700) $6,054.85
Drainage of tonsil abscess (42700) $726.10
Dstr nrolytc agnt parverteb fct sngl crvcl/thora (64633) $2,800.25
Dstr nrolytc agnt parverteb fct sngl lmbr/sacral (64635) $3,820.72
Ed proc insert intraosseous IV (36680) $1,185.65
Ed proc insj temp ndwellg bladder catheter complicated (51703) $227.50
Ed proc remve fb nasal- hospital (30300) $379.75
Ed prof artl pnxr w/drawal bld dx (36600) $278.45
Ed prof burn - large - hospital (16030) $903.80
Ed prof burn medium - hospital (16025) $884.10
Ed prof burn small - hospital (16020) $736.80
Ed prof catheterization/straight (51701) $379.75
Ed prof closed tx post hip arthroplasty (27265) $963.92
Ed prof closed tx pst malleolus fx w/manipulation (27768) $4,777.75
Ed prof closed tx radial head/neck fx w/manipulation (24655) $6,569.40
Ed prof drain dental abscess-hospital (41800) $379.75
Ed prof insert foley cath simple (51702) $507.85
Ed prof insert non tunnel cv cath >5 (36556) $3,407.95
Ed prof insertion of heart electr (33210) $9,338.20
Ed prof int lac 12.6-20cm bd - hospital (12035) $1,185.35
Ed prof int lac 7.6-12.5cm bd - hospital (12034) $1,185.35
Ed prof interphalangeal dislocation- hospital (26770) $701.05
Ed prof naso/oro-gastric tube plmt req phys&fluor gdn (43752) $3,002.85
Egd percutaneous placement gastrostomy tube (43246) $8,218.25
Embolectomy or thrombectomy, with or without catheter; femoropopliteal, aortoiliac artery, by leg incision (34201) $14,771.60
Embolectomy or thrombectomy, with or without catheter; popliteal-tibio-peroneal artery, by leg incision (34203) $12,383.50
Endovascular temporary balloon arterial occlusion, head or neck (extracranial/intracranial) including selective… (61623) $18,897.70
Endoven ablti ther chem adhesive 1st vein (36482) $16,500.88
Endovenous rf 1st vein (36475) $15,318.32
Er inj anesthetic agent, peripheral nerve or branch (64450) $2,416.52
Escharotomy 1st incision (16035) $1,166.25
Evac subungual hematoma (11740) $157
Exc h-f-nk-sp b9+marg 0.5/< (11420) $4,819.60
Exc h-f-nk-sp b9+marg 1.1-2 (11422) $3,372.65
Exc tr-ext b9+marg 1.1-2 cm (11402) $1,223.20
Exchange biliary drg catheter prq w/img gid rs&i (47536) $9,388.05
Exchange nephrostomy catheter prq w/img gid rs&i (50435) $4,732.20
Exchange transfusion, blood; newborn Age Under 21 (36450) $1,362.85
Exchng absc/cst drg cath rad gid spx (49423) $3,627.10
Excision of superficial tracheostomy lesions and/or granulation tissue (31899) $605.75
Excision of thrombosed hemorrhoid, external (46320) $3,508
Exploration with removal of deep foreign body, forearm or wrist (25248) $6,569.40
External cannula declotting (36860) $3,072.15
External cannula declotting (separate procedure); with balloon catheter Age Under 21 (36861) $17,159.75
Fetal contraction stress test (59020) $1,002.40
Fine needle aspiration bx w/CT gdn 1st lesion (10009) $4,677.75
Fine needle aspiration bx w/fluor gdn 1st lesion (10007) $2,249.75
Fine needle aspiration bx w/us gdn 1st lesion (10005) $3,725.85
Ganglion impar nerve block (64999) $1,941.05
Gastric lavage (43753) $1,369.20
Guide cathet fluid drainage (10030) $2,510.65
I&d abscess simple/single (10060) $768.85
I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION TechFee (27301) $8,446.95
I&d hematoma/seroma/fluid (10140) $5,658.45
I&d pilonidal cyst simple (10080) $1,199.65
I&d upper arm/elbow deep abscess/hematoma (23930) $11,614.55
Image fluid collxn drainag cath transrec/vaginal (49407) $5,730.60
Image-guide fluid collxn drainage cath visc perq (49405) $7,163.20
Img-guide fluid collxn drainag cath periton perq (49406) $5,926.75
Incise external hemorrhoid (46083) $734.70
Incise/drain eyelid lining (68020) $4,138.32
INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE TechFee (10061) $2,905.55
Incision and drainage of Bartholin's gland abscess (56420) $592.35
Incision and drainage of pilonidal cyst; complicated (10081) $7,288
Incision and drainage of submucosal abscess, rectum (45005) $3,508
Incision and drainage of vulva or perineal abscess (56405) $953.65
Incision and drainage, complex, postoperative wound infection Age Under 21 (10180) $17,899.60
Incision and drainage, forearm and/or wrist; bursa Age Under 21 (25031) $6,569.40
Incision and drainage, forearm and/or wrist; deep abscess or hematoma Age Under 21 (25028) $13,230.48
Incision and drainage, pelvis or hip joint area; deep abscess or hematoma Age Under 21 (26990) $20,498.10
Incision and drainage, perianal abscess, superficial (46050) $2,716.95
Incision and drainage, upper arm or elbow area; bursa Age Under 21 (23931) $6,626.98
Incision and removal of foreign body, subcutaneous tissues; complicated (10121) $9,198.65
Incision and removal of foreign body, subcutaneous tissues; simple (10120) $1,355.60
Incision of rectal abscess (46040) $3,508
Incision&drainage bursa foot (28001) $4,819.60
Incisional biopsy skin single lesion (11106) $1,390.85
Infectious disease (Bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 22… (0202U) $1,516.90
Infusion of drug to dissolve blood clot in brain (37195) $1,312.65
Initial treatment, first degree burn, when no more than local treatment is required (16000) $595.15
Inj epidural blood or clot patch (62273) $806.20
Inj paravert f jnt c/t 1 lev (64490) $2,709.55
Inj paravert f jnt l/s 1 lev (64493) $2,709.55
Inj,Anes Agent,Femoral Nerve,Single (64447) $1,681.60
Injctn, abdmnl abscss/fstla, w sft tsse sub (amnfx) w/wo img gdnc/cntrst (49999) $9,829.20
Injection aa&/strd axillary nerve w/img gdn (64417) $2,709.55
Injection aa&/strd brachial plexus w/img gdn (64415) $2,709.55
Injection aa&/strd greater occipital nerve (64405) $1,210.62
Injection aa&/strd ilioinguinal ih nerves (64425) $1,587
Injection aa&/strd intercostal nrv single lvl (64420) $1,978.60
Injection aa&/strd pudendal nerve (64430) $2,709.55
Injection aa&/strd sciatic nerve w/img gdn (64445) $2,055.75
Injection aa&/strd suprascapular nerve (64418) $2,055.75
Injection aa&/strd trigeminal nerve each branch (64400) $1,014.40
Injection aa&/strd vagus nerve (64408) $880.45
Injection anes lmbr/thrc paravertbrl sympathetic (64520) $2,470.65
Injection for identification of sentinel node (38792) $1,726.70
Injection of sinus tract; therapeutic (separate procedure) Age Under 21 (20500) $2,426.65
Injection px prq tx extremity pseudoaneurysm (36002) $1,420.40
Injection sclerosant multiple incmptnt veins (36471) $4,106.75
Injection sclerosant single incmptnt vein (36470) $883.92
Injection(s), anesthetic agent(s) and/or steroid; paracervical (uterine) nerve Age Under 21 (64435) $2,826.68
Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s) (20552) $1,227.75
Injection(s); single or multiple trigger point(s), 3 or more muscle(s) (20553) $1,111.45
Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar fascia) (20550) $1,167.90
Injection, anesthetic agent; celiac plexus, with or without radiologic monitoring Age Under 21 (64530) $2,470.65
Injection, anesthetic agent; sphenopalatine ganglion Age Under 21 (64505) $401.75
Ins cath ren art 1st bilat (36252) $15,384.95
Ins cath ren art 1st unilat (36251) $8,936.75
Ins cath ren art 2nd+ bilat (36254) $22,139
Ins cath ren art 2nd+ unilat (36253) $7,510.35
Ins intrvas vc filtr w/wo vas acs vsl selxn rs&i (37191) $17,159.75
Ins/rplcmnt perm subq impltbl dfb w/subq eltrd (33270) $46,703.15
Insert and remove bone pin (20650) $9,622.15
Insert cecostomy/other colonic tube percutaneous (49442) $14,902.10
Insert cervical dilator (59200) $953.70
Insert drug implant device (11981) $190
Insert gastrostomy tube percutaneous (49440) $4,998.70
Insert heart pm atrial (33206) $13,435.65
Insert non-tunnel cv cath < 5 y/o (36555) $3,407.95
Insert pulse gen mult leads (33221) $22,380.85
Insert tunneled cvc w/o subq port/pmp age <5 yr (36557) $14,791.85
Insertion indwelling tunneled pleural catheter (32550) $10,563.80
Insertion of implantable defibrillator pulse generator only; with existing single lead Age Under 21 (33240) $33,223.50
Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); ventricular Age Under 21 (33207) $13,435.65
Insertion of pacemaker pulse generator only; with existing dual leads Age Under 21 (33213) $11,816.10
Insertion of pacemaker pulse generator only; with existing single lead Age Under 21 (33212) $10,309.95
Insertion of transvenous intrahepatic portosystemic shunt(s) (tips) (includes venous access, hepatic and portal vein… (37182) $26,432.50
Insertion of tube into airway for aspiration of secretions (31720) $1,124.40
Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; age 5 years or older Age… (36561) $10,884.10
Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; age 5 years or… (36558) $9,454.95
Insertion or replacement of temporary transvenous dual chamber pacing electrodes (separate procedure) Age Under 21 (33211) $9,338.20
Insertion picc w/o img gdn 5 yr/> (36569) $3,686.30
Insertion picc w/rs&i 5 yr/> (36573) $2,238.30
Insertion subq cardiac rhythm monitor w/prgrmg (33285) $12,281.80
Insertion tunnel intraperitoneal cath dial open (49421) $6,617.30
Insj 1 transvns eltrd perm pacemaker/impltbl dfb (33216) $23,161.50
Insj 2 transvns eltrd perm pacemaker/impltbl dfb (33217) $19,090.65
Insj eltrd car ven sys attch prev pm/dfb pls gen (33224) $13,188.20
Insj intraperitoneal catheter w/img guid (49418) $22,831.70
Insj of subq implantable defibrillator electrode (33271) $19,090.65
Insj prph ctr vad w/subq port age 5 yr/> (36571) $10,361.10
Insj tun vad req 2 cath 2 sits w/o subq port/pmp (36565) $10,361.10
Insj tunneled ctr vad w/subq port under 5 yr (36560) $10,361.10
Insj Tunneled Ctr Vad W/Subq Pump (36563) $17,159.75
Insj/rplcmt perm dfb w/trnsvns lds 1/dual chmbr (33249) $55,757.35
Insj/rplcmt spinal npg/rcvr pocket crtj&connj (63685) $92,309.20
Insrt heart pm atrial & vent (33208) $37,580.80
Insrt pulse gen w/dual leads (33230) $33,223.50
Insrt pulse gen w/mult leads (33231) $46,703.15
Intraoral i&d tongue/floor lingual (41000) $1,635.60
Intraoral i&d tongue/floor masticator space (41009) $1,635.60
Intraoral i&d tongue/floor sublngl supfc (41005) $726.10
Intraoral i&d tongue/floor submental space (41007) $4,533.50
Intraoral i&d tongue/floor submndblr space (41008) $9,570.95
Intro cath dialysis circuit dx angrph fluor s&i (36901) $5,040.50
Intro cath dialysis circuit w/tcat plmt IV stent (36903) $43,423.50
Intro cath dialysis circuit w/trluml balo angiop (36902) $15,092.10
Intubation endotracheal (31500) $1,299.10
Laryngoscopy direct, with or without tracheoscopy; for aspiration Age Under 21 (31515) $4,487.65
Laryngoscopy flx rmvl foreign body(s) (31577) $1,213.85
Laryngoscopy w/foreign body removal (31530) $5,045.50
Ligation of a-v fistula (37607) $9,889.60
Ligation of inferior vena cava (37619) $37,620.50
Long gi tube placement (44500) $2,166
Lumbar puncture (62270) $1,465.90
Marsupialization bartholin's gland cyst (56440) $9,293.75
Mastotomy expl drg absc dp (19020) $4,819.60
Meas post-voiding residual urine&/bladder cap (51798) $184.60
Mechanical removal obstructive material from nonvascular catheter/device (32999) $8,069.15
Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen… (36596) $3,966.20
Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate… (36595) $10,361.10
Medial canthopexy (21280) $701.05
Myelography via lumbar inject rs&i lumbosacral (62304) $2,026.05
Myelography via lumbar injection rs&i cervical (62302) $2,026.05
Myelography via lumbar injection rs&i thoracic (62303) $3,058.10
Needle insertion w/o injection 1 or 2 muscles (20560) $66
Needle insertion w/o injection 3 or more muscles (20561) $66
Neuroplasty and/or transposition; cranial nerve (specify) Age Under 21 (64716) $3,007.35
Nfct ds DNA untrgt ngnrj seq (0152U) $6,378.60
Njx aa&/strd tfrm epi c/t 1 (64479) $2,709.55
Njx cholangio prq w/img gid rs&i existing access (47531) $10,481.40
Njx cholangio prq w/img gid rs&i new access (47532) $11,272.90
Njx dx/ther sbst intrlmnr lmbr/sac w/img gdn (62323) $1,689.55
Njx dx/ther sbst intrlmnr lmbr/sac w/img gdn (62327) $2,709.55
Njx px antegrde nfrosgrm &/urtrgrm exstng acess (50431) $3,194.32
Njx px antegrde nfrosgrm &/urtrgrm new access (50430) $3,649.18
Non stress test (59025) $919.65
Nonslctv cath thor aorta angio intr/xtrcranl art (36221) $9,617.50
Obstructive material removal from gi tube (49460) $5,102.15
Onc Pan-Tumor DNA & RNA Next-Generation Sequencing Other Outpatient (0211U) $25,365
Open/perq placement intravascular stent initial (37236) $26,403.35
Open/perq placement intravascular stent same 1st (37238) $21,465.60
Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); 2 to 4 lesions (11056) $707.30
Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion (11055) $691.95
Perc rf ablate renal tumor (50592) $29,273.38
Percut ablate liver rf (47382) $28,550.85
Percutaneous aspiration within the nucleus pulposus, intervertebral disc, or paravertebral tissue for diagnostic… (62267) $2,079
Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic… (37188) $12,927
Pericardiocentesis w/img guidance when performed (33016) $1,991.35
Perq dev breast 1st strtctc (19283) $3,598.40
Perq dev breast 1st us imag (19285) $1,765.55
Perq device breast 1st imag (19281) $4,241
Perq dilation xst trc endourologic px w/img (50436) $11,632.45
Perq dilation xst trc new access renal coltj sys (50437) $11,890.95
Perq drainage pleura insert cath w/imaging (32557) $4,154.85
Perq drainage pleura insert cath w/o imaging (32556) $3,286.88
Perq replacement gtube not req revj gstrst trc (43762) $2,192.95
Perq thrmbc/nfs dial circuit tcat plmt IV stent (36906) $64,367.95
Perq thrmbc/nfs dial circuit trluml balo angiop (36905) $42,499.60
Perq thrmbc/nfs dialysis circuit img dx angrph (36904) $18,582.80
Perq vert agmntj cavity crtj uni/bi cannulation (22513) $14,349.75
Perq vert agmntj cavity crtj uni/bi cannulj lmbr (22514) $14,349.75
Perq vertebroplasty uni/bi injection lumbosacral (22511) $3,837.85
Perq vertebroplasty uni/bi injx cervicothoracic (22510) $3,837.85
Place duod/jej tube perc (49441) $11,097.15
Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous,… (49411) $7,947.20
Plmt bile duct stent prq existing access (47538) $14,739.70
Plmt bile duct stent prq new access w/o sep cath (47539) $15,441.60
Plmt bile duct stent prq new access w/sep cath (47540) $16,143.45
Plmt nephrostomy cath prq new access rs&i (50432) $7,746.32
Plmt nephroureteral cath prq new access rs&i (50433) $9,956.82
Plmt sft tiss loclzj dev perq 1st lesion (10035) $4,443.75
Plmt urtrl stent prq new access w/sep nfros cath (50695) $11,849.38
Plmt urtrl stent prq pre-existing nfros tract (50693) $8,842.98
Plmt urtrl stnt prq new acess w/o sep nfros cath (50694) $11,591.80
Pr closed treatment sesamoid fracture (28530) $963.92
Prim prq trluml mchnl thrmbc n-cor n-icra 1st (37184) $25,139.75
Proctosigmoidoscopy fb (45307) $8,346.75
Prq impltj nstim electrode array epidural (63650) $20,604
Prq plmt biliary drg cath w/img gid rs&i externl (47533) $11,033.05
Prq plmt biliary drg cath w/img gid rs&i int-ext (47534) $11,033.05
Prq transcatheter rtrvl intrvas fb with imaging (37197) $10,361.10
Prq transluminal mechanical thrombectomy vein (37187) $18,827.10
Punch biopsy skin single lesion (11104) $1,335.20
Puncture aspiration of abscess, hematoma, bulla, or cyst (10160) $1,845.70
Puncture aspiration of cyst of breast (19000) $1,016
Push enteroscopy w/ submucosal injection and enterocutaneous fistula closure (44799) $6,101.55
Pvb thoracic single injection site w/img gid (64461) $1,978.60
Relocate skin pocket implantable defibrillator (33223) $3,906.95
Relocation of skin pocket for pacemaker (33222) $3,906.95
Removal (via snare/capture) and replacement of internally dwelling ureteral stent via percutaneous approach, including… (50382) $11,541.22
Removal biliary drg catheter req fluor gid rs&i (47537) $1,164.65
Removal foreign body foot complicated (28193) $6,626.98
REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS TechFee (28190) $1,858.90
Removal foreign body mouth (40804) $2,694.70
Removal foreign body shoulder subcutaneous (23330) $6,626.98
Removal foreign body upper arm/elbow deep (24201) $11,614.55
Removal impacted cerumen irrigation/lvg unilat (69209) $177.65
Removal impacted cerumen requiring instrumentation, unilateral (69210) $280.05
Removal implantable contraceptive capsules (11976) $1,619.85
Removal implantable defib pulse generator only (33241) $4,606.55
Removal of cerclage suture under anesthesia (other than local) Age Under 21 (59871) $9,293.75
Removal of fecal impaction or foreign body (separate procedure) under anesthesia (45915) $1,773.25
Removal of foreign body in muscle or tendon sheath; simple (20520) $4,819.60
Removal of foreign body in scrotum (55120) $6,054.85
Removal of foreign body in voice box using an endoscope with mirror (31511) $588.85
Removal of foreign body of upper arm or elbow area, accessed beneath the skin (24200) $4,819.60
Removal of foreign body, external eye; conjunctival superficial (65205) $379.75
Removal of foreign body, external eye; corneal, without slit lamp (65220) $1,184.45
Removal of foreign body, foot; deep (28192) $4,819.60
Removal of foreign body, pelvis or hip; deep (subfascial or intramuscular) Age Under 21 (27087) $13,230.48
Removal of foreign body, shoulder; deep (subfascial or intramuscular) Age Under 21 (23333) $11,614.55
Removal of iud (58301) $953.65
Removal of nail bed (11750) $1,099.40
Removal of pm generator (33233) $9,271.85
Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions (11200) $522.60
Removal of transvenous pacemaker electrode(s); dual lead system Age Under 21 (33235) $6,915.75
Removal of transvenous pacemaker electrode(s); single lead system, atrial or ventricular Age Under 21 (33234) $6,798
Removal of tunneled intraperitoneal catheter (49422) $9,867.25
Removal subcutaneous cardiac rhythm monitor (33286) $3,163.10
Removal tunneled cv cath (36590) $3,239.05
Removal, non-biodegradable drug delivery implant (11982) $1,184.45
Remove eyelid foreign body (67938) $1,190.75
Remove foreign body from eye (65210) $1,628.62
Remove hip foreign body (27086) $11,614.55
Remove lung catheter (32552) $2,116.95
Remove pharynx foreign body (42809) $1,184.45
Remove ureter stent percut (50384) $11,541.22
Remove vaginal foreign body (57415) $9,293.75
Remvl perm pm pls gen w/repl plse gen 2 lead sys (33228) $14,051.55
Remvl perm pm pls gen w/repl plse gen mult lead (33229) $21,360.80
Remvl perm pm plse gen w/repl plse gen sngl lead (33227) $12,483.70
Renal biopsy; percutaneous, by trocar or needle Age Under 21 (50200) $3,919.40
Repair blood vessel lesion (35226) $2,705.95
Repair blood vessel with vein graft; lower extremity (35256) $5,879.90
Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) $1,185.35
REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM TechFee (13132) $2,065.35
Repair complex scalp/arm/leg 2.6-7.5 cm (13121) $2,065.35
Repair complex trunk 2.6-7.5 cm (13101) $2,065.35
Repair eyelid wound (67930) $9,551.60
Repair finger tendon (26418) $4,777.75
Repair forearm tendon/muscle (25260) $9,622.15
REPAIR INTERMEDIATE F/E/E/N/L and /MUC 2.5 CM/< (12051) $1,185.35
REPAIR INTERMEDIATE F/E/E/N/L and /MUC 2.6-5.0 CM (12052) $1,185.35
REPAIR INTERMEDIATE F/E/E/N/L and /MUC 7.6-12.5 CM (12054) $1,185.35
Repair intermediate f/e/e/n/l&/muc 12.6-20.0cm (12055) $1,185.35
Repair intermediate n/h/f/xtrnl gent 12.6-20 cm (12045) $2,065.35
Repair intermediate n/h/f/xtrnl gent 2.5cm/< (12041) $1,185.35
Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) $1,185.35
Repair intermediate n/h/f/xtrnl gent 7.6-12.5cm (12044) $2,065.35
REPAIR INTERMEDIATE S/A/T/E 2.5 CM/< TechFee (12031) $1,185.35
REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM TechFee (12032) $1,185.35
REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM TechFee (12036) $2,065.35
Repair Intermediate Wound Face,e/e/n/ L/ Mucous Membranes 5.1cm To 7.5cm (12053) $1,185.35
Repair Intermediate Wound Face,e/e/n/ L/ Mucous Membranes20.1cm To 30.0cm (12056) $1,185.35
Repair Intermediate Wound Face,ears,eyelids,nose, Lips And Or Mucous Membranes Over 30.0cm (12057) $1,185.35
Repair Intermediate Wounds Of Scalp, Underarms, Truck And/or Extremities Over 30.0cm (12037) $5,421.10
Repair lac palate<2 cm (42180) $1,635.60
Repair lead pace-defib dual (33220) $4,181.95
Repair lead pace-defib one (33218) $4,181.95
Repair lip full thickness vermillion only - lac - lip rn (40650) $1,635.60
Repair lip, full thickness; up to half vertical height Age Under 21 (40652) $1,635.60
Repair of abnormal anal drainage tract with tissue glue (46706) $2,939.50
Repair of laceration 2.5 cm or less; floor of mouth and/or anterior two-thirds of tongue (41250) $1,184.45
Repair of laceration of tongue, floor of mouth, over 2.6 cm or complex (41252) $726.10
Repair of nail bed (11760) $1,867
Repair of tunneled or non-tunneled central venous access catheter, without subcutaneous port or pump, central or… (36575) $685.70
Repair palate (42182) $17,408.70
Repair tongue lacer,post 1/3 (41251) $726.10
Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm (13151) $2,065.35
Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm (13152) $2,065.35
Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm (13120) $2,065.35
Repair, complex, trunk; 1.1 cm to 2.5 cm (13100) $2,065.35
Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; over 30.0 cm (12047) $5,421.10
Repair, tendon or muscle, upper arm or elbow, each tendon or muscle, primary or secondary (excludes rotator cuff) Age… (24341) $29,242.05
Replace duodenostomy/jejunostomy tube perq (49451) $2,605.90
Replace gastrostomy/cecostomy tube percutaneous (49450) $2,958.30
Replace picvad cath (36585) $10,361.10
Replace tunneled cv cath (36582) $10,361.10
Replacement gastro-jejunostomy tube percutaneous (49452) $6,016.30
Replacement, catheter only, of central venous access device, with subcutaneous port or pump, central or peripheral… (36578) $3,407.95
Repos previously implanted subq implantable dfb (33273) $5,521.35
Reposition l ventric lead (33226) $3,315.80
Reposition venous catheter (36597) $3,072.15
Repositioning of a naso- or oro-gastric feeding tube, through the duodenum for enteric nutrition Age Under 21 (43761) $3,452.45
Repositioning of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and… (37192) $7,117.95
Reset dislocated jaw (21480) $963.92
Revision, open, arteriovenous fistula; without thrombectomy, autogenous or nonautogenous dialysis graft (separate… (36832) $17,446.80
Revj incl rplcmt nstim eltrd prq ra incl fluor (63663) $20,330.80
Revj transvns intrhptc portosystemic shnt (tips) (37183) $24,781.10
Revj/rmvl impl spi npg/rcvr dtch connj eltrd ra (63688) $10,114.75
Rmvl & rplcmt xtrnl accessible nephrourtrl cath (50387) $7,761.92
Rmvl embedded fb from dentalvlr struxs soft tiss (41805) $4,533.50
Rmvl embedded fb vestibule mouth comp (40805) $1,635.60
RMVL FB XTRNL AUDITORY CANAL W/O ANES TechFee (69200) $379.75
RMVL FB XTRNL EYE CORNEAL W/SLIT LAMP TechFee (65222) $379.75
Rmvl foreign body muscle/tendon sheath deep/comp (20525) $8,446.95
Rmvl impltbl dfb pls gen w/rplcmt pls gen mlt ld (33264) $33,359.40
Rmvl impltbl dfb plse gen w/repl plse gen 1 lead (33262) $24,146.70
Rmvl impltbl dfb plse gen w/rplcmt plse gen 2 ld (33263) $24,321.45
Rmvl nfros tube req fluoro guidance (50389) $1,711.48
Rmvl of access device (36589) $2,021.65
Rmvl of subq implantable defibrillator electrode (33272) $5,521.35
Rmvl spinal nstim eltrd prq array incl fluor (63661) $5,739.65
Rmvl1/dual chmbr impltbl dfb eltrd transvns xtrj (33244) $7,004.05
Rplc gtube revj gstrst trc (43763) $2,283.25
Rplcmt compl non-tun cvc w/o subq port/pmp (36580) $1,761.65
Rplcmt compl tun cvc w/o subq port/pmp (36581) $8,271.05
Rpr blvsl w/grf other/than vein lower extremity (35286) $17,062.15
Rpr ctr vad w/subq port/pmp ctr/prph insj sit (36576) $4,575.15
Rpr intermediate n/h/f/xtrnl gent 20.1-30.0 cm (12046) $2,065.35
Rpr lip fth>1half ver ht/cpx (40654) $4,533.50
Rpr tdn/musc xtnsr f/arm&/wrist prim 1 ea tdn (25270) $9,622.15
Rpsg prev implted pm/dfb r atr/r ventr electrode (33215) $3,492.80
Rtrvl intrvas vc filtr w/wo acs vsl selxn rs&i (37193) $9,484.10
Sclerotherapy fluid collection prq w/img gid (49185) $4,276.85
Sigmoidoscopy w/fb removal (45332) $3,508
SIMPLE REPAIR F/E/E/N/L/M 2.5CM/< TechFee (12011) $595.15
SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM TechFee (12013) $595.15
SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM TechFee (12014) $595.15
SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5 CM TechFee (12015) $595.15
Simple repair f/e/e/n/l/m >30.0 cm (12018) $595.15
SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/< TechFee (12001) $852.30
SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK >30.0CM TechFee (12007) $595.15
Simple Repair Superficial Wound F/e/,eyelids,n/l/ And Or Mucous Membranes 20.1cm To 30.0cm (12017) $1,185.35
Simple Repair Superficial Wound F/e/eyelids,n/l/ And Or Mucous Membranes 12.6cm To 20.0cm (12016) $1,185.35
Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) $1,168.05
Skin tissue procedure unlisted (17999) $740.65
Slctv cath carotid/innom art angio intrcranl art (36223) $24,209.68
Slctv cath carotid/innom art angio xtrcranl art (36222) $12,251.48
Slctv cath intrnl carotid art angio intrcrnl art (36224) $22,742.30
Slctv cath subclavian art angio vertebral artery (36225) $11,146.58
Slctv cath vertebral art angio vertebral artery (36226) $23,862.15
SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM TechFee (12002) $896.30
SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM TechFee (12005) $1,185.35
Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) $1,185.35
Strapping ankle (29540) $468.40
Strapping elbow or wrist (29260) $181.85
Strapping hand/finger (29280) $181.85
Strapping hip (29520) $522.15
Strapping of knee (29530) $379.75
Strapping of shoulder (29240) $379.75
Strapping of toes (29550) $181.85
Strapping unna boot (29580) $851.32
Sub grft f/s/n/h/f/g/m/d <100sq cm 1st 25 sq cm (15275) $4,314.12
Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; full… (67935) $9,551.60
Tangential biopsy skin single lesion (11102) $1,335.20
Tcat insj/rpl perm leadless pacemaker rv w/img (33274) $21,695.60
Therapeutic apheresis; for plasma pheresis Age Under 21 (36514) $9,028.75
Therapeutic spinal pnxr drainage csf w/fluor/CT (62329) $1,465.90
Therapeutic spinal puncture drainage csf (62272) $1,465.90
Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance (32555) $3,943
Thrombectomy of arterial or venous graft (other than hemodialysis graft or fistula); Age Under 21 (35875) $17,159.75
Thrombectomy, direct or with catheter; axillary and subclavian vein, by arm incision Age Under 21 (34490) $12,383.50
Thrombectomy, direct or with catheter; vena cava, iliac, femoropopliteal vein, by leg incision (34421) $10,361.10
Thrombectomy, open, arteriovenous fistula without revision, autogenous or nonautogenous dialysis graft (separate… (36831) $8,264.95
Thrombolysis art/venous infsn w/image subsq tx (37213) $3,407.95
Thrombolysis arterial infusion icra rs&i init tx (37211) $15,429
Thrombolysis venous infusion w/imaging init tx (37212) $12,927
Transcatheter biopsy (37200) $12,200
Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a… (61626) $23,622.15
Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a… (61624) $30,227.55
Transfer of tendon to restore intrinsic function; ring and small finger Age Under 21 (26497) $86,966
Transfusion, blood or blood components (36430) $1,195.65
Transtracheal (percutaneous) introduction of needle wire dilator/stent or indwelling tube for oxygen therapy Age Under… (31730) $2,267.85
Treat craniofacial fracture (21431) $9,570.95
Treat dental ridge fracture (21440) $9,570.95
Treat foot dislocation (28545) $13,230.48
Treat hip socket fracture (27222) $1,927.82
Treat humerus fracture (24577) $6,569.40
Treat knee fracture (27532) $13,230.48
Treat lower leg fracture (27825) $6,569.40
Treat mouth roof fracture (21421) $9,570.95
Treat tail bone fracture (27200) $701.05
Treat thumb fracture (26645) $6,569.40
Treat toe dislocation (28630) $701.05
Treat ulnar fracture (24675) $6,569.40
Treat wrist bone fracture (25635) $6,569.40
Treat wrist bone fracture (25624) $6,569.40
Treat wrist dislocation (25690) $6,569.40
Treat wrist dislocation (25675) $963.92
TREATMENT CLOSED ELBOW DISLOCATION REQ ANES TechFee (24605) $6,569.40
Treatment of bladder lesion (51720) $1,560.85
Treatment of closed elbow dislocation; without anesthesia (24600) $701.05
Treatment of heel fracture (28405) $963.92
Treatment of tarsal bone fracture (except talus and calcaneus); without manipulation, each (28450) $701.05
Trimming of nondystrophic nails, any number (11719) $269.15
Trlml balo angiop open/perq img s&i 1st art (37246) $12,634.50
Trlml balo angiop open/perq w/img s&i 1st vein (37248) $8,423
Tx superficial wound dehiscence simple closure (12020) $2,065.35
Tx superficial wound dehiscence w/packing (12021) $1,185.35
Tx tarsal bone fx xcp talus&calcn w/manj (28455) $4,777.75
Unlisted procedure rectum (45999) $1,312.75
Upgrade of pacemaker system (33214) $14,029.60
Vaginal delivery (59409) $7,503
Vasc embolize/occlude bleed (37244) $26,346.05
Vascular embolization or occlusion arterial rs&i (37242) $113,869.65
Vascular embolization or occlusion venous rs&i (37241) $137,683.70
Vascular embolize/occlude organ tumor infarct (37243) $22,607.50
Vascular surgery procedure (37799) $6,762.22
Venipuncture (36415) $87.65
Version cephalic external (59412) $3,931
Wedge excision skin nail fold (11765) $1,185.35